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Abstract Background The objective of this study is to assess whether urethral preservation can be performed safely using frozen section analysis (FSA) of the urethral stump on urethral recurrence after radical cystectomy. Methods Between June 2012 and July 2022, we investigated consecutive male patients who underwent urethral FSA during radical cystectomy for urothelial carcinoma. For FSA‐abnormal cases, urethrectomy was performed, and for FSA‐normal cases, the urethra was preserved. The diagnostic accuracy of FSA was assessed in comparison with the pathological findings of the permanent sections of the same tissue. Postoperatively, computed tomography and urinary cytology were performed as routine surveillance of recurrence. Results Of the 77 patients included in this study, three patients with abnormal FSA underwent concurrent urethrectomy. The negative predictive value of urethral FSA was 100%. With a median postoperative follow‐up of 38 months (interquartile ranges 21–71), no urethral recurrence was observed. Conclusions FSA may be useful in determining the indication for urethrectomy.

Abstract Objective The objective of this work is to assess the relationship between the morphological characteristics of a central tumour and the perioperative outcomes of robot‐assisted partial nephrectomy (RAPN). Subjects and Methods We retrospectively analysed the data from 186 patients with central tumours involving the renal sinus, who underwent RAPN in a single‐centre study between February 2015 and June 2022. All cases were assigned a RENAL nephrometry score based on preoperative images. The shape of the protruding portion of the tumour was classified into four types: ‘flat’, ‘spherical’, ‘single‐hump’, and ‘complex‐hump’, and was independently assessed by two readers. The trifecta is defined as the warm ischemia time within 25 min, negative surgical margins, and no major postoperative complications. Univariate and multivariate analyses were performed to identify the factors associated with the failing trifecta. Results Trifecta was achieved in 113 cases (60.8%), and the achievement rate in flat, spherical, single‐hump, and complex‐hump types was 83.3%, 74.5%, 64.3%, and 21.3%, respectively. Prolonged warm ischemia time was the primary cause of the failure to achieve the trifecta. The rate of positive surgical margins and upstage to pathological T3a was greater for complex humps while the rate of major complications and postoperative GFR preservation did not differ between shapes. On multivariate analysis for failing trifecta achievement, the complex‐hump protrusion was found to be an independent positive predictor (odds ratio: 15.8; p

Abstract To evaluate the surgical and functional outcomes between robot-assisted (CRO-RAPN) vs. laparoscopic (CRO-LPN) methods of cortical-renorrhaphy-omitting partial nephrectomy. Between July 2012 and June 2020, patients with localized clinical T1-2 renal masses who underwent CRO-RAPN or CRO-LPN were reviewed. The outcomes of the two groups were compared using propensity-score matching. Trifecta was defined as negative surgical margin, warm ischemic time

Introduction Cytoreductive nephrectomy has been used in combination with systemic therapy for the treatment of metastatic renal cell carcinoma, although its efficacy in the era of immune checkpoint inhibitors remains controversial. Case presentation A 57‐year‐old woman was diagnosed with left renal cell carcinoma and lung carcinomatous lymphangiosis (cT3aN0M1). After receiving combined immunotherapy, she achieved complete response for the lung metastases and partial response for the primary tumor. After five months of systemic therapy, she underwent partial nephrectomy to remove the primary tumor, followed by eight courses of nivolumab monotherapy. One year postoperatively, she remained recurrence‐free. Conclusion Cytoreductive partial nephrectomy for surgical consolidation may be a treatment option for metastatic renal cell carcinoma.

Abstract Background To compare 5-aminolevulinic acid (5-ALA)-mediated photodynamic diagnosis (PDD) with narrow-band imaging (NBI) for cancer detection during transurethral resection of bladder tumour (TURBT). Methods Between June 2018 and October 2020, 114 patients and 282 lesions were included in the analysis. Patients were orally administered 5-ALA (20 mg/kg) 2 h before TURBT. The bladder was inspected with white light (WL), PDD, and NBI for each patient, and all areas positive by at least one method were resected or biopsied. The imaging data were then compared to the pathology results. Results The sensitivities of WL, PDD, and NBI for detecting urothelial carcinoma were 88.1%, 89.6%, and 76.2%, respectively. The specificity, positive predictive value, and negative predictive value for detecting urothelial carcinoma were 47.5%, 80.9%, and 61.3%, respectively, for WL; 22.5%, 74.5%, and 46.2%, respectively, for PDD; and 46.3%, 78.2%, and 43.5%, respectively, for NBI. PDD was significantly more sensitive than NBI for all lesions (p

For a low-carbon society, it is necessary to extract hydrogen for fuel cells from biogas rather than from fossil fuels. However, impurities contained in the biogas affect the fuel cell; hence, there is a need for system and operation methods to remove these impurities. In this study, to develop a fuel cell system for the effective utilization of biogas-derived hydrogen, the compositional change and concentration of impurities in the hydrogen recirculation system under actual operation were evaluated using process simulation. Then, the mitigation operation for performance degradation using simple purification methods was evaluated on the proton exchange membrane fuel cells (PEMFC) stack. In the process simulation of the hydrogen recirculation system, including the PEMFC stack, the concentration of impurities remained at a level that did not pose a problem to the performance. In the constant voltage test for a simulated gas supply of biogas-derived hydrogen, the conditions for applying the methanation reforming and air bleeding methods were analyzed. As a result, methanation reforming is more suitable for supplying biogas-containing CO to the PEMFC stack for continuous operation.

Abstract  Wild-type measles virus (wtMeV) adapted well to cotton rat lung (CRL) cells after serial passages. In order to evaluate the contributions of the individual genes of wtMeV for adaptation, whole genome sequences of the adapted and original viruses were determined and analyzed. The results showed that there were two mutations in the whole genome of the adapted virus. One mutation was located at the 265th nucleotide in the open reading frame (ORF) of the M gene, resulting in the substitution of the 89th amino acid from E (glutamate) to K (lysine). The other was a silent mutation located at the 4182nd nucleotide in the ORF of the L gene. It was demonstrated that the E89K mutation in the M protein is responsible for the adaptation of wtMeV MV99Y in CRL cells. Cotton rats were infected with adapted virus and the original strain via intranasal inoculation. Virus titer results showed that adapted strain replicated better than the original strain in cotton rat lungs. It is suggested that the E89K mutation also contributes to the enhancement of wtMeV replication in a cotton rat model infected intranasally. The results revealed that the E89K mutation in the M protein plays a key role in wtMeV adaptation in cotton rat and CRL cells. [ABSTRACT FROM AUTHOR]

A wearable leg support system for hemiplegia has been proposed in this paper. Power assist suits, which are studied by many researchers lately, are not applicable to those people with lower limb paralysis caused by spinal cord injury or stroke. We have developed a wearable leg support system, Manipuleg-2, that has actuators at hip, knee, and ankle, and has a special control lever mounted on the unaffected shoulder. The postures of user's arm and wrist are detected by the lever with 3 DOF, and are transformed to the actuator joint angles for manipulation of the exoskeleton leg. Walking experiments have been conducted for an able-bodied subject with the developed system on a level floor and a certain uneven floor, and the results show that the subject has mastered how to manipulate the control lever to walk properly.