An immunofluorescence technique was used to study antibody-coated bacteria (ACB) in the urinary sediments from 40 patients with bacterial prostatitis, 20 patients with cystitis and 41 patients with urethral indwelling catheters. The immunoglobulin levels of serum and expressed prostatic secretions (EPS) were measured in urologically normal men and patients with prostatitis.
The results obtained were as follows:
1) ACB were present in the urine from 19 of 24 patients (79.2 per cent) with acute bacterial prostatitis and 10 of 16 patients (62.5 per cent) with chronic bacterial prostatitis. ACB were not observed in the urine from 20 patients with acute or chronic cystitis.
2) ACB were present in the urine from 10 of 41 patients (24.4 per cent) with urethral indwelling catheters, 9 of 35 male patients (25.7 per cent) and 1 of 6 female patients (16.7 per cent).
3) The class of antibody complexed with the bacteria in urine was determined in 25 of the immunofluorescence-positive specimens from 25 patients with bacterial prostatitis. Fluorescence tests were positive for IgG in all of 25, for IgA in 12 (48 per cent) and for IgM in 6 specimens (24 per cent).
4) The detection of ACB was not influenced by the bacterial species.
5) There was no significant difference in the serum immunoglobulin levels between the patients with bacterial prostatitis and the patients with nonbacterial prostatitis.
6) The IgG and IgM levels of EPS in the patients with bacterial prostatitis were significantly higher than in urologically normal men or patients with nonbacterial prostatitis.
7) The immunoglobulin levels of EPS in the patients with bacterial prostatitis significantly decreased after chemotherapy, while those in the patients with nonbacterial prostatitis were little altered after chemotherapy.
It is suggested that the ACB test and measurement of the immunoglobulin levels of EPS may be a useful method for the diagnosis and the chemotherapy of bacterial prostatitis.

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Measurement of oxalic acid in urine is very important because oxalate is an important constituent of urolithiasis.
Previously reported methods of determination of oxalic acid are quite complicated.
Thus we developed a very simple and rapid method of estimation of oxalic acid in urine.
This method is an application and an improvement of the method of qualitative analysis of oxalic acid developed by Snell and Snell.
The oxalate is reduced to glyoxalic acid, which forms a coloured compound with phenylhydrazine hydrochloride. It can be determined colorimetrically.
Oxalate recovery is good. Other compounds having the structure similar to oxalic acid are not reactive.
The accuracy of this method makes it useful for routine determination of urinary oxalic acid.

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Urinary oxalate excretion of stone-formers (93 cases) and none stone-formers (86 cases) were determined using the new method reported previously. In none stone-formers, the amount of urinary oxalate excretion was estimated to be 29.5±12.6 (S.D.) mg/24hrs, which is almost the same value as measured by the other methods, and ranged from 4.3 to 54.7mg/24hrs with our new method. In stone-formers, although most of them failed within the normal range their average value, 33.7±14.5 (S.D.) mg/24 hrs, showed a significant increase (p<0.02) compaired to none stone-formers. Among them, apparently increased values over 55mg/24hrs were found in 17 cases (18.3%).
In both groups (stone-formers and none stone-formers) there was no difference between the sexes in the amount of urinary oxalate excretion. However, the male stone-formers showed a significant increase of the amount compaired to the male none stone-formers, but not in the females. This will indicate that other contributing factors or mechanisms exist in the stone formation in the female stone-formers.
In both groups there was no correlation between ages and renal functions indicated by creatinine clearance upon the amount of urinary oxalate excretion excluding a child.
It was found that the stone-formers of calcium oxalate excreted more urinary oxalate than the stone-formers of calcium phosphate. This may mean that urinary oxalate itself has some roles in the stone formation mechanism for calcium oxalate calculi.
Since there was no difference between both groups in concentration of urinary oxalate, the difference in the amount of urinary oxalate excretion is considered to be dependent on urinary volume, namely stone-formers having larger urinary volumes than none stone-formers. To elucidate this phenomenon all of the cases were divided into 4 groups according to urinary volume in steps of 800ml. In both groups of the stone-formers and none stone-formers, concentrations of urinary oxalate decreased with increase of urinary volumes, however the amount of urinary oxalate excretion increased with the urinary volumes and the degree of this increase was significant in the stone-formers. From these results it is considered that urinary oxalate excretion is dependent on the urinary volume and this mechanism occurs in renal tubular abnomality in oxalate reabsorption or excretion without disturbance of renal function.
In the cases of apparently increased excretion of urinary oxalate, it is suspected that there are absorptive abnomality of oxalate or its precursors, or abnormal endogenous production of oxalate.
From these studies presented here, it is useful in clinical investigations for stone formation that the amount of urinary oxalate excretion can be determined in simple procedure using our new method. In fact two cases of primary hyperoxaluria were diagnosed by measurment of markedly increased urinary oxalate excretion by this method during this study.

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With newer ultrasound instruments, gray scale transrectal ultrasonotomography is a useful diagnostic method with its ability to visualize the prostate.
In this study, Aloka. SSD-60C, UIR-2 scan converter and transrectal scanning chair equipped with 4MHz concave oscillating disc were used, and its gray scale display was compared with the conventional display.
This gray scale technique offers high resolution imaging of prostatic structures. Therefore, the anatomical delineation and pathological process of prostatic diseases can be analyzed by this method.

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The specific reactivities of lymphocytes to tumor associated antigens were studied on 19 patients with bladder carcinoma and 12 age matched control subjects. The specific reactivities were measured by means of leukocyte adherence inhibition test (LAI) and leukocyte migration inhibition test (LMI).
Autologous and allogeneic crude extracts were prepared from resected bladder carcinoma tissue for antigen. Tumor and normal tissues were homogenized and centrifuged at 20, 000g, 4°C for 60 minutes. Supernate filtered by millipore filter (0.45μ) was used as antigen. Final concentration of tissue extracts was adjusted to 100μg/ml of protein.
LAI test was done according to the method of Halliday and LMI test was according to Mcillmurray.
Serum used in this experiment was fetal calf serum (FCS) to exclude the inhibitory effect of serum from patients with bladder carcinoma.
% adherence was calculated and LAI index was obtained by dividing % adherence with antigen by that without antigen. And migration index (LMI index) was calculated by dividing migration area with antigen by that without antigen.
When normal leukocytes were challenged against normal tissue extracts or transitional cell carcinoma extracts, LAI indexes were about 0.9 for each. Leukocytes from patients with bladder carcinoma showed normal responsiveness to autologous intact bladder mucous membrane extract. However, leukocytes from patients with bladder carcinoma were challenged against autologous or allogeneic transitional cell carcinoma extracts, LAI indexes were significantly lowered. In other malignant diseases such as prostatic sarcoma, the tissue had no specific antigenicity like normal tissue extracts.
LMI indexes showed the same results as LAI test and LMI indexes were also significantly lowered only when transitional cell carcinoma extracts were used. In 6 patients with bladder carcinoma nonspecific and specific immune responses were studied before and after treatment.

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A method for clinical evaluation of antimicrobial agents on simple urinary tract infections was reported.
The outlines were summarized as follows,
1) Acute simple cystitis of the female aged from 16 to 59 years old was adopted as an object to keep the condition constant.
2) Pain on urination, pyuria over 10 cells/hpf and bacteriuria over 10⁴CFU/ml were considerd to be necessary for the diagnosis.
3) Clinical efficacy of the drug was estimated after 3 days' treatment.
4) Overall clinical efficacy was evaluated based on the response of symptom, pyuria and bacteriuria.
5) Overall clinical efficacy was classified into 3 degrees; excellent, good and poor (or failed).
However, it was not agreeable to compare the rate of “excellent” between drugs, because the back ground characters of patients such as degree of pyuria before treatment or age sometimes affect the rate.

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Correlation between the disc sensitivity and the clinical effect were investigated in 205 cases with acute simple cystitis and also in 283 cases with chronic complicated urinary tract infection (UTI).
The results were summarized as follows.
1. Significant correlation between the disc sensitivity and the bacteriological response were observed in cases with acute simple cystitis treated with 1g or 0.5g of ampicillin, but the correlation in cases treated with 2g of ampicillin was not significant.
2. Dose response in acute simple cystitis was significant only in cases with resistant strains, which were judged by the negativity of the disc sensitivity test.
3. Significant correlation between the disc sensitivity and the bacteriological response was also observed in cases with chronic complicated UTI treated with ampicillin or carindacillin, but correlation in cases treated with gentamicin was not significant.
4. In comparison with acute simple cystitis and chronic complicated UTI, both treated with 2g of ampicillin, bacteriological eradication rate was higher in acute cases than chronic cases both in the sensitive and resistant group. But the difference of eradication rate between acute and chronic cases was more obvious in the resistant group.
5. It was considered sufficient to divide the sensitivity of causative organisms into two groups, “sensitive” which was judged (+++)-(+), and “resistant” which was judged (-) by the disc sensitivity test.
6. From these results, the disc sensitivity test was considered useful in predicting the clinical efficacy of chemotherapy of UTI.

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Prepubertal hypospadias (n=15, age 2-3/4-5-5/6) were investigated for male gonadal functions, which consisted of bone age, length of phallus, type of hypospadia, plasma LH on LH-RH (100μg, i. v.) and plasma testosterone on HCG (fourth day after 10000 I. U., i. m.).
Bone ages were retarded in five cases and the phallus was smaller than normal Japanese boys in fourteen cases. Plasma LH was low (1-5 mIU/ml) and responses on LH-RH were meaningful in nine cases as normal prepubertal boys. Plasma testosterone was low (0.2-0.8ng/ml) and responses on HCG were meaningful in twelve cases as normal prepubertal boys.
Responses on both LH-RH and HCG were meaningful in nine cases and poor in three cases, therefore the former were presumed to have normal pituitary-gonadal axis and the later to be hypogonadism. Bone age, length of phallus and type of hypospadia were not correlated with the results of LH-RH and HCG tests in our series.

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To determinate stages of bladder cancer, pelvic arteriography was performed in 201 patients. Arteriographical staging was classified into 3 groupes according to Shiraishi's criteria; type I with submucosal infiltration, type II with muscular infiltration and type III with extravesical extention.
These arteriographic diagnosis was compared with other clinical examinations, pathological inspections and the prognosis. The following results were obtained.
1) The correspondence of arteriographic types to histological staging was 75.5% in all cases, 65.1% in type I, 80% in type II and 85% in type III.
2) The arteriographic accuracy was more excellent when tumor was in the lateral wall of the bladder than in the base of the bladder.
3) We concluded that pelvic arteriography was unnecessary for a pedunculated, papillary bladder tumor of underthumb head size.
4) 98.5% of type I group and 92.7% of type II group was under B₂ in staging, and therefore pelvic arteriography is a clinically significant examination according to our therapeutic principle that a tumor under B₂ in staging is indicated for radical operation.
5) Prognosis of type III group was extremely poor and it corresponded well with the prognosis of stage C-D group. This suggests that our therapeutic principle, mentioned above, is clinically appropriate and that the findings of pelvic arteriography are important in the presumption of prognosis of bladder cancer patients.

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A permanent established cell line (NBT-2) derived from a human urinary bladder carcinoma is described.
The tissue for cell cultures was taken from a 64-year-old male during partial cystectomy for urinary bladder carcinoma. A papillary growth, 1.0×1.5×1.5cm in size was found in the vicinity of the left ureteral orifice with basal invasions into the bladder wall. According to the pathological report, though the papillary growth appeared to be of grade III transitional cell carcinoma, the intramuscular invasions were proved to be more undifferentiated (grade IV).
Those cultured cells have been maintained for 28 months and passed 120 times. The bases that NBT-2 cells are identical with those of the urinary bladder carcinoma are as follows:
1) The tissue for cell cultures was removed from the urinary bladder carcinoma.
2) The epithelial-like cells grew more rapidly than the fibroblast-like cells and the final transition in primary cultures showed a complete monolayer of epithelial-like cells.
3) Ultrastructural characteristics of NBT-2 cells resembled those of high grade urinary bladder carcinoma cells.
4) Chromosomal analysis of the early cultured cells (4th in vitro passages) showed the presence of two hypertriploid stemlines (72 and 74).
5) Histological examination of the heterotransplant into the cheek pouches of a golden Syrian hamster revealed that the nature of the cells was much alike to undifferentiated transitional cell carcinoma (grade IV) of the original tumor.

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A nerve fiber in adrenal adenoma from a 12-year-old girl with Cushing's syndrome was observed by electron microscopy. It occurred in perivascular space. Axons were covered with Schwann's cell and contained small non-cored and cored vesicles (approximately 500Å and 1200Å respectively). A nerve fiber is rarely found in adrenal adenoma producing hypercorticalism. The functional significance of the nerve fiber is epuivocal, however, it may work on the capillary and indirectly regulate secretion of steroid hormones.

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