An 8-year-old girl had been found to have a congenital ventricular septal defect (VSD), based on the presence of a cardiac murmur from birth. She had a history of infective endocarditis and lung abscess when she was 2 years old. Mild aortic regurgitation was revealed by an echocardiogram in August 2004. Right-heart catherization revealed a step up in the oxygen saturation of the right ventricle, aortography showed a deformity of the noncoronary cusp and mild aortic regurgitation, and Doppler color-flow echocardiography detected progression of aortic regurgitation. The patient underwent surgical repair of the VSD with a cardiopulmonary bypass. Following direct suturing combined with pledgets for perimembranous VSD, infusion of cardioplegia revealed the aneurysmal sac extruding from the wall of the right atrium. The final diagnosis was an aneurysm of the sinus of Valsalva from the noncoronary aortic sinus into the right atrium (type IV of Konno). The aneurysm was sutured by polyethylene strings with pledgets. The postoperative course was uneventful, and echocardiography performed before discharge showed no deformity of the sinus of Valsalva and trivial aortic regurgitation which was less than before surgery. She was discharged on the 7th postoperative day.

Adolescent ; Adult ; Brain Neoplasms ; surgery ; Female ; Hemangioma, Cavernous ; surgery ; Humans ; Male ; Young Adult

Background/Aims: Several studies have assessed the effect of cool temperature on colonic peristalsis. Transient receptor potential melastatin 8 (TRPM8) is a temperature-sensitive ion channel activated by mild cooling expressed in the colon. We examined the antispasmodic effect of cool temperature on colonic peristalsis in a prospective, randomized, single-blind trial and based on the video imaging and intraluminal pressure of the proximal colon in rats and TRPM8-deficient mice. Methods: In the clinical trial, we randomly assigned a total of 94 patients scheduled to undergo colonoscopy to 2 groups: the mildly cool water (n = 47) and control (n = 47) groups. We used 20 mL of 15°C water for the mildly cool water. The primary outcome was the proportion of subjects with improved peristalsis after treatment. In the rodent proximal colon, we evaluated the intraluminal pressure and performed video imaging of the rodent proximal colon with cool water administration into the colonic lumen. Clinical trial registry website (Trial No. UMIN-CTR; UMIN000030725). Results: In the randomized controlled trial, after treatment, the proportion of subjects with no peristalsis with cool water was significantly higher than that in the placebo group (44.7% vs 23.4%; P < 0.05). In the rodent colon model, cool temperature water was associated with a significant decrease in colonic peristalsis through its suppression of the ratio of peak frequency (P < 0.05). Cool temperaturetreated TRPM8-deficient mice did not show a reduction in colonic peristalsis compared with wild-type mice. Conclusion For the first time, this study demonstrates that cool temperature-dependent suppression of colonic peristalsis may be associated with TRPM8 activation.