The authors have reported on the observations of the upper urinary tract by their own “Pyeloureteroscope” which is passed transurethrally. One of the great problems in this procedure is that “Pyeloureteroscope” is not so easily passed into ureter as usual ureteral catheters, because it is flexible with outer plastic coating and its diameter is much larger than that of the routinely used ureteral catheter. Besides these facts, it is prohibited to push it into ureter forcefully, as glass fibers are easily broken by flexing power.
In order to solve this problem, the authors have developed a new procedure using a plastic guide tube. Firstly, a plastic guide tube measuring 3mm in diameter is placed into bladder via our new cystoscope specially made for “Pyeloureteroscope”. No. 7 ureteral catheter is introduced into ureter while lifting the guide tube by the cystoscope lever. Following the insertion of No. 7 ureteral catheter, the guide tube is pushed into the same ureter along the ureteral catheter for several centimeters. Then, the ureteral catheter is taken out and “Pyeloureteroscope” is replaced for it (see Figure 3). The authors believe this is a very easy and reliable method. Another advantage of this method is that a side way from the guide tube can be used as a irrigating channel to obtain clear view.
With the aid of this method, the authors have brought a great progress toward the daily practical use of “Pyeloureteroscope”.

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The reports of the loss of emission after retroperitoneal lymph node dissection in testicular tumors are increasing recently. A review of the literature revealed brief mention of this complication in their statistical reports by Whitmore (1962), Nagamatsu (1963), Notter (1964) and Richardson (1965), and more detailed reports by Leiter and Brendler (1967) and Kom and associates (1971).
As no report of this condition in testicular tumors was found in Japan so far, detailed study on the condition of libido, erection, orgasm and ejaculation of the adult patients who had undergone retroperitoneal lymph node dissection was attempted and the following results were obtained.
1) Loss of emission was found following retroperitoneal lymph node dissection in 6 of 8 cases, aged 24 to 43 years, even though normal erection and orgasm were present. Retrograde ejaculation was not encountered.
2) On the other hand, the emission was preserved in 15 of 16 cases treated with high orchiectomy and irradiation to the retroperitoneal lymph nodes. The remaining one case of teratomatous mixed tumor with inoperable large abdominal mass lost emission in the later stage. Total tumor dose ranged between 2, 800 and 5, 000R, did not interfere with libido, erection, ejaculation, emission and orgasm.
The problem of loss of emission in post-node dissection patients is serious, considering that there are many young patients and the survival rate is increasing recently.
It is emphasized that the indication of the retroperitoneal lymph node dissection should be carefully decided, taking into consideration not only the histological classification and staging of the tumor, but also possible occurrence of the loss of emission.

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The canine kidneys were preserved at a low temperature (2°-4°C) in a hyperbaric oxygen chamber (3ATM) up to 168 hours. These kidneys had been removed few minutes after autotransplantation and examined for histochemical enzyme activities and mitochondrial respiration. The following results were obtained.
1. Histological findings (H. E. stain)
Although great individual differences are seen in the histological findings, the changes such as dissociation of the epithelium of the proximal tubuli begin to appear at about 24 hours of preservation. Generally hyperemia of interstitial capillaries, especially those in the renal medulla, is intense. The interstitium is somewhat edematous. At about 72 hours of preservation, dilatation and hyperemia of the glomerular arterioles are markedly intensified and the presence of vascular disturbance can be inferred. However, even at 168 hours of kidney preservation some healthy nephrons persist.
2. Histochemical enzyme activities
Enzyme activities of LAP, SDH, ATP-ase, β-G, Al-p-ase and Acid-p-ase were studied. There was a great variation in enzyme activities in each specimens. However, almost no change was noted in ATP-ase. Other histochemical enzyme activities decreased in parallel with degeneration of the renal tubular epithelium. As the time of preservation lengthens, the areas of decreasing activities progress in extent. However, even at 168 hours some nephrons retain enzyme activities and some healthy nephrons persist. Changes during this period are continuous and it is difficult to judge at what degree of disappearance the viability of the whole kidneic is irretrievably lost.
3. Electron microscopic findings of the mitochondrial fractions
Mitochondria were separated by the Hogeboom and Schneider method and confirmed through the electron microscope. However, even mitochondria obtained from a healthy control kidney showed marked swelling and rupture of their outer membranes. No characteristic differences in parallel with the preservation time were seen from the morphological findings by the electron microscope.
4. Respiratory control function of the mitochondria
The average values for the ADP/0 ratio and RCI (Respiratory Control Index) for the healthy control kidneys were 1.246 and 1.99 respectively. The ADP/0 ratio and RCI of mitochondria of preserved kidneys was calculated on a percentage basis based on the healthy control kidneys. Up to 24 hours, excluding those in which Indigo carmine excretion was not observed within 10 minutes, the ADP/0 ratio was more than 80%, and RCI was at the 80% level. In the 48 hours preserved kidney two groups were established, one group with the ADP/0 ratio maintained at 70-80% and the other group with a decrease and eventual disappearance being noted. The number in the two groups was the same, being 37.8% on the average. RCI was 70% on the average when unmeasurable cases were made to represent 0. As for the kidneys preserved more than 72 hours, the ADP/0 ratio was 0 in all cases and it was inferred that oxidative phosphorylation was disturbed. In the 168 hours preserved kidney the respiratory control function was extinguished. From the above findings it can be accepted that preservation of the kidney at 2°-4°C under 3ATM oxygen for 48 hours is the limit of viability. Preservation for more than 72 hours is extremely difficult.

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A dye density test for diagnosis of renovascular hypertension is described. Dye densities are measured by the Goldberg TC refractometer and the Hitachi hand refractometer. The test is easily done. Curves of urine densities are then drawn, representing differential function in terms of renal tubular concentrating ability. Hyperconcentration of the dye occurred consistently with positive Howard, Rapoport and Stamey tests. The dye density test places emphasis on the concentration of the urographic media rather than on the urinary volume. The most satisfactory attribute of the dye density test has been its constant reliability with the smaller ureteral catheters, which have greater advantages of minimizing adverse side effects reported by others using larger catheters. There may be a significant place for the dye density test in the routine evaluation of hypertension, because the test is carried out with ease and without adverse side effects, the results are immediately available, urine densities can be measured by the local hospital laboratory, and there is a consistent correlation among dye density measurements, Howard, Rapoport and Stamey tests.

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A series of the patients with metastatic renal cell carcinoma given hormonal treatment was reported. Medroxyprogesterone acetate (MPA) 40-100mg orally everyday, and/or testosterone propionate 100mg intramuscularly everyday and/or betamethasone 0.5-1mg orally everyday were administered to 28 patients. Four cases (14.3%) showed objective signs of tumor regression, in which one complete response from MPA and 3 partial objective response from MPA with betamethasone and testosterone were noted. The duration of response was from 4 to 8 months. Six cases (21.4%) showed subjective regression. No adverse side effect was observed after long periods of administration.
These results are superior to those treated with usual chemotherapy. Moreover, hormonal treatment was free from serious side effects. Therefore, hormonal treatment was well worth first choice against metastatic renal cell carcinoma.

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I applied β-glucuronidase (β-G) inhibitor in urine, 2, 5-di-o-acetyl, D-glucaro (1-4) (6-3) dilactone (SLA), which was produced on Boyland's hypothesis, for the purpose of preventing recurrence after operation of bladder tumor.
Comparing the group of forty-four cases given SLA in low grade and low stage with another group of fifty-two cases not given SLA, I examined the rate of recurrence by analyzing the various factors, the fluctuation of β-G activity and the amount of glucaric acid in urine by using SLA in bladder tumor patients before and after operation: I also examined the relationships between β-G activity and o-glucuronide.
1) β-G activity in urine of bladder tumor patients showed higher numerical value than that of the normal control.
2) β-G activity in urine was remarkably decreased by applying SLA, and was fully checked for a three year's duration.
3) No difference was seen about the amount of excretion of glucaric acid in urine between bladder tumor patients and normal controls.
4) By applying SLA, the amount of exretion of glucaric acid in urine was remarkably increased, amounting to about 150mg/day and no difference was seen during the period of the application of SLA.
5) The amount of excretion of loaded Salicylamide-o-glucuronide tended to be larger at high β-G activity than low β-G activity in urine.
6) By administration of SLA, the recurrence rate of bladder tumor more than two years after the operation was significantly lower than in the non-SLA group. However, the recurrence rate soon after the operation showed no difference.
7) The most striking effect by administration of SLA was recognized in single, peduncurated and small sized tumors.
8) Some effect of preventing the recurrence soon after the operation by instillating anti-cancer drugs into the bladder was recognized.
9) Combining the therapy with SLA-administration and instillation of anti-cancer drugs into the bladder was more effective than the separate use of either alone.
10) Combining the therapy with administration of SLA and Vitamin B₆ was also more effective than the separate use.

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Once urogenital tuberculosis was one of the most representative diseases in urology, but recently it has become much rarer. A statistical study of urogenital tuberculosis was made on urological outpatients of the eleven representative hospitals in the Niigata Prefecture, Japan. During the 10-yearperiod (1961-1970) the incidence of tuberculosis became much lower. At the beginning of this period, the incidence in out-patients was more than 1%, but at the end it was less than 0.5%. Average age of patients tended to be elder. Less frequent occurrence of urogenital tuberculosis and less marked symptoms and signs due to antibiotic therapy are presenting a different clinical problem in diagnosis and treatment of urogenital tuberculosis.

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