In study of the mechanism of renal hypertension, several reports have suggested that there are some relations between action of angiotensin and function of the sympathetic nerve endings.
The present experiments were undertaken primarily to examine whether the adrenergic mechanism is involved in the process of the vasoconstrictor action of angiotensin. In these experiments isolated rabbit ear vessels were perfused with Locke-Ringer solution (pH 7.3, 37°C) according to the method of Krawkow-Pissemski. The second object of the experiments was to test whether release of noradrenaline from sympathetic nerve endings could be augmented during the infusion of angiotensin which causes an elevation of the blood presure. For this purpose, urinary excretions of catecholamines and their ortho-methylated products were measured after the infusion of angiotensin (0.04μg/Kg/min for 2 hours) into rabbits. Tyramine which causes release of noradrenaline from sympathetic nerve endings was also infused (200μg/Kg/min) into rabbits to study the functional state of the sympathetic nerve endings. Finally the effect of angiotensin on catecholamine release was directly examined in vitro, by using the slices of the bovine adrenal medulla incubated with Lock's solution at 37°C in Magnus' bath.
The following results were obtained.
1) In perfusion experiments on isolated rabbit ear vessels, the vasoconstrictor action of angiotensin was more weaker than that of noradrenaline.
2) This action of angiotensin was not affected by either in vivo pretreatment with reserpine or in vitro pretreatment of imidaline or atropine.
3) Subthreshold amounts of angiotensin greatly enhanced the response of rabbit ear vessels to noradrenaline and also to tyramine.
4) The intravenous infusion of angiotensin into rabbits did not produce a significant increase in the urinary excretion of catecholamines and their metabolites, but a marked increase was caused by the infusion of tyramine.
5) When a combination of tyramine and angiotensin was infused, a more remarkable increase in urinary excretion of catecholamines and their metabolites was observed.
6) Tyramine and acetylcholine enhanced the spontaneous release of catecholamine from bovine adrenal medulla slices, but angiotensin did not.
These results were discussed, and it was concluded that (i) the vasoconstrictor action of angiotensin is not mediated by neurotransmitters, (ii) angiotensin potentiates the vasoconstrictor actions of noradrenaline and tyramine, and (iii) the catecholamine releasing action of tyramine might be enhanced in the presence of angiotensin, however this is still obscure yet.

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The effect of combined administration of corticosteroids in the long-term chemotherapy (SM, PAS and INH) for urinary tuberculosis was investigated in 53 patients. The results were as follows:
(1) Influence of combined administration of corticosteroids on healing processes of renal tuberculosis was investigated on 18 nephrectomized specimens. The findings were compared with those of the control group (8 cases), in which triple drug chemotherapy was not combined with corticosteroids. Pathological examination of the specimens revealed that the healing processes were not promoted, but rather retarded by the combination of corticosteroids.
(2) In 9 cases corticosteroids were administered for 14 to 89 days in the initial stage of long-term chemotherapy in order to investigate the clinical effects. The results were beneficial in all cases except a case in which ureteral obstruction of minor degree had developed after chemotherapy of 2 years and 4 months. In the control group (15 cases), in which chemotherapy was not combined with corticosteroids, two patients had been performed nephrectomy due to deterioration of renal function.
(3) The effect on tuberculous cystitis was remarkable. Improvement in vesical symptoms and signs had been achieved in shorter periods than in the control.
(4) In 3 cases in which combined administration was done in association with ureteroplasty for ureteral stenosis the beneficial results were verified from follow-up studies.
(5) No side-effects were experienced in every course of the long-term chemotherapy combined with corticosteroids.
These results indicated that the combination of corticosteroids in long-term anti-tuberculous chemotherapy for urinary tuberculosis was effective in improvement of tuberculous cystitis and in prevention of secondary complications and that corticosteroids should be used as a supplemental drug of chemotherapy in selected cases.

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Prostatic cancer now is a problem of increasing importance in Japan. Various types of treatment for prostatic cancer have been tried and evaluated so far, yet hundreds of patients die every year because of difficulty in its early diagnosis. Although most urologists have the opinion that radical prostatectomy may be the only cure for prostatic cancer, it is also a fact that complications noted in the radical prostatectomy sometimes give more trouble to the patient than the disease itself. Transurethral resection of course is not a radical measure, but a conservative one to relieve obstruction of the lower urinary tract caused by the condition. This paper is given to report our late experiences of thirty-four transurethral resections which were performed in twenty-eight patients of prostatic cancer at the Jikei University Hospital and the Iwate Medical University Hospital, from Februafy 1961 to January 1965.
Of the total twenty-eight patients, twenty-one patients (75per cent) were diagnosed as incurable cancer upon initioal examination, classified as group C or D by Kaufman's classification. The remaining seven patients (25per cent) were classified as group A or B. These cases could be called as curable cancer by radical prostatic surgery, but transurethral resection was chosen because of patient's senility or poor general condition. Obstructive urinary symptoms were the chief complaints in the majority of the patients (25 patients: 89per cent).
The amount of tissue resected weighed 10 grams on the average, oaring from 1 to 42 grams, and the time needed for the resecting procedure was 42 minutes on the average, oaring from 5 to 65 minutes. Satisfactory relief of the obstructive urinary symptoms was obtained in all the cases.
Urigal (cytal) was used as an irrigating medium in all the cases, and no remarkable change was noted in the postoperative serum electrolytes.
The blood loss during the resecting procedure was about 134cc, macroscopic hematuria disappeared within two to three days and indwelling catheter was removed on the 3rd postoperative day on the average.
Endocrine therapy, either by the administration of antiandrogenic hormone or by intracapsular orchiectomy or by a combination of the two has been done in all the patients.
Of the total twenty-eight patients, seventeen patients (61per cent) have been known to be alive and continued to be under our observation. Nine patients (32per cent) had died either by the disease (7 patients) or by postoperative complications (2 patients). No communication was obtained postoperatively from the remaining two cases.
Of the seventeen patients, in each of whom combined therapy of transurethral resection and anti-androgenic hormone was performed, nine patients were noted to have been surviving up to Jauary 1965, that it for more than 14 months (5 to 42 months) postoperatively on the average. Of the nine patients, in whom intracapsular orchiectomy was performed along with transurethral resection and also administration of antiandrogenic hormone, eight patients were noted to have been surviving for more than 24 months (5 to 45 months) after the operation on the average.
Fourteen patients who were classified as group A, B or C upon initial examination revealed apparently better survival rate (86per cent) than the twelve patients classified as group D (42per cent).
Taking the above mentioned results into consideration, the authors assumed that transurethral resection is a desirable operation for relief of obstructive urinary symptoms noted in prostatic cancer.
Combined therapy of administration of antiandrogenic hormone together with intracapsular orchiectomy is recommended.

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The purpose of the present report has been to investigate the fibrinolytic activity in blood in relation to prostatic surgery and other urologic surgery.
The results can be summarized as follows:
1) It was confirmed that in prostatic surgery the fibrinolytic activity in blood increased more remarkably than in other urologic surgery and that the plasmin activity was also higher in the former. But in all cases, the fibrinolytic activity increased temporally, and two or three hours after enucleation of adenoma it decreased to the preoperative level. At the postoperative course, there were no difference between both operations.
2) A comparative study of the fibrinolytic activity after operation was made as for open prostatectomy, TUR for prostatic hypertrophy and TUR for prostatism. It was found that the increase of the fibrinolytic activity was most remarkable in the open prostatectomy which gave the greatest surgical attack. More over, it was found that also in the needle biopsy of the prostate the fibrinolytic activity was high.
3) In cases with prostatic tumor, the fibrinolytic activity in blood increased remarkably and especially SK-activated plasmin activity increased most highly. Thus it is apparent that the prostatic tumor has a great reserve faculty which can activate the fibrinolytic enzymes.
4) As the result of the observation of the relation between bleeding and fibrinolysis in prostatectomy, it was found that only the fibrinolytic activity in circulating blood did not necessarily explain the relation. Therefore, the author emphasizes that the local process of plasmin activity has an important significance.
5) The data of the effects of a plasmin inhibitor (EACA) was showed, and dosage and route of the administration were discussed.
6) The author made a consideration on euglobulin lysis time determination and fibrin plate method, and stated clinical usefulness of euglobulin lysis time determination.

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The renal vessels of the rabbit were ligated and its subpelvis connective tissue was daily explored for the mesenchymal system with toluidin-blue test by Kramer and Windrum method, from the next day of the ligation to the 170th day.
The results obtained are as follows:
1) On the first day after the ligation, an infiltration by histocytes is seen in the connective tissue directly underlying the epithelium.
2) On the 5th day, β-metachromasia and numorous infiltrations by lymphocytes, eosinophilic leukocytes, histocytes and fibroblasts are observed in the subepithelial and sumbmascular connective tissues.
3) On the 9th day, the cells showing α-metachromasia become pronounced.
4) On the 10th day appear many phagocytes.
5) On the 20th day appear a number of foreign body giant cells, whereas ather cell infiltrations are on the decrease.
6) On the 30th day, a bone formation is recognized under the hyperplastic epithelium.
7) On the 35th day is seen a bone tissue with bone marrow capable of hematopoiesis.
8) On the 45th day, the bone tissue is extended to the medulla of the kidney.
From the facts above mentioned, it is presumed that it is not the mesenchymal remannts but the mesenchymal reaction under the epeithelium and the muscular layer of the renal pelvis, caused by ligation of the renal vessels, that plays a standing role in metaplasia of the bone.
It should be suggested here that heterotopia of a smooth muscle in the urinary tract after a plastic surgery on that region, which constitutes a smiliar condition to the foregoing experiment, may be attributed to the same mechanism.

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AMCHA, described chemically as 4-aminomethylcyclohexane-1-carboxylic acid, was developed by professor Okamoto, and was found more powerful than ε-aminocaproic acid in antifibrinolytic activity. Recent investigations have revealed that there are two typs of stereo-(isomers) of AMCHA, cis-and transand especially the latter has potent antifibrinolytic activities, among which the suppression of plasminogen activator is prominent. We have tested trans-AMCHA in the treatment of the following urological disoders and have obtained considerably good results. I. Idiopathic renal bldeeing. II. Bleeding from renal tumor, and Surgery upon the renal parenchyma III. Surgery upon the prostatic hypertrophy IV. Others.
Having a powerful suppressive action of plasminogen activator, trans-AMCHA enhnces the hemostatic effect in the hemorrhagic condition resulting from an elevated plasmin activity by producing aquite rapid coagulation.

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