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1.
Sci Rep ; 11(1): 17946, 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34504174

RESUMO

Fluorescence imaging of tumours facilitates rapid intraoperative diagnosis. Thus far, a promising activatable fluorescence probe for hepatocellular carcinoma (HCC) has not been developed. Herein, the utility of the fluorescence imaging of HCC using a ß-galactosidase (ß-Gal)-activatable fluorescence probe SPiDER-ßGal was examined. ß-Gal activity was measured in cryopreserved tissues from 68 patients. Live cell imaging of HCC cell lines and imaging of tumour-bearing model mice were performed using SPiDER-ßGal. Furthermore, fluorescence imaging was performed in 27 freshly resected human HCC specimens. In cryopreserved samples, ß-Gal activity was significantly higher in tumour tissues than in non-tumour tissues. Fluorescence was observed in HCC cell lines. In mouse models, tumours displayed stronger fluorescence than normal liver tissue. In freshly resected specimens, fluorescence intensity in the tumour was significantly higher than that in non-tumour liver specimens as early as 2 min after spraying. Receiver operating characteristic curves were generated to determine the diagnostic value of SPiDER-ßGal 10 min after its spraying; an area under the curve of 0.864, sensitivity of 85.2%, and specificity of 74.1% were observed for SPiDER-ßGal. SPiDER-ßGal is useful for the rapid fluorescence imaging of HCC. Fluorescence imaging guided by SPiDER-ßGal would help surgeons detect tumours rapidly and achieve complete liver resection.

2.
Int Urol Nephrol ; 53(11): 2281-2288, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34510283

RESUMO

PURPOSE: Whether the Mayo adhesive probability score, an index of the perinephric fat environment, could be a predictive factor for renal function deterioration after partial nephrectomy was investigated. METHODS: A retrospective case-control study of 78 patients who underwent laparoscopic partial nephrectomy was performed. An estimated glomerular filtration rate preservation rate at ≤ 90% at 3 months after surgery was defined as postoperative renal function deterioration. These patients were divided into two groups (non-deterioration and deterioration groups). Patient factors including Mayo adhesive probability scores (both tumor and unaffected sides) and surgical factors were evaluated to identify the predictors for postoperative renal function deterioration. The statistical analysis used univariate and multivariate logistic regression analyses. RESULTS: Thirty-seven (47.4%) patients had postoperative renal function deterioration after partial nephrectomy. Univariate analysis identified Mayo adhesive probability score on the unaffected side (p = 0.02), and warm ischemia time (p < 0.01) as predictors of postoperative renal function deterioration. On multivariate analyses, Mayo adhesive probability score on the unaffected side (odds ratio: 1.38 [1.05-1.79], p = 0.02) and warm ischemia time (odds ratio: 1.04 [1.01-1.07], p < 0.01) were significantly associated with postoperative renal function deterioration as same as univariate analysis. On receive operating characteristic curve analysis, Mayo adhesive probability score on the unaffected side (cutoff value 1.5; p = 0.02) and warm ischemia time (cutoff value 26.5 min; p = 0.01) were significant predictors of renal function deterioration 3 month after surgery. CONCLUSION: The Mayo adhesive probability score on the unaffected side and warm ischemia time are useful predictors for renal function deterioration after partial nephrectomy. TRIAL REGISTRATION NUMBER: 2019-249, January 21st, 2019, retrospectively registered.

3.
ChemSusChem ; 2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34498412

RESUMO

π-Conjugated polymers are important materials for organic photovoltaics. While search for new backbone systems is central to the development of π-conjugated polymers, side-chain engineering is also imperative. Here, two benzodithiophene-thiazolothiazole copolymers, PSTz1 and POTz1, were synthesized, for which the side-chain placement was different. Due to less steric hindrance between the side chains, PSTz1 had a more coplanar backbone than POTz1. This led to significant differences in trend of the performance for the binary and ternary blend cells that used a fullerene (PC71 BM) and/or non-fullerene (ITIC) as the acceptor materials. Whereas PSTz1 showed higher photovoltaic performance in the PC71 BM-based cell, POTz1 showed higher performance in the ITIC-based cell. Furthermore, in the ternary blend cell, whereas increase in the PC71 BM content improved the photovoltaic performance for the PSTz1 system, it was detrimental to the performance for the POTz1 system. These results could be a good guideline for maximizing the performance of organic photovoltaics.

4.
Photodiagnosis Photodyn Ther ; 35: 102420, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34242818

RESUMO

BACKGROUND: Accurate diagnosis of peritoneal metastasis in gastric cancer (GC) is important to determine the appropriate treatment. This study aimed to examine whether matrix metalloprotease-14 (MMP-14) was a candidate enzyme in fluorescence imaging for the diagnosis of peritoneal metastasis in GC. METHODS: GC and normal peritoneal (NP) tissues from 96 and 20 patients, respectively were evaluated for MMP-14 expression. Live cell imaging of GC cell lines (NUGC4, MKN45, MKN74, HGC-27, and Kato-III) was performed using the MMP-14-activatable fluorescence probe; BODIPY-MMP. Furthermore, the overall survival (OS) was calculated in all patients (n = 96). RESULTS: MMP-14 expression was significantly higher in GC tissues (median: 3.57 ng/mg protein; range:0.64-24.4 ng/mg protein) than in NP tissues (median: 1.34 ng/mg protein; median: 0.53-3.09 ng/mg protein) (P < 0.01). Receiver operating characteristic curves showed that the area under the curve, sensitivity, and specificity were 0.907, 84.4%, and 90.0%, respectively. In live cell imaging using the BODIPY-MMP, fluorescence was observed in five GC cell lines. In the analysis of OS, the high expression of the MMP-14 group had a significantly poorer OS rate than the low expression of the MMP-14 group (P = 0.02). In the multivariate analyses, MMP-14 expression was an independent risk factor for OS (hazard ratio: 2.33; 95 % confidence interval: 1.05-5.45; P = 0.04). CONCLUSION: MMP-14 is a promising enzyme in intraoperative fluorescence imaging for peritoneal metastasis in GC, especially in patients with poor prognosis.


Assuntos
Neoplasias Peritoneais , Fotoquimioterapia , Neoplasias Gástricas , Biomarcadores Tumorais , Humanos , Metaloproteinase 14 da Matriz , Neoplasias Peritoneais/diagnóstico por imagem , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Prognóstico , Neoplasias Gástricas/diagnóstico por imagem
5.
Int J Clin Oncol ; 26(10): 1947-1954, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34191191

RESUMO

BACKGROUND: The aims of this study were to investigate prognosis and validate prognostic models [Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic Renal Cell Carcinoma Data Consortium (IMDC), and Japanese metastatic renal cancer (JMRC) models] in the targeted therapy era in Japanese patients with metastatic renal cell carcinoma. METHODS: We retrospectively analyzed 692 patients who were diagnosed with mRCC from January 2008 to August 2018 in the Michinoku Japan Urological Cancer Study Group database. Nivolumab as sequential therapy was widely used. Other immune checkpoint inhibitors were excluded from this study. RESULTS: The median overall survival (95% confident interval) in all, MSKCC favorable, intermediate, and poor risk patients was 41.0 months (33.9-46.8), not reached (63.5 to not estimable), 46.8 months (37.1-52.9), and 10.4 months (8.9-14.4), respectively. The median overall survival (95% confident interval) in IMDC favorable, intermediate, and poor risk patients was not reached (61.6 to not estimable), 47.4 months (41.4-56.5), and 11.5 (9.9-16.3), respectively. The c-index of the MSKCC, IMDC, and JMRC models calculated at mRCC diagnosis was 0.680, 0.689, and 0.700, respectively. No statistical differences were found in the c-index among the models. CONCLUSION: While the real-world overall survival in Japanese patients with mRCC in the targeted therapy era improved compared to that previously reported in the cytokine era, there was no clear difference in the survival of poor risk patients between these eras. There were no differences in the superiority among the models.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Carcinoma de Células Renais/tratamento farmacológico , Humanos , Japão , Neoplasias Renais/tratamento farmacológico , Terapia de Alvo Molecular , Prognóstico , Estudos Retrospectivos
6.
Sci Rep ; 11(1): 10664, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-34021168

RESUMO

Diagnosis of peritoneal metastasis in gastric cancer (GC) is essential for determining appropriate therapeutic strategies and avoiding non-essential laparotomy or gastrectomy. Recently, a variety of activatable fluorescence probes that can detect enzyme activities have been developed for cancer imaging. The aim of this study was to identify the key enzyme involved in peritoneal metastasis in GC. The enzymatic activity of gamma-glutamyl transpeptidase, dipeptidyl peptidase IV, and ß-galactosidase (ß-Gal) was assessed in lysates prepared from preserved human GC (n = 89) and normal peritoneal (NP; n = 20) samples. ß-Gal activity was significantly higher in the human GC samples than in NP samples, whereas no differences were observed in the activities of the other enzymes. Therefore, we used SPiDER-ßGal, a fluorescent probe that can be activated by ß-Gal, for imaging GC cell lines, peritoneal metastasis in a mouse model, and fresh human resected GC samples (n = 13). All cell lines showed fluorescence after applying SPiDER-ßGal, and metastatic nodules in the mice gradually developed high fluorescence that could be visualized with SPiDER-ßGal. The human GC samples showed significantly higher fluorescence than NP samples. ß-Gal is a useful target enzyme for fluorescence imaging of peritoneal metastasis in GC.

7.
Nihon Shokakibyo Gakkai Zasshi ; 118(5): 480-489, 2021.
Artigo em Japonês | MEDLINE | ID: mdl-33967133

RESUMO

A 66-year-old man was admitted to our department with hypercalcemia, pancreatic and liver tumors, and periportal lymph node enlargement. Contrast-enhanced computed tomography revealed a tumor in the pancreatic tail and the right hepatic lobe along with periportal lymphadenopathy. Laboratory data revealed hypercalcemia and high serum parathyroid hormone-related protein (PTHrP) levels. Using a 22-gauge Franseen needle, we performed endoscopic ultrasonography-guided fine-needle biopsy of the pancreatic mass and an enlarged lymph node. Histopathological examination of the biopsy specimen revealed moderately to well-differentiated pancreatic adenocarcinoma with poorly differentiated squamous cell elements, as well as squamous cell carcinoma of the lymph node. Immunohistochemical examination showed that the pancreatic tissue was weakly immunopositive and the lymph node was strongly immunopositive for anti-PTHrP antibody. We diagnosed the patient with pancreatic adenosquamous carcinoma with liver and lymph node metastasis, associated with hypercalcemia of malignancy secondary to PTHrP secretion. We administered systemic chemotherapy comprising gemcitabine and nab-paclitaxel. Unfortunately, the patient died 8 months after being diagnosed with this malignancy. PTHrP-producing adenosquamous carcinoma of the pancreas is rare;only 14 cases are reported in the literature. Based on immunohistochemical evaluation, this case report suggests that metastatic lymph nodes may lead to the overproduction of PTHrP in such cases.


Assuntos
Adenocarcinoma , Neoplasias Pancreáticas , Idoso , Biópsia por Agulha Fina , Humanos , Masculino , Neoplasias Pancreáticas/diagnóstico por imagem , Proteína Relacionada ao Hormônio Paratireóideo , Ultrassonografia de Intervenção
8.
JSLS ; 25(1)2021.
Artigo em Inglês | MEDLINE | ID: mdl-33879996

RESUMO

Background and Objectives: This study was conducted to identify whether surgical stress during the peri-operative period of robot-assisted radical prostatectomy might affect biochemical recurrence in patients with positive surgical margins. Methods: Participants in the present study were 324 consecutive patients with localized prostate cancer who underwent robot-assisted radical prostatectomy between February 2013 and June 2018. Positive surgical margins were diagnosed in 61 of them. Patients with positive surgical margins were divided into those with (n = 19) and those without (n = 42) biochemical recurrence. Lymph node dissection, estimated blood loss, inhalation anesthetic volume, and surgical duration were evaluated as indicators of surgical stress. White blood cell count, C-reactive protein, body temperature, and usage of analgesics were postoperatively evaluated as surrogate markers of surgical stress. The associations between factors, including patients' characteristics and pathological features, and biochemical recurrence were investigated. Results: In univariate analyses, surgical duration (P = 0.004), D'Amico risk class (P = 0.002), Gleason score (P = 0.022) and the number of positive cores in prostate biopsy (P = 0.009) were statistically significantly associated with biochemical recurrence. In multivariate analyses, only surgical duration was significantly associated with biochemical recurrence (P = 0.042), at a cut-off value of surgical duration of 228.5 minutes. Conclusions: Prolonged surgical duration is associated with biochemical recurrence in patients with positive surgical margins. Thus, surgical duration should be limited as much as possible to reduce surgical stress, which might cause biochemical recurrence.


Assuntos
Recidiva Local de Neoplasia/epidemiologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Estresse Fisiológico , Idoso , Anestésicos Inalatórios/administração & dosagem , Perda Sanguínea Cirúrgica , Humanos , Excisão de Linfonodo/efeitos adversos , Masculino , Margens de Excisão , Pessoa de Meia-Idade , Análise Multivariada , Gradação de Tumores , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/diagnóstico , Duração da Cirurgia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Fatores de Risco
9.
Int J Urol ; 28(7): 734-740, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33745187

RESUMO

OBJECTIVES: To identify the prevalence and predictors of postoperative detrusor underactivity during the early postoperative period after robot-assisted radical prostatectomy. METHODS: We carried out a prospective observational study of 64 patients scheduled for robot-assisted radical prostatectomy using urodynamic study before and 1 month after robot-assisted radical prostatectomy. Detrusor underactivity was defined as maximum flow rate ≤15 mL/s and detrusor pressure at maximum flow rate ≤25 cmH2 O during voiding. Incidences of pre- and postoperative detrusor underactivity were assessed, and predictors of postoperative detrusor underactivity were determined using uni- and multivariate logistic regression analyses. Factors comprised patient characteristics (age, prostate weight etc.), operative factors (surgical duration, nerve sparing etc.) and preoperative urodynamic study parameters (maximum flow rate, bladder contractile index etc.). RESULTS: Pre- and postoperative detrusor underactivity at 1 month after robot-assisted radical prostatectomy were detected in one patient (1.6%) and 24 patients (37.5%), respectively. Univariate analysis selected preoperative maximum flow rate (P = 0.02), detrusor pressure at maximum flow rate (P = 0.04) and bladder contractile index (P < 0.01) as predictors of postoperative detrusor underactivity (odds ratio 0.83, 0.97 and 0.94, respectively). On multivariate analyses, only preoperative bladder contractile index was associated with postoperative detrusor underactivity (P < 0.01; odds ratio 0.94). A cut-off of 102.8 offered optimal accuracy in receiver operating characteristic analysis. Patient characteristics and operative factors were not significantly associated with postoperative detrusor underactivity. CONCLUSIONS: A comparatively high prevalence of postoperative detrusor underactivity is observed in patients at 1 month after robot-assisted radical prostatectomy. Patients with preoperative low bladder contractile index have a higher probability of developing early postoperative detrusor underactivity after robot-assisted radical prostatectomy.


Assuntos
Robótica , Bexiga Inativa , Humanos , Masculino , Período Pós-Operatório , Prevalência , Próstata , Prostatectomia/efeitos adversos , Urodinâmica
10.
Intern Med ; 60(17): 2783-2791, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-33746162

RESUMO

Although cases of gastrointestinal toxicity of pembrolizumab have been reported, cases of acute immune-mediated colitis accompanied with metachronous esophageal disorders (esophagitis and ulcer) are rare. We herein report a case of acute colitis and metachronous esophageal ulcers due to an immune-related adverse event following concomitant pembrolizumab chemotherapy for lung adenocarcinoma. To our knowledge, there have so far been no reports of cases in which both acute immune-mediated colitis and metachronous esophageal ulcers developed. We therefore report the details of this case along with a review of the pertinent literature.


Assuntos
Colite , Doenças do Esôfago , Esofagite , Colite/induzido quimicamente , Colite/diagnóstico , Doenças do Esôfago/induzido quimicamente , Doenças do Esôfago/diagnóstico , Humanos , Inibidores de Checkpoint Imunológico , Úlcera/induzido quimicamente , Úlcera/diagnóstico
11.
Cancer Sci ; 112(5): 1899-1910, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33619826

RESUMO

Enzalutamide (Enz) is a second-generation androgen receptor (AR) antagonist for castration-resistant prostate cancer (CRPC) therapy, and it prolongs survival time in these patients. However, during Enz treatment, CRPC patients usually acquire resistance to Enz and often show cross-resistance to other AR signaling inhibitors. Although glucocorticoid receptor (GR) is involved in this resistance, the role of GR has not yet been clarified. Here, we report that chronic Enz treatment induced GR-mediated glucose transporter 4 (GLUT4) upregulation, and that upregulation was associated with resistance to Enz and other AR signaling inhibitors. Additionally, inhibition of GLUT4 suppressed cell proliferation in Enz-resistant prostate cancer cells, which recovered from Enz resistance and cross-resistance without changes in GR expression. Thus, a combination of Enz and a GLUT4 inhibitor could be useful in Enz-resistant CRPC patients.


Assuntos
Antineoplásicos/uso terapêutico , Transportador de Glucose Tipo 4/metabolismo , Feniltioidantoína/análogos & derivados , Neoplasias de Próstata Resistentes à Castração/tratamento farmacológico , Neoplasias de Próstata Resistentes à Castração/metabolismo , Receptores de Glucocorticoides/metabolismo , Antagonistas de Receptores de Andrógenos/uso terapêutico , Linhagem Celular Tumoral , Proliferação de Células , Resistencia a Medicamentos Antineoplásicos , Glucose/metabolismo , Proteínas Facilitadoras de Transporte de Glucose/metabolismo , Transportador de Glucose Tipo 1/metabolismo , Transportador de Glucose Tipo 3/metabolismo , Transportador de Glucose Tipo 4/antagonistas & inibidores , Humanos , Masculino , Feniltioidantoína/uso terapêutico , Receptores Androgênicos/metabolismo , Regulação para Cima
12.
Gan To Kagaku Ryoho ; 48(2): 288-290, 2021 Feb.
Artigo em Japonês | MEDLINE | ID: mdl-33597384

RESUMO

A 59-year-old woman's father and paternal grandmother died of colorectal cancer and her paternal uncle died of pancreatic cancer. She was positive for fecal occult blood and underwent colonoscopy. The colonoscopy revealed a type 0-Ⅱa+ Ⅱc lesion in the transverse colon suspected to be submucosal deep invasion, and the biopsy revealed poorly differentiated adenocarcinoma. Contrast-enhanced CT showed no regional lymphatic metastasis or distant metastasis. She was diagnosed with transverse colon cancer, T1N0M0, cStage Ⅰ, and laparoscopic partial colectomy and D2 lymphadenectomy were performed. Histopathological examinations showed medullary carcinoma, pT2(MP), Ly1a, V0, BD1, Pn1a, pPM0, pDM0, pN0. She had 2 of the items in the revised Bethesda Guideline, and was suspected of having Lynch syndrome(LS). There is no definitive diagnosis of LS because she did not want MSI or other genetic testing. However, the surveillance should be required not only for recurrence of colon cancer but also for occurrence of LS-related tumors.


Assuntos
Carcinoma Medular , Colo Transverso , Neoplasias do Colo , Laparoscopia , Colectomia , Colo Transverso/cirurgia , Neoplasias do Colo/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia
13.
World J Urol ; 39(8): 3035-3040, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33398425

RESUMO

PURPOSE: To clarify the role of Trp64Arg polymorphisms of the gene encoding the ß3-adrenoceptor for lower urinary tract function in males, the present study investigated the association between the Trp64Arg polymorphisms and lower urinary tract symptoms (LUTS) and function. METHODS: This prospective observational study included patients who underwent robot-assisted radical prostatectomy. Before surgery, blood samples were collected, and analyses of ß3-adrenoceptor gene polymorphism were performed using the real-time polymerase chain reaction. The present cohort was divided into patients with wild type (Trp64Trp) and with variant type (Trp64Arg + Arg64Arg), and LUTS and lower urinary tract function before surgery were compared between them. RESULTS: Wild type was found in 247 patients, with variant type in 129. There were no significant differences in LUTS between the two groups. Residual urine volume (PVR) (wild type: variant type = 47 ± 53 mL: 58 ± 77 mL, P = 0.04) and voiding time on uroflowmetry (wild type: variant type = 29 ± 15 s: 33 ± 17 s, P = 0.04) were significantly increased in the variant type. CONCLUSION: The Trp64Arg variant of the ß3-adrenoceptor gene significantly increased PVR and voiding time in men. However, it was not significantly associated with the emergence of LUTS. Thus, since the effect of ß3-adrenoceptor gene polymorphisms on the genitourinary organs might be weak, whether men possess the Trp64Arg variant of the ß3-adrenoceptor gene might not critically affect urinary quality of life, but modestly affect the lower urinary tract function.

14.
Sci Rep ; 10(1): 19844, 2020 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-33199757

RESUMO

This study aimed to investigate the influence of chronic ischemia on nitric oxide biosynthesis in the bladder and the effect of administering tetrahydrobiopterin (BH4), a cofactor for endothelial nitric oxide synthase (eNOS), on chronic ischemia-related lower urinary tract dysfunction (LUTD). This study divided male Sprague-Dawley rats into Control, chronic bladder ischemia (CBI) and CBI with oral BH4 supplementation (CBI/BH4) groups. In the CBI group, bladder capacity and bladder muscle strip contractility were significantly lower, and arterial wall was significantly thicker than in Controls. Significant improvements were seen in bladder capacity, muscle strip contractility and arterial wall thickening in the CBI/BH4 group as compared with the CBI group. Western blot analysis of bladder showed expressions of eNOS (p = 0.043), HIF-1α (p < 0.01) and dihydrofolate reductase (DHFR) (p < 0.01), which could regenerate BH4, were significantly higher in the CBI group than in Controls. In the CBI/BH4 group, HIF-1α (p = 0.012) and DHFR expressions (p = 0.018) were significantly decreased compared with the CBI group. Our results suggest that chronic ischemia increases eNOS and DHFR in the bladder to prevent atherosclerosis progression. However, DHFR could not synthesize sufficient BH4 relative to the increased eNOS, resulting in LUTD. BH4 supplementation protects lower urinary tract function by promoting eNOS activity.


Assuntos
Biopterina/análogos & derivados , Isquemia/prevenção & controle , Óxido Nítrico/biossíntese , Bexiga Urinária/irrigação sanguínea , Animais , Disponibilidade Biológica , Biopterina/administração & dosagem , Biopterina/farmacologia , Regulação da Expressão Gênica/efeitos dos fármacos , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Isquemia/etiologia , Isquemia/metabolismo , Masculino , Contração Muscular/efeitos dos fármacos , Óxido Nítrico Sintase Tipo III/metabolismo , Oxirredução , Ratos , Ratos Sprague-Dawley , Tetra-Hidrofolato Desidrogenase/metabolismo , Bexiga Urinária/efeitos dos fármacos
15.
IJU Case Rep ; 3(2): 36-39, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32743465

RESUMO

Introduction: Chromophobe renal cell carcinoma presents in early pathological stages with a lower risk of metastasis. However, aggressive features and metastasis can occur. A rare case of rapidly progressive disease with histological changes is presented. Case presentation: A 56-year-old woman had a right renal tumor with multiple lymph node metastases, and the pathological diagnosis of the biopsy specimens from the primary tumor was chromophobe renal cell carcinoma. After sunitinib treatment, the metastatic lymph node had decreased in size and the numbers of circulating tumor cells were decreased, consequently, cytoreductive nephrectomy was performed. However, rapid progression of lymph node metastases was observed. Histopathological examination showed that the renal tumor was diagnosed as spindle cell renal carcinoma. Conclusion: It appears that the primary tumor underwent epithelial-mesenchymal transition; further tissue specimen collection and analysis might be needed.

16.
IJU Case Rep ; 3(2): 53-56, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32743469

RESUMO

Introduction: Congenital lipoid adrenal hyperplasia is a rare disease that causes disorders of sex development. The 46,XY patient presents with female external genitalia and inguinal testes. We describe the case of a patient with congenital lipoid adrenal hyperplasia and investigated the testes of this patient in detail. Case presentation: A 15-day-old 46,XY neonate presented with severe adrenal insufficiency. Congenital lipoid adrenal hyperplasia was diagnosed after detection of steroidogenic acute regulatory gene mutations. At 2 years and 5 months, she underwent bilateral gonadectomy. Leydig cells were observed both with and without lipid droplets in the testes of this patient. We also demonstrated immunohistochemically that some testosterone-synthesizing enzymes were maintained in this patient. Conclusion: The results indicated transcription of testosterone-synthesizing enzymes remained despite lipid accumulation in this patient. The pattern of expression of testosterone-synthesizing enzymes suggested fetal Leydig cells may have remained after birth in the testes of this patient.

17.
Anticancer Res ; 40(8): 4299-4307, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32727757

RESUMO

BACKGROUND/AIM: The present research was performed to clarify the differences in circulating tumor cells (CTCs) counts between non-muscle-invasive (NMIBC) and muscle-invasive (MIBC) bladder cancer following transurethral resection of bladder tumor (TURBT). PATIENTS AND METHODS: The cohort in the prospective research was categorized into the NMIBC (n=13) and the MIBC (n=13) groups. The pre- and postoperative number of CTCs was counted by the FISHMAN-R® system. RESULTS: The difference of the number of preoperative CTCs between the NMIBC group (2.3±2.6) and MIBC group (4.8±4.2) did not reach statistical significance (p=0.08). However, there was a significantly greater increase in postoperative CTC count in the MIBC group (14.6±14.6) than in the NMIBC group (3.1±2.1, p=0.01). CONCLUSION: After TURBT, more carcinoma cells can be discharged from the bladder in the MIBC. Excessive deep layer resection and excessive pressure of the infusion fluid during TURBT should be avoided in patients with MIBC.


Assuntos
Invasividade Neoplásica , Células Neoplásicas Circulantes , Uretra , Neoplasias da Bexiga Urinária/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Anticancer Res ; 40(6): 3163-3167, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32487611

RESUMO

BACKGROUND/AIM: Ultrasonically activated surgical devices (USADs) have become indispensable instruments for gastrointestinal surgery. In this study, we investigated the oncological safety of the use of USADs. MATERIALS AND METHODS: We harvested and cultivated the splashes and mist scattered from an USAD when cutting MKN45-derived cancer nodules. Seven days later, we observed viable cancer cells and the total number of cells was counted. The histopathology of the nodules cut by the USAD was also examined. RESULTS: The existence of viable cancer cells was confirmed by ex vivo cell culture. The number of viable cancer cells was reduced by slow grasping of the USAD. The surface of cancerous tissue cut by the USAD was partially heat-denatured, however, there were some parts in which cancerous tissue was exposed on the surface. CONCLUSION: Surgeons should recognize the possibility that cancer cells may be scattered by USAD use.


Assuntos
Procedimentos Cirúrgicos do Sistema Digestório/métodos , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Terapia por Ultrassom/métodos , Animais , Linhagem Celular Tumoral , Feminino , Humanos , Camundongos , Camundongos Nus , Neoplasias Gástricas/patologia
19.
Int Urol Nephrol ; 52(10): 1877-1884, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32451781

RESUMO

PURPOSE: The aim of the present study was to investigate whether renal dysfunction following rhabdomyolysis occurs after robot-assisted radical prostatectomy (RARP), and to investigate the factors related to rhabdomyolysis after RARP. METHODS: A total of 180 consecutive patients who underwent RARP at our institution were investigated. Rhabdomyolysis was defined as creatine kinase (CK) > 1050 IU/L after RARP. The association between CK and renal function after RARP was investigated, and the factors related to rhabdomyolysis after RARP were also investigated. RESULTS: Postoperative CK (407 ± 936 IU/L) was significantly higher than preoperative CK (134 ± 75 IU/L) (p < 0.001), and eGFR after RARP was significantly negatively correlated with CK on the day after RARP (correlation coefficient (ρ) = - 0.248, p = 0.007), but the significant negative correlation disappeared on the 7th day after RARP (ρ = - 0.010, p = 0.32). On multivariate analysis, postoperative CK elevation was significantly correlated with console time (p = 0.002). Rhabdomyolysis was observed in 6.1% (11/180), and of the patients with rhabdomyolysis, acute renal failure was transiently observed in 45.5% (5/11). On multivariate analysis, rhabdomyolysis was significantly associated with higher body mass index (BMI) (> 25.7 kg/m2) and longer console time (> 188 min) (p = 0.02 and p = 0.005, respectively). CONCLUSION: Temporary renal dysfunction can occur after RARP due to CK elevation. Thus, sufficient attention must be paid to renal insufficiency after elevation of CK values for several days after RARP. Because rhabdomyolysis after RARP was associated with both obesity and long console time, console time during RARP should be shortened, especially in patients with obesity.


Assuntos
Nefropatias/etiologia , Nefropatias/fisiopatologia , Rim/fisiopatologia , Prostatectomia/efeitos adversos , Rabdomiólise/etiologia , Rabdomiólise/fisiopatologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Prostatectomia/métodos , Estudos Retrospectivos , Rabdomiólise/complicações , Fatores de Tempo
20.
Int Urol Nephrol ; 52(1): 67-76, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31571159

RESUMO

PURPOSE: To assess whether the preoperative 1-h pad test could predict postoperative urinary incontinence and quality of life after robot-assisted radical prostatectomy. METHODS: A total of 329 patients who underwent robot-assisted radical prostatectomy between 2013 and 2016 were prospectively enrolled in this study. These patients were divided into the preoperative urinary continence group and the preoperative urinary incontinence group according to the 1-h pad test. The time to achieve urinary continence, lower urinary tract function evaluated by uroflowmetry and post-voided residual urine volume, and quality of life evaluated by King's Health Questionnaire and International Consultation on Incontinence Questionnaire-Short Form were compared between these two groups. RESULTS: There were 190 patients (58%) in the preoperative urinary continence group (1-h pad test ≤ 2 g) and 139 patients (42%) in the preoperative urinary incontinence group (1-h pad test > 2 g). In the preoperative urinary continence/incontinence groups, 83%/76% of patients achieved continence within 12 months, respectively, and urinary incontinence remained significantly longer in the preoperative incontinence group than in the preoperative continence group (P = 0.042). Although there were no significant differences in all quality of life items between the two groups before surgery, several items were significantly higher in the preoperative urinary continence group. CONCLUSION: Achievement of urinary continence and improvement of urinary quality of life are delayed in patients with preoperative urinary incontinence assessed by the 1-h pad test. The preoperative 1-h pad test could be a useful predictor of prolonged urinary incontinence and poor quality of life after robot-assisted radical prostatectomy.


Assuntos
Complicações Pós-Operatórias/etiologia , Prostatectomia/efeitos adversos , Neoplasias da Próstata/cirurgia , Qualidade de Vida , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Incontinência Urinária/etiologia , Idoso , Humanos , Tampões Absorventes para a Incontinência Urinária , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Estudos Prospectivos , Incontinência Urinária/diagnóstico
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