Study of the relative timing of shear forces on the sole of the forefoot during walking.

A portable recording device for the measurement of ambulatory longitudinal shear forces in a horizontal plane under the forefoot is described. The timing of the shear forces under 40 feet has been investigated, together with the relationships to each other and to body weight, leg length, cadence, velocity and stride length: they are compared by regression analysis. Shear forces under the forefoot are shown to occur for approximately 73-80% of the stance time. The maximum longitudinal shear forces and the maximum vertical forces are shown to occur at the same time under the first, fourth and fifth metatarsal heads.

Forces under the foot.

A transducer has been developed to record the shear or horizontal components of force beneath the sole of the foot. When used with a vertical force transducer it has enabled a comprehensive analysis of the mechanical forces acting beneath the foot when walking in various types of footwear. Considerable differences have been recorded between the footwear. Particularly low forces are present in a plaster cast and to a lesser extent with Plastazote insoles. The possible application of these findings to the management of ulceration of the sole of the foot in diabetes mellitus and leprosy is discussed.

An examination of the xenon clearance method.

A definition of cortical and juxta-medullary regions is suggested based on a grouping of nephrons of common flow characteristics. A possible error is suggested in the xenon clearance method of measuring the regional flows. Experiments to test the source of error and its magnitude are described. It is concluded that while the error is present its effect on conventional component analysis is small.

The renal blood flow and the glomerular filtration rate of anaesthetized dogs during acute changes in plasma sodium concentration.

1. The effects of acute changes in plasma Na concentration (P(Na)) on renal blood flow (RBF) and glomerular filtration rate (GFR) were studied in anaesthetized greyhounds. Saline was infused at a constant rate (0.1 ml. kg(-1) min(-1)) either into a renal artery or into a systemic vein. Plasma Na concentration was altered by varying the Na concentration of the infused saline from 0.154 to 0.077, 0.616 or 1.232 M.2. Blood pressure (B.P.), packed cell volume (PCV), concentration of plasma solids (PS) and the plasma concentration of H(+) and K (P(K)) ions were measured but no attempt was made to contain their fluctuation.3. An infusion of hypertonic saline into a renal artery usually led to an ipsilateral increase in RBF for 5-15 min, followed by a progressive fall. Over-all, mean values of RBF fell with P(Na) throughout the range studied (120-190 m-mole l.(-1)). Glomerular filtration rate rose with P(Na) to reach maximal values at P(Na) levels of 140-160 m-mole l.(-1), but fell thereafter. The combined fall in RBF and GFR, without change in filtration fraction, at P(Na) values above 160 m-mole l.(-1) is consistent with an alteration in afferent arteriolar resistance. The fall in GFR despite a rise in RBF noted when P(Na) was reduced below 140 m-mole l.(-1) requires an additional explanation.4. Renal blood flow was independent of P(K); it was inversely related to [H(+)] and directly related to PS. Glomerular filtration rate was independent of PCV and P(K). It was also inversely related to [H(+)] and directly related to PS up to a value of 6 g 100 g(-1) plasma, after which the relationship was reversed. These results suggest that the renal vascular responses to acute changes in P(Na) may be mediated in part, at least, by concurrent change in PS and [H(+)].

Plasma sodium concentration and sodium excretion in the anaesthetized dog.

1. The effect of acute alterations of plasma sodium concentration (PNa) on renal sodium excretion (UNaV) was investigated by three types of experiments on anaesthetized dogs: (a) A local increase in PNa at one kidney was produced by infusion of hypertonic saline directly into its artery while systemic levels of PNa were stabilized by haemodialysis. (b) Systemic levels of PNa were lowered by exchange transfusion of blood for an equal volume of salt-free dextran-in-dextrose solution. The results were contrasted with those observed after similar exchanges, but using dextran-in-saline solution. (c) The level of PNa was altered by varying the sodium concentration of a saline solution infused at a fixed rate either intravenously or into one renal artery. 2. All three types of experiment suggest a dependence of UNaV on PNa Analysis demonstrated that this relationship was not due to contemporary changes in: packed cell volume; plasma solids concentration; plasma potassium concentration; blood pressure or plasma hydrogen ion concentration. The distribution of these variables did not change with PNa except for plasma hydrogen ion concentration. Moreover, the relationship persisted when data were selected to exclude clearance periods in which the value for any variable had shifted past the group mean obtained before PNa was altered. 3. The fall in UNaV at low levels of PNa could be attributed to a fall in glomerular filtration rate (GFR), but the progressive rise in UNaV seen as PNa exceeded 150 m-mole 1(-1) occurred despite a fall in GFR and no apparent change in the mean filtered load of sodium. These results suggest that the increased sodium excretion accompanying raised levels of PNa is due to reduced tubular re-absorption of sodium.

The effect of acute changes in haematocrit in the anaesthetized dog on the volume and character of the urine.

1. Acute changes in haematocrit were produced by exchange transfusion of dextran-in-saline or packed red cells.2. There were no significant changes in glomerular filtration rate, blood pressure, central venous pressure, heart rate, respiratory rate, blood volume or extracellular fluid volume following the exchange transfusions.3. Urine volume increased after haemodilution but decreased after haemoconcentration.4. The diuresis after haemodilution occurred despite an infusion of ADH or alcohol. Thus it could not be attributed to a change in circulating ADH level.5. There were two types of diuresis. The ;water diuretic' response was characterized by an increase in free water clearance with a reduction in urinary sodium concentration; the ;sodium diuretic' response by an increase in urinary sodium concentration but no change, or a fall, in free water clearance.6. The results were related to changes in medullary osmotic gradient found by other workers to occur when medullary blood flow rate is altered.

The effects of changes in haematocrit on the intrarenal distribution of blood flow in the dog's kidney.

1. The effect of changes in the haematocrit of blood perfusing the kidney on its intrarenal distribution was studied in dogs.2. Two types of preparations were employed. (i) In the isolated perfused kidney evidence is presented that flow in the autoregulating preparation represents predominantly cortical flow while flow in the ;low flow non-autoregulating' kidney reflects medullary flow. (ii) In the intact kidney renal blood flow rate and its intrarenal distribution was studied by the injection of (133)Xe into the renal artery and measuring its clearance from the kidney by an external counter.3. In both types of preparation cortical flow was found to be independent of changes in P.C.V. but medullary flow varied inversely with haematocrit.4. A change in the haematocrit of the perfusing blood leads to alteration of its viscosity. It was argued that an increase in viscosity must lead to a reduction in the resistance of the cortical afferent arterioles but that medullary afferent arterioles were not able to respond in this manner.5. These findings demonstrate that changes in total body haematocrit cause a redistribution of blood flow between renal cortex and medulla.