Faculty Profiles - NASU Yasutomo

Papers - NASU Yasutomo

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Laparoscopic radical cystectomy: A report of our initial four cases

Yasuyuki Kobayashi, Hiroaki Kurahashi, Kensuke Bekku, Kouichiro Wada, Ryuta Tanimoto, Katsumi Sasaki, Motoo Araki, Shin Ebara, Toyohiko Watanabe, Hiromi Kumon, Yasutomo Nasu

Nishinihon Journal of Urology 75 ( 7 ) 352 - 358 2013.7

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

Although previously, laparoscopic radical cystectomy (LRC) has been performed as advanced medicine only within limited institutions, it can now be performed using national health insurance according to the medical treatment fee revision of 2012. We began preparing for LRC from 2011 in our institution and we performed LRC for the first timein July 2012. To date, we have performed LRC in four cases. First case : we performed LRC and left retroperitoneal nephroureterectomy for left renal pelvic cancer. Operative time was 450 minutes (LRC, 190 minutes) and estimated blood loss was 700 ml. Second case : we performed LRC for bladder cancer (BCG failure). Operative time was 390 minutes and estimated blood loss was 1000 ml. Third case : we performed LRC and lymphadenectomy for bladder cancer (cT2N0M0). Operative time was 510 minutes and estimated blood loss was 500 ml. Fourth case: we performed LRC and lymphadenectomy for bladder cancer (cT2N0M0). Operative time was 550 minutes and estimated blood loss was 335 ml. As regards problems at the time of introduction of LRC, indication, lymphadenectomy, and urinary tract diversion, etc. are discussed.

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岡山大学病院泌尿器科における初期腎移植症例の検討

和田耕一郎, 荒木元朗, 吉岡貴史, 有吉勇一, 小林泰之, 渡辺豊彦, 那須保友, 清水千聖, 赤木滋, 杉山斉, 槇野博史, 上松克利, 公文裕巳

日本透析医学会雑誌 46 ( Suppl.1 ) 627 - 627 2013.5

Dose-response analysis of testosterone replacement therapy in patients with female to male gender identity disorder

NAKAMURA Aya, WATANABE Masami, SUGIMOTO Morito, SAKO Tomoko, MAHMOOD Sabina, KAKU Haruki, NASU Yasutomo, ISHII Kazushi, NAGAI Atsushi, KUMON Hiromi

Endocrinologia Japonica 60 ( 3 ) 275 - 281 2013.3

Language：English Publishing type：Research paper (scientific journal) Publisher：The Japan Endocrine Society

Gender identity disorder (GID) is a conflict between a person's actual physical gender and the one they identify him or herself with. Testosterone is the key agent in the medical treatment of female to male GID patients. We conducted a dose-response analysis of testosterone replacement therapy (TRT) in 138 patients to determine the onset of the therapeutic effects. The TRT consisted of intramuscular injection of testosterone enanthate and patients were divided into three groups; 250 mg every two weeks, 250 mg every three weeks and 125 mg every two weeks. The onset of deepening of voice, increase in facial hair and cessation of menses was evaluated in each group. At one month after the start of TRT, the onset of these physical changes was more prevalent in the group receiving the higher dose of testosterone, and there were dose-dependent effects observed between the three treatment groups. On the other hand, at six months after the start of TRT, most of the patients had achieved treatment responses and there were no dose-dependent effects with regard to the percentage of patients with therapeutic effects. No significant side effects were observed in any of the treatment groups. We demonstrated that the early onset of the treatment effects of TRT is dose-dependent, but within six months of starting TRT, all three doses were highly effective. Current study provides useful information to determine the initial dose of TRT and to suggest possible changes that should be made in the continuous dosage for long term TRT.

DOI： 10.1507/endocrj.EJ12-0319

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Other Link： http://search.jamas.or.jp/link/ui/2014114876

当科における上部尿路BCG灌流療法の治療成績

別宮謙介, 江原伸, 平田武志, 谷本竜太, 小林泰之, 賀来春紀, 那須保友, 公文裕巳

泌尿器外科 26 ( 3 ) 334 - 335 2013.3

腹腔鏡下膀胱全摘除術における初期経験に関する報告

小林泰之, 佐々木克己, 別宮謙介, 和田耕一郎, 荒木元朗, 江原伸, 渡辺豊彦, 那須保友, 公文裕巳

日本泌尿器科学会雑誌 104 ( 2 ) 303 - 303 2013.3

Could salvage surgery after chemotherapy have clinical impact on cancer survival of patients with metastatic urothelial carcinoma? Reviewed

Kensuke Bekku, Takashi Saika, Yasuyuki Kobayashi, Ryo Kioshimoto, Taiki Kanbara, Yasutomo Nasu, Hiromi Kumon

INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 18 ( 1 ) 110 - 115 2013.2

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER JAPAN KK

The clinical impact of salvage surgery after chemotherapy on cancer survival of patients with metastatic urothelial carcinoma is controversial. We aimed to verify the clinical role of salvage surgery by analyzing the long-term outcome in patients with urothelial carcinoma treated by chemotherapy.
Between 2003 and 2010 at a single institution, 31 of 47 patients (66%) with metastatic urothelial carcinoma showed objective responses (CR in 4, PR in 27) after multiple courses of cisplatin/gemcitabine/paclitaxel-based chemotherapy, and a cohort of patients with partial response (PR) were retrospectively enrolled. Twelve (10 male and 2 female, median age 64.0 years) of 27 patients with PR underwent salvage surgeries after the chemotherapy: metastatectomy of residual lesions (10 retroperitoneal lymph nodes, 2 lung), and 6 radical surgeries for primary lesions as well. Progression-free survival and overall patient survival rates were analyzed retrospectively and compared with those of patients without salvage surgery.
All 12 patients achieved surgical CR. Pathological findings of metastatic lesions showed viable cancer cells in 3 patients. In univariate analysis, sole salvage surgery affected overall survival in 27 patients with PR to the chemotherapy (P = 0.0037). Progression-free survival and overall survival rates in patients with salvage surgery were better than those in 15 PR patients without the surgery (39.8 vs. 0%, and 71.6 vs. 12.1% at 3 years, P = 0.01032 and 0.01048; log-rank test).
Salvage surgery for patients with residual tumor who achieve partial response to chemotherapy could have a possible impact on cancer survival.

DOI： 10.1007/s10147-011-0350-z

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Cancer stem cell-like characteristics of a CD133+ subpopulation in the J82 human bladder cancer cell line. Reviewed

Peng Huang, Masami Watanabe, Haruki Kaku, Hideo Ueki, Hirofumi Noguchi, Morito Sugimoto, Takeshi Hirata, Hiroshi Yamada, Kohji Takei, Shaobo Zheng, Kai Xu, Yasutomo Nasu, Yasuyuki Fujii, Chunxiao Liu, Hiromi Kumon

Molecular and Clinical Oncology 180 - 184 2013.1

岡山大学泌尿器科における腎移植症例の検討

有吉勇一, 荒木元朗, 吉岡貴史, 和田耕一郎, 小林泰之, 江原伸, 渡辺豊彦, 那須保友, 公文裕巳, 清水千聖, 赤木滋, 杉山斉, 槇野博史, 齋藤和英, 高橋公太

移植 47 ( 6 ) 489 - 489 2012.12

DIRECT THERAPEUTIC EFFECT OF REIC/DKK-3-ENCODING ADENOVIRAL VECTOR FOR NON-SMALL CELL LUNG CANCER Reviewed

Yamamoto Hiromasa, Tanaka Norimitsu, Toyooka Shinichi, Watanabe Masami, Sakaguchi Masakiyo, Soh Junichi, Shien Kazuhiko, Furukawa Masashi, Asano Hiroaki, Tsukuda Kazunori, Nasu Yasutomo, Huh Nam-ho, Kumon Hiromi, Miyoshi Shinichirou

JOURNAL OF THORACIC ONCOLOGY 7 ( 11 ) S463 2012.11

Preclinical biodistribution and safety study of reduced expression in immortalized cells/Dickkopf-3-encoding adenoviral vector for prostate cancer gene therapy Reviewed

Morito Sugimoto, Masami Watanabe, Haruki Kaku, Shun-Ai Li, Hirofumi Noguchi, Hideo Ueki, Masakiyo Sakaguchi, Nam-Ho Huh, Yasutomo Nasu, Hiromi Kumon

ONCOLOGY REPORTS 28 ( 5 ) 1645 - 1652 2012.11

Language：English Publishing type：Research paper (scientific journal) Publisher：SPANDIDOS PUBL LTD

The biodistribution and safety of adenoviral vectors encoding the human REIC/Dkk-3 tumor suppressor gene (Ad-REIC) were examined in this preclinical study for in situ prostate cancer gene therapy. First, the in vitro apoptotic effects of Ad-REIC in normal and cancer cells derived from the prostate and liver were examined. Significant apoptotic effects were observed at 100 MOI (multiplicity of infection) in prostate cancer cells (LNCaP, PC3) and hepatoma cells (HEP3B and HEPG2); however, no effects were seen in normal cells. To analyze the safety of intraprostatic Ad-REIC administration, the biodistribution and histology after Ad-REIC injection were evaluated in various organs of normal male C57BL6 mice. In a supporting study, vector dissemination following intravenous injection of Ad-REIC into tail veins was determined. To evaluate whether Ad-REIC was present in the collected tissue specimens, human REIC gene detection was performed using DNA-PCR. Intraprostatic treatment administered at lower doses showed vector biodistribution into the colon, urinary bladder and prostate. At higher doses, vector dissemination was observed in tissues more distant from the prostate, including the lung, thymus, heart, liver and adrenal gland. After intravenous injection a: Ad-REIC, dissemination was observed in the liver and spleen. These results indicate that the biodistribution of Ad-REIC is determined by the dose and route of administration. Although acute inflammatory effects were observed in the prostate after intraprostatic administration at higher doses, no abnormal histological findings were noted in the other tissues, including those of intravenously treated mice. Regarding the safety of Ad-REIC administration, no deaths and no signs of toxicity or unusual behavior were observed in the mice in any treatment group. Based on these preclinical experiments, adenovirus-mediated in situ REIC/Dkk-3 gene therapy is considered to be safe for use as a treatment for human prostate cancer.

DOI： 10.3892/or.2012.2001

和田耕一郎, 谷本竜太, 小林泰之, 佐々木克己, 荒木元朗, 江原伸, 上原慎也, 渡辺豊彦, 那須保友, 公文裕巳

Japanese Journal of Endourology 25 ( 3 ) 280 - 280 2012.11

岡山大学病院におけるロボット補助下前立腺全摘術の初期経験

平田武志, 小林泰之, 荒木元朗, 江原伸, 上原慎也, 渡邊豊彦, 雑賀隆史, 那須保友, 公文裕巳

Japanese Journal of Endourology 25 ( 3 ) 242 - 242 2012.11

Laparoscopic management of complicated urachal remnants in adults Reviewed

Motoo Araki, Takashi Saika, Daiji Araki, Yasuyuki Kobayashi, Shinya Uehara, Toyohiko Watanabe, Kiyoshi Yamada, Yasutomo Nasu, Hiromi Kumon

WORLD JOURNAL OF UROLOGY 30 ( 5 ) 647 - 650 2012.10

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

Objectives The traditional surgical approach for removing a urachal remnant is via a large transverse or midline infraumbilical incision. We review our experience with laparoscopic urachal cyst excision and report the efficacy and outcomes of this approach as a less morbid, minimally invasive alternative.
Methods Between August 2005 and March 2009, eight patients with a mean age of 26 years who had symptomatic urachal cysts underwent laparoscopic radical excision of the urachal remnant. Using three ports, the urachal remnant was dissected from the umbilicus to the bladder dome and then removed intact via the umbilicus. Umbilicoplasty was performed by a plastic surgeon. We retrospectively reviewed the perioperative records to assess morbidity and outcomes.
Results All eight operations were completed successfully. No intraoperative or postoperative complications were reported at a mean follow-up of 3.2 years. Mean operative time was 147.5 min including umbilicoplasty. Pathological evaluation confirmed a benign urachal remnant in each case. There have been no recurrences of symptoms nor postoperative complications during follow-up. Mean time to full recovery, defined as return to normal life without pain, was 16 days. The patients with bladder cuff resection had a delayed full convalescence (25 vs. 13 days) due to a minimum degree of dysuria.
Conclusion A laparoscopic approach with the removal of urachal remnants via the umbilicus appears to be a safe and effective alternative with better cosmesis when compared to an open approach.

DOI： 10.1007/s00345-012-0829-x

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救済化学療法後にhCG plateauとなった精巣腫瘍の3例の検討

小林泰之, 別宮謙介, 谷本竜太, 江原伸, 那須保友, 公文裕巳

西日本泌尿器科 74 ( 増刊 ) 137 - 137 2012.10

虫垂炎術前CTにて偶発的に発見されたXp11.2転座型腎癌、多発転移の1例

高村剛輔, 小林泰之, 弓狩一晃, 神原太樹, 和田耕一郎, 杉本盛人, 江原伸, 那須保友, 公文裕巳, 柳井広之

西日本泌尿器科 74 ( 増刊 ) 167 - 167 2012.10

生体腎移植後に血中アスペルギルス抗原陽性となった2症例

有吉勇一, 荒木元朗, 吉岡貴史, 清水千聖, 和田耕一郎, 小林泰之, 江原伸, 渡辺豊彦, 那須保友, 公文裕巳

移植 47 ( 総会臨時 ) 346 - 346 2012.9

岡山大学泌尿器科における腎移植症例の検討

吉岡貴史, 荒木元朗, 和田耕一郎, 有吉勇一, 清水千聖, 小林泰之, 佐々木克己, 江原伸, 渡邉豊彦, 那須保友, 公文裕巳

移植 47 ( 総会臨時 ) 328 - 328 2012.9

REIC/Dkk-3-encoding adenoviral vector as a potentially effective therapeutic agent for bladder cancer Reviewed

Takeshi Hirata, Masami Watanabe, Haruki Kaku, Yasuyuki Kobayashi, Hiroshi Yamada, Masakiyo Sakaguchi, Kohji Takei, Nam-Ho Huh, Yasutomo Nasu, Hiromi Kumon

INTERNATIONAL JOURNAL OF ONCOLOGY 41 ( 2 ) 559 - 564 2012.8

Language：English Publishing type：Research paper (scientific journal) Publisher：SPANDIDOS PUBL LTD

Bladder cancer is one of the most common urogenital malignancies. The intravesical instillation of anticancer agents is an attractive strategy to treat a superficial lesion or floating/disseminated cancer cells after transurethral operation. An adenovirus carrying REIC/Dkk-3, a tumor suppressor gene (Ad-REIC), exhibits cancer-specific apoptotic effects in various types of cancer cells. The aim of the present study was to examine the potential of Ad-REIC as a therapeutic agent for bladder cancer. KK47 and RT4 human bladder cancer cells were sensitive to the Ad-REIC treatment for apoptosis induction, but some human bladder cancer cell lines (T24, J82 and TccSup) were resistant. Significant cell growth inhibition was observed when these resistant cancer cell lines were treated with Ad-REIC in a condition of floating cells, which is clinically observed after transurethral operation and becomes a cause of intravesical cancer dissemination. The therapeutic potential of Ad-REIC for the treatment of multidrug-resistant bladder cancer was investigated. The adriamycin-resistant KK47 bladder cancer cells (KK47/ADM), which also present multidrug resistance, showed induction of significant apoptosis following Ad-REIC treatment. The Ad-REIC treatment induced downregulation of P-glycoprotein in KK47/ADM cells and restored the sensitivity to doxorubicin (adriamycin). Ad-REIC suppressed P-glycoprotein expression in a c-Jun-NH2-kinase (JNK)-dependent manner. Therefore, the current study indicated two therapeutic aspects of the Ad-REIC agent against human bladder cancer cells, as an apoptosis inducer/cell growth inhibitor and as a sensitizer of chemotherapeutic agents in multidrug-resistant cancer cells. The intravesical instillation of Ad-REIC could be an attractive therapeutic method in human bladder cancer where the treatment of superficial lesions and floating/disseminated or multidrug-resistant cancer cells is necessary.

DOI： 10.3892/ijo.2012.1503

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Clear cell sarcoma of the kidney with inferior vena cava tumor thrombus in a child: A case report

Akihiro Mori, Kensuke Bekku, Katsumi Sasaki, Ryo Kishimoto, Kazushi Ishii, Shinya Uehara, Toyohiko Watanabe, Yasutomo Nasu, Hiromi Kumon, Yoshiko Miyamura, Hiroyuki Yanai

Nishinihon Journal of Urology 74 ( 8 ) 449 - 453 2012.8

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

Clear cell carcinoma of the kidney is a rare renal tumor accounting for about 4% of childhood malignant renal neoplasms, and inferior vena cava thrombus is extremely rare. In this report, we present a case of clear cell sarcoma of the kidney with inferior vena cava tumor thrombus in a child, this being the second report of clear cell carcinoma of the kidney with tumor thrombus in Japan. The patient was a 16-month-old girl, who was admitted to our hospital for investigation of a right renal tumor with inferior vena cava thrombus. At first, we performed tumor needle biopsy and made a diagnosis of clear cell sarcoma of the kidney. According to the protocol issued by National Wilms Tumor Study-5, chemotherapy comprising vincristine, doxorubicin, cyclophosphamide and etoposide was started. After 2 cycles of the chemotherapy, radical nephrectomy, thrombectomy and segmental hepatectomy were performed and complete resection was possible. Following radiotherapy to the renal bed and adjuvant chemotherapy with ifosfamide, carboplatin, and etoposide, no clinical evidence of recurrence or metastasis has been noted during the subsequent period of about 1 year.

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A novel gene expression system for detecting viable bladder cancer cells Reviewed

Hideo Ueki, Masami Watanabe, Haruki Kaku, Peng Huang, Shun-Ai Li, Kazuhiko Ochiai, Takeshi Hirata, Hirofumi Noguchi, Hiroshi Yamada, Kohji Takei, Yasutomo Nasu, Yuji Kashiwakura, Hiromi Kumon

INTERNATIONAL JOURNAL OF ONCOLOGY 41 ( 1 ) 135 - 140 2012.7

Language：English Publishing type：Research paper (scientific journal) Publisher：SPANDIDOS PUBL LTD

A novel transcriptional system was developed that can robustly enhance cancer-specific gene expression. In the system, hTERT promoter-driven gene expression was enhanced by an advanced two-step transcriptional amplification (TSTA). This construct was used to develop a novel system for detection of bladder cancer cells. The current study evaluated the advanced TSTA system by examining the cancer-specific gene transcription in various bladder cancer cell lines. The system significantly enhanced cancer-specific luciferase gene expression in the bladder cancer cell lines in comparison to the previous expression system of one-step or conventional TSTA. The fold gain of the enhancement was significantly correlated to the telomerase activity of the cell lines. A green fluorescent protein (GFP) gene encoding plasmid vector was constructed where hTERT promoter-driving transcription is enhanced by the advanced TSTA to utilize the system for the imaging and detection of viable bladder cancer cells. The advanced TSTA-hTERT-GFP plasmid successfully induced cancer-specific gene expression, showing robust GFP expression in human bladder cancer cell lines, but no visible GFP expression in normal bladder urothelial cells. The control GFP plasm id with a CMV promoter yielded GFP expression in both normal bladder cells and cancer cells. The advanced TSTA-hTERT-GFP plasmid allowed selective visualization of viable human bladder cancer cells in mixed cell culture containing 10- and 100-fold more normal bladder urothelial cells. These findings indicate that the advanced TSTA-hTERT expressional system is a valuable tool for detecting viable bladder cancer cells. The current system can be applied for in vitro detection of bladder cancer cells in urine and other types of cancer cells disseminated in vivo.

DOI： 10.3892/ijo.2012.1417

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Papers - NASU Yasutomo