A study of the dynamic renal function in rabbits using MRI by Gd-DTPA was performed. T1 of rabbit kidney, which had been operated (complete unilateral ureteral occlusion or incomplete unilateral occulusion of the renal artery) was calculated before and after intravenous injection of 0.05mmol/kg of Gd-DTPA, continuously for 90 minutes. All images were obtained by the 0.1 Tesla resistive type MRI.
The changes of 1/T1 of cortex and medulla of both kidneys were plotted (MRI renography).
T1 of renal cortex was shorter than that of renal medulla in normal kidney by plain T1 image, and T1 of both parts of the kidney was elongated day after day in unilateral hydronephrotis without contrast media. The peak was marked 2 minutes after injection of Gd-DTPA and the half-life of the excretory phase was 30 minute in the cortex and 40 minute in the medulla in normal MRI renography.
The operated site was higher than the opposite-site in the change of 1/T1 (the peak value—the value before administration) immediately after operation, but after 24 hours the operated site was lower, in hydronephrotic rabbits. The renal parenchymal damage due to ureteral obstruction was accurately and sensitively detected. In renal arterial stenosis, the change of 1/T1 was minimal in the operated-site because of the reduction of excretion of contrast media due to decrease of GFR.
It was concluded that MRI renography was able to detect regional dynamic renal function and it was expected that calculation of ERBF, GFR and tubular excretory function was quantitively examined by mathematical analysis.

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Immunohistochemical technique using anti-bromodeoxyuridine (BrdUrd) monoclonal antibody allowed a rapid demonstration of cellular proliferative activity in bladder tumors. The incorporation of the thymidine analogue, BrdUrd into DNA was performed in vitro labeling technique. The percentage of S phase fraction cells was expressed as labeling index (L. I.).
The discrimination between BrdUrd labeled and unlabeled cells was easy because of the abscence of background staining. The distribution of BrdUrd incorporated cells was relatively uniform in bladder tumors. However, there was some variation of L. I. that depends on the histological site within the same tumor. L. I. of bladder tumors was higher than that of normal bladder.
Although further studies are required, we suppose that this method could bring a new light for the study of cell kinetics in bladder tumors.

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The influence of dilatation and incision to vesicoureteral junction in rabbits was studied radiologically and histopathologically. Each 12 Japanese white rabbits were submitted to one of the following procedures to the left ureteral orifice.
1) Dilatation up to 10F
2) Dilatation up to 7F
3) Incision of submucosal ureter
As for the radiological examination, cystography and IVU were performed on the 1st and 3rd days and in the 1st, 2nd, 4th and 8th weeks after operation. In the radiological examination, VUR was observed in 8 of 12 amimals in 10F dilatation group. Dilatation of the upper urinary tract was seen in 10 animals including 4 without VUR. No VUR was observed in the 7F dilatation group and incision group.
As for the histopathological examination, the bladder and ureter were excised after radiological examination. In the 10F dilatation group, damage and fibrosis of intramural ureteral muscle layers were observed, which might be due to laceration of the ureteral wall by excessive dilatation. Furthermore, the area of muscle layers in a cross section of the intramural ureter was significantly decrased in the 10F dilatation group compared with control (p<0.01). In the 7F dilatation group and incision group, histopathological change of the interamural ureter were insignificant.
Comparing the human ureter with the rabbit ureter, 7F dilatation in the rabbit is comparable to 16F dilatation in humans which is the maximum size dilatation in ordinary cases of dilatation of the ureteral orifice. While, 10F dilatation in rabbits is comparable to the extraordinarily huge 24F dilatation in humans.
In conclusion, it is suggested, from the present experiment using rabbits, that the usual procedure of dilatation and incision to the vesicoureteral junction in humans seems to have insignificant influence on the urinary tract.

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In previous papers, we reported that prolonged bladder overdistension resulted in nerve degeneration in the bladder wall in dogs. These results implicated that the nerve degeneration might be due to a decrease in blood supply to the bladder wall.
To clarify the relationship between the nerve degeneration and ischemic condition of the bladder, the present study was carried out. Ischemia was achieved by bilateral ligation of the caudal vesical arteries and veins. Using a hydrogen gas clearance method, the decrease rate in blood flow was 78% immediately after ligation. Degeneration of the cholinergic axons and changes in the Schwann cells were electromicroscopically observed on the 3rd day after ligation to some extent. One or 2 weeks after ligation, the degeneration was prominent in approximately 50% of the cholinergic axons. The contractibility of the detrusor muscle with acetylcholine was measured using an isometric in vitro technique. The contraction response level was significantly elevated one week after ligation, subsequently decreasing to a lower level 4 weeks after ligation. Light microscopic studies using Masson's trichrome staining, revealed a marked connective tissue proliferation between muscle bundles in the bladder 4 weeks after ligation.
These findings suggest that a decrease in the blood supply to the bladder may lead to degeneration of the cholinergic axons and subsequent supersensitivity of the detrusor muscle to acetylcholine. In addition, prolonged bladder overdistension caused by lower urinary tract obstructions may also develop nerve degeneration through a decrease in blood supply to the bladder.

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This study was undertaken to determine the effects of unilateral ureteral obstruction on the renal tissue levels of adenine nucleotides in order to elucidate the mechanisms underlying the hydronephrosis and how such changes may be recovered after relief of obstruction.
Ureteral obstruciton with hydronephrosis was produced by ligation of a unilateral ureter in Wistar rats. Before and at 6 months after the operation, measurement of adenine nucleotides (ATP, ADP and AMP) was performed according to the method of Nagata and Rusmussen. Calculation of energy charge was made by Atkinson's formula. The levels of inorganic phosphate (Pi) and its specific activity (S. A.) were calculated from ³²P-orthophosphate incorporation. The same procedures were adopted after complete relief of ureteral obstruction lasting for 1, 2, 3, 4, 5 and 6 months. Shamoperated controls were also observed.
The results revealed that the level of ATP sharply decreased to about 60% of normal one month after ureteral ligation with a further decline continuing up to 6 months. ADP and AMP showed a mild decrease. Cell Pi and its S. A. increasd during these periods. Recovery of the nucleotides after relief of ligation was prominent in the group with 1 and 2 months' ligation. A longer period of ligation, however, prevent the nucleotides from reaching the former levels. The levels of energy charge during the periods of ureterla obstruction and its relief did not show any significant change.
These results suggest that, there is positive relationship between the progress of hydronephrosis and decrease of ATP, and after ureteral obstruction in excess 3 months, complete recovery of ATP-generating system could not take place. This probably reflected irreversible chnages in the energyreguiring system of kidney.

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The effects of hydrostatic pressure in the renal excretory system on adenine nucleotides and inorganic phosphate were investigated in human hydronephrotic kidneys. Specimens were obtained surgically. Measurement of adenine nucleotides was performed according to the methods of Hurlbert and Potter. From this measurement, Atkinson's energy charge was calculated. Martin-Doity's methods was employed to measure the inorganic phosphate in the hydronephrotic kidneys. Surgically obtained specimens were incubated in vitro with radioactive phosphate tracer (³²P) to investigate the turnover of phosphates. Then degree of hydronephrosis was determined by Oka's criteria.
The results revealed that the contents of renal tissue adenine nucleotide (ATP) in degrees C and D hydronephrosis decreased to 70% and 60% of normal, respectively. Inorganic phosphate contents also decreased. However, there were no great differences in energy charges between C and D hydronephrosis, and no significant differences between these groups and the control. Turnover rates of radioactive phosphates (³²P) in adenine nucleotides and onorganic phosphates showed a marked decrease.
From the above observations, the levels of energy charge in hydronephrotic kidneys did not show any significant change, but it was suggested that urinary obstruction, causing hydronephrosis, leads to significant impairment of renal adenylate and phosphate metabolism in humans.

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Five cases of papillary adenocarcinomas of the prostate were studied for the clinical features, histologic characteristics and immunohistochemical nature of prostatic specific antigen, and one case of them was studied by electron microscopy.
Our results, as well as those presented previously, demonstrate the prostatic origin of this tumor, and these lesions should be called “Prostatic ductal adenocarcinoma with endometrioid features”. In accordance with the observations of other authors, antiandrogen therapy for these patients was considered justifiable.

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Flow cytometric analysis of nuclear DNA contents was made using frozen tissue speciens obtained from low grade (grade 1, 2) renal cell carcinomas, they were compared with the morphologic grades. DNA histograms were evaluated by DNA index (DI) and per cent proliferative compartment (%PC). Aneuploid DNA histograms were found in 9 of 22 specimens (41%). Of which 6 specimens showed aneuploid cell clones in near triploid region, the others showed tetraploid peak. Aneuploid DNA patterns were demonstrated in 2 of 7 grade 1 tumors (29%) and 7 of 15 grade 2 tumors (47%), but the difference was not statistically significant. The %PC of grade 2 tumors was significantly greater than that of normal renal parenchyma (p<0.05). However, no difference in the %PC or DI was found between the grade 1 and grade 2 tumors. The results showed that abnormal DNA histograms were frequently found in low grade renal cell carcinomas, but these changes did not show any correlation to morphologic grading.

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Carcinoembryonic antigen (CEA) on the tissues of bladder cancer in 66 cases was detected using the recently elaborated immunogold-silver staning method and urinary CEA levels in some of the cases were measured by radioimmunoassay.
In immunogold-silver stained sections, CEA-positive tumor cells were detected in 33 (53.2%) of 62 transitional cell carcinomas (TCC), all of 3 adenocarcinomas, and in an undifferentiated carcinoma. These values of frequency were higher than the analogous values reported by the majority of previous authors, probably due to the high sensitivity of the technique used in the present study. In the first mentioned carcinomas (TCC), CEA-reactivity in the tumor tissues were correlated significantly with the histological grade (p<0.02) and pathological stage (p<0.01). From these result, positive CEA reaction in the tumor tissues seems to be a parameter for the malignant potential of tumors. On the contrary, there was no significant correlation between CEA-reactivity in the tumor tissues and tumor recurrence after TUR operation in 23 cases.
Urinay CEA levels of midstream specimens were measured in 19 cases of bladder cancer and in 16 healthy controls. The specimens were centrifugated at 3000rpm for 6 minutes in order to exclude the possibility of contamination, and stored at -20°C until assay.
Urinary CEA levels of healthy controls were significantly higher in females than in males (p<0.001). In male patients with bladder cancer, urinary CEA levels were significantly elevated as compared with the levels in male controls (p<0.02). However, this was not significant in females. Further, no correlation could be established between urinary CEA levels and the immunohistological CEA reactivity.
This immunogold-silver staining method, including an improved procedure of physical development, is easier to perform and more clear-cut than the immunoperoxidase method. Therefore, it will be applicable to detect various tumor markers.

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During the past 21 years, we have repaired 36 cases of posterior urethral stricuture following traumatic pelvic fracture. The Michalowski method was applied to 6 cases with follow up observation period of 1 to 21 years (average 8.8 years).
As for complications, 2 cases of impotency and 3 cases of ejaculatory disturbance were noted. However, neither restenosis nor urinary incontinence occurred and postoperative voiding status was satisfactory in every case.
Posterior urethral defect more than 5cm long, stenosis extending from the membranous to the bulbous urethra and immobilished anterior urethra are the indications of this Michalowski method.
The Key points of this method are as follows: (1) X-type skin incision is recommended when the operative method is not decided before surgery. (2) 26F Foley catheter for adults and 22F for children are indwelt in the perineal fistula. (3) Distal urethral anastomosis should be done cautiously with less reactive suture material. (4) The skin tube as anterior urethra ahould be burned deep enough and straight.
A representative case with 7cm urethral defect treated successfully by this Michalowski method is reported.

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A survey concerning main evening meal intake was made in 80 male patients with urolithiasis, and calcium concentrations excreted in their first morning spot urines were measured.
Over 40% of the total daily intake of nutrients was ingested at this meal, as was the highest ratio of animal protein (54.1%). Increased intake at this meal was not significantly related to intake at breakfast and lunch.
Calcuim excretion in the first morning spot urine correlated with evening meal intake of calcium (p<0.01) and total protein (p<0.05). There was no significant difference in urinary calcium concentrations between the 80 male stone formers and the 44 controls; but subjects with high calcium concentrations (>15mg/dl) were observed in 60% of the patients and 50% of the controls. However, calcium excretion in the stone formers was significantly higher than in the controls (p<0.01).
These results suggest that it is desirable to reduce urinary calcium concentrations during sleep, since this seems to be one of the most effective means of preventing urolithiasis.
Recommendations for effecting these aims are as follows.
a) Total dietary intake should be divided equally into three meals, and a large evening meal should be avoided.
b) Intake of calcium-rich food at this meal should also be avoided.
c) High fluid intake after the evening meal is recommended.
d) The interval between dining and going to bed should be as long as possible.

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As C. trachomatis has emerged as one of the major causative organisms of nongonococcal urethritis (NGU) and related infections, there has been an increasing need for refined diagnostic procedures. Since December 1984, we have survayed 281 male outpatients with and without urogenital infections (UGI). Chlamydial organisms were examined by the direct immunofluorescence antibody technique (DIF) using the MicroTrak and the isolation in cell cultures, and antibodies were assayed by means of the microplate immunofluorescence antibody technique (MFA) using L₂/434/Bu as antigen.
The reuslts are summarized as follows:
1) The organisms were detected in 53 of 148 patienys with UGI (35.6%), 5 of 25 patients with gonococcal urethritis (GU) (20.0%), 43 of 90 patients with NGU (47.3%), 2 of 21 patients with prostatitis (9.5%) and 3 of 9 patients with epididymitis (33.3%) by DIF. The organisms were isolated from 49 out of 145 male patients with UGI (33.8%), 5 of 24 patients with GU (20.8%), 39 of 85 patients with NGU (45.9%), 4 of 24 patients with prostatitis (16.7%) and one of 9 patients with epididymitis (11.9%). The organisms were isolated from one of 32 patients without UGI. When C. trachomatis was isolated and/or specifically stained by DIF, we scored as antigen positive.
2) For the patients on the first visit, the coincidence ratio between the isolation and DIF was 88.7%, indicating a significant correlation between these two different procedures for the antigen detection (p<0.01).
3) In 68 patients with positive antigen, serum IgM titers were detected in 12 patients (17.6%), while serum IgG titers were found in 38 patients (55.9%).
The positive rates of serum IgG and IgM titers of C. trachomatis on the patients with urethritis were 52.2% and 15.5%, respectively. These results may indicate that the organisms invading urogenital tract are not to be enough antigenic stimulation for the antibody formation, consequently resulting in the poor humoral response.

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We evaluated the bone mineral content (BMC) of 17 patients with idiopathic hypercalciuria, 22 patients with normocalciuria and 6 patients with primary hyperparathyroidism in calcium urolithiasis by the radiological assessment of bone density using microdensitometer (MD method). The BMC was significantly decreased in renal hypercalciuria with recurrent urolithiasis or primary hyperparathyroidism, but not in normocalciuria, renal hypercalciuria with initial urolithiasis or absorptive hypercalciuria. There were no correlation of the decrease of the BMC with the values of the fasting urinary cyclic-AMP excretion in renal hypercalciuria.
These results suggest that a long term negative calcium balance may be important component of disordered calcium metabolism of the bone in idiopathic hypercalciuria.

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It is evident that vesicoureteral reflux (VUR) is associated with renal parenchymal damage (renal scarring). Renal scarring has been estimated to be one of the etiologic factors of renal dysfunction or hypertension in patients with VUR. It has been widely accepted that new development or progression of scarring rarely occurs during the follow-up period. Only few detailed data have been reported on the formation of new scars, possibly because they develop early in childhood. To study the factors surrounding the new development and progression of renal scarring, we analysed the serial urographys (IVP) and clinical histories from 711 children with primary VUR who were treated during the last 13 years.
A new scar was defined as development of caliceal deformity coupled with thinning of the corresponding parenchyma in an area of the kidney which had been considered to be normal in the previous IVP. Progression of scarring was defined as the loss of parencyma in the area of previous scarring.
1) Incidence; New scars had developed in 36 kidneys of 32 children (4.5%). Twenty-two children (24 kidneys) had had normal kidneys initially, and in 10 (12 kidneys) the new scars developed in previously scarred kidneys. Progression of scarring was observed in 31 kidneys of 26 children (3.7%). Among the patients, 3 had new scars on one kidney and progression on the other.
2) VUR grade; VUR was graded accoring to the Internatioanl Classification. There was a tendency for scarring to develop or progress with more severe reflux. Neither new scars nor progression was found in kidneys with low grade VUR. For grade I-II, scar was formed at 0%, grade III 3%, grade IV, 11%, grade V, 17%.
3) Urinary tract infection (UTI): All but one child had UTIs with fever (pyelonephritis) in their histories. About one half had UTIs more than twice a year. In more than 90% of the patients, UTI occurred during the interval period or within one year before the last IVP which did not show a new scar or progression.
4) Bladder function: According to the findings of the urodynamic evaluations of the lower tract, children were divided into two groups; high-pressure bladder and normal, stable bladder. Of all the patients, 32 (58%) were categorized as high-pressure bladder group.
5) Age of new scarring or progression: The mean age at which new scarring was observed was 7 years 10 months (ranged from 2 to 18 years), and the mean age of progression was 8 years 6 months (from 4 to 15 years). In about one fourth of children, new scarring or progression was detected after the age of 10 years.
In thirty-five kidneys, the evidence of new scarring or progression was first demonstrated after the antireflux operation. Of 200 kidneys in which reflux had stopped spontaneously, 4 (2%) showed progression of scarring.
6) Impaired renal functin: Renal function was impaired in 5 children (9%). There was only one child with hypertension.
From the results of our study, we recommend to operate on children with high-grade VUR or frequent UTI even in early childhood in order to lower the possibility of new development or progression of renal scars. The antireflux surgery must be preceded by eradication of the lower tract abnormalities which may cause the high-pressure reflux.

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From January 1961 to June 1986, 705 patients with transitional cell carcinoma of the urinary bladder were treated at the Center for Adult Diseases, Osaka.
Four hundred and ninety-three patients underwent transurethral resection (TUR), 142 total cystectomy with urinary diversion, and 34 segmental resection. Five-year survival rates after TUR, total cystectomy and segmental resection were 76.8%, 59.8% and 46.2%, respectively. Ten-year survival rates were 61.2%, 49.4% and 41.6%, respectively.
Of 493 patients treated by TUR, 302 were G1, 155 were G2 and 36 were G3. five- and ten-year survival rates of G1 were 85.9% and 72.0%, those of G2 were 66.1% and 44.6%, and those of G3 were 39.8% and 24.9%, respectively.
Among the 493 patients, 227 were pTa, 196 were pT1 and 43 were pT2 or higher stages than pT2. Five- and ten-year survival rates of pTa were 91.5% and 78.5%, those of pT 1 were 75.5% and 60.6%, and those of pT2 or higher stages than pT2 were 49.0% and 22.0%, respectively.
Intravesical recurrence after TUR was significantly more frequent in patients with high grade and/or high stage tumors at first treatment.
Of 142 patients treated by total cystectomy, 13 were G1, 66 were G2 and 63 were G3. The five-year survival rate of G1 was 62.9%, that of G2 was 67.6%, and that of G3 was 51.7%.
Among the 142 patients, eight were pTis, seven were pTa, 37 were pT1, 32 were pT2, 19 were pT3a, 25 were pT3b and 14 were pT4. The five-year survival rate of pTis was 100%, that of pTa was 83.3%, that of pT1 was 64.3%, that of pT2 was 76.1%, that of pT3a was 58.4%, that of pT3b was 33.1% and that of pT4 was 25.9%.
In patients with G3 and deeply invasive carcinoma, survival of patients after total cystectomy was significantly better than those after TUR.

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The pathogenesis of ascending pyelonephritis was studied using the experimental model that was produced in mice after challenge with Candida albicans.
The mice were inoculated with 0.1ml C. albicans suspension (10⁶ cells) into the bladder transurethrally. Inoculated C. albicans reached the kidney via the transureteral route. The mice that had received beads in the bladder became highly susceptible to fatal infection with C. albicans and the course of infection was reproducible. In the early stage of infection, acute pyelonephritic changes and subsequent chronic pyelonephritic changes were produced. The histopathological findings suggest that in most of infected mice infection in the renal parenchyma mainly develop by the transcanalicular route, but in fewer mice by the subcapsular route. In the mice which succumbed to the infection, C. albicans appeared to have multiplied plentifully in the kidney with subsequent dissemination to other organs. The severity of inflammatory changes in the kidney of infected mice depended on the virulence of the challenged strains, but infrequently severe inflammatory changes were also produced in mice challenged with a low virulent strain.

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Thirty-one patients were entered into our protocol which was designed to evaluate the ablative and prophylactic effects of intravesical bacillus Calmette-Guerin (BCG) on superficial papillary transitional cell carcinoma of the bladder. These patients initially received the induction regimen which consisted of 12 intravesical instillations of 80mg BCG (Tokyo strain) at the frequency of 1 or 3×/week. Seventeen patients (55%) achieved a complete response and 7 (23%) achieved a partial response. The complete responders as well as the partial and non-responders who underwent a complete transurethral resection of the residual tumors were subsequently placed on the maintenance regimen which consisted of 6 biweekly instillations followed by monthly instillations for 21 months. Four patients experienced tumor recurrence at 3, 4, 6 and 18 months, while 27 remained free of disease during 3 to 32 months (average 22 months) of follow-up. The recurrence rate, when determined by the Kaplan-Meier method, was 9.6% at 12 months and 14.5% at 24 months.
Tumor recurrence was observed in 2 of 17 patients with persistently positive PPD skin test, in 1 of 2 with persistently negative skin test, and in 1 of 2 whose skin test converted from negative to postive during the induction period but reverted to negative during the maintenance period. None of 10 patients whose skin test showed positive conversion and remained positive during the maintenance period had recurrent tumors.
Side-effects during the induction period included cystitis in 27 patients (87%) and fever in 5 (16%). During the maintenance period, cystitis was seen in 31 patients (100%), fever in 5(16%), prostatitis in 1 (3.2%), epididymitis in 1 (3.2%), and hepatic dysfunction in 1 (3.2%). All the patients tolerated the induction regimen but the maintenance regimen was discontinued before 2 years in 10 patients (32%) because of intolerable irritative bladder symptoms.
Our results indicate the efficacy of intravesical BCG in eradicating existing tumors and preventing tumor recurrence in patients with superficial papillary bladder tumors.

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Intermediate filaments were considered the specific marker proteins which recognized the differences between normal and transformed cells. Recent studies have revealed that intermediate filament proteins are expressed in tissues of different embryologic origin in characteristric patterns.
Cytokeratins are a family of polypeptides of intermediate filaments in which diverse epithelia are expressed in different, yet specific, combinations. Vimentin type of intermediates is present in cells of mesenchymal origin.
We have studied the cytokeratins and vimentin in normal kidney tissue, in comparison with those in renal cell carcinoma, by two dimentional gel electrophoreses and immunofluorescence microscopy.
As for basic cytokeratin by NEPHGE procedure, tissues of renal medulla contain cytokeratin polypeptide nos. 1, 2, 3, 4, and 6.
By contrast, renal cell carsinomas contain only cytokeratin no. 4, which resemble those of cortex containing cytokeratin no. 1. and 4.
As for acidic cytokeratin by IEF procedure, similar cytokeratin pattern is observed in normal kidney tissue and renal cell carcinoma except defecting cytokeratin no. 12 in renal cell carcinoma.
Vimentin is also observed in all renal cell carcinoma.
When frozen sections are examined by immunofluorescence microsiopy, all epithelia of the kidney tissues and renal cell carcinomas are stained with monoclonal cytokeratin antibody.
By contrast, vimentin antibody is not stained in normal tissue, but in renal cell carcinoma.
From this point of view, it is plausible that renal cell carcinoma is not a mere adenocarcinoma, but has a nature of sarcoma.

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Quantification of renal blood flow was performed using phasedarray sector probe in 20 kidney transplant patients during stable graft function. Doppler signals were not obtained in 3 patients; one was 8th-month pregnant woman and two were children having poor kidney function. The angle of ultrasouhd beam to the vessel, the maximum and minumum velocities in the renal artery and the diameter of the vessel were 59.8 degree, 71.7cm/sec, 23.1cm/sec and 2.5mm on average, respectively.
Blood flow volume was measured using the equation: V=π×(φ/2)²×FVI/T×60, φ; diameter of the renal artery, FYI; Flow Velocity Integral, T; time of pulse period. Blood flow volume ranged from 18ml/min to 150ml/min.
The equipment has some characteristics, which are 1) to be able to gain pulsed Doppler signals under real time B scope observation, 2) to be able to choose freely angle of Doppler beam to vessel, 3) to be able choose a site of origin of Doppler signals.
As a contributing factor to renal blood flow volume, the angle of beam to the vessel and the diameter of the vessel were considered to be most important.

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Human external urethral sphincter (EUS) muslce was isolated from urethrae obtained in surgery by glycerination. Electrophoretic samples were made from the isolated EUS muscle and pyrophosphate electrophoresis and two-dimensional electrophoresis were performed. Denatured myosin isozymes and myosin light chain components from EUS muscle were analysed by pyrophospahte electrophoresis and two-dimensional electrophoresis, respectively. Human EUS was concluded to be comprised with both fast twitch and slow twitch muscle fibers. The distribution of fast and slow myosin in EUS was examined in six cases. The distribution was various from case to case. In no case the percentage of slow twitch myosin was less than 38.8%.

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4-hour fasting urine collection from 7AM to 11AM was tried in 117 patients with idiopathic urinary Ca stone disease and comparisons of urinary calcium (Ca), phosphorus (P), magnesium (Mg) and uric acid (U. A) excretions were made between 4-hour fasting urine collection and standard 24 hour urine collection.
The results were as follows:
1) Urinary excretions of Ca, P, Mg, (mg/g, creat) in 4-hour urine collection were lower than those in 24hour urine collection with significant difference (P<0.01) probably due to effect of fasting, while there was positive correlation in urinary Ca, P, Mg excretions between these two urine collections (p<0.01). In U. A. urinary excretions, there was no significant difference between two urine collections, but posivite correlation was recognized (p<0.01).
2) 13 patients with idopathic hypercalciuria in urinary stone patients were classified according to Pak's method into 2 groups, 9 patients with absorptive hypercalciuria (A. H.) and 4 patients with renal hypercalciuria (R. H.). Ca excretions in 4-hour urine collection (mg/4hrs) were compared between these two groups. Ca excretions in patients with R. H. were significantly higher than those in patients with A. H. (p<0.05).
From these results, it was suggested that 4hour fasting urine collection would be useful for differential diagnosis of idiopathic hypercalciuria.

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We report a case of renovascular hypertension due to renal artery branch obstruction. Preoperatively, selective segmental renal vein catheterization was used to obtain venous blood sample for renin assay. By this technique a localized source of hyperreninemia was identified as left upper and middle segmental area. After left nephrectomy, the renal tissure renin concentration of ischemic area was remarkably elevated. Also the hypertropy of JG cells was observed by histological examination.
These results show that the hyperreninemia is due to high renin production from the ischemic part of the kidney.

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