We investigated the functional and hemodynamic effects on the kidney of tris (hydroxymethyl) amino methane (THAM) infusion during sustained hemorrhagic hypotension in dogs. The large osmotic load introduced into the vascular compartment during hemorrhagic hypotension resulted in a marked reduction in systemic vascular resistance and a return of cardiac output, total renal blood flow, and the renal arteriographic pattern to normal range. The observed diuresis is probably due to an osmotic effect, because the glomerular filtration rate remains significantly depressed. Anatomical assignment of the mathematical components of the xenon washout curve led to an assessment of intrarenal blood flow distribution that was at variance with the arteriographic pattern and the intrarenal distribution of tagged microspheres.

Animals↗

PubMedDate not supplied

Computed tomography of posterior lumbar apophyseal ring fractures.

Lumbar apophyseal fracture is an uncommon injury that occurs during adolescence. We described two cases in young adults with back pain. The radiographic findings were distinctive. In both cases CT demonstrated characteristic bony fragments displaced posteriorly into the spinal canal and a corresponding defect in the posteroinferior aspect of the vertebral body rim. Recognition of this entity is important in evaluating back pain in both adolescents and adults.

Adult↗

PubMedDate not supplied

Reiter's syndrome: a male and female disease.

A diagnosis of Reiter's syndrome was made in 12 males and 13 females based on an asymmetrical oligoarthritis with lower extremity predominance and at least 1 characteristic extraarticular manifestation. The pattern of disease was similar in both sexes; females had more extensive upper extremity joint involvement and ocular inflammation; males had more nonbacterial urethritis. Eighty-two % of males and 62% of females were HLA-B27 positive. We suggest that Reiter's syndrome has not been diagnosed in more females in the past because of an historical bias, a reliance on the complete classical triad, and confusion with seronegative rheumatoid arthritis.

Adolescent↗