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It has been widely recognized that cyclosporine A (CyA) is useful in transplantation of the kidneys. On the other hand, the nephrotoxicity as one of its adverse effects is clinically important. There have been accumulated pieces of pathological evidence that CyA causes the renal proximal tubule damage. However, there are few reports available on the changes in the proximal tubular function. Recently, lithium clearance (CLi) has been employed to assess the proximal tubular function in CyA nephrotoxicity, because lithium ions are mainly reabsorbed throughout the proximal tubules in the same proportion as sodium and water. Several studies have already shown that long-term CyA administration results in a decrease in CLi reflecting enhanced lithium ion reabsorption. I studied, in male Sprague-Dawley rats, 1) whether short term and small dose of CyA administration which does not induce the renal tubular cell damage affects CLi and 2) the possibility that high salt intake influences CLi in CyA nephrotoxicity. Then, I divided rats into 6 groups: three groups were allowed the access to water, but the other three groups of rats were allowed to drink only saline. Group 2 and 3 were received 12.5 mg/kg and 25 mg/kg, respectively, of CyA intraperitoneally every day. As for creatinine clearance (Ccr), Ccr of group 3 (CyA 25) was the lowest, being significantly different from the other two groups. The most important result is fractional reabsorption of sodium and water in the proximal tubule. There is a significant difference between 1-A (vehicle, H2O) and 2-A (CyA 12.5, H2O), but no significant difference between 1-B (vehicle, saline) and 2-B (CyA 12.5, saline).(ABSTRACT TRUNCATED AT 250 WORDS)

We report a case of a right adrenal pheochromocytoma with prominent anterolateral displacement of the inferior vena cava. A right ipsilateral anterior subcostal incision extending from the xiphoid process to the 11th intercostal space allowed for wide upward retraction of the right costal arch. This incision is useful for easy mobilization of the liver and manipulation of the inferior vena cava without thoracotomy.

To study the limitations of lymphangiography in the detection of early lymphatic spread of pelvic malignancies, we evaluated 587 lymph nodes from 23 patients with stages pNO to 2 carcinoma of the bladder or prostate. Pelvic lymphadenectomy was performed 5 to 10 days after bipedal lymphangiography. Excised lymph nodes were separated one by one and an x-ray of each node was taken (lymphnodegram). The individual lymphnodegram was compared to the histological findings. Interpretations of lymphnodegrams from all 17 nodes with metastases were positive in 5, suspicious in 1, negative in 9 and radiolucent in 2. False negative judgments occurred chiefly because metastatic foci were microscopic. Two lymph nodes without metastasis were interpreted as positive for disease because of fat replacement of the nodes. These results indicated that lymphangiography is not suitable for the detection of early lymphatic metastases of carcinoma of the bladder or prostate.