We report a case of surgical treatment of iatrogenic cardiac trauma. A patient with cardiac tamponade was treated by pericardiocentesis. During pericardiocentesis both right and left ventricles were perforated. These perforations were repaired in the beating heart state using 20 monofilament mattress sutures reinforced by felt pledgets. Iatrogenic cardiac trauma is rare. Fatal complications might arise when proper procedures are not followed during the placement of a catheter for pericardiocentesis. Here we present successfull surgical treatment of cardiac penetrations induced by pericardiocentesis.

A 59-year-old man had been treated at another institution for bacterial meningitis (Streptococcus pneumoniae). He had severe back pain and lumbago. Computed tomographic (CT) scanning of the chest and abdomen demonstrated saccular aneurysms at the diaphragm in the descending thoracic aorta and the infrarenal abdominal aorta. An extended left posterolateral retroperitoneal incision was performed for resection of the thoracoabdominal aneurysm and replacement of an in situ dacron graft with rifampicin using cardiopulmonary bypass. The abdominal aneurysm was resected and replaced by an in situ dacron graft with rifampicin. The grafts were covered with a pedicled omental flap. The tissue culture was negative. After subsequent intravenous antibiotic therapy for 2 months, the patient was discharged without any evidence of remaining infection.

Several studies have shown that low cardiorespiratory fitness (CRF) or heavy alcohol consumption is risks of total or certain types of cancer death. However, the combined influence of CRF and drinking habits on total cancer mortality is not clear. The purpose of this study was to investigate the joint effect of CRF and drinking habits on total cancer mortality among Japanese men. We evaluated the CRF and drinking habits on risk of total cancer mortality in 8,760 Japanese men (age: 19-59 yr) who were given a submaximal exercise test, a medical examination test, and questionnaires on their health habits. CRF was measured using a cycle ergometer test, and the men were classified into two categories by CRF levels based on the reference value of CRF (R-CRF) in “Physical Activity Reference for Health Promotion 2013” (Under R-CRF and Over R-CRF). Also, the men were assigned to Non Drinking, Moderate Drinking, and Heavy Drinking categories. There were 178 cancer deaths during the 20-yr follow-up period. Relative risk and 95% confidence intervals for total cancer mortality were obtained using the Cox proportional hazards model while adjusting for age, body mass index, systolic blood pressure, and smoking habits. Using the Under R-CRF & Heavy Drinking group as reference, the relative risk and 95% confidence intervals were 0.37 (0.16–0.85) for the Over R-CRF & Non Drinking group. This result suggests that Japanese male with a high CRF and a low drinking habit have a lower risk of total cancer mortality.

Methods: This study included 46 patients who underwent spinal reconstruction surgery for thoracolumbar osteoporotic vertebral fractures and kyphosis and were followed up for 1 year postoperatively. DJK was defined as an advanced kyphosis angle >10° between the LIV and one lower vertebra. The patients were divided into groups with and without DJK. The risk factors of the two groups, such as patient background, surgery-related factors, radiographic parameters, and clinical outcomes, were analyzed. Results: The DJK and non-DJK groups included 14 and 32 patients, respectively, without significant differences in patient background. Those with instability in the distal adjacent LIV disc had a significantly higher risk of DJK occurrence (28.6% vs. 3.2%, p=0.027). DJK occurrence significantly increased in those with the sagittal stable vertebra not included in the fixation range (57.1% vs. 18.8%, p=0.020). Other preoperative radiographic parameters were not significantly different. Instability in the distal adjacent LIV disc (adjusted odds ratio, 14.50; p=0.029) and the exclusion of the sagittal stable vertebra from the fixation range (adjusted odds ratio, 5.29; p=0.020) were significant risk factors for DJK occurrence. Conclusions Regarding spinal reconstruction surgery in patients with osteoporotic vertebral fractures, instability in the distal adjacent LIV disc and the exclusion of the sagittal stable vertebra from the fixation range were risk factors for DJK occurrence in the short term.

Background/Aims: Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study. Methods: This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD. Results: Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4). Conclusions Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.

Advances in information and communication technology (ICT)-especially, the spread of social networking services (SNSs)-have facilitated the dissemination of information and an explosion of health information lacking scientific evidence. Therefore, we believe that community pharmacies are the most suitable bases for distributing health information. In 2019, we launched the health support pharmacy “Toyonaka Model” in collaboration with the pharmaceutical association, municipal government, and university. Touch-panel digital signage (DS) was used for real-time distribution of ever-changing information and a rapid grasp of pharmacy users’ responses to various types of information. Between September 2019 and August 2021, one DS was installed in a pharmacy in each of Toyonaka City’s seven areas along with 14 questions on the usefulness of the delivered information. Respondents answered the 14 questions by a tablet or questionnaire; touch logs for DS were collected. When a pharmacy user consulted with a pharmacist about information delivered via DS, the contents were recorded and described by the pharmacist on a 4-point scale (e.g., “inquiry only,” “went through to execution”). From the 850 completed questionnaires and 61,565 touches, 88.7% of the respondents indicated that the information was useful, and 90.0% expressed interest in receiving more health information in the future. Thus, health information provided by DS may be useful to pharmacy users, as demonstrated by 113 cases in which the pharmacist was consulted regarding such information. In 62 of these cases, there were indications that the DS information might have influenced users’ behavior and intended actions.

Mouthwash is used to support brushing because it is distributed throughout the oral cavity. In this study, we examined the efficacy of a mixture of three hot water extracts (from Hordeum vulgare L, Apocynum venetum L, and Brasenia schreberi J. F. Gmel) for the purpose of developing an effective mouthwash. The mixture suppressed enhanced tumor necrosis factor α and matrix metalloproteinase 3 gene expression by Porphyromonas gingivalis lipopolysaccharide stimulation in human gingival fibroblasts. Furthermore, human studies using a mouthwash containing the plant extracts (MW) improved gingival index and bleeding on probing in the gum, and reduced the concentration of methyl mercaptan, which causes bad breath, in the mouth. These findings suggest that continued use of MW has positive effects on gingival inflammation and halitosis, and is useful for maintaining oral health.