Depth perception, eye alignment and cortical ocular dominance of dark-related cats

On first exposure to light, animals that have been reared from birth until about 4 months of age in total darkness exhibit substantial visual and visuomotor deficits, which decline in severity during the first few months following exposure to light. In order to determine whether dark-reared animals eventually acquire stereoscopic vision following exposure to light we examined the binocular status of 5 dark-reared animals two of which developed convergent eye alignment. The binocular status was assessed behaviorally by measurements of the ability of each animal to perceive depth using either one or both eyes, and physiologically by documentation of the distribution of cortical ocular dominance of a sample of visual acuity, their binocular depth perception remained very poor, comparable to the monocular performance of normal cats. In marked contrast to normal animals none of the dark-reared animals, even those with normal eye alignment, performed substantially better binocularly than monocularly, a result indicating the absence of a uniquely binocular mechanism for depth perception in these animals. Although the dark-reared animals were found to retain a substantial (but reduced) complement of binocularly influenced cortical neurons, the tuning of these cells for retinal disparity must be insufficiently precise to mediate depth perception under binocular viewing conditions that is superior to that which can be achieved monocularly.

Evidence that resistance to the calcemic action of parathyroid hormone in rats with acute uremia is caused by phosphate retention

An animal model was developed to examine the cause of resistance to the calcemic action of PTH in renal failure. Thyroparathyroidectomized (TPTX) rats were repeatedly reinfused with their excreted urine, over a 5-hour period, to produce an acute uremic animal with normal kidneys. Nonuremic controls were infused with equivalent volumes of a simple electrolyte solution. Using this model, we have demonstrated impaired calcemic response to PTH (Lilly Parathyroid Extract, 80 U/100 g) in urine-infused rats compared with electrolyte-infused rats. The final plasma calcium concentrations were 12.0 +/- 0.3 and 14.9 +/- 0.3 mg/dl, respectively (P less than 0.001). The cause of this impaired calcemic response was investigated by reinfusing rats with their own urine that had been pretreated with either activated charcoal or zirconium oxide in two different anionic forms, or urine that had been ultrafiltrated through an Amicon membrane of which the stated molecular-weight cut-off of the smallest pore-size membrane was 500 daltons. It was found that charcoal and ultrafiltration techniques had no effect, whereas the zirconium oxide treatment completely corrected the impaired calcemic response and returned the plasma phosphorus to a concentration similar to that in nonuremic controls. This can be explained by the fact that the principal effect of zirconium oxide on urine is to remove inorganic phosphate. Other groups of TPTX rats given PTH extract were infused with an electrolyte solution containing varying amounts of phosphate up to a maximum similar to the amount that a urine-infused rat would receive. A highly significant inverse relationship was found between the dose of phosphate infused with the electrolyte solution and the measured calcemic response to PTH. This relationship is represented by the following equation: calcium (mg/dl) = 14.84 - 0.139 inorganic phosphate; r = 0.915, P less than 0.001. From these series of studies, we conclude that phosphate retention is the cause of resistance to the calcemic action of PTH extract in this acute uremic model.

Assessment of depth perception in cats

A behavioural method is described for the assessment of depth perception of kittens. Measurement is made of the smallest separation in depth that can be discriminated between two adjacent stimuli under both monocular and binocular viewing conditions. Normal animals can discriminate much smaller separations in depth when using two eyes than with monocular viewing, implying the presence of a cue to depth that is uniquely available with binocular viewing. The test provides a quick and reliable way of screening animals for stereopsis.

Experience with polytetrafluoroethylene grafts in patients on long-term hemodialysis

Expanded polytetrafluoroethylene (PTFE) is a new material now being used to create subcutaneous arteriovenous anastomoses for vascular access in hemodialysis. The authors have been impressed with the versatility of grafts made from this material and, where failure occurs, the ease with which surgical revision can be carried out. Two cases are described to illustrate the adaptability of this material to reconstruction. The authors' initial impression based on 22 months' experience is that PTFE grafts have appreciably modified the management with respect to vascular access, of many patients on long-term hemodialysis.

Complications in expanded polytetrafluoroethylene arteriovenous grafts: an angiographic study

Expanded polytetrafluoroethylene grafts were used for creation of arteriovenous shunts in 35 patients on chronic hemodialysis. When flow studies or mechanical factors indicated abnormal flow in the graft, angiography was performed. Detection of venous backflow or obstruction, arterial stenosis, aneurysm formation, or graft kinking facilitated correction and thus salvage of the grafts.

Resistance to parathyroid hormone in renal failure: role of vitamin D metabolites

Resistance to the calcemic action of parathyroid extract (PTE) was shown in thyroparathyroidectomized rats after 5 hr of renal failure that was induced by either bilateral nephrectomy (NPX) or ureter ligation (UL). Studies were carried out to investigate the relationship of parathyroid resistance to the vitamin D status of the animal. Concentrations of 1,25-dihydroxycholecalciferol (1,25(OH)2D3) and 24,25-dihydroxycholecalciferol (24,25(OH)2D3) were similar in pooled sera samples from rats either UL or sham-operated and treated with PTE. Pretreatment with oral 25-hydroxycholecalciferol or with a combination of i.v. 24,25(OH)2D3 and 1,25(OH)2D3 prior to UL failed to alter the resistance. Resistance was also present in a group in vitamin-D-deficient rats. A similar group given 1 microgram of vitamin D2 showed more parathyroid resistance than did the group not given vitamin D2. In chronic renal failure of 28 day's duration, parathyroid resistance was again demonstrated, but, in contrast to the acute renal failure models, this was partly corrected by prior 1,25(OH)2D3 administration. These studies show that parathyroid resistance is not caused by an abnormality of vitamin D metabolism in the acute renal failure model, and we suggest that the phenomenon is due to the accumulation of one or more uremic factors.

Hemodynamic studies in patients with expanded polytetrafluoroethylene (PTFE) forearm grafts

21 patients with polytetrafluoroethylene grafts inserted for hemodialysis access were studied to assess the hemodynamic parameters. Mean graft flow was 1.9 l/min with a range of 0.2-3.8 l/min. Intragraft pressure varied from 1 to 83 mmHg and was dependent on systemic pressure, graft flow and the presence of stenotic lesions. Mean cardiac output was 7.1 l/min and index 4.0 l/min and was positively correlated with graft flow. By obtaining this data surgical corrective action was taken in several patients prospectively thus removing the abnormalities and ensuring continued graft patency. The techniques described are reproducible and simple and can be carried out in less than five minutes with minimal patient discomfort or hazard.

Changes in the red cell, plasma and inulin spaces and in the total water contents of rat femurs in cortisone induced osteoporosis

Measurements of the bone vascular space by use of 99mTc-labelled red cells and 131I-serum albumin, and of the 3H-inulin spaces and total water contents were carried out in female rats treated for four weeks by daily subcutaneous injections of 15 mg cortisone acetate. Significant decreases in bone vascularity, inulin space and water contents were noted as compared to controls. These changes were not associated with differences in plasma calcium values, or parathyroid gland weights. They were found to be present together with significant decreases in bone density and ash contents of the femoral shafts in the steroid-treated animals. It is suggested that the changes in the vascular and extravascular fluid spaces of bones were probably consequent upon a generally depressed level of cellular activity and bone turnover, which could be found in steroid induced osteoporosis.

Polytetrafluorethylene (PTFE) grafts for hemodialysis. 18 months' experience

18 months clinical experience with 6 mm polytetrafluorethylene forearm grafts for hemodialysis access has been described. 35 grafts were implanted, all in patients who had unsuitable vessels for construction of a regular Brescia-Cimino forearm fistula. The overall patency was 71% with mean duration of 10.3 months, and at any one time more than 85% of the grafts at risk were functional. Complications, including undesirable flow rates, edema, thrombosis, aneurysm and cardiac failure have been discussed and rational methods of avoidance described. We believe the polytetrafluorethylene (PTFE) graft represents an important advance in hemodialysis access.

Natural fluorescence in serum of patients with chronic renal failure not to be confused with creatine kinase-BB isoenzyme

We assessed the reported presence of creatine kinase-BB isoenzyme in the serum of patients with chronic renal failure. Our study showed that the blood of these patients contains a fluorescent material with an electrophoretic mobility similar to that of the BB isoenzyme on cellulose acetate strips. The fluorescing material is, however, completely distinct from BB isoenzyme and its nature is as yet undetermined.

Natural fluorescence in serum of patients with chronic renal failure not to be confused with creatine kinase-BB isoenzyme

We assessed the reported presence of creatine kinase-BB isoenzyme in the serum of patients with chronic renal failure. Our study showed that the blood of these patients contains a fluorescent material with an electrophoretic mobility similar to that of the BB isoenzyme on cellulose acetate strips. The fluorescing material is, however, completely distinct from BB isoenzyme and its nature is as yet undetermined.

Changes in red cell space of bone in hypocalcemic states: studies in rat femur

With the use of technetium-99m-labeled red cells, the red cell space of the femur was found to be increased in rats fed a 0.01 percent Ca diet for 4 wk, at which time they were also hypocalcemic. Rats fed the same diet for 2 wk did not demonstrate hypocalcemia nor hypervascularity of the femur. Thyroparathyroidectomized (TPTX) rats fed the calcium-deficient diet produced hypocalcemia nor hypervascularity as did TPTX rats fed a normal diet for 4 wk. However, bone vascularity was normal at 2 wk post-TPTX (normal diet) when the degree of hypocalcemia was less marked. Inhibition of prostaglandin synthetase with oral indomethacin 0.2 mg/100 g per 12 h for 60 h did not alter the red cell space estimates but did increase bone blood flow in both normal and calcium-deficient animals. Acute restoration of normocalcemia with CaCl2 orally in the calcium-deficient rats did not revert the bone hypervascularity. The evidence suggests that in these models of hypocalcemic states, the rise in the vascular space of bone does not result from the influence of PTH, calcitonin, diet, or prostaglandins.

Changes in red cell, plasma, inulin, and total water compartments in rat femurs. Comparison of vitamin D deficiency and diphosphonate induced rickets

The vascular space, as measured with the use of 99m-technetium-labelled red cells and 131I-serum albumin, as well as the 14C-inulin and 3H2O fluid compartments were measured in rats which had been made rachitic by the use of a low phosphate vitamin D-deficient diet. A similar group of rachitic animals fed vitamin D2 50 IU, 5 and 3 days prior to sacrifice and a weight-matched control group were also studied. The same spaces were measured in rats made rachitic by daily s.c. injections of ethane-1-hydroxy-1,1-diphosphonate (EHDP) for 4 weeks and a weight-matched saline injected control group. Findings indicated that the red cell and RISA spaces were unchanged in the untreated D-deficient group as compared to controls but increased after being repleted with vitamin D. By contrast, the vascular space was depressed in the EHDP-treated group. The water content was elevated in D-deficient rickets returning towards normal on healing, whilst both inulin and water spaces were increased in the EHDP-treated animals. Thus, while the extravascular space reflected the presence of osteoid, the vascular space depended on cellular turnover and the process of mineralization.

A new technique for measuring blood flow in polytetrafluorethylene grafts for hemodialysis

A method has been described for the measurement of blood flow in non branching grafts using the isotope dilution principle. The technique is simple, reproducible and consistent and can be performed in less than ten minutes.

The calcium and vitamin D status in an elderly female population and their response to administered supplemental vitamin D3

Recent reports have implicated the importance of impaired calcium absorption, inadequate dietary vitamin D, and low serum vitamin D levels in the genesis of metabolic bone diseases in the elderly. This study evaluated the dietary intakes of calcium and Vitamin D, calcium absorption, and serum 25 hydroxycholecalciferol (25 OH D) levels in a population of women (mean age 83 yrs) compared to healthy volunteers (mean age 35 yrs). Dietary intakes of both calcium and vitamin D and serum 25 OH D levels were found to be comparable in both groups. Calcium absorption was normal in the subjects studied and did not change significantly after two 2-week periods of oral supplementation with vitamin D3 in doses of 500 I.U./day and 10,000 I.U./day, although the serum 25 OH D levels rose significantly and comparably in both groups. Thus other etiological factors may play relevant roles in the causation of bone diseases in the elderly and unless deficient dietary or serum vitamin D levels are demonstrated, empirical supplementation with vitamin D should not be undertaken. The differences of the above findings from previously published data are discussed.

Hypomagnesemic hypocalcemia. Early serum calcium and late parathyroid hormone increase with magnesium therapy

A patient with short-bowel syndrome developed severe hypomagnesemia (0.2 mEq/liter) associated with symptomatic hypocalcemia (6.1 mg/100 ml). Parathyroid hormone (PTH) levels were normal but inappropriately low. During therapy with magnesium sulfate, an initial hypocalcemia was followed by a calcemic response without a change in PTH levels. This indicates improved bone responsiveness to circulating low levels of endogenous PTH with magnesium replenishment, which appears to be related to the restoration of magnesium-dependent cellular mechanisms. The additional observation of a slow and delayed increase in PTH, despite normal calcium levels, indicates improvement of hormone synthesis.

Technetium-99m-pyrophosphate bone scans in hyperparathyroidism

Most patients with primary hyperparathyroidism have normal 5-hr bone-to-soft-tissue ratios for 99MTc-pyrophosphate. In contrast, all five patients with advanced secondary hyperparathyroidism in this study showed significant (p less than 0.001) increases of bone uptake. In the early period after parathyroidectomy, there was no quantitative or qualitative change in uptake. A limited decrease of bone uptake was observed only after prolonged periods of observation. In itself, parathyroid activity seems to have little direct influence on bone uptake of 99MTc-pyrophosphate.

Abnormal 99mTechnetium-tin-pyrophosphate bone scans in chronic renal failure

A high incidence of abnormal 99mTechnetium-tin-pyrophosphate (99mTcPPi) is reported in a population of chronic renal failure patients. Using the 5 hour bone to soft tissue ratio as a quantitative index of increased uptake, 78% of 45 long-term dialysis patients and a similar proportion of non-dialyzed chronic renal failure patients were found to have increased uptakes. In animal studies using a uremic model, similar increased uptakes of 99mTcPPi was found with evidence of increased vascularity as reflected by red cell or plasma volumes in the bone or by the uptake of concomitantly administered 45Ca. The evidence suggests that the abnormal bone scans reflect abnormalities in collagen metabolism that occurs in the uremic state and that 99mTcPPi scans are useful in the diagnosis and management of renal osteodystrophy.

Relationship between bone uptake of 99mTc-pyrophosphate and hydroxyproline in blood and urine

In a group of hospital patients with various diseases, the urinary hydroxyproline-to-creatinine ratio showed a significant correlation (r = 0.63; p less than 0.001) with the 5-hr bone-to-soft-tissue ratio for 99mTc-pyrophosphate uptake. In patients on chronic hemodialysis, a similar correlation was found between the 5-hr bone-to-soft-tissue ratio and hydroxyproline levels in plasma and serum. The findings suggest that 99mTc-pyrophosphate binding by bone is related to collagen metabolism.

Observations on the mechanism of 99mTc-labeled phosphate complex uptake in metabolic bone disease

This communication describes a series of clinical and animal in vivo and in vitro investigations designed to elucidate the mechanism of 99mTc-Sn-phosphate complex concentration in metabolic bone disease. Rachitic and lathyritic animals were used as experimental models. Based on these studies it is concluded that 99mTc alters the pharmacology of the phosphate complexes, in particular pyrophosphate, which was the test agent most extensively employed, so that the usual affinity for mineral is for the greater part replaced by organic matrix binding. There is also evidence to suggest the immature collagen moiety of the organic matrix is the prime target of 99mTc-Sn-phosphate complex binding. Specifically, the aldehyde groups of the collagen molecule are suspected as being the major site of interaction.