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In regularly dialyzed patients in basal gastric juice and after stimulation with pentagastrin the volume of titrable acidity, urea and ammonia were assessed. It was revealed that in relation to the plasma urea concentration in basal juice the mean urea and ammonia concentration is roughly half and in stimulation juice roughly one third. The urea concentration in gastric juice is negatively correlated to the ammonia concentration. Urea excretion into the stomach depends on the plasma urea level and on the secretory gastric activity. The decisive factor of gastric secretion is probably parietal cell secretion. From the results ensues that gastric juice of dialyzed patients contains a quantitatively significant amount of urea and ammonia. Ammonia due to its neutralizing action distorts the examination of gastric acidity assessed by titration. The findings call for a revision of hitherto known data concerning gastric secretion of uraemic patients.

On the basis of 15-years' experience with the allogeneic transplantation of the kidney, the authors present recommendations, concerning the dosage of azathioprine and prednisone (methylprednisolone) during the schematic immunosuppression. There are favourable first experiences with the immunosuppression controlled according to continuous following of the count of lymphocytes able to form rosettes E (degree of immunosuppression) and that of functional granulocytes (toxicity).

A clinical-morphological study in 134 recipients of first renal allografts (15 related and 119 non-related) was performed with the aim to establish prognosis of different types of rejection nephropathy. Following order of prognosis (from the worst to the best) was found: necrotic lesion, early vascular lesion, late vascular lesion, late interstitial lesion. Several factors of importance were discussed.

The authors evaluated the effect of perioperative hydration by 20% human albumin, packed red blood cells (RBC) and saline in allogenic renal graft recipients. In the group of recipients selectively hydrated, the incidence of postoperative oligoanuria decreased from the initial 62 to 25.7% compared with 50% in the group of nonhydrated patients. However, in the former group graft ruptures occurred in 10% as against 1.6% only in the latter. Potential causal relation between the higher incidence of ruptures and perioperative hydration has not been demonstrated and will be subject to further study. With respect to the lower risk imposed on the patients with rupture than on those with postoperative oligoanuria (higher survival rate of grafts and lower mortality of patients) the authors recommend routine introduction of body fluid expansion during operation in allogenic renal graft recipients from cadaver donors.

Processing of data from 79 pregnancies (incl. 11 observed by the authors) in 64 women (incl. 6 of their own patients) after renal transplantation revealed that approximately in 20% of the pregnancies in chronological association with the pregnancy the function of the graft deteriorated or ceased and in four instances this participated indirectly in the mother's death within one year after delivery. The effect of immunosuppressive treatment of the pregnant mother on the development of the foetus and 57 evaluated infants resp. was manifested by a 50% incidence of prematurity, in seven neonates by clinical or post-mortem findings of adrenal hypofunction or hypoplasia resp. and by hypofunction or hypoplasia of the lymphatic apparatus. Only in one neonate and one foetus (observed by the authors) an inborn defect was revealed. In five neonates chromosomal aberrations were described. The above findings support our disapproval of pregnancy in women after renal transplantation with the exception of recipients of grafts from siblings with closely related tissue properties and with a renal function stabilized for a long period and with minimal immunosuppression.

Dynamic scintigraphy, a non-invasive method, is suitable due to its sparing procedure in particular in clinical conditions where more pretentious examination methods are contraindicated or risky. Very frequently it can serve as a guide for more aimed examination methods. Its diagnostic value is great in particular where pathological conditions of the efferent urinary pathways are concerned, i.e. above all fistulae. In parenchymatous lesions it provides information on focal processes of an inflammatory and non-inflammatory nature. Investigation of both functions, of perfusion and transport of hippuran is sometimes a supplement for the differentiation of ATN and rejection nephropathies. The distribution of perfusion after administration of technetate helps to detect occlusion of the afferent arteries and minor arterioles.

A report is presented on the first case of miliary tuberculosis in a group of 84 kidney transplant recipients treated in the Institute of Clinical and Experimental Medicine, Prague, until March 1976. The specific process was verified by bacteriological investigations of the sputum and urine. Productive specific tuberculoid-type nodules with sporadically occurring acidoresistant rods were detected in a bioptic specimen of the transplanted kidney. Also discussed are therapeutical problems in progressive renal graft insufficiency and in simultaneous chronic hepatopathy.

The paper deals with the incidence of infectious complications and rejection crises in patients with renal transplants. It was revealed by statistical methods that there exists a certain correlation between infections and rejections, which depends on the type of the infectious agent. In patients where infectious complications were caused only by gram-negative flora an indirect relationship was revealed, while in patients with infectious complications where gram-positive flora, viruses or fungi participated, a marked direct correlation was found. Statistical methods proved also a higher incidence of rejection crises in patients with active cytomegalic infection.