Masahiro Uno

Ogaki Municipal Hospital, Gihu, Gifu, Japan

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Publications (28)17.03 Total impact

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    ABSTRACT: A 77-year-old woman was referred to our hospital with complaints of fever and left chest pain. Computed tomography showed left pyothorax and left pyonephrosis with left ureter calculus. After admission, drainage of the left thoracic cavity was performed and she was treated with antibiotics. On the third hospital day, debridement for pyothorax was performed because her condition had not improved. During surgery, we found perforation of the diaphragm, and abscess appeared from the perforated area. We suspected that perforation of the diaphragmfromthe left pyonephrosis caused left pyothorax, and performed left nephrectomy. After the operation, relapse of the pyothorax and surgical wound infection occurred, but her condition improved and she discharged on the 46 th hospital day. Relapse of the abscess has not occurred.
    No preview · Article · Dec 2015 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: We performed ultrasound-guided biopsies on 14 patients having tumors that were difficult to distinguish as benign or malignant on computed tomography. The study took place from January 2004 to December 2011. Of the 14 tumors biopsied, 12 were malignant, 1 was benign, and 1 was a sampling error. Of the 12 malignant tumors, 7 were primary kidney carcinomas. Six patients received radical or partial nephrectomies, and all had a good prognosis. Three patients with metastatic kidney cancers died of the primary disease. Eleven patients (85.5%) were diagnosed pathologically by biopsies, allowing us to decide the course of treatment. However, because our tests also revealed one sampling error and one unspecified cancer, we determined that there are limitations to a renal biopsy.
    No preview · Article · Mar 2013 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: We treated 345 patients who presented with localized prostatic cancer by hormonal monotherapy at Ogaki Municipal Hospital between 1999 and 2008. The overall 5-year survival rate for localized prostatic cancer was 81.9%. The 5-year cause-specific survival rate was 97.6%. The 5-year no-relapse rate was 94%. The 5year cause-specific survival rates of low risk, intermediate risk, and high risk group according to D'Amico risk grouping were 100%, 100%, 93.6%, respectively. There was not a significant difference in cause-specific survival rate between each risk group. The 5-year norelapse rates of low risk, intermediate risk, high risk group were 98.1%, 98.2%, 82.1%, respectively. There was a significant difference in no-relapse rates between intermediate risk and high risk group. Multivariate proportional hazard analysis showed that Gleason score was independent prognostic risk factor. Gleason score, PSA nadir level and pretreatment PSA value were independent relapse risk factors. The overall survival curve for localized prostate cancer was similar to the expected survival curves for age-matched men.
    No preview · Article · Feb 2012 · Japanese Journal of Clinical Urology
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    ABSTRACT: A 64-year-old man presented to our emergency room with right back pain on July 10, 2009. At the emergency room, abdominal enhanced computed tomography revealed a cystic lesion in the retroperitoneum. Then he was referred to our department. We performed percutaneous drainage of the retroperitoneal lesion and aspirated white pus. The retroperitoneal cystic lesion proved to be an abscess. Microscopic examination of a Gram stained specimen of the abscess revealed gram-positive bacillary fragments ; therefore, we suspected the pathogen to be Nocardia. He had a history of chronic glomerulonephritis and had received treatment consisting of 20 mg prednisolone, and 75 mg cyclosporine per day. He was regularly visiting the department of cardiovascular for follow-up of chronic heart failure. On the day before his visit to our emergency room, his chest X-ray medicine had revealed a nodular shadow. Then he was referred to the department of respiratory medicine and was scheduled to receive a bronchoscopy later. We suspected the nodule of the lung also to be an abscess of Nocardia. Later, head computed tomography (CT) revealed a brain abscess the pathogen of which was Nocardia. Nocardia is a filamentous, gram-positive, branched bacterium and classified as an aerobic actinobacteria. Nocardia species are difficult to diagnose due to non-specific clinical and histological manifestation. We report this case of disseminated nocardiosis presenting as retroperitoneal abscess. The disseminated nocardiosis was diagnosed without delay by percutaneous drainage and appropriate treatment was provided.
    No preview · Article · Dec 2010 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: We report a case of mucinous tubular and spindle cell carcinoma (MTSCC) of the kidney. A 68-years old female consulted a primary hospital with a chief complaint of back pain. Computed tomography revealed the tumor of the left kidney, so she was referred to our department. The tumor, 45 x 42 mm in length, was slightly enhanced, and that had well-defined margins. We performed radical nephrectomy. Pathological findings suggested MTSCC. MTSCC is a rare type of renal cell carcinoma composed of a combination of low-grade tubular cuboidal cells and spindle cells in a mucinous stroma. The immunohistochemistry is effective in its diagnosis.
    Preview · Article · Mar 2010 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: A 68-year-old man had been followed up for chronic renal failure and hypothyroidism by the local medical office. He needed hemodialysis and was introduced to our hospital. Ultrasonography showed a tumor in the left kidney, and so he was introduced to our department Further examination revealed renal cell carcinoma that was present in a horseshoe kidney. Left nephrectomy with division of the isthmus was perfomed by the transabdominal approach. Horseshoe kidneys need anatomical with regard to aberrant vessels, and 3D-CT or angiography needs to be peformed before the operation. It is also necessary to pay attention to medicine, drip, infection, etc., before and after the operation for any patient with chronic renal failure.
    No preview · Article · Jan 2009 · Nishinihon Journal of Urology
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    ABSTRACT: A 60-year-old woman underwent detailed examinations for hepatic disorders and pancreatic tumor at the Department of Internal Medicine. A tumor mass in her left renal pelvis and a thickened wall in her left ureter were observed on computed tomography (CT) and magnetic resonance imaging (MRI) images. Retrograde ureteropyelography and drip infusion pyelography images showed a stenosis in 1 vertebral body from the left ureteropelvic junction. Urinary cytology finding was class III-a; however, malignancy could not be disregarded. Since the patient continued to experience severe dorsal pain, a left nephroureterectomy was subsequently performed at the patient's request. Pathological tests showed no malignant findings, and based on the chronic pyelonephritis, we diagnosed her condition as an inflammatory pseudotumor. Not many inflammatory pseudotumors are found in the urinary tract, and even fewer are manifest in the renal pelvis and ureter. Although inflammatory pseudotumors are generally benign, cases of repeated local recurrence exist. Therefore, a meticulous follow-up observation is required.
    No preview · Article · Dec 2008 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: Prostate cancer is rarely detected from abnormal chest radiographs. We report two cases of prostate cancer detected from pleural effusion. Case 1 is a 76-year-old man who consulted the department of internal medicine of our hospital with dyspnea and abdominal fullness. Pleural effusion and multiple hepatic tumors of unknown origin were pointed out, but he refused any further investigation or treatment for them. Six months later, he consulted a family doctor with urinary frequency and lumbago. Increased serum prostate specific antigen (PSA) level to 864 ng/ml was recognized, then he was referred to our department. Under diagnosis of prostate cancer, T4NOM1c, maximal androgen blockade (MAB) was performed. Serum PSA level was decreased once to 8.1 ng/ml, but then rose gradually and he died 13 months after the beginning of the therapy. Case 2 was a 78-year-old man who was referred to our department to determine the origin of carcinomatous pleuritis detected in a routine general check up of hepatitis C. The serum PSA level was increased to 12,900 ng/ml, and the diagnosis was prostate cancer, T3aNOM1c. Although MAB was performed, the serum PSA level did not decrease markedly. He died 16 month after the beginning of the therapy.
    No preview · Article · Sep 2008 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: A 12-year-old boy visited a local medical office with the complaints of abdominal pain and vomiting. After returning home, he experienced right intrascrotal swelling and hardness. Four days later he visited the clinic again. Ultrasound sonography showed intrascrotal abnormality, and he was introduced to our hospital. The right intrascrotal mass was the size of a ping-pong ball and it was tender. Laboratory data showed inflammatory findings, but the boy was afebrile. Tumor markers alpha fetoprotein and β-human chorionic gonadotropin were normal. We considered epididymitis and prescribed antibiotic drugs. Tenderness and inflammatory symptoms disappeared, but intrascrotal swelling and hardness remained. We could not deny the possibility of malignant disease such as testicular or adenomatoid tumor, and so we performed open biopsy. Intraoperative biopsy results showed epididymitis and its prevalence to the testis, but we could not obtain macroscopic view of normal testicular tissue on the incisional face. Right high orchitectomy was performed. Pathological diagnosis of the specimen was spermatic granuloma. Spermatic granuloma usually occurs in adults with the high potential of producing sperm, however in this case, the patient was a young boy. In the last twenty years in Japan, 16 cases have been reported and in most cases of the spermatic granulomas were found within the tail of the epididymis. It is rare for spermatic granuloma to involve the entire testis.
    No preview · Article · Nov 2007 · Nishinihon Journal of Urology
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    ABSTRACT: A 34-year-old woman was admitted to our hospital with left low abdominal pain and abdominal expansion. Since she was suspected of suffering from spontaneous rupture of a left renal angiomyolipoma (AML), she was admitted to our hospital. Her anemia improved through the use of blood transfusion after she was hospitalized. There was a history of AML explosion twice in the past and therefore surgical treatment was selected. Left nephrectomy was undertaken and the patient has made good progress since the operation.
    No preview · Article · Nov 2006
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    ABSTRACT: A 52-year-old man was admitted to our hospital with gross hematuria, low abdominal pain and miction pain. Cystoscopy revealed a large broad-based tumor surrounding the right bladder wall. We suspected invasive bladder cancer and performed a punch biopsy and a transurethral biopsy. However, the pathological diagnosis was proliferative cystitis. Tumor formation arising from proliferative cystitis is relatively rare. Treatment with steroids led to a complete response.
    No preview · Article · Apr 2006 · Nishinihon Journal of Urology
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    ABSTRACT: A 51-year-old man with left renal tumor and multiple lung metastases was admitted to our hospital for treatment. Left nephrectomy was performed, and pathological diagnosis was renal cell carcinoma (clear cell carcinoma, G2, pT3a). Initially, Interferon-alpha (IFN-alpha) therapy was started for lung metastases. About 40 days after surgery, head magnetic resonance imaging revealed brain metastases, and therefore gamma knife radiosurgery(GKS) was performed. Since chest computed tomography showed no change in lung metastases, we tried a combination of interleukin-2 (IL-2) and IFN-alpha therapy to elininate those metastases. As a result, neither lung nor brain metastases could be detected at the 4th month follow-up examination. At 5 months after the IL-2 and IFN-alpha therapy, the patient attempted suicide. Therefore, the IL-2 and IFN-alpha therapy was stopped and an antidepressant was prescribed. Now 11 months after withdrawal of the IL-2 and IFN-alpha, the patient's mental condition remains stable. No recurrence of the cancer has been detected by CT.
    No preview · Article · Jul 2005 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: We report a case of renal hemangiopericytoma which was incidentally discovered by ultrasonography at a health screening. A 58-year-old man was admitted to our hospital for close examination of the renal tumor. Computed tomography revealed the left renal tumor, 60 x 50 mm in size, which was well enhanced with contrast medium. Magnetic resonance imaging revealed an isointensity mass (T1-weighted) and high-intensity mass (T2-weighted) at the left kidney. Radical nephrectomy was performed on suspicion of left renal cell carcinoma. Histopathological examination revealed renal hemangiopericytoma. The present case is the 7th in the Japanese literature.
    No preview · Article · Feb 2005 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: We studied 181 patients diagnosed with male urethritis at Oogaki Municipal Hospital from April 2002 to March 2004. Twenty-two out of 92 patients diagnosed with gonococcal urethritis (GU) and 52 out of 89 patients diagnosed with non-gonococcal urethritis (NGU) were positive for Chlamidia trichomatis by polymerase chain reaction (PCR). Most patients of male urethritis were in their twenties. Of GU patients, 39 (67%) were infected from commercial sex workers (CSWs). Of NGU patients, 12 (30%) were infected from CSWs, 24 (40%) from girl friends and 4 (10%) from their Twenty-eight (48%) out of GU patients were infected through oral sex. spouse. Eighty-three GU patients were treated with SPCM (2 g, one shot). Fifty-five patients could be evaluated for the efficacy of treatment. Elimination rate of Neisseria gonorrhoeae was 100% and 14 out of 18 patients with persisting urethritis had C. trichomatis. Eighty-two NGU patients were treated with minocycline, tosufloxacin, levofloxacin, gatiflixacin or clarithromycine. Sixty-six patients could be evaluated for the efficacy of treatment. Forty-one patients were diagnosed with non-gonococcal chlamydial urethritis (NGCU) and 25 patients were diagnosed with non-gonococcal, non-chlamydial urethritis (NGNCU). The clinical curative rate of NGCU and NGNCU was 93% (38/41) and 80% (20/25), respectively.
    No preview · Article · Feb 2005 · Hinyokika kiyo. Acta urologica Japonica
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    ABSTRACT: Even with curative surgery, renal cell carcinoma occasionally recurs in other organs, with fatal results. In this study, we identified independent prognostic factors for survival in patients with renal cell carcinoma after curative surgery. The records of 482 patients (mean age, 61.0 years; range, 17-90 years) who underwent curative surgery for renal cell carcinoma at Gifu University Hospital and its affiliated hospitals between 1991 and 2000 were reviewed. The average follow-up period was 42 months (range, 10-140 months). Clinical characteristics of the 482 patients were divided into three categories: patient factors (sex, age, performance status, and mode of tumor discovery), tumor factors (T classification, N classification, mode of infiltration, histological grade, and venous invasion), and treatment factor (whether or not adjuvant therapy with interferon-alpha was used). Stepwise multivariate Cox proportional hazards regression modeling was performed to identify independent determinants of survival. Of the patient factors, performance status and mode of tumor discovery were independent factors predicting survival. Of the tumor factors, venous invasion and mode of infiltration were independent factors predicting survival. Use or non-use of adjuvant therapy was not significantly associated with survival. Overall, performance status, venous invasion, mode of infiltration, and histological grade were shown to be independent prognostic factors, in descending order of importance. Performance status, venous invasion, mode of infiltration, and histological grade, in descending order, were the most important factors predicting survival after curative surgery for renal cell carcinoma.
    No preview · Article · Jan 2005 · International Journal of Clinical Oncology
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    ABSTRACT: We report two cases of residual seminoma tumors evaluated by FDG-PET after chemotherapy. The first case was relapsed stage I seminoma in a retroperitoneal lymph node that had enlarged to about 70 mm in diameter. After systemic chemotherapy, the lymph node was reduced to 31 mm. A follow-up FDG-PET scan to evaluate residual malignancy in the tumor was negative. The second case was relapsed stage I seminoma in a retroperitoneal lymph node that had enlarged to 34 × 24 mm. After systemic chemotherapy, the metastatic lesion was reduced to 11 mm. Follow-up FDG-PET scan to evaluate malignancy of the residual tumor was negative. When residual seminoma tumors are reduced after chemotherapy, a negative FDG-PET study may reveal no residual viable cells. This suggests that FDG-PET is useful for judging the therapeutic effect, and evaluation of the residual seminoma tumor may be performed by follow-up FDG-PET.
    No preview · Article · Nov 2004
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    ABSTRACT: We evaluated the antimicrobial susceptibilities of 178 strains of Neisseria gonorrhoeae isolated from male urethritis at our hospital from January 1998 to December 2002. Minimal inhibitory concentrations (MICs) for isolated strains were determined about 5 antimicrobials, penicillin G (PCG), cefpodoxime proxetil (CPDX-PR), cefotaxime (CTX), minocycline (MINO), tosufloxacin (TFLX). The population of PCG- and MINO-resistant N. gonorrhoeae did not change in this period. The population of CPDX-PR-resistant N. gonorrhoeae has become more than 10% since 2000. The population of TFLX-resistant N. gonorrhoeae was increased year by year and has become more than 50% in 2002. Because fluoroquinolones were used as first-line therapy for gonococcal infection in Japan, rapid increase of fluoroquinolones-resistant N. gonorrhoeae was occurring. If we frequently treat with oral cephem antimicrobial agents for gonococcal infection, it is suggested that oral cephem-resistant N. gonorrhoeae will be increase.
    No preview · Article · Jan 2004

  • No preview · Article · Apr 1998 · British Journal of Urology
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    ABSTRACT: We attempted to detect Mycoplasma genitalium in urethral swab specimens by a polymerase chain reaction based assay to determine the prevalence of M. genitalium in patients with urethritis. We examined a total of 171 Japanese men who presented to our hospital from February 1995 through January 1997. Of these men 150 had symptoms and signs compatible with acute urethritis and 21 had no symptoms or signs of urethritis. Urethral swab specimens were used to culture Neisseria gonorrhoeae, to detect Chlamydia trachomatis by an enzyme immunoassay and to detect M. genitalium by a polymerase chain reaction based assay. Gonococcal urethritis was diagnosed in 74 symptomatic men, and nongonococcal urethritis was diagnosed in 76 symptomatic men. Of the 74 cases of gonococcal urethritis 3 (4.1%) were positive for M. genitalium, and 14 (18.9%) were positive for C. trachomatis. Of the 76 cases of nongonococcal urethritis 10 (13.2%) were positive for M. genitalium, and 42 (55.2%) were positive for C. trachomatis. While only 1 of the 42 cases with chlamydial nongonococcal urethritis (2.4%) was positive for M. genitalium, 9 of the 34 chlamydia negative nongonococcal urethritis cases (26.5%) were positive for the mycoplasma. In contrast, all 21 cases men were negative for N. gonorrhoeae, M. genitalium, and C. trachomatis. The prevalences of M. genitalium in patients with gonococcal urethritis and nongonococcal urethritis who attended our clinic were 4.1 and 13.2%, respectively. M. genitalium was detected significantly more often in men with nongonococcal urethritis than in asymptomatic men. In addition, its prevalence in men with chlamydia negative nongonococcal urethritis (26.5%) was significantly greater than in those with chlamydia positive nongonococcal urethritis (2.4%). These findings suggest that M. genitalium may be associated with the development of nongonococcal urethritis independent of C. trachomatis.
    No preview · Article · Mar 1998 · The Journal of Urology
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    ABSTRACT: We developed a polymerase chain reaction (PCR)-based assay for detectingBacteroides ureolyticus. No DNA fragments hybridizing the internal probe specific forB. ureolyticus were amplified from the DNAs of other bacterial species tested. This assay can detect the amount of DNA corresponding to 18 cells ofB. ureolyticus. Using this assay, we examined urethral swab specimens from men with nongonococcal urethritis (NGU) and asymptomatic men for the presence ofB. ureolyticus. WhileB. ureolyticus was detected in 6 (12.0%) of 50 asymptomatic men, this was not significantly different from the detection rate of 19.3% (22 of 114 specimens) in men with NGU. This study demonstrates that the PCR-based assay can be applied for detectingB. ureolyticus in clinical specimens and suggests that this assay might develop into a useful tool for analyzing the pathogenicity of this organism in various organs.
    No preview · Article · Dec 1997 · Journal of Infection and Chemotherapy