The Biopsy material taken from 18 cases which were diagnosed to be nephrotic symdrome of un-known origin on the clinical viewpoint. These were examined histologically as well as electronmicro-scopically, On the basis of electronoptic findings of mitochondria of the glomerular epithelial cell three types were postulated : A ; demonstrating severe enlargement of michondria including so-called myelin body. The latter being merely vacuolic rather peculiar is seen in concetric structure the shell of which is electron dense. Histologically sedan and PAS stainings failed to reveal neutral fat and mucopoly-saccharide, There were five cases assumed to be in this group which revealed mild nephrotic syndrome; lower proteinuria, almost normal cholesterinemia occasional edema and normal TP except for arbitural PSP excretion. B ; characterised by moderate enlargement of mitochondria, advancing disarrangement of crista, occasional electron dense granules in the glomerular epithelial cells. The basement membrane showed mederate thickning on lightmicroscopy and occasional fusion of foot processes. There were five cases being in this kathegory with occasional severe proteinuria and higher cholesterinemia. C ; show-ing almost normal mitochondria of the epithelial cell but rather severe thickning and flattening of epithelial foot processes. Eight cases were observed to be in the group exhibiting typical syndrome of nephrotisis and effective steroid and ACTH therapies. On the morphological and functional findings is drawn conclusion that the mitochondria of the glomerular epithelial cell would contribute to contaoll albuminuria with deformation of it. It would there-fore be mentioned that the protein leaking through the basement membrane could be taken in the cytoplasma the mitochondria of which play a role to manufacture it to from proteinuria of the ultafiltrate.

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1) The correlation of structure and function of human kidney in acute, subacute and chronic renal failure was studied, morphologically by microdissectional and histological methods. 2) In acute renal failure due to mismatched transfusion, changes of tubular epithelium were noted mainly in the distal tubules, while in the case due to toxic agents were found in the proximal as well as the distal ones. According to these findings, it is suggested that as a result of striking back duff u-sion of tubular fluid through the damaged epithelium, marked oliguria may occure. 3) In the case of subacute nephritis, membranous and exsudative changes in glomerulus and local 'hypertrophy with dilatation of lumens in the terminal portion of the proximal tubules were observed. According to these observations, the tubular dominant, as physiollogically suggested at a point of view in glomerular tubular balance, was also morphollogically supposed. This may result marked edema which affects unfavorably. 4) In human chronic renal failure, small mumbers of hypertrophied nephrons were observed in the contracted tissue. Formerly, it was assumed in my 1 st Report, that the renal function after partial resection of the Kidney in dogs were so similar to that of human chronic renal diseases. On account of these bases, it is suggested that the renal function of the human chronic renal failure may be done mainly by these small numbers of hypertrophied nephrons and not by the large numbers of atrophic nephrons. 5) In chronic renal failure, the tubular segmentation, so I called, one of the state of atrophic changes, were observed and the mechanism of the tubular segmentation were discussed by microdissectional method.

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An observation was made on the influence of high energy phosphorus bound substance-ATP-and the activated form of Vit. B₁ by phosphorilation - Co-Carboxylase - on the renal function, and wass studied the glucose metabolism in the kidney having renal disease or the rats kidney experimentally introduced renal disorder. ATP made a rise of renal clearance in the normal kidney of rabbits. After ATP and Co-Carb. administration PSP-test showed a rise or an improvement in cases lightly disturbed renal function, but not definite change in serious cases. ATP made a marked improvment of Δ10 P in the lightly disturbed rats kidney by potassium chromate but the minimum increase and slow return to the begining rate in serious cases. These improved also pyruvic acid and α-ketoglutalic acid in the renal disease. Thus it may be assumed that ATP and Co-Carb. improved the renal function on activating the the phosphorus metabolism and leading the smooth TCA cycle, and that PSP-test may indicate the reactivity of the renal function.

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The authors performed the statistical survey on 1095 cases which were hospitalized in the authors' clinic of internal medicine in a period from the December of 1937 to the end of 1960. Among them 15 cases in 1937 were excluded in the annual statistics. Combined cases with nephrotic syndrom were excluded from this study. 1) Sex and age of patients. The statistical analysis was done in every 5 years term on each sex. The highest number of incidence was in ranges of 5 to 15 age and the more advanced age, the fewer number of incidence. However there was still observed rarely in over 60 years old person. The number of incidence was higher in the male person, especialy in both ranges under 15 years and over 50 years old, while no significant difference was observed in other ranges of age. 2) Annual statistics during a period of 23 years. There were two remarkable increases of number of cases in 1939 and 1956. Between these two peaks the lowest number of cases was observed in 1949. 3) Seasonal variations of number of patients. The highest number of patients was observed in winter, the lowest in summer. The number of cases in spring and autumn were almost similar. 4) The original diseases and the period until the first appearance of glomerulonephritic syndrom. Acute tonsillitis (41%), common cold and influenza (21.4%), purulent inflamation (4.8%), unspeci-fic inflamatory diseases (4.6%), scarlet fever and scarlet fever like erruption (3.1%) and purpura (0.7%) were noticed as the original diseases. The percentage of cases without noticeable original disease was 24.4. The acute tonsillitis was a main original disease in adult persons while in infant cases other orginal diseases were overwhelmingly numerous as the cause of acute glomerulonephritis. There was a certain delay until the first appearance of noticeable symptoms of glomerulonephritis by the difference of original diseases: within two weeks in cases of acute tonsillitis, common cold, influenza, and unspecific inflamatory diseases, four weeks in cases of purulent inflammatory diseases and purpura. 5) Prognosis of the acute glomerulonephritis. The statistical analysis was done on 541 cases in which the prognostic information of 153 cases was collected from the inquiry to the patient or his family. 488 cases (89.7%) recovered completly without any detectable change in urine test, 39 cases(7. 2%) left some changes in urine test or hypertension, and 17 cases (3.1%) resulted in the death mainly by aggravation of glomerulonephritis. The percentage of complete recovery in infants was 93 and it was 86 in adults, while sex difference was not significant, that is, 89% in male patients and 91% in female. The period for recovery was one to two months in most cases, however cases in which over one year was necessary to recover was 12.8%. Infant showed a better recovery of 90% than adult of 83% within one year term of observa-tion. The percentage difference of cases of completely recovery by kinds of original diseases was not so significantly high, i. e., from 94 to 86%. Among them, the glomerulonephritis caused by purpura showed three deaths in five, No peculiar relationship between the period of recovery from the acute glomerulonephritis and the kind of original disease was observed. Cases which left permantently the glomerulonephritic syndrom was 39 (7.3%) in which 12 infants were included. The sex difference was 26 male patients and 13 female. Five hypertension cases were observed in which male patients occupies four and one infant was included. Among 17 deaths, the number of adult person was 12 and the number of male patients was 10. The death was occurred by uremia in 9 cases, by heart attack in 4, pancreatic cancer in one and unknown in 3. 8 cases were glomerulonephritis without any noticeable original disease. Conclusively the authors make a notice on a better prognosis of acute glomerulonephritis not only in infant but also in adult. Changes in u

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