Body fluid compartments, renal blood flow, and hormones at 6,000 m in normal subjects.

We previously described a syndrome of congestive heart failure occurring in healthy young men at extreme altitude (Anand et al. Lancet 335: 561-565, 1990). The pathogenesis of this condition is unclear. We therefore measured body fluid compartments, renal blood flow, and a variety of plasma hormones in 10 asymptomatic young men staying above 6,000 m for > 10 wk and compared the results with controls at sea level. Body compartments were measured with isotope dilution techniques and renal blood flow with o-[125I]iodohippurate sodium. There was a marked expansion of all the fluid spaces: total body sodium was 14% above normal (P < 0.05), total body water was 18% above normal (P < 0.05), plasma volume was 33% above normal (P < 0.05), and blood volume was 84.5% above normal (P < 0.001). The effective renal plasma flow was lower than normal by 55% (P < 0.001), but the reduction in the effective renal blood flow was 37% below normal (P < 0.001) because the hematocrit was high (41.6% above normal). Plasma norepinephrine was nearly 3 times normal (P < 0.01), cortisol 3 times normal (P < 0.001), and growth hormone 18 times normal (P < 0.01). Aldosterone was twice normal (P < 0.03). Plasma epinephrine, atrial natriuretic peptide, and plasma renin activity were unchanged. The degree of fluid retention in these normal subjects was similar to that in patients with severe untreated congestive heart failure (Anand et al. Circulation 80: 299-305, 1989), whereas sodium retention and reduction in effective renal blood flow were less.(ABSTRACT TRUNCATED AT 250 WORDS)

A study of intra-uterine device in families of army personnel.

PIP: A pilot study of 250 families using IUDs for family planning at Delhi Cantt, India was conducted in 1970. 46.8% had no symptoms, but abnormal uterine bleeding was noted by 26.8%, backache by 9%, and excessive discharge by 7.6%. 37.2% developed irregular menstruation. 22.4% of total insertions were removed due to bleeding, 6.8% for a planned pregnancy. 5.2% expelled the IUD. The over-all failure rate was 1.6% due to pregnancy with the IUD in situ. After removal 22.7% practiced other contraceptive methods regularly; 6.9% elected vasectomy, and 68.4% did not use any method. The IUD was used successfully by only 61.2 % of the cases; thus the unsuccessful experience of over 38% represents a strong deterrent for the IUD program.^ieng

Clinical, ultrasonographic and CT evaluation of orbital rhabdomyosarcomas with management.

Fourteen cases of orbital rhabdomyosarcoma have been studied. Clinical presentation was by way of short history, fast growing proptosis, inflammatory signs and epistaxis. Computerised tomography showed only a mass lesion without bony involvement and was very useful in follow up. Ultrasonography revealed pseudo-encapsulation of the tumour which is postulated as possibly specific of Rhabdomyosarcoma due to its fast growth, cellular content and oedema fluid. A survival rate of 21% over a 3 year period has been achieved by combined mode therapy consisting of surgery, radiation and chemotherapy.

Unusual presentation of lacrimal gland tumours.

The diagnosis of orbital tumour is a challenge to the ophthalmologist. The aim of this paper is to highlight the unusual presentation of lacrimal gland tumours.