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        A preliminary oncologic outcome and postoperative complications in patients undergoing robotassisted radical cystectomy: Initial experience

        Satoru Muto,Kousuke Kitamura,Takeshi Ieda,Fumitaka Shimizu,Masayoshi Nagata,Shuji Isotani,Hisamitsu Ide,Raizo Yamaguchi,Shigeo Horie 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.3

        Purpose: Robot-assisted radical cystectomy (RARC) was originally intended to replace open radical cystectomy (ORC) as a minimally invasive surgery for patients with invasive bladder cancer. The purpose of this study was to evaluate the advantages of robotic surgery, comparing perioperative and oncologic outcomes between RARC and ORC. Materials and Methods: Between June 2012 and August 2016, 49 bladder cancer patients were given a radical cystectomy, 21 robotically and 28 by open procedure. We compared the clinical variables between the RARC and ORC groups. Results: In the RARC group, the median estimated blood loss (EBL) during cystectomy, total EBL, operative time during cystectomy, and total operative time were 0 mL, 457.5 mL, 199 minutes, and 561 minutes, respectively. EBL during cystectomy (p<0.001), total EBL (p<0.001), and operative time during cystectomy (p=0.003) in the RARC group were significantly lower compared with the ORC group. Time to resumption of a regular diet (p<0.001) and length of stay (p=0.017) were also significantly shorter compared with the ORC group. However, total operative time in the RARC group (median, 561 minutes) was significantly longer compared with the ORC group (median, 492.5 minutes; p=0.015). Conclusions: This Japanese study presented evidence that RARC yields benefits in terms of BL and time to regular diet, while consuming greater total operative time. RARC may be a minimally invasive surgical alternative to ORC with less EBL and shorter length of stay.

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        Acute Effect of Whole-Body Periodic Acceleration on Brachial Flow-Mediated Vasodilatation Assessed by a Novel Semi-Automatic Vessel Chasing UNEXEF18G System

        Bonpei Takase,Hidemi Hattori,Yoshihiro Tanaka,Akimi Uehata,Masayoshi Nagata,Masayuki Ishihara,Masatoshi Fujita 한국심초음파학회 2013 Journal of Cardiovascular Imaging (J Cardiovasc Im Vol.21 No.3

        Background: Repeated application of whole-body periodic acceleration (WBPA) upregulates endothelial nitric oxide synthase and improves brachial artery endothelial function (BAEF) as assessed by measurement of flow-mediated vasodilatation (FMD). However, the acute effect of a single application of WBPA on BAEF has not been fully characterized. In addition, although a novel semi-automatic vessel chasing system (UNEXEF18G) has now been developed in Japan, the direct comparison of UNEXEF18G with a conventional method for FMD measures has not been conducted even if UNEXEF18G has already been utilized in a relatively large scale study. Methods: We have developed a novel semi-automatic vessel chasing system (UNEXEF18G) that can measure FMD on-line,identify time to peak vasodilatation (TPV), and determine the area under the vasodilatation curve (AUC). Thus, 45 min of WBPA was applied in 20 healthy volunteers (age, 34 ± 13 years), and BAEF was measured by UNEXEF18G before and after WBPA. Also, UNEXEF18G measured FMD was compared with those of a conventional FMD measurement method at rest in order to validate a novel UNEXEF18G measured FMD. Results: Single WBPA resulted in a significant increase in FMD (from 6.4 ± 3.4 to 10.7 ± 4.3%, p < 0.01), a significant decrease in TPV and a significant increase in AUC. In the validation study for UNEXEF18G, Bland and Altman analysis showed that UNEXEF18G measured FMD was almost identical to those of the conventional method at rest. Conclusion: These data suggest the usefulness of a new UNEXEF18G and that single application of WBPA results in acute improvement in BAEF in humans.

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