Results of 12 years' treatment of chronic renal failure by dialysis and transplantation.

The survival of 305 patients with chronic renal failure treated at the Vancouver General Hospital by centre and home peritoneal dialysis, centre and home hemodialysis and cadaver renal transplantation over a 12-year period was analysed. There was decreasing survival with age except in patients undergoing home dialysis. Hypertension and analgesic nephropathy as primary causes of renal disease were associated with a poor prognosis. Hence age and diagnosis appear to be two of the main determinants of survival. Cardiovascular disease was the commonest cause of death but seven deaths were due to dialysis dementia. The results compare favourably with other published statistics.     

Free erythrocyte protoporphyrin level and nerve conduction velocity in end-stage renal disease.

Increased free erythrocyte protoporphyrin concentrations and depressed motor nerve conduction velocities (MNCV) were observed in 45 patients on maintenance haemodialysis. Neither of these findings could be correlated with age, duration or frequency of dialysis, or the degree of uraemia present. A strong negative correlation (r=--0-53; P less than 0-001), however, existed between the free erythrocyte protoporphyrin level and the MNCV, which suggested either (a) a direct effect of iron status on nerve function, or (b) a toxic factor in "uraemia" that depresses both nerve conduction and haemsynthetase activity.     

Ganglioside treatment of diabetic rats; effects on nerve adenosine triphosphatase activity and motor nerve conduction velocity

Ouabain-sensitive ATPase activity (expressed as nmol ADP produced/h/mg (wet) nerve +/- SEM) was measured in homogenates of sciatic nerve from control rats and rats with streptozotocin-induced diabetes of 8 wk duration. Nerves from diabetic rats showed activity (21.7 +/- 2.0) which was significantly (p less than 0.05) less than that of controls (34.6 +/- 4.8). These animals also showed a deficit in conduction velocity (m/sec +/- SEM) of sciatic nerve motoneurones (50.7 +/- 0.4 vs. 57.7 +/- 0.7 in controls; p less than 0.001). In parallel, matched control and diabetic groups were treated daily with mixed gangliosides extracted from bovine brain (10 mg/kg i.p.). After such treatment for 8 wk the deficit in ouabain-sensitive ATPase activity did not develop in the diabetic group (treated diabetics, 31.9 +/- 3.7; treated controls, 34.5 +/- 3.8). However, the treatment did not affect the deficit in motor nerve conduction velocity (treated diabetics, 50.9 +/- 1.1 vs. treated controls, 57.9 +/- 0.5; p less than 0.001). Accumulations of the polyol pathway metabolites--sorbitol and fructose--together with depletion of nerve myo-inositol were similar in both diabetic groups. These data indicate an etiology for the conduction velocity deficit which differs from that of the deficit in ouabain-sensitive ATPase.     

Effect of long term dialysis therapy on blood prolactin patients with chronic renal failure

An effect of dialysis therapy on baseline prolactinemia and prolactinemia following suppression test with alpha-bromocriptine was determined in 34 patients with chronic renal failure. Gradual decrease in hyperprolactinemia with the duration of dialysis therapy has been observed. Prolactinemia baseline values in patients dialysed for 100 months did not differ from those determined in healthy individuals.     

The diabetic polyneuropathy. II. Polyneuropathy, angiopathy and nerve conduction velocity

789 patients with diabetes mellitus were studied by clinical and electroneurographical examination. Motor conduction velocity of the median and the tibial nerve and sensory conduction of the median nerve were determined. 81.1% of the patients we suffering from diabetes which began in childhood or adolescence, 13.9% were suffering from maturity onset diabetes. Average duration of the disease was 9.5 years, average age was 26.7 years. Clinical signs of polyneuropathy were found in 19.1%. Typical findings were pain and paraesthesia, lack or abolition of triceps surae reflexes, impaired pallaesthesia on lower extremities. 48.3% of 151 patients with clinical signs of polyneuropathy were suffering from combined angiopathy, 32.5% from microangiopathy, 7.9% from macroangiopathy. Severity of complicating retinopathy and macroangio,athy were found to be correlated with polyneuropathy. 58.2% of 323 diabetics with at least one delayed nerve conduction velocity exhibited signs of angiopathy. In nearly 30% of children and adolescents after comparatively short duration of the disease at least one conduction velocity was delayed. In diabetic children and adolescents metabolic disturbances are assumed to cause peripheral nerve dysfunction.     

A study of conduction velocity in nonmyelinated nerve fibers.

By treating a nonmyelinated nerve fiber as a continuous cable consisting of three distinct zones (Resting, transitional, and excited), the following mathematical expression was derived: (formula: see text) where v is the conduction velocity, d the diameter of the fiber, R the resistance of the membrane of unit area at the peak of excitation, rho the resistivity of the medium inside the fiber, and C the capacity of membrane per unit area. The validity of this expression was demonstrated by using squid giant nerve fibers intracellularly perfused with dilute salt solutions. The relationship between these results and previous theories and experiments on conduction velocity is discussed.     

Hoffmann's reflex evoked on the soleus muscle and motor neural conduction velocity of the tibial nerve]

H reflex on the soleus muscle and motor tibial nerve conduction velocity are used to study peripheral nervous system maturation in 68 healthy children, from birth to 4 years of age. Proximal an distal conduction velocities develop in a parallel and approximately exponential way but proximal conduction velocities remain always faster. The latencies slightly decrease during the first 18 months of life and then increase very slowly.     

Effect in vivo of a sub-hypnotic dose of ethanol on nerve conduction velocity in mice

Relative nerve conduction time (reciprocal of velocity), before and after administration of ethanol, was studied in the caudal nerves of 58 mice. Doses of 1.4, 2.0, 2.5, 3.0, and 4.24 g ethanol/kg body wt., given i.p., were used. The tail was maintained at 37.0° and a control (saline) injection preceeded the ethanol injection. Doses of 1.4 and 2.0 g/kg did not produce significant effects on conduction time but doses of 2.5, 3.0, and 4.24 g/kg did, the relative conduction times twelve minutes after ethanol increasing by 1.2, 1.8, and 3.1 percent, respectively. This appears to be the first controlled demonstration of an acute $\text{in}$$\text{vivo}$ effect of ethanol on conduction velocity.