In order to clarify the physiological role of antidiuretic hormone (ADH) in regulating the renal water handling, a bioassay for ADH in urine was devised, and urinary excretion of ADH was determined in 21 normal subjects, 14 patients with central diabetes insipidus, and 8 patients with inappropriate secretion of ADH (SIADH). Under normally hydrated states, 12 normal subjects and 7 patients with central diabetes insipidus excreted 22.9±3.2mU of ADH/day (12.9±2.0μU/ml) (mean±s. E.), and less than 8.2mU/day (2.0μU/ml), respectively. 8 patients with SIADH excreted ADH ranging from 15.6 to 808.2mU/day. Under dehydrated states, ADH excretion increased to 3.0±0.5mU/hr (137.9±33.4μU/ml) (mean±S. E.) in 9 normal subjects. At that time, plasma and urine osmolality increased to 282.5±1.1 and 1004±43mOsm/kg (mean±S. E.), respectively. In all of 7 patients with central diabetes insipidus, urinary ADH could be detected when plasma osmolality increased to 298.4±1.7 mOsm/kg (mean±S. E.) after water deprivation. In 9 normal subjects, urinary ADH excretion decreased after water loading from 3.0±0.5 mU/hr to below 0.6mU/ hr (0.6μU/ml) with a concurrent reduction of plasma and urine osmolality to 274.8±1.4 and 81±7mOsm/kg (mean±S. E.), respectively. Two types of daily urinary excretion patterns of ADH were found in patients with SIADH. One of them had ectopic ADH producing tumor and excreted a relatively large amount of ADH, and the other was a non-tumor case which excreted a normal amount of ADH. However, either case showed no suppressibility of ADH in the face of an expansion of body fluid with hypo-osmolality of the plasma.
Human albumin prepared by the trichloroacetic acid method was treated with bromelin, ficin, papain, pronase or trypsin. Pronase- or trypsin-treated albumin showed four fragments on polyacrylamide disc electrophoresis. When rabbit antiserum to pronase-treated albumin was adsorbed with monkey albumin, antibody with human specificity was completely abolished, whereas anti-albumin serum adsorbed with pronase-treated albumin retained the antibody to human albumin. It was considered that antigenic site with human specificity in albumin structure was inactivated by pronase.
When a slice of calcium bilirubinate stone was incubated in a solution of tetrasodium salt of ethylendiamine-tetraacetic acid (EDTA. 4Na), a potent chelating agent, the solution exhibited a yellow brown tint, which was spectroscopically characteristic of bilirubin. Microscopic examination of the slice revealed dissolution of granules of calcium bilirubinate, leaving behind a reticular matrix of PAS-positive substance. The effect of EDTA. 4Na was influenced by pH, being fully effective only at pH 10 or more, and by temperature and concentration as well. Simultaneous application of bile salt enhanced the activity of EDTA. 4Na, hydrophilizing the gallstone surface to facilitate chelating reaction and also dissolving minor fatty components of the stone. Heparin at proper concentrations also promoted disintegration of the stone, changing surface potential of its constituent particles to the dispersion-prone charge. The effect of composite EDTA. 4Na-bile salt-heparin was thus significantly greater than that of single EDTA. 4Na. This mixture is promising for clinical application as a means of direct dissolution of residual gallstones.
Fourteen autopsied cases of malignant nephrosclerosis were classified into 6 of pure form in which syndrome of malignant hypertension developed from the beginning of the disease, and 8 of exacerbated form with appearance of the syndrome in the course of essential hypertension. Pathohistological study of these cases elucidated the differences in histologic manifestations between pure and exacerbated forms of malignant nephrosclerosis as to which little had been known as yet. In the pure form arterioles and small arteries characteristically demonstrated acute or recent lesions such as fibrinoid necrosis and hemorrhage into intima, and intimal cellular hyperplasia of somewhat longer duration, whereas in the exacerbated form coexistence of vascular lesions of various intensities and durations, acute (fibrinoid necrosis and hemorrhage), intermediate (intimal cellular hyperplasia) to chronic (sclerosis and lamellar elastosis), and superposition of more recent vascular lesions on more advanced or older ones were noted. Superposition of vascular alterations was interpreted to be not necessarily specific for exacerbated form but histologic manifestation of recurrence which is liable to be the case more frequently in exacerbated form than in pure form in the longer course of essential hypertension or of malignant hypertension. Some other related problems were also considered and discussed.
The purpose of the present study is to determine the risk of infections associated with umbilical vessel catheterization. During a period of recent four years, 97 catheters were inserted into the umbilical vessels of 94 newborn infants in a newborn nursery. Thirty percent of the catheter tips were colonized upon removal with pathogens (11%) and contaminants. The rate of catheter colonization was not dependent on sex, gestational age, birth weight and duration of catheteriza-tion. Bacteria were isolated from blood specimen drawn via the catheter upon removal in one patient, but blood sample from peripheral artery and catheter tip yielded no organisms in this patient. One patient (1%) was found to be septi-cemic while the catheter was in place. Culture of the catheter tip and blood drawn via the catheter proved unreliable in the diagnosis of subsequent systemic infection. Judicious surveillance for systemic infection by peripheral blood culture is necessary.
The cell cycle of the human bladder carcinoma cell line (MGH-U1 cells) was prolonged immediately after low dose of triethylene thiophosphoramide (Thio Tepa). Although the elongated cell cycle time seemed to return to the control level 48 hr following the treatment, there still remained postsynthetic accumulation and postmitotic diminution in the cell population and the cells were insensitive to high dose of the agent. The present results suggest that Thio Tepa is less effective for G2 cells, but more effective for G1 or S cells.
Thirty-three patients with acute pyelonephritis were studied with regard to the changes in plasma renin activity (PRA) along the clinical course of the disease. 1) Abnormally high PRA was found in 64% of patients in the active stage of acute pyelonephritis; they showed a decrease in urinary output of sodium, a reduction in creatinine clearance, and high indices of inflammatory activity. 2) The changes of PRA in the course of acute pyelonephritis were negatively correlated to the urinary sodium excretion and creatinine clearance, but positively to the activity of inflammation, serum sodium concentration and the number of E. coli in the urine. PRA returned to normal with the improvement of pyelonephritis. 3) Concerning the mechanism of hyperreninemia in the active stage of the disease, the following three factors may be considered; renal ischemia, negative sodium balance in the body, and inflammation. Of these, the negative sodium balance seems to be the most important. The patients could not take enough foods to maintain their energy and sodium balance because of fever and pain. 4) The significance of resting PRA in acute pyelonephritis might be to reflect the sodium status in the body, but not to be related to hypertension
Human embryo kidney (HEK) cells infected with adenovirus type 12 and its cytocidal mutants (Cyt) synthesized different glycoproteins respectively on the cell surface at the early stage of infection. Furthermore, a less and a highly tumorigenic Cyt mutants synthesized different glycoproteins. The level of sialyltransferase activity in the microsomes of HEK cells was increased when cells were infected with adenovirus type 12. It was confirmed that there was a positive correlation between the sialyltransferase activity in the microsomes and tumorigenicity.
Quantitative changes of the pancreatic islets in diabetes mellitus were analyzed by a stereological method. 26 maturity-onset and 5 growth-onset diabetics, and 37 nondiabetics including 9 hypertensives were selected from autopsy materials and the pancreases were subjected to histometry. The total islet volume Vi was 0.974cm3 in the control, whereas it was only 0.596 and 0.255 cm3 in the maturityonset and growth-onset diabetic groups, respectively. The hypertensive group gave almost the same value as the control. There was an obvious negative correlation between Vi and the maximum blood sugar level during glucose tolerance test, whether the case was diabetic or not. Moreover, in the diabetic group Vi diminished with descending age of onset. These findings indicate the importance of Vi in the pathophysiology of diabetes and support the classical concept of insulin deficiency as the primary pathogenetic role. On the other hand, the total islet number Ni decreased with increasing mean radius_??_, and the diabetic and control cases shared a common regression of Ni on _??_. The diabetic pancreas was not characterized by Ni, _??_ or by the distribution pattern of r.
Urinary and skin porphyrins were determined with thin layer chromatography and fluorescent scanning analysis in 6 hexachlorobenzene-induced porphyric rats. In both urine and skin, uroporphyrin predominated followed by heptacarboxylic porphyrin and/or coproporphyrin. After UV-A irradiation, there were neither significant changes in the skin porphyrin level nor direct correlation between skin porphyrin levels and intensities of the UV light irradiated. However, there was an intimate correlation between the fluctuation of the skin levels of the uroporphyrin and of the heptacarboxylic porphyrin.