In order to investigate the chemosensitivity test with a stem cell assay for renal cell carcinoma, primary culture of human renal cell carcinoma in soft agar was studied.
The soft agar culture was constructed with Ham's F-12 medium, 8% fetal calf serum and agarose. Final agarose concentrations were 0.4% for the basal layer and 0.24% for the culture layer. And 0.2% collagenase was used for isolating the cancer cells. Dissociated cancer cells were plated into the soft asar dish and cultured for 3 to 4 weeks. Formed colonies (more than 30 cells per colony) were counted.
Colony-formation in the soft agar dish was observed in 13 out of 16 cases (81%) and these plating efficiency were 0.2 to 0.5%.
Preliminary chemosensitivity tests were performed using our systems. The results indicated that this stem cell assay was applicable to clinical cancer chemotherapy.

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An experimental model of chronic hydronephrosis due to an extrinsic partial ureteral obstruction was produced in Wistar rats. The reproducibility and quality of this experimental hydonephrosis were determined by intravenous pyelography, renal cortical blood flow studies using a hydrogen gas clearance method, histological and microangiographic studies. The partial obstruction was induced by instilling a droplet of an α-cyanoacrylate monomer solution around the left lower ureter. Hydronephrosis produced by a complete double ligation of the ureter was used as control. On the basis of IVP findings, the degree of hydronephrosis was rated on the following basis: normal=grade 0, moderate=grade I, severe=grade II and no opacification=grade III. Out of 105 rats, a moderate or severe progressive hydronephrosis occurred in 97 one week after the induction of hydronephrosis; grades 0, I, II and III were observed in 6 (5.7%), 75 (71.4%), 22 (21%) and 2 rats (1.9%), respectively. In these kidneys, renal cortical hemodynamics decreased gradually in course of time, and the decreasing rate was less progressive than that in the complete ligation group. The microangiograph demonstrated an appreciable amounts of well-preserved glomeruli even at the terminal stage of the experiment and a gradual decreasing rate of the distribution of the glomeruli. In addition, the histological study revealed that hydronephrotic changes in this model were milder and less progressive than those in the complete ligation group.
In conclusion, the present model has a high reproducibility in developing chronic hydronephrosis and may be introduced to the experimental studies of pyelonephritis, renal function, renal stone formation and others.

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One of the major problems to be solved in renal transplantation is how to achieve satisfactory immunosuppressive effects and reduce complications arising from immunosuppression.
As is generally known, various lymphocytes hold the key to the occurrence of acute rejection.
As a new trial for the immunosuppressive method in renal transplantation, we carried out removal of lymphocytes, that is, lymphapheresis by the use of Blood Cell Separator (IBM 2997).
Blood flow taken out of a shunt for dialysis is treated with Blood Cell Separator to remove only lymphocytes, while plasma and other cells are returned continuously into the body.
On the average 3×10⁹ lymphocytes were removed at the time of each lymphapheresis. Some platelets and granulocytes adjacent to the lymphocytic layer were also removed. However, the numbers of peripheral platelets and leukocytes showed no significant decrease.
On the other hand, the number of peripheral lymphocytes decreased significantly after single lymphapheresis but leveled off thereafter despite repeated lymphapheresis.
Single lymphapheresis took about two hours and the amount of blood treated was 6L for adults and 3L for children.
We provided a bypass on the venous side of the hemodialysis circuit so that lymphapheresis can be performed during hemodialysis.
Subsequently, lymphapheresis can be performed without any further intervention on the patients in preoperative hemodialysis or when hemodialysis is needed for postoperative ATN (acute tubular necrosis) or rejection.
Furthermore, lymphapheresis has contributed to perform renal transplantation easily and safely and can be performed whenever it is needed before and after transplantation.
Biopsy of lymph nodes after lymphapheresis showed a distinct atrophy.
Preoperative lymphapheresis was performed in 11 cases of renal transplantation from March, 1981, to October, 1982, at our institution.
Among these 11 cases, only one case showed rejection leading to the graft loss, although they were varied in the histocompatibility, the number of repeated lymphapheresis before the operation (2-30 times) and the duration of postoperative observation (1-20 months). This was a case in which administration of immunosuppressive agents could not be continued because of respiratory complication.
Mild rejection occurred in most of the cases but it recovered easily with an increased dosis of steroid.
The cases treated with preoperative lymphapheresis tended to require less amount of steroid compared to the cases receiving no lymphapheresis.
The result of preoperative lymphapheresis in renal transplantation has so far been satisfactory.

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A radical en bloc resection for penile cancer, including the penis, scrotum, scrotal contents and skin of the groin, hypogastrium and perineum with bilateral inguinal and pelvic lymph nodes dissection, presents difficult surgical problems because of the resulting extensive skin defects. Up to now there has been no effective technique for covering such skin defects which allows sufficient resection without causing any postoperative problems.
We report 4 cases of advanced penile cancer without distant metastasis and describe a technique for covering massive skin defects by using a tensor fascia lata myocutaneous flap after radical resection. In our 4 patients, there was no major flap necrosis, but wound infections occurred in 2 cases, lymphorrhea in all 4 cases. These complications were resolved by effective drainage, irrigation with povidone iodine and administration of antibiotics. Although all patients have the complication of difficulties in standing up from a sitting position due to loss of tensor fascia lata muscles, there has been no clinically detected effect on gait or knee stability. After 29 months one patient is still alive without any sign of recurrence, although the other 3 patients died from a recurrence of the cancer from between 2 and 7 months after the operation. Our results are reasonably successful as one patient has been completely cured to date, and as our technique is shown to be effective in treating such symptoms as infection and severe pain in intractable cancer.

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To assess the significance of urinary ferritin in renal impairment, serum and urinary ferritin, β₂-microglobulin (β₂-MG) and serum creatinine were determined in 73 patients with renal impairment (7 with chronic glomerulonephritis, 22 with acute stage of pyelonephritis, 16 with chronic pyelonephritis, 11 with urinary tract cancer involved to upper urinary tract, 2 with renal tuberculosis, 3 with polycystic kindney, 2 with renal injury and 10 with non-infected hydronephrosis).
The results were as follows:
1) Although no significant relationship was noted in serum ferritin and creatinine, significant relationship was noted in serum β₂-MG and creatinine in both benign (r=0.830, N=56) and malignant diseases (r=0.817, N=19).
2) Urinary β₂-MG increased markedly in patients with acute stage of pyelonephritis and urinary tract cancer, while urinary ferritin increased markedly in those with chronic glomerulonephritis and urinary tract cancer. Therefore, it was suggested that appearance of urinary ferritin was caused by urinary tract cancer and/or necrosis of cancer cells, disturbance of sieving effect and necrosis of renal tubular cells.

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Administration of hematoporphyrin derivative (HpD) which is a tumor-specific photosensitive substance, followed by irradiation with light is a rapidly developing technique in the diagnosis and treatment of cancer. In this method lasers are used as the exciting light to induce photochemical reaction as they are convenient to use with endoscopic systems. Cancer are localized by emission of fluorescence induced with violet light from a krypton-ion laser (Spectra-Physics Co. Model 164-11), while in photoradiation therapy (PRT) cancer cells are destroyed by red light from an argon-dye laser (Spectra-Physics Co. Model 171-08 and Model 375-01).
The HpD was provided by Dr. T. J. Dougherty (Roswell Park Memorial Institute).
The authors investigated this system in 11 cases of superficial tumors of the urinary bladder since Novemver, 1980. Recurrence of photoradiated tumors was observed in 3 cases but not in the other 8 cases during a 6-18 months follow-up period. The irradiation was performed 48-72hr after the intravenous administration of 2.5-5.0mg/kg body weight HpD and irradiation with the argon-dye laser was performed for 20-25min. The laser beams were delivered via a quartz fiber inserted through the device for inserting a ureter catheter of a flexible fiberoptic cystoscope (Kaiba, Tokyo). Fluorescence was seen in all cases radiated with violet light. Following PRT with red light the irradiated tumor soon swelled and became edematous. The surface of the tumor was destroyed in 7-14 days and was replaced with a whitish necrotic mass. The mass gradually exforliated and diminished in size, and the tumor completely disappeard in 7-10 weeks.
PRT is absolutely indicated for tumors in which histopathologic finding suggest up to a depth of pT1b and invasion it can be effective to destroy some tumors up to pT2 if they are in a shallow part of the tunica muscularis. However tumors with invasion as far as pT3 or deeper do not appear treatable by PRT alone.
No recurrence was seen in 8 of 11 cases during 6-10 months follow-up. Recurrence was seen in 3 cases at 6-18 months.
The result suggests that this method is effective in cases of bladder tumors with invasion up to a depth of pT1b and cases up to pT2.

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Clinical efficacies of 15 antimicrobial agents, ampicillin, carbenicillin, carindacillin, piperacillin, cefazolin, cefoxitin, cefmetazole, cefamandole, ceftizoxime, cefotaxime, cefinenoxime, latamoxef, gentamicin, amikacin and pipemidic acid on 2218 patients with complicated urinary tract infections were studied. All patients had pyuria of 5 or more WBCs per hpf, bacteriuria of 10⁴ or more bacteria per ml of urine and underlying urinary disease.
Overall clinical efficacy of the treatment was evaluated by the criteria proposed by the UTI Committee in Japan as excellent, moderate or poor based on the combination of changes in pyuria and bacteriuria. Excellent plus moderate responses were obtained in 53.2% of the 1597 patients with monomicrobial infections and in 36.9% of the 621 patients with polymicrobial infections. This difference was statistically significant. The difference of clinical efficacies between patients with monomicrobial infections and those with polymicrobial infections was especially significant in patients treated with penicillins and cephems of the first generation.
Bacteriological responses to the treatment were determined in sensitive, intermediate and resistant groups. Bacteriological response was defined as eradicated if bacteria identical to the original strain were not isolated after treatment, and as persisted if bacteria identical to the original strain were isolated after treatment regardless of bacterial count. Bacterial eradication rate of penicillin sensitive strains(MIC:≤12.5μg/ml) was significantly lower in patients with polymicrobial infections than in those with monomicrobial infections. But no significant differences were observed between patients with monomicrobial and polymicrobial infections treated with the other antibiotics in the bacterial eradication rates.
The responses to antibiotics of single and mixed culture of Escherichia coli and β-lactamase producing Staphylococcus epidermidis were studied in an in vitro system by use of biophotometer. When ampicillin was added to achieve a concentration of 25μg per ml (4 MIC for both strains), rapid lysis of E. coli and delayed lysis of S. epidermidis occurred, growth of both organismus was suppressed for the whole 24 hour period of observation. When the mixture of the two organismus was exposed to a similar concentration of ampicillin, rapid lysis was again observed, but growth resumed after several hours. The MIC of both organismus which were fully grown in the broth were determined again, but the susceptibility of the organismus to ampicillin was not different from that of the original strains, and it was observed that the concentration of ampicillin was rapidly reduced in the broth of the mixture. When the mixture of the two organismus was exposed to amoxicillin, similar results were obtained. But when the mixture was exposed to cefotaxime or ampicillin with clavulanic acid, growth of both organismus was suppressed throughout the 24 hour period of observation.
In conclusion, β-lactamase production by another organismus in the mixture, was considered one possible reason why fully susceptible bacteria, which would normally be eradicated when present as the single infecting organism, frequently persisted when present in mixed infection.

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Clinical characteristics of 48 patients with renovascular hypertension in 23 years (1958-1981) were summarized and discussed. Etiological disorders included fibromuscular dysplasia (19 patients), atherosclerosis (13 patients), aortitis syndrome (4 patients), aneurysm of renal artery (4 patients) and unknown (7 patients). Thirty-eight patients (43 kidneys) were surgically treated, mainly by nephrectomy or reconstruction by spleno-renal anastomosis, aorto-renal bypass or vein patch graft in early years, mainly by renal autotransplantation or nephrectomy in recent years.
Short-term cure rate with operative procedures was 71% overall, 90% in recent 10 years. Better results were obtained by renal autotransplantation or nephrectomy rather than reconstructive surgery except autotransplantation. Operative mortality was documented in 2 patients (infection or renal failure).
Hypertension of renovascular origin which had been resistent to medical management has become comparatively easily controlled by renin-angiotensin inhibitors in recent years. However, operative intervention with the purpose of restoring renal blood flow and maintaining renal function should be considered first. Renal revascularizarion must be tried if possible and nephrectomy is indicated only for a nonsalvageable kidney or for a technically nonreconstructable lesion. We have performed renal autotransplantation in 14 patients with good and stable outcome.

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For the purpose of prediction of functional recovery of unilateral hydronephrosis, pelvic urine analysis was performed in dogs for 1-8 weeks' periods of complete unilateral ureteral obstruction. Pelvic urine was collected through percutaneous pelvic puncture and fractional excretion rate of Na, K, Urea-N and osmolarity was calculated.
Prolonged obstruction resulted in a marked increase of V/GFR and FENa, which corresponded well to the histological findings.
After 1, 3. 5, or 8 weeks of obstruction, the obstruction was released by uretero-cutaneoustomy and split renal function studies were performed weekly for 4 weeks. Renal function estimated by Ccr and IVP at 4 weeks after release of obstruction showed a marked improvement in kidneys, which showed lower V/GFR and FENa, especially less than 5% and 3% respectively, at the time of release of obstruction.
Since fractional excretion rate of each component in pelvic urine can be calculated without urine volume measurement and corresponds well to functional recovery, clinical implication for obstructed human kidney may be suggested.

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To investigate the role of anti-B lymphocyte antibodies in acute rejection, we screened serum samples from 45 recipients of one haplotype matched first living related donor kidney transplant for cytotoxic antibodies against pane B and T lymphocyte. The acute rejection episode was found in 31 recipients. We compared the type of the antibodies produced after transplant with that occurring before and after any rejection episode. 7 of 8 (87.5%) recipients with B- and T-warm antibodies but no B-cold antibody after rejection fell into immunological failure in a year. Of the patients with B-cold or No antibody, 7 of 23 (30.4%) experienced immunological failure in a year. (p<0.025) The patients showing no antibodies or B-cold pattern before rejection and never developing new antibodies after rejection lost 2 of 8 (25.0%) grafts in a year. Of the 7 patients wiht no antibodies befor rejection, but developing B-cold antibody with or without B-or T-warm antibisies after rejection episode never fell into immunological failure in a year. In contrast to these two groups, the recipients belonged to other groups lost 12 of 16 (75.0%) grafts in a year. (p<0.005) In our three cases of accelerated rejection, we could rarely detect the antibodies, but in other groups, we found a correlation between development of anti lymphocyte antibodies and graft outcomes. In summary, we cofirmed the deleterious effects of B- and T-warm antibodies and protective effects of B-cold antibosdy on allografts after kidney transplantation.

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Circulating prostate antigen-binding globulins (PA-BG) and prostatic acid phosphatase-binding globulins (PAP-BG) have been detected by newly developed enzyme immunoassays (EIA). In these assay systems, serum PA-BG could be detected as low as 2.0μg/ml and PAP-BG was quantitable to 1.0μg/ml. A total of 167 sera drawn from patients with various diseases including prostate cancer have been assayed for PA-BG and PAP-BG. Serum PA-BG ranged from less than 2.0 to 200μg/ml with a mean of 17.8 in normal males. One of normal males, and pancreas cancer patients, each and 7 patients with stage D prostate cancer exceeded 111μg/ml (mean+2 SD in normal males).
Serum PA-BG level in patients with stage D prostate cancer alone was statistically higher than those of other group patients (p<0.01). Sera from a group of normal males were shown to have PAP-BG level ranging from 1.9 to 78μg/ml with a mean of 11.2. Serum PAP-BG values in normal controls, nonprostatic cancer patients and patients with all stages of prostate cancer were similarily distrubuted.
There was a statistically suggestive difference in serum PAP-BG level between BPH and other groups (p<0.05). No correlation was found between serum PA and PA-BG, PAP and PAP-BG, or PA-BG and PAP-BG values in prostate cancer (Supported in part by grant-in-aid for Fundamental Scientific Research No 57480305 from Ministry of Education, Japan).

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Quantitative studies of separate renal function during and after unilateral partial ureteral obstruction were performed in eleven female mongrel dogs.
In the experiments, the dogs underwent a left cutaneous ureterostomy using a vaginal cuff for protection of the ureteral stoma to facilitate repeated separate urine collection for a considerable long period. Then, a partial ureteral obstruction was created at the lower part of the right ureter by a silk knot. The obstruction was kept for five weeks, then the ureteral silk was deligated, and the dogs were followed for 5 more weeks after release of ureteral obstruction.
Split renal function studies were carried out at 1, 3, 5 weeks during obstruction, and 1, 3, 5 weeks after release. Clearance study was performed under constant diuresis to exclude the possible influences of hydronephrosis. The following values were obtained in each renal function studies: Glomerular filtration rate (GFR), creatinine excretion rate (ER_cr), sodium clearance (C_Na), fraction of filtered sodium excreted (FE_Na), potassium clearance (C_k), fraction of filtered potassium excreted (FE_k), osmolar clearance (C_osm), osmolar clearance as percent of GFR (C_osm/GFR), and free water clearance (CH₂O).
Then, each ratios were calculated from the value of obstruction side divided by that of normal side. Regarding free water clearance, the difference was calculated from normal kidney value minus obstructed kidney value. These ratios and difference were compared with GFR recovery ratio 5 weeks after relief of obstruction in the same dog. The results were as follows:
1) GFR and EF_cr of partially obstructed kidney decreased during obstruction and their recovery after relief of obstruction paralleled the degree of their decrease during obstruction. Statistically, GFR ratio had a highly significant correlation with ER_cr ratio through the period (p<0.001).
2) Absolute rate of sodium excretion was less in the partially obstructed kidney and C_Na ratio showed no significant correlation with GFR ratio at any time. FE_Na was uniformly greater on the side with partially obstructed kidney than on the control side after relief of obstruction.
3) Absolute rates of potassium and solute excretion were always lower on the side with partially obstructed kidney than on the control side during and following obstruction.
4) CH₂O was higher on the obstructed side after relief of obstruction.
5) GFR ratio 5 weeks after relief of obstruction had a significant correlation to each value at 5 weeks of obstruction; ER_cr ratio (p<0.001, correlation coefficent: r=0.918), C_Na ratio (p<0.001, r=0.878), FE_Na ratio (p<0.01, r=-0.761), C_k ratio (p<0.001, r=0.944), FE_k ratio (p<0.001, r=-0.929), C_osm ratio (p<0.01, r=0.860), C_osm/GFR ratio (p<0.01, r=-0.800) and CH₂O difference (p<0.001, r=-0.909).

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1. Chronic administration (24-48 months) of human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG) were performed for 16 cases of adolescent and adult males with hypogonadotropic hypogonadism.
2. HCG were administered intramuscularly, 3.000-5.000×IU/M² once or twice weekly and hMG 75 IU/M² twice weekly.
3. The causes of hypogonadotropic hypogonadism were consisted of isolated gonadotropin deficiency (10 cases), Kallmann syndrome (3 cases), hypophysectomy after puberty (2 cases) and meningococcal meningitis after puberty (1 cases).
4. In the period of administration of hCG and hMG, serum levels of testosterone were measured once every six months, and changes of external genitalia and increases of sperm count were evaluated after administration.
5. In 10 cases of isolated gonadotropin deficiency, increases of serum testosterone to the lower limit of normal adult males, remarkable changes in external genitalia and moderate increases of sperm count were found only in 2 cases. In other cases the above changes were not so remarkable.
6. In 3 cases of Kallmann syndrome, the responses of serum testosterone, remarkable changes of external genitalia and increases of sperm count could not be found.
7. In all of the three cases with histories of hypophysectomy and meningitis, increases of serum testosterone to the level in normal adult males, remarkable changes of external genitalia and remarkable increases of sperm count were found.
8. In additional examination for testicular-biopsy performed pre and post administrations of hMG and hCG, in some cases, findings of seminiferous tubules and interstitial tissues were correlated with the above results.

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In sixty-three patients complaining of impotence (Table 1), REM-penogram (measurement of nocturnal penile tumescence) was recorded, and EEG-sleep characteristics was analysed. The parameter of sleep studies is displayed in Table 2. Brain-stem function was examined by the use of the optokinetic nystagmus test, an eye tracking test, and an adrenalin loading test in some patients.
The following results were obtained:
1) In the 63 patients complaining of impotence, 35 were diagnosed as functonal and 28 as organic from the REM-penogram. EEG-sleep characteristics of all cases, both the functonal group and the organic group, are shown in Table 4. REM-T/TST of the organic group was significantly lower than that of the functional group.
2) In the functional cases, lower REM-T/TST was seen in cases with end-stage renal failure and brain-neck injury (Tables 5 and 6).
3) The abnormality of REM sleep was seen more frequently in cases with brain-stem dysfunction (Tables 7 and 8).
From the results summarized above, it is suggested that in the impotent patient the function of the brain-stem, which includes the center of REM sleep and sexual behavior, is disturbed to some extent. At the same time, it can be inferred that the abnomality of the REM sleep noted in this study is a response of disturbed brain-stem function.

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So far we have mainly depended on the difference in response to visual sexual stimulation (VSS) to distinguish functional male impotence from organic one. Any sign of positive response to VSS on the penothermocurve (PTC) or on penile tumescence monitoring (PTM) is judged as indicating functional impotence, while no response at all as falling under organic impotence. However, it has become known that individual differences stand persistently against placing all cases showing no response to VSS under the category of organic impotence. Then in an effort to find a more reliable discrimination criterion, we tried all-night sleep polygraphy in 38 cases without response to VSS to examine whether they did disclose nocturnal penile tumescence (NPT) coincident with the REM sleep stage. As a result, except only 6 cases, the remaining vast majority of 32 were found showing evidence of NPT coinciding with the REM sleep stage, though with some individual difference, confirming the application as highly reliable for objective discrimination of functional from organic impotence.
The results of all-night sleep polygraphy were also studied with relation to erection. It was found that the control subjects competent for normal erection had a penile circumference at complete erection larger compared with the pre-erection level by 20% or more. Then for impotence patients, 81.5% of them had a NPT level of penile circumference larger than the intact size by 20% or more. NPT was identifiable in some impotence cases not only at the REM sleep stage but at non-REM stage as well. Particularly notable was the fact that 6 of 18 cases had evidence of complete erection at the non-REM stage. At present, however, the phenomenon of NPT at the non-REM stage yet remains unavailbale for elucidation. In any event for the sole objective of categorizing impotence, evidence of NPT, especially with full erection, may well justify the case to be classfied as functional impotence.
In conclusion, the entire reliance on penile tumescence monitoring (PTM), omitting the checking of electroencephalogram, may well be of use for diagnosing impotence whether functional or organic. At least for the cases showing no response to VSS, it seems essential to identify the response with NPT, positive or negative.

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Many materials have been used in surgical management of erectile impotence. Presently, the two main types of prosthesis being used are the inflatable and the semirigid double rods.
We have performed operative insertion of the semirigid prosthesis, Finney prosthesis, in 28 cases. In most them impotence occurred after pelvic surgery. Insertion of the prosthesis was performed either by the perineal or penile base approach.
We reviewed our experience of Finney procedure and compared surgical results of each approach. The average operative time of the perineal approach was 75 minutes and the time of the penile approach was 25 minutes.
Of all 28 cases, sexual intercourse has become to be possible by the time of 5 weeks after the operation, in spite of local pain, which disappeared within a week or so spontaneously. There was no serious complication in our cases. In 5 cases out of 20 of the perineal approach, the local pain persisted over a week after surgery, but it disappeared by the time of 3 to 4 weeks postoperatively. On the other hand, there was no such problem in cases of the penile approach. In 3 cases operated by the perineal approach, difficulty of urination was worsened. These were the cases of postoperative A-P resection for rectal cancer. Intermittent self cathetelization was educated to theses patients. In 4 cases of ours, the penile edema appeared, but there was no marked difference of its occurrence between the perineal and the penile approach. Anyway, we have experienced no case of infection and no case in whom prosthesis needed to be removed because of any reasons due to the operation.
After all, we have confirmed that the insert operation of Finney prosthesis is a safe and useful procedure for impotence and that the penile base approach is more satisfactory since it has resulted in fewer complication and shorter operative time.

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Serum levels of α-fetoprotein (AFP), carcinoembryonic antigen (CEA) and human chorionic gonadotropin (HCG) and its beta subunit (β-HCG) and urinary levels of HCG were measured in 62 cases of germinal testicular cancer. (26 cases of seminoma and 36 cases of nonseminoma).
The serum AFP levels were elevated in 81.8% with non-seminoma patients by double autobody radiommunoassay (RIA), but in 50% by RIA and including other methods. In seminoma patients, elevation of serum AFP levels was not found.
The serum β-HCG levels were elevated in 40% of the seminoma patients. On the other hand, the serum β-HCG levels were elevated in 62.5% of the non-seminoma patients. Patients with choriocarcinoma always had elevated levels of β-HCG.
The serum CEA levels were elevated only 2 of 10 with seminoma and 1 of 16 without seminoma: CEA was found not to be a useful marker in testicular cancer.
In staging and monitoring testicular cancer, serial measurement of serum AFP and HCG is very useful.

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Mucinous adenocarcinoma arising from the prostate are so rare that only 41 cases have been reported in the literature. The first case of mucinous adenocarcinoma of the prostate which was responsive to chemotherapy is reported.
(Case Report) A 65-year-old male was presented with a one-year history of prostatism and was found to have clinical evidence of intracapsular prostatic tumor. Resected tissue revealed histologic features of mucinous adenocarcinoma of the prostate. Acid and alkaline phosphatase values were within normal limits. The patient was managed by bilateral orchiectomy and with diethylstilbestrol for one year. Then he underwent exploratory laparotomy, cystoprostatectomy and ileal conduit urinary diversion. Histologic examination confirmed mucinous adenocarcinoma of the prostate. Subsequently the patient received irradiation and chemotherapy using 5-fluorouracil and cyclophosphamide. However the disease was progressive. Radionucleotide bone scan revealed osseous metastasis. Partial remission occurred for 80 days with peplomycin (3-[(s)-1'-phenylethylamino] propylaminobleomycin), which is an analogue of bleomycin. He died 3 years after the establishment of diagnosis.
(Comment) The diagnosis of mutinous adenocarcinoma of the prostate was made by histochemical examination and by exclusion of an extraprostatic primary source.
The primary tumor showed histopathological features of mostly mucinous component, partly tubular component and the transitional part between them. It was suggested that this tubular component might produce abundant mucus culminating in the mucinous adenocarcinoma with both muconodular and signet-ring cell pattern.

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Since a clinical and histological entity of localized mediastinal lymph node hyperplasia has been established by Castleman in 1956, many reports of giant lymph node hyperplasia have appeared in the literature. Although giant lymph node hyperplasia may occur in any lymph node areas of the body, it is most commonly found in intrathoracic cavity. Pelvic retroperitoneal lesion is a rare condition which has been described only five occasions. We have recently experienced the sixth case in a 27-year-old woman, who complained of pollakisuria and lower abdominal mass. In the hematological examination, severe thrombocytepenia and elevated erythrocyte sedimentation rate were revealed. The excretory urogram showed the displacement of bilateral ureters and the bladder to the left. After predonisolon had been medicated for two months and the platelet increased to the lower normal limit, retroperitoneal exploration of the right paravesical space was carried out and the mass was removed. Grossly, the removed tumor was solitary and measuring 14×8×7cm. in size. Microscopically, the tumor was composed of small, atrophic lymphoid follicles.
Capillaries with fibrous hyalinization penetrated the small follicle center and the capillary proliferation in the nearly interfollicular tissue were noted. Then a diagnosis of the hyaline vascular type of giant lymph node hyperplasia in the pelvic retroperitoneum was made. After the removal of the tumor, normal excretory urogram was demonstrated and platelet counts remain within normal limit.

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