Publications by authors named "Akatsuka J"

Prostate cancer (PCa) is a clinically heterogeneous disease. Predicting clinically significant PCa with low-intermediate prostate-specific antigen (PSA), which often includes aggressive cancers, is imperative. This study evaluated the predictive accuracy of deep learning analysis using multimodal medical data focused on clinically significant PCa in patients with PSA ≤ 20 ng/mL.

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Background: Several effective treatment modalities against metastatic castration-resistant prostate cancer (mCRPC) are available; however, an unmet clinical need persists for mCRPC treatment because resistance to these therapies is inevitable. This study aimed to evaluate the status of comprehensive genomic profiling (CGP) and its impact on subsequent treatments for patients with mCRPC at our hospital.

Methods: Between December 2020 and August 2023, we assessed 41 patients with mCRPC who underwent CGP testing at the Nippon Medical School Hospital.

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Background: The presence of collateral vessels (CVs) on contrast-enhanced computed tomography is a poor prognostic factor in renal cell carcinoma (RCC), but its value in small RCC (sRCC; < 4 cm) remains unknown. In this study, we investigated whether presence of CVs is a predictor of high potential for metastasis in sRCC.

Methods: We retrospectively reviewed clinical and imaging data of patients with pathologically confirmed sRCC evaluated at our institution between 2011 and 2021.

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Background: This study aimed to investigate the preoperative risk factors for prolonged operating time in retroperitoneoscopic radical nephrectomy (RRN) for renal cell carcinoma (RCC).

Methods: We retrospectively reviewed patients treated for RRN between January 2015 and December 2021. Clinical data, including radiological findings such as visceral fat area (VFA), subcutaneous fat area (SFA), and posterior perirenal fat thickness (PFT) were collected.

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Article Synopsis
  • Peritoneal washing cytology (CY) is primarily used for staging pancreatic cancer and assessing intraperitoneal status for better prognosis predictions.
  • This study explored using deep learning techniques like Vision Transformer (ViT) and Convolutional Neural Network (CNN) to analyze CY specimen images from 88 patients to predict their 1-year survival rates.
  • The findings revealed that both AI models had high accuracy in prognosis prediction, with ViT being slightly more effective, and identified neutrophils as a potential negative prognostic marker for these patients.
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Background: Prolonged laparoscopic nephroureterectomy (LNU) for upper tract urothelial cancer (UTUC) can increase the frequency of intravesical recurrence after surgery. Therefore, it is important for urological surgeons to have knowledge on preoperative risk factors for prolonged LNU. However, few studies have investigated the risk factors for prolonged LNU.

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Background: Index tumors are the most aggressive tumors of the prostate. However, their clinical significance remains unclear. This study aimed to assess the incidence of index tumor location according to the zonal origin and whether these locations affect the prognosis after radical prostatectomy in patients with negative surgical margins.

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In patients with high-risk prostate cancer (HRPC) after radical prostatectomy (RP), biochemical recurrence (BCR) increases the risk of distant metastasis. Accordingly, additional prognostic biomarkers are required to identify the subpopulation of patients with HRPC who develop clinical recurrence (CR) after BCR. The objective of this study was to identify biomarkers in formalin-fixed paraffin-embedded (FFPE) RP samples that are prognostic for CR in patients with HRPC who experience BCR after RP (post-RP BCR).

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Background: The Vesical Imaging Reporting and Data System (VI-RADS) is widely used for predicting muscle-invasive bladder cancer (MIBC). This study aimed to determine the clinicopathological significance of the VI-RADS ≧4 (VI≧4) group.

Methods: Patients who underwent transurethral resections of bladder tumors during the study period and preoperative magnetic resonance imaging were considered.

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This study presents the enfortumab vedotin (EV) treatment analysis at our institution. We retrospectively analyzed patients with metastatic urothelial cancer (mUC) treated with EV between January 2021 and October 2023. EV was administered at 1.

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Article Synopsis
  • A study examined the potential of artificial intelligence (AI) to predict recurrence in pancreatic ductal adenocarcinoma patients after surgery and chemotherapy.
  • Researchers applied machine learning to analyze vast amounts of histopathological image data and combined it with clinical information to enhance predictive accuracy.
  • The results showed that integrating AI with clinical data improved prediction, revealing that poorly differentiated tumors were significantly linked to higher recurrence rates.
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  • Renal abscesses can pose serious health risks and are difficult to diagnose based solely on clinical symptoms, necessitating careful evaluation.
  • A case study of a 69-year-old woman revealed left renal masses following lung carcinosarcoma surgery, initially suspected to be metastases.
  • Ultimately, a laparoscopic nephrectomy confirmed the diagnosis of a renal abscess without any malignant cells, highlighting the challenges in differentiating between abscesses and tumors.
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The case presented is of a 47-year-old patient with an extravesical pedunculated bladder leiomyoma, which was difficult to distinguish from a retroperitoneal tumor. Preoperatively, it was suspected to be a retroperitoneal tumor and a laparotomy with tumor resection was performed. lntraoperatively, the bladder and tumor were connected by a cord-like tissue.

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Introduction: We report a rare case of marked rectal stenosis due to Douglas' pouch metastasis of renal pelvic urothelial carcinoma successfully treated with enfortumab vedotin.

Case Presentation: A 77-year-old female presented with difficulty in defecation and abdominal distension. She had received two courses of cisplatin plus gemcitabine followed by four courses of maintenance avelumab for postoperative lymph node metastasis of renal pelvic urothelial carcinoma.

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Background: To investigate the impact of Perirenal fat stranding (PRFS) on progression after radical nephroureterectomy (RNU) for renal pelvic urothelial carcinoma (RPUC) without hydronephrosis and to reveal the pathological findings of PRFS.

Methods: Clinicopathological data, including computed tomography (CT) findings of the ipsilateral PRFS, were collected from the medical records of 56 patients treated with RNU for RPUC without hydronephrosis between 2011 and 2021 at our institution. PRFS on CT was classified as either low or high PRFS.

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Background: The optimal treatment modality for locally advanced prostate cancer has not been established. Radiotherapy, hormonal therapy, and combination treatments are the main strategies, although the feasibility of radical prostatectomy as a first-line therapy needs to be considered. This retrospective analysis of pathological results of extracted specimens evaluated long-term oncological outcomes for high-risk prostate cancer treated surgically.

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Introduction: We encountered an extremely rare case of a vesicocutaneous fistula due to vesical diverticulitis with stones.

Case Presentation: A 78-year-old male patient presented to our department with complaints of suppurative discharge in the suprapubic area. Computed tomography revealed an enlarged prostate, a vesical diverticulum with stones located on the ventral side, and an aberrant connection between the anterior bladder wall and the external surface of the skin.

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Postoperative rhabdomyolysis is a rare but potentially fatal surgical complication. We experienced a case of rhabdomyolysis after laparoscopic radical nephrectomy (LRN). Right renal carcinoma was diagnosed in a 31-year-old woman with a body mass index of 28.

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Background: Active surveillance (AS) is one of the treatment methods for patients with small renal masses (SRMs; < 4 cm), including renal cell carcinomas (RCCs). However, some small RCCs may exhibit aggressive neoplastic behaviors and metastasize. Little is known about imaging biomarkers capable of identifying potentially aggressive small RCCs.

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Article Synopsis
  • * The AI system was trained to analyze 12 segments of the uterovaginal area for high-grade lesions, achieving a recall rate of 62.1% and an overall correct response rate of 89.7%.
  • * Results showed a significant correlation between the AI's detection rates and evaluations made by experienced gynecologic oncologists, highlighting the potential of AI as a valuable tool in the management of cervical conditions.
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Background: We evaluated the association of prostate volume (PV) with the efficacy and safety of transurethral enucleation with bipolar energy (TUEB) for treatment of benign prostatic hyperplasia (BPH).

Methods: We retrospectively evaluated data from 180 patients with symptomatic BPH who underwent TUEB between 2008 and 2015. Efficacy was assessed by perioperative changes in international prostate symptom score (IPSS), Quality of Life Score (QOLS), maximum flow rate on uroflowmetry (Qmax), and serum prostate-specific antigen level (PSA), which were recorded at 3 months postoperatively.

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Robot-assisted laparoscopic prostatectomy (RALP) for prostate cancer was introduced in 2000 and rapidly gained popularity. The Da Vinci Surgical System? can ensure improved local control of cancer and fewer perioperative complications. However, RALP is performed in the steep-Trendelenburg position (a combination of lithotomy and head-down tilt position/Lloyd-Davies position) to obtain a good surgical view, and as a result, well leg compartment syndrome (WLCS) can become a serious complication of RALP.

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This paper describes the aeroacoustics experiments conducted with supersonic jets, exhausting from rectangular nozzles with an aspect ratio of 2, to examine the jet noise reduction by two different methods. The first method involves the use of fluid inserts, which are produced by distributed air blowing into the diverging section of a convergent-divergent exhaust nozzle. The second method involves the integration of fluid shields in dual flow rectangular jets.

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Accurate prostate cancer screening is imperative for reducing the risk of cancer death. Ultrasound imaging, although easy, tends to have low resolution and high inter-observer variability. Here, we show that our integrated machine learning approach enabled the detection of pathological high-grade cancer by the ultrasound procedure.

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Background: One of the major concerns of patients with upper tract urothelial carcinoma (UTUC) treated with nephroureterectomy is intravesical recurrence (IVR). The purpose of the present study was to investigate the predictive risk factors for IVR after retroperitoneoscopic nephroureterectomy (RNU) for UTUC.

Methods: Clinicopathological and surgical information were collected from the medical records of 73 patients treated with RNU for non-metastatic UTUC, without a history of or concomitant bladder cancer.

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