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rhIGF-I does not accelerate the recovery of renal function in ARF patients with substantial comorbidity.

From a radiobiologic perspective, risk-to-benefit ratios of radiologic studies are favorable, given the importance of medical information obtained. Current practice patterns regarding use of radiologic studies appear to be acceptable.

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546BRITISH MEDICAL JOURNAL 8 MARCH 1975 noted that electron-dense deposits in electronmicrographs were usually on the "endothelial surface of the glomerular capillary wall." Such lesions were clearly not among those we saw.With regard to the relationship between Q.M.N. and the tropical nephropathy seen in Senegal the similarities lie in the histological features rather than in the immunofluorescence findings. Thus in both conditions a fibrillary change in the capillary wall leads to focal and segmental glomerulosclerosis. Moreover, electronmicrographs show intrusion of basementmembrane-like material into the capillary lumen, which was one of the lesions that White (1973) stressed in Q.M.N. He also reported the presence of curious lacunar areas of basement membrane resorption, at the centre of which were electrondense flecks. These were not noted in the study of Q.M.N. made by Allison etal. (1971), though they described conspicuous electron-dense deposits within the glomerular basement membrane in 12 out of 14 cases, deposits which were not seen by White.In short, the two unusual nephropathies we observed in Senegal differed, despite some similarities, from others hitherto reported in West Africa. One