Hypercholesterolemic Imai rats spontaneously develop proteinuria and glomerulosclerosis, especially in males. A sex difference in glomerular injury has been recognized, but the role of sex hormones in glomerular injury remains unclear. Therefore, we investigated whether estrogen administration influences the progressive glomerular injury in male Imai rats. Estrogen produced a significant decrease in body weight. Systolic blood pressure in estrogen-treated rats was significantly lower than that in controls. Estrogen attenuated the progression of glomerular injury by significantly reducing proteinuria and glomerular sclerosis. The glomerulosclerosis index was significantly higher in controls than in estrogen-treated rats. Estrogen suppressed serum testosterone levels, whereas it increased GH levels. Results suggest that estrogen appears to play an inhibitory role on the development of glomerular injury, by itself or in association with sex-related factors regulated by estrogen and testosterone.

Hypercholesterolemic Imai rats, especially males, spontaneously develop proteinuria and glomerulosclerosis. We have shown that castration attenuated the progression of glomerular injury in male Imai rats. The present study was designed to investigate whether the attenuating effect of castration on glomerulosclerosis is eliminated by administration of testosterone. Testosterone propionate (TP) eliminated the attenuating effect of castration on the progression of glomerular injury by significantly and dose dependently increasing proteinuria and enhancing glomerular sclerosis. TP at 1 mg failed to reverse glomerulosclerosis to the control levels, despite a dose of TP sufficient to restore urinary protein excretion, serom testosterone level and glomerular growth. The results indicated that besides testosterone other sex-related hormones may be involved in the development of glomerulosclerosis in male Imai rats.

A 77-year-old woman with a residual right hemiparesis following a subarachnoid hemorrhage was found lying over a bedrail at home. She lived alone, and we suspect that she was reaching for the telephone when she fell over the bedrail. Her right flank was red and swollen. Abdominal computed tomography showed marked swelling of the muscles of the right lateral abdominal wall. She had an established rhabdomyolysis compressed by the bedrail and acute renal failure. This case illustrated bedrail-related rhabdomyolysis caused by abdominal wall injury. The use of bedrails is a risk of the injury for the frail elderly people and should be avoided to prevent bedrail-related injuries. Health professionals should consider home environmental factors so that the frail elderly people can easily move and carry out their daily life activities.

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[Summary]We attempted to clarify the effect of age on the clinical manifestations and complications of systemic lupus erythematosus (SLE). One hundred and forty two patients with SLE were classified into 3 groups according to their ages at the time of diagnosis.The number of patients of the 3 groups, younger onset group (less than 19 years old), common onset group (between 20 and 39 years old), and older onset group (more than 40 years old) was 27, 91 and 24, respectively. There was a higher incidence of malar rash, oral ulcers, fever elevation and renal disorder, especially nephrotic syndrome, in the younger onset group than in the other two groups. Serositis, particularly pericarditis, hypocomplementemia and anti-DNA antibody were also more frequent in the younger onset group compared with the other two groups.As for complications, although avascular bone .necrosis of femoral head is more frequent in the younger onset group, there was no significant difference in the incidences of herpes zoster and vascular thrombosis between the three groups. The response to the corticosteroid therapy and the prognosis were generally poorer in the younger onset group than in the other two groups. These data suggest that clinical manifestations and complications in younger patients with SLE differ from those in older patients.