Hidekatsu Furuta

Catecholamine metabolism in pheochromocytoma and normal adrenal medullae.

The tissue contents of catecholamine, its precursor and its major metabolites were determined in 8 human pheochromocytomas and 26 normal adrenal glands. Pheochromocytomas contained significantly larger amounts of norepinephrine, dopamine, dihydroxyphenylalanine, tyrosine hydroxylase activity, metanephrine, normetanephrine and vanillylmandelic acid than did normal adrenal medullae. The content ratio of epinephrine/norepinephrine in normal adrenal medullae was significantly higher than that in pheochromocytomas but there were considerable individual variations in the metanephrine/normetanephrine and vanillylmandelic acid/3-methoxy-4-hydroxyphenylethylglycol ratios in pheochromocytomas. In normal adrenal medullae the tissue content of tyrosine hydroxylase activity correlated inversely with the tissue contents of epinephrine (r equals -0.78, p less than 0.001), norepinephrine (r equals -0.78, p less than 0.001) and total catecholamines (r equals -0.87, p less than 0.001), respectively but no significant relation was found between both parameters in pheochromocytomas. These results indicate the possible presence of a negative feedback mechanism of catecholamine via tyrosine hydroxylase in normal adrenal medullae but none in pheochromocytomas. In addition, the increased degradation catecholamine pathway in pheochromocytomas appears to be unstable compared to that in normal adrenal medullae.

Effect of high-calcium diet on urinary oxalate excretion in urinary stone formers.

The effect of mild high-calcium diet or regular-calcium diet on urinary calcium excretion, urinary oxalate excretion, urinary calcium/creatinine ratio, urinary oxalate/creatinine ratio, and the probability of being a stone former (PSF) were studied in 85 patients with idiopathic urolithiasis. Intake of high-calcium diet for 5-6 days reduced (p less than 0.01-p less than 0.001) urinary oxalate excretion, urinary oxalate/creatine ratio and PSF in patients with idiopathic hypercalciuria. Under the regular-calcium diet, administration of 60 mg/day of pyridoxal phosphate for 3 months lowered (p less than 0.05-p less than 0.01) urinary oxalate excretion, urinary oxalate/creatinine ratio and PSF in patients with idiopathic hypercalciuria alone. From these findings, intake of mild high-calcium diet appears to be beneficial to decrease the urinary oxalate excretion and PSF in patients with idiopathic hypercalciuria. Pyridoxal phosphate has all the features of suppressing such risk factors for stone formation in patients with idiopathic hypercalciuria.

Age-related differences in norepinephrine and non-collagenous protein in human vas deferens.

The existence of norepinephrine or non-collagenous protein in some tissues is believed to reflect the sympathetic discharge of the structures and plays an important role in contractile ability. Specimens of vas deferens were obtained from 44 subjects in various decades of life from age 20 to 84, and levels of norepinephrine, non-collagenous protein, collagen and elastin were determined. The level of norepinephrine and non-collagenous protein declined with increasing age. Both parameters inversely correlated with age. Collagen and elastin increased with advancing age. The regression line and coefficient of correlation between both variables showed significantly positive correlations. It is suggested that the contractile ability of human vas deferens, as defined by norepinephrine and non-collagenous protein contents, decreases with age, and the age-related increase in collagen and elastin may be of importance in reducing the contractile capability of this structure.

The Effect of Adrenal Surgery on Plasma Atrial Natriuretic Factor and Sodium Escape Phenomenon in Patients with Primary Aldosteronism

Plasma concentrations of atrial natriuretic factor and some vasoactive substances were determined in 8 patients with aldosterone-producing adenoma, 10 with idiopathic adrenal hyperplasia, 10 normotensive subjects and 12 patients with essential hypertension. Plasma atrial natriuretic factor concentration in patients with aldosterone-producing adenoma was the highest among the examined groups. Adrenal surgery reduced plasma concentrations of atrial natriuretic factor and aldosterone concomitant with the elevation in urinary sodium excretion, plasma renin activity and urinary sodium-to-potassium ratio. Withdrawal of trilostane (3 beta-hydroxysteroid dehydrogenase inhibitor) in patients with idiopathic adrenal hyperplasia increased plasma concentrations of atrial natriuretic factor and aldosterone, and decreased the urinary sodium-to-potassium ratio, plasma renin activity and urinary sodium excretion. However, reduced urinary sodium excretion following trilostane treatment returned to the control level successively despite the high levels of plasma atrial natriuretic factor and aldosterone. Acute infusion of saline remarkably increased plasma atrial natriuretic factor concentration in patients with idiopathic adrenal hyperplasia and aldosterone-producing adenoma. These results suggest that a high level of atrial natriuretic factor is a characteristic feature in patients with aldosterone-producing adenoma caused chiefly by the expansion of extracellular fluid volume, and circulating atrial natriuretic factor may contribute to regulation of the sodium escape phenomenon in patients with aldosterone-producing adenoma or idiopathic adrenal hyperplasia.

Unilateral Renal Agenesis with or without Ipsilateral Adrenal Agenesis

We analyzed 7 patients with unilateral renal agenesis. The coexistence of unilateral renal agenesis with ipsilateral adrenal agenesis was confirmed surgically in 2 patients, 1 of whom had clinical features of Cushings syndrome owing to adrenocortical adenoma of a solitary adrenal gland. It is imperative to suspect abnormalities of the ipsilateral adrenal gland when unilateral renal agenesis is encountered. Unilateral renal agenesis usually is asymptomatic. Recognition of this anomaly is essential for early correct diagnosis.

Plasma concentration of atrial natriuretic factor in idiopathic oedema.

Low level of plasma atrial natriuretic factor (ANF) under altered dietary sodium and its elevation during bigeminy were found in a 40-year-old woman with idiopathic oedema. The natriuretic effect of this peptide and the role of renin-angiotensin-aldsterone system in oedema formation in this disorder are discussed.

Effect of hyperbaric oxygen therapy on essential haematuria.

Forty-three patients with essential haematuria were studied for 35 days to determine the efficacy of hyperbaric oxyten (OHP) exposure on haemostatic ability.Out of 15 untreated patients, haematuria persisted for the study period in all but one patient (6.7%). Out of 11 patients who received 90 mg/day of carbazochrome sodium sulfate and 750 mg/day of tranexanic acid excellent haemostatic results had been obtained in 2 (18.2%). Results of exposure of 17 patients to 2 atm. pressure of OHP for 90 min daily were excellent in 10 (58.8%) and good in one (5.9%). No serious adverse effects had been noted following OHP treatment. These results indicate that OHP can be applied for the treatment of essential haematuria if routine haemostatic drugs fail to improve the condition.

Impaired urine concentrating ability in Itai-itai (ouch-ouch) disease

A case of Itai-itai (ouch-ouch) disease with reduced urinary kallikrein excretion and slightly enhanced renin-angiotensin-aldosterone system is described. Although it is well known that cadmium toxicity frequently affects the renal tubular lesions, this report is the first to demonstrate the impaired urine concentrating ability in this disease.