Minoxidil is a potent direct-acting peripheral vasodilator indicated in the management of severe or refractory hypertension. Well-known adverse effects include reflex tachycardia, fluid retention and hypertrichosis. This drug has also been reported to cause pericardial effusion in about three percent of nondialyzed patients with compromised renal function and to cause cardiac tamponade less frequently. Many studies have reported that the mean duration of therapy that caused pericardial effusion was about 8 months (range 1 month-53 months). We report a case of cardiac tamponade in nondialyzed patient with chronic renal failure receiving minoxidil for 10 years. A 58-year-old female was admitted to our hospital with dyspnea of NYHA III. She was a chronic renal failure patient without dialysis treatment and received kidney transplantation from cadaver donor and was dignosed chronic rejection in 1994. Minoxidil 10mg has been used for past 10 years. Lasix has been used for past 2 years, with dosage of 40mg to 240mg. On admission, blood pressure was 90/60mm Hg. Cardiomegaly was seen on chest radiograph. The two-dimensional echocardiogram showed a large amount of pericardial effusion. Emergency treatment with pericardiocentesis removed 2500ml of straw- colored pericardial fluid and resulted in marked improvement of dyspnea and stabilized blood pressure. The minoxidil was discontinued. The evidence of pericardial effusion was not seen for 12 months after minoxidil had been discontinued.
Blood Pressure ; Cadaver ; Cardiac Tamponade* ; Cardiomegaly ; Dialysis ; Dyspnea ; Emergency Treatment ; Female ; Furosemide ; Humans ; Hypertension ; Hypertrichosis ; Kidney Failure, Chronic* ; Kidney Transplantation ; Middle Aged ; Minoxidil* ; Pericardial Effusion ; Pericardiocentesis ; Radiography, Thoracic ; Reflex ; Tachycardia ; Tissue Donors

No abstract available.

No abstract available.
Hypokalemia

Bone is a heterogenous and anisotrophic material exhibiting elastic, viscoelastis and plasticproperties. A considerable amount of information is now available regarding biomechanical properties and mechanisms of fractures of mature long bones, but less is known about the properties of the growing bones. In order to assess the biomechanical properties under tension, rabbits growing bones were loaded with Instron Modal 1,000 until fracture occurred. Two hundred tibiae of 100 New Zealand white immature rabbits were divided into 6 experimental groups according to maturity and size. Group I-R(40 right tibiae of 1-month old rabbits), Group I-L (40 left tibiae of 1-month old rabbits), Group II-R(20 right tibiae of 3-month old rabbits), Group II-L (20 left tibiae of 3-month old rabbits), Group III-R(40 rigth tibiae of 5-month old rabbits), and Group III-L(40 left tibiae of 5-month old rabbits). The following results were obtained. 1. Fracture type was transverse.or nearly transverse in 170 out of the total 200 tibiae(85%).
Absorption ; Elastic Modulus ; New Zealand ; Rabbits ; Tensile Strength ; Tibia

We carried out animal experiment in order to determine the effect of resection of nerves, muscles and tendons on the induction of osteoporosis. One hundred and forty rats, weighing approximately 250 gm, were divided into seven groups. In Group I, as a control group, the three skin incisions, one on the anterior aspect of the knee, one on the anteromedial aspect of proximal thigh, and one on the posterior aspect of proximal thigh were made and wounds were sutured. In Group II, the patellar tendon and the extensor digitorum longus tendon were divided to disable knee extension. In Group III, all the knee flexors were divided. In Group IV, all the knee extensors and flexors were divided. In Group V, the femoral nerve was divided to disable knee extension. In Group VI, the sciatic and obturator nerves were divided to diable knee flexion. In Group VII, the sciatic, and obtrator nerves were all divided. Before the procedures, bone density was measured by photon absorptiometry and postoperatively, the measurement was repeated every two weeks until the eighth week. At the time of each measurement, two rats were sacrificed out of each group and were submitted to microphotographic measurement of the tibial cortices. The results were as follows. l. In the muscle and tendon resection groups (Group II, Group III, Group IV), the bone density significantly decreased two weeks after operation and then, gradually increased four, six and eight weeks. 2. In the nerve resection groups (Group V, Group VI, and Group VII), the bone density decreased significantly two and four weeks after operation and then gradually increased six, and eight weeks after operation. 3. In both motor resection and denervation, the paralysis of both flexors and extensors of the knee, caused more decrease in bone density than the paralysis of either flexor or extensor. 4. In the muscle and tendon resection groups, the bone density was significantly more decrease two weeks after operation when the flexors were resected, but thereafter there was no significant difference between the flexors and extensors resection. In the nerve resection group, the paralysis of knee flexors caused more decrease in bone density than the paralysis of knee extensors throughout the entire experimental period. 5. The nerve resection groups demonstrated significantly more severe loss of bone density than muscle and tendon resection groups throughout the entire experimental period. 6. The values of bone density measured by photon absorptiometry correlated well with the cortical thickness indices. Bssed upon these observations, we came to the following conclusions. 1. The osteoporosis following injuries of the nerve, muscle, and tendon is most significant at two weeks after injury. 2. Denervation causes more severe osteoporosis than muscle and tendon injuries. 3. It is suggested that the photon absorptiometry is a reliable means in the evaluation of the osteoporosis.
Absorptiometry, Photon ; Animal Experimentation ; Animals ; Bone Density ; Denervation ; Femoral Nerve ; Knee ; Muscles ; Obturator Nerve ; Osteoporosis ; Paralysis ; Patellar Ligament ; Rats ; Skin ; Tendon Injuries ; Tendons ; Thigh ; Tibia ; Wounds and Injuries

Rhizobium radiobacter has been recognized as a rare pathogen affecting debilitated patients and usually associated with indwelling foreign body. Rhizobium radiobacter is a rare pathogen of peritonitis in patients on peritoneal dialysis. It is assumed that a cure can hardly be expected without removal of a peritoneal dialysis catheter. We experienced a case of Rhizoboum radiobacter peritonitis in a patient on CAPD successfully cured without removal of the peritoneal dialysis catheter. The patient was 42-year-old male and maintained on CAPD for 2 months. He visited with cloudy peritoneal dialysate effluent and showed mild abdominal tenderness. 650 leucocytes/microL were counted and Rhizobium radiobacter was isolated in the peritoneal dialysate effluent. His peritonitis was completely resolved with 3 weeks course of intraperitoneal ceftazidime and oral ciprofloxacin. He has maintained on CAPD without recurrence of peritonitis for 12 months.
Adult ; Agrobacterium tumefaciens* ; Catheters* ; Ceftazidime ; Ciprofloxacin ; Foreign Bodies ; Humans ; Male ; Peritoneal Dialysis ; Peritoneal Dialysis, Continuous Ambulatory* ; Peritonitis* ; Recurrence ; Rhizobium*

Diuretics are commonly used to control edema across various clinical fields. Diuretics inhibit sodium reabsorption in specific renal tubules, resulting in increased urinary sodium and water excretion. Loop diuretics are the most potent diuretics. In this article, we review five important aspects of loop diuretics, in particular furosemide, which must be considered when prescribing this medicine: (1) oral versus intravenous treatment, (2) dosage, (3) continuous versus bolus infusion, (4) application in chronic kidney disease patients, and (5) side effects. The bioavailability of furosemide differs between oral and intravenous therapy. Additionally, the threshold and ceiling doses of furosemide differ according to the particular clinical condition of the patient, for example in patients with severe edema or chronic kidney disease. To maximize the efficiency of furosemide, a clear understanding of how the mode of delivery will impact bioavailability and the required dosage is necessary.
Biological Availability ; Diuretics ; Edema ; Furosemide ; Humans ; Renal Insufficiency, Chronic ; Sodium ; Sodium Potassium Chloride Symporter Inhibitors*

Calcium-binding proteins play an important role in the protection, differentiation, and reorganization of the central nervous system. The effects of neonatal retinal deafferentiation on calretinin, and tracing of retinotectal pathway were examined immunohistochemically in the superficial layer of the rat superior colliculus. Tracing with cholera toxin was revealed on the superior colliculus contralateral to the ocular injection. On the contralateral side of superior colliculus, the calretinin-immunoreactive (IR) cells were dramatically increased, calretinin-IR fibers were markedly decreased in the superficial layer. These results show that retinal deafferentation results in an increase of calretinin-immunoreactive cells within the superficial layers of the superior colliculus, which suggest reorganization of neurons in superior colliculus.
Animals ; Calbindin 2 ; Calcium-Binding Proteins ; Central Nervous System ; Cholera Toxin ; Eye Enucleation* ; Neurons ; Rats* ; Retinaldehyde ; Superior Colliculi

No abstract available.
Child* ; Humans

Creatinine ; Humans ; Male ; Meals ; Methods ; Nitrogen ; Osmolar Concentration ; Potassium ; Sodium ; Sodium, Dietary ; Specific Gravity ; Urea ; Urine Specimen Collection