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Akito Terai

Publications and source records attributed to Akito Terai.

At least 55 records · Page 3Linked to original sources
PubMed2004

Identification by proteomic analysis of calreticulin as a marker for bladder cancer and evaluation of the diagnostic accuracy of its detection in urine.

BACKGROUND: New methods for detection of bladder cancer are needed because cystoscopy is both invasive and expensive and urine cytology has low sensitivity. We screened proteins as tumor markers for bladder cancer by proteomic analysis of cancerous and healthy tissues and investigated the diagnostic accuracy of one such marker in urine. METHODS: Three specimens of bladder cancer and healthy urothelium, respectively, were used for proteome differential display using narrow-pH-range two-dimensional electrophoresis. To evaluate the presence of calreticulin (CRT) as detected by Western blotting, we obtained 22 cancerous and 10 noncancerous surgical specimens from transurethral resection or radical cystectomy. To evaluate urinary CRT, we collected 70 and 181 urine samples from patients with and without bladder cancer, respectively. Anti-CRT COOH-terminus antibody was used to detect CRT in tissue and urine. RESULTS: Proteomic analysis revealed increased CRT (55 kDa; pI 4.3) in cancer tissue. Quantitative Western blot analysis showed that CRT was increased in cancer tissue (P = 0.0003). Urinary CRT had a sensitivity of 73% (95% confidence interval, 62-83%) at a specificity of 86% (80-91%) for bladder cancer in the samples tested. CONCLUSIONS: Proteomic analysis is useful in searching for candidate proteins as biomarkers and led to the identification of urinary CRT. The diagnostic accuracy of urinary CRT for bladder cancer appears comparable to that of Food and Drug Administration-cleared urinary markers, but further studies are needed to determine its diagnostic role.

Aged↗
PubMed2004

Laparoscopic partial nephrectomy using microwave tissue coagulator for small renal tumors: usefulness and complications.

OBJECTIVES: We evaluated the usefulness and complications of laparoscopic partial nephrectomy for small renal tumors using a microwave tissue coagulator without renal pedicle clamping. METHODS: Between September 1999 and March 2003, 19 patients with small renal tumors 11 to 45 mm in diameter underwent laparoscopic partial nephrectomy without renal ischemia. RESULTS: Six and 13 patients were treated by the transperitoneal and retroperitoneal approaches, respectively. Excluding a case with open conversion due to dense perirenal adhesions, 18 patients successfully underwent laparoscopic procedures. The mean operative time was 240 minutes with minimal blood loss in 14 patients and 100 to 400 ml in 4. In a patient, frozen sections revealed a positive surgical margin and additional resection was performed. Postoperative complications included extended urine leakage for 14 days, arteriovenous fistula and almost total loss of renal function, respectively, in a patient. With the median follow-up of 19 months, no patients showed local recurrence or distant metastasis by CT scan. CONCLUSIONS: Laparoscopic non-ischemic partial nephrectomy using a microwave tissue coagulator may be useful for treating small renal tumors because it does not require advanced laparoscopic skill. However, the indication of this procedure should be highly selective in order to minimize serious complications secondary to unexpected collateral damage to surrounding structures.

Adult↗
PubMed2004

High incidence of inguinal hernia after radical retropubic prostatectomy.

OBJECTIVES: To assess the incidence of, and risk factors for, inguinal hernia after retropubic radical prostatectomy compared with after pelvic lymph node dissection and total cystectomy. METHODS: A total of 155 radical prostatectomies, 35 pelvic lymph node dissections, and 56 total cystectomies were included in this study. We reviewed the charts retrospectively and evaluated the incidence of, and risk factors for, inguinal hernia after surgery using Kaplan-Meier plots and a Cox proportional hazard model. RESULTS: Of 155 patients in the radical prostatectomy group, 35 patients in the pelvic lymph node dissection group, and 56 patients in the cystectomy group, 33 (21.3%), 4 (11.4%), and 3 (5.4%), respectively, developed inguinal hernias during follow-up. In the radical prostatectomy group, 27 (81.8%) of the 33 patients developed inguinal hernia within 2 years postoperatively. Multivariate Cox proportional hazard analysis revealed that prostatectomy group, past history of inguinal hernia, and body mass index of less than 23 were significant risk factors for postoperative inguinal hernia. CONCLUSIONS: The incidence of inguinal hernia after radical prostatectomy is not low. Urologists should realize that inguinal hernia is one of the major complications of radical prostatectomy and examine the groin preoperatively and postoperatively.

Aged↗
PubMed2004

Comparative analysis of lower urinary tract symptoms and bother in both sexes.

OBJECTIVES: To compare the prevalence and severity of lower urinary tract symptoms (LUTS) in Japanese men and women and to analyze the impact on bother in an age-stratified manner. METHODS: A consecutive series of 2328 men (mean age 49.5 years) and 1735 women (mean age 48.3 years) who underwent multiphasic health screening at our institution completed the self-administered International Prostate Symptom Score (IPSS) questionnaire with quality-of-life (QOL) assessment. RESULTS: A significant age-related increase in the IPSSs and QOL scores was observed in both sexes. Age-stratified analysis showed that the total IPSS, voiding symptoms, and QOL score were significantly greater in men than in women, and the storage symptoms were not significantly different between both sexes. The percentage with moderate to severe symptoms (IPSS 8 or greater) among those younger than 40, 40 to 49, 50 to 59, 60 to 69, and 70 years old or older was 7.9%, 12.0%, 23.7%, 32.0%, and 48.7%, respectively, in men and 6.5%, 8.3%, 12.1%, 13.8%, and 31.8%, respectively, in women. Within each category of the severity of IPSS, the distribution of the QOL score was very similar in both sexes, showing no sex difference in the impact of LUTS on bother. CONCLUSIONS: These data showed a similar age-related development of LUTS in both sexes, except that voiding symptoms were more prevalent among men. The impact of LUTS on bother was also comparable between men and women.

Adult↗
PubMed2004

Retroperitoneoscopic ureterocalicostomy for congenital proximal ureteral stenosis.

We report the first case of retroperitoneoscopic ureterocalicostomy in a 17-year-old male patient with severe left hydronephrosis caused by a long congenital upper ureteral stenosis. With a retroperitoneoscopic approach, the stenotic segment was resected, the thin renal parenchyma overlying the lower calyx was fenestrated by a modest excision, and the proximal ureter was anastomosed to the lower pole in an end-to-end manner. At 2 years postoperatively, the patient was asymptomatic, with a significant reduction in hydronephrosis and a patent upper ureter. Retroperitoneoscopic ureterocalicostomy is technically feasible and can provide long-term successful reconstruction of a complicated ureteropelvic junction obstruction.

Adolescent↗
PubMed2004

Association of lower urinary tract symptoms with erectile dysfunction in Japanese men.

OBJECTIVES: To assess the age-stratified prevalence of erectile dysfunction (ED) and how lower urinary tract symptoms (LUTS) are associated with ED, and to estimate the correlates of ED among Japanese men. METHODS: A self-administered questionnaire of the International Prostate Symptom Score and the abridged 5-item version of the International Index of Erectile Function were given to 3189 noninstitutionalized men during a multiphasic health screening. The data from 2084 men who provided complete responses to the questionnaire were analyzed. RESULTS: The prevalence of moderate to severe ED increased from 13.4% among those younger than 40 years to 20.6%, 39.9%, and 63.1% among those aged 40 to 49, 50 to 59, and 60 years or older, respectively. Most were dissatisfied with their sex life regardless of age. The severity of ED was significantly associated with moderate to severe International Prostate Symptom Scores (age-adjusted odds ratio 1.52), specifically in the urgency (1.75) and nocturia (1.36) domains, and for those with diabetes mellitus (2.54) and coronary artery disease (8.04). CONCLUSIONS: ED is highly prevalent among Japanese men with LUTS and is significantly associated with the severity of LUTS after controlling for age. This significant aspect of life for men of all ages should be taken into account when treating patients with LUTS.

Adult↗
PubMed2004

Assessment of body image alteration after renal surgery using a novel three-dimensional laser scanner.

OBJECTIVES: To evaluate the utility of a newly developed three-dimensional (3D) body surface laser scanner and evaluate the body surface image of patients undergoing renal surgery to determine the impact of surgery on body image alterations. METHODS: The body surface image in the upright position was obtained using the Bodyline Scanner (Hamamatsu Photonics K.K., Hamamatsu, Japan), a 3D body surface laser scanner, in 27 patients who had undergone renal surgery. We compared the objective results of body image scanning with the subjective results of a self-administered questionnaire on perception and concern about body image alteration. RESULTS: The abdominal body surface area and volume of the operative side was significantly larger than that of the contralateral side in 18 patients undergoing renal surgery using a flank incision (median area 50.7%, P = 0.002; volume 51.2%, P <0.001). A statistically significant difference was not observed in 9 patients undergoing transperitoneal or laparoscopic surgery (median area 50.0%, P = 0.34; volume 49.9%, P = 0.40). The volume alteration measured by the 3D body surface laser scanner correlated with the patients' perception (P = 0.01) and concern (P = 0.03) about postoperative body image alteration as assessed by the self-administered questionnaire. CONCLUSIONS: The 3D body surface scanner is promising as a tool in the medical field in that it enables a computerized body image to be constructed in the upright position that reflects patients' subjective perceptions well. Using this, we observed that the flank incision causes postoperative changes in body image perceptible to the patient and a cause for concern.

Aged↗
PubMed2004

Primary localized amyloidosis of urethra: magnetic resonance imaging findings.

Amyloidosis of the urogenital tract is relatively rare. We experienced a case of primary localized amyloidosis of the urethra and report its characteristics on magnetic resonance imaging. In our case, the lesion exhibited low signal intensity on T1-weighted and T2-weighted images and was well-enhanced on gadolinium-enhanced T1-weighted images. The gross appearance on cystoscopic examination suggested urethral malignancy but the low signal intensity is atypical for malignant tissue. Because magnetic resonance imaging clearly demonstrated the local extent and depth of the lesion, it was useful in making our decision to perform conservative resection.

Adult↗
PubMed2004

Effect of urinary incontinence on lower urinary tract symptoms in Japanese women.

OBJECTIVES: To assess whether urinary incontinence and its severity are associated with the International Prostate Symptom Score (IPSS) in Japanese women using linguistically validated questionnaires. METHODS: Using a self-administered questionnaire of the IPSS and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), lower urinary tract symptoms were evaluated in a consecutive series of 1634 women (mean age 48.1 years) who underwent multiphasic health screening at our institution. Ordinal logistic regression analysis was applied, with age, ICIQ-SF, and continence status as the explanatory variable and IPSS severity as the response variable. RESULTS: All scores, including the IPSS (with its voiding and storage symptom scores) and the ICIQ-SF, were significantly greater for the incontinent than the continent women and for those with urge and mixed incontinence than those with stress incontinence. Including all women, IPSS severity was significantly associated with age (odds ratio [OR] 1.03), ICIQ-SF (OR 1.22), and urge (OR 2.79) and mixed (OR 3.54) incontinence, but not with stress incontinence. Among women with stress incontinence, however, the IPSS severity was significantly associated with the ICIQ-SF (OR 1.21), but not with age. CONCLUSIONS: Not only continence status, but also its severity (ICIQ-SF score), has a significant impact on IPSS. We, therefore, must be cautious about interpreting the epidemiologic data on female lower urinary tract symptoms without simultaneous quantitative assessment of urinary incontinence with a validated instrument.

Adult↗
PubMed2004

Retroperitoneoscopic treatment of caliceal diverticular calculi: report of two cases and review of the literature.

Two women with symptomatic stone-filled caliceal diverticula were treated by a retroperitoneoscopic approach. With a three-port technique, the diverticulum was marsupialized, the calculi removed, the cavity fulgurated, and perirenal fat inserted. The patients had no morbidity and remain stone and symptom free. They represent the 17th and 18th reported cases of this condition. We also review the clinical results in the literature.

Adult↗
PubMed2004

The use of artificial neural network analysis to improve the predictive accuracy of prostate biopsy in the Japanese population.

OBJECTIVE: We examined the efficacy of an artificial neural network analysis (ANNA) based on parameters available from previously existing examinations for improving the predictive accuracy of prostate cancer screening in the Japanese population. METHODS: Two hundred and twenty-eight patients with prostate-specific antigen (PSA) of 2-10 ng/ml were enrolled in this study. Two artificial neural network analysis (ANNA) models were constructed: ANNA1 with patient age, total PSA, free to total PSA ratio, prostate volume, transition zone volume (TZ), PSA density (PSAD) and PSA-TZ density (PSATZ) as input variables, and ANNA2 with presumed circle area ratio (PCAR), digital rectal examination (DRE) findings and chief complaint added as variables. The predictive accuracies of the ANNA models were compared with conventional PSA and volume-related parameters and a logistic regression (LR) model by receiver operating characteristic (ROC) curve analysis. RESULTS: Of 228 patients, 58 (25.5%) were diagnosed with prostate cancer. While ANNA2 had a slightly larger area under the curve (AUC) than ANNA1 (0.782 versus 0.793, P = 0.8477), the AUC of ANNA2 was significantly greater than those of ln(PSA), PSAD, PSATZ and free to total PSA ratio (P = 0.0004, 0.0230, 0.0304, and 0.0037, respectively). The accuracy of ANNA2 was significantly better than that of LR analysis at 90 and 95% sensitivity levels (P = 0.0051 and P < 0.0001, respectively). At 95% sensitivity level, ANNA2 reduced unnecessary biopsies by 40.0% with a negative predictive value of 95.7%. CONCLUSIONS: To determine the indication of prostate biopsy for PSA value in the range of 2-10 ng/ml, the ANNA model has the possibility to reduce unnecessary biopsies without missing many cases of cancers.

Aged↗
PubMed2004

Verotoxin induces rapid elimination of human renal tumor xenografts in SCID mice.

PURPOSE: Verotoxins (VTs) are subunit toxins produced by enteropathogenic Escherichia coli. The VT receptor glycolipid Gb3, which mediates the cytotoxicity of VTs, has been reported to be elevated on the surface of several tumor cell lines. In this study the effect of VT1 as an antineoplastic agent was assessed using various human urological cancer cell lines. MATERIALS AND METHODS: The expression of Gb3 on human cancer cell lines originating from renal cell carcinoma (ACHN, A-704, CAKI-1 and CAKI- 2), prostate cancer (LNCaP and PC3) and testicular tumor (2102Ep) were examined by FACScan (Becton Dickinson, Sunnyvale, California). These cell lines were cultured with various concentrations of VT1 and subjected to microculture tetrazolium dye assay for determination of cell viability. Furthermore, ACHN cells were inoculated into the backs of SCID mice and intratumor injection of VT1 was performed. Pathological samples were examined by hematoxylin and eosin staining as well as by TUNEL assay. RESULTS: The growth of ACHN, CAKI-1, A-704, 2102Ep and LNCaP but not CAKI-2 and PC3 was significantly inhibited by co-incubation with VT1, as determined by microculture tetrazolium dye assays, consistent with FACScan results for Gb3 expression. When mice bearing ACHN tumors were injected with VT1, rapid reduction in the size of subcutaneous tumors was observed with complete regression within 5 to 7 days. Pathological examination by the TUNEL method indicated that the cytotoxicity of VT1 was mediated by apoptosis. CONCLUSIONS: These results suggest that VTs could be candidates for antineoplastic agents against Gb3 expressing tumors for clinical use.

Animals↗
PubMed2004

Impact of volume weighted mean nuclear volume on outcomes following salvage radiation therapy after radical prostatectomy.

PURPOSE: Although salvage radiation therapy (RT) is a potentially curative treatment option for men with biochemical failure after radical prostatectomy (RP), to our knowledge there are no definitive pretreatment factors predicting patients likely to benefit from this treatment. We examined the impact of volume weighted mean nuclear volume (MNV) of biopsy specimens on disease outcomes and describe its usefulness as a new independent predictor. MATERIALS AND METHODS: We analyzed 33 patients who received salvage RT for biochemical failure after RP, including 11 who had received neoadjuvant hormone therapy before RP. Salvage RT was delivered to the prostatic bed at a total dose of 60 Gy with a 4-field contoured technique. Unbiased estimates of MNV were calculated from more than 100 cancer nuclei per patient captured from biopsy specimens based on a stereological method and compared with other clinical and pathological findings, including patient age, pretreatment prostate specific antigen (PSA), PSA density, biopsy Gleason score, neoadjuvant therapy, surgical Gleason score, pathological stage, tumor volume, surgical margin status, biochemical disease-free duration before RT, nadir PSA and PSA doubling time before RT, and pre-RT PSA with regard to predicting the disease outcome after salvage RT. RESULTS: The median followup after salvage RT was 43.4 months. A total of 17 patients (52%) experienced biochemical failure a median of 6.7 months (range 0 to 48.1) after RT. On univariate analysis MNV and log(pre-RT PSA) were significant predictors of disease outcome in all patients and in the 22 nonneoadjuvant patient subset (p = 0.0124 and 0.0159, respectively). Log(nadir PSA) and PSA doubling time were also significant in the latter subset (p = 0.0287 and 0.0475, respectively). However, dual multivariate analysis revealed that MNV was the only independent predictor in the 2 groups (logistic regression analysis p = 0.00931 and 0.03511, and Cox proportional hazards analysis p = 0.00483 and 0.02277, respectively). There was a statistically significant biochemical disease-free survival advantage for small vs large MNV in each data set (p = 0.0072 and 0.0036, respectively). CONCLUSIONS: Our results suggest that an estimate of MNV contributes significantly to the prediction of biochemical control after salvage RT. However, further investigation in a larger nonneoadjuvant population is needed to confirm its significance in combination with other clinical and pathological findings.

Aged↗
PubMed2004

Diagnostic potential in bladder cancer of a panel of tumor markers (calreticulin, gamma -synuclein, and catechol-o-methyltransferase) identified by proteomic analysis.

Using proteomic analysis, we previously identified calreticulin (CRT) as a potentially useful urinary marker for bladder cancer. Now, we have also identified gamma -synuclein (SNCG) and a soluble isoform of catechol-o-methyltransferase (s-COMT) as novel candidates for tumor markers in bladder cancer, by means of proteomic analysis. In the process of establishing a superior tumor marker system, we investigated the diagnostic value of a combination assay of these three proteins. Voided urine samples were obtained from 112 bladder cancer and 230 control patients. Urinary CRT, SNCG, and s-COMT were measured as a combined marker by quantitative western blot analysis. Relative concentration of each protein was calculated and the diagnostic value of a concomitant examination of these markers was evaluated by receiver operator characteristic analysis. With the best diagnostic cutoff, the overall sensitivity of the combined markers was 76.8% (95% confidence interval, 69-81%) with a specificity of 77.4% (72-80%), while those of a single use of CRT were 71.4% and 77.8%, respectively. When evaluated in relation to tumor characteristics, such as grade, stage, size, and outcome of urinary cytology, the diagnostic capacity of the combined markers was equal to or better than that of CRT in all categories. Concomitant use of CRT, SNCG, and s-COMT had higher sensitivity for detection of bladder cancer than did single use of CRT. Our study suggests that use of this panel of markers will improve the diagnosis of bladder cancer and may allow the development of a protein microarray assay or multi-channel enzyme-linked immunosorbent assay.

Aged↗
PubMed2004

Role of sildenafil citrate in treatment of erectile dysfunction after radical retropubic prostatectomy.

BACKGROUND: Sildenafil citrate was introduced as a treatment for erectile dysfunction in April 1998 in the United States and has been available since March 1999 in Japan. In this article, we assess the efficacy of sildenafil in the treatment of erectile dysfunction in Japanese men after radical retropubic prostatectomy for localized prostate cancer. METHODS: Of 106 men who underwent radical retropubic prostatectomy between January 1994 and March 2000, 43 were prescribed sildenafil at their request after radical retropubic prostatectomy. Medication was initiated at 25 mg, and if this was ineffective, the dose was increased to 50 mg. Of the patients, 18 underwent bilateral and 21 unilateral nerve sparing (NS) procedures, while in 4 patients, a non-NS procedure was performed. These patients were interviewed using a questionnaire about their response to sildenafil and using the 5-item International Index of Erectile Function (IIEF-5) questionnaire. RESULTS: Thirty-three of the 43 patients were eligible for evaluation of the efficacy of sildenafil and 27 completed the IIEF-5 questionnaires. Sildenafil at 50 mg had a better effect on sexual function than 25 mg in most Japanese patients. Of the 16 patients who underwent bilateral NS procedures, 10 (62.5%) had improved ability for intercourse and 3 (18.8%) had improved erections. Of the 13 patients who underwent unilateral NS procedures, 7 (53.8%) had improved ability for intercourse and 4 (30.8%) had improved erections. None of the 4 patients who underwent non-NS procedures had a positive response. Of 24 patients with positive response to sildenafil, 3 (12.5%) did not have to take sildenafil after receiving it because they did not require it for intercourse. Mean IIEF-5 score increased from 4.3 to 11.4 (P < 0.0001). Patient age, time since surgery, PSA and pathological stage did not have statistically significant effects on outcome. The most commonly cited adverse effect was headache (21%). CONCLUSION: Sildenafil is equally effective for erectile dysfunction in Japanese patients who have undergone bilateral and unilateral NS procedures, and aids recovery of natural erectile function after radical retropubic prostatectomy. However, non-NS procedure patients had no response to sildenafil. This study suggested that sildenafil is well tolerated and should be initially used for treatment of Japanese men with erectile dysfunction after radical retropubic prostatectomy.

Aged↗
PubMed2004

Laparoscopic nephropexy: treatment outcome and quality of life.

BACKGROUND: The recent introduction of laparoscopic procedures has markedly altered urological surgery. Laparoscopic nephropexy has attracted the attention of urologists as a treatment for nephroptosis. Herein, we describe our experiences and quality-of-life outcome of laparoscopic nephropexy and discuss its indications and surgical techniques. METHODS: From May 1998 to February 2002, six female patients, ranging in age from 20 to 64 years (median age 39.8 years), with symptomatic nephroptosis underwent laparoscopic nephropexy. Mean preoperative downward kidney displacement was 2.25 vertebral bodies (range 2-2.5) and all affected kidneys were tilted at orthostasis. One patient underwent nephropexy through the transperitoneal approach and the remaining patients underwent nephropexy through the retroperitoneal approach. To evaluate surgical results, postoperative follow-up interview (pain visual analog scale and the short-form 36 (SF-36) health survey questionnaire) and objective examinations were performed. RESULTS: All procedures were accomplished without complication. Postoperative intravenous pyelography correctly confirmed fixed kidney in both supine and erect positions. All patients reported an improvement of symptoms approximately 1 month after nephropexy and no symptoms have recurred during the follow-up period (range 6.3-50.7 months). On the SF-36, two domains, including role limitations due to emotional problems (RE) and mental health (MH), exhibited significant improvement postoperatively (P = 0.0405 and P = 0.0351, respectively). CONCLUSIONS: Laparoscopic, in particular retroperitoneoscopic, nephropexy yields excellent outcomes and greatly improves general health-related quality of life, particularly mental status, as a minimally invasive treatment for symptomatic nephroptosis.

Adult↗
PubMed2004

Prevalence of and risk factors for nocturia: Analysis of a health screening program.

BACKGROUND: We examined the prevalence of and risk factors for nocturia in Kurashiki city and the surrounding area, a rural area in Japan. MATERIALS AND METHODS: We collected data on 6517 individuals (4568 men and 1949 women) who participated in a multiphasic health screening. We analyzed the relationships between nocturia assessed by a questionnaire (voiding twice or more during night) and other variables including age, hypertension, cardiovascular disease, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes mellitus (DM), chronic renal failure, benign prostatic hyperplasia (BPH), smoking habit and alcohol intake. RESULTS: Overall, 1856 individuals (28.5%) answered that they arose to urinate at least twice during the night. This rate increased with age from 16.5% in individuals younger than 50 to 60.0% in those older than 69. Logistic regression analysis revealed that cohorts of subjects 50-59, 60-69, and 70 years old or over had, respectively, 1.75, 3.35, and 6.21 times the prevalence of nocturia of the 49 years or younger cohort. Hypertension (odds ratio [OR] 1.64) and DM (OR 1.70) were other independent positive risk factors for nocturia. On the other hand, current smokers who smoked 20 or more cigarettes per day were less likely to have nocturia than non-smokers (OR 0.72). In male individuals, BPH was another independent positive risk factor (OR 1.35). Gender was not associated with nocturia. CONCLUSIONS: Although population bias is an important limitation to this study, nocturia is associated with various factors suggesting that multiple approaches are needed to the treatment of patients with nocturia.

Age Distribution↗