ABSTRACT
Along with hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), which performs the work of the kidneys, is used in treating chronic renal failure. CAPD (hereafter referred to as PD) can be conveniently done at the patient's home.Other advantages of it include less adveres effects on the cardiovascular system as homeostasis of body fluid is maintained;less dietary restriction;reduction in the frequency of outpatient treatment;availability of a system suited to the patient's lifestyle;and being comparatively easy to return to work. Nonetheless, home PD patients remain at risk of peritonitis, exit-site infection, and undernutrition due to protein-losing enteropathy. Moreover, patients may feel that they have gotten wary of taking care of themselve. Recently, we have come upon a case of end-stage renal failure in a 59-year-old articular rheumatic who was unable to exchange dialysis bags because her finger joints were deformed. So, we applied a PD system using the SMAP method to the patient with the result that she became able to manage to operate the PD by herself.Our patient wished to take it upon herself to perform PD using a UV-F twin-bag system. Ordinarily, bags have to be exchanged four times a day and every time bags are exchanged, several clamping procedures are required. It was impossible for her to exchange bags because of deformed finger joints. To make the impossible possible, a supplementary device for exchanging bags had to be fixed. It was also necessary for her to learn how to manipulate the newly attached device in addition to the existing device. With the SMAP method, there is plenty of time before PD gets started. So it was possible to examine the self-management method thoroughly and learn the trick of operating the new device. Our experience showed that PD by the SMAP method is useful to articular rheumatic patients with finger joint deformities.
Subject(s)
Patients , Peritoneal Dialysis, Continuous Ambulatory , Fingers , JointsABSTRACT
Objectives : The present study investigates the effects of body iron stores upon indices of biosynthesis and destruction of red blood cells (RBC) induced by a single session of cycling exercise.<BR>Design : Eight sedentary female students were divided into groups depending on their body iron stores : normal (C group, n=5) and iron deficient (D group, n=3) . Blood samples were collected at five time points of before (pre), immediately after (0 hours), then 1, 3 and 6 hours after exercise (248±31 kcal, 70% V0<SUB>2</SUB> peak level) . Osmotic fragility and serum haptoglobin (hp) concentration served as of for degradation, and δ-aminolevulinate dehydratase (ALAD) activity, erythropoietin concentration and number of reticulocytes served as indices of RBC biosynthesis.<BR>Results : A single session of cycling exercise did not affect the level of RBC, hemoglobin, hematocrit, serum iron, ferritin, transferrin saturation, hp and osmotic fragility in either groups. The δ-ALAD activity increased at 3 (p<0.05) and 6 hours (p<0.01) after exercise compared with that at 0 hours in the C group. In contrast, δ -ALAD activity in the D group was significantly lower at 3 hours after exercise than that of C group (p<0.001) . Reticulocytes and erythropoietin concentration increased gradually in the C group after exercise, but not in the D group.<BR>Conclusions : A single session of cycling exercise under our experimental conditions enhanced RBC biosynthesis indicated by δ -ALAD activity, whereas exercise-induced hemolysis was not evident. Body iron stores affect the δ -ALAD activity induced by a single bout of cycling exercise.
ABSTRACT
We have reported that many chrysanthemum- and lettuce-growers have dermatitis caused by juice of the leaves of these plants and that this dermatitis is caused by an allergic mechanism. In arecent questionnaire on the cause of this dermatitis, half the farmers answerd that it was due to agricultural chemicals. Therefore, we tested the farmers by skin patch tests with several widely used chemicals. In the tests, daconil gave the strongest reaction, results being positive in 60% of the farmers. Daconil was very irritative and phototoxic, the percentage of positive reactions in the patch test with 800 times diluted daconil solution of the concentration commonly used being about 30% after 48 hours and about 60% at 48 hours after peeling off the patch.<BR>The parcentage of positive reactions in the skin patch test with several fractions of chrysanthemums on chrysanthemum-growers were significantly higher than non-farm-workers. Similary, tests with allergen extracted from lettuce showed a significantly higher percentage incidence in lettuce -growers than in other subjects. The patch test with 4000 times diluted daconil solution showed ahigher incidence in farmers than in other subjects. Therefore, 4000 times diluted daconil solution seems to cause allergic contact dermatitis in farmers, and as farmers reported, dermatitis seems to be caused by allergy to farm products, and the irritability, phototoxicity and allergenicity of TPN (Daconil).