Search

Of 74 patients undergoing long-term hemodialysis who were observed during a 21-month period, seven developed uremic pericarditis. Five of these patients developed intractable pericarditis, unresponsive to intensive dialysis and pericardiocentesis, and were treated with prolonged pericardial drainage (16 to 60 hours) by an indwelling polyethylene catheter and instillation of triamcinolone hexacetonide. Evidence of intractability was based on either the recurrence of cardiac tamponade after pericardiocentesis (two patients) or progression in the size of the pericardial effusion despite four weeks of intensive dialysis (three patients). These five patients recovered and subsequently were observed from 1 to 15 months with no evidence of recurrent pericarditis. This procedure may be an effective alternative to the surgical management of intractable uremic pericarditis, particularly in the patient at high risk for anesthesia and major surgery.

Chronic renal failure in man is associated with hyperglucagonemia that is not corrected by hemodialysis. Plasma glucagon concentrations were measured in nine patients before and after renal transplantation. Mean plasma glucagon concentration in eight patients with chronic renal failure before transplantation was 295 plus or minus 171 pg/ml (plus or minus SD). After successful transplantation, mean plasma glucagon concentration fell to 134 plus or minus 81 pg/ml (plus or minus SD) (P less than 0.001). Plasma glucagon concentration remained elevated in an additional patient who received a cadaveric graft that never functioned. Immunologic rejection of transplanted kidneys was associated with a dramatic increase of plasma glucagon concentration.

Argon ions were accelerated to 1.17x10(10) electron volts in the Princeton Particle Accelerator. The synchrotron was tuned by use of a neon beam with a charge-to-mass ratio equal to that of the argon ions. The fully accelerated argon ions were detected by the observation of etched tracks in cellulose nitrate sheets and also by the use of scintillation counters. Predictions of the range and of the characteristics of argon tracks in plastics were confirmed.

Glucose reabsorption was measured in dogs in which sodium reabsorption was stimulated by obstruction of the thoracic inferior vena cava or inhibited by volume expansion with Ringer's lactate. Glucose reabsorption was much higher during periods of enhanced sodium reabsorption than during sodium diuresis. The relationship of glucose reabsorption to glomerular filtration rate was examined using data from animals that had fractional sodium excretion rates of less than 1%. Under this condition the relationship of glucose reabsorption to glomerular filtration rate is highly linear. When points obtained during sodium diuresis (C(Na)/GFR>0.1) are plotted on the same graph, glucose reabsorption at any given glomerular filtration rate is much less than during antidiuresis. Glucose reabsorption divided by glomerular filtration rate varies inversely with fractional sodium excretion. This study demonstrates that glomerular tubular balance for glucose exists in the dog and that this balance is changed when sodium reabsorption changes.

Nitrogen ions in charge states N(5+) and N(6+) have been accelerated in the Princeton Particle Accelerator to 4 and 7.4 billion electron volts (Gev), respectively. An external N(5+) beam of 1 x 10(6) particles per second has been obtained and focused to a 6-millimeter-diameter spot. The N(6+) beam was about 2 x 10(5) particles per second. The total charge-changing collision cross section of N(5+) in water vapor was determined as a function of ion energy. The improvement in vacuum necessary to increase the N(5+) beam at least tenfold was calculated. The N(6+) total cross section is probably smaller than that of N(5+) at the higher energies.