The mechanism of urine transport in the upper urinary tract has not been well elucidated yet. The author reviewing the previous literatures pertaining to it studied the pressure in the renal pelvis and ureter on 200 patients (246 ureters) using the strain gauge electromanometer. The cases of various urinary tract diseases were included.
First, the normal values were settled, and then alterations of the pressure under the various physiologic conditions and influences of a few drugs on the ureteral function were evaluated.
The results obtained may be summarized as follows.
(1) Normal pressure in the renal pelvis: The intrapelvic pressure fluctuates from 0 to 13mmHg being 4.5mmHg in average. The amplitude of it is much lower than that of the ureter.
(2) Normal pressure of the ureter: The resting pressure is 0-17mmHg (3.1-4.9mmHg in average). The amplitude of the contraction is 5-58mmHg (21.4-25.6mmHg in average). The frequency is 1-7 times per minute (3.4-4.0 times in average). The duration of the contraction is 1.0-10.0 seconds (2.5-5.7 seconds in average). The travel rate is 4-6cm. per second. The resting pressure and contraction amplitude is generally increased at the lower part of the ureter. The contraction complexes are also prolonged and are furnished with more pressure spikes.
(3) Anesthesia of various types does not produce any specific changes of the intraureteral pressure.
(4) Changing the position from the supine to the semi-sitting causes a slight raise in resting pressure, an increase in contraction frequency and a prolongation of contraction complexes.
(5) If the intravesical pressure exceeds beyond a certain level, the resting pressure in the ureter begins to rise. Further increase leads to slow increase of the frequency of the ureteral contraction, prolongation of the contractile waves, decrease of the amplitude and occurrence of more complicated contraction complexes. If the bladder volume becomes more than 200ml., the travel rate of ureteral contraction tends to decrease.
(6) General response of the ureter to increase in urine flow is increase in contraction frequency, elevation in resting pressure, prolongation of contractile waves and decrease in amplitude. The rate of changes in urine flow, however, plays an important role in this subject, further studies are indicated.
In experiments on dogs, the author designed an entirely new method to regulate the urine flow in the ureter by shutting of it from the kidney according to circumstances. This has been found to be useful for observation of influence of urine flow upon ureteral functions.
(7) The ureteral response at the time of its obstruction is found to be much the same when the intra-vesical pressure is raised.
(8) While the intrapelvic pressure of the well-established case of hydronephrosis is low (2-5mmHg), in the progressing one, the resting pressure of the ureter is generally elevated.
(9) In two cases of megaloureter, the urometrogram showed impaired ureteral functions.
(10) At the time of vesico-ureteral relux, the changes of the pressure in the ureter and bladder are synchronous, but retrograde contractions are not constant observation.
(11) The change of the ureteral pressure in the woman late in pregnancy is that os obstructive type.
(12) While a parasympatholytic drug and smooth muscle relaxants tend to decrease the frequency of ureteral contraction, both a parasympathomimetic drug and a smooth muscle stimulant do not exert an effect on the ureteral function. Activated vitamin B₁ drugs (Thiamine derivatives) accelerate generally the ureteral function although they shows minor deviations as to their effect.

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Radioisotope renography, renal scanning, and renal angiography were performed on a total of 47 cases of renal tuberculosis: unilateral renal tuberculosis, 34 cases, bilateral, 5 cases; and that of solitary kidney 8 cases.
The diagnostic efficacy of these three methods were compared and following results were obtained.
1. The diagnostic rates of tuberculosis obtained by these three methods were: radioisotpoe renography, 92%; renal scanning, 96%; and renal angiography 88%.
2. The affected kidneys were devided into 4 groups: Group 1 of the kidney with normal pyelographic appearance, Group 2 of the kidneys with lokalized sites, Group 3 of desolute kidney and Group 4 of the kidney with stenosis of the upper urinary tract.
Radioisotope renography was found effective in diagnosis of renal tuberculosis of Group 4, and renal scanning and renal angiography were effective in that of Group 2, all these methods were found effective.

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A histological study of the testes surgically obtained from 50 cases with prostatic carcinoma was performed. 29 cases received 500 to 27, 500mg of Honvan and in 4 cases of them hemicastrations were performed before and after the Honvan treatment in order to compare the histological findings. The remaining 21 cases were control cases.
The following lesions of the testes were observed after the Honvan treatment; 1) atrophy of the Leydig cells and dissociation of the islands, 2) fibrillar thickening and hyalinization of the tubular wall with atrophy of the seminiferous tubules, 3) decreased spermiogenesis associated with degeneration of the germinal epithelium, 5) atrophy of the Sertoli cells, and 6) an increace in number of the fibroblast-like cells and in quantity of amorphous substance in the interstitium.
It was considered that these findings were essentially the same kind of senile degeneration, but intensively accelerated with the estrogenic effect on the tissue directly or indirectly.
The severity of the lesions seemingly had relationships with the total dosage and the period of the Honvan administration. Obvious changes were observed in cases given more than 1, 000mg of Honvan and more remarkable changes in cases more than 2, 750mg. Even more than 7, 000mg of Honvan, however, did not induce the testicular lesions beyond the level of less than 5, 000mg.
Relatively more remarkable changes were observed in the cases treated for a period of over 20 days.
The three cases with 2, 750 to 4, 750mg of Honvan for 29 to 40 days presented the most severe lesions.
Since the amount, as well as the period, of the Honvan administration had a relationship to the severity of testicular lesion, it was assumed that an adequate estrogenic treatment would induce a so-called chemical castration histologically.

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Apparent permeability constants of peritoneum and artificial kidney twin-coil were determined by the multiple tracer method using ²⁴NaCl, ⁴²KCl, ¹⁴C-urea, THO and ¹⁴C-mannitol in the way previously reported. The experimental data shown in Tables 3 and 6 were obtained from 9 adult patients, consisting of 6 patients examined by ²⁴NaCl, ⁴²KCl, THO, and ¹⁴C-urea, and 3 by ²⁴NaCl and ¹⁴C-mannitol, and from 3 twin-coils examined by ²⁴NaCl, ⁴²KCl, THO and ¹⁴C-urea.
From these data, the following conclusions were obtained.
1) The apparent permeability constants of H₂O, urea, K and mannitol are in average 2.42, 1.44, 1.40 and 0.656 times as large as that of Na respectively. Those of K, Na and mannitol are in proportion to their diffusion constants in water. On the other hand, peritoneal permeability of urea and H₂O is greater than expected from their diffusion constants in water.
2) On the assumption that, mannitol does not penetrate the cell-wall and that, it passes through the intercellular space of the peritoneal membrane by simple diffusion, it is considered that, H₂O, urea, K and Na pass for the most part through the intercellular space of the peritoneal membrane by simple diffusionn and that a small amount of H₂O and urea is transported through the peritoneal cell-wall. It is strongly suggested that, the transfer of these substances through the peritoneal membrane is carried out by “passive transport”.
3) Peritoneal clearance and dialysance of an artificial kidney can be calculated at any flow rate from apparent permeability constants of the peritoneum and twin-coil. Their relationships are shown in Fig. 5 and 6. Peritoneal clearance and dialysance of an artificial kidney increase in accordance with the increase of the flow rate, and approach their apparent permeability constants at the infinite flow rate. These maximum urea and K dialysances of an artificial kidney are about 7 times as large as those of peritoneal clearance.
4) When intermittent peritoneal dialysis is done using a liter of dialysate at a time, average 28.4 minutes are required for the inflow and outflow of the dialysate. To get maximum efficacy, it is desirbale to perform one peritoneal dialysis by an intermittent technique about 40 minutes from the beginning of inflow to the end of outflow of the dialysate.

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