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Yoshida-Hata N, Mimura M, Aikawa M, Kashima T. A case of bilateral amyloidosis localized to extraocular muscles mimicking thyroid eye disease. BMC Ophthalmol 2024; 24:42. [PMID: 38279160 PMCID: PMC10811829 DOI: 10.1186/s12886-024-03295-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/15/2024] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Amyloidosis is a rare condition characterized by the abnormal deposition of amyloid proteins in various tissues and organs. While systemic amyloidosis has been well-documented, amyloid deposition in extraocular muscles is an exceptionally rare occurrence, with only 35 reported cases. This case report sheds light on the importance of considering amyloidosis in the differential diagnosis of patients presenting with proptosis and diplopia, which are often associated with thyroid eye disease. CASE PRESENTATION A woman in her twenties sought medical attention due to a complaint of diplopia. Her ocular examination revealed almost normal findings except for exotropia and proptosis. Orbital magnetic resonance imaging displayed fusiform enlargement of nearly all eye muscles, a presentation typically observed in thyroid eye disease. However, despite corticosteroid therapy, her symptoms showed no improvement. Given the unusual lack of response to conventional treatment, and inhomogeneous enhancement of the muscle, an extraocular muscle biopsy was conducted. This biopsy yielded a unique finding-amyloid deposition within the muscle tissue. This discovery was particularly intriguing due to the extreme rarity of amyloidosis affecting extraocular muscles, with fewer than three dozen documented cases worldwide. CONCLUSION This unique case underscores the critical need for a comprehensive approach to diagnosing patients with proptosis and diplopia. While these symptoms are commonly attributed to thyroid eye disease, it is essential to consider alternative diagnoses such as amyloidosis, especially when standard treatments fail to yield results. The discovery of amyloid deposition in the extraocular muscles, although exceedingly rare, emphasizes the significance of a thorough differential diagnosis. In conclusion, this case report highlights the importance of vigilance in clinical practice, encouraging ophthalmologists to explore less common diagnostic possibilities when faced with challenging cases. Further research and clinical investigation are warranted to better understand the mechanisms and potential treatments for amyloidosis affecting the extraocular muscles.
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Affiliation(s)
| | - Masashi Mimura
- Oculofacial Clinic Osaka, 1-12-6, Umeda Kita-ku, Osaka-city, 530-0001, Osaka, Japan
| | - Miwa Aikawa
- Oculofacial Clinic Tokyo, 1-15-4 Ginza, Chuo-ku, 104-0061, Tokyo, Japan
| | - Tomoyuki Kashima
- Oculofacial Clinic Tokyo, 1-15-4 Ginza, Chuo-ku, 104-0061, Tokyo, Japan
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Mimura M, Akagi T, Kohmoto R, Fujita Y, Sato Y, Ikeda T. Measurement of vitreous humor pressure in vivo using an optic fiber pressure sensor. Sci Rep 2023; 13:18233. [PMID: 37880357 PMCID: PMC10600124 DOI: 10.1038/s41598-023-45616-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 10/21/2023] [Indexed: 10/27/2023] Open
Abstract
We conducted a study to assess the pressure difference between the aqueous and vitreous humors in rabbit eyes using a direct intraocular pressure (IOP) measurement method. A micro-optic-fiber pressure sensor was utilized for this purpose. Preliminary experiments with enucleated porcine eyes confirmed the sensor's accuracy in measuring both aqueous and vitreous humor pressure. The main study involved six healthy albino rabbits, where the sensor measured the pressure in the anterior chamber (aIOP) and posterior vitreous-cavity (pIOP). These measurements were compared to aIOP values obtained through rebound tonometry. Additionally, pre- and postoperative pressure comparisons were made after performing a vitrectomy. Results revealed a significant disparity between aqueous and vitreous humor pressures. Prior to vitrectomy, pIOP was 22.8 mmHg, over twice as high as aIOP (11.0 mmHg), but decreased to a similar level following the procedure. Comparison between the sensor measurements and rebound tonometry showed agreement in aIOP values. In conclusion, our study demonstrates that vitreous humor pressure is consistently higher than aqueous humor pressure, reaching the upper limit of normal IOP. Furthermore, vitrectomy effectively reduces pIOP, aligning it with aIOP. These findings contribute valuable insights into intraocular pressure dynamics and have implications for clinical interventions targeting ocular pressure regulation.
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Affiliation(s)
- Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan.
- Department of Ophthalmology, Hyogo Medical University, 1-1, Mukogawa-Cho, Nishinomiya-Shi, Hyogo , 663-8501, Japan.
- Department of Ophthalmology, Toho University Sakura Medical Center, Sakura-City, Chiba, Japan.
| | - Tadamichi Akagi
- Division of Ophthalmology and Visual Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Ryosuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Yasushi Fujita
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Yohei Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
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Fujita Y, Jin D, Mimura M, Sato Y, Takai S, Kida T. Activation of Mast-Cell-Derived Chymase in the Lacrimal Glands of Patients with IgG4-Related Ophthalmic Disease. Int J Mol Sci 2022; 23:ijms23052556. [PMID: 35269701 PMCID: PMC8910072 DOI: 10.3390/ijms23052556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 01/25/2023] Open
Abstract
The purpose of this present study was to investigate the distribution and expression of chymase in the lacrimal glands (LGs) of patients afflicted with IgG4-related ophthalmic disease (IgG4-ROD). LGs from patients with severe canalicular obstruction were considered the control group. Toluidine blue staining confirmed a significant increase in the number of mast cells in the LGs obtained from the IgG4-ROD patients. In addition, immunostaining of serial sections from the LGs showed a significant increase in the number of chymase-positive cells and tryptase-positive cells in the IgG4-ROD LGs compared to the normal control LGs. The mRNA expression of chymase, tryptase, TGF-β1, and collagen-I tended to increase in the IgG4-ROD LGs. Immunostaining of vimentin and α-smooth muscle actin (α-SMA) showed that myofibroblasts were the main cellular components in severely fibrotic regions of LGs in patients with IgG4-ROD. Linear regression analyses on the number of mast cells, chymase-positive cells, and tryptase-positive cells revealed significant positive correlations between those respective cells. Our findings suggest that chymase may play a role in the fibrotic disorder of IgG4-ROD LGs through the regulation of TGF-β1 activation and collagen-I deposition, and that it may be a therapeutic target for patients afflicted with IgG4-ROD.
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Affiliation(s)
- Yasushi Fujita
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (Y.S.); (T.K.)
- Correspondence: ; Tel.: +81-72-683-1221
| | - Denan Jin
- Department of Innovative Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (D.J.); (S.T.)
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (Y.S.); (T.K.)
| | - Yohei Sato
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (Y.S.); (T.K.)
| | - Shinji Takai
- Department of Innovative Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (D.J.); (S.T.)
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Japan; (M.M.); (Y.S.); (T.K.)
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Mizuno H, Suzuki H, Mimura M, Fukumoto M, Sato T, Kida T, Ikeda T. Three cases of macular hole that occurred in inferior scleral staphyloma associated with tilted disc syndrome: a case series. J Med Case Rep 2022; 16:36. [PMID: 35090537 PMCID: PMC8800225 DOI: 10.1186/s13256-022-03252-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
Background The objective is to examine the clinical characteristics of three patients with macular hole that occurred in inferior posterior staphyloma associated with tilted disc syndrome. Case presentations This study involved three eyes of three Japanese female patients (mean age 76.0 years, range 73–84 years) with macular hole occurring in inferior posterior staphyloma associated with tilted disc syndrome. One of the three eyes was slightly myopic, while the other two eyes were highly myopic. In all three eyes, the macular hole was found to be located in or near the margin of the inferior posterior staphyloma. In one eye, the extent of retinoschisis was rather broad in the margin of the macular hole, and another eye had a history of treatment for choroidal neovascularization. As surgical treatment, the internal limiting membrane in areas surrounding the macular hole was detached after producing artificial posterior vitreous detachment, and a gas tamponade was performed. It was found during surgery that the extensibility of the retina in the margin of the MH was decreased in the three eyes as compared with a usual macular hole. Although the macular hole was successfully closed in all three cases post surgery, the layer structure of the central retina was poorly repaired in all three cases and choroidal neovascularization remained in one case. In all three cases, corrected visual acuity remained at 0.3–0.5 post surgery. Conclusions Our findings showed poor improvement of visual acuity in all three cases post surgery, even if closure of the macular hole is achieved, thus suggesting that in cases of macular hole associated with tilted disc syndrome and inferior posterior staphyloma, the presence of macular dysfunction existing prior to the onset of macular hole affects visual prognosis.
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Affiliation(s)
- Hiroshi Mizuno
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan.,Department of Ophthalmology, Hirakata City Hospital, Hirakata, Osaka, Japan
| | - Masashi Mimura
- Department of Ophthalmology, First Towakai Hospital, Takatsuki, Osaka, Japan
| | | | - Takaki Sato
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Kaisei Hospital, 1-6-10 Miyahara Yodogawa-ku, Osaka, 532-0003, Japan.
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Mimura M, Nishikawa Y, Inagaki K, Sato Y, Fujita Y, Kikkawa D. Change of intraocular blood flow during treatment for thyroid eye disease. Taiwan J Ophthalmol 2022; 12:97-100. [PMID: 35399966 PMCID: PMC8988972 DOI: 10.4103/tjo.tjo_2_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022] Open
Abstract
To report a sequential observational study of changes in the retinal and choroidal blood flow during medical and surgical treatments for a thyroid eye disease (TED) patient, using optical coherence tomography angiography (OCTA) and laser speckle flowgraphy (LSFG). A 28-year-old man with a history of Graves’ disease diagnosed 8 months prior was presented in the active phase of TED. His clinical activity score (CAS) was 6, but without diplopia or visual loss. Intraocular pressure measurement was OD 20 mmHg and OS 24 mmHg. Thyrotropin receptor antibody (TRAb) and thyroid-stimulating antibody levels were 18.8 IU/L and 4347%. Magnetic resonance imaging revealed enlargement of both extraocular muscles and fat compartments in both orbits. The patient underwent IV pulsed steroid therapy (1 g/day, 3 days) followed by an oral prednisone for 1 month. His CAS score decreased to 4. Bilateral orbital fat decompression decreased his final CAS score to 1 in both eyes. Intraocular blood flow was measured using laser speckle flowgraphy (LSFG), and OCTA was performed. Retinal blood flow increased slightly, but choroidal blood flow showed a robust increase. Choroidal blood flow measured using both LSFG and OCTA was negatively correlated with the CAS score and TRAb. In our case report, the ocular perfusion, especially choroidal blood flow, may decrease in active TED, which may be reversed by medical and surgical treatment.
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Sato Y, Mimura M, Fujita Y, Oku H, Ikeda T. Chronologic Analysis of Tear Dynamics on Blinking Using Quantitative Manometry in Healthy Humans. Ophthalmic Plast Reconstr Surg 2022; 38:22-28. [PMID: 33710038 DOI: 10.1097/iop.0000000000001962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To analyze the tear dynamics during blinking by measuring the inner pressure of the upper lacrimal drainage system. METHODS This observational study involved 11 healthy bi- or tricenarian volunteers. Direct manometry was performed using a fiber optic pressure sensor inserted into the conjunctival sac, upper/lower canaliculus (5 mm from punctum), and inferior lacrimal sac (15 mm from punctum) during both involuntary and intentional tight blinking. Pressure was measured 200 times/second during 3 separate blinks and then chronologically analyzed. RESULTS In all subjects of all locations during both types of blinking, the inner pressures during the stationary eyelid closing/opening were positive/approximately zero, while a positive/negative pressure spike was observed during the eyelid closing/opening movement. The averages of the maximum pressure in the spike during the intentional tight blinking (tPmax: mm Hg) in the conjunctival sac, upper/lower canaliculus, and lacrimal sac were 8.00, 12.39/12.93, and 10.59, respectively, while for the minimum (tPmin: mm Hg), the pressures were -3.18, -3.91/-3.43, and -3.31, respectively. The tPmax and tPmin in the lacrimal duct were positively correlated with that of the conjunctival sac, which suggested synchronism of the drainage system. However, the tPmax in the canaliculus was significantly higher than that of the conjunctival sac, which suggested that tears do not flow from the conjunctival sac into the lacrimal duct during eyelid closure. CONCLUSIONS The upper lacrimal drainage system functions as one united lumen in the lacrimal pump. The positive /negative pressure spike is essential for the lacrimal pump to efficiently eject/aspirate the tear from the lacrimal/conjunctival sac.
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Affiliation(s)
- Yohei Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
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Mimura M, Matsuura T, Takagi M, Taki K, Sato Y, Fujita Y, Oku H, Ikeda T. A randomized clinical trial of triamcinolone acetonide injection for suppression of inflammation after blepharoptosis surgery. J Plast Reconstr Aesthet Surg 2021; 75:1744-1749. [PMID: 34961699 DOI: 10.1016/j.bjps.2021.11.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 11/14/2021] [Indexed: 11/16/2022]
Abstract
This study aimed to determine the effectiveness of triamcinolone acetonide in suppressing inflammation after blepharoptosis surgery. The study was designed as prospective, randomized, two medical centers' clinical trial. Thirty-two patients with involutional blepharoptosis of the same degree in both eyelids underwent bilateral transcutaneous levator advancement. At the end of the surgery, 4 mg/0.1 ml of triamcinolone acetonide was injected into a randomly selected upper eyelid. The fellow eyelid was not injected and was used as control. Facial photographs were taken on day 1, week 1, month 1, and month 3, and the degree of inflammation, the margin reflex distance 1 (MRD-1), and levator function (LF) between the two eyelids of each patient were compared. The primary outcome was the selection of the less inflamed eyelid decided by the majority of three individuals unrelated to the study. MRD-1 and LF were analyzed for secondary outcomes. As a result, the injected eyelid was judged to be the less inflamed eyelid in all cases. The MRD-1 in the postoperative period less than 1 month was significantly larger in the injected eyelids than the control eyelids (P<0.03). The postsurgical MRD-1 at month 3, the postsurgical LF at all postsurgical examination times were not statistically different. Adverse complications by the injection, including ptosis, levator dysfunction, increase of the intraocular pressure, and visual disturbance were not observed. In conclusion, a triamcinolone acetonide injection after ptosis surgery is both safe and effective in reducing the early postsurgical inflammation and helpful in an earlier return to a daily routine for the patients.
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Affiliation(s)
- Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan; Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.
| | | | - Mai Takagi
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Koichiro Taki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Yohei Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Yasushi Fujita
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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Mimura M, Sato Y, Fujita Y, Oku H, Sato B, Ikeda T. Impact of habitual swimming on the success of lacrimal surgery. Jpn J Ophthalmol 2021; 65:849-854. [PMID: 34357441 DOI: 10.1007/s10384-021-00865-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To elucidate how factors associated with swimming affect the lacrimal ducts of swimmers. STUDY DESIGN Prospective, interventional cohort study, METHODS: Five hundred seventy four consecutive epiphora patients were surveyed via a questionnaire regarding details of their swimming-pool usage; i.e., frequency, swim-goggles' wear, and type of pool activity (i.e., swimming vs. waist-depth walking). In this cohort, all the swimmers over 20 years old with anatomical lacrimal duct obstruction underwent surgical reconstruction. The surgical success rates at 12-months postoperative were compared using multivariable logistic regression analyses between swimmer/non-swimmer patients, those with a history of high/low frequency of pool usage, and those with high/low amount of conjunctival contact with the swimming-pool water. RESULTS Of the patients with anatomical lacrimal duct obstruction, 6.4% were habitual swimmers; nasolacrimal duct obstruction was more common in the swimmers than in the non-swimmers' controls (89.1%/66.7%, P = 0.025). The success rate of lacrimal surgery for the swimmers with anatomical nasolacrimal duct obstruction was lower (60.6%) than of the non-swimmers (83.3%, P = 0.048). A receiver operating characteristic curve analysis of the frequency for the prediction of surgical failure showed that the threshold was 4 days/week. The success rate was statistically lower (26.7%) in the high-frequency swimmers compared to the low-frequency swimmers (88.9%, P = 0.037). However, no statistical difference in the high/low ocular surface contact to the swimming-pool water was observed (71.4%/57.7%, P = 0.56). CONCLUSION Habitual swimmers have a high risk of nasolacrimal-duct damage retrogradely from the nasal cavity that lowers lacrimal surgery's success rate.
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Affiliation(s)
- Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan. .,Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.
| | - Yohei Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
| | - Yasushi Fujita
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
| | - Bunpei Sato
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan
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Hirokawa T, Mimura M, Tonari M, Sato Y, Fujita Y, Matsuo J, Oku H, Sugasawa J, Ikeda T. Compressive optic neuropathy (CON) in Graves' disease caused by hypertrophy of levator and superior rectus muscles: A case report. Medicine (Baltimore) 2021; 100:e25062. [PMID: 33832074 PMCID: PMC8036063 DOI: 10.1097/md.0000000000025062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/15/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Enlargemento of the medial rectus is the most predominant factor of compressive optic neuropathy (CON) in Graves' disease. This case report indicates that CON could develop only from the hypertrophic superior levator and superior rectus (SL/SR) muscle in a patient with poorly controlled Graves' disease, and described the possible risk of FT3-thyrotoxicosis with a prominent goiter to develop the current rare case with a review of the literature. PATIENT CONCERNS A 66-year-old woman undergoing endocrine management of hyperthyroidism with prominent goiter visited the Department of Ophthalmology due to right-eye upper-eyelid retraction. DIAGNOSES At initial presentation, the right and left margin reflex distance-1 (MRD-1) was 3.2 mm and 2.1 mm, respectively, and no proptosis or visual dysfunction was observed. Despite insufficient hormonal regulation, she refused to undergo goiter removal. The upper eyelid retraction gradually worsened to 7.7 mm of MRD-1, followed by the onset of 20 prism diopters (PD) of the right hypertropia, resulting in right-eye CON after 6 months. Her free thyroxin level was 3.88 ng/dl and free triiodothyronine was 24.90 pg/ml. Computed tomography and magnetic resonance imaging showed only SL/SR enlargement in the right orbit. INTERVENTIONS Intravenous steroid and radiation therapy resulted in visual improvement; however, a prominent upper eyelid retraction and 35PD of hypertropia remained in her right eye. Orbital decompression, upper retraction repair, and superior rectus recession were performed to prevent the recurrence of CON and correct any disfigurement. OUTCOMES The combination of conventional intravenous steroid pulse therapy, radiotherapy, and orbital decompression was effective, and no recurrence was observed for more than 1.5-years postoperatively. LESSONS Enlargement of the SL/SR muscle complex may independently induce the CON. We believe that strict attention should be paid to patients with triiodothyronine thyrotoxicosis with progressive eyelid retraction and hypertropia.
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Kitada T, Mimura M, Takahashi Y, Takagi M, Oku H, Ikeda T. Dacryoendoscopy-guided re-canalization of canaliculops: Two case reports. Medicine (Baltimore) 2021; 100:e24985. [PMID: 33725869 PMCID: PMC7969210 DOI: 10.1097/md.0000000000024985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/11/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE Canaliculops is a rare condition, and only 11 cases have been reported previously. We report 2 cases of canaliculops, which were successfully treated using the new recanalization technique under dacryoendoscopy followed by bicanalicular lacrimal intubation. PATIENT CONCERNS A 78-year-old man and a 76-year-old woman had 3- and 1-year histories of medial-upper eyelid swelling (left and right, respectively) without any inflammatory signs, history of periocular trauma, herpes infection, use of specific drugs, or ophthalmic diseases of note. DIAGNOSES The cystic lesions were evaluated using ultrasound biometry or computed tomography to find the lumen of the horizontal canaliculus was exceedingly expanded, and to confirm the clinical diagnosis of canaliculops. INTERVENTIONS As the 2 cases of canaliculops were caused by upper puncta and common canaliculus obstructions, canaliculops of the upper eyelid were recanalized under dacryoendoscopic guidance, followed by bicanalicular intubation. The tubes were kept in situ involving bi-weekly irrigation and instillation of antibiotic and anti-inflammatory eye drops, and were removed after 2 to 3 months of follow-up. OUTCOMES Epiphora, and eyelid swelling were completely resolved immediately after the procedure, and the lesions did not recur on follow-up after more than 6 months. LESSONS Eleven case series of canaliculops have been described previously, but this is the first report of this recanalization procedure offering a new, less invasive treatment option compared to complete or partial resection of the cystic lesion.
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Affiliation(s)
- Tomoko Kitada
- Department of Ophthalmology, Osaka Medical College, Takatsuki
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka
| | - Yasuhiro Takahashi
- Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan
| | - Mai Takagi
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki
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Yatomi T, Uchida T, Takeuchi H, Kuramochi S, Yoshimura K, Mimura M, Uchida H. Prescription patterns of psychotropics in patients receiving synthetic glucocorticoids. Acta Psychiatr Scand 2020; 142:242-248. [PMID: 32677065 DOI: 10.1111/acps.13217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/10/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Synthetic glucocorticoids cause various psychiatric symptoms. Prescription of psychotropic drugs could be considered to be a proxy for manifestation of psychiatric symptoms. The aim of this study was to investigate the prescriptions of psychotropics in outpatients receiving synthetic glucocorticoids. METHODS We used the claims sampling data during January 2015 from the National Database of Health Insurance Claims and Specific Health Checkups of Japan made by the Ministry of Health, Labor, and Welfare in Japan. We compared the prescription rates of psychotropics between outpatients receiving oral synthetic glucocorticoids and age- and sex-matched controls and the prescription rates of psychotropics among the eight dosage groups of synthetic glucocorticoids by chi-squared test, and chlorpromazine/imipramine/diazepam equivalent doses (or daily defined doses) of respective psychotropics among these groups using Welch's t-test. RESULTS Synthetic glucocorticoids were prescribed to 3.1% (n = 18 122) of 581 990 patients. The prescription rates of psychotropics were significantly higher among the synthetic glucocorticoid recipients than among the non-recipients: antipsychotics, 1.8% (n = 321) vs. 1.1% (n = 201) (P = 1.4 × 10-7 ); antidepressants, 4.0% (n = 724) vs. 2.0% (n = 359) (P = 8.7 × 10-30 ); anxiolytics/hypnotics, 16.7% (n = 3029) vs. 10.2% (n = 1841) (P = 2.7 × 10-75 ); and mood stabilizers, 1.3% (n = 238) vs. 0.7% (n = 120) (P = 3.6 × 10-10 ) respectively. There was no significant difference in the prescription rates of any psychotropic drugs, other than anxiolytics/hypnotics, among the eight synthetic glucocorticoid dosage groups. CONCLUSION Prescriptions of oral synthetic glucocorticoids were found to be associated with the use of any of the types of psychotropic drugs, other than anxiolytics/hypnotics, although a causal relationship could not be confirmed due to the retrospective and cross-sectional nature of this study.
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Affiliation(s)
- T Yatomi
- Department of Neuropsychiatry, Kawasaki Municipal Hospital, Kanagawa, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - T Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - H Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - S Kuramochi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry, Yamanashi Prefectural Kita Hospital, Yamanashi, Japan
| | - K Yoshimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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12
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Terubayashi Y, Morishita S, Kohmoto R, Mimura M, Fukumoto M, Sato T, Kobayashi T, Kida T, Ikeda T. Type III uveal effusion syndrome suspected to be related to pachychoroid spectrum disease: A case report. Medicine (Baltimore) 2020; 99:e21441. [PMID: 32756157 PMCID: PMC7402756 DOI: 10.1097/md.0000000000021441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION We report a case of type III uveal effusion syndrome (UES) suspected to be related to pachychoroid spectrum disease. PATIENT CONCERNS A 42-year-old man became aware of visual field constriction and deterioration of visual acuity in his right eye. DIAGNOSIS Upon examination, a bullous non-rhegmatogenous retinal detachment was observed in the inferior 2 quadrants of the right eye fundus, and the subretinal fluid moved with postural changes. The axial length in that eye was 22.36 mm, thus indicating no nanophthalmia. Preoperative indocyanine green angiography revealed dilated choroidal vessels in the posterior pole of the right eye and mild leakage in the late phase. Optical coherence tomography examination revealed choroidal thickening in both eyes. INTERVENTIONS For treatment, we first performed sclerotomy, and the intraoperative findings showed no thickening of the sclera. Following surgery, reattachment of the retina was not achieved. OUTCOMES Thus, we next performed vitrectomy, which led to successful reattachment of the retina. LESSONS In this case, we theorize that pachychoroid spectrum disease might have been involved in the pathogenesis of type III UES.
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13
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Nishi H, Kohmoto R, Mimura M, Fukumoto M, Sato T, Kida T, Ikeda T. Concurrent vitrectomy for persistent pupillary membrane complicated by severe myopia and vitreomacular traction syndrome: A case report. Medicine (Baltimore) 2020; 99:e20895. [PMID: 32590799 PMCID: PMC7328996 DOI: 10.1097/md.0000000000020895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia. PATIENT CONCERNS This study involved a 63-year-old female patient who had been diagnosed with bilateral PPM at a local eye clinic and who was subsequently referred to our department for a more detailed examination due to a recent decrease of visual acuity. DIAGNOSES Slit-lamp microscopy examination revealed bilateral PPM. The ocular fundus revealed peripapillary conus and myopic change in both eyes. Optical coherence tomography examination revealed no particular abnormalities in the right eye, yet did show findings indicative of vitreomacular traction syndrome in the left eye. INTERVENTIONS In both eyes, we performed surgical removal of the PPM, phacoemulsification aspiration, and intraocular lens implantation, yet in the patient's left eye, vitrectomy was also performed. OUTCOMES After surgery, the patient's visual acuity improved in both eyes. CONCLUSION The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.
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14
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Yoshida Y, Sato T, Oosuka S, Mimura M, Fukumoto M, Kobayashi T, Kida T, Ikeda T. Two cases of diabetic macular edema complicated by an atypical macular hole. BMC Ophthalmol 2020; 20:171. [PMID: 32349686 PMCID: PMC7191691 DOI: 10.1186/s12886-020-01444-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Here we report two patients who developed an atypical macular hole (MH) during the treatment course for diabetic macular edema (DME). Case presentations Patient 1 was a 73-year-old male. Optical coherence tomography (OCT) revealed perifoveal retinoschisis (RS) in addition to cystoid macular edema and serous retinal detachment (SRD) in his left eye, and that an MH had developed during the clinical course. A convex surface was formed at the MH margin toward the vitreous cavity, and granular shadows were observed in the fluid cuff. Intraoperative findings revealed a thin epiretinal macular membrane (ERM) around the MH. Patient 2 was a 79-year-old male. Although the patient underwent pars plana vitrectomy (PPV) for proliferative diabetic retinopathy (PDR) in both eyes, RS and a thin ERM in addition to SRD was observed in his left eye after surgery, and an MH developed during the clinical course. As in Patient 1, a convex surface was formed at the fluid cuff margin toward the vitreous cavity. Conclusions Both patients had persistent DME, SRD, RS, and a thin ERM before the development of the MH. OCT revealed the formation of a convex surface at the MH margin toward the vitreous cavity, suggesting that the fragility of the layered structure of the retina combined with tangential retinal traction may have been involved in the atypical MH form.
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15
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Tonari M, Nishikawa Y, Matsuo J, Mimura M, Oku H, Sugasawa J, Ikeda N, Kurisu Y, Ikeda T. A Case of Giant Pituitary Adenoma Associated with a Postoperative Mental Disorder That Ultimately Resulted in Bilateral Blindness. Case Rep Ophthalmol 2020; 11:92-99. [PMID: 32308609 PMCID: PMC7154240 DOI: 10.1159/000506392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 02/09/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To report the case of a patient with adrenocorticotropic hormone (ACTH)-producing pituitary adenoma who developed a mental disorder after initial surgery that kept him from undergoing scheduled follow-up visits and who ultimately had a giant recurrent tumor that resulted in blindness. Case Report A 37-year-old male presented with the primary complaint of decreased visual acuity (VA) in both eyes and visual field defects. Visual field examination revealed bitemporal hemianopia. Magnetic resonance imaging (MRI) showed a pituitary tumor of approximately 4 cm in diameter extending from the intrasellar region to the sphenoid sinus and the suprasellar region. Transnasal transsphenoidal surgery was performed. Immunostaining of tumor tissue collected intraoperatively showed ACTH-positive cells, thus leading to the diagnosis of ACTH-producing pituitary adenoma. Postoperatively, the patient reportedly developed mental disorder that possibly interfered with scheduled appointments or continuous follow-up visits for many years, so we had no postoperative data about the vision/visual filed. Seven years later, he presented with markedly decreased VA (i.e., no light perception) in both eyes. Fundus examination showed bilateral marked optic disc atrophy. MRI showed a larger than 8-cm diameter giant recurrent pituitary adenoma in the suprasellar region, for which craniotomy was performed for partial tumor resection. Preoperatively, his blood cortisol level was low, and the lesion was deemed a nonfunctioning pituitary adenoma. Postoperatively, no significant complications occurred, yet his VA was no light perception OD and light perception OS. Conclusions Clinicians should be aware that patients with ACTH-producing pituitary adenomas may develop a mental disorder following surgery and possibly be unable to undergo scheduled follow-up, thus illustrating the importance of establishing an adequate patient follow-up system.
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Affiliation(s)
- Masahiro Tonari
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Yuko Nishikawa
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Junko Matsuo
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Jun Sugasawa
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Naokado Ikeda
- Department of Neurosurgery, Osaka Medical College, Takatsuki-City, Japan
| | - Yoshitaka Kurisu
- Department of Pathology, Osaka Medical College, Takatsuki-City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
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16
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Sato Y, Mano N, Watanabe H, Miyamoto M, Shimizu K, Mukai N, Mimura M, Oku H, Ikeda T. A Case of Idiopathic Orbital Inflammation with Shallow Anterior Chamber and Choroidal Detachment. Case Rep Ophthalmol 2020; 11:8-15. [PMID: 32009933 PMCID: PMC6984139 DOI: 10.1159/000505314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 12/08/2019] [Indexed: 11/19/2022] Open
Abstract
We report a case of idiopathic orbital inflammation with a shallow anterior chamber and choroidal detachments. This study involved an 87-year-old female patient who presented at our department after becoming aware of the progression of diplopia. Examination of the patient's right eye revealed proptosis, as well as conjunctival edema with dilated and tortuous blood vessels. The right-eye anterior chamber was shallow, and fundus examination revealed marked choroidal detachments. Magnetic resonance imaging revealed enlargement of the right-orbit extraocular muscles and a suspected compression of the right-orbit superior and inferior ophthalmic veins, yet no expansion of the cavernous sinus. We diagnosed the patient as having idiopathic orbital inflammation in her right orbit, and subsequently started corticosteroid therapy. One week after initiating treatment, the anterior chamber was found to be nearing a normal depth, and the choroidal detachments were found to have disappeared. Our findings revealed that the inflammatory swelling of the extraocular muscle due to idiopathic orbital inflammation resulted in compression of the right-orbit superior and inferior ophthalmic veins, thus leading to an apparent choroidal circulation disorder that presented with a shallow anterior chamber and marked choroidal detachments.
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Affiliation(s)
- Yohei Sato
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan.,Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Natsuko Mano
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan.,Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Hiroko Watanabe
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan.,Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Makiko Miyamoto
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan.,Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Kazuhiro Shimizu
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan.,Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Noriko Mukai
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
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18
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Oku H, Kida T, Horie T, Taki K, Mimura M, Kojima S, Ikeda T. Tau Is Involved in Death of Retinal Ganglion Cells of Rats From Optic Nerve Crush. Invest Ophthalmol Vis Sci 2019; 60:2380-2387. [PMID: 31141609 DOI: 10.1167/iovs.19-26683] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine whether tauopathies are associated with impaired autophagy and involved in the death of retinal ganglion cells (RGCs) of rats from an optic nerve crush (ONC). Methods Short interfering RNA (siRNA) of the tau gene (si-Tau) or nontargeting siRNA (si-NC) was injected intravitreally 48 hours prior to ONC. The effects of silencing the tau gene on neuroprotection were determined by the number of Tuj-1-stained RGCs on days 7 and 14 after the ONC. The changes in the expressions of phosphorylated tau, P62, and LC3B were determined by immunoblots and immunohistochemistry on day 7. Results Autophagy was impaired in the retina on day 7 after the ONC as the P62 level increased by 3.1-fold from the sham control level with a reduction in the ratio LC3B2/LC3B1. There was a 2.1-fold increase of phosphorylated tau (ser 396) in the retina, and si-Tau depressed the increase by 1.3-fold (n = 3 each). The expressions of tau and P62 were well colocalized. They were observed in the somas of RGCs and retinal nerve fibers (RNFs), and these expressions were increased after the ONC. Pretreatment by si-Tau showed significant protection in the number of RGCs after the ONC. Specifically, the density of RGCs was 540 ± 74.5 cells/mm2 on day 14 in the si-NC group, while the level was maintained at 1321 ± 192 cells/mm2 in the si-Tau group (n = 4 each). Conclusions Silencing the tau gene is neuroprotective, and tauopathies may be involved in the death of RGCs after ONC. Impaired autophagy may be involved in ONC-induced tauopathies.
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Affiliation(s)
- Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Taeko Horie
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Koichiro Taki
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
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19
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Kubo K, Fleischhacker WW, Suzuki T, Yasui-Furukori N, Mimura M, Uchida H. Placebo effects in adult and adolescent patients with schizophrenia: combined analysis of nine RCTs. Acta Psychiatr Scand 2019; 139:108-116. [PMID: 30198163 DOI: 10.1111/acps.12960] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/20/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine characteristics of placebo responders and seek optimal criteria of early improvement with placebo for predicting subsequent placebo response in patients with schizophrenia. METHOD Data of 672 patients with schizophrenia randomized to placebo in nine double-blind antipsychotic trials were analyzed. Multiple logistic regression analyses were conducted to examine associations between placebo response at week 6 (i.e., a ≥ 25% reduction in the Positive and Negative Syndrome Scale [PANSS] score) and gender, age, study locations, baseline PANSS total or Marder 5-Factor scores, and per cent PANSS score reduction at week 1. Predictive power of improvement at week 1 for subsequent response was investigated; sensitivity and specificity of incremental 5% cutoff points between 5% and 25% reduction in the PANSS total score at week 1 were calculated. RESULTS Per cent PANSS total score reduction at week 1 and lower PANSS Marder disorganized thought scores at baseline were significantly associated with subsequent placebo response. A 10% reduction in a per-protocol analysis or a 15% reduction in last-observation-carried-forward analysis in the PANSS total score at week 1 showed the highest predictive power. CONCLUSION These findings are informative to identify potential placebo responders at the earliest opportunity for optimal trial design for schizophrenia.
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Affiliation(s)
- K Kubo
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - W W Fleischhacker
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - T Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry and Clinical Ethics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - N Yasui-Furukori
- Department of Neuropsychiatry, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
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20
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Sato T, Yasuhara T, Fukumoto M, Mimura M, Kobayashi T, Kida T, Kojima S, Oku H, Ikeda T. Investigation of scleral thermal injuries caused by ultrasonic pars plana phacoemulsification and aspiration using pig eyes. Int Ophthalmol 2018; 39:2015-2021. [PMID: 30353259 DOI: 10.1007/s10792-018-1036-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/11/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE The purpose of this study was to investigate the thermal injuries caused by ultrasonic pars plana phacoemulsification and aspiration (PPPEA) using pig eyes. METHOD Using a 20-gauge (G) vitrectomy system (Accurus®, Fragmatome; Alcon Laboratories) in both the 'open-tip' and 'closed-tip' techniques, PPPEA was performed in pig eyes and the subsequent thermal injuries generated around the scleral wound were measured by infrared thermal imaging (thermography). Post surgery, the state of the scleral wound was observed under a microscope, and a tissue slice containing the scleral wound was then prepared and observed under an optical microscope. RESULTS Thermography measurements revealed a slight temperature rise around the scleral wound in the open-tip case, yet a marked temperature rise in the closed-tip case. The scleral wound incision produced by the open tip was linear, while that produced by the closed tip was expanded. Histological examination revealed mild degeneration of the sclera around the wound in the open-tip case, yet marked tissue degeneration by thermal injuries in the closed-tip case. CONCLUSION Our findings showed that in PPPEA, the temperature of the tip of a 20G vitrectomy system rapidly increases due to the closed-tip technique, thus producing obvious thermal damage to the scleral wound. In order to prevent thermal injuries to the scleral wound during PPPEA, it is important to shorten the time of ultrasonic oscillation during surgery as much as possible while the tip is occluded with nuclear fragments.
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Affiliation(s)
- Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | | | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan.
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21
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Kabir MH, Mimura M, Tsai JC. Spreading Waves in a Farmers and Hunter-Gatherers Model of the Neolithic Transition in Europe. Bull Math Biol 2018; 80:2452-2480. [DOI: 10.1007/s11538-018-0475-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
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22
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Yonemoto Y, Morishita S, Fukumoto M, Mimura M, Sato T, Kida T, Kojima S, Oku H, Sugasawa J, Ikeda T. Bilateral rhegmatogenous retinal detachment due to unusual retinal degeneration in Down syndrome: A case report. Medicine (Baltimore) 2018; 97:e10896. [PMID: 29851814 PMCID: PMC6392586 DOI: 10.1097/md.0000000000010896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
RATIONALE The aim of this study was to report a case of Down syndrome (DS) complicated with bilateral retinal detachment (RD) due to unusual retinal degeneration. PATIENT CONCERNS A 9-year-old girl complained of bilateral visual disturbance during a follow-up examination for myopia and strabismus. DIAGNOSES Slit-lamp examination revealed moderate posterior subcapsular cataract in both eyes. B-mode echography showed bilateral bullous RD; however, it was difficult to detect the causal retinal breaks due to poor mydriasis. INTERVENTIONS For treatment, the patient underwent bilateral lensectomy, vitrectomy, and silicone oil tamponade. OUTCOMES Intraoperative findings revealed symmetrical retinal breaks and unusual caterpillar-like retinal degeneration on the upper temporal side of both eyes. Three months later, the patient underwent bilateral silicone oil removal and intraocular lens implantation. LESSONS In this case, the retinal degeneration was morphologically different from retinal lattice degeneration, thus suggesting that it might be involved in the onset of DS-related bilateral RD.
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Affiliation(s)
- Yumiko Yonemoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
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Kimura D, Sato T, Oosuka S, Kohmoto R, Fukumoto M, Mimura M, Tajiri K, Kobayashi T, Kida T, Ikeda T. Case Report of a Family Affected by Stickler Syndrome in Which Rhegmatogenous Retinal Detachment Occurred in Five Eyes of Three Siblings. Case Rep Ophthalmol 2018; 9:1-8. [PMID: 29643775 PMCID: PMC5892342 DOI: 10.1159/000485551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/22/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose Stickler syndrome is an autosomal dominant inherited disorder that is well known to be highly associated with the development of rhegmatogenous retinal detachment. In this study, we report the case of a family affected by Stickler syndrome in which rhegmatogenous retinal detachment developed in 5 eyes of 3 siblings. Case Series For treatment, we performed vitreous surgery on 1 eye of the eldest son, and bilateral scleral buckling surgery on the 2 younger children. A good postoperative outcome was obtained on the 4 eyes that underwent scleral buckling surgery, yet the prognosis was poor on the 1 eye that underwent vitrectomy due to redetachment of the retina and corneal complication. Since vitreous surgery was quite difficult due to strong vitreoretinal adhesion, we created an artificial posterior vitreous detachment via the bimanual technique combined with encircling. For the scleral buckling surgery, broad scleral extrusion was needed to seal multiple retinal breaks. Conclusions The findings of this study showed a high prevalence of rhegmatogenous retinal detachment in a single family with Stickler syndrome. In these cases, scleral buckling surgery was effective for treating the detached retina, and some prophylactic treatment, such as laser photocoagulation to prevent the occurrence of rhegmatogenous retinal detachment, should be considered for such cases in the future.
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Affiliation(s)
- Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki-City, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Shou Oosuka
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Kensuke Tajiri
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
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Mizuno Y, Hofer A, Frajo-Apor B, Wartelsteiner F, Kemmler G, Pardeller S, Suzuki T, Mimura M, Fleischhacker WW, Uchida H. Religiosity and psychological resilience in patients with schizophrenia and bipolar disorder: an international cross-sectional study. Acta Psychiatr Scand 2018; 137:316-327. [PMID: 29141100 DOI: 10.1111/acps.12838] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The impact of religious/spiritual activities on clinical outcomes in patients with serious mental illnesses remains controversial, which was addressed in this international cross-sectional study. METHOD Three-hundred sixty-nine subjects were recruited from Austria (n = 189) and Japan (n = 180), consisting of 112 outpatients with paranoid schizophrenia, 120 with bipolar I disorder (DSM-IV), and 137 healthy controls. Religiosity was assessed in terms of attendance and importance of religious/spiritual activities, while resilience was assessed using the 25-item Resilience Scale. General linear models were used to test whether higher religiosity will be associated with higher resilience, higher social functioning, and lower psychopathology. The association between levels of spiritual well-being and resilience was also examined. RESULTS Attendance of religious services (F[4,365] = 0.827, P = 0.509) and importance of religion/spirituality (F[3,365] = 1.513, P = 0.211) did not show significant associations with resilience. Regarding clinical measures, a modest association between higher importance of religion/spirituality and residual manic symptoms was observed in bipolar patients (F[3,118] = 3.120, P = 0.029). In contrast to the findings regarding religiosity, spiritual well-being showed a strong positive correlation with resilience (r = 0.584, P < 0.001). CONCLUSION The protective effect of religiosity in terms of resilience, social functioning, and psychopathology was not evident in our sample. Spiritual well-being appears more relevant to resilience than religiosity.
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Affiliation(s)
- Y Mizuno
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - A Hofer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - B Frajo-Apor
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - F Wartelsteiner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - G Kemmler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - S Pardeller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - T Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Neuropsychiatry and Clinical Ethics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - W W Fleischhacker
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Geriatric Mental Health Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Alameddine RM, Ko AC, Mimura M, Parker BA, Lin JH, Korn BS, Kikkawa DO. Orbital fat regeneration following hormonal treatment of metastatic breast carcinoma. Orbit 2017; 37:187-190. [PMID: 29072521 DOI: 10.1080/01676830.2017.1383468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Enophthalmos in the setting of breast cancer metastatic to the orbit results primarily from the disease pathogenesis, or secondary to treatment effects. Orbital volume restoration and fat regeneration following endocrine treatment monotherapy has not been previously reported. A 76- year-old previously healthy female presented with progressive right enophthalmos secondary to metastatic lobular breast carcinoma. Treatment with an aromatase inhibitor (letrozole) resulted in tumor regression and orbital fat restoration with a corresponding improvement in orbital volume and enophthalmos on clinical exam. The patient is alive on continued letrozole with no progressive disease ten years after diagnosis. This case illustrates the resilience of orbital soft tissues and ability of orbital fat to regenerate in face of breast cancer metastasis. We hypothesize that endocrine monotherapy, and avoidance of radiation therapy, allowed for differentiation of remaining orbital stem cells, and facilitated the fat regenerative process.
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Affiliation(s)
- Ramzi M Alameddine
- a Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology , Shiley Eye Institute , La Jolla , CA , USA.,b Department of Ophthalmology , American University of Beirut Medical Center , Beirut , Lebanon
| | - Audrey C Ko
- a Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology , Shiley Eye Institute , La Jolla , CA , USA
| | - Masashi Mimura
- a Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology , Shiley Eye Institute , La Jolla , CA , USA
| | - Barbara A Parker
- c Department of Medicine , UC San Diego Moores Cancer Center , La Jolla , CA , USA
| | - Jonathan H Lin
- d UC San Diego Department of Pathology , San Diego , California , USA.,f Veterans Affairs San Diego Healthcare System , San Diego , California , USA
| | - Bobby S Korn
- a Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology , Shiley Eye Institute , La Jolla , CA , USA.,e Division of Plastic Surgery , UC San Diego Department of Surgery , La Jolla , CA , USA
| | - Don O Kikkawa
- a Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology , Shiley Eye Institute , La Jolla , CA , USA.,e Division of Plastic Surgery , UC San Diego Department of Surgery , La Jolla , CA , USA
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Oku H, Morishita S, Horie T, Kida T, Mimura M, Kojima S, Ikeda T. P7C3 Suppresses Neuroinflammation and Protects Retinal Ganglion Cells of Rats from Optic Nerve Crush. Invest Ophthalmol Vis Sci 2017; 58:4877-4888. [PMID: 28973334 DOI: 10.1167/iovs.17-22179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine whether P7C3-A20 can inhibit the phosphorylation of the mammalian target of rapamycin (mTOR), depress neuroinflammation, and protect retinal ganglion cells (RGCs) of rats from optic nerve crush (ONC). Methods The left optic nerve was crushed, and 5.0 mg/kg/d of P7C3-A20, 1.0 mg/kg/d of rapamycin, or their vehicle was injected intraperitoneally for 3 consecutive days beginning 1 day before the ONC. The protective effects on the RGCs were determined by immunohistochemical staining for Tuj-1. The level of phosphorylated mTOR was determined by immunoblotting. The neuroinflammation in the optic nerve was determined by changes in the expression of CD68, TNF-α, MCP-1, and iNOS. Results The density of Tuj-1-stained cells in the control was 2010 ± 81.5/mm2 and 1842 ± 80.4/mm2 on days 7 and 14 after the sham operation. These levels were lower at 995 ± 122/mm2 and 450 ± 52.4/mm2 on days 7 and 14 after the ONC, respectively. Rapamycin and P7C3-A20 preserved the density at significantly higher levels on both days (P < 0.05, Scheffe test). The level of phosphorylated mTOR increased by 1.56-fold above the control level on day 7. Rapamycin and P7C3 significantly lowered the level of phosphorylated mTOR to 0.89-fold and 0.67-fold of the control, respectively. There was an accumulation of CD68+ cells that were immunoreactive to TNF-α at the crush site. The expression of MCP-1 and iNOS was increased chiefly in the astrocytes around the lesion. These inflammatory events were suppressed by both rapamycin and P7C3. Conclusions P7C3-A20 can inhibit mTOR phosphorylation in the crushed optic nerve, which may suppress neuroinflammation and preserve the RGCs.
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Affiliation(s)
- Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Taeko Horie
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
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Svensson T, Inoue M, Sawada N, Charvat H, Mimura M, Tsugane S. High serum total cholesterol is associated with suicide mortality in Japanese women. Acta Psychiatr Scand 2017; 136:259-268. [PMID: 28547796 DOI: 10.1111/acps.12758] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the association between serum total cholesterol (TC) and suicide using a large general population cohort with long follow-up times. METHOD Analyses included 16 341 men and 28 905 women aged 40-69 from the Japan Public Health Center-based Prospective Study followed from 1990 to 2012. TC levels were defined per clinical guidelines: low (<4.66 mmol/l [180 mg/dl]), normal (4.66-5.70 mmol/l [180-220 mg/dl]), and high (≥5.70 mmol/l [220 mg/dl]). Cox proportional hazards regression models were used to determine hazard ratios (HR) and confidence intervals (CI) for suicide according to TC level. Mean follow-up time was 19 years for men and 20 years for women. RESULTS There were 185 suicides (men: 107; women: 78) during follow-up. Compared to women with normal TC, women with high TC had a significantly increased risk of suicide (HR = 1.90, 95% CI, 1.13-3.19). Incremental increases (0.26 mmol/l [10 mg/dl]) of low-density lipoprotein (HR = 1.11, 95% CI, 1.02-1.21) and non-high-density lipoprotein cholesterol (HR = 1.09, 95% CI, 1.01-1.18) were also associated with increased risk of suicide in women. There was no association between TC levels, or lipid fractions, and suicide in men. CONCLUSION High TC levels may be associated with an increased risk of suicide in women.
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Affiliation(s)
- T Svensson
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.,Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Inoue
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - N Sawada
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - H Charvat
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - S Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
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Hofer A, Mizuno Y, Wartelsteiner F, Wolfgang Fleischhacker W, Frajo-Apor B, Kemmler G, Mimura M, Pardeller S, Sondermann C, Suzuki T, Welte A, Uchida H. Quality of life in schizophrenia and bipolar disorder: The impact of symptomatic remission and resilience. Eur Psychiatry 2017; 46:42-47. [PMID: 28992535 DOI: 10.1016/j.eurpsy.2017.08.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 08/18/2017] [Accepted: 08/20/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQOL) is significantly affected in individuals with schizophrenia or bipolar I disorder (BD-I). The current study investigated whether symptomatic remission and resilience might differently impact HRQOL in these patients. METHODS Fifty-two patients with schizophrenia and 60 patients suffering from BD-I from outpatient mental health services as well as 77 healthy control subjects from the general community were included into a cross-sectional study. HRQOL and resilience were assessed using the WHOQOL-BREF and the Resilience Scale. In patients, psychopathology was quantified by the Positive and Negative Syndrome Scale or the Montgomery Asberg Depression Rating Scale and the Young Mania Rating Scale, respectively. RESULTS Notably, both patient groups showed lower HRQOL and resilience compared to control subjects, non-remitted patients indicated lower HRQOL than remitted ones. The effect of remission on HRQOL was significantly larger in patients with BD-I than in those with schizophrenia but did not explain the difference in HRQOL between groups. Resilience predicted HRQOL in all three groups. When accounting for the effect of resilience among remitted patients, only the difference in HRQOL between schizophrenia patients and control subjects was significant. CONCLUSION These findings demonstrate the impact of symptomatic remission and resilience on HRQOL of both patients suffering from schizophrenia and BD-I and indicate that these factors are especially relevant for HRQOL of patients with BD-I.
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Affiliation(s)
- A Hofer
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria.
| | - Y Mizuno
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan; Institute of Psychiatry, Psychology and Neuroscience, King's College London, Department of Psychosis Studies, London, UK
| | - F Wartelsteiner
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - W Wolfgang Fleischhacker
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - B Frajo-Apor
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - G Kemmler
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - M Mimura
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - S Pardeller
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - C Sondermann
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - T Suzuki
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
| | - A Welte
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstr. 35, 6020 Innsbruck, Austria
| | - H Uchida
- Keio University School of Medicine, Department of Neuropsychiatry, Tokyo, Japan
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Ochi R, Sato B, Morishita S, Imagawa Y, Mimura M, Fukumoto M, Sato T, Kobayashi T, Kida T, Ikeda T. Case of asteroid hyalosis that developed severely reduced vision after cataract surgery. BMC Ophthalmol 2017; 17:68. [PMID: 28506223 PMCID: PMC5433071 DOI: 10.1186/s12886-017-0467-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 05/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report our findings in a patient with asteroid hyalosis (AH) who had a severe reduction of his visual acuity following cataract surgery. The vision was improved by vitreous surgery. CASE PRESENTATION The patient was an 81-year-old man. Following cataract surgery on his left eye, his decimal best-corrected visual acuity (BCVA) was markedly reduced from 0.2 to 0.02. A large number of asteroid bodies (ABs) was observed to be concentrated on the posterior surface of the implanted intraocular lens. Ultrasound B-mode images showed turbidity of the vitreous that was denser in the anterior vitreous where the ABs were concentrated. During vitrectomy, the ABs were observed to be concentrated in the anterior vitreous cavity, and a complete posterior vitreous detachment (PVD) was present. After vitrectomy successfully removed the ABs, the visibility of the fundus improved and the BCVA recovered to 1.0. CONCLUSION We suggest that the visual impairment after the cataract surgery was due to the concentrated ABs in the anterior vitreous cavity. The clustering of the ABs in the anterior vitreous cavity was most likely caused by the PVD that developed during the cataract surgery.
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Affiliation(s)
- Ryosuke Ochi
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka-City, Osaka, Japan.,Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Bumpei Sato
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka-City, Osaka, Japan.,Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka-City, Osaka, Japan.,Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Yukihiro Imagawa
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka-City, Osaka, Japan.,Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
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Hirano J, Takamiya A, Yamagata B, Hotta S, Miyasaka Y, Pu S, Iwanami A, Uchida H, Mimura M. Frontal and temporal cortical functional recovery after electroconvulsive therapy for depression: A longitudinal functional near-infrared spectroscopy study. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Takamiya A, Hirano J, Pascual-Marqui R, Kito S, Kishimoto T, Mimura M. Electroconvulsive therapy modulates intralimbic and corticolimbic information flow: partial Granger causality analysis of resting EEG. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Nishikawa A, Hashimoto H, Takeda M, Kontani K, Miyatake T, Mimura M, Nagamatsu M, Yokoi T. Retrospective analysis of the survival benefit of chemotherapy for recurrent or advanced epithelial ovarian carcinoma in patients previously treated with paclitaxel plus platinum-based chemotherapy. EUR J GYNAECOL ONCOL 2016; 37:451-454. [PMID: 29894065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM The outcomes of treatment for women with recurrent or advanced epithelial ovarian carcinoma previously treated with pacli- taxel plus platinum-based chemotherapy were analyzed. MATERIALS AND METHODS Retrospective analysis was performed in a total of 65 series of treatments provided for 35 patients with a history of paclitaxel plus platinum-based chemotherapy. The chemotherapy regimens used were classified into the following four types for analysis: conventional paclitaxel plus carboplatin therapy (TC arm), pegylated liposomal doxorubicin-containing regimens (PLD arm), CPT-11-containing regimens (CPT-11 arm), and others. Disease-control rates (DCRs) were compared and subjected to univariate analysis. Progression-free survival (PFS) was determined from the date of the first cycle of each chemotherapy with the Kaplan-Meier method, and comparisons were performed using the log-rank test. RESULTS DCR was 80%, 71%, and 26% for the TC, PLD, and CPT-l arms, respectively. The median PFS was 286, 372, and 76 days for the TC, PLD, and CPT-11 arms, respectively. There was no discernible difference in PFS between the TC and the PLD arm. In contrast, PFS of the CPT- 11 arm was significantly shorter than that of the TC and PLD arms. In addition, three of seven (42.9%) treatments in the PLD arm maintained a progression-free period for longer than one year, while only one of 25 (4%) treatments in the TC arm maintained a progression-free period for more than one year. CONCLUSIONS The PFS of PLD is similar to that of TC. PLD-containing regimens might have a potential benefit with a higher PFS over one year than the TC regimen.
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Oku H, Morishita S, Horie T, Kida T, Mimura M, Fukumoto M, Kojima S, Ikeda T. Nitric Oxide Increases the Expression of Aquaporin-4 Protein in Rat Optic Nerve Astrocytes through the Cyclic Guanosine Monophosphate/Protein Kinase G Pathway. Ophthalmic Res 2015; 54:212-21. [PMID: 26517822 DOI: 10.1159/000440846] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/03/2015] [Indexed: 11/19/2022]
Abstract
AIMS Nitric oxide (NO) is associated with neuroinflammation in the central nervous system. We determined whether NO increases the expression of aquaporin-4 (AQP4) in optic nerve astrocytes of rats. METHODS Isolated astrocytes were incubated under normoxic or hypoxic conditions with or without glucose (5.5 mM). The astrocytes were also exposed to different concentrations of S-nitroso-N-acetyl-DL-penicillamine (SNAP, 1.0-100 μM), an NO donor. The expression of AQP4 was determined by Western blot analyses, and NO formation was measured by the Griess reaction. The changes in astrocytic cellular volumes were determined by flow cytometry. RESULTS Hypoxia and glucose deprivation increased AQP4 expression and NO formation. Inhibition of NO synthetase (NOS) significantly suppressed these changes. SNAP caused a significant increase in AQP4 expression, and the increase was significantly suppressed by carboxy-PTIO, a scavenger of NO. Incubation with 8-Br-cyclic guanosine monophosphate (cGMP) mimicked the effects of SNAP, while the addition of either 1H-[1,2,4]oxadiazolo[4,3,-a]quinoxalin-1-one (ODQ; inhibitor of soluble guanylate cyclase) or KT5823 (protein kinase G inhibitor) suppressed the SNAP-induced increase in AQP4 significantly. SNAP also caused a significant increase in astrocytic cellular volume through the AQP4 channels. CONCLUSIONS NO increased the AQP4 expression of optic nerve astrocytes through the cGMP/protein kinase G pathway and enlarged their volume.
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Affiliation(s)
- Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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Tsuboi T, Bies RR, Suzuki T, Takeuchi H, Nakajima S, Graff-Guerrero A, Mamo DC, Caravaggio F, Plitman E, Mimura M, Pollock BG, Uchida H. Predicting Plasma Olanzapine Concentration Following a Change in Dosage: A Population Pharmacokinetic Study. Pharmacopsychiatry 2015; 48:286-91. [PMID: 26506574 DOI: 10.1055/s-0035-1565070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Due to high inter-individual variability in peripheral pharmacokinetic parameters, dosing of antipsychotics currently relies on clinical trial-and-error, and predicting antipsychotic plasma concentrations before changing a dose has been a challenge. METHODS Patients with schizophrenia receiving a stable dose of olanzapine were included. 2 plasma samples were collected at 2 given time points for the measurement of plasma olanzapine concentrations. At least 7 days after a dosage change of olanzapine, a third sample was collected. The plasma concentration of the third sample was predicted in a blinded fashion using a mixed-effects model with NONMEM(®), using the following information: the 2 baseline plasma concentrations, the interval between the last dose and blood draw, and clinical and demographic information. RESULTS 31 subjects (mean±SD age=56.0±11.6; 19 men) were enrolled. The mean prediction (95% confidence interval) errors were 1.6 (-2.8 to 6.0) ng/mL. A highly significant correlation was observed between the observed and predicted concentrations of the third sample (r=0.91, p<0.001). DISCUSSION Plasma olanzapine concentrations following an actual dosage change can be predicted in advance with a high degree of certainty.
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Affiliation(s)
- T Tsuboi
- Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan
| | - R R Bies
- Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - H Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - S Nakajima
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - A Graff-Guerrero
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - D C Mamo
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - F Caravaggio
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - E Plitman
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - B G Pollock
- Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Mimura M, Ueki M, Oku H, Sato B, Ikeda T. Effect of rebamipide ophthalmic suspension on the success of lacrimal stent intubation. Graefes Arch Clin Exp Ophthalmol 2015; 254:385-9. [PMID: 26483146 DOI: 10.1007/s00417-015-3190-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 09/24/2015] [Accepted: 09/30/2015] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the effect of the postoperative administration of rebamipide ophthalmic suspension on the success rate of lacrimal stent intubation (LSI) for the treatment of primary acquired nasolacrimal duct obstruction (PANDO). METHODS This comparative interventional cohort study investigated 110 consecutive patients with PANDO who were treated with LSI and followed up for 12 months postoperatively at one institution. LSI was performed by one surgeon, and all patients received identical postoperative care. Among the total 110 patients, 71 underwent LSI with postoperative administration of rebamipide ophthalmic suspension, and 39 underwent LSI without administration of the suspension. Data related to patient age, gender, laterality, and postoperative administration of rebamipide ophthalmic suspension were collected and used as independent variables, and logistic regression analyses were performed to compare the anatomical success rate at 12 months postoperatively between patients with and without postoperative administration of the suspension. RESULTS The anatomical success rate of LSI in patients with and without postoperative administration of rebamipide ophthalmic suspension was 90.1 and 69.2 %, respectively. A comparison of these success rates showed statistical significance, in that the rate of treatment success was higher in PANDO patients who underwent LSI with postoperative administration of the suspension [odds ratio (OR), 3.37; P < 0.05]. CONCLUSIONS The findings of this study show that postoperative administration of rebamipide ophthalmic suspension increases the rate of anatomical success in patients who undergo LSI for the treatment of PANDO.
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Affiliation(s)
- Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan. .,Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan.
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Bunpei Sato
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
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Svensson T, Inoue M, Charvat H, Sawada N, Iwasaki M, Sasazuki S, Shimazu T, Yamaji T, Ikeda A, Kawamura N, Mimura M, Tsugane S. Coping Behaviors and Suicide in the Middle-Aged and Older Japanese General Population: the Japan Public Health Center-based Prospective Study. Int J Epidemiol 2015. [DOI: 10.1093/ije/dyv096.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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37
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Mimura M. Mental health after the Great East Japan Earthquake. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.09.318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Mano N, Mitsutsuji T, Yoshikawa Y, Miyamoto M, Watanabe H, Shimizu K, Miki M, Mimura M, Ueki M, Ikeda T. Optical Coherence Tomography in an Infant with Walker-Warburg Syndrome. Case Rep Ophthalmol 2015; 6:210-5. [PMID: 26265907 PMCID: PMC4519600 DOI: 10.1159/000435771] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Purpose Walker-Warburg syndrome (WWS) is a type of congenital muscular dystrophy (CMD) characterised by severe brain malformation, lissencephaly, and congenital eye abnormalities. Despite the coexistence of various eye abnormalities, results from optical coherence tomography (OCT) in WWS have not previously been reported. We herein report specific OCT findings in an infant with WWS. Patients and Methods The patient was a 14-day-old boy delivered by caesarean section at 38 weeks and 4 days of gestation and with a birth weight of 2,543 g. A cranial MRI showed lissencephaly, hydrocephalus, an encephalocele, and cerebellar hypoplasia, consistent with the diagnosis of WWS. Results A bilateral ocular examination showed no abnormalities of the anterior eye segment. A fundus examination showed a persistent hyaloid artery in the vitreous cavity, a widespread loss of fundus pigmentation, transparent choroidal vessels (some choroidal vessel sections were visible), and the absence of a distinct macular reflex. OCT showed no foveal pit and an indistinct laminar structure of the retina. The infant subsequently developed congenital glaucoma and he then died of respiratory failure at the age of 8 months. Conclusions WWS is associated with a high incidence of congenital eye abnormalities, and this infant showed findings consistent with WWS. OCT revealed a marked retinal dysplasia.
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Affiliation(s)
- Natsuko Mano
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan
| | | | - Yamato Yoshikawa
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan
| | - Makiko Miyamoto
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan
| | - Hiroko Watanabe
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan
| | - Kazuhiro Shimizu
- Department of Ophthalmology, Takatsuki Hospital, Takatsuki City, Japan
| | - Michiko Miki
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
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Ochi R, Sato B, Mimura M, Morishita S, Fukumoto M, Kida T, Sugasawa J, Ikeda T. A Case of Coats' Disease with Spontaneous Retinal Reattachment after Total Detachment. Case Rep Ophthalmol 2015; 6:200-3. [PMID: 26265905 PMCID: PMC4519598 DOI: 10.1159/000434676] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Purpose To report a case of Coats’ disease in which spontaneous reattachment occurred after total retinal detachment. Patient and Methods A young boy (patient age: 4 years and 11 months) presented with leukocoria in the left eye. Slit-lamp examination revealed total retinal detachment with abnormal retinal blood vessels and subretinal exudation just behind the lens. Computed tomography imaging showed no solid mass lesion in the intraocular space. Secondary total retinal detachment as a complication of Coats’ disease was diagnosed. No light perception was detected, so we determined that surgical treatment was not indicated. Results Four months after the initial diagnosis, the retina showed complete reattachment with a large amount of subretinal hard exudate. Visual acuity remained unchanged, with no light perception. Conclusions We speculate that the spontaneous retinal reattachment in the present case was caused by the decreased permeability of the abnormal retinal vessels and the good functional effect of the retinal pigment epithelium.
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Affiliation(s)
- Ryosuke Ochi
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Bunpei Sato
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Jun Sugasawa
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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Akiyama Y, Saito E, Futai H, Ogita K, Sakae H, Fukunaga M, Tsuji H, Chikahira M, Mimura M. Comprehensive Study of Pathogenic Genes Distributed in Escherichia coli Isolated from Cattle. Shokuhin Eiseigaku Zasshi 2015; 56:118-22. [PMID: 26156168 DOI: 10.3358/shokueishi.56.118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pathogenic genes such as stx1, stx2, STh gene, STp gene, LT gene, invE, eae, aggR, afaD, astA, cdt and cnf were investigated in Escherichia coli isolated from cattle during Nov. 2012 and Aug. 2013. Plural pathogenic genes were concurrently detected by multiplex PCR, and screen-positive genes were confirmed and sub-classified by PCR. Among 100 cattle investigated, 180 E. coli strains with diarrheic genes (DEC) were detected in 79 cattle, and 45 of them, isolated from 32 cattle, were Shiga toxin-producing E. coli (STEC). More than 30% of cattle carried astA, cdt, cnf and stx2 in descending order. STh gene, LT gene, invE, aggR and afaD were not detected in this study. Both stx1 and stx2 were concurrently detected from 6 of 45 STEC strains and stx2 alone was detected from 19. Seventeen STEC strains carried STp gene, astA, or cdt along with stx1 or stx2. Additionally, 135 remaining DEC were classified into 18 enterotoxigenic E. coli with STp gene, 25 enteropathogenic E. coli with eae, and 92 other DEC with astA, cdt and cnf. Both O and H serotypes were identified in 48 strains, including O157 : H7, O1H7 and so on. O157 : H7 were identified in 3 strains that carried stx2 and eae together, as found in human pathogenic strains isolated from patients with gastroenteritis and hemolytic-uremic syndrome.
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Affiliation(s)
- Yumi Akiyama
- Public Health Science Research Center, Hyogo Prefectural Institute of Public Health and Consumer Sciences
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41
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Svensson T, Inoue M, Sawada N, Iwasaki M, Sasazuki S, Shimazu T, Yamaji T, Ikeda A, Kawamura N, Mimura M, Tsugane S. The association between complete and partial non-response to psychosocial questions and suicide: the JPHC Study. Eur J Public Health 2014; 25:424-30. [DOI: 10.1093/eurpub/cku209] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Suzuki H, Oku H, Horie T, Morishita S, Tonari M, Oku K, Okubo A, Kida T, Mimura M, Fukumoto M, Kojima S, Takai S, Ikeda T. Changes in expression of aquaporin-4 and aquaporin-9 in optic nerve after crushing in rats. PLoS One 2014; 9:e114694. [PMID: 25479407 PMCID: PMC4257723 DOI: 10.1371/journal.pone.0114694] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Accepted: 11/12/2014] [Indexed: 12/23/2022] Open
Abstract
The purpose of this study was to determine the temporal and spatial changes in the expression of AQP4 and AQP9 in the optic nerve after it is crushed. The left optic nerves of rats were either crushed (crushed group) or sham operated (sham group), and they were excised before, and at 1, 2, 4, 7, and 14 days later. Four optic nerves were pooled for each time point in both groups. The expression of AQP4 and AQP9 was determined by western blot analyses. Immunohistochemistry was used to determine the spatial expression of AQP4, AQP9, and GFAP in the optic nerve. Optic nerve edema was determined by measuring the water content in the optic nerve. The barrier function of the optic nerve vessels was determined by the extravasated Evans blue dye on days 7 and 14. The results showed that the expression of AQP4 was increased on day 1 but the level was significantly lower than that in the sham group on days 4 and 7 (P<0.05). In contrast, the expression of AQP9 gradually increased, and the level was significantly higher than that in the sham group on days 7 and 14 (P<0.05, Tukey-Kramer). The down-regulation of AQP4 was associated with crush-induced optic nerve edema, and the water content of the nerve was significantly increased by 4.3% in the crushed optic nerve from that of the untouched fellow nerve on day 7. The expression of AQP4 and GFAP was reduced at the crushed site where AQP4-negative and AQP9-positive astrocytes were present. The barrier function was impaired at the crushed site on days 7 and 14, restrictedly where AQP4-negative and AQP9-positive astrocytes were present. The presence of AQP9-positive astrocytes at the crushed site may counteract the metabolic damage but this change did not fully compensate for the barrier function defect.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
- * E-mail:
| | - Taeko Horie
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Masahiro Tonari
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Kazuma Oku
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Akiko Okubo
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | | | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Shinji Takai
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Osaka, Japan
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Tarumi R, Suzuki T, Tani H, Den R, Sawada N, Sakurai H, Tsutsumi-Ozawa C, Ohtani A, Mimura M, Uchida H. Timing of adjunctive therapy in the treatment of depression: a chart review. Pharmacopsychiatry 2014; 47:259-62. [PMID: 25181576 DOI: 10.1055/s-0034-1387784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The objective of this study was to examine the evolution of antidepressant switch and adjunctive therapy. METHODS This chart review was conducted at 6 primary psychiatric clinics or hospitals, in Tokyo, Japan. A chart review of longitudinal prescriptions was conducted regarding 633 outpatients with major depressive disorder for up to 2 years after their first visit. Patients who had already received antidepressants prior to the visit were excluded. RESULTS 22.6% (N=143) of the patients completed or continued the outpatient treatment over the 2 years while 27 (4.3%), 23 (3.6%), and 439 (69.4%) patients discontinued it due to hospitalization, referral to another clinic, and loss to follow-up, respectively. A total of 597 episodes of antidepressant treatment were identified. Among them, 482 episodes (80.7%) were associated with the suggested dose ranges while antidepressant drugs were under-dosed in 19.3% (N=115) of the episodes. 50 patients (7.9%) received adjunctive therapy; it was employed after a median of only one antidepressant had been tried. CONCLUSION Psychiatrists may be hasty in prescribing an adjunctive therapy in the treatment of depression.
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Affiliation(s)
- R Tarumi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - T Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - H Tani
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - R Den
- Department of Psychiatry, Komagino Hospital, Tokyo, Japan
| | - N Sawada
- Department of Psychiatry, Asakadai Mental Clinic, Saitama, Japan
| | - H Sakurai
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - C Tsutsumi-Ozawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - A Ohtani
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - M Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - H Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
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Nakagawa H, Kubota K, Kon T, Mimura M, Kobayashi W, Kimura H. Hypothyroidism after radiotherapy for head and neck cancer patients. J Oral Maxillofac Surg 2014. [DOI: 10.1016/j.joms.2014.06.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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45
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Miyashita R, Hirata N, Sugino S, Mimura M, Yamakage M. Improved non-invasive total haemoglobin measurements after in-vivo adjustment. Anaesthesia 2014; 69:752-6. [PMID: 24800903 DOI: 10.1111/anae.12681] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2014] [Indexed: 11/30/2022]
Abstract
We hypothesised that an in-vivo adjustment method and/or a newer sensor would increase the accuracy of non-invasive and continuous haemoglobin monitoring (SpHb) measurements. Two sensors, the R1-25 and R2-25a (the newer version), were used with laboratory total haemoglobin concentration (tHb) values simultaneously recorded. In-vivo adjusted SpHb (AdHb) was calculated by a simple formula: AdHb = SpHb - (1(st) SpHb - 1(st) tHb). The correlation coefficients between SpHb (or AdHb) and tHb were compared: SpHb in both sensors correlated strongly with tHb (p < 0.0001). In-vivo adjustment improved the correlation coefficient between SpHb and tHb from 0.86 to 0.95 for the R1-25 and from 0.83 to 0.93 for the R2-25a. There was no difference between the R1-25 and R2-25a sensors. The in vivo adjustment method improved the accuracy of SpHb measurements in both sensors.
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Affiliation(s)
- R Miyashita
- Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
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Abstract
Purpose To assess efficacy of the conservative management of patients with congenital dacryocystocele. Materials and methods This was a retrospective case series involving six sides of five infants with a dacryocystocele treated at Osaka Kaisei Hospital, Osaka, Japan. The conservative management protocol consisted of the application of warm compresses and massage over the mass, with the addition of antibiotics when dacryocystitis developed. Patient age at the time of resolution, presence of retrograde outflow of contents of dacryocystoceles from the puncta, and development of dacryocystitis were recorded. Results The dacryocystocele was unilateral in four patients and bilateral in one patient. A nasal cyst was present in four patients without respiratory distress. The median patient age at the time of the diagnosis was 7 days (range 2–10 days). Conservative management was selected in all patients, and the dacryocystocele was resolved in all patients at a median patient age of 14.5 days (range 11–105 days). Two sides developed dacryocystitis, which resolved in a few days with antibiotic treatment. In those two sides, rupture of the dacryocystoceles to the common canaliculus with retrograde discharge of the contents from the puncta before the dacryocystitis developed was noted. For the other four treated sides, no such discharge or development of dacryocystitis was observed. Conclusion The findings of this study show that a dacryocystocele has a good chance of resolving spontaneously with conservative management and careful observation, and that rupture of the dacryocystocele to the common canaliculus might be an important precursor of dacryocystitis.
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Affiliation(s)
- Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan ; Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan
| | - Bunpei Sato
- Department of Ophthalmology, Osaka Kaisei Hospital, Osaka, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Osaka, Japan
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Hattori Y, Shibamoto Y, Takaoka T, Hayashi A, Manabe Y, Iwata H, Hashizume C, Matsui T, Mimura M. EP-1434: Comparison of the efficacy of particle therapy and photon therapy in the same patients. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31552-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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48
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Hattori Y, Iwata H, Iwabuchi M, Sugie C, Uchiyama K, Matsui T, Mimura M, Manabe Y, Murata R, Shibamoto Y. Improved Prognosis of Patients With Nasal N/K T-Cell Lymphoma Treated by Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shinfuku M, Uchida H, Tsutsumi C, Suzuki T, Watanabe K, Kimura Y, Tsutsumi Y, Ishii K, Imasaka Y, Mimura M, Kapur S. How Psychotropic Polypharmacy in Schizophrenia Begins: A Longitudinal Perspective. Pharmacopsychiatry 2011; 45:133-7. [DOI: 10.1055/s-0031-1297934] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- M. Shinfuku
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, Asaka Hospital, Fukushima, Japan
| | - H. Uchida
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Geriatric Mental Health Program, Centre for Addiction and Mental Health,Toronto, Canada
- Department of Psychiatry, Asakadai Mental Clinic, Saitama, Japan
| | - C. Tsutsumi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, Komagino Hospital,Tokyo, Japan
| | - T. Suzuki
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - K. Watanabe
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
- Department of Psychiatry, Ohizumi Hospital, Tokyo, Japan
| | - Y. Kimura
- Department of Psychiatry, Asakadai Mental Clinic, Saitama, Japan
- Department of Psychiatry, Ohizumi Hospital, Tokyo, Japan
| | - Y. Tsutsumi
- Department of Psychiatry, Ongata Hospital, Tokyo, Japan
| | - K. Ishii
- Department of Psychiatry, Ohizumi Hospital, Tokyo, Japan
| | - Y. Imasaka
- Department of Psychiatry, Ohizumi Hospital, Tokyo, Japan
- Department of Psychiatry, Ohizumi Mental Clinic, Tokyo, Japan
| | - M. Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - S. Kapur
- Institute of Psychiatry, King's College, London, United Kingdom
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Sugie C, Shibamoto Y, Ayakawa S, Mimura M, Komai K, Ishii M, Miyamoto A, Oda K. Craniospinal irradiation using helical tomotherapy: evaluation of acute toxicity and dose distribution. Technol Cancer Res Treat 2011; 10:187-95. [PMID: 21381797 DOI: 10.7785/tcrt.2012.500194] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to evaluate acute toxicity of craniospinal irradiation (CSI) using helical tomotherapy (HT) and compare its dose distribution with that of conventional linac-based plans. Twelve patients with various brain tumors were treated with HT-CSI. Median patient age was 14 years (range: 4-37 years). Median CSI dose was 30.6 Gy in 18 fractions (range: 23.4-40 Gy in 13-25 fractions). Toxicities were assessed according to the Common Terminology Criteria for Adverse Events version 4.0. Before CSI, 11 patients (92%) received neoadjuvant chemotherapy, so acute toxicity was evaluated by comparing patient status before and after CSI. HT-CSI plans were compared with linac-based CSI plans made using Pinnacle(3) planning system in 9 patients. All patients completed planned CSI without interruption. Grade 3 or higher toxicities were leukopenia seen in 11 patients (92%), anorexia in 6 (50%), anemia in 5 (42%), and thrombopenia in 5 (42%). Administration of granulocyte colony-stimulating factor, platelet transfusion and total parenteral nutrition were required in 8 (67%), 5 (42%) and 5 (42%) patients, respectively. HT plans were superior to linac-based plans in terms of homogeneity and conformality in planning target volume (PTV). For most organs at risk (OARs), volumes receiving more than 10 Gy (V10 Gy) or 20 Gy (V20 Gy) were lower in HT plans. However, HT plans significantly increased mean doses to the lung, kidneys and liver, and V5 Gy of 6 OARs including the lung. Despite intensive neoadjuvant chemotherapy, acute toxicity of HT-CSI was acceptable. HT provided better dose distribution in PTV than conventional linac. In most OARs, smaller volumes received >10-20 Gy in HT plans, although larger volumes received 5-10 Gy.
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Affiliation(s)
- C Sugie
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
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