Faculty Profiles - NASU Yasutomo

Papers - NASU Yasutomo

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腎細胞癌の臨床的検討

白崎義範, 那須保友, 津島知靖, 公文裕巳

日本泌尿器科学会雑誌 94 ( 2 ) 305 - 305 2003

前立腺癌と良性疾患の鑑別に最も有効な前立腺関連マーカーの組み合わせに関する研究

津島知靖, 那須保友, 雑賀隆史, 新良治, 石戸則孝, 高本均, 山田大介, 陶山文三, 原雅弘, 赤澤信幸, 小武家誠, 宮地禎幸, 公文裕巳

日本泌尿器科学会雑誌 94 ( 2 ) 318 - 318 2003

Clinical study of G3 superficial bladder cancer without concomitant CIS treated with conservative therapy Reviewed

T Saika, T Tsushima, Y Nasu, R Arata, H Kaku, N Kusaka, H Kumon

JAPANESE JOURNAL OF CLINICAL ONCOLOGY 32 ( 11 ) 461 - 465 2002.11

Language：English Publishing type：Research paper (scientific journal) Publisher：OXFORD UNIV PRESS

Objective: The treatment for superficial G3 transitional cell carcinoma (TCC) of the urinary bladder remains controversial. It is important to reveal the clinical features of superficial G3 bladder cancer that can be treated conservatively.
Patients and Methods: A total of 39 patients with primary superficial bladder cancer (Ta, T1) with G3 components but without concomitant carcinoma in situ (CIS), who had been treated initially with transurethral resection (TUR), were retrospectively analyzed for factors related to tumor recurrence, progression and survival. The patients were 34 males and five females who,se age ranged from 49 to 85 years (average, 68 years). Initial tumor stages were Ta in one patient and T1 in 38. Initial treatments were TUR alone in 18 patients and TUR with adjuvant therapy (intravesical chemotherapy or BCG therapy) in 21. Factors examined included age, gender, morphology, size and number of tumors and adjuvant therapies.
Results: Follow-up periods were 3-138 months (median, 37 months). Tumor recurrence, progression and cancer death were observed in 23, seven and four cases, respectively. The 5-year progression-free rate (75%) and survival rate (83%) in 39 patients with G3 did not show a statistically significant difference from those of the 109 patients with G1 or the 187 patients with G2-superficial bladder cancer who were treated with TUR initially. Only the rate of recurrence of patients with G3 was significantly higher than that of patients with G2 or G1. Adjuvant therapies reduced the recurrence rate of the patients with G3. Only tumor morphology, papillary or non-papillary, affected both the progression-free rate and the survival rate of patients with G3. There were no statistically significant differences associated with other factors.
Conclusion: The results suggest that superficial G3 bladder cancer could be treated with TUR initially, especially for papillary tumors.

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前立腺全摘術後のPSA failureの定義とその妥当性について-超高感度測定法にて3ポイント連続上昇と定義した場合

妹尾孝司, 雑賀隆史, 那須保友, 津島知靖, 公文裕巳, 三宅知子, 宮地禎幸, 石戸則孝, 高本均, 小林泰之, 武田克治, 枝村康平, 林俊秀

西日本泌尿器科 64 ( 増刊 ) 179 - 179 2002.11

転移巣切除を行った腎細胞癌骨転移の2例

中田哲也, 倉繁拓志, 日下信行, 白崎義範, 賀来春紀, 新良治, 那須保友, 津島知靖, 公文裕巳, 中田英二, 上野孝展, 杉原進介, 原田良昭, 井上一

骨転移: 病態・診断・治療 17 ( 1 ) 23 - 30 2002.9

Language：Japanese Publisher：岡山骨転移カンファレンス事務局

症例1:67歳男.背部痛を主訴とした.右腎腫瘍の診断で,根治的右腎摘出術及び下大静脈人工血管置換術施行の既往があった.背部痛と両下半身の痺れが徐々に増悪し,第9腰椎に対しCTガイド下骨生検を施行した結果,腎細胞癌の胸椎転移と診断した.放射線療法施行後に第9胸椎全摘椎体置換術,第6-12胸椎後方固定術を行い,症状の改善をみた.症例2:49歳男.右大腿部痛,食欲不振を主訴とした.CT及びMRIより腎細胞癌の骨,肺転移巣と診断し,左腎摘術を施行した.肺転移巣は腎摘後,IFN-α投与開始早期に消失した.右大腿骨頭転移巣に対し放射線治療と右大腿骨腫瘍広範切除術を施行し,第6肋骨転移巣に対しては肋骨切除術を施行した.いずれも癌細胞を認めなかった.以上より,腎細胞癌骨転移症例における転移巣への治療法は姑息的治療が中心となっているが,症例を選択すれば転移巣切除術も有効な治療法となり得ると考えられた

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Prostate specific antigen complexed to alpha-1-antichymotrypsin in patients with intermediate prostate specific antigen levels Reviewed

T Saika, T Tsushima, Y Nasu, N Kusaka, Y Miyaji, H Takamoto, K Takeda, S Uno, H Kumon

CANCER 94 ( 6 ) 1685 - 1691 2002.3

Language：English Publishing type：Research paper (scientific journal) Publisher：JOHN WILEY & SONS INC

BACKGROUND. The authors attempted to evaluate prospectively the usefulness of serum prostate specific antigen (PSA) complexed to alpha-1-antichymotrypsin (PSA-ACT) in the early detection of prostate carcinoma and its ability to discriminate between prostate carcinoma and benign prostatic hyperplasia (BPH), especially among patients with intermediate PSA levels.
METHODS. Between December 1999 and August 2000, systematic sextant biopsies were performed on 281 prospective patients with prostate carcinoma who had serum PSA levels between 4.1 ng/mL and 20.0 ng/mL. The serum samples were assayed by using kits that were designed specifically for measuring serum PSA, PSA-ACT, and free PSA levels. The clinical values of PSA, PSA-ACT, the free PSA to total PSA ratio (F/T ratio), the free PSA to PSA-ACT ratio, PSA density (PSAD), and PSA-ACT density (ACTD) were compared by using receiver operating characteristic (ROC) curve analysis.
RESULTS. Biopsy yielded no evidence of malignancy in 198 patients, and prostate carcinoma was confirmed in 83 patients. ROC analysis demonstrated that the area under the curve (AUC) for PSA-ACT was greater than that for total PSA and was equivalent to that for the F/T ratio in both groups of patients (PSA ranges of 4.1-20.0 ng/mL and 4.1-10.0 ng/mL, respectively). The AUC for the ACTD was greater than the AUC for the PSAD and had the highest value of all parameters.
CONCLUSIONS. The measurement of PSA-ACT represents an alternative to the use of total and free PSA. The ACTD value is the most useful for discriminating between BPH and prostate carcinoma. (C) 2002 American Cancer Society

DOI： 10.1002/cncr.10377

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Laparoscopic radical prostatectomy: initial cases at Okayama University Hospital.

Nagai Atsushi, Nasu Yasutomo, Shirasaki Yoshinori, Iguchi Hiroki, Arata Ryouji, Tsugawa Masaya, Tsushima Tomoyasu, Kumon Hiromi

Acta Medica Okayama 56 ( 1 ) 51 - 52 2002

Validation of transrectal ultrasonographic volumetry for orthotopic prostate tumours in mice

Kraaji R, van Weerden W.M, de Ridder C.M, Gussenhoven E.J, Honkoop J, Nasu Y, Bangma C.H

Lab Anim 36 ( 2 ) 165 - 172 2002

Gene therapy for prostate cancer: toxicological profile of four HSV-tk transducing adenoviral vectors regulated by different promoters Reviewed

S Ebara, S Shimura, Y Nasu, H Kaku, H Kumon, G Yang, J Wang, TL Timme, E Aguilar-Cordova, TC Thompson

PROSTATE CANCER AND PROSTATIC DISEASES 5 ( 4 ) 316 - 325 2002

Language：English Publishing type：Research paper (scientific journal) Publisher：NATURE PUBLISHING GROUP

Adenoviral vector delivery of the Herpes simplex virus thymidine kinase (HSV-tk) gene in combination with the prodrug ganciclovir (GCV) has been tested in phase I clinical trials for prostate cancer and found to exhibit a satisfactory toxicity profile. We have developed additional adenoviral vectors with differing promoters to optimize the expression profile and in the present study evaluate the potential systemic toxicity of these vectors. Four recombinant adenoviral vectors that express the HSV-tk gene were generated using three different promoters: CMV (leftward orientation); RSV (both rightward and leftward orientation); and the mouse caveolin-1 (cav-1) promoter (leftward orientation). Efficacy was determined in vitro by cytotoxicity assays in a mouse prostate cancer cell line, RM-9, and in vivo by treating orthotopic tumors. Potential toxicity was evaluated from liver histology and apoptotic cell counts and enzyme levels in the serum following intravenous adenoviral vector injection. Although there were differences in HSV-tk expression at the protein level among the four vectors there were no significant differences in in-vitro cytotoxicity studies with GCV or in vivo in tumor growth suppression of an orthotopic mouse prostate cancer model in GCV treated mice. Intravenous delivery of high doses of all adenoviral vectors lead to abnormalities in liver function as measured by specific serum markers and histological evaluation of liver tissue and increased levels of apoptosis in the liver. These abnormalities were most prevalent with the vector containing the CMV promoter and the rightward oriented RSV promoter. They were least prevalent in the vector regulated by the cav-1 promoter. Upregulation of specific chemokines, MIP-2 and MIP-1beta was correlated with apoptotic counts. Our results demonstrate that comprehensive toxicological analysis of adenoviral vectors provides internally consistent information that can differentiate vectors with comparable efficacy based on toxicity. In these studies vectors with the cav-1 promoter-driven and leftward RSV-driven HSV-tk gene demonstrated minimal toxicities with cytotoxic effectiveness comparable to more toxic vectors. Our studies further suggest that promoter selection can influence the toxic effects of an adenoviral gene therapy vector.

DOI： 10.1038/sj.pcan.4500610

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表在性膀胱癌に対するエピルビシン(EPI)術後補助膀注療法

津島知靖, 雑賀隆史, 新良治, 賀来春紀, 那須保友, 公文裕巳, 朝日俊彦, 武田克治, 荒巻謙二, 三枝道尚, 大和豊子, 宮地禎幸, 小武家誠

日本泌尿器科学会雑誌 93 ( 2 ) 177 - 177 2002

進行性前立腺癌におけるNY-ESO-1の発現と免疫原性の検討

中田哲也, 倉繁拓志, 雑賀隆史, 野口雄司, 小野俊朗, 那須保友, 津島知靖, 中山容一, 公文裕巳, 宮地禎幸, 村上貴典, 牧佳男

日本泌尿器科学会雑誌 93 ( 2 ) 331 - 331 2002

前立腺癌に対する自殺遺伝子治療臨床研究について

那須保友, 公文裕巳, Thompson Timothy C.

日本泌尿器科学会雑誌 93 ( 2 ) 99 - 99 2002

腎細胞癌における新しい癌抑制遺伝子(REIC gene)の発現について

黒瀬恭平, 江原伸, 賀来春紀, 狩山玲子, 荒尾雄二郎, 那須保友, 津島知靖, 公文裕巳

日本泌尿器科学会雑誌 93 ( 2 ) 261 - 261 2002

膀胱全摘除術後患者の経時的QOL変化

新良治, 津島知靖, 小武家誠, 宮地禎幸, 高松正武, 大枝忠史, 石井和史, 大和豊子, 石井亜矢乃, 国富公人, 高本均, 那須保友, 公文裕巳

日本泌尿器科学会雑誌 93 ( 2 ) 307 - 307 2002

Orthotopic neobladder reconstruction in elderly bladder cancer patients Reviewed

T Saika, B Suyama, T Murata, D Manabe, T Kurashige, Y Nasu, T Tsushima, H Kumon

INTERNATIONAL JOURNAL OF UROLOGY 8 ( 10 ) 533 - 538 2001.10

Language：English Publishing type：Research paper (scientific journal) Publisher：BLACKWELL SCIENCE ASIA

Background: We compared the clinical results of orthotopic neobladder reconstruction in elderly patients and those in younger patients retrospectively in order to verify whether age is a critical factor in selecting a method of urinary diversion.
Methods: Following radical cystectomy for bladder cancer, 12 patients aged 75 or older and 17 patients under 75 who underwent orthotopic neobladder reconstruction between January 1992 and May 1999 were investigated in this study. The authors TS and BS were among the surgeons who performed operations for all cases. Of the 12 elderly patients, orthotopic neobladders were constructed according to Hautmann's method in nine cases, Studer's method in one case and Reddy's method in two cases. Of the 17 younger patients, these methods were employed in 12, one and four cases, respectively. Operative procedure, early and late complications, prognosis, continence and voiding pattern were investigated in these patients.
Results: The follow-up periods for elderly and younger groups ranged from 21.3 to 82.7 months and from 8.8 to 94.2 months, respectively. No difference in operation time, amount of bleeding or postoperative length of hospitalization was observed between elderly and younger patients. The rates of early complications in elderly and younger patients were 41.7% and 35.3%, respectively. Late complication rates were 33.3% and 47.1%, respectively The difference in these complication rates was not statistically significant. One of the elderly and two of the younger patients had local recurrence and metastasis postoperatively. Those three patients had died of their bladder cancer. No statistically significant difference between groups was recognized in either cause-specific survival or overall survival, nor was there such a difference in relation to micturition/continence.
Conclusion: Based on these results, we believe that because age is not a critical factor in the selection of urinary diversion method, neobladder reconstruction following cystectomy for bladder cancer is indicated in elderly patients. As stoma management is difficult for the patients, we consider orthotopic neobladder reconstruction to be the method of choice if the patients' general physical condition allows.

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Retro peritoneoscopic pyelotomy combined with the transposition of crossing vessels for ureteropelvic junction obstruction

NAGAI A

J Urol 165 23 - 26 2001

Optimal starting time for flutamide to prevent disease flare in prostate cancer patients treated with a gonadotropin-releasing hormone agonist Reviewed

T Tsushima, Y Nasu, T Saika, Y Maki, M Noda, B Suyama, T Yamato, H Kumon

UROLOGIA INTERNATIONALIS 66 ( 3 ) 135 - 139 2001

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

Objective: Flare-up phenomena, such as an increase in prostate-specific antigen (PSA) and/or deterioration of symptoms, are observed in some patients undergoing gonadotropin-releasing hormone (GnRH) agonist therapy. This study was carried out to determine the optimal time for starting the administration of flutamide to prevent flare-up phenomena. Patients and Methods: Twenty-six patients with prostate cancer and elevated serum levels of PSA were randomly assigned to 5 groups. Group A patients (n = 6) were treated with a subcutaneous injection of 3.75 mg leuprorelin acetate depot alone. Group B, C, D and E patients (5 patients in each group) were treated with 375 mg/day of orally administered flutamide combined with leuprorelin. Flutamide was initiated on the day of leuprorelin injection in group B, and at 1, 2 and 4 weeks before leuprorelin injection in groups C, D and E, respectively. Serum PSA and testosterone levels were measured in each patient. Results: Pretreatment with flutamide increased the serum testosterone level, but the testosterone surge after leuprorelin administration was almost the same in all 5 treatment groups. In patients who had been treated with flutamide in combination with leuprorelin, the mean PSA level did not exceed the pretreatment levels after leuprorelin administration. The rate of decrease in PSA in the group receiving simultaneous administration of flutamide with leuprorelin showed a decline comparable to that during the period before leuprorelin administration in the flutamide pretreatment groups. Conclusion: Simultaneous administration of flutamide with a GnRH agonist is sufficient to prevent flare-up phenomena. Copyright (C) 2001 S. Karger AG, Basel.

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Treatment of androgen-independent prostate cancer with dexamethasone: A prospective study in stage D2 patients Reviewed

T Saika, N Kusaka, T Tsushima, T Yamato, T Ohashi, B Suyama, R Arata, Y Nasu, H Kumon

INTERNATIONAL JOURNAL OF UROLOGY 8 ( 6 ) 290 - 294 2001

Language：English Publishing type：Research paper (scientific journal) Publisher：BLACKWELL SCIENCE ASIA

Purpose: In order to evaluate the efficacy of dexamethasone in the treatment of Japanese men with androgen-independent prostate cancer, a prospective study was conducted using prostate-specific antigen (PSA) as a primary end-point.
Methods: Nineteen Japanese men with stage D2 androgen-independent prostate cancer were registered and treatment was started. After ruling out anti-androgen withdrawal syndrome, they were treated with dexamethasone (1.5 mg daily). Patients were monitored for PSA, symptoms, radiologic response, survival rate, time to disease progression, time to treatment failure and complications.
Results: Prostate-specific antigen levels decreased in nine patients (50.0%); five (27.8%) showed a 50% or greater decrease and two (11.1%) showed an 80% or greater decrease. For the nine patients, the mean duration of PSA response was 7.3 months and the median duration was 2.1 months (range, 1.2-27.5+). Bone pain, which was noted in 13 patients at study entry, improved in seven patients (53.8%). Of nine patients who had serial radiographic examinations with bone scan, three (33%) showed partial response, two (22%) were stable and four (44%) showed disease progression. Treatment was well tolerated, except for one patient who suffered a severe pulmonary infection.
Conclusion: Dexamethasone decreased PSA levels and produced subjective symptomatic improvement in the patients with stage D2 androgen-independent prostate cancer.

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Total PSA 4.0〜20.0ng/ml症例におけるPSA α1-antichymotrypsin complex(PSA-ACT)の有用性

津島知靖, 那須保友, 永井敦, 門田晃一, 雑賀隆史, 新良治, 賀来春紀, 白崎義範, 公文裕巳, 宮地禎幸, 高本均, 武田克治, 宇埜智

日本泌尿器科学会雑誌 92 ( 2 ) 275 - 275 2001

移行上皮癌におけるCancer/Testis抗原NY-ESO-1の発現と免疫応答

倉繁拓志, 雑賀隆史, 中田哲也, 野口雄司, 小野俊朗, 日下信行, 白崎義範, 賀来春紀, 新良治, 那須保友, 津島知靖, 中山睿一, 公文裕巳

日本泌尿器科学会雑誌 92 ( 2 ) 347 - 347 2001

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