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Kazuhiro Sakaguchi,1 Masanori Yoshikawa,1 Yukio Fujita,1 Yoshifumi Yamamoto,1 Takahiro Ibaraki,1 Nobuhiro Fujioka,1 Takao Osa,1 Motoo Yamauchi,1 Hiroshi Ichikawa,2 Shigeo Muro1 1Department of Respiratory Medicine, Nara Medical University, Kashihara, Nara, Japan; 2Major of Medical Life Systems, Graduate School of Life and Medical Sciences, Doshisha University, Kyotanabe, Kyoto, JapanCorrespondence: Masanori Yoshikawa, Department of Respiratory Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan, Tel +81-744-22-3051, Fax +81-744-29-0907, Email noriy@naramed-u.ac.jpBackground: Oxidative stress is an important mechanism for the development and progression of chronic obstructive pulmonary disease (COPD). It may also contribute to systemic manifestation in patients with COPD. Reactive oxygen species (ROS) including free radicals play a crucial role in oxidative stress in COPD. The aims of this study were to determine serum scavenging capacity profile against multiple free radicals and to evaluate its correlation with pathophysiology, exacerbations, and prognosis in patients with COPD.Methods: Serum scavenging capacity profile against multiple free radicals comprising hydroxyl radical (•OH), superoxide radical (O2−•), alkoxy radical (RO•), methyl radical (•CH3), alkylperoxyl radical (ROO•), and singlet oxygen (1O2) was assessed using the multiple free-radical scavenging method in 37 patients with COPD (mean age, 71 years; mean forced expiratory volume in 1 s, 55.2% predicted). The severity of emphysema was evaluated by Goddard classification on chest computed tomography. Exacerbations were recorded prospectively for 1 year and the overall mortality was assessed 5 years after the initial assessment.Results: •OH scavenging capacity was significantly decreased (p < 0.05) and O2−• and •CH3 scavenging capacity tended to decrease in patients with COPD compared to that in healthy controls. On the other hand, ROO• scavenging capacity tended to increase. In addition, RO• scavenging capacity was associated with severity of emphysema (p < 0.05) and exacerbation frequency (p < 0.02). There was a difference in the profile of the scavenging capacity between survived and deceased patients with COPD for 5 years after initial assessment.Conclusion: Characteristic profile of free radical scavenging capacity can provide insight into the pathophysiology and prognosis of patients with COPD.Keywords: oxidative stress, free radicals, the multiple free-radical scavenging method, pathophysiology, exacerbations, prognosis

Nobuhiro Fujioka,1 Masahiro Kitabatake,2 Noriko Ouji-Sageshima,2 Takahiro Ibaraki,1 Makiko Kumamoto,1 Yukio Fujita,1 Shigeto Hontsu,1 Motoo Yamauchi,1 Masanori Yoshikawa,1 Shigeo Muro,1 Toshihiro Ito2 1Department of Respiratory Medicine, Nara Medical University, Kashihara, Nara, Japan; 2Department of Immunology, Nara Medical University, Kashihara, Nara, JapanCorrespondence: Toshihiro ItoDepartment of Immunology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, JapanTel +81-744-22-3051Fax +81-744-29-7503Email toshi-ito@naramed-u.ac.jpPurpose: Chronic obstructive pulmonary disease (COPD) is a worldwide problem because of its high prevalence and mortality. However, there is no fundamental treatment to ameliorate their pathological change in COPD lung. Recently, adipose-derived mesenchymal stem cells (ADSCs) have attracted attention in the field of regenerative medicine to repair damaged organs. Moreover, their utility in treating respiratory diseases has been reported in some animal models. However, the detailed mechanism by which ADSCs improve chronic respiratory diseases, including COPD, remains to be elucidated. We examined whether human ADSCs (hADSCs) ameliorated elastase-induced emphysema and whether hADSCs differentiated into alveolar epithelial cells in a murine model of COPD.Methods: Female SCID-beige mice (6 weeks old) were divided into the following four groups according to whether they received an intratracheal injection of phosphate-buffered saline or porcine pancreatic elastase, and whether they received an intravenous injection of saline or hADSCs 3 days after intratracheal injection; Control group, hADSC group, Elastase group, and Elastase-hADSC group. We evaluated the lung function, assessed histological changes, and compared gene expression between hADSCs isolated from the lung of Elastase-hADSC group and naïve hADSCs 28 days after saline or elastase administration.Results: hADSCs improved the pathogenesis of COPD, including the mean linear intercept and forced expiratory volume, in an elastase-induced emphysema model in mice. Furthermore, hADSCs were observed in the lungs of elastase-treated mice at 25 days after administration. These cells expressed genes related to mesenchymal–epithelial transition and surface markers of alveolar epithelial cells, such as TTF-1, β-catenin, and E-cadherin.Conclusion: hADSCs have the potential to improve the pathogenesis of COPD by differentiating into alveolar epithelial cells by mesenchymal–epithelial transition.Keywords: chronic obstructive pulmonary disease, mesenchymal–epithelial transition, adipose derived mesenchymal stem cell, pulmonary function test

Keisuke Kiba,1 Yasunori Akashi,1 Motokiyo Yoshikawa,1 Yutaka Yamamoto,1 Akihide Hirayama,1 Kiyohide Fujimoto,2 Hirotsugu Uemura3 1Department of Urology, Kindai University Nara Hospital, Ikoma-City, Nara, Japan; 2Department of Urology, Nara Medical University, Kashihara-City, Nara, Japan; 3Department of Urology, Kindai University Faculty of Medicine, Sayama-City, Osaka, JapanCorrespondence: Keisuke KibaDepartment of Urology, Kindai University Nara Hospital, 1248-1 Otoda-cho, Ikoma-City, Nara, JapanTel +81-743-77-0880Fax +81-743-77-0890Email kiba_uma@yahoo.co.jpPurpose: The aim of this study was to compare the safety and efficacy of photoselective vaporization of the prostate (PVP) and transurethral enucleation with a bipolar system (TUEB).Patients and Methods: Patients who underwent PVP or TUEB surgery for lower urinary tract symptoms due to bladder outlet obstruction at our institution from September 2015 to May 2019 were retrospectively reviewed. A total of 83 patients (PVP: n=45, TUEB: n=38) who were available for follow-up at least 12 months after surgery were included. Preoperative characteristics, perioperative parameters, and postoperative outcomes—such as International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and complications―at 3, 6, and 12 months after surgery were compared between the two groups.Results: Although differences in age, IPSS, and QoL were not significant, a significantly greater prostate volume, lower Qmax, and greater PVR were noted in the TUEB group. In perioperative parameters, a significantly shorter operation time, less change in serum hemoglobin, fewer days of catheterization, and shorter length of stay were observed in the PVP group. As for postoperative outcomes, the IPSS storage subscore and PVR were significantly improved in the TUEB group. As complications, stress urinary incontinence was more frequently observed in the TUEB group, and urethral stricture was more common in the PVP group.Conclusion: The present data suggest that PVP and TUEB are efficient and safe surgical treatment options. Management of patients undergoing PVP in the perioperative period appears easy. Improvements of subjective and objective parameters were superior after TUEB than after PVP.Keywords: prostate, prostatic hyperplasia, transurethral resection of prostate, laser therapy

Kazumi Minato,1 Munemitsu Yoshikawa,1 Hideo Nakanishi,1 Kaori Hasegawa2 1Department of Ophthalmology, Eye Center, Hidaka Medical Center, Toyooka Hospital, Toyooka City, Hyogo 669-5392, Japan; 2Department of Microbiology, Toyooka Hospital, Toyooka City, Hyogo 668-0065, JapanCorrespondence: Kazumi MinatoDepartment of Ophthalmology, Eye Center, Hidaka Medical Center, Toyooka Hospital, Hidaka-Cho Iwanaka 81, Toyooka City, Hyogo 669-5392, JapanTel +81-796-42-1611Fax +81-796-42-2344Email kazuminato@outlook.jpBackground: Prototheca spp. are rare human pathogens, and only three cases of Prototheca keratitis have been reported. They were treated with anti-fungal drugs and surgical excision. Two of the three cases were successful, and the case of an immunocompromised patient was not successful. Thus, the best treatment of Prototheca keratitis is still undetermined, and further investigations are needed. The purpose of this report is to present our findings in a case of Prototheca keratitis that was successfully treated with topical medications without surgical excision.Methods: This study was performed in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Hidaka Medical Center, Toyooka Hospital. A written informed consent was obtained from the patient before beginning the medical treatments.Case Report: A 75-year-old man with a history of stage 4 prostate carcinoma and bilateral limbal stem cell deficiency had undergone keratoepithelioplasty on his left eye for the deficiency. Postoperatively, a greyish-white epithelial opacity was noted on the central cornea of his left eye, and he had been treated with topical fluorometholone and oral dexamethasone together with a therapeutic contact lens. Corneal smears and contact lens swabs were positive for Prototheca spp. He required a continuous treatment with amphotericin B (AMPH-B) ointment, topical fluconazole (FLCZ), and voriconazole (VRCZ). This treatment protocol was effective, but recurrences developed when his general condition worsened.Conclusion: Our findings indicate that Prototheca keratitis can be successfully treated but not cured with topical AMPH-B, FLCZ, and VRCZ without surgical treatment. However, recurrences can develop when the general condition of the patient worsens. Thus, continuous monitoring and treatment are necessary in cases of Prototheca keratitis.Keywords: Prototheca spp., infection, cornea, treatment

Yutaka Yamamoto,1 Keisuke Kiba,1 Motokiyo Yoshikawa,1 Akihide Hirayama,1 Seiji Kunikata,1 Hirotsugu Uemura2 1Department of Urology, Nara Hospital, Kindai University Faculty of Medicine, Ikoma, 2Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Japan Objective: The aim of this study was to evaluate the biochemical recurrence (BCR) in patients with high-risk prostate cancer (PCa) treated with radical prostatectomy (RP) or radiotherapy (RT) plus androgen deprivation therapy (ADT).Methods: Subjects were patients with National Comprehensive Cancer Network-defined high-risk PCa treated with either RP or RT plus ADT. We calculated BCR-free survival in patients with those treatments and evaluated risk factor against BCR.Results: A total of 114 patients, 71 RP and 43 RT plus ADT, were evaluated. A total of 59 and 20.9% of patients experienced BCR in the RP and RT treatment groups, respectively. The 5-year BCR-free survival probabilities improved significantly for patients who received RT compared to those who received RP (81.3 vs 37.3%, P

Tadamichi Akagi, Munemitsu Yoshikawa, Hideo Nakanishi, Nagahisa Yoshimura Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan Abstract: Glaucoma drainage device implantation is efficacious for the treatment of pediatric glaucoma patients when multiple angle surgeries fail. However, tube touching of the corneal endothelium is one of the major postoperative complications to deal with. A 15-month-old male patient with Wilms’ tumor, aniridia, genitourinary anomalies, and mental retardation (WAGR) syndrome was diagnosed with bilateral developmental glaucoma. He underwent Baerveldt glaucoma implant (BGI) surgeries in both eyes after multiple failed trabeculotomies. The tube in his right eye was touching the cornea 15 months after BGI surgery. To avoid corneal endothelium damage, BGI tube repositioning with scleral fixation was performed without serious complications. The bilateral BGI surgeries achieved successful intraocular pressure reduction for over 2 years and tube repositioning with scleral fixation of BGI tube was successful for BGI tube malposition. Although careful attention to intraocular pressure and tube malposition is essential after glaucoma drainage device implantation, especially in pediatric cases, BGI surgery is effective in the management of developmental glaucoma following unsuccessful angle surgeries. Keywords: Baerveldt glaucoma implant, developmental glaucoma, WAGR syndrome, tube repositioning, glaucoma drainage device

The pellet ablation mechanism is an interesting subject for plasma fuelling in fusion plasmas. In GAMMA 10/PDX, pellet injection experiments for higher density plasma production are planned to conduct detached plasma experiments in the higher density plasma condition. We measured the pellet ablation cloud by using the two-directional simultaneous photography system in GAMMA 10/PDX. The tomography reconstruction technique was used for considering the pellet trajectory in the plasma and pellet ablation. The three-dimensional pellet trajectory and pellet ablation images in the plasma were clearly obtained for the first time, to the best of our knowledge. [ABSTRACT FROM AUTHOR]