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Collegiate American football injuries through the 2007-2008 season in a Kansai Division I team were analyzed using injury rates (IR) per 1,000 athlete-exposures (1,000AE: one athlete-exposure was defined as a player participating in one game or one practice). The total number of injuries through spring, fall, and postseason was 208 injuries. Through all seasons, the game injury rate (GIR) was 25.7 per 1,000 AE, and the practice injury rate (PIR) was 13.2 per 1,000 AE. The GIR was 2.1 times higher than the PIR (p<0.05), and injury risks were greatest during games. On the other hand, the PIR (12.9 per 1,000 AE) during the fall season in this study was about 6 times higher than the PIR (2.1 per 1,000 AE) of NCAA all Divisions in the U.S.A. Future studies need to identify the injury mechanism during practices and games. It is also necessary to change the practice circumstances so that the PIR can be reduced. The most common types of injury during games were sprain (33.2%), following strain (22.6%). The most common region of injury was the lower extremity (55.3%), indicating 17.1 per 1,000 AE in the GIR. Although there was no significant difference in the injured body sites between games and practices, the GIRs in the knee (6.7 per 1,000AE) and the ankle (6.7 per 1,000AE) were highest. Future research is required on injury prevention methods for the sprains in the lower extremity during games. [ABSTRACT FROM AUTHOR]

Objective  Discrepancies between sleep timing on work/school and free days, also known as social jetlag (SJL), can cause health problems. These issues occur most often in individuals from adolescence to the early 20s, which is equivalent to the age of university students. This study was designed to explore the recommended level of physical activity required to minimize SJL and to examine the relationship between SJL and objective physical activity among female university students. Methods  We assessed the SJL of 68 female students using the Japanese version of the Munich Chronotype Questionnaire. The objective physical activity and sleep variables of subjects were also evaluated at 3 to 4 weeks using a small triaxial accelerometer. Results  A significant negative correlation was found between SJL and physical activity on both free (r = - 0.435, p  < 0.001) and school days (r = - 0.341, p  < 0.01). According to the linear regression analysis, physical activity of 11,174 steps on school days and 10,713 steps on free days had the lowest SJL value. Total sleep time on free days had a significant positive correlation with SJL (r = 0.399, p  < 0.001) and a negative correlation with physical activity (r = - 0.520, p  < 0.001). Discussion  Our results suggest that substantial SJL may cause chronic fatigue and lead to a low level of physical activity in female university students. These results also imply that the recommended level of physical activity necessary to minimize SJL among these students is around 11,000 steps on both school and free days., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Abstract: Iguchi, J, Hojo, T, Fujisawa, Y, Kuzuhara, K, Yanase, K, Hirono, T, Koyama, Y, Tateuchi, H, and Ichihashi, N. Synergistic dominance induced by hip extension exercise alters biomechanics and muscular activity during sprinting and suggests a potential link to hamstring strain. J Strength Cond Res 37(9): 1770-1776, 2023-Hamstring strain is likely to occur during the late swing phase or the first half of the stance phase in sprinting. During the late swing phase, the hamstrings and gluteus maximus (Gmax) contract eccentrically to decelerate the lower limb. We hypothesized that, when the Gmax becomes dysfunctional because of delayed onset muscle soreness (DOMS), the hamstring workload is increased (i.e., there is synergetic dominance), which could lead to an increased risk of strain. A total of healthy 15 male undergraduate or graduate students (age 23.1 ± 1.28 years) were recruited to perform exercises and maximal sprints. On day 1, before subjects performing DOMS-causing exercises, and on day 3, while subjects were experiencing DOMS in the Gmax, lower-limb biomechanical and muscle activity data were recorded using a motion analysis system and electromyography (EMG), respectively. Data were analyzed and compared between day 1 and day 3. Hip flexion angle on day 3 was significantly lower than that on day 1, but the opposite was true for the knee flexion angle (P < 0.05). Vastus medialis (VM), biceps femoris (BF), and Gmax muscle activities on day 3 were significantly higher than those on day 1 (P < 0.05). Peak propulsive forces on day 3 were significantly higher than those on day 1 (P < 0.05). Kinematic changes such as decreased hip flexion angle and EMG changes such as increased BF EMG activity on day 3 to compensate for the loss of function of the Gmax may potentially increase the risk of hamstring strain., (Copyright © 2023 National Strength and Conditioning Association.)

Robot-assisted gait training using a voluntary-driven wearable cyborg, Hybrid Assistive Limb (HAL), has been shown to improve the mobility of patients with neurological disorders; however, its effect on the quality of life (QOL) of patients is not clear. The aim of this study was to assess the effects of HAL-assisted gait training on QOL and mobility in patients with neuromuscular diseases (NMDs). Ten patients with NMDs (seven men and three women, mean age: 57 ± 11 years), with impairment in mobility but could walk alone with aids underwent two courses of gait training with HAL over 6 months, and the single course consisted of nine sessions of training for 4 weeks. We compared the findings of the 2 min walk test, 10 m walk test, the Short Form-36 (SF-36) questionnaire, and the Hospital Anxiety and Depression Scale at baseline, after the 1st training, before the 2nd training, and after the 2nd training using the Friedman test. A significant improvement was observed in the 2 min walking distance from baseline (93 ± 50 m) to after the 2nd training (115 ± 48 m, P = 0.034), as well as in the domains of vitality (P = 0.019) and mental component summary score (P = 0.019) of SF-36. The improvement in 10 m walking speed was significantly correlated with that in the physical functioning (R = 0.831, P = 0.003) and role physical (R = 0.697, P = 0.025) domains in the SF-36. Our findings suggest that HAL-assisted gait training is effective in improving QOL associated with mental health as well as gait ability in selected patients with NMDs., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Iguchi J, Kuzuhara, K, Katai, K, Hojo, T, Fujisawa, Y, Kimura, M, Yanagida, Y, and Yamada, Y. Seasonal changes in anthropometric, physiological, nutritional, and performance factors in collegiate rowers. J Strength Cond Res 34(11): 3225-3231, 2020-Well-controlled seasonal distribution of training intensity seems to be an important variable for endurance athletes' success as competitors and for avoidance of overtraining. The aim of this study was to examine the interrelationships of training distribution, body composition, energy intake/expenditure, and rowing ergometer performance throughout the 2012-2013 season. In this study of 15 collegiate male rowers, most of whom started rowing during their time at the university, we divided the 2012-2013 season (total 37 weeks) into 3 phases (off-season, December to mid-March, 16 weeks; pre-season, late March-April, 5 weeks; and in-season, May-August, 16 weeks) and analyzed the transition of 2,000-m rowing ergometer time, training intensity/volume, body composition (body mass and body fat), and energy intake/expenditure in each phase. There were significant main effects of the training time by the intensities; 2,000-m rowing ergometer time; energy expenditure; and protein, fat, and carbohydrate intake across the seasons (p < 0.05). Two findings were particularly important. First, on-water high-intensity training, especially for inexperienced rowers, may contribute to improvement of 2,000-m rowing ergometer performance. Second, higher intake of carbohydrate, and to a lesser degree, protein, is necessary for optimal training adaptation (e.g., increase of muscle glycogen content), and results in better 2,000-m performance on the rowing ergometer. Also, those findings may be beneficial to the coaches who are interested in designing the well-controlled seasonal training program, which is especially intended to improve the 2,000-m rowing ergometer performance as well as avoidance of overtraining.

Functional movement screen (FMS) has been used to establish normative data and determine potential injury risk for young adults and athletes, but there are few data in elementary school-age children. The purpose of this study was to establish fundamental values for the FMS in elementary school-age mini-basketball players. Secondary purposes were to examine relationships between functional movement patterns and age, peak height velocity (PHV), and body mass index (BMI), and to compare functional movement patterns between boys and girls and between individuals with and without a history of injury. The mean composite FMS score was 16.5 ± 2.2 (16.5 ± 2.4 for boys, 16.5 ± 1.7 for girls). The composite FMS score was positively correlated with age (r = .312) and negatively correlated with the BMI (r = - .371). However, the FMS score was not correlated with PHV or with PHV age. The FMS score was not different between boys and girls or between individuals who reported a previous injury and those who did not. However, boys in the mini-basketball teams performed better than girls on the trunk stability push-up and rotary stability tests. Age and the body mass index were significantly associated with better and poorer functional movement, respectively.

Context:   Soccer is the most popular junior sport in the world. In junior sports, injury analysis and injury-prevention measures for players, especially those under 12 years of age, are urgently needed., Objective:   To prospectively study the incidence, sites, types, and mechanisms of injuries in elementary school-aged junior soccer players during games and practices., Design:   Descriptive epidemiology study., Setting:   Elementary school-aged junior soccer teams in Nagoya, Japan., Patients or Other Participants:   Eighty-nine players in 5 community-based club teams of junior soccer (U-12, age range = 11-12 years; U-11, age range = 10-11 years; U-10, age ≤10 years)., Main Outcome Measure(s):   Data on all game and practice injuries for the 2013-2014 season were collected using an injury report form. Injury rates were calculated according to injury site, type, and mechanism., Results:   The overall injury rate was 2.59/1000 athlete-hours (AHs). The game injury rate (GIR; 6.43/1000 AHs) was higher than the practice injury rate (PIR; 1.49/1000 AHs; P < .05). The most common anatomical areas of injury during games and practices were the lower limbs (62.5% and 4.02/1000 AHs versus 38.5% and 0.57/1000 AHs, respectively). Contusions (27.6%, n = 8) were the most frequent type of overall injuries. Most game injuries resulted from body contact (43.8%, 2.81/1000 AHs), whereas most practice injuries resulted from other types of contact (53.8%, 0.83/1000 AHs)., Conclusions:   The GIRs were higher than the PIRs in Japanese junior soccer players. A lower overall PIR suggested that players in the U-12 age group practiced under appropriate conditions. However, the higher GIR in this age category needs to be decreased.

Iguchi, J, Watanabe, Y, Kimura, M, Fujisawa, Y, Hojo, T, Yuasa, Y, Higashi, S, and Kuzuhara, K. Risk factors for injury among Japanese collegiate players of American football based on performance test results. J Strength Cond Res 30(12): 3405-3411, 2016-The purpose of this study was to identify how risk factors for injury during American football are related to players' physical strength as determined using typical performance tests. One hundred 53 Japanese collegiate players of American football were recruited for this study. Eight potential risk factors were evaluated: position (skill vs. lineman), body mass index, back squat one-repetition maximum, vertical jump height, power, height, body weight, and previous injury. Using multivariate Cox regression, we examined how these factors were associated with knee sprain, ankle sprain, and hamstring strain. We recorded 63 injuries (17 knee sprains, 23 ankle sprains, and 23 hamstring strains). Players with higher power were at significantly greater risk for knee sprains (p = 0.04), those with low power had a significantly higher incidence of ankle sprain (p = 0.01), and vertical jump height was a significant predictor of hamstring strain (p = 0.02). We identified several independent predictors of injuries associated with American football. Our findings may contribute to the development of effective screening tests and prevention exercises.

Context: Mini-basketball is one of the most popular junior sports in Japan. Mini-basketball-related injuries may increase because of early specialization. However, no reports have been published to date concerning basketball injuries in children younger than 12 years of age., Objective: To prospectively study the incidence, sites, types, and mechanisms of injuries in mini-basketball teams., Design: Descriptive epidemiology study., Setting: Mini-basketball teams in Kobe, Japan., Patients or Other Participants: A total of 95 players in 7 community-based mini-basketball club teams (age range, 9 through 12 years)., Main Outcome Measure(s): Data on all practice and game injuries for the 2013-2014 season were collected using an injury report form. Injury rates were calculated according to site, type, and mechanism., Results: The overall injury rate was 3.83 per 1000 athlete-hours (AHs). The game injury rate ( 12.92/1000 AHs) was higher than the practice injury rate (3.13/1000 AHs; P < .05). The most common anatomical areas of injury during games and practices were the head and neck (36.4%, 4.70/1000 AHs) and the upper limbs (47.8%, 1.50/1000 AHs). Sprains (42.9%, n = 39) were the most common type of injuries overall, followed by contusions (29.7%, n = 27). Most game injuries resulted from body contact (45.5%, 5.87/1000 AHs), whereas most practice injuries resulted from other contact (56.5%, 1.77/1000 AHs)., Conclusions: Game injury rates were higher than practice injury rates in Japanese mini-basketball players. The high practice injury rate in this study may be due to specific factors related to growth, such as individual differences in height, or to skills, such as inexperience in ball handling.

Background: Central line-associated bloodstream infection (CLABSI) is an important concern associated with central venous catheter (CVC) use. The objective of this study was to determine the influences of CVC access sites, CVC types, and presumed causative microorganisms on CLABSI occurrence in an acute care hospital., Methods: We conducted a prospective, observational study of CLABSI occurrence for 3 consecutive years in a 600-bed Japanese acute care hospital. Data collected included patient characteristics, CVC access sites, CVC types, and microorganisms isolated by blood culture., Results: For 1,650 CVCs used for 1,237 patients, 39 cases of infection were identified. Most infections had occurred within 1 month of CVC insertion. Maximal sterile barrier precautions had been used for most cases (97.3%). The average CLABSI occurrence days with internal jugular vein access were shorter than those with subclavian vein access and femoral vein access. CLABSI rates were 1.1 and 0.7 for single- and multilumen CVCs, respectively. CLABSI occurrence tended to be shorter when gram-positive cocci were isolated and tended to be longer when fungi (Candida spp) were isolated., Conclusion: Most CLABSI cases had occurred within 1 month of CVC insertion. Longer CVC duration increased chance of fungal infection., (Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

Context: Previous research on American football injuries in Japan has focused on incidence proportion in terms of the number of injuries divided by the number of players. This is the first study to examine injury rates over several seasons., Objective: To conduct a prospective study of injuries in a Japanese Division I collegiate American football team over the 2007 through 2009 seasons., Design: Cohort study., Setting: Collegiate football team at Doshisha University, Kyoto, Japan., Patients or Other Participants: All 289 athletes who played on the collegiate Division I football team during the 2007 through 2009 seasons., Main Outcome Measure(s): A certified athletic trainer kept a daily record of all practice and game injuries. Injury rates were calculated according to season, injury type, body part, severity, and mechanism. Injuries were also analyzed according to position of player, school year, and playing experience., Results: The game injury rate (GIR; 32.7 injuries/1000 athlete-exposures) was higher than the practice injury rate (PIR; 10.9 injuries/1000 athlete-exposures) over the 3 seasons (P < .05). The PIR was higher among Japanese players than the comparable United States collegiate football injury rates (5.8-7.0 injuries/1000 athlete-exposures). Ankle and foot injuries occurred more frequently during games, whereas thigh and gluteal injuries occurred more frequently during practices., Conclusions: Our data show differences between games and practices in terms of injury rates, body parts injured, and positions of players injured. The high PIR in Japan may be due to the increased contact during practices and length of practices compared with the United States. Further research involving multiple teams is recommended to validate the trends noted in this study. The expanded data set could assist in the development of safety regulations and preventive interventions for Japanese football.

Iguchi, J, Yamada, Y, Ando, S, Fujisawa, Y, Hojo, T, Nishimura, K, Kuzuhara, K, Yuasa, Y, and Ichihashi, N. Physical and performance characteristics of Japanese division 1 collegiate football players. J Strength Cond Res 25(12): 3368-3377, 2011-This study aimed to establish the physical and performance characteristics of football players in the Japanese Division 1 collegiate football program and perform a comparison of these characteristics between Japanese (n = 208) and US Division 1 football players (n = 797). The following comparisons were made: (a) between a higher-ranked university team vs. a lower-ranked university team in Japan, (b) between different playing positions in Japan, (c) between starters and nonstarters in Japan, and (d) between playing positions in Japan vs. those in the United States. The results of this study suggest that players in the higher-ranked university team were heavier, stronger in back squat, jumped higher, and had greater power than those on the lower-ranked team. Furthermore, linemen were generally characterized by larger size, greater strength, and more fat as compared with backs. On the other hand, backs tended to be faster, smaller in physical size, have higher vertical jump height, and show greater relative strength than linemen did. Starters were taller, heavier, stronger, had more powerful, and more fat-free mass than nonstarters. Finally, our results revealed that players in the United States were superior to players in Japan in all body status comparisons (p < 0.01). This study revealed that performance and superior body composition are essential for the success of a football player. Power and strength seem to be key factors in defining good football performance.

Context: As the Asian Ice Hockey League gradually expands and becomes more competitive, ice hockey-related injuries may increase. However, no reports have been published on ice hockey injuries in Japan, including the method of injury and the daily supervision of the players during the regular season., Objective: To prospectively study the incidence, types, and mechanisms of ice hockey injuries in an elite Japanese ice hockey team., Design: Prospective observational cohort study design., Setting: An elite ice hockey team, Tokyo, Japan., Patients or Other Participants: Ninety-four players during the 2002-2005 seasons., Main Outcome Measure(s): Data were collected for 3 consecutive seasons using an injury reporting form., Results: The overall game injury rate was 74.3 per 1000 player-game hours and 11.7 per 1000 player-game hours for injuries resulting in any time loss. The overall practice injury rates were 11.2 per 1000 player-practice hours and 1.1 per 1000 player-practice hours for injuries resulting in any time loss. Forwards had the highest rate of injury, followed by defensemen and then goalkeepers. Contusions were the most common injury, followed by strains, lacerations, and sprains., Conclusions: Most injuries among Japanese ice hockey players occurred during games. Game or play intensity may influence the injury rate during games.

We conducted the present study to elucidate the fate of post-transplant mesangial IgA deposit under the long-term observation. Out of a total of 45 cases with post-transplant mesangial IgA deposition, nine cases with more than 4 yr of follow-up term were enrolled in this study, and clinicopathologic characteristics were described. The study included three men and six women with a mean age of 34.2 yr. The average observation time from the detection of mesangial IgA deposition was 6.1 yr. Three cases were categorized as recurrent IgA nephropathy, while six cases were classified into latent mesangial IgA deposition. One case with hypertension developed end-stage renal disease. The significant improvement in microscopic hematuria was observed in one recurrent IgA nephropathy case. Microscopic findings included mild mesangial stalk thickening in all but one case. IgA deposition demonstrated a significant decrease in three latent mesangial IgA deposition cases. No apparent reduction in dense deposit quantity was observed on electron microscopy. There was no association between clinicopathologic findings and the regimen of anti-immunosuppressive agents. This study showed the improvement of the disease activity did occur in both recurrent IgA nephropathy and latent mesangial IgA deposition. Further investigation of latent mesangial IgA deposition may present the important clue to the pathogenesis of IgA nephropathy.

Kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD) usually continue to increase in size, even after patients begin dialysis therapy, and the mass effects may lead to severe complications. Such external conventional therapies as surgical and laparoscopic procedures have not yielded satisfactory results. Because kidneys in patients with ADPKD usually are supplied by well-developed arteries, we attempted renal contraction therapy in patients with ADPKD by renal transcatheter arterial embolization (TAE) using intravascular coils. After obtaining informed consent, we selected anuric patients on dialysis therapy with markedly distended abdomens or macroscopic hematuria. Between October 1996 and December 2000, a total of 64 patients were treated. Renal size, abdominal circumference, dry weight, hematocrit, and insulin-like growth factor-I were measured before TAE and 3, 6, and 12 months after TAE. Renal sizes decreased to 73.8% +/- 12.0%, 61.7% +/- 14.7%, and 53.4% +/- 11.6% of preinterventional values at 3, 6, and 12 months after therapy, respectively (P < 0.0001). Abdominal circumference and dry weight were significantly decreased at 3, 6, and 12 months (P < 0.0001) compared with baseline values before therapy. Hematocrits increased sequentially after 3, 6, and 12 months (P < 0.0001). Levels of insulin-like growth factor-I an index of nutritional status, significantly increased at 3, 6, and 12 months compared with the baseline value (P < 0.001). This therapy was effective for all patients. Serious complications were not seen after this treatment, although such minor complications as fever and flank pain were observed within the first week after the procedure. Our internal treatment with TAE is a safe and effective procedure that has resulted in improvement in the quality of life and nutritional status of patients with ADPKD., (Copyright 2002 by the National Kidney Foundation, Inc.)

We report autopsy findings of a 69-year-old man on long-term CAPD therapy for 13 years who showed linear peritoneal calcification. Continuous ambulatory peritoneal dialysis (CAPD) was started in 1982. He has been administered excessive amounts of vitamin D(3) derivatives (VitD) (2.0 to 2.5 microg daily) and calcium carbonate (4 g daily) for secondary hyperparathyroidism since initiation of CAPD. In May 1995, his intact parathyroid hormone (PTH) level increased over 1,000 pg/mL. Immediately after VitD was changed from pill to liquid, the dose was increased to 5 microg daily. Although the serum calcium level remained between 4.5 and 4.9 mEq/L, and serum phosphate level was 5.0 to 7.2 mg/dL, plain abdominal radiography and computed tomography showed continuous calcification along the intestinal wall in October 1995. In spite of the continuation of CAPD therapy, he remained asymptomatic until he died of congestive heart failure in January 1997. He experienced eight episodes of peritonitis during his clinical course. Autopsy showed that numerous calcified plaques were present on the submucosal portion between the thickened serosa and the longitudinal layer of the muscularis externa. The remainder of the subserosa was fibrotic, and the small arteries had markedly thickened intima and severely narrowed lumina.

We report a patient with autosomal dominant polycystic kidney disease (ADPKD) undergoing long-term hemodialysis who underwent transcatheter arterial embolization (TAE) of the renal arteries to shrink enlarged kidneys. In 1983, the patient started hemodialysis because of chronic renal failure secondary to ADPKD. However, renal size continued to increase. In January 1997, he was admitted to our hospital with abdominal distension and anorexia, in addition to progression of anemia. Upper gastroendoscopy showed an esophageal ulcer and severe external compression of the stomach. Renal angiography using the Seldinger technique showed stretched and deformed segmental renal arteries with massive enlargement of the kidneys. TAE with stainless steel coils was performed on both renal arteries. With a rapid and progressive decrease in kidney size, anorexia and anemia were improved, and the gastrointestinal compression was eliminated. In some patients with ADPKD, renal size continues to increase even after the initiation of dialysis. In about 10 years, patients develop gastrointestinal complications, such as dysphagia, ileus, severe constipation, and intestinal perforation. Surgical procedures such as nephrectomy are not satisfactory. This report shows that TAE is a safe and effective therapy for patients with ADPKD with massively enlarged kidneys.

This is a report on a surgery performed in February, 1995 describing the donation of a living donor's horseshoe kidney used for renal transplantation. The recipient was a 31 years-old male on hemodialysis since 1994. The donor was the healthy 55 years-old father of the recipient who had an uncomplicated horseshoe kidney. The isthmus was perfused by an accessory artery. Via transperitoneal approach, the horseshoe kidney was mobilized for in situ perfusion. A microwave coagulator was used to divide the isthmus, and the cut surfaces were closed by mattress sutures and fibrin glue. The left kidney was transplanted into the recipient's right iliacfossa. While his post-transplant course was complicated by urinary leakage, the graft remained free of rejection until and beyond the 6 months post transplant period when he was discharged at s-Cr 1.7 mg/dl. The donor's convalescence was uneventful. During the 20 months post-transplant period both the donor and recipient are doing well.

Urinary excretion of albumin was measured after renal transplantation in 37 patients who received cyclosporine quadrotherapy (cyclosporine A, azathioprine, prednisolone and antilymphocytoglobulin). In 26 patients with a favorable clinical course, daily urinary albumin level increased significantly on the first operative day. Subsequently, it decreased gradually, and remained at about 40mg/day after 3 weeks. In these patients, the urinary albumin level did not correlate with blood pressure, whole blood cyclosporine level, serum creatinine level nor urinary enzyme level, i.e. beta 2-microglobulin, NAG, gamma-GTP. As for correlation between the urinary albumin level and biopsy findings in 21 patients who underwent renal graft biopsy, the urinary albumin level was significantly increased in 5 patients with high degree of lymphocyte infiltration in the renal graft as compared with 16 patients with low degree of infiltration. However, there was no significant correlation between the urinary albumin level and the degree of tubular damage. In 4 patients of allograft rejection, a clinical course was reflected better in the albumin level than in the urinary enzyme level, these results show that the measurement of urinary albumin is a useful clinical examination to evaluate the allograft rejection of renal transplantation in cyclosporine era.

Unilateral renal agenesis with impaired renal function was found in all 3 siblings of a single family, in association with various metabolic disorders such as diabetes mellitus, hyperuricemia and hyperbilirubinemia with gallstones. The present report suggests that unilateral renal agenesis could occur as a manifestation of a genetic disorder.