Bilateral ureteral ligation was done on the rats to cause acute uremia, and the dripping fixation method by Maunsbach et al was carried out on thier kidneys.
The following results were obtained from light and electron microscopic observations.
1) The penetrating rate of osmium tetroxide by the dripping fixation method in my experiments was 10-15μ per minute, showing a little lower rate than 20μ per minute reported by Maunsbach et al.
2) The outer cortical tubules fixed by dripping method were not all open lumina against Maunsbach's report and conversly closed lumina were observed in greater number.
3) In the middle portion fixed by both methods of dripping and immersion, remarkable vacuoles appeared in epithelial cells of proximal tubules in both groups of uni and bilateral ureteral ligations and I regard it as an artificial change produced by the fixation.
4) With light microscopy I could not distinguish exactly between vacuoles produced by artificial change and vacuoles of a lysosome like structure, but with electron microscopy the former could be evidently distinguished from the latter. The former were vacuoles produced by separation of plasma membrane.
5) In the group of bilateral ureteral ligation, big vacuoles were observed in the visceral epithelial cells of Bowman's capsule and sometimes these vacuoles and erythrocytes were noted in urinary space of Bowman's capsule.
6) The vacuoles immediately under the microvilli of proximal tubules increased remarkably in the group of bilateral ureteral ligation.
7) In epithelial cells of proximal tubules in the group of bilateral ureteral ligation, swelling of the cytoplasm, projection of whole cells into tubular lumen or occasionally destruction of cells were observed.
8) In epithelial cells of proximal tubules in the group of bilateral ureteral ligation, vacuoles of lysosome-like structure appeared evidently and increased in proportion to the progress of hours after ligation and at last the cells were entirely filled with only these vacuoles. This finding accorded with vacuolar degeneration observed with light microscopy. Similar vacuoles were also noted very slightly in the group of unilateral ureteral ligation.
9) With light microscopy by the Gomori's method, it proved that, acid phosphatase existed in epithelial cells of proximal tubules in the group of bilateral ureteral ligation. Therefore, I regard vacuoles of lysosome-like structure as to be those which lysosome had changed.

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Morphologic changes of the glomerulus of experimental hydronephrosis in the male Wister rats produced by complete mechanical obstruction of the right ureter were studied by electron-microscopy.
The results are summarized as follows:
1) Capillary basement membrane of the normal rats glomeruls is about 500 to 800Å in thickness, endothelial pore is about 300Å in diameter, and the basement membrane of Bowman's capsule is about 800 to 1100Å in thickness.
2) Electron-microscopic changes of the glomerulus began about 2 weeks after ligation and these became marked in 3 or 4 weeks in general.
3) Changes in glomerular epithelial cells: Proliferation and swelling were observed 2 weeks after and reached maximum about a month after. Cells became flatter 2 or 2.5 months after, degenerated and became fibrous at last.
4) Changes in glomerular endothelial cells: Changes began slowly and were very little. Only disappearance of endothelial pore and flattening of cells were observed 2 months after.
5) Changes in capillary basement membrane: Thickening and proliferation of basement membrane-like materials were observed 2 weeks after and these became marked in a month. After 4 months, when all other components turned into collagen fiber, the basement membrane remained unchanged. (I defined thickness over 1000Å as thickening.)
6) Changes of mesangium: The mesangium was well preserved for a fairly long time and proliferation remained very little to the last.
7) Changes of Bowman's capsule: Thickening and winding of the basement membrane of Bowman's capsule and proliferation and swelling of epithelial cells were observed 3 weeks after. The thickening reached its maximum and then-gradually degeneration advanced.

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Thirty-five kidneys with upper urinary tract obstruction due to various causes were studied electron-microscopically. Biopsy was made on the kidney cortex and the changes of glomerulus were studied.
The results are summarized as follows:
1) Changes in glomerular epithelial cells: Proliferation was observed in many of congenital origins and a change of the pedicles was much related to proteinuria.
Changes in glomerular endothelial cells were very little.
Changes in the capillary basement membrane: Thickening was accompanied by winding in many cases, the thickest being 1.4μ. (I defined thickness over 4000Å as thickening.)
The glomerulus with severe hyaline degeneration light-microscopically was observed electrom-microscopically to retain the form of the basement membrane.
Changes in mesangium: Proliferations of various degrees were observed in thirty three cases.
Changes in Bowman's capsule: Thickening above the grade (++) was observed in thirteen cases and the thickest was 6μ. (I defined thickness over 10000Å as thickening.)
2) Changes related to the cause of upper urinary tract obstruction: Severe changes were observed in the retrocaval ureter, infiltration of carcinoma uteri and renal stone.
3) Changes related to the site of upper urinary tract obstruction: The nearer to kidney pelvis obstruction was, so severe as the changes were.
4) Changes related to proteinuria: Many changes of glomerular epithelial cells, especially of the pidicles and capillary basement membrane were observed in the cases of proteinuria.
5) Changes related to hypertension (above max. B. P. 150mmHg): Thickening of glomerular capillary basement membrane was observed and membrane-like material was produced.
6) Changes related to infections of the urinary tract: Changes were severe in the cases which were accompanied by or had undergone infections of the urinary tract. Proliferation of the mesangium and thickening of the basement membrane and Bowman's capsule were observed.
7) Changes related to renal function: Changes were found to correspond with the findings of I. V. P. In the cases of severe renal dysfunction, proliferation of the mesangium, thickening of the basement membrane and proliferation of the endothelial cells were observed.
8) Some of other special observations by electron-microscopy are also reported.

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In one hundred and fourteen cases of normal subjects, and in eighty-six patients with upper urinary kcalculi, daily excretions of urinary calcium, orthophosphate, pyrophosphate, cirtic acid, magnesium, creatinine, uric acid and alkaline phosphatase activity were estimated. The results of urine analysis in both groups were respectively compared.
In the calculous patient group, significantly higher levels of urinary pyrophosphate and citric acid, but significantly lower levels of urinary magnesium were demonstrated. Urinary excretions of the remaining compositions, especially urinary calcium levels showed no significant differences between both groups. But idiopathic hypercalcinuria, in which over 300mg of calcium are excreted in the 24 hour urine with normal serum levels of calcium and phosphorus, was found in 11 percent of normal subjects over 20 years old, whereas the group of calculous patients showed higher incidence of 19 percent hypercalcinuria. Also it is interesting that hypercalcinuria is not demonstrated in thirty-nine normal subjects under twenty years old.
The inhibitor index proposed by Fleisch, H. et al., which is expressed in the ratio of pyrophosphate: calcium×orthophosphate, showed significantly higher value in the calculi group. This difference was more distinctly observed in the comparison between calculous patients with hypercalcinuria and normal subjects. Moreover, the chronological values of the ratio in the control group show the interesting variations, which conversely correspond to the age distribution of the urinary calculus. These findings are supposed to indicate that the ratio possibly correlates to the formation of the urinary calcareous stone.
In eleven cases of calculous patients and five cases of normal adults, orthophosphates (Na₂HPO₄+KH₂PO₄) in daily dosis of 2gm were administered by mouth. Before and after administration the consecutive biochemical analysis was performed and was compared. The results definitely demostrated that the administration of the phosphates preparation caused significant increase of urinary citric acid, pyrophosphate and the inhibitor index expressed in the ratio of pyrophosphate: calcium×orthophosphate, but significant decrease of urinary calcium and magnesium. These changes of urine compositions caused by administration of phosphates, suggests that orthophosphates have clinical usefullness in prevention of the formation of the urinary calcareous stone.

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Sixty-seven cases of hematospermia and 66 autopsy specimens of the normal seminal vesicle were subjected to investigation in an attempt to elucidate the mechanism of its development which has hitherto remained unknown.
1) From the clinical symptoms, present condition and urological laboratory findings of the 67 cases of hematospermia, it was found that 13 cases of them had sclerosis of the vesical sphincter and 2 cases benign prostatic hypertrophy, all of them showing a distended seminal vesicle on the X-ray film.
2) On the 66 autopsy specimens taken from males ranging 11 to 81 years of age with an apparently normal lower urinary tract and genital organ, one of the seminal vesicles was studied histologically and the other by means of microdissection. Histologically, the wall of the seminal vesicle was quite compact and the blood vessels were abundant in the surrounding tissue and adventitious coat of the vesicle but unexpectedly scanty in the submucous coat. Whereas microdissection revealed a number of vessels penetrating almost rectangularly from the middle of the muscular layer into the submucous layer.
On the basis of these findings, it is speculated that the orifice of the ejaculatory duct grows narrower on account of a disease of the bladder neck, thus causing the pressure within the seminal vesicle to rise and the vesicle to distend. This results in direst pressure upon the blood vessels entering the submucous layer rectangularly until the vessels break and bleed.

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Vaso-epididymography which has the purpose to examine roentgenologically the patency of the proximal portion of the seminal tract, has not been so widely applied as vaso-vesiculography. Therefore, clinical data concerning the vaso-epididymography are too scanty and insufficient to evaluate definitely its clinical usefullness.
The author performed the vaso-epididymography by the following technique in 151 patients (fourteen cases of normal adults as a control group, ninety cases of azoospermia and oligospermia, fourteen cases of epididymitis including one case of spermainvasion, five cases of spermatocele, three cases of hydrocele testis, four cases of maldiscent testis, four cases of male hermaphroditism, seven cases of hypogonadism, two cases of hematospermia, seven cases of prostatic cancer under the endocrine treatment, one case of epididymal anomaly).
Technique of vaso-epididymography:
Under local anesthesia with one per cent novocain, the upper portion of the scrotum is incised in about 4.0cm length, and the testis is drawn out of the incision. Vas deferens is deliberately freed from the surrounding tissues. A hypodermic needle (gauge No. 24) with blunted tip is inserted precisely into the lumen of the vas through a small stab wound on it toward the proximal direction. The water-soluble radiopaque media (0.4-0.6ml) is injected very gently and slowly in several minutes. Then, the needle is reinserted in the reverse direction through the same opening of the vas, and the radiopaque media (2.0-5.0ml) is also injected for vaso-vesiculography. The testicular biopsy, if neccessary, can be performed at the same time. On X-ray filming for vaso-epididymography, the position of the testis, the epididymis and the vas placed directly on the film should carefully be arranged in such a way as not to be overlapping each other. For this purpose the author has found a dental film (Occlusal, Fuji Film Co. Ltd.) very useful. The vaso-vesiculography is performed in the conventional way after the closure of incision.
The vaso-epididymography taken by the above-mentioned technique is demonstrated to visualize very clearly and sharply the entire structure of the epididymal and proximal vasal lumen. The vaso-epididymography may be classified in four types (see figures in the Japanese text).
1) Clear visualization of epididymal and vasal lumen.
2) Visualization of epididymal body and tail, and the vas.
3) Visualization of epididymal tail and the vas.
4) No visualization of the epididymal lumen.
From these comparative investigations on findings of the vaso-epididymography, the testicular biopsy and the semen, it may be concluded that type 1, type 2 and type 3 of the vaso-epididymography demonstrate the patency of the epididymal lumen and the vaso-epididymal junction. Type 4 can be considered to show the difficult passage or complete obliteration between the epididymal tail and the vas.
Thus, the vaso-epididymography is thought to be a very useful method for examination of the proximal portion of the seminal tract, especially in the study of the male infertility. No serious complications have been encountered.

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