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Kyoda Y, Ichihara K, Muranaka I, Sakai Y, Nakamura M, Shinkai N, Kozen N, Yorozuya W, Morooka D, Maruo K, Tachikawa K, Shibamori K, Nofuji S, Fujino K, Kato S, Yoshida T, Shindo T, Maehana T, Hashimoto K, Kobayashi K, Tanaka T, Masumori N. Efficacy of cognitive behavioral therapy using self-check sheet for patients with nocturia in real-world clinical practice. Low Urin Tract Symptoms 2023; 15:225-230. [PMID: 37614063 DOI: 10.1111/luts.12498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/30/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES We previously demonstrated the efficacy of cognitive behavioral therapy (CBT) using a self-check sheet for patients with nocturia in a randomized controlled study. Additionally, we investigated the efficacy of the intervention in real-world clinical practice. METHODS Two hundred forty-three outpatients with complaint of nocturia who practiced CBT for 4 weeks using a self-check sheet were included in this trial, which took place from April 2021 to March 2022 in 20 institutions. RESULTS Of the 243 patients, 215 who achieved 50% or more of the behavioral therapy tasks were included in the analysis. Their mean age ± SD was 77.1 ± 7.7. A significant decrease was observed in nighttime frequency at 4 weeks after CBT using self-check sheets (pre 3.3 and post 2.8, p < .001). Nighttime frequency was decreased one or more times and was defined as treatment success in 102 patients (47.4%). Pretreatment nighttime frequency in the treatment-success group was significantly higher than that of the failure group (3.5 ± 1.0 vs. 3.2 ± 1.0, p = .013). In multivariate logistic regression analysis, predictive factors of treatment success were pretreatment nocturnal frequency of four or more (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.01-3.30; p = .046) and the absence of diabetes mellitus (OR 3.08, 95% CI 1.34-7.06; p = .008). CONCLUSIONS CBT using a self-check sheet requiring less time, less labor, less cost, and less medication is very beneficial for both patients and medical staff in real-world clinical practice.
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Affiliation(s)
- Yuki Kyoda
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Yakumo General Hospital, Yakumo, Japan
- Hokkaido Prefectural Haboro Hospital, Haboro, Japan
- Rumoi Municipal Hospital, Rumoi, Japan
| | | | - Ippei Muranaka
- Hokkaido Social Work Association Obihiro Hospital, Obihiro, Japan
| | | | | | | | | | | | | | | | | | - Kosuke Shibamori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Kuriyama Red Cross Hospital, Kuriyama, Japan
- Hokkaido Social Work Association Toya Hospital, Toyako, Japan
- JCHO Noboribetsu Medical Center, Noboribetsu, Japan
| | - Seisuke Nofuji
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Kuriyama Red Cross Hospital, Kuriyama, Japan
- Hokkaido Social Work Association Toya Hospital, Toyako, Japan
- JCHO Noboribetsu Medical Center, Noboribetsu, Japan
| | - Keiko Fujino
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Kuriyama Red Cross Hospital, Kuriyama, Japan
- Hokkaido Social Work Association Toya Hospital, Toyako, Japan
- JCHO Noboribetsu Medical Center, Noboribetsu, Japan
| | | | | | - Tetsuya Shindo
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Takeshi Maehana
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
- Nemuro City Hospital, Nemuro, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
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Saeki M, Ichihara K, Yasuda M, Nirasawa S, Takahashi S. Is it meaningful to apply midstream urine culture to urine specimens with negative Gram stain results? J Infect Chemother 2023:S1341-321X(23)00103-4. [PMID: 37100241 DOI: 10.1016/j.jiac.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/04/2023] [Accepted: 04/18/2023] [Indexed: 04/28/2023]
Abstract
INTRODUCTION Gram staining is a convenient method for bacterial estimation. Urine culture is typically used to diagnose urinary tract infections. Therefore, urine culture is also performed on Gram stain-negative urine specimens. However, the frequency of uropathogen identification in these samples remains unclear. METHODS From 2016 to 2019, we retrospectively compared the results of Gram staining and urine culture tests on midstream urine specimens submitted for the diagnosis of urinary tract infections to confirm the significance of urine culture on Gram stain-negative specimens. Analysis was performed according to the patients' sex and age, and the frequency of uropathogen identification in the culture was examined. RESULTS A total of 1763 urine specimens (women, 931; men, 832) were collected. Of these, 448 (25.4%) were not positive on Gram staining but were positive on culture. In specimens without bacteria on Gram staining, the frequencies of specimens with uropathogens detected on culture were 20.8% (22/160) in women aged <50 years, 21.4% (71/332) in women aged ≥50 years, 2.0% (2/97) in men aged <50 years, and 7.8% (39/499) in men aged ≥50 years. CONCLUSIONS In men aged <50 years, the frequency of uropathogenic bacteria identification by urine culture was low in Gram stain-negative specimens. Therefore, urine cultures may be excluded from this group. In contrast, in women, a small number of Gram stain-negative specimens showed significant culture results for the diagnosis of urinary tract infection. Therefore, urine culture should not be omitted in women without careful consideration.
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Affiliation(s)
- Masachika Saeki
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan; Department of Urology, Sapporo Central Hospital, Sapporo, Japan
| | - Mitsuru Yasuda
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Shinya Nirasawa
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan
| | - Satoshi Takahashi
- Division of Laboratory Medicine, Sapporo Medical University Hospital, Sapporo, Japan; Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan.
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Kyoda Y, Kimura M, Shimizu T, Miyao N, Ogasawara T, Shimizu T, Iwasawa A, Yorozuya W, Hashimoto J, Ichihara K, Takei F, Uchida K, Kouzen N, Suzuki N, Tachikawa K, Shibuya A, Muranaka I, Okada M, Igarashi M, Shibamori K, Nofuji S, Fujino K, Toyota T, Ito Y, Shinkai N, Hashimoto K, Kobayashi K, Tanaka T, Masumori N. Efficacy and safety of desmopressin orally disintegrating tablets 25 and 50 μg in male patients with nocturia: A Japanese real‐world multicenter clinical study. Low Urin Tract Symptoms 2022; 14:410-415. [DOI: 10.1111/luts.12459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/16/2022] [Accepted: 07/14/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Yuki Kyoda
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
- Nemuro City Hospital Nemuro Japan
- Yakumo General Hospital Yakumo Japan
- Hokkaido Prefectural Haboro Hospital Haboro Japan
- Rumoi Municipal Hospital Rumoi Japan
| | | | | | | | - Takuto Ogasawara
- Department of Urology Steel Memorial Muroran Hospital Muroran Japan
| | | | | | - Wakako Yorozuya
- Department of Urology Kushiro Red Cross Hospital Kushiro Japan
| | - Jiro Hashimoto
- Teine Urological Clinic Sapporo Japan
- Teine Ekimae Urological Clinic Sapporo Japan
| | - Koji Ichihara
- Department of Urology Sapporo Central Hospital Sapporo Japan
| | - Fumiyasu Takei
- Tokachi Urological Clinic Otofuke Japan
- Obihiro Urological Clinic Obihiro Japan
| | | | - Nodoka Kouzen
- Department of Urology JCHO Hokkaido Medical Center Sapporo Japan
| | | | | | | | - Ippei Muranaka
- Department of Urology Hokkaido Social Work Association Obihiro Hospital Obihiro Japan
| | - Manabu Okada
- Department of Urology Hokkaido Social Work Association Obihiro Hospital Obihiro Japan
| | | | - Kosuke Shibamori
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
- Kuriyama Red Cross Hospital Kuriyama Japan
- Hokkaido Social Work Association Toya Hospital Toyako Japan
- JCHO Noboribetsu Medical Center Noboribetsu Japan
| | - Seisuke Nofuji
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
- Kuriyama Red Cross Hospital Kuriyama Japan
- Hokkaido Social Work Association Toya Hospital Toyako Japan
- JCHO Noboribetsu Medical Center Noboribetsu Japan
| | - Keiko Fujino
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
- Kuriyama Red Cross Hospital Kuriyama Japan
- Hokkaido Social Work Association Toya Hospital Toyako Japan
- JCHO Noboribetsu Medical Center Noboribetsu Japan
| | - Tomohiro Toyota
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
| | - Yu Ito
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
| | - Nobuo Shinkai
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
| | - Kohei Hashimoto
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
| | - Ko Kobayashi
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
| | - Toshiaki Tanaka
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
| | - Naoya Masumori
- Department of Urology Sapporo Medical University School of Medicine Sapporo Japan
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Mahato R, Lamsal M, Ichihara K. M249 Establishment of reference intervals (RIS) for common biochemical parameters in healthy Nepalese adults. Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Baba T, Endo T, Ikeda U, Ikeda H, Ichihara K, Masumori N, Saito T. Self-administration of gender-affirming hormones and supratherapeutic dosing are relatively common in Japanese transgender women. J Obstet Gynaecol Res 2022; 48:2208-2213. [PMID: 35304797 DOI: 10.1111/jog.15231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/15/2022] [Accepted: 03/12/2022] [Indexed: 11/30/2022]
Abstract
AIM This study was performed to determine the proportion of transgender women with self-adjusted hormone administration and excess dosing. METHODS The medical records of 87 transgender women who visited our gender clinic from 2010 through 2019 were reviewed. The complete blood count and serum concentrations of D-dimer, gonadotropins, and sex steroids were compared between transgender women who were self-administering gender-affirming hormones and women not using such hormones. RESULTS Fifty-eight of 87 (66.7%) transgender women had contravened the guideline and self-adjusted their hormone administration. The hormonal data of one woman with hypopituitarism were eliminated from the analyses. The serum gonadotropin and testosterone levels were significantly lower in the self-administration group than in the hormone-naïve group. Gonadotropin levels below the lower limit of normal were found in 32/86 (37.2%) transgender women. The testosterone levels in six transgender women were not analyzed because these women had undergone sex reassignment surgery before visiting our hospital. Testosterone levels below the lower limit of normal men were found in 36/80 (45.0%) transgender women. Unexpectedly, 29/36 (80.6%) transgender women who were classified as having suppressed serum testosterone levels had testosterone levels of <0.6 ng/mL, which corresponds to the levels in cisgender women. The white blood cell count and hemoglobin concentration were significantly different between the groups. CONCLUSION Self-initiated hormonal treatments seem to affect the serum concentrations of gonadotropin and sex steroids and the complete blood count. The prevalence of transgender women with self-adjusted use of gender-affirming hormones is high, and an excess dose of hormones occasionally occurs.
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Affiliation(s)
- Tsuyoshi Baba
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Toshiaki Endo
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
| | - Utako Ikeda
- Department of Gynecology, Tonan Hospital, Sapporo, Japan
| | | | - Koji Ichihara
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Tsuyoshi Saito
- Department of Obstetrics and Gynecology, Sapporo Medical University, Sapporo, Japan
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Tabata H, Sasaki M, Kataoka-Sasaki Y, Shinkai N, Ichihara K, Masumori N, Kocsis JD, Honmou O. Possible role of intravenous administration of mesenchymal stem cells to alleviate interstitial cystitis/bladder pain syndrome in a Toll-like receptor-7 agonist-induced experimental animal model in rat. BMC Urol 2021; 21:156. [PMID: 34774029 PMCID: PMC8590770 DOI: 10.1186/s12894-021-00923-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 11/08/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Interstitial cystitis/bladder pain syndrome (IC/BPS) categorized with and without Hunner lesions is a condition that displays chronic pelvic pain related to the bladder with no efficacious treatment options. There are strong associations suggested between Hunner-type IC and autoimmune diseases. Recently, we established an animal model of Hunner-type IC using a Toll-like receptor-7 (TLR7) agonist. Intravenous infusion of mesenchymal stem cells (MSCs) can be used to treat injury via multimodal and orchestrated therapeutic mechanisms including anti-inflammatory effects. Here, we investigated whether infused MSCs elicit therapeutic efficacy associated with the TLR7-related anti-inflammatory pathway in our Hunner-type IC model. METHODS Voiding behaviors were monitored 24 h prior to the Loxoribine (LX), which is a TLR7 agonist instillation in order to establish a Hunner-type IC model (from - 24 to 0 h) in female Sprague-Dawley rats. LX was instilled transurethrally into the bladder. At 0 h, the initial freezing behavior test confirmed that no freezing behavior was observed in any of the animals. The LX-instilled animals were randomized. Randomized LX-instilled rats were intravenously infused with MSCs or with vehicle through the right external jugular vein. Sampling tissue for green fluorescent protein (GFP)-positive MSCs were carried out at 48 h. Second voiding behavior tests were monitored from 72 to 96 h. After the final evaluation of the freezing behavior test at 96 h after LX instillation (72 h after MSC or vehicle infusion), histological evaluation with H&E staining and quantitative real-time polymerase chain reaction (RT-PCR) to analyze the mRNA expression levels of inflammatory cytokines were performed. RESULTS Freezing behavior was reduced in the MSC group, and voiding behavior in the MSC group did not deteriorate. Hematoxylin-eosin staining showed that mucosal edema, leukocyte infiltration, and hemorrhage were suppressed in the MSC group. The relative expression of interferon-β mRNA in the bladder of the MSC group was inhibited. Numerous GFP-positive MSCs were distributed mainly in the submucosal and mucosal layers of the inflammatory bladder wall. CONCLUSION Intravenous infusion of MSCs may have therapeutic efficacy in a LX-instilled Hunner-type IC rat model via a TLR7-related anti-inflammatory pathway.
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Affiliation(s)
- Hidetoshi Tabata
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Masanori Sasaki
- Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8556, Japan.
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06510, USA.
- Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, CT, 06516, USA.
| | - Yuko Kataoka-Sasaki
- Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8556, Japan
| | - Nobuo Shinkai
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, 060-8556, Japan
| | - Jeffery D Kocsis
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06510, USA
- Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
| | - Osamu Honmou
- Department of Neural Regenerative Medicine, Research Institute for Frontier Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, 060-8556, Japan
- Department of Neurology, Yale University School of Medicine, New Haven, CT, 06510, USA
- Center for Neuroscience and Regeneration Research, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
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Maehana T, Ichihara K, Takahashi S, Takahashi Y, Hashimoto K, Tanaka T, Masumori N. Significance of urinary liver-type fatty acid-binding protein in patients with normal renal function after undergoing intestinal urinary diversion: a preliminary study. Clin Exp Nephrol 2021; 25:1151-1157. [PMID: 34100166 DOI: 10.1007/s10157-021-02088-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Liver-type fatty acid-binding protein (L-FABP) in urine is one of the early diagnostic biomarkers for acute and chronic kidney injuries. Although this protein is also identified in the intestine, there is no verified reference value for patients with intestinal urinary diversion (UD). The aim of the present study was to measure L-FABP values in such patients and compare them with the results for patients without UD. METHODS Spot urine specimens were collected from 41 patients with UD and 50 subjects without UD with estimated glomerular filtration rates of over 60 ml/min/1.73 m2, and the L-FABP values were measured. The normal upper cutoff value in healthy subjects without UD is considered to be 7.24 μg/g Cr. First, the median values of the two groups were compared. Next, the subjects with negative proteinuria and without comorbidities associated with renal function were further selected and the median values of the groups were compared. RESULTS The mean age was significantly higher in the UD group. The types of UD were ileal conduit (38 patients) and ileal neobladder (three patients). The median L-FABP value in the UD group was significantly higher than that in the non-diversion group (89.1 μg/g Cr vs. 2.0 μg/g Cr, p < 0.0001). After adjustment for their backgrounds, the median value remained higher in the UD group. CONCLUSIONS L-FABP values in subjects with UD are higher than in those without UD. By this result, to develop a reference value in patients with intestinal UD population, further studies are required.
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Affiliation(s)
- Takeshi Maehana
- Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Yusuke Takahashi
- Department of Clinical Laboratory Science, School of Medical Technology, Health Sciences University of Hokkaido, Sapporo, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-8543, Japan
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Kirisawa T, Ichihara K, Sakai Y, Morooka D, Iyoki T, Masumori N. Physical and Psychological Effects of Gender-Affirming Hormonal Treatment Using Intramuscular Testosterone Enanthate in Japanese Transgender Men. Sex Med 2021; 9:100306. [PMID: 33540366 PMCID: PMC8072143 DOI: 10.1016/j.esxm.2020.100306] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/02/2020] [Accepted: 12/06/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION The evidence on gender-affirming hormonal treatment (HT) for transgender persons is still insufficient. AIM To characterize the physical and psychological effects of HT using testosterone enanthate in transgender men, and to validate the safety of this treatment. METHODS A total of 85 Japanese transgender men who were followed up for at least 1 year at our gender clinic from 2004 to 2017 were included in this study. All self-reported effects that they recognized and regularly acquired laboratory data were investigated after initiation of HT. MAIN OUTCOME MEASURE HT mainly using testosterone enanthate 250 mg every 2 weeks caused the most desired physical effects to appear promptly and effectively, whereas small but not negligible numbers of undesired physical and psychological effects were also confirmed. RESULTS The initial dose of testosterone enanthate was 250 mg for 72 (84.7%) subjects, and the injection interval was maintained every 2 weeks for 70 (82.3%). Most physical effects appeared within 6 months. A deepened voice (87.1%), cessation of menses (78.8%), acne (69.4%), and facial (52.9%)/body (37.6%) hair growth occurred within 3 months. Although recognition of psychological effects was rare, emotional instability (9.4%) and increased libido (7.1%) appeared in the relatively early phase after beginning HT. The mean values for red blood cells, hemoglobin, uric acid, and alkaline phosphatase were significantly increased for 2 year. During the observation period, there were no life-threatening adverse effects in any subjects. CONCLUSION The present HT strategy is effective and safe for Japanese transgender men. The information from self-reported effects and objective data from blood tests can help both physicians and transgender men to understand testosterone HT. Kirisawa T, Ichihara K, Sakai Y, et al. Physical and Psychological Effects of Gender-Affirming Hormonal Treatment Using Intramuscular Testosterone Enanthate in Japanese Transgender Men. Sex Med 2021;9:100306.
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Affiliation(s)
- Takahiro Kirisawa
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Yasuyuki Sakai
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Daichi Morooka
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Takaya Iyoki
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
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Yorozuya W, Ichihara K, Yamana A, Masumori N. [CLINICAL OUTCOMES OF GENDER AFFIRMING SURGERY FOR GENDER DYSPHORIA/INCONGRUENCE: A SINGLE-INSTITUTE EXPERIENCE]. Nihon Hinyokika Gakkai Zasshi 2021; 112:123-130. [PMID: 35858806 DOI: 10.5980/jpnjurol.112.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
(Purpose) To investigate clinical outcomes of gender affirming surgery performed for gender dysphoria/incongruence. (Material and methods) This retrospective observational study included 59 transgender persons (41 transgender men and 18 transgender women) who received gender affirming surgery at Sapporo Medical University Hospital from June 2006 through December 2018. Their medical charts were reviewed and peri- and postoperative complications within one year after surgery were checked and graded according to the Clavien-Dindo classification. In addition, the voiding condition in transgender men, and the length of the constructed vagina in transgender women were investigated over time as functional outcomes. (Results) The median age at surgery was 32 years and the median duration of gender affirming hormone treatment was 40 months. In transgender men, the median operation time and blood loss were 393 minutes and 970 ml, respectively. Two subjects needed red blood cell transfusion. For transgender women, the operation time was 347 minutes, and the blood loss was 590 ml, and none needed transfusion. Some postoperative complications were observed in the 18 transgender men, and 6 patients required surgical repair associated with the neo-urethra. Among the transgender women, 17 had postoperative complications but none of them was classified as grade 3 or more. Gait disorder occurred in 7, and remained in three even in the final observational period. This event occurred more often in those with a body mass index of 25 kg/m2 or more, higher values of postoperative serum creatine kinase, and was more likely to occur with the use of a boot-type leg holder. As functional outcomes, urinary retention was observed in one transgender man after the cystostomy was removed, and temporary re-catheterization was needed. Others had no complaint about their urination. In the transgender women, the constructed vaginal length after skin inversion was gradually shortened (from 10 to 8 cm) for three months after surgery. (Conclusion) Gender affirming surgery was performed safely in our institution. It is necessary to investigate the long-term functional outcomes and/or the changes in quality of life between the pre- and postoperative periods in the future.
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Affiliation(s)
- Wakako Yorozuya
- Department of Urology, Sapporo Medical University, School of Medicine
| | | | - Azusa Yamana
- Department of Urology, Sapporo Medical University, School of Medicine
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University, School of Medicine
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Shinkai N, Ichihara K, Kobayashi K, Tabata H, Hashimoto K, Fukuta F, Tanaka T, Masumori N. Long-term tadalafil administration can prevent functional and structural changes of the urinary bladder in male rats with partial bladder outlet obstruction. Neurourol Urodyn 2020; 39:1330-1337. [PMID: 32401423 DOI: 10.1002/nau.24383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/30/2020] [Accepted: 04/30/2020] [Indexed: 02/03/2023]
Abstract
AIMS There have been few reports on whether long-term oral phosphodiesterase 5 inhibitor administration can ameliorate bladder changes due to bladder outlet obstruction (BOO). Therefore, we clarified the chronological changes of the bladder using male BOO rats and evaluated the effects of tadalafil on these changes. METHODS Eight-week-old male Sprague-Dawley rats were used. BOO was created by placing a polyethylene catheter around the urethra. Then, the rats were orally treated with a vehicle, or tadalafil 2 or 10 mg/kg until each evaluation period. Cystometric measurements were performed and the degree of fibrosis in the smooth muscle layer was evaluated at 2, 4, and 16 weeks. RESULTS In BOO rats, a significant increase in the number of non-voiding contractions (NVCs) and a shortened intercontraction interval (ICI) were observed in the earlier phase (2 and 4 weeks) compared to Sham rats. In the chronic phase (16 weeks), markedly increased residual urine volume and an extended ICI were observed accompanied by enhanced smooth muscle fibrosis. These results indicated that the bladder in BOO rats represented the overactive phenotype in the earlier phase and changed into the underactive phenotype in the chronic phase. Even in Sham rats, an increased number of NVCs and enhanced fibrosis were observed with time. Tadalafil administration significantly prevented these bladder changes in both BOO and Sham rats. CONCLUSIONS Long-term oral administration of tadalafil can prevent functional and histological changes in the BOO rat bladder. This agent is also effective for the bladder functional change even in non-obstructed rats.
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Affiliation(s)
- Nobuo Shinkai
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Central Hospital, Hokkaido, Japan
| | - Ko Kobayashi
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Hidetoshi Tabata
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Kohei Hashimoto
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Fumimasa Fukuta
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Toshiaki Tanaka
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, School of Medicine, Sapporo Medical University, Hokkaido, Japan
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11
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Kyoda Y, Ichihara K, Hashimoto K, Kobayashi K, Fukuta F, Masumori N. Sustained density of neuroendocrine cells with aging precedes development of prostatic hyperplasia in spontaneously hypertensive rats. BMC Urol 2019; 19:91. [PMID: 31619214 PMCID: PMC6794739 DOI: 10.1186/s12894-019-0528-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Neuroendocrine (NE) cells may have an impact on the development and initial growth of benign prostatic hyperplasia (BPH) according to previous human studies. METHODS To explore the relationship of NE cells and BPH development, we compared the density of NE cells and also prostatic weight in spontaneously hypertensive rats (SHR), which develop by aging, and Wistar-Kyoto rats (WKY) as control. The total weights of the epithelium and stroma in the ventral lobes of 8-, 12, 16-, 28- and 56-week-old SHR and WKY were calculated using Image J software. NE cells in the ventral prostatic ducts (VPd) were quantified using immunohistochemical staining for serotonin. RESULTS Although there was no significant difference in the estimated total weight of the epithelium and stroma in the ventral lobes adjusted by body weight (ES weight) between the two groups at 8, 12 and 16 weeks of age, ES weight was significantly greater in the SHR group than in the WKT group at 28 and 56 weeks. The density of NE cells in the VPd decreased with aging in the WKY group, whereas it was sustained until 16 weeks and then decreased with aging in the SHR group. The difference in the density between the two groups was most marked at 16 weeks of age. CONCLUSION In the natural history of BPH, NE cells may play an important role in the initial development of BPH because sustained density of NE cells in the VPd precedes the development of prostatic hyperplasia.
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Affiliation(s)
- Yuki Kyoda
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, 060-8543, Japan
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12
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Matsuo K, Ichihara K, Gotoh M, Masumori N. Comparison of the Uroflowmetry Parameter Results Between Transgender Males Undergoing Gender-Affirming Hormone Therapy and Age-Matched Cisgender Females: Preliminary Data. Transgend Health 2019; 4:152-156. [PMID: 31321304 PMCID: PMC6637770 DOI: 10.1089/trgh.2019.0025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: Gender-affirming hormone therapy (GHT) using testosterone is administered to transgender males. Although various effects caused by hormonal therapy have been reported, those on lower urinary tract function have remained unclear. The present study compared the uroflowmetry (UFM) parameter results between transgender males and age-matched cisgender females. Methods: A total of 26 transgender males who received GHT for longer than 1 year and the same number of age-matched cisgender females were enrolled. The UFM parameter results and postvoid residual urine volume (PVR) were compared between groups. Results: The median age at enrollment was 31.5 years, and the median duration of hormonal therapy was 2.7 years. There was no significant difference in the maximum flow rate or average flow rate between groups, whereas the mean voided volume (VV) (370±168 vs. 252±73 mL, p<0.001) and PVR (57.3±39.5 vs. 19.4±30.5 mL, p<0.001) were significantly greater in the transgender male group than those in the cisgender female group. Conclusion: The VV on UFM and postvoided residual urine volume in the transgender males who received GHT for >1 year were significantly increased compared with age-matched cisgender females.
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Affiliation(s)
- Kazuna Matsuo
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan.,Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Koji Ichihara
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
| | - Momokazu Gotoh
- Department of Urology, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Naoya Masumori
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Japan
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13
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Hiyama Y, Takahashi S, Uehara T, Ichihara K, Hashimoto J, Matsukawa M, Taguchi K, Kunishima Y, Hotta H, Yanase M, Itoh N, Hirose T, Takeyama K, Tachiki H, Masumori N. Selective culture of Escherichia coli to prevent infective complications of transrectal ultrasound-guided prostate biopsy: Clinical efficacy and analysis of characteristics of quinolone-resistant Escherichia coli. Int J Urol 2019; 26:655-660. [PMID: 30959574 DOI: 10.1111/iju.13960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 03/11/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate a regimen of targeted prophylaxis using rectal swab culture in patients undergoing transrectal ultrasound-guided prostate biopsy, and to investigate the characteristics of isolated fluoroquinolone-resistant Escherichia coli. METHODS A prospective study was carried out from June 2013 through December 2014. Rectal swabs were cultured on agar plates containing either 2 μg/mL levofloxacin or 1 μg/mL sitafloxacin before transrectal ultrasound-guided prostate biopsy. Patients with susceptible organisms received levofloxacin or sitafloxacin, whereas those with resistant organisms received directed antimicrobial prophylaxis according to the results of the antimicrobial susceptibility test. Patients with infectious complications after prostate biopsy were identified, and characteristics of patients carrying fluoroquinolone-resistant Escherichia coli were analyzed. RESULTS A total of 397 men underwent transrectal ultrasound-guided prostate biopsy. Of these patients, 74 (18.6%) had fluoroquinolone-resistant Escherichia coli. All fluoroquinolone-resistant Escherichia coli were susceptible to amikacin and meropenem. The risk factor for possible fluoroquinolone-resistant Escherichia coli was age of ≥73 years. Three (0.7%) patients who received appropriate antimicrobial prophylaxis had high-grade fever after the prostate biopsy. However, the pathogens were not fluoroquinolone-resistant Escherichia coli. CONCLUSIONS Targeted antimicrobial prophylaxis in patients undergoing transrectal ultrasound-guided prostate biopsy can be associated with reducing severe infectious complications caused by fluoroquinolone-resistant Escherichia coli.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Teruhisa Uehara
- Department of Pediatric Urology, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Central Hospital, Sapporo, Hokkaido, Japan
| | - Jiro Hashimoto
- Department of Urology, Kushiro Red Cross Hospital, Kushiro, Hokkaido, Japan
| | - Masanori Matsukawa
- Department of Urology, Takikawa Municipal Hospital, Takikawa, Hokkaido, Japan
| | - Keisuke Taguchi
- Department of Urology, Oji General Hospital, Tomakomai, Hokkaido, Japan
| | - Yasuharu Kunishima
- Department of Urology, Obihiro Kyokai Hospital, Obihiro, Hokkaido, Japan.,Department of Urology, Sunagawa City Medical Center, Sunagawa, Hokkaido, Japan
| | - Hiroshi Hotta
- Department of Urology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Hokkaido, Japan
| | - Masahiro Yanase
- Department of Urology, Sunagawa City Medical Center, Sunagawa, Hokkaido, Japan
| | - Naoki Itoh
- Department of Urology, NTT East Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Takaoki Hirose
- Department of Urology, Japan Community Health Care Organization Hokkaido Hospital, Sapporo, Hokkaido, Japan
| | - Koh Takeyama
- Department of Urology, Hakodate National Hospital, Hakodate, Hokkaido, Japan
| | - Hitoshi Tachiki
- Department of Urology, Steel Memorial Muroran Hospital, Muroran, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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14
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Zhong XH, Ding J, Zhou JH, Yu ZH, Sun SZ, Bao Y, Mao JH, Yu L, Li ZH, Han ZM, Song HM, Jiang XY, Liu YL, Zhang BL, Xia ZK, Jin CH, Zhu GH, Wang M, Feng SP, Shen Y, Huang SM, Ma QS, Li HX, Wang XJ, Ichihara K, Yao C, Dong CY. [A multicenter study of reference intervals for 15 laboratory parameters in Chinese children]. Zhonghua Er Ke Za Zhi 2019; 56:835-845. [PMID: 30392208 DOI: 10.3760/cma.j.issn.0578-1310.2018.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To establish comprehensive laboratory reference intervals for Chinese children. Methods: This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex. Results: In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old. Conclusion: This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.
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Affiliation(s)
- X H Zhong
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
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15
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Ichihara K, Masumori N, Iwasawa A, Taguchi K, Yamaguchi Y, Nishimura M, Sasamura H, Suzuki N, Haga K, Miyao N, Hirose T. Silodosin as second-line α-blocker monotherapy in patients with benign prostatic hyperplasia: A prospective observational study. Int J Urol 2018; 25:849-854. [DOI: 10.1111/iju.13757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Koji Ichihara
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Naoya Masumori
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | | | - Keisuke Taguchi
- Department of Urology; Oji General Hospital; Tomakomai Hokkaido Japan
| | | | | | - Hiroto Sasamura
- Department of Urology; Hokkaido Medical Center; Sapporo Hokkaido Japan
| | | | - Kazunori Haga
- Department of Urology; Sanjyukai Hospital; Sapporo Hokkaido Japan
| | - Noriomi Miyao
- Department of Urology; Muroran City General Hospital; Muroran Hokkaido Japan
| | - Takaoki Hirose
- Department of Urology; JCHO Hokkaido Hospital; Sapporo Hokkaido Japan
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16
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Masumori N, Ichihara K, Maehana T. Modified Nephrometry Score With Body Mass Index More Accurately Predicts Ischemic Time in Transabdominal Laparoscopic Partial Nephrectomy for Small Renal Masses. Urology 2018; 122:104-109. [PMID: 30219558 DOI: 10.1016/j.urology.2018.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/21/2018] [Accepted: 09/04/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To accurately predict the ischemic time (IT) and select candidates for transabdominal laparoscopic partial nephrectomy (LPN). METHODS Transabdominal LPN was performed for 135 Japanese patients with renal masses <7 cm in diameter between 2009 and 2016 by a single surgeon in a single institute. The renal parenchymal sutures were done with a combination of felt, Hem-o-lok and Lapra-Ty. The original R.E.N.A.L. nephreometry score (NS) was modified as follows. In terms of the tumor size (R), 1, 2, and 3 points were given for ≤2.5, 2.5-4, and >4 cm, respectively. For tumor location (A), 1, 2, and 3 points were given for anterior, on the coronal plane, and posterior, respectively. RESULTS The median IT was 24.6 minutes. Using the original NS, 64, 65, and 6 patients were categorized into low (4-6), moderate (7-9), and high (10-12) complexity, respectively. With the modified NS, 42, 75, and 18 patients were categorized into low (5-7), moderate (8-11), and high (12-15) complexity, respectively. Pearson's correlation coefficient (R) between the original NS and IT was 0.297, whereas the R was improved to 0.388 when the modified NS was employed. If the modified NS was low complexity, 95.2% achieved IT <30 minutes. Of them, none showed IT ≥30 minutes if the body mass index was <25 kg/m2. CONCLUSION The modified NS had a better correlation to the IT than the original NS for patients with tumor sizes <7 cm who underwent transabdominal LPN. The modified NS with body mass index is a practical tool to select candidates for transabdominal LPN.
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Affiliation(s)
- Naoya Masumori
- Department of Urologic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan.
| | - Koji Ichihara
- Department of Urologic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Takeshi Maehana
- Department of Urologic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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17
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Hirobe M, Tanaka T, Shindo T, Ichihara K, Hotta H, Takahashi A, Kato R, Yanase M, Matsukawa M, Itoh N, Kunishima Y, Taguchi K, Horita H, Masumori N. Complications within 90 days after radical cystectomy for bladder cancer: results of a multicenter prospective study in Japan. Int J Clin Oncol 2018; 23:734-741. [PMID: 29442282 DOI: 10.1007/s10147-018-1245-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/18/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE We prospectively evaluated the 90-day postoperative mortality and morbidity of open radical cystectomy by using a standardized reporting methodology. Additionally, we assessed the preoperative characteristics to determine risk factors for major complications. METHODS This multicenter prospective study included 185 consecutive patients undergoing open radical cystectomy from October 2010 through March 2014. Postoperative complications within 90 days were recorded and graded according to the modified Clavien-Dindo classification. RESULTS Totally, 328 postoperative complications were observed in 149 patients (80.5%). Of these events, 73 (22.2%) were high grade (≥ Grade III), and developed in 46 patients (24.9%). Three patients (1.6%) died postoperatively. Urinary tract infection, wound complications, and paralytic ileus were common complications that occurred in 55 (29.7%), 42 (22.7%) and 41 (22.2%) patients, respectively. Ureteroenteric stricture was diagnosed in 13 of the 151 patients (8.6%) undergoing intestinal urinary diversion. Emergency room visits were required for 13 patients (7.0%) and readmission after discharge was needed for 36 (19.5%). A body mass index ≥ 25 kg/m2, smoking history and Charlson Comorbidity Index ≥ 2 were independent risk factors for high-grade complications, and their odds ratios (95% confidence intervals) were 2.357 (1.123-4.948), 2.843 (1.225-6.596) and 3.025 (1.390-6.596), respectively. CONCLUSIONS Open radical cystectomy is associated with a high incidence of postoperative complications. Most, however, are of low grade. Our results suggest that obesity, a smoking history, and increasing comorbidity are risk factors for major complications.
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Affiliation(s)
- Megumi Hirobe
- Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Tetsuya Shindo
- Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Hiroshi Hotta
- Division of Urology, Asahikawa Red Cross Hospital, Asahikawa, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Atsushi Takahashi
- Division of Urology, Hakodate Goryoukaku Hospital, Hakodate, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Ryuichi Kato
- Division of Urology, Muroran City General Hospital, Muroran, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Masahiro Yanase
- Division of Urology, Sunagawa City Medical Center, Sunagawa, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Masanori Matsukawa
- Division of Urology, Takikawa Municipal Hospital, Takikawa, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Naoki Itoh
- Division of Urology, NTT-East Corporation Sapporo Medical Center, Sapporo, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Yasuharu Kunishima
- Division of Urology, Hokkaido Social Work Association Obihiro Hospital, Obihiro, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Keisuke Taguchi
- Division of Urology, Oji General Hospital, Tomakomai, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Hiroki Horita
- Division of Urology, Hokkaido Saiseikai Otaru Hospital, Otaru, Japan.,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Minami-1 Nishi-16, Chuo-ku, Sapporo, 060-8543, Japan. .,Sapporo Medical University Urologic Oncology Consortium (SUOC), Sapporo, Japan.
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18
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Fujino K, Hiyama Y, Uehara T, Ichihara K, Hashimoto J, Fujii S, Shinagawa M, Takahashi S, Masumori N. The efficacy of faropenem for patients with acute cystitis caused by extended spectrum β-lactamase producing Escherichia coli. J Infect Chemother 2017; 23:336-338. [DOI: 10.1016/j.jiac.2016.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/25/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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19
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Hiyama Y, Takahashi S, Uehara T, Ichihara K, Hashimoto J, Masumori N. A case of infective endocarditis and pyogenic spondylitis after transrectal ultrasound guided prostate biopsy. J Infect Chemother 2016; 22:767-769. [PMID: 27374863 DOI: 10.1016/j.jiac.2016.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 04/12/2016] [Accepted: 05/10/2016] [Indexed: 11/17/2022]
Abstract
We report a patient with infective endocarditis and pyrogenic spondylitis occurring simultaneously. The patient was a 59-year-old man. He was suspected of having prostate cancer due to a high prostate-specific antigen concentration noted in a checkup. He then underwent a transrectal ultrasound guided prostate biopsy with cefotiam as antimicrobial prophylaxis. He had a fever higher than 38 °C and lumbar pain for a few days after the biopsy. Enterococcus faecalis was isolated from 2 sets of blood culture. Magnetic resonance imaging revealed an abnormal image at C7/Th1 with a signal decrease in T1-weighted sequences and signal increase in T2-weighted sequences that were suspected to be due to bone destruction. Therefore, he was diagnosed as having pyogenic spondylitis by an orthopedist. At the same time, he complained of palpitation and a heart murmur was detected. Then transesophageal echocardiography was performed by a cardiologist and it revealed vegetation in his left ventricle and aortic regurgitation, and finally acute cardiac insufficiency was determined. He was treated with tazobactam/piperacillin and aortic valve displacement surgery. Based on the results of the prostate biopsy and image inspection, he was diagnosed as having localized prostate cancer. He was treated by androgen deprivation therapy and external beam radiation therapy. We have to keep in mind that E. faecalis can be a potential pathogen for severe infectious complications after prostate biopsy, especially if a cephalosporin is selected for antimicrobial prophylaxis.
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Affiliation(s)
- Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Japan
| | | | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | | | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Japan
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20
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Ikehata Y, Tanaka T, Ichihara K, Kobayashi K, Kitamura H, Takahashi S, Masumori N. Incidence and risk factors for acute kidney injury after radical cystectomy. Int J Urol 2016; 23:558-63. [DOI: 10.1111/iju.13104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 03/13/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Yoshinori Ikehata
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Toshiaki Tanaka
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Koji Ichihara
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Ko Kobayashi
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Hiroshi Kitamura
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Satoshi Takahashi
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
| | - Naoya Masumori
- Department of Urology; Sapporo Medical University School of Medicine; Sapporo Hokkaido Japan
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21
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Ichihara K, Tanaka T, Takahashi S, Matsukawa M, Yanase M, Kitamura H, Masumori N. Serum procalcitonin level in chronic hemodialytic patients with no evidence of bacterial infection. Ren Replace Ther 2016. [DOI: 10.1186/s41100-016-0025-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Ichihara K, Masumori N, Takahashi S, Miyao N, Kato R. Bladder Neck Rupture and Vesicovaginal Fistula Associated with Pelvic Fracture in Female. Low Urin Tract Symptoms 2015; 7:115-7. [PMID: 26663692 DOI: 10.1111/luts.12056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2013] [Revised: 01/05/2014] [Accepted: 01/23/2014] [Indexed: 11/27/2022]
Abstract
CASE Female urethral injury or bladder neck rupture associated with pelvic fracture is rare. The experience of this injury is limited and the management is still challenging. Here we describe a young female patient with urethral injury and vesicovaginal fistula associated with pelvic fracture due to traffic accident. We discuss the recommendation and management about this problem. OUTCOME We selected staged surgical management for this case, and fortunately succeeded in the repair of the urethral and vaginal injury and acquired favorable continence. CONCLUSION Appropriate management should be selected according to the condition in each patient. But it should be taken into consideration that a patient with pelvic fracture is critically ill, and an experienced urologist of this field is not always available at that time.
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Affiliation(s)
- Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Noriomi Miyao
- Department of Urology, Muroran General City Hospital, Muroran, Japan
| | - Ryuichi Kato
- Department of Urology, Muroran General City Hospital, Muroran, Japan
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23
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LeBlanc K, Jensen K, Krarup PM, Jorgensen L, Mynster T, Zappa B, Begolli L, Quazi S, Bhargava A, Luque JB, Suarez Gráu JM, Menchero JG, Moreno JG, Juraro JG, Ferreras ID, Nardi M, Millo P, Usai A, Lorusso R, Grivon M, Persico F, Allieta R, Christoffersen M, Brandt E, Helgstrand F, Westen M, Rosenberg J, Kehlet H, Strandfeit P, Bisgaard T, Vanini P, Kabbara S, Elia E, Piancastelli A, Guglielminetti D, Katsumoto F, Ahlqvist S, Björk D, Jänes A, Weisby-Enbom L, Israelsson L, Cengiz Y, Ndungu B, Kiragu P, Odende K, Jovanovic S, Pejcic V, Filipovic N, Trenkic M, Pavlovic A, Jovanovc B, Tatic M, Jovanovic A, Misra MC, Bansal VK, Subodh H, Krishna A, Bansal D, Ray S, Rajeshwari S, Björklund I, Burman A, Riccio PA, Vetrone G, Linguerri R, Liotta S, Antor M, Scottá M, Khalil H, Ichihara K, Takuo H, Ogawa M, Hidaka S, Hara K, Taki T, Ohashi S, Yoshida K, Galimov O, Shkundin A, Khanov V, Sarik J, Basta M, Bauder A, Kovach S, Fischer J, Tang L, Fei X, Xu M. Incisional Hernia: Daily Cases. Hernia 2015; 19 Suppl 1:S85-92. [PMID: 26518867 DOI: 10.1007/bf03355332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- K LeBlanc
- Our Lady of the Lake Physician Group, Baton Rouge, Louisiana, USA.,Department of Surgery, Louisiana State University School of Medicine, Baton Rouge, Louisiana, USA
| | - K Jensen
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - P-M Krarup
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark.,Danish Colorectal Cancer Group, Denmark
| | - L Jorgensen
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark
| | - T Mynster
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen, Denmark.,Danish Colorectal Cancer Group, Denmark
| | - B Zappa
- King George Hospital, London, UK
| | | | - S Quazi
- King George Hospital, London, UK
| | | | | | | | | | | | | | | | - M Nardi
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - P Millo
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - A Usai
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - R Lorusso
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - M Grivon
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - F Persico
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - R Allieta
- Division of General Surgery, USL Valle D'Aosta - Umberto Parini Regional Hospital, Aosta, Italy
| | - M Christoffersen
- Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - E Brandt
- Department of Gastrointestinal Surgery, Køge Hospital, University of Copenhagen, Køge, Denmark
| | - F Helgstrand
- Department of Gastrointestinal Surgery, Køge Hospital, University of Copenhagen, Køge, Denmark
| | - M Westen
- Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - J Rosenberg
- Gastro Unit, Surgical Division, Herlev Hospital, University of Copenhagen, Herlev, Denmark
| | - H Kehlet
- Section of Surgical Pathophysiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - P Strandfeit
- Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - T Bisgaard
- Gastro Unit, Surgical Division, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark
| | - P Vanini
- Casa di Cura Privata Malatesta Novello, Cesena, Italy
| | - S Kabbara
- Casa di Cura Privata Malatesta Novello, Cesena, Italy
| | - E Elia
- Casa di Cura Privata Malatesta Novello, Cesena, Italy
| | | | | | - F Katsumoto
- Katsumoto Day Surgery Clinic, Kitakyusyu, Japan
| | - S Ahlqvist
- Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden
| | - D Björk
- Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden
| | - A Jänes
- Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden
| | - L Weisby-Enbom
- Department of Radiology, Sundsvall Hospital, Sundsvall, Sweden
| | - L Israelsson
- Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden.,Department of Surgery and Perioperative, Umeå University, Umeå, Sweden
| | - Y Cengiz
- Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden.,Department of Surgery and Perioperative, Umeå University, Umeå, Sweden
| | - B Ndungu
- The University of Nairobi, Nairobi, Kenya
| | - P Kiragu
- Maralal County Hospital, Maralal, Kenya
| | - K Odende
- Kenyatta National Hospital, Nairobi, Kenya
| | - S Jovanovic
- Center for minimally invasive surgery, Nis, Serbia
| | - V Pejcic
- Center for minimally invasive surgery, Nis, Serbia
| | - N Filipovic
- Center for minimally invasive surgery, Nis, Serbia
| | - M Trenkic
- Center for minimally invasive surgery, Nis, Serbia
| | - A Pavlovic
- Center for minimally invasive surgery, Nis, Serbia
| | - B Jovanovc
- Center for minimally invasive surgery, Nis, Serbia
| | - M Tatic
- Center for minimally invasive surgery, Nis, Serbia
| | - A Jovanovic
- Center for minimally invasive surgery, Nis, Serbia
| | - M C Misra
- All India Institute of Medical Sciences, New Delhi, India
| | - V K Bansal
- All India Institute of Medical Sciences, New Delhi, India
| | - H Subodh
- All India Institute of Medical Sciences, New Delhi, India
| | - A Krishna
- All India Institute of Medical Sciences, New Delhi, India
| | - D Bansal
- All India Institute of Medical Sciences, New Delhi, India
| | - S Ray
- All India Institute of Medical Sciences, New Delhi, India
| | - S Rajeshwari
- All India Institute of Medical Sciences, New Delhi, India
| | | | - A Burman
- Department of Surgery, Sundsvall Hospital, Sundsvall, Sweden
| | | | | | | | | | - M Antor
- Department of Digestive Surgery, Rouen University Hospital, Rouen, France
| | | | | | | | - H Takuo
- Katsusika Medical Center, Tokyo, Japan
| | - M Ogawa
- Katsusika Medical Center, Tokyo, Japan
| | - S Hidaka
- Katsusika Medical Center, Tokyo, Japan
| | - K Hara
- Katsusika Medical Center, Tokyo, Japan
| | - T Taki
- Katsusika Medical Center, Tokyo, Japan
| | - S Ohashi
- Katsusika Medical Center, Tokyo, Japan
| | - K Yoshida
- Katsusika Medical Center, Tokyo, Japan
| | - O Galimov
- Bashkir State Medical University, Ufa, Russia
| | - A Shkundin
- Bashkir State Medical University, Ufa, Russia
| | - V Khanov
- Bashkir State Medical University, Ufa, Russia
| | - J Sarik
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - M Basta
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - A Bauder
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - S Kovach
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - J Fischer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - L Tang
- Shaoxing people' hospital, Shaoxing, China
| | - X Fei
- Shaoxing people' hospital, Shaoxing, China
| | - M Xu
- Shaoxing people' hospital, Shaoxing, China
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Aizawa N, Sugiyama R, Ichihara K, Fujimura T, Fukuhara H, Homma Y, Igawa Y. Functional roles of bladder α1-adrenoceptors in the activation of single-unit primary bladder afferent activity in rats. BJU Int 2015; 117:993-1001. [PMID: 26332379 DOI: 10.1111/bju.13313] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To clarify the involvement of bladder α1-adrenoceptors (α1-ARs) in afferent pathways by investigating the effects of silodosin and BMY7378, selective α1A- or α1D-AR antagonists, respectively, on single-unit afferent nerve fibre activity (SAA) of the primary bladder afferent nerves and their relationship with bladder microcontractions in rats. MATERIALS AND METHODS A total of 63 female Sprague-Dawley rats were anaesthetized with urethane. The SAA of Aδ and C fibres generated from the left L6 dorsal roots was determined using electrical stimulation of the left pelvic nerve and bladder distension. After measuring baseline SAA during constant filling cystometry, the procedure was repeated with i.v. (0.3-30 μg/kg) or intravesical (10 μm) administration of each antagonist. In separate rats, the bladder was filled with saline until the intravesical pressure reached 30 cmH2 O, and was kept under isovolumetric conditions, then the recording was performed with i.v.-administered vehicle and silodosin (0.3 μg/kg). RESULTS A total of Aδ fibres and 33 C fibres were isolated from 63 rats. The SAA of Aδ fibres, but not C fibres, were dose-dependently decreased after both i.v. and intravesical administrations of each of the antagonists. In the experiments under bladder isovolumetric conditions, silodosin administration significantly decreased the SAA of Aδ fibres, but not C fibres, compared with vehicle administration. There were no significant effects on either the mean basal bladder pressure or microcontractions. CONCLUSION The present study suggests that both α1A- or α1D-ARs in the rat bladder are involved in the activation of the bladder mechanosensory Aδ fibres during bladder filling, and that this activation may not be related to bladder microcontractions.
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Affiliation(s)
- Naoki Aizawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Rino Sugiyama
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Koji Ichihara
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yukio Homma
- Department of Urology, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Kamei J, Furuta A, Akiyama Y, Niimi A, Ichihara K, Fujimura T, Fukuhara H, Kume H, Homma Y, Igawa Y. Video-urodynamic effects of mirabegron, a β3 -adrenoceptor agonist, in patients with low-compliance bladder. Int J Urol 2015; 22:956-61. [PMID: 26177781 DOI: 10.1111/iju.12867] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 06/10/2015] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To investigate video-urodynamic effects of mirabegron, a β3 -adrenoceptor agonist, on low-compliance bladder. METHODS We retrospectively reviewed nine patients (three men, six women, age 17-68 years) who had been diagnosed with lower urinary tract dysfunction with low-compliance bladder, and who underwent video-urodynamic study before and during administration of mirabegron 50 mg once daily. Urodynamic parameters were compared before and after treatment. RESULTS Mirabegron treatment significantly increased first desire to void and cystometric capacity with an average increment of 80 mL (P = 0.027) and 123 mL (P = 0.005), respectively. Bladder compliance also significantly increased (mean value 8.1 mL/cmH2 O before, 18.2 mL/cmH2 O after, P = 0.024). In the six patients who had been taking anticholinergic agents at baseline video-urodynamic study and then switched to mirabegron, mean cystometric capacity and bladder compliance were also increased significantly from 208.3 to 346.8 mL (P = 0.015) and from 7.2 to 17.5 mL/cmH2 O (P = 0.047), respectively. Vesicoureteral reflux grade was improved in three of the four patients who had shown vesicoureteral reflux on cystography before treatment. CONCLUSIONS Mirabegron improves cystometric capacity and bladder compliance, and it lowers vesicoureteral reflux grade in patients with low-compliance bladder. Thus, mirabegron might represent a good alternative drug for low-compliance bladder refractory to anticholinergic treatment.
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Affiliation(s)
- Jun Kamei
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akira Furuta
- Department of Urology, Jikei University School of Medicine, Tokyo, Japan
| | - Yoshiyuki Akiyama
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Niimi
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koji Ichihara
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuya Fujimura
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Fukuhara
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yukio Homma
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Matsuki M, Tanaka T, Maehana T, Ichihara K, Yanase M, Matsukawa M, Adachi H, Takahashi S, Masumori N. Serum cystatin C can be used as a marker of renal function even in patients with intestinal urinary diversion. Asian J Urol 2015; 2:167-169. [PMID: 29264138 PMCID: PMC5730715 DOI: 10.1016/j.ajur.2015.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 06/23/2015] [Accepted: 07/08/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Recently, serum cystatin C (CysC) has been used as a novel marker of renal function. However, there is a lack of data on CysC levels in patients with intestinal urinary diversion (UD). Here we report CysC levels in such patients. METHODS We prospectively observed 38 patients who were diagnosed with bladder cancer and subsequently treated with radical cystectomy and UD at our institution in 2012 and 2013. Serum creatinine (sCr) and CysC were obtained optionally at the same time at least 1 month after radical cystectomy and UD. RESULTS The median CysC and sCr concentrations were 1.12 mg/L (range 0.75-2.47 mg/L) and 0.99 mg/dL (range 0.61-2.22 mg/dL), respectively. The median estimated concentrations of glomerular filtration rate (GFR) based on CysC (eGFRcys) and GFR based on creatinine (eGFRcreat) were 61.08 mL/min/1.73 m2 (range 22.64-99.89 mL/min/1.73 m2) and 58.01 mL/min/1.73 m2 (range 23.48-91.82 mL/min/1.73 m2), respectively. CysC had a significant correlation with sCr (r = 0.8607, p < 0.0001) and eGFRcreat (r = -0.8993, p < 0.0001). eGFRcys also had a significant correlation with eGFRcreat (r = 0.8104, p < 0.0001). CONCLUSION The correlation between CysC and sCr was strong and the correlation coefficient was equivalent to that in patients without UD. The results suggest that CysC is not affected by UD and can be used as a marker of renal function similarly to sCr in patients with UD.
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Affiliation(s)
- Masahiro Matsuki
- Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
| | - Toshiaki Tanaka
- Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
| | - Takeshi Maehana
- Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
| | - Masahiro Yanase
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
- Department of Urology, Sunagawa City Medical Center, Sunagawa, Japan
| | - Masanori Matsukawa
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
- Department of Urology, Takikawa Municipal Hospital, Takikawa, Japan
| | - Hideki Adachi
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
- Department of Urology, SaiseikaiOtaru Hospital, Otaru, Japan
| | - Satoshi Takahashi
- Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University, School of Medicine, Sapporo, Japan
- Sapporo Kidney Disease Treatment Forum, Sapporo, Japan
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Kurimura Y, Takahashi S, Hiyama Y, Uehara T, Ichihara K, Hashimoto J, Nishiyama N, Kitamura H, Masumori N. [Significance of Procalcitonin Measurement in Cases with Febrile Condition during Chemotherapy for Urological Cancer]. Hinyokika Kiyo 2015; 61:141-145. [PMID: 26037672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We examined the usefulness of measurement of procalcitonin (PCT) for patients, who developed febrile neutropenia during cancer chemotherapy for urological cancer. Of the Patients who underwent cancer chemotherapy for bladder, renal pelvic or ureteral, and testicular cancer in our department from 2010 to 2013, 51 had febrile events. Their clinical courses and PCT values were retrospectively reviewed and analyzed. PCT was positive in 12 patients and negative in 39. The duration with febrile status was significantly longer in the PCT-positive group than in the PCT-negative group. There was no significant difference between the blood count values in each group, but C-reactive protein (CRP) was significantly higher in the PCT-positive group than in the PCT-negative group. There were no significant differences between the 2 groups in other tests with blood. There were 12 patients with febrile neutropenia (FN) but all were classified into low-risk by the MASCC scoring system. Four of these 12 patients were positive for PCT. Our results suggested that, in patients with a fever of 37.5°C or more during the course of cancer chemotherapy for urologic cancer, bacteremia possibly existed if the patient was positive for PCT. In addition, the duration of fever tended to be longer and the condition was more severe. When the patients with urological cancer undergo cancer chemotherapy manifest high-grade fever, PCT is promising and valuable as an indicator of the severity of infection.
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Affiliation(s)
- Yuichiro Kurimura
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Satoshi Takahashi
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Yoshiki Hiyama
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Teruhisa Uehara
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Koji Ichihara
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Jiro Hashimoto
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Naotaka Nishiyama
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Hiroshi Kitamura
- The Department of Urology, Sapporo Medical University School of Medicine
| | - Naoya Masumori
- The Department of Urology, Sapporo Medical University School of Medicine
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28
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Kamei J, Aizawa N, Nakagawa T, Ito H, Sugiyama R, Akiyama Y, Ichihara K, Kaneko S, Homma Y, Igawa Y. MP12-03 FUNCTIONAL CHANGES OF THE BLADDER
IN VIVO
IN MICE LACKING TRANSIENT RECEPTOR POTENTIAL MELASTAIN 2 (TRPM2) CHANNELS. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Takahashi S, Ichihara K, Hashimoto K, Hiyama Y, Muranaka T, Hashimoto J, Fukuta F, Kobayashi K, Niiyama Y, Yamakage M, Masumori N. Serum antimicrobial concentrations for surgical antimicrobial prophylaxis in radical nephrectomy and radical prostatectomy. J Infect Chemother 2015; 21:464-7. [PMID: 25817353 DOI: 10.1016/j.jiac.2015.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/01/2015] [Accepted: 03/02/2015] [Indexed: 11/28/2022]
Abstract
To evaluate the current methods of surgical antimicrobial prophylaxis from the viewpoint of pharmacokinetics for patients undergo urologic surgery, this study was designed to measure the serum concentrations of two different prophylactic antimicrobial agents in different types of urologic surgery. This prospective study included 39 patients with prostate cancer, renal pelvic cancer, ureteral cancer or renal cancer treated by radical surgery from August 2005 to March 2006. Blood samples were taken intraoperatively at 30 min and 180 min after the beginning of the first administration. The half-life of the beta phase of cefazolin is 2.46 h and that of piperacillin is 0.7 h according to their manufacturers. The average serum concentration of cefazolin at 30 min was 144 μg/mL in the prostatectomy group and 175 μg/mL in the nephrectomy group. At 180 min, the average concentration of cefazolin was 37 μg/mL in prostatectomy group and 59 μg/mL in the nephrectomy group. The average concentration of piperacillin at 30 min was 134 μg/mL in the prostatectomy group and 137 μg/mL in the nephrectomy group. At 180 min, the average concentration of piperacillin was 10 μg/mL in the prostatectomy group and 22 μg/mL in the nephrectomy group. Thus, the concentration at 180 min after the beginning of infusion was different according to the half-life of each antimicrobial agent. Therefore, up-to-date guidelines for surgical antimicrobial prophylaxis that deal with additional types of intraoperative prophylaxis should be consulted if the operation exceeds two half-lives of the prophylactic antimicrobial agents used in real-life clinical practice.
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Affiliation(s)
- Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Kohei Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Takashi Muranaka
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Ko Kobayashi
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Yukitoshi Niiyama
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Japan
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30
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Takahashi S, Ichihara K, Hiyama Y, Uehara T, Hashimoto J, Masumori N. Do patients who complain of lower urinary tract symptoms frequently have clinically significant pyuria? J Infect Chemother 2015; 21:31-3. [DOI: 10.1016/j.jiac.2014.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 07/26/2014] [Accepted: 08/22/2014] [Indexed: 11/30/2022]
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Yamamoto T, Takahashi S, Ichihara K, Hiyama Y, Uehara T, Hashimoto J, Hirobe M, Masumori N. How do we understand the disagreement in the frequency of surgical site infection between the CDC and Clavien-Dindo classifications? J Infect Chemother 2014; 21:130-3. [PMID: 25434696 DOI: 10.1016/j.jiac.2014.10.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/12/2014] [Accepted: 10/25/2014] [Indexed: 10/24/2022]
Abstract
To clarify the discrepancy in the incidence and severity of surgical site infections (SSI) for radical cystectomy between reports based on the CDC guideline and those using the Clavien-Dindo classification we evaluated 449 consecutive patients who underwent radical cystectomy for bladder cancer between 1990 and 2012. Of the 115 (25.6%) patients with SSI defined by the CDC guideline, 89 could be analyzed. We compared the SSI rates and severity defined by the CDC guideline and Clavien-Dindo classifications. There were 58 patients with superficial SSI, 16 with deep SSI, and 15 with organ/space SSI according to the CDC guideline. All patients with organ/space SSI were judged as "not having SSI" by the Clavien-Dindo classification. They were classified as having "intestinal prolapse", "intestinal fistula", "abdominal abscess" and "pelvic abscess." There was a significant association between the treatment duration and depth of SSI based on the CDC guideline by Spearman's rank-correlation coefficient (p < 0.001, r = 0.614) and with the grade of complications (p < 0.001, r = 0.632) in the Clavien-Dindo classification. Multivariate analysis showed that patients with grade III SSI in the Clavien-Dindo classification needed a significantly longer treatment duration. It is necessary to be aware that a discrepancy can occur automatically due to the different natures of the definitions. Using the CDC guideline, we can effectively estimate the future treatment period when SSI occurs. With the Clavien-Dindo classification, grade III SSI requires a longer treatment duration.
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Affiliation(s)
- Takanobu Yamamoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Teruhisa Uehara
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Megumi Hirobe
- Department of Urology, Sapporo Medical University School of Medicine, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Japan
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Ichihara K, Masumori N, Fukuta F, Tsukamoto T, Iwasawa A, Tanaka Y. A randomized controlled study of the efficacy of tamsulosin monotherapy and its combination with mirabegron for overactive bladder induced by benign prostatic obstruction. J Urol 2014; 193:921-6. [PMID: 25254938 DOI: 10.1016/j.juro.2014.09.091] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2014] [Indexed: 11/16/2022]
Abstract
PURPOSE We evaluated the efficacy and safety of add-on treatment with a β3-adrenoceptor agonist (mirabegron) for overactive bladder symptoms remaining after α1-blocker (tamsulosin) treatment in men with benign prostatic obstruction. MATERIALS AND METHODS Patients with benign prostatic obstruction with urinary urgency at least once per week and a total OABSS of 3 or more points after 8 or more weeks of treatment with tamsulosin were enrolled in the study. They were randomly allocated to receive 0.2 mg tamsulosin daily or 0.2 mg tamsulosin and 50 mg mirabegron daily for 8 weeks. The primary end point was change in total OABSS. Safety assessments included change in post-void residual urine volume and adverse events. RESULTS From January 2012 through September 2013 a total of 94 patients were randomized. Of these patients 76 completed the protocol treatment. In the full analysis set the change in total OABSS during the treatment period was significantly greater in the combination group than in the monotherapy group (-2.21 vs -0.87, p=0.012). The changes in scores for urinary urgency, daytime frequency, International Prostate Symptom Score storage symptom subscore and quality of life index at 8 weeks were significantly greater in the combination group. The change in post-void residual urine volume was significantly greater in the combination group. Although 6 patients experienced adverse events in the combination group, urinary retention was observed in only 1 patient. CONCLUSIONS Combined tamsulosin and mirabegron treatment is effective and safe for patients with benign prostatic obstruction who have overactive bladder symptoms after tamsulosin monotherapy.
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Affiliation(s)
- Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan.
| | - Fumimasa Fukuta
- Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | - Taiji Tsukamoto
- Department of Urology, Sapporo Medical University School of Medicine, Hokkaido, Japan
| | | | - Yoshinori Tanaka
- Department of Urology, Hokkaido Prefectural Esashi Hospital, Hokkaido, Japan
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Takahashi S, Kiyota H, Ito S, Iwasawa A, Hiyama Y, Uehara T, Ichihara K, Hashimoto J, Masumori N, Sunaoshi K, Takeda K, Suzuki N, Hosobe T, Goto H, Suzuki H, Onodera S. Clinical Efficacy of a Single Two Gram Dose of Azithromycin Extended Release for Male Patients with Urethritis. Antibiotics (Basel) 2014; 3:109-20. [PMID: 27025738 PMCID: PMC4790393 DOI: 10.3390/antibiotics3020109] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 02/26/2014] [Accepted: 03/04/2014] [Indexed: 12/02/2022] Open
Abstract
To clarify the clinical efficacy of a single oral 2 g dose of azithromycin extended-release for heterosexual male patients with urethritis, and the current antimicrobial sensitivity of Neisseria gonorrhoeae to azithromycin, a prospective clinical trial was conducted from 2011-2013. In patients with gonococcal urethritis, the eradication rate was 90.9% (30 of 33). The susceptibility rates of isolated Neisseria gonorrhoeae strains to ceftriaxone, spectinomycin, cefixime and azithromycin were 100%, 100%, 95.3% (41/43) and 37.2% (16/43), respectively. In the patients with nongonococcal urethritis, the eradication rate was 90.0% (45 of 50). The microbiological eradication rates for the pathogens were 90.9% (30/33) for Neisseria gonorrhoeae, 91.5% (43/47) for Chlamydia trachomatis, 71.4% (5/7) for Mycoplasma genitalium, and 100% (13/13) for Ureaplasma urealyticum. The main adverse event was diarrhea and its manifestation rate was 35.2% (32 of 120). The symptom of diarrhea was mostly temporary and resolved spontaneously. The conclusion was that the treatment regimen with a single oral 2 g dose of azithromycin extended-release would be effective for patients with urethritis. However, the antimicrobial susceptibilities of Neisseria gonorrhoeae and Mycoplasma genitalium should be carefully monitored because of possible treatment failure.
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Affiliation(s)
- Satoshi Takahashi
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Hiroshi Kiyota
- Department of Urology, the Jikei University Katsushika Medical Center, 6-41-2 Aoto Katsushika-ku, Tokyo 1258506, Japan.
| | - Shin Ito
- iClinic, 5-9-6, Nagamachi, Taihaku-ku, Sendai, Miyagi 9820011, Japan.
| | - Akihiko Iwasawa
- Iwasawa Clinic, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0600061, Japan.
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Teruhisa Uehara
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Jiro Hashimoto
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, S. 1, W. 16, Chuo-ku, Sapporo, Hokkaido 0608543, Japan.
| | - Kenichi Sunaoshi
- Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan.
| | - Koichi Takeda
- Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan.
| | - Nobukazu Suzuki
- Teine Urologic Clinic, 1-12, Maeda 6-7, Teine-ku, Sapporo 0060816, Japan.
| | - Takahide Hosobe
- Hosobe Clinic, 1-1-15, Nezu, Bunkyo-ku, Tokyo 1130031, Japan.
| | - Hirokazu Goto
- Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan.
| | - Hidenori Suzuki
- Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan.
| | - Shoichi Onodera
- Department of Urology, Fuji City General Hospital, 50 Takashima-Cho, Fuji, Shizuoka 4178567, Japan.
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Ikehata Y, Tanaka T, Ichihara K, Kobayashi K, Kitamura H, Takahashi S, Masumori N. MP60-01 INCIDENCE AND RISK FACTORS FOR ACUTE KIDNEY INJURY AFTER RADICAL CYSTECTOMY. J Urol 2014. [DOI: 10.1016/j.juro.2014.02.1755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mizukami N, Yamauchi M, Koike K, Watanabe A, Ichihara K, Masumori N, Yamakage M. Olanzapine for the prevention of chemotherapy-induced nausea and vomiting in patients receiving highly or moderately emetogenic chemotherapy: a randomized, double-blind, placebo-controlled study. J Pain Symptom Manage 2014; 47:542-50. [PMID: 23856100 DOI: 10.1016/j.jpainsymman.2013.05.003] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Revised: 05/02/2013] [Accepted: 05/04/2013] [Indexed: 01/01/2023]
Abstract
CONTEXT Chemotherapy-induced nausea and vomiting (CINV) can severely impair patients' quality of life (QOL). Psychotropics, especially olanzapine, have a strong antiemetic effect. OBJECTIVES To determine whether olanzapine could reduce the frequency of CINV and improve patients' QOL during chemotherapy. METHODS This was a randomized, double-blind, placebo-controlled trial. Forty-four patients scheduled to receive highly or moderately emetogenic chemotherapy were enrolled. All patients received a 5-hydroxytryptamine3 receptor antagonist, steroid, and neurokinin-1 receptor antagonist. Patients were randomly assigned to take 5 mg/day of oral olanzapine (OL group, n = 22) or placebo (control group, n = 22) daily from the day before chemotherapy (Day 0) to Day 5. The primary endpoint was the rate of patients who achieved total control (no vomiting, no use of rescue medications, and maximum nausea of <5/100mm on a visual analogue scale). The secondary endpoint was Functional Living Index-Emesis questionnaire score on Days 0 and 6. RESULTS The rate of patients achieving total control was significantly higher in the OL group (86% and 64% in acute and delayed phases, respectively) than in the control group (55% and 23%, P = 0.045, P = 0.014, respectively). Furthermore, the OL group experienced a better QOL than the control group, as reported on the Functional Living Index-Emesis questionnaire (P = 0.0004). CONCLUSION The addition of 5mg/day of oral olanzapine to standard therapy can reduce the frequency of CINV and improve QOL of patients receiving highly or moderately emetogenic chemotherapy.
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Affiliation(s)
- Naomi Mizukami
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan.
| | - Masanori Yamauchi
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Kazuhiko Koike
- Division of Palliative Medicine, Higashi-Sapporo Hospital, Sapporo, Hokkaido, Japan
| | - Akihiko Watanabe
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Koji Ichihara
- Department of Urologic Surgery and Andrology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Naoya Masumori
- Department of Urologic Surgery and Andrology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
| | - Michiaki Yamakage
- Department of Anesthesiology, Sapporo Medical University Hospital, Sapporo, Hokkaido, Japan
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Matsuki M, Ichihara K, Matsuda Y, Taguchi K. [Clinical features of six patients with pancreas metastasis from renal cell carcinoma]. Hinyokika Kiyo 2014; 60:105-108. [PMID: 24759494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We retrospectively reviewed patients who underwent radical or partial nephrectomy and were followed up in Oji General Hospital from 1992 through 2012. A total of 6 patients had disease recurrence in the pancreas during follow-up. We investigated their clinical features and treatment outcomes. The median age at diagnosis was 75 years. The median interval from nephrectomy to the detection of pancreatic metastasis was 114 months. As local therapy for metastasis, surgical resection was selected for 4 patients. On the other hand, administration of medication, including interferon alpha and sunitinib was selected for 2 patients with other simultaneous metastatic sites. One of the 4 patients with surgical resection had disease recurrence in the residual pancreas and needed additional excision. At the median follow-up of 38 months after treatment of pancreatic metastasis, one patient remained alive without evidence of disease, 3 patients were alive with recurrent disease, and 2 patients had died of the disease.
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Sugiyama T, Saito M, Nishigori H, Nagase S, Yaegashi N, Sagawa N, Kawano R, Ichihara K, Sanaka M, Akazawa S, Anazawa S, Waguri M, Sameshima H, Hiramatsu Y, Toyoda N. Comparison of pregnancy outcomes between women with gestational diabetes and overt diabetes first diagnosed in pregnancy: a retrospective multi-institutional study in Japan. Diabetes Res Clin Pract 2014; 103:20-5. [PMID: 24405981 DOI: 10.1016/j.diabres.2013.10.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/31/2013] [Accepted: 10/28/2013] [Indexed: 12/16/2022]
Abstract
AIMS To determine differences in pregnancy outcomes including diabetic complications, maternal and perinatal complications between gestational diabetes mellitus and overt diabetes in pregnancy in Japan. METHODS A multi-institutional retrospective study compared pregnancy outcomes between gestational diabetes mellitus and overt diabetes in pregnancy. We examined pregnant women who met the former criteria for gestational diabetes mellitus and received dietary intervention with self-monitoring of blood glucose with or without insulin. Overt diabetes in pregnancy was defined as ≥2 abnormal values on 75-g oral glucose tolerance test, fasting glucose ≥126 mg/dl (7.0 mmol/l) and 2-h postprandial glucose ≥200 mg/dl (11.1 mmol/l), or glycated hemoglobin levels ≥6.5% (48 mmol/mol). RESULTS Data were collected on 1267 women with gestational diabetes and 348 with overt diabetes in pregnancy. Pregestational body mass index was higher (26.2 ± 6.1 vs. 24.9 ± 5.7 kg, P<0.05) and gestational age at delivery was earlier (37.8 ± 2.5 weeks vs. 38.1 ± 2.1 weeks, P<0.05) in overt diabetes than in gestational diabetes. Glycated hemoglobin (6.8 ± 1.1% [51 mmol/mol] vs. 5.8 ± 0.5% [40 mmol/mol], P<0.05) and glucose on 75-g oral glucose tolerance test and prevalence of retinopathy (1.2% vs. 0%, P<0.05) and pregnancy-induced hypertension (10.1% vs. 6.1%, P<0.05) were higher in overt diabetes than in gestational diabetes. Pregnancy-induced hypertension was associated with pregestational body mass index, gestational weight gain, chronic hypertension, and nulliparity but not with 75-g oral glucose tolerance test. CONCLUSIONS Overt diabetes in pregnancy is significantly associated with maternal complications such as retinopathy and pregnancy-induced hypertension.
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Affiliation(s)
- T Sugiyama
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan.
| | - M Saito
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - H Nishigori
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - S Nagase
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - N Yaegashi
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Miyagi 980-8574, Japan
| | - N Sagawa
- Department of Obstetrics and Gynecology, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan
| | - R Kawano
- Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - K Ichihara
- Department of Laboratory Science, Faculty of Health Science, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan
| | - M Sanaka
- Diabetes Center, Tokyo Women's University School of Medicine, Tokyo 162-8666, Japan
| | - S Akazawa
- Department of Diabetes and Endocrinology, Shin-Koga Hospital, Kurume, Fukuoka 830-8522, Japan
| | - S Anazawa
- Saiseikai Central Hospital, Tokyo 108-0073, Japan
| | - M Waguri
- Department of Maternal Internal Medicine, Osaka Medical Center and Research Institute for Maternal and Children Health, Izumi 594-1101, Japan
| | - H Sameshima
- Department of Obstetrics and Gynecology, Miyazaki University School of Medicine, Miyazaki 889-1692, Japan
| | - Y Hiramatsu
- Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - N Toyoda
- Department of Obstetrics and Gynecology, Suzuka University of Medical Science, Suzuka, Mie 513-3670, Japan
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Ichihara K, Masumori N, Kitamura H, Hasegawa T, Tsukamoto T. Clinical outcomes of urothelial carcinoma of the prostate detected in radical cystectomy specimens. Int J Clin Oncol 2012; 19:152-6. [DOI: 10.1007/s10147-012-0508-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 12/02/2012] [Indexed: 11/24/2022]
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Okano K, Araki M, Mimura Y, Nogaki H, Ichihara K. Simultaneous assay of activated platelet count and platelet-activating capacity by P-selectin detection using K2-EDTA-treated whole blood for antiplatelet agents. Int J Lab Hematol 2012; 34:621-9. [PMID: 22862794 DOI: 10.1111/j.1751-553x.2012.01447.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2011] [Accepted: 05/10/2012] [Indexed: 12/01/2022]
Abstract
INTRODUCTION It is well recognized that examinations of activated platelets (aPLTs) and platelet-activating capacity are very important to observe and prevent embolic diseases (events) such as ischemic stroke and myocardial infarction. Previously, we reported an appropriate measurement technique of aPLT for clinical assay. In this paper, we investigated stable conditions for measurement of activating capacity of platelets. METHODS Blood samples were taken from healthy volunteers using anticoagulants of 2K-EDTA, sodium citrate and heparin, and platelets were stimulated with adenosine diphosphate (ADP) or collagen. We demonstrated platelet-activating capacity by detection of scattering light, absorbance, microscopic observation, and P-selectin (CD62P) expression. We also performed basic experiments in seven healthy volunteers to test the clinical application of these assays with monitoring aspirin therapy. RESULTS We judged that samples of whole blood with 2K-EDTA were suitable for CD62P expression assay as functional assessments of platelet activity, because platelets treated with anticoagulants such as sodium citrate and heparin were extremely damaged after stimulation, and it was difficult to measure the CD62P expression by flow cytometry. For optimal results, samples should be tested within 1 h after the drawing of blood and stimulated with ADP or collagen for 10 min. The CD62P-positive platelet value of blood from volunteers who had taken aspirin was decreased, and platelet activation was inhibited as well. CONCLUSION The simultaneous assay of aPLT and platelet-activating capacity by CD62P detection using whole blood treated with the K2-EDTA anticoagulant was useful for the monitoring of antiplatelet drugs.
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Affiliation(s)
- K Okano
- Faculty of Health Sciences, Yamaguchi University School of Medicine, Ube, Japan
| | - M Araki
- Onoda Red Cross Hospital Sanyo-Onoda, Japan
| | - Y Mimura
- Faculty of Health Sciences, Yamaguchi University School of Medicine, Ube, Japan
| | - H Nogaki
- Faculty of Health Sciences, Yamaguchi University School of Medicine, Ube, Japan
| | - K Ichihara
- Faculty of Health Sciences, Yamaguchi University School of Medicine, Ube, Japan
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Masumori N, Tanaka T, Takeuchi M, Ichihara K, Inoue R, Shinkai N, Maehana T, Mizuno T, Tabata H, Hiyama Y, Tsukamoto T. [A case of Crohn's disease developing bladder rupture 4 months after laparoscopic sigmoidectomy with partial cystectomy for vesicosigmoidal fistula]. Hinyokika Kiyo 2012; 58:237-241. [PMID: 22767277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
A 32-year-old well-nourished man having a vesicosigmoidal fistula due to Crohn's disease received laparoscopic sigmoidectomy with partial cystectomy. The bladder wall was closed with an all-layer running suture and additional interrupted sutures using 2-0 Vicryl. Four months after surgery, the suture site on the bladder showed perforation to the abdominal cavity. Since the same event occurred again 6 months after surgery, open partial cystectomy was performed to repair the perforated site 8 months after the initial surgery. The perforated site showed a thinning bladder wall composed of normal urothelium, scar tissue and thin detrusor muscle. Non-caseating granuloma was not found in the specimen, even though it was slightly observed in the margin of the detrusor muscle resected in the initial surgery. Although it was possible that the persisting activity of Crohn's disease, subclinical impaired nutrition due to Crohn's disease or insufficient suturing of the bladder wall were involved in the bladder rupture, the definitive cause remains unknown.
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Affiliation(s)
- Naoya Masumori
- The Department of Urology, Sapporo Medical University School of Medicine
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Ichihara K, Masumori N, Muto M, Fukuta F, Hirobe M, Kitamura H, Tsukamoto T. [Retrospetive analysis of early postoperative complications of radical cystectomy and urinary diversion performed during a 17-year period]. Hinyokika Kiyo 2010; 56:605-611. [PMID: 21187703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We retrospectively analyzed early postoperative complications in 293 consecutive patients withbladder cancer who underwent radical cystectomy with urinary diversion from 1990 to 2007 at the Department of Urology of the Sapporo Medical University School of Medicine. The Common Terminology Criteria for Adverse Events (ver 3.0) was used to evaluate complications that occurred within 30 days after surgery, and grade 3 and higher grades according to the criteria were defined as complications in this study. The guidelines of the Centers for Disease Control and Prevention were used for the classification of surgical site infection. Early postoperative complications were found in 158 cases (54%). Acute pyelonephritis (APN), which was related to the removal of the ureteral catheter, was the most frequent complication, found in 96 (33%), followed by surgical site infection in 39 (13%), and ileus in 33 (11%). When transient APN was excluded, the rate for complications was 30%. Possible life-threatening complications were experienced in 15 patients (5%) including 2 (0.7%) who eventually died of the complications. The preoperative grade 3 score of the American Society of Anesthesiologists (ASA score) was significantly related to development of early postoperative complications in univariate analysis. In multivariate analysis, a grade 3 ASA score and the estimated blood loss were independent factors to predict development of early complications. Postoperative nasogastric tubing was not related to ileus after surgery, suggesting that postoperative indwelling of the tube is not routinely needed. Although about half of the patients experienced early postoperative complications, they were usually transient and manageable. Thus, careful evaluation of the preoperative ASA score and a reduction in the amount of bleeding during surgery may lower the development of early postoperative complications.
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Affiliation(s)
- Koji Ichihara
- The Department of Urology, Sapporo Medical University School of Medicine, Japan
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Fukuta F, Masumori N, Honma I, Muto M, Ichihara K, Kitamura H, Tsukamoto T. Clinical outcomes of patients with pT0 bladder cancer after radical cystectomy: a single-institute experience. Jpn J Clin Oncol 2010; 41:115-20. [PMID: 20696818 DOI: 10.1093/jjco/hyq148] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To investigate the clinical outcomes of patients who underwent radical cystectomy for bladder cancer at a single institution and compare those who had pT0 specimens with those who had residual cancer. METHODS From January 1990 to December 2006, 186 patients underwent radical cystectomy with or without neoadjuvant chemotherapy for cT2 or higher stage urothelial carcinoma in the bladder in our hospital. We estimated the 5-year disease-free survival, cancer-specific survival and overall survival by the pathological stage. RESULTS The median follow-up of the 186 patients was 38.5 months (0-194). Of these, 51 received neoadjuvant chemotherapy. For all subjects, the 5-year disease-free survival was 54.9%, cancer-specific survival 61.0% and overall survival 57.1%. Of the 186 patients, 24 (12.9%) had no residual cancer in the bladder specimen at radical cystectomy. Of the 24 patients with pT0, only 1 (4.2%) died of bladder cancer. The 5-year disease-free survival, cancer-specific survival and overall survival rates in patients with pT0 were ∼96.0%. We found pT0 histology in 11 of the 51 patients (21.6%) with neoadjuvant chemotherapy and in 13 of the 135 patients (9.6%) with radical cystectomy alone (P = 0.047). CONCLUSIONS We demonstrated that the outcomes of patients who underwent radical cystectomy were similar to those in previous reports. Patients with pT0 showed favorable outcomes for disease-free survival, cancer-specific survival and overall survival in our study. However, they should be periodically followed up because pT0 does not always mean cure.
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Affiliation(s)
- Fumimasa Fukuta
- Department of Urology, School of Medicine, Sapporo Medical University, Sapporo, Hokkaido, Japan
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Hisasue SI, Hashimoto K, Furuya R, Takeuchi M, Kyoda Y, Maeda T, Kobayashi K, Tanaka T, Ichihara K, Kato R, Kitamura H, Takahashi S, Masumori N, Tsukamoto T. 701 THE IMPACT OF ERECTILE FUNCTION ON THE CAVERNOUS NERVE QUANTITY IN THE RADICAL PROSTATECTOMY SPECIMEN. J Urol 2010. [DOI: 10.1016/j.juro.2010.02.1142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Hatanaka N, Yamamoto Y, Ichihara K, Mastuo S, Nakamura Y, Watanabe M, Iwatani Y. A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results. J Clin Pathol 2008; 61:514-8. [DOI: 10.1136/jcp.2007.050195] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Various scales have been devised to predict development of pressure ulcers on the basis of clinical and laboratory data, such as the Braden Scale (Braden score), which is used to monitor activity and skin conditions of bedridden patients. However, none of these scales facilitates clinically reliable prediction.Aims:To develop a clinical laboratory data-based predictive equation for the development of pressure ulcers.Methods:Subjects were 149 hospitalised patients with respiratory disorders who were monitored for the development of pressure ulcers over a 3-month period. The proportional hazards model (Cox regression) was used to analyse the results of 12 basic laboratory tests on the day of hospitalisation in comparison with Braden score.Results:Pressure ulcers developed in 38 patients within the study period. A Cox regression model consisting solely of Braden scale items showed that none of these items contributed to significantly predicting pressure ulcers. Rather, a combination of haemoglobin (Hb), C-reactive protein (CRP), albumin (Alb), age, and gender produced the best model for prediction. Using the set of explanatory variables, we created a new indicator based on a multiple logistic regression equation. The new indicator showed high sensitivity (0.73) and specificity (0.70), and its diagnostic power was higher than that of Alb, Hb, CRP, or the Braden score alone.Conclusions:The new indicator may become a more useful clinical tool for predicting presser ulcers than Braden score. The new indicator warrants verification studies to facilitate its clinical implementation in the future.
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Ichihara K, Takahashi A, Hirobe M, Honma I, Fukuta F, Masumori N, Tsukamoto T. [Early postoperative complications of radical cystectomy and urinary diversion in elderly patients]. Hinyokika Kiyo 2007; 53:527-32. [PMID: 17874542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Clinical and operative features and early postoperative complications were reviewed in 26 patients 75 years old and older who were treated with radical cystectomy including pelvic lymphadenectomy and urinary diversion in our hospital from 1994 to 2005. These findings were compared with those in 170 patients younger than 75 years old who received the same surgery and in 26 patients 75 years old and older who were not surgically treated. Early postoperative complications were found in 9 elderly patients (34%), but there were no deaths in the preoperative and early postoperative periods. There was no significant difference in the rate of early postoperative complications between patients 75 years old and older and those younger than 75. Preoperative performance status (PS) and the American Society of Anesthesiologists Score (ASA score) were significantly better in elderly patients with the surgery than those without surgery. Therefore, evaluation with PS and the ASA score may allow urologists to appropriately select elderly candidates for radical cystectomy and urinary diversion. Chronological age alone is not a determinant for indicating the surgery.
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Affiliation(s)
- Koji Ichihara
- Department of Urology, Sapporo Medical University School of Medicine
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Ichihara K, Takahashi S, Takahashi A, Masumori N, Itoh N, Hasegawa T, Takagi Y, Taguchi K, Tsukamoto T. [Malignant fibrous histiocytoma of the retroperitoneum--review of clinical course and histopathology]. Hinyokika Kiyo 2006; 52:761-4. [PMID: 17131862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The definition of malignant fibrous histiocytoma (MFH) was modified and simplified in the new WHO-Soft Tissue and Bone Tumor Classification published in 2002. We reviewed the clinical courses of 7 patients with MFH of the retroperitoneum treated in our hospital from 1985 to 2005 and reexamined their pathological diagnoses according to the new classification. All pathological specimens were reviewed again by an expert pathologist (TH) and were confirmed as MFH. Median follow-up was 5 months (0.5 to 44 months). Five patients were diagnosed as having the pleomorphic type, and 2, the inflammatory type. The tumor was located in the retroperitoneal space in 6 patients and around the left spermatic cord in 1. Radical surgery was the primary treatment for 6 patients. The disease recurred locally in 5 patients and distant metastasis developed in 3. The lung and liver were the principal locations of distant metastases. The 2-year disease-specific survival rate was 30% and 2 patients have been alive for more than 3 years. Our experience and those of others reported in the literature suggested that the factors for long-term survival in MFH are pleomorphic-type histology, superficial location, small tumor size and intensive wide excision, although most patients with MFH might have a poor prognosis. Because the tumor size of MFH tended to be large, especially that in the retroperitoneal cavity, wide excision with sufficient tumor-free margin is hard to guarantee.
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Affiliation(s)
- Koji Ichihara
- The Department of Urology, Sapporo Medical University School of Medicine
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Nakamura H, Ejiri H, Fushimi K, Ichihara K, Matsuoka K, Nomachi M, Hazama R, Umehara S, Yoshida S, Ogama T, Sakiuchi T, Hai VH, Sugaya Y, collaboration TM. MOON for spectroscopic studies of double beta decays and the present status of the MOON-1 prototype detector. ACTA ACUST UNITED AC 2006. [DOI: 10.1088/1742-6596/39/1/091] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Umehara S, Kishimoto T, Ogawa I, Hazama R, Yoshida S, Matsuoka K, Yokoyama D, Mukaida K, Ichihara K, Hirano Y, Yanagisawa A. CANDLES for double beta decay of48Ca. ACTA ACUST UNITED AC 2006. [DOI: 10.1088/1742-6596/39/1/093] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Murakami S, Otsuka K, Hotta N, Yamanaka G, Kubo Y, Matsuoka O, Yamanaka T, Shinagawa M, Nunoda S, Nishimura Y, Shibata K, Takasugi E, Nishinaga M, Ishine M, Wada T, Okumiya K, Matsubayashi K, Yano S, Ichihara K, Cornélissen G, Halberg F. Common carotid intima-media thickness is predictive of all-cause and cardiovascular mortality in elderly community-dwelling people: Longitudinal Investigation for the Longevity and Aging in Hokkaido County (LILAC) study. Biomed Pharmacother 2005; 59 Suppl 1:S49-53. [PMID: 16275507 PMCID: PMC2758635 DOI: 10.1016/s0753-3322(05)80010-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Several cohort studies have examined the association of carotid intima-media thickness (IMT) with the risk of stroke or myocardial infarction in apparently healthy persons. We investigated the predictive value of IMT of cardiovascular mortality in elderly community-dwelling people, beyond the prediction provided by age and MMSE, assessed by means of a multivariate Cox model. Carotid IMT and plaque were evaluated bilaterally with ultrasonography in 298 people older than 75 years (120 men and 178 women, average age: 79.6 years). The LILAC study started on July 25, 2000. Consultations were repeated every year. The follow-up ended on November 30, 2004. During the mean follow-up span of 1152 days, 30 subjects (21 men and nine women) died. Nine deaths were attributable to cardiovascular causes (myocardial infarction: two men and three women; stroke: two men and two women). The age- and MMSE-adjusted relative risk (RR) and 95% confidence interval (95% CI) of developing all-cause mortality was assessed. A 0.3 mm increase in left IMT was associated with a RR of predicted 1.647 (1.075-2.524), and a similar increase in right IMT with a RR of 3.327 (1.429-7.746). For cardiovascular mortality, the corresponding RR values were 2.351 (1.029-5.372) and 2.890 (1.059-7.891), respectively. Carotid IMT assessed by ultrasonography is positively associated with an increased risk of all-cause and cardiovascular death in elderly community-dwelling people.
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Affiliation(s)
- S. Murakami
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Division of Neurocardiology and Chronoecology, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Department of Internal Medicine, Osaka Medical University, Osaka, Japan
| | - K. Otsuka
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Division of Neurocardiology and Chronoecology, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Corresponding author. E-mail address: (K. Otsuka)
| | - N. Hotta
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Division of Neurocardiology and Chronoecology, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - G. Yamanaka
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - Y. Kubo
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - O. Matsuoka
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - T. Yamanaka
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Division of Neurocardiology and Chronoecology, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - M. Shinagawa
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - S. Nunoda
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - Y. Nishimura
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - K. Shibata
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Division of Neurocardiology and Chronoecology, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - E. Takasugi
- Department of Medicine, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
- Division of Neurocardiology and Chronoecology, Medical Center East, Tokyo Women's Medical University, Nishiogu 2-1-10, Arakawa, Tokyo 116-8567, Japan
| | - M. Nishinaga
- Department of Gerontology, School of Medicine, Kochi University, Kochi, Japan
| | - M. Ishine
- Department of Field Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - T. Wada
- Department of Field Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - K. Okumiya
- Research Institute for Humanity and Nature, Kyoto, Japan
| | - K. Matsubayashi
- Center for South-East Asian Studies, Kyoto University, Kyoto, Japan
| | - S. Yano
- Sorachi Health and Welfare Office, Sorachi-Godochosha, Iwamizawa, Hokkaido, Japan
| | - K. Ichihara
- Division of Clinical Laboratory Sciences, Faculty of Health Sciences, School of Medicine, Yamaguchi University, Ube, Japan
| | - G. Cornélissen
- Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN, USA
| | - F. Halberg
- Halberg Chronobiology Center, University of Minnesota, Minneapolis, MN, USA
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