Many investigators assume the protein concentration and colloid osmotic pressure of interstitial fluid and lymph to be identical even after the lymph has passed through a lymph node. We quantitated the degree of modification of lymph by the dog popliteal lymph node by perfusing isolated lymph nodes in situ at physiological flow rates with homologous plasma or plasma diluted to low protein concentration. This enabled us to compare directly prenodal and postnodal lymph flows and protein concentrations. When undiluted plasma was infused into the node, fluid filtered from the blood into the lymph, diluting the lymph. When diluted plasma was infused, fluid was absorbed from the lymph, concentrating the lymph. Nearly all (98%) of the change in lymph protein concentration could be explained by transfer of protein-free fluid either into or out of the lymph. However, when the nodes were perfused with lymph having a colloid osmotic pressure that exactly balanced the hydrostatic and osmotic forces acting across the lymph node blood-lymph barrier, the lymph was not modified during nodal transit. This "equilibrium colloid osmotic pressure" averaged 60% of that of plasma. The concentrating-diluting mechanism became more significant as the perfusion rate decreased and/or as the colloid osmotic pressure of the afferent lymph was made progressively greater than or less than the equilibrium colloid osmotic pressure. We conclude that lymph nodes modify lymph protein concentration and colloid osmotic pressure except when these are already at equilibrium values for given lymph node conditions. Therefore, the assumption that postnodal lymph is representative of interstitial fluid, especially at low but still physiological lymph flows, is likely to be incorrect.

The purpose of this study was to investigate intraoperatively a population of patients with end-stage liver disease before and after liver transplantation with respect to (a) the range of hepatic and systemic hemodynamics and their changes associated with transplantation and (b) the ability to identify native hemodynamic correlates with specific diagnostic groups. Hepatic artery and portal vein blood flows were determined with square-wave electromagnetic flowmetry. Significant differences related to the type of preservation solution used--Euro-Collins or University of Wisconsin--were identified in some hepatic and systemic hemodynamic measurements from the graft livers. Specifically, cardiac output, total liver blood flow and liver weight were significantly increased in the Euro-Collins group compared with the native and University of Wisconsin groups. Hepatic artery flow was significantly greater and portal vein pressure was significantly lower in the University of Wisconsin group than in the native or Euro-Collins group. In general, comparing the graft and native livers, hepatic artery and portal vein blood flow increased significantly after transplantation, as did hepatic oxygen consumption. Portal vein pressures were dramatically reduced, but systemic arterial pressure remained remarkably constant. The percentage of cardiac output going to the liver increased, as did the portal vein percentage of the total liver blood flow. Diagnostic groups could not clearly be associated with characteristic native liver or systemic hemodynamics. Hemodynamics may be associated more with the stage of the disease process than the disease itself.

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The interacting effects of aldosterone and plasma potassium concentration on steady-state renal potassium excretion were studied in two groups of chronically adrenalectomized dogs. In group I (six dogs, 22.9 kg) aldosterone was infused intravenously at 20 micrograms/day while potassium intake was changed in steps of 7-10 days duration from 10 to 30 to 100 meq/day. At the completion of each step, plasma potassium concentration, urinary potassium excretion, and other variables that potentially may affect renal function were measured. In group II (six dogs, 22.2 kg) a similar protocol was followed except that aldosterone was infused at 250 micrograms/day and the potassium intake levels were 30, 100, and 200 meq/day. Plasma potassium concentration and excretion data for the 20 micrograms/day group were: 3.22 +/- 0.26 meq/liter and 5 +/- 1 meq/day, 4.35 +/- 0.08 meq/liter and 21 +/- 2 meq/day, and 5.88 meq/liter and 82 +/- 3 meq/day at the 10, 30, and 100 meq/day intake levels, respectively. For the 250 micrograms/day group the values were: 2.72 +/- 0.18 meq/liter and 28 +/- 7 meq/day, 4.16 +/- 0.14 meq/liter and 71 +/- 8 meq/day, and 4.40 +/- 0.14 meq/liter and 172 +/- 26 meq/day at the 30, 100, and 200 meq/day intake levels. Therefore, the increase in aldosterone infusion rate shifted the relationship between plasma potassium concentration and potassium excretion to the left so that at a given level of plasma potassium a greater amount of potassium was excreted. In the normal range of plasma potassium concentration (4.00-4.40 meq/liter) the increase in aldosterone levels resulted in a four- to eightfold increase in daily potassium excretion.