Penile erection is controlled by a valvular structure in the helicine artery in humans. The opening and closing of this valve are believed to be regulated by the autonomic nervous system, especially through the release of vasoactive intestinal polypeptide (VIP). We determined the content of VIP in cavernous tissue in 18 impotent patients and in 5 normal controls by radioimmunoassay, and we examined the distribution of VIP-ergic nerve fibers in cavernous tissue by an immunohistochemical method. As a result, it was found that the lower penile VIP content was more frequent among patients with organic impotence than among the controls. Furthermore, VIP-ergic nerve fibers were seen to be diffusely and loosely distributed in a large number of organic impotence patients. These findings suggest that organic impotence in some patients may be due to decreases in the VIP content and in VIP-ergic nerve fibers.

Lipogranulomas developing secondarily in the genitourinary system have been reported rather frequently, but primary lipogranulomas without any past history of etiologically related conditions are rare. We report on 2 cases recently encountered in which tumors were diagnosed as sclerosing lipogranuloma on histopathologic examination.

Bilateral and synchronous testicular tumors consisting of different cell types on each side are rare. We describe one additional case of synchronous bilateral testicular tumors comprised of different cell types on each side and review the relative literature.

In an attempt to develop as objective a method for the evaluation of impotence as possible, the authors assigned numerical values to four parameters considered essential to sexual function, namely, libido, erection, ejaculation, and orgasm, and used the sum totals of these scores, collected before and after initiation of therapy, as indicators of overall sexual function. Numerical values were assigned according to a logarithmic scale, in four stages from 0 to 10, i.e., 0, 1, 3, and 10; a score of 0 signified “normal” and a score of 10, “abnormal.” By comparing sum totals of scores computed before and after initiation of therapy, the authors were able to evaluate therapeutic efficacy on the basis of changes in these sum totals. Using this method, the mean total score for a control group of 24 normal subjects was 1.67 ± 0.26 (mean ± standard error). For the test group, which consisted of 24 patients of psychogenic impotence, the mean total score prior to initiation of therapy was 16.46 ± 3.55, an extremely high score in comparison with the control group. After four weeks of therapy, the mean total score dropped to 9.37 ± 1.77, indicating a statistically significant (p < 0.05) decrease over the pre-therapy mean total score.

The status of spermatogenesis in Snell dwarf, little and congenitally hypothyroid mice was studied. In all of these mice with a hormone deficiency the seminiferous tubules were smaller in size and contained fewer spermatogonia, spermatocytes, spermatids and spermatozoa than did those of normal control mice. There was no substantial difference in the Johnsen score between the hormone-deficient mice and normal control mice, but the former had underdeveloped seminiferous tubules with a corresponding paucity of germ cells, which may be partly responsible for the infertility of these mice. In the present study, growth hormone and thyroxine were administered separately to growth hormone-deficient and thyroxine-deficient mice, respectively. Such replacement therapy brought about an increase in cell counts of the seminiferous tubules and in sperm counts in both groups.

我々は, 正常腎機能を有する200例の成人および89例の慢性腎不全患者において, 超音波計測による腎の大きさの測定と腎実質の echogenicity の程度を調べた.成人正常400腎の計測値の平均は, 長径102±6.9mm, 厚径44±5.4mm, 横径51±5.3mmであった. 今回の研究では, 成人群の腎の大きさにおいて左右差, 男女差および年代差は認められなかった.慢性機能不全腎178腎の平均は74±10.0mm厚径38±5.9mmで, 障害腎は正常腎に比べて明らかに萎縮していることを示した(p<0.05). さらに, serum creatinine level と腎の大きさとは良く相関していた. 腎実質の echogenicity についてみると, 正常腎では全例が肝実質の echo level より低かったが, 腎不全患者ではこの傾向は6%に認めたのみである.腎実質の echogenicity は障害腎では正常腎に比べて明らかに増強しており, serum creatinine level と腎実質の echogenicity の関係をみると, 腎機能が低下するに伴って echogenicity は増強する傾向を示した.

A clinical trial was performed with the tranquilizer Bromazepam on 39 patients undergoing diagnosis of psychogenic impotence, and the drug effect was evaluated according to the criteria based on our protocol. The protocol specifies 8 tests (1 for libido, 4 for erection, 2 for ejaculation, 1 for orgasm) which are scored according to an arbitrary logarithmic scoring system. At the end of the study the points made in the 8 tests were added to obtain the total score as the basis for evaluation of the overall drug effect. After treatment all tests showed an improvement, and the improvement in erection during masturbation, reflective erection, and condition of ejaculation was statistically significant. The total score also improved from 16.77 +/- 2.62 (mean +/- S.D.) before treatment to 11.42 +/- 1.96 after treatment, and the change was again statistically significant (P less than 0.05). The rate of satisfaction as a subjective symptom of improvement also increased from 25.38 +/- 4.40% to 39.10 +/- 4.53%. The results of the present study provide evidence to indicate that Bromazepam is beneficial for psychogenic impotence.

In 11 cases undergoing vasectomy for the purpose of contraception, and in 2 vasectomized men receiving reanastomosis to regain conceptive potential, their semen samples were obtained before and after the operation and changes in seminal levels in a variety of amino acids were compared. Seminal levels of amino acids were determined by employing auto amino acid analyzer (JLC-6AH). Preoperative values for seminal amino acids in their 11 patients underwent notable changes with vasectomy. The most prominent among the general decreases was a drop by as much as 51% for proline, followed by 48.9% for aspartic acid, over 30% each for threonine, glycine, alanine, valine, leucine, lysine, and arginine, 29.9% for isoleucine, 29% for serine, 26.4% for phenylalanine, 24.1% for tyrosine, and 23.6% for glutamine. On the other hand, of the 2 patients undergoing reanastomosis of the vas deferens, the 1 who achieved impregnation after the operation showed remarkably low preoperative levels in almost all seminal plasma amino acids. After the operation and with the appearance of sperm in the semen, however, amino acid levels rose; at 4 months, when impregnation was confirmed, some varieties were noted at a 1.5-9.5 fold increase over preoperative values. In the other reanastomosis patient, although sperm did not appear at the 2 week postoperative sampling, values of various amino acids in the seminal plasma had risen 1.4-6.3 times the preoperative level. The fact that vasectomy caused various free amnio acids to decrease markedly in the seminal plasma may tell us that amino acids, equivalent in amount to their decreases, probably had originated from the testicles and epididymides located above the vas deferens. On the other hand, reanastomosis of the vas deferens caused various free amino acids within the fluid of the testicles and epididymides to flow into the semen, elevating the level of total seminal amino acids. Therefore, when increases in free amino acids in seminal plasma do not accompany the appearance of sperm, it may be interpreted that some problems in the testicles or epididymides are responsible for impairing otherwise successful reanastomosis of the vas deferens. Thus, it seems appropriate to conclude that success or failure of reanastomosis of the vas deferens can be judged by determining amino acids in seminal plasma without resorting to seminalvesiculography. (author's)

Despite the fact that the number of reported cases of ureteral tumors has increased considerably during the last two decades throughout the world, cases of bilateral ureteral tumor remain to be rare.A case of bilateral asynchronous ureteral tumor in 64 years old male was reported together with the discussion on 34 previously reported cases of bilateral ureteral tumor (17 synchronisms, 11 asynchronisms and 6 unknowns).