It has been shown that nephrotoxicity of kanamycin is enhanced when administered with low molecular weight plasma expanders. Release of lysosomal enzyme (β-glucuronidase) in vitro, and release of soluble enzyme (lactic dehydrogenase) into blood stream were taken asthe indicators of tissue damage caused by administration of drugs in this study.
Five groups of female albino rats weighing 180 to 200g were treated by 1) dehydration, 2) dehydration and kanamycin (abrv. Km), 3) dehydration and low molecular weight dextran (abrv. Dxt, 50ml/kg of 10% solution), 4) dehydration, Km and Dxt, or 5) dehydration, Km, Dxt and hydrocortisone.
β-Glucuronidase study: Activity of the enzyme was measured in the supernatant fraction of tissue homogenate obtained by mechanical destruction and centrifugation, and in the medium containing the enzyme released from the lysosomal fraction during incubation at 37°C. Both experiments showed that the release of β-glucuronidase was most marked in group 4). The activity in groups 2), 3) and 5) was statistically lower than that in 1). These data indicated that the combination of Km and Dxt more labilized the kidney lysosome than the administration of either drug alone did, and that hydrocortisone partly restored the labilizing effect of these drugs.
Lactic dehydrogenase (LDH) study: 1) Serum LDH level was not increased by dehydration alone. Dxt caused a rapid and short-term rise. However, combination of Dxt and Km showed a gradual longlasting increase of serum LDH activity. Cortisone incompletely inhibited the increase. 2) Kidney fraction of LDH (absorbed on DEAE cellulose) showed about 50% of the total activity on the average 6 hours after treatment with the combination. With Dext alone, only a few per cent of the total was absorbed on DEAE cellulose, indicating that most LDH in serum was released from the liver. Cortisone did not affect the ratio of fractions greatly. 3) Electrophoretic separation of LDH isoenzymes showed that LDH-5 was dominant in the serum from animals treated with Dxt. However, in the animals treated with the combination, 5 bands (from LDH-1 to LDH-5) were visible. Cortisone did not affect the released isoenzyme pattern.

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The vascular architecture of four cases of renal adenocarcinoma was studied histologically and microangiographically and the architecture was revealed to differ from that of others.
Alveoli of cancer cells are covered with a layer of endothelium. The spaces between the alveoli make themselves complicated blood spaces rather than blood vessels and the spaces communicate with each other, i. e., a sinusoidal structure. Beneath the capsule, the sinusoids receive blood from capsular arteries and the sinusoids with the connective tissue between cancer cells and the endothelium drain to a vein, like in a central vein of the liver.
Such structure is nearly universal in every type of renal adenocarcinomas and it is oncogenetically interesting that the structure is sometimes seen in certain endocrine organs including the adrenal gland.
In such a structure cancer cells adjacent to the endothelium easily fall off to the blood space and spread by blood borne metastasis.
Angiographically the contrast media pools and/or stagnates in the complicated blood spaces (sinusoids) and results in findings of “pooling”, “puddling” etc. Expanded blood spaces caused, for example, by necrotic desquation result in “laking” or “a-v fistula”.

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In 1940, a method for determination of retin from its enzymatic activity was published by Leloier et al. Thereafter, especially since 1963, several improvements for the indirrect assay of renin were made by many investigators. However, we frequently noted disagreement among the results obtained by these methods. In this paper, we described experimental results concerning the reliability of the rat bioassay for determination of angiotensin (AT) content as well as purification of renin from hog kidneys, properties and inhibition of angiotensinase (ATase) activity, and some properties of renin activity.
Assay of AT was done by comparison of pressor response samples with standard AT(Hypertensin Ciba) solution when these solutions were injected to anesthetized rats intravenously. By this method, variance of the assay was ±7.2ng/ml (S. D.) when synthetic AT II were injected at a dose of 100ng/ml, ±4.7ng/ml at 50ng/ml and ±2.0ng/ml at 10ng/ml. The detectable lower limit was sometimes 1ng/ml, but usually 2-3ng/ml.
We used the renin solution extracted from hog kidneys by the method of Haas et al. (Arch. Biochem. Biophys. 1965). At a pH of 7.5, we could not detect ATase activity in this solution. At pH=5.0, though the activity was detected to a certain degree, addition of diisopropylfluorophosphate (DFP) decreased the activity considerably.
Destruction rate of synthetic AT II by ATase was very rapid early in the incubation. But it became slow with time. It seemed to us that the majer cause was reduction of AT content momentarily in the incubation mixture. ATase activity in plasma did not change obviously at the condition of pH 7.4, 37°C, for 90min. The AT destruction reaction seemed to be of the first order, when AT concentration was varied from 0.05-1μg/ml and the incubation carried on for a certain constant time. But successive change of AT concentration of each sample did not coinside with the first order reaction. We thought it was possible that the reaction had been prevented by a certain factor in plasma. The percentage of AT destraction increased with the rise of ATase content in incubation mixture, but the rate became disproportionate to the amount of ATase, when it was over a certain amount.
The largest ATase activity in plasma was shown near neutralty, and the activity was diminished considerably by acid treatment. Addition of ethylonediaminetetraacetate (EDTA) and DFP, at concentrations of 0.003 and 0.001mol/l respectively, inhibited the activity almost completely at a pH less than 5.5.
In our experimental condition, hog renin activity was the largest at pH=6. Although, in the initial stage of incubation, produced AT was proportional to the added amount of renin, the prolonged incubation lead to breaking such a relation. In order to complete that relation, the amount of AT produced should be less than 10 percent of angiotensinogen content. For this reason, it is the authors' opinion that the incubation to determine renin activity in plasma should be performedinapproximately 2 hours.

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It is notoriously difficult to make a differential diagnosis objectively between organic and functional impotence.
The author devised testing procedures designed to offer a method of differential diagnosis of both types of impotence by observing changes in the blood circulation in the cavernous body of the penis by the aid of isotope (¹³¹I-RISA).
A total of 24 patients with disturbances in erection were examined. Of them, ten had experienced tauma or undergone a surgical operation of some organ in the pelvic cavity. Twelve were presumed to be cases of mental impotence. The remaining two were regarded as cases of psychotic impotence. In addition, five normal adult males served as controls and were subjected to the same tests as the patients mentioned above.
In the examination, a renogram apparatus, which is in general use, was employed. Such a collimator as shown in Fig. 2 was often used to avoid the counting of gamma rays coming from any portion other than the penis to the largest possible extent. The isotope used was ¹³¹I-human serum albumin (RISA).
It was injected intravenously in a dose of 20-40μCi. The isotope was administered in the manner as men tioned above. Changes in the blood circulation of the penis were recorded as a curve (the author called the curve a radioisotope penogram). When this curve became flat, the patient was injected subcutaneously with 1ml of yohimbine preparation (Fujicapin) and held under observation for any change in this curve.
1. Findings on the penogram of the normal adult male.
The curve of the penogram recorded in the normal adult male could be classified roughly into two types. In one type, the curve which had become flat after the administration with ¹³¹I-RISA began to as cend several minutes after Fujicapin had been administered. In the other type, the curve began to ascend after the administration with Fujicapin. It continued to ascend for 15-20 minutes. After that, it showed further rises recurrently.
2. Findings on the penogram of the impotent patient.
There was no difference in the penogram between the subject affected with mental or psychotic impotence and the normal human adult. Both in the normal and impotent persons, the circulating blood increased in amount in the penis after administration with Fujicapin. On the other hand, no changes in amount of circulating blood were observed at all in patients suffering from organic impotence after administration with Fujicapin. These patients had some disturbance in the nervi erigentes or in the erectile tissue.
It is presumed that the method of testing developed in the present investigation may make it possible to determine whether or not the inferior erection center of the sacral region of the spinal cord and other por tions inferior to this center is free from any disturbance.

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Except for the publications of Heller, Loefer et al., Pearman and Lash, we are unable to find any references in the literature relating to the treatment of organic impotence.
We implant silicone implants to the patients who are incapable of erection because of true organic diseases. The purpose of this study is to design a prosthesis which conforms with the anatomical architecture of the penis.
The shape of the silicone penile implant is a half circle rod, flat on the bottom and curved on top, 10-12mm. in diameter and 10cm. in length. Under general or lumbar anesthesia, a 3cm incision is made in the mid-dorsal shaft and subcutaneous tissue. Care is taken to minimize the disturbance to the veins and nerves by retracting them laterally. Colles' fascia is identified and incised. Below this, Buck's fascia is identified and incised. Further below this, the tunica albuginea is identified. With the aid of a vein retractor and with meniscus scissors a pocket is made between Buck's fascia and the tunica albuginea of corpora cavernosa proximally as far as the suspensory ligament of the penis and distally to just under the corona of the glans penis. The silastic rod is inserted into the pocket. Buck's fascia is closed with 5-0 chromic atraumatic catgut or 5-0 nylon. Colles' fascia is closed in a like manner. The skin is sutured with 5-0 nylon. Sexual intercourse is discouraged for at least 4 weeks.
This operation is recommended as a treatment for organic impotence.

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Tsuji et al reported successful reconstruction of the bladder, utilizing gelatin sponge in 1970. They reinforced gelatin sponge by immersing it into 99 per cent ethyl alcohol for one hour and proved that the material was either absorbed or discharged after reconstruction of the bladder. Orikasa, after further experimental and clinical investigation, advocates that “novecutane” (plastic bandage spray) sprayed gelatin sponge is much more elastic and firmer than the alcohol immersed sponge. We tried cystoplasty using “nobecutane” reinforced gelatin sponge on two cases with contracted bladder and found that in suturing the sponge with the cut end of the contracted bladder, the “nobecutane” sprayed sponge was much more preferable than the alcohol immersed sponge. In both cases the bladder capacity was enlarged 3 to 4 times larger than the original. However, the detailed observation on our clinical cases demonstrated that “nobecutane” sprayed gelatin sponge was not absorbed spontaneously and some fragments of the sponge remained inside the bladder for a long time, forming a stone of the bladder in one case.
Thus, the authors are of the opinion that the prosthetic material should be evacuated easily and completely from the bladder during the short postoperative course, in order to prevent inflammation and calculous formation due to residual fragmens.

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A midline incision for orchiopexy is described and our experience in 7 cases is summarized.
By this approach, a wide exposure is obtained and an adequate length of the funiculus is secured relatively easily. Furthermore, the final pathway to the scrotum was shortened by bringing out the testis directly through the external inguinal ring rather than having it traversed the inguinal canal.
The midline incision is preferred for cases of 1) non-palpable testicle, 2) high lying testicle in the upper inguinal canal and 3) bilateral high lying testicles or bilateral non-palpable testes.

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Two cases of retroperitoneal teratoma, one in a 8 months old female infant and another in a 3 months old female infant, with the chief complaint of abdominal mass, were reported. Both cases were successfully treated by total extirpation. The histological examinations revealed benign teratoma and up to the present, there has been no sign of recurrence.
The domestic literatures were reviewed and 59 cases of retroperitoneal teratoma in infants were tabulated.

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