There have been published numerous electron-microscopic studies on the prostate which is representative of the so-called hormone-dependent organs. The studies, which are concerned, among others, with the influence upon the prostate in such experimentally induced, female hormone-predominant milieu as produced by testectomy or administration of antiandrogenic hormones, have demonstrated a significant epithelial atrophy of the prostate. With the view of full understanding of the findings of the effect of estrogen administration, the present study was undertaken to investigate the ultrastructure of the epithelial cells of anterior prostatic lobe of normal rats as well as initial changes of the epithelium associated with estrogen dosing.
For electron-microscopy the following staining procedures were employed: the uranyl acetate-lead nitrate double stain, PAM staining, ruthenium red stain and histochemical acid phosphatase reaction.
1. The epithelium of the anterior lobe of the prostate of normal rats comprises tall columnar cells which do not essentially differ in basic structure from those of other organs. The cells being a proteinsecreting epithelium were noted to possess remarkably well developed rough endoplasmic reticulum and present regularly altering features of physiologic function characterized by differences in electron density determined by the proportion of endoplasmic reticulum.
2. In sections with uranyl acetate-lead nitrate double staining or with Ru-red staining, the cytoplasmic secretory granules in the upper pole region were observed to be distinguishable into two types, i. e., the highly electron-opaque fine granules and those which were moderately electron-dense with a homogeneous structure. All secretory granules, nevertheless, proved to be positive in PAM stained sections and some of the granules were positive for acid phosphatase. No particular histochemical properties that would provide a distinction between the two types have been demonstrated, however. In contrast to the active macroapocrine mechanism which has been postulated as operating in the prostatic secretion, electron microscopic findings corresponding to the passive microapocrine mechanism by the classification of Kurozumi were obtained.
3. As for influence of estrogen administration on the epithelial cells of the prostate, findings indicative of regressive changes characterized primarily by cytomembranolytic figures as a whole, viz, a marked dilatation of rough surfaced ergastoplasmic reticulum along with mitochondrial degeneration, diminished secretory granules and increased dense bodies were noted in rats given estrogen for 3 consecutive days. Animals receiving the hormone for an extended period of 6 days exhibited a more pronounced cytomembranolytic figure. The epithelium presented features of an ultimate cellular degeneration with a marked dilatation of endoplasmic reticulum and complete destruction of cytoplasmic matrix as the principal manifestations. Concomitant with these findings were further increased dense bodies as well as lipoid droplet-like substance and myeline-like structures found in the basal region along with PAM-positive free surfaces of cells which were undemonstrable in the normal controls. These findings collectively indicated a state preparatory for restoration in cellular function associated with membrane metabolism.
4. There are two theories concerned with deterioration of the prostatic columnar epithelium in animals receiving estrogen. One is that the phenomenon represents the very effect of direct disturbance of energy from oxidative phosphorylation caused by the administered hormone on organelles, such as rough surfaced endoplasmic reticulum, mitochondria and ribosomes. The other theory is that the epithelial degeneration is a consequence of indirect disturbance where the hormone exerts adverse influence rather systematically upon the cellular metabolic process aimed at protein synthesis, hence primari

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The statistics and therapy of testicular tumors, especially embryonal carcinoma, in children are reported with a comprehensive review from literatures.
I. Statistical study
1. A total of 93 cases of testicular tumors were treated in our hospital from January 1964 to December 1973, of which 20 cases (21.5%) occurred in childhood.
2. The testicular tumors in our series consisted of 16 embryonal carcinomas, 2 mature teratomas, 1 myxosarcoma and 1 malignant lymphoma.
The age distribution was less than 3 years and 4 months in germinal cell tumors, but 2 nongerminal cell tumors were seen at 6 and 9 years. The time interval between tumor detection and orchiectomy was less than 6 months, except one case of mature teratoma operated after 1 year and 10 months. They were all estimated to be in stage I by abdominal palpation, IVP or lymphography and chest X-ray.
3. Fifteen out of 16 cases of embryonal carcinoma are alive and well more than 1 year with an observed 5-year-survival rate of 92.3%.
4. Four cases of teratomas and nongerminal cell tumors are alive and well more than 8 years after the orchiectomy with or without post-operative irradiation to the retroperitoneal lymph nodes.
II. Treatment and results of 16 cases of embryonal carcinoma
1. Three cases receiving orchiectomy alone are living well more than 10 years. In one case, the recurrent residual spermatic cord was extirpated and irradiated at the age of 3.
2. Seven cases received orchiectomy and irradiation, six of which are alive and well more than 3 years. One case died of retroperitoneal lymph nodes metastasis 18 months later in spite of the prophylactic irradiation of 2, 900 rad/25 fractions/48 days.
3. Two cases operated on for orchiectomy with retroperitoneal lymph nodes dissection and irradiation are alive and well more than 6 years.
4. Four cases received orchiectomy and dissection, 3 of which are alive and well more than 1 year. One case, developing 2 pulmonary metastatic lesions 6 months later, was cured by irradiation with bleomycin and alive well under the control of anticancer drugs for 2 years.
5. All lymph nodes disseced were found histologically negative in 6 cases.
6. No growth retardation of body length and weight was observed due to the prophylactic irradiation to retroperitoneal lymph nodes. Lameness was seen in one case 4 years after the irradiation to the metastatic lesions of spermatic cord at the left coxal region.
III. Treatment planning according to stage
1. Early histological diagnosis and accurate staging are important for treatment planning. Lymphogram or direct transperitoneal palpation of the retroperitoneal lymph nodes at orchiectomy are recommended.
2. High orchiectomy should be performed in all patients.
3. Orchiectomy alone might be enough in controlling children in stage I less than 2-year-old. For boys in stage I more than 2-year-old, the prophylactic irradiation of 3, 000-4, 000 rad/4-5 weeks to the retroperitoneal lymph nodes might be necessary.
4. For the cases in stage II, dissection of lymph nodes should be performed with or without postoperative irradiation and chemotherapy.
IV. Other finding
The activities of serum lactic dehydrogenase changed in parallel with growth or regression of tumor size. Values of LDH in cases of favorable course ranged between 300 and 600 units.

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Recently, the incidence of bladder cancer has increased and many chemical substances have been suspected as carcinogens.
Clinically, it is well-known that incidence of human urinary bladder cancer (including papilloma) in female is lower than that in male, female to male ratio being only twenty to fourty per cent. It is also recognized that the urothelium is easily influenced by sex hormones.
The authors have studied the effects of testosterone propionate, estradiol and estriol on experimental bladder tumors induced in eight-week-old Wistar-Imamichi strain male rats by oral administration of 0.02mg/head/day of N-butyl-N-(4-hydroxybutyl)-nitrosamine as carcinogen for eight weeks (average total doses: 1.12mg).
The results were as follows:
1) In the group which was not treated for twelve weeks after completion of the carcinogen administration, six out of twenty-five cases showed bladder-tumors and two of twenty-five showed hyperplasia.
2) In the group which was injected intramuscularly 3mg/kg (body weight) of testosterone propionate (Enarmon-oil^®) one time weekly from the beginning of the carcinogen administration through the twentieth week, nine out of twenty-three cases showed bladder tumors and two were with hyperplasia.
3) In the group which was injected intramuscularly 3mg/kg (body weight) of estradiol (Ovahormone benzoate^®) one time weekly from the beginning of the carcinogen administration through the twentieth week, two out of twenty-three cases developed bladder tumors and five were with hyperplasia.
4) In the group which was injected intramuscularly 3mg/kg (body weight) of estriol (Estriel-depot^®) one time weekly from the beginning of the carcinogen administration through the twentieth week, two out of twenty four cases showed bladder tumors and three were with hyperplasia.
5) In the group which was not treated for twenty weeks, none was with bladder tumor or hyperplasia.
There were significant difference between the testosterone propionate group and the estradiol group (p<0.02), and the testosterone propionate group and the estriol group (p<0.02) in the incidence of bladder tumor.
But there was not a significant difference between the testosterone propionate group and estriol group (p=2.704) in the incidence of bladder tumor or hyperplasia.

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Red cell volume (RCV) and plasma volume (PV) were determined separately in 21 cases of pheochromocytoma before and after surgery. The following results were obtained:
1) A typical pattern of circulating blood volume in pheochromocytoma could be summarized as follows: a) Reduction of RCV. b) Change of PV in proportion to catecholamine secretion of the tumor. c) Dissociation between peripheral hematocrit and total body hematocrit.
2) In some cases (especially in male), however, no reduction of RCV was observed.
3) After the treatment with receptor blockers, no change of RCV with some changes of PV in proportion to the effect of the blockers was observed.
A standard method for “Blood overtransfusion” was discussed.

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Two cases of Kallmann's syndrome (hypogonadotropic hypogonadism with anosmia) are reported.
Case 1: A 23-year-old man visited our hospital on Aug. 27, 1973, with the chief complaint of a small penis. In his early infancy he apparently was normal except he could not walk until four years old. He noticed the alterations in his genitalia from the latter half of his elementary school days. Plasma levels of pituitary follicle stimulating and luteinizing hormones, as determined by radioimm. unoassay, were low, and the level of the latter hormone did not rise even after administration of luteinizing hormone releasing hormone. A testicular biopsy showed an immature testis and the Leydig cells were not observed. The diagnosis of right renal aplasia and anosmia was also established and right testicular aplasia was suspected.
Case 2: A 25-year-old man visited our hospital on May 13, 1974, with the chief complaint of evaluation of a small penis. In his birth history and early infancy he was apparently normal. Although he noticed the change of voice and rapid growth after graduation of junior high school, the penile development was not noticed. Plasma levels of pituitary follicle stimulating and luteinizing hormones were low, and the level of the latter hormone hardly rose, following administration of luteinizing hormone releasing hormone. A testicular biopsy showed an immature testis, and tests for olfactory sense revealed anosmia.

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A case of XX-male syndrome in a newborn infant was reported.
A 10-day-old mature infant was found to have a penile hypospadia and a bifid scrotum. Biopsy of the bilateral scrotal contents revealed immature testicular tissue and normal epididymal tissue. Sex chromatin was positive on the buccal smear and chromosome analysis on the peripheral blood showed 46, XX.
So-called XX-male syndrome is extremely rare, and only 48 cases have been reported in the world literature. Such a patient has normal male sexual organs, sometimes associated with hypospadia, and the chromosome constitution of 46, XX.

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