(Purpose) To establish reference range of serum Total Testosterone (T-T) and Free Testosterone (F-T) in Japanese male adults.
(Subjects and Method) Among 1, 172 male adults, who daily lived their healthy life, 1, 143 subjects in the year range from 20 to 77 years old, who had serum LH concentration within its reference range (For 20-70years old: 1.1-25.9mIU/mL), were selected. As diurnal rhythm of both T-T and F-T was observed, blood samples were collected in the morning when T-T and F-T concentration were relatively stable at their high concentration levels. The collected samples were stored at-20 degree C until they were used for assays.
(Results) Reference range for T-T has decided to express by the mean+/-2SD calculated from the entire test results, because influence of aging on the results was negligible, Reference range of T-T has established as 2.01-7.50ng/mL. The other hand, reference ranges of F-T classified for every decade have decided to express by the mean+/-2SD of each decade subgroup, because great influence of aging on F-T was observed.
For each decade from 20 years on and >70 years, reference ranges of F-T have established as: 8.5-27.9pg/mL, 7.6-23.1pg/mL, 7.7-21.6pg/mL, 6.9-18.4pg/mL, 5.4-16.7pg/mL, and 4.5-13.8pg/mL, respectively.
(Conclusion) Reference ranges of serum T-T and F-T in Japanese male adults have established. And the value of Young Adult Mean (YAM) of F-T calculated for a group of the ages between 20 and 39 years have been proposed as a guideline of requirement for the Androgen Replacement Therapy (HRT). The value of 80% and 70% of YAM were 12.4pg/mL and 10.9pg/mL, respectively.

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(Purpose) To assess the effectiveness and tolerability of estramustine sodium phosphate in men with hot flushes during combined androgen blockade (CAB) therapy for prostate cancer.
(Patients and Methods) Seven men with moderate to severe hot flushes were received estramustine sodium phosphate. Treatment response was assessed by hot flush score.
(Results) A significant reduction in the hot flush score was seen with all patients. No thromboembolic complications occurred in any patients.
(Conclusions) Estramustine sodium phosphate appears to be a promising, well-tolerated and useful therapy for men with hot flushes during CAB treatment for prostate cancer.

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(Background) Urination disorders start to appear in an age-dependent fashion, which contribute to the degradation of quality of life (QOL) in erderly persons. This study focused on elucidating changes of the lower urinary tract symptoms (LUTS) and changing of voiding condition with aging in the subjects, who offered the health checks.
(Methods) We evaluated urinary function in 225 Japanese males (age 20-79), estimated International prostate symptom score (IPSS), QOL score, uroflowmetry, prostate volume and residual urine (estimated from transabdominal ultrasonography). In addition, 539 females (age 20-89) were assigned IPSS and QOL scores.
(Results) The distribution of severity of symptoms significantly changed with age in both sexes. QOL scores tended to increase in males, IPSS, prostate volume and residual urine were significantly increasing related to age, and advanced age was associated with a decline of voiding volume and Qmax. Comparison of QOL scores and IPSS criteria demonstrated a significantly positive correlation with incomplete emptying and a weak stream. A significant negative correlation was found between the QOL score and Qmax. The distribution of middle level of symptom, divided by clinical guideline for benign prostatic hyperplasia, significantly increased with age. On the other hand, in females, the QOL score seemed to be stable whilst there was a slight increase of IPSS. In contrast, frequency and incomplete emptying were significantly related to QOL scores.
(Conclusions) These investigations supported changing of lower urinary tract disorder with aging in both sexes. Since the approximate 50% of sixth and seventh decade males, classified to the middle level of symtom, which need treatment, the high incident of degradation of the LUTS with age, should predict for the future.

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A 72-year-old man referred our hospital with the chief complaint of macroscopic hematuria. He had undergone simple left nephrectomy for left renal stone when he was 27-years-old. His urine cytology showed class IIIb. They were 4 times. We performed random biopsy of the bladder and retrograde pyelography of the right. But they were no positive findings for the cause of hematuria and for the existence of malignancy. After 2 months, he had macroscopic hematuria again. Cystoscopic re-examination revealed a fibrin out of the residual left ureteral orifice. Computed tomographic scan showed a perivesical mass. The diagnosis was the carcinoma of the ureteral stump. We performed ureterectomy. The pathological study revealed the undifferentiated carcinoma. This case is the first report of the undifferentiated carcinoma occurred on the residual ureteral stump in the Japanese literature.

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Gastroduodenal ulcers in renal transplant recipients are usually originated from excessive acid secretion or infection of Helicobacter pyroli. Herein, we report a case of cytomegalovirus (CMV)-induced gastric ulcer following cadaveric renal transplantation.
The patient was a 48-year-old man with chronic renal failure and received cadaveric renal transplantation. A month later, he had epigastralgia without CMV-positive antigenemia and received gastrointestinal fiberscopy. Endoscopically, gastric ulcer was identified. Histological findings revealed conspicious nuclear enlargement of the non-epithelial cells in the ulcer bed, which indicated CMV infection. The patient was treated with ganciclovir for 2 weeks and the symptom was relieved. He discharged with a good renal function on day 75 posttransplant.
CMV infection plays an important role in gastric ulcer after renal transplantation. Antigenemia assay dose not seem feasible for the detection of CMV-induced gastric ulcer.

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