Cardiovascular lesions in Sprague-Dawley rats induced by long-term treatment with caffeine

Male Sprague-Dawley rats were treated with phenacetin, phenazone or caffeine in the diet or with combinations of these chemicals for up to 117 weeks. Twenty of twenty-eight rats receiving caffeine only developed moderate to severe myocardial fibrosis compared with five control rats, in spite of the fact that the control rats had a sixteen weeks longer average life-span. Four caffeine-treated rats had histologic evidence of acute myocardial infarction which was not found in any of the other rats. Forty percent of the rats treated with caffeine only or with caffeine and phenacetin in combination were found to have periarteritis nodosa-like lesions in the mesenteric vessels. Seventy-nine percent of the rats treated with caffeine only and 52 percent of those treated with caffeine and phenacetin died from cardiovascular disease, compared with 17 percent among the control rats. Thus, long-term administration of caffeine to Sprague-Dawley rats is associated with markedly reduced life-span due to cardiovascular disease.

[Extracorporeal kidney surgery and calicovesicostomy in urothelial tumors of the upper urinary tract]

On the basis of 3 own cases it is reported on a new alternative treatment in otherwise inoperable cases in patients with urothelium tumours of the upper urinary tract. The histologically ascertained transitory cell carcinomas are treated by extracorporeal tumour resection and autotransplantation with calicovesicostomy. Main indications are malignant tumours of the renal pelvis and of the ureter in individual kidneys and in bilateral affection.

Analysis of Fat-Soluble Vitamins. XXV. High Performance Liquid Chromatographic Determination of Vitamin D in Multivitamin Preparations: Collaborative Study1

The HPLC method for determining vitamin D in multivitamin preparations was studied collaboratively. Samples were distributed to 43 laboratories in 10 countries. Twenty-four laboratories gave their results. The method specifies a reverse phase system for the cleanup and a straight phase system for the determination. Difficulties arise when laboratories are equipped with HPLC apparatus with a single column. Laboratories experienced in vitamin D analysis reported good results, even if they were equipped with a single column HPLC apparatus. Eleven of the 24 laboratories reported satisfactory results. For this rather complicated method, the coefficient of variation for a single assay is acceptable. The method has been adopted official first action as an alternative procedure to the chemical method for determining vitamin D in multivitamins.

Clear cell adenocarcinoma of the urethra. A case report

Clear cell adenocarcinoma of the urethra is a very rare entity. The presented case in a 35-year-old woman is the fourth in the literature. The tumour was localized in the wall of the urethra and infiltrated into the outer muscular layer of the urinary bladder. Metastatic spread was found in the paraaortic lymph nodes up to the level of the renal arteries. The final outcome was fatal in spite of the combined treatment with extensive surgery, cytostatic drugs and radiotherapy.

Focal prostatic granulomas. A sequel to transurethral resection

Clinical and histologic findings in 6 cases of prostatic granuloma following transurethral prostatic resection are described. The repeat operations were performed 1 week to 14 months after the initial resection because of severe micturition urgency, voiding difficulty or persistent haematuria. Bacteriuria did not seem to be of aetiologic importance for the granulomas. In all cases the granulomas contained areas of fibrinoid necrosis, and in three cases the granulomas were surrounded by eosinophilic infiltrates. The condition is not widely recognized by pathologists, which was illustrated by the initial diagnosis of specific inflammation consistent with tuberculosis in three patients. Though the disorder seems to be self-limiting, its association with persistent haematuria after transurethral prostatic resection is noteworthy.

Sister-chromatid exchanges and chromosomal aberrations in rats treated with phenacetin, phenazone and caffeine

To study chromosomal aberrations and the frequency of sister-chromatid exchanges (SCE) a long-term chronic toxicity study was performed in rats treated with phenacetin, phenazone and caffeine, alone and in different combinations. Compared with controls, aberrations such as gaps, breaks and structural dearrangements were only increased in the group treated by phenacetin alone. After mitomycin C treatment of the blood culture, the aberrations were markedly, but not significantly, increased. All experimental groups showed a higher SCE frequency, most deviating in the rats treated with phenacetin alone. This correlates with the fact that phenacetin is a strong general carcinogen.

The significance of lamina propria invasion on the prognosis of patients with bladder tumors

We reviewed 177 patients with superficial bladder tumors. The prognosis for 78 patients with non-invasive grades 1 to 3 tumors was excellent regardless of treatment. In 99 patients with tumors infiltrating the lamina propria the 5 and 10-year survival rates were 71 and 64 per cent, respectively. The prognosis of patients with grades 2 and 3 tumors infiltrating the lamina propria submitted to transurethral resection or cystectomy was excellent. In contrast, the prognosis was poor among patients with signs of tumor invasion of the lymphatic vessels of the lamina propria and patients undergoing transurethral resection and supervoltage irradiation. Our study indicates that patients with grade 1 to 3 bladder tumors, which are confined to the mucosa or do not infiltrate deeper than into the lamina propria should, if possible, be managed by transurethral resection. However, if lymphatic invasion is present the patient does not seem to benefit from an operation alone. Thus, the combined treatment of supervoltage irradiation and an extensive operation may be considered in these patients.

Heparin enhances the rate of binding of fibronectin to collagen

125I-labelled fibronectin is shown to bind to both native and denatured collagen immobilized on Sephadex beads in reactions that exhibit different kinetics. The rates of both reactions were enhanced by the presence of heparin or highly sulphated dextran sulphate but not by other glycosaminoglycans or dextran sulphates having low sulphate contents.

Topical application of 5-fluorouracil cream: a therapeutic alternative in the treatment of urothelial tumours of the distal urethra. A case report

A case of secondary urothelial tumour of the distal male urethra is presented. The tumour was successfully treated by local application of 5-Fluorouracil cream. No side-effects were observed. Repeated topical applications of 5-Fluorouracil may be a therapeutic alternative to surgical treatment of urothelial urethral tumours.

A prognostic study of urothelial renal pelvic tumors: comparison between the prognosis of patients treated with intrafascial nephrectomy and perifascial nephroureterectomy

A comparison of the prognosis between 2 series of patients with urothelial renal pelvic tumors is presented. One series comprising 70 patients was operated with intrafascial nephrectomy with extirpation of varying length of the ureter. The other series comprising 38 patients was operated with transabdominal perifascial nephrectomy with homolateral adrenalectomy, total ureterectomy and in 28 patients retroperitoneal lymphadenectomy. The 5-year survival was 51% in the patients operated with intrafascial nephrectomy and 84% in the patients operated with perifascial nephrectomy. The difference in prognosis is statistically significant (p less than or equal to 0.01) and cannot be explained by differences in extent of tumor infiltration, tumor grade or tumor size. The main difference in prognosis between the two series was in patients with high stage tumors (Grabstald stage 3 and 4). The 5-year survival was 74% in patients with stage 3 and 4 tumors in the patients operated with perifascial nephrectomy compared with 37% in the patients operated with intrafascial nephrectomy. Since it is not possible with absolute certainty to determine tumor stage before the operation, an aggressive attitude against urothelial renal pelvic tumors is recommended. Thus the patients should undergo transabdominal perifascial nephroureterectomy including a cuff of the bladder wall and homolateral adrenalectomy. In patient with bilateral tumors, renal insufficiency of tumor in a single kidney parenchyma saving partial resection must be performed.

Polypoid cystitis: a catheter associated lesion of the human bladder

Histopathological examination of the urinary bladders of 63 patients dying in a geriatric clinic was performed. In 40 of 51 patients who had been treated with a urinary catheter, histological changes of polypoid cystitis were found. In 34 of the bladders the lesion engaged the posterior wall which corresponds to the localization of the tip of the catheter. The frequency of polypoid cystitis increased with increasing time of catheter treatment and reached its peak by three months. After that time the frequency was relatively constant. The frequency of polypoid cystitis seemed not to be influenced by bacterial urinary tract infection. Urothelial atypia was not seen after the catheter treatment.

Isolation of the pericellular matrix of human fibroblast cultures

The pericellular matrix of human fibroblast cultures was isolated, using sequential extraction with sodium deoxycholate and hypotonic buffer in the presence of protease inhibitor. The matrix attached to the growth substratum had a "sackcloth-like" structure as seen by phase contrast, immunofluorescence, and scanning electron microscopy, and it had a vaguely filamentous ultrastructure similar to that seen in intact cell layers. The matrix consisted of hyaluronic acid and heparan sulfate as the major glycosaminoglycan components and fibronectin and procollagen as major polypeptides as shown by metabolic labeling, gel electrophoresis, immunofluorescence, and collagenase digestion. This pericellular matrix can be regarded as an in vitro equivalent of the loose connective tissue matrix.

Extracorporeal surgery and autotransplantation for carcinoma of the pelvis and ureter

Multiple transitional cell tumours of the renal pelvis and proximal ureter of a solitary kidney were successfully managed by total ureterectomy, extracorporeal subtotal resection of the renal pelvis, autotransplantation, and calicovesicostomy. The method permits resection of a maximum of the uroepithelium of the upper urinary tract at the same time as it preserves available renal parenchyma. It also implies a new and exciting approach to the renal pelvis for endoscopic postoperative control and local treatment of the malignancy.

Rapid platelet consumption in a case of metastatic osteogenic sarcoma of the breast

An operation was carried out on an elderly female because of an osteogenic sarcoma of the breast. One year later she developed a state of rapid thrombocytolysis resistant to high dose prednisolone therapy and spleenectomy. At autopsy a large single metastasis was found in the right atrium and tumour emboli in the pulmonary artery. It is suggested that the shortening in platelet survival might have had an immunological background. Trapping of fibrinous material within tumour emboli and mechanical platelet destruction caused by the tumour appear to have been contributing factors.

Urothelial hyperplasia of the urinary bladder of the rat induced by mechanical perforation and phenacetin treatment

Mechanical perforation of the urinary bladder of Sprague-Dawley rats and subsequent administration of phenacetin in the diet induced urothelial hyperplasia in 11 of 12 rats. No pathological changes were found in the bladders of the control rats only submitted to mechanical perforation or phenacetin treatment only. The hyperplastic changes varied from mild focal urothelial hyperplasia after one week to severe focal and diffuse nodular and papillary hyperplasia after 3 weeks.

Primary hyperoxaluria (glycolic acid variant): a clinical and genetical investigation of eight cases

The clinical features of eight cases of primary hyperoxaluria have been summarized. The possibility of different phenotypes is discussed. A reduction, but no normalization, of the oxalate formation during pyridoxine therapy was found. A renal transplantation performed in one of the patients failed because of the formation of nephrocalcinosis.

Malignancies of the urinary tract and their relation to analgesic abuse

A relationship between analgesic abuse and urothelial renal pelvic tumors was first observed in 1965. Since then more than 100 cases of such tumors have been reported in abusers of phenacetin-containing drugs; most of these cases have been from Sweden. Many patients had a preexisting nephropathy with renal papillary necrosis. The total consumption of the drugs could be estimated to several kilograms, and the average period of consumption was 17 yr in the Göteborg study. The manifest development of the tumor often came a few years after the cessation of the drug abuse. The clinical picture and the pathologic findings are described and the five-year survival rate is given. Multiple tumors in the urinary tract were common. Carcinogenic factors are discussed. Phenacetin is an aromatic amide with N-hydroxylated metabolites, closely related to known carcinogenic amines like the naphthylamines which earlier caused occupational bladder cancer. Furthermore, the data on exposition (consumption) time and tumor induction time were very similar in occupational bladder cancer and in renal pelvic cancer related to analgesic abuse. Animal experiments of long-term phenacetin feeding have produced a high degree of papillary epithelial hyperplasia. Further investigations are under way.

The influence of N-[4-(5-nitro-2-Furyl)-2-thiazolyl]formamide and phenacetin on the immune status in male Fischer rats

The effect of N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide (FANTF) and phenacetin on the immune status of Fischer rats was determined utilizing the spleen plaque and phytohemagglutinin blastogenesis assays 6, 10, and 15 weeks after administration at doses of 0.2 per cent and 0.535 per cent, respectively. Azathioprine (0.02 per cent of the diet) was tested as a known immunosuppressive chemical for comparison, and a negative control group, fed a control diet without added chemicals, was also tested. Immunosuppression was shown in the rats receiving azathioprine at all times by both assays, whereas in FANFT-fed rats immunosuppression was greater than in the control group (not statistically significant). Results from rats fed phenacetin were not significantly different than those of the control group. These results show that immunosuppression does not occur in rats administered phenacetin for up to 15 weeks, nor in FANFT-induced bladder carcinogenesis at the time of reversible bladder mucosal hyperplasia (6 weeks), or when the mucosal lesions have become irreversible, non-invasive carcinomas (10 and 15 weeks).

Tumours of urinary bladder and ureter associated with abuse of phenacetin-containing analgesics

Forty-two patients with a bladder tumour and 4 patients with a ureteral tumour and a history of abuse of phenacetin-containing analgesics were studied. The sex ratio was 1:1, and the mean age 63 years. The estimated amount of ingested phenacetin was 7.1 kg, the estimated mean exposure time 21 years, and the estimated mean induction time 30 years. Renal papillary necrosis and impaired renal function were found in 34 patients. A history of recurrent urinary tract infection was found in 80 per cent of the patients, suggesting that the combination of phenacetin-abuse and chronic inflammation might be responsible for the localization of the tumours to the bladder. The majority of the bladder tumours were of low grade (1 and 2); muscular invasion was seldom found and metastases were rare. The patients were followed for 1.5-13 years. Twenty-six patients died; the mean survival time was 46 months. Uremia due to analgesic nephropathy was the main cause of death in 14 patients and contributed to death in another 7 patients. Three of the patients with ureteral tumours had received radiological treatment against the pelvic region, 15-20 years prior to the diagnosis of the ureteral tumour.

Mechanical and metabolic effects of diazoxide in rat uterus

Diazoxide relaxed both polarized and depolarized rat uterus. The drug also conteracted the contractions elicited by Ca2+ in a competitive manner. The relaxing effect was associated with an increase in the tissue level of cyclic AMP. This metabolic effect of diazoxide was inhibited by propranolol-treatment and in preparations from reserpinized animals, while the mechanical effects were only partially reduced. Diazoxide was also found to increase the release of tritium from preparations preloaded with [3H]-noradrenaline. It is suggested that diazoxide may induce some of its mechanical and metabolic effects by releasing the adrenergic transmittor substance noradrenaline. An effect of diazoxide on the Ca2+-metabolism is also probable.

Urothelial changes of the renal papillae in Sprague-Dawley rats induced by long term feeding of phenacetin

Thirty female Sprague-Dawley rats were fed 0.535 per cent phenacetin in the diet for up to 110 weeks. Twenty-six of these rats developed urothelial hyperplasia, partly papillary, of the renal papillae. Twenty-eight rats showed dilatation of the vasa recta frequently associated with thrombus formation and calcification. One phenacetin fed rat had epithelial hyperplasia associated with chronic pyelitis. In 2 of the 30 control rats urothelial hyperplasia was found to be associated with chronic pyelitis. The hyperplastic urothelial changes and vascular changes were often, but not always, present simultaneously. One control rat developed a mammary carcinoma, as compared with 5 rats in the phenacetin group. Four phenacetin fed rats developed carcinoma of the ear duct. The results of the present investigation provide evidence that phenacetin can induce proliferative lesions of the urothelium of the rat renal pelvis with weak carcinogenic activity in the ear duct and mammary glands.

Urothelial hyperplasia of the renal papillae in female Sprague-Dawley rats induced by long term feeding of phenacetin

Twenty-one of 40 rats fed phenacetin in the diet for up to 86 weeks developed urothelial hyperplasia of the renal papillae. Two of 30 rats in the control group had similar changes associated with chronic pyelitis. The difference is statistically significant (p less than 0.01).

Early lesions in experimental bladder cancer: experimental design and light microscopic findings

N-[4-(5-Nitro-2-furyl)-2-thiazolyl]formamide (FANFT) fed to male and female Fischer rats at a dose of 0.2% of the diet induces lesions of the urinary bladder which progress from mild hyperplasia at 2 to 4 weeks, to moderate hyperplasia at 6 to 8 weeks, severe nodular and papillary hyperplasia at 10 to 14 weeks, and microinvasive carcinomas by 25 weeks as observed by light microscopy. Male Fischer rats fed FANFT for 2 to 4 weeks and then maintained on control diet show regression of the bladder lesions within 2 weeks to normal-appearing mucosa which persists through 50 weeks. Rats fed FANFT for 6 weeks show regression of the moderately hyperplastic epithelium to normal within 4 weeks after being placed on control diet which persists through 50 weeks. Rats fed FANFT for 8 to 10 weeks show regression of the hyperplastic bladder epithelium within 2 weeks of receiving control diet, but focal areas of mild hyperplasia are detectable through the 20th week of the experiment. By the 50th week the rats fed FANFT for 8 weeks all had moderate to marked hyperplasia, but the rats fed FANFT for 10 weeks had transitional cell tumors, one of which was invasive through the entire thickness of the bladder wall. The lesions present in rats fed FANFT for 12, 14, or 20 weeks continued to progress to invasive tumors (microinvasive or invasion of muscle) after the rats had been maintained on control diet through 50 weeks. Thus, the hyperplastic lesions developing through 6 weeks of FANFT administration appear to be reversible if FANFT is discontinued, but later lesions appear to be irreversible.

A clinicopathologic and prognostic study of epithelial tumors of the renal pelvis

The aim of the present investigation was to assess the prognosis of epithelial pelvic tumors and evaluate from multivariate analysis the influence of different morphologic and clinical factors on the prognosis. The basic data are derived from the Swedish national series of patients with epithelial renal pelvic tumors diagnosed by histologic examination during 1962-63. Ninety-four of the 102 patients studied had a urothelial pelvic tumor and eight had an epidermoid carcinoma. The corrected 5-year survival rate was 51% in the curatively operated series, 60% among the males and 33% among the females. Infiltration depth was found to be of significant importance for the 5-year survival and thus a strong predictor for prognosis. Furthermore, each tumor grade and tumor structure exerts some influence on the prognosis independent of the infiltration depth. Nine patients had verified, and 16 patients had suspected phenacetin abuse and/or renal papillary necrosis. The survival rate was low and the relative frequency of females was high in this group of patients. These data may indicate a poorer prognosis in patients with phenacetin abuse, and may explain the sex difference in 5-year survival. Thirty-eight per cent of the patients with urothelial tumors of the renal pelvis had a synchronous or asynchronous tumor elsewhere in the urinary tract. The high frequency of local recurrence as well as the high frequency of infiltrating tumors and multiple tumors indicate the necessity for a more extensive operation such as perifascial nephrectomy with total ureterectomy including a cuff of the bladder.

Urothelial neoplasms of the upper urinary tract. A correlation between cytologic and histologic findings in 43 patients with urothelial neoplasms of the renal pelvis or ureter

The present study elucidates the possibilities to diagnose and classify urothelial tumors of the upper urinary tract by means of exfoliative cytology on voided urine using a membrane filter method. In a series of 30 patients with renal pelvic tumors and 13 patients with ureteral tumors an overall agreement between cytology and histopathology was obtained in 25 cases (58%). None of the Grade 1 tumors or of the non-invasive Grade 2 tumors were regarded as positive by cytology whilst two out of five invasive Grade 2 tumors had positive cytologic reports. The series included 24 patients with poorly differentiated or anaplastic tumors, 17 of whom had positive cytology (71%). By excluding from the series 13 patients with obstructed urinary passages or radiologically non-functioning kidneys on the tumor side an agreement between cytology and pathology was reached in 83 per cent of the cases, regardless of tumor grade, and in 17 out of 18 patients with Grade 3-4 tumors (94%).

Variations of cyclic nucleotide monophosphate levels during spontaneous uterine contractions

Oscillations on the concentrations of cyclic nucliotides occurred during spontaneous rhythmic contractions in rat uterus. The levels of cyclic GMP and cyclic AMP were highest at the beginning of the contraction respectively the relaxation.

Urothelial renal pelvic tumours in phenacetin abusers

The appearances of renal pelvic tumours at urography and pyelography in 25 phenacetin abusers were correlated with the microscopy of operative specimens. Radiography was found to contribute to the preoperative assessment of malignancy grade.

Phenacetin abuse and renal pelvic carcinoma

This work is a review of 62 patients with abuse of phenacetin containing drugs and uroepithelial tumours of the renal pelvis, all of them carcinomas. Most of the patients had a pre-existing nephropathy with papillary necrosis as a prominent feature. Renal impairment contributed to the poor prognosis. On the basis of present knowledge of urinary tract carcinogens and phenacetin metabolites, it is assumed that phenacetin is the crucial factor for development of the tumours.

Multiple-Sine-Slit Microdensitometer and MTF Evaluation for High Resolution Emulsions. 1: Theory and Mode of Operation

The Multiple-Sine-Slit Microdensitometer (MSSM) measures transmittance modulation by scanning the sample with a sinusoidal irradiance distribution generated by laser two-beam interference. The theory of the instrument is derived both from conventional microdensitometry and from treating the sample as a complex valued grating that diffracts two impinging coherent fields. The instrument has a constant MTF of 0.5; its principle disregards any phase modulations in the sample; and its large measuring area improves signal-to-noise ratio by 1-2 orders of magnitude. These are necessary qualifications for determining the MTF of recording materials of very high resolution. With a He-Ne laser, the range of the MSSM spans from 4 c/mm to 1500 c/mm. The practical implementations of the evaluation of film MTF's with this system are described.

Multiple-Sine-Slit Microdensitometer and MTF Evaluation for High Resolution Emulsions. 2: MTF Data and Other Recording Parameters of High Resolution Emulsions for Holography

By means of the Multiple-Sine-Slit Microdensitometer (MSSM), MTF's up to 1500 c/mm have been evaluated for five photographic plates for holography, Agfa-Gevaert Scientia 10E75, 8E75, 8E75B, and Kodak 649-F and Type 120-02. For comparison, an as-if-MTF has also been derived from diffraction efficiency measurements. In addition sensitivity at lambda = 633 nm, the macroscopic characteristic tau(A) vs logE and alpha(2)(E), and scattered-flux data are reported for these five plates.