Fumio Ito

Tokyo Women's Medical University, Edo, Tōkyō, Japan

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Publications (81)198.45 Total impact

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    ABSTRACT: A 61-year-old female received intravenous injection of calcium chloride after common iliac artery bypass surgery. A red flare appeared at the site of the intravenous infusion on the left forearm and gradually progressed to induration. Seven weeks later, she was referred to the Department of Dermatology for management. Physical examination showed an indurated plaque measuring 13 × 65 mm in size, with linearly distributed ulcers covered by yellowish-white substance, surrounded by reddish skin. Laboratory tests showed no significant abnormalities including serum calcium, phosphate and thyroid hormones. Cultures were negative for microorganisms. Histopathological examination showed calcium deposition confined to the dermis. The lesion healed spontaneously within 2 months with scar formation. A review of the Japanese literature showed confinement of calcium deposits to the dermis in most of the reported cases. We speculate that the pathomechanism of dermal calcinosis includes needle-induced tissue injury with capillary destruction, leading to release of excess calcium between collagen fibers, and its binding to phosphate in the dermis and deposition as calcium phosphate crystals.
    Case Reports in Dermatology 03/2014; 6(1):85-90. DOI:10.1159/000360807
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    ABSTRACT: We report a case of neobladder-rectal fistula that developed as an early postoperative complication of radical cystectomy and orthotopic neobladder construction procedures. A 75-year-old man underwent a radical cystectomy and orthotopic neobladder construction using Studer's method for locally invasive bladder cancer (cT2N0M0). The patient had severe watery diarrhea on postoperative day 20, and was diagnosed with a neobladder-rectal fistula based on cystography findings. We inserted a Foley catheter into the neobladder, and performed conservative treatment. Four months after development of the fistula, cystography revealed that it had spontaneously closed. A neobladder-rectal fistula is an extremely rare complication, with no other known reports. Herein, we present this case of neobladder-rectal fistula and discuss its formation, diagnosis and treatment, along with reference to previous reports of neobladder-vaginal fistulas.
    Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology 07/2013; 104(4):616-9. DOI:10.5980/jpnjurol.104.616
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    ABSTRACT: Patients with ostomy including urinary stoma often develop peristomal complications, especially skin damage. The patient in this case was a 69-year old female with a history of urothelial carcinoma of the bladder and left ureter who underwent transurethral resection of a bladder tumor, nephroureterectomy and cystectomy combined with ureterocutaneostomy. Later, she had recurrence of urothelial carcinoma in the remaining ureter that spread to the peristomal epidermis, with a skin appearance resembling Paget's disease. We report this case based on its clinical significance since we believe it is the first description of this condition in the literature.
    Rare tumors 07/2013; 5(3):e49. DOI:10.4081/rt.2013.e49
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    ABSTRACT: A 66-year-old man with a history of sporadic von Recklinghausen' s disease was treated for pseudosarcomatous myofibroblastic proliferation in the bladder. The patient had a history of repetitive recurrence of bladder carcinoma requiring transurethral resection (TUR) 4 times and 1 course of intravesical BCG instillation. Three months after the fourth TUR, an intravesical solid mass 4 cm in diameter was detected. Suspicion of recurrent bladder carcinoma led to a fifth TUR procedure. Pathological findings showed submucosal growth of myofibroblasts with myxoidal stroma and we made a diagnosis of Pseudosarcomatous myofibroblastic proliferation. The patient was well with no evidence of recurrence after 1 year.
    Hinyokika kiyo. Acta urologica Japonica 02/2013; 59(2):125-7.
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    ABSTRACT: Bicalutamide is an anti-androgen that is used worldwide to treat prostate cancer (CaP). However, there are no data on blood bicalutamide concentrations in hemodialysis (HD) patients with CaP. Therefore, we investigated the plasma levels of bicalutamide during the peridialysis period in this population. The study group included 5 HD patients with CaP who had been treated with bicalutamide (80 mg/day) for at least 3 months. Blood samples were taken during and between HD sessions and the plasma concentrations of the active R enantiomer (R-bicalutamide) were assessed using an HPLC assay. The plasma R-bicalutamide levels on the non-dialysis day were measured in 2 patients (patients 1 and 2) immediately before dosing and 8 and 24 h after dosing. These levels were 18,730, 19,090 and 19,420 ng/ml (patient 1), and 4,522, 4,581, and 5,296 ng/ml (patient 2), respectively. The mean plasma levels of R-bicalutamide in all 5 subjects just before HD, and 2 and 4 h after the start of HD were 8,726, 9,354 and 10,068 ng/ml, respectively. These results show that bicalutamide does not accumulate and is not diluted in the blood circulation of HD patients when given at the normal dosage used in the general population.
    Urologia Internationalis 08/2012; 89(2):162-5. DOI:10.1159/000339919 · 1.15 Impact Factor
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    ABSTRACT: The aims of this study were: (i) to analyze the perioperative outcomes of laparoscopic radical nephrectomy for renal cell carcinoma in patients with dialysis-dependent end-stage renal disease and (ii) to reveal perioperative management problems that are unique to these patients. Between June 2004 and June 2011, laparoscopic radical nephrectomy was performed in 39 patients who had renal cell carcinoma and dialysis-dependent end-stage renal disease. The operative outcomes of these patients were compared with the operative outcomes of 104 non-end-stage renal disease patients with sporadic renal cell carcinoma who underwent laparoscopic radical nephrectomy during the same period. Laparoscopic surgery was completed in thirty-eight end-stage renal disease patients. One patient was converted to open surgery because of an intraoperative injury to the inferior vena cava. This patient was excluded from the analysis. The mean operative time was 240 min; blood loss, 157 mL; and postoperative hospital stay, 9.6 days. Postoperative complications were observed in six patients, as follows: retroperitoneal hematoma and abscess in one patient, thrombosis of the arteriovenous fistula in three patients, pneumonia in one patient, and gastrointestinal bleeding in one patient. Eleven patients required blood transfusions. There was no significant difference between the end-stage renal disease patients and the non-end-stage renal disease patients in the mean operative time or the amount of blood loss. In conclusion, laparoscopic radical nephrectomy is feasible for dialysis-dependent end-stage renal disease patients, as well as for non-end-stage renal disease patients; however, end-stage renal disease patients may have a higher probability of experiencing non-life-threatening complications.
    Therapeutic apheresis and dialysis: official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy 06/2012; 16(3):254-9. DOI:10.1111/j.1744-9987.2012.01060.x · 1.53 Impact Factor
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    ABSTRACT: The patient was a 22-year-old woman with a history of tuberous sclerosis who complained of abdominal distention. Computed tomography showed bilateral renal masses with minimal fat tissue that were unlike classical angiomyolipoma (AML), as well as enlargement of the paraaortic lymph nodes, pleural effusion, and ascites, similar to other advanced malignant neoplasms such as renal cell carcinoma and renal sarcoma. We performed a left nephrectomy to relieve the symptoms. A pathological examination revealed that the tumor was composed of polygonal epithelioid cells positive for both αSMA and HMB-45, as well as spindle-shaped cells, while immunoreactivity proved the tumor to be an eAML, a subtype of AML with malignant potential. Although the patient was scheduled for postoperative adjuvant chemotherapy, her condition worsened and she died on postoperative day 24 before receiving chemotherapy. We discuss this case with reference to previous reports.
    Hinyokika kiyo. Acta urologica Japonica 01/2012; 58(1):21-4.
  • Urology 09/2011; 78(3). DOI:10.1016/j.urology.2011.07.756 · 2.13 Impact Factor
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    ABSTRACT: We assessed whether adequately functioning parenchyma is preserved in patients with pre-existing chronic kidney disease (CKD) after partial nephrectomy (PN) compared with those who underwent radical nephrectomy (RN). A total of 95 patients with pre-existing CKD who underwent curative surgery for pathological T1a-T2N0M0 renal cell carcinoma with a follow-up period of 12 months or more were the subject of the present study. Of these, 51 patients underwent RN, and 44 PN. Renal function was assessed by using the estimated glomerular filtration rate (e-GFR). We classified the subjects into two groups according to the preoperative e-GFR: preoperative e-GFR 45-59 mL/min/1.73 m(2) (68 patients); and 30-44 mL/min/1.73 m(2) (27 patients). In the former group, the probability of freedom from new onset of e-GFR <45 mL/min/1.73 m(2) stemmed from the significant difference between the PN and RN groups (P = 0.006; PN: 2 years 64%; RN: 2 years 22%). In contrast, in the latter group, the probability of freedom from new onset of e-GFR <30 mL/min/1.73 m(2) was not associated with a significant difference between PN and RN group (P = 0.80). Overall survival and the number of the patients who went on to develop end-stage renal disease requiring renal replacement therapy between PN and RN were not significantly different in each group. Death from renal cell carcinoma was not noted in either group. PN could significantly prevent development to late-stage CKD in patients with preoperative e-GFR 45-59 mL/min/1.73 m(2) compared with RN. Patients with preoperative e-GFR 30-44 mL/min/1.73 m(2) should be reviewed in a more strict study.
    International Journal of Urology 06/2011; 18(6):472-6. DOI:10.1111/j.1442-2042.2011.02765.x · 1.80 Impact Factor
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    ABSTRACT: The benefit of lymphadenectomy (LND) in patients with urothelial carcinoma of the upper urinary tract (UCUUT) has remained controversial. The aim of this study was to examine the influence of the LND template and the total number of lymph nodes (LN) when increasing the number of patients undergoing complete dissection of regional nodes (CompLND). A total of 109 UCUUT patients with clinically negative nodes underwent nephroureterectomy with concomitant lymphadenectomy at our center. Patients' survival was examined according to the type of LND and the number of removed LN. Univariate analysis was performed to find the cut-off value of LN influencing survival. Seventy-eight patients underwent CompLND. Incomplete lymphadenectomy was performed in an additional 41 patients. In the patients with pT2 or higher who were clinically negative for nodal metastasis, any cut-off value for the total number of LN removed showed no statistical significance. In contrast, CompLND had a significant impact on patient survival. The Cox proportional hazard model showed that CompLND was a significant factor after adjusting for adjuvant chemotherapy. The total number of removed LN was not significant. In patients with muscle-invasive clinical node-negative UCUUT, the number of LN removed shows minimal influence on their survival. In contrast, the influence of the particular type of lymphadenectomy is statistically significant. These findings suggest that the extent of lymphadenectomy should be determined by the template and not by the number of removed LN.
    International Journal of Urology 10/2010; 17(10):848-54. DOI:10.1111/j.1442-2042.2010.02610.x · 1.80 Impact Factor
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    ABSTRACT: To analyze the prognosis of patients with sporadic bilateral renal cell carcinoma (RCC). From January 1979 to December 2007, 984 patients with sporadic RCC underwent surgery at our department. Of these, 53 patients (5.7%) presenting with bilateral RCC were included in this retrospective analysis. Thirty-one of the 53 bilateral RCC patients had synchronous RCC, and 22 had metachronous RCC. Distant metastases by the time of the bilateral tumor occurrence were found in four patients (13%) in the synchronous group and in 10 patients (48%) in the metachronous group. No difference was found between the two groups in terms of overall survival. In contrast, survival after the second surgery in the metachronous group was significantly lower than that after the first surgery (P < 0.001) in the synchronous group (P = 0.02). In addition, the incidence of local recurrence after partial nephrectomy was higher in the metachronous group (26%) compared to the synchronous group (4%, P = 0.04) or the unilateral RCC patients (0.4%, P < 0.01). Metachronous occurrence of RCC in the contralateral kidney is associated with an unfavorable prognosis, suggesting that metachronous contralateral tumors might be metastasis of the original tumors. A stricter follow-up schedule is advisable for metachronous bilateral RCC patients.
    International Journal of Urology 07/2010; 17(7):615-22. DOI:10.1111/j.1442-2042.2010.02541.x · 1.80 Impact Factor
  • The Journal of Urology 04/2010; 183(4). DOI:10.1016/j.juro.2010.02.490 · 3.75 Impact Factor
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    ABSTRACT: Close examination of a 67-year-old Japanese man, who complained of persistent nocturia, revealed that a semitransparent polypoid tumor had developed from the bladder neck to the prostatic urethra obstructing the internal urethral meatus, which resulted in excessive urinary retention and post-renal dysfunction. The tumor was resected by a transurethral procedure and a pathological examination of specimens revealed aggressive angiomyxoma (AAM) of the prostate. AAM usually develops in the intrapelvic and perineal organs of females. So far as we know, this is the second case of primary prostatic AAM reported in the English literature, and is the first case where the patient encountered urethral obstruction.
    Rare tumors 03/2010; 2(1):e15. DOI:10.4081/rt.2010.e15
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    ABSTRACT: Case ReportThe patient was a 78-year old Japanese man, who was treated previously for a peptic ulcer, an abdominal aortic aneurysm, and angina pectoris. He had been employed until the age of 60 years old in the production of plastic auto parts, such as those made from polyethylene and acrylonitrile-butadiene-styrene copolymer.In May 2006, the patient noticed a bruise on his back after falling and become aware of persistent pain in his left flank. He consulted a family doctor, who diagnosed the condition as a hemorrhage from a left renal cyst and prescribed conservative treatment. However, the symptoms remained and the patient was referred to our hospital three months later.Routine blood tests showed the presence of anemia and an IAP value that increased to 1060, while other parameters were within the normal range and a urine test showed no abnormal findings including hematuria. An abdominal CT scan demonstrated a distinctly bordered mass located on the upper pole of the left kidney that measured approximately 14 cm in maximum diameter. The images also showed that the distribution of contrast material was limited to the margin of the mass without focal pooling, which suggested that the central part was hemorrhagic or necrotized, while the periphery had no obvious tumor formation (Figure 1). Additionally, CT scanning depicted a newly developed low density area with poor contrast in the sixth segment of the liver (Figure 1). Therefore, we considered that the lesions located in the left kidney and liver corresponded, respectively, to primary renal and metastatic hepatic lesions of renal cell carcinoma. We performed a radical nephrectomy in August 2006 in order to achieve tumor cytoreduction. The excised kidney was 960 g in weight, while the tumorous lesion was approximately 18×11×7 cm in size, and composed of a non-specific hematoma and surrounding fibrous capsule (Figure 2). The initial pathological diagnosis was a chronic hematoma with no evidence of malignancy.Figure 1Abdominal CT scan findings obtained before the initial operation. An approximately 14 cm-sized mass with a distinct border was found located on the upper pole of the left kidney (A). The distribution of contrast material was limited to its margin without ...Figure 2Macroscopic appearance of affected kidney. The mass was located on the upper pole of the left kidney. The majority of the lesion was occupied by a non-specific hematoma and its periphery was composed of fibrous tissue. No neoplastic lesions were observed ... Two months after the operation, follow-up CT scans showed the hepatic lesion to be increasing in size and multiplying; however, we were not able to perform a liver biopsy because of the high risk of bleeding or rupture. Four months after the operation, spinal paralysis developed suddenly, and MR imaging revealed a new tumor that had destroyed the twelfth thoracic vertebra and compressed the adjacent spinal cord. The tumor was removed immediately by orthopedic surgeons. According to the pathological report, the tumor in the thoracic vertebra was composed of spindle cells with mildly atypical nuclei and a sheet-like appearance, and which were proliferating and infiltrating the surrounding area. Following the second surgery, cross-sections of the total kidney specimen were prepared and subjected to re-evaluation, which demonstrated spindle-shaped tumor cells, the same as those seen in the thoracic vertebra (Figure 3).Figure 3Microscopic findings of the primary renal lesion. Most areas of the specimens were occupied by the non-specific hematoma, whereas the tumor was located in the periphery of the hematoma (A). Spindle-shaped tumor cells with low-grade atypia had proliferated ... Immunohistochemistry findings showed that the neoplastic cells were not positive for cytokeratin, a marker of epithelial cells, but rather for vimentin, a marker of mesenchymal cells. The neoplastic cells were positive also for factor VIII-related antigen, CD31, and CD34, which are markers of endothelial cells, and for VEGF and its receptor, Flk-1. These immunohistochemical findings supported a final diagnosis of angiosarcoma. Immediately after the final diagnosis, recombinant interleukin-2 monotherapy (35 ~ 70 C × 104 IU three times a week for a total dose of 22×106 IU) was started for the liver metastases in February 2007. However, the patient died of metastatic disease 13 months after the initial operation.
    Rare tumors 07/2009; 1(2):e28. DOI:10.4081/rt.2009.e28
  • The Journal of Urology 04/2009; 181(4):440-440. DOI:10.1016/S0022-5347(09)61249-0 · 3.75 Impact Factor
  • The Journal of Urology 04/2009; 181(4):134-134. DOI:10.1016/S0022-5347(09)60386-4 · 3.75 Impact Factor
  • The Journal of Urology 04/2009; 181(4):437-437. DOI:10.1016/S0022-5347(09)61240-4 · 3.75 Impact Factor
  • The Journal of Urology 04/2009; 181(4):437-437. DOI:10.1016/S0022-5347(09)61241-6 · 3.75 Impact Factor
  • Article: Reply.
    Urology 12/2008; 72(5):1088-1089. DOI:10.1016/j.urology.2008.08.431 · 2.13 Impact Factor
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    ABSTRACT: To assess the influence of cold ischemia on postoperative renal function and the new onset of late-stage chronic kidney disease during long-term follow-up after partial nephrectomy. A total of 131 patients with renal tumors who underwent partial nephrectomy and were followed up for >or=12 months were included in the present study. Renal function was analyzed using the estimated glomerular filtration rate (e-GFR). We classified the subjects into 3 groups according to the length of cold ischemia time: group 1, 1-30 minutes; group 2, 31-60 minutes; and group 3, >60 minutes. Although the postoperative e-GFR was lower in group 3 than in groups 1 and 2, no significant difference was found among the 3 groups during long-term follow-up when preoperative CKD was absent. A cold ischemia time of >or=44 minutes significantly increased the probability of freedom from the new onset of an e-GFR of <45 mL/min/1.73 m(2), but this difference was minimal. Multivariate analysis showed that the preoperative e-GFR and the relative decrease of e-GFR at 1 year after surgery were the significant factors determining postoperative renal function. A cold ischemia time of >44 minutes appears to be a threshold influencing the new onset of late-stage CKD; however, it was not a significant factor on multivariate analysis. Thus, renal hypothermia appears to prevent the deterioration of renal function long term after surgery for patients undergoing a longer ischemia time.
    Urology 10/2008; 72(5):1083-8; discussion 1088-9. DOI:10.1016/j.urology.2008.06.074 · 2.13 Impact Factor

Publication Stats

547 Citations
198.45 Total Impact Points

Institutions

  • 1999–2014
    • Tokyo Women's Medical University
      • • Department of Dermatology
      • • Department of Urology
      Edo, Tōkyō, Japan
  • 2011
    • Kameda Medical Center
      Kameda, Niigata, Japan
  • 2009
    • Toyohashi Municipal Hospital
      Toyohasi, Aichi, Japan
  • 2004
    • National Institute of Health and Nutrition
      Edo, Tōkyō, Japan
  • 1998
    • The Jikei University School of Medicine
      Edo, Tōkyō, Japan
  • 1994–1998
    • Tokyo Junshin Women's College
      • • Department of Urology
      • • Department of Medicine
      Edo, Tōkyō, Japan