Search PubMed⌕ Search

Biomedical subjects

J Walls

Publications and source records attributed to J Walls.

At least 217 records · Page 12Linked to original sources

Renal function studies after nephrectomy in renal donors.

Two to six years after they had donated a kidney the 24-hour creatinine clearances of five women and four men had recovered to 85% and 87% respectively of prenephrectomy performance. The male donors had a lower 24-hour creatinine clearance than age-matched controls, but during dextrose and inulin infusion they had similar values for inulin clearance, creatinine clearance, and glucose reabsorption. By contrast, the female donors had significantly reduced clearances both over 24 hours and during infusion, as well as impaired ability to reabsorb glucose. This suggests that potential female donors should be more vigorously investigated before nephrectomy.

Adult↗

Carnitine-palmityl-transferase deficiency.

An increasing number of cases of myopathy due to disordered lipid metabolism have recently been recognised and these appear to fall into two contrasting clinical and biochemical categories. Some patients present with steadily prograssive proximal weakness which sometimes responds to steroid therapy and which is due to carnitine deficiency in skeletal muscle. In the second category, patients usually present with muscle cramps on exertion then followed by myoglobinuria without established proximal myopathy and their symptoms are associated with deficiency of carnitine palmityl transferase in skeletal muscle. In this paper we report a patient who has well-documented carnitine palmityl transferase deficiency, whose symptoms were triggered by violent exercise after fasting and in whom there was variable histochemical and ultrastructural evidence of lipid accumulation in muscle biopsy samples. Development of the patient's symptoms was suppressed by a high carbohydrate diet.

Acyltransferases↗

Bone densitometry.

Explore the source record for details and available documents.

Bone Diseases↗

Nature of the acidifying defect after the relief of ureteral obstruction.

Nature of the acidifying defect observed after relief of ureteral obstruction. The acidifying capacity of the normal and experimental kidney was studied in rats three hours after release of complete unilateral ureteral obstruction or after unilateral release of unilateral ureteral obstruction, mean plasma bicarbonate concentration was 23.5 mEq/liter, and plasma pH, 7.45. Urine pH from the postreleased kidney was 7.47 and 6.01 from the control side. Net acid escretion averaged 0.97 muEq/min in the experimental kidney. Fractional excretion of bicarbonate averaged 0.02% in the control and 3.17% in the experimental kidney. In eight animals with unilateral release of bilateral ureteral obstruction, mean plasma bicarbonate was 16.9 mEq/min and plasma pH was7.35. Mean urine pH in the postreleased Kidney was 6.11, net acid excretion averaged 2.01 plus or minus 0.69 muEq/min and fractional bicarbonate excretion averaged 0.84%.

Ammonium Chloride↗

Effects of acetazolamide on the urinary excretion of cyclic AMP and on the activity of renal adenyl cyclase.

Acetazolamide, an inhibitor of the enzyme carbonic anhydrase, increased the urinary excretion of cyclic AMP in normal and parathyroidectomized rats. The increase was greater in rats with intact parathyroid glands than in parathyroidectomized rats. This rise in the urinary excretion of cyclic AMP was not due to an increase in urine flow or a change in urine pH. Furosemide caused an increase in urine flow, but did not affect the excretion of cyclic AMP or phosphate. Alkalinization of the urine with bicarbonate did not increase the urinary excretion of phosphate or cyclic AMP. Acetazolamide increased the productionof cyclic AMP by rat renal cortical slices in vitro. This effect was dose-dependent. Acetazolamide also stimulated the activity of renal cortical adenyl cyclase in a dose-dependent manner but had no effect on the activity of cyclic nucleotide phosphodiesterase. The pattern of urinary excretion of cyclic AMP and phosphate after administration of acetazolamide was similar to that observed in rats given parathyroid hormone. It is suggested that acetazolamide stimulates the renal production of cyclic AMP by activating adenyl cyclase and that this may be the mechanism by which this inhibitor of carbonic anhydrase produces phosphaturia.

Acetazolamide↗

Prolonged oliguria with survival in acute bilateral cortical necrosis.

Survival is uncommon in cases of acute bilateral cortical necrosis. Three cases admitted to the renal unit at Newcastle have regained useful renal function after oliguric phases of 38, 46, and 120 days.Prolonged periods of intermittent dialysis are justified in patients in whom a firm diagnosis of acute cortical necrosis is made.

Acute Kidney Injury↗

Post-hoc diagnosis of congenital long QT syndrome in patients with tetralogy of Fallot.

This report describes two patients diagnosed with congenital long QT syndrome after surgical repair of tetralogy of Fallot. Despite the fact that both patients had preoperative electrocardiograms demonstrating QT prolongation, neither was diagnosed until long after their surgeries, when they or their relatives presented with symptoms of long QT syndrome. A brief discussion highlights the reasons why long QT syndrome may be overlooked in patients with structural heart defects and the clinical importance of identifying these patients preoperatively.

Anti-Arrhythmia Agents↗

Dilated cardiomyopathy masquerading as long QT syndrome.

Atrioventricular block has been described in association with cases of long QT syndrome and mortality is increased in this subgroup. We describe an infant with congenital QT prolongation and atrioventricular block with normal cardiac function, leading to the initial diagnosis of long QT syndrome. She subsequently developed dilated cardiomyopathy requiring cardiac transplantation. We postulate that the presenting electrocardiograph abnormalities were early manifestations of the myocardial disease, preceding the development of myocardial dysfunction by several months. The need for heightened surveillance in cases of QT prolongation with atrioventricular block is amplified by the possibility of an evolving cardiomyopathy.

Adult↗

Increased incidence of end-stage renal failure secondary to diabetes mellitus in Asian ethnic groups in the United Kingdom.

Diabetic renal disease is more common in patients of Asian ethnic origin than White Caucasians in the United Kingdom. This study determines whether a disparity in the incidence of end-stage renal failure secondary to diabetes mellitus exists between these ethnic groups. The incidence of treated end-stage renal failure was estimated using the person-time at risk incidence rate for patients receiving renal replacement therapy secondary to diabetes mellitus in the county of Leicestershire from 1979 to 1988. The incidence rate of end-stage renal failure expressed for the estimated population of patients with diabetes mellitus in patients of Asian ethnic origin was 486.6 (95% CI, 185.1 to 788.1) cases per million person-years per year, compared to 35.6 (17 to 54.2) in White Caucasians. All patients of Asian ethnic origin developing end-stage renal failure had non-insulin-dependent diabetes. The high incidence of end-stage renal failure secondary to diabetes mellitus in patients of Asian ethnic origin in the UK imparts significant public health implications for resource planning and allocation, and the need to initiate strategies to ameliorate renal disease in this ethnic group.

Asia↗