Shunro Momose

Human renal cell carcinoma: establishment and characterization of two new cell lines.

Characterization studies have been carried out on 2 cell lines (KPK 1 and KPK 13) established from human renal adenocarcinoma. KPK 1 and KPK 13 have been passaged 178 times in vitro for about 6 years and 7 months and 78 times for about 3 years an 2 months, respectively. Although morphologic differences exist between the 2 lines, each has an epithelial morphology and exhibits multilayering. Doubling time of KPK 1 and KPK 13 cells was 29 hours and 51 hours, respectively. Both KPK 1 and KPK 13 induced tumors at the site of subcutaneous injection, closely resembling the original tumor from which they were derived. Chromosome number of both cell lines was 100 per cent aneuploid and the presence of Y chromosomes was confirmed by G banding in KPK 13 cells. KPK 1 was found to have high thromboplastic and high fibrinolytic activities, whereas KPK 13 was shown to have comparatively low thromboplastic and no detectable fibrinolytic activities. These activities were detected in the serum free supernatant fraction from KPK 1 cells but were not detected in that from KPK 13 cells.

Non-Obstructive Vesicoureteral Reflux in Adults: Value of Conservative Treatment

Chronic or recurrent non-obstructive urinary tract infection was investigated in 158 adult patients, 39 of whom had vesicoureteral reflux. Conservative, long-term chemotherapy did not eradicate the reflux in these patients. The characteristics of reflux in adults were studied with cystograms, excretory urograms, cystoscopic findings of the ureteral orifices or trigones and the clinical histories of the patients. These data were evaluated and compared to data obtained from adults with chronic or recurrent uncomplicated urinary tract infection and from children with vesicoureteral reflux who were referred to us during the same period. Non-obstructive vesicoureteral reflux in adults may be considered to be congenital in most cases, since the proportion of trigonal anomalies in adults with reflux is equal to that in children and the frequency of abnormalities at the ureteral orifice and trigonal region is significantly more than the frequency noted in control patients with uncomplicated pyelonephritis. Characteristically, excretory urography revealed caliceal scarring in adults with reflux in contrast to children, in whom a normal or dilated pattern of the upper tract was prominent. Recurring renal infection, for which this congenital defect of the ureterovesical valve must be responsible, produces progressive renal damage. Prolonged conservative treatment is of little use and is often destructive in adults with reflux.

Postoperative prophylactic intravesical instillation of cytosine arabinoside and mitomycin C in superficial bladder tumor

A follow-up study was made on 225 Japanese patients with superficial bladder tumors who were treated postoperatively with intravesical instillation of cytosine arabinoside and mitomycin C nineteen times during one year. Cumulative recurrence rates of the tumor were 16.7 and 41.9 per cent during the first 1 and 3.5 years after surgery, respectively. These results are superior to the previous findings in cases in which instillation therapy was not given. Histologically, there was no definite difference in recurrence among the groups with low-grade and high-grade tumors. The recurrence rate of multiple tumors was higher than that of a solitary tumor. Earlier postoperative instillation appeared to be more effective during the initial one year after surgery.

Establishment of a human renal pelvic cancer cell line producing tissue thromboplastin and plasminogen activator

SummaryA new epithelial cell line derived from undifferentiated carcinoma of human renal pelvis, designated KP 1, was established in vitro. The cell line has been passaged 190 times in vitro for 5 years and 9 months. The predominant cell in KP1 was a tear-drop-shaped cell. Doubling time of the cell line was 35 h. The malignant epithelial character of this line was verified by carcinogenictiy in the subcuticular layer of nude mice and by karyotypic analysis which revealed the cells to be completely aneuploid with a model chromosome number in the hypertriploid range. KP 1 cells were shown to produce both tissue thromboplastin and plasminogen activator which was immunologically identical to urokinase, the plasminogen activator in urine.

Surgical Treatment of Renovascular Hypertension Associated with Bilateral Renal Artery Stenosis

We report on 15 patients operated upon for renovascular hypertension associated with bilateral renal artery stenosis. Followup has been for 1 to 12 years. Four of 5 patients with positive split renal function studies and 3 of 5 patients with positive renal vein renin assays underwent unilateral operations on the positive side. All of these patients were cured or improved. The guide for unilateral operations in hypertensive patients with bilateral renal artery stenosis by angiography was the physiological information obtained from the preoperative screening tests, especially the plasma renin activity ratios of the 3 different veins and the split renal function studies.

Renal autotransplantation as a means of revascularization in renovascular hypertension.

Renal autotransplantation seems to be of great value as a means of renal revascularization in hypertension of renovascular origin, especially in those cases in which the preceding angioplastic procedures have resulted in failure. It is also applicable as a primary procedure for those in whom the revascularization in situ is considered to be technically difficult because of the severity and extension of the vascular lesion. The two cases of renovascular hypertension reported here were treated by renal autotransplantation to the ipsilateral iliac fossa subsequent to unsuccessful revascularization in situ. The transplanted kidneys are functioning normally and the patients have remained normotensive for fourteen and twenty months, respectively. A brief reference was made regarding the management of the ureter in renal autotransplantation.

Bilateral renal artery stenosis and renovascular hypertension in rabbits.

In 21 rabbits bilateral renal artery stenosis was produced by constriction of the right renal artery with 1 of 3 different clips in size followed by left renal artery constriction with the smallest clip. Five to 6 weeks after left renal artery constriction, 5 ml. of the blood samples for the measurement of plasma renin activity (PRA) was taken from both renal veins and the distal vena cava, and the left nephrectomy was performed. In 17 out of 21 rabbits, PRA was determined in 3 different blood veins: L, left renal vein PRA; R, right renal vein PRA; and P, distal vena cava vein PRA. Three PRA patterns, L greater than P greater than or equal to R (A type), L, R greater than P (B type) and R greater than L not equal to P (C type), were observed. Removal of the left kidney caused a significant decrease in the average blood pressure persisting for 5 weeks in the rabbits with the type A pattern of PRA (p less than 0.05). In all 4 animals with the type B or C pattern of PRA hypertension persisted even after removal of the left kidney. Comparison of the PRA values between the venous blood in 3 different vascular trees seems very useful to predict the depressor response that follows nephrectomy of the severer constricted side.

An Evaluation of Average Flow Rate in Traumatic Neurogenic Bladder Dysfunction

The average flow rate of 60 male patients with spinal cord injuries was studied in a simplified method with a urine cup and a stopwatch. Results were based on the level of the lesion, course of injury, sensation of micturition, cystometric type and cystographic change. The average flow rate of 60 patients with traumatic spinal cord injury was 10.62 plus or minus 5.37 ml. per second, while that of 10 normal adult male patients was 15.70 plus or minus 3.10 ml. per second. The average flow rate was better in patients who had normal or nearly normal proprioceptive sensation than in those without this sensation. Bladder deterioration was not noted on the cystograms of patients who had normal proprioceptive sensations. Therefore, patients with traumatic cord bladders with normal urinary sensation may have a good prognosis, while those with disturbed proprioceptive sensation may require some urological manipulation to reduce urethral resistance.

Followup Study After Conservative and Surgical Treatment of Vesicoureteral Reflux

Our series of 94 cases (145 ureters) of vesicoureteral reflux is reviewed. The occasional disappearance of reflux during conservative treatment should not be mistaken for cure because of its variable nature. To avoid such a mistake voiding cystography under fluoroscopic monitoring is repeated indefinitely. Those patients who were treated surgically were followed for at least 2 to 3 years before cure was established. Transient ureteral dilatation after reimplantation was eradicated within 3 months. Postoperative urinary infection was observed at various intervals, ranging from 1 week to 5 months, and the erythrocyte sedimentation rate was likely to be influenced by infection. Postoperative chemotherapy was continued until the erythrocyte sedimentation rate was normal and there was no infection and/or dilatation of the upper tract.

Renal autotransplantation--results of 15 years follow-up.

Three patients with renovascular hypertension who underwent renal autotransplantation were followed for over 15 years. These patients were all normotensive and renal functions were satisfactory, during the follow-up period.