月橘烯碱抗着床作用及其激素活性的研究

小鼠于妊娠第1～3天,po或sc月橘烯碱(yuehchukene)2mg或4mg/kg·d有明显的抗着床作用。金黄地鼠于妊娠1～3天,sc月橘烯碱4mg/kg·d却无此作用。月橘烯碱有明显的雌激素活性,与雌二醇合用有协同作用。该化合物无雄激素或抗雄激素活性;无孕激素或抗孕激素活性。放射受体竞争实验测得月橘烯碱对[³H]-雌二醇与雌激素受体特异性结合抑制50%的浓度(IC₅₀)为4.2×10^-6mol/L,表观解离常数(KI)为1.24×10^-6mol/L。说明月橘烯碱与雌激素受体有一定的亲和力。     

Rapidly progressive glomerulonephritis in a patient with rheumatoid arthritis during treatment with high-dosage D-penicillamine

A patient with advanced rheumatoid arthritis and severe clinical manifestations of rheumatoid vasculitis died of acute renal failure after 30 months of treatment with high-dosage D-penicillamine. She had had no signs of adverse drug reactions until the terminal illness. Although streptococcal pharyngitis was diagnosed late in her disease, penicillamine-induced immune complex glomerular damage is considered more likely than poststreptococcal glomerulonephritis, because her microscopic hematuria preceded diagnosis of pharyngitis. Postmortem examination disclosed findings suggestive of rapidly progressive glomerulonephritis of immune complex pathogenesis. The short period of microscopic hematuria and the rapidity of development of renal failure before death emphasize the need for frequent monitoring of renal function and prompt discontinuation of D-penicillamine treatment upon detection of otherwise unexplained hematuria. There is urgent need for early immunological evaluation, renal biopsy, and vigorous therapeutic measures.     

Immunhistologische Untersuchungen bei der diffusen mesangialen Sklerose mit nephrotischem Syndrom im Säuglingsalter

Zusammenfassung Bei einem Säugling, der im Alter von 10 Monaten an einem steroid-resistenten nephrotischen Syndrom erkrankte, wurde bei der Nierenbiopsie eine diffuse mesangiale Sklerose der Glomeruli festgestellt. Nach dem Tod an interstitieller Pneumonie 3 Monate nach Krankheitsbeginn wurde der Nierenbefund bestätigt. Der Prozeß betraf sämtliche Glomeruli, war aber segmental verschieden stark ausgeprägt. Immunhistologisch wurden granuläre Ablagerungen von IgM und Komplement (C3) im Mesangium und subendothelial an der Basalmembran beobachtet. Die Befunde sprechen dafür, daß bei der Pathogenese der diffusen mesangialen Sklerose möglicherweise die Bildung und glomeruläre Ablagerung von Immunkomplexen eine Rolle spielen.

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Immunhistological Findings in Diffuse Mesangial Sclerosis Associated with the Nephrotic Syndrome of Infancy

A 10-month-old infant developed a steroid resistant nephrotic syndrome. The renal biopsy revealed diffuse mesangial sclerosis of the glomerula. The child died from interstitial pneumonia 3 months after onset of the renal symptoms. Post mortem, the glomerular changes were diffuse but prominent in certain segments of the glomeruli. The immunohistological examination showed granular deposits of IgM and C3 in the mesangium and in the subendothelial region of the basement membrane. These findings are compatible with the hypo. thesis that diffuse mesangial sclerosis is caused by glomerular deposition of immune complexes.