Histological examinations of the thyroid, adrenal and sexual glands which were obtained from 10 cases of diabetics, were performed. These were selected from the routine necropsy cases at the Department of Pathology, Tohoku University School of Medicine. All cases known to have had endocrine disease without diabetics were excluded. These tissues were fixed in 10% neutral formol saline and sectioned at a thickness of 4 micra. These sections were stainedby Hematoxylin-Eosin, Elastica-Masson, PAS stain etc.
In most of patients, follicles of the thyroid gland were large and the epithelial cells of them were low and flat. The colloid was increased in amount. These appearances suggested hypofunction of the thyroid gland.
Characteristic features of the adrenal cortex in diabetics were hyperplasia of the zona fasciculata. No remarkable change in the zona glomerulosa, reticularis and medulla of the adrenal glands was recognized without hyperemia.
Testicular findings revealed thkicnening of the basement membrane of the tubules and hypospermatogenesis.
The ovaries of almost all diabetic patients were atrophic and fibrous. Maturating ovarian follicles were not seen.
Endocrine studies of patients revealed that almost all cases had normal limits of urinary excretion of 17-KS and 17-OHCS.
Results of the histological and endocrinological studies suggest that these changes in diabetics are due to hypofunction of the pituitary gland (hypoexcretion of ACTH, TSH and Gonadotropin). Furthermore, these hypofunction of the adrenal cortex and thyroid gland seemed to have influence of the sexual function. On the other hand, the degenerations of the nerves innervating sexual glands in diabetics were confirmed by Saito and Kurihara. According to these findings it can be assumed that sexual disturbances in diabetics will be of neurogenic origin and impairment of endocrine tissues.

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Quantitative bacterial counts of the urine were carried out by a following surface streaked plate technique method.
With a sterile pipet, 0.1ml. of serially diluted, unsedimented urine was transferred onto the surface of well-dried blood agar.
The urine was then evenly streaked out over the surface of the plate with a sterile L-shaped platinum loop. The results of the investigation were shown as follows.
1) Bacterial counts performed upon 64 urinary specimens were found to exhibit a good degree of correlation with those obtained by means of the standard dilution pour plate method.
Advantages of the plate method became apparent. Organisms could be counted its discrete colonies separately in the case of mixed infections and colonies could be picked up quickly from mixed cultures after 24 hours for final indentification and drug resistance studies.
2) When refrigerated at temperature of 4°C, variation of urinary PH had a considerable influence upon the bacterial counts of urine specimens.
3) Seventy-three patients with no clinical evidence of urinary tract infections were found to contain less than 100, 000 bacteria per ml. in their urine.
In the patients with symptoms generally recognized as those of urinary tract infections, there were two separate but overlapping population groups.
Among 48 untreated patients, 62.6 per cent were found to have more than 100, 000 bacteria per ml. of urine. Conversely, 67.6 per cent of 53 treated patients were found usually to have less than 100, 000 bacteria per ml. Criteria of infection should be decided when several successive daily specimens of urine contained fixed bacteria.
4) The growth of bacteria was inhibited by antibacterial agents and urinary PH. Also, dilution and vesical emptying (voiding) reduced bacterial counts.
5) The gram stain of the freshly collected and sedimented urine will differentiate contamination from infection, since gramstained smears of centrifuged urines were positive in 90 per cent of counts of 100, 000 and in. 182 per cent of counts between 1, 000 and 100, 000.

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Urinary infection is a common complication of operation of the bladder and prostate and of drainage by indwelling catheters.
This paper deals with the diagnosis of the infections and change of flora and cross infection.
The investigation of the urine both before and after operation in forty-three cases of bladder surgery showed as follows.
1) A change in bacterial flora was frequently encountered during the prolonged use of an indwelling catheter.
2) Urinary pH had inhibited the degree of bacterial multiplication in urine. Bacterial counts of the most common pathogens of the urinary tract decreased markedly as the pH decreases.
3) By the results of a comparison with the hemagglutinin titer and bacterial count of urine, infection was diagnosed when seven or more successive daily specimens of urine contained more than 5, 000 bacteria per nil.
4) A change in bacterial flora and recurrence would be found frequently during the course of the antibacterial treatment.
It was observed that the pyocyaneus and protens forms were the most frequent forms of infection and that the other forms often replace them e. q., pyocyaneus, proteus in the later post-operative period.
Hospital infection with resistant strains and change of flora appear mostly above all in patients with prostatectomy.
5) The introduction of the combined precautions, an aseptic technique and a closed drainage system reduced the incidence of infection.

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According to the duration of chemotherapy before operation, I classified into five groups (that is, from group I to group V), 77 cases, which were diagnosed as renal tuberculosis, on which nephro-ureterectomy was performed, and also examined the relation between the duration of chemotherapy and the morbid change of ureter; and came to the following conclusion.
1) Clear parallel relations could not acknowleged among ureter swelling, caseous mass of ureteral lumina and the duration of chemotherapy.
2) In the frequency of the cases in which ureters were broken, there could not be acknowledged any difference among all groups. In the frequency of epithelial regeneration, the generation was acknowledged in none of the 18 cases on which chemotherapy was not performed, but it was aknowledged in 6 of 48 cases on which chemotherapy was performed.
3) In the frequency of tubercles which ware acknowledged in those cases, there could be acknowledged no difference between each group, but in the tubercles of the cases on which chemotherapy was performed, a surrounding of connective tissue could be aknowledged.
4) The longer chemotherapy was performed, the fewer were tuberculous bacilli of the group. Tuberculous bacilli were akcnowledged in 8 of 77 cases (taht is, 10.4%).
5) In the cases in which the urinary bladder was affected, caseous mass of ureteral lumina was ack-knowledged 57.2% and was clearly more, compared with 42.9% of the cases in whch the urinary bladder was not affected.
6) Lower ureteral stenosis was aknowledged in 4 cases. Of these four, one belonging to group I was owing to the abundance of caseous mass, and the other three cases were owing to fibrous stenosis.

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Although many complications have been reported, the translumbar needle aortography appears to be the technic widely used in our country. In recent years, however, the percutaneous transfemoral catheter arteriography has largely replaced the translumbar approach. The transfemoral approach allows respositioning of the catheter and makes selective catheterization of the renal artery possible.
In our clinic, renal arteriography by the transfemoral approach has been the mthod of choice and the majority of the cases have been evaluated adequately. However, in a small number of cases, with probable aorto-iliac occlusive disease or abdominal aortic aneurysms, an alternate approach is indicated. In those cases, left transaxillary or transbrachial, catheter or non-catheter, arteriography or intravenous abdominal aortography has been commonly used in many places. In our clinic, the percutaneous left transaxillary, cather or the direct non-catheter, left brachial arteriography has been profitable.

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We had made the clinical observations on the aged patients (over 60 years old) in the Urology Department of Tokyo University Hospital during the period of 1945 to 1955 (Jap. J. Urol., 48, 205, 1957). Present report is the clinical observations after that, during the period of 1956 to 1964.
The pacentage of the aged patients among the out-patients has increased year by year. The aged in-patients during these 9 years were 636 cases, with the rate of 28.7 percent of the whole in-patients.
The examination findings on admission, operative morbidity and mortality of these patients, conditions on admission of mortal cases, urinary tract infections of the aged patients, and others, were statistically studied with special reference to the ageing.
It was observed that the physical disturbances on admission increased with the ageing as well as operative hazards.

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Seven cases of penile cancer seen in our clinic during the period of eleven years from 1953 to 1963 were reported. A statistical study was made on 264 cases of penile cancer reported to us from main medical facilities in Japan including our 7 cases. The results are as follows.
As to our cases;
1) During the period of eleven years from 1953 to 1963, 7 cases of penile cancer (0.105%) were seen out of 6, 638 male patients in our clinic.
2) All the 7 cases were squamous cell carcinoma pathologically.,
3) Circumcision had been performed in 24 cases (9.09%) out of 264. Penile cancer occured within a year after circumcision in 6 cases (25%) out of 24 and within two years in 5 cases (20.85%).
4) The 3 cases were treated with total penectomy, radical groin dissection and irradiation. The other 3 cases were treated with partial penectomy and irradiation. A case was treated merely with partial penectomy.
Out of 291 cases from main medical facilities in our country, 264 cases were diagnosed histologically. The statistics are as follows.
1) Out of 136, 098 male urogenital patients, there were 264 penile cancers among 5, 876 cases of malignant tumor. The penile cancers were 0.193% of all male urogenital patients and 4.49% of malignant tumors.
2) The age of these cases ranged from 21 to 94 with the average-53 years.
3) As to initial lesions, 127 cases (54.74%) out of 232 were at plans, 42 cases (18.10%) at foreskin, 45 cases (19.39%) at sulcus coronarius, 16 cases (6.89%) at shaft and 2 cases (0.86%) at prepuce, while the lesions of other 32 cases were not described.
4) Microscopically 251 cases (95.09%) out of 264 were squamous cell carcinoma, 5 cases (1.89%) basal cell carcinoma, 3 cases (1.13%) adenocarcinoma, 3 cases (1.13%) melanocarcinoma and 2 cases (0.75%) simple carcinoma.
5) Metastasis was discovered in 130 (49.28%) out of 264 cases and in 125 cases metastasis in the inguinal nodes.
6) As to treatments, 54 cases (21.95%) were treated with total penectomy, radical groin dissection and irradiation, 53 cases (21.54%) with total penectomy and irradiation, 42 cases (17.0%) with total penectomy and radical groin dissection, 38 cases (15.44%) merely with total penectomy. The treatment of other 18 cases was not reported.
7) As to the course of 159 cases, 73 cases (45.91%) died within a year after the treatment, 29 cases (18.23%) within two years, 20 cases (12.57%) within three years, 14 cases (8.80%) within four years, 9 cases (5.66%) within five years, and 14 cases (8.80%) were found still alive for more than five years.

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A Japanese male aged 17 came for treatment complaining of anomaly of the genitalia. Detailed history was not available as his parents had died while he was very young, but the present status indicated the diagnosis of transposition the penis and scrotum. Besides, anoplasty for anal atresia had been performed on him and abnormality of the position and shape of the anus and hypospadias were observed. There were no other abnormalities which would have hindered his growth to this day. The operation was successful and the penis and scrotum recovered their normal positions.
No such anomaly has eves been reported in Japan, so this one represents the first case reported.

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