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Iriyama A.,Tokyo Metropolitan Geriatric Hospital | Iriyama A.,University of Tokyo | Kadonosono K.,Yokohama City University | Tamaki Y.,University of Tokyo | Yanagi Y.,University of Tokyo
Retina | Year: 2012

Purpose: To investigate the effects of Brilliant Blue G (BBG) on rat retinal ganglion cells (RGCs), both in vitro and in vivo. Methods: In vitro, rat RGCs were purified by a 2-step immunopanning procedure, briefly exposed to BBG (250 mg/L), and irradiated with an endoilluminator for 15 minutes or incubated in the presence of BBG (concentration, 2-250 mg/L) without irradiation. The number of viable RGCs was counted after 3 days in culture. In vivo, after rats received an intravitreal injection of 3 μL of BBG (0.25 and 2.5 mg/L), the number of viable RGCs was examined by a 1,1′-dioctadecyl-1-3,3,3′, 3′-tetramethylindocarbocyanine perchlorate-retrolabeling technique. Results: In vitro, a brief exposure to BBG and irradiation did not affect RGC survival. However, BBG reduced the number of viable RGCs in a dose-dependent manner when the cells were exposed for 3 days. In vivo, when rats received an intravitreous injection of 0.25 mg/L BBG, the number of viable RGCs was not affected. The number of viable RGCs showed a tendency to decrease in the 2.5-mg/L group 14 days after the injection, but the difference was not significant compared with the number in the saline-treated control group. Conclusion: Brilliant Blue G exerts no detectable detrimental effect on RGCs after short-time exposure, and no significant toxic effect even after a longer-time exposure in the current experimental setting. © The Ophthalmic Communications Society, Inc. Source

Miyake K.,Shohzankai Medical Foundation | Ota I.,Shohzankai Medical Foundation | Miyake G.,Shohzankai Medical Foundation | Numaga J.,Tokyo Metropolitan Geriatric Hospital
Journal of Cataract and Refractive Surgery | Year: 2011

Purpose: To compare a topical nonsteroidal antiinflammatory drug (nepafenac 0.1%) and a topical steroidal antiinflammatory drug (fluorometholone 0.1%) in preventing cystoid macular edema (CME) and blood-aqueous barrier (BAB) disruption after small-incision cataract extraction with foldable intraocular lens (IOL) implantation. Setting: Shohzankai Medical Foundation, Miyake Eye Hospital, Nagoya, Japan. Design: Randomized double-masked single-center clinical trial. Methods: Patients were randomized to receive nepafenac 0.1% eyedrops or fluorometholone 0.1% eyedrops for 5 weeks after phacoemulsification with foldable IOL implantation. The incidence and severity of CME were evaluated by fluorescein angiography, retinal foveal thickness on optical coherence tomography, and BAB disruption on laser flare-cell photometry. Results: Thirty patients received nepafenac and 29 patients, fluorometholone. Five weeks postoperatively, the incidence of fluorescein angiographic CME was significantly lower in the nepafenac group (14.3%) than in the fluorometholone group (81.5%) (P<.0001). The fovea was thinner in the nepafenac group than in the fluorometholone group at 2 weeks (P=.0266) and 5 weeks (P=.0055). At 1, 2, and 5 weeks, anterior chamber flare was significantly less in the nepafenac group than in the fluorometholone group (P<.0001, P<.0001, and P=.0304, respectively). The visual acuity recovery from baseline was significantly greater in the nepafenac group (80.0%) than in the fluorometholone group (55.2%) (P=.0395). There were no serious side effects in either group. Conclusion: Nepafenac was more effective than fluorometholone in preventing angiographic CME and BAB disruption, and results indicate nepafenac leads to more rapid visual recovery. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.© 2011 ASCRS and ESCRS. Source

Nishimura T.,Tokyo Metropolitan Geriatric Hospital
Journal of Artificial Organs | Year: 2014

Extracorporeal VADs are less expensive, their prices reimbursable by the health insurance being about one-sixth of those of implantable VADs in Japan. However, a disadvantage is that, in Japan, their use is restricted to hospitals, necessitating prolonged hospitalization, reducing the patients' quality of life. According to the Japanese registry for Mechanically Assisted Circulatory Support, the survival rate does not differ significantly between patients with extracorporeal and implantable VADs. As in Europe and North America, extracorporeal VADs in Japan are commonly used as Bridge to Decision or Bridge to Recovery. Extracorporeal VADs are switched to implantable VADs as a Bridge-to-Bridge strategy after stabilization or when cardiac function recovery fails. They are also used as right ventricular assist devices (RVADs) in patients with right heart failure. A special characteristic of extracorporeal VADs in Japan is their frequent use as a Bridge to Candidacy. In Japan, indications for implantable VADs are restricted to patients registered for heart transplantation. Therefore, in patients who cannot be registered for transplantation because of transient renal dysfunction, etc., due to heart failure, extracorporeal VADs are used first, and then replaced by implantable VADs after transplant registry is done. Here, we describe the current status of extracorporeal VADs in Japan, focusing on the environmental backgrounds, along with a review of the relevant literature. © 2014 The Japanese Society for Artificial Organs. Source

Yamawaki T.,Hiroshima City Hospital | Sakurai K.,Tokyo Metropolitan Geriatric Hospital
Brain and Nerve | Year: 2013

Superficial siderosis (SS) is a rare condition in which hemosiderin is deposited on the pial surface of the brain and/or spinal cord. Hemosiderin deposition is the consequence of recurrent or persistent hemorrhage in the subarachnoid space. There are two types of SS. In "classical"-type SS, hypointense MRI signals are observed in the brainstem and cerebellum with diffuse and symmetrical margins. Causes of hemorrhage in the "classical" type include tumor, vascular abnormality, injury, and dural defect. The source of hemorrhage is not apparent in approximately 50% of patients despite extensive examination. In "localized"-type SS, hypointense MRI signals are localized in the cerebral cortex. The most common causes of hemorrhage in the "localized" type are cerebral amyloid angiopathy and/or Alzheimer's disease. Patients with SS usually present with slowly progressive and irreversible cerebellar ataxia, sensorineural hearing loss, and/or myelopathy due to involvement of the acoustic nerve, cerebellum, and spinal cord. T2-weighted imaging (WI) or T2*WI demonstrates characteristic linear low-intensity signals along the surface of the brain and spinal cord. Treatment of SS involves identification and surgical correction of the bleeding source. Deferiprone, which is a lipid-soluble iron chelator that can penetrate the blood-brain barrier, is reportedly effective at improving the clinical symptoms and deposition of hemosiderin. It is thus a hopeful treatment option for SS. Source

Objective: This study aimed to examine the efficacy and safety of nepafenac ophthalmic suspension compared to placebo in the management of postoperative inflammation and ocular pain in Japanese patients undergoing cataract surgery. Methods: This was a multicenter, randomized, double-masked, placebo-controlled clinical study. Patients received nepafenac or placebo TID beginning 1 day before cataract surgery and continuing on the day of surgery for 14 days. One additional drop was administered on the day of surgery. The primary efficacy variables were the percentage of patients cured at postoperative day 14 visit (cure defined as aqueous cells score + aqueous flare score = 0) and the percentage of patients who were pain free at all postoperative visits. Results: The cure rate on day 14 after surgery was 71.4% (75/105) in the nepafenac group and 28.6% (30/105) in the placebo group, showing a significant difference in cure rate between groups. The nepafenac group demonstrated higher cure rates than those in the placebo group, with a significant difference in cure rate on days 7 and 14 postoperatively. The ocular pain-free rate was 96.2% (102/106) in the nepafenac group and 67.6% (71/105) in the placebo group, showing a significant difference between groups. Concerning adverse events (AEs), 26 AEs were reported in 21 subjects (19.6%) in the nepafenac group and 31 AEs were reported in 24 subjects (22.4%) in the placebo group. Conclusion: Nepafenac ophthalmic suspension is a nonsteroidal anti-inflammatory drug effective in the prevention of postoperative inflammation and ocular pain associated with cataract surgery. © 2011 The Author(s). Source

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