ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Thirty-seven patients, oliguric after a renal insult and with a rising plasma urea despite correction of deficits of blood, plasma, and fluid and in whom urinary osmolality and urea were low, were studied before and after the infusion of 20 to 60 g of 20% mannitol to determine if and how a diurelic response in patients in the early stages of “acute tubular necrosis” could be predicted. In the 20 patients in whom there was a diuresis and a statistically significant increase in urinary osmolality and urinary urea in the 48 hours after mannitol, the mean urine:plasma osmolality ratio before mannitol was 1.29 ± 0.0.16 (mean ± Standard error) and the duration of oliguria 27 ± 3.3 hours; in the 17 patients who remained oliguria with no change in urinary urea and urinary osmolality the mean urine:plasma osmolality before mannitol was 1.04 ± 0.022 (p < 0.001) and the duration of oliguria 44 ± 7.0 hours (p < 0.05). In the six patients with no response to mannitol despite urine:plasma osmolality ratios greater than 1.05 the duration of oliguria was more than 50 hours in two and persistent hypotension with peripheral circulatory failure was present in three. It is concluded that a response to mannitol is to he expected when the urine: plasma osmolality is greater than 1.05 and the duration of oliguria is less than 50 hours and persistent peripheral circulatory failure is absent; the urine: plasma urea ratio was of little value in predicting a response to mannitol.

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

The effect of mannitol osmotic diuresis was studied in 40 patients with various glomerular filtration rates (GFR) (range 2 to 100 ml/min). Mannitol produced excretion of significant amounts of water, sodium and chloride in all patients. The increase in potassium, bicarbonate and urate excretion was much less significant, while phosphate excretion increased only in the patients with low GFR; urea and ammonia were inconstantly affected. These results are interpreted to indicate that mannitol osmotic diuresis can be used successfully as a diuretic even in patients with low GFR.

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

In hepatic failure with ascites, plasma kininogen values were lower than normal; but no significant changes were observed in the kinia and kininogenase activity of the plasma. An increase in plasma kininogen was observed during the last gestational quarter of pregnant women, but there were no significant changes in kinin and kininogenase activity. The plasma kininogen content was significantly greater in normal men than in normal non-pregnant women. It is suggested that besides the decreased production of kininogen due to impaired liver function, endocrine changes associated with hepatic failure might influence the concentration of kininogen. In addition, it is hypothesized that reproduction and sex hormones affect the concentration of substrate in plasma.

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Cephalexin, a new cephalosporin antibiotic which is well absorbed orally, was evaluated in the treatment of 66 infectious occurring in 63 patients using daily doses of 1 to 6 grams. In 59 infections it was the only antibiotic used and in seven it was used after initial therapy with parenteral cephalothin and/or kanamycin. Favorable responses were obtained in ten patients with puenmococeal pneumonia, one with staphylococcal pneumonia, three with purulent bronchitis, four with gram-negative bacillary pneumonia, and five with streptococcal pharyngitis. One case of streptococcal pharyngitis recurred and two cases of penumococeal pneumonia bad incomplete responses, probably because of concomitant non-bacterial disease. Acute soft tissue infections in 23 patients caused by staphylococci and/or streptococci nil responded dramatically. Six patients with complicated gram-negative bacillary or mixed soft tissue infections showed either clinical or bacteriologic improvement, Responses in urinary tract infections were related to the underlying diseases; one patient with acute prostatitis was cured, but only two of seven with chronic infectious remained abacteriurie. Four episodes of septicemia without shock caused by a staphylococcus,E. coli, klebsiella, andP. mirabilis, respectively, were cured with cephalexin alone. No significant toxicity was observed. Seventeen penicillin-allergic patients received cephalexin without adverse reaction. Thus, cephalexin was effective in the treatment of infections caused by penicillin-sensitive and resistant staphylococci, pneumocoeei, streptococci, klebsiella,E. coli, andP. mirabilis.

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

In a classical case of Goodpasture's syndrome (GS) with fulminant glomerulonephritis, hemorrbagic pulmonary hemosiderosis and anemia, immunosuppressive therapy failed to prevent renal destruction. Cadaveric source for renal homograft was elected initially because of uncertain prognosis of lung disease. Cadaveric homograft was rejected, and subsequent bilateral nephrectomy and removal of the rejected homograft were followed by resolution of pulmonary dysfunction. Retransplantation from related donor was successful; patient remains free of pulmonary and renal disease 40 months later. Removal of necrotic glomeruli may underlie clearing of pulmonary disease observed after nephrectomy. Glomerular necrosis is reportedly characteristic of glomerulouephritis associated with pulmonary hemorrhage. Glmerular basement membrane (GBM) antigens released from necrotic glomeruli could have two possible effects (1) stimulating production of anti-GBM antibody, and (2) reacting with circulating anti-GBM antibody to form toxic immune complexes which injure the lungs. Nephrectomy would ball pulmonary damage by removing the source of antigen. Clinical experience (four reported cases) independently justifies nephrectomy when renal failure supervenes in GS. Resolution of pulmonary disease can be confirmed while patient is maintained on dialysis, and homotransplantation performed subsequently.

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

摘要:

Lymphocytes obtained from the peripheral blood of 24 patients with chronic uremia of variable etiology were cultured. Unstimulated and PHA-P stimulated lymphocytes were pulse labeled with 111-5-uridine and 113-thymidine and were assayed by liquid scintillation spectrometry. RNA synthesis by chronic uremic lymphocytes was the same as that of normal lymphocytes. Two response patterns of DNA synthesis by lymphocytes from patients with chronic uremia were recognized. One pattern was similar to that of normal unstimulated lymphocytes. The second pattern, characterizing more than 60% of cultures of lymphocytes from patients with chronic uremia, displayed a significantly higher spontaneous response, similar to that of stimulated normal lymphocytes. These data suggest that lymphocytes, from two groups of patients with chronic uremia, synthesize DNA at different rates in vitro. The group displaying a high rate of DNA synthesis was correlated with long duration of uremia, regardless of etiology. Over half of the patients with chronic uremia possess lymphocytes which may be stimulated by unknown factors, consistent with previously demonstrated altered response patterns of these cells. Additional data are presented, which indicate that the in vitro survival (T/2) of peripheral blood lymphocytes from patients with chronic uremia is significantly shorter than that of lymphocytes from matched normal controls. Serial studies of normal persons and uremic individuals maintained on chronic hemodialysis indicate that nucleic acid synthesis patterns remain abnormal in the latter group. These differences between nucleic acid metabolism in normal and uremic lymphocytes have been confirmed by spectrophotometric determination of nucleic acids extracted from lymphocyte cultures at various times. Serial studies have shown these alterations to be consistent and persistent. Profile studies of RNA and DNA synthesis rates have confirmed these alterations and have uncovered KNA aberrations also. Results of these profile studies explain the phenomenon of “conversions” seen frequently in uremic lymphocyte cultures. It is proposed that these changes, occurring in lymphocytopenic uremic patients, reflect preferential decrease of long-lived small lymphocytes and a relative increase of short-lived lymphocytes with fast nucleic acid turnover rates.

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1970

数据来源: OVID