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Yonezawa, Japan

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.

Kabayama J.,Sanyudo Hospital | 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.

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.

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.

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.

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