The incidence of uremic peripheral neuropathy and the effect of hemodialysis were evaluated in 35 non-dialysed patients with chronic renal failure (CRF) and 50 dialysed patients. Signs and symptoms of peripheral nerve dysfunction and motor nerve conduction velocity (NCV) were studied in both groups. The incidence of clinical neuropathy was 28.5% in CRF group and 18% in dialysed group, in-dicating that clinical neuropathy was improved by chronic dialysis therapy. The NCV in lower and upper extremities was almost equally affected, and this indicates the discrepancy of clinical neuropathy and electro-physiological neuropathy. The NCV in patients with terminal renal failure was significantly reduced, and statistical analysis showed an inverse relationship between NCV and serum creatinine or blood urea concentration, while this correlation was not shown in dialysed patients. No correlation was shown between NCV and methylguanidine (MG) or guanidino-succinic acid (GSA) of ECUM solution in terminal renal failure. It is suggested that uremic peripheral neuropathy might be influenced by substances other than creatinine, urea, MG and GSA. Chronic intermittent dialysis resulted in improvement of NCV, and this was shown more clearly in the group with frequent dialysis per week (3/W). Evidence of improvement of NCV was not observed within several months after starting dialysis therapy. Thereafter, gradual improvement was seen overr one year and NCV was maintained stationary in subnormal level by adequate dialysis therapy. It is suggested that the patho-physiological aspects of dialysis stage maybe influ-enced with the duration of dialysis therapy. In conclusion, subclassif ication of dialysis stage, i. e., introductory, intermediate and stabilized stage is necessary for evaluation of patho-physiologic study in dialysis stage. Introductory stage means the period of several months after starting dialysis therapy, intermediate stage the one within one year and stabilized stage the one over one year, respectively.

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Two patients of nephrotic syndrome with gastric carcinoma we presented. Examination of routine renal biopsy revealed the characteristic light, immunofluorescent and electronn microscopic features of membranous nephropathy. Subepithelial electron-dense deposits were corresponded to immunofluorescent deposits containing IgG and beta-l-c in the two cases. When tested by immunodiffusion, there was a line between the glomerular eluate obtained from the glomeruli of the patient's and carcinoembryonic antigen (CEA), prepared. And this eluate reacted specifically the surface of patients' tumor cells. The reactivity of the eluate was aboiisned by absorption of an extract of patient, s tumor tissue and CEA prepared. In addition, CEA was also demonstrated in the patients' urines. These events suggest that an immune mechanism related the gastric carcinoma is responsible for the glomerular lesion. Probably it is carcinoembryonic antigen-antibody complexes to have induced the nephropathy.

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Immunofluorescent studies were performed on the renal tissues obtained from 136 patients of various renal disease using FITC-labeled antibodies against kappa and lambda chain of immuno-globulins to compare with the deposition of heavy chains (gamma, alpha and mu), beta-1C and fibrinogen. Staining for both light chains (bitype) was positive in 84 cases. Twenty-two biopsy specimens showed positive staining for only one of the light chains (monotype). Thirty cases were revealed to be negative for light chain staining. No significant difference was observed in laboratory findings, light mrcroscopie timings, clinical courses and therapeutic effects between the monotypic deposition of light chains. There was also no significant difference in the staining pattern and localization between the deposition of light and heavy chains, except that the light chain deposition was observed almost exclusively on mesangial areas in certain cases in which the deposits of heavy chains were more prominent on mesangium than on capillary walls. No specific correlation was noticed between the kind of renal diseases and the type of light chains, but deposits in SLE were predominantly positive for lambda chains. Almost half of tre cases with monotypic staining of light chains were positive only for gamma chain without concomitant deposits of other heavy chains. Likewise, 19 of 30 cases with no demonstrable light chain deposits were found to be positive only for gamma chain.

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Two patients with acute glomerulonephritis and anaphylactoid purpura nephritis underwent biopsy within the ten days from their onsets. The specimens were examined by light microscopy, electron microscopy and immunofluorescent technics. Fluorescein-labeled immunoglobulin G fraction obtained from patients sera were used for the detection of unknown antigens.1) Streptococcal antigen and immunoglobulin A were obserbed in the mesangial area of glomeruli of the renal tissue from the patient with acute glomerulonephritis. In contrast immunoglobulin G and complement were distributed diffusely along the glomerular basement membrane. These suggest that immunoglobulin A and streptococcal antigen may be a role in immunologically mediated glomerular injuary in acute glomerulonephritis.2) In anaphylactoid purpura nephritis, immunoglobulin A and fibrinogen deposition were obserbed in the predominantry glomerular basement membrane. But in this case antigenic sites were not deteced in the glomeruli of the renal tissue.

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