1. The staining method of sex chromatin must be simplified and at the same time the picture must be clear and readily observable in order to be accepted as a routine clinical examination, and further it becomes necessary to set a standard or criterion.
i) In the present work a comparative study was made on cases with normal and abnormal sex chromosome constitution using the following methods: Guard's staining method, Feulgen staining method, acetoorcein staining method, Giemsa staining method and hematoxylin and eosin staining method. As a result it was shown that the aceto-orcein staining method satisfied the above described conditions.
ii) Studies were made on 100 cases, each of normal male and female subjects, and on 18 cases of abnormalities of the sex chromosome constitution, with respect to the frequency of appearance of different heterochromatic bodies in the nucleus. As a result the author is now of the opinion that sex chromatin should be limited to heterochromatic bodies of 1μ or thereabouts adjacent to nuclear membrane.
2. In regard to the frequency of sex chromatin abnormalities in mentally defective children and the correlation between sex chromatin and sex chromosome constitution, no detailed reports have been published in Japan.
i) A study was made on 1, 198 cases (male 683, female 515) of mentally defective children in Hokkaido. As a result of the sex chromatin test, 13 male and 2 female cases with sex chromatin abnormalities were found. The percentage of sex chromatin abnormalities in male cases was 1.90% which is twice as high as that in Europe and America.
ii) Studies were also made on the correlation between the sex chromatin and sex chromosome constitution of the screened cases. From the finding in sex chromatin it was shown that it was possible to surmize the sex chromosome constitution. This substantiates the significance of the sex chromatin test as a screening method. In recent years the hypothesis that the maximal number of sex chromatin is equal to the number of X chromosomes substracted by 1 has been set forth by some workers such as Ohno and Lyon. In regard to this the sex chromatin findings in the present work on abnormalities of the sex chromosome constitution substantiates the above theory.

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Determination of renin in human kidneys obtained at operation of renal or adrenal diseases was carried out in more than 100 cases.
Crude extract of human kidney acidified to pH 3.0 and incubated at 0°C for 30min. was used for renin preparations, which were practically free from angiotensinases. The pretreated renin preparation was reacted with human plasma at pH 6.5, 37°C, for 30min., and angiotensin thus formed was bioassayed.
The renin content was expressed in reaction constants (K) throughout this study.
Renin content was increased in 3 of 4 cases with renovascular hypertension. In one case of malignant hypertension, normotensive aldosteronism, polycythemia with hypertension and renal artery stenosis, and acute ureteral stenosis with hypertension, the renin content was high.
In hypertensive patients with adrenal orgin, such as primary aldosteronism, Cushing's syndrome, and pheochromocytoma, renin content decreased.
In hydronephrotic kidneys, including the ones with ureteral stone, renin content seemed inversely proportional rather to renal damage than to arterial blood pressure.
In tuberculous kidneys, uneven distribution of renin was proved.
From these data, the relationship between renin content and arterial blood pressure was discussed. The author has suggested that renin was not a primary cause of hypertension.

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The patho-physiological observations of ureteral ligation for varying duration (23 to 180 days) using different sizes (3, 4, 5, and 6F.) of intraluminal splint catheters were made in this study. Renal pelvic and ureteral pressure tracings, intravenous urograms, radioisotope renograms, urine analysis, and histopathological examinations were done on 24 dogs.
General Findings:
Pyelonephritis was found in 88% of the ligated and 44% in the contralateral normal side. Hydronephrosis was seen in 58% of cases on the ligated side and no hydronephrosis was seen in cases of 5F. and 6F. size ligation or on the contralateral normal side. Three small atrophic kidneys were seen in cases over 120 days after ureteral ligation with 4F., 5F. and 6F. size catheter respectively.
Pressure Tracings:
Generally, the amplitude of peristalsis in the upper ureter was relatively lower and not so sharp as compared with the lower ureter. Also the smaller size obstruction showed the lower amplitude. The frequency in the lower ureter was relatively less than the upper ureter, and the smaller size obstruction produced slightly less frequency.
The resting pressure above the ligature was markedly higher than the lower ureter, especially within 100 days postoperatively. After that time the pressure became equal to that of the lower ureter. The more severe obstruction showed the higher resting pressure in both the upper ureter and renal pelvis, especially around the 50th day after ligation.
Response to Histamine on the pressure tracing of the upper ureter showed up to 100 days after ligation even 3F. size obstruction.
X-Ray Examinations:
In the intravenous urogram, the smaller size obstruction produced rapidly severe hydronephrosis and renal hypofunction. 5F. and 6F. catheter size obstruction usually did not produce hydronephrosis up to five months after ligation. It also showed almost normal renal excretion but some of them revealed a small atrophic kidney after four months of ligation.
Radioisotope Renograms:
The smaller size of splint reduced the secondary rise of the renogram more quickly in the case of partial obstruction. On the other hand, 5F. and 6F. size observation almost did not affect the renogram until about 50 days postoperatively in cases without renal infection.
Urinary Composition:
The amounts of sugar, urea nitrogen, uric acids, calcium, and potassium in the urine in the hydronephrotic sac decreased markedly as compared with the control. Sodium and chloride increased in the former case, these changes were much more marked in the case of infected urine. In cases of longer periods of ureteral obstruction, the amounts of urea nitrogen and uric acid decreased more markedly.
Poststenotic Ureteral Dilatation:
Almost all cases showed poststenotic dilatation in both regular I. V. P. and cinefluoroscopy. In cases of 5F. and 6F. size obstruction the ratio of the inside diameter of the lower ureter to that of the upper ureter was higher than in the cases of 3F. and 4F. The dilated lower ureter showed muscular hypertrophy microscopically.
Cine-studies of these showed dyskinesia and revealed how poststenotic dilatation developes. There appeared to be a buffering action by the ureter which protected the kidney against obstruction and allowed a free flow back and forth above the stenosis.
Histopathological Findings:
In most cases of chronic ureteral obstruction, generally, the medullary zone was damaged much more severely than the cortical. The rising ueteral and pelvic pressure seems to act upon the collecting ducts first and then the distal tubules. The glomeruli would be damaged at a later stage. Renal infection was the most important factor to accelerate producing both hydronephrosis and renal hypofunction.
This investigation was supported in part by USPHS Research Grant AM 07785, the Maey Duke Biddle Foundation and the United Medical Research Foundation of North Carolina.

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An attempt was done to study on X-ray pictures, histological changes and their relation in 39 cases of pyelonephritis. The following results were obtained.
On pyelogram, slight deformity of the renal pelvis was demonstrated in acute form and remarkable changes were found in the renal parenchyma, pelvis, calyx, ureter and sometimes in the opposite kidney in chronic form.
On renal angiogram, no particular abnormalities were found in acute form, remarkable changes were, however, demonstrated in the renal artery and medium and small sized arteries.
Histologically, inflammatory changes were relatively localized in the papilla and fornix in acute form, but the more it progressed to chronic form, inflammatory changes advanced farther in the parenchyma and marked changes were noted in the glomeruli, Bowman's capsules, tubuli, interstitial tissue, renal arteries, medium and small sized arteries and renal capsule.
In regard with the relation between X-ray pictures and histology in pyelonephritis, deformity of the renal pelvis was demonstrated on X-ray picture in the histologically acute form in which inflammatory changes were localized relatively in the papilla and fornix. On the other hand, because the more chronic and progressive, the more marked inflammatory changes were noted in the parenchyma and the changes were marked in the glomeruli, Bowman's capsules, renal tubuli, intersitial tissue, renal arteries, medium and small sized argeries and renal cortex, various pathological findings were demonstrated on X-ray pictures in the renal parenchyma, pelvis, calices, renal artery, medium and small sized arteries, ureter and farther in the opposite kidney.

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Young's modified method being employed, hemagglutinin titers were determined to evaluate the antibody responses to O-antigens of dominant microorganisms isolated from urines in patients with urinary tract infections. Two hundred and thirty trials have been undertaken to cover to postoperative course of infections.
1) Hemagglutinin levels in preoperative non-infections cases demonstrate under 1/160, which are equivalent to those in normal subjects in author's previous study.
2) Microorganisms isolated from urines in 31 patients postoperatively are 67 strains, of which 41 strains (61%) show high hemagglutinin responses.
3) The specificity of organisms is noted in this antibody forming responses. Significant rise of titers in Enterobacteriaceae and Pseudomonas aeruginosa groups and low antibody responses in Alcaligenes and Staphylococcus groups are evident with one exception of high response in Staphylococcus epidermidis found in two cases, when it is combined with Enterobacteriaceae (E. coli and Kiebsiella) infection.
4) Hemagglutinin titers reach to the highest level within 3 weeks in most cases from the onset of infections (mean 3.3 weeks).
5) The rise and fall of this hemagglutinin response can be classified into 3 types.
I. Rapid rise and fall: This type represents the group of patients whose infections are usually controlled by medication.
II. Rapid rise and long duration: This means the long standing infections due to the same organism despite the multiple choices of chemotherapy.
III. Initial high level and gradual fall: This type indicates the eradication of infection which has been persisted in preoperative period.
These 3 types of hemagglutinin responses relatively manifest the courses of urinary tract infections.
6) Positive reaction (above 1/160) is obtained in 41 out of 59 patients whose urines contain more than 10⁵ organisms per ml, and there are obvious correlations between the degree of bacteriuria and significant rising of antibodies (above 1/640).
7) Antibody rises to Enterobacteriaceae, particularly to E. coli, are found 80-100 per cent in patients with fever above 38°C. There is no remarkable difference noted among strains of Enterobacteriaceae in the incidence of significant elevation of titers (above 1/640).
These results are discussed in relations to the similar biological activities of endotoxins in gram-negative bacteria.
8) No correlations is found between antibiotics sensitivities and hemagglutinin levels.
9) Continuous irrigation with 0.5% acetic acid solution through the indwelling catheter after prostatectomy induces good preventing effect to the postoperative infections. It is generally acceptable to keep urine acid in expecting bacteriostatic effect to the infecting organisms as to get low antibody response resulting the early eradication of infection.
10) Antibody response is concluded to demonstrate the specificity of infecting organisms and the process of infection. The rise and fall of this hemagglutinin titers to the microorganisms indicate the pathogenicities of these isolates in the urinary tract infections.

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Ten years have passed since our department was founded and began urological services independently. We take this opportunity to report the results of clinical and statistical observations on the medical works which we made for the past ten years.
In the latter half, the number of patients increased, and the method of operations and clinical examinations made great advance both in number and quality. The reasons are as follows: 1) At Hokuriku area, many new urologists, who had been trained at our clinic, have begun their works actively. 2) Other doctors and the general public have become to recognize urology. 3) Great advance has been made in the diagnosis and treatment of renal hypertension, pyelonephritis, adrenal diseases, tumor of the bladder, male infertility and so on.

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