Cryptococcal chorioretinitis with immune reconstitution inflammatory syndrome.

Immune Reconstitution Inflammatory Syndrome (IRIS) is an inflammatory syndrome in the context of immune restoration directed at a specific infectious antigen despite resolution of infection, often associated with opportunistic infections. IRIS has been reported in 30% to 35% of HIV patients who have cryptococcosis in whom antiretroviral therapy was initiated. We would like to report a case of IRIS localized to the eye secondary to cryptococcal infection.

Lichen simplex chronicus - A Psychocutaneous disorder?

Lichen simplex chronicus is classified as a skin disorder determined or influenced by emotional factors. This study was conducted to determine the involvement of the psyche in this psychocutaneous disorder. Forty six patients of lichen simplex chronicus were chosen for this study.

Multidrug resistant Mycobacterium tuberculosis in patients with human immunodeficiency virus infection.

Multidrug resistant Mycobacterium tuberculosis (MDR-MTB) infection has not been recognized as a serious problem in patients with human immunodeficiency virus (HIV) infection. Multidrug resistance (MDR) has appeared in our medical center in 24 out of 72 patients between January 1990 and May 1991 compared to 8 out of 132 patients within the period from 1982 to 1987 (relative risk 5.50 with 95 percent confidence interval 2.

Cardiopathia fantastica and arteritis factitia as manifestations of Munchausen syndrome.

We describe three patients, each with a cardiovascular presentation of Munchausen's syndrome. Two patients' symptoms masqueraded as unstable angina (cardiopathia fantastica); one required intra-aortic balloon counterpulsation, while repeated cardiac catheterizations revealed normal coronary arteries. The third patient, with at least 27 documented hospital admissions, first presented as the cardiopathia fantastica variety and progressed to recurrent thromboembolism and limb amputations as a result of iatrogenic complications induced by angiographic and surgical procedures (arteritis factitia).

Water extraction from the inner medullary collecting tubule system: a role for urea.

Recent examinations of the inner medullary collecting tubule membrane in vitro have demonstrated that its reflection coefficient to urea (sigma urea) is significantly less than unity and less than sigma NaClhe presence of antidiuretic hormone. Fluid entering the inner medullary collecting tubule has a higher urea concentration and lower NaCl concentration than does the medullary interstitium, although total osmolarity is nearly equal on either side of the membrane. The transtubular difference in solute composition, together with the difference between sigma urea and sigma NaCl, should result in a driving force for extraction of water from the tubule.

An examination of transcapillary water flux in renal inner medulla.

We recently demonstrated that net fluid uptake occurs in the capillary system of the inner medulla. To define the site of fluid uptake, the concentration of protein was determined in plasma from descending vasa recta at the base and tip of the exposed papilla in Munich-Wister rats. The vasa recta plasma-to-arterial plasma protein concentration ratio (VR/P) was 1.

Potassium secretion by the decending limb or pars recta of the juxtamedullary nephron in vivo.

Potassium reabsorption by the juxtamedullary nephron up to the hairpin turn was studied by the micropuncture technique in the exposed renal papilla of rats. In 18 nondiuretic rats, the fraction of filtered potassium remaining at the end of the desdending limb averaged 113 +/- 9%, indicating either that potassium is not reabsorbed by the juxtamedullary proximal tubule and descending limb or that potassium is reabsorbed and secreted in those segments. Furosemide, a drug which inhibits NaCl reabsorption in the ascending limb downstream from the descending limb, significantly decreased the potassium remaining at the end of the descending limb from 106 +/- 12 to 72 +/-11% in seven rats.

Hydraulic and oncotic pressure measurements in inner medulla of mammalian kidney.

The vasa recta are thought to play an important role in the transfer of water andsolutes within the renal medulla. Hydraulic pressures were measured in vasa recta onthe surface of the exposed papilla in young Munich Wistar rats, and blood was collected from these microvessels for determination of total protein concentration and calculation of colloid oncotic pressure. In descending vasa recta at the base of the exposed papilla, mean hydraulic pressure was 9.

The effect of urea infusion on the urinary concentrating mechanism in protein-depleted rats.

To explore the role of urea in the urinary concentrating mechanism, the contents of vasa recta, Henle's descending limbs and collecting ducts were sampled by micropuncture of the renal papilla before and after infusion of urea in 10 protein-depleted rats. Eight protein-depleted rats not given urea were similarly studied as a control group. After urea administration, osmolality and the concentrations of urea and nonurea solute of urine from both exposed and contralateral kideny increased significantly.