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Yamashita S.,Osaka Koseinenkin Hospital
Clinical calcium | Year: 2010

Osteogenesis imperfecta (OI) is a genetic disorder characterized by fragile bone and reduced bone mineral density. Cyclic intravenous pamidronate is now the most widely used treatment for moderate to severe forms of OI. Oral bisphosphonates provide clinical benefit and convenience to the patients with mild form of OI. Recently, some studies demonstrated that intravenous zolendronate in children with OI is safe in short-term and similarly effective to parmidronate. Optimal dose, duration of treatment and long-term safety of newer bisphosphonates require further investigations. Source


PURPOSE: To compare the efficacy and safety of 0.0015% tafluprost ophthalmic solution (Tafluprost) with Placebo ophthalmic solution (Placebo) in normal tension glaucoma (NTG). SETTING: Total of 94 patients enrolled in a randomized, double-blind, parallel-group and multicenter study. METHOD: Patients with NTG were randomly assigned to either Tafluprost or Placebo. Both ophthalmic solutions were instilled once a day in the morning for 4 weeks. RESULTS: Mean intraocular pressure (IOP) changes from baseline were -4.0 +/- 1.7 mmHg in Tafluprost administered patients and -1.4 +/- 1.8 mmHg in Placebo administered patients at 4 weeks, with a statistically significant difference (p<0.001). IOP change at 4 weeks, % IOP reduction at 2 and 4 weeks were also significantly greater in Tafluprost than in Placebo. A total of 51.0% in Tafluprost treated group and 8.9% in Placebo treated group reported adverse drug reactions. CONCLUSION: These results indicate that Tafluprost is clinically useful in the treatment of NTG. Source


Fujimori T.,Osaka University | Iwasaki M.,Osaka University | Okuda S.,Osaka Rosai Hospital | Takenaka S.,Osaka Koseinenkin Hospital | And 3 more authors.
Spine | Year: 2014

STUDY DESIGN.: Retrospective study. OBJECTIVE.: We sought to determine the long-term outcomes of laminoplasty versus anterior decompression and fusion in the treatment of cervical myelopathy caused by ossification of the posterior longitudinal ligament (OPLL) and to ascertain what factors should be considered in selecting appropriate surgical procedure. SUMMARY OF BACKGROUND DATA.: There are little data about long-term results of cervical myelopathy due to OPLL with an occupying ratio 60% or more. METHODS.: We retrospectively studied 27 patients having OPLL with an occupying ratio 60% or more and a follow-up period of at least 2 years. Clinical outcome was evaluated using Japanese Orthopaedic Association scores and recovery rates (≥75%, excellent; 50%-74%, good; 25%-50%, fair; and <25%, poor). RESULTS.: The mean age and the mean duration of follow-up were 57 years and 10.2 years. The mean Japanese Orthopaedic Association score was 9.3 before surgery and 12.4 at the final follow-up examination. There were 15 patients in the laminoplasty group (LAM group) and 12 patients in the anterior decompression and fusion group (ADF group). The ADF group had a significantly better recovery rate at final evaluation (53% vs. 30%; P = 0.04), a longer duration of surgery (314 vs. 128 min; P < 0.01), and greater blood loss (600 vs. 240 mL; P < 0.01) than did the LAM group. In the LAM group, 4 patients with excellent or good results had a significantly larger degree of cervical lordosis (30 vs. 10 ; P = 0.002) than others. CONCLUSION.: The ADF group had a significantly better recovery rate than the LAM group, although the degree of surgical invasiveness was high. ADF is generally recommended for OPLL with an occupying ratio 60% or more. © 2013, Lippincott Williams & Wilkins. Source


Fuji T.,Osaka Koseinenkin Hospital | Fujita S.,Takarazuka Daiichi Hospital | Tachibana S.,Mishuku Hospital | Kawai Y.,Sanno Hospital
Journal of Thrombosis and Haemostasis | Year: 2010

Edoxaban (the free base of DU-176b) is an oral, direct factor (F)Xa inhibitor in clinical development for the prevention and treatment of thromboembolic events. Objectives: The aim of the present study was to evaluate the efficacy and safety of edoxaban for the prevention of venous thromboembolism (VTE) in patients undergoing total knee arthroplasty (TKA). Patients/methods: This was a randomized, double-blind, placebo-controlled, multicenter study conducted in Japan. A total of 523 Japanese patients were assigned to receive edoxaban 5, 15, 30 or 60 mg once daily or placebo for 11-14 days. A placebo control was used as neither low-molecular-weight heparin (LMWH) nor fondaparinux had been approved for thromboprophylaxis at the time of the study in Japan. The primary efficacy outcome was the incidence of VTE (lower-extremity deep vein thrombosis, symptomatic pulmonary embolism or symptomatic deep vein thrombosis). The primary safety outcome was the incidence of major and clinically relevant non-major bleeding. Results: Edoxaban produced a significant dose-related reduction in VTE: the incidence of VTE was 29.5%, 26.1%, 12.5% and 9.1% in the edoxaban 5-, 15-, 30- and 60-mg treatment groups vs. 48.3% in the placebo group. The incidence of major and clinically relevant non-major bleeding was similar across all groups without any significant differences among edoxaban doses or between edoxaban and placebo. Conclusions: Edoxaban demonstrated significant dose-dependent reductions in VTE in patients undergoing TKA with a bleeding incidence similar to placebo. [This trial is registered with JAPIC, JapicCTI-060283 (ja).] © 2010 International Society on Thrombosis and Haemostasis. Source


Yamamoto T.,Gifu University | Kuwayama Y.,Osaka Koseinenkin Hospital
Ophthalmology | Year: 2011

Purpose To introduce the Collaborative Bleb-related Infection Incidence and Treatment Study and to provide an interim, 2.5-year follow-up report of the findings. This prospective study sought to determine the incidence, severity, and prognosis of bleb-related infection and to investigate the efficacy of the antibacterial therapy in preventing it. Design Prospective cohort study. Participants A total of 908 eyes of 908 glaucoma patients who had undergone mitomycin C-augmented trabeculectomy or trabeculectomy combined with phacoemulsification and intraocular lens implantation performed at 34 clinical centers. Methods Outcomes were measured at 6-month intervals, with special attention to bleb-related infections, and data for 2.5 years of follow-up result were summarized. Main Outcome Measures The incidence and severity of bleb-related infection. Results Of the 908 eyes, 9 eyes developed a bleb-related infection. The Kaplan-Meier survival analysis revealed that the probability of development of bleb-related infection was 1.5±0.6% (cumulative probability ± standard error) at the 2.5-year follow in the trabeculectomy cases and 1.4±1.0% in the combined surgery cases. It was 1.5% in both cases with a limbal-based flap and in those with a fornix-based flap. It was significantly different between cases with bleb leakage and those without it (P = 0.037; log-rank test). Conclusions The cumulative probability of bleb-related infection was prospectively determined to be 1.5±0.6% in eyes treated with mitomycin C-augmented trabeculectomy or trabeculectomy combined with phacoemulsification and intraocular lens implantation at the 2.5-year follow-up in the Collaborative Bleb-related Infection Incidence and Treatment Study. Financial Disclosure(s) The authors have no proprietary or commercial interest in any materials discussed in this article. © 2011 American Academy of Ophthalmology. Source

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