James A. Pitcock

Familial juvenile polyposis of the colon

Familial juvenile polyposis of the colon is characterized by multiple juvenile polyps, frequent recurrences, and a family history of carcinoma or adenomatous polyposis of the colon. Two cases are presented, and the 6 previously reported families with this condition are summarized. A few of the lesions in these patients had features of both juvenile and adenomatous polyps, and one patient had an adenomatous polyp of the jejunum. Further studies are necessary to determine the frequency with which juvenile polyposis and carcinoma of the colon occur in the same family, and to identify a possible relationship between the 2 in these families.

Malignant hypertension in blacks: Malignant intrarenal arterial disease as observed by light and electron microscopy

Volhard and Fahr recognized that hypertensive intrarenal vascular disease could be divided into two groups corresponding to the clinical states of benign and malignant hypertension. Since that time, numerous papers on malignant hypertension, primarily dealing with European derived populations, have emphasized fibrinoid necrosis of small arteries and arterioles as the lesion of malignant hypertension, although some have also recognized a myxoid intimal lesion as characteristic. Today in the United States, however, a significant proportion of malignant hypertension occurs in blacks. In the present study, patients have lacked fibrinoid necrosis of arterioles and only rarely have had some atypical necrosis of small arteries. The prominent, but not pathognomonic, lesion in this series is a myxoid intimal thickening of small arteries consisting of smooth muscle cells, acid mucopolysaccharides, basement membrane-like materal, collagen, and other amorphous and unidentified material, probably plasma derived.

Renal medullary fibrosis in hypertension

Abstract The degree of fibrosis in both the inner and outer medullae of the kidney was semiquantitated in 100 unselected autopsies in a blind study. A statistically significant relationship between renal medullary fibrosis in both zones, hypertension, and renal arterio- and arteriolar sclerosis was observed. The part medullary fibrosis plays in this relationship was not indicated by this study, but it most likely is secondary to the renal arterial disease. Renal medullary fibrosis adds another relationship between the renal medulla and the hypertensive state. Since there is experimental evidence in support of an antihypertensive function exerted by the renal medulla, renal medullary fibrosis could be an index of the loss of such function.

Giant-cell Reaction of Bone: Report Of Two Cases

Two cases of giant-cell reaction are described and added to the previously reported cases bringing the total number in the literature to five. All lesions involve the small bones of the hand and are roentgenographically lytic lesions. Giant-cell reaction responds to conservative surgical treatment, and there have been no known recurrences. This lesion should be considered when a bone lesion with numerous giant cells is found in the hand.

SECRETION OF MEDULLIPIN I BY ISOLATED KIDNEYS PERFUSED UNDER ELEVATED PRESSURE

1. Medullipin I (Med I) is a hormone extracted from renal papillae and its renomedullary interstitial cells (RIC). Med I is stimulated by elevation of the renal artery perfusion pressure.

The renal antihypertensive endocrine function: its relation to cytochrome P-450

Unclipping the Goldblatt hypertensive rat lowers the blood pressure by cells in the renal papilla, the renomedullary interstitial cells (RIC), secreting a hormone that is part of a vasodilator system. A vasodilator, termed medullipin I, can be extracted from the renal papilla. Medullipin I and the renal venous effluent following unclipping have identical biologic properties. Medullipin I appears to be the agent secreted by the kidney following unclipping. Both medullipin I and the renal venous effluent must traverse the liver to be active. Medullipin I is converted in the liver to its active form, medullipin II. The blood pressure-lowering effect of both medullipin I and the renal venous effluent after unclipping are blocked by SKF 525A, the inhibitor of cytochrome P-450. The relation of the kidney to the liver was tested using the rate of decline of the blood pressure after unclipping as an index of the endocrine antihypertensive function of the kidney--acceleration of the decline being considered as increased function, decrease of the decline as decreased function. Five compounds: BW755C, phenobarbital, ketoconazole, eicosatetraynoic acid (ETYA) and butylated hydroxytoluene (BHT), and two manipulations: uretero-caval anastomosis (UCA) and removal of the liver from the circulation were used followed by unclipping. BW755C, inhibitor of both cyclo-oxygenase and lipoxygenase, potentiated the antihypertensive function to a maximum. It is reasoned that inhibition of the first two pathways of arachidonic acid metabolism potentiates the third pathway, the cytochrome P-450 pathway.(ABSTRACT TRUNCATED AT 250 WORDS)

Microinvasive carcinoma of the cervix

The depth and pattern of invasion were compared in 115 cases of microinvasive carcinoma. The 71 invading 1 mm. or less were focal (96 per cent) rather than confluent (4 per cent) and were cured by simple hysterectomy(one vaginal vault recurrence). The 44 invading 2 to 5 mm. showed a confluent pattern in 39 per cent; a need for treating pelvic lymphatics was demonstrated by one with a positive hypogastric lymph node and by two pelvic recurrences. An additional 26 cases assessed as beyond microinvasive (6 to 10 mm. in depth) included five of 16 without radical treatment who died from cancer, while all treated radically survived, including five with lymphatic involvement.

Biologic Contrasts Between Medullipin I and Vasoactive Glyceryl Compounds

Medullipin I causes a delayed onset depressor response when injected intravenously into rats. The glyceryl compounds selachyl alcohol (SA) and monoolein (MO) cause similar vasodepression. The neutral lipid 1-O-hexadecyl-2-acetyl-sn-glycerol (HAG) was suggested by Blank et al to be medullipin I (Med I, formerly ANRL). Biologic comparisons were made between Med I and various glyceryl compounds, including SA, MO, HAG, alkyl glyceryl ethers of phosphatidyl choline (termed APRL by us), diacylated SA, and the n-butyl boronic acid derivative of SA and MO. The n-butyl boronic acid derivative of Med I also was evaluated. The delay in onset of the depressor response to Med I was reduced by the injection of Med I into the portal vein; that of SA and MO was not. Med I, SA, and MO were activated by the liver, while APRL and HAG were not. Tween 20 inhibited Med I, SA, and MO, but not APRL and HAG. Proadifen (SKF 525A) inhibited Med I, but not SA and MO. The n-butyl boronic acid derivatives of SA, MO, and Med I were inactive. Med I, like SA and MO, appeared to have two hydroxyl groups in close proximity. It was concluded that Med I is neither HAG, APRL, SA, nor MO.

Isolation and culture of juxtaglomerular and renomedullary interstitial cells

Publisher Summary This chapter focuses on the isolation and culture of juxtaglomerular and renomedullary interstitial cells. Two monolayer cell cultures having unique biologic attributes can be derived from the kidney by special techniques. The juxtaglomerular cells (JGCs) are derived from the renal cortex. The renomedullary interstitial cells (RICs) are derived from the renal medulla, especially its inner portion or renal papilla. Both cell lines exert local as well as systemic effects. Juxtaglomerular cells were isolated from the kidneys of neonatal rats belonging to an inbred rat strain (Wistar/GM). The hypertension induced by cultured JGCs constitutes a unique model of experimental hypertension. It offers possibilities in attempts to dissect out the role of the renin-angiotensin system in initiating and maintaining the hypertensive state. Transplants of fragmented renal medulla were used originally to prevent the hypertensive state. The concentration of RICs within these transplants makes them the source of the RIC monolayer cell culture.

morphometric Studies on the Rat Renal Papilla of Resistant and Sensitive Strains in Partial Nephrectomy Salt Hypertension

The renomedullary interstitial cell (RIC) was studied morphometrically in the partial nephrectomy-salt (Chanutin-Ferris) model of hypertension. The RIC were compared in four strains of rat, two of them being resistant to the induction of this form of hypertension and two of them being sensitive. The Dahl salt-resistant (R/JR) rat was compared to a commercial Sprague-Dawley (SD) strain, and a Wistar derived strain discovered in Belgrade by Susic and Kentera (WB) was compared to a commercial Wistar strain (W). In both studies, resistance and sensitivity correlated well with the state of the RIC before the experimental procedure, the resistant strain having more numerous and better granulated RIC than the sensitive strain. It may therefore be possible to predict salt-resistance or sensitivity in rats by morphological examination of the RIC.