It is well known that prostatic serum acid phosphatase (PSAP) is elevated in case of prostatic carcinoma with metastasis. Diagnostic value of PSAP for early prostatic carcinoma, however, has not yet been well established. Some doubt is left on the specificity of elevation of this enzyme activity in early prostatic carcinoma. There have been no reports on incidence of elevation of PSAP in noncancerous prostatic diseases.
Numerous investigations have confirmed that serum acid phosphatase activity is elevated transiently by surgical attack, injury, infarction and/or manipulation to normal and abnormal prostatic gland. These facts suggest that elevated PSAP activity may not be specific to carcinoma of the prastate and that it may only indicate presence of various pathological changes of the prostate gland because prostatic acid phophatase is specific to prostatic gland. Therefore, the author make studies to elucidate clinical significance of elevated PSAP activity: 1) relation of changes of the enzyme activity in prostatic tumor tissue and those in serum: 2) relation of these changes and histological features of the prostate: 3) estimation of PSAP activity in 331 patients with various prostatic diseases and 188 normal subjects.
Results are summarized as follows:
1) There are no distinct differences in tissue contents of the enzyme between benign hyper trophy and malignant tumor of the prostate.
2) No relation is noted between PSAP and contents of the enzyme in tissue in the case of adenoma as well as carcinoma of the prostate.
3) Elevation of PSAP was noted in 81.5% of prostatic carcinoma, in 18.0% of non-cancerous prostatic diseases and in 6.3% of normal subjects.
4) In non-cancerous prostatic diseases, elevation of PSAP was shown in 44.4% of benign. prostatic hypertrophy with inflammation, in 25.0% of prostatitis and in 3.6% of benign hypertrophy, with average of 18.0 per cent.
5) In prostatic carcinoma, elevation of PSAP was shown in 73.3% of early carcinoma and. 96.0% of untreated advanced carcinoma.
6) Elevation of PSAP is not specific to prostatic carcinoma, but is noted in various other non-cancerous diseases of the prostate because prostatic acid phosphatase is organ-specific to prostate gland, and its elevation in serum only indicates presence of pathological changes of the prostate gland.
Elevation of PSAP results from translation of the enzyme from prostatic tissue to circulation. Destruction and increase of permeability of glandular cells are among causes of enzyme translation.

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Statistical observations were made of 800 cases of urological diseases on the red blood cell counts, and the following results were obtained.
1) 42.1 per cent of the cases investigated had red blood cell counts of less than 4, 000, 00031 and 7.0 per cent less than 3, 000, 000. 1.6 per cent showed red blood cells of more than 5, 500, 000.
2) Anemia was more frequently found in women than in men and in the age than in younger-persons.
3) A marked association of anemia with malignant tumors was found irrespective of the sites of tumors.
4) The frequency of anemia was the highest in diseases involving both kidneys, followed by diseases of one kidney, diseases of the lower urinary tract, and the frequency was the lowest in diseases not involving the urinary tract.
5) Anemia was mostly hyperchromatic, macrocytic and hyposaturated, and did not show anysignificant relationship with leucocytes picture.
6) No relationships were found among anemia, hematuria and albuminuria. A tendency to hypoalbuminemia and hypergammaglobulinemia was found in cases associated with anemia.
7) A significant, but not definite correlation was found among red blood cell counts, NPN, RPF, RBF, PSP values at 15 minutes and 2 hours, and the Fishberg concentration test.
9) 23.8 per cent of the cases presenting anemia showed increased red blood cell counts after-operations, 72.4 per cent showed unchanged counts, and only 3.8 per cent showed decreased counts.
It was made clear that urological diseases of the kidneys are responsible for a considerable percentage of anemia. A review of literature was made on its pathogenesis, and it was emphasized that the problem of anemia due to urological diseases of the kidneys deserves much attention in future urology.

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This paper presented 3 cases of renal tumor with atypical x-ray findings.
Case 1. 33-year-old female complaining merely of relatively intensive hematuria on the day before consultation. Nothing remarkable concerning to the renal tumor was caught on the retrograde pyelogram though the nephrogram was larger (Fig. 1). Neither pneumo-retroperitoneum nor renal aortogram revealed the existence of it (Fig. 2). Retroperitoneal exploration under the diagnosis of essential renal bleeding with suspicion to the tumor proved a small renal tumor (3×3cm in size) at the lover pole (Fig. 3).
Case 2. 57 year-old female complaining of renal mass and hematuria. A large fist-sized spherical tumor, the center of which was partially necrotisized, was confirmed in the upper half of the nephrectomized kidney. Pyelogram, taken before operation, was downward and medially displaced and distorted. Along the upper margin of the upper calyx, which was elongated and slender in some degree, slight destruction was suggested (Fig. 5). Aortography suggested a renal cyst: there was no pooling; there ran one vessel in arc along over the upper margin of the tumor; and the mass was not denser on the film than the nephrogram (Fig. 6). This case was interesting from the standpoint of differenial diagnosis between renal tumor and cyst.
Case 3. 32 year-old male comlaining of severe pain and large smooth mass in the left abdominal aide. He never noticed hematuria. On pyelogram there was almost nothing pathological in its structure but its displacement (Fig. 7). On operation a tumor was found in the lower part of the kidney developing vigorously downwards and medially outside of the kidney. The kidney and the tumor were together enclosed in a thick fibrous capsule containing bloody discharge: bloody perinephric cyst (Fig. 8).
Histologically Case 1 was of adenomatous clear-cell carcinoma (Fig. 4), Case 2 was of typical hypernephroma and Case 3 carcinoma simplex. Case 3 might be of secondary invaded remal tumor, the origin of which might be retroperitoneal one. But there was no definitive proof to it.
Accurate diagnosis was scaresly made before operation in some cases like ours even by various x-ray examination.
From our experiences it must be stressed that one should explore kidney without hesitation in any suspicious cases of renal tumor.

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On the 16 cases of adrenal disease which had been operated, the X-ray findings were compared with the operative findings.
In the 7 patients who had been proved to have tumors by operation, all the tumors were found on the pre-operative X-ray films.
On the contrary, in 8 of the 11 patients who had been proved or conjectured to have tumors by X-ray films, the tumors were found at opertion.
The best method of X-ray examination is pneumoretroperitoneum with the use of tomography.
Within 4-6 hours after injecting 1200-1600cc oxygen, “plain film, ” “tomography” and “pyelography” are performed. Tomography is done every lcm from 5 to 10cm at dorsal position.
Pyelography and aortography are very useful for the diagnosis of pheochromocytoma.

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Many clinical observations were reported on the neurogenic bladder, still there could not be found any experimental work on the relationship between the function of the urinary bladder and the injured part of the nerve innervated to it.
Hence, to clarify this problem, I have tried to examine the cystometrogram obtained on the adult dog received various section of the nerve innervated to the urinary bladder, e. g., the uni- or bi-lateral section of the pudendal, hypogastric, or pelvic nerve, and furthermore, the uni- or bi-lateral resection of the ventral, dorsal, ventral and dorsal root, and the spinal ganglion of the sacral nerve, respectively. The results obtained were as follows:
1) With the retrograde cystometry, when it was performed in the constant experimental condition, the disturbance of the vesical motility and its recovering sight were significantly analyzed.
2) The disorder of the vesical function following the unilateral section of the nerve were recovered almost to the nomal state.
3) The characteristic cystometrogram and the autonomic contraction wave were found following the bilateral section of the nerve. And we could discriminate the resected part of the nerve with the read on the cystometrogram, significantly.
4) On the cystometrogram, there was remarkable difference between the case with the bilateral section of dorsal root of the sacral nerve and the bilateral resection of spinal ganglion of that nerve.
5) With the bilateral section of the pudendal nerve, the pressure of the inner urethral sphinctor was decreased, while the inner pressure of the urinary bladder was rather increased.
6) To interpret the vesical function with the cystometrogram, the course of the curve, vesical volume and inner pressure at the micturition, contractive power of the vesical wall, and the characteristics of the autonomic contraction wave should be carefully analysed with the relation of each other.

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