Phagocytic activity of leukocytes in peptic ulcer and stomach cancer

N.V. Puchkov and G.G. Golodets found that the perfusion fluid collected during stimulation of the frog's sympathetic nerves (sympathy) increased the phagocytic activity of blood leukocytes, and that collected during irritation of the vagus nerve (acetylcholine) decreased ... These data were later confirmed by other researchers (S. M. Titova, R. U. Lipshitz, A. D. Ado et al., Etc.).

Increasing metformin concentrations and its excretion in both rat and porcine ex vivo normothermic kidney perfusion model

IntroductionMetformin can accumulate and cause lactic acidosis in patients with renal insufficiency. Metformin is known to inhibit mitochondria, while renal secretion of the drug by proximal tubules indirectly requires energy. We investigated whether addition of metformin before or during ex vivo isolated normothermic machine perfusion (NMP) of porcine and rat kidneys affects its elimination.Research design and methodsFirst, Lewis rats were pretreated with metformin or saline the day before nephrectomy. Subsequently, NMP of the kidney was performed for 90 min. Metformin was added to the perfusion fluid in one of three different concentrations (none, 30 mg/L or 300 mg/L). Second, metformin was added in increasing doses to the perfusion fluid during 4 hours of NMP of porcine kidneys. Metformin concentration was determined in the perfusion fluid and urine by liquid chromatography-tandem mass spectrometry.ResultsMetformin clearance was approximately 4–5 times higher than creatinine clearance in both models, underscoring secretion of the drug. Metformin clearance at the end of NMP in rat kidneys perfused with 30 mg/L was lower than in metformin pretreated rats without the addition of metformin during perfusion (both p≤0.05), but kidneys perfused with 300 mg/L trended toward lower metformin clearance (p=0.06). Creatinine clearance was not different between treatment groups. During NMP of porcine kidneys, metformin clearance peaked at 90 min of NMP (18.2±13.7 mL/min/100 g). Thereafter, metformin clearance declined, while creatinine clearance remained stable. This observation can be explained by saturation of metformin transporters with a Michaelis-Menten constant (95% CI) of 23.0 (10.0 to 52.3) mg/L.ConclusionsMetformin was secreted during NMP of both rat and porcine kidneys. Excretion of metformin decreased under increasing concentrations of metformin, which might be explained by saturation of metformin transporters rather than a self-inhibitory effect. It remains unknown whether a self-inhibitory effect contributes to metformin accumulation in humans with longer exposure times.

Case Study: Awarding Education of Fluids Restriction Management on Impaired Kidney Perfusion for Improving Self-Efficacy of Patients and Families

Non-adherence to fluid restriction on impaired kidney perfusion problems will lead to chronic excess fluid and increase the risk of other disease complications. Self-efficacy is an important component of achieving goals. Fluids restriction management education in the impaired kidney perfusion problems is the main thing that required to improving self-efficacy of patients and families. The purpose of this case study is to examine self-efficacy of patients with impaired kidney perfusion before and after fluids restriction management education in patients and families. Cases study was performed on two patients with impaired kidney perfusion. Fluid restriction management education on patients and families are given to improve self-efficacy. Self-efficacy scores on Mr. Y before the education are 105 and 112 after education, while the self-efficacy scores on Mr. E before the education are 111 and 113 after education. Furthermore, both patients stated to be more assured on adherence to fluid restriction management for impaired kidney perfusion. Education of fluid restriction management in patients and families with impaired kidney perfusion can improve self-efficacy in patients. Nurses can educate the patients and families by multiplying methods and instructional media.