Y. Miyauchi

Ehime University, Matuyama, Ehime, Japan

Are you Y. Miyauchi?

Claim your profile

Publications (20)15.99 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a case of multilocular cystic nephroma. A 7-year-old boy consulted our hospital for further investigation of an episode of asymptomatic macrohematuria. Computed tomography and magnetic resonance imaging showed multilocular cysts in the upper pole of the left kidney with a mild contrast effect in the walls. Solid lesions were not identified within the cysts. With a suspected diagnosis of multilocular cystic adenoma, the patient underwent laparoscopic left nephrectomy. Pathological diagnosis was multilocular cystic nephroma. The postoperative course was uneventful. It was decided that the patient needs to be carefully followed up due to potential malignancy.
    No preview · Article · Sep 2015
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a case of ectopic pheochromocytoma where there were negative findings for 123I-MIBG scintigraphy but positive findings for l8FDG-PET imaging. A 46-year-old woman was referred to our hospital because of hypertension pointed out by medical screening and a tumor pointed out by PET screening that was located behind the head of the pancreas. Endocrinological examinations demonstrated elevated levels of plasma and urine catecholamines with a predominance of noradrenaline, and their urine metabolites. 123I-MIBG scintigraphy did not show an accumulation of the tracer, however 18FDG-PET imaging showed an increased accumulation of the tracer within the tumor. These results were suggestive of a diagnosis of ectopic pheochromocytoma, and the tumor was resected by open surgery. The pathological diagnosis was paraganglioma. The post-operative course was uneventful and the patient has remained disease-free as of the time of writing.
    No preview · Article · Dec 2014 · Nishinihon Journal of Urology
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a rare case of dedifferentiated retroperitoneal liposarcoma A 59-year-old woman complaining of abdominal distension was found to have a huge tumor. Abdominal enhanced CT scan showed a large lobulated left retroperitoneal mass measuring 14 cm in diameter, containing fat and soft-tissue nodules, with suggested invasion of the left kidney. One month later, the tumor had enlarged rapidly to 19 cm in diameter and had extended medially past the midline. The tumor was excised together with the left kidney as one lump. The total weight was 3,395 g. The cut surface of the tumor showed a solid mass with irregular bleeding and necrotic components. Histopathological examination revealed dedifferentiated liposarcoma with invasion of the left kidney (pT2b cNOMO). Liposarcoma which grows rapidly and becomes dedifferentiated at the same time carries a poor prognosis. Accordingly, the current patient needs to be rigorously and continuously followed up.
    No preview · Article · Apr 2014 · Nishinihon Journal of Urology

  • No preview · Article · Nov 2013 · Annals of Oncology
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 62-year-old man with the complaint of left cervical mass, which was rapidly progressive, was referred to our hospital from a clinic. The patient was introduced to our department under suspicion of metastasis from left adrenal cancer according to computed tomography (CT) and positron emission tomography (PET)-CT findings. Pathological examination of the cervical tumor by open biopsy revealed metastasis of adrenocortical carcinoma Liver and multiple bone metastases were also found on CT. Under the diagnosis of stage IV non-functioning adrenocortical carcinoma, mitotane therapy was started from May 2010. Combination chemotherapy with etoposide, doxorubicin and cisplatin (EDP) was added to the mitotane therapy from June 2010. After 2 courses of the therapy with EDP plus mitotane, all tumors showed progression. Then, administration of mitotane only was continued. A further 2 months later, all tumors had significantly decreased in size and the tendency for decrease has been maintained for about 8 months. The dosage was reduced because of Grade 3 anorexia. However, administration of mitotane in our case has been effective.
    No preview · Article · Dec 2012 · Nishinihon Journal of Urology
  • H. Iio · T. Sasaki · Y. Miyauchi · N. Tanji · T. Terado · A. Matsumoto
    [Show abstract] [Hide abstract]
    ABSTRACT: A 60-year-old man with insulin dependent diabetes mellitus was referred to a clinic because of fever and right hydronephrosis. Candida albicans was found in the urine culture. Conservative therapy including catheterization with double J stent and oral antifungal administration was momentary successful, but right hydronephrosis and fever immediately recurred after removal of the stent. Then, the patient was introduced to our hospital for prolonged mycosis of urinary tract. Trichosporon asahii was isolated in the urine culture in our hospital. Ureteroscopy revealed fungus balls in the urinary tract, which were successfully removed one by one using a basket catheter and irrigation by physiological solution. Oral antifungal agent was administered after the surgery. The postoperative course was uneventful and satisfactory without recurrence.
    No preview · Article · Sep 2012 · Japanese Journal of Clinical Urology
  • [Show abstract] [Hide abstract]
    ABSTRACT: A 73-year-old man visited our department with the complaint of intermittent macrohematuria from the ileal conduit. He had undergone total pelvic exenteration, colostomy, and ileal conduit construction for rectal cancer eleven years earlier. Enhanced CT revealed varices around the ileal conduit and collateral pathways on the ileal and subcutaneous veins. Under a diagnosis of bleeding stomal varices, trans-cutaneous and hepatic sclerotherapy was performed. Since angiography revealed varices around both the ileal conduit and the artificial anus, sclerotherapy was carried out against both varices. Thereafter, bleeding from the artificial anus was again seen. Enhanced CT and angiography revealed an aneurysm. Transcatheter arterial embolization with coils and N-butyl-2-cyanoacrylate was then successfully performed. The post-embolization course has been uneventful and satisfactory, and to date, no recurrence has been noted.
    No preview · Article · Jun 2012 · Nishinihon Journal of Urology
  • [Show abstract] [Hide abstract]
    ABSTRACT: Tension-free vaginal mesh (TVM) surgery for the treatment of pelvic organ prolapse (POP) is a procedure that has spread throughout the world. In Japan, TVM surgery has been carried out since 2005. The aim of this paper is to describe our experience of 100 TVM operations. We applied anterior TVM in 65, posterior TVM in 6, anterior and posterior TVM in 18, and complete TVM in 11 patients. At 18 months' follow-up, none of the patients presented with more than stage II POP recurrence. Bladder and rectal injuries due to needle passage were reported in 2 cases each. Those injuries were recognized and sutured during the operation. Hemorrhage in excess of 400 ml occurred during the operation in only one case. Vaginal mesh extrusion was observed in 3 cases and one of these patients required partial surgical removal of the mesh. TVM surgery is expected to become a decisive innovation in the treatment of POP. However, we are still in need of follow-up data over the longterm.
    No preview · Article · Apr 2012 · Nishinihon Journal of Urology

  • No preview · Article · Jul 2008 · Pathology
  • [Show abstract] [Hide abstract]
    ABSTRACT: The number of patients receiving dialysis therapy for end-stage kidney disease (ESRD) in Japan has continued to grow, and according to the statistics of the Japanese Society for Dialysis Therapy their number had exceeded 250,000 by the end of 2005. According to the treatment method, more than 96% of the patients have received hemodialysis (HD), and those receiving peritoneal dialysis (CAPD) have accounted for less than 4%. The ratios according to the method of dialysis therapy in 120 countries worldwide show that 89% of patients receive HD and 11% receive CAPD, and thus the proportion that receive CAPD is smaller in Japan. The benefits of CAPD are that patients are forced to spend less time in a medical institution than with HD, and there is less impact on the circulatory system. Accordingly, with the aim of rehabilitating patients to their former lives by taking advantage of the benefits of CAPD, since October 1995 we have been proactively advancing the promotion of CAPD in our hospital for patients with severe heart failure and for elderly patients. In this study we analyzed the clinical picture of the 97 patients who were capable of being followed up, and we assessed the results of promoting CAPD and the problems associated with it. The 5-year survival rate was 63% for diabetics (DM) and 89.5% for non-diabetics (non-DM), and the rates were comparable to the survival rate of HD patients of the Japanese Society for Dialysis Therapy. There were 11 dropouts from CAPD, and the most common reason for dropouts were cases (4 cases) in which it had become impossible for the patients themselves to change the CAPD packs because of a cerebral infarct. There were 35 deaths, and 15 of them were due to heart failure. Of the 30 DM patients, 3 had been on CAPD for more than 7 years, but the mean HbA1 value after the introduction of CAPD was 6.7% and glycemic control was good. In addition, 21 elderly patients 70 years of age and over had been started on CAPD, and 40% of them had been on it continuously for 3 years. The rate of rehabilitation of CAPD patients to their former lives was a favorable 64%. The rate of rehabilitation to the patients' former lives with CAPD was high, and if it was a short time, the survival rate was comparable to that achieved by HD. In terms of problems, fortunately there were no cases of encapsulating peritoneal sclerosis (EPS) in the present study, but when promoting CAPD it is important not to miss the timing for the switch from CAPD to HD in order to prevent EPS, and it is important to prevent intractable peritonitis, which is suspected of being one of the risk factors for EPS. Second, it is necessary to utilize social resources, such as nursing care facilities, in order to promote CAPD among the elderly, etc., and to extend the CAPD continuation rate. Third, if glycemic control can be made favorable, long-term continuous CAPD is possible even in DM patients. In the future, glycemic control in DM patients will become easier as a result of the availability of dialysis fluid containing Icodextrin. In order to promote CAPD it is necessary to correctly explain to patients and their families the benefits, drawbacks, indications, and the clinical results and risk rates of HD, CAPD, and kidney transplantation, when chronic renal failure progresses and renal substitution therapy becomes necessary. HD, CAPD, and kidney transplantation are not independent treatment methods, and it is critical to explain them to patients and their families along with the need to select the treatment method according to the patient's condition (both medical and social).
    No preview · Article · Jun 2007
  • T. Sato · Y. Miyauchi · N. Tanji · M. Yokoyama
    [Show abstract] [Hide abstract]
    ABSTRACT: At present, approximately 30,000 people are started on dialysis therapy in Japan annually, and drug therapy, including the use of nephroprotective agents, predominantly RAS inhibitors (ACEI, ARB), oral sorbents, etc., and diet therapy centered on protein restriction have therefore been provided to treat patients with maintenance-stage chronic renal failure in order to delay starting patients on dialysis. After demonstration of the nephroprotective efficacy of low-protein food in the 5/6 nephrectomy rat model by Brenner et al., low-protein therapy was promoted in Japan, and although favorable results were reported with regard to the nephroprotective efficacy of low-protein food, no results have been provided in the form of clinical trials which can be recognized worldwide. Nevertheless, it is a common experience clinically that low-protein food delays the onset of manifestations of uremia and metabolic abnormalities unrelated to GFR. Moreover, drugs that cause constipation, such as oral sorbents (Kremezin®), oral phospho-sorbents, calcium polyethylene acid, etc., are sometimes used as drug therapy for patients with maintenance-stage chronic renal failure. Constipation is the main reason that impedes compliance with taking these drugs orally. We previously gave high-calorie low-protein cookies (RKF-1) to CAPD patients, and relief of constipation and BUN-lowering action were reported in over 80%. Therefore, in the present study we gave RKF-1 cookies to 9 patients with chronic renal failure in the maintenance stage, who were suffering from constipation. Improvement in constipation was observed in every patient within a short time, similar to the results in the CAPD patients. A significant difference (P < 0.05) was also observed in the BUN values over a short period (before: 51.4±23.6 mg/dl; after: 37.8±13.6 mg/dl). We conclude that RKF-1 has BUN-lowering action, and it appears capable of serving as a useful dietary supplement for renal protection.
    No preview · Article · Jun 2007
  • [Show abstract] [Hide abstract]
    ABSTRACT: Liposarcoma of the adrenal gland is extremely rare. We report a rare case of primary liposarcoma that had arisen from the adrenal gland and we review other cases in the literature. A 50-year-old man presenting with an abnormal mass in the right adrenal region was admitted to our department. On computed tomography, a heterogenous mass measuring 6 cm in diameter with a regular surface was identified in the right adrenal region, adjacent to the right kidney. During his clinical course of about 10 years, the tumor had continued to grow. With a suspected diagnosis of myelolipoma of the adrenal gland, the patient underwent retroperitoneal laparoscopic right adrenalectomy in June 2004. Microscopic examination revealed that the surgically excised mass consisted of large fat cells and a few lipoblasts adjacent to the cortical layer of the adrenal gland. A diagnosis of primary adrenal liposarcoma was therefore made and the postoperative course was uneventful. The patient was closely followed up, but no tumor recurrence or metastasis has been noted.
    No preview · Article · Dec 2006
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cisplatin-based combination chemotherapy has been considered as standard therapy for advanced or metastatic urothelial carcinoma. A recent study has, however, revealed that gemcitabine may have the potential to act synergistically with cisplatin. Therefore, the side effects of gemcitabine plus cisplatin (GC) therapy were compared with those of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) therapy in patients with advanced or metastatic urothelial carcinoma. Twenty-two patients received GC therapy. Gemcitabine (1000 mg/m2) was administered on days 1, 8 and 15 of each 28-day cycle. Cisplatin (70 mg/m2) was administered on day 2 of each cycle. As a control group, 24 patients received MVAC therapy (methotrexate at 30 mg/m2 on days 1, 15, 22, vinblastine at 3 mg/m2 on days 2, 15, 22, doxorubicin at 30 mg/m2 on day 2, and cisplatin at 70 mg/m2 on day 2 of each 28-day cycle. In the group of patients which received GC therapy, the overall response rates based on independent radiologic reviews of the 20 patients with measurable disease were 55%, with 20% CR and 35% PR. Fewer GC patients as compared with MVAC patients had grade 3/4 anorexia (4.5% vs. 75%, respectively), stomatitis (9.0% vs. 66.7%, respectively), and alopecia (27.3% vs. 100%, respectively). On the other hand, there were no significant differences in the incidence or pattern of hematologic toxicities between the group receiving GC therapy and that receiving MVAC therapy. Fatal neutropenic sepsis occurred in one patient receiving MVAC therapy. GC therapy is effective for the treatment of advanced or metastatic urothelial carcinoma, with an acceptable clinical safety profile. This study also indicates that GC therapy may be better tolerated and safer than MVAC therapy.
    No preview · Article · Oct 2006 · Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In a 32-year-old pregnant woman, routine ultrasonography revealed right hydronephrosis and a huge retroperitoneal mass (20 x 7 cm) containing a fluid collection. Percutaneous drainage of the mass was performed and 2 L of clear, yellowish fluid was collected. Four months following the delivery, a recurrent retroperitoneal lymphocele was identified. Six months after the delivery, laparoscopic marsupialization was performed through a 10-mm umbilical camera port and two 5-mm ports on the right side of the abdomen. A posterior peritoneal window was established by creating a wide opening in the anterior wall of the lymphocele. Subsequent ultrasonography did not indicate a recurrence of the lymphocele or right hydronephrosis over a follow-up period of 8 months.
    Preview · Article · May 2006 · International Journal of Urology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: (Objective) Cisplatin-based combination chemotherapy has been considered as standard therapy for advanced or metastatic urothelial carcinoma. A recent study has, however, revealed that gemcitabine may have the potential to act synergistically with cisplatin. Therefore, the side effects of gemcitabine plus cisplatin (GC) therapy were compared with those of methotrexate, vinblastine, doxorubicin and cisplatin (MVAC) therapy in patients with advanced or metastatic urothelial carcinoma.(Patients and Methods) Twenty-two patients received GC therapy. Gemcitabine (1, 000mg/m2) was administered on Days 1, 8 and 15 of each 28-day cycle. Cisplatin (70mg/m2) was administered on Day 2 of each cycle. As a control group, 24 patients received MVAC therapy methotrexate at 30mg/m2 on Days 1, 15, 22, vinblastine at 3mg/m2 on Days 2, 15, 22, doxorubicin at 30mg/m2 on Day 2, and cisplatin at 70mg/m2 on Day 2 of each. 28-day cycle.(Results) In the group of patients which received GC therapy, the overall response rates based on independent radiologic reviews of the 20 patients with measurable disease were 55%, with 20% CR and 35% PR. Fewer GC patients as compared with MVAC patients had grade 3/4 anorexia (4.5% vs. 75%, respectively), stomatitis (9.0% vs. 66.7%, respectively), and alopecia (27.3% vs. 100%, respectively). On the other hand, there were no significant differences in the incidence or pattern of hematologic toxicities between the group receiving GC therapy and that receiving MVAC therapy. Fatal neutropenic sepsis occurred in one patient receiving MVAC therapy.(Conclusion) GC therapy is effective for the treatment of advanced or metastatic urothelial carcinoma, with an acceptable clinical safety profile. This study also indicates that GC therapy may be better tolerated and safer than MVAC therapy.
    Preview · Article · Jan 2006 · Nippon Hinyōkika Gakkai zasshi. The japanese journal of urology
  • Y. Miyauchi · S. Ishiguro · A. Toshino · N. Tanji · M. Yokoyama
    [Show abstract] [Hide abstract]
    ABSTRACT: A case of neuroendocrine carcinoma of the prostate, where the patient exhibited the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and oculomotor nerve palsy, is reported. The 67-year-old man had received transurethral resection of the prostate for benign prostatic hyperplasia in June 2003, and the surgical specimens had revealed no malignancy. However, since hyponatremia continued, the patient was admitted to our hospital. After various examinations, his condition was diagnosed as SIADH. He received medical treatment and the hyponatremia resolved completely. The following September, he was again admitted to our hospital, this time because of diplopia, ptosis, gross hematuria and anal pain. Magnetic Resonance Imaging (MRI) showed abnormal masses on the Turkish saddle, at the bottom of the right orbit and in the pelvis. The serum level of prostate-specific antigen (PSA) was normal. Histopathological examination of the intrapelvic mass revealed neuroendocrine carcinoma. He died from multiple organ failure eleven days after the diagnosis.
    No preview · Article · Feb 2005
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Therapeutic approaches directed at reducing proteinuria are under development. The aim of the present study was to prospectively elucidate the impact of losartan treatment in renal transplant recipients with persistent proteinuria. Twenty-eight patients with persistent proteinuria or mild hypertension were assigned to receive losartan. Proteinuria was defined as a ratio of urinary protein to urinary creatinine (U(P)/U(Cr)) >0.5 in continual urinary tests in the outpatient setting. All patients with mild hypertension reached target blood pressure (BP) with losartan treatment, but the change was not significant. In twelve patients with proteinuria before initiation of the study, urinary protein excretion was significantly reduced with treatment. No correlation was observed between reductions in proteinuria and mean BP. A significant decrease was identified in the hemoglobin concentration of patients with serum creatinine concentrations >2.0 mg/dl before the study. Losartan efficiently reduces proteinuria in renal transplant recipients with adequate tolerance. Multicentric prospective studies are required to confirm its clinical effectiveness.
    Preview · Article · Jul 2004 · In vivo (Athens, Greece)
  • [Show abstract] [Hide abstract]
    ABSTRACT: Urinary tract infection is a complication of hydronephrosis and antibiotics such as gentamicin are indicated for treatment. However, gentamicin can cause drug-induced nephropathy in dehydrated patients. We used a rat kidney model to investigate the effects of gentamicin administration on functional recovery from unilateral hydronephrosis. Gentamicin was intraperitoneally injected twice for 48 hours following the release of a unilateral ureteral obstruction. The function of both kidneys was separately quantified by Technetium-99mDMSA renoscintigraphy. We examined morphological changes in renal tubular cells by electron microscopy and by in situ DNA 3'-end labeling. Renal function in the contralateral, but not the obstructed, kidney was significantly damaged by gentamicin administration under our conditions and electron microscopy confirmed the presence of myeloid bodies in renal tubular cells. In situ DNA 3'-end labeling revealed characteristic damage to the renal tubules. These results suggest that damage to each kidney should be considered individually after gentamicin administration during recovery from hydronephrosis.
    No preview · Article · Mar 2003 · In vivo (Athens, Greece)
  • [Show abstract] [Hide abstract]
    ABSTRACT: The first renal transplantation in the Department of Urology of Ehime University Hospital was performed in October 1982. We have since experienced 149 cases of living donor and 30 cases cadaver donor renal transplantation turning the two decades. We herein report the results of these cases, in particular the long-term outcomes.
    No preview · Article · Jan 2003 · Nishinihon Journal of Urology
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Little is known about the mechanisms underlying recovery from hydronephrosis. Using a rat kidney model, we investigated the possible contribution of growth factors during regeneration after hydronephrosis. After the unilateral ureteral obstruction for 7 days, the obstruction was released by ureterocystostomy. Epidermal growth factor (EGF), hepatocyte growth factor (HGF) and transforming growth factor-beta1 (TGF-beta1) were studied using immunohistochemistry and semiquantitative reverse transcriptase-polymerase chain reaction (RT-PCR). The immunoreaction of EGF in the medulla of both obstructed and contralateral kidneys increased after releasing the obstruction. The release of ureteral obstruction brought further increased immunoreaction of HGF to both the cortex and the medulla of the contralateral kidney. The immunoreaction of TGF-beta1 also increased in the interstitium especially around the blood vessels in the post-obstructed kidney. The expression of HGF and EGF mRNA in both kidneys and TGF-beta1 mRNA in the obstructed kidney were increased after releasing the obstruction. These results suggest that various growth factors may be involved in the post-obstructive tubular recovery and interstitial damage in the rat kidney.
    Preview · Article · Dec 1999 · International Journal of Urology