The purpose of the present investigation was to examine the relationship between the open water swimming (OW) performance and the swimming speed at 2, 3, and 4 mmol/l of blood lactate concentration (SSLA2, SSLA3, and SSLA4) or the critical swimming speed (CSS). Six male collegiate swimmers performed the 10 kilometers of OW, as well as the multi-stage graded swimming test, in order to determine the SSLA2, SSLA3, SSLA4. Furthermore, the CSS was calculated based on the personal best records for 50 to 1500 meters of free-style indoor swimming. As a result, the SSLA2, SSLA3, SSLA4, and CSS corresponded to 102±6%, 106±6%, 110±7%, and 106±5% of the average swimming speed of the OW, respectively. Thereafter, the SSLA2 did not differ significantly in comparison to the average swimming speed of the OW, whereas the SSLA3, SSLA4, and CSS differed significantly with the average swimming speed of the OW (p＜0.05). Furthermore, the average swimming speed during the OW significantly correlated with the SSLA2, SSLA3, SSLA4, and CSS, respectively (p＜0.05). These results suggest that the OW performance significantly correlated with the swimming speed at 2 to 3 mmol/l of the blood lactate concentrations and CSS. Furthermore, regarding these parameters, the SSLA2 may accurately reflect the average swimming speed of OW.

Objective: There are few reports of the long-term outcomes of elderlypatients with prostate cancer. We analyzed data from our institution from the past 12years, including the patient history, treatment methods, and prognosis of patients withprostate cancer aged 80 years or more.

Patients and Methods: A total of 179 cases of prostate cancer in patientsaged 80 years or more were retrospectively evaluated. We divided them chronologically intogroups A, B, C, and D: Group A included 40 cases from 2002–2004; Group B, 48 cases from2005–2007; Group C, 46 cases from 2008–2010; and Group D, 45 cases from 2011–2013.

Results: Sixty-one (30%) patients changed treatment course. Interestingly,no cancer deaths occurred in the patients who changed treatment course. Although 14 (7.8%)cancer deaths occurred (A: B: C: D = 4: 4: 6: 0, respectively), all occurred in 2011 orlater.

Conclusion: In our study, over 50 patients who underwent treatment survivedfor 5 years or more. By treating prostate cancer in elderly patients when appropriate, wecan lower the mortality rate due to prostate cancer. Our results support the activetreatment of prostate cancer in elderly patients.

Objectives: Gauze remnants form gauzeomas after surgery, if infection has not occurred. We present a case of gauzeoma diagnosed after surgery.Patient: A 72-year-old man noticed a mass in his lower abdomen. He had undergone surgery for left inguinal hernia 21 years ago. A retroperitoneal mass was found on computed tomography (CT) and magnetic resonance imaging (MRI), and he was then referred to our hospital. A detailed abdominal ultrasonography, CT, and MRI revealed a cystic mass with a bulkhead-like structure near the bladder. These findings indicated the possibility of a malignant cyst; hence, an open surgery was performed to excise the mass. Macroscopically, the specimen was clearly bound, covered with a capsule, and filled with pus and had a gauze inside.Results: Based on the patient history and position of the mass, it was diagnosed as gauzeoma, which had strayed into the retroperitoneal cavity during the surgery for inguinal hernia.Conclusion: The imaging findings of gauzeoma are diverse; hence, it is often difficult to diagnose without surgery. However, gauzeoma can be lethal if the cystic mass is infected; thus, it is important to diagnose it correctly.

A 76-year-old Japanese man visited a nearby medical clinic complaining of abdominal distention. He had undergone extraperitoneal laparoscopic prostatectomy at our institution 5 months before the onset of abdominal distention. An imaging study revealed a large cystic lesion, and biochemical examination of a sample obtained via cyst puncture led to a diagnosis of lymphocele. As the lymphocele was resistant to puncture, drainage, and sclerotherapy with minomycin, laparoscopic fenestration was performed. Although the patient developed an adhesive ileus postoperatively, the cyst has not recurred. Fenestration surgery is a feasible option for lymphocele refractory to various conservative therapies.

Introduction: Cabazitaxel (CBZ) is used worldwide for castration-resistant prostate cancer after docetaxel treatment. In July 2014 the drug was approved in Japan with the same induction dose used for Caucasian patients. In this study, we examined and compared the results of an initial low-dose CBZ treatment in patients admitted to our hospital.Patients and Methods: Between July 2014 and August 2018, sixteen mCRPC patients were enrolled and underwent a low-dose CBZ treatment at our hospital. We compared the results with those of a Japanese metastatic docetaxel- and castration-resistant prostate cancer Phase I study.Results: The median patient age was 77 years (range, 53–84 years). Of the 16 patients, eight (50%) had a lymph node metastasis and 11 (68.8%) had a distant metastasis, 10 of whom had only a bone metastasis. The median dose of CBZ was 30 mg (range, 20–32 mg) and the median number of CBZ cycles was 2.5 (range, 1–18). The PSA level of 9 (56.3%) patients decreased after CBZ treatment, including 4 (25%) who showed a decrease to <50%. The median time interval in which the PSA level decreased was 2 months (range, 1–18 months). The observed adverse events (AE) were neutropenia (31.3%), febrile neutropenia (6.3%), fatigue (43.8%), nausea (18.8%), diarrhea (12.5%), decreased appetite (25%), dysgeusia (6.3%), white blood cell count decrease (43.8%), platelet count decrease (12.3%), and anemia (75%). However, no patient listed an AE as the reason for discontinuing the treatment.Conclusions: Even at a low dose, CBZ could improve the PSA value in patients with CRPC previously treated with docetaxel. Dose reduction and prophylactic administration of sustained G-CSF were also safe treatment options. Further studies involving an introduction period including a modulation of duration and dose are necessary, especially in Japanese patients.