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Aim: Radical nephroureterectomy (RNU) is the gold standard treatment for upper tract urothelial carcinoma (UTUC), but the usefulness of this surgery for older patients is rarely discussed. The prognosis following RNU for patients ≥80 years old remains controversial. We retrospectively investigated the prognosis of UTUC in patients ≥80 years old who underwent RNU. Methods: Between January 1990 and December 2015, 451 patients with UTUC underwent RNU at six hospitals affiliated with Kitasato University (Kanagawa, Japan), eight patients who underwent neoadjuvant chemotherapy and two patients with metastases before surgery were excluded. Patients were divided into three groups according to their age at the time of RNU: ≤64 years (n = 135), 65–79 years (n = 254), and ≥80 years (n = 52). Recurrence‐free survival (RFS), cancer‐specific survival (CSS), and overall survival (OS) curves were estimated using Kaplan–Meier analysis for all patients and each pT stage. Independent prognostic factors for survival were examined via multivariate analysis. Results: RFS and CSS did not significantly differ between the three groups, but OS was significantly poorer in patients ≥80 years old. Stratification by pT stage (≤pT1, ≥pT2, and ≥pT3) yielded the same results. In the multivariate analysis for OS, an age of ≥80 years was a significant independent risk factor (hazard ratio: 3.01, p =.01), but RFS and CSS did not significantly differ. Conclusion: Oncological outcomes showed the same anticancer effects in patients ≥80 years old who underwent RNU for UTUC compared with those of younger patients. Our study suggests that surgical treatment is a beneficial option for older patients who can tolerate radical surgery. [ABSTRACT FROM AUTHOR]

Recently, the number of older people and the reduction in infant birth rates in Japan have increased. Elderly against the younger increased to more than 28.9% in 2020. According to the Japanese aging society, a welfare pneumatic device to rehabilitate the temporally injured elderly and the disabled has been actively researched and developed. However, the developed rehabilitation device is almost always used for a patient who is not bedridden. Therefore, the joint of a bedridden patient is given only a passive exercise, by a physical therapist (PT). In this study, in order to reduce the burden of PTs, we aim to develop a rehabilitation device that can be used by anyone assisting the bedridden patient. The target joint was decided to be an ankle-joint because it is difficult for patients with contractions to walk. Therefore, a fan-shaped pneumatic soft actuator (FPSA) using a no-stretch hose with weaved bellows and silicone rubber string was proposed and tested. In addition, the characteristics of FPSA with different pitches and lengths are measured. To predict the bending angle of FPSA, a simplified shape analytical model of it is proposed. It can be confirmed that a calculated bending angle of FPSA using the model generally agrees with the experimental result. The proposed analytical model is a first-stage model that does not include the influence of external forces on FPSA. The ankle-joint rehabilitation device using FPSAs is proposed and tested, where an ankle-joint is changed from a plantarflexion to a dorsiflexion motion by pressurizing both FPSAs on the tested device. And it can be confirmed that a range of motion ("ROM" for short) is satisfied in an inversion and eversion driven by operating one or another FPSA on the device. [ABSTRACT FROM AUTHOR]

Objectives: Crush syndrome (CS) is characterized by a systemic manifestation of traumatic rhabdomyolysis, leading to multiple organ dysfunction and death. Ischemia-reperfusion (IR) injury is commonly responsible for systemic response. Extending studies have shown that hydrogen gas treatment ameliorated IR injury in numerous experimental models; however, its effect on CS has not been well examined. This study aimed to investigate the effects of hydrogen gas inhalation following crush injury in an experimental model of CS. Methods: Male Sprague-Dawley rats were subjected to experimental CS by applying a total of 3.0 kg weight to both hindlimb under general anesthesia for 6 h. Immediately after decompression, the animals were randomly placed in a gas chamber filled with either air or 1.3% hydrogen gas. Animals were sacrificed 18 h or 24 h following gas exposure for non-survival studies or for survival study, respectively. Results: The rats with hydrogen treatment (n = 6) had a higher 24-h survival than the rats with air treatment (n = 9) (100% vs. 44%, p = 0.035). Lactate concentrations (2.9 ± 0.2 vs. 2.2 ± 0.2 mmol/L, p = 0.040) and creatine kinase (34,178 ± 13,580 vs. 5005 ± 842 IU/L, p = 0.016) were lower in the hydrogen group compared with the air group 18 h after decompression (n = 4 in the air group, and n = 5 in the H2 group). Histological analysis revealed that the damage to the rectus femoris muscle and kidney appeared to be ameliorated by hydrogen treatment. Conclusion: Hydrogen gas inhalation may be a promising therapeutic approach in the treatment of CS. [ABSTRACT FROM AUTHOR]

Aim: Intravesical recurrence (IVR) after nephroureterectomy for upper tract urothelial carcinoma (UTUC) is relatively frequent, occurring in about 30–50% of patients. The aim of this study was to investigate the differences of the prognosis and IVR between open and laparoscopic surgery and to elucidate the risk factor of IVR. Patients and methods: We retrospectively analyzed data from 403 patients with UTUC treated with laparoscopic or open nephroureterectomy at six affiliated hospitals between 1990 and 2015. The clinicopathological factors of each group were examined using Kaplan–Meier plots, and univariate and multivariate analyses. Results: There was no difference in recurrence and cancer‐specific mortality between open and laparoscopic surgery in univariate and multivariate analyses. There was no significant difference in IVR rate between the laparoscopic and open groups (p =.22). Among the patients with IVR, 84% of patients relapsed within 2 years. Univariate analysis of IVR showed a significant increase in patients with low‐grade (p =.03, HR = 1.64) or low‐stage urothelial carcinoma (pT1 or lower, p =.006, HR = 1.77) with no lymph node involvement (p =.002, HR = 10.3) or lymphovascular invasion (p =.009, HR = 1.79). Surgical modality was not an independent factor. In multivariate analysis, there was no independent predictive factor for IVR. Conclusions: There was no difference in recurrence, cancer‐specific mortality, and IVR between open and laparoscopic surgery. On the other hand, our results suggested that the low malignant potential tumor may be a risk factor for IVR. This finding provides insight into IVR, which may help with the development of personalized prevention and treatment strategies. [ABSTRACT FROM AUTHOR]