89 patients were operated on for pheochromocytoma. 61 patients (37 women and 24 men) were available for extended follow-up. The final survey, performed 79.1 +/- 66.9 months postoperatively, provided data on survival, blood pressure tumor recurrence, malignant metastatic lesions, cardiovascular complications and coexisting diseases. There were 4 deaths during the follow-up period, including 2 instances of malignant pheochromocytoma. Permanent normalization of blood pressure was achieved in 38 patients (62.3%). This hypotensive effect was noted in 79.2% of patients with preoperative paroxysmal hypertension and in 40.8% of those with sustained hypertension. Permanent or re-developing postoperative hypertension was noted in 23 (37.7%) patients. This includes 4 cases of malignant pheochromocytoma, 4 cases of recurrent benign pheochromocytoma and 15 cases of essential hypertension. Cardiovascular complications during follow-up were rare and concerned the patients with essential hypertension diagnosed postoperatively.

1. Ten patients with essential hypertension and ten healthy men were submitted to mental stress consisting of Kraepelin's arithmetic test combined with noise. Concentrations of plasma and urine catecholamines and of their metabolites as well as plasma renin activity before and after the test were studied. 2. In both groups a significant increase of noradrenaline and adrenaline in blood and noradrenaline in urine was observed. The urinary excretion of dopamine fell significantly in both groups after stress. 3. After mental stress a significant increase in urinary excretion of 3-methoxy-4-hydroxyphenylglycol was observed in both groups. The excretion of vanillylmandelic acid decreased significantly only in healthy subjects. 4. The plasma renin activity rose significantly in both groups but the increase was more pronounced in healthy subjects.

In 110 patients the diagnosis of pheochromocytoma was established by biochemical tests. These patients displayed various patterns of urinary and plasma catecholamines and their metabolites. The estimation of urinary methoxycatecholamines proved the most useful screening procedure. In patients with equivocal biochemical results the clonidine suppression test appeared to be a useful diagnostic tool. Clinical analysis displayed a bizzare course and unusual symptoms and signs in some patients. Computerized tomography and adrenal scintigraphic imaging with ¹³¹I-meta-iodobenzylguanidine were found to be the most reliable non-invasive methods for localization of the tumor.

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SUMMARYUrinary excretion of catecholamines, vanillylmandelic acid, and methoxycatecholamines was studied in 50 patients with renovascular hypertension.The urinary excretion of noradrenaline was increased in patients with elevated peripheral plasma renin activity and in those with elevated renal vein renin ratio in comparison with the patients with normal plasma renin activity.The urinary excretion of dopamine was diminished and vanillylmandelic acid increased in the entire group of patients with renovascular hypertension.In the investigated group, following sodium restriction, the mean urinary excretion of noradrenaline increased while dopamine excretion decreased.These results suggest that the increased sympathetic-activity may play a role in the pathogenesis of renovascular hypertention.