Extremely-slow, half-number shockwave lithotripsy for asymptomatic renal stones <20 mm

Katsuhiro Ito,Toshifumi Takahashi,Toru Kanno,Takashi Okada,Yoshihito Higashi,Hitoshi Yamada 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.1

Purpose: To compare the treatment success rate and safety of reduced (30 shocks/min, 1,200 shocks/session) versus standard (60 shocks/min, 2,400 shocks/session) extracorporeal shockwave lithotripsy for the management of renal stones. Materials and Methods: We retrospectively analyzed 404 patients who underwent extracorporeal shockwave lithotripsy for 5–20-mm renal stones between April 2011 and March 2019. Patients selected the reduced or standard protocol (group R and S) after explaining the potential benefits and disadvantages. The primary outcome was treatment success within 12 weeks, which was defined as no residual fragment or fragments <4 mm on ultrasonography and plain radiograph. Results: In total, 94 and 310 patients underwent shockwave lithotripsy with a reduced and standard protocol, respectively. The background characteristics of the participants did not significantly differ. The treatment success within 12 weeks was achieved in 78 (83.0%) patients in group R and 259 (83.5%) in group S (p=0.88). The median number of the session was 3 (interquartile range, 2–4) in both groups (p=0.53). The total complication rates were 5.4% in group R and 6.1% in group S. Three (1.0%) patients in group S experienced perirenal hematoma, which was conservatively treated. The reduced protocol was not associated with treatment success in the multivariate analysis adjusted for potential confounders (odds ratio, 0.91; 95% confidence interval, 0.46–1.80; p=0.78). Conclusions: The new treatment amendment with a slower delivery rate successfully reduced the total number of shocks need to fragment renal stones <20 mm without compromising the stone-free rate.

Predictive factors and radiological findings of adrenohepatic adhesion during laparoscopic adrenalectomy

Katsuhiro Ito,Hiromasa Araki,Toshihiro Uchida,Yumi Manabe,Yu Miyazaki,Haruki Itoh,Mutsuki Mishina,Hiroshi Okuno 대한비뇨의학회 2020 Investigative and Clinical Urology Vol.61 No.3

Purpose: This retrospective study aimed to identify predictive factors and imaging features of adrenohepatic adhesion found during laparoscopic right adrenalectomy. Materials and Methods: Altogether, 77 patients underwent laparoscopic right adrenalectomy between January 2005 and December 2018. Adrenohepatic adhesion was defined as strict adhesion that required either partial adrenalectomy with coagulation of residual tissue or partial hepatectomy to accomplish complete resection. We assessed their surgical video records to determine if adrenohepatic adhesion was present. Age, sex, body mass index, tumor size, tumor diagnosis and radiological findings (attachment between the liver and the adrenal gland, diameters of the right and left adrenal veins and its ratio) were evaluated as preoperative variables. Results: Adrenohepatic adhesion was present in 11 of the 77 patients (14.3%). Age, sex, and body mass index were not statistically significant factors. Tumor size was significantly small in adhesion group (14.2 mm vs. 25.9 mm, p=0.02). Attachment to the liver and adrenal gland was frequently seen regardless of the adhesion. The mean right/left adrenal veins diameters ratio was significantly lower in the adhesion group (0.8 vs. 1.1, p=0.01). Multivariate logistic regression analysis demonstrated the right/left adrenal veins diameters ratio was the only significant predictor of adhesion. The sensitivity, specificity, negative predictive value and positive predictive value were 0.82, 0.76, 0.43, and 0.95 respectively when the optimal cutoff value for the ratio was 0.9 (area under the curve, 0.75; 95% confidence interval, 0.60–0.90). Conclusions: The right/left adrenal veins diameters ratio was possible predictor of adrenohepatic adhesion.

「日本語における本動詞としての授受動詞と視点」 : その日本語?育への?用

伊東克洋(Katsuhiro Ito) 한국일본문화학회 2002 日本文化學報 Vol.15 No.-

In order to express the idea of giving and receiving in Japanese, seven different verbsare usually used. But exclude honorific forms, the verbs are basically three「やる」「くれる」「もらう」. The differences of these verbs are not only the direction of giving and receiving the things, but are their points of view. That is to say, who the giver is or who the recipient is. Also, it makes a difference whether or not the speaker is talking to or speaking about a person within or outside of speaker's social group. Those within the speaker's social group is 「ウチ」, those outside of speaker s social group is 「ソト」in this paper. As for Japanese learners, the verbs of giving and receiving in Japanese would be difficult to learn. But not only the Japanese learners, Japanese teacher should know the structure of these kinds of verbs much deeper for the learners. This paper research the relations of direction and point of view and "in-group" v.s. "out-group" of the verbs of giving and receiving in Japanese. And also this paper says the suggestion of their application to Japanese education.

Features and Outcomes of Children with Ulcerative Colitis who Undergo a Diagnostic Change: A Single-Center Experience

Ito, Natsuki,Takeuchi, Ichiro,Kyodo, Reiko,Hirano, Yuri,Sato, Takuro,Usami, Masaaki,Shimizu, Hirotaka,Shimizu, Toshiaki,Arai, Katsuhiro The Korean Society of Pediatric Gastroenterology 2021 Pediatric gastroenterology, hepatology & nutrition Vol.24 No.4

Purpose: A change in diagnosis from ulcerative colitis (UC) to Crohn's disease (CD) has been reported in pediatric inflammatory bowel disease; however, only a few clinical characteristics and predictors of this diagnostic change have been reported. We aimed to describe the clinical characteristics of patients with UC who underwent a change in diagnosis to CD and identify variables associated with the change. Methods: The medical records of pediatric patients with UC who were followed up at the National Center for Child Health and Development between 2006 and 2019 were retrospectively reviewed. Clinical data on disease phenotype, laboratory parameters, endoscopic findings, and treatment of patients whose diagnosis changed to CD (cCD) were compared to those of patients whose diagnosis remained UC (rUC). Results: Among the 111 patients initially diagnosed with UC, 11 (9.9%) patients were subsequently diagnosed with CD during follow-up. There was no significant difference between the cCD and rUC groups in terms of sex, age at initial diagnosis, and the extent and severity of disease at initial diagnosis. Albumin and hemoglobin levels were significantly lower in the cCD group than in the rUC group. The proportion of patients who required biologics was significantly higher in the cCD group than in the rUC group (p<0.05). Conclusion: Approximately 10% children initially diagnosed with UC were subsequently diagnosed with CD. Hypoalbuminemia and anemia at initial diagnosis and use of biologics could be predictors of this diagnostic change.

Advantage of urological experience with both transperitoneal and retroperitoneal laparoscopy in lymph node biopsy for malignant lymphoma diagnosis

Hiroaki Kawanishi,Katsuhiro Ito,Satoshi Kamido,Yuka Kohno,Toshihiro Uemura,Keiji Kato,Hirotsugu Uetsuki,Hitoshi Ohno,Kazuhiro Okumura 대한비뇨의학회 2016 Investigative and Clinical Urology Vol.57 No.6

Purpose: Laparoscopic urologists are familiar with both transperitoneal and retroperitoneal approaches. That experience is an advantage when devising a strategy for intra-abdominal lymph node biopsy. We report the feasibility and effectiveness of laparoscopic biopsy using a urological laparoscopic technique for the treatment of patients with clinically suspected intra-abdominal lymphoma. Materials and Methods: From October 2010 to April 2015, a total of 22 patients underwent laparoscopic biopsy for suspected intra-abdominal lymphoma. We adopted a retroperitoneal approach for paraaortic or paracaval masses, whereas we used a transperitoneal approach for mesenteric, iliac, or obturator masses. Whenever possible, an entire node was removed; otherwise, the biopsy consisted of wedge resection sized at least 1 cm3. Results: Biopsy specimens were obtained from the following lymph node sites: 10 paraaortic, 5 paracaval, 3 mesenteric, 2 obturator, 1 common iliac, and 1 perinephric fat. Laparoscopic lymph node biopsy was completed in all patients, and there were no conversions to open surgery. The median operating time was 97 minutes (range, 62–167 minutes). The estimated blood loss was <50 mL in all cases. Postoperatively, one patient (4.5%) had symptomatic chylous lymphocele that required surgical intervention. Precise diagnosis was established for all patients: malignant lymphoma in 20 patients and metastatic urothelial carcinoma and squamous cell carcinoma of unknown origin in 1 patient each. All lymphomas could be fully subclassified. Conclusions: Appropriate use of the transperitoneal or retroperitoneal approach is safe and effective for laparoscopic lymph node biopsy in patients with suspected intra-abdominal lymphoma.