The present study was designed to assess the role of the bowel as a source of urinary tract infection in patients with Pseudomonas aeruginosa. In investigation of the urological ward in 1976, fecal specimens were obtained from 262 patients. The carriage-rate of P. aeruginosa on admission was 7.8%, and 14.2% of the patients carried that organism when leaving hospital. During the patients' stay in the ward, the carriage-rate increased. It seemed that the increase was perhaps due to a spread of P. aeruginosa from the intestinal tract of one patient to another.
Oral administration of antimicrobial agents was an important factor for colonization of P. aeruginosa in the bowel during the patients' stay in the ward.
Stools were also examined from the hospital kitchin staff for twelve months, but in contrast with the patients, only a few of them were positive for P. aeruginosa.
Oral polymyxin B was effective in eliminating P. aeruginosa, when it was present in the bowel. In 1977 and 1978, polymyxin B was given orally when P. aeruginosa was found in the feces, and the carriage-rate of P. aeruginosa in the bowel when leaving hospital was lower than that in 1976.
Most of P. aeruginosa isolated from urine in our ward were typable, and type C, E and G were dominant. Numerous different strains, especially typecially type B, E and G were identified in the feces. But dominant serotypes of P. aeruginosa isolated from urine changed year after year, and the change was coincided with that of P. aeruginosa from feces.
In eleven patients, the serotype of P. aeruginosa from urine and feces was identical, and all of them were catheterized in the urinary tract. Patients carrying P. aeruginosa in the bowel seemed to be the source contaminating the hospital environment. Sporadic urinary tract infection by P. aeruginosa might be due to organisms carried by patients in their own gastrointestinal tract.
Over 95% of P. aeruginosa isolated from urine and feces produced protease, and over 80% produced elastase. Most of P. aeruginosa were susceptible to gentamicin, tobramycin, amikacin and polymyxin B, and the frequency of gentamicin resistance of that organism was about 10%.

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Presence of androgen receptors must be essential for the effectiveness of anti-androgen therapy against the prostatic cancer. Radioreceptor assay of androgens using cytosol fraction has been studied, but not used widely in the area of prostatic cancer study because of pleomorphism of prostatic cancer cells and difficulty to obtain relatively large amounts of tumor tissues. In this study, we developed a new amplified method to detect the localization of androgen receptors within the human prostatic tissue specimens.
Four BPH tissues were obtained from patients undergoing retropubic prostatectomy. Cryostatfrozen sections of the tissue were cut at 10μm thick, air-dried, fixed in 10% formalin in PBS (pH7.4) for five minutes, and washed in three baths of PBS. The tissue sections were treated with 50μl of 100nM tritiated dihydrotestosterone (³H-DHT) in a humid box at room temperature for two hours, washed, and air-dried. The sections were then dipped into Sakura MRM-2 autoradiographic emulsion and dried at room temperature, followed by dipping into scintillator solution consisted of 7% PPO and 0.02% POPOP dissolved in dioxan, and exposed in the dark at -85°C for two weeks. After exposure the emulsion sheets covering the sections were developed, and the sections were stained with hematoxylin. As control, the bladder tissue which was not androgen target organ was treated with ³H-DHT using the exactly same methods simultaneusly.
The binding of ³H-DHT to receptors were demonstrated as silver grains on the stained tissue sections. The binding of ³H-DHT to the prostatic tissue was inhibited by additional non-radioactive DHT remarkably (Fig. 3) and by testosterone partially (Fig. 4), but not affected by additional progesterone and 17β-estradiol (Fig. 6). No binding of ³H-DHT to the bladder tissue was found (Fig. 7).
These results showed that the binding of ³H-DHT to the prostatic tissue was a specific reaction of ³H-DHT and androgen receptor.
Androgen receptors were seen in the nuclei and the cytoplasmas of glandular epithelial cells of prostate. However, stromal cells contained less abundant androgen receptors.
The method reported here has several advantages in detecting the androgen receptor of the prostatic tissue in comparison with the radioreceptor assay and other histochemical methods.
1) The needle biopsied specimens are big enough to examine. Therefore, repeated examinations of prostatic cancer patients are available before and after treatment.
2) Morphological observation are also possible on the same specimen because the specimens are stained with hematoxylin simultaneously. Therefore, we can know the relative ratio of androgen receptor positive cells and negative cells.
3) Binding of ³H-DHT to the receptor with this method may be more specific than other histochemical methods, since binding of ³H-DHT to the receptor was inhibited by 200-fold excess of nonradioactive DHT.
4) Treatment of scintillator, fluorographic technique shortens the exposure periods. The exposure periods are approximately six to twelve times shorter than that of the conventional autoradiography.

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Micropuncture techniques developed for the study of renal physiology have been adapted for investigation of the male reproductive tract. In an attempt to gain more information about the cells of seminiferous tubules we have recorded intracellular potentials in isolated tubules of rats by means of micro-electrode method. After sacrifice a single tubule was placed in the tissue bath which contains solution previously bubbled with 95% O₂ and 5% CO₂. Micro-electrodes filled with 3M KCl containing peroxidase were used to identify the impaled cell of the seminiferous tubule histochemically. They, held in a micromanipulator, were inserted longitudinally from above into the tubules under visual control using a stereomicroscope. They were connected to the input of a Model 707 Micro Probe System (W-P Instruments, Inc) to a pen recorder. The potential was noted and a small amount of KCl solution was ejected by means of microiontophoresis. And then the tubule was prefixed in glutaraldehyde solution, incubated in DAB (diaminobenzidine)-H₂O₂ Tris-HCl buffer solution and then postfixed in osmium tetroxide. The doubly fixed tissue was dehydrated in ethanole series and embedded in Epon 812. Thin continuous sections of 3 micron intervals were cut on a ultramicrotome.
The results obtained were as follows:
1) The mean value of the membrane potentials recorded from cells of the seminiferous tubules was -30.49±7.41mV (mean±s. e.). These portentials were lower than that of exciting cells such as neural cells or muscular cells.
2) The phasic changes in potential were obserbed. We presume that they are associated with contractions of the cells of the boundary tissue.
3) Although further investigation is neccessary, this cell was cosidered to be a Sertoli cell.

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Using isometric in vitro technique, the sensitivity to acetylcholine and prostaglandins was studied in rats denervated by injecting 10% phenolglycerin into a subarachnoidal space between the 5th and 6th lumbar vertebrae, 1 to 28 days after injection.
The amplitude of spontaneous contractions of strips prepared from the bladders significantly increased 3 to 28 days after denervation as compared with those of control rats. The increase of the spontaneous contractions in rats 3 to 7 days after denervation was larger than that in rats 14 to 28 days after denervation.
An increase of contraction response to acetylcholine was observed from 3 days after denervation and reached a maximum level 7 days after denervation. This level remained for the period from 14 to 28 days after denervation.
Prostaglandin E₂ and F_2α induced the small contractions in control strips. The increase of contraction response to prostaglandins was observed 7 to 28 days after denervation. The increase of contraction response to prostaglandin E₂ was not observed 4 days after denervation.
These results suggested that supersensitivity of the bladder in denervated rats to acetylcholine mainly occurred through a pre junctional mechanisms at an early stage of denervation, however, through a post junctional mechanism at a later stage covering 7 to 28 days after denervation.

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The sizes of single crystals of apatite in 56 urinary calculi were measured by means of the X-ray diffraction line broadening technique.
(a) The length along c-axis (Lc) could be determined for 56 the specimens; it ranges from 110Å to 1160Å.
The width along an a-axis (La) could be measured for some selected specimens only because of the poor resolution of the X-ray diffraction peak indexed as (300).
(b) Lc is likely to be larger than La, and La tends to increase in proportion to increasing Lc.
(c) Lc tends to be larger in lower urinary tract calculi as compared with that in upper urinary tract calculi.
(d) Lc is likely to be smaller at the core area than at the surface area in individual calculi.
(e) Lc tends to be larger in apatite-calucium oxalate mixed calculi as compared with apatite-calculi.
(f) No clear correlative relationahip was detected between the crystal sizes of apatite and the major diameters of the urinary calculi.

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Obstructive nephropathy is a reversible renal failure if early detection and diversion are performed. Usually, however, the development of ureteral obstruction from metastatic cancer is an advanced disease. The urologist is then called upon to make the controversial decision as to whether to grant the patient a peaceful uremic death, or to prolong life and extend suffering by means of urinary diversion. The controversy prompted us to review the clinical course of our patients with uremia secondary to malignant cancer and associated ureteral obstruction. We were especially concerned with the time interval between the initial diagnosis of malignancy and subsequent diversion, as well as to survival time after diverson. In addition, we reviewed preoperative clinical data which might be useful in predicting recoverable preserved function of affected kidneys following urinary diversion.
Forty-four patients were included in this study who had uremia caused by ureteral obstruction secondary to malignant disease. These patients underwent urinary diversion from 1971 to 1980. Of the 44 patients, 24 were men and 20 were women, ranging in age from 13 to 81 years, with a mode range in the 6th decade. Tumors of the prostate, stomach and colorectum were the 3 most common lesions in men, accounting for 66.6%. The incidence of uterine cancer was extremely high in women and this together with colorectal cancer accounted for 75% of all female cancers.
In patients with uterine cancer the duration of disease before diversion, i. e. latent period, was relatively long and averaged 33.4 months. In all but one case, obstructive nephropathy took place more than one year after the initial diagnosis and start of treatment. Mean survival time of these patients with obstructive nephropathy was 4.4 months, none of these patients survived more than one year after diversion. Latent period and survival time in patients with colorectal cancer averaged 13.1 months and 6.4 months, respectively, while in patients with stomach cancer, these figures averaged 15.1 months and 3.8 months, respectively. As exception, however, patients with prostatic cancer appeared far better than those with malignancies of other organs. The latent period of patients with prostatic cancer ranged widely, with one patient developing uremia 11 years after castration for prostatic cancer. Mean survival time of this group was 10.2 months and two patients survived more than 2 years.
On the basis of retrospective analysis, patients were classified into 3 groups according to the extent of recovered renal function after diversion. Group I included 18 patients in whom serum creatinine level decreased lower than 2.0mg/dl within one week after diversion. Group II included 18 patients in whom more than one week elapsed until the level of serum creatinine decreased lower than 2.0mg/di. Group III included 6 patients in whom diversion resulted in lowered serum creatinine levels but never lower than 2.0mg/dl, even after 3 weeks following diversion. Two of the 44 patients were excluded because of the lack of available records. The mean value of BUN and creatinine level before operation were not significantly different among these 3 groups, thereby indicating that the degree of azotemia was indifferent to the recovery of renal function after diversion. On the other hand, there was a statistically significant difference in the mean values of serum potassium between groups I and II (P<0.05). Serum hemoglobin levels showed significant differences between groups I and II (P<0.01) and between groups I and III (P<0.01). In addition, the mean values of FENa were statistically different between groups I and II (P<0.001) and group I and III (P<0.02). These data suggest that patients with severe hyperkalemia, anemia and high value of FENa may have less chance of complete reversibility of renal failure or delayed recovery from azotemia.

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Although ^99mTc-DTPA renoscintiphoto is widely used for renal dynamic study, the intrarenal transference of this radionuclide tracer has not been investigated in detail.
The present study consists of a series of sequential whole-body macroautoradiography of rats to investigate the mode of transference of this material in the body. Besides, optimum technical conditions for the autoradiography with ^99mTc were investigated.
Since this substance is a γ-emitter with a short physical half-life, some modifications to customary procedure were necessary. The fundamental point of the modifications was to shorten the freezing and drying time to the utmost. Consequently, all the technical procedures after the sectioning had to be operated in a freeze-box in order to prevent the sections from melting.
Besides, the exposure to the film had to be performed also in the freeze-box, although the sensitivity of the film was consequently lowered in the cold circumstances.
In spite of these disadvantages, favourable informations on the distribution of ^99mTc-DTPA were obtained.
The analysis of autoradiograms was done referring the following three items; qualitative analysis, measurement of radioactivity, and computer analysis. Among them, the computer analysis was considered to be one of the objective and reliable methods.
The specific distribution of this tracer to the urinary system was investigated with passage of time and phase, by means of whole-body autoradiography in the rat. In the early phase, comparatively high accumulation of this tracer in the blood, lung, and liver was observed, and their disappearance patterns were also similar. In the kidney, rapid distribution of this tracer to the cortex and also to the pelvis was observed from its early phase. Reaccumulation of this tracer to the cortex was also observed on re-circulation of the blood into the kidney, but its intrarenal transference was observed in a short time. The pattern of sequential intrarenal distribution of this tracer was similar to that of the other GFR substances.
However, clear discrimination between so-called vascular, functional, and excretory phases was hardly made by ^99mTc-DTPA renoscintiphoto.

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The laser light scatterring patterns from cells in urine were measured and analyzed using the light scattering pattern analyzing system developed for this purpose. The system was designed and constructed using a microscope, He-Ne laser, photodiode array, transient recoder, mini-computer and some optics. This novel technique provided with shape and morphological information of cells in urine, which allowed one to perform discrimination among cell type and property. We have analyzed the wide-angle laser scattering patterns of cells in urine from a bladder cancer patient and thus obtained the result which could be used to descriminate malignant cells from benign cells in urine. Therefore, it is to be noted that this method is applicable to the following automated cytology system employing a simple data processing system for the short-time analysis of the wide-angle laser scattering pattern developed in this work.

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Fifty-five patients with tuberculous contracted bladder underwent ileocystoplasty. The operation methods adopted were Scheele's method for 29 cases (including one case reoperated later by Goodwind's method), Goodwin's method (cap-patch or cup-patch method) for 22 cases and other methods for 5 cases.
Pre-and postoperative vesical capacity and the length of ileum isolated for cystoplasty were examined retrospectively. Studies were also done on complication, morbidity and mortality. Electrolytes absorption by isolated ileum and excreted electrolytes volume were examined clinically and experimentally.
The following results were obtained:
1) Thirty-five patients (63.6%) are ascertained to be alive at present. Twelve cases have survived more than 21 years (the longest has passed 29 years) and 28 cases more than 10 years.
2) Ten patients were dead, including 3 cases (5.5%) of operative death, all of which were in the earlier years of our experience.
3) In all the cases who were alive vesical capacity was successfully enlarged postoperatively (200-600ml.) even in cases with severely contracted bladder.
4) Electrolytes absorption (insorption and exsorption according to Code) by the isolated ileal mucosa was confirmed experimentally and clinically.
5) Electrolyte volume excreted in the urine per day did not show much difference from normal control. However, in a few cases with reduced urinary volume some abnormal electrolyte excretion was observed. Since even in cases with poor renal function electrolytes excretion could be regulated by increasing urinary volume, sufficient fluid intake should be instructed to the patients with ileocystoplasty.

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Studies were done on 55 cases of ileocystoplasty for tuberculous contracted bladder. Serum electrolytes, renal function and vesical function were examined on 17 cases of ileocystoplasty by Scheele's method, 14 cases by Goodwin's method and 4 cases by the other methods.
The following results were obtained:
1) Although absorption of electrolytes by the isolated ileal mucosa was observed, serum electrolytes of the patients with normal renal function showed normal values.
2) Despite the absorption of creatinine by the isolated ileum, normal serum creatinine value was maintained in cases with normal renal function. It is presumed that also in cases with ileocystoplasty renal function can be estimated by serum creatinine value.
3) By the pyelogram and the appearance of the dye excretion the intravenous urography was valuable to know the status of renal function besides serum creatinine value.
4) Considered from the vesical function such as urinary frequency, status of micturition, voiding pressure and residual urine, Goodwin's method was superior to Scheele's method.
5) Since patients treated by ileocystoplasty by Scheele's method as well as by Goodwin's method can live uneventful and socially active life for long years, both of these methods can be successfully applied to increase the vesical capacity of the tuberculous contracted bladder.

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A 42-year-old male with renovascular hypertension involving left congenital solitary kidney is reported. The pathophysiology of this case closely resembled that of experimental one. kidney Goldblatt hypertension in the following respects: peripheral renin activity was normal without the treatment to reduce the plasma volume, but it increased and the blood pressure was lowered in response to angiotensin II analogue by means of sodium restriction and administration of furosemide. Renin activity was increased when angiotensin I converting enzyme inhibitor was administered. When renal autotransplantation was performed as a renal revascularization procedure, the blood pressure became normal. It is necessary to correct plasma volume if renin dependence of renovascular hypertension cases involving patient with a solitary kidney is to be proved. Among the available renal artery reconstruction procedures, renal autotransplantation is the method of choice because it provides wide exposure with minimal risk of technical failure or postoperative vascular complications.

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A case of pheochromocytoma (left adrenal and para-aortic pheochromocytoma) recurring 10 years after the first resection of right adrenal pheochromocytoma was reported.
A 22-year-old male was transferred to our hospital due to dyspnea, epistaxis and hypertension (210/160). He had the history of right adrenal pheochromocytoma (28.5g) that had been resected in our hospital, at his age of 12. Gastrojejunostomy was successfully performed due to duodenal stricture owing to ulcerative scar formation 4 years after the first operation. Owing to his high value of urinary catecholamine excretion (norepinephrine; 23, 020μg/day, epinephrine; 7μg/day), recurrent pheochromocytoma was suspected.
Routine laboratory studies revealed a high fasting blood glucose level, high erythrocyte sedimentation rate, leucocytosis, 4+ serum C-reactive protein, and proteinuria. Endocrinological studies showed normal thyroid and adrenal cortical function. Basal metabolic rate (+41.5%) and plasma renin activity (17.3ng/ml/h) were elevated. Computerized tomography showed 2 masses located on the left adrenal gland and in the right renal hilar region. Two tumors (110g, 20g) were successfully resected through the trans-abdominal approach. Both tumors showed the same histological features as the previously resected pheochromocytoma and no vascular invation and/or capscular invasion.
Recurrent benign pheochromocytoma may be defined as follows.
1. It is not metastasis of the tumors.
2. It is not an apparent remnant of synchronous multiple pheochromocytoma.
3. There exists a certain period in which its subjective and/or objective symptoms are free.
In the Japanese literature, 3 such cases including this case which are consistent with the above definition have been reported. All 3 patients are male, under 25 years old. The period of recurrence ranges from 7 to 13 years.
In general, juvenile pheochromocytoma has the tendency of being multiple synchronously and/or metachronously. Considering the fact the number of operated juvenile pheochromocytoma has been increasing in Japan, careful follow-up should be carried out to detect a recurrent pheochromocytoma as early as possible.

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