In the setting of high salt intake, aldosterone stimulates fibrosis in the heart, great vessels, and kidney of rats. We used uninephrectomized rats treated with angiotensin II and placed on a high salt diet to exaggerate renal fibrosis. We then tested whether mineralocorticoid receptor blockade by spironolactone or aldosterone synthase inhibition by FAD286 have similar effects on end-organ damage and gene expression. Individually, both drugs prevented the hypertensive response to uninephrectomy and high salt intake but not when angiotensin II was administered. Following 4 weeks of treatment with FAD286, plasma aldosterone was reduced, whereas spironolactone increased aldosterone at 8 weeks of treatment. Angiotensin II and high salt treatment caused albuminuria, azotemia, renovascular hypertrophy, glomerular injury, increased plasminogen activator inhibitor-1 (PAI-1), and osteopontin mRNA expression, as well as tubulointerstitial fibrosis in the kidney. Both drugs prevented these renal effects and attenuated cardiac and aortic medial hypertrophy while reducing osteopontin and transforming growth factor-β mRNA expression in the aorta. The two drugs also reduced cardiac interstitial fibrosis but had no effect on that of the perivascular region. Although spironolactone enhanced angiotensin II and salt-stimulated PAI-1 mRNA expression in aorta and heart, spironolactone and FAD286 prevented renal PAI-1 mRNA protein expression. Our study shows that mineralocorticoid receptor antagonism and aldosterone synthase inhibition similarly decrease hypertrophy and interstitial fibrosis of the kidney and heart caused by angiotensin II and high salt.

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Obesity-related glomerulopathy (ORG) is a secondary form of focal and segmental glomerulosclerosis (FSGS) occurring in severely obese patients. A significant percentage of individuals with ORG will develop renal insufficiency or end stage renal disease. We report here a 17-year-old girl with morbid obesity (body mass index 56.8 kg/m(2)) and ORG presenting with nephrotic range proteinuria, who failed to improve following treatment with diet, exercise and angiotensin-converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB) therapy. Laparoscopic gastric bypass surgery was performed, and within 2 weeks following the surgery, the patient had lost 5.7 kg body weight and showed a remarkable decrease in protein excretion to one tenth of pre-surgery levels. More than 1 year after surgery, the patient's urine protein and kidney function have remained normal while off renin-angiotensin system inhibition therapy. This is the first report of successful use of gastric bypass surgery for obesity-related glomerulopathy in an adolescent. We propose that gastric bypass surgery be considered for patients with ORG.

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SUMMARYOn two organic farms, nitrate-N and ammonium-N in the surface layers of the soil of representative fields were recorded for 2 years. Nitrate-N was also determined in different soil layers down to 120 cm at the beginning, middle and end of two winters and at intervals after ploughing three fields, to seek evidence of leaching.Nitrate-N and ammonium-N were both consistently low in the surface layers of fields in ley. Nitrate-N accumulated in arable soils on some occasions when there was little or no crop uptake of N, after ploughing, and after very heavy applications of manure.There was some evidence of nitrate leaching in all five fields which were deep-sampled. In four cases, the loss by leaching appeared to be < 25 kg N/ha per winter. In the other case, in which a 4-year ley was ploughed on 5 October, the loss by leaching appeared to be c. 70 kg N/ha. Ploughing in winter, rather than early autumn, might have reduced the nitrate leached, but the drilling of the next crop might have been delayed.The nitrate concentration of water draining from recently ploughed sandy soil in Shropshire was high, but it would have been diluted by water draining from unploughed fields.

SUMMARY The purpose of this investigation was to quantify normal nutritive sucking, using a microcomputer‐based instrument which replicated the infant's customary bottle‐feeding routine. 86 feeding sessions were recorded from infants ranging between 1–5 and 11‐5 months of age. Suck height, suck area and percentage of time spent sucking were unrelated to age. Volume per suck declined with age, as did intersuck interval, which corresponded to a more rapid sucking rate. This meant that volume per minute of sucking time was fairly constant. The apparatus provided an objective description of the patterns of normal nutritive sucking in infants to which abnormal sucking patterns may be compared. RÉSUMÉ Allures développementales de la succion nutritionnelle normale chez le nourrisson Le but de cette recherche a été de quantifier la succion nutritionnelle normale, utilisant un appareillage monté sur micro‐ordinateur, reproduisant les habitudes alimentation au biberon des nourrissons. 86 sessions alimentation furent enregistrées chez des nourrissons âgés de 1, 5 à 11,5 mois. L'importance de la succion, aire de succion et le pourcentage de temps passéà la succion n'est pas apparu reliéà l'âge. Le volume absorbé par succion variait avec âge, de même que intervalle entre deux succions, ce qui se traduisait par un taux de succion plus rapide. Cela signifiait que le volume absorbé par minute de succion restait sensiblement constant. L'appareillage a fourni une description objective des allures de la succion nutritionnelle normale du nourrisson, permettant une comparaison avec les succions anormales. ZUSAMMENFASSUNG Entwicklungsmuster des normalen Saugens bei Kindern Es war das Ziel dieser Arbeit, das normale Saugen mit Hilfe eines durch Mikrokomputer gesteuerten Gerätes zu quantifizieren, das die gewöhnliche Routine der Flaschenfütterung beim Kind wiedergab. 86 Fütterungen von Kindern im Alter zwischen 1–5 und 11‐5 Monaten wurden aufgenommen. Saughöhe, Saugbereich und der Zeitanteil des Saugens hatten keine Relation zum Alter. Das Volumen pro Zug nahm mit dem Alter ab, wie auch das Interval zwischen den Zügen, was zu schnellerem Saugen führte. Das bedeutet, daß das Saugvolumen pro Minute ziemlich konstant war. Das Gerät lieferte eine objektive Beschreibung der normalen Saugmuster bei Kindern, mit denen abnorme Saugmuster verglichen werden können. RESUMEN Esquemas de desarrollo de la succión nutritiva normal en lactantes El propósito de esta investigación fue el cuantificar la succión nutritiva normal, usando un instrumento basado en un microcomputador que copiaba la rutina acostumbrada del niño al alimentarse con biberón. Se registraron 86 sesiones de alimentación en niños de 1,5 a 11,5 meses de edad. El vigor de la succión, el área de succión y el porcentaje de tiempo pasado succionando no estaban en relación con la edad. El volumen de la succión declinaba con la edad, lo mismo que el intervalo entre ca da succión, lo que correspondía a una frecuencia de succión más rápida. Esto significa que el volumen por minuto de tiempo...

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