Granulomatous glomerulonephritis, without systemic disorder

The case of a 12-year-old girl dying of renal insufficiency is described. At autopsy granulomatous glomerulonephritis was found without any systemic disease. The glomerular light-, immunofluorescent- and electron microscopic changes were studied. Four hundred glomeruli were analyzed by light microscopic investigation and graded (I-IV). By immunofluorescent investigation, intraglomerular and in the more severely affected glomeruli, periglomerular immunoglobulin deposition was detected. Electron microscopic investigation revealed mononuclear cells and fibroblasts in the glomerular and periglomerular cellular infiltrate, resulting in fragmentation and rupture of Bowman's capsule and loss of the glomerular structure.

[Quantitative morphological studies on the zoma glomerulosa of the rat adrenal gland. I. Basic principles of stereology]

Quantitative morphological study of the zona glomerulosa of the rat adrenal was carried out. Basic principles of the method used are reviewed. The most important stereological methods and correlations described in the literature and used for the study of quantitative relations of the stereological structure on two-dimensional microscopic pictures are discussed.

[Quantitative morphological studies on the zona glomerulosa of the rat adrenal gland. II. Effect of potassium and heparin on the zona glomerulosa]

Authors studied the effect of potassium and heparin on the zona glomerulosa of rats by stereological methods. As the effect of potassium tolerance test the weight of the adrenals, the wideness and volume of the zona glomerulosa, the number and the volume of the cells of it, further the volume of the mitochondria and nuclei in each cell have shown significant increase. After treatment with heparin the wideness of the zona glomerulosa and the volume of the mitochondria appeared to be decreased. Results are in accordance with the aldosterone-level-increasing effect of potassium and with the antialdosteron effect of the heparin.

Determination of the numerical density of spherical and ellipsoidal particles in the zona glomerulosa, based on distribution measurements. II. Application of the methods

Stereologic investigations of the adrenal zona glomerulosa of rats were carried out in control, potassium loaded and heparin treated animals. The nuclei of the cells were considered as spheres, and the mitochondria as prolate (= elongated) ellipsoids of revolution. Size and shape distribution, numerical densities and mean volumes of particles were calculated. Control measurements were performed in order to test the acceptability of estimation errors. These stereologic methods proved to be suitable in experimental studies.

Experimental studies on factors causing acute serum sickness glomerulonephritis of immune complex origin. I. The role of immune complexes and the immunological status of the host

In acute serum sickness glomerulonephritis induced in rabbits by large doses of BSA, the relationship of the host's immunological status and the severity of renal histological changes was studied. It was found that good antibody producers developed more severe renal lesions. The higher avidity of antibodies enhances the inflammatory effect of immune complexes. Kidney is favoured for deposition of immune complexes especially in the case of chronic immune complex formation in the presence of antigen excess. Diminished phagocytic function of leukocytes (probably decreased immune complex saturating capacity) may also contribute to the severity of renal histological alterations.

Experimental studies on factors causing acute serum sickness glomerulonephritis of immune complex origin. II. Pathomorphological analysis

Seventeen rabbits were given a single, large dose of bovine serum albumin (BSA) intravenously. Percutaneous kidney biopsy was carried out on the 14th and 31st days after BSA administration. Proteinuria was measured and the glomerular changes were analysed in order to find a correlation between the degree of proteinuria and glomerular alterations, i.e. number of electron-dense deposits (EDD), polymorphonuclear leukocytes (PMNL), and mononuclear marcophages (MNM). The results speak in favour of the decisive role of mononuclear macrophages in enhancement of glomerular permeability.

[The action spectrum of cytostatics in the management of glomerulonephritis]

It was reported on the results of the cytostatic immunosuppressive treatment during a 6 years' observation time in 100 patients with glomerulonephritis in immunopathogenesis. The diagnosing was made according to the homogeneous opinion: clinical, immunological and histological. Of the 100 patients 33 suffered from SLE and 67 from other nephropathies with immunopathogenesis. In the therapy were used prednisolone, 6-mercaptopurine, azathioprine, cyclophosphamide and their combination, respectively. On the one hand, the therapeutic results were estimated as short-term results, on the other hand as long-term results with regard to the clinical syndromes as well as to the individual histological forms according to the categories of the full remission, the partial remission and also as "unchanged". It was established, whether an optimum result may be achieved in the different clinical and histological types. The best results may be achieved with the combination of 6-mercaptopurine and cyclophosphamide. The cytostatic therapy of the glomerulopathies should be used more aimedly in different clinical syndromes and histological forms.

[Nephropathy associated with systemic lupus erythematosus]

The investigation of needle- kidney biopsy from patients with SLE- nephrotic syndrome was carried out by the aid of light- immunofluorescent- and electron microscopy. Membranous-, focal-proliferative-, and diffuse-proliferative forms of the SLE- nephrotic syndrome were distinguished. Clinical characteristics of the different forms are described. Authors believe, that the underlying process of nephrological symptoms of various degree as well as readily distinguishable clinico-pathological pictures is the formation of circulating immunocomplexes of different size, developing due to basic disease itself. Comparison of the clinical symptoms and the morphological picture indicate that the elapse of time between the onset of the underlying disease and the nephrotic syndrome has an important part in the formation of the SLE-nephropathy of focal- and diffuse-proliferative type.