Gynecomastia: a clinical experience.

The purpose of this manuscript is to describe a one year experience with Gynecomastia. The patients studied were men who came to the clinic with breast enlargement. The clinical experience appeared to reflect an unexpected number of patients with this diagnosis. The result revealed thirty percent of this group had potentially progressive underlying causes of Gynecomastia.

Chagas' disease: a case in south Mississippi.

Chagas' Disease is common in Central and South America. As the number of immigrants increase in the United States and North America the incidence of Chagas' Disease is increasing. This is a report of chronic Chagas' Disease diagnosed on the Gulf Coast. A review of the recent literature suggests seropositivity in the United States to be approximately 350,000 people with approximately 100,000 cases of chronic Chagas' Disease. The triad of cardiomegaly, megaesophagus, and mental disease are common symptoms. A case report, literature review, epidemiology, and diagnostic studies are presented.

Chronic hemodialysis in the anephric goat.

The Spanish brush goat (Capra hiricus) was studied as an animal model for the anephric state. This rugged animal has a hardy appetite and offers ready blood access for dialysis and sampling. BUN, plasma creatinine and potassium could be brought to normal values by daily hemodialysis. Continual weight loss, severe anemia and some tendency for the development of hypertension were observed despite dialysis. Maintenance of a healthy rumen proved a continual challenge but was possible by hyperalimentation and vigorous dialysis immediately postnephrectomy.

Myocardial depressant effects of sodium acetate.

Sodium acetate produced a direct, dose-related decrease in myocardial contractile force in the dog and isolated rabbit papillary muscle. In the dog, there was also a decrease in blood pressure which was attributed primarily to the fall in contractile force. However, sodium acetate was found to have weak vasodilator properties as shown by the decreases in hind-limb perfusion pressure.

Vibrometry and uremic peripheral neuropathy.

The vibratory sensation threshold (VST) was measured with a vibrometer to assess the progression of neuropathy in patients with end-stage renal disease. Normal patients and patients receiving chronic hemodialysis were studied. We found that the longer the patients were dialyzed, the lower their VST (P less than 0.01). Regression equations were established to predict threshold values versus age of both groups, and VST versus months on dialysis in the patient population. Vibrometry was an important addition to the assessment of peripheral neuropathy in our dialysis patients. It offers low cost, little patient preparation, and requires little professional time for examination and interpretation.

Direct renal effects of sodium acetate in the dog.

Sodium acetate (AC) is used in clinical medicine as it provides a ready source of fixed base. The direct renal dynamics of this buffer salt are not well known. In anesthetized dogs the left renal artery was infused with solutions of AC. In concentrations of 0.1 to 0.5 muEq/min, the acetate ion was always immediately detected in the urine. There were no demonstrable renal changes in volume, PAH clearance, creatinine clearance or electrolytes during the perfusion periods. Direct infusion of AC into the renal artery did not cause any change in blood pressure. We conclude that AC in the conditions of our experiments did not cause renal vasodilation or changes in renal excretions patterns and appears to have a zero renal threshold.

Effect of sodium acetate infusion on renal function in the dog.

Sodium acetate (AC) is routinely used in dialysis solutions in hemodialysis units as it provides a ready source of fixed base. The renal dynamics of the buffer salt are not well known. Anesthetized dogs received i.v. infusions of AC at a rate of 40 to 600 muEq/kg/min. Urinary AC and bicarbonate excretion was measured and correlated with PAH and creatinine clearance and urinary electrolyte excretion. AC appeared in the urine as quickly as it was detected in the plasma. Its excretion gradually increased and tended to parallel bicarbonate excretion. PAH clearance increased with the advent of AC infusion, plasma pH and bicarbonate increase as AC is introduced. AC infusion caused an immediate drop in blood pressure. The systolic blood pressure returned to control in 3-5 min; there was a more gradual return in diastolic pressure. We conclude that AC is filtered and excreted into the urine at low plasma levels and has a low renal threshold.