Mahito Nakayama

Inhibition of Puromycin-lnduced Renal Injury by a Superoxide Dismutase Derivative with Prolonged in vivo Half-Life

To know the possible involvement of reactive oxygen species and the site(s) of their action in puromycin aminonucleoside (PAN)-induced renal injury, two types of superoxide dismutase (SOD) derivatives were synthesized: one (SM-SOD) circulates bound to albumin with a half-life of 6 h and the other (AH-SOD) linked with hexamethylenediamines rapidly undergoes glomerular filtration and accumulates in renal proximal tubule cells without being excreted in urine. When injected intravenously to the rat, PAN induced a marked proteinuria, increased plasma levels of cholesterol and triglyceride, and suppressed the growth of animals. Intravenously administered SM-SOD significantly inhibited such changes induced by PAN. However, native SOD which rapidly undergoes urinary excretion failed to inhibit the renal injury caused by PAN. Though AH-SOD markedly accumulated in renal proximal tubule cells, it also failed to inhibit the renal injury. These results suggested that superoxide and/or its hazardous metabolite(s) in and around the renal glomerulus, but not in tubule cells, may play critical roles in the pathogenesis of PAN-induced renal injury.

Assay of Angiotensin I by Fluorescence Polarization Method

Fluorescence polarization technique was applied for the assay of angiotensin I (Al) in human plasma. In this assay system, fluorescein labeled Al (F-Al), which retained the original antigenicity, and antibody to Al was allowed to interact in a cuvette in the instruments yielding an increase in the fluorescence polarization (P) value. Non-labeled Al in the sample blocked the binding of F-Al to the antibody resulting lower P value. Log of antigen concentration and P value was found to exhibit reverse linear proportionality between 0.05 ng to 2 ng/ml of antigen (Al) concentration. The present method was compared with standard radioimmunoassay method and the result showed that data were compatible with each other. The calculation of P value is automated and three cavity filter and optics of the instrument gave reliable results. The method is fast (less than 2 min), sensitive (less than 10 picomole/ml) and simple (no separation step before readout of the results).

Effects of Pregnancy and Estrogen on the Angiotensin II Pressor Response of the Rabbit Using Serial Systolic Blood Pressure Measurement in the Ear

Serial systolic blood pressure measurements were made in order to assess the effects of pregnancy and estrogen on the angiotensin II pressor response of the rabbit. The systolic blood pressure of the ear in 5 pregnant rabbits did not change throughout the gestational period, being compatible with that in 14 nonpregnant rabbits. However, vascular resistance to infused angiotensin II (over 13.1 ng/kg/min required to elicit a pressor response of 20 mmHg in systolic pressure) was demonstrated as early as the 10th day of pregnancy, and maximum mean resistance occurred on the 20th day: the mean pressor dose required was 34.5 ± 3.6 ng/kg/min (mean ± S.D.). In a separate series, vascular resistance in castrated rabbits was demonstrated as early as the 10th day of estrogen administration, reached a maximum at the 4th week, and then gradually decreased to the control level (pretreatment, 10.5 ± 2.5 ng/kg/min; 10 days, 18.9 ± 2.3 ng/kg/min; 4 weeks, 32.4 ± 5.4 ng/kg/min; 10 weeks, 18.3 ± 3.6 ng/kg/min; and 24 weeks,...

Renal Impairment and Intraglomerular Mononuclear Phagocytes in Cholesterol-Fed Rabbits

Morphological and immunohistochemical studies using the anti-macrophage monoclonal antibody RbM2 were performed in cholesterol-fed rabbits. From the beginning of the experiment, the levels of lipoproteins showed the pattern of familial type III hyperlipoproteinemia patients, and glomerular endothelial and mesangial cells had lipid deposits. By the 3rd week, RbM2-positive cells appeared in the capillary lumina. These cells became larger and increased in number after the 8th week. Although they had become very large and had increased noticeably by the 20th week, few sclerotic glomeruli were observed. We could hardly detect any proliferation of or foamy changes in the mesangial cells, and monocyte/macrophages showed no proliferative capacity within the glomeruli. These findings suggest that hyperlipidemia alone did not cause proliferation or foam transformation of the mesangial cells. The glomerular macrophages, probably derived from circulating monocytes, did not induce a glomerular injury under the short-term hyperlipidemic conditions of these experiments.

A case of bleeding duodenal varices located in the third portion

SummaryWe described a patient with isolated duodenal varices of the third portion, preoperatively diagnosed by hypotonic duodenography and endoscopy. These varices seemed to be caused by portal hypertension due to liver cirrhosis. The third to the fourth portion of duodenum should be examined carefully in patients with liver cirrhosis, especially with gastrointestinal bleedings of unknown origin.

A clinical study of nine myeloma patients with severe renal failure.

当院で過去3.5年間に経験された腎不全を合併し体外循環を必要とした多発性骨髄腫患老9例 (Group A) と, 腎不全を呈さない多発性骨髄腫患者18例 (Group B) および慢性腎炎末期にて透析導入となった27例 (Group C) について比較検討した. Group Aの内訳は, IgA myelomaが4例 (44.4%), light chain myelomaが5例 (55.6%) で, 男性4名, 女性5名で平均年齢は61.9歳であった. Group Bに比べ, Group AはHb値が有意に低く, Group Cと比べるとGroup Aでは, Hb値が低くCa値が有意に高かったが, その平均値は正常範囲にあった.Myeloma診断後のmedian servival timeは15か月であり, Group Bに比べ生存率に有意差を認めなかった. 透析離脱率は9例中2例 (22.2%) と低くその一因に血漿交換の併用率の低さが考えられた. 今後, 腎不全合併のmyeloma患者の早期診断には, 免疫蛋白電気泳動法などを積極的に行うべきであり, 治療については, 化学療法と血液透析に加えて, 血漿交換を積極的に行い, 腎機能回復率が向上するか否かを検討したいと考える.

An aged SLE patient with rapidly progressing renal failure.

全身性エリテマトーデス (SLE) は, 20歳代をピークとし, 女性に多くみられる疾患である. 今回我々は, ネフローゼ症候群から比較的急速な経過をたどり腎不全となり, 薬物療法と, DFPPにより透析を離脱させ得た高齢者SLEの1症例を経験した. 高齢発症SLEは若年発症SLEと比べ特殊な病型を呈し早期診断が困難な例が多い. 本症例では, 関節炎, 漿膜炎に加え, 激しい腎障害を呈し高齢者SLEには珍しいことと考えられた. また血清学的検査では, 補体の著しい低下は認めなかったが, 血中免疫複合体値と腎障害度が相関すると考えられた. DFPPは免疫複合体量の多いSLE患者ならびに, 免疫抑制剤の副作用の出易い高齢患者では, 試みるべき治療法の一つとして考慮すべきと考える.

A case of eclampsia during the 18th week of gestation

We report a rare case of eclampsia which occurred during the 18th gestational week in the absence of hydatidiform disease or Rh isoimmunization. In spite of extensive examinations during pregnancy and postpartum, we were unable to find any underlying disease, and the patient returned to being normotensive and non‐proteinuric postpartum.