Yuji Tokuda

Management of extrinsic malignant ureteral obstruction with urinary diversion

Objective:  The effectiveness of urinary diversion for patients with renal insufficiency due to extrinsic ureteral obstruction was assessed.

Adipose tissue explants and MDCK cells reciprocally regulate their morphogenesis in coculture

Adipokine-producing fatty tissues, composed of preadipocytes, adipocytes, and mesenchymal stem cells, surround the kidney. To study the interaction between renal tubular cells and adipose tissue, we cocultured adipose tissue fragments and MDCK cells. MDCK cells in the coculture showed a taller columnar shape with improved organization of their microvilli and basal lamina than that seen in MDCK cell monoculture. The adipose tissue-induced change in morphology was replicated when we added leptin to MDCK cells cultured alone. Adiponectin abolished the leptin effect. Adipose tissue fragments inhibited MDCK cell division and also the formation of single-stranded DNA, an indicator of apoptosis. The fragments promoted the expression of polarity-associated proteins, including the tight junction molecules, ZO-1, atypical protein kinase C, and Cdc42. Further, the fragments also accelerated the expression of pendrin, the chloride/iodide transporter in the MDCK cells. In turn, MDCK cells decreased the number of preadipocytes and CD44+/CD105+ mesenchymal stem cells in the fragments, and promoted adiponectin production from the fragments. Thus, our study shows that adipose tissue fragments promote the hypertrophy, polarization, and differentiation of MDCK cells by attenuating their growth and apoptosis through opposing endocrine or paracrine effects of leptin and adiponectin. Further, MDCK cells inhibit the regeneration of preadipocytes and mesenchymal stem cells in adipose tissue.

Effects of adipocytes on the proliferation and differentiation of prostate cancer cells in a 3-D culture model.

Objective:  To investigate how the mechanism of adipocyte–prostate cancer cell interaction affects the proliferation and differentiation of prostate cancer cells.

Suture Granuloma Showing False-Positive Findings on FDG-PET

We report a case of a 33-year-old male with a mixed germ-cell testicular tumor. Postoperative follow-up FDG-PET revealed concentration of FDG in the left inguinal area which is not tumor metastasis or local recurrence but suture reactivity granuloma. In this paper, we reviewed suture granulomas associated with false-positive findings on FDG-PET after surgery. If FDG-PET will be used more frequently in the future, it will be necessary to refrain from using silk thread in order to prevent any unnecessary surgery.

Negative for High-Grade Urothelial Carcinoma (Negative)

All anatomic pathology diagnostic categories include one that infers that the patient has little if any risk of a significant disease. Cytologic terminology systems conform to that convention, although identifying cellular criteria that fit into that category can be challenging. The primary goal of The Paris System for Reporting Urinary Cytology (The Paris System) is to define changes that place the patient at significant risk for high-grade urothelial carcinoma (HGUC). The Paris System has adopted the philosophy that so long as a cause of cellular alterations can be identified and the cause is not life threatening, then the cellular sample belongs in the Negative for HGUC (NHGUC) category. Furthermore, since there also may be changes suggesting or indicating low-grade urothelial neoplasia (LGUN), the sample may still be placed in the Negative category, noting the additional possibility of LGUN. Certainly, if another neoplasm beside LGUN is present, that also will be indicated in the diagnostic decision for the patient.

Prostate‐specific antigen assay using whole blood samples spotted on filter paper and its application to mass screening for prostate cancer

Aim:  The disc assay system for prostate‐specific antigen (PSA) is a novel technique using a small amount of whole blood on filter paper. The accuracy of this assay system and its feasibility for use in prostate cancer mass screening were evaluated.

Adequacy of Urine Specimens (Adequacy)

Adequacy is a source of disagreement and controversy in all areas of cytopathology, and urinary tract specimens are no exception. For the purposes of this chapter, the term “adequacy” for urine specimens is used to refer to the usefulness of the specimen to diagnose or broach the suspicion of urothelial carcinoma. As such, adequacy of urine specimens for the diagnosis of urothelial carcinoma is determined by the interplay of four specimen characteristics: collection type, cellularity, volume, and cytomorphological findings. In this chapter, we introduce an algorithm for how these variables should be used to arrive at a systematic adequacy determination and how future investigations into the adequacy of urine specimens should be framed.

Is the eGFR formula adequate for evaluating renal function before chemotherapy in patients with urogenital cancer? A suggestion for clinical application of eGFR formula

BackgroundAccurate evaluation of renal function is required before cancer chemotherapy. Various kinds of formula have been developed for estimating creatinine clearance (Ccr) or glomerular filtration rate (GFR) conveniently. We retrospectively examined the reliability of the GFR estimating formula using the renal function data in cancer chemotherapy.MethodsClinical data of 12 patients with urogenital cancer from 1998 to 2013 in Saga University Hospital were reviewed. Patients were treated with 6–21 (median 10.5) courses of chemotherapy and those patients underwent 9–29 (median 14.5) times of 24hrCcr tests before and during chemotherapy. We compared estimated GFR (eGFR) with 24hrCcr. In addition, we developed a novel method to estimate the Ccr using the patient-inherent 24hrCcr/eGFR ratio, which is calculated from initial 3 or 4 determinations of 24hrCcr and the corresponding eGFR. Those estimated Ccrs were also compared with 24hrCcr.ResultsThe dissociation between 24hrCcr and eGFR was not constant, and a large dissociation was observed in some cases. The newly devised estimated Ccr demonstrated less dissociation from 24hrCcr compared with eGFR.ConclusionsThe eGFR formula is not adequate for the clinical use in cancer chemotherapy. The absolute value of eGFR is not reliable, but clinical use of eGFR as relative value seems to be acceptable. To avoid troublesome 24hrCcr measurement in long-term cancer chemotherapy, eGFR formula can be used for estimating Ccr in combination with the specific inherent 24hrCcr/eGFR ratio, which is obtained from 3 or 4 times of actual 24hrCcr measurements.

Usefulness of Blocksom vesicostomy in elderly men with chronic urinary retention and severe dementia.

In the present article, we present the usefulness of Blocksom vesicostomy in elderly men with chronic urinary retention.