Lateral subtalar dislocation. A case report.
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Biomedical subjects
Publications and source records attributed to R France.
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Sulfated glycosaminoglycans have been stained at the ultrastructural level in interstitial matrix of the rat renal papilla, using colloidal thorium dioxide at low pH. Concentration of these proteoglycans was maintained during diuresis, and was thought to be greatly diminished during antidiuresis. The possible relation of these findings to the kidney's mechanism for urine concentration and dilution is discussed.
The pattern and frequency of neurovegetative symptoms was studied in 57 patients with chronic pain. Seventy-nine percent of these patients had a diagnosable depressive illness, but endogenous depression was rare (5%). Patients with chronic pain were divided into major depressives, minor/intermittent depressives and patients with no depression. A control group of nonendogenous major depressives without pain was also utilized. Major depressives differed from the other two chronic pain groups in that there was more frequent or severe early waking, weight loss, anorexia, diminished libido and initial insomnia. Diurnal variation of mood was not a characteristic of major depression with chronic pain, and did not differ in frequency from the other two chronic pain groups. Major depressives exhibited a profile of neurovegetative symptoms very similar to that found in the control group of major depressives. Over one-third of minor/intermittent depressed patients with chronic pain exhibited atypical (reversed) vegetative symptoms of hyperphagia and weight gain. This finding, together with our review of the literature, suggests an important and previously unrecognized link between atypical depression and chronic pain.
In a controlled, evaluated study of a behaviourally orientated clinical psychology service based in a health centre two randomised groups of patients were compared. Patients in the control group received usual primary care management; subject patients received the same, but in addition were able to consult a clinical psychologist in the health centre. Outcome was assessed by psychosocial and economic measures. These showed changes in favour of the subject condition, many of which were statistically significant.
In a study of myocardial magnesium and calcium levels in 1236 samples of heart muscle taken at necropsy in 28 centres in England and Wales, samples from patients who died from ischaemic heart disease had a mean Mg level 23 microgram/g lower and a mean Ca level 4 microgram/g higher than the mean for the total series after allowance had been made for a number of relevant factors. Mg levels were slightly higher and Ca levels slightly lower in sudden than in lingering deaths. There was no evidence of any association between the tissue levels and the levels of Mg or Ca in domestic tap-water, but there was a weak association between mean tissue Mg level and IHD mortality rates in the various towns.
Studies demonstrating the antagonism by prostaglandins (PGs) of antidiuretic hormone (ADH) action led to the proposal that renal medullary PGs may act to attenuate the physiologic effects of ADH via a negative-feedback loop. Therefore, we examined urinary PG excretion, an indicator of renal PG synthesis, in rats with hereditary diabetes insipidus (DI) utilizing gas chromatography-mass spectrometry. The DI rats, devoid of ADH, excrete much less prostaglandin E2 (PGE2) than normal Long-Evans rats (39 +/- 5 vs. 228 +/- 53 ng/24 h, means +/- SE, P less than 0.005). DI and normal rats were treated for 35 days with ADH while separate groups of DI and normal controls received vehicle only. The ADH treatment increased urinary PGE2 excretion in DI rats to 233 +/- 35 ng/24 h whereas PGE2 excretion was unaffected by vehicle treatment. ADH treatment in normal rats similarly increased PGE2 excretion from 215 +/- 49 to 410 +/- 63 ng/24 h (P less than 0.05). To determine whether the rise in PGE2 excretion is the result of the rise in papillary osmolality, we subjected DI rats to dehydration, which increased urine osmolality from 130 +/- 10 to 302 +/- 12 mosmol/kg H2O but left urinary PGE2 unaffected. We conclude that ADH stimulates renal medullary PGE2 synthesis in vivo.
An electron microscopic comparison was made of intracellular granules of the renal papilla and inner medulla in two types of potassium depletion: one in a 47-year-old white male with chronic potassium-wasting renal disease and the other in the experimentally depleted rat. The granules in both cases were composed of small and large vesicles; myelin figures; small particles; and dense bodies, with a partial, or complete, single limiting membrane. Ultrastructurally, the constituent elements of the granules were essentially the same in the two types of potassium depletion. It was concluded that the intracellular granules in the human tissue were the result of potassium depletion and a counterpart to those in the potassium-depleted rat.
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