I. Relationship between renal function and nephron population in chronic glomeronephritis and pyelonephritis. The present study was carried out to clarify the relationship between renal dysfunction and morphological changes of the kidney. The kidneys from the 12 cases of chronic glomerulonephritis, 4 cases of pyelonephritis, and a case of lupus nephritis were examined. The kidneys were bisected along the long axies. Three coronal sections were taken from each of the bisected ones. 5 micron thick slides for microscopic examination were prepared. The number of glomeruli of each slide was counted to estimate the efficient cortical volume. The glomerular changes were graded from 0 to IV according to the grading by Parrish and Ueda. The average number of glomeruli was 658 per 1 section in the normal kidney, so that two nomal kidneys contain 1800, 000 glomeruli. In the cases of chronic glomerulonephritis, glomeruli of grade I and II changes averaged 16.7 per 1 section, namely 23, 000 in two kidneys, glomeruli of grade III 43. 8, and grade IV 148. 8, thus showing a marked decrease in total number. The glomeruli were evenly distributed in every cases. GFR was from 1.4 to 11.5 cc/min, 5.7 cc/min on the average, showing marked decrease in the renal function. Small number of functioning glomeruli, showing I to II glomerular changes, were observed even in the seemingly completly devasteted kidneys. The functioning glomeruli were 1.28% of those of normal kidney, GFR was about 5% of normal, thus the function of glomeruli of grade I and II changes increased. These glomeruli showed compensatory hypertrophy. The glomeruli of grade III changes appeared to function, though a little. The glomeruli of grade IV changes do not function at all. In cases of pyelonephritis, the distribution of the glomeruli was uneven, which is a characteristic of this disease, and the number of glomeruli was markedly decreased as in the cases of chronic glomerulonephritis. In the case of lupus nephritis, the glomeruli were evenly distributed. GFR was 50 cc/min, 340, 000 of glomeruli showing grade I and II changes were counted in both kidneys. The number of these glomeruli was 19% of the normal kidneys. This would suggest that lupus nephritis may represent a form of a latent stage of chronic glomerulisephritis. II. Nephron population in the essential hypertension. The kidneys from 11 cases of essential hypertension were examined. The functioning glomeruli (grade 0 to II changes) averaged 397.7 per 1 section, so that two normal kidneys contain 910, 000 glomeruli. The functioning glomeruli were 63.7, % of those of normal subjects, grade IV changes increased, and glomeruli were evenly distributed. The kidney of essential hypertension have glomeruli that normal function were supported, and showed glomerular hypertrophy. In the essential hypertension, the number of glomeruli was correlated to age, however in some cases of young patients glomeruli were decreased. Blood pressure and grade of sclerotic changes of renal arterioles were no correlated to the number of glomeruli, but correlated to the period of hypertension. The sclerotic changes of arterioles and the damage of renal tubules in hypertension increased more than those of normal subjects.

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For the purpose of clarifying the mechanisms underlying protein-transporting capactity & droplet formation in renal tubule cells, an intravenous injection of Peroxidase, a protein non-existent in normal renal cells, was made for histo & cyto-chemicrl examinations. (1)In normal albino-rats, peroxidase was injectee in an unsaturated (0.05 mg per 1 g body weight) & a saturated amount (0.3 mg per 1 g body weight) from the vein of the tail for histo-chemi cal examination. It was found that staining of tissue was slightin an unsaturated amount & thus droplet formation was hardly visible. On the contrary, the brush border & cytoplasma of the renal tubule reacted remarkably in a saturated amount & droplet formation was also seen. (2) After intravenous injection of a saturated omount of peroxidase, the animals, were sacrificee by expeximetal aemorrhage accarding to passage of time & cell fractions were determined biochemically. The 15-minute level showee the highest activity, & peroxidase activity was marked especially in the microsome fraction. In contrast to this, the mitochondria fraction containing droplets in a great amount showed the highest peroxidase activity 30 minutes after intravenous injection. (3) Time-to-time in vestigation of the peroxidase reaction in urine after intravenous injection of its saturated amount revealed that peroxidase activity reached the highest level 30 minutes later, after which time it grodually decreased.(4) The rats of egg-albumin loading, droplet formation was relatively clearly visible after peroxio Base injection, but in this group peroxidase was not visible into cytoplasma. The following could be presumed regading protein transportation & droplet formation in proximal renal tubule cells. Peroxidase attached to the brush border might beabsorbed into the cell by pino-cytosis, but when peroxidase is loaded in an unsaturated amount to cells, it might pass through cells & be carried to peritubular capillaries. When protein is loaded in an amount greated than the saturated, surplus protein might be left in pinocytotic vesicles with a resultant droplet formation.

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Bacterial count in urinary tract with diabetic nephropathy was investigated, since there had been frequent cases of diabetes accompanied with urinary tract infection especially pyelonephritis.The result obtained with all 114 diabetes urine culture showed more than 10⁵/cc urine of bacteria at 13.1%, and at 20% of diabetic patients with positive proteinumia. 16.6% of all diabetic urine culture revealed more than 10⁴/cc urine of bacteria, and 28% with positive proteinuria, whose count could be assumed to diagnose possible urinary tract infection. Whereas only 13.4% with negative proteinuria had more than 10⁴/cc urine of bacteria. Out of all patients at our department during past one yeat excepting diabetes 11.9% were noted pyelonephritis, whose per cent were about half of that seen in diabetic patients. There were rather many urinary tract infections with diabetes being suffered more than 10 years or with more than 180 mg/dl of fasting blood sugar. These results might seggest that diabetic nephropathy could be introcuced by pyelenephritis compounded with several other courses like metabolic disturbances.

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There are frequent evidence of temporary hematuria in patients suffered from severe electric shock. The participation of fibrinolytic enzyme system in the cause of these phenomena is suspected. After giving the electric current on N. ischiadicus of rabbits, the renal bleeding and the fibrinolytic enzyme system of their blood and urine were examined. The local fibrinolytic enzyme system in the tissue of kidney was also investigated. 1) The rabbit treated with above mentioned method showed hematuria. 2) The acceleration of fibrinolytic activity due to plasminogen activator in blood was observed. 3) The inhibitory effect of their urine to fibrinolytic enzyme system was also noticed. 4) Both the extracts from the cortex and the marrow of kidney revealed anti-fibrinolyt+ic activity. However, the accele-ration of fibrinolytic activity was found in the extract from the pelvis of kidney.

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