It is known that cryptorchidism, testicular atrophy of post mumps orchitis, and various immature, dysgenetic testis are more likely to develop a tumor than normal testis.
Testicular atrophy and immature testis are believed to especially predispose tumor development.
Conversely, the function of the testis of a patient with a testicular tumor may be hypoactivated and may become immature, dysgenetic and atrophic. Therefore, I investigated from various approaches the functions of the testis of patients with testicular tumors who are under our care. I also investigated pituitary gonadotropin, to observe how it is related to the hypofunction of the testis. The 45 testicular tumor patients, from 20 to 39 of age, who are under care of the Department of Urology, Yokohama City University, School of Medicine and its affiliated hospitals.
1) Size of the opposite testis of a testicular tumor patient was measured.
The mean was 11.4±5.53ml (normal, 11.08-21.23ml), which was smaller than normal.
2) The semen of a testicular tumor patient was examined. The volume of the semen of a testicular tumor patient tended to be less than normal.
As for the number of the sperma, 80% of the patients examined had oligospermia or azoospermia.
3) In the orchiectomy of a testicular tumor patient, biopsy of the opposite testis was made in order to explore it histologically.
(1) Most of the seminiferous tubules examined (80%) were found to be with hypospermatogenesis. However, only a few of them showed such severeness as fibrosis and hyalinization of the tissue.
(2) The interstitial cell showed a slight proliferation.
(3) Hypertrophy of the wall of the blood vessel was milder than that of the normal blood vessel.
4) An examination was made of the fertility of a testicular tumor patient, before the discovery of the tumor.
(1) Infertility for over three years was found in about 20% of the patients examined.
(2) There was a tendency that even a patient, who had normal fertility and successfully impregnated, developed tumors after more than two years of infertility.
5) Pre-operative determination of hormones in the urine of a testicular tumor patient was made.
(1) Most of 1705, 17OHCS, estorogen in the urine was within a normal range.
(2) Pituitary gonadotropin in the urine was apt to be high.
Judging from the fact that a testicular tumor is developed in cryptorchidism at a high rate, that a tumor is often developed in testicular atrophy of post mumps orchitis, that a tumor is often developed in the immature, dysgenetic testis and that an experimental testicular tumor formation is related to testicular atrophy, it can be said that the development of a testicular tumor has a close causal relation with testicular hypofunction. In conformity with the above and in addition to the data obtained, I would like to state the following:
1) The testicular function, especially spermatogenesis of a testicular tumor patient is apt to be hypoactivated regardless of a definite cause such as cryptorchidism, immature and dygenetic testis and post mumps orchitis testicular atrophy.
2) Hypospermatogenesis precedes the development of a tumor.
3) Hypersecretion of FSH is developed for hypospermatogenesis.
4) I infer that under the conditions of hypospermatogenesis, a germ cell is stimulated by hypercrinism of FSH, and its proliferation is activated. At this point I can say that there is some unknown cause which directs the proliferation of the cell wrongly to result in a tumor.

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A lowering of urinary fibrinolytic activity would result in an increase in the amount of mucosub-stances in the urine, which is seen in patients with renal calculi, and is a prelude to the formation of the matrix of calculi. Fifty-two patients with urinary calculi were subjected to the determination of urinary total nondialyzable solids (TNDS), fibrinolytic activity and urokinase inhibitory activity in urine and blood. Eighteen presumed normal individuals served as control. In a preliminary experiment, degradation products of urinary mucosubstances by fibrinolysin and urokinase (Green Cross Co., Osaka) were estimated in 2 cases of urolithiasis.
The results obtained were as follows:
1. A significant increase of TNDS was noted in the urolithiasis group when compared with the control group (p<0.05).
2. There was no significant difference in the urinary fibrinolytic activities per 12-hour urine output between the two groups, but in terms of the activity per one ml of the 12-hour specimen the considerable decrease was observed in the urolithiasis group (0.05<p<0.1).
3. Fibrinolytic activity in blood on euglobulin lysis time was reduced in 18 patients of the urolithiasis group, and plasma urokinase inhibitory activity was significantly increased in the urolithiasis group (p<0.01).
4. Urinary TNDS underwent rapid degradation with fibrinolysin, but was little affected with the urokinase in vitro.

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Plasma FSH, LH and testosterone were measured by a radioimmunoassay technique in 15 cases with sterility and 5 normal males following intramuscular injection of synthetic LH-RH (0.1mg).
In almost all cases with sterility, an increment of plasma FSH and LH values following LH-RH administration was seen. However, the reaction of pituitary to LH-RH administration occurred slightly slower in a group of azoospermia than in the controls, while it seemed quite normal in a group of oligospermia.
On the other hand, the increase of plasma testosterone was lower than normal in patients with sterility following the LH-RH loading test.
As mentioned avove, the pituitary reacted to LH-RH in male sterility, but the LH-RH loading test resulted in almost no increase of plasma testosterone. These facts suggest that the interstitial cells themselves are not functioning normally in male sterility. The obtained results also show that the LH-RH loading test is much superior to the conventional HCG test or the rapid HCG test recently applied, since it makes diagnosis possible for both pituitary and gonad conditions at the same time, besides shortening the time for the test.

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Clinical analysis was done on the surgical results and prognosis of 24 operated cases with reno-vascular hypertension experienced at the Yokohama City University Hospital and of 202 operated renovascular hypertensives from the collective review of the past Japanese medical literatures.
Following-up on the operated cases revealed that a maximal blood pressure reduction was achieved at the 6th post-operative/month, followed by a gradual but slow elevation of blood pressre 2, 5, and 10 years after the operation.
Analysis on the factors which might influence prognosis of reno-vascular hypertension after surgery revealed the following findings:
1) Age and duration of hypertension had little influence on prognosis of reno-vascular hypertension after surgery.
2) Prognosis of reno-vascular hypertension after surgery was deeply affected by the etiology of renal artery stenosis. The aortitis syndrome which was peculiar in Japan and in the other Asian countries had most poor prognosis in blood pressure reduction associated with a high mortality rate. Fibromuscular hyperplasia showed more favourable prognosis than atherosclerosis.
3) Slightly better blood pressure response was attained by nephrectomy than by angioplastic operation in the collective cases whereas a reverse result was obtained in the author's cases. In the angioplastic group, poor prognosis was indicated when the artificial graft was applied.
4) Favourable blood pressure reduction coluld not be expected if total renal function was lowered or if nephrosclerotic change was present in the stenotic and non-stenotic kidney.
5) Cardiovascular damage was closely correlated to poor prognosis whereas optic fundi change was not.
6) Poor prognosis after surgery could be expected when peripheral plasma renin activity was not elevated significantly, or when renal vein renin ratio between the affected and the unaffected kidney was below 1.5.

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In order to evaluate the efficacy and safety of a new aminoglycoside antibiotic, 3′, 4′-dideoxykanamycin B (DKB), in urinary tract infections, a controlled trial with gentamicin (GM) as the reference standard was carried out by double-blind technique at 11 institutions throughout Japan. From the results obtained, the following conclusions were drawn:
(1) With respect to the allocation of GM and DKB, there was no serious bias in favor of ither drug in the entire series of 148 cases studied, or in the divided subgroups with and without cystitis.
(2) Global judgement made at participating institutions was substantially in accordance with the general plan described in the study protocol: emphasis was placed on bacteriuria turning negative, with consideration given to whether and to what extent pollakiuria and urine sediment findings were improved.
(3) No difference in clinical significance was observed on an average basis between the global judgement for GM and that for DKB as assessed in the entire series (statistically P=0.7969) or in subgroups with and without cystitis.
(4) Untoward reactions were observed somewhat more frequently in patients treated with GM (P=0.1078).

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