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Urobiotic is a combination of antibiotic (oxytetrac y cline HC1) , chemotherapeutic (sulfamethizole) and analgesic (phenazopyridine HC1) agents designed specifically for urinary tract infections. Tw e nty patients with various urinary tract infections were treated with "Urobiotic" in this study. The dosages were 1 capsule 4 times daily in 8 cases and 2 capsules 4 times daily in the remaining 12 cases, both of which continued for 5 to 7 days. The effects thus attained are summarized as follows : In patients with acute cystitis, "Urobiotic" was noted to be effective in 4 out of 5 cases in which 4 capsules daily were given, and in all of 6 cases in which the dosage was 8 capsules daily. In chronic urinary infections, consisting of 6 cases of chronic cystitis and 3 cases of chronic pyelonephritis, "Urobiotic" was noted to be not effective in all of 3 cases in which the dosage was 4 capsules daily, but effective in 4 out of 6 cases in which 8 capsules daily were given. As side effects, mild gastric discomfort was noted in only 1 patient who was given 8 capsules daily. In con c lusion, "Urobiotic" was believed to be an effective remedy not only for acute cystitis, but also for chronic urinary tract infections. Dosage recommended is 8 capsules daily.

This report deals with a case of giant calculus arising in the urinary bladder of a 59 years old Japanese male, who had had a history of urinary frequency and discomfort for the previous 7 years. The calculus weighed 900 grams and the main component of which was uric acid calculus. The calculus divided into two parts with a smooth flat surface and each of them had its own nucleus. The domestic literature s have been reviewed and 39 cases of giant vesical calculus, weighing more than 200 grams, have been tabulated in weight order. The largest vesical calculus reported in Japan has been of 910 grams in weight, and this case is placed next to it.

This report deals with a case of rhabdomyosarcoma arising in the retro v esical space of a 11 months old female infant. The tumor, 4.2 x4.0 x2.7 cm in size, 40 grams in weight, with marked adhesions to the surrounding tissue was removed surgically togather with regional lymphnodes. Histological diagnosis was rhabdomyosarcoma and metastases were seen in regional lymphnodes. The postoperative course so far has been uneventful and the patient was discharged on 40 th postoperative day, after irradiation therapy with 60Co. The domestic literatures have been reviewed and 11 cases of retro p eritoneal rhabdomyosarcoma have been tabulated (table 2).

This report deals with a case of leiomyoma arising i n the right retroperitoneal space in a 74 years old Japanese female. The tumor, 840 grams in weight, 15 x 18 x 13 cm in size, with irregular nodular surface and partly adhered to vena cava, was successfully removed together with a part of the wall of vena cava. The postoperative course was uneventful and the patient has been in good health up to the present time, that is for about a year after surgery without any evidence of recurrence. The domestic literatures hav e been reviewed and 15 cases of smooth muscle tumors of the retroperitoneal space were collected and tabulated (Table 2). Twelve of them were malignant (leiomyosarcoma) while the remaining three were of a benign nature.

1) Furadantin was used in 47 patients with various urinar y tract infections. The dosage was 100 mg four times a day for seven days in average. Bacteriological and clinical cure were obtained in 12 patients, improvement in 19 patients but no change was observed in 16 patients. 2) Furadantin was highly effective to the patients with Escherichia or Staphylococcus infection but was not effective to those with Pseudomonas or Candida infection. 3) Unpleasant side-effects developed in 9 of 47 patients. The r e actions were mostly mild and gastrointestinal but severe headache, tinnitus, nausea and vomiting developed in an exceptional patient and, was forced to discontinue the dosage. 4) Furadantin Sensi-Disc test, was performed on 165 bacterial strains isolated from the patients with urinary tract infection and was found to be highly sensitive to Staphylococcus, Escherichia, Streptococcus viridans and Streptococcus hemolytics, relatively sensitive to Streptococcus faecalis, Corynebacterium, Klebsiella, Alkaligenes faecalis, Citrobacter etc., and resistant to Pseudomonas, Proteus, Cloaca and Candida. 5) Furadantin was found to be sensitive to 5 6% of the total 165 bacterial strains by the sensi-disc test, and when it was compared to those of the other antibiotics or chemotherapeutics, it was next to Kanamycin (73%) and was superior to Chloromycetin (49%), Erythromycin (34%), Streptomycin (30%), Terramycin (27%), Penicillin (27%), and Sulfisoxazol (6%). 6) The excretory concentration of Furadantin into the urine following the oral administration of Furadantin 100 mg was determined by bacteriological assay and it demonstrated the maximun concentration in three hours, then a rapid fall in the next hour and below the minimum inhibitory level after five hours. As a conclusion, we believe that Furadantin is an effective chemotherapeutic agent for combating urinary tract infections.

Fm-7 (flavon 5, 7-disodium oxyacetate) was applied in the urological practice and the following results were obtained. 1) This was obviously effective in more than half of the cases with essential hematuria or hemospermia. 2) No side effect was encountered at all in 30 trial cases.

Thirty-one patients with various urinary tract infec t ions were treated with Cephaloridine. A single dose of 500 mg was administered intramusculary for five to nine days and its results were evaluated. In seven cases of acute cystitis, Cephaloridine was highly effective and bacteriological cure was obtained in five of them. In twenty-four cases of various chronic urinary tract infections, Cephaloridine was effective in fifteen cases (bacteriological cure in four cases, improvement in eleven cases), but was not effective in the remaining nine cases. Bacteriological study reveale d that Cephaloridine was effective in the treatment of urinary tract infections caused by E. coli, Proteus, Klebsiella, Staphylococcus and Enterococcus, and was not effective in those caused by Pseudomonas. Cephaloridine sensi-disc test w as performed on 119 bacterial strains isolated from the patients with various urinary tract infections and was found to be highly sensitive to E. coli, Enterococcus and Staphylococcus, relatively sensitive to Proteus and Klebsiella, and resistant to Pseudomonas. Unpleasant side effects developed in two of the total sixty-one patients who were administered Cephaloridine at our hospital. The reactions were rather severe revealing allergic exanthema associated with facial edema, chill and dyspnea, but was subsided shortly after the administration of an anti-histamic drug.

The urinary excretion of Furadantin following the oral a d ministration of enteric coated tablet 100 mg was determined by bacteriological assay and the result was conpaired with those of the uncoated tablets 100 mg, 150 mg and 200 mg. The excretion of Furadantin enteric coated tablet into the urine was apparently slower than those of the uncoated tablets but reached to sufficiently high level in one hour and kept the effective level for eight hours. Twenty-five patients with various urinary tract infections were treated with Furad a ntin enteric coated tablet 100 mg q.i.d. for seven days in average. Bacteriological and clinical cure were obtained in 3 patients, improvement in 12 patients and no improvement in 10 patients. Mild gastric discomfort and anorexia were observed in 3 of 25 patients during the treatment with Furadantin enteric coated tablet. But the reactions were apparently milder than those of the uncoated tablet and none of our patients war forced to discontinue the treatment.

Twenty-one patients with various urinary tract infections, inc l u ding ten patients with cord bladder, were treated with Nalidixic Acid (Wintomylon). The drug was supplied in a form of 0.25 gram tablet and was given orally at a dose of two tablets four times daily for five to fourteen days. In four cases of a cute cystitis, Nalidixic Acid was highly effective and bacteriological cure was obtained in all the cases. In seven cases of chronic u rinary tract infections, Nalidixic Acid was effective in five cases (bacteriological cure in a case and improvement in four cases), but was not effective in the remaining two cases. In all of ten case s of cord bladder, which were all associated with chronic urinary tract infections due to E. Coli, apparent improvement was observed with the administration of Nalidixic Acid for ten days. Bacteriological study reve a led that Nalidixic Acid was effective in the treatment of urinary tract infections caused by Gram negative organisms, especially in those caused by Proteus, E. Coli or Pseudomonas.

This report deals with a case of urethral divcrticulum with stone arising in the anterior urethra at peno-scrotal junction in a 67 years old Japanese male. Considering the clinical history and histological findings, this diverticulum was assumed to be a congenital one. The stone weighed 19 gm (2.5 x3.9 x 2.0cm) of which main component was phosphatic calculus. The domestic literatures were reviewed and seventy-nine cases of diverticu l u m of the male urethra so far reported have been tabulated by location and etiology. Forty of them were found to be congenital and twenty-four were found to be acquired diverticula. Thirtyseven out of the eighty-two diverticula were associated with stone.

A case of non-specific granuloma of the male urethra noted in a 63-year-old Japanese male has been reported. The patient came with a complaint of a firm tumor-like mass in the perineal region accompanied by disturbances on urination. His past history was noncontributory except for an episode of acute urethritis following sexual experience about twenty years ago. By palpation, there was, in the perineal region, a firm, nodular, hen-egg sized tumor-like mass of which clinical findings suspected to be a malignant tumor. Further, urethrocystogram revealed a large shadow defect in the inferior portion of the perineal urethra. Postoperatively, however, by histopathological examination, the mass was found to be an inflammatory granuloma of a nonspecific etiology. The mass resected was 21 grams in weight, 5.5 x2.8 x 2.0 in size, firm in consistency, and markedly adhered to the surrounding tissues. In Japanes e literatures only three similar cases have been reported.

Bayrena (2-(p-aminobenzenesulfonamido)-5-methoxypyrimidi ne), a new long acting sulfonamide, was used in twenty-one patients with various urinary tract infections. Fourteen of the cases were with acute cystitis and the remaining 7 cases were with chronic urinary tract infections of various etiology. The daily dosage was i nitiated with 1 gram (2 tablets) and followed by maintenance dosage of 0.5 graiaa (1 tablet). The length of administration varied from 5 to 28 days ; about 9 days in average. Bayrena was found to be effective in 11 out of 14 cases of the acute cystitis (79 %), but only in 2 out of 7 cases of the chronic urinary tract infection (29 %). The remaining 8 cases showed no response to the Bayrena treatment. Side-effect due to the routine oral adm i n istration of Bayrena was almost negligible. A mild epigastric discomfort and anorexia were noted in only one case. As a conclusion, we believe that Bayrena is an effective chem etherapeutic agent for combating acute urinary tract infections.

Fm-7 (flavon 5, 7-disodium oxyacetate) was applied in the urological practice and the following results were obtained. 1) This was obviously effective in more than half of the cases with essential hematuria or hemospermia. 2) No side effect was encountered at all in 30 trial cases.

This report deals with a case of calcified tissue mass found in the lower pole of the left kidney in a 29-year-old Japanese female who was refered to us by a local physician under a diagnosis of left nephrolithiasis. Urological exam i n ation revealed an irregular shaped calcified mass projecting downward from the lower pole of the left kidney. The rest of the urinary tract appeared normal. Urinalysis and urine culture examinations including for tuberculous bacilli were all negative. Partial nephrectomy was performed on April 7, 1965, and the mass was remov e d with the surrounding kidney tissue of the left lower pole. The mass was irregular nodular shaped but well-encapsulated, measured as much as 2.0 x 2.2 x1.3 cm. It was moderately firm and, on section, disclosed greyish-white solid material, which was sharply circumscribed from the remaining portions of the kidney. It involved both the cortex and the medulla and encroached upon, but did not open into the renal pelvis. The histological findings consisted of extensive f i bruos tissue with marked calcium deposition and some epithelial cells forming tubular appearance. However, there were no evidence of definite tuberculous pathology, though it was deeply suspected. The postoperative course was uneventful and the pa t i ent has been in good health up to present and enjoying normal life.

Lower urinary tract infection, frequently troublesome and difficult to eradicate, has been considered as an almost inevitable complication following transurethral prostatic resection. In an effort to treat this complication after transurethral prostatic resection, achymotripsin enteric-coated tablet, a pancreatic proteolytic enzyme, was administered to twenty patients and the result was compared to that of twenty-one control patients. The administration of the a-chymotripsin enteric-coated tablet was, as a rule, started two weeks after the transurethral prostatic resection with a dosage of 2 tablets 3 times a day (1 tablet contains 100 Ch. Ti. of a-chymotripsin) and was continued as long as the urinary tract infection had persisted. The duratio n of postoperative urinary tract infection in the a-chymotripsin treated group was 8.5 weeks on the average (varied from 5 to 15 weeks) which was 3.1 weeks shorter than that of the control group (11.6 weeks on the average, varied from 6 to 19 weeks). No unpleasant side effect occurred in this series, except for one patient who complained of a mild degree of loss of appetite during the treatment with a-chymotripsin enteric-coated tablet, which disappeared soon after the completion of the treatment. In conclusion, the use of a-chymotripsin enteric-coated tablet was believed to be an effective therapeutic measure for combating urinary tract infection following transurethral prostatic resection.

Use of irrigating fluids are necessary and im p ortant, for transurethral prostatic resection. However, occurrence of side effects due to mostly changes in the electrolytes of the body fluids and complications well-known as TUR-reaction are not uncommon. In an attempt to prevent the so-called TUR-reaction, the following two kinds of mannitol solution for intravenous use were administered before, during and after the procedure. solution-I (M-I) Mannitol 15 % Glucose 5 % NaC1 0. 45 % solution-II (M-II) Mannitol 5 % Glucose 5 % NaC1 0. 25 % Clinical effectiveness of the solutions was evaluated by studying 15 recent cases of prostatic hypertrophy given our mannitol solutions (the first series), and 10 control cases of the same condition in which the TUR-procedure was performed using glucose or Ringer's solution (the second series). In the both series, " urigal " was used as irrigating fluid, which was put at the height of 60 to 80 cm. from the mid-bladder level. In the first series, the 15 patients studied were at first given 1 00 ml. of M-I for 15 to 20 minutes prior to the TUR-procedure, followed by administration of 300 ml. of the same for over an hour during the surgical procedure. Then after the surgery, M-II was given intravenously at the rate of 200 ml. per hour until 7 a.m. of the following day, the total of the solution being to be from 1, 800 to 4, 000 ml. The amount of tissue resected varied fro m 4 to 46 gm. and the operating time was mostly limited to one hour. In both of ne seri e s, serum electrolytes (Na, K, Cl, Ca), BUN and hematocrit were examined just before, immediately after, and further 4-, 8-and 24-hours after the completion of the TUR procedure. Urinary output via catheter was also measured every hour during the first 4 hours then every 4 hours during the first 24 hours after the surgery. The results obtained were as follows : The urinary output measured at a n one hour interval during the first 4 hours varied from 130 to 400 ml. The total of 4-h

Twenty-one patients with various urinary tract infections, inc l u ding ten patients with cord bladder, were treated with Nalidixic Acid (Wintomylon). The drug was supplied in a form of 0.25 gram tablet and was given orally at a dose of two tablets four times daily for five to fourteen days. In four cases of a cute cystitis, Nalidixic Acid was highly effective and bacteriological cure was obtained in all the cases. In seven cases of chronic u rinary tract infections, Nalidixic Acid was effective in five cases (bacteriological cure in a case and improvement in four cases), but was not effective in the remaining two cases. In all of ten case s of cord bladder, which were all associated with chronic urinary tract infections due to E. Coli, apparent improvement was observed with the administration of Nalidixic Acid for ten days. Bacteriological study reve a led that Nalidixic Acid was effective in the treatment of urinary tract infections caused by Gram negative organisms, especially in those caused by Proteus, E. Coli or Pseudomonas.

Thirty-one patients with various urinary tract infec t ions were treated with Cephaloridine. A single dose of 500 mg was administered intramusculary for five to nine days and its results were evaluated. In seven cases of acute cystitis, Cephaloridine was highly effective and bacteriological cure was obtained in five of them. In twenty-four cases of various chronic urinary tract infections, Cephaloridine was effective in fifteen cases (bacteriological cure in four cases, improvement in eleven cases), but was not effective in the remaining nine cases. Bacteriological study reveale d that Cephaloridine was effective in the treatment of urinary tract infections caused by E. coli, Proteus, Klebsiella, Staphylococcus and Enterococcus, and was not effective in those caused by Pseudomonas. Cephaloridine sensi-disc test w as performed on 119 bacterial strains isolated from the patients with various urinary tract infections and was found to be highly sensitive to E. coli, Enterococcus and Staphylococcus, relatively sensitive to Proteus and Klebsiella, and resistant to Pseudomonas. Unpleasant side effects developed in two of the total sixty-one patients who were administered Cephaloridine at our hospital. The reactions were rather severe revealing allergic exanthema associated with facial edema, chill and dyspnea, but was subsided shortly after the administration of an anti-histamic drug.

This report deals with a case of urethral divcrticulum with stone arising in the anterior urethra at peno-scrotal junction in a 67 years old Japanese male. Considering the clinical history and histological findings, this diverticulum was assumed to be a congenital one. The stone weighed 19 gm (2.5 x3.9 x 2.0cm) of which main component was phosphatic calculus. The domestic literatures were reviewed and seventy-nine cases of diverticu l u m of the male urethra so far reported have been tabulated by location and etiology. Forty of them were found to be congenital and twenty-four were found to be acquired diverticula. Thirtyseven out of the eighty-two diverticula were associated with stone.

This report deals with a case of leiomyoma arising i n the right retroperitoneal space in a 74 years old Japanese female. The tumor, 840 grams in weight, 15 x 18 x 13 cm in size, with irregular nodular surface and partly adhered to vena cava, was successfully removed together with a part of the wall of vena cava. The postoperative course was uneventful and the patient has been in good health up to the present time, that is for about a year after surgery without any evidence of recurrence. The domestic literatures hav e been reviewed and 15 cases of smooth muscle tumors of the retroperitoneal space were collected and tabulated (Table 2). Twelve of them were malignant (leiomyosarcoma) while the remaining three were of a benign nature.

Bayrena (2-(p-aminobenzenesulfonamido)-5-methoxypyrimidi ne), a new long acting sulfonamide, was used in twenty-one patients with various urinary tract infections. Fourteen of the cases were with acute cystitis and the remaining 7 cases were with chronic urinary tract infections of various etiology. The daily dosage was i nitiated with 1 gram (2 tablets) and followed by maintenance dosage of 0.5 graiaa (1 tablet). The length of administration varied from 5 to 28 days ; about 9 days in average. Bayrena was found to be effective in 11 out of 14 cases of the acute cystitis (79 %), but only in 2 out of 7 cases of the chronic urinary tract infection (29 %). The remaining 8 cases showed no response to the Bayrena treatment. Side-effect due to the routine oral adm i n istration of Bayrena was almost negligible. A mild epigastric discomfort and anorexia were noted in only one case. As a conclusion, we believe that Bayrena is an effective chem etherapeutic agent for combating acute urinary tract infections.

Urobiotic is a combination of antibiotic (oxytetrac y cline HC1) , chemotherapeutic (sulfamethizole) and analgesic (phenazopyridine HC1) agents designed specifically for urinary tract infections. Tw e nty patients with various urinary tract infections were treated with "Urobiotic" in this study. The dosages were 1 capsule 4 times daily in 8 cases and 2 capsules 4 times daily in the remaining 12 cases, both of which continued for 5 to 7 days. The effects thus attained are summarized as follows : In patients with acute cystitis, "Urobiotic" was noted to be effective in 4 out of 5 cases in which 4 capsules daily were given, and in all of 6 cases in which the dosage was 8 capsules daily. In chronic urinary infections, consisting of 6 cases of chronic cystitis and 3 cases of chronic pyelonephritis, "Urobiotic" was noted to be not effective in all of 3 cases in which the dosage was 4 capsules daily, but effective in 4 out of 6 cases in which 8 capsules daily were given. As side effects, mild gastric discomfort was noted in only 1 patient who was given 8 capsules daily. In con c lusion, "Urobiotic" was believed to be an effective remedy not only for acute cystitis, but also for chronic urinary tract infections. Dosage recommended is 8 capsules daily.

This report deals with a case of rhabdomyosarcoma arising in the retro v esical space of a 11 months old female infant. The tumor, 4.2 x4.0 x2.7 cm in size, 40 grams in weight, with marked adhesions to the surrounding tissue was removed surgically togather with regional lymphnodes. Histological diagnosis was rhabdomyosarcoma and metastases were seen in regional lymphnodes. The postoperative course so far has been uneventful and the patient was discharged on 40 th postoperative day, after irradiation therapy with 60Co. The domestic literatures have been reviewed and 11 cases of retro p eritoneal rhabdomyosarcoma have been tabulated (table 2).

A case of non-specific granuloma of the male urethra noted in a 63-year-old Japanese male has been reported. The patient came with a complaint of a firm tumor-like mass in the perineal region accompanied by disturbances on urination. His past history was noncontributory except for an episode of acute urethritis following sexual experience about twenty years ago. By palpation, there was, in the perineal region, a firm, nodular, hen-egg sized tumor-like mass of which clinical findings suspected to be a malignant tumor. Further, urethrocystogram revealed a large shadow defect in the inferior portion of the perineal urethra. Postoperatively, however, by histopathological examination, the mass was found to be an inflammatory granuloma of a nonspecific etiology. The mass resected was 21 grams in weight, 5.5 x2.8 x 2.0 in size, firm in consistency, and markedly adhered to the surrounding tissues. In Japanes e literatures only three similar cases have been reported.

This report deals with a case of giant calculus arising in the urinary bladder of a 59 years old Japanese male, who had had a history of urinary frequency and discomfort for the previous 7 years. The calculus weighed 900 grams and the main component of which was uric acid calculus. The calculus divided into two parts with a smooth flat surface and each of them had its own nucleus. The domestic literature s have been reviewed and 39 cases of giant vesical calculus, weighing more than 200 grams, have been tabulated in weight order. The largest vesical calculus reported in Japan has been of 910 grams in weight, and this case is placed next to it.

The urinary excretion of Furadantin following the oral a d ministration of enteric coated tablet 100 mg was determined by bacteriological assay and the result was conpaired with those of the uncoated tablets 100 mg, 150 mg and 200 mg. The excretion of Furadantin enteric coated tablet into the urine was apparently slower than those of the uncoated tablets but reached to sufficiently high level in one hour and kept the effective level for eight hours. Twenty-five patients with various urinary tract infections were treated with Furad a ntin enteric coated tablet 100 mg q.i.d. for seven days in average. Bacteriological and clinical cure were obtained in 3 patients, improvement in 12 patients and no improvement in 10 patients. Mild gastric discomfort and anorexia were observed in 3 of 25 patients during the treatment with Furadantin enteric coated tablet. But the reactions were apparently milder than those of the uncoated tablet and none of our patients war forced to discontinue the treatment.

1) Furadantin was used in 47 patients with various urinar y tract infections. The dosage was 100 mg four times a day for seven days in average. Bacteriological and clinical cure were obtained in 12 patients, improvement in 19 patients but no change was observed in 16 patients. 2) Furadantin was highly effective to the patients with Escherichia or Staphylococcus infection but was not effective to those with Pseudomonas or Candida infection. 3) Unpleasant side-effects developed in 9 of 47 patients. The r e actions were mostly mild and gastrointestinal but severe headache, tinnitus, nausea and vomiting developed in an exceptional patient and, was forced to discontinue the dosage. 4) Furadantin Sensi-Disc test, was performed on 165 bacterial strains isolated from the patients with urinary tract infection and was found to be highly sensitive to Staphylococcus, Escherichia, Streptococcus viridans and Streptococcus hemolytics, relatively sensitive to Streptococcus faecalis, Corynebacterium, Klebsiella, Alkaligenes faecalis, Citrobacter etc., and resistant to Pseudomonas, Proteus, Cloaca and Candida. 5) Furadantin was found to be sensitive to 5 6% of the total 165 bacterial strains by the sensi-disc test, and when it was compared to those of the other antibiotics or chemotherapeutics, it was next to Kanamycin (73%) and was superior to Chloromycetin (49%), Erythromycin (34%), Streptomycin (30%), Terramycin (27%), Penicillin (27%), and Sulfisoxazol (6%). 6) The excretory concentration of Furadantin into the urine following the oral administration of Furadantin 100 mg was determined by bacteriological assay and it demonstrated the maximun concentration in three hours, then a rapid fall in the next hour and below the minimum inhibitory level after five hours. As a conclusion, we believe that Furadantin is an effective chemotherapeutic agent for combating urinary tract infections.