ISSN:1660-8151    

DOI:10.1159/000180143

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

Complete bilateral malignant ureteral occlusion was relieved by introduction of a nephrostomy tube, first into the right kidney and 3 weeks later into the left kidney. When the second nephrostomy tube was introduced, the right kidney had recovered sufficiently to eliminate the uremic environment and to serve as control organ. This offered the rare opportunity to study in man the function of the kidney following chronic obstruction, independent of systemic influences on tubular function, such as uremia, secondary hyperparathyroidism and the state of hydration of the patient. In the left (‘experimental’) kidney glomerular filtration (GFR) was markedly reduced and fractional and, on occasions, absolute excretion of sodium, calcium and magnesium exceeded simultaneous values in the right (‘control’) kidney. During hypotonic saline and mannitol diuresis, free water clearance relative to GFR and calculated distal delivery of sodium in the experimental kidney exceeded control values by more than twofold and more than threefold, respectively. Distal tubular function, as judged by the ability to generate free water and exchange sodium for potassium, appeared spared. These data suggest that in obstructive uropathy in man there is an intrarenal resetting of the glomerulotubular balance resulting in diminution of proximal tubular reabsorption of sodium, water and probably also divalent cations, which leads to enhanced tubular flow (‘overperfusion’) in the relatively intact distal nephrons. This change in glomerulotubular balance is brought about by an undefined mechanism, initiated by ureteral occlusion or by reduction in nephron population or their combination, and contributes to the profuse natriuresis and diuresis seen following the relief of uretera

ISSN:1660-8151    

DOI:10.1159/000180144

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

A hypersplenic syndrome developed in a group of 15 chronic hemodialysis patients. Splenectomy eliminated or reduced the need for routine transfusion requirements; granulocytopenia, lymphocytopenia and thrombocytopenia were corrected. Following renal transplantation azathioprine therapy was tolerated in the splenectomized group. One patient who refused splenectomy had persistent severe leukopenia. Spleens were normal to moderately increased in weight and contained an immunoreactive white pulp and a normal red pulp though increased hemosiderin was sometimes present. Serum ironsaturation decreased following removal of the spleen. Serum IgM levels fell after splenectomy but IgG and IgA were unchanged. Sources of chronic antigenic stimulation that may have produced the lymphoid hyperplasia included hepatitis antigen, bacterial and other viral antigens, and blood transfusions.The beneficial effect of splenectomy in these patients probably results from restoration of a delicate hematologic balance between hematopoiesis and destruction after removal of a major site of cellular sequestration and destruction and the hyperreactive immunoglobulin-producing lymphoidtissue.

ISSN:1660-8151    

DOI:10.1159/000180145

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

An acute immune disease is described in a 53-year-old man following preventive TAB inoculation. Very florid involvement of the renal vascular tree was associated with renal failure. Involvement of the vessels of the pulmonary tree and spleen also occurred. A retrospective review of 420 patients with glomerulonephritis seen during the last 10 years disclosed eight patients with histories strongly suggestive of renal involvement related in time to preventive inoculation. The possibility that occult renal involvement related to preventive inoculation may cause ‘latent’ glomerulonephritis in some patients is rai

ISSN:1660-8151    

DOI:10.1159/000180146

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

The effect of spironolactone (300 mg/day) for 28 days onthe systemic blood pressure has been studied in 4 normal and 22 hypertensive subjects in an attempt to distinguish those patients with primary aldosteronism who are suitable for adrenal exploration. No patient had any evidence of primary parenchymal renal disease. Full blood pressure control was achieved in 8 patients. Of these, 2 had renal artery stenosis, 2 microadenomata of the adrenal glands and 4 a solitary adrenal adenoma. Significant reductions in blood pressure were also noted in the remaining 14 patients, but normal values had not been attained in the 28 days of study. Although reductions in blood pressure were usually accompanied by a negative cumulative sodium balance, this was not an invariable feature and there was other convincing evidence to suggest that the hypotensive effect of spironolactone might be mediated through mechanism(s) independent of changes in external sodium balance. The interrelationships between the above observations and the plasma electrolyte, renin and aldosterone concentrations are discussed.

ISSN:1660-8151    

DOI:10.1159/000180147

出版商:S. Karger AG    

年代:1972

数据来源: Karger

摘要:

A case is reported of excessive ultrafiltration and muscle cramps caused by fibrin partial occlusion of the coil venous outlet during multiple reuse. There was a normal pressure in the venous line. The condition can best be detected by inspection of the coil during washout.

ISSN:1660-8151    

DOI:10.1159/000180148

出版商:S. Karger AG    

年代:1972

数据来源: Karger

ISSN:1660-8151    

DOI:10.1159/000180149

出版商:S. Karger AG    

年代:1972

数据来源: Karger