Urinary 17-ketosteroids were fractionated into androsterone, etiocholanolone and dyhydroepiandrosterone by the use of gas-liquid chromatography. Changes of urinary 17-ketosteroids, their fractions and 17-hydroxycorticosteroids following anti-androgenic treatments were investigated with special reference to extragonadal androgens. Effects of ACTH and gonadotropin (HCG and PMS) administrations on these steroid metabolites were analysed. The results were as follow:
(1) Pre-treatment levels of urinary total 17KS, their fractions and 17OHCS did not differ significantly from those of the healthy controls and patients with prostatic hyperplasia.
(2) Levels of urinary total 17KS, androsterone and etiocholanolone were markedly reduced following castration. The reduced levels were maintained with administration of estrogens.
(3) Neither castration nor estrogen administration resulted in any alteration of ACTH response. Analysis of urinary 17KS fractionation suggested rather an elevated responsiveness.
(4) Administration of HCG on castrated patients resulted in an increase of urinary androgen metabolites, suggesting an androgen-stimulating effect of HCG on the adrenal cortex. The effect was not reduced by administration of estrogens.
(5) Administration of estrogens decreased both ACTH and HCG responses, probably by the route of the pituitary-adrenal axis.
(6) Administration of PMS did not show any remarkable effect on excretion rates of urinary androgen metabolites both of gonadal and adrenal origins.
The results suggested that the elevated responsiveness of extragonadal androgen secretion should be suppressed by continuous administration of estrogens.

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Minamata disease which broke out on the coast of Minamata, a southern city in Japan, from 1955 to 1959, was a disorder of the central nervous system. It was proved that the cause of this disease was methyl mercuric compound which was taken from fishes or shellfishes contaminated by an effluent from a chemical plant. There have been many clinical and pathological reports on this disease. However, up to today, there have been no observations on the function of the urinary tract in this disease. The purpose of the present report is to research into the renal and vesical functions in Minamata disease.
Examinations were made in 33 cases of Minamata disease, including neurological examination, electroencephalography, renal clearance test, PSP test, Fishberg's concentration test, blood chemistry, urine examination, IVP, cystography and cystometry. As controls, renal function and cystometrogram in 15 rabbits of ethyl mercuric phosphate poisoning and cystometrogram in 21 cases of brain diseases were studied.
The following results were obtained.
1) Neurological examination and electroencephalography revealed that, the chiefly disturbed portions in Minamata disease were the cerebral cortex and cerebellum. In the cerebral cortex, the chief lesions involved covered Sulcus calcalinus and Gyrus centralis in adult cases. In children, especially in congenital cases, involvement is extended wider to the frontal lobe.
2) A majority of cases of Minamata disease showed normal renal function, while some showed moderate disturbance of RPF and proximal tubular function.
3) Hypertonic small bladder was observed in 4 of 14 adult cases of Minamata disease, in 5 of 7 child cases and in 11 of 12 congenital cases. On the other hand, 3 of 14 adult cases showed a normotonic or hypotonic large bladder. Efficiency of micturition was generally good. Urinary incontinence was observed in only 3 congenital cases.
4) Six rabbits which were given 2mg per kg of body weight of ethyl mercuric phosphate every other day developed moderate disturbance of renal function; and 9 rabbits, which were given 4mg per kg of body weight every day showed severe disturbance of that at the time of development of Minamata-disease-like symptoms. Some of these rabbits showed hypertonic small bladder, while some others showed large bladder.
5) A large number of cases of either cerebral arteriosclerosis or frontal lobe tumor showed a hypertonic bladder, on the other hand, almost all cases of traumatic epidural hematoma showed a hypotonic bladder.
The above results show that organic mercuric compounds have direct poisoning effect on the kidney, but in Mimanata disease, the disturbance of renal function was very rare. The results also suggest that there may be two centers which control the urinary bladder. One is the suppression certer which might be situated in the frontal part of the frontal lobe and the other is the promotion center situated behind the former.

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24 hour urine values of testosterone glucuronide were determined using the modified Vermeulen-Verplancke's method (1963).
A. Healthy male, healthy female, male castrate and male hypogonadism.
1. Baseline value of urinary T. was 49.0±20.5γ/day in 15 healthy young males, 26γ/day in a 64 years old healthy male, and 16.0±8.9γ/day in 4 healthy young females.
The value was 15.3±3.7γ/day in 7 adult male castrates and 17.1±6.0γ/day in 8 male hypogonadisms.
2. Following HCG administration (5000U×2 day for three days), the excretion of urinary T. showed a remarkable increase (113%) in healthy young male, but only a slight increase (53%) in an aged man.
In 7 cases of male castrates and 8 cases of Klinefelter's syndrome, T. excretion value was not influenced by HCG administration.
3. The increase of urinary T. following ACTH administration (ACTH-Z 40U) was variable (50-200%) in a healthy young male.
Urinary T. value in 3 cases of Klinefelter's syndrome was not influenced by ACTH administration.
Urinary T. of 7 cases of male castrates increased following ACTH administration, and it was noted that, the rate of increase was apparently dependent upon the lapse of time after castration.
The castrated 4-20 years ago showed only a slight increase (51%), while the recently castrated showed a remarkable increase (151%).
4. The excretion of urinary T. on the day of testosterone administration (T. propionate in oil 100mg) was as a rule over 100γ/day in healthy males, but definitely lower in male castrates (43.0γ/day) and male hypogonadisms (51.1γ/day).
B. Cushing's syndrome.
Male patients of Cushing's syndrome (3 cases with bilateral adrenal hyperplasia) showed normal urinary T. value before and after the operation.
However, female patients (1 case with unilateral adrenal adenoma and 1 case with bilateral adrenal hyperplasis) showed increased urinary T. excretion value (80 and 28γ/day) before the operation, and the value decreased to normal female range after the operation.
In 2 cases after bilateral adrenalectomy (1 male and 1 female), urinary To value did not show any significant change following ACTH or HCG administration.
C. Intersex.
Urinary T. value in one case of male hermaphroditism (16 years old) and in one case of female hermaphroditism due to congenital adrenogenital syndrome (20 years old) was in the normal range of a healthy young male.
Urinary T. in one case of testicular feminization (16 years old) whose testicles had been removed 7 years ago, was 26γ/day, and HCG administration had no increasing effect, but the value following ACTH administration reached up to 103γ/day.

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Renal homotransplantation has been carried out in five patients with terminal renal disease at the Department of Urology, Osaka City University Hospital.
The arterial anastomosis by end-to-end type to the hypogastric artery was placed in four cases, and in another case, end-to-side anastomosis to the external iliac artery was performed. The latter was technically simple and the homograft has been in good function.
The cases were briefly reported and the problems about the arterial anastomosis were reviewed and discussed.

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In order to show the prostate roentgenologically, several methods have been attempted with poor results. We have succeeded to display the prostate clearly by the method of direct injection of water soluble contrast medium into the prostate by rectal puncture.
After insertion of a 17 gauge canula into the prostate without anesthesia, 76 percent of Na and Methylglucamic salt of N, N′-diacetyl 3, 5-diamino-2, 4, 6-trijod benzoic acid (Urografin) is injected slowly, then the first roentgenogram is made. Second film is taken simultaneously with pneumocystography and urethrography.
These two roentgenograms show the clear-cut prostatogram, and also the relation between the prostate, the urethra and the bladder neck.
There are several merits in this method;
(1) Prostatic puncture can be done without anesthesia.
(2) Successive puncture of another lobe of the prostate is very easy.
Fifty cases were taken with this method, and excellent prostatograms were obtained especially in cases of prostatic hypertrophy.
Few complications, an attack of fever of 38°C and slight pain on urination occured but disappeared in a few days.

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A method of organ culture under hyperbaric oxygenation using the closed chamber system was utilized for the present study on both papillary and invasive tumors and normal mucosa of human urinary bladder. Those tissues were fragmented approximately 0.2cm in diameter and placed on a piece of silicon pause then cultured in the petri dishes with the fluid medium containing 10 per cent calf serum added to Eagle's medium. A fragment of gelfoam sponge placed on the bottom of each culture dish was used as a raft.
The cultures were maintained in an incubator at 37C of temperature for 5 days under various gas phases, which were pure air, air containing 40 per cent oxygen and 100 per cent oxygen and also under one and two atmospheres on each. The pH of the culture media was controlled at 7.2 to 7.4 with the difusion of carbon dioxide gas into the gas chambers according to the color indication of each culture medium.
Satisfactory results were obtained in the culture groups of papillary tumors which were maintained in pure air at 2 atmospheres and in air containing 40 per cent of oxygen at 1 atmosphere. As to the invasive type of carcinomas, however, it was more difficult to preserve the structure in this system; i. e. the satisfactory results were obtained in about a half of the cultures maintained in the same gas phases. Normal mucosa of the urinary bladder was easily affected by the minor deviation of oxygen contents and alter the original cellular characteristics.
Some histochemical studies on the cultures suggested a corelation between the degree of reaction of LDH and histological findings on the degree of preserving the original structure.
It will be suspected that the tissue oxygen demand is increased in the papillary tumors but being unstable or decreased in the invasive carcinomas. A further attempt of the organ culture on tumor of the urinary bladder using this culture system is now on schedule.

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