Pathology of the Kidney in Dysproteinemia is an academic monograph describing in detail the causes and development of structural and functional changes in the human kidney resulting from the deposition of abnormal circulating serum proteins. The material presented was obtained from 147 cases of renal involvement associated with Dysproteinemia encountered in university and community hospital settings. The described entities account for 4.5% of 3.260 biopsies of native kidneys examined over a period of approximately 25 years. While some of the lesions are quite rare, others are relatively common and seen fairly frequently in a reasonably busy renal biopsy service. Together they constitute a group of extremely interesting lesions in terms of immunology, morphology, and pathogenesis.This book should be of interest to pathologists- especially renal pathologists, immunologists, and internists. Both general internists and sub-specialists in nephrology and hematology will find this volume useful, as will medical residents and medical technologists in these various specialties. As a monograph it is user-friendly, since the subject matter is sufficiently circumscribed to permit expanded or detailed visual and textual treatment of specific lesions in a single easy-to-wield volume.

The prevalence of hypertension is almost three times as high as that of diabetes mellitus type 2, with both conditions being major risk factors for stroke, ischemic heart disease, cardiac arrhythmias, and heart failure. The exact prevalence of hypertension related to hormonal derangements (endocrine hypertension) is not known but estimated to affect less than 15% of hypertensive patients. Recent scientific discoveries have increased the understanding of the pathophysiologic mechanisms of hypertension. In Endocrine Hypertension, a renowned panel of experts provides a comprehensive, state-of-the-art overview of this disorder, discussing when to assign an endocrine cause in one of many conditions that may present with hypertension. The first part of Endocrine Hypertension is dedicated to adrenal causes. The second part of the volume concerns potential nonadrenal causes of hypertension, such as growth hormone excess or deficiency, primary hyperparathyroidism, vitamin D deficiency, testosterone deficiency, insulin resistance, obesity-associated hypertension, and the role of central mineralocorticoid receptors and cardiovascular disease. An important contribution to the literature, Endocrine Hypertension is an indispensable reference not only for endocrinologists, diabetologists, and adrenal investigators, but also for translational scientists and clinicians from cardiology, internal medicine, pediatrics, family medicine, geriatrics, urology, and reproductive medicine / gynecology.

The thrust here is for those who want to know more than the answer to an exam question - an approach to disease diagnosis and treatment which emphasizes thoughtful consideration of alternatives, finding ones way through uncertainties and lack of knowledge. The annual seminar on which this volume is based has evolved into a forum for open discussion of puzzling questions - actually old questions in the light of new data. To me, the adventure of life is in recognizing the openendedness of all things. So you thought that a certain disease was a settled question? In medicine a "settled" question is a transient conclusion. Even the solutions to the so-called simplest problems have another side. Our aim this year was to air out concepts and conclusions about hypertension, fluid-electrolytes, and tubulopathies. The stars were Drs. Juan Rodriguez-Soriano, Alan Gruskin, and Donald Potter, along with Drs. Gustavo Gordillo, Ronald Kallen, and Antonia Novello as guest faculty. Local stars included Drs. Mary Jane Jesse, Jacques Bourgoignie, and Carlos Vaamonde. Their contributions added to those of the other faculty and registrants, coalesced into vibrant exchanges which are reproduced here for the reader's perusal.

The discovery of a potent vasoconstrictor, endothelin (ET)-1, derived from vascular endothelial cells was among a variety of key lines of investigation that helped to fuel a major explosion of studies related to endothelial cell biology. This was particularly evident within the pharmaceutical industry where receptor antagonists were quickly developed and are now on the market for treatment of pulmonary hypertension and in development for other diseases such as diabetic nephropathy and cancer. Importantly, we know that the kidney contains the highest level of ET-1 production and receptor expression in the body where it has been demonstrated to function as a pro-natriuretic autocrine and paracrine factor that is activated in conditions of high salt intake. This eBook provides a review of the various mechanisms whereby ET-1 has been shown to function within the kidney through a wide range of actions that include direct effects on tubular transport, intrarenal hemodynamics, as well as neural and endocrine functions. Much has yet to be discerned, but it is clear that the ET system is a major physiological regulator of fluid-electrolyte balance and blood pressure through these renal actions. Table of Contents: Discovery of Endothelin / Basic Biology of the Endothelin System / Renal Localization / Renal Hemodynamics / Renal Tubular Actions of Endothelin / Endothelin in Neural Modulation of Renal Function / Physiological Role of Endothelin / Endothelin in Renal Pathology / References / Author Biographies

Despite our efforts at creating clinical performance measures, clinical practice guidelines and intense government regulations, we still have disparities in care, poor outcomes and quality that is inferior to many other nations. Bundling and payment reform challenge the ability to deliver good care to patients even further. Chronic dialysis is at a crossroads. Physicians and providers must incorporate new approaches, reinventing the paradigm of how to plot the course of patient therapy. This book offers new ideas. It is refreshing, timely and engaging, with a wide range of topics by leading authors, each designed to help meet the challenges yet to come.

The 6th triennial meeting of the International Study Group for Tryp- tophan Research (ISTRY) was held May 9-12, 1989 in Baltimore, Maryland (USA). From the wide variety of topics and disciplines represented, as documented in this volume, it is clear that tryptophan research and ISTRY are alive and well. ISTRY traces its or1g1ns to at a tryptophan symposium organized in 1971 by H. Schievelbein at Hohenried near Munich (Germany). Up to that time there had been occasional international tryptophan conferences at irregular inter- vals. A number of participants at the Hohenried meeting felt that an inter- national tryptophan organization should be formed to organize regular meet- ings and to foster collaboration and information exchange on tryptophan-re- lated topics. Thanks mainly to the founding work of H. Schievelbein and W. Kochen, an executive committee was elected and ISTRY was born. The inaugural meeting in 1974 was held in Padova (Italy) to honor L. Musajo, one of the foremost pioneers in tryptophan studies. This first ISTRY meeting was suc- cessfully organized by L. Musajo, G. Allegri, A. De Antoni, and C. Costa, and was critical in assuring the viability of the new organization. Subsequent meetings were held in 1977 in Madison, Wisconsin (USA), organized by R.R. Brown, D.P. Rose, and W.E. Knox, honoring C.P. Berg; 1980 in Kyoto (Japan), organized by O. Hayaishi, R. Kido, Y. Ishimura, T. Deguchi, T. Hino, T.

The presence of Chronic Kidney Disease (CKD) increases the risk of death from cardiovascular causes and makes the management of heart failure difficult. The coexistence of CKD and heart failure is increasing in prevalence worldwide and requires a unique and subtle approach to patient management. Managing the Kidney in Heart Failure focuses on the therapeutic management of cardio renal patients. Common heart and kidney failure conditions are presented along with treatment scenarios aimed to reduce cardiovascular mortality and preserve kidney function. Co-authored by a Nephrologist and Cardiologist, each chapter of this concise and practical handbook offers a unified perspective to these chronic conditions.

Volume 4 of Contemporary Nephrology summarizes major advances in 16 different areas of nephrology during the years 1985 and 1986. Major changes in the composition of the Editorial Board and authorship of the different chapters have occurred in this volume. Six distinguished contributors have retired from the Editorial Board. They include Dr. Zalman A. Agus, Philadelphia; Dr. Robert Anderson, Denver; Dr. Eli Friedman, Brooklyn; Dr. Richard Glassock, Torrance, California; Dr. James Schafer, Birmingham, Alabama; and Dr. Gordon Williams, Bos ton. We are grateful to them for their outstanding contributions to the of this series and for their advice and suggestions as first three volumes members of the Editorial Board. They certainly deserve substantial credit for the success of this series. Seven outstanding academicians have joined the Board. They in clude Dr. Vito M. Campese, Professor of Medicine at the University of Southern California, who contributed the chapter on "Recent Advances in the Role of the Renal Nervous System and Renin in Hypertension"; Dr. William G. Couser, Professor of Medicine and Head of the Division of Nephrology at the University of Washington in Seattle ("Immunologic Aspects of Renal Disease"); Dr. Garabed Eknoyan, Professor of Medicine and Vice Chairman of the Department of Medicine at Baylor College of Medicine ("The Uremic Syndrome"); Dr. H. David Humes, Associate Professor of Medicine and Chief of the Nephrology Section at the Uni versity of Michigan Medical School, Veterans Administration Medical Center ("Acute Renal Failure and Toxic Nephropathy"); Dr."

This book started out as a "Manual. " The idea was to offer straightforward instruction on how to handle patients in whom renal function is altered by intrinsic as well as systemic or extrarenal disease. While we have attempted to provide simple approaches to most conditions, we have gone beyond that and offer here more detailed description of pathophysiology, diagnosis and therapy. Thus, the "Manual" has become a Handbook. In so doing we hope we have widened the audience for which the book may be useful. As it now stands, we envision that students, house staff, nephrology trainees, nephrologists, primary-care physicians, and nurses of specialized units, interested in kidney-related disturbances and in alterations of the composi tion of the extracellular fluid, will benefit from reading the Handbook. While providing a rational background for the treatments outlined, each author has attempted to narrate the reasons why such therapy is utilized. Frequently, the information is provided in tables and figures to which ready reference can be made. The flow-chart approach has also been utilized to illustrate pathophysiological sequence or steps in therapy. In most instances, the discussion of pathophysiology has been limited to what is widely ac cepted rather than treading into anything controversial, unless the nature of the problem or the nature of our knowledge is ambiguous."

Over the last decade the development of new molecular biology tools, advanced microscopy, live imaging and systems biology approaches have revolutionized our conception of how embryonic development proceeds. One fundamental aspect of development biology is the concept of morphogenesis: understanding how a group of multipotent cells organize and differentiate into a complex organ. In Kidney Development: Methods and Protocols, expert researchers in the field detail different approaches to tackle kidney development. These approaches include culture and live imaging aspects of kidney development, analyzing the 3-dimensional aspects of branching morphogenesis as well as nephrogenesis, manipulation of the gene/protein expression during kidney development as well as in the adult kidney, and how to assess kidney malformation and disease. Written in the highly successful Methods in Molecular Biology (TM) series format, chapters include introductions to their respective topics, lists of the necessary materials and reagents, step-by-step, readily reproducible laboratory protocols, and key tips on troubleshooting and avoiding known pitfalls. Authoritative and practical, Kidney Development: Methods and Protocols seeks to aid scientists in the further study of the process of morphogenesis which is fundamental important not only for studying developmental biology but also for regenerative medicine.

The last 20 years has seen an enormous increase in our knowledge about the management of patients with terminal renal failure. Despite this, even the most successful dialysis and transplant patients require long term specialist supervision so that renal units will have an incremental work load until the death rate of patients undergoing treatment equals the rate of intake of new patients. Furthermore, innumerable conditions which were once regarded as contraindications to therapy may no longer be seen in this light, so that the number of new patients coming forward for treatment each year is increasing rapidly. Dialysis and transplantation are expensive forms of treatment, in terms of staff, facilities and consumables, and it is therefore inevitable that there will be problems in providing treatment for all who need it. These will be particularly acute in times of economic crisis. This book contains the proceedings of a conference which was set up to explore the difference between the supply and the demand for treatment in the United Kingdom, to compare the situation with that in other countries, to explore possible solutions and possibly assign responsibility for the shortfall and to examine the practical and moral implications of our failure to treat the treatable.

LOUIS TOBIAN There are many reasons for suspecting that the medulla of the kidney is involved in the pathogenesis of hypertension. Although our present knowledge does not permit the assignment of a precise and exact role for the medulla, there are so many indications of its involvement that this is an appropriate time for the subject to be thoroughly reviewed, as Drs. MandaI and Bohman have done in this volume. The involvement of the renal medulla in hypertension was first strongly indicated by the studies of Eric Muirhead. Studying renoprival hyperten sion, he demonstrated that the injection of extracts of renal medulla could prevent this type of hypertension in the dog, rabbit, and rat. Subsequently, a number of experiments showed that implants of renal medulla could not only prevent renoprival hypertension but also greatly reduce the level of blood pressure in Goldblatt hypertension in the rat and rabbit. It was later noted that the majority of the surviving cells in these medullary implants were interstitial cells. Pitcock and Muirhead were able to culture these interstitial cells, and implants of the cultured cells lowered blood pressure in renoprival hypertension and Goldblatt hypertension, particularly in the rat. We were able to confirm these general observations by employing implants of medulla in "postsalt" hypertension. The medullary implants did indeed bring the blood pressure down."

Gabriel of Urantia asked the question, in the beginning of his struggle with dialysis, "God, why is this happening to me?" Throughout his 8-month dialysis experience, 3 days a week, 4 hours a day, being tied down to a chair while his blood flowed from his body through a machine and back, he realizes-from the people he meets also on dialysis and in the hospitals after post-kidney-transplant-that very bad things happen to very good people. He met young and old alike, tied down to the machines just like he was, and the young people were the hardest for him to resolve in his mind with God and also to try to give them hope. As a minister, he felt obligated to do so. Being a Pastor of a church (Global Community Communications Alliance-a very social, environmental, and spiritual activist church), he knew that bad things happened to good people who try to change the world. But this disease is personal, between him and God you might say. So he had to discover for himself why God allowed this to happen to him and to the other very good people he met with various traumatic illnesses in the hospitals and dialysis centers. Gabriel of Urantia tries to explain how he felt along the path, from the beginning to the receiving of his new kidney from his 22-year-old daughter and gaining the hope and health to continue not only his spiritual work, but his work as a musician, guitar player, and singer (in which he was planning a tour around the country with his 11-piece Bright & Morning Star Band), while now taking immunosuppressant drugs to keep him alive. He had all the fears that a new transplant patient has. How long will the kidney last? What other affects do these drugs have on my body? He writes about his experience with the medical world, the services he experienced from both very qualified people and those not so qualified (experienced and inexperienced care givers), as well as the bureaucracy of the medical field and insurance companies (both private and governmental). He realized that often in the medical field, the right hand didn't know what the left hand was doing and the patient suffered the results. Beyond that, Gabriel of Urantia tries to give hope to people with life-threatening illnesses by sharing his faith in the Creator to all who may read his book. A must-read for anyone on dialysis or with any life-threatening illness, from a writer who went through this and can identify with what they are going through and give them hope through this trauma in their lives.

The aim of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY is to publish every year a volume to keep nephrologists up to date on all the rapidly changing areas of nephrology. Each volume will be published by the end of each calendar year which corresponds with the annual meeting of the American Society of Nephrology. Each issue of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY will be divided into sections; each section will have different primary focus every year, depending upon what area is of greatest interest at the time. In other words, each annual volume will deal with what is truly current in nephrology. All the authors appointed for the chapters of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY are known experts in the field who will give an objective review of the topic up-dating the readers on the world-wide literature. A crucial point for the success of the INTERNATIONAL YEARBOOKS OF NEPHROLOGY is the list of the references at the end of each chapter. We have asked all authors to provide a complete, accurate and up-to-date list of important references. In order to guarantee the most up-to-date yearbook, very rapid production is mandatory. Rapid publication can be obtained only with camera-ready manuscripts for direct photo-offset reproduction. Thus we have agreed to use photo-offset printing for the series. For the first issue of the series, the INTERNATIONAL YEARBOOK OF NEPHROLOGY 1989, the Editorial Board has focused attention on the latest and most important scientific and clinical advances in nephrology.

Heme oxygenases (HOs) are the enzymes responsible for the breakdown of heme and the generation of biliverdin/bilirubin and carbon monoxide (CO). The kidney is a complex organ consisting of many different cell types all working together for the single purpose of filtering the blood to eliminate waste products and conserving ions, minerals, and water necessary for life. HO enzymes and their products play a critical role in the normal function of the kidney as well as protecting the kidney from various insults including ischemia and exposure to nephrotoxins. For example, the HO metabolite, bilirubin, is a potent antioxidant which can limit damage to renal tubular epithelial cells following exposure to nephrotoxins associated with chemotherapy or traumatic injury. Another HO metabolite, CO, is an important vasodilator of renal blood vessels and helps protect against severe decreases in renal blood flow in conditions as diverse as exposure to radiocontrast agents and in hypertension-induced kidney disease. HO and its metabolites also play an important role in the survival of kidney cells after acute and chronic injuries by regulating important cell growth and programmed cell death pathways. The intent of this volume is to highlight the important role that HO enzymes and their related metabolites, bilirubin and CO, play in the regulation of renal function and in the response of the kidney to both acute and chronic pathologies. Table of Contents: Introduction to the HO System / HO and Renal Vascular Function / HO and Renal Tubule Function / HO and Acute Kidney Injury / HO and Chronic Kidney Injury / Future of Renal HO Research / References

The effect of calcium antagonists on heart muscle and blood circulation is the reason that they have found widespread clinical application for a number of years. Less well known, in contrast, is the effect this group of substances has on the kidneys, both on kidney cells and the blood flow through the kidneys. This effect was the subject of a workshop we organized in Tiibingen in June 1986. Different groups studied the effects of these substances, especially in animals, on the processing of calcium by the kidney cells and on blood flow. A possible explanation is that the calcium antagonists block the influx of calcium through special cell canals, especially the cells of the distal tubule. It is necessary to test whether there is a blockade or only a reduction in the passage of calcium. Our understanding of the effect of calcium antagonists is in large part based on the results of morphologic, physiologic, and pharmacologic studies of calcium in the kidneys. The particular processes involved in nephrocalcinosis are special objects of study with regard to calcium antagonists. This book presents the results of experimental studies of the effect of calcium antagonists on nephrocalcinosis and acute renal failure after ischemia. In this context, the clinician is particularly interested in the use of calcium antagonists to protect against the kidney in urolithiasis, in acute renal failure and during kidney transplantation. The book is thus of interest to urologists and nephrologists as well as pharmacologists. biochemists, physiologists, and others in research.

For more than a generation haemodialysis has been the principal method of treating patients with both acute and chronic renal failure. Initially, developments and improvements in the system were highly technical and relevant to only a relatively small number of specialists in nephrology. More recently, as advances in therapy have dem onstrated the value of haemofiltration in the intensive therapy unit and haemoperfusion for certain types of poisoning, the basic principles of haemodialysis have been perceived as important in many areas of clinical practice. In this volume, the potential advantages of bicarbonate haemo dialysis are objectively assessed, the technical and clinical aspects of both haemofiltration and haemoperfusion discussed and the con tinuing problems associated with such extra corporeal circuits analysed. All the chapters have been written by recognized experts in their field. The increasing availability of highly technical facilities for appropriately selected patients should ensure that the information contained in the book is relevant not only to nephrologists but to all practising clinicians. ABOUT THE EDITOR Dr Graeme R. D. Catto is Professor in Medicine and Therapeutics at the University of Aberdeen and Honorary Consultant Phy sician/Nephrologist to the Grampian Health Board. His current inter est in transplant immunology was stimulated as a Harkness Fellow at Harvard Medical School and the Peter Bent Brighton Hospital, Boston, USA. He is a member of many medical societies including the Association of Physicians of Great Britain and Ireland, the Renal Association and the Transplantation Society."

Chronic renal disease has received increasing attention and concern since the passage in 1972 of PL 92-603, which provided coverage for end-stage renal disease (ESRD) treatment by the federal government. The human and economic costs of the ESRD program serve to emphasize the need to prevent or to arrest those diseases resulting in chronic renal failure, since none of the available treatments is without complications and/or side effects. The ESRD program, the only federal one that provides coverage for a catastrophic illness for almost the entire population (those qualifying under Social Security), cost almost $2 billion in 1983. The escalating costs of the ESRD program are attributed to the increasing number of patients requiring treatment and have focused concerns of the United States Government, both Congress and the administration, on ESRD. The National Institutes of Health (NIH), especially the Kidney, Urology, and Hematology Division of the National Institutes of Arthritis, Diabetes, and Digestive and Kidney Diseases (NIADDK), supports a sizable research program that bears on chronic renal disease and in association with this has sponsored many conferences and workshops on research on and causes and complications of chronic renal failure. This book is an outgrowth of the issues addressed by participants at a number of NIH conferences held in the 1980s.

This is the first textbook entirely dedicated to the endovascular treatment of complications related to arteriovenous accesses for hemodialysis (native fistulas and prosthetic grafts). The book addresses the anatomy of upper limb arteries and veins as well as the clinical presentation of patients and the way to perform and read a fistulogram. Many details and illustrations are provided, clarifying the subtleties in catheterization and the dilation of stenoses. From a strategic point of view, it is explained for the first time that many stenoses must either be ignored or deliberately underdilated. A wealth of images helps to understand the different stages of access recovery from thrombosis. As the number of incident dialysis patients is increasing by 5% every year, this is a field of growing interest. In testament to this there are several annual or bi-annual meetings held by numerous national and international societies (vascularaccesssociety.com, sfav.org, vasamd.org, dialysiscontroversies.org, asdin.org).

Professor David Kerr Royal Victoria Infirmary) Newcastle upon Tyne Do we need another book on renal disease? There are few small books, particularly from this side of the Atlantic, which provide a really sound foundation of renal physiology, biochemistry and immunology. For two decades "The Kidney" by Hugh de Wardener has given a splendid background in renal physiology but I doubt if any author has brought to this subject as wide an experience and knowledge of basic science as Dr Wardle possesses. His researches have ranged over haematology, the role of in travascular coagulation in acute renal failure, the biochemistry of uremic metabolites, the immunology of glomerulonephritis, to hyperlipidemia in the genesis of arterial disease. In all these topics he has mastered the laboratory techniques as well as studying the patients personally. He therefore has a unique opportunity to show how renal disease can be illuminated by an understanding of the pathogenetic mechanism and to point the way to future treatment more logical than the crude and empirical methods we use today. This approach should appeal particularly to the young graduate whose memory of biocht: mistry and physiology is still reasonably fresh."

It must be considered that there is nothing more difficult to carry out, nor more doubtful of success, nor more dangerous to handle, than to initiate a new order of things. Machiavelli: The Prince (1513) These are the Proceedings of a Conference on Temperature and Environmental Factors and the Testis which took place at New York University School of Medicine, December 8th and 9th, 1989. There is good reason to believe that this was the first of its kind to address, exclusively, the implications of temperature for this highly thermosensitive organ and its precious genetic cargo. The organizers of the Conference hoped to stimulate interest in this area which, paradoxically, has a considerable literature but which has received scant attention and sometimes outright opposition from clinicians expert in male infertility. There have been studies of the relationship of temperature to reproduction starting in the mid-18th Century with observations of the relationship of water temperature to spawning of fish. There is also a vast literature on the deleterious effects of externally applied heat upon spermatogenesis but little study of the possibility that intrinsic heat may be an important etiologic factor in subfertile semen. Today, fertility research has largely ignored this in favor of research in areas which have not produced successes, in terms of live births, comparable to what can be obtained by varicocelectomy (when appropriate) or scrotal hypothermia: viz. 1. Concentration upon the endocrine aspects of testicular function and its relation to spermatogenesis.

This book is intended for use by nephrologists, internists, hospitals, trainees in these specialties and indeed anyone interested in renal medicine. It contains top-class authoritative and up-to-date reviews by internationally renowned experts coming from some of the best nephrology centres in the world. It covers the diagnosis, causes and management of acute kidney injury. It also includes a discussion of the diagnosis of chronic kidney disease, including the use of simple clinical and laboratory data, imaging, proteinomics and renal biopsy. It reviews the general management of chronic kidney disease, including an in-depth analysis of kidney transplant immunology. This book is therefore a comprehensive, authoritative text with clear explanation of even the most complex topics.

Chronic Kidney Disease (CKD) is a recognized risk factor for cardiovascular events and death. The coexistence of CKD and heart failure is increasing in prevalence worldwide and requires a unique and subtle approach to patient management. The Kidney in Heart Failure focuses on the changes that occur in kidney physiology as a function of a failing heart. This comprehensive resource covers epidemiology, pathophysiology, management of kidney disorders and advances in nephropathy management. In addition, the latest therapies, common heart failure dilemmas and kidney disease markers are included. Each chapter is co-authored by a Nephrologist and Cardiologist, offering a unified perspective to these chronic conditions. This indispensible volume provides the reader with the depth-of-knowledge needed for assessing and treating the cardio renal patient.

The cause of end-stage renal failure in one-third of patients treated by regular haemodialysis or kidney transplantation is some variety of glomerular disease. Less serious glomerular dis orders are more common and often cause inappropriate conster nation to the patients and, sometimes, to their doctors. Similar clinical features can be produced by pathological lesions ranging from the trivial to the life-threatening, and renal biopsy is often necessary to establish the diagnosis. However, its widespread use during the past 20 years has enabled clinicopathological correlations to be made and the natural history of many 'glomerulopathies' to be established, though large areas of uncer tainty remain. In contrast to symptomatic measures, such as the management of uraemia or the nephrottc syndrome, the use of treatment in arresting the progress of the glomerular lesion itself is controver sial and is based on anecdotal evidence rather than controlled trials. Knowledge of the renal pathology will, at least, enable conditions in which immunosuppressive therapy is appropriate to be distinguished from those which are benign or self-limiting. In this book symptomatic management of the clinical syn dromes is detailed, but classification is firmly based on renal histological appearances. The relevance of immunofluorescent microscopy, ultrathin section examination and electron micros copy to our understanding of pathogenesis is described, as well as the uses of these techniques for morphological discrimination."

Currently, individuals interested in seeking an in-depth discussion of transplantation immunology must seek individual articles published in several journals, or extrapolate information from various non-transplant immunology textbooks. The purpose of this text is to provide the reader with a single source of information for the basic science of immunobiology of organ transplantation. It is unique that it focuses on immunobiology from the basic research side, with an emphasis on the cellular and molecular levels. The readers will be physicians, scientists, and graduate students interested and engaged in the study of immunology as it relates to allo- and xenotransplantation. This book is designed to be the reference standard for the immunobiology of transplantation.