It is known that testicular teratocarcinomas occur spontaneously in mice of strains 129 and they produce α-fetoprotein (AFP). But AFP producing teratocarcinomas in rats are not yet established.
This is a report on experimental induction of teratomas containing yolk sac tumors in rats and serum AFP levels of these rats. The experimental procedures and results are as follows:
Group 1: Pregnant rats of strains Donryu mated with Donryu males were fetectomized at 12 days of gestation, and the fetal membranes were pulled out into the peritoneal cavities. After 3 or 4 months extra-uterine tumors, histologically teratomas, developed in 11 of 15 rats. High serum AFP levels were obtained in 4 rats with teratomas containing the elements of yolk sac tumors.
Group 2: Pregnant Donryu rats mated with Donryu males underwent the samee procedure, but were inoculated with murine sarcoma virus (Moloney) into the remained placentas. Teratomas developed in 18 of 19 rats, and 4 with tumors containing yolk sac tumor elements were shown to have high concentration of serum AFP.
Group 3: Pregnant rats of strains WKA mated with WKA males were operated on with the same procedure as in group 2. Teratomas occurred in 2 3 of 31 rats, and 12 rats which had yolk sac tumor components demonstrated high levels of serum AFP.
Group 4: Pregnant Donryu rats mated with WKA males underwent the same procedure including virus inoculation. All 10 rats did not have any tumors nor showed any elevation of serum AFP.
Group 5: Non-pregnant WKA rats were inoculated with murine sarcoma virus (Moloney). None developed tumors and showed high levels of serum AFP. Teratomas containing yolk sac tumors were succesfully transplanted into syngeneic young adults by intra peritoneal trocar implantation.
Histological findings of the experimentally induced tumors and AFP production were discussed in relation to multipotentiality of yolk sac cells.

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The nonspecific cellular immune response of 50 patients with urinary bladder carcinoma was measured by PHA-induced blastoid transformation of peripheral lymphocytes. Blastoid transformation was determined by quantitation of tritium thymidine incorporation (cpm).
A rate of blastogenesis of lymphocytes was revealed as stimulation index (SI) that was calculated dividing cpm with PHA by that without PHA.
SI of the control was 29.8±1.6 (mean±SE), but SI of the patients with autologous sera was 14.6±1.0 having significantly lower reactivity.
SI among each grade and stage of the bladder carcinoma was compared. There was a converse correlation in SI to grade and stage of the tumor.
Surgical treatment improved SI only in the grade I and stage A patients in whom post operative SI became significantly higher than preoperative SI. In high grade and high stage, there was no significance between pre and post operative. SI.
In 27 out of 50 patients, tuberculin skin test was examined and positive reaction was noticed in 13/27 (48.1%), this reaction seemed to correlate with grade and stage of the tumor.
Peripheral lymphocytes counts of the patients, however, was kept almost the same value as the control.
SI of the patients with autologous sera was not always parallel with peripheral lymphocytes counts.
Thus, the nonspecific cellular immune response of the patients with bladder carcinoma was depressed.
I discussed about the inhibitory factors of PHA-induced blastogenesis of lymphocytes and subpopulation of peripheral lymphocytes in the patients with bladder carcinoma.

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With a newly postulated effect estimation, 50 cases of bladder cancers treated with 70 times of hydrostatic pressure method were divided into 3 groups, consisted of 12 cases with a dramatic response, 20 cases with satisfactory effects and 18 cases with a fairly good response. In 6 cases responded dramatically, the maximum follow-up period was over 2 years. No cases were ensued by carcinoma death in the group with a satisfactory response, except for one case died from a cerebrovascular accident. Even in the non-effective group including 4 cases of carcinoma death and 7 cases performed total cystectomy, successful application of this method made transurethral surgery possible. Moreover, there were many cases with favorable outlook and prolonged life time. In extended observations of clinical courses in 50 cases, the presence of cases with generalized peculiar signs and symptomes following the treatment and the follow-up analysis of variations in repeated tuberculin skin tests during the course before and after the procedure might indicate an intervened immune system in the treatment mechanism.

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Recently, the prevalence of the gamma camera has provided in urology with increased availability of gamma camera renography using various radiopharmaceuticals. Using gamma camera renal images can be obtained in a few minutes and also renograms are depicted by setting regions of interests (ROI) on the each kidney simultaneously. Therefore, one of many advantages of the gamma camera renography is that information on time-course renal function and morphology can be obtained simultaneously.
The clinical study was made on renography by ^99mTc-(Sn) DTPA.
One hundred and eighty-six cases (96 males and 90 females) were examined with age of 11 to 97 years old (mean 60.2 years old).
In this study, Searle Pho/Gamma HP gamma camera was used with Data Store Play Back System, Diverging collimator and 32KW Nova Computer System.
The radiopharmaceuticals used were 2 to 10mCi of ^99mTc-(Sn) DTPA and 300μCi of ¹³¹I-Hippuran.
The results were as follows:
1) Although ^99mTc-(Sn) DTPA is a GFR substance, its renal clearance is relatively fast. Therefore, ^99mTc-(Sn) DTPA could be applied for dynamic renal study similar to ¹³¹I-Hippuran.
2) As gamma camera renograms was depicted after ROI setting on the each kidney, contribution from the extrarenal activity could be excluded. Simultaneous gamma camera images also served to obtain information of renal morphology and the manner of urine flow in the upper urinary tract.
3) ^99mTc-(Sn) DTPA renogram was found to be useful to differentiate the obstructive renal disease, when ¹³¹I-Hippuran renogram showed obstructive pattern in patients with parenchymal disease.
4) In parenchymal renal disease ^99mTc-(Sn) DTPA renogram disclosed pathological changes earlier than ¹³¹I-Hippuran renogram.
In obstructive renal disease involving the upper urinary tract, in spite of the apparent improvement of ¹³¹I-Hippuran renogram, ^99mTc-(Sn) DTPA renogram still revealed the latest state of disease. Therefore, ^99mTc-(Sn) DTPA renogram showed more sensitivity in detecting both obstructive and parenchymal renal disease and provide clinicians with useful aid in the follow up studies of operated cases with, for example, obstructive uropathy in the upper urinary tract.
In summary, ^99mTc-(Sn) DTPA gamma camera study is found to be an useful aid in clinical urology. This technique is atraumatic, simple and safe even on such cases with poor risk, aged or children.

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In the past, ²⁰³Hg-Neohydrin was commonly in use as a renal imaging agent. However, ²⁰³Hg-Neohydrin has such drawbacks as requiring high radiation dose to the patient. In an attempt to overcome this disadvantage, ¹⁹⁷Hg-Neohydrin and ^99mTc-labeled renal scanning agents have been evaluated.
In this report ^99mTc-dimerucaputosuccinic acid (^99mTc-DMSA: Medi-Physics) was evaluated for the clinical renal imaging. Ninety-seven cases consisted of 53 females and 44 males ranging from 12 to 89 years old (mean 60.4 years old) were studied by this new radiopharmaceutical.
Pho/Gamma 4 gamma camera with parallel hole high resolution and pinhole collimators and Graphic 5φ scanner were used. The images were obtained at 30min, 1, 2, 3, 4 and 6 hours after intravenous injection of 5mCi of ^99mTc-DMSA. In some cases, radioisotope angiogram was obtained after bolus injection of 10mCi of ^99mTc-DMSA.
In all cases, clear renal images were obtained up to 6 hours after injection. When the pinhole collimator was used in order to enlarge each kidney to full size of the field of view, more detail of renal image could be seen with improved resolution compared with images obtained by parallel collimator or Graphic scanner. When a breath-holding technique is applied it could minimize the image-degrading effect of respiratory movement of the kidneys.
Because this radiopharmaceutical accumulates in renal cortex and renal medulla demonstrates relatively cold area, normal variation of this new renal image was more marked than that of previous renal images. Normal renal image using ^99mTc-DMSA and pinhole collimator were classified into three paterns. In patients with chronic pyelonephritis, renal images usually demonstrated marked cortical atrophy. Renal infarct, polycystic kidney and renal cell carcinoma were also clearly depicted by the combination of ^99mTc-DMSA and pinhole collimator.
In conclusion, renal imaging by ^99mTc-DMSA combined with pinhole collimator was found to be the most useful method currently available for renal imaging. Improved image served for the readings of normal renal structure, characteristic findings of the cases with pyelonephritis and other space occupying lesions such as polycystic kidney, renal infarct, renal carcinoma and etc.

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Sixty three cases admitted to the Osaka University Hospital during the past nineteen years with renal cell carcinoma were studied with regard to their clinical manifestations, histopathological findings and prognostic features. The results obtained were as follows.
1. There were 50 males with an average of 55.7 years old and 13 females with that of 45.7, with a ratio of 3.8:1.
2. In our series, the most frequent symptoms were hematuria (75%), palpable mass (46%), and fever (22%). The classical triad of hematuria, pain and mass were observed only in 6 patients (10%).
3. Laboratory findings of the cases showed elevated ESR in 52%, anemia in 25%, leucocytosis in 17% and leucocytopenia in 24%. Peripheral blood lymphocyte count was below normal limit in 24%. High serum calcium and alkaline phosphatase were observed in 7% and 21% respectively.
4. The weight of the tumor was over 500g in 46%, and marked local spread beyond the renal capsule (high stage) was seen in 39%. Metastases were found in 10 patients (16%) at the time of the first visit and renal vein involvement were revealed in 19%.
5. Histopathological examination revealed grade 1 or 2 in 25 cases, grade 3 in 27 cases, grade 4 in 11 cases, according to the classification presented by Skinner et al. Concernig the cell type, clear cell carcinoma was in 36 cases, granular cell carcinoma in 17 cases and mixed cell type in 10 cases.
6. The five year survival rate of our series was 42%. Several factors influencing prognosis were analysed and tumor weight, local extention, malignancy grading, metastases, renal vein involvement, all of which were considered to have important mean for the prognosis of the disease. Elevated ESR and fever also seemed to indicate poor prognosis.
7. Operative extirpation of the tumor was a radical treatment only for the cases of low grade, low stage and tumor weight below 500g, without any metastases or renal vein involvement.

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Forty-nine cases of cancer of the penis were treated at the Cancer Institute Hospital between 1947 and 1968.
The method of treatment for the primary lesions was mainly radiotherapy, and that for metastasis to the inguinal lymph nodes was lymphadenectomy with or without irradiation.
The over-all 5-year survival rate was 87.8%. The cause of death was the exacerbation of metastatic lymphadenopathy. Hematogenous metastasis was found in only one case with lymph node metastasis in our series.
The primary lesions were cured in all cases, but the subsequent recurrence and late radiation injury developed in 30% and 35%, respectively. Six recurrent tumors developing later than 5 years can be assumed to be radiation cancer. Radiotherapy was also effective for controlling the recurrent lesions. There were some cases of disturbances in sexual intercours due to various radiation injuries.
The detection rate of metastatic adenopathy was 0% in N₀ stage, 38.9 in N₁N₂N₃ stage, and 100% in N₃ stage, respectively.
The over-all 5-year survival rate of metastatic lymphadenopathy cases was 53.8%, and those of cases showing unilateral and bilateral extension were 75% and 0%, respectively.

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A 75 years old female diagnosed as malignant melanoma in the vaginal wall and the urethra metastasized to the retroperitoneal space and died 2 years and 2 months later in spite of radiation therapy followed by BCG treatment. This is the 20th reported case in the female genitourinary tract of this disease in the Japanese literature.

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A 5-year-old boy was first seen on April 10, 1973, with a complaint of gross hematuria and right flank pain. An x-ray examination revealed a retrocaval ureter with a non-opaque stone in the upper portion of the ureter. The stone was interpreted as a xanthine stone, because serum and urinary uric acid levels were very low and serum and urinary oxypurine levels were very high (Table 1).
On October 1, 1974, he was operated upon. A chocolate-colored, smooth, oval and easily broken stone was removed from the right ureter which encircled the vena cava. The ureter was completely freed and restored to normal position with an end-to-end anastomosis. The stone consisting of 93.5% of xanthine measured 2 by 1.3 by 1cm and weighed 2.3g showing many concentric rings on section. Post operative course was uneventful. He was dicharged on October 22, 1974.
Etiology of xanthine stone formation was briefly discussed.

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