Nephrocalcinosis in a young male with anorexia nervosa.

Nephrocalcinosis (NC) has been described as a long-term complication of anorexia nervosa (AN). This is the first report of this complication in an adolescent male patient. We describe the case of a 12-year-old male with AN who presented with acute food restriction and excessive exercising leading to three inpatient admissions. The patient experienced an isolated episode of dysuria and hematuria while on calcium and vitamin D supplementation. Investigations revealed hypophosphatemia, hypercalciuria and mild NC. Follow-up confirmed the presence of NC and possible nephrolithiasis (NL). We discuss the pathophysiology and risk factors of NC and NL in the context of an early presentation of AN. We suggest fluid intake should be liberalized under observation and calcium and vitamin D supplementation should be initiated with caution in patients presenting with AN and risk factors for NC and NL.

The medicalization of sunlight in the early twentieth century.

This paper traces the emergence of the therapeutic use of sunlight in medicine during the first half of the twentieth century. This was a period of considerable flux in medicine with various strands of practice and theory competing. Drawing on two case studies of sunlight therapy, both artificial (actinotherapy) and natural (heliotherapy), in the treatment of rickets and tuberculosis this paper will explore how medicine was constituted within these regimes. The paper will argue that therapeutic and clinical applications of sunlight helped establish an association between sunlight and health but also defined a particular and specific performance of medicine.

Single-channel characterization of the rabbit recombinant RyR2 reveals a novel inactivation property of physiological concentrations of ATP.

Ryanodine receptor 2 (RyR2) cDNA has been available for more than 15 years; however, due to the complex nature of ligand gating in this channel, many aspects of recombinant RyR2 function have been unresearched. We established a stable, inducible HEK 293 cell line expressing full-length rabbit RyR2 cDNA and assessed the single-channel properties of the recombinant RyR2, with particular reference to ligand regulation with Ca2+ as the permeant ion. We found that the single-channel conductances of recombinant RyR2 and RyR2 isolated from cardiac muscle are essentially identical, as is irreversible modification by ryanodine. Although it is known that RyR2 expressed in HEK 293 cells is not associated with FKBP12.6, we demonstrate that these channels do not exhibit any discernable disorganized gating characteristics or subconductance states. We also show that the gating of recombinant RyR2 is indistinguishable from that of channels isolated from cardiac muscle when activated by cytosolic Ca2+, caffeine or suramin. The mechanisms underlying ATP activation are also similar; however, the experiments highlighted a novel effect of ATP at physiologically relevant concentrations of 5-10 mM. With Ca2+ as permeant ion, 5-10 mM ATP consistently inactivated recombinant channels (15/16 experiments). Such inactivation was rarely observed with native RyR2 isolated from cardiac muscle (1 in 16 experiments). However, if the channels were purified, inactivation by ATP was then revealed in all experiments. This action of ATP may be relevant for inactivation of sarcoplasmic reticulum Ca2+ release during cardiac excitation-contraction coupling or may represent unnatural behavior that is revealed when RyR2 is purified or expressed in noncardiac systems.