Details of a Researcher - Oya, Mototsugu

Papers - Oya, Mototsugu

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PREDICTING PROSTATE SPECIFIC ANTIGEN RECURRENCE AFTER RADICAL PROSTATECTOMY BY CLINICOPATHOLOGICAL FACTORS: SUITABILITY OF MAGNETIC RESONANCE IMAGING

Hattori Seiya, Kosaka Takeo, Mizuno Ryuichi, Yasumizu Yota, Miyajima Akira, Nagata Hirohiko, Yazawa Satoshi, Kikuchi Eiji, Nakagawa Ken, Mikami Shuji, Tanimoto Akihiro, Jinzaki Masahiro, Oya Mototsugu

JOURNAL OF UROLOGY 189 ( 4 ) E99 - E99 2013.04

Research paper (scientific journal), Joint Work, ISSN 0022-5347

A prospective longitudinal survey of erectile dysfunction in patients with localized prostate cancer treated with permanent prostate brachytherapy

Matsushima Masashi, Kikuchi Eiji, Maeda Takahiro, Nakashima Jun, Sugawara Akitomo, Ando Toshiyuki, Mizuno Ryuichi, Nagata Hirohiko, Miyajima Akira, Shigematsu Naoyuki, Oya Mototsugu

Journal of Urology 189 ( 3 ) 1014 - 1018 2013.03

ISSN 0022-5347

Purpose: Few studies have evaluated changes in erectile function with time before and after prostate brachytherapy using the International Index of Erectile Function-15, a sensitive, validated tool for assessing male sexual dysfunction. In this prospective study we evaluated the natural history of erectile function after prostate brachytherapy without supplemental therapy (external beam radiotherapy, phosphodiesterase-5 inhibitors or androgen deprivation therapy) using the International Index of Erectile Function-15. Materials and Methods: We identified 119 patients who were followed at least 12 months after prostate brachytherapy between 2004 and 2010. Sexual and erectile function status were assessed before brachytherapy (baseline), and 3, 6, 12, 18, 24 and 36 months postoperatively using the International Index of Erectile Function-15. Results: Mean total International Index of Erectile Function-15 score, and scores on the erectile function, orgasmic function, sexual desire and intercourse satisfaction domains 3 months after brachytherapy were significantly lower than at baseline (p <0.05). They remained lower until 36 months after prostate brachytherapy. Erectile function was maintained 12 months after brachytherapy in 16 of the 48 men (33.3%) with a baseline erectile function domain score of 11 or greater. There was no significant difference in clinical features except the age of patients who maintained the erectile function domain score and their counterparts 12 months after brachytherapy. Multivariate analysis revealed that age 70 years or greater was the only predictive factor for deteriorating erectile function after brachytherapy (p = 0.035). Conclusions: Findings indicate a global decrease in all domains of the International Index of Erectile Function-15 score 12 months after prostate brachytherapy. Also, patient age may influence the preservation of brachytherapy related potency.

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Lymphoceles post radical prostatectomy

Yasumizu Yota, Miyajima Akira, Oya Mototsugu

Japanese Journal of Clinical Urology 67 ( 3 ) 241 - 245 2013.03

ISSN 0385-2393

What is the predictor of prolonged operative time during laparoscopic radical prostatectomy?

Kaneko Gou, Miyajima Akira, Yazawa Satoshi, Yuge Kazuyuki, Kikuchi Eiji, Asanuma Hiroshi, Nakagawa Ken, Oya Mototsugu

International Journal of Urology 20 ( 3 ) 330 - 336 2013.03

ISSN 0919-8172

Objectives: To study the impact of high body mass index and large prostate weight on operative time of laparoscopic radical prostatectomy. Methods: A retrospective analysis of medical records from patients who had undergone extraperitoneal laparoscopic radical prostatectomy by a single surgeon at our institution between September 2008 and April 2011 was carried out. For each case, the following parameters were recorded: age, body mass index, prostate weight, cross-section area of the Retzius space, and history of previous lower abdominal surgery, repeated prostate biopsy and neoadjuvant hormone therapy. The laparoscopic radical prostatectomy procedure was divided into seven surgical steps: (i) port insertion and lymph node dissection; (ii) endopelvic fascia incision; (iii) dorsal vein complex ligation; (iv) prostate dissection from bladder neck; (v) dissection of seminal vesicles and vas deferens; (vi) prostate dissection from rectum; and (vii) vesicourethral anastomosis. The overall operative time and the duration of each surgical step were retrieved. Potential predictors of prolonged total operative time and prolonged duration of a step were assessed by multivariate logistic regression analysis. Results: A total of 152 patients were analyzed. High body mass index (≥25.0kg/m²) and prostate weight were independent predictors of prolonged total operative time. High body mass index was an independent predictor of prolonged step1, 3, 4, 5 and 6. Prostate weight was an independent predictor of prolonged step2, 5 and 6. A history of previous lower abdominal surgery was a predictor of prolonged step1. Conclusions: High body mass index and high prostate weight are independent predictors of prolonged total operative time in extraperitoneal laparoscopic radical prostatectomy. Although high body mass index seems to affect most of the surgical steps of the procedure, prostate weight mainly impacts the dissection close to the prostate, as enlarged prostate results in a narrower working space.

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Induction of pluripotent stem cells from primordial germ cells by single reprogramming factors

Nagamatsu Go, Kosaka Takeo, Saito Shigeru, Honda Hiroaki, Takubo Keiyo, Kinoshita Taisuke, Akiyama Hideo, Sudo Tetsuo, Horimoto Katsuhisa, Oya Mototsugu, Suda Toshio

Stem Cells 31 ( 3 ) 479 - 487 2013.03

ISSN 1066-5099

Germ cells are similar to pluripotent stem cells in terms of gene expression patterns and the capacity to convert to pluripotent stem cells in culture. The factors involved in germ cell development are also able to reprogram somatic cells. This suggests that germ cells are useful tools for investigating the mechanisms responsible for somatic cell reprograming. In this study, the expression of reprograming factors in primordial germ cells (PGCs) was analyzed. PGCs expressed Oct3/4, Sox2, and c-Myc but not Klf4. However, Klf2, Klf5, Essrb, or Essrg, which were expressed in PGCs, could compensate for Klf4 during somatic cell reprograming. Furthermore, PGCs could be converted to a pluripotent state by infection with any of the known reprogramming factors (Oct3/4, Sox2, Klf4, and c-Myc). These cells were designated as multipotent PGCs (mPGCs). Contrary to differences in the origins of somatic cells in somatic cell reprogramming, we hypothesized that the gene expression levels of the reprogramming factors would vary in mPGCs. Candidate genes involved in the regulation of tumorigenicity and/or reprogramming efficiency were identified by comparing the gene expression profiles of mPGCs generated by the exogenous expression of c-Myc or L-Myc.

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Is inflammation related to any diseases?

Oya Mototsugu

International journal of urology : official journal of the Japanese Urological Association 20 ( 2 ) 135 2013.02

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Does laparoendoscopic single-site adrenalectomy increase surgical risk in patients with pheochromocytoma?

Hattori Seiya, Miyajima Akira, Maeda Takahiro, Hasegawa Masanori, Takeda Toshikazu, Kosaka Takeo, Kikuchi Eiji, Nakagawa Ken, Oya Mototsugu

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 27 ( 2 ) 593 - 598 2013.02

Research paper (scientific journal), Joint Work, ISSN 0930-2794

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Human castration resistant prostate cancer rather prefer to decreased 5 alpha-reductase activity

Kosaka Takeo, Miyajima Akira, Nagata Hirohiko, Maeda Takahiro, Kikuchi Eiji, Oya Mototsugu

SCIENTIFIC REPORTS 3 E304 - E305 2013.02

Research paper (scientific journal), Joint Work, ISSN 2045-2322

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Editorial Comment to How to prepare and present scientific manuscripts in English

Oya Mototsugu

International Journal of Urology 20 ( 2 ) 139 2013.02

ISSN 0919-8172

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New targeted agents for advanced renal cell carcinoma

Mizuno Ryuichi, Oya Mototsugu

Japanese Journal of Clinical Urology 67 ( 1 ) 67 - 72 2013.01

ISSN 0385-2393

Human castration resistant prostate cancer rather prefer to decreased 5α-reductase activity

Kosaka Takeo, Miyajima Akira, Nagata Hirohiko, Maeda Takahiro, Kikuchi Eiji, Oya Mototsugu

Scientific Reports 3 2013

Physiologically relevant steroid 5α-reductase (SRD5A) activity that is essential for dihydrotestosterone (DHT) biosynthesis in human castration-resistant prostate cancer (CRPC) has not been fully characterized yet. In this study to ascertain the potential SRD5A activity, we cultured two human CRPC cell lines, C4-2 and C4-2AT6, with the steroid precursor: ¹³C-[2,3,4]-androstenedione (¹³C-Adione), and analyzed the sequential biosynthesis of ¹³C-[2,3,4]-testosterone ( ¹³C-T) and ¹³C-[2,3,4]-DHT (¹³C-DHT) by liquid chromatography/mass spectrometry (LC/MS/MS). The ¹³C-DHT/ ¹³C-T concentration ratio detected by LC/MS/MS in C4-2AT6 cells appeared to reflect the SRD5A activity. The ratio in C4-2AT6 was significantly lower than that in C4-2. An increased concentration of DHT did not have a positive effect on cell proliferation, rather it exhibited inhibitory effects. 5α-reductase inhibitors did not have any inhibitory effect at clinically achievable concentrations. These results indicate that CRPC cells may have an unknown regulation system to protect themselves from an androgenic suppressive effect mediated by SRD5A activity.

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Chromophobe renal cell carcinoma, oncocytic variant

Kuroda Naoto, Tanaka Azusa, Yamaguchi Tadanori, Kasahara Kotaro, Naruse Keishi, Yamada Yosuke, Hatanaka Kanako, Shinohara Nobuo, Nagashima Yoji, Mikami Shuji, Oya Mototsugu, Hamashima Takeru, Michal Michal, Hes Ondrej

Medical Molecular Morphology 46 ( 1 ) 49 - 55 2013

ISSN 1860-1480

In chromophobe renal cell carcinoma (RCC), two forms of typical and eosinophilic variants have been reported to date. We have previously reported a new variant of chromophobe RCC, namely an oncocytic variant. However, little is known on the histological features of this variant. In this article, we report such five cases. Macroscopically, the tumor was well demarcated, but unencapsulated. The cut surface of the tumor showed brown in color, but neither hemorrhage nor necrosis was seen. Microscopically, the tumor consisted of predominant tubular configuration with or without various proportion of solid-sheet pattern. In one tumor, tumor cells microscopically invaded branches of renal vein. In addition, the constituting cells were characterized by the oncocytic cytoplasm, trivial to minimal variation in tumor size, indistinct to slightly distinct cell border, centrally located round nuclei and the absence of perinuclear halo. These characteristics entirely resembled renal oncocytoma. However, neoplastic cells immunohistochemically showed the diffuse and strong labeling for cytokeratin 7 and mitochondrial antigen in all cases. In addition, in fluorescence in situ hybridization (FISH) study the loss of more than four chromosomes among chromosomes 7, 10, 13, 17 and 21 was confirmed in all tumors and the diagnosis of chromophobe RCC was rendered. In conclusion, we propose a new variant, namely an oncocytic variant, of chromophobe RCC morphologically resembling renal oncocytoma and biologically showing characteristics of chromophobe RCC, and this recognition is practically crucial in the differential diagnosis from renal oncocytoma.

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Technical difficulties of transumbilical laparoendoscopic single-site adrenalectomy

Ishida Masaru, Miyajima Akira, Takeda Toshikazu, Hasegawa Masanori, Kikuchi Eiji, Oya Mototsugu

World Journal of Urology 31 ( 1 ) 199 - 203 2013

ISSN 0724-4983

Purpose: Interest in laparoendoscopic single-site (LESS) surgery has increased in recent years. The aim of this study was to evaluate the feasibility and safety of transumbilical LESS adrenalectomy and to elucidate the technical differences between LESS and conventional laparoscopic surgery. Methods: This study was comparing 10 consecutive transumbilical LESS adrenalectomies and 10 conventional laparoscopic adrenalectomies performed between March 2006 and April 2010 for benign adrenal tumors. Perioperative parameters were compared, and we reviewed our surgical videos and analyzed technical characteristics of the surgeries. Results: There was no open conversion in laparoscopic group, no additional port placement in LESS group, and no perioperative complications in either group. No significant differences in operative time, estimated blood loss, or resumption of oral intake were observed between two groups. Pneumoperitoneum time did not differ between LESS and laparoscopic groups (91. 2 vs. 74. 3 min, P = 0. 257). In LESS group only, time was needed for adjustment of roticulator (14. 5 ± 8. 1 min). After subtracting the time needed for adjustment, operative time between two groups was more comparable (76. 7 vs. 74. 3 min, P = 0. 880). One-handed manipulation time in LESS group decreased in a time-dependent manner (r = -0. 806, P < 0. 0049). Tissue re-grasping during operation was more frequently observed in LESS group (16. 2 vs. 2. 2 times, P < 0. 001). Conclusions: Transumbilical LESS adrenalectomy is feasible and comparable to conventional laparoscopic adrenalectomy. There are still obvious technical difficulties associated with LESS surgery, and it is essential that these be overcome in order to improve this surgical technique.

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What is the most effective tool for detecting prostate cancer using a standard MR scanner?

Osugi Kei, Tanimoto Akihiro, Nakashima Jun, Shinoda Kazunobu, Hashiguchi Akinori, Oya Mototsugu, Jinzaki Masahiro, Kuribayashi Sachio

Magnetic Resonance in Medical Sciences 12 ( 4 ) 271 - 280 2013

ISSN 1347-3182

Purpose: We aimed to determine which of the following magnetic resonance (MR) imaging sequences is most effective for detecting prostate cancer: T₂-weighted (T₂W), dynamic contrast-enhanced (DCE) T₁-weighted (T₁W), or diffusion-weighted (DWI) imaging or apparent diffusion coefficient (ADC) mapping. Materials and Methods: We included 37 male patients with prostate cancer who underwent MR imaging before radical prostatectomy in this retrospective study. Sixty-four foci (>5 mm in size; 35 in the peripheral zone [PZ], 29 in the transitional zone [TZ]) were histopathologically determined to be prostate cancer. We determined the capacity of T₂W, DCE-T₁W, DWI, ADC mapping alone, and the combination of ADC mapping with DWI, and conventional MR sequences to detect prostate cancer, including their sensitivity and positive predictive value (PPV), with reference to the results obtained in histopathological examinations of whole-mount sections. Results: In the PZ, sensitivities were 31.4% (T₂W), 37.1% (DCE-T₁W), 51.4% (DWI), and 71.4% (ADC mapping); PPVs were 78.6% (T₂W), 92.9% (DCE-T₁W), 94.7% (DWI), and 96.0% (ADC mapping). Sensitivity was significantly higher of ADC mapping than other sequences. In the TZ, sensitivities were 55.1% (T₂W), 44.8% (DCE-T₁W), 82.8% (DWI), and 89.7% (ADC mapping); PPVs were 64.0% (T₂W), 46.4% (DCE-T₁W), 70.6% (DWI), and 72.2% (ADC mapping). Sensitivity was significantly higher of ADC mapping and DWI than conventional MR imaging, but there was no significant correlation between DWI/ADC mapping and T₂W/DCE-T₁W with respect to PPVs. Combining sequences did not improve sensitivity; only the PPV in the TZ improved when ADC mapping was combined with DCE-T₁W. Conclusion: ADC mapping is the most effective standard MR imaging tool for detecting prostate cancer. The addition of DCE-T₁W may improve the PPV of ADC mapping for diagnosing cancer in the TZ.

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Burden of overactive bladder symptom on quality of life in stroke patients

Itoh Yoshiaki, Yamada Satoshi, Konoeda Fumie, Koizumi Kenzo, Nagata Hirohiko, Oya Mototsugu, Suzuki Norihiro

Neurourology and Urodynamics 32 ( 5 ) 428 - 434 2013

ISSN 0733-2467

Aims Overactive bladder (OAB) affects the daily life of many stroke victims. In contrast to urinary incontinence, little is known about the prevalence and risk factors for OAB among stroke patients. Therefore, we conducted a questionnaire survey and analyzed the results together with the clinical data and MRI findings. Methods A total of 500 volunteer patients with chronic-phase stroke were enrolled. The overactive bladder symptom score (OABSS), Short Form 8 (SF-8) health survey questionnaire, and some key international questionnaires about urinary dysfunction were assessed. Results We diagnosed 141 patients (28%) with OAB, among whom 103 (73%) had never been treated for their symptoms. Patients with OAB showed lower scores in both the physical and mental components of the SF-8, which suggested the burden of OAB on the quality of life of stroke patients. Advanced age and male gender were closely related to high OABSS. The modified Rankin Scale (mRS) was positively correlated with OABSS. Patients with cerebral infarction and those with intracerebral hemorrhage showed a similarly high OABSS. The severity of deep white-matter hyperintensity on MRI, classified by the 4-grade Fazekas scoring system, was significantly associated with high OABSS irrespective of presence of accompanying infarcts. Patients with cerebral infarcts in the region of anterior circulation showed a higher OABSS than those with cerebral infarcts in the posterior circulation. Conclusions Based on the present risk analysis, patient care should be preferentially focused on the detection and treatment of OAB to improve the quality of life of stroke patients.

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Effect of a novel nuclear factor-jb activation inhibitor on renal ischemia-reperfusion injury

Kono Hidaka, Nakagawa Ken, Morita Shinya, Shinoda Kazunobu, Mizuno Ryuichi, Kikuchi Eiji, Miyajima Akira, Umezawa Kazuo, Oya Mototsugu

Transplantation 96 ( 10 ) 863 - 870 2013

ISSN 0041-1337

Background. In kidney transplantation, the relationship between prolonged warm or cold ischemic storage of kidneys and a higher incidence of delayed graft function is previously known, and delayed graft function has been known to aggravate poor long-term graft survival. We investigated the effect of a novel nuclear factor-JB activation inhibitor, dehydroxymethylepoxyquinomicin (DHMEQ), on renal ischemia-reperfusion (I/R) injury. Methods. DHMEQ was administered to Lewis rats once just before renal artery clamping (DHMEQ pretreatment group), and the effect on I/R injury was investigated. Results. In the DHMEQ pretreatment group, the 24-hr urine volume on days 1 to 3 after I/R was significantly larger, and the protein concentration of the urine on days 2 to 7 was significantly smaller than in the untreated group. The serum creatinine level was significantly improved, and significantly lower levels of the inflammatory cells and inflammatory cytokines were present in the kidneys on day 1. The relative ratio of nuclear to cytoplasmic nuclear factor-JB and oxidative stress of kidney tissue on day 1 were significantly decreased. Conclusions. Treatment with DHMEQ before renal artery clamping may therefore be useful for renal I/R injury and application to renal transplantation is expected.

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Risk of subsequent tumour recurrence and stage progression in bacille Calmette-Guérin relapsing non-muscle-invasive bladder cancer

Matsumoto Kazuhiro, Kikuchi Eiji, Shirakawa Hiroshi, Hayakawa Nozomi, Tanaka Nobuyuki, Ninomiya Akiharu, Miyajima Akira, Nakamura So, Oya Mototsugu

BJU International 110 ( 11 B ) 2012.12

ISSN 1464-4096

OBJECTIVE • To investigate the risk of subsequent tumour recurrence and stage progression in bacillus Calmette-Guérin (BCG)-relapsing non-muscle-invasive bladder cancer, defined as recurrence after achieving a disease-free status for 6 months. PATIENTS AND METHODS • A total of 183 patients with BCGrelapsing tumours were treated with conservative therapy between 1985 and 2008 at our three institutions. • We analysed the association between their clinicopathological parameters and subsequent tumour recurrence or stage progression. RESULTS • Additional induction courses of BCG or anticancer drug (mitomycin C or epirubicin) instillations were performed in 119 patients and 24 patients, respectively. The remaining 40 patients did not undergo any adjuvant therapy. • Multivariate analysis showed that a relapsing tumour with a pathologically high risk (defined as tumours with G3 and/or pT1 and/or concomitant carcinoma in situ ) was a significant risk factor for subsequent tumour recurrence ( P = 0.002; hazard ratio [ HR ] 2.15). Additional BCG instillation significantly decreased the subsequent tumour recurrence rate ( P < 0.001; HR 0.41). • Multivariate analysis also showed that a relapsing tumour with a pathologically high risk was also significantly associated with stage progression ( P < 0.001; HR 8.05). CONCLUSIONS • An additional course of BCG instillation might be effective in patients with BCG-relapsing tumours with pathologically intermediate risk. • Nevertheless, some patients with high-risk pathological features developed subsequent stage progression. Such patients should be followed up closely and counselled on the need for aggressive therapeutic options, such as radical cystectomy.

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Visceral obesity is a strong predictor of perioperative outcome in patients undergoing laparoscopic radical nephrectomy

Hagiwara Masayuki, Miyajima Akira, Hasegawa Masanori, Jinzaki Masahiro, Kikuchi Eiji, Nakagawa Ken, Oya Mototsugu

BJU International 110 ( 11 C ) 2012.12

ISSN 1464-4096

OBJECTIVE • To examine the impact of visceral fat on surgical complexity in patients undergoing laparoscopic nephrectomy. PATIENTS AND METHODS • We reviewed the medical records of 121 patients who underwent laparoscopic nephrectomy from 2006 to 2010 at our institution. • The total fat area, visceral fat area (VFA) and subcutaneous fat area were measured at the level of the umbilicus using computed tomography (CT). • To identify the type of obesity, we divided VFA into ≥ 100 cm 2 and < 100 cm 2 . A VFA ≥ 100 cm 2 was used as the definition of visceral obesity. • We evaluated the impact of the VFA on technical difficulties encountered during laparoscopic nephrectomy by measuring operating time. RESULTS • A significant correlation was observed between body mass index (BMI) and operating time ( P < 0.001, r =0.316) in the patients undergoing laparoscopic nephrectomy. • VFA was also significantly correlated with operating time ( P < 0.001, r =0.348), and the correlation coefficient of VFA was higher than that of BMI. • Multivariate analysis showed that a high VFA was an independent risk factor for prolonged operating time ( P =0.009, odds ratio; 3.70), whereas BMI was not found to be a risk factor. CONCLUSIONS • The present data indicate that measurement of VFA by CT is of benefit for predicting the technical difficulty associated with laparoscopic radical nephrectomy. • Visceral obesity, which is one factor involved in metabolic syndrome, has a greater impact than BMI on the complexity of laparoscopic radical nephrectomy.

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Risk factors for perioperative complications of laparoscopic adrenalectomy including single-site surgery

Hattori Seiya, Miyajima Akira, Maeda Takahiro, Hasegawa Masanori, Takeda Toshikazu, Kosaka Takeo, Kikuchi Eiji, Nakagawa Ken, Shibata Hirotaka, Oya Mototsugu

Journal of Endourology 26 ( 11 ) 1463 - 1467 2012.11

ISSN 0892-7790

Purpose: To determine predictive factors for perioperative complications of laparoscopic adrenalectomy (LA) including single-site surgery performed or supervised by experienced laparoscopic surgeons. Patients and Methods: We retrospectively reviewed 265 consecutive unilateral LAs performed at a single institution from 2001 to 2011. All surgical procedures were performed or supervised by one of two experienced laparoscopic surgeons. The transabdominal approach was used in 248 patients, while a retroperitoneal approach was used in 17 patients. Laparoendoscopic single-site adrenalectomy was performed in 58 patients. Predictive factors for postoperative complications were analyzed. Results: There were no postoperative deaths. At least one postoperative complication occurred in 12 (4.6%) patients. No patient underwent reoperation for a complication. Only one (0.4%) patient's procedure was converted to open surgery, and only this patient needed a blood transfusion during the operation. One patient who underwent laparoendoscopic single-site adrenalectomy had the procedure converted to conventional laparoscopic adrenalectomy. Multivariable logistic regression analysis showed that an American Society of Anesthesiologists-physical status grade 3 or above was the only predictive factor for perioperative complications. Conclusion: American Society of Anesthesiologists-physical status grade 3 or above was a statistically significant factor for perioperative complications associated with laparoscopic adrenalectomy that involved laparoendoscopic single-site adrenalectomy, which was performed or supervised by an experienced laparoscopic surgeon. According to the findings of this retrospective study, single-site operation, obesity, adrenal tumor size, and tumor type may not be considered as risk factors for perioperative complications after LA performed or supervised by an experienced laparoscopic surgeon.

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[The molecular mechanisms of resistance to androgen deprivation therapy in prostate cancer].

Kosaka Takeo, Oya Mototsugu

Nihon rinsho. Japanese journal of clinical medicine 70 Suppl 8 353 - 359 2012.11

ISSN 0047-1852

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