The serum protein fractions and urinary protein fractions originated from serum were studied in patients with glomerulonephritis, SLE-nephropathy, and pyelonephritis, residents in cadmium polluted area, workers of earthenware factory, and renal homo-and autotransplants. The protein fractions were determined by means of the single radial immunodiffusion method and the antibody absorption method. Among protein fractions Al, α₁-Lp, α₂-Lp, α₂-M, β_IC/IA, Tr, Ig-M and Ig-G were investigated.
1. The serum level of Ig-G in glomerulonephritis was lower, Ig-M in subchronic glomerulonephritis and β_IC/IA in chronic glomerulonephritis were higher than the normal average.
The higher molecular weight proteins (β_Ic/IA, Ig-M) of urine in chronic glomerulonephritis were more than in subchronic glomerulonephritis.
2. α₁-Lp, Ig-G and Ig-M concentrations in urine of SLE-nephropathy were high, and its pattern was different from that of glomerulonephritis.
3. The urinary protein concentrations in patients with pyelonephritis, residents in cadmium polluted area and workers of earthenware factory were lower than those of glomerulonephritis and SLE-nephropathy.
4. The higher molecular weight proteins in urine were detected in chronic rejection after renal homotransplantation.

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Plasma and urinary carcinoembryonic antigen (CEA) assays were performed in 56 patients with urologic cancer and 20 controls. 93 plasma samples and 74 urine samples were determined by Roche Kit (Hansen Z-gel method). Plasma CEA level was elevated in 53% (17/32) in patients with bladder cancer and in 8% (2/25) in patients after treatment. Out of 8 patients with prostatic carcinoma, 2 patients had elevated CEA level. The incidence of plasma CEA positive cases in all urologic cancer was 22%. The normal range of urinary CEA was designated 0 to 3.0ng/ml. Urinary CEA level was elevated in 58% (15/26) in patients with bladder cancer and in 33% (4/12) in tumor free patients. However, all five infected urine from benign disease and 4 conduit urine showed high CEA level.
We thought that inflammation of urothelium as well as malignant changes caused production of CEA-like substance, so we concluded that the occurrence of elevated urinary CEA level, except urinary infection, was highly significant.

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A specially designed apparatus for withdrawing a urethral catheter at a constant speed is described. This apparatus consists of two principal components; one is a DC-motor controlling circuit and the other is a marker system which automatically monitors the location of the catheter in the urethra. Using this apparatus, examinations were carried out to study the reproducibility of urethral pressure profile, and the results were as follows.
1) From the bladder neck to the UPmax, the error in reproducibility was small as seen from a small standard deviation.
2) Beyond the UPmax, the error in reproducibility increased.
3) At the withdrawal speed of 25, 50, and 100mm/min, no remarkable change of the error in reproducibility was observed.

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DISA CO₂-Cystometer (21G45 cystograph) was used and its clinical value was discussed. Its advantages were summarized as follows.
1. Small sized catheter was usable.
2. Equipment setup time and operational time were shortened.
3. Its operation could be repeated easily and immediately.
4. The more physiological micturition reflex was provocated.
Its disadvantages were high equipment cost and inaccuracy of bladder capacity. Carbon dioxide urehtral pressure profile was not so valuable as that mediated by water, because a more larger infusion rate was needed in operation due to compressibility of carbon dioxide itself and because desire to urinate was induced during operation.

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The intercellular relationships between smooth muscle cells and the arrangements and neuromuscular relationships of autonomic nerves in the submucosa, smooth muscle layers and adventitia of the human vas deferens have been studied light-microscopically, by the histochemical cholinesterase reaction, and electron-microscopically. On the other hand, the spatial relationship between axons and Schwann cells have been examined electron-microscopically by means of PAM (periodic acid-methenamine silver) staining and tannic acid-glutaraldehyde fixation. Materials were taken at 2-3cm distance from the distal portion of the gars epididymica of the human vas deferens. The results were as follows:
1) Many cholinesterase-positive nerves were identified in the submucosa, and formed a plexus along the epithelial lining of the human vas deferens. Many axon profiles containing numerous small agranular and occasional large granular vesicles were confirmed by electron microscopy. These nerves in the submucosa were considered sensory in function.
2) Large cholinesterase-positive and negative nerves ran in the adventitia. Some large unmyelinated axons bundled up by a Schwann cell and by numerous endoneural collagen fibrils electron-microscopically ran within a complete envelope of the perineural sheath. Some myelinated axons which were considered visceral afferent fibres were rarely intermingled with many unmyelinated axons.
3) The distribution of the cholinesterase-positive nerves amongst the muscle layers was sparse. The directions of running of these nerves were generally parallel with each muscle layer.
4) Electron microscopy confirmed that the musculature of the human vas deferens had a rich autonomic innervation. The ramose naked axon not only had the narrowest neuromuscular cleft measuring about 200Å, but also intruded deeply into the smooth muscle cells. The latter axon profile was very rare in the human vas deferens. According to the classification of the synaptic vesicles, a cholinergic axon and a noradrenergic axon were ensheathed with the same Schwann cell rarely.
5) The interrelations between adjacent muscle cells in the human vas deferens were various in type. The adjacent muscle cells issued interdigitated cytoplasmic processes each other, and the bulbous process of one smooth muscle cell intruded into the groove of the other muscle cell. Sometimes, bulbous protrusions (bulbous exfoldings) which were considered to be a mechanism for the transfer of material between muscle cells were observed. Nexus-like junctions were rare, but by the use of glutaraldehyde and osmium tetroxide in this study, the adjacent muscle cell membranes appeared only a single dense line. It is necessary to further study the human vas deferens with regard to “nexus”, using potassium permanganate fixation.
6) The deposits of silver grains, consisting of partially unclear clefts between axolemma and the plasma membrane of Schwann cell, were observed by means of PAM staining. This finding appeared to suggest the existence of glycoprotein in this portion.
7) The gap junction lattice between axolemma and the plasma membrane of Schwann cell was observed by means of tannic acid-glutaraldehyde fixation. This finding was considered to suggest the possibility of electrotonic coupling in this portion.

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Transrectal ultrasonotomography provides us with information as to the presence, localization and size of a lesion in the urinary bladder with ease, and has become one of the routine diagnostic examinations of bladder tumor in our clinic.
A ultrasonographic study of diagnosing the stage of bladder tumors was made on 17 patients. These tumors were histologically examined by transurethral resection or biopsy of tumor, or total cystectomy. Ultrasonographic diagnosis agreed with the histological findings in 11 (64.7%) of 17 patients. Restricted to 8 cases which histological findings were examined by total cystectomy, an accuracy of 77.8% (7 cases) was obtained, and this technique will become more accurate by further ultrasonographic examination of patients with bladder tumor.
In addition, this ultrasonotomography is carried out for the follow-up study of chemotherapy and/or radiotherapy of bladder tumor and let us know the effect of these therapies.
Because of its non-invasive nature and diagnostic accuracy, transrectal ultrasonotomography should be used widely for the routine examination of bladder tumor.

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To clarify the causes of urolithiasis, the authors routinely measure calcium, phosphate, magnesium and uric acid in blood and urine, as well as oxalate and citrate in urine of patients with urolithiasis. This report concerns with such investigations with special reference to calcium and ionized calcium.
The subjects were 51 patients, 20-59 years of age, with urolithiasis in whom calcium stones were clearly revealed by infrared spectroscopy (excluding cases with clear causes such as primary hyperparathyroidism and renal tubular acidosis). The urinary excretion of calcium showed significant differences from that of controls (28 persons) (p<0.001). In the control group, the urinary excretion of calcium was 99.6±68mg/day (mean±SD). So therefore, we designated 168mg/day as the normal upper limit. On the basis of these results, the patients were divided into the hypercalciuric stone group (HSG: above 168mg/day) and the normocalciuric stone group (NSG: below 168mg/day). Comparative studies were performed on these two groups and controls with respect to total serum calcium, ionized calcium (measured with an Orion ionized calcium analyzer, Model SS-20), ionized calcium/calcium ratio, filtered calcium and the reabsorption rate of calcium.
The HSG showed significant differences from the other two groups in total serum calcium and urinary excretion of calcium, but there were no significant differences between the NSG and controls. In the case of ionized calcium, there was no significant difference between the HSG and NSG, but both groups did show a significant difference from the controls. For the ionization rate, there was no significant difference between the HSG and controls, while there was a significant difference between the NSG and controls. There were no significant differences among the three groups for filtered calcium and creatinine clearance, but the reab-sorption rate of calcium was remarkably lower in the HSG.
These results suggest that there may be a clear difference in the mechanism of stone formation between the HSG and NSG. In the HSG, it is assumed that caclium reabsorption disturbances may arise because of primary abnormalities in the renal tubulus, while in the NSG, the parathyroids may have a major effect of some sort on urolithiasis and factors such as matrix appear to play a major role. From the above results, it implies that there may be at least two mechanisms involved in calcium stone formation.

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Split renal function studies including examinations on urinary oxygen tension and reabsorption of sodium were carried out on 13 cases of unilateral renovascular hypertension, 4 cases of bilateral renovascular hypertension, 5 cases of essential hypertension and on 5 cases with unilateral renal disorders not relating to hypertension.
Anaerobically collected renal pelvic urine was examined by the gas analyzer with Clark type oxygen electrode. The urinary oxygen tension ratio (% increase) was calculated as
ischemic side-contralateral side/contralateral side×100 (%)
and the sodium reabsorption ratio (% reduction) was calculated as
contralateral side-ischemic side/contralateral side×100 (%)
where reabsorption of sodium of the each kidney was calculated as (GFR×serum sodium content-urine volume×urinary sodium content).
As for urinary oxygen tension ratio, 10 out of 13 unilateral renovascular hypertensives showed 30% or more increases, whereas one case showed only a 10% increase and the other 2 showed no increase.
Every operated unilateral renovascular hypertensive patients showing 30% or more increases in urinary oxygen tension ratio gained normotension after surgery, whereas 2 cases without significant elevation of urinary oxygen tension ratio did not show any improvement in their hypertensive state postoperatively.
Urinary oxygen tension ratio of bilateral renovascular hypertensive patients ranged between 0-30% and that of the control gorup without renal disease ranged between 3--6%.
The control group with unilateral renal diseases showed decreased urinary oxygen tension on the diseased side except in one case.
Unilateral renovascular hypertensive patients had 25% or more reduction in sodium reabsorption ratio. Bilateral renovascular hypertensive patients showed no more reduction than 25% whereas the control group showed various distribution in reduction percentages.
Urinary oxygen tension ratio showed correlationship with the Howard test and with the RVRR (renal vein renin ratio).
Elevated urinary oxygen tension in the ischemic kidney can be attributed to reduced urinary sodium reabsorption and hence reduced oxygen consumption in the renal medulla.
The urinary oxygen tension ratio (% increase) coupled with the sodium reabsorption ratio (% decrease) can be one of the indicators of renal ischemia in diagnosing unilateral renovascular hypertension.

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Prostatic tissue and seminal plasma levels of chemotherapeutics (CEX, DOTC and SMX-TMP) were determined in humans and in dogs.
1. CEX: Prostatic tissue/serum ratios in dogs were 23-53% (mean 34.6%) and that in humans were 10-65% (mean 43.7%). Prostatic fluid/serum ratios in dogs were 1.3-5.1% (mean 3.1%) and Seminal plasma/serum ratios in humans were 0.5-2.4% (mean 1.7%).
2. DOTC: Prostatic tissue/serum ratios in dogs were 21-80% (mean 43.9%) and that in humans were 25-300% (mean 97.7%). Prostatic fluid/serum ratios in dogs were 16-47% (mean 26.8%) and Seminal plasma/serum ratios in humans were 23-44% (mean 35.1%).
3. SMX-TMP (only in dogs)
SMX: Prostatic tissue/serum ratios were 45-48% (mean 46.4%) and Prostatic fluid/serum ratios were 12.7-28.9% (mean 18.4%).
TMP: Prostatic tissue/serum ratios were 2.6-8.0 fold (mean 4.5 fold) and Prostatic fluid/serum ratios were 7.5-27 fold (mean 13 fold).

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Generally, oliguria or anuria is a characteristic feature in renal failure. It is less recognized, however, that renal failure may occur in the presence of a normal or increased urine output. This phenomenon has been called non-oliguric or high output renal failure. We have recently experienced nine such cases at the Fukuoka University Hospital since 1973. All of them accompanied with urinary tract obstruction. Six of them had ureteral obstruction. Daily urine output, serum creatinine and blood urea nitrogen were measured before and after relief of obstruction. In all of six cases, daily urine output was more than 600ml but azotemia and serum creatinine were progressively increasing. Moreover, GFR, serum osmolality, absolute osmolar clearance, fractional osmolar clearance (C_osm/GFR), sodium clearance and excretion fraction of filtered sodium (EFN_a) were measured in three cases.
We emphasize that most of postrenal renal failure following chronically progressive obstruction of urinary tract exhibits such characteristic features without oliguria, and that measurement of daily urine volume is not a reliable indicator of renal failure.

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Transurethral resection is now established as a good definitive alternative to open prostatectomy. Six hundred and forty-three transurethral resections were performed by myself in these five years at a hospital. Interest was focused on 547 transurethral prostatectomies. Almost all prostatectomies finished within 60 minutes. The largest prostate needed 69 minutes and the resected tissues weighed 92 gram. After experiences with 200 cases a stable state of the technique was achieved. None received pre-operative or operative blood transfusion and three received transfusion post-operatively. No death occurred. No serious complications occurred either.

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