Application of Intraoperative CT-Ultrasound Fusion Imaging in Hip Endoscopy for Treatment of Iatrogenic Impingement Due to PLLA Screw: A Novel Surgical Technique.

Ultrasound-assisted surgery is becoming an established tool in the medical field. The addition of imagery to ultrasound-assisted surgery may enable one to perform a procedure in a safer and more accurate manner. This can be achieved through fusion imaging (fusion), a technology that synchronizes MRI or CT images with ultrasound images. We describe intraoperative CT-ultrasound fusion-guided (or -assisted) hip endoscopy for the removal of an impinging poly L-lactic acid screw, which was difficult to identify on fluoroscopy during surgery. The fusion technology enables merging two advantages of ultrasound: the real-time guidance capabilities and CT or MRI and the bird's eye view that makes minimally invasive arthroscopic and endoscopic surgery less invasive, precise, and safe.

Coffee, green tea, black tea and oolong tea consumption and risk of mortality from cardiovascular disease in Japanese men and women.

BACKGROUND: The effects of coffee and green, black and oolong teas and caffeine intake on cardiovascular disease (CVD) mortality have not been well defined in Asian countries. METHODS: To examine the relationship between the consumption of these beverages and risk of mortality from CVD, 76,979 individuals aged 40-79 years free of stroke, coronary heart disease (CHD) and cancer at entry were prospectively followed. The daily consumption of beverages was assessed by questionnaires. RESULTS: 1362 deaths were documented from strokes and 650 deaths from CHD after 1,010,787 person-years of follow-up. Compared with non-drinkers of coffee, the multivariable HR and 95% CI for those drinking 1-6 cups/week, 1-2 cups/day and ≥ 3 cups/day were 0.78 (0.50 to 1.20), 0.67 (0.47 to 0.96) and 0.45 (0.17 to 0.87) for strokes among men (p = 0.009 for trend). Compared with non-drinkers of green tea, the multivariable HR for those drinking 1-6 cups/week, 1-2 cups/day, 3-5 cups/day and ≥ 6 cups/day were 0.34 (0.06-1.75), 0.28 (0.07-1.11), 0.39 (0.18-0.85) and 0.42 (0.17-0.88) for CHD among women (p = 0.038 for trend). As for oolong tea, the multivariable HR of those drinking 1-6 cups/week and ≥ 1 cups/day were 1.00 (0.65-1.55) and 0.39 (0.17-0.88) for total CVD among men (p = 0.049 for trend). Risk reduction for total CVD across categories of caffeine intake was most prominently observed in the second highest quintile, with a 38% lower risk among men and 22% among women. CONCLUSIONS: Consumption of coffee, green tea and oolong tea and total caffeine intake was associated with a reduced risk of mortality from CVD.

Effect of anakinra on arthropathy in CINCA/NOMID syndrome.

CINCA/NOMID is an autoinflammatory disorder characterized by the triad of neonatal onset of cutaneous symptoms, chronic meningitis, and recurrent fever and it presents with distinctive osteoarthropathy, synovitis mainly of the large joints and overgrowth of epimetaphyseal cartilage, particularly of the long bones. The cartilage overgrowth eventually causes osseous overgrowth and deformity that persists beyond skeletal maturity and leads to limb length discrepancy, joint contracture, and early degenerative arthropathy. Autoinflammation in CAPS/NOMID has been proven to derive from excessive release of interleukin-1 (IL-1). It has been well documented that the IL-1 receptor antagonist anakinra (Kineret(R)) helps mitigate systemic inflammation in the disorder. However, a general consensus has not been reached on its beneficial effect on osteoarthropathy. The case of a girl with CINCA/NOMID syndrome who showed dramatic improvement of osteoarthropathy after anakinra treatment is reported. A 4-year-old girl suffered at the age of 10 months from a generalized urticarial skin lesion with recurrent episodes of fever and growth disorder. Blood examination revealed persistent massive neutrophilia, anemia and intense acute phase response. She manifested knee joint swelling with limited ROM when she was 20 months old and was diagnosed as being CINCA/NOMID based on characteristic findings of radiograph despite negative CIAS1 mutation. Radiological examination demonstrated metaphyseal fraying and cupping and widening of the growth plate in the distal femur. MR imaging showed mottled gadolinium enhancement at the chondrosseous junction. Neither significant joint effusion nor synovitis was identified. At 2 years and 7 months of age, anakinra, 2 mg/kg/day given by regular daily subcutaneous injections, was started. A few days after the initiation of the treatment, her clinical symptoms and laboratory findings of active inflammation were promptly alleviated. She was not able to walk unaided prior to the treatment, but she walked independently 1 month after the treatment. Follow-up radiographs and MR imaging showed that growth plate widening and gadolinium enhancement at the chondrosseous junction were less conspicuous. Furthermore, longitudinal growth of the femur and tibia was identified during 20 months of observation.

Associations of food and nutrient intakes with serum IGF-I, IGF-II, IGFBP-3, TGF-b1, total SOD activity and sFas levels among middle-aged Japanese: the Japan Collaborative Cohort study.

No observational study has examined whether cancer-related biomarkers are associated with diet in Japanese. We therefore assessed sex-specific food and nutrient intakes according to serum IGF-I, IGF-II, IGFBP-3, TGF-b1, total SOD activity and sFas levels, under a cross-sectional study of 10,350 control subjects who answered the food frequency questionnaire in the first-wave nested case-control study within the Japan Collaborative Cohort Study. For both men and women, IGF-I levels were associated with higher intakes of milk, fruits, green tea, calcium and vitamin C. IGF-II levels were associated with higher intakes of milk, yogurt, fruits and miso soup, and lower intakes of rice, coffee and carbohydrate. IGFBP-3 levels were associated with higher intakes of milk, yogurt, fruits and vitamin C, and lower intakes of rice, energy, protein, carbohydrate, sodium and polyunsaturated fatty acids. TGF-b1 levels were associated with lower intakes of coffee intakes, and higher intakes of miso soup and sodium. Total SOD activity levels were associated with lower intakes of most nutrients other than energy, carbohydrate, iron, copper, manganese, retinol equivalents, vitamin A, B2, B12, niacin, folic acid, vitamin C and fish fat. sFas levels were associated with higher intakes of manganese and folic acids. The results of the present study should help to account for findings on those biomarkers regarding risks of cancer and other lifestyle-related diseases in terms of dietary confounding as causality.

Fish, omega-3 polyunsaturated fatty acids, and mortality from cardiovascular diseases in a nationwide community-based cohort of Japanese men and women the JACC (Japan Collaborative Cohort Study for Evaluation of Cancer Risk) Study.

OBJECTIVES: The objective of our study was to test the hypothesis that fish or omega-3 polyunsaturated fatty acids (PUFA) intakes would be inversely associated with risks of mortality from ischemic heart disease, cardiac arrest, heart failure, stroke, and total cardiovascular disease. BACKGROUND: Data on associations of dietary intake of fish and of omega-3 PUFA with risk of cardiovascular disease among Asian societies have been limited. METHODS: We conducted a prospective study consisting of 57,972 Japanese men and women. Dietary intakes of fish and omega-3 PUFA were determined by food frequency questionnaire, and participants were followed up for 12.7 years. Hazard ratios and 95% confidence intervals were calculated according to quintiles of fish or omega-3 PUFA intake. RESULTS: We observed generally inverse associations of fish and omega-3 PUFA intakes with risks of mortality from heart failure (multivariable hazard ratio [95% confidence interval] for highest versus lowest quintiles = 0.76 [0.53 to 1.09] for fish and 0.58 [0.36 to 0.93] for omega-3 PUFA). Associations with ischemic heart disease or myocardial infarction were relatively weak and not statistically significant after adjustment for potential risk factors. Neither fish nor omega-3 PUFA dietary intake was associated with mortality from total stroke, its subtypes, or cardiac arrest. For mortality from total cardiovascular disease, intakes of fish and omega-3 PUFA were associated with 18% to 19% lower risk. CONCLUSIONS: We found an inverse association between fish and omega-3 PUFA dietary intakes and cardiovascular mortality, especially for heart failure, suggesting a protective effect of fish intake on cardiovascular diseases.

Green tea consumption and the risk of pancreatic cancer in Japanese adults.

OBJECTIVE: Green tea polyphenols have been shown to inhibit tumor growth in animal and in vitro studies. We examined the relationship between green tea consumption and the risk of death from pancreatic cancer in a large Japanese cohort. METHODS: At baseline (1988-1990), study participants reported the frequency and amount of green tea consumption during the past year. They were followed-up for mortality until December 31, 2003. Relative risk and 95% confidence intervals were calculated from Cox proportional hazard models. RESULTS: During an average follow-up of 13 years, we observed 292 pancreatic cancer deaths. In men and women combined, the relative risk was 1.23 (95% confidence interval, 0.84-1.80) for participants who consumed 7 or more cups of green tea per day as compared with those who consumed less than 1 cup per day, after adjustment for potential confounding factors. No significant trend in risk reduction was noted, with increasing consumption of green tea. We found no inverse association between cups of green tea consumed per day and the risk of pancreatic cancer in either men or women. CONCLUSIONS: Our findings do not support the hypothesis that green tea consumption is associated with decreased risk of pancreatic cancer in humans.

[Trace elements and sperm parameters in semen of male partners of infertile couples].

OBJECTIVE: The relationships between element concentrations and sperm parameters in semen samples were investigated. METHODS: Semen samples (n = 113) were donated voluntarily by male partners of infertile couples. The concentrations of fourteen elements (Na, K, P, Ca, Zn, Mg, Fe, Cu, Se, Mn, Sn, Co, Ni, and Cd) in semen were determined by atomic absorption spectrometry, fluorometry, or colorimetry. Element concentrations in seminal plasma and in sperm were also measured. RESULTS: Element concentrations in semen were in the order Na > P, K > Ca > Zn > Mg > > Fe> Cu, Se > Mn > Sn, Ni, Co, Cd. When the samples were divided into two groups in terms of sperm concentration and number, the Se concentration in semen with normal parameter values (sperm concentration > or = 20 x 10(6) and sperm number > or = 40 x 10(6)), 99.4 +/- 37.4 ng/ml, was higher than that in semen with abnormal parameter values (sperm concentration < or = 20 x 10(6) and/or sperm number < or = 40 x 10(6)), 72.1 +/- 33.9 ng/ml (p < 0.001). A clearer positive correlation between the Se concentration and the sperm concentration was observed in the sperm portion (r = 0.853, p < 0.001) than in semen (r = 0.512, p < 0.001) and seminal plasma (r = 0.292, p = 0.003). Statistically significant correlations were also observed between the concentration of Se, P, Zn, Cu, Fe, or Mn in semen, the sperm portion or seminal plasma and the sperm concentration, semen volume or abnormal morphology, although correlation coefficients were small. CONCLUSION: Among biologically essential elements in semen of infertile males, Se was a good indicator of sperm concentration; however, other trace elements did not indicate clear relationships between their concentrations and sperm parameters.

Risk of pancreatic cancer in relation to alcohol drinking, coffee consumption and medical history: findings from the Japan collaborative cohort study for evaluation of cancer risk.

We evaluated the associations of such lifestyle factors as alcohol drinking, coffee consumption and medical history with risk of death from pancreatic cancer in a large-scale prospective cohort study [the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC study)] in Japan. Subjects were 110,792 (46,465 men and 64,327 women) inhabitants who were enrolled from 45 areas throughout Japan. At baseline, a self-administered questionnaire was used to obtain information on lifestyle factors and medical history. Cox proportional hazard models were used to calculate relative risks. During the follow-up period (mean +/- SD 8.1 +/- 1.8 years), 225 deaths due to pancreatic cancer were identified. Overall, neither alcohol nor coffee intake was associated with risk of death from pancreatic cancer. Heavy coffee consumption (> or =4 cups/day), however, may increase the risk. Men who reported a history of diabetes mellitus and women who reported a history of gallstone/cholecystitis were at significantly (2-fold) increased risk of death from pancreatic cancer.

[Keshan disease--a review from the aspect of history and etiology].

OBJECTIVE: Keshan disease is an endemic cardiomyopathy found in Keshan, north-east China. The first patient was identified in 1935. This disease is characterized by a blood circulation disorder, endocardium abnormality and myocardium necrosis. Selenium (Se) deficiency is thought to be a major factor by Chinese scientists. However, the exact etiology has not been clarified up to now. The government decided to apply sodium selenite to growing crops, and the incidence of the disease decreased dramatically. However, a few cases still occur as chronic or latent types. This paper reviews Keshan disease from a historical aspect and also the present situation. METHODS: We made a reference survey and summarised the etiology, pathological changes, clinical manifestation, and other views of Keshan disease. RESULT: So far, epidemiological surveys have shown that Keshan disease occurs in large areas in 14 provinces in China, mainly in the countryside. It has been confirmed by clinical and pathological studies that Keshan disease is an independent endemic myocardial disease caused by biological and geological factors. The largest prevalence age rates are boys under 15 years old and women of childbearing age. There are several hypotheses; acute carbon monoxide poisoning, virus infection, malnutrition, or selenium deficiency. The first is not currently believed to be the cause. The following was pointed out; studies on the relationship between diet and the endemic areas of Keshan disease in 1961, where the food custom of the local residents was relatively simple and a so-called "one-sided diet" (eating a limited variety of food) might be related to the incidence of Keshan disease. In 1973, large-scale investigations on the natural environments were performed in the endemic areas of Keshan disease in the whole country. As a result, it was reported that there was a relationship between the incidence of Keshan disease and the special natural environment in the endemic areas and the cause of Keshan disease was strongly supported by nutritional, biological, geological and chemical (selenium deficiency) factors. In 1981, on the other hand, it was found that the levels of antibodies against Coxsackie virus were higher in the serum of Keshan disease patients than of normal subjects. This fact supposed that the cause of Keshan disease was related to a virus infection. However, it is difficult to explain why the clinical and pathological manifestations of Keshan disease are similar to those of other diseases, e.g. idiopathic dilatational myocardial disease. Further research should be performed on Keshan disease to clarify the etiology.