JaLCDOI 10.18926/AMO/56871
FullText URL 73_3_269.pdf
Author Tsuboi, Ichiro| Araki, Motoo| Fujiwara, Hiroyasu| Iguchi, Toshihiro| Hiraki, Takao| Arichi, Naoko| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Sako, Tomoko| Takamoto, Atsushi| Wada, Koichiro| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Yanai, Hiroyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Shiina, Hiroaki| Kanazawa, Susumu| Nasu, Yasutomo|
Abstract Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up.
Keywords cryoablation partial nephrectomy renal cell carcinoma renal allograft renal transplantation
Amo Type Case Report
Published Date 2019-06
Publication Title Acta Medica Okayama
Volume volume73
Issue issue3
Publisher Okayama University Medical School
Start Page 269
End Page 272
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 31235976
JaLCDOI 10.18926/AMO/56455
Author Oiwa, Yuko| Watanabe, Toyohiko| Sadahira, Takuya| Ishii, Ayano| Sako, Tomoko| Inoue, Miyabi| Wada, Koichiro| Kobayashi, Yasuyuki| Araki, Motoo| Nasu, Yasutomo|
Abstract We measured basal clitoral blood flow by Doppler sonography to determine whether tension-free vaginal mesh(TVM) affects the clitoral blood flow and sexual function in women with pelvic organ prolapse (POP). We performed a prospective study of 22 patients who underwent TVM for POP. Clitoral blood flow was measured by Doppler ultrasound. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the clitoral arteries were measured preoperatively and at 1, 3, and 6 months postoperatively. Female sexual function was also investigated with the Female Sexual Function Index (FSFI). The mean PI and RI were increased at 1 month and significantly decreased at 6 months postoperatively (p<0.05). In contrast, the mean PSV and EDV decreased at 1 month postoperatively and increased at 6 months postoperatively. These four parameters recovered to baseline levels at 6 months following surgery. Total FSFI scores improved significantly from 10.2±7.9 at baseline to 18.2±8.9 at 6 months postoperatively. Color Doppler ultrasonography is potentially useful in measuring clitoral blood flow in patients treated with TVM for POP. Prospective long-term studies are needed to evaluate the utility of this modality as a diagnostic and prognostic tool for female sexual dysfunction.
Keywords clitoris pelvic organ prolapse Doppler ultrasound
Amo Type Original Article
Published Date 2019-02
Publication Title Acta Medica Okayama
Volume volume73
Issue issue1
Publisher Okayama University Medical School
Start Page 21
End Page 27
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2019 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30820051
JaLCDOI 10.18926/AMO/56380
FullText URL 72_6_605.pdf
Author Mitsui, Yosuke| Sadahira, Takuya| Maruyama, Yuki| Wada, Koichiro| Tanimoto, Ryuta| Sugimoto, Morito| Araki, Motoo| Watanabe, Masami| Yanai, Hiroyuki| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract Metastatic prostate cancer (PCa) cases that cannot be detected on repeat prostate biopsy are extremely rare. Our patient was a 51-year-old Japanese man diagnosed as metastatic PCa by histopathological examination of lesions obtained bone biopsy and lymph node dissection. The primary tumor was not detected after repeated prostate biopsy. Metastatic PCa was diagnosed based on immunohistochemical staining: PSA, AR, P504S, and NKX3.1 of bone and lymph node with metastasis. We speculate that the primary PCa was “burned-out,” demonstrating remote metastases with no apparent primary tumor in the prostate. Burned-out PCa may be difficult to diagnose and treat due to its rarity.
Keywords prostate cancer metastasis unknown primary tumor repeat biopsy CRPC
Amo Type Case Report
Published Date 2018-12
Publication Title Acta Medica Okayama
Volume volume72
Issue issue6
Publisher Okayama University Medical School
Start Page 605
End Page 609
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2018 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 30573917
NAID 120006545165
JaLCDOI 10.18926/AMO/55445
FullText URL 71_5_449.pdf
Author Mitsui, Yosuke| Wada, Koichiro| Araki, Motoo| Yoshioka, Takashi| Ariyoshi, Yuichi| Nishimura, Shingo| Kobayashi, Yasuyuki| Sasaki, Katsumi| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract We describe a 40-year-old living-donor renal-transplant recipient who underwent successful ureterolithotripsy. He had been on hemodialysis for >15 years pre-transplant and underwent ureteroureterostomy along with the surgery. One year post-transplant, ultrasound examination demonstrated hydronephrosis, and CT showed a 6-mm ureteral calculus at the ureteroureterostomy site. No pain and no elevated serum creatinine were present. As the ureter was easily accessed, we performed a ureterolithotripsy, which would confirm whether a suture caused the calculus. Despite ureteral tortuosity, laser stone fragmentation succeeded. The calculus was completely removed with an antegrade guidewire. Mild postoperative ureteral stenosis resolved with a temporary ureteral stent without balloon dilation. Ureterolithotripsy is effective even in renal transplant recipients with ureteroureterostomy.
Keywords lithotripsy recipient renal transplant ureteroscopy ureteral stone
Amo Type Case Report
Published Date 2017-10
Publication Title Acta Medica Okayama
Volume volume71
Issue issue5
Publisher Okayama University Medical School
Start Page 449
End Page 452
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 29042705
JaLCDOI 10.18926/AMO/55313
FullText URL 71_4_351.pdf
Author Araki, Motoo| Wada, Koichiro| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Yoshioka, Takashi| Ariyoshi, Yuichi| Fujio, Kei| Takamoto, Atsushi| Sugimoto, Morito| Sasaki, Katsumi| Kobayashi, Yasuyuki| Ebara, Shin| Taninishi, Hideki| Amano, Hiroyuki| Inui, Masashi| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract A 38-year-old woman with a 2.7-cm left ureteral stenosis requiring chronic ureteral stent exchange elected to undergo robotic renal autotransplantation. Left ureteropelvic junction obstruction (UPJO) was also suspected. Robotic donor nephrectomy contributed to the fine dissection for desmoplastic changes. The kidney was removed through a Gelport and examined on ice. UPJO was not seen. An end-to-side robotic anastomosis was created between the renal and external iliac vessels. The console time was 507 min, and the warm ischemia time was 4 min 5 sec. She became stent-free. Robotic renal autotransplantation is a new, minimally invasive approach to renal preservation.
Keywords robotic surgery renal autotransplantation ureteral stenosis laparoscopic surgery renal transplantation
Amo Type Case Report
Published Date 2017-08
Publication Title Acta Medica Okayama
Volume volume71
Issue issue4
Publisher Okayama University Medical School
Start Page 351
End Page 355
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2017 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 28824192
JaLCDOI 10.18926/AMO/54185
FullText URL 70_2_69.pdf
Author Kobayashi, Yasuyuki| Kurahashi, Hiroaki| Matsumoto, Yuko| Wada, Koichiro| Sasaki, Katsumi| Araki, Motoo| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract In minimally invasive partial nephrectomy (MIPN), it is important to preoperatively predict the degree of difficulty of tumor resection. When severe adhesions occur between the renal capsule and perinephric adipose tissue, detachment can be difficult. Preoperative prediction of adhesion is thought to be useful in the selection of surgical procedure. Subjects were 63 patients of a single surgeon who had received MIPN between April 2008 and August 2013 at Okayama University Hospital. Of these patients, this study followed 47 in whom the presence or absence of adhesions between the renal capsule and perinephric adipose tissue was confirmed using intraoperative videos. Data collected included: sex, BMI, CT finding (presence of fibroids in perinephric adipose tissue), comorbidities and lifestyle. Adhesion was observed in 7 patients (14.9%). The mean operative time was 291.6min in the adhesion group, and 226.3min in the group without. The increased time in the adhesions group was significant (p<0.05). Predictive factors were a positive CT finding for fibroid structure and comorbidity of hypertension (p<0.05). In MIPN, difficulty of surgery can be affected by the presence of adhesion of the perinephric adipose tissue. Predicting such adhesion from preoperative CT is thus important.
Keywords renal cell carcinoma partial nephrectomy renal capsule adhension
Amo Type Original Article
Published Date 2016-04
Publication Title Acta Medica Okayama
Volume volume70
Issue issue2
Publisher Okayama University Medical School
Start Page 69
End Page 74
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2016 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 27094831
Web of Sience KeyUT 000377626300001