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Effect of dialysate volume on peritoneal dialysis kinetics. The effect of peritoneal dialysate volume on the rates of transperitoneal urea and creatinine equilibration was determined over a 120-min sampling period. Equilibration half-time (t 1/2 ) was prolonged when volume was increased from 1 to 2 to 3 liters. Some data suggest this delay was not attributable to a decrease in peritoneal permeability or blood flow. If that is true, our data indicate that slower urea equilibration with larger dialysate volumes is due to changes in volume/surface area relationships. Because solutes equilibrated more rapidly into 1 liter than into 2 liters, peritoneal clearances using an exchange schedule of 1 liter every 30 min were comparable to those obtained with 2 liters exchanged every 60 min. Therefore, patients susceptible to cardiopulmonary complications may be dialyzed without loss of efficiency by infusing 1 liter every 30 min instead of the usual 2 liters every 60 min. Effet du volume de dialyse sur la cinetique de la dialyse peritoneale. L'effet du volume du dialysat peritoneal sur les vitesses d'equilibration transperitoneale de l'uree et de la creatinine a ete etudie pendant une periode de prelevements de 120 min. Le temps de demi-equilibration (t 1/2 ) est allonge quand le volume est augmente de 1 a 2 et de 2 a 3 litres. Certains faits suggerent que ce retard n'est pas attribuable a une diminution de la permeabilite ou du debit sanguin peritoneaux. Dans ce cas nos resultats indiqueraient que l'equilibration plus lente de l'uree, quand le volume de dialysat est plus grand, serait liee aux modifications du rapport volume/surface. Du fait que les substances dissoutes s'equilibrent plus rapidement dans 1 l que dans 2 l les clearances peritoneales sont comparables dans un programme d'echange d'un litre toutes les 30 minutes a celles obtennes dans un programme d'exchange de 2 litres toutes les 60 minutes. Par consequent il est possible de dialyser les malades exposes a des complications cardiopulmonaires sans perte d'efficacite, en injectant 1 litre toutes les 30 minutes au lieu des 2 litres habituels toutes les 60 minutes.

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The object of my study was an attempt to discover what social factors might be said to contribute to either mental health or mental ill-health in old age. I studied the histories of four groups of 50 aged in four different settings which in retrospect might be said to form a spectrum. That is to say that each subsequent social background seemed to be more conducive to normal ageing than the preceding one. The actual sequence of the whole investigation, for technical reasons, was, however, as follows: In the first place I made contact with patients in Tooting Bec Mental Hospital; as a second group I chose people in a Club for Old Age Pensioners in Streatham; thirdly, I visited old people living by themselves in Fulham; and finally, 1 interviewed a group who are living on an Estate at Mill Hill, the Estate being maintained by the Society of Linen and Woollen Drapers. In all but the last sample I studied the cases of 25 men and 25 women.

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Das Durchschnittsalter der Patienten zum Zeitpunkt der Entdeckung einer einseitigen Merenagenesie im Krankengut der Mayo-Klinik einer neueren Aufstellung betragt etwa 37 Jahre. Das bedeutet, das die einseitige Merenagenesie ein Zufallsbefund sein kann, auf den kaum klinische Symptome hinzuweisen vermogen. In der Kinderurologie ist dieser Befund nicht ganz so zufallig. Bei 13 unserer 16 Patienten der letzten 10 Jahre waren es rezidivierende Urininfekte und Gedeihstorungen oder andere zusatzliche Misbildungen, die zur Abklarung des Urogenitalsystems fuhrten. Nur bei dreien waren es reine Zufallsbefunde etwa der Art, das nach einem Sturz auf die rechte Flanke mit nachfolgender Hamaturie ein i.v. Pyelogramm und die weiteren Zusatzabklarungen eine Merenagenesie der linken Seite zeigten.

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