誤認の適応性と進化に関する構成論的研究

名古屋大学Nagoya University博士(学術)名古屋大学博士学位論文 学位の種類；博士（学術）（課程）　学位授与年月日；平成20年3月25日doctoral thesi

Effects of Songs Recorded by Parents on the Vital Signs of Preterm Infants: A Randomized Controlled Trial

Background: Preterm infants often have unstable vital signs and prolonged hospital stays that can hinder parent–infant bonding, especially under COVID-19 restrictions. This study aimed to evaluate whether listening to songs recorded by parents was effective in stabilizing the condition of premature infants. Methods: This randomized controlled study was conducted at the University of Miyazaki Hospital from October 2022 to March 2024 during the COVID-19 pandemic period. The participants were preterm infants born at less than 33 weeks gestation and their parents, all of whom recorded songs. The recorded songs were played daily to the infants in the intervention group, while the control group received usual care. Primary outcomes included vital signs (respiratory rate, pulse oximetry saturation, heart rate) and activity level. Results: Data for 33 preterm infants (intervention, n = 17 [total 749 sessions]; control, n = 16 [total 721 sessions]) were analyzed for changes in vital signs and activity levels. The intervention reduced infants’ respiratory rates (4.1 [95% CI: 2.5–5.6], p < 0.001) and slightly but statistically significantly increased pulse oximetry saturation (0.6 [95% CI: 0.02–1.2], p < 0.044). Conclusions: Recorded parental songs were found to safely stabilize the respiratory status of preterm infants and may serve as an accessible intervention to support parent–infant attachment, particularly in settings with restricted parental visitation

Antepartum Antibiotic Therapy under 34 Weeks of Gestation and Its Impact on Early-Onset Neonatal Infection and Maternal Vaginal Microbiota

Abstract The use of prenatal antibiotics should be carefully considered, owing to their potential adverse effects on neonatal outcomes. This study aimed to identify the contributing factors to early-onset neonatal infection and to determine the influence of antepartum antibiotics on women and neonates. This study included 127 pregnant women without obvious intra-amniotic infection on admission, who delivered under 34 weeks of gestation. Information on maternal and neonatal characteristics was obtained from their medical charts. Vaginal swabs were taken from all women on admission. In total, 29 (22.8%) neonates developed early-onset infection. Multivariate analysis revealed that antepartum antibiotics were the most strongly associated factor for early-onset neonatal infection (odds ratio, 11.2; 95% confidence interval, 4.08–31.02). The frequency of early-onset neonatal infection was significantly higher in women who received antibiotic therapy than in those who did not; no significant difference in prolonging their gestation or neonatal morbidities was observed. The prevalence of women who hosted vaginal microorganisms on admission was similar to that in women whose infants subsequently developed early-onset neonatal infection compared with that of women whose infants did not. Among infants of the 40 women who received antepartum antibiotic therapy, 21 developed early-onset infection. Of the women who delivered these 21 infants, 62% (13/21) showed reduced lactobacilli and 43% (9/21) had resistant bacterial strains in their vaginal microbiota at the time of delivery. The use of antepartum antibiotics is the most strongly associated factor in early-onset neonatal infection; it does not prolong gestation and would change the vaginal environment.Citation: Muraoka, J.; Kaneko, M.; Doi, K.; Kodama, Y.; Sameshima, H. Antepartum Antibiotic Therapy under 34 Weeks of Gestation and Its Impact on Early-Onset Neonatal Infection and Maternal Vaginal Microbiota. Microbiol. Res. 2022, 13, 598-608. https://doi.org/10.3390/microbiolres1303004

Trends in the causes of stillbirths over 20 years in Southern Japan

Background This study aimed to determine the temporal trend in the causes of stillbirths over a period of two decades using a regional perinatal database in order to facilitate the development of perinatal strategies to prevent stillbirths in Japan. Methods This was a population-based retrospective study. Cases of perinatal death and neurological damage were reported by perinatal centers and primary birth clinics, followed by their peer review and audit, and final registration in the database. Data for stillbirths, defined as fetal death at ≥ 22 weeks of gestation between January 1, 2001, and December 31, 2020, were extracted from the database. Causes of stillbirths were reclassified according to the ReCoDe system. Temporal trends in the causes of stillbirths per 1,000 births and proportion of the causes were evaluated using the Cochran-Armitage test. Results Over the 20 years, in the study region, a total of 205,025 were delivered at ≥ 22 weeks of gestation, and 569 were stillborn (2.8 per 1,000 births). The most common cause of stillbirth was “no relevant condition identified” in 39.5% cases, followed by “abruption” in 12.3%, “lethal congenital anomaly” in 9.5%, and “umbilical cord, other” in 5.8%. The trends in stillbirths caused by “fetal growth restriction,” “abruption,” “asphyxia,” and “no relevant condition identified” significantly decreased. However, no change in trend due to “lethal congenital anomaly” was seen. The stillbirth trend caused by “cord, other” significantly increased. The proportion of stillbirths related to unidentified causes remained unchanged. Conclusions Over the 20-year period, the rate of stillbirths caused by abruption, fetal growth restriction, and asphyxia, which can be reduced by early detection and intervention, decreased. The incidence of stillbirths caused by cord constriction increased. Investigations to prevent cord-accident stillbirths would be required to further reduce stillbirths in the study region. Establishment of algorithms that allow the identification of the causes of stillbirths would be crucial to reduce instances of stillbirths due to unidentified causes

Impact of Skin Lesions on Morbidity and Mortality in Extremely Premature Infants in One Tertiary Center in Southern Japan

Objective: Skin is an important tissue and influenced by developmental changes in premature newborns. We determined the impact of skin lesions on neonatal mortality and morbidity in extremely premature infants. Methods: From 2004 to 2011, 121 extremely premature infants born at 22 to 25 weeks of gestation were enrolled. Among them, 19 infants were excluded, 47 infants had skin lesion, while the remaining 55 infants served as controls. Univariate and multivariate analysis were used. Results: A multivariate analysis showed the gestational age at delivery to be the only variable that remained significantly associated with skin lesions (OR 2.7) after adjusting for any confounding variables. Temporal changes in the clinical manifestations showed that 90% the infants with skin lesions showed respiratory and circulatory instability first, thus suggesting the skin lesions as a consequence of prematurity. Regarding neonatal mortality, skin lesions and focal intestinal perforation were covariates that remained significant after adjusting for any confounding variables. Conclusions: In extremely premature infants, skin lesions occur as a consequence of prematurity-related circulatory and respiratory instability, which is significantly associated with neonatal mortality. These findings suggest that it is important to manage the respiratory and circulatory condition to prevent the skin lesions in order to improve the survival rate.Citation: Yamada N, Kodama Y, Kaneko M, Sameshima H, Ikenoue T (2015) Impact of Skin Lesions on Morbidity and Mortality in Extremely Premature Infants in One Tertiary Center in Southern Japan. J Neonatal Biol 4: 179. doi:10.4172/2167-0897.100017

Novel SKIC3 variants in tricho-hepato-enteric syndrome with hemochromatosis

Tricho-hepato-enteric syndrome (THES), a rare autosomal recessive disorder caused by variants in the SKIC3 or SKIC2 gene, is characterized by intractable diarrhea, woolly hair, growth restriction and liver disease. Here we report a neonatal case of THES with neonatal hemochromatosis, in which the novel compound heterozygous SKIC3 variants NM_014639.4:c.815_816del p.(Gly272AlafsTer9) and NM_014639.4:c.2284G>A p.(Gly762Arg) were identified. Further research is needed to elucidate the mechanisms underlying iron metabolism dysregulation in THES

Molecular mechanisms driving the interactions between platelet and gastric cancer cells during peritoneal dissemination

Platelets (PLTs) facilitate tumor progression and the spread of metastasis. They also interact with cancer cells in various cancer types. Furthermore, PLTs form complexes with gastric cancer (GC) cells via direct contact and promote their malignant behaviors. The objective of the present study was to explore the molecular mechanisms driving these interactions and to evaluate the potential for preventing peritoneal dissemination by inhibiting PLT activation in GC cells. The present study examined the roles of PLT activation pathways in the increased malignancy of GC cells facilitated by PLT‑cancer cells. Transforming growth factor‑β receptor kinase inhibitor (TRKI), Src family kinase inhibitor (PP2) and Syk inhibitor (R406) were used to identify the molecules influencing these interactions. Their therapeutic effects were verified via cell experiments and validated using a mouse GC peritoneal dissemination model. Notably, only the PLT activation pathway‑related inhibitors TRKI and PP2, but not R406, inhibited the PLT‑enhanced migration and invasion of GC cells. In vivo analyses revealed that PLT‑enhanced peritoneal dissemination was suppressed by PP2. Overall, the present study revealed the important role of the Srk family in the interactions between PLTs and GC cells, suggesting kinase inhibitors as promising therapeutic agents to mitigate the progression of peritoneal metastasis in patients with GC

Data_Sheet_1_The Arabidopsis Sin3-HDAC Complex Facilitates Temporal Histone Deacetylation at the CCA1 and PRR9 Loci for Robust Circadian Oscillation.PDF

The circadian clock synchronizes endogenous rhythmic processes with environmental cycles and maximizes plant fitness. Multiple regulatory layers shape circadian oscillation, and chromatin modification is emerging as an important scheme for precise circadian waveforms. Here, we report the role of an evolutionarily conserved Sin3-histone deacetylase complex (HDAC) in circadian oscillation in Arabidopsis. SAP30 FUNCTION-RELATED 1 (AFR1) and AFR2, which are key components of Sin3-HDAC complex, are circadianly-regulated and possibly facilitate the temporal formation of the Arabidopsis Sin3-HDAC complex at dusk. The evening-expressed AFR proteins bind directly to the CIRCADIAN CLOCK ASSOCIATED 1 (CCA1) and PSEUDO-RESPONSE REGULATOR 9 (PRR9) promoters and catalyze histone 3 (H3) deacetylation at the cognate regions to repress expression, allowing the declining phase of their expression at dusk. In support, the CCA1 and PRR9 genes were de-repressed around dusk in the afr1-1afr2-1 double mutant. These findings indicate that periodic histone deacetylation at the morning genes by the Sin3-HDAC complex contributes to robust circadian maintenance in higher plants.</p

Fetal heart rate patterns complicated by chorioamnionitis and subsequent cerebral palsy in Japan

Aim: This retrospective study was performed to investigate whether certain fetal heart rate patterns were associated with subsequent cerebral palsy (CP) in infants with chorioamnionitis at or near term. Methods: We used cases registered by the Japan Obstetric Compensation System for CP, which is a nationwide population-based database. Among them, 133 infants with chorioamnionitis who were born at ≥34 weeks of gestation were enrolled. All infants underwent magnetic resonance imaging (MRI), and all fetal heart rate charts had been interpreted according to the National Institute of Child Health and Human Development criteria, focusing on antepartum and immediately before delivery. Results: The incidence of CP after chorioamnionitis at ≥34 weeks of gestation was 0.3 per 10 000 in Japan. Between the clinical (24%) and subclinical groups (76%), the incidence of abnormal fetal heart rate patterns did not differ. According to the MRI classification, 88% of the infants with CP showed hypoxic–ischemic encephalopathy. Half of the infants with CP experienced terminal bradycardia, leading to severe acidosis and exclusively to hypoxic–ischemic encephalopathy. In another half, who did not experience bradycardia, 80% had moderate acidosis (pH 7.00–7.20) resulting in hypoxic–ischemic encephalopathy, and the remaining 20% showed non-acidosis resulting in brain damage other than hypoxic–ischemic encephalopathy. The fetal heart rate patterns before the terminal bradycardia showed that the incidence rates of late deceleration or decreased variability were high (>60%). Conclusion: Fifty percent of pregnant women with chorioamnionitis-related CP had terminal bradycardia that exclusively resulted in hypoxic–ischemic encephalopathy.Citeation: Yamaguchi-Goto T, Ohashi M, Kodama Y, Sameshima H. Fetal heart rate patterns complicated by chorioamnionitis and subsequent cerebral palsy in Japan. J Obstet Gynaecol Res. 2023 Feb;49(2):625-634. doi: 10.1111/jog.15508

1342 大規模掘削における地下水変化予測とその対策

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