Several valuable results were obtained from follow-up studies by the postcard examination of 150 nephritics, who were admitted for 6 years from 1955 to 1962 in our institute (15 cases of them died during stay in the hospital).
1) Over 90% of cases answered to this research.
2) 27 of 1, 325 cases (they are picked up at random) had a history of nephritis during infancy. They are thought to be completely healed without any residua, and were properly treated at that time.
3) The recovery of the acute nephritis mainly depends on the following factors;
(1) Age: the younger patient more easily becomes free from albuminuria than elderly one. There is no difference between both sexes.
(2) Onset: The nephritis with a previous infection (Type I by Ellis) recovers fairly well and rarely relapses or advances (recovery rate 70% and mortality 5%). On the contrary, nephritis without sign of previous infection (Type ) is hard to improve and easy to advance (recovery 0, mortality over 30%). The above fact lead to the following conclusion;
a) Nephritics of Type I have something like immunity to nephritis.
b) Type I is essentially different from Type II.
c) Type II has rather chronic tendency.
(3) Stage and status of the illness: the recovery rate of Type I seems to depend on its stage and status at the time on admission to the hospital. The stage can be classified into early (within 10 days after the onset of illness) and late stage (more than one month after the onset) and the status can be classified into mild (only showing hypertension and urinary changes) and severe case (edema and serum changes with other systemic signs).
a) When they are in early stage and mild status, all of them could be expected complete recovery.
b) When they are in early stage and severe status, many of them would recover.
c) When they are in late stage but mild status, sometimes could recover but take in longer periode of time.
d) When they are in late stage and severe status, would not be expected to improve. Therefore early treatment is the best way to relieve nephritis of Type I.
4) Administration of the specific treatment of the acute nephritis must be carefully indicated.
(1) Tonsillectomy has not significantly altered the outcome of the nephritis, and should be performed after the disease becomes stable.
(2) Glucocorticoids have exellent effect to the nephrtic syndrome, which could be classified into 2 types as same as the nephritis, i. e. Type I and II. Type III nephrosis very often resists to this therapy and fails to recover, even though after showing favorite but temporary relief.
(3) Patients of Type I nephritis would not be necessary to keep confine to special diet and limit activities after recovery.
5) Mortal cases: 30 cases were mortal. They were acute and chronic glomerulonephritis, nephrosclerosis and collagen disease.
(1) 70% of the cases died within 5 years from the first onset of illness (average one year from the last attack to death), Therefore the patient who does not show any improvement should be carefully observed for at least 5 years.
(2) Increasing value of NPN indicates further advance of the renal failure.100mg% NPN suggests afterlife of the patient will be two months, and over 240 mg% means within two weeks to expire. So that effort should be exerted to low down raised NPN and to improve renal circulation during this period as much as possible.
(3) Bloodtransfusion is effective to correct anemia but at the same time elevate NPN, thus shorten the afterlife of the patient in renal failure. This fact lead to the hypothesis that the anemia in the renal failure is not passive result, but active reaction to resist against the renal insufficiency.

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We cultivated the urine from 26 patients who had kidney tuberculosis and had visited to our clinic recently, in whom tubercle bacilli were positive in the 13 cases. We found that SM resistant bacilli were 30.7 per-cent, INH 23.1 per-cent and non-resistant bacilli on PAS. Generally SM resistance became higher in proportion to overall doses of SM administered, but as to INH no distinct relation was found between the resistance and the medicine administered. About the clinical progress, although it was depend on the combined therapy of SM, INH and PAS, the patients of non-resistant to these medicines had been doing well as well as the patients of resistant to these medicine and received surgical operation for unilateral kidney tuberculosis.
But on the cases of bilateral kidney tuberculosis or the one which exstirpated already one side due to kidney tuberculosis and was resistant to these medicine should be considered to change the medicine adequately. For this purpose the resistant test must be performed at the first medical examination and during the course as well. On the case that tubercle bacilli were not cultivated the change of the medicine should be carefully considered by the clinical progress.

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We got the following result on investigation of the present status of the experiment from Jan. 1956 to Dec. 1963.
1) The experimental articles increased and became complicated year by year.
2) About 50% of all the experiments were the bacteriological experiments. Besides, About 90% of those were experiment of tubercle bacilli.
3) Among the experiments of tubercle bacilli the drug resistance determination of anti-tuberculous agents was 5.4% in 1956. But it increased year by year, and reached to 14% in 1963. It increased as about three times as the first in eight years.
4) We determined only the drug resistance of the primary anti-tuberculous drugs between 1953 to 1956. But we began the drug resistance determinations of the secondary anti-tuberculous drugs in 1960. And it occupied 43.3% of the drug resistance determinations in 1963.
5) There were a few drugs unfit for “Ogawa Medium” among the secondary anti-tuberculous drugs when we determined the drug resistance, and the experiment has become complicated And we should try to discover the secondary reactions as fast as possible through the various basic experiments before we use new drugs.

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The author reported two cases of so called essential renal hematuria which were treated by hemostatics (Adona, Thrombogen and Trostin) with complete recovery.
Examinations of urogenital system and autonomic nervous system etc, were done without any abnormality on these cases. That indicated this hematuria was caused by local interstitial nephritis.
It was said that the anti-plasmic treatment was remarkably effective for the cases in which the serum plasmine were hyperactive (by Dr. T. Ichikawa, Jap. J. Urol. Vol. 54 No. 8, 1963)
But ecaminations of fibrinolytic enzyme of serum were not done in my cases, so that the anti-plasmic treatment would be expected on the next chance.

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1) Essential renal haematuria is a special renal bleeding which is hard to clarify of its cause by various examinations. The causes would be numerous and is one of the symptomcomplex.
2) The therapeutic method for this disease can be cited as follows: absolute led rest with styptics, injection to the renal pelvis, rejection of the focal infections field, medical treatment for autonomic nervous system, administration of antiallergic agents and antihistamins.
3) Through various examinations from January 1962 to August 1963, I experienced following 12 cases of so-called essential renal haematuria.
Eight cases out of them were cured, the course of one case was unknown and 3 cases were operated and cured. Microscopic findings of these 3 cases of nephrectomy were as follow;
1st case: Renal infarction (long renal bleeding)
2nd case: Pyelitis (operated because of intense bleeding)
3rd case: Pyelitis (found clotted blood during the course and suspected as a tumor)

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After the Shimamoto's report, the author investigated on 33 cases of so-called essential renal bleeding, especially on focal infectious renal bleeding.
Out of 33 cases, 9 cases (27 per-cents) were focal infectious renal bleeding and 24 cases (73 per-cents) were due to other causes.
Twenty-two cases had chronic inflammatory lesions in the tonsils and teeth, but in only 9 cases (40.9 per-cents) their tonsils and teeth were apparent foci of renal bleeding and their inflammatory processes were much severe.
The etiology of essential renal bleeding except the focal infectious renal bleeding is still obscure at present time and I suppose in some cases the allergy must be related on.

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The number of patients who visited our clinic in the past ten years and diagnosed as renal hematuria was 119 namely 1.12% of total outpatients, and of these fifty two were admitted to the hospital. The number of male and female was each twenty six.
In ten cases bleeding came from the right, in thirty seven from the left, and in four cases bleeding on both sides was recognized.
In three cases nephrectomy was performed. Examination of the extirpated kidneys revealed that in the first case varix near the papilla, in the second submucous hemorrhage and lymphocytic infiltration of renal pelvis and in the last case hemorrhage in the Bowman's capsule was recognized.

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Statistical observations were done on 26 cases of so-called essential hematuria (11 males and 15 females) in 8-year period from January 1955 to January 1962, The average age of the whole group was 40 years, ranging from 24 to 60 years old. At the first cystoscopic examination blood came from only the right ureteral orifice in 8 cases: only the left in 18; none from both sides.
In sixteen patients, in whom the cause of unilateral renal bleeding were obscure after urological examinations, nephrectomy was performed because of all other methods of treatment had failed, Macroscopic and histological examination of the removed kidneys showed the following results:
1) Macroscopic review revealed, aberrant renal vessel 6, kidney cyst 1, renkli formation in kidney 1, perinephritis 1, ureteral bleeding 1, bleeding from renal pelvis 1 and splenic incisur of kidney 1.
2) Microscopic examination disclosed localized interstitial nephritis 3, pyelonephritis 2, cavernous hemangioma 1 and ureteral bleeding 1.

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A 32-years old woman developed the episode of fever and stethalgia periodically over nineteen months following the disappearence of fever due to pulmonary tuberculosis.
We considered that this patient would belong to the periodic fever described by Reimann because of fever with unkown etiology.
However the stethalgia was in close correlation to the operation of broncheetasis occured secondarily from pulmonary tuberculosis.

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Because of the insufficient expansion of the lung decortication with thoracoplasty was executed to 4 cases who had underwent operation of lobectomy or segmental resection. Two of them were accompanied with bronchial fistula.
In those cases number & length of the resected ribs were extremely saved in comparison of simple thoracoplasty.
The recovery of the lung capacity, however, did not come up to our expectations.
This procedure should be tried to these cases who show insufficient expansion of lung after lobectomy or segmental resection.

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