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 Donna E. Hansel
Christopher J. Kane
Gladell P. Paner
Sam S. Chang Editors

The Kidney
A Comprehensive Guide
to Pathologic Diagnosis and
Management

123
The Kidney
Donna E. Hansel • Christopher J. Kane
Gladell P. Paner • Sam S. Chang
Editors

The Kidney
A Comprehensive Guide
to Pathologic Diagnosis
and Management
Editors
Donna E. Hansel, M.D., Ph.D. Christopher J. Kane, M.D., F.A.C.S.
Department of Pathology Department of Urology
University of California at San Diego University of California at San Diego
San Diego, CA, USA San Diego, CA, USA

Gladell P. Paner, M.D. Sam S. Chang, M.D., F.A.C.S., M.B.A.

Department of Pathology and Surgery Department of Urologic Surgery
Section of Urology Vanderbilt University Medical Center
University of Chicago Nashville, TN, USA
Chicago, IL, USA

ISBN 978-1-4939-3285-6 ISBN 978-1-4939-3286-3 (eBook)

DOI 10.1007/978-1-4939-3286-3

Library of Congress Control Number: 2015955743

Springer New York Heidelberg Dordrecht London

© Springer Science+Business Media New York 2016
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or
part of the material is concerned, specifically the rights of translation, reprinting, reuse of
illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way,
and transmission or information storage and retrieval, electronic adaptation, computer software,
or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, express or implied, with respect to the material
contained herein or for any errors or omissions that may have been made.

Printed on acid-free paper

Springer Science+Business Media LLC New York is part of Springer Science+Business Media
(www.springer.com)
Contents

1 Embryology, Anatomy, and Histology of the Kidney................. 1

Jennifer M. McBride
2 Polycystic Kidney Disease ............................................................ 19
Shreyas S. Joshi, Gladell P. Paner, and Sam S. Chang
3 Nonneoplastic Disease Presenting as a Renal Lesion................. 37
Shane M. Pearce, Priya Rao, Stephen Thomas,
and Scott E. Eggener
4 Overview and Staging of Renal Neoplasms ................................ 53
Gladell P. Paner
5 Conventional Forms of Renal Neoplasia..................................... 67
Ithaar H. Derweesh, Omer A. Raheem, and Ahmed Shabaik
6 Familial Forms of Renal Cell Carcinoma
and Associated Syndromes ........................................................... 81
Charles C. Guo, Armine K. Smith, and Christian P. Pavlovich
7 Translocation-Associated Carcinoma ......................................... 97
Zachary Klaassen, John M. DiBianco, and Martha K. Terris
8 Collecting Duct Carcinoma and Renal Medullary
Carcinoma...................................................................................... 109
Jamie Koo, Christopher P. Filson, Jiaoti Huang,
and Allan J. Pantuck
9 Emerging and Recently Described Subtypes
of Renal Carcinoma ...................................................................... 125
Leili Mirsadraei, Michelle S. Hirsch, Christopher J. Kane,
and Donna E. Hansel
10 Non-epithelial Renal Neoplasms of the Adult Kidney ............... 141
Chad R. Ritch, Giovanna A. Giannico, Lan L. Gellert,
Peter E. Clark, and Omar Hameed
11 Pediatric Renal Neoplasms........................................................... 149
Michael Yap, Mariah Zampieri Leivo, Denise M. Malicki,
Donna E. Hansel, and George Chiang

v
vi Contents

12 Glomerular Disease ....................................................................... 175

Edward R. Gould and Anna Marie Burgner
13 Nonneoplastic Kidney Diseases in the Setting
of a Renal Mass ............................................................................. 199
Anthony Chang and Vanesa Bijol

Index ....................................................................................................... 207

Contributors

Vanesa Bijol, M.D. Department of Pathology, Brigham and Women’s

Hospital, Boston, MA, USA
Anna M. Burgner, M.D. Division of Nephrology, Department of Medicine,
Vanderbilt University Medical Center, Nashville, TN, USA
Anthony Chang, M.D. Department of Pathology, University of Chicago
Medical Center, Chicago, IL, USA
Sam S. Chang, M.D., M.B.A. Department of Urologic Surgery, Vanderbilt
University Medical Center, Nashville, TN, USA
George Chiang, M.D. Division of Pediatric Urology, Rady Children’s
Hospital, University of California at San Diego, San Diego, CA, USA
Peter E. Clark, M.D. Department of Urologic Surgery, Vanderbilt University
Medical Center, Nashville, TN, USA
Ithaar H. Derweesh, M.D. Department of Urology, University of California
San Diego, San Diego, CA, USA
John M. DiBianco Department of Surgery, Section of Urology, Medical
College of Georgia – Georgia Regents University, Augusta, GA, USA
Scott E. Eggener, M.D. Department of Surgery, Section of Urology,
University of Chicago, Chicago, IL, USA
Christopher P. Filson, M.D., M.S. Department of Urology, Institute
of Urologic Oncology, David Geffen School of Medicine at UCLA, Los
Angeles, CA, USA
Lan L. Gellert, M.D., Ph.D. Department of Pathology, Microbiology
and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
Giovanna A. Giannico, M.D. Department of Pathology, Microbiology
and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
Edward R. Gould, M.D. Division of Nephrology, Department of Medicine,
Vanderbilt University Medical Center, Nashville, TN, USA
Charles C. Guo, M.D. Department of Pathology, MD Anderson Cancer
Center, University of Texas, Houston, TX, USA

vii
viii Contributors

Omar Hameed, M.D. Department of Pathology, Microbiology and

Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
Department of Urologic Surgery, Vanderbilt University Medical Center,
Nashville, TN, USA
Donna E. Hansel, M.D., Ph.D. Department of Pathology, University of
California at San Diego, San Diego, CA, USA
Michelle S. Hirsch, M.D., Ph.D. Department of Pathology, Brigham and
Women’s Hospital, Harvard Medical School, Boston, MA, USA
Jiaoti Huang, M.D., Ph.D. Department of Pathology and Laboratory
Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Shreyas S. Joshi, M.D. Department of Urologic Surgery, Vanderbilt
University Medical Center, Nashville, TN, USA
Christopher J. Kane, M.D., F.A.C.S. Department of Urology, University of
California San Diego, San Diego, CA, USA
Zachary Klaassen, M.D. Department of Surgery, Section of Urology,
Medical College of Georgia – Georgia Regents University, Augusta, GA, USA
Jamie Koo, M.D. Department of Pathology and Laboratory Medicine,
David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Mariah Zampieri Leivo, M.D. Department of Pathology, University of
California at San Diego, San Diego, CA, USA
Denise M. Malicki, M.D., Ph.D. Department of Pathology, Rady
Children’s Hospital San Diego, University of California at San Diego,
San Diego, CA, USA
Jennifer M. McBride, Ph.D. Cleveland Clinic, Lerner College of Medicine
of Case Western Reserve University, Cleveland, OH, USA
Leili Mirsadraei, M.D. Department of Pathology, University of California
at San Diego, San Diego, CA, USA
Gladell P. Paner, M.D. Department of Pathology and Surgery, Section of
Urology, University of Chicago Medical Center, Chicago, IL, USA
Allan J. Pantuck, M.D. Department of Urology, Institute of Urologic
Oncology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
Christian P. Pavlovich, M.D. Department of Urology, Johns Hopkins
University School of Medicine, Johns Hopkins Bayview Medical Center,
Baltimore, MD, USA
Shane M. Pearce, M.D. Department of Surgery, Section of Urology,
University of Chicago, Chicago, IL, USA
Omer A. Raheem, M.D. Department of Urology, University of California
San Diego, San Diego, CA, USA
Contributors ix

Priya Rao, M.D. Department of Pathology, MD Anderson Cancer Center,

The University of Texas, Houston, TX, USA
Chad R. Ritch, M.D., M.B.A. Department of Urology, University of Miami,
Miami, FL, USA
Ahmed Shabaik, M.D. Department of Pathology, University of California,
San Diego Medical Center, San Diego, CA, USA
Armine K. Smith, M.D. Department of Urology, Johns Hopkins School of
Medicine, Sibley Memorial Hospital, Washington, DC, USA
Martha K. Terris, M.D. Department of Surgery, Section of Urology, Medical
College of Georgia – Georgia Regents University, Augusta, GA, USA
Stephen Thomas, M.D. Department of Radiology, University of Chicago,
Chicago, IL, USA
Michael Yap, M.D. Division of Pediatric Urology, Rady Children’s Hospital,
University of California at San Diego, San Diego, CA, USA
 Embryology, Anatomy,
and Histology of the Kidney
Jennifer M. McBride
Development of the Kidney
During embryonic development, the urinary sys-
tem emerges from the dorsal body wall as a lon-
gitudinal elevation of intermediate mesoderm
known as the urogenital ridge (Fig. 1.1a, b).
Located along each side of the aorta, the urogeni-
tal ridge gives rise to both the urinary system as
the nephrogenic cord and the genital system as
the gonadal ridge. The following is a description
of kidney development from rudimentary non-
functional structures of the nephrogenic cord to
definitive functional organs.
Early in the fourth week, the primitive kidneys
or pronephroi appear as elevations along the cervi-
cal region of the developing embryo [1]. These
transitory structures consist of epithelial buds
which extend ventromedially and pronephric ducts
which extend caudally to eventually open into the
cloaca of the hindgut (Fig. 1.2a). By the end of the
fourth week, the pronephroi have degenerated
with the pronephric ducts persisting to become
incorporated into the second set of kidneys as the
mesonephric (Wolffian) duct (Fig. 1.2b).
J.M. McBride, Ph.D. (*)
Cleveland Clinic, Lerner College of Medicine of Case
Western Reserve University, Cleveland Clinic/NA24,
9500 Euclid Avenue, Cleveland, OH 44195, USA
e-mail: mcbridj@ccf.org
© Springer Science+Business Media New York 2016
D.E. Hansel et al. (eds.), The Kidney, DOI 10.1007/978-1-4939-3286-3_1
1
During the fourth week, the mesonephroi
emerge caudal to the pronephroi and function as
interim structures until full development of the
permanent kidneys around week 9. Along the
length of the mesonephric (Wolffian) ducts (for-
merly pronephric ducts), mesonephric tubules
begin to emerge on either side of the vertebral
column extending from the upper thoracic region
to mid-lumbar levels (Fig. 1.3a, b), with cranial
tubules regressing by the end of week 5. The
remaining tubules located in the upper three lum-
bar levels differentiate into cup-like pouches
which extend medially to meet loops of capillar-
ies emerging from the aorta (Fig. 1.3c). These
structures are collectively referred to as a renal
corpuscle and consist of the cup-like glomerular
capsule and capillary plexus (Fig. 1.3d). During
week 9, the mesonephric ducts regress in the
female but persist in the male as part of the geni-
tal duct system including the ductus deferens,
duct of epididymis, ejaculatory ducts, and semi-
nal vesicles.
During the fifth week, the definitive kidneys
or metanephroi begin to develop. Two sources
give rise to the definitive kidneys: the ureteric
bud (metanephric diverticulum) and the meta-
nephrogenic blastema (metanephric mass of mes-
enchyme) (Fig. 1.4a). The ureteric buds emerge
as outgrowths of the mesonephric ducts adjacent
to their entrance into the cloaca. As they elon-
gate, the ureteric buds invade the metanephro-
genic blastema which grows from the caudal
1
2 J.M. McBride

Fig. 1.1 (a) Lateral view of embryo in fourth week. (b) with permission, Cleveland Clinic Center for Medical Art
Transverse section demonstrating development of the uro- & Photography © 2015. All Rights Reserved)
genital ridge from the intermediate mesoderm (reprinted

Fig. 1.2 Depiction of the nephric system transitions from the cloaca. (b) Ventral view (reprinted with permission,
the fourth to fifth week. (a) Lateral illustration of embryo Cleveland Clinic Center for Medical Art & Photography
in the fifth week with the development of the transitory © 2015. All Rights Reserved)
pronephroi and pronephric ducts which open caudally into

aspect of the nephrogenic cord. Penetration of the and tubules, calyces, and primitive renal pelvis
metanephric mesenchyme induces the ureteric (Fig. 1.4b–d). Reciprocally, the distal end of the
bud to undergo a series of repetitive branchings, bud induces the metanephric mesenchyme to
leading to formation of the renal collecting ducts condense and form metanephric vesicles which
1 Embryology, Anatomy, and Histology of the Kidney
Fig. 1.3 (a) Lateral view indicating degeneration of the
pronephros and emergence of the mesonephros. (b)
Ventral view. (c) Sequential development of the meso-
nephric tubules from weeks 5 to 11. (d) The medial aspect
will further develop into a series of metanephric
tubules (Fig. 1.5a, b). The connection formed
between the lumens from these S-shaped meta-
nephric tubules with that of the ureteric duct
results in the formation of the definitive urinifer-
ous tubule (Fig. 1.5c). These uriniferous tubules
will further differentiate into proximal convoluted
tubules, distal convoluted tubules, and the neph-
ron loop including descending and ascending
nephron loops (Fig. 1.5d).
3
of the mesonephric tubules extends to meet loops of capil-
laries emerging from the aorta (reprinted with permission,
Cleveland Clinic Center for Medical Art & Photography
© 2015. All Rights Reserved)
During the tenth week, the metanephroi
become functional as the distal convoluted and
collecting tubules begin to adjoin. In addition, the
population of glomeruli further increases during
this time up until week 32 of gestation. Nephrons
also continue to form with approximately two
million nephrons present in each kidney at term.
Between weeks 6 and 9, the kidneys withdraw
from the pelvis and ascend along either side of
the aorta to reach their permanent location along
4 J.M. McBride
Fig. 1.4 Metanephros development from the ureteric bud
and metanephrogenic blastema. (a) Lateral view of an
embryo in the fifth week of development. (b–d) Sequential
branching of the ureteric bud as it penetrates the meta-
the posterior abdominal wall of the lumbar region
(Fig. 1.6a–d). During their ascent, the kidneys’
original blood supply from the common iliac
arteries disappears with branches from succes-
sive levels of the aorta taking their place. After
contacting the suprarenal glands, the kidneys
become fixed in their position with primary arte-
rial supply deriving from the abdominal aorta.
Caudal arterial branches may remain as acces-
sory renal arteries; typically, these branches arise
from the aorta to enter the hilum of the kidney.
nephric mesenchyme (reprinted with permission,
Cleveland Clinic Center for Medical Art & Photography
© 2015. All Rights Reserved)
Anatomy of the Kidney
Overall Structure
The kidneys are reddish-brown bean-shaped
structures located retroperitoneally along the pos-
terior abdominal wall (Fig. 1.7). While posture
and dynamic changes of the diaphragm can mod-
ify their relationship to surrounding structures, in
the supine position, the kidneys typically extend
1 Embryology, Anatomy, and Histology of the Kidney 5

Fig. 1.5 Development of nephrons. (a) The distal end of ureteric duct, will form the uriniferous tubules (reprinted
the ureteric bud develops into a series of metanephric with permission, Cleveland Clinic Center for Medical Art
tubules. (b–d) These S-shaped structures, along with the & Photography © 2015. All Rights Reserved)
6 J.M. McBride

Fig. 1.6 Ventral abdominopelvic view of embryo from region of the posterior abdominal wall (reprinted with
weeks 6 to 9. (a–d) The kidneys ascend alongside of the permission, Cleveland Clinic Center for Medical Art &
aorta to reach their permanent location in the lumbar Photography © 2015. All Rights Reserved)
1 Embryology, Anatomy, and Histology of the Kidney
Fig. 1.7 Retroperitoneal
location of the kidneys along
the posterior abdominal wall
(reprinted with permission,
Cleveland Clinic Center for
Medical Art & Photography
© 2015. All Rights
Reserved)
from vertebral levels TXII–LIII. The right kidney
occupies a position slightly lower due to its rela-
tionship with the liver superiorly. Conversely, the
left kidney rests slightly closer to the midline, has
a narrower profile, and is somewhat longer. On its
medial surface, the kidneys are occupied by blood
vessels, nerves, lymphatics, and the renal pelvis
entering and exiting the concave-shaped hilum
which faces anteriorly and medially.
Adjacent Structures
Due to their position in the paravertebral gutters
along the posterior abdominal wall, the kidneys
are in contact with the surfaces of several struc-
tures directly or through an intervening layer of
peritoneum. Anteriorly, the left kidney is related
to the spleen, suprarenal gland, stomach,
pancreas, jejunum, descending colon, and left
colic flexure (Fig. 1.8a). Alternatively, the
anterior surface of the right kidney is related to
the liver, suprarenal gland, small intestine, right
colic flexure, and descending part of the duode-
num. Posteriorly, both kidneys are related to the
psoas major muscle, quadratus lumborum mus-
cle, transversus abdominis muscle, diaphragm,
7
costodiaphragmatic recess, eleventh rib (left kid-
ney only), twelfth rib, subcostal nerve, ilioingui-
nal nerve, and iliohypogastric nerve (Fig. 1.8b).
Fascial Contributions
The retroperitoneal connective tissue is orga-
nized around the kidneys to form interchanging
layers of fascia and adipose tissue. In immediate
contact with the kidney is the renal capsule, a
fibrous layer which encapsulates the kidney, but
it is histologically distinct from the renal paren-
chyma. Surrounding the renal capsule is the peri-
nephric (perirenal) fat, an accumulation of
adipose tissue from the extraperitoneal fatty layer
(Fig. 1.9). Adjacent to the anterolateral aspect of
the kidney and enclosing the perinephric fat are
two layers extending from transversalis fascia
that surround the kidney and are referred to as
renal (Gerota’s) fascia. Towards the midline, the
anterior layer of renal fascia adjoins to the con-
nective tissue of the inferior vena cava, aorta, or
anterior layer from the opposing side. The poste-
rior layer of renal fascia travels medially to adjoin
to the fascia covering the anterior surface of the
psoas major muscle. In addition to covering the
8 J.M. McBride

Fig. 1.8 Relationship of

surrounding structures to the
kidney. (a) Anterior surface.
(b) Posterior surface
(reprinted with permission,
Cleveland Clinic Center for
Medical Art & Photography
© 2015. All Rights
Reserved)

kidney, renal fascia also encapsulates the supra-
renal gland superiorly; however, an intervening
septum ordinarily separates the two structures. A
final outermost layer of adipose tissue, paraneph-
ric fat, is found posteriorly and lateral to the kid-
ney residing between the posterior layer of renal
fascia and transversalis fascia.
Arterial Supply, Venous Drainage,
and Lymphatics
The renal arteries are the primary arterial supply
to the kidneys and extend off of the abdominal
aorta between vertebral levels LI and LII (Fig.
1.10). Comparatively, the right renal artery
emerges from the aorta slightly more superior
and passes posterior to the inferior vena cava as it
extends towards the kidney. As they course
towards the kidney, the renal arteries give off sev-
eral nonrenal branches which perfuse the adja-
cent renal capsule, ureters, and suprarenal glands.
Just prior to reaching the renal hilum, they divide
into five segmental arteries: superior/apical,
anterosuperior, anteroinferior, inferior, and
posterior. These terminal arteries are responsible
for perfusing corresponding regions of the kid-
ney. Clinically, this allows for identification of
1 Embryology, Anatomy, and Histology of the Kidney 9

Fig. 1.9 Illustration of fascia and adipose tissue surrounding the kidney (reprinted with permission, Cleveland Clinic
Center for Medical Art & Photography © 2015. All Rights Reserved)

surgically resectable renal segments as the seg-
mental branches exhibit very little anastomotic
properties. Accessory renal arteries may also be
present, originating directly from the abdominal
aorta to enter the hilum or other level (extrahilar
arteries) of the kidney.
Positioned anterior to the renal arteries are the
renal veins that arise from several small branches
exiting the renal hilum. Both veins converge on
the inferior vena cava residing just right of mid-
line (Fig. 1.11). Due to the positioning of the
inferior vena cava, the left renal vein is longer in
length and passes anterior to the aorta and poste-
rior to the descending segment of the superior
mesenteric artery. This vascular relationship can
be significantly compromised with the develop-
ment of an aneurysm in either the aorta or supe-
rior mesenteric artery.
Lymphatic drainage from the kidneys, ureters,
and suprarenal glands all coalesce into the left
10
Fig. 1.10 Arterial supply to the kidney (reprinted with permission, Cleveland Clinic Center for Medical Art &
Photography © 2015. All Rights Reserved)
and right lateral lumbar (caval or aortic) nodes
(Fig. 1.12). These nodes are located near the
source of the renal arteries bilaterally [2].
Innervation
The kidneys receive nervous system input from
the sympathetic nervous system originating from
T12 to L1 levels of the spinal cord. These fibers
form a renal plexus along the surface of the renal
arteries and receive contributions from the celiac
plexus, least splanchnic, and first lumbar splanch-
nic nerves (Fig. 1.13). Upon reaching the kidney,
these fibers are responsible for regulating renal
blood flow, salt and water reabsorption by the
nephron, and glomerular filtration rate. In con-
trast to sympathetic nerve function, parasympa-
thetic innervation does not appear to play a
significant role in regulating kidney function [3].
J.M. McBride
Histology of the Kidney
Renal Capsule
Externally, the kidney is surrounded by the renal
capsule, a fibrous connective tissue structure
weakly attached to the kidney surface. The capsule
includes two discrete layers: an inner layer of myo-
fibroblasts and an outer layer of collagen fibers and
fibroblasts [4]. At the hilum, the capsule penetrates
the area of the sinus to contribute to the connective
tissue covering of the calyces and renal pelvis.
Parenchyma
Overview
When viewing the hemisected kidney, two
regions are clearly visible: the centrally located
medulla with inner and outer segments and the
1 Embryology, Anatomy, and Histology of the Kidney
Fig. 1.11 Venous drainage
from the kidney (reprinted
with permission, Cleveland
Clinic Center for Medical
Art & Photography © 2015.
All Rights Reserved)
overlying cortex which is subdivided into an
outer cortex and a juxtamedullary cortex sitting
adjacent to the medullary pyramids (Fig. 1.14).
Within each kidney, 8–12 conical-shaped medul-
lary pyramids exist with their bases directed
towards the overlying cortex. Between each pyra-
mid, a segment of cortex interjects to form a renal
column (of Bertin). The association of the medul-
lary pyramids and their surrounding cortical tis-
sue constitute a renal lobe, with the total number
of lobes in the kidney determined by the number
of pyramids present. Another level of organiza-
tion of kidney parenchyma is the lobule which
consists of a central medullary ray and the corti-
cal tissue surrounding it. Interstitial tissue
throughout the parenchyma is extremely scarce,
consisting mostly of reticular tissue and some
11
collagenous fibers which surround blood vessels,
large papillary ducts, and glomerular capsules.
Cortex
In the fresh state, the cortex appears brownish
red, a coloring indicative of the extensive blood
flow passing through the complex network of
vasculature. Every minute, the kidneys receive
approximately 20 % of the cardiac output, with
90 % directed towards the cortex and 10 % to the
medulla. Populating the cortex are renal corpus-
cles and various segments of the tubule system
including convoluted and straight tubules of the
nephron, collecting tubules, and collecting ducts
(Fig. 1.15). The renal corpuscle represents the
initial, dilated portion of the nephron. Closer
examination of this sphere-shaped structure
12
Fig. 1.12 Lymphatic
drainage from the kidneys to
the lateral lumbar (caval or
aortic) nodes (reprinted with
permission, Cleveland Clinic
Center for Medical Art &
Photography © 2015. All
Rights Reserved)
reveals an accompanying capillary system known
as the glomerulus. Situated between areas of
renal corpuscles and their closely approximated
convoluted and collecting tubules are areas of
medullary rays which consist of straight tubules
of the nephrons and collecting ducts.
Medulla
The medulla consists of 8–12 conical-shaped
medullary pyramids and intervening areas of cor-
tical tissue referred to as renal columns (Fig.
1.14). These structures contain the same cortical
structures as described previously but are
regarded as part of the medulla. Organizationally,
the medullary pyramid and its surrounding corti-
cal tissue constitute a lobe of the kidney, with
8–12 lobes present in a human kidney. Each lobe
is further subdivided into lobules which consist
J.M. McBride
of a central medullary ray and surrounding corti-
cal tissue. Within the medullary pyramids are
straight tubules and collecting ducts which are
accompanied by the vasa recta, a capillary net-
work oriented in parallel to the tubules and ducts.
The medullary pyramids are divided into an outer
and inner medulla with the inner segment ori-
ented towards the apical end or papilla. Each of
these divisions contains specific segments of the
nephron. The inner medulla contains the descend-
ing thin limbs, ascending thin limbs, and inner
medullary collecting ducts. The outer medulla is
further subdivided into an outer stripe with proxi-
mal straight tubules, distal straight tubules, and
outer medullary collecting ducts and an inner
stripe with descending thin limbs, distal straight
tubules, and outer medullary collecting ducts.
The collecting ducts open into a perforated region
1 Embryology, Anatomy, and Histology of the Kidney
Fig. 1.13 Sympathetic innervation to the kidneys (reprinted with permission, Cleveland Clinic Center for Medical Art
& Photography © 2015. All Rights Reserved)
of the papilla known as the area cribrosa. Each
papilla projects into a cup-like minor calyx which
is an extension of the renal pelvis.
Renal Corpuscle
The renal corpuscles consist of a tuft of glomeru-
lar capillaries surrounded by the visceral and
parietal layers of Bowman’s capsule (Fig. 1.16a,
b). Each corpuscle has a vascular pole with an
13
afferent and efferent arteriole, as well as a urinary
pole in which the proximal tubule arises. Lining
the lumen of the capillaries is a layer of fenes-
trated simple squamous endothelium, with fenes-
trations spanning 60–100 nm. Immediately
adjacent to the basement membrane of the capil-
lary wall is the visceral layer of Bowman’s cap-
sule. It is comprised of podocytes or visceral
epithelial cells which give off primary processes
and then secondary processes called pedicels or
foot processes (Fig. 1.17). As the foot processes
14
Fig. 1.14 Depiction of kidney structure in the hemisected kidney (reprinted with permission, Cleveland Clinic Center
for Medical Art & Photography © 2015. All Rights Reserved)
interdigitate with one another around the capil-
lary, filtration slits with a diameter of 20–25 nm
are formed. Each slit is covered by a filtration slit
diaphragm to limit the passage of smaller mole-
cules. Together, the capillary endothelium, glo-
merular basement membrane, and the visceral
layer of Bowman’s capsule form the filtration
apparatus of the kidney. Surrounding these struc-
tures is the external or parietal layer of Bowman’s
capsule. This layer consists of simple squamous
epithelium supported by an indistinct basement
membrane.
Between the loops of the glomerular capillar-
ies and around the vascular pole are mesangial
cells which play a significant role in maintaining
J.M. McBride
the structure and support of the glomerular filtra-
tion barrier. While the primary role of mesangial
cells is phagocytosis and structural support, they
also proliferate in response to glomerular injury.
In addition, these cells retain contractile proper-
ties which allow them to regulate glomerular dis-
tension in response to increases in blood
pressure.
Nephron
Functionally, the nephron is responsible for the
production of urine. In humans, there are approx-
imately two million nephrons present in each kid-
1 Embryology, Anatomy, and Histology of the Kidney
Fig. 1.15 Diagram of adult
kidney indicating the
relationship of nephrons to
their collecting tubules and
ducts within the cortex and
medulla (reprinted with
permission, Cleveland Clinic
Center for Medical Art &
Photography © 2015. All
Rights Reserved)
ney. The initial segment is comprised of the renal
corpuscle with its glomerulus and surrounding
renal or Bowman’s capsule (Fig. 1.15). Blood
entering the glomerular capillary loops passes
first through an afferent arteriole and then drains
from the efferent arteriole, both of which are
located at the vascular pole of Bowman’s cap-
sule. On the opposite side of the renal corpuscle
is the urinary pole, where the proximal convo-
luted tubule originates. The remaining tubular
segments of the nephron include the proximal
thick segment, thin segment, and distal thick
segment.
Nephron Tubules
As mentioned previously, the proximal convo-
luted tubule represents the initial tubule segment
stemming from the urinary pole of the renal cor-
puscle. This segment takes a tortuous course
15
through the cortex before entering the medullary
ray as the proximal straight tubule or thick
descending limb of the loop of Henle to enter the
medulla (Fig. 1.15). Continuing as the thin
descending limb, within the medulla it makes a
turn to head back towards the cortex as the thin
ascending limb. Entering the medullary ray of the
cortex, it transitions into the distal straight tubule
or thick ascending limb of the loop of Henle.
After leaving the medullary ray, the distal straight
tubule makes contact with the vascular pole of its
renal corpuscle. The epithelial cells of the tubule
near the afferent arteriole of the glomerulus are
modified to form the macula densa. After leaving
the corpuscle, the tubule becomes the distal con-
voluted tubule which empties into a collecting
duct within the medullary ray by way of an
arched collecting tubule or connecting tubule
(Fig. 1.15).
16 J.M. McBride

Fig. 1.16 The renal

corpuscle. (a) Schematic
representation. (b) Light
micrograph. Note the
parietal layer of Bowman’s
capsule (BC), surrounding
proximal convoluted tubules
(PCT) and distal convoluted
tubules (DCT) (reprinted
with permission, Cleveland
Clinic Center for Medical
Art & Photography © 2015.
All Rights Reserved)

Proximal Convoluted Tubule Functionally, the increased surface area offered

The lumen of the proximal convoluted tubule is
lined by cuboidal cells with a prominent brush
border consisting of apically located microvilli
(Fig. 1.16b). Another distinguishing feature is
the basal striations, which contain a high con-
centration of vertically oriented mitochondria.
by the brush border makes this segment of the
nephron the primary site of reabsorption, with
approximately 65% of the total ultrafiltrate per
day being reabsorbed here. With the aid of trans-
membrane proteins, Na+/K+-ATPase pumps,
and AQP-1, the majority of salts and water
1 Embryology, Anatomy, and Histology of the Kidney
Fig. 1.17 Transmission electron micrograph of a glomer-
ular capillary and neighboring podocyte. Pedicels (Pe) of
the podocyte rest on the basement membrane adjacent to
are absorbed within the proximal convoluted
tubule. In addition, the proximal convoluted
tubule also reabsorbs glucose, amino acids, and
polypeptides.
Loop of Henle
With a less prominent role in reabsorption, the
cuboidal-shaped cells of the proximal straight
tubule have a much shorter brush border and
smaller, less intricate basal domain and randomly
oriented mitochondria. The thin segment is lined
with simple squamous epithelium with cells fur-
ther subdivided at the electron microscopy level
into types I–IV based on contact with neighbor-
ing cells, abundance of intracellular organelles,
as well as the presence and morphology of micro-
villi. At the level of the descending thin limb,
water passively diffuses out to the interstitial
space, while a small amount of NaCl and urea
enters into the nephron lumen. In contrast, NaCl
passively diffuses out to the interstitial space at
17
the endothelium of the fenestrated glomerular capillary
(courtesy of Jesus Macias, University of California at San
Diego)
the level of the thin ascending limb. The thin
ascending limb is also impermeable to water.
Transitioning into the distal straight tubule,
the cells lining the lumen exhibit a cuboidal
shape, fewer microvilli, extensive basolateral
plications, and numerous basal located mito-
chondria. At this level, NaCl is actively pumped
out of the nephron lumen and into the medul-
lary interstitium. Near the vascular pole, the
cells of the straight tubule take on a columnar
shape and are more numerous. As the cells
appear crowded and somewhat overlapping,
this area is referred to as the macula densa, a
component of the juxtaglomerular apparatus.
The distal convoluted tubule is the continuation
of the distal straight tubule within the cortical
labyrinth. It is similar in structure and appear-
ance. Exchange of Na+ and K+ at this level is
mediated through aldosterone secreted by the
adrenal glands. Under this influence, Na+ is
reabsorbed and K+ is secreted.
18 J.M. McBride

Fig. 1.18 Light micrograph

from the outer potion of the
medulla region. Note the
presence of proximal straight
tubules (P), distal straight
tubules (D), collecting
tubules (CT), and thin
segments (T)

Collecting Tubules and Ducts
Connecting to the distal convoluted tubules are
collecting tubules (Fig. 1.18) which then transi-
tion into collecting ducts. Both of these structures
are comprised of simple epithelium. In general,
the cells of the collecting ducts transition from
squamous to cuboidal in nature as they pass from
outer to inner medulla and become columnar near
the renal papilla. The two principal cell types in
the collecting tubules and collecting ducts are
light cells or collecting duct cells and dark cells or
intercalated cells. The collecting duct cells are
greater in number and are identified by their pale-
staining cytoplasm and sparse microvilli. These
cells possess several aquaporin channels and thus
play a role in water permeability in the collecting
ducts. In contrast, the intercalated cells are less
abundant and exhibit a dark staining cytoplasm.
These cells secrete H+ or bicarbonate and thus
play an important role in acid–base balance.
References
1. The urogenital system. In: Moore KL, Persaud TVN,
editors. The developing human: clinically oriented
embryology. 9th ed. Philadelphia: Saunders; 2013.
p. 245–53.
2. Abdomen. In: Drake RL, Vogl AW, Mitchell AWM,
editors. Gray’s anatomy for students. 3rd ed.
Philadelphia: Churchill Livingstone; 2015. p. 373–97.
3. Structure and function of the kidneys. In: Koeppen
BM, Stanton BA, editors. Renal physiology. 4th ed.
Philadelphia: Mosby; 2007. p. 19–30.
4. Urinary system. In: Ross MH, Pawlina W, editors.
Histology a text and atlas: with correlated cell and
molecular biology. 6th ed. Philadelphia: Lippincott
Williams & Wilkins; 2011. p. 698–739.
 Polycystic Kidney Disease
Shreyas S. Joshi, Gladell P. Paner,
and Sam S. Chang
Autosomal Dominant Polycystic
Kidney Disease
Background
Autosomal dominant polycystic kidney disease
(ADPKD) is a common heritable form of renal
cystic disease with an incidence of up to 1 in 400
live births [1, 2]. It is one of the most common
monogenetic disorders in the USA and is also the
most common heritable cause of renal failure,
accounting for up to 15 % of all patients receiv-
ing hemodialysis [2–4]. Its genetic pattern of
inheritance has been extensively studied and
generally transmits in the expected autosomal
dominant fashion. Although up to 10 % of cases
present sporadically, the presence of other con-
tributory loci is the focus of ongoing investiga-
tion [5–7]. The age of onset of ADPKD is
S.S. Joshi, M.D. (*) • S.S. Chang, M.D., M.B.A.
Department of Urologic Surgery, Vanderbilt
University Medical Center, A-1302 Medical Center
North, Nashville, TN 37232, USA
e-mail: shreyas.joshi@vanderbilt.edu;
sam.chang@vanderbilt.edu
G.P. Paner, M.D.
Department of Pathology and Surgery, Section of
Urology, University of Chicago Medical Center,
Chicago, IL 60637, USA
e-mail: gladell.paner@uchospitals.edu
© Springer Science+Business Media New York 2016
D.E. Hansel et al. (eds.), The Kidney, DOI 10.1007/978-1-4939-3286-3_2
2
predictably in the 4th or 5th decade of life, with
penetrance approaching 100 % for all patients
who live long enough. Rare cases in infants and
children do occur and tend to portend a more
aggressive form of the disease; but for the stereo-
typical adult patient, progression to serious mani-
festations, like renal failure, rarely occurs before
the 4th decade of life [8]. ADPKD is a heteroge-
neous disease once it manifests. Associated
anomalies are commonly co-expressed, includ-
ing cysts of the liver, pancreas, spleen, seminal
vesicles, arachnoid membrane, and lungs. Non-
cystic lesions include berry aneurysms (vascular
aneurysms of the circle of Willis), colonic diver-
ticula, aortic aneurysms, and mitral valve pro-
lapse [9].
Genetics/Pathogenesis
Almost all ADPKD cases are the result of muta-
tions in either PDK1 or PDK2 genes located on
the short arm of chromosome 16 and the long
arm of chromosome 4, respectively [10–12]. The
resultant gene products, polycystin-1 and poly-
cystin-2, are both part of a complex of molecules
that regulate cell proliferation and cyst forma-
tion. These proteins are thought to interact as part
of the same pathway; thus, a mutation in either
can lead to similar disease manifestations [13].
The presence of a third specific locus, PDK3, has
been evaluated as the cause of disease in a very
small subset of patients, though recent reanalysis
19
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its much greater reliability under all working conditions. The
overhead wire is not one continuous cable, but is divided into
sections of about half a mile in length, each section being supplied
with current from a separate main. At each point where the current is
fed to the trolley wire a sort of metal box may be seen at the side of
the street. These boxes are called “feeder pillars,” and each contains
a switch by means of which the current can be cut off from that
particular section, for repairing or other purposes. Above the car is
fixed an arm provided with a trolley wheel which runs along the wire,
and this wheel takes the current from the wire. From the wheel the
current passes down the trolley arm to the controller, which is
operated by the driver, and from there to the motors beneath the car.
Leaving the motors it passes to the wheels and then to the rails, from
which it is led off at intervals by cables and so returned to the
generating station. The current carried by the rails is at a pressure of
only a few volts, so that there is not the slightest danger of shock
from them. There are generally two electric motors beneath the car,
and the horse-power of each varies from about fifteen to twenty-five.
The controller consists mainly of a number of graduated
resistances. To start the car the driver moves a handle forward notch
by notch, thus gradually cutting out the resistance, and so the motors
receive more and more current until they are running at full speed.
The movement of the controller handle also alters the connexion of
the motors. When the car is started the motors are connected in
series, so that the full current passes through each, while the
pressure is divided between them; but when the car is well on the
move the controller connects the motors in parallel, so that each
receives the full pressure of the current.
The conduit and surface contact systems are much the same as
the trolley system except in the method of supplying the current to
the cars. In the conduit system two conductors conveying the current
are placed in an underground channel or conduit of concrete
strengthened by iron yokes. The top of the conduit is almost closed
in so as to leave only a narrow slot, through which passes the
current collector of the car. This current collector, or “plough” as it is
called, carries two slippers which make contact with the conductors,
and thus take current from them. In this system the current returns
along one of the conductors, so that no current passes along the
track rails. This is the most expensive of the three systems, both in
construction and maintenance.
The surface contact or stud system is like the conduit system in
having conductors placed in a sort of underground trough, but in this
case contact with the conductors is made by means of metal studs
fixed at intervals in the middle of the track. The studs are really the
tops of underground boxes each containing a switch, which, when
drawn up to a certain position, connects the stud to the conductors.
These switches are arranged to be moved by magnets fixed beneath
the car, and thus when the car passes over a stud the magnets work
the switch and connect the stud to the conductors, so that the stud is
then “alive.” The current is taken from the studs by means of sliding
brushes or skates which are carried by the car. The studs are thus
alive only when the car is passing over them, and at all other times
they are dead, and not in any way dangerous.
The weight and speed of electric cars make it important to have
a thoroughly reliable system of brakes. First of all there are ordinary
mechanical brakes, which press against the wheels. Then there are
electro-magnetic slipper brakes which press on the rails instead of
on the wheels of the car. These brakes are operated by electro-
magnets of great power, the current necessary to excite the magnets
being taken from the motors. Finally there is a most interesting and
ingenious method of regenerative control. Before a car can be
stopped after it has attained considerable speed a certain amount of
energy has to be got rid of in some way. With the ordinary
mechanical or electro-magnetic brakes this energy is wasted, but in
the regenerative method it is turned into electric current, which is
sent back into the circuit. If an electric motor is supplied with
mechanical power instead of electric current it becomes a dynamo,
and generates current instead of using it. In the regenerative system,
when a car is “coasting” down a hill it drives the wheels, and the
wheels drive the motors, so that the latter become dynamos and
generate current which is sent back to the power station. In this way
some of the abnormal amount of current taken by a car in climbing a
hill is returned when the car descends the hill. The regenerative
system limits the speed of the car, so that it cannot possibly get
beyond control.

PLATE VII.

By permission of Siemens Brothers Dynamo Works Ltd.

ELECTRIC COLLIERY RAILWAY.

A large tramway system spreads outwards from the centre of a

city to the suburbs, and usually terminates at various points on the
outskirts of these suburbs. It often happens that there are villages
lying some distance beyond these terminal points, and it is very
desirable that there should be some means of transport between
these villages and the city. An extension of the existing tramway is
not practicable in many cases, because the traffic would not be
sufficient to pay for the heavy outlay, and also because the road may
not be of sufficient width to admit of cars running on a fixed track.
The difficulty may be overcome satisfactorily by the use of trackless
trolley cars. With these cars the costly business of laying a rail track
is altogether avoided, only a system of overhead wires being
necessary. As there is no rail to take the return current, a second
overhead wire is required. The car is fitted with two trolley arms, and
the current is taken from one wire by the first arm, sent through the
controller and the motors, and returned by the second arm to the
other wire, and so back to the generating station. The trolley poles
are so arranged that they allow the car to be steered round
obstructions or slow traffic, and the car wheels are usually fitted with
solid rubber tyres. Trackless cars are not capable of dealing with a
large traffic, but they are specially suitable where an infrequent
service, say a half-hourly one, is enough to meet requirements.
We come now to electric railways. These may be divided into
two classes, those with separate locomotives and those without. The
separate locomotive method is largely used for haulage purposes in
collieries and large works of various kinds. In Plate VII. is seen an
electric locomotive hauling a train of coal waggons in a colliery near
the Tyne, and it will be seen that the overhead system is used, the
trolley arm and wheel being replaced by sliding bows. In a colliery
railway it is generally impossible to select the most favourable track
from the railway constructor’s point of view, as the line must be
arranged to serve certain points. This often means taking the line
sometimes through low tunnels or bridges where the overhead wire
must be low, and sometimes over public roads where the wire must
be high; and the sliding bow is better able than the trolley arm and
wheel to adapt itself to these variations. In the colliery where this
locomotive is used the height of the overhead wire ranges from 10
feet 6 inches through tunnels or bridges, to 21 feet where the public
road is crossed. The locomotive weighs 33½ tons, and has four
electric motors each developing 50 horse-power with the current
employed. It will be noticed that the locomotive has two sets of
buffers. This is because it has to deal with both main line waggons
and the smaller colliery waggons, the upper set of buffers being for
the former, and the lower and narrower set for the latter. Plate VIII.
shows a 50-ton locomotive on the British Columbia Electric Railway,
and a powerful locomotive in use in South America. In each case it
will be seen that the trolley wheel is used.
 In this country electric railways for passenger traffic are mostly
worked on what is known as the multiple-unit system, in which no
separate locomotives are used, the motors and driving mechanism
being placed on the cars themselves. There are also other cars
without this equipment, so that a train consists of a single motor-car
with or without trailer, or of two motor-cars with trailer between, or in
fact of any other combination. When a train contains two or more
motor-cars all the controllers, which are very similar to those on
electric tramcars, are electrically connected so as to be worked
together from one master controller. This system allows the length of
the train to be adjusted to the number of passengers, so that no
power is wasted in running empty cars during periods of small traffic.
In suburban railways, where the stopping-places are many and close
together, the efficiency of the service depends to a large extent upon
the time occupied in bringing the trains from rest to full speed. In this
respect the electric train has a great advantage over the ordinary
train hauled by a steam locomotive, for it can pick up speed at three
or more times the rate of the latter, thus enabling greater average
speeds and a more frequent service to be maintained.
Electric trains are supplied with current from a central generating
station, just as in the case of electric tramcars, but on passenger
lines the overhead wire is in most cases replaced by a third rail. This
live rail is placed upon insulators just outside the track rail, and the
current is collected from it by sliding metal slippers which are carried
by the cars. The return current may pass along the track rails as in
the case of trolley tramcars, or be conveyed by another insulated
conducting rail running along the middle of the track.
The electric railways already described are run on continuous
current, but there are also railways run on alternating current. A
section of the London, Brighton, and South Coast Railway is
electrically operated by alternating current, the kind of current used
being that known as single-phase. The overhead system is used,
and the current is led to the wire at a pressure of about 6000 volts.
This current is collected by sliding bows and conveyed to
transformers carried on the trains, from which it emerges at a
pressure of about 300 volts, and is then sent through the motors.
The overhead wires are not fixed directly to the supports as in the
case of overhead tramway wires, but instead two steel cables are
carried by the supports, and the live wires are hung from these. The
effect of this arrangement is to make the sliding bows run steadily
and evenly along the wires without jumping or jolting. If ever
electricity takes the place of steam for long distance railway traffic,
this system, or some modification of it, probably will be employed.
Mention must be made also of the Kearney high speed electric
mono-railway. In this system the cars, which are electrically driven,
are fitted above and below with grooved wheels. The lower wheels
run on a single central rail fixed to sleepers resting on the ground,
and the upper wheels run on an overhead guide rail. It is claimed
that speeds of 150 miles an hour are attainable with safety and
economy in working. This system is yet only just out of the
experimental stage, but its working appears to be exceedingly
satisfactory.
A self-contained electric locomotive has been constructed by the
North British Locomotive Company. It is fitted with a steam turbine
which drives a dynamo generating continuous current, and the
current is used to drive four electric motors. This locomotive has
undergone extensive trials, but its practical value as compared with
the ordinary type of electric locomotive supplied with current from an
outside source is not yet definitely established.
At first sight it appears as though the electric storage cell or
accumulator ought to provide an almost perfect means of supplying
power for self-propelled electric vehicles of all kinds. In practice,
however, it has been found that against the advantages of the
accumulator there are to be set certain great drawbacks, which have
not yet been overcome. Many attempts have been made to apply
accumulator traction to electric tramway systems, but they have all
failed, and the idea has been abandoned. There are many reasons
for the failure of these attempts. The weight of a battery of
accumulators large enough to run a car with a load of passengers is
tremendous, and this is of course so much dead weight to be hauled
along, and it becomes a very serious matter when steep hills have to
be negotiated. When a car is started on a steep up-gradient a
sudden and heavy demand for current is made, and this puts upon
the accumulators a strain which they are not able to bear without
injury. Another great drawback is the comparatively short time for
which accumulators can give a heavy current, for this necessitates
the frequent return of the cars to the central station in order to have
the batteries re-charged. Finally, accumulators are sensitive things,
and the continuous heavy vibration of a tramcar is ruinous to them.
The application of accumulators to automobiles is much more
feasible, and within certain limits the electric motor-car may be
considered a practical success. The electric automobile is superior to
the petrol-driven car in its delightfully easy and silent running, and its
freedom from all objectionable smells. On the other hand high
speeds cannot be attained, and there is the trouble of having the
accumulators re-charged, but for city work this is not a serious
matter. Two sets of accumulators are used, so that one can be left at
the garage to be charged while the other is in use, the replacing of
the exhausted set by the freshly charged one being a matter of only
a few minutes. The petrol-driven car is undoubtedly superior in every
way for touring purposes. Petrol can now be obtained practically
anywhere, whereas accumulator charging stations are comparatively
few and far between, especially in country districts; and there is no
comparison as regards convenience between the filling of a petrol
tank and the charging of a set of accumulators, for one process
takes a few minutes and the other a few hours.
Accumulator-driven locomotives are not in general use, but for
certain special purposes they have proved very satisfactory. A large
locomotive of this kind was used for removing excavated material
and for taking in the iron segments, sleepers, rails, and other
materials in the construction of the Great Northern, Piccadilly, and
Brompton Tube Railway. This locomotive is 50 feet 6 inches long,
and it carries a battery of eighty large “chloride” cells, the total weight
of locomotive and battery being about 64 tons. It is capable of
hauling a load of 60 tons at a rate of from 7 to 9 miles an hour on the
level.
Amongst the latest developments of accumulator traction is a
complete train to take the place of a steam locomotive hauling a
single coach on the United Railways of Cuba. According to the
Scientific American the train consists of three cars, each having a
battery of 216 cells, supplying current at 200 volts to the motors.
Each car has accommodation for forty-two passengers, and the
three are arranged to work on the multiple-unit system from one
master controller. The batteries will run from 60 to 100 miles for each
charging of seven hours.
 CHAPTER XII
ELECTRIC LIGHTING

In the first year of the nineteenth century one of the greatest of

England’s scientists, Sir Humphry Davy, became lecturer on
chemistry to the Royal Institution, where his brilliant lectures
attracted large and enthusiastic audiences. He was an indefatigable
experimenter, and in order to help on his work the Institution placed
at his disposal a very large voltaic battery consisting of 2000 cells. In
1802 he found that if two rods of carbon, one connected to each
terminal of his great battery, were first made to touch one another
and then gradually separated, a brilliant arch of light was formed
between them. The intense brilliance of this electric arch, or arc as it
came to be called, naturally suggested the possibility of utilizing
Davy’s discovery for lighting purposes, but the maintaining of the
necessary current proved a serious obstacle. The first cost of a
battery of the required size was considerable, but this was a small
matter compared with the expense of keeping the cells in good
working order. Several very ingenious and more or less efficient arc
lamps fed by battery current were produced by various inventors, but
for the above reason they were of little use except for experimental
purposes, and the commercial success of the arc lamp was an
impossibility until the dynamo came to be a really reliable source of
current. Since that time innumerable shapes and forms of arc lamps
have been devised, while the use of such lamps has increased by
leaps and bounds. To-day, wherever artificial illumination on a large
scale is required, there the arc lamp is to be found.
When the carbon rods are brought into contact and then slightly
separated, a spark passes between them. Particles of carbon are
torn off by the spark and volatilized, and these incandescent
particles form a sort of bridge which is a sufficiently good conductor
for the current to pass across it from one rod to the other. When the
carbons are placed horizontally, the glowing mass is carried upwards
by the ascending currents of heated air, and it assumes the arch-like
form from which it gets its name. If the carbons are vertical the curve
is not produced, a more or less straight line being formed instead.
The electric arc may be formed between any conducting substances,
but for practical lighting purposes carbon is found to be most
suitable.
Either continuous or alternating currents may be used to form
the arc. With continuous current, if the carbon rods are fully exposed
to the air, they gradually consume away, and minute particles of
carbon are carried across from the positive rod to the negative rod,
so that the former wastes at about twice the rate of the latter. The
end of the positive rod becomes hollowed out so as to resemble a
little crater, and the end of the negative rod becomes more or less
pointed. The fact that with continuous current the positive rod
consumes away twice as fast as the negative rod, may be taken
advantage of to decrease the cost of new carbons, by replacing the
wasted positive rod with a new one, and using the unconsumed
1
portion of the old positive rod as a new negative rod. If alternating
current is used, each rod in turn becomes the positive rod, so that no
crater is formed, and both the carbons have the same shape and are
consumed at the same rate. A humming noise is liable to be
produced by the alternating current arc, but by careful construction of
the lamp this noise is reduced to the minimum.

1
In actual practice the positive carbon is made
double the thickness of the negative, so that the
two consume at about the same rate.

If the carbons are enclosed in a suitable globe the rate of

wasting is very much less. The oxygen inside the globe becomes
rapidly consumed, and although the globe is not air-tight, the heated
gases produced inside it check the entrance of further supplies of
fresh air as long as the lamp is kept burning. When the light is
extinguished, and the lamp cools down, fresh air enters again freely.
Arc lamp carbons may be either solid or cored. The solid form is
made entirely of very hard carbon, while the cored form consists of a
narrow tube of carbon filled up with soft graphite. Cored carbons
usually burn more steadily than the solid form. In what are known as
flame arc lamps the carbons are impregnated with certain metallic
salts, such as calcium. These lamps give more light for the same
amount of current. The arc is long and flame-like, and usually of a
striking yellow colour, but it is not so steady as the ordinary arc.
As the carbon rods waste away,
the length of the arc increases, and if
this increase goes beyond a certain
limit the arc breaks and the current
ceases. If the arc is to be kept going
for any length of time some
arrangement for pushing the rods
closer together must be provided, in
order to counteract the waste. In arc
lamps this pushing together, or
“feeding” as it is called, is done
automatically, as is also the first
bringing together and separating of
the rods to start or strike the arc. Fig. Fig. 21.—Diagram showing simple
method of carbon regulation for
21 shows a simple arrangement for
Arc Lamps.
this purpose. A is the positive
carbon, and B the negative. C is the
holder for the positive carbon, and this is connected to the rod D,
which is made of soft iron. This rod is wound with two separate coils
of wire as shown, coil E having a low resistance, and coil F a high
one. These two coils are solenoids, and D is the core, (Chapter VII.).
When the lamp is not in use, the weight of the holder keeps the
positive carbon in contact with the negative carbon. When switched
on, the current flows along the cable to the point H. Here it has two
paths open to it, one through coil E to the positive carbon, and the
other through coil F and back to the source of supply. But coil E has
a much lower resistance than coil F, and so most of the current
chooses the easier path through E, only a small amount of current
taking the path through the other coil. Both coils are now
magnetized, and E tends to draw the rod D upwards, while F tends
to pull it downwards. Coil E, however, has much greater power than
coil F, because a much larger amount of current is passing through
it; and so it overcomes the feeble pull of F, and draws up the rod.
The raising of D lifts the positive carbon away from the negative
carbon, and the arc is struck. The carbons now begin to waste away,
and very slowly the distance between them increases. The path of
the current passing through coil E is from carbon A to carbon B by
way of the arc, and as the length of the gap between A and B
increases, the resistance of this path also increases. The way
through coil E thus becomes less easy, and as time goes on more
and more current takes the alternative path through coil F. This
results in a decrease in the magnetism of E, and an increase in that
of F, and at a certain point F becomes the more powerful of the two,
and pulls down the rod. In this way the positive carbon is lowered
and brought nearer to the negative carbon. Directly the diminishing
distance between A and B reaches a certain limit, coil E once more
asserts its superiority, and by overcoming the pull of F it stops the
further approach of the carbons. So, by the opposing forces of the
two coils, the carbons are maintained between safe limits, in spite of
their wasting away.
PLATE IX.
 By permission of Union Electric Co. Ltd.

NIGHT PHOTOGRAPHS, TAKEN BY THE LIGHT OF THE

ARC LAMPS.

The arc lamp is largely used for the illumination of wide streets,
public squares, railway stations, and the exteriors of theatres, music-
halls, picture houses, and large shops. The intense brilliancy of the
light produced may be judged from the accompanying photographs
(Plate IX.), which were taken entirely by the light of the arc lamps.
Still more powerful arc lamps are constructed for use in lighthouses.
The illuminating power of some of these lamps is equal to that of
hundreds of thousands of candles, and the light, concentrated by
large reflectors, is visible at distances varying from thirty to one
hundred miles.
Arc lamps are also largely used for lighting interiors, such as
large showrooms, factories or workshops. For this kind of lighting the
dazzling glare of the outdoor lamp would be very objectionable and
harmful to the eyes, so methods of indirect lighting are employed to
give a soft and pleasant light. Most of the light in the arc lamp comes
from the positive carbon, and for ordinary outdoor lighting this carbon
is placed above the negative carbon. In lamps for interior lighting the
arrangement is frequently reversed, so that the positive carbon is
below. Most of the light is thus directed upwards, and if the ceiling is
fairly low and of a white colour the rays are reflected by it, and a soft
and evenly diffused lighting is the result. Some light comes also from
the negative carbon, and those downward rays are reflected to the
ceiling by a reflector placed beneath the lamp. Where the ceiling is
very high or of an unsuitable colour, a sort of artificial ceiling in the
shape of a large white reflector is placed above the lamp to produce
the same effect. Sometimes the lamp is arranged so that part of the
light is reflected to the ceiling, and part transmitted directly through a
semi-transparent reflector below the lamp. The composition of the
light of the arc lamp is very similar to that of sunlight, and by the use
of such lamps the well-known difficulty of judging and matching
colours by artificial light is greatly reduced. This fact is of great value
in drapery establishments, and the arc lamp has proved a great
success for lighting rooms used for night painting classes.
The powerful searchlights used by warships are arc lamps
provided with special arrangements for projecting the light in any
direction. A reflector behind the arc concentrates the light and sends
it out as a bundle of parallel rays, and the illuminating power is such
that a good searchlight has a working range of nearly two miles in
clear weather. According to the size of the projector, the illumination
varies from about 3000 to 30,000 or 40,000 candle-power. For some
purposes, such as the illuminating of narrow stretches of water, a
wider beam is required, and this is obtained by a diverging lens
placed in front of the arc. In passing through this lens the light is
dispersed or spread out to a greater or less extent according to the
nature of the lens. Searchlights are used in navigating the Suez
Canal by night, for lighting up the buoys along the sides of the canal.
The ordinary form of searchlight does this quite well, but at the same
time it illuminates equally an approaching vessel, so that the pilot on
this vessel is dazzled by the blinding glare. To avoid this dangerous
state of things a split reflector is used, which produces two separate
beams with a dark space between them. In this way the sides of the
canal are illuminated, but the light is not thrown upon oncoming
vessels, so that the pilots can see clearly.
Glass reflectors are much more efficient than metallic ones, but
they have the disadvantage of being easily put out of action by
gunfire. This defect is remedied by protecting the glass reflector by a
screen of wire netting. This is secured at the back of the reflector,
and even if the glass is shattered to a considerable extent, as by a
rifle bullet, the netting holds it together, and keeps it quite
serviceable. Reflectors protected in this way are not put out of action
by even two or three shots fired through them. Searchlight arcs and
reflectors are enclosed in metal cylinders, which can be moved in
any direction, vertically or horizontally.
In the arc lamps already described, a large proportion of the light
comes from the incandescent carbon electrodes. About the year
1901 an American electrician, Mr. P. C. Hewitt, brought out an arc
lamp in which the electrodes took no part in producing the light, the
whole of which came from a glowing stream of mercury vapour. This
lamp, under the name of the Cooper-Hewitt mercury vapour lamp,
has certain advantages over other electric illuminants, and it has
come into extensive use.
 Fig. 22.—Sketch of Mercury Vapour Lamp.

It consists of a long glass tube, exhausted of air, and containing

a small quantity of mercury. Platinum wires to take the current from
the source of supply are sealed in at each end. The tube is attached
to a light tubular framework of metal suspended from the ceiling, and
this frame is arranged so that it can be tilted slightly downwards by
pulling a chain. As shown in Fig. 22, the normal position of the lamp
is not quite horizontal, but tilted slightly downwards towards the end
of the tube having the bulb containing the mercury. The platinum
wire at this end dips into the mercury, so making a metallic contact
with it. The lamp is lighted by switching on the current and pulling
down the chain. The altered angle makes the mercury flow along the
tube towards the other platinum electrode, and as soon as it touches
this a conducting path for the current is formed from end to end of
the tube. The lamp is now allowed to fall back to its original angle, so
that the mercury returns to its bulb. There is now no metallic
connexion between the electrodes, but the current continues to pass
through the tube as a vacuum discharge. Some of the mercury is
immediately vaporized and rendered brilliantly incandescent, and so
the light is produced. The trouble of pulling down the chain is
avoided in the automatic mercury vapour lamp, which is tilted by an
electro-magnet. This magnet is automatically cut out of circuit as
soon as the tilting is completed and the arc struck.
The average length of the tube in the ordinary form of mercury
vapour lamp is about 30 inches, and a light of from 500 to 3000
candle-power is produced, according to the current used. Another
form, known as the “Silica” lamp, is enclosed in a globe like that of
an ordinary electric arc lamp. The tube is only about 5 or 6 inches in
length, and it is made of quartz instead of glass, the arrangements
for automatically tilting the tube being similar to those in the ordinary
form of lamp.
The light of the mercury vapour lamp is different from that of all
other lamps. Its peculiarity is that it contains practically no red rays,
most of the light being yellow, with a certain proportion of green and
blue. The result is a light of a peacock-blue colour. The absence of
red rays alters colour-values greatly, scarlet objects appearing black;
and on this account it is impossible to match colours by this light. In
many respects, however, the deficiency in red rays is a great positive
advantage. Every one who has worked by mercury vapour light must
have noticed that it enables very fine details to be seen with
remarkable distinctness. This property is due to an interesting fact.
Daylight and ordinary artificial light is a compound or mixture of rays
of different colours. It is a well-known optical fact that a simple lens is
unable to bring all these rays to the same focus; so that if we sharply
focus an image by red light, it is out of focus or blurred by blue light.
This defect of the lens is called “chromatic aberration.” The eye too
suffers from chromatic aberration, so that it cannot focus sharply all
the different rays at the same time. The violet rays are brought to a
focus considerably in front of the red rays, and the green and the
yellow rays come in between the two. The eye therefore
automatically and unconsciously effects a compromise, and focuses
for the greenish-yellow rays. The mercury vapour light consists very
largely of these rays, and consequently it enables the image to be
focused with greater sharpness; or, in other words, it increases the
acuteness of vision. Experiments carried out by Dr. Louis Bell and
Dr. C. H. Williams demonstrated this increase in visual sharpness
very conclusively. Type, all of exactly the same size, was examined
by mercury vapour light, and by the light from an electric
incandescent lamp with tungsten filament. The feeling of sharper
definition produced by the mercury vapour light was so strong that
many observers were certain that the type was larger, and they were
convinced that it was exactly the same only after careful personal
examination.
Mercury vapour light apparently imposes less strain upon the
eyes than ordinary artificial light, and this desirable feature is the
result of the absence of the red rays, which, besides having little
effect in producing vision, are tiring to the eyes on account of their
heating action. The light is very highly actinic, and for this reason it is
largely used for studio and other interior photographic work. In cases
where true daylight colour effects are necessary, a special
fluorescent reflector is used with the lamp. By transforming the
frequency of the light waves, this reflector supplies the missing red
and orange rays, the result being a light giving normal colour effects.
Another interesting vapour lamp may be mentioned briefly. This
has a highly exhausted glass tube containing neon, a rare gas
discovered by Sir William Ramsay. The light of this lamp contains no
blue rays, and it is of a striking red colour. Neon lamps are used
chiefly for advertising purposes, and they are most effective for
illuminated designs and announcements, the peculiar and distinctive
colour of the light attracting the eye at once.
An electric current meets with some resistance in passing
through any substance, and if the substance is a bad conductor the
resistance is very great. As the current forces its way through the
resistance, heat is produced, and a very thin wire, which offers a
high resistance, may be raised to a white heat by an electric current,
and it then glows with a brilliant light. This fact forms the basis of the
electric incandescent or glow lamp.
In the year 1878, Thomas A. Edison set himself the task of
producing a perfect electric incandescent lamp, which should be
capable of superseding gas for household and other interior lighting.
The first and the greatest difficulty was that of finding a substance
which could be formed into a fine filament, and which could be kept
in a state of incandescence without melting or burning away.
Platinum was first chosen, on account of its very high melting-point,
and the fact that it was not acted upon by the gases of the air.
Edison’s earliest lamps consisted of a piece of very thin platinum
wire in the shape of a spiral, and enclosed in a glass bulb from which
the air was exhausted. The ends of the spiral were connected to
outside wires sealed into the bulb. It was found, however, that
keeping platinum continuously at a high temperature caused it to
disintegrate slowly, so that the lamps had only a short life. Fine
threads or filaments of carbon were then tried, and found to be much
more durable, besides being a great deal cheaper. The carbon
filament lamp quickly became a commercial success, and up to quite
recent years it was the only form of electric incandescent lamp in
general use.
In 1903 a German scientist, Dr. Auer von Welsbach, of
incandescent gas mantle fame, produced an electric lamp in which
the filament was made of the metal osmium, and this was followed
by a lamp using the metal tantalum for the filament, the invention of
Siemens and Halske. For a while the tantalum lamp was very
successful, but more recently it has been superseded in popularity
by lamps having a filament of the metal tungsten. The success of
these lamps has caused the carbon lamp to decline in favour. The
metal filaments become incandescent much more easily than the
carbon filament, and for the same candle-power the metal filament
lamp consumes much less current than the carbon lamp.
The construction of tungsten lamps is very interesting. Tungsten
is a very brittle metal, and at first the lamps were fitted with a number
of separate filaments. These were made by mixing tungsten powder
with a sort of paste, and then squirting the mixture through very
small apertures, so that it formed hair-like threads. Early in 1911
lamps having a filament consisting of a single continuous piece of
drawn tungsten wire were produced. It had been known for some
time that although tungsten was so brittle at ordinary temperatures, it
became quite soft and flexible when heated to incandescence in the
lamp, and that it lost this quality again as soon as it cooled down. A
process was discovered by which the metal could be made