Urinary hypoxia: an intraoperative marker of risk of cardiac surgery-associated acute kidney injury.

Background: Acute kidney injury (AKI) is common after cardiac surgery and profoundly affects postoperative mortality and morbidity. There are no validated methods to assess risk of AKI intraoperatively.

Methods: We determined the association between postoperative AKI and intraoperative urinary oxygen tension (PO2), measured via a fiber optic probe in the tip of the urinary catheter, in 65 patients undergoing high-risk cardiac surgery requiring cardiopulmonary bypass (CPB).

Primary meningococcal arthritis as a presentation of nodal marginal zone lymphoma.

A 68-year-old man presented with a 4-day history of worsening knee and arm pain. On examination, there was erythema and swelling of the left knee and both wrists. Joint aspiration grew Blood tests showed an unusually high total protein level (100 g/L) and an IgM kappa paraprotein band of 45 g/L on protein electrophoresis.

Deep phenotyping of 89 xeroderma pigmentosum patients reveals unexpected heterogeneity dependent on the precise molecular defect.

Xeroderma pigmentosum (XP) is a rare DNA repair disorder characterized by increased susceptibility to UV radiation (UVR)-induced skin pigmentation, skin cancers, ocular surface disease, and, in some patients, sunburn and neurological degeneration. Genetically, it is assigned to eight complementation groups (XP-A to -G and variant). For the last 5 y, the UK national multidisciplinary XP service has provided follow-up for 89 XP patients, representing most of the XP patients in the United Kingdom.

Basal renal O2 consumption and the efficiency of O2 utilization for Na+ reabsorption.

We examined how the presence of a fixed level of basal renal O2 consumption (Vo2(basal); O2 used for processes independent of Na(+) transport) confounds the utility of the ratio of Na(+) reabsorption (TNa(+)) to total renal Vo2 (Vo2(total)) as an index of the efficiency of O2 utilization for TNa(+). We performed a systematic review and additional experiments in anesthetized rabbits to obtain the best possible estimate of the fractional contribution of Vo2(basal) to Vo2(total) under physiological conditions (basal percent renal Vo2). Estimates of basal percent renal Vo2 from 24 studies varied from 0% to 81.

STUDIES ON THE SUPRARENAL CORTEX : VI. THE EFFECT OF SUPRARENAL CORTICAL HORMONE UPON THE ELECTROLYTE EXCRETION OF THE INTACT NORMAL DOG. A PROPOSED METHOD OF COMPARATIVE ASSAY.

The effect of the administration of suprarenal cortical hormone upon the excretion of sodium and potassium has been studied on normal dogs. It is shown to be qualitatively similar to the effect of this hormone upon suprarenalectomized animals and upon patients with Addison's disease. The phenomenon is proposed as the basis for a suitable method for comparative assay of suprarenal cortical extracts.

STUDIES ON THE SUPRARENAL CORTEX : V. THE INFLUENCE OF THE CORTICAL HORMONE UPON THE EXCRETION OF WATER AND ELECTROLYTES IN THE SUPRARENALECTOMIZED DOG.

1. The withdrawal of maintenance injections of the cortical hormone from the suprarenalectomized dog during balance experiments, in which a constant meat diet is given, with constant fluid and salt intake, is followed by increased urinary loss of sodium and chloride, and by retention of potassium and nitrogen. 2.

STUDIES ON THE SUPRARENAL CORTEX : IV. THE EFFECT OF SODIUM SALTS IN SUSTAINING THE SUPRARENALECTOMIZED DOG.

1. A group of experiments is reported in which bilaterally suprarenalectomized adult male dogs have been maintained in apparently normal condition over prolonged periods, up to 5 months, without the use of any suprarenal gland preparation or extract and by the administration of sodium chloride and sodium bicarbonate alone. Withdrawal of the salts then produced typical suprarenal insufficiency.

STUDIES ON THE SUPRARENAL CORTEX : III. PLASMA ELECTROLYTES AND ELECTROLYTE EXCRETION DURING SUPRARENAL INSUFFICIENCY IN THE DOG.

A characteristic alteration in the electrolyte structure of the blood plasma of the suprarenalectomized dog occurs when injections of cortical extract are stopped. This alteration progresses during the course of the suprarenal insufficiency, parallel with the hemoconcentration and the loss in weight. When injections of cortical extract are resumed, the electrolyte structure returns to its original form, the alterations paralleling the dilution of the blood and the return of the body weight to its original level.

STUDIES ON THE SUPRARENAL CORTEX : II. METABOLISM, CIRCULATION, AND BLOOD CONCENTRATION DURING SUPRARENAL INSUFFICIENCY IN THE DOG.

1. The basal oxygen consumption, respiratory quotient, blood flow, blood pressure, and the changes in concentration of the arterial blood were determined in suprarenalectomized dogs (a) when receiving injections of cortical extract (Swingle-Pfiffner), (b) during suprarenal insufficiency induced by withdrawal of the injections, and (c) during the period of recovery brought about by resumption of extract injections. 2.

STUDIES ON THE SUPRARENAL CORTEX : I. CORTICAL SUPRARENAL INSUFFICIENCY AND THE ACTION OF THE CORTICAL HORMONE UPON THE NORMAL AND SUPRARENALECTOMIZED DOG.

1. The methods used in the operation and care of suprarenalectomized dogs are given. 2.

STUDIES ON BLOOD CELL METABOLISM : I. THE EFFECT OF METHYLENE BLUE AND OTHER DYES UPON THE OXYGEN CONSUMPTION OF MAMMALIAN AND AVIAN ERYTHROCYTES.

1. The respiratory metabolism of non-nucleated mammalian erythrocytes is enormously accelerated and approaches the magnitude of the metabolism of the nucleated erythrocytes of birds on the addition of methylene blue (and certain other dyes), to a final concentration of 0.005-0.

THE OXYGEN AND CARBON DIOXIDE CONTENT OF ARTERIAL AND OF VENOUS BLOOD IN NORMAL INDIVIDUALS AND IN PATIENTS WITH ANEMIA AND HEART DISEASE.

1. The oxygen content of venous and of arterial blood from fifteen essentially normal individuals at rest in bed has been determined. 2.