La escuela española de neurología cajaliana. La semilla iberoamericana / No disponible

No disponible

Cytokines involved in the immunosuppressor period in experimental fasciolosis in rats.

The aim of this study was to evaluate the kinetics of the cytokines interferon-gamma, interleukin-2, interleukin-10 and interleukin-4 produced by spleen mononuclear cells stimulated by Con A during an experimental infection in rats with Fasciola hepatica. The proliferative response to Con A of Spm cells from rats infected with F. hepatica was significantly decreased on day 7 post-infection (P<0.006) and simultaneously an increase of interferon-gamma, interleukin-10 and interleukin-4 production along with a decrease of interleukin-2 by spleen mononuclear cells were observed. Interleukin-4 and interleukin-10 were involved in ablating cellular proliferation in vitro, as the addition of neutralising antibodies to either cytokine reversed the proliferative block. The addition of exogenous recombinant interleukin-2 also restored the proliferative response by spleen mononuclear cells obtained 7 days after infection from infected rats. At the same time, we found an increase in interleukin-10 production by peritoneal cells (in close contact with the flukes) and decreased nitric oxide levels. In addition, histological studies on the liver on day 7 after infection showed the presence of parasite inside migratory tunnels in the parenchyma, and polymorphonuclear leukocytes, predominantly eosinophils, around the parasite. The transient suppression in proliferative response mediated by cytokines interleukin-4 and interleukin-10 in the spleen, and diminution of nitric oxide production in the peritoneum could be mechanisms to evade the protective immune response during the first stages of liver penetration by the parasite.

[The cells of accessory immune system]. / Las células del sistema inmune accesorio.

In the Reticulo-Endothelial System (RES), named at present Accessory Immune System (AIS), two chief groups of cells can be recognized: 1--Antigen-presenting cells: Dendritic cells 2--Antigen-processing cells: Macrophages (or Histiocytic cell) True malignant Langerhans cell neoplasm has not been yet clearly demonstrated. Finally, it is important to note that marcrophages and dentritic cells are commonly observed as relative cells in numerous malignant tumors (carcinomas, sarcomas, lymphomas, etc) However, their precise role has yet to be determined.

[Identification of Helicobacter pylori and associated gastric lesions]. / Identificación de Helicobacter pylori y lesiones gástricas asociadas.

In this study is presented a silver stain technique for Helicobacter pylori with ammoniacal silver carbonato of Del Río Hortega, in biopsies and surgical specimens embebbed in paraffine. This study was performed between 1999 to 2001, and 717 gastroscopics biopsies were observed, that included: 705 chronic gastritis (98.32%), 11 gastric carcinomas (1.53%), and 1 low-grade lymphoma (0.13%). It is important to note the low incidence of adenocarcinomas and lymphomas from 717 gastroscopic biopsies during the period of 1999-2001, only 11 carcinomas and 1 lymphoma. We added 28 retrospective studies of biopsies and surgical specimens. These latter group included 21 adenocarcinomas and 7 low-grade lymphomas. Hence, there were a total of 745 cases with: 705 chronic gastritis, 32 adenocarcinomas, and 8 low-grade lymphomas. In 705 chronic gastritis, 325 (46.10%) were associated with H pylori, and they were Chronic Superficial Gastritis of Mild (8.62%), Moderate (61.23%), and Severe (12.92%) intensity; and Follicular Gastritis in 17.23%. In a serie of 82 total Follicular Gastritis (82/705), H pylori was founded in 68.29% (56/82). This relative frequency of association between H pylori with Chronic Gastritis in general (46.10%), and with Follicular Gastritis in particular (68.29%), could be explain because: a--many gastroscopic biopsies did not became from antrum, site of H pylori growing. Or b--there was another etiologic factor without morphologic value. There is a clear evidence that H pylori is an important factor in the pathogenesis of these chronic gastritis, from primary Acute Gastritis occurred in children and young patients, to Chronic Superficial Gastritis, Follicular Gastritis, Atrophic Gastritis, intestinal metaplasia, and Peptic Ulcer present in adult patients. Adenocarcinomas were associated with moderate and severe Chronic Superficial Gastritis, Atrophic Gastritis, intestinal metaplasia, and moderate and severe dysplasias of glandular epithelium. H pylori was founded in only 35% of adenocarcinomas, probably related to the presence of atrophic gastritis associated with metaplastic/dysplastic changes, or necrotic tissues, which would possibly explain the absent of H pylori growing under these circumstances. Low-grade lymphomas (MALT-type), arise from lymphatic tissue of the mucosa, and were associated with chronic gastritis, atrophy, and intestinal metaplasia. H pylori was founded in 75% of all lymphomas. Also in this case, there is a clear pathogenic evidence between H pylori infection and the development of low-grade lymphoma, specially in early stages, since it is possible the complete resolution after antibiotic therapy or partial gastrectomy.

Impaired activity of phagocytic cells in Candida albicans infection after exposure to chronic varied stress.

OBJECTIVE: Candidiasis is a prototypic opportunistic fungal disease that may follow severe modulations of the immune system of the host. The purpose of this study was to evaluate which innate immune mechanisms involved in the protection against fungal invasion are impaired under stress conditions. METHODS: Wistar rats were infected intraperitoneally with Candida albicans and immediately exposed to chronic varied stress (CVS) over 10 days (CVS; Ca-S); the fungal burden (CFU), histopathological lesion and ACTH levels were evaluated. Additionally, functional assessment of peritoneal cells (PC) included the phagocytic and anticandidacidal activities and the production of H(2)O(2) and NO. RESULTS: In the only infected animals (Ca), C. albicans colonization stimulated an efficient inflammatory response, while in Ca-S rats poor tissue reactions were associated with increased CFU in livers and kidneys (p < 0.05, Ca vs. Ca-S). Whereas the phagocytic process was not modified, the candidacidal activity of PC was significantly decreased after the application of CVS (p < 0.001, Ca vs. Ca-S). The H(2)O(2) production by macrophages and neutrophils was downregulated by the infection, and while at early intervals these cells possessed a residual oxidative capacity, by day 10, the production of this metabolite was blocked. Spontaneous NO production by macrophages was significantly increased in both Ca and Ca-S animals (p < 0.001), but in stressed rats, this reactive nitrogen intermediate was noticeably downregulated (p < 0.05, Ca vs. Ca-S). The hyperactivity of hypothalamus-pituitary-adrenal axis after exposure to stress was confirmed by an increase in baseline plasma ACTH levels. CONCLUSION: These results show that during infection with C. albicans, the exposure to CVS contributes to the spread of the fungus and downregulates critical functions of phagocytic cells involved in the control of this opportunistic pathogen.

Las células del sistema inmune accesorio. / [The cells of accessory immune system]

In the Reticulo-Endothelial System (RES), named at present Accessory Immune System (AIS), two chief groups of cells can be recognized: 1--Antigen-presenting cells: Dendritic cells 2--Antigen-processing cells: Macrophages (or Histiocytic cell) True malignant Langerhans cell neoplasm has not been yet clearly demonstrated. Finally, it is important to note that marcrophages and dentritic cells are commonly observed as relative cells in numerous malignant tumors (carcinomas, sarcomas, lymphomas, etc) However, their precise role has yet to be determined.

Identificación de Helicobacter pylori y lesiones gástricas asociadas. / [Identification of Helicobacter pylori and associated gastric lesions]

In this study is presented a silver stain technique for Helicobacter pylori with ammoniacal silver carbonato of Del Río Hortega, in biopsies and surgical specimens embebbed in paraffine. This study was performed between 1999 to 2001, and 717 gastroscopics biopsies were observed, that included: 705 chronic gastritis (98.32

), 11 gastric carcinomas (1.53

), and 1 low-grade lymphoma (0.13

). It is important to note the low incidence of adenocarcinomas and lymphomas from 717 gastroscopic biopsies during the period of 1999-2001, only 11 carcinomas and 1 lymphoma. We added 28 retrospective studies of biopsies and surgical specimens. These latter group included 21 adenocarcinomas and 7 low-grade lymphomas. Hence, there were a total of 745 cases with: 705 chronic gastritis, 32 adenocarcinomas, and 8 low-grade lymphomas. In 705 chronic gastritis, 325 (46.10

) were associated with H pylori, and they were Chronic Superficial Gastritis of Mild (8.62

), Moderate (61.23

), and Severe (12.92

) intensity; and Follicular Gastritis in 17.23

. In a serie of 82 total Follicular Gastritis (82/705), H pylori was founded in 68.29

(56/82). This relative frequency of association between H pylori with Chronic Gastritis in general (46.10

), and with Follicular Gastritis in particular (68.29

), could be explain because: a--many gastroscopic biopsies did not became from antrum, site of H pylori growing. Or b--there was another etiologic factor without morphologic value. There is a clear evidence that H pylori is an important factor in the pathogenesis of these chronic gastritis, from primary Acute Gastritis occurred in children and young patients, to Chronic Superficial Gastritis, Follicular Gastritis, Atrophic Gastritis, intestinal metaplasia, and Peptic Ulcer present in adult patients. Adenocarcinomas were associated with moderate and severe Chronic Superficial Gastritis, Atrophic Gastritis, intestinal metaplasia, and moderate and severe dysplasias of glandular epithelium. H pylori was founded in only 35

of adenocarcinomas, probably related to the presence of atrophic gastritis associated with metaplastic/dysplastic changes, or necrotic tissues, which would possibly explain the absent of H pylori growing under these circumstances. Low-grade lymphomas (MALT-type), arise from lymphatic tissue of the mucosa, and were associated with chronic gastritis, atrophy, and intestinal metaplasia. H pylori was founded in 75

of all lymphomas. Also in this case, there is a clear pathogenic evidence between H pylori infection and the development of low-grade lymphoma, specially in early stages, since it is possible the complete resolution after antibiotic therapy or partial gastrectomy.

[Morphology of the cells in myxoid tumors]. / Morfologia de las celulas en los tumores mixoides.

We describe a morphologic study of myxoid cells in myxoid tumors or with myxoid regions: myxoid fibrosarcoma, myxoma, myxoid liposarcoma, embryonal rhabdomyosarcoma, chondroma, chondrosarcoma, myxoid leiomyosarcoma, schwannoma, and odontoameloblastoma; and we compare with fibroblasts of umbilical cord, embryonal mesenquima and loose connective tissue in inflammatory conditions. Histologic techniques: H-E, PAS, Masson's trichrom, and Del Río Hortega's panoptic silver staining. Histologically Del Río Hortega's technique reveals bipolar fibroblasts with long processes. In myxoma and myxoid fibrosarcoma they are stellated with abundant processes and mucin cytoplasm secretion contained in bowls that slides through cytoplasmic expansions and discharge into intercellular space. The lipoblasts of myxoid liposarcoma are also stellated with abundant processes and contain drops of lipids. The rhabdomyoblasts are raquetoid cells with cross striated cytoplasm, myofibrils and cigar-shaped nuclei. Schwannomas are composed of spindle and bipolar cells with long and thin cytoplasmic extensions. The chondroblasts in chondromas and chondrosarcomas have wide cytoplasm with short processes. The odontoblasts in odontoameloblastomas have wide cytoplasm and long processes directly extended toward adjacent dentinal. These morphologic details can help in the differential diagnosis associated with immunoperoxidase stains.

[Medullary carcinoma of the stomach]. / Carcinoma medular de estómago.

The aim of this work is to show the important histiocytic oblation present in a case of stomach medullary carcinoma, marked with silver technique of Del Río Hortega. This carcinoma is poor differentiated with a predominant lymphoid infiltrate, of better prognosis, that shares many characteristic with medullary carcinoma of breast, lung, nasopharynx, thymus and salivary gland. Histologic techniques: Hematoxilin & Eosin, PAS, PAS-Alcian blue, Alcian blue, Masson's trichrome, macrophagues Del Río Hortega-Polak, and reticulin Del Rio Hortega silver impregnations techniques. Gastric medullary carcinoma shows an important lymphoid infiltration T and B, and dendritic, plasmodials and giant multinucleated macrophagues in close relations with neoplasic cells. The results suggest that Epstein-Barr virus (EBV) becomes associated with gastric medullary carcinoma.

[Epithelial-myoepithelial carcinoma--a technique to identify myoepithelial cells]. / Carcinoma epitelial-mioepitelial--técnica para identificar células mioepiteliales.

Two epithelial-myoepithelial carcinoma of parotid gland from two female patients of 48 and 80 years old, and normal gland tissue, are studied with Del Río Hortega-Polak silver impregnation technique. It is a selective and alternative method to mark myoepithelial cells in sections of paraffin embedding material or in frozen sections.

Morfologia de las celulas en los tumores mixoides. / [Morphology of the cells in myxoid tumors]

We describe a morphologic study of myxoid cells in myxoid tumors or with myxoid regions: myxoid fibrosarcoma, myxoma, myxoid liposarcoma, embryonal rhabdomyosarcoma, chondroma, chondrosarcoma, myxoid leiomyosarcoma, schwannoma, and odontoameloblastoma; and we compare with fibroblasts of umbilical cord, embryonal mesenquima and loose connective tissue in inflammatory conditions. Histologic techniques: H-E, PAS, Massons trichrom, and Del Río Hortegas panoptic silver staining. Histologically Del Río Hortegas technique reveals bipolar fibroblasts with long processes. In myxoma and myxoid fibrosarcoma they are stellated with abundant processes and mucin cytoplasm secretion contained in bowls that slides through cytoplasmic expansions and discharge into intercellular space. The lipoblasts of myxoid liposarcoma are also stellated with abundant processes and contain drops of lipids. The rhabdomyoblasts are raquetoid cells with cross striated cytoplasm, myofibrils and cigar-shaped nuclei. Schwannomas are composed of spindle and bipolar cells with long and thin cytoplasmic extensions. The chondroblasts in chondromas and chondrosarcomas have wide cytoplasm with short processes. The odontoblasts in odontoameloblastomas have wide cytoplasm and long processes directly extended toward adjacent dentinal. These morphologic details can help in the differential diagnosis associated with immunoperoxidase stains.

Carcinoma medular de estómago. / [Medullary carcinoma of the stomach]

The aim of this work is to show the important histiocytic oblation present in a case of stomach medullary carcinoma, marked with silver technique of Del Río Hortega. This carcinoma is poor differentiated with a predominant lymphoid infiltrate, of better prognosis, that shares many characteristic with medullary carcinoma of breast, lung, nasopharynx, thymus and salivary gland. Histologic techniques: Hematoxilin & Eosin, PAS, PAS-Alcian blue, Alcian blue, Massons trichrome, macrophagues Del Río Hortega-Polak, and reticulin Del Rio Hortega silver impregnations techniques. Gastric medullary carcinoma shows an important lymphoid infiltration T and B, and dendritic, plasmodials and giant multinucleated macrophagues in close relations with neoplasic cells. The results suggest that Epstein-Barr virus (EBV) becomes associated with gastric medullary carcinoma.

Carcinoma epitelial-mioepitelial--técnica para identificar células mioepiteliales. / [Epithelial-myoepithelial carcinoma--a technique to identify myoepithelial cells]

Two epithelial-myoepithelial carcinoma of parotid gland from two female patients of 48 and 80 years old, and normal gland tissue, are studied with Del Río Hortega-Polak silver impregnation technique. It is a selective and alternative method to mark myoepithelial cells in sections of paraffin embedding material or in frozen sections.

[Tumors with rhabdomyoblasts and neuroblasts]. / Tumores con rabdomioblastos y neuroblastos.

A metallic impregnation technique, Del Río Hortega's double impregnation, to evidence neuroblasts and rhabdomyoblasts, with recommendations as to the times of impregnation to obtains better results is evaluated. The images obtained are highly demonstrative both of the embryo elements of the primitive mesenchyma from myoblast, myotube, a rhabdomyoblastic ribbon cell with transverse streaks to the neoplastic elements of this lineage and to the neuroblasts with their extensions. The study material includes a renal tumor of Wilms with rhabdomyoblasts and neuroblasts and a cerebellum neuroblastoma with a rhabdomyoblastic element. These injuries are considered dysembryoplasic. We also studied two botryoid embryo rhabdomyosarcomas, begin one or them unusually found in a menopausic woman, two Müller mixed tumors of the uterus and Fallopian tubes, a rhabdomyoma in pharynx and three human embryos from aborted material between 5 and 13 weeks old. We emphasize the use of double impregnation to study rhabdomyoblasts and neuroblasts. In rhabdomyosarcomas, structures and elements similar to those of the embryo stage--racketoid and ribbon cells, myotubes and rhabdomyoblasts--can be observed. The tumor of Wilms is a dysembryoplasic tumor composed of renal blastem where we have found rhabdomyoblasts and neuroblasts. In the cerebellum neuroblastoma we observe rhabdomyoblasts with certain organism (ectomesenchyma). Finally, we describe a rather infrequent case of a cervix botryoid rhabdomyosarcoma of a menopausic woman.

[Severe acute pancreatitis. Clinical and therapeutic contribution of diagnostic imaging]. / Pancreatitis aguda severa. Aporte clínico y terapéutico del diagnóstico por imágenes.

Ultrasonography and dynamic tomography are used in the study of acute pancreatitis, thus helping to interpret the diverse anatomophysiopathologic variables. We present 41 patients studied by ultrasonography, on admission and twenty-four hours later or more. After seventy-two hours, a dynamic tomography was performed. We did a clinicotomographic correlation assessing necrosis, and multiple Ranson criteria, being complemented with the anatomopathologic study of specimens both in the complications and in the elective biliary surgery. There were three puncture aspirates for bacteriology. Eight (19.5%) patients developed local complications and four (9.75%) presented organ failure. Ultrasonography showed biliopancreatic hypertension in 45% of cases of biliary pancreatitis and was reversible in nature. Dynamic tomography was important in defining morphology and pancreatic necrotic involvement. There were two patients with intrapancreatic necrosis, six with intra and extrapancreatic necrosis and eleven patients who presents a dissemination of the process into the extrapancreatic tissues. The prevalence of glandular necrosis was 24%. Both, ultrasonography and dynamic tomography allowed to the identify a spectrum of lesions representative of cavitated extrapancreatic necrosis and enzymatic pericholecystitis. Likewise, they contributed to define medical treatment as well as indications, opportunities and approaches in the surgical and/or percutaneous treatment of septic complications.

[Comparative structural study of the glial blastomas of the central nervous system]. / Estudio estructural comparativo de los blastomas gliales del sistema nervioso central.

The objective of our work is to compare 2 diagnostics methods and demonstrate the similarities of the different Central Nervous System Glial Tumor Classifications. Immuno-marking techniques for gliofibrilar acid protein (GFAP), and special silver impregnations to compare the results according to the last histogenetic interpretations were used. 95 Gliomas were studied with hematoxiline-eosine and silver techniques, and in 58 randomized selected cases the technique for GFAP was also used. Both methods showed the same results in the diagnosis of Glial Tumors whose cells possess gliofibrils: Glioepitelioma (Ependymoma), Glioblastoma, Astroblastoma, and Astrocytoma. In the Oligodendrioglomas whose cells possess microtubules but not gliofibrils, the silver techniques marked these cells and their prolongations while the technique for GFAP did not. Regarding Gliomas, there are similarities by comparing the Del Río Ortega-Polak classification with those of the WHO and other authors. There are differences only in the "names" of some tumors or in their histogenetic interpretation, which are not substantial and are confined to the "Polar Espongioblastoma" and "Gliosarcoma". Therefore, we think that the recognition of the Del Río Hortega-Polak classification is justified.

Tumores con rabdomioblastos y neuroblastos. / [Tumors with rhabdomyoblasts and neuroblasts]

A metallic impregnation technique, Del Río Hortegas double impregnation, to evidence neuroblasts and rhabdomyoblasts, with recommendations as to the times of impregnation to obtains better results is evaluated. The images obtained are highly demonstrative both of the embryo elements of the primitive mesenchyma from myoblast, myotube, a rhabdomyoblastic ribbon cell with transverse streaks to the neoplastic elements of this lineage and to the neuroblasts with their extensions. The study material includes a renal tumor of Wilms with rhabdomyoblasts and neuroblasts and a cerebellum neuroblastoma with a rhabdomyoblastic element. These injuries are considered dysembryoplasic. We also studied two botryoid embryo rhabdomyosarcomas, begin one or them unusually found in a menopausic woman, two M³ller mixed tumors of the uterus and Fallopian tubes, a rhabdomyoma in pharynx and three human embryos from aborted material between 5 and 13 weeks old. We emphasize the use of double impregnation to study rhabdomyoblasts and neuroblasts. In rhabdomyosarcomas, structures and elements similar to those of the embryo stage--racketoid and ribbon cells, myotubes and rhabdomyoblasts--can be observed. The tumor of Wilms is a dysembryoplasic tumor composed of renal blastem where we have found rhabdomyoblasts and neuroblasts. In the cerebellum neuroblastoma we observe rhabdomyoblasts with certain organism (ectomesenchyma). Finally, we describe a rather infrequent case of a cervix botryoid rhabdomyosarcoma of a menopausic woman.

Pancreatitis aguda severa. Aporte clínico y terapéutico del diagnóstico por imágenes. / [Severe acute pancreatitis. Clinical and therapeutic contribution of diagnostic imaging]

Ultrasonography and dynamic tomography are used in the study of acute pancreatitis, thus helping to interpret the diverse anatomophysiopathologic variables. We present 41 patients studied by ultrasonography, on admission and twenty-four hours later or more. After seventy-two hours, a dynamic tomography was performed. We did a clinicotomographic correlation assessing necrosis, and multiple Ranson criteria, being complemented with the anatomopathologic study of specimens both in the complications and in the elective biliary surgery. There were three puncture aspirates for bacteriology. Eight (19.5

) patients developed local complications and four (9.75

) presented organ failure. Ultrasonography showed biliopancreatic hypertension in 45

of cases of biliary pancreatitis and was reversible in nature. Dynamic tomography was important in defining morphology and pancreatic necrotic involvement. There were two patients with intrapancreatic necrosis, six with intra and extrapancreatic necrosis and eleven patients who presents a dissemination of the process into the extrapancreatic tissues. The prevalence of glandular necrosis was 24

. Both, ultrasonography and dynamic tomography allowed to the identify a spectrum of lesions representative of cavitated extrapancreatic necrosis and enzymatic pericholecystitis. Likewise, they contributed to define medical treatment as well as indications, opportunities and approaches in the surgical and/or percutaneous treatment of septic complications.

Fasciola hepatica-induced immune suppression of spleen mononuclear cell proliferation: role of nitric oxide.

The aim of the present study was to evaluate the proliferative response of spleen mononuclear cells (Spm) to mitogens in rats infected with Fasciola hepatica and its correlation with Spm and peritoneal cell (PC) nitric oxide (NO) production on Days 1, 3, 7, 14, 30, and 60 postinfection. In addition, histological changes in the liver were also studied. The proliferative response to Con A of F. hepatica-infected Spm was significantly decreased on Day 7 postinfection (P < 0.01). However, a pronounced increase of the proliferative response was detected from Day 3 until Day 60 when Spm were stimulated with LPS. In order to determine whether NO levels were modified during F. hepatica infections, we quantified nitrite in Spm and PC supernatants in cultures. Our results indicate a profound decrease of nitrite production by LPS-stimulated PC on the first and second weeks postinfection, and an increase in the levels of this mediator on LPS-stimulated Spm at the same postinfection time. The F. hepatica excretory-secretory antigen (ESA) was in part involved in the decrease of nitrite production by LPS-stimulated PC. A mechanism to avoid an immune response during the first stages of liver penetration could explain the transient suppression observed in Spm proliferative responses. On the other hand, the decrease in NO production by rat-infected PC could also be one of the strategies of the parasite to avoid the potential killing effect of NO during peritoneal migration.

Long-term enalapril and hydrochlorothiazide in radiation nephritis.

Radiation of the kidney often leads to renal failure. The contribution of arterial hypertension to the development of this complication is unclear. The aim of this study was to determine the renal effects of antihypertensive therapy in 1- and 2-kidney rat models of radiation nephritis. Five groups of Long Evans rats had X-irradiation of the left kidney. In groups 1 and 2, the right kidney was left undisturbed (2-kidney model). The rats in group 3, 4 and 5 underwent right nephrectomy 21 days before radiation (1-kidney model). Groups 1 and 3 received no drug treatment and served as controls for each model. Groups 2 and 4 had enalapril 50 mg/l in drinking water and group 5 hydrochlorothiazide (HCT) 200 mg/l, also in drinking water. Blood pressure increased significantly in both control groups and remained normal throughout the study in all treated groups. At the end of the study, mean urinary protein excretion was lower in the two enalapril-treated groups but not in HCT-treated animals. Groups 1 and 2 (2-kidney models) showed similar increments in plasma creatinine (PCreat), and, in both groups, the creatinine clearance (CCreat) dropped to the same extent. Among nephrectomized animals (1-kidney model), PCreat was lower and CCreat higher in the enalapril-treated group. Consistent with these findings, glomerular sclerosis was less severe in both enalapril-treated groups. We conclude that, in radiation nephritis, lowering blood pressure with enalapril exerts a beneficial effect on renal function and structure, whereas a similar reduction in blood pressure induced by HCT does not.