1. Adrenal scintigram was performed for 4 patients with Cushing's syndrome due to ACTH excess, 4 patients with Cushing's syndrome due to unilateral adrenal adenoma, 7 patients with primary aldosteronism, 2 patients with pheochromocytoma and 3 patients with other hypertension, and selective adrenal venography was performed for 12 patients of them.
2. Preoperative determination of the site of the adrenal tumor was made in 6 of 13 patients by PRP, 7 of 9 patients by selective adrenal venography and all of 13 patients by adrenal scintigram, so that adrenal scintigram was proved to be very valuable.
3. It was successful to make early diagnosis for the site of small aldosterone-producing tumor within 1cm in diameter 2 to 4 days after intravenous administration of the tracer dose of 0.3 to 0.4mCi of ¹³¹I-6β-iodomethyl-19-nor-cholest-5(10)-en-3β-ol (¹³¹I-Adosterol) by means of an Gamma camera, aided by computer processing, i. e., subtraction, smoothing, leveling, associated with liver scan with ^99mTcphytate on the same position.
4. Selective adrenal venography should be performed, unless PRP and adrenal scintigram were able to diagnose the tumor site.

View full abstract

The cytochemical localization and intensity of adenosine triphosphatase (ATPase) activity in the spermatozoa from fertile and infertile human ejaculate were observed by means of the electron microscope.
Spermatozoa from fertile and infertile human ejaculate were fixed in 1% glutaraldehyde and treated histochemically to demonstrate Ca⁺⁺ and Mg⁺⁺ dependent ATPase. Furthermore, as substrates, ADP, AMP and β-glycerophosphate were used. The localization of Ca⁺⁺-activated ATPase was not different from that of Mg⁺⁺-activated ATPase. In the fertile human ejaculated spermatozoa, ATPase activity was found on the surface of the acrosome and mitochondria consisting of the mitochondrial sheath, around the outer coarse fibers and in the axial filament complex. Compared with the result with fertile specimen, in the infertile human ejaculated spermatozoa, ATPase activity on the motile structures, the outer coarse fibers and the axial filament complex were considerably weak and occasionally not recognized.
From this study, it may be considered that ATPase around the outer coarse fibers and in the axial filament complex of spermatozoa may serve to mediate contraction of the axonemal elements during motility.

View full abstract

Simultaneous measurements of the voiding factors: vesical pressure, urethral pressure, intraabdominal pressure, tone of anal sphincter, E. M. G. of anal sphincter including external urethral sphincter partially and flow rate or velocity were made by using a six channel polygraph. The values of measurement and patterns of voiding factors were analyzed and their correlation was studied to make clear characteristics of the voiding mechanism of normal status and obstructive diseases.
This report centers about the urinary flow rate in many voiding factors. Ultrasonic Doppler flowmeter is used for the measurement of urinary flow rate. The principle, structure of the flowmeter (Fig. 2-1, 2-2), the conditions of measuring technique (Fig. 4), the method of calibration (Fig. 6, 7, 8, 10), the limit of this method due to the error of measurement (Fig. 11) and the parameters which could be determined by this method (Fig. 12) were discussed.
It was concluded that this apparatus was probably useful to measure the urinary flow rate and velocity nonobstructively.
Fourteen parameters were taken from the relation between the urinary flow rate and vesical pressure.
Based on those, the correlation by T-test between normal boys and girls, high and low voiding voumes, normal and abnormal subjects with lower urinary tract obstructive disorder including neurogenic bladder were investigated.
The result
1) The correlation between normal boys and girls.
It was found that the effect of vesical pressure was immediately refected on urinary flow rate in girls. It was suggested that it is due to the specific anatomical and functional characters of the urethra in girls.
2) The correlation between normal and disordered subjects in lower urinary tract.
It was known that the energy, which was lost at the lower urinary tract in the latter, was extremely large. The average energy loss was in the order of neurogenic bladder, congenital bladder neck obstruction and urethral hypertonia.
When the paper speed was kept constant, the urinary flow rate curve appeared as below (Fig. 13, 14, 15, 16).
Normal subject: bell type wave
Stenosis of external urethral meatus: spike wave
Urethral hypertonia: Plateau wave or plateau and spike wave
Congenital bladder neck obstruction: plateau wave or plateau and spike wave
Neurogenic bladder:
Brain bladder: bell or plateau wave
Cord bladder:
Automatic type: hill type and spike wave
Autonomous type: intermittent serrated wave
The waves are changeable under the influence of urine output and catheters for vesical and urehtral pressure measurements. The classification according to the patterns is also only a supplementary method.

View full abstract

Recently serratia marcescens infection of the urinary tract has been more prevalent than realized. Serratia marcescens were isolated from 95 cases out of 1, 059 urinary tract infections (44 cases of pure infection diseases, 16 cases associated with calculous diseases, 8 cases with tumors and others) during the last two years at our department. Clinical and laboratory studies were made on Serratia marcescens infection of the urinary tract.
The Results are as follows:
1) None of the outpatients with urinary tract infection had a positive culture of serratia marcescens, on the other hand, some of inpatients especially those with indwelling catheter had positive culture.
2) Serratia marcescens infections of the urinary tract are occasionally thought to be hospital acquired, but the frequency of the serratia marcescens of the urinary tract may be attributed to low resistance of host side to infections.
3) Antibiotics sensitivity tests (disc technique) to serratia marcescens are shown sensitive to Gentamycin, Nitrofurantoin, Nalidic acid but resistant to synthetic penicillins or cephalosphorins.
4) Urosepses of Serratia marcescens are rather few but in some cases such as cachexia due to neoplasma or renal failure, the prognosis is lethal.

View full abstract

After an upper half of dog bladder was excised and repaired with gelatin sponge sprayed with Nobecutane, blood supply and nerve regeneration during the developing process of new bladder wall were observed.
1) Blood supply to new bladder wall
The blood supply was investigated by dye injection method and microangiography. At an early period after the bladder repair, newly formed connective tissue at the bladder defect is receiving blood principally from the organs adhereing to the outer surface of the grafted portion. As adhesion becomes loose with time and muscle regeneration progresses toward the center of grafted portion, blood flow from original bladder wall increases in rate and finally normal distribution of blood vessel is established in the new bladder wall 8 months later.
2) Regeneration on nerve
The nerve regeneration was investigated with histochemical techniques. Adrenergic and cholinergic nerves adjacent to vessels are found near the cut edge of the bladder wall in early period after bladder repair. Then nerves adjacent to vessels extend to the central part of the new bladder wall with growth of blood vessels from cut edges of the bladder, and a little later nerves unrelated to vessels also extend with progression of muscle regeneration from the cut edges. Finally, adrenergic and cholinergic nerves are distributed in the new bladder wall as about equally as normal bladder wall, but ganglion cells are never seen in the new bladder wall.

View full abstract

Cytogenetic observations were made to investigate the roles played by chromosomes in malignant tumours of the human urogenital tracts. The presence of any characteristic chromosomal patterns for specific carcinomas were searched for, and a possibility of clinical application of chromosomal findings in diagnosis and treatment was also investigated.
Satisfactory preparations of chromosomes from human solid tumours were considerably difficult to obtain by the technique of the direct methods as used in the present study, although this method is preferable for exclusion of in vitro alterations which may be adherent to the tissue culture methods. In the author's study, successful chromosome preparations in which more than 7 metaphase plates could be examined were obtained in 24 tumours-3 renal carcinomas, 2 carcinomas of the renal pelvis, 13 urinary bladder carcinomas, 1 prostatic carcinoma and 5 testicular tumours-out of 58 tumours examined cytogenetically.
The results were as follows:
1) Three renal carcinomas and 2 carcinomas of the renal pelvis tended to be near diploid or hypodiploid.
2) In the analysis of 12 cases of bladder carcinomas, of which histological diagnosis showed to be transitional cell carcinoma, it was found that tumours of the low grade malignancy had the tendency towards near diploidy and those with high grade malignancy had the tendency to be near triploid and also had wider distributions in chromosome numbers. However, in two exceptional cases, where histological patterns were of lower malignancy (Grade II) in spite of triploid range, frequent recurrences were observed at the site of resection. These findings may suggest that the tendency to polyploidy and/or wide distribution of chromosome numbers in the transitional cell carcinoma of the bladder indicates needs of more careful follow-up study and of radical treatment.
3) A case of prostatic adenocarcinoma showed hypodiploid range in chromosome number.
4) In 2 cases of seminomas, one was near diploid, and the other had a wide distribution of chromosome number without any mode formation. So was in a case of embryonal carcinoma. One benign teratoma was near diploid and one malignant teratoma tended to be hyperdiploid.
5) Though no tumor-specific chromosomal aberrations were observed in the present study of human tumours of the urogenital tract, it was suggested that further cytogenetic studies of human tumours might give significant aids in clinical diagnosis, selection of treatment methods, or prognostic evaluation.

View full abstract

Three male hermaphrodites, equivalent to group A-2a by Jones' classidication, have been reported.
Case 1: Presence of left testis in her left atrophic scrotum of a 4-year-old girl resulted in change of her legal sex. Phallus was small and external urethral orifice located in perineum; perineal hypospadias. Uterus, normal in size for his (her) age, and right testis were disclosed in intraabdominal cavity.
Case 2: A 23-year-old male, complaining of bilateral vacant scrotum. Penis fully developed without hypospadias. Laparotomy revealed well developed uterus and bilateral testes intra-abdominally.
Case 3: At the time of herniotomy a 19-year-old male was found to have uterus in right inguinal canal, right testis in right scrotum and left one in abdominal space, close to the entrance of right inguinal canal, so-called hernia uteri inguinalis. In these 3 cases sex chromatin was negative and karyotype was 46XY.
The following hypotheses have been presented for the etiology of male hermaphroditism.
1) Reduced or ineffective müllerian suppressing hormone secretion.
2) Diminished response of müllerian duct to müllerian suppressing hormone.
3) Malfunction of fetal testes during the period of the critical stage, 50th to 60th day in human embryo.
Statistical analysis has been attempted on 47 cases, 44 cases being reported in 3 major Japanese journals related to urology over the past 16 years (1959 to 1974).

View full abstract

A 48-year-old house wife was first seen with complain of persistent loss of appetite. She consulted a physician, who pointed out a palpable mass in the right flank and a deformity of rt. -pyelogram, and then she referred to our department.
In operation, the tumor firmly adhered to the hilus of the rt. -kidney, and nephrectomy was performed. The pathological diagnosis of this tumor was benign schwannoma.
Histopathological and clinical implications of the retroperitoneal neurinoma were discussed. The cases of the retroperitoneal neurinoma reported in Japanese literature have been reviewed.

View full abstract