Since Carrel and Burrows in 1910 practically established the in vitro cultivation procedure of several organs and tissues of animals, it is usually admitted that the kidney tissue is one of the most cultivable organs in the body. In these days, the kidney cells are multiplied even in industrial scale and used routinely for virus harvest in the virological field. However, the cell origin of the cultured kidney cells remains still obscure, because it is very difficult to follow them up from their original cells of the nephron. The purpose of this work is to find what kinds of the epithelial cells of the nephron grow up in vitro, using the stationary monolayer culture meteod.

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To identity the origin of the endathelium-like cells of the glomerular tufts in diffuse glomerulone-phritis, the histologic changes of the glomeruli in Masugi-nephritis were studied electron microscopically. The materials were 12 rabbits of unilateral Masugi-nephritis, produced by a single injection of 1.25 ml/kg body weight of duck anti-rabbit kidney serum during the transient ligation of the left renal artery. Each rabbit received an intravenous injection of carbon black suspensin (25% dilution of Pilot black ink) 24 hours before the sacrifice. Two of them, were in addition, injected with total dosis of 30 mg of prednisolone within 24 hours before the sacrifice at 8 th day after the injection of nephrotoxin Clinical course of the disease was divided into following four stages ; latent ( 5 days after the injection), initial (6 - 7 th days), severest (8 th day) and healing stage (14 th day). The results obtained are summarized as follows. 1. Four kinds of cells were recognizable in the glomerular tufts of nephritic rabbit kidneys. They are epithelial, endothelial, mesangial, and endothelium-like cells. 2. Through all stages the endothelial cells formed endothelial canals, and the desmosomes persisted between the cells. In the initial and severest stages the canals were often compressed so intensely by the proliferated endothelium-like cells that they were transformed into slit-like cavities. No transforma-tion of the endothelial cells into mesangial or endothelium-like cells was observed, 3. The mesangial cells were surrounded by basement membrane-like material (mesangial matrix). With progression of nephritis, they showed elevation of phagocytic activity and the incaease in number of rough surfaced endoplasmic reticulums and RNP garnu'les. They often invaded into the subendothelial spaces in the initial stage and thereafter. 4. The endothelium-like cells were classified into follwoing four types according to their cytologic features: i) The cells with large Golgi complex and many phagosomes which are arranged in rosette-like pattern around the Golgi complex. Their cytoplasm and rough surfaced endoplasmic reticulumm resemble to those of normal mesangial cells. This type of cells appeared in the latent and initiall stages, and in the severest stage, too, in the predonisolone-treated animals. ii) The cells of this type resemble to those of type 1. But RNP granules and endoplasmic reticulums are abundant than in type 1 cells. iii) In this type of cells, Golgi complex is not so distinct and the phagocytic activity is low. But endoplasmic reticulums which are located diffusely within the cytoplasm, are markedly increased in number and size. RNP granules are also increased in number. iv) The cytoplasm of this type of cells swells oedemateously, and the cells look like endothelial cells. They are divided into two subtypes, the cells with and without markedly increased phagocytic activity. The latter cells seemed to be in.n degenerative process. 5. The cells of type 2, 3 and 4 appeared in the severest stage. Every type of endothelium-like cells was always found in the subendothelial spaces. Transitional features were found between four types and mesangial cells. In the severest stage and thereafter, the deposits similary to mesangial matrix or basement membrane were to be seen around these cells. 6. In the prednisolone-treated animals, the structure of glomeruli was well preserved, so that the endothelium-like cells were clearly differentiated from the endothelial cells. Invasion of mesangial cellss beneath the endothelial layers was often observed. Conclusion From these observations it is suggested that the endothelium-like cells originate from mesangial cells and hat the former represent the various features of the latter caused by the conditions of the environments around them.In the latent stage, the majority of the proliferated intracapillary cells are endothelial cells. In the initial and severest stages t

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Peritoneal dialysis is generally accepted as a major therapeutic procedure for renal failure, uremia, and distortions in blood electrolytes and other chemical components. Although its dialyzing effect is less efficient than hemodilysis, peritoneal dialysis is employed frequently as appropriate means of treat-ment for these disorders because of technical simplicity and absence of complicated or expensive apparatus. Advanced understanding of water and electrolyte metabolism as well as availability of more potent diuretics provide the more efficient measures in the treatment of edema. However, the treatment of refractory edema, congestive heart failure and pulmonary edema appearing in patients with renal failure are still eluded the adequate control. In such overhydrated states hemodialysis and peritoneal dialysis with hypertonic dialysis fluid may be the treatment of choice. The purpose of this paper is to evaluate peritoneal dialysis comparing its effect with that of hemodialysis, to analyse the kinetics of peritoneal dialysis with hypertonic irrigation fluid, to define the influences on circulation, and finally to elucidate the clinical effectiveness of dialysis with hypertonic fluid for removal of excess fluid. 1) Intermittent peritoneal dialysis were performed on 22 patients in 86 occasions using commercially available peritoneal dialysis fluid. An amelioration of uremic signs and symptomes with improvement in azotemia, electrolyte abnormalities and metabolic acidosis were obtained. Peritoneal dialysis was about one-sixth as efficient as Kolff Twin-Coil artificial kidney. Peritonitis was in 3 cases which were dialyzed with indwelling peritoneal catheters. On the other hand, peritonitis was not observed in cases dialyzed with multipuncture technics. 2) Experiments were performed with mongrel dogs of 8-14 kg. to evaluate the peritoneal dialysis with a dialysis fluid containing 7.0% dextrose and its influence upon circulation. The dogs were divided into three groups ; dehydrated normal dogs (group I, 8 dogs), dehydrated uremic dogs (group II, 4 dogs) and overhydrated uremic dogs (group III, 4 dogs). The dogs were made uremic by ligation of bilateral ureters and used for the experiments between 2 and 4 days after the operation. Serial determinations of intraperitoneal fluid were carried out on the osmolality and the isotope, sodium and chloride concent-rations after the intraperitoneal administration of 500 ml. of hypertonic dialysis fluid containing 7.0% dextrose with 10-20 pc of RISA. Intraperitoneal fluid volumes were calculated from isotope concentra-tions. Predialysis plasma osmolality of group II and III was higher than that of group I. Soon after the initiation of dialysis, the fluid osmolality fell rapidly and leveled off in 120 minutes (group II and III) or 180 minutes (group I) when the fluid osmolality was in equilibrium with plasma osmolality. Intraperitoneal fluid increased rather rapidly in the first 30 minutes and no significant difference was observed among three groups in their time course profil. Thus, the most efficient peritoneal dialysis can be obtained when the dialysate is changed every 30 minutes. A rapid decrease in sodium and chloride concentration, possibly due to a shift of water into the peritoneal cavity, occurred reaching the nadir from 60 to 120 minutes. The ratio of sodium to water lost during this procedure was in favor of water, indicating water being removed in excess of sodium. Blood pressure decreased in group I, stayed unchanged in group II and III. Increase of hematocrit and decrease of plasma volume were far greater in group I than in II and III. There were no significant difference in the intraperitoneal fluid volume among three groups. These facts suggest that less untoward influences upon circulation iu group II and III were probably, at least in part, due to overhydration in these groups. 3) Clinically, about 500 ml. of fluid removal were attained when one liter each

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Between January 1963 and December 1965, 100 cases of renal homotransplantations (25 from living donors and 75 from cadavers) were performed on 84 patients with terminal renal failure at The Cleveland Clinic Foundation. In 84 recipient, 53 are still living and three of them have been living over two years, 17 over one year (three of 53 are now back on periodic hemodialysis). In 25 transplants from living donors, 15 have still be functioning and 3 of which are now over two years, two over one year. In 75 cadaver homografts, 35 are functioning, ten of which are now over one year. In general, live donor homografts begin to show diuresis within a few hours after transplantation, and for cadaver kidneys, oliguric period of from several days to a few weeks preceded the onset of diuresis. Thereafter, uremic symptoms subside or are eliminated, havipg a majority of recipients be liberated from diet restriction and resume their active and useful lives. Large dosis of azathioprine and steroid were used as the major immunosuppressive drugs. When the evidences for possible rejection, such as fever, oligulia, azotemia or hypertension were noticed, either resumption of large dosis of steroid, actinomycin-c or local Jrradiation of Cobalt were employed to suppress rejection crisis. Failure of homografts, when developed, usually were seen within the first three months. Postoperative complications (homograft infarction, necrosis or stricture of ureter, disruption of renal artery anastomosis etc.) were the commonest cause of failure and rejection or infection were the second. We failed to find an unequivocal evidence for the correlation between rejection and either ischemic time or ABO blood type crossing. Possible relation of blood type crossing with homograft infarction was suggested. Isotope scanning and/or angiogram of transplant often provided the useful adjuncts for diagnosis of post-transplantation renal failure. Infection was the major cause for recipient's ceath (58). We have experienced two Berths of fluminent necrotizing hepatitis and two other cases who died of symptoms similar to "Wiskott-Aldrich. Syndrome ", on whom cytomegalic inclusion bodies were found at autopsy. We were impressed withh severe leucopenia in some of the infected patients who followed fluminent fatal course. We were encouraged by the good result oI cadaver homotransplation and emphasized the important role of hemodialysis in renal tracsplantation. Developement of the proper methode for anticipation of immunological compatibility and the so-called "kidney bank" were desired.

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