Biomedical subjects
Publications and source records attributed to P Ackrill.
Abnormal lung perfusion scans using radioactive particles were found in five out of six cases of hepatic cirrhosis with arterial hypoxaemia. None had clinical evidence of cardiopulmonary disease or signs of pulmonary embolism on arteriography. The scan defects are probably caused by a disorder of the pulmonary microvasculature, which may show regional variation in severity.
1. A comparison was made of various transport properties and electron-microscopical characteristics of isolated urinary bladders from toads (Bufo bufo) maintained in either tap water or 0.7% saline (0.7 g NaCl in 100 ml. H(2)O) for 10 days to 2 months.2. In the absence of Pitressin, isolated bladders from saline-adapted toads showed:(a) markedly, and significantly, lower osmotic water flow;(b) moderately, but not significantly, lower urea permeability;(c) no significant change in net sodium transport (measured as short-circuit current, I(sc)); and(d) significantly smaller intercellular space/mucosal cell ratios in electron-micrographs.3. Differences in the transport and electron-microscopical characteristics between bladders from water-exposed and saline-adapted toads became more evident in the presence of exogenous Pitressin (10 m-u./ml. serosal solution):(a) the stimulating influence of Pitressin on osmotic water flow, short-circuit current and urea permeability was considerably smaller in bladders from saline-adapted toads than in those from water-exposed toads;(b) the influence of Pitressin on short-circuit current was reduced more profoundly than that on either water flow or urea permeability;(c) the Pitressin-induced increment in intercellular space/mucosal cell ratio was significantly smaller in electron-micrographs of bladders from saline-adapted toads than in those from water exposed toads.4. The effects of saline adaptation are discussed in relation to decreased permeability of mucosal membrane barriers.
Explore the source record for details and available documents.
There is considerable evidence that the principal functional abnormality in patients with acute reversible renal failure (ARF, or "acute tubular necrosis") is reduced cortical perfusion with diminished glomerular filtration. However, in such patients, high-dose intravenous urograms most commonly show an immediate obvious nephrogram. Since nephrographic density is believed to depend on the filtration of contrast medium into the tubular lumen, it is difficult to reconcile the early development of the nephrogram if glomerular filtration is reduced. Extensive experiments with both mercuric chloride and glycerol rat models of ARF have confirmed rapid intraluminal accumulation of contrast medium, albeit in reduced amounts. Studies using the normally filtered compound sodium nitroprusside and its precipitation as "prussian blue" suggest rapid transtubular diffusion from peritubular capillaries in kidneys with ARF. This, it is suggested, is also the mechanism for the rapid intraluminal ingress of contrast media and explains the early appearance of nephrogram. The less common intravenous urogram finding in ARF of a slowly developing and increasingly dense nephrogram may then represent cases with only slight tubular necrosis with predominant reduction in glomerular filtration.
The role of the anaemia co-ordinator has developed subsequent to the introduction of erythropoietin therapy for renal anaemia, and posts have been established at an increasing number of hospitals in the UK. While co-ordinators have previously tended to come from a nursing background, the post at our hospital has been held jointly by a pharmacist and a clinical nurse specialist since July 1997. This paper presents an informal evaluation of our experience of joint working, and has drawn on diary entries to outline the components of the service provided. The main focus is on the boundary negotiated between pharmacist and nurse responsibilities and expertise, involving as it does areas of potential conflict and complementarity. Through a critical examination of the assumptions and expectations associated with 'generic' pharmacist and nurse roles, we begin to clarify the respective contributions which the disciplines make to anaemia management.