A monoclonal antibody termed “RS-11” was obtained from a hybridoma clone established by fusion between P3X63Ag8-U1 mouse myeloma cells and spleen cells of a Wistar rat which was hyperimmune to the same strain rat bladder cancer cells induced by BBN (N-butyl, N-hydroxy-butylnitrosamine). Immunoperoxidase staining of cultured cells showed that RS-11 was reactive to rat, dog and human bladder cancer cell lines as well as various cells except myeloma cells, leukemia cells and erythrocytes. By the immunostaining pattern the RS-11-defined antigen was expressed on the cell surface as well as in the cytoplasm of bladder cancer cells. Immunohistochemical examination of tumor tissues revealed that RS-11 was reactive to rat, dog and human bladder cancer, small part of human testicular cancer, penile cancer and meningioma. It was not reactive to other types of cancer and rat and human normal tissues except part of human pancreatic excretory ducts, renal collecting tubules and basal or middle layer of esophagus, tongue and skin. RS-11 was not reactive to glycolipid fraction extracted from antigen-bearing cells and less reactive to the protease-treated cells than to non-treated cells. This suggested that the antigenic determinant to RS-11 was present on a protein.

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The usefulness of prostatic specific antigen (PSA) as a tumor marker of prostatic cancer was investigated in comparison with prostatic acid phosphatase. PSA was measured by RIA method and prostatic acid phosphatase was measured by RIA method and enzyme method (PAP and P-ACP, respectively). The subjects were 14 patients with prostatic hypertrophy and 42 patients with non-treated cancer histologically diagnosed by biopsy. They had been examined at the Department of Urology, Showa University School of Medicine, during the period between September 1981 and May 1987. The patients with prostatic cancer underwent various tests and we divided them into three groups: 17 in the stage AB group, 18 in the stage C group and 7 in the stage D group. We defined that the normal range of PSA would be less than 7.5ng/ml. Among PSA, PAP, and P-ACP, only in PSA there were statistically significant differences between the prostatic hypertrophy group and each prostatic cancer group. The positive rate of PSA in the early-stage group was 52.9%. This is higher than the rates of the other two tumor markers. Simultaneous determination of PAP and PSA increased the positive rate by only 2.4% in comparison with PSA alone. Accordingly it seemed unnecessary to determine PAP together with PSA in screening tests for prostatic cancer. The correlation between PAP and PSA in the serum was relatively high (r=0.74). These results suggest that PSA is the most suitable marker in screening tests.

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Some basal examinaitons about the effect of citrate on calcium oxalate were carried out. These studies consisted of following three experiments, the effect on the solubility of calcium oxalate, the inhibitory activity to the ability of calcium oxalate crystal forming and inhibitory effect of citrate on renal tubular deposits of calcium oxalate crystal in the rat.
The following results have been obtained:
1) Citrate increased solubility of calcium oxalate within a range of physiological pH and the effect was enhanced in an alkaline condition. Cirtrate also increased solubility of hydroxyapatite in comparison with control, whereas an extreme decrease was confirmed in the alkaline condition.
2) The ability of crystal forming of calcium oxalate was studied using the aggregometer. As concentration of citrate increased, crystal forming of calcium oxalate decreased.
3) Calcium oxalate crystals were developed in the renal tubules of rats that received ethylene glycol (0.4%). Forming of these crystals was markedly suppressed by administration of citrate concomitantly.
These results suggested the possibility that citrate might inhibit the formation of calcium oxalate stone and might be useful for actual clinical treatment of calcium oxalate stone.

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1. Calcium stone formers (male; 170, female; 61) and healthy controls (male; 72, female; 37) were examined with respect to urinay citrate and several urinary biochemistries. Urinary citrate was determined using an enzymatic method which we had reported.
The following results were obtained:
1) The mean value of urinary citrate excretion was 383.9±156.5mg/day in male controls, and 452.6±171.4mg/day in female controls. In healthy controls, urinary citrate in females was significantly higher than in males (p<0.05).
2) In male patients with calcium urolithiasis urinary citrate was significantly lower than the healthy controls. In female patients urinary citrate excretion was significantly lower only in the group of recurrent stone formers.
3) Hypocitraturia was defined when citrate excretion was under 200mg/day in males and under 250mg/day in female. According to this definition, 45 of 116 male patients (26.5%) and 17 of 61 female patients (27.9%) were classified to hypocitraturia.
4) Hypocitraturia was associated with hypercalciuria in 12.4 per cent of male stone formers, and in 6.6 per cent of female stone formers. Both of hypocitraturia and hyperoxaluria were found in only about 10 per cent of stone formers in both sexes. These results showed that hypocitraturia itself was one of the serious risk factors of stone formation.
5) There were low statistical correlation between urinary citrate and urine volume, urinary magnesium, uric acid, phosphorus or oxalate. Urinary citrate was correlated with urinary calcium only in stone formers and was not correlated with urinary pH.
2. Citrate therapy with sodium-potassium-citrate (CG-120) was performed in 31 calcium stone formers. During the therapy urinary citrate excretion was significantly increased and the effect was sustained. Of 23 patients, who have received citrate therapy for at least 6 months, only two patients had recurrence of stones after treatment. Citrate therapy was considered to be useful for preventing the recurrence of calcium urolithiasis.

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We studied the method of transurethral enucleation in order to operate more successfully and safely and to decrease operation time.
Should the adenoma of the upper side be resected totally or subtotally before detachment? In five patients an adenoma of the upper side was resected totally (anterior total resection group). In fifty-two patients an upper adenoma was resected subtotally and after the detaching process the upper adenoma was resected totally (anterior subtotal rescetion group). In all patients partially detached adenomas were firstly resected to the surgical capsule at 8, 4 and 6 o'clock (longitudinal resection) and the rest of the adenoma was resected totally at the next cutting process. The upper side of the urethra was covered with thick anterior f ibromuscular stroma, in which a perforation did not occur, but in three of the five patients (60% of the anterior total resection group) the venous sinus was opened by deep cutting. Resection time after the detaching process was from 9 to 60 minutes with an average of 26 minutes.
Resection of the adenoma of the upper side before the detaching process (anterior subtotal resection) is better than anterior total resection. Three longitudinal resections after the detachment are advantageous in that easy total resection is possible and that they save operation time.

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Prostate-specific antigen (PA), a new marker for prostate cancer, has been detected with a competitive binding type enzyme immunoassay (EIA, MARKIT-F PA) and evaluated clinically. Of a total of 238 serum samples from normal human subjects, 20 female cases had serum PA levels ranging from less than 1.5 to 3.9ng/ml. In other 218 male cases, these values distributed in the range of <1.5-5.0ng/ml. These values were not related to age. Based upon our previous report, we used 3.6ng/ml as a cut-off value for male cases. Positive rates in various urological diseases were as follows; Stage A of prostate cancer; 20% (2/10), stage B; 46% (6/13), stage C; 64% (7/11), stage D; 89% (68/76), benign prostatic hypertrophy; 6% (5/82), renal cell carcinoma; 3% (1/32), renal pelvic or ureter tumor; 6% (1/18), bladder tumor; 2% (1/64), testicular tumor; 0% (0/18), and prostatitis; 33% (3/9). With Students' t test, a statistically significant difference (p<0.05) was observed between prostate cancer and other diseases in serum PA levels. There was a tendency to have high serum PA values as the stages progressed in the patients with prostate cancer. In positive rates, a statistical difference was observed with Fisher's test between stage D and other stages. But in distributions, no significant statistical difference among clinical stages or histopathological grades was observed with Students' t test. In 48 cases with prostate cancer prior to the treatment, simultaneous determinations of srum PA, prostatic acid phosphatase (PAP, RIA) and γ-Seminoprotein (γ-Sm, EIA) have been done. Positive rate in each single assay of PA, PAP and γ-Sm was 73, 63 and 73%, respectively. Of these cases, 81% (39 patients) could be diagnosed by showing elevated serum levels in one of the markers. Serum PA assay using this EIA system is suggested to become and useful aid for diagnosis of patients with prostate cancer, especially when combined with PAP and γ-Sm.

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Morphological and biochemical aspects of androgen dependency of rat prostate gland were reevaluated by our original microdissection technique. As shown in the previous paper, rat prostate is morphogenetically clasiffied into 5 lobes (i.e., ventral, lateral type 1, lateral type 2, dorsal lobes and coagulating gland).
In this study, androgen deprivation-induced regression and androgen-induced regeneration of those prostatic lobes were individually investigated by various hormonal treatment. Regression of the prostatic gland was studied by castration or 17β-estradiol treatment and regeneration was studied by testosterone propionate (TP) treatment. Marked difference in the degree and rapidity of morphological and biochemical change were observed among prostatic lobes. Coagulating gland and the ventral lobe were more sensitive to sex hormones than the other lobes with regard to the gross ductal branching morphology, histology, wet weight and DNA contents. The ventral lobe is most androgen dependent, the lateral type 1 lobe has the least androgen dependency in their morphological and functional maintenance. This study clearly shows that the prostatic gland is not a homogenenous organ in its morphology and cellular activities. We consider that this intraglandular heterogeneity is one of the most important biological characters of the prostatic gland and may directly relate to the pathogenesis of such localized abnormal growth as prostatic hyperplasia and cancer of the prostatic gland.

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Glomerular and proximal tubular functions of the surface nephron after release of complete unilateral ureteral obstruction (CUUO) were studied in rats. The superficial proximal tubule in which Lissamine Green (L. G.) appeared in the first 30sec after intravenous injection of L. G. was defined as a Functioning Nephron (F. N.). Number of F. N. (N_f) was used as an index of glomerular function. Proximal tubular function was assessed by the peritubular membrane potential of the proximal tubular cell (E_M).
N_f increased significantly 1hr after release of obstruction in both 3 day' and 1 week'CUUO. One week after release of obstruction, a further significant increase in N_f was observed in 1 week'CUUO but not in 3 days'CUUO.
Superficial proximal tubule in which L. G. appeared in the first 16sec was defined as a good F. N. In both 3 days' and 1 week'CUUO, the ratio of good F. N. to F. N. (%_gN_f) increased 1hr after release of obstruction. A further increase in %_gN_f was observed one week after release of obstruction. The data indicate that the individual nephron function continues to recover till one week after release of obstruction.
E_M increased significantly 1hr after release of obstruction in both 3 days' and 1 week'CUUO. However, no further significant increase in E_M was observed one week after release of obstruction in both 3 days' and 1 week'CUUO. One week after release of obstruction N_f and E_M were still significantly lower than the corresponding control values.
The data suggest: 1) N_f continues to increase with an improvement of the filtrative function of the individual nephron for 1 week after release of obstruciton, 2) the recovery of proximal tubular function is completed immediately after release of obstruction, and 3) filtrative function is slow in recovery compared to the proximal tubular function.

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The deterioration of the renal function during complete unilateral ureteral obstruction (CUUO) and functional recovery after relief of obstruction were studied in the young rat using Lissamine Green (L. G.) injection method and microelectrode technique. Pelvic volume of 3 days'CUUO kidney was 15.7 times as large as young control (in adult rat 6.3 times as large as adult control) and that of 1 week'CUUO kidney was 47.5 times (16.7 times in adult). Number of Functioning Nephrons (N_f: ×10³/cm²) measured by L. G. injection method was 14.8±0.9 in control (15.1±0.5 in adult control). In 3 days'CUUO kidney N_f reduced to 20.9% of young control (in adult rat 12.6% of adult control), and recovered to 73.6% (58.9% in adult) 1 week after relief of obstruciton. In 1 week'CUUO kidney, N_f reduced to 0% of control (5.6% in adult) and recovered to 48.6% (47.7% in adult) 1 week after relief of obstruction. Basolateral membrane potential of the proximal tubular cell (E_M) was -68.1±0.8mV in control (-71.0±0.8mV in adult control). In 3 days'CUUO kidney, E_M reduced to 78.4% of control (in adult 73.7% of adult control) and recovered to 92.8% (88.2% in adult) 1 week after relief of obstruction. In 1 week'CUUO kidney, E_M rduced to 58.6% of control (67.5% in adult) and recovered to 84.7% (85.1% in adult) 1 week after relief of obstruction.
1. In the early stage of CUUO, renal functional deterioration in young rats was relatively slight compared with adult rats and renal function after relief of obstruciton in young rats was better than that in adult rats. 2. In the late stage of young'CUUO, the renal pelvis was expanded and renal functional deterioration was highly progressive. However, renal function after relief of obstruction in young rats was the same as that in adult rats.

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Although autotransplantation of the adrenal tissue has been performed clinically, the result so far is not satisfactory. There are many factors that may affect the graft survival; streoid replacement, endogenous or exogenous ACTH, the size and volume of the transplanted tissue, the transplanted site and so forth.
In order to find the suitable condition for autotransplantation, we performed adrenal autotransplantation in rats. Adult male Wistar rats were used. After bilateral adrenalectomy, immeddiate autotransplantation to the flank muscle pocket was performed with a unilateral adrenal gland divided into eight pieces (the autotransplanted group). The control group underwent a sham operation consisting of an abdominal incisions and identification of bilateral adrenal glands. Animals were maintained on a regular diet with physiological saline solution ad lib. At 3, 7, 14, 28, 56 days after surgery, 5 animals of each group were sacrificed after obtaining blood and urine sample for determination of corticosterone, sodium and potassium concentration. At the same time the grafts were taken out and submitted to hematoxylin and eosin (HE) staining, histchemical study of 3β-hydroxysteroid dehydrogenase (3β-HSD) and electron microscopy.
After surgery, plasma corticosterone concentration of the autotransplanted group increased gradually and reached the control level on the 56th day following surgery. In the histological study, the autotransplanted adrenal gland showed early necrosis of the medulla and the cortex on the third day. On the 7th day, regeneration was observed starting from the outer cortical cells adjacent to the adrenal capsule. On the 56th day, the cortical zonation was found to be restored. Staining showing 3β-HSD activity was noted in the regenerated adrenal tissue histochemically on the 7th day. The intensity of 3β-HSD staining increased in the regenerated cells with the progress of the regeneration. The fine structural changes accompanying regeneration of the autotransplanted tissue revealed the mitochondria of tubular type in the outer cortical cell on the 7th day and additionally those of vesicular type in the inner cortical cell on the 56th day.
The correlation between the increase of plasma corticosterone concentration and the histological findings of regeneration was closely demonstrated in this experiment. Therefore, this experiment should be used to further evaluate variable factors affecting the graft survival.

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We studied the clinical usefulness of noradrenaline denervation supersensitivity test for the diagnosis of peripheral nerve injury of urethra.
Noradrenaline denervation supersensitivity test was performed in 43 patients with neurogenic bladder (13 patients with postoperative cervical cancer, 11 patients with postoperative rectal cancer, 11 patients with myelomeningocele in the lumbosacral area and 8 patients with cerebrovascular accident) and 9 patients with chronic prostatitis as neurologically normal controls.
Noradrenaline denervation supersensitivity was positive in 9 of the 13 patients with cervical cancer, 7 of the 11 with rectal cancer but no other patients.
Absence of noradrenaline denervation supersensitivity in patieats with myelomeningocele may indicate sympathetically normal urethras in those patients.
Therefore, we may conclude that noradrenaline denervation supersensitivity test is useful for the detection of sympathetic nevne injury of the urethra.

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Since 1974, we have treated 100 cases of urethral stricture including 32 cases of traumatic origin.
The thirty-two traumatic urethral stricture cases consisted of 12 bulbous (37.5%), 19 membranous (59.3%) and 1 meatal (3.1%) stenosis.
In 10 out of the 32 cases, internal urethrotomy was performed. It was successful in 8 cases except one missing case. The rest of the patients were treated by end-to-end anastomosis method in 6, Badenoch method in 15 and Michalowski method in one case. In no case failure of surgery was noted.
Except for 1 internal urethrotomy case requiring secondary urethroplasty, no re-operation was needed and none of them is visiting our clinic for urethral dilatation.
As for complication, complete urinary incontinence due to iatrogenesis in 1 case, complete sexual impotence in 2 cases and incomplete impotence in 2 other cases were noted.
Impotence following surgery may be attributable to severity of injury, aging and psychological influence of monetary compensation relating to trauma.
Pre-operative diagnosis as to the location of stricture, whether bulbous or membranous, is mandatory for successful urethral repair.

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A new modality of topical chemotherapy using intermittent arterial infusion combined with alteration of intrapelvic hemodynamics was applied to primary lesion of advanced prostatic carcinoma. Eight patients with advanced prostatic cancer were studied to evaluate clinical value of this method with regard to clinical symptoms, performance status and tumor regression rate before and after the treatment.
The tip of an indwelling infusion tube was inserted into a unilateral internal iliac artery through a branch of the subclavian artery (5 cases) or femoral artery (3 cases), the abundance nad distribution of tumor revessel on the angiograms being consulted. The opposite end of the infusion tube was connected to a reservoir implanted intradermally in the subclavicular portion (5 cases) or ipsilateral thigh (3 cases). The alteration of intrapelvic hemodynamics was achieved by steel coil embolization in the contralateral internal iliac artery via an angiographic catheter.
Anti-cancer agents, cis-platinum and adriamycin, each 10mg, were infused for 10 minutes through a puncture of the reservoir with a 27 gauge butterfly needle. One course of the chemotherapy included 4 infusions once a week, followed by weekly maintenance administration.
After coil embolization, pelvic angiography demonstrated distinct tumor vessels which were not visible before embolization. Furthermore, intensive RI accumulation was found at the site of tumor by scintigram with ^99mTc-MAA injected through the infusion tube.
Of 8 patients who received this treatment, 5 of 6 having presented dysuria prior to the chemotherapy revealed relief of voiding difficulty. Regarding performance status, 6 patients showed improvement and the remaining 2 were unchanged. Surprisingly, all patients had greater than 80 percent reduction in tumor size, which suggested complete remission. No serious side effects such as myelosupression, renal and/or hepatic dysfunction was noted, although minimal transient anorexia, incontinence or anemia was found, each in one patient.
These clinical observations suggest that intermittent arterial chemotherapy is not only of great value in clinical setting but also can be safely and easily done for short-term admission in the management of advanced prostatic cancer.

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Diuresis ultrasonotomography (DUT) was performed in 8 cases with pelviureteric junctin stenosis (PUJS) to evaluate the degree of obstruciton. 8 patients with either hypospadia or undecended testis were served as controls.
Both longitudinal and transverse dissociation of renal pelvis were measured every 5 minutes up to 60 minutes after I. V. administration of f urosemide (0.5mg/kg).
The echographic longitudinal and transverse dissociations of the renal pelvis in the controls were 2.3±2.8mm and 1.9±1.2mm (mean S. D.), respectively. The central dissociation after diuresis in the controls were within 5mm. The sonographic patterns obtained from DUT in the cases with PUJS were classified into three categories, obstructive (no improvement of increased dissociation after diuresis), dilated but non obstructive (improvement of increased dissociation after diuresis as time passed) and normal patterns.
The results were satisfactory in comparison with those of diuresis renogram using ^99mTc-DTPA which were performed in the same cases.
We consider this safe, accurate and non-invasive DUT as an appropriate method to evaluate the degree of obstructive uropathy.

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The contractile effects and the mode of action of GRP (Gastrin Releasing Peptide)-related peptides and bombesin on the smooth muslce of the guinea-pig urinary bladder were studied in vitro. GRP_1-27, and two different carboxyl terminal fragments of GRP_1-27 (GRP_14-27 and GRP_18-27) caused dose-dependent contractions of the preparations with equal potency. Bombesin similarly caused dosedependent contractions of the strips, but appeared to be more potent than the GRP-related peptides. An amino terminal fragment of GRP_1-27 (GRP_1-14), however, did not exhibit any contractile activity on the detrusor smooth muscle. The GRP_18-27-induced contraction was not affected by pretreatment with phentolamine, propranolol, atropine, tetrodotoxin, hexamethonium or hemicholinium-3. It is suggested that the GRP-related peptides as well as bombesin have contractile effects on the detrusor smooth muscle, and that the carboxyl terminal decapeptides (GRP_18-27) may be the minimal length of peptides essential for the contractile activity. It has been also demonstrated that the contractile effects of the GRP-related peptides are independent of nervous activity and not mediated through adrenergic nor cholinergic receptors, possibly directly acting on the detrusor smooth muslce cells.

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In order to evaluate original kidneys morphologically, ultrasoundtomography (USTG) and computed tomography (CT) were performed on 39 patients undergoing long term hemodialysis. The mean age of 39(26 male and 13 female) dialysis patients was 51.4 years. The duration of dialysis varied from 6 months to 15 years.
Renal cysts were detected in 35 of the 39 patiens (89.7%) by CT, and in 8 of 27 patients (34.8%) by USTG. There was a significant correlation between the size of cysts and the duration of hemodialysis.
Renal cysts with abnormal density were found in 4 patiens (10.3%) by CT, and dynamic CT was a useful technique to discrimate cysts with abnormal density from renal tumor.
Renal calcifications were found in 26 of 39 patients (66.7%) by CT, and in 8 of 23 patients (34.8%) by USTG. Likewise, there was a significant correlation between the grade of renal calcifications and the duration of hemodialysis, but there was no correlation between the grade of calcifications and serum alkaline phosphatase (ALP), parathyroid hormone (PTH) and calcium (Ca).
Plasma renin activity (PRA) was increased with hemodialysis periods prolonged, and it was suggested that there was a relationship between the increase of PRA and the atrophy of renal parenchyma.

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We evaluated Thomsen-Friedenreich antigen (T-Ag) and tumor-specific soybean agglutinin antigen (SBA-Ag) in 63 patients, who had transurethral resection for bladder cancer. All patients were followed up for at least 3 years. T-Ag was detected by the immunofluorescience method using monoclonal antibodies against T-Ag, which was isolated from human erythrocytes.
Tumor-specific SBA-Ag was detected by SBA-FITC after blocking with type O serum and anti T monoclonal antibodies.
The G3/G1-3 ratios of T-Ag positive tumors or cryptic T-Ag positive tumors, which presented T-Ag only after neuraminidase treatment, were 5.6% or 6.7%, respectively. On the other hand, G3/G1-3 ratio of the tumors which showed neither T-Ag nor criptic T-Ag was 46.7%. Thus, the T-Ag expression and the histological grades were correlated significantly (p<0.05). The T-Ag negative and cryptic T negative tumors had a higher risk for recurrence than others.
The SBA-Ag expression was correlated with the histological grades, although it was statistically not significant. T-Ag and SBA-Ag negative tumors seemed to have very high possibility of recurrence.
These data indicate that combination of the two marker expression (T-Ag and SBA-Ag) may help clinicians predict the prognosis of urothelial tumors.

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Two cases of adult Wilms' tumor were presented. A 32-year-old man underwent radical left nephrectomy under the diagnosis of renal cell carcinoma at another hospital. During the operation, the tumor wall was perforated and tumor spillage occurred. The pathological examination revealed adult wilms' tumor. According to the regimen of National Wilms Tumor Study, radiation and chemotherapy were added. The recurrent abdominal masses were again removed one and a half year later. However, recurrent masses were again found and the patient was referred to our hospital. These resurrent tumors with surrounding organs and tissues were removed. Recurrent abdominal masses were again resected 1 year later. Hepatic metastases appeared and the patient died 4 years after the initial symptoms. A 50-year-old man was admitted to this hospital with asymptomatic grosshematuria. CT scan showed a non-homogenous mass in the left renal pelvis. Ultrasound revealed a large cystic mass arising from the upper pole. Angiography showed a hypovascular tumor in the left upper pole. Urine cytology indicated transisional cell carcinoma. Radical left nephroureterectomy was performed under the diagnosis of renal pelvic carcinoma extending to the renal parenchyma. During the operation, the cystic tumor capsule was ruptured. Pathological findings revealed adult wilms tumor. In spite of the radiation and chemotherapy, the huge recurrent masses in the abdominal cavity were observed and the patient died about 10 months after his initial symptoms. Based on collected Japanese and English reports on adult wilms tumor, the differences between the adult's and child's tumor and prognostic significance of tumor spillage during oeration were discussed.

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A case of renal capsular leiomyoblastoma is presented.
A 36 year-old female was admitted to our hospital because of a left flank mass on Jan. 21, 1980.
A left retrograde pyelogram showed upper medial displacement of the left renal pelvis and calyx, and median dislocation of the left ureter. An abdominal CT-scan showed a large mass with soft tissue density.
Selective renal arteriography showed the lower border of the left kidney to be compressed by a vascular tumor that was supplied by the superior capsular artery and the perforating middle capsular artery.
Transperitoneal radical nephrectomy was performed on Jan. 25, 1980. The tumor weighed 1030 gm. Hisotlogical diagnosis was renal leiomyoblastoma originating from renal capsule.
The patient was well without recurrence 24 months after operation.
Our present case is the 2nd case of renal capsular leiomyoblastoma reported in the English and Japanese literature.

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Four patients with advanced testicular cancer which had been refractory to prior BVP therapy were treated with combination chemotherapy containing CDDP and VP-16 (salvage chemotherapy). Following the high dose salvage therapy using 100mg/sq. m CDDP and 500mg/sq. m VP-16 devided in 5-fractioned dose either with or without belomycin, two patients achieved complete remission (CR) and remained disease free for more than 4 months, though bone marrow suppression was remarkable. Two patients treated with low dose therapy failed to be salvaged.
Therefore, it was concluded that salvage chemotherapy should be given at high dose. However, because of increased myelosuppresion following salvage chemotherapy in patients with prior treatment, salvage regimen (PEB) should be, ab initio, given to patients with far advanced testicular cancer.

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