Hypercalcemia associated with parenteral amino acid and dextrose infusion

A patient receiving parenteral nutrition with an amino acid dextrose solution developed hypercalcemia which seemed related to the rate of nutrient infusion. In a retrospective study of patients receiving parenteral nutrition over a 3-month period six of 72 (8%) developed hypercalcemia. After changes in infusion rate there were corresponding changes in the serum calcium concentration. There was a significant correlation between the serum calcium concentration and the average infusion rate over the preceding four days (p = 0.012). This was even more significant (p less than 0.005) when ionized calcium was calculated to diminish the effects of calcium binding by proteins.

The effect of single morning and evening rinses of chlorhexidine on the development of tooth staining and plaque accumulation. A blind cross-over trial

A dietary aetiology for tooth staining associated with the use of chlorhexidine has been postulated. The time related activity of chlorhexidine would therefore suggest that evening rinsing would result in less staining than morning rinsing. This study measured tooth and tongue staining and plaque accumulation in a group of 18 volunteers, rinsing once at night or once in the morning with chlorhexidine in a blind cross-over design. Beverage intake during two 10-day periods was prescribed. Significantly more tooth staining, but not tongue staining, was seen with morning rinsing. Plaque accumulation showed a trend to more plaque with morning rinsing, which was not significant. The findings would be consistent with a dietary aetiology for tooth staining. However, these results emphasise the considerable duration of activity of chlorhexidine on surfaces in the oral cavity and the theory of progressive desorption of chlorhexidine from the tooth surface is questioned.

Long term visual deprivation in a human

D.C. had a congenital monocular cataract removed at 19 years of age. Preoperatively, he was virtually blind in the deprived eye. By 4 months after surgery he could resolve about 1.4 c/deg by acuity did not improve further over the next 7 months. Immediately postoperatively, the temporal retina was blind, but over the next 4 months its visual field increased to 20. The temporal retina continued, however, to have elevated thresholds. D.C. also exhibited a peculiar form of binocular competition. Thresholds of the deprived binocular portions of the nasal retina were greatly elevated by light falling on the non-deprived eye. Visual function in the non-deprived eye was normal.

Immunosuppression in canine renal allografts using niridazole

The immunosuppressive activity of niridazole in unmatched kidney allografts in nephrectomized dogs was studied. The drug alone was not effective, but improved survival when used with azathioprine and prednisolone or azathioprine alone. However, niridazole was toxic in dogs in the doses used (25 or 50 mg/kg/day).

Significance of glomerular C3b receptors in human renal diseases

In order to elucidate their role in mediating renal immune injury in man, the glomerular C3b receptors have been analyzed in frozen sections of 205 kidneys biopsied from 199 patients affected by various well-defined renal diseases. Using fluoresceinated C3b-coated bacteria as the indicator system, the receptor activity has been compared with that found in 10 normal human kidneys. In 76 out of 98 cases (77%) of glomerulonephritis (GN) with capillary wall abnormalities, a significant loss of receptor activity has been observed. No difference was present between the 89 patients affected by GN presumably due to immune complexes (ICX) parietal deposition (membranoproliferative, membranous, acute poststreptococcal GN and proliferative GN of SLE and cryoglobulinemia) and the 9 patients affected by GN presumably due to anti-GBM antibodies (Goodpasture's syndrome and extracapillary GN). In the group of ICX-GN, no correlation could be demonstrated between inhibition of C3b receptors and the presence of parietal C3 deposits. A significant loss of receptors activity has been also demonstrated in 12 out of 13 patients with amyloidosis or diabetic glomerulosclerosis. On the contrary, inhibition of C3b receptors has been observed in only 3 out of 20 patients with nonglomerular renal diseases (interstitial and vascular nephropathies) and in only 11 out of 57 patients (19%) affected by mesangial GN with no capillary wall abnormalities (Berger's disease, Henoch-Schonlein purpura and mesangial GN of SLE). C3b receptors were normal in 13 out of 17 patients affected by lipoid nephrosis (minimal change GN or focal glomerulosclerosis). In conclusion, the analysis of C3b receptors in renal diseases do not support the hypothesis of their involvement in parietal localization of C3b-bearing ICX: these results rather suggest that the receptors become undetectable in many glomerular diseases (immune-mediated or not) with lesions of capillary walls, because of the loss of integrity of C3b receptor-bearing visceral epithelial cells.

Distribution of circulating immunoreactive components of parathyroid hormone in normal subjects and in patients with primary and secondary hyperparathyroidism: the role of the kidney and of the serum calcium concentration

1. The distribution of intact parathyroid hormone-(1-84) [PTH-(1-84)] and of its COOH-terminal fragments was determined in human serum by column chromatography. In addition to PTH-(1-84) (peak I), COOH-terminal fragments having molecular weights of approximately 4000-7000 (peak II) and immunoreactive components co-eluting with human PTH-(1-12) (peak III) were observed. 2. Mean concentrations of intact PTH-(-84) and of its COOH-terminal fragments were significantly raised in chronic renal failure as compared with those of normal subjects. Mean amounts of peak II were higher in patients with chronic renal insufficiency than in nutritional vitamin D deficiency, in pseudohypoparathyroidism and in primary hyperparathyroidism, despite comparable amounts of PTH-(1-84). 3. In chronic renal failure as well as in a group of patients with vitamin D deficiency, pseudohypoparathyroidism and primary hyperparathyroidism and in controls, significant linear relations were found between the serum concentrations of calcium and log (peak II/peak I). Our findings suggest that the conversion of intact PTH-(1-84) into COOH-terminal fragments by the parathyroid glands (resulting in a raised secretion of fragments) and/or in peripheral organs may be directly related to the serum concentration of calcium. However, the degradation of the fragments may also be suppressed in a calcium-dependent manner.

Calcitonin and calcium ionophores: cyclic AMP responses in cells of a human lymphoid line

Receptors for calcitonin, as assayed by the specific binding of 125I-labeled salmon calcitonin and stimulation of cyclic AMP formation, were found in 8866 cells derived from a human lymphoid line. The affinity of calcitonin from different species and of various analogues of human calcitonin for the binding sites and their ability to stimulate cyclic AMP formation were closely related to their hypocalcemic activity and presumably reflected biological properties of the hormones. Besides calcitonin, prostaglandin E1 and beta-adrenergic catecholamines stimulated cyclic AMP formation in these cells. The calcium ionophores, A23187 and Br-X-573A, did not influence the specific binding of 125I-labeled salmon calcitonin. A23187, however, suppressed basal and calcitonin-stimulated formation of cyclic AMP in the presence of at least 0.6 mM calcium in the incubation medium. Br-X-537A did not require extracellular calcium to suppress basal and calcitonin-stimulated formation of cyclic AMP, suggesting that the release of calcium from internal stores may regulate adenylyate cyclase activity in 8866 cells.

Prolonged complement activation in mice

Because antibody responses to the alternative complement pathway activator, cobra venom factor, are T-dependent and B mice therefore do not develop resistance to its action, it was possible to examine whether renal injury occurs under circumstances of protracted third-phase alternative pathway activation. After periods of up to three months, no evidence from measurements of blood urea or proteinuria or from examinations with light microscopy immunofluorescence or electron microscopy was obtained to indicate a directly nephrotoxic effect of this type of complement activation.

Veterans Administration hospital staff attitudes toward alcoholism

Attitudes toward alcoholism among psychiatrists, psychologists, social workers, registered nurses, licensed practical nurses, and nursing assistants (464 subjects) were surveyed. A nine-factor questionnaire was utilized (emotional difficulties, character defect, social status, illness conception, harmless indulgence and addiction liability). All groups were homogeneous in their perceptions about emotional difficulties contributing to alcoholism, alcoholics not coming from the lower socioeconomic strata of society, and the belief that alcoholics did recover and could be helped by treatment. Age, sex, and special training in the treatment of alcoholism did not have any significant influence on attitudes. All groups believed that periodic excessive drinkers could be alcoholics. None of the groups believed that the alcoholic had a character defect. Psychologists disbelieved the concepts of illness and addiction liability. All groups disagreed with harmless indulgence. Nursing assistants tended to see the alcoholic as a harmless heavy drinker. Working on a special alcoholism treatment unit did not alter the perceptions of psychiatrists, psychologists and nursing assistants. Social workers and registered nurses showed only a minor trend toward a positive attitude change, while the trend went in the opposite direction for licensed practical nurses.

C3b receptors in glomerular disease

Using two indicator systems--sheep erythrocytes or fluoresceinated S. typhi coated with C3b the presence of a receptor for C3b (but not C3d) in the normal human glomerulus is confirmed. No receptor could be detected in other species tested (mouse, rat, guinea-pig, rabbit and rhesus monkey). Binding of indicator particles was reduced or lost in diseases associated with glomerular capillary deposition of C3, but not in those with mesangial deposition alone. However in some cases the receptor was lost in the absence of detectable C3 deposition. No receptors were detected in proliferating cells in glomerular crescents.

Defibrination with ancrod in nephrotoxic nephritis in rabbits

Defibrination with ancrod in nephrotoxic nephritis in rabbits. In rabbits with nephrotoxic nephritis, defibrination with ancrod provided protection when administered during the autologous phase, after extensive glomerular fibrin deposition had occurred and crescents and renal failure were developing. When further glomerular fibrin deposition was prevented by defibrination, deposited fibrin was rapidly removed, indicating that glomerular fibrin-clearing mechanisms are retained in crescentic nephritis. Defibrination had no effect on the extent of glomerular C3 deposition or on the amount of proteinuria.

Clonal growth of bovine vascular endothelial cells: fibroblast growth factor as a survival agent

Bovine vascular endothelial cells do not grow when cultured at low density unless fibroblast growth factor is included in the culture medium. When endothelial cells obtained from the intimal surface of fetal and adult aortas were seeded at low density (8 cells per cm2), they formed small colonies of large, irregular, vacuolated cells. At very low density (0.3 cells per cm2) they did not survive. The addition of fibroblast growth factor to endothelial cells maintained at such low densities resulted in the formation of vigorously growing colonies of small, uniform cells. Electron microscopy showed that the cultured endothelial cells had the fine structure characteristics of endothelial cells. Immunofluorescence microscopy revealed antihemophilic factor (Factor VIII) antigen in the cells. Our results demonstrated that fibroblast growth factor permits the survival of endothelial cells plated at extremely low cell density. With the use of fibroblast growth factor, endothelial cell clones are easily produced.

Determination of human body burden baseline date of platinum through autopsy tissue analysis

Results of analysis for platinum in 97 autopsy sets are presented. Analysis was performed by a specially developed emission spectrochemical method. Almost half of the individuals studied were found to have detectable platinum in one or more tissue samples. Platinum was found to be deposited in 13 of 21 tissue types investigated. Surprisingly high values were observed in subcutaneous fat, previously not considered to be a target site for platinum deposition. These data will serve as a human tissue platinum burden baseline in EPA's Catalyst Research Program.

Carbon monoxide in school buses

Following an incident in which eight children became ill from carbon monoxide in a school bus, an investigation was made of CO levels in school buses in the Seattle area. The procedure selected for the evaluation was to test a large number of buses at a nearby ski resort. On the day selected for the sampling, over 200 buses arrived, bringing school children from a number of school districts in the Seattle are for skiing lessons. As they arrived, 33 buses were checked immediately to determine in-transit levels of CO. Four of the 33 buses had CO levels in excess of Environmental Protection Agency maximum allowable concentrations for an 8-hr exposure. As the buses sat idling in the parking lot, 65 of them were tested--during the lunch hour when the students returned to the buses to have their lunch and to rest. Two buses had nearly 3 times the concentration of CO permitted by the EPA for a 1-hr exposure. A total of seven buses (10 per cent) had concentrations of CO not permitted by the EPA for more than a 1-hr period. Altogether there were 24 buses (36 per cent) that had levels of CO in excess of EPA standards for an 8-hr exposure. As a result of these determinations and other observations a number of recommendations were made to reduce the hazard of exposure to carbon monoxide in school buses.

Coronary artery disease in an 18 year old with pseudoxanthoma elasticum: successful surgical therapy

An 18 year old girl with pseudoxanthoma elasticum, a 7 year history of angina pectoris and evidence of an old anteroseptal myocardial infarction was found on coronary angiography to have three vessel coronary artery disease. A triple coronary artery-saphenous vein bypass graft was performed, and she has been asymptomatic for 1 year. Histologic examination of a segment of the right coronary artery revealed changes consistent with the vascular lesion of pseudoxanthoma elasticum.