高圧酸素の副腎エピネフリン・ノルエピネフリン含量増加作用-とくに高血圧自然発症ラットを中心として -

ウィスター京都ラット(WKY), 高血圧自然発症ラット(SHR), 高血圧自然発症脳卒中易発症ラット(SHRSP)を5群に分け, 6週齢より13週齢まで以下のごとぎ実験操作を連日施行した.第1群は対照群, 第皿群は大気下における絶対圧2気圧の高圧酸素処置群, 第皿群は高濃度酸素環境下における高圧酸素処置群, 第W群はhydralazine投与群, 第V群は1%飲料食塩水投与下における副腎別除群である.第1群のSHR, SHRSPの副腎中のエピネフリン(E), ノルェピネフリン(NE)含量は同群のWKYのぞ治より高値であった(P<0, 05-Pく0.001).同様の傾向が副腎E含量についても認められた.第ll, 皿群のSHR, SHRSPの副腎E・NE含量は第1群のSHR, SHRSPのそれよりそれぞれ高値を示した(P<0.05～P<0.001).しかし両群間のstrainmatchedhypertensiveratsの血圧は同レベルであった.副腎別除術(V)はどのratstrainにも有意の血圧変動を惹起させなかった.hydralazine(N)投与はSHR, SHRSPの血圧を低下させたが, 副腎E・NE含量に有意の影響を与えなかった.以上の成績より, SHR, SHRSPの副腎髄質機能が高圧酸素処置により充進することが証明された.また同時に, 副腎髄質機能の充進がこれらの動物の高血圧のpathogenesisとほとんど無関係であることが判明した.Adrenal catecholamines were determined in Wistar Kyoto rats (WKY), and stroke-prone and stroke-resistant spontaneously hypertensive rats (SHRSP, SHR) treated with hyperbaric oxygen for 90 minutes daily from 6 to 13 weeks of age. The animals were divided into 5 groups. Group I (control group), was handled under the same conditions as pressure-treated groups II and III, but with ambient oxygen pressure and concentration. Group II (pressure-control group), was treated with 2 atmospheric absolute pressures (ATA) of air without any oxygen provided. Group III (high-oxygen group), was exposed to 2 ATA under the environment of air saturating oxygen. Group IV (antihypertensive group), was treated with hydralazine. Group V (adrenalectomized group), was given 1% NaCl solution and bilateral adrenalectomy. The average contents of adrenal norepinephrine of SHR and of SHRSP in Group I were greater (p less than 0.05-p less than 0.001) than those of the WKY in Group I. A similar tendency was also observed for the content of adrenal epinephrine. The average concentrations of adrenal epinephrine and norepinephrine of SHR and SHRSP in Group II and III were significantly (p less than 0.05-p less than 0.001) greater than those of the respective rats in Group I, but no significant differences were noted in the blood pressure between pressure-treated groups (II, III) and the control group (I). Adrenalectomized SHR, SHRSP and WKY rats (Group V) had similar blood pressure levels as the control rats (Group I). The development of hypertension in SHR and SHRSP was effectively suppressed by the treatment with hydralazine, which, however failed to reduce concentrations of adrenal epinephrine and norepinephrine in these rats. These results indicate that increased adrenomedullary function in SHR and SHRSP is further enhanced by hyperbaric oxygenation treatment, but that high concentrations of adrenal catecholamines are not required for the pathogenesis of spontaneous hypertension of these animals at this age

進行性尿路上皮癌の治療経験

23例の進行性尿路上皮腫瘍に対し, 外科療法, 化学療法, 放射線療法をおこなった.放射線療法の有無にかかわらず, 根治的外科手術により8例がtumor freeになった.15例に対する化学療法で1例が, CR, 5例がPRとなった.low grade, low stage, Karnofsky performance ratingが高い例に対しては高成績が得られた.CDDP, ADM, cyclophosphamideの三者併用療法, またはCDDP中心の化学療法は進行性尿路上皮腫瘍に対して有効であると推測されたTwenty-three patients with locally advanced and/or metastatic urothelial tumors were treated by surgery, chemotherapy or radiation. Radical operation with or without radiation resulted in tumor free conditions in 8 patients. Fifteen patients who had a few dimensionally estimable disease parameters, underwent chemotherapy. Objective responses were obtained in 6 of the 15 patients (1 CR and 5 PR). The objective response of low grade or low stage tumors or cases with high Karnofsky performance ratings was moderate. Combination chemotherapy with cisplatin (CDDP), doxorubicin (ADM) and cyclophosphamide or a CDDP-containing combination appeared to be beneficial for patients with advanced urothelial tract tumors with palliative purpose

精巣上体アデノマトイド腫瘍の免疫組織学的検索

症例1は50歳男性で, 左精巣上体尾部に発生した直径1cmの腫瘍であった.症例2は36歳男性で, 右陰嚢内に生じた直径1.5cmの腫瘍で, 精巣上体, 精巣からは独立していた.症例3は46歳男性, 左精巣上体頭部に生じた, 直径1.3cmの腫瘍であった.以上の3例のアデノマトイド腫瘍に対して免疫組織化学的検査(ケラチン, CEA, 第VIII因子関連抗原)を行った.結果は3例共, 中皮細胞由来を示唆するものであった.さらに組織学的分類との比較を行い, 若干の文献的考察を加えて報告した.Three cases of epididymal adenomatoid tumor are presented. The adenoid compositions of the tumors lined by epithelial cells showed a canalicular pattern with large vascular spaces, tubular pattern with glandlike regions or plexiform pattern with connective tissue strands. Immunohistochemistry demonstrated positive cytoplasmic staining for keratin, but negative for carcinoembryonic antigen and factor VIII-related antigen in each neoplastic tissue. These findings support the mesothelial origin of the epididymal adenomatoid tumors

腎動脈塞栓術後の腎癌患者にみられる傍糸球体細胞, 腎髄質問質細胞の過形成

腎癌36例に腎摘除術ないしは腎動脈塞栓術兼腎摘除術を施行した.前者のみでは, 血圧は不変で, 測定したvasoactive substanceも変化しなかった.後者を施行すると, まず腎摘除術に先行して行った.腎動脈塞栓術により血圧は上昇し, 血漿レニン活性(PRA)と尿中プロスタグランディンE2 (PG)排泄量は正の相関をもって増加した.摘除腎には, 傍糸球体装置および髄質間質細胞の過形成が見られた.すなわち, 腎癌患者における急速な腎虚血はレニン分泌細胞の増殖とともにPG分泌細胞の増殖も惹起させることが推測されたRenal tissue was obtained from 36 patients with renal cell carcinoma, some of whom received renal arterial embolization. The removed specimens was examined histopathologically and the concentration of some vasoactive substances in these patients was measured. Nephrectomy alone produced no discernible changes in blood pressure, vasoactive substances determined or histopathological findings of the kidney. Renal arterial embolization raised the blood pressure in association with the elevation of plasma renin activity (PRA) and urinary prostaglandin (PG) E2 excretion. A linear relationship was found to exist between PRA and mean blood pressure (r = 0.70, p less than 0.001). Hyperplasia of the juxtaglomerular (JG) apparatus, and high granularity of sudan black B granules in renomedullary interstitial cells were confirmed in removed kidneys of patients who had received embolization alone. Subsequently high renin production would be anticipated to influence overproduction of renal PG E2 in acute ischemic kidney in patients with renal cell carcinoma, and hypertension following renal arterial embolization appears to be caused by the hyperplasia of the JG apparatus

Hyperbaric oxygen therapy for radiation cystitis in patients with prostate cancer: A long-term follow-up study

Objective:To assess the safety and efficacy of hyperbaric oxygen (HBO) for treating radiation cystitis a long-term follow-up study was done in patients with prostate cancer, the second most common malignancy in Japan.\nPatients and Methods:A total of 38 patients at an age of 68 +- 8 years with radiation cystitis following irradiation of prostate cancer were treated with HBO at 2 absolute atmospheric pressures for 90 min daily. The average number of HBO treatment sessions in each patient was 62 +- 12. The follow-up period was 11.6 +- 3.7 years. We evaluated objective and subjective symptoms periodically with special reference to the initiation timing of HBO therapy.\nResults:High efficacy ratios of objective and subjective findings were obtained at 2 and 4 (79-95%) years, respectively. After 7 years\u27 follow-up, these ratios decreased slightly (72-83%) but still remained stable thereafter (75-88%) without any serious accident. Comparison of late morbidity scores before and 11.6 years after HBO therapy showed significant improvement (p < 0.0005). Twenty-eight patients (74%) obtained nonrecurrent outcome. They had received 18% lower (p < 0.001) radiation dosage than recurrent patients. The interval between the onset of hematuria and start of HBO treatment in nonrecurrent patients was 30% shorter (p < 0.001) than that of recurrent patients.\nConclusions: We elucidated the long-term safety and beneficial effect of HBO therapy of radiation cystitis in patients with prostate cancer. Early application of HBO treatment after the onset of hematuria appears to produce favorable outcome