Faculty Profiles - ARAKI Motoo

Papers - ARAKI Motoo

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Detection and isolation of nanobacteria-like particles from urinary stones: long-withheld data. Reviewed International journal

Hiromi Kumon, Akira Matsumoto, Shinya Uehara, Fernando Abarzua, Motoo Araki, Ken Tsutsui, Ken-ichi Tomochika

International journal of urology : official journal of the Japanese Urological Association 18 ( 6 ) 458 - 65 2011.6

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY

OBJECTIVES: To report our experimental results on detection and isolation of nanobacteria-like particles (NLP) from urinary stone samples. METHODS: From March 2001 to August 2003, 47 urinary stone samples from Japanese patients and 18 from Paraguayan patients were collected and used for compositional analysis, direct survey of NLP by scanning electron microscopy (SEM) and their cultural isolation. For the isolation, culturing was carried out using strict aseptic techniques. Dulbecco's modified Eagle medium with 10% gamma-irradiated fetal bovine serum was used based on the original method described by Kajander and Ciftçioglu. RESULTS: Positive NLP detection rates for Japanese and Paraguayan patient samples were 61.7% (29/47) and 66.7% (12/18), respectively. Positive NLP isolation rates for Japanese patient samples were 20.6% (7/34) and 20.0% (2/10) for Paraguayan patient samples. In the initial isolation, markedly different periods of incubation time were needed for each of the nine cases (6-220 days; median 36 days). Positive detection and isolation were obtained in stone samples with or without calcium phosphate. Growth modes and morphogenesis of NLP were divided into two phases; rod-shaped NLP was detected mainly as a floating form growing in culture medium and spherical NLP with a characteristic apatite shell was detected as an attached form growing on the surface of culture dishes. CONCLUSIONS: Lifeless calcifying nanoparticles can be isolated from various human urinary stones, cultured in cell culture mediums and show two characteristic growth phases.

DOI： 10.1111/j.1442-2042.2011.02763.x

URETEROSCOPIC EVALUATION AND TREATMENT OF CHRONIC UNILATERAL HEMATURIA: A 24-YEAR EXPERIENCE Reviewed

Motoo Araki, Shinya Uehara, Koichi Monden, Toyohiko Watanabe, Takashi Saika, Yasutomo Nasu, Hiromi Kumon

JOURNAL OF UROLOGY 185 ( 4 ) E556 - E557 2011.4

CHANGES IN CLITORIAL BLOOD FLOW FOLLOWING SURGERY WITH TENSION-FREE VAGINAL MESH FOR PELVIC ORGAN PROLAPSE Reviewed

Toyohiko Watanabe, Miyabi Inoue, Ayano Ishii, Toyoko Yamato, Motoo Araki, Shinya Uehara, Takashi Saika, Yasutomo Nasu, Hiromi Kumon

JOURNAL OF UROLOGY 185 ( 4 ) E685 - E685 2011.4

ロボット支援腹腔鏡下前立腺全摘除術の初期経験

雑賀隆史, 上原慎也, 渡邊豊彦, 小林泰之, 荒木元朗, 佐々木克己, 上松克利, 能勢宏幸, 岸本涼, 別宮謙介, 神原太樹, 那須保友, 公文裕巳

西日本泌尿器科 73 ( 4 ) 201 - 201 2011.4

術前6週間の免疫抑制とリツキサンを用いて成功した免疫学的ハイリスク生体腎移植症例の1例

河内啓一郎, 荒木元朗, 小武家誠, 上松克利, 小林泰之, 雑賀隆史, 那須保友, 公文裕巳, 齋藤和英, 高橋公太

移植 45 ( 5 ) 535 - 536 2010.10

CLITORIAL BLOOD FLOW CHANGES AFTER SURGERY WITH TENSION-FREE VAGINAL MESH FOR PELVIC ORGAN PROLAPSE Reviewed

Watanabe Toyohiko, Inoue Miyabi, Ishii Ayano, Yamato Toyoko, Nose Hiroyuki, Uematsu Katsutoshi, Sasaki Katsumi, Araki Motoo, Uehara Shinya, Saika Takashi, Nasu Yasutomo, Kumon Hiromi

JOURNAL OF UROLOGY 183 ( 4 ) E583 2010.4

URETEROSCOPIC EVALUATION AND TREATMENT OF CHRONIC UNILATERAL HEMATURIA: A 23-YEAR EXPERIENCE Reviewed

Araki Motoo, Uehara Shinya, Watanabe Toyohiko, Saika Takashi, Nasu Yasutomo, Kumon Hiromi

JOURNAL OF UROLOGY 183 ( 4 ) E494 2010.4

OMINOUS AZITHROMYCIN RESISTANCE TREND OF GONOCOCCAL URETHRITIS IN JAPAN

Motoo Araki, Shinya Uehara, Ayano Ishii, Hiroyuki Nose, Toyohiko Watanabe, Satoshi Uno, Koichi Monden, Tohru Araki, Yasutomo Nasu, Hiromi Kumon

JOURNAL OF UROLOGY 183 ( 4 ) E317 - E317 2010.4

Robot-assisted laparoscopic radical prostatectomy in the Asian population: modified port configuration and ultradissection. Reviewed International journal

Wooju Jeong, Motoo Araki, Sung Yul Park, Young Hoon Lee, Hiromi Kumon, Sung Joon Hong, Koon Ho Rha

International journal of urology : official journal of the Japanese Urological Association 17 ( 3 ) 297 - 300 2010.3

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-BLACKWELL PUBLISHING, INC

We have carried out over 360 cases of robot-assisted laparoscopic radical prostatectomy (RARP) to date. In the present study, we detail our current technique at Yonsei University College of Medicine. The six-port transperitoneal approach is utilized. The most lateral two ports were placed medially and caudally in patients with a small pelvis to avoid interference between the ports and the pelvis (modified port configuration). Lymph node dissection is carried out in the external iliac, obturator and infraobturator area. The dissection on the lateral border of the bladder neck is carried out until it reaches the seminal vesicle (ultradissection). After transection of the bladder neck, vasa seminal vesicles are dissected further. Neurovascular bundles are preserved in selected patients. The dorsal venous complex (DVC) and the urethra are transected without suturing. Urethrovesical anastomosis is carried out with 3-0 monocryl running suture, incorporating with the edge of DVC. The puboprostatic collar and bladder are incorporated by 3-0 monocryl running suture (puboperineoplasty). Between November 2007 and September 2008, RARP was carried out using this technique in 182 patients. Median height, weight, body mass index and prostate-specific antigen (PSA) were 168 cm, 68 kg, 24 kg/M(2) and 7.1 ng/mL, respectively. Mean operative time was 192 min and average blood loss was 250 mL. Median catheterization time was 8 days. Positive surgical margin rates for pT2, pT3 and pT4 disease was 12.7, 48 and 100%, respectively. Intraoperative complication rate was 2.7%. Fifty-five patients completed a minimum of 10 months follow up. Their continence rate was 91%. RARP is a safe and feasible surgical modality for prostate cancer among Asian patients with a small pelvis. Our technique achieves a precise bladder neck dissection.

DOI： 10.1111/j.1442-2042.2010.02480.x

Role of patient-physician dialogue in selecting the type of urinary diversion. International journal

Devendar Katkoori, Murugesan Manoharan, Motoo Araki, Mark S Soloway

Urologia internationalis 84 ( 1 ) 40 - 4 2010

Language：English Publishing type：Research paper (scientific journal)

INTRODUCTION: We analyze patient-physician dialogue prior to radical cystectomy (RC) when choosing the type of urinary diversion (UD). METHODS: 132 patients operated by one surgical team between 2003 and 2005 were included. Physician's recommendation, patient's decision and UD (neobladder (NB) or ileal conduit (IC)) performed were analyzed. Patients were grouped based on age, considering that age is often a limiting factor for NB. RESULTS: When offered either NB or IC, 85% (49/58) in group I (<70 years) and 55% (12/22) in group II (> or =70 years) elected NB. An IC was suggested for 16% (11/69) in group I and 65% (41/63) in group II. Six patients (2 in group I, 4 in group II) wanted a NB even though an IC was suggested. CONCLUSIONS: Counseling patients is important. When an IC was suggested, over 80% accepted this advice. When both were offered, younger patients usually elected a NB. Older patients preferred an IC.

DOI： 10.1159/000273464

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腹腔鏡下尿膜管遺残摘出術の4例

荒木元朗, 雑賀隆史, 上原慎一, 那須保友, 小林泰之, 渡邊豊彦, 公文裕巳

日本内視鏡外科学会雑誌 14 ( 7 ) 344 - 344 2009.12

CTガイド下RFAが困難であったVHL随伴腎癌に対する腹腔鏡補助下RFAの経験

上松克利, 雑賀隆史, 郷原秀夫, 三村秀文, 荒木元朗, 石井亜矢乃, 小林泰之, 那須保友, 金澤右, 公文裕巳

Japanese Journal of Endourology and ESWL 22 ( 3 ) 165 - 165 2009.11

前立腺癌に対するHybrid radical prostatectomyのOncological outcomes

雑賀隆史, 小林泰之, 上原慎也, 荒木元朗, 高尾彰, 上杉達也, 那須保友, 公文裕巳

日本癌治療学会誌 44 ( 2 ) 428 - 428 2009.9

URETEROSCOPIC EVALUATION AND TREATMENT OF CHRONIC UNILATERAL HEMATURIA: A 22-YEAR EXPERIENCE Reviewed

Araki Motoo, Uehara Shinichi, Monden Koichi, Watanabe Toyohiko, Saika Takashi, Nasu Yasutomo, Kumon Hiromi

JOURNAL OF UROLOGY 181 ( 4 ) 450 2009.4

A Clinical Investigation of the Mechanism of Loxoprofen, a Non-steroidal Anti-inflammatory Drug, for Patients with Nocturia Reviewed

Araki Tohru, Yokoyama Teruhiko, Araki Motoo, Furuya Seiji

Acta Medica Okayama 62 ( 6 ) 373 - 378 2008.12

Language：English Publisher：Okayama University Medical School

<p>We previously reported the effectiveness of loxoprofen sodium (loxoprofen), a non-steroidal anti-inflammatory drug, for patients with lower urinary tract symptoms (LUTS) complaining of nocturia. In this study, we explored the mechanism of loxoprofen in the treatment of nocturia. Fifty-six patients complaining of nocturia were enrolled. They took a single 60-mg tablet of loxoprofen at bedtime for 14 days. The effects of this treatment were assessed by bladder diaries. Nocturia improved (nocturia decreased ≥1 void/night) in 40 patients (71.4%). Nocturnal urine volume was reduced in 31 of 40 (77.5%) without nocturnal single-void volume increase. Nocturnal single-void volume increased in 4 of 40 (10.0%) without nocturnal urine volume reduction. Two of 40 (5.0%) demonstrated both nocturnal urine volume reduction and nocturnal single-void volume increase. Three (7.5%) were exceptions to the above. In conclusion, the main mechanism of loxoprofen is the reduction of nocturnal urine volume for the treatment of nocturia and the second mechanism is the increased bladder capacity.</p>

DOI： 10.18926/AMO/30949

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Other Link： http://search.jamas.or.jp/link/ui/2009175789

Catheter-free 120W lithium triborate (LBO) laser photoselective vaporization prostatectomy (PVP) for benign prostatic hyperplasia (BPH). Reviewed International journal

Massimiliano Spaliviero, Motoo Araki, Jay B Page, Carson Wong

Lasers in surgery and medicine 40 ( 8 ) 529 - 34 2008.10

Language：English Publishing type：Research paper (scientific journal) Publisher：WILEY-LISS

INTRODUCTION AND OBJECTIVE: We evaluate the safety and efficacy of catheter-free LBO laser PVP for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). METHODS: We prospectively evaluated our initial LBO laser PVP experience and the need for urethral catheterization. RESULTS: Seventy consecutive patients were identified. 49 (70%) were discharged without (C-) and 21 (30%) were discharged with (C+) a urethral catheter. There were no significant differences in pre-operative parameters, including age (C-: 65+/-10 vs. C+: 69+/-9 years), AUASS (C-: 22+/-6 vs. C+: 21+/-6), Qmax (C-: 10+/-4 vs. C+: 8+/-3 ml/second), PVR (C-: 62+/-105 vs. C+: 57+/-82 ml) and prostate volume (C-: 65+/-35 vs. C+: 86+/-53 ml). There were no significant differences in laser time and energy usage. AUASS, Qmax and PVR values showed significant improvement within each group (P<0.05), but there were no significant differences between the two groups. All were outpatient procedures. 2/70 (2.9%) patients required catheter reinsertion in C+. The overall incidence of adverse events was low and did not differ between the two groups. CONCLUSIONS: Our experience suggests that catheter-free LBO laser PVP is safe and effective for the treatment of LUTS secondary to BPH.

DOI： 10.1002/lsm.20678

Web of Science

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Short-term outcomes of Greenlight HPS laser photoselective vaporization prostatectomy (PVP) for benign prostatic hyperplasia (BPH). Reviewed International journal

Massimiliano Spaliviero, Motoo Araki, Carson Wong

Journal of endourology 22 ( 10 ) 2341 - 7 2008.10

Language：English Publishing type：Research paper (scientific journal) Publisher：MARY ANN LIEBERT INC

PURPOSE: We evaluated our initial experience with the GreenLight HPS laser, a technologically improved version of the potassium-titanyl-phosphate (KTP) laser for PVP. MATERIALS AND METHODS: Transurethral PVP was performed using a GreenLight HPS side-firing laser system. Patients had American Urological Association Symptom Score (AUASS), Quality of Life (QoL) score, Sexual Health Inventory for Men (SHIM) score, serum prostate specific antigen (PSA), maximum flow rate (Qmax) and post void residual (PVR) determinations and volumetric prostate measurements with transrectal ultrasonography (TRUS). Laser and operative times and energy usage were recorded. AUASS, QoL, SHIM, Qmax and PVR were evaluated 1, 4, 12, 24, and 52 weeks post-surgery. Serum PSA and TRUS were obtained at 12 weeks and serum PSA was repeated at 52 weeks. RESULTS: Seventy consecutive patients with a median age of 67 (45-86) years underwent GreenLight HPS laser PVP from July 2006 through March 2008. Median prostate volume was 61.6 (20.9-263.0) mL with a median PSA of 1.4 (0.1 -10.1) ng/mL. Mean laser and operative times and energy usage were 13 (3-34) minutes, 30 (6-100) minutes and 85 (11-235) kJ, respectively. All were outpatient procedures with 49 (70%) patients catheter-free at discharge. No urethral strictures or urinary incontinence were noted. Median AUASS decreased from 22 to 8, 6, 5, 5, and 4 (p<0.001) while the median Qmax increased from 9.4 to 20.4, 20.3, 21.2, 18.8, and 20.0 mL/s (p<0.001) during the follow-up period. CONCLUSIONS: At one year, our experience suggests that GreenLight HPS laser PVP is safe and effective for treating lower urinary tract symptoms secondary to BPH.

DOI： 10.1089/end.2008.9708

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High-power potassium-titanyl-phosphate laser photoselective vaporization prostatectomy for symptomatic benign prostatic hyperplasia. Reviewed International journal

Motoo Araki, Po N Lam, Carson Wong

Journal of endourology 22 ( 6 ) 1311 - 4 2008.6

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal) Publisher：MARY ANN LIEBERT INC

BACKGROUND AND PURPOSE: Potassium-titanyl-phosphate (KTP) laser photoselective vaporization prostatectomy (PVP) is a relatively new technology for the management of lower urinary-tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). We review our initial experience. PATIENTS AND METHODS: We prospectively evaluated our initial 12-month experience with 80 W KTP laser PVP. All had American Urological Association symptom score (AUASS), American Society of Anesthesiologists (ASA) risk score, serum prostate-specific antigen (PSA), maximum flow rate (Qmax), and postvoid residual (PVR) determinations and transrectal ultrasonography. RESULTS: There were 160 consecutive patients identified, with a mean age of 69.7 years (range 34-88 yrs) and a mean ASA score of 2.4 (range 1-4). The mean prostate volume was 72.3 cm(3) (range 20.3-261 cm(3)), with a mean PSA level of 2.2 ng/mL (range 0.1-17.9 ng/mL). Mean laser time and energy usage were 33.4 minutes (range 4-165 min) and 99.0 kJ (range 11.3-524 kJ), respectively. All were outpatient procedures with 96 (60%) patients catheter-free at discharge. Twenty-eight patients need catheter drainage for 1 week. Urinary-tract infections developed in 13 patients. Fourteen patients had clinically insignificant hematuria for more than 1 week. Bladder neck contractures that necessitated intervention developed in three patients. Three patients had persistent urinary retention. No urethral strictures or urinary incontinence were noted. Mean AUASS decreased significantly from 23 to 13, 9, 8, 7, and 6 (P < 0.05) at 1, 4, 12, 24, and 52 weeks, respectively. Qmax and PVR values also showed statistically significant improvement. CONCLUSION: Our initial results demonstrate that KTP laser PVP is safe and effective for the management of LUTS secondary to BPH.

DOI： 10.1089/end.2008.0140

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Intraoperative placing of drains decreases the incidence of lymphocele and deep vein thrombosis after renal transplantation. Reviewed International journal

Ithaar H Derweesh, Hazem R Ismail, David A Goldfarb, Motoo Araki, Lingmei Zhou, Charles Modlin, Venkatesh Krishnamurthi, Stuart M Flechner, Andrew C Novick

BJU international 101 ( 11 ) 1415 - 9 2008.6

Language：English Publishing type：Research paper (scientific journal)

OBJECTIVE: To investigate the effect of placing a prophylactic drain during renal transplantation on the incidence of lymphocele, wound complication and deep venous thrombosis (DVT) in renal transplant recipients induced with sirolimus vs calcineurin inhibitors (CNI), as sirolimus-based immunosuppression is a risk factor for the formation of fluid collections after transplantation. PATIENTS AND METHODS: We analysed 165 consecutive adult renal transplant patients at our institution between January 2004 and February 2005. Group 1 (84) did not receive an intraoperative drain and group 2 (81) did. Recipients were analysed within each group based on immunosuppression (sirolimus or CNI) and whether they had wound complication, fluid collection, lymphocele treatment, or DVT. RESULTS: In group 1 and 2, respectively, the wound complication rate was 22.6% vs 13.6% (P = 0.134), the fluid collection rate 45.2% vs 16.% (P < 0.001), the lymphocele treatment rate 19.0% vs 2.5% (P = 0.001) the DVT rate 14.3% vs 4.9% (P = 0.043) the fluid collection rate (for CNI) 26.5% vs 16.0% (P = 0.246), the lymphocele treatment rate (for CNI) 5.9% vs 0% (P = 0.084), the fluid collection rate (sirolimus) 58.0% vs 16.1% (P < 0.001) and lymphocele treatment rate (sirolimus) 28% vs 6.5% (P = 0.018). Multivariate analysis of risk factors for fluid collection showed significance for no drain (odds ratio 3.30, P = 0.002), associated wound complication (2.41, P = 0.041) and sirolimus (2.48, P = 0.015). CONCLUSIONS: Placing a drain during transplantation decreased the incidence of fluid collection, lymphocele treatment and DVT. The reduction of fluid collection and lymphocele were significant for patients treated with sirolimus. We recommend placing a drain in patients undergoing induction with sirolimus-based immunosuppression.

DOI： 10.1111/j.1464-410X.2007.07427.x

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Ureteroscopic evaluation and treatment of chronic unilateral hematuria: A 20-year experience Reviewed

Araki Motoo, Monden Kouichi, Uehara Shinya, Watanabe Toyohiko, Saika Takashi, Nasu Yasutomo, Kumon Hiromi

JOURNAL OF UROLOGY 179 ( 4 ) 282 2008.4

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Papers - ARAKI Motoo