1) The biochemical determination of Glutaminase I activity (Glut. I) using rabbit kidney with acute and chronic ureteric obstruction and renal ischemia, being experimentally created, as well as surgical specimen and biopsy of human kidney was performed.
2) Renal cortical Glut. I activity was found decreased to approximately 60%, medullar Glut. I activity to less than a half compared to the other healthy side one day after ligation of unilateral ureter.
Two days after ligation, however, cortical Glut. I activity increased to 1.5-3 times as much as the healthy side and medullar Glut. I activity was extremely low.
One week after ligation, some of cortical Glut. I activity had a slight increase but all medullar Glut. I activity was low.
Two weeks after ligation, cortical Glut. I activity had a definite tendency of decrease and none of them had normal or high activity.
Medullar Glut. I activity also had a definite decrease tendency.
It was interested that renal cortical and medullar Glut. I activity with infected urine in pelvis and ureter was significantly low or unmeasurable.
After bilateral ureteric ligation and unilateral ureteric ligation of solitary kidney, cortical and medullar Glut. I activity decrease was more rapid than the one of unilateral ureteric ligation of bilateral kidney.
The transient increase, seen in unilateral ligation of bilateral kidney, was not found.
3) Release of ureteric obstruction; after 3 days ligation, Glut. I activity had a significant decrease on one day after deligation and showed recovery during one and 3 weeks.
4) In experimentall hydronephrosis in various degree, successfully produced 5-17 weeks after winding celophan band around the lower part of ureter, Glut. I activity was determined.
In low degree hydronephrosis estimated by I. V. P., cortical Glut. I activity was within normal limits and medullar Glut. I activity had a slight decrease.
High degree hydronephrosis: Cortical Glut. I activity had a decrease in 2, an increase in 3 and medullar Glut. I activity a decrease in 4 with one exception.
Mannitol diuresis effect; determination of Glut. I activity and urinary ammonia excretion was performed.
The kidney with Glut. I activity which was less than 50% compared to the one of contralateral normal kidney, had remarkablly low ammonia excretion.
5) Recovery of Glut. I activity in unilateral rabbit kidney with ischemia was slow in cortex and rapid in medulla.
6) With mannitol effect, Glut. I activity had a significant decrease compared to control.
7) Acid-Base load; Ammonium chloride or sodium bicarbonate was orally administrated for 7-21 days Glut. I activity has a increase tendency in cortex and medulla.
8) Clinical cases:
In normal human kidney, Glut. I activity was higher than in medulla contrary to rabbit kidney and the value was one digit Glut. I activity higher than the one of rabbit kidney.
1) Hydronephrosis due to chronically obstructed ureter; Glut. I activity in low and moderate grade hydronephrosis was almost equal to the control, on the contrary, in high grade hydronephrosis, a remarkable Glut. I activity decrease found in 4 out of 9, normal limits in 4, abnormal increase in one, and cortical Glut. I activity decrease found in 3 out of 4.
Namely, almost a half of them had normal level of cortical Glut. I activity and even compensatory increase of cortical Glut. I activity.
2) Pyelonephritis and nephrophthisis; Significant decrease compared to control.
3) Kidney tumor; remarkably low activity in tumor.
4) Polycystic kidney; Glut. I activity of cyst wall was within lower limits of normal value.
5) Highly traumatized kidney; Necrotic as well as comparatively healthy part had a decrease tendency, especially in cortex.

View full abstract

Using tracer kinetics of ²⁴NaCl and ³H₂O, the influence of surgical intervention on the volumes of body water compartments and the rate of transcapillary sodium exchange were investigated in ten patients without any electrolyte imbalance and azotemia.
Effects of surgical intervention were as follows.
1) Reduction of the plasma volume was 27.3 per cent in average.
2) No significant differences were noted in the volumes of extracellular water, interstitial water, rapidly and slowly equilibrating sodium spaces, intracellular water and total body water.
3) The rate constant of the sodium from plasma to interstitial water increased 28.0 percent in average. However, no remarkable difference was found in the transcapillary sodium exchange per minute per kilogram of the body weight.

View full abstract

The role of the hypogastric nerves in the activity of cat's bladder was studied by means of nerve stimulation as well as exploration of the pattern of afferent impulses obtained from the same nerve.
The results were as follows:
1) Section of the hypogastric nerve resulted in lengthening of the period of spontaneous rhythmic contraction of the bladder in case of high intravesical pressure, while shortening of the period in case of low intravesical pressure.
2) Stimulation given to the peripheral cut-end of the hypogastric nerve developed a brief contraction of the bladder which was followed by a marked relaxation. These characteristic phenomenon did not occur when the pelvic nerve and/or the inferior mesenteric ganglion was cut prior to the examination.
3) The effect of stimulation of the peripheral cut-end showed no significant difference as compared with the effect of the central cut-end of the nerve.
4) Autonomic reflex changes such as a rise of blood pressure and a change of respiratory pattern were obtained when stimulation was applied to the central cut-end. Such change, however, was not seen when the peripheral cut-end was stimulated.
5) Hypogastric afferent impulses evoked by increase of intravesical pressure were considered to be two different groups. The first group comprised of impulses which were supposed to carry painful sensation without bearing any relation to mechanism of micturition. This type of impulses was observed only when the bladder was distended maximally and its adaptation was uaually very slow. The second group comparised of impulses which were induced along with gradual rise of the intravesical pressure.
Summarising the above results of experiments, it may be concluded that:
1) The hypogastric nerve appears to inhibit the activity of the bladder;
2) Dr. Sokownin's finding is not acceptable. He clearly stated that there was an axon reflex by way of the inferior mesenteric ganglion;
3) The fact that centripetal stimulation of the hypogastric nerve brings about autonomic reflex changes suggests that the bladder activity, more specifically, its relaxation seems to be more closely related to the reflex micturition center located in the medulla oblongata rather than the influence of the hypogastric nerve;
4) Afferent impulses passing through the hypogastric nerve seems to be the evidence of transmission of the painful sensation. It may well be understood that the change of the intravesical pressure is conducted through the same pathway.

View full abstract

Transurethral implantation of Yoshida sarcoma and AH 130 hepatoma in the urinary bladder was attempted in rats. A vinyl tube, 1mm in diameter, which had a slight bent induced by a wire placed in the lumen of the tube, was introduced into the urinary bladder of female rats anesthesized by ether. Extreme care was taken not to injure the urethra and to prevet possible intra-peritoneal penetration. Ascites tumor was then injected in a quantity of 0.04cc through the tube.
The results obtaind are as follows:
1) Successful implantation was made in 34 of 47 cases (72.3%) in Yoshida sarcoma and in 34 of 45 cases (75.5%) in AH 130 hepatoma. Both Yoshida sarcoma and AH 130 hepatoma were implanted onto the bladder epithelium. Then, Yoshida sarcoma mainly grew infiltratively into the tief portion of the vesical wall, i. e., muscle tissue and serosa, while AH 130 hepatoma in greater part grew papillomatous into the vesical lumen like the growth of human papillomatous cancer.
2) Hydroureter, which indicates involvement of the ureteral orfice, was found in 55.8% in Yoshida sarcoma and 73.5% in AH 130 hepatoma. Ascites formation was noted in only 5.9% in both Yoshida sarcoma and AH 130 heaptoma.
3) Both in Yoshida sarcoma and AH 130 hepatoma metastasis was found in the resional lymphnodes and distant organs in many cases. In Yoshida sarcoma, lymphatic metastasis was seen in all the cases and metastasis to the lung, kidney, liver and spleen was revealed in 81.3-93.8%. However, metastasis was found less frequently in the internal genitalia and intestines: 43.8% in the former and 12.5% in the latter.
In AH 130 hepatoma lymphatic metastasis was found in 93.3%. The lung, liver and spleen was metastasized in 60.0-86.6%. In the internal genitaria, rectum and small intestine metastasis was found in 33.3%, 20.0% and 14.4% respectively.
4) Spreading ways of the implanted tumors were different according to the organs involved: the tumors spread lymphogenously to the retroperitoneal lymphnodes, hematogenously to the lung, liver and spleen, and continuously to the internal genitalien and rectum.
But the kidney was found to be involved both hematogenously and intracanalicularly.

View full abstract

From April, 1959 to August, 1965, we have experienced 185 cases of the urinary bladder cancer. Since the surgical operation such as partial cystectomy and total cystectomy was mainly employed for their treatment, the number of cases received partial cystectomy had reached over 69. Because, the conservation of the residual vesical wall after the resection of the tumor throughout partial cystectomy was assumed physiologically to be reasonable for the patient. For this reason the operation should be proved of its surgical radicality for the cancer. Therefore, the main purpose of our clinical and patho-histological studies on the bladder cancer were subjected to clarify the limitation of surgical radicality of the operation concerning the appropriate extention of its indication. Here, the results of some clinical examinations on 55 cases of more than one-year survivals received partial cystectomy were presented with references of follow-up study.
First, as for survival rate, 88.0% was obtained for 3-year-survivals, while 75.0% for 5-year-survivals. Concerning the stage of the tumor, 100% of survival rate was found in the case of 1, 2, 3, and 4-year-survivals with low stage tumor, while 87.5% for 5-year-survivals. And furthermore, 70.0% for 1-year-survivals, 75.0% for 2-year-, 57.1% for 3-year-, 42.9% for 4-year-, and 50.0% for 5-year-survivals with high stage tumor, respectively. With these results we could assume that the significant surgical radicality of partial cystectomy could be found as far as the case with low stage tumor.
Next, the recurrence was observed in 15 cases (27.3%). The high recurrence rate was observed when the size of the tumor was over hen's-egg as well as when the tumor was multiple or nonpapillary growth. Furthermore, it was also observed when the tumor was located in the vaults, anterior wall, or trigone of the bladder.
On the other hand, the relation between the recurrence rate and the resected size of the bladder wall around the tumor was examined. The recurrence was observed in the rate of 73.3% of the case in which below 1.5 cm of bladder wall around the tumor was resected, while it was observed in the rate of 10.0% of the case in which over 1.5cm of that was resected.
With these results obtained above, we could assume that the considerable radicality of the partial cystectomy could be obtained when it was performed with the resection of over 1.5cm of bladder wall around the low stage tumor, and that further apropriate indication of this surgical operation could be found when it was employed on the single or papillary growth and below hen's-egg sized tumor.

View full abstract

Performances of translumbar aortography were done on 318 cases with 366 times from 1953 to February, 1965. We mentioned of complications (13.8%) divided as laryngeal spasms due to anesthesia. (0.63%), respiratory discomforts after puncture (0.94%), transient backaches after injection (5.9%) and transient rashes or nauseas due to contrast medium (6.3%), especially, discussed the respiratory complications that were pneumothorax, hemothorax, chylothorax, dyspnea and pleural effusion in the literature added our two cases.

View full abstract

Mme P…2 ans. Consulte le 3 décembre 1964 pour des crises douloureuses lombo-abdominales droites.
La première est survenue en novembre 1963; son maximum est lombaire; la douleur irradie à la région inguinale et au membre inférieur; elle est accompagnée de cystite, de fiévre (39°), de frissons et de vomissements. En raison de cette crise la malade est opérée avec le diagnostic de kyste de l'ovaire.
La deuxième se produit en février 1964.
Troisiéme crise en avril. Une urographie est faite et considérée comme normale. Depuis les crises se renouvellent toutes les 6 à 8 semaines.
Entre les crises la malade se porte parfaitement.
A l'examen, malade en bon étát général. Palper négatif; urine limpide, sans albumine. La radiographie du 4 avril ne montre pas de calculs; l'urographie qui avait été considérée comme normale ne l'est pas; si le rein droit est de bonne valeur fonctionnelle, le pyélogramme, exagérément écarté de la colonne, a son axe oblique de haut en bas et de dehors en dedans; c'est celui d'un rein á uretère double ou bifide dont le rénicule supérieur n'élimine pas le produit opaque; la partie supérieure de l'uretère de ce rénicule doit être responsable du refoulement du pyélogramme par sa distension.
La malade n'a pas eu de crises pendant son enfance; elle n'a jamais présenté d'incontinence ni de pertes vaginales.
Diagnostic: uretéro-hydronéphrose développée dans l'appareil excréteur d'un rein droit á uretère double. Les coliques néphrétiques avec fiévre sont dues à des rétentions d'urine septique dans le pyèlon supérieur. La résection du rénicule et l'ablation de son uretère sont conseillées.
Hospitalisation le 1 avril 1965. Depuis l'examen du 3 décembre la malade a présenté une nouvelle crise de rétention à la suite de laquelle le rein droit est resté douloureux à la fatigue.
Un nouvel examen est négatif; l'urine est limpide et sans albumine. A la cystoscopie, rien d'anormal; à droite it n'y a qu'un orifice uréteral, normal comme le gauche; pas de bombement de la muqueuse de la partie droite du plancher vésical.
Une nouvelle urographie est demandée. Cette fois le pyélogramme est pratiquement normal, un peu plus petit que le gauche. Les particularités qui avaient fait faire le diagnostic ont disparu. Le bassinet est revenu à distance normale de la colonne et le grand axe du pyélogramme est maintenant vertical. L'explication de ces différences est la suivante: l'urographie d'avril 1964 a été faite en période de douleurs, donc de rétention; l'urographie d'avril 1965 a été faite alors que la malade ne souffrait pas, en dehors d'une phase de rétention: l'uretéro-hydronéphrose vide, le pyéogramme a repris as place.
Le 5 avril. Lombotomie droite dont la partie supérieure suit le dernier espace intércostal. Rein de bel aspect. A son pôle inférieur on découvre les deux uretéres, l'un normal, l'autre plus interne, est distendu (1cm 1/2 de diamètre), épaissi.
Dissection des deux uretères vers le haut; l'uretère normal se perd rapidement dans le sinus rénal; l'uretère pathologique est croisé par un pédicule vasculaire polaire inférieur, puis par le pédicule principal, qui passent en avant de lui.
Dissection de cet uretère vers le bas, en le séparant de l'uretère n

View full abstract

Investigations were carried out to see the effect of Eviprostat on sixteen cases of prostatic hypertrophy and one case of sclerosis of the bladder neck.
The results were summarized as follows:
1. Fourteen patients of sixteen or 87.5 per cent of the cases with prostatic hypertrophy responded well to this drug. One case with bladder neck sclerosis having side effect with general dullness did not.
2. Though the complaints receded well with this drug, but the objective signs didn't so much. However, in one of the cases good results were obtained in pneumocystographic finding.
3. Eviprostat is estimated to be of much value for the treatment of cases of prostatic hypertrophy. It would be emphasized to try it in this disease to releave from the troublesome complaints, even in the operation obligatory cases provisionally.

View full abstract