Nobuo Tsuru

Increased Circulating Levels of Natriuretic Peptides Predict Future Cardiac Event in Patients with Chronic Hemodialysis

Background/Aim: Cardiovascular events are the major determinant of the prognosis in patients with chronic hemodialysis. The present study was designed to investigate whether increased plasma levels of atrial or brain natriuretic peptides (ANP or BNP) predict future cardiac events in such patients. Methods: Fifty-three patients undergoing chronic hemodialysis without clinical symptoms suggestive of cardiac disorders were enrolled and their blood was sampled for ANP and BNP measurements. Electrocardiograms demonstrated left ventricular hypertrophy in 28 patients but no other abnormal findings. We followed them up for 11.3 ± 0.2 months. The endpoint was cardiac events. Results: Cardiac events occurred in 13 patients (CE group). Both ANP and BNP levels were higher in CE group than in patients without cardiac events (ANP: 118 ± 21 vs. 56 ± 5 pg/ml, BNP: 769 ± 204 vs. 193 ± 25 pg/ml, respectively). Receiver operating characteristics curve revealed that the cut-off levels of ANP and BNP were 58 and 390 pg/ml, respectively. Using the Kaplan-Meier method, the incidence of cardiac events was significantly greater in patients with higher levels of ANP (50.0 vs. 0.0%) or BNP (72.7 vs. 11.9%) than in those with lower levels of the peptides. Conclusion: Elevated levels of ANP or BNP indicate an increased risk of cardiac events and these peptides are clinically useful to predict cardiac events in patients with hemodialysis.

Role of Doppler ultrasound and resistive index in benign prostatic hypertrophy

Background: The aim of the present study was to assess the resistive index in patients with benign prostatic hypertrophy (BPH) and the role of power Doppler ultrasonography.

Resistance index in benign prostatic hyperplasia using power doppler imaging and clinical outcomes after transurethral vaporization of the prostate

Abstract  Background:  Using power Doppler ultrasonography (PDUS), we investigate the change of resistance index (RI) before and after transurethral vaporization of the prostate (TUVP) in benign prostatic hyperplasia (BPH) patients.

Laparoscopic Nephrectomy, Ex Vivo Repair, and Autotransplantation for a Renal Artery Aneurysm : Report of a Case

A 57-year-old woman was hospitalized with a left renal artery aneurysm (RAA). The aneurysm measured 35 mm in diameter and was located at the renal artery bifurcation. We performed a laparoscopic nephrectomy using a retroperitoneal approach and performed an ex vivo repair of the renal artery. The reconstructed kidney was then autotransplanted at the left iliac fossa. The patients postoperative course was uneventful. A laparoscopic nephrectomy and ex vivo repair are both considered to be effective for treating complex RAA.

Comparisons of perioperative outcomes and costs between open and laparoscopic radical prostatectomy : A propensity-score matching analysis based on the Japanese Diagnosis Procedure Combination database

We compared perioperative outcomes and costs between open and laparoscopic radical prostatectomy for prostate cancer. The Japanese Diagnosis Procedure Combination database, including cases from 2007 to 2010, was used by one‐to‐one propensity‐score matching. The following items were compared: complication rate; homologous and autologous transfusion rate; first cystography day and cystography repeat rate; anesthesia time; postoperative length of stay; and costs. Multivariate analyses were carried out by including age, Charlson Comorbidity Index, T stage, hospital volume and hospital academic status as variables. As a result, among 15 616 open and 1997 laparoscopic radical prostatectomies, 1627 propensity‐score matched pairs were generated. The laparoscopic approach showed a better overall complication rate (3.4% vs 5.0%), homologous transfusion rate (3.3% vs 9.2%), autologous transfusion rate (44.9% vs 79.3%), first cystography day (mean 6th vs 7th day), mean postoperative length of stay (mean 11 vs 13 days), and cost without surgery and anesthesia (mean

Regional, institutional and individual factors affecting selection of minimally invasive nephroureterectomy in Japan: a national database analysis.

7965 vs

Retrograde flexible ureteroscopy-assisted retroperitoneal laparoscopic ureteroureterostomy for refractory ureteral stricture: A case report

9235; all P < 0.001). Anesthesia time was longer (mean 345 vs 285 min) and total cost was higher (mean

Laparoscopic repair of a ureteric sciatic hernia: report of a case.

14 980 vs

Retrospective comparative study of 59 cases of laparoscopic radical prostatectomy: Transperitoneal anterior versus transperitoneal posterior approach

12 356) for the laparoscopic approach (both P < 0.001). The secondary cystography rates were comparable between the groups (18.3% vs 15.7%, P = 0.144). The multivariate analyses showed similar trends. In conclusion, these findings confirm several benefits of laparoscopy over open approach for radical prostatectomy.

Relapse of scrotal calcinosis 7 years after primary excision.

To reveal individual, institutional and regional factors affecting selection of minimally invasive nephroureterectomy in Japan.