Kabayama J.,Sanyudo Hospital |
Ueda T.,Nihonmatsu Eye Hosp |
Hiramatsu R.,Higashiomiya Gen Hosp |
Takahashi H.,Showa University
Japanese Journal of Clinical Ophthalmology | Year: 2015
Purpose: To report changes in intraocular pressure (IOP) following trabeculotome surgery with continuous medication. Cases and Method: This study was made on 46 eyes of 34 cases who received trabeculotome surgery in the past 3 years. The age averaged 76 years. Primary open-angle glaucoma was present in 42 eyes. Capsular glaucoma was present in 4 eyes. Simultaneous cataract surgery was made on 41 eyes. Cases were followed up for an average of 9 months after surgery. All the cases received the same medication before and after surgery. Findings: IOP averaged 21.1 ±4.2 mmHg before and 14.9±3.8 mmHg 6 months after surgery. The difference was significant (p<0.001). All the eyes showed transient hyphema after surgery. IOP rose to 30 mmHg or more within one week of surgery in 6 eyes. IOP was controlled within two days of systemic treatment with carbonic anhydrase inhibitor. Additional surgery was performed in 4 eyes within 3 months of trabeculotome surgery. Conclusion: IOP decreased for 6 months after trabeculotome surgery under continuous medication. All the 46 eyes showed transient hyphema after surgery. Six eyes showed transient rise of IOP after surgery.
Ikari Y.,Tokai University |
Misumi K.,Chiba Nishi General Hospital |
Yokoi H.,Kokura Memorial Hospital |
Ogata N.,Tokai University |
And 9 more authors.
Cardiovascular Intervention and Therapeutics | Year: 2013
Carotid artery stenting (CAS) was approved by the government and reimbursement was started in 2008 in Japan, probably the last country in the world. CASCARD is a retrospective registry study performed by cardiologists to assess initial results of CAS in Japan. CAS was indicated for patients with at least one high risk factor for carotid endarterectomy and with >50 % stenosis in symptomatic or >80 % stenosis in asymptomatic patients. Primary endpoint was major adverse events (MAE) including death, myocardial infarction and any stroke at 30 days. Between April 2008 and March 2010, a total of 704 cases were enrolled from 55 centers. The study population with an average age of 74 ± 8 years included 62 % asymptomatic patients, with 23 % of cases with contralateral carotid artery occlusion or significant stenoses. Angioguard filter wire was exclusively used as a primary protection device and successfully passed the lesion in 701 cases (99. 6 %). Precise stent was implanted successfully in all cases. MAE at 30 days was 3. 7:0. 3 % death, 0 % myocardial infarction, and 3. 4 % stroke (0. 4 % major ipsilateral stroke). Death or any stroke rate at 30 days was 2. 7 % in asymptomatic and 5. 5 % in symptomatic patients. The CASCARD study showed that the initial results of CAS in Japan are acceptable for both symptomatic and asymptomatic cases. © 2012 Japanese Association of Cardiovascular Intervention and Therapeutics.
Hiramatsu R.,Sanyudo Hospital |
Hiramatsu R.,Showa University |
Sasamoto T.,Showa University |
Koide R.,Showa University
Japanese Journal of Clinical Ophthalmology | Year: 2012
Purpose 'To report a case of sebaceous carcinoma of the upper eyelid who received resection followed by double-armed buried suture to treat trichiasis. Case : A 67-year-old female presented with deformation in her left upper eyelid. She had been diagnosed with chalazion 5 years before and been treated by incision. Findings : Biopsy of the eyelid showed sebaceous carcinoma. The tumor was resected and the defect was reconstructed. She received transplantation of mucous membrane from the hard palate 12 months later. Another 13 months later, trichiasis was treated by double-armed buried suture. She had been doing well for 12 months until present. There has been no recurrence of the tumor. Conclusion : Use of double-armed buried suture was effective to treat trichiasis that developed after upper eyelid reconstruction in a case of sebaceous carcinoma. Rinsko Ganka (Jpn J Clin Ophthalmol) 66(5) : 637-640, 2012.
Watanabe A.,Tohoku University |
Goto H.,Kyorin University |
Soma K.,Kitasato University |
Kikuchi T.,Tohoku University |
And 11 more authors.
Journal of Infection and Chemotherapy | Year: 2012
Clinical results for linezolid (LZD) treatment of hospital-acquired pneumonia (HAP) caused by methicillin- resistant Staphylococcus aureus (MRSA), particularly microbiologically evaluable or severe cases, are limited in Japan. A prospective observational study was conducted in order to assess the usefulness of LZD in Japanese patients with MRSA pneumonia. The study tracked fifteen participants treated with LZD for pneumonia who met the criteria of the HAP guidelines and were confirmed to have pneumonia caused by MRSA. Of these, six were severe and 13 had received antibiotic treatment before treatment with LZD. Of the 13 participants assessed for their clinical responses, seven were rated as cures, three were rated as failures, and three were indeterminate. The overall cure rate (cure/cure ? failure) was 70.0% (7/10), and the cure rate by severity was 33.3% (1/3) for severe cases and 85.5% (6/7) for moderate cases. The one severe case with a clinical response rating of cure had failed to respond to vancomycin. Among the seven participants with a clinical response rating of cure, the microbiological response was eradication in three, presumed eradication in three, and indeterminate in one. Three serious adverse events occurred in two of the 15 participants, but none were considered to be causally related to LZD. The results suggest that LZD has high potential for severe and multidrug- resistant cases. A higher cure rate was achieved in moderate cases. In cases of pneumonia that are most likely MRSA infections with poor prognosis, it was suggested to be important for patient outcome to implement the most effective therapy before the patient's condition becomes serious. © Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases 2011.
Ohtake H.,Yamagata University |
Kawamura H.,Sanyudo Hospital |
Matsuzaki M.,Hoshi General Hospital |
Yokoyama E.,Sanyudo Hospital |
And 3 more authors.
Annals of Diagnostic Pathology | Year: 2010
Only 17 cases of oncocytic adrenocortical carcinoma have been reported in the English literature. Here, we report an incidental case of oncocytic adrenocortical carcinoma. The patient was a 69-year-old man with the chief complaint of abdominal pain. Abdominal computed tomography revealed a left adrenal tumor. No hormonal symptoms were observed. The excised tumor was whitish, encapsulated, and 75 × 60 × 45 mm in size. Large polygonal tumor cells were arranged in a generally diffuse architecture and exhibited abundant eosinophilic granular cytoplasm. Nuclear atypia with atypical mitotic figures and capsular and sinusoidal invasions were observed. The tumor cells were immunopositive for vimentin, neuron-specific enolase, and synaptophysin but not for α-inhibin, melan A, or p53. Diffuse and strong immunopositivity with an antimitochondrial antibody proved that this tumor was truly oncocytic. Upon review of previous cases of oncocytic adrenocortical tumors, we reconsidered the diagnostic findings of the potential for malignancy. © 2010 Elsevier Inc. All rights reserved.
Satake H.,Yamagata University |
Hanaka N.,Masu Memorial Hospital |
Honma R.,Yamagata Saisei Hospital |
Watanabe T.,Okitama Public General Hospital |
And 14 more authors.
Orthopedics | Year: 2016
The current study investigated the incidence of complications after surgery for distal radial fractures. This multicenter retrospective study was conducted at 11 institutions. A total of 824 patients who had distal radius fractures that were treated surgically between January 2010 and August 2012 were identified. The study patients were older than 18 years and were observed for at least 12 weeks after surgery for distal radius fractures with a volar locking plate. Sex, age, fracture type according to AO classification, implants, wrist range of motion, grip strength, fracture consolidation rate, and complications were studied. Analysis included 694 patients, including 529 women and 165 men, with a mean age of 64 years. The mean follow-up period was 27 weeks. The fracture consolidation rate was 100%. There were 52 complications (7.5%), including 18 cases of carpal tunnel syndrome, 12 cases of peripheral nerve palsy, 8 cases of trigger digit, 4 cases of tendon rupture (none of the flexor pollicis longus), and 10 others. There was no rupture of the flexor pollicis longus tendon because careful attention was paid to the relationship between the implant and the tendon. Peripheral nerve palsy may have been caused by intraoperative traction in 7 cases, temporary fixation by percutaneous Kirschner wires in 3 cases, and axillary nerve block in 1 case; 1 case appeared to be idiopathic. Tendon ruptures were mainly caused by mechanical stress. Copyright © SLACK Incorporated.
Yang S.,Yamagata University |
Takakubo Y.,Yamagata University |
Takakubo Y.,University of Helsinki |
Kobayashi S.,Yamagata University |
And 8 more authors.
Clinics in Orthopedic Surgery | Year: 2012
Background: Minocycline-induced pigmentation of bone (black bone) is well described in tooth-bearing intra-oral bone, but is less known in periarticular bone in patients who have undergone total joint arthroplasty. On a retrospective basis, we investigated the short-term clinico-radiological results of total joint arthroplasties in which the patient developed minocycline-induced periarticular black bone. Methods: We found 5 cases (0.08%), in 4 patients, of periarticular bone pigmentation revealed during total joint arthroplasties (2 hips, 2 knees, and 1 ankle) in our series of total joint surgeries (6,548 cases) over a 10-year time period in our 3 institutes. Their mean age was 56 years at surgery. All patients had received long-term minocycline treatment. Mean dosage and duration of minocycline was 160 mg/day and 2.2 years, respectively. Minocycline had been prescribed for reactive arthritis (one), rheumatoid arthritis (two) and late infection after total joint arthroplasty (two patients). Mean follow-up period was 3.4 years after the surgeries. Results: All cases had black or brown pigmentation in the periarticular bones during the surgery. There was no pigmentation in the cartilage or soft tissues of the joints. The mean Japanese Orthopaedic Association (JOA) score or Japanese Society for Surgery of the Foot (JSSF) scale for rheumatoid arthritis foot and ankle joints at latest follow-up (case 1, 66; case 2, 87; case 3, 77; case 4, 77; case 5, 80) improved compared to those of pre-surgery (case 1, 47; case 2, 45; case 3, 55; case 4, 34; case 5, 55). No implant loosening was noted on radiographic examination during the follow-up period. No abnormal bone formation, bone necrosis, hemosiderin deposition, malignancy or metallic debris was found on histological examination. Conclusions: No clinico-radiological symptoms of total joint arthroplasties showed in the patients with minocycline-induced periariticular black bone in the short-term. Systemic minocycline treatment has the potential to induce significant black pigmentation of many tissues. In particular, minocycline-induced pigmentation of periarticular bone may be accelerated by inflammation due to rheumatic or pyogenic arthritis. Surgeons should recognize the risk of bone pigmentation in inflamed joints due to the systemic treatment of minocycline and explore its influence on periarticular bone and total joint arthroplasty in the long-term. © 2012 by The Korean Orthopaedic Association.
Makino T.,Sanyudo Hospital |
Makino T.,Yamagata University |
Kawamura H.,Sanyudo Hospital |
Yokoyama E.,Sanyudo Hospital |
And 2 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2012
In patients with HER2-positive breast cancer, cerebral metastasis sometimes occurs even if the breast tumor and liver/lung metastasis are controlled with trastuzumab. We encountered a case of HER2-positive breast cancer with cerebral metastasis presenting with hydrocephalus, in which VP shunting was successful, enabling continued treatment with lapatinib+capecitabine and improvement of the patient's QOL. VP shunting relieved the symptoms of the brain metastasis, including headache and vomiting, which was damaging for the patient. In addition, the efficacy of lapatinib for the treatment of cerebral metastasis in HER2-positive breast cancer has been reported. In our case of HER2-positive breast cancer with brain metastasis that presented with hydrocephalus, VP shunting relieved the symptoms and improved the QOL of the patient, enabling treatment with lapatinib+capecitabine to be continued.
Isawa T.,Sendai Kousei Hospital |
Suzuki K.,Sendai Kousei Hospital |
Abe H.,Sanyudo Hospital
Vascular Disease Management | Year: 2015
Acute axillary artery occlusion associated with proximal humeral fracture is rare. Traditionally, axillary artery complications associated with humeral fractures are managed with open surgery. However, open vascular repair presents a considerable challenge to even the most skilled surgeons. Endovascular treatment (EVT) offers an alternative to surgical management. We describe the case of an 82-year-old Japanese male with acute upper limb ischemia (AULI) secondary to acute axillary artery occlusion caused by a proximal humeral fracture. He was successfully treated with EVT. Unless there is vessel transection, EVT is feasible and offers a minimally invasive and prompt therapy for AULI resulting from axillary artery occlusion.
Hiramatsu R.,Sanyudo Hospital |
Hiramatsu R.,Showa University |
Fujisawa K.,Showa University
Saudi Journal of Ophthalmology | Year: 2012
One of the greatest issues facing the cataract surgeon today is accurate prediction of post-operative refractive error. With use of intraoperative autorefractometry (IOAR), such errors can be detected and post-operative refractive errors avoided. An 83-year-old woman was admitted for right eye phacoemulsification, with aimed at -1.78D with Sanders/Retzlaff/Kraff/T (SRK/T) formula implantation under local anesthesia. IOAR was performed after IOL insertion. The first estimate was +1.1D, indicating hyperopia, and far from the desired refraction above 2D. IOL exchange to +11.5D was, therefore, performed. The second estimate was -0.13D and the operation was completed. The final refraction (3 years after operation) was -0.25D. With IOAR, we were able to avoid the unpleasant surprise of a mistaken intraocular lens power. Intraoperative autorefractometry is useful for avoiding errors in IOL power. © 2012 Saudi Ophthalmological Society, King Saud University.