If contraindications, especially high blood pressure and abnormal haemostasis, are respected, ultrasound-guided percutaneous renal biopsy with an automated biopsy device is safe. Skilled operators obtain satisfactory amounts of kidney tissue in almost all cases.

Summary Head and neck movements affect both the length of the trachea and the position of tracheal tubes. This is of relevance when using cuffed tubes because changes in the position of the tube tip may not be equal to changes in the position of the cuff. The aim of the study was to assess the impact of head and neck movement on the position of the tube tip and the cuff of newly designed, oral preformed tracheal tubes in children. The tracheas of 128 children aged 1–8 years were intubated with preformed oral tubes. The distances ‘carina‐to‐tracheal tube tip’ and ‘vocal cords‐to‐tube tip’ were measured endoscopically. These measurements were performed with the head and neck in a functional neutral position (110°), during neck flexion (80°) and neck extension (130°). Tracheal length was dependent on head and neck position: neck extension elongated the trachea (p < 0.0001), and neck flexion shortened the trachea (p < 0.0001). Neck flexion moved the tube inward and resulted in endobronchial displacement in two patients. Neck extension moved the tube outwards. While no cuff was positioned between the vocal cords, cuff movement to the cricoid area occurred frequently. Complex interactions during head and neck movement along with the fixed insertion depth of preformed tubes often cause inadvertent malpositioning of the tube tip and cuff. Further changes to tube and cuff lengths might improve the safety of oral preformed tubes in children.

We developed an immunohistochemical method for visualization of vitamin D (VDR) and estrogen receptors (ER) in cryostat sections, using monoclonal antibodies (MAb) to the vitamin D receptor and estrogen receptor, respectively. This method is based on an avidin-biotin labeling technique (LAB). To establish a reliable and sensitive method which can be used easily as a routine diagnostic procedure, we systematically compared four different immunoenzymatic methods with respect to their efficiency in detecting vitamin D and estrogen receptors. Compared to the indirect bridged avidin-biotin (IBRAB), the peroxidase- anti-peroxidase (PAP), and the avidin-biotin complex (ABC) methods, the LAB method produced stronger staining intensities and had higher detection efficiency for both vitamin D and estrogen receptors. In addition, the LAB method had a higher spatial resolution compared to the ABC technique in detection of VDR in normal human skin biopsies. In the case of steroid receptors, i.e., nuclear antigens, immunohistochemistry must deal with a relatively low number of antigenic sites per cell, restricted accessibility of the antigens, and slight differences in antigen concentrations among cells. Under these particular conditions, the chemical properties of the conjugates used in the LAB method may explain why it is superior to the other methods. Consequently, the LAB method is recommended for visualization of ER and VDR.

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Over a period of 68 months we observed 33 patients with biopsy-confirmed severe crescentic glomerulonephritis (GN) and another 5 patients who fulfilled the clinical criteria of rapidly progressive glomerulonephritis (RPGN; no biopsy confirmation) in a region comprising approximately 930,000 inhabitants. Additional 7 patients with Wegener’s granulomatosis (WG)/microscopic polyarteritis (MP) from the same region were not seen by nephrologists. The calculated annual incidence of crescentic GN/RPGN is 0.7/100,000. Of the 38 patients 13 had classical WG, 7 MP, 3 systemic lupus erythematosus, 5 Schönlein-Henoch purpura, 3 Goodpasture’s syndrome, 2 IgA glomerulonephritis. Of note is the high prevalence of WG/MP and the relative frequency of Schönlein-Henoch purpura. At the last follow-up, 3 patients were dead (8%), 7 patients were on dialysis (18%), 7 patients had elevated serum creatinine (18%) and 21 patients had normal serum creatinine (55%). We conclude that: (i) RPGN is more frequent than reported; (ii) WG and MP account for more than 50% of cases of RPGN; (iii) renal functional prognosis is good in WG/MP, but less favorable in RPGN of other causes; (iv) severe hypertension is not a feature of RPGN; (v) WG/MP, and not Goodpasture’s syndrome, is the most common cause of pulmonary hemorrhage in association with RPGN; (vi) death from infection or malignoma is uncommon (not observed in this series); (vii) de novo IgA GN may occur in patients in remission from WG (2 observations).