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Our A.,Hoshigaoka Koseinenkin Hospital
Nippon Ganka Gakkai zasshi | Year: 2010

PURPOSE: To investigate risk factors for visual impairment following bleb-related infection after trabeculectomy with mitomycin C. METHODS: We retrospectively reviewed 31 cases of bleb-related infection at Osaka Koseinenkin hospital from 2004 to 2007. RESULTS: Twelve cases of blebitis and 19 cases of bleb-related endophthalmitis were studied. According to the stage of infection, each patient was continued to be treated following a previously decided treatment strategy. Fifteen patients underwent pars plana vitrctomy. Two patients with blebitis progressed to endopthalmitis. Visual acuity in seven eyes (22.6%) decreased by two or more lines following infection. Risk factors for visual impairments following bleb-related infections were recurrence of infection (p = 0.022), negative Seidel tests (p = 0.0056), aphakia (p = 0.045), avitreous (p = 0.00070), positive Streptococcus species (p = 0.029), and prolonged inflammation (p = 0.014). CONCLUSIONS: Recurrence of infection, negative Seidel tests, aphakia and avitreous are risk factors for visual impairment following bleb-related infection after trabeculectomy. Source


Shimono T.,Hoshigaoka Koseinenkin Hospital
Nihon Hoshasen Gijutsu Gakkai zasshi | Year: 2012

Ionization chamber measurements in radiation therapy should be repeatedly performed until a stable reading is obtained. Ionization chambers exhibit a response which depends on time elapsed since the previous irradiation. In this study, we investigated the response of a set of two Farmer-style, one Plane parallel, and seven small ionization chambers, which are exposed to 4, 6, 10, and 14 MV. The results show that Farmer-style and Plane parallel ionization chambers settle quickly within 9-20 min. On the other hand, small ionization chambers exhibit settling times of 12-33 min for 6, 10, and 14 MV. It will take longer for a settling time of 4 MV. The settling time showed time dependent irradiation. The first reading was up to 0.76% lower in the Farmer-style and Plane parallel ionization chambers. The small ionization chambers had a 2.60% lower first reading and more gradual response in reaching a stable reading. In this study, individual ionization chambers can vary significantly in their settling behavior. Variation of the responses on ionization chambers were confirmed not only when radiation was not used for a week but also when it was halted for a month. Pre-irradiation of small ionization chambers is clearly warranted for eliminating inadvertent error in the calibration of radiation beams. Source


Iwai T.,Hoshigaoka Koseinenkin Hospital
International orthopaedics | Year: 2013

Tranexamic acid (TXA) reduces blood loss in patients undergoing total knee arthroplasty (TKA). However, few studies have reported the optimum timing and dosage for administration of TXA. The purpose of this study was to evaluate the effect of repeat-dose TXA on blood loss during TKA and the necessity of autologous blood donation or postoperative autotransfusion. We enrolled 78 patients with primary osteoarthritis undergoing cemented TKAs. Consecutive patients were divided into three groups, as follows: control group (n = 31), single-TXA group (n = 21) in whom TXA (1,000 mg) was intravenously administered 10 min before deflation of the tourniquet, and twice-TXA group (n = 26) in whom TXA (1,000 mg) was intravenously administered 10 min before deflation of the tourniquet and 3 h after the operation. We measured the volume of drained blood after the operation. Haemoglobin (Hb) levels were measured at days 1, 4 and 7 postoperation. Venous thromboembolic events (VTE) were screened using compression ultrasonography at enrollment and 1 and 7 days after operation. The mean volume of drained blood after the operation was lower in the twice-TXA group than in the single-TXA (p < 0.001) and control (p < 0.0001) groups. No significant differences were observed in the incidence of VTE between these groups. Administration of TXA twice reduced postoperative blood loss after TKA, and TXA was not associated with the risk of deep-vein thrombosis (DVT) or pulmonary embolism (PE). Further, administration of TXA twice may eliminate the need for blood transfusion during TKA. Source


Tsuji S.,Hoshigaoka Koseinenkin Hospital | Tomita T.,Osaka University | Inaoka M.,Nissay Hospital | Higashiyama M.,Nissay Hospital
Clinical Orthopaedics and Related Research | Year: 2010

Abnormal reactions accompanied by bone formation in the osteoarticular region induced by long-term administration of etretinate have been reported. We treated a patient who received continuous treatment of psoriatic erythroderma with etretinate for 7 years, and who had an osseous bridge that extended across the acetabulum over the femur on both sides. The patient experienced a major gait disturbance and eventually was unable to walk. Functional gait was restored by resecting the ossified regions and radiotherapy. Histologic sections of the ossified lesions showed enchondral ossification in the ligament attachment site in the joint margin, with advancing ossification along the articular capsule; the pattern was similar to that in diffuse idiopathic skeletal hyperostosis. This is the first report of an osseous bridge associated with long-term administration of etretinate extending across the acetabulum over the femur on both sides. © 2009 The Association of Bone and Joint Surgeons ®. Source


Wada E.,Hoshigaoka Koseinenkin Hospital | Kawai H.,Hoshigaoka Koseinenkin Hospital
Spinal Cord | Year: 2010

Study design: Case report. Objectives: To report the late onset of cervical myelopathy secondary to fibrous scar tissue formation around an epidural electrode implanted for spinal cord stimulation (SCS). Setting: Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, Osaka, Japan.Method and results:A 49-year-old man who had an electrode implanted for SCS 5 years ago was referred to our department on 2 March 2005, complaining of difficulty using chopsticks and walking. A computed tomography scan with myelography revealed severe spinal cord compression around the epidural electrode. Surgical removal of the electrode was not effective. Removal of fibrous scar tissue during a second surgery significantly improved his neurological symptoms. Conclusion: Late onset cervical myelopathy secondary to fibrous scar tissue formation around the epidural electrode should be considered a possible event associated with SCS therapy. © 2010 International Spinal Cord Society All rights reserved. Source

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