Persistence Rate with Tadalafil for Treatment of Male Lower Urinary Tract Symptoms.

OBJECTIVES: We examined the persistence rate with tadalafil for treatment of male lower urinary tract symptoms (LUTS) and explored the factors relevant to withdrawal. PATIENTS AND METHODS: We retrospectively collected the data of male patients who received tadalafil treatment for LUTS. The persistence rate and the reason for withdrawal were investigated. RESULTS: A total of 155 patients were examined. Mean age and mean observation period were 71.9 (48-93) years and 15.1 (1-52) months, respectively. During the observation period, 74 patients (48%) withdrew tadalafil. The Kaplan-Meier curve indicated a 58% persistence rate at 1 year. The reasons for withdrawal included insufficient efficacy (31 patients, 42%), adverse events (21 patients, 28%), or symptom improvement (8 patients, 11%). Patients who continued tadalafil were significantly younger than those who withdrew it due to insufficient efficiency (71.4 ± 9.6 vs. 74.9 ± 9.1 years). CONCLUSIONS: Most patients withdrew tadalafil due to insufficient efficacy. Older patients are likely to withdraw the treatment because of insufficient efficacy, thus, tadalafil for male LUTS could be more effective for younger patients.

[Initial Experiences of Dynamic Sentinel Lymph Node Biopsy (DSNB) in Patients with Penile Cancer].

We present 2 cases of penile cancer in which the inguinal lymph node was not palpable and inguinal lymph node dissection (ILND) could be safely avoided by conducting dynamic sentinel lymph node biopsy (DSNB). The first case was in a 54-year-old man complaining of penile tumor for at least 3 months. We performed partial penectomy and DSNB. The pathological diagnosis was squamous cell carcinoma (SCC), pT2-3. There was no cancer metastasis in sentinel nodes (0/2). There has been no recurrence for 6 years after operation. The second case was 65-year-old man suffering from penile tumor for at least 6 months. We performed partial penectomy and DSNB. The pathological diagnosis was SCC,pT2. There was no cancer metastasis in sentinel nodes (0/3). There has been no recurrence for 1 year after operation. ILND has been recommended for intermediate and high-risk penile cancer even in patients with non-palpable inguinal lymph nodes. However,the complication of ILND is very high. DSNB has the potential to avoid ILND if there is no cancer metastasis in sentinel nodes.

[Relationship between Early Complications after Radical Cystectomy and Psoas Muscle Mass].

Psoas muscle mass index (PMI) is related to sarcopenia. We examined whether PMI is associated with early complications after radical cystectomy. Seventy one male and 29 female patients who were 65 years old or older and who had undergone radical cystectomy at our hospital from April 2005 to March 2018 were retrospectively analyzed. Psoas muscle section area was measured manually on preoperative computed tomography (CT) scan and normalized by patient's height. Early postoperative complications of grade 3 or more occurred in 12 male (16.9%) and 5 female (17.2%) patients. PMI was lower in male patients who had early postoperative complications of grade 3 or more than in those without complications (5.61 vs 6.54 cm2 /m2, p=0. 08), although the difference was not statistically significant. There was suggested to be a relationship between early postoperative complications after radical cystectomy and preoperative PMI in elderly male patients.

Long-term symptomatic outcome after transurethral resection of the prostate: A urodynamics-based assessment.

OBJECTIVES: To examine the long-term outcomes of transurethral resection of the prostate. METHODS: We retrospectively collected the data of patients who had undergone transurethral resection of the prostate before December 2010. Patients had been evaluated by urodynamics and the International Prostate Symptom Score preoperatively, and they were re-evaluated by using the International Prostate Symptom Score at the minimum 7 years after transurethral resection of the prostate. Patients who received any treatments to improve voiding symptoms were defined as having a relapse of voiding dysfunction. The Schäfer nomogram was used to assess the degree of obstruction and detrusor contractility. We assessed the change in International Prostate Symptom Score over time depending on obstruction (Schäfer grade 3-6) versus no obstruction (Schäfer grade 0-2), and normal detrusor contractility (strong and normal) versus detrusor underactivity (weak and very weak). Relapse rates of voiding dysfunction were determined using the Kaplan-Meier method. RESULTS: A total of 39 patients were included. The mean age at transurethral resection of the prostate was 69.8 years, and the mean observation period after transurethral resection of the prostate was 114 months. During the observation period, eight patients (21%) were categorized as relapse of voiding dysfunction and the mean time to relapse was 4.2 years. Patients categorized as no obstruction or detrusor underactivity had a higher recurrence rate of voiding dysfunction with a statistical significance between those with versus without obstruction. Except for patients with relapse of voiding dysfunction, improvement of the International Prostate Symptom Score was maintained over a period of 10 years after transurethral resection of the prostate. CONCLUSIONS: Favorable long-term symptomatic outcome after transurethral resection of the prostate is likely in patients with urodynamic obstruction. Patients without urodynamic obstruction are likely to have a relapse of voiding symptoms and require additional treatments in the long term.

[A Case of Adenocarcinoma of the Reconstructed Bladder 45 Years after Ileocystoplasty].

The patient was a 66-year-old man who had undergone ileocystoplasty and right nephrectomy at the age of 21 for the treatment of urinarytract tuberculosis. He had been receiving hemodialysis from the age of 58. Regular computed tomography (CT) examination at the age of 63 revealed a bladder mass, but the transurethral biopsyof the bladder mass did not reveal malignant findings. At the age of 66, his urine cytology indicated a suspicion of malignancy, and bladder tumor was detected by cystoscopy. The patient was referred to our hospital and we performed transurethral resection of the bladder tumor. Pathological diagnosis was papillaryadenocarcinoma. Because left lower ureteral cancer was also suspected byCT scan, we performed left nephroureterectomy and radical cystectomy. Pathological examination revealed adenocarcinoma of the reconstructed bladder. The patient remains free of disease for 1 year and 11 months after the operation. Forty-five cases of bladder cancer after enterocystoplasty have been reported in Japan. There are no guidelines for follow-up protocols after enterocystoplasty. A long-term follow-up is mandatory because of the possibilityof development of bladder malignancylong after the enterocystoplasty.

Comparative Subcellular Localization Analysis of Magnetosome Proteins Reveals a Unique Localization Behavior of Mms6 Protein onto Magnetite Crystals.

UNLABELLED: The magnetosome is an organelle specialized for inorganic magnetite crystal synthesis in magnetotactic bacteria. The complex mechanism of magnetosome formation is regulated by magnetosome proteins in a stepwise manner. Protein localization is a key step for magnetosome development; however, a global study of magnetosome protein localization remains to be conducted. Here, we comparatively analyzed the subcellular localization of a series of green fluorescent protein (GFP)-tagged magnetosome proteins. The protein localizations were categorized into 5 groups (short-length linear, middle-length linear, long-length linear, cell membrane, and intracellular dispersing), which were related to the protein functions. Mms6, which regulates magnetite crystal growth, localized along magnetosome chain structures under magnetite-forming (microaerobic) conditions but was dispersed in the cell under nonforming (aerobic) conditions. Correlative fluorescence and electron microscopy analyses revealed that Mms6 preferentially localized to magnetosomes enclosing magnetite crystals. We suggest that a highly organized spatial regulation mechanism controls magnetosome protein localization during magnetosome formation in magnetotactic bacteria. IMPORTANCE: Magnetotactic bacteria synthesize magnetite (Fe3O4) nanocrystals in a prokaryotic organelle called the magnetosome. This organelle is formed using various magnetosome proteins in multiple steps, including vesicle formation, magnetosome alignment, and magnetite crystal formation, to provide compartmentalized nanospaces for the regulation of iron concentrations and redox conditions, enabling the synthesis of a morphologically controlled magnetite crystal. Thus, to rationalize the complex organelle development, the localization of magnetosome proteins is considered to be highly regulated; however, the mechanisms remain largely unknown. Here, we performed comparative localization analysis of magnetosome proteins that revealed the presence of a spatial regulation mechanism within the linear structure of magnetosomes. This discovery provides evidence of a highly regulated protein localization mechanism for this bacterial organelle development.

Stereohaptic Vibration: Out-of-Body Localization of Virtual Vibration Source Through Multiple Vibrotactile Stimuli on the Forearms.

This paper proposes a novel concept of "stereohaptic vibration," which employs distributed vibration to localize vibration sources outside the body. Inspired by amplitude panning, a stereophonic sound display technique, we developed a method to localize a virtual vibration source (VVS) by polarizing the perceived intensity of multiple vibration stimuli to a specific orientation. Considering the perceptual characteristics of high-frequency vibration, the perceived intensity of the VVS was allocated to multiple vibrators according to the distance and direction of the target. The velocity discrimination performance was confirmed by utilizing four stimuli around the arm and one vibration stimulus to the palm to localize the movement of a VVS throughout the arm. Discrimination experiments of the trajectory of outgoing objects with a single arm and dual arms revealed that our approach could localize in three dimensions, even outside the body. The proposed technology for localizing external virtual vibration sources is expected to enhance the virtual reality experience.

[Analysis of patients with advanced gastric cancer undergoing S-1/CDDP combined neoadjuvant chemotherapy].

We retrospectively examined patients with advanced gastric cancer who underwent S-1/CDDP combined neoadjuvant chemotherapy. Nine patients who had the factor of curative surgery deemed not feasible for advanced gastric cancer were enrolled. 80 mg/m2 of S-1 was given orally from days 1-14, and 60 mg/m2 of CDDP was administered on day 8. Patients were treated with a three-cycle protocol. When an adverse event greater than Grade 3 showed, we judged that chemotherapy could not be continued and surgery was performed. An anti-tumor effect on the imaging was found in all cases of PR. The histological effect was judged to be Grade 3 and pathological CR in two cases. In the postoperative period, all patients received adjuvant chemotherapy. S-1/CDDP combined neoadjuvant chemotherapy is a potential regimen for advanced gastric cancer.

[A case of gastric gastrointestinal stromal tumor resected after chemotherapy with imatinib].

We report a case of a residual stomach gastrointestinal stromal tumor (GIST) successfully treated with resection. We were able to curatively resect after treatment with imatinib. A 33-year-old man underwent distal gastrectomy for duodenal ulcer perforation at the age of 18. He began to experience back pain, and the diagnosis of mild gastritis was made over observation in near medicine, but he was admitted to our hospital because his symptoms continued for 5 months. Abdominal CT and MRI showed a protruding lesion of approximately 17 cm in the left upper-abdomen. Surgery was performed, but the tumor had directly invaded the surrounding organs. To find the definite diagnosis, a biopsy was performed. The histopathological diagnosis was c-kit-positive GIST. Administration of imatinib 400 mg/day was commenced. After 6 months of treatment, CT revealed a roughly 68% reduction in the tumor's diameter. The radical operation was considered feasible and total gastrectomy was performed. The postoperative course was uneventful. Neoadjuvant therapy with imatinib may become a useful means of conserving improve organ and complete resection rate increase with tumor reduction.

[Response in a case of advanced rectal cancer treated by chemoradiation with S-1/oxaliplatin].

A 62-year-old male was admitted to our hospital because of anal pain and bloody stool. After careful examination, a locally advanced rectal cancer was found, and an invasion of the prostate was suspected. The prevention of pelvic recurrence and downstaging for S-1/oxaliplatin (SOX), combined with preoperative chemoradiation (CRT) make, PR decision (reduction rate 70%), and surgery (APR+central D3) were performed. The postoperative course was uneventful and the patient was discharged 18 hospital days after surgery. The outpatient is receiving the adjuvant chemotherapy by single S-1 now. Advanced lower rectal cancer S-1/oxaliplatin (SOX), combined with preoperative chemoradiation (CRT), have fewer adverse events and are considered to be useful.

Upregulated solute carrier family 37 member 1 in colorectal cancer is associated with poor patient outcome and metastasis.

Solute carrier (SLC) drug transporters exchange various molecules without energy from adenosine triphosphate hydrolysis, indicating an association with anticancer drug resistance. However, the expression and role of SLC transporters in malignant tumors has not yet been fully elucidated. Therefore, in the current study, the expression of SLC37A family genes was evaluated in patients with colorectal cancer (CRC), and it was revealed that SLC family 37 member 1 (SLC37A1) expression was significantly increased in tumorous tissues compared with that in non-tumorous tissues. The cases with upregulated expression of SLC37A1 by immunohistochemical staining were significantly associated with positive venous invasion and liver metastasis. Furthermore, upregulated SLC37A1 expression was associated with poor overall survival time in the present cohort. These results indicated that SLC37A1 is involved in the hematogenous metastasis of CRC. To investigate whether SLC37A1 is associated with hematogenous metastasis and glycolipid metabolism, SLC37A1 was knocked down in colon cancer cells, and the expression of sialyl Lewis A and sialyl Lewis X was observed to be decreased. In summary, upregulation of SLC37A1 was observed in patients with CRC, and was associated with poor patient outcomes and survival. To the best of our knowledge, the present study is the first to propose a key role of SLC37A1 in CRC, and additional studies are warranted to reveal the functional role of SLC37A1 in CRC development.