H. Jarosz

Concentration of renin in the renal interstitium, as reflected in lymph.

The relationship between renin activity in renal venous plasma and in renal interstitial fluid, as reflected in the hilar lymph, was observed. Control measurements in 28 dogs demonstrated that renin levels in the hilar lymph were 3.5 +/-- (SEM) 0.4 times higher than in renal venous plasma and 6.1 +/- 1.0 times higher than in arterial plasma. Renin activity was increased to varying levels by raising ureteric pressure and by the administration of different doses of furosemide. Under all conditions, the changes in renin activity in renal venous plasma and in the interstitium, as reflected in the hilar lymph, were in parallel although often marked in the hilar lymph. Thus, the study shows that under conditions of increased renin release, the interstitial renin activity rises in consort with increases in arteriovenous plasma differences. This increase in interstitial renin activity occurred even under circumstances when renal blood flow is known to increase, thereby suggesting that angiotensin generated in the interstitium may have little effect on the cortical arteriolar caliber.

Selective postoperative radioactive iodine treatment of thyroid carcinoma

In a consecutive series of 234 patients with differentiated thyroid carcinoma of follicular cell origin (Hurthle cell tumors excluded), a radioactive iodine (131I) scan was obtained 3 to 6 months after thyroidectomy and 4 weeks after cessation of thyroid hormone treatments, only if extrathyroidal tumor extension or nodal or distant metastases were present. Twenty‐one patients (9%) with 131I uptake of 3% or more (group 1) were treated with 150 to 200 mCi of 131I. Forty‐four patients (19%) with less than 3% uptake (group 2) and 169 patients (72%) without evidence of metastases or extrathyroidal spread (group 3) were treated only with thyroid hormone. All patients initially underwent total thyroidectomy and modified neck dissection if cervical lymph node metastases were present. Three patients in group 1 and one patient in group 2 had recurrent tumor with a mean follow‐up of 8.9 and 8.4 years. There were no recurrences in group 3 with a mean follow‐up of 7.2 years. Death rate from thyroid carcinoma was 5% in group 1 (one patient) and 0% in groups 2 and 3. In conclusion, 1311 scanning and therapy may be omitted in patients with differentiated thyroid carcinoma in the absence of local tumor extension or regional or distant metastases. Therapy with 131I is not demonstrated to be of benefit in this population of patients. (SURGERY 1989;106:956‐9.)