Renal functions of nine patients with homotransplanted kidney from living donors were consecutively examined during the period of two months after the operation.
As parameters of tubular function, excretion fraction of filtered sodium (EF_Na) and urine-plasma ratio of creatinine (U/P_cr) were determined as well as clearances of creatinine (C_cr) and para-aminohippurate (C_PAH).
The following results were obtained as a common functional change of the transplanted kidneys during the period of early Renal functions of nine patients with homotransplanted kidney from living donors were consecutively examined during the period of two months after the operation.
As parameters of tubular function, excretion fraction of filtered sodium (EF_Na) and urine-plasma ratio of creatinine (U/P_cr) were determined as well as clearances of creatinine (C_cr) and para-aminohippurate (C_PAH).
The following results were obtained as a common functional change of the transplanted kidneys during the period of early rejection.
The earliest change of kidney function was manifested as a reduction of EF_Na (less than 2%) and increase of U/P_cr (more than 20) which appeared simultaneously with the general clinical signs such as fever and leucocytosis. However, these changes had no relationship with the severity of the rejection.
As EF_Na and U/P_cr were restored to the previous levels, urine flow decreased abruptly and an elevation of BUN, acidosis, and decrease of C_cr and C_PAH appeared as well.
During the oliguric period continuing for 3 to 8 days, EF_Na increased as a rebound and U/P_cr decreased reciprocally. In spite of immuno-suppressive therapy, these changes as well as azotemia and lowered clearances advanced markedly even for several days after the cessation of oliguric phase.
When recovery of these functional changes initiated, urine volume was still increasing and reached its peak several days later.
Functional recovery was observed relatively rapidly with a slight delay in urine flow, EF_Na and acidosis.
In accord with the reduction of the EF_Na, a tendency of hyponatremia and hypochloremia which disappeared after the oliguric phase was noted. When acidosis was present in the polyuric phase, hyperchloremia was concomitantly recognized.
Reduction of EF_Na and increase of U/P_cr have been reported in stenosis of the renal artery, thrombosis of the renal vein or stricture of the ureter. However it is not so difficult to differentiate the early rejection from these diseases, since there is a difference in the variation pattern of EF_Na and U/P_cr after the initial change.
It may be concluded that determination of the EF_Na and U/P_cr is highly significant for detection of the earliest sign of early rejection, evaluation of the effect of immuno-suppresive therapy and differential diagnosis of oliguria which occur in the homotransplanted kidney.

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1) A slight modification of competitive protein binding assay for plasma testosterone of Maeda was studied. 0.25ml of male plasma was sufficient for the assay.
2) The change of plasma testosterone level by aging was studied in men. The prepubertal level was 80.92±44.12ng/100ml. That sharply increased between 15 to 19 years of age and reached to the maximum level (670±239.11ng/100ml) in twenties. And then it was gradually decreasing with age. The level in sixties was 334.16±77.54ng/100ml.
3) The decreasing process of plasma testosterone level after castration was examined in detail. A 50% deduction was found after 2 to 6 hours and plasma testosterone level reached the prepubertal boy's level after 12 to 24 hours.
4) The effect of five days' H. C. G. (5, 000IU) administration on plasma testosterone concentration in normal adult male was studied. The increase in the plasma testosterone level was persistent for a few days even after the cessation of administration.
5) After intramuscular injection of 100mg of testosterone propionate the rise in the plasma testosterone level in two normal males rapidly reached a peak in 1 to 5 hours and declined to the base line level in 48 hours. However, in castrated patients, the level slowly reached a peak after 8 to 12 hours and returned to the normal value after 36 to 48 hours.

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Infusion of MMC into the internal iliac artery was carried out for 13 cases with progressive inoperable bladder cancer. The following results were obtained.
1) Cystoscopy at the time of discharge showed disappearance of the tumor in four cases of them and reduction in three cases. 2) After intravenous injection of one shot of MMC to the patient with bladder cancer, the maximum concentration in blood showed within five minutes and then decreased rapidly. The MMC concentration in the median cubital vein after infusion into the internal iliac arteries was lower than the concentration after administration by intravenous drip infusion. MMC excreted into urine corresponded to about 5 to 10% of the dose given. 3) Pathological examinations of the tumor tissue after this therapy revealed edema in interstitium, hyperplasia of connective tissue and round cell infiltration, in a dition to vacuolation and swelling of protoplasm, pyknosis, nuclear decay and disappearance of cancer cells. Futher, no atypical cells were found by the examination of urinary exfoliated cells. 4) Following the infusion, four cases showed gastric hemorrhage and two of them died. In addition, another patient died of perforation of the urinary bladder probably due to necrosis of the tumor. 5) This therapy appears to have little influence upon the function of the urinary bladder. Muscular atrophy of the lower extremities and disorder of the peripheral nerve caused pain which however, did not develop to a disabled gait. 6) It is desirable that this therapy, when applied to progressive bladder cancer, should not accompany any operation as long as possible. 7) Of 13 patients who received this therapy, four patients survived for a year, three for two years and two for more than three years.

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The blood concentration of the Mitomycin C in various vessels (artery, vena iliaca communis: infusion side and opposite side, vena portae and vena cava inferior: bifurcations of vena renalis and vena hepatica) were studied in two groups of dogs administratered as follows;
Group 1. Continuous injection into the internal iliac artery (1mg/kg/24 hours)
Group 2. Infusion into the lumen of urinary bladder (1mg/kg kept intravesically for 90 minutes)
The results were as follow:
1) In group 1, the concentration of the agent in vena iliaca communis of infusion side (0.144mcg/ml) reached the highest level 6 hours after the beginning of injection and then kept constant following 18 hours. The same results were observed in the other vessels although the concentrations were lower.
2) In group 2, the concentration of the agent in vena iliaca communis (0.064mcg/ml) reached the highest level 90 minuts after infusion and 0.006mcg/ml 6 hours after infusion. But the agent could not be detected in the other vessels 6 hours after infusion.

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The adrenocortical function following surgery have been estimated in many ways in the literature, but the recent progress in this study suggests to use plasma cortisol activity. For the determination of this subtance, the fluorimetrical method of Rudd et al. with slight modification was used. The purpose of this paper is to compare the grade of stress to the adrenal cortex between open prostatectomy and transurethral resection of prostate (TUR-P) in geriatric patients. In our clinic, the determination of plasma cortisol was applied to clarify this problem. Fourteen benign prostatic hypertrophied patients (60 to 81 years old) were studied, in whom open prostatectomy (suprapubically and perineally) or TUR-P were performed. Successive determination of the plasma cortisol activity was done preoperatively and postoperatively (5 to 7 days following the surgery).
The results were as follows:
1) Immediately after the surgery, the levels of cortisol activity rose significantly in the both groups. This was thought to be a normal response of the adrenal cortex.
2) On the first postoperative day, the cortisol levels of TUR-P groups returned to normal already and it resembled the stress pattern of response of “Minor surgery” group.
3) On the contrary, the cortisol levels of open surgery groups decreased gradually day after day and it returned to the usual value 1 week following the surgery. These findings resembled “Major surgery” group.

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