Publications by authors named "Shinjiro Kono"

13 Publications

  • Page 1 of 1

Tear film break-up patterns in thyroid eye disease.

Sci Rep 2021 Mar 5;11(1):5288. Epub 2021 Mar 5.

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan.

Evaluation of tear film break-up pattern (TFBUP) is the main diagnostic method for tear film-oriented therapy (TFOT) of dry eye. This prospective, observational study examined TFBUPs in 154 eyes/sides from 78 patients with thyroid eye disease (TED) who met the diagnostic criteria for dry eye in Japan. TFBUPs were classified as area, line, spot, dimple, and random breaks. Results for the status of TED and dry eye were compared between the TFBUPs. Consequently, line, spot, dimple, and random breaks were observed in 80 (51.9%), 29 (18.8%), 10 (6.5%), and 35 eyes (22.7%) while no eyes showed area breaks. The random break group had the highest incidence of lid lag/Graefe sign and superior limbic keratoconjunctivitis (SLK) (P < 0.050). Although the incidence of each TFBUP is almost equal in patients with simple dry eye without TED, line breaks were more frequently observed in TED. In addition, while random breaks in simple dry eye are usually only associated with minor ocular surface damages, those in TED were associated with a higher incidence of concomitant SLK. These results will be helpful for understanding the etiology of dry eye in TED and for TFOT in TED.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-84661-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935998PMC
March 2021

Relationship Between Eyelid Pressure and Lacrimal Status in Mild Facial Nerve Palsy.

Cureus 2021 Jan 20;13(1):e12830. Epub 2021 Jan 20.

Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Aichi, JPN.

Purpose: Facial nerve palsy is frequently associated with both epiphora and dry eye, and orbicularis oculi muscle weakness or paralysis is the main cause of these symptoms. Eyelid pressure is a quantitatively measurable parameter for evaluating the tone and function of the orbicularis oculi muscle. The aim of this study was to examine the relationship between eyelid pressure and lacrimal status in patients with mild facial nerve palsy.

Methods: This prospective, interventional study included 10 patients with unilateral facial nerve palsy. The severity of facial nerve palsy was determined using the CADS scale (cornea, static asymmetry, dynamic function, and synkinesis). Eyelid pressure was measured using a blepharo-tensiometer. Lacrimal status was quantified through tear meniscus height (TMH), clinical assessment of meibomian gland dysfunction (MGD) (eyelid margin abnormalities, Marx line, meibum expression, and loss of meibomian glands), corneal fluorescein staining, tear break-up time, and Schirmer test I results.

Results: All 10 patients suffered from mild facial nerve palsy without eyelid ectropion or entropion, or gustatory epiphora. Lower eyelid pressure during forceful eye closure was significantly decreased in affected eyes (P = 0.007), but upper eyelid pressure during forceful eye closure and static upper and lower eyelid pressure were not significantly different between the affected and unaffected sides (P > 0.050). The TMH, MGD, and dry eye measurements showed no significant difference between the affected and unaffected eyes (P > 0.050).

Conclusions: Mild facial nerve palsy is associated with decreased lower eyelid pressure during forceful eye closure. However, no other differences in upper eyelid pressure during forceful eye closure, static eyelid pressure, TMH, MGD, or dry eye disease symptoms were noted. These results imply that eyelid pressure slightly decreases due to mild facial nerve palsy, but this change may be clinically negligible.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7759/cureus.12830DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899130PMC
January 2021

Amyloidosis in the Palpebral Conjunctiva Mimicking Lymphoproliferative Lesion.

Case Rep Ophthalmol 2021 Jan-Apr;12(1):73-76. Epub 2021 Jan 14.

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan.

A 47-year-old Japanese woman presented with a 1-year history of foreign body sensation in the right eye. Upon examination, a linear soft tissue lesion in the lower conjunctival fornix was noted. The mass resembled a conjunctival lymphoproliferative lesion but was pinkish-yellow rather than salmon pink in color. Histopathology of the biopsy specimens revealed amyloidosis. Systemic workup showed no other lesions. The conjunctival lesion did not recur at 3 months postoperatively. Since conjunctival amyloidosis mimics conjunctival lymphoproliferative lesions, it is important to keep conjunctival amyloidosis as a differential diagnosis in the diagnosis of a pinkish conjunctival lesion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000510392DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879327PMC
January 2021

Modified Loop Myopexy (Yokoyama's Procedure) for High Myopic Strabismus Fixus.

Case Rep Ophthalmol 2021 Jan-Apr;12(1):68-72. Epub 2021 Jan 14.

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan.

In the classic loop myopexy (Yokoyama) procedure, muscle belly union in the deep orbit is technically difficult, particularly in patients with deep-set eyes and narrow palpebral fissures. Our modified procedure includes a lateral canthotomy and cantholysis and upper conjunctival fornix incisions to facilitate this step.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000510818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879241PMC
January 2021

Disabling muscle of Riolan: A novel concept of orbicularis oculi myectomy for refractory benign essential blepharospasm.

Eur J Ophthalmol 2021 Feb 12:1120672121991043. Epub 2021 Feb 12.

Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan.

Purpose: To examine the effectiveness of orbicularis oculi myectomy with disabling the muscle of Riolan in patients with benign essential blepharospasm refractory to botulinum toxin-A (BTX-A) injection.

Methods: This retrospective, observational study included 25 patients. After removal of the redundant skin and underlying orbicularis oculi muscle (OOM) with or without extended OOM removal to the area of the superior orbital rim, the tarsal plate and the gray line were vertically severed at 2 points to disable the muscle of Riolan. The surgical effectiveness was evaluated using the visual analogue scale (VAS), functional disability score (FDS), and the presence or absence of necessity or enhanced effectiveness of BTX-A injection after surgery.

Results: The symptoms improved in 23 patients (92.0%). The VAS and total FDS were significantly improved from 8.4 ± 1.7 to 4.0 ± 2.4 (reduction rate, 50.7 ± 35.6%) and from 74.6 ± 22.2 to 34.7 ± 25.3 (reduction rate, 53.4 ± 27.4%) after surgery, respectively (both,  < 0.001). Among the 23 patients whose symptoms improved after surgery, BTX-A injection was not required in 11 of them (47.8%). Among the remaining 12 patients (52.2%), the effectiveness of BTX-A was post-operatively enhanced in eight patients (34.8%). There were no serious complications, and none of the patients experienced madarosis.

Conclusion: Disabling the muscle of Riolan is a valuable option of OOM myectomy in patients with refractory benign essential blepharospasm, without the development of serious complications, including madarosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1120672121991043DOI Listing
February 2021

Dacryoendoscopic examination for location of internal orifice of congenital lacrimal fistula: A case series.

Int J Pediatr Otorhinolaryngol 2020 Dec 29;139:110408. Epub 2020 Sep 29.

Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan. Electronic address:

We examined the location of the internal orifice of congenital lacrimal fistula using a dacryoendoscope in 5 patients. A suture inserted from the skin orifice and passing into the lacrimal drainage system through the fistula track was identified using a dacryoendoscope. Consequently, the suture passed into the lacrimal sac in all patients. Although the internal orifice had been reported to be predominantly located in the common canaliculus, the methods previously used for identification of the internal orifice were less accurate. The results in our study suggest a higher incidence of congenital lacrimal fistulae connected with the lacrimal sac.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijporl.2020.110408DOI Listing
December 2020

Patency of the lacrimal drainage system in patients with a peripunctal tumour.

Orbit 2020 Apr 6;39(2):102-106. Epub 2019 Jun 6.

Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Aichi, Japan.

: To examine the patency or secondary obstruction of the lacrimal drainage system in patients with a peripunctal tumour.: This retrospective, observational, and comparative study included 10 patients with a peripunctal tumour. Lacrimal probing and syringing in all patients and dacryoendoscopic examinations in 5 patients were performed to check for patency of the lacrimal drainage system. Tear meniscus height (TMH) was measured bilaterally in the upper and lower eyelids using anterior segment optical coherence tomography and compared in relation to the affected side using one-way ANOVA.: All patients did not complain of epiphora. Probing gave a hard stop and irrigation fluid passed into the nose. A patent punctum/canaliculus was also confirmed by dacryoendoscopy in all of the 5 patients. TMH was not significantly different among the sides ( = .900).: This study shows patency of the lacrimal drainage system in patients with a peripunctal tumour and no significant difference in TMH among the sides, resulting in absence of epiphora in all patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/01676830.2019.1626446DOI Listing
April 2020

Effectiveness of monotherapy and combined therapy with calcitonin and minodronic acid hydrate, a bisphosphonate, for early treatment in patients with new vertebral fractures: An open-label, randomized, parallel-group study.

J Orthop Sci 2017 May 18;22(3):536-541. Epub 2017 Jan 18.

National Hospital Organization Hokkaido Medical Center, Yamanote 5-7, Nishi-ku, Sapporo, Hokkaido, 063-0005, Japan.

Background: Evidence related to the effectiveness of combination drug therapy for the treatment of osteoporosis is currently considered insufficient. Therefore, this study was performed to clarify the effects of monotherapy, and combination therapy, with a bisphosphonate (minodronic acid hydrate), a bone resorption inhibitor, and calcitonin (elcatonin), which is effective for the alleviation of pain due to vertebral fractures in osteoporotic patients.

Methods: Study participants comprised of 51 female subjects with post-menopausal osteoporosis, whose main complaint was acute lower back pain caused by vertebral fractures. Subjects were randomly allocated into three groups and then administered with either intramuscular injections of elcatonin at a dose of 20 units weekly, minodronic acid hydrate at a dose of 1 mg daily, or a combination of these two drugs. As primary endpoints, time-dependent changes in levels of pain were assessed using a visual analog scale from baseline to 6 months of duration. In addition, we examined the effects of monotherapies, and a combination therapy on bone resorption, with changes in bone mineral density at 4 sites and advanced hip assessment parameters from baseline to 6 months. A two-tailed significance level of 5% was used for hypothesis testing.

Results: Elcatonin monotherapy showed some alleviation of pain immediately after any vertebral fractures, which was more than in the minodronic acid hydrate monotherapy group. In addition, the minodronic acid hydrate monotherapy group experienced more effective inhibited bone resorption than the elcatonin monotherapy group. In the combination therapy, the efficacy for alleviating pain and inhibiting bone resorption was equivalent to the effect observed in the elcatonin and minodronic acid hydrate monotherapy groups respectively, with further improved values of bone mineral density observed in the femoral neck and lumbar vertebrae, and in parameters of advanced hip assessment compared with both monotherapy groups.

Conclusions: Combination therapy with elcatonin and minodronic acid hydrate appears to be an effective treatment for osteoporosis patients with lower back pain, caused by fresh vertebral fractures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jos.2016.12.021DOI Listing
May 2017

Effectiveness of elcatonin for alleviating pain and inhibiting bone resorption in patients with osteoporotic vertebral fractures.

J Bone Miner Metab 2017 Sep 9;35(5):544-553. Epub 2016 Nov 9.

National Hospital Organization Hokkaido Medical Center, Hokkaido, Japan.

Elderly patients with osteoporotic vertebral fractures often experience severe pain that reduces their quality of life (QOL). Calcitonin, a bone resorption inhibitor, has been reported to alleviate pain in such patients; however, few clinical studies have demonstrated this effect. The objective of this study was to compare changes in pain scores, activities of daily living (ADL), QOL, bone resorption, bone mineral density (BMD), and fracture healing among patients with new vertebral fractures who received different treatment modalities. We conducted an open-label, multicenter, randomized, parallel control group study comprising 107 female patients ≥55 years old with acute back pain from vertebral fracture. All subjects received either intramuscular injections of elcatonin, a derivative of calcitonin, or an oral nonsteroidal antiinflammatory drug (NSAID) combined with an active vitamin D (VD3) analogue for 6 months. The pain was assessed using a visual analogue scale, and ADL and QOL were assessed using questionnaires. BMD was measured using dual-energy X-ray absorptiometry. A two-tailed significance level of 5% was used. The elcatonin IM group had significantly higher QOL score at 2 weeks and later, and significantly lower VAS and ADL scores than those in the NSAID + VD3 group at 1 month and later. The elcatonin IM group had significantly reduced TRACP-5b levels compared with those in the NSAID + VD3 group at 3 months and later and significantly higher percent changes in BMD than the NSAID + VD3 group. These results suggest that elcatonin significantly alleviated pain, inhibited bone resorption, and improved ADL, QOL, and BMD compared with NSAID + VD3.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00774-016-0791-6DOI Listing
September 2017

Relationship between lenticular power and refractive error in children with hyperopia.

Clin Ophthalmol 2013 24;7:601-6. Epub 2013 Mar 24.

Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Fukuiken, Japan.

Objectives: To evaluate the contribution of axial length, and lenticular and corneal power to the spherical equivalent refractive error in children with hyperopia between 3 and 13 years of age, using noncontact optical biometry.

Methods: There were 62 children between 3 and 13 years of age with hyperopia (+2 diopters [D] or more) who underwent automated refraction measurement with cycloplegia, to measure spherical equivalent refractive error and corneal power. Axial length was measured using an optic biometer that does not require contact with the cornea. The refractive power of the lens was calculated using the Sanders-Retzlaff-Kraff formula. Single regression analysis was used to evaluate the correlation among the optical parameters.

Results: There was a significant positive correlation between age and axial length (P = 0.0014); however, the degree of hyperopia did not decrease with aging (P = 0.59). There was a significant negative correlation between age and the refractive power of the lens (P = 0.0001) but not that of the cornea (P = 0.43). A significant negative correlation was observed between the degree of hyperopia and lenticular power (P < 0.0001).

Conclusion: Although this study is small scale and cross sectional, the analysis, using noncontact biometry, showed that lenticular power was negatively correlated with refractive error and age, indicating that lower lens power may contribute to the degree of hyperopia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/OPTH.S42051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616694PMC
April 2013

Tumor-induced osteomalacia: benign tumor recurrence after two surgical resections at two different medical institutions.

Endocr Pract 2013 Jul-Aug;19(4):e97-101

Department of Endocrinology and Diabetes, Saitama Medical University, Saitama 350-0495, Japan.

Objective: To describe an exceedingly rare case of tumor-induced osteomalacia (TIO) caused by a benign phosphaturic mesenchymal tumor that recurred after two surgical resections at two different medical institutions.

Methods: A 69-year-old man complained of a 3-year history of persistent whole body pain and presented with hypophosphatemia, elevated serum levels of bone-specific alkaline phosphatase and fibroblast growth factor-23 (FGF-23), and multiple fractures. The patient was suspected of having TIO. We conducted the following diagnostic modalities considered useful to detect the tumor: serum FGF-23 level measurement in the extremities, positron emission tomography (PET)-computed tomography (CT),and magnetic resonance imaging (MRI).

Results: The causative tumor could be detected in the right humerus not by venous catheterization for serum FGF-23 level measurement but by the combination of PET-CT and MRI. The authors, who had successfully treated two patients with TIO, visually confirmed the absence of any tumor residue during tumorectomy. Nevertheless, the tumor recurred after surgery. The residual tumor could be localized in the right humerus not by PET-CT but by the combination of superficial venous sampling at 10 sites and MRI. The residual tumor recurred after the second tumorectomy at another hospital. This patient indicates that the possibility--a benign causative tumor may not be completely resected by surgery--cannot be ruled out thoroughly.

Conclusion: Superficial venous sampling at multiple sites may be a surrogate for venous catheterization. Patients with TIO should be meticulously followed-up after surgery to detect any residual tumor by periodic biochemical monitoring and by imaging modalities accordingly.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4158/EP13042.CRDOI Listing
March 2014

Molecular mechanism of the life and death of the osteoclast.

Ann N Y Acad Sci 2006 Apr;1068:180-6

Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

The life span of osteoclasts is critically regulated by various cytokines, and therapeutics such as bisphosphonates act directly on osteoclasts and induce apoptosis of the cells. This article will focus on the molecular mechanism of osteoclast apoptosis and summarize the recent advances in this field with an emphasis on the role of intracellular signaling pathways.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1196/annals.1346.020DOI Listing
April 2006