A resume of investigations on urethral stricture as outlined in the reports of Rrof. Tabayashi and Midorikawa was published by our department in 1958. It was then noted that in the area of urethral stricture a definite sequence of changes was taking place in the locations neighboring the connective tissue and its arteriolar walls. The present report is concerned with the details of these changes.
Urethral stricture has hitherto been regarded as a sequela of gonorrhoeal infection, but at present there is an increasing incidence of traumatic origin, which, though somewhat differing according to geographic locations, is largely due to the rapid advances in mechanical civilization such as heavy industry, skyscraper construction and automobile manufacture. Tuberculosis also plays a role in a relatively small percentage of cases. There is also a group of urethral stricture in which the cause is unknown as judged from the past history or routine examination. A statistical summary of all cases seen in our department is herewith attempted:
Etiological incidence of urethral stricture (%) during the 10 year period
The stricture occurred at the bulba and pars membranecea urethra in 35 cases, while it involved the anterior urethra in 5 cases.
The materials for the present investigation consisted of the transverse or longitudinal serial sections prepared from 1-4.5cm circular blocks of stricture tissue obtained from these 40 patients. The sections were stained by 10 different methods, namely hamatoxylineosin, Van Gieson's stain, Weigert's method, Mallory's stain, Mallory's phosphotungstic acid-hematoxylin stain, PAS stain and others.
The general and pathological findings of the tissue may here be omitted, since they agree fairly well with the description published by Midorikawa in his on “Clinical and histopathological studies on urethral stricture” (Japan 'J. Urology, Vol 49, No. 11, 1958). Of the histological observations those presenting various changes of peripheral arterioles may be classified as follows:
This table indicates that the cases with vasculitic type are by far most numerous, followed in order by those showing hypertrophy of middle layer and sclerrotic changes, while only a few presented no systematic changes.
These changes may be summarized as follows:
1) Internal meatus. The internal meatus presented varying degrees and shapes of narrowing, such as central or marginal, oval or similunar, narrowing as well as dendritic or even obstructive in nature. Occasional thrombosis containing erythrocytes and desquamated endothelial cells.
2) Internal layer. The internal layer was seen to have undergone hypertrophy in various manners, such as fibrotic and proliferative hypertrophy, or hyaline degeneration, producing the narrowing of the internal meatus.
3) Middle layer. The middle layer exhibited pictures of degenerative changes In almost all cases, including the irregularities in the arrangement as well as swelling, dissolution and even disappearance of smooth muscles.
4) External layer. The extanal layer wes generally indistinct in appearance, although there were a few wick presented fibrotic proliferation or cicatrization.
5) Many cases showed cellular infiltrations, hypertrophied internal layer and degenerative changes in the middle layer, while inflammatory cellular infiltrations around the blood vessels were frequently encountered. Generally speaking, the infiltrative changes were most remarkable in the perivascular areas. These cells were recognaized to have migrated from the internal layer into the perivascular tissues, or from the perivascular areas into the vessel walls.
6) Elastic fibers. There were many instances of vasculitic type in which degenerative pictures consisted of semicircular remains of tissues resulting from the well demarkated partial. dissolution or disappearance of swollen, proliffiferative and internal elastic layer.
In addition to the above cases, the

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In 1953 Nagata and Yamamoto developed a method for carrying out the metachromatic reaction (the term “metachromatic reaction” will be referred to as “MR” in this paper) on the urine. The results of experiments initiated in this department have already been reported by these investigators respectively. In this country the results of follow-up studies on the “MR” have been recorded. Making a study on a substance in the urine which took on a blue color in the presence of Nile blue, J. Desbords et al. of France in 1952 presumed that the substance responsible for the change of color would be a free fatty acid with more than 16 carbon atoms. Previously Yamamoto et al. undertook follow-up studies thereon according to the methods of Inouye and Noda. The methods were modified by Fujii who made a basic study on the basis of the follow-up studies. Tne author using Fujii's modification of the methods has isolated and identified higher fatty acids from the blood, serum and urine of 34 cases of urosis, particularly nephrotuberculosis and 20 healthy subjects as well as from the urine of 15 cases of non-tuberculous urosis. At the same time the “MR” was per formed on the urine samples in an attempt to seek a relationship between higher fatty acids and the “MR”. The fat loading test was carried out on one case of nephrotuberculosis and one healthy subject. Some findings were noted when similar observations were made. It is the purpose of this paper to describe the findings.
Methods and Materials.
In the early morning 7cc of blood was collected from the cubital vein of 54 subjects on a fasting stomach respectively, including patients and healthy people. Two cc of the blood was used. Serum was isolated from the remaining blood and 1-cc serum samples were prepared. At the same time as the blood was taken, urine was collected and 100cc of it was concentrated to 5cc on a boiling water-bath. The urine samples thus prepared were employed. The original method for carrying out the “MR” was applied to a part of the urine samples and the estimation of the results was macroscopically made. Experiments were carried out only on the urine samples obtained from 15 cases of urosis. The fat loading test was performed on cases of nephrotuberculosis who always presented the positive “MR” and on 2 healthy subjects in whom the “MR” was always negative. Each sample obtained from the subjects was placed in a flask used for hydrolysis and 50ml of a 6% KOH solution was added. The resulting solution was heated at 100°C for about 3 hours for saponification. After cooling 20ml of 7N H₂SO₄ was added to result in the production of free fatty acids. The sample was transferred to a triturium in which the free fatty acids were extracted twice with 30ml of petroleum ether. The ether extract was washed twice in water and thrice in ethylenglycolglycelin-water (1:1:1) and the washings were discarded. The ether layer was heated to 60-70°C to remove ether. The residus was dissolved in 0.2ml of ether alcohol by heating. In a capillary tube about 0.02ml of the resultant solution was collected and drops of it were applied on the original point of defatted and dried filter paper No. 50, Toyo Filter Paper Co., Ltd. Paper chromatography was thus performed accordiding to Fujii's modification of the methods. The suspected fatty acids were identified by comparing the Rf values thus obtained from each sample with the Rf values of high fatty acids standardized by the author. These suspected fatty acids will be referred to as fatty acids in this paper.
Results.
1) Group of healthy subjects:
Two or three spots representing each fatty acid were demonstrated when paper chromatography was carried out using the blood and serum samples from this group. There were 26 spots representing 2 saturated fatty acids, including petargonic acid; 26 spots representing 3. u

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