Wistar male rats were divided into 4 groups.
I. castrated rats.
II. normal rats.
III. rats treated every other day with intramuscular injections of 2mg of testosterone propionate after castration.
IV. rats treated every other day with intramuscular injections of 0.5mg of testosterone propionate after castration.
Every two rats from each group have been sacrificed and the weight of seminal vesicles from sacrificed animals were measured biweekly for 4 months, and those seminal vesicles were also studied with the light and electron microscopes. The weight of the seminal vesicles from castrated rats decreased rapidly during the first 7 weeks, and thereafter remarkable change was not observed. On the contrary, the weight of the seminal vesicles from the testosteron propionate treated rats increased first rapidly and then slowly.
With increasing amount of testosterore propionate, the weight also increased proportionately. After castration, there was a general involution of the organs with macroscopic atrophy and reduced amount of secretory material, and ultrastructualy the epithelial cells, the smooth muscle cells contained less organelles as compared with the controls. On the other hand, with testosterone propinate therapy, the growth and secretory activity in epithelial cells of the seminal vesicles more increased than the controls, and ultrastructualy the epithelial cells, the smooth muscle cells and the fibroblasts contained more organelles than in the controls, and protein like materials were observed in and out of smooth muscle cells.

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A case of right renal cell carcinoma involving the vena cava inferior was reported. A 65 year-old man was admitted to our clinic because of abdominal mass. Vena cavography revealed a large tumor thrombus extending to the suprarenal vena cava and existence of double vena cava inferior. Right nephrectomy and vena cava resection were performed. Post operative course was uneventful and renal insufficiency did not occur. The rationale for aggressive surgical treatment to renal cell carcinoma involving the vena caves inferior was discussed and double vena cava inferior was reviewed.

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Recovery of renal function and irreversible damage in the kidney after release of obstruction by means of renography, intravenous pyelography and histological examination, were observed in the eleven cases with unilateral non-visualizing kidney obstructed by a ureteral stone.
The results were as follows:
1) Return to normal renal function was noticed if the duration of obstruction was less than a month. But return on function was delayed and irreversible damage was resulted if the duration of obstruction was longer than two months.
2) On intravenous pyelogram, normal urogram was observed within a year in the cases whose obstructed duration was less than two months. But renal atrophy gradually progressed even after removal of obstruction.
3) The irreversible changes in obstructed kidney was mainly intimal fibrous thickening of distal renal arterys with narrowing of lumen. As soon as these arterial organic damages developed, the return to normal renal function could not be assesed though the high interarenal pressure fell by removal of obstruction and some improvement on renal function could be obtained by increased on renal blood flow.
4) Six patients with unilateral obstructed kidney developed hypertension (over 90mmHg on lower pressure). Hypertension was cured after release of obstruction or nephrectomy of obstructed kidney on them. We think this reduction of the blood pressure was attributed to improvement on renal blood flow but it was transient on the case with the irreversible changes in obstructed kidney.
5) One of the hypertensive patients was presented with the lumenal stenosis due to segmental fibro-muscular hyperplasia at the main renal artery in the obstructed kidney. His hypertension was immediately cured by removal of the obstructed kidney.

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31 patients, 25 females and 6 males, suffering from stress incontinence were treated with the oral administration of ephedrine hydrochloride, a sympathomimetic agent. 19% of patients had neurogenic bladder dysfunction, whereas the rest suffered from the decreased urethral resistance and/or the lack of the pelvic support. The overall results; excellent 29%, effective 45% and non-effective 26%.
The conventional slow-filling cystometry is one of the most desired diagnostic tools to evaluate whether the patient has the occult neurogenic bladder as well. With urethral pressure profile, stress incontinence was characterized by the decreased maximum urethral closure pressure. No statistical difference emerged in the value of the maximum urethral closure pressure and functional profile length from ephedrine treatment. An abnormal urinary flow curve was observed in 36% of cases. Cystourethrography combined with a metal chain placed in the urethra was found of value to analyze the morphologic relationship between urethra and bladder and to advise a surgical intervention in the selected cases. For a neurogenic bladder patient the supplementary therapy such as intermittent self-catheterization, imipramine and propantheline is mandatory depending upon his clinical symptoms. It should be stressed that no one can establish a solid diagnosis without performing the urodynamic studies for a patient complaining urinary incontinence.

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Since the role of tryptophan metabolites on bladder carcinogenesis was suggested by Dunning et al. (1950), interest for endogenous bladder carcinogens has stimulated extensive studies of urinary excretion of tryptophan metabolites in patients with bladder cancer and several reports have supported the hypothesis that tryptophan metabolites may play an important role in human bladder carcinogenesis.
Although 8-methyl ether of xanthurenic acid is a metabolite of tryptophan in humans, swine and monkeys, being watched as a carcinogenic substance for urinary bladder or lymphoreticular system of the mouse, there have been no report concerning 8-methyl ether of xanthurenic acid in patients with bladder cancer.
In this study, a new method for the determination of urinary quinoline compounds using thin layer chromatography followed by fluorescent scanning was originated which was available to the examination with its sufficient recovery rate and the determination for urinary excretion of 8-methyl ether of xanthurenic acid in patients with bladder cancer was firstly attempted with other two quinoline compounds (kynurenic acid and xanthurenic acid).
The results were as follows:
1) Of 33 patients with spontaneous bladder cancer, 13 had abnormal excretion of 8-methyl ether of xanthurenic acid.
2) In basal urinary excretion of quinoline compounds, kynurenic acid and 8-methyl ether of xanthurenic acid in male bladder cancer patients and xanthurenic acid in female bladder cancer patients were significantly higher than the control subjects.
3) There were more patients with bladder cancer who excreted abnormal quinoline compounds in pre-loading than in post-loading of L-tryptophan.

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The autonomic innervation was investigated morphologically in the wall of the normal and experimentally induced neurogenic bladders of male rats. Observations were made of the adrenergic fibers by fruorescent histochemical technique and of the acetylcholinesterase-positive fibers by enzymatic histochemical technique.
The results obtained were as follows.
1) Adrenergic fibers terminated, after the arrival at the bladder neck with the inferior branch of the vesical artery, in large numbers in the muscle of the bladder neck but not in that of the body of the bladder.
2) It seemed to be sure that adrenergic fibers in the muscle of the bladder neck changed their neurons in the pelvic ganglia, according to the studies after severance of the hypogastric nerve, ligation of the inferior branch of the vesical artery, proximal ligation of the vesical artery and destruction of the pelvic ganglia.
3) A small number of grouped acetylcholinesterase-positive and negative cells were observed outside the bladder wall near the vesicoureteral junction but not within the bladder wall.
4) There were a greater number of acetylcholinesterase-positive fibers in the longitudinal muscles than in the circular muscles in both the neck and the body of the bladder.
5) Bilateral severance of the pelvic splanchnic nerve was followed by disapperance of acetylcholinesterase-positive fibers in some bundles of muscle but not in other bundles, the findings which suggests the presence of 2 types of fibers: fibers involved in direct innervation from the micturition center in the sacral part of the spinal cord and those with alternating neurons.
6) The pelvic splanchnic nerve appeared to innervate the urinary bladder bilaterally based on the studies after unilateral and bilateral severance of the pelvic splanchnic nerve.

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Recently, to evaluate the transplanted renal function, creatinine clearance and serum creatinine, which show cortical function, have been preferred. But medullary function is also important for proper evaluation.
For this purpose, urinary concentration tests, response of urinary volume and osmolarity by pitressin loading under water dieresis were performed. Concerning with these tests, cystoscopic examinations for new ureteral orifice, excretory urography for the transplanted kidney and ureter, and voiding cystography for vesicoureteral reflux were also made.
Twenty-five patients had renal transplantation (living related) in Kanazawa Medical University Hospital during the period of March 1975 through December 1978. One of them died due to duodenal perforation and sepsis, and the graft of one patient was removed due to hyperacute rejection two days after the operation. Therefore, twenty-three cases were studied, but the same set of examinations could not be performed in all cases.
In donors, examinations were made before nephrectomy and two weeks after nephrectomy, and in recipients, 40-80 days after transplantation (discharged from the hospital), as well as one year, two years and three years thereafter. Concentration tests were made by the Fishberg's method and pitressin loading tests were done by a modification of Massry's method. About 500-600ml of water was given orally, 5% glucose solution was infused intravenously, and urinary volume was stable at 10ml per one minute. Then, as the first loading one miliunit of pitressin (water soluble) per 1kg (body weight) was injected intravenously, urinary volume and osmolarity were measured four times every 15 minutes, and then 10.0 miliunits of pitressin was given as the second loading. In normal cases (such as donors), urinary volume decreased, and osmolarity increased more than 400mOsm/kg by the first loading of pitressin. By the second loading, urinary volume decreased, and osmolarity was more than 600-700mOsm/kg.
As for the results of examinations, concentration tests which were evaluated by specific gravity showed a few differences between before and after nephrectomy of donors. But, when they were evaluated by osmolarity, no statistic difference was noticed. In recipients, whose histocompatibilty was HLA-identical and showed no rejection, specific gravity (osmolarity) of urine was normal. But, in recipients of HLA-haloidentical and showing rejection crisis, specific gravity (osmolarity) fixed in the lower border of the normal range or in the abnormal range.
Response for pitressin loading showed almost the same pattern in donors and recipients of HLA-identical. It is supposed that renal response has its individual character. When a removed kidney is transplanted to recipient's iliac fossa or, in other words, “new circumstance”, its character is handed down. On the other hand, when the rejection crisis occurs, the pattern of response changes and the maximum point of osmolarity decreases. These data may mean that rejection crisis gives damages to the renal medulla which is also the target area of pitressin.
By calculation of osmolar clearance per GFR of the kidney, when rejection crisis occurs, it was higher than in normal cases. It means that the kidney is in an overworking state per nephron. In donors, who are over 50 years old, osmolar clearance has a tendency to show a higher increase than in preoperative condition.
By observing the appearance of the new ureteral orifice, thee cases of HLA-identical showed a smooth extention of ureteral and vesical mucosa each other and a good normal vascularity. But the cases of HLA-haploidentical showed an edematous orifice and an unnatural state in recipient's vesical mucosa.
Excretory urography revealed a normal renal function and no dilatation of ureter. Voiding cystography revealed that vesicoureteral reflux did not exist in the transplanted ureter but in the bilateral own ureters of two cases.
In

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In a study of the local immunity in the urinary tract, we have reported on the urinary Immunoglobulin level in normal controls and the localization of In a study of the local immunity in the urinary tract, we have reported on the urinary Immunoglobulin level in normal controls and the localization of urinary Secretory IgA in the urinary tract, using Enzyme-linked Immunosorbent Assay (E. L. I. S. A.) method as a detective method and Enzyme-antibody technique for the study of its localization on tissue. In this study, we observed the urinary SIgA level in various urological diseases and its changes in the course of diseases.
The summary of conclusion obtained were as follows:
1) The values of SIgA in 147 cases suffering from urological diseases were very high in the cured stage of acute cystitis and neurogenic bladder, especially at the stage of combination of urinary tract infection compared with 34-normal controls. But in acute pyelonephritis its values were very low. In the urological tumors, SIgA values were normal at the stage with tumor, but they decreased after operation, especially in bladder cancer its values were one-fifth of the stage before operation. In urolithiasis, the values of SIgA were very low regardless of presence of stone or not.
2) The relation between the values of SIgA and the course of diseases was studied. In 17 acute lower urinary tract infections, most cases revealed high values of SIgA at the infectious stage. The ratio of SIgA at the infectious and cured stage were divided into two groups, one was less than 10 times and another was about 1, 000 times. But this difference was not related to either the infecting organism, the duration to the consultation or cure from onset. SIgA was not reactive in 2 acute upper urinary tract infections. In 10 infections of 8 cases of chronic urinary tract infections, SIgA was highly reactive at the lower one, but even in pyelonephritis its values were revealed about 10 times larger than those in the non-infected stage. The days needed from the onset of infection to the peak of SIgA values were longer than that from the peak to return, and reinfection due to the same organism and the second reaction of SIgA was observed, therefore it was thought to be a lack of immune memory at the urinary tract. In some cases, the normalization of the values of SIgA preceded the disappearance of the urinary tract infection, SIgA was thought to be used as the marker of infection. The values of SIgA observed in one case of renal cell carcinoma were about 1.8mg/day before operation, and revealed high response after embolic infarction of renal artery and nephrectomy. But at 4 days after operation its value was suddenly decreased to 0.5mg/day. At present, 1 year after surgery, it was 0.8mg/day.
3) The localization of SIgA on the tissues were studied by the indirect method of Enzymeantibody technique. The tissues studied were obtained from 3 patients with renal cell carcinoma, one with vesical cancer and one with testicular tumor. In renal cell carcinoma, SIgA was recognized at tumor cell cytoplasma and invaded lymphocytes as well as the normal tubular cells. SIgA was strongly localized in papillary tumor cell cytoplasma in vesical cancer. But in testicular tumor SIgA was not found. We thought that, in the urological epithelial tumors, SIgA was secreted from the tumor cell itself or the normal epithelial cell was to be highly reactive against tumor antigens.

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The study was done with the use of specific red cell adherence test (SRCA), a modification of Coombs' mixed cell agglutination test, to examine the presence or abscence of ABH isoantigens in normal urogenital tissues, as well as their change in the evolution of carcinoma in those tissues.
1) The ABH isoantigens were strongly present in the glomerulus and the collecting duct of the kidney, the transitional epithelium of the pelvis, ureter, bladder, and urethra, and weakly in the seminal vesicle and epididymitis, but are absent in the tubulus in the kidney.
2) The ABH isoantigens are present in 22 of 30 cases of benign prostatic hyperplasia, but only in 2 of 23 cases of prostatic cancer.
3) In the bladder, the ABH isoantigens are present in 11 of 16 cases of normal epithelium, 2 of 2 cases of the Brunn's nest, 0 of 1 cases of ca, in situ, 16 of 48 cases of low grade tumor, and 0 of 11 cases of high grade tumor. This study comfirmed the previous findings in other organs; the loss of tissue ABH isoantigens corresponds with the degree of anaplasia.
4) Positive ABH isoantigens in the low grade papillary transitional carcinoma of the bladder seemed to correlate well with low incidence of tumor recurrence as 3 of 12 cases with positive ABH isoantigens showed recurrence for at least 3 years, while 17 of 23 cases without ABH isoantigens did so. The 2 cases, in whom the cancer became eventually invasive and caused cancer death, did not show ABH isoantigens even in their original low grade tumor. SRCA is an immunohistological method that is expected to improve the diagnosis, therapy and survival in the low grade bladder cancer.

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The relationship between duration of gross hematuria and factors appearing to affect such duration was studied on 12 cases of nephrolithotomy utilizing one- layer interrupted suture of renal parenchyma (Dr. H. Taguchi) and the following results were obtained.
1. The average duration of gross hematuria as observed from postoperative day 0 to day 14 was 4.7±4.2 days.
2. No correlation was observed between the duration of postoperative gross hematuria on the one hand and the patient's age, ischemic time and length of renal parenchymal incision.
3. Renal biopsy during surgery indicated a significantly longer duration of postoperative hematuria among patients with chronic pyelonephritis as compared with other patients.
4. Although the complication of chronic pyelonephritis did not prevent us from carrying out nephrolithotomy, it is suggested that this complication may be one of the factors prolonging duration of postoperative hematuria. Rigorous care must be taken to completely close the incision and to exactly suture the renal pelvic mucosa if postoperative hematuria in one-layer suture of renal parenchyma is to be reduced to a minimum.

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