Publications by authors named "Masahiro Shiba"

37 Publications

Intraoperative monitoring of placental blood flow after cesarean birth to diagnose placenta accreta spectrum disorder: A preliminary study.

Int J Gynaecol Obstet 2020 02 3;148(2):267-269. Epub 2019 Dec 3.

Department of Obstetrics and Gynecology, School of Medicine, Teikyo University, Tokyo, Japan.

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http://dx.doi.org/10.1002/ijgo.13059DOI Listing
February 2020

[Urachal Actinomycosis : A Case Report].

Hinyokika Kiyo 2018 Apr;64(4):161-164

The Department of Urology, Sakai City Medical Center.

The patient was a 66-year-old woman who was examined by a local physician for the chief complaint of a mass palpable in the left lower abdomen. Abdominal plain computed tomography (CT) indicated a subcutaneous mass extending continuously from the apex of the bladder to the retropubic space, and she was referred to our medical department. Tumor markers were normal, and cystoscopic examination indicated no clear findings. Abdominal contrast-enhanced CT and plain abdominal magnetic resonance imaging results led to suspicion of actinomycosis. An open biopsy was performed on the subcutaneous mass, and subsequent histopathological testing led to a definitive diagnosis of actinomycosis. After 2 weeks of antibiotic therapy, the mass had diminished on CT. There has been no relapse approximately 24 weeks after discontinuation of the antibiotic therapy.
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http://dx.doi.org/10.14989/ActaUrolJap_64_4_161DOI Listing
April 2018

[A Case of Epithelioid Angiomyolipoma of the Kidney with Tumor Thrombus Extending into the Renal Vein : Case Report].

Hinyokika Kiyo 2017 Jun;63(6):235-238

The Department of Urology, Sakai City Medical Center.

A 31-year-old man was referred to our hospital for macroscopic hematuria. An abdominal computed tomography (CT) scan showed a 36×30 mm enhancing left renal tumor with tumor thrombus extending into the left renal vein. Therefore,we diagnosed the tumor as a clinically classified cT3aN0M0 left renal cell carcinoma. Retroperitoneal laparoscopic radical left nephrectomy with renal vein thrombectomy was performed,with removal of the left kidney with the mass and tumor thrombus en bloc. The pathological diagnosis was epithelioid angiomyolipoma (EAML) of the left kidney. EAML is a rare tumor with malignant potential. In this case,although no signs of recurrence or metastasis have been observed for 9 months post-operation,we recommended a careful follow-up regimen.
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http://dx.doi.org/10.14989/ActaUrolJap_63_6_235DOI Listing
June 2017

[Metastasis to the Tongue from Renal Cell Carcinoma 10 Years after Nephrectomy : A Case Report].

Hinyokika Kiyo 2016 Aug;62(8):407-10

The Department of Pathology, Sakai City Medical Center.

A 71-year-old woman underwent left radical nephrectomy for renal cell carcinoma (clear cell carcinoma, pT1bN0M0) ten years previously. She noticed a tumor on the tip of her tongue and was admitted for dental and oral surgery. The tumor was about 10 mm in size, and tumor resection was done. It was pathologically diagnosed as clear cell carcinoma, which was metastasis of renal cell carcinoma. Computer tomography scan during the same period revealed left hilar lymph node and bilateral lung metastases. We chose to use sunitinib as the treatment for the metastases. Computer tomography revealed a complete response (CR) after sunitinib treatment was given for 10 months, and we are still continuing the treatment to maintain the CR status.
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http://dx.doi.org/10.14989/ActaUrolJap_62_8_407DOI Listing
August 2016

[A Case of Arteriovenous Malformation Located in Retroperitoneum].

Hinyokika Kiyo 2016 Mar;62(3):127-30

The Department of Pathology, Sakai City Medical Center.

A 67-year-old woman was referred to our hospital for precise examination and treatment as an abdominal computed tomographic (CT) scan showed a retroperitoneal tumor located below the hilus of the right kidney. The enhanced CT and magnetic resonance imaging (MRI) revealed contrast enhancement in both early and late phase, which confirmed that the tumor showed abundant blood perfusion and adhered to the duodenum. We performed open surgery in order to remove the tumor and make a precise diagnosis. The tumor was excised en bloc with a part of the gonadal vein because the right gonadal vein was adjacent to the tumor in the craniocaudal direction. The pathological diagnosis was arteriovenous malformation. Arteriovenous malformation located in the retroperitoneum is very rare.
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March 2016

L5 Radiculopathy due to Foraminal Stenosis Accompanied With Vacuum Phenomena of the L5/S Disc on Radiography Images in Extension Position.

Spine (Phila Pa 1976) 2015 Dec;40(23):1831-5

Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Study Design: Retrospective study for L5 radiculopathy due to foraminal stenosis with vacuum phenomena (VP) at the L5/S disc.

Objective: To investigate the influence of the L5/S VP on L5 radiculopathy, due to L5/S foraminal stenosis.

Summary Of Background Data: Foraminal stenosis has often been detected via images. However, although this condition is well known, it is occasionally overlooked during diagnosis, because spinal nerve compression is not always visible on stationary images.

Methods: Patients who underwent lumbar spine surgery were examined to determine the presence of foraminal stenosis (n = 194). The presence of VP and the range of motion of the L5/S disc were assessed on radiography with the lumbar spine in the extended and flexed positions. The shapes of the L5/S foramina were confirmed using sagittal magnetic resonance imaging. Patients who showed VP were divided into 2 groups: patients with (group A) and without (group B) symptomatic foraminal stenosis. The relationship between the VP and symptomatic foraminal stenosis was examined.

Results: In total, 35 cases of VP at the L5/S disc were noted on lateral radiography. L5 radiculopathy due to L5/S foraminal stenosis was identified in 14 of these 35 cases. The ranges of L5/S angles were 10° ± 4° and 5° ± 3° in groups A and B, respectively, and these values were significantly different (P < 0.01). 11 (48%) of 23 L5/S foramina that showed VP of the L5/S disc and were completely occupied by a disc below the caudal edge of the vertebra had symptomatic foraminal stenosis.

Conclusion: Our results indicated that VP, which showed a large range of motion angle between flexion and extension, triggered symptoms of foraminal stenosis at the L5/S disc. The dynamic motion of the VP should thus be considered for the diagnosis of L5/S foraminal stenosis.

Level Of Evidence: 3.
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http://dx.doi.org/10.1097/BRS.0000000000001067DOI Listing
December 2015

Drop metastasis of adrenocorticotropic hormone-producing pituitary carcinoma to the cauda equina.

Asian Spine J 2014 Oct 18;8(5):680-3. Epub 2014 Oct 18.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

The diagnosis of pituitary carcinoma cannot be made easily histologically, and most cases of pituitary carcinoma are diagnosed only after the clinical detection of metastasis. Distant metastasis of pituitary tumor occurs in 0.1% to 0.2% of cases and has been reported in the liver, bone and central nervous system, with only one case of metastasis to the cauda equine reported. This study describes a rare case of the drop metastasis of adrenocorticotropic hormone-producing pituitary adenocarcinoma to the cauda equina, causing cauda equina syndrome.
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http://dx.doi.org/10.4184/asj.2014.8.5.680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4206820PMC
October 2014

Reduction of caudal traction force using dural sac opening rather than spinal cord detethering for tethered cord syndrome caused by lipomyelomeningocele: a case report.

Spine J 2014 Oct 5;14(10):e1-3. Epub 2014 Mar 5.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, 8-1 Kawadacho, Shinjuku, Tokyo, Japan.

Background Context: A few reports have addressed tethered cord syndrome. Detethering surgery has been performed in these cases because abnormal tension on the spinal cord causes neurologic and urologic symptoms.

Purpose: To discuss the surgical treatment of tethered cord syndrome with the belief that the tension on the cord can be decreased by shifting tethered cord to the dorsal side.

Study Design: A patient with tethered cord syndrome was surgically treated by shifting the tethered cord to the dorsal side by harnessing the lumbar lordosis instead of detethering.

Methods: We performed surgery to shift the tethered cord to the dorsal side by harnessing the lumbar lordosis to decrease the tension on the spinal cord.

Results: The tethered cord that was pressed to the ventral side because of a lipoma was shifted dorsally by laminectomy and opening of the dural sac. Pain and numbness were alleviated immediately after surgery.

Conclusions: The method used in the present case, that is, shifting the tethered cord and lipoma to the dorsal side by harnessing the lumbar lordosis instead of detethering, is a viable treatment option for tethered cord syndrome.
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http://dx.doi.org/10.1016/j.spinee.2014.02.031DOI Listing
October 2014

Low parathyroid hormone levels in patients who underwent/would undergo hemodialysis result in bone graft failure after posterolateral fusion.

Spine (Phila Pa 1976) 2014 Feb;39(4):327-31

From the Department of Orthopedic Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.

Study Design: Case series.

Objective: To reveal the association between levels of parathyroid hormone (PTH) and outcome of bone fusion in patients who underwent/would undergo hemodialysis.

Summary Of Background Data: Among the different bone lesions observed in patients who underwent/would undergo hemodialysis, adynamic bone disease is regarded as a factor associated with bone graft failure because of severely reduced bone turnover. Although PTH levels reflect the pathological findings of bone lesions in patients who underwent/would undergo hemodialysis, the relationship between PTH levels and the outcome of bone fusion in patients who underwent/would undergo hemodialysis has not been investigated.

Methods: Patients who underwent/would undergo hemodialysis (n = 48) with lumbar spine lesion underwent posterolateral spinal fusion with instrumentation. The outcome of bone fusion was assessed radiographically 12 months after surgery, and sensitivity and specificity were determined using preoperative PTH levels as the standard.

Results: A significant difference in PTH levels was observed between the good fusion (mean, 235.4 pg/mL) and poor fusion (mean, 100.0 pg/mL) groups. The intersection of the sensitivity and specificity plots, generated using preoperative PTH levels, was 150 pg/mL, and the area under the receiver operating characteristic curve was 0.72.

Conclusion: Low PTH levels are a risk factor for bone graft failure in patients who underwent/would undergo hemodialysis. Accordingly, PTH level can be a useful predictor of the outcome of bone fusion.

Level Of Evidence: 4.
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http://dx.doi.org/10.1097/BRS.0000000000000132DOI Listing
February 2014

[Urinary re-diversion using afferent limb as an ileal conduit for urethral recurrence after ileal neobladder reconstruction by Studer method : a case report].

Hinyokika Kiyo 2013 Oct;59(10):677-81

The Department of Urology, Sakai City Hospital.

A 68-year-old man who had previously undergone radical cystectomy and ileal neobladder reconstruction by the Studer method for invasive bladder cancer one year ago was urgently admitted to our hospital with gross hematuria and severe anemia. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed an expanded ileal neobladder with a huge coagulum and tumor. Cystoscopy showed a non-papillary tumor occurring from the urethral anastomotic region toward the ileal neobladder and suggested the possibility of partial invasion to the ileal neobladder wall. The pathologic diagnosis of transurethral resection was invasive urothelial carcinoma, high grade, G3. We performed resection of ileal neobladder and urinary re-diversion using an afferent limb as ileal conduit. Unfortunately, in this case, a radical cure was not provided, but we considered that urinary re-diversion using an afferent limb as ileal conduit can be a useful option for urethral recurrence after ileal neobladder reconstruction.
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October 2013

Spinal cord infarction in diabetic pregnancy: a case report.

J Obstet Gynaecol Res 2013 Oct 15;39(10):1471-5. Epub 2013 Jul 15.

Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo, Japan.

Spinal cord infarction (SCI) is uncommon as compared to cerebral stroke. Moreover, SCI during pregnancy is rare. Here, we report a case of SCI in diabetic pregnancy, properly diagnosed, promptly treated, and a good prognosis achieved. A 38-year-old, pregnant woman, para 1, with type 1 diabetes mellitus on insulin since 14 years of age, was admitted to our hospital for paresthesia and numbness in the lower left side of the body, with movement disturbances. On the basis of the temporal profile of the onset and the multiple resonance imaging scans, SCI was diagnosed. Steroid pulse therapy and low-dose aspirin administration was initiated. Her symptoms were improved and discharged. A repeat cesarean section was performed at 37 weeks of gestation and her postoperative course was uneventful. Her daily activities were not hindered severely, though she experienced defecation discomfort.
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http://dx.doi.org/10.1111/jog.12087DOI Listing
October 2013

Clinical outcome of percutaneous drainage for spondylodiscitis.

J Neurol Surg A Cent Eur Neurosurg 2014 Jan 20;75(1):7-11. Epub 2013 May 20.

Department of Orthopedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Background: Although vertebral debridement with interbody fusion is a useful procedure for the treatment of spondylodiscitis, anterior interbody fusion (AIF) is risky to perform on patients in a poor condition since it is highly invasive. Percutaneous nucleotomy and drainage (PND) is less invasive than AIF, but there only have been few reports regarding the outcome. The purpose of this study was to test the efficacy of PND for spondylodiscitis.

Patients And Methods: To analyze the effectiveness of different surgical treatments, 111 patients with spondylodiscitis were studied retrospectively. The average durations from the start of treatment until the C-reactive protein fell below 1.0 mg/dL or below the baseline value, which was defined as "recovery time" in the present study, were compared among PND, AIF, and posterior decompression.

Results: PND was performed when conservative treatment has been done for average 2.0 ± 0.9 months. Of the 18 PND patients, 15 (83%) showed recovery; 63 (97%) of the 65 patients who had AIF showed recovery. There was no significant difference of the mean recovery time after PND and AIF. All 10 patients whithout methicillin-resistant Staphylococcus aureus (MRSA) recovered after PND, whereas 3 of 8 patients with MRSA did not recover after PND. Of the 3 unsuccessful PND cases, 1 later had AIF, and 1 repeated PND. One patient could not undergo additional surgery because of a poor general condition.

Conclusions: Although the results of PND were inferior to AIF, PND is a useful next step after conservative treatment for patients in a poor condition. PND can be the initial procedure for spondylodiscitis before AIF if its limitations are understood.
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http://dx.doi.org/10.1055/s-0033-1334490DOI Listing
January 2014

Interscalene brachial plexus block for scapular and upper chest pain due to cervical radiculopathy: a randomized controlled clinical trial.

J Orthop Sci 2012 Sep 25;17(5):515-20. Epub 2012 Jul 25.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Tokyo, Japan.

Background: Animal experiments have shown that one of the pathways for pain originating from the cervical spine is the sympathetic trunk. However, there have been few reports regarding the cervical pain pathway and efficacy of interscalene brachial plexus block for upper limb, scapular and chest pain originating in the cervical spine in clinical cases. The purpose of the present study was to clarify the efficacy of interscalene brachial plexus block for upper limb, scapular and chest pain.

Methods: Patients (137 men and 223 women) who had cervical radicular pain were studied. The intensity of upper limb, scapular and chest pain was measured by using a VAS before injection and at 5 min and 7 days after injection. To evaluate the efficacy of interscalene brachial plexus block, patients with cervical radicular pain who had received NSAIDs for at least 2 weeks were randomized to interscalene brachial plexus block or control block groups. VAS scores were compared to assess the effects of injection and the pain pathway.

Results: The average VAS score for upper limb pain with or without scapular and chest pain was significantly reduced by interscalene brachial plexus block compared with control block at 5 min and 7 days after injection. After interscalene brachial plexus block, 89 patients reported symptoms of stellate ganglion block versus no patients after control block. Scapular and chest pain was significantly reduced in the patients with stellate ganglion block compared to those without stellate ganglion block.

Conclusions: Interscalene brachial plexus block is useful for upper limb, scapular and chest pain due to disorders of the cervical spine. The scapular and chest pain pathway is more likely to be interrupted by an interscalene brachial plexus block that causes a stellate ganglion block compared to an interscalene brachial plexus block without stellate ganglion block.
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http://dx.doi.org/10.1007/s00776-012-0248-2DOI Listing
September 2012

TRPV4-associated skeletal dysplasias.

Am J Med Genet C Semin Med Genet 2012 Aug 12;160C(3):190-204. Epub 2012 Jul 12.

Génétique Médicale, CHUV, Av. Decker 2, 1011 Lausanne, Switzerland.

Dominant mutations in the TRPV4 gene result in a bone dysplasia family and form a continuous phenotypic spectrum that includes, in decreasing severity, lethal, and nonlethal metatropic dysplasia (MD), spondylometaphyseal dysplasia Kozlowski type (SMDK), and autosomal dominant brachyolmia. Several rare variant phenotypes that have some overlap but deviate in some ways from the general pattern have also been described. The known variant phenotypes are spondyloepiphyseal dysplasia Maroteaux type (Pseudo-Morquio type 2), parastremmatic dysplasia, and familial digital arthropathy with brachydactyly. Interestingly, different TRPV4 mutations have been associated with dominantly inherited neurologic disorders such as congenital spinal muscular atrophy and hereditary motor and sensory neuropathy. Finally, a small number of patients have been identified in whom a TRPV4 mutation results in a phenotype combining skeletal dysplasia with peripheral neuropathy. The TRPV4 gene encodes a regulated calcium channel implicated in multiple and diverse cellular processes. Over 50 different TRPV4 mutations have been reported, with two codons appearing to be mutational hot spots: P799 in exon 15, mostly associated with MD, and R594 in exon 11, associated with SMDK. While most pathogenic mutations tested so far result in activation of the calcium channel in vitro, the mechanisms through which TRPV4 activation results in skeletal dysplasia and/or peripheral neuropathy remain unclear and the genotype-phenotype correlations in this group of disorders remains somewhat mysterious. Since the phenotypic expression of most mutations seems to be relatively constant, careful clinical and radiographic assessment is useful in directing molecular analysis.
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http://dx.doi.org/10.1002/ajmg.c.31335DOI Listing
August 2012

Efficacy and safety of firocoxib for the treatment of pain associated with soft tissue surgery in dogs under field conditions in Japan.

J Vet Med Sci 2012 Oct 31;74(10):1283-9. Epub 2012 May 31.

Merial Japan, Tokyo Opera City Tower, 3-20-2 Nishi Shinjuku, Shinjuku, Tokyo, Japan.

Use of firocoxib in dogs for postoperative pain control has not been published in any of the journals in Japan. A field study was conducted to evaluate the efficacy and safety of firocoxib in dogs in controlling pain associated with soft tissue surgery in Japan. The study followed a negative control, double-blind, multicenter clinical efficacy study using a randomized block design. A total of 131 client-owned dogs presented to the clinical practices for soft tissue surgery were enrolled. Sixty-nine dogs were allocated to the firocoxib-treated group and received 5 mg/kg of firocoxib orally on Day 0 before the surgery and once daily through Day 2, while 62 dogs were allocated to the non-treated group handled in a similar manner only without the firocoxib administration. Pain assessment took place on Day 0 before the surgery through Day 2. The primary efficacy variable was a success/failure variable based on whether the dog needed rescue medication (based on pain assessment after the surgery or Investigator's judgment) and a significant difference between firocoxib-treated group (16.4%) and non-treated group (50.0%) (P=0.0031) was observed. There was no adverse event during the study that was considered to be related to the administration of firocoxib. This study indicated the clinical efficacy and safety profile of firocoxib administered to control pain associated with soft tissue surgery under field condition.
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http://dx.doi.org/10.1292/jvms.11-0306DOI Listing
October 2012

Efficacy and limitations of intraoperative spinal cord monitoring using nasopharyngeal tube electrodes.

J Neurosurg Spine 2010 Aug;13(2):200-10

Department of Orthopaedic Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Chiba, Japan.

Object: Motor evoked potentials are widely used for intraoperative spinal cord monitoring. However, there are problems with anesthetic constraints and high trial-by-trial variability of compound muscle action potential amplitude in muscle motor evoked potential monitoring. It is difficult to determine when to warn the surgeon of an occurrence of spinal cord risk. A method of estimation for motor function in the spinal cord has not been established. To monitor spinal cord function with reliable evoked potentials, including the upper cervical spinal cord and the ventral spinal cord, the authors developed a nasopharyngeal tube electrode that can be placed in front of the upper and ventral cervical spinal cord. The purpose of this study was to investigate the origins and pathways of descending or ascending spinal cord evoked potentials (SCEPs) elicited with this electrode, and the usefulness and limitations of this method.

Methods: A nasopharyngeal tube electrode was inserted into the nostril. A catheter electrode was placed in the epidural or subarachnoid space at the thoracic spine. Ventral SCEP was recorded from the thoracic spinal cord after transpharyngeal stimulation, and dorsal SCEP was recorded with the nasopharyngeal electrode after thoracic spinal cord stimulation. There was no restriction of anesthetic technique in recording. When the amplitude of either of the SCEPs declined to 80% of the baseline, a warning was provided to the surgeon during the observed operative procedure. At the end of surgery, less than 50% or more than 30% of the baseline amplitude was considered a significant change in both SCEPs. The sensitivity and specificity for both SCEPs to detect neurological deterioration were calculated.

Results: The electrode provided noninvasive access to the ventral cervicomedullary junction. The SCEPs showed stable responses. A response change was only observed in situations involving a risky procedure for the spinal cord. Ventral SCEPs showed high sensitivity (73.1%) for identifying patients with new neurological deficits or an exacerbation of preexisting neurological deficits after surgery, but dorsal SCEPs showed lower sensitivity (46.1%) in the total number of cases. Both SCEPs showed high specificities. The sensitivities of ventral SCEP, dorsal SCEP, and either SCEP were 100.0%, 50.0%, and 100.0% for the upper cervical spinal cord, 33.3%, 0%, and 55.6% for the lower cervical spinal cord, and 77.8%, 64.7%, and 88.2% for the thoracic spinal cord.

Conclusions: Combined recording of both SCEPs estimated the ventral and dorsal white matter function in the spinal cord. Measuring the SCEPs with the nasopharyngeal electrode can be another useful approach for upper cervical and thoracic spinal cord monitoring. Ventral SCEP was more reliable for monitoring postoperative spinal cord function than dorsal SCEP. Ventral SCEP does not estimate the gray matter and spinal root functions in the lower cervical spinal cord.
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http://dx.doi.org/10.3171/2010.3.SPINE08298DOI Listing
August 2010

Erythematous and bullous rash strongly indicating toxic epidermal necrolysis associated with the use of intravenous ritodrine hydrochloride.

J Obstet Gynaecol Res 2010 Jun;36(3):676-80

Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo, Japan.

Toxic epidermal necrolysis (TEN) is a very rare drug reaction associated with a high mortality rate. This condition warrants prompt recognition, diagnosis and treatment. Only one case report of TEN that was possibly induced by ritodrine hydrochloride, a tocolytic agent, was found in English literature. Here, we report the case of a 26-year-old pregnant woman who was suspected with TEN following the intravenous administration of ritodrine hydrochloride in the 35(th) week of gestation. An emergency cesarean section was performed because the labor pains caused systemic intolerable haphalgesia. After the surgery, intensive dermatological treatment commenced, which helped her recover from the serious condition. The result of the drug-induced lymphocyte stimulation test for ritodrine hydrochloride was positive. When a skin eruption appears during the administration of ritodrine, we must consider the benefits as well as the risks of continuous use of tocolytic agents because there is a risk of Stevens-Johnson syndrome or TEN.
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http://dx.doi.org/10.1111/j.1447-0756.2010.01173.xDOI Listing
June 2010

Type-I interferon receptor expression: its circadian rhythm and downregulation after interferon-alpha administration in peripheral blood cells from renal cancer patients.

Int J Urol 2009 Apr 18;16(4):356-9. Epub 2009 Mar 18.

Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Objectives: To investigate the regulation of interferon-alpha (IFN-alpha) receptor expression in metastatic renal cell carcinoma (RCC) after IFN-alpha administration.

Methods: Blood sampling was carried out in eight patients with metastatic RCC and six healthy volunteers. Flow-cytometric analysis using a monoclonal antibody against the active subunit of the type-I IFN-alpha receptor (IFNAR2) was carried out to examine the circadian rhythm of IFNAR2 expression in peripheral blood mononuclear cells (PBMC) as well as its downregulation after IFN-alpha administration.

Results: According to its circadian rhythm IFNAR2 in PBMC had a peak expression at night. Once IFN-alpha is administered, IFNAR2 levels in PBMC showed downregulation within 48 h and recovered within another 48 h.

Conclusions: Our findings might support the establishment of an optimal schedule for IFN-alpha administration.
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http://dx.doi.org/10.1111/j.1442-2042.2009.02265.xDOI Listing
April 2009

Decreased immunostaining for macrophage scavenger receptor is associated with poor prognosis of prostate cancer.

BJU Int 2009 Feb 3;103(4):470-4. Epub 2008 Sep 3.

Department of Urology, Osaka University Graduate School of Medicine, Osaka, Japan.

Objective: The aim of this study is to evaluate the expression of the macrophage scavenger receptor (MSR) in prostate needle biopsy specimens as a possible prognostic factor for prostate cancer. As MSR reportedly has a role in recognizing foreign pathogenic substances, MSR-positive inflammatory cells are often detected in solid tumours, and there is a correlation between the relative risk of prostate cancer and polymorphism of the MSR gene.

Patients And Methods: MSR was evaluated by immunostaining in needle biopsies of the prostate from 135 patients who were confirmed to have prostate cancer. Among these men, 70 were treated by radical prostatectomy or by radiotherapy as definitive therapy; the other 65 were treated by hormonal therapy because of advanced disease or age. Needle-biopsy specimens were sectioned at 5 microm and immunostained with a monoclonal antibody against MSR. Six microscopic (x400) fields around the cancer foci were selected in each case for analysis.

Results: The median number of MSR-positive cells (MSR count) in each case was 24. There was an inverse correlation between the MSR count and Gleason score and clinical stage. The MSR count was lower in patients with biochemical (prostate-specific antigen, PSA) failure than that in those with no PSA failure (P < 0.001). In all patients, the recurrence-free survival (RFS) rate was significantly higher in those with a high MSR count (> or =24) than that in those with low MSR count (<24, P < 0.001). Moreover, for patients treated by definitive or hormonal therapy, the RFS rates in those with a higher MSR count were higher than in those with a lower MSR count (P < 0.001 and 0.014, respectively). Cox multivariate analysis showed that the MSR count was a prognostic factor for prostate cancer in addition to extraprostatic extension and Gleason score (P = 0.002, 0.038 and 0.011, respectively).

Conclusion: The results of immunostaining of MSR in needle-biopsy specimens is a prognostic factor for prostate cancer.
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http://dx.doi.org/10.1111/j.1464-410X.2008.08013.xDOI Listing
February 2009

Multifractal description of the maternal surface of the placenta.

Gynecol Obstet Invest 2008 7;66(2):127-33. Epub 2008 May 7.

Department of Obstetrics, Center for Perinatal Medicine, Nagano Children's Hospital, Nagano, Japan.

Background: Recently, multifractal analysis based on generalized concepts of fractals has been applied to biological tissues composed of complex structures.

Methods: Using digitized images of the maternal surface of 278 placentas, multifractal parameters were measured with a fractal analysis software.

Results: The values of alpha(min), alpha(0), alpha(max) and the degree of multifractality given by the alpha(max) - alpha(min) difference calculated from 278 placentas were 1.840 +/- 0.068, 2.089 +/- 0.034, 2.856 +/- 0.128 and 1.017 +/- 0.136, respectively. A significant decrease of alpha(min) and as a consequence a significant increase in the degree of multifractality were observed according to gestational age. The alpha(0) value of the placenta complicated by pregnancy-induced hypertension (PIH) was significantly higher than that without PIH. The alpha(min) and alpha(0) values of the placenta having intrauterine growth restriction (IUGR) were significantly higher than those without IUGR. On the other hand, the presence of chorioamnionitis did not change multifractal properties of the maternal surface of the placenta.

Conclusion: The multifractal parameters may be objective indices of the heterogeneity or complexity of the macroscopic morphology of the maternal surface of the placenta. Multifractal analysis holds a promise for quantitatively evaluating physiological and pathological development of the placenta.
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http://dx.doi.org/10.1159/000129671DOI Listing
December 2008

The growth-inhibitory effects of dexamethasone on renal cell carcinoma in vivo and in vitro.

Cancer Invest 2008 Feb;26(1):35-40

Department of Urology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Background: Recently, several kinase inhibitors have been reported to exert stronger growth inhibitory effects on metastatic renal cell carcinomas (RCCs) than cytokines such as interferons (IFNs) and interleukin-2 (IL-2). On the contrary, the adverse effects of these drugs are also severe. The aim of this study is to analyze the growth-inhibitory effects of DEXamethasone (DEX) on RCC in vivo and in vitro.

Methods: The MTT assay was performed using three RCC cell lines, OUR-10, Caki-1, and NC65. OUR-10 cells were subcutaneously transplanted to the dorsal area of nude mice. The nuclear translocation of glucocorticoid receptor (GR) and NF-kappa B was examined using appropriate antibodies. Concentrations of interleukin-6 (IL-6), IL-8, and vascular endothelial cell growth factor (VEGF) in the conditioned media and cytosol were measured by enzyme-linked immunosorbent assay (ELISA).

Results: All three RCC cell lines responded to DEX treatment. The growth of OUR-10 xenografts was significantly inhibited by administration of DEX. GR was translocated into the nucleus on DEX treatment. Intracellular IL-6, as well as IL-6 in the conditioned medium, decreased in OUR-10 cells following treatment with increasing amounts of DEX. Concentrations of IL-8 and VEGF in the conditioned medium of OUR-10 and NC65 cells also decreased following DEX treatment, with the inhibition of nuclear translocation of NF-kappa B.

Conclusion: DEX treatment is a candidate for advanced RCC therapy by inhibiting the activation of NF-kappa B and its downstream products such as IL-6, IL-8 and VEGF.
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http://dx.doi.org/10.1080/07357900701638418DOI Listing
February 2008

Nonlinear analyses of heart rate variability in monochorionic and dichorionic twin fetuses.

Gynecol Obstet Invest 2008 13;65(2):73-80. Epub 2007 Sep 13.

Department of Obstetrics, Center for Perinatal Medicine, Nagano Children's Hospital, Toyoshina, Azumino, Japan.

Aims: To examine whether the heart rate dynamics of a monochorionic diamniotic (MD) twin fetus is different from a dichorionic diamniotic (DD) twin fetus by nonlinear methods of time series analysis.

Methods: 32 fetal heart rate (FHR) recordings from healthy MD twin fetuses and 58 recordings from healthy DD twin fetuses were used. Nonlinear analyses included attractor reconstruction, calculation of the largest Lyapunov exponents, and estimation of correlation dimension.

Results: FHR of healthy twin fetuses was shown to have unique nonlinear characteristics. The largest Lyapunov exponent significantly increased during the pregnancy period. In 30-36 weeks, correlation dimension in MD twins was significantly lower than that in DD twins. In DD twins, we observed a significant increase of correlation dimension from 22-29 to 30-36 weeks. In 22-29 weeks, the difference of the values of correlation dimension in each MD twin pair was significantly lower than that in each DD twin pair.

Conclusions: The heart rate dynamics of healthy MD and DD twin fetuses becomes more chaotic according to gestational age. From the viewpoint of the FHR-regulating system, a pair of MD twins seems to have a more strict binding than a pair of DD twins before 30 weeks' gestation.
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http://dx.doi.org/10.1159/000108287DOI Listing
April 2008

Somatic mutations of the von Hippel-Lindau disease gene in renal carcinomas occurring in patients with long-term dialysis.

Nephrol Dial Transplant 2007 Jul 16;22(7):2052-5. Epub 2007 Apr 16.

Department of Specific Organ Regulation (Urology), Osaka University Graduate School of Medicine, and Department of Urology, Inoue Hospital, Suita, Japan.

Background: Renal cell carcinoma (RCC) frequently occurs in patients with long-term dialysis. Long-term dialysis causes distinctive pathological changes in the kidney, which is known as acquired cystic disease of the kidney (ACDK). It is of great interest to know whether RCCs occurring in the dialytic kidneys harbour the same or similar mutations of the von Hippel-Lindau (VHL) gene as conventional dialysis-unrelated clear cell RCCs so often do.

Methods: Renal cancer tissues (eight clear cell, two papillary, one Bellini duct and three of the so-called dialysis-specific renal carcinomas) from 13 patients undergoing long-term dialysis were examined for somatic mutations of the VHL disease gene. By means of laser capture microdissection, cancerous and surrounding non-cancerous renal tissues from dialytic patients were subjected to PCR-based direct sequencing of the VHL gene.

Results: Direct forward and reverse sequencing showed that three tumours possessed VHL gene mutations (713delG, 500-504del5-bp and 709A>G). These three mutations were identified in clear cell carcinomas occurring in association with end-stage renal disease undergoing dialysis for 194, 147 and 125 months. None of the non-tumour tissues or other carcinoma tissues analysed, including dialysis-specific carcinoma, possessed VHL gene mutations.

Conclusion: These results indicate that VHL tumour-suppressor gene mutation is involved in clear cell carcinoma in association with long-term dialysis. Mutation of the VHL gene was not found in any of the dialysis-specific RCCs studied herein.
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http://dx.doi.org/10.1093/ndt/gfm184DOI Listing
July 2007

Sesquiterpene lactone parthenolide suppresses tumor growth in a xenograft model of renal cell carcinoma by inhibiting the activation of NF-kappaB.

Int J Cancer 2007 Jun;120(12):2576-81

Department of Urology, Osaka University, Graduate School of Medicine, Suita-city, Osaka, Japan.

The transcription factor nuclear factor-kappaB (NF-kappaB) has been shown to be constitutively activated in various human malignancies, including leukemia, lymphoma and a number of solid tumors. NF-kappaB regulates the transcriptional of genes important for tumor invasion, metastasis and chemoresistance. The sesquiterpene lactone parthenolide, an inhibition of NF-kappaB, has been used conventionally to treat migraines and inflammation. In this study, renal cancer cell lines OUR-10 and ACHN were used for in vitro experiments to evaluate growth-inhibitory effects of parthenolide. An OUR-10 xenograft model in nude mice was also used to investigate the in vivo growth-inhibitory effects of parthenolide. Apoptosis in response to treatment of OUR-10 cells with parthenolide was confirmed. Localization of NF-kappaB in response to parthenolide treatment was examined of by immunofluorostaining of OUR-10 cells with antibody against NF-kappaB p65 and by Western blot analysis of OUR-10 cell and tumor nuclear and cytosol fraction. Parthenolide effectively inhibited proliferation of cultured OUR-10 cells and triggered apoptosis in vitro. Subcutaneous injection or oral administration of parthenolide showed significant tumor growth inhibition in the xenograft model via decreased production of interleukin-8 (IL-8) or vascular endothelial growth factor (VEGF). Immunohistochemistry and Western blot analysis showed decreased nuclear localization of NF-kappaB and phosphorylated NF-kappaB protein and subsequently expression of MMP-9, Bcl-xL and Cox-2 in response to parthenolide treatment. These results indicate that parthenolide is a useful in the treatment of renal cell carcinoma and acts via inhibition of NF-kappaB.
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http://dx.doi.org/10.1002/ijc.22570DOI Listing
June 2007

Acquired thoracolumbar kyphotic deformity treated by closing-opening wedge osteotomy.

J Orthop Sci 2007 Jan 31;12(1):89-92. Epub 2007 Jan 31.

Department of Orthopaedic Surgery, Tokyo Women's Medical University, School of Medicine, 8-1 Kawada-cho, Shinjuku, Tokyo, 162-8666, Japan.

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http://dx.doi.org/10.1007/s00776-006-1082-1DOI Listing
January 2007

Fractal analysis of the maternal surface of the placenta: preliminary report.

Gynecol Obstet Invest 2007 22;63(4):229-33. Epub 2006 Dec 22.

Department of Obstetrics, Center for Perinatal Medicine, Nagano Children's Hospital, Nagano, Japan.

Aims: The objective of this study was to determine whether the maternal surface of the placenta is fractal, and whether the mean fractal dimension differs according to the gestational age and clinically or pathologically different conditions.

Methods: Using digitized images of the maternal surface of 75 placentas, fractal dimensions were measured with a fractal analysis software.

Results: The mean fractal dimension of the maternal surface of the placentas significantly exceeded the topological dimension of a surface (= 2). This means that the morphological pattern of the maternal surface fulfills the mathematical definition of fractal structures. Among the three different groups of gestational age, the mean fractal dimension in 22-29 weeks was significantly lower than that in 30-36 and 37-41 weeks (p = 0.022 and 0.014, respectively). Although not significantly different (p = 0.149), in 30-36 weeks the mean fractal dimension of the placentas complicated by pregnancy-induced hypertension (PIH) was greater than that without PIH.

Conclusion: Fractal geometry, a vocabulary of irregular shapes, can be useful for describing quantitatively the architecture of the maternal surface of the placenta and become a useful tool for analyzing physiological and pathological placental formation mathematically.
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http://dx.doi.org/10.1159/000098198DOI Listing
June 2007

Drop of egg production in chickens by experimental infection with an avian metapneumovirus strain PLE8T1 derived from swollen head syndrome and the application to evaluate vaccine.

J Vet Med Sci 2006 Aug;68(8):783-7

Tsukuba Laboratories, Merial Japan Limited, Ibaraki, Japan.

Decreases in egg production and increased incidence of abnormal eggs due to malformation of egg shells were observed in specific pathogen free (SPF) 173-day-old laying hens inoculated intravenously with an avian metapneumovirus (aMPV) strain PLE8T1. This strain was derived from an isolate from broiler birds exhibiting swollen head syndrome (SHS). Some SPF birds inoculated with the virus showed, slight diarrhea without any respiratory symptoms. Thus, the PLE8T1 strain was used as a challenge virus to evaluate efficacy of aMPV vaccines. SPF chickens which received a live attenuated aMPV vaccine (NEMOVAC; Merial) at 7 or 77 days old and an inactivated aMPV vaccine (OVO-4; Merial) at 105 days old were protected against poor egg production caused by the challenge with the PLE8T1 strain. Thus, aMPV, the PLE8T1 strain passaged 22 times after isolation, from birds exhibiting SHS, could induce a drop in egg production in laying hens accompanied by malformation of egg shells. It was suggested that this challenge system could be applied to evaluate the efficacy of aMPV vaccine.
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http://dx.doi.org/10.1292/jvms.68.783DOI Listing
August 2006

Radiofrequency ablation for cystic adenomyosis: a case report.

J Reprod Med 2006 May;51(5):427-30

Department of Obstetrics and Gynecology, Teikyo University, School of Medicine, Kaga, Itabashi-ku, Tokyo, Japan.

Background: Cystic adenomyosis is an uncommon feature of adenomyosis, and women with the disease usually undergo laparotomy. We treated a case of cystic adenomyosis with radiofrequency ablation.

Case: A 21-year-old woman had severe dysmenorrhea supposedly caused by cystic adenomyosis. Under general anesthesia and ultrasound guidance, a radiofrequency needle was inserted into the cyst through the cervix, and the cyst was ablated. The procedures took about 15 minutes, with no complications. Lower abdominal pain and a high fever occurred 3 days later but disappeared soon after necrotic tissue was discharged. The cystic lesion disappeared, and the severity of the dysmenorrhea decreased by one-third as compared with that before the ablation.

Conclusion: This was the first case of cystic adenomyosis treated with radiofrequency ablation.
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May 2006

[Ureteral polyp resected with a ureteroscope: report of two cases].

Hinyokika Kiyo 2005 Dec;51(12):809-12

The Department of Urology, Osaka University Graduate School of Medicine.

Two cases of ureteral polyp resected by a transurethral approach are presented. Case 1: A 70-year-old woman was referred to our clinic because of hydronephrosis incidentally found. Excretory urography demonstrated a filling defect with a long and round smooth contour in the left lower ureter without hydroureter. Urine cytology was negative for malignant cells. Under the clinical diagnosis of left ureteral polyp, polyp was resected transurethrally. The pathological diagnosis was fibroepithelial polyp. Case 2: A 59-year-old woman was referred to our clinic with a chief complaint of macroscopic hematuria. Excretory urography revealed a filling defect with a long and round smooth contour in the left upper ureter. Because urine cytology was negative for malignant cells, left ureteral polyp was suspected. After the operation by tranthurethral approach, the pathological diagnosis was fibroepithelial polyp. No intraoperative complication was observed in either case. Ureteral polyps resected by a transurethral approach are relatively rare. We reviewed and discussed 46 cases of ureteral polyp resected transurethrally, reported in Japan including our two cases.
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December 2005
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