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Renal infection rarely occurs after the intravenous injection of gram-negative bacteria, namely, Escherichia coli into normal animals (1). If the kidney is subjected to experimental trauma (2), ureteral ligation (3), medullary scarring secondary to cautery injury (4), or chemical injury (1), an increased susceptibility to infection results.These experimental models, however, do not expflain tile hlighl lneilence cf pyeloneptihrits in human pregnancy (5-12). The development of pyelonephritis in pregnant women has been ascribed to the anatomical and functional changes of the urinary tract usually observed from the third month of pregnancy to a few weeks after delivery (5,7,12). Dilatation of the ureters and renal pelves has been attributed to obstruction of the ureter by the pregnant uterus (13) Diethylstilbestrol.2 Pellets contained 75% diethylstilbestrol and 25% cholesterol by weight. The pellets were weighed3 and placed subcutaneously through a skin incision, 15 mm long, at the base of the neck of rats under light ether anesthesia. The incision was closed with a skin clip. At the time of sacrifice, the pellets were recovered from most animals, dried, and weighed. The amount of diethylstilbestrol absorbed was estimated to be 0.75 times the difference in pellet weight. Shamape.rAtion wart carried otA inr contrcd rktw Bacteria. The strain of F. rali (1FN 9) irud ha-a been maintained in this laboratory for 7 years, and details of its handling were described previously (3). A volume of 0.5 ml of a 4-hour culture (containing 2.5 to 7.5 X 10' organisms per ml) was injected into the tail vein of each rat. Tenfold dilutions in 0.85% sodium chloride solution were incubated in agar pour plates to enumerate each inoculum. Removal of the urinary tract for bacteriological and pathological studies. Sterile technique was maintained during all surgical procedures. Under pentobarbital anesthesia, the abdominal wall was cleaned with 70% alcohol and incised so that the entire urinary tract was exposed. After urine and blood were collected in some ahiiiiiil, tsia kidneys, ufeters, and bladletbr weic iviliuved and placed in Petri dishes for macroscopic examination and sectioning. A mid-line longitudinal section was made in each kidney which appeared grossly abscessed or hydronephrotic. One-half of the kidney, both ureters, and the bladder were fixed in 10%o formol for histological examination. The remaining half of the kidney was placed in a Teflon tissue homogenizer and ground in 4.5 ml of 0.85%o sodium chloride solution until a homogeneous suspension was obtained. Whole kidneys were cultured after homogenization with 9.0 ml of saline. These concentrations represented a 101 dilution. Subsequent tenfold dilutions were prepared in saline solution. Agar pour plates were made from these dilutions, and colony counts were determined after incubation for 48 hours.Counts ranging between 30 and 300 colonies were taken as most nearly representative. When the greatest dilution contained too many colonies to be counted, the numDiethylstilbestr...

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Quality of life is the most controversial issue surrounding home hemodialysis. We examined how sixteen adolescents and their six families reacted to having a father on home hemodialysis, exploring the interplay between adolescent developmental conflicts and family stresses. Family members underwent role changes to adjust to alterations imposed by hemodialysis. Some adolescents helped relieve family stresses by taking an active role in dialysis. These eight adolescents developed greater self-esteem which enhanced identity growth and facilitated separation. Psychological responses were observed that resembled the "death guilt," "psychic numbing," and "invisible contamination" described in Hiroshima survivors. Adolescent developmental problems can be dwarfed by family conflicts around chronic illness and dialysis. Families adjusted to home hemodialysis showing new growth, managing with a barely workable arrangement, or adapting unsuccessfully. Understanding more about how home hemodialysis can influence family interactions can enable the medical staff to facilitate beneficial changes, and thereby improve the quality of life for patient and family.