Masato Fujisawa

The Australian Society of Otolaryngology Head & Neck Surgery, Evans Head, New South Wales, Australia

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Publications (657)1550.74 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: 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; 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
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    ABSTRACT: Cinacalcet is a promising therapy widely used in dialysis patients with hyperparathyroidism resistant to conventional therapy. However, reports regarding the influence of cinacalcet cessation after long-term use on kidney transplantation patients are few. This retrospective observational study included 40 dialysis patients who underwent kidney transplantation. Creatinine, corrected calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone levels were assessed before and after kidney transplantation according to pretransplant treatment of chronic kidney disease-mineral and bone disorder. Ultrasonography revealed enlargement of the parathyroid in all patients treated with cinacalcet. Although the data at the time of kidney transplantation were comparable, the serum levels of calcium, alkaline phosphatase, and intact parathyroid hormone after kidney transplantation were higher in patients treated with cinacalcet than in those treated without. However, serum phosphate levels in the cinacalcet group were slightly higher at the time of kidney transplantation and significantly lower 3 months later. Mineral abnormalities persisted in kidney transplant patients with enlarged parathyroid glands after discontinuation of cinacalcet treatment. Parathyroidectomy should be considered in kidney transplant candidates with the risk of developing refractory hyperparathyroidism after transplantation.
    Clinical and Experimental Nephrology 03/2015; DOI:10.1007/s10157-015-1107-1 · 1.71 Impact Factor
  • Hideaki Miyake, Masato Fujisawa
    International Journal of Urology 03/2015; DOI:10.1111/iju.12740 · 1.80 Impact Factor
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    ABSTRACT: The objective of this study was to investigate the significance of changes from the standard dosing schedule of sunitinib, which is 4 weeks of treatment and 2 weeks off (schedule 4/2), to an alternative schedule with 2 weeks of treatment and 1 week off (schedule 2/1), after encountering dose-limiting toxicity in 45 consecutive Japanese patients with metastatic renal cell carcinoma (mRCC). Despite a definitively improved relative dose intensity of sunitinib by changing from schedule 4/2 to 2/1, this difference was not significant. Adverse events (AEs) occurred in all patients on both schedules 4/2 and 2/1; however, the proportion of patients experiencing AEs ≥ grade 3 on schedule 2/1 was significantly lower than that on schedule 4/2. Quality of life (QOL) analysis using SF-36 revealed that all eight scores during schedule 2/1 were more favorable than those during schedule 4/2, and there were significant differences in 2 of the 8 scores between these two schedules. Furthermore, multivariate analyses, which were performed to evaluate the contribution of several AEs on schedule 2/1 to the improvement of each score in SF-36, revealed that fatigue had independent impacts on two scores, despite the lack of an independent association between any scores and the remaining AEs examined. These findings suggest that schedule 2/1 is the optimal dosing schedule of sunitinib against mRCC that balances efficacy and toxicity, since treatment on schedule 2/1 resulted in a markedly improved QOL compared with that on schedule 4/2 by relieving the profile of sunitinib-related AEs.
    Medical Oncology 03/2015; 32(3):528. DOI:10.1007/s12032-015-0528-8 · 2.06 Impact Factor
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    ABSTRACT: Therapeutic options are limited for Neisseria gonorrhoeae infection, especially for oral drugs. The purpose of this study is to investigate the susceptibility of N. gonorrohoeae to oral Azithromycin (AZM) and the correlation between AZM resistance-related gene mutations and minimum inhibitory concentration (MIC). We measured the AZM MIC of clinical strains of N. gonorrhoeae and sequenced such as the peptidyltransferase loop in domain V of 23S rRNA, and investigated the statistical correlation between AZM MIC and those presence and number of the mutations. In 59 N. gonorrhoeae strains, our statistical data showed a deletion mutation was seen significantly more often in the higher MIC group (0.5 μg/mL or higher) (35/37: 94.6 %) compared with the lower MIC group (0.25 μg/mL or less) (4/22: 13.6 %) (p<0.0001). However, a mutation of codon 40 (Ala→Asp) in the mtrR gene (Helix Turn Helix) was seen significantly more often in the lower MIC group (12/22: 54.5 %) (p<0.0001). In NG-MAST analyses, ST4777 was representative of the lower MIC group and ST1407, ST6798 and ST6800 was representative of the higher MIC group. The NG-MAST type 1407 was detected as the most prevalent type in AZM resistant or intermediate strains as previously described. In conclusion, A deletion mutation of the mtrR promoter region may be a significant indicator for higher MIC (0.5 μg/mL or higher). ST4777 was often seen in the lower MIC group and ST1407, ST6798 and ST6800 were characteristic of the higher MIC group. Further research with a greater number of strains would help elucidate the mechanism of AZM resistance in N. gonorrhoeae infection. Copyright © 2015, American Society for Microbiology. All Rights Reserved.
    Antimicrobial Agents and Chemotherapy 02/2015; 59(5). DOI:10.1128/AAC.04320-14 · 4.45 Impact Factor
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    ABSTRACT: To evaluate the expression of multiple molecular markers associated with autophagy, a cellular degradation pathway for the clearance of damaged or superfluous proteins and organelles, in clear cell renal cell carcinoma (CCRCC) in order to identify the prognostic significance of these markers in patients undergoing radical nephrectomy. Expression levels of five markers, including autophagy-related gene 5 (Atg5), Atg9, Beclin 1, microtubule-associated protein light chain 3 (LC3), and UNC-51-like kinase 1 (ULK1), in radical nephrectomy specimens from a total of 100 patients with non-metastatic CCRCC were measured by immunohistochemical staining. All the five markers were significantly correlated with some pathological factors reflecting an aggressive phenotype, including the pathological T stage, tumor grade, and microvascular invasion. During the follow-up period of this series (median 58.0 months), disease recurrence developed in 41 of the 100 patients, with a 5-year recurrence-free survival (RFS) rate of 61.3 %. On univariate analysis, expression levels of Atg5 and Beclin 1, in addition to the pathological T stage, microvascular invasion, and preoperative CRP level, were identified as significant predictors of disease recurrence. Of these factors, the expression of Beclin 1 and preoperative CRP level were independently correlated with RFS on multivariate analysis. These findings suggest that the combined assessment of expression levels of autophagy-associated markers, particularly Beclin 1, in radical nephrectomy specimens with conventional prognostic parameters, would contribute to the precise prediction of postoperative disease recurrence in patients with non-metastatic CCRCC.
    Journal of Cancer Research and Clinical Oncology 02/2015; DOI:10.1007/s00432-015-1923-4 · 3.01 Impact Factor
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    ABSTRACT: To characterize clinical advantages in robot-assisted partial nephrectomy (RAPN) for targeting renal hilar tumors, and compare them with those of open PN (OPN). This study included 31 consecutive patients with renal hilar tumors, consisting of 15 and 16 who received OPN and RAPN, respectively, between January 2012 and May 2014. The perioperative and oncological outcomes of the two approaches were compared. In this series, a hilar tumor was defined as a renal cortical tumor located in the renal hilum that was shown, by preoperative imaging, to be in direct physical contact with the renal artery and/or vein. There were no significant differences between demographic variables of the OPN and RAPN groups. Intended surgical procedures were successfully completed for all 31 cases. Despite lack of a significant difference between ischemia times in the two groups, operative time for RAPN was significantly longer than for OPN, and estimated blood loss during RAPN was significantly less than that during OPN. There were no significant differences between incidence of postoperative complications or percentage decrease in estimated glomerular filtration rate 4 weeks after surgery in the two groups. Indicators of postoperative recovery seemed to favor RAPN compared with OPN, with significant differences. No patient in either group was pathologically diagnosed with a positive surgical margin. These findings suggest that, compared with OPN, RAPN is an effective, safe, and less invasive surgical option for renal hilar tumors.
    International Journal of Clinical Oncology 01/2015; DOI:10.1007/s10147-015-0783-x · 2.17 Impact Factor
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    ABSTRACT: To evaluate the expression of multiple molecular markers involved in the mammalian target of rapamycin (mTOR) signaling pathway in human muscle-invasive bladder cancer (BC) and to assess the therapeutic efficacies of mTOR inhibitors in human BC KoTCC-1 cells. Expression levels of 5 markers, including PTEN, phosphorylated (p)-Akt, p-mTOR, p-p70 ribosomal S6 kinase, and p-4E-binding protein 1 (4E-BP1), were measured in radical cystectomy specimens from 49 patients with muscle-invasive BC by immunohistochemical staining. We then analyzed the effects of treatment with temsirolimus or Ku-0063794, a dual inhibitor of mTOR complex 1 (C1) and mTOR complex 2 (C2), on changes in the growth and expression profiles of 5 mTOR-associated markers in KoTCC-1 cells. During the follow-up period of this study, disease recurred in 27 patients (55.1%), and of several factors examined, the expression level of p-4E-BP1 in addition to the pathological T stage was independently related to recurrence-free survival on multivariate analysis. Although the growth of KoTCC-1 cells was inhibited by both temsirolimus and Ku-0063794 in dose-dependent manners, treatment with Ku-0063794 resulted in a marked decrease in the expression of p-4E-BP1 in KoTCC-1 cells compared with that with temsirolimus. Furthermore, the growth-inhibitory effect of both mTOR inhibitors was shown to be proportional to the expression levels of p-4E-BP1. The phosphorylation status of 4E-BP1 appeared to be correlated with the prognosis of patients with muscle-invasive BC following radical cystectomy as well as the sensitivities of BC cells to mTOR inhibitors; therefore, the inactivation of 4E-BP1 using Ku-0063794 may be a promising novel approach for muscle-invasive BC. Copyright © 2015 Elsevier Inc. All rights reserved.
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    ABSTRACT: The objective of this study was to analyze the clinical outcomes of TIP (paclitaxel, ifosfamide and cisplatin) incorporated into induction chemotherapy for patients with metastatic germ cell tumor (GCT) characterized by unfavorable clinical features. This study included 37 patients, who were categorized into intermediate- or poor-risk GCT according to the International Germ Cell Consensus Classification (IGCCC). All 37 patients received two cycles of bleomycin, etoposide and cisplatin (BEP) followed by several cycles of TIP. Following treatment with TIP, 25 patients achieved the normalization of serum tumor markers. In addition, surgical resection of the residual tumors following TIP was performed in 17 patients who were pathologically diagnosed with no viable cancer cells. At a median follow-up of 36 months, 31 patients were alive, including 27 with no evidence of disease, whereas the remaining six died of disease progression. The 5-year disease-free survival (DFS) and overall survival (OS) rates in these 37 patients were 72.9 and 85.3 %, respectively. Despite the lack of a significant predictor of OS, univariate analysis identified the presence of a choriocarcinoma element and IGCCC as significant predictors of DFS, of which only the presence of a choriocarcinoma element appeared to be independently associated with DFS. In this series, treatment-related death did not occur, although 27 patients had at least one adverse event corresponding to grade 3≤. Collectively, it would be of worth to pursue the significance of the early incorporation of TIP into induction chemotherapy for patients with intermediate- or poor-risk metastatic GCT in the future.
    Medical Oncology 12/2014; 31(12):296. DOI:10.1007/s12032-014-0296-x · 2.06 Impact Factor
  • Hideaki Miyake, Masato Fujisawa
    International Journal of Urology 12/2014; 22(3). DOI:10.1111/iju.12676 · 1.80 Impact Factor
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    ABSTRACT: To depict an embryological origin of the duplicated ureter and to investigate whether the urogenital sinus absorb not only the Wolffian duct but also the ureter. During studies using sections of human fetuses (45 specimens), we incidentally found a specific type of ureteral duplication (at approximately 7 weeks) in which two unilateral ureters joined at the ureterovesical junction, apparently representing a morphology intermediate between complete and partial ureteral duplication. Because the existing literature lack any photographic representation of early development of the ureterovesical junction, we studied horizontal sections of 10 human embryos (approximately 5-6 weeks of gestation) in which the ureter did not join the urogenital sinus (future bladder) but instead joined the Wolffian duct (future vas deferens). The sinus consistently showed a reverse Y-shape where the arms extended posteriorly to receive the Wolffian duct. When absorption of the duct into the sinus wall reached the distal end of the ureter, the arm-like parts appeared to enlarge posteriorly for further involvement of the duct with little or no incorporation of the ureter. Therefore, the future trigone of the bladder might develop from these arm-like parts of the sinus posterior wall. Consequently, in the present case of ureteral duplication, it is considered that the ureters would probably have merged with the Wolffian duct at closely adjacent sites. The present study represented the first photographic demonstration of the early development of the human ureterovesical junction. This article is protected by copyright. All rights reserved.
    BJU International 11/2014; DOI:10.1111/bju.13006 · 3.13 Impact Factor
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    ABSTRACT: To investigate the impact of proteinuria on the renal function of patients with metastatic renal cell carcinoma (mRCC) who received axitinib, a tyrosine kinase inhibitor specifically targeting vascular endothelial growth factor receptors. This study included 65 consecutive Japanese patients who were diagnosed with mRCC and were subsequently treated with axitinib for at least 12 weeks. The association between the changes in the estimated glomerular filtration rate (eGFR) and proteinuria in these 65 patients was retrospectively assessed. Of the 65 patients, 41 (63.1 %) were judged to be positive for proteinuria. There were no significant differences between the eGFR value before the introduction of axitinib and that at the last clinic visit in either group with or without proteinuria. Furthermore, no significant correlation was noted between the changes in eGFR and the urine protein to creatinine ratio in the group positive for proteinuria, and there was no significant effect of the duration of treatment with axitinib on the changes in eGFR in the proteinuria group. Of several factors examined, univariate analysis identified age, eGFR prior to the introduction of axitinib, and timing of axitinib introduction, but not the presence of proteinuria, as predictors of a decrease in eGFR of >10 %; however, only age appeared to be independently associated with a decrease in eGFR of >10 %. These findings suggest that treatment with axitinib may not have a significant adverse impact on the renal function in patients with mRCC, irrespective of the presence of proteinuria.
    International Journal of Clinical Oncology 11/2014; DOI:10.1007/s10147-014-0770-7 · 2.17 Impact Factor
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    ABSTRACT: To compare the quality of surgical management of the neurovascular bundle (NVB) by assessment of neuronal nitric oxide synthase (nNOS)-positive nerves in surgical specimens between open retropubic radical prostatectomy (RP; ORRP) and robot-assisted RP (RARP). This study included 65 (99 sides, NVB resection; 31 sides, NVB preservation) and 83 (106 sides, NVB resection; 60 sides, NVB preservation) patients undergoing ORRP and RARP, respectively. The posterior sectors from the apex, mid, and base areas on each side were immunohistochemically stained with an nNOS antibody. On the sides with NVB resection, there were no significant differences in the numbers of nNOS-positive nerves in any areas between the ORRP and RARP groups; however, on the sides with NVB preservation, the numbers of nNOS-positive nerves in the ORRP group were significantly higher than those in the RARP group at the apex (84.4 vs 59.2; P = .0028), mid (71.2 vs 52.4; P = .016), and base (148.0 vs 40.8; P <.001) areas. In 55 patients who were judged not to have severe erectile dysfunction before surgery and subsequently underwent nerve-sparing RP, there was a significantly inverse correlation between the total number of nNOS-positive nerves on both sides and the postoperative erectile function. These findings suggest that RARP might be suitable for performing precise nerve-sparing surgery compared with ORPP, particularly in the base area of the prostate and that the quantification of nNOS-positive nerves in surgical specimens could be a useful approach for predicting the postoperative erectile function. Copyright © 2014 Elsevier Inc. All rights reserved.
    Urology 11/2014; 191(4). DOI:10.1016/j.urology.2014.05.081 · 2.13 Impact Factor
  • Katsumi Shigemura, Masato Fujisawa
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    ABSTRACT: Hedgehog (Hh) signaling is aberrantly activated in several hematological and solid cancers. Therapeutic options are sometimes lacking for urological cancers because their mechanisms of progression are imperfectly understood. Studies establishing the anti-tumor effects and safety of inhibitors of Hh pathways are needed for tumors in which the Hh pathways are activated. At present vismodegib is clinically available for basal cell carcinoma, and is expected to be extended to treat other cancers. Cholecalciferol, the precursor of active vitamin D3, is a strong inhibitor of Shh-Gli signaling and may have growth inhibitory effects in renal cancer. As a supplementary therapy it may promote tumor regression. Preclinical data in prostate cancer suggest that while suppressing Hh signaling could reduce invasion and metastasis, it may also result in acquired drug resistance after long-term use. Combining Hh inhibitors with ionizing radiation and/or chemotherapy could improve treatment while lessening the risk of acquired drug resistance. Expression of Shh-related ligand gene and Shh-Gli-inducible target genes like FOXM1 or IGF2 is characteristic of urothelial tumor samples. Overexpression of Shh is observed in 96% of non-muscle invasive bladder cancer and 52% of muscle invasive bladder cancer samples. This review summarizes recently reported trends in Hh signaling activation studies in urological cancer, especially focusing on possible clinical applications.
    Current Drug Targets 11/2014; 16(3). DOI:10.2174/1389450115666141125122643 · 3.60 Impact Factor
  • Katsumi Shigemura, Masato Fujisawa
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    ABSTRACT: Neisseria gonorrhoeae is a common causative microorganism of male urethritis. The most important problem with this infectious disease is antibiotic resistance. For instance, in the 1980's-1990's, most studies showed almost 100 % susceptibility of N. gonorrhoeae to the representative cephalosporines, cefixime and cefpodoxime. By the late 1990s the reported susceptibility decreased to 93.3 -100 % and further decreased to 82.9-100 % in the early 2000's. However, reported susceptibility revived to 95.8-100 % in the late 2000's to 2010's. The susceptibility of N. gonorrhoeae to penicillins varies in different countries or regions. A 2002 Japanese study showed a resistance ratio of about 30% while Laos, China and Korea showed 80-100 % resistance. Fluoroquinolones demonstrated a dramatic change of effect on N. gonorrhoeae. In the early 1990's, 0.3-1.3 % of N. gonorrhoeae showed low susceptibility or resistance to ciprofloxacin in US but this figure jumped to 9.5 % by 1999. In Asia, ciprofloxacin resistance or lower susceptibility by N. gonorrhoeae was about 80-90% in the early 2000's and this trend still continues to the present day. Azithromycin is currently the possible last weapon for N. gonorrhoeae treatment per oral administration. The susceptibility of N. gonorrhoeae to this drug was 100 % in Indonesia in 2004 and the latest study from Germany showed 6 % resistance in strains from 2010-2011. In this review, we summarize the history and epidemiology of the antibiotic susceptibilities of N. gonorrhoeae, since the most frequently used antibiotics vary between countries or regions.
    Current Drug Targets 11/2014; 16(3). · 3.60 Impact Factor
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    ABSTRACT: The prevalence of extended-spectrum β-lactamases (ESBLs) has been increasing worldwide. Recently, a pandemic clone of Escherichia coli O25:H4, sequence type 131 (ST131), producing ESBL-type CTX-M-15 has been reported as a major problem. In this study, we investigated the molecular characteristics of 72 ESBL-producing E. coli isolates. We detected the ESBL blaCTX-M gene and nine virulence factor genes (papC, papEF, fimH, hlyA, iutA, sfa, eaeA, bfpA, and aggR) by PCR and DNA sequencing, plasmid replicon typing, phylogenetic grouping, repetitive-sequence-based PCR (rep-PCR), and multilocus sequence typing. All strains were positive for blaCTX-M. Twenty-two (30.6%) strains in CTX-M-1 group included 9 (12.5%) of CTX-M-15, 3 (4.2%) in CTX-M-2 group, and 47 (65.3%) strains in CTX-M-9 group. The CTX-M-15-producing E. coli O25:H4 ST131 was derived from phylogenetic group B2 and rep-PCR pattern d. The most prevalent virulence factor was fimH (72 strains; 100%) and the most common replicon type was the IncF type (65 strains; 90.3%). The CTX-M-9 group was significantly associated with the presence of papC and papEF [OR (95% CI)=9.22 (1.32-64.7), p=0.025] or hlyA [OR (95% CI)=5.57 (1.17-26.4), p=0.031]. In conclusion, we confirmed that CTX-M-15-producing E. coli O25:H4 ST131 has emerged in Japan and found significant virulence factors with CTX-M-9 group.
    Microbial drug resistance (Larchmont, N.Y.) 10/2014; 21(2). DOI:10.1089/mdr.2014.0083 · 2.52 Impact Factor
  • Nobuyuki Hinata, Masato Fujisawa
    Urology 10/2014; 84(4):987-8. DOI:10.1016/j.urology.2014.07.027 · 2.13 Impact Factor
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    ABSTRACT: We investigated the clinical effectiveness and safety of tazobactam/piperacillin (TAZ/PIPC) in a 1:8 ratio, a β-lactamase inhibitor with penicillin antibiotic, for the prevention of febrile infectious complication after prostate biopsy. Each patient received a single dose of TAZ/PIPC 4.5 g, 30 min before the biopsy in Group 1 or TAZ/PIPC 4.5 g twice, once 30 min before and once after the biopsy (just before discharge or 5 h after the biopsy), in Group 2. Estimation of efficacy was performed within 1-month after prostate biopsy. Clinical diagnosis of febrile infectious complication was based on a body temperature elevation greater than 38 °C. Infectious complication after prostate biopsy was detected in 2.5% (4/160 patients) in Group 1 and in 0.45% (2/442 patients) in Group 2. All of the patients with febrile infectious complication had risk factors: 5 patients had voiding disturbance, 2 patients had diabetes mellitus and 1 patient had steroid dosing. In group 1, 88 patients had at least one risk factor and 72 patients had no risk factors. Of the patients with a risk factor, 4 had febrile infectious complication after prostate biopsy, but there was no significant difference between the two groups. In group 2, 87 patients had at least one risk factor and 255 patients had no risk factors. The patients with a risk factor had febrile infectious complication significantly more frequently than did patients without a risk factor (P = 0.038). Therefore, TAZ/PIPC appears to be effective as preoperative prophylaxis against the occurrence of febrile infectious complication after prostate biopsy.
    Journal of Infection and Chemotherapy 10/2014; 20(9-10). DOI:10.1016/j.jiac.2014.06.011 · 1.38 Impact Factor

Publication Stats

5k Citations
1,550.74 Total Impact Points

Institutions

  • 2014
    • The Australian Society of Otolaryngology Head & Neck Surgery
      Evans Head, New South Wales, Australia
  • 1987–2014
    • Kobe University
      • • Division of Urology
      • • International Center for Medical Research and Treatment
      Kōbe, Hyōgo, Japan
  • 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