Variability of activity concentrations and radial distributions of 137Cs and 90Sr in trunk wood of Scots pine and Silver birch.

This study analyzes the variability of 137Cs and 90Sr concentrations in wood and their radial distributions in the trunks of Scots pine and Silver birch trees in the small uniformly contaminated forest stands in the Chornobyl Exclusion Zone. Concentrations of both radionuclides follow a lognormal distribution with a large scatter of values measured in the trees within the stands (GSD ranges from 1.6 to 2.0). No correlation was found between the concentrations of the two radionuclides measured in individual trees, or between their concentrations and tree diameter. The average 137Cs and 90Sr Tag were 8.4 × 10-4 m2 kg-1 and 8.8 × 10-3 m2 kg-1 for pine, respectively, and 9.3 × 10-4 m2 kg-1 and 1.1 × 10-2 m2 kg-1 for birch, indicating a much higher availability of 90Sr for uptake by the studied species. For 137Cs, the Tag values are within the range recommended by the IAEA Handbook (IAEA, 2010), while the values for 90Sr exceed the recommended range for birch and are close to its upper value for pine. The highest concentrations of 137Cs in pine at the height of 1.3 m were measured in the youngest sapwood rings; they were lower in the rest of the sapwood and decreased further in the heartwood, but remained relatively high even in annual rings that were the heartwood at the time of deposition, suggesting sapwood-to-heartwood translocation of the radionuclide by diffusion and/or ray transport. In contrast, 90Sr concentrations increased through the sapwood from the trunk periphery in pine trees up to 80 years old and remained stable through the sapwood in older trees (except for higher concentrations in the young annual rings), but dropped to zero in physiologically inactive heartwood tissues. In most birch trees, regardless of age, 137Cs concentrations demonstrated an increasing trend from the trunk periphery towards the pith, while concentrations of 90Sr were relatively stable in the whole trunk except in the oldest annual rings, where they increased sharply, likely indicating active transport of the radionuclide to senescing tissues.

Natural attenuation of Fukushima-derived radiocesium in soils due to its vertical and lateral migration.

Processes of vertical and lateral migration lead to gradual reduction in contamination of catchment soil, particularly its top layer. The reduction can be considered as natural attenuation. This, in turn, results in a gradual decrease of radiocesium activity concentrations in the surface runoff and river water, in both dissolved and particulate forms. The purpose of this research is to study the dynamics of Fukushima-derived radiocesium in undisturbed soils and floodplain deposits exposed to erosion and sedimentation during floods. Combined observations of radiocesium vertical distribution in soil and sediment deposition on artificial lawn-grass mats on the Niida River floodplain allowed us to estimate both annual mean sediment accumulation rates and maximum sedimentation rates corresponding to an extreme flood event during Tropical Storm Etau, 6-11 September 2015. Dose rates were reduced considerably for floodplain sections with high sedimentation because the top soil layer with high radionuclide contamination was eroded and/or buried under cleaner fresh sediments produced mostly due to bank erosion and sediments movements. Rate constants of natural attenuation on the sites of the Takase River and floodplain of Niida River was found to be in range 0.2-0.4 year-1. For the site in the lower reach of the Niida River, collimated shield dose readings from soil surfaces slightly increased during the period of observation from February to July 2016. Generally, due to more precipitation, steeper slopes, higher temperatures and increased biological activities in soils, self-purification of radioactive contamination in Fukushima associated with vertical and lateral radionuclide migration is faster than in Chernobyl. In many cases, monitored natural attenuation along with appropriate restrictions seems to be optimal option for water remediation in Fukushima contaminated areas.

The IUR Forum: Worldwide Harmonisation of Networks to Support Integration of Scientific Knowledge and Consensus Development in Radioecology.

During the past decades, many specialised networks have formed to meet specific radioecological objectives, whether regional or sectorial (purpose-oriented). Regional networks deal with an array of radioecological issues related to their territories. Examples include the South Pacific network of radioecologists, and the European network of excellence in radioecology. The latter is now part of the European platform for radiation protection. Sectorial networks are more problem-oriented, often with wider international representativeness, but restricted to one specific issue, (e.g. radioactive waste, low-level atmospheric contamination, modelling). All such networks, while often working in relative isolation, contribute to a flow of scientific information which, through United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR's) efforts of synthesis, feeds into the radiation protection frameworks of protecting humans and the environment. The IUR has therefore prompted a co-construction process aimed at improving worldwide harmonisation of radioecology networks. An initiative based on an initial set of 15 networks, now called the IUR FORUM, was launched in June 2014. The IUR Forum agreed to build a framework for improved coordination of scientific knowledge, integration and consensus development relative to environmental radioactivity. Three objectives have been collectively assigned to the IUR FORUM: (1) coordination, (2) global integration and construction of consensus and (3) maintenance of expertise. One particular achievement of the FORUM was an improved description and common understanding of the respective roles and functions of the various networks within the overall scene of radioecology R&D. It clarifies how the various networks assembled within the IUR FORUM interface with UNSCEAR and other international regulatory bodies (IAEA, ICRP), and how consensus on the assessment of risk is constructed. All these agencies interact with regional networks covering different geographical areas, and with other networks which address specific topics within radiation protection. After holding its first Consensus Symposium in 2015, examining the possible ecological impact of radiation from environmental contamination, the IUR FORUM continues its work towards improved radiation protection of humans and the environment. We welcome new members.

Behavior of accidentally released radiocesium in soil-water environment: Looking at Fukushima from a Chernobyl perspective.

Quantitative characteristics of dissolved and particulate radiocesium wash-off from contaminated watersheds after the FDNPP accident are calculated based on published monitoring data. Comparative analysis is provided for radiocesium wash-off parameters and distribution coefficients, Kd, between suspended matter and water in rivers and surface runoff on Fukushima and Chernobyl contaminated areas for the first years after the accidents. It was found that radiocesium distribution coefficient in Fukushima rivers is essentially higher (1-2 orders of magnitude) than corresponding values for rivers and surface runoff within the Chernobyl zone. This can be associated with two factors: first, the high fraction of clays in the predominant soils and sediments of the Fukushima area and accordingly a higher value of the radiocesium Interception Potential, RIP, in general, and secondly the presence of water insoluble glassy particles containing radiocesium in the accidental fallout at Fukushima. It was found also that normalized dissolved wash-off coefficients for Fukushima catchments are 1-2 orders of magnitude lower than corresponding values for the Chernobyl zone. Normalized particulate wash-off coefficients are comparable for Fukushima and Chernobyl. Results of the investigation of radiocesium's ((134)Cs and (137)Cs) vertical distribution in soils of the close-in area of the Fukushima Dai-ichi NPP - Okuma town and floodplain of the Niida river are presented. The radiocesium migration in undisturbed forest and grassland soils at Fukushima contaminated area has been shown to be faster as compared to the Chernobyl 30-km zone during the first three years after the accidents. This may be associated with higher annual precipitation (by about 2.5 times) in Fukushima as compared to the Chernobyl zone, as well as the differences in the soil characteristics and temperature regime throughout a year. Investigation and analysis of Fukushima's radiocesium distribution in soils of Niida river catchment revealed accumulation zones of contaminated sediments on its floodplain. Average sediment deposition rates varied from 0.3 to 3.3 cm/year.

Modification of (137)Cs transfer to rape (Brassica napus L.) phytomass under the influence of soil microorganisms.

After nuclear accidents, such as those experienced in Chernobyl and Fukushima, microorganisms may help purify contaminated soils by changing the mobility of radionuclides and their availability for plants by altering the physical and chemical properties of the substrate. Here, using model experiments with quartz sand as a substrate we investigate the influence of microorganisms on (137)Cs transfer from substrate to plants. The highest transition of (137)Cs from substrate to plants (50% increase compared to the control) was observed after Brassica napus L. seeds were inoculated by Azotobacter chroococcum. The best results for reducing the accumulation of (137)Cs radionuclides (30% less) were noted after the inoculation by Burkholderia sp.. Furthermore, Bacillus megaterium demonstrated an increased ability to accumulate (137)Cs. This research improves our prediction of the behavior of radionuclides in soil and may contribute towards new, microbiological countermeasures for soil remediation following nuclear accidents.

A subtype prediction score for primary aldosteronism.

Primary aldosteronism (PA) is the most common cause of endocrine hypertension. Although adrenal venous sampling (AVS) is recommended as the gold standard procedure for subtype classification in PA, it is a specialized technique with limited availability. The objective of this study was to develop a scoring system that predicted PA subtype using clinical characteristics. Seventy-one patients with PA were studied. The subjects were diagnosed as having either unilateral (n=32) or bilateral disease (n=39) based on AVS, surgery and/or the postoperative clinical course. Variables associated with laterality in the univariate analysis were entered into multivariable logistic regression models and the regression coefficients were used to construct a subtype prediction score. The diagnostic significance of the score was then evaluated using receiver operating characteristic (ROC) curve analysis. The subtype prediction score was calculated as follows: serum potassium ⩽3.4 mEq l(-1), 2 points; plasma aldosterone concentration ⩾165 pg ml(-1), 3 points; and aldosterone to renin ratio ⩾1000 in a post-captopril challenge test (plasma renin activity in ng ml(-1) h(-1)), 3 points. ROC curve analysis for the ability to discriminate between unilateral and bilateral PA showed that a score of 5 points had 75% sensitivity and 95% specificity, and a score of 3 points had a sensitivity of 97% and a specificity of 59%. The area under the ROC curve was 0.920 (95% confidence interval, 0.859-0.979). Our subtype prediction score could discriminate between unilateral and bilateral PA and is useful for selecting patients who should undergo AVS before surgery.

The effect of nasal speaking valve on the speech under experimental velopharyngeal incompetence condition.

Velopharyngeal incompetence (VPI) is a contributing factor to speech disorders, frequently accompanying disorders, such as cleft palate, congenital paralysis of the soft palate, and cerebrovascular disease. For the treatment of these types of dysarthria, a Nasal Speaking Valve (NSV), which regulates nasal emission utilizing one-way valve, has been reported to be effective. As the unpleasantness while wearing the NSV was less than that with the conventional Palatal Lift Prosthesis, the NSV could be worn for a longer period of time. As NSV is inserted into the nostrils, this device could easily be provided for edentulous patients. This study aimed to evaluate the effect of NSV on experimentally induced VPI condition. Intelligibility of monosyllabic speech, intelligibility of conversational speech, nasalance score and acoustic analysis were used to evaluate the effect of NSV. Local infiltration anaesthesia was achieved to the area of levator veli palatini muscle and tensor veli palatine muscle of seven adult male subjects. In all subjects, remarkable suppression of the soft palate movement could be observed after the local infiltration anesthesia. Although the utterance supported by NSV under the experimentally induced VPI condition was less natural than the normal utterance, the intelligibility was markedly improved by the device. From the results of this study, the acoustic properties of NSV on the pure VPI condition, which was enabled by the newly established experimental induction, were revealed. This experimental model was also proved to provide a basis for the improvement in the treatment modalities for VPI.

Last resort for renal transplant recipients, 'restored kidneys' from living donors/patients.

Because of the grave shortage of deceased kidney allografts in Japan, we have embarked on a new source of organs, 'Restored kidneys' from living patients. From January 1991 through September 2006, 42 kidneys (eight benign pathology, eight small renal cancers, eight ureteral cancers, six aneurysms, eight severe nephrotic syndrome from four patients and four ureteral stenosis) were obtained from 38 patients/donors after extensive discussion of treatment modalities and risks. All patients/donors agreed to undergo total nephrectomy. The lesions were removed/repaired ex vivo on the back table, then transplanted. All recipients were notified of all possible risks including donor disease recurrence. One, 5 and 10-year patient survival rates of restored transplant patients were 92.9%, 79.3% and 63.8%, respectively. One, 5 and 10-year graft survival rates of restored kidney transplant patients were 78.6%, 51.8% and 42.7%, respectively. There were no recurrences of small renal cell carcinomas. There was one recurrence of ureteral cancer in the transplanted kidney 15 months after operation. In countries where deceased donors are scarce, such as Japan, the restored kidneys can be a last resort for renal allografts.

Nasal speaking valve: a device for managing velopharyngeal incompetence.

Velopharyngeal incompetence is a contributing factor for speech disorders, and other frequently accompanying disorders, such as cleft palate, congenital paralysis of the soft palate and cerebrovascular disease. A palatal lift prosthesis (PLP) has been fabricated for managing velopharyngeal incompetence to improve speech. Because of discomfort, such as difficulty in swallowing or vomiting reflex, while wearing the PLP, rigorous adjustment is required. Patients may have difficulty becoming accustomed to using the prosthesis. This article reports on a newly developed device, the nasal speaking valve, for improving hypernasal speech caused by velopharyngeal incompetence.

Analysis of facultative lithotroph distribution and diversity on volcanic deposits by use of the large subunit of ribulose 1,5-bisphosphate carboxylase/oxygenase.

A 492- to 495-bp fragment of the gene coding for the large subunit of the form I ribulose 1,5-bisphosphate carboxylase/oxygenase (RubisCO) (rbcL) was amplified by PCR from facultatively lithotrophic aerobic CO-oxidizing bacteria, colorless and purple sulfide-oxidizing microbial mats, and genomic DNA extracts from tephra and ash deposits from Kilauea volcano, for which atmospheric CO and hydrogen have been previously documented as important substrates. PCR products from the mats and volcanic sites were used to construct rbcL clone libraries. Phylogenetic analyses showed that the rbcL sequences from all isolates clustered with form IC rbcL sequences derived from facultative lithotrophs. In contrast, the microbial mat clone sequences clustered with sequences from obligate lithotrophs representative of form IA rbcL. Clone sequences from volcanic sites fell within the form IC clade, suggesting that these sites were dominated by facultative lithotrophs, an observation consistent with biogeochemical patterns at the sites. Based on phylogenetic and statistical analyses, clone libraries differed significantly among volcanic sites, indicating that they support distinct lithotrophic assemblages. Although some of the clone sequences were similar to known rbcL sequences, most were novel. Based on nucleotide diversity and average pairwise difference, a forested site and an 1894 lava flow were found to support the most diverse and least diverse lithotrophic populations, respectively. These indices of diversity were not correlated with rates of atmospheric CO and hydrogen uptake but were correlated with estimates of respiration and microbial biomass.

[A case of post-tuberculosis chronic empyema with effective low-dose, long-term clarithromycin administration].

A 78-year-old woman with post-tuberculosis chronic empyema who underwent unsuccessful decortication in July 1993, was admitted to our hospital in November 1994 because of M. tuberculosis in her sputum. One month after anti-tuberculosis treatment, the M. tuberculosis disappeared from the sputum, but a pleurocutaneous fistula that exuded abundant bloody pus containing Pseudomonas aeruginosa persisted in the area of chronic empyema. In July 1997, 200 mg of clarithromycin (CAM) was administered daily; 21 months later, the pus and pleurocutaneous fistula had disappeared. Post-tuberculosis chronic empyema with a fistula is generally an intractable condition that necessitates surgery. In this case, the empyema did not improve during the 4 years after the surgery. However, low-dose, long-term CAM administration brought about a disappearance of pus from the fistula and closure of the empyema spaces.

Relationships of serum levels of insulinlike growth factors with indices of bone metabolism and nutritional conditions in hemodialysis patients.

Insulinlike growth factor (IGF) I and IGF-II are synthesized in osteoblasts and stimulate proliferation, differentiation, and matrix synthesis in these cells. There is some evidence that IGFs act on bone cells not only by paracrine but also by endocrine pathways, suggesting that circulating IGFs may be of importance for the regulation of bone metabolism. On the other hand, the serum IGF-I level is also thought to be a good indicator of the nutritional conditions in hemodialysis patients. The present study was performed to analyze the correlations of circulating levels of IGF-I, IGF-II, IGF-binding protein (IGFBP) 1 and IGFBP-3 with biochemical markers of bone metabolism and parameters of the urea kinetic model which reflect nutritional conditions in hemodialysis patients. We also examined the differences between these relationships in male and female patients on hemodialysis. Sixty-two hemodialysis patients, 36 men (male group) and 26 women (female group), were included in this study. We measured the serum levels of IGF-I, IGF-II, IGFBP-1, and IGFBP-3. The bone mineral content (BMC) of the radius was measured by dual-energy X-ray absorptiometry. We calculated Kt/V, protein catabolic rate, and percent creatinine generation rate (%CGR). We also examined the relationships between serum levels of IGFs and BMC and the parameters of the urea kinetic model. It was found that the serum levels of IGF-I in the hemodialysis patients were almost the same as those in the control group. However, the serum levels of IGF-II, IGFBP-1, and IGFBP-3 in the hemodialysis patients were significantly higher than those in the control group. In the male group, the serum IGF-I levels showed a significant correlation with both serum intact parathyroid hormone levels and BMC, but no significant correlations between these indices were found in the female group. The serum levels of both IGF-I and IGF-II showed significant correlations with %CGR in the male group, but not in the female group. Stepwise multiple regression analysis was performed to clarify the relationship between serum levels of IGFs and BMC or %CGR. It was found that age, hemodialysis duration, serum intact parathyroid hormone levels, and sex were independent factors associated with BMC. The %CGR was associated independently with serum levels of IGF-I, and IGF-II and with the presence of diabetes mellitus. In conclusion, it is thought that serum levels of IGF-I and IGF-II can be used as indices of nutritional conditions in hemodialysis patients. However, the serum IGF-I level cannot be used as a marker of bone metabolism in hemodialysis patients.

Long-term follow-up study on patients with sleep apnea syndrome.

We did a 5-year follow-up study on sleep apnea syndrome (SAS)-related symptoms and respiratory disorder variables on 109 patients. At follow up, SAS-related symptoms were improved in a significantly higher percentage of the treatment success group than the treatment failure group. A significant deterioration of the respiratory disorder variables was recognized only in the patients 40-60 years of age. These results indicate that treatment effect for SAS might be maintained in the long term and that the natural evolution of the disorder might be prominent in middle-aged patients.

P300 abnormalities in patients with severe sleep apnea syndrome.

We investigated the mechanism of abnormal P300 findings in the patients with severe sleep apnea syndrome (SAS). Compared with controls, SAS patients showed significantly longer latency of P300. Not the mean sleep latency in multiple sleep latency test but the percentage of total periods in which percentage desaturation time fell below 90% to total sleep time correlated with P300 latency in the patients. During nasal CPAP treatment, P300 latency was significantly shortened in the patients under 45 years, while the elderly patients did not show statistical change. We speculated that P300 latencies might be prolonged due to nocturnal hypoxia with SAS and the abnormality might be irreversible, especially in elderly patients.

Aggregated occurrence of sleep apnea syndrome in a family.

We experienced a family in whom sleep apnea syndrome (SAS) was recognized in six members and habitual snoring in seven members among 26 subjects of four generations. In all members with snoring, the disorder was noticed before the age of 20. Hypercapnic response study showed normal findings, and ultrafast magnetic resonance image of the upper airway revealed that the obstruction of the upper airway occurred at the velopharyngeal portion during apneic episodes in all SAS-afflicted subjects. In this family, the similar craniofacial structural abnormalities were thought to cause the aggregated occurrences of the disorders at young ages, and obesity was regarded as a contributor for the aggravated symptoms.

Effects of guided bone regeneration with non-resorbable and bioabsorbable barrier membranes on osseointegration around hydroxyapatite-coated and uncoated threaded titanium dental implants placed into a surgically-created dehiscence type defect in rabbit tibia: a pilot study.

The purpose of this study was to evaluate the effects of guided bone regeneration (GBR) with either a non-resorbable (ePTFE) or bioabsorbable barrier membrane (RSLT) on osseointegration and extent of bone formation around hydroxyapatite-coated (HA) and uncoated threaded titanium (Ti) dental implants placed into surgically-created dehiscence type defects in rabbit tibia. A dehiscence type bone defect, approximately 3 mm in width and height was surgically created on the outer surface of the bone in each tibia of 9 rabbits. For the conventional group, either a HA or a Ti implant was then placed at this site. After the same procedure was performed as in the conventional group, the implant site of the GBR group was covered with either an ePTFE or a RSLT. After 4 months, the rabbits were sacrificed. Specimens were prepared and examined histometrically. It was found that the mean percentage of osseointegration tended to increase in HA compared to Ti implants, both with and without membranes. There was a tendency that the extent of newly regenerated bone was higher in the GBR group than that in the conventional group.

Recovery of infectious human parainfluenza type 2 virus from cDNA clones and properties of the defective virus without V-specific cysteine-rich domain.

A full-length cDNA clone was constructed from the genome of the human parainfluenza type 2 virus (hPIV2). First, Vero cells were infected with recombinant vaccinia virus expressing T7 RNA polymerase, and then the plasmid encoding the antigenome sequence was transfected into Vero cells together with polymerase unit plasmids, NP, P, and L, which were under control of the T7 polymerase promoter. Subsequently, the transfected cells were cocultured with fresh Vero cells. Rescue of recombinant hPIV2 (rPIV2) from cDNA clone was demonstrated by finding the introduced genetic tag. As an application of reverse genetics, we introduced one nucleotide change (UCU to ACU) to immediate downstream of the RNA-editing site of the V gene in the full-length hPIV2 cDNA and were able to obtain infectious viruses [rPIV2V(-)] from the cDNA. The rPIV2V(-) possessed a defective V protein that did not have the unique cysteine-rich domain in its carboxyl terminus (the V-protein-specific domain). The rPIV2V(-) showed no growth in CV-1 and FL cells. Replication of the rPIV2V(-) in these cells, however, was partially recovered by adding anti-interferon (IFN)-beta antibody into the culture medium, showing that the rPIV2V(-) is highly sensitive against IFN and that no growth of rPIV2V(-) in CV-1 and FL cells is mainly due to its hypersensitivity to endogenously produced IFN. These findings indicate that the V-protein-specific domain of hPIV2 is related to IFN resistance. On the other hand, the rPIV2V(-) efficiently replicated in Vero cells, which are known as a IFN-non-producers. However, the virus yields of rPIV2V(-) in Vero cells were 10- to100-fold lower than those of control rPIV2, although syntheses of the viral-specific proteins and their mRNAs in rPIV2V(-)-infected Vero cells were augmented up to 48 p.i. in comparison with those of rPIV2. Furthermore, the rPIV2V(-) virions showed anomalous in size as compared with rPIV2 virions. These results suggest that the V protein plays an important role in the hPIV2 assembly, maturation, and morphogenesis.

Palatal radicular multigrooves associated with severe periodontal defects in maxillary central incisors.

BACKGROUND: This case report describes a rare condition of palatal radicular multigrooves on teeth 11 and 21 with severe periodontal defects and the findings at 3-year follow-up. METHOD: Radiculoplasty using hand curettes and rotary burs were used to remove the multigrooves on the root surfaces and change the wrinkled root form to the relatively flat and smooth normal root morphology. Minor tooth movement and frenotomy were performed for a diastema between teeth 11 and 21. Supportive periodontal therapy started immediately after completion of the active treatment. RESULTS: Improved healthy periodontal tissues and adequate plaque control have been maintained.

Cross-talk between RANKL and FRP-1/CD98 Systems: RANKL-mediated osteoclastogenesis is suppressed by an inhibitory anti-CD98 heavy chain mAb and CD98-mediated osteoclastogenesis is suppressed by osteoclastogenesis inhibitory factor.

The two pathways to osteoclastogenesis, RANKL-mediated and CD98-mediated osteoclastogenesis, have recently been reported. RANKL, OCIF, and TIMP-3 mRNAs are not found in monocytes freshly isolated or incubated with anti-FRP-1/CD98hc antibody. RANK, TACE, and M-CSF mRNAs can be detected in these cells. Interestingly, the expressed amount of RANK mRNA increases by cultivation of monocytes with anti-CD98hc antibody and maximal expression is observed in osteoclast-like cells. CD98-mediated cell aggregation and multinucleated giant cell formation are blocked by OCIF. OCIF also suppressed the CD98-mediated induction of Sp1 and c-src mRNAs in monocytes. Soluble RANK shows no effect on CD98-mediated cell aggregation and multinucleated giant cell formation. When blood monocytes were incubated with RANKL and M-CSF, c-src and Sp1 mRNAs were first found in blood monocytes incubated with these cytokines for 7 days. On the contrary, c-src mRNA could be detected 3 h after treatment of blood monocytes with anti-CD98hc mAb. LAT-1 mRNA was not found, and the expression levels of Y(+)LAT-1 and Y(+)LAT-2 mRNAs were not changed in monocytes stimulated without or with anti-CD98hc mAb or RANKL and M-CSF. An inhibitory mAb directed against CD98hc, HBJ 127, shows a suppressive effect on RANKL-mediated cell aggregation and cell fusion. Thus, there is cross-talk between these two pathways.

Familial interstitial nephritis with progressive renal failure.

We describe a 53-year-old woman with chronic interstitial nephritis and asymptomatic impairment of renal function. Seven members of her family were suffering from renal failure and underwent hemodialysis. At the time of their hospital admissions, they had shown evidence of end-stage renal failure at 40 to 50 years of age. Lack of proteinuria, hematuria, hypertension, hyperuricemia, hearing loss, and visual impairment were present before the deterioration of the renal function. Renal biopsy of the presented case indicated chronic interstitial nephritis without glomerular basement membrane abnormalities. Progressive decline of renal function and the inheritance pattern of autosomal dominance in this family suggested the diagnosis of familial interstitial nephritis.