The structure and optical properties of carbon-doped titanium oxides, TiO2, in the rutile and anatase forms have been investigated theoretically from first principles. Two possible doping sites were studied, carbon at an oxygen site (anion doping) and carbon at a titanium site (cation doping). The calculated structures suggest that cation-doped carbon atoms form a carbonate-type structure, whereas anion-doped carbon atoms do not invoke any significant structural change. A density-of-states analysis revealed three in-gap impurity states for anion doping. The optical properties of anion-doped cells qualitatively agree with the experimentally reported visible-light absorbance values. We ascribe part of the absorption to transitions from the valence band to one of the impurity states. These transitions should be able to promote photocatalytic reactions, because electron holes in the valence band are considered to be crucial for this process. Neither in-gap impurity states nor visible-light absorbance were observed in the case of cation doping. The effect of oxygen vacancies was also investigated. Introduction of oxygen vacancies into anion-doped TiO2 populates the impurity states and thus suppresses photocatalysis. The interaction of a doped carbon atom with an oxygen vacancy at a finite spatial separation was also carried out. The possibility of either a carbon-oxygen vacancy pair or higher carbon-oxygen vacancy complex existing is discussed.

Background: Before the androgen target therapy era, flutamide was widely used for castrationresistant prostate cancer in Japan. Enzalutamide is currently the recommended treatment; however, the efficacy and safety of enzalutamide and flutamide after combined androgen blockade therapy with bicalutamide, has not been compared. Methods: Patients with castration-resistant prostate cancer who received combined androgen blockade therapy with bicalutamide were randomly assigned to receive either enzalutamide or flutamide. The primary endpoint for efficacy was the 3-month prostate-specific antigen response rate. This trial is registered with ClinicalTrials.gov (NCT02346578) and the University hospital Medical Information Network (UMIN000016301) Results: Overall, 103 patients were enrolled. The 3-(80.8% vs. 35.3%; p<0.001) and 6-month (73.1% vs. 31.4%; p<0.001) prostate-specific antigen response rates were higher in the enzalutamide than in the flutamide group. The 3-month disease progression rates (radiographic or prostate-specific antigen progression) were 6.4% and 38.8% in the enzalutamide and flutamide groups, respectively (hazard ratio [HR]: 0.16; 95% confidence interval [CI]: 0.05-0.47; p<0.001); the 6-month rates were 11.4% and 51.1%, respectively (HR: 0.22; 95% CI: 0.09-0.50; p<0.001). Enzalutamide provided superior prostate-specific antigen progression-free survival compared with flutamide (HR: 0.29; 95% CI: 0.15-0.54; p<0.001). Median time to prostate-specific antigen 4 progression-free survival was not reached and was 6.6 months in the enzalutamide and flutamide groups, respectively. Conclusions: As an alternative anti-androgen therapy in patients with castration-resistant prostate cancer who fail bicalutamide-combined androgen blockade therapy, enzalutamide provides superior clinical outcomes compared with flutamide. Enzalutamide should be preferred over flutamide in these patients.

This article presents a new transurethral resection (TUR) system for use in endoscopic surgery. By using an electroconductive solution (physiological saline) as the perfusate in lieu of conventional non-electroconductive solution (Uromatic), additional anesthesia (e.g., obturator nerve blocking) is not required. The new TUR is carried out in an electroconductive solution such as saline, and because radiofrequency current flows from the resecting electrode through the perfusate to the outer sheath, no counter-electrode is needed. We have treated both bladder tumor and benign prostatic hyperplasia cases with this new system. Surgery was safely performed in all TUR-bt cases without requiring obturator nerve blocking. During both TUR-bt and transurethral resection of the prostate (TUR-P) using this system, tissue resection and coagulation equivalents were similar to the conventional TUR system. In previous TUR, preoperative obturator nerve blocking was necessary, and in some cases, incomplete blocking or complications occurred. When physiological saline is used as the perfusate, blood electrolyte levels are not greatly changed, even after extensive resection of the bladder wall; as a result, this new system is also cost effective because physiological saline is less expensive than non-electroconductive solutions and requires no counter-electrode. Thus, in comparison with conventional TUR, this new system is both significantly safer and more cost effective.

Objectives: To examine the difference in improvement of lower urinary tract symptoms between morning and evening dosing of α1-blocker naftopidil. Methods: A total of 177 male patients with nocturia were included in the present study and randomized to morning or evening dosing of naftopidil. The International Prostate Symptom Score, quality of life index and nocturia quality of life index were compared between the two study groups at 12 weeks. Results: A total of 143 patients (morning group: n = 70, evening group: n = 73) were analyzed as a result of the dropout of 34 patients because of failure to give consent, adverse events and failure to attend. Nocturia, quality of life index and nocturia quality of life index at 12 weeks were significantly better in the evening group compared with the morning group. In a multivariate model, both the dosing time of naftopidil and the initial nocturia quality of life index were significantly associated with change in nocturia quality of life index. Conclusions: Evening dosing of naftopidil seems to be more effective in treating nocturia in male patients with lower urinary tract symptoms.

We report on a case of renal cell carcinoma (RCC) with hemorrhagic cyst formation in a 4-year-old boy. The patient presented with asymptomatic macrohematuria. Abdominal ultrasound, computed tomography and magnetic resonance imaging demonstrated a left renal complicated cyst, 18 mm in diameter. Renal malignancy was suspected, and left radical nephrectomy was performed. Pathological diagnosis was a complicated cyst filled with bloody clots, with a wall composed of RCC. No metastases to the regional lymph nodes or other organs were found. This is an extremely rare occurrence of such a small RCC that developed a hemorrhagic cyst in a boy of this young age. The boy is being followed-up without any additional treatment.