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Hanawa K, Sawada N, Yokota Y, Aikawa J, Otake Y, Sugimura K, Shimura H, Mochizuki T, Kira S, Mitsui T. Effect of rechallenge nivolumab in a hemodialysis patient with multiple metastases from a rapidly progressed T1a renal clear cell carcinoma: An autopsy case. IJU Case Rep 2024; 7:202-205. [PMID: 38686062 PMCID: PMC11056251 DOI: 10.1002/iju5.12699] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 01/23/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction Distant metastasis of T1a renal cell carcinoma is rare and whether metastasis is more probable in patients undergoing hemodialysis remains unclear. We report the autopsy case of a patient undergoing hemodialysis with multiple metastases that rapidly progressed from T1a renal cell carcinoma treated with multimodal therapy including nivolumab. Case presentation A 70-year-old male who underwent hemodialysis was diagnosed with clear cell carcinoma (pT1a, G2) after nephrectomy. Six months post-surgery, bone and lung metastases appeared and treated with radiotherapy and pazopanib, respectively. Nivolumab was administered as second- and fourth-line treatments for lung metastases. The patient died approximately 60 months after initial diagnosis; however, nivolumab controlled disease progression for 24 months. An autopsy revealed the lung's occupation with clear cell carcinoma tumor tissue. Conclusion Nivolumab has potential to control lung metastasis progression. Additionally, rechallenge is possible in patients with renal cell carcinoma undergoing hemodialysis.
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Affiliation(s)
- Kazushi Hanawa
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Yuka Yokota
- Department of Human Pathology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Junki Aikawa
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Yuko Otake
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Koki Sugimura
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Hiroshi Shimura
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Takanori Mochizuki
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Satoru Kira
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
| | - Takahiko Mitsui
- Department of Urology, Interdisciplinary Graduate School of MedicineUniversity of YamanashiChuo CityYamanashiJapan
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Sugimura K, Kira S, Shimura H, Mochizuki T, Sawada N, Mitsui T. Robot-assisted radical nephroureterectomy for right renal pelvic tumor post sacrocolpopexy with mesh: A case report. Int J Surg Case Rep 2024; 117:109523. [PMID: 38492315 PMCID: PMC10955413 DOI: 10.1016/j.ijscr.2024.109523] [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: 02/21/2024] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 03/18/2024] Open
Abstract
INTRODUCTION Robot-assisted nephroureterectomy for upper tract urothelial carcinoma has been increasingly performed as a minimally invasive procedure recently. However, there are concerns regarding its adoption in highly complex cases with dense adhesions. PRESENTATION OF CASE An 86-year-old woman presented to our hospital with gross hematuria one year after having undergone robot-assisted sacrocolpopexy using a mesh for pelvic organ prolapse. Cystoscopy revealed hematuria from the right ureteral orifice. Computed tomography suggested right hydronephrosis; retrograde pyelography showed a defect in the right renal pelvis with class V urine cytology of the urine from the right kidney. Based on these findings, a right renal pelvic tumor was diagnosed, and robot-assisted nephroureterectomy was performed. The patient was discharged on postoperative day 7 without complications. DISCUSSION To the best of our knowledge, this is the first case report in which robot-assisted radical nephroureterectomy was performed after robot-assisted sacrocolpopexy with a mesh. Dense tissue adhesions are encountered not only between the bladder and the anterior vaginal wall but also around the right ureter in the pelvis. In this case, dense adhesions were confirmed around the right ureter in the pelvis. CONCLUSION Robot-assisted nephroureterectomy may be considered an option for minimally invasive surgery in cases with a history of pelvic organ prolapse surgery using mesh.
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Affiliation(s)
- Koki Sugimura
- Department of Urology, Kameda Medical Center, Chiba, Japan
| | - Satoru Kira
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan.
| | - Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan
| | - Takanori Mochizuki
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan
| | - Norifumi Sawada
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Yamanashi, Japan
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Mochizuki T, Manita S, Shimura H, Kira S, Sawada N, Bito H, Sakimura K, Augustine GJ, Mitsui T, Takeda M, Kitamura K. Optogenetic stimulation of neurons in the anterior cingulate cortex induces changes in intravesical bladder pressure and the micturition reflex. Sci Rep 2024; 14:6367. [PMID: 38493201 PMCID: PMC10944464 DOI: 10.1038/s41598-024-56806-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024] Open
Abstract
Lower urinary tract (LUT) function is controlled by the central nervous system, including higher-order cognitive brain regions. The anterior cingulate cortex (ACC) is one of these regions, but the role of its activity in LUT function remains poorly understood. In the present study, we conducted optogenetic experiments to manipulate neural activity in mouse ACC while monitoring bladder pressure to elucidate how the activity of ACC regulates LUT function. Selective optogenetic stimulation of excitatory neurons in ACC induced a sharp increase in bladder pressure, whereas activation of inhibitory neurons in ACC prolonged the interval between bladder contractions. Pharmacological manipulation of ACC also altered bladder contractions, consistent with those observed in optogenetic experiments. Optogenetic mapping of the cortical area responsible for eliciting the increase in bladder pressure revealed that stimulation to ACC showed more potent effects than the neighboring motor cortical areas. These results suggest that ACC plays a crucial role in initiating the bladder pressure change and the micturition reflex. Thus, the balance between excitation and inhibition in ACC may regulate the reflex bidirectionally.
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Affiliation(s)
- Takanori Mochizuki
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Satoshi Manita
- Department of Neurophysiology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Shimura
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Satoru Kira
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Norifumi Sawada
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Haruhiko Bito
- Department of Neurochemistry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenji Sakimura
- Department of Cellular Neurobiology, Brain Research Institute, Niigata University, Niigata, Japan
| | | | - Takahiko Mitsui
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Kazuo Kitamura
- Department of Neurophysiology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan.
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Hanawa K, Sawada N, Aikawa J, Otake Y, Kasai Y, Mochizuki K, Shimura H, Mochizuki T, Kira S, Mitsui T. Hypopituitarism induced by pembrolizumab plus axitinib in the treatment of metastatic renal cell carcinoma: A case report. Oncol Lett 2024; 27:66. [PMID: 38192652 PMCID: PMC10773211 DOI: 10.3892/ol.2023.14199] [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: 05/18/2023] [Accepted: 10/19/2023] [Indexed: 01/10/2024] Open
Abstract
Immune checkpoint inhibitor (ICI) therapies have broadened the armamentarium for metastatic renal cell carcinoma (mRCC). As the ICI therapy spreads in the clinical settings, immune-related adverse events are more of a concern for clinicians. The present study reports three cases of mRCC treated with pembrolizumab plus axitinib and diagnosed hypopituitarism based on clinical symptoms and hormonal profile. Acute methylprednisolone infusion therapy was necessary in one case because of severe adrenal hypofunction; however, the clinical symptoms of the other two cases were controlled with oral corticosteroid therapy. To the best of our knowledge, there is no report of pembrolizumab plus axitinib related hypopituitarism in the treatment of mRCC. The present cases suggests that hypopituitarism after pembrolizumab plus axitinib treatment for mRCC can be handled with steroid therapy even after the development of hypopituitarism.
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Affiliation(s)
- Kazushi Hanawa
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Junki Aikawa
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Yuko Otake
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Yoshifumi Kasai
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Keito Mochizuki
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Hiroshi Shimura
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Takanori Mochizuki
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Satoru Kira
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
| | - Takahiko Mitsui
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3821, Japan
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Shimura H, Sato A, Kira S, Sawada N, Satoh H, Mitsui T. Scrotal epidermoid cysts penetrating the penile corpora cavernosa: Two case reports. IJU Case Rep 2024; 7:14-17. [PMID: 38173445 PMCID: PMC10758898 DOI: 10.1002/iju5.12656] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 10/03/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Epidermoid cysts are tumors and that rarely occur in intrascrotal extratesticular tissues. It is extremely rare for the tumors to penetrate the penile corpora cavernosa. Case presentation We encountered a 4-year-old and a 6-year-old boy with intrascrotal tumors that penetrated the penile corpora cavernosa. Both the patients underwent tumor resection. In the former case, some of the tumor within the corpora cavernosa was left behind, while in the latter case, the tumor was completely resected. Pathological examination in both cases confirmed the diagnosis of epidermoid cysts. Conclusion We should consider the possibility of epidermoid cysts in children presenting with intrascrotal tumors. Moreover, care should be taken when handling the corpora cavernosa during surgery.
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Affiliation(s)
- Hiroshi Shimura
- Department of UrologyUniversity of Yamanashi Graduate School of Medical SciencesYamanashiJapan
| | - Atsuko Sato
- Department of Pediatric Urology and Kidney TransplantsTokyo Metropolitan Children's Medical CenterTokyoJapan
| | - Satoru Kira
- Department of UrologyUniversity of Yamanashi Graduate School of Medical SciencesYamanashiJapan
| | - Norifumi Sawada
- Department of UrologyUniversity of Yamanashi Graduate School of Medical SciencesYamanashiJapan
| | - Hiroyuki Satoh
- Department of Pediatric Urology and Kidney TransplantsTokyo Metropolitan Children's Medical CenterTokyoJapan
| | - Takahiko Mitsui
- Department of UrologyUniversity of Yamanashi Graduate School of Medical SciencesYamanashiJapan
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Shimura H. Editorial Comment on Frequency of tethered cord syndrome in pediatric patients with refractory daytime urinary incontinence. Int J Urol 2023; 30:935-936. [PMID: 37596714 DOI: 10.1111/iju.15268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Affiliation(s)
- Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Yamanashi, Japan
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Nakagomi H, Mitsui T, Shimura H, Ihara T, Kira S, Sawada N, Takeda M. Mirabegron for overactive bladder in frail patients 80 years or over (HOKUTO study). BMC Urol 2022; 22:40. [PMID: 35313873 PMCID: PMC8939141 DOI: 10.1186/s12894-022-00989-7] [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: 10/31/2021] [Accepted: 03/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We assessed the efficacy and safety of mirabegron, a β3-adrenoceptor agonist, in older adults (≥ 80 years old) with overactive bladder (OAB). METHODS OAB patients aged ≥ 80 years were enrolled in this prospective, single-arm observational study. OAB was diagnosed based on the OAB symptom score (OABSS); i.e., a total score of ≥ 3 points and an urgency score of ≥ 2 points. Patients who received 50 mg mirabegron once daily were evaluated at the baseline and at 4, 8, and 12 weeks. The changes from the baseline in the OABSS, International Prostate Symptom Score (IPSS), OAB questionnaire (OAB-q) score, and Vulnerable Elders Survey (VES-13) score were determined. Adverse events, laboratory tests, 12-lead electrocardiography, the QT interval according to Fridericia's formula (QTcF), uroflowmetry, the post-void residual urine volume (PVR), and the Mini-Mental State Examination (MMSE) score were used to assess safety. RESULTS Forty-three patients (median age: 84 years, range: 80-96 years) were examined. They had high rates of comorbidities and polypharmacy. Mirabegron significantly improved in total score of the OABSS, including urgency and urge incontinence. The total IPSS, IPSS quality-of-life (QOL) index, and OAB-q scores also significantly improved. Mirabegron improved in the VES-13 score. There were no significant changes in laboratory test values, uroflowmetry findings, PVR, the QTcF, or MMSE score. Two patients (4.7%) withdrew from the study after experiencing adverse events. CONCLUSIONS Mirabegron was well tolerated and significantly improved in OAB symptoms, and QOL in older patients. Trial registration The present clinical study was approved by University of Yamanashi Institutional Review Board prior to study initiation (ID1447) and was retrospectively registered with the UMIN Clinical Trials Registry (UMIN-CTR), Japan (UMIN000045996) on Nov 6, 2021.
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Affiliation(s)
- Hiroshi Nakagomi
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan.
| | - Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan
| | - Tatsuya Ihara
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan
| | - Satoru Kira
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan
| | - Norifumi Sawada
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan
| | - Masayuki Takeda
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, 1110 Shimokato, Chuo City, Yamanashi, 409-3898, Japan
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Ihara T, Shimura H, Tsuchiya S, Kanda M, Kira S, Sawada N, Takeda M, Mitsui T, Shigetomi E, Shinozaki Y, Koizumi S. Effects of fatty acid metabolites on nocturia. Sci Rep 2022; 12:3050. [PMID: 35197540 PMCID: PMC8866436 DOI: 10.1038/s41598-022-07096-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/11/2022] [Indexed: 12/05/2022] Open
Abstract
Dysregulation of circadian rhythm can cause nocturia. Levels of fatty acid metabolites, such as palmitoylethanolamide (PEA), 9-hydroxy-10E,12Z-octadecadienoic acid (9-HODE), and 4-hydroxy-5E,7Z,10Z,13Z,16Z,19Z-docosahexaenoic acid (4-HDoHE), are higher in the serum of patients with nocturia; however, the reason remains unknown. Here, we investigated the circadian rhythm of fatty acid metabolites and their effect on voiding in mice. WT and Clock mutant (ClockΔ19/Δ19) mice, a model for nocturia with circadian rhythm disorder, were used. Levels of serum PEA, 9-HODE, and 4-HDoHEl were measured every 8 h using LC/MS. Voiding pattern was recorded using metabolic cages after administration of PEA, 9-HODE, and 4-HDoHE to WT mice. Levels of serum PEA and 9-HODE fluctuated with circadian rhythm in WT mice, which were lower during the light phase. In contrast, circadian PEA and 9-HODE level deteriorated or retreated in ClockΔ19/Δ19 mice. Levels of serum PEA, 9-HODE, and 4-HDoHE were higher in ClockΔ19/Δ19 than in WT mice. Voiding frequency increased in PEA- and 4-HDoHE-administered mice. Bladder capacity decreased in PEA-administered mice. The changes of these bladder functions in mice were similar to those in elderly humans with nocturia. These findings highlighted the novel effect of lipids on the pathology of nocturia. These may be used for development of biomarkers and better therapies for nocturia.
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Affiliation(s)
- Tatsuya Ihara
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan.
| | - Hiroshi Shimura
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Sachiko Tsuchiya
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Mie Kanda
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Satoru Kira
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Masayuki Takeda
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Takahiko Mitsui
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 409-3898, Japan
| | - Eiji Shigetomi
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yoichi Shinozaki
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Schuichi Koizumi
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
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Shimura H, Manita S, Mochizuki T, Matsuda Y, Ihara T, Kira S, Mitsui T, Kitamura K, Takeda M. Therapeutic potential of cell-type selective optogenetics for a mouse model with urinary frequency. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00406-1] [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: 11/26/2022]
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Shimura H, Kuwahara Y, Aikawa J, Watanabe N, Nakamura K, Tsukamoto T, Terada S, Mitsui T, Takeda M. Cine magnetic resonance imaging provides novel predictors of early continence recovery after radical prostatectomy: Assessment of the dynamics of pelvic floor muscles. Neurourol Urodyn 2020; 40:256-264. [PMID: 33064316 DOI: 10.1002/nau.24544] [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: 07/09/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/09/2022]
Abstract
AIMS Postprostatectomy incontinence is a major complication of prostatectomy. Although pelvic floor muscle training can successfully treat postprostatectomy incontinence, evidence for how muscle movement affects continence recovery is lacking. We evaluated dynamic factors of prostatectomy patients using cine magnetic resonance imaging to identify risk factors for postprostatectomy incontinence and reveal the contribution of pelvic floor muscles to continence recovery. METHODS A total of 128 prostate cancer patients who underwent robot-assisted laparoscopic surgery were enrolled. Cine magnetic resonance imaging was performed preoperatively and 6 months after surgery. Continence was defined as pad-free or use of safety pads. We defined the bladder neck elevation distance during pelvic floor muscle training as the bladder elevation distance. Patients with continence recovery within 1 month comprised the continence group (n = 48); other patients comprised the incontinence group (n = 80). RESULTS The preoperative bladder elevation distance was significantly longer in the continence group than in the incontinence group (10.4 vs. 8.2 mm; p < .001). The postoperative bladder elevation distance of the continence group tended to be longer (9.9 vs. 8.9 mm; p = .057). Multivariate analysis showed that the preoperative bladder elevation distance significantly contributed to continence recovery (p = .016). Patients with a longer preoperative bladder elevation distance (>8.5 mm) experienced continence recovery significantly faster than patients with a shorter distance (<8.5mm) (p = .038). CONCLUSIONS Bladder elevation distance, a novel dynamic parameter, was strongly associated with early continence recovery. Cine magnetic resonance imaging can assess a patient's risk of postprostatectomy incontinence and guide pelvic floor muscle training.
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Affiliation(s)
- Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Japan
| | | | - Junki Aikawa
- Department of Urology, Nagakubo Hospital, Kunitachi, Japan
| | | | - Kenzo Nakamura
- Department of Urology, Nagakubo Hospital, Kunitachi, Japan
| | | | - Shigehiko Terada
- Department of Radiology, Medical Scanning Nippori, Arakawa, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Japan
| | - Masayuki Takeda
- Department of Urology, University of Yamanashi Graduate School of Medical Sciences, Chuo, Japan
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Iijima M, Orimo S, Terashi H, Suzuki M, Hayashi A, Shimura H, Kitagawa K, Okuma Y. Effects of istradefylline for quality of life in Parkinson's disease with freezing of gait: A singlearm, open-label, prospective, multicenter study. Parkinsonism Relat Disord 2020. [DOI: 10.1016/j.parkreldis.2020.06.264] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shimura H, Watanabe N, Nakamura K, Tsukamoto T, Kuwahara Y, Terada S, Mitsui T, Takeda M. Bladder elevation in pelvic floor muscle training evaluated by cine MRI (magnetic resonance imaging) is associated with early recovery of continence after radical prostatectomy. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)32862-7] [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: 11/17/2022] Open
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Fujita K, Kaburagi H, Nimura A, Miyamoto T, Wakabayashi Y, Seki Y, Aoyama H, Shimura H, Kato R, Okawa A. Lower grip strength and dynamic body balance in women with distal radial fractures. Osteoporos Int 2019; 30:949-956. [PMID: 30607458 PMCID: PMC6502779 DOI: 10.1007/s00198-018-04816-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/14/2018] [Indexed: 12/30/2022]
Abstract
UNLABELLED In this case-control study, we concluded that women with distal radial fractures who were surgically treated showed lower grip strength and dynamic body balancing than those of controls. These results suggest that measurements of grip strength and dynamic body balance may be useful screening tools to assess future fracture risk. INTRODUCTION Patients with distal radial fractures (DRFs) are at risk of future fragility fractures. However, their physical characteristics and tendencies for falls remain unclear. We aimed to compare the physical characteristics of women with and without distal radial fractures. METHODS We included 128 women with a DRF as their first fragility fracture (fracture group) who underwent surgical treatment. Concurrently, 128 age- and sex-matched participants without a history of fragility fractures were selected as controls (control group). The participants underwent assessments of grip strength and the body balancing ability test. Measurements were taken twice in the fracture group, at 2 weeks and 6 months postoperatively, and once in the control group. The body balancing ability test included the Functional Reach Test, Timed Up and Go test (TUG), 2-Step test (2ST), and Timed Uni-pedal Stance test. The participants also completed questionnaires about their health. RESULTS There were no significant differences (p > 0.05) in patient characteristics between the groups. The fracture group showed lower grip strength across all age groups. In the DRF group, prolonged TUG time was observed at 2 weeks postoperatively in all age groups and at 6 months in participants aged 55-74 years; the 2ST score was significantly lower in participants aged between 65 and 74 years. CONCLUSIONS Women with DRF demonstrated lower grip strength and dynamic body balancing ability. Lower grip strength and dynamic body balancing ability were identified as significant risk factors in women with DRF, suggesting that these may be useful screening tools to assess fracture risk.
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Affiliation(s)
- K Fujita
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - H Kaburagi
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - A Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Miyamoto
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Wakabayashi
- Department of Orthopedic Surgery, Yokohama City Minato Red Cross Hospital, Kanagawa, Japan
| | - Y Seki
- Department of Orthopedic Surgery, Suwa Central Hospital, Nagano, Japan
| | - H Aoyama
- Department of Orthopedic Surgery, JA Toride Medical Center, Ibaraki, Japan
| | - H Shimura
- Department of Orthopedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - R Kato
- JA Kyosai Research Institute, Tokyo, Japan
| | - A Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Fujita K, Kaburagi H, Nimura A, Miyamoto T, Wakabayashi Y, Seki Y, Aoyama H, Shimura H, Kato R, Okawa A. Correction to: Lower grip strength and dynamic body balance in women with distal radial fractures. Osteoporos Int 2019; 30:697. [PMID: 30806728 PMCID: PMC6828462 DOI: 10.1007/s00198-019-04860-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The article Lower grip strength and dynamic body balance in women with distal radial fractures, written by. K. Fujita, H. Kaburagi, A. Nimura, T. Miyamoto, Y. Wakabayashi, Y. Seki, H. Aoyama, H. Shimura, R. Kato, A. Okawa was originally published electronically on the publisher's internet portal.
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Affiliation(s)
- K Fujita
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - H Kaburagi
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - A Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Miyamoto
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Y Wakabayashi
- Department of Orthopedic Surgery, Yokohama City Minato Red Cross Hospital, Kanagawa, Japan
| | - Y Seki
- Department of Orthopedic Surgery, Suwa Central Hospital, Nagano, Japan
| | - H Aoyama
- Department of Orthopedic Surgery, JAToride Medical Center, Ibaraki, Japan
| | - H Shimura
- Department of Orthopedic Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan
| | - R Kato
- JA Kyosai Research Institute, Tokyo, Japan
| | - A Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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15
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Shimura H, Mitsui T, Kira S, Ihara T, Sawada N, Nakagomi H, Miyamoto T, Tsuchiya S, Kanda M, Takeda M. Metabolomic Analysis of Overactive Bladder in Male Patients: Identification of Potential Metabolite Biomarkers. Urology 2018; 118:158-163. [DOI: 10.1016/j.urology.2018.05.001] [Citation(s) in RCA: 3] [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] [Received: 02/27/2018] [Revised: 04/18/2018] [Accepted: 05/01/2018] [Indexed: 12/18/2022]
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16
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Shimura H, Mitsui T, Fukasawa M, Ihara T, Kira S, Sawada N, Takeda M. Ileocystoplasty with ureteral reimplantation into the afferent ileal limb for high-grade vesicoureteral reflux in a boy with lower urinary tract dysfunction. Journal of Pediatric Surgery Case Reports 2018. [DOI: 10.1016/j.epsc.2018.05.013] [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: 10/16/2022] Open
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17
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Mitsui T, Kira S, Ihara T, Sawada N, Nakagomi H, Miyamoto T, Shimura H, Yokomichi H, Takeda M. Metabolomics Approach to Male Lower Urinary Tract Symptoms: Identification of Possible Biomarkers and Potential Targets for New Treatments. J Urol 2018; 199:1312-1318. [DOI: 10.1016/j.juro.2017.11.070] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Takahiko Mitsui
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Satoru Kira
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Tatsuya Ihara
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Norifumi Sawada
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Nakagomi
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Tatsuya Miyamoto
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Shimura
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Yokomichi
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
| | - Masayuki Takeda
- Departments of Urology and Health Sciences (HY), Graduate School of Medical Sciences, University of Yamanashi, Yamanashi, Japan
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18
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Shimura H, Mitsui T, Kira S, Ihara T, Nakagomi H, Sawada N, Takeda M. MP38-18 METABOLOMICS APPROACH FOR ASSOCIATION WITH OVERACTIVE BLADDER IN MALES: AN IDENTIFICATION OF POTENTIAL TARGETS FOR NEW TREATMENTS. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1245] [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: 11/29/2022]
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19
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Shimura H, Mitsui T, Tsuchiya S, Miyamoto T, Ihara T, Kira S, Nakagomi H, Sawada N, Imai Y, Mochizuki T, Takeda M. Development of novel and non-invasive diagnostic markers for lower urinary tract symptoms using urothelial cells in voided urine. Neurourol Urodyn 2017; 37:1137-1143. [PMID: 29044760 DOI: 10.1002/nau.23436] [Citation(s) in RCA: 2] [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: 08/10/2017] [Accepted: 09/25/2017] [Indexed: 12/23/2022]
Abstract
OBJECTIVES We evaluated the association between lower urinary tract symptoms (LUTS) and the expression of connexin (Cx) and transient receptor potential (TRP) channel on urothelial cells non-invasively collected from voided urine in humans. METHODS A total of 55 patients (36 males and 19 females, median age: 71 years old), who were followed up at University of Yamanashi Hospital, were enrolled in the present study. Urothelial cells were collected from voided urine of patients, and the mRNA expression of each subtype of Cxs and TRP channels was measured using quantitive real-time reverse transcription polymerase chain reaction. We then analyzed the correlation between the expression of Cxs and TRP channels and symptom scores in International Prostate Symptom Scoreand Overactive Bladder Symptom Score, in addition to Interstitial Cystitis Symptom Index (ICSI) from only interstitial cystitis (IC) patients. RESULTS Non-adjusted statistical procedure using Spearman's rank-correlation showed that there were significant correlations between the following expressions and symptom scores; (positive correlations) Cx26 versus urgency score, Cx40 versus nocturia, TRPM2 versus intermittency, TRPV1 versus urge incontinence, (negative correlation) Cx40 versus intermittency, TRPM7 versus pollakisuria. However, a multiple comparison adjustment using Bonferroni correction showed that only Cx40 had a trend of correlation with nocturia in ICSI. CONCLUSIONS The expressions of Cxs and TRP channels on urothelial cells in voided urine could be related to LUTS. Further analysis of urothelial cells in voided urine has the potential to reveal the mechanism of the LUTS and develop new markers with non-invasive methods.
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Affiliation(s)
- Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Sachiko Tsuchiya
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Tatsuya Miyamoto
- Department of Urology, Fujiyoshida Municipal Medical Center, Fujiyoshida, Yamanashi, Japan
| | - Tatsuya Ihara
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Satoru Kira
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Hiroshi Nakagomi
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Norifumi Sawada
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Yuki Imai
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Takanori Mochizuki
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
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20
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Kuroki T, Tanaka R, Shimada Y, Yamashiro K, Ueno Y, Shimura H, Urabe T, Hattori N. Exendin-4 inhibits MMP-9 activation and reduces infarct growth after focal cerebral ischemia in hyperglycemic mice. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2469] [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: 10/18/2022]
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21
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Shimura H, Hayashi A, Aiba S, Shimada Y, Nobutaka Hattori N, Takao U. Effect of rotigotine on 25 patients with Parkinson's disease for 156 weeks, a single-arm, prospective study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2071] [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: 10/18/2022]
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22
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Iijima M, Orimo S, Terashi H, Suzuki M, Hayashi A, Shimura H, Mitoma H, Kitagawa K, Okuma Y. Efficacy of istradefylline for gait disorders in patients with Parkinson’s disease: A single-arm, prospective, multicenter, joint clinical study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.994] [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: 11/16/2022]
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23
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Fukasawa M, Sawada N, Shimura H, Ihara T, Kira S, Zakoji H, Mitsui T, Takeda M. Successful Radiotherapy for Advanced Small Cell Carcinoma of the Prostate with Syndrome of Inappropriate Secretion of Antidiuretic Hormone. Urol Case Rep 2017; 13:147-148. [PMID: 28567332 PMCID: PMC5440674 DOI: 10.1016/j.eucr.2017.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 04/11/2017] [Accepted: 04/20/2017] [Indexed: 11/24/2022] Open
Abstract
Small cell carcinoma of the prostate (SCCP) is rare in clinical practice. It is often accompanied with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). We present a case of SCCP with SIADH that was successfully treated with radiotherapy in the metastatic lymphnodes and prostate. The patient was an 81-year-old male with a castrate-resistant prostate cancer (CRPC) with invaded rectum and multiple metastases of pelvic lymphnodes. Hyponatremia was present. After radiotherapy, serum sodium increased and neuron-specific enolase (NSE) decreased. To our knowledge, this is the first case of SCCP with SIADH treated with radiotherapy to improve hyponatremia.
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Affiliation(s)
- Masanari Fukasawa
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Hiroshi Shimura
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Tatsuya Ihara
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Satoru Kira
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Hidenori Zakoji
- Department of Urology, Tokai University Hachioji Hospital, Hachioji, Japan
| | - Takahiko Mitsui
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan
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24
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Shimura H, Ihara T, Mitsui T, Takeda M. Tuberculous Granuloma in the Scrotal Skin After Intravesical Bacillus Calmette-Guerin Therapy for Bladder Cancer: A Case Report. Urol Case Rep 2017; 11:4-6. [PMID: 28083473 PMCID: PMC5220255 DOI: 10.1016/j.eucr.2016.11.001] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/01/2016] [Indexed: 11/12/2022] Open
Abstract
Rare cases of tuberculous urinary tract or genital infection caused by intravesical Intravesical Bacillus Calmette-Guerin (BCG) instillation therapy have been reported. We encountered a patient with tuberculous granuloma in the scrotal skin after intravesical BCG therapy for bladder cancer. There was evidence of infection in the scrotal skin, but not in the epididymis. To the best of our knowledge, this is the first report of tuberculous granuloma in the scrotal skin without epididymitis after intravesical BCG therapy. In our case, lower urinary tract symptoms such as the terminal dribbling of urine appear to support the theory of direct BCG inoculation.
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Affiliation(s)
- Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo city, Yamanashi, Japan
| | - Tatsuya Ihara
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo city, Yamanashi, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo city, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo city, Yamanashi, Japan
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25
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Shimura H, Mitsui T, Aoki T, Kamiyama M, Yamagishi T, Takeda M. Persistent Urinary Incontinence After Nephrectomy: A Case of Inverted-Y Ureteral Duplication with Ectopic Ureteral Insertion into the Vagina. Urol Case Rep 2016; 9:58-61. [PMID: 27747162 PMCID: PMC5061114 DOI: 10.1016/j.eucr.2016.09.001] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Revised: 08/30/2016] [Accepted: 09/07/2016] [Indexed: 12/16/2022] Open
Abstract
Inverted-Y ureteral duplication is one of the rarest anomalies of ureteral branching. We encountered a 20-year-old female patient with persistent incontinence even after nephrectomy for ectopic ureteral insertion into the vagina. She had inverted-Y ureteral duplication between the bladder and vagina, and urine was being transported from the bladder to the vagina. To the best of our knowledge, this is a rare case of inverted-Y ureteral duplication with ectopic ureteral insertion into the vagina as well as the ureter into the bladder, which became apparent due to persistent urinary incontinence even after nephrectomy.
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Affiliation(s)
- Hiroshi Shimura
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Takahiko Mitsui
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Tadashi Aoki
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Manabu Kamiyama
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Takashi Yamagishi
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, University of Yamanashi Graduate School of Medical Science, Chuo, Yamanashi, Japan
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Zakoji H, Miyamoto T, Kira S, Sawada N, Ootake Y, Shimura H, Mitsui T, Takeda M. Complete Laparoscopic Nephroureterectomy for the Upper Urinary Tract Urothelial Carcinoma in a Female Patient with Severe Senile Kyphosis: An Initial Case Report. J Endourol Case Rep 2015; 1:56-8. [PMID: 27579391 PMCID: PMC4996554 DOI: 10.1089/cren.2015.0018] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hidenori Zakoji
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Tatsuya Miyamoto
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Satoru Kira
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Norifumi Sawada
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yuko Ootake
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Shimura
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Takahiko Mitsui
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
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27
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Watanabe S, Kodera S, Shimura H. Investigation of risk factors predicting recurrence of colonic diverticular hemorrhage and development of a recurrence risk score. Acta Gastroenterol Belg 2014; 77:408-412. [PMID: 25682630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Colonic diverticular hemorrhage often recurs. Several studies have identified risk factors for recurrence, but to our knowledge, none have focused on risk factors in the clinical situation. The present study aimed to identify risk factors for the recurrence of hemorrhage and to create a recurrence risk score. METHOD Hospitalized patients diagnosed with diverticular bleeding from 2008 to 2013 (N = 151) were included in a retrospective cohort study. Risk factors predicting re-bleeding were identified using multivariate analysis, and a risk score was developed using receiver operator characteristic (ROC) analysis. RESULTS Recurrence was identified in 52 patients (34.4%) at a median interval of 11.5 months. A history of hypertension and hyperlipidemia, a faster heart rate on admission, and longer hospitalization period were significant risk factors for re-bleeding. We developed a re-bleeding risk score by using these 4 factors; the area under the curve of ROC curve was 0.8. With this risk score, if the cut-off point is 7, then the sensitivity is very high (94%; specificity: 26%); if the cutoff point is 14, the specificity is very high (97%; sensitivity: 40%). This enables the division of patients into 3 groups: high risk, intermediate risk, and low risk. CONCLUSION Colonic diverticular hemorrhage often recurs, and patients have high recurrence rates within short periods. Risk factors for re-bleeding include a history of hypertension and hyperlipidemia, faster heart rate, and longer hospitalization period, and the risk score may supply useful information for clinicians to aid management.
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28
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Shimada Y, Tanaka R, Shimura H, Yamashiro K, Urabe T, Hattori N. Phosphorylation enhances recombinant HSP27 neuroprotection against focal cerebral ischemia in mice. Neuroscience 2014; 278:113-21. [DOI: 10.1016/j.neuroscience.2014.07.073] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/18/2014] [Accepted: 07/31/2014] [Indexed: 11/29/2022]
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29
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Shimura H, Masuda S, Kimura H. Research and development productivity map: visualization of industry status. J Clin Pharm Ther 2014; 39:175-80. [DOI: 10.1111/jcpt.12126] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 12/09/2013] [Indexed: 01/23/2023]
Affiliation(s)
- H. Shimura
- Pharmaco-Business Innovation Laboratory; Graduate School of Pharmaceutical Sciences; The University of Tokyo; Tokyo Japan
| | - S. Masuda
- Pharmaco-Business Innovation Laboratory; Graduate School of Pharmaceutical Sciences; The University of Tokyo; Tokyo Japan
| | - H. Kimura
- Pharmaco-Business Innovation Laboratory; Graduate School of Pharmaceutical Sciences; The University of Tokyo; Tokyo Japan
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30
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Hayashi A, Shimura H, Aiba S, Yoneyama M, Mitoma H. Automatic detection of freezing index of Parkinson'/INS;s disease using a portable gait rhythmogram. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.609] [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] [Indexed: 11/29/2022]
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31
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Yatomi Y, Tanaka R, Shimura H, Miyamoto N, Yamashiro K, Takanashi M, Urabe T, Hattori N. Chronic brain ischemia induces the expression of glial glutamate transporter EAAT2 in subcortical white matter. Neuroscience 2013; 244:113-21. [PMID: 23602887 DOI: 10.1016/j.neuroscience.2013.04.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/02/2013] [Indexed: 01/11/2023]
Abstract
Glutamate plays a central role in brain physiology and pathology. The involvement of excitatory amino acid transporters (EAATs) in neurodegenerative disorders including acute stroke has been widely studied, but little is known about the role of glial glutamate transporters in white matter injury after chronic cerebral hypoperfusion. The present study evaluated the expression of glial (EAAT1 and EAAT2) and neuronal (EAAT3) glutamate transporters in subcortical white matter and cortex, before and 3-28 days after the ligation of bilateral common carotid arteries (LBCCA) in rat brain. K-B staining showed a gradual increase of demyelination in white matter after ischemia, while there was no cortical involvement. Between 3 and 7 days after LBCCA, a significant increase in EAAT2 protein levels was observed in the ischemic brain and the number of EAAT2-positive cells also significantly increased both in the cortical and white matter lesions. EAAT2 was detected in glial-fibrillary acidic protein (GFAP)-positive astrocytes in both the cortex and white matter, but not in neuronal and oligodendroglial cells. EAAT1 was slightly elevated after ischemia only in the white matter, but EAAT3 was at almost similar levels both in the cortex and white matter after ischemia. A significant increase in EAAT2 expression level was also noted in the deep white matter of chronic human ischemic brain tissue compared to the control group. Our findings suggest important roles for up-regulated EAAT2 in chronic brain ischemia especially in the regulation of high-affinity of extracellular glutamate and minimization of white matter damage.
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Affiliation(s)
- Y Yatomi
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
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Funakoshi T, Kazumi Y, Okada R, Nishimoto K, Saito M, Amagai M, Shimura H, Ohyama M. Intractable ulcer caused by Mycobacterium shinshuense: successful identification of mycobacterium strain by 16S ribosomal RNA 3'-end sequencing. Clin Exp Dermatol 2009; 34:e712-5. [PMID: 19663856 DOI: 10.1111/j.1365-2230.2009.03442.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
An extremely rare case of intractable ulcer caused by Mycobacterium shinshuense is described. A 59-year-old Japanese woman developed an ulcerated subcutaneous induration on the upper arm. Ziehl-Neelsen staining revealed positive bacilli. Tissue culture isolated Mycobacterium species, but standard identification techniques (including molecular biological approaches such as DNA-DNA hybridization) could not distinguish the precise causative pathogen, although it was narrowed down to three possibilities: Mycobacterium marinum, Mycobacterium ulcerans and M. shinshuense. Finally, a novel 16S rRNA sequencing method enabled the diagnosis of M. shinshuense infection. The epidemiology of the cutaneous infection caused by this mycobacterium has yet to be elucidated, but a review of reported cases indicated that ulcers having some resemblance to those caused by M. ulcerans infection were found in nonendemic areas and that M. shinshuense could be considered as the cause. The approach introduced in this report could provide a powerful tool for the identification of this organism.
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Affiliation(s)
- T Funakoshi
- Department of Dermatology, Keio University School of Medicine, Tokyo, Japan
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Miyamoto N, Tanaka R, Zhang N, Shimura H, Onodera M, Mochizuki H, Hattori N, Urabe T. Crucial role for Ser133-phosphorylated form of cyclic AMP-responsive element binding protein signaling in the differentiation and survival of neural progenitors under chronic cerebral hypoperfusion. Neuroscience 2009; 162:525-36. [PMID: 19426786 DOI: 10.1016/j.neuroscience.2009.05.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2009] [Revised: 04/14/2009] [Accepted: 05/02/2009] [Indexed: 02/07/2023]
Abstract
Various stimuli, such as ischemia/hypoxia enhance newborn cell survival in the subventricular zone and their migration tangentially in chains toward the olfactory bulb. The present study assessed the fate of newborn neurons from subventricular zone to olfactory bulb under conditions of chronic cerebral hypoperfusion, and examined the role of cAMP-responsive element binding protein signaling on the survival of these neurons by using cilostazol, a potent inhibitor of type III phosphodiesterase. Rats underwent bilateral common carotid artery ligation. They were divided into sham-operated (n=70), vehicle- (n=70), and type III phosphodiesterase inhibitor-treated (n=70) groups. Immunohistochemically-stained section for 5-bromodeoxyuridine and a series of neuronal and glial markers were analyzed at days 7, 14, 21 and 28 after hypoperfusion. The reduction of olfactory bulb size gradually progressed in the vehicle group (P<0.05), but not in the sham-operated and type III phosphodiesterase inhibitor-treated group. The subventricular zone of the vehicle-treated rats contained significantly larger numbers of newborn neuroblasts after hypoperfusion, compared with sham-operated rats (P<0.05), but significantly lower numbers in the rostral migratory stream and olfactory bulb (P<0.05). Treatment of rats with type III phosphodiesterase inhibitor increased the number of neuroblasts and enhanced the survival and differentiation of cells (P<0.05). Phosphorylated cAMP-responsive element binding protein within neuroblasts was markedly decreased in the subventricular zone, rostral migratory stream, and olfactory bulb of vehicle-treated rats (P<0.05), but treatment with type III phosphodiesterase inhibitor resulted in recovery of this expression throughout hypoperfusion, leading to enhanced neurogenesis (P<0.05). These effects were abrogated by protein kinase A and C inhibitor. Our results indicated that cAMP-responsive element binding protein signaling is a key mediator of neurogenesis after prolonged hypoperfusion and provide the basis for new regenerative therapies for ischemic brain injury.
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Affiliation(s)
- N Miyamoto
- Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Shimura H, Schlossmacher M, Hattori N, Mizuno Y, Kosik K, Selkoe D. Interaction between parkin and alpha-synuclein. J Neurochem 2008. [DOI: 10.1046/j.1471-4159.81.s1.49_4.x] [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: 11/20/2022]
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Doi A, Ishida A, Imamaki M, Shimura H, Niitsuma Y, Miyazaki M. Epithelioid Hemangioendothelioma Causing Acute Abdominal Aortic Obstruction and Bilateral Limb Ischemia. Eur J Vasc Endovasc Surg 2008. [DOI: 10.1016/j.ejvs.2007.09.027] [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: 10/22/2022]
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Kano S, Homma H, Sasaki S, Shimura H. In situ monitoring of friction surfaces and their sequence pattern analysis. Philos Trans A Math Phys Eng Sci 2008; 366:665-71. [PMID: 17698464 DOI: 10.1098/rsta.2007.2117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Friction occurs between solid surfaces, and even sometimes on lubricated surfaces. To understand tribological subjects, it is important to know the changes that occur in friction surfaces. In this study, a laser strobe technique is applied to a friction surface observation. The recorded surface images were analysed using pattern-matching methods and their correlations are discussed. A test using pin-on-plate methods with carbon steels was performed using a reciprocating motion speed of 10 Hz for 4.9 N. A pulsed laser light (Nd:YAG SHG=532 nm, 5 ns per pulse) was irradiated onto the friction surface. It was induced using an optical microscope that was located just to the side of the pin. The laser pulse was synchronized with the plate motion, which was a trigger of the laser pulse. The surface image was stored for every cycle. These sequences were calculated and their correlations were analysed as a function of the surface pattern and the friction track size and shape. Analysis revealed that some groups were distinguishable as parameters of the damage size and shape.
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Affiliation(s)
- S Kano
- National Institute of Advanced Industrial Science and Technology, (AIST), Namiki 1-2-1, Tsukuba, Ibaraki 305-8564, Japan.
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Doi A, Ishida A, Imamaki M, Shimura H, Niitsuma Y, Miyazaki M. Epithelioid Hemangioendothelioma Causing Acute Abdominal Aortic Obstruction and Bilateral Limb Ischemia. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/j.ejvsextra.2007.09.008] [Citation(s) in RCA: 2] [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] [Indexed: 11/17/2022]
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Chida K, Saito H, Ito D, Shimura H, Zuguchi M, Takai Y. FFT analysis of the X-ray tube voltage waveforms of high-frequency generators for radiographic systems. Acta Radiol 2005; 46:810-4. [PMID: 16392605 DOI: 10.1080/02841850500335069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To present a novel method for analyzing the voltage waveform from high-frequency X-ray generators for radiographic systems. MATERIAL AND METHODS The output signal of the actual voltage across the tube of a high-frequency generator was measured using the built-in voltage sense taps that are used for voltage regulation feedback in X-ray generators. The output signal was stored in an analyzing recorder, and the waveforms were analyzed using FFT analysis. The FFT analysis of high-frequency generators consisted of obtaining the power spectrum, comparing the major frequency components in the tube voltage waveforms, and examining the intensity of each frequency component. RESULTS FFT analysis enables an objective comparison of the complex tube voltage waveforms in high-frequency X-ray generators. FFT analysis detected the change in the X-ray tube voltage waveform that occurred when there were problems with the high-frequency generator. CONCLUSION High-frequency X-ray generators are becoming the universal choice for radiographic systems. The X-ray tube voltage and its waveform are important features of an X-ray generator, and quality assurance (QA) is important, too. As a tool for engineers involved in the design and development of X-ray generators, we can see that our methods (FFT analysis) might have some value as a means of describing generator performance under varying conditions. Furthermore, since the X-ray tube voltage waveform of a high-frequency generator is complex, FFT analysis may be useful for QA of the waveform.
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Affiliation(s)
- K Chida
- Department of Radiological Technology, Tohoku University School of Health Sciences, Aobaku, Sendai, Japan.
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Sasaki T, Shimura H, Sasahira T, Fujii K, Kuniyasu H. High concentration of deoxycholic acid abrogates in vitro transformation of IEC6 intestinal cells by azoxymethane. J Exp Clin Cancer Res 2005; 24:625-31. [PMID: 16471326] [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: 05/06/2023]
Abstract
In this study, we designed an in vitro azoxymethane (AOM)-induced carcinogenesis model and analyzed the effect of deoxycholic acid (DCA) on growth, apoptosis, genotoxicity, and transformation of IEC6 intestinal cells. CYP2E1 production was confirmed in IEC6 cells. The growth of IEC6 cells was enhanced by DCA (100 microg/ml). However, IEC6 cells treated with DCA (200 microg/ml) were inhibited and disappeared at 48 hrs after treatment. Apoptotic cells increased 11.2 times by treatment with DCA (200 microg/ml) as compared to cells with no treatment. DNA injury detected by comet assay was found in cells treated with AOM, but not in cells treated with DCA (100 microg/ml) and AOM. The number of colony formation in soft agar increased by AOM treatment. However, the number of foci treated with DCA (100 microg/ml) plus AOM was 69% that of cells treated with AOM alone. Two out of the 6 mice subcutaneously injected with AOM-treated IEC6 cells showed tumorigenesis, whereas IEC6 cells treated with DCA (100 microg/ml) plus AOM or DCA (100 microg/ml) alone did not form any tumor. Reduced protein expression of MLH1, Bcl-2 was detected in IEC6 cells treated with DCA (100 microg/ml). Production of Bax, pJNK, TGF-beta, TGFBRI, TGFBRII, and beta-catenin were higher in IEC6 cells treated with DCA (100 microg/ml) than that in cells with no treatment. These results suggest that high-dose DCA induced apoptosis and inhibited AOM-induced in vitro transformation of IEC6 cells.
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Affiliation(s)
- T Sasaki
- Dept. of Molecular Pathology, Nara Medical University, Nara, Japan
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Imamaki M, Ishida A, Shimura H, Kohno H, Ishida K, Niitsuma Y, Miyazaki M. [Kinking of skeletonized internal thoracic artery graft]. Kyobu Geka 2004; 57:1191-5. [PMID: 15609655] [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: 05/01/2023]
Abstract
A 66-year-old woman underwent coronary artery bypass grafting (CABG). Postoperative angiography on postoperative day (POD) 11 revealed that right internal thoracic artery (RITA) anastomosed to left anterior descending artery (LAD) had a kinking. The angiography performed 30 months after operation revealed no specific changes in the kinking of RITA and in the left ventricular function. Another case was a 74-year-old man with chronic renal failure under hemodialysis. He underwent CABG with left internal thoracic artery (LITA) to LAD. Post-operatively he had chest pain during hemodialysis. On POD 10, angiography revealed that LITA had a kinking with moderate stenosis and normal left ventricular function. The angiography performed 10 months after operation revealed no specific changes in the kinking of LITA. However, left ventriculography revealed akinesis in the antero-apical region. It suggested that the viability was lost due to the graft kinking of LITA and steal phenomenon on hemodialysis.
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Affiliation(s)
- Mizuho Imamaki
- Division of Cardiovascular Surgery, Chiba University School of Medicine, Chiba, Japan
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Sasaki T, Shimura H, Tanaka T, Nakashima K, Matsuo K, Ikeda S. Protection of trocar sites from gallbladder cancer implantation by sodium hyaluronate shill carboxymethylcellulose?based bioresorbable membrane (Seprafilm) in a nurine model. Surg Endosc 2004; 18:246-51. [PMID: 14691710 DOI: 10.1007/s00464-003-8128-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2003] [Accepted: 07/28/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND The risk of port site metastasis in laparoscopic surgery for cancer patients is a problem that has yet to be resolved. We examined the protective effect of a sodium hyaluronate-based bioresorbable membrane (Seprafilm) on tumor cell implantation at laparoscopic trocar sites. METHODS Four 2-mm trocar sites were created in nude mice, and the peritoneal wounds were covered with different-sized pieces of Seprafilm. The protective effect of Seprafilm on the implantation of GB-d1 (a human gallbladder cancer cell line) at the trocar sites was assessed after 7 days. In addition, the effects of sodium hyaluronate and Seprafilm on the growth and motility of GB-d1 were examined in vitro. RESULTS Seprafilm significantly decreased the incidence of implantation compared with the control group. Histologically, Seprafilm was observed on days 1 and 3, as a sheet of gel that covered the injured peritoneum and muscle layer. In an invasion assay using Seprafilm, no cells were found to infiltrate through the gel sheet. CONCLUSION Seprafilm protects peritoneal wounds by physically covering the injured peritoneum. Therefore, if Seprafilm were attached to the injured peritoneum after laparoscopic surgery for cancer patients, it might reduce port site metastasis.
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Affiliation(s)
- T Sasaki
- First Department of Surgery, Fukuoka University School of Medicine, Nanakuma 7-45-1, Jonan-ku, Fukuoka, 814-0180, Japan.
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Imamaki M, Masuda M, Ishida A, Shimura H, Nishimura K, Yazima N, Ishida K, Miyazaki M. [Is the quality of off-pump coronary artery bypass grafting equivalent to that of conventional coronary artery bypass grafting]. Kyobu Geka 2003; 56:699-702. [PMID: 12910954] [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: 03/04/2023]
Abstract
We analyzed 44 patients undergoing coronary artery bypass grafting (CABG) from November 2001 to March 2003. Of 44 patients, 40 patients (29 men and 11 women; mean age 68.1 +/- 9.2 years) underwent off-pump CABG (OPCAB) [90.9%]. The mean number of bypass grafts was 2.53 +/- 0.78. In-hospital mortality was none and major complications except for one case of reexploration for bleeding were not seen. The early patency rate of over-all grafts was 94.6%. The quality of OPCAB was considered to be equivalent to conventional CABG.
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Affiliation(s)
- M Imamaki
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Imamaki M, Masuda M, Ishida A, Shimura H, Hirano M, Nishimura K, Nakajima N, Miyazaki M. [Total arch replacement using prior selective cerebral perfusion]. Kyobu Geka 2002; 55:320-4. [PMID: 11968711] [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: 02/24/2023]
Abstract
Prior selective cerebral perfusion is the method whereby selective cerebral perfusion and systemic perfusion start almost simultaneously, and the arch vessels are clamped. Cerebral circulation is isolated from systemic circulation to avoid cerebral embolization owing to detachment of atherosclerotic material from the aorta, caused by the "sandblasting" effect of high-velocity jets of blood exiting the aortic canula. Twenty-seven consecutive patients underwent total arch replacement for degenerative aortic arch aneurysm using prior selective cerebral perfusion from 1992 to 2001. Surgical death (within 1 month after operation) was 2 cases (7.4%), in-hospital death was 5 cases (18.5%). Systemic circulatory arrest time is almost equal to the time which distal anastomosis takes. The time was 81.4 +/- 24.3 minutes. Selective cerebral perfusion time was 194.9 +/- 30.9 minutes. Extracorporeal circulation time was 280.6 +/- 55.3 minutes. The time for emergence from anesthesia was 6.0 +/- 2.7 hours. Permanent neurologic dysfunction which was thought to occurred within 48 hours after surgery was noted in 1 case (3.7%). Postoperative survival at 8 years was 73.3%. There was 1 arch aneurismal related accident. Prior selective cerebral perfusion may be useful for avoiding cerebral embolization.
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Affiliation(s)
- M Imamaki
- Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
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Mizuno Y, Hattori N, Kitada T, Matsumine H, Mori H, Shimura H, Kubo S, Kobayashi H, Asakawa S, Minoshima S, Shimizu N. Familial Parkinson's disease. Alpha-synuclein and parkin. Adv Neurol 2002; 86:13-21. [PMID: 11553970] [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: 02/21/2023]
Abstract
We have reviewed recent progress in establishing the function of alpha-synuclein and parkin in relation to nigral degeneration in autosomal dominant and autosomal recessive PD. Mutations of alpha-synuclein (Ala53Thr and Ala30Pro) cause a form of autosomal dominant PD with early onset. Parkin is a novel protein expressed in the cytoplasm, including the terminal regions and Golgi apparatus. Mutations of parkin cause a form of autosomal recessive young-onset PD (ARJP). Both proteins appear to be associated with fast axonal transport. In addition, in sporadic PD, normal alpha-synuclein shows an increased tendency to self-aggregate. Thus, altered axonal transport of presynaptic proteins appears to play a crucial role in neurodegeneration in PD.
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Affiliation(s)
- Y Mizuno
- Department of Neurology, Juntendo University School of Medicine, Tokyo 113-8421, Japan
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Nakano H, Bachellier P, Weber JC, Oussoultzoglou E, Dieng M, Shimura H, Boudjema K, Wolf P, Jaeck D. Arterial and vena caval resections combined with pancreaticoduodenectomy in highly selected patients with periampullary malignancies. Hepatogastroenterology 2002; 49:258-62. [PMID: 11941970] [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: 02/24/2023]
Abstract
BACKGROUND/AIMS To obtain a margin-negative resection and increase the indication for resection of periampullary malignancies, pancreaticoduodenectomy with a SM-PVR (superior mesenterico-portal vein resection) has been performed. However, an arterial resection, other vascular resections except SM-PVR (e.g., an inferior vena caval resection), or a metastatic tumor resection combined with pancreaticoduodenectomy has yet to be fully elucidated because of the high risk of postoperative complications and extremely poor long-term survival in patients undergoing these exceptional procedures. The present report focused on highly selected patients undergoing an arterial resection or a vena caval resection associated with pancreaticoduodenectomy. METHODOLOGY Besides 31 patients with periampullary tumors undergoing pancreaticoduodenectomy associated with SM-PVR in our department, a group of 4 patients underwent arterial resections and another patient underwent pancreaticoduodenectomy combined with a resection of liver metastasis together with an inferior vena caval resection. These five patients were reported in the present study. RESULTS A 27 year-old-woman presented pancreatic ductal adenocarcinoma of the pancreatic head and a liver metastasis in which involvements of the superior mesenterico-portal vein and the inferior vena cava were shown. Pancreaticoduodenectomy was performed with SM-PVR associated with a left hemihepatectomy combined with a segment 1 resection and an inferior vena caval resection. The patient did not present severe postoperative complications and experienced a good quality of life during 16 months after surgery. Four other patients underwent arterial resections. These arterial resections were performed only when a margin-negative resection was feasible. The superior mesenteric artery was resected and reconstructed with a Goretex graft in one patient. The right hepatic artery was resected and reconstructed with a saphenous graft in two patients. The other patient underwent a resection of the common hepatic artery and reconstruction was performed with the splenic artery. Three of the four patients presented postoperative complications but were conservatively treated. Two patients are still alive 25 months and 8 months after surgery. One patient died of sepsis 5 months after surgery, and the other died of cancer progression 19 months after surgery. CONCLUSIONS The indication for retropancreatic arterial resection associated with pancreaticoduodenectomy should be carefully evaluated only when a margin-negative resection can be achieved. An appropriate bypass method of arterial reconstruction should be selected because a direct end-to-end anastomosis is not always feasible. Hepatectomy for metastases of pancreatic ductal carcinoma should be also regarded as an exceptional procedure.
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Affiliation(s)
- Hiroshi Nakano
- Centre de Chirurgie Viscirale et de Transplantation Hôpital de Hautepierre, Avenue Molière, 67098 Strasbourg, France
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Tanaka K, Suzuki T, Chiba T, Shimura H, Hattori N, Mizuno Y. Parkin is linked to the ubiquitin pathway. J Mol Med (Berl) 2001; 79:482-94. [PMID: 11692161 DOI: 10.1007/s001090100242] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2001] [Accepted: 03/22/2001] [Indexed: 11/24/2022]
Abstract
Autosomal recessive juvenile parkinsonism (AR-JP) is one of the most common forms of familial Parkinson's disease. AR-JP is characterized by selective and massive loss of dopaminergic neurons in the substantia nigra of the midbrain and absence of Lewy bodies, the pathological hallmark of idiopathic Parkinson's disease. Parkin, the causative gene of AR-JP, encodes a 52-kDa protein that is a RING-type ubiquitin (Ub) protein ligase (E3) collaborating with a Ub-conjugating enzyme (E2) belonging to a cognate class of UbcH7 or UbcH8. Analysis of parkin mutations in AP-JP patients reveals that the functional loss of parkin as an E3 enzyme is the molecular basis of AR-JP. Thus it is now clear that AR-JP is due to failure of proteolysis mediated by the Ub-proteasome system and accumulation of as yet unidentified protein(s) causes nigral neuronal death without formation of Lewy bodies. These findings should shed new light on the mechanisms underlying neurodegeneration in sporadic Parkinson's disease as well as AR-JP.
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Affiliation(s)
- K Tanaka
- Tokyo Metropolitan Institute of Medical Science and CREST, Japan Science and Technology Corporation, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8613, Japan.
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Shimura H, Schlossmacher MG, Hattori N, Frosch MP, Trockenbacher A, Schneider R, Mizuno Y, Kosik KS, Selkoe DJ. Ubiquitination of a new form of alpha-synuclein by parkin from human brain: implications for Parkinson's disease. Science 2001; 293:263-9. [PMID: 11431533 DOI: 10.1126/science.1060627] [Citation(s) in RCA: 745] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Parkinson's disease (PD) is a common neurodegenerative disorder characterized by the progressive accumulation in selected neurons of protein inclusions containing alpha-synuclein and ubiquitin. Rare inherited forms of PD are caused by autosomal dominant mutations in alpha-synuclein or by autosomal recessive mutations in parkin, an E3 ubiquitin ligase. We hypothesized that these two gene products interact functionally, namely, that parkin ubiquitinates alpha-synuclein normally and that this process is altered in autosomal recessive PD. We have now identified a protein complex in normal human brain that includes parkin as the E3 ubiquitin ligase, UbcH7 as its associated E2 ubiquitin conjugating enzyme, and a new 22-kilodalton glycosylated form of alpha-synuclein (alphaSp22) as its substrate. In contrast to normal parkin, mutant parkin associated with autosomal recessive PD failed to bind alphaSp22. In an in vitro ubiquitination assay, alphaSp22 was modified by normal but not mutant parkin into polyubiquitinated, high molecular weight species. Accordingly, alphaSp22 accumulated in a non-ubiquitinated form in parkin-deficient PD brains. We conclude that alphaSp22 is a substrate for parkin's ubiquitin ligase activity in normal human brain and that loss of parkin function causes pathological alphaSp22 accumulation. These findings demonstrate a critical biochemical reaction between the two PD-linked gene products and suggest that this reaction underlies the accumulation of ubiquitinated alpha-synuclein in conventional PD.
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Affiliation(s)
- H Shimura
- Center for Neurologic Diseases, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Abstract
We recently identified a novel gene, parkin, as a pathogenic gene for autosomal recessive juvenile parkinsonism. Parkin encodes a 52-kDa protein with a ubiquitin-like domain and two RING-finger motifs. To provide a insight into the function of parkin, we have examined its intracellular distribution in cultured cells. We found that parkin was localized in the trans-Golgi network and the secretory vesicles in U-373MG or SH-SY5Y cells by immunocytochemical analyses. In the subsequent subcellular fractionation studies of rat brain, we showed that parkin was copurified with the synaptic vesicles (SVs) when we used low ionic conditions throughout the procedure. An immunoelectromicroscopic analysis indicated that parkin was present on the SV membrane. Parkin was readily released from SVs into the soluble phase by increasing ionic strength at neutral pH, but not by a non-ionic detergent. To elucidate its responsible region for membrane association, we transfected with green fluorescent protein-tagged deletion mutants of parkin into COS-1 cells followed by subcellular fractionation. We demonstrated the ability of parkin to bind to the membranes through a broad region except for the ubiquitin-like domain. The significance of SV localization of parkin is discussed.
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Affiliation(s)
- S I Kubo
- Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan
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49
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Weber JC, Nakano H, Bachellier P, Oussoultzoglou E, Inoue K, Shimura H, Wolf P, Chenard-Neu MP, Jaeck D. Is a proliferation index of cancer cells a reliable prognostic factor after hepatectomy in patients with colorectal liver metastases? Am J Surg 2001; 182:81-8. [PMID: 11532423 DOI: 10.1016/s0002-9610(01)00656-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND In spite of many reports focusing on prognostic factors after hepatectomy in patients with colorectal liver metastases, few studies have investigated pathological factors, eg, fibrous pseudocapsulation, growth pattern at the tumor margin, and proliferation activity of cancer cells, other than histological type and surgical margin. The aim of the present study was to investigate whether absence of pseudocapsulation, infiltrative growth pattern of metastases, and higher proliferation of cancer cells shown by Ki-67 immunohistochemical reactivity were associated with poorer survival after hepatectomy among patients with colorectal liver metastases. METHODS Between 1988 and 1998, 221 patients underwent hepatic resection of colorectal metastases with curative intent in our institution. Pathology analyses were focused on pseudocapsulation of liver metastases, growth pattern at the tumor edge, and Ki-67 labelling index (Ki-67 LI) of cancer cell nuclei. Univariate analyses of survival and of disease-free survival were performed for several clinicopathological factors, and multivariate analyses of survival and disease-free survival were also performed. RESULTS The univariate survival analyses showed that pseudocapsulation, growth pattern, and Ki-67 LI were significant prognostic factors, besides synchronous versus metachronous occurrence of metastases, carcinoembryonic antigen level before hepatectomy, and number of metastases. A multivariate analysis showed that Ki-67 labeling index was the most reliable prognostic factor of survival. In addition, Ki-67 LI and microscopic growth pattern were multivariately predictive factors of disease-free survival. CONCLUSIONS This large single-institution study showed that investigation of cancer cell proliferation and pathologic characteristics of the tumor margin are major prognostic factors.
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Affiliation(s)
- J C Weber
- Centre de Chirurgie Viscérale et de Transplantation, Hôpital Universitaire de Hautepierre, Avenue Molière, 67098, Strasbourg Cedex, France
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50
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Masuda M, Mogi K, Nakaya M, Pearce Y, Imamaki M, Shimura H, Okada Y, Nishimura K, Nakajima N. Surgical treatment for chronic pulmonary thromboembolism under cardiopulmonary bypass with selective cerebral perfusion. Surg Today 2001; 31:108-12. [PMID: 11291702 DOI: 10.1007/s005950170192] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The median sternotomy approach for the treatment of chronic pulmonary thromboembolism was recently improved by Daily, Jamieson, and coworkers who adopted it for use under cardiopulmonary bypass with intermittent circulatory arrest; however, we have sometimes found that the circulatory arrest time was too short to complete thromboendarterectomy. Therefore, we attempted to perform a selective cerebral perfusion technique to extend the endarterectomy time. Although we noted slight back-bleeding from the bronchial arteries, we were able to extend the endarterectomy time without causing any postoperative delirium. We conclude that the median sternotomy approach using cardiopulmonary bypass with selective cerebral perfusion may be the best option for extending the thromboendarterectomy time.
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Affiliation(s)
- M Masuda
- First Department of Surgery, Chiba University School of Medicine, Japan
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