I employed the myelography, using water soluble contrast medium, on 26 patients with dysfunction of the bladder. The relation between the changes of the myelogram and the function of the bladder was studied.
The results are as follows:
1) In 5 patients with severe dysfunction of the bladder, myelogram showed many abnormal findings including meningocele, widening of column, sacral cyst, and defect of the sacral roots.
2) In 5 patients with mild dysfunction of the bladder, the myelogram showed a cystic widening of the roots and a narrowing of the sacrall column.
3) In 7 of the 16 patients with slight dysfunction of the bladder or normal function, the myelogram showed a cystic widening of the sacral roots, assymmetric sacral roots, unclear roots, etc.
4) In 9 patients with spina bifida occulta, the myelogram showed a cystic widening of the roots, a narrowing of the sacral roots, assymmetric roots, and unclear roots. These findings were thought to be related to a dysfunction of the bladder due to spina bifida occults.
5) I think the myelography is a usefull method to find out the underlying cause of the neurogenic bladder and recurrent chronic inflammation of the urinary tracts.

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For 58 cases with carcinoma of the prostate, the interrelationship between clinical effect by antiandrogenic treatment with castration and stilbestrols and change of serum acid phosphatase levels were studied and the following results were obtained.
1. Pretreatment serum total and prostatic acid phosphatase levels had no significant correlation with five-year survival rate.
2. Patients responding with a decrease in the serum acid phosphatase level to the antiandrogenic treatment showed better therapeutic response one year after the start of the treatment and a higher fiveyear survival rate than those who responded with an increase.
3. For diagnosis and as an index of treatment in patients with prostatic carcinoma, prostatic serum acid phosphatase was not specific more than total serum acid phosphatase.

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With a certain criteria of the clinical effects due to hydrostatic pressure technique for carcinoma of the urinary bladder, the results of 25 cases obtained with this method consisted of 10 cases with a dramatic response, 8 cases with satisfactory effects and 7 cases with fairly good response, except for only 1 case ensued by carcinoma death. The speciality of hydrostatic pressure technique is essentially belonged to immune therapy, with experimental elucidation of immunological mechanism by Hashimoto. With easy judgment of its effects in rather short period after the procedure, hydrostatic pressure technique should be applied not as a tentative treatment but as the first choice procedure especially on cases beyond transurethral surgery. Estimation of increased cases without any necessity of total cystectomy might be emphasized, with exact application of this method based on both host qualification and tumor conditions.
The method indication is summarized as follows; tumor factors are composed of their locations, growth patterns and stages of their advancement. Tumors occupying within 10mm. around ureteral orifices showed marked resistance to the treatment. Sessile carcinoma usually showed a relatively poor response which might be resulted in the fragility of the bladder wall caused by cancer infiltration. The host reactions were parallel to positive degrees of tuberculin skin test or a number of lymphocytes in peripheral blood and/or in tumor tissues.

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Infarction of the prostate in hyperplastic glands is more frequent than generally supposed. In 120 cases of hyperplastic prostates, twenty-four instances of infarction were found, constituting in frequency of 20 per cent.
The lesion of infarction, which occurs only in hyperplastic nodule, consists of foci of coagulation necrosis involving epithelial and stromal elements. Squamous epithelial metaplasia, as well as the so-called “regenerating epithelial dysplasia”, frequently develops around the periphery of an area of infarction. These epithelial changes may mislead one into considering the conditions as a malignant tumor, when he is unaquainted with this process. The significance of epithelial metaplasia or dysplasia in the differential diagnosis from carcinoma should be noticed.
In cases with infarction, the average weight of enucleated glands increased by more than 50%, the attacks of urinary retention occurred 1.7 times more frequent and the duration of symptoms was 20 months shorter, as compared to those in cases without infarction.

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Renal angiomyolipoma is rare and mostly associated with tuberous sclerosis. Herein is reported a case of primary angiomyolipoma without tuberous sclerosis which occurred in the renal sinus. Such a case is of exceptional rarity and very interesting because it must be considered in the differential diagnosis of parapelvic cyst.
A 50-year-old female visited our hospital on December 12, 1972, complaining urethral bleeding after the resection of caruncle. She had pain in the right flank. Physical examination revealed no abnormal mass. Blood pressure was 150/100. On intravenous pyelography a right pelvic deformity was found. The retrograde pyelogram demonstrated a compressed renal pelvis and dilated calyces. The responsible lesion seemed to extend out of the sinus and compressed the upper ureter from medial side. This finding was thought to be not compatible with parapelvic cyst. Nephrotomography combined with contrast medium infusion and pneumoretroperitoneum was performed and the mass was poor in vessels. Arteriography was not done. Stigmata of the tuberous sclerosis complex were not evident.
On January 17, 1973, under general anesthesia exploration was carried through transabdominal approach. An encapsulated yellow tumor arising from the right renal sinus extended out of the hilus and downward along the inferior vena cava. The right kidney and the mass were removed. The patient was uneventful postoperatively.
The yellow lipoma-like tumor measured 8.0×4.0×4.0cm. The exact site of origin was difficult to determine. On microscopic examination the tumor was mainly consisted of abundant mature fatty tissue. There were scattered patchy foci of abnormally thick walled vessels surrounded by cuffs of slender smooth muscle cells irradiating from the wall. Those angiomatous vessels were composed of smooth muscle cells resembling arterial wall but had no elastic fiber. The tumor was considered to be a hamartoma rather than true neoplasm. The renal parenchyma showed the picture of chronic pyelonephritis. Calyces were compressed and enlarged.
Prince and associates, reporting their 30 cases, noted that most of the tumor located within the parenchyma of the kidney. The case reported by Appel and associates, however, had a myxoma in the renal sinus which compressed collecting system, resembling parapelvic cyst. In case of angioendothelioma reported by Prince and associates the pelvis was flattened ventro-posteriorly. Such mesenchymal tumors must be considered in the diagnosis of parapelvic space occupying lesions.

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