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Tanaka H.,Okayama Saiseikai General Hospital
Clinical calcium | Year: 2011

Bone mass during infantile period relates closely to adult bone mass and small bone mass in infancy has been thought as one of the risk factors for osteoporosis. Although bone mass accrual during infantile period is determined by perinatal condition, nutrition and endocrine factors, among these factors, infant growth at third trimester of pregnancy is important to determine life-long bone health. For nutritional factors, vitamin D and calcium are important. The effects of estrogen on infant bone are also discussed. Source


Tanaka H.,Okayama Saiseikai General Hospital
Clinical calcium | Year: 2010

Osteogenesis imperfecta (OI) is characterized by its bone fragility. But the spectrum of the severity of the fragility is widely distributed. Recently, amino-bisphosphonate has been introduced into the treatment of the bone fragility of OI. Apparently, the treatment may reduce the frequency of the fractures in severe form of OI. However, its efficacy has not been supported by strong evidences, such as randomized controlled clinical trial. This section describes the pathophysiology and new pathogenetic mechanism of OI, and describes recent evidence for the efficacy of BP treatment in OI. Source


Orita Y.,Okayama Saiseikai General Hospital | Sugitani I.,Cancer Institute Hospital | Matsuura M.,Cancer Institute | Ushijima M.,Cancer Institute | And 3 more authors.
Surgery | Year: 2010

Background: The treatment of bone metastasis in association with thyroid cancer represents a difficult challenge. Given the paucity of patients with bone metastasis and the difficulty of treating this disease, few studies have investigated the clinical features and prognostic factors of bone metastasis from differentiated thyroid cancer. Methods: During the 31-year-period from 1976 to 2006, a total of 1,398 patients underwent initial thyroidectomy at Cancer Institute Hospital for differentiated thyroid carcinomas, including standard papillary thyroid carcinoma, papillary microcarcinoma (primary tumor diameter ≤1.0 cm), and follicular thyroid carcinoma. Among these, 25 (2%) patients displayed bone metastasis at initial presentation (synchronous) and 27 patients showed bone metastasis during follow-up (metachronous). The records for these 52 patients were reviewed retrospectively to identify prognostic factors and analyze treatment strategies. Results: Univariate analysis for disease-specific survival indicated metachronous bone metastasis and the presence of distant metastasis at sites other than bone as indicators of significantly worse prognosis. The type of cancer (papillary thyroid carcinoma versus follicular thyroid carcinoma) was not a significant indicator of prognosis; however, patients with papillary microcarcinoma showed significantly worse survival than patients with standard papillary and follicular thyroid carcinoma. A significant survival advantage was observed among patients who underwent radioactive iodine therapy, and better prognosis seemed to be obtained with greater doses of radioactive iodine. Operative resection of metastatic bone lesions also seemed to be associated with better prognosis. A multivariate analysis for disease-specific survival identified the coexistence of distant metastasis at sites other than bone as the only independent variable indicative of poor prognosis. Conclusion: In the absence of definitive, effective treatments for this disease, radioactive iodine therapy combined with resection of bone metastasis, wherever possible, seems to represent the most potent therapy available. Although bone metastasis is a strong sign of poor prognosis, early detection and administration of appropriate therapy using radioactive iodine seems likely to improve the survival rate and quality of life in patients with bone metastasis from differentiated thyroid carcinoma. © 2010 Mosby, Inc. All rights reserved. Source


Maehara T.,Kagawa Rosai Hospital | Moritani S.,Okayama Saiseikai General Hospital | Ikuma H.,Kagawa Rosai Hospital | Shinohara K.,Kagawa Rosai Hospital | Yokoyama Y.,Kagawa Rosai Hospital
Injury | Year: 2013

Objective: This study was designed to evaluate the frequency of intraoperative complications associated with titanium locking compression plate (LCP) removal. Design: Retrospective study. Methods: Medical records were reviewed for surgical technique, plate types used, position and number of screws, time from internal fixation to plate removal, and intraoperative complications. Radiographs were reviewed to evaluate the position of the plates and screws and the accuracy of the screw direction. Mann-Whitney and Yates Chi-square tests were calculated with the level of significance at P < 0.05. Results: All LCPs could be removed. Of the 342 locking head screws (LHSs), a total of 21 (6.1%) screws, 3 (2.0%) 5.0 mm screws (3/153) and 18 (10.7%) 3.5 mm screws (18/169), were difficult to remove. The frequency of difficulty associated with the 3.5 mm LHSs was significantly higher than that of the 5.0 mm LHSs (P < 0.01). The frequency of difficulty associated with the removal of LHSs at the diaphysis was higher than that of LHSs at the epiphysis (P < 0.01), especially with 3.5 mm LHSs. The mean age was significantly lower in the patients in whom removal was difficult (P < 0.05). Our analysis revealed that the frequency of removal difficulty was high when a 3.5 mm LHS was inserted into the diaphysis of young patients. Conclusions: We should recognize that the removal of LCPs can involve numerous problems and great care should be exercised, especially in cases involving 3.5 mm LHSs. © 2013 Elsevier Ltd. Source


Tanaka H.,Okayama Saiseikai General Hospital
Clinical calcium | Year: 2010

FGFR3 has been establishing its position in growth plate cartilage after the identification as a responsible gene for achondroplasia. The major pathway of the pathogenesis in achondroplasia is the suppression of PTHrP-PTHR system, which is mainly mediated by ERK activation induced by constitutive active FGFR3. However, intracellular signaling system in FGFR3 is complex and the molecular pathogenesis of achondroplasia and related disorders has not been fully clarified. Especially, recently found human loss-of-function mutations in newly identified syndromes casted novel findings in the relation between phenotype and receptor function. In this review, I summarized recent consensus in the pathogenesis of FGFR3 related chondrodysplasia. Source

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