Transperitoneal implantatioms of MH 134 hepatoma Yoshida sarcoma and AH 130 hepatoma in the urinary bladder were attempted in rats.
The results obtained were as follows:
1. In MH 134 hepatoma experiment, when the tumor tissue was used for implantation, successful transplantation was done in 24 out of 25 animals (95.6%) and when ascitic fluid was used, the experiment was successful in 100%. In Yoshida sarcoma experiment, all implantations were successfully taken. In AH 130 hepatoma experiment, tumor tissue implantation was successfully done in 25 out of 26 (96.2%) and when ascitic fluid was used was successful in 23 out of 29 animals namely in 79.3%.
2. Macroscopic findings demonstrated tumorous enlargement of the bladder, the findings most pronounced in Yoshida sarcoma experiment and more so in the cases kept longer after the transplantion.
3. Histological characteristics of the transplanted tumor differed according to the method of the transplantation and original tumor used. In MH 134 hepatoma tissue transplantation experiments, changes observed were limited in the submucosa and in ascitic fluid implantation animals demonstrated stratified mucosal membrane and intramucosal cancer cell infiltration. In Yoshida sarcoma experiments, in both sarcoma tissue implantation and ascitic fluid implantation, demonstrated partial falling off of the mucosa or tumorous changes in the mucosa accompanied with submucosal change. In AH 130 hepatoma experiments, sloughing of the mucosa and tumorous changes of the mucosa as well as the papillomatous projection of the mucosa into the bladder lumen were observed. The most severe changes were noted in Yoshida sarcoma experiment group and the longer the time of the experiment the more pronounced the findings.
4. Ascites occurred, in transperitoneal transplantion in urinary bladder, in 55.6 to 58.3% in MH 134 hepatoma experiments, in 50.0 to 53.8% in Yoshida sarcoma experiments, and in 39.1 to 44.0% in AH 130 hepatomo experiments. The longer the animals were kept after the transplantation, the higher the rate of occurrence of the ascites.
5. In transperitoneal transplantation experiments, hydroureter occurred in 66.7 to 70.8% in MH 134 hepatoma group, in 61.5 to 75.0% in Yoshida sarcoma group, and in 60.9 to 92.0% in AH 130 hepatoma group. The extent of the developed hydroureter apparently depended upon the length of time following the transplantation.
6. The swelling of the retroperitoneal lymph glands was observed in all cases except one case of the successful transplantation.
7. The average survival days of the tumor transplanted animals were 19.3 days in the case with MH 134 hepatoma in tissue mass, and 17.4 days in the ascitic fluid; 19.1 days in the case with Yoshida sarcoma in tissue mass, and 16.1 days in the ascitic fluid; 20.6 days in the case with AH 130 in tissue mass, and 19.3 days in the ascitic fluid.

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The biochemical approaches were adopted for studies of connestive tissue formation in human prostate, under the comparison of histological figures.
The results were obtained stoichiometrically as follows:
1) Of the amount of collagen in human prostate, prostatic hyperplasia, especialy on the case of fibro-mascular type was shown higher value than normal.
2) By the fractionation of collagen obtained from hyperplastic and normal prostate, about 85% of collagen was belong to insoluble collagen and 15% was obtained as soluble fraction.
3) The total amount of mucopolysaccharides in prostatic hyperplasia showed much higher value than normal prostate.
4) In order to compare the component of MPS between hyperplastic and normal prostate, the fractionation of MPS was studied. The results were shown that hyaluronic acid fraction was much higher in hyperplasia than in normal and chondroitin sulfate fraction was not so much elevated in hyperplasia, but heparine value was much lower in hyperplasia than in normal.
5) On the enzymatic studies, we determined activities of MPS synthetic enzymes, such as glutamine-hexose 6-P transamidase, glucosamine 6-P acetylase, P-glucosamine mutase, P-glucomutase, and UDPG-dehydrogenase. Both pathways, hexosamine and hexuronic acid synthesis, exist in prostate, and moreover we found that glutamine H6P transamidase activity in hyperplastic prostate was 200% as high as normal and the activities of other enzymes also showed high specific activities in hyperplastic prostates.
The pathological meanings about elevations of MPS synthetic enzyme activities in prostate hyperplasia discussed in this paper.

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Histological and biochemical examinations on the testicular tissue of 30 adult dogs were performed 1 to 21 weeks after unilateral section of the various nerves innervated to it; e. g., the section of the ventral roots, the dorsal roots, both the ventral and dorsal roots of D₁₃-L₂ spinal nerves, the resection of the spinal ganglions of that nerves, and the section of the hypogastric nerve, respectively.
The results obtained were as follows:
1. After unilateral section of the ventral roots, the germinal cells were decreased remarkably and spermatogenesis was stopped completely, while rather significant change in the interstitial tissue could not be found.
2. After unilateral section of both the ventral and dorsal roots, the tubular basement membrane was markedly thickened and the germinal epithelium was composed almost entirely of Sertoli cells. The interstitial connective tissue was increased in amount.
3. After unilateral section of the dorsal roots, the germinal cells were disintegrating. The interstitial tissue revealed rather edematous sight.
4. After unilateral removal of the spinal ganglions, no remarkable change was observed in the tubules, while edema of the interstitial tissue were recognized. The interstitial cells were significantly increased.
5. After unilateral section of the hypogastric nerve, the germinal cells were considerably decreased. The interstitial tissue revealed rather edematous sight.
6. In general, Qo₂ and Qco₂ of the testicular tissue were increased after section of the various testicular nerves, especially, after the section of both the ventral and dorsal roots.
Remarkable changes in Qo₂ and Qco₂ after removal of the spinal ganglions or section of the hypogastric nerve could not be recognized.
7. Succinic- and lactic- dehydrogenase activities were generally decreased after section of various terticular nerves, but the ratio of them were increased corresponding to the changes in the interstitial tissue, for instance, in the case with section of both the ventral and dorsal roots, the case with section of the dorsal roots or removal of the spinal ganglions. As mentioned above, the characteristic chages in the histological and biochemical aspects of the testicular tissue were observed corresponding to the kind of the nerve resected.
And furthermore, it was assumed that these changes would be produced by the direct reaction of the testicular tissue due to the section of the nerves.

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Fifty-five transurethral resections were performed on 46 cases of bladder tumor in the period between November 1959 and March 1964, at the Jikei University Hospital.
The operative technique consists of removing all the tumor tissue down to the level of the bladder wall at first, and the base is then resected carefully, attempting to resect down to the halfway level of the bladder muscle layer, usually to the depth of one loop.
We stage our tumors as to depth of extension according to the method of Jewett. The staging of tumors by transurethral biopsy and bimanual pelvic examination is extremely important from not only a prognostic but a therapeutic viewpoint.
We follow the histological grading as classified by Royce and Ackerman, namely, Grades I, II, III and IV. Grade I is not malignant except for the tendency to recur.
The ages of the patients varied between 28 and 78 years; the average age at operation was 58 years. Men predominated over women 39:7, or 5. 6:1.
The sterile distilled water was used as irrigating fluid in majority of the cases to prevent implantation of the loose tumor cells to the vesical or urethral mucosa.
The biggest tumor tissue resected weighed 30 grams, but the average weight was 3.4 grams.
The length of the time needed for the resecting procedure varied between 5 and 70 minutes: the average time was 28 minutes.
The average blood loss was about 68cc during the resecting procedure, macroscopic hematuria disappeared in 3 days and indwelling catheter was removed on the 3rd postoperative day on the average.
The venous blood specimens were taken before and immediately after the resecting procedure to examine the changes of the serum Na, K, Cl and BUN levels. The serum Na decreased 1.5mEq/L. Cl decreased 1mEq/L, BUN decreased 0.4mg/dl and only K increased 0.2mEq/L on the average after the resecting procedure.
The operative and postoperative complications consisted of 31 urinary infections, 3 vesical perforations, 2 serum hepatitis, an acute cardiac failure, an acute pneumonia, an urethro-rectal fistula, an epididymitis and a meatal stricture.
The histologicol pattern of the tumors in this series consisted of 40 transitional cell carcinomas, an undifferentiated carcinoma, an epidermoid carcinoma, 2 adenocarcinoma and 2 mucinous adenocarcinomas. Their depth of infiltration according to the Jewett's staging were: stage 0 in 13 cases, stage A in 7 cases, stage B1 in 10 cases, stage B2 in 8 cases and stage C in 8 cases.
The low grade and low stage group revealed best survival rate; 21 of the 24 cases or 84% have been surviving more than 13 months and 19 of them are known to be free of tumor. The others are: low grade and high stage group 50% and high grade and low stage group 50% and high grade and high stage group 54%.
Though my experience is still limited and follow up period is not long enough, I feel that transurethral resection is the treatment of choice in the vast majority of bladder tumors, especially for treating low grade and low stage lesions.

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Physiologic changes were observed following infusion of distilled water, 5% glucose and isotonic sorbitol-mannitol solution in dogs in order to clarify the cause and nature of the so called transurethral resection reaction. Thirty six dogs in total were divided into 3 groups. The infusion rate was relative rapid, 2.5cc/kg./min. in each group.
Marked bradycardia and elevation of systolic blood pressure were observed in every cases, especially in the group of distilled water. Decrease of hematocrit was marked in the distilled water group but not in the isotonic solution groups. Rapid decrease of blood pressure was not seen in every case in spite of marked hyponatremia. Active sodium loss through the kidney was not demonstrated in the isotonic solution groups, by means of sodium clearance change within the volume of absorption which is considered to occur actually in TURP. No marked difference was found between 5% glucose and sorbitol-mannitol solution on physiological changes.
It is preferred to avoid the use of distilled water as an irrigating fluid in TURP, considering the appearance of earlier and severe reaction.

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In the urology area, when these kinds of diseases -renal tumor, prostate hypertrophy, cancer of prostate and cancer of urinary bladder, which are necessary to be operated upon for, are treated, disorders of renal function are perceived in pretty degenerated conditions. Though they are different from one another in their degree of aggravation, these disorders are discovered even before operation. In this respect, these disorders are different from other surgical ones. These disorders are found rather in aged persons than in young ones. The operation for these diseases gives metabolism a considerable change, and on this occasion the excretion of potassium increased in the urine after operations, as one of the fundamental changes in the waterelectrolyte metabolism. After the impaired of renal function and aged persons undergo an operation, it can be supposed sufficiently that their serum potassium and Ke will undergo a greater change than those of healthy renal and younger persons.
Before and after operation, practicing nephrectomy (renal tumor), ileocystoplasty after Tasker modified methode and Scheele's methode (remaining kidney tuberculosis and contracted bladder), partial cystectomy (cancer of the urinary bladder), total cystectomy with ureterocutaneostomy (cancer of the urinary bladder), and adrenalectomy (primary aldosteronism), I have recently pursued the change of serum potassium and total exchangeable potassium and brought about the following results:
1. With the change of serum potassium shown in the cases of the impaired renal function before operation, only one case showed hyperkalemia, and all the others were in the normal range, and the difference from the cases of normal renal function could not be found. In one or two weeks after operation, a few of the cases of cancer of the urinary bladder showed hypokalemia, but all the others were almost in the normal range.
In these caces, as compared with the cases of normal renal function, Ke was apt to fall through the period before and after operation.
2. A definite tendency was not shown in the change of serum potassium in hypertension occured after operation, and the same result was also brought about in the case of Ke.
3. Serum potassium of 5 cases of operation performed on patients for renal tumor was in the normal range in all the cases before operation, though it showed a tendency to hyperkalemia in 2 cases of them after opeartion. In aged patients that showed the impairment of renal function, Ke was low for 2 weeks after operation, but in the other 3 cases, it was in the normal range both before and after operation.
In all 5 cases of renal tumor, tumor was comparatively small. These cases, except one case of an aged patient whose renal function was impaired were those of young patients whose renal function was normal. Accordingly it is assumed that in these cases the falling of Ke was small after operation.
4. Out of the serum potassium of 10 cases, in which i leocystoplasty after Tasker modified methode and Scheele's methode was executed for the contracted bladder, that of 8 cases was normal before operation, and that of 2 cases showed slight hyperkalemia before operation.
In 4 days after operation, about half of the cases showed hyperkalemia, but for 7 weeks almost all the cases were changed into the normal range.
Ke in almost all the cases was in the normal range before operation, and it has fallen more in 4 days after operation, as compared before operation, but it was still in the normal range. In a week after operation it brought about a change within the normal range, except one case with the impairment of renal function.
In this procedure, urine is poured into the isolated ileum. Potassium was stable in its change, as compared with the case of Sigma bladder.
5. Serum potassium in the case, in which partial cystectomy was executed for cancer of the urinary bladder was all in the normal range before operation, but 3 out of 7

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