In this paper an attempt was made to modify the common concentration test of renal function with posterior pituitary extract. Further the studies were intended to judge the segmental function of the water dependent nephrons by using the creatinin and the osmoral clearances at the same time during the above test. In the test, the input and the output of body fluids were adjusted every 30 minutes to maintain the level of body fluids. Two hours after the initial intake of 600ml water, 100mu of atonin, the posterior pituitary extract was subcutaneously administered. In 26 healthy adults the difference of the values of specific gravity before and after the administration of atonin was 15.0±3.9.
In these experiments the osmotic pressure and the volume of the urine were investigated. It was found that the mechanism of the “Atonin test” was quite similar to that of the concentration test and that the specific gravity method served better than the urine volume method as an index of osmotic pressure which represents the concentration of urine directly. Although from the stand point of technical errors in the measurement, the osmotic pressure and the urine volume methods were more accurate than the specific gravity method.
In the same experiment the creatinin clearance, the difference of creatinin u/p ratios before and after the administration of atonin, the dffference of osmoral u/p ratios before and after the administration of atonin and the creatinin/osmoral clearance ratio were investigated. In healthy adults the mean value of each of these 4 investigation subjects was 98.0±13.7ml/min., 61.6±25.5 1.55±0.40 and 42.0±10.2 respectively.
Since the creatinin clearance represents GFR, the difference of creatinin u/p ratios the reabsorptive function of the total renal tubuli, the difference of osmoral u/p ratios the selective reabsorptive ability of the distal tubuli and the creatinin/osmoral clearance ratio principally the obligative reabsorptive ability of the proximal tubuli, —though in the last ratio the osmoral diuresis caused by exogenous osmotic substances, urea or salt should be excluded—the renogram which is shown by the creatinin clearance and the indices of water reabsorptive ability is also helpful in judging the segmental function of the nephrons. The fact that indices of water reabsorptive ability does not require the measurement of urine volume and much specimen is of great advantage to study the differential renal function.

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The bleeding due to honvan therapy is an extremely rare side effect, and the following case is the third report following Schwerdtfeger's and Balogh's case.
S.O., a 58-year-old man. For 2 years the patient suffered from prostatic cancer and bone metastasis. Following castration, the injection of honvan was given the patient for the period from May 2, 1961 through May 26, 1962 in the following manners;
the 1st course 250mg per day 20 times,
the 2nd course 250mg per day 15 times,
the 3rd course 250mg per week 12 times.
Each course brought a good effect and the size of prostate was reduced. Besides complaints around his loin and chest became less and less, and the serum acid phosphatase, which had been high in the early stage (2.55 BL units), finally returned to the normal level.
Five months after the above injection, the patient started to complain about a mild pain in the regions, and the level of the serum acid peosphatase rose slightly again (0.80 BL units). In the 4th course, honvan 250mg per day was injected 20 times intravenously from Oct. 15, 1962. This course however did not bring any decrease fo the level of acid phosphatase (1.16 BL units). On the next day (Nov. 15, 1962) after the last injection gingival bleeding and purpura on the dorsum of his right hand appeared.
The laboratory findings were as follows; erythrocyte 426×10⁴, hemoglobin 13.3g/dl, hematcrit 43%, thrombocyte 392×10³, leucocyte 13800 with 35% band neutrophils, 46% segmented neutrophils, 0% eosinophils, 13% lymphocytes, 6% monocytes and toxic granule of leucocyte, TTT 6.6, Kunkel.
20.0, bleeding time 2min., coagulation time 11min.-18min., Rumpel-Leede (-), serum plasmin index 7min. and 30sec., and blood pressure 120/85 mmHg.
Because of the insisting high level of serum acid phosphatase (2.29 BL units), while remission of bleeding was brought without having any treatment after 3 weeks of the symptoms, the 5th course of injection was given him from Dec. 7 as follows; drip infusion of honvan 500mg every other day 6 times. On the last day (Dec. 19) of the above. injection, the bleeding at the point where the needle was inserted and the gingival bleedig started, and the former continued for 2 days, in spite of medical treatment to stop it. On Dec. 21 the patient started to vomit and came into the conditions of mist vision, and repeated the drawing of deep breaths which was followed by come. And then he was exhausted about 5 hours later.
The patients experienced episodes of bleeding mostly in the form of hypodermal or gingival bleeding. The symptom was reversible and a remission was brought in all cases but the 2nd episode of ours that drove the patient to death under the symptoms suspicious of intracranial bleeding. The Schwerdtfeger theory that toxic substances from destroyed tissue of prostatic cancer and metastasis injure liver and blood vessel and increase the bleeding tendency is generally accepted.

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