To understand the significance of urinary Secretory IgA (SIgA) in the urinary local immunity, we developed an Enzyme-linked immunosorbent Assay (E. L. I. S. A.) method for better detection. Previously, we reported on the urinary immunoglobulins level in normal controls, the localization of urinary SIgA at the urinary tract and the SIgA values in various urological disease. In this paper, we studied the antibacterial activity of SIgA in vitro.
The summary of the conclusion obtained is as follows;
1) Purified SIgA originated from human colostrum alone did not reveal the antibacterial activity against E. coli NIHJ JC-2 at a concentration of 6.3μg/ml to 100μg/ml in Trypticase Soy Broth (TCSB). Egg-white Lysozyme alone was not an effective either in inhibiting the growth of this strain, but urea had an inhibitory action on bacterial growth in proportion to its concentration. In the condition adding 2μg/ml of Lysozyme and 3% of urea in TCSB, 1μg/ml of SIgA from colostrum revealed a bacteriostatic activity for about 4 hours.
2) Normal human urines were proved to have a slight bacteriostatic activity against E. coli, but this activity did not show good correlation to the urinary SIgA level detected with E. L. I. S. A.. Urine from patients recently-infected by E. coli had a marked bacteriostatic action against E. coli NIHJ JC-2. Of such urines, one was bacteriocidal against not only E. coli but also S. aureus FDA 209P, P. aeruginosa Shogen and K. pneumoniae PCI 602. In this urine, after absorption of SIgA with anti SC, P. aeruginosa only began to grow again. Therefore, it was suggested that urinary SIgA took part in this antibacterial activity.

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Previously we reported on urinary flow rates, urethral pressure profiles and their responses to α-adrenergic blocking agent (phentolamine 5mg iv) in patients who were urodynamically diagnosed as bladder neck contracture. It was found there were some responders to α-adrenergic blocking agent in these patients. In responders, urinary flow rates were remarkably improved and maximum urethral closure pressures were more significantly decreased after intravenous administration of Phentolamine (5mg). These results suggested us that the sympathetic nervous system of posterior urethra had important roles in the causation of bladder neck contracture.
In this study, with the use of histochemical fluorescent technique (Falck-Hillarp's method), we examined the distribution of adrenergic neurons and its terminals in the bladder neck tissues which were transurethrally resected.
The results were as follows.
1. At the submucosal layer, the fluorescence of adrenergic nerve terminals was presented and closely corresponded to collagen fibers and blood vessels.
2. At the muscle layer, adrenergic neurons and terminals were more richly presented. The fluorescence of the muscle layer was more intensive than that of the submucosal layer.
3. At the muscle layer of the responders to α-adrenergic blocking agent, the fluorescence had a tendency to be richer and more intensive than that of non-responders.
From these results, we concluded that sympathetic overactivity of bladder neck smooth muscle was the most important cause in the responders to α-adrenergic blocking agent.

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1) A new type of apparatus for microexplosion with an explosive charging chamber of lead azide and a holder for experimental use was developed.
2) Using the above mentioned apparatus, the explosive of different weights was blasted at different distances towards bladder fragments from adult dogs. Although various finds of destruction were encountered on the fragments, almost no injury was observed in histology by blasts with explosives below 5mg in weight and at distances over 10mm between the fragments and the explosives. According to detonation theory and our unpublished data, the peak pressure of blast at this critical point was thought to be approximately 36kg/cm².
3) It might be expected to analyze not only the dynamic effect of blast by shock wave, but also the static effect of it by generated gas in the next step of our study.

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The authors examined the blood pictures, especially the platelets and fibrinolytic enzyme systems of blood obtained from the renal artery, renal vein, aorta, vena cava and cutaneous vein by means of Seldinger's method. The subjects (mainly patients with the renal disorders) comprised 75 individuals (46 males; 29 females) with an average age of 37.4 yr (range, 14-to 74-yr-old).
1. The count of platelets in blood from the normal renal artery was almost equal to that from the normal renal vein. The platelet adhesion in the normal renal artery tended more intense than that in the normal renal vein. The platelet aggregation induced at a final concentration of 2×10^-5M of adenosinediphosphate in the normal renal vein tended more intense than that in the normal renal artery. However, in some of the 74 subjects so far examined, the difference between the platelet adhesion and the platelet aggregation in the diseased renal artery and the colateral renal vein was observed.
2. The count of red blood cells and the values of hematocrit in the renal artery was usually smaller than those in the other sites including the renal vein, but the difference in the color index of blood among these sites was not observed.
3. The count of white blood cells in the renal vein tended to be larger than that in the renal artery.
4. The value of the plasmin, the anti-plasmin and the fibrin/fibrinogen degradation products in blood obtained from these sites was almost equal.
5. The transmission electron micrograph (TEM) of the diseased renal artery and the colateral renal vein of a case suffering from so-called idiopathic renal bleeding was shown, and the possibility of the difference in platelet-TEM among some of renal disorders was suggested.

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1) We have already reported on drilling experiments of extracted urinary calculi by the use of laser beam.
2) As the second step, experiments using a CO₂ gas laser guided through a manipulator which consists of three arms and mirrors, and also using a Nd:YAG laser guided through an optical fiber, was performed.
3) Some stones were not merely perforated but also disintegrated in a wet condition.
4) Although a CO₂ gas laser was more effective than a Nd:YAG laser in the destruction of stones, an optical fiber combined with Nd:YAG laser was easier to handle than a manipulator combinded with a CO₂ gas laser.

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The function of autonomic receptors was studied using an isometric in vitro technique and urethral smooth muscle strips isolated from adult female dogs. The urethral pressure profile measurement method of Brown and Wickham was also employed with some modifications in female dogs. All agents used were intravenously injected.
In in vitro studies, noradrenalin and adrenalin produced a dose-dependent contraction which was blocked by phentolamine. The contraction in the transversal strips tended to be stronger than that in the longitudinal strips. Isoproterenol caused a weak relaxation which was blocked by propranolol. Acetylcholine provoked a weak contraction which was blocked by atropine. These results indicate that the urethral smooth muscle contain alpha- and beta-adrenergic receptors and muscarinic cholinergic receptor, and there is a dominancy of alpha-adrenergic receptor in reaction.
Noradrenalin produced a significant increase of intra-pressure of the midurethra in the urethral pressure profile and this response was reduced by phentolamine. Isoproterenol produced a significant decrease of the urethral pressure and this response was reduced by propranolol. The reaction to acetylcholirte was small and inconstant. Phentolamine induced a significant (approximately 62%) decrease of the urethral pressure, while the effects of propranolol and atropine were smaller. Hexamethonium also induced a significant decrease of the urethral pressure (approximately 37%). From these results, it is suggested that the urethral resting pressure is maintained mainly by the alphaadrenergic receptor activity.
Papaverine induced a significant decrease of the urethral pressure (approximately 41%). This agent abolished the increased pressure maintained by continuous drip infusion of noradrenalin, however, it showed a slight effect on the transient increase response to one shot injection of noradrenalin. The results suggest that the urethral pressure response to noradrenalin is mediated via alpha-adrenergic receptors in the urethral smooth musculature.
Changes of the urethral pressure in relation to vesical distension and urination were studied with simultaneous recording of intravesical pressure by means of cystostomy under various conditions. Along with vesical distension, the urethral pressure increased gradually. With the onset of vesical contraction consequent to micturition reflex, the urethral pressure decreased. After treatment with gallamine, both the increase and decrease responses remained although these responses were reduced. After treatment with phentolamine, the responses were reduced significantly, while they were abolished almost completely in dogs concomitantly with both agents. Little effect of propranolol on the responses was observed. These results indicate that the urethral function during a collecting phase of the urinary bladder and micturition can be achieved not only by the urethral striated musculature but also by the smooth musculature, and the latter is mainly controlled by the alpha-adrenergic receptor mechanism.

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We studied the distribution of serum cholesterol, triglycerides, phospholipids, free fatty acid and serum lipoprotein fraction levels after more than 12 hours' fasting in 189 cases of benign prostatic hypertrophy and 29 cases of untreated prostatic cancer, who were not complicated with cardiovascular disturbances, and additionally in 17 cases of the benign prostatic hypertrophy complicated with cardiovascular disease and 28 cases of other non-advanced urogenital tumors (23 cases of bladder tumor, 3 cases of kidney cancer and 2 cases of testicular tumor). All the patients were over 50 years old. Lipoprotein fractions were measured by agarose-gel-electrophoresis. The results were as follows;
1) The serum lipid values of the group of benign prostatic hypertrophy without cardiovascular disturbances did not show any significant differences from the values of 43 cases of the control group. In lipoprotein fractions, β-lipoprotein fraction values were found to be lower than those of the control group, but within the normal range.
2) The fluctuations of serum lipids and lipoprotein fractions with age were observed in the group of benign prostatic hypertrophy without cardiovascular disturbances as well as those in 447 cases of Japanese healthy elder males.
3) In the prostatic cancer group, the serum lipids levels were not particularly different from the other groups except for the group of benign prostatic hypertrophy complicated with cardiovascular disturbances, while in lipoprotein fractions, some significant increase of β+Pre-β/α lipoprotein fraction ratio was observed. Also, there was observed a high frequency of hyperlipoproteinemia, actually as high as in the group of benign prostatic hypertrophy complicated with cardiovascular disturbances.
In view of the above results, differences of β+Pre-β/α lipoprotein fraction ratio between the group of benign prostatic hypertrophy without cardiovascular disturbances and the group of prostatic cancer was clearly observed. The fact that there were many cases who already had hyperlipoproteinemia in the prostatic cancer group was an interesting finding, when this is considered together with the fact that cardiovascular complications are caused by estrogen treatment to the patients with carcinoma of the prostate.

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Twenty-three patients with prostatic cancer were treated with estramustine phosphate disodium (Estracyt), hexestrol (Hexron) and diethylstilbestrol 4, 4-diphosphoric ester (Honvan). Sixteen cases were given 560 to 840mg of Estracyt, 6 cases 30mg of Hexron and 1 case 200mg of Honvan orally daily.
Fasting serum lipids and lipoprotein fractions were measured before and during the treatment with these drugs. Furthermore, in 3 patients with benign prostatic hypertrophy who were tried with the administration of 100mg per day of Honvan orally, changes of fasting serum lipids were studied.
The results were as follows:
1) In a relatively short period (1 to 2 months) since the start of Estracyt administration, a decrease of total cholesterol (TC) and an extreme increase of triglycerides (TG) were confirmed. The value of phospholipids (PL) was also found inclined to rise and the value of free fatty acids (NEFA) increased in the first 5 to 6 months. With regards to the lipoprotein fractions, the decline of β-lipoprotein fraction (LDL) and increase of Pre-β-lipoprotein fraction (VLDL) and α-lipoprotein fraction (HDL) were recognized, and a gradual decrease of β+Pre-β/α lipoprotein fraction ratio was observed, which in 10 to 12 months was found rising.
2) In 5 cases to whom Estracyt 840mg per day was given, almost no difference was observed in their TC, PL and NEFA values from those of 11 cases given 560mg per day, but their TG increase and β-lipoprotein fraction decrease as well as Pre-β-lipoprotein fraction increase were more obvious in the group of 840mg administration than in the group of 560mg.
3) Cardiovascular complications, although not serious, were found in 2 cases of the group of Estracyt administration. Something characteristic of these two cases was that their β+Pre-β/α lipoprotein fraction ratio decline was either very gradual or rather turned to increase markedly despite the extreme rise of their TG values.
4) The serum lipid values of the group of Hexron administration did not show any obvious changes except in TG. Their TG values did not show much change either in the first 5 to 6 months, but an increase was seen after 7 to 9 months. Their lipoprotein fractions were in about the same pattern as that of the Estracyt group except that the fluctuation amplitude was smaller.
5) In the group of Honvan administration, TG value began to rise so soon as 2 to 4 weeks after the start of the administration, and this was not exceptional in the 1 cases of prostatic cancer and in the three cases of benign prostatic hypertrophy, suggesting the possibility that this extreme increase of TG could not be specific to prostatic cancer.
In view of the above results that suggest high occurrences of hypertriglycelidemia and hyperlipoproteinemia sooner or later in cases of prostatic cancer to whom Estracyt, Hexron or Honvan is given, our conclusive opinion is that we must pay sufficient cautions against these coronary risk factors during long term treatment with these drugs for patients with prostatic cancer.

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Although there have been a variety of methods for evaluation of functional states of the transplanted kidney, no direct method for measuring intrarenal microcirculation has been so far available.
The purpose of this study was to determine if a polarographic measurement of intrarenal oxygen tension is useful for a rapid assessment of functional states of the autotransplanted kidney.
The experiments were performed on 25 mongrel dogs, weighing 8.5 to 32kg. After iv Thiamylal-Na administration, the kidney and ureter were exposed through a midline incision. Copper electrodes (a diameter of 300μ) were inserted into the renal cortex and medulla to the depth of 5mm and 15mm, respectively and tissue oxygen tensions were measured by the Yagi's polarographic method. The kidney was perfused immediately after nephrectomy and the renal artery was anastomosed to the right femoral artery and the renal vein to the right femoral vein. After the anastomosis was established, the renal PO₂ was monitored for 1hr.
Changes in the polarographic amplitudes after nephrectomy were expressed as percentage of the level obtained before nephrectomy.
Dogs were given 100% oxygen 41/min for 5min through a nasal catheter before and after autotransplantation of the kidney.
The results obtained were as follows:
1) The percent increase in PO₂ after 100% oxygen inhalation was 37% in the renal cortex and 13% in the renal medulla before autotransplantation, indicating a greater blood flow in the cortex than in the medulla.
2) The dogs with autotransplanted kidneys were divided into three groups according to the diuretic states: group I, good diuresis throughout experiment; group II, initially good diuresis, but anuria developed later and group III, no diuresis at all. The group I comprised 15 dogs, the group II 5 dogs and the group III 5 dogs.
3) The time required for autotransplantation averaged 47min, ranging from 17 to 83min. There was no clear relationship between the time required for autotransplantation and the diuretic states.
4) During perfusion of the isolated kidney, both cortical and medullary PO₂ were reduced about 50% in the groups I and II. The reduction of PO₂ (80%) was striking in the group III. For the latter case, restoration of the renal function either could not be expected or should have required a prolonged period of time.
5) A rapid restoration of PO₂ was observed in all groups shortly after autotransplantation. However, while the group I was capable of maintaining normal PO₂ level in both the cortex and the medulla, the group II had lower PO₂ in the medulla than the control, and the group III had much lower PO₂ in both the cortex and the medulla. A progressive tubular degeneration might account for discontinuance of diuresis in the group II, whereas in the group III a total reduction of renal blood flow might have caused no diuresis.
6) In contrast to the other two groups, the group I showed a good tissue PO₂ response to 100% O₂ inhalation. This finding may explain why only the group I was able to restore a normal renal function.
The results presented suggest that changes in the renal cortical and medullary PO₂ fairly reflect the functional states of the autotranspianted kidneys. It is suggested that the intrarenal tisr ue oxygen monitoring can be used clinically as an assessment of functional states of the transplanted kidney.

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At two hospitals where gentamicin (abbreviated as GM) resistant strains of Pseudomonas aeruginosa had been isolated with high incidences, organisms of Pseudomonas aeruginosa which are resistant to aminoglycosides were collected in order to isolate their R plasmids carrying resistance to aminoglycosides including GM and examine their genetic properties. Furthermore, each of these organisms was phage typed and analyzed for their relationship to the source of GM resistant R plasmids.
A total of 141 strains of P. aeruginosa, consisting of 41 strains isolated at hospital A and 100 strains isolated at hospital B, were examined. Using the agar plate dilution method, strains having resistance to GM, dibekacin (DKB), tobramycin (TOB) and amikacin (AMK) were selected and used as the donor organism for an experiment on transconjugants. For preparing transconjugants, two methods were applied: one was to transfer resistance in a broth conjugally and the other on a membrane filter. As the recipient organism for conjugated transference, P. aeruginosa, ML 4262 (trp^-his^-ilv^-met^-rif^r) and ML 4600 (trp^- his^-) were used.
Of all the isolates, GM resistant strains amounted to 56% for hospital A and 38% for hospital B, with high incidences for both hospitals. Most of these strains showed cross-resistance to DKB and TOB. On the other hand, the results of the experiment on the conjugated transference revealed an obvious difference in the incidence of isolation of resistance transferable organisms between the two hospitals. At hospital A, resistance transferable strains were isolated with higher incidences, with all the isolated R plasmids having a resistance marker based on the resistance to GM, DKB and TOB. Regarding the phage types of these organisms having R plasmids, there were some strains classified into different phage types despite the fact that they possessed the same R plasmids. These results indicated a possibility of the spread and establishment of aminoglycosides resistance at the level of R plasmids in addition to a dissemination of GM resistant P. aeruginosa at hospital A.
At hospital B, where GM resistance transferring R plasmids were not isolated, aminoglycosides resistant strains with the same pattern of resistance to GM, DKB and TOB amounted to 31 of 37 strains isolated at this hospital. Thirty of these 31 strains exhibited a similar phage type. This fact suggests that there was a dissemination of GM resistant organisms themselves at hospital B.
These results showed that the spread of GM resistant organisms is related to abuse of antimicrobial agents and intrahorpital infections and that studies from two sides, namely that at plasmids level and phage typing, are required in order to obtain a countermeasure against the development of resistance.

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E. coli was inoculated into rat bladder. After several periods of free voiding, the bladder was observed with a transmission electron microscope. Further, a silicone tube was introduced to the bladder with bacterial suspension, and the effect of the foreign body on cystitis was observed.
As a first step, the bacteria were attached to the luminal membrane. Then, the luminal membrane became infolded to envelope the bacteria and to take them within the cytoplasm. The unit membrane surrounding the bacteria were destroyed later and some of these bacteria were found to be deformed or multiplicated within the cytoplasm. Finaly, the infected epithelial cells were collapsed and desquamated, which were washed out with bacteria. Within 24 hrs after bacterial inoculation, epithelium showed complete recovery forming normal three layers.
On the other hand, the epithelial cells of the bladder in which foreign body and bacteria were put, exhibited an earlier and severer infection which postpones as long as 48 hrs after inoculation.
This experiment may show one of the defense mechanism of the vesical epithelium to the E. coli infection. Further, foreign bodies in the bladder are thought to make this washing out phenomenon or epithelial regeneration imperfect.

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