Physiologic regulation of cholesterol synthesis in the rat prostate was studied in comparison with hepatic cholesterogenesis.
Cholesterol synthesized from ¹⁴C-labelled acetate or mevalonate with tissue slices were determined under various conditions such as aging, castration, administration of testosterone and mating. The diurnal change of cholesterogenesis in the rat ventral prostate was also investigated.
The results can be summarized as follows:
1. During day time, cholesterol synthesis from acetate was more than that in the liver, but the synthesis from mevalonate was predominat in the liver.
2. Cholesterol synthesis in the prostate took place mainly in the ventral lobe and partly in dorsolateral lobe.
3. As in the liver, β-hydroxy-β-methylglutaryl CoA (HMG-CoA) reductase played a main role as the rate-limiting enzyme for cholesterogenesis in the prostate. In the synthetic pathway of cholesterol, squalene was markedly accumulated in the liver and lanosterol in the prostate.
4. Cholesterol syntheses in the liver and prostate were lower in aged rats, and this was attributed to the decreased activity of HMG-CoA reductase.
5. Cholesterol synthesis from acetate in the rat ventral prostate was reduced by castration and was recovered partly by administration of testosterone. Cholesterol synthesis in the dorsolateral prostate was not affected by castration and treatment with testosterone. In contrast with the results with the ventral prostate, hepatic cholesterogenesis in male rats was enhanced by castration and suppressed by administration of testosterone.
6. Although the diurnal change in cholesterol synthesis from acetate was observed in the rat ventral prostate as in the liver, the amplitude of circadian rhythm observed in the ventral prostate was smaller than that in the liver. Furthermore, in contrast with the hepatic diurnal rhythm, the cholestero-genesis in the ventral prostate was predominant during day time.

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Intravesical instillation of anti-cancer drug using mainly thio-TEPA has been attempted to prevent reccurrence after conservative therapy on seventy-five cases of superficial bladder tumor diagnosed as papillary tumor. The effect of intravesical instillation in preventing recurrence was studied by comparing the recurrence ratio with that in seventy-three cases of control group treated without instillation.
The results were as follows:
1) Recurrence was found in 44 out of 73 cases (60.3%) in the non-instillated group, while in 24 out of 75 cases (32%) in the instillated group.
2) Recurrence was found in 24 out of 44 cases (54.5%) 6 months after the operation and within 2 years over 80% of the cases in the non-instillated group. Recurrence was found in 2 out of 24 cases (8.3%) at 6 months postoperatively and within 3 years about 80% of total cases in the instillated group.
3) Recurrence in the primary part of the bladder within 6 months postoperatively was noticed in 19 out of 22 cases (86.4%) in the non-instillated group and in all of the instillated group. And the recurrence after 6 months or more was found in 10 out of 22 cases (45.5%) in the non-instillated group and in 8 out of 20 cases (40%) in the instillated group.
4) The frequency of recurrence is the same among different degrees of cytological abnormality in the non-instillated group. However, it was remarkably low in cases with low grade tumor in the instillated group.
5) The incidence of recurrence after partial cystectomy is the same among the two groups. However, the recurrence rate after TUC and TUR is lower in the instillated group than in the non-instillated group.
6) As shown by the actuarial method, the frequency of recurrence within the first postoperative year in the non-instillated and instillated group is 44.6 and 12.7per cent respectively. And within the secound postoperative year it is 21.8 and 10per cent, respectively. However, the anti-recurrence effect of this therapy after the 3rd year is not remarkable and the recurrence rate each year is about 10per cent.
7) The longer the period of anti-recurrence therapy, the lower the incidence of recurrence. However, the anti-recurrence effect was found for only one year after the treatment.
8) The same effect was found on the cases with recurrence one or more years after the anti-recurrence therapy, using more intensive (duration and frequency) anti-cancer therapy.
From the results above mentioned it was concluded that intravesical instillation of anti-cancer drug was most effective on the early (within postoperative 6 months) recurrent cases. The period of periodic intravesical instillation therapy was enough for one year postoperatively for the cases with early recurrence. However, much longer period of therapy was needed for the cases with late or frequent high grade recurrence.

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The DNA values, determined by a microspectrophotometer, of the cells separated from fixed specimens of bladder cancer were compared according to the grade and stage of cancer tissues. The histogram of nuclear DNA values showed a flattness of the mode, a deviation of stem line to the right, and an increased incidence of polyploid cells in accordance with the increase in both grade and stage of cancer. Prognosis seems to be related more closely to DNA values of cancer tissues than to the stage and grade of cancer.
To make urinary cytology objective, DNA values of exfoliated cells from fresh cancer tissues and the cells in urine in the same patients were compared. A histogram of nuclear DNA values of exfoliated cells in urine showed a pattern similar to that in exfoliated cells from fresh cancer tissues. In addition to dignosis of cancer, diagnosis of its grade could be made in some cases by determining nuclear DNA values of exfoliated cells in urine. When combined with an automatic instrument for measuring DNA values, urinary cytology can be made automatically.

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Neurogenic bladder dysfunction caused by tabes dorsalis (tabetic bladder) was found in 4 patients, 3 males and 1 female, aged from 57 to 67. The chief complaint comprised difficulty in urination, retention and/or incontinence. Serological test for syphilis was positive in the all cases. The flaccid anal tonus was found in 3 and the bulbocavernous reflex was negative in 3. Cystometric examination revealed an autonomous bladder in 2 and a hypotonic bladder in 2. The former responded to the denervation supersensitivity test (Lapides-Glahn test) but the latter did not. The maximum urethral pressure was found decreased by urethral pressure profile, which was characteristic of the tabetic bladder.
Intermittent self-catheterization was of effect in the all cases as a conservative method of treatment. Transurethral resection of the bladder neck was attempted in 1 case to reduce residual urine further. 2 patients died of meningovascular syphilis 4 years and 2 weeks, respectively, after the first visit to our clinic. In summary, tabetic bladder dysfunction is based upon the impairment of bladder sensory and motor nerves, which, in turn, prevents the synergitic movement of the detrusor and sphincter muscles.

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Dimethylnitrosamine (20μg/g) was given once intraperitoneally in newborn rats in order to induce renal parenchymal tumors. The rats were followed for 9 months after dimethylnitrosamine (DMN) administration. In female rats without bilateral oophorectomy and male ones with bilateral orchiectomy following DMN intraperitoneal injection, incidence of renal tumor was significantly higher (75 to 77.8%), compared with control rats without tumor growth receiving only physiological saline injection.
It was suggested that sex hormones were related with the induction of renal parenchymal tumor in rats. We assume that androgen had a suppressive effect for the carcinogenesis of DMN, while estrogen an enhancing action for it.
Histological patterns of renal parenchymal tumor were nephroblastoma and adenocarcinoma. The former presumably occurred from renal stromal tissue and the latter from renal tubuli.

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A study has been made of 10 women with primary carcinoma of the urethra treated from 1946 through 1975 at the Cancer Institute Hospital, Tokyo. The ages at the time of diagnosis ranged from 48 to 68 years. Protruding meatal masses were described by 3 patients (30 percent) and burning on urination by 2. There were seen 5 cases of squamous cell carcinoma, 2 cases of transitional cell carcinoma, 2 cases of adenocarcinoma and 1 case of basal cell carcinoma. The lesions were staged retrospectively according to the TNM classification (classification 1968, trial period 1969-1973) and also criteria outlined by Grabstald and associates. Four cases were staged in T1, 2 cases in T2, 3 in T3 and 1 in T4. Prognosis was related to the clinical stage of the disease and patients in T1 and T2 were mostly favorable.
Six patients were treated with radiation therapy alone, 3 with a combination of radiotherapy and surgery and 1 by operation alone. Of the 9 patients treated with radiotherapy 2 received interstitial irradiation, 3 had a combination of interstitial and external irradiation and 4 received external irradiation.
Two patients recently treated with a combination of radiation and surgery had received each dose irradiation followed by intramuscular injection of bleomycin. The primary lesions in 9 of 10 cases were well controlled.
The complication that developed only in 2 patients treated with radiotherapy was urethral stricture which required periodical urethral dilatation.
Our current policy of the treatment will be summarized as follows. For the management of T1 either local excision or radiation therapy by interstitial irradiation using radium 226 and/or external irradiation is chosen, in case of T2 partial urethrectomy combined with irradiation is performed and in case of T3 or T4 radical surgery is combined with irradiation.
If metastases to lymph nodes are identified, pelvic lymph node and/or inguinal lymph node dissection is necessary.

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We have investigated 49 patients with ectopic ureteral insertion; 24 cases with unduplicated, 22 cases with completely duplicated, and 3 cases with incompletely duplicated collecting system.
In general, no matter whether it is cranially or caudally ectopic, the further the ureteral orifice is from its normal site, the greaterr is the abnormality likely to be found in the kidney. But the severity of renal dysplasia found in our series was not necessarily correlated to the degree of ectopy of the ureteral orifice. It should be emphasized that the kidneys with vaginal insertion were almost always with focal dysplasia. A few embryological explanations, especially concerning the role of Müllerian duct in the migration of ureteral orifice, were described.
The histological comparison between the duplicated and unduplicated collecting system also revealed qualitative differences. The kidneys of the duplicated collecting system showed a high incidence and degree of the cyst formation, whereas those of the unduplicated collecting system showed a high incidence of the metaplastic cartilage.

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