JaLCDOI 10.18926/AMO/55205
FullText URL 71_3_227.pdf
Author Sasaki, Katsumi| Wada, Koichiro| Araki, Motoo| Kobayashi, Yasuyuki| Sugimoto, Morito| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract  We elucidate the fate of cases clinically suspected of carcinoma in situ (Cis) of the upper tract with serial ureteroscopy. Of 143 patients who underwent ureteroscopy for suspected upper tract urothelial carcinoma (UTUC) between January 2008 and February 2016, 12 cases with consistently positive urine cytology and poorly detectable upper-tract malignancies by imaging were reviewed. In these 12 patients, 19 ureteroscopy procedures (25 renal units) were performed. Vesical random biopsy was performed before the 1st ureteroscopy to exclude malignancy of the bladder in all 12 cases. Median follow-up was 42 (13-67) months. Positive biopsy results at the 1st ureteroscopy were obtained in 3 (25%) patients and all were diagnosed wth Cis of the upper tract. Two (17%) of 9 patients who were negative or inconclusive at the 1st ureteroscopy were finally diagnosed as UTUC, but plural ureteroscopy procedures were needed for the diagnoses in both. Carcinoma of the bladder appeared in 5 (42%) patients during follow-up, despite the earlier ruling out of vesical malignancy. Four (33%) of those 5 patients never developed upper-tract urothelial carcinoma during follow-up. Caution is required before undertaking radical surgery for cases clinically suspected of Cis of the upper tract. In our experience, only 42% of such patients developed UTUC; another 33% eventually developed carcinoma of the bladder without UTUC.
Keywords carcinoma in situ carcinoma of the bladder upper tract urothelial carcinoma ureteroscopy urine cytology
Amo Type Original Article
Published Date 2017-06
Publication Title Acta Medica Okayama
Volume volume71
Issue issue3
Publisher Okayama University Medical School
Start Page 227
End Page 232
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 28655942
JaLCDOI 10.18926/AMO/54989
FullText URL 71_2_187.pdf
Author Takamoto, Atsushi| Araki, Motoo| Wada, Koichiro| Sugimoto, Morito| Kobayashi, Yasuyuki| Sasaki, Katsumi| Watanabe, Toyohiko| Nasu, Yasutomo|
Abstract We report the case of a 58-year-old Japanese man with bilateral synchronous renal cell carcinoma (RCC). The diameters of the right and left tumors were 56 and 69 mm, respectively. Both tumors were endophytic. Cryoablation with prophylactic embolization was performed for the left tumor, and 1 month later, a right open partial nephrectomy was performed. No recurrence was observed during a 16-month follow-up, and the serum creatinine level has been stable. The prognosis of bilateral synchronous RCC is better than that of dialysis patients. The novel approach of combining cryoablation and partial nephrectomy can achieve good cancer control and renal function in bilateral RCC.
Keywords cryoablation multiple renal masses nephron-sparing surgery renal cell carcinoma synchronous multiple primary
Amo Type Case Report
Published Date 2017-04
Publication Title Acta Medica Okayama
Volume volume71
Issue issue2
Publisher Okayama University Medical School
Start Page 187
End Page 190
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 28420902
JaLCDOI 10.18926/AMO/54508
FullText URL 70_4_299.pdf
Author Wada, Koichiro| Uehara, Shinya| Ishii, Ayano| Sadahira, Takuya| Yamamoto, Masumi| Mitsuhata, Ritsuko| Takamoto , Atsushi| Araki, Motoo| Kobayashi, Yasuyuki| Watanabe, Masami| Watanabe, Toyohiko| Hotta, Katsuyuki| Nasu, Yasutomo|
Abstract Urinary tract infections (UTIs) are the most common bacterial infections in women, and many patients experience frequent recurrence. The aim of this report is to introduce an on-going prospective phase II clinical trial performed to evaluate the preventive effectiveness of Lactobacillus vaginal suppositories for prevention of recurrent cystitis. Patients enrolled in this study are administered vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus every 2 days or 3 times a week for one year. The primary endpoint is recurrence of cystitis and the secondary endpoints are adverse events. Recruitment began in December 2013 and target sample size is 20 participants.
Keywords probiotics lactobacilli Lactobacillus crispatus urinary tract infection vaginal suppository
Amo Type Clinical Study Protocols
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 299
End Page 302
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 27549677
Web of Sience KeyUT 000384748600012
JaLCDOI 10.18926/AMO/54507
FullText URL 70_4_295.pdf
Author Araki, Motoo| Wada, Koichiro| Mitsui, Yosuke| Kubota, Risa| Yoshioka, Takashi| Ariyoshi, Yuichi| Kobayashi, Yasuyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hiroshi| Wada, Jun| Watanabe, Masami| Watanabe, Toyohiko| Hotta, Katsuyuki| Nasu, Yasutomo|
Abstract Although graft survival following renal transplantation (RTx) has improved, outcomes following highrisk RTx are variable. Preexisting antibodies, including donor-specific antibodies (DSA), play an important role in graft dysfunction and survival. We have designed a study to investigate the safety and efficacy of anti-CD20 monoclonal antibodies (rituximab) in high-risk RTx recipients. Major eligibility criteria include: 1) major and minor ABO blood group mismatch, 2) positive DSA. Thirty-five patients will receive 200 mg/body of rituximab. The primary endpoint is the incidence of B cell depletion. This study will clarify whether rituximab is efficacious in improving graft survival in high-risk RTx recipients.
Keywords end-stage renal disease immunosuppression kidney transplantation
Amo Type Clinical Study Protocols
Published Date 2016-08
Publication Title Acta Medica Okayama
Volume volume70
Issue issue4
Publisher Okayama University Medical School
Start Page 295
End Page 297
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 27549676
Web of Sience KeyUT 000384748600011
JaLCDOI 10.18926/AMO/54423
FullText URL 70_3_223.pdf
Author Ebara, Shin| Kobayashi, Yasuyuki| Sasaki, Katsumi| Araki, Motoo| Sugimoto, Morito| Wada, Koichirou| Fujio, Kei| Takamoto, Atsushi| Watanabe, Toyohiko| Yanai, Hiroyuki| Nasu, Yasutomo|
Abstract The present case report describes a case of recurrent and advanced urachal carcinoma including neuroendocrine features with iliac bone metastasis after partial cystectomy and adjuvant chemotherapy consisting of irinotecan and cisplatin in a 32-year-old man. He received gemcitabine/cisplatin/ paclitaxel (GCP) combination chemotherapy, consisting of gemcitabin (1,000mg/m2) on day 1, 8, cisplatin (70mg/m2) on day 1, and paclitaxel (80mg/m2) on day 1 and 8. After three cycles of chemotherapy, PET-CT showed complete regression of the disease. So the patient underwent total cystourethrectomy, and histological examination showed an almost complete pathological response. External beam radiation therapy was also given to the ileac bone metastasis regions. However, PET-CT taken 17 months after the external beam radiation showed multiple lung metastases. He received GCP chemotherapy again, which resulted in a complete response again after three cycles of chemotherapy. This is the first report on GCP chemotherapy used not only as a salvage chemotherapy but also as a rechallenge regimen for metastatic urachal cancer including a neuroendocrine component.
Amo Type Case Report
Published Date 2016-06
Publication Title Acta Medica Okayama
Volume volume70
Issue issue3
Publisher Okayama University Medical School
Start Page 223
End Page 227
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 27339213
Web of Sience KeyUT 000379406100011
JaLCDOI 10.18926/AMO/52144
FullText URL 68_1_47.pdf
Author Ishikawa, Tsutomu| Araki, Motoo| Hirata, Takeshi| Watanabe, Masami| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo| Kumon, Hiromi|
Abstract We report 3 patients with the rare complication of an indwelling urethral catheter misdirected into the ureter. This is the largest series to date. Patients were referred to us for a variety of reasons following exchange of their chronic indwelling urinary catheters. CT in all cases demonstrated the urinary catheters residing in the left ureter. The ages of the patients were 37, 67 and 81 years old. All patients suffered from neurogenic bladder. Two patients were female, one was male, and 2 of the 3 had a sensory disorder inhibiting their pain response. The catheters were replaced with open-end Foley catheters. Extensive follow-up CT scans were obtained in one case, demonstrating improvement of hydronephrosis and no evidence of ureteral stenosis. Cystoscopy in this patient demonstrated normally positioned and functioning ureteral orifices. Although the placement of an indwelling urethral catheter is a comparatively safe procedure, one must keep in mind that this complication can occur, particularly in female patients with neurogenic bladder. CT without contrast is a noninvasive, definitive diagnostic tool.
Keywords complication indwelling urethral catheter imaging computed tomography ureter
Amo Type Case Report
Published Date 2014-02
Publication Title Acta Medica Okayama
Volume volume68
Issue issue1
Publisher Okayama University Medical School
Start Page 47
End Page 51
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24553489
Web of Sience KeyUT 000331592800008
JaLCDOI 10.18926/AMO/48078
FullText URL 66_1_23.pdf
Author Watanabe, Toyohiko| Inoue, Miyabi| Ishii, Ayano| Yamato, Toyoko| Yamamoto, Masumi| Sasaki, Katsumi| Kobayashi, Yasuyuki| Araki, Motoo| Uehara, Shinya| Saika, Takashi| Kumon, Hiromi|
Abstract Polypropylene mesh implants for the correction of pelvic organ prolapse (POP) are now available in Japan. We developed an innovative approach for correcting POP by placing polypropylene mesh transvaginally with laparoscopic assistance. From June 2007 through March 2010, sixteen consecutive patients with symptomatic stage 2 or 3 pelvic organ prolapse underwent the laparoscopic-assisted tension-free vaginal mesh procedure at Okayama University Hospital. All patients were evaluated before and at 1, 3, 6, and 12 months after surgery. Female sexual function was also evaluated with the Female Sexual Function Index (FSFI). The procedure was performed successfully without significant complications. Fifteen of 16 patients were considered anatomically cured (93.8%) at 12 months postoperatively. One patient with a recurrent stage 3 vaginal vault prolapse required sacral colpopexy six months postoperatively. Total FSFI scores improved significantly from 10.3±1.3 at baseline to 18.0±1.2 at 12 months after surgery. The laparoscopic-assisted trans-vaginal mesh is a safe, effective, and simple procedure for POP repairs. The procedure not only restores anatomic relationships but also improves sexual function.
Keywords tension-free vaginal mesh pelvic organ prolapse laparoscopic female urology sexual function
Amo Type Original Article
Published Date 2012-02
Publication Title Acta Medica Okayama
Volume volume66
Issue issue1
Publisher Okayama University Medical School
Start Page 23
End Page 29
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22358136
Web of Sience KeyUT 000300800700004
Author Yokoyama, Teruhiko| Watanabe, Toyohiko| Saika, Takashi| Nasu, Yasutomo| Kumon, Hiromi| Miyaji, Yoshiyuki| Nagai, Atsushi|
Published Date 2007-10-02
Publication Title International Journal of Urology
Volume volume14
Issue issue7
Content Type Journal Article
JaLCDOI 10.18926/AMO/31836
FullText URL fulltext.pdf
Author Wada, Koichiro| Kariyama, Reiko| Mitsuhata, Ritsuko| Uehara, Shinya| Watanabe, Toyohiko| Monden, Koichi| Kumon, Hiromi|
Abstract <p>Urinary tract infections (UTIs) due to fluoroquinolone-insusceptible Escherichia coli have become increasingly common in recent years. We investigated the potential relationships between clinical measures to combat fluoroquinolone-insusceptible E. coli and experimental analyses on E. coli isolates. Over a 14-year period from 1994 through 2007, a total of 828 E. coli isolates were collected from patients (one isolate per patient) with UTI at the urology ward of Okayama University Hospital. We analyzed the mutations in quinolone resistance-determining regions of DNA gyrase (gyrA) and topoisomerase IV (parC). The production of biofilm by these isolates was also examined and the associated medical records were retrospectively reviewed. Seven of 189 (3.7%) strains from uncomplicated UTIs and 82 of 639 (12.8%) strains from complicated UTIs were insusceptible to fluoroquinolones. Amino acid replacements of type II topoisomerases were frequently observed at positions 83 and 87 in GyrA and at positions 80 and 84 in ParC. No significant difference in the biofilm-forming capabilities was observed between fluoroquinolone-susceptible and -insusceptible E. coli. Our study suggests that biofilm formation of fluoroquinolone-insusceptible E. coli isolates is not a major mechanism of resistance in patients with UTI.</p>
Keywords fluoroquinolone Escherichia coli biofilm MICs QRDRs
Amo Type Original Article
Published Date 2009-10
Publication Title Acta Medica Okayama
Volume volume63
Issue issue5
Publisher Okayama University Medical School
Start Page 263
End Page 272
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 19893602
Web of Sience KeyUT 000271132000006
JaLCDOI 10.18926/AMO/30950
FullText URL fulltext.pdf
Author Saika, Takashi| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Manabe, Daisuke| Ebara, Shin| Uehara, Shinya| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>To evaluate morbidity in Hybrid Radical Prostatectomy (HRP, hybridized laparoscopic and open retropubic radical prostatectomy). The operative and pathological outcomes obtained in 25 consecutive patients who underwent HRP were reviewed. The median operating time was 220min, median blood loss was 550ml, and no patient required an allogenic blood transfusion. No severe postoperative complications were observed. The surgical margin was positive in 12% of all patients, and in 1 patient with pT2 or less (4.5%). These results indicate that HRP is safe and may be able to combine the benefits of both laparoscopic and open procedures.</p>
Keywords prostate cancer radical prostatectomy hybrid surgery morbidity positive surgical margin
Amo Type Original Article
Published Date 2008-12
Publication Title Acta Medica Okayama
Volume volume62
Issue issue6
Publisher Okayama University Medical School
Start Page 379
End Page 384
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
Web of Sience KeyUT 000262025000004
Author 渡邉 豊彦|
Published Date 1995-03-25
Publication Title
Content Type Thesis or Dissertation