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Volume 75, Issue 2
Displaying 1-18 of 18 articles from this issue
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Shigezo Kinura, Masaaki Nakazono, Hiroshi Tazaki1984 Volume 75 Issue 2 Pages 181-196
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSNephrotoxity of Sisomicin, a recently developed aminoglycoside, was studied in the sequence of proximal tubular damage and repair after administration of the agent based on light and electron microscopic observations and biochemical evaluations using over 50 Wistar strain rats weighing 200-250gr.
Sisomicine was administered intramuscularly at a dose of either 60 or 100mg/kg/day for 7 days continuously and during the first 3 administration days, the animals were kept dehydrated.
The animals were sacrificed on 3, 7, and 12th days to study damage processes in the proximal tubular epithelium and the recovery was evaluated in the animals sacrificed in 2, 3, and 4th week after discontinuation of the injection. As a control study, Ceftizoxime was administered to rats intraperitoneally at a dose rate either 800 or 1200mg/kg/day under the same conditions to those of the experimental series.
The most dramatic and characteristic morphological change in the proximal tubular epithelium after aminoglcosides administration is that myeloid bodies can be observed under electron microscopy.
Appearance of the myeloid bodies has been confirmed a common morphological change in the epithelium after administration of either amphiphilic or cationic amphiphilic agents. Both formation and degenerative processes of the myeloid body were studied through electron microscopic observation.
After aminoglycoside administration, lysosomal enzymes which concern with fat metabolism, namely sphingomyelinase, are kept in inhibitatory conditions, so that it is difficult for the enzymes to digest the substances completely which configurate the myeloid body in a certain period and they are stored in the lysosomes.
Our conclusion is that renal insufficiency develops clinically at the point when the accumulated myeloid body is over the maximum capacity of lysosome. In other words, the accumulation process reaches the stage of lysosomes overloading.View full abstractDownload PDF (15537K) -
With Special Reference to the Correlation between the Side of Brain Lesions and the Disturbance of MicturitionTadakazu Ueda1984 Volume 75 Issue 2 Pages 197-210
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESS259 cases of brain bladder dut to various neurological diseases were studied with standard urological examinations and urodynamic methods. The side of brain lesions was decided chiefly on the findings of brain computed tomography, referring to neurological physical examinations and cerebral angiography. The correlation between the side of brain lesions and the disturbance of micturition was investigated and the following results were obtained.
1) The causative diseases of brain bladder were classified into five groups: group I, the cerebrovascular disease; group II, degenerative diseases; group III, brain tumors; group IV, psychogenic diseases; and group V, the others.
2) As for urinary symptoms, there were 135 cases (52%) of difficulty of urination, 106 cases (41%) of urinary incontinence and 92 cases (36%) of frequency. Besides these main symptoms, hematuria, residual sensation and others were found in 66 cases (25%).
3) It was statistically proved that there was correlation between left hemiplegia and difficulty of urination or frequency, and between right hemiplegia and urinary incontinence (p<0.5%).
4) The cases of left hemicerebral lesions accompanied mostly by urinary incontinence and showed hyperreflexia in the pattern of cystometrogram in groups I and III. On the other hand, most of right hemicerebral lesions revealed to have difficulty of urination and relatively high frequency of hyperreflexia in comparison with the pattern of areflexia or normal.
5) Various data about the rate of urinary tract infection or urodynamics including urethral pressure profile, uroflowmetry and sphincter-EMO were reported in the relationship between the side of brain lesions and the disturbance of micturition.View full abstractDownload PDF (4423K) -
Hideyuki Akaza, Kiyoo Koseki, Katsumi Kobayashi, Tadao Niijima, M. S. ...1984 Volume 75 Issue 2 Pages 211-214
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSA Bleomycin/Concanavalin-A conjugate (BLM/Con A) was prepared for the purpose of enhancing activity of Bleomycin. The extent of substitution was approximately 8 moles BLM per a mole Con A. Fifty percent inhibiting concentrations of the conjugate (IC50) against cultured HeLa cells were 40μg/ml at the continuous treatment (72hrs. treatment) and 10.6μg/ml at the short time exposure (1hr. treat-ment). The IC50 values as BLM corrected from the weight ratio of the conjugate were 0.432μg/ml at the continuous treamtment and 1.14μg/ml at the short time exposure, whereas the IC50, when HeLa cells were treated by BLM alone, were 1.9μg/ml at the former condition and 20.0μg/ml at the latter condition. Con A itself did not inhibit the growth of HeLa cells at the concentration of up to 10μg/ml. Twenty mg/ml of α-methyl-D-mannoside, specific inhibitor of Con A, prevented the growth inhibiting activity of the conjugate.
BLM/Con A conjugate was tested for a possibility as an intravesical chemotherapeutic agent against an experimental bladder tumor that was made by tumor cell (MBT-2) implantation to the fulgulated mouse (C3HIHe) bladder mucosa.
The results indicated that BLM/Con A conjugate might be useful as an intravesical chemotherapeutic agent against a bladder tumor. Further experiments are now undergoing.View full abstractDownload PDF (465K) -
Toru Hara, Teruo Highchi, Hitoshi Goshima, Naohide Hiranoi, Akira Kimu ...1984 Volume 75 Issue 2 Pages 215-221
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSNMR-CT of whole bodies for urological lesions such as prostatic tumour, renal tumour, adrenal tumour and hydronephrosis have been obtained by a prototype machine manufactured by Toshiba Corporation since May 1982. The principle and features of this new imaging technique are reported, and clinical application in urology are discussed.
This new technique for obtaining cross-sectional pictures through whole human body without exposing the patient to ionizing radiation, has proved to be useful diagnostic tool for urological lesions, and could provide us with information of the functional and/or physiological state of viscera. NMR-CT could also be an efficient method in diagnosing neoplastic lesions and will reveal their anatomical and pathophysiological natures in the near future.View full abstractDownload PDF (5442K) -
Yukio Honma, Yoshiki Sugiyama, Tadaichi Kitamura, Shohei Nakamura, Yoj ...1984 Volume 75 Issue 2 Pages 222-228
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSConsecutive 128 cases of transitional cell carcinoma of the urinary bladder were analyzed related to pathological findings and the mode of operation: transurethral resection or partial cystectomy (conservative operation) and total cystectomy. Indication of operation was determined mainly by cystoscopic findings. In 83 cases for coservative operation, no cancer death was found and only one was finally cystectomized. In 45 cases for total cystectomy, a good five-year survival rate of 58% was obtained, although 2 cases seemed to be treatable by conservative operations.
These results show that indication of conservative operation is successfully determined by cystoscopic findings and rarely forced to be changed even for recurrent tumors, and total cystectomy should be carefully indicated by utilizing diagnostic tools other than cystoscopy.View full abstractDownload PDF (900K) -
Kenji Rinsho, Satoru Ishikawa, Shinichi Nemoto, Shori Kano, Kenkichi K ...1984 Volume 75 Issue 2 Pages 229-232
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSPatients with estrogen-resistant adenocarcinoma of the prostate were treated by infusion of antineoplastic drugs. In clinical evaluation of the therapeutic effectiveness, we found that there were many problems about the method of evaluation.
1) It is difficult to measure objectivelly the size of prostatic cancer. The transrectal ultrasonotomography is too expensive.
2) The metastasis to bone is difficult not only to quantitate but also to interpret. New areas of sclerotic or osteoblastic lesions in bone survey can be an indication of either progression or regression of tumor. Bone scan is a qualitative examination and quantitative improvement is difficult to make clear.
3) The timing of evaluation is a very important factor which influences the result.View full abstractDownload PDF (2091K) -
1. Enhanced Synthesis of Collagen and Non-Collagenous Protein in Renal Artery of Spontaneously Hypertensive Rats: The Possible Role Causing HypertensionTeruhiro Nakada1984 Volume 75 Issue 2 Pages 233-239
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSMetabolism of vascular protein was investigated by determining the incorporation rate of 3H-proline into the collagen and non-collagenous protein in vasculatures in young genetically hypertensive rats some of which received antihypertensive drugs.
The incorporation of 3H-proline into the collagen or non-collagenous protein in renal artery in 8-week-old spontaneously hypertensive rats (SHR) and in stroke-prone spontaneously hypertensive rats (SHRSP) was significantly greater than that in Wistar Kyoto rats (WKY). Administration of clonidine or phenoxybemzamine (POB) decreased the incorporation of tritiated proline into the collagen and non-collagenous protein in each rat strain, concomitant with a reduction of blood pressure. The incorporation rates of tritiated proline into these fibrous protein fractions were similar in the heart of each rat strain treated with either clonidine or POB. The free 3H-proline radioactivity 2 hrs in serum after the injection of tritiated proline was similar in each examined group.
These results indicate that increased synthesis of collagen and non-collagenous protein in the renal artery in young genetically hypertensive rats is involved in the pathogenesis of development of hypertension.View full abstractDownload PDF (844K) -
2. High Amount of Collagen and Non-Collagenous Protein in Renal Artery of Hypertensive PatientsTeruhiro Nakada, Hiroshi Koike, Takashi Katayama1984 Volume 75 Issue 2 Pages 240-244
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSFractions of collagen, non-collagenous protein and elastin were extracted from renal arteries of 24 normotensive subjects and 12 hypertensive patients. Evidence has been presented showeing that (1) the amounts of collagen and non-collagenous protein in hypertensives were 70% (p<0.001) and 50% (p<0.001) greater than those of normotensives, respectively; (2) the ratio of collagen/elastin of hypertensives was 70% greater (p<0.001) than that of normotensives; (3) positive correlations were noted between collagen content and mean arterial pressure (MAP) (r=0.65, p<0.00), non-collagenous protein content and MAP (r=0.51, p<0.01) and ratio of collagen/elastin and MAP (r=0.61, p<0.001), respectively; (4) the amounts of collagen and non-collagenous protein tended to increase with aging, but the changes were statistically insignificant; (5) no significant differences were noted between males and females in collagen content, non-collagenous protein content and elastin content.
The current findings, taken together with previous experimental works, provide a basis for speculation on the possible role in the pathogenesis of hypertension of increased amounts of collagen and non-collagenous protein in renal artery.View full abstractDownload PDF (541K) -
Evaluation of Renal Function by Urinary Excretion of β2-MicroglobulinRyuichiro Konda, Seiichi Orikasa1984 Volume 75 Issue 2 Pages 245-254
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSUrinary Excretion rate of β2-microglobulin (β2-MG) was determined to evaluate renal function of 74 children with sterile reflux. Spot urine was used for assay of urinary β2-MG and the ratio of urinary β2-MG to creatinine was calculated to correct the possible difference resulting from variable conditions of diuresis.
41% of the children with reflux showed abnormally high urinary ratio and high values were frequently observed in children with high grade reflux. However, over one-third of children with low grade reflux showed also high value, and there was no correlation between the grade of reflux and the urinary ratio. Although the urinary ratio exceeded the upper limit of normal range in 33% of cases with normal IVP and in 53% of those with abnormal IVP, there was no correlation between IVP finding and urinary ratio. Renal ratio (renal size), an index of renal growth, was also investigated and compared with urinary ratio.
The urinary ratio was high in 32% of children with normal sized kidneys and 74% of those with small sized kidneys. In a few cases with small sized kidney, however, it was within the normal range. This discrepancy may be due to reduced excretion of β2-MG from completely damaged nephrons associated with regional interstitial fibrosis.
The urinary ratio obtained before and after the antireflux operation demonstrated postoperative amelioration in all 11 cases with high preoperative values.
These results indicate that the renal disturbance was caused by sterile reflux alone and improved by elimination of reflux. It has also become clear that neither grade of reflux nor IVP finding serves as a method to detect subtle renal damage, and that renal disturbance occurs even in cases with reflux of low grade and normal IVP. It is necessary to evaluate both urinary ratio and renal ratio (renal size) in cases with completely damaged nephrons, because they show often normal urinary excretion rate of β2-MG.View full abstractDownload PDF (1188K) -
I. Clinical and Experimental Studies on Immunosuppression by Combined use of Azathioprine and MizoribineTakeshi Matsuura, Seiji Kunikata, Hidenori Kanda, Masanori Iguchi, Tak ...1984 Volume 75 Issue 2 Pages 255-262
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSOur clinical and experimental results of immunosuppressive therapy by combined use of azathioprine and mizoribine are reported.
One year graft survival rate was 75.6% in the cases of living related renal transplantation. We experienced rather frequent occurence of leukopenia as an adverse effect of immunosuppression especially in the recipients whose grafts were poorly functioning. Because mizoribine is excreted from kidney, it is necessary to reduce the dosage of mizoribine to prevent the accumulation of the drug.
Combined use of azathioprine and mizoribine inhibited PHA induced lymphocyte blastogenesis more strongly than separate use of each drug. The influence of azathioprine and mizoribine on the cell cycle progression of cultured cell line was analysed by flow cytometry. Both drugs showed similar mode of action, namely, cultured cell was accumulated to S phase. Because azathioprine and mizoribine act at different point in the synthesis of purine nucleotides, combined use of them seems to block the pathway of DNA synthesis sequentially and stronger immunosuppressive effect is expected.View full abstractDownload PDF (937K) -
III. Development of Urethral Pressure TomographyTakashi Morita1984 Volume 75 Issue 2 Pages 263-268
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSA new catheter with four lumen at an angle of 90° around the circumference of the tip was designed for recording the urethral pressure profiles at the anterior, right, posterior and left walls of the urethra. These four directional urethral pressure profiles were composed as cross sections of urethra like tomography using a microcomputer.
This new method of drawing the cross sections of urethral pressure profile may be called as urethral pressure tomography (UPT). Using the UPT method, the urethral function and urethral form can be examined on three dimensional aspect.View full abstractDownload PDF (1980K) -
Clinical Experience and Preliminary Study of Thomsem-Friedenreich AntigenKinuko Sasaki, Akio Maru, Shigeo Sakashita, Tomohiko Koyanagi1984 Volume 75 Issue 2 Pages 269-277
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSClinical experience on thirteen cases of carcinoma in situ (CIS) of urinary bladder were reported. T (Thomsen-Friedenreich) antigen, a precursor of other blood group antigen than ABH, was investigated by the technicque of Avidin-Biotin-Peroxidase Complex (ABC) method primarily in these CIS lesion. We also investigated T antigen expression in ureteropelvic tumor and attempted to correlate its expression with their prognosis.
Overall clinical pictures of CIS simulate chronic cystitis in symptomatology as well as in cystscopic findings. Urine cytology was highly positive with almost all showing more than class 3b abnormalities. In many instances, CIS lesion involved all bladder area and extened also to the ureter and prostate in some. Total cystectomy, TUR and irradiation were treatment of choice in ten, two and one patient, respectively.
T antigen, which is expressed in many carcinomas, and arbitrarily defined here as T(+), is usually not detected in normal epithelium of such organs as the bladder. Normally, T antigen is cryptic but can be unmasked with neuraminidase. The cells which express the T antigen only after pretreatment with neuraminidase are defined as cryptic T(+). The cells which lacked T even after neuraminidase treatment are called cryptic T(-). We investigated the T antigen expression in CIS lesion and ureteropelvic tumor by staining paraffin section with T-specific lectin (peanut agglutinin). In nine cases of CIS which ABH was negative, cryptic T(+), T(+) and cryptic T(-) were found in three, one and five cases, respectively. In ten cases of high grade ureteropelvic tumor, which ABH was negative in all cases, cryptic T(+) was found in five cases. Of these five cases, three are alive and well over five years after surgery, while one was dead and the other was lost to follow up. These data, although preliminary, indicate that, by combining two markers (ABH antigen and T antigen), prognosis of urothelial tumor may be assessed with much improved predictability. Prospective study along this line is warranted in our CIS cases.View full abstractDownload PDF (4443K) -
Fujio Masuda, Yoshikazu Arai, Tetsuro Ohnishi, Jyojiro Nakada, Masayas ...1984 Volume 75 Issue 2 Pages 278-282
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSOut of 112 patients with renal cell carcinoma, seen in the Jikei University Hospital during the 11-year period from July 1973 through June 1983, 9 (8.0%) exhibited brain metastasis. The examination of the afflicted side of the primary focus revealed the brain metastasis in 6 of 63 patients (9.5%) in the case of the left renal carcinoma, and in 3 of 48 patients (6.3%) in the case of the right.
There was thus a tendency for the brain metastasis to occur more easily in the left than in the right renal cancer. As for the time of the metastasis discovery, it was already at the time of initial diagnosis in 2 cases, and in the other 7, it was after nephrectomy. The average interval between the operation and metastasis discovery was 3 years, and in 4 of the 7 cases (57%), over 3 years had passed in between. Seven of the 9 cases were complicated by pulmonary metastasis, and it was considered most frequent that the brain metastasis occurred by the route through the pulmonary metastatic focus. As for the symptom of brain metastasis, dyskinesia was most frequent, being seen in 5 cases (56%), followed by headache, nausea, lalopathy, dysopia and dusuria. As for the diagnostic method, CT scanning was most effective, and as for the treatment, 4 of the 9 cases were subjected to operation with the highest efficacy. But radiotherapy and chemotherapy, performed on 4 cases, were without effect. One-year survival rate for the 9 cases was 22%, and the interval between the diagnosis of brain metastasis and death for the 7 dead cases ranged 2 months to 4 years and 6 months, with the mean of 11.4 months. The time of diagnosis and the method of therapy were recognised as the factors influencing the prognosis of brain metastasis.View full abstractDownload PDF (1922K) -
First Report: In 132 Biopsy CasesAkihiro Yamamoto, Fumio Yoneda, Go Akagi1984 Volume 75 Issue 2 Pages 283-289
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSNon-neoplastic lesions of the bladder epithelium were examined histologically in 132 biopsy cases who had some urological symptoms such as macrohematuria, pollakisuria and miction pain, but no history of bladder cancer. Brunn's nests and cystitis glandularis were seen in 52 cases (39.4%) and 21 cases (15.9%), respectively. In patients with prostatic hypertrophy, the incidence of Brunn's nests was obviously high. Squamous metaplasia was significantly frequent in the female (14/77 cases) than in the male (2/55 cases). Hyperplasia and dysplasia were detected in 13 cases (9.8%) and 5 cases (3.8%), respectively. Columnar and cuboidal metaplasia were rare. Squamous metaplasia, hyperplasia and cystitis glandularis were frequently seen associated with lymphocytic infiltration in the lamina propria. These results suggest that these three lesions are closely related to chronic inflammation.View full abstractDownload PDF (4176K) -
Second Report: The Influence of Indwelling CatheterizationAkihiro Yamamoto, Fumio Yoneda, Go Akagi1984 Volume 75 Issue 2 Pages 290-294
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSHistopathological changes of the bladder epithelium in 33 male and 2 female patients treated with indwelling catheterization was studied by mucosal biopsies. The duration of indwelling catheterization ranged from 1month to 9years, with an average of 2years and 5months. Dysplasia and hyperplasia were detected in 5 (14.3%) and 8 (22.9%) of 35 cases, respectively. Squamous metaplasia, columnar metaplasia, Brunn's nests and cystitis glandularis were seen in 5 (14.3%), 4 (11.4%), 13 (37.1%) and 3 (8.6%) of cases, respectively. Cuboidal metaplasia was found in only one case. Lymphocytic infiltration in the lamina propria was observed in all cases. Dysplasia and squamous metaplasia were not detected in patients with indwelling catheterization for less than 1year. Compared with patients free from catheters, dysplasia, hyperplasia and columnar metaplasia were more frequent in patients with catheterization. In male patients with catheterization, the incidence of squamous metaplasia was also high. Since some of these lesions are considered to be premalignant conditions, patients with long-term indwelling catheterization should be examined periodically by cytology and cystoscopy.View full abstractDownload PDF (2127K) -
MORPHOLOGICAL EVALUATION BY RADIOGRAPHY AND FUNCTIONAL EVALUATION BY URODYNAMIC STUDYMineo Kobayashi, Atsuo Kondo, Osamu Kobayashi, Hideo Mitsuya1984 Volume 75 Issue 2 Pages 295-303
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSTwenty-seven kidneys in 23 patients suffering from congenital obstruction at the ureteropelvic junction experienced during the past 8years were investigated by radiographic and urodynamic studies. Pyeloplasty was performed in 24 kidneys of 20 patients, in which 18 kidneys were operated on by the Anderson-Hynes' method and 6 kidneys by the Foley YV method. The conclusions were as follows:
1. There was no significant difference in the operating time, bleeding volume, period of nephrostomy tube intubated, and period of admission between the Anderson-Hynes' and Foley YV method.
2. In cases of non-visualized congenital large hydronephrosis, the separate renal function study through a percutaneous nephrostomy was found important for deciding the operative method.
3. Pelvicaliceal space morphologically measured in the X-ray film decreased in 58.3% of the cases, where the Anderson-Hynes' method was superior to the Foley YV method.
4. The overall results evaluated by means of drip infusion pyelography revealed excellent in 4.2% of the cases and good in 50%, where the Anderson-Hynes's was superior to Foley YV method.
5. Pressure flow study was performed in 11 kidneys pre-operatively and in 8 kidneys postoperatively. Three kidneys were judged to be of no indication for pyeloplasty. When pressure flow study was performed for the evaluation of urinary passage through a nephrostomy tube within 1month after the pyeloplastic surgery, the relative pressure of less than 20cm of water suggested the presence of no urinary obstruction.
6. Diuresis renogram with 99mTc-DTPA was studied post-operatively in 12 kidneys. The obstructive pattern was consistent with the advanced dilated upper urinary tract in spite of the improved urinary passage suggested by excretory urography and pressure flow study.View full abstractDownload PDF (3283K) -
Fujio Masuda, Yoshikazu Arai, Kazuya Toshiro, Gyojiro Nakada, Tetsuro ...1984 Volume 75 Issue 2 Pages 304-309
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSWe reviewed operative results, and intra- and postoperative complications of 77 cases who underwent abdominal nephrectomy at the Jikei University Hospital during the 15years period from April 1968 to March 1983. In cases who did not undergo other combined operations or who did not have intraoperative complications, the mean time required for operation was 212 minutes and the mean amount of blood loss was 983ml. As to the effect by lymphadenctomy, the time required for operation was 283 minutes and blood loss was 1290ml in cases who underwent lymphadenectomy as compared to 168 minutes and 704ml, respectively, in cases who did not undergo lymphadenectomy. Thus, lymphadenctomy caused a prolongation of 115 minutes in operative time and an increase of 586ml in the amount of blood loss. No difference was seen either in the required operative time or the amount of blood loss between cases who received preoperative renal artery embolization and cases who did not receive such operation.
Intraoperative complications occurred in 10 cases (13.0%). The commonest complications were splenic damages and vascular injuries, which were seen in 3 cases each. Splenic damages were considered to be the greatest potential disadvantage of this approach. Postoperative complications developed in 11 cases (14.3%). Among these cases, 1 case each of sepsis, renal failure and chylous ascites (in total 3 cases) died within the first month after the operation. Postoperative mortality was 3.9%. From these results it was considered that satisfying results can be obtained by abdominal nephrectomy in majority of cases of renal cell carcinoma, while the thoracoabdominal approach appears to be more suitable for certain cases associated with large tumors or obesity.View full abstractDownload PDF (824K) -
Tadaichi Kitamura, Yukio Homma, Yoji Nishimura1984 Volume 75 Issue 2 Pages 310-315
Published: 1984
Released on J-STAGE: July 23, 2010
JOURNAL FREE ACCESSDuring the preoperative examination, hypouricemia was found in a 69-year-old male with bladder cancer. His serum level of uric acid was 0.9-1.1mg/dl and his urinary excretion of uric acid was 520mg/24hr. An extensive examination for uric acid clearance revealed that uric acid clearance and its ratio to endogenous creatinine clearance were 51.9ml/min/1.73m2 and 50.6%, respectively. A diagnosis of renal hypouricemia was given on the basis of these results and without evidence of other metabolic abnormality.
The mechanism of isolated tubular defect of uric acid reabsorption was speculated as either a defect of presecretory reabsorption or an incomplete defect of both presecretory and postsecretory reabsorption after performing oral load tests of pyrazinamide, probenecid and benzbromarone in the patient.
As the serum level of uric acid was low after transurethral resection of the bladder cancer and it was also low in one of his two daughters, renal hypouricemia was assumed to be familial and fortuitously combined with bladder cancer.View full abstractDownload PDF (1904K)
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