Erratum: Intra-Operative Damage to the Pelvic Diaphragm Musculature and Difficulty in Exposure of the Urethra Are Risk Factors of Postoperative Urinary Incontinence after Laparoscopic Radical Prostatectomy: Review of Surgical Video

<i>Purpose: </i>The aim of this study was to clarify risk factors related to postoperative urinary incontinence after laparoscopic radical prostatectomy (LRP). <i>Patients and Methods: </i>Outcomes of 214 consecutive patients who underwent LRP at our institute between April 2001 and January 2009 were reviewed. Patients were divided into 2 groups, continent patients (group A: n = 172), who used one or fewer urinary pads per day 6 months after LRP, and incontinent patients (group B: n = 42), who used two or more pads per day 6 months after LRP. Patient age, prostate specific antigen before LRP, blood loss, duration of indwelling urethral catheter, and the positive margin rate between the 2 groups were compared. In addition, surgical videos were reviewed with attention paid to surgical procedures. We examined the correlation between the occurrence of urinary incontinence and the rate of patients with intra-operative damage to the pelvic diaphragm musculature and difficulty in exposure of the urethra during LRP. <i>Results: </i>There were no significant differences in patient age, prostate specific antigen before LRP, blood loss, duration of indwelling urethral catheter, positive margin rate between groups A and B. However, significant differences were found in the rate of patients with damage to the pelvic diaphragm musculature (16.3 and 73.8%, respectively) and difficulty in exposure of the urethra (20.9 and 83.3%, respectively) during LRP. <i>Conclusions: </i>Intra-operative damage to the pelvic diaphragm musculature and difficulty in exposure of the urethra during LRP are risk factors of urinary incontinence after LRP

Supplementary Material for: Novel Splice Site Mutation in MAMLD1 in a Patient with Hypospadias

<i>MAMLD1</i> is a causative gene for disorders of sex development. Several <i>MAMLD1</i> mutations have been shown to cause hypospadias by generating dysfunctional proteins and/or unstable mRNAs. Here, we identified an intronic mutation of <i>MAMLD1</i> (g.IVS4−2A>G) in 1 of 180 hypospadias patients. RT-PCR of the patient's skin sample showed normal expression of full-length<i> MAMLD1</i> and markedly reduced expression of a known splice variant lacking exon 4. A hitherto unreported splice variant that lacks exon 5 was similarly identified in samples of the patient and control individuals. The full-length transcript of the patient contained mutant mRNA lacking the first 10 nucleotides of exon 5 (c.1822_1831delACTCATGTAG, p.K609fsX1070). In vitro assays using cells expressing the full-length wild-type and mutant proteins revealed reduced expression of the mutant. The expression of the wild-type and mutant MAMLD1 showed parallel changes upon treatment with a proteasome inhibitor and a translation inhibitor. The mutant-expressing cells exerted low transactivation activity for the <i>Hes3</i> promoter, which reflected limited expression of the mutant protein. These results imply that the pathogenic events resulting from <i>MAMLD1</i> mutations include splice errors. Furthermore, this study raises the possibility of translation failure of MAMLD1 mutants, which deserves further investigation

Supplementary Material for: Endoscopic features of synchronous multiple early gastric cancers: Findings from a nationwide cohort

Introduction: We investigated the factors associated with synchronous multiple early gastric cancers and determined their localization. Methods: We analyzed 8191 patients who underwent endoscopic submucosal dissection for early gastric cancers at 33 hospitals in Japan from November 2013 to October 2016. Background factors were compared between single-lesion (n=7221) and synchronous multi-lesion cases (n=970) using univariate and multivariate analyses. We extracted cases with two synchronous lesions (n=832) and evaluated their localization. Results: Significant independent risk factors for synchronous multiple early gastric cancer were older age (≥75 years old) (OR=1.257), male sex (OR=1.385), severe mucosal atrophy (OR=1.400), tumor localization in the middle (OR=1.362) or lower region (OR=1.404), and submucosal invasion (OR=1.528 (SM1), 1.488 (SM2)). Depressed macroscopic type (OR=0.679) and pure undifferentiated histology OR=0.334) were more common in single early gastric cancers. When one lesion was in the upper region, the other was more frequently located in the lesser curvature of the middle region. When one lesion was in the middle region, the other was more frequently located in the middle region or the lesser curvature of the lower region. When one lesion was in the lower region, the other was more frequently located in the lesser curvature of the middle region or the lower region. Conclusion: Factors associated with synchronous multiple early gastric cancer included older age, male sex, severe mucosal atrophy, tumor localization in the middle or lower region, and tumor submucosal invasion. Our findings provide useful information regarding specific areas that should be examined carefully when one lesion is detected