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Purpose: To examine the effectiveness of videoconferencing technology for delivering comprehensive weight management treatment. Methods: This retrospective cohort study was conducted by extraction of data from medical records for the years 2008-2010. The treatment included a series of 12 weekly MOVE! R � classes delivered using videoconferencing. Data were extracted from the time of baseline weight to 1 year after baseline weight for the MOVE! participants (n = 60) and from a concurrent control group (n = 60) that did not participate in MOVE! treatment. Findings: Results indicated that the MOVE! group lost weight while the control group gained weight, resulting in a mean difference between the groups of −5.5 ± 2.7 kg (95% CI =− 8.0 to −3.0; P < .0001). Conclusions: These results indicate that videoconferencing is an effective method to provide the MOVE! Weight Management Program to veterans. Weight loss was maintained for one year after baseline in the MOVE! group. This is very promising as weight re-gain is a common issue and these results support using videoconferencing for a long-term weight management treatment option.

Bradykinin (BK) is a peptide known to activate afferent nerve fibers from the kidney and elicit reflex changes in the cardiovascular system. The present study was specifically designed to test the hypothesis that bradykinin B2 receptors mediated the pressor responses elicited during intrarenal bradykinin administration. Pulsed Doppler flow probes were positioned around the left renal artery to measure renal blood flow (RBF). A catheter, to permit selective intrarenal administration of BK, was advanced into the proximal left renal artery. The femoral artery was cannulated to measure mean arterial pressure (MAP). MAP, heart rate (HR), and RBF were recorded from conscious unrestrained rats while five-point cumulative dose-response curves during an intrarenal infusion of BK (5-80 µg·kg-1·min-1) were constructed. Intrarenal infusion of BK elicited dose-dependent increases in MAP (maximum pressor response, 26 ± 3 mmHg), accompanied by a significant tachycardia (130 ± 18 beats/min) and a 28% increase in RBF. Ganglionic blockade abolished the BK-induced increases in MAP (maximum response, -6 ± 5 mmHg), HR (maximum response 31 ± 14 beats/min), and RBF (maximum response, 7 ± 2%). Selective intrarenal B2-receptor blockade with HOE-140 (50 µg/kg intrarenal bolus) abolished the increases in MAP and HR observed during intrarenal infusion of BK (maximum MAP response, -2 ± 3 mmHg; maximum HR response, 15 ± 11 beats/min). Similarly, the increases in RBF were prevented after HOE-140 treatment. In fact, after HOE-140, intrarenal BK produced a significant decrease in RBF (22%) at the highest dose of BK. Results from this study show that the cardiovascular responses elicited by intrarenal BK are mediated predominantly via a B2-receptor mechanism.Key words: bradykinin, blood pressure, renal hemodynamics, B2 receptors, autonomic nervous system.

Effect of acute increases in filtered HCO 3 - on renal hydrogen transporters: II. H + -ATPase. Adaptive increases in renal bicarbonate reabsorp-tion occur in response to acute increases in filtered bicarbonate ( FL HCO 3 ). In a previous study, we showed that an increase in FL HCO 3 induced by plasma volume expansion increased the V max for Na + /H + exchange activity in renal cortical brush border membrane vesicles (BBMV), providing a potential mechanism for the adaptive increase in HCO 3 - reabsorption. The present studies were undertaken to determine whether the increase in FL HCO 3 induced by plasma expansion also stimulates the other major H + transporter in cortical BBMV, the H + -ATPase. H + -ATPase activity was assessed in BBMV obtained from hydropenic and plasma expanded Munich-Wistar rats, using a NADH-linked ATPase assay. H + -ATPase activity was measured as the ouabain and oligomycin-insensitive, bafilomycin A1-sensitive component of total ATPase activity. Acute plasma expansion doubled single nephron FL HCO 3 , and this change was associated with a 64% increase in the V max for H + -ATPase activity, with no change in apparent K m . The V max for H + -ATPase activity correlated directly with whole kidney GFR and FL HCO 3 ( r = 0.68 and 0.72, respectively), and with single nephron GFR and FL HCO 3 ( r = 0.76 and 0.80, respectively). Thus, the mechanism for the adaptive increase in proximal tubular HCO 3 - reabsorption that occurs in response to acute increases in FL HCO 3 appears to be related to increased activity of both H + -ATPase and Na + /H + exchange in the apical membrane of the proximal tubule epithelium.

To examine the effectiveness of videoconferencing technology for delivering comprehensive weight management treatment.This retrospective cohort study was conducted by extraction of data from medical records for the years 2008-2010. The treatment included a series of 12 weekly MOVE!® classes delivered using videoconferencing. Data were extracted from the time of baseline weight to 1 year after baseline weight for the MOVE! participants (n = 60) and from a concurrent control group (n = 60) that did not participate in MOVE! treatment.Results indicated that the MOVE! group lost weight while the control group gained weight, resulting in a mean difference between the groups of -5.5 ± 2.7 kg (95% CI = -8.0 to -3.0; P.0001).These results indicate that videoconferencing is an effective method to provide the MOVE! Weight Management Program to veterans. Weight loss was maintained for one year after baseline in the MOVE! group. This is very promising as weight re-gain is a common issue and these results support using videoconferencing for a long-term weight management treatment option.

Studies were undertaken in Munich-Wistar rats to assess the influence of changes in filtered bicarbonate (FLHCO3), induced by changes in GFR, on Na+/H+ exchange activity in renal brush border membrane vesicles (BBMV). Whole-kidney and micropuncture measurements of GFR, FLHCO3, and whole-kidney and proximal tubule HCO3 reabsorption (APRHCO3) were coupled with BBMV measurements of H+ gradient-driven 22Na+ uptake in each animal studied. 22Na+ uptake was measured at three Na+ concentration gradients to allow calculation of Vmax and Km for Na+/H+ exchange. GFR was varied by studying animals under conditions of hydropenia, plasma repletion, and acute plasma expansion. The increase in GFR, FLHCO3, and APRHCO3 induced by plasma administration correlated directly with an increase in the Vmax for Na+/H+ exchange in BBMV. The Km for sodium was unaffected. In the plasma-expanded rats, the Vmax for Na+/H+ exchange was 22% greater than in the hydropenic rats (P less than 0.025) whereas APRHCO3 was 86% greater (P less than 0.001). These results indicate that increases in FLHCO3, induced by acute increases in GFR, stimulate Na+/H+ exchange activity in proximal tubular epithelium. This stimulation is a mechanism which can, in part, account for the delivery dependence of proximal bicarbonate reabsorption.

In response to Army experiences in Operation Iraqi Freedom, the Army Science Board was tasked to investigate: 1) Forces for Theater opening and initial logistics operations; 2) The proposed Deployment Distribution Operations Center; 3) Asset in-transit visibility and management; and 4) Water production, storage, transport, and chilling on the battlefield. Each of these four major topics included numerous subtaskings. The study generated many specific recommendations for improving in-theater logistics distribution, with the major recommendations including: 1a) Revise doctrine to codify the distinction between Joint theater-level and Army/Land Component logistic responsibilities, recognizing the need for a Joint theater-level Logistics commander to direct and execute the theater-level logistics tasks; 1b) Develop a Joint Theater Sustainment Command for assignment to Combatant Commands; 2) Implement useful practices of other services; 3) Complete a thorough business-based cost/benefit analysis of RFID before spending any more money on it; 4) Fix the chlorination problem of ROWPU (Reverse Osmosis Water Purification Unit) produced water. The study proposed specific force structures for both Joint theater-level and Army/Land Component logistics forces, identified specific practices of other Services that the Army should consider adopting, and identified promising water production technologies for further development.

A study focusing on the means to enable rapid power projection incorporating analyses of situations involving enemy anti-access activities. The study panel: (I) identified enablers for early and continuous entry of forces and supplies into and within the theater of operations; (2) Identified enablers to realize the full potential of the Revolution in Military Logistics pertaining to providing the required sustainment to early deploying forces; (3) Addressed the implications of an enemy "anti-access" capability and (4) Assessed current programmed assets in terms of meeting these challenges. The central recommendations developed include: (1) Establishing the 2nd Armored Calvary Regiment as lethal early entry force; (2) Establishing a National Guard prepositioned equipment group (Brigade size); (3) Increasing Army participation in DARPA's Advanced Logistics Project; (4) Leveraging commercial operators of air/sea lift particularly with respect to the agile port concept and influencing commercial high speed shipping to incorporate national defense features.

Bradykinin (BK) is a peptide which evokes remarkably different changes in cardiovascular function. Systemic bolus injection of BK results in a rapid drop in blood pressure via an endothelium-dependent mechanism. On the other hand, local administration of BK can activate a powerful pressor reflex by stimulating afferent nerves located in the abdominal viscera, the heart, and the kidney. In the present study, the cardiovascular and renal hemodynamic effects during sustained (intravenous infusion) and transient (intravenous bolus injection) elevations in circulating BK were characterized and the receptor mechanism eliciting these effects was investigated. Mean arterial pressure (MAP), heart rate (HR), and renal blood flow (RBF) were recorded from conscious unrestrained rats while five-point cumulative dose-response curves were constructed during infusion or bolus injection of BK (5-80 microg kg(-1)). Infusion of BK produced dose-dependent increases in MAP (maximum response = 27 +/- 3 mmHg) accompanied by a significant tachycardia (maximum response = 159 +/- 20 bpm), a 28 +/- 6% increase in RBF, and no changes in renal vascular resistance (RVR). The BK-induced increases in MAP, HR, and RBF were abolished after treatment with a ganglion blocker (maximum responses: MAP = 2 +/- 3 mmHg, HR = 13 +/- 4 bpm, RBF = 4 +/- 2%) or with an agent which blocks B2-receptors (maximum responses: MAP = 1 +/- 1 mmHg, HR = 6 +/- 5 bpm, RBF = 6 +/- 2%). In marked contrast, bolus administration of BK resulted in hypotensive responses (maximum decline in MAP = -37 +/- 4 mmHg), reflex tachycardia (maximum increase in HR = 45 +/- 9 bpm), increases in RBF (maximum response = 13 +/- 4%), and significant reductions in RVR (maximum response = 38 +/- 5%). These responses were also prevented when B2-receptors were blocked (maximum responses: MAP = 3 +/- 2 mmHg, HR = 17 +/- 6 bpm, RBF = 3 +/- 3%, RVR = 9 +/- 4%). In summary, BK infusions activated a cardiopressor reflex while BK injections caused hypotension. These opposite effects were both mediated via B2-receptors. These findings suggest that BK can have complex effects on the cardiovascular system that may be dependent on the sites, magnitude, and duration of elevated BK concentrations.

In immunoelectron microscopic investigations, retention of antigenic sites is crucial. Methods for preparing samples for conventional electron microscopy involve chemical fixatives followed by dehydration in organic solvents and embedding in plastic resins, all procedures potentially detrimental to antigenicity. Cryomethods provide a physical fixation alternative for the preparation of biological samples for ultrastructural, immunocytochemical, and microanalysis studies without the use of any chemicals. This can be particularly useful in diagnostic pathology, providing an alternative to conventional fixation methods which sometimes destroy the antigen in question. The recent development of a portable cryofixation device, the PS1000 Portable Metal Mirror Ultra-Rapid Cryofixation Unit (Delaware Diamond Knives, Inc., Wilmington, DE, USA), provides an opportunity to freeze tissue immediately after procurement for use in diagnostic immunocytochemistry studies. This feasibility study examined the quality of tissue preservation with this device, in terms of both preservation of cellular ultrastructure and immunolabeling. Human tonsil and thymus tissue was slam frozen and, after cryosubstitution in Lowicryl K11M, was examined by immunoelectron microscopy. Good ultrastructural preservation was obtained and reasonable immunolabeling with antibodies to AE1/AE3 keratin filaments was also observed.

This free-flow micropuncture study examined the dependence of bicarbonate reabsorption in the rat superficial proximal convoluted tubule to changes in filtered bicarbonate load, and thereby the contribution of the proximal tubule to the whole kidney's response to such changes. The independent effects of extracellular fluid (ECF) volume expansion and of acidosis on proximal bicarbonate reabsorption were also examined. When the plasma volume contraction incurred by the micropuncture preparatory surgery was corrected by isoncotic plasma infusion ( congruent with1.3% body wt), single nephron glomerular filtration rate (SNGFR), and the filtered total CO(2) load increased by 50%. Absolute proximal reabsorption of total CO(2) (measured by microcalorimetry) increased by 30%, from 808+/-47 during volume contraction to 1,081+/-57 pmol/min.g kidney wt after plasma repletion, as fractional total CO(2) reabsorption decreased from 0.90 to 0.77. Aortic constriction in these plasma-repleted rats returned the filtered load and reabsorption of total CO(2) to the previous volume contracted levels. In other animals isohydric ECF expansion with plasma (5% body wt) or Ringer's solution (10% body wt), or both, produced no further diminution in fractional proximal total CO(2) reabsorption (0.76-0.81). Metabolic acidosis was associated with very high fractional proximal total CO(2) reabsorptive rates of 0.82 to 0.91 over a wide range of SNGFR and ECF volumes. At a single level of SNGFR, end-proximal total CO(2) concentration progressively decreased from 5.6+/-0.5 to 1.6 +/-0.2 mM as arterial pH fell from 7.4 to 7.1. Expansion of ECF volume in the acidotic rats did not inhibit the ability of the proximal tubule to lower end-proximal total CO(2) concentrations to minimal levels. In conclusion, bicarbonate reabsorption in the superficial proximal convoluted tubule is highly load-dependent (75-90%) in normal and acidotic rats. No inhibitory effect of ECF volume per se on proximal bicarbonate reabsorption, independent of altering the filtered bicarbonate load, could be discerned. Acidosis enabled the end-proximal luminal bicarbonate concentration to fall below normal values and reduced distal bicarbonate delivery.

Pressures and flows were measured in surface glomerular capillaries, efferent arterioles, and proximal tubules of 22 Wistar rats in the early autologous phase of nephrotoxic serum nephritis (NSN). Linear deposits of rabbit and rat IgG and C3 component of complement were demonstrated in glomerular capillary walls by immunofluorescence microscopy. Light microscopy revealed diffuse proliferative glomerulonephritis, and proteinuria was present. Although whole kidney and single nephron glomerular filtration rate (GFR) in NSN (0.8 plus or minus 0.04 SE2 ml/min and 2 plus or minus 2 nl/min, respectively) remained unchanged from values in 16 weight-matched NORMAL HYDROPENIC control rats (0.8 plus or minus 0.08 and 28 plus or minus 2), important alterations in glomerular dynamics were noted. Mean transcapillary hydraulic pressure difference (deltaP) averaged 41 plus or minus 1 mm Hg in NSN versus 32 plus or minus 1 in controls (P LESS THAN 0.005). Oncotic pressures at the afferent (piA) end of the glomerular capillary were similar in both groups ( 16 mm /g) but increased much less by the efferent end (piE) in NSN (to 29 plus or minus 1 mm Hg) than in controls (33 plus or minus 1, P less than 0.025). Hence, equality between deltaP and piE, denoting filtration pressure equilibrium, obtained in control but not in NSN rats. While glomerular plasma flow rate was slightly higher in NSN (88 plus or minus 8 nl/min) than in controls (76 plus or minus 6, P greater than 0.2), the failure to achieve filtration equilibrium in NSN rats was primarily the consequence of a marked fall in the glomerular capillary ultrafiltration coefficient, Kf, to a mean value of 0.03 nl/(s times mm Hg), considerably lower than that found recently for the normal rat, 0.08 nl/(s times mm Hg). Thus, despite extensive glomerular injury, evidenced morphologically and by the low Kf, GFR remained normal. This maintenance of GFR resulted primarily from increases in deltaP, which tended to increase the net driving force for filtration, and thereby compensate for the reduction in Kf.

After restoring plasma volume to conscious levels, glomerular pressures and flows governing single nephron glomerular filtration rate (SNGFR) were measured in Munich-Wistar rats possessing surface glomeruli accessible to micropuncture. Although the mean glomerular transcapillary hydraulic pressure difference in these euvolemic rats was similar to that observed in hydropenic animals, initial glomerular plasma flow rate and SNGFR were at least 50% higher than in hydropenic rats. Nevertheless, filtration pressure equilibrium was generally achieved in euvolemic rats, as in hydropenic rats. Afferent and efferent arteriolar resistances were found to be lower in euvolemic than hydropenic rats, suggesting more potent vasoconstrictor forces in the latter group.

Dynamics of glomerular ultrafiltration: VI. Studies in the primate. Pressures and flows were measured in accessible surface glomeruli of the squirrel monkey under conditions of normal hydropenia. Mean glomerular capillary hydrostatic pressure and the mean glomerular transcapillary hydrostatic pressure difference (ΔP) averaged approximately 45 mm Hg and 35 mm Hg, respectively. These findings are in close accord with recent direct estimates in the rat. The net driving force for ultrafiltration was found to decline from a maximum value of about 12 mm Hg at the afferent end of the glomerular capillary network essentially to zero by the efferent end, indicating that, in the monkey as in the rat, filtration pressure equilibrium is achieved under normal hydropenic conditions. The monkey differs from the rat in one important respect, however, in that, as has long been recognized, the monkey tends to have higher systemic total plasma protein concentrations (CA) than the rat. This is of interest since monkey, like man, is found to have lower filtration fractions than the rat. Since ΔP is found to be essentially similar in monkey and rat, and since, at filtration pressure equilibrium, filtration fraction is determined by ΔP and CA, these observed differences in filtration fraction between rodent and primate must therefore be due to these differences in CA.

Many inexperienced operations research analysts react to a new study requirement by immediately categorizing the problem into a solution methodology. In effect, they commit themselves to a particular technical tool and turn on the biggest computer they can find to run it before they fully understand the problem. We believe that a thorough front-end analysis of the problem allows you to determine the best solution approach and, in some cases, may even produce the answer as a result of the application of common sense. The “five whats” focus your attention on the key aspects of front-end analysis.

This study compared the incidence of posttreatment pain associated with the use of formocresol, Cresatin, eugenol, CMCP, iodine-potassium iodide, and a dry cotton pellet. The incidence of pain was also examined in relation to patient factors and the type of treatment performed. Variables such as age, sex, and treatment procedures were studied to determine any statistical difference in relation to postoperative pain. A statistical analysis on the collected data showed no statistical significance between the incidence of pain and the medicament used. There was no significant difference in the incidence of pain between sexes or between different age groups. The only significant variable was that there was less frequency of posttreatment pain after obturation.

Protective effects of a soy diet in preventing obesity-linked renal disease.BackgroundHypertension, hyperlipidemia, hyperfiltration, hyperinsulinemia, glomerular hypertrophy, and ultimately glomerular injury and renal failure are associated with obesity in the Zucker rat. Evidence from other laboratories suggests that soy protein might offer renal protection.MethodsAt five weeks of age obese rats were placed on diets containing either soy or casein as a protein source and studied until 24 weeks of age. At six weeks of age and every four weeks thereafter, 24-hour urine collections were obtained along with measurements of systolic blood pressure (tail cuff) and blood from the tail vein. At the end of the study the kidneys were fixed and sectioned for histology.ResultsBoth groups gained weight and developed systemic hypertension and hyperinsulinemia at the same rate. Glomerular filtration rate (creatinine clearance) also was similar between groups throughout the study and both groups developed glomerular hypertrophy to the same extent. The development of hypertriglyceridemia was actually accelerated in the soy-fed rats compared to the casein-fed animals. The soy diet, however, virtually completely prevented the development of hypercholesterolemia, primarily low-density lipoprotein (LDL) and/or very low-density lipoprotein (VLDL) cholesterol, and slowed the development of proteinuria and glomerular injury.ConclusionsThe data suggest that an important determinant of the protective effects of soy was related to the prevention of hypercholesterolemia in this model. Other unmeasured differences between groups, such as differences in glomerular capillary blood pressure or the effects of the antioxidant properties of soy components also may have contributed to the protective effects of soy.

Prevention of obesity-linked renal disease: Age-dependent effects of dietary food restriction. Background Hyperphagic obese Zucker rats develop glomerular injury and die of renal disease, an outcome prevented by food restriction at an early age. We examined the effects of food restriction imposed at different ages on systemic, renal hemodynamic, and hormonal changes to gain insight into the mechanisms of obesity-linked glomerular injury. Methods At 6 weeks of age obese Zucker rats were either fed ad libitum or were restricted in food intake at various ages (6, 12, 26, or 50 weeks) to that consumed by lean Zucker rats (14 g/day). Every four weeks 24-hour urine collections, blood pressure, and venous blood samples were obtained until the end of study (60 weeks). Results Food restriction at 6 or 12 weeks of age prevented glomerular injury and hypertrophy and delayed the development of hypertension, hypercholesterolemia, and hyperinsulinemia. Food restriction at 26 weeks of age reduced proteinuria, while restriction at 50 weeks prevented further increases in proteinuria without altering pre-existing hypercholesterolemia, hypertension, or hyperinsulinemia. Hypertriglyceridemia and glomerular hyperfiltration in the obese animals were reversed at any age by food restriction. Plasma leptin levels were elevated in all obese groups. Conclusions ( 1 ) Early food restriction provided the greatest metabolic and renal benefits; ( 2 ) glomerular injury correlated with hyperphagia-induced hyperfiltration and hypertriglyceridemia and both were prevented by food restriction; ( 3 ) hypercholesterolemia was due to an increase in LDL and/or VLDL cholesterol; and ( 4 ) leptin does not directly contribute to glomerular injury in the obese Zucker rat.

We have recently shown that in the early autologous phase of nephrotoxic serum nephritis (NSN) single nephron glomerular filtration rate is unchanged from values in normal hydropenic control rats, but that single nephron filtration fraction and efferent arteriolar oncotic pressure (piE) are reduced because of a marked reduction in the glomerular capillary ultrafiltration coefficient. The present study was undertaken to examine the influence of this decline in piE as well as the other known determinants of peritubular capillary fluid exchange on absolute proximal fluid reabsorption (APR) in NSN. The findings indicate that APR and proximal fractional reabsorption are reduced significantly in NSN, relative to values in a separate group of age and weight-matched normal hydropenic control rats studied concurrently. In addition to the measured decline in piE, efferent arteriolar plasma flow (Qe) and peritubular capillary hydraulic pressure (Pc) were found to increase significantly, while interstitial oncotic pressure, estimated from hilar lymph, was not significantly different from values in control rats. Using a mathematical model of peritubular capillary fluid uptake we found that, assuming that the capillary permeability-surface area product and interstitial hydraulic pressure are unchanged in NSN, the observed changes in piE and Pc are sufficient to offset the effect of the increase in QE, yielding a calculated reduction in APR of approximately 4 nl/min, in excellent agreement with the observed mean decline of 4.1 nl/min. These findings suggest that control of APR in NSN is mediated by the same factors that regulate APR under normal physiological conditions, namely, the imbalance of forces governing peritubular capillary uptake of isotonic reabsorbate.

The advantages of a standard condensed graphic method of expressing the results of the examination of well samples are here considered. A tentative scheme for this purpose is here proposed. This scheme is probably unnecessarily detailed for use in oil fields which have been long developed and in which formation contacts are clearly defined. Its special value seems to lie in the preparation of well logs from wildcat areas, or from areas in which sub-divisions of well known formations are contemplated. The scheme here given is tentative and the article is written less with the idea of establishing a rigid system than of stimulating an exchange of ideas on a very important subject that has not received much publicity.