Sapporo Medical Journal

Abstract : Background: The primary goal of central precocious puberty treatment is to preserve final adult height. Safe and effective treatment of central precocious puberty in the form of long-acting GnRH analogs has been available for many years. Aim of study: To study the clinical characters of patients with central precocious puberty and their response to GnRh agonist therapy. Patients and Method: A randomized clinical trial study that conducted at Pediatric Endocrinology Outpatient Clinic in Children Welfare Teaching Hospital / Medical City from 1st of November 2018 to 30th of October 2019. It included 83 patients presented to the hospital because of early pubertal development and diagnosed with central precocious puberty. Subcutaneous injections of GnRH agonist (goserelin acetate [Zoladex]) were administered to all patients. Patients were observed for weight, height and sex maturation rate in addition to laboratory data were taken after at least 12 months. Results: In this study, there were significant decrease in height, suppression of the significant increase in bone age, and a significant increase in BMI level after treatment compared to that before treatment. Basal LH, FSH estradiol & testosterone values after treatment decline to significant levels. Conclusion: GnRHa treatment for CPP is safe and can be curative by improving the predicted height and delaying the growth rate.

Abstract : Introduction, Ureterolithiasis is the most common type of all urolithiasis. The management characteristics and efficacy of ureterolithiasis management using URS, ESWL, and ureterolithotomy in Dr. Soetomo General Hospital Surabaya are evaluated in this study. Material and Method This study used a descriptive study with a retrospective design. All medical record data of patients with reteral stone who were treated at Dr. Soetomo General Hospital Surabaya from 2014-2019. Result There were 801 patients included in the study. The highest incidence of ureteral stones was in the 51-60 years old age group (31.08%), predominantly among male patients (67.79%). URS was the most commonly performed procedure (61%). There were 270 patients with stone size < 1 cm. The procedures performed were URS and ESWL. The URS group showed significantly higher postoperative treatment (3.4 ± 2.1 days) compared to the ESWL group (p<0.05). There were 531 patients with stone size > 1 cm. The procedures performed in this group were URS, ESWL, ureterolithotomy. The shortest mean operation duration was in the ESWL group (61.56 minutes, p<0.05). Conclusion, The highest stone-free-rate (SFR) was discovered in the ureterolithotomy group (97.1%, p<0.05). ESWL had the shortest postoperative treatment duration (1 day, p<0.05). Ureterolithotomy generated the highest SFR. However, the patients had a greater hb change compared to URS. Keywords— Ureteral stone, URS, ESWL, Ureterolithotomy, Stone-free rate

Abstract : This was a descriptive study with a retrospective approach evaluating the medical record data of renal trauma patients for the past four years. A total of 84 renal trauma cases were obtained, consisting mostly of 5 to 20 years old (35.71%) male (86.9%) patients. The types were classified into blunt trauma (95.2%) mostly caused by motor vehicular accidents and penetrating trauma (4.8%). The severity was mostly dominated by grade I trauma (33.3%) followed by grade IV (23%) and III (19,2%). Anemia was the most prevalent complication (28.3%) and most patients had hematuria (82.1%). Most of the patients’ hemodynamic status was stable (86.9%) and were treated conservatively (88.4%). Only 9 patients were surgically treated with a total of 11 procedures. The most common procedure performed was nephrectomy (36.3%); followed by renorraphy (27.7%), DJ stent insertion (9%), blood clot evacuation (9%), embolization (9%), and urinoma drainage (9%). The highest mortality rate was seen among patients with grade IV renal trauma (50%). Renal trauma in East Java was mostly found in men and was caused by MVA. Most hemodynamically stable patients were mostly treated conservatively and did not require a blood transfusion. Other co-existing organ injuries affected the patients’ prognosis.

Abstract : Objective: Endothelial dysfunction (ED) in type-2 diabetes mellitus (DM) plays a crucial role in angiopathies development and progression. The most frequent cause of endothelial dysfunction in DM is oxidative stress. Aim of the study: To investigate the relationship between ascorbic acid level in serum and some anti-oxidant parameters in blood with clinical, and duplex findings of brachial artery and aorta in patients with type 2 -DM. Patients and methods: Case-Control prospective study included sixty patients with type 2-DM, and 20 healthy volunteers were included. History of peripheral ischemia, diabetic retinopathy, frequency of metabolic syndrome was analyzed. Measurements of plasma levels of ascorbate, super oxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GTx) and lipid peroxidase (LPO) were studied. Estimation of HOMA-IR was also done. Duplex study in brachial artery and aorta to measure flow mediated vasodilatation (FMD) reactive hyperemia and intima media thickness (IMT) of aorta was done. Echocardiography was done to measure ejection fraction (EF%) and left ventricular dimensions. Results: Patients’ group showed highly significantly decreased plasma insulin (P=0.009), plasma ascorbate, SOD, CAT and glutathione (P=0.001, each) than control, while showed highly significant increased plasma level of fasting sugar, T-Cholesterol, LDL and lipid peroxidation (P=0.001 each) than control. Urinary ACR was highly significantly also increased in patient’ group (P

Abstract : Background: Since the egression of the coronavirus 2019 (COVID-19) disease, more than 200 countries and areas around the world were affected. To the present, it is not clear whether COVID has effects on thyroid function or not. Object: The target of the current revision is to compare thyroid function in COVID cases with and without history of thyroid illness to find out the thyroid disturbance in both groups. Methods: The present study enrolled 86 COVID affected patients that alienated to groups with and without history of thyroid cases, beside comorbidities with diabetes or hypertension. Thyroid hormones [triiodothyronine (T3) and thyroxine (T4)], thyrotropin (TSH) and thyroid peroxidase (TPO) concentrations were analyzed and assessed. Results: Most of the participants (88.4%) had normal T3 and TPO level, that there was no significant difference (p = 0.069) between groups of with and without history of thyroid disease and/or upraised of TPO antibody level. Also T4 levels of the participants with no history of thyroid disease and normal TPO did not differ significantly (p =0.725) from those with a history of thyroid disease and/or high TPO. Regarding the level of TSH was significant difference (p<0.001) between the patients with high TSH, no history of thyroid disease and normal TPO (0.0%) and those with high TSH, history of thyroid disease and/or high TPO (34.0%). Conclusions: There is high prevalence of subclinical hypothyroidism in the COVID patients with family history of