1The effects of theophylline and cholera toxin on water and anion movements across rabbit ileum in vitro and the reversal of these effects by the opiate action of loperamide have been investigated. Water movement across the mucosal and serosal surfaces of the tissue was measured continuously by a high resolution method. 2 Theophylline caused an increase in short circuit current and reversed the direction of net Cl1 movement, due mainly to a decrease in mucosal-serosal flux. It also caused a rapid, but transient, reversal in the direction of fluid movement across the mucosal surface. Fluid outflow across the serosal surface was decreased but not reversed. Cholera toxin caused a slow inhibition of water movement across both mucosal and serosal surfaces. 3 Theophylline increased the exit rate of"Br across the mucosal surface and decreased the exit rate of "Br across the serosal surface. Theophylline increased the exit rate of 3H-labelled mannitol across the mucosal surface. 4 Loperamide reversed the effects of theophylline and cholera toxin on water flow across the mucosal and serosal surfaces and on net transepithelial Cl-flux; it also increased the rate of "Br exit across the serosal surface of theophylline-treated tissue. These effects of loperamide could be reversed by naloxone.5 The hydraulic conductivity, Lp of the serosal surface was measured directly by determining the osmotic flow generated by low concentrations of polyethylene glycol (mol. wt. 20000 and 90000).Theophylline reduced the Lp by 57%. Loperamide added to theophylline-treated tissues increased the Lp by 340%. This effect was reversed by naloxone.6 These results indicate that modulation of intestinal smooth muscle tone affects transepithelial ion and water flows in vitro. The increase in tone induced by secretagogues increases ion and water reflux via wide shunt channels in the mucosa and thereby reduces net absorption. The increased net fluid and electrolyte absorption induced by loperamide results from the opiate-dependent inhibition of acetylcholine release from intrinsic ganglia which reduces smooth muscle tone and thereby enhances the fluid and electrolyte conductance of the submucosal layers.
SUMMARY1. The effects of clonidine and dopamine on water movements across the mucosal and serosal surfaces of rabbit ileum have been investigated using a high-resolution method for monitoring water flows in vitro.2. Theophylline (10 mM) and carbamyl choline (10 /1M) caused a reduction in fluid inflow across the mucosal surface and a smaller decrease in fluid outflow across the serosal surface. Addition of the x2-adrenergic agonist clonidine or dopamine fully reversed the theophylline, or carbamyl choline-induced decrease in mucosal inflow in a dose-related manner.3. The effects of clonidine on mucosal inflow are blocked by the a2-adrenergic antagonist, yohimbine. Yohimbine was much less effective than pimozide or dbutaclamol in blocking the effect of dopamine on mucosal inflow. These findings support the view that there are separate a2-adrenergic and dopaminergic receptors. Theophylline reduced the Lp by 35 %. Clonidine (1 ,UM) added to theophylline-treated tissues increased the Lp by 66%. This effect was prevented by yohimbine (1 uM).5. The effects of theophylline, clonidine and dopamine on the permeability of the mucosal and serosal surfaces of the tissue to [3H]mannitol were measured. These showed that theophylline increased the rate of labelled mannitol loss across the mucosal surface but reduced the mannitol permeability across the serosal surface. This latter effect was reversed by clonidine and dopamine.6. Changes in transepithelial electrical potential difference (PD), short-circuit current and resistance were monitored. Theophylline caused a rapid increase in PD and short-circuit current and a slower increase in resistance. Clonidine (5 /bM) reversed the effects on PD and resistance but was without significant effect on shortcircuit current. The results suggest that a major component of secretagogue-induced reduction in fluid transport in vitro is due to mechanical changes in the submucosa, probably induced by modulation of neurotransmitter release within the tissue.
Background & Objective: A simple blood test (urea and creatinine) and a urine test may indicate renal function deterioration and presence of microalbuminuria, which is also the first clinical signs of renal dysfunction in patients with diabetes mellitus. This cost effective test easy to perform even in the absence of advance facilities in a hospital. That is why we planned to conducted this study to assess the comparison between of spot urine protein:creatinine ratio with 24-hour urinary protein in patients with type 2 diabetes mellitus. Materials and Methods: This prospective hospital based clinical study was conducted in the Department of General Medicine, Liaquat University of Medical & Health Sciences, Jamshoro, over a period of six months from 10th May 2018 to 9th November 2019 through a consecutive sampling technique. All the patients having age more than 18 years of both gender, and type 2 diabetes mellitus were enrolled in this study. Three cc blood was taken to determine the serum creatinine levels and twenty-four hour 2ml urine sample was also collected to determine the urinary protein levels. The proteinuria ≥300mg/dl in 24-hour urine sample was considered as significant proteinuria. Kappa statistics was used to find agreement between spot urine protein and 24 hours urinary protein. Results: A total 95 patients were evaluated and their mean age was 41.91±14.29 years, with male predominance (n = 66, 69.4%). Average 24 hour urinary protein was 1216.99±949.51mg and spot-urine evaluation of protein was 1919.12±2129.25mg. The agreement between spot urinary protein creatinine ratio and 24 hour urinary protein was found in 82.1% of cases through Kappa statistics and the calculated agreement between the two procedures was 0.975 which provides sufficient agreement to use spot urine protein:creatinine ratio in routine diagnosis of proteinuria. Conclusion: The study have shown that the protein:creatinine ratio for a random urine sample might be used to rule out the presence of significant proteinuria as defined by a quantitative measure of the 24-hour urine protein excretion.
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