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Purpose Sperm function tests do not adequately assess fertilization potential, and new indices are required. We have previously reported that human testis‐specific actin capping proteins may be involved in both sperm morphology and function. This study aimed to determine whether testis‐specific actin capping proteins can be a predictive marker of IVF success. Methods Ninety‐seven infertile couples who underwent IVF at an infertility clinic were included. Sperm were immunohistochemically stained to evaluate capping protein expression, and the percentage of sperms with normal staining was calculated. The relationship between actin capping protein expression and IVF outcomes was examined. Results The couples were divided into four groups according to the percentage of normally expressing actin capping protein as follows: ≥90% Group Ⅰ, 80%–90% Group Ⅱ, 70%–80% Group Ⅲ, and, This study aimed to determine whether testis‐specific actin capping proteins can be a predictive marker of IVF success.Multiple linear regression showed a significant trend in the fertilization rates of IVF across the 4 groups. The human testis‐specific actin capping protein may be a marker of male contributing factors that predicts IVF outcomes.

BACKGROUND The pathophysiology of the prostate enlargement underlying lower urinary tract symptoms is unknown. Meanwhile, the gut microbiota can contribute to various host conditions. We hypothesized that the gut microbiota plays a role in prostate enlargement. METHODS We included 128 patients who underwent prostate biopsies at our hospitals between December 2018 and March 2020, excluding those who had used antibiotics within the past 6 months and those who were diagnosed with prostate cancer of cT3 or higher. Patients with prostate volumes ≥30 ml were defined as the prostate-enlargement (PE) group; those with prostate volumes

66 Background: In the PREVAIL study, enzalutamide was demonstrated to be effective in men with chemo-naïve metastatic castration-resistant prostate cancer (CRPC). In Japan, enzalutamide was introduced in 2014. Real-world evidence is needed for the long-term safety and efficacy of enzalutamide. The aim of this study was to evaluate the efficacy, safety and prognostic factors in CRPC treated with enzalutamide. Methods: This multicenter, prospective, observational study enrolled 163 Japanese CRPC patients between January 2016 and March 2019. Eligibility criteria were men with chemo-naïve CRPC, no prior treatment with novel androgen receptor signaling inhibitors, and an ECOG- Performance Status ≤ 2. The switching of bicalutamide and flutamide was eligible. Written consent for participation has been obtained from the patient. Enzalutamide 160 mg/day was administered once daily according to usual practice. Data were collected from medical records at baseline and every 3 months until march 2021. The primary endpoint was overall survival (OS), and factors associated with OS were examined. Cox proportional hazards model was used for statistics. The secondary endpoints were PSA response and safety. Results: At a median follow-up of 26.0 months, the median OS was 42.1 months and 24-month OS rate was 69%. Univariate analysis showed that time to CRPC, pretreatment serum PSA, baseline NSE, and baseline interleukin-6 (IL-6) levels were associated with OS. Multivariate analysis revealed that pretreatment serum PSA (hazard ratio [HR] 2.30, 95% confidence interval [CI] 1.30-4.10), baseline NSE (HR 2.97, 95%CI 1.24-7.11), and baseline IL-6 (HR 2.32 95%CI 1.32-4.09) were independent risk factors for OS. PSA decline more than 50% was 74% (n=120). Fatigue (30%, n=49), constipation (20%, n=32) and appetite loss (18%, n=29) were the most common adverse events (AEs). Dose reduction/drug discontinuation rates were 20% (n=33) due to AEs and 18% (n=29) due to patient request. Conclusions: The efficacy and safety of enzalutamide in Japanese real clinical practice were comparable to those reported in PREVAIL study. The present analysis also suggests that serum PSA, NSE and IL-6 levels are independent prognostic factors in CRPC patients. Clinical trial information: UMIN000019855 . [Table: see text]

Monitoring only neutron flux in a nuclear reactor core has an advantage of offering reactor power monitoring accuracy. We started the development of a new nuclear instrumentation based on the measu...

Bacterial flora has clinical significance for the host. The metabolic environment created by this flora influences immunotherapy in urothelial carcinoma. However, there are no reports on the clinical significance of bacterial flora in the host bloodstream. We aimed to clarify the correlation between extracellular vesicle (EV)-derived blood microflora information and tumor immunological status in urothelial carcinoma (UC) patients. Serum samples were collected from 20 healthy donors, 50 patients with localized UC, and 31 patients with metastatic UC (mUC) who had undergone pembrolizumab treatment. Bacterial DNA in EVs was extracted from each sample. Metagenomic sequencing was performed after amplification of the V1-V2 region of the bacterial 16S rRNA gene. Using the matched tumor tissue and serum samples, we revealed that the smaller amount of peripheral EVs carrying Firmicutes DNA was significantly correlated with the higher number of infiltrating T cells within tumor tissues (CD3; p = 0.015, CD4; p = 0.039, CD8; p = 0.0084) and the higher expression of activation markers on their surface (ICOS on both CD4; p = 0.0013 and CD8 T cells; p = 0.016 and 4-1BB on CD4 T cells; p = 0.016). In terms of circulating metabolic information, L-Ser and L-Pro levels, which play important roles in T cell expansion and proliferation, were significantly higher in the Firmicutes-low group (p = 0.010). All of the patients with higher Firmicutes abundance had disease progression without any clinical response (p = 0.026) and significantly inferior prognosis for pembrolizumab therapy (p = 0.035). This is the first study on the importance of peripheral bacterial EVs in cancer patients treated with cancer immunotherapy.

Nocturnal polyuria is the most frequent cause of nocturia, a common disease associated with a compromised quality of life and increased mortality. Its pathogenesis is complex, and the detailed underlying mechanism remains unknown. Herein, we report that concomitant intake of a high-salt diet and reduced nitric oxide (NO) production achieved through Nω-Nitro-L-arginine methyl ester hydrochloride (L-NAME) administration in mice resulted in nocturnal polyuria recapitulating the clinical features in humans. High salt intake under reduced NO production overactivated the angiotensin II-SPAK (STE20/SPS1-related proline–alanine-rich protein kinase)-NCC (sodium chloride co-transporter) pathway in the kidney, resulting in the insufficient excretion of sodium during the day and its excessive excretion at night. Excessive Na excretion at night in turn leads to nocturnal polyuria due to osmotic diuresis. Our study identified a central role for the intrarenal angiotensin II-SPAK-NCC pathway in the pathophysiology of nocturnal polyuria, highlighting its potential as a promising therapeutic target.

In 2012, the Japanese Society for Dialysis Therapy (JSDT) established the order of correction of P, corrected Ca (cCa), and whole PTH (w-PTH) in the treatment of Chronic Kidney Disease-Metabolic Bone Disorder (CKD-MBD) as P-first. However, there is no report that analyzes whether this rule is in line with reality and what the adequate rate of P is. Therefore, we analyzed the test values of our 48 patients during the year of 2019 and examined the validity of the results. The results showed that the adequate range rates were 70.8% for P, 100% for cCa, and 89.6% for w-PTH. This result is better than the JSDT Web-based Analysis of Dialysis Data Archives (WADDA) P adequacy rate of 66.2%. Although the guideline is P-first, it is often the case that we cannot reach the adequate level; therefore, healthcare professionals and patients often blame each other. We believe that this is due to the mismatch between the modern era of processed foods covered with P additives and treatment methods (P intake restriction and P-binders). The development of processed foods with P additives has brought light and darkness to mankind. The light side is freedom from starvation, and the dark side is a new condition caused by P burden: P burden disease including CKD-MBD.

The micromix (MMX) combustion concept is a DLN gas turbine combustion technology designed for high hydrogen content fuels. Multiple non-premixed miniaturized flames based on jet in cross-flow (JICF) are inherently safe against flashback and ensure a stable operation in various operative conditions. The objective of this paper is to investigate the influence of pressure on the micromix flame with focus on the flame initiation point and the NOx emissions. A numerical model based on a steady RANS approach and the Complex Chemistry model with relevant reactions of the GRI 3.0 mechanism is used to predict the reactive flow and NOx emissions at various pressure conditions. Regarding the turbulence-chemical interaction, the Laminar Flame Concept (LFC) and the Eddy Dissipation Concept (EDC) are compared. The numerical results are validated against experimental results that have been acquired at a high pressure test facility for industrial can-type gas turbine combustors with regard to flame initiation and NOx emissions. The numerical approach is adequate to predict the flame initiation point and NOx emission trends. Interestingly, the flame shifts its initiation point during the pressure increase in upstream direction, whereby the flame attachment shifts from anchoring behind a downstream located bluff body towards anchoring directly at the hydrogen jet. The LFC predicts this change and the NOx emissions more accurately than the EDC. The resulting NOx correlation regarding the pressure is similar to a non-premixed type combustion configuration.

Oscillating velocity vector fields are often observed in fluid flow fields. A flow field caused by the Karman vortices is a typical example of an oscillating velocity vector field. In particle image velocimetry (PIV), a velocity vector field is determined from an image sequence representing a fluid flow field visualised by particles (Adrian, 1991; Raffel et al., 2007). When we focus on an oscillating velocity vector field, we can expect that the oscillatory characteristic of the field is useful for determining a high accurate velocity vector field. Thus, utilising the oscillatory characteristic as an additional constraint is an interesting topic for the PIV approaches, such as the matching-based approach and the gradient-based one. Thematching-based approach utilises a pattern-matching procedure, which calculates a crosscorrelation function between two image templates on the two successive image frames. The peak position of the obtained two-dimensional cross-correlation function provides a displacement vector for a brightness pattern during one frame, that is, a velocity vector. Under the low density of particles, it is possible to track a particular particle during two or more successive image frames by the pattern-matching procedure (Hassan et al., 1992). When the density of particles is in the middle range, the pattern-matching procedure for a particle distribution function is utilised to detect its velocity vector (Willert and Gharib, 1991). The gradient-based approach first estimates spatio-temporal gradients on an image brightness function, and then derives the basic constraint equation consisting of the gradients and two velocity components (Horn and Schunck, 1981). The basic constraint equation is derived from the correspondence of a moving image brightness pattern during a short time period. Next, it organises the error function consisting of the basic constraint equation and additional one(s) modelling the characteristics of a fluid flow field. Finally, minimising the error function by an optimisation method provides the two velocity components. There are several problems in the matching-based approach and the gradient-based one. With the gradient-based approach, it is difficult to determine high speed flow fields. In contrast to this, while the matching-based approach can determine such the high speed flow fields, the sub-pixel accuracy of the approach is generally unreliable. The gradient-based approach 4

Purpose: To determine the pathophysiology of nocturnal polyuria associated with renal dysfunction.Methods: Patients who underwent laparoscopic nephrectomy were studied prospectively. The diurnal variation in urine volume, osmolality, and salt excretion were measured on preoperative day two and postoperative day seven. The factors associated with an increase in the nighttime urine volume rate with decreased renal function were evaluated by multiple linear regression analysis.Results: Forty-nine patients were included. The eGFR decreased from 73.3 ± 2.0 to 47.2 ± 1.6 mL/min/1.73 m2 (P < 0.01) and the nighttime urine volume rate increased from 40.6% ± 2.0% to 45.3% ± 1.5% (P = 0.04) with nephrectomy. The nighttime urine osmolality decreased from 273 ± 15 to 212 ± 10 mOsm/kg (P < 0.01) and the nighttime salt excretion rate increased from 38.7% ± 2.1% to 48.8% ± 1.7% (P < 0.01) with nephrectomy. Multiple linear regression analysis revealed that the increase in the nighttime urine volume rate was strongly affected by the increase in the nighttime salt excretion rate.Conclusion: A decrease in renal function causes an increase in the nighttime urine volume rate, mainly due to an increase in nighttime salt excretion.Trial registration number: UMIN000036760 (University Hospital Medical Information Network Clinical Trials Registry)Date of registration: From June 1st, 2019 to October 31th 2020

BACKGROUND Varicocoele-induced male infertility potentially involves oxidative stress. Although varicocoelectomy is recommended for varicocoele patients presenting abnormal semen findings, no pharmacotherapeutic methods currently exist. We have recently developed a silicon-based agent that produces hydrogen by the reaction with water. OBJECTIVES This study aimed to investigate the therapeutic effects of oral administration of a Si-based agent on varicocoele rat. MATERIALS AND METHODS Twenty-one rats were divided into four groups: varicocoele + normal diet (n = 5), varicocoele + Si-based agent-supplemented diet (n = 6), sham + normal diet (n = 5), and sham + Si-based agent-supplemented diet (n = 5). All rats were euthanized four weeks after surgery. RESULTS The mean left epididymal sperm motility was 74.4% in the sham group, 72.3% in the sham + Si group, 57.6% in the varicocoele group, and 66.9% in the varicocoele + Si group. Epididymal sperm motility was significantly lower in the varicocoele group, but was significantly higher upon Si-based agent ingestion (P

Purpose: Germ cell tumors (GCTs) are the most common malignant neoplasms in adolescents and young adults, and most patients with these tumors can be completely cured. Therefore, maintaining quality of life (QOL) is important. Erectile dys-function (ED) is one factor that reduces the QOL of GCT survivors. We aimed to clarify the relationship between ED and age, follow-up period, serum levels of hormones, and treatment methods for GCT survivors. Materials and Methods:Materials and Methods: We evaluated ED using the Sexual Health Inventory for Men questionnaire (SHIM) and measured serum levels of hormones in survivors after GCT treatment. The relationships between the SHIM score responses and age, se-rum levels of hormones, follow-up period, and treatment methods were assessed using a logistic analysis. Results:Results: Fifty-two GCT survivors were enrolled and 46 survivors completed the SHIM. The median age, follow-up period, and SHIM score were 38 years, 35 months, and 18, respectively. Regarding the SHIM scores, 85% had scores

Accepted: 2017-04-29, 資料番号: SA1170154000

Since we experienced a case that S-1+Cisplatin (CDDP) therapy was effective for bladder primary signet ring cell adenocarcinoma of pT4N0M0, we report here the time course of its pathophysiology and the treatment of that patient, and discuss the justification of the chemotherapy for the T4 case with the comparison of the previous cases. The present case is a 66 years old man. Because he was aware of the urinary frequency and the sense of incongruity at abdominal region for approximately three months, he visited our hospital for the consultation of his symptoms in July, 2015. The anterior wall showed a torose lesion by cystoscopy from the left sidewall, and we found the histopathology signet ring cell adenocarcinoma after transurethral resection of the bladder tumor. As a result of thorough investigation of thoracic abdominal CT, whole body PET-CT and endoscopy of the upper gastrointestinal tract, we diagnosed it as bladder primary signet ring cell adenocarcinoma with cT3N0M0. Consequently, we tried total cystectomy in August, 2015, however both bladder and pelvic wall were adhered strongly each other; we gave up the total cystectomy and changed the strategy to the urinary diversion by bilateral ureterocutaneous fistula. A biopsy of the adhesion site of the right pelvic wall showed the invasion of the signet ring cell adenocarcinoma, which enabled us to diagnose as pT4bN0M0. Therefore, we performed the chemotherapy with the S-1+CDDP for 12 courses, 16 months from August, 2015 after the surgery. After the initiation of the chemotherapy, the tumor marker was tended to decrease for eight months, but turned to increase thereafter. Because there was no evidence for neither distant nor lymph node metastases of tumor revealed by CT and the MRI, we diagnosed it as Stable Disease at least by CT and MRI examinations for 16 months. The major side-effects were not found during the strengthened chemotherapy without the recurrence until January, 2017. Since this case is very rare, we report the time courses and treatment strategy of a patient with bladder primary signet ring cell adenocarcinoma.

A 38-year-old man had a right lower retroperitoneal mass found by abdominal echography in a medical examination, and he consulted the internal medicine of Sumitomo Hospital. On the suspicion of malignant lymphoma, he received a laparotomy with biopsy. Pathological examination revealed that the tumor was either benign lymphadenopathy or low-grade malignant lymphoma, and he was follow-up. Two years later, he was introduced to our department because the follow-up computed tomography revealed signs of a tumor and a mass of adjunctive adipose tissue that increased markedly. Thus, we suspected that the tumor was liposarcoma before the operation, and performed retroperitoneal tumor resection. However, we found that the tumor was pathologically a hyaline vascular type of Castleman's disease and the pathological examination showed no malignant cells in the peritumoral adipose tissue. Since Castleman's disease lacks the characteristic symptoms or image findings, the preoperative diagnosis is generally difficult. Cases with growth of the peritumoral adipose tissue are rare, and the differentiation from the liposarcoma is usually difficult. We discussed how to perform the differential diagnosis of Castleman's disease, and especially about the differential diagnosis of liposarcoma.

A 48-year-old female was referred to our hospital for further urological examination of primary amenorrhea. She had been suffering from amenorrhea since 12 years old. Although she had normal female external genitalia, she had a blind-ended vagina with complete absence of the uterus.Laboratory tests showed high testosterone level and the 46 XY karyotype. Thus, our diagnosis was androgen insensivity syndrome. Magnetic resonance imaging showed bilateral intra-abdominal testes. We performed laparoscopic bilateral gonadalectomy. Pathological diagnosis was seminoma in the right gonad. She is free of recurrence 6 months after operation.

(Purpose) We investigated the outcome of selective organ preservation in invasive bladder cancer using chemoradiation therapy. (Patients and method) We examined locally invasive bladder cancer in 60 patients (51 men, 9 women; mean age at treatment 66.1 years) who underwent chemoradiation therapy for bladder preservation in the Department of Urology at Sumitomo Hospital between 2000 and 2015. The clinical stage was T1, T2, T3 and T4 in 4, 24, 17, 4 patients. Our protocol includes transurethral resection of the bladder tumor (TURBT) and 46 Gy radiation (2 Gy/fraction) to the bladder with concurrent cisplatin chemotherapy (20 mg/body/day, 10 days, intravenously). The initial evaluation included urine cytology and transurethral bladder biopsy. If patients developed superficial residual or recurrent cancer, they were treated with TURBT and/or intravesical Bacillus Calmette-Guerin (BCG), while patients with invasive residual or recurrent cancer were advised to undergo a salvage cystectomy. The mean follow-up was 55 months. (Results) The first assessment after the chemoradiation therapy showed that the complete remission rate for evaluable cases was 72% (38/53) and bladder preservation was achieved in 56 patients (93%). The 1-, 3-, and 5-year overall survival rate was 95, 86, and 78%, respectively. The 1-, 3-, and 5-year cancer-specific survival rate was 97, 90, and 85%, respectively. The 5-year patient survival rate with an intact bladder was 68%. Hydronephrosis and cisplatin dose (

A 65-year-old man presented to a clinic with a chief complaint of macrohematuria and frequent urination. The computed tomographic scan and cystoscopy revealed a dome of bladder tumor. He was referred to our hospital with the diagnosis of bladder tumor. He had undergone bilateral inguinal hernia repair and magnetic resonance imaging suggested mesh plug migration on the urinary bladder inserted into the right inguinal lesion 11 years previously. Under the diagnosis of mesh plug migration, partial cystectomy with extraction of the foreign body was performed. After the surgery he was well and symptoms had disappeared.

For this study, a BiFeO3 (BFO) perovskite/(Fe,Zn)3O4 (FZO) spinel sample grown on SrTiO3:Nb (0 0 1) has been prepared using pulsed laser deposition with a single target composition of (Bi1.1FeO3)0.65(Fe2.2Zn0.8O4)0.35. The nanoscale electrical properties of ferroelectric BFO/semi-conducting FZO thin film have been investigated using piezoresponse force microscopy (PFM) and conductive-atomic force microscopy (C-AFM). Scanning probe methods reveal that BFO grows as nano-islets with a complex structure which is coherent with the cross-sectional high-angle annular dark-field scanning transmission electron microscopy (HAADF-STEM) images. The comparison between nanoscale electrical techniques and HAADF-STEM images have allowed to understand the origin of the different physical properties of the multiferroic/magnetoconductive co-deposited thin film at the nanoscale. By using PFM/C-AFM techniques, we were able to fully distinguish BFO and FZO materials in the nanostructured sample without using destructive material characterization methods.

Accepted: 2015-01-06, 資料番号: SA1150075000

Micro milling tools made of Single Crystalline Diamond (SCD) have been developed to machine micro dies and molds made of ceramics. The milling tools of a cylindrical SCD having many sharp cutting edges are fabricated 3-dimensionally by scanning a laser beam. Flat shape of binder-less tungsten carbide mold was cut with the developed milling tool to evaluate the tool wears and its life. Some micro aspheric molds of tungsten carbide were cut with the milling tool at a rotational speed of 50,000 min-1. The ceramic molds were cut in the ductile mode. By cutting with the milling tool, the form accuracy obtained was about 100 nm P–V and the surface roughness 8 nm Rz.

The patient was a 76-year-old man. Because bilateral adrenal tumor (right adrenal gland 7 cm, left adrenal gland 1.5 cm) was detected in by computed tomography (CT) in methotrexate (MTX) administration for articular rheumatism from 2011, he was referred to this hospital in February, 2016. An endocrine examination, and imaging study did not lead to a definitive diagnosis and CT-guided lower needle biopsy was performed. The pathological diagnosis was diffuse large B cell lymphoma. Also, in situ hybridization revealed EBER-positive and the diagnosis of MTX-related lymphoproliferative disease (MTXLPD) was made in conjunction with the medical history. After MTX cancellation, the tumor became markedly smaller. The annual incidence of this disorder in the RA patients during MTX internal use is reported as 0.06%. According to the site of origin, lymphatic extranodal disease accounts for approximately half of the cases, but this is the third case of primary adrenal origin reported.

This paper proposes a reaction-diffusion algorithm for image edge detection in the framework of FitzHugh-Nagumo model. FitzHugh-Nagumo model has two variables, activator and inhibitor, which are governed by two timeevolving differential equations, respectively, for simulating a process of biological excitation and inhibition phenomenon observed along a nerve. The proposed algorithm places FitzHugh-Nagumo elements, which contains a pair of activator and inhibitor variables, at the image grids. At first, the algorithm gives initial conditions of the elements according to an inputted gray level image. Then, it performs preprocessing for reducing noise by using only inhibition equation at the elements, and finally performs edge-detection by using both excitation and inhibition equations. The performance of the proposed algorithm is investigated with artificial and real images.