JaLCDOI 10.18926/AMO/56871
フルテキストURL 73_3_269.pdf
著者 Tsuboi, Ichiro| Araki, Motoo| Fujiwara, Hiroyasu| Iguchi, Toshihiro| Hiraki, Takao| Arichi, Naoko| Kawamura, Kasumi| Maruyama, Yuki| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Sako, Tomoko| Takamoto, Atsushi| Wada, Koichiro| Kobayashi, Yasuyuki| Watanabe, Toyohiko| Yanai, Hiroyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hitoshi| Wada, Jun| Shiina, Hiroaki| Kanazawa, Susumu| Nasu, Yasutomo|
抄録 Nephron-sparing treatment should be offered whenever possible to avoid dialysis in allograph cases. Cryoablation is a new treatment option for treating small-sized renal cell cancer (RCCs). We report a case of RCC arising in a kidney allograft treated by cryoablation. To our knowledge, this is the first case in Asia of RCC in a renal allograft treated using cryoablation. Contrast-enhanced CT-guided percutaneous renal needle biopsy and cryoablation were used to identify the RCC, which could not be identified by other techniques. The postoperative course was uneventful. Contrast-enhanced CT also showed no recurrence or metastases at the 6-month follow-up.
キーワード cryoablation partial nephrectomy renal cell carcinoma renal allograft renal transplantation
Amo Type Case Report
発行日 2019-06
出版物タイトル Acta Medica Okayama
73巻
3号
出版者 Okayama University Medical School
開始ページ 269
終了ページ 272
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 31235976
JaLCDOI 10.18926/AMO/56455
著者 Oiwa, Yuko| Watanabe, Toyohiko| Sadahira, Takuya| Ishii, Ayano| Sako, Tomoko| Inoue, Miyabi| Wada, Koichiro| Kobayashi, Yasuyuki| Araki, Motoo| Nasu, Yasutomo|
抄録 We measured basal clitoral blood flow by Doppler sonography to determine whether tension-free vaginal mesh(TVM) affects the clitoral blood flow and sexual function in women with pelvic organ prolapse (POP). We performed a prospective study of 22 patients who underwent TVM for POP. Clitoral blood flow was measured by Doppler ultrasound. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the clitoral arteries were measured preoperatively and at 1, 3, and 6 months postoperatively. Female sexual function was also investigated with the Female Sexual Function Index (FSFI). The mean PI and RI were increased at 1 month and significantly decreased at 6 months postoperatively (p<0.05). In contrast, the mean PSV and EDV decreased at 1 month postoperatively and increased at 6 months postoperatively. These four parameters recovered to baseline levels at 6 months following surgery. Total FSFI scores improved significantly from 10.2±7.9 at baseline to 18.2±8.9 at 6 months postoperatively. Color Doppler ultrasonography is potentially useful in measuring clitoral blood flow in patients treated with TVM for POP. Prospective long-term studies are needed to evaluate the utility of this modality as a diagnostic and prognostic tool for female sexual dysfunction.
キーワード clitoris pelvic organ prolapse Doppler ultrasound
Amo Type Original Article
発行日 2019-02
出版物タイトル Acta Medica Okayama
73巻
1号
出版者 Okayama University Medical School
開始ページ 21
終了ページ 27
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2019 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30820051
JaLCDOI 10.18926/AMO/56380
フルテキストURL 72_6_605.pdf
著者 Mitsui, Yosuke| Sadahira, Takuya| Maruyama, Yuki| Wada, Koichiro| Tanimoto, Ryuta| Sugimoto, Morito| Araki, Motoo| Watanabe, Masami| Yanai, Hiroyuki| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録 Metastatic prostate cancer (PCa) cases that cannot be detected on repeat prostate biopsy are extremely rare. Our patient was a 51-year-old Japanese man diagnosed as metastatic PCa by histopathological examination of lesions obtained bone biopsy and lymph node dissection. The primary tumor was not detected after repeated prostate biopsy. Metastatic PCa was diagnosed based on immunohistochemical staining: PSA, AR, P504S, and NKX3.1 of bone and lymph node with metastasis. We speculate that the primary PCa was “burned-out,” demonstrating remote metastases with no apparent primary tumor in the prostate. Burned-out PCa may be difficult to diagnose and treat due to its rarity.
キーワード prostate cancer metastasis unknown primary tumor repeat biopsy CRPC
Amo Type Case Report
発行日 2018-12
出版物タイトル Acta Medica Okayama
72巻
6号
出版者 Okayama University Medical School
開始ページ 605
終了ページ 609
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2018 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 30573917
NAID 120006545165
JaLCDOI 10.18926/AMO/55445
フルテキストURL 71_5_449.pdf
著者 Mitsui, Yosuke| Wada, Koichiro| Araki, Motoo| Yoshioka, Takashi| Ariyoshi, Yuichi| Nishimura, Shingo| Kobayashi, Yasuyuki| Sasaki, Katsumi| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録 We describe a 40-year-old living-donor renal-transplant recipient who underwent successful ureterolithotripsy. He had been on hemodialysis for >15 years pre-transplant and underwent ureteroureterostomy along with the surgery. One year post-transplant, ultrasound examination demonstrated hydronephrosis, and CT showed a 6-mm ureteral calculus at the ureteroureterostomy site. No pain and no elevated serum creatinine were present. As the ureter was easily accessed, we performed a ureterolithotripsy, which would confirm whether a suture caused the calculus. Despite ureteral tortuosity, laser stone fragmentation succeeded. The calculus was completely removed with an antegrade guidewire. Mild postoperative ureteral stenosis resolved with a temporary ureteral stent without balloon dilation. Ureterolithotripsy is effective even in renal transplant recipients with ureteroureterostomy.
キーワード lithotripsy recipient renal transplant ureteroscopy ureteral stone
Amo Type Case Report
発行日 2017-10
出版物タイトル Acta Medica Okayama
71巻
5号
出版者 Okayama University Medical School
開始ページ 449
終了ページ 452
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 29042705
JaLCDOI 10.18926/AMO/55313
フルテキストURL 71_4_351.pdf
著者 Araki, Motoo| Wada, Koichiro| Mitsui, Yosuke| Sadahira, Takuya| Kubota, Risa| Nishimura, Shingo| Yoshioka, Takashi| Ariyoshi, Yuichi| Fujio, Kei| Takamoto, Atsushi| Sugimoto, Morito| Sasaki, Katsumi| Kobayashi, Yasuyuki| Ebara, Shin| Taninishi, Hideki| Amano, Hiroyuki| Inui, Masashi| Watanabe, Masami| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録 A 38-year-old woman with a 2.7-cm left ureteral stenosis requiring chronic ureteral stent exchange elected to undergo robotic renal autotransplantation. Left ureteropelvic junction obstruction (UPJO) was also suspected. Robotic donor nephrectomy contributed to the fine dissection for desmoplastic changes. The kidney was removed through a Gelport and examined on ice. UPJO was not seen. An end-to-side robotic anastomosis was created between the renal and external iliac vessels. The console time was 507 min, and the warm ischemia time was 4 min 5 sec. She became stent-free. Robotic renal autotransplantation is a new, minimally invasive approach to renal preservation.
キーワード robotic surgery renal autotransplantation ureteral stenosis laparoscopic surgery renal transplantation
Amo Type Case Report
発行日 2017-08
出版物タイトル Acta Medica Okayama
71巻
4号
出版者 Okayama University Medical School
開始ページ 351
終了ページ 355
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28824192
JaLCDOI 10.18926/AMO/55205
フルテキストURL 71_3_227.pdf
著者 Sasaki, Katsumi| Wada, Koichiro| Araki, Motoo| Kobayashi, Yasuyuki| Sugimoto, Morito| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録  We elucidate the fate of cases clinically suspected of carcinoma in situ (Cis) of the upper tract with serial ureteroscopy. Of 143 patients who underwent ureteroscopy for suspected upper tract urothelial carcinoma (UTUC) between January 2008 and February 2016, 12 cases with consistently positive urine cytology and poorly detectable upper-tract malignancies by imaging were reviewed. In these 12 patients, 19 ureteroscopy procedures (25 renal units) were performed. Vesical random biopsy was performed before the 1st ureteroscopy to exclude malignancy of the bladder in all 12 cases. Median follow-up was 42 (13-67) months. Positive biopsy results at the 1st ureteroscopy were obtained in 3 (25%) patients and all were diagnosed wth Cis of the upper tract. Two (17%) of 9 patients who were negative or inconclusive at the 1st ureteroscopy were finally diagnosed as UTUC, but plural ureteroscopy procedures were needed for the diagnoses in both. Carcinoma of the bladder appeared in 5 (42%) patients during follow-up, despite the earlier ruling out of vesical malignancy. Four (33%) of those 5 patients never developed upper-tract urothelial carcinoma during follow-up. Caution is required before undertaking radical surgery for cases clinically suspected of Cis of the upper tract. In our experience, only 42% of such patients developed UTUC; another 33% eventually developed carcinoma of the bladder without UTUC.
キーワード carcinoma in situ carcinoma of the bladder upper tract urothelial carcinoma ureteroscopy urine cytology
Amo Type Original Article
発行日 2017-06
出版物タイトル Acta Medica Okayama
71巻
3号
出版者 Okayama University Medical School
開始ページ 227
終了ページ 232
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28655942
JaLCDOI 10.18926/AMO/54989
フルテキストURL 71_2_187.pdf
著者 Takamoto, Atsushi| Araki, Motoo| Wada, Koichiro| Sugimoto, Morito| Kobayashi, Yasuyuki| Sasaki, Katsumi| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録 We report the case of a 58-year-old Japanese man with bilateral synchronous renal cell carcinoma (RCC). The diameters of the right and left tumors were 56 and 69 mm, respectively. Both tumors were endophytic. Cryoablation with prophylactic embolization was performed for the left tumor, and 1 month later, a right open partial nephrectomy was performed. No recurrence was observed during a 16-month follow-up, and the serum creatinine level has been stable. The prognosis of bilateral synchronous RCC is better than that of dialysis patients. The novel approach of combining cryoablation and partial nephrectomy can achieve good cancer control and renal function in bilateral RCC.
キーワード cryoablation multiple renal masses nephron-sparing surgery renal cell carcinoma synchronous multiple primary
Amo Type Case Report
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 187
終了ページ 190
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420902
JaLCDOI 10.18926/AMO/54982
フルテキストURL 71_2_135.pdf
著者 Mori, Akihiro| Watanabe, Masami| Sadahira, Takuya| Kobayashi, Yasuyuki| Ariyoshi, Yuichi| Ueki, Hideo| Wada, Koichiro| Ochiai, Kazuhiko| Li, Shun-Ai| Nasu, Yasutomo|
抄録 The cluster of differentiation 147 (CD147), also known as EMMPRIN, is a key molecule that promotes cancer progression. We previously developed an adenoviral vector encoding a tumor suppressor REIC/Dkk-3 gene (Ad-REIC) for cancer gene therapy. The therapeutic effects are based on suppressing the growth of cancer cells, but, the underlying molecular mechanism has not been fully clarified. To elucidate this mechanism, we investigated the effects of Ad-REIC on the expression of CD147 in LNCaP prostate cancer cells. Western blotting revealed that the expression of CD147 was significantly suppressed by Ad-REIC. Ad-REIC also suppressed the cell growth of LNCaP cells. Since other researchers have demonstrated that phosphorylated mitogen-activated protein kinases (MAPKs) and c-Myc protein positively regulate the expression of CD147, we investigated the correlation between the CD147 level and the activation of MAPK and c-Myc expression. Unexpectedly, no positive correlation was observed between CD147 and its possible regulators, suggesting that another signaling pathway was involved in the downregulation of CD147. This is the first study to show the downregulation of CD147 by Ad-REIC in prostate cancer cells. At least some of the therapeutic effects of Ad-REIC may be due to the downregulation of the cancer-progression factor, CD147.
キーワード prostate cancer REIC/Dkk-3 CD147 cell growth p38 MAP kinase
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 135
終了ページ 142
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420895
JaLCDOI 10.18926/AMO/54976
フルテキストURL 71_2_91.pdf
著者 Ogawa, Nanako| Sato, Shuhei| Ida, Kentaro| Kato, Katsuya| Ariyoshi, Yuichi| Wada, Koichiro| Nasu, Yasutomo| Kanazawa, Susumu|
抄録 The aim of this study was to investigate the utility of single-source dual-energy computed tomography (SS-DECT) composition analysis in characterizing different types of urinary stones and differentiating them from phleboliths. This study included 29 patients with urinary stones who were scheduled for surgery. All patients were scanned, first using single-energy computed tomography acquisition and then DECT acquisition on SS-DECT. Dual-energy data were archived to a Gemstone spectral imaging (GSI) viewer (GE Healthcare, Milwaukee, WI, USA). Hounsfield units (HU) and effective atomic numbers (Zeff) were estimated using the GSI viewer. The results of dual-energy analysis were compared with the biochemical constitution of the stones. The chemical analysis determined that the stones included 32 calcium-based, 6 cystine and 1 struvite stone. Both HU and Zeff values were helpful in differentiating calcium-based stones from cystine and struvite stones and phleboliths. The Zeff values of phleboliths were significantly higher than those for struvite and cystine stones, whereas it was difficult to distinguish phleboliths from struvite and cystine stones using the HU values. Composition analysis using SS-DECT is helpful for distinguishing urinary stone types and discriminating phleboliths from urinary stones. Zeff values may be more useful than HU values for differentiating urinary stones from phleboliths.
キーワード single-source dual-energy computed tomography effective atomic number urinary stone phlebolith
Amo Type Original Article
発行日 2017-04
出版物タイトル Acta Medica Okayama
71巻
2号
出版者 Okayama University Medical School
開始ページ 91
終了ページ 96
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2017 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 28420889
JaLCDOI 10.18926/AMO/54508
フルテキストURL 70_4_299.pdf
著者 Wada, Koichiro| Uehara, Shinya| Ishii, Ayano| Sadahira, Takuya| Yamamoto, Masumi| Mitsuhata, Ritsuko| Takamoto , Atsushi| Araki, Motoo| Kobayashi, Yasuyuki| Watanabe, Masami| Watanabe, Toyohiko| Hotta, Katsuyuki| Nasu, Yasutomo|
抄録 Urinary tract infections (UTIs) are the most common bacterial infections in women, and many patients experience frequent recurrence. The aim of this report is to introduce an on-going prospective phase II clinical trial performed to evaluate the preventive effectiveness of Lactobacillus vaginal suppositories for prevention of recurrent cystitis. Patients enrolled in this study are administered vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus every 2 days or 3 times a week for one year. The primary endpoint is recurrence of cystitis and the secondary endpoints are adverse events. Recruitment began in December 2013 and target sample size is 20 participants.
キーワード probiotics lactobacilli Lactobacillus crispatus urinary tract infection vaginal suppository
Amo Type Clinical Study Protocols
発行日 2016-08
出版物タイトル Acta Medica Okayama
70巻
4号
出版者 Okayama University Medical School
開始ページ 299
終了ページ 302
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27549677
Web of Sience KeyUT 000384748600012
JaLCDOI 10.18926/AMO/54507
フルテキストURL 70_4_295.pdf
著者 Araki, Motoo| Wada, Koichiro| Mitsui, Yosuke| Kubota, Risa| Yoshioka, Takashi| Ariyoshi, Yuichi| Kobayashi, Yasuyuki| Kitagawa, Masashi| Tanabe, Katsuyuki| Sugiyama, Hiroshi| Wada, Jun| Watanabe, Masami| Watanabe, Toyohiko| Hotta, Katsuyuki| Nasu, Yasutomo|
抄録 Although graft survival following renal transplantation (RTx) has improved, outcomes following highrisk RTx are variable. Preexisting antibodies, including donor-specific antibodies (DSA), play an important role in graft dysfunction and survival. We have designed a study to investigate the safety and efficacy of anti-CD20 monoclonal antibodies (rituximab) in high-risk RTx recipients. Major eligibility criteria include: 1) major and minor ABO blood group mismatch, 2) positive DSA. Thirty-five patients will receive 200 mg/body of rituximab. The primary endpoint is the incidence of B cell depletion. This study will clarify whether rituximab is efficacious in improving graft survival in high-risk RTx recipients.
キーワード end-stage renal disease immunosuppression kidney transplantation
Amo Type Clinical Study Protocols
発行日 2016-08
出版物タイトル Acta Medica Okayama
70巻
4号
出版者 Okayama University Medical School
開始ページ 295
終了ページ 297
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27549676
Web of Sience KeyUT 000384748600011
JaLCDOI 10.18926/AMO/54414
フルテキストURL 70_3_159.pdf
著者 Yoshioka, Takashi| Otsuki, Hideo| Uehara, Shinya| Shimizu, Toshihiro| Murao, Wataru| Fujio, Koji| Fujio, Kei| Wada, Koichiro| Araki, Motoo| Nasu, Yasutomo|
抄録 Upper urinary tract calculi are common; however, there is no recommended treatment selection for elderly patients. Ureteroscopic holmium laser lithotripsy (URS lithotripsy) is minimally invasive, and it provides a high stone-free rate (SFR) treatment for upper urinary tract calculi. Here, we retrospectively evaluated the surgical outcomes of URS lithotripsy after dividing the 189 cases into 3 groups by patient age: the ʻ<65 groupʼ (<65 years old, n=108), the ʻ65-74 groupʼ (65-74 years old, n=42), and the ʻ 75 groupʼ ( 75 years old, n=39). The patientsʼ characteristics, stone status, and perioperative outcomes were assessed. The 65-74 group and the 75 group had a significantly higher prevalence of hypertension compared to the<65 group. Compared to the<65 group, the 65-74 group had a significantly higher prevalence of hyperlipidemia, and the 75 group had significantly higher the American Society of Anesthesiologists (ASA) scores. Despite these preoperative risk factors, SFR and postoperative pyelonephritis in the 65-74 group and the 75 group were similar to those of the<65 group. In conclusion, URS lithotripsy is the preferred treatment for upper urinary tract calculi, even for elderly patients who have multiple preoperative risk factors.
キーワード upper urinary tract calculi ureteroscopy (URS) holmium laser lithotripsy elderly patients stone-free rate (SFR)
Amo Type Original Article
発行日 2016-06
出版物タイトル Acta Medica Okayama
70巻
3号
出版者 Okayama University Medical School
開始ページ 159
終了ページ 166
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27339204
Web of Sience KeyUT 000379406100002
JaLCDOI 10.18926/AMO/54185
フルテキストURL 70_2_69.pdf
著者 Kobayashi, Yasuyuki| Kurahashi, Hiroaki| Matsumoto, Yuko| Wada, Koichiro| Sasaki, Katsumi| Araki, Motoo| Ebara, Shin| Watanabe, Toyohiko| Nasu, Yasutomo|
抄録 In minimally invasive partial nephrectomy (MIPN), it is important to preoperatively predict the degree of difficulty of tumor resection. When severe adhesions occur between the renal capsule and perinephric adipose tissue, detachment can be difficult. Preoperative prediction of adhesion is thought to be useful in the selection of surgical procedure. Subjects were 63 patients of a single surgeon who had received MIPN between April 2008 and August 2013 at Okayama University Hospital. Of these patients, this study followed 47 in whom the presence or absence of adhesions between the renal capsule and perinephric adipose tissue was confirmed using intraoperative videos. Data collected included: sex, BMI, CT finding (presence of fibroids in perinephric adipose tissue), comorbidities and lifestyle. Adhesion was observed in 7 patients (14.9%). The mean operative time was 291.6min in the adhesion group, and 226.3min in the group without. The increased time in the adhesions group was significant (p<0.05). Predictive factors were a positive CT finding for fibroid structure and comorbidity of hypertension (p<0.05). In MIPN, difficulty of surgery can be affected by the presence of adhesion of the perinephric adipose tissue. Predicting such adhesion from preoperative CT is thus important.
キーワード renal cell carcinoma partial nephrectomy renal capsule adhension
Amo Type Original Article
発行日 2016-04
出版物タイトル Acta Medica Okayama
70巻
2号
出版者 Okayama University Medical School
開始ページ 69
終了ページ 74
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2016 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 27094831
Web of Sience KeyUT 000377626300001
JaLCDOI 10.18926/AMO/52405
フルテキストURL 68_2_89.pdf
著者 Sako, Shinichi| Kariyama, Reiko| Mitsuhata, Ritsuko| Yamamoto, Masumi| Wada, Koichiro| Ishii, Ayano| Uehara, Shinya| Kokeguchi, Susumu| Kusano, Nobuchika| Kumon, Hiromi|
抄録 We conducted a study on molecular epidemiology and clinical implications of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa isolated from urine. Over a 10-year period from 2001 through 2010, a total of 92 MBL-producing P. aeruginosa urine isolates were collected from patients (one isolate per patient) who were admitted to 5 hospitals in Okayama Prefecture, Japan. When cross-infection was suspected in the hospital, pulsed-field gel electrophoresis was performed. In the resulting dendrogram of 79 MBL-producing P. aeruginosa urine isolates, no identical isolates and 7 pairs of isolates with ≥80% similarity were found. The biofilm-forming capabilities of 92 MBL-producing P. aeruginosa urine isolates were significantly greater than those of 92 non-MBL-producing urine isolates in a medium of modified artificial urine. The imipenem resistance transferred in 16 of 18 isolates tested, and these frequencies were in the range of 10-3 to 10-9. All of 18 isolates tested belonged to internationally spread sequence type 235 and had 3 gene cassettes of antimicrobial resistance genes in the class 1 integron. The strong biofilm-forming capabilities of MBL-producing P. aeruginosa urine isolates could be seriously implicated in nosocomial infections. To prevent spread of the organism and transferable genes, effective strategies to inhibit biofilm formation in medical settings are needed.
キーワード Pseudomonas aeruginosa metallo-β-lactamase molecular epidemiology biofilm urinary tract infection
Amo Type Original Article
発行日 2014-04
出版物タイトル Acta Medica Okayama
68巻
2号
出版者 Okayama University Medical School
開始ページ 89
終了ページ 99
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
著作権者 CopyrightⒸ 2014 by Okayama University Medical School
論文のバージョン publisher
査読 有り
PubMed ID 24743784
Web of Sience KeyUT 000334652700004
関連URL http://ousar.lib.okayama-u.ac.jp/metadata/52504
JaLCDOI 10.18926/AMO/32863
フルテキストURL fulltext.pdf
著者 Murao, Wataru| Wada, Koichiro| Matsumoto, Akira| Fujiwara, Michihisa| Fukushi, Hideto| Kishimoto, Toshio| Monden, Koichi| Kariyama, Reiko| Kumon, Hiromi|
抄録 <p>In 2000, chlamydial strains OK133 and OK135 were isolated from 2 female patients with cervicitis. These strains were unresponsive to commercially available PCR and LCR test kits for the diagnosis of Chlamydia trachomatis infection, and their phenotypic characteristics were very similar. The OK135 nucleotide sequence in MOMP-VD2 gene closely resembled that of Chlamydophila caviae GPIC. A similar strain was isolated in 2003 from a male patient OKM2 with urethritis, from which the strain SC10-6 was cloned by the plaque purification method. The nucleotide sequence of the entire MOMP gene of SC10-6 was exactly the same as that of OK135. Thus, the strains OK135 and SC10-6, together with OK133, have been called C. caviae-like Chlamydia. We designed primers for nested PCR assay, the product of which showed a single-band 311-bp fragment, to detect C. caviae-like Chlamydia. Of swab specimens obtained from 202 patients from 2003 to 2006 (119 male and 83 female patients), 18 specimens (8.9%) from 14 male and 4 female patients were positive, suggesting that C. caviae-like Chlamydia infection is rather common. Thus far, it has not been determined whether C. caviae-like Chlamydia is pathogenic for humans.</p>
キーワード Chlamydophila caviae-like Chlamydia urethra uterine cervix epidemiology sexually transmitted infection
Amo Type Original Article
発行日 2010-02
出版物タイトル Acta Medica Okayama
64巻
1号
出版者 Okayama University Medical School
開始ページ 1
終了ページ 9
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 20200578
Web of Sience KeyUT 000274868300001
JaLCDOI 10.18926/AMO/31836
フルテキストURL fulltext.pdf
著者 Wada, Koichiro| Kariyama, Reiko| Mitsuhata, Ritsuko| Uehara, Shinya| Watanabe, Toyohiko| Monden, Koichi| Kumon, Hiromi|
抄録 <p>Urinary tract infections (UTIs) due to fluoroquinolone-insusceptible Escherichia coli have become increasingly common in recent years. We investigated the potential relationships between clinical measures to combat fluoroquinolone-insusceptible E. coli and experimental analyses on E. coli isolates. Over a 14-year period from 1994 through 2007, a total of 828 E. coli isolates were collected from patients (one isolate per patient) with UTI at the urology ward of Okayama University Hospital. We analyzed the mutations in quinolone resistance-determining regions of DNA gyrase (gyrA) and topoisomerase IV (parC). The production of biofilm by these isolates was also examined and the associated medical records were retrospectively reviewed. Seven of 189 (3.7%) strains from uncomplicated UTIs and 82 of 639 (12.8%) strains from complicated UTIs were insusceptible to fluoroquinolones. Amino acid replacements of type II topoisomerases were frequently observed at positions 83 and 87 in GyrA and at positions 80 and 84 in ParC. No significant difference in the biofilm-forming capabilities was observed between fluoroquinolone-susceptible and -insusceptible E. coli. Our study suggests that biofilm formation of fluoroquinolone-insusceptible E. coli isolates is not a major mechanism of resistance in patients with UTI.</p>
キーワード fluoroquinolone Escherichia coli biofilm MICs QRDRs
Amo Type Original Article
発行日 2009-10
出版物タイトル Acta Medica Okayama
63巻
5号
出版者 Okayama University Medical School
開始ページ 263
終了ページ 272
ISSN 0386-300X
NCID AA00508441
資料タイプ 学術雑誌論文
言語 English
論文のバージョン publisher
査読 有り
PubMed ID 19893602
Web of Sience KeyUT 000271132000006