42 results on '"Taiju Hyuga"'
Search Results
2. Wound healing responses of urinary extravasation after urethral injury
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Taiju Hyuga, Kota Fujimoto, Daiki Hashimoto, Kazuya Tanabe, Taro Kubo, Shigeru Nakamura, Yuko Ueda, Eriko Fujita-Jimbo, Kazuhiro Muramatsu, Kentaro Suzuki, Hitoshi Osaka, Shinichi Asamura, Kimihiko Moriya, Hideo Nakai, and Gen Yamada
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Medicine ,Science - Abstract
Abstract The post-surgical fluid leakage from the tubular tissues is a critical symptom after gastrointestinal or urinary tract surgeries. Elucidating the mechanism for such abnormalities is vital in surgical and medical science. The exposure of the fluid such as peritonitis due to urinary or gastrointestinal perforation has been reported to induce severe inflammation to the surrounding tissue. However, there have been no reports for the tissue responses by fluid extravasation and assessment of post-surgical and injury complication processes is therefore vital. The current model mouse study aims to investigate the effect of the urinary extravasation of the urethral injuries. Analyses on the urinary extravasation affecting both urethral mesenchyme and epithelium and the resultant spongio-fibrosis/urethral stricture were performed. The urine was injected from the lumen of urethra exposing the surrounding mesenchyme after the injury. The wound healing responses with urinary extravasation were shown as severe edematous mesenchymal lesions with the narrow urethral lumen. The epithelial cell proliferation was significantly increased in the wide layers. The mesenchymal spongio-fibrosis was induced by urethral injury with subsequent extravasation. The current report thus offers a novel research tool for surgical sciences on the urinary tract.
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- 2023
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3. A pediatric case of inverted papilloma in the bladder detected by screening ultrasonography based on findings from a school medical checkup
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Taiju Hyuga, Shigeru Nakamura, Kazuya Tanabe, Taro Kubo, Hitomi Niijima, Yuta Kawahara, Waka Nakata, Rieko Furukawa, Mio Sakaguchi, Akira Shimada, Mitsuru Matsuki, Toshiro Niki, Yasunori Kamiyama, Kimihiko Moriya, and Hideo Nakai
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Bladder tumor ,Inverted papilloma ,School medical checkup ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
We report a case of a girl with inverted papilloma of the urinary bladder, which was detected by ultrasonographic screening based on the findings of a school medical checkup. The case was an 11-year-old girl. She was diagnosed as having occult hematuria and proteinuria by a school medical checkup. Abdominal ultrasonography revealed a high echoic lesion protruding into the bladder. Cystoscopic findings showed a thumb fingertip-sized papillary pedunculated tumor located at the trigone in the bladder. Transurethral resection was performed and pathological examination rendered the diagnosis of inverted papilloma of the urinary bladder. Eight cases of bladder inverted papilloma in children have been reported including our case. This is the first case detected asymptomatically based on a school medical checkup. We believe that ultrasound screening of the urinary tract should be considered when treating patients with positive occult hematuria, such as in a school medical checkup.
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- 2022
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4. A visualization system for erectile vascular dynamics
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Kota Fujimoto, Daiki Hashimoto, Kenichi Kashimada, Shinji Kumegawa, Yuko Ueda, Taiju Hyuga, Tsuyoshi Hirashima, Norimitsu Inoue, Kentaro Suzuki, Isao Hara, Shinichi Asamura, and Gen Yamada
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corpus cavernosum ,contraction/relaxation ,vascular dynamics ,erectile dysfunction ,ED ,Biology (General) ,QH301-705.5 - Abstract
Erection is an essential process which requires the male penis for copulation. This copulatory process depends on the vascular dynamic regulation of the penis. The corpus cavernosum (CC) in the upper (dorsal) part of the penis plays a major role in regulating blood flow inside the penis. When the CC is filled with blood, the sinusoids, including micro-vessels, dilate during erection. The CC is an androgen-dependent organ, and various genital abnormalities including erectile dysfunction (ED) are widely known. Previous studies have shown that androgen deprivation by castration results in significantly decreased smooth muscles of the CC. Experimental works in erectile biology have previously measured intracavernosal penile pressure and mechanical tension. Such reports analyze limited features without assessing the dynamic aspects of the erectile process. In the current study, we established a novel explant system enabling direct visual imaging of the sinusoidal lumen to evaluate the dynamic movement of the cavernous space. To analyze the alternation of sinusoidal spaces, micro-dissected CC explants by patent blue dye injection were incubated and examined for their structural alternations during relaxation/contraction. The dynamic process of relaxation/contraction was analyzed with various external factors administered to the CC. The system enabled the imaging of relaxation/contraction of the lumens of the sinusoids and the collagen-containing tissues. Histological analysis on the explant system also showed the relaxation/contraction. Thus, the system mimics the regulatory process of dynamic relaxation/contraction in the erectile response. The current system also enabled evaluating the erectile pathophysiology. In the current study, the lumen of sinusoids relaxed/contracted in castrated mice similarly with normal mice. These results suggested that the dynamic erectile relaxation/contraction process was similarly retained in castrated mice. However, the system also revealed decreased duration time of erection in castrated mice. The current study is expected to promote further understanding of the pathophysiology of ED, which will be useful for new treatments in the future. Hence, the current system provides unique information to investigate the novel regulations of erectile function, which can provide tools for analyzing the pathology of ED.
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- 2022
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5. Radiation inducible MafB gene is required for thymic regeneration
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Daiki Hashimoto, Jose Gabriel R. Colet, Aki Murashima, Kota Fujimoto, Yuko Ueda, Kentaro Suzuki, Taiju Hyuga, Hiroaki Hemmi, Tsuneyasu Kaisho, Satoru Takahashi, Yousuke Takahama, and Gen Yamada
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Medicine ,Science - Abstract
Abstract The thymus facilitates mature T cell production by providing a suitable stromal microenvironment. This microenvironment is impaired by radiation and aging which lead to immune system disturbances known as thymic involution. Young adult thymus shows thymic recovery after such involution. Although various genes have been reported for thymocytes and thymic epithelial cells in such processes, the roles of stromal transcription factors in these remain incompletely understood. MafB (v-maf musculoaponeurotic fibrosarcoma oncogene homolog B) is a transcription factor expressed in thymic stroma and its expression was induced a day after radiation exposure. Hence, the roles of mesenchymal MafB in the process of thymic regeneration offers an intriguing research topic also for radiation biology. The current study investigated whether MafB plays roles in the adult thymus. MafB/green fluorescent protein knock-in mutant (MafB +/GFP) mice showed impaired thymic regeneration after the sublethal irradiation, judged by reduced thymus size, total thymocyte number and medullary complexity. Furthermore, IL4 was induced after irradiation and such induction was reduced in mutant mice. The mutants also displayed signs of accelerated age-related thymic involution. Altogether, these results suggest possible functions of MafB in the processes of thymic recovery after irradiation, and maintenance during aging.
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- 2021
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6. 3D reconstruction and histopathological analyses on murine corporal body
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Daiki Hashimoto, Mizuki Kajimoto, Yuko Ueda, Taiju Hyuga, Kota Fujimoto, Saaya Inoue, Kentaro Suzuki, Tomoya Kataoka, Kazunori Kimura, and Gen Yamada
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aging ,corpus cavernosum ,erectile dysfunction ,penis ,sinusoid ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 ,Reproduction ,QH471-489 - Abstract
Abstract Purpose Erectile dysfunction (ED) is one of the increasing diseases with aging society. The basis of ED derived from local penile abnormality is poorly understood because of the complex three‐dimensional (3D) distribution of sinusoids in corpus cavernosum (CC). Understanding the 3D histological structure of penis is thus necessary. Analyses on the status of regulatory signals for such abnormality are also performed. Methods To analyze the 3D structure of sinusoid, 3D reconstruction from serial sections of murine CC were performed. Histological analyses between young (2 months old) and aged (14 months old) CC were performed. As for chondrogenic signaling status of aged CC, SOX9 and RBPJK staining was examined. Results Sinusoids prominently developed in the outer regions of CC adjacent to tunica albuginea. Aged CC samples contained ectopic chondrocytes in such regions. Associating with the appearance of chondrocytes, the expression of SOX9, chondrogenic regulator, was upregulated. The expression of RBPJK, one of the Notch signal regulators, was downregulated in the aged CC. Conclusions Prominent sinusoids distribute in the outer region of CC which may possess important roles for erection. A possibility of ectopic chondrogenesis induced by alteration of SOX9/Notch signaling with aging is indicated.
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- 2021
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7. Establishment of mouse line showing inducible priapism‐like phenotypes
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Daiki Hashimoto, Kota Fujimoto, Shin Morioka, Shinya Ayabe, Tomoya Kataoka, Ryutaro Fukumura, Yuko Ueda, Mizuki Kajimoto, Taiju Hyuga, Kentaro Suzuki, Isao Hara, Shinichi Asamura, Shigeharu Wakana, Atsushi Yoshiki, Yoichi Gondo, Masaru Tamura, Takehiko Sasaki, and Gen Yamada
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corpus cavernosum ,erectile dysfunction ,erection ,phosphatidylinositol transfer proteins alpha (Pitpna) ,priapism ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 ,Reproduction ,QH471-489 - Abstract
Abstract Purpose Penile research is expected to reveal new targets for treatment and prevention of the complex mechanisms of its disorder including erectile dysfunction (ED). Thus, analyses of the molecular processes of penile ED and continuous erection as priapism are essential issues of reproductive medicine. Methods By performing mouse N‐ethyl‐N‐nitrosourea mutagenesis and exome sequencing, we established a novel mouse line displaying protruded genitalia phenotype (PGP; priapism‐like phenotype) and identified a novel Pitpna gene mutation for PGP. Extensive histological analyses on the Pitpna mutant and intracavernous pressure measurement (ICP) and liquid chromatography–electrospray ionization tandem mass spectrometry (LC–ESI/MS)/MS analyses were performed. Results We evaluated the role of phospholipids during erection for the first time and showed the mutants of inducible phenotypes of priapism. Moreover, quantitative analysis using LC–ESI/MS/MS revealed that the level of phosphatidylinositol (PI) was significantly lower in the mutant penile samples. These results imply that PI may contribute to penile erection by PITPα. Conclusions Our findings suggest that the current mutant is a mouse model for priapism and abnormalities in PI signaling pathways through PITPα may lead to priapism providing an attractive novel therapeutic target in its treatment.
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- 2022
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8. Lateral Thoracic Artery Can Stabilize Circulation in the Pectoralis Major Myocutaneous Pedicle Flap: Single-center, Prospective, Uncontrolled Case Series
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Shinji Kumegawa, MD, Hidetaka Miyazaki, DDS, PhD, Yasuhiro Sakata, MD, Kazuhisa Uemura, MD, Kazuki Ueno, MD, Yoshitaka Wada, MD, PhD, Taiju Hyuga, MD, PhD, and Shinichi Asamura, MD, PhD
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Surgery ,RD1-811 - Abstract
Background:. Head and neck reconstructions using the pectoralis major myocutaneous pedicle flap (PMMF) with thoracoacromial artery alone are prone to hemodynamic instability, possibly leading to infection, prolapse, hematoma, seroma, and partial or total flap failure (6%–71%). Aside from unstable blood circulation, reported risk factors for these complications include feminine gender, smoking, and having diabetes mellitus. Preservation of the lateral thoracic artery in addition to the thoracoacromial artery has been suggested as a way to improve unstable blood circulation in the PMMF. Methods:. This is a single-center, prospective, uncontrolled case series. Circulation to the PMMF was studied intraoperatively with and without lateral thoracic artery clamping after harvest. Indocyanine green (ICG) angiopathy, a quantitative hemodynamic assessment method, was used to analyze three parameters: maximum intensity (Imax), time from start of ICG to maximum intensity (Tmax), and slope of intensity (Smax = Imax/Tmax). Hemodynamic parameters, such as pulse rate and blood pressure, were all within normal ranges. Allergy to contrast media was criterion for exclusion. Results:. Six patients all had oral cancer as their primary disease. Their background was characterized by established risk factors: four patients had a history of smoking, two had diabetes mellitus, and two were women. Postoperatively, no patients had complications at the recipient or donor sites. Mean results of the analysis were Imax: 60 ± 47, Tmax: 91 ± 55, Smax: 0.8 ± 0.5 in the clamped group and Imax: 85 ± 40, Tmax: 73 ± 42, Smax: 1.8 ± 1.5 in the un-clamped group. Significant difference was observed in Imax (P = 0.03) and Smax (P = 0.03). Conclusion:. Lateral thoracic artery preservation appears to be useful for stabilizing blood circulation to the PMMF, including in patients considered to be at high-risk for complications, such as women, smokers, and patients with diabetes mellitus.
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- 2021
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9. Pediatric Primary Alveolar Soft Part Sarcoma of the Bladder
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Kazuya Tanabe, Shigeru Nakamura, Taiju Hyuga, Shina Kawai, Masahiro Yamazaki, Yohei Kawashima, Rieko Furukawa, Toshiro Niki, Shigeru Ono, and Hideo Nakai
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Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
A 9-year-old girl was diagnosed with primary alveolar soft part sarcoma of the bladder after imaging examinations and transurethral resection (TUR) of the bladder tumor. As a positive surgical margin of the TUR indicated residual tumor cells, we performed a cystourethrectomy to remove the tumor. A continent urinary reservoir for self-catheterization was constructed using the Mainz pouch technique, and an abdominal (umbilical) continent catheterizable stoma using the appendix was performed. For 2.5 years postoperatively, the patient remained free of local recurrence and distant metastasis. The patient’s clinical course has been favorable, with good management of clean intermittent self-catheterization.
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- 2018
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10. Importance and difficulty of correctly diagnosing covered cloacal exstrophy for adequate reconstruction: A case report
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Insu Kawahara, Shigeru Ono, Katsuhisa Baba, Atsuhisa Fukuta, Yuki Tsuji, Yoshiko Usui, Taiju Hyuga, Shina Kawai, Shigeru Nakamura, and Hideo Nakai
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Covered cloacal exstrophy ,Rescue operation ,Short colon ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Covered cloacal exstrophy (CCE) is extremely rare condition. In patients with a single perineal orifice and no pubic bone separation, it is very difficult to suspect and/or diagnose CCE based on external signs alone. We present the case of a 2-month-old girl diagnosed with CCE based on cystography, ileostomy contrast study and cystoscopy.
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- 2015
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11. Aggressive diagnosis and treatment for posterior urethral valve as an etiology for vesicoureteral reflux or urge incontinence in children
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Hideo Nakai, Taiju Hyuga, Shina Kawai, Taro Kubo, and Shigeru Nakamura
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Urinary incontinence ,Urethral obstruction ,Vesicoureteral reflux ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Vesicoureteral reflux (VUR) is one of the most common diseases in pediatric urology and classified into primary and secondary VUR. Although posterior urethral valve (PUV) is well known as a cause of the secondary VUR, it is controversial that minor urethral deformity recognized in voiding cystourethrography represents mild end of PUV spectrum and contributes to the secondary VUR. We have been studying for these ten years congenital urethral obstructive lesions with special attention to its urethrographic and endoscopic morphology as well as therapeutic response with transurethral incision. Our conclusion to date is that congenital obstructive lesion in the postero-membranous urethra is exclusively PUV (types 1 and 3) and that severity of obstruction depends on broad spectrum of morphological features recognized in PUV. Endoscopic diagnostic criteria for PUV are being consolidated.
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- 2017
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12. Vibegron shows high efficacy in pediatric patients with refractory daytime urinary incontinence
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Taiju Hyuga, Kazuya Tanabe, Taro Kubo, Shigeru Nakamura, Hideo Nakai, and Kimihiko Moriya
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Urology ,Neurology (clinical) - Published
- 2023
13. Androgen/Wnt/β‐catenin signal axis augments cell proliferation of the mouse erectile tissue, corpus cavernosum
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Mizuki Kajimoto, Kentaro Suzuki, Yuko Ueda, Kota Fujimoto, Toru Takeo, Naomi Nakagata, Taiju Hyuga, Kyoichi Isono, and Gen Yamada
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Male ,Mice ,Embryology ,Pediatrics, Perinatology and Child Health ,Androgens ,Animals ,Female ,General Medicine ,Wnt Signaling Pathway ,beta Catenin ,Cell Proliferation ,Penis ,Developmental Biology - Abstract
The murine penile erectile tissues including corpus cavernosum (CC) are composed of blood vessels, smooth muscle, and connective tissue, showing marked sexual differences. It has been known that the androgens are required for sexually dimorphic organogenesis. It is however unknown about the features of androgen signaling during mouse CC development. It is also unclear how androgen-driven downstream factors are involved such processes. In the current study, we analyzed the onset of sexually dimorphic CC formation based on histological analyses, the dynamics of androgen receptor (AR) expression, and regulation of cell proliferation. Of note, we identified Dickkopf-related protein 2 (Dkk2), an inhibitor of β-catenin signaling, was predominantly expressed in female CC compared with male. Furthermore, administration of androgens resulted in activation of β-catenin signaling. We have found the Sox9 gene, one of the essential markers for chondrocyte, was specifically expressed in the developing CC. Hence, we utilized CC-specific, Sox9
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- 2022
14. 3D reconstruction and histopathological analyses on murine corporal body
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Kota Fujimoto, Kentaro Suzuki, Gen Yamada, Daiki Hashimoto, Taiju Hyuga, Kazunori Kimura, Saaya Inoue, Mizuki Kajimoto, Yuko Ueda, and Tomoya Kataoka
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0301 basic medicine ,Pathology ,medicine.medical_specialty ,lcsh:QH471-489 ,erectile dysfunction ,Notch signaling pathway ,SOX9 ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,03 medical and health sciences ,Tunica albuginea (ovaries) ,penis ,0302 clinical medicine ,Sinusoid ,corpus cavernosum ,medicine ,lcsh:Reproduction ,lcsh:RC648-665 ,030219 obstetrics & reproductive medicine ,business.industry ,aging ,Original Articles ,Cell Biology ,medicine.disease ,Chondrogenesis ,030104 developmental biology ,medicine.anatomical_structure ,Erectile dysfunction ,Reproductive Medicine ,Original Article ,Abnormality ,business ,Penis ,sinusoid - Abstract
Purpose Erectile dysfunction (ED) is one of the increasing diseases with aging society. The basis of ED derived from local penile abnormality is poorly understood because of the complex three‐dimensional (3D) distribution of sinusoids in corpus cavernosum (CC). Understanding the 3D histological structure of penis is thus necessary. Analyses on the status of regulatory signals for such abnormality are also performed. Methods To analyze the 3D structure of sinusoid, 3D reconstruction from serial sections of murine CC were performed. Histological analyses between young (2 months old) and aged (14 months old) CC were performed. As for chondrogenic signaling status of aged CC, SOX9 and RBPJK staining was examined. Results Sinusoids prominently developed in the outer regions of CC adjacent to tunica albuginea. Aged CC samples contained ectopic chondrocytes in such regions. Associating with the appearance of chondrocytes, the expression of SOX9, chondrogenic regulator, was upregulated. The expression of RBPJK, one of the Notch signal regulators, was downregulated in the aged CC. Conclusions Prominent sinusoids distribute in the outer region of CC which may possess important roles for erection. A possibility of ectopic chondrogenesis induced by alteration of SOX9/Notch signaling with aging is indicated.
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- 2021
15. Dynamic erectile responses of a novel penile organ model utilizing TPEM†
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Kentaro Suzuki, Makoto Tachibana, Atsushi Yoshiki, Shin Morioka, Daiki Hashimoto, Shunsuke Kuroki, Takehiko Sasaki, Tomoya Kataoka, Hisao Yamamura, Taiju Hyuga, Kota Fujimoto, Kazunori Kimura, Nobuhiko Yamamoto, Tsuyoshi Hirashima, and Gen Yamada
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Male ,Contraction (grammar) ,RHOA ,030232 urology & nephrology ,Erectile tissue ,Biology ,Models, Biological ,Nitric oxide ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,Organ Culture Techniques ,0302 clinical medicine ,Erectile Dysfunction ,medicine ,Animals ,Phenylephrine ,Cells, Cultured ,Mice, Inbred ICR ,Microscopy ,030219 obstetrics & reproductive medicine ,Penile Erection ,Cell Biology ,General Medicine ,medicine.disease ,Tadalafil ,Cell biology ,medicine.anatomical_structure ,Erectile dysfunction ,Reproductive Medicine ,chemistry ,biology.protein ,Penis ,medicine.drug - Abstract
Male penis is required to become erect during copulation. In the upper (dorsal) part of penis, the erectile tissue termed corpus cavernosum (CC) plays fundamental roles for erection by regulating the inner blood flow. When blood flows into the CC, the microvascular complex termed sinusoidal space is reported to expand during erection. A novel in vitro explant system to analyze the dynamic erectile responses during contraction/relaxation is established. The current data show regulatory contraction/relaxation processes induced by phenylephrine (PE) and nitric oxide (NO) donor mimicking dynamic erectile responses by in vitro CC explants. Two-photon excitation microscopy (TPEM) observation shows the synchronous movement of sinusoidal space and the entire CC. By taking advantages of the CC explant system, tadalafil (Cialis) was shown to increase sinusoidal relaxation. Histopathological changes have been generally reported associating with erection in several pathological conditions. Various stressed statuses have been suggested to occur in the erectile responses by previous studies. The current CC explant model enables to analyze such conditions through directly manipulating CC in the repeated contraction/relaxation processes. Expression of oxidative stress marker and contraction-related genes, Hypoxia-inducible factor 1-alpha (Hif1a), glutathione peroxidase 1 (Gpx1), Ras homolog family member A (RhoA), and Rho-associated protein kinase (Rock), was significantly increased in such repeated contraction/relaxation. Altogether, it is suggested that the system is valuable for analyzing structural changes and physiological responses to several regulators in the field of penile medicine.
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- 2021
16. Indigo Carmine Dye–Assisted Lymphatic-Sparing Microsurgical Subinguinal Varicocelectomy Among Children and Adolescents
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Satoshi Ando, Shigeru Nakamura, Taiju Hyuga, Kazuya Tanabe, Hideo Nakai, and Tetsuya Fujimura
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Surgery - Abstract
The purpose of this study is to clarify the safety and efficacy of indigo carmine dye–assisted lymphatic-sparing microsurgical subinguinal varicocelectomy for children and adolescents in our institution. Medical records of boys aged ≤ 15 years who underwent varicocelectomy between November 2008 and December 2019 at our institution were retrospectively reviewed. Microsurgical subinguinal varicocelectomy was performed using indigo carmine injection under the tunica vaginalis to preserve lymphatics. A total of 29 patients underwent varicocelectomy, among whom six underwent retroperitoneal high ligation (modified Palomo technique), nine underwent laparoscopic varicocelectomy, and 14 underwent microsurgical subinguinal varicocelectomy. The median operative time for retroperitoneal high ligation, laparoscopic varicocelectomy, and microsurgical subinguinal varicocelectomy was 71 (IQR: 59–82.5) min, 131 (95–151) min, and 125.5 (112–134.25) min, respectively. Among the patients who underwent laparoscopic varicocelectomy, one and two experienced hydrocele and varicocele recurrence as postoperative complications, respectively. None of the patients who underwent microsurgical subinguinal varicocelectomy developed hydrocele and varicocele recurrence during 15.5-month median follow-up period (IQR: 11.25–25.75 month). Indigo carmine dye–assisted lymphatic-sparing microsurgical subinguinal varicocelectomy can be a safe and efficient treatment modality among children and adolescents.
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- 2022
17. Loop ureterocystoplasty for multiple reimplantation failures of refluxing megaureter to atrophic bladder: A novel technique and its long term outcome
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Shina Kawai, Satoru Inoguchi, Taro Kubo, Kazuya Tanabe, Taiju Hyuga, Shigeru Nakamura, and Hideo Nakai
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Novel technique ,medicine.medical_specialty ,Urinary bladder ,business.industry ,Augmentation cystoplasty, ureterocystoplasty, ureteroneocystostomy ,Pediatrics, Pediatric Surgery, Pediatric Urology ,Small bladder ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,Surgery ,Ureter ,medicine.anatomical_structure ,augmentation cystoplasty, ureterocystoplasty, ureteroneocystostomy ,medicine ,business ,Refluxing Megaureter - Abstract
We encountered a 9-year-old boy with a small bladder who had previously undergone multiple ureteroneocystostomies for unilateral refluxing megaureter. He underwent excision of the affected non-functioning kidney and ureterocystoplasty used the dilated regional ureter, in which the loop shaped urinary bladder was reconstructed without detubularization of the dilated ureter. The long-term postoperative course has been satisfactory. There have been no reports of ureterocystoplasty used a dilated ureter after multiple ureteroneocystostomies and none describing ureterocystoplasty in which the ureter was looped. This case is presented herein.
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- 2019
18. Regulatory roles of epithelial-mesenchymal interaction (EMI) during early and androgen dependent external genitalia development
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Gen Yamada, Kentaro Suzuki, Alvin R. Acebedo, Mizuki Kajimoto, Taiju Hyuga, Yoshichika Yoshioka, Daiki Hashimoto, Shinichi Miyagawa, and Jun ichiro Enmi
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Male ,0301 basic medicine ,Cancer Research ,Organogenesis ,Mesenchyme ,Biology ,Fibroblast growth factor ,Mesoderm ,03 medical and health sciences ,Urorectal septum ,0302 clinical medicine ,Conditional gene knockout ,medicine ,Animals ,Genitalia ,Genital tubercle ,Molecular Biology ,Endoderm ,Embryogenesis ,Gene Expression Regulation, Developmental ,Cell Biology ,Embryo, Mammalian ,Cell biology ,030104 developmental biology ,medicine.anatomical_structure ,MAFB ,Androgens ,Female ,030217 neurology & neurosurgery ,Developmental Biology - Abstract
Development of external genitalia (ExG) has been a topic of long mystery in the field of organogenesis research. Early stage male and female of mouse embryos develop a common genital tubercle (GT) in the perineum whose outgrowth extends distally from the posterior cloacal regions. Concomitant with GT outgrowth, the cloaca is divided into urogenital sinus and anorectum by urorectal septum (URS) internally. The outgrowth of the GT is associated with the formation of endodermal epithelial urethral plate (UP) attached to the ventral epidermis of the GT. Such a common developmental phase is observed until around embryonic day 15.5 (E15.5) morphologically in mouse embryogenesis. Various growth factor genes, such as Fibroblast growth factor (Fgf) and Wnt genes are expressed and function during GT formation. Since the discovery of key growth factor signals and several regulatory molecules, elucidation of their functions has been achieved utilizing mouse developmental models, conditional gene knockout mouse and in vitro culture. Analyses on the phenotypes of such mouse models have revealed that several growth factor families play fundamental roles in ExG organogenesis based on the epithelial-mesenchymal interaction (EMI). More recently, EMI between developing urethral epithelia and its bilateral mesenchyme of later stages is also reported during subsequent stage of androgen-dependent male-type urethral formation in the mouse embryo. Mafb, belonging to AP-1 family and a key androgen-responsive mesenchymal gene, is identified and starts to be expressed around E14.5 when masculinization of the urethra is initiated. Mesenchymal cell condensation and migration, which are regulated by nonmuscle myosin, are shown to be essential process for masculinization. Hence, studies on EMI at various embryonic stages are important not only for early but also for subsequent masculinization of the urethra. In this review, a dynamic mode of EMI for both early and late phases of ExG development is discussed.
- Published
- 2019
19. Retroperitoneoscopy-Assisted Dismembered Pyeloplasty With Single-Site Plus One Port in Older Children With Congenital Hydronephrosis
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Kazuya Tanabe, Shigeru Nakamura, Taiju Hyuga, Taro Kubo, Shina Kawai, and Hideo Nakai
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Treatment Outcome ,Adolescent ,Humans ,Urologic Surgical Procedures ,Kidney Pelvis ,Laparoscopy ,General Medicine ,Hydronephrosis ,Child ,Retrospective Studies ,Ureteral Obstruction - Abstract
This study aimed to clarify the advantage of retroperitoneoscopy-assisted dismembered pyeloplasty with single-site plus one port (RPSPO) for pediatric congenital hydronephrosis in patients aged ≥7 years.We retrospectively compared a group of patients aged ≥7 years (study group) with patients aged7 years (comparison group), who underwent RPSPO between August 2015 and August 2018, in terms of preoperative patient characteristics, intra- and perioperative results, and postoperative results.The study group consisted of eight patients. The median body weight at surgery was 27 kg (20-38 kg). The median age at surgery was 102.5 m (87-139 m). The severity of hydronephrosis on the affected side graded by the Society for Fetal Urology grade was grade 3 in one case and grade 2 or less in all other cases. All patients underwent aRPSPO is an advantageous procedure for older children because it allows precise ureteropelvic neoanastomosis under direct vision and the same wound size as in younger children.
- Published
- 2021
20. The discrepancy between the uroflowmetry parameters, curve patterns, and lower urinary tract symptoms of children with nocturnal enuresis according to the presence or absence of daytime urinary incontinence
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Kazuya Tanabe, Taiju Hyuga, Shigeru Nakamura, Hideo Nakai, and Shina Kawai
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Male ,medicine.medical_specialty ,Urology ,030232 urology & nephrology ,Staccato ,Nocturnal ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Lower Urinary Tract Symptoms ,Lower urinary tract symptoms ,Enuresis ,Surveys and Questionnaires ,Internal medicine ,medicine ,Humans ,Child ,Retrospective Studies ,030219 obstetrics & reproductive medicine ,Urinary symptoms ,business.industry ,Significant difference ,medicine.disease ,Curve pattern ,Urodynamics ,Urinary Incontinence ,Child, Preschool ,Daytime Urinary Incontinence ,Female ,Neurology (clinical) ,medicine.symptom ,Rheology ,business ,Nocturnal Enuresis - Abstract
AIM To evaluate the uroflowmetry (UFM), which reflects the urinary symptoms of children with nocturnal enuresis (NE). METHODS This study retrospectively investigated 93 children who underwent UFM three times on the same day (≥8 years old; mean age: 9 years and 10 months; 66 boys and 27 girls). Children with the combination of daytime incontinence (DI) and NE (DI+NE group: n = 45) and NE alone (isolated NE group: n = 48) were compared. UFM curve patterns were classified into five types: bell (B), tower (T), staccato (S), plateau (P), and interrupted (I). An unclassified (U) curve pattern was designated when all three curve patterns differed. Patterns other than the B pattern were considered abnormal (A). Each score in the dysfunctional voiding symptom score (DVSS) was also compared between the two groups. RESULTS The UFM curve pattern was B (n = 21), T (n = 15), S (n = 4), P (n = 1), U (n = 4) in the DI+NE group and B (n = 25), T (n = 10), S (n = 7), P (n = 2), U (n = 4) in the isolated NE group, indicating no significant difference (B vs A; P = .680). The two items of DVSS questionnaire were significantly greater in the DI+NE group than in the isolated NE group (voiding postponement: 0.93 ± 1.18 vs 0.23 ± 0.56, P = .001, urgency: 2.09 ± 1.06 vs 0.56 ± 0.85, P
- Published
- 2019
21. Distal Urethroplasty and Glanuloplasty Procedure Can be Suitable for All Types of Glanular/Subcoronal Hypospadias
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Hideo Nakai, Shina Kawai, Taiju Hyuga, and Shigeru Nakamura
- Subjects
medicine.medical_specialty ,Meatus ,business.industry ,Urology ,Urethroplasty ,medicine.medical_treatment ,030232 urology & nephrology ,Glanuloplasty ,medicine.disease ,Meatal stenosis ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Urethra ,medicine.anatomical_structure ,Hypospadias ,030220 oncology & carcinogenesis ,medicine ,medicine.symptom ,business ,Glans ,Chordee - Abstract
Objective To correct all types of glanular/subcoronal hypospadias, we performed surgery named the distal urethroplasty and glanuloplasty procedure (DUG procedure). We analyzed cases that we have experienced. Methods A vertical incision with the meatal margin was made in the 12 o'clock direction, with the margin of the external urethral meatus as the center. By this meatoplasty according to Heineke-Mikulicz principle, we changed all type of glanular/subcoronal hypospadias to the hypospadias with wide meatus and wide glans. And then Thiersh-Duplay procedure was performed. Results Consecutive 24 underwent modified DUG procedure. The mean age at the time of surgery was 19.0 ± 11.9 months and the mean preoperative glans width was 13 ± 1.5 mm. The external urethral meatus was located glanular in 13 and subcoronal in 11. Hypoplastic urethra (HU) was observed in 7. Skin chordee in 10, penile torsion in 6 and meatal stenosis in 10 were observed. The mean surgical duration was 106 ± 25.4 minutes and the mean postoperative observation period was 40.5 ± 26.2 months. All patients with preoperative skin chordee, penile torsion, and meatal stenosis were improved postoperatively, and in all cases, apart from the patient with meatal regression with longest HU from glanular to distal penile, the slit-like shape of the external urethral meatus was achieved. Conclusion DUG procedure can be used for any type of glanular/subcoronal hypospadias but care should be taken not to indicate too aggressively for glanular/subcoronal hypospadias accompanying long HU to distal penile shaft.
- Published
- 2019
22. Mid-Term Safety and Efficacy of the Modified Double Hydrodistention Implantation Technique (HIT), Termed Systematic Multi-Site HIT (SMHIT), for Patients with Primary Vesicoureteral Reflux
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Shigeru Nakamura, Shina Kawai, Kazuya Tanabe, Satoru Inoguchi, Taiju Hyuga, Hideo Nakai, and Taro Kubo
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medicine.medical_specialty ,endoscopic treatment ,Urology ,Urinary system ,Radiography ,030232 urology & nephrology ,dextranomer hyaluronic acid ,Vesicoureteral reflux ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Major complication ,Original Research ,030219 obstetrics & reproductive medicine ,business.industry ,Research and Reports in Urology ,Multi site ,Reflux ,Dx/HA ,vesicoureteral reflux ,medicine.disease ,Surgery ,Concomitant ,Dextranomer ,business ,medicine.drug - Abstract
Shigeru Nakamura,1 Kazuya Tanabe,1 Taiju Hyuga,1,2 Taro Kubo,1 Satoru Inoguchi,1 Shina Kawai,1 Hideo Nakai1 1Department of Pediatric Urology, Jichi Medical University, Children’s Medical Center Tochigi, Shimotsuke, Japan; 2Department of Developmental Genetics, Institute of Advanced Medicine, Wakayama Medical University (WMU), Wakayama, JapanCorrespondence: Shigeru NakamuraDepartment of Pediatric Urology, Jichi Medical University, Children’s Medical Center, 3311-1, Yakushiji, Shimotsuke, Tochigi 329-0498, JapanTel +81-285-44-2111Fax +81-285-44-8452Email naka251148@gmail.comPurpose: To evaluate the treatment outcomes and postoperative complications associated with the systematic multi-site hydrodistention implantation technique (SMHIT) for primary vesicoureteral reflux (VUR) and to determine its mid-term efficacy and safety.Patients and Methods: We retrospectively reviewed the data for 17 ureters from 12 consecutive children, aged ≥ 1 year, with grade II–IV reflux and a history of febrile urinary tract infections (FUTI), who underwent a single-session of SMHIT. The primary outcome was the absence of postoperative FUTI (clinical success). The secondary outcome was improvement in reflux to grade 0–I on postoperative voiding cystourethrography (radiographic success).Results: Five and 7 children had bilateral and unilateral reflux, respectively. Reflux was categorized as grade II, III, and IV reflux in 2, 12, and 3 ureters, respectively. Seven of 10 (70%) toilet-trained children had bladder-bowel dysfunction (BBD) preoperatively. The SMHIT was performed for all patients, after which BBD improved. The mean postoperative follow-up period was 6 years and 9 months. The clinical success rate was 100%. Radiographic success was achieved in 16/17 ureters (94%) at 3– 4 months, 17/17 (100%) ureters at 1 year, and 17/17 (100%) ureters at 3 years postoperatively. Major complications did not develop postoperatively.Conclusion: When prioritizing treatment of concomitant BBD in children with primary VUR and avoiding dextranomer/hyaluronic acid injection therapy in contraindicated children according to the Food and Drug Administration recommendations, a single-session of SMHIT may be as effective and safe in the mid-term as performing open anti-reflux surgery.Keywords: dextranomer hyaluronic acid, Dx/HA, endoscopic treatment, vesicoureteral reflux
- Published
- 2020
23. Evaluation of surgical procedures of mouse urethra by visualization and the formation of fistula
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Kentaro Suzuki, Daiki Hashimoto, Shigeru Nakamura, Shinichi Asamura, Taiju Hyuga, Hideo Nakai, Gen Yamada, Kei-ichi Katayama, Shinji Kumegawa, and Daisuke Matsumaru
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Indocyanine Green ,Male ,medicine.medical_specialty ,Fistula ,Urethral stricture ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Contrast Media ,lcsh:Medicine ,Anastomotic Leak ,Mouse Urethra ,Article ,Mice ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Urethra ,medicine ,Animals ,lcsh:Science ,Urethral Stricture ,Hypospadias ,Mice, Inbred ICR ,Multidisciplinary ,Genitourinary system ,business.industry ,lcsh:R ,Plastic Surgery Procedures ,Surgical procedures ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Surgery, Computer-Assisted ,chemistry ,030220 oncology & carcinogenesis ,Models, Animal ,Urologic Surgical Procedures ,lcsh:Q ,Anatomy ,business ,Indocyanine green - Abstract
Visualization of the surgically operated tissues is vital to improve surgical model animals including mouse. Urological surgeries for urethra include series of fine manipulations to treat the increasing number of birth defects such as hypospadias. Hence visualization of the urethral status is vital. Inappropriate urethral surgical procedure often leads to the incomplete wound healing and subsequent formation of urethro-cutaneous fistula or urethral stricture. Application of indocyanine green mediated visualization of the urethra was first performed in the current study. Indocyanine green revealed the bladder but not the urethral status in mouse. Antegrade injection of contrast agent into the bladder enabled to detect the urethral status in vivo. The visualization of the leakage of contrast agent from the operated region was shown as the state of urethral fistula in the current hypospadias mouse model and urethral stricture was also revealed. A second trial for contrast agent was performed after the initial operation and a tendency of accelerated urethral stricture was observed. Thus, assessment of post-surgical conditions of urogenital tissues can be improved by the current analyses on the urethral status.
- Published
- 2020
24. Radiation inducible MafB gene is required for thymic regeneration
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Tsuneyasu Kaisho, Hiroaki Hemmi, Gen Yamada, Jose Gabriel R. Colet, Kentaro Suzuki, Daiki Hashimoto, Yuko Ueda, Kota Fujimoto, Aki Murashima, Satoru Takahashi, Yousuke Takahama, Taiju Hyuga, Hashimoto, Daiki, Colet, Jose Gabriel R, Murashima, Aki, Fujimoto, Kota, Ueda, Yuko, Suzuki, Kentaro, Hyuga, Taiju, Hemmi, Hiroaki, Kaisho, Tsuneyasu, Takahashi, Satoru, Takahama, Yousuke, and Yamada, Gen
- Subjects
0301 basic medicine ,Male ,Aging ,Stromal cell ,Science ,MafB Transcription Factor ,Immunology ,Mice, Transgenic ,Thymus Gland ,Pathogenesis ,Biology ,Article ,thymic ,thymic regeneration ,03 medical and health sciences ,Mice ,0302 clinical medicine ,thymus ,Animals ,Regeneration ,Involution (medicine) ,Gene Knock-In Techniques ,Transcription factor ,Cell Proliferation ,Thymic involution ,Multidisciplinary ,Thymocytes ,Regeneration (biology) ,Mesenchymal stem cell ,Cell biology ,MafB ,radiation ,Thymocyte ,030104 developmental biology ,Gene Expression Regulation ,MAFB ,030220 oncology & carcinogenesis ,Mutation ,Medicine ,Whole-Body Irradiation - Abstract
The thymus facilitates mature T cell production by providing a suitable stromal microenvironment. This microenvironment is impaired by radiation and aging which lead to immune system disturbances known as thymic involution. Young adult thymus shows thymic recovery after such involution. Although various genes have been reported for thymocytes and thymic epithelial cells in such processes, the roles of stromal transcription factors in these remain incompletely understood. MafB (v-maf musculoaponeurotic fibrosarcoma oncogene homolog B) is a transcription factor expressed in thymic stroma and its expression was induced a day after radiation exposure. Hence, the roles of mesenchymal MafB in the process of thymic regeneration offers an intriguing research topic also for radiation biology. The current study investigated whether MafB plays roles in the adult thymus. MafB/green fluorescent protein knock-in mutant (MafB+/GFP) mice showed impaired thymic regeneration after the sublethal irradiation, judged by reduced thymus size, total thymocyte number and medullary complexity. Furthermore, IL4 was induced after irradiation and such induction was reduced in mutant mice. The mutants also displayed signs of accelerated age-related thymic involution. Altogether, these results suggest possible functions of MafB in the processes of thymic recovery after irradiation, and maintenance during aging.
- Published
- 2020
25. Lateral Thoracic Artery Can Stabilize Circulation in the Pectoralis Major Myocutaneous Pedicle Flap: Single-center, Prospective, Uncontrolled Case Series
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Kazuki Ueno, Kazuhisa Uemura, Yoshitaka Wada, Shinichi Asamura, Taiju Hyuga, Yasuhiro Sakata, Shinji Kumegawa, and Hidetaka Miyazaki
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medicine.medical_specialty ,RD1-811 ,Lateral thoracic artery ,business.industry ,Hemodynamics ,Reconstructive ,medicine.disease ,Surgery ,Angiopathy ,chemistry.chemical_compound ,Hematoma ,Blood pressure ,Thoracoacromial artery ,chemistry ,medicine.artery ,Seroma ,Medicine ,Original Article ,business ,Indocyanine green - Abstract
Background:. Head and neck reconstructions using the pectoralis major myocutaneous pedicle flap (PMMF) with thoracoacromial artery alone are prone to hemodynamic instability, possibly leading to infection, prolapse, hematoma, seroma, and partial or total flap failure (6%–71%). Aside from unstable blood circulation, reported risk factors for these complications include feminine gender, smoking, and having diabetes mellitus. Preservation of the lateral thoracic artery in addition to the thoracoacromial artery has been suggested as a way to improve unstable blood circulation in the PMMF. Methods:. This is a single-center, prospective, uncontrolled case series. Circulation to the PMMF was studied intraoperatively with and without lateral thoracic artery clamping after harvest. Indocyanine green (ICG) angiopathy, a quantitative hemodynamic assessment method, was used to analyze three parameters: maximum intensity (Imax), time from start of ICG to maximum intensity (Tmax), and slope of intensity (Smax = Imax/Tmax). Hemodynamic parameters, such as pulse rate and blood pressure, were all within normal ranges. Allergy to contrast media was criterion for exclusion. Results:. Six patients all had oral cancer as their primary disease. Their background was characterized by established risk factors: four patients had a history of smoking, two had diabetes mellitus, and two were women. Postoperatively, no patients had complications at the recipient or donor sites. Mean results of the analysis were Imax: 60 ± 47, Tmax: 91 ± 55, Smax: 0.8 ± 0.5 in the clamped group and Imax: 85 ± 40, Tmax: 73 ± 42, Smax: 1.8 ± 1.5 in the un-clamped group. Significant difference was observed in Imax (P = 0.03) and Smax (P = 0.03). Conclusion:. Lateral thoracic artery preservation appears to be useful for stabilizing blood circulation to the PMMF, including in patients considered to be at high-risk for complications, such as women, smokers, and patients with diabetes mellitus.
- Published
- 2021
26. Long-Term Outcome of the Pippi Salle Procedure for Intractable Urinary Incontinence in Patients with Severe Intrinsic Urethral Sphincter Deficiency
- Author
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Shigeru Nakamura, Taiju Hyuga, Hideo Nakai, and Shina Kawai
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adolescent ,Urology ,Urinary Bladder ,Urination ,Urinary incontinence ,Vesicoureteral reflux ,Young Adult ,Urethra ,medicine ,Humans ,Child ,Retrospective Studies ,Suburethral Slings ,Urinary bladder ,Spina bifida ,business.industry ,Urethral sphincter ,Middle Aged ,medicine.disease ,Surgery ,Neck of urinary bladder ,Treatment Outcome ,Urinary Incontinence ,medicine.anatomical_structure ,Bladder augmentation ,Urologic Surgical Procedures ,Female ,medicine.symptom ,business ,Follow-Up Studies - Abstract
We evaluated the long-term outcome of the Pippi Salle procedure in patients with severe intrinsic urethral sphincter deficiency.We performed the Pippi Salle procedure in 6 males and 6 females with severe intrinsic sphincter deficiency between March 2003 and August 2013. Median patient age was 15 years (range 6 to 45). Mean followup was 75 months (range 17 to 142). Six males and 3 females had neurogenic intrinsic sphincter deficiency (spina bifida in 8 and spinal cord injury in 1). Three females had anatomical intrinsic sphincter deficiency (idiopathic bladder hypoplasia in 2 and pseudo-ureterocele in 1). Four patients had previously undergone bladder neck surgery, 3 had been treated with endoscopic injection of collagen, 2 had undergone fascial sling and 1 had been treated with tension-free vaginal tape surgery. The Pippi Salle procedure was performed alone (2 patients), or in combination with bladder augmentation (4) or catheterizable abdominal stoma (1), or both (5).Complete dryness was achieved in 7 patients (58%). Of 9 patients with neurogenic intrinsic sphincter deficiency 7 (78%) achieved complete dryness. Eight patients experienced complications, including continued urinary incontinence (5), difficulty catheterizing per urethra (3) and urinary calculi (1). These 8 patients were successfully treated with additional endoscopic interventions, including injection of collagen in 4, injection of dextranomer-hyaluronic acid in 1, transurethral incision of urethral kink in 3 and vesicolithotripsy in 1. After these simple interventions complete dryness was achieved in all 12 patients.Although we experienced some minor complications in the short term, most patients were simply and successfully treated with endoscopic surgery. The long-term results of the Pippi Salle procedure are promising.
- Published
- 2015
27. Hedgehog Signaling for Urogenital Organogenesis and Prostate Cancer: An Implication for the Epithelial–Mesenchyme Interaction (EMI)
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Daiki Kajioka, Gen Yamada, Shinichi Miyagawa, Kentaro Suzuki, Yutaro Hayashi, Ryuma Haraguchi, Taiju Hyuga, Mellissa C. Alcantara, and Yoshiyuki Kojima
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Male ,Epithelial-Mesenchymal Transition ,hedgehog ,epithelial–mesenchymal interaction (EMI) ,Organogenesis ,medicine.medical_treatment ,Mesenchyme ,Review ,androgen ,Cell Communication ,Biology ,Bone morphogenetic protein ,Catalysis ,Inorganic Chemistry ,Paracrine signalling ,external genitalia ,bone morphogenetic protein ,Tumor Microenvironment ,medicine ,Animals ,Humans ,Hedgehog Proteins ,Protein Interaction Maps ,Physical and Theoretical Chemistry ,Molecular Biology ,Hedgehog ,Spectroscopy ,Growth factor ,Organic Chemistry ,Gene Expression Regulation, Developmental ,Prostatic Neoplasms ,General Medicine ,prostate cancer ,basement membrane ,Hedgehog signaling pathway ,Computer Science Applications ,Cell biology ,Crosstalk (biology) ,medicine.anatomical_structure ,Bone Morphogenetic Proteins ,Androgens ,Signal transduction ,Signal Transduction - Abstract
Hedgehog (Hh) signaling is an essential growth factor signaling pathway especially in the regulation of epithelial–mesenchymal interactions (EMI) during the development of the urogenital organs such as the bladder and the external genitalia (EXG). The Hh ligands are often expressed in the epithelia, affecting the surrounding mesenchyme, and thus constituting a form of paracrine signaling. The development of the urogenital organ, therefore, provides an intriguing opportunity to study EMI and its relationship with other pathways, such as hormonal signaling. Cellular interactions of prostate cancer (PCa) with its neighboring tissue is also noteworthy. The local microenvironment, including the bone metastatic site, can release cellular signals which can affect the malignant tumors, and vice versa. Thus, it is necessary to compare possible similarities and divergences in Hh signaling functions and its interaction with other local growth factors, such as BMP (bone morphogenetic protein) between organogenesis and tumorigenesis. Additionally, this review will discuss two pertinent research aspects of Hh signaling: (1) the potential signaling crosstalk between Hh and androgen signaling; and (2) the effect of signaling between the epithelia and the mesenchyme on the status of the basement membrane with extracellular matrix structures located on the epithelial–mesenchymal interface.
- Published
- 2019
28. Does small voided volume influence uroflowmetry curve patterns in Japanese children with daytime urinary incontinence?
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Makiko Mieno, Hideo Nakai, Kazuya Tanabe, Taiju Hyuga, Shigeru Nakamura, and Shina Kawai
- Subjects
Male ,medicine.medical_specialty ,Urology ,Urinary Bladder ,030232 urology & nephrology ,Urination ,Staccato ,03 medical and health sciences ,0302 clinical medicine ,Japan ,030225 pediatrics ,medicine ,Humans ,Child ,Retrospective Studies ,Bell curve ,business.industry ,Incidence ,Reproducibility of Results ,medicine.disease ,Overactive bladder ,Pediatrics, Perinatology and Child Health ,Daytime Urinary Incontinence ,Female ,Diurnal Enuresis ,Rheology ,business ,Follow-Up Studies - Abstract
A voided volume (VV) of50% of the expected bladder capacity for age is considered small VV. It was recommended that a VV ≥50% of expected bladder capacity for age is required to assess uroflowmetry (UFM) curves because a small VV causes changes in UFM curve characteristics. However, no clear consensus has been reached on the criterion for evaluating UFM curve patterns.The aim of the study was to evaluate the reproducibility and characteristics of UFM curve patterns in children with daytime urinary incontinence (DUI) and with a variety of VVs.This study investigated 119 children (79 boys and 40 girls) with primary DUI who underwent UFM 3 times on the same day and were classified into two groups: small VV (50% of expected bladder capacity for age) in 0-1 of the 3 UFM measurements (group 1; normal VV) or in 2-3 of the 3 UFM measurements (group 2; small VV). The authors then evaluated the agreement of UFM curve patterns among the 3 measurements, classifying complete, partial, or no agreement according to the number of identical curve patterns. The authors also evaluated the most characteristic patterns of UFM curve patterns for each group.Group 1 comprised 45 children, and group 2 comprised 74 children. Rates of complete agreement (group 1, 24/45; group 2, 30/74), partial agreement (group 1, 19/45; group 2, 35/74), and no agreement (group 1, 2/45; group 2, 9/74) did not differ significantly between groups (p = 0.226). Bell curve patterns were significantly more common in group 1 than in group 2 (p = 0.025). Frequency of the tower pattern was significantly higher in group 2 than in group 1 (p = 0.006) (Summary table).No differences in agreement rates of UFM curve patterns were seen between two groups (small and normal VV). The authors thus suggest that UFM curve patterns can be validly assessed in children with DUI and with small VV. It was found that the bell pattern was significantly more common among children with normal VV, whereas the tower pattern was significantly more common among children with small VV. The tower pattern reflects an overactive bladder. The present results suggest that some children have DUI that is not attributable to urgency.Reproducibility of UFM curve patterns might be properly assessed even in children with DUI and with small VV. This result suggests the presence of various pathological conditions other than the conditions with urgency underlying DUI.
- Published
- 2019
29. Prevention of recurrent febrile urinary tract infection in infants: Ultrasonography-oriented approach is more practical than a top-down approach
- Author
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Rieko Furukawa, Takahiro Kanai, Shina Kawai, Kazuya Tanabe, Taiju Hyuga, Shigeru Nakamura, Toshinori Aihara, Jun Aoyagi, Jun Odaka, Hideo Nakai, Hiroyuki Betsui, Takashi Saito, and Takane Ito
- Subjects
Male ,medicine.medical_specialty ,Fever ,Dmsa scintigraphy ,Urinary system ,Observation period ,Urology ,030204 cardiovascular system & hematology ,Renal scintigraphy ,03 medical and health sciences ,0302 clinical medicine ,Cystourethrography ,Recurrence ,030225 pediatrics ,medicine ,Secondary Prevention ,Humans ,False Positive Reactions ,Radionuclide Imaging ,Retrospective Studies ,Ultrasonography ,business.industry ,Febrile urinary tract infection ,Infant ,Dimercaptosuccinic acid ,Pediatrics, Perinatology and Child Health ,Technetium Tc 99m Dimercaptosuccinic Acid ,Urinary Tract Infections ,Female ,Radiopharmaceuticals ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background We previously reported that the top-down approach (TDA) for infants with febrile urinary tract infections (fUTI) could prevent recurrent fUTI (r-fUTI) but produced a high number of false-positives on acute-phase 99m Tc dimercaptosuccinic acid (DMSA) renal scintigraphy. Therefore we compared the ultrasonography-oriented approach (USOA) with TDA from the viewpoint of prevention of r-fUTI. Methods The TDA was applied between July 2010 and February 2014 and the USOA was applied between March 2014 and April 2017 in infants with first fUTI. In the USOA group, voiding cystourethrography (VCUG) was performed in the case of abnormality on acute-phase renal bladder ultrasonography (RBUS) or on chronic- phase DMSA, which were performed in all cases. The frequency of r-fUTI was compared between the TDA group and USOA group retrospectively. Results Seventy-four infants (52 male) and 79 infants (60 male) received TDA or USOA, respectively. No significant differences were found between the TDA and USOA groups in male : female ratio, age in months at initial onset of fUTI, observation period, or number of cases of r-fUTI (TDA group, n = 4; USOA group, n = 5). Seventy-four DMSA scintigraphy and 25 VCUG were carried out in the USOA group, and 111 DMSA scintigraphy and 34 VCUG in the TDA group. Conclusions Both USOA and TDA were valid for prevention of r-fUTI, but USOA was superior to TDA with regard to the reduced number of patients undergoing VCUG and DMSA.
- Published
- 2018
30. Developmental mutant mouse models for external genitalia formation
- Author
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Kentaro Suzuki, Alvin R. Acebedo, Gen Yamada, Daiki Hashimoto, Taiju Hyuga, and Mellissa C. Alcantara
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0301 basic medicine ,Male ,Embryology ,Organogenesis ,MafB Transcription Factor ,Morphogenesis ,030105 genetics & heredity ,Biology ,urologic and male genital diseases ,Perineum ,Congenital Abnormalities ,03 medical and health sciences ,Mice ,Conditional gene knockout ,medicine ,Animals ,Humans ,Genitalia ,Genital tubercle ,Wnt Signaling Pathway ,Mice, Knockout ,Sex Characteristics ,urogenital system ,Endoderm ,Gene Expression Regulation, Developmental ,General Medicine ,Embryo, Mammalian ,female genital diseases and pregnancy complications ,Teratology ,Cell biology ,Transcription Factor AP-1 ,Disease Models, Animal ,030104 developmental biology ,Urethra ,medicine.anatomical_structure ,Cloaca (embryology) ,Pediatrics, Perinatology and Child Health ,Female ,Developmental biology ,Developmental Biology - Abstract
Development of external genitalia and perineum is the subject of developmental biology as well as toxicology and teratology researches. Cloaca forms in the lower (caudal) end of endoderm. Such endodermal epithelia and surrounding mesenchyme interact with various signals to form the external genitalia. External genitalia (the anlage termed as genital tubercle: GT) formation shows prominent sexually dimorphic morphogenesis in late embryonic stages, which is an unexplored developmental research field because of many reasons. External genitalia develop adjacent to the cloaca which develops urethra and corporal bodies. Developmental regulators including growth factor signals are necessary for epithelia-mesenchyme interaction (EMI) in posterior embryos including the cloaca and urethra in the genitalia. In the case of male type urethra, formation of tubular urethra proceeds from the lower (ventral) side of external genitalia as a masculinization process in contrast to the case of female urethra. Mechanisms for its development are not elucidated yet due to the lack of suitable mutant mouse models. Because of the recent progresses of Cre (recombinase)-mediated conditional target gene modification analyses, many developmental regulatory genes become increasingly analyzed. Conditional gene knockout mouse approaches and tissue lineage approaches are expected to offer vital information for such sexually dimorphic developmental processes. This review aims to offer recent updates on the progresses of these emerging developmental processes for the research field of congenital anomalies.
- Published
- 2018
31. AUTHOR REPLY
- Author
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Shina Kawai, Taiju Hyuga, Shigeru Nakamura, and Hideo Nakai
- Subjects
Urology - Published
- 2018
32. Pediatric Primary Alveolar Soft Part Sarcoma of the Bladder
- Author
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Masahiro Yamazaki, Rieko Furukawa, Shigeru Nakamura, Toshiro Niki, Shina Kawai, Yohei Kawashima, Shigeru Ono, Kazuya Tanabe, Taiju Hyuga, and Hideo Nakai
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,030232 urology & nephrology ,Clinical course ,Case Report ,General Medicine ,lcsh:Diseases of the genitourinary system. Urology ,lcsh:RC870-923 ,Primary Alveolar Soft Part Sarcoma ,Appendix ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Stoma (medicine) ,Cystourethrectomy ,030220 oncology & carcinogenesis ,medicine ,Bladder tumor ,Pouch ,Positive Surgical Margin ,business - Abstract
A 9-year-old girl was diagnosed with primary alveolar soft part sarcoma of the bladder after imaging examinations and transurethral resection (TUR) of the bladder tumor. As a positive surgical margin of the TUR indicated residual tumor cells, we performed a cystourethrectomy to remove the tumor. A continent urinary reservoir for self-catheterization was constructed using the Mainz pouch technique, and an abdominal (umbilical) continent catheterizable stoma using the appendix was performed. For 2.5 years postoperatively, the patient remained free of local recurrence and distant metastasis. The patient’s clinical course has been favorable, with good management of clean intermittent self-catheterization.
- Published
- 2018
33. The Endoscopic Morphological Features of Congenital Posterior Urethral Obstructions in Boys with Refractory Daytime Urinary Incontinence and Nocturnal Enuresis
- Author
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Hideo Nakai, Taiju Hyuga, Taro Kubo, Shigeru Nakamura, and Shina Kawai
- Subjects
Male ,Posterior urethral valve ,medicine.medical_specialty ,Cystography ,Urethral Obstruction ,Adolescent ,Urethra ,Refractory ,Enuresis ,medicine ,Humans ,Child ,medicine.diagnostic_test ,business.industry ,Cystoscopy ,medicine.disease ,Surgery ,Endoscopy ,medicine.anatomical_structure ,Pediatrics, Perinatology and Child Health ,Diurnal Enuresis ,Diurnal enuresis ,medicine.symptom ,business ,Nocturnal Enuresis - Abstract
Purpose This study aims to evaluate the endoscopic morphological features of congenital posterior urethral obstructions in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. Patients and Methods A total of 54 consecutive patients underwent endoscopy and were diagnosed with a posterior urethral valve (PUV) (types 1–4). PUV type 1 was classified as severe, moderate, or mild. A transurethral incision (TUI) was mainly performed for anterior wall lesions of the PUV. Voiding cystourethrography and pressure flow studies (PFS) were performed before and 3 to 4 months after TUI. Clinical symptoms were evaluated 6 months after TUI, and outcomes were assessed according to PFS waveform pattern groups (synergic pattern [SP] and dyssynergic pattern [DP]). Results All patients had PUV type 1 and/or 3 (i.e., n = 34 type 1, 7 type 3, and 13 types 1 and 3). There were severe (n = 1), moderate (n = 21), and mild (n = 25) cases of PUV type 1. According to PFS, SP and DP were present in 43 and 11 patients, respectively. TUI was effective in the SP group and symptoms improved in 77.4 and 69.3% of patients with daytime incontinence and nocturnal enuresis, respectively. Almost no effect was observed in the DP group. A significant decrease in the detrusor pressure was observed at maximum flow rate using PFS in the SP group. Conclusions PUV type 1 encompassed lesions with a spectrum of obstructions ranging from severe to mild, with mild types whose main obstructive lesion existed at the anterior wall of urethra occurring most frequently in boys with refractory daytime urinary incontinence and/or nocturnal enuresis.
- Published
- 2015
34. The changes of urethral morphology recognized in voiding cystourethrography after endoscopic transurethral incision for posterior urethral valve in boys with intractable daytime urinary incontinence and nocturnal enuresis
- Author
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Shigeru Nakamura, Rieko Furukawa, Toshinori Aihara, Hideo Nakai, Shina Kawai, Makiko Mieno, Taiju Hyuga, and Taro Kubo
- Subjects
Posterior urethral valve ,Male ,medicine.medical_specialty ,Urology ,media_common.quotation_subject ,Radiography ,030232 urology & nephrology ,Urinary Diversion ,Urination ,03 medical and health sciences ,0302 clinical medicine ,Cystourethrography ,Japan ,Lower Urinary Tract Symptoms ,Urethra ,Enuresis ,medicine ,Humans ,In patient ,Postoperative Period ,Child ,media_common ,Retrospective Studies ,business.industry ,Endoscopy ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,030220 oncology & carcinogenesis ,Daytime Urinary Incontinence ,medicine.symptom ,Diurnal Enuresis ,business ,Nocturnal Enuresis - Abstract
Endoscopic transurethral incision (TUI) of posterior urethral valve (PUV) can improve daytime urinary incontinence (DUI) and nocturnal enuresis (NE). However, the underlying mechanism has not been elucidated. In this study, we retrospectively examined the mobility of the urethra before and after TUI by measuring the urethral angle with voiding cystourethrography (VCUG), to clarify the effects of TUI on the morphology of the urethra during voiding. Between July 2010 and December 2014, 29 boys with intractable DUI and/or NE were diagnosed as PUV and underwent endoscopic TUI. VCUG during voiding phase was performed at sequential radiographic spot images (1 image per second) at a 45° angle in oblique standing position. The point at which the angle of the urethra was the smallest during urination was regarded as the minimum urethral angle. The maximum urethral angle during early voiding phase was compared with the minimum urethral angle, and the percentage by which this angle changed was calculated as the flexion rate. Then changes in minimum urethral angle and flexion rate were analyzed before and 3–4 months after TUI. After TUI, the minimum urethral angle on VCUG became more obtuse (before vs. after TUI, respectively: 112.7 vs. 124.5°, p
- Published
- 2016
35. Evaluation of the Effectiveness of a Short-term Treatment and Repeat Treatment of Nocturnal Enuresis Using an Enuresis Alarm
- Author
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Shina Kawai, Taiju Hyuga, Shigeru Nakamura, and Hideo Nakai
- Subjects
Short term treatment ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Adolescent ,Urology ,030232 urology & nephrology ,Patient characteristics ,Nocturnal ,03 medical and health sciences ,0302 clinical medicine ,Enuresis ,030225 pediatrics ,Medicine ,Humans ,Time point ,Child ,Complete response ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Treatment Outcome ,Clinical Alarms ,Retreatment ,Daytime Urinary Incontinence ,Female ,medicine.symptom ,business ,Nocturnal Enuresis - Abstract
Objective To evaluate the effectiveness of a 3-month enuresis alarm (EA) treatment and repeat EA treatment among pediatric patients with nocturnal enuresis, and to compare patient characteristics among “responders” and “nonresponders” to treatment. Materials and Methods Clinical outcomes were retrospectively evaluated for 137 children (94 boys and 43 girls, mean age, 10.1 years). Effectiveness was evaluated after an initial 3-month treatment, using the International Children's Continence Society criteria. Among children in the no-response group at 3 months, those who continued the EA treatment for ≥4 months were subclassified into group 1, whereas children who repeated the EA treatment at an interval ≥6 months were subclassified into group 2. Results Among our 137 cases, 19 achieved complete response and 47 achieved partial response at 3 months, for an overall treatment effectiveness rate of 48%. Among the no-response group, treatment was extended in 17 cases (group 1), with 3 (18%) achieving a successful outcome. Treatment was repeated in 18 cases (group 2). In group 2, 8 (44%) achieved successful outcome at 3-month time point. Daytime urinary incontinence did not modify treatment effectiveness. Conclusion EA treatment should be given for a short period of time and should not be continued without a definite purpose or clear response. Suspending and then repeating this treatment after an appropriate interval is effective for patients who do not respond to the initial course of treatment.
- Published
- 2016
36. Top-down approach is possible strategy for predicting breakthrough fUTIs and renal scars in infants
- Author
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Toshinori Aihara, Takashi Saito, Rieko Furukawa, Jun Odaka, Hideo Nakai, Taiju Hyuga, Shigeru Nakamura, Takahiro Kanai, Shina Kawai, Jun Aoyagi, and Takane Ito
- Subjects
Male ,medicine.medical_specialty ,Fever ,030232 urology & nephrology ,Urology ,Scintigraphy ,Kidney ,Vesicoureteral reflux ,Risk Assessment ,03 medical and health sciences ,Cicatrix ,0302 clinical medicine ,Recurrence ,030225 pediatrics ,Renal scar ,Medicine ,Humans ,Sex organ ,Antibiotic prophylaxis ,Radionuclide Imaging ,medicine.diagnostic_test ,business.industry ,Febrile urinary tract infection ,Incidence ,Infant ,medicine.disease ,Dimercaptosuccinic acid ,Pediatrics, Perinatology and Child Health ,Technetium Tc 99m Dimercaptosuccinic Acid ,Urinary Tract Infections ,Renal scars ,Female ,Radiopharmaceuticals ,business ,medicine.drug ,Follow-Up Studies - Abstract
Background Acute-phase technetium-99 m dimercaptosuccinic acid (DMSA) scintigraphy is recommended for initial imaging in children with febrile urinary tract infection (fUTI). Recently, the importance of identifying patients at risk of recurrent fUTI (r-fUTI) has been emphasized. To clarify the effectiveness of DMSA scintigraphy for predicting r-fUTI in infants, we investigated the relationship between defects on DMSA scintigraphy and r-fUTI. Methods Seventy-nine consecutive infants (male: female, 60:19) with fUTI were enrolled in this study. DMSA scintigraphy was performed in the acute phase, and patients with defect underwent voiding cystourethrography and chronic-phase (6 months later) DMSA scintigraphy. Patients were followed on continuous antibiotic prophylaxis (CAP). Results Defects on acute-phase DMSA scintigraphy were observed in 32 children (40.5%) of 79. The mean follow-up observation period was 17.0 ± 10.1 months. Four patients had r-fUTI (5%). Two of them had defects on DMSA scintigraphy in both the acute phase and chronic phase, and had bilateral vesicoureteral reflux (VUR) grade IV. Two others had r-fUTI without defects on DMSA and did not have VUR. Twelve patients had defect on chronic-phase DMSA scintigraphy and four of them had no VUR. Conclusions The top-down approach is a possible method for predicting r-fUTI in infants and does not miss clinically significant VUR. Also, given that the prevalence of r-fUTI was 5% regardless of the presence of defects on acute-phase DMSA, then, in conjunction with genital hygiene and CAP, acute-phase DMSA might be unnecessary if chronic-phase DMSA is performed for all patients to detect renal scar.
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- 2016
37. Long-Term Outcome of Low Scrotal Approach Orchiopexy without Ligation of the Processus Vaginalis
- Author
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Taiju Hyuga, Shina Kawai, Shigeru Nakamura, Hideo Nakai, and Taro Kubo
- Subjects
Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,030232 urology & nephrology ,Abdominal cavity ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Scrotum ,Cryptorchidism ,medicine ,Humans ,In patient ,Orchiopexy ,Child ,Scrotal approach ,Ligation ,Retrospective Studies ,business.industry ,Patent processus vaginalis ,Infant ,Mean age ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Child, Preschool ,business ,Follow-Up Studies - Abstract
We performed low scrotal approach orchiopexy in patients with prescrotal cryptorchidism. The processus vaginalis was not ligated if it was not widely patent. We retrospectively evaluated the long-term outcomes of low scrotal approach orchiopexy without processus vaginalis ligation.A total of 137 patients (227 testes) were diagnosed with prescrotal cryptorchidism between October 2009 and April 2014. All patients underwent low scrotal approach orchiopexy. Mean age at surgery was 34.9 months. The processus vaginalis was deemed to be not widely patent when a sound could not be passed into the abdominal cavity through the internal inguinal ring, and the processus vaginalis was not ligated in such cases.Intraoperative findings revealed that the processus vaginalis was widely patent in 10 testes and was not widely patent in 217. A widely patent processus vaginalis was closed via scrotal approach in 5 testes, while an inguinal approach was necessary in 5. Median followup was 44 months (range 20 to 73). Postoperative complications included reascending testis in 1 case where an inguinal approach was necessary. No patient manifested testicular atrophy or inguinal hernia.Low scrotal approach orchiopexy is a useful and safe procedure for treating patients with prescrotal cryptorchidism. Ligation is unnecessary when the processus vaginalis is not widely patent.
- Published
- 2016
38. Initial evaluation of prostate cancer with real-time elastography based on step-section pathologic analysis after radical prostatectomy: A preliminary study
- Author
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Masahiro Sumura, Kazushi Shigeno, Tatsuaki Yoneda, Hiroaki Shiina, Mikio Igawa, and Taiju Hyuga
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medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Prostatectomy ,Urology ,medicine.medical_treatment ,Magnetic resonance imaging ,Rectal examination ,medicine.disease ,Prostate cancer ,medicine.anatomical_structure ,Prostate ,medicine ,Transrectal ultrasonography ,Elastography ,Radiology ,business ,Real time elastography - Abstract
Objective: To determine whether real-time elastography can be used to detect prostate cancer as a relatively non-invasive modality based on the tissue strain value. Patients and Methods: Seventeen patients underwent real-time elastography in conjunction with digital rectal examination (DRE), conventional gray-scale transrectal ultrasonography (TRUS), color Doppler ultrasonography (CDUS), and magnetic resonance imaging (MRI) prior to radical prostatectomy. The elastogram was compared to findings of conventional modalities and pathological findings of prostatectomy specimens. To obtain the elastogram, compression of the prostate was performed along with a visual indicator on a video screen. Results: Twenty of 27 pathologically confirmed tumors were detected with real-time elastography. The cancer detection rate with real-time elastography was superior to the rates of other modalities and nearly equal to both on the anterior side (75.0%) and the posterior side (73.7%) of the prostate. A higher tumor detection rate for real-time elastography was observed for tumors with a higher Gleason score and larger tumor volume. Conclusion: In our preliminary study, real-time elastography in conjunction with gray-scale TRUS is a non-invasive modality to detect prostate cancer.
- Published
- 2007
39. Renal dysplasia characterized by prominent cartilaginous metaplasia lesions in VACTERL association
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Takeo Nakaya, Akira Tanaka, Toshiro Niki, Yukichi Tanaka, Hideo Nakai, Shina Kawai, and Taiju Hyuga
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0301 basic medicine ,Kidney ,Pathology ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,030232 urology & nephrology ,General Medicine ,urologic and male genital diseases ,medicine.disease ,Renal dysplasia ,VACTERL association ,Nephrectomy ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,medicine.anatomical_structure ,Dysplasia ,Metaplasia ,medicine ,Kidney surgery ,medicine.symptom ,business ,Tetralogy of Fallot - Abstract
Background Renal dysplasia is the most important cause of end-stage renal disease in children. The histopathological characteristic of dysplasia is primitive tubules with fibromuscular disorganization. Renal dysplasia often includes metaplastic cartilage. Metaplastic cartilage in renal dysplasia has been explained as occurring secondary to vesicoureteral reflux (VUR). Additionally, renal dysplasia is observed in renal dysplasia-associated syndromes, which are combinations of multiple developmental malformations and include VACTERL association. Case presentation We observed the following multiple developmental malformations in a 108-day-old male infant during a nephrectomy: a nonfunctioning right kidney with VUR, hemidiaphragmatic eventration, a ventricular septal defect (VSD) with tetralogy of Fallot in the heart, cryptorchidism, and hyperdactylia. These developmental anomalies satisfied the diagnostic criteria for VACTERL association. A surgical specimen of the right nonfunctioning kidney revealed prominent cartilaginous metaplasia in the renal dysplasia with VUR. The densities of the ectopic cartilaginous lesions in this nonfunctioning kidney were extraordinarily high compared with other renal dysplasia cases. Giemsa banding of his genome produced normal results. The patient has not undergone further detailed genomic investigation. Conclusion This case might be a novel type of VACTERL association, that is, renal dysplasia combined with prominent cartilaginous metaplasia, tetralogy of Fallot and VSD of the heart, hemidiaphragmatic eventration, and hyperdactylia.
- Published
- 2017
40. [A case of renal malacoplakia that was difficult to distinguish from cystic renal cell carcinoma]
- Author
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Kazuo Kawakami, Toshikatsu Ishino, Shigenobu Nakamura, and Taiju Hyuga
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Male ,medicine.medical_specialty ,Percutaneous ,Urology ,medicine.medical_treatment ,Malacoplakia ,Diagnosis, Differential ,Renal cell carcinoma ,medicine ,Ascending colon ,Humans ,Carcinoma, Renal Cell ,Aged ,High grade fever ,Kidney ,business.industry ,Kidney Diseases, Cystic ,medicine.disease ,Nephrectomy ,Kidney Neoplasms ,medicine.anatomical_structure ,Kidney Diseases ,Radiology ,Differential diagnosis ,business - Abstract
A 66 years old man visited our hospital with a chief complaint of right flank pain and abdominal palpable mass. Abdominal enhanced computed tomography scan showed a large cystic mass with infiltrating surrounding tissue in the right kidney. We diagnosed it infected cystic renal cell carcinoma because of high grade fever and acute inflammatory response. It was surgically unresectable tumor. Therefore, percutaneous puncture and drainage was performed under ultrasound guidance. In the culture of drainage fluid, Escherichia coli (E. coli) was isolated. Then, we confirmed reduction in the size of the tumor, right radical nephrectomy was performed. Because of tumor invasion to ascending colon, we performed the excision of right kidney together with ascending colon. Histological study confirmed target-shaped Michaelis-Gutmann body, and the definitive diagnosis was malacoplakia of the kidney. We reported a case of renal malacoplakia that was difficult to distinguish from cystic renal cell carcinoma. Our case is 12th case of renal malacoplakia in the Japanese literature.
- Published
- 2011
41. [A case of emphysematous cystitis treated by clean intermittent catheterization : a case report]
- Author
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Taiju, Hyuga and Kazuo, Kawakami
- Subjects
Aged, 80 and over ,Emphysema ,Male ,Cystitis ,Humans ,Urinary Catheterization - Abstract
Emphysematous cystitis is a rare condition characterized by air formation in and around the bladder wall by gas-forming organisms. An 89-year-old non-diabetic man with benign prostatic hyperplasia and neurogenic bladder presented at our hospital with fever and lower abdominal pain. Urinalysis and urine culture revealed pyuria and bacteriuria with Citrobacter freundii. Abdominal computed tomography revealed intramural gas, which suggested the diagnosis of emphysematous cystitis. He recovered and the intramural gas appeared to have disappeared on the abdominal computed tomography after urinary drainage and antibiotic therapy. Ninty-nine cases of emphysematous cystitis have been reported in Japan including this case.
- Published
- 2010
42. The Endoscopic Morphological Features of Congenital Posterior Urethral Obstructions in Boys with Refractory Daytime Urinary Incontinence and Nocturnal Enuresis.
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Shigeru Nakamura, Taiju Hyuga, Shina Kawai, Taro Kubo, Hideo Nakai, Nakamura, Shigeru, Hyuga, Taiju, Kawai, Shina, Kubo, Taro, and Nakai, Hideo
- Subjects
- *
URINARY incontinence , *ENURESIS , *TRANSURETHRAL prostatectomy , *PEDIATRIC urology , *URETHRA abnormalities , *URETHRA surgery , *CYSTOSCOPY , *URETHRA ,URETHRAL obstruction - Abstract
Purpose This study aims to evaluate the endoscopic morphological features of congenital posterior urethral obstructions in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. Patients and Methods A total of 54 consecutive patients underwent endoscopy and were diagnosed with a posterior urethral valve (PUV) (types 1-4). PUV type 1 was classified as severe, moderate, or mild. A transurethral incision (TUI) was mainly performed for anterior wall lesions of the PUV. Voiding cystourethrography and pressure flow studies (PFS) were performed before and 3 to 4 months after TUI. Clinical symptoms were evaluated 6 months after TUI, and outcomes were assessed according to PFS waveform pattern groups (synergic pattern [SP] and dyssynergic pattern [DP]). Results All patients had PUV type 1 and/or 3 (i.e., n = 34 type 1, 7 type 3, and 13 types 1 and 3). There were severe (n = 1), moderate (n = 21), and mild (n = 25) cases of PUV type 1. According to PFS, SP and DP were present in 43 and 11 patients, respectively. TUI was effective in the SP group and symptoms improved in 77.4 and 69.3% of patients with daytime incontinence and nocturnal enuresis, respectively. Almost no effect was observed in the DP group. A significant decrease in the detrusor pressure was observed at maximum flow rate using PFS in the SP group. Conclusions PUV type 1 encompassed lesions with a spectrum of obstructions ranging from severe to mild, with mild types whose main obstructive lesion existed at the anterior wall of urethra occurring most frequently in boys with refractory daytime urinary incontinence and/or nocturnal enuresis. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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