Statistical studies and analysis of the cases of urethral injuries associated with pelvic fracture collected from 38 departments of urology of medical school in Japan were performed.
The data were compared with those of our hospital. References to the orthopedic data of our hospital were made, too.
Some case reports warning enough against the time-missing treatment were also made.
From the results above, early accurate diagnosis and deliberate first aid for this kind of patients were emphasized, which lead to the good prognosis.

抄録全体を表示

Since the middle of nineteenth century, the extracorporeal normothermic perfusion of the isolated kidney has already been started by using the heart-lung-kidney preparation. It has been particularly used as a vehicle for the physiological and pharmacological studies. Lately the extracorporeal perfusion of the kidney during the renal transplantation has become necessary for the purpose of preservation of the organ and a number of reports on the functional capacity or viability of the perfused kidney have appeared. However there are very few reports on the renal hemodynamics discussed from the standpoint of transplantation immunity when the isolated kidney was perfused with the auto-, homo-, or heterologous blood.
In the present paper the author used the extracorporeal perfusion apparatus (MERA C type roller pump, disc type oxygenator) for the perfusion of isolated kidneys and tried to produce an identical experimental condition each time in order to avoid several technical problems and specific or unspecific vital reactions occurring during the renal transplantation. Each of isolated dog kidneys was perfused with the auto-, homo-, or heterologous blood; 3, 7, and 4 cases respectively. The perfusate consisted of the auto-, homo-, or heterologous blood 350ml, 20% mannitol 100ml, aminophyllin 1.0g and heparin 50mg. The changes in those kidneys were investigated by using the autologous blood perfused group as a control and the following results were obtained.
1) The renal blood flow obtained from the group perfused with the autologous blood was within a range of 117-171.4ml/100g tissue/min, which was the highest among the three groups. That of the group perfused with the heterologous blood was within a range of 20-84.2ml/min, which was the lowest of all. The group perfused with the homologous blood showed three types of blood flow; high and low flow rates similar to those shown by the previous two groups and the intermediary flow rate between those two. The renal blood flow of all groups tended to decrease as the perfusion proceeded and the kidneys which showed less blood flow at the initiation of perfusion had a tendency to lower the blood flow more rapidly than others. When the blood flow was high enough, the arterial blood pressure of the perfused kidney stayed stable at a relatively low range (around 100mmHg), but in others the pressure inclined to increase as the time passed.
2) The hemagglutination reaction tested by blood cross matching was positive in four out of seven cases perfused with the homologous blood and in three out of four cases perfused with the heterologous blood. Of the homologous blood perfused group two cases, which showed a type of high renal blood flow and its gradual decrease by time similar to those seen in the autologous blood perfused group were found to be hemagglutination reaction negative.
3) Although the urine flow of the perfused kidneys showed variable changes, the flow was maintained above 5ml/100g tissue/min in the cases perfused with autologous blood and was below 3ml/100g tissue/min in most of the cases perfused with the homologous blood. The urine flow from the kidneys perfused with the heterologous blood, however, was within 3.5-4.5ml/100g tissue/min, showing a range between the two previous ones.
4) The osmotic pressure clearance values of perfused kidneys showed excellent correlation to the urine volumes in all groups.
5) Throughout the experiment the weight gains of perfused kidneys were between 20-60%, but no significant difference in the rate of weight gain was noticed among the groups.
6) Although there were some differences among the groups, the general histological changes found in the perfused kidneys in all groups were turbidity, swelling and vacuolar degeneration of the proximal tubules, some tubular dilatation and interstitial edema. There were noticeable differences in the glomerular changes among the groups, showing a slight change in the autologous blood

抄録全体を表示

Favorable results were obtained in the treatment of 13 cases of cancer of urinary bladder (including 4 cases of relapse) with continuous infusion of anticancer agent into the internal iliac artery.
1) A polyethylene tube was inserted in retrograde fashion from the branch of the femoral artery on the side of the tumor and was led via external iliac artery into the internal iliac artery. The tip was placed directly above the point of branching of superior, cystic artery. Mitomycin C, 2-5mg/day, was continuously infused through this, giving the total of 50-168mg.
2) In 3 cases, the tumor disappeared, a marked shrinkage was seen in 7, and slight shrinkage was found in 3.
3) Histologically, tumor cells revealed ballooning of the protoplasm, vacuolar degeneration, nuclear pyknosis and karyorrhexis, interstitial edema and proliferation.
4) When the dose of Mitomycin C went beyond 80mg, anemia, leukopenia, skin ulcer in the gluteal area, and paresis of lower extremities tended to develop, In cases in which the superior gluteal artery was ligated, local side effects were mild.
5) In 1 of 13 cases, fatal outcome occurred due to intestinal hemorrhage, and death due to cor pulmonale occurred in 1. In other 11, no relapse was seen over a period of 1-2 years.
6) This treatment combined with TUR effectively prevented the relapse of the tumor.

抄録全体を表示

In the treatment of cancer of the urinary bladder, effects and side effects of anticancer agent through various routes of administration were studied.
1) In four groups of dogs, 1mg/kg of Mitomycin C was administered as follows;
Group 1. Systemic administration
Group 2. One shot injection into the internal iliac artery
Group 3. Infusion into the lumen of the urinary bladder
Group 4. Continuous injection into the internal iliac artery
2) Mitomycin C was demonstrated in the bladder tissue in low concentration in groups 2 and 4, but not at all in groups 1 and 3.
3) Concentration of Mitomycin C in blood followed the order of group 1, 2, 4 and 3.
4) The phosphorylase and succinic dehydrogenase activity in the bladder tissue showed decrease in the order of group 4, 2, 3 and 1.
5) Side effects were noted to be severe in the order of group 1, 2, 4 and 3.
6) Continuous infusion of anticancer agent into the internal iliac artery gave the most intense destructive effects on bladder tissue with relatively mild systemic side effects, representing a reasonable method of administration of anticancer agent.

抄録全体を表示

The cause of the prostatitis or chronic prostatitis has been considered to be a bacterial infectious disease. However, recent reports show that the number of cases of non-infectious prostatitis has been increasing. Therefore, immunological studies on the mechanism of the production of the prostatitis were carried out. As test materials, the prostate freshly isolated from the guinea pig and the autopsied man were suspended in saline and homogenized.
The homogenized prostate combined with Freund's complete adjuvant was injected to rabbits and rabbit anti-guinea pig prostate or anti-human prostate serum was obtained. Immunoserological experiments on the antigen-antibody system of the prostate were carried out and the following results were obtained:
1) By serological tests with precipitation reaction, gel diffusion method (Ouchterlony), the passive sensitized red cell hemagglutination reaction and the passive sensitized red cell hemagglutination in hibition test, the organ and the species antigen specificity were demonstrated. However, the common antigenicity between the human prostate and the semen was observed.
2) Specificities of the antigen-antibody system of the guinea pig and human prostate were also observed with the PCA reaction of the guinea pig.
3) By density gradient centrifugation technique, it was demonstrated that the antigenic substance of the guinea pig's prostate might be localized in the microsome of the tissue.
4) The homogenates of the guinea pig or human prostate were fractionated with starch block electrophoresis and almost the same patterns were observed and the antigenic activity was remarkably clear in the globulin fraction.
5) Rabbit anti-guinea pig prostate serum was fractionated with Sephadex G'200 and the powerful antibody activity was observed in the second peak.
6) No histological change of the prostate was observed in the guinea pig actively sensitized with guinea pig's prostate combined with Freund's complete adjuvant or in the guinea pig passively sensitized intravenously with rabbit anti-guinea pig prostate serum.
However, in the guinea pig locally injected with the rabbit anti-guinea pig prostate serum, slight cellular infiltration in the interstitialis was observed.
These results may reveal not only the antigen specificity and the antigen-antibody system of the prostate but also the possibility of the auto-immune mechanism of the production of the prostatitis.

抄録全体を表示

In an attempt to elucidate the mechanism for the vesicoureteral reflux, anatomical studies were made on the ureterovesical junction of normal and affected cases. The results were as follows:
1) Macro- and micro-dissections and histological findings of autopsied normal ten cases of male adult respectively revealed that: Waldeyer's sheath rises around the ureter about 3cm above the bladder and ends at the intramural ureter; part of the terminus of the ureteral muscles joins the muscles of the other side to form Mercier's bar, and the rest, after forming the triangular part of the so-called Bell's muscle, terminates as a few muscular bundles at the vermontanum without intruding into the prostate.
2) From histological examination of the lower ureter of nine affected male cases consisting of congenital vesical sphincter sclerosis (1), neurogenic bladder (1), tumor at the lower end of the ureter (2), ureterocele (3), and hydroflux (2), it was demonstrated that: in the cases that showed vesicoureteral reflux, irregular arrangement and hypertrophy of the ureteral muscular bundles and a marked increase of the connective tissue, and in those without vesicoureteral reflux, the muscular bundles of the ureter showed no changes or hypertrophy of the muscular bundles and a slight increase of the connective tissue.
3) The ureter is fixed to the bladder by Waldeyer's sheath, Mercier's bar and so-called Bell's muscle and it is speculated that organic changes in any of these supporting parts may cause, vesicoureteral reflux.
4) In the pathogenesis of vesicoureteral reflux, Mercier's bar or so-called Bell's muscle plays more significant role than Waldeyer's sheath.

抄録全体を表示