Gosuke Inoue

Renin Release in Patients with Benign Essential Hypertension

In 16 of 28 patients with benign essential hypertension, reduction of mean arterial pressure to 75 to 120 mm Hg by infusion of sodium nitroprusside caused significant increase in renin release estimated by the renal-systemic difference of renin activity and renal plasma flow (RPF). The threshold at which renin release increased was shifted to a range that was intermediate between that previously reported for normotensive subjects and that for patients with renovascular hypertension, but the average magnitude of renin release was almost comparable to that in normotensive subjects. In the other 12 patients, no significant renin release occurred during reduction in pressure of comparable degree.The difference in renin release was difficult to explain by the difference in severity of hypertensive disease or in sodium excretion, but increased renin release was usually associated with a decrease in RBF and a rise in renal vascular resistance, while insignificant release was usually associated with an insignificant change in RBF and a decrease in resistance. The average known duration of hypertension was significantly greater in the unresponsive patients. It is suggested that renal sympathetic nerve activity may be a factor in the variations in renin release in patients with essential hypertension.

Age-Related Change in Acid Mucopolysaccharides Level and Water Content in the Papillary Region of Human Kidneys

An attempt has been made to explore the interrelationship between the age-related changes in acid mucopolysaccharides (AMPS) and water content of the renal papilla. Water content of human renal papilla changes significantly with age but the correlation between AMPS and water content of this region is just below the 5% level. On the other hand, the ratio of water content to AMPS decreases significantly with advancing age. Since the change in the ratio of these two substances is interpreted to express mainly the alteration of the ground substance with age, the possibility is discussed that the age-related changes in AMPS and water content of the renal papilla might be related to the decrement in concentrating ability of urine in the elderly person.

The Effect of Amino Acid Infusion on Partial Pressure of Oxygen in Pelvic Urine of the Rat

Renal function decreases with age, but the precise mechanism of the decrease is unknown. Recently, Brenner et al. have proposed the hypothesis that high protein intake may injury renal function in various clinical settings including the aging kidney. Since connective tissue in the renal papilla changes with age, high protein intake may have some deleterious effect on the renal papilla. In this study, the effect of amino acid infusion on partial pressure of oxygen of pelvic urine was examined in the rat. After amino acid infusion, glomerular filtration rate significantly increased and partial pressure of oxygen of pelvic urine decreased, while partial pressure of oxygen of arterial blood remained unchanged. The findings imply that high protein intake may affect the renal papilla both acutely and chronically through renal medullary hypoxia.

Age-Related Changes of Acid Mucopolysaccharides in Various Portions of the Renal Artery

Acid mucopolysaccharides (AMPS) of the renal arterial system were studied to observe changes with advancing age. The arteries were dissected from cadaver kidneys, made free of lesions, and divided into three portions according to locations. Uronic acid measurements showed that the AMPS contents were significantly different among the three portions, with trend of decrease from proximal towards distal portions. With age there was a linear increase of AMPS, which was most marked in the proximal portion. It should be stressed that the aging process of the vascular system differs in different portions of the renal arterial system.

A CASE OF JUVENILE CANCER OF THE LIVER IN WHICH THE PARTICIPATION OF HEREDITARY FACTOR MAY BE CONSIDERED

肝癌或は肝硬変症の発生に遺伝的素因の関与することがあることは古くから知られている.われわれは肝癌で死亡した患者の母の同胞4人中2人が肝癌といわれており,母は肝硬変症,患者の同胞3人中2人がそれぞれ肝癌,肝硬変症を有するのを知り,それぞれについて臨床的,病理学的に検討する機会を得た.母は47才のときから腹水,浮腫,肝機能障害があり,発病以来1年で意識障害,下血を来たして死亡.臨床的に肝硬変症と診断された.姉は37才で肝機能は正常であるが,肝生検により肝硬変症と診断された.妹は28才時,全経過4カ月で死亡.肝腫,肝機能障害,腹水,肺転移が認められ,肝癌と診断された.患者は34才,男.4年前から肝腫大に気づかれているが,発熱,腹痛,異和感などの症状が自覚されてから4カ月の経過で死亡した.剖検によりB型肝変硬を伴なう肝癌が確認された.最近3年間に当内科に入院した肝癌,肝硬変症患者では,肝癌7例では二等親以内に肝癌といわれているものは3例43%にあり,又,肝硬変症患者72例中,血縁に肝疾患をもつものは13例18%であった.これらの疾患の遺伝的素因がうかがわれるものであるが,個々の症例の診断をたしかめることのできた一家系として貴重な症例である.