In 14 patients between 44 and 85 of age who were orchidectomized for prostatic cancer, and of whom most were undergoing additional treatments with anti-androgenic hormones, plasma levels of FSH, LH, and testosterone were determined, and in 12 of them a LH-RH loading test was performed to examine its effects on the pituitary secretory function, as well as on the adrenal cortical function of testosterone secretion. In two cases out of the 12, a HCG loading test was also applied to study response of the adrenal gland to HCG. Results show that the combined therapy of orchidectomy with subsequent anti-androgenic hormone administration caused a rapid fall of the plasma levels of FSH, LH, and testosterone, whereas in the early stage the pituitary continued to respond to LH-RH loading. Clinically, pain caused by urination and from bone metastases all disappeared without much problem, though the prostatic tumor itself was without appreciable change. After more than 6 month's application of anti-androgenic hormones, the plasma level of testosterone began to rise, and the pitutary response to LH-RH became depressed. However, a slight increase in plasma LH stimulated the sensitive adrenal to produce more testosterone. However, there was no correlation between the increase in plasma testosterone and the aggravation of the tumor. Medical adrenalectomy in addition to orchidectomy and hormonal therapy worked to reduce testosterone in plasma to negligible amounts, alleviating pains of bone metastases and troubles with urination. In one case which underwent only orchidectomy with no supplementary treatments, plasma levels of FSH, LH, and also testosterone were observed to increase 2 years after the orchidectomy, with the pituitary reacting positively to LH-RH loading; the condition of prostatic tumor became aggravated and no appreciable improvement in urination.

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The author has treated 21 ureters (19 cases) by the simplified Girgis triangular flap ureterovesicoplasty modified by taguchi. In this simplified method, the sutures between the two margins of the incised transplanted ureters and the two limbs of the V-shaped incision in the bladder floor were carried out by simple interrupted method instead of interrupted horizontal mattress method after Girgis.
Long-term results (from 1 to 9 years after operation) of patients with this operation were studied using X-ray examination (IVP and Cystography), renal function tests (PSP, BUN and creatinin) and urinalysis. Furthermore, animal experiments with 20 female adult mongrels were conducted and follow-up studies were made using the above mentioned method and moreover anatomical and histological examination, in order to justify the clinical effectiveness of this simplified method. Following results were obtained:
1) The operative procedures were very simple as compared to the original Girgis method.
2) After this operation a stricture in the region of anastomosis did not occur in any case.
3) In all of the ureters without preoperative VUR (vesicoureteral reflux), it did not occur after the opertion. However, in 11 ureters with preoperative VUR, 4 showed VUR even after the operation.
4) In all of the 19 cases, the degree of hydronephrosis and renal function were improved or unchanged.
5) Urinary findings were worsened in 3 out of the 19 cases.
6) From the clinical studies it was noted that this method is contraindicated to the cases with high grade hydroureter and severe inflammatory and edematous changes of the bladder wall.
7) From the animal experiments it was demonstrated that slight or moderate hydronephrosis short after the operation is attributed to the mechanical inflammatory or edematous changes of the terminal ureter. However, these changes disappeared usually 2 months after the operation.
From the experimental and clinical studies the author concluded that the simplified method by Taguchi is one of the best method for ureterovesiconeostomy preventing postoperative VUR.

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Transuretero-ureterostomy was performed in 32 adult dogs (the right ureter as donor and left ureter as recipient), and the results were evaluated in short and long terms. In 10 animals (short-term observation group), electroureterograrms (electromyograms of the ureter) were recorded 30 minutes, 1, 3, and 6 hours postoperatively and changes in peristaltic action potential discharge were observed at 6 hours postoperatively under elevated intrabladder pressure. In the other 22 dogs (longterm observation group), electroureterograms were recorded in oliguric and diuretic states, and intraluminal pressures were determined in the ureter at the site of anastomosis and in the pelvis. Also, changes in peristaltic action potential discharge were studied under elevated intrabladder pressure in a diuretic state. Further, roentgenographic and histological investigations of the urinary tract were carried out. The results obtained are summarized in the following.
1) Frequencies of normoperistaltic action potential discharge in the right and the upper left ureter increased or decreased incongruously 1 to 3 hours postoperatively, but showed a general tendency to restore the preoperative levels at 6 hours. In the lower left ureter, the discharge frequencies markedly decreased at 30 minutes but returned to normal gradually in 1 to 3 hours. A mild slowdown of the conduction rate of peristalsis generally observed postoperatively was evaluated as rather insignificant.
In the dogs of the long-term observation group, the frequencies of postoperative normoperistaltic action potential discharge were below the intact levels in an oliguric state but almost equivalent to such levels in a diuretic state. The peristalsis conduction rates were not signicicantly different between the pre- and postoperative levels.
2) The postoperative peristaltic movement across the anastomotic site had the following five features. Type I: Normoperistalsis was transmitted without hindrance from the upper through the lower ureter. Type II: Normoperistalsis was transmitted from the upper to the lower ureter, but accompanied antiperistalsis starting at the anastomotic site in the opposite ureter. Type III: Normoperistalsis in the upper ureter was blocked at the anastomotic site. Type IV: Antiperistalsis occurred at the anastomotic site. Type V: Antiperistalsis occurred starting at the ureterovesical junction. Each ureter of each animal was classified according to the type. In the dogs of the short-term group, the right ureter had predominantly Type III. There was no instance of Type I and there were only a few of Type V. On the other hand, the upper left ureter either Type I, III, or IV, but with the lapse of postoperative hours, Type I became progressively predominant in that tract, with an increase in the rate of free conduction of peristalsis through the anastomotic site. In the animals of the long-term group, Types I and II in the right ureter, which absent were in the dogs of the short-term group, could be observed.
3) In 4 dogs of the short-term group, the resting and contracting pressures of the ureter determined at the anastomotic site were on the average 4.8cmH₂O and 35.1cmH₂O, respectively, while in 8 dogs of the long-term group, the comparative figures were 1.9cmH₂O and 29.0cmH₂O. On the other hand, intrapelvic resting and contracting pressures measured in 4 dogs of the long-term group were on the average 2.2cmH₂O and 12.1cmH₂O, respectively, changes in pressure level on antiperistalsis seen in Type II were less than 2-3cmH₂O.
4) In dogs of the short-term group, the frequencies of peristaltic action potential discharge at an elevated intrabladder pressure did not show any alteration at all in the right and the upper left ureters in 3 cases, nor in the lower left ureter in 4 cases. In animals of the long-term group, the frequencies increased, tending toward the preoperative leve

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A case of leiomyosarcoma arising from the prostatic area, previously reported in the journal, died on January 25, 1974. The death followed two years after the onset of his symptom, although the tumor had shown some degree of response to both radiotherapy and chemotherapy.
Autopsy was performed one hour after death. A hugh tumor involving bladder wall extended to the left iliac fossa. The tumor weighed 110gm, measuring 150cm in longest diameter. The cut surface was firm, dull white, nodular, and multiple necrotic foci were found. Under the microscope, the cells were markedly pleomorphic. Giant cells with large, hyperchromatic, plural nuclei were frequent. Mitotic figures were present but rather rare. Hyalinisation occurred in numerous areas. No distant metastasis was found. Death was attributed to cachexia.

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