RESUMO
Secondary hyperparathyroidism is ubiquitous in patients with end-stage renal disease who are on dialysis. We report a dialysis patient with an unusual manifestation of hyperparathyroidism. Initially, the patient was misdiagnosed to have clavicular osteomyelitis. The underlying hyperparathyroidism was not recognized, only to be discovered later, when the patient presented with spastic paraplegia and massive ectopic calcification in the cervical spine. The patient made a complete recovery following surgical resection and parathyroidectomy.
Assuntos
Calcinose/complicações , Vértebras Cervicais/patologia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/complicações , Falência Renal Crônica/complicações , Paraplegia/etiologia , Diálise Renal , Calcinose/etiologia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/etiologia , Distúrbio Mineral e Ósseo na Doença Renal Crônica/cirurgia , Humanos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Doenças da Coluna Vertebral/complicações , Doenças da Coluna Vertebral/etiologiaRESUMO
The rate of aqueous formation was measured with fluorophotometry in a group of 113 normal human subjects who ranged in age from 20 to 83 years. A slight decrease in the rate of aqueous humor formation with aging was detected, but the rate was remarkably stable. The rate of aqueous humor formation was more stable than intraocular pressure or anterior chamber volume in this group and more stable than the tonographic C value reported by other investigators.
Assuntos
Envelhecimento , Humor Aquoso/fisiologia , Adulto , Idoso , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-IdadeRESUMO
Measurements of corneal thickness, endothelial cell size, endothelial permeability to fluorescein, and intraocular pressure were made in two groups of human subjects: 21 persons with cornea guttata (early Fuchs dystrophy without epithelial edema) and 17 persons age- and sex-matched but with normal corneas. Statistically significant differences were found between the two groups in all four measured variables. The two groups did not differ with respect to the variability in endothelial cell sizes. There were statistically significant positive correlations between endothelial permeability to fluorescein, endothelial cell size, and corneal thickness. The endothelial pump rate was calculated for each group, and the difference was not statistically significant. Our results suggest that the earliest defect in Fuchs' dystrophy is solely a breakdown in barrier function and thus increased permeability, resulting in a thicker cornea.
Assuntos
Córnea/patologia , Distrofias Hereditárias da Córnea/patologia , Distrofia Endotelial de Fuchs/patologia , Adulto , Idoso , Córnea/citologia , Córnea/fisiopatologia , Endotélio/citologia , Endotélio/patologia , Endotélio/fisiopatologia , Feminino , Fluoresceínas , Distrofia Endotelial de Fuchs/fisiopatologia , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , PermeabilidadeRESUMO
The relationship of plasma calcium levels to changes in plasma specific gravity, total protein, and albumin induced by venous stasis was investigated. Factors were derived for adjusting calcium results to offset the effects of variation in protein concentration and thus to make them of increased discriminatory value to the clinician. The validity of an existing specific gravity correction has been substantiated, but a more exact adjustment of 0.23 mg/100 ml of calcium for every 0.001 change in specific gravity is proposed. We recommend for automated laboratories that the factor based on albumin be used: 0.09 mg/100 ml of calcium should be subtracted from the total calcium value for every increase of 0.1 g in albumin above 4.6 g/100 ml, and a corresponding addition should be made for values of albumin below 4.6 g/100 ml.Using a calcium specific electrode, it has been shown that the ionized calcium concentration does not alter with prolonged venous stasis.
