Although it is well confirmed in various diseases, that there are closer resemblances between the members of an identical twin-pair than between the members of a binovular one, only a few cases of glomerulonephritis in both twin-pair members are reported. Since the first report by Galton (1876), in total 224 twin-pairs are found in the literatures in this country and abroad in respect of glomerulonephritis. But in only 24 out of these 224 pairs, the disease occurred in both twin members. This paper describes rare cases of a pair of identical twin-brothers, aged 14, both affected with acute glomerulonephritis after acute infection of the upper air tract. Case 1.A twin had an acute infection of the upper air tract May 5, 1962. After only one day's treatment, he neglected it in spite of the illness not getting better. On May 27 edema of his face was noticed and hypertension (160/110 mmHg), heavy albuminuria, and hematuria were detected. Clinical examinations revealed markedly decreased renal functions and azotemia over 100 mg/dl. In September he became uremic and died October 10. The course of the disease was that of the subacute glomerulonephritis. Autopsy revealed markedly contracted kidneys. Case 2.Another twin took concomitantly the same infection, After two weeks' treatment he became well. As his twin-brother had been admitted to the hospital, he was examined for precaution's sake and was found to have a slight albuminuria. He was also admitted to the hospital on July 23. On admission renal functions, blood pressure, and the other clinical findings were within normal. But during the hospitalization for over 18 months, the renal functions tended gradually to decline and the urinary findings were only slightly improved. The renal needle biopsy performed 4 months after the infection revealed moderate changes of chronic stage of glomerulonephritis. These cases are thought to be an example to show, on the one hand, the close effect of the treatment of the antecedent infection on the severeness of glomerulonephritis and, on the other hand, the resemblance in the course (unfavorable in these cases) of the disease in identical twins.

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The complication of renal change in patient with gout is well recognized, but the mechanism of the Tenal disturbance is not fully elucidated. Urine analysis and kidney function were studied in 27 patients with gout and renal biopsy was carried out in 13 cases. Relationships between renal impairment, duration of the disease, serum urate level and X-ray findings of the bones and joints were investigated. Their ages range from 24 to 75 years and the duration of the disease from 2 to 16 years.The following results were obtained :1) Proteinuria was positive in 41%, red blood cells in sediment 26%, white blood cells 26%, casts 7%. Urin culture was positive in 4 of 13 cases (31%). The history of the nephrolithiasis was found in 2 of 27 cases (7%).2) In renal function tests, GFR (Thiosulfate standard method) showed disorders in 50%, RPF (PAH :standard method) 83%, PSP excretion during 15 min. 88%, PSP excretion during 2 hours 62%, and Fishberg's concentration test 73%. Serum urea nitrogen was raised in 44%. Abnormal findings of intravenous pyelography were found in 8 of 18 patients (44%). Therefore all patients showed a slight or severe disorder in renal function tests. 3) Renal biopsy in 13 patients revealed a case of suspected chronic pyelonephritis, 2 cases of chronic-pyelonephritis, a case of chronic pyelonephritis with arteriolosclerosis, 4 cases of arteriolosclerosis and one case of chronic glomerulonephritis. Normal finding was found in only 2 cases. By De Galantha's method and modified Saint Hiraire's method no urate deposit was proved in any of the specimens. 4) The histological lesions of glomeruli were slighter than that of arterioles, tubules and interstitial tissue. Possibly this is a cause why occurrence of abnormal urine findings was scanty compared with disturbances in renal function and histology. 5) Proteinuria increased as the duration of the disease prolonged or X-ray findings of the bones and joints progressed and after the age of 50. But it showed no correlation to serum urate level. 6) Renal function correlated to age of the patients, but no particular relationships were observed between the duration of the disease and changes in the joints and bones or serum urate level. 7) Histological features of the kidney showed a significant correlation to renal function. 8) A striking result was obtained that the majority of the patients with a short duration of illness, comparatively low level of serum urate and slight X-ray changes in the bones and joints showed an un-a expectedly serious renal impairment. 9) Based on these findings, the author would conclude that these are two types of kidney injuries. Namely, one is tubular type in which disturbance is initiated from tubules and interstitial tissue due to urate deposits and another is vascular type which is mainly characterized by arteriolosclerosis initiated from hypertrophy of the vascular wall. These two types of the lesions may combine in the course of the disease. Further it may be complicated by infection, resulting in a variety of histological pictures in autopsied cases. And this will be the reason why renal function tests in gouty patients reveal no definite pattern. 10) A case history was discussed in which the changes of the bones and joints were preceded by that in the kidney and the kidney was especially injured than the bones and joints as a result of hyperuricemia.

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Pneumoretroperitoneum was carried out in 20 healthy persons and in 75 patients who were suspectedd of having movable kidney because of the kidney palpable in dorsal decubitus or standing posture or att deep respiration, and/or because of lateral abdominal pain or traction feeling of viscera. After this, 4 simple X-photos of kidney were taken in both dorsal decubitus and standing posture in deep expiration. and inspiration phases, in order to find out the respiratory and postural transposition of the kidney. The results obtained are as follows : 1) The respiratory and postural transposition of the kidney does not exceed 3 cm in healthy persons. Therefore, when kidneys are movable over 3 cm, they may be diagnosed as movable kidneys. 2) Some kidneys may be moved only by respiration, and others, only by postural change : and so for diagnosing movable kidney it is necessary to observe the kidney transposition caused not only by postural change but also by respiration. It is also necessary to investigate the torsion and bending of the pedicle including vessels, ureter and nerves, for diagnosing movable kidney. 3) Females, especially over 40 years of age, are apt to suffer from movable kidney. The appea rance of movable kidney is not different between left side and right side. 4) Movable kidney is apt to be found with visceral ptosis, hypertension and nephritis ; and sometimes the patient with movable kidney has such complaints as dull lateral abdominal pain, constipation, , traction feeling of viscera, lumbago ect. 5) Microhematuria and proteinuria are observed more frequently in movable kidney than in normal kidney. 6) Many of the patients with movable kidney suffer from hypertension, which is characterized by the distinct daily change of maximal as well as minimal blood pressure.

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To a total of 72 cases including 20 normal subjects and 7 cases with primary aldosteronism, 80 cc of 10% sodium thiosulfate was administered intravenously early in the morning. Fifteen minutes after the completion of the administration, potassium clearance [C_K(Na thiosulf.)]was determined twice at 30 minute intervals. 1) In the normal subjects, C_K(Na thiosulf.) remained below 30 cc/min in general, whereas after salt restriction or daily administration of DOCA it showed a tendency to increase. Spironolactone ad-ministration minimized this effect of salt restriction on C_K (Na thiosulf.) 2) In all of the cases with primary aldosteronism, C_K(Na thiosulf.) showed a higher level than. 35 cc/min, while it showed a normal level during the administration of spironolactone or after the remo-val of adrenal tumor. 3) C_K(Na thiosulf.) in essential hypertension and in secondary aldosteronism associated with edemaa was normal. 4) In a case with renovascular hypertension, C_K (Na thiosulf.) was increased in spite of normal secretion rate of aldosterone. The increase of C_K(Na thiosulf.) was attributed to the respiratory alkalo-sis. 5) C_K (Na thiosulf.) increased significantly when sodium bicarbonate was administered orally to normal subjects, or when ammonium chloride was given daily to the patients with primary aldoste on sm. From the above findings, the increase of Cx (Na thiosulf.) is considered to be partially related to acid-base balance. Moreover, the loading of sodium thiosulfate, which is hardly reabsorbed from the proximal renal tubules, may increase sodium loading to the distal tubules, and when there is hyperocre-tion of aldosterone acting upon these sites, potassium excretion may be elevated through the exchange-for sodium, producing further increase of potassium clearance. The confirmation of the increase of potassium clearance following the administration of sodium thiosulfate, therefore, may be of significant value for the diagnosis of primary aldosteronism.

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The experiments were performed to determine the distribution of neohydrin Hg-203 in the body and radiation effect to the kidney by using rabbits. The results were as follows :1) Neohydrin Hg-203 was combined with serum albumin soon after the intravenous administration, gradually distributed to the various organs (kidneys, spleen, liver etc.) and was excreted rather slowly from the kidneys.2) Neohydrin Hg-203 concentrated mostly in the cortex of the kidneys and it reached to the maximum level in about an hour after administration.3) The micro-and macroautoradiograph of rabbits' kidney with intravenous administration of neohy-drin Hg-203 one hour prior to tracing revealed that the radiomercury was mostly taken up by the proximal tubules.4) Radiation effects of neohydrin Hg-203 to the kidneys were observed with the doses less than. 10 μc/kg. The characteristic histological changes were swelling of the primary tubular cell, hyaline droplet degeneration, swelling of the glomerulus and its adhesion with Bowman's capsule. These changes were present to the highest degree in one week after administration and grossly recovered three weeks after. Therefore one should be careful to use unnecessary large doses of neohydrin Hg-203, especially in the cases with renal poor function.

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