Tunneled double-lumen silicone hemodialysis catheter placement in three patients with permanent pacemaker wires: a case study.

Permanent pacemaker wires have been described as a cause of central vein stenosis. Furthermore, in hemodialysis (HD) patients with transvenous pacemakers, permanent vascular access (VA) created at the ipsilateral arm is not always successful. We report the use of tunneled double-lumen silicone HD catheters, as permanent VA in three HD patients wearing permanent transvenous pacemakers. In one patient, the catheter was inserted ipsilateral to the pacemaker site. Catheter-related infections were the most significant complications.

Experience with the use of uncuffed double-lumen silicone hemodialysis catheters.

AIM: This study aimed to describe our experience with the use of uncuffed double-lumen silicone hemodialysis catheters (USHDCs) that were used in 54 cases as a temporary vascular access (VA). SUBJECTS AND METHODS: We recorded, retrospectively, all the USHDCs (size 13.5 French (F), length 15, 20 and 24 cm) that were inserted in our dialysis unit from July 2003 to September 2004. Catheter and patient characteristics, as well as catheter related complications, were recorded. RESULTS: There were 88 catheters used in 54 cases (44 patients). The catheters remained in place for a total of 2537 days (range 8-127 days, mean 46.9 +/- 31.1). For catheter placement, the internal jugular veins (group A) or the femoral veins (group B) were used in a non-randomized manner. In group A, in 17 cases, 31 catheters were used for a total of 1169 days (mean 68.7 +/- 28.5), while in group B, in 37 cases, 57 catheters were used for a total of 1368 days (mean 36.9 +/- 27.1; p < 0.001). In group B, 81% of cases (30/37) were ambulatory from the time of insertion. Mean urea reduction ratio (URR) in well functioning catheters (blood flow > or = 200 ml/min) was 65.5 +/- 4.6% in group A and 56.9 +/- 6.2% in group B; p < 0.001. Catheter-related bacteremia was observed in five group A cases and in seven group B cases (p = ns). Three cases of minor bleeding at the insertion site and three cases of ipsilateral leg edema were recorded in group B patients. In group A, only one case of bleeding at the insertion site was recorded. CONCLUSION: Uncuffed double-lumen silicone hemodialysis catheters (USHDCs), 13.5 F in size, provided a very efficient temporary VA when placed in the jugular vein. Femoral placement of these catheters can also be used successfully in non bed-ridden patients, but delivering a lower dialysis dose.

DNA variation in a 13-Mb region including the F9 gene: inferring the genealogical history and causal role of a hemophilia B mutation (IVS 5+13 A-->G).

About 5.5% of all UK hemophilia B patients have the base substitution IVS 5+13 A-->G as the only change in their factor (F)IX gene (F9). This generates a novel donor splice site which fits the consensus better than the normal intron 5 donor splice. Use of the novel splice site should result in a missense mutation followed by the abnormal addition of four amino acids to the patients' FIX. In order to explain the prevalence of this mutation, its genealogical history is examined. Analysis of restriction fragment length polymorphism in the 21 reference UK individuals (from different families) with the above mutation showed identical haplotypes in 19 while two differed from the rest and from each other. In order to investigate the history of the mutation and to verify that it had occurred independently more than once, the sequence variation in 1.5-kb segments scattered over a 13-Mb region including F9 was examined in 18 patients and 15 controls. This variation was then analyzed with a recently developed Bayesian approach that reconstructs the genealogy of the gene investigated while providing evidence of independent mutations that contribute disconnected branches to the genealogical tree. The method also provides minimum estimates of the age of the mutation inherited by the members of coherent trees. This revealed that 17 or 18 mutant genes descend from a founder who probably lived 450 years ago, while one patient carries an independent mutation. The independent recurrence of the IVS5+13 A-->G mutation strongly supports the conclusion that it is the cause of these patients' mild hemophilia.

Prosthetic graft placement using the deep forearm veins in hemodialysis patients: a preliminary report.

When the superficial arm veins are not suitable for the creation of a conventional endogenous arteriovenous (A-V) fistula or the placement of a prosthetic graft in the forearm, the use of the deep forearm veins as an outflow system to construct an A-V graft access seems to be a reasonable alternative. Using this approach, we placed 6 prosthetic grafts in 6 hemodialysis patients in whom conventional methods had failed. Adequate functioning of this 'deep vein'-type vascular access in these 6 patients has been maintained for 3, 6, 11, 15, 19 and 24 months, respectively, without complications or any need for further interventions. Only one graft failed after 6 months. Our preliminary results indicate that this technique can be used successfully when the superficial forearm veins have been exhausted, thus avoiding the use of upper-arm or axillary veins.

Mutation rates in humans. II. Sporadic mutation-specific rates and rate of detrimental human mutations inferred from hemophilia B.

We estimated the rates per base per generation of specific types of mutations, using our direct estimate of the overall mutation rate for hemophilia B and information on the mutations present in the United Kingdom's population as well as those reported year by year in the hemophilia B world database. These rates are as follows: transitions at CpG sites 9.7x10-8, other transitions 7.3x10-9, transversions at CpG sites 5.4x10-9, other transversions 6.9x10-9, and small deletions/insertions causing frameshifts 3.2x10-10. By taking into account the ratio of male to female mutation rates, the above figures were converted into rates appropriate for autosomal DNA-namely, 1.3x10-7, 9.9x10-9, 7.3x10-9, 9.4x10-9, 6.5x10-10, where the latter is the rate for all small deletion/insertion events. Mutation rates were also independently estimated from the sequence divergence observed in randomly chosen sequences from the human and chimpanzee X and Y chromosomes. These estimates were highly compatible with those obtained from hemophilia B and showed higher mutation rates in the male, but they showed no evidence for a significant excess of transitions at CpG sites in the spectrum of Y-sequence divergence relative to that of X-chromosome divergence. Our data suggest an overall mutation rate of 2.14x10-8 per base per generation, or 128 mutations per human zygote. Since the effective target for hemophilia B mutations is only 1.05% of the factor IX gene, the rate of detrimental mutations, per human zygote, suggested by the hemophilia data is approximately 1.3.

DNA variation in a 5-Mb region of the X chromosome and estimates of sex-specific/type-specific mutation rates.

We describe a new approach for the study of human genome variation, based on our solid-phase fluorescence chemical mismatch-cleavage method. Multiplex screening rates >/=80 kb/36-lane gels are achieved, and accuracy of mismatch location is within +/-2 bp. The density of differences between DNA from any two humans is sufficiently low, and the estimate of their position is accurate enough, to avoid sequencing of most polymorphic sites when defining their allelic state. Furthermore, highly variable sequences, such as microsatellites, are distinguished easily, so that separate consideration can be given to loci that do and do not fit the definition of infinite mutation sites. We examined a 5-Mb region of Xq22 to define the haplotypes of 23 men (9 Europeans, 9 Ashkenazim, and 5 Pygmies) by reference to DNA from one Italian man. Fifty-eight 1.5-kb segments revealed 102 segregating sites. Seven of these are shared by all three groups, two by Pygmies and Europeans, two by Pygmies and Ashkenazim, and 19 by Ashkenazim and Europeans. Europeans are the least polymorphic, and Pygmies are the most polymorphic. Conserved allelic associations were recognizable within 40-kb DNA segments, and so was recombination in the longer intervals separating such segments. The men showed only three segregating sites in a 16.5-kb unique region of the Y chromosome. Divergence between X- and Y-chromosome sequences of humans and chimpanzees indicated higher male mutation rates for different types of mutations. These rates for the X chromosomes were very similar to those estimated for the X-linked factor IX gene in the U.K. population.

Extracellular ATP raises cytosolic calcium and activates basolateral chloride conductance in Necturus proximal tubule.

1. Extracellular nucleotides modulate ionic transport mechanisms in various epithelia. In the present study, we investigated the effects of extracellular ATP on the intracellular free Ca+2 concentration ([Ca2+]i) and electrophysiological properties of Necturus maculosus proximal convoluted tubule (PCT). 2. ATP raised [Ca2+]i in microdissected fura-2-loaded PCTs (half-maximal effect, approximately mumol 1(-1) ATP). The initial ATP-induced changes in [Ca2+]i were not blunted by the removal of external Ca2+ nor by the presence of Ca2+ channel blockers, but were abolished by thapsigargin and suramin. The sequence for the potency of various agonists on [Ca2+]i was 2-methylthioATP (2MeSATP) = ADP = ATP >> UTP, 2',3',-O-(4-benzoilbenzoil) ATP (BzATP), alpha, beta-methylene ATP (AMPCPP), adenosine. 3. In vivo electrophysiological measurements showed that 100 mumol 1(-1) peritubular ATP added to a Ringer solution reduced the basolateral cell membrane potential (Vm) and increased the cell membrane input conductance. In a low Cl- solution, this ATP-induced depolarization was enhanced. These effects were inhibited by 1 mmol l-1 SITS, consistent with the activation of a basolateral Cl- conductance. 4. The ATP-induced change in Vm was reproduced by ADP but not by UTP or adenosine, and was prevented by suramin. 5. The ATP-induced membrane depolarization was not influenced by thapsigargin, BAPTA AM, or staurosporine and was not reproduced by manoeuvres increasing [Ca2+]i or intracellular cAMP content. 6. We conclude that, in Necturus PCT, a P2y receptor mobilizes Ca2+ mainly from intracellular pools and increases a basolateral Cl- conductance, GCl. The activation of GCl occurs by a mechanism which is not related either to an increase in [Ca2+]i or cAMP content, or to PKC activation.

Symmetric pH dependence of buffering power in giant fused cells from frog kidney proximal tubule.

This study measures the intrinsic buffering power (beta(i)) of giant fused cells from the proximal kidney tubule of the frog (Rana ridibunda) as a function of intracellular pH (pHi). We monitored pHi and transmembrane potential difference during acid or alkaline cell loading, achieved by removal of NH4Cl-containing solutions or CO2-HCO3(-)-equilibrated solutions, respectively, in the absence of extracellular Na+. Data were well fit by the equation for a single, monoprotic buffer with a maximum beta(i) at a pHi of 7.39 +/- 0.06 and a total buffer concentration of 30.7 +/- 1.6 mM (means +/- SD). From pHi measurements obtained during CO2-HCO3- exposure, we also calculated the buffering power afforded by the CO2-HCO3- pair, and we show its increasing contribution to total buffering power at increasing PCO2 and pHi. To our knowledge, this is the first report of a cell type in which intrinsic cell buffers can be adequately approximated as a single monoprotic buffer with a negative logarithm of apparent dissociation constant in the normal physiological range and essentially symmetric dependence on pHi in both acid and alkaline ranges.

Extracellular urea concentration modulates cAMP production in the mouse MTAL.

Ionic reabsorption along the ascending limb of Henle's loop (TAL) is controlled by hormonal stimulation. Most of the hormones that affect this reabsorption regulate ionic transporter activity via cAMP, and some of these hormonal actions have been shown to be modulated by interstitial osmolarity. We studied the early effects of increasing extracellular urea concentration on the production of cAMP induced by arginine vasopressin (AVP) and forskolin in a suspension of medullary portions of TAL (MTAL) prepared from mouse kidney. The addition of urea, performed fifteen minutes before adenylyl cyclase stimulation, decreased both AVP- and forskolin-induced cAMP production. This effect, observed both in the presence and the absence of phosphodiesterase inhibition, was optimal with 300 mmol/liter urea. Addition of urea to the extracellular medium disturbed several cellular parameters, but the decrease in cAMP production appeared to be mediated by the activation of both the protein kinase A and a phosphatase rather than by the modifications in phospholipid metabolism. Since cAMP is the major cytosolic transductional factor in MTAL cells, urea present in the medullary interstitium may thus be considered as an important modulator of hormonal actions in this segment of the nephron.

Further investigation of ionic diffusive properties and of NH4+ pathways in Xenopus laevis oocyte cell membrane.

To study the ionic diffusive properties and the NH4+ pathways in the Xenopus laevis oocyte cell membrane, we recorded the effects of various inhibitors on membrane potential (Vm) and membrane resistance (Rm); intracellular acidification was taken as an index of NH4+ influx from the bath to the cytoplasm. The following results were obtained: in the control state, barium and quinine (Q) ions depolarized Vm and raised Rm, consistent with inhibition of K+ conductance(s). Diphenylamine-2-carboxylic acid (DPC), 3',5'-dichlorodiphenylamine-2-carboxylic acid (DCDPC) and gadolinium ions hyperpolarized Vm and increased Rm, suggesting the inhibition of nonselective cationic conductance(s). In the presence of 20 mmol/l NH4Cl, Vm depolarized, Rm fell, and intracellular pH (pHi) decreased, consistent with an NH4+ influx. In the presence of DPC, the same manoeuvre induced a biphasic Vm change (i.e. a spike depolarization followed by a membrane hyperpolarization) and a fall of Rm; in most oocytes, intracellular acidification persisted and was reversible upon adding ouabain (Oua). These results indicate that a DPC-sensitive conductance is not the unique NH4+ pathway and that Na, K-ATPase may also mediate NH4+ influx. However, Oua did not prevent the Rm decrease, suggesting that ouabain-insensitive rheogenic pathway(s) are activated. Thus, we investigated the Vm change induced by NH4Cl addition in the presence of DPC: the spike depolarization followed by secondary hyperpolarization became a plateau depolarization when Q was added, suggesting involvement of Q-sensitive pathway(s) in the above described biphasic Vm change. In the presence of DPC, Q and Oua, intracellular acidification upon adding NH4Cl persisted consistent with further NH4+ influx through quinine-, DPC- and Oua-insensitive pathway(s).

Actions of isoproterenol in frog proximal tubules.

In the present work, we compared biochemical and electrophysiological actions of isoproterenol on frog proximal tubular cells by using tubule suspensions and giant entities obtained by cell fusion. Isoproterenol (ISO) dose-dependently stimulated cAMP production in tubule suspension and depolarized the "giant cell" membrane. Both effects were triggered by beta receptor occupancy, but strongly differed in their concentration-dependency, since depolarization occurred with an ISO concentration as low as 10(-12) mol/l whereas cAMP accumulation could be seen only with more than 10(-8) mol/l ISO. ISO-induced membrane depolarization was mimicked by forskolin which directly stimulated the catalytic subunit of adenylyl cyclase. In both isoproterenol- and forskolin-stimulated giant cells, membrane depolarization was accompanied by a decrease in membrane conductance, and both effects were inhibited by tetraethylammonium (TEA) and 4-aminopyridine (4-AP). On the other hand, ISO- and forskolin-induced cAMP production were not affected by TEA. The present data thus show that isoproterenol produces two independent effects in frog proximal tubule: it depolarizes the cell membrane by blocking a K+ conductance and activates adenylyl cyclase.

Differential regulation of membrane potential and conductance via intra- and extracellular pH in fused proximal tubular cells of frog kidney.

Intracellular pH (pHi), membrane potential (Vm) and membrane conductance (Gm) in fused proximal tubular cells of the frog kidney, were determined at three extracellular pH (pHo) values, 7.5, 8.5 and 6.5. Imposed changes of pHo by +/- 1 pH unit induced parallel but smaller shifts of pHi. The alkaline milieu hyperpolarized the cells and increased Gm, whereas the acid milieu depolarized and lowered Gm. We subsequently introduced a weak acid and its conjugate base (acetic acid/acetate), or a weak base and its conjugate acid (NH3/NH4+), at pHo 7.5, 8.5 and 6.5 to shift pHi without altering pHo, or to shift pHi against imposed changes of pHo. From these experiments, we observed that under some circumstances Vm varied with pHo but without Gm or pHi changes, whereas under other circumstances changes of Gm occurred during alterations of pHi while pHo and Vm remained unaltered. At pHi approximately 6.5 associated with Vm approximately -10 mV, Gm dramatically increased to quasi-infinite values. This increase was not an artifact since Gm returned to its control value following recovery to the control solution or in the presence of hyperosmotic solution. In conclusion, we demonstrate a differential regulation whereby Vm and Gm are controlled by pHo and pHi: pHo modulates mainly Vm and pHi modulates chiefly Gm. Furthermore, at pHi approximately 6.5 and Vm approximately -10 mV, our data reveal a large Gm that tends towards infinite values in a reversible fashion.

Triflocin, a novel inhibitor for the Na-HCO3 symport in the proximal tubule.

1. Triflocin, applied at millimolar concentration hyperpolarizes the basolateral membrane of Necturus proximal convoluted tubular cells, in vivo. 2. Barium, 2.5 x 10(-3) M, ouabain, 10(-3) M, or amiloride 10(-4) M, fail to prevent this hyperpolarization. 3. Triflocin has no effect on the intracellular chloride activity. 4. In physiological acid base conditions, Triflocin increases intracellular pH. 5. Upon an acute isohydric hypercapnia, Triflocin depolarizes the basolateral membrane potential. 6. It is concluded that, Triflocin inhibits the basolateral electrogenic Na-(HCO3)n > 1 cotransport in proximal tubules.

ATP-regulated chloride conductance in endoplasmic reticulum (ER)-enriched pig pancreas microsomes.

The Cl- conductance of endoplasmic reticulum-enriched pancreatic microsomes was identified. Its regulation by nucleotides was investigated by measuring the rate of cation ionophore-induced microsome swelling in the presence of an inward Cl- gradient. The conductance was solubilized and reconstituted into liposomes. The Cl- conductance in intact microsomes was inhibited by stilbene (10(-4) M) and indanyloxyacetic acid (10(-5) M) derivatives. ATP increased Cl- conductance with half-maximal stimulation at 8 x 10(-6) M. Other trinucleotides (GTP, CTP and UTP) were without effect at 10(-4) M. The non-hydrolysable analogue of ATP, adenosine 5'-[beta gamma-methylene]triphosphate (AppCH2p) increased Cl- conductance with a potency similar to that of ATP. The same concentration of adenosine 5'-[gamma-thio]triphosphate (ATP gamma S) which is a substrate for kinases, had no effect. ATP stimulation of Cl- conductance was inhibited by stilbene derivatives. The data suggest the presence of at least one ATP-binding site, and show that the ATP does not need to be hydrolyzed and that its spatial conformation is important for activating the Cl- conductance. Solubilized microsomal proteins reconstituted into liposomes retained their stilbene-inhibited, ATP-stimulated Cl- conductance. A 167 kDa protein was detected by anti-CFTR antibodies in the intact microsomes, but not in the solubilized proteins. The 64 kDa protein (a component of a ubiquitous Cl- channel) was detected in the both intact and solubilized microsomes. These results suggest that this Cl- conductance is not a CFTR protein.

Change of apparent stoichiometry of proximal-tubule Na(+)-HCO3- cotransport upon experimental reversal of its orientation.

Electrogenic cotransport of Na+ with HCO3- has been reported in numerous tissues. It has always been shown with a net transfer of negative charge, but in some situations achieves net outward transport of both species with a stoichiometry of at least three HCO3- ions per Na+ ion (3:1), and in other situations achieves net inward transport of both species and has a stoichiometry of at most two HCO3- ions per Na+ ion (2:1). This suggests either that there may be more than one protein responsible for Na(+)-HCO3- cotransport in different tissues or that if there is a single protein, its stoichiometry may differ depending on the orientation of net transport. The present study, using conventional or double-barreled ion-selective microelectrodes to follow basolateral membrane potential and intracellular pH or Na+ activity in Necturus proximal convoluted tubule in vivo, shows that the orientation of the basolateral Na(+)-HCO3- cotransporter can be reversed upon switching from a perfusate simulating normal acid-base conditions to one that imposes peritubular isohydric hypercapnia. Moreover, accompanying the reversal of orientation is a change of apparent stoichiometry from 3:1 to 2:1. Given that the observed change of orientation and accompanying change of apparent stoichiometry occur within seconds and in the same preparation, these results suggest that a single transport protein is responsible for both types of behavior.

Composition, reactivity and surface interactions of three dental silane primers.

Three commercially available dental silane primers, two single-phase prehydrolyzed and one two-component system were investigated for their composition, extent of hydrolysis, surface interactions, bond strength and interfacial topography when used on three representative porcelain alloys (Au-Pd, high-Pd, Ni-Cr). Five tests, 1H FT-NMR, FTIR, GPC, ESCA and EPMA, were used to determine the composition and the surface interaction profiles. Shear tests were performed to assess the bond strength values. According to the results, all the primers contain gamma-methacryloxypropyltrimethoxysilane (gamma-MPTS) at concentrations of 1.15-18.86 g/100 mL, two in ethanol and one in isopropanol. Traces of acetic acid were found in the prehydrolyzed primers. All the primers demonstrated partial hydrolysis of the methoxy groups. Prehydrolyzed primers exhibited a higher rate of hydrolysis and better orientation of hydrolyzed methoxy groups towards the Ni-Cr alloy surface. Due to the extent of surface oxidation, the Ni-Cr alloy provided more bonding sites for silanols than the other two types of alloys. The Ni-Cr alloy demonstrated the highest shear bond strength values on smooth surfaces regardless of the type of primer used. The results of the present study suggest that active prepolymerized primers may provide significant advantages over two-component systems in the repair of Ni-Cr porcelain fractures involving removal of the metal oxide layer.

Luminal pH in the amphibian distal tubule: effects of carbonic anhydrase and carbonic anhydrase inhibitors.

To better delineate acid-base transport properties in the distal tubule (DT) of Necturus in vivo, we 1) studied the effects of peritubular (pt) isohydric increase of PCO2 and [HCO3-]pt on luminal pH (pHlu), and 2) measured the steady-state pHlu under various experimental conditions. The experiments were carried out on initial (DTi) or distal (DTd) loops of the DT in control state and then during intravenous infusion of carbonic anhydrase (CA) or CA inhibitors (CAI). In control state, isohydric increase of PCO2 and [HCO3-]pt results in transient acidification of the DTi lumen, whereas in DTd lumen the same maneuver yields sustained (plateau) acidification. Under systemic infusion of CAI, isohydric increase of PCO2 and [HCO3-]pt lowers pHlu (sustained fall of pHlu) in DTi and DTd, whereas under CA infusion both segments exhibit only transient acidification. During intravenous infusion with benzolamide DTi steady-state pHlu falls, suggesting that this maneuver inhibits a functional luminal CA, in contrast to the DTd, whose pHlu remains unaltered. Intravenous infusion of CA significantly increases steady-state DTd pHlu; by contrast, steady-state pHlu in DTi does not change. These data are consistent with the presence of functional luminal CA in the DTi, whereas the DTd segment lacks the luminal enzyme.

Millimolar amiloride concentrations block K conductance in proximal tubular cells.

1. Amiloride, applied at millimolar concentrations, results in the blockade of K+ conductance in amphibian proximal convoluted cells (PCT), fused into giant cells. 2. Amiloride results directly in a blockade of K+ conductance that is not related to inhibition of the Na(+)-H+ antiport, which would lower intracellular pH, adversely affecting K+ conductance. On the contrary, high amiloride concentrations promote entry of this lipophilic base in the cell, leading to higher cell pH. 3. Under voltage clamp conditions, control vs. amiloride, current-voltage curves from PCT fused giant cells intersect at -86.2 +/- 3.4 mV, a value close to the equilibrium potential for potassium. 4. Hexamethylene amiloride, 10(-5) M, irreversibly depolarizes the membrane potential. 5. Barium decreased by 50% the initial slope of realkalinization, following removal of a solution containing NH4Cl, as did amiloride. In addition, these blockers reduced membrane conductance by 40%, suggesting that a fraction of the amiloride-suppressible NH4+ efflux may be conductive. 6. Amiloride does not directly inhibit the Na(+)-K+, ATPase in our preparation, contrary to the prevalent belief. 7. In vivo studies show that amiloride interferes with an apical K+ conductance but it does not alter basolateral K+ conductance.

Thiazide-sensitive Na-Cl cotransport mediates NaCl absorption in amphibian distal tubule.

To find out the mechanism(s) underlying NaCl absorption in the distal tubule of Necturus, we devised a variant of the split-drop technique. Following injection an oil column, subsequently split by a NaCl solution isotonic to plasma, a double-barrelled microelectrode (conventional/selective to Na+ or to Cl- ions) recorded Na+ (alpha Na) or Cl- (alpha Cl) activity and transepithelial potential (Vte). Paired control/low-Na+ solutions yielded reabsorptive half-times (t1/2) of 0.68 +/- 0.11 min and 7.6 +/- 1.8 min respectively; corresponding Vte values were -22.2 +/- 4.0 mV and -7.6 +/- 1.9 mV. t1/2 values of control versus low-Cl- solutions were 0.77 +/- 0.32 min and 6.5 +/- 1.7 min respectively, whereas respective Vte values were not different from one another: -23.8 +/- 4.3 mV versus -18.8 +/- 5.5 mV. Nominally K(+)-free solutions or bumetanide, 10 mumol/l, did not alter t1/2 or Vte, with regard to the paired control. Amiloride, 5 mumol/l or 2 mmol/l, failed to decrease t1/2 or to lower Vte; apparently, the role of a Na+/H+ antiport does not contribute significantly to NaCl absorption. Furosemide, 0.1 mmol/l, reduced t1/2 by 54% with regard to the control state. Determination of t1/2 as a function of increasing hydrochlorothiazide concentrations revealed apical high- and low-affinity sites, estimated at 0.56 mumol/l and 0.115 mmol/l respectively. Taken together these observations indicate that NaCl absorption is predominantly carried out by an electroneutral Na(+)-Cl- cotransport.

Barium- or quinine-induced depolarization activates K+, Na+ and cationic conductances in frog proximal tubular cells.

1. Frog proximal tubular cells were fused into giant cells. We measured membrane potential (Vm), its changes (delta Vm), and current-induced voltage changes (delta psi) in single cells, during control and experimental states. Each cell served as its own control. 2. In the presence of a physiological Ringer solution, the transference number for potassium (tK) was 0.50. Barium (3 mM) reduced membrane conductance (Gm) by 50%; low-Cl- solutions and low-Na+ solutions also diminished Gm, by 52 and 30%, respectively. The association of barium and low-NaCl solutions decreased Gm to approximately 38% of control, indicating that the impermeant substitute of a physiological ion may interact with other pathways; alternatively, blockade of steady-state conductances may activate physiologically silent processes. 3. In an attempt to enhance the contribution of the partial K+ conductance (GK) to Gm, fused cells were exposed to low-Cl- solutions, containing in addition 0.1 mM-methazolamide, to inhibit the rheogenic Na(+)-HCO3-symport, and 1 microM-amiloride, to block Na+ conductance (GNa). tK went up to 0.83. 4. The high tK preparation was challenged with barium (3 mM) or quinine (Quin, 1 mM). These blockers produced large depolarizations (approximately 60 mV), however, although Gm decreased along early- and mid-depolarization, Gm plateaued and eventually it increased with larger and larger depolarization. 5. Depolarization-associated increase in Gm reflects activation of other conductances. These are Na+, cationic, and K+ conductance(s) poorly sensitive to quinine or barium. In the presence of Ba(2+)- or Quin-induced depolarization, injection of depolarizing current produces delayed increase in conductance. 6. Depolarization-induced activation of cationic conductance (Gcat) and GNa results in enlargement of the K+ electrochemical potential difference, to about 70 mV; this difference allows recycling of K+ ions outwards, since a GK is still detected and may contribute up to 38% of the total conductance.