Adrenal venography has been performed in 19 cases including 4 cases of Cushing's syndrome, 5 cases of primary aldosteronism, 2 cases of adrenogenital syndrome, 2 cases of retroperitoneal tumor, 3 cases of hypertension, and others.
Adrenal tumors were roentgenographically identified in 2 cases of Cushing's syndrome and 4 cases of primary aldosteronism and a case of adrenogenital syndrome, and hyperplasia in a case of Cushing's syndrome, a case of Cushing's disease and a case of adrenogenital syndrome. The diagnostic accuracy of adrenal venography was confirmed by surgical exploration in 10 cases except a case of primary aldosteronism in which venography was misleading due to a poor X-ray condition. The smallest tumor diagnosed was 1.8cm in diameter. There were no serious complications during and after this examination.
In the conventional perirenal gas insufflation combined with tomography, the normal adrenal gland, adrenal hyperplasia and small tumor less than 2cm in diameter would only show their dim outline. In addition, that a soft tissue mass in suprarenal space sometimes assumes lesions of the adrenal gland on the retroperitoneal peumogram was confirmed by surgical scrutiny.
Adrenal venography is, at present, the most accurate roentgenographic method for assessing the adrenal lesions except pheochromocytoma and differentiating a retroperitoneal tumor from an adrenal tumor.

View full abstract

Compared with another adrenal steroids, it is not long since aldosterone was first isolated and synthetized. It was, only 16 years ago when Conn first described the primary aldosteronism a new adrenal syndrome. Therefore, even today, details of this steroid remain obscure. Only a few confirmatory reports of the hyperaldosteronism have so far been published. In this paper, a case of primary aldosteronism (PA) and 2 cases of secondary aldosteronism (SA) are reported. In reviewing the characteristics of our clinical data, some fascinating clinical and fundamental relations between PA and SA are discussed.

View full abstract

Hyperchloremic acidosis is not rarely observed in patients with chronic obstructive uropathy. The mechanisms for these alteration have not been clearly estalbished. As an approach to elucidating the underlying mechanisms of electrolytes abnormalities, measurements of serum electrolytes and the response of acid excretion in the urine to administration of ammonium chloride have been evaluated. The present report deals with 17 patients with obstructive uropathy who showed hyperchloremic acidosis (chloride: higher than 111mEq/L, more than twice in 4-5 weeks; bicarbonate: less than 22mEq/L). For the purpose of comparison, 8 patients with obstructive uropathy as well as normochloremic acidosis were studied as controls.
The observed difference on the serum electrolytes was that serum sodium concentration was within the normal range in the patients with hyperchloremic acidosis. On the contrary, low level of serum sodium concentration was encountered in the patients with normochloremic acidosis.
The considered possibility was that a decrease of serum bicarbonate concentration was compensated by an increase of serum chloride concentration, because measurement of serum phosphate and sulfate concentration showed no significant increase, if present at all, regardless the existence of acidosis. As might be obvious in the patients with normochloremic acidosis, electroneutrality is maintained by a decrease of serum sodium concentration, compensating a decrease of serum bicarbonate concentration.
Impairment of hydrogen ion excretion was encountered on oral ammonium chloride loading in both acidotic patients, which was manifest especially in the patients with hyperchloremic acidosis.
It is suggested that the pattern of acid excretion is not only due to simple loss of functioning nephrons, but also due to spxcific defects in tubular acid excretion.
Thus, hyperchloremic acidosis in chronic obstructive uropathy might be attributed to specific tubular defects which produce a situation compatible with that found in renal tubular acidosis. The development of hyperchloremia might become evident when the serum sodium concentration is within the normal range.

View full abstract

The renal preservation has become one of the most important problems in human renal transplantation. The purpose of this paper is to find a better way to preserve the kidney, by evaluating energy metabolism and tissue respiration of the preserved canine kidneys. Hurbert and Potter's method (with column chromatography using Dowex-1 x-8 resin) was employed to the slices of the kidney to determine the renal adenosine nucleotides (ATP). Oxygen consumption (QO₂) was also determined in the cortex of the sliced kidney with Warburg manometer. Both parameters, ATP content and QO₂, were the excellent methods to examine the viability of the preserved kidney. They declined gradually after storage for six hours and decreased markedly thereafter. As far as the preservation methods were concerned, hypothermic (4°C) saline immersion under hyperbaric oxygen atomosphere as well as the hypothermic perfusion with canine plasma plus 10% dextran (1:1) under hyperbaric oxygen atomosphere (3 atomospheres) was beneficial. Metabolic benefits were not seen after the storage by simple preservation at room temperature, hypothermic immersion alone, preservation under hyperbaric oxygen atomosphere, or the combination of the two latters.
When 10^-4M of inosine was mixed to the perfusate composed of canine plasma plus 10% dextran, ATP content in the kidney was significantly increased, thus inosine was proved efficacious to preserve the canine kidneys.

View full abstract

In 40 patients with bladder cancer (transitional cell carcinoma, 35; squamous cell carcinoma, 5), the detection of circulating tumor cells has been studied by a filter membrane method. Blood samples (4ml) were simultaneously collected from the antecubital and iliac veins before, during and after partial cystectomy, transurethral fulguration or electroresection through the open bladder. The obtained blood samples were added to 5ml of saline solution containing 20mg of Streptolysin S (INF-fraction, 1, 500×10⁴-HU/g); after 20 minutes of incubation at 37°C, they were then centrifugated at 1, 000r.p.m. for 10 minutes, and the sediments were mixed evenly with 15ml of saline solution. Using a vacuum-pressure pump, these mixtures were filtrated through a Sartorius membrane filter (φ47mm, pore size 10μ). The membranes were fixed, stained (H-E) and subjected to microscopic examination. The results obtained were as follows:
1. Before operation, the positive rates of circulating tumor cells in antecubital and iliac blood samples were 7 and 17 per cent, respectively.
2. During surgical intervention, both rates increased to 38 and 35 per cent, respectively. In 27 cases of a histologically low malignant tumor (stage A), the rate in the iliac samples was 33 per cent, while no tumor cells were detected in the antecubital samples. Ten cases undergoing transurethral fulguration showed a rate of 30 per cent in iliac samples.
3. The tumor cell-positive iliac samples had cells ranging in number from 2 to 195. Among these samples, however, there were only 2 cases which contained more than 10 cells per 1ml of blood.
4. There was no interrelation between the prognosis and the rates. However, the fact that even transurethral fulguration, which was generally performed on small and low malignant tumors, caused the appearance of circulating tumor cells would indicate the administration of antitumor drugs.

View full abstract

Since the original reports of transrectal prostatography by direct puncture of the prostatic gland under television monitoring and/or cineradiography, attempts have been made to utilize this technique in various conditions of the prostate. It was confirmed by our observations that the benign hyperplasia of the prostate was a well vascularized mass prostatographically. For this reason, we thought that the prostatogram and phlebogram of the veins surrounding the prostatic gland were visualized immediately and only transiently following injection of small volumes of contrast material into the parenchyma of the prostate. If the contrast material remained longer in the prostatic gland, the prostatogram would delineate the prostate more clearly and it might be more useful for the diagnosis of many clinical conditions, especially for the detection of malignancy in the prostate. For this purpose, we have examined the effect of epirenamine, a temporary but powerful vasoconstrictor, in the transrectal prostatograms which assures greater certainty of diagnosis.
We also hoped to evaluate the effect of epirenamine. The effect of intra-prostatic epirenamine injection in transrectal prostatography was studied in benign prostatic hyperplasia. Time and dose criteria were defined and prostatographic findings were stated.
The greater vasoconstriction produced by this method in periprostatic and intra-prostatic vessels, as compared with that without epirenamine, was substantiated. The small-dose contrast material prostatography was made possible by reducing prostatic circulation by intra-prostatic injection of epirenamine just prior to the adenographic phase of transrectal prostatography.

View full abstract