We studied single dose intravesical doxorubicin instillation (50 mg. dissolved in 30 ml. saline) in 29 patients with bladder tumor and 2 with dysplasia of the bladder. The results demonstrated that 1) the levels of doxorubicin hydrochloride in extracts of tumors were significantly higher than those of histologically normal bladder tissues in all regions examined except the dome, 2) the incorporation concentration of the drug into the smallest tumor was 3-fold greater than that of larger tumors, 3) tissue concentration of the drug in histologically normal bladder tissues was 2.4-fold greater in patients with recurrent than with primary bladder tumors, and 4) a high concentration of the agent was noted in unifocal, multifocal and primary tumors classified as papillary noninvasive or invasive transitional cell carcinoma. These findings indicate that intravesical installation of doxorubicin hydrochloride can be incorporated to a high degree by relatively small papillary noninvasive or invasive transitional cell carcinoma located in almost all regions except the bladder dome.
Contents of catecholamines were determined in 46 adrenal specimens removed from subjects without adrenal disease. These subjects were allocated in a retrospective conformation to two points: one for renal function and another for blood pressure. Based on the findings, elevated adrenal catecholamines associated with hypertension appear to impair renal function in man.
A left renal artery aneurysm was found in a 45-year-old normotensive man. In an attempt to evade the possible occurrence of aneurysmal rupture, aneurysmectomy in addition to left renal biopsy (first surgery) was performed. This vascular operation led to a virtually complete renal artery stenosis concomitant with the development of hypertension. The renin-angiotensin-aldosterone system and levels of plasma prostaglandins were also increased following this failed surgery. Reconstruction of the affected renal artery was technically so difficult that left nephrectomy was carried out (second surgery). Renal specimens obtained at the first surgery revealed no histological abnormalities. Discriminating histological findings of the kidney obtained at the second surgery were remarkable; hyperplasia of the juxtaglomerular cells producing renin and hyperplasia of the renomedullary interstitial cells which had pecularities similar to cells known to secrete renal prostaglandins. High levels of the renin-angiotensin-aldosterone system and plasma prostaglandins after the first surgery were reduced following the second surgery. It is suggested that acute constriction of the renal artery led to a hyperplastic change of the the juxtaglomerular cells and the renomedullary interstitial cells and stimulated an inappropriate release of renin and renal prostaglandins.
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