The electrolyte and water losses in 75 instances of diuresis following Mercuhydrin were studied in 17 edematous patients.The loss of potassium was appreciable following exhibition of the drug to patients who retained their dietary sodium almost completely.Occurrence of such clinical symptoms as weakness, nausea, and ventricular premature contractions might be attributed to this loss of potassium.The fluid lcst by mercurial diuresis was isotonic with body fluids.The chloride concen- tration was fairly constant at 151 mEq.per liter.The concentrations of sodium and potassium were more variable, the average concentrations being 97 and 35 mEq.per liter, respectively.Lcss of water and electrolyte in these concentrations leaves the patient in relative alkalosis, with a loss of intracellular potassium and a gain in intracellular sodium.
Objective: To examine the associations between postmortem Alzheimer disease (AD) neuropathology and autopsy-verified cardiovascular disease. Methods: The authors examined 99 subjects (mean age at death = 87.6; SD = 8.7) from the Mount Sinai School of Medicine Department of Psychiatry Brain Bank who were devoid of cerebrovascular disease–associated lesions or of non–AD-related neuropathology. Density of neuritic plaques (NPs) and neurofibrillary tangles (NFTs) as well as coronary artery and aortic atherosclerosis, left ventricular wall thickness, and heart weight were measured. Partial correlations were used to assess the associations of the four cardiovascular variables with NPs and NFTs in the hippocampus, entorhinal cortex, and multiple regions of the cerebral cortex after controlling for age at death, sex, dementia severity, body mass index, and ApoE genotype. These analyses were also repeated separately for ApoE4 carriers and noncarriers. Results: The extent of coronary artery disease and to a lesser extent atherosclerosis were significantly associated with the density of cardinal neuropathologic lesions of AD in this autopsy sample (significant correlations between 0.22 and 0.29). These associations were more pronounced for the ApoE4 allele carriers (n = 42; significant correlations between 0.34 and 0.47). Conclusions: The degree of coronary artery disease is independently associated with the cardinal neuropathological lesions of Alzheimer disease. These associations are primarily attributable to individuals with the ApoE4 allele.
Elevated serum total cholesterol (TC) has been considered a risk factor for Alzheimers disease (AD), but conflicting results have confused understanding of the relationships of serum lipids to the presence of AD in the elderly. Methods: To clarify these issues, we evaluated correlations of admission TC, low-density (LDL) and high-density (HDL) cholesterol directly with the densities of Alzheimer hallmarks--neuritic plaques (NP) and neurofibrillary tangles (NFT)--in nursing home residents (n=281). Results: Significant positive associations of TC and LDL with NP densities were found in both the neocortex (TC: r=0.151, p=0.013 and LDL: r=0.190, p=0.005) and the hippocampal/entorhinal (allocortical) region (TC: r=0.182, p=0.002 and LDL: r=0.203, p=0.003). Associations of HDL with NP were less strong but also significant. In contrast, after adjustment for confounders, no correlations of NFT with any lipid were significant.When subjects with any non-AD neuropathology (largely vascular) were excluded, the TC-plaque and LDL-plaque associations for the remaining “Pure AD” subgroup were consistently stronger than for the full sample. The TC- and LDL-plaque correlations were also stronger for the subgroup of 87 subjects with an APOE 4 allele. Conclusions: The findings indicate that serum TC and LDL levels clearly relate to densities of NP, but not to densities of NFT. The stronger associations found in the subgroup that excluded all subjects with non-AD neuropathology suggest that cerebrovascular involvement does not explain these lipid-plaque relationships. Since the associations of TC/LDL with NP were particularly stronger in 4 carriers, varying prevalence of this allele may explain some discrepancies among prior studies.
SummaryGlomerular filtration and renal plasma flow were found to be normal in eleven patients with cirrhosis of the liver who were accumulating edema fluid indicating that the retention of sodium is due to increased tubular reabsorption.
