Renal arterial hypertension in pediatric patients

Three hundred twenty-three children with hypertension due to different kidney disorders were analysed. Acute transient hypertension was the most frequent form of renal hypertension and was usually due to acute post-infectious glomerulonephritis. Chronic hypertension was frequently associated with renal insufficiency. In glomerular disorders the appearance of hypertension was usually accompanied by renal failure.

Factor VIIIR:Ag/Factor VIII:C and their ratio in obstetrical cases

Factor VIIIR:Ag and Factor VIII:C levels were found to be significantly increased during pregnancy, labor and puerperium, but not to the extent observed by European and American authors. The ratio Factor VIIIR:Ag/Factor VIII:C was elevated only between the third and sixth hour of labor with respect to early labor, and during parturition and early puerperium with respect to late labor. However, this ratio was in the same range as the normal non-pregnant controls, but in the cases of complicated pregnancy, the ratio reached values much higher than the normal. It was concluded that determination of the ratio appears to be of little value in normal cases but may be of use when there are obstetrical complications. Studies are being performed to try to explain the limited rise in Factor VIII:Ag and Factor VIII:C levels observed in our cases.

Ulcerative colitis, autoimmune hemolytic anemia and rectovaginal fistula: report of a case

A case of autoimmune hemolytic anemia associated with ulcerative colitis and rectovaginal fistula in a 27-year-old woman is reported. It appeared during the first episode of ulcerative colitis occurring in the immediate puerperium. Laboratory studies revealed a positive direct Coombs test with polyspecific sera and monospecific for IgG. Panagglutinins and cold agglutinins with titers under 1:50 were also demonstrated. Treatment with steroid therapy was sufficient for a swift and complete recovery of the patient, the direct Coombs test becoming negative six weeks after admission.

Changes in the luteinizing hormone content of the rat pars tuberalis during the estrus cycle and after lesions in the preoptic area

The rat pars tuberalis was studied with conventional electron microscopy and immunocytochemistry for the demonstration of luteinizing hormone (LH). The LH-secreting cells were preferentially located in two regions of the pars tuberalis (PT), namely, that surrounding the neural stalk and that occupying the tuberoinfundibular sulci. Dialyzed extracts of PT prepared after removal of the pituitary stalk, had the capacity to induce ovulation in chlorpromazine-blocked rats in proestrus. In radioimmunoassays carried out under the same conditions, the PT extracts yielded displacement curves parallel to those of standard LH. The immunoreactive LH content of the female PT was determined at three phases of the estrous cycle: diestrus, afternoon of proestrus and estrus. The lowest values were found in rats sacrificed in the evening of proestrus (18.00 h), and they were about one sixth of the peak values found at estrus. 1 month after inducing lesions in the preoptic area of female rats, the LH content of the PT was four times higher than the highest values found during the estrous cycle. The results suggest that the rat PT does secret LH, and that this secretory activity fluctuates with the estrous cycle, but in a manner that differs from that reported for LH secretion of the pars distalis.

Amenorrhea-galactorrhea associated with Cushing's disease due to pituitary tumor

Two patients with amenorrhea-galactorrhea and Cushing's disease due to pituitary tumor are presented. In both cases, a diagnosis of prolactin-secreting tumor with moderate hyperprolactinemia was established, then Cushing's disease developed years later. Despite the typical clinical features of Cushing's disease, a dexamethasone suppression test inhibited both blood ACTH and cortisol concentrations in the 2 patients. Hypophysectomy was performed in 1 case, and the histologic study revealed the presence of a cromophobe adenoma. The other case was treated by external radiation which improved the clinical situation. Clinical and endocrinological studies in these 2 cases were compared with previous reports in the literature in order to discuss the etiology of this unusual association. It is concluded that patients with pituitary tumors presenting moderate hyperprolactinemia may also have excessive secretion of ACTH.

Electrophysiological effects of imipramine on bovine ventricular muscle and Purkinje fibres

1 The effect of imipramine in concentrations between 0.01 microM and 50 microM has been studied on bovine Purkinje fibres and ventricular muscle transmembrane potentials. 2 In electrically stimulated fibres, imipramine had no effect on the resting membrane potential, but decreased the action potential amplitude, overshoot and maximum rate of depolarization (Vmax). 3 In Purkinje fibres, imipramine also decreased the conduction velocity and shifted the membrane responsiveness and recovery time curves downward and to the right. 4 In both Purkinje fibres and ventricular muscle, imipramine decreased the amplitude of phase 2 and prolonged phase 3. In Purkinje fibres, imipramine did not alter the action potential duration (APD) but prolonged the effective refractory period (ERP). In ventricular muscle, at concentrations higher than 1 microM imipramine shortened both the APD and the ERP and made the ERP long as compared to APD. 5 Imipramine decreased the slope of phase 4 diastolic depolarization in spontaneously beating Purkinje fibres. 6 These properties of imipramine are quite similar to those of quinidine or procainamide (class 1 antiarrhythmics). The mechanisms responsible for the cardiac effect of imipramine are discussed.

Electrophysiological effects of desipramine on guinea pig papillary muscles

The effects of desipramine (DMI) in concentrations between 1 x 10(-7) M and 1 x 10(-4) M on various electrophysiological parameters were evaluated in ventricular papillary muscles of guinea pig. At concentrations less than 5 x 10(-5) M, DMI produced a significant shortening in the action potential duration (APD) measured at both 50% and 100% of repolarization. At 1 x 10(-4) M, the terminal portion of repolarization was so prolonged that the total APD was not significantly different from control values. DMI (greater than 1 X 10(-5) M) did not change the resting potential but significantly, decreased the overshoot potential, the amplitude, and the maximum rate of rise of phase O depolarization (Vmax) and shifted the membrane responsiveness and membrane reactivation curves downward and to the right. The effective refractory period (ERP) was shortened or lengthened, the effect being dependent on the concentration, but always made the ERP long relative to APD. DMI, (1 X 10(-5) M and 5 x 10(-5) M), attenuated and abolished the spontaneous activity and the Ca-mediated action potentials induced in ventricular muscle fibers. The mechanisms responsible for DMI's in vivo arrhythmogenic or antiarrhythmic effects are discussed. In terms of changes in ion conductance most effects can be explained by a reduction in sodium and calcium conductance.

Electrophysiological actions of chlorimipramine on guinea-pig ventricular fibres

Chlorimipramine (CMI, 1 x 10(-5)M to 7 X 10(-5)M) decreased the amplitude, overshoot and rate of rise of ventricular action potentials and abolished the Ca-mediated action potentials elicited in guinea-pig papillary muscles. These results indicates that CMI inhibits the rise in sodium and calcium conductances during the cardiac action potential.

The Warren operation for anal incontinence caused by disruption of the anterior segment of the anal sphincter, perineal body, and rectovaginal septum: report of five cases

The use of the Warren vaginal flap operation for repair of a traumatic deformity consisting of disruption of the perineal body, anterior segment of the external anal sphincter, and lower half of the rectovaginal septum is described. Modifications described in this article include use of the jackknife position to give better exposure and epinephrine infiltration to give a bloodless field. The incidences of infection and recurrence appear lower than with the layer technique.