Author Kurahashi, Hiroaki| Watanabe, Masami| Sugimoto, Morito| Ariyoshi, Yuichi| Mahmood, Sabina| Araki, Motoo| Ishii, Kazushi| Nasu, Yasutomo| Nagai, Atsushi| Kumon, Hiromi|
Published Date 2013-12
Publication Title Endocrine Journal
Volume volume60
Issue issue12
Content Type Journal Article
JaLCDOI 10.18926/AMO/48668
FullText URL 66_4_291.pdf
Author Yokoyama, Teruhiko| Yamamoto, Yumiko| Suzuki, Tomonori| Oguma, Keiji| Nagai, Atsushi|
Abstract Several studies have demonstrated the efficacy of intraprostatic injection of botulinum neurotoxin type A (BoNT/A) against symptomatic benign prostatic hyperplasia (BPH). The most commonly used BoNT/A product, Botox®, forms large complexes and composed of neurotoxin (NTX) as well as non-toxic components. We purified NTX lacking non-toxic components. We investigated the efficacy of this newly purified NTX for men with BPH. Ten male patients (mean age, 70.0 years) with BPH received 100 units (prostate volume [PV] <30ml) or 200 units (PV ァ30ml) of NTX injected into the prostate via a minimally invasive outpatient technique. Evaluation included uroflowmetry, postvoid residual urine volume (PVR), PV, and International Prostate Symptom Score (IPSS) measured at baseline and 1, 3, 6, and 12 months post-treatment. The status of 7 of the 10 patients examined was found to have improved within 1 month of treatment. The mean IPSS decreased from 23.8±7.0 to 16.3±10.3 (p=0.0093) at 1 month, to 14.9±8.2 (p=0.0074) at 3 months, and to 16.9±7.3 (p=0.018) at 12 months. The mean PV decreased from 47.8±21.2 to 39.2±19.5ml (p=0.0076) at 3 months. The PVR improved at 3 and 6 months post-treatment. Intraprostatic NTX injection induces prostate shrinkage and is effective in men with BPH.
Keywords botulinum neurotoxin type A benign prostatic hyperplasia therapy
Amo Type Original Article
Published Date 2012-08
Publication Title Acta Medica Okayama
Volume volume66
Issue issue4
Publisher Okayama University Medical School
Start Page 291
End Page 297
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2012 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22918201
Web of Sience KeyUT 000307918900001
JaLCDOI 10.18926/AMO/47017
FullText URL 65_5_343.pdf
Author Hara, Ryoei| Fujii, Tomohiro| Jo, Yoshimasa| Yokoyama, Teruhiko| Miyaji, Yoshiyuki| Nagai, Atsushi|
Abstract We report the case of a 7-year-old girl with a single ectopic ureter who was treated with retroperitoneoscopic nephrectomy for a chief complaint of urinary incontinence. Preoperative CT showed a contrasted dysplastic kidney of 1cm in the renal fossa and a left ureteral opening into the vagina. Retroperitoneoscopic left nephrectomy was conducted with opening of the lateroconal fascia to enable identification of the dysplastic kidney. No intraoperative complications were encountered. Urinary incontinence improved immediately after surgery. This case shows that a retroperitoneal approach can be used in nephrectomy if the position of the kidney can be determined preoperatively.
Keywords dysplastic kidney nephrectomy retroperitoneal approach single ectopic ureter urinary incontinence
Amo Type Case Report
Published Date 2011-10
Publication Title Acta Medica Okayama
Volume volume65
Issue issue5
Publisher Okayama University Medical School
Start Page 343
End Page 345
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2011 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 22037272
Web of Sience KeyUT 000296116400009
Author Yokoyama, Teruhiko| Watanabe, Toyohiko| Saika, Takashi| Nasu, Yasutomo| Kumon, Hiromi| Miyaji, Yoshiyuki| Nagai, Atsushi|
Published Date 2007-10-02
Publication Title International Journal of Urology
Volume volume14
Issue issue7
Content Type Journal Article
JaLCDOI 10.18926/AMO/32106
FullText URL fulltext.pdf
Author Yokoyama, Teruhiko| Tsugawa, Masaya| Nagai, Atsushi| Kumon, Hiromi|
Abstract <p>We retrospectively evaluated the subjective and objective treatment results of transurethral microwave thermotherapy (TUMT) for benign prostatic hyperplasia (BPH) and explored the difference in effectiveness between 30- and 60-min single treatments. From June 1997 through March 2003, 58 men with BPH underwent TUMT using the Targis device. Twenty-seven and 31 patients each received a single treatment of 60 or 30 min, respectively. Evaluations after treatment included a clinical determination of the International Prostate Symptom Score, urodynamic assessments by peak flow rate, and magnetic resonance imaging (MRI). In the 60-min treatment, the symptom score improved significantly, from 17.9 to 9.5 after 2 months. Similarly, there was a significant improvement in peak flow rate, from 6.7 to 11.2 ml/sec after 2 months. In the 30-min treatment, the symptom score also improved significantly, from 18.4 to 13.4 after 2 weeks. Similarly, there was a significant improvement in the peak flow rate, from 6.4 to 11.7 ml/sec after 1 month. MRI imaging showed necrosis of the prostate gland 2 weeks after either treatment. These results demonstrated that both the 60-min and the 30-min treatments were effective for patients with BPH. Moreover, the 30-min treatment led to quicker improvement than the 60-min treatment. Thus, a 30-min TUMT protocol is considered recommendable for this treatment.</p>
Keywords prostate benign prostatic hyperplasia microwave thermotherapy MRI
Amo Type Article
Published Date 2004-06
Publication Title Acta Medica Okayama
Volume volume58
Issue issue3
Publisher Okayama University Medical School
Start Page 151
End Page 156
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 15471437
Web of Sience KeyUT 000222273300006
JaLCDOI 10.18926/AMO/32084
FullText URL fulltext.pdf
Author Abarzua, Fernando| Monden, Koichi| Nagai, Atsushi| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>Ureteroscopy has evolved in many aspects, particularly in the flexibility and size of ureteroscopes. We have developed a new detachable access sheath to make ureteroscopic procedures more straight-forward and to reduce possible damage to delicate instruments used in the procedure.</p>
Keywords ureteroscopy detachable accesss heath
Amo Type Article
Published Date 2004-08
Publication Title Acta Medica Okayama
Volume volume58
Issue issue4
Publisher Okayama University Medical School
Start Page 215
End Page 216
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 15551759
Web of Sience KeyUT 000223559700006
JaLCDOI 10.18926/AMO/31978
FullText URL fulltext.pdf
Author Ozawa, Hideo| Nagai, Atsushi| Uematsu, Katsutoshi| Ohmori, Hiroyuki| Kumon, Hiromi|
Abstract <p>We report a case in which retroperitoneoscopic pyelolithotomy was the procedure selected to treat a large stone in the upper urinary tract. A 71-year-old woman who had multiple cerebral infarction and dementia was admitted with a persistent high fever unresponsive to antibiotics. The diagnosis was pyelonephritis and urosepsis associated with ureteral calculus. A large calculus(3.0 x 2.0 cm)was found in the left ureter at the L3 level. She underwent nephrostomy of the left side. After the patient's general condition had improved, surgery was performed successfully with an uneventful recovery. The findings in this case confirm that retroperitoneoscopic surgery allows removal of a large stone in a single, minimally invasive procedures.</p>
Keywords retroperitoneoscopic pyelolithotomy urinary stone laparoscopic surgery
Amo Type Article
Published Date 2005-06
Publication Title Acta Medica Okayama
Volume volume59
Issue issue3
Publisher Okayama University Medical School
Start Page 109
End Page 112
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16049564
Web of Sience KeyUT 000230039100006
JaLCDOI 10.18926/AMO/31976
FullText URL fulltext.pdf
Author Nagai, Atsushi| Tokuyama, Eijirou| Nanba, Yuzaburo| Tsutsui, Tetsuya| Kimata, Yoshihiro| Nakatsuka, Mikiya| Koshima, Isao| Saika, Takashi| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>The first case of sex reassignment surgery (SRS) in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.</p>
Keywords gender identity disorder sex reassignment surgery male to female transsexual
Amo Type Article
Published Date 2005-10
Publication Title Acta Medica Okayama
Volume volume59
Issue issue5
Publisher Okayama University Medical School
Start Page 231
End Page 233
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16286961
Web of Sience KeyUT 000232835600008
JaLCDOI 10.18926/AMO/31973
FullText URL fulltext.pdf
Author Edamura, Kohei| Saika, Takashi| Senoh, Takashi| Koizumi, Fumihito| Manabe, Daisuke| Ebara, Shin| Kaku, Haruki| Yokoyama, Teruhiko| Abarzua, Fernando| Nagai, Atsushi| Nasu, Yasutomo| Tsushima, Tomoyasu| Kumon, Hiromi|
Abstract <p>This study was undertaken to reveal the trends of prostate cancer and the outcome of treatment modalities for each disease stage in patients in a single institute over a 10-year period. From January 1994 through December 2003, 420 consecutive patients with previously untreated and histologically confirmed prostate cancer were analyzed for annual distributions of disease stages and treatment modalities and for long-term clinical progression-free survival, prostate cancer-specific survival, and prostate-specific antigen (PSA) failure-free survival rates for each stage and treatment modality. Annual trends showed that the number of patients, especially those with clinically localized cancer, increased dramatically. The 5-year disease-specific survival rates for patients with clinically localized disease were 100 percent for all treatment modalities, including hormonal therapy alone. Patients with PSA levels less than 10 ng/ml showed an 81 percent 5-year PSA failure-free survival rate with radical prostatectomy. Stage C patients treated by surgery or radiation-based therapy with concomitant hormonal therapy obtained 93 percent and 100 percent cause-specific survival rates, respectively, and those treated by hormonal therapy alone showed a 79 percent rate. The number of patients with localized prostate cancer was increasing in this decade. While long-term hormonal therapy alone was highly efficient in controlling localized prostate cancer, radical therapies in conjunction with neo-adjuvant hormonal therapy produced better survival rates in cases of locally advanced disease.</p>
Keywords prostate carcinoma long-term cohort retrospective outcome
Amo Type Article
Published Date 2005-10
Publication Title Acta Medica Okayama
Volume volume59
Issue issue5
Publisher Okayama University Medical School
Start Page 195
End Page 199
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16286958
Web of Sience KeyUT 000232835600003
JaLCDOI 10.18926/AMO/31964
FullText URL fulltext.pdf
Author Nagai, Atsushi| Nasu, Yasutomo| Watanabe, Masami| Kusumi, Norihiro| Tsuboi, Hiromu| Kumon, Hiromi|
Abstract <p>We investigated the usefulness of one-stage urethroplasty by the parameatal foreskin flap method (OUPF procedure), which is useful for repairing all types of hypospadias. Between June 1992 and March 2001, the OUPF procedure was performed on 18 patients with hypospadias: 10 patients with distal and 8 with proximal hypospadias. The follow-up periods ranged from 33-75 months, with an average of 52 months. The duration of surgery, the catheter indwelling period, and the postoperative complications of each patient were analyzed. The median age of the patients at the time of surgery was 3 years and 8 months. The length of surgery for OUPF II ranged from 150-230 min (average 186 min), and from 190-365 min (average 267 min) for OUPF IV. Postoperative complications were confirmed in 3 of the 18 patients (16.6%). Two patients had fistulas, and one had a meatal regression. The fistulas were successfully closed by the simple multilayered closure method. After adopting DuoDerm dressings instead of elastic bandages for protection of the wound, no fistulization occurred. DuoDerm dressings are useful in the healing of wounds without complications. To date, the longest follow-up period has been 75 months, and during that time there have been no late complications such as urethral stenosis or penile curvature. OUPF is a useful method in the treatment of hypospadias with a low incidence of early and late complications.</p>
Keywords hypospadias one-stageure throplasty OUPF DuoDerm dressings
Amo Type Article
Published Date 2005-04
Publication Title Acta Medica Okayama
Volume volume59
Issue issue2
Publisher Okayama University Medical School
Start Page 45
End Page 48
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16049554
Web of Sience KeyUT 000228590000002
JaLCDOI 10.18926/AMO/31956
FullText URL fulltext.pdf
Author Nagai, Atsushi| Kusumi, Norihiro| Tsuboi, Hiromu| Ishii, Kazushi| Saika, Takashi| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>We report on 64 patients who did not achieve erections adequate for satisfactory sexual intercourse from among a total of 243 patients who were prescribed PDE5 inhibitors for erectile dysfunction (ED). Intracavernous injection (ICI) of PGE was performed in this non-responder group. An ICI of 20 or 40 mcg of PGE1 in 1 ml saline was performed and the responses evaluated. Forty-nine out of 64 (77 percent ) cases responded to 20 mcg of PGE1. Forty mcg of PGE was injected into the 15 non-responding cases, and 9 patients responded favorably. The overall effective rate was 58/64 (91 percent ). No major adverse effects were observed.</p>
Keywords prostaglandin E1 intracavernous injection erectile dysfunction PDE5 inhibitors
Amo Type Short Communication
Published Date 2005-12
Publication Title Acta Medica Okayama
Volume volume59
Issue issue6
Publisher Okayama University Medical School
Start Page 279
End Page 280
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16418771
Web of Sience KeyUT 000234176600006
JaLCDOI 10.18926/AMO/31722
FullText URL fulltext.pdf
Author Nagai, Atsushi| Nasu, Yasutomo| Shirasaki, Yoshinori| Iguchi, Hiroki| Arata, Ryouji| Tsugawa, Masaya| Tsushima, Tomoyasu| Kumon, Hiromi|
Abstract <p>We performed laparoscopic prostatectomy in seven cases with organ-confined prostate cancer. In 6 cases, the surgery was completed successfully and the mean operative time was 424 min. Volume of blood loss was 200 to 3,200 ml and catheterization lasted 6 to 37 days. No major complications were observed in 6 of the cases. In one case, open surgical conversion was necessary mainly due to a bladder injury. Although these were the first cases of laparoscopic prostatectomy in our institution, the technical difficulty and complexity of the surgery were moderate. We believe that laparoscopic radical prostatectomy will become a standard option for the treatment of organ-confined prostate cancer.</p>
Keywords prosatatic cancer laparoscopy prostatectomy
Amo Type Article
Published Date 2002-02
Publication Title Acta Medica Okayama
Volume volume56
Issue issue1
Publisher Okayama University Medical School
Start Page 51
End Page 52
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 11873945
Web of Sience KeyUT 000174031300009
JaLCDOI 10.18926/AMO/31681
FullText URL fulltext.pdf
Author Iguchi, Hiroki| Watanabe, Masami| Kamitani, Akihiro| Nagai, Atsushi| Hosoya, Osamu| Tsutsui, Kimiko| Kumon, Hiromi|
Abstract <p>Dynamin is a protein essential to endocytosis. Dynamin 2, a dynamin isoform, is expressed most intensely in testicular tissue; however, precise localization has never been studied. Therefore, we investigated the expression of dynamin 2 in rat testicular tissue using immunohistochemical methods, and discuss here the physiological function of this protein. Testicular tissues were obtained from Wistar rats at 10, 21 and 63 days of age. Immunohistochemistrical examination and Western blot analysis were conducted using dynamin 2 specific antibody. Western blot analysis showed that expression in 21- and 63-day-old rats was more intense than that in 10-day-old rats. Dynamin 2 expression was observed using immunohistochemical method in the seminiferous tubules of all rats. In the 63-day-old rats, the expression was intense, especially in spermatids in the earlier maturation stages and in spermatocytes, and was observed in Sertoli cells. However, in spermatids, the expression gradually declined as spermatids matured to spermatozoa. In the 21-day-old rats, the expression was evident in spermatocytes and Sertoli cells, but that in the 10-day-old rats was weak. Intense expression of dynamin 2 during spermatogenesis suggests that this protein plays an important role in this process.</p>
Keywords dynamin 2 endocytosis spermatogenesis
Amo Type Article
Published Date 2002-08
Publication Title Acta Medica Okayama
Volume volume56
Issue issue4
Publisher Okayama University Medical School
Start Page 205
End Page 209
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 12199526
Web of Sience KeyUT 000177382600006
JaLCDOI 10.18926/AMO/30759
FullText URL fulltext.pdf
Author Kaku, Haruki| Saika, Takashi| Tsushima, Tomoyasu| Nagai, Atsushi| Yokoyama, Teruhiko| Abarzua, Fernando| Ebara, Shin| Manabe, Daisuke| Nasu, Yasutomo| Kumon, Hiromi|
Abstract <p>We evaluated the efficiency and toxicity of estramustine phosphate (ECT), ifosfamide (IFM) and cisplatin (CDDP) combination chemotherapy in twenty-one patients with hormone-refractory prostate cancer (HRPC), for which there is currently no effective treatment. Patients received a daily dose of 560 mg ECT in combination with 1.2 g/m2 IFM on days 1 to 5 and 70 mg/m2 CDDP on day 1. This combination therapy was given every 3 to 4 weeks. An objective response of more than 50% reduction in prostate-specific antigen was observed in 9 of 18 patients (50%), and a more than 50% reduction in bi-dimensionally measurable soft-tissue lesions was observed in 2 of 7 patients (29%). The median duration of response among the cases showing partial response was 40 weeks, while the median duration of response of overall partial-response plus stable cases was 30 weeks. The median survival duration of all cases was 47 weeks. Toxicity was modest and acceptable. In conclusion, the ECT, IFM and CDDP combination chemotherapy regimen is a viable treatment option for HRPC. However, in comparison with our previous chemotherapy regimen of IFM and CDDP, no additional long-lasting effects resulting from the inclusion of ECT could be affirmed.</p>
Keywords hormone-refractory prostate cancer chemotherapy estramustine phosphate ifosfamide cisplatin
Amo Type Article
Published Date 2006-02
Publication Title Acta Medica Okayama
Volume volume60
Issue issue1
Publisher Okayama University Medical School
Start Page 43
End Page 49
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16508688
Web of Sience KeyUT 000235538900005