Myocarditis after COVID-19 Vaccination

Aim: The ongoing COVID-19 pandemic is an acute medical, social, political and economic problem. Acute myocarditis is a rare complication of the widely used mRNA-based vaccines. Case Presentation: 20-year old male with no preexisting disease or cardiovascular risk factor presented in October 2021 with chest pain after receiving the second dose of the Moderna COVID-19 vaccine 2 days previously. He discharged from ward care only a few days after his initial presentation. Conclusion: Despite the meta-analysis results suggesting a higher risk of myocarditis with COVID-19 vaccination, vaccination should still be recommended because benefits of the vaccine likely outweigh its harms.

Effects of bile acids on cyclooxygenase-2 expression in a rat model of duodenoesophageal anastomosis

AIM: To examine the expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) in rat esophageal lesions induced by reflux of duodenal contents.

Rabeprazole is effective for bile reflux oesophagitis after total gastrectomy in a rat model

AIM:To elucidate the effect of a proton pump inhibitor(PPI,rabeparazole)on oesophageal bile reflux in oesophagitis after total gastrectomy.METHODS:Twenty-one 8-week-old male Wistar rats were studied.They were performed oesophagoduodenostomy of total gastrectomy to induce oesophageal reflux of biliary and pancreatic juice.Five rats were performed the sham operation(Sham).On post-operative day 7,they were treated with saline(Control)(n=8)or PPI(rabeprazole,30 mg/kg per day,ip)(n=8)for 2 wk.On post-operative 21,all rats were sacrificed and each oesophagus was evaluated histologically.Oesophageal injury was evaluated by macroscopic and microscopic findings as well as the expression of cyclooxygenase-2(COX2).We measured bile acid in the oesophageal lumen and the common bile duct.RESULTS:At 3 wk after surgery,a histological study analysis revealed an increase in the thickness of the epithelium,elongation of the lamina propria and basal cell hyperplasia in the oesophageal mucosa.The macroscopic ulcer score and microscopic ulcer length of the control group were significantly higher compared to those of the rabeprazole-treated group.The expression of COX2 was significantly increased according to the immunostaining in the control group compared to rabeprazole-treated group.Although there was no difference between the control and PPI groups in the total bile acid in the common bile duct,the bileacid activity in the oesophageal lumen was significantly decreased in the rabeprazole-treated group due to augmentation of the duodenal motor complex.CONCLUSION:With this model,rabeprazole is good effect for reflux esophagitis after total gastrectomy from bile reflux.Bile acid is an important factor in the mucosal lesion induced by duodenal reflux.

Study of Plant Cultivation Using a Light-Emitting Diode Illumination System to Control the Spectral Irradiance Distribution

In plant cultivation, the number of photons is more important than the light energy from the chemical reactions that occur during photosynthesis. In addition, the blue and red photon flux (B/R) ratio is an important parameter for plant cultivation. Here we discuss the effect of the spectral irradiance distribution and the B/R ratio on plant cultivation. We cultivated lettuce seedlings, Lactuca sativa L. Cv. Okayama, using a light-emitting diode illumination system that can precisely control the spectral irradiance distribution and B/R ratio. The B/R ratio varied from 0.36 to 2.06 according to the intensity of the blue light when the photosynthetic photon flux density values were sufficient to ensure the 150 - 200?μmol⋅m−2⋅s−1.?High photon flux densities of blue light result in reduced plant length, plant height, and leaf area, thereby suggesting its role in the suppression of leaf growth. Therefore, we conclude that a lower photon flux of blue light (B/R Ratio) is optimal for lettuce cultivation.

Three Cases of Severe Stercoral Colitis

Stercoral colitis is the inflammation of the colonic wall caused by fecal impaction. When a patient with a history of chronic constipation visits the Emergency Center with diffuse abdominal pain, sepsis and or rectal bleeding, clinicians should consider the possibility of stercoral colorectal perforation. An accurate diagnosis on a computed tomography (CT) scan (for fecal impaction, intra-abdominal feces, intraperitoneal free air, stranding of the peri-colonic fat in the segment, presence of extraluminal bubbles of gas) may facilitate early surgical intervention and improve the patient’s prognosis based on our clinical experience dealing with three patients who had stercoral colitis.

Serum Albumin Levels in Emergency Patients with Low BMI

A low body mass index (BMI) is often associated with low nutritional status and adverse health outcomes. While the BMI is used in describing “thinness” meaning cachexia, serum albumin levels were also used in assessing patient’s nutritional conditions. Object: A retrospective study was conducted to determine whether the extremes of BMI and/or cachexia increased the morbidity and mortality in our critical emergency department. Methods: A hundred and five cases with low BMI (≤18.5 kg/m2) were chosen from the patients who were admitted to our critical emergency department from Sept 2013 to Aug 2016. The relationship between serum albumin levels on admission and prognosis were analyzed. Results: No significant correlations were observed between body mass index and albumin levels in thin patients. Lower levels of serum albumin (p Conclusions: Even with low BMI, if the albumin value was 3.3 g/dL or more, the prognosis was good in our emergency department. Estimation of albumin level on admission is not only a simple and objective way to assess the nutritional status but also a useful outcome predictor of critically ill patients coming to emergency centers.

A Super-Aged Case with Marked Hyponatremia Reaching 98 mEq/L;Clinical Implications of Low Serum Sodium

A 79-year-old man, an in-patient at a long-term hospital suffers from Alzheimer dementia and thyroid hypofunction. Recently, he had also suffered from pneumonia followed by impaired consciousness and referred to our hospital for further examination. At the time of admission, the level of consciousness was JCS III-200 and other vital signs were normal. He had no edema on his limbs but had dry skin. According to chest CT, we detected pneumonia. Based on the laboratory data on admission, we detected low osmolality of 206 mOsm/kg of water and serum Na 98 mEq/L, beside urinary Na 54.1 mEq/L. We confirmed severe hyponatremia of hypersecretion type. Fluid replacement therapy was started mainly with Ringer’s solution which is similar to extracellular fluid. We diagnosed it as SIADH induced by adrenal crisis based on the significant lower serum Na value and low blood sugar. Consequently, the patient was administered Hydrocortisone and Fludrocortisone acetate. On the 14th day, serum Na level improved from 98 mEq/L to 140 mEq/L. After daily monitoring of serum Na and urinary Na, administration of fludrocortisone acetate was terminated. The patient was discharged on 25th day, since serum Na was stabilized with oral administration of hydrocortisone and oral salt supplement. This case report shows that adrenal crisis can be triggered by pneumonia. In cases of impaired consciousness, if hyponatremia and hypoglycemia are observed, we may have to suspect the possibility of adrenal crisis. Therefore, urinary biochemical examination is an important part of the laboratory tests.