Prostatic cancer cells are known to be shrunken after castration or antiandrogenic treatment. In this paper electron micrographs of normal prostate, benign prostatic hypertrophy, prostatic cancer cells and castrated prostatic cancer cells were demonstrated.
Specimens were obtained from 3 healthy persons, 3 cases with benign prostatic hypertrophy and 8 cases with prostatic cancer. In cases of prostatic cancer, the pictures of cancer cell were compared before and after castration.
In normal prostatic gland, tall columnar epithelia developed well. These cells were separated from stroma by a basement membrane. Along the basement membrane, basal cells were scattered, which appeared to have no secretory function. In glandular cells, round or oval nuclei were present at the basal region. Endoplasmic reticulum, mitochondria, secretory granules and vacuoles were observed in the cytoplasm. In benign prostatic hypertrophy internal structures of the cell did not differed significantly from those in normal prostate. As to cancer cells it was sometimes difficult to differentiate malignant cells from normal ones. However, the most prominent feature of prostatic cancer cell was shown by changes of nuclei which were featured by irregularity of the nuclear membrane and increases in number and size of nucleic chromatins. Numerous cytoplasmic organelles, especially endoplasmic reticulum and mitochondria were seen to be scattered in the cytoplasm. Prostatic cancer cells were observed to destroy the basement membrane and invade into the surrounding connective tissue. The most evident effect of castration on the cancer cells was collapse of endoplasmic reticulum and mitochondria, and degeneration of the cancer cell at the end stadium. Numerous cytoplasmic inclusion bodies were seen, which appeared to be transformed from mitochondria and endoplasmic reticulum. After castration, mature and immature collagen fibers were noted throughout the prostatic tissue around the fibroblast. These findings are considered to be the effect of castration.

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The extremely rare tumor of a hemangiopericytoma of the kidney is reported, and some aspects of this tumor discussed. The results are summarirzed as follows:
1) Hemangiopericytoma may arise wherever there are capillaries but is most common in the skin and the subcutaneous tissue. In the literature, however, we could find only 1 case of the kidney in Japan.
2) Final diagnosis must be made histologically. Hematoxylin-eosin stain and silver reticulin stain are necessary.
3) The histologic appearance of this tumor does not indicate whether it is benign or malignant. But clinically this tumor may be malignant. This has been demonstrated by direct extension of tumor tissue, recurrence after excision and also metastases.
4) Symptoms are very uncommon. Pain in the area of the tumor and vague gastrointestinal symptoms may be present, but generally, the only findings is that of a tumor mass.
5) Intravenous and retrograde pyelograms demonstrate distention, elongation and displacement of the pelves and calyces. In our case, “pooling phenomenon” is shown by aortogram. But hematuria is not usual.
6) It is impossible to state whether this tumor arose from the kidney parenchma, or arose from the capsule. In the literature, however, it seems to arise from the capsule, involve and invade the kidney.
7) Treatment of this tumor is primarily complete surgical excision and postoperative radiation therapy.
8) It is thought that a lymph-node disection is not necessary since metastases are hematogenous.

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This study is concerned chiefly with the description of a new instrument which permits study of the resting and voluntary tonus of the sphincter. I have called the instrument as the air-sphincterometer.
A large number of random patients have been examined, and among the findings obtained the following have clinical import:
When intravesical pressure is low (bladder content 0ml),
1) The range of resting tonus in the male was 59.2-63.21mm.Hg. and in the female the corresponding figures are 57.41-63.65mm.Hg. Tonus of the sphincter by voluntary contraction is more vigorous in the male than in the female. The range for males were 78.25-82.13mm.Hg. and for females 69.07-72.69mm.Hg.
2) Patients with enuresis showed lower range than the normals. The range of resting tonus in the male were 51.74-58.66mm.Hg. and in the female the corresponding figures were 48.90-53.90mm.Hg.
3) Only one of 3 females with varying degrees of dysuria, showed extremely high voluntary tonus of the sphincter.
4) After retropubic prostatectomy for prostatic hypertrophy, the resting tonus of the sphincter drops slightly.
5) During spinal anesthesia in 4 males and 6 females, the resting tonus dropped to about one half of the pre-anesthetic level.
6) During general anesthesia in 3 male patients, the resting tonus dropped to about one half of the pre-anesthetic level.
7) Within a few minutes after death in the male, the resting tonus fell to an average of 30mm.Hg. When intravesical pressure is highly elevated (bladder content 400ml),
1) The range of the resting tonus in the male were 66.06-73.30mm.Hg. and in the female, the corresponding figures were 62.29-69.13mm.Hg. During voluntary contraction of the sphincter in males were 78.47-83.27mm.Hgl and the tonus randed between 66.85-73.41mm.Hg, in females.
2) In patients with enuresis, the tonus were lower than the normal. The range of the resting tonus in male were 50.65-56.51mm.Hg. and in the females, the corresponding figures were 47.31-51.11mm.Hg.

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In 66 urologically normal adults and 73 cases with diseases of upper urinary tract, various examinations were made to clarify the fundamental problems on electro-ureterography-through-cystoscope.
The results obtained are as follows:
1. Wave pattern of the action potential
A standard wave pattern, which has all of the four deflections, i. e., positive before-potential, negative main potential, negative accessory potential and positive after-potential, was recorded both in the ureter of the normal persons and that of the patients with deseases of the upper urinary tract. In the normal ureter, the action potential was found to travel from the renal pelvis down to the urinary bladder.
2. Electro-ureterographic difference between the upper and the lower portions of the ureter
No remarkable difference in discharge interval, amplitude and duration of the action potential was observed between the upper and the lower portions of the ureter. But conduction velocity was found to be faster in the lower portion.
Similarity of the discharge interval recorded both in the upper and the lower portions of the ureter showed that all peristalsis was conducted from the upper portion down to the lower portion without fading away on the way.
3. Electro-ureterographic difference between the right and the left ureters
Discharges of the action potential of the both ureters were not synchronized. However, measured values of the action potential were almost similar in the both ureters.
4. Relation between urinary volume and ureteral peristalsis
i) Despite of urine volume, the discharge interval was found to be almost the same, when the secretion rate of urine was constant. Alteration of discharge interval was proved to occur, when the secretion rate of urine was changing: The discharge interval shortened when urinary output increased abruptly and the discharge interval prolonged when urinary output was reduced. When the urine volume resumed to be constant, the shortened or prolonged interval gradually returned to the values seen before the alteration of urine output.
ii) Showing no relation with secretion rate of urine, conduction velocity of the action potential altered parallel to the alteration of the discharge interval. The amplitude and duration remained almost constant, regardless of the change in urine volume or in the discharge interval.
5. Ureteral response to the intravesical infusion
When the bladder was infused to some degree with a physiologic saline solution, the discharge interval began to shorten. The time lapsed from the onset of the infusion till appearance of the phenomenon became shorter with larger urine output. Further, the phenomenon occurred with small intravesical content as the urine output became larger.
6. Normal values in electro-ureterogram
Taking 99.8% confidence limits of the values measured in 66 normal adults, the normal ranges of various measurements of the action potential were decided as follows discharge interval 6.0-33.7 sec.; amplitude 0.13-1.02mV; duration 0.2-1.1sec.; conduction velocity 2.0-66.6mm/sec.
7. On retrograde peristalsis
i) Genetic ways of retrograde peristalsis could be divided into five types: appearance of a retrograde peristalsis in group, appearence of a retrograde peristalsis between consecutive antegrade peristalses, appearance of an antegrade peristalsis between two consecutive retrograde peristalses, appearance of retrograde peristalses only, and alternative appearance of ante- and retrograde peristalses. The frequency of these five types was found to be in the abovementioned order.
ii) Transition from antegrade peristalsis to retrograde peristalsis occurred after abnormally longer discharge interval of the former. On the other hand, transition from retrograde peristalsis to antegrade peristalsis occurred after shorter discharge interval, compared to the preceded retrograde peristalsis. In rare occasions, above-mentioned relation became re

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A study of 753 cases with prostatic diseases is reported in this article. Those cases were seen in the Department of Urology, Niigata University Medical School during the period from 1950 to 1956 and in the Department of Urology, Osaka University Medical School during the period from 1957 to 1965. Prostatectomy was performed upon 724 cases and the rest, 29 cases had no bloody operation. Retropubic prostatectomy was performed on 508 cases (70%), and suprapubic and perineal prostatectomies on rather fewer cases.
All the cases were analysed under various factors such as age, preoperative symptoms, operative technique, postoperative course, survival rate, duration of both hematuria and indwelling urethral catheter, postoperative complications, and cause of death.
The urinary retention absolutely indicates prostatectomy and the respiratory disturbances were relative contraindication. The ratio between benign prostatic hypertrophy and prostatic cancer was 7 to 1. The mortality rate of retropubic prostatectomy for benign prostatic hypertrophy was 4.3% and the rate for prostatic cancer, 11.8%. The highest occurrence of operative death was seen in age 71 to 80. The five year survival rate after prostatectomy for benign prostatic hypetrophy was 90% and for prostatic cancer, 67%. It was a notable fact that postoperative infection by germs gradually increased during the last three years. And consequently, prophylactic vasectomy ineffectively prevented the occurrence of postoperative epididymitis.
The results showed that retropubic prostatectomy is at least one of the most effective methods for prostatic diseases and the authors believe that it might be very much desirable to stick to one and the same method.

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The absorption of irrigating fluid and the associated reaction syndrom with fluid and electrolyte changes are well known ill effects to the patient undergoing transurethral prostatic resection. The intravenous infusion of hypertonic solutions of mannitol containing electrolytes and glucose (Resectol) were investigated clinically to determine its possible protective effects in patients undergoing the procedure.
There are two types of Resectol, namely, Resectol-T and Resectol-U.
Resectol-T consists of 15 per cent mannitol solution with 5 per cent glucose, 6 per cent dextran, 0.85 per cent sodium chloride and 0.05 per cent calcium chloride.
Resectol-U consists of 5 per cent mannitol solution with 5 per cent glucose, 0.25 per cent sodium chloride and 0.02 per cent calcium chloride.
Thirty consecutive patients who underwent transui ethral prostatic resection were studied. They were given 100ml of Resectol-T for the 15- to 20-minutes period prior to transurethral prostatic resection, and another 300ml over an 1-hour period during the resecting procedure. Postoperatively, Resectol-U at the rate of 200ml per hour was given until 7 a. m. in the morning after surgery, a total of about 3, 000 to 4, 000ml.
The irrigating fluid was urigal (cytal) and the height of the irrigating fluid was 60 to 80cm from the mid bladder level in all the cases. The amount of tissue resected varied from 4gm to 46gm and the operating time was limited to 1-hour.
Serum electrolytes and BUN determinations were done immediately before surgery, immediately following, 4 hours, 8 hours and 24 hours after completion of the transurethral prostatic resection in all the cases. Urinary output via catheter was measured every hour for the first 4 hours after surgery, then every 4 hours for the first 24 hours.
Urinary output levels measured at 1-hour intervals varied from 100ml to 470ml. However the total 4-hour output volumes were comparable to 4-hour intake volumes. The Resectol-treated patients showed an average 24-hour output of 2964ml, which was 731ml less than the average intake over the same period. The ten control patients showed an average 24-hour output of 1010ml, which was 1954ml less than the Resectol-treated patients.
In the Resectol-treated series, serum sodium levels had dropped as much as 4.0meq/L on the average immediately after surgery, and gradually returned to preoperative levels within 8 hours. Serum potassium levels had also dropped as much as 0.5meq/L on the average immediately after surgery, then gradually returned to preoperative levels within 8 hours.
In the control series, however, serum potassium levels had elevated postoperatively and exceeded the normal limit as much as 0.2meq/L at the 4-hour period after resection. Whereas, serum sodium levels remained within normal limits.
Serum chlor level revealed no remarkable change in both Resectol-treated and control series.
The most remarkable merit of Resectol was noted in the changes of BUN levels. In the control series, BUN levels gradually elevated postoperatively and reached as high as 29.9mg/dl on the average at the 24-hours period, suggesting a riskyness of transurethral prostatic resection in the aged patients with impaired kidney function. On the contrary, in the Resectol-treated series, BUN levels were successfully controlled within normal limits.
There were no cases of oliguria or renal shutdown in the entire series of 40 cases. Blood pressure reading were more stable in the 30 Resectrl-treated patients compared to 10 control patients.
In conclusion, the authors think that the intravenous infusion of Resectol-T and Resectol-U administered in the manner reported in this paper is a desirable way to promote excretion of toxic materials, increase urinary output, obviate postoperative irrigations and minimize danger of postoperative renal failure.

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