It is the fact that there are yet to be solved area about tolerable amount of exercise that can be carried out by children with chronic renal failure. In order to determine the appropriate exercise for the children with chronic renal failure, muscle strength measurement, spirometry, exercise test by bicycle ergometer were conducted on 6 children with chronic renal failure. The results of the test were compared with those of normal healthy children of comparable age group and which showed that the children with chronic renal failure were markedly weaker. Considering Patients' age, their muscle seemed to be weak abnormally, but judging from their built, their muscle appeared slightly weak or with in normal range. Read out of experiment of spirometry, vital capacity, maximum voluntary volume and carbon monoxide diffusing capacity were remarkably low, while forced expiratory volume was normal and residual volume was clearly high. Exercise test (0.5 kp×5 min, by ergometer) indicated an existence of difference in O₂ intake % and heart rate between patients and normal children. Significant correlation was observed between heart rate and hemoglobin (r=-0.746), O₂ intake % and blood urea nitrogen (r=0.90), O₂ intake % and hemoglobin (r=0.785) and heart rate and blood urea nitrogen (r=0, 541). Blood urea nitrogen was elevated during exercise when the patients' heart rate was over 140 beats/min.

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The first, the patients' cardial function during exercise (0.5 kp×5 min., 0.75 kp×5 min.) was studied by using UCG and EKG. LVIDd (left ventricular internal dimension diastole) of the patients at rest position was found to be wider than the standard of comparable age. LVIDd and stroke volume of the patients after exercise were unchanged, while LVIDd and stroke volume of a healthy man after exercise became greater in value. EKG taken during exercise of 2 patients with chronic renal failure, of which one patient's ST depression was found to be lower than 1 mm. ST depression over 1 m was observed even during light degree of exercise stage. The second, the effect of hemodialysis of the patients' exercise capacity was studied. While administering hemodialysis on the patients, although respiratory volume, O₂ intake and respiratory quotient value were elevated, O₂ intake % was unchanged. No significant change in spirometry readout was noticed before and after administering hemo-dialysis. When heart rate of exercised patients before and after administration of hemodialysis was compared, patients' heart rate before hemodialysis indicated lower reading in comparison with the heart rate after hemodialysis.

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Exercise capacity of the patients was measured by Åstrand's fomula. According to the fomula, permissible exercise strength was expected 10 ml/min./kg as O₂ intake. But as heart rate was not proportional to O₂ intake during exercise at the patients, their permissible exercise strength may be a little lower than 10 ml/min./kg. In order to compare above result with the condition under daily routine, the next two experiments were done, 1) Observation had been made on the patients exercising 5 minutes each day for a week. 2) In order to study the patients' condition under normal daily routine, a patient was equipped with a portable tape cardiogram to record the patient's heart rate during a day. To compare with the patient, anormal child of comparable age was also equipped with it. Result: 1) Patients' exercise capacity were observed to be lowest on the next day of hemodialysis. 2) It was learned from the recorded heart rate that the patient was always higher than that of the normal child. It was also noticed that the patient's heart rate was not over 150 beats/min, even during physical exercise, This may means that the patient restricted his exercise by himself. *Astrand's Astrand's fomula=relationship between O₂ intake and heart rate.

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It is generally considered that the pathogenesis of lupus nephritis is due to the deposition of immune complexes (I.C.) on glomeruli, We measured the circulating I.C. in the SLE sera obtained from 11 patients by using the three methods (Anti-complementary activity, ¹²⁵IC1q-Binding assay and platelet aggregation test) which were able to detect the I.C. Then we compaired the levels of I.C obtained from these methods to the serological factors and renal findings (GFR, proteinuria and hematuria) in SLE patients. The results were as follows: 1) The sensitivities of ACA. and ¹²⁵IC1q-BA were more than 10 μg aggregated IgG/ml. ACA. and ¹²⁵IC1q-Ba were correlated to each other in the SLE sera. 2) Levels of ACA, ¹²⁵IC1q-BA in CH50<20μ group were higher than CH50≥20 p group. Although there was not significant difference between two groups in PL-A. 3) The levels of three methods were higher in DNA-Ab positive group than the negative group. 4) A.C.A., ¹²⁵IC1q-BA were not correlated to GFR, proteinuria and hematuria. These results show that the renal findings were not correlated to the levels of I.C. The glomerular injury are considered not only as the direct injury of deposition of I.C. but also as the localized immune response which subsequently occurred from the deposition of I.C.

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A radioimmunoassay for plasma fibrinopeptide A (FPA) was applied to the detection of urinary FPA, using FPA antiserum, standard FPA, and desaminotyrosyl FPA obtained from IMCO, Sweden. ¹²⁵I FPA was prepared by the iodination of desaminotyrosyl FPA using cloramine T method. Urinary and plasma FPA were measured in patients with malignancies, toxemia of pregnancy bone fructure, burn, malignant hypertension and renal disease. Renal disease consisted of Lipoid Neph-rosis, Membranous Nephropaty, Chronic Glomerulonephritis, Acute Glomerulonephritis and Lupus Nephritis. The results were as follows: 1. In normal subjects; normal plasma FPA level is below 2 ng/ml (0.3±0.4 ng/ml), and normal urinary FPA level is below 2.4 ng/ml (0.8±0.7 ng/ml). 2. In diseases other than renal disease; A. High plasma FPA levels were seen in malignancies, and bone fructure. B. High urinary FPA levels were seen in malignancies, burn, and malignant hypertension. C. In these case, no relationship was seen between urinary and plasma FPA. 3. In renal disease; A. In Lipoid Nephrosis, urinary FPA was always normal, inspite of the presence of urinary FDP and heavy urinary protein. B. In Membranous Nephropathy, urinary FPA was almost normal except in one case. C. In some cases of Chronic Glomerulonephritis, high levels of urinary FPA were observed. These cases were accompanied by high levels of urinary FDP, but not much urinary protein. D. In Lupus Nephritis and Acute Glomerulonephritis, we could not detect any significant level of urinary FPA. These results suggested intrarenal coagulation might be involved in cases with high urinary FPA levels in but not in volved in cases with normal urinary FPA.

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A 24 year-old man was first noted proteinuria in (17 year-old). At the time, his serum creatinine was 2.8 mg/dl and intravenous pyelography revealed normal size kidney without cyst. Renal biopsy was compatible with the findings of rapidly progressive glomerulonephritis. In, he was placed on intermittent hemodialysis. In, he suddenly complained of macroscopic hematuria and fever, Since computerized tomography suggested polycystic kidney and abscess, bilateral nephrectomy was performed in The left kidney was 244 g in weight and the right kidney with hematoma weighed 458 g. Numerous cysts up to 2 cm in diameter were noted both in the cortex and the medulla. Numerous cysts lined with cuboidal cells and tumors invariably arose from the lining epithelium of the cysts. Tumor cells were composed of two types: clear cells and eosinophilic granular cells, Invasive clear cell carcinoma was found in the limited area adjacent to the hematoma. These findings suggested the tumor had the multicentric development. Our case is not congenital polycystic kidney because of negative family history of polycystic kidney and biopsy proved glomerulonephritis as his original disease. Recently, Dunnill et al, reported "acquired cystic disease of the kidney" and suggested high incidence and high risk of malignancy in such patients. We believe that this is the first report of "acquired cystic disease" in Japan. Only twenty cases of "acquired cystic disease" has been reported in the literatures. Eight out of 20 cases showed tumor, and one had renal cell carcinoma with systemic metastasis. Our case is the second report of renal malignancy occurring in "acquired cystic disease". While the numbers of long-term survival on hemodialysis are increasing rapidly, this entity will be of great importance because of high incidence of the disease itself and frequent complication of carcinoma.

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CIC were detected in 71 serum specimens from 22 patients with SLE by measurement of 125I-C1q binding activity (C1q-BA). The mean value of C1q-BA was significantly increased in SLE (N=71) compared to normal (N=10). C1q-BA was also significantly increased in SLE with renal symptoms (60 sera from 15 cases) compared to SLE without renal symptom (11 sera from 7 cases). Mean values of CH50, C3 and C4 were significantly low in positive C1q-BA group (C1q-BA is more than 5.6%) compared to them in negative C1q-BA group. Serum C1q level was also inclined to be low in positive C1q-BA group. Whereas γ-globuline level and urinary RBC were significantly high in positive C1q-BA group. Positive rates of ANF, DNA antibody and LE cell were also higher in them. On the other hand, ENA antibody and Sm antibody as well as ESR, urine protein and renal function were not correlated to C1q-BA. In serial measurements, the patients with SLE showed high C1q-BA in active stage and it returned to be normal in inactive stage, when steroid was successfully administered. C1q-BA was reversely moved with CH50, C3 and C4, whereas it moved in parallel with serum γ-globuline level. There were no relation between C1q-BA and the glomerular histology, fixation of immuno-giobulin (IgG, IgM, IgA), fibrinogen and complement components (C3, C4, C1q, C3A) in the glomeruli. In sucrose density gradient analysis of 4 sera from SLE patients showed high C1q-BA in macro-molecular zone (≥19S), and C1q reactive fractions were also found in intermediate zone (between 7s and 19s) in 2 sera of them. But they had no difference between SLE with renal symptoms and without renal symptom in sucrose density analysis.

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