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Differential Risk Factors for Early Intravesical Recurrence After Radical Nephroureterectomy for Upper Urinary Tract Carcinoma According to the History of Non-Muscle Invasive Bladder Cancer
Get PDFObjectives: To evaluate the preoperative risk factors for early intravesical recurrence after radical nephroureterectomy (RNU) in patients with upper urinary tract carcinoma (UTUC) according to the history of non-muscle invasive bladder cancer (NMIBC).
Methods: We retrospectively evaluated patients who underwent RNU for UTUC between 2012 and 2022 at 14 hospitals. Early recurrence was defined as intravesical pathologically confirmed recurrence within 1 year after RNU. Patients who received single-dose immediate intravesical instillation (IVI) as prevention for intravesical recurrence were excluded. Using preoperative factors, we examined the risk factors for early intravesical recurrences in patients with and without a history of NMIBC. Death from any cause within 1 year after RNU was regarded as a competitive risk.
Results: We included 504 UTUC patients who were treated with RNU. Among these patients, 126 (25.0%) had a history of NMIBC, whereas 378 (75%) did not. According to multivariate analysis, the presence of macrohematuria, positive cytology in self-voided urine, and performing diagnostic ureteroscopy prior to RNU were risk factors in patients without a history of NMIBC. On the other hand, an NMIBC diagnosis within 1 year prior to RNU and an extravesical approach for bladder cuff management were risk factors in RNU-treated patients with a history of NMIBC.
Conclusions: Early intravesical recurrence risk factors differ between UTUC patients with and without a history of NMIBC. Different stratification may be needed to predict intravesical recurrence risk in these two types of UTUC patients.
Keywords: intravesical recurrence; non‐muscle invasive bladder cancer; radical nephroureterectomy; upper urinary tract carcinoma.journal articl
Water Vapor Energy Therapy Safely Reduces Urinary Medication Use: A Multicenter Retrospective Real-World Study in Japan (SCCOP Study 24-01)
Get PDFObjective: The Japanese guidelines for male lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH) recommend the water vapor energy therapy (WAVE) procedure only for patients in whom conventional BPH surgery is unsuitable due to advanced age or comorbidities. This study aims to evaluate the efficacy and safety of the WAVE procedure using the Rezum system in Japan.
Methods: This multicenter retrospective study included patients who underwent the WAVE procedure between August 2022 and December 2023. A total of 311 patients from 13 institutions were registered. The number of medications for LUTS was determined before surgery and 6 months after surgery. Additionally, voiding function and perioperative complications were analyzed.
Results: Of the 311 patients, 291 were eligible for analysis. The mean number of LUTS medications significantly decreased from 1.4 to 0.6 (p < 0.001). The mean maximum urinary flow rate significantly improved from 9.8 mL/s preoperatively to 12.2 mL/s at 6 months postoperatively (p < 0.001). The mean post-void residual volume also significantly decreased from 124 to 78 mL (p < 0.001). Furthermore, the mean total International Prostate Symptom Score significantly improved from 17.8 to 8.9 (p < 0.001). Complications classified as Clavien-Dindo Grade III or higher occurred in four cases (1.2%).
Conclusion: This large-scale, multicenter study demonstrates that the WAVE procedure improves LUTS, reduces the number of LUTS medications, and is both effective and safe for elderly patients with multiple comorbidities in Japan.journal articl
Practice and consideration of public relations for admissions combining various means
Get PDFThis paper introduces the admissions publicity activities of the School of Medicine and School of Health Sciences and discusses their effectiveness. We use a combination of diverse means to publicize admissions. For example, we offer open campus days, which include tours, lectures on medical professionals ’work, and individual consultations with current students to provide prospective students with a concrete image of the school. In addition, we believe that information sessions held by visiting high and preparatory schools directly communicate the university’s features and curriculum, increasing students’ motivation to pursue higher education and contributing to higher application rates. We publish a university guide booklet to convey the distinctive features and educational philosophy of Sapporo Medical University to prospective students and their parents. Additionally, we utilize our website and social networking service (SNS) to disseminate the latest information. We believe that by implementing these activities, we can achieve effective publicity and attract outstanding applicants. It is important to evaluate the effectiveness of each activity continuously to make future improvements.technical repor
Recombinant thrombomodulin and recombinant antithrombin attenuate pulmonary endothelial glycocalyx degradation and neutrophil extracellular trap formation in ventilator-induced lung injury in the context of endotoxemia
Get PDF研究論文紹介人工呼吸器関連肺障害の病態には人工呼吸による機械的ストレスだけでなく，血管内皮障害も関わるとされている．本研究では，リポポリサッカイライドの投与と高一回換気量による人工呼吸器関連肺障害モデルを用いて，血管内皮機能に重要な内皮グリコカリックス障害および好中球細胞外トラップ（NETs）形成の動態を評価し，組換えトロンボモジュリン（rTM）および組換えアンチトロンビン（rAT）の介入効果を検討した．rTMおよびrATはいずれも，グリコカリックス障害およびNETs形成を抑制し，肺障害の軽減に寄与した．othe
Single-cell profiling of acral melanoma infiltrating lymphocytes reveals a suppressive tumor microenvironment
Get PDF研究論文紹介掌蹠型黒色腫は，非白人において最も一般的なメラノーマのサブタイプである．がん免疫療法の進歩にもかかわらず，現在の免疫チェックポイント阻害薬は掌蹠型黒色腫に対して不十分なままである．そこで，掌蹠型黒色腫における腫瘍浸潤Tリンパ球のT細胞受容体の反応性スクリーニングと，単一細胞フェノタイピングを用いた包括的な免疫プロファイリングを行った．欧米型の紫外線誘発型の皮膚型メラノーマと比較して，掌蹠型黒色腫は腫瘍反応性CD8T 細胞に乏しく，制御性CD4T 細胞に富んでいた．腫瘍反応性CD8T 細胞は，免疫チェックポイント蛋白の不均一な発現を示し，KLRC1（NKG2A）を新たな治療標的分子として同定した．全体として，本研究は掌蹠型黒色腫における免疫抑制性腫瘍微小環境と，治療抵抗性を克服するための基礎を提供する．othe
LINC02154 promotes cell cycle and mitochondrial function in oral squamous cell carcinoma
Get PDF研究論文紹介新規口腔がん関連長鎖ノンコーディングRNA を同定するためにThe Cancer Genome Atlas（TCGA）の頭頚部癌の遺伝子発現データを解析し，LINC02154 を同定した．LINC02154 のノックダウンは口腔がんの細胞増殖を抑制し， アポトーシスを誘導した．LINC02154 はRNA 結合蛋白であるHNRNPK の発現調節を介して細胞周期関連遺伝子の転写因子であるFOXM1 を制御する事が明らかとなった．また，LINC02154 は酸化的リン酸化に関連するMT-CO1 等のミトコンドリア関連遺伝子の発現調節に関与し，ミトコンドリア機能を制御する事が明らかとなった．othe
Combined effect of early nutrition therapy and rehabilitation for patients with chronic obstructive pulmonary disease exacerbation: a prospective randomized controlled trial
Get PDF札幌医科大学博士（医学）doctoral thesi
Defecation disorder and anal function after surgery for lower rectal cancer in elderly patients
Get PDF札幌医科大学博士（医学）doctoral thesi