Roentgenograms are often utilized as offering the sole basis of endoscopic examination in the diagnosis of urological diseases, particularly in the disorders of the kidney and ureter. The position of the kidney, the shape of the pelvis and the course of the ureter present individual differences under various influences.
Embryologically, the kidneys lie in the pelvic cavity during the early stage, but they assume the normal position during the 8-9th fetal weeks. As to the shape of the renal pelvis, in addition to the well-known 3 types (adult) of Hyrtl, further detailed classifications have been proposed. There are still unsolved problems pertaining to the kidney, and it is necessary to investigate the true nature of such problems as abnormal position of the kidney and the formative process of the pelvis for the purpose of elucidating the diseases and pathology of this movable organ. The author has endeavored to study these problems by means of fetal pyelography in conjunction with autopsy findings. The results of observations have been compared with the findings recorded in the literature, which are here reported. A total of 100 specimens have been used as materials for pyelographic observations, comprising fetuses obtained from miscarriage or abortion between the 4th fetal month (16th fetal week) and 10th fetal month (40th fetal week) as well as still-born infants dying immediately after birth. Special emphasis was placed on the position, development, shape and other salient features of the renal pelvis; the observation was also made on malformations. The contents of the present investigation consist of tabulated data on the measurements obtained according to the fetal months and weeks, with statistical treatment, discussion on embryological problems within pertinent limits, together with consideration of pyelographic findings from various angles.
1) The various measurement curves in regard to the kidney and pelvis, the bisecting line of the vertebral bodies was taken as the first base line, while the conjugate of bilateral iliac crests as the second base line.
2) For the theoretical consideration of the embryology of the kidney and ureter, a new inter-pretation has been inducted on the basis of the literature.
3) The length of the long axis of the pelvis increases gradually from 1.0cm in the 4th fetal month to about 2.5cm in the 10th month. The left kidney shows a better development than the right during the fetal period.
4) The area of pelvis was measured by the reproduced projection method as well as by the use of a planimeter. The left side appears to develop normally but the right side shows some irregularities, probably due to frequent presence of cauliflower-shaped pelvis ci the right side during the first half of the fetal period. However, during the 10th month, both sides appear to grow rapidly.
5) For determining the position of the pelvis, the rectangular locus of the center of the long axis of the pelvis. The first base line in such a case is Y axis, while the second base line is X axis. The locus gradually ascends at approximately similar angles (slightly greater than 45°) from the 4th to the 10th month. Furthermore, the ratio of X to Y in this rectangular coordinate differs according to each fetal month. Thus, by calculating this ratio a comparison can be made with the adult pelvis.
6) The angle subtended by the so-called pelvic long axis and the bisecting line of the vertebraris 2.63° (left) and 3.17° (right), the values approximately 1/4-1/6 of the measurements made by Yamanouchi and Hirose. This fact signifies that the kidneys in the fetal period are in a vertical position.
7) The volume of fetal pelvis is extremely small as compared to that of adult and it is difficult to express its exact numerical values. Although there may be variations according to the stage of development, it may be proper to consider it to be 0.1-0.6cc.
8) The fetal pattern of pelvis has been clas

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The author and his collaborators have reported that tuberculosis patients show a high percentage of Nagata and Yamamoto's metachromatic reaction of urine and the reaction of the renal tuberculosis patients becomes gradually negative following the elapse of time after nephlectomy. Colorimetric investigation was also made on the changes produced in the tone of the coloring of the reaction.
In the present paper, macroscopical and colorimetric observations were made on the metachromatic reactions of the urine collected prior to and after the inoculation of tubercle bacilli, a human strain H₃₇RV and a bovine strain Miwa, into the auricular vein of 7 normal rabbits and into the left renal artery of 5 normal rabbits. As control, 1 to 3cc of physiological saline was inoculated into either the auricular vein or the renal artery of 4 normal rabbits. As staining solution, carbol fuchsin or carbol nilblue was used. Stated in the following are the results obtained thereof:
1. When carbol fuchsin was used as staining solution:
All the 7 rabbits received the inoculation of tubercle bacilli into the auricular vein presented positive metachromatic reaction by the end of the 4th week after inoculation. While, all the 5 rabbits received the inoculation into the renal artery showed positive reaction before the end of the 3rd week. Colorimetric findings confirmed the results of macroscopic observations.
2. When carbol nilblue was used as staining solution:
Metachromatic reaction of all the rabbits received the inoculation of tubercle bacilli either into the auricular vein or into the renal artery became positive within 3 weeks after inoculation.
3. While, the reaction of all the control rabbits received the inoculation of physiologicalsaline either into the auricular vein or into the renal artery remained negative.
4. When carbol nilblue was used as a staining solution of the metachromatic reaction of urine, a distinct difference was produced between the positive and negative reactions immediately after starting the test, but the tone of the coloring of reaction easily changed following the elapse of time.
On the other hand, little changes were produced in the tone of the reaction when carbol fuchsin was used as the staining solution.

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In the previous paper, a report was made on the findings of the metachromatic reaction of urine collected from the rabbits experimentally infected with tubercle bacilli. In the present paper, pathohistological findings of the rabbits used in the above experiments will be discussed in relation to the findings of metachromatic reaction of their urine.
Leasions produced in the rabbits inoculated with tubercle bacilli into the auricular vein were heavy milliary tuberculosis of both lungs and mild one of the liver and the kidney. No lesions were detected in the ureter and the urinary bladder.
While, the lesions formed in the rabbits inoculated with tubercle bacilli into the left renal artery were mostly heavy milliary tuberculosis of both lungs and the left kidney with mild lesions in the liver. In some cases, however, tuberculosis nodules were formed in the left ureter and the urinary bladder.
No lesions other than tuberculous changes were observed in the experimental rabbits and no lesions were detected in the control rabbits.
In view of the findings stated above, together with the results of previous study, the author believes that the presence of tuberculous lesions in the viscera is one of the most important factors to cause positive metachromatic reactions of urine.

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The authors have reported a case of enuresis which presented an epileptiform EEG. This case is a kind of epileptic equivalents and may be called “vesical epilepsy”. Anticonvulsanttherapy was very successful in this case.

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A 42 year old man, complained dull pain in the left side of his abdomen.
Urological examinations revealed that he had bilateral complete duplication of renal pelvis with complete duplication of ureter which uncrossed and opened in the bladder in such a way as violates Weigert-Meyer's law.
And there was slight hydronephrosis with renal calculi in the upper renal pelvis on the left side.
During the operation, there suddenly was unreversible cyanosis in lower part of the kidney caused by the pressure of abnormal renal artery, and then nephrectomy was performed. Renal calculi were composed of calcium phosphate.
In general, the duplication of renal pelvis and ureter is not so rare.
In Japan clinically 44 cases of bilateral duplication of renal pelvis and ureter have been reported on.
Moreover, those cases violating Weigert-Meyer's law have been only 4 in number (unilateral 3, bilateral 1.).
The present case seems to be the second one concerning the bilateral violation in Japan.

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A vesical agenesis in human boody is supposed to be one of the rarest malformations throughout the world. This is clearly shown that in Japan we have never seen and heard such a rare fact in our life. But fortunately recently we writers were given an opportunately to study, operate and cure such a patient in our Medical College and so we consider it our duty to report to the readers who are interested in this case.
A female-26 years of age-was sent to our hospital “clinic” to consult doctors on May 16, 1956 with a chief complaint of pain of micturition and incontinentia urinae.
Her past history in illness-Nothing particular was seen. She was easily delivered of her child at the completion of her maturity.
But after her delivery, her urethra was occluded and urine was incessantly leaking from her vagina (female organ). Doctors who were in charge of the patient decided to operate the affected part of the disease. After both excretory urogram and pneumo-retro-peritoneum it was suggested that her bladder, left kidney and left ureter completely lacked and it was ascertained through surgical operation, and her right ureter was considerably dilated and had its size feeling as if it were common bladder in appearance. No other malformation was found in this case of internal sexual organs, spinal column, liver and gastrointestinal tract etc.
Then ureterosigmoidostomy was introduced in this place, on May 26, 1956 and thanks to our strict precaution against hyperchloremic acidosis and urinary infections, it was proved that all blood urea nitrogen and minerals were in the normal conditions.
Her convalescence was uneventful contrary to our expectations with a slight symptom of pyelitis, and she has soon recovered her health and resumed her home without any anxiety.
We are glad to report here this abnormal case with much interest; because such a case is extremely rare and furthermore the patient has grown up to be an adult in good conditions with a successful result through ureterosigmoidostomy.

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We recently experienced two-cases of the sponge kidney. The first case has been reported by Sato & Kawaji in 1957, which were associated with bilateral multiple renal calculi.
Generally the sponge kidney are not infrequently associated renal calculi, therefore differential diagnosis is to be made from the NEPHROCALCINOSIS and the NECROTIZING PAPILLITIS or RENAL PAPILLARY NECROSIS.
These lesions appear on X-ray similar each to other.
Ammonium chloride tolerance test, pneumopyelography during operation, and discovery of multiple cysts in renal pyramids on specimen are the points of differentiation.
Literatures were reviewed and the formely reported cases were collected and shown on table.

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