The defect of the bladder wall of 2cm in diameter was formed surgically in 40 rabbits of around 2.5kg body weight.
This defect was covered either by omentum or by combination of omentum and gold leaf.
These rabbits were killed 2 days, one, two or four weeks after the operation and the bladder walls were observed histologically.
The results were as follows:
1) The regeneration of the defect of the bladder wall was slightly postponed in the group with combination in comparison with the group with omentum alone.
2) Such phenomena seemed to depend upon the gold leaf as a foreign body which was apt to interrupt the regeneration of the mucous membrane and become the nucleus of the urinary bladder stone.
3) The strong reactions of urine infiltration were hardly found in the group with the combination of gold leaf and omentum compared with those in the group with omentum alone.
4) These results seemed to suggest some foreign body reactions to gold leaf; and slight infiltration of the urine by omentum.
The former was concluded from the fact that the gold leaf was included completely within the regenerated tissue in some rabbits.
Conclusion
The results of these experiments suggest that the gold leaf will be a good material to substitute for the defect of bladder wall, if its size and thickness and the technique of operation are more examined in future studies.

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Intravesical instillation of thio-TEPA, Mitomycin C (MMC) and 5-Fluorouracil (5-Fu) with a single or triple drug regimens has been attempted on cases of urinary bladder tumors admitted in our hospital for four years from 1966 to 1969.
The instillation was usually carried out twice a week to reach total doses of thio-TEPA 300mg and MMC 100mg. Triple drug regimen instillation was tried with thio-TEPA 20mg, MMC 10mg and 5-Fu 500mg.
1) Antitumor effect of intravesical instillation
1. Thio-TEPA was applied to 29 cases of non-infiltrative bladder tumor, resulting in complete destruction in 6 cases (20.7%), partial destruction in 14 cases (48.3%) and ineffectiveness in 9 cases. On the other hand, partial destruction was observed in 14 cases (51.9%) and without effect in 13 cases (48.1%) of 28 cases of infiltrative tumor. Complete destruction was found in no case.
2. Based on the evaluation of partial destruction, prominent or moderate destructive findings of the tumors were examined cystoscopically in the non-infiltrative cases, whereas only superficial destruction was observed in the infiltrative cases.
3. The mean dose of thio-TEPA 367mg has been thought necessary to obtain complete destructive effect in non-infiltrative cases. However, even the mean dose of 234mg or 204mg seemed to show only partial destruction or no effect.
4. Non-infiltrative tumors smaller than pea-size prominently reduced in size or completely disappeared with doses of thio-TEPA less than 180mg. On the contrary, tumors larger than pea-size showed a reduction in size or disappearance with doses of thio-TEPA 250 to 300mg. Drug susceptibility might be evaluated by observing the superficial tumor change with the instillation of thio-TEPA 120mg.
5. MMC has been singly used on 17 cases of bladder tumor. 13 cases of them were non-infiltrative and the size of tumors was small. Complete disappearance of tumors was found in 3 cases out of these non-infiltrative cases.
6. Intravesical instillation of triple drug regimens was applied to 12 cases, resulting in complete destruction in one (8.3%), partial destruction in eight (75.0%) and without effect in 2 cases (16.7%).
2) Histopathological changes of tumors by the instillation
Histopathological studies were performed in 12 cases with single regimen of thio-TEPA and in 8 cases with the three drug regimens instillation.
1. Characteristic pathological changes such as reduction of tumor cells in number, vacuolation, pleomorphism, decrease of cohesiveness, piknosis and interstitial fibrosis were observed following the treatment.
2. Among the case with proved histopathological improvement, the mean dose of thio-TEPA was 320mg.
3. No specific correlation between histopathological effect and malignancy of the tumors was suggested.
3) Side effect of the intracavital chemotherapy
Leucopenia, bladder irritability and reduction of bladder capacity were common as side effects of the treatment.
1. Leucopenia was found in 30 of 42 cases (71.2%) with thio-TEPA instillation, thrombocytopenia in 16 of 21 cases (61.9%) and pancytopenia in 2 of 51 cases (3.6%).
2. Leucopenia was encountered in 6 of 11 cases (54.5%) in the combined group.
3. Bladder irritability was complained in 19 of 56 cases (34.0%), while decrease of bladder capacity was observed in 6 cases (10.7%) of the single drug regimen group.
4. On the other hand, bladder irritability was recognized in 5 of 12 cases (41.7%) and decrease of bladder capacity was found in 2 cases (16.7%) of the combined group.
4) Absorption of the instillated drugs from the bladder mucosa
1. Transmission of the drugs into blood was assumed in all 5 cases intravesically instillated with ³²P thio-TEPA and MMC, while 5-Fu was proved in blood in 3 of 5 cases.
Thio-TEPA was higher in blood compared with instillated dose. MMC and 5-Fu were next to it.
2. Recovery ratio of thio-TEPA from the urine was least among three agents mar

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Testicular tissue obtained from twenty-three men by open biopsy, were cultured by Trowell's organ culture method.
The results are summarized as follows.
1) In the organ culture using TC-199 medium with 15% calf serum (32°C, 5% CO₂ in air), seminiferous tubules were maintained even after fifty-six days.
2) Tubular fibrosis increased gradually in the course of culture.
3) Concerning with germinal cells, secondary spermatocytes and early spermatids began to degenerate after four day culture. And following them, late spermatids started to show necrotic changes after seven days. These cells almost disappeared after two week culture. Primary spermatocytes showed necrotic changes in seven day culture, but some of them were still alive in three week culture.
4) Spermatogonia have no change in number even after twenty-eight days in culture, but considerably decreased in fifty-six day culture. However, pale type A spermatogonia still survived in fifty-six day culture. Hypertrophic spermatogonia were observed after twenty-eight day culture.
These data indicate the unique characteristics of human spermatogonia.
5) Sertoli cells were alive in the tubules in fifty-six day culture without decrease in number.
6) Interstitial cells showed gradual fibroblast-like changes.
7) By radioautographic studies, it is certified that labeled resting spermatocytes could mature to pachytene spermatocytes after thirteen day culture at the same speed as in the normal in vivo condition. This finding means that human spermatogonia can differentiate into the pachytene stage even in the condition without gonadotropins.
8) In culture medium containing gonadotropins (FSH 1, 000μg/ml or HCG 1, 000IU/ml), immature Sertoli cells showed maturation after two week culture. Germinal cells, however, did not show any reaction to an addition of gonadotropins and testosterone into the culture medium. In mature testis, the addition rather stimulated the degeneration of germinal cells.
These deta revealed that certain other factors should be present with gonadotropins for maintaining and developing germinal cells in organ culture.

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It is well known that arteriovenous fistula of the kidney also produces cardiovascular symptoms, such as hypertension, congestive heart failure and so on.
In this paper three cases of congenital arteriovenous fistula due to intrarenal vascular malformation, which were diagnosed preoperatively by arteriographic examination, were reported.
All of these cases showed only gross hematuria without any cardiovascular symptoms.
Nephrectomy was performed on two cases and the third case was treated by partial nephrectomy.
Microangiographic study was carried out on two removed kidneys. Cirsoid appearance of small, tortuous vascular density was clearly demonstrated on these microangiograms.
Histological findings were subpelvic arteriovenous malformations on three cases.

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