Subacute adrenal hemorrhage by blunt abdominal contusion during snowboarding (Case report)

The adrenal glands lies deep in the abdomen, seemingly protected from blunt contusion. Wereport a case of a young female presenting left adrenal hemorrhage due to blunt abdominal contusioncaused by a collision during snowboarding, which was successfully treated with embolization

Structural diversity of cancer-related and non-cancer-related prostate-specific antigen

科学研究費補助金研究成果報告書研究種目: 基盤研究(C)研究期間: 2002～2003課題番号: 14571496研究代表者: 吉貴 達寛（滋賀医科大学・医学部・助教授）研究分担者: 若林 賢彦（滋賀医科大学・医学部・講師）研究分担者: 上仁 数義（滋賀医科大学・医学部・助手）研究分担者: 片岡 晃（滋賀医科大学・医学部・助手

Significance and development of Urine uroplakin III mRNA measurement in vesicoureteral reflux

科学研究費補助金研究成果報告書研究種目: 基盤研究(C)研究期間: 2005～2006課題番号: 17591673研究代表者: 上仁 数義（滋賀医科大学・医学部・助手）研究分担者: 吉貴 達寛（滋賀医科大学・医学部・助教授）研究分担者: 成田 充弘（滋賀医科大学・医学部・講師）研究分担者: 影山 進（滋賀医科大学・医学部・助手）研究分担者: 坂野 祐司（滋賀医科大学・医学部・助手

Development of combined tumor markers identified by proteomics in urothelial cancer

科学研究費補助金研究成果報告書研究種目: 基盤研究(C)研究期間: 2004～2005課題番号: 16591593研究代表者: 吉貴 達寛（滋賀医科大学・医学部・助教授）研究分担者: 若林 賢彦（滋賀医科大学・医学部・講師）研究分担者: 金 哲将（滋賀医科大学・医学部・講師）研究分担者: 成田 充弘（滋賀医科大学・医学部・助手）研究分担者: 上仁 数義（滋賀医科大学・医学部・助手

Identification of novel imprinted tumor suppressor gene on 14q for human renal mil carcinoma

科学研究費補助金研究成果報告書研究種目: 基盤研究(B)研究期間: 2005～2007課題番号: 17390438研究代表者: 川上 享弘（滋賀医科大学・医学部・非常勤講師）研究分担者: 岡本 圭生（滋賀医科大学・医学部・講師）研究分担者: 岡田 裕作（滋賀医科大学・医学部・教授）研究分担者: 成田 充弘（滋賀医科大学・医学部・講師）研究分担者: 上仁 数義（滋賀医科大学・医学部・助教）研究分担者: 牛田 博（滋賀医科大学・医学部・助教

Study of human uroplakin in various diseases of urinary tract

科学研究費補助金研究成果報告書研究種目: 基盤研究(C)研究期間: 2001～2002課題番号: 13671648研究代表者: 田中 努（滋賀医科大学・医学部・助手）研究代表者: 片岡 晃（滋賀医科大学・医学部・助手）研究分担者: 岡田 裕作（滋賀医科大学・医学部・教授）研究分担者: 吉貴 達寛（滋賀医科大学・医学部・助教授）研究分担者: 若林 賢彦（滋賀医科大学・医学部・講師）研究分担者: 金 哲将（滋賀医科大学・医学部・講師）研究分担者: 上仁 数義（滋賀医科大学・医学部・助手）研究分担者: 岡本 圭生（滋賀医科大学・医学部・助手

Prognostic nutritional index of early post-pembrolizumab therapy predicts long-term survival in patients with advanced urothelial carcinoma

Pembrolizumab has been widely used to treat advanced urothelial carcinoma that has progressed after first-line platinum-based chemotherapy. Because its clinical benefits are limited, biomarkers that can predict a good response to pembrolizumab are required. The prognostic nutritional index (PNI), calculated using the serum albumin level and peripheral lymphocyte count, has been evaluated as a predictive biomarker in cancer immunotherapy. The present study investigated the application of PNI as a predictive biomarker for pembrolizumab response in patients with advanced urothelial cancer. A retrospective study was conducted on 34 patients treated with pembrolizumab at Shiga University of Medical Science Hospital between January 2018 and July 2022. The posttreatment PNI (post-PNI) was calculated within 2 months of starting pembrolizumab. The present study investigated the association between post-PNI and objective response, overall survival (OS) and progression-free survival (PFS). The patient cohort was stratified into two categories, high and low post-PNI groups, with a cutoff value of post-PNI at 40. The higher post-PNI group demonstrated a better disease control rate than the lower post-PNI group (complete response + partial response + stable disease, 75 vs. 21%, P=0.004). Regarding median OS, the higher post-PNI group exhibited a significantly longer survival time than the lower post-PNI group (23.1 vs. 2.9 months, P<0.001). Similarly, the higher post-PNI group exhibited a significantly longer PFS than the lower post-PNI group (10.2 vs.1.9 months, P<0.001). Multivariate analysis showed that a higher post-PNI value was an independent predictor for OS (hazard ratio, 0.04; 95% confidence interval, 0.01-0.14; P<0.001) and PFS (hazard ratio, 0.12; 95% confidence interval, 0.04-0.35; P<0.001). The present study indicated that the post-PNI was a predictor of favorable clinical outcomes in patients treated with pembrolizumab for advanced urothelial carcinoma

Objective patterning of uroflowmetry curves in children with daytime and nighttime wetting.

PURPOSE: Pediatric uroflowmetry curve interpretation is incompletely standardized. Thus, we propose new, objective patterning. MATERIALS AND METHODS: Uroflowmetry curves were obtained in 100 children presenting with daytime incontinence or enuresis. Each curve was compared with a standard curve generated from a published nomogram and a new patterning method was formulated. Staccato and interrupted patterns were defined using International Children's Continence Society criteria. The remaining curves were divided by the deviation of the maximal flow rate from the median nomogram value as certain patterns, including tower-greater than 130%, not abnormal-70% to 130% and plateau-less than 70%. The correlation between the presenting symptom and patterns or other uroflowmetry parameters was evaluated. Six pediatric urologists also patterned the same curves subjectively. RESULTS: All curves could be classified as 1 of the defined patterns using this method. Pattern distribution reflected the spectrum of presenting symptoms with more tower, interrupted and staccato patterns in children with daytime wetting than in those with monosymptomatic enuresis. Age adjusted voided volume was also smaller in the former group but post-void residual urine, and maximal and average flow rates did not correlate with presenting symptoms. Subjective patterning showed marked interobserver differences. When patterning applied by the current method was used as a reference, observer sensitivity for abnormal patterns inversely correlated with specificity. CONCLUSIONS: Subjective uroflowmetry patterning is liable to personal bias. The proposed method enables objective patterning that complies with International Children's Continence Society standardization and clinical presentation

The location of the bladder neck in postoperative cystography predicts continence convalescence after radical prostatectomy

Abstract Background This study was conducted to determine whether the location of the bladder neck in postoperative cystography predicts recovery of continence after radical prostatectomy. Methods Between 2008 and 2015, 203 patients who underwent laparoscopic radical prostatectomy (LRP, n = 99) and robot assisted radical prostatectomy (RARP, n = 104) were analyzed. The location of the bladder neck was visualized by postoperative routine cystography, and quantitative evaluation of the bladder neck position was performed according to the bladder neck to pubic symphysis (BNPS) ratio proposed by Olgin et al. (J Endourol, 2014). Recovery of continence was defined as no pad use or one security pad per day. To determine the predictive factors for recovery of continence at 1, 3, 6 and 12 months, several parameters were analyzed using logistic regression analysis, including age (≤68 vs. > 68, BMI (≤23.4 vs. > 23.4 kg/m2), surgical procedure (LRP vs. RARP), prostate volume (≤38 vs. > 38 mL), nerve-sparing technique, vesico-urethral anastomosis leakage, and BNPS ratio (≤0.59 vs. > 0.59). Results The mean postoperative follow-up was 1131 days (79–2880). At 1, 3, 6 and 12 months after surgery, continence recovery rates were 25, 53, 68 and 81%, respectively. Although older age (> 68) and RARP were significant risk factors for incontinence within 3 months, neither was significant after 6 months. A high BNPS ratio (> 0.59) was the only significant risk factor for the persistence of incontinence at all observation points, up to 12 months. Conclusions A lower bladder neck position after prostatectomy predicts prolonged incontinence

A proposal of new concept of tumorgenesis in human testicular cancer by abnormal de-methylation of interspersed elements

科学研究費補助金研究成果報告書研究種目: 基盤研究(B)研究期間: 2007～2009課題番号: 19390413研究代表者: 岡本 圭生（滋賀医科大学・医学部・講師）研究分担者: 川上 享弘（滋賀医科大学・医学部・非常勤講師）研究分担者: 岡田 裕作（滋賀医科大学・医学部・教授）研究分担者: 上仁 数義（滋賀医科大学・医学部・助教）研究分担者: 牛田 博（滋賀医科大学・医学部・助教