The initial change with time, which is considered important in the study of the mechanism of acute renal failure, was investigated by using uranyl nitrate (abbreviated as UN in the following) induced acute renal failure model. The change in renal cortical sulfhydryl (SH) group in the initial stage of the disease was investigated with GSH which is considered to protect protein-SH group so that the relation between the change in SH group and the functional and morphological changes might be clarified. The relation between the renal functional and morphological changes as well as the presence of the the protective effect of EDTA in the initial stage of acute renal failure were investigated with EDTA, heavy metal chelating agent. The result is as follows.
1. With UN administration alone, glomerular filtration rate (GFR) and renal tubular sodium reabsorption rate were decreased accompanied with significant decrease in the content of soluble protein-SH group. Pretreatment with GSH significantly checked the decrease in the soluble protein-SH group content. However, GFR was reduced. Since there was no relation between the content of soluble protein-SH group and GFR, SH group might not be responsible for the decrease in GFR induced by UN.
2. Intravenous injection of EDTA immediately after UN administration showed a protective effect against acute renal failure.
3. Swelling of glomerular endothelial cell and decrease in endothelial fenestrae were observed by the morphological study on the following 3 groups: 1) Group in which only UN as administered; 2) Group which had pretreatment with GSH before UN administration; 3) Group which had intravenous injection of EDTA 20 minutes after UN administration. Remarkable and irregular thickening of the inner transparent layer of the glomerular basement membrane due to the deposit of amorphous material and the decrease in GFR were also noted in those groups. On the other hand, the characteristic change found in the glomerular capillary loop was rarely seen in the group which had intravenous injection of EDTA immediately after UN administration, suggesting the protective effect of EDTA against the decrease of GFR.
4. The relation between the functional change and the morphological change may suggest that the characteristic morphological change in the glomerular capillary loop has some relation to the glomerular filtration which may cause the decrease in GFR.

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The relation between the content of cholesterol and phospholipids accumulated in the prostatic tissue with benign hyperplasia, and the volumetric proportion of the glandular component (abbreviation: glandular ratio) and the weight of excised adenoma, were studied by enzymatic method and morphometrical method.
As a result, it was found out that the content of total and free cholesterol in the prostatic tissue with benign hyperplasia were significantly correlated with its glandular ratio. In the view of this result, it has been suggested that the cholesterol accumulated in the prostatic tissue with benign hyperplasia mainly localized in the glandular component and that it increased in proportion to the increase of glandular component. However, the glandular ratio was not found to be correlated with the content of phospholipids.
The content of free cholesterol in the prostatic tissue with benign hyperplasia was significantly correlated with the weight of excised adenoma. However, there was no correlation between the content of total cholesterol and phospholipids in the prostatic tissue with benign hyperplasia, and the weight of the excised adenoma.

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The concentrations of total cholesterol and phospholipids in human prostatic fluid were determined by enzymatic method.
The patients ranged in age from 15 to 79. Total cholesterol concentration in prostatic fluid of 126 males varied between 15.9 and 350.3mg/dl with a mean value and standard error of 130.6±5.9mg/dl. Total cholesterol concentration in prostatic fluid increased in the twenties, reached to its peak in the thirties and forties, and decreased in those over their sixties. There was a tendency that total cholesterol concentration in prostatic fluid in patients with prostatitis was less than that in cases without genitourinary tract infection, particularly in cases in their twenties through forties. Regarding the age group from fifty to seventy, there was no significant difference between total cholesterol concentration in prostatic fluid in patients with benign prostatic hyperplasia and that in cases without benign prostatic hyperplasia. These results suggest that aging and infection inhibit total cholesterol concentration in prostatic fluid.
Phospholipids concentration in prostatic fluid of 112 males ranged from 31.6 to 3181mg/dl with a mean value and standard error of 276.1±49.9mg/dl. Phospholipids concentration in prostatic fluid was the highest in the sixties.

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To elucidate progressive renal damage associated with chronic pyelonephritis, histological examination was performed in 114 operative specimens consisting of renal calculi, hydronephrosis, vesicoureteral reflux and others (nephrectomy or partial nephrectomy) and the following results were obtained.
1) Thirty-three of 105 nephrectomy cases showed successive proteinuria even in postoperative stage. Most of them showed significant glomerular sclerosis in the kidney of the operated side.
2) Periodic acid Schiff (PAS) positive material, supposedly Tamm-Horsfall protein, was found in 64 cases (56.1%). They were found mostly in moderate grade of hydronephrosis and in small numbers in slight or server grade.
3) Numerous round cell infiltration was found around PAS positive material which was not rarely seen escaping into venous and/or lymphatic spaces. This predominant lymphatic reaction strongly suggested immunological nature.
4) From these findings it can be speculated that PAS positive material in interstitium could cause immunologically patholigical changes in the opposite kidney and this might account for the progression of chronic pyelonephritis.

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Liposome is a bilayered phospholipid vesicles, and was originally developed as a model for biomem-branes. Liposome has attracted attention in recent years as a potential carrier of anticancer drugs thereby enhancing the therapeutic effect. This study was designed to clarify the following problems associated with clinical application of liposome in future.
1) The influence of liposome-entrapped anticancer drugs on cytotoxic activity in in vitro system.
2) The effect of liposome-entrapped anticancer drugs in the host tissues.
3) The in vivo therapeutic efficacy of liposome-entrapped bleomycin in the treatment of testicular tumor transplanted in nude mice.
For cytotoxicity test, KU-2 cells, dervived from human renal cell carcinoma were used. Effect of free and liposome-entrapped bleomycin on the growth of KU-2 cells was determined. Enhanced effect was noted in the latter group. Also effect of free and liposome-entrapped bleomycin on the cell cycle traverse of KU-2 cells was determined by means of flow microfluorometry. Obvious effects of G2-block was noted in liposome-entrapped bleomycin.
Therapeutic effect of free and liposome-entrapped bleomycin on the testicular tumor bearing nude mice (KUNU-1) was examined. Antitumor effects of bleomycin was enhanced by entrapment of bleomycin into liposome, mean growth rates of the tumor by administration of free and liposome-entrapped bleomycin at day 5 were 91.1±8% and 76.1±14%, respectively.
Bleomycin, either free or liposome-entrapped, was injected into the peritoneal cavity of KUNU-1 mice in a dose of 5mg. When liposome-entrapped bleomycin was given, increase in the concentration of bleomycin was sixfold in the spleen; threefold in the liver; twofold in the kidney and one and half fold in the lung.
These results indicate that liposome entrapment modified the pharmacokinetics and enhanced the anticancer activity of the drug mediated by slow delivery rather than providing selective cytotoxic effect of the drug to tumors.

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Conti's hypothesis of human penile erection is well known, and penile hemodynamics is explicated by the fine penile anatomy observed by Conti.
Recently it is suggested that there may be some inosistencies in his hypothesis. For the purpose of investigating human penile erection, penile micro-circulation was observed by the Yagi's polarographic method.
As an index of the tissue blood flow changes, measurements of the tissue oxygen tension were made polarographically in the penile skin, the corpus cavernosum and the thigh skin of 16 males aged 20-26 years.
The oxygen cathodes of an enameled copper wire, 300μ in diameter, were implanted in those tissues, and the tissue oxygen tensions were measured as the electric voltage instead of the electric currents flowing through the oxygen cathodes, and the polarographic amplitudes were expressed as the changes in the electric voltage.
At first, the levels of each tissue oxygen tension were measured when the penis was flaccid. The changes in response to inhalation of high oxygen gas mixture were also measured.
Furthermore, penile erection was induced by visual and auditory sexual stimulation.
During all processes of the erection, the changes of the tissue oxygen tension were measured.
The results were as follows;
1. In the flaccid penis, the tissue oxygen tension of the corpus cavernosum was 69±30μv (mean±S. D.) and no changes could be observed in response to the inhalation of high oxygen gas mixture.
2. In the flaccid penis, the tissue oxygen tension of the penile skin and thigh skin were 187±91μv (mean±S. D.) and 210±106μv (mean±S. D.) respectively. In response to inhalation of high oxygen gas mixture those tensions increased up to 410±135μv (mean±S. D.) and 405±206μv (mean±S. D.), respectively.
3. At the onset of erection, the tissue oxygen tension of the corpus cavernosum increased up to 494±218μv (mean±S. D.) and this level is about 7 times as high as that of flaccid penis.
4. When the erection was secured, the tissue oxygen tension of the corpus cavernosum gradulally decreased to 253±106μv (mean S. D.) which was still significantly higher than the flaccid level.
5. In the process of detumesence, the tissue oxygen tension of the corpus cavernosum showed a transient increase to 401±237μv (mean±S. D.). After a while it dropped to the flaccid level.
6. The tissue oxygen tension of the penile skin decreased to 145±105μv (mean±S. D.) from 187±91μv (mean±S. D.) of the flaccid level, and was kept at this level druing all processes of erection. There was no change of the tissue oxygen tension of the thigh and remained at 210±106μv (mean±S. D.) of the flaccid level.
On the basis of these results, the mechanism of the human penile erection was deduced. The increase of arterial inflow to the corpus cavernosum cause the increase in penile volume during the onset of erection. Even though a steady-state of erection is reached, the importance of a continuous high-volume flow for erection has been demonstrated. However, once erection is secured, it can be maintained by a somewhat slower flow. This suggests that the resistance was passively increased following the establishment of erection.
On the other hand, a decrease in blood flow occurs in the penile skin during erection.
The subsidence of penile erection may be caused not only by a decrease inflow to the corpus cavernosum but also by it's contraction.

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We examined retrospectively the histological bladder specimens of one hundred patients who had undergone total cystectomy, in order to estimate the clinical significance of vessel invasion in bladder cancer.
The results were as follows:
1) Of 100 patients, 46 (46%) showed positive vessel invasion, and lymphatic permeation was almost as great as venous invasion.
2) It was obvious that the incidence of vessel invasion was greater in high stage tumor than in low stage one, that is to say, the greater the stage of infiltration, the greater the incidence of vessel involvement. Most vessel invasion was found in relatively close proximity to primary tumor.
3) The vessel invasion was approximately four times as frequent in high grade (grade 3) tumor as in low grade (grade 1 and 2) one. Therefore, it was suggested that malignant tumor cells demonstrating marked cellular atypia had more destructive proliferation against vessels.
4) Pelvic lymph node metastasis was detected in 17 (47.2%) out of 36 patients with positive lymphatic permeation and of 10 patients with only positive vascular invasion, 2 (20%) manifested lymph node involvement. No pelvic lymph node metastasis was observed in patients without lymphatic permeation or vascular invasion.
5) The incidence of lymph node metastasis was 15.4% in the cases of demonstrating lymphatic permeation in the region below the superficaial muscle layer, but was 75% in the region beyond the deep muscle layer. We stress the necessity of postoperative adjuant therapy when lymphatic carcinomatous permeation is identified in the specimens obtained by total cystectomy, even if there is no demonstrable lymph node metastasis in pelvic lymphadenectomy.
6) 32 (69.6%) out of 46 patients with positive vessel invasion died and the main cause of the death was mostly cachexia due to cancer, but of 54 patiwnts without vessel invasion, 15 (27.8%) died mostly of causes other than cancer.
7) Of 21 patients with pelvic lymph node metastasis, 17 (80.9%) died and the mumber of metastasized nodes was 1 to 53 (average of 12). although 4 patients, having 1 to 3 lymph nodes metastasis (average of 1.5) are alive. Therefore, we concluded that the prognosis was very poor if the number of metastasized lymph nodes was beyond a few, despite the pelvic lymph node dissection.

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A study of 56 cases of Klinefelter's syndrome encountered at the Chiba University Hospital in the years 1960-1981 is presented. Eighty per cent of them ranged in age from 25 to 34 years. Two-thirds had chief complaints of sterility. The average ages of their father and mother at their birth were 34.7 and 30.5 years, respectively. Fifty-three cases had a karyotype of 47XXY and two cases had that of 48XXXY.
The karyotype of one case was 46XY/47XXY mosaicism. From their average stature and body weight they had a common constitution of the Japanese males. Thirty per cent of them had gynecomastia. Testicular biopsies were performed in 39 cases, 31 cases of which showed no spermatogenesis and two infant cases had immature spermatogonial cells.
Before treatment, the average blood levels of both luteinizing hormone (LH) and follicle stimulating hormone (FSH) were elevated when compared with those in normal adult males, but the average blood level of testosterone was decreased.
There was no correlation between the blood levels of LH and testosterone. The difference of blood LH, FSH and testosterone levels between the groups with and without gynecomastia was not statistically significant. Human chorionic gonadotropin (hCG 4000 IU) administered im for three days led to a 1, 4-fold increase of blood testosterone level on the average. There were a fivefold increase in blood LH level and a twofold increase in blood FSH level thirty minutes after LH-releasing hormone (LH-RH, 100μg) was administered iv. Blood LH and FSH levels were observed in four cases under androgen replacement by injection of the depot testosterone. In two of these four cases both blood LH and FSH levels were decreased to normal range and the other two remained high.

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A simple method for the preparation of exfoliated cells from the urinary bladder for scanning electron microscopic observation is described. It involves the centrifugation of the specimen directly onto coverslips coated with poly-L-lysine. Exfoliated cells were easily identified and their surface structures well preserved.
Scanning electron microscopic observation of exfoliated cells from the urinary bladder can be easily performed by this method and may be clinically useful in selected circumstances where light microscopic cytologic observation frequently fails.
This method is especially useful for 1) detection of recurrent low-grade, low-stage bladder tumors after surgery or radiation therapy and 2) screening industrial workers who are at high risk for exposure to bladder carcinogens.

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Of 42 families of non obstructive reflux of children, familial occurence of reflux were was in 11 families, (26.5%). The members of documented reflux were 4 fathers (4/24, 16.7%), 3 mothers (3/29, 10.3%), 8 sibships (8/40, 20.0%) and 1 grandaunt. HLA typings were examined on 9 families with familial occurrence but no haplotype in relation to the inheritence of reflux as found.
It was suggested that asymptomatic low grade reflux did not deteriorate renal function.

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A 42 year-old male was hospitalized because of a palpable mass in the left flank. He had repeated episodes of epigastralgia but no history of trauma. Laboratory studies were almost normal, but x-ray studies demonstrated a large cystic mass in the left kidney with diminshed function. A preoperative diagnosis of left solitary renal cyst was made.
Reteroperitoneal exploration disclosed a large cyst, containing about 600ml. of yellow grey fluid, which was compressing the kidney substance markedly. Nephrectomy and excision of the cyst was performed. The specimen of the cyst showed no malignant features but was composed of granulation tissue. The pathological diagnosis was perirenal encysted hematoma.
The pertient literature was reviewed and the cause was discussed.

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