Faculty Profiles - ARAKI Motoo

Papers - ARAKI Motoo

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Bladder tumors with multiple cardiac metastases, with elevated serum granulocyte colony-stimulating factor. Reviewed International journal

Naoya Nagasaki, Tomofumi Watanabe, Kohei Edamura, Motoo Araki, Takuya Sadahira

The American journal of medicine 136 ( 8 ) e161-e162 2023.4

Renal cryoablation combined with prior transcatheter arterial embolization in non-dialysis patients with stage 4 or 5 chronic kidney disease: a retrospective study Reviewed

Noriyuki Umakoshi, Toshihiro Iguchi, Yusuke Matsui, Koji Tomita, Mayu Uka, Takahiro Kawabata, Kazuaki Munetomo, Shoma Nagata, Hideo Gobara, Motoo Araki, Takao Hiraki

Japanese Journal of Radiology 2023.4

Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

Abstract

Purpose

To retrospectively evaluate cryoablation combined with prior transcatheter arterial embolization (TAE) for renal cell carcinoma (RCC) in non-dialysis patients with stage 4 or 5 chronic kidney disease (CKD).

Materials and methods

Patients with stage 4 or 5 CKD undergoing TAE and cryoablation for RCC between May 2012 and October 2021 were included. TAE was selectively performed using iodized oil with absolute ethanol or gelatin sponge 1–14 days before cryoablation. Local efficacy, safety, and changes in renal function were evaluated.

Results

Nine patients (seven men and two women; median age, 64 years; range 52–88 years) with nine RCCs (mean diameter, 3.0 ± 1.0 cm; range 1.7–4.7 cm) were included. The mean pre-treatment estimated glomerular filtration rate (eGFR) was 24.2 ± 5.6 ml/min/1.73 m² (range 10.4–29.2 ml/min/1.73 m²). The mean amount of contrast medium used in TAE was 58 ± 29 ml (range 40–128 ml). Except in one patient (grade 3 pyelonephritis), no grade ≥ 3 complications occurred. During the follow-up period (median, 18 months; range 7–54 months), no local tumor progression occurred. In two patients with pre-treatment eGFR of < 20 ml/min/1.73 m², hemodialysis was initiated at 3 and 19 months after cryoablation. At their last follow-up, the remaining seven patients showed a decrease of 6.2 ± 5.3 ml/min/1.73 m² (range 0.7–17.2 ml/min/1.73 m²) in their eGFR.

Conclusion

Cryoablation combined with TAE for RCC in non-dialysis patients with stage 4 or 5 CKD was effective and safe, with an acceptable impact on renal function.

DOI： 10.1007/s11604-023-01416-z

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Other Link： https://link.springer.com/article/10.1007/s11604-023-01416-z/fulltext.html

Complications of Percutaneous Cryoablation for Renal Tumors and Methods for Avoiding Them. Reviewed

Toshihiro Iguchi, Yusuke Matsui, Koji Tomita, Mayu Uka, Noriyuki Umakoshi, Takahiro Kawabata, Kazuaki Munetomo, Shoma Nagata, Motoo Araki, Takao Hiraki

Acta medica Okayama 77 ( 2 ) 121 - 129 2023.4

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

Percutaneous cryoablation of renal tumors is widely used because of its high efficacy and safety. This high safety can be attributed, at least in part, to the visibility of the ablated area as an "ice ball". This therapy has fewer complications (incidence, 0-7.2%) and is less invasive than surgery. Minor bleeding is inevitable in most kidney-related procedures, and indeed the most common complication of this therapy is bleeding (hematoma and hematuria). However, patients require treatment such as transfusion or transarterial embolization in only 0-4% of bleeding cases. Various other complications such as ureteral or collecting system injury, bowel injury, nerve injury, skin injury, infection, pneumothorax, and tract seeding also occur, but they are usually minor and asymptomatic. However, operators should know and avoid the various complications associated with this therapy. This study aimed to summarize the complications of percutaneous cryoablation for renal tumors and provide some techniques for achieving safe procedures.

DOI： 10.18926/AMO/65141

PubMed

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前立腺癌:Next 10 years～どうなる,どうする,前立腺癌～限局性前立腺癌に対するFocal therapy Reviewed

小林泰之, 枝村康平, 西村慎吾, 岩田健宏, 片山聡, 定平卓也, 小林知子, 荒木元朗

西日本泌尿器科 85 ( 4 ) 106 - 109 2023.4

Language：Japanese Publisher：(一社)西日本泌尿器科学会

限局性前立腺癌の治療は臨床的Insignificant cancerに対してActive surveillance,Significant cancerに対しては根治的治療が選択される。しかしながら,癌制御とQOL維持の両立の点を考慮するといずれの治療も十分とは言えない患者群が存在し,このような症例に対する治療としてFocal therapyが期待されている。Focal therapyに関する諸家らの報告では,短～中期腫瘍学的結果は良好であり,尿禁制や性機能も優れていた。本邦においては,2021年4月に日本泌尿器科学会より「前立腺癌局所治療医療機器の臨床評価方法に関するガイドライン」が出され,今後,Focal therapyのエビデンスが蓄積されていくものと期待される。(著者抄録)

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Gerota fasciaとは何物なのか cadaverを用いた組織学的検討 Reviewed

小林泰之, 枝村康平, 定平卓也, 富永悠介, 片山聡, 岩田健宏, 西村慎吾, 別宮謙介, 小林知子, 小見山高明, 百田龍輔, 荒木元朗

Japanese Journal of Endourology and Robotics 36 ( 1 ) 118 - 123 2023.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

腹腔鏡下腎摘除術において,Gerota fascia(以下:Gf)は経腹的アプローチでは膜構造として容易に認識できるが,後腹膜アプローチではその見え方が経腹的アプローチとは大きく異なり,その存在自体を認識できない症例が少なくない.今回,我々は死亡献体より腎臓と腎臓周囲臓器を一塊に摘出し,Gfに剥離操作を加えない状態で検体作成を行い,線維の走行,密度などについて組織学的検討を行った.その結果,Gfは筋上膜のような強固な膜とは構造が異なり,密度・配列など多様なコラーゲン線維のまばらな結合組織で構成されていることが分かった.すなわち,Gfが膜状構造物に観察されるのは,結合組織が剥離操作にて変化した結果の可能性があり,アプローチする方向の違いによりその形態が異なって見えることを念頭におく必要があるものと考えられる.(著者抄録)

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【ロボット時代の若手への腹腔鏡教育を考える】ロボット時代の若手への腹腔鏡教育を考える腎副腎メンターの立場から Reviewed

小林泰之, 枝村康平, 定平卓也, 富永悠介, 片山聡, 岩田健宏, 西村慎吾, 小林知子, 荒木元朗

Japanese Journal of Endourology and Robotics 36 ( 1 ) 57 - 60 2023.4

Language：Japanese Publisher：(一社)日本泌尿器内視鏡・ロボティクス学会

ロボット手術の普及により,腹腔鏡手術教育は大きく変化しつつある.一番の問題点は,ロボット支援下部分切除術の普及に伴い,これまでより難易度の高い症例が腹腔鏡下腎摘除術の対象となり,相対的に初心者が行う腹腔鏡手術件数が減少していることである.加えて,手術環境の急激な変化により,初心者のトレーニング背景も複雑化してきており,手術教育もそれらに対応すべく変化が求められている.岡山大学病院では,従来通りの模範手術を核とした集団指導に加えて,ある程度の執刀経験のある術者に対して,個別指導を行い対応している.加えて,最近のWeb会議システムを用い,関連施設の垣根を超えたWeb勉強会を行っている.(著者抄録)

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局所進行性膀胱癌に対する根治的膀胱全摘除術前化学療法としてのゲムシタビン、シスプラチン、パクリタキセル3剤併用化学療法の治療成績(Clinical Outcomes of Neoadjuvant Paclitaxel/Cisplatin/Gemcitabine compared with Gemcitabine/Cisplatin for Muscle-Invasive Bladder cancer)

河田達志, 別宮謙介, 片山聡, 岩田健宏, 枝村康平, 小林泰之, 津川卓士, 坪井一馬, 定平卓也, 西村慎吾, 小林知子, 江原伸, 荒木元朗

日本泌尿器科学会総会 110回 OP36 - 02 2023.4

転移性腎細胞がんに対する免疫チェックポイント阻害剤の有効性における転移部位腫瘍径の影響(The impact of metastatic tumor burden to the efficacy of immune checkpoint inhibitors for metastatic renal cell carcinoma)

岩田健宏, 片山聡, 吉永香澄, 丸山雄樹, 定平卓也, 西村慎吾, 別宮健介, 枝村康平, 小林知子, 小林泰之, 渡邉豊彦, 荒木元朗

日本泌尿器科学会総会 110回 OP25 - 05 2023.4

cT1腎癌におけるロボット支援腎部分切除(RAPN)と経皮的凍結療法(PCA)の傾向スコアマッチング解析を用いた周術期成績・術後腎機能の検討(Oncological outcomes and renal function in robot-assisted partial nephrectomy vs percutaneous cryoablation for cT1 RCC: A propensity score-matched analysis)

山野井友昭, 別宮謙介, 馬越紀行, 定平卓也, 片山聡, 岩田健宏, 宇賀麻由, 西村慎吾, 枝村康平, 小林知子, 小林泰之, 荒木元朗, 平木隆夫

日本泌尿器科学会総会 110回 PP75 - 01 2023.4

腎癌に対する経皮的凍結療法とロボット支援下腎部分切除術の対費用効果についての後方視的比較検討(Percutaneous Cryoablatin vs Robot-Assisted Partial Nephrectomy in Renal Carcinoma: Cost Analysis)

宇賀麻由, 別宮謙介, 山野井友昭, 永田翔馬, 宗友一晃, 馬越紀行, 川端隆寛, 冨田晃司, 松井裕輔, 生口俊浩, 郷原英夫, 荒木元朗, 平木隆夫

日本インターベンショナルラジオロジー学会雑誌 38 ( Suppl. ) 211 - 211 2023.4

Tumor burdenはペムブロリズマブ療法を受けた転移性尿路上皮癌患者の予後因子となる多施設共同研究(Radiological tumor burden as prognostic biomarker in patients with metastatic urothelial carcinoma treated with immune checkpoint inhibitor)

片山聡, 岩田健宏, 小林泰之, 小林知子, 枝村康平, 坪井一馬, 高本篤, 坪井一朗, 久住倫宏, 中田哲也, 佐々木克己, 和田耕一郎, 荒木元朗

日本泌尿器科学会総会 110回 OP79 - 02 2023.4

The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing E. coli Strains from Urinary Tract Infections Reviewed

Kazuma Sakaeda, Takuya Sadahira, Yuki Maruyama, Takehiro Iwata, Masami Watanabe, Koichiro Wada, Motoo Araki

Antibiotics 12 ( 3 ) 522 - 522 2023.3

Publishing type：Research paper (scientific journal) Publisher：MDPI AG

We carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing E. coli strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing E. coli strains isolated from urine samples collected from patients treated at our institution between 2008 and 2018. These sequences were compared with results for antimicrobial drug susceptibility determined using a micro-liquid dilution method. We also analyzed cases treated with FMOX at our institution to examine its clinical efficacy. Of the 911 E. coli strains identified, 158 (17.3%) were ESBL-producing. Of these, 67.7% (107/158) were strain ST-131 in ST analysis. Nearly all (154/158; 97.5%) were CTX-M genotypes, with M-14 and M-27 predominating. The isolated strains were sensitive to FMOX in drug susceptibility tests. Among the patient samples, 33 cases received FMOX, and of these, 5 had ESBL-producing E. coli. Among these five cases, three received FMOX for surgical prophylaxis as urinary carriers of ESBL-producing E. coli, and postoperative infections were prevented in all three patients. The other two patients received FMOX treatment for urinary tract infections. FMOX treatment was successful for one, and the other was switched to carbapenem. Our results suggest that FMOX has efficacy for perioperative prophylactic administration in urologic surgery involving carriers of ESBL-producing bacteria and for therapeutic administration for urinary tract infections. Use of FMOX avoids over-reliance on carbapenems or β-lactamase inhibitors and thus is an effective antimicrobial countermeasure.

DOI： 10.3390/antibiotics12030522

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乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 168 2023.3

Staphylococcus saprophyticus感染結石による閉塞性腎盂腎炎の一例

渡部智文, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 142 2023.3

乳酸菌由来抗菌ペプチドの探索

岩田健宏, 定平卓也, 渡部智文, 丸山雄樹, 和田耕一郎, 山本満寿美, 石井亜矢乃, 渡邉豊彦, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 168 2023.3

Staphylococcus saprophyticus感染結石による閉塞性腎盂腎炎の一例

渡部智文, 定平卓也, 丸山雄樹, 岩田健宏, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 P - 142 2023.3

腟細菌叢解析による反復性膀胱炎への乳酸菌腟坐剤の効果の検証

丸山雄樹, 定平卓也, 岩田健宏, 石井亜矢乃, 和田耕一郎, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 O - 172 2023.3

腟細菌叢解析による反復性膀胱炎への乳酸菌腟坐剤の効果の検証

丸山雄樹, 定平卓也, 岩田健宏, 石井亜矢乃, 和田耕一郎, 荒木元朗

日本感染症学会総会・学術講演会・日本化学療法学会学術集会合同学会プログラム・抄録集 97回・71回 O - 172 2023.3

Activated CTLA-4-independent immunosuppression of Treg cells disturbs CTLA-4 blockade-mediated antitumor immunity. Reviewed International journal

Tomofumi Watanabe, Takamasa Ishino, Youki Ueda, Joji Nagasaki, Takuya Sadahira, Hiromichi Dansako, Motoo Araki, Yosuke Togashi

Cancer science 2023.2

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

Combination therapy with anti-cytotoxic T lymphocyte-associated protein 4 (CTLA-4) and anti-programmed death-1 (PD-1) monoclonal antibodies (mAbs) has dramatically improved the prognosis of patients with multiple types of cancer, including renal cell carcinoma (RCC). However, more than half of RCC patients fail to respond to this therapy. Regulatory T cells (Treg cells) are a subset of highly immunosuppressive CD4+ T cells that promote the immune escape of tumors by suppressing effector T cells in the tumor microenvironment (TME) through various mechanisms. CTLA-4 is constitutively expressed in Treg cells and is regarded as a key molecule for Treg cell-mediated immunosuppressive functions, suppressing antigen-presenting cells by binding to CD80/CD86. Reducing Treg cells in the TME with an anti-CTLA-4 mAb with antibody-dependent cellular cytotoxicity (ADCC) activity is considered an essential mechanism to achieve tumor regression. In contrast, we demonstrated that only CTLA-4 blockade without ADCC activity enhanced CD28 costimulatory signaling pathways in Treg cells and promoted Treg-cell proliferation in mouse models. CTLA-4 blockade also augmented CTLA-4-independent immunosuppressive functions, including cytokine production, leading to insufficient antitumor effects. Similar results were also observed in human peripheral blood lymphocytes and tumor-infiltrating lymphocytes from patients with RCC. Our findings highlight the importance of Treg-cell depletion to achieve tumor regression in response to CTLA-4 blockade therapies.

DOI： 10.1111/cas.15756

PubMed

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異所性腎患者に発生したmicropapillary variantを伴う筋層浸潤性膀胱癌に対して,ロボット支援下膀胱全摘除術を施行した一例

原惇也, 堀井聡, 岩田健宏, 鵜川聖也, 長崎直也, 松島萌希, 奥村美紗, 渡部智文, 関戸崇了, 吉永香澄, 丸山雄樹, 長尾賢太郎, 山野井友昭, 富永悠介, 定平卓也, 片山聡, 西村慎吾, 別宮謙介, 枝村康平, 小林知子, 荒木元朗, 石井亜矢乃, 渡部昌実, 渡邉豊彦, 小林泰之

西日本泌尿器科 85 ( 増刊号1 ) 46 - 46 2023.1

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