Masato Fujisawa

Kobe University, Kōbe, Hyōgo, Japan

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Publications (688)1646.34 Total impact

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    ABSTRACT: Rotavirus infections are a major cause of diarrhea in children in both developed and developing countries. Rotavirus genetics, patient immunity, and environmental factors are thought to be related to the severity of acute diarrhea due to rotavirus in infants and young children. The objective of this study was to provide a correlation between rotavirus genotypes, clinical factors and degree of severity of acute diarrhea in children under 5 years old in Surabaya, Indonesia. A cross-sectional study was conducted in children aged 1-60 months with acute diarrhea hospitalized in Soetomo Hospital, Surabaya, Indonesia from April to December 2013. Rotavirus in stool specimens was identified by ELISA and genotyping (G-type and P-type) using multiplex reverse transcription PCR. Severity was measured using the Ruuska and Vesikari scoring system. The clinical factors were investigated included patient's age (months), hydration, antibiotic administration, nutritional state, co-bacterial infection and co-viral infection. A total of 88 children met the criteria; 80.7% were aged 6-24 months, watery diarrhea was the most common type (77.3%) and 73.6% of the subjects were co-infected with bacteria, of which pathogenic Escherichia coli was the most common (42.5%). The predominant VP7 genotyping (G-type) was G2 (31.8%) and that of VP4 genotyping (P-type) was P[4] (31.8%). The predominant rotavirus genotype was G2P[4] (19.3%); G1P[4] and G9P[4] were uncommon with a prevalence of 4.5%. There were significant differences between the common genotype and uncommon genotype with respect to the total severity score of diarrhea (p <0.05). G3, G4 and G9 were significantly correlated with severe diarrhea (p = 0.009) in multivariate analyses and with frequency of diarrhea (>10 times a day) (p = 0.045) in univariate analyses, but there was no significant correlation between P typing and severity of diarrhea. For combination genotyping of G and P, G2P[4] was significantly correlated with severe diarrhea in multivariate analyses (p = 0.029). There is a correlation between rotavirus genotype and severity of acute diarrhea in children. Genotype G2P[4] has the highest prevalence. G3, G4, G9 and G2P[4] combination genotype were found to be associated with severe diarrhea.
    Gut Pathogens 12/2015; 7(1). DOI:10.1186/s13099-015-0048-2 · 2.07 Impact Factor
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    ABSTRACT: A kidney transplant case with de novo donor-specific antibody showed monoclonal plasma cell infiltration into the graft with ABO incompatibility. Three years after transplantation, the patient's graft function suddenly deteriorated. Interstitial edema and the predominant infiltration of inflammatory plasma cells with kappa chain monoclonality were observed in biopsy specimens. The in situ hybridization of Epstein-Barr virus was negative and post-transplant lymphoproliferative disorder was not evident from radiological examinations. On laboratory examination, the patient had de novo donor-specific antibody for HLA-DQ. We suspected plasma cell-rich acute rejection for which methylprednisolone pulse therapy, plasma exchange, rituximab, and 15-deoxyspergualin were given. In the ensuing biopsy, the degree of plasma cell infiltration was similar to the first biopsy; however, kappa chain monoclonality relatively weakened. Owing to resistance to these treatments, intravenous immunoglobulin (IVIG) (0.5 g/kg/day) was added. The serum creatinine level gradually declined to 3.1 mg/dL; however, it increased up to 3.6 mg/dL again. In the final biopsy, the infiltrated plasma cells disappeared but severe interstitial fibrosis developed. This case showed difficulty in the diagnosis and treatment of plasma cell-rich acute rejection. A detailed consideration of this case may be helpful in understanding the clinical features and pathogenesis of this condition. © 2015 Asian Pacific Society of Nephrology.
    Nephrology 07/2015; 20 Suppl 2(S2):66-9. DOI:10.1111/nep.12471 · 1.86 Impact Factor
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    ABSTRACT: The potential of S-1 for the treatment of metastatic renal cell carcinoma (mRCC) has been shown in two phase 2 studies. We aimed to assess the safety, tolerance, pharmacokinetics and clinical activity of S-1 combined with sorafenib in patients with mRCC. In this multicenter, single-arm, open-label, phase 1/2 study of S-1 plus sorafenib, we recruited patients with clear-cell or papillary renal cell carcinoma who had received a maximum of one prior cytokine-based regimen. The phase 1 primary endpoints were the maximum tolerated dose (MTD) and recommended dose (RD). S-1 was administered orally at 60, 80, 100 or 120 mg/day on days 1 to 28 of a 42-day cycle in combination with sorafenib (400 or 800 mg/day), given daily with dose adjustment. In phase 2, the primary endpoint was to assess the overall response rate (ORR) at the RD. Nine patients were enrolled into phase 1 and 21 (including 6 patients who received the RD in the phase 1 portion) were enrolled into phase 2. In the phase 1 portion, the MTD could not be determined, and the RD was defined as S-1 80 mg/m(2)/day on days 1-28+sorafenib 800 mg/day on days 1-42. In the phase 2 portion, 21 patients were fully assessable for efficacy and safety. The confirmed ORR was 52% (95% CI, 29.8-74.3), including one complete response (5%) and 10 partial responses (48%). The median progression free survival was 9.9 (95% CI, 6.5-17.1) months. The most frequently reported treatment-related adverse event for all grades was hand-foot skin reaction (100%). The major reasons for dose reduction were hand-foot skin reaction (38%) and rash (14%). Combination therapy with S-1 plus sorafenib is effective and tolerable for patients with mRCC. However, skin events management is important in S-1 plus sorafenib combination therapy. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.
    Annals of Oncology 06/2015; DOI:10.1093/annonc/mdv280 · 6.58 Impact Factor
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    ABSTRACT: Purpose To evaluate retrospectively the outcomes of microdissection testicular sperm extraction (micro-TESE) in men with nonobstructive azoospermia (NOA) and to identify the parameters predicting successful sperm retrieval in this cohort of patients. Methods After excluding patients with normal testicular volume and serum follicle-stimulating hormone (FSH) level who received conventional TESE, this study included 329 consecutive NOA patients undergoing micro-TESE at our institution. The significance of several factors, including age, testicular volume, etiology and serum levels of FSH, luteinizing hormone (LH) and serum testosterone (T), as predictors of successful sperm retrieval, was evaluated. Results Of the 329 men included in this series, 246 (74.8 %), 40 (12.2 %), and 43 (13.1 %) were pathologically diagnosed with Sertoli cell only, maturation arrest, and hypospermatogenesis, respectively. Spermatozoa were retrieved in 97 (29.5 %) of these 329 men by micro-TESE. Older age and non-idiopathic etiology were significantly associated with the probability of successful sperm retrieval; however, there were no significant effects of testicular volume as well as serum levels of FSH, LH, and T on sperm retrieval outcome. Furthermore, Johnsen score of the micro-TESE specimen showed a significant association with whether spermatozoa were successfully retrieved. Univariate analysis of preoperative parameters identified older age and non-idiopathic etiology as significant predictors of successful sperm retrieval, of which only etiology appeared to be independently related to successful sperm retrieval on multivariate analysis. Conclusions Spermatozoa are significantly less likely to be successfully retrieved by micro-TESE in men with idiopathic azoospermia.
    Reproductive Medicine and Biology 06/2015; DOI:10.1007/s12522-015-0212-x
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    ABSTRACT: Objectives To assess the significance of performance status as a prognostic factor after radical cystectomy for urothelial carcinoma of the bladder.Methods The present study included 730 consecutive patients with urothelial carcinoma of the bladder who underwent radical cystectomy. Clinicopathological outcomes in these patients were analyzed focusing on the impact of performance status, which was assessed using the Karnofsky Performance Status scale before surgery. Patients were classified into groups with Karnofsky Performance Status ≥90 and ≤80.ResultsA total of 561 (76.8%) and 169 (23.2%) patients were judged to have Karnofsky Performance Status ≥90 and ≤80, respectively. During a mean of 52.0 months, disease recurrence and mortality occurred in 257 (35.2%) and 249 (34.1%) patients, respectively, and the 5-year recurrence-free and overall survival rates were 64.1 and 65.3%, respectively. There were significant differences in age, hemoglobin, albumin, estimated glomerular filtration rate, pathological T stage and nodal involvement between the Karnofsky Performance Status ≥90 and ≤80 groups. Multivariate analysis showed independent impacts of Karnofsky Performance Status, pathological T stage, nodal involvement and lymphovascular invasion on recurrence-free survival, as well as independent impacts of Karnofsky Performance Status, age, body mass index, hemoglobin, pathological T stage, nodal involvement and lymphovascular invasion on overall survival.Conclusions The results suggest a significant association between impaired performance status and unfavorable prognosis in patients with urothelial carcinoma of the bladder undergoing radical cystectomy.
    International Journal of Urology 05/2015; DOI:10.1111/iju.12804 · 1.80 Impact Factor
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    ABSTRACT: The objective of this study was to characterise the status of health-related quality of life (HRQOL) in Japanese men with late-onset hypogonadism (LOH) treated with testosterone replacement therapy (TRT). HRQOL in 69 consecutive Japanese men with LOH undergoing TRT for at least 6 months was prospectively evaluated before and 6 months after the initiation of TRT using the Medical Outcomes Study 8-Item Short-Form Health Survey (SF-8). All eight-scale scores except for bodily pain (BP) in the 69 patients at 6 months after the introduction of TRT significantly improved compared with those before TRT; however, all scale scores except for BP in the 69 patients were significantly inferior to those in age-matched Japanese controls irrespective of the timing of SF-8. Multivariate analyses of several parameters revealed that both age and Aging Male Symptom (AMS) score had an independent impact on mental health (MH), despite the lack of an independent association between any score and the remaining factors examined. TRT appeared to significantly improve the status of HRQOL in men with LOH; however, even after the introduction of TRT, HRQOL associated with MH remained significantly impaired in elderly men and/or those with a high AMS score. © 2015 Blackwell Verlag GmbH.
    Andrologia 05/2015; DOI:10.1111/and.12433 · 1.17 Impact Factor
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    ABSTRACT: To identify patients with metastatic renal cell carcinoma (mRCC) who received tyrosine kinase inhibitors (TKIs) in both first- and second-line settings in order to investigate the association of oncological outcomes between the two lines of therapy. Patients with Methods: The study included 76 consecutive patients with mRCC treated with second-line TKI therapy after the failure of first-line TKI therapy. The association of oncological outcomes between first- and second-line therapies was analyzed in these 76 patients. In this series, the objective response rates (ORRs) to first- and second-line TKI therapies were 10.5% and 25.0%, respectively. The ORR to second-line TKI therapy was not significantly different among patients achieving a complete or partial response, stable disease and progressive disease to first-line TKI therapy (37.5%, 21.6% and 29.4%, respectively; p=0.34). The median durations of progression-free survival (PFS) with first- and second-line TKI therapies were 7.9 and 8.1 months, respectively, and there was no significant correlation between them (p=0.78). Out of the examined factors, the pre-treatment C-reactive protein level, number of metastatic sites and Memorial Sloan-Kettering Cancer Center risk classification model, but not the response to first-line TKI therapy, were independently associated with PFS on second-line TKI therapy, based on multivariate analysis. The clinical response to second-line TKI therapy is not dependent on that to first-line TKI therapy in patients with mRCC; therefore, it may not be necessary to switch to an alternative agent with a mechanism different from TKIs as second-line therapy, even if patients do not respond to first-line TKI therapy. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.
    Anticancer research 05/2015; 35(5):3067-73. · 1.87 Impact Factor
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    ABSTRACT: To investigate the optimal dose of vancomycin (VCM) for methicillin-resistant Staphylococcus aureus infections in the urological patients including renal dysfunction. We had 143 sets of available data from the consecutive patients treated in the urological department for analysis in VCM dose, VCM trough and estimated glomerular filtration rate: eGFR at VCM trough examination. Patients were classified according to eGFR level, and we calculated the regression line between VCM dose and VCM trough accordingly. Median VCM dose were 1000 (range 500-3500) mg per day, the VCM trough was 15.6 ± 7.89 μg/ml, and eGFR was 61.1 ± 27.2 ml/min/1.73 m(2). Our regression analysis (x axis: VCM dose (mg) and y axis: VCM trough (μg/ml) was statistically significant in the group with eGFR of 30-60 ml/min/1.73 m(2) (y = 26.103x + 481.7; r (2) = 0.1291) and the group with eGFR of 60-90 ml/min/1.73 m(2) (y = 48.891x + 350.75; r (2) = 0.2561) in both with (p = 0.021 and 0.035, respectively) or without (p = 0.012 and 0.004, respectively) adjustments by body weight for VCM doses. These data showed that the optimal dose of VCM varied according to the eGFR value in consecutive urological patients with various renal functions.
    International Urology and Nephrology 04/2015; 47(6). DOI:10.1007/s11255-015-0973-5 · 1.29 Impact Factor
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    ABSTRACT: To evaluate the expression of multiple molecular markers involved in autophagy, a cellular degradation pathway for the clearance of damaged or superfluous proteins and organelles, in localized prostate cancer (PC) to clarify the prognostic significance of these markers in patients undergoing radical prostatectomy (RP). Expression levels of 5 autophagy markers, including autophagy-related gene 5, autophagy-related gene 9, Beclin1, microtubule-associated protein light chain 3, and UNC-51-like kinase 1 (ULK1), in RP specimens from 160 consecutive patients with clinically localized PC were measured by immunohistochemical staining. Of these 5 markers, ULK1 expression was significantly correlated with the incidence of biochemical recurrence (BR). On univariate analysis, ULK1 expression, serum prostate-specific antigen level, pathologic stage, Gleason score, seminal vesicle invasion, and surgical margin status were identified as significant predictors of BR. All these significant factors except for seminal vesicle invasion were independently associated with BR on multivariate analysis. Furthermore, significant differences in BR-free survival according to the positive numbers of these 5 independent risk factors were noted, that is, BR occurred in 2 of 33 patients negative for risk factors (6.1%), 20 of 76 patients positive for 1 or 2 risk factors (26.3%), and 38 of 51 patients positive for ≥3 risk factors (74.5%). Collectively, these findings suggest that measurement of expression levels of potential autophagy markers, particularly ULK1, in RP specimens, in addition to conventional parameters, may contribute to the accurate prediction of BR after RP for localized PC. Copyright © 2015 Elsevier Inc. All rights reserved.
    Urology 04/2015; 85(6). DOI:10.1016/j.urology.2015.03.006 · 2.13 Impact Factor
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    ABSTRACT: There are several mechanisms for antibiotic-resistant Pseudomonas aeruginosa. The purpose of this study is to investigate the association between the expression of efflux pump-coding genes and antibiotic resistance in P. aeruginosa causing urinary tract infections (UTIs). We extracted the RNA from 105 clinical strains of P. aeruginosa isolated from UTI patients with full data on antibiotic MICs and assayed real-time quantitative reverse-transcription PCR. We investigated the gene expressions of four resistance nodulation cell division-type multi-drug efflux pump systems (MexAB-OprM, MexCD-OprJ, MexEF-OprN and MexXY(-OprA)) and the correlation of the MICs of nine antibiotics, risk factors and antibiotic resistance-related genes with expressions of mexB, mexC, mexE and mexY. Multivariate statistical data demonstrated a significant relationship between increased expression of mexB or mexC and complicated UTI (Odds ratio=8.03, P<0.001 and Odds ratio=8.86, P=0.032, respectively). We also found a significant association between the increased expression of mexC and resistance to levofloxacin (LVFX) (Odds ratio=4.48, P=0.035). In conclusion, increased expression of mexC leads to LVFX resistance in P. aeruginosa causing UTI. These results contribute to our knowledge of the efflux pump system and antibiotic resistance.The Journal of Antibiotics advance online publication, 8 April 2015; doi:10.1038/ja.2015.34.
    The Journal of Antibiotics 04/2015; DOI:10.1038/ja.2015.34 · 2.04 Impact Factor
  • Hiromoto Tei, Hideaki Miyake, Masato Fujisawa
    European Urology Supplements 04/2015; 193(4):e692-e693. DOI:10.1016/j.juro.2015.02.1996 · 3.37 Impact Factor
  • Noritoshi Enatsu, Hideaki Miyake, Masato Fujisawa
    The Journal of Urology 04/2015; 193(4):e988. DOI:10.1016/j.juro.2015.02.2796 · 3.75 Impact Factor
  • The Journal of Urology 04/2015; 193(4):e698. DOI:10.1016/j.juro.2015.02.2087 · 3.75 Impact Factor
  • The Journal of Urology 04/2015; 193(4):e797-e798. DOI:10.1016/j.juro.2015.02.2312 · 3.75 Impact Factor
  • European Urology Supplements 04/2015; 14(2):e178-e178a. DOI:10.1016/S1569-9056(15)60180-4 · 3.37 Impact Factor
  • Satoshi Imai, Hideaki Miyake, Masato Fujisawa
    The Journal of Urology 04/2015; 193(4):e456-e457. DOI:10.1016/j.juro.2015.02.757 · 3.75 Impact Factor
  • The Journal of Urology 04/2015; 193(4):e987-e988. DOI:10.1016/j.juro.2015.02.2795 · 3.75 Impact Factor
  • Hiromoto Tei, Hideaki Miyake, Masato Fujisawa
    The Journal of Urology 04/2015; 193(4):e442-e443. DOI:10.1016/j.juro.2015.02.1276 · 3.75 Impact Factor
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    ABSTRACT: The objective of this study was to assess the impact of urethral fibrosis on the continence status following robot-assisted radical prostatectomy (RARP). The findings of fibrosis of the urethral wall and periurethral tissue in 185 patients undergoing RARP were each divided into grade 0 to 3 based on preoperative T2-weighted magnetic resonance imaging. Urethral fibrosis was defined as the sum of both grades, and scores ≤ 2 and ≥ 3 were considered as 'no/mild' and 'severe' fibrosis, respectively. The incidences of continence in patients with no/mild fibrosis were significantly higher at 3, 6, and 12 months after RARP than those with severe fibrosis. Furthermore, urethral fibrosis was identified as an independent predictor of the postoperative continence status at 3, 6, and 12 months after RARP. Assessment of urethral fibrosis could be a significant predictor of recovery of the urinary continence status after RARP. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.
    European Urology Supplements 04/2015; 193(4):e182. DOI:10.1016/j.juro.2015.02.859 · 3.37 Impact Factor
  • The Journal of Urology 04/2015; 193(4):e193-e194. DOI:10.1016/j.juro.2015.02.925 · 3.75 Impact Factor

Publication Stats

5k Citations
1,646.34 Total Impact Points

Institutions

  • 1987–2015
    • Kobe University
      • • Division of Urology
      • • International Center for Medical Research and Treatment
      Kōbe, Hyōgo, Japan
  • 2014
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 2010–2012
    • Hyogo Prefectural Amagasaki Hospital
      Amagasaki, Hyōgo, Japan
    • Hyogo Cancer Center
      Akasi, Hyōgo, Japan
  • 2011
    • Government of the People's Republic of China
      Peping, Beijing, China
    • Institute for Molecular Medicine and Cell Therapy
      Düsseldorf, North Rhine-Westphalia, Germany
  • 2007–2009
    • Hyogo College of Medicine
      Nishinomiya, Hyōgo, Japan
  • 2008
    • Osaka City University
      • Department of Urology
      Ōsaka, Ōsaka, Japan
    • Kyoto Prefectural University
      Kioto, Kyōto, Japan
  • 2006–2007
    • Nishiwaki Municipal Hospital
      Нишиваки, Hyōgo, Japan
    • Vancouver General Hospital
      Vancouver, British Columbia, Canada
  • 2003–2007
    • Kawasaki Medical University
      • Department of Urology
      Kurasiki, Okayama, Japan
  • 2004
    • Tsumura & Co.
      Edo, Tōkyō, Japan
  • 1996
    • Hyogo Prefectural Kakogawa Medical Center
      Ōsaka, Ōsaka, Japan