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  1. Article ; Online: Automated Classification of Urinary Cells

    Atsushi Teramoto / Ayano Michiba / Yuka Kiriyama / Eiko Sakurai / Ryoichi Shiroki / Tetsuya Tsukamoto

    Applied Sciences, Vol 13, Iss 1763, p

    Using Convolutional Neural Network Pre-trained on Lung Cells

    2023  Volume 1763

    Abstract: Urine cytology, which is based on the examination of cellular images obtained from urine, is widely used for the diagnosis of bladder cancer. However, the diagnosis is sometimes difficult in highly heterogeneous carcinomas exhibiting weak cellular atypia. ...

    Abstract Urine cytology, which is based on the examination of cellular images obtained from urine, is widely used for the diagnosis of bladder cancer. However, the diagnosis is sometimes difficult in highly heterogeneous carcinomas exhibiting weak cellular atypia. In this study, we propose a new deep learning method that utilizes image information from another organ for the automated classification of urinary cells. We first extracted 3137 images from 291 lung cytology specimens obtained from lung biopsies and trained a classification process for benign and malignant cells using VGG-16, a convolutional neural network (CNN). Subsequently, 1380 images were extracted from 123 urine cytology specimens and used to fine-tune the CNN that was pre-trained with lung cells. To confirm the effectiveness of the proposed method, we introduced three different CNN training methods and compared their classification performances. The evaluation results showed that the classification accuracy of the fine-tuned CNN based on the proposed method was 98.8% regarding sensitivity and 98.2% for specificity of malignant cells, which were higher than those of the CNN trained with only lung cells or only urinary cells. The evaluation results showed that urinary cells could be automatically classified with a high accuracy rate. These results suggest the possibility of building a versatile deep-learning model using cells from different organs.
    Keywords urinary cell ; classification ; deep learning ; convolutional neural network ; Technology ; T ; Engineering (General). Civil engineering (General) ; TA1-2040 ; Biology (General) ; QH301-705.5 ; Physics ; QC1-999 ; Chemistry ; QD1-999
    Subject code 006
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Early experience with robot-assisted radical cystectomy and intracorporeal ileal conduit urinary diversion at Fujita Health University School of Medicine

    Kosuke Fukaya / Naohiko Fukami / Mamoru Kusaka / Ryoichi Shiroki

    Fujita Medical Journal, Vol 4, Iss 2, Pp 29-

    2018  Volume 35

    Abstract: Objectives: Open radical cystectomy (ORC) is a highly invasive, but widely performed, standard treatment for muscle-invasive bladder cancer (MIBC). Robot-assisted radical cystectomy (RARC) is increasingly performed worldwide as a minimally invasive ... ...

    Abstract Objectives: Open radical cystectomy (ORC) is a highly invasive, but widely performed, standard treatment for muscle-invasive bladder cancer (MIBC). Robot-assisted radical cystectomy (RARC) is increasingly performed worldwide as a minimally invasive procedure that can replace ORC. In June 2011, we started performing RARC procedures in which urinary diversion is performed intracorporeally. We compared the safety and invasiveness of RARC and ORC procedures that were performed in the same period. Methods: Sixteen patients who underwent RARC and intracorporeal ileal conduit urinary diversion (IC-ICUD) were included. Robot-assisted surgery was performed with a head-down tilt of 30° and radical cystectomy was performed transperitoneally. The head-down tilt was then adjusted to 10°–15° for performing IC-ICUD. Results: All RARC+IC-ICUD procedures were completed without conversion to ORC. The median operation time was 373 min (276–497 min), median console time was 320 min (227–431 min), and median estimated blood loss volume was 200 ml (100–1500 ml). No ≥grade 3 complications as per the Clavien–Dindo classification were identified. RARC had lower blood loss and transfusion rates compared with ORC, thereby shortening the postoperative hospital stay. Conclusions: We reported our experiences with RARC+IC-ICUD and describe the operative method. IC-ICUD accelerates postoperative recovery of intestinal function and decreases the rate of complications, such as intestinal obstruction and ureteral stenosis. Our findings suggest that RARC+IC-ICUD can be performed with minimal invasiveness and high safety in patients with MIBC.
    Keywords cystectomy ; robot-assisted radical cystectomy (rarc) ; bladder cancer ; intracorporeal ileal conduit ; urinary diversion ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2018-05-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Comparing pentafecta outcomes between nerve sparing and non nerve sparing robot-assisted radical prostatectomy in a propensity score-matched study

    Tanan Bejrananda / Kiyoshi Takahara / Dutsadee Sowanthip / Tomonari Motonaga / Kota Yagi / Wataru Nakamura / Masanobu Saruta / Takuhisa Nukaya / Masashi Takenaka / Kenji Zennami / Manabu Ichino / Hitomi Sasaki / Makoto Sumitomo / Ryoichi Shiroki

    Scientific Reports, Vol 13, Iss 1, Pp 1-

    2023  Volume 10

    Abstract: Abstract Pentafecta (continence, potency, cancer control, free surgical margins, and no complications) is an important outcome of prostatectomy. Our objective was to assess the pentafecta achievement between nerve-spring and non-nerve-sparing robot- ... ...

    Abstract Abstract Pentafecta (continence, potency, cancer control, free surgical margins, and no complications) is an important outcome of prostatectomy. Our objective was to assess the pentafecta achievement between nerve-spring and non-nerve-sparing robot-assisted radical prostatectomy (RARP) in a large single-center cohort. The study included 1674 patients treated with RARP between August 2009 and November 2022 to assess the clinical outcomes. Cox regression analyses were performed to evaluate the prognostic significance of RARP for pentafecta achievement, and 1:1 propensity score matching (PSM) was performed between the nerve-sparing and non-nerve-sparing to test the validity of the results. Pentafecta definition included continence, which was defined as the use of zero pads; potency, which was defined as the ability to achieve and maintain satisfactory erections or ones firm enough for sexual activity and sexual intercourse. The biochemical recurrence rate was defined as two consecutive PSA levels > 0.2 ng/mL after RARP; 90-day Clavien–Dindo complications ≤ 3a; and a negative surgical pathologic margin. The median follow-up period was 61.3 months (IQR 6–159 months). A multivariate Cox regression analysis demonstrated that pentafecta achievement was significantly associated with nerve-sparing (NS) approach (1188 patients) (OR 4.16; 95% CI 2.51–6.9), p < 0.001), unilateral nerve preservation (983 patients) (OR 3.83; 95% CI 2.31–6.37, p < 0.001) and bilateral nerve preservation (205 patients) (OR 7.43; 95% CI 4.14–13.36, p < 0.001). After propensity matching, pentafecta achievement rates in the NS (476 patients) and non-NS (476 patients) groups were 72 (15.1%) and 19 (4%), respectively. (p < 0.001). NS in RARP offers a superior advantage in pentafecta achievement compared with non-NS RARP. This validation study provides the pentafecta outcome after RARP associated with nerve-sparing in clinical practice.
    Keywords Medicine ; R ; Science ; Q
    Subject code 616
    Language English
    Publishing date 2023-09-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Measurement of effective renal plasma flow using model analysis of dynamic CT in the preoperative evaluation of the renal transplant donors

    Yumi Kataoka / Hitoshi Nishio / Ryo Matsukiyo / Ryoichi Kato / Midori Hasegawa / Takashi Kenmochi / Ryoichi Shiroki / Hiroshi Toyama / Takashi Ichihara / Shigeki Kobayashi

    Fujita Medical Journal, Vol 6, Iss 3, Pp 73-

    2020  Volume 80

    Abstract: Objectives: Renal scintigraphy is widely used to evaluate residual function of a transplanted kidney from the donor. Dynamic computed tomography (CT) imaging can evaluate both kidney morphology and regional renal function. The aim of this study was to ... ...

    Abstract Objectives: Renal scintigraphy is widely used to evaluate residual function of a transplanted kidney from the donor. Dynamic computed tomography (CT) imaging can evaluate both kidney morphology and regional renal function. The aim of this study was to develop an imaging protocol and a calculation method using dynamic CT for assessing the effective renal plasma flow (ERPF) by model analysis, and to evaluate the validity of the obtained ERPF values. Methods: Preoperative dynamic CT examination with a low radiation dose exposure system was performed for 25 renal transplant donors, and ERPF was calculated from the obtained images (CT-ERPF). To calculate CT-ERPF, we set the region of interest (ROI) in the renal cortex using automatic ROI-setting software developed in our laboratory. We compared the processing time with automatic and manual ROI settings. To evaluate the validity of CT-ERPF, we examined the correlation of age with CT-ERPF and compared with reported ERPF values. We also compared the uptake rates of technetium-99m-dimercaptosuccinic acid and CT-ERPF in terms of the right-to-left ratio. Results: There was good agreement of CT-ERPF assessed using automatic and manual ROIs. CT-ERPF was negatively correlated with age and showed values below the reference ERPF range in 21 cases. The right-to-left ratio of CT-ERPF showed a significant correlation with that of technetium-99m-dimercaptosuccinic acid. Conclusions: Using our method, CT-ERPF was a useful indicator for preoperative evaluation of donor’s renal function.
    Keywords low radiation dose ct ; dynamic ct ; effective renal plasma flow ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2020-08-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Concurrent palliative radiation with pembrolizumab for platinum-refractory urothelial carcinoma is associated with improved overall survival

    Keita Nakamori / Shogo Yamazaki / Kazumasa Komura / Wataru Fukuokaya / Takahiro Adachi / Yosuke Hirasawa / Takeshi Hashimoto / Atsuhiko Yoshizawa / Takaya Ohno / Yusuke Yano / Kazuki Nishimura / Satoshi Tokushige / Taizo Uchimoto / Shutaro Yamamoto / Kosuke Iwatani / Fumihiko Urabe / Keiichiro Mori / Takafumi Yanagisawa / Shunsuke Tsuduki /
    Kiyoshi Takahara / Teruo Inamoto / Jun Miki / Takahiro Kimura / Yoshio Ohno / Ryoichi Shiroki / Haruhito Azuma

    Clinical and Translational Radiation Oncology, Vol 39, Iss , Pp 100558- (2023)

    2023  

    Abstract: Background and Purpose: Pembrolizumab has now become a standard of care in metastatic urothelial carcinoma (mUC), although the treatment effect of the drug substantially differs among individuals. Emerging evidence suggests that radiotherapy exerts a ... ...

    Abstract Background and Purpose: Pembrolizumab has now become a standard of care in metastatic urothelial carcinoma (mUC), although the treatment effect of the drug substantially differs among individuals. Emerging evidence suggests that radiotherapy exerts a synergistic effect with PD-1 blockade. We sought to elucidate the survival outcomes in patients who underwent palliative radiation with the pembrolizumab treatment. Methods: We retrospectively investigated our multi-institutional dataset of 235 platinum-refractory mUC patients treated with pembrolizumab as second-line treatment, collected from January 2018 and October 2021. Propensity score matching was performed to reduce biases by potential confounding factors for overall survival (OS). Results: With a median follow-up of 6.8 months, the median OS from the initiation of pembrolizumab was 13 months in 235 patients. Palliative radiation was performed in 71 (30.2%) patients for whom the median radiation dose and fraction were 30 Gy and 10 fractions, respectively. Irradiated sites were bone in 24 (33.8%), lymph node in 17 (23.9%), lung in 3 (4.2%), brain in 8 (11.3%), and other sites in 19 (26.8%). OS from the initiation of pembrolizumab was significantly longer in patients who underwent concurrent palliative radiation with pembrolizumab (39 patients: median OS: 21 months) than in both patients with palliative radiation before pembrolizumab (32 patients: median OS: 9 months) (p = 0.001) and those without palliative radiation throughout the follow-up (164 patients: median OS: 13 months) (p = 0.019). After the propensity-score matching by putative confounding factors, longer OS in patients treated with concurrent palliative radiation with pembrolizumab (n = 36) was still observed compared to patients without the concurrent palliative radiation (n = 36) in the pair matched cohort (median OS of 29 and 13 months, respectively, p = 0.033). Conclusions: Our findings suggest that the concurrent administration of palliative radiation with pembrolizumab offers a favorable ...
    Keywords Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Subject code 616 ; 610
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: A case of an inflammatory myofibroblastic tumor of the bladder in a young woman

    Hokuto Akamatsu / Shimpei Akiyama / Ryoichi Kato / Hitoshi Ishise / Ryoichi Shiroki / Yuka Kiriyama / Makoto Kuroda / Hiroshi Toyama

    Fujita Medical Journal, Vol 3, Iss 1, Pp 20-

    2017  Volume 23

    Abstract: We herein report a relatively rare case of an inflammatory myofibroblastic tumor (IMT) of the bladder in a young woman. In contrast to IMTs of other organs, IMTs of the lower urinary tract involve the mixture of a non-neoplastic lesion with a neoplastic ... ...

    Abstract We herein report a relatively rare case of an inflammatory myofibroblastic tumor (IMT) of the bladder in a young woman. In contrast to IMTs of other organs, IMTs of the lower urinary tract involve the mixture of a non-neoplastic lesion with a neoplastic lesion; therefore, the determination of whether other neoplastic lesions are present is important. In this case, magnetic resonance imaging confirmed a pedunculated lobulated tumor that protruded from the posterior left bladder wall into the lumen. The lobulated area exhibited a low-intensity signal on T1-weighted imaging (T1WI) and a high-intensity signal similar to that of urine on T2-weighted imaging (T2WI). Morphologically, the peduncle resembled a submucosal mass with faint low-intensity signaling on T1WI and faint high-intensity signaling on T2WI. These findings differ from those of a neoplastic lesion of the bladder mucous membrane. The presence of lesions from the muscularis propria to the submucosa and in areas with markedly high-intensity signals exhibiting a nodular fasciitis pattern on T2WI is considered useful for the differential diagnosis of IMT on imaging examination.
    Keywords inflammatory myofibroblastic tumor ; urinary bladder ; inflammatory pseudotumor ; magnetic resonance imaging ; submucosal tumor ; Medicine (General) ; R5-920
    Language English
    Publishing date 2017-02-01T00:00:00Z
    Publisher Fujita Medical Society
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Serum Tissue Inhibitor of Metalloproteinases 1 (TIMP-1) Predicts Organ Recovery from Delayed Graft Function after Kidney Transplantation from Donors after Cardiac Death

    Mamoru Kusaka M.D. / Yoko Kuroyanagi / Manabu Ichino / Hitomi Sasaki / Takahiro Maruyama / Kunihiro Hayakawa / Ryoichi Shiroki / Atsushi Sugitani / Hiroki Kurahashi / Kiyotaka Hoshinaga

    Cell Transplantation, Vol

    2010  Volume 19

    Abstract: Donors after cardiac death (DCD) have recently become an important source of renal transplants to alleviate the shortage of renal grafts in kidney transplantation (KTx), although DCD kidneys often have complications associated with a delayed graft ... ...

    Abstract Donors after cardiac death (DCD) have recently become an important source of renal transplants to alleviate the shortage of renal grafts in kidney transplantation (KTx), although DCD kidneys often have complications associated with a delayed graft function (DGF). A microarray-based approach using renal biopsy samples obtained at 1 h after KTx from DCD identified the tissue inhibitor of metalloproteinases 1 (TIMP-1) gene as a potential predictive marker for DGF. The current study measured serum TIMP-1 in patients undergoing KTx and analyzed the time course after KTx. The average serum TIMP-1 level before KTx was 240 ± 10 ng/ml ( n = 34). In patients undergoing KTx from a living donor ( n = 23), the serum TIMP-1 levels showed no increase after KTx (POD1: 226 ± 12, POD2: 211 ± 12, and POD3: 195 ± 10 ng/ml), but in one case, the only patient who required post-KTx HD due to DGF, the level on POD1 was the highest among subjects (361 ng/ml). In contrast, patients undergoing KTx from DCDs ( n = 11), the serum TIMP-1 levels increased rapidly after a KTx (POD1: 418 ± 32, POD2: 385 ± 42, and POD3: 278 ± 25 ng/ml). However, two patients who avoided post-KTx HD due to the immediate function of the graft did not show increased levels (<370 ng/ml) on either POD1 or POD2. The peak serum TIMP-1 values appeared to correlate to the post-KTx dialysis period. Furthermore, the increment of serum TIMP-1 on the early POD was found to be predictive of immediate or delayed function of the grafts. These data suggest that monitoring of serum TIMP-1 levels allow the prediction of graft recovery and the need for HD after a KTx from a DCD.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2010-06-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Analysis of the Serological and Cellular Sensitization Induced by Encapsulated Human Islets Transplantation in Type I and Type II Diabetes Patients

    Ryoichi Shiroki / T. Mohanakumar Ph.D. / David W. Scharp

    Cell Transplantation, Vol

    1995  Volume 4

    Keywords Medicine ; R
    Language English
    Publishing date 1995-09-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Global Expression Profiles in 1-Hour Biopsy Specimens of Human Kidney Transplantation from Donors after Cardiac Death

    Mamoru Kusaka M.D. / Yoko Kuroyanagi / Terumi Mori / Kayuri Nagaoka / Hitomi Sasaki / Takahiro Maruyama / Kunihiro Hayakawa / Ryoichi Shiroki / Hiroki Kurahashi / Kiyotaka Hoshinaga

    Cell Transplantation, Vol

    2009  Volume 18

    Abstract: Because of the worldwide shortage of renal grafts, kidney transplantation (KTx) from donors after cardiac death (DCD) is an alternative way to obtain KTx from brain-dead donors. Although the prognosis of DCD KTx is gradually improving, the graft often ... ...

    Abstract Because of the worldwide shortage of renal grafts, kidney transplantation (KTx) from donors after cardiac death (DCD) is an alternative way to obtain KTx from brain-dead donors. Although the prognosis of DCD KTx is gradually improving, the graft often undergoes delayed graft function (DGF), rendering the control of DGF essential for post-KTx patient care. In an attempt to characterize etiology of DGF, genome-wide gene expression profiling was performed using renal biopsy samples performed at 1 h after KTx from DCD and the data were compared with those of KTx from living donors (LD). A total of 526 genes were differentially expressed between them. Genes involved in acute inflammation were activated, while metabolic pathways were consistently downregulated in DCD. These findings imply the inferior performance of the DCD grafts relative to LD grafts. Several genes were identified where the expression levels were correlated well with parameters indicating short- and long-term prognosis of the DCD patients. In addition, several genes encoding secretory proteins were identified that might reflect the performance of the graft and be potential noninvasive biomarkers. These data provide a good source for candidates of biomarkers that are potentially useful for the control of DGF.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2009-05-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Serum Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Organ Recovery from Delayed Graft Function after Kidney Transplantation from Donors after Cardiac Death

    Mamoru Kusaka M.D. / Yoko Kuroyanagi / Terumi Mori / Kayuri Nagaoka / Hitomi Sasaki / Takahiro Maruyama / Kunihiro Hayakawa / Ryoichi Shiroki / Hiroki Kurahashi / Kiyotaka Hoshinaga

    Cell Transplantation, Vol

    2008  Volume 17

    Abstract: Because of a worldwide shortage of renal grafts, kidneys procured from donors after cardiac death (DCD) have recently become an important source of renal transplants. However, DCD kidneys often have complications with delayed graft function (DGF) and ... ...

    Abstract Because of a worldwide shortage of renal grafts, kidneys procured from donors after cardiac death (DCD) have recently become an important source of renal transplants. However, DCD kidneys often have complications with delayed graft function (DGF) and recipients require hemodialysis (HD) in the early period after kidney transplantation (KTx). This study evaluated serum NGAL as a potential specific parameter to predict early functional recovery of transplanted DCD kidneys. The average serum neutrophil gelatinase-associated lipocalin (NGAL) level in normal samples was 53 ± 30 ng/ml, while that in patients with chronic renal failure requiring HD was markedly raised at 963 ± 33 ng/ml. In patients undergoing a living-related KTx from a living donor (n = 11), serum NGAL level decreased rapidly after KTx, and only in two cases, with serum NGAL levels over 400 ng/ml on postoperative day 1 (POD1), was HD required due to DGF. In contrast, all patients undergoing a KTx from a DCD (n = 5) required HD due to DGF. Even in these cases, serum NGAL levels decreased rapidly several days after a KTx prior to the recovery of urine output and preceding the decrease in serum creatinine level. The pattern of decline in serum NGAL was biphasic, the decrease after the second peak indicating a functional recovery within the next several days. These data suggest that monitoring of serum NGAL levels may allow us to predict graft recovery and the need for HD after a KTx from a DCD.
    Keywords Medicine ; R
    Subject code 610
    Language English
    Publishing date 2008-01-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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