The orbito-ventromedial undercutting (Hirose) is one of the latest and the most improved psychosurgical methods for the improvement in the emotional aspect of various mentally disturbed patients, who failed torespond to various other treatments. Seventeen cases subjected to the orbito-ventromedial undercutting: i. e. 4atypical schizophrenics, 3 schizophrenics, 1 manic-depressive psychotic, 3 obsessive-compulsive neurotics and 1psychopath were studied on their mental symptoms both before and after the operation, the daily excretion ofutinary uropepsin and 17-KS.
(1) Before the operation, the uropepsin revealed high level with irregular fluctuation in all of the atypicalschizophrenics and either high level with large fluctuation or low level with flat curve among the schizophrenics. The manic-depressive patient showed low uropepsin level with a slight elevation in a manic phase, andthe epileptics showed either markedly high level with large fluctuation or normal level. In the mentallyretarded, high level with unstable excretion curve was obtained and in the obsessive-compulsive patients, lowlevel with considerable fluctuation was observed. The day-to-day excretion level of uropepsin in psychopathwas in normal range.
(2) In the most of the cases, two peaks appeared in the excretion curve of uropepsin which were obtainedduring 2 or 3 weeks after the operation. The first peak was assumed to be based on the non-specific reactionto the surgical intervention itself, and the second to be related to the mental and somatic symptoms due to theintervention on the frontal lobe.
(3) After two or three weeks of the operation, the excretion of uropepsin was stabilized and the effect ofthe surgery became manifest. The pattern of the excretion curves were classified into three groups as comparedto those obtained before the operation: i. e. the elevated, the decreased and the unchanged groups. In the firsttwo groups, the change sustained for a long period of time after the operation.
(4) The amount of urinary 17-KS excretion before the operation was in normal range in the atypicalschizophrenics, the schizophrenics, the mentally retarded, the obsessive-compulsive neurotics and the psychopath. Only the manic-depressive patient showed low values especially during the depressive phase.
(5) The 17-KS excretion curve measured immediately after the operation showed both the initial and thesecond peaks in one case and only the initial peak in 4 out of 12 cases.(6) The average values of the postoperative 17-KS were also classified into 3 groups as compared to thepreoperative level: the elevated, the decreased and the unchanged. In the first two groups, the change sustainedfor a long period after the operation.
(7) Discussions were made on the relationship of the results of the endocrinological measurements tothe emotional changes, the disease conditions and the effect of the surgery.

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