The effects of ACTH and cortisone on the adrenal cortex of the rat were studied enzyme-histochemically.
The animals were divided into five groups.
1. control
2. ACTH 2.0i.u./day
3. ACTH 0.1i.u./day
4. cortisone 2.5mg/day
5. cortisone 0.1mg/day
The following enzyme histochemical stainings were performed; lactate dehydrogenase (LD), glucose-6-phosphate dehydrogenase (G6PD), 6-phosphogluconate dehydrogenase (6PGD), isocitrate dehydrogenase (ICD), succinate dehydrogenase (SD), malate dehydrogenase (MD) and 3β-hydroxy-steroid dehydrogenase (3β-HSD).
All these enzyme activities increased after the treatment with ACTH and decreased with cortisone. These changes are especially remarkable in G6PD and 6PGD stainings.
After the treatment with ACTH for 21 days, strong activities of these two dehydrogenases remained for the following 7 days, while rapid recovery of enzyme activities were seen in the histochemical stainings of these two dehydrogenases with the cessation of cortisone administration.
These findings were observed mainly in zona fasciculata and zona reticularis, and little changes were seen in zona glomerulosa. The former two zones showed similar histochemical changes, and might be considered functionally one zone, which consists of clear cells and compact cells.

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(1) 78 cases of renal neoplasms, both benign and malignant, were seen at the Department of Urology, Niigata University Hospital from Jan. 1950 to Dec. 1966. This group was made up of 65 tumors of the renal parenchyma, 12 tumors of the renal pelvis and a tumor of the renal capsule. Follow-up study was made on all of them. Of all 78 cases, 75 cases (96.2%) were traced and 3 cases were missed from the study. Survival data in cases of malignant neoplasms was evaluated by the actuarial method. Prognosis was related to clinical findngs. Of 65 tumors of the renal parenchyma, 63 were malignant and 2 were benign. Among them there were 50 renal cell carcinomas and 8 Wilms' tumors. Of 12 tumors of the renal pelvis, 11 were malignant and one was benign.
(2) For the entire traced series of malignat renal tumors, 3-year, 5-year, and 10-year survival rates were 47.6%, 35.1%, and 21.6%, respectively. 5-year survival rate for malignant tumors of the renal parenchyma was 33.1%, while the rate for renal pelvic tumors was 48.5%. For renal cell carcinomas 3-year, 5-year, and 10-year survival rates were 54.9%, 37.2%, and 20.1%, respectively, while for Wilms' tumors 3-year and 5-year survival rates were 25% each.
(3) Prognosis was related to period between onset of symptoms and admission, grades of anemia and leucocytosis, erythrocyte sedimentation rate, size of tumor and venous involvement. The highest survival rate was obtained in cases treated by both surgery and irradiation.

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During a five year period since 1963 to 1968, two hundred paraplegics due to cord injury had been examined for their bladder function by the hydrodynamic studies, including suprapubic and retrograde cystometry and sphinctermetry.
Two types of pathological bladder function derived from upper motor neuron lesion (UMNL) and from lower motor neuron lesion (LMNL) were differentiated by conal activity test, which was chiefly examined by the bulbocavernosus reflex.
1) Reserved power of voiding was estimated by retrograde cystometry and was expressed as maximum retaining pressure (MRP). No significant difference of average MRP values between two groups of LMNL and UMNL was noted. However, there was a significant difference between the catheter-free paraplegia and catheter-life paraplegia.
2) Maximum voiding pressure (MVP) recorded by means of suprapubic cystometry was almost in normal range and there was no difference between UMNL and LMNL, although MVP was lower than MRP in those paraplegics who were able to void without catheterization. It is thought that patients with paraplegia also can void with some reserved power even though their flow rates are limited.
3) Retrograde resistance (RR) was directly examined by sphincterometry and voiding resistance (VR) was calculated from the values of MVP and MFR recorded by combined method. VR value was higher than in normal subject because of lower flow rate in paraplegics. But VR was correlative with RR in the LMNL group but not in the UMNL group.
4) A ratio of difference between MRP and MVP to MRP (%) was calculated. This was considered as the spare ability of micturition and one of the practical parameter of “efficiency of micturition”. Relation to other parameters of bladder dysfunction, such as a ratio of residual-capacity (%), excretory urography, and urinary infections were also studied and was found that the grade of bladder dysfunction was chracteristically proportional to “efficiency of micturition”.
5) Transurethral resection of bladder outlets was carried out in 33 cases. The patients whose value of efficiency of micturition were low, were well corrected for their bladder function by transurethral resection. Efficiency of micturition was considered of more effective and convenient parameter to decide the indication of TUR in paraplegia.

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In order to investigate diurnal rhythm of urine excretion, 47 patients were studied. The results are summerized as follows:
1) The excretory patterns of urine volume during 24 hours in usual life were classified into five types. They are the nocturnal oliguric type, 9p.m.-3a.m. oliguric type, 0a.m.-6a.m. oliguric type, nocturic type and flat type. The subjects without renal insufficiency showed the nocturic type invariably.
2) In the subjects without renal insufficiency, two excretory patterns of total solute were noticed, the first type with maximum excretion at noon, the second type with maximum excretion in the morning and evening, in contrast with various types of volume.
3) The graphic relation between urine volume and total solute excreted in hourly fraction of urine in usual life clarified the facts that there were two groups independent of types of excretory pattern of volume, one showing a straight line in distribution and the other showing a shift to the right. The total solute in fractions of urine at night was less than that in daytime in each group.
4) Two subjects were kept under a constant water load. From the observation of graphic relation between urine volume and total solute excretion in this experiment, the shift of fractional urine to the right was revealed to be water dieresis.
5) Three subjects were kept under a constant water load and pitressin was injected subcutaneously, and then each subject reached the state of osmotic diuresis in maximum antidiuresis by exogenous ADH.
One subject received constant infusion of 2.5% saline under restriction of water. He represented osmotic diuresis in maximum antidiuresis by endogenous ADH. From the observation of graphic relation between urine volume and total solute excretion in these experiments, straight linear distributions were thought to be chiefly due to osmotic diuresis.
6) In usual life, water diuresis and osmotic diuresis, the rate of Na and total solute excretion into urine was almost constant. From the result that total solute and Na excretion were increased in parallel after administration of hypertonic saline, it is assumed that Na is related to total solute excretion.
From the above results it is thought that diurnal rhythm of urine excretion comes essentially from osmotic diuresis due to diurnal rhythm of total solute excretion but, to some extent, the latter varies with water diuresis.

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In recent years, studies of the quantitative analysis on the mineral contents of the bone by means of densitometry of the roentgenogram of the forearm have been made in fields of medicine. In the urological field, however, this investigation is still scanty though its clinical application may lead to worthy information as to the diagnosis and treatment of the metabolic imbalance of calcium or phosphor.
The authors determined the mineral contents of the ulna in 28 patients with urolithiasis and 35 healthy adults by X-rays.
The patient's right forearm was placed in a water-phantom containing a wetting agent in order to standardize the thickness of the non-osserous tissues. The points 3.6cm above the distal edge of the ulna to be examined were chosen. The quantity of the bone salt in the above-mentioned portion was compared with an aluminium step wedge (7 steps of 2cm width, 0.5mm thick, from 0.5 to 5mm) by the densitometric measurement at the same points on the roentgenogram.
The results obtained in the clinical cases were as follows:
1. The mean value of healthy males was 388±105.8mg/cm³, healthy females was 345±131.2mg/cm³. 2. The mean value of male patients with urolithiasis was 304±81.2mg/cm³, female patients was 242±90.2mg/cm³. 3. There was found to be a tendency of higher mineral contents in the male than in the female. 4. No significant difference of the mineral contents was found between the groups of urolithiasis and healthy adults. 5. A 25-year-old male of suspected hyperparathyroidism with a high urinary hydroxyproline excretion showed a significantly low value (156mg/cm³) of the mineral contents. The authors emphasized that, the objective or quantitative evaluation of the roentgenogram should play a more important role in X-ray diagnosis in the future.

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In order to carry out the intraarterial infusion of carcinostatic substance into the internal iliac artery for progressive bladder cancer, basic experiments were carried out using dogs. The following results were obtained. i) After intravenous injection of one shot of MMC, the maximum concentration in blood shows a difference between the artery and the vein. The concentration in the artery was about twice as high as that in the vein. ii) Upon injection of MMC into the internal iliac artery, an extremely high concentration in the cystic artery blood was obtained. Moreover, upon ligation of the internal iliac artery, local concentration in blood became approximately 3 times that obtained without ligation. iii) Concentration of MMC in the tissue of the organ was very low as compared with the concentration in blood. Generally speaking, the concentration was lower in the liver an renal cortex but high in the renal medulla. Upon administration into the internal iliac artery, MMC concentration in bladder tissue became high. The highest value was obtained in the lateral wall of the cervix. iv) While the liver, renal cortex and bladder tissue had a considerably anti-MMC property, MMC inactivation was weak in the renal medulla. Even by a low concentration of MMC, its tissue metabolism was not abnormal. v) Most of the human bladder tumor tissues appear to be sensitive to MMC. The minimum effective concentration and time of contact was about 1mcg/ml and 10 minutes respectively. vi) In clinical application of this method, ligation of internal iliac artery, MMC concentration of 100mcg/ml, speed of injection of 4ml./min, and time of injection of 10 minutes in intermittent administration appear to be adequate.

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In this paper the mechanism of so-called ejaculation, which can be devided into two phenomena, seminal emission into the posterior urethra and ejaculation from the place, was studied, using posterior urethrogram, i. e. recording of alteration of intraurethral pressure.
The posterior urethrogram was recorded with a # 4 catheter, one end of which was inserted into the posterior urethra and the other connected to the electric manometer. Upon examination, the urethra was closed at both the internal and external orifices with a clump and suture, respectively and alteration of pressure in the posterior urethra caused by emission was recorded.
Using young male dogs as experimental material, effects on the posterior urethrogram of section and electric stimulation of the hypogastric, pudendal, pelvic and I-IV sacral nerves were examined. Electric stimulation was made continuously with square wave of 1-5V in amplitude, 2msec in duration and 5-40cps.
The results obtained are as follows
1) Stimulation of the peripheral cut end of the hypogastric, pudendal, pelvic and I-IV sacral nerves. Only the hypogastric stimulation caused seminal emission. Stimulation of the other nerves did not cause seminal emission. The posterior urethrogram, therefore, was recorded only when hypogastric stimulation was performed.
2) Characteristics of the posterior urethrogram. By hypogastric stimulation seminal fluid was secreted and collected into the posterior urethra. This caused a gradual rise of the posterior urethral pressure. When the pressure rose as high as its maximum pressure, 30-85cmH₂O with an average of 53.0cmH₂O, rhythmic alteration of the intraurethral pressure was seen to occur. The alteration was either accompanied or caused by periurethral and perineal musculature. When the external urethral orifice was opened, ejaculation occurred synchronizing with the rhythmic contraction. The time required for occurrence of rhythmic contraction from the onset of the hypogastric stimulation was 3min, to 14min. 40sec. with an average of 6min. 49sec. The rhythmic pressure alteration was 8-72cmH₂O in amplitude and 14/5-20/5c/sec.
3) Effect of section and stimulation of the bilateral pudendal nerve on the posterior urethrogram. The pudendal neurectomy did not change the seminal emission caused by hypogastric stimulation and the intraurethral pressure rose as before the neurectomy. However, the rhythmic contraction did not occur even after the intraurethral pressure surpassed the highest pressure seen before the neurectomy. The rhythmic contraction did not occur by intra-urethral instillation of physiologic saline, either. Stimulation of the peripheral cut end of the nerve caused temporary rise of the posterior urethral pressure and ejection of seminal fluid from the external urethral orifice was seen when it was opened. Therefore, rhythmic contraction, i. e., the action of ejaculation was thought to be related to both the hypogastric and pudendal nerves.
4) Effect of section and stimulation of the bilateral pelvic nerve. After section of the nerve, emission caused by hypogastric stimulation decreased markedly and posterior urethral pressure rose only slightly without rhythmic contraction. When the posterior urethral pressure increased by instillation, urethral rhythmic contraction occurred. Stimulation of peripheral cut end of the pelvic nerve did not cause marked alteration of the intraurethral pressure. With these results, it was sugestive that the pelvic nerve was not related to ejaculation (ejection of the semen from the urethra) but closely to emission.
5) Effect of section and stimulation of the I-IV sacral nerves on the posterior urethrogram. After section of the I-IV sacral nerves, emission caused by hypogastric stimulation decreased markedly and posterior urethral pressure increased only slightly, showing no rhythmic alteration. Intraurethral instillation of the physiologic saline did not cause th

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Although duplication of the collecting system is a rather common anomaly, triplicate anomalies are rare. This paper presents a case of triplication of the ureter with the duplication on the other side and bilateral ectopic openings. A 3-year-old female patient had had continuous enuretic leakage of urine, though she has been continent. Roentgenographic examinations showed triplication on the right side with ectopic opening of the uppermost ureter; In the left, upper calices and pelvis were found extremely dilated and the hydroureter drained down to the vagina. Surgical intervention was necessary.
Triplication of the ureter was first reported by Wrany in 1870. Since then 45 cases were reported and among them, 13 cases had the duplication in the other side. These 46 cases are summarized. The development of such anomalies is discussed.

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