This study was carried out to clarify the correlation between the function and the histology of the kidney in the aged, as well as to examine the effect of the surgical operation on the kidney function.
From 593 persons with the age over 60 admitted to our clinic, 100 patients were selected for the experiment. Three younger patients were used for controlling subjects.
Renal biopsy was performed in these patients with Vim-Silverman needle (Kark), obtaining more than 7 glomeruli. For clearance tests, G. F. R. and R. P. F. were measured, using sodium thio-sulfate and para-aminohippurate respectively.
Comparison of the values of the renal clearances wih the findings on the kidney was performed preoperatively in all cases. In 48 surgical cases, renal clearance was measured in both preoperative period and postoperative period, i. e. on the 3rd day, 1at, 2nd and 3rd week postoperatively.
The results are summarized as follows:
1) In 58 cases, regressive and inflammatory lesions were seen in the renal corpuscles; in 78 cases, in the tubuli; in 72 cases, in the interstitium and in 49 cases, in the blood vessels. However, the blood vessels were involved to a mild degree in most cases.
2) Involvements of the renal tubuli and interstitium were revealed severer with the age of the patients.
3) Severe involvements of the renal tubul; and interstitium were often encountered among the cases with the diseases complicating with urinary passage disturbance, e. g. prostatic hypertrophy, prostatic cancer, cancer of the urinary bladder etc.
4) Reduction in the values of the renal clearances in the preoperative period was noted in more cases than in the younger age group: The reduction was more prononced with the age of the patients.
5) Marked reduction in the values of the renal clearance tests was noted in cases with severe involvements in the renal tubuli and interstitium.
6) In many cases, especially in the cases with severe involvements in the renal tubuli and interstitium, G. F. R. and R. P. F. decreased markedly after the operation, as compared to the younger aged group. In these cases the decreased values of G. F. R. and R. P. F. were noted even in the preoperative period and reduced further in the postoperative period with delayed recovery of the values.

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The dysfunction of urinary bladder which appears during cource of diabetes mellitus has been a subject of investigations. Many reports have been issued on clinical features of the dysfunction, but the pathogenesis still has remained unexplained in many respects. In order to clarify it, following study was performed.
In 20 of 43 mongrel dogs with alloxan diabetes of 7-300 days' durtaion, histologic examination was done on the nerves innervating to the bladder: the posterior and anterior roots of the lunbar nerves I-IV, posterior and anterior roots of the sacral nerves I-III, hypogastric nerves and pelvic nerves. The results are summarrized as follows:
1) Wide-spread, bilateral demyelination was noted in the myelinated fivers in all the above mentioned nerves.
2) Commonest sites of demyelination were the roots of the spinal nerves, especially in the sacral nerves. The degeneration was more pronounced in the posterior roots than in the anterior roots.
3) The demyelination was most frequently found in the small-sized fibers and less frequently in the medium-sized. None was found in the large-sized fibers.
It follows from this findings that finer nerve fibers are more susceptible to the diabetic changes than the large-sized. Finer nerve fibers are affected in the early stage of the disease, while the large-sized fibers may be involved slowly with gradual occurrence of the degeneration in the later stage.
4) Abnormal cystometrograms were obtained in 5 dogs; hypotonic curve in 4 dogs and autonomous curve in 1 dog. In all these dogs, presence of degeneration in myelinated fibers in the pelvic and hypogastric nerves was cnfirmed. From this finding it follows that demyelination of nerve fibers can be closely related with appearence of the vesical dysfunction seen in the diabetic dogs.
From these findings it can be assumed that dysfunction of the urinary bladder which appears during course of diabetes mellitus will be of neurogenic origin and that it should be called as “Diabetic Neurogenic Bladder.”

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The attitude of interstitial tissue of the vesical wall was observed histologically on the whole layer specimen of bladder carcinoma in 55 cases. The results obtained were as follows:
These bladder carcinoma were classified with its cell type as into 49 of transitional carcinoma and 6 of undifferentiated ones. According to Broder's classification with malignancy grading, it was found that these were composed of 3 of 1st grade, 15 of 2nd grade, 21 of 3rd grade, and 10 of 4th grade of transitional type, and 2 of 3rd grade and 4 of 4th grade of undifferentiated type, respectively. Therefore, there could be found mainly of 2nd, 3rd, and 4th grade of the formers and 4th grade of the latters.
The cell infiltration and the subsequently developed granulatin were found in the interstitial tissue of the less malignant transitional carcinoma, as 3 in 3 of 1st grade and 14 in 15 of 2nd grade, while in the much malignant one, there could be found the fibrosis of he interstital tissue, as 10 in 21 of 3rd grade and 7 in 10 of 4th grade. And furthermore, the fibrosis of the interstitial tissue was found in all cases of 3rd and 4th grade of undifferentiated carcinoma.
These results were thought to reveal the fact that the cell infiltration or the granulation in the interstitial tissue could be found mainly in the less malignant carcinoma, while the fibrosis, the increase in number of interstitial cells, could be found corresponding to the development of the malignancy of the tumor. The almost same results were obtained with the observation on the interstitial tissue of vesical wall around the tumor.
In the bladder carcinoma, there should be found certain inflammatory cell infiltration in the submucosal layer of the vesical wall just same as seen in the simple cystitis. The cell infiltration and the subsequent granulation or fibrosis was found in all cases in the interstitial tissue of the tumor or the vesical wall around the tumor. In these cell infiltration, the lymph cells, the polynuclear leucocytes, and the basophilic leucocytes were significantly observed, while the figure of the granulation or the fibrosis in various grade was found in different part of the same specimen. And these changes around the tumor were observed markedly just like enveloping the tumor tissue, however, the cell infiltration in the distant part from the tumor was rather slight.
These results were tought to reveal the fact that the interstitial tissue of the vesical wall with the bladder carcinoma would show certain protective reaction just like the other interstitial tissue with some malignant tumor.

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Serotonin is considered a kind of shock-producing substances and its physiological and Pharmacological properties have gradually been elucidated by many investigators since its discovery by Rapport in 1948.
Using rabbits, investigations were carried out on the participation of Serotonin in producing renal hematuria which may be explained by Reilly's phenomenon, as well as, on the effect of Serotonin on the fibrinolytic enzyme system in vivo, and the effect of an anti-serotonin agent, Cyproheptadine (Periactin: Nippon Merck-Banyu), on the renal hematuria and the fibrinolytic enzyme system.
1) Serotonin, immediately after an intravenous injection, increased plasminogen or proactivator in the blood transiently. While, it showed almost no influence on the fibrinolytic enzyme system in urine, and it did not induce hematuria. There was no increase in the urinary excretion of 5-HIAA (by the method of Sjoerdsma et al.).
2) In the case of Reilly's phenomenon, there was no urinary excretion of 5-HIAA.
3) In the renal hematuria caused by Reilly's phenomenon, Serotonin showed a slight inhibitory tendency by the retrograde infusion in the renal pelvis. Its effect on the fibrinolytic enzyme system in the blood was complicated.
4) Periactin inhibited the renal hematuria caused by Reilly's phenomenon, and also inhibited the fibrinolyic effect of urine. By administration of Periactin, moreover, the increase of plasminogen or proactivator in the blood was inhibited and the mucous membrane of the renal pelvis acquired fibrinolytic ability.

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Adrenaline pilocarpine and atropine were each administered to 3 cases of so-called prostatic eosinophilia (PE) and 3 cases which were negative for PE. Blood was collected once before administration and 30 minutes, 1 hr, 2 hrs, 3 hrs and 4 hrs after administration for the purpose of observing changes in eosinocytes. After adrenaline administration eosinocytes showed a temporaty increase, but decreased afterwards. However, such changes were not seen in the case of the two other drugs. A temporary increase in eosinocytes occurred 30 minutes afer administration in cases wnich were positive in PE, whereas one hour was taken in such cases that were negative for PE. Hence it was shown that the reaction of adrenaline to eosinocytes in cases positive for PE was sensitive, as compared with that in negative cases.

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Adrenaline (AD) and ACTH were alone administered respectively to 3 typical cases of prostatic eosinophilia and 3 controls, and the prosate was also done im Combination with AD or ACTH administration in an attempt to explore the effects upon circulationg eosinocytes. Following AD administration, eosinocytes showed a temporary increase and then a decrease in the cases and controls. This temporary increase occurred in a short time, as compared with the controls. ACTH administration produced a definite decrease in eosinocytes in both the cases and controls. As compared with AD administration, simultaneous use of AD and massage of the prostate kept changes in eosinocytes constant. When ACTH was administered to the cases of prostatic acidocytosis in combination with the massage of the prostate, the decreasing effects of ACTH upon eosinocytes were more greatly inhibited than when ACTH was given alone. In general, the massage of the prostate inhibited the decreasing effects of ACTH upon eosinocytes and the effects of ACTH upon leukocytes.

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To experimental nephrotomic incision of rabbits, we treated them with three manners.
a) with ordinary mattress suture (control group)
b) with covering the adhesive on wound-surface.
c) with interpositioning the adhesive between the wound.
The results were as follows,
1) 7th days later, the histologic reactions to controll group were slightly degenerative, but wound healing was normal.
2) 3 months later, the histologic reactions were equally fibrotic, and any renal imparements were not observed.
3) In comparison to the other suture-methods, the adhesive-method is more simplified to closure to nephrotomic incision.

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