The ductus deferens as well as the ampulla of vas deferens has been recognized as one of male accessory sex organs for transport and storage of sperms. Only a limited number of papers have been reported on electron microscopy of human ductus deferens and ampulla.
Ultracytochemical localization of ACPase also shows the fine structural site of the intracellular digestion. The object of the present investigation is to delineate the ultrastructural findings and localization of ACPase by Gomori method in order to estimate the function of the ductus deferens and ampulla of vas deferens.
Ultrastructurally, a lot of plnocytotic infoldings, vesicles, multivesicular bodies related to the absorptive function are demonstrated in the apical cytoplasm of the epithelial cells in both ductus deferens and ampulla. Ampulla epithelial cells, however, have a lot of secretory granules in the apical resion, which would be one proof of the secretory function. Cilia are noted in the surface of the ampulla. The presence of a cilium is regarded as the sign of active transport of the sperm. The localization of the ACPase is found in the Golgi apparatus, dense body, multivesicular body, secondary lysosomes in both ductus deferens and ampulla, These findings suggest that the enzyme is primarily engaged in the digestion in the epithelial cell of deferens and ampulla.

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A novel lactoseries ganglioside, disialosyl Le^a (III⁴FucIII⁶NeuAcIV³NeuAcLc₄) was extracted and purified from matastatic liver tumors of the colonic cancer, and a specific monoclonal antibody was raised against this structure, The antigen level in sera of patients with urological cancer and with various benign diseases as well as healthy subjects was investigated by inhibition assay using pure glycolipid coated on the plastic plate. High serum levels were detected in patients with renal cancer (25%), bladder cancer (51.2%), renal pelvic and ureteral cancer (20.0%), testicular cancer (57.1%), prostatic cancer (30.0%), and liver cirrhosis (41.1%), though low antigen levels were seen with penile cancer, many benign diseases and in healthy subjects. These data indicate that disialosyl Le^a antgien in sera offers a useful parameter for diagnosis of some urological cancers especially bladder cancer and testicular cancer, if a more simplified and less expensive assay method is developed.

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The enhancing cytotoxic effect of nicardipine, a Ca²⁺ antagonist, on vinblastine (VLB) was examined in primary renal cell carcinoma cells by human tumor clonogenic assay (HTCA). Eleven of 25 specimens (44%) were evaluable for chemosensitivity testing. Nicardipine was used at a nontoxic concentration of 1, 10μM. Nicardipine enhanced the cytotoxity of VLB in HTCA 1 to 16 folds and 5 to 189 folds with 1 and 10μM nicardipine, respectively, in terms of the concentration of 50% inhibition of colony formation (IC₅₀). Defining positive drug sensitivity as at least a 70% inhibition of colony formation, only one of 11 specimens (9%) was sensitive to VLB. Whereas 3 of 9 specimens (33%) and 5 of 8 specimens (63%) were sensitive to VLB plus nicardipine at the concentration of 1 and 10μM, respectively. It is suggested that nicardipine has an enhanced cytotoxity of VLB in the cells of primary renal cell carcinoma. Furthermore, these data suggest that combination therapy of VLB and nicardipine may be usefull for developing the chemotherapy of renal cell carcinoma.

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The enhancing cytotoxic effect of nicardipine, a Ca²⁺ antagonist, on vinblastine (VLB) was examined in seven patients with advanced renal cell carcinoma. For this purpose, plasma concentration of nicardipine was determined by electron capture gas chromatograpy. Furthermore, the side reaction of VLB combined with nicardipine was evaluated. Plasma concentration of nicardipine was maintained more than 1μM which is experimentally expected to give anticancer effect, in the half the patients receiving orally more than 70mg of nicardipine 3 times a day. The major side effects were drop of blood pressure and myelosuppression. Six patients (86%) had WBC<3, 000/mm³ and five (71%) had BP<100mmHg. But, these side effects were not serious. These data suggest that the VLB combined with nicardipine might be clinically applicable for the treatment of metastatic renal cell carcinoma.

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From January 1957 to December 1984, 301 patients with renal cell carcinoma were treated at the Jikei University Hospital and related hospitals. The cases were classified as to whether the renal tumor was diagnosed before or after 1978. After 1978 the use of computed tomography (CT) increased greatly. We studied clinical characteristics of patients with non specific urinary tract symptoms or without any direct signs of renal cell carcinoma as an incidental finding.
In the pre-1978 group, 12 out of 123 (9.8%) cases were incidental findings. Out of 178 cases diagnosed after 1978, 37 (20.8%) were incidental. Then, the rate of incidental diagnosis was increasing in recent years (the period after 1978). There was no significant difference between the incidental cases of the two time periods in terms of the mean age, sex ratio, and affected side. The most common findings that led to the diagnosis in the incidental group were a fever of unknown origin, metastatic signs and gastrointestinal signs. The tests that most often led to the diagnosis were CT scan (46.9%), IVP, ultrasonography, and X-rays of the gastrointestinal tract.
Our data indicated that patients with incidentally-found tumors did not have a very low disease stage and, therfore, their survival rate was not much better than that of patients with the recognized signs and symptoms of renal cell carcinoma. With increasing use of effective tecniques such as CT scans and ultrasonography, the number of incidentally-found renal cell carcinoma will cotinue to increase. But renal cell carcinomas thus found are not always in an early stage.

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A remote controlled transcystoscopic intracavitary after-loading unit has been introduced to irradiation therapy of bladder carcinoma. Using intense radiation therapy, a significant dose can be delivered to the tumor in a short period of time. Uning transcystoscopic intracavitary irradiation, we have treated fourteen patients with transitional cell carcinoma of the bladder. Nine patients initially showed a complete response, although within several months, 3 patients subsequently showed recurrence in a different part of the bladder. Utilizing this technique, technical difficulties and severe complications were not encountered. The preliminary results and actual technique of transcystoscopic intracavitary irradiation are reported.

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A new intracavitary whole bladder mucosal irradiation procedure has been introduced for multiple, recurrent tumors, or carcinoma in situ of the urinary bladder. Using a remote controllled afterloading unit and a specially designed applicator constructed with a balloon catheter and a loading tube, a sufficient dose can be delivered evenly to the bladder mucosa. The technique of the intracavitary whole bladder mucosal irradiation and the preliminary results are described. Nineteen patients with recurrent or multiple bladder tumors have been treated by this procedure. Most patients tolerated the procedure without any difficulties. No morbidity and no mortality were noted. Nine of 10 patients with 6 months or more of follow up term had no recurrence. Intracavitary whole bladder mucosal irradiation would be superior method as the treatment of recurrent or multiple superficial bladder cancer, including carcinoma in situ, which are uncontrolled by other conservative measures. Further data, including longer follow up, are needed to define the potentially promising role of this procedure.

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A total of 31 cases of multiple lower calyceal calculi operated during the 4 year period from 1980 to 1983 were divided into two groups: one group consisted of 22 cases treated by pyelolithotory or nephrolithotomy to remove calculi only and the other group consisted of 9 cases treated by partial nephrectomy of the lower pole. In these two groups comparisons were made in terms of recurrence rate of calculi. Patients were followed up for 3 to 6 years after the operation. In 13 out of 22 cases (59.1%) treated by pyelolithotomy or nephrolithotomy, recurrence of calculi was observed. The interval from the operation to relapse in 13 cases was within 1 year in 3 cases, 1 to 2 years in 6 cases, 2 to 3 years and 3 to 4 years in 2 cases. As to the site of relapse, calculi appeared again in the lower calyx similar to the original site in all but 2 cases. In 1 of these exceptinal cases spontaneous pass was seen and in the other case calculi were found in the ureter. In contrast to these cases, recurrence of calculi occurred in none of 9 cases treated by partial nephrectomy. From these results, it is considered that even today when percutaneous nephrolithotomy and extracorporeal shock wave lithotripsy have advanced and propagated, partial nephrectomy should be considered for prevention of relapse in the treatment of cases of multiple lower calyceal calculi.

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One hundred and eighteen patients with ureteral calculi were treated by transureteral lithotripsy using a rigid ureteroscope between March, 1985 and Nov., 1986. Two Patients had calculi in the bilateral ureters. Most calculi were disintegrated by the ultrasonic lithotripsy and/or electrohydroliclithotripsy and were removed by stone basket under direct vision. 122 procedures were performed for the removal of ureteral stones. Stones were removed completely in 93 procedures (76%) and imcompletelo in 8 procedures (7%). The stone could not be removed in 21 procedures (17%). Immediate complications were ureteral avulusion in 2 procedures and ureteral perforation in 10. In 3 of 12 patients with immediate complications, open surgery was necessary. which were ureteroneocystostomy, ureteroureterostomy or draingage and nephrostomy. Postoperative complications were pyrexia in 7 patients, acute prostatitis in 2, bladder tamponade in 1 and ureteral stricture in 1, who was treated with the psoas bladder hitch and ureteroneocystostomy. In the follo-up with excretroy urogram in 23 patients, the obstructive change in ureteral end arising from the insertion of the ureteroscope to the ureter, disappeard with in 4-16 weeks after procedures.
This procedure has great advantages in removing ureteral calculi, compared with percutaneous nephroscopic procedure or ureterolithotomy. However, it could not yield a complete success in the removal of calculi in the middle or the upper ureter. It also has complications requiring open reconstructive surgery. Therefore, the indication of this procedure should be necessary with more discussion.

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E-PTFE (expanded-polytetrafluoroethylene) which has been clinically used as a basic material as artificial blood vessel and pericardium is recently investigated for its possibility as a prosthesis for urinary tract replacement. This is a report on experimental studies with an E-PEFE graft as a artificial ureter.
About 4cm long E-PTFE tube grafts were implanted between the pelvis of the autotransplanted kidney and the bladder in 9 dogs. X-ray examination (IVP and CG) was performed, and macroscopic and microscopic findings were taken from 2 weeks to 21 months after the operation.
The results are as follows:
(1) There was no leakage and no stone formation except in one dog whose E-PTFE graft slid down into the bladder and formed calcification around the graft.
(2) Almost normal histologic findings in the kidneys were observed in 5 of the 9 dogs. Hydronephrosis was observed in 4 dogs, of which 2 had obstructive uropathy caused by stenosis due to graft kinking or granulative tissue formation after the graft migration.
(3) No noticeable change but accumulation of amorphous eosinophilic substance was observed in the interfibril space of the graft itself.
(4) The E-PTFE graft used as a 4cm long artifical ureter was ultimately excluded after the tubular epithelium regeneration was developed on the outer side of the grafts.
In conclution, although the implanted E-PTFE graft as an artifical ureter migrated from the original implanted site, it is suggested that the E-PTFE graft functioned as an artifical ureter for some period and then migrated and that a pseudoureter, a tubular tissue with regenerative epithelium and muscle fibers, had the function of carrying urine.

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Since January 1979, we have been using abdominal ultrasonography for screening in all patients with abdominal diseases. Twenty-five cases of renal cell carcinoma out of the 41, 983 screened patients were discovered by abdominal ultrasonography in the past eight years.
The classic symptoms such as hematuria, abdominal mass and flank pain were observed as chief complaints at the time of ultrasonographical examination in eight cases. In twelve cases, nonurologic symptoms were chief complaints at the time of the ultrasonographical examination. An ultrasonographical examination performed in the routine health check-up incidentally revealed renal tumor in five cases and all of them had no symptoms. The tumors of these five cases were smaller than those of the other cases and these five cases were in low stages and had good prognosis. Hematuria was not seen in 18 (72%) out of the 25 cases and 3 cases (12%) revealed no abnormality on intravenous pyelogram. These facts suggest that ultrasonography might be helpful in early detection of renal cell carcinoma.
At present, early detection followed by radical surgery is the best treatment for renal cell carcinoma, since there is no better nonsurgical therapy. For early diagnosis of renal cell carcinoma, our data showed that the use of ultrasonography in the screening of abdominal diseases at the routine health check-up was extremely important in addition to paying attention to nonurologic symptoms which were observed in some cases of renal cell carcinoma.

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Histologic features of transitional cell carcinoma of the urinary bladder obtained in curative surgery in 131 patients were analyzed in relation to the patient prognosis. Histologic features involved the stage, grade, growth pattern, infiltration pattern (INF), and lymphatic (ly) and vascular (V) invasion. Survival rate was estimated by Kaplan-Meier's method and statistical difference of the prognosis was analyzed by Cox-Mantel's test.
The overall 5-year survival rate (5y-SR) of the low stage tumor (_pT_is-pT_1b) was 71%, but its 5y-SR significantly decreased to a range of 30-50% when the tumor was G3, nonpapillary, INFβ-γ and or ly1-2. On the other hand, although 5y-SR of high stage tumor (_pT_2-pT₄) was as low as 24%, its 5y-SR approximated to 50% when the tumor was papillary or without lymphatic invasion.
The tumor grade well reflected the malignant potential of this disease: the 5y-SRs of G1, G2 and G3 tumors were 87%, 59% and 17%, respectively, with significant differences of prognosis among them. Even in low stage, the 5y-SR of G3 tumor was 40%. In contrast to the difinitive prognostic values of G1 and G3 tumor grades, the position of G2 tumor seemed undetermined. However, the prognosis of G2 tumor was clearly differentiated when the tumor histology was classified according to the growth pattern; the 5y-SR of G2 papillary tumor was 70%, while that of G2 nonpapillary tumor was 21% (p<0.001).
The histologically defined growth pattern also exhibited the malignant potential of this tumor. The overall 5y-SR of papillary tumor was 72%, and even in high stage, its 5y-SR was over 50%. On the other hand, the 5y-SR of nonpapillary tumor was below 46% regardless of other histologic features, the overall 5y-SR of nonpapillary tumor being 19%.
The present results indicate the importance of histologic features and their relationships in better understanding of the natural history of bladder carcinoma.

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We studied the usefulness of transurethral ultrasonography in diagnosing the invasion of uterine cervical cancer to the bladder. Ten female patients with bladder tumors, as a control group, were examined by transurethral ultrasonography. The cervix of the uterus of them was clearly demonstrated on the tomogram. Fourty-two patients with uterine cervical cancer (FIGO stages 0 and I: 11 cases, stage II: 6 cases, stages III and IV: 22 cases, recurrence group: 3 cases) were examined by transurethral ultrasonography. The findings were classified into 3echo patterns according to the changes of the tomogram of the interface between the bladder wall and the cervix of the uterus. The criteria are as follows; BI₀: the image of the bladder muscle layer adjoining the cervix of the uterus keeps thin smooth continuity. BI₁: the image of the bladder muscle layer adjoining the cervix of the uterus is indented or destroyed, and an irregular hyperechoic area appears by the side of the uterus. BI₂: the image of the bladder muscle layer is covered by the echoes growing from the cervix of the uterus. We concluded that BI₀ seen in 31 cases corresponded to negative signs of the tumor invasion to the bladder wall, BI₁ in 9 cases to signs of the tumor invasion to the bladder muscle layer, and BI₂ in 2 cases to signs of the tumor invasion to mucosa or submucosal layer of the bladder. The antero-posterior diameter and lateral diameter of the uterine cervical image were measured and “presumed ellipse area” was calculated in each stage of patients. The results showed that the more advanced the stage was, the larger became the uterine cervical size. As a result of cystoscopic examination performed in all cases at the same time, the findings such as flat mucosal edema and/or an elevated base of the bladder seemed to be not significant for diagnosing bladder involvement by uterine cervical cancer. Transurethral ultrasonography is considered to be a very accurate and objective method for diagnosing the invasion of uterine cervical cancer to the bladder.

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The use of a suprapubic trocar in transurethral prostatic resection was evaluated and compared to the conventional filling and emptying technique. Fifty transurethral prostatic resections with suprapubic trocar and 19 resections by conventional technique were performed from Oct. 1984 to Dec. 1985. The operating time (minutes per gm of resected tissue) of the TURP with trocar was 2.5min/gm, which was significantly shorter than that of the conventional TURP (3.2min/gm). The loss of blood during TURP was slightly larger in the group operated on with trocar technique when over 30gm tissue was resected. The concentration of serum sodium just after operation, that indicated the absorption of the irrigating fluid, was lower in the group with conventional technique, especially when over 30gm tissue was resected. The bladder pressure during suprapubic trocar technique did not exceed 10cmH₂O (0-8cmH₂O), but the pressure at conventional technique was between 0 and 81cmH₂O.
We recommend the suprapubic trocar technique in TURP, since it saves the time of resection and it holds the bladder pressure under the pelvic venous pressure, there by the amount of absorbed fluid is minimized. And the technique facilitates the operation, because we can keep the view clearly and uninterruptedly

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Among 1, 120 patients with primary bladder tumor registered from 1960 to 1982, 678 having histopath-logically confirmed superficial papillary tumors (Ta, T1) were selected for the present study. Patients having primary carcinoma in situ (CIS) were excluded from the present study and those who had Ta/T1 tumor with assosiated CIS were included.
The patients were divided into three groups accoding to the histopathological grade of initial tumors; G0-G1, G2, and G3 groups. The G0-G1 group consisted of 298 cases and had exellent 5-and 10-year actuarial survival rates of 90 and 85%, respectively. The G2 group consisted of 284 cases and revealed a favourable 5-year actuarial survival rate of 80.4%, but the survival rate gradually decreased thereafter to 59% at 10 years. The G3 group consisted of 79 cases and showed a poor 5-year actuarial survival rate of 60%, but none had died thereafter in contrast with the G2 group. The result revealed a significant decrease of 5-year actuarial survival rate of patients with high grade tumors. The survival rate of each group was influenced by neither tumor size nor patient sexes. Five-year survival rates were worse in patients with G3 tumors aged over 60 years than those under 60 years of age and in patients with multiple G2 tumors than those with a solitary G2 tumors (p<0.05). Furthermore, the incidence of high grade tumors was found to increase gradually in recent years (p<0.005) as well as with the advance of patients age (p<0.005).

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Eighty my of BCG (Tokyo Strain, 1.5×10⁷ viable units of BCG/mg) was dissolved in 30ml of saline and instilled intravesically without cutaneous inoculation of BCG. In the therapeutic group, BCG was administrated once a week for 2 months followed by 2 week's instillation for additional 2 months, In prophylactic group, the patients were treated once or twice per 2 weeks for 2 months, and then monthly more than one year.
In 8 patients who underwent therapeutic instillation, 3 out of 4 patients with small papillary tumors showed complete disapperance of their tumors in 4 months and other 4 patients with carcinoma in situ became free of tumor within 2.5 months. Among 18 patients who underwent prophylactic instillation therapy, 17 patients (94.4%) have had no tumor recurrence 2.5 to 25 months after the innitiation of the BCG therapy.
In vivo and in vitro studies on property of immune reactions in the patients undergone BCG therapy were made. The present study demonstrated the following; (1) delayed hypersensitivity skin test responded to PPD tested 2 months after the initiation of the treatment converted from negative to positive in 7 out of 9 cases and enhanced in 5 out of 8 being originally positive case; (2) in vitro study using peripheral blood lymphocyte (PBL) isolated from the patients demonstrated that production of IFN-γ by PBL restimulated in vitro with BCG was significantly enhanced in the patients with BCG therapy than those without and that instillation therapy yielded the enhancedment of interleukin-1 (IL-1) production by monocyte in 5 out of 9 patients; (3) there was close correlation (p<0.02) between IFN-titer produced by PBL and IL-1 activity by monocyte and (4) PPD skin test 2 months after initiation of BCG therapy was negative in 3 patients whose PBL failed to produce IFN-γ foliwoing restimulation with BCG in vitro.
These results indicate that patient's PBL and monocytes might be sensitized systemically by BCG therapy despite its local application to the bladder.

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Intravenous Digital Subtraction Angiography (IVDSA) was performed on 140 cases with the following urogenital diseases: 48 idiopathic hematuria, 40 vascular disease, 19 urogenital tumor, 11 renal trauma, 6 urogenital anomaly, 5 chronic renal failure and 11 others.
All of these cases were examined in the supine position. IVDSA in the sitting position and pharmaco-IVDSA were also performed on 80 and 20 cases, respectively. IVDSA in the sitting position employed in this study has several advantages as follows: (1) Reduced amount of bowel gas in the Image Intensifier with less artifact, (2) Improved visualization of abdominal vessels, particularly the renal artery, and (3) Better identification of the displacement of abdominal vessels. Pharmaco-IVDSA performed with a concominant use of Dopamine (Dose of 5ng/kg/min. for 3 minutes before the injection of contrast material) could provide more distinct images of renal vasculature and a dense nephrogram as compared with those obtained by conventional IVDSA.
In 95% of the 140 cases, IVDSA provided actual and well-opacified vascular images serving for the diagnosis of these urogenital diseases. The accuracy of diagnosis was 69% on the average in this series. The rate of correct diagnosis was 98% for vascular disease, 91% for renal trauma, 83% for urogenital vascular anomaly, 80% for contracted kidney, 63% for mass lesion, and 46% for idiopathic hematuria. Surprisingly, IVDSA provided a correct diagnostic rate of 100% for renal cell carcinoma which was the most challenging disease to be screened. IVDSA proved to be the most useful especially for vascular diseases such as aneurysm or renovascular hypertension. Moreover, it had a relative indication for the screening of renal mass resulting from renal bleeding and moderate renal trauma as well as for the evaluation of vascular anomaly and compromised renal function in chronic renal failure. However, IVDSA was contra-indicated to infectious renal diseases and severe renal trauma.
From these results, we concluded that the indication of IVDSA was extended by the sitting position IVDSA and pharmaco-IVDSA, and that this technique proved to be a practical, noninvasive, well-tolerated method for the screening and follow-up evaluation of several urogenital diseases.

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Immunohistochemical studies of prostatic acid phosphatase and prostatic specific antigen were performed in 73 cases of prostatic adenocarcinoma. Monoclonal and polyclonal antibodies to prostatic acid phosphatase and prostatic specific antigen were commercially available. Eighty-six percent of well differentiated adenocarcinoma, 50% of moderate differentiated adenocarcinoma, 36% of poorly differentiated adenocarcinoma showed positive staining for prostatic acid phosphatase using monoclonal antibody, namely 51% of adenocarcinoma of this study had positivity. The good correlation of tumor differentiation with monoclonal antibody staining to prostatic acid phosphatase was recognized in this study. Autopsy cases (9) and ineffective cases (7) to hormonal and other therapy showed low positivity to monoclonal antibody to prostatic acid phosphatase. Monoclonal antibody to prostatic acid phosphatase was a useful marker to detect tumor differentiation of prostatic carcinoma and amenability to therapy. All specimens of this study showed high (above 85%) positivity to monoclonal antibody to prostatic specific antigen, and to polyclonal antibodies to these two antigens.

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There have been many controversies regarding radical surgery for both localized and locally extensive carcinoma of the prostate. In this paper we aimed to assess the indication of radical prostatectomy or radical cystoprostatectomy to the prostatic carcinoma from our own results of the surgical cases.
The surgical procedures experienced in our department were classified as 42 cases of radical prostatectomy, 8 of cytoprostatectomy and one of pelvic exenteration. The endocrine therapy was added to the non-curative cases postoperatively. As to stage A cases, all were alive without cancer and the five-year survival rate was 100%. With regard to stage B cases, 19 of 22 were well without carcinoma (86%) and the five-year survival rate was 87.5%. Of 16 cases with stage C, 11 were alive without cancer (69%). Four of 6 cases with stage D showed no evidence of disease after surgery (67%). The five-year survival rates of stage C and D were 68.2% and 66.7%, respectively. Pathological findings revealed high rates of cancer invasion to the surrounding tissues in cases of stage B₂ and lymphnode metastases in stage C cases. From the present clinical investigation, radical surgery would be indicated for the treatment of localized prostatic carcinoma, and radical surgery combined with the endocrine therapy for invasive carcinoma.

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Histological mapping of the bladder was performed in 42 surgical total cystectomy specimens. Removed bladders were opened by an anterior incision accordsng to the general rule for clinical and pathological studies on bladder cancer of Japanese Urological Association. Fixed tissue was cut into 5×20mm sized blocks. The areas of blocks including the tumor tissue and comprising histologicallly identified cancer cells were measured.
There were no significant differences among groups pT1, 2, 3 and 4 in clinical tumor areas. In pT2, 3 and 4 groups the areas of blocks comprising cancer cells histologically were greater than that of the clinical tumor. Every specimen showed diffuse epithelial abnormalities such as proliferative cystitis, squamous cell metaplasia and other degenerative changes. The blocks had evidence of these changes were occupied to equal or surpass the blooks comprising the cancer cells. These areas in groups pT3 and 4 were significant greater than that of pT1 and 2. The tumor invaded progressively to the deep muscle layer of bladder had marked tendency to spread diffusely.

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Balloon occluded arterial infusion therapy with CDDP and ADM was performed in invasive bladder carcinoma patients comprising 10 inoperable and 8 curative operative cases. In the inoperable group, whole body CT revealed reduction in tumor size in four, specimen by TUR showed the down staging in two, and pathological study at autopsy showed good effects on bladder but no effect on metastatic lesion in one case. In the curative operation group, we evaluated the effect of chemotherapy by mapping histology. BOAT was more effective in muscle layers than in mucosa. We found massive fibrosis, necrotic masses and non viable cancer cells in the muscle layer, and slight destructive architecture of tumor tissue in the mucosal layer. There were no changing in grading. These results suggested that this therapeutic modality would be an effective adjuvant chemotherapy.

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Magnetic resonance imaging (MRI) was performed in 18 patients with adrenal masses using a superconducting magnet operating at 1.5 Tesla. Seven pheochromocytomas, five aldosterone-producing adenomas, two hydrocortisone-producing adenomas, two adrenal metastases, one adrenal carcinoma and one adrenal myelolipoma were examined by this method. Spin-echo pulse sequences were obtained at the repetition time (TR) 0.1-1.6sec and the echo time (TE) 14-75msec. T₁-weighted images of phechromocytomas were similar in signal intensity to the kidney, while T₂-weighted images revealed much higher intensity than those of the liver and kidney. The signal intensity on T₁-and T₂-weighted images of adrenal adenomas were similar, irrespective of endocrine characteristics, to that of the liver and kidney.
T₁-weighted images which detect small masses more than 1cm in diameter offer anatomic resolution similar to computed tomography (CT) and T₂-weighted images give information about internal characteristic of adrenal masses. It is expected that MRI is more useful in diagnosis of adrenal masses than CT.

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A case of papillary cystadenocarcinoma of the prostate is reported. The patient was a 77 year-old-man, who was admitted to our hospital on September 23 1986, with the complaint of urethral pain and dysuria. On rectal examination a cystic tumor greater than a fist was palpated on the right side of the prostate. The diagnosis of right retrovesical tumor was established by cystoscopy, ultrasonography, CT scan and vesiculography. Total cystoprostatectomy with construction of bilateral ureterocutaneostomy was done in October 28, 1986. Histological diagnosis was papillary cystadenocarcinoma of the prostate.
Papillary cystadenocarcinoma of the prostate is very rare. A report of the case and review of the literature are presented.

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