The functional significances of the bladder epithelium are not yet well known. The transitional epithelium of the bladder is subjected to considerable physiological stimuli such as pressure changes during filling and emptying of the bladder and variations in the osmotic concentration of urine. The transitional epithelium of the bladder is well adapted to these stresses. It is generally known that the special histological structure and interrelationship of component cells of the transitional epithelium and the presence of a condensation of cytoplasm in surface cells are accepted generally. The mechanism by which the bladder epithelium is adapted to changes in the area of the mucous membrane during filling and emptying is also known. It has long been known experimentally and clinically that vesical mucosa regenerate rapidly even after its complete excision. The existence of the basal membrane in the bladder mucosa was demonstrated by many authors. Another open problems are that of active-transport function of the transitional epithelium.
There have been numerous reports with regard to the histochemistry of the transitional epithelium. Many aUthors have described the localization of alkaline phosphatase in the bladder wall of various animal species, including frog, mouse, rat, guinea pig, rabbit, cat, dog and man. They described the presence of alkaline phosphatase in the inner cell layers of the epithelium but it was absent in the cells of the surface layer.
Recently, attention has also been paid to the presence of extremely active tissue plasminogen activator in the bladder epithelium of many species. But detailed interrelationship between alkaline phosphatase and tissue plasminogen activator has not yet been well known.
An attempt was made to contribute to the histophysiology of the transitional epithelium of the normal bladder by studying distribution of alkaline phosphatase and tissue plasminogen activator in the normal bladder wall of guinea pig. The localization of such substances on the bladder wall has not been studied previously.
A total of 20 white adult guinea pigs, of both sexes, were used in the present study. The activity of plasminogen activator in the tissue and urine was examined by the modified histochemical fibrin slide technique. The distribution of alkaline phosphatase was demonstrated by a modification of the coupling azo dye method.
The fibrinolytic activity of bladder urine varied slightly among different individuals, but the activity in the sediment and supernatant of urine did not appear after 90 minutes of incubation on the both plasminogen-rich or -free fibrin slide in all animals studied.
In the normal bladder wall of guinea pig, fibrinolytic active-sites were observed at four different localizations as described below: (a) Fibrinolytic activity appeared diffusely widespread associated with the mucosa, originating from the transitional epithelium, after incubation periods ranging from 10 to 20 minutes. (b) Focal zones of lysis were seen in relation to some blood vessels in the submucosa and muscular coat after 20 to 30 minutes of incubation. (c) Lysed areas along some collection of desquamated epithelial cells were observed lying freely in the bladder cavity after 20 to 30 minutes of incubation. (d) Zones of lysis were found associated with the transitional epithelium and subepithelial connective tissue in the ureter which penetrate through the bladder wall.
With regard to the distribution of alkaline phosphatase in the bladder, the reaction was intense in the thin layer of the subepithelial connective tissue located immediately below the lining basal membrane and apeared after shortest incubation periods (i. e. 5min.) than did the reaction in the transitional epithelium. The epithelium showed a moderately inte

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The normal transitional epithelium of the urinary bladder is histopathologically situated between the squamous cell with lower differentiation and the columnar cell with higher differentiation. In relation to this notion, the author has attempted to raise the following hypothesis.
The epithelium of the bladder, under long-term stess such as chronic infection and physical or chemical stimuli, tends to cause metaplasia in the process of regeneration of injured epithelial tissue, for a better protection of the original epithelium, depending on its environmental situation. The direction of this metaplasia could be towards either squamous or columnar, and these two directions could also be present independently or together in combination. And it would be the bladder epithelium itself that determined the direction of metaplasia, in order to be protected better in each situation. The epithelium, in which metaplasia has once developed, has already started to proceed into the progressive cell-division towards abnormal direction, with a possibility either of continuing its stable activity of metaplasia or growing into a critical condition such as malignant alteration.
Bearing this hypothesis in mind, the author carried out histopathological studies of the bladder epithelium in 154 cases of paraplegia, with use of the specimens such as the cytologic smears of the urine and the tissues of the bladder neck obtained at biopsy and autopsy.
The significant findings in these studies were summarized in the followings.
1) In the smeras of the urine, developement of metaplasia with squamous epithelium was found in 85 cases (64%) among 134 cases examined.
2) In the biopsied specimens from the bladder-neck, squamous metaplasia was also found in 25 cases (73.5%) among 34 cases.
3) The finding described in 1) and 2) were considered not to be related with the severity of the urinary-tract infection accompanied.
The developent of squamous metaplasia was estimated to be about 5-6 months after the onset of paraplegia when urinary tract infection was accompanied.
4) In the postmortem examination of the urinary bladder in 21 cases of paraplegia, 6 cases had squamous metaplasia, 1 case had partially columnar metaplasia, and 4 cases had bladder carcinoma in which squamous cell carcinoma was found in 3 cases.
The finding that squamous cell carcinoma developed predominantly in the bladder in cases of paraplegsia is considered to be in contrast to the fact that occurrence of adenocarcinoma was observed predominantly in cases of bladder exstrophy, similarly accompanied with chronic infection, being exposed to physical or chemical stimuli for a long period.
It is thus conceivable that the bladder epithelium in cases of paraplegia, under chronic stimuli of infection, has, in its process of regeneration, some difficulty to proceed into its original transitional epithelium, and rather tends to regenerate into squamous cell metaplasia for a protecting effect, and finally to progress into malignancy as squamous cell carcinoma when some unknown cancer-producing factors are additionally involved in these situations.
It is also suggested that long-lasting stimuli such as chronic urinary-tract infection and foreign bodies are playing very important roles in cases of paraplegia, in the process of regenerative changes of the injured normal bladder epithelium into squamous metaplasia, and even further into neoplasm.

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Three MLC identical paris were identified among unrelated healthy subjects. MLC identity was determined by the following criteria.
1) Complete absence of MLC response measured by DNA synthesis at duplicated cultures of mutual one way and two way mixed culture.
2) Unimpaired MLC response of responding cells of the two subjects against another unrelated control.
MLC unresponsiveness was confirmed by recurrent cultures and estimation of DNA synthesis at various culture period. HLA non-identity was shown on two MLC identical unrelated pairs. Lymphocyte transfer test as a model of transplantation immunity was also performed between two of the three MLC identical unrelated pairs. The minimum reaction was observed at the MLC identical pair.
Discrepancy between HLA identity, MLC identity and prolonged graft survival between two subjects in relation to the presence of consanguineal relation were discussed. The possible importance of MLC as a histocompatibility test among unrelated subjects was suggested.

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The effects of autonomic drugs on closure of the internal urethral orifice during ejaculation were investigated in dogs.
Methods and materials. The closure of the internal urethral orifice was measured with latex balloon inserted into the orifice. Seminal emission and ejaculation were measured with posterior urethrogram. In this study the nerve fibers descending on the anterior wall of the aorta into the plexus were tentatively named as the central branch of the lower mesenteric. plexus and fibers entering from the lateral portion into the plexus as the lateral branch of the plexus. These two groups of the fibers were cut and the peripheral end of the cut fibers were electrically stimulated with square waves of 2 msec, 10Hz and 2V. To cause closure of the internal urethral orifice, the lateral branch was stimulated with above-mentioned condition for 3sec in every 20sec. And to cause seminal emission and ejaculation the central branch was stimulated continuously.
The autonomic drugs were given into the aorta just above its bifurcation.
The results obtained are as follows:
1) Effect of α-adrenergic drugs. Administration of phenylephrine (α-stimulant), 10-100μg, caused closure of the internal urethral orifice and phentolamine (α-blocker), 1-10mg, suppressed the closure. Seminal emission was suppressed completely by phentolamine, and rhythmic alterations of posterior urethral pressure, which is considered as ejaculation, were also abolished. With α-stimulant the rhythmic alterations were induced.
2) Effects of β-adrenergic drugs.
Isoproterenol (β-stimulant), 10-30μg, depressed the closure of the internal urethral orifice and propranolol (β-blocker), 1-10mg strengthened it. But these depressing and strengthening effects are thought to be pretencious phenomena.
Seminal emission and the rhythmic alterations of the posterior urethral pressure did not show any significant change after administration of the β-stimulant and β-blocker.
3) Effects of cholinergic and anticholinergic drugs.
Acetylcholine (1-10μg) and atropine (1-10μg) did not show any significant effect on closure of the internal urethral orifice as well as seminal emission and rhythmic alteration of the posterior urethral pressure.
4) Effects of ganglion stimulant and blocker.
Closure of the internal urethral orifice was strengthened by DMPP (10-30μg), and was suppressed by hexamethonium (100-500μg). No significant effect on seminal emission or the rhythmic alterations were observed.
From these results it is concluded that the internal urethral orifice during ejaculation as well as seminal emission and ejaculation is predominantly under the control of α-adrenergic receptor mechanism.

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Before March 1971, 53 patients were treated with renal allotransplantation at the Departments of Urology of 10 Schools of Medicine in Japan. The collected experience of 53 kidney transplantations has permitted analysis of data on age, sex, survivals of recipients, source of donor kidney, types of disease in patients receiving renal transplants, blood groups, histocompatibility, dialysis, time of nephrectomy, type of perfusate, ischemic period, onset of function, types of ureteral anastomosis, immunosuppressive therapy, diagnosis and therapy of rejection, distribution of certain values related to kidney function, blood pressuree after transplantation, activity of recipients following transplants, complications, cause of transplant failure and/or death, and complications in donors. This report is the first comprehensive compilation of data on human kidney transplants in Japan, though limited to those performed at departments of urology. It is urgent that the human kidney transplant registry be updated as a continuous aid in evaluation of data on all human kidney transplants done so that we might share experiences and minimize duplication of error.

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