- Email: [email protected]
Indoor Air Pollution
693
BOOK REVIEWS
Center and Albert Einstein York
]Slew
N. Y. State J. Med., 87: 143-146 (Mar.) 1987 Classically, the diagnosis of hyperparathyroidism is based upon the finding of hypercalcemia, hypophosphatemia and hypercalciuria, often associated with hyposthenuria and polyuria but multiphasic biochemical screening has altered somewhat this conventional concept of the disease. In this report 37 patients (29 women and 8 men) with nonfamilial hyperparathyroidism ranging from 40 to 80 years old were reviewed. In 13 patients surgical confirmation of the disease was available, in 20 the diagnosis was based on biochemical studies alone, and 4 had kidney stones and surgically proved parathyroid disease. All but 2 patients had an elevated blood level of C-terminal parathyroid hormone in the face of hypercalcemia. Hyposthenuria was found in only 11 patients and polyuria was found in only 3. Hypercalciuria was seen in all patients with stone disease but infrequently in those with a presumptive diagnosis of hyperparathyroidism. In the entire series urinary calcium excretion was less than 100 mg./24 hours in 13 patients, and less than 200 mg./24 hours in 26. Thus, hypercalciuria is not a reliable guide to the pressure of hyperparathyroidism but its presence requires more aggressive treatment because of the greater likelihood of urinary calculi. T. D. A. 3 figures, 1 table, 19 references
half and 22 per cent the fu!i marathon as detected dipstick and confirmed ,,.,,.,,wc·rn~" Three runners had gross hematuria. Of the runners with hematuria dysmorphic erythrocytes were found in 30 per cent of the half and 80 per cent of the full marathon groups. Follovvup resting specimens at 4 to 12 weeks were normal. The urinary erythrocytes of patients with glomerular lesions lose hemoglobin and become misshapen. These changes appear to result from the trauma of passage through the glomerulus and can be identified under scanning electron microscopy or phase contrast microscopy. The presence of dysmorphic erthyrocytes is a strong indication of a glomerular source for the bleeding. The greater incidence of dysmorphic hematuria and proteinuria in the full run group suggests development of a glomerular leak with the extreme demands of the full marathon distance. The predominance of normomorphic hematuria and infrequency of proteinuria in the short run group suggests an extraglomerular source of bleeding, such as bladder contusions as has been demonstrated previously by cystoscopic examinations. M. G. F. 3 figures, 14 references Indoor Air Pollution L. E. HINKLE, JR., Department of Medicine, Division of Human Ecology, Cornell University Medical College, New York, New York
N. Y. State J. Med., 87: 196-197 (Apr.) 1987 Focal Ad:renocortical Cytomegaly Observed in Two Adult Cases
M. YAMASHINA, Department of Pathology, Saitama Medical School, Saitama, Japan Arch. Path. Lab. Med., 110: 1072-1075 (Nov.) 1986 The author reports focal cytomegaly of the adrenocortical tissue in a patient who sustained severe trauma to the left kidney requiring left adrenalectomy with nephrectomy. Another patient with this condition died of metastatic bronchogenic carcinoma with no metastasis to the adrenal glands. Both lesions exhibited focal aggregation of cytomegalic cortical cells with dense eosinophilic cytoplasm. The paucity of cytomegaly in adults might be owing to the lack of clinical symptoms and/ or the small pieces of tissue usually available to the pathologist for examination. N. J. 4 figures, 16 references
Pollution of the air indoors may arise from a variety of sources, including infectious agents disseminated by other persons, antigens from animals, commercial by-products of manufacturing, combustion products and substances in the building construction or its furnishings. Much has been made of the toxic effects of radon gas or asbestos, which is a clear hazard to miners or construction workers, but there is no evidence that asbestos, once installed in the walls of a building, poses any hazard to its occupants. One must distinguish the psychological reaction to perceived odors from a true toxicological effect. T. D. A. 4 references
BOOK REVIEWS Clinics in Ge:riatiric Med.foin.e. Ud11a:ry focon.tl.nence J. G.
MISCELLANEOUS Haematuria Following a Ma:rathon Run: Smu·ce a.nd Significance
R. I. REID, D. H. HOSKING AND E. W. RAMSEY, Department of Surgery (Urology), University of Manitoba, Winnipeg, Canada Brit. J. Urol., 59: 133-136 (Feb.) 1987 Urine specimens were obtained from 98 male runners before and immediately after running a half (21 km.) or full (42 km.) marathon. Specimens were examined for protein, blood and erythrocyte morphology as determined by phase contrast microscopy. Proteinuria occurred in 36 per cent of those running the half and 69 per cent running the full marathon. Hematuria with or without proteinuria occurred in 21 per cent running the
W. B. Saunders vol. 2, No. 4, 886 pages, 1986 The editor of this volume in the series has done an excellent job in compiling a complete treatise on incontinence, and its special and particularly devastating implications in the elderly population. The entire subject is covered, although the urological issues are not discussed as thoroughly as would be found in a strictly urological textbook. Rather, a multidisciplinary approach has been taken with a strong element of compassion toward the subject intimately weaved through the presentations. Ouslander ties the text together with pertinent commentaries and he has selected experienced authors to present the material. Sociological and nursing issues, often ignored in urological manuscripts, are given equal footing with purely diagnostic and therapeutic issues. The chapter on epidemiology highlights the widely varying prevalence data and notes wide under-reporting of incontinence in community surveys. It is concluded that up to 10 per cent of
BOOK REVIEWS
Center and Albert Einstein York
]Slew
N. Y. State J. Med., 87: 143-146 (Mar.) 1987 Classically, the diagnosis of hyperparathyroidism is based upon the finding of hypercalcemia, hypophosphatemia and hypercalciuria, often associated with hyposthenuria and polyuria but multiphasic biochemical screening has altered somewhat this conventional concept of the disease. In this report 37 patients (29 women and 8 men) with nonfamilial hyperparathyroidism ranging from 40 to 80 years old were reviewed. In 13 patients surgical confirmation of the disease was available, in 20 the diagnosis was based on biochemical studies alone, and 4 had kidney stones and surgically proved parathyroid disease. All but 2 patients had an elevated blood level of C-terminal parathyroid hormone in the face of hypercalcemia. Hyposthenuria was found in only 11 patients and polyuria was found in only 3. Hypercalciuria was seen in all patients with stone disease but infrequently in those with a presumptive diagnosis of hyperparathyroidism. In the entire series urinary calcium excretion was less than 100 mg./24 hours in 13 patients, and less than 200 mg./24 hours in 26. Thus, hypercalciuria is not a reliable guide to the pressure of hyperparathyroidism but its presence requires more aggressive treatment because of the greater likelihood of urinary calculi. T. D. A. 3 figures, 1 table, 19 references
half and 22 per cent the fu!i marathon as detected dipstick and confirmed ,,.,,.,,wc·rn~" Three runners had gross hematuria. Of the runners with hematuria dysmorphic erythrocytes were found in 30 per cent of the half and 80 per cent of the full marathon groups. Follovvup resting specimens at 4 to 12 weeks were normal. The urinary erythrocytes of patients with glomerular lesions lose hemoglobin and become misshapen. These changes appear to result from the trauma of passage through the glomerulus and can be identified under scanning electron microscopy or phase contrast microscopy. The presence of dysmorphic erthyrocytes is a strong indication of a glomerular source for the bleeding. The greater incidence of dysmorphic hematuria and proteinuria in the full run group suggests development of a glomerular leak with the extreme demands of the full marathon distance. The predominance of normomorphic hematuria and infrequency of proteinuria in the short run group suggests an extraglomerular source of bleeding, such as bladder contusions as has been demonstrated previously by cystoscopic examinations. M. G. F. 3 figures, 14 references Indoor Air Pollution L. E. HINKLE, JR., Department of Medicine, Division of Human Ecology, Cornell University Medical College, New York, New York
N. Y. State J. Med., 87: 196-197 (Apr.) 1987 Focal Ad:renocortical Cytomegaly Observed in Two Adult Cases
M. YAMASHINA, Department of Pathology, Saitama Medical School, Saitama, Japan Arch. Path. Lab. Med., 110: 1072-1075 (Nov.) 1986 The author reports focal cytomegaly of the adrenocortical tissue in a patient who sustained severe trauma to the left kidney requiring left adrenalectomy with nephrectomy. Another patient with this condition died of metastatic bronchogenic carcinoma with no metastasis to the adrenal glands. Both lesions exhibited focal aggregation of cytomegalic cortical cells with dense eosinophilic cytoplasm. The paucity of cytomegaly in adults might be owing to the lack of clinical symptoms and/ or the small pieces of tissue usually available to the pathologist for examination. N. J. 4 figures, 16 references
Pollution of the air indoors may arise from a variety of sources, including infectious agents disseminated by other persons, antigens from animals, commercial by-products of manufacturing, combustion products and substances in the building construction or its furnishings. Much has been made of the toxic effects of radon gas or asbestos, which is a clear hazard to miners or construction workers, but there is no evidence that asbestos, once installed in the walls of a building, poses any hazard to its occupants. One must distinguish the psychological reaction to perceived odors from a true toxicological effect. T. D. A. 4 references
BOOK REVIEWS Clinics in Ge:riatiric Med.foin.e. Ud11a:ry focon.tl.nence J. G.
MISCELLANEOUS Haematuria Following a Ma:rathon Run: Smu·ce a.nd Significance
R. I. REID, D. H. HOSKING AND E. W. RAMSEY, Department of Surgery (Urology), University of Manitoba, Winnipeg, Canada Brit. J. Urol., 59: 133-136 (Feb.) 1987 Urine specimens were obtained from 98 male runners before and immediately after running a half (21 km.) or full (42 km.) marathon. Specimens were examined for protein, blood and erythrocyte morphology as determined by phase contrast microscopy. Proteinuria occurred in 36 per cent of those running the half and 69 per cent running the full marathon. Hematuria with or without proteinuria occurred in 21 per cent running the
W. B. Saunders vol. 2, No. 4, 886 pages, 1986 The editor of this volume in the series has done an excellent job in compiling a complete treatise on incontinence, and its special and particularly devastating implications in the elderly population. The entire subject is covered, although the urological issues are not discussed as thoroughly as would be found in a strictly urological textbook. Rather, a multidisciplinary approach has been taken with a strong element of compassion toward the subject intimately weaved through the presentations. Ouslander ties the text together with pertinent commentaries and he has selected experienced authors to present the material. Sociological and nursing issues, often ignored in urological manuscripts, are given equal footing with purely diagnostic and therapeutic issues. The chapter on epidemiology highlights the widely varying prevalence data and notes wide under-reporting of incontinence in community surveys. It is concluded that up to 10 per cent of