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Association of Pro-Inflammatory Diet with Long-Term Risk of All-Cause and Cardiovascular Disease Mortality: NIPPON DATA80
滋賀医科大学博士(医学)Aim:
A pro-inflammatory diet may increase the risk of cardiovascular disease (CVD) and all-cause mortality. However, this remains inconclusive as there is yet no study using a dietary record method that has been conducted in a large general population. Furthermore, an underestimation of the pro-inflammatory diet may exist due to the unmeasured effect of salt intake. Thus, in this study, we aimed to examine how pro-inflammatory diet is associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population.
Methods:
A national nutrition survey was conducted throughout Japan in 1980. After considering the exclusion criteria, 9284 individuals (56% women aged 30-92 years) were included in this study. In total, 20 dietary parameters derived from 3-day weighed dietary records were used to calculate the dietary inflammatory index (DII). The causes of death were monitored until 2009. The Cox proportional hazards model was used to determine multivariable-adjusted hazard ratios (HRs). Stratified analysis according to salt intake level was also performed.
Results:
Compared with the lowest quartile of DII, multivariable-adjusted HRs (95% confidence intervals) in the highest quartile were 1.28 (1.15, 1.41), 1.35 (1.14, 1.60), 1.48 (1.15, 1.92), 1.62 (1.11, 2.38), and 1.34 (1.03, 1.75) for all-cause mortality, CVD mortality, atherosclerotic CVD mortality, coronary heart disease mortality, and stroke mortality, respectively. Stratified analysis revealed stronger associations among individuals with higher salt intake.
Conclusions:
As per our findings, a pro-inflammatory diet was determined to be positively associated with the long-term risk of all-cause and CVD mortality in a representative Japanese population. Thus, considering both salt intake and pro-inflammatory diet is deemed crucial for a comprehensive assessment of CVD risk.令和6年度doctoral thesi
Role of basal cells in nasal polyp epithelium in the pathophysiology of eosinophilic chronic rhinosinusitis (eCRS)
滋賀医科大学博士(医学)Background:
Basal cell hyperplasia is commonly observed in nasal polyp epithelium of eosinophilic chronic rhinosinusitis (eCRS). We examined the function and mechanisms of basal cell hyperplasia in the pathophysiology of eCRS.
Methods:
We found that normal human bronchial epithelial (NHBE) cells obtained basal cell characteristics when cultured with PneumaCult™-Ex Plus Medium. Most of the cells passaged three times expressed basal cell surface markers CD49f and CD271 by flow cytometry, and basal cell nuclear marker p63 by immunohistochemical staining. We named these NHBE cells with basal cell characteristics cultured Basal-like cells (cBC), and NHBE cells cultured with BEGM™ cultured Epithelial cells (cEC). The characteristics of cBC and cEC were examined and compared by RNA sequencing, RT-PCR, ELISA, and cell proliferation studies.
Results:
RNA sequencing revealed that cBC showed higher gene expression of thymic stromal lymphopoietin (TSLP), IL-8, TLR3, and TLR4, and lower expression of PAR-2 compared with cEC. The mRNA expression of TSLP, IL-8, TLR3, and TLR4 was significantly increased in cBC, and that of PAR-2 was significantly increased in cEC by RT-PCR. Poly(I:C)-induced TSLP production and LPS-induced IL-8 production were significantly increased in cBC. IL-4 and IL-13 stimulated the proliferation of cBC. Finally, the frequency of p63-positive basal cells was increased in nasal polyp epithelium of eCRS, and Ki67-positive proliferating cells were increased in p63-positive basal cells.
Conclusions:
Type 2 cytokines IL-4 and IL-13 induce basal cell hyperplasia, and basal cells exacerbate type 2 inflammation by producing TSLP in nasal polyp of eCRS.令和6年度doctoral thesi
Association between plasma complement factor H concentration and clinical outcomes in patients with sepsis
滋賀医科大学博士(医学)Acute medicine & surgery. 2021 Jan 19;8(1):e625.
doi: 10.1002/ams2.625. eCollection 2021 Jan-Dec.令和6年度thesi
Difference in one-year late lumen loss between high- and low-dose paclitaxel-coated balloons for femoropopliteal disease
滋賀医科大学博士(医学)Heart and vessels. 2024 Jul;39(7):582-588.
doi: 10.1007/s00380-024-02370-0. Epub 2024 Feb 16.令和6年度thesi
Superior mesenteric artery syndrome in a neonate: A case report
Introduction:
Superior mesenteric artery syndrome (SMAS) is a complete or incomplete obstruction of the third portion of the duodenum caused by compression between the aorta and the superior mesenteric artery (SMA). Some diagnostic strategies and treatments exist for adults; however, in neonates, these are controversial because the condition is uncommon.
Case presentation:
A 4-day-old male infant with a birth weight of 2630 g was referred to our hospital with a 2-day history of bilious vomiting. Ultrasonography and contrast enema revealed no malrotation or midgut volvulus. On day 7 of life, an upper gastrointestinal series with contrast revealed obstruction of passage in the third portion of the duodenum. Congenital duodenal stenosis was suspected, and exploratory laparotomy was performed on day 9 of life. The SMA compressed and narrowed the third portion of the duodenum. The duodenum was mobilized and the ligament of Treitz was divided using the technique described by Strong, which released the duodenal compression. A feeding tube was successfully inserted through the duodenum. No duodenal web was observed and SMAS was suspected. The patient's postoperative course was uneventful and SMAS was diagnosed. Complete oral intake was achieved on postoperative day 20, and the patient was discharged on postoperative day 30.
Conclusions:
Neonatal SMAS is a rare but possible cause of duodenal obstruction. The procedure reported by Strong is useful in neonatal cases.journal articl
Honeycomb lung appearance accompanied by pediatric Langerhans cell histiocytosis: changes in imaging findings following chemotherapy
journal articl
Effectiveness of an articulating laparoscopic needle holder for cesarean scar defect repair
Aim:
To evaluate the efficacy of an articulating laparoscopic needle holder in laparoscopic surgery for cesarean scar defect.
Methods:
We performed a retrospective case-control study at the Shiga University of Medical Science. Patients who underwent laparoscopic uterine scar repair were divided into an articulating laparoscopic needle holder (ArtiSential®) group and a rigid needle holder (conventional) group to compare the suture and total operative times. Uterine myometrial suturing involves a double-layer interrupted suture, including a modified Gambee suture for the first layer. We measured the residual myometrial thickness using magnetic resonance imaging preoperatively and at 3 months postoperatively.
Results:
Both groups comprised 10 patients each. The time per stitch for the first and second layers was significantly shorter in the ArtiSential group than in the conventional group (median 208 s vs. 403 s, p < 0.0001 and median 17 s vs. 29 s; p < 0.0001, respectively). The total operating time was significantly shorter in the ArtiSential group (mean 188 min vs. 240 min, p = 0.0015). The postoperative residual myometrial thickness (mean 9.1 mm in the ArtiSential group and 9.6 mm in the conventional group) was significantly higher than the preoperative residual myometrial thickness (mean 1.6 mm in the ArtiSential group and 1.6 mm in the conventional group) (p < 0.0001 in both groups).
Conclusions:
An articulating needle holder is useful in laparoscopic surgery for cesarean scar defect, especially when a modified Gambee suture is required.journal articl
Does abdominal protrusion in pregnant women affect abdominal injury severity in motor vehicle collisions? A nationwide database study
Aims:
Some pregnant women avoid vehicle driving owing to the risk of contact between their protruding abdomen and steering wheel. This study was performed to determine whether abdominal protrusion in late-term pregnant car users affects the occurrence and severity of abdominal injuries in motor vehicle collisions using a national crash database.
Methods:
The National Automotive Sampling System/Crashworthiness Data System was used to analyse maternal background, collision characteristics, outcome and Abbreviated Injury Scale (AIS) scores for the body regions of all persons involved in the collision.
Results:
Comparison of pregnant and non-pregnant women in the driver's seat showed no significant differences in the rate of AIS scores of ≥2 (2+) for abdominal injuries and female outcomes. Comparison of use of the driver's seat and front passenger's seat by pregnant women showed no significant difference in rate of AIS 2+ injuries or in maternal and fetal outcomes. Comparison of pregnant women with a gestational age of ≤27 and >27 weeks in the driver's seat showed no significant differences in rate of AIS 2+ injuries or in maternal and fetal outcomes.
Conclusions:
Based on the data from relatively low-speed frontal collisions, obstetrician/gynaecologists should advise pregnant women that they do not need to change their preferred car seat from the driver's seat to another seat because of fear of contact between their protruding abdomen and the vehicle interior.journal articl