Changes in partition of extracellular fluid volumes in anemic dialyzed uremic patients after partial correction of the anemia with recombinant human erythropoietin treatment.

The purpose of this work was to study the effects of correcting anemia on the distribution and partition of body fluids in dialyzed uremic subjects. We studied nine (7 m, 2 f) patients before and three months after the start of i.v. treatment with rHu-EPO, measuring total body water (TBW) with 3H2O, extracellular fluid volume (ECFV) with 35SO4 and plasma volume (PV) with 125I-SA. The intracellular water (ICW) and the interstitial fluid volumes (IFV) were derived by calculation from those measurements. The total blood volume (TBV) was calculated from the PV and the packed cell volume (PCV). Mean TBW, 482 +/- 45 (M +/- SD) ml/kg/bw and ECFV, 168 +/- 27.5 ml were significantly lower in patients than in nine matched normal controls, while the mean ICW (315 +/- 43 ml/kg) was similar. PCV before the start of rHu-EPO was 17.2 +/- 2.9% and had risen significantly to 31.3 +/- 4.8% (p = 0.000) after three months of therapy. Body weight (58 +/- 13 kg), TBW, ECFV and ICW did not change. TBV before rHU-EPO was 68.7 +/- 7.5 ml/kg and remained nearly unchanged, while PV fell significantly from 57 +/- 9 to 48 +/- 8 ml/kg (p < 0.025), with the calculated IFV rising from 111 +/- 25 to 127 +/- 27 (p = 0.000). The PV/IFV ratio decreased from 0.53 +/- 0.12 to 0.38 +/- 0.09 (p = 0.001). The decrease in PV/IFV ratio was paralleled by simultaneous increase in PCV in all but one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Red cell membrane during erythropoietin therapy in hemodialysis and in hemodiafiltration.

This study assessed the effect of recombinant human erythropoietin (r-HuEPO) on red cell membrane behaviour in patients undergoing hemodialysis (HD) and hemodiafiltration (HDF). We studied erythrocyte osmotic fragility (EOF), mechanical fragility (EMF) and deformability (ED) before and after r-HuEPO therapy in patients on conventional dialysis treatment with a cuprophan membrane and in subjects undergoing HDF with a polyacrylonitrile membrane. Non-uremic, non-anemic subjects were enrolled as controls. Red cell membrane defects were more evident in HD than in HDF; r-HuEPO seemed to improve deformability in both groups compared to controls (p less than 0.005) possibly through the great production of red cells during this therapy.

[Liposarcoma of the spermatic cord: a clinical case]. / Liposarcoma del funicolo spermatico: un caso clinico.

A case of spermatic cord liposarcoma is reviewed. Radical orchiectomy is an adequate form of treatment while retroperitoneal lymphadenectomy and adjunctive radiotherapy or chemotherapy appear to be controversial. A close follow-up is mandatory to detect early relapses or distant metastasis.

Regression of left ventricular hypertrophy in hypertensive dialyzed uremic patients on long-term antihypertensive therapy.

There have been no studies of the possibility of reversing the left ventricular hypertrophy (LVH) of chronically hemodialyzed hypertensive uremics (HDH) with long-term antihypertensive therapy. We have measured left ventricular sizes of eight (6 male, 2 female, aged 29 to 61 years) HDH with M-mode echocardiography, before and 12, 18 and 24 months after the start of a combined antihypertensive therapy which included ACE-inhibitors, beta-blockers and calcium-antagonists. Pre-treatment values for mean blood pressure (MBP), 116.6 +/- 2.9 mm Hg, end diastolic diameter (EDD), 62.6 +/- 6.6 mm, interventricular septum (IVS), 14.2 +/- 3.0 mm, and left ventricular mass index (LVMi), 239 +/- 61 g/m2, were all significantly higher than those for nine sex- and age-matched hemodialyzed normotensive subjects (HDN) with comparable hemoglobin (Hb) levels. During the antihypertensive treatment, both the systolic and diastolic BP decreased steadily (P = 0.0001; P = 0.0003; ANOVA) and significantly by the third month (P < 0.05; P < 0.01), reaching levels comparable to those of the HDN group after 12 months. At this time the LVMi (204 +/- 67) and the IVS (13.1 +/- 2.7), although both significantly lower than baseline, were still higher than in the HDN group, while the EDD was similar. After 24 months, however, both the IVS (12.3 +/- 3.1) and the LVMi (161 +/- 65) were no longer different from those of the HDN group.(ABSTRACT TRUNCATED AT 250 WORDS)

[Intrinsic endometriosis of the ureter. Clinical case]. / Endometriosi intrinseca dell'uretere. Caso clinico.

Endometriosis is defined as the presence of endometrial tissue outside the cavity of the uterus. The urinary tract is rarely affected, only 1 to 11%. Bladder is the most frequent urinary localization while the ureteral involvement is rare. We report a case of intrinsic ureteral endometriosis in a woman with left hydronephrosis, lumbar pain and septic fever. Instrumental and laboratory investigations can hardly lead to a reliable diagnosis of ureteral endometriosis. A final diagnosis is feasible only by histologic examination, which obviously implies surgery.