Yoshio Naya - Academia.edu (original) (raw)

Papers by Yoshio Naya

European Urology, Jul 1, 2004

Backgrounds: The aim of this study is to ascertain whether Bayer complexed PSA (cPSA) and volume ... more Backgrounds: The aim of this study is to ascertain whether Bayer complexed PSA (cPSA) and volume referenced cPSA could enhance the detection of prostate cancer in Japanese men. Methods: A total of 214 Japanese men whose serum total PSA (tPSA) values ranged from 1.2 ng/ml to 4600 ng/ml were enrolled from two institutions. Serum samples for tPSA, free PSA, PSA-alpha-1-antichymotripsin (PSA-ACT) and cPSA (ADVIA-Centaur) were obtained in all cases. In addition, total gland (TGV) as well as transition zone volume (TZV) were determined in all cases who underwent untrasound guided prostate biopsy (sextant and two additional transition zone biopsies). Biopsy outcome was correlated to the following parameters: tPSA, cPSA, PSA-ACT, free to total (F/T) PSA ratio, 2 complex to total (C/T) PSA ratios and 6 volume referenced parameters. Results: Prostate cancer was detected in 85 of 214 patients (40%). The area under the receiver operating characteristic curve in non-volume referenced variables was highest for cPSA (0.736), followed by PSA-ACT (0.735), tPSA (0.722), F/T PSA ratio (0.613) and C/T PSA ratio (0.591). Comparing tPSA with the cutoff value of 4.0 ng/ml, the cutoff value with a 2.8 ng/ml of cPSA detected one more positive biopsy patient, decreasing one more cancer missed case and 8 more false positive cases. At sensitivities of 85% to 95% in men with tPSA between 4.00 and 10.00 ng/ml (n ¼ 116), there were no significant differences in the corresponding specificities between tPSA and cPSA, or between cPSA and PSA-ACT. At sensitivities of 90% to 95%, the corresponding specificities of PSA-ACT adjusted for transition zone volume revealed best performance. As for the performance in men with a tPSA less than 4.0 ng/ml, the specificities of cPSA performed best, and differed significantly from PSA-ACT and F/T PSA at sensitivities of 80% to 90%. Conclusion: Bayer cPSA could replace the first screening test by total PSA and can enhance cancer detection, compared with PSA-ACT. However, cPSA did not provide additional value in differentiating cancer from noncancer cases in men with a tPSA between 4.00 and 10.00 ng/ml.

The Journal of Urology, Apr 1, 1999

Ultrasound in Medicine and Biology, 1997

Power Doppler imaging was performed in 77 patients with lower urinary tract symptoms to character... more Power Doppler imaging was performed in 77 patients with lower urinary tract symptoms to characterize Doppler blood-flow signals in benign prostatic hyperplasia (BPH). Pulsatile blood flows were detected in all patients, demonstrating a significant increase of the resistive index (RI) in BPH cases (n = 40, 0.72 +-0.05, p c O.OOOl), compared to those with a healthy prostate (n = 37, 0.64 + 0.04). Of 40 patients with BPH, 28 (70%) had an RI of 0.70 or higher; all but 1 patient with a healthy prostate (1 of 37,3%) had an RI lower than 0.70 (p < 0.0001). In all 10 patients with BPH, the elevated RI decreased significantly to a normal control level after surgical treatment (0.72 2 0.02 vs. 0.64 f 0.05, p < 0.001). In conclusion, Doppler RI might be useful as a new urodynamic parameter in BPH.

Journal of The National Comprehensive Cancer Network, May 1, 2004

Prostate cancer is a clinically significant health care problem in the United States. Total prost... more Prostate cancer is a clinically significant health care problem in the United States. Total prostate specific antigen (tPSA) is widely used to detect prostate cancer with a significant increase in the incidence of organ-confined disease at the time of diagnosis. The limitations of tPSA are low specificity and positive predictive value. Numerous attempts to enhance PSA's performance based on prostate volume, patient age, patient race, and PSA velocity have shown little clinical improvement. Percent free PSA has proven to be somewhat improved but still limited. Recently, the complexed PSA (cPSA) assay was developed and multisite institutional studies have shown that cPSA has improved specificity over tPSA. Complexed PSA can replace tPSA as a first screening test. (JNCCN 2004;2:209-212).

The Journal of Urology, Apr 1, 2012

naires. Participants' opinion of ED as medical, psychological or lifestyle conditions and its ass... more naires. Participants' opinion of ED as medical, psychological or lifestyle conditions and its associations with cardiac co-morbidities were analyzed. Subjects' views on PDE5-I and TCM in relation to safety, and acceptance were also studied. Sub-analysis of cohort's race, gender, age, income, educational levels and sexual activeness were demonstrated. ACCEPT was conducted in Malaysia as the population represents diversity in Asia. RESULTS: Amongst 3372 subjects recruited (2032 males, 1340 females), 75%, 68% and 75% believed ED is a medical, lifestyle and psychological condition, respectively. Overall, 59%, 53% and 50% of participants did not associate ED with respective hyperlipidemia, heart disease and hypertension; while 83% related it to depression. A total of 89% thought ED is treatable with PDE5-I with 82% efficacy; while TCM had 62% treatability and 73% effectiveness on ED. PDE5-I is considered safe in 73% against 57% for TCM, while 33% and 30% believed the options are linked to sudden death, respectively. Forty five percent of the participants assumed PDE5-I to be addictive versus 38% on TCM. PDE5-I is considered trustworthy by 75% of all and 74% are willing to accept it as first line treatment, compared to 54% trusting TCM with 49% acceptability. CONCLUSIONS: The acceptance of ED as a medical condition may enable clinician to identify cardiac risk factors at early stages and also determine treatment-seeking behavior in men. ACCEPT study identified conflicting perceptions of ED as medical, as well as lifestyle and psychological conditions. Overall, the association of ED with depression is significantly higher than cardiac risk factors. Despite relatively short availability of PDE5-I in Asia, compared to TCM, our data revealed favorable perception of PDE5-I on efficacy, safety, trustworthiness and acceptability. However, TCM is still widely regarded as an important treatment option. The sub-analysis of the cohort may enable targeted awareness on certain populations.

Urology, Oct 1, 2009

Introduction and Objectives: ED affects quality of life in elderly men. We evaluated PDE5 inhibit... more Introduction and Objectives: ED affects quality of life in elderly men. We evaluated PDE5 inhibitors, intracavernous injections and penile prosthesis in men over 65 years. Materials and Methods: There were 505 patients who consulted a single urologist for ED between 2004 and 2008 at our institution, of whom 96 (19%) were older than 65. ED severity, aetiology and treatments efficiency were retrospectively reviewed. The treatment was considered successful when erection allowed penetration. The first line therapy was PDE5 inhibitors, except after radical prostatectomy. Intracavernous injections (ICI) were used in case of failure. Penile prosthesis was proposed if necessary. Mean follow up was 23.2 months. Results: Mean age was 69.1 Ϯ 3.8 years. ED was complete in 60.3%. Aetiology was organic in 89.6% (42.7% after pelvic surgery) and multifactorial in 59.4%. Furthermore, half of ED (51.7%) were partially drug-induced. PDE5 inhibitors were contraindicated in 5.2% of patients. PDE5 inhibitors mean success rate was 27.4% but 29.4% of satisfied patients stopped oral therapy because of its cost. After exclusion of pelvic surgery postoperative ED patients, PDE5 inhibitors mean success rate was 36.4%. Mean ICI success rate was 64% and 70.7% after pelvic surgery. However 37.5% of ICI responders interrupted the treatment because of difficulty to use, pain or priapism. Penile prosthesis was implanted in 16 patients (17.2%) with a satisfaction rate of 87.5%. Only 46.5% of patients were satisfied with first line therapy. No successful ED treatment was found in 39.2% of patients (50% after pelvic surgery and 32.7% in other aetiologies). Conclusions: After 65, PDE5 inhibitors were found to be less successful than described in younger patient. History of cardiovascular disease, pelvic surgery and treatments adverse effects hamper ED treatment success rate. According to these results, the current treatment algorithm for ED might be adjusted in the elderly.

Urologia Internationalis, Nov 20, 2013

Objective: The efficacy of skin icing to reduce the pain of goserelin injection has been reported... more Objective: The efficacy of skin icing to reduce the pain of goserelin injection has been reported. We investigated the optimal icing time with a frozen gel pack and its effectiveness. Methods: Abdominal skin temperatures of 49 healthy volunteers were measured after application of the frozen gel pack for 10, 15 and 30 s, and it was decided that a 15-second icing was adequate. For 55 consecutive patients who received goserelin (10.8 mg) injection, pain was evaluated employing a visual analog scale (VAS). The first injection was administered routinely. A second injection was administered after skin icing in 27 of 55 patients who wanted to try icing. At the time of the third injection, all patient decided whether they were to receive icing or the routine method. Results: After icing, VAS scores decreased in 20 of 27 patients. At the third injection, 18 patients requested icing. Conclusion: When a patient complains of injection pain, the icing method should be considered for pain reduction.

The Prostate, 1993

The maximum horizontal area (MHA) of the seminal vesicles was measured in 20 prostatic cancer pat... more The maximum horizontal area (MHA) of the seminal vesicles was measured in 20 prostatic cancer patients by means of transrectal sonography (TRS) after LHRH analog treatment. MHA of the seminal vesicles changed in parallel to the serum testosterone (T) level and decreased by 11-62%, compared with the baseline after LHRH analog treatment for 4 months. Two different patterns were observed for the change of MHA. In 9 cases, MHA of the seminal vesicles increased transiently and then decreased gradually, while in the other 11 cases, MHA decreased continuously from the beginning with no significant increase. Thus, the direct and dynamic response of the seminal vesicles to the change of serum T level was clarified.

Urology, Feb 1, 2006

Objectives. To compare the distribution of total and complexed prostate-specific antigen (cPSA) i... more Objectives. To compare the distribution of total and complexed prostate-specific antigen (cPSA) in men with and without prostate cancer with another studied population and to ascertain whether cPSA could enhance the detection of prostate cancer in Japanese men. Methods. A total of 760 men whose serum total PSA (tPSA) values ranged from 1.0 to 100 ng/mL were enrolled. Serum samples for tPSA and cPSA (ADVIA Centaur) were obtained in all cases. The area under the curve was calculated for comparison of the tPSA and cPSA values. We calculated the number of cancers missed and false-positive results at various cutoff values of cPSA compared with the conventional tPSA threshold of 4.0 ng/mL. Results. Prostate cancer was detected in 268 (35.3%) of 760 patients. cPSA was greater than 8.3 ng/mL (equivalent to 10.0 ng/mL tPSA) in 46.6% of the men with cancer. The area under the curve for cPSA (0.741) was significantly better than that for tPSA (0.721, P Ͻ0.001). At a sensitivity of 85% to 95%, significant differences were found in the corresponding specificity between tPSA and cPSA. cPSA at a 3.0-ng/mL threshold detected an identical number of cancers as a tPSA cutoff of 4.0 ng/mL; however, it decreased the false-positive results by 28 cases. Conclusions. To our knowledge, this is the first report of the distribution of cPSA in Japanese men using a urologic referral population. cPSA can be an alternative to tPSA as the first screening test. A substantial number of men in Japan with prostate cancer are currently diagnosed with a tPSA value greater than 10.0 ng/mL.

International Journal of Impotence Research, Feb 2, 2006

The aim of the present study was to evaluate the relationship between motorcycling and erectile d... more The aim of the present study was to evaluate the relationship between motorcycling and erectile dysfunction (ED). We investigated the relationship between motorcycling and erectile function using the 5-items version of the International Index of Erectile Function (IIEF5) in 234 motorcyclists (response rate 75%) and 752 healthy controls (response rate 66%). In all, 161 (69%) of 234 motorcyclists were diagnosed as ED based on IIEF5. The prevalence of ED in the motorcycle group increased by age as: 58, 63, 76 and 93%, for motorcyclists in 20-29, 30-39, 40-49 and 50-59 years, respectively. There was a significant difference in the prevalence of ED between the motorcycle group and the control group in all age groups. On stepwise logistic regression analysis, motorcycling was the strongest risk factor for ED. Although the severity of ED in motorcyclists was not so severe, motorcycling may be one of risk factors for ED.

Urology, Oct 1, 1997

Objectives. To examine the predictive value of ultrasonic measurements obtained by transrectal ul... more Objectives. To examine the predictive value of ultrasonic measurements obtained by transrectal ultrasonography for infravesical obstruction as evaluated by pressure flow studies. Methods. In 85 men with moderate to severe lower urinary tract symptoms, ultrasonic measurements including prostatic volume, transition zone volume, transition zone index (transition zone volume/prostatic volume), and presumed circle area ratio (PCAR) were compared with urodynamic parameters obtained by pressure flow studies. Results. There were significant interrelationships between these ultrasonic measurements, which were all significantly greater in the obstructed patients than in the unobstructed patients. A simple regression analysis demonstrated that prostatic volume (I-= 0.362, P < 0.00 1), transition zone volume (r = 0.373, P < 0.0005), transition zone index (r = 0.331, P < 0.005). and PCAR (r = 0.487, P < 0.0001) correlated significantly with the Abrams-Griffiths number. More importantly, a multiple regression analysis demonstrated PCAR to be the only independent determinant of the Abrams-Griffiths number. A receiver operator characteristics curve analysis showed that 0.8 was the most suitable cutoff value of PCAR for the prediction of infravesical obstruction with a diagnostic accuracy of 76.5%. Conclusions. PCAR is useful as a transrectal ultrasonic measurement in assessing the severity of infravesical obstruction in men with lower urinary tract symptoms.

日本性機能学会雑誌 = The japanese journal of Impotence Research, Aug 1, 2006

International Journal of Clinical Oncology, 2016

Neurourology and Urodynamics, 2013

The Journal of Urology, Apr 1, 2016

The Journal of Urology, Apr 1, 2013

Ultrasound in Medicine and Biology, 1997

Recently, we developed the measurement of UEBW and reported its usefulness as a measure of bladde... more Recently, we developed the measurement of UEBW and reported its usefulness as a measure of bladder hypertrophy in clinical settings (1). UEBW could predict infravesical obstruction with a diagnostic accuracy as high as 86.2% in men with substantial urinary symptoms (2). This study was designed to test the reproducibility of UEBW measurement. The overall mean UEBW of the first measurement and that of the second one by one observer on 36 cases was 42.8 + 22.6~ and 42.9 f 22.69. resDectivelv.

Tohoku Journal of Experimental Medicine, 1997

European Urology, Jul 1, 2004

Backgrounds: The aim of this study is to ascertain whether Bayer complexed PSA (cPSA) and volume ... more Backgrounds: The aim of this study is to ascertain whether Bayer complexed PSA (cPSA) and volume referenced cPSA could enhance the detection of prostate cancer in Japanese men. Methods: A total of 214 Japanese men whose serum total PSA (tPSA) values ranged from 1.2 ng/ml to 4600 ng/ml were enrolled from two institutions. Serum samples for tPSA, free PSA, PSA-alpha-1-antichymotripsin (PSA-ACT) and cPSA (ADVIA-Centaur) were obtained in all cases. In addition, total gland (TGV) as well as transition zone volume (TZV) were determined in all cases who underwent untrasound guided prostate biopsy (sextant and two additional transition zone biopsies). Biopsy outcome was correlated to the following parameters: tPSA, cPSA, PSA-ACT, free to total (F/T) PSA ratio, 2 complex to total (C/T) PSA ratios and 6 volume referenced parameters. Results: Prostate cancer was detected in 85 of 214 patients (40%). The area under the receiver operating characteristic curve in non-volume referenced variables was highest for cPSA (0.736), followed by PSA-ACT (0.735), tPSA (0.722), F/T PSA ratio (0.613) and C/T PSA ratio (0.591). Comparing tPSA with the cutoff value of 4.0 ng/ml, the cutoff value with a 2.8 ng/ml of cPSA detected one more positive biopsy patient, decreasing one more cancer missed case and 8 more false positive cases. At sensitivities of 85% to 95% in men with tPSA between 4.00 and 10.00 ng/ml (n ¼ 116), there were no significant differences in the corresponding specificities between tPSA and cPSA, or between cPSA and PSA-ACT. At sensitivities of 90% to 95%, the corresponding specificities of PSA-ACT adjusted for transition zone volume revealed best performance. As for the performance in men with a tPSA less than 4.0 ng/ml, the specificities of cPSA performed best, and differed significantly from PSA-ACT and F/T PSA at sensitivities of 80% to 90%. Conclusion: Bayer cPSA could replace the first screening test by total PSA and can enhance cancer detection, compared with PSA-ACT. However, cPSA did not provide additional value in differentiating cancer from noncancer cases in men with a tPSA between 4.00 and 10.00 ng/ml.

The Journal of Urology, Apr 1, 1999

Ultrasound in Medicine and Biology, 1997

Power Doppler imaging was performed in 77 patients with lower urinary tract symptoms to character... more Power Doppler imaging was performed in 77 patients with lower urinary tract symptoms to characterize Doppler blood-flow signals in benign prostatic hyperplasia (BPH). Pulsatile blood flows were detected in all patients, demonstrating a significant increase of the resistive index (RI) in BPH cases (n = 40, 0.72 +-0.05, p c O.OOOl), compared to those with a healthy prostate (n = 37, 0.64 + 0.04). Of 40 patients with BPH, 28 (70%) had an RI of 0.70 or higher; all but 1 patient with a healthy prostate (1 of 37,3%) had an RI lower than 0.70 (p < 0.0001). In all 10 patients with BPH, the elevated RI decreased significantly to a normal control level after surgical treatment (0.72 2 0.02 vs. 0.64 f 0.05, p < 0.001). In conclusion, Doppler RI might be useful as a new urodynamic parameter in BPH.

Journal of The National Comprehensive Cancer Network, May 1, 2004

Prostate cancer is a clinically significant health care problem in the United States. Total prost... more Prostate cancer is a clinically significant health care problem in the United States. Total prostate specific antigen (tPSA) is widely used to detect prostate cancer with a significant increase in the incidence of organ-confined disease at the time of diagnosis. The limitations of tPSA are low specificity and positive predictive value. Numerous attempts to enhance PSA's performance based on prostate volume, patient age, patient race, and PSA velocity have shown little clinical improvement. Percent free PSA has proven to be somewhat improved but still limited. Recently, the complexed PSA (cPSA) assay was developed and multisite institutional studies have shown that cPSA has improved specificity over tPSA. Complexed PSA can replace tPSA as a first screening test. (JNCCN 2004;2:209-212).

The Journal of Urology, Apr 1, 2012

naires. Participants' opinion of ED as medical, psychological or lifestyle conditions and its ass... more naires. Participants' opinion of ED as medical, psychological or lifestyle conditions and its associations with cardiac co-morbidities were analyzed. Subjects' views on PDE5-I and TCM in relation to safety, and acceptance were also studied. Sub-analysis of cohort's race, gender, age, income, educational levels and sexual activeness were demonstrated. ACCEPT was conducted in Malaysia as the population represents diversity in Asia. RESULTS: Amongst 3372 subjects recruited (2032 males, 1340 females), 75%, 68% and 75% believed ED is a medical, lifestyle and psychological condition, respectively. Overall, 59%, 53% and 50% of participants did not associate ED with respective hyperlipidemia, heart disease and hypertension; while 83% related it to depression. A total of 89% thought ED is treatable with PDE5-I with 82% efficacy; while TCM had 62% treatability and 73% effectiveness on ED. PDE5-I is considered safe in 73% against 57% for TCM, while 33% and 30% believed the options are linked to sudden death, respectively. Forty five percent of the participants assumed PDE5-I to be addictive versus 38% on TCM. PDE5-I is considered trustworthy by 75% of all and 74% are willing to accept it as first line treatment, compared to 54% trusting TCM with 49% acceptability. CONCLUSIONS: The acceptance of ED as a medical condition may enable clinician to identify cardiac risk factors at early stages and also determine treatment-seeking behavior in men. ACCEPT study identified conflicting perceptions of ED as medical, as well as lifestyle and psychological conditions. Overall, the association of ED with depression is significantly higher than cardiac risk factors. Despite relatively short availability of PDE5-I in Asia, compared to TCM, our data revealed favorable perception of PDE5-I on efficacy, safety, trustworthiness and acceptability. However, TCM is still widely regarded as an important treatment option. The sub-analysis of the cohort may enable targeted awareness on certain populations.

Urology, Oct 1, 2009

Introduction and Objectives: ED affects quality of life in elderly men. We evaluated PDE5 inhibit... more Introduction and Objectives: ED affects quality of life in elderly men. We evaluated PDE5 inhibitors, intracavernous injections and penile prosthesis in men over 65 years. Materials and Methods: There were 505 patients who consulted a single urologist for ED between 2004 and 2008 at our institution, of whom 96 (19%) were older than 65. ED severity, aetiology and treatments efficiency were retrospectively reviewed. The treatment was considered successful when erection allowed penetration. The first line therapy was PDE5 inhibitors, except after radical prostatectomy. Intracavernous injections (ICI) were used in case of failure. Penile prosthesis was proposed if necessary. Mean follow up was 23.2 months. Results: Mean age was 69.1 Ϯ 3.8 years. ED was complete in 60.3%. Aetiology was organic in 89.6% (42.7% after pelvic surgery) and multifactorial in 59.4%. Furthermore, half of ED (51.7%) were partially drug-induced. PDE5 inhibitors were contraindicated in 5.2% of patients. PDE5 inhibitors mean success rate was 27.4% but 29.4% of satisfied patients stopped oral therapy because of its cost. After exclusion of pelvic surgery postoperative ED patients, PDE5 inhibitors mean success rate was 36.4%. Mean ICI success rate was 64% and 70.7% after pelvic surgery. However 37.5% of ICI responders interrupted the treatment because of difficulty to use, pain or priapism. Penile prosthesis was implanted in 16 patients (17.2%) with a satisfaction rate of 87.5%. Only 46.5% of patients were satisfied with first line therapy. No successful ED treatment was found in 39.2% of patients (50% after pelvic surgery and 32.7% in other aetiologies). Conclusions: After 65, PDE5 inhibitors were found to be less successful than described in younger patient. History of cardiovascular disease, pelvic surgery and treatments adverse effects hamper ED treatment success rate. According to these results, the current treatment algorithm for ED might be adjusted in the elderly.

Urologia Internationalis, Nov 20, 2013

Objective: The efficacy of skin icing to reduce the pain of goserelin injection has been reported... more Objective: The efficacy of skin icing to reduce the pain of goserelin injection has been reported. We investigated the optimal icing time with a frozen gel pack and its effectiveness. Methods: Abdominal skin temperatures of 49 healthy volunteers were measured after application of the frozen gel pack for 10, 15 and 30 s, and it was decided that a 15-second icing was adequate. For 55 consecutive patients who received goserelin (10.8 mg) injection, pain was evaluated employing a visual analog scale (VAS). The first injection was administered routinely. A second injection was administered after skin icing in 27 of 55 patients who wanted to try icing. At the time of the third injection, all patient decided whether they were to receive icing or the routine method. Results: After icing, VAS scores decreased in 20 of 27 patients. At the third injection, 18 patients requested icing. Conclusion: When a patient complains of injection pain, the icing method should be considered for pain reduction.

The Prostate, 1993

The maximum horizontal area (MHA) of the seminal vesicles was measured in 20 prostatic cancer pat... more The maximum horizontal area (MHA) of the seminal vesicles was measured in 20 prostatic cancer patients by means of transrectal sonography (TRS) after LHRH analog treatment. MHA of the seminal vesicles changed in parallel to the serum testosterone (T) level and decreased by 11-62%, compared with the baseline after LHRH analog treatment for 4 months. Two different patterns were observed for the change of MHA. In 9 cases, MHA of the seminal vesicles increased transiently and then decreased gradually, while in the other 11 cases, MHA decreased continuously from the beginning with no significant increase. Thus, the direct and dynamic response of the seminal vesicles to the change of serum T level was clarified.

Urology, Feb 1, 2006

Objectives. To compare the distribution of total and complexed prostate-specific antigen (cPSA) i... more Objectives. To compare the distribution of total and complexed prostate-specific antigen (cPSA) in men with and without prostate cancer with another studied population and to ascertain whether cPSA could enhance the detection of prostate cancer in Japanese men. Methods. A total of 760 men whose serum total PSA (tPSA) values ranged from 1.0 to 100 ng/mL were enrolled. Serum samples for tPSA and cPSA (ADVIA Centaur) were obtained in all cases. The area under the curve was calculated for comparison of the tPSA and cPSA values. We calculated the number of cancers missed and false-positive results at various cutoff values of cPSA compared with the conventional tPSA threshold of 4.0 ng/mL. Results. Prostate cancer was detected in 268 (35.3%) of 760 patients. cPSA was greater than 8.3 ng/mL (equivalent to 10.0 ng/mL tPSA) in 46.6% of the men with cancer. The area under the curve for cPSA (0.741) was significantly better than that for tPSA (0.721, P Ͻ0.001). At a sensitivity of 85% to 95%, significant differences were found in the corresponding specificity between tPSA and cPSA. cPSA at a 3.0-ng/mL threshold detected an identical number of cancers as a tPSA cutoff of 4.0 ng/mL; however, it decreased the false-positive results by 28 cases. Conclusions. To our knowledge, this is the first report of the distribution of cPSA in Japanese men using a urologic referral population. cPSA can be an alternative to tPSA as the first screening test. A substantial number of men in Japan with prostate cancer are currently diagnosed with a tPSA value greater than 10.0 ng/mL.

International Journal of Impotence Research, Feb 2, 2006

The aim of the present study was to evaluate the relationship between motorcycling and erectile d... more The aim of the present study was to evaluate the relationship between motorcycling and erectile dysfunction (ED). We investigated the relationship between motorcycling and erectile function using the 5-items version of the International Index of Erectile Function (IIEF5) in 234 motorcyclists (response rate 75%) and 752 healthy controls (response rate 66%). In all, 161 (69%) of 234 motorcyclists were diagnosed as ED based on IIEF5. The prevalence of ED in the motorcycle group increased by age as: 58, 63, 76 and 93%, for motorcyclists in 20-29, 30-39, 40-49 and 50-59 years, respectively. There was a significant difference in the prevalence of ED between the motorcycle group and the control group in all age groups. On stepwise logistic regression analysis, motorcycling was the strongest risk factor for ED. Although the severity of ED in motorcyclists was not so severe, motorcycling may be one of risk factors for ED.

Urology, Oct 1, 1997

Objectives. To examine the predictive value of ultrasonic measurements obtained by transrectal ul... more Objectives. To examine the predictive value of ultrasonic measurements obtained by transrectal ultrasonography for infravesical obstruction as evaluated by pressure flow studies. Methods. In 85 men with moderate to severe lower urinary tract symptoms, ultrasonic measurements including prostatic volume, transition zone volume, transition zone index (transition zone volume/prostatic volume), and presumed circle area ratio (PCAR) were compared with urodynamic parameters obtained by pressure flow studies. Results. There were significant interrelationships between these ultrasonic measurements, which were all significantly greater in the obstructed patients than in the unobstructed patients. A simple regression analysis demonstrated that prostatic volume (I-= 0.362, P < 0.00 1), transition zone volume (r = 0.373, P < 0.0005), transition zone index (r = 0.331, P < 0.005). and PCAR (r = 0.487, P < 0.0001) correlated significantly with the Abrams-Griffiths number. More importantly, a multiple regression analysis demonstrated PCAR to be the only independent determinant of the Abrams-Griffiths number. A receiver operator characteristics curve analysis showed that 0.8 was the most suitable cutoff value of PCAR for the prediction of infravesical obstruction with a diagnostic accuracy of 76.5%. Conclusions. PCAR is useful as a transrectal ultrasonic measurement in assessing the severity of infravesical obstruction in men with lower urinary tract symptoms.

日本性機能学会雑誌 = The japanese journal of Impotence Research, Aug 1, 2006

International Journal of Clinical Oncology, 2016

Neurourology and Urodynamics, 2013

The Journal of Urology, Apr 1, 2016

The Journal of Urology, Apr 1, 2013

Ultrasound in Medicine and Biology, 1997

Recently, we developed the measurement of UEBW and reported its usefulness as a measure of bladde... more Recently, we developed the measurement of UEBW and reported its usefulness as a measure of bladder hypertrophy in clinical settings (1). UEBW could predict infravesical obstruction with a diagnostic accuracy as high as 86.2% in men with substantial urinary symptoms (2). This study was designed to test the reproducibility of UEBW measurement. The overall mean UEBW of the first measurement and that of the second one by one observer on 36 cases was 42.8 + 22.6~ and 42.9 f 22.69. resDectivelv.

Tohoku Journal of Experimental Medicine, 1997