L-Leucyl-β-naphthylamine hydrolase (LNH) activities in serum and urine were investigated in 35 healthy adults and 119 patients with various urological or renal disorders. The activities were determined by the method of Goldbarg and Rutenburg (1958). In some of them, histochemical investigations were made on the pathological specimens obtained at operation or through biopsy, according to the method of Nachlas et al. (1957). An additional experimental investigation on acute renal failure was made in dogs, in which mercury bichloride was administered intravenously.
The results were as follows: -
(1) In the healthy adults the serum LNH activities were 98.0 units on the average with standard deviation of ±41.5. The urinary LNH activities in the male ranged from 45.5 to 192.5 units a day, the average being 120.8 with standard deviation of ±43.2, while those in the female ranged from 13.8 to 119.0 units a day, the average being 51.5±58.2.
(2) The serum LNH activities did not show any significant changes in patients with urological or renal diseases.
(3) A significant elevation was verified in the urinary activities of the patients with malignant renal neoplasm, renal tuberculosis and acute renal failure. No significant changes of urinary LNH activities were verified in the patients with benign renal tumor, essential renal hematuria, renal pelvic neoplasm, ureteral neoplasm, hydronephrosis, and renal or ureteral calculi.
(4) In 30 per cent of the patients with bladder carcinoma the urinary LNH activities were elevated, but histochemical examinations of the specimens did not show any activity in the tumor tissue.
(5) Though histochemically some activities were verified in the tissue specimens of prostatic carcinoma or benign adenoma, the serum and urinary LNH activities revealed no significant elevation.
It was suggested that the urinary LNH activities might be of diagnostic and therapeutic value in some of the urological disorders, especially in relation with renal tubular damages.

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Serum and urinary lysozyme activity (Lys.) was assayed by turbid-metric method.
1) Elevated serum and urinary lysozyme activity were found, as a rule, in patients with impaired renal function, especially with blood urea nitrogen (BUN) more than 30mg./dl.. Some cases of chronic glomerulonephritis, nephrotic symdrome and pyelonephritis, even though BUN levels were less than 30mg./dl., were found to have significant lysozymuria.
2) Moderate to high lysozymuria was often observed for several days after urological surgery. Postoperative lysozymuria was of high grade especially in cases of partial nephrectomy, total nephroureterectomy and ureterovesiconeostomy. The degree of operative trauma, the operation-time and the volume of blood transfusion did not have any relationship with the value of postoperative urinary Lys. No correlation was found between serum Lys. and the surgery.
3) The decrease of highly elevated serum and urinary Lys. after release of ureteral obstruction or renal ischemia in the clinical and experimental cases of solitary kidney, paralleled to the decrease of BUN. Therefore, the consecutive measurement of Lys. was an accurate reflection of the recovery of renal damage. It was noted in some cases of solitary kidney that Lys. of the bladder urine was definitely higher than that of kidney urine (obtained through nephrostomy tube).
4) Cases with chronic renal failure showed high serum and urinary Lys. Hemodialysis did not have any significant effect on serum and urinary Lys. In two cases, kept under chronic hemodialysis, high serum lysozyme value did not decrease after bilateral nephrectomy. In two cases of renal homo-transplantation, serum and urinary Lys. returned to normal, when the transplanted kidney gained satisfactory function, and slight increase of urinary Lys. was observed just before and during the rejection crisis. However in regard to the efficacy of lysozyme determination in predicting renal homograft rejection, there remained some problems to be solved in this study.

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For the purpose of establishing the value of renal angiography in detecting the early sign of renal homograft rejection, and diferenciating the other causes of postoperative renal insufficiency apt to be confused with the signs of rejection, we performed renal auto- and homotransplantation in adult mongrel dogs. Transfemoral renal angiography was performed at several intervals after an operation, and postmortem angiographic, microangiographic and histological examinations were also performed. In addition, we carried out the evaluation of the immunosuppressive effect of a few drugs. The results of these experiments were as follows;
1) When the ureter was anastomosed to the skin in autotransplanted groups, retrograde infection was frequently seen. So, the findings of pyelonephritis were angiographically seen. On the other hand, when the ureter was implanted into the bladder, the findings of infection decreased markedly and intrarenal arteries showed normal appearances.
2) Accordingly we implanted the ureter into the bladder, and performed various antibiotic therapies in all homotransplanted cases in order to avoid that inflammatory changes should affect renal vascular changes of the homotransplantation itself, and followngi results were obtained.
a) In the homotransplanted group without immunosuppression, the aorta of the host gradually decreased in size angiographically, and this finding was not seen in the Imuran-treated group. Consequently, the authors supposed that there were some immunological factors which caused this phenomenon.
b) The angiographic changes of the intrarenal branches in the homotransplanted kidney were spread, narrowing, straightenning, sparse distribution, marginal beading, etc. These findings resembled those of pyelonephritis.
c) The most specific finding which was seen in the homotransplanted kidney was diffuse linear deficit of cortical opacification in the nephrographic phase. In some cases this change was seen earlier than other angiographic changes or histological changes or elevation of BUN. Consequently, we supposed that this finding was one of the earliest signs of the homograft rejection.
d) The immunosuppressive effect of Glycirrhizin was not so marked, and as to Cobaltiprotoporphyrin, we could not find any immunosuppressive effect. But, our series were too few to elicit some conclusion about immunosuppressive effects of these drugs, and we expected further experiments.
3) According to the findings on the postmortem renal arteriogram, the microangiogram and the histological section, it is concluded that the arteriographic findings in homotransplanted kidney in vivo in dicate not only the change of the artery itself, but also the presence of lesion in periarterial tissue, which affects the blood supply, and reveal the localization and the extent of the disturbance of the renal function.

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For the recent period of 5 years and 10 months 131 cases of renal tuberculosis have been observed and treated. In principle, the concomitant use of SM, PAS and INAH was made in all cases, and nephrectomy was performed in 54 cases. On the one hand, the effects of treatment were followed in cases of renal tuberculosis by means of the quantitative method of metachromatic reactions (MR) in the urine. Chemotherapy was stopped when MR continued to be negative for more than 6 months.
Results:
1) MR in the group receiving the operation with the combined use of chemotherapy turned negative earlier than in the group receiving chemotherapy alone.
2) Among the chemically-treated group, the negativity of MR was not attained in cases of tuberculosis of both kidneys, in cases of tuberculosis of the remaining kidney, and in cases with tuberculous complications of organs other than the urinary tract.
3) At the point of continuous negativity of MR, the urines were all negative for bacillus tuberculosis, proteins and leucocytes, while the blood sedimentation rate was normal, and improvements of renal functions and pyelographs were noticed.
4) The quantitative MR correlates well with the active pathological changes in the tuberculous lesions of the kidney and hence the metachromatic reactions are deemed to be of high value as an index to the determination of the point of chemotherapy stoppage.

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Plasma testosterone levels were determined utilizing the protein-binding as described by Mayes & Nugent (J. Clin. Endocr., 28, 1169, 1968) with several modifications. Data revealed the mean value of 7.73±1.75mμg/ml in six normal adult males, and the precision of 15% in terms of variation coefficient was obtained.
It is emphasized that the technique is of clinical use as a routine method for the determination of the hormone.

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