The importance of osmolality fall and ultrafiltration rate on hemodialysis side effects. Influence of intravenous mannitol

The decreases in serum osmolality as well as the rate of ultrafiltration during hemodialysis and the influence of each upon the side effects of this treatment were studied in 13 chronic stable dialysis patients. Mannitol (9 mosm/kg water) was infused in two out of four dialyses, in a double blind fashion. A solution of 5% glucose in water was used as control. 1 week after the treatment, there was no residual mannitol in the patients' serum (p less than 0.0005). The decrease in osmolality during dialysis was lower when the patients received treatment with mannitol than with placebo: 14.7 versus 25.0 mosm/kg water (p less than 0.001). The symptoms during dialysis were much less severe when the patients received mannitol (p less than 0.05). Analyzed separately, ultrafiltration rate had no effect on severity of symptoms during dialysis (p greater than 0.1). Decrease in serum osmolality during dialysis seems to be the most important factor in the genesis of dialysis symptoms in chronic stable dialysis patients and are counteracted by the infusion of an osmotically active substance such as mannitol, 1 g/kg/dialysis; this results in a slight increase in body weight between dialyses, and cannot be used routinely because of slow accumulation.

Relative numbers of several types of synaptic connections in the substantia gelatinosa of the cat spinal cord

The relative numbers of axo-dendritic, axo-axonic, dendro-axonic and dendro-dendritic synapses were determined by classifying and recording all such specialized contacts in sample areas of the substantia gelatinosa. The samples were taken from segments L1-L5 of the cat spinal cord. In the glomerular complexes 97% of all synapses were recorded as axo-dentritic. In substantia gelatinosa deprived of glomerular complexes by dorsal root section, 96.5% were axo-dendritic. The remainders were about equally divided between axo-axonic, dendro-dendritic and dendro-axonic synapses.

Beclomethasone dipropionate dry-powder inhalation compared with conventional aerosol in chronic asthma

In a double-blind study beclomethasone dipropionate inhaled as a dry powder in doses of 100 microgram four times daily and 150 microgram four times daily was compared with the conventional aerosol dose of 100 microgram four times daily in 20 outpatients with chronic asthma. Each of the three treatments was given for four weeks. The dry powder in a dose of 150 microgram four times daily had advantages over the other two treatments in terms of FEV1 and the number of exacerbations of asthma during the study. There were no adverse reactions to inhaling dry-powder beclomethasone. It was concluded that this new way of administering the drug was effective in chronic asthma, and should allow most patients with chronic asthma who cannot use conventional pressurised aerosols efficiently to benefit from inhaled corticosteroid treatment.

Methadone blockade in the treatment of opiate addiction: a follow-up study

This paper describes methadone blockade treatment of 50 opiate addicts. At follow-up, 36 patients were traced and interviewed. Results show that 89% of the 36 patients cooperated with the treatment programme, 88% had no new criminal convictions and 75% remained drug-free, apart from taking methadone during the follow-up period (mean, 12-5 months). Five of the 36 patients were free of all drug addictions, including methadone.

Effects of water immersion to the neck on pulmonary circulation and tissue volume in man

Utilizing the rebreathing of a gas mixture containing C2H2, C180, He O2, and N2, we obtained serial measurements of the pulmonary capillary blood flow (Qc), diffusing capacity per unit of alveolar volume (DL/VA), functional residual capacity (FRC), pulmonary tissue plus capillary blood volume (VTPC), and O2 comsumption (VO2) in five normal subjects under the following conditions: 1) 6 h of sitting, 2) 4 h of sitting while immersed in thermoneutral water to the neck, and 3) 4 h of lying in thermoneutral water to the neck. Water immersion (NI) was preceded and followed by 1-h prestudy and 1-h recovery periods. The measurements were made at 30-min intervals. Seated NI produced a fourfold increase in sodium excretion (UNaV), a 25-36% increase in Qc, a 45-59% increase in DL/VA, and a 30-36% decrease in FRC. This occurred as early as the 1st h of NI and persisted throughout the 4-h period of study. Throughout the seated control and NI periods, VO2, heart rate, and VTPC remained constant. During supine NI, Qc, HR, DL/VA, FRC, and VO2 did not differ significantly from supine prestudy. These date demonstrate that seated NI causes a significant increase of Qc and DL/VA which persists throughout the immersion period. Furthermore, the lack of change of VTPC suggests that the central vascular engorgement induced by seated NI is not accompanied by extravasation of fluid into the pulmonary interstitial space.

Specialized contacts of astrocytes with astrocytes and with other cell types in the spinal cord of the cat

Adult and half grown healthy male and female cats were used in this study. The white and gray matter of dorsolateral region in the upper lumbar levels of the spinal cord were examined by electron microscopy after fixation by aldehyde perfusion and commonly used methods of embedding, sectioning and staining. The report is limited to description and illustration of specialized junctions of astrocytes. In addition to previously described astrocyte-astrocyte gap junctions, astrocytes are connected by gap junctions to oligodendroglia cells and to neurons. Astrocytes also are connected with each other and with neurons by juctions characterized by wide (250 A) gaps containing opaque gap material and by dense material adhering to the inner surfaces of the plasma membranes. The results suggest a morphological basis for adhesion and intercommunication between all adult derivatives of the embryonic neural tube.

Effect of aminoglutethimide on serum progesterone and estrogen in the pregnant baboon (Papio SP)

AG was administered orally twice daily for 1 or 3 days to six baboons whose duration of pregnancy ranged from 31 to 99 days. Serum progesterone levels were reduced to as little as 3.2% of the initial concentration in one animal and to 20% or less in four of the five remaining baboons. Serum estrogen levels were depressed by 50% or more in three of the four animals in which they were measured. However, pregnancy ensued for at least 3 wk after treatment in all animals. The data suggest that peripheral blood levels of sex steroids may not reflect the critical concentration of hormones required at the uteroplacental juncture for the successful pregnancy maintenance.

Effects of sinus nerve stimulation on carotid body glomus cells

The sinus nerve or sympathetic trunk was stimulated unilaterally in one group of adult cats or Syrian hamsters while in another group the sinus nerve or sympathetic trunk was cut unilaterally and the animals were given reserpine. In a third group, atropine was administered prior to sinus nerve stimulation. All tissues were processed for the detection of primary monoamines. The carotid bodies on the operated sides were compared with those on the unoperated sides of the same animal in order to determine if amine depletion occurred following the experimental procedures. After sinus nerve stimulation alone, the density of the granules in the glomus cells was decreased, but changes were not noted in the granules following sympathetic nerve stimulation. Sinus nerve stimulation after atropine administration resulted in no change in granule density. Sinus nerve transection followed by reserpine treatment resulted in a greater decrease in granule density on the unoperated than on the operated side. Transection of the sympathetic components to the carotid body followed by reserpine injections resulted in a decrease in granule density in the glomus cells on both the operated and unoperated sides. These results suggest that the sinus nerve must be intact for reserpine to exert an effect and that the sinus nerve may contain efferent fibers which modulate amine secretion.

Long-term results with the serrated teflon vena caval clip in the prevention of pulmonary embolism

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