Search

Background: The diurnal rhythm in water and solute diuresis is known to be disturbed in older adults with nocturia due to nocturnal polyuria. We estimated the prevalence of increased natriuresis in nocturia due to nocturnal polyuria by comparing individuals with and without nocturnal polyuria., Methods: We calculated the night-to-day ratio of excreted urinary sodium and potassium concentrations adjusted for urinary creatinine concentration and urinary osmolality using spot urine samples collected at 2 PM (daytime) and 6 AM (nighttime) and compared results among controls with nocturia and paitents with nocturia with and without nocturnal polyuria., Results: Among 83 patients aged 50 to 86 years, the mean night-to-day ratio of excreted urinary sodium and potassium concentrations in the nocturia group with nocturnal polyuria (n = 40) was 2.5, which was significantly higher (p = 0.034) than those in the control group (n = 23; 0.7) and the nocturia group without nocturnal polyuria (n = 20; 0.9). After adjustment for age, no difference in potassium and urinary osmolality existed among groups. Thirteen patients (33%) in the nocturia group with nocturnal polyuria showed increased natriuresis when a 2.0 night-to-day ratio of excreted urinary sodium was applied as a cut-off for increased natriuresis, whereas only 3 (7%) patients in the combined groups without nocturnal polyuria had increased natriuresis (p = 0.005)., Conclusions: One-third of patients with nocturia due to nocturnal polyuria had increased natriuresis. Assessment of a night-to-day ratio of excreted urinary sodium using spot urine samples could facilitate a better understanding of the underlying pathophysiology and optimal management of nocturnal polyuria., (© 2025 Wiley Periodicals LLC.)

Objective: We investigated the impact of intraoperative tumor capsule injury (TCI) during robot-assisted partial nephrectomy (RAPN) or laparoscopic partial nephrectomy (LPN) on oncological outcomes, as well as underlying factors of intraoperative TCI for improving surgical outcomes., Methods: A total of 253 patients who underwent RAPN or LPN between 2010 and 2022 were retrospectively analyzed and were divided into two groups: non-TCI and TCI groups. The background was compared between two groups. We investigated the surgical records or video to evaluate TCI and seek the possible causes for TCI. Multivariate logistic regression analysis was performed to identify prognostic factors for cancer recurrence., Results: Of the 253 patients, 227 have renal cell carcinoma (RCC), with 29 patients having TCI. The TCI group had larger tumors, a lower rate of trifecta achievement, higher bleeding, higher T stage, and a lower rate of clear cell RCC (ccRCC) histological types as compared to non-TCI group. Disease recurrence rate was 13.8% with TCI and 1.0% with non-TCI (odds ratio 15.7; 95% confidence interval, 2.73-90.1; p = 0.003). Univariate and multivariate analyses confirmed TCI as an independent prognostic factor for disease-free survival. Compared with ccRCC, non-clear cell RCC (non-ccRCC) was found to have a higher probability of TCI and a significantly thinner capsule thickness on pathological evaluation., Conclusion: TCI had a negative impact on oncological outcomes. Surgeons should consider thickness of tumor capsules, especially in cases with non-ccRCC, to minimize the risk of TCI during partial nephrectomy., (© 2025 The Japanese Urological Association.)

Background : Hydrogen gas (H 2 ) has been shown to be effective in the treatment of various clinical conditions, from acute illnesses to chronic illnesses. However, its clinical indications and the corresponding appropriate hydrogen delivery methods have yet to be determined. This is due to the fact that the pharmacokinetics and pharmacodynamics of hydrogen in each delivery method have not been experimentally proven. Here, we verified the pharmacokinetics of hydrogen after the infusion of hydrogen-saturated saline. Methods : Hydrogen-saturated saline was prepared and checked for sterility and component specifications. Hydrogen-saturated saline was administered intravenously (125 mL/h) through the left internal jugular vein of pigs, and the blood hydrogen concentration was measured over time. Results : It was confirmed that hydrogen can be safely mixed under pressure into intravenous solutions (pharmaceutical products) without the contamination of foreign substances by using a needle-less vial access cannula. No change in the PH or composition of the solution was observed due to hydrogen filling. The hydrogen concentrations of blood samples collected from the left internal jugular vein 3 cm to the heart from the tip of the infusion line were 6.4 (30 min), 4.7 (60 min), 4.9 (90 min), and 5.3 (120 min) ppb w / w , respectively. The hydrogen concentrations of blood samples collected from the right atrium were 0.7 (30 min), 0.5 (60 min), 0.7 (90 min), and 0.7 (120 min) ppb, respectively. The hydrogen concentration of blood samples collected from the right internal carotid artery were 0.1 (pre), 0.2 (30 min), 0.3 (60 min), 0.0 (90 min), and 0.0 (120 min) ppb w / w , respectively. Conclusions : We confirmed that hydrogen could be safely pressurized and filled into intravenous (pharmaceutical) solution without contamination by foreign objects using a needle-free vial access cannula. When saturated hydrogen saline was dripped intravenously, almost all of the hydrogen was expelled during its passage through the lungs and could not be supplied to the arterial side.

Lysophosphatidylethanolamine (LPE) is a bioactive lipid mediator involved in diverse cellular functions. In this study, we investigated the effects of three LPE species, 1-palmitoyl LPE (16:0 LPE), 1-stearoyl LPE (18:0 LPE), and 1-oleoyl LPE (18:1 LPE) on pre-osteoblast MC3T3-E1 cells. All LPE species stimulated cell proliferation and activated the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) 1/2. MAPK/ERK1/2 activation by 16:0 LPE and 18:1 LPE was inhibited by the Gq/11 inhibitor YM-254890, while activation by 18:0 LPE was blocked by the Gi/o inhibitor pertussis toxin. Intracellular Ca 2+ transients were triggered by 16:0 LPE and 18:1 LPE but not by 18:0 LPE, with YM-254890 suppressing these responses. These results suggest that 16:0 and 18:1 LPE act via Gq/11-coupled G protein coupled receptors (GPCRs), and 18:0 LPE acts via Gi/o-coupled GPCRs. Furthermore, receptor desensitization experiments suggested that each LPE acts through distinct GPCRs. Interestingly, 18:0 LPE suppressed osteogenic differentiation, reducing mineralization, alkaline phosphatase activity, and osteogenic gene expression, whereas 16:0 LPE and 18:1 LPE had no such effects. These results suggest the physiological significance of LPEs in bone formation and indicate that different LPE species and their receptors play distinctive roles in this process., Competing Interests: Declarations. Competing interests: The 24-well plates with a special surface modification used in this study were generously provided free of charge by the Stella Chemifa Corporation. T.U. and N.S. are patent holders for the 24-well plates featuring the special surface modification. Additionally, a separate collaborative research agreement, including funding support, has been established with Stella Chemifa Corporation; however, the agreement is unrelated to the present study., (© 2024. The Author(s).)

Introduction: Limited evidence exists regarding differences in post-operative renal function and ileal conduit-related complications, including ureteroenteric anastomotic stricture (UAS) and parastomal hernia (PH), between radical cystectomy (RC) with extracorporeal urinary diversion (ECUD) and robot-assisted RC with intracorporeal UD (ICUD)., Methods: We retrospectively collected the baseline and post-RC follow-up data from 179 patients receiving RC with ileal conduit UD (152 ECUD and 27 ICUD). The estimated glomerular filtration rate (eGFR, mL/min/1.73 m 2 ) and occurrence of UAS and PH were post-operatively monitored. Chronic kidney disease (CKD) stages were determined based on eGFR level. UD-related complications were evaluated using the Clavien-Dindo system. Time-course changes in eGFR level and CKD-related survival rates were compared in both the original and propensity score-matched cohorts., Results: Although the original ECUD group had higher eGFR levels (median, 60.9 vs. 52.1), comparison of the adjusted cohorts revealed no significant difference at any time points, CKD upstaging-free survival, and CKD stage 3b-free survival. Out of 179 patients, three (1.7%), eight (4.5%), and 14 (7.8%) experienced grade I, II, and IIIa UAS, respectively. Thirteen (7.3%) developed PH during follow-up. No significant differences were observed in UAS rates (p = 0.38), PH rates (p = 0.69), CKD upstaging-free survival, and CKD stage 3b-free survival between two groups., Conclusion: No significant difference was observed in post-operative renal function and UD-related complication rates among the different types of surgery in patients undergoing RC in our institute. Further research is needed to determine the optimal surgical approach for each patient to minimize risks of CKD upstaging, UAS, and PH., (© 2025 Asia Endosurgery Task Force and Japan Society of Endoscopic Surgery and John Wiley & Sons Australia, Ltd.)