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| 1.
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Shotaro, Nakanishi ; Miyazato, Minoru ; Tanaka, Kei ; Uema, Namiko ; Saito, Seiichi
概要:
Congenital mid-ureteral strictures (CMS) are rare. Most congenital strictures occur at the ureteropelvic junction or ure
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terovesical junction, with mid-ureteral strictures accounting for only 4–5% of all cases of ureteral obstruction in children. Furthermore, there are very few reports of coexisting mid-ureteral stricture and ureterovesical junction obstruction (UVJO). Here, we report a case of coexisting UVJO and CMS. CMS was not detected on preoperative magnetic resonance imaging, and hydronephrosis remained after ureteroneocystostomy. Therefore, MRI was repeated and CMS was diagnosed, for which we performed ureteroureterostomy. Intraoperative retrograde pyelography (RGP) aids definitive diagnosis of UVJO.
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| 2.
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Koikea, Shin ; Nakanishi, Shotaro ; Nohara, Sunao ; Miyahira, Hirofumi ; Tamaki, Tomoko ; Saito, Seiichi
概要:
Large adrenocortical adenomas have rarely been reported. We describe a case of a 26-year-old man who underwent an adrena
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lectomy for a large adrenocortical adenoma (8.6 × 7.7 cm). Although the lesion had typical malignant features on imaging, histopathological examination revealed an adrenocortical adenoma. This highlights that imaging alone may not be able to distinguish adrenocortical carcinomas from adrenal masses. In most cases, a resection should be performed for early diagnosis and management of large adrenal masses with malignant features on imaging. To our knowledge, this is the first report of a large adrenocortical adenoma diagnosed with multiple imaging investigations.
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| 3.
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Tsuzuki, Shunsuke ; Nakanishi, Shotaro ; Tamaki, Mitsuyoshi ; Oshiro, Takuma ; Miki, Jun ; Yamada, Hiroki ; Shimomura, Tatsuya ; Kimura, Takahiro ; Furuta, Nozomu ; Saito, Seiichi ; Egawa, Shin
概要:
Background:There was no clear evidence whether the initial dose of enzalutamide affects the incidence of adverse events
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(AEs), and oncological outcome in patients with castration-resistant prostate cancer (CRPC).\nMethods:The clinical charts of 233 patients with CRPC treated with enzalutamide were reviewed retrospectively. After 1:3 propensity score matching (PSM), 124 patients were divided into a reduced dose group and a standard dose group, and the prostate specific antigen (PSA) response and the incidence of AEs were compared.\nResults:190 patients with CRPC initiated with standard dose enzalutamide were younger and better performance status compared with 43 patients beginning with reduced dose. After PSM, the baseline characteristics were not different between the standard and the reduced dose group. In the PSM cohort, the PSA response rate was significantly lower in the reduced dose group than in the standard dose group (-66.3% and -87.4%, p = 0.02). The incidence rates of AEs were not statistically different between the groups (22.6% and 34.4%, respectively, p = 0.24).\nConclusion:\nInitiating treatment with a reduced dose of enzalutamide did not significantly decrease the incidence rate of AEs, and it showed poorer PSA response rate. There is no clear rationale for treating with a reduced initial dose of enzalutamide to reduce the incidence of AEs.
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| 4.
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Nakanishi, Shotaro ; Goya, Masato ; Tamaki, Mitsuyoshi ; Oshiro, Takuma ; Saito, Seiichi
概要:
Objective:To date, there are no useful markers for predicting the prognosis of metastatic hormone-sensitive prostate can
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cer (mHSPC). We evaluated the effect of early changes in prostate-specific antigen (PSA) levels after androgen deprivation therapy (ADT) on castration-resistant prostate cancer (CRPC) progression and overall survival (OS) in mHSPC patients.\nResults:In 71 primary mHSPC patients treated with ADT, the median times to CRPC and OS were 15 months and 92 months, respectively. In multivariate analysis, a Gleason score of ≥ 8 (p = 0.004), an extent of disease value (EOD) of ≥ 2 (p = 0.004), and a 3-month PSA level > 1% of the pretreatment level (p = 0.017) were independent predictors of shorter time to CRPC. The area under the receiver operating characteristic curve was feasible at 0.822. A 3-month PSA level > 1% of the pretreatment level was an independent predictor of OS (p = 0.004). Three factors were independent predictors of shorter time to CRPC. A 3-month PSA level > 1% of the pretreatment level correlated with a poor prognosis.
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| 5.
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Miyazato, Minoru ; Ashikari, Asuka ; Nakamura, Koshi ; Nakamura, Takehiro ; Yamashiro, Kiyoto ; Uema, Tsugumi ; Uehara, Moriyuki ; Masuzaki, Hiroaki ; Saito, Seiichi ; Maeda, Shiro ; Ishida, Hajime ; Matsushita, Masayuki
概要:
Purpose:To evaluate the effect of a mobile digital intervention on voiding patterns, we performed 24-h voided volume mon
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itoring in individuals with metabolic disorders.\nMethods:Participants with metabolic disorders were grouped into either the intervention group (n = 17), who had access to a smartphone app (CARADA), or the non-intervention group (n = 11), who did not. Urine monitoring was conducted for 24 h using a novel digital self-health monitoring system for urine excretion (s-HMSU). Body weight, abdominal circumference, blood pressure, and biomarkers were measured.\nResults:Physical findings and blood test results at baseline and 6 months indicated no significant between-group differences. Night-time frequency did not change between baseline and 6 months in the intervention group but significantly worsened at 6 months in the non-intervention group, as compared to baseline (1.0 ± 0.7 vs. 1.5 ± 0.5, p < 0.05). The change in night-time frequency over 6 months did not differ between the intervention and non-intervention groups. Furthermore, the change in hours of undisturbed sleep over 6 months did not differ between the two groups. However, compared with baseline, nocturnal polyuria index tended to worsen at 6 months in the non-intervention group.\nConclusion:Our study results suggest that mobile digital intervention might be useful for behavioral therapy to improve night-time frequency and urine production and that s-HMSU might be beneficial for confirming the prevention of progress in individuals with metabolic disorders, which can aid in modifying lifestyle.
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| 6.
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Tsuchida, Akiko ; Senda, Motohiro ; Ito, Akihiro ; Saito, Seiichi ; Kiso, Makoto ; Ando, Takayuki ; Harduin-Lepers, Anne ; Matsuda, Akio ; Furukawa, Keiko ; Furukawa, Koichi
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| 7.
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Nakanishi, Shotaro ; Nishida, Sho ; Miyazato, Minoru ; Goya, Masato ; Saito, Seiichi
概要:
We present a 78-year-old male with renal cell carcinoma who developed myasthenia gravis complicated by myositis after ni
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volumab administration, which was verified by the presence of antibodies against the acetylcholine receptor. The initial symptom was posterior neck pain, and biochemical examination of blood showed elevated levels of hepatic enzymes and creatine phosphokinase. The level of antibody against the acetylcholine receptor increased 4.1-fold. His condition progressed rapidly resulting in respiratory failure 15 days after conservative therapy.
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| 8.
論文（リポジトリ） |
論文（リポジトリ）
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Nakanishi, Shotaro ; Nishida, Sho ; Miyazato, Minoru ; Goya, Masato ; Saito, Seiichi
概要:
We present a 78-year-old male with renal cell carcinoma who developed myasthenia gravis complicated by myositis after ni
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volumab administration, which was verified by the presence of antibodies against the acetylcholine receptor. The initial symptom was posterior neck pain, and biochemical examination of blood showed elevated levels of hepatic enzymes and creatine phosphokinase. The level of antibody against the acetylcholine receptor increased 4.1-fold. His condition progressed rapidly resulting in respiratory failure 15 days after conservative therapy.
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| 9.
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Yonamine, Tomoko ; Kaname, Tadashi ; Chinen, Yasutsugu ; Tamashiro, Kouichi ; Kosuge, Noritake ; Saito, Seiichi
概要:
Hereditary leiomyomatosis and renal cell cancer is a rare, inherited disease caused by mutations in the fumarate hydrata
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se gene. It is characterized by cutaneous leiomyomas, uterine leiomyomas, and/or renal cell cancer. We present the case of a 42-year-old woman with a heterozygous missense mutation (p.M195T) in the fumarate hydratase gene. Although the patient did not have cutaneous leiomyoma and she had no family history of hereditary leiomyomatosis and renal cell cancer, the presence of early onset symptomatic uterine leiomyoma and type 2 papillary renal cell cancer confirmed the diagnosis of hereditary leiomyomatosis and renal cell cancer.
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| 10.
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Matsumura, Eri ; Kosuge, Noritake ; Nakanishi, Shotaro ; Suda, Tetsuji ; Sugawa, Ai ; Fujimura, Tsutomu ; Miyagi, Ryota ; Yoshimi, Naoki ; Saito, Seiichi
概要:
Urothelial carcinoma of the bladder (UCB) is potentially life-threatening; therefore, we aimed to discover a novel urine
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biomarker for diagnosis and prognostication of UCB. This is a retrospective case-control study. Exploration of a new biomarker using urine from 20 UCB patients in the present study revealed that urinary level of lactoferrin (LF), a multifunctional glycoprotein released from neutrophils, was higher in 11 of 15 with invasive/high-grade UCB than 5 with non-invasive one, and 2 healthy adults. We therefore focused on LF and assessed the value of urine LF normalized by urine creatinine concentration (LF/Cr) using an enzyme-linked immunosorbent assay. Diagnostic performance of urine LF/Cr was examined using urine from 92 patients with primary (newly diagnosed) untreated UCB and 166 controls without UCB, including 62 patients with pyuria, and 104 subjects without pyuria consisting of 84 patients and 20 healthy adults. However, the diagnostic accuracies were accompanied by the risk of bias. In 92 primary UCB patients, both pyuria and tumor-infiltrating neutrophils (TINs) were independent predictors for urine LF/Cr. In contrast, TINs or urine LF/Cr were independent predictors for invasive histology, whereas pyuria was not. In terms of prognostication, urine LF/Cr and nodal metastasis were independent predictors of disease-specific survival in 22 patients with muscle-invasive bladder cancer, characterized by a high mortality rate, in the Cox proportional hazards model. In conclusion, urine LF/Cr linked to TINs was a predictor of both invasive histology and prognosis in UCB. Urine LF/Cr is a potential biomarker reflecting the degree of malignancy in UCB.
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