As a preliminary investigation for the study of macrophages in prostatic fluid, methods for the detection of macrophages were studied.
The methods, based on the detection of characteristics of macrophages such as adhesion of modified sheep erythrocytes or phagocytosis of latex beads, were shown to be inappropriate because both macrophages and polymorphonuclear leukocytes were positive by these methods. However, using these techniques, it was found that leukocytes appeared in urine from cystitis patients still possessed phagocytic potency.
Staining for non-specific esterase was found to be the most appropriate method for the detection of macrophages. Five to sixteen percentage (Ave. 10.2%) of leukocytes in prostatic fluid from five nonbacterial prostatitis patients were strongly positive by this staining and were regarded as macrophages, while none of leukocytes from cystitis patients were positive.

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A histopathological study on unilateral recurrent Masugi nephritis, induced by repeated intravenous injections of anti-rabbit kidney hen serum into rabbits in the beginning of the course of clamping of right renal arteries for 20 minutes at intervals of one month, is presented. The mode of development of renal lesions in the same individual animals for up to 199 experimental days was ascertained on the basis of the findings of biopsy materials surgically resected repeatedly as well as autopsy materials.
The results are as follows:
1) In the left kidney, a recurrent glomerulonephritis leading to granular atrophy of the kidney was induced by means of repeated injections of anti-rabbit kidney hen sera, whereas, in the right kidney, there developed a mild and focal glomerulonephritis and a tendency to compensatory hypertrophy only after second injection.
2) Recent and old proliferative glomerulonephritis, formation of recent and fibrous epithelial crescent, recent endothelial proliferation in the glomerular capillary loops having sclerosed basement membrane, recent endothelial proliferation in the periphferally arranged blood space of glomerular loops having fibrosis, crowding of previously proliferated cells towards axis of the loops, etc. were induced in the left kidneys after second injections. They were interpreted as histological manifestations of the recurrence of Masugi nephritis. Subendothelial cellular proliferation with fibrosis of glomerular loops comparable in its histogenesis to that of “circumferential mesangial interposition” was also encountered in the left kidney having second injection of anti-rabbit kidney hen serum.
3) In the urinary tubular tissues especially those of proximal convolution attached to destructed glomeruli, there appeared atrophy of epithelial cells, hyaline thickening of basement membrane, and edema and sclerosis of interstitial tissue. A double-contoured thickening, loosing and undulation of tubular basement membrane associated with ingrowth of fibroblast and collagen fibers into the intervening tissues between atrophic epithelial cells and basement membrane were noted.
4) Perinuclear vesicle formation of leiomyofibers of the media of arterioles in the proximity to severely injured or destructed glomeruli was not infrequently observed.

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We studied urinary SIgA in healthy adult females and patients with various kinds of urinary tract infections and obtained the following results.
1) In healthy adult females, the urinary SIgA levels ranges from 58.8 to 488.5μg/dl with a mean of 158.6μg/dl and SIgA/u-creatinine ratios from 1.0 to 3.5 with a mean of 2.1. Diurnal investigation showed that the excretion increased in the afternoon.
2) In the patients with acute simple cystitis, urinary SIgA excretion obviously increased from 61.8 to 1820.0μg/dl with a mean of 473.8μg/dl in urin ry SIgA levels and from 1.0 to 29.4 with a mean of 9.0 in the SIgA/u-creatinine ratios. After the onset of scute simple cysti is, urinary SIgA excretion increased sooner in the patients with recurrent episodes than in those without an episode in the past. The highest excretion was noticed in the patients with a frequency of less than once a year. The excretion returned to normal level immediately after initiation of chemotherapy.
3) In the patients with chronic cystitis, accompanying chronic proliferative changes in the bladder, the urinary SIgA levels ranged from 160.3 to 942.0μg/dl with a mean of 381.7μ/dl and the SIgA/u-creatinine ratios from 1.2 to 9.7μg/dl with a mean of 5.2.
4) In the patients with chronic complicated cystitis, the urinary SIgA levels ranged from 382.5 to 1761.0μg/dl with a mean of 836.7μg/dl and the SIgA/u-creatinine ratios from 5.8 to 26.0 with a mean of 12.7.
5) In the patients with urethral syndrome, the urinary SIgA levels ranged from 90.0 to 742.0μg/dl with a mean of 241.9μg/dl and the SIgA/u-creatinine ratios from 0.9 to 8.0 with a mean of 2.8.
6) In the patients with acute pyelonephritis, the urinary SIgA levels ranged from 52.4 to 419.3μg/dl with a mean of 219.3μg/dl and SIgA/u-creatinine ratios from 0.9 to 5.1 with a mean of 2.8.
7) In the patients with chronic pyelonephritis, the urinary SIgA levels ranged from 94.6 to 316.8μg/dl with a mean of 151.9μg/dl and SIgA/u-creatinine ratios from 0.7 to 4.8 with a mean of 2.5.
8) In the patients with either nephrostomy or ureterostomy, the urinary SIgA levels ranged from 0 to 73.7μg/dl with a mean of 33.4μg/dl and SIgA/u-creatinine ratios from 0 to 1.1 with a mean of 0.6. In the patients with ileal conduit, the urinary SIgA levels ranged from 27.3 to 47.5μg/dl with a mean of 36.3μ/dl and SIgA/u-creatinine ratios from 0.5 to 1.1 with a mean of 0.9.
9) These studies show that urinary SIgA excretion shows an obvious increase in the lower urinary tract infections, while it remains at a low level in the upper urinary tract during infections.

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We studied the function of urinary SIgA on adherence of E. coli, isolated from acute simple cystitis, to the vesical epithelial cell and obtained the following results.
1) The number of E. coli, adhering to the vesical epithelial cells which were taken from healthy adult-females, ranged from 4 to 33 per cell with a mean of 18. When SIgA was added to 200μg/dl, the number of adhered E. coli decreased from 2 to 25 with a mean of 14.
2) From 9 to 135 of E. coli adhered to the vesical epithelial cells, taken from patients with the history of lower urinary tract infection, and the bacteria easily adhered to cells taken from patients with recurrent episodes of lower urinary tract infection in the past. When SIgA was added, the number of E. coli adhering to the cells obviously decreased to 5 to 61 with a mean of 25.
3) The relation between the real urinary SIgA levels and the experimental levels on adhesion suggested that the effective level of SIgA in urine might be near the non-infected urinary SIgA levels.
4) These results suggest that urinary SIgA might have a function of inhibiting invading bacteria from adhering to the urinary tract mucosa.

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The abnormalities in urine of calcium oxalate stone formers in comparison with control subjects were studied in order to clarify the mechanism of calcium stone formation.
The results were as follows:
1) The daily excretion of calcium, oxalic acid, uric acid and creatinine was determined in fifty-five normal men, fifty-two single stone formers and thirty-seven recurrent stone formers. The calcium excretion was higher in recurrent stone formers (190±21mg/day, mean±SEM) and single stone formers (160±11mg/day) than in normal controls (116±11mg/day). The calcium to creatinine ratio of these groups showed almost similar value. The oxalic acid excretion was higher in recurrent stone formers (34.3±4.0mg/day) than in single stone formers (24.0±2.3mg/day) and controls (24.8±1.6mg/day). The value of calcium (mg/day)×oxalic acid (mg/day) was 6815 in recurrent stone formers, 4689 in single stone formers and 3195 in controls. The value of calcium×oxalic acid/creatinine was also elevated in relation to the severity of the disease. There was no difference of uric acid excretion among the three groups.
2) The particle size distribution of calcium oxalate crystals were measured in fresh morning urine from ten recurrent stone formers and five controls using Coulter counter Model ZBl. The crystal volume excreted by the controls was 0.37-0.05×10⁶μm³/ml (mean±SEM), whereas the volume excreted by the stone formers was 2.21±0.21×10⁶μm³/ml. These values showed significant difference. It was concluded that patients with recurrent calcium oxalate stone disease excreted more crystals of calcium oxalate and the crystals were generally larger and more aggregated than those found in urine of normal subjects. These findings were also obtained with light microscopy. Using this technique calcium oxalate crystalluria may be expressed as either the number or the volume of crystals excreted per unit volume of urine.
3) A simple system was developed to study the effect of inhibitors of crystal aggregation in vitro under controlled conditions in which crystal growth could not be observed. A measure of the aggregation of added calcium oxalate crystals was obtained by calculating the percent increase in the fraction of particles greater than 9μm in diameter after 4hr incubation in metastable solution with respect to calcium oxalate. The aggregation of added crystals was determined by Coulter counter and compared with the control solution. The degree of aggregation was expressed as inhibitory activity.
In this system, urine of either controls or stone formers inhibited aggregation when added at concentration as low as 5%, where inhibitory activity was almost 100%. The inhibitory activity of the urine from ten recurrent stone formers was significantly decreased (38.4%) compared with fifteen controls (60.2%) and ten single stone formers (55.4%).
4) Effects of citrate, magnesium, urea, creatinine, methylene blue, sodium copper chlorophyllin, EDTA, pyrophosphate and glycosaminoglycans on calcium oxalate crystal aggregation were examined. Of the known inhibitors tested, citrate, magnesium, pyrophosphate, glycosaminoglycans and sodium copper chlorophyllin were effective, whereas methylene blue and EDTA had no effect on the aggregation of calcium oxalate crystals in vitro. Urea and creatinine had no effect. Potent inhibition was observed with glycosaminoglycans, especially with heparin.

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In the serial study on the genesis of urolithiasis, the influence of menstrual cycle on the urinary excretion of citric acid and electrolytes was investigated.
Twenty-nine matured females, unmarried and aged 20 years, with the normal menstrual cycle were selected for the study. The early morning urine was collected periodically 8 times during the period of about one month and examined for estrogen, citric acid, Ca, Mg, P, Na, K, Cl and uric acid. The obtained results were corrected for comparison by the value of creatinine. The menstrual cycle was divided into the following four phases; before the start of menstruation (1st phase), about the end of menstruation (2nd phase), ovulational period (3rd phase) and the intermediate period between the 3rd and next 1st phases (4th phase). The urine samples corresponding to each phase were selected and subjected for assay, so that the relation of menstrual cycle to the excretion of the above-mentioned components was investigated.
The following results were obtained. When averaged throughout the whole cycle, the amount of citric acid excreted in urine was 309.5±161.5mg/g. creatinine. The minimum excretion of 245.7mg/g. creatinine was noted at the 2nd phase and the maximum of 363.0mg/g. creatinine at the 4th phase. The difference was statistically significant (p<0.05). This finding suggests that the menstrual cycle should be taken into consideration for examining the urinary excretion of citric acid. Incidentally, correlations of the urinary components were examined at each phase, and many of the parameters which showed correlation at the phases other than the 3rd phase were found to be no longer correlated each other at the 3rd phase. It was thus demonstrated that the urinary excretion of citric acid and other components is more greatly influenced than expected by rapid changes which take place during ovulation.

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Effects of mitomycin C or 5-fluorouracil on compensatory renal enlargement after unilateral nephrectomy in rats were studied by analyzing patterns of changes in DNA, RNA and protein contents.
The remaining kidneys of rats following unilateral nephrectomy or sham-operated kidneys were removed on the 1st, 3rd, 5th, 7th, 10th and 14th day after the operation. Just after the operation, animals received intraperitoneal injections of either mitomycin C (0.292mg/kg body weight) or 5-fluorouracil (21mg/kg body weight). DNA, RNA and protein in cortical, medullas y and tubular fractions of the removed kidney were determined according to Burton's method, orcinol method and Lowery's method, respectively. The data were expressed as ratios of the values in the left kidney to those of the right kidney in each animal.
In the animals treated with mitomycin C or 5-fluorouracil, the increase in kidney weight after unilateral nephrectomy was similar to that of the untreated animals up to the 10th day, but significantly lower on the 14th day. The ratio of cortical weight to medullary weight, however, remained almost constant during the experimental period.
In the nephrectomized control rat, hyperplastic and hypertrophic responses were noticed in both cortex and medulla, as judged from patterns of increments in DNA, RNA and protein contents. However, hyperplastic response which was active between the 1st and 3rd day was somewhat stronger in the cortex than in the medulla. The effect of mitomycin C to the nephrectomized animals was characterized by severe suppression of hyperplasia in both cortex and medulla, and by remarkable decrease in DNA content on the 7th day, suggesting the presence of destructed nuclei. This decreased level of DNA content recovered rapidly after the 7th day. The hypertrophic response was not significantly impaired by mitomycin C. A single administration of 5-fluorouracil resulted in a remarkable suppression of hypertrophic response on the 1st day, and a slight decrease in hyperplasia on the 3rd day. Thereafter, no significant change was observed.
On the basis of the above results, clinical meanings of administration of antitumor drugs after nephrectomy were discussed.

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Thirty-four cases with micturitional disturbance (24 male and 10 female) resulting from cerebrovascular accidents were examined by recording urethral pressure profile (UPP), cystometrogram and external sphincter electromyogram. The site of the lesions of these subjects were diagnosed by neurological examination, cerebral angiography and brain computed tomography.
By correlation of these data, the following conclusions were obtained.
1) Cystometry showed hyperactive bladder in 25 cases (74%) of the 34 cases examined, and external sphincter electromyography demonstrated normal sphincter in 14 cases (50%).
2) In cases with putaminal lesion, cystometry showed hyperactive bladder frequently (78%) but external sphincter electromyography demonstrated that external sphincter remined under volitional control (67%).
3) In cases with frontal and/or internal capsular lesion, cystometry demonstrated hyperactive bladder commonly (89%) and external sphincter electromyography tended to show uninhibited reflex relaxation with detrusor hyperreflexia (56%).
4) In most of the cases whose cystometry showed inactive bladder, atrophic change was revealed in the whole brain by brain computed tomography. In these cases we cannot deny the possibility that atrophic change may occur in the pontine-mesencephalic reticular formation where the detrusor motor center is believed to be present.

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The follow up study of 26 cases with hydronephrosis (28 renal pelves) after pyeloplasty was reported. The analysis was made from the view-point of the improvement of hydronephrosis and urinary tract infection (UTI). Roentgenologic improvement of form and excretory ability of the kidney was estimaded by the correponding scores before and after operation. Pyuria of more than five leucocytes/H. P. F. was regarded as an evidence for presence of UTI in this report. The conclusions were as follows:
1) Although children showed a better effective rate than adults in pyeloplasty, it does not always mean pyeloplasty has better effect on children's hydronephrosis than adult's. There are some examples to the contrary. For examples, children did not get good marks than adult in pyeloplasty of UPJ stricture.
2) As for the methods of operations, the statistical analysis produced no difference between Anderson-Hynes' method and Culp-Scardino's.
3) Improvement of hydronephrosis continued for about a year after operation. It is recommended that we should pay more careful attention to the first year and continue to watch for two years.
4) In cases in which UTI was not present preoperatively, postoperative UTI disappeared within 3 months after the removal of a catheter. On the other hand, in cases complicated with preoperative UTI, postoperative UTI persisted for about 5 months.
5) It is advisable to prevent postoperative UTI by the use of closed drainage system. An indwelling catheter should be eliminated within two to three weeks, because a catheter indwelled postoperatively over four weeks seemed to accelerate UTI.

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Two cases of Thorotrast kidney accompanied with renal pelvic carcinoma were described. Although both of them had no obvious history of previous retrograde pyelography using Thorotrast, plain films of the abdomen showed dense opaque shadows characteristic of Thorotrast deposits.
One patient, 64-year-old male, died of disseminated metastases, and the other, 86-year-old male, of renal failure. Histologic examination of the autopsy specimens revealed moderately differentiated squamous cell carcinoma in the renal pelvis and other metastasized organs in the former, and transitional cell carcinoma with adenomatous parts of the renal pelvis in the latter where tumor formations has not been recognized at autopsy. Furthermore, the submucosal tissues in the vicinity of the carcinoma retained a large amount of black granules, which, on soft X-ray picture and microautoradiograph or gammaray spectra, or both, proved to be Thorotrast.

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Significance of polymicrobial infections of the urinary tract was investigated immunologically in 24 patients with long term indwelling catheter.
Relation between bacterial counts in the urine and the serum or urinary antibody levels were studied. Serum and urine-recoated. antibody coated bacteria were detected in relation to the serum or urinary antibody levels and the urinary irnmunoglobuline levels.
The results obtained were as follows:
1) The serum antibody titers to autologous antigens derived from patients' own feces were below 64. Therefore, the significnat titer of serum antibody was considered 128 or higher.
2) There was a significant correlation between the serum antibody titers to homologous antigens and the bacterial counts in urine.
3) The serum antibody titers tended to rise in two weeks in cases with increasing bacterial counts.
4) There was a significant correlation between the response of serum antibody and the positivity of S-R. ACB of IgG class, and also between the response of urinary antibody and U-R. ACB of IgG class. The positive rate of S-R. ACB to IgG and IgA was higher than that to S-IgA and IgM, and the positive rate of U-R. ACB to IgG and S-IgA was higher than the others.
5) There was no significant difference in the urinary immunoglobulin levels of IgG and IgA between U-R. ACB positive and negative cases. The levels of urinary immunoglobulin were related to the positivity of U-R. ACB to S-IgA, and IgM of which the positive rate was low.
6) The positive rate of the urinary antibody was 25% of 12 cases who had had indwelling-catheter for a long time. In all of the urinary antibody positive cases, U-R. ACB to IgG class could be detected. Many organisms isolated from one urinary tract produced their own serum and urinary antibody response and showed positive reaction in R. ACB detection.

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