1. Renal preservation has been an important problem in performing renal transplantation. In this paper, transplantation studies of stored kidney are presented
2. Using 10 adult mongrel dogs, basic experiments were carried out to determine the optimal storage solution, temperature and method from histological findings.
1) Solution A (500ml of 5% dextrose with 10% low molecular weight dextran, 2% procaine 50ml, heparin 15 mg and tetracycline 250mg) was found to be less harmful and revealed better preserving effect than the solution B (physiologic saline 500ml, 2% procaine 50ml, heparin 15 mg and tetracycline 250mg). 2) Simple immersion into solution A or B was apparently superior to the perfusion technique with the same solution at the same temperature. 3) Storage in a refrigerator at 0 to 4°C significantly reduced renal damage resulting from periods of ischemia. 4) The preservation of a kidney would be best accomplished by immersing it in a solution A at temperature 0 to 4°C, however, even with this method, the permissible length of storage seemed to be limited within 10 to 24 hours. 5) Microscopic sections of renal tissue stored by this technique revealed that the glomeruli were safely preserved for 12 hours while tubuli had developed hydropic degeneration in one hour, vacuolation in 2 hours and localized necrotic change in 10 to 12 hours.
3. Twenty autotransplantation experiments were carried out on adult mongrel dogs.
1) The kidneys were immersed in the above mentioned storage method for 30 minutes to 24 hours and then brought out for autotransplantation. 2) Fourteen of the 20 autotransplanted kidneys exhibited mechanical failure and postoperative accident. Six dogs (1 animal with 2 hours, 1 with 4 hours, 3 with 10 hours and 1 with 24 hours storing) were alive and well for periods of 150 to 690 days after removal of the contralateral kidneys in 3 to 5 weeks after autotransplantation. 3) The autotransplanted kidneys which were preserved for 10 and 24 hours started to secrete within 5 to 10 minutes of establishing the new circulation. 4) With 24 hours preservation, the transplanted kidney was known to be functioning by aortography and intravenous pyelography on the 7th postoperative day, as well as the group which were preserved 10 hours on the 6th day. 5) At 3 months and one year postoperatively, their blood urea nitrogen levels ranged between 20 and 47.5mg/dl, and serum electrolytes, urinalyses, urinary concentration tests, PSP tests, radioisotope renograms and systolic blood pressures were within almost normal limits. 6) With 10 hours immersion, biopsy specimens, obtained one week and 3 months after the transplantation, not only revealed good functioning kidney but demonstrated almost normal histologic patterns. However, with 24 hours, the histological finding of the biopsied specimen, obtained 3 months after the autotransplantation, showed slight chronic inflammatory changes.

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It has recently been studied clinically and histologically to work out that administration of kanamycin in combination with sodium alginate solution given as a plasma expander develops acute renal failure. In this study, respiratopy activity of renal tissue and some enzyme activities in the tissue have been employed as indicators of tissue damage in addition to the routine indicators such as histological findings and blood urea nitrogen levels. Kanamycin was administered to the rats intramuscularly (500mg/kg body weight/day), and sodium alginate intraperitoneally (60ml of 0.4% solution/kg/day). No water was given to the rats in the whole experimental periods. Succinoxidase, glutaminase, alkaline phosphatase were the enzymes studied.
Results
1) Decrease in respiratory activity of renal tissue was observed 24 hours after the administration of kanamycin and sodium alginate. 48 hours after the administration course had started, respiratory activity of renal tissue from experimental animals was less than half of that from controls. Much less impairment was brought about by kanamycin or sodium alginate alone. 2) Decrease in the activities of glutaminase, succinoxidase and alkaline phosphatase were observed by combined administration. Such decrease in enzyme activities was noticed earlier and more seriously than impairment in respiratory activity. 3) Elevation of blood urea nitrogen level seems being correlated with renal impairment. 4) Histological examinations of kidneys administered with kanamycin and sodium alginate revealed complete destruction of tissue especially in the epithelium of proximal and distal tubules 48 to 72 hours after administration course had started, 5) In vitro addition of a comparable amount of kanamycin and sodium alginate to kidney homogenates did not cause inhibition of succinoxidase activity, whereas addition of kanamycin only caused 25% inhibition of O₂ uptake. 6) Neither remarkable change in respiratory activity nor histological change of liver tissue was noticed even after 48 to 72 hours after the administration of kanamycin and sodium alginate to the rats.

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The method of organ culture under hyper-baric oxygen was applied in the present report for they determination of in vitro effects of several anticancer agents onto human bladder carcinomas. Anticancer agents currently being used on clinical cases of bladder carcinoma, such as Mitomycin C, Thio-Tepa and saccharolactone were added to the culture medium at each concentration to be tested. Tissues of transitional cell carcinoma grade 1 to 3 from 21 cases were cultured under 2 atmospheres for 40 hours, temperature at 37°C and pH at 7.2 to 7.4. Cultured tissues were studied histologically, electronmicroscopically and also studied with autoradiography. The autoradiographs were made by ³H-thymidine added to the medium at the last 2 hours of culture period.
In control cultures, tissues from grade 2 of transitional cell carcinoma were well maintained under 2 atmospheres for 48 hours and autoradiographs revealed that the labeling indices of the superficial zone of the explants were higher than the deeper zone where cancer cells were still synthesizing DNA. In cultures with Mitomycin C 1.0mcg per ml, cancer cells near the surface of explants were markedly degenerated, while the cells in deeper zones partly survived and the labeled cells were seen. In cultures with Thio-Tepa 1.0mcg per ml cancer cells of the entire specimen were degenerated. The DNA synthesizing cells were not recognized so far with ³H-thymidine autoradiography of Thio-Tepa group. In cultures with saccharolactone 1.0mcg per ml, the degenerated foci were seen in entire specimens but the degree of degeneration was slight.
By electronmicroscopy, cancer cells near the basement membrane showed deformities of nuclei and nucleoli with a minimum dosis of Thio-Tepa, while the cytoplasmic organellae were affected with Mitomycin C.
The different modes of action of each anticancer agents can be studied with this hyperbaric organ culture system. The results are applicable for the local instillation therapy of carcinoma of the urinary bladder.

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The clear differences of ESR spectra between normal mucosa and transitional cell carcinoma of human urinary bladder was described in the previous report of this series. In the present study the results were reconfirmed with the increased number of cases (11/13) and materials (23/25).
The materials were stored in a freezer at -20°C for a long period and the effects of spontaneous oxidization of ESR spectra were studied and the following results were obtained.
(1) The degree of spontaneous oxidization was classified into the following four types by the quality and quantity of Fe³⁺ ions as the indicator.
Type 1. The absorption of Fe³⁺ is not clearly identified and the g-value is approximately 2.009±0.001. Type 2. The absorption of Fe³⁺ is clear and the g-value is 2.023±0.002. Type 3. The absorption of Fe³⁺ is remarkablly enlarged and the g-value moves to 2.023±0.007. Type 4. The absorption of Fe³⁺ disappears. Meanwhile, the effects of spontaneous oxidization on absorptions other than Fe³⁺ which is mainly hfs due to ¹⁴N; were analyzed.
Type 1. As mentioned in the previous report, the main difference of ESR spectra between normal mucosa and transitional cell carcinoma is that the absorption of hfs due to ¹⁴N; appears in the latter but not in the former. Type 2. Absorptions of ¹⁴N;-hfs are recognized in both normal mucosa and transitional cell carcinoma. Also the absorptions are three to five times larger than that of Type 1. Type 3. The absorptions increase in both normal mucosa and transitional cell carcinoma or they disappear in some materials. Type 4. The ¹⁴N;-hfs and all other absorptions disappear.
Absorptions without hfs are recognized as followings.
Type 1. The absorptions are extremely small in fresh materials while they increase thereafter by combination with oxygen. Type 2, 3 and 4. The absorption disappears with the increase of Fe³⁺. This was seen in all materials examined but one exceptions
(2) Transitional cell carcinomas and two of normal mucosa reached Type 2 within 8 to 15 days of storage, however, four materials from normal mucosa remained in Type 1 even after 30 days of storage Four transitional cell carcinomas stored for 3 months reached to Type 3 and 4 on each two materials respectively.
(3) A clear absorption was recognized at g=4.5±0.3 in some materials with ¹⁴N;-hfs. The absorptions of heme-Fe or non-heme-Fe in lower magnetic field which were obtained by Spin Hamiltonian are 600 and 4.3 respectively. Therefore it will be concluded that the absorption of 4.5±0.3 is unable to be heme-Fe.

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The high concentrated level of ¹⁴N;-hfs in tissues of transitional cell carcinoma has been published as a part of series of present study, in which the ESR spectra from the cancer tissues were compared with normal mucosa of the urinary bladder taken from the area distant from the tumor or different individuals without badder tumor. In the present paper, the tumor surrounding mucosa, 1.0cm in width and grossly normal was studied with ESR on 4 cases and the results were compared with those of tumors and distant areas. It was revealed that the tumor surrounding mucosa containing a high level of ¹⁴N;-hfs on ESR spectra in all cases studied. The materials with ¹⁴N;-hfs signals had concealed the foci of abnormally proliferating cells in 6 to 17% of all the serial sections studied histologically. In some cases, the degrees of ¹⁴N;-hfs signals remained in high level as if that of tumor itself though the decreased levels of malignancies which represented by histology on the tumor surrounding mucosa. Actually the signals of ¹⁴N;-hfs were larger than that of tumor itself in the distant area of the first case, and same level in the tumor surrounding mucosa of the third case, while they decreased down 60-70% in another materials with ¹⁴N;-hfs. In the forth case, however, the signals of ¹⁴N;-hfs were not recognized in tumor itself as one of exceptions in the previous paper but the signals were recorded in the tumor surrounding tissues.
The results suggest that the appearance of ¹⁴N;-hfs is related with the activity of tumor proliferation rather than the existence of tumors, however, the amount of ¹⁴N;-hfs may or may not relate with histological findings. A complete chemical analysis of ¹⁴N;-hfs will be extremely difficult or almost impossible by the methods available at the present time. Therefore the analytical method used in the present paper, if a large series of cases were studied with blind tests, would be a useful way to identify a precancerous lesions in clinical medicine.

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Cystoplasty using gelatin sponge sprayed with Nobecutane was carried out in 4 cases of contracted bladder and one case of congenital hour-glass bladder. The operative technique is very simple and easy to perform. Although the operation failed in one case of contracted bladder, the result of the other 4 cases was excellent. Self-micturition was permitted after 2 weeks postoperatively. Satisfactory bladder capacity was gained and no residual urine. Biopsy of new bladder wall in one case of contracted bladder showed satisfactory epithelial and muscle regeneration.

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Diethylstilbestrol diphosphate which has been in wide use for cancer of the prostate is said to change to active form (stilbestrol) by acid phosphatase. Tubis et al. (1967) suggested probability of scintiscanning of the prostate gland by ¹³¹I labeled diethylstilbestrol diphosphate. Yet there has been no literature on this subject. This paper deals with results of animal experiment and clinical studies with this drug. Fifty five μCi of ¹³¹I labeled diethylstilbestrol diphosphate for each rat was administered by the tail vein. Specific activity of ¹³¹I labeled diethylstilbestrol diphosphate was 67μCi per mg. Each group of this experiment consisted of 3 male rats weighing 110-150g. Radioactivities of each organ (prostate, liver, kidney, spleen, heart, lung, intestine, adrenal and testicle) were determined in different time intervals (5, 15, 30, 60min., 3, 6, 12, 24hr., 2, 3, 5, 7 day) and the relative specific activity (R. S. A.) of each organ was computed. The highest concentration was observed in the liver followed by the kidney, and a relatively long retension was recognized in the liver. The R. S. A. in the prostate was demonstrated to be lower than expected (Table 1).
In clinical studies on 10 patients (7 prostatic cancer, 1 prostatitis, 1 bladder tumor and 1 chronic cystitis), 500μCi of ¹³¹I labeled diethylstilbestrol diphosphate was administered intravenously. The uptake by each organ was in the same order as described in the rats, and the uptake by prostatic cancer and its metastatic lesion was not so large as expected. The scintigram of the prostate gland was not depicted. In rabbit experiment the prostatic concentration of ¹³¹I labeled diethylstilbestrol diphosphate was 0.03-0.04% of the administered dose (56μCi/kg) in 3 hours. Prior administration of non labeled diethylstilbestrol diphosphate (71.4mg/kg) did not alter this radioactive concentration level.
From these results it will be inferred that (1) concentration in the prostate gland or prostatic cancer tissue must be smaller than expected, (2) there is no probability of prostatic scintigram by ¹³¹I labeled diethylstilbestrol diphosphate, and (3) after dephosphorylation, most of stilbestrol passes almost immediately into general circulation and the passage, if it is transient, takes cytostatic effect for prostatic cancer.

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We have experienced 22 cases of tumors of the testis during past 9 years from April, 1959 to March, 1968. A clinico-statistical study was made on these 22 cases of testicular tumors. The resuls obtained are as follows:
1. Incidence of testicular tumors: 0.23% (22 cases out of 9422 male out-patients). 2. The age of those cases ranged from 2 to 63 years old. 3. Affected sides of those cases: 9 cases on right side, 10 cases on left side and 2 cases on both side. One case was unknown. This case had a retroperitoneal tumor (Seminoma) and neither sides of testis were explained histologically to be a tumor. 4. Relationship of cryptorchidism: One case (4.5%) out of 22 cases. 5. Histopathology: Seminoma in 8 cases, Embryonal carcinoma in 4 cases, Teratoma benign in 3 cases, Teratocarcinoma in 2 cases, Rhabdomyosarcoma in 2 cases, Leucaemic infiltration in 2 cases and Neurofibroma in one case. 6. Treatment: 8 patients treated with orchidectomy and retroperitoneal lymphadenectomy; 6 cases with orchidectomy, retroperitoneal lymphadenectomy and irradiation; 3 cases with chemotherapy; 2 cases with merely orchidectomy; one case with orchidectomy, retroperitoneal lymphadenectomy and chemotherapy; one case with orchidectomy, retroperitoneal lymphadenectomy, irradiation and chemotherapy; one case with orchidectomy and irradiation. 7. Prognosis: 7 cases out of 22 patients died in 2 months to one year. Histological diagnosis of these 7 cases was Seminoma (2 cases), Rhabdomyosarcoma (2 cases), Leucaemic infiltration (2 cases) and Teratocarcinoma (1 case).

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