We understand the term “worthful recovery” as that the kidney recovers to such an extent that it has the ability of maintaining healthy life by itself alone when the mate kidney happens to be severely damaged or removed in the future.
In this study, we have clinically studied the limitation of the preoperative renal function which promises the worthy recovery after surgery for removing obstruction in hydronephrosis. In other words, we have studied the indication of kidney conservative operation in hydronephrosis from the functional viewpoint
For the examination of the renal function, clearances of PAH, intrinsic inuline and osmorality were mainly employed.
In Tab. 1 clearances in healthy male adults are shown. Results in various degree of hydronephrosis are shown in Tab. 2. To know the tendency of renal function of each degree of hydronephrosis the average values are entered. Here, errors due to dead space of enlarged renal pelvis must naturally be considered: the larger the dead space, the greater the error.
To know the lower limit of renal function which can sustain healthy life we examined 3 groups of patients: chronic nephritis (Tab. 3), acquired healthy solitary kidney (Tab. 4) and nephrostomized hydronephrotic solitary kidney (Tab. 5). From the lowest values of clearance in these groups we found that the very limitation of renal function was as shown in Tab. 6.
For obtaining the data on renal function as exactly as possible in hydronephrosis, with least trouble due to the dead space, we performed nephrostomy for collecting urine. Since it was confirmed by us that the kidney reached an almost stable state 2 weeks to 20 days after nephrostomy (we called it “shortly after”) we evaluated the possibility of the worthful recovery from the renal functions at this stage.
Between the clearances and RA-ratio (relation of the size of renal artery to that of abdominal aorta at the level of branching of the latter) there was only a slight correlation ((Figs. 4, 5, 6).
In B-grade hydronephrosis (low degree) renal functions shortly after nephrostomy were far above the above mentioned limitation (Tab. 7) and all of the cases recovered well as expected (Fig. 7, for instance). In D-grade (middle degree) hydronephrosis renal functions shortly after nephrostomy were not under the limitation (Tab. 6) and also recovered satisfactorily. In E-grade (high degree) hydronephrosis, in which the indication of conservance of the kidney should be earnestly discussed (Tab. 9), only 2 of 6 cases recover ed satisfactorily. The renal functions shortly after nephrostomy were in these 2 cases above or around the limitation.
From the clinical estimations in hydronephrosis we are sure that the above mentioned limitation of renal functions for healthy life can be applicable for selecting the indication of conservative operation of hydronephrosis. If the renal functions shortly after nephrostomy below the limitation, saving the kidney is not worthwhile.
Two cases of interest are here demonstrated: Case 1, 32 yrs male. Advanced hydronephrosis and hydroureter with vesico-ureteral reflux in acquired solitary kidney. Cystography reveals the condition well (Fig. 1). Renal functions following the indwelling catheterization of the bladder are shown in Fig. 2. He is healthy thereafter. As to the consideration of error due to dead space in this case, clearances of 1 hour and 24-hour's examinations are shown in Fig. 3.
Case 2. (6th case in Tab. 9). 18 yrs male. E-grade hydronephrosis as shown in Figs. 8 and 9. On nephrostomy we found that about thick the half of the kidney became thin to 1 to 2mm thick and the remaining parenchyma was not more than 1cm thick. But, the renal functions shortly after nephrostomy were over the limitation, which rendered us to conserve the kidney. The course of renal function after nephrostomy is shown in Fig. 10. Pyelo-uretero-plasty brought good results in renal function.

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Observations were made on 20 patients with prostatic cancer before and after the radiation. to pituifarg Urine gonadotropin, urine 17 ketosteroid, urine 17 hydroxycorticosteroid and urine 17 ketogenic steroid were measured. ACTH test and Metopirone test were also performed.
The results were as follows:
1) Urine gonadotropin became very low within a week after a sufficient pituitary ablation. However, this low urine gonadotropin had no direct relationship with complete anatomical ablation of the pituitary gland.
2) Urine steroids continued to fall for 3 weeks after the radiation, but some patients showed temporary high levels of urine 17 OHCS and 17 KGS.
3) Metopirone test is useful to evaluate the degree of hypophyseal ablation, but there were some cases which had needed a long period until the slow reaction appeared.
4) Our present procedure had no influences on the adrenocortical reserve function.
5) It was Metopirone test that was most useful to determine the clinical effect of this procedures.

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1. Chloromadinone acetate was administered to castrated rats which were concomitantly treated with testosterone, and anti-androgenic effect of chloromadinone acetate was observed as inhibition of prostatic growth evoked by testosterone.
2. Anti-androgenic effect by chloiomadinone acetate seems to be one tenth of that by cyproterone acetate in rat ventral prostate.
3. The activity of 5α-reductase in benign prostatic hypertrophy seems to be rather high, however, that in prostatic cancer was significantly reduced.
4. Treatment of 36 cases of benign prostatic hypertrophy with chloromadinone acetate, daily dose of which were 25-600mg, revealed improvements of chief complaints and regressive change of prostatic size. These effects were obtained after several weeks from start of treatment, and on 12 weeks after onset of administration most cases showed objective improvements in urethrogram and palpation size. In cases performed prostatectomy after drug administration, atrophy of glands and increase of connective tissue was observed in prostatic specimens.

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A contraction of dog prostate was successfully recorded by mechanography. The prostate contracted in the vertical direction rather than horizontal and both prostatic lobes moved simultaneously in the same degree. The contraction was induced by administration of various drugs as well as by hypogastric or pelvic nerve stimulation. Further results will be published in the next paper.

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Sexual impotence is a most common complaint of patients suffering from priapism. However, there are only a few reports on the relation among the incidence of impaired potency, causes of priapism, duration of pathological erection, methods of treatments and others. Therefore, in this study, an effort was made to clarify these relations. Sexual function following priapism of nine cases was investigated by personal interview. The cases for this study were patients treated at the Tohoku University Hospital during period from April, 1959, to February, 1971.
In 57.1 per cent of the subjects sufficient potency in coitus was reported. Cases with no sufficient erection or no erection during the sexual intercourse were found in 42.9 per cent of the subjects.
Mean age of the cases with sufficient erection in coitus was lower than that in the impotent groups.
Priapism was accompanied by many factors and it was unable to clarify what kind of factors was most associated with sexual impotence.
Mean duration of pathological erection in cases with sufficient erection was longer than that in the impotent groups.
Prognosis of cases with surgical treatments was better than that of those with conservative therapies.

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