Journal of St. Marianna University
Online ISSN : 2189-0277
Print ISSN : 2185-1336
ISSN-L : 2185-1336
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original article
  • Hisako Yamamoto, Kanako Takeda, Yusaku Miyamoto, Hitoshi Yamamoto
    2020 Volume 11 Issue 1 Pages 1-7
    Published: 2020
    Released: July 13, 2020
    JOURNALS FREE ACCESS

    Benign childhood epilepsy with centrotemporal spikes (BECTS) is the most common childhood type of epilepsy. Whether treatment should be initiated and the necessity of treatment for abnormality of interictal encephalography (EEG) in BECTS remain controversial. We investigated the relationship between age in months at seizure onset, duration of interictal EEG abnormality, and the period until the disappearance of seizures in BECTS patients receiving in treatment (TR group) or no-treatment (NT group). There was a negative correlation between the age at seizure onset and the duration of interictal EEG abnormality (p<0.01), whereas there was a positive correlation between the duration of interictal EEG abnormality and the period until the disappearance of seizures (p<0.05). There was a significant difference in the duration of interictal EEG abnormalities and the period until the disappearance of seizures between the NT and TR groups (p<0.01). Our results suggested that there may be an association between interictal EEG abnormalities and the duration of seizure in BECTS, indicating that interictal EEG abnormality may be a target for treatment.

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  • Saori Morita, Takeshi Tateda, Souichiro Inoue
    2020 Volume 11 Issue 1 Pages 9-19
    Published: 2020
    Released: July 13, 2020
    JOURNALS FREE ACCESS

    It is unknown whether acute kidney injury (AKI) affects de novo chronic kidney disease (CKD). The aim of this study was to examine the relationship between de novo CKD and perioperative AKI after major abdominal surgery. We hypothesized that AKI after major abdominal surgery would induce de novo CKD and performed a retrospective observational analysis after adjusting for preoperative covariates with propensity score matching. A total of 347 patients with normal renal function, who underwent major abdominal surgery, were observed for 2 years postoperatively. The incidence of AKI within 7 days of surgery was 13.2%. During the 2-year observation period, de novo CKD occurred in 22% of patients with AKI and in 8% of patients with a non-acute kidney injury (NAKI) (p=0.007). Based on the propensity score-matched analysis, the incidence of CKD was 22% for AKI and 13% for NAKI (p=0.070). All-patient analysis revealed that the probability of being CKD-free was lower in AKI patients, compared to that in NAKI patients (p=0.002). This was not the case for the propensity score-matched analysis (p=0.166). The survival rate was lower in patients with AKI compared to those with NAKI in propensity score-matched analysis (p=0.033).
    A Cox proportional hazard regression analysis did not identify any risk factors for de novo CKD after surgery. We found that AKI patients showed higher mortality than non-AKI patients during the 2-year observation period after major abdominal surgery. However, we could not demonstrate that AKI affects de novo CKD in patients without renal dysfunction. The early detection and diagnosis of postoperative AKI will be key to perioperative management for major abdominal surgery.

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  • Fumito Sugaya, Rena Sumie, Ryota Nabeshima, Ryotaro Miyano, Takayuki T ...
    2020 Volume 11 Issue 1 Pages 21-29
    Published: 2020
    Released: July 13, 2020
    JOURNALS FREE ACCESS

    It is known that human placenta extract (HPE), which contains numerous bioactive substances, can improve symptoms of hair loss. However, the mechanisms underlying this effect are unclear. It is reported that androgenetic alopecia (AGA) is induced and/or suppressed by arachidonic acid metabolites that affect hair follicle component cells. We investigated the effect of HPE on arachidonic acid metabolism using cultured hair follicle-derived keratinocytes. PG-E2, PG-F2a, PG-I2 (6keto-PG-F1a), PG-D2 and TX-A2 (TX-B2) were measured in medium cultured with HPE. The cultured cells were used for the expression analysis of these five prostanoid synthase genes. The cultured keratinocytes produced all five types of prostanoids. However, the synthase genes of PG-D2 and PG-I2, i.e., PTGDS and PTGIS, did not express in cultured keratinocytes. In contrast, PG-E2 and PG-F2a synthase genes, i.e., PTGES and AKR1C3, could be detected. HPE enhanced the production of PG-E2 and PG-F2a, whereas that of PG-D2 was decreased. Minoxidil had no effect on arachidonic acid metabolism. HPE significantly increased the PG-E2/PG-D2 and PG-F2a/PGD2 ratios, whereas minoxidil showed no significant effect. HPE enhanced the production of PG-E2 and PG-F2a and suppressed that of PG-D2. The effects of HPE on hair growth could be mediated by its effects on arachidonic acid metabolism.

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case report
  • Yumi Obata, Satoshi Arimura, Takashi Kunihara, Takeshi Tateda, Soichir ...
    2020 Volume 11 Issue 1 Pages 31-36
    Published: 2020
    Released: July 13, 2020
    JOURNALS FREE ACCESS

    Background: Aortic regurgitation (AR) can complicate acute aortic dissection (AAD). Treatment requires differentiation between AR that was present before onset of the AD and not directly involved in the dissection and AR that occurred as a result of ascending aorta dilatation associated with the AD. We encountered a case of AD accompanied by AR for which replacement of the ascending aorta was indicated on the basis of initial transesophageal echocardiography (TEE) findings and exploration of the surgical field. Despite aortic replacement, the AR persisted, requiring aortic valvuloplasty (AVP).
    Case presentation: The patient was a 67-year-old woman (height,162 cm; weight, 67 kg) with Stanford type A AAD. Preoperative TEE revealed an aortoventricular junction (AVJ) of 18 mm, an effective height (eH) of 7 mm, sinuses of Valsalva of 38 mm, and a sino-tubular junction of 39 mm, together indicating severe AR. There was no pericardial effusion, and the ejection fraction was 60%. The eH throughout the surgical field measured 8 mm, and the AVJ measured 24 mm. AR resulting from dilatation of the ascending aorta was diagnosed, and we simply replaced the ascending aorta. Immediately after removal of the cross-clamp, we observed moderate central valvular regurgitation as well as a trace AR jet emanating from the commissure between the left and noncoronary cusps, so we performed AVP (involving central plication and 20-mm suture annuloplasty) to treat the residual AR. After central plication, the eH measured 8 mm throughout the field, and TEE performed after discontinuation of cardiopulmonary bypass revealed an AVJ of 19 mm, an eH of 8 mm, sinuses of Valsalva of 31 mm, and an STJ of 23 mm, confirming that the AR was resolved.
    Conclusion: Our case illustrates the importance of determining, during the initial intraoperative TEE evaluation of patients undergoing surgery for AAD, a need for AV management and the advisability of AVP. Comprehensive TEE evaluation is called for—evaluation that includes not only measurement of the aortic complex, the eH, and coaptation lengths, but also measurement of the short axis of the valve leaflets and the extent of dissection.

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