Nodular renal blastema,nephroblastoniatosis, and Wilms' tumor: Different points on the same disease spectrum?

A case of nodular renal blastema developing into nephroblastomatosis is presented. Definitions and histopathology of these entities is given, and it is suggested that they represent a developmental spectrum with natural progression to Wilms' tumor.     

Studies on potassium induced coronary dilation in the isolated guinea pig heart

Summary Changes of coronary flow in the isolated perfused spontaneously beating guinea pig heart were induced by elevation of potassium concentration in the perfusion medium (4–16 meq/l). Potassium caused a dose-dependent transient increase of diastolic coronary inflow. The response was inhibited by ouabain (1.4×10^–7 M) or reduced temperature. Rubidium ions elicited almost identical vasodilator effects which were also inhibited by ouabain.Autoregulation of coronary flow, reactive hyperemia, and hypoxic coronary dilation were not significantly altered in the presence of ouabain.The results support the hypothesis that potassium as well as rubidium cause vasodilation by activating a Na⁺, K⁺-ATPase. On the other hand, they do not favour the view of an essential involvement of potassium ions in local regulation of coronary flow under the conditions studied.A preliminary report of this study was presented at the 42nd meeting of the German Physiologic Society in Hannover, Germany [Pflügers Arch.343, R20 (1973)].     

Klebsiella pneumoniae bacteremia in the community hospital

The purpose of this study was to elicit the circumstances of occurrence and organism sensitivities of Klebsiella pneumoniae bacteremia in the community hospital, since data on this illness from the community hospital are rare. All records of documented Klebsiella pneumoniae bacteremia (46 cases) at Alachua General Hospital, Gainesville, Florida, over the period July 14, 1982, through July 27, 1985, were reviewed in detail. Fifty-nine percent (27 organisms) were nosocomial, whereas 41% (19 organisms) were community acquired. The most common predisposing disorders in these patients were, in decreasing order, malignancy; following gastrointestinal or biliary surgery; biliary tract obstruction; diabetes; and unknown. Twenty-two percent (10) of the patients died from bacteremia. The majority of organisms tested were sensitive to mezlocillin, cephalothin, cefoxitin, tetracycline, tobramycin, gentamicin, co-trimoxazole and ceftizoxime. Therapy was considered to be appropriate in 89% (41) of the patients and inappropriate in 10.9% (5) of the patients. Contrary to previous thought, Klebsiella pneumoniae bacteremia is a relatively common problem in the community hospital and may be community acquired as well as nosocomial. There are many characteristics of this disease in the community that are different from those reported in studies on Klebsiella pneumoniae bacteremia from large referral centers.