Current methods for measurements of androgen receptors are primarily biochemical. However, the biochemical method requires relatively large amounts of tissue and is hardly applicable to the biopsy specimen. In the present study, we developed an autoradiographic technique for detection of androgen binding and compared this method with the biochemical measurement.
Human prostatic tissues were obtained from patients with benign prostatic hyperplasia and prostatic cancer at the time of operation. Each specimen was divided into two portions; one for autoradiographic analysis, the other for biochemical assay. For autoradiographic study, frozen tissue sections were incubated in PBS containing ³H-R1881 (Synthetic androgen) and processed for microautoradiography.
The results showed that silver grains were mainly localized in the epithelium of the prostate. The number of grains was significantly decreased by addition of excess unlabelled R1881. A grain density of the epithelium was determined by counting the grain number within the unit area. This value was compared with the concentration of R1881 binding sites obtained from the biochemical assay. Statistical analysis showed a significant correlation between the two assay systems (r=0.946, p<0.01).
These results indicate that the autoradiographic technique is a useful method to determine the androgen binding sites in prostatic tissue.

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Cytosolic and nuclear androgen receptors were measured in external genital skin tissues with various maldevelopment, such as hypospadias, buried penis, cryptorchism, in order to evaluate the androgen responsiveness of skin tissues in these disease.
Cytosol and nuclear extract were prepared from foreskin and scrotal skin tissues biopsied at the time of operation, and androgen receptor was assayed using methyltrienolone (R-1881) as the ligand. The results were summarized as follows.
Both cytosolic and nuclear androgen receptor contents measured in normal foreskin and scrotal skin were revealed to be age dependent. Furthermore, the results of receptor assay studied in enlarged clitoral tissues with congenital adrenal hyperplasia and in scrotal skin tissues with primary or secondary hypogonadotropic hypogonadism indicated that androgen receptor content was affected by endogeneous androgen levels in its target organ tissues.
In the study of cytosolic and nuclear androgen receptors of genital skin tissues, the mean value of nuclear receptors was lower (p<0.05) in patients with buried penis, hypospadia than in normal subjects, although no significant difference was observed with cytosolic receptors.
It is suggested that one of possible causes for maldevelopment of external genitalis is reduced nuclear androgen receptor levels in target tissues.

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1. A bladder cancer was experimentally induced by oral administration of 0.025% BBN to rats. The rosette-forming rate with guinea pig erythrocytes in the thymus lymphocyte group was observed at specific time intervals before tumor formation until carcinogenation, and the in vitro effect of the liquid factor, extracted from calf thymus (cTHF) was studied. Furthermore, cTHF was divided into 14 subfractions by high-speed liquid chromatography equipped with a gel filtration column, and the biological activities of the subfractions (in the differentiation system of T precursor cell into T cell, acquisition of the rosette-forming ability was used as the index) were studied comparatively.
2. The formation rate of rosette-forming cells by bonding of the thymus lymphocyte group and guinea pig erythrocytes showed a decreasing tendency from about 8 weeks after BBN administration and an obvious decrease in the test group from about 12 weeks. In the control group, on the other hand, no marked decreasing tendency in the rosette-forming rate was observed during the observation period.
3. When the thymus lymphocyte group in the BBN group was pretreated with cTHF in vitro, the lowered rosett-forming rate began to elevate, while almost no change was noted in the control group.
4. Of the 14 subfractions isolated from cTHF by high-speed liquid chromatography, the addition of the 9th and 13th subfractions was more effective in restoring the rosette-forming rate than the addition of cTHF.

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Six cases of full thickness skin graft urethroplasty are reported. The results appeared to be good in four cases of patch graft and one case of tube graft. The sixth tube graft was fair. This method is not popular in Japan, but considered a very effective method of urethroplasty.
One case of pendulous urethral stricutre (8cm long) was treated successfully by tube graft. This lesion was induced by transdermal injection of a foreign body by the patient.

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Clinical statistical analysis was made of urological operations performed on 82 elderly patients during last 8 years. The analysis comprised:
1. In 49% of the cases bladder cancer was found to be the most frequent primary lesions. ECG showed abnormal findings in 31% of the cases. Spirometry showed abnormlities in 49%. The incidence of abnomal levels of serum creatinin, BUN and creatinin clearance were 46%, 59% and 84%, respectively. The incidence of the abnormal level of serum protein was 32% and that of the abnormal level of hemoglobin 51%. The most common preoperative complication was presbyacusis (41%), followed by hypertention (23%) and diabetes mellitus (23%).
2. The most frequently performed surgical operation was TUR-Bt (22% of the cases). Lumber spinal block was the most frequently used anesthesia (63%). General anesthesia was administered in only 3% of the cases. The average operating time was 144 minutes. The average volumes of blood loss and blood transfusion were 289ml and 270ml, respectively.
3. In the case of postoperative complications, wound infection ocurred in 31% of the cases (the highest). This was followed by disturbances of cardiac function ocurring in 23% of the cases.

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During the past 20 years' period, 35 cases with posterior urethral stenosis following pelvic fracture got surgical repair at the St. Marianna University School of Medicine. The surgical methods were pull-through method in 30 cases and Michalowski method in 5 cases.
We noted postoperative incontinence in 2 cases (5.7%) which was attributable to previous surgery at other hospitals. Another one case had incontinence due to trauma itself.
As Turner-Warwick has stressed, although the external sphincter muscle is damaged at the time of posterior urethral injury, the internal sphincter muscle is well preserved.
In order to protect internal sphincteric function, immediate reconstruction of the posterior urethra after trauma especially by the interlocking method should be avoided and temporary cystostomy is recommended. Cystography at rest through a cystostomy tube before final reconstructive surgery can confirm patency of the internal sphincter muslce.
Urinary incontinence after surgery can be avoided by careful dissection of the scar, leaving soft healthy tissue.

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From 1979 to 1984, 163 traumatic spinal cord or caudal injury patients in the acute phase and 89 patients in the recovery or stable phase were managed in our Center. It was designated that the former was study group and the latter was control group. There were 138 male and 25 female patients with a mean age of 43 years in the study group and 76 male and 13 female patients with a mean age of 38 years in the control group.
Incidence and degree of urinary tract complications were compared between these two groups for different follow up periods. The incidence of high grade urinary tract complications was 7 out of 114 cases (6%) in the study group against 8 out of 38 cases (21%) in the control group which were followed up for an average period of 0.9 year, and was 1 out of 49 cases (2%) in the study group against 12 out of 51 cases (24%) in the control group followed up for an average period of 3.3-3.4 years. There was a statistical difference between the two groups (p<0.01).
The number of patients using intermittent catheterization was more and that of patient using indwelling catheter was less in the study group than in the control group. There was a tendency that the study group had less high-grade complications with any methods of urination.
There was also a statistical significance in the incidence of urinary tract complications such as renal or vesical stones, urethral stenosis, urethral diverticulum, and autonomic dysreflexia between the two groups, 11 out of 163 cases (7%) in the study group and 29 out of 89 cases (33%) in the control group.
This analysis confirms that the urinary tract managements of the study group is superior to those of the control group for traumatic spinal or caudal injury patients.

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It has been reported that γ-GTP activity is present in high levels in human semen.
In this article γ-GTP activity of the semen in 63 present cases, including idiopathic infertility 43, varicocele 5, post-vesectomy patients 3, idiopathic spermatocele 1, congenital absence of the ductus deferens and the seminal vesicles 1, idiopathic dilatation of the seminal vesicles 1 and normal control cases 9, and of the fluid obtained by means of puncturing from the spermatocele and from the dilatated seminal vesicles were measured in order to clarify differences of levels of γ-GTP activity in various diseases and the surces of γ-GTP in human semen. It was showed that γ-GTP activity in the semen of the patients diagnosed as idiopathic infertility were 12, 509±7, 120 (M±SD)mIU/ml (N=43), azoospermia 11, 578±2, 844 (N=5), varicocele 12, 044±2, 282 (N=5), post-vasectomy patients 12, 656±7, 118 (N=3) and normal cases 13, 216±3, 549 (N=9).
There were no significant differences among γ-GTP activity in the semen of the various diseases mentioned above. The γ-GTP activity in male infertility was neither related with sperm numbers nor sperm motility in the semen examined. It was proved that the sources of γ-GTP activity in human semen were not from the testis, epididymis and sperm, but the prostate and/or the seminal vesicles because γ-GTP activity did not decrease by vasectomy and the activity in the fluid of the idiopathic spermatocele were very low (514, 34 and 59mIU/ml).
On the other hand γ-GTP activity in the ejaculated semen of the patient diagnosed as congenital absence of the ductus deferens and the seminal vesicles was 47, 320mIU/ml, and the activity in the ejaculated semen and the fluid of the dilatated seminal vesicles of the patient diagnosed as idiopathic dilatation of the seminal vesicles were 19, 540 and 4, 450mIU/ml.
And so it was suggested that γ-GTP activity in human semen mainly originated from the prostate and partially from the seminal vesicles.

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Indomethacin is known to be an inhibitor of prostaglandin biosynthesis. The role of prostaglandins on the renal cortical blood flow and the urinary sodium excretion in each of the clipped ischemic kidney and unclipped contralateral kidney was studied by administration of indomethacin using the models of two-kidney Goldblatt hypertensive rabbits (2k-GH rabbits).
Male Japanese white rabbits weighing 2.5-3.5kg were used in this study. 2k-GH rabbits with elevation of mean arterial blood pressure (30±9mmHg) were examined under pentobarbital anesthesia 4 weeks after left renal artery clipping. In 2k-GH rabbits (N=8), indomethacin was administrated with priming intravenous injection of 9mg/kg, followed by a constant infusion at 1mg/kg/hr. In 2k-GH rabbits (N=7), diluent without indomethacin was injected as a control study. Renal cortical blood flow was measured at the inner cortex by a thermscouple method before and after indomethacin injection. Urinary sodium excretion (U_NaV), para-aminohippurate clearance (C_PAH) and creatinine clearance (C_cr) were calculated from split renal urine collected for 40 minutes before and after indomethacin administration.
The blood flow of the inner cortex decreased in both the clipped and the contralateral unclipped kidney after indomethacin injection, but recovery of blood flow was observed in the ischemic kidney earlier than in the contralateral kidney. There was no significant change in arterial blood pressure after indomethacin injection. A significant decrease (p<0.02) in total urinary sodium excretion was observed from 309±302μEq/40min to 77±111μEq/40min in the contralateral unclipped kidney after indomethacin injection, while no significant changes were observed in the clipped ischemic kidney. The total urine volume (UV), C_PAH and C_cr decreased significantly from 5.40±5.37ml/40min to 1.68±2.16ml/40min (p<0.02), from 11.1±4.4ml/min to 4.7±4.2ml/min (p<0.01) and from 1.8±0.8ml/min to 0.5±0.4ml/min (p<0.01), respectively, in the contralateral unclipped kidney, while no significant changes were observed in the clipped ischemic kidney. A good correlation was observed between the rate of reduction of total U_NaV and that of C_PAH in the unclipped contralateral kidney (r=0.83, p<0.02).
These results suggest that prostaglandins play a role in keeping the blood flow of the inner cortex in both the clipped ischemic kidney and the unclipped contralateral kidney of 2k-GH rabbits. Prostaglandins are speculated to play a role in the exaggerated sodium excretion from the unclipped contralateral kidney, acting as an antihypertensive substance protecting against the sodium retention, while prostaglandins have little effects on natriutesis in the clipped ischemic kidney in 2k-GH rabbits.

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A fundamental study on lymphocyte electrophoresis was performed with the purpose to apply it as an immunological monitoring in renal transplant recipients. Electrophoretic mobility of lymphocytes from healthy individuals and patients on hemodialysis or after renal transplantation was analyzed by means of a fully automated cell electrophoresis apparatus (Parmoquant). Electrophoretic mobility histograms of lymphocytes from normal individuals showed two distinct peaks. The faster peak consisted mainly of nylon-wool non-adherent cells and the slower peak consisted mainly of nylon-wool adherent cells. OKT4 and OKT8 positive cells showed almost the same electrophoretic mobility in the faster peak. In vitro incubation of lymphocytes with cyclosporine or methyl-prednisolone, or radiation showed little influence on lymphocyte electrophoretic mobility. However, a remarkable slowing of electrophoretic mobility of lymphocytes was observed after in vivo administration of methyl-prednisolon.
Although electrophoretic mobility of lymphocytes had a close correlation with T and B subpopulation, a discrepancy between them was often demonstrated. The discrepancy was related to appearance of low mobility T cells. Some pathological immune status can be detected as an alteration of electronic charge of lymphocyte. The lymphocyte electrophoretic mobility test may be useful for immunological monitoring in renal transplant recipients.

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Lymphocyte electrohoretic mobility test and lymphocyte subset analysis were performed for immunological subset analysis were performed for immunological monitoring in renal transplant recipients. In an early post-transplant period, a decrease of fast moving cells accompanied by a significant increase of low mobility T cells (LMT) was observed. In patients with stable graft function long after transplantation, electrophoretic mobility of lymphocytes (MOB) increased and LMT level was slightly higher than in control. In these patients, a significant increase of OKT11 positive cell population accompanied by a significant increase of OKT8 positive cell population and a significant decrease of B1 positive cell population were observed.
Sudden increase of MOB and sudden decrease of LMT were closely related to a typical acute rejection. On the contrary, there was no characteristic change of OKT4/OKT8 ratio.
It is concluded from these data that lymphocyte electrophoretic mobility test offers an immunological basis for judgement of immune status or diagnosis of rejection, and serial determination of lymphocyte electrophretic mobility and lymphocyte subset analysis are useful as immunological monitoring in renal transplant recipients.

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From June, 1982, through April, 1985, seventeen patients undergoing radical cystectomy with pelvic lymphadenectomy in pathologic stage PT3, PT4 and/or with N+ disease, received adjuvant chemotherapy consisted of CDDP or its combination. Nine other patients with high grade malignancy (grade 3) were also treated with adjuvant prophylactic chemotherapy following cystectomy.
Of the 17 patients of invasive bladder cancer, 14 were alive with no evidence of disease for an average of 16 months and one patient was alive with recurrence for 20 months. The remaining 2 patients survived for 7 and 10 months, respectively, and died of cancer progression. Tumor free survival rate at 33 months was 84%.
Of the 9 patients with high grade malignancy 8 were alive with no evidence of disease for an average of 11 months. One patients died of cancer progression at 15 months after cystectomy. Survival rate at 25 months was 67%.
Nausea and vomiting occurred in most patients during administration of CDDP. Mild myelosup-pression occurred in a few patients who received combined chemotherapy. No nephrotoxicity and ototoxicity were observed.
Although adjuvant prophylactic chemotherapy after cystectomy for invasive bladder cancer seemed effective in this study, the longer follow-up will be necessary to conclude if the observed high survival rate indicates real lasting benefits for these patients.

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Total cystectomy (TCX) with urinary diversion is adopted in a current therapy for invasive bladder cancer, despite its inevitable disadvantage to patient's performans status. An adjuvant may preserve the bladder function of patients with invasive tumors. In this respect, we reviewed 29 patients with T2-3 bladder cancer treated with either transurethral resection (TUR) or partial cystectomy (PCX): 14 patients (12 in T2 and 2 in T3 tumor) received no preoperative adjuvant (control-group) and the remaining 15 (6 in T2 and 9 in T3) received preoperative arterial chemoembolization with microencapsulated mitomycin C, peplomycin and/or cisplatin (MC-group).
The patients in MC-group well tolerated the microcapule therapy without any severe side effect. Substantial tumor reduction greater than 50% was seen in 11 of 14 measurable patients, facilitating the organ-preserving operations.
Twelve TURs and 2 PCXs were employed as an initial operation in control-group, and 12 TURs and 3 PCXs in MC-group.
Actuarial disease-free survival probabilities at 1 and 3 years after operation were 35.7 and 19.0%, respectively, in control-group, while these were 64.5 and 64.5% in MC-group. For 11 patients with recurrence in control-group, 4 TCXs, 4 TURs and 2 PCXs were indicated. For 5 patients with recurrence in MC-group, 2 TCXs and 3 TURs were done. Six patients in control-group died of cancer, but none in MC-group. Three-year survival probability was estimated as 66.1% in control-group and 100% in MC-group. Statistically significant differencies (p<0.05, Cox-Mantel test) in both tumor recurrence and survival were found between control- and MC-groups.
The results indicate that the microcapsule therapy is an effective adjuvant in extending the indication of organ-preserving operations in the treatment of invasive bladder cancer.

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Blood group substances of bladder tissues were investigated in 194 tissue specimens obtained from 47 patients with transitional cell carcinoma of the bladder. The antigenicity was assessed by the specific red cell adherence (SRCA) test. Over-all SRCA reaction in an individual case was evaluated as positive, intermediate or negative based on the SRCA findings of all specimens containing the tumor or the non-tumorous epithelium.
In 33 cases (70%), all of the tumor specimens showed an SRCA reaction consistent with the over-all SRCA estimation in individual cases. But, in the remaining 14 cases (30%), SRCA reactions of individual tumor specimens revealed partial inconsistency with the over-all SRCA estimation, indicating multiformity of malignant potential of tumors.
Of 29 cases with stages Ta-T1 tumors, 10-year survival rate of the esitmated over-all SRCA-positive group was 91%, while that of the SRCA-intermediate and -negative group was 57%. As to the over-all SRCA estimation of the non-tumorous epithelium, 10-year survival rate of the SRCA-positive group was 88%, while that of SRCA-intermediate and -negative group was 39%.
Of 23 cases who underwent organ-preserving operation for Ta-T1 tumors, 5-year recurrence rate of the estimated tumor SRCA-positive group was 20%, while that of the SRCA-intermediate and -negative group was 44%. Furthermore, 5-year-recurrence rate of the non-tumor SRCA-positive group was 28%, while that of the non-tumor SRCA-intermediate and -negative group was 43%.
Our observation indicates the prognostic significance of the antigenicity of non-malignant epithelium, in association with that of tumor tissue, in the tumor-bearing bladder.

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To clearize the limitation and the refractory mechanism during endocrine therapy for prostatic cancer patient, retrospective correlative analysis of histological grading with prognosis were studied. The pathological spacimens were reviewed by Gleason's grading system on repeatedly biopsied and TUR materials in consecutively followed sixty nine patients initially consulted in 1974-1980.
1) By Gleason's predominant pattern, actural five-year survival rate was 55.6% for pattern I, II., 56.5% for pattern III, 32.7% for pattern IV, and 27.7% for pattern V, in needle biopsied spacimens before treatment.
2) Histological comparison between initial biopsied and re-biopsied or TUR-P spacimen during endocrine therapy showed grade up in eleven of thirty-five (31.4%) in stage C and fourteen of thirty-eight (36.8%) in stage D cases. In addition, no grade change was revealed in fourteen of thirth-five (40%) of stage C and twenty-two of thirty-eight (357.8%) in stage D.
3) In refractory and/or dead cases of initially clinical stage B to D patients, 25 of 60 cases (41.6%) revealed grade-up. In addition, 24 of 54 cases (44.4%) of stage C and D patients including five cases of Gleason score 10 was found no change of grading figure.
Getting together, in our study, consideration of tumor grade by Gleason system provided a more accurate prediction of prognosis. These results corroborate that re-evaluation of histological grade by repeat biopsy during endocrine therapy for prostatic cancer patient is more helpful to make determination of the therapeutic alteration positively.

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It has been reported that there is big difference in response to isoproterenol between in vitro muscle strip and in vivo whole body. In order to resolve this problem, we have examined the difference in doseresponse, time-course and stretch-response to isoproterenol between the body and base of rabbit bladder.
We obtained the results that there was no qualitative difference in dose-response and time-course between these two regions and that stretching of the strips did not alter the effect of isoproterenol significantly. By these results, we can not explain the discrepancy of the potency between whole bladder and muscle strip. However, we have obtained the interesting result that the strips could be classified into stable and unstable, and stable strips responded to isoproterenol poorly, whereas unstable ones responded very strongly.
From this result, the difference in potency between whole bladder and muscle strip may be adequately explained: The potency and magnitude of the effect of isoproterenol on the urinary bladder is poor itself, as obtained in vivo and in vitro with whole bladder and stable muscle strips. However, in muscle strip study, the strips easily become unstable and the unstable strips respond to isoproterenol strongly.

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The contractile responses to dobutamine, a beta one adrenoceptor agonist and terbutaline, a beta two adrenoceptor agonist, were examined by measurement of the isometric force in rabbit pelviureteral smooth muscle strips. Dobutamine caused an increase of contractile force in the renal pelvic strip in the presence of phentolamine, an alpha adrenoceptor blocking agent, and a slight decrease in the ureteral strip. Terbutaline caused a decrease of contractile force in renal pelvic and ureteral strips. The responses of pelviureteral strips to dobutamine or terbutaline were inhibited by propranolol, a beta adrenoceptor blocking agent.
These results seem to suggest that beta one adrenoceptors which cause a contraction exist mainly in the renal pelvis and that beta two adrenoceptors which cause a relaxation exist in both the renal pelvis and the ureter.

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102 cases of renal pelvic and ureteral tumors treated at Osaka University Hospital between 1957 and 1984, were reviewed retrospectively. They consisted of 44 renal pelvic tumors, 37 ureteral tumors and 21 renal pelvic and ureteral tumors. The incidence of these tumors was 0.16% among all new out-patients. Patients ranged in age from 38 to 81 years old (average: 59.6). There were 82 males and 20 females, the ratio being 4.1:1.0. The involved side was left in 48 and right in 51. Three cases were bilateral. The most frequent symptom was macrohematuria, which was seen in 79 cases (77.5%). The major finding of IVP was non-visualizing kidney, which was seen in 52 cases (51.0%). Positive urinary cytology was obtained in 34 cases (54.0%). As the surgical method, total nephroureterectomy with bladder cuff was performed in 72 cases (72.0%), nephroureterectomy and total cystectomy in 4, nephroureterectomy in 10, nephrectomy in 11 and distal ureterectomy with ureterocystoneostomy in one case. Histologically, 97 were with transitional cell carcinoma and 5 were with squamous cell carcinoma. Simultaneous urothelial tumors were seen in the bladder of 12 patients. Subsequent bladder tumors were found in 27 cases in the follow-up period. Over-all survival rates (Kaplan-Meier) at 1, 3, 5 and 10 years were 70.8%, 45.1%, 39.0% and 30.6%, respectively.

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We found three families with 2, 8-dihydroxyadenine urolithiasis. One of the families had three patients among the siblings and each of the other two families had one patient. Family studies have suggested that the disease is inherited as an autosomal recessive fashion in all the families. Patients of two of the families were completely deficient in adenine phosphoribosyltransferase (APRT) activities both in hemolysates and in T-cell extracts, while three sibling patients of the other family were only partially deficient in the enzyme activities. Previous reports about this disease indicated that all the patients in Caucacians were of the former type (complete deficiency), while more than half of the patients in Japan were of the latter type (partical deficiency). Our present studies indicate that some Japanese families with 2, 8-dihydroxyadenine lithiasis are really only partially deficient in the enzyme activities and that both types of the disease are inherited as an autosomal recessive manner.

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