Divided renal function test has been recommended as an excellent diagnostic tool for unilateral renal hypertension. But the criteria of this test for unilateral renal hypertension; i. e. reductoin of urine volume over 50% and urinary sodium concentration over 20% as compared with mate kidney, is not always observed in clinical cases.
This report is based on the results of divided renal function studies in twenty-six dogs in which hypertension was produced experimentally with constriction of unilateral renal artery, and the results were compared with those of stop flow method performed in nine of the hypertensive dogs. The dogs were divided into three groups depending on the period of hypertension following constriction of unilateral renal artery; the first stage, until the tenth day after constriction; the second stage, from eleventh day to one month; and third stage, from one month to six months. Volume, acidity and osmolarity of urine, sodium, potassium and chloride concentration of urine, and C_PAH, C_IN and PSP excretion were examined.
Conclusions are as follows.
1) Results of divided renal function studies were varied depending on the stage of renal hypertension.
2) The criteria of the divided renal function test for unilateral renal hypertension; i. e. reduction of urine volume over 50% and sodium concentration over 20% as compared with mate kidney, was not observed in most of the cases. The fact results from concomitant reduction of function of mate kidney. Therefore such a critera is not considered practical.
3) Following results were obtained from the kidney with constricted renal artery.
In the first stage, decrease of urine volume, C_PAH, C_IN and PSP excretion, and increase of osmolarity, acidity, potassium and chloride concentration of urine, were noted in all cases and decrease or increase of urinary sodium concentration in some.
In the second and the third stages, decrease of urine volume, acidity of urine, C_PAH, C_IN, PSP excretion and urinary sodium concentration, and increase of osmolarity, potassium and chloride concentration of urine are noted.
4) Stop flow method revealed that these results were mainly dependent on difference of function of the distal tubule between both kidneys.
5) Unilateral renal hypertension in almost all clinical cases are similar to the experimental hypertension in the second and the third stages. Therefore, the results in these experimental groups can be applied to clinical cases.
6) The results of this experiment bring about a new broad criteria of the divided renal function test for unilateral renal hypertension by which the disease will be diagnosed more frequently.
7) From this study it can be said that the tubular function may be revealed by the divided renal function studies and that indication for conservative operation for unilateral renal hypertension will be decided.

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The causes of hydronephrosis submitted to plastic surgery in Japan are in majority of cases the stricture and abnormal vessel at the uretero-pelvic juncture (UPJ) (Tab. 2).
In the cases with abnormal vessel many a clinic in Japan choice the pyelo-ureteral plasty rather than the dissection of the vessel (Tab. 4). As to the technique of plasty Foley's Y-plasty is performed most often with fairly good results (Tab. 3). But it cannot always relieve the impaired hydronephrotic kidney as seen in the world literatures. The simpler method of v. Lichtenberg (Fig. 1), as was performed in the authors own 5 cases (Tab. 7; Fig. 2-4), proves also to be well to obtain good results as far as recovery of the function of the kidney and the upper urinary tracts is concerned.
To obtain a good result by plasty in hydronephrosis it is essential to establish proper indication for it. For this purpose it was studied clinically on several points: pyelograms, renal function by the method of intravenous pyelography, renal aortograms, open biopsies of the kidney, renal infection and movement of renal pelvis and ureter, before operation, and discussed here. Further, necessities of resection of the dilated pelvic wall was discussed.
The author has been reached to the conclusion, at present, that in the cases which have E-grade (according to the graduation made by Huzino in the authors clinic) hydronephrosis judged from the retrograde or percutaneous punctuating pyelogram, and in which any calyceal shadow in 60-minute delayed intravenous pyelogram, was displayed, and further when they show any movement rontgen-kymographially in the upper urinary tracts, the plastic surgery is indicative. Of course, the existence of renal infection should be considered. But, it is not wise to abandon plastic surgery because of intensive turbidity (pyuria) of the renal urine. Percutaneous renal biopsy, if possible, may help the selection. Though there is no necessity of resection of the dilated pelvic wall in up to D-grade hydronephrosis, it may promote the improvement (Fig. 7). The technique of plasty would be selected as on prefers. The essentials for the plasty are to recover and insure the smooth flow of urine and not necessarily to make better the cosmetic appearance.

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Among those patients conventionally classified under the category of ‘bladder neurosis’, there are, though in indefinite numbers, patients who have paroxysmal arhythm in their EEG, that is, patients who have diencephalic epilepsy (Gibbs) or epilepsy of brain-stem (Shimoda), i. e., so-called primary epileptic equivalent. These latter patients can be classified into two groups, (1) those who have no organic irregularities urologically but feel in their brain as if they had such disorders, and (2) those who have originally a defective diencephalon, but whose complex symptoms are brought about by some psychological provoking causes, such as trauma or unclean sexual intercourse, their diencephalons defect having no direct relation with their bladder symptoms. We should like to add, that there have been many who did not show any irregular EEG findings among those patients who have conventionally been classified under the category of ‘bladder neurosis’.

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This paper is to report two cases of papillomatous tumor of the renal pelvis and to add its statistic review of the past ten years.
Case I, a 70 years old male, was first seen by us in March, 1960, complaining of gross hematuria of ten days duration associated with nausea and thirst. Prior to this, he had had occasional episode of asymptomatic hematuria usually once in a month since about three years ago. As examinations revealed possible papillary growth in the right renal pelvis and ureter, his right upper urinary tract was removed surgically including a part of the bladder wall around the ureteral orifice. The pathological diagnosis was papillary carcinoma of high grade malignancy.
Case II, a 58 years old male, was first seen by us on October 6, 1960, complaining of occasional gross hematuria of one year duration. At the onset of this illness, he was seen at a hospital and hematuria was proved comming from the tumor of the left renal pelvis, but was left alone as hematuria stopped spontaneously. On admission, examinations revealed papillary growth in the left renal pelvis which already spread to the ureter. The pat ient was treated in the same way as case I and the pathological diagnosis was benign prpillomatosis.
During the past ten years (1951-1960), 143 cases of the tumor of renal pelvis were reported in our country. Here we presented additional two cases bringing the total number to 145. The ages of the 130 patients whose cases were recorded in the literature varied between four and seventy-nine years; 11 cases were between 71 and 80 years, 31 between 61 and 70, 41 between 51 and 60, 29 between 41 and 50, 10 between 31 and 40, 6 between 21 and 30, 1 between 11 and 20, and 1 undor 10 year of age. The majority were between 51 and 60 years of age and the male-female ratio was 111:19. The left-right ratio was 52:63 and only one case was reported bilateral.
The pathological diagnoses and their frequencies of the 136 recorded cases were as follows; papilloma in 41 cases (30.1%), papillary carcinoma in 46 cases (33.8%), transitional cell carcinoma in 21 cases (15.4%), squamous cell carcinoma in 19 cases (14.0%), basal cell carcinoma in 4 cases, adenocarcinoma in 3 cases and choriocarcinoma in 2 cases.

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A series of twenty cases was treated with Rowatirex. They are three ureteric and seventeen renal lithiasis, two of which existed bilaterally. The result: In case of ureteric stones, one passed spontaneously, one descended, and one did not respond. In case of renal lithiasis, spontaneous passage or disappearance of stone shadow was obtained in four cases, and reduction or decrease of stone was proved in three cases, but no significant changes were observed in nine cases, and three stones were enlarged. The side effects were seen in two cases as gastro-enteric disorder.

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