Antithrombotic Mechanisms of Urokinase lmmobilized Polyurethane

Urokinase immobilized polymer is highly antithrombotic, which cannot be explained only by fibrinolysis. We immobllized 10 IU/cm2 of urokinase to polyurethane by using maleic anhydride methylvinyl ether copolymer as a carrier. Then we incubated blood in circular tubes made of this material, measured the clotting factors and observed the surface of the tubes after incubation by scanning electronmicroscopy and immunofluorescence microscopy. After 5 min incubation, the relative activities of factors V, VIII, IX, X and XII, fibrinogeil, plasminogen and α2 plasmin inhibitor decreased, but the activity of factor VII increased. No platelet adhesion to the surface of the urokinase immobilized polyurethane was observed and there was no significant adsorption of serum proteins, including fibrinogen, fibronectin and vWF antigen, or the surface. Urokinase-immobilized polyurethane catalyzed the digestion of clotting factors as well as fibrinolysis and also inhibited platelet adhesion on its surface probably by inhibiting protein adsorption and its clinical application including vessel prosthesis should be developed further.

Effects of a dielectric material in an ion source on the ion beam current density and ion beam energy

To understand a strong focusing phenomenon that occurs in a low-energy hydrogen ion beam, the electron temperature, the electron density, and the space potential in an ion source with cusped magnetic fields are measured before and after the transition to the focusing state using an electrostatic probe. The experimental results show that no significant changes are observed before or after the transition. However, we found unique phenomena that are characterized by the position of the electrostatic probe in the ion source chamber. Specifically, the extracted ion beam current density and energy are obviously enhanced in the case where the electrostatic probe, which is covered by a dielectric material, is placed close to an acceleration electrode.

High current density ion beam obtained by a transition to a highly focused state in extremely low-energy region

A high current density (≈3 mA/cm(2)) hydrogen ion beam source operating in an extremely low-energy region (E(ib) ≈ 150-200 eV) has been realized by using a transition to a highly focused state, where the beam is extracted from the ion source chamber through three concave electrodes with nominal focal lengths of ≈350 mm. The transition occurs when the beam energy exceeds a threshold value between 145 and 170 eV. Low-level hysteresis is observed in the transition when E(ib) is being reduced. The radial profiles of the ion beam current density and the low temperature ion current density can be obtained separately using a Faraday cup with a grid in front. The measured profiles confirm that more than a half of the extracted beam ions reaches the target plate with a good focusing profile with a full width at half maximum of ≈3 cm. Estimation of the particle balances in beam ions, the slow ions, and the electrons indicates the possibility that the secondary electron emission from the target plate and electron impact ionization of hydrogen may play roles as particle sources in this extremely low-energy beam after the compensation of beam ion space charge.

Quasi-steady carbon plasma source for neutral beam injector

Carbon plasma is successfully sustained during 1000 s without any carrier gas in the bucket type ionization chamber with cusp magnetic field. Every several seconds, seed plasmas having ∼3 ms duration time are injected into the ionization chamber by a shunting arch plasma gun. The weakly ionized carbon plasma ejected from the shunting arch is also ionized by 2.45 GHz microwave at the electron cyclotron resonance surface and the plasma can be sustained even in the interval of gun discharges. Control of the gun discharge interval allows to keep high pressure and to sustain the plasma for long duration.

Electron density profile measurements at a self-focusing ion beam with high current density and low energy extracted through concave electrodes

The self-focusing phenomenon has been observed in a high current density and low energy ion beam. In order to study the mechanism of this phenomenon, a special designed double probe to measure the electron density and temperature is installed into the chamber where the high current density ion beam is injected. Electron density profile is successfully measured without the influence of the ion beam components. Estimated electron temperature and density are ∼0.9 eV and ∼8 × 10(8) cm(-3) at the center of ion beam cross section, respectively. It was found that a large amount of electrons are spontaneously accumulated in the ion beam line in the case of self-forcing state.

Self-focusing of a high current density ion beam extracted with concave electrodes in a low energy region around 150 eV

Spontaneous self-focusing of ion beam with high current density (Jc ∼ 2 mA/cm(2), Ib ∼ 65 mA) in low energy region (∼150 eV) is observed in a hydrogen ion beam extracted from an ordinary bucket type ion source with three electrodes having concave shape (acceleration, deceleration, and grounded electrodes). The focusing appears abruptly in the beam energy region over ∼135-150 eV, and the Jc jumps up from 0.7 to 2 mA/cm(2). Simultaneously a strong electron flow also appears in the beam region. The electron flow has almost the same current density. Probably these electrons compensate the ion space charge and suppress the beam divergence.

Development of low-energy and high-current-density ion beam system

A low-energy ion beam system operating at a dc voltage of less than 300 V was developed using an ion source with a multicusp magnetic field. A high-current-density ion beam of 6.9 mA∕cm(2) was successfully extracted at the electrode. The beam extraction characteristics for flat and concave electrodes were compared. In the case of a concave electrode with a designed focal length of 350 mm, it was observed that the beam profile was sharper than that obtained using a flat electrode.

Shunting arc plasma source for pure carbon ion beam

A plasma source is developed using a coaxial shunting arc plasma gun to extract a pure carbon ion beam. The pure carbon ion beam is a new type of deposition system for diamond and other carbon materials. Our plasma device generates pure carbon plasma from solid-state carbon material without using a hydrocarbon gas such as methane gas, and the plasma does not contain any hydrogen. The ion saturation current of the discharge measured by a double probe is about 0.2 mA∕mm(2) at the peak of the pulse.

Lateral Grain Growth in the Excimer Laser Crystallization of Poly-Si

We have succeeded in obtaining nondoped, thin poly-Si film (thickness ∼500Å) with excellent crystallinity and large grain size (Maximum grain size ∼4.5 μ m) by an excimer laser annealing Method, which offers the features of low-temperature processing and a short processing time. The grain size distribution shrinks in the region around 1.5 μ m and this poly-Si film exhibits a strong (111) crystallographic orientation. Poly-Si thin film transistors using these films show quite a high field effect mobility of 440cm2/V · s below 600°C process.

Very Wide-Gap and Device-Quality a-Si:H from Highly H2 Diluted SiH4 Plasma Decomposed by High RF Power

The H2 dilution technique at a high deposition rate (RD) was investigated by depositing hydrogenated amorphous silicon (a-Si:H) under a high if power density of 750 mW/cm2, which is 20 times as large as that of conventional conditions. It was found that the H2 dilution ratio γ ( = [H2 gas flow rate] / [SiH4 gas flow rate]) tendency of the film properties, such as the H content (CH), optical gap (Eopt), SiH2/SiH and photoconductivity (σph) of a-Si:H is different for the high rf power (750 mW/cm2) and the medium rf power (75 mW/cm2) conditions. Under medium rf power, the CH, Eopt and SiH2/SiH decrease as γ increases. Under the high if power, on the contrary, the CH and Eopt, monotonously increase while maintaining a low SiH2/SiH and a high σph of 10-6 S/cm as γ increases. These results suggest that increasing the rf power enhances the H incorporation reactions due to H2 dilution. It is thought that a high rf power causes the depletion of SiH4 and hence the extinction of H radicals, expressed by SiH4 + H* → SiH3* + H2, is suppressed. A high H radical density enhances the incorporation of H into a-Si:H, resulting in very wide-gap a-Si:H with a high CH, Consequently, very wide-gap a-Si:H with device-quality (Eopt of 1.82 eV with an (αhv)1/3 plot, corresponding to > 2.1 eV with Tauc's plot, and σph of 10-6 S/cm) can be obtained at a high RD of 12 Å/s without carbon alloying.

Effects of filament geometry on the arc efficiency of a high-intensity He+ ion source

A strongly focusing high-intensity He(+) ion source equipped with three concave electrodes has been designed and constructed as the beam source for a high-energy He(0) neutral beam probe system to diagnose fusion-produced alpha particles in thermonuclear fusion plasmas. The reduction of heat load onto the concave extraction electrodes is particularly important for a long pulse operation, as the heat load deforms the electrodes and thus the beam focal length. The effects on the arc efficiency (beam current/arc power) of the ion source due to the discharge filament structure (straight-type and L-shape-type filaments), size (filament diameters of 2 and 1.5 mm), number, and the locations have been studied. Choice of the appropriate filament structure improved the arc efficiency by 17%.

Development of a strongly focusing high-intensity He(+) ion source for a confined alpha particle measurement at ITER

A strongly focusing high-intensity He(+) ion source has been designed and constructed as a beam source for a high-energy He(0) beam probe system for diagnosis of fusion produced alpha particles in the thermonuclear fusion plasmas. The He(+) beam was extracted from the ion source at an acceleration voltage of 18-35 kV. Temperature distributions of the beam target were observed with an IR camera. The 1/e-holding beam profile half-width was about 15 mm at optimum perveance (Perv) of 0.03 (I(beam)=2.4 A). A beam current about 3 A was achieved at an acceleration voltage of 26.7 kV with an arc power of 10 kW (Perv=0.023).

Angiotensin-converting enzyme inhibitor withdrawal and ACE gene polymorphism

AIMS

Withdrawal of angiotensin-converting enzyme (ACE) inhibitors may affect the progression of chronic renal failure and an insertion/deletion (I/D) polymorphism of the ACE gene may influence it.

METHODS

We retrospectively collected patients with chronic glomerulonephritis and benign nephrosclerosis who discontinued ACE inhibitor use. The relationship between the decline of renal function after the withdrawal and the influencing factors such as ACE gene polymorphism, blood pressure and proteinuria were evaluated using multiple regression analysis.

RESULTS

Forty-two patients (initial serum creatinine 0.5 - 6.5 mg/dl) had been treated and discontinued ACE inhibitor use. Only patients with the II or DI genotypes of the ACE gene developed the deterioration of renal function, starting at 2 months after the withdrawal. Stepwise regression analysis revealed that the level of proteinuria after the withdrawal, presence of the insertion of ACE gene and serum creatinine level at the time of withdrawal mainly influenced the decline of renal function after the withdrawal (adjusted R2 = 0.48).

CONCLUSION

Withdrawal of ACE inhibitor causes the deterioration of renal function in patients with the II or DI genotypes, high proteinuria after the withdrawal, and high serum creatinine level at the withdrawal, which probably causes the rebound increase in serum ACE activity.

Overexpression of the cytoprotective protein clusterin decreases radiosensitivity in the human LNCaP prostate tumour model

OBJECTIVE

To evaluate the effect of clusterin overexpression on radiation-induced tumour growth rates and apoptosis in human prostate LNCaP cells, as prostate cancer cells are relatively resistant to radiation-induced apoptosis and local recurrences are common, but overexpression of the anti-apoptotic protein clusterin can accelerate progression to androgen-independence and to confer a chemoresistant phenotype in various prostate cancer models.

MATERIALS AND METHODS

Western blot analysis and immunohistochemistry were used to compare clusterin expression levels in parental (P) and clusterin-transfected (T) LNCaP cells in vitro and in vivo. The effects of radiation on clusterin-expression in both parental LNCaP/P and clusterin-transfected LNCaP/T tumours were analysed by Northern blot analysis. The cellular response to radiation was determined up to 3 weeks after irradiation using tetrazolium and re-growth assays, and cell-cycle analysis by flow cytometry.

RESULTS

Clusterin mRNA expression increased from undetectable to low levels in LNCaP/P tumours after radiation and more than three-fold in LNCaP/T tumours. Clusterin overexpression decreased the radiosensitivity in a time-dependent manner, reducing the extent of growth arrest and apoptosis by up to 54%. Re-growth assays showed that the improved survival rates of LNCaP/T cells after radiation did not change after 3 days, remaining constant over 3 weeks.

CONCLUSIONS

These results identify clusterin as a promoter of cell survival that may help mediate resistance to radiation-induced apoptosis. Furthermore, clusterin overexpression seems to provide an extended protection against radiation-induced cell cycle arrest and apoptosis.

Prevalence of a training module for difficult airway management: a comparison between Japan and the United Kingdom

To examine the education of trainees with regard to difficult airway management, we sent a questionnaire to all 89 Japanese University Departments of Anaesthesia (to be answered by a person who was responsible for teaching trainees) and all 280 Royal College of Anaesthetists' Tutors in the UK. The presence or absence of a formal training module for difficult airway management, timing and methods of training, types of airway devices that should be taught, and tutors' expertise with various techniques and devices were surveyed. Sixty-seven of the 89 Japanese tutors (75%) and 167 of 280 UK tutors (60%) replied to the questionnaire. Only 19 of 67 (28%) Japanese anaesthetists and 33 of 167 (20%) UK anaesthetists who replied, indicated that they had a difficult airway training module. In six Japanese departments (9%) and 115 (69%) UK departments, equipment for percutaneous transtracheal ventilation was readily available. Airway devices and techniques that tutors considered necessary to be mastered in the first 2 years of training, differed considerably between Japan and the UK, with notable differences in the use of gum elastic bougies and awake intubation. A training module for difficult airway management is often not provided and equipment for emergency transtracheal ventilation is often unavailable in both countries.

Chemosensitization of human renal cell cancer using antisense oligonucleotides targeting the antiapoptotic gene clusterin

BACKGROUND

Renal cell cancer (RCC) is a chemoresistant disease with no active chemotherapeutic agent achieving objective response rates higher than 15%. Clusterin is a cell survival gene that increases in human renal tubular epithelial cells after various states of injury and disease. Downregulation of clusterin, using antisense oligonucleotides (ASO), has recently been shown to increase chemosensitivity in several prostate cancer models. The objectives in this study were to evaluate clusterin expression levels in human RCC and normal kidney tissue, and to test whether clusterin ASO could also enhance chemosensitivity in human RCC Caki-2 cells both in vitro and in vivo.

METHODS

Immunohistochemical staining was used to characterize clusterin expression in 67 RCC and normal kidney tissues obtained from radical nephrectomy specimens. Northern blot analysis was used to assess changes in clusterin mRNA expression after ASO and paclitaxel treatment. The effects of combined clusterin ASO and paclitaxel treatment on Caki-2 cell growth was examined using an MTT assay. Athymic mice bearing Caki-2 tumors were treated with clusterin ASO alone, clusterin ASO plus paclitaxel, and mismatch control oligonucleotides plus paclitaxel, over a period of 28 days with measurement of tumor volumes once weekly over 8 weeks.

RESULTS

Immunohistochemistry of normal and malignant kidney tissue sections of 67 patients demonstrated positive clusterin staining for almost all RCC (98%) and an overexpression, compared to normal tissue, in a majority of RCC (69%). Clusterin ASO, but not mismatch control oligonucleotides, decreased clusterin mRNA expression in Caki-2 cells in a dose-dependent and sequence-specific manner. Pretreatment of Caki-2 cells with clusterin ASO significantly enhanced chemosensitivity to paclitaxel in vitro. Characteristic apoptotic DNA laddering was observed after combined treatment with ASO plus paclitaxel, but not with either agent alone. In vivo administration of clusterin ASO plus paclitaxel acted synergistically to increase apoptosis and significantly delay Caki-2 tumor growth, compared to mismatch control oligonucleotide plus paclitaxel. In addition, TUNEL staining revealed increased apoptotic cells in tumors treated with clusterin ASO plus paclitaxel compared to treatment with either clusterin ASO or paclitaxel alone.

CONCLUSION

These findings confirm that the use of clusterin ASO may be a feasible strategy to enhance chemosensitivity for patients with advanced RCC.

Patients with renal hypouricemia with exercise-induced acute renal failure and chronic renal dysfunction

We here report the case of a 38-year-old male with back pain and vomiting occurring after exercise. Serum creatinine level was elevated, and he was admitted to our hospital with diagnosis of acute renal failure (ARF). He had experienced similar attacks at least 4 times, including the present episode, from the age of 22 years. After admission, the patient was managed only by resting, and remission was nearly attained in about 1 month. The renal biopsy specimen performed on day 15 showed findings of acute tubular necrosis, thickening of the tubular basement membrane, and interstitial fibrosis. After remission, the serum uric acid level was 0.7-0.8 mg/dl, fractional excretion of uric acid was 0.63, and the possibility of other diseases facilitating the excretion of uric acid was denied. Therefore, ARF associated with idiopathic renal hypouricemia was diagnosed. Since only mild responses were observed in a pyradinamide loading test and a benzbromarone loading test, the case was considered to be a presecretary reabsorption disorder type. Renal function tests showed the almost complete recovery of the glomerular filtration rate (GFR: 114 ml/min/1.73 m2), but the urine concentrating ability was markedly decreased (specific gravity 1.019 and osmolarity 516 mOsm/kgxH2O in Fishberg test). Past data from this patient indicated that this renal dysfunction had been persisting for ten years. We examined 9 patients with renal hypouricemia and focused on the differences between the two groups (with or without complications). Four patients had a history of exercise-induced ARF or calculus. The urine concentrating ability was significantly lower in these patients (group A) than in the other patients without complications (group B). The glomerular filtration rate in group A was within the normal range, but was lower than in group B. These results suggested the possibility that patients with renal hypouricemia with complications may have chronic renal dysfunction in the future.

[Intravenous sedation with target-controlled infusion (TCI) in patients with difficult airways]

Tracheal intubation was facilitated with an intubating laryngeal mask (ILM) in two patients with difficult airways. Target-controlled infusion (TCI) of propofol and fentanyl was used for sedation during placement of an ILM. An ILM was inserted smoothly. Spontaneous ventilation and oxygenation were well maintained throughout the induction. Both patients were satisfied with intravenous sedation using TCI for awake instrumentation of their airways.

Intranephron distribution and regulation of endothelin-converting enzyme-1 in cyclosporin A-induced acute renal failure in rats

Endothelin-1 (ET-1) is thought to play a significant role in acute renal failure induced by cyclosporin A (CsA). The cDNA sequence encoding endothelin-converting enzyme-1 (ECE-1), which produces the active form of ET-1 from big ET-1, was recently reported. To elicit the role of ECE-1 in the glomerular and tubular dysfunction induced by CsA, the effects of CsA on mRNA and protein expression of ECE-1 in rat kidney and on mRNA expression of prepro-ET-1 and ET A- and B-type receptors in glomeruli were studied. ECE-1 mRNA was detected in glomeruli and in whole nephron segments. ECE-1 mRNA expression was downregulated in all nephron segments at 24 h after CsA injection. Protein levels were also downregulated in glomeruli and in the outer and inner medulla. CsA rapidly increased prepro-ET-1 mRNA expression in glomeruli at 30 to 60 min after injection; this rapid increase was followed by an increase in plasma ET-1 levels. These increases were followed by decreased expression of ECE-1, ET A-type receptor, and ET B-type receptor mRNA at 6 h after injection, and serum creatinine levels were increased at 24 h after CsA injection. It is suggested that downregulation of glomerular and tubular ECE-1 expression may be caused by increased ET-1 synthesis in CsA-induced acute renal failure.

Effect of extradural analgesia on the paradoxical arousal response of the electroencephalogram

Despite widespread recognition of the potential role of the processed electroencephalogram (pEEG) as a monitor of depth of anaesthesia, few studies have examined the effects of surgical stimuli on the intraoperative pEEG. Two groups of gynaecological patients (n = 10 in each group), with or without pre-incisional extradural analgesia, undergoing gynaecological laparotomy under nitrous oxide and isoflurane anaesthesia were monitored with routine haemodynamic observations and pEEG. Patients who received pre-incisional extradural analgesia showed no significant changes in pEEG variables during surgery (mean spectral edge frequency 95 percentile (SEF95) 13.3 (SD 1.4) Hz), whereas in all patients without pre-incisional extradural analgesia, a significant decrease in SEF95 was noted (6.5 (1.1) Hz after incision compared with a pre-incisional value of 12.5 (1.4) Hz) together with an increase in arterial pressure (paradoxical response). In the latter group, SEF95 and arterial pressure returned to pre-incisional values after extradural analgesia was established during operation. During emergence from anaesthesia, both groups showed a significant increase in SEF95 (25.7 (1.4) Hz). This study suggests that intraoperative pEEG arousal response was different from changes detected when anaesthesia was terminated at the end of surgery. Surgical stimuli in the absence of adequate analgesia induced a paradoxical arousal response.

Risk factors for left ventricular hypertrophy in chronic hemodialysis patients

Left ventricular hypertrophy is reported to be common in chronic hemodialysis patients, and also to increase the risk for mortality in chronic hemodialysis patients. An echocardiographical and clinical study was carried out to investigate the risk factors for left ventricular hypertrophy in 151 non-diabetic chronic hemodialysis patients without valvular diseases or myocardial infarction in two hemodialysis units in Fukuoka, Japan. The left ventricular mass index (LVMI) correlated positively to age, systolic blood pressure and interdialysis weight gain while it correlated negatively to the duration of hemodialysis therapy and hematocrit. Resorting to a multivariate analysis, the LVMI was found to positively correlate to age and the systolic blood pressure while it correlated negatively with the duration of hemodialysis therapy and the hematocrit level. These findings suggest that hypertension and anemia may thus be independent risk factors for left ventricular hypertrophy.

Processed electroencephalogram during combined extradural and general anaesthesia

The processed electroencephalogram (pEEG) was monitored in eight patients undergoing gynaecological laparotomy under combined extradural and nitrous oxide-isoflurane anaesthesia. Pre-incisional mean spectral edge frequency 95 percentile (SEF95) and median frequency (MF) were 11.67 (SD 1.63) Hz and 3.74 (0.24) Hz, respectively. After skin incision, both SEF95 and MF decreased to 6.61 (2.04) Hz and 2.72 (0.32) Hz, respectively (P < 0.001). An increase in mean arterial pressure after incision suggested inadequate depth of anaesthesia. After introduction of extradural analgesia, these variables returned to pre-incisional values (SEF95 11.65 (1.73); MF 4.02 (0.41)). Reduction of end-tidal isoflurane from 1.0% to 0.5% after extradural analgesia did not cause significant pEEG changes. pEEG may assist anaesthetists to recognize adequacy of combined general-extradural anaesthesia.

Strategic locus for the activation of the superoxide dismutase gene in the nephron

Upon exposure to a transient ischemia, the distal tubule of the kidney often escapes the severe damage which afflicts the proximal tubule. To ascertain whether this feature of the distal tubule is attributable to its intrinsic cellular properties, we focused on two pairs of unique tubule segments; distal versus proximal convoluted tubules in the superficial cortex and distal versus proximal straight tubules in the outer stripe of the outer medulla. These tubules were chosen because, firstly, they can be identified by morphology and immunostaining, and secondly, each pair has the same anatomical relationship to the circulation. Detailed morphometric analyses were performed six hours following unilateral transient ischemia in adult rats to semiquantitate the local tissue damage in these specific nephron segments. The architecture of the distal convoluted and straight tubules was remarkably well preserved, contrasting to the moderate to extensive necrotic changes seen in the proximal tubules. In search of the potential intrinsic cellular mechanism that underlies the observed difference, we examined the segmental distribution along the nephron of manganese superoxide dismutase gene transcripts by in situ hybridization. This antioxidant enzyme gene was expressed primarily in the distal tubules with contrastingly low levels of expression in the proximal tubules. Moreover, following ischemia-reperfusion, this distal tubule-dominant pattern was further accentuated immediately following reperfusion. The study indicates that the marked difference between the proximal and distal tubules in their susceptibility to injury in vivo is attributable to their intrinsic cellular properties, which include the local level of antioxidants.

Developmental expression of renal angiotensin II receptor genes in the mouse

The cellular distribution of angiotensin II type 1 (AT1) and type 2 (AT2) receptor mRNA was examined in mouse kidneys at several embryonic stages (12 to 18 days; 19 days = full term) and up to three weeks after birth by in situ hybridization. The expression of both AT1 and AT2 mRNAs appeared simultaneously at 14 days of gestation. However, their distributions were contrasting: AT1 mRNA was expressed in mature glomeruli and maturing S-shaped bodies throughout the stages examined. AT1 expression was also detected at 16 days of gestation in the proximal and distal tubules and peaked at the end of gestation. Both the temporal and spatial expression of AT1 coincide with the differentiation and proliferation of glomerular mesangial and tubular cells during nephrogenesis. In contrast, AT2 mRNA was present only in the mesenchymal cells adjacent to the stalk of the ureter bud at early developmental stages, and, later, extended to the mesenchymal cells located near, but outside, the nephrogenic area of superficial cortex and also the cells between collecting ducts. AT2 expression in these regions decreased markedly within three weeks after birth. Temporally and spatially, AT2 mRNA expression coincides with the epithelial-mesenchymal interactions that take place during early phases of nephrogenesis. The site of AT2 expression also overlaps closely with that of a specific group of cells which undergo apoptosis following nephrogenesis. Thus, contrary to current belief, the activation of AT1 and AT2 genes takes place in different cell types of the kidney during embryonic development, and thereby conceivably contributes to the ontogeny of those specific renal cells.

[One-year experience as a clinical anaesthetist in England]

Current practice of British clinical anaesthesia is introduced, including anaesthesia in the operating theatre as well as obstetric analgesia in the labour ward. Although many people feel that British National Health Service has been affected by their chronic economic recession, the author's general impression is that the standard of anaesthetic care is kept at a quite high level despite financial difficulties. It is still valuable to experience clinical anaesthesia in the United Kingdom and the author encourages young Japanese anaesthetists to get an opportunity to work in British hospitals.

Inhibitory effects of antihypertensive drugs on mesangial cell proliferation after anti-thymocyte serum (ATS)-induced mesangiolysis in spontaneously hypertensive rats

The effects of antihypertensive drugs on mesangial cell proliferation were studied in spontaneously hypertensive rats (SHR) with anti-thymocyte serum (ATS)-induced glomerulo-nephritis. Rats were treated with either enalapril (Group 1), nifedipine (Group 2), or reserpine + hydrochlorothiazide + hydralazine (Group 3), or were untreated (Group 4). The animals were sacrificed 2, 4 and 7 days after ATS injection and the glomerular cell number and degree of mesangial area expansion were examined. A marked, similar decrease in glomerular nuclear cell number (NC) due to severe mesangiolysis was observed in all of the groups on day 2. Thereafter, an increase in NC reflecting mesangial cell proliferation after mesangiolysis occurred in Group 4 on days 4 and 7. In Group 1 and 2, the NC was significantly smaller than that in Group 4 on days 4 and 7, indicating suppression of mesangial cell proliferation. In Group 3, however, the number of NCs did not differ from that in Group 4 on days 4 and 7, indicating a lack of such suppression by conventional antihypertensive drugs. The degree of mesangial area expansion (MS) showed the same pattern as mesangial cell proliferation. That is, the rapid increases in MS seen in Group 4 on days 4 and 7 were apparently suppressed in Groups 1 and 2, but not in Group 3. Our in vivo observations that both an angiotensin converting enzyme (ACE) inhibitor and a calcium channel blocker suppress mesangial cell proliferation and mesangial area expansion suggest that these agents have practical implications in the treatment of mesangial proliferative glomerular diseases through the suppression of excess mesangial cell proliferation.

Effects of endothelin and angiotensin II on renal hemodynamics in experimental mesangial proliferative nephritis

The renal hemodynamic response to pressor substances in the diseased kidney has been suggested to be different from that in the normal kidney. The aim of this study was to investigate the effects of endothelin and angiotensin II on renal hemodynamics in experimental nephritis induced by the administration of antithymocyte serum in Wistar rats. This model showed mesangiolytic lesions in the glomeruli on day 2 and hypercellular lesions on day 8. Prior to the injection of either endothelin or angiotensin II, the glomerular filtration rate and renal plasma flow were significantly lower in model rats on day 2 or day 8 than in the control rats. The basal glomerular filtration rate and renal plasma flow on day 8 were negatively correlated with the mesangium cell number. The injection of endothelin (0.5 ng/kg BW) led to a decrease in both renal plasma flow and glomerular filtration rate in rats on day 8 which was significantly greater than that in the control rats. Similarly, angiotensin II infusion (0.2 micrograms/kg BW) reduced both renal plasma flow and glomerular filtration rate in the rats on day 8 and the reductions were significantly greater than those in the control rats. In conclusion, renal hemodynamics in rats with mesangial proliferation of the kidney were more sensitive to both endothelin and angiotensin II than those in the normal kidney.