Since Albright et al. first described in 1929 that the parathyroid hormone increased phosphorus excretion from the kidney, it has been well known that the parathyroid hormone has the direct effect not only on the bone but on the kidney.
In this study, ultrastructural changes of canine kidneys, in which hyperparathyroidism was induced experimentally by means of parathyroid extract injection, were studied using electron microscope.
Because the most prominent changes were observed in the proximal convoluted tubules, it was considered that the parathyroid hormone acts chiefly upon this site in the kidney.
Ultrastructural changes in the proximal convoluted tubules of the kidney in experimentally induced hyperparathyroidism were as follows
1. Tubular lumen was open and the microvilli of brush border were loosely arranged. Cytoplasm of tubular epithelium was often protruded and fell into the tubular lumen. Sometimes fibrillous substance or small spherical bodies, presumably the origin of urinary tract calculi, appeared in the tubular lumen.
2. In the tubular epithelium, vesicles, vacuoles and electron dense bodies including lysosomes were increased in number possibly due to increase of mucopolysaccharide transport by the effect of the parathyroid hormone. Mitochondria were swollen or vacuolized, and decreased in number.
3. Deposition of electron dense substance was found in the basement membrane which increased in thickness. This alteration was considered probably the first evidence of nephrocalcinosis.

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Although many works have been made on the urinary 17-KS determinations as one of the studies concerning with the androgen metabolism in male hypogonadism, the majority of them have dealt with the urinary total 17-KS determinations alone, which were not enough to know the trend of the intricate androgen metabolism
Unexpectedly few workers have reported about the urinary 17-KS fractions in patients of male hypogonadism. There is scarecely any report on the details of the pattern of urinary 17-KS fractions in male hypogonadism classified according to the type of the disease.
From this point of view, Dr. Kawakura in our department has previously reported on the basal pattern of the fractionations in the various types of male hypogonadism (Jap. J. Urol., 55, 950, 1954).
The present writer has studied on the shift of urinary 17-KS fractions following the administration of ACTH and HCG as an aid to know the pituitary-adreno-gonadal relationship.
The findings are summarized as follows;
1. Shift of urinary 17-OHCS output following administration of ACTH has shown retardation type of response; i. e., the rate of increase of urinary 17-OHCS was retarded in all 4 cases of hypo-GTE, in one case out of 2 hyper-GTE and in one anorchia, compared to the young healthy.
2. The increase of urinary total 17-KS has been gradual and slight after ACTH administration in the patients of male hypogonadism, compared to the young healthy.
3. As regards urinary levels of each 17-KS fractions, their responses to ACTH were lower in the hypo-GTE than in the normal young. In other types of male hypogonadism, some case responded as well as the normal young, others have responded more slightly than the normal young.
4. Andro.+Etio. /DEA.+11-oxy-17-KS ratio after ACTH administration has definitely decreased in the normal young, but slightly decreased in the castrated and male hypogonadism, and this ratio has even increased in a few cases of Klinefelter's syndrome and hypo-GTE.
5. Total urinary 17-KS output after HCG administration has increased in only 2 of 4 hypo GTE and one of 3 Klinefelter's syndrome. Except these cases, total 17-KS has scarcely shown any responses to the HCG administration.
6. Increase of Andro. and Etio. fractions after HCG administration has been small in every type of male hypogonadism.
7. Andro.+Etio./DEA.+11-oxy-17-KS ratio after HCG administration has been higher than 2.0 in the normal young, but lower than 2.0 in all cases of castrate and male hypogonadism. Andro.+Etio./11-oxy 17-KS ratio following HCG administration has been above 2.0 in the normal young, but lower than 2.0 in the male hydrogonadism except one hypo-GTE (after medical treatment) and one hyper-GTE.
8. The ratio of Andro./Etio. has not shown any apparent changes after the administration of ACTH and HCG.
Reviewing the above mentioned data, the writer has made a brief comment on the androgen metabolism which would take place at the gonad and adrenal cortex.

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In Geikoen Hospital 100 cases of renal tuberculosis were given sanatorium treatment. In the present study, clinical course of these patients during hospitalization were observed and their prognosis was persued. As the result of the investigation, sanatorium treatment was proved to be effective for renal tuberculosis.

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The existence of a contractile type of cells in the boundary tissue of seminiferous tubules has been ascertained by electron microscopy on the testes in rats, mice and dogs.
These cells are flattened to form a thin layer of cytoplasm around the seminiferous tubule. Distribution of cytoplasmic organelles such as granular ER, mitochondria and Golgi complex is confined within the central region of the cell body. The major peripheral portion of the cytoplasm is filled with numerous fine filaments, <5mμ in thickness. Pinocytic vesicles and accumulations of dense substance are found immediately beneath the plasma membrane, outer surface of which is lined with thin basement membrane.
Thus, the fine structure of these cells shows some close similarities to that of smooth muscle cells and myo-epithelial cells.

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The findings of cystography, urethrography, cystoscopy and intravenous pyelography as well as complications, treatments and prognosis in 171 cases of traumatic spinal cord injury at the Bibai Rosai Hosptial (high lesion 43, middle lesion 56 and low lesion 72) are reported in this paper.
1. The patterns of retrograde cystograms were classified to 5 fundamental types which were atonic type bladder, normal type bladder, distorted type bladder, pine tree shaped bladder and contracted bladder. Within 6 months after injury, the writer found atonic bladder in more than a half of total cases, distorted type bladder in about one-fourth, normal type bladder and pine tree shaped bladder in 10% respectively. After 1 year, however, atonic bladder was seldom found; the incidence of distorted bladder increased to about 70% and that of pine tree shaped bladder to 20%. and normal type bladder remained within 10%.
After 2 years, distorted bladder in over 60%, pine tree shaped bladder in more than 30% and contracted bladder in 6% was seen.
Related with level of cord lesion, the number of atonic bladder decreased more rapidly in the high lesion group than in the middle and low lesion groups. Correlation between bladder type and bladder efficiency was not seen in the present series.
2. Trabeculation of bladder was found in 24% within 6 months after injury, in 44% at one year and 90% after 2 years. Trabeculation in the high lesion group occured more often than in the other groups between 6 months to one year. After 2 years inspite of the level of the lesion, the incidence of trabeculation was elevated to about 90%.
Elongation of bladder dome was observed in about 15% of total cases within 1 year, and its increased to 36% after 2 years.
The percentage of dilatation of posterior urethra was 37% within 1 year, then was enhanced to 50 or 60%.
Over a half of patients had sinking of bladder base within 6 months. Its percentage was gradually lowered with time. Inspite of the time elapsed since injury, it was always higher in the low lesion group than in the other groups.
Relationship between these abnormal findings of cystograms and bladder efficiency was not. observed in this series.
3. Within 6 months after injury, spastic external sphincter was observed only in the high lesion group. After 2 years, however, its incidence did not have any significant difference among these three groups (10-15%).
Relaxed external sphincter was seen in 19% of total cases without the incidental difference among each group after one year.
4. The percentage of the cases with hypofunctional kidney by IVP within 6 months, after 1 year and after 2 years was 10%, 31% and 36% respectively. Inspite of the higher incidence of marked renal hypofunction in the high lesion group, the incidence of hypofunctional kidney was almost the same in three groups.
There was no correlation between renal function and bladder efficiency: Lowering of the renal function was observed in as high as 40% of the cases with good bladder efficiency.
5. The incidence of vesicoureteral reflux was 19% of total cases and had no diffierence among each group. It was about 10% within 1 year and was elevated to 30% after 2 years. 80% of kidneys with VUR showed renal hypofunction and they became worse with time. VUR was found in 50% of contracted bladder, in about 15% of distorted type bladder and pine tree shaped bladder, but was seldom complicated with atonic and normal type bladder.
6. Calculous formation was found in 14% of total cases.
7. 59 patients out of 120 achieved satisfactory micturition without surgical treatments, and another 26 cases with various operative interventions.
8. Follow up studies on 50 cases after discharge were performed. Out of 19 cases with no residual urine on discharge, 16 cases (840) had no residual on the reexamination time, and only 2 cases claimed fever of pyelonephritis after discharge.
Out of 12 cases with residual rate of les

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Since the metachromatic reaction method of urine (MR) was developed by Nagata and Yamamoto in 1953, it has been demonstrated by many other investigators to be helpful in the diagnosis and prognosis of tuberculosis of the kidney and bladder. This time the MR was carried out in urine specimens from 3 cases of tuberculosis of the kidney and bladder and 2 case of non-tuberculous urosis, which specimens were preserved for 10 years by the freezing method. It was found that quite the same MR as in the fresh urine specimens before 10 years had occurred in the former urine. That is, it was demonstrated by the present investigation that the initial MR could be made to reappear 10 years later if urine specimens from tuberculosis of the kidney and bladder were preserved by the freezing technique.

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A twenty-year-old girl with hypertension due to bilateral renal artery stenosis was treated by patch graft on the left, and aorto-renal bypass graft procedure on the right renal artery with remarkable improvement of hypertension.
Histological study on the specimen obtained from the left renal artery revealed that the stenosis was due to marked sclerosis of arterial wall caused by non-specific arteritis.
As this case was complicated by left subclavian artery stenosis and coarctation of abdominal aorta, a brief reference was made to the pathogenetic relationship between these stenotic vascular disorders.

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