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HIRAYAMA Akihide

    Kindai University Nara Hospital　Professor/General Manager
Last Updated :2024/04/23

Researcher Information

J-Global ID

Research Interests

  • 泌尿器科学   Neurobiology   Urology   

Research Areas

  • Life sciences / Urology

Academic & Professional Experience

  • 2017/04 - Today  Kindai UniversityNara Hospital Kindai University教授
  • 2014/01 - 2017/03  Kindai UniversityNara Hospital Kindai University准教授
  • 2013/01 - 2013/12  Nara Medical University准教授
  • 2006/07 - 2012/12  Nara Medical University講師
  • 2001/01 - 2006/06  Nara Medical University助手

Association Memberships

  • 欧州泌尿器科学会   JAPAN SOCIETY OF CLINICAL ONCOLOGY   老年泌尿器科学会   日本泌尿器科内視鏡学会   国際尿禁制学会（ICS）   日本透析療法学会   日本排尿機能学会   日本泌尿器科学会   

Published Papers

  • Yasunori Akashi; Yutaka Yamamoto; Mamoru Hashimoto; Shogo Adomi; Kazutoshi Fujita; Keisuke Kiba; Takafumi Minami; Kazuhiro Yoshimura; Akihide Hirayama; Hirotsugu Uemura
    Cancers 15 (24) 2023/12 
    INTRODUCTION: Immune checkpoint inhibitor (ICI) therapy has significantly improved the prognosis of some patients with advanced urothelial carcinoma (UC), but it does not provide high therapeutic efficacy in all patients. Therefore, identifying predictive biomarkers is crucial in determining which patients are candidates for ICI treatment. This study aimed to identify the predictors of ICI treatment response in patients with platinum-refractory advanced UC treated with pembrolizumab. METHODS: Patients with platinum-refractory advanced UC who had received pembrolizumab at two hospitals in Japan were included. Univariate and multivariate analyses were performed to identify biomarkers for progression-free survival (PFS) and overall survival (OS). RESULTS: Forty-one patients were evaluable for this analysis. Their median age was 75 years, and the vast majority of the patients were male (85.4%). The objective response rate was 29.3%, with a median overall survival (OS) of 17.8 months. On multivariate analysis, an Eastern Cooperative Oncology Group performance status (ECOG-PS) ≥ 2 (HR = 6.33, p = 0.03) and a baseline neutrophil-to-lymphocyte ratio (NLR) > 3 (HR = 2.79, p = 0.04) were significantly associated with poor OS. Antibiotic exposure did not have a significant impact on either PFS or OS. CONCLUSIONS: ECOG-PS ≥ 2 and baseline NLR > 3 were independent risk factors for OS in patients with platinum-refractory advanced UC treated with pembrolizumab. Antibiotic exposure was not a predictor of ICI treatment response.
  • Mamoru Hashimoto; Sergei Karnup; Stephanie L Daugherty; Kang Jun Cho; Eri Banno; Nobutaka Shimizu; Kazutoshi Fujita; Akihide Hirayama; Hirotsugu Uemura; William C de Groat; Jonathan M Beckel; Naoki Yoshimura
    Neurourology and urodynamics 2023/11 
    OBJECTIVES: We examined sex differences of lower urinary tract function and molecular mechanisms in mice with and without spinal cord injury (SCI). METHODS: SCI was induced by Th8-9 spinal cord transection in male and female mice. We evaluated cystometrograms (CMG) and electromyography (EMG) of external urethral sphincter (EUS) at 6 weeks after SCI in spinal intact (SI) and SCI mice. The mRNA levels of Piezo2 and TRPV1 were measured in L6-S1 dorsal root ganglia (DRG). Protein levels of nerve growth factor (NGF) in the bladder mucosa was evaluated using an enzyme-linked immunosorbent assay. RESULTS: Sex differences were found in the EUS behavior during voiding as voiding events in female mice with or without SCI occurred during EUS relaxation periods without EUS bursting activity whereas male mice with or without SCI urinated during EUS bursting activity in EMG recordings. In both sexes, SCI decreased voiding efficiency along with increased tonic EUS activities evident as reduced EUS relaxation time in females and longer active periods of EUS bursting activity in males. mRNA levels of Piezo2 and TRPV1 of DRG in male and female SCI mice were significantly upregulated compared with SI mice. NGF in the bladder mucosa showed a significant increase in male and female SCI mice compared with SI mice. However, there were no significant differences in Piezo2 or TRPV1 levels in DRG or NGF protein levels in the bladder mucosa between male and female SCI mice. CONCLUSIONS: We demonstrated that female and male mice voided during EUS relaxation and EUS bursting activity, respectively. Also, upregulation of TRPV1 and Piezo2 in L6-S1 DRG and NGF in the bladder could be involved in SCI-induced lower urinary tract dysfunction in both sexes of mice.
  • Shogo Adomi; Kazutoshi Fujita; Hiroyuki Kita; Ken Kuwahara; Yasunori Akashi; Mitsuhisa Nishimoto; Naoki Matsumura; Koichi Sugimoto; Takafumi Minami; Masahiro Nozawa; Kazuhiro Yoshimura; Hideo Tahara; Akihide Hirayama; Tsukasa Nishioka; Atsunobu Esa; Hirotsugu Uemura
    Cancer diagnosis & prognosis 3 (4) 484 - 490 2023 
    BACKGROUND/AIM: The treatment strategy for metastatic upper tract urothelial carcinoma (mUTUC) is currently based on the evidence from metastatic urinary bladder cancer (mUBC). However, some reports have shown that the outcomes of UTUC differ from those of UBC. Therefore, we retrospectively analyzed the prognosis of patients with mUBC and mUTUC treated with first-line platinum-based chemotherapy. PATIENTS AND METHODS: Patients who underwent platinum-based chemotherapy at the Kindai University Hospital and affiliated hospitals between January 2010 and December 2021 were included in the study. There were 56 patients with mUBC and 73 with mUTUC. Kaplan-Meier curves were used to estimate progression-free (PFS) and overall (OS) survival. Multivariate analyses were performed using Cox proportional hazards model to predict prognostic factors. RESULTS: The median PFS was 4.5 and 4.0 months for the mUBC and mUTUC groups, respectively (p=0.094). The median OS was 17.0 months for both groups (p=0.821). The multivariate analysis showed no prognostic factor for PFS. The multivariate analysis for OS showed that younger age at the initiation of chemotherapy and immune checkpoint inhibitor use after first-line therapy were significantly associated with better OS. CONCLUSION: Platinum-based chemotherapy had a similar effect on patients with mUTUC and mUBC.
  • 化学療法を施行した転移性腎盂・尿管癌と転移性膀胱癌の予後の臨床的検討
    安富 正悟; 藤田 和利; 北 博行; 桑原 賢; 明石 泰典; 松村 直紀; 杉本 公一; 南 高文; 野澤 昌弘; 吉村 一宏; 田原 秀男; 平山 暁秀; 西岡 伯; 江左 篤宣; 植村 天受
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 60回 O33 - 5 2022/10
  • Mamoru Hashimoto; Nobutaka Shimizu; Saizo Fujimoto; Ken Kuwahara; Mitsuhisa Nishimoto; Shogo Adomi; Eri Banno; Takafumi Minami; Kazutoshi Fujita; Kazuhiro Yoshimura; Akihide Hirayama; Hirotsugu Uemura
    International urology and nephrology 2022/09 
    PURPOSE: In this study, we aimed to elucidate the pathophysiology of post-micturition dribble (PMD) through analyzing several variables including pressure flow study (PFS) findings and symptoms questionnaire. METHODS: We retrospectively analyzed male patients who visited our department between 2010 and 2020. We used modified international prostate symptom score (m-IPSS), which consists of eight sub-score related to lower urinary tract symptoms (Incomplete Emptying, Frequency, Intermittency, Urgency, Weak Stream, Straining, Nocturia, and PMD) and one question related to quality of life (QOL). Multivariate regression analysis was conducted to evaluate the relationship between PMD and the variables, including age, prostate volume (PV), body mass index, bladder outlet obstruction index (BOOI), bladder contractility index, and bladder voiding efficiency, which were obtained by PFS. RESULTS: A total of 143 male patients were analyzed. The patients with PMD showed significantly larger PV and higher BOOI, and worse IPSS total and QOL score than those without PMD. Multivariate regression analysis showed that large PV and BOOI were significantly associated with PMD. In Spearman's correlation analysis, PMD and each m-IPSS sub-score except nocturia had significant positive correlation. Furthermore, Spearman's correlation analysis showed that PMD and QOL had significant strong positive correlation. CONCLUSION: PMD was significantly associated with large PV and BOO evaluated by PFS. Furthermore, PMD significantly exacerbated QOL. The severity of PMD and the other m-IPSS sub-score except nocturia could have intercorrelation with each other.
  • Mitsuhisa Nishimoto; Kazutoshi Fujita; Yutaka Yamamoto; Mamoru Hashimoto; Shogo Adomi; Eri Banno; Yoshitaka Saito; Nobutaka Shimizu; Yasunori Mori; Takafumi Minami; Masahiro Nozawa; Kazuhiro Nose; Akihide Hirayama; Kazuhiro Yoshimura; Hirotsugu Uemura
    Translational cancer research 11 (8) 2681 - 2687 2022/08 
    Background: Several therapeutic agents are available for metastatic castration-resistant prostate cancer (CRPC). However, prognosis is still not well developed. The Gleason score (GS) is a prognostic factor available for patients with metastatic CRPC. GSs ranging from 6 to 10 and GSs ≥8 are usually categorized as single prognostic factors. In this study, we evaluated the prognosis of high-GS metastatic CRPC in Japanese men. Methods: Overall, 105 patients with metastatic CRPC with a GS ≥8 were retrospectively analyzed. Multivariate analyses of patient age, GS, and Eastern Cooperative Oncology Group performance status (ECOG-PS) were performed using Cox proportional hazards analysis to predict overall survival (OS). Results: GS 8 had all Gleason patterns of 4+4. Thirty patients (28.6%) had GS of 8, and 75 (71.4%) had GS of 9 or 10. As a first-line treatment for metastatic CRPC, 42 patients (40%) received abiraterone, 35 (33.3%) received enzalutamide, and 26 (24.8%) received docetaxel. The 5-year OS in patients with GS of 8 was 65.0% [95% confidence interval (CI): 43.07-86.82%], while the 5-year OS in patients with GS of 9 or 10 was 37.0% (95% CI: 24.41-56.11%). There was a significant difference in OS between the GS 8 and GS 9-10 groups (log-rank test, P=0.038). Multivariate analysis showed that GS and ECOG-PS were significant prognostic factors for OS. Conclusions: Patients with metastatic CRPC with GS 9-10 had poor prognoses, suggesting the need for additional treatment options.
  • Kazumasa Torimoto; Tomohiro Ueda; Masato Kasahara; Akihide Hirayama; Chie Matsushita; Yoshihiro Matsumoto; Daisuke Gotoh; Yasushi Nakai; Makito Miyake; Katsuya Aoki; Kiyohide Fujimoto
    Lower urinary tract symptoms 2022/03 
    OBJECTIVES: Diagnosis of Hunner-type interstitial cystitis (HIC) relies on the ability to identify Hunner lesions endoscopically, which can lead to storage symptom misdiagnosis. Here, we examined serum biomarkers for HIC and verified their utility. METHODS: Based on the previous definition of the Japanese guidelines, which did not distinguish HIC and non-HIC diseases, we searched for serum biomarkers in 25 patients with interstitial cystitis (IC) and 25 control participants using metabolomics during 2013-2014. In 2019, we conducted a validation study in HIC and control groups. Serum samples were analyzed using liquid chromatography-tandem mass spectrometry, and candidate biomarker concentrations were compared between the groups using Mann-Whitney test. RESULTS: Metabolomics targeted 678 metabolites and revealed that the levels of 14 lysolipids, seven γ-glutamyl amino acids, and two monoacylglycerols were significantly different between the IC and control groups. The following metabolites were selected from each metabolite category as candidates: 1-linoleoylglycerophosphocholine (1-linoleloyl-GPC [18:2]), γ-glutamylisoleucine (γ-Glu-Ile), and 1-arachidonylglycerol (1-AG). The serum concentrations of 1-linoleoyl-GPC (18:2) in the HIC and control groups were 27 920 ± 6261 and 40 360 ± 1514 ng/mL (P = 0.0003), respectively. The serum concentrations of γ-Glu-Ile and 1-AG were not significantly different between the groups. When the cut-off value of 1-linoleoyl-GPC (18:2) was set at 28 400 ng/mL, the sensitivity and specificity were 68% and 84%, respectively. CONCLUSIONS: Serum 1-linoleoyl-GPC (18:2) is a candidate diagnostic biomarker for HIC. Additional studies on whether this biomarker can distinguish HIC from other diseases with high urination frequency are required for its clinical use.
  • 尿流動態検査を用いた男性患者の排尿後尿滴下に影響を与える因子の検討
    橋本 士; 西本 光寿; 清水 信貴; 南 高文; 藤田 和利; 野澤 昌弘; 吉村 一宏; 平山 暁秀; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 OP01 - 03 2021/12
  • 内分泌療法未治療転移性前立腺癌に対するアビラテロンとアンドロゲン遮断療法の比較
    松村 直紀; 藤田 和利; 西本 光寿; 山本 豊; 永井 康晴; 南 高文; 野澤 昌弘; 森本 康裕; 田原 秀男; 上島 成也; 平山 暁秀; 吉村 一宏; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 OP10 - 03 2021/12
  • 高Gleason Score転移性去勢抵抗性前立腺癌における予後の検討
    西本 光寿; 藤田 和利; 山本 豊; 橋本 士; 安富 正悟; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和宏; 平山 暁秀; 吉村 一宏; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 OP12 - 06 2021/12
  • 転移性尿路上皮癌に対するペムブロリズマブの使用成績
    明石 泰典; 山本 豊; 安富 正悟; 橋本 士; 喜馬 啓介; 西本 光寿; 清水 信貴; 南 高文; 藤田 和利; 野澤 昌弘; 吉村 一宏; 平山 暁秀; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 PP25 - 06 2021/12
  • 尿流動態検査を用いた男性患者の排尿後尿滴下に影響を与える因子の検討
    橋本 士; 西本 光寿; 清水 信貴; 南 高文; 藤田 和利; 野澤 昌弘; 吉村 一宏; 平山 暁秀; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 OP01 - 03 2021/12
  • 内分泌療法未治療転移性前立腺癌に対するアビラテロンとアンドロゲン遮断療法の比較
    松村 直紀; 藤田 和利; 西本 光寿; 山本 豊; 永井 康晴; 南 高文; 野澤 昌弘; 森本 康裕; 田原 秀男; 上島 成也; 平山 暁秀; 吉村 一宏; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 OP10 - 03 2021/12
  • 高Gleason Score転移性去勢抵抗性前立腺癌における予後の検討
    西本 光寿; 藤田 和利; 山本 豊; 橋本 士; 安富 正悟; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和宏; 平山 暁秀; 吉村 一宏; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 OP12 - 06 2021/12
  • 転移性尿路上皮癌に対するペムブロリズマブの使用成績
    明石 泰典; 山本 豊; 安富 正悟; 橋本 士; 喜馬 啓介; 西本 光寿; 清水 信貴; 南 高文; 藤田 和利; 野澤 昌弘; 吉村 一宏; 平山 暁秀; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 109回 PP25 - 06 2021/12
  • 非転移性去勢抵抗性前立腺癌の予後予測因子についての検討
    西本 光寿; 藤田 和利; 山本 豊; 橋本 士; 安富 正悟; 坂野 恵里; 齋藤 允孝; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和宏; 平山 暁秀; 吉村 一宏; 植村 天受
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 59回 P29 - 2 2021/10
  • 高グリソン転移性去勢抵抗性前立腺癌における予後の検討
    藤田 和利; 西本 光寿; 山本 豊; 橋本 士; 安冨 正悟; 坂野 恵里; 齋藤 允孝; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和弘; 平山 暁秀; 吉村 一宏; 植村 天受
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 59回 O62 - 7 2021/10
  • 内分泌療法未治療転移性前立腺癌に対するアビラテロンとアンドロゲン遮断療法の比較
    松村 直紀; 藤田 和利; 西本 光寿; 山本 豊; 桑原 賢; 永井 康晴; 南 高文; 野澤 昌弘; 森本 康裕; 田原 秀男; 上島 成也; 江左 篤宣; 平山 暁秀; 吉村 一宏; 植村 天受
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 59回 O63 - 1 2021/10
  • 非転移性去勢抵抗性前立腺癌の予後予測因子についての検討
    西本 光寿; 藤田 和利; 山本 豊; 橋本 士; 安富 正悟; 坂野 恵里; 齋藤 允孝; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和宏; 平山 暁秀; 吉村 一宏; 植村 天受
    日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 59回 P29 - 2 2021/10
  • Nobutaka Shimizu; Daisuke Gotoh; Mitsuhisa Nishimoto; Mamoru Hashimoto; Tetsuichi Saito; Kazutoshi Fujita; Akihide Hirayama; Naoki Yoshimura; Hirotsugu Uemura
    International journal of urology : official journal of the Japanese Urological Association 28 (10) 1068 - 1072 2021/10 
    OBJECTIVES: To investigate the effect of vibegron, a new clinically approved β3-adrenoceptor agonist in lower urinary tract dysfunction in mice with spinal cord injury. METHODS: Investigators performed cystometry under awake conditions in 4-week spinal cord injury female mice. Two weeks after spinal cord injury, saline or vibegron (30 mg/kg) was orally administered for 2 weeks prior to the urodynamic study. Investigators removed L6-S1 dorsal root ganglia from the saline- or vibegron-treated spinal cord injury mice as well as from saline-treated normal (spinal intact) mice to evaluate the levels of transient receptor potential cation channel subfamily V member 1, transient receptor potential cation channel subfamily A member 1, activating transcription factor 3, and inducible nitric oxide synthase transcripts using real-time polymerase chain reaction. RESULTS: In vibegron-treated spinal cord injury mice, nonvoiding contractions during bladder filling, which were increased in spinal cord injury compared to spinal intact mice, were significantly decreased. Micturition pressure or voiding efficiency was not significantly increased in comparison to measurements in saline-treated spinal cord injury mice. The expression of transient receptor potential cation channel subfamily V member 1, transient receptor potential cation channel subfamily A member 1, activating transcription factor 3, and inducible nitric oxide synthase messenger RNA was increased in spinal cord injury mice compared to spinal intact mice, but significantly decreased after vibegron treatment. CONCLUSIONS: Vibegron improves spinal cord injury-induced detrusor overactivity in addition to significantly reducing C-fiber afferent receptors such as transient receptor potential cation channel subfamily V member 1, transient receptor potential cation channel subfamily A member 1, and inflammatory cytokines/markers, such as activating transcription factor 3 and inducible nitric oxide synthase, in spinal cord injury mice. Thus, vibegron might be effective in the treatment of storage lower urinary tract dysfunction induced by C-fiber afferent activation after spinal cord injury.
  • Naoki Matsumura; Kazutoshi Fujita; Mitsuhisa Nishimoto; Yutaka Yamamoto; Ken Kuwahara; Yasuharu Nagai; Takafumi Minami; Yuji Hatanaka; Masahiro Nozawa; Yasuhiro Morimoto; Hideo Tahara; Shigeya Uejima; Atsunobu Esa; Akihide Hirayama; Kazuhiro Yoshimura; Hirotsugu Uemura
    Frontiers in oncology 11 769068 - 769068 2021 
    This study aimed to compare the effects of abiraterone acetate plus prednisone (AAP) with androgen deprivation therapy (ADT) with those of combined androgen blockade (CAB) therapy in patients with high-risk metastatic hormone-sensitive prostate cancer (mHSPC). This study retrospectively identified 163 patients with high-risk mHSPC at Kindai University and affiliated hospitals between January 2014 and December 2020. Kaplan-Meier analysis was used to summarize progression-free survival (PFS) and overall survival (OS). Multivariate Cox proportional hazard modeling was used to identify the prognostic factors in the overall cohort. Propensity score matching was used to adjust the clinical characteristics, and log-rank test was applied to these propensity score-matched cohorts. Seventy-four patients who received AAP with ADT and 89 patients who received CAB were included in this study. The median follow-up duration was 27 months (range, 2-89 months). The median PFS and OS were not reached by the AAP+ADT group and 15 and 79 months, respectively, in the CAB group. The Eastern Cooperative Oncology Group (ECOG) performance status (PS) score and AAP+ADT were significant prognostic factors for PFS, whereas ECOG PS score, visceral metastasis, and AAP+ADT were significant prognostic factors for OS. The 2-year PFS was 76.1% in the AAP+ADT group and 38.6% in the CAB group (P < 0.0001), and the 2-year OS was 90.2% in the AAP+ADT group and 84.8% in the CAB group (P = 0.015). In conclusion, AAP+ADT had better PFS and OS than CAB in patients with high-risk mHSPC.
  • Mamoru Hashimoto; Nobutaka Shimizu; Mitsuhisa Nishimoto; Takafumi Minami; Kazutoshi Fujita; Kazuhiro Yoshimura; Akihide Hirayama; Hirotsugu Uemura
    Research and reports in urology 13 557 - 563 2021 
    Purpose: This study aimed to elucidate the relationship of psoas muscle atrophy and visceral obesity with lower urinary tract symptoms in geriatric female patients. Patients and Methods: We retrospectively reviewed the medical records of female patients aged ≥65 years. The psoas muscle index was defined, using computed tomography, as the cross-sectional area of the psoas muscle at the third lumbar vertebral level divided by the body surface area. We also measured visceral fat area at the umbilical level using computed tomography. We used logistic regression analysis to examine the relationships between the International Prostate Symptom Score (total score, voiding subscore, and storage subscore) and variables, such as age, body mass index, psoas muscle index, and visceral fat area. The International Prostate Symptom Score was categorized as mild, moderate, or severe. Results: One hundred thirty-nine patients were included in our study. In the logistic regression analysis, we found statistically significant relationships between severe (versus mild-to-moderate) International Prostate Symptom Score storage subscore and variables, including low and high levels of psoas muscle index and visceral fat area, respectively. We could not find any significant relationships between the International Prostate Symptom Score total score and voiding subscore and the variables. Conclusion: Psoas muscle atrophy and visceral fat accumulation are potential risk factors for severe storage symptoms in female patients aged ≥65 years.
  • イミダフェナシン投与後の夜間多尿改善と尿濃縮効果の関係について
    橋本 士; 杉本 公一; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和宏; 田原 秀男; 吉村 一宏; 平山 暁秀; 植村 天受
    日本泌尿器科学会総会 (一社)日本泌尿器科学会総会事務局 108回 491 - 491 2020/12
  • 75歳以上の高齢女性患者におけるサルコペニア、内臓脂肪が下部尿路症状に与える影響
    橋本 士; 西本 光寿; 清水 信貴; 森 康範; 南 高文; 藤田 和利; 野澤 昌弘; 能勢 和宏; 吉村 一宏; 平山 暁秀; 植村 天受
    日本排尿機能学会誌 (一社)日本排尿機能学会 31 (1) 266 - 266 1347-6513 2020/10
  • 脊髄損傷マウスモデルの膀胱機能障害に対するビベグロンの効果
    清水 信貴; 西本 光寿; 後藤 大輔; 橋本 士; 平山 暁秀; 吉村 直樹; 植村 天受
    日本排尿機能学会誌 (一社)日本排尿機能学会 31 (1) 210 - 210 1347-6513 2020/10
  • 75歳以上の高齢女性患者におけるサルコペニア、内臓脂肪が下部尿路症状に与える影響
    橋本 士; 西本 光寿; 清水 信貴; 森 康範; 南 高文; 藤田 和利; 野澤 昌弘; 能勢 和宏; 吉村 一宏; 平山 暁秀; 植村 天受
    日本排尿機能学会誌 (一社)日本排尿機能学会 31 (1) 266 - 266 1347-6513 2020/10
  • 橋本 士; 西本 光寿; 清水 信貴; 森 康範; 南 高文; 野澤 昌弘; 能勢 和宏; 吉村 一宏; 平山 暁秀; 植村 天受
    日本老年泌尿器科学会誌 日本老年泌尿器科学会 33 (1) 101 - 101 2187-3682 2020/08
  • Motokiyo Yoshikawa; Kazumasa Torimoto; Akihide Hirayama; Keisuke Kiba; Yutaka Yamamoto; Yasunori Akashi; Nobutaka Shimizu; Nobumichi Tanaka; Hirotsugu Uemura; Kiyohide Fujimoto
    Neurourology and Urodynamics Wiley 39 (5) 1550 - 1556 0733-2467 2020/06
  • Keisuke Kiba; Yasunori Akashi; Motokiyo Yoshikawa; Yutaka Yamamoto; Akihide Hirayama; Kiyohide Fujimoto; Hirotsugu Uemura
    Research and reports in urology 12 569 - 575 2020 
    Purpose: 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.
  • 橋本 士; 杉本 公一; 清水 信貴; 南 高文; 野澤 昌弘; 能勢 和宏; 田原 秀男; 吉村 一宏; 平山 暁秀; 植村 天受
    日本老年泌尿器科学会誌 日本老年泌尿器科学会 32 (1) 158 - 158 2187-3682 2019/05
  • Effects of nerve growth factor neutralization on TRP channel expression in laser-captured bladder afferent neurons in mice with spinal cord injury.
    Shimizu N; Wada N; Shimizu T; Suzuki T; Takaoka EI; Kanai AJ; de Groat WC; Hirayama A; Hashimoto M; Uemura H; Yoshimura N
    Neurosci lett 683 100 - 103 2018/06 [Refereed]
  • Yutaka Yamamoto; Yasunori Akashi; Takahumi Minami; Masahiro Nozawa; Keisuke Kiba; Motokiyo Yoshikawa; Akihide Hirayama; Hirotsugu Uemura
    Case reports in urology 2018 1414395 - 1414395 2018 [Refereed]
     
    Introduction: The treatment strategy for castration-resistant prostate cancer (CRPC) has changed with the approval of several new agents. In 2011, abiraterone acetate was approved for the treatment of metastatic CRPC; however abiraterone is known to cause mineralocorticoid excess syndrome characterized by hypokalemia, fluid retention, and hypertension. We experienced two cases of grade 4 hypokalemia associated with abiraterone treatment. Case Presentation: Case 1: a 71-year-old male with metastatic CRPC presented with convulsive seizures two weeks after receiving abiraterone plus prednisone. The serum potassium level was 2.1mEq/l. We determined that convulsive seizure was caused by hypokalemia associated with abiraterone. Case 2: a 68-year-old male with metastatic CRPC presented with severe lethargy one month after receiving abiraterone plus prednisone. The serum potassium level was 1.7mEq/l and we concluded that severe lethargy was caused by hypokalemia associated with abiraterone. They were treated with potassium supplementation and increased prednisone following withdrawal of abiraterone. Discussion: The two patients had been on glucocorticoid therapy before abiraterone therapy. Prolonged administration of exogenous glucocorticoid can lead adrenocortical insufficiency and consequently reduce endogenous glucocorticoid production. This situation may increase the risk of abiraterone-induced mineralocorticoid excess. To reduce the risk of abiraterone-induced hypokalemia, evaluation of adrenocortical insufficiency is required.
  • Gotoh D; Torimoto K; Tatsumi Y; Hori S; Yamada A; Miyake M; Morizawa Y; Aoki K; Tanaka N; Hirayama A; Fujimoto K
    Neurourol Urodyn. 2018 [Refereed]
  • Aquaporin-2 plays an important role in water transportation through the bladder wall in rats.
    Morizawa Y; Torimoto K; Hori S; Gotoh D; Nakai Y; Miyake M; Hirayama A; Tanaka N; Fujimoto K
    Neurourol Urodyn. 2018 [Refereed]
  • Mamoru Hashimoto; Nobutaka Shimizu; Koichi Sugimoto; Sachiko Hongoh; Takafumi Minami; Masahiro Nozawa; Kazuhiro Yoshimura; Akihide Hirayama; Hideo Tahara; Hirotsugu Uemura
    Lower urinary tract symptoms 9 (3) 157 - 160 2017/09 [Refereed]
     
    OBJECTIVES: To assess the efficacy of dutasteride add-on therapy for patients with benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS) with small prostates who have been treated with α-blocker therapy for >3 months. METHODS: A total of 110 men with clinical BPH were enrolled. There were 17 and 93 subjects with a prostate volume (PV) <30 and ≥30 mL, respectively. All subjects had been treated with α-blocker therapy for >3 months. Subjective and objective clinical variables were assessed using the total International Prostate Symptom Score (IPSS-T), IPSS quality of life (IPSS-QoL), IPSS voiding subscore (IPSS-V), IPSS storage subscore (IPSS-S), overactive bladder symptom score (OABSS), PV, prostate specific antigen (PSA) level, post-void residual (PVR), and maximum flow rate (Qmax). These variables were assessed at baseline and every 3 months for 1 year. RESULTS: In the small prostate group, IPSS-T and IPSS-V showed improvements from baseline at 6 and 9 months, storage subscore at 6 months, and OABSS at 3 months, but no sustained improvements were observed. During the study period, only the IPSS QoL scores did not show any improvement. Conversly, dutasteride was significantly effective at improving IPSS-T, IPSS-V, IPSS-S, and IPSS-QoL scores throughout the study period in the large prostate BPH group. PSA levels and PV significantly decreased in both groups throughout the study. CONCLUSIONS: Benign prostatic hyperplasia in LUTS patients with small prostates did not show a sustainable benefit from the addition of dutasteride to α-blocker therapy.
  • Increased Urine Production Due to Leg Fluid Displacement Reduces Hours of Undisturbed Sleep.
    Kiba K; Hirayama A; Yoshikawa M; Yamamoto Y; Torimoto K; Shimizu N; Tanaka N; Fujimoto K; Uemura H
    Low Urin Tract Symptoms. 2017 [Refereed]
  • Matsushita C; Torimoto K; Goto D; Morizawa Y; Kiba K; Shinohara M; Hirayama A; Kurumatani N; Fujimoto K
    J.Urol 197 243 - 248 2017 [Refereed]
  • Keisuke Kiba; Akihide Hirayama; Motokiyo Yoshikawa; Yutaka Yamamoto; Kazumasa Torimoto; Kiyohide Fujimoto; Hirotsugu Uemura
    Hinyokika kiyo. Acta urologica Japonica 62 (5) 243 - 8 0018-1994 2016/05 [Refereed]
     
    A total of 29 men 60 years and older (mean age 74 years) who complained at least once about nocturnal voiding and were diagnosed with nocturnal polyuria in the frequency volume chart (FVC) were enrolled in this study. Body water was measured by bioelectric impedance analysis just after lying down at 4 pm and after raising legs 30 minutes later. Nocturnal urine production was measured by FVC, and urine production per unit of time at first nocturnal voiding (urine volume at first nocturnal voiding/hours of undisturbed sleep (HUS) : UFN/HUS), urine production per unit of time during sleep (total nocturnal urine volume/hours of sleep : TNV/HS), etc was evaluated. Extra cellular water (ECW) of 0.19 l (4.0%) in legs was reduced caused by body position changing. There was a significant positive correlation between the amount of ECW in legs and UFN/HUS, TNV/HS (r＝0. 57, p＝0.001 ; r＝0. 38, p＝0.042, respectively). Moreover, UFN/HUS had a significant correlation with soft lean mass in legs, ECW in legs and daytime water intake. This study suggested that a change in leg fluids caused by a change in position results in increased urine production and decreased HUS.
  • Torimoto K; Matsushita C; Yamada A; Goto D; Matsumoto Y; Hosokawa Y; Miyake M; Aoki K; Hirayama A; Tanaka N; Fujimoto K
    Neurourol Urodyn. 10 2016 [Refereed]
  • Atsushi Tomioka; Nobumichi Tanaka; Motokiyo Yoshikawa; Makito Miyake; Satoshi Anai; Yoshitomo Chihara; Eijiro Okajima; Akihide Hirayama; Yoshihiko Hirao; Kiyohide Fujimoto
    BMC CANCER BIOMED CENTRAL LTD 15 1471-2407 2015/05 [Refereed]
     
    Background: Primary androgen deprivation therapy (PADT) has played an important role in the treatment of prostate cancer. We sought to identify factors of PSA progression in our series of patients with localized and locally advanced prostate cancer treated with PADT. Methods: Six-hundred forty-nine patients with localized and locally advanced prostate cancer who received PADT from 1998 to 2005 by Nara Uro-Oncology Research Group were enrolled. Age, T classification, stage, PSA level at diagnosis, Gleason score, laterality of cancer detected by biopsy and seminal vesicle involvement (SVI) were adopted as parameters of PSA progression. Cox's proportional hazards model was used to determine the predictive factors for PSA progression. Results: The median follow-up period and the median PSA level at diagnosis were 49 months and 15 ng/mL. The 5-year disease specific survival rate, overall survival rate and PSA progression-free survival (PFS) rate were 97.9 %, 91.9 % and 71.2 %, respectively. The univariate analysis showed that the PSA level at diagnosis, Gleason score, laterality of cancer detected by biopsy and SVI were independent predictive parameters of PSA-PFS. However, by multivariate analysis, only laterality of cancer detected by biopsy (unilateral vs. bilateral) was an independent predictive parameter of PSA-PFS (p = 0.034). The patients were classified into new risk groups base on three factors: PSA level at diagnosis, Gleason score, and laterality of cancer detected by biopsy. The PSA-PFS rates at 5-years in the low-(none or one factor), intermediate-(two factors) and high-risk (three factors) groups were 78.2 %, 62.5 % and 46.9 % (p < 0.001), respectively. Conclusion: In localized or locally advanced prostate cancer patients who received PADT, laterality of cancer detected by biopsy was a significant predictor associated with a longer PSA-PFS. Our new risk grouping indicates the usefulness of PSA-PFS.
  • Nobumichi Tanaka; Kazumasa Torimoto; Isao Asakawa; Makito Miyake; Satoshi Anai; Akihide Hirayama; Masatoshi Hasegawa; Noboru Konishi; Kiyohide Fujimoto
    RADIATION ONCOLOGY BIOMED CENTRAL LTD 9 1748-717X 2014/12 [Refereed]
     
    Background: To evaluate the effect of two different alpha-1 adrenoceptor antagonists on lower urinary tract symptoms in patients who underwent LDR-brachytherapy. Methods: A total of 141 patients who had been clinically diagnosed with localized prostate cancer and underwent LDR-brachytherapy were enrolled. Patients were randomized and allocated to two groups (silodosin 8 mg vs. naftopidil 75 mg). The primary endpoint was a change in the international prostate symptom score (IPSS) at 3 months after seed implantation. Secondary endpoints included the recovery rate of IPSS at 12 months after seed implantation, the change in IPSS and overactive bladder symptom score, uroflowmetric parameters, and frequency volume chart (FVC). To determine independent variables that can predict IPSS recovery, logistic regression analysis was carried out. Results: The mean change in the IPSS at 3 months after seed implantation in both groups was. 10.6 (naftopidil) and. 10.4 (silodosin), respectively. There was not a significant difference between the two groups (p=0.728). An increase in urinary frequency and a decrease in total urinated volume and mean voided volume were observed in FVC for 12 months after seed implantation. Multivariate analysis revealed that the urethral dose (UD30) was an independent predictive parameter of IPSS recovery. Patients with UD30 < 200Gy showed a higher recovery rate of IPSS at 12 months after seed implantation. Conclusion: There was no significant difference of serial change in IPSS between silodosin and naftopidil during the first year after seed implantation. A lower dose on the urethra was an independent predictor of IPSS recovery at 12 months after seed implantation.
  • Yasushi Nakai; Satoshi Anai; Masaomi Kuwada; Makito Miyake; Yoshitomo Chihara; Nobumichi Tanaka; Akihide Hirayama; Katsunori Yoshida; Yoshihiko Hirao; Kiyohide Fujimoto
    BMC UROLOGY BIOMED CENTRAL LTD 14 1471-2490 2014/08 [Refereed]
     
    Background: Past attempts at detecting prostate cancer (PCa) cells in voided urine by traditional cytology have been impeded by undesirably low sensitivities but high specificities. To improve the sensitivities, we evaluate the feasibility and clinical utility of photodynamic diagnosis (PDD) of prostate cancer by using 5-aminolevulinic acid (5-ALA) to examine shed prostate cancer cells in voided urine samples. Methods: One hundred thirty-eight patients with an abnormal digital rectal exam (DRE) and/or abnormal prostate-specific antigen (PSA) levels were recruited between April 2009 and December 2010. Voided urine specimens were collected before prostate biopsy. Urine specimens were treated with 5-ALA and imaged by fluorescence microscopy and reported as protoporphyrin IX (PPIX) positive (presence of cells demonstrating simultaneous PPIX fluorescence) or PPIX negative (lack of cells demonstrating fluorescence). Results: Of the 138 patients, PCa was detected on needle biopsy in 81 patients (58.7%); of these 81 patients with PCa, 60 were PPIX-positive (sensitivity: 74.1%). Although 57 patients did not harbor PCa by conventional diagnostic procedures, 17 of these at-risk patients were found to be PPIX-positive (specificity: 70.2%). PPIX-PDD was more sensitive compared with DRE and transrectal ultrasound and more specific compared with PSA and PSA density. The incidence of PPIX-PDD positivity did not increase with increasing total PSA levels, tumor stage or Gleason score. Conclusions: To our knowledge, this is the first successful demonstration of PPIX in urine sediments treated with 5-ALA used to detect PCa in a noninvasive yet highly sensitive manner. However, further studies are warranted to determine the role of PPIX-PPD for PCa detection.
  • Mitsuru Tani; Akihide Hirayama; Kazumasa Torimoto; Chie Matsushita; Atsushi Yamada; Kiyohide Fujimoto
    INTERNATIONAL JOURNAL OF UROLOGY WILEY-BLACKWELL 21 (6) 595 - 600 0919-8172 2014/06 [Refereed]
     
    Objectives To evaluate how guidance on water-intake impacts the degree of nocturia. Methods A total of 67 male patients were enrolled in the present study. Patients were asked to adjust their water and food intakes so that their 24-h urine production/bodyweight would be equal or lower than 30 mL/kg. One month after the treatment, the therapeutic gain from and adverse effects of fluid restriction were examined by comparing the pretreatment and post-treatment value of various parameters. Results Overall, 65 eligible patients were evaluated. In 44 patients (67%), the frequency of nocturia was improved to one or more times. The change in frequency of nocturia showed a positive correlation with the change in nocturnal urine volume. The change in nocturnal urine volume showed a positive correlation with the changes in 24-h urine production/bodyweight, 24-h drinking volume and daytime drinking volume. The changes in 24-h urine production/bodyweight and daytime drinking volume were independent factors influencing therapeutic effect. None of the participants reported any adverse event. Conclusions In patients with a 24-h urine production/bodyweight equal or higher than 30 mL/kg, guidance on water intake might be considered effective and safe as a lifestyle therapy. Water restriction should be carried out not only in the evening, but also during daytime.
  • Nobumichi Tanaka; Isao Asakawa; Emiko Katayama; Akihide Hirayama; Masatoshi Hasegawa; Noboru Konishi; Kiyohide Fujimoto
    RADIATION ONCOLOGY BIOMED CENTRAL LTD 9 1748-717X 2014/05 [Refereed]
     
    Background: To assess the biochemical recurrence (BCR)-free rate in patients who underwent prostate low-dose-rate brachytherapy (LDR-brachytherapy), using two different definitions (Phoenix definition and PSA >= 0.2 ng/mL). Methods: Two hundreds and three patients who were clinically diagnosed with localized prostate cancer (cT1c-2cN0M0) and underwent LDR-brachytherapy between July 2004 and September 2008 were enrolled. The median follow-up period was 72 months. We evaluated the BCR-free rate using the Phoenix definition and the PSA cut-off value of 0.2 ng/mL, as in the definition for radical prostatectomy. To evaluate an independent variable that can predict BCR, Cox's proportional hazard regression analysis was carried out. Results: The BCR-free rate in patients using the Phoenix definition was acceptable (5-year: 92.8%). The 5-year BCR-free rate using the strict definition (PSA >= 0.2 ng/mL) was 74.1%. Cox's proportional hazard regression analysis showed that a higher biological effective dose (BED) of >= 180 Gy2 was the only independent variable that could predict BCR (HR: 0.570, 95% C.I.: 0.327-0.994, p = 0.048). Patients with a higher BED (>= 180 Gy2) had a significantly higher BCR-free rate than those with a lower BED (<180 Gy2) (5-year BCR-free rate: 80.5% vs. 67.4%). Conclusions: A higher BED >= 180 Gy2 promises a favorable BCR-free rate, even if the strict definition is adopted.
  • Atsushi Tomioka; Nobumichi Tanaka; Motokiyo Yoshikawa; Makito Miyake; Satoshi Anai; Yoshitomo Chihara; Eijiro Okajima; Akihide Hirayama; Yoshihiko Hirao; Kiyohide Fujimoto
    BMC UROLOGY BIOMED CENTRAL LTD 14 1471-2490 2014/04 [Refereed]
     
    Background: Primary androgen deprivation therapy (PADT) is the most effective systemic therapy for patients with metastatic prostate cancer. Nevertheless, once PSA progression develops, the prognosis is serious and mortal. We sought to identify factors that predicted the prognosis in a series of patients with metastatic prostate cancer. Methods: Two-hundred eighty-six metastatic prostate cancer patients who received PADT from 1998 to 2005 in Nara Uro-Oncology Research Group were enrolled. The log-rank test and Cox's proportional hazards model were used to determine the predictive factors for prognosis; rate of castration-resistant prostate cancer (CRPC) and overall survival. Results: The median age, follow-up period and PSA level at diagnosis were 73 years, 47 months and 174 ng/mL, respectively. The 5-year overall survival rate was 63.0%. The multivariable analysis showed that Gleason score (Hazard ratio [HR]: 1.362; 95% confidence interval [C.I.], 1.023-1.813), nadir PSA (HR:6.332; 95% C.I., 4.006-9.861) and time from PADT to nadir (HR: 4.408; 95% C.I., 3.099-6.271) were independent prognostic factors of the incidence of CRPC. The independent parameters in the multivariate analysis that predicted overall survival were nadir PSA (HR:5.221; 95% C.I., 2.757-9.889) and time from PADT to nadir (HR:4.008; 95% C.I., 2.137-7.517). Conclusions: Nadir PSA and time from PADT to nadir were factors that affect both CRPC and overall survival in a cohort of patients with metastatic prostate cancer. Lower nadir PSA level and longer time from PADT to nadir were good for survival and progression.
  • Yukinari Hosokawa; Nobumichi Tanaka; Hisakazu Mibu; Satoshi Anai; Kazumasa Torimoto; Tatsuo Yoneda; Akihide Hirayama; Katsunori Yoshida; Yoshiki Hayashi; Yoshihiko Hirao; Kiyohide Fujimoto
    WORLD JOURNAL OF SURGICAL ONCOLOGY BIOMED CENTRAL LTD 12 1477-7819 2014/03 [Refereed]
     
    Background: To evaluate the clinical usefulness of estimated glomerular filtration rate (eGFR) divided by functional renal volume (FRV) measured by three-dimensional image reconstruction (eGFR/FRV) for the prediction of functional outcomes after nephrectomy. Methods: Eighty-three patients who underwent nephrectomy were enrolled. The FRV of each patient was measured before surgery. Preoperative medical information on proteinuria, blood pressure, blood glucose level, body mass index (BMI), hemoglobin level and serum cholesterol level were also obtained. We evaluated the relationships between eGFR/FRV and each of these parameters before surgery. We also assessed the potential relationship between eGFR/FRV and the 3-year postoperative eGFR. Stepwise multiple regression analyses were conducted to elucidate independent factors. Results: The median FRV and eGFR were 310.15 cm(3) and 79.0 ml/min/1.73 m(2) before surgery, respectively. The correlation between FRV and eGFR was statistically significant (r = 0.465, P < 0.001). The median eGFR/FRV was 0.24 ml/min/1.73 m(2)/cm(3). Stepwise multiple regression analysis showed that the independent parameters (multiple correlation coefficient, r = 0.389, P = 0.031) associated with eGFR/FRV were proteinuria, BMI, age and hypertension. Proteinuria was statistically associated with eGFR/FRV, and the independent parameters (multiple correlation coefficient, r = 0.694, P < 0.001) associated with the 3-year postoperative eGFR were age, BMI and eGFR/FRV. The eGFR/FRV was statistically associated with the 3-year postoperative eGFR (r = 0.559, P < 0.001). Conclusion: The present results demonstrated that patients with proteinuria are expected to have a lower eGFR/FRV than those without proteinuria. The present study also supports the notion that eGFR/FRV is the primary determinant of the long-term functional outcome after nephrectomy. It should be taken into consideration that patients with a low eGFR/FRV may develop chronic kidney disease after nephrectomy.
  • Hoshiyama F; Hirayama A; Tanaka M; Taniguchi; M。Ohi M; Momose H; Nakamura T; Ogawa S; Torimoto K; Tanaka N; Fujimoto K
    Urology 84 892 - 896 2014 [Refereed]
  • Nobumichi Tanaka; Akihide Hirayama; Tatsuo Yoneda; Katsunori Yoshida; Keiji Shimada; Noboru Konishi; Kiyohide Fujimoto
    BMC CANCER BIOMED CENTRAL LTD 13 588 - 594 1471-2407 2013/12 [Refereed]
     
    Background: To assess the trends of risk classification and primary therapy in Japanese patients who were diagnosed with prostate cancer between 2004-2006 and 2007-2009. Methods: A total of 4752 patients who were newly diagnosed with prostate cancer at Nara Medical University and its 23 affiliated hospitals between 2004 and 2009 were enrolled. The differences in risk classification and primary therapy were compared in patients who were newly diagnosed between 2004-2006 (prior period) and 2007-2009 (latter period). Results: The proportion of patients with a high or greater risk significantly decreased in the latter period compared to the prior period (p < 0.001). The proportion of primary androgen deprivation therapy (PADT) was 50% in the prior period, and 40% in the latter period. On the other hand, the proportion of radiation therapy was 14% in the prior period, but 24% in the latter period. The proportion of radical prostatectomy was the same in the two periods (30%). The primary therapy was significantly different between the two periods (p < 0.001). Conclusions: Higher risk patients significantly decreased in the latter period compared to the prior period. The use of PADT also significantly decreased in the latter period. However, there were still higher risk patients in Japan, and the use of PADT was still common in patients with localized prostate cancer or locally advanced prostate cancer in Japan.
  • Akihide Hirayama; Kazumasa Torimoto; Chie Mastusita; Nozomi Okamoto; Masayuki Morikawa; Nobumichi Tanaka; Kastunori Yoshida; Kiyohide Fujimoto; Yoshihiko Hirao; Norio Kurumatani
    JOURNAL OF UROLOGY ELSEVIER SCIENCE INC 189 (3) 980 - 986 0022-5347 2013/03 [Refereed]
     
    Purpose: We evaluated the natural history of nocturia and determined factors influencing the incidence or remission of nocturia. Materials and Methods: Study subjects were 4,427 volunteers 65 years old or older who participated in the Fujiwara-kyo Study. The nocturia prevalence was assessed at baseline and 1 year later. Nocturia incidence and remission rates were calculated and factors influencing these results were evaluated based on characteristics, including gender, age, body mass index, HbA1c, creatinine clearance, life style, comorbidities, depressive status, metabolic syndrome and voiding symptoms. Independent factors were determined by multivariate analysis. Results: Of the 4,427 subjects 3,685 provided complete replies to self-administered questionnaires at baseline and 1 year later. The prevalence of nocturia at baseline and 1 year later was 47.0% and 50.3%, and nocturia incidence and remission rates were 20.0% and 15.4%, respectively. Male gender, high body mass index, voiding symptom deterioration and new onset overactive bladder were independent factors associated with the nocturia incidence. Male gender, sum of the voiding symptoms, age and new onset overactive bladder were independent negative factors associated with nocturia remission. Conclusions: The prevalence of nocturia worsened with time, although nocturia in older subjects progressed dynamically. Male gender, age, body mass index, sum of voiding symptoms, voiding symptom deterioration and new onset overactive bladder influence the natural history of nocturia.
  • Nobumichi Tanaka; Isao Asakawa; Satoshi Anai; Akihide Hirayama; Masatoshi Hasegawa; Noboru Konishi; Kiyohide Fujimoto
    RADIATION ONCOLOGY BIOMED CENTRAL LTD 8 1748-717X 2013/01 [Refereed]
     
    Background: To compare the periodical incidence rates of genitourinary (GU) and gastrointestinal (GI) toxicity in patients who underwent prostate low-dose-rate brachytherapy between the monotherapy group (seed implantation alone) and the boost group (in combination with external beam radiation therapy (EBRT)). Methods: A total of 218 patients with a median follow-up of 42.5 months were enrolled. The patients were divided into 2 groups by treatment modality, namely, the monotherapy group (155 patients) and the boost group (63 patients). The periodical incidence rates of GU and GI toxicity were separately evaluated and compared between the monotherapy group and the boost group using the National Cancer Institute - Common Terminology Criteria for Adverse Events, version 3.0. To elucidate an independent factor among clinical and postdosimetric parameters to predict grade 2 or higher GU and GI toxicity in the acute and late phases, univariate and multivariate logistic regression analyses were carried out. Results: Of all patients, 78.0% showed acute GU toxicity, and 7.8% showed acute GI toxicity, while 63.8% showed late GU toxicity, and 21.1% showed late GI toxicity. The incidence rates of late GU and GI toxicity were significantly higher in the boost group. Multivariate analysis showed that the International Prostate Symptom Score (IPSS) before seed implantation was a significant parameter to predict acute GU toxicity, while there were no significant predictive parameters for acute GI toxicity. On the other hand, combination with EBRT was a significant predictive parameter for late GU toxicity, and rectal volume (mL) receiving 100% of the prescribed dose (R100) was a significant predictive parameter for late GI toxicity. Conclusions: The boost group showed higher incidence rates of both GU and GI toxicity. Higher IPSS before seed implantation, combination with EBRT and a higher R100 were significant predictors for acute GU, late GU and late GI toxicity.
  • Yamada A; Torimoto K; Obata K; Hirayama A; Fujimoto K; Takaki M
    J Physiol Sci. 14 2013 [Refereed]
  • Nobumichi Tanaka; Isao Asakawa; Kiyohide Fujimoto; Satoshi Anai; Akihide Hirayama; Masatoshi Hasegawa; Noboru Konishi; Yoshihiko Hirao
    BMC UROLOGY BIOMED CENTRAL LTD 12 1471-2490 2012/09 [Refereed]
     
    Background: To clarify the significant clinicopathological and postdosimetric parameters to predict PSA bounce in patients who underwent low-dose-rate brachytherapy (LDR-brachytherapy) for prostate cancer. Methods: We studied 200 consecutive patients who received LDR-brachytherapy between July 2004 and November 2008. Of them, 137 patients did not receive neoadjuvant or adjuvant androgen deprivation therapy. One hundred and forty-two patients were treated with LDR-brachytherapy alone, and 58 were treated with LDR-brachytherapy in combination with external beam radiation therapy. The cut-off value of PSA bounce was 0.1 ng/mL. The incidence, time, height, and duration of PSA bounce were investigated. Clinicopathological and postdosimetric parameters were evaluated to elucidate independent factors to predict PSA bounce in hormonena ve patients who underwent LDR-brachytherapy alone. Results: Fifty patients (25%) showed PSA bounce and 10 patients (5%) showed PSA failure. The median time, height, and duration of PSA bounce were 17 months, 0.29 ng/mL, and 7.0 months, respectively. In 103 hormonena ve patients treated with LDR-brachytherapy alone, and univariate Cox proportional regression hazard model indicated that age and minimal percentage of the dose received by 30% and 90% of the urethra were independent predictors of PSA bounce. With a multivariate Cox proportional regression hazard model, minimal percentage of the dose received by 90% of the urethra was the most significant parameter of PSA bounce. Conclusions: Minimal percentage of the dose received by 90% of the urethra was the most significant predictor of PSA bounce in hormone-naive patients treated with LDR-brachytherapy alone.
  • Akihide Hirayama; Kazumasa Torimoto; Chie Mastusita; Nozomi Okamoto; Masayuki Morikawa; Nobumichi Tanaka; Kiyohide Fujimoto; Kastunori Yoshida; Yoshihiko Hirao; Norio Kurumatani
    UROLOGY ELSEVIER SCIENCE INC 80 (1) 71 - 76 0090-4295 2012/07 [Refereed]
     
    OBJECTIVE To evaluate the risk factors for new-onset overactive bladder (OAB) in older subjects. METHODS The present study enrolled 4427 subjects aged >= 65 years who had participated in the Fujiwarakyo study. The prevalence of OAB at baseline and 1 year later was evaluated using the OAB symptom score questionnaire. The incidence and remission rate of OAB were calculated. We identified the risk factors for OAB by evaluating the difference in characteristics (including sex, age, body mass index, life style, comorbidities, depressive status, metabolic syndrome, and sum of voiding symptoms) between those with and without new-onset OAB. In addition, the independent risk factors were determined by multivariate analysis. RESULTS Of the 4427 subjects, 3685 completely replied to the self-administrated questionnaires at baseline and 1 year later. The incidence and remission rate of OAB was 11.9% and 29.8%, respectively. The male/female ratio, sum of voiding symptoms, alcohol consumption and smoking, hypertension, and depressive status in subjects with new-onset OAB, were significantly greater than those in subjects without new-onset OAB. A multivariate analysis, including sex (odds ratio 2.0, P < .0001), sum of voiding symptoms (odds ratio 1.1, P < .0001), and depressive status (odds ratio 1.8, P < .0001) were independent factors for new-onset OAB in older subjects. CONCLUSION The results of the present study have demonstrated that male sex, the sum of voiding symptoms, and depression were independent factors for new-onset OAB. It is necessary to determine whether the treatment of patients with voiding symptoms or depression controls for new-onset OAB. UROLOGY 80: 71-76, 2012. (c) 2012 Elsevier Inc.
  • Nobumichi Tanaka; Kiyohide Fujimoto; Akihide Hirayama; Yasushi Nakai; Yoshitomo Chihara; Satoshi Anai; Atsushi Tomioka; Keiji Shimada; Noboru Konishi; Yoshihiko Hirao
    Advances in Urology 1687-6369 2012 [Refereed]
     
    Purpose. The purpose of this study is to investigate whether the clinicopathological biopsy findings can predict the oncological outcome in patients who undergo radical prostatectomy. Materials and Methods. Between January 1997 and March 2006, 255 patients with clinically localized adenocarcinoma of the prostate (clinical T1-3N0M0) who had undergone retropubic radical prostatectomy were enrolled in this study. None of the patients received neoadjuvant or adjuvant therapy. Clinicopathological parameters were assessed to determine a predictive parameter of biochemical recurrence. Results. Of the total 255 patients, 77 showed biochemical recurrence during the follow-up period. The estimated 5-year overall survival, 5-year cause-specific survival, and 5-year biochemical recurrence-free survival rates were 97.7%, 99.5%, and 67.3%, respectively. Multivariate analysis using the Cox proportional hazards model showed that calculated cancer volume was an independent predictor among the preoperative clinicopathological parameters (P< 0.05). SVI and PSM were independent predictors among the postoperative parameters (SVI P< 0.001, PSM P=0.049). Among the significant preoperative and postoperative parameters, calculated cancer volume remained an independent predictive parameter in multivariate analysis (P< 0.01). Conclusions. Tumor volume, as calculated by preoperative parameters, is an independent predictor of biochemical recurrence in patients who had undergone radical prostatectomy. © 2012 Nobumichi Tanaka et al.
  • Nobumichi Tanaka; Kiyohide Fujimoto; Akihide Hirayama; Kazumasa Torimoto; Eijiro Okajima; Masahiro Tanaka; Makito Miyake; Keiji Shimada; Noboru Konishi; Yoshihiko Hirao
    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY SPRINGER TOKYO 16 (5) 553 - 559 1341-9625 2011/10 [Refereed]
     
    Background The aim of this study was to evaluate the oncological outcomes in patients who underwent radical prostatectomy in various risk groups. Methods The subjects were 468 patients with clinically localized or locally advanced adenocarcinoma of the prostate (T1-3N0M0) who underwent retropubic radical prostatectomy with/without neoadjuvant and/or adjuvant therapy at Nara Medical University and its affiliated hospitals between January 1997 and December 2006. All patients were stratified by D'Amico risk classification. The independent predictor of biochemical recurrence was determined in each risk group. Results Of all 468 patients, 171 patients showed biochemical recurrence during a mean follow-up period of 53 months. The 5-year estimated biochemical recurrence-free survival rates in the low, intermediate, and high-risk groups were 77.3, 71.3, and 46.3%, respectively. The multivariate analysis using Cox's proportional hazard model showed that patient age in the low-risk group, seminal vesicle involvement in the intermediate-risk group, and prostate-specific antigen value at diagnosis, surgical Gleason score, percent positive core, and perineural invasion in the high-risk group were independent predictors of biochemical recurrence. Conclusions The high-risk patients showed a significant higher biochemical recurrence than the low- and intermediate-risk patients. The independent predictor of biochemical recurrence was different in each risk group.
  • Nobumichi Tanaka; Kiyohide Fujimoto; Takayuki Shinkai; Yasushi Nakai; Masaomi Kuwada; Satoshi Anai; Makito Miyake; Akihide Hirayama; Masatoshi Hasegawa; Yoshihiko Hirao
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY OXFORD UNIV PRESS 41 (10) 1209 - 1213 0368-2811 2011/10 [Refereed]
     
    Objective: According to several guidelines, it is acceptable to spare a bone scan in the patients who are newly diagnosed with low-risk prostate cancer. Our aim is to clarify a suitable group whereby a bone scan could be spared at the initial staging of prostate cancer. Methods: Consecutive 857 patients who were newly diagnosed from 2004 through 2009 and received bone scans using technetium 99m methylene diphosphonate at the initial staging were enrolled. The proportion of positive bone metastases by age distribution, prostate-specific antigen level at diagnosis, Gleason score and clinical T stage were evaluated. Univariate and multivariate logistic regression analyses were performed to identify the predictors of positive bone metastases. Results: Of all 857 patients, 40 patients (4.7%) showed bone metastases. Patients with higher age, prostate-specific antigen level, clinical stage and Gleason score showed significantly higher rate of bone metastases (P < 0.001). In univariate logistic regression analyses, age, prostate-specific antigen level, clinical stage and Gleason score were independent predictors of bone metastasis. The multivariate analysis showed that both the prostate-specific antigen level >50 ng/ml and the Gleason score >= 4 + 3 were independent predictors of bone metastases. Conclusions: The incidences of bone metastases in patients with a prostate-specific antigen level of <= 20 ng/ml and Gleason score of <= 6 were reasonably low. Collectively, a bone scan is not necessary as a routine examination for these patients at their initial staging of prostate cancer.
  • Kazumasa Torimoto; Shoji Samma; Yoriaki Kagebayashi; Yoshitomo Chihara; Nobumichi Tanaka; Akihide Hirayama; Kiyohide Fujimoto; Yoshihiko Hirao
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY OXFORD UNIV PRESS 41 (4) 577 - 581 0368-2811 2011/04 [Refereed]
     
    Objective: In Japan, androgen deprivation therapy is employed as the primary therapy for prostate cancer in more than 50% of patients, which is a percentage larger than that in the USA. The adverse effects of androgen deprivation therapy on body composition and lipid profile associated with metabolic syndrome have been reported mainly in Caucasian populations, and few studies have been performed in East Asian populations, including Japanese. Methods: This study enrolled 39 Japanese patients who were starting to receive androgen deprivation therapy for prostate cancer. Subjects were evaluated at baseline and at 3, 6, 9 and 12 months. Body composition and lipid profiles were measured by bioelectrical impedance analysis and using blood samples, respectively. Results: The volume of fat and visceral fat was significantly increased 6 months after the treatment and continued to increase until 12 months. On the other hand, skeletal muscle was significantly decreased during the same period. The serum concentration of total cholesterol and low-density lipoprotein cholesterol increased significantly over the same period. Conclusions: Androgen deprivation therapy changed the body composition and lipid profile of men with prostate cancer. It was demonstrated that even Japanese patients with prostate cancer who are treated with androgen deprivation therapy have the risk of developing metabolic syndrome.
  • 松下 千枝; 鳥本 一匡; 明山 達哉; 永吉 純一; 平山 暁秀; 藤本 清秀; 吉田 克法; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 102 (2) 557 - 557 2011
  • Tanaka N; Fujimoto K; Hirayama A; Samma S; Momose H; Kaneko Y; Haramoto M; Hayashi Y; Nakagawa Y; Otani T; Watanabe S; Hirao Y
    BMC Urol 27 11 - 16 2011 [Refereed]
  • Hirayama A; Torimoto K; Yamada A; Tanaka N; Fujimoto K; Yoshida K; Hirao Y
    Urology 77 426 - 431 2011 [Refereed]
  • Nobumichi Tanaka; Kiyohide Fujimoto; Isao Asakawa; Akihide Hirayama; Tatsuo Yoneda; Katsunori Yoshida; Yoshihiko Hirao; Masatoshi Hasegawa; Noboru Konishi
    BRACHYTHERAPY ELSEVIER SCIENCE INC 9 (4) 300 - 306 1538-4721 2010/10 [Refereed]
     
    PURPOSE: The purpose of this study was to prospectively assess the variations in health-related quality of life (HR-QoL) in patients who underwent low dose rate prostate brachytherapy using iodine-125 seed source during the first year after seed implantation. METHODS AND MATERIALS: Between July 2004 and December 2006, 109 patients underwent low dose rate brachytherapy. The Medical Outcomes study 36-Item Short Form; the University of California, Los Angeles-Prostate Cancer Index; and the International Index of Erectile Function-5 were evaluated before and at 1, 3, 6, and 12 months after seed implantation. RESULTS: In Medical Outcomes study 36-Item Short Form analyses and the HR-QoL scores were well preserved during the first year after seed implantation. In the University of California, Los Angeles-Prostate Cancer Index analyses, the urinary function and bother scores showed significant decrease during 6 months after seed implantation. The bowel function and bother scores showed significant decrease at 3 months after seed implantation. The sexual function score showed significant decrease at 3, 6, and 12 months after seed implantation, whereas the sexual bother score showed no change during the first year. The International Index of Erectile Function-5 score dramatically decreased at 1, 3, 6, and 12 months after seed implantation. CONCLUSIONS: The general HR-QoL in the patients who underwent seed implantation was well preserved during the first year after seed implantation, whereas the urinary, bowel, and sexual function and bother scores showed transient deterioration during the first year after seed implantation. Especially, sexual function showed significant deterioration in Japanese men after seed implantation. (C) 2010 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
  • Nobumichi Tanaka; Kiyohide Fujimoto; Akihide Hirayama; Tatsuo Yoneda; Katsunori Yoshida; Yoshihiko Hirao
    JAPANESE JOURNAL OF CLINICAL ONCOLOGY OXFORD UNIV PRESS 40 (6) 588 - 592 0368-2811 2010/06 [Refereed]
     
    Objective: We assessed the variations in stage, prostate specific antigen at diagnosis, Gleason score, risk classification and primary therapy in Japanese prostate cancer patients, and compared with those of the US patients. Methods: Between 2004 and 2006, the distribution of primary therapy and clinical characteristics of 2303 newly diagnosed patients at Nara Medical University and its 23 affiliated hospitals were assessed to compare with those of the Cancer of the Prostate Strategic Urological Research Endeavor data and to clarify the differences in data between the USA and Japan. Results: The proportions of clinical T stage of 3-4, prostate specific antigen at diagnosis >20 ng/ml, Gleason score of 8-10 and high-risk group were greater in our study than those of the Cancer of the Prostate Strategic Urological Research Endeavor data (T3-4, 26.2 vs. 3.5-11.8%; prostate-specific antigen, 34.1 vs. 8.1-27.0%; Gleason score, 29.3 vs. 9.7-12.1%). Regarding the primary treatments, 51% of patients received primary androgen deprivation therapy, 30% underwent radical prostatectomy, 14% received radiation therapy and 2% had watchful waiting in our study, while the corresponding figures in the Cancer of the Prostate Strategic Urological Research Endeavor data were: radical prostatectomy, 44%; radiation therapy, 23%; primary androgen deprivation therapy 20% and watchful waiting 10%. Conclusions: The Japanese prostate cancer patients still have higher prostate-specific antigen at diagnosis, higher Gleason score and higher clinical stage than the US patients. The trends of primary therapy for prostate cancer were different from those in the USA. The higher rate of primary androgen deprivation therapy is characteristic for the Japanese patients.
  • 松下 千枝; 平山 暁秀; 鳥本 一匡; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 101 (2) 248 - 248 2010
  • 平山 暁秀; 岡田 啓希; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 101 (2) 223 - 223 2010
  • 藤本 健; 喜馬 啓介; 星山 文明; 小野 隆征; 大山 信雄; 百瀬 均; 中農 勇; 平山 暁秀; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 101 (2) 476 - 476 2010
  • Kinue Aihara; Akihide Hirayama; Nobumichi Tanaka; Kiyohide Fujimoto; Kastunori Yoshida; Yoshihiko Hirao
    INTERNATIONAL JOURNAL OF UROLOGY WILEY-BLACKWELL PUBLISHING, INC 16 (12) 947 - 952 0919-8172 2009/12 [Refereed]
     
    Objectives: To evaluate the safety, diagnostic potential and therapeutic efficacy of cystoscopy with hydrodistension under local anesthesia in patients with suspected painful bladder syndrome/interstitial cystitis (PBS/IC). Methods: Thirty-six patients with frequency, urgency or bladder pain for >= 6 months and an average voided volume of < 200 mL were enrolled in the study. Hydrodistension was carried out 10 min after instillation of 10 mL of 4% lidocaine. The instilled saline volume for hydrodistension was determined based on each patient's level of tolerance of urinary sensation and symptoms. Results: Overall, 30 patients (median age 54 years, range 25-76) were evaluated. The median instilled saline volume was 450 mL (250 to 580 mL). No patients were admitted to hospital due to adverse events associated with hydrodistension. Glomerulation was found in 23 patients and two had Hunner's ulcers. Therapeutic efficacy at one month after hydrodistension was shown in 21/30 patients (71%). A median efficacy period of 20 +/- 3.7 weeks was determined by Kaplan-Meier analysis. Factors with an independent influence on therapeutic efficacy of hydrodistension were not identified, but patients with an instilled volume greater than the median volume had significantly longer efficacy periods (P < 0.022). Conclusions: Cystoscopy with hydrodistension under local anesthesia provides a simple and safe method for differential diagnosis and has some therapeutic efficacy in patients with suspected PBS/IC.
  • Yoshihiro Matsumoto; Kazumasa Torimoto; Hiroko Matsuyoshi; Akihide Hirayama; Kiyohide Fujimoto; Naoki Yoshimura; Yoshihiko Hirao
    Biomedical Research 30 (6) 331 - 335 0388-6107 2009/12 [Refereed]
     
    The spontaneously diabetic Torii (SDT) rat has recently been established as a model of type 2 diabetes mellitus (DM). The usefulness of this rat model for the study of diabetic voiding dysfunction was investigated. Male SDT rats and male Sprague-Dawley (SD) rats were used. Voiding function was evaluated by a metabolic cage study and cystometry. Total voided volume for 24 h, mean voided volume, and urinary frequency for 24 h were significantly greater in SDT rats at the age of 36 weeks. From cystometry mean inter-micturition interval (IMI) was significantly longer in SDT rats at the age of 22 and 36 weeks. In SDT rats mean IMI was significantly longer at the age of 36 weeks than at the age of 22 weeks. Mean voiding pressure was significantly higher in SDT rats at the age of 22 and 36 weeks. In the present study, SDT rats showed typical diabetic voiding dysfunction similar to other diabetic rat models. It was suggested that activity of the bladder afferent pathways is decreased and the urethral relaxation mechanism is impaired in SDT rats. In addition, SDT rats are suitable to study chronic diabetic voiding dysfunction because they survive without insulin treatment for as long as 60 weeks.
  • Katsuya Aoki; Akihide Hirayama; Nobumichi Tanaka; Tatsuo Yoneda; Katsunori Yoshida; Kiyohide Fujimoto; Yoshihiko Hirao
    BIOMEDICAL RESEARCH-TOKYO BIOMEDICAL RESEARCH PRESS LTD 30 (6) 343 - 347 0388-6107 2009/12 [Refereed]
     
    We conducted two Studies to examine the hypothesis that lower urinary tract obstruction induces excessive production of prostaglandin E2 (PGE2) in the bladder In Young boys, with consequent overactive bladder (OAB) symptoms. The Subjects were boys aged less than 15 years old who were scheduled to undergo Surgery in Our department from October 2006 to March 2008. In Study I (n = 25), the patients were divided into two groups based oil the presence or absence of lower urinary tract obstruction. In Study 2 (n = 38), the patients were classified by age. The PGE2 level in the bladder was determined by washing with saline before the operation and urinary symptoms were evaluated using the Pediatric Lower Urinary Tract Scoring System. In Study 1, the PGE2 level in the bladder of patients with lower Urinary tract obstruction was higher than in those without obstruction (49.1 +/- 37.4 vs. 21.5 +/- 10.1 pg/mL, P = 0.0475). In Study 2, the PGE2 level in the bladder was negatively correlated with age (r = -0.379, P = 0.0207). A higher level of PGE2 is found in boys with bladder Outlet obstruction due to Urethral Stricture and ill younger boys, and this elevated level of PGE2 may induce OAB symptoms.
  • M. Tanaka; K. Fujimoto; Y. Chihara; K. Torimoto; T. Yoneda; N. Tanaka; A. Hirayama; N. Miyanaga; H. Akaza; Y. Hirao
    PROSTATE CANCER AND PROSTATIC DISEASES NATURE PUBLISHING GROUP 12 (3) 247 - 252 1365-7852 2009/09 [Refereed]
     
    The aim of this study was to evaluate the effect of supplementing healthy men with soy isoflavones on the serum levels of sex hormones implicated in prostate cancer development. A total of 28 Japanese healthy volunteers (18 equol producers and 10 equol non-producers) between 30 and 59 years of age were given soy isoflavones (60mg daily) supplements for 3 months, and the changes in their sex hormone levels were investigated at the baseline and after administration. The serum and urine concentrations of daidzein, genistein, and the levels of equol in the fasting blood samples and 24-h stored urine samples were also measured. All 28 volunteers completed the 3-month supplementation with isoflavone. No changes in the serum levels of estradiol and total testosterone were detected after 3-month supplementation. The serum levels of sex hormone-binding globulin significantly increased, and the serum levels of free testosterone and dihydrotestosterone (DHT) decreased significantly after 3-month supplementation. Among the 10 equol non-producers, equol became detectable in the serum of two healthy volunteers after 3-month supplementation. This study revealed that short-term administration of soy isoflavones stimulated the production of serum equol and decreased the serum DHT level in Japanese healthy volunteers. These results suggest the possibility of converting equol non-producers to producers by prolonged and consistent soy isoflavones consumption. Prostate Cancer and Prostatic Diseases (2009) 12, 247-252; doi: 10.1038/pcan.2009.10; published online 14 July 2009
  • 三宅 牧人; 藤本 清秀; 松下 千枝; 千原 良友; 田中 雅博; 平山 暁秀; 平尾 佳彦; 植村 天受
    泌尿器科紀要 泌尿器科紀要刊行会 55 (6) 371 - 375 0018-1994 2009/06 [Refereed]
     
    24歳男。患者は初め左頸部の無痛性腫瘤を主訴に受診し、左鎖骨上リンパ節腫瘤を指摘された。生検で未分化な腫瘍細胞のリンパ節転移と診断され、あわせて傍大動脈リンパ節転移も確認された。LDHやα-fetoprotein(AFP)、free-β-human chorionic gonadotropin(F-βHCG)は異常高値が認められ、超音波では右精巣内に長径約3cmの腫瘤がみられた。右高位精巣摘出術を施行したところ、病理学的に進行精巣原発胚細胞性腫瘍で、術後は化学療法、後腹膜リンパ節郭清術、末梢血幹細胞輸血併用大量化学療法等が行われた。外来で経過観察となっていたが、多発性肺転移を認めて肺腫瘍切除術を施行、完全寛解が確認された。更に5ヵ月後には右心房内へ進展する上大静脈腫瘍塞栓を認めたたため、腫瘍塞栓摘出術を施行し、奇形腫悪性転化に伴う粘液産生性腺癌であった。以後、2年間は再発なく経過したが、その後は徐々に全身状態が悪化し、患者は脳梗塞と思われる状態で最終的に死亡となった。
  • Makito Miyake; Kiyohide Fujimoto; Chie Matsushita; Yoshitomo Chihara; Masahiro Tanaka; Akihide Hirayama; Yoshihiko Hirao; Hirotsugu Uemura
    Hinyokika kiyo. Acta urologica Japonica 55 (6) 371 - 5 0018-1994 2009/06 [Refereed]
     
    A 24-year-old man was referred to our hospital with a painless mass on the left side of his neck. Ultrasonography detected right testicular tumor and computerized tomography scanning revealed a left supraclavicular lymph node mass and bulky retroperitoneal lymph node mass. He initially underwent right high orchiectomy, combination chemotherapy and retroperitoneal lymph node dissection for advanced testicular non-seminomatous germ cell tumor. Six years later, late relapse was detected in the lung. After complete remission of the lung metastasis with chemotherapy, the serum alpha-fetoprotein began to increase because of superior vena caval thrombus extending into the right atrium. Emergency surgical excision was performed successfully using extracorporeal circulation to prevent pulmonary embolism and the resected specimen pathologically revealed adenocarcinoma interpreted as teratoma malignant transformation. Adjuvant chemotherapy consisting of paclitaxel, ifosfamide and nedaplatin were administered for subsequent slight elevation of serum F-human chorionic gonadotropin beta, resulting in successful normalization again. Later, he suddenly died of cerebral infarction without any evidence of recurrence 138 months after his initial presentation. We report herein an extremely uncommon case of advanced testicular germ cell tumor with development of superior vena caval thrombus extending into the right atrium.
  • Osamu Natsume; Yoshiteru Kaneko; Akihide Hirayama; Kiyohide Fujimoto; Yoshihiko Hirao
    INTERNATIONAL JOURNAL OF UROLOGY WILEY-BLACKWELL PUBLISHING, INC 16 (3) 307 - 313 0919-8172 2009/03 [Refereed]
     
    To investigate the pathophysiology of nocturnal polyuria associated with aging. Fifty patients (mean age 67.7 years, range 50-87) with nocturia were recruited for this prospective study. Patients were classified into nocturnal polyuria (NP) and non-nocturnal polyuria (non-NP) groups based on records of their frequency-volume charts. A hypertonic saline infusion test was carried out to evaluate individual osmotic and volume control. In the NP group, there was a significantly increased nocturnal diuretic rate compared with the daytime diuretic rate. In the non-NP group, there was a significantly decreased nocturnal diuretic rate compared with the daytime rate. There was also a positive correlation between systolic blood pressure and nocturnal diuretic rate, and a negative correlation between systolic blood pressure and daytime diuretic rate in those with NP, but no correlation in those without NP. Thus, a close relationship between diuretic rates and systolic blood pressure was seen in NP patients. Moreover, a slight overall shift upward from the physiological range of plasma osmolality relative to arginine vasopressin after hypertonic saline loading was seen in those with NP compared with those without. An altered circadian rhythm was also seen in diurnal plasma arginine vasopressin levels in patients with and without NP. Patients with nocturnal polyuria are likely to have a more hypervolemic or vasoconstrictive condition. It is considered that non-osmotic control takes on a greater meaning in patients with nocturnal polyuria, though osmotic control contributes less to diuresis within the physiological plasma osmolality range with aging.
  • 平山 暁秀; 喜馬 敬介; 篠原 雅岳; 豊島 優多; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 100 (2) 384 - 384 2009
  • 岡島 英二郎; 田中 雅博; 穴井 智; 丸山 良夫; 渡辺 秀次; 三馬 省二; 百瀬 均; 林 美樹; 仲川 嘉紀; 平山 暁秀; 田中 宣道; 吉田 克法; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 100 (2) 380 - 380 2009
  • Torimoto K; Hirayama A; Samma S; Yoshida K; Fujimoto K; Hirao Y
    J.Urol 181 219 - 224 2009 [Refereed]
  • 相原 衣江; 平山 暁秀; 星山 文明; 堀川 直樹; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 99 (2) 472 - 472 2008
  • Tani M; Hirayama A; Fujimoto K; Torimoto K; Akiyama T; Hirao Y
    Int J urol 15 151 - 154 2008 [Refereed]
  • 鳥本 一匡; 千原 良友; 影林 頼明; 中井 靖; 山田 篤; 吉川 元清; 平山 暁秀; 藤本 清秀; 三馬 省二; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 98 (2) 379 - 379 2007
  • 田中 雅博; 藤本 清秀; 近藤 秀明; 千原 良友; 鳥本 一匡; 田中 宣道; 平山 暁秀; 吉田 克法; 平尾 佳彦; 赤座 英之
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 98 (2) 459 - 459 2007
  • 谷 満; 平山 暁秀; 鳥本 一匡; 明山 達哉; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 98 (2) 528 - 528 2007
  • Tatsuya Akiyama; Akihide Hirayama; Kiyohide Fujimoto; Kazumasa Torimoto; Kastunori Yoshida; Yoshihiko Hirao
    UROLOGY ELSEVIER SCIENCE INC 69 (1) 98 - 102 0090-4295 2007/01 [Refereed]
     
    OBJECTIVES To determine the cutoff value of early-morning urinary arginine vasopressin (uAVP)/urinary creatinine (uCr) for patients with nocturnal polyuria (NP), and to investigate whether abnormal secretion of AVP at nighttime is a risk factor of NP in elderly men. METHODS A total of 189 men older than 50 years of age with nocturia were enrolled. The frequency volume chart a was recorded. The UAVP, urinary sodium, uCr, and osmolarity of a single urine sample voided at 6:00 AM were measured in all cases. Two definitions of NP-nocturnal urine volume/ 24-hr production greater than 0.35 (NP index [NPI] definition) and a nocturnal urine volume of 0.9 mL/min X the sleeping duration or greater (NUV definition)-were used for analysis. RESULTS uAVP/uCr was an independent predictor for NP according to the NPI and NUV definitions. The cutoff value of uAVP/uCr for NP was 23.4 pg/mL/Cr according to the NPI definition and 28.3 pg/mL/Cr according to the NUV definition. The sensitivity of the cutoff value according to the NPI and NUV definitions was 69% and 77%, respectively, and the specificity was 61% and 66%, respectively. In both NP definitions, 31% and 38% of the patients with a uAVP/uCr greater than the cutoff value showed NP. Significant differences in NUV and urine osmolarity, but not in uAvp/uCr and uNa/uCr, between the NP group and the non-NP group were found using both NP definitions. CONCLUSIONS We demonstrated that age and uAVP/uCr were independent predictive factors for nocturia in patients with NP. The cutoff value of uAVP/uCr is a useful screening marker for NP in elderly men with nocturia. (c) 2007 Elsevier Inc.
  • 石橋 道男; 近藤 秀明; 千原 良友; 鳥本 一匡; 田中 雅博; 米田 龍生; 田中 基幹; 田中 宣道; 平山 暁秀; 藤本 清秀; 吉田 克法; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 97 (2) 335 - 335 2006
  • 鳥本 一匡; 松本 吉弘; 松吉 ひろ子; 平山 暁秀; 藤本 清秀; 吉村 直樹; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 97 (2) 374 - 374 2006
  • 小野 隆征; 平山 暁秀; 鳥本 一匡; 百瀬 均; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 97 (2) 307 - 307 2006
  • Shiomi T; Hirayama A; Fujimoto K; Hirao Y
    Int J urol 11 20 - 25 2006 [Refereed]
  • Hirayama A; Fujimoto K; Akiyama T; Hirao Y
    Urology 65 1064 - 1069 2006 [Refereed]
  • A Hirayama; K Fujimoto; Y Matsumoto; Y Hirao
    UROLOGY ELSEVIER SCIENCE INC 65 (6) 1064 - 1069 0090-4295 2005/06 [Refereed]
     
    Objectives. To investigate whether detrusor overactivity (DO) and the response to the ice water test (IWT) influence nighttime urinary frequency in patients with lower urinary tract symptoms. Methods. A total of 114 patients with lower urinary tract symptoms, who were older than 50 years, with an International Prostate Symptom Score 8 or more points and a quality of life index of 2 or greater, were evaluated by a 48-hour frequency-volume chart, free flowmetry, pressure flow study, and IWT. Results. The DO-positive IWT responders had a significantly greater bladder outlet obstruction index than did the DO-positive IWT nonresponders and the DO-negative IWT nonresponders. The DO-positive IWT responders had significantly more frequent nocturia and smaller nighttime maximal and minimal voided volumes than did the DO-negative IWT nonresponders without any difference in the nocturnal voided volume. The patients with nocturia two or more times had a significantly larger nocturnal voided volume and smaller nighttime minimal voided volume than the patients with nocturia less than two times. The incidence of DO-positive IWT responders was significantly greater among the patients with nocturia three or more times than that among those with nocturia less than three times. In the multivariate logistic model, the nocturnal voided volume and nighttime minimal voided volume were independently associated with nocturia two or more times and the DO-positive IWT responders were independently associated with nocturia three or more times. Conclusions. Once high-grade bladder outlet obstruction induces C-fiber-related DO, it is strongly suggested that this process, together with nocturnal polyuria, plays an important role in the consequent clinical manifestations of nocturia in patients with lower urinary tract symptoms.
  • 鳥本 一匡; 松吉 ひろ子; 松本 吉弘; 平山 暁秀; 藤本 清秀; 平尾 佳彦; 吉村 直樹
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 96 (2) 176 - 176 2005
  • 明山 達哉; 平山 暁秀; 谷 満; 鳥本 一匡; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 96 (2) 235 - 235 2005
  • 平山 暁秀; 松本 吉弘; 松吉 ひろ子; 藤本 清秀; 平尾 佳彦
    日本泌尿器科学会雑誌 一般社団法人 日本泌尿器科学会 95 (2) 472 - 472 2004
  • A Hirayama; K Fujimoto; Y Matsumoto; S Ozono; Y Hirao
    UROLOGY ELSEVIER SCIENCE INC 62 (5) 909 - 913 0090-4295 2003/11 [Refereed]
     
    Objectives. To elucidate the clinical significance of detrusor overactivity (DO) that is probably due to C-fiber activation caused by bladder outlet obstruction (BOO), we examined the responses to the ice water test (IWT) in patients with benign prostatic hyperplasia (BPH) and assessed the results with reference to the clinical manifestations and urodynamic findings. Methods. A total of 127 patients without neurologic disease, who were older than 50 years of age, with an International Prostate Symptom Score of 8 points or greater and a quality of life index of 2 or more points, were enrolled in this study. We tested the response to ice water instillation by monitoring the intravesical pressure in all cases and assessed the results with reference to the findings of International Prostate Symptom Score and quality of life index questionnaires, BOO indexes, 48-hour frequency volume charts, prostate volume, and data from free-flowmetry and pressure flow studies for detecting DO. Twenty patients with neurogenic bladder dysfunction underwent IWT as a control group. Results. The responders to the IWT accounted for 14 (70%) of the 20 patients with neurogenic bladder dysfunction and 35 (27%) of the 127 patients without neurologic disease. All of these responders showed DO on the pressure flow studies. The patients without neurologic disease who responded to the IWT had higher BOO indexes than did the nonresponders and had a smaller volume at a maximal desire to void on the urodynamic studies. The largest single-voided volume recorded from the 48-hour frequency volume charts was also smaller for the responders than for the nonresponders. Conclusions. The patients with BPH clearly showed that DO was mainly due to active C-fibers stimulated by high-grade BOO and that DO was a cause of urgency and frequency-related symptoms with decreased bladder capacity. It will be necessary to assess the inhibitory effect of capsaicin on DO caused by activation of C-fibers and the reversibility of C-fiber activation after surgical treatment for BPH, so that the criteria for decision-making for the treatment of BPH maybe clarified with the aid of the IWT. (C) 2003 Elsevier Inc.
  • Chihara Y; Fujimoto K; Takada S; Hirayama A; Cho M; Yoshida K; Ozono S, Hirao
    Int J urol 10 2003 [Refereed]

Books etc

  • 高齢者の下部尿路障害のクリニカル・パール
    平山 暁秀 (Contributor)2014
  • 夜間頻尿の発生機序と治療
    平山 暁秀 (Contributor)2014
  • 2011年卒後教育テキスト
    平山 暁秀 (Contributor)2011
  • 泌尿器科診療ガイド
    平山 暁秀 (Contributor)2011
  • 性器脱・尿失禁の治療
    平山 暁秀 (Contributor)2009
  • よくわかって役に立つ 前立腺肥大症のすべて
    平山 暁秀 (Contributor)2009
  • 排泄リハビリテーション
    平山 暁秀 (Contributor)2009
  • EBM 泌尿器疾患の治療
    平山 暁秀 (Contributor)2009
  • 夜間頻尿診療ガイドライン
    平山 暁秀 (Contributor)2009
  • ファーマナビゲーター 下部尿路機能障害編
    平山 暁秀 (Contributor)2008
  • Effects of clean intermitlent cathcterization on Bladder deformity in spina bitida patients
    Spina bitida(springer-verlag). 1999
  • やさしい過活動膀胱の自己管理
    平山 暁秀 (Contributor)

MISC

Awards & Honors

  • 2007/03 第7回オルガノン泌尿器科研究奨励賞
     
    受賞者: 平山 暁秀
  • 2005/03 第５回オルガノン泌尿器科研究奨励賞
     
    受賞者: 平山 暁秀

Research Grants & Projects

  • 地域高齢者の夜間頻尿が睡眠に及ぼす影響に関する研究
    日本学術振興会：
    Date (from‐to) : 2012 -2015 
    Author : 平山 暁秀
  • 睡眠障害は夜間頻尿の原因になるか?:簡易脳波睡眠診断を用いた検討
    日本学術振興会：
    Date (from‐to) : 2010 -2012 
    Author : 平尾佳彦
  • Genetic aberations in urinary disturbance
  • The development of Ambulatory Urodynamics with Telemetry system.

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