The aim of this study was to compare (a) two different umbilical cord blood (UCB) collection methods while the placenta is still in the uterus (in utero), and (b) to evaluate the efficacy of four cryopreservation protocols based on UCB haematopoiestic stem cell (HSC) recovery. We analysed UCB samples collected with our original collection system designed for active Syringe/Flush/Syringe method or by standard in utero method. For comparing different cryopreservation procedures, dimethyl sulphoxide (DMSO) at final concentration of 5 and 10% was used and combined with our own controlled-rate or uncontrolled-rate cryopreservation. A total of 99 samples were collected. A significantly higher UCB volume, total nucleated cell and mononuclear cell were seen following the first collection strategy (n= 49; mean +/- SD, 103 +/- 35.4 mL; 12.34 +/- 5.27 x 10(8); 595 +/- 3.47 x 10(6)) vs. the second strategy (n= 50; 86 +/- 29.3 mL; 9.87 +/- 4.47; 424 +/- 2.82 x 10(6)) respectively (P < 0.01). The discard rate was 14% for the first and 36% for the second collection strategy (P < 0.01). It was shown that the most efficient procedure was the controlled-rate protocol combined with lower (5%) DMSO concentration. Using active Syringe/Flush/Syringe method, we collected UCB with greater volumes and with lower discard rate compared to the standard by gravity technique. The data presented also showed much better recovery of UCB cells when controlled-rate freezing procedure and 5% DMSO were combined.

54 biopsy cylinders of patients with different chronic sclerosing interstitial nephritides were investigated morphometrically. The point-counting method was used to determine the relative interstitial volume of the renal cortex. In this study, as in earlier investigations on inflammatory and noninflammatory glomerular diseases, as well as in studies on benign nephrosclerosis, significant positive correlations could be found between serum creatinine concentration and enlargement of the interstitium induced by fibrosis. Furthermore, correlations between decreasing serum creatinine clearance and fibrosis-induced interstitial broadening could be established. Enlargement of the interstitium by lymphocytic and plasma cellular infiltrates had no influence on renal function. Only in 1 patient were the findings not congruent with the above-mentioned observations. This could be explained by a severe anorexia nervosa with muscular atrophy and lack of available creatinine. The clearance values, however, showed the expected impairment of renal function. Interstitial fibrosis may lead to a narrowing of the postglomerular vessel network and to an elevated postglomerular flow resistance. In spite of increased glomerular filtration pressure, slowing of the glomerular blood flow could lead to an elevated serum creatinine concentration. A reduced glomerular filtration rate could lead to tubular atrophy as a sign of inactivity. Furthermore, the deficient Na-Cl resorption in atrophic tubules most likely perpetuates the decrease in the glomerular filtration rate. The glomerular filtration rate could be diminished by the so-called Thurau mechanism.

We report the clinical and morphological features of a distinctive hepatorenal disorder in four patients and review the five similar patients in the literature. The main clinical characteristics were early onset of cholestatic liver disease and progressive tubulointerstitial nephritis leading to renal death in early childhood. Liver histology showed disturbed architecture with nodular and acinar formations and portal fibrosis and bile duct proliferation. Histological abnormalities in the kidney were severe interstitial fibrosis and tubular atrophy and dilatation, while the typical features of nephronophthisis were lacking. These clinical and morphological characteristics distinguish our patients from the majority described, as having nephronophthisis and congenital hepatic fibrosis or any other known syndrome with concomitant hepatorenal involvement. We suggest that the association of cholestatic liver disease and progressive tubulointerstitial nephritis represents a new syndrome.

A boy who developed haemolytic-uraemic syndrome (HUS) at 8 years 6 months of age had four further episodes of the disease during the next 3 years. No renal abnormalities were detected between the attacks nor in the 2.5 years after the last recurrence. Reduced levels of serum complement were found during four of the episodes and in two intervening periods.

Moraxella bovis was repeatedly isolated from cerebrospinal fluid in a girl with two episodes of shunt nephritis. Clinical remission of nephritis was achieved only after shunt replacement. A list of about 20 infectious agents reported to date in patients with shunt nephritis is given. M. bovis is yet another agent previously not reported in patients with shunt nephritis.