Biomedical subjects
Publications and source records attributed to W Trebbin.
When interpreting renal sonograms, one should be aware of the possibility of mistaking fat and scarring in the renal fossa for a normal kidney in a patient with a history of prior nephrectomy. When in doubt, the ultrasound findings should be confirmed with a CT scan.
The urinary excretion of kininogen, kallikrein (total and active), and kinins were measured in 7 men with severe liver disease and ascites. The results were compared with a group of normal controls matched for sodium excretion. Significant reductions in kinin excretion were noted in the patients with liver disease which could not be accounted for by differences in age, plasma renin, aldosterone excretion or sodium excretion. Both active kallikrein and kininogen excretion were reduced suggesting that deficiencies of enzyme and substrate contributed to the kinin deficiency. The importance of kininogen in the physiologic regulation of kinin excretion in this clinical state is discussed.
The kallikrein-kininogen-kinin system (KKK) has been implicated in the renal sodium excretion response to changes in dietary sodium. However, both increases and decreases in the activity of this system have been observed when urinary sodium excretion is augmented by a variety of maneuvers. To further evaluate the potential physiologic role of this system, we measured three components of the KKK system in urine. Total kallikrein, intact kininogen, and kinin were measured twice in normal individuals during balance on both a high (250 mEq/day) or low (10 mEq/day) sodium intake. A consistent and significant reduction in the activity of all three components of the KKK system was noted during the high salt intake. Furthermore, during the high sodium intake, further acute reductions in components of this system were observed when an acute saline but not water load was administered. The consistent response of the various components of the KKK system to both acute and chronic sodium loading suggests that the system is physiologically linked to the regulation of sodium balance. However, the directional changes argue against a primary natriuretic effect of this system.
The case of a man who developed a leiomyosarcoma in association with a surgically created arteriovenous fistula is reported. This unusual complication of a dialysis fistula is the first reported case of a leiomyosarcoma occurring in a surgically created fistula.