Clinical studies were performed on 58 cases of penile cancer, treated at our clinic during the last 23 years from 1955 to 1977. The results are as follows:
The average age of these 58 cases was 58.6 years old, ranged from 33 years old to 84 years old. The average of the interval between the onset and clinical visit was 19.8 months, and that of cancer death was 40.3 months.
Forty-one cases of 58 cases (70.7%) were phimotic.
As to the initial localization of tumors, 38 cases (65.5%) were at the glans penis.
The treatment consisted of surgery, irradiation and chemotherapy. The treatment in the early period (1955-1968) was mainly surgery, and that in the late period (1968-1972) was mainly Bleomycin chemotherapy.
Forty-nine cases were classified by Jackson's staging, and the results are as follows: stage I; 27 cases, stage II; 13 cases, stage III; 5 cases, stage IV; 4 cases.
The 5-year-survival rate of low stage (stage I and stage II) patients was 90.0%, and that of high stage (stage III and stage IV) patients was 22.2%.
The over-all 5-year survival rate of 49 cases was 77.6%.

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For a period of 10 years from 1968 to 1977, renal angiographic examinations were carried out in 42 out of 144 patients with unexplained renal hematuria, at the Department of Urology, Hiroshima University Hospital. In these cases, conservative treatments were unsuccessful.
The results of the angiographic examination including renal phlebography and inferior venacavography in these cases were as follows:
1) Of 42 patients examined, 19 had renal and perirenal vascular lesions and 2 had renal parenchymal disorders.
2) In 19 patients with renal and perirenal vascular lesions, renal pelvic and ureteral varices were observed in 9 cases, intrarenal arteriovenous fistula in 3 cases, left inferior vena cava in 2 cases, double inferior vena cava in 1 case, retroaortic left renal vein in 2 cases, circumaortic renal venous ring in 2 cases, and renal segmental infarct in 1 case.
3) In 4 out of 7 patients who had congenital anomalies of inferior vena cava or renal vein, varices of renal pelvis and ureter were observed.
The results described above suggest the possibilities that the congenital anomalies of inferior vena cava and renal vein may cause congestion of the renal and ureteral venous systems, and the congestion may be a predisposing condition of renal hematuria.

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The conventional theories on the quantitation of the urethral resistance have been reviewed. The urethral resistance could be theoretically induced from the bladder work done during the voiding. Furthermore a hypothetical diagram has been proposed with the correlation between bladder work and urethral resistance, which might be of value to differentiate the type of micturition disturbance.

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Pituitary-gonadal endocrine function was studied by measuring serum LH, FSH and testosterone (T) levels under various conditions using radioimmunoassay methods in 18 patients with various types of male hermaphroditism. Among them, 11 patients were classified as group A1 (;male hermaphroditism with no breast development and rudimentary or no mullerian structures), 3 patients as group A2 (;male hermaphroditism with well formed mullerian structures) and 2 patients as group B2 (;male hermaphroditism with breast development and ambiguous external genitalia) according to the classification modified from that proposed by Jones. In the other 2 patients, it was not determined whether they belonged to group A1 or group B2 because of their prepubertal age.
In addition, 4 patients with true hermaphroditism and 3 patients with gonadal dysgenesis were studied for comparison. The pubertal and postpubertal patients with male hermaphroditism excluding those of group B2 showed strikingly elevated levels of both serum LH and FSH. The levels of serum LH and FSH were further elevated by LH-RH administration. Serum T levels in them were widely ranged from subnormal to normal adult male levels, and hCG stimulation test revealed a poor Leydig cell reserve capacity in some cases.
In the pubertal and postpubertal patients with male hermaphroditism of group B2, serum FSH values were in the upper limit of normal adult male range, but the levels of serum LH were abnormally elevated despite their normal or high levels of serum T. Serum gonadotropin levels in two patients with male hermaphroditism of group A2 were studied along with usual course of clinical treatment. It was observed that further increased levels of serum gonadotropins after castration were suppressed to almost undetectable levels by estrogen replacement therapy. The serum gonadotropin levels in one of the patients with male hermaphroditism of group B2 were not suppressed by single administration of testosterone depot 100mg.
In contrast to these abnormally elevated levels of serum gonadotropins in adult patients with male hermaphroditism, the prepubertal cases showed normal age-matched male levels of serum gonadotropins.
Four patients were studied longitudinally for 3 or 5 years and abrupt rises of serum gonadotropin levels to the abnormally high range were observed with the onset of puberty. These pubertal rises of serum gonadotropin levels from the normal range to an abnormally high range were also observed in the studies on patients with true hermaphroditism.
Meanwhile, the patients with gonadal dysgenesis of prepubertal age showed somewhat elevated levels of serum gonadotropins. It is concluded that development of puberty causes abnormal changes in pituitary gonadal endocrine function in patients with male hermaphroditism. The aspects of these abnormalities are thought to be compatible in some cases with those of primary gonadal failure and in some cases with those of androgen insensitivity in target organs.
Possible mechanism was discussed for these abnormal alterations in pituitary gonadal endocrine axis during puberty in patients with male hermaphroditism.

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During a 25 year period from 1953 to 1977, a total of 104 cases of renal cell carcinoma were treated at the Jikei University Hospital. In 31 out of these 104 cases (30%) pulmonary metastasis was observed. Of these 31 cases, pulmonary metastasis was noted initially in 12 cases, and in the remaining 19 cases it occurred after nephrectomy. The time elapsed from the treatment of primary lesion to the detection of pulmonary metastasis was less than one year in 12 cases (63%), one to 2 years in 5 cases, 4 years and 4 months in one case, and 7 years in one case.
The treatment used for pulmonary metastasis included pneumectomy in one case, radiotherapy in 3 cases, chemotherapy in 15 cases and hormonal therapy in 11 cases.
In one case which underwent pneumectomy, metastasis to the lung was detected one year and 1 month after nephrectomy, for which pneumonectomy was performed. This patient has been well without showing relapses for these 4 years and 11 months.
Among 3 cases treated by radiotherapy, objective improvement was noted in one case, and in the other 2 cases there was no improvement. In the one effective case metastasis of carcinoma to the lung was found 5 months after nephrectomy, but it disappeared following irradiation of 5, 000 rads by Linac. Since then 6 years have passed without any recurrence of carcinoma.
Fifteen cases were treated with chemotherapeutic agents: three drugs (mitomycin C, 5-fluorouracil and cytosine arabinoside) were used combinedly in 9 cases, 4 drugs (actinomycin D, vincristine, methotrexate and cyclophosphamide) combinedly in 4 cases, and 5-fluorouracil dry syrup was used in 3 cases. Out of these 15 cases, objective improvement was observed in 3 cases (20%): namely, one case received three drugs (mitomycin C, 5-fluorouracil, and cytosine arabinaside) combinedly and 2 cases received 5-fluorouracil dry syrup. In all of these three cases metastasis to the lung was detected after nephrectomy. Both of 2 cases treated 5-fluorouracil dry syrup had a complete remission by chest X-ray examination. They remained well without recurrence of carcinoma in 9 and 6 months, respectively.
Hormonal agents used were progesterone and testosterone. In none of the 11 cases treated with these agents remission of metastatic lesion was confirmed by chest X-ray examination.

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Transcatheter arterial embolization of renal cell carcinoma was performed by injecting a mixture of oxidized cellulose and contrast medium in 10 cases.
Water-soluble contrast medium was added to minced oxidized cellulose and stirred well until white viscous suspension was obtained. The suspension containing oxidized cellulose was injected gradually into the renal artery under careful fluoroscopic control.
No untoward effect except fever and pain in the renal region was noted. After an initial rise of serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase, alkaline phosphatase and creatine phosphokinase, they returned to their normal levels within 2 to 4 weeks after embolization. Transient rises of plasma renin activity and blood pressure was observed.
Ease of surgery was noted when radical nephrectomy was performed within a short interval after embolization.
However, no reduction of tumor metastasis took place after embolization. Blastogenesis examined by concanavalin A and phytohemagglutinin revealed a lowered immune response in patients with renal cell carcinoma which persisted after embolization. The immune response was stimulated after radical nephrectomy.
Oxidized cellulose is a safe and suitable embolizing agent for a short term embolization of renal cell carcinoma.

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Transaminase activity in human ejaculates was measured by a colorimetric method of Reitman-Frankel. Unspecific enhancement of absorption at 505mU was observed by addition of 2.4-dinitrophenylhydrasine to the ejaculate. Therefore, control incubation with corresponding specimen itself appeared indispensable for determination of the enzyme activity inhuman ejaculate. The activity thus determined was designated as corrected activity (C. A.). Meanwhile, transaminase activity assayed with water blank as usually adopted for the determination of the activity in serum was designated as apparent activity (A. A.) in the present paper. Consequently, A. A. was higher than C. A.
C. A. and A. A. of GOT revealed a significant correlation (r=0.75, p<0.001) while no correlation was found between both values of GPT. Averages of GOT activity (C. A.) in human ejaculates were
305.6±17.7 R. F. unit/ml (n=16) in normospermias,
116.8±12.5 R. F. unit/ml (n=30) in oligospermias and
70.9±7.3 R. F. unit/ml (n=25) in azospermias (mean±S.E.).
While mean GPT activity in the ejaculate was 15.9±2.4 R. F. unit/ml (n=34), which was similar to the normal level of serum. Furthermore, GOT activities showed a significant correlation to either sperm concentration (C. A. r=0.87 and A. A. r=0.59, p<0.001) or sperm motility (C. A. r=0.32, p<0.05). No such a correlation was recognized in GPT activity.
When each ejaculate was separated to seminal plasma and spermatozoa by centrifugation at 100xg for 5 minutes, approximately all GOT activity of each specimen were found to localize in the respective seminal plasma. The suspended spermatozoa in physiological saline contained extremely low GOT activity after washed three times with saline solution, which showed no correlations with the concentration of spermatozoa.
The results above indicate that the major part of GOT activity in human ejaculates would be supplied by the secretion of the seminal tract and not by spermatozoa. The presumption is also supported by the following result in the present study that very low GOT activity in the ejaculate of a castrated adult has obviously increased after androgen administration.
GOT activities in ejaculates were reduced to 44-80% after vasectomy. Therefore, it appears likely that the seminal tract proximal to the vas deference might play an important role in supplying the enzymes in ejaculates. All of accessory sexual organ tissues contained high GOT activities in comparison with those in bladder epithelium or smooth muscular tissue.
In conclusion, since investigations recently reported indicate that spermatogenesis is regulated by androgens as well as FSH, GOT activity in human ejaculates would be a good indicator for clinical evaluation of the quality of the ejaculate.

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Fifty seven cases of ileal conduit urinary diversion were performed in Kyushu University during 13 years from 1963 to 1976.
Wound infection was the most common complication followed by intestinal obstruction, upper urinary tract calculus, and urinary fistula. It seemed that malignant disease group had more early complications and benign disease group had more late complications.
Thirty per cent of upper urinary tracts in benign disease group deteriolated on intra-venous urogram, though 9.1 per cent in malignant disease group deteriolated (p<0.05).
One hundred and twenty four urines were obtained by the method of double lumen catheter for bacteriological examination. 50 per cent of urines included over 10⁵ bacteria per ml. in benign disease group, though 14.3 per cent in malignant disease group (p<0.05). Correlation was noted between pre- and post-operative urogram findings and urinary tract infections.
Five years survival rate of the urinary bladder cancer was 58 per cent. Radical cystectomy showed better result (82 per cent) than simple cystectomy (46 per cent).

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In order to investigate the role of polyamines, i. e., spermidine (SPD) and spermine (SPM), in male reproductive behavior and bladder function, polyamine concentration in the brain, male reproductive organs and bladder was examined in dogs. Separation of polyamines was performed according to Endo and Ogura's method.
The results are as follows:
In the brain, SPD content showed the highest level in the medulla oblongata, and it decreased in the brain sections near the cerebrum. On the contrary, SPM content was the highest in the hippocampus, and it decreased in the brain sections distant from the cerebrum. The SPD/SPM ratio was highest in the medulla oblongata and decreased in the brain sections near the cerebrum. The value of the ratio was more than 1 in all sections of the brain.
In the male reproductive organs and bladder, SPD content showed the highest level in the testis, and the lowest level in the bladder body. The adrenal gland, prostate, epididymis, bladder apex, vas deferens, and bladder neck showed intermediate levels. SPM content showed the highest level in the prostate and the lowest level in the bladder neck. The testis, adrenal gland, epididymis, bladder apex, vas deferens, and bladder body showed intermediate levels. The SPD/SPM ratio exhibited the highest value in the epididymis and the lowest in the prostate. The testis, bladder neck, vas deferens, adrenal gland, bladder apex, and bladder body showed intermediate values. The value of this ratio was less than 1 in all these organs. This suggests that the functional role of polyamines may differ in the central nervous system and the male reproductive organs and bladder.

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The changes of polyamines in the brain, male reproductive organs and urinary bladder after spinal cord injury were investigated by using male mongrel dogs. The polyamine determinations were made in dogs 1 week after transection of the spinal cord at the 11th thoracic vertebra.
The results are as follows:
In the male reproductive organs spermidine (SPD) contents in the prostate and testis were reduced markedly (P<0.05), while spermine (SPM) contents increased in the adrenal gland (P<0.01). In the urinary bladder, SPD increased in the neck portion, compared to those of the apex and body of the bladder (P<0.025). In the brain SPD increased markedly in the anterior hypothalamus (P<0.01).

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The experience in ureterocalicostomy on six patients with ureteral or renal calculi was reported. Three of the six patients had ureteral calculi with severe hydronephrosis and three others had renal calculi with intrarenal pelvic stenosis. After ureterocalicostomy the renal function improved in all patients and urinary tract infection disappeared.
Ureterocalicostomy is the operation of choice for ureteral calculi associated with severe hydronephrosis and renal calculi associated with intrarenal pelvic stenosis. Operative details were also discussed.

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