Nancy Telfer

Resolution of Muscle Calcification in Rhabdomyolysis and Acute Renal Failure

We studied four patients with acute renal failure associated with nontraumatic rhabdomyolysis to evaluate the presence and progression of calcium deposits in damaged muscle tissue. Conventional and electron radiography and technetium-99m diphosphonate (TcDP) scans were done during the oliguric phase of acute renal failure and repeated after renal function returned to normal. Three patients showed deposits of calcium by conventional radiography and all by electron radiography and TcDP during the oliguric period. When the patients recovered renal function and muscle injuries healed, calcium deposits disappeared. The results show that calcium deposits in damaged muscle occur during the oliguric phase of acute renal failure due to rhabdomyolysis and the calcification disappears with recovery of renal failure; and TcDP scans are the most sensitive method of detecting calcium deposits in these patients.

Injuries of the spleen.

Pathology, Clinical manifestations, and diagnostic aids such as abdominal paracentesis, angiography, and radionuclide studies, and important features of emergency splenectomy.

Erythrocyte survival in chronic renal failure. Role of secondary hyperparathyroidism.

The human erythrocyte (RBC) is a target organ for parathyroid hormone (PTH) and the hormone increases RBC osmotic fragility and induces their hemolysis. The present study was undertaken to examine whether elevated blood levels of PTH affect RBC survival, and therefore whether PTH, being an extracorpuscular factor, is responsible for the shortened RBC survival in chronic renal failure. 51Cr-labeled RBC survival was elevated in six normal dogs, in six animals with chronic renal failure and secondary hyperparathyroidism (NPX), and in six thyroparathyroidectomized dogs (NPX-TPTX) with comparable degree and duration of chronic renal failure. In the normal dogs, 51Cr-labeled RBC survival ranged between 22 and 35 (25.6 +/- 1.9) d. In the NPX dogs, 51Cr-labeled RBC survival was shortened and the values ranged between 16 and 20 (18.4 +/- 0.6) d, a value significantly (P less than 0.01) lower than normal dogs. In NPX-TPTX dogs, 51Cr-labeled RBC survival ranged between 20 and 33 (25.2 +/- 1.8) d, a value not different from that in normal dogs but significantly higher (P less than 0.01) than that in NPX animals. Our data demonstrate that excess blood levels of PTH and not other consequences of the uremic state are responsible for the shortened RBC survival in chronic renal failure.

Hypersplenism in the Uremic Hemodialyzed Patient

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

Further evidence that ouabain-resistant variants induced by chemical carcinogens in transformable C3H/10T1/2 Cl 8 mouse fibroblasts are mutants

Abstract Ouabain-resistant (Oua r ) variants were induced in C3H/10T1/2 Cl 8 cells by the chemical carcinogens, N -methyl- N ′-nitro- N -nitrosoguanidine (MNNG), N -acetoxy- N -2-acetylaminofluorene (N-AcO-AAF), and benzo[ a ]pyrene (BaP). The use of the Poisson calculation to determine Oua r variant frequencies gave more linear dose-response curves than when variant frequencies were calculated from the observed number of Oua r colonies. Increasing the Oua concentration from 3 to 6 mM decreased the frequency of Oua r variants. When cloned Oua r variants were mixed with wild-type cells, there was no metabolic cooperation and no loss of mutants when mock expression-time curves were determined. Oua r variants remained Oua r after prolonged cultivation in the absence of Oua. 86 Rubidium ( 86 Rb) uptake was at least 10-fold more resistant to inhibition by Oua in Oua r variants than in wild-type cells. In one Oua r clone, one-third of the 86 Rb uptake was not inhibited by Oua concentrations as high as 10 mM, indicating that C3H/10T1/2 Cl 8 cells might be triploid at the Oua r locus. The relationship between the inhibition of 86 Rb uptake and the cytotoxicity caused by the same concentration of Oua was the same for 2 Oua r clones and wild-type C3H/10T1/2 Cl 8 cells. Therefore, the Oua r variants detected by this assay are most likely true mutants possessing an altered Na + K + transport system, the Na + K + Mg 2+ -activated adenosine triphosphate (ATPase), that is more resistant to Oua inhibition than the ATPase in wild-type cells.

Total exchangeable potassium in systemic lupus erythematosus with reference to "triamcinolone myopathy".

Summary Total exchangeable potassium, using K42, was determined in a group of female control subjects and 2 groups of patients with systemic lupus erythematosus. One of these groups was receiving adrenal cortical steroids including triamcinolone, the other salicylates and antimalarials only. Serial determinations were also done on one patient receiving long term steroid therapy. No significant differences in total exchangeable potassium values could be demonstrated among the 3 groups, and steroid therapy, including triamcinolone, did not appear to have an effect on total exchangeable potassium. The authors are indebted to Juanita Lestina and Marva Jenkins for their technical assistance.