673 results on '"Keiichi Ito"'
Search Results
152. PD30-01 PRIMARY REALIGNMENT FOR BLUNT STRADDLE INJURY OF THE BULBAR URETHRA IS ASSOCIATED WITH PROLONGED TIME TO URETHROPLASTY AND INCREASED STRICTURE COMPLEXITY
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Masayuki Shinchi, Ryuichi Azuma, Eiji Takahashi, Fumihiro Kimura, Tomohiko Asano, Akio Horiguchi, Kenichiro Ojima, Keiichi Ito, and Ayako Masunaga
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medicine.medical_specialty ,Straddle ,Blunt ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,medicine ,Bulbar urethra ,business ,Surgery - Published
- 2018
153. PD21-09 MYOFIBROBLAST-DOMINANT PROLIFERATION BUT NOT FIBROBLAST PROLIFERATION ASSOCIATES WITH MORE SEVERE FIBROSIS IN BULBAR URETHRAL STRICTURE
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Keiichi Ito, Yusuke Hirano, Yusuke Shinchi, Kosuke Miyai, Akio Horiguchi, and Tomohiko Asano
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Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,Urology ,medicine ,Severe fibrosis ,Fibroblast ,business ,Myofibroblast ,Bulbar urethral stricture - Published
- 2018
154. MP10-01 NICORANDIL INCREASES RENAL NITRIC OXIDE (NO), DECREASES TRASFORMING GROWTH FACTOR (TGF)-β, AND AMELIORATES RENAL INJURY IN UNILATERAL URETERAL OBSTRUCTION (UUO) IN RATS
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Tomohiko Asano, Hitoshi Tsuda, Takako Asano, Keiichi Ito, and Ayako Masunaga
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medicine.medical_specialty ,business.industry ,Urology ,Growth factor ,medicine.medical_treatment ,Nitric oxide ,chemistry.chemical_compound ,Renal injury ,chemistry ,medicine ,business ,Nicorandil ,medicine.drug ,Transforming growth factor - Published
- 2018
155. [A CASE OF METASTATIC BLADDER UROTHELIAL CARCINOMA WHOSE DISEASE WAS CONTROLLED FOR A RELATIVE LONG PERIOD BY MULTIDISCIPLINARY TREATMENT INCLUDING RADIATION TO A LUNG METASTASIS AND MULTIPLE COURSES OF CHEMOTHERAPY]
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Yujiro Tsujita, Taiki Kanbara, Junichi Asakuma, Akio Horiguchi, Tomohiko Asano, Shinsuke Tasaki, Shinsuke Hamada, Keiichi Ito, and Hidehiko Yoshii
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medicine.medical_specialty ,Lung Neoplasms ,Time Factors ,Urology ,medicine.medical_treatment ,Urinary system ,Urinary Bladder ,Vinblastine ,Metastasis ,Fatal Outcome ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Infusions, Intra-Arterial ,Kidney Pelvis ,Neoplasm Invasiveness ,Aged ,Chemotherapy ,Lung ,Performance status ,business.industry ,Ureteral Neoplasms ,Carcinoma ,Liver Neoplasms ,Chemoradiotherapy ,medicine.disease ,Combined Modality Therapy ,Kidney Neoplasms ,Radiation therapy ,medicine.anatomical_structure ,Methotrexate ,Urinary Bladder Neoplasms ,Doxorubicin ,BCG Vaccine ,Female ,Radiology ,Cisplatin ,business ,Organ Sparing Treatments ,medicine.drug - Abstract
A 67-year-old woman complained of urinary frequency and gross hematuria. She was referred to our hospital with the diagnosis of bladder tumor. Transurethral resection of the bladder tumor (TURBT) was performed and pathological diagnosis was urothelial carcinoma (G2>G3) with muscular invasion. Because she hoped bladder preservation therapy, she received two courses of M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) therapy, one course of arterial infusion chemotherapy, and chemoradiotherapy with cisplatin. After those therapies she underwent 4 times of TURBT and two courses intravesical BCG therapy. However, solitary lung metastasis appeared 19 months after the initial TURBT. Multidisciplinary treatments including 25 courses of various multiagent chemotherapies, radiation therapy to the lung metastasis and surgical resection of a urethral recurrence were performed. Although a localized radiation pneumonitis was developed, the lung metastasis appeared to be controlled for 26 months after the radiation therapy to the lung. Bilateral ureteral and renal pelvic tumors appeared after the radiation therapy. Severe bleeding was occurred from renal pelvic tumors several times and she needed the hospital stay 2 times. Active bleeding stopped after the administration of chemotherapy each time. Although she died of occlusive jaundice due to the liver metastasis, she had been alive due to the multidisciplinary treatment for 67 months after lung metastasis appearance with relatively good performance status.
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- 2018
156. Abstract TMP44: Neurological Severity and Activities of Daily Life in Patients With Ischemic Stroke at Convalescent Rehabilitation
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Joe Senda, Masahiko Kanamori, Keiichi Ito, Hideo Kishimoto, Masahisa Katsuno, Tomomitsu Kotake, and Gen Sobue
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Advanced and Specialized Nursing ,medicine.medical_specialty ,Rehabilitation ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Leukoaraiosis ,Infarction ,Magnetic resonance imaging ,medicine.disease ,Embolism ,Internal medicine ,Acute care ,Ischemic stroke ,medicine ,Cardiology ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Stroke - Abstract
Background and purpose: There are discrepancies between neurological severity and activities of daily life (ADL) after stroke. We investigated associations between neurological severity and ADL in patients with ischemic stroke at the convalescent rehabilitation stage. We particularly focused on the condition of leukoaraiosis on magnetic resonance imaging (MRI) and various clinical factors. Methods: The participants included 723 patients with ischemic stroke (484 men and 239 women; mean age, 73.2 ± 8.5 years; subtypes, lacunar infarction [n = 54], atherothrombosis [n = 305], artery-to-artery embolism [n = 105], cardiogenic embolism [n = 129], undetermined embolism [n = 93], and uncategorized ischemic stroke [n = 37]) which were transferred from acute care hospitals for inpatient convalescent rehabilitation. Leukoaraiosis was graded according to periventricular hyperintensity (PVH) and deep white matter hyperintensity on MRI. The National Institutes of Health Stroke Scale (NIHSS) was used to measure neurological severity and the Functional Independence Measure (FIM) was used to assess ADL at admission and discharge. Results: Multiple regression analysis revealed that total FIM scores were significantly associated with leukoaraiosis as estimated by PVH grade (P = 0.001) and NIHSS score (P < 0.001) both at admission and discharge for all patients, in addition to clinical factors, such as age, history of heart disease, and bilateral infarction lesions. In contrast, multiple regression analysis of NIHSS scores revealed no association with PVH. Conclusions: Our study revealed that ADL were associated with the degree of leukoaraiosis as indicated by PVH at the convalescent rehabilitation stage in patients with ischemic stroke. However, neurological severity was not associated with leukoaraiosis, likely because the progression patterns and anatomic backgrounds of PVH affect ADL and rehabilitation outcomes in post ischemic stroke.
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- 2018
157. All-in-one bag based photooxidative cell membrane perforation system for mass cell processing
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Takayoshi Ohba, Keiichi Ito, Shigeo Nakamura, Misato Kikuchi, Takahiro Hasimoto, Takashi K. Saito, and Chumei Saito
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Cell membrane ,Membrane ,medicine.anatomical_structure ,Materials science ,Cell processing ,Drug delivery ,Cell ,Perforation (oil well) ,medicine ,Biophysics ,Light irradiation ,Photosensitizer - Abstract
In recent years, cell processing technology has evolved in the advanced medical field, and the processed cells are applied to various diseases which hardly be treated. In order to treat these diseases, the cells must have the functions which are necessary for the treatment. However, it's difficult to add some artificial functions to cells, such as drug delivery Our photochemical cell membrane perforation is an new approach for the cell processing. This method allows a large number of cells to perforate recoverable holes on cell membranes with a nano brush shaped stamp including photosensitizer and light irradiation to activate the photosensitizer. Advantages of the method are as follows: The number of processed cells can be increased easily because our stamp-based cell processing is like a printing technology, and survival ratio of the processed cell are fundamentally high since the perforation is based on recoverable oxidative damages to the cells.
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- 2017
158. Cre-dependent ACR2-expressing reporter mouse strain for efficient long-lasting inhibition of neuronal activity
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Yasutaka Mukai, Yan Li, Akiyo Nakamura, Noriaki Fukatsu, Daisuke Iijima, Manabu Abe, Kenji Sakimura, Keiichi Itoi, and Akihiro Yamanaka
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Medicine ,Science - Abstract
Abstract Optogenetics is a powerful tool for manipulating neuronal activity by light illumination with high temporal and spatial resolution. Anion-channelrhodopsins (ACRs) are light-gated anion channels that allow researchers to efficiently inhibit neuronal activity. A blue light-sensitive ACR2 has recently been used in several in vivo studies; however, the reporter mouse strain expressing ACR2 has not yet been reported. Here, we generated a new reporter mouse strain, LSL-ACR2, in which ACR2 is expressed under the control of Cre recombinase. We crossed this strain with a noradrenergic neuron-specific driver mouse (NAT-Cre) to generate NAT-ACR2 mice. We confirmed Cre-dependent expression and function of ACR2 in the targeted neurons by immunohistochemistry and electrophysiological recordings in vitro, and confirmed physiological function using an in vivo behavioral experiment. Our results show that the LSL-ACR2 mouse strain can be applied for optogenetic inhibition of targeted neurons, particularly for long-lasting continuous inhibition, upon crossing with Cre-driver mouse strains. The LSL-ACR2 strain can be used to prepare transgenic mice with homogenous expression of ACR2 in targeted neurons with a high penetration ratio, good reproducibility, and no tissue invasion.
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- 2023
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159. A pilot study of photoacoustic imaging system for improved real-time visualization of neurovascular bundle during radical prostatectomy
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Kaku Irisawa, Keiichi Ito, Tadashi Kasamatsu, Hitoshi Tsuda, Masayuki Shinchi, Kazuhiro Hirota, Makoto Kawaguchi, Miya Ishihara, Hiroshi Shinmoto, Akio Horiguchi, Tomohiko Asano, and Kazuhiro Tsujita
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Pathology ,medicine.medical_specialty ,Prostatectomy ,business.industry ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Neurovascular bundle ,01 natural sciences ,Imaging phantom ,010309 optics ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Oncology ,Periprostatic ,Prostate ,0103 physical sciences ,medicine ,Medical imaging ,Photoacoustic Techniques ,business ,Microvessel ,Biomedical engineering - Abstract
BACKGROUND Photoacoustic imaging, a noninvasive imaging based on optical excitation and ultrasonic detection, enables one to visualize the distribution of hemoglobin and acquire a map of microvessels without using contrast agents. We examined whether it helps visualize periprostatic microvessels and improves visualization of the neurovascular bundle. METHODS We developed a photoacoustic imaging (PAI) system with a hand-held probe combining optical illumination and a conventional linear array ultrasound probe. In experiments with a phantom model, it was able to visualize vessels with diameters as small as 300 μm within a depth of 10 mm. We also developed a TRUS type probe for our photoacoustic imaging system and used it to intraoperatively monitor periprostatic tissues in seven patients with clinically organ-confined prostate cancer who were undergoing non-nerve-sparing retropubic radical prostatectomy. Images of periprostatic tissues from resected prostatectomy specimens were also obtained using the linear photoacoustic probe, and the consistency of the microvessel distribution and co-existence of nerve fibers was examined by double immunostaining of paraffin-embedded sections with anti-CD31 and anti-S-100 antibodies. RESULTS Intraoperative monitoring of periprostatic tissues with the TRUS photoacoustic probe showed substantial signals on the posterolateral surface of the prostate and clearly demonstrated the location and extent of the neurovascular bundle better than does TRUS alone. Photoacoustic images of the periprostatic tissues in resected specimens also showed substantial signals that were especially strong on the posterolateral surface of the prostate. Nerve fibers were closely co-localized with periprostatic microvessels and the pattern of their distribution was consistent with that of PAI signals. CONCLUSIONS The intraoperative photoacoustic imaging located the microvascular complex in the neurovascular bundle. Moreover, the neurovascular bundle was easier to identify by PAI than by TRUS alone, suggesting that PAI could be helpful in nerve-sparing radical prostatectomy. Prostate 76:307–315, 2016. © 2015 Wiley Periodicals, Inc.
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- 2015
160. Bortezomib and belinostat inhibit renal cancer growth synergistically by causing ubiquitinated protein accumulation and endoplasmic reticulum stress
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Takako Asano, Kazuki Okubo, Tomohiko Asano, Makoto Isono, Akinori Sato, and Keiichi Ito
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business.industry ,medicine.drug_class ,Bortezomib ,General Neuroscience ,Endoplasmic reticulum ,Histone deacetylase inhibitor ,Articles ,General Medicine ,General Biochemistry, Genetics and Molecular Biology ,chemistry.chemical_compound ,Proteasome ,chemistry ,Cancer cell ,Immunology ,Proteasome inhibitor ,medicine ,Unfolded protein response ,Cancer research ,General Pharmacology, Toxicology and Pharmaceutics ,business ,Belinostat ,medicine.drug - Abstract
There is no curative treatment for advanced renal cancer, and a novel treatment approach is urgently required. Inducing ubiquitinated protein accumulation and endoplasmic reticulum (ER) stress has recently emerged as a new approach in the treatment of malignancies. In the present study, we hypothesized that the histone deacetylase inhibitor belinostat would increase the amount of unfolded proteins in cells by inhibiting heat-shock protein (HSP) 90, and that the proteasome inhibitor bortezomib would inhibit their degradation by inhibiting the proteasome, thus causing ubiquitinated protein accumulation and ER stress synergistically. The combination of bortezomib and belinostat induced significant increases in apoptosis and inhibited renal cancer growth synergistically (combination indexes
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- 2015
161. RENAL CELL CARCINOMA PRESENTING WITH HIGH-OUTPUT HEART FAILURE DUE TO ARTERIOVENOUS FISTULA
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Makoto Isono, Keiichi Ito, Ayako Masunaga, Tomohiko Asano, Masayuki Sinchi, Daisuke Watanabe, and Akio Horiguchi
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medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Arteriovenous fistula ,Renal hilum ,Nephrectomy ,Inferior vena cava ,Renal cell carcinoma ,medicine ,Humans ,Right Renal Artery ,Carcinoma, Renal Cell ,High-output heart failure ,Heart Failure ,business.industry ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Kidney Neoplasms ,Surgery ,Clear cell renal cell carcinoma ,medicine.anatomical_structure ,medicine.vein ,Arteriovenous Fistula ,Female ,Radiology ,Tomography, X-Ray Computed ,business - Abstract
A 64-year-old woman who has a history of congestive heart failure and atrial fibrillation was admitted to our hospital with the exacerbation of exertional dyspnea and urinary retention due to severe gross hematuria. Contrast-enhanced computed tomography showed a tumor involving the inferior and middle poles of the right kidney with no nodal involvement, or distant metastases, but that was accompanied by markedly proliferated blood vessels around the inferior vena cava and right renal vein, seemingly a result of an arteriovenous fistula. After embolization of the right renal artery, right radical nephrectomy was performed via a thoracoabdominal incision. The histological diagnosis of the tumor was clear cell renal cell carcinoma, G2 > G3, Fuhrman nuclear grade3, pT2a. Although the presence of an arteriovenous fistula was not confirmed histologically, the severely condensed proliferation of the blood vessels in the renal hilum is consistent with the diagnosis of an arteriovenous fistula accompanying renal cell carcinoma. Immediately after the operation, her symptoms of congestive heart failure, including dyspnea, subsided and her serum BNP levels and CTR value returned to normal levels. Two years after the operation, she shows no signs of recurrence or metastasis. To the best of our knowledge, there have been 25 cases of arteriovenous fistulas accompanied by renal cell carcinoma but only a few in which the symptoms were those of severe congestive heart failure. Clinicians should be aware that renal cell carcinoima could be a cause of heart failure.
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- 2015
162. Mediator subunit MED1 is required for E2A-PBX1-mediated oncogenic transcription and leukemic cell growth.
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Yu-Ling Lee, Keiichi Ito, Wen-Chieh Pi, I-Hsuan Lin, Chi-Shuen Chu, Malik, Sohail, I-Hsin Cheng, Wei-Yi Chen, and Roeder, Robert G.
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CELL growth , *RNA polymerase II , *GENETIC regulation , *CELL receptors , *LYMPHOBLASTIC leukemia - Abstract
The chimeric transcription factor E2A-PBX1, containing the N-terminal activation domains of E2A fused to the C-terminal DNA-binding domain of PBX1, results in 5% of pediatric acute lymphoblastic leukemias (ALL). We recently have reported a mechanism for RUNX1-dependent recruitment of E2A-PBX1 to chromatin in pre-B leukemic cells; but the subsequent E2A-PBX1 functions through various coactivators and the general transcriptional machinery remain unclear. The Mediator complex plays a critical role in cell-specific gene activation by serving as a key coactivator for gene-specific transcription factors that facilitates their function through the RNA polymerase II transcriptional machinery, but whether Mediator contributes to aberrant expression of E2A-PBX1 target genes remains largely unexplored. Here we show that Mediator interacts directly with E2A-PBX1 through an interaction of the MED1 subunit with an E2A activation domain. Results of MED1 depletion by CRISPR/Cas9 further indicate that MED1 is specifically required for E2APBX1-dependent gene activation and leukemic cell growth. Integrated transcriptome and cistrome analyses identify pre-B cell receptor and cell cycle regulatory genes as direct cotargets of MED1 and E2A-PBX1. Notably, complementary biochemical analyses also demonstrate that recruitment of E2A-PBX1 to a target DNA template involves a direct interaction with DNA-bound RUNX1 that can be further stabilized by EBF1. These findings suggest that E2A-PBX1 interactions with RUNX1 and MED1/Mediator are of functional importance for both gene-specific transcriptional activation and maintenance of E2A-PBX1-driven leukemia. The MED1 dependency for E2A-PBX1-mediated gene activation and leukemogenesis may provide a potential therapeutic opportunity by targeting MED1 in E2A-PBX1+ pre-B leukemia. [ABSTRACT FROM AUTHOR]
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- 2021
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163. Tumor necrosis is a strong predictor for recurrence in patients with pathological T1a renal cell carcinoma
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Akinori Sato, Eiji Takahashi, Kenji Kuroda, Shinsuke Tasaki, Hideyuki Shimazaki, Junichi Asakuma, Kenji Seguchi, Akio Horiguchi, Keiichi Ito, and Tomohiko Asano
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Cancer Research ,medicine.medical_specialty ,Univariate analysis ,Pathology ,renal cell carcinoma ,recurrence ,Oncogene ,Performance status ,business.industry ,medicine.medical_treatment ,Cancer ,predictor ,Articles ,medicine.disease ,Gastroenterology ,tumor necrosis ,Nephrectomy ,Metastasis ,Oncology ,Renal cell carcinoma ,Internal medicine ,medicine ,business ,Pathological ,pathological T1a - Abstract
Patients with pT1aN0M0 renal cell carcinoma (RCC) generally have good prognosis, and recurrence is rare. However, metastasis develops postoperatively in a small number of patients with pT1aN0M0 RCC. The present study was undertaken to identify predictors for recurrence in patients with pT1aN0M0 RCC. We reviewed the clinicopathological factors of 133 patients with pT1aN0M0 RCC who underwent radical or partial nephrectomy at the Department of Urology, National Defense Medical College (Saitama, Japan). Clinicopathological factors, including age, gender, tumor size, histological subtype, tumor grade, microvascular invasion, histological tumor necrosis, C-reactive protein levels and performance status were reviewed. These factors were compared between patients with and without postoperative recurrence. Recurrence-free survival (RFS) and cause-specific survival (CSS) rates were calculated using the Kaplan-Meier method. Univariate and multivariate analyses were performed to determine independent factors predicting recurrence in patients with pT1aN0M0 RCC. The 5-year RFS and CSS rates were 97.2 and 99.1%, respectively. When clinicopathological factors were compared between patients with and without recurrence, tumor size (P=0.0390) and percentage of tumor necrosis (P
- Published
- 2014
164. Usefulness of a high-speed surgical air drill in pubectomy during delayed anastomotic urethroplasty for pelvic fracture urethral injury.
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Akio Horiguchi, Kenichiro Ojima, Masayuki Shinchi, Yusuke Hirano, Koetsu Hamamoto, Keiichi Ito, Tomohiko Asano, and Ryuichi Azuma
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PELVIC fractures ,URETHROPLASTY ,WOUNDS & injuries ,BLOOD grouping & crossmatching ,URETHRA - Abstract
Objectives: Pubectomy is an ancillary technique used to increase exposure of the disrupted urethra and reduce anastomotic tension, which can be difficult for inexperienced surgeons. The objective of the present study was to illustrate the use of an air drill enabling delicate and precise bone resection in pubectomy for delayed anastomotic urethroplasty for pelvic fracture urethral injury. Methods: Between 2009 and 2019, 88 male patients underwent delayed anastomotic urethroplasty with pubectomy for pelvic fracture urethral injury. A total of 73 procedures used a high-speed surgical air drill (HiLAN HS; Aesculap, Tuttlingen, Germany) equipped with a short-hand piece. Operative time and blood loss in the air drill patient group (group 1) were compared with that of patients who underwent pubectomy using a rongeur and/or gouge (group 2, n = 15). Results: In 65 group 1 patients, urethroplasty was carried out using the perineal approach, with partial inferior pubectomy. Eight group 1 patients, whose proximal urethral end was displaced upward superior to the upper edge of pubis, underwent urethroplasty using the perineal and abdominal approach, with a superior partial pubectomy and supracrural urethral rerouting. No difficulty was encountered using the air drill in any of the cases. There was no significant difference in median operative time between the groups (group 1 256 min vs group 2 228 min; P = 0.31). The median blood loss in group 1 was significantly lower than group 2 (149 mL vs 453 mL; P < 0.0001). Conclusions: Surgical air drills might facilitate pubectomy in patients undergoing delayed anastomotic urethroplasty for pelvic fracture urethral injury. This tool offers the advantage of a delicate bone resection with reduced blood loss. [ABSTRACT FROM AUTHOR]
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- 2020
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165. Differential CRH expression level determines efficiency of Cre- and Flp-dependent recombination
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Chen Zhao, Clemens Ries, Ying Du, Jingwei Zhang, Kenji Sakimura, Keiichi Itoi, and Jan M. Deussing
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corticotropin-releasing hormone ,CRH ,CRF ,Cre ,Flp ,reporter ,Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 - Abstract
Corticotropin-releasing hormone expressing (CRH+) neurons are distributed throughout the brain and play a crucial role in shaping the stress responses. Mouse models expressing site-specific recombinases (SSRs) or reporter genes are important tools providing genetic access to defined cell types and have been widely used to address CRH+ neurons and connected brain circuits. Here, we investigated a recently generated CRH-FlpO driver line expanding the CRH system-related tool box. We directly compared it to a previously established and widely used CRH-Cre line with respect to the FlpO expression pattern and recombination efficiency. In the brain, FlpO mRNA distribution fully recapitulates the expression pattern of endogenous Crh. Combining both Crh locus driven SSRs driver lines with appropriate reporters revealed an overall coherence of respective spatial patterns of reporter gene activation validating CRH-FlpO mice as a valuable tool complementing existing CRH-Cre and reporter lines. However, a substantially lower number of reporter-expressing neurons was discerned in CRH-FlpO mice. Using an additional CRH reporter mouse line (CRH-Venus) and a mouse line allowing for conversion of Cre into FlpO activity (CAG-LSL-FlpO) in combination with intersectional and subtractive mouse genetic approaches, we were able to demonstrate that the reduced number of tdTomato reporter expressing CRH+ neurons can be ascribed to the lower recombination efficiency of FlpO compared to Cre recombinase. This discrepancy particularly manifests under conditions of low CRH expression and can be overcome by utilizing homozygous CRH-FlpO mice. These findings have direct experimental implications which have to be carefully considered when targeting CRH+ neurons using CRH-FlpO mice. However, the lower FlpO-dependent recombination efficiency also entails advantages as it provides a broader dynamic range of expression allowing for the visualization of cells showing stress-induced CRH expression which is not detectable in highly sensitive CRH-Cre mice as Cre-mediated recombination has largely been completed in all cells generally possessing the capacity to express CRH. These findings underscore the importance of a comprehensive evaluation of novel SSR driver lines prior to their application.
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- 2023
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166. Impact of body mass index on clinicopathological outcomes in patients with renal cell carcinoma without anorexia‑cachexia syndrome
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Akio Horiguchi, Junichi Asakuma, Shinsuke Tasaki, Kenji Kuroda, Keiichi Ito, Akinori Sato, Daisuke Watanabe, and Tomohiko Asano
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0301 basic medicine ,Oncology ,obesity ,renal cell carcinoma ,Cancer Research ,medicine.medical_specialty ,overall survival ,body mass index ,Anorexia ,cachexia ,Gastroenterology ,Cachexia ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Weight loss ,Internal medicine ,medicine ,Hypoalbuminemia ,business.industry ,Hazard ratio ,Articles ,medicine.disease ,Confidence interval ,030104 developmental biology ,anorexia ,030220 oncology & carcinogenesis ,medicine.symptom ,business ,Body mass index - Abstract
Although obesity defined by a high body mass index (BMI) is generally associated with increased risk of renal cell carcinoma (RCC), low BMI has paradoxically been associated with increased tumor aggressiveness and poor prognosis. As anorexia-cachexia syndrome (ACS) is associated with decreased BMI and is frequently observed in patients with advanced RCC, the present study investigated the association of BMI with tumor aggressiveness and prognosis in RCC in relation to ACS. The association of BMI with clinicopathological parameters was analyzed in 503 consecutive patients who underwent surgery for RCC. Kaplan-Meier curves and rates of overall survival (OS) stratified by BMI were also compared in relation to the presence or absence of ACS, defined as the presence of anorexia or malaise, and/or weight loss and/or hypoalbuminemia. Low BMI was significantly associated with high-grade tumors (P=0.0027) and the presence of distant metastasis (P=0.0025), and patients with a lower BMI had significantly shorter OS than those with a higher BMI (P=0.0441). Patients with ACS had a significantly lower BMI (mean, 21.5 kg/m2) than those without ACS (mean, 23.5 kg/m2; P
- Published
- 2017
167. Clinical implication of ectopic liver lipid accumulation in renal cell carcinoma patients without visceral obesity
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Keiichi Ito, Tomohiko Asano, Akio Horiguchi, Daisuke Watanabe, Kenji Kuroda, Shinsuke Tasaki, Junichi Asakuma, Akinori Sato, and Hiroshi Shinmoto
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Adult ,Male ,medicine.medical_specialty ,Pathology ,030232 urology & nephrology ,lcsh:Medicine ,Kaplan-Meier Estimate ,urologic and male genital diseases ,Gastroenterology ,Article ,Metastasis ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Renal cell carcinoma ,Internal medicine ,medicine ,Carcinoma ,Humans ,lcsh:Science ,Carcinoma, Renal Cell ,Aged ,Aged, 80 and over ,Multidisciplinary ,business.industry ,lcsh:R ,Fatty liver ,Cancer ,Lipid metabolism ,Middle Aged ,Ectopic liver ,medicine.disease ,Lipid Metabolism ,female genital diseases and pregnancy complications ,Kidney Neoplasms ,Fatty Liver ,Liver ,030220 oncology & carcinogenesis ,Obesity, Abdominal ,lcsh:Q ,Female ,business ,Tomography, X-Ray Computed ,Body mass index - Abstract
Fatty liver has emerged as a prognostic marker of cancer, so we investigated the impact of ectopic lipid accumulation in liver on the clinical outcome for patients with renal cell carcinoma (RCC). The records of 230 consecutive patients who had undergone surgery for RCC were reviewed, and liver lipid accumulation was estimated from the attenuation in unenhanced preoperative CT images. The median liver CT values of patients with G3 tumors was lower than that of patients with G1–2 tumors (P = 0.0116), that of patients with pT3–4 tumors was lower than that of patients with pT1–2 tumors (P = 0.0336), and that of patients with visceral obesity defined as a visceral fat area ≥ 100 cm2 was lower than that of patients without visceral obesity (P P = 0.0401), that of patients with metastasis was lower than that of patients without metastasis (P = 0.026), and fatty liver was associated with shorter overall survival (P = 0.0009). Ectopic lipid accumulation in liver thus seems to be a predictor of aggressive forms of RCC.
- Published
- 2017
168. A Case of Hemorrhagic Adrenal Pseudocyst Mimicking Solid Tumor
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Kazuyoshi Tachi, Tomohiko Asano, Hiroshi Shinmoto, Takako Kono, Keiichi Ito, Takashi Kimura, Kenji Seguchi, and Makoto Isono
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Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Adrenal Gland Neoplasm ,Adrenal Gland Diseases ,Adrenal Gland Neoplasms ,Hemorrhage ,Therapeutics ,Malignancy ,030218 nuclear medicine & medical imaging ,Lesion ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Diagnosis ,medicine ,Endocrine system ,Humans ,Aged ,medicine.diagnostic_test ,Adrenal gland ,business.industry ,Cysts ,Adrenalectomy ,Magnetic resonance imaging ,General Medicine ,Articles ,medicine.disease ,digestive system diseases ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Female ,Differential diagnosis ,medicine.symptom ,business - Abstract
Patient: Female, 78 Final Diagnosis: Adrenal pseudocyst Symptoms: None Medication: — Clinical Procedure: Operation Specialty: Urology Objective: Mistake in diagnosis Background: Adrenal pseudocysts are often discovered incidentally on imaging, but the diagnosis and treatment can be challenging. A case of adrenal pseudocyst with hemorrhage is presented that mimicked a solid tumor on imaging, resulting in adrenalectomy. Case Report: A 78-year-old woman was found to have a right adrenal lesion on abdominal imaging. Enhanced computed tomography (CT) showed a heterogeneously enhanced mass, and magnetic resonance imaging (MRI) showed a high-intensity T1-weighted and T2-weighed image, with an irregular enhanced margin. The imaging findings were suggestive of a solid tumor of the adrenal gland. Although full endocrine serological studies were negative, the lesion increased in size at two-year follow-up. Right laparoscopic adrenalectomy was performed, and a benign hemorrhagic adrenal pseudocyst was diagnosed histologically. Conclusions: Adrenal pseudocyst can be associated with acute intracystic hemorrhage, and imaging will show contrast enhancement, suggesting malignancy. In such cases, surgical excision is both diagnostic and curative.
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- 2017
169. P1101Long-term benefit of enzyme replacement therapy on cardiac manifestation in Japanese Fabry disease
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Keiichi Ito, Ikuo Taniguchi, Kenichi Hongo, Ikuko Anan, Michihiro Yoshimura, and Makoto Kawai
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Pediatrics ,medicine.medical_specialty ,business.industry ,medicine ,Enzyme replacement therapy ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,Fabry disease ,Term (time) - Published
- 2017
170. Corrigendum to 'Differences in Brain Metabolic Impairment between Chronic Mild/Moderate TBI Patients with and without Visible Brain Lesions Based on MRI'
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Keiichi Ito, Yoshitaka Asano, Yuka Ikegame, and Jun Shinoda
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Adult ,Male ,General Immunology and Microbiology ,lcsh:R ,lcsh:Medicine ,Brain ,Reproducibility of Results ,General Medicine ,Magnetic Resonance Imaging ,Multimodal Imaging ,Sensitivity and Specificity ,Severity of Illness Index ,General Biochemistry, Genetics and Molecular Biology ,Diagnosis, Differential ,Fluorodeoxyglucose F18 ,Positron-Emission Tomography ,Brain Injuries, Traumatic ,Humans ,Female ,Radiopharmaceuticals ,Corrigendum - Abstract
Introduction. Many patients with mild/moderate traumatic brain injury (m/mTBI) in the chronic stage suffer from executive brain function impairment. Analyzing brain metabolism is important for elucidating the pathological mechanisms associated with their symptoms. This study aimed to determine the differences in brain glucose metabolism between m/mTBI patients with and without visible traumatic brain lesions based on MRI. Methods. Ninety patients with chronic m/mTBI due to traffic accidents were enrolled and divided into two groups based on their MRI findings. Group A comprised 50 patients with visible lesions. Group B comprised 40 patients without visible lesions. Patients underwent FDG-PET scans following cognitive tests. FDG-PET images were analyzed using voxel-by-voxel univariate statistical tests. Results. There were no significant differences in the cognitive tests between Group A and Group B. Based on FDG-PET findings, brain metabolism significantly decreased in the orbital gyrus, cingulate gyrus, and medial thalamus but increased in the parietal and occipital convexity in Group A compared with that in the control. Compared with the control, patients in Group B exhibited no significant changes. Conclusions. These results suggest that different pathological mechanisms may underlie cognitive impairment in m/mTBI patients with and without organic brain damage.
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- 2017
171. Primary Realignment for Pelvic Fracture Urethral Injury Is Associated With Prolonged Time to Urethroplasty and Increased Stenosis Complexity
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Keiichi Ito, Kenichiro Ojima, Masayuki Shinchi, Akio Horiguchi, Ayako Masunaga, Ryuichi Azuma, Kazuki Okubo, Kazuki Kawamura, and Tomohiko Asano
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Urologic Surgical Procedures, Male ,Urethrotomy ,Urethral stricture ,Urology ,medicine.medical_treatment ,Urethroplasty ,030232 urology & nephrology ,Urethral stenosis ,Anastomosis ,03 medical and health sciences ,Fractures, Bone ,0302 clinical medicine ,Urethra ,medicine ,Humans ,Pelvic Bones ,Retrospective Studies ,Urethral Stricture ,Trauma Severity Indices ,business.industry ,Anastomosis, Surgical ,Suture Techniques ,Cystoscopy ,Plastic Surgery Procedures ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,Stenosis ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Pelvic fracture ,Disease Progression ,business ,Follow-Up Studies - Abstract
Objective To compare the clinical courses of patients with pelvic fracture urethral injury (PFUI) according to initial management strategy. Methods We reviewed the clinical courses of 63 patients with PFUI who were initially treated elsewhere and underwent delayed anastomotic urethroplasty by a single surgeon between 2008 and 2015. Patients were grouped according to their initial treatment: by suprapubic tube placement alone (49 patients, SPT group) or primary realignment (14 patients, PR group). Time to urethroplasty was defined as the period between injury and delayed urethroplasty. Clinical data regarding the status of urethral stenosis, urethroplasty procedure, and treatment outcome were analyzed. Results The mean time to urethroplasty in the PR group was about 3 times than that in the SPT group (133 months vs 47 months, P = .035). Fifty percent of the PR group (7 of 14) had a history of repeated urethrotomy or dilation before referral, a percentage significantly higher than that of the SPT group (20.4%, 10 of 49, P = .027). The percentage of patients having a false passage and iatrogenic scar was significantly higher in the PR group (42.9% vs 16.3%, P = .035), but there was no significant between-group difference in urethral stenosis length, operative time, operative blood loss, or the percentage of patients requiring inferior pubectomy or urethral rerouting. Conclusion PR does not facilitate delayed urethroplasty, and patients who undergo PR are at high risk of having a more complicated stenosis and longer time to urethroplasty, presumably because of repeated transurethral procedures.
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- 2017
172. PD60-03 PRE- AND POST-TREATMENT URETHROGRAMS SHOW THAT TRANSURETHRAL TREATMENTS INCREASE THE COMPLEXITY OF URETHRAL STRICTURES
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Keiichi Ito, Akio Horiguchi, Masayuki Shinchi, Ryuichi Azuma, and Tomohiko Asano
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medicine.medical_specialty ,business.industry ,Urology ,Medicine ,business ,Pre and post ,Surgery - Published
- 2017
173. STAT3 inhibition by WP1066 suppresses the growth and invasiveness of bladder cancer cells
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Tomohiko Asano, Akio Horiguchi, Yoshine Mayumi, Toshihiro Kushibiki, Shinsuke Tasaki, Yujiro Tsujita, Keiichi Ito, Makoto Isono, and Takako Asano
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0301 basic medicine ,STAT3 Transcription Factor ,Cancer Research ,Angiogenesis ,Pyridines ,Cell ,Apoptosis ,Biology ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Cell Line, Tumor ,medicine ,Biomarkers, Tumor ,Humans ,Neoplasm Invasiveness ,Cell Proliferation ,Matrigel ,Bladder cancer ,Oncogene ,Cell growth ,General Medicine ,Cell cycle ,Tyrphostins ,medicine.disease ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,Urinary Bladder Neoplasms ,030220 oncology & carcinogenesis ,Cancer research ,Signal Transduction - Abstract
Signal transducer and activator of transcription 3 (STAT3) regulates the expression of genes mediating cell survival, proliferation and angiogenesis and is aberrantly activated in various types of malignancies, including bladder cancer. We examined whether it could be a novel therapeutic target for bladder cancer using the STAT3 inhibitor WP1066. In T24 and UMUC-3 bladder cancer cells, 5 µM WP1066 prevented the phosphorylation of STAT3 and 2.5 µM WP1066 decreased cell survival and proliferation significantly (P
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- 2017
174. MP16-07 USEFULNESS OF INFLAMMATORY MARKER DYNAMICS ONE MONTH AFTER THE FIRST-LINE TARGETED THERAPY INITIATION FOR PFS PREDICTION IN PATIENTS WITH METASTATIC CLEAR CELL RENAL CELL CARCINOMA
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Shuji Mikami, Tsuyoshi Masuda, Tetsuo Monma, Mototsugu Oya, Masayuki Hagiwara, Kent Kanao, Yujiro Ito, Nobuyuki Tanaka, Suguru Shirotake, Yasumasa Miyazaki, Ryuichi Mizuno, Masafumi Oyama, Yota Yasumizu, Tomohiko Asano, Keiichi Ito, Ayako Masunaga, and Ken Nakagawa
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Oncology ,medicine.medical_specialty ,business.industry ,Urology ,First line ,medicine.medical_treatment ,medicine.disease ,Targeted therapy ,Clear cell renal cell carcinoma ,Inflammatory marker ,Internal medicine ,medicine ,In patient ,business - Published
- 2017
175. PD29-10 PREDICTION OF THE TYPE OF URETHROPLASTY FOR PELVIC FRACTURE URETHRAL INJURY BY PUBO-URETHRAL STUMP ANGLE MEASURED ON PREOPERATIVE MRI
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Shigeyoshi Soga, Hiromi Edo, Tomohiko Asano, Ryuichi Azuma, Keiichi Ito, Masayuki Shinchi, Akio Horiguchi, and Hiroshi Shinmoto
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Urethral injury ,medicine.medical_specialty ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,medicine ,Pelvic fracture ,business ,medicine.disease ,Surgery - Published
- 2017
176. MP67-11 THE IMPACT OF MODIFIED INTERNATIONAL METASTATIC RENAL CELL CARCINOMA DATABASE CONSORTIUM MODEL USING A TWO-STEP STRATIFICATION PROCESS
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Suguru Shirotake, Hideyuki Kondo, Keiichi Ito, Nobuyuki Tanaka, Mototsugu Oya, Masafumi Oyama, Yota Yasumizu, Kent Kanao, and Koshiro Nishimoto
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Oncology ,medicine.medical_specialty ,business.industry ,Renal cell carcinoma ,Urology ,Internal medicine ,Two step ,medicine ,Stratification (water) ,business ,medicine.disease - Published
- 2017
177. Pilot Study of Prostate Cancer Angiogenesis Imaging Using a Photoacoustic Imaging System
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Hitoshi Tsuda, Akiko Nakamura, Keiichi Ito, Takatsugu Wada, Miya Ishihara, Masayuki Shinchi, Tomohiko Asano, Hiroshi Shinmoto, and Akio Horiguchi
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0301 basic medicine ,Male ,Pathology ,medicine.medical_specialty ,Prostate biopsy ,Angiogenesis ,Urology ,medicine.medical_treatment ,Pilot Projects ,Neovascularization ,Photoacoustic Techniques ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine ,Humans ,Aged ,Retrospective Studies ,Ultrasonography ,Prostatectomy ,medicine.diagnostic_test ,Neovascularization, Pathologic ,business.industry ,Ultrasound ,Prostate ,Prostatic Neoplasms ,Reproducibility of Results ,Equipment Design ,Middle Aged ,medicine.disease ,Peripheral ,Intensity (physics) ,030104 developmental biology ,030220 oncology & carcinogenesis ,Microvessels ,medicine.symptom ,business - Abstract
Objectives To investigate a link between the appearance of photoacoustic imaging (PAI) and microvasculature in prostate cancer and to assess the feasibility of PAI for angiogenesis imaging in prostate cancer. Methods We have developed a PAI system equipped with a transrectal ultrasound (TRUS)-type probe. Three patients who underwent PAI just before prostate biopsy and subsequently underwent radical prostatectomy were included. The PAI appearance was retrospectively reviewed, and in each patient, 4 representative areas were selected: 1 with high PAI signal intensity, 1 with low PAI signal intensity, 1 peripheral to the index tumor, and 1 inside the index tumor. The correlation of PAI intensity with 3 microvascular parameters—microvascular density, total vascular area (TVA), and total vascular length (TVL)—assessed by CD34-immunostaining in resected specimens was analyzed. Results In all 3 patients the PAI intensity, TVA, and TVL in areas with high-intensity PAI signals were significantly higher than those in areas with low-intensity PAI signals, suggesting that PAI appearance describes the distribution of microvasculature in prostatic tissue correctly. All index tumors showed a ring-like PAI appearance consisting of a peripheral area of high signal intensity completely or partially surrounding an area with low signal intensity. The PAI intensity, TVA, and TVL in the periphery of the index tumors were significantly higher than those inside of the index tumors. Conclusion The intensity of PAI signals might reflect the microvascularity in normal prostatic tissues and index tumors. PAI could be a novel modality for imaging prostate cancer angiogenesis.
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- 2017
178. Continuous cell supply from Krt7-expressing hematopoietic stem cells during native hematopoiesis revealed by targeted in vivo gene transfer method
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Satoshi Yamazaki, Keiichi Ito, Yoko Tajima, Adam C. Wilkinson, Ayumi Umino, and Hiromitsu Nakauchi
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0301 basic medicine ,Genotype ,Genetic Vectors ,Cell ,Gene Expression ,Mice, Transgenic ,Stem cell factor ,Biology ,Article ,Cell Line ,Mice ,03 medical and health sciences ,Genes, Reporter ,medicine ,Animals ,Humans ,Cell Lineage ,Multidisciplinary ,Keratin-7 ,Lentivirus ,Gene Transfer Techniques ,Hematopoietic stem cell ,Gene targeting ,Hematopoietic Stem Cells ,Molecular biology ,Hematopoiesis ,Cell biology ,Transplantation ,Haematopoiesis ,030104 developmental biology ,medicine.anatomical_structure ,Cell culture ,Gene Targeting ,Stem cell - Abstract
The nature of hematopoietic stem cells under normal hematopoiesis remained largely unknown due to the limited assays available to monitor their behavior in situ. Here, we develop a new mouse model to transfer genes specifically into the primitive hematopoietic stem cell compartment through the utilization of a modified Rcas/TVA system. We succeeded in transferring a GFP reporter gene into adult hematopoietic stem cells in vivo, which are predominantly quiescent, by generating pseudotyped-lentivirus. Furthermore, we demonstrate the utility of this system to study neonatal hematopoiesis, a developmental stage that has been difficult to analyze to date. Using the system developed in this study, we observed continuous multi-lineage hematopoietic cell supply in peripheral blood from Krt7-positive hematopoietic stem cells during unperturbed homeostatic condition. This powerful experimental system could provide a new standard tool to analyze hematopoiesis under physiological condition without transplantation.
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- 2017
179. Forthcoming Drugs for Metastatic Renal Cell Carcinoma Therapy
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Keiichi Ito
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Drug ,Oncology ,medicine.medical_specialty ,business.industry ,medicine.drug_class ,media_common.quotation_subject ,Drug resistance ,urologic and male genital diseases ,medicine.disease ,mTORC2 ,female genital diseases and pregnancy complications ,Tyrosine-kinase inhibitor ,Renal cell carcinoma ,Internal medicine ,medicine ,Cancer research ,business ,Adverse effect ,Tyrosine kinase ,PI3K/AKT/mTOR pathway ,media_common - Abstract
The development of tyrosine kinase inhibitors (TKIs) and inhibitors of mammalian target of rapamycin (mTOR) have led to great progress in the treatment of advanced renal cell carcinoma (RCC). However, in most cases, RCC cells eventually develop drug resistance or drug treatments are stopped because of their adverse events (AEs).
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- 2017
180. Clinical significance of p21-activated kinase 1 expression level in patients with upper urinary tract urothelial carcinoma
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Yujiro Tsujita, Makoto Isono, Tomohiko Asano, Keiichi Ito, Akinori Sato, Kenji Seguchi, Akio Horiguchi, Junichi Asakuma, Kenji Kuroda, and Takako Asano
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Adult ,Male ,Urologic Neoplasms ,Cancer Research ,Pathology ,medicine.medical_specialty ,Lymphovascular invasion ,Gene Expression Regulation, Enzymologic ,PAK1 ,Biomarkers, Tumor ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Clinical significance ,Urinary Tract ,Aged ,Upper urinary tract ,Carcinoma, Transitional Cell ,Kinase ,business.industry ,Histology ,General Medicine ,Middle Aged ,Prognosis ,Immunohistochemistry ,Gene Expression Regulation, Neoplastic ,p21-Activated Kinases ,Oncology ,T-stage ,Female ,Neoplasm Recurrence, Local ,Urothelium ,business - Abstract
Objective: The p21-activated kinase serine/threonine kinases have been outlined as the main cytoskeletal remolding regulators. The same holds true for cell proliferation and motility. They additionally have a part in cellular invasion and carcinogenesis, but the effect of p21-activated kinase 1 expression on the progression of upper urinary tract urothelial carcinoma remains unclear. Therefore, we assessed the relation of p21-activated kinase 1 positivity level to clinicopathological features in patients with upper urinary tract urothelial carcinoma. Methods: Immunohistochemical staining was performed using formalin-fixed and paraffin-embedded specimens, which were all from 124 patients with upper urinary tract urothelial carcinoma. The determination of staining level was based on the intensity of the staining along with portion of cells stained. Correlation of p21-activated kinase 1 positivity with clinicopathological parameters, including disease-specific or extravesical-recurrence-free survival, was evaluated. Results: Statistically significant association was observed between moderate or more than moderate p21-activated kinase 1 positivity and higher tumor grade, pathological T stage, lymphovascular invasion, history of adjuvant chemotherapy and extravesical recurrence. Positivity for p21-activated kinase 1 had a significant association with shortened disease-specific survival in a multivariate analysis among clinicopathological parameters. Strongly positive p21-activated kinase 1 expression was also one of the independent factors for shortened extravesical-recurrence-free survival time in N0M0 upper urinary tract urothelial carcinoma patients in another multivariate analysis as well as histology and lymphovascular invasion (P= 0.0304, hazard ratio = 4.425). Conclusions: We conclude that our findings can help us continue a careful follow-up for upper urinary tract urothelial carcinoma patients with high p21-activated kinase 1 expression in surgical specimens.
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- 2014
181. The increasing impact of a higher body mass index on the decrease in plasma B-type natriuretic peptide levels
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Satoshi Arase, Michihiro Yoshimura, Keiichi Ito, Takayuki Ogawa, Kimiaki Komukai, Kosuke Minai, Makoto Kawai, Kazuo Ogawa, and Tokiko Nakane
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medicine.medical_specialty ,Obesity paradox ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,New york heart association ,Physiology (medical) ,Internal medicine ,Natriuretic peptide ,medicine ,In patient ,cardiovascular diseases ,Plasma B-type natriuretic peptide ,Body mass index ,business.industry ,nutritional and metabolic diseases ,New York Heart Association (NYHA) functional classification ,medicine.disease ,Endocrinology ,Heart failure ,Distribution pattern ,NYHA classification ,cardiovascular system ,Cardiology ,Cardiology and Cardiovascular Medicine ,business ,human activities ,hormones, hormone substitutes, and hormone antagonists ,circulatory and respiratory physiology - Abstract
Background Plasma B-type natriuretic peptide (BNP) levels are increased in patients with heart failure and are negatively correlated with body mass index (BMI). However, the effects of BMI in decreasing the plasma BNP levels have not been examined among patients in different BMI categories. Methods 676 consecutive patients were divided into groups according to their BMI and heart failure grade. We examined the relationship between plasma BNP level and BMI in patients who were admitted to our cardiovascular unit. Results There were significant differences, not only in the mean plasma BNP level, but also in the distribution pattern of the plasma BNP levels between the low- and high-BMI groups. The plasma BNP levels were negatively correlated with the BMI values in each group stratified by the New York Heart Association (NYHA) class (I, II and III+IV); however, the regression line was steeper for the higher NYHA classification, and the plasma BNP levels remained low in patients with a high BMI, even in the NYHA III+IV group. Conclusions BMI is a significant factor that reduces the plasma BNP level. This impact is significantly increased in patients with a high BMI, even among those with a worsening severity of heart failure.
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- 2014
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182. Erythropoietin production in renal cell carcinoma and renal cysts in autosomal dominant polycystic kidney disease in a chronic dialysis patient with polycythemia: A case report
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Tomohiko Asano, Takako Asano, Keiichi Ito, Hidehiko Yoshii, Susumu Tominaga, and Harutake Sawazaki
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renal cell carcinoma ,Cancer Research ,Pathology ,medicine.medical_specialty ,Anemia ,medicine.medical_treatment ,Autosomal dominant polycystic kidney disease ,Urology ,Hematocrit ,urologic and male genital diseases ,Renal cell carcinoma ,hemic and lymphatic diseases ,medicine ,Cyst ,Kidney ,autosomal dominant polycystic kidney disease ,medicine.diagnostic_test ,business.industry ,Articles ,medicine.disease ,Nephrectomy ,medicine.anatomical_structure ,Oncology ,Erythropoietin ,polycythemia ,immunohistochemistry ,erythropoietin ,business ,medicine.drug - Abstract
In patients undergoing chronic hemodialysis (HD), erythropoietin (EPO) production from the kidney generally decreases and renal anemia develops. Patients without anemia, but with high serum EPO (sEPO) levels are rare among HD patients. The current study presents the case of a 67-year-old female HD patient with autosomal dominant polycystic kidney disease (ADPKD) and renal cell carcinoma (RCC), manifesting polycythemia with elevated sEPO levels. A radical nephrectomy was performed, which diminished the polycythemia, but the sEPO levels remained high. To determine the origin of the EPO production, immunohistochemistry was performed to detect EPO in the RCC and the renal cysts of the surgically resected kidney. In addition, the sEPO and EPO levels in a renal cyst were determined by enzyme immunoassay. EPO expression was demonstrated in RCC and cyst epithelial cells using immunohistochemistry, revealing extremely high EPO levels in the cyst fluid. Due to the remission of polycythemia following the nephrectomy, EPO production from the resected kidney appeared to have been the cause of the polycythemia. Positive EPO staining of the renal cysts in the resected polycystic kidney and sustained sEPO elevation following nephrectomy led to the hypothesis of EPO production in the renal cysts of the contralateral polycystic kidney. Although the postoperative EPO level was higher than the normal range, the hematocrit (Hct) level gradually decreased and recombinant human EPO was required again three months following the nephrectomy. Eight months after the nephrectomy, the Hct level was 30.2% with the use of rHuEPO. In conclusion, EPO production from RCC and renal cysts in ADPKD appeared to cause polycythemia in the HD patient.
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- 2014
183. Preconditioning actions of aldosterone through p38 signaling modulation in isolated rat hearts
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Ryuko Anzawa, Keiichi Ito, Taro Date, Masami Fujisaki, Yusuke Kashiwagi, Kenichi Hongo, Takuya Yoshino, Yosuke Kayama, Tomohisa Nagoshi, Michihiro Yoshimura, and Daisuke Katoh
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Male ,Cardiac function curve ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Ischemia ,Hemodynamics ,Myocardial Reperfusion Injury ,Stimulation ,Spironolactone ,p38 Mitogen-Activated Protein Kinases ,chemistry.chemical_compound ,Endocrinology ,Mineralocorticoid receptor ,Internal medicine ,medicine ,Animals ,Rats, Wistar ,Aldosterone ,biology ,business.industry ,Myocardium ,Heart ,medicine.disease ,Eplerenone ,Rats ,Perfusion ,chemistry ,Ischemic Preconditioning, Myocardial ,biology.protein ,Creatine kinase ,business ,Signal Transduction ,medicine.drug - Abstract
Although persistent excessive actions of aldosterone have unfavorable effects on the cardiovascular system, primarily via mineralocorticoid receptor (MR)-dependent pathways, the pathophysiological significance of aldosterone cascade activation in heart diseases has not yet been fully clarified. We herein examined the effects of short-term aldosterone stimulation at a physiological dose on cardiac function during ischemia–reperfusion injury (IRI). In order to study the effects of aldosterone preconditioning, male Wistar rat Langendorff hearts were perfused with 10−9 mol/l of aldosterone for 10 min before ischemia, and the response to IRI was assessed. Although aldosterone did not affect the baseline hemodynamic parameters, preconditioning actions of aldosterone significantly improved the recovery in left ventricular contractility and left ventricular end-diastolic pressure associated with a reduced activity of creatine phosphokinase released into the perfusate after ischemia–reperfusion. Notably, the MR inhibitor eplerenone did not abrogate these beneficial effects. Biochemical analyses revealed that p38MAPK phosphorylation was significantly increased during aldosterone preconditioning before ischemia, whereas its phosphorylation was substantially attenuated during sustained ischemia–reperfusion, compared with the results for in the non-preconditioned control hearts. This dual regulation of p38MAPK was not affected by eplerenone. The phosphorylation levels of other MAPKs were not altered by aldosterone preconditioning. In conclusion, the temporal induction of the aldosterone cascade, at a physiological dose, has favorable effects on cardiac functional recovery and injury following ischemia–reperfusion in a MR-independent manner. Phasic dynamism of p38MAPK activation may play a key role in the physiological compensatory pathway of aldosterone under severe cardiac pathological conditions.
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- 2014
184. Corticosteroids increase intracellular free sodium ion concentration via glucocorticoid receptor pathway in cultured neonatal rat cardiomyocytes
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Michihiro Yoshimura, Taro Date, Makoto Kawai, Takuya Yoshino, Kenichi Hongo, Yosuke Kayama, Daisuke Katoh, and Keiichi Ito
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Cardiomyocytes ,medicine.medical_specialty ,Aldosterone ,medicine.drug_class ,Glucocorticoid receptor ,Hypertrophy ,Biology ,Intracellular sodium ,chemistry.chemical_compound ,Endocrinology ,Mineralocorticoid receptor ,Downregulation and upregulation ,chemistry ,Corticosterone ,Mineralocorticoid ,Internal medicine ,medicine ,Corticosteroids ,Original Article ,Cardiology and Cardiovascular Medicine ,Glucocorticoid ,Intracellular ,medicine.drug - Abstract
Background Glucocorticoids as well as mineralocorticoid have been shown to play essential roles in the regulation of electrical and mechanical activities in cardiomyocytes. Excess of these hormones is an independent risk factor for cardiovascular disease. Intracellular sodium ([Na + ] i ) kinetics are involved in cardiac diseases, including ischemia, heart failure and hypertrophy. However, intrinsic mediators that regulate [Na + ] i in cardiomyocytes have not been widely discussed. Moreover, the quantitative estimation of altered [Na + ] i in cultured cardiomyocytes and the association between the level of [Na + ] i and the severity of pathological conditions, such as hypertrophy, have not been precisely reported. Methods and results We herein demonstrate the quantitative estimation of [Na + ] i in cultured neonatal rat cardiomyocytes following 24 h of treatment with corticosterone, aldosterone and dexamethasone. The physiological concentration of glucocorticoids increased [Na + ] i up to approximately 2.5 mM (an almost 1.5-fold increase compared to the control) in a dose-dependent manner; this effect was blocked by a glucocorticoid receptor (GR) antagonist but not a mineralocorticoid receptor antagonist. Furthermore, glucocorticoids induced cardiac hypertrophy, and the hypertrophic gene expression was positively and significantly correlated with the level of [Na + ] i . Dexamethasone induced the upregulation of Na + /Ca 2 + exchanger 1 at the mRNA and protein levels. Conclusions The physiological concentration of glucocorticoids increases [Na + ] i via GR. The dexamethasone-induced upregulation of NCX1 is partly involved in the glucocorticoid-induced alteration of [Na + ] i in cardiomyocytes. These results provide new insight into the mechanisms by which glucocorticoid excess within a physiological concentration contributes to the development of cardiac pathology.
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- 2014
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185. Preoperative Risk Factors for Extraurothelial Recurrence in Patients with Ureteral Cancer Treated with Radical Nephroureterectomy
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Kenji Seguchi, Akinori Sato, Kazuyoshi Tachi, Tomohiko Asano, Akio Horiguchi, Shinsuke Hamada, Junichi Asakuma, Keiichi Ito, Kenji Kuroda, and Shinsuke Tasaki
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Male ,medicine.medical_specialty ,Time Factors ,Urology ,urologic and male genital diseases ,Nephrectomy ,Risk Assessment ,Carcinoembryonic antigen ,Japan ,Risk Factors ,medicine ,Humans ,Neutrophil to lymphocyte ratio ,Lymph node ,Ureteral neoplasm ,Aged ,Retrospective Studies ,Carcinoma, Transitional Cell ,biology ,Ureteral Neoplasms ,urogenital system ,business.industry ,Incidence ,Cancer ,Ureteral cancer ,Prognosis ,medicine.disease ,Surgery ,Dissection ,medicine.anatomical_structure ,Lymphatic Metastasis ,Preoperative Period ,biology.protein ,Lymph Node Excision ,Female ,CA19-9 ,Radiology ,Neoplasm Recurrence, Local ,Ureter ,business ,Follow-Up Studies - Abstract
Recent studies have suggested that lymph node dissection may improve the prognosis in patients with upper tract urothelial carcinoma. Therefore, patients who will benefit from lymph node dissection need to be selected before surgery. Because patients who have extraurothelial recurrence theoretically include those whose prognoses are improved by lymph node dissection, we conducted this study to determine the preoperative predictors of extraurothelial recurrence in patients with ureteral cancer.Because it is not appropriate to categorize the preoperative radiologic findings of ureteral cancer and those of renal pelvic cancer using the same classification criteria, we focused on ureteral cancer. We reviewed preoperative factors in 70 patients with ureteral cancer treated with radical nephroureterectomy. Laboratory tests including inflammatory indices, tumor markers and estimated glomerular filtration rate, along with radiologic findings, were evaluated. Multivariate analyses were performed to determine independent factors predicting extraurothelial recurrence in patients with ureteral cancer.Positive cytology, cT stage 3 or greater, length of ureteral cancer 3 cm or greater and estimated glomerular filtration rate less than 60 ml/minute/1.73 m2 were independent predictors of extraurothelial recurrence on multivariate analysis. When patients were stratified into 3 groups according to the number of risk factors, the 3-year extraurothelial recurrence-free survival rates were 95.2% in the low risk group, 75.8% in the intermediate risk group and 25.1% in the high risk group.Positive cytology, cT stage 3 or greater, length of ureteral cancer 3 cm or greater and estimated glomerular filtration rate less than 60 ml/minute/1.73 m2 were preoperative predictive factors of extraurothelial recurrence in patients with ureteral cancer and lymph node dissection may be omitted for low risk patients.
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- 2014
186. Prognostic Impact of Fatty Acid Synthase Expression in Upper Urinary Tract Urothelial Carcinoma
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Akio Horiguchi, Kosuke Miyai, Keiichi Ito, Takako Asano, Kenji Kuroda, Keiichi Iwaya, Junichi Asakuma, Shinsuke Hamada, and Tomohiko Asano
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Adult ,Male ,Urologic Neoplasms ,Cancer Research ,Pathology ,medicine.medical_specialty ,Gastroenterology ,Gene Expression Regulation, Enzymologic ,Predictive Value of Tests ,Internal medicine ,Biomarkers, Tumor ,Adjuvant therapy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Pathological ,Aged ,Upper urinary tract ,Carcinoma, Transitional Cell ,biology ,ATP synthase ,business.industry ,Cancer ,General Medicine ,Middle Aged ,Prognosis ,medicine.disease ,Fatty Acid Synthase, Type I ,Gene Expression Regulation, Neoplastic ,Fatty acid synthase ,Oncology ,Cancer cell ,biology.protein ,Female ,Neoplasm Recurrence, Local ,Antibody ,business - Abstract
Objective: Fatty acid synthase has been shown to be highly expressed in various types of cancers with increased tumour aggressiveness. In this study we examined the level of fatty acid synthase expression in surgically resected upper urinary tract urothelial carcinoma specimens and evaluated the relations between fatty acid synthase expression and the patients’ pathological features and clinical outcomes. Methods: Sections of paraffin-embedded tumour specimens from 113 patients who underwent surgical treatment for upper urinary tract urothelial carcinoma were immunostained with a polyclonal fatty acid synthase antibody, and a tumour was considered to have high fatty acid synthase expression if .50% of the cancer cells stained with moderate-to-strong intensity. Associations between fatty acid synthase expression and the patients’ pathological parameters and survival were analyzed statistically. Results: During the follow-up time (median: 46.8 months), 61 patients (54.0%) had recurrence and 17 (15.0%) died of upper urinary tract urothelial carcinoma. High fatty acid synthase expression was significantly associated with high tumour grade (P ¼ 0.0273). Patients with high fatty acid synthase expression had significantly worse recurrence-free survival and extravesicalrecurrence-free survival than those with low fatty acid synthase expression (P ¼ 0.0171, P ¼ 0.0228, respectively). In multivariate analysis, high fatty acid synthase expression was an independent predictor of shortened recurrence-free survival (P ¼ 0.0220, hazard ratio (HR) ¼ 1.970). Conclusions: Fatty acid synthase expression in upper urinary tract urothelial carcinoma is an independent predictor for tumour recurrence. Patients with high fatty acid synthase expression in upper urinary tract urothelial carcinoma should be followed carefully and adjuvant therapy for them should be considered.Keywords: fatty acid synthase, upper urinary tract urothelial carcinoma, prognosis
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- 2014
187. Abstract 5237: Development of a gene expression database of renal cell carcinoma cases by NGS-combined HiCEP to identify tumor markers
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Makoto Kawaguchi, Hirotaka Matsuo, Ryoko Araki, Seiko Shimizu, Mikiya Takao, Akiyoshi Nakayama, Yosuke Kitamura, Masumi Abe, Keiichi Ito, and Nariyoshi Shinomiya
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Cancer Research ,Oncology - Abstract
Objectives: High coverage expression profiling (HiCEP) is an AFLP-based comprehensive gene expression analysis technique invented in Japan. HiCEP has two unique characteristics. First, it can detect low amounts of mRNA with high sensitivity and reliability. Second, HiCEP enables highly quantitative and reproducible mRNA expression analyses. However, it requires complicated processes, including TA cloning of isolated transcripts, to obtain sequence information on detected peaks. We performed next-generation sequencing (NGS)-combined HiCEP and tried to establish a gene expression database of renal cell carcinoma (RCC) cases to identify effective tumor markers. Materials and methods: We collected cancerous and macroscopically non-cancerous regions from 83 RCC cases. Of these, six cases with clear cell RCC were analyzed by HiCEP. Total RNA was extracted from the cancerous and non-cancerous tissues of six clear cell RCC cases, and transcribed to cDNA. The cDNA was synthesized and subjected to digestion with the restriction enzymes MspI or MseI, followed by adapter ligation. Selective PCR by 256 kinds of primer pairs was used to amplify the HiCEP fragments, and products with fluorescently-labeled primer were then analyzed by capillary electrophoresis. HiCEP fragments were sequenced using a next-generation sequencer (ion PGM, Thermo Fisher Scientific). We compared the expression levels of HiCEP peaks in cancerous tissues with those in non-cancerous tissues. Results: We detected several HiCEP peaks in cancerous tissues that showed five times higher expression than in normal tissues. We determined the sequences of the HiCEP fragments by NGS, and developed the first ever cancerous tissue HiCEP fragment database. Conclusion: We successfully established an RCC gene expression database by NGS-combined HiCEP. We are now performing replication analyses and further analyses of blood samples from the same RCC cases to be able to identify diagnostic and prognostic markers of RCC. Citation Format: Makoto Kawaguchi, Hirotaka Matsuo, Ryoko Araki, Seiko Shimizu, Mikiya Takao, Akiyoshi Nakayama, Yosuke Kitamura, Masumi Abe, Keiichi Ito, Nariyoshi Shinomiya. Development of a gene expression database of renal cell carcinoma cases by NGS-combined HiCEP to identify tumor markers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 5237.
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- 2019
188. The role of adjuvant chemotherapy for pT2-4 upper urinary tract urothelial cancer: Exploratory analysis of large multi-institutional study (JCOG1110A)
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Kentaro Kuroiwa, Hiroyuki Nishiyama, Osamu Ogawa, Hiroyuki Fujimoto, Chikara Ohyama, Keiichi Ito, Toshiki Tanikawa, Seiji Naito, Momokazu Gotoh, Junki Mizusawa, Junko Eba, Akito Yamaguchi, Takahiro Kojima, Naoya Masumori, Masatoshi Eto, Yoshiyuki Kakehi, Mikio Sugimoto, Tomohiko Ichikawa, Hideyasu Matsuyama, and Junichi Inokuchi
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Cancer Research ,medicine.medical_specialty ,Oncology ,business.industry ,Adjuvant chemotherapy ,Urology ,Medicine ,Urothelial cancer ,Exploratory analysis ,urologic and male genital diseases ,business ,Upper urinary tract - Abstract
374 Background: Recently, it was presented that adjuvant chemotherapy (AC) after radical nephroureterectomy (RNU) improved metastasis-free survival in pT2-4 upper urinary tract urothelial cancer (UTUC) with a median follow-up of 17.6 months (POUT study). However, the impact of AC on other outcomes remains unclear, especially for pT2 disease. Methods: The large case-series study, JCOG1110A, included 2,744 patients with non-metastatic UTUC who underwent RNU in 30 institutions in Japan between 1995 and 2009. In this analysis, patients with prior history or synchronous bladder cancer, patients who received neoadjuvant chemotherapy were excluded. Patients who received AC except for GC (gemcitabine, cisplatin) or MVAC (methotrexate, vinblastine, doxorubicin, cisplatin) were also excluded. We extracted pT2-4 patients as study subjects from remaining patients, and identified 950 patients. The impact of AC on overall survival (OS) and extravesical recurrence-free survival (RFS) were examined by the multivariable Cox regression model in all patient and pT2, pT3-4 subgroups. Results: Of 244 pT2 and 706 pT3-4 patients with a median follow-up of 41.1 months, AC were performed in 34 (13.9%) and 183 (25.9%). In AC (+) group, high frequency of pT3-4 disease, high grade tumor, pathological node metastasis, lymphovascular invasion, and younger age were seen compared to AC (-) group. The 5-year survival of the AC (+) and AC (-) were 66.0% and 67.4% for OS, 58.0% and 57.8% for RFS, respectively. Multivariable analysis showed the improved outcome in AC (+) group on both OS and RFS in all patients (OS: HR 0.60, 95% CI 0.41-0.89, RFS: HR 0.71, 95% CI 0.51-1.00). Although AC had a great impact on OS in pT3-4 patients (HR 0.56, 95% CI 0.36-0.87), there was no clear impact on either OS or RFS in pT2 patients (OS: HR 0.81, 95% CI 0.32-2.07, RFS: HR 0.69, 95% CI 0.29-1.62). Conclusions: AC after RNU had the significant impacts on OS and RFS in pT2-4 UTUC patients. This tendency was seen strongly in pT3-4 patients, but not in only pT2 patients. The randomized trial is necessary to determine the utility of AC in UTUC patients, especially in pT2 patients. Clinical trial information: NCT01993979.
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- 2019
189. Development of modified IMDC model for metastatic renal cell carcinoma patients
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Takeo Kosaka, Masafumi Oyama, G. Kaneko, Nobuyuki Tanaka, Keiichi Ito, Mototsugu Oya, Suguru Shirotake, and Koshiro Nishimoto
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Renal cell carcinoma ,business.industry ,Urology ,medicine ,Cancer research ,medicine.disease ,business - Published
- 2019
190. Mesenchymal progenitor cells in mouse foetal liver regulate differentiation and proliferation of hepatoblasts
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Ayaka Yanagida, Yuji Yamazaki, Akihide Kamiya, Keiichi Ito, Hiromitsu Nakauchi, and Ken Okada
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Green Fluorescent Proteins ,Cell Culture Techniques ,Mice, Transgenic ,Pleiotrophin ,Colony-Forming Units Assay ,Mice ,Fetus ,Cell–cell interaction ,medicine ,Animals ,Progenitor cell ,Cell Proliferation ,Midkine ,Hepatology ,Cluster of differentiation ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,Mesenchymal stem cell ,Gene Expression Regulation, Developmental ,Cell Differentiation ,Mesenchymal Stem Cells ,Flow Cytometry ,Molecular biology ,Cell biology ,Mice, Inbred C57BL ,Liver ,Cell culture ,Hepatocytes ,biology.protein ,Hepatocyte growth factor ,medicine.drug - Abstract
Background & aims Hepatoblasts are somatic progenitor cells of the foetal liver that possess high proliferative capacity and bi-potency for differentiation into both hepatocytes and cholangiocytes. Although mesenchymal cells are known to be important for liver ontogeny, current understanding of their interaction with hepatoblasts remains obscure. Mesenchymal cell populations in the developing liver were purified and their potential to support proliferation and differentiation of hepatoblasts was examined. Methods Foetal liver cells were fractionated with a flow cytometer using antibodies against cell surface markers. Gene expression of mesenchymal-specific transcripts and morphological characteristics were analysed. The ability of the mesenchymal cells to support hepatoblast function was analysed using a transwell and direct coculture system. Results CD45(-) Ter119(-) CD71(-) Dlk1(mid) PDGFRα(+) cells from the mid-foetal stage liver expressed the mesenchymal cell-specific transcription factors H2.0-like homeobox 1 and LIM homeobox 2 at high levels. Foetal mesenchymal cells make contact with hepatoblasts in vivo and possess the potential to differentiate into chondrocytes, osteocytes and adipocytes under appropriate cell culture conditions, indicating that these cells are possible candidates for mesenchymal stem/progenitor cells. Foetal mesenchymal cells expressed pleiotrophin, hepatocyte growth factor and midkine 1, which are involved in the growth of hepatoblasts. Using the coculture system with hepatoblasts and foetal mesenchymal cells, these cells were shown to support proliferation and maturation of hepatoblasts through indirect and direct interactions respectively. Conclusions Dlk1(mid) PDGFRα(+) cells in non-haematopoetic fraction derived from the foetal liver exhibit mesenchymal stem/progenitor cell characteristics and have abilities to support proliferation and differentiation of hepatoblasts.
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- 2013
191. Acquired Cystic Disease-Associated Renal Cell Carcinoma Extending to the Renal Pelvis Mimicking Urothelial Carcinoma on Computed Tomography (CT): Two Case Reports.
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Hiromi Edo, Yohsuke Suyama, Hiroaki Sugiura, Kenichiro Ojima, Keiichi Ito, Kosuke Miyai, Susumu Matsukuma, and Hiroshi Shinmoto
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RENAL cell carcinoma ,TRANSITIONAL cell carcinoma ,KIDNEY pelvis ,COMPUTED tomography ,MAGNETIC resonance imaging ,ADENOID cystic carcinoma - Abstract
Objective: Mistake in diagnosis. Background: Acquired cystic disease-associated renal cell carcinoma (ACD-associated RCC), which was added to the 2016 World Health Organization classification, is the most common subtype of RCC in patients undergoing longterm dialysis. ACD-associated RCC is underrecognized and reports of computed tomography (CT) and magnetic resonance imaging findings for the lesion are sparse. Similar to urothelial carcinoma, ACD-associated RCC is poorly to slightly enhanced on dynamic CT. Here, we report 2 cases of ACD-associated RCC filling the renal pelvis and mimicking urothelial carcinoma. Case Reports: We describe 2 cases of ACD-associated RCC filling the left renal pelvis in patients undergoing dialysis for more than 10 years. In both cases, the patient's chief complaint was hematuria, and a left renal pelvic mass with poor enhancement was seen on dynamic CT. In both cases, the preoperative diagnosis was urothelial carcinoma of the left renal pelvis. Total nephroureterectomy was performed, and the final diagnosis was ACD-associated RCC. Conclusions: ACD-associated RCC is a common tumor in patients undergoing long-term dialysis. When ACD-associated RCC is located in the renal pelvis, the imaging findings are similar to those of urothelial carcinoma. Therefore, it is important for radiologists to include ACD-associated RCC in the differential diagnosis. [ABSTRACT FROM AUTHOR]
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- 2020
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192. Analysis of Diffusion-weighted MR Images Based on a Gamma Distribution Model to Differentiate Prostate Cancers with Different Gleason Score.
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Hiroko Tomita, Shigeyoshi Soga, Yohsuke Suyama, Keiichi Ito, Tomohiko Asano, and Hiroshi Shinmoto
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GAMMA distributions ,MAGNETIC resonance imaging ,PROSTATE cancer ,PROSTATE biopsy ,PROSTATECTOMY - Abstract
Purpose: Prostate cancer management includes identification of clinically significant cancers that may require curative treatment. Statistical models based on gamma distribution can describe diffusion signal decay curves of prostate cancer. The purpose of this study was to evaluate the ability of parameters obtained with the gamma model in differentiating prostate cancers with different Gleason score values. Methods: This study included 155 patients with prostate cancer who underwent multiparametric magnetic resonance imaging prior to prostate biopsy (127 patients) or radical prostatectomy (28 patients) between January 2015 and June 2017; 159 foci of prostate cancer were included in our study. We compared cases scored as Gleason score (GS) 3 + 3 and GS ≥ 3 + 4, and analyzed cases scored as GS ≤ 3+ 4 and GS ≥ 4 + 3 based on the gamma model (Frac < 1.0, Frac < 0.8, Frac < 0.5, Frac < 0.3, and Frac > 3.0), and apparent diffusion coefficient (ADC). Results: Among 159 cancerous lesions in 155 patients, 13 (8.2%) were GS 3 + 3 prostate cancers, 51 (32.0%) were GS 3 + 4 prostate cancers, 30 (18.2%) were GS 4 + 3 cancers, and 65 (40.9%) were GS ≥ 4 + 4 cancers. Frac < 0.3, Frac < 0.5, Frac < 0.8, and Frac < 1.0 were significantly higher and ADC values were significantly lower in GS ≥ 4 + 3 cancers than in GS ≤ 3 + 4 cancers (P < 0.01, P < 0.01, P < 0.01, P = 0.01, and P < 0.01, respectively). With receiver operating characteristic (ROC) analysis, Frac < 0.3 and Frac < 0.5 had significantly greater area under the ROC curve for discriminating GS ≥ 4 + 3 cancers from GS ≤ 3 + 4 cancers than ADC (P = 0.03, P < 0.01, respectively). Conclusion: Frac < 0.3 and Frac < 0.5 showed higher diagnostic performance than ADC for differentiating GS ≥ 4 + 3 from GS ≤ 3 + 4 cancers. The gamma model may add additional value in discrimination of tumor grades. [ABSTRACT FROM AUTHOR]
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- 2020
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193. Unidirectional block on the mitral isthmus during radiofrequency application for perimitral atrial tachycardia
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Keiichi Inada, Michihiro Yoshimura, Ryohsuke Narui, Shin-ichi Tanigawa, Seigo Yamashita, Kenichi Sugimoto, Michifumi Tokuda, Taro Date, Seiichiro Matsuo, Mika Hioki, Teiichi Yamane, and Keiichi Ito
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Tachycardia ,medicine.medical_specialty ,Linear region ,lcsh:Diseases of the circulatory (Cardiovascular) system ,business.industry ,medicine.medical_treatment ,Catheter ablation ,Ablation ,lcsh:RC666-701 ,Internal medicine ,Perimitral tachycardia ,medicine ,Cardiology ,Left inferior pulmonary vein ,cardiovascular system ,Mitral isthmus ,Mitral annulus ,cardiovascular diseases ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Unidirectional conduction block ,Atrial tachycardia - Abstract
We present the case of a patient who developed regular, narrow QRS tachycardia after ablation for long-standing persistent atrial fibrillation. During the electrophysiological study, this tachycardia was diagnosed as macroreentrant atrial tachycardia circulating around the mitral annulus. Catheter ablation was performed to treat the tachycardia by targeting the linear region between the annulus and the left inferior pulmonary vein. Although linear radiofrequency application along the mitral isthmus (MI) line resulted in the termination of this tachycardia, a unidirectional conduction block was observed through the MI. Bidirectional conduction block was subsequently achieved by delivering supplemental radiofrequency energies at the gap on the MI.
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- 2013
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194. Elevated fatty acid synthase expression in prostate needle biopsy cores predicts upgraded Gleason score in radical prostatectomy specimens
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Kosuke Miyai, Tomohiko Asano, Keiichi Iwaya, Shinsuke Hamada, Akio Horiguchi, Kenji Kuroda, and Keiichi Ito
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Pathology ,medicine.medical_specialty ,Prostate biopsy ,medicine.diagnostic_test ,biology ,Prostatectomy ,business.industry ,Urology ,medicine.medical_treatment ,Odds ratio ,Fatty acid synthase ,medicine.anatomical_structure ,Oncology ,Prostate ,Biopsy ,medicine ,biology.protein ,T-stage ,business ,Immunostaining - Abstract
BACKGROUND We examined whether fatty acid synthase (FAS) expression in prostate biopsy cores had valuable information and could predict a Gleason score (GS) upgraded from biopsy to radical prostatectomy (RP) specimens. METHODS Immunostaining with a FAS antibody was performed on paraffin-embedded prostate biopsy cores with GS 5–6 obtained from 80 patients who subsequently underwent RP. The correlations between FAS expression and clinicopathological parameters, upgrading group, and clinicopathological parameters including FAS expression were analyzed. Logistic regression analysis was performed to identify a significant set of independent predictors for upgrading GS. RESULTS A total of 46 patients (57.5%) with biopsy GS 5–6 were upgraded to GS ≥7 at RP. FAS expression was significantly associated with clinical T stage (P = 0.0232) and positive core rate (P = 0.0245). Upgrading from biopsy GS 5–6 to GS ≥7 at RP was significantly associated with clinical T stage (P = 0.0337), positive core rate (P = 0.0262), and FAS expression (P
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- 2013
195. Characterization of sporadic acute hepatitis E and comparison of hepatitis E virus genomes in acute hepatitis patients and pig liver sold as food in Mie, Japan
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Hiroshi Okano, Hiroaki Okamoto, Kazushi Sugimoto, Hiroki Tanaka, Tatsunori Nakano, Tsutomu Nishizawa, Keiichi Ito, Yoshiaki Isono, Shigeo Nagashima, Makoto Kobayashi, Shigeru Ohmori, Yumi Oya, Masaharu Takahashi, and Tadashi Maegawa
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Hepatitis ,Hepatology ,Acute hepatitis E ,viruses ,virus diseases ,Biology ,medicine.disease ,Hepatitis E ,medicine.disease_cause ,Genome ,Virology ,digestive system diseases ,Infectious Diseases ,Hepatitis E virus ,Genotype ,medicine ,Pig liver ,Acute hepatitis - Abstract
Aim To characterize hepatitis E in Mie prefecture and to investigate whether raw pig liver sold as food in Mie is contaminated with hepatitis E virus (HEV) strains similar to those recovered from patients. Methods Seventeen patients with sporadic acute hepatitis E treated from 2004 to 2012 were studied. A total of 243 packages of raw pig liver from regional grocery stores were tested for the presence of HEV RNA. The partial genomic sequences of human and swine HEV isolates were determined and subjected to the phylogenetic analyses. Results The HEV isolates recovered from the 17 patients segregated into genotype 3 (n = 15) and genotype 4 (n = 2), and 15 genotype 3 isolates further segregated into 3e (n = 11) and 3b (n = 4). Pig liver specimens from 12 (4.9%) of the 243 packages had detectable HEV RNA. All 12 swine HEV isolates were grouped into genotype 3 (3a or 3b). Although no 3e strains were isolated from pig liver specimens, two 3b swine strains were 99.5–100% identical to two HEV strains recovered from hepatitis patients, within 412-nt partial sequences. Conclusion The 3e HEV was prevalent among hepatitis E patients. HEV RNA was detected in approximately 5% of pig liver sold as food. The presence of identical HEV strains between hepatitis patients and pig liver indicated that pigs play an important role as reservoirs for HEV in humans in Mie. Further studies are needed to clarify the source of 3e HEV in the animal and environmental reservoirs.
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- 2013
196. Modified posterior musculofascial plate reconstruction decreases the posterior vesicourethral angle and improves urinary continence recovery in patients undergoing laparoscopic radical prostatectomy
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Seguchi Kenji, Shinsuke Hamada, Shinsuke Tasaki, Tomohiko Asano, Junichi Asakuma, Akio Horiguchi, Akinori Sato, Kenji Kuroda, Keiichi Ito, and Hidehiko Yoshii
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Cancer Research ,medicine.medical_specialty ,Urinary continence ,Laparoscopic radical prostatectomy ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Articles ,Fascia ,Anastomosis ,Surgery ,Neck of urinary bladder ,Cystography ,Urethra ,medicine.anatomical_structure ,Oncology ,Suture (anatomy) ,medicine ,business - Abstract
The aim of this study was to evaluate the efficacy of our modified posterior musculofascial plate reconstruction (PMPR) procedure in laparoscopic radical prostatectomy (LRP). Prior to 2010, four operative procedures were used to expedite continence recovery: preserving the fascia covering the levator ani muscle, preserving the bladder neck, securing a functional urethral length by using a lateral-view dissection technique and suspending the vesicourethral anastomosis from the puboprostatic ligaments. Since February, 2010, a running suture between Denonvilliers' fascia (DF) and the median fibrous raphe (MFR, the fibrous tissue that lies immediately underneath the urethra) has also been used. In vesicourethral anastomosis, a double-armed running suture was performed. At the beginning of the anastomosis, the first stitches (at 1 and 11 o'clock positions on the bladder neck) were placed 1-2 cm dorsocephalad to the bladder neck (first through the seromuscular layer and then through the full thickness of the bladder neck). At the 5 and 7 o'clock positions of the urethra, the stitches were placed through the urethral mucosa as well as the the reconstructed musculofascial plate. The bladder shape was evaluated by postoperative cystography and the clinical results were compared between patients undergoing LRP without PMPR (group A) and those undergoing LRP with PMPR (group B). The cystograms demonstrated that the PMPR significantly shortened the vertical length of the bladder and significantly decreased the posterior vesicourethral angle. At 1, 3 and 6 months after LRP, the number of daily used pads was significantly lower in group B compared to that in group A and the time to achieve a pad-free status was significantly shorter in group B. Our modified PMPR procedure significantly improved the recovery of urinary continence following LRP and this improvement may be due in part to changes of the bladder shape.
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- 2013
197. Increased expression of α-actinin-4 is associated with unfavorable pathological features and invasiveness of bladder cancer
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Takako Asano, Hidehiko Yoshii, Masamichi Hayakawa, Tomohiko Asano, Akio Horiguchi, and Keiichi Ito
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Adult ,Male ,Cancer Research ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Blotting, Western ,Apoptosis ,Adenocarcinoma ,Biology ,Immunoenzyme Techniques ,Cystectomy ,Cell Movement ,Cell Adhesion ,Tumor Cells, Cultured ,medicine ,Humans ,Actinin ,Neoplasm Invasiveness ,RNA, Small Interfering ,Aged ,Cell Proliferation ,Neoplasm Staging ,Aged, 80 and over ,Muscle Neoplasms ,Bladder cancer ,Oncogene ,Cancer ,General Medicine ,Middle Aged ,Cell cycle ,Prognosis ,medicine.disease ,Molecular medicine ,Drug Combinations ,Urinary Bladder Neoplasms ,Oncology ,Cancer cell ,Carcinoma, Squamous Cell ,Cancer research ,Immunohistochemistry ,Female ,Proteoglycans ,Collagen ,Laminin ,Neoplasm Grading ,Neoplasm Recurrence, Local ,Carcinoma in Situ - Abstract
In the present study, the association between clinicopathological parameters and α-actinin-4 (ACTN4) expression in bladder cancer specimens was evaluated, and the functional role of ACTN4 in bladder cancer cells was investigated. Immunohistochemistry using anti-ACTN4 antibody was performed in bladder cancer specimens (53 superficial and 42 muscle-invasive cases) from 95 patients who underwent radical cystectomy (n=46) or transurethral resection (TUR) only (n=49). We divided the levels of ACTN4 expression into 2 groups (low or high) by comparing the staining intensity in each specimen with that of the vascular endothelial cells in the same specimen, and we evaluated the correlations between these levels and pathological parameters, recurrence and prognosis. We also investigated the effects of ACTN4 suppression by siRNA on the invasive ability and proliferation of T24 and KU19-19 cells. High ACTN4 expression was significantly associated with higher tumor grade and higher pT stage. In patients with superficial bladder cancer treated only by TUR, the rate of intravesical recurrence did not differ significantly between patients with high ACTN4 expression and patients with low ACTN4 expression. In patients who had muscle‑invasive tumors and underwent radical cystectomy, high ACTN4 expression was associated with neither recurrence nor poor prognosis. Nonetheless, high ACTN4 expression was shown by a large percentage (81%) of patients with muscle-invasive bladder cancer and by a small percentage (17%) of patients with superficial bladder cancer. Furthermore, the leading edges of the invasive bladder cancer showed increased ACTN4 expression. ACTN4 suppression significantly reduced the number of invading bladder cancer cells but unexpectedly increased the proliferation of bladder cancer cells. ACTN4 suppression increased the phosphorylation of ERKs but not AKT or STAT3, suggesting that the increased proliferation due to ACTN4 suppression was mediated in part by the ERK pathway. ACTN4 expression may suppress the proliferation of bladder cancer cells and may produce conditions which facilitate cancer cell invasion.
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- 2013
198. Malignant lymphoma of mucosa-associated lymphoid tissue involving the renal pelvis and the entire ureter: A case report
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Hideo Otsuki, Keiichi Ito, Takeo Kosaka, Ken-ichi Sato, Tatsumi Kaji, Hideyuki Shimazaki, and Tomohiko Asano
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Cancer Research ,Pathology ,medicine.medical_specialty ,upper urinary tract ,business.industry ,MALT lymphoma ,nephroureterectomy ,Articles ,medicine.disease ,Lymphoma ,ureteral wall thickening ,Ureter ,medicine.anatomical_structure ,Lymphatic system ,rituximab ,Oncology ,immune system diseases ,hemic and lymphatic diseases ,medicine ,mucosa-associated lymphoid tissue lymphoma ,CD5 ,business ,Mucosa-associated lymphoid tissue ,Renal pelvis ,Hydronephrosis - Abstract
Mucosa-associated lymphoid tissue (MALT) lymphoma occurs in various sites, but rarely in the urinary tract. Imaging studies of a 69-year-old male revealed a left hydronephrosis and diffuse thickening of the renal pelvic and upper ureteral wall. Retrograde pyelography revealed a narrowing in this region, and brush cytology specimens contained atypical cells. As the lesion was considered to be malignant, surgical excision was performed. Histological analysis revealed an intense lymphoid infiltrate mainly consisting of B cells. The immunohistochemistry results demonstrated that the lesion was positive for CD20 and CD79a and negative for CD5 and cyclin D1. These findings led to a diagnosis of MALT lymphoma. Pathological exploration disclosed a focally dense invasion of lymphoma cells into not only the renal pelvis, but the whole ureteral wall and surrounding tissue; therefore, the patient underwent eight courses of rituximab treatment. Diffuse invasion of lymphoma cells into the whole ureter was rarely observed. Since the surgery, the patient has survived for 78 months without evidence of a recurrence of lymphoma.
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- 2013
199. CAUSES AND SALVAGE OF FAILED URETHROPLASTIES FOR TRAUMATIC URETHRAL INJURY
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Masamichi Hayakawa, Tomohiko Asano, Akio Horiguchi, Keiichi Ito, Kenji Seguchi, Junichi Asakuma, Shinsuke Hamada, Akinori Sato, Kenji Kuroda, Ryuichi Azuma, and Shinsuke Tasaki
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Male ,Reoperation ,Urethral injury ,medicine.medical_specialty ,Adolescent ,Urology ,Urethroplasty ,medicine.medical_treatment ,Salvage therapy ,Anastomosis ,Buccal mucosa ,Urethra ,Humans ,Medicine ,Anastomotic urethroplasty ,Salvage Therapy ,Urethral Stricture ,business.industry ,Middle Aged ,Plastic Surgery Procedures ,Pelvic girdle pain ,medicine.disease ,Surgery ,Treatment Outcome ,Pelvic fracture ,medicine.symptom ,business - Abstract
Objectives Salvage urethroplasty after failed repair of traumatic urethral injury is a urological challenge, and we herein describe our experience with it. Methods From October 2010 to January 2012, five patients underwent salvage repair of failed urethroplasties for traumatic urethral injuries: three bulbar straddle injuries and two pelvic fracture urethral injuries. One of the three failed urethroplasties for bulbar straddle injuries was a stricture excision and primary anastomosis, and its failure was due to periurethral abscess formation. Another was an augmented anastomotic urethroplasty using buccal mucosa, and its failure was due to periurethral abscess formation. The third was a tube graft urethroplasty using buccal mucosa, and its failure was due to a stricture at the anastomotic site. Two failed urethroplasties for pelvic fracture urethral injuries were perineal anastomotic repairs combined with corporal separation and inferior pubectomy, and the failures of both were due to ischemic bulbar necrosis. The urethral gap lengths estimated from urethrograms ranged from 12 to 45 mm (mean = 26 mm). Results Urethroplasties in all patients with bulbar straddle injuries were salvaged by stricture excision and primary anastomosis with corporal separation, and urethroplasties in both patients with pelvic fracture urethral injuries were salvaged by abdominal transpubic perineal urethroplasty. Although the patients who underwent transpubic urethroplasty had transient pelvic girdle pain, no severe complications were observed. All patients were for 10 to 25 months postoperatively (mean = 16 months) able to void satisfactorily without additional treatment. Conclusions Failed urethroplasties for traumatic urethral injuries can be salvaged with a second reconstruction surgery. The procedure of choice for this salvage is anastomotic urethroplasty with techniques for tension-free anastomosis.
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- 2013
200. A Study for collecting background data on Wistar Hannover [Crl:WI(Han)] rats in embryo-fetal development studies - comparative data to Sprague Dawley rats
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Shigeru Hisada, Hiromasa Takashima, Takashi Ikeda, Keiichi Ito, Yoji Miwa, Mika Senuma, Ken-ichi Noritake, Eiji Maki, and Taishi Tateishi
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medicine.medical_specialty ,Organogenesis ,Placenta ,Physiology ,Toxicology ,Fetal Development ,Rats, Sprague-Dawley ,Eating ,Corpus Luteum ,Pregnancy ,Internal medicine ,Toxicity Tests ,medicine ,Sprague dawley rats ,Animals ,Supernumerary ,Embryo Implantation ,Rats, Wistar ,Fetus ,business.industry ,Incidence (epidemiology) ,Body Weight ,Background data ,Fetal Body Weight ,Embryo ,Organ Size ,Musculoskeletal Abnormalities ,Rats ,Viscera ,Endocrinology ,Fetal Weight ,Models, Animal ,Toxicity ,Female ,business - Abstract
The purpose of the present study was to collect the background data on Wistar Hannover [Crl:WI(Han)] (hereafter Wistar Han) rats in embryo-fetal development studies from the 6 safety research facilities of pharmaceutical companies and contract research organizations. In each facility, 20 or 22 female rats were dosed with vehicle solution during the organogenesis period. As a result, no abnormalities in clinical signs and necropsy findings in dams were found. Body weights and food consumption in dams were lower than those in Sprague Dawley (SD) rats. The number of corpora lutea (13.3 vs. 16.0 in SD) and implantations (11.8 vs. 14.7) were fewer, and fetal body weights (3.66 vs. 3.70) and placental weights (0.42 vs. 0.45) tended to be lower than those in SD rats. Regarding the fetal abnormalities, the incidence of several findings such as the persistent left umbilical artery (10.4% vs. 1.1%) and cervical (5.2% vs. 0.4%), full (7.4% vs. 0.9%) or short supernumerary (64.5% vs. 9.9%) and wavy ribs (6.6% vs. 0.3%) was higher than that in SD rats. Our present study showed that they maintained a sufficient number of live fetuses and the difference in the fetal sex ratio was not observed. In conclusion, Wistar Han rats were considered to be a suitable strain for embryo-fetal development toxicity study. Since the incidence of several abnormalities was higher than that in SD rats, it may be said that to accumulate background control data is important to evaluate the embryo-fetal development toxicity study using Wistar Han rats.
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- 2013
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