Temperature-dependent structure of liquid water investigated by means of energy-dispersive x-ray diffraction and molecular dynamics simulations.

X-ray diffraction is investigated in the supercooled region (263-273 K) and, for comparison, at ambient conditions. By means of an energy-dispersive set-up coherent x-ray scattering cross sections within a wide range of momentum transfer values are monitored simultaneously using in-house laboratory equipment. The data are corrected for the energy-dependent detector response, geometric broadening effects, sample absorption and Compton scattering. The corrected diffraction curves are in good agreement with results from the Advanced Light Source (ALS). Additional comparisons with available literature data and with computer simulation results of different rigid water models are presented, relating the scattering intensities to the microscopic H-bond structure and dynamics.

[Diuretic resistant ascites in hepatic cirrhosis and renal insufficiency (author's transl)]. / Diuretikaresistenter Aszites bei Leberzirrhose und Niereninsuffizienz. Behandlung mit einem peritoneo-cayalen Drainagesystem.

In decompensated hepatic cirrhosis the glomerular filtration rate is reduced. Use of diuretics frequently leads to hyponatraemia, hypotension, hypovolaemia and oliguria. The ensuing renal insufficiency is reversible when the peritoneal fluid is redirected into the vascular system. For this purpose a subcutaneously implantable pump developed by Agishi was used in a 37-year-old patient permitting drainage of the ascites from the peritoneal cavity into the superior vena cava using an actively operated pumping mechanism. Use of the pump in the patient abolished the ascites, considerably improved renal function, equilibrated electrolyte metabolism and improved renal response to diuretics.

[Calcium and phosphate metabolism in hemofiltration (author's transl)]. / Calcium-phosphat-stoffwechsel und Hämofiltration.

In 10 patients undergoing hemofiltration treatment acute changes of parameters in the calcium-phosphate metaboism were investigated. Balance studies were also performed in all patients. Control studies were conducted after a 3-month interval in 7 patients. Whereas ionized calcium and 25-HCC remained constant, there was a significant decrease in phosphate, magnesium, fluoride and parathyroid hormone. Corresponding to these results, negative balances could be seen during the course of a hemofiltration treatment: for phosphate a mean value of -593 mg, for magnesium -8.4 mEq and for fluoride -458 microgram. When a calcium content of 3.75 mEq/l was used in the substitution solution, an only slightly positive calcium balance of +1.51 mEq/l (mean value) was found. A significant correlation between calcium and fluid balance was demonstrated by means of 197 filtration treatments of one patient: the calcium balance became negative whenever the fluid loss was greater than 3.86 liters. After a 3-month period no significant changes in the above parameters were found, which indicates, that disturbances in the calcium-phosphate-parathyroid hormone metabolism do not only lie in a reduced renal elimination. Even though our results do not indicate that hemofiltration treatment induces or increases the chances of renal osteodystrophy, the calcium concentration of the substitution solution should be increased to 4.0 mEq/l, in order to guarentee a positive calcium balance even by forced filtration.