The lower urinary tract in mammals consists of the bladder, a storage organ for urine, and the urethra through which urine is expelled to the outside. In the male the urethra extends outside the body as the penis.
The lower urinary tract is innervated by pelvic (parasympathetic) nerves and hypogas tric nerves which combine on each side at the pelvic plexus. Fibres pass to the bladder, urethra, genital organs, rectum and blood vessels. In addition to the pelvic and hypogastric nerves there is sacral outflow to skeletal muscle, such as the external sphincters of the urethra and anus, in the pudendal nerve and the sympathetic chain extends caudally with branches lying in the sacral outflow that supply the penis and other organs though not the bladder. Bladder evacuation and penile erection are produced by activity of the pelvic nerves whereas sympathetic activity usually dominates during urine storage and penile flaccidity, though it may not be essential for either.

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Between August 1987 and July 1992, 19 patients with esophageal achalasia were treated at the Third Department of Surgery, Nihon University School of Medicine.
Preoperative EUS was performed in all of them. EUS findings were classified accord ing to thickness of the muscle layer of the esophagus.
This classification was compaired with X-ray findings, manometric findings and patho logical findings of muscle layer which was obtained by operation. There was no correlation between EUS findings and X-ray grade of esophageal dilatation, manometric classification, while there was correlation between EUS findings and X-ray type of esophageal dilatation.
EUS findings were not correlative with degeneration of Auerbach's plexus, while there were correlative with the diameter of the muscle cell and their nuclear. The thickness ofmuscle layer was corralative with grade of seriousness of the disease, and EUS findings, which measure the thickness directry, is useful for the descision of the severity grade and therapy in esophageal achalasia.

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To clarify the regulatory mechanism of blood flow of anodermal mucosal layers responding to the localized and transient coolong stimulation (around -4°C), we examined the change of anodermal blood flow with use of Laser Doppler Flowmeter (Periflux, Perimed). The cooling stimulation was applied to anoderm by the insertion of chilled cold stick (Poscool, Maruho) into the anus of 11 healthy male volunteer, aged 20-25 years.
Experimental results obtained are as follow;
1) The anodermal blood flow of healthy subjects are variant in degree and widely distributed from 30 to 80 Perfusion Unit (PU)
2) After cooling for five minutes by the insertion of a frozen Poscool, anodermal blood flow were increased in 8 cases out of eleven (72.7%). The changes corresponds to be 1.4 to 5.2 times.
3) Eight cases are divided into two groupes on the basis of the time course after cooling: the one is "delayed responding group" (there is a delay 10-40 minutes before the blood flow is increasing) and the other is"rapid responding group" (the blood flow is immediately increasing).
These results indicate that the anodermal blood flow, which are exposed to cooling, of healthy subjects is regulated not only by nervous mechanism but by humoral mechanism. Then, based on the Lewis reaction (cold vasodilatation), it is suggested that the short time cooling of anoderm should be appreciated as a conservative therapy of hemorrhoids and anal fissures.

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Gallstone formation is frequently seen following gastric surgery. Since dysmotility and bile stasis of the gallbladder is considered as an important factor in the pathogenesis of gallstone formation, altered gallbladder motility due to gastric surgery may have a role in the development of post-gastrectomy gallstone formation. To test this hypothesis, the effect of distal partial gastrectomy on gallbladder motility were studied.
Gastroduodenal and gallbladder contractions were recorded by chronically implanted strain gauge transducers under conscious state. Gallbladder volume changes were monitored using chronically indwelling gallbladder catheter. Fasted and fed motility were studied in control (n=5) and gastrectomized (n=3) dogs. Plasma concentration of puta tive hormone CCK was measured. Effect of CCK-OP and motilin on gallbladder emptying were also studied.
In fasted state, gallbladder volume was periodically decreased synchronous with phase 3 of interdigestive migrating contractions (IMC) in the gastroduodenum in both group of dogs. The correlation between gastric and gallbladder contractions was preserved even following distal partial gastrectomy, though the frequency of phasic contractions during phase 3 of IMC was decreased in the gastrectomized dogs. Postprandial gallbladder emptying tend to decreased in the gastrectomized dogs, while there were no difference in the postprandial plasma CCK concentrations and CCK-OP induced gallbladder emptying between groups. Digestive period was shortened in the gastrectomized dogs, which resulted in early gallbladder refilling and prolonged interdigestive period.
Decreased frequency of gallbladder phasic contractions during IMC and prolonged interdigestive period could cause bile stasis in the gallbladder, which may, in part, explain post-gastrectomy gallbladder formation.

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