研究者詳細 - 荒木　元朗

論文 - 荒木　元朗

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Negative impact of being underweight on the outcomes of single-session shockwave lithotripsy in patients with upper urinary tract calculi: a retrospective cohort study. 査読国際誌

Takashi Yoshioka, Kenji Omae, Tatsushi Kawada, Yosuke Inoue, Morito Sugimoto, Tadashi Oeda, Tomoya Yamasaki, Kei Fujio, Hideo Otsuki, Shinya Uehara, Motoo Araki, Shunichi Fukuhara

World journal of urology 39 ( 2 ) 571 - 577 2021年2月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To evaluate the association between being underweight and shockwave lithotripsy outcomes. METHODS: This retrospective two-centre cohort study conducted in Japan involved 597 patients diagnosed with a single urinary tract calculus based on computed tomography and who underwent shockwave lithotripsy between 2006 and 2016. We divided the patients into four groups based on their body mass index (underweight, ≤ 18.4; normal weight, 18.5-24.9; overweight, 25-29.9; obese, ≥ 30 kg/m2). We performed multivariable logistic regression analysis and estimated the odds ratio for success of single-session shockwave lithotripsy. RESULTS: Of the 597 patients, 25 (4.2%) were underweight and 34 (5.7%) were obese. After adjusting for age, sex, calculus localisation, maximum stone length, mean stone density, and skin-to-stone distance, being underweight showed a significantly negative association with success of single-session shockwave lithotripsy (odds ratio 0.25, 95% confidence interval 0.09-0.69) compared to being normal weight. CONCLUSIONS: This study showed the negative impact of being underweight on the outcomes of shockwave lithotripsy in patients with upper urinary tract calculi. This finding provides a novel viewpoint regarding the body mass index and should aid improved treatment selection for patients with upper urinary tract calculi.

DOI： 10.1007/s00345-020-03199-8

神経線維腫症1型に合併した後腹膜悪性末梢神経鞘腫瘍の1例査読

宗田大二郎, 岩田健宏, 定平卓也, 富永悠介, 片山聡, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友, 中田英二, 柳井広之

西日本泌尿器科 82 ( 6 ) 596 - 600 2021年2月

記述言語：日本語出版者・発行元：西日本泌尿器科学会

症例は30代,女性。過去に左腋窩皮膚生検で神経線維腫と診断され,特徴的な皮膚所見や家族歴などから神経線維腫症1型(NF-1;von Recklinghausen病)を疑われていたが放置していた。20XX年2月に右大腿部痛,背部痛を主訴に近医を受診しMRI,造影CTで約13cm大の後腹膜腫瘤を指摘され,L2神経根からの発生と脊柱管内の浸潤も疑われ,神経線維腫の疑いとして手術目的に当科紹介された。合同での手術が必要と考えられたため,整形外科に紹介しMRIガイド下生検で悪性末梢神経鞘腫瘍の可能性を示唆された。同年6月に腫瘍の動脈塞栓術施行後に右後腹膜腫瘍摘出術を施行し,病理結果から悪性末梢神経鞘腫瘍と診断された。術後10ヵ月現在再発認めず,外来通院中である。後腹膜原発腫瘍において悪性末梢神経鞘腫瘍は極めて稀な症例であり,有効な治療法は確立されていない。今回,後腹膜原発の悪性末梢神経鞘腫瘍の1例を経験したので,若干の文献的考察を加えて報告する。(著者抄録)

岡山大学病院における去勢抵抗性前立腺癌に対するドセタキセルの長期治療成績

河田達志, 高本篤, 横山周平, 宗田大二郎, 坪井一馬, 長尾賢太郎, 富永悠介, 岩田健宏, 西村慎吾, 佐古智子, 枝村康平, 小林泰之, 荒木元朗, 渡邉豊彦, 那須保友

西日本泌尿器科 82 ( 6 ) 605 - 605 2021年2月

The role of Wnt signaling in male reproductive physiology and pathology. 査読国際誌

Ruizhi Xue, Wenfeng Lin, Jingkai Sun, Masami Watanabe, Abai Xu, Motoo Araki, Yasutomo Nasu, Zhengyan Tang, Peng Huang

Molecular human reproduction 27 ( 1 ) 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）

Accumulating evidence has shown that Wnt signaling is deeply involved in male reproductive physiology, and malfunction of the signal path can cause pathological changes in genital organs and sperm cells. These abnormalities are diverse in manifestation and have been constantly found in the knockout models of Wnt studies. Nevertheless, most of the research solely focused on a certain factor in the Wnt pathway, and there are few reports on the overall relation between Wnt signals and male reproductive physiology. In our review, Wnt findings relating to the reproductive system were sought and summarized in terms of Wnt ligands, Wnt receptors, Wnt intracellular signals and Wnt regulators. By sorting out and integrating relevant functions, as well as underlining the controversies among different reports, our review aims to offer an overview of Wnt signaling in male reproductive physiology and pathology for further mechanistic studies.

DOI： 10.1093/molehr/gaaa085

The role of Wnt signaling in male reproductive physiology and pathology 査読国際誌

Ruizhi Xue, Wenfeng Lin, Jingkai Sun, Masami Watanabe, Abai Xu, Motoo Araki, Yasutomo Nasu, Zhengyan Tang, Peng Huang

Molecular Human Reproduction 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：Oxford University Press ({OUP})

Accumulating evidence has shown that Wnt signaling is deeply involved in male reproductive physiology, and malfunction of the signal path can cause pathological changes in genital organs and sperm cells. These abnormalities are diverse in manifestation and have been constantly found in the knockout models of Wnt studies. Nevertheless, most of the research solely focused on a certain factor in the Wnt pathway, and there are few reports on the overall relation between Wnt signals and male reproductive physiology. In our review, Wnt findings relating to the reproductive system were sought and summarized in terms of Wnt ligands, Wnt receptors, Wnt intracellular signals and Wnt regulators. By sorting out and integrating relevant functions, as well as underlining the controversies among different reports, our review aims to offer an overview of Wnt signaling in male reproductive physiology and pathology for further mechanistic studies.

DOI： 10.1093/molehr/gaaa085

Long-term ureteroscopic management of upper tract urothelial carcinoma: 28-year single-centre experience. 査読国際誌

Yuki Maruyama, Motoo Araki, Koichiro Wada, Kasumi Yoshinaga, Yosuke Mitsui, Takuya Sadahira, Shingo Nishimura, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Manoj Monga, Yasutomo Nasu, Hiromi Kumon

Japanese journal of clinical oncology 51 ( 1 ) 130 - 137 2021年1月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: Long-term survival outcomes of patients who undergo endoscopic management of non-invasive upper tract urothelial carcinoma remain uncertain. The longest mean follow-up period in previous studies was 6.1 years. This study reports the long-term outcomes of patients with upper tract urothelial carcinoma who underwent ureteroscopic ablation at a single institution over a 28-year period. METHODS: We identified all patients who underwent ureteroscopic management of upper tract urothelial carcinoma as their primary treatment at our institution between January 1991 and April 2011. Survival outcomes, including overall survival, cancer-specific survival, upper-tract recurrence-free survival and renal unit survival, were estimated using Kaplan-Meier methodology. RESULTS: A total of 15 patients underwent endoscopic management, with a mean age at diagnosis of 66 years. All patients underwent ureteroscopy, and biopsy-confirmed pathology was obtained. Median (range; mean) follow-up was 11.7 (2.3-20.9, 11.9) years. Upper tract recurrence occurred in 87% (n = 13) of patients. Twenty percent (n = 3) of patients proceeded to nephroureterectomy. The estimated cancer-specific survival rate was 93% at 5, 10, 15 and 20 years. Estimated overall survival rates were 86, 80, 54 and 20% at 5, 10, 15 and 20 years. Only one patient experienced cancer-specific mortality. The estimated mean and median overall survival times were 14.5 and 16.6 years, respectively. The estimated mean cancer-specific survival time was not reached. CONCLUSIONS: Although upper tract recurrence is common, endoscopic management of non-invasive upper tract urothelial carcinoma provides a 90% cancer-specific survival rate at 20 years in selected patients.

DOI： 10.1093/jjco/hyaa132

Comparison of inflammation-based prognostic scores as predictors of survival outcomes in patients with germ cell tumors. 査読国際誌

Kasumi Yoshinaga, Takuya Sadahira, Yuki Maruyama, Yosuke Mitsui, Takehiro Iwata, Koichiro Wada, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Investigative and clinical urology 62 ( 1 ) 47 - 55 2021年1月

記述言語：英語掲載種別：研究論文（学術雑誌）出版者・発行元：The Korean Urological Association

PURPOSE: The aim of this study was to compare the prognostic value of pretreatment inflammation-based scoring systems in terms of overall survival (OS) and progression-free survival (PFS) in patients with germ cell tumors (GCTs) receiving bleomycin, etoposide, and cisplatin (BEP) chemotherapy. MATERIALS AND METHODS: We evaluated 63 patients with GCTs retrospectively. The Glasgow prognostic score (GPS), neutrophil-to-lymphocyte ratio, prognostic index, platelet-to-lymphocyte ratio (PLR), prognostic nutritional index (PNI), systemic immune-inflammation index, and albumin-to-globulin ratio (AGR) were measured in all patients before chemotherapy. To assess the predictive ability of each scoring system, areas under the receiver operating characteristic curve were calculated, and multivariate analysis was performed to identify associations between the predictive scores and OS. RESULTS: Of all the inflammation-based scoring systems, the GPS had the greatest area under the curve (0.847) for predicting OS, followed by the PNI (0.829) and AGR (0.810). Kaplan-Meier analyses revealed that the GPS, PNI, and AGR were significantly associated with OS, whereas the GPS, PLR, and PNI were significantly associated with PFS. In the multivariate analysis, the GPS was an independent predictor of OS and PFS. CONCLUSIONS: We demonstrated that the GPS was the most valuable biomarker of OS and PFS in patients with GCTs.

DOI： 10.4111/icu.20200103

Dual-Functional PLGA Nanoparticles Co-Loaded with Indocyanine Green and Resiquimod for Prostate Cancer Treatment. 査読国際誌

Wenfeng Lin, Chaoming Li, Naijin Xu, Masami Watanabe, Ruizhi Xue, Abai Xu, Motoo Araki, Ruifen Sun, Chunxiao Liu, Yasutomo Nasu, Peng Huang

International journal of nanomedicine 16 2775 - 2787 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

Purpose: With the advance of screening techniques, there is a growing number of low-risk or intermediate-risk prostate cancer (PCa) cases, remaining a serious threat to men's health. To obtain better efficacy, a growing interest has been attracted to develop such emerging treatments as immunotherapy and focal therapy. However, few studies offer guidance on whether and how to combine these modalities against PCa. This study was designed to develop dual-functional nanoparticles (NPs) which combined photothermal therapy (PTT) with immunotherapy and determine the anti-tumor efficacy for PCa treatment. Methods: By a double emulsion technique, the drug nanocarrier, poly(lactic-co-glycolic acid) or PLGA, was applied for co-loading of a fluorescent dye, indocyanine green (ICG) and a toll-like receptor 7/8 (TLR7/8) agonist resiquimod (R848) to synthesize PLGA-ICG-R848 NPs. Next, we determined their characteristic features and evaluated whether they inhibited the cell viability in multiple PCa cell lines. After treatment with PLGA-ICG-R848, the maturation markers of bone marrow-derived dendritic cells (BMDCs) were detected by flow cytometry. By establishing a subcutaneous xenograft model of mouse PCa, we explored both the anti-tumor effect and immune response following the NPs-based laser ablation. Results: With a mean diameter of 157.7 nm, PLGA-ICG-R848 exhibited no cytotoxic effect in PCa cells, but they significantly decreased RM9 cell viability to (3.9±1.0)% after laser irradiation. Moreover, PLGA-ICG-R848 promoted BMDCs maturation with the significantly elevated proportions of CD11c+CD86+ and CD11c+CD80+ cells. Following PLGA-ICG-R848-based laser ablation in vivo, the decreased bioluminescent signals indicated a significant inhibition of PCa growth, while the ratio of splenic natural killer (NK) cells in PLGA-ICG-R848 was (3.96±1.88)% compared with (0.99±0.10)% in PBS group, revealing the enhanced immune response against PCa. Conclusion: The dual-functional PLGA-ICG-R848 NPs under laser irradiation exhibit the anti-tumor efficacy for PCa treatment by combining PTT with immunotherapy.

DOI： 10.2147/IJN.S301552

Management of Groin Pain Using an Iliohypogastric Nerve Block in a Patient with Inguinal Hernia due to Persistent Müllerian Duct Syndrome. 査読国際誌

Takanori Sekito, Takuya Sadahira, Masahiro Sugihara, Kohei Edamura, Motoo Araki, Yasutomo Nasu

Case reports in urology 2021 7577632 - 7577632 2021年

記述言語：英語

Persistent Müllerian duct syndrome can cause an inguinal hernia, although this is a rare occurrence; recurrent inguinal hernias can, in turn, cause ongoing groin pain. Management of groin pain plays an important role in patients' quality of life. We present our experience with a 43-year-old man who had a 2-week history of left-sided groin pain. The patient underwent laparoscopic surgery for a left inguinal hernia via the transabdominal preperitoneal approach. Right-sided cryptorchidism was noted during surgery, with a solid structure-thought to be a uterus-extending into the left inguinal canal. The diagnosis was persistent Müllerian duct syndrome, and the groin pain was relieved after a laparoscopic right orchiectomy with a bilateral preperitoneal hernia repair using a mesh. Four years later, magnetic resonance imaging performed for new-onset left groin pain showed a left inguinal hernia caused by the uterine structure. We diagnosed the recurrent hernia as the cause of his pain. Prior to performing any invasive surgical procedures, an iliohypogastric nerve block was performed using 1% lidocaine. Short-term analgesia was provided by the block, improving his quality of life. He has been followed since then and has declined surgical neurectomy. An iliohypogastric nerve block can be an effective method of controlling groin pain caused by an inguinal hernia resulting from persistent Müllerian duct syndrome; the effectiveness of the nerve block will help determine whether surgical neurectomy is indicated for permanent pain control.

DOI： 10.1155/2021/7577632

Discovery and Validation of Nitroxoline as a Novel STAT3 Inhibitor in Drug-resistant Urothelial Bladder Cancer. 査読国際誌

Wenfeng Lin, Jingkai Sun, Takuya Sadahira, Naijin Xu, Koichiro Wada, Chunxiao Liu, Motoo Araki, Abai Xu, Masami Watanabe, Yasutomo Nasu, Peng Huang

International journal of biological sciences 17 ( 12 ) 3255 - 3267 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

Repeated cycles of first-line chemotherapy drugs such as doxorubicin (DOX) and cisplatin (CIS) trigger frequent chemoresistance in recurrent urothelial bladder cancer (UBC). Nitroxoline (NTX), an antibiotic to treat urinary tract infections, has been recently repurposed for cancer treatment. Here we aimed to investigate whether NTX suppresses drug-resistant UBC and its molecular mechanism. The drug-resistant cell lines T24/DOX and T24/CIS were established by continual exposure of parental cell line T24 to DOX and CIS, respectively. T24/DOX and T24/CIS cells were resistant to DOX and CIS, respectively, but they were sensitive to NTX time- and dose-dependently. Overexpressions of STAT3 and P-glycoprotein (P-gp) were identified in T24/DOX and T24/CIS, which could be reversed by NTX. Western blot revealed that NTX downregulated p-STAT3, c-Myc, Cyclin D1, CDK4, CDK6, Bcl-xL, Mcl-1, and Survivin, which were further confirmed by Stattic, a selective STAT3 inhibitor. In vivo, NTX exhibited the significant anti-tumor effect in T24/DOX and T24/CIS tumor-bearing mice. These results suggested that NTX-induced P-gp reversal, G0/G1 arrest, and apoptosis in drug-resistant UBC were mediated by inhibition of STAT3 signaling. Our findings repurpose NTX as a novel STAT3 inhibitor to induce P-gp reversal, G0/G1 arrest, and apoptosis in drug-resistant UBC.

DOI： 10.7150/ijbs.63125

Repurposing of posaconazole as a hedgehog/SMO signaling inhibitor for embryonal rhabdomyosarcoma therapy. 国際誌

Jingkai Sun, Wenfeng Lin, Chaoming Li, Hideo Ueki, Ruizhi Xue, Takuya Sadahira, Hao Hu, Koichiro Wada, Na Li, Chunxiao Liu, Motoo Araki, Abai Xu, Peng Huang

American journal of cancer research 11 ( 9 ) 4528 - 4540 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

Posaconazole (POS) is a novel antifungal agent, which has been repurposed as an anti-tumor drug for its potential inhibition of Hedgehog signaling pathway. Hedgehog pathway is reported to be abnormally activated in embryonal rhabdomyosarcoma (ERMS), this study aimed to reveal whether POS could inhibit Hedgehog signaling pathway in ERMS. Following POS treatment, XTT viability assay was used to determine the cell proliferation of ERMS cell lines. Protein changes related to Hedgehog signaling, cell cycle and autophagy were detected by Western blot. The cell cycle distribution was analyzed by flow cytometry. Moreover, a subcutaneous tumor mouse model of ERMS was established to assess the anti-tumor effect of POS. POS was found to inhibit tumor progression by inducing G0/G1 arrest and autophagy of RD, RMS-YM, and KYM-1 cells dose-dependently. Western blot demonstrated that POS downregulated the expressions of SMO, Gli1, c-Myc, CDK4, and CDK6, while upregulated the expressions of autophagy-related proteins. Immunofluorescence microscopy revealed a significant increase of LC3B puncta in POS-treated ERMS cells. Furthermore, POS treatment led to a significant inhibition of tumor growth in mice bearing ERMS. Our findings could provide a theoretical basis and have important clinical implications in developing POS as a promising agent against ERMS by targeting Hedgehog pathway.

A Clinical Trial Evaluating the Usefulness of Tailored Antimicrobial Prophylaxis Using Rectal-culture Screening Media Prior to Transrectal Prostate Biopsy: A Multicenter, Randomized Controlled Trial.

Takuya Sadahira, Yuki Maruyama, Yoshiki Hiyama, Hiroyuki Kitano, Hiroki Yamada, Takayuki Goto, Tsubasa Kondo, Katsumi Shigemura, Yosuke Mitsui, Takehiro Iwata, Kohei Edamura, Motoo Araki, Masami Watanabe, Tadasu Takenaka, Jun Teishima, Yasuyoshi Miyata, Kiyohito Ishikawa, Ei-Ichiro Takaoka, Jun Miyazaki, Satoshi Takahashi, Naoya Masumori, Hiroshi Kiyota, Masato Fujisawa, Shingo Yamamoto, Takafumi Sakuma, Norihiro Kusumi, Takaharu Ichikawa, Toyohiko Watanabe, Yoshitsugu Nasu, Masaya Tsugawa, Yasutomo Nasu, Koichiro Wada

Acta medica Okayama 75 ( 5 ) 663 - 667 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

The aim of this report is to introduce an on-going, multicenter, randomized controlled trial to evaluate whether tailored antimicrobial prophylaxis guided by rectal culture screening prevents acute bacterial prostatitis following transrectal prostate biopsy (TRPB). Patients will be randomized into an intervention or non-intervention group; tazobactam-piperacillin or levofloxacin will be prophylactically administered according to the results of rectal culture prior to TRPB in the intervention group whereas levofloxacin will be routinely given in the non-intervention group. The primary endpoint is the occurrence rate of acute bacterial prostatitis after TRPB. Recruitment begins in April, 2021 and the target total sample size is 5,100 participants.

DOI： 10.18926/AMO/62782

Medical uses for phenol in the urinary tract: A possible forgotten treatment

Sadahira T, Maruyama Y, Watanabe T, Sekito T, Mitsui Y, Wada K, Araki M, Watanabe M

Medicine International 1 ( 13 ) 2021年

A second opinion pathology review improves the diagnostic concordance between prostate cancer biopsy and radical prostatectomy specimens

Maehara T, Sadahira T, Maruyama Y, Wada K, Araki M, Watanabe M, Watanabe T, Yanai H, Nasu Y

UROLOGY ANNALS 13 ( 2 ) 119 - 124 2021年

【地方の腎移植の継続と継承-組織・指導医の取り組みと今後の展望-】岡山大学における腎移植継承の取り組み

荒木元朗, 西村慎吾, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 富永悠介, 岩田健宏, 片山聡, 佐古智子, 枝村康平, 小林泰之, 那須保友

腎移植・血管外科 33 ( 2 ) 67 - 71 2021年

【地方の腎移植の継続と継承-組織・指導医の取り組みと今後の展望-】岡山大学における腎移植継承の取り組み

荒木元朗, 西村慎吾, 吉永香澄, 丸山雄樹, 山野井友昭, 定平卓也, 富永悠介, 岩田健宏, 片山聡, 佐古智子, 枝村康平, 小林泰之, 那須保友

腎移植・血管外科 33 ( 2 ) 67 - 71 2021年

記述言語：日本語出版者・発行元：腎移植・血管外科研究会

1.岡山大学の腎移植の背景・歴史岡山大学泌尿器科は2009年に新しい腎移植プログラムを立ち上げ総計144例となった.成績も1年生存・生着率100%を維持している.2.人材確保医局員の確保から始まる.3.育成腎移植は幅広いテクニックが要求される.血管縫合糸は若手医師でも縫いやすく結紮もし易いGore-tex sutureを用いている.いい雰囲気でやることを心がけている.4.腎臓内科との連携術前術後連携を取るため腎移植カンファレンスを月一回行い情報共有している.5.教室内での他の領域の医師との関係腎移植チームのメンバーも腫瘍の手術やロボット手術を担当することによって腎移植のみに偏らない配慮をしている.6.働き方改革移植前後の管理の簡略化に努めている.(著者抄録)

Medical uses for phenol in the urinary tract: A possible forgotten treatment (Review). 国際誌

Takuya Sadahira, Yuki Maruyama, Toyohiko Watanabe, Takanori Sekito, Yosuke Mitsui, Koichiro Wada, Motoo Araki, Masami Watanabe

Medicine international 1 ( 4 ) 13 - 13 2021年

記述言語：英語掲載種別：研究論文（学術雑誌）

Phenol is a chemical compound that was first used medically as an antiseptic. At low concentrations, phenol exerts local anesthetic effects achieved through denervation; at high concentrations, it exerts a potent protein-denaturing effect that induces apoptosis. Phenol injection therapy has a long history of use in urology. It is reportedly effective for hemorrhagic cystitis, benign prostate hyperplasia, overactive bladder, hydrocele, bladder tumors, interstitial cystitis and other benign urologic diseases, and it is also used as a tool to decrease bleeding during prostate surgery. The present review article summarizes the medical applications of phenol in urological field. The articles available on the medical uses of phenol are primarily older and retrospective, involving small numbers of patients. In the absence of comparative studies with other treatments, it is impossible to determine the relative benefit of phenol. However, the treatment outcomes of phenol injection are fairly well-established. Phenol therapy may be an option for patients who are poor candidates for invasive treatment. Further studies are required, however, as are improvements in the injection technique to reduce the rate of complications.

DOI： 10.3892/mi.2021.13

Surgical treatment for a periurethral diverticulum with dysuria: A case reports

Satoko Matsuo, Ryuta Tanimoto, Morito Sugimoto, Tomoyasu Tsushima, Aya Nakamura, Takuya Sadahira, Shogo Watari, Yasuyuki Kobayashi, Motoo Araki, Toyohiko Watanabe, Yasutomo Nasu

Nishinihon Journal of Urology 82 ( 5 ) 514 - 517 2020年12月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：The West Japan Urological Association

A 46-year-old woman visited a urological clinic with the chief complaint of urinary frequency and dysuria. She had been examined with regular follow-up MRI following excision of a uterine fibroid, which had revealed a cystic lesion around the urethra. Her symptoms did not improve under medical treatment, so she was then referred to our hospital for further treatment. Abdominal ultrasound revealed no post-void residual urine but a cystic lesion around the urethra. Internal examination indicated an elastic soft mass below the anterior vaginal wall. Communication between the cystic lesion and the urethra was observed with cystourethroscopy when the cystic lesion was punctured in a transvaginal way and injected with indigo carmine. Her symptoms improved for a while, however, nine months later, the cystitis symptoms recurred, and MRI showed an enlarged cystic lesion. Transvaginal urethral diverticulectomy was then performed. The communication of diverticulum with the urethra was closed, and the mucosal lining within the diverticulum was removed as much as possible. The periurethral fascia and vaginal wall were closed, respectively. The patient had no perioperative complications and no recurrent urinary symptoms.

Low-dose rituximab induction therapy is effective in immunological high-risk renal transplantation without increasing cytomegalovirus infection. 査読国際誌

Kasumi Yoshinaga, Motoo Araki, Koichiro Wada, Yuki Maruyama, Yosuke Mitsui, Takuya Sadahira, Risa Kubota, Shingo Nishimura, Yasuyuki Kobayashi, Hidemi Takeuchi, Katsuyuki Tanabe, Masashi Kitagawa, Hiroshi Morinaga, Haruhito Adam Uchida, Shinji Kitamura, Hitoshi Sugiyama, Jun Wada, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu

International journal of urology : official journal of the Japanese Urological Association 27 ( 12 ) 1136 - 1142 2020年12月

担当区分：責任著者記述言語：英語掲載種別：研究論文（学術雑誌）

OBJECTIVES: To analyze the effect and impact of low-dose rituximab induction therapy on cytomegalovirus infection in living-donor renal transplantation. METHODS: A total of 92 recipients undergoing living-donor renal transplantation at Okayama University Hospital from May 2009 to August 2018 were evaluated retrospectively. Indications for preoperative rituximab (200 mg/body) were the following: (i) ABO major mismatch; (ii) ABO minor mismatch; (iii) donor-specific anti-human leukocyte antigen antibody-positive; and (iv) focal segmental glomerulosclerosis. We excluded four recipients who were followed <3 months, five who received >200 mg/body rituximab and seven who received prophylactic therapy for cytomegalovirus. RESULTS: There were 59 patients in the rituximab group and 17 in the non-rituximab group. Groups differed significantly in age (median age 53 vs 37 years, respectively; P = 0.04), but not in sex (male 64% vs 65%, P = 1.00), focal segmental glomerulosclerosis (3% vs 0%, P = 1.00) or percentage of cytomegalovirus-seronegative recipients of renal allografts from cytomegalovirus-seropositive donors (12% vs 18%, P = 0.68). The estimated glomerular filtration rate did not differ significantly between groups until 24 months after transplantation. Cytomegalovirus clinical symptoms (10% vs 24%, P = 0.22), including fever ≥38°C (5% vs 12%, P = 0.31) and gastrointestinal symptoms (5% vs 12%, P = 0.31), and the 5-year survival rates of death-censored graft loss (90% vs 83%, P = 0.43) did not differ significantly between groups. CONCLUSIONS: Low-dose rituximab induction therapy is effective in immunological high-risk recipients without increasing cytomegalovirus infection in the absence of valganciclovir prophylaxis.

DOI： 10.1111/iju.14382

当院における開腹膀胱全摘術(ORC)と腹腔鏡下膀胱全摘術(LRC)の治療成績の比較

和田里章悟, 小林泰之, 定平卓也, 片山聡, 岩田健宏, 西村慎吾, 高本篤, 佐古智子, 枝村康平, 荒木元朗, 渡部昌実, 渡邉豊彦, 那須保友

日本泌尿器科学会総会 108回 1138 - 1138 2020年12月

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