An experimental model of bladder carcinoma was established in the rabbit using transplantable V₂ carcinoma. Submucosally inoculated V₂ carcinoma cells were successfully transplanted into the bladder wall with an incidence of 96% (78/81) with the first experimental week. Significant correlation was demonstrated between the growing tumor size and inoculated tumor cell numbers. Nodullary growing submucosal tumor progressed to mucosal ulceration followed by invasive growth to the muscle layers with relatively restrictive boundary. About 4 weeks after inoculation, lymphatic metastases to the lungs were evidently observed with a high frequency. The extremely high transplantability of the tumor and short experimental periods of this model system might be advantageous for practical studies of bladder carcinoma.

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Responding to the necessity of selective cancer chemotherapy, the possibility of magnetic control of anticancer drugs in urinary bladder was proposed.
Ferromagnetic mitomycin C microcapsules (FM-MMC-m. c.) were instilled into the rabbit bladder through cystostomy where V₂ tumor was implanted and guided on the tumor surface by an external magnet. The tumor size was measured 2 weeks after the treatment. The tumor growth rate, compared with non-treated group, was 30.5±12.4% (mean±S. E., n=4) in the FM-MMC-m. c. group, while that in the non-encapsulated group (n=5) was 108.2±10.4%. The result suggested that intravesical instillation of FM-MMC-m. c. with magnetic control was an effective therapy for V₂ bladder tumor. Another experiments showed that MMC levels in the bladder wall at the magnet of the FM-MMC-m. c. group were significantly higher than those of the non-encapsulated MMC group (p<0.005). MMC levels in the peripheral blood and urine of FM-MMC-m. c. group were also higher than those of control group. The results indicated that magnet control of FM-MMC-m. c. in the bladder wall produced a sustained release of biologically active MMC in vitro as well as in vivo. Concentrated MMC was released into the tumor for an extended period of time from the microcapsules confined on the tumor surface with the external magnetic field.
Instillation of the FM-MMC-m. c. into the bladder lumen in the magnetic field is applicable to an intensive topical chemotherapy of urinary bladder cancer with less toxicity to normal mucosal layer.

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A model of hyperthermia for urinary bladder cancer was reported. Hyperthermic treatment was investigated by the irrigation with hot saline through cystostomy tube 3 days after the transplantation of V₂ carcinoma cells into the rabbit bladder wall.
The average tumor size (length × width) 2 weeks after the treatment in control, normothermic (36-38°C), and hyperthermic (42-44°C) groups were 395±31, 385±55 and 62±11mm², respectively. In contrast to the effect on tumor growth in each group, the changes of normal bladder mucosa was not remarkable by the microscopic examination. Survivals of the rabbits with urinary bladder carcinoma following the hyperthermic treatment and control groups were 58.5±6.9 and 44.2±1.8 days, respectively. Moreover, the mean body weight at the 6th week showed a marked decrease in the control group (2700±300g) as compared to the hyperthermic group (3250±122g).
The result suggests that the hyperthermic irrigation of the urinary bladder is useful for preventing the tumor growth and prolonging the survival time with minimum damage to the normal bladder mucosa.

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Fifty cases of carcinoma of the urinary bladder treated in the Osaka City University Hospital for the past five years were studied with respect to the histological features and the clinical significance of the stromal reactions.
The results were summarized as follows.
1) The stromal fibrous reaction showed a significant correlation with the tumor growth pattern, infiltration depth and invasion mode (p<0.05, p<0.025, p<0.025 respecively), but not with tumor grade.
2) In the relation between the clinical features and the cellular reactions, correlation was found only between the number of neutrophils and infiltration depth (p<0.05).
3) Presence or absence of cellular and fibrous reactions had a significant correlation with prognosis.

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Uninhibited bladder in children was studied with regard to its 1) clinical and uroradiographic features, 2) relevancy to non-obstructive VUR and 3) urodynamic aspects.
Results
1) Clinical and uroradiographic features.
a) Incidence. There were in total 84 children who were diagnosed as such at our institution during the last 5 years. When simple enuretic children were excluded, girls comprise more than 70 per cent of them with a peak incidence 5 years and gradually decrease thereafter.
b) The representative symptoms were (both diurnal and nocturnal) urinary incontinence, recurrent urinary infection and/or combination the two, particularly among the girls with urinary infection this was considered to be a primary factor for its recurrence.
c) On voiding cystourethrography DUS like appearance was seen in 24 girls. Further studies suggested that although uninhibited bladder ofter simulate DUS on cystourethrography, DUS itself is a rare entity which is hardly ever responsible for initiation of uninhibited contractions.
2) Its role in the non-obstructive VUR.
81 children with non-obstructive VUR were studied with particular emphasis on their cystometric findings.
a) Study of the incidence of non-obstructive VUR among different age groups indicated the presence of two peaks, one of which was between 3 to 5 years that coincided with the age when uninhibited bladder became symptomatic. When the grading of VUR was compared among the girls in 3 to 7 years of age, it was found that VUR was more severe in those who had uninhibited bladder than in normals.
b) When VUR was associated with uninhibited bladder, its cure is highly expected even in grade II_b to III cases.
c) It is suggested that uninhibited bladder somehow influenced the antireflux mechanism of UVJ, possibly leading to occurrence of VUR and/or its aggravation, to say the least.
3) Urodynamic study in 40 children with combined cystometry, uroflowmetry and sphincter electromyography indicated that there are only a few cases with vesical sphincteric dyssynergia in these children.

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In an effort to clarify the cellular localization of human chorionic gonadotropin (HCG), β₁-pregnancy specific glycoprotein (SP₁) and alfafetoprotein (AFP) on germ cell testicular tumor tissue, formalin fixed paraffin embedded tissue specimen of 48 cases germ cell testicular tumors and metastatic tumors to the retroperitoneal lymph nodes were studied with peroxidase antiperoxidase method. The following results were obtained in adult type non seminomatous germ cell tumor tissue from 25cases. Production sites of HCG, SP₁ and AFP were found 16 cases (64%). 14 cases (56%), and 18 cases (69.2%) respectively. However, in 8 cases, infant type germ cell testicular tumor tissue production sites of HCG and SP₁ were not found at all but AFP were found in 4 cases (50%).
Nine out of the 25 cases with adult type non seminomatous germ cell tumor showed an elevation of serum levels of AFP preoperatively, all of the 9 cases demonstrated AFP in their tumor tissue. Tissue existence of AFP in these tumor tissue were correlated well with preoperative high serum marker levels.
Seven out of 25 cases with adult type non seminomatous germ cell tumor showed an elevation of serum levels of β subunit HCG preoperatively, except in one of the 7 cases production sites of HCG was found within their tumor tissue.
One case showed an elevation of the serum level of β subunit HCG preoperatively, in whom production sites of HCG were not found in its tumor tissue, showed a continued elevation of β subunit HCG postoperatively.
It was suspected that residual tumor must be present. Therefore, intensive chemotherapy was done.
Localization of HCG and SP₁ was found almost within syncytiotrophoblastic giant cell like cells among the embryonal cell carcinoma and syncytiotrophoblastic giant cell in choriocarcinoma but in one case that was found within the cell lining a cyst.
Distribution of SP₁ was always narrow compared to HCG.
There were 2 cases in whom production sites of HCG were found but in the adacent tumor tissue SP₁ were not found.
Among the embryonal carcinoma cells, AFP was found with dark brown deposit of Diaminobenzidine or its sparse deposit. As reported earlier, AFP were found within endodermal sinus tumor tissue but within a part of teratoma cell lining the cyst with dark deposit of Diaminobenzidine was also found simultaneously.
Six out of 15 cases of seminoma showed abnormal high serum levels of β subunit HCG preoperatively, 4 of the 6 cases cellular localization of HCG and SP₁ was found within syncytiotrophoblastic giant cell like cells.
Although one case with serum levels of β subunit HCG within normal range one day before operation, HCG and SP₁ were found within syncytiotrophoblastic giant cell like cells. Therefore, diagnosis of pure seminoma requires preoperative measurement of serum levels of β subunit HCG and immunohistochemical method.

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In 25 cases nephrectomied for malignant renal tumor 33 CT examinations were taken, one month to 6 years after the nephrectomy. The primary renal malignant lesion was renal cell carcinoma in 19 cases, transitional cell carcinoma in 4 cases and sarcoma in 2 cases. CT was taken using Somatom, with scanning time of 4.5 or 5 seconds, matrix of 256×256, section thickness of 7 or 8 mm.
Out of these 25 cases local recurrence was noted in 5 cases. The findings of local recurrence included soft-tissue mass of the vacant renal fossa, obscurity of the inferior vena cava and enlargement and irregularity of the psoas muscle. In these 5 cases the number of tumor masses was 1 to 3, with sizes of 1.4×2.7 to 6×7cm. The site was on the same side of the nephrectomied site in 3 cases, on the opposite side in 1 case and bilateral in 1 case. The inferior vena cava was obscure due to invasion of tumor in 3 cases. The psoas muscle on the recurrent side showed an enlargement and irregularity in 3 cases. The diagnosis with CT was confirmed by both ultrasound examination and surgery in 2 cases, by angiography in one case and by autopsy in one case out of the 5 cases.
Since CT is useful for early detection of local recurrence, it is advisable that the examinations should be carried out periodically even though the patient became asymptomatic postoperatively. CT is also of use to examine the presence or absence of residual tumor after nephrectomy or to determine the therapeutic efficacy.

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We reported a 23 year-old man complaining of retrograde ejaculation who was found to have a posterior urethral valve. Review of the literature revealed that the cases of posterior urethral valve are reported rarely and we could not find the report assosiated with ejaculation disturbance in Japan.

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The present paper describes a case of a male tailor, ages 50 years, who underwent complete removal of the whole urinary tract as a treatment for bilateral asynchronous renal pelvic and bladder tumors. Left total nephro-ureterectomy was carried out in May 1971. The pathological examination of the specimen revealed non-invasive transitional cell carcinoma grade I-II. After 4 years from the above operation, small papillary tumors were recognized in his urinary bladder for several times during the following few years and managed with transurethral resection and fulguration. All of the tumor specimens showed almost similar histological findings as the initial renal pelvic tumor. In June 1979 a quickly growing tumor was found in the residual right pelvis, while he was receiving vesical instillation of antitumor agents. Lymphangiogram, lung tomogram and scintigram of the liver and bones revealed no evidence of metastases. Although there were no obvious tumors in the bladder cystoscopically, a tiny tumor was found at the lower portion of the right ureter. Therefore, right total nephro-ureterectomy and cysto-urethrectomy were performed. Microscopically, both tumors of the right renal pelvis and the ureter were a grade I-II transitional cell carcinoma without invasion. No cancerous lesions were found in the bladder and urethra. His post-operative course has been uneventful without any signs of tumor recurrence under maintenance hemodialysis for 9 month.
Bilateral renal pelvic tumor is rare and 21 previously reported cases of bilateral renal pelvic tumor were compared and discussed.

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The cases of retroperitoneal non-chromaffin paraganglioma with symptoms of anuria were reported. A total of 15 cases, including these 2 cases of ours, of paraganglioma which occurred in retroperitoneum and had no symptoms of hypertension were collected as the cases examined in our country; 10 cases were confirmed as non-chromaffin paraganglioma.

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A case of transient renovascular hypertention after nephrolithotomy was reported. The patient, a 51-year-old male, was diagnosed as having a right staghorn calculus. His preoperative blood pressure was 120/66mmHg. Nephrolithotomy was undertaken by the method of one-layer interrupted parenchymal suture.
It took 28 minutes to clamp the renal pedicle. The blood loss during the operation amounted to only 300cc without requiring blood transfusion. While the right kidney had no accessory artery nor aberrant vessels, the renal pedicle was accidentally twisted by nearly 180° at the time of occluding the blood flow.
Macroscopic hematuria in the postoperative period continued for only 3 days, but hypertension was observed on the night of operation. On the 4th day after operation the blood pressure rose to 224/130mmHg, showing a high plasma renin activity of 7.8ng/ml/hr (normal value is 0.5-2.0). After administration of Aldomet, the blood pressure and renin activity returned to normal, and the antihypertensive drug was discontinued.
Drip infusion pyelography (DIP) 15 days after operation showed only a very slight image of the right renalcalyces and a pattern of renogram was compatible with functional disturbance in the right kidney. RI-angiography demonstrated a decrease of the right renal blood flow. Excretory urography 24 days after operation revealed good renal function and calyectasis improved. In the CT scanning a small zone of scar was observed along the site of incision of the right renal parenchyma.
The patient was discharged 33 days after the operation and thereafter his condition improved to the extent that he could assume his occupational responsibilities. The blood pressure 8 months after operation was estimated to be normal and the right renal function was favorably maintained.
The discussion concerns the cause of renovascular hypertension which is characterized during renal or reteroperitoneal operation. In this case, spasm of the main renal artery was suggested to be the cause of hypertension, because torsion of the renal pedicle occurred during the operation and the hypertension was transient.

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