Noriyuki Ito

Nishi-Kobe Medical Center, Kōbe, Hyōgo, Japan

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Publications (64)139.02 Total impact

  • International Journal of Urology 04/2015; DOI:10.1111/iju.12767 · 1.80 Impact Factor
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    ABSTRACT: We assessed the effect of subcuticular buried sutures with subcutaneous closed suction drain to prevent surgical site infection (SSI) in patients undergoing total cystectomy with urinary diversion using the intestine. We reviewed the clinical charts of 43 consecutive patients who underwent total cystectomy with urinary diversion using the intestine from February 2006 to March 2011 at Nishi-Kobe Medical Center. All patients received intravenous prophylactic antibiotics before and throughout surgery as well as for three days after surgery. Skin closure was performed with interrupted vertical mattress sutures with 2-0 nylon on the first 22 patients (mattress group), and with interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous closed suction drain on the remaining 21 patients (subcuticular buried suture with subcutaneous drain ; SBD group). SSI occurred in 7 (31.8%) patients in the mattress group, but did not affect any patient in the SBD group. We compared risk factors for SSI between the groups, and found that the method of skin closure was significant risk factor for SSI (P=0.005). We concluded that interrupted subcuticular buried sutures with 4-0 absorbable monofilament with subcutaneous suction drain is effective for prevention of SSI in total cystectomy with urinary diversion using the intestine.
    Hinyokika kiyo. Acta urologica Japonica 11/2014; 60(11):537-542.
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    ABSTRACT: We prospectively investigated the safety and efficacy of sunitinib using a modified regimen (2 weeks on/1 weekoff) in 24 patients (22 males, 2 females ; age range 39-86 years, median 64 years) with metastatic renal cell carcinoma (RCC). During the observation period (3-62 weeks, median 21 weeks), thrombocytopenia was seen in 13 (54.2%), leukopenia in 11 (45.8%), hand-foot syndrome in 5 (20.8%), hypertension in 4 (16.7%), and hypothyroidism in 3 (12.5%) patients, while grade 3 or higher adverse events were found in 4 (16.7%), 1 (4.2%), 1 (4.2%), 2 (8.3%), and 0 patients, respectively. Of the 21 patients evaluable for response, 5 (23. 8%) showed partial response, 8 (38.1%) stable disease, and 8 (38.1%) progressive disease. This new modified regimen may lead to a reduction in adverse events for treatment of patients with metastatic RCC as a substitute for the standard dosing regimen of sunitinib.
    Hinyokika kiyo. Acta urologica Japonica 05/2014; 60(5):209-14.
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    ABSTRACT: We prospectively investigated the rates of incidence of surgical site infection (SSI), urinary tract infection (UTI), and remote infection (RI) in 4,677 patients who underwent urological surgery from January to December 2010, including 2,507 endourological cases, 1,276 clean cases, 807 clean-contaminated cases, and 87 contaminated cases involving bowel segments. A single dose of antimicrobial prophylaxis (AMP) was administered in the endourological, clean, and clean-contaminated surgery cases, except for patients who underwent transurethral resection of the prostate (TURP) or percutaneous nephrolithotripsy (PNL). AMP was administered within 72 h in TURP and PNL, and AMP was administered within 48 h in contaminated surgery cases. In cases of endourological surgery, UTI was observed in 4 % and RI in 0 %, and SSI, UTI, and RI were seen in 1 %, 1 %, and 1 %, respectively, of clean surgery cases, in 3 %, 3 %, and 2 %, respectively, of clean-contaminated surgery cases, and in 17 %, 30 %, and 10 %, respectively, of contaminated surgery cases. In multivariate analysis of the risk factors for infection, operative time was a significant risk factor for UTI in endourological surgery, and American Society of Anesthesiologists score and operative time were significant risk factors for RI in clean surgery. No significant risk factor was found in analyses of clean-contaminated and contaminated surgery cases. A single-dose AMP regimen was shown to be effective and feasible for prevention of perioperative infection in urological surgery.
    Journal of Infection and Chemotherapy 07/2013; DOI:10.1007/s10156-013-0631-8 · 1.38 Impact Factor
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    ABSTRACT: A 67-year-old man was referred to our hospital for evaluation of large urinary-diversion calculus. He had undergone urinary diversion for invasive bladder cancer with an Indiana pouch, when he was 52 years old. We performed the surgery using a laparoscopic trocar and an entrapment bag, for reducing the risk of bladder damage by the lithoclast and small residual fragments of the calculus. There has been no recurrence of stone formation 18 months after the surgery. This technique of percutaneous cystolithotomy of a large urinary calculus utilizing laparoscopic and endourologic instrumentation, is quick and safe, and can be used for complete stone removal, thereby decreasing the risk of recurrent stone formation.
    Hinyokika kiyo. Acta urologica Japonica 11/2012; 58(11):617-9.
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    ABSTRACT: A 67-year old man was diagnosed with advanced prostate cancer with multiple pelvic lymph nodes and multiple bone metastases (cT2N1M1b), with an initial prostate specific antigen of 1,300 ng/ml. Prostate biopsy specimens revealed poorly differentiated adenocarcinoma, Gleason's score 5+3. He was treated with maximal androgen blockade (MAB) from 2001, but showed resistance to hormone therapy and docetaxel in 2007. External radiation therapy for bone pain was difficult due to multiple lesions. 89Sr therapy was started in 2009. The therapy could be performed 5 times without any side effects. Good pain control and decreasing PSA was obtained at each dose.
    Hinyokika kiyo. Acta urologica Japonica 09/2012; 58(9):515-8.
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    ABSTRACT: A 75-year-old man was admitted to our hospital with liver dysfunction and elevated C-reactive protein level. He was diagnosed with renal tumor by ultrasonography. Computed tomography revealed a renal cell carcinoma (cT3aN0M0) with Stauffer syndrome. Laparoscopic radical nephrectomy was performed. Histological findings indicated clear cell carcinoma with a sarcomatoid component. After 1 month, lung metastasis was detected on an X-ray film. Interferon-α was administered, and complete response was achieved 2 months later. He has shown no evidence of recurrence in 27 months.
    Hinyokika kiyo. Acta urologica Japonica 05/2011; 57(5):237-41.
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    ABSTRACT: A 46-year-old woman with gross hematuria was referred to our hospital with suspicion of bilateral renal cell carcinoma. Computed tomography (CT) showed multiple renal tumors with contrast enhancement and multiple lung nodules. Based on a diagnosis of bilateral multiple renal cell carcinoma with multiple lung metastases, a combination therapy with interferon-alpha (IFN-alpha) and 5-flurouracil (5-FU) was initiated. Six months later, all the renal and pulmonary lesions remained the same, and IFN-alpha alone was continued thereafter. One tumor in the right upper pole decreased in size during the next six years, while all the other lesions remained unchanged. Then the immunotherapy was discontinued on the basis of possibility that the tumors could be benign lesions. Three years later,the right upper renal tumor disappeared on CT, but, one of the left renal tumors showed progressive disease. The patient underwent left partial nephrectomy together with resection of neighboring small tumors. All the excised tumors were diagnosed as chromophobe renal cell carcinoma on histological examination. There has been no change with the remaining tumors for 1.5 years postoperatively.
    Hinyokika kiyo. Acta urologica Japonica 06/2010; 56(6):319-21.
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    ABSTRACT: We evaluated the relationship between the type of suture and occurrence of anastomotic stricture after radical retropubic prostatectomy (RRP). From April 2005 to February 2008, 48 RRP were performed. In the former 24 cases, 2-0 absorbable braided sutures were used (group A), and in the latter 24 cases, 3-0 absorbable monofilament sutures were used (group B) in the vesicourethral anastomosis. In group B, operation time was longer, blood loss was less and tumor stage was lower. While five patients in group A developed an anastomotic stricture, but no one in group B developed a stricture. Univariate analysis of the two groups revealed that only the type of suture and age were significant parameters for the anastomotic stricture.
    Hinyokika kiyo. Acta urologica Japonica 02/2010; 56(2):95-8.
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    Takeshi Sano, Keiko Tanaka, Noriyuki Ito
    International Journal of Urology 01/2010; 17(1):99. DOI:10.1111/j.1442-2042.2009.02422.x · 1.80 Impact Factor
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    ABSTRACT: We describe the longitudinal follow-up of calcineurin activity and its clinical relevance in 4 de novo living-donor kidney transplant recipients treated with cyclosporine (n=1) or tacrolimus (n=3). The calcineurin activity in peripheral blood mononuclear cells was measured in combination with therapeutic drug monitoring during hospitalization. Serial blood samplings were performed after the oral administration of each drug to evaluate the temporal pharmacokinetic and pharmacodynamic profiles. Significant changes in enzyme activity were evaluated in relation to clinical outcomes. A nadir of calcineurin activity occurred at the maximum blood drug concentration within 4 h post-dose in most cases. Unlike cyclosporine, tacrolimus partially suppressed calcineurin activity throughout the dosing interval compared to the pre-dose level (cyclosporine, 62-67% inhibition; tacrolimus, 13-35% inhibition). Notably, calcineurin activity rapidly increased a few days before the onset of acute rejection in 2 patients, 1 receiving cyclosporine and 1 receiving tacrolimus, despite the achievement of therapeutic trough blood concentrations. These preliminary findings indicate that therapeutic monitoring of calcineurin activity in addition to the measurement of blood drug concentrations may be helpful to evaluate the pharmacodynamic effects of cyclosporine and tacrolimus early after renal transplantation.
    Drug Metabolism and Pharmacokinetics 01/2010; 25(5):411-7. DOI:10.2133/dmpk.DMPK-10-RG-026 · 2.86 Impact Factor
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    ABSTRACT: We report a case of a 59-year-old woman who presented with gross hematuria due to development of a pseudoaneurysm that was diagnosed using Doppler ultrasonography 16 days after retroperitoneoscopic partial nephrectomy for renal cell carcinoma. Hematuria resolved after the patient was treated with selective angioembolization of the pseudoaneurysm. There has been no recurrence of the pseudoaneurysm for 28 months after the procedure.
    Hinyokika kiyo. Acta urologica Japonica 08/2009; 55(8):499-502.
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    ABSTRACT: Skeletal complications are a crucial factor in the quality of life and the prognosis of patients with hormone-refractory prostate cancer (HRPC); however, their true prevalence and impact on the prognosis remain largely unknown. In this study, we retrospectively investigated the prevalence of skeletal complications and survival of HRPC patients in a single Japanese institute. From 1990 to 2004, 151 patients with prostate cancer were estimated to have HRPC after androgen ablation therapy in a single institute. The medical records of the patients were reviewed for documentation of skeletal complications, and overall survival was calculated from the diagnosis of HRPC. At the diagnosis of HRPC, bone metastases and bone pain were observed in 83.8% and 44.7% of patients, respectively. During follow-up, 80.0% and 14.2% of patients experienced bone pain and bone fracture, respectively. Moreover, 74.2% and 43.9% of the patients received nonsteroidal anti-inflammatory drugs and opioids for bone pain, respectively, and 50.9% of the patients underwent radiotherapy for palliative pain control. A high score on the extent of disease observed on the bone scan and the presence of bone pain at the diagnosis of HRPC were independent prognostic factors on multivariate analysis (hazard ratio = 1.753 and 2.118, P = .033 and .007, respectively). Despite a small number of subjects, our retrospective survey demonstrated the high prevalence and mortality rate of skeletal complications in Japanese HRPC patients. Patients with bone pain at the diagnosis of HRPC had significantly poorer prognosis than those without.
    Urology 06/2009; 73(5):1104-9. DOI:10.1016/j.urology.2008.07.062 · 2.13 Impact Factor
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    ABSTRACT: Overactive bladder is a highly prevalent clinical condition that is often caused by bladder outlet obstruction (BOO). Increased coupling of bladder smooth muscle cells (BSMC) via gap junctions has been hypothesized as a mechanism for myogenic bladder overactivity in BOO, although little is known about the regulatory system underlying such changes. Here, we report the involvement of basic fibroblast growth factor (bFGF) and connexin 43, a bladder gap junction protein, in bladder overactivity. BOO created by urethral constriction in rats resulted in elevated bFGF and connexin 43 levels in the bladder urothelium and muscle layer, respectively, and muscle strips from these bladders were more sensitive than those from sham-operated controls to a cholinergic agonist. In vitro bFGF treatment increased connexin 43 expression in cultured rat BSMC via the ERK 1/2 pathway. This finding was supported by another in vivo model, where bFGF released from gelatin hydrogels fixed on rat bladder walls caused connexin 43 upregulation and gap junction formation in the muscle layer. Bladder muscle strips in this model showed increased sensitivity to a cholinergic agonist that was blocked by inhibition of gap junction function with alpha-glycyrrhetinic acid. Cystometric analyses of this model showed typical features of detrusor overactivity such as significantly increased micturition frequency and decreased bladder capacity. These findings suggest that bFGF from the urothelium could induce bladder hypersensitivity to acetylcholine via gap junction generation in the smooth muscle, thereby contributing to the myogenic overactivity of obstructed bladders.
    AJP Renal Physiology 05/2009; 297(1):F46-54. DOI:10.1152/ajprenal.90207.2008 · 4.42 Impact Factor
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    ABSTRACT: Secreted frizzled-related protein 1 (SFRP1) is a candidate tumor suppressor gene located at 8p11.2 and antagonizes the Wnt signaling pathway. Epigenetic inactivation of SFRP1 by methylation of its promoter CpG island has recently been reported in several types of cancers. In the present study, we examined the expression and methylation status of SFRP1 in renal cell carcinoma (RCC). Three RCC cell lines were tested and none expressed the SFRP1 transcript. Bisulfite sequencing of the SFRP1 promoter and treatment of the RCC cell lines with 5-aza-2'-deoxycytidine and/or trichostatin A revealed the association between SFRP1 expression and promoter hypermethylation. Methylation-specific PCR detected hypermethylation in 26/57 (45.6%) conventional RCC cases and 2/8 (25%) papillary RCC cases. Quantitative real-time PCR showed >3-fold decrease of SFRP1 expression in 33/34 (97.1%) conventional RCC cases. Microsatellite analysis showed loss of heterozygosity at the SFRP1 locus (D8S1180) in only 3/28 (10.7%) conventional RCC cases. The present findings indicate that methylation-associated silencing of SFRP1 frequently occurs in RCC and plays a pivotal role in early carcinogenesis. However, previous immunohistochemical studies on beta-catenin have suggested that activation of the canonical Wnt pathway through beta-catenin stabilization is infrequent in RCC. Thus, further basic studies are required to elucidate how the loss of SFRP1 activity contributes to the Wnt and other signaling pathways in RCC.
    Oncology Reports 11/2008; 20(5):1257-63. DOI:10.3892/or_00000138 · 2.19 Impact Factor
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    ABSTRACT: TU3A, located on 3p21.1, was originally identified as a candidate tumor suppressor gene in renal cell carcinoma (RCC). Recently, down-regulation of TU3A expression has been reported not only in RCC but also in other types of cancers. However, no studies have evaluated the mechanism underlying TU3A inactivation. In the present study, we first examined the expression and promoter CpG island methylation of TU3A in RCC. TU3A mRNA was slightly or not expressed in 3 RCC cell lines (ACHN, Caki-1 and NC65). Bisulfite sequencing of the TU3A promoter and treatment of the RCC cell lines with 5-aza-2'-deoxycytidine and/or trichostatin A revealed an association between TU3A expression and promoter hypermethylation. Next, we analyzed TU3A methylation in primary RCC by using combined bisulfite restriction analysis. Mean methylated fraction was 19.2% (range: 0-57.3%) in 53 conventional RCCs and 2.3% (range: 0-12.7%) in 24 corresponding normal kidneys. We defined a methylation fraction of >20% as hypermethylation. TU3A hypermethylation was detected in 22 (41.5%) of 53 RCCs and significantly associated with advanced tumor stage (>T2 vs. T1 and T2: P=0.005, > or = N1 or M1 vs. N0M0: P=0.001) and poor disease-specific survival (P=0.0038). Furthermore, we observed promoter hyper-methylation of TU3A in several types of cancer cell lines and primary cancers of the bladder and testis. To our knowledge, the present study is the first to demonstrate the epigenetic inactivation of TU3A in human cancers. The findings of this study warrant further study to investigate the role of TU3A methylation in cancer development.
    International Journal of Oncology 10/2008; 33(4):893-9. · 2.77 Impact Factor
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    ABSTRACT: We investigated the effect of 5-aza-2'-deoxycytidine (DAC), a DNA methyltransferase inhibitor, on transitional cell carcinoma (TCC) cell lines, and examined the synergistic suppression of TCC growth by DAC and five chemotherapeutic agents. We measured the cytotoxicity of DAC and chemotherapeutic agents against five TCC cell lines using the WST-1 assay, and analyzed the synergy of DAC and these agents by isobolographic analysis. The effects of each single agent or the combined treatment on apoptosis induction and cell cycle arrest were analyzed by flow cytometric analysis. We also investigated caspase activity and PCNA expression to clarify the mechanism of the synergistic actions of DAC and chemotherapeutic agents against TCC. We demonstrated that DAC could significantly increase the susceptibility of TCC cells to cisplatin (CDDP). Synergistic growth suppression by DAC and CDDP was confirmed in all TCC cell lines tested, but not by DAC combined with other chemotherapeutic agents. DAC inhibited proliferation via inducing G2/M cell cycle arrest, whereas CDDP inhibited proliferation via inducing both apoptosis and G2/M arrest. DAC enhanced the CDDP-induced upregulation of caspase activity and antiproliferative effect, resulting in an increase of cells in subG1 and G2/M phases. In addition, the synergy of DAC and CDDP was independent of p53 status in TCC. The synergy of DAC and CDDP against TCC suggested that combination chemotherapy with these two agents might be a new strategy to improve the clinical response rate of this malignancy, regardless of p53 mutation.
    Urology 07/2008; 71(6):1220-5. DOI:10.1016/j.urology.2007.11.029 · 2.13 Impact Factor
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    ABSTRACT: A 69-year-old man was referred to our hospital with a chief complaint of asymptomatic gross hematuria. After radiological evaluations, left nephroureterectomy with bladder cuff was performed under a clinical diagnosis of a left ureteral tumor (2 cm). Histological examination revealed a small cell carcinoma of the ureter (pT3, pN1). After the operation, adjuvant chemotherapy with irinotecan, etoposide and cisplatin was administered in combination with radiation therapy. At 14 months after the operation, there has been no evidence of recurrence. To our knowledge, this is the 22nd report of a small cell carcinoma originating from the ureter.
    Hinyokika kiyo. Acta urologica Japonica 06/2008; 54(6):411-3.
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    ABSTRACT: Renal cell carcinoma (RCC) is characterized by a variable and unpredictable clinical course. Thus, accurate prediction of the prognosis is important in clinical settings. We conducted microarray-based study to identify a novel prognostic marker in conventional RCC. The present study included the patients surgically treated at Kyoto University Hospital. Gene expression profiling of 39 samples was carried out to select candidate prognostic markers. Quantitative real-time PCR of 65 samples confirmed the microarray experiment results. Finally, we evaluated the significance of potential markers at their protein expression level by immunohistochemically analyzing 230 conventional RCC patients. Using expression profiling analysis, we identified 14 candidate genes whose expression levels predicted unfavorable disease-specific survival. Next, we examined the expression levels of nine candidate genes by quantitative real-time PCR and selected CUB-domain containing protein 1 (CDCP1) for further immunohistochemical analysis. Positive staining for CDCP1 inversely correlated with disease-specific and recurrence-free survivals. In multivariate analysis including clinical/pathological factors, CDCP1 staining was a significant predictor of disease-specific and recurrence-free survivals. We identified CDCP1 as a potential prognostic marker for conventional RCC. Further studies might be required to confirm the prognostic value of CDCP1 and to understand its function in RCC progression.
    Journal of Cancer Research and Clinical Oncology 06/2008; 134(12):1363-9. DOI:10.1007/s00432-008-0412-4 · 3.01 Impact Factor
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    ABSTRACT: We conducted a multi-institute survey on the conditions related to urologic management of severe voiding dysfunction after hysterectomy for uterine cancer with or without postoperative irradiation. Our first study population was a group of adult female patients currently managed by urologists, using clean intermittent catheterization (CIC). Of the 287 patients in this group, 99 (34%) had suffered from uterine cancer. Of these patients, 94 underwent hysterectomy for this disease; 44 and 30 were treated with or without postoperative radiation, respectively, while postoperative irradiation status was unknown for 20. Median follow-up after surgery was 21 (0.2-52) years and median interval from operation to the introduction of CIC was 4.0 (0-49) years. CIC tended to be introduced later for patients with postoperative radiation than those without it. Seventy-four patients, who required invasive urologic interventions other than CIC for voiding dysfunction after hysterectomy, are the second study population. Most of these (82%) had received postoperative irradiation. Continuous Foley catheter placement was the most frequent procedure. Long-term follow-up and urologic management for voiding dysfunction is required for patients undergoing hysterectomy.
    Hinyokika kiyo. Acta urologica Japonica 06/2008; 54(6):401-5.

Publication Stats

604 Citations
139.02 Total Impact Points


  • 2010–2014
    • Nishi-Kobe Medical Center
      Kōbe, Hyōgo, Japan
  • 2003–2010
    • Kyoto University
      • • Department of Pharmacy
      • • Department of Urology
      Kyoto, Kyoto-fu, Japan
  • 2009
    • Akita University
      Akita, Akita, Japan
  • 2007
    • Kinki University
      Ōsaka, Ōsaka, Japan