433 results match your criteria: "Chubu-Rosai Hospital[Affiliation]"

Marin Amat syndrome is a phenomenon in which eyelids close upon opening of the mouth during the recovery phase after facial nerve paralysis. In this report, we present two surgically treated cases of Marin Amat syndrome with aponeurotic ptosis. Case 1: A 66-year-old man had developed left Bell's palsy a year prior to presentation and underwent rehabilitation at the Neurology Department of Japan Community Healthcare Organization Chukyo Hospital.

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Rituximab (RTX) has been reported to effectively maintain remission in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). In this multicenter study involving 57 patients who achieved remission after 24 weeks, we evaluated the effectiveness of RTX in maintaining remission in patients with AAV. Patients were divided into three groups based on RTX administration: continuous, induction phase-only, and maintenance phase-only groups.

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Objective: To assess the prevalence and outcomes among regimens of glucocorticoid tapering for microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA) in real-world practice.

Methods: We retrospectively examined the Japan Collaborative Registry of ANCA-associated Vasculitis (J-CANVAS) registry, and evaluated the prevalence of glucocorticoid tapering regimens in the PEXIVAS trial. In patients with newly diagnosed MPA and GPA, we compared outcomes among standard and reduced pace regimens.

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Article Synopsis
  • Tocilizumab (TCZ) is an effective treatment for giant cell arteritis (GCA), but its impact on treatment changes and outcomes following relapses or discontinuations due to adverse events (AEs) is not well studied.
  • In a retrospective study of 62 GCA patients receiving TCZ, 16% experienced relapses, often after dosage adjustments or stopping TCZ; most relapses were manageable with treatment modifications.
  • About 45% of patients experienced AEs, with a small portion discontinuing TCZ; those who used alternative immunosuppressive therapies had better outcomes in managing GCA and avoiding relapses.
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Introduction: In Japan, transgender individuals have historically had limited therapeutic options, prompting many to seek gender-affirming surgeries in private or foreign clinics because of restricted access to public hospitals. This has led to challenges for patients undergoing surgery.

Case Presentation: A transgender man underwent surgery at a private clinic and experienced recurrent complications.

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We report a case of numb chin syndrome caused by a small cortical infarction in the postcentral gyrus. A 67-year-old man suddenly developed numbness in his right lower lip and the chin. There were no apparent abnormal neurological symptoms other than numbness.

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Background: The characteristics of patients with advanced chronic kidney disease (CKD) who are recipients of public assistance in Japan, and the adequacy of their medical care have not been reported previously.

Methods: The records of patients with CKD stage G5 who visited nine facilities in Japan from April to June 2013 were retrospectively reviewed to compare the characteristics and care of recipients of public assistance with those of non-recipients. Receiving a presentation of kidney replacement therapy (KRT) options and polypharmacy were used as indicators of suboptimal medical care.

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We aimed to clarify the long-term safety and efficacy of rituximab (RTX) as a remission induction therapy following severe relapse in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). We retrospectively collected the data of patients with severely relapsed AAV from a Japanese multicentre cohort. The primary exposure was RTX use; the primary outcome was complete remission (CR) proportions at week 24.

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Background: Because the clinical benefit of antiplatelet therapy (APT) for patients with nonsignificant coronary artery disease (CAD) remains poorly understood, we evaluated it in patients after fractional flow reserve (FFR)-guided deferral of revascularization.

Methods And Results: From the J-CONFIRM (Long-Term Outcomes of Japanese Patients with Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), we investigated 265 patients with deferred lesions who did not require APT for secondary prevention of cardiovascular disease. A 2-year landmark analysis assessed the relationship between APT at 2 years and 5-year major cardiac adverse events (MACE: composite of all-cause death, target vessel-related myocardial infarction, clinically driven target vessel revascularization).

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Introduction: Segmental spinal deformity results from vertebral compression fracture (VCF) and progressive collapse of the fractured vertebral body (VB). The VB stenting (VBS) system comprises a balloon-assisted, expandable, intrasomatic, metal stent that helps maintain the restored VB during balloon removal and cement injection, which minimizes cement leakage. We performed a prospective, multicenter, clinical trial of the VBS system in Japanese patients with acute VCF owing to primary osteoporosis.

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Article Synopsis
  • Water diuresis complicates the treatment of profound hyponatremia, often appearing within the first 24 hours of therapy alongside shifts in urine characteristics.
  • Monitoring urine output and composition during early treatment is crucial for promptly identifying this condition.
  • In a study of 47 patients, 64% exhibited water diuresis, primarily due to various causes, with significant changes in urine volume and electrolytes noted shortly after treatment initiation.
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  • Femoral neck fractures (FNF) are common in elderly people, and the conjoined tendon-preserving posterior (CPP) approach was created to reduce postoperative dislocation during hemiarthroplasty (HA) compared to the traditional posterolateral (PL) approach.
  • A study evaluated 135 patients from each group who underwent HA, observing dislocation rates, operation times, and functional outcomes over an average follow-up of 32.4 months.
  • The results showed that the CPP approach had a significantly lower dislocation rate (0% vs. 4.4%) and similar functional outcomes compared to the PL approach, despite having more instances of varus stem insertion.
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Study Design: Retrospective cohort study.

Objectives: Imaging changes in the vertebral body after posterior lumbar interbody fusion (PLIF) are determined to be trabecular bone remodeling (TBR). This study aimed to investigate the influence of cage materials on TBR and segment stabilization in PLIF by studying image changes.

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Article Synopsis
  • - EMPA-KIDNEY studied the effects of empagliflozin (10 mg daily) on patients with chronic kidney disease, involving 6,609 participants, including 612 from Japan, to assess its impact on kidney disease progression and cardiovascular death.
  • - Japanese participants exhibited higher albumin levels and eGFR compared to those from other regions, with a significant reduction in the primary outcome for those on empagliflozin (13.1%) versus placebo (16.9%) over a median follow-up of 2 years.
  • - The results indicated that empagliflozin safely lowers the risk of kidney disease progression and cardiovascular death across diverse populations, with effects being consistent in both Japanese and non-Japanese participants
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Objectives: To evaluate the effectiveness and safety of two different intravenous methylprednisolone (IVMP) pulse doses in patients with severe microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA).

Methods: We emulated a target trial using observational data from the nationwide registry in Japan. Patients with severe glomerulonephritis or diffuse alveolar haemorrhage were selected and pseudo-randomized into three groups using propensity score-based overlap weighting as follows: non-IVMP, IVMP 0.

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Hyperammonemia is a crucial differential diagnosis leading to consciousness disorders. While it is often associated with liver failure in most cases, it is imperative to be aware that hyperammonemia can also be induced by rare urease-producing bacteria, such as  causing obstructive urinary tract infections, as seen in this case. We report the case of an 85-year-old woman with no history of liver dysfunction and no previous indications of voiding difficulties.

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Macrolide antibiotics such as clarithromycin (CLR) and azithromycin are the key drugs used in multidrug therapy for complex (MAC) diseases. For these antibacterial drugs, drug susceptibility has been correlated with clinical response in MAC diseases. We have previously demonstrated the correlation between drug susceptibility and mutations in the 23S rRNA gene, which confers resistance to macrolides.

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The relationship between sex differences and long-term outcomes after fractional flow reserve (FFR)- and instantaneous wave-free ratio (iFR)-guided deferral of revascularization has yet to be elucidated. From the J-CONFIRM registry (long-term outcomes of Japanese patients with deferral of coronary intervention based on FFR in a multicenter registry), this study included 432 lesions from 385 patients (men, 323 lesions in 286 patients; women, 109 lesions in 99 patients) with paired data of FFR and iFR. The primary endpoint was the cumulative 5-year incidence of target vessel failure (TVF), including cardiac death, target vessel-related myocardial infarction, and clinically driven target vessel revascularization.

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Introduction: The aim of the study was to explore the association between urate-lowering agents and reduced response to erythropoietin-stimulating agents in patients suffering from chronic kidney disease G5.

Methods: We conducted a cross-sectional, multicenter study in Japan between April and June 2013, enrolling patients aged 20 years or older with an estimated glomerular filtration rate of ≤15 mL/min/1.73 m2.

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Article Synopsis
  • Fractures in elderly individuals, especially those with end-stage kidney disease (ESKD), significantly increase mortality risk, highlighting an urgent health issue.
  • This study seeks to quantitatively analyze mortality rates following hip and spine fractures among ESKD patients undergoing various kidney replacement therapies.
  • A meta-analysis of 26 studies revealed alarming one-year and five-year mortality rates post-fracture, with hip fractures showing higher mortality compared to spine fractures.
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A nationwide multicenter study of the cost effectiveness of five leading drugs for pharmacological management of cervicobrachial symptoms.

J Orthop Sci

January 2025

Department of Orthopaedic Surgery, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Kofu, Japan. Electronic address:

Background: Cervicobrachial pain frequently affects the quality of life (QOL) of the general public and has a significant economic impact on the health care systems of various countries. There are a number of treatment options for this disease, including widely-used drug therapy, but the effectiveness of each option is indeterminate, and there have been no published cost-effectiveness analysis studies so far. This prospective observational study aimed to examine the cost-effectiveness of drug treatment for cervicobrachial symptoms.

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This study aimed to examine the effectiveness of early rehabilitation in patients with femoral neck fractures admitted to acute care settings in Japan using the data registered with the Japan Association of Rehabilitation Databases (JARD). We included data for 401 patients (out of 3088 patients) aged ≥ 65 years (85 males, 316 females) from nine hospitals who sustained a femoral neck fracture between July 2005 and September 2015. Using the number of days until surgery or the number of days until the start of rehabilitation or both as the explanatory variables, and the indoor mobility at discharge as the outcome variable, we calculated the adjusted rate ratio (ARR) and 95% confidence interval (CI) using Poisson regression analysis (age, sex, cognitive impairment, concurrent symptoms, and previous history of fracture adjusted as covariates).

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Background Chronic kidney disease (CKD) might influence fractional flow reserve (FFR) value, potentially attenuating its prognostic utility. However, few large-scale data are available regarding clinical outcomes after FFR-guided deferral of revascularization in patients with CKD. Methods and Results From the J-CONFIRM registry (Long-Term Outcomes of Japanese Patients With Deferral of Coronary Intervention Based on Fractional Flow Reserve in Multicenter Registry), 1218 patients were divided into 3 groups according to renal function: (1) non-CKD (estimated glomerular filtration rate ≥60 mL/min per 1.

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