Effects of medroxalol on renal function and the renin-angiotensin-aldosterone axis.

Ten subjects with hypertension received medroxalol, which blocks both alpha- and beta-adrenergic receptors, has intrinsic sympathomimetic beta 2-agonist properties and is a direct vasodilator. Renal function tests consisting of inulin clearance and p-amino hippuric acid (PAH) clearance, plasma renin activity (PRA) in recumbent and upright postures, and aldosterone excretion rate were performed. After intravenous medroxalol, inulin clearance and PAH clearance rose, renal vascular resistance fell, recumbent PRA was unchanged, and the rise in PRA with upright posture was blunted.

Rapidly progressive glomerulonephritis in a patient with syphilis. Identification of antitreponemal antibody and treponemal antigen in renal tissue.

A 37-year-old man presented with biopsy-proved rapidly progressive glomerulonephritis and a strongly positive fluorescent treponemal antibody result. The patient was treated with hemodialysis, plasmapheresis, methylprednisolone, and penicillin, with rapid improvement and stabilization of renal function. Antibody was eluted from the frozen renal tissue and demonstrated a strongly positive reaction to the treponemal antigen when used in the fluorescent treponemal antibody test.

Erythropoietin deficiency and inhibition of erythropoiesis in renal insufficiency.

The relative importance of erythropoietin (Ep) and inhibition of erythropoiesis in the anemia of chronic renal insufficiency has been investigated. Sixty patients with varying degrees of renal insufficiency, 40 normal subjects and 40 patients with anemia and normal renal function, were studied. Erythroid (CFU-E) and granulocytic (CFU-GM) progenitor cell colony formation were assayed in fetal mouse liver and human bone marrow cultures, respectively.

Hemodialysis and continuous ambulatory peritoneal dialysis effects on erythropoiesis in renal failure.

Parameters of erythropoiesis were studied in patients with endstage renal disease established on continuous ambulatory peritoneal dialysis (CAPD) and regular hemodialysis treatment (RDT). Serum erythropoietin was measured by radioimmunoassay, and erythroid progenitor cell (CFU-E) formation was assayed in fetal mouse liver cultures. Serum erythropoietin concentrations in both CAPD (35.

Impaired oxidative metabolism by leukocytes from renal transplant recipients: a potential mechanism for the increased susceptibility to infection.

Stimulated neutrophils exhibit a burst of oxidative metabolism which results in the formation of superoxide anion and other oxygen species that participate in bacterial killing. Chemiluminescence which is also produced is a sensitive measure of oxidative metabolism and correlates well with antimicrobial activity. Because infection is an important cause of morbidity and mortality in renal transplant recipients we examined chemiluminescence and superoxide production by leukocytes from transplant patients in response to a soluble (phorbol myristate acetate) and to a particulate stimulus (opsonized zymosan).

Motile curved rods in women attending a STD clinic.

Motile anaerobic curved rods were cultured from vaginal discharge of 19 of 262 women attending an STD clinic. In 26 women, motile rods were observed by examination of wet smears. In all 5 specimens culture-positive for motile anaerobic curved rods of the long type, motile rods were observed in the wet smears, while in only 6 of the 14 specimens culture-positive for motile anaerobic curved rods of the short type, were motile rods seen in wet smears.

Primary isolation of curved rods from women with vaginal discharge.

The occurrence of motile anaerobic curved rods in vaginal discharge was studied in 94 samples from women attending an STD clinic. Almost all wet smear preparations of discharge contained motile rods. Anaerobic curved rods were isolated from 46% of the samples.

Excision of mediastinal parathyroid gland by mediastinoscopy.

Mediastinal parathyroid tissue continues to be a significant problem in patients with recurrent or persistent hypercalcemia after parathyroid surgery. In two such cases, we used mediastinoscopy to locate and remove mediastinal parathyroid glands, thus avoiding the morbidity of median sternotomy.

Disseminated tuberculosis in a renal transplant recipient: presentation as an anterior mediastinal mass.

A 26-year-old man who had had a successful cadaveric renal transplant six months previously was admitted for evaluation of fever and dysuria. Chest x-ray revealed a new left pleural effusion, bilateral nodular parenchymal densities, and an anterior mediastinal mass. A biopsy of the mediastinal mass to exclude concurrent malignancy and positive AFB stains from pleural fluid and urine confirmed a diagnosis of disseminated tuberculosis.

Treatment of severe hypertension with labetalol compared with methyldopa and furosemide. Results of a long-term, double-blind, multicenter trial.

Eighty-one severely hypertensive patients were enrolled in a multicenter, double-blind, parallel group study evaluating the efficacy and safety of labetalol alone or in combination with furosemide versus methyldopa in combination with furosemide. A one day to four week placebo lead-in phase was followed by a one- to six-week titration period and a one-year maintenance period. Treatment with labetalol alone or in combination with furosemide, as well as methyldopa plus furosemide, was associated with significant reductions in supine and standing blood pressure levels.

Intravenous labetalol in the treatment of severe hypertension and hypertensive emergencies.

The antihypertensive effects of intravenous labetalol were evaluated in 59 patients with hypertensive crises or severe hypertension in need of rapid lowering of blood pressure in a multicenter study. Patients appearing with a supine diastolic blood pressure 125 mm Hg or greater, or a supine systolic blood pressure of more than 200 mm Hg received an initial mini-bolus injection (20 mg) of labetalol. This was followed by repeated incremental doses of 20 to 80 mg given at 10 minute intervals to achieve a supine diastolic blood pressure of less than 95 mm Hg or decrease 30 mm Hg or greater, or a satisfactory decrease in systolic blood pressure.

Antihypertensives and their impact on renal function.

Antihypertensive agents possess many properties that could cause alterations in renal function. These are: alterations in systemic hemodynamics, changes in the renin-angiotensin aldosterone system, direct intrarenal effects, and alterations in salt and water metabolism. This article reviews the antihypertensive agents in general usage and major points are made concerning potential deleterious effects of methyldopa and nonselective beta-adrenergic blocking drugs on renal function.

Rhabdomyolysis-induced acute renal failure in Legionnaires' disease.

A 57-year-old man with legionnaires' disease had acute renal failure as a result of nontraumatic rhabdomyolysis. This report documents an association between legionnaires' disease and rhabdomyolysis, an association only rarely suggested previously. The mechanism of rhabdomyolysis is unknown.

Chemiluminescence and superoxide anion production by leukocytes from diabetic patients.

Stimulated neutrophils exhibit a burst of oxidative metabolism which results in the formation of superoxide anion and other oxygen species that participate in bacterial killing. Chemiluminescence is also produced and is a sensitive measure of oxidative metabolism and correlates well with antimicrobial activity. Since infection is an important cause of morbidity and mortality in diabetic patients we examined chemiluminescence and superoxide production by leukocytes from diabetics in the resting state and in response to a soluble (phorbol myristate acetate) and to a particulate stimulus (opsonized zymosan).

Antihypertensive effectiveness of intravenous labetalol in accelerated hypertension.

Labetalol, an antihypertensive agent that blocks both beta- and alpha-adrenergic receptors, was administered intravenously to 19 patients with accelerated hypertension who required rapid lowering of blood pressure. Systolic blood pressure was lowered from 209 +/- 4 to 143 +/- 2 mm Hg; diastolic blood pressure was reduced from 140 +/- 2 to 93 +/- 2 mm Hg. Side-effects were minimal and included nausea, epigastric burning, rhinorrhea, and premature ventricular contractions.

Hematuria and red cell casts in typical diabetic nephropathy.

Hematuria and red cell casts are unusual urinary findings in patients with diabetic nephropathy. This glomerular disease is more typically characterized by the presence of moderate to severe proteinuria. Hematuria with red blood cell casts in patients with suspected diabetic nephropathy suggests the presence of a second, unrelated form of glomerulonephritis.

Labetalol. Current research and therapeutic status.

Labetalol hydrochloride is the prototype drug of a new class of antihypertensive agents that competitively and peripherally blocks both beta- and alpha-adrenergic receptors. It possesses approximately one fourth of the beta-blocking activity of propranolol hydrochloride and one half of the alpha-blocking activity of phentolamine. In humans, the effective beta- to alpha-blocking activity is approximately 7:1.

Early polyuria in the rat following single-dose cis-dichlorodiammineplatinum (II): effects on plasma vasopressin concentration and posterior pituitary function.

Central effects associated with DDP-induced early polyuria are described. Male Sprague-Dawley rats injected intraperitoneally with DDP (5 mg/kg) have a threefold increase in urine volume in the first 24 hr after treatment. This is accompanied by a corresponding decrease in Uosm but no decrease in renal function as indicated by serum creatinine or GFR.

Rapid typing of herpes simplex virus based on immunological specificity of viral thymidine kinase and typing according to sensitivity to iododeoxyuridine.

We describe two methods for typing of herpes simplex virus (HSV). One procedure is based on the finding that the multiplication of HSV type 1 strains in primary rabbit kidney cells is inhibited by 2 x 10(-5) M iododeoxyuridine, whereas growth of HSV type 2 strains is considerably less affected. Forty-nine different HSV isolates were typed according to this method.

Urethritis in men.

This presentation provides an overview of urethritis in men, touching on its diagnosis, clinical manifestations, epidemiology, and treatment. In men presenting with signs and symptoms of urethritis, the importance of obtaining information as to the patient's sexual contacts is stressed. Methods for obtaining smears and culture samples are discussed, with special reference to the importance of differentiating between gonococcal and nongonococcal urethritis (NGU).

Coronary angiography with Iopamidol.

Iopamidol, a new non-ionic contrast medium with low osmolality, was compared with Isopaque Coronar during selective coronary angiography in 16 patients. Iopamidol caused significantly less bradycardia, less ECG changes and less fall in blood pressure than Isopaque Coronar. No subjective adverse effects such as chest pain, vomiting, nausea or sensation of heat occurred.

Plasma clonidine concentration and pharmacologic effect.

Analysis of sequential plasma samples in 14 hypertensive subjects receiving their usual oral dose of clonidine (0.1 to 0.6 mg twice daily) indicated that clonidine plasma concentration increased for the first 2 hr and then decreased and stabilized over the next 12 hr.