研究等業績 - その他 - 成田 伸太郎
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Narita S.
Surgical Laparoscopy, Endoscopy and Percutaneous Techniques ( Surgical Laparoscopy, Endoscopy and Percutaneous Techniques ) 27 ( 4 ) e69 - e73 2017年
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【鏡視下腎摘出術の新展開】LESS/RPSドナー腎採取術の現況と展望
井上 高光, 成田 伸太郎, 齋藤 満, 奈良 健平, 神田 壮平, 沼倉 一幸, 佐藤 滋, 羽渕 友則
腎移植・血管外科 ( 腎移植・血管外科研究会 ) 29 ( 3 ) 144 - 152 2017年
本邦の生体ドナー腎採取術の9割以上は腹腔鏡下ドナー腎採取術(laparoscopic donor nephrectomy:LDN)で行われているが、近年、一部の施設で単孔式腹腔鏡手術(Laparoendoscopic single-site surgery:LESS)に代表されるreduced port surgery(RPS)を採用したLDNが推進されてきた。従来法のLDN(Std-LDN)より更に低侵襲性や整容性を高めることは、数少ない生体腎移植ドナー候補に対して提供手術に納得していただくために重要であると考えられる。一方、LDNは健康なボランティアに対する手術であるため、安全性と採取腎の良好な機能が絶対的な要件である。従って、LESS/RPSの術式においては低侵襲性、整容性を担保しつつ同時に安全性も担保するreduced port surgery(RPS)の考え方が重要であると考えられる。腎に対するLESSでは副腎など小さな臓器の場合と異なり、腎摘出に必要な約5cmの単孔ではストレート鉗子のみでの操作で比較的容易に術式の完遂が可能である。また採取対象の腎の大きさは、腫瘍性疾患と異なり、各ドナー間でのばらつきが少ないため、ドナー腎採取術はLESSの良い適応であると考えられる。本稿では、LESSドナー腎採取術(Laparoendoscopic single-site donor nephrectomy:LESSDN)およびRPSを採用したLDNについて、国内外の過去の文献および当科の取り組みを紹介し、今後を展望する。(著者抄録)
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[A Case of Giant Prostate Carcinoma Effectively Treated with External-Beam Radiation Therapy].
Sohei Kanda, Shintaro Narita, Naoki Komine, Seiichi Kitajima, Misa Yamauchi, Akihiro Sugita, Yutaka Saito, Tomonori Habuchi
Hinyokika kiyo. Acta urologica Japonica 62 ( 12 ) 647 - 650 2016年12月
We present a case of gigantic prostate tumor in a patient with castration-resistant prostate cancer with successful local control by external-beam radiation therapy. A 71-year-old man was shown to have a prostate specific antigen (PSA)level of 24.5 ng/ml, Gleason 9, cT2N1M1a, prostate adenocarcinoma with an estimated prostate volume of 26.9 g. He achieved a PSA nadir at 4 months after the initial androgen deprivation therapy and was diagnosed with castration-resistant prostate cancer three years later. Eight months after the diagnosis of castration-resistant prostate cancer, he visited our hospital due to urinary retention. Abdominal computed tomography scan showed a gigantic prostatic mass occupying the whole pelvic cavity along with multiple lymph node, bone and liver metastases. The estimated volume of the prostate was 878 g. A tumor needle biopsy revealed a histological finding similar to the initial prostate biopsy which was adenocarcinoma with Gleason 9. He underwent external beam radiation therapy (60 Gy) to the prostate, which brought about excellent local control with a 96.7% shrinkage of tumor at 2 months after radiation therapy. He had no complaints of urinary symptoms and no need for urethral catheterization until he died of prostate cancer metastases.
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Altered miRNA expression in high-fat diet-induced prostate cancer progression.
Taketoshi Nara, Shintaro Narita, Huang Mingguo, Toshiaki Yoshioka, Atsushi Koizumi, Kazuyuki Numakura, Hiroshi Tsuruta, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Shigeru Satoh, Tomonori Habuchi
Carcinogenesis 37 ( 12 ) 1129 - 1137 2016年12月
Recent evidence suggests that a high-fat diet (HFD) plays an important role in prostate carcinogenesis; however, underlying mechanisms largely remain unknown. Here, we investigated microRNA (miRNA) expression changes in murine prostate cancer (PCa) xenografts using two different diets: HFD and control diet. We then assessed the roles and targets of altered miRNAs in HFD-induced PCa progression. We identified 38 up- and 21 downregulated miRNAs in xenografts under HFD conditions using the miRCURY LNA™ microRNA array. The differences in 10 candidate miRNAs were validated using quantitative RT-PCR. We focused on miR-130a because the expression levels were significantly lower in the three PCa cell lines in comparison with benign prostate PINT1B cells. PCa cells cultured in a medium containing HFD mouse serum were associated with significantly higher cell proliferation rates and lower miR-130a expression levels. Further, miR-130a modulated MET expression in PCa cells, and MET was overexpressed in in vitro and in vivo HFD-induced PCa progression models. Moreover, ectopic miR-130a downregulated AR in LNCaP cells and DICER1 in PC-3 and DU145 cells, respectively. In human tissues, as elucidated using laser capture microdissection, the mean miR-130a expression level in cancer epithelium was significantly lower than that in normal epithelium. Furthermore, cytoplasmic MET in PCa tissues was overexpressed in patients with higher body mass index. In conclusion, a substantial number of miRNAs was altered in HFD-induced PCa growth. Specifically, miR-130a was attenuated in HFD-induced PCa progression with MET overexpression. miRNAs thus have implications in the mechanism, prevention and treatment of HFD-induced PCa progression.
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Efficacy and safety of bladder hydrodistension for decreased bladder capacity induced by intravesical BCG therapy.
Kazuyuki Numakura, Norihiko Tsuchiya, Hiroshi Tsuruta, Susumu Akihama, Mitsuru Saito, Takamitsu Inoue, Shintaro Narita, Mingguo Huang, Shigeru Satoh, Tomonori Habuchi
Scandinavian journal of urology 50 ( 6 ) 429 - 432 2016年12月
OBJECTIVE: Intravesical BCG therapy is widely used for the treatment of high-risk, non-muscle-invasive bladder cancer. Among various reported side-effects, decreased bladder capacity is a serious side-effect that significantly worsens patients' quality of life. This article reports the efficacy and safety of bladder hydrodistension (BHD) in six patients with seriously decreased bladder capacity caused by BCG treatment. METHODS: Six patients with low bladder capacity (<100 ml in voiding diaries) and complaint of grade 3 irritative symptoms were diagnosed with decreased bladder capacity and treated with BHD. Alleviation of symptoms was defined as medication being discontinued or reduced after BHD. RESULTS: Five patients were male and one was female, and the mean age was 67.7 years. The mean interval between the last transurethral resection and BCG therapy was 26.0 days. Before BHD, all patients had been treated with antibiotics, anticholinergics and non-steroidal anti-inflammatory drugs (NSAIDs). The median bladder capacity before treatment was 40 ml (range 30-100 ml), and the median capacity increased to 200 ml (175-250 ml) within 2 weeks following BHD therapy. Four patients stopped NSAID use and three patients stopped anticholinergic use. One patient needed total cystectomy for recurrent symptoms. With a median follow-up period of 32 months, the bladder capacity remained stable without symptomatic deterioration in the remaining five patients. There was neither tumor spread nor disseminated tuberculosis infection. CONCLUSIONS: BHD appears to be an effective treatment option in patients with severely decreased bladder capacity. Its efficacy and safety were acceptable.
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von Hippel-Lindau病に合併した腫瘍性病変に対するアキシチニブによる治療経験
関根 悠哉, 成田 伸太郎, 五十嵐 龍馬, 奈良 健平, 松田 芳教, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 羽渕 友則, 佐藤 滋, 立木 裕
泌尿器外科 ( 医学図書出版(株) ) 29 ( 12 ) 1794 - 1794 2016年12月
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ロボット支援腹腔鏡下前立腺全摘除術(RALP)における神経温存が術後尿失禁に及ぼす影響
高山 孝一朗, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 成田 伸太郎, 羽渕 友則
日本排尿機能学会誌 ( (一社)日本排尿機能学会 ) 27 ( 1 ) 267 - 267 2016年12月
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石田 雅宣, 井上 高光, 前野 淳, 喜早 祐介, 高山 孝一朗, 小泉 淳, 山本 竜平, 沼倉 一幸, 鶴田 大, 齋藤 満, 成田 伸太郎, 羽渕 友則, 佐藤 滋
泌尿器外科 ( 医学図書出版(株) ) 29 ( 12 ) 1793 - 1794 2016年12月
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単一施設における根治的前立腺全摘術3術式における断端陽性率と陽性部位の比較
小泉 淳, 成田 伸太郎, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
Japanese Journal of Endourology ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 29 ( 3 ) 196 - 196 2016年11月
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井上 高光, 成田 伸太郎, 齋藤 満, 沼倉 一幸, 鶴田 大, 前野 淳, 羽渕 友則
Japanese Journal of Endourology ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 29 ( 3 ) 250 - 250 2016年11月
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沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 滿, 井上 高光, 成田 伸太郎, 黄 明国, 佐藤 滋, 羽渕 友則
Japanese Journal of Endourology ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 29 ( 3 ) 237 - 237 2016年11月
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腹腔鏡下腎摘除(基本編) 当科における腹腔鏡下腎摘除術手術手技習得にむけての取り組み
成田 伸太郎, 井上 高光, 羽渕 友則
Japanese Journal of Endourology ( (一社)日本泌尿器内視鏡・ロボティクス学会 ) 29 ( 3 ) 109 - 109 2016年11月
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Secondary bladder amyloidosis with familial Mediterranean fever in a living donor kidney transplant recipient: a case report.
Sentaro Imamura, Shintaro Narita, Ryuta Nishikomori, Hiroshi Tsuruta, Kazuyuki Numakura, Atsushi Maeno, Mitsuru Saito, Takamitsu Inoue, Norihiko Tsuchiya, Hiroshi Nanjo, Toshio Heike, Shigeru Satoh, Tomonori Habuchi
BMC research notes 9 ( 1 ) 473 - 473 2016年10月
BACKGROUND: Secondary bladder amyloidosis is an extremely rare disease, resulting from a chronic systematic inflammatory disorder associated with amyloid deposits. Although uncommon in Japan, familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease characterized by recurrent episodes of fever of short duration and serositis and is frequently associated with systemic amyloidosis. Here, we present a case of a Japanese patient complaining of fever and macroscopic hematuria after a living donor renal transplantation. Consequently, he was diagnosed with secondary bladder amyloidosis with FMF. CASE PRESENTATION: A 64-year-old Japanese male received a living ABO-incompatible kidney transplant from his wife. The postoperative clinical course was normal, and the patient was discharged 21 days after the transplantation with a serum creatinine level of 0.78 mg/dl. The patient frequently complained of general fatigue and fever of unknown origin. Six months later, the patient presented with continuous general fatigue, macroscopic hematuria, and fever. Cystoscopic examination of the bladder showed an edematous region with bleeding, and a transurethral biopsy revealed amyloid deposits. His wife stated that the patient had a recurrent high fever since the age of 40 years and that his younger brother was suspected to have a familial autoinflammatory syndrome; thus, the patient was also suspected to have a familial autoinflammatory syndrome. Based on his brother's medical history and the genetic tests, which showed a homozygous mutation (M694V/M694V) for the Mediterranean fever protein, he was diagnosed with FMF. Although colchicine treatment for FMF was planned, the patient had an untimely death due to heart failure. We re-evaluated the pathological findings of the various tissue biopsies obtained during the treatment after the renal transplantation. Immunohistochemistry revealed amyloid deposits in the bladder region, renal allograft, and myocardium and the condition was diagnosed as AA amyloidosis associated with FMF. CONCLUSION: We presented a case of systemic amyloidosis with FMF, involving the bladder region, myocardium, and renal allograft, diagnosed after renal transplantation. Bladder amyloidosis should be considered in patients with macroscopic hematuria, particularly in the kidney transplant recipients with idiopathic chronic renal disease. Diagnosis of secondary bladder amyloidosis may result in the early detection of underlying diseases, which may contribute to patient prognosis.
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前立腺癌間質微小環境と前立腺癌進展における脂肪酸結合分子4の役割
黄 明国, 小泉 淳, 成田 伸太郎, 井上 高光, 佐々木 雄彦, 羽渕 友則
日本癌学会総会記事 ( 日本癌学会 ) 75回 J - 2068 2016年10月
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単一施設における根治的前立腺全摘術3術式の断端陽性率と断端陽性部位の比較
小泉 淳, 成田 伸太郎, 奈良 健平, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 前野 淳, 齋藤 満, 井上 高光, 佐藤 滋, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 54回 P53 - 7 2016年10月
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転移性尿路上皮癌に対する二次化学療法としてGN療法を行った3例の検討
鶴田 大, 井上 高光, 成田 伸太郎, 齋藤 満, 前野 淳, 沼倉 一幸, 佐藤 滋, 賀本 敏行, 羽渕 友則
日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 ) 54回 P46 - 1 2016年10月
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前立腺癌術後再発に対する内分泌および化学療法中に発生した小細胞癌の一例
齋藤 拓郎, 前野 淳, 井上 高光, 喜早 祐介, 提箸 隆一郎, 高山 孝一朗, 鶴田 大, 齋藤 満, 成田 伸太郎, 土谷 順彦, 羽渕 友則, 佐藤 滋
泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1494 - 1494 2016年09月
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喜早 祐介, 前野 淳, 高山 孝一朗, 沼倉 一幸, 鶴田 大, 斎藤 満, 井上 高光, 成田 伸太郎, 土谷 順彦, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1497 - 1498 2016年09月
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肝転移破裂に対し肝動脈化学塞栓術を施行し、長期生存が得られている腎癌症例
松田 芳教, 鶴田 大, 喜早 祐介, 高山 孝一朗, 小泉 淳, 奈良 健平, 本間 直子, 前野 淳, 斉藤 満, 井上 高光, 成田 伸太郎, 秋濱 晋, 佐藤 滋, 羽渕 友則
泌尿器外科 ( 医学図書出版(株) ) 29 ( 9 ) 1499 - 1499 2016年09月
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腎移植後脂質代謝異常症の検討
沼倉 一幸, 加賀谷 英彰, 山本 竜平, 齋藤 滿, 鶴田 大, 前野 淳, 井上 高光, 成田 伸太郎, 黄 明国, 土谷 順彦, 羽渕 友則, 新岡 丈典, 三浦 昌朋, 佐藤 滋
移植 ( (一社)日本移植学会 ) 51 ( 総会臨時 ) 294 - 294 2016年09月