The author made attempts to find an artificial graft material which would spontaneously dissolve and be discharged, and therefore render the necessity to remove unnecessary.
1) In the preliminary experiment for repair of the upper half of the bladder, the glue plate was dissolved within 24 hours, and so not suitable garft material. The catgut membrane was discharged into the bladder cavity, and so not suitable for this experiment attempting to find a spontaneously soluble graft material. The gelatin sponge was too fragile to be sewn to the cut edge of the bladder and dissolved so rapidly that all of the animals expired of urinary leakage into the peritoneal cavity within one week.
However, when the gelatin sponge was immersed in 99% ethyl alcohol for over one hour, it became harder and increasingly elastic. As a result anastomosis to the cut edges was possible and also urinary leakage became less and infrequent.
2) Repair of the upper half of the bladder in rabbits using the alcohol treated gelatin sponge was performed.
8 of 23 rabbits expired of urinary leakage within one week, but the others survived with good general conditions. Fine fragmented sponge material was discharged into the urine over 1-2 weeks postoperatively. Histologically, after one week the outer surface of grafted part was covered with only a thin granulation tissue and severe hemorrhage and inflammatory cell infiltration was seen in the gelatin sponge. After 2 weeks the inner portion of gelatin sponge was discharged into the bladder cavity, but the outer portion of the sponge was infiltrated with inflammatory granulation tissue and a sufficiently thick granulation wall to prevent urinary leakage was established. By the end of 6 weeks, the degree of inflammatory reaction decreased and granulation tissue progressed to connective tissue while epithelial regeneration progressed to cover the inner surface of the grafted part completely. Muscle regeneration began after 6 weeks and progressed thereafter, and at 10 weeks the new bladder wall showed a complete muscle layer.
3) Artificial bladder was constructed of gelatin sponge and used for bladder reconstruction following subtotal and total cystectomy in female dogs. An indwelling uretheral catheter was left for 10-14 days postoperatively. No ureter catheter was used.
Subtotal cystectomy; 3 out of 5 dogs survived over 2 months with good general conditions. The capacity of the new bladder was 30cc at the end of one month and 210cc at 5 months later. Histologically, after 2 months the new bladder showed complete epithelial covering and muscle regeneration also began from the cut edges and progr essed toward the dome of bladder. The new bladder at 5 months had a complete muscle layer up to the dome.
Total cystectomy; 3 of 5 dogs survived at least 3 weeks. The dogs showed a status of urinary incontinence following the withdrawal of urethral catheter. Two dogs expired at the end of 3-5 weeks mainly of hydrouretero-nephrosis caused by structure of the new ureteral orifices, and their newly formed bladder showed a capacity of 30-50cc. Histologically, however, epithelial regeneration was incomplete and no muscle layer was seen. One dog was sacrificed at the end of 6 weeks. The capacity of the new bladder was over 60cc and the ureteric orifices showed only a slight obstruction. Histollgically, the new bladder showed a complete epithelial covering and also a complete muscle layer up to the dome where the ureteric orifices are located.
4) Bladder reconstruction using the alcohol treated “gelatin sponge bladder” was done following extensive partial csystectomy for bladder cancer in 2 cases. The indwelling urethral catheter was withdrawn 2-4 weeks after the operation. The capacity of the new bladder was over 200cc at 2-3 months. However, both cases showed a development of small new papillary tumor, not only in the original bladder but also in the new regenerated bladder portion and required

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We have observed the course of tuberculosis of the prostate in 95 cases on palpation, for one to 15 years. These cases had complication of tuberculosis of the urinary tract and mostly received chemotherapies for 4 to 5 years. Among 95 cases, aggravation was seen in only one. Among 36 cases that were observed for more than 3 years, cure was 30.5%, improvement in 50.0% and unchanged in 19.4%. Figure 1-3 show some examples. The conventional concept that tuberculosis of the prostate cannot be completely healed should be discarded.

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Histological study of 175 prostates with or without nodular hyperplasia was carried out. As to the commonest site of the involvement of prostatic hyperplasia, the inner part of the lateral lobe as well as the middle lobe has been described by numerous investigators. The former has been usually called as the inner gland, but the present author failed to confirm any histological difference of the epithelium or a boundary between the inner and the outer gland.
The earliest demonstrable lesion of nodular hyperplasia was composed of stromal and epithelial hyperplasia, being classified into five histological types.
Type Ia was a localized lesion purely composed of fibroblasts associated with diffuse lymphocytic infiltration.
Type Ib had the same histological features as type Ia, except for a finding with some proliferation of smooth muscle in the lesion of fibroblastic hyperplasia.
These two types of stromal hyperplasia were induced in the periurethral layer of the inner gland and frequently observed in the aged group after 60 years old.
Type IIa was represented by epithelial hyperplasia of the distal duct without any stromal proliferation. The duct had a crescent-like cavity with a characteristic epithelial growth resulting in a papillary formation outwards from the inner side of the crescent. The lesion was usually induced in the middle layer of the inner gland and in the middle lobe.
Type IIb consisted of lobular hyperplasia without signs of stromal proliferation. The lesion appeared in the 5th decade and increased its incidence with aging. Lobular hyperplasia was usually observed in the outer layer of the inner gland and also in the middle lobe.
Glandular hyperplasia was further divided into two types, ductal and lobular, which was first described by the present author according to the usual manner of similar lesions in other organs. It was highly suggested that ductal and lobular hyperplasia developed to a typical adenomatous nodule, or to a fibroadenomatous one when the stroma was involved in hyperplasia.
Type III showed combined stromal and epithelial hyperplasia, which was composed of ductal or lobular hyperplasia associated with proliferation of fibrous or fibromuscular stroma. The commonest site involvement is the middle layer of the inner gland as well as the middle lobe.
In conclusion, hyperplasia of the prostate would be induced pluralistically from the stroma and the epithelium, most commonly in the so-called inner gland and in the middle lobe with the process of aging.

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Lactic dehydrogenase (LDH) isozyme of normal renal tissue in 4 cases, of ischemic renal tissue in 2 cases and of renal-cell-tumor tissue in 12 cases and glutamic oxalacetic transaminae (GOT) isozyme of renal-cell-tumor tissue in 7 cases were examined by the use of columnchromatography with DEAE sephadex A-50. The results were as follows:
1) As to the LDH isozyme pattern of normal renal tissue, LDH₁ occupied about 2/3 of all LDH isozymes of the cortex, and the medulla had both LDH₄ and LDH₅, which were not in the cortex.
2) LDH isozyme patten of the cortex of ischemic kidney was the same as of the cortex of the normal kidney.
3) About a half of renal-cell-tumor tissue had an increase of total LDH activity. The LDH isozyme pattern was not constant. In general, LDH₁ decreased and LDH₄ and LDH₅ increased.
4) The total GOT activity of renal-cell-tumor tissue decreased to 1/2 or 1/3 of the normal renal cortex. But because the decrease of GOTm (in mitochondria) was more remarkably than of GOTs (in supernatant) the ratio of GOTs/GOTm increased to about 5/1 (2/1 in normal).
5) In a case of renal granular cell tumor, LDH isozyme and GOT isozyme of the tumor tissue were almost normal.
6) Considering the meaning of LDH isozyme and GOT isozyme in the metabolism, we can say that the increase of glycolysis and the decrease of respiration are the character of energic metabolism in the tumor cell of the kidney.

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As to the fibrin plate method, the effect of fibrin membrane preparation and some experimental conditions for determination on the width of fibrinolytic area was examined.
1. The preparation of fibrin membrane
1) In relation between the amount of fibrinogen in the fibrin membrane and the width of the fibrinolytic area, the latter was almost constant against the fibrinogen concentration within the range of 300-500mg/dl. But it was significantly expanded under the fibrinogen concentration of 100mg/dl.
No significant difference could be found against the thrombin concentration within the range of 10-100u./ml. But over 500u./ml, the width of fibrinolytic area was slightly reduced.
There could be found a inversely proportional relation between the thickness of the fibrin membrane and the width of fibrinolytic area, and furthermore, larger standard deviation of estimated value could be found corresponding to the development of the thickness.
In relation between the ionic strength of the buffer solution pH 7.3 as solvent and the width of fibrinolytic area, the results with μ=0.15 buffer was somewhat larger (5-21%) than that with μ=0.50.
2) Next, the effect of heat treatment, which required to denaturate the plasminogen in the fibrin itself, and the width of fibrinolytic area was examined.
It was clarified that: i) the width of fibrinolytic area in the plate treated at 85°C for 10 minutes was reduced to about 47.3% of that of the standard plate without any heating. ii) the results in the plate with 30 minutes heating at the same temperature was 42.9% of the latter, iii) the value with 50 minutes heating was 35.8%, respectively. Complete denaturation of plasminogen in the plate with heating at 85°C for 30 minutes could be found.
2. Experimental conditions
The effect of the concentration of streptokinase on the fibrinolytic activity of the plasma was examined.
The width of fibrinolytic area was slightly increased corresponding to the increasse of streptokinase concentration within the range of 100-10, 000u./ml. But some decrease of it could be found at the concentration of streptokinase over 1000, 000u./ml.
In relation between the incubation time of the plateat 37°C and the width of fibrinolytic area, the maximal expanding rate of the fibrinolytic area in every one hour was found at 16 hours incubation (21mm²/hr.), and it became a rather constant value (6-6.5mm²/hr.) after 20-24 hours of incubation.
Next, the relation between the temperature of incubation and the width of fibrinolytic area at 18 hours incubation was examined. At 34°C incubation, it was about 70.8% of that of 37°C incubation, while the value of 146% was obtained at 41°C. About 10% deviation was found corresponding to the 1°C temperature alteration arround 37°C.
3. Reproducibility The standard deviation of the results obtained from the standard plate as the width of fibrinolytic area was ±6.1-12.9mm² within the range of 198-248mm², and it was rather diversed corresponding to the expansion of the width.
In the heat-treated plate, the value of standard deviation was ±14.4-15.8mm² within the range of 278-367mm² of the width, and the more lower reproducibility was confirmed on the heat -treated plate.
With the results obtained above, the more available fibrin plate is: 100-300mg/dl of fibrinogen concentration, 10-100u./ml of thrombin concentration, pH7.3 buffer solution (μ=0.15), and 1.3mm in thickness of fibrin membrane, 30 minutes heating at 85°C. And the more reasonable procedure is: 18 hours incubation at 37°C (one point check between 18-24 hours), and 100-10, 000u./ml of streptokinase concentration.

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The active component and its activity on the fibrinolytic enzyme system in blood, tissue, urine and its extracts was analysed.
According to the results of the first report, the fibrin plate (St. -plate) composed of 100mg/dl fibrin solution, 100u./ml thrombin solution, pH7.3 phosphate buffer (μ=0.15), and fibrin membrane of 1.3mm in thickness, was used. Furthermore, the heat-treated plate (H. -plate), which is the standard plate treated at 85°C for 30 minutes, was also used in comparison. The incubation time was 18 hours at 37°C in both cases.
1. Blood
The streptokinase-plasmin activity (SK-pl. activity) in serum and citrated plasma (plasma) was 413mm² in the former and 486mm² in the latter with St. -plate, and it was 291 and 353 with H. -plate, respectively. While the antiplasmic activity was 1410mm² in the former and 1404mm² in the latter. Namely, the serum had shown rather higher antiplasmic activity compared with the plasma.
The change of SK-pl. activity in plasma during the storage at different temperature was examined. It was reduced by time at any temperature during storage, but the reducing rate was rather lower in the preparation kept at lower temperature. Especially, the samples kept in ice-box showed only minimal decrease of its activity as from 253mm² to 251mm² during the first 24 hours.
Next, the fibrinolytic activity of euglobulin fraction and globulin fraction of the plasma was compared.
First, not any plasmin activity could be found on both of them, but SK-pl. activity was 641mm² and 580mm² on St. -plate and 390mm² and 367mm² on H. -plate, respectively. Namely, it revealed rather a higher activity of fibrionlytic action in the euglobulin fraction of the plasma. (The SK-pl. activity of the whole plasma was 504mm² on St. -plate and 306mm² on H. -plate.) The reason why the fibrinolytic activity of euglobulin fraction of the plasma was rather more dominant than that of whole plasma is: the antiplasmic activity was 1006mm² of the whole plasma compared with 614mm² of the euglobulin fraction, and about 40% of antiplasmic activity of whole plasma was assumed to be eliminated out in the euglobulin fraction.
The value of fibrinolytic activity in blood obtained from 17-49 aged healthy men and women (with 95% confidence interval) was: with St. -plate, 0mm² in plasma, 387-489mm² in SK-plasma, 0-46mm² in euglobulin fraction, and 496-646mm² in SK-euglobulin fraction; with H. -plate, 0mm² in plasma, 242-302mm² in SK-plasma, 0-16mm² in euglobulin fraction, and 392-398mm² in SK-euglobulin fraction, respectively. The antiplasmic activity of plasma was 673-769mm².
2. Tissue
The amount of plasminogen activator in the tissue homogenate and its extract obtained by Astrup-Albrechtsen's method was compared. A rather higher value could be found in the latter.
3. Urine
The amount of plasminogen activator was compared on each portion of fresh urine, 50% alcohol extract, aceton extract, and KSCN extract of the urine with St. -plate. The activity of them were 455, 195, 72, and 64mm², respectively, and the most high activity of urokinase was found in the fresh urine. However, in the cases of proteinuria, the urokinase activity was rather higher in the extract compared with the one from no protein containing urine. Furthermore, the activity of urokinase was quickly reduced even in the preparation kept in ice-box.

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To clarify the biological mechanism of occurrence of fibrinolytic phenomena at a surgical operation as well as the factors relating the surgical procedure, the fibrinolytic activity of peripheral blood of the cases who received a surgical operation on the genitourinary organs, especially a prostatectomy was observed. The method of determination was described previously in the second report.
1. The effect of surgical operation of the genitourinary organs on fibrinolytic activity was examined by the estimation of SK-pl. activity with St. -plate. There could be found a progressive decrease of the activity after surgery of the kidney or the urinary bladder, while it increased gradually during 24 hours after surgery of the ureter. Furthermore, clearly increased activity was already found 3 hours after a prostatectomy. On the other hand, not any significant change could be found when using H. -plate, in each case.
2. The course of the temporal increment of fibrinolytic activity after a prostatic surgery was analysed by the observation on the results of experimental prostatectomy in the rabbit. And an expansion of fibrinolytic area on St. -plate was confirmed only during 2-3 hours of the postoperative course. The same result was rather obviously found on SK-pl. activity, than plasmin activity.
3. The relation between the surgical factors in prostatic operation and the fibrinolytic activity in the blood was examined. Rather high SK. -pl. activities were found in the case with hen's egg-sized prostate, as well as the adenomas of 21-40g in weight, or the adenomas with severe adhesion. As to the surgical technique, the most high activity was found in the blood after TURP, then come transpubic total prostatectomy and retropubic prostatectomy.
With the results obtained above, it was assumed that the difference in the effect of surgical operation of different organs with fibrinolytic activity in the blood reveals the importance to be concerned about the direct effect of the operation itself as the factor affecting the fibrinolytic activity, except an emotional uneasiness, anesthesia, or fatigue at the operation.
With the experimental prostatectomy in the rabbit, it was clarified that the more significant apparence of the plasminogen activator or proactivator in the blood after the surgery was confirmed, than that of plasmin or plasminogen. And furthermore, with the analysis on the relation between the surgical factors of prostatectomy and postoperative fibrinolytic activity, some close relationship between the manipulation of the surgical capsule of the prostate during the surgical operation and the increase of fibrinolytic activity in the blood was assumed. And this reveals that the plasminogen activator and proactivator which appear in the blood after the prostatectomy would originate from the surgical capsule of the prostate.

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Thin slices of urinary calculi were prepared, and the chemical compounds were analized and the structural patterns were observed. These observations were mineralogically performed by the polarization microscope. From this study, the mixed stones having chemical compounds, weddellite, whewelli te and apatite, were encountered most frequently.
Then this slice of stone was placed in the solvents in vitro and the process of its dissolution was observed by the polarization microscope. By this study, it was found that struvite was most soluble. Solvability order of the chemical compounds of urinary calculi was as follow, struvite, apatite, weddel-lite, whewellite, uric acid and cystine. Uric acid and cystine were paticullary difficult.
Regarding solvents, tetrasoclium E. D. T. A. was the most effective and then ordered as follow, dosodium ElD. T. A., renacidin, solution G, solution M, gurcuronic acid and urease. Gurcuronic acid and urease did not show any dissolution reaction, but slight reaction to struvite.
The stone of which the main compound is struvite, was soluble to acid solvent. The stone of which the main compound is apatite, was not related to pH and the stones having main compounds of wed-dellite, whewellite, uric acid and cystine, were soluble to alkaline solvent.

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With a view to elucidating the muscular structure of the vesical sphincter, comparative study has been performed, in contrast, between the microdissections by means of a micromanipulator and the histological findings, both of which were obtained from the normal vesical spincter and that of hypertrophy of the prostate. The following are the results:
1. A normal vesical sphincter is, at the neck of the bladder, a circular muscle layer, semi-lunar in shape and open at the upper part, which is, in other words, a sort of continum of muscle layers. Each of those individual muscular fibers run in a linear direction, thin but even in thickness, and each of them run parallel. The terminals of those muscular bundles are partly distributed within the prostate and reach partly the vermontanum.
2. The vesical sphincter with adenoma in the prostate is thinner than in the normal case, irregular, and high in intensity. The running of each muscular bundle is so complicatedly disarranged that it has been found impossible to trace the bundles to their terminals.
3. Histological findings of the normal vesical sphincter are that each muscular bundle of the bladder is thin, compared with the circular muscle layer, runs straight, coarse in the connective tissues, and compact in general.
4. The vesical sphincter with adenoma in the prostate presents an increase both in connective tissues and muscle fibers, and they are so commingled mosaically that they appear like fibromyoma. The sphincter has also been seen to be intruded by adenoma mixedly.
Those findings lead to the following conclusion:
a) The vesical sphincter is considered to form part of the prostate.
b) The vesical sphincter is recognized to be in the form of muscular bundles, semilunar in shape and open at its upper part; and the part from the neck of the bladder to the vermontanum is inferred to participate in sphincteric function.

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The massage of the prostata was done in 60 cases of urosis and the absolut number of peripheral eosinocytes before and after the procedure was counted in an attempt to study what Yamamoto called prostatic eosinophilia (PE). At the same time the Charcot-Leyden crystals-forming capacity and cytochemistry of peripheral eosinocytes in all the cases were studied by means of the same procedures that used by Shikada. “Thus” the effects of the masage of the prostate were studied.
Results
1) The “PE” phenomenon was seen in 5 of the 60 cases of urosis.
2) As to Charcot-Leyden crystals-forming eosinocytes from the 5 cases which showed positive reactions for the “PE” phenomenon, 3 and 5 cases showed positive reactions before and after the massage of the prostata, respectively.
3) The massage of the prostata is considered to provide significant means for testing the Charcot-Leyden crystal-forming capacity of “PE” positive cases.
4) Eosinocytes from the 5 cases showing positive reactions for the “PE” phenomenon are specific eosinocytes different from normal eosinocytes from a cyto chemical viewpoint.
5) The massazge of the prostata has no effects upon the cyto chemical findings noted in eosinocytes from both “PE”-positive and “PE-negative cases.
6) Eosinocytes from a female case showed a positive reaction for the Charcot-Leyden crystals-forming capacityl From a cytochemical standpoint the same findings that seen in “PE”-positive cases were noted in those eosinocytes.
7) As his co-worker asserts, the present author proposes to interprete the “PE” phenomenon as re-activity due to allergic pathologic changes in the prostate.

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