Leydig cells of the testis have been repoted to be target cells of luteinizing hormone by biochemical studies. A limited number of histochemical studies have also shown the localization of the luteinizing hormone in the testicular tissue of experimental animals. However, there has been no report on the immunohistochemical localizations of gonadotropin in human testis.
The aim of the present study is to verify and discuss the localization of luteinizing hormone in the human testicular tissue using immunohistochemical technique. Anti-hCG antisera were obtained from the rabbit immunized by hCG (10, 000-15, 000iu/mg). Anti-rabbit IgG goat IgG were also received from the goat immunized by normal rabbit IgG, and, thereafter, they were labelled with fluorescein isothiocyanate (FITC) or horse radish peroxidase (HRP).
Immunohistochemical preparations were carried out as follows: (1) Testicular specimens were obtained from 20 cases of urological patients at the testicular operations. (2) Tissues were fixed immediately with cold 95% ethanol, 10% formalin or Zanboni solution.
Then, they were dehydrated, embedded in paraffin, and cut into 3-4μ sections. (3) Immunohistochemical stainings were performed using both indirect immunofluoresceine and immunoperoxidase techniques.
Immunohistochemical localizations of LH were clearly seen in the testicular interstitial cell of 16 cases except 3 cases of prostatic cancer after antiandrogen treatment and 1 case of 8 years old boy. Positive fluoresceine reactions were detected only in several Leydig cells, presumably immature Leydig cell, while reaction products were shown in the typical mature Leydig cell containing numbers of granules in the cytoplasm by the HRP method.
These localizations were limited only to cytoplasm of the interstitial cells. Reactions were not observed in the nucleus and cytoplasmic membrane by either FITC or HRP method. No reaction was found in the spermatogenic cells, Sertoli cells, basement membrane and peritubular myoid cells.
The present investigation demonstrated the immunohistochemical localization of LH in the interstitial cell cytoplasm of human testis. However, further study should be followed to clarify the intracellular site of gonadotropin by electron microscopic studies.

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Preliminary clinical studies suggested that hyperthermic treatment resulted in regression of bladder tumor. The present paper is aimed to discuss the efficacy of this method by analysing 69 cases of bladder tumors. The bladder was treated with heated irrigant 10 times continuously unless side effect occurred. Thio-Tepa or Adriamycin was added to the irrigant in some cases.
1) Complete and partial regressions were noted in 15 of the 69 cases and 28 of the 69 cases respectively, while no regression was observed in 26 of the 69 cases. Therefore, 63 per cent (43 of 69 cases) showed tumor regression by the hyperthermic treatment. In relation to the clinicopathological study and hyperthermia, regression was noted in 82 per cent of pedunculated tumors, 92per cent of small tumors, 80per cent of TI tumors, and 77per cent of grade I tumors.
2) 18 cases with severe complication were treated with hyperthermia. Regression was seen in 56 per cent (10 of 18). 3 died of tumor and 2 died of cardiovascular diseases. 5 were alive over one year.
3) Intractable hematuria was terminated or controlled in 50per cent (8 of 16) and macroscopic hematuria was terminated in 70per cent (19 of 27) following hyperthermia.
4) As the side effect, pronounced high blood pressure was recorded in 37 cases during the treatment. Following hyperthermia, acute epididymitis was found in 7 cases. 11 developed vesicoureteral reflux after the treatment.
5) Of 54 cases with complete follow up data, recurrence of the tumors was noted in 12 cases (22per cent). Recurrence occurred within 6 months in 5 cases, within one year in 6 cases and after one year in 1 case. These results may not indicate that hyperthermia is of value in the prevention of tumor recurrence.
Therefore, hyperthermic treatment is effective for superficial bladder tumor, and may be applied to patients with severe complications.

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For the differential diagnosis of organic and functional impotence, we have used radioisotope penography to determine their rates of increase in penial blood flow at erection. In a further attempt to achieve the aim more conveniently, we recently tried to trace change in penial skin temperature concomitant with erection in 33 subjects, including 22 with impotence, 5 with Klinefelter's syndrome and 6 control cases.
The trace in penial skin temperature—named as penothermocurve—was obtained after a visual sexual stimulation (V. S. S.). By way of comparison, radioisotope penography was applied in 23 of 33 test subjects.
The results showed that, 6 among the 22 impotence cases who had no past ailments predisposed to organic impotence, revealed an average rise of 1.58°C in penial skin temperature after V. S. S., of 13 others with past history of trauma or others who were likely to lead to organic impotence revealed an average 0.77°C in penial skin. Of remaining 3 cases with psychotic impotence, an average temperature rise was 0.73°C. An average temperature rise of 5 Klinefelter's syndrome cases was 1.16°C after V. S. S. The 6 control cases revealed an average temperature rise of 1.28°C.
In the 23 cases with radioisotope penograms, 15 B-type cases had an average rise of 1.23°C, while 6 A-type cases had an average temperature rise of 0.68°C. The other 2 cases without any responses in radioisotope penogram had an average temperature rise of 0.3°C after V. S. S.
It has thus become evident that the cases with increasing penial blood flow with V. S. S. showed proportional increases in penital skin temperatures, indicating a satisfactory consistency between our tracing of penothermocurve and the radioisotope penography test in distinguishing functional from organic impotence. Our penothermocurve method, free of technical difficulties in handling R. I., simple and practicable anywhere, would be worthy of recommendation in objective differential diagnosis between functional and organic impotences.

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As a diagnostic technique for differentiating between organic and functional impotence, we have developed the “radioisotope penography” to identify the features of intrapenial blood flow in patients. As an isotope for our penography, we previously used simply ¹³¹I-human serum albumin, ^113mIn-micro-colloid, or ^99mTcO^-₄-. But recently a unique method using ^99mTc-labeled autologous red blood cells has been developed and apparently is preferable to any of the foregoing isotopes in quantitating intrapenial blood. This is a report on our radioisotope penographies using ^99mTc-labeled autologous red blood cells and some of the clinical results obtained.
In 25 impotent patients, radioisotope penography was performed using ^99mTc-red blood cells (labeling the patient's own red blood cells with ^99mTc) for quantitative analysis of intrapenial blood volume. A visual sexual stimulation (V. S. S.) was shown the patient after injection of ^99mTc-red blood cells. Patients showing a complete erection had an increase in pooled blood 4.2-11.2 times greater than before the V. S. S. (mean increase, 8.0). In cases with incomplete erections after the V. S. S., intrapenial blood volumes were 3.3-7.0 times greater than before the V. S. S. (mean increase, 4.9). In cases showing a gentle rise in their penogram curves without evidence of an erection, intrapenial blood volumes after the V. S. S. were 2.0-3.3 times those before the V. S. S. (mean increase, 2.9). By contrast, in those cases showing no response to the V. S. S. and no rise in their penogram curves, post-V. S. S. increase in intrapenial pool of blood was very slight, only 1.4-1.7 times the original volume.

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A fibrin slide technique has been adopted to study the localization of fibrinolytic activity of rat kidneys and quantitative assessment of fibrinolysis on their isolated glomeruli. Sections from 6 rat kidneys revealedlysis over the arcuate and interlobular vessels. In some specimens weak fibrinolytic activity was demonstrated in the glomeruli. Using 0.7% human fibrinogen solution and a preparation of isolated glomeruli, glomerular fibrinolysis was highly active and could be measured quantitatively. Lack of activity on plasminogen-free fibrin demonstrated the absence of nonspecific proteases. This quantitative method should allow more accurate studies of pathological glomerular fibrinolysis, and isolated glomeruli would be a useful material for studies of urokinase production.

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The plasma level of aldosterone has been measured by radioimmunoassay (RIA) with Sephadex LH-20 column chromatography in our laboratories. However, the techniques of chromatography are complicated. Recently, a direct RIA of plasma aldosterone using a highly specific antiserum has been reported from a few laboratories. The direct assay is thought to been useful to treat a large number of samples.
In this report, a direct RIA of plasma aldosterone was achieved by using anti-aldosterone-18, 21-diacetate-3-oxime bovine serum albumin provided from CIS as an antiserum. Procedure of extraction in a direct method is as usual. Plasma aldosterone was extracted with dichloromethane. The extract was washed with 0.1N acetic acid and distilled water. The solvent was evaporated, and the dried residues were dissolved in buffer solution for RIA. Aldosterone values obtained from the direct method were compared to those obtained by the chromatographic method. The most suitable conditions of the direct method are as follows:
1. Preparation of standard curve must be treated in exactly the same way as the extraction procedure of plasma sample. The most suitable standard curve was obtained from the case in which the standard aldosterone was added to 5% bovine serum albumin.
2. Incubation for 30 minutes at 37°C followed by 2 hours at 4°C was confirmed as the most suitable condition in this assay procedure.
3. A large quantity of cortisol added to plasma in vitro did not interfere with aldosterone values by this method. Dilution curve of the high concentration of plasma aldosterone was paralleled with standard curve. High specificity of this antiserum was clear from these observations.
4. Recovery of added aldosterone to pool plasma was over 93%.
5. Reproducibility of this assay was satisfactory: The intra assay and inter assay variations were 5% to 14% and 10% to 19% respectively.
6. Comparing between the direct assay and Sephadex LH-20 column chromatography was established to measure in 123 samplex which contained aldosterone valued from 0 to 160ng/dl. Correlationship between these two methods was excellent: r=0.96; y=1.08x-2.55.
7. By the direct method, the mean level of plasma aldosterone in normal subjects was 6±3ng/dl at lying, and was 8±4ng/dl at standing. The mean concentration from 19 patients of primary aldosteronism was 71ng/dl. After operation in 4 patients of primary aldosteronism, plasma aldosterone was under 6ng/dl.
These results demonstrated that this direct method is a rapid, simple, efficient and accurate one for measuring plasma aldosterone as a routine test.

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The human kidney is the most advanced in phylogeny and its embryonic development through three distinct organ systems reflects the stages of evolution of the organ through phylogeny. The primitive kidneys, the pronephros and mesonephros, become vestigial in the human being but act as inducers of the definitive metanephric kidney.
Maldeveloped kidneys which are frequently associated with congenital ureteral and/or lower urinary tract abnormalities have usually been devided into agenesis, aplasia and hypoplasia. Recently, the term renal dysplasia is used by many authors to mean renal maldevelopment, but its definition, etiology and classification are still controvertial.
In this paper, renal dysplasia means congenital underdevelopment or developmental arrest of the renal parenchyma, i. e. the persistence of fetal structures “primitive ducts”. Other so-called ‘dysplastic’ structures, i. e. metaplastic cartilage, primitive glomeruli, etc, should be defined as dysplastic only when these structures were found with the primitive ducts.
The clinical and pathological findings in 120 patients submitted to partial or total nephrectomy and 15 autopsied specimens from the neonates and the immature babies have been reviewed. Histological examination of these kidneys showed the evidence of dysplasia in 24 in association with various abnormalities of the urinary tract (ectopic ureter 9, ureterocele 5, refluxing megaloureter 3, congenital hydronephrosis 2, multicystic kidney 3, distal ureteral atresia 2).
There were 10 duplex systems in which upper half kidneys were involved in 9, lower half kidney in 1 (VUR).
Renal dysplasia should be understood not only as a part of maldeveloped kidney, but also as a part of cystic disorders of kidney, the correlation of which were summarized in Table 3.
From the clinical view of renal pathology and urinary tract abnormalities, renal dysplasia was classified into three groups. In group 1, total dysplasia (aplastic, multicystic) was associated with atresia or absence of the renal pelvis and ureter. In group 2, hypoplastic dysplasia or dysplasia of the upper or lower half kidney; the ureter, although patent, had some anatomical or functional abnormalities which resulted in urinary stasis and reflux. In group 3, hydronephrotic dysplasia with multiple cortical cysts, was associated mostly with obstruction of lower urinary tract and infrequently with congenital hydronephrosis. There are sometimes difficulties to strictly classify and differenciate these 3 groups because of existence of intermediate one.
Back pressure from the urinary stasis or reflux in the fetal period may be one of the most important factors in the development of the dysplastic kidney, and the importance of the onset of injuries to the developing fetal kidney was stressed.

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Herein it is reported statistical studies on hematuria in outpatients who visited our department between 1971 and 1973. The total number of outpatients with hematuria was 589 cases (10.3%). The ratio of asymptomatic hematuria against symptomatic hematuria was two to three.
The commonest disease with asymptomatic hematuria was essential renal bleeding and that of symptomatic hematuria was cystitis and urethritis. Tumors of urinary tract were found in 12.9% of outpatients with hematuria: 17.0% with asymptomatic hematuria and 10.3% with symptomatic hematuria. Malignant tumors were in 10.2% of outpatients with hematuria. Tumors of urinary tract were more frequent in older age group. Admission and suitable treatment were required in sixty cases (10.5%) of outpatients with hematuria.

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In our previous report, we demonstrated that there were significant changes in several serum proteins in patients with malignant tumors of the urogenital system and suggested that measurement of these proteins would be helpful for evaluation of the clinical stage in these patients.
In this report, we analyzed the changes of the serum proteins such as prealbumin (Pre), α₁-acid glycoprotein (α₁-AG), α₁-antitrypsin (α₁-AT), α₂-HS glycoprotein (α₂-HS), ceruloplasmin (Cp), haptoglobin (Hp) and transferrin (Tf), by the quantitative measurement by the use of Behringwerke Partigens, particularly along with the clinical course of 81 cases of malignant tumors of the urogenital system.
Our findings were summarized as follows.
1) In improved group, all of measured serum proteins returned to the normal range as the illness improved.
2) In aggravated group, changes of the serum proteins became more pronounced as the illness progressed. It was significantly noted that α₁-AG, α₁-AT, Cp and Hp increased and Pre, α₂-HS and Tf decreased in cancer of the bladder, α₁-AG increased and Pre and Tf decreased in cancer of the prostate, Hp increased and Pre and Tf decreased in the tumors of the testicle, and α₁-AG, α₁-AT and Hp increased and α₂-HS and Tf decreased in tumors of other organs.
3) Surgical operation and irradiation therapy resulted in increases of α₁-AG, α₁-AT, Cp and Hp of various degree for about two months.
4) Estrogen administration into cancer of the prostate yielded a decrease of α₁-AG and an increase of Cp. Estrogen produced more pronounced changes than tumor itself and infection.
5) α₁-AG, α₁-AT, Cp and Hp showed moderate changes in the presence of infection. In aggravated group, however, tumor itself produced more pronounced changes on these proteins than infection.
6) Decreases of Pre, α₁-AG and Hp and an increase of Cp were observed in cases with hepatic dysfunction.
It is concluded that changes of these serum proteins reflected clinical course fairly well, that is, whether patients with malignant tumors of the urogenital system improved or aggravated, and that the follow-up of the serum protein changes may be clinically helpful for evaluation of prognosis of the patients with malignancy.

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