Protective Effects of Pear Extract on Skin from In Vitro and In Vivo UVA-Induced Damage.

The ancient Chinese medical book "Compendium of Materia Medica" records that pears can relieve symptoms of respiratory-related diseases. Previous research has shown that pear Pyrus Pyrifolia (Burm.f.) Nakai has antioxidant and anti-inflammatory properties. However, the anti-inflammatory, antioxidant, and anti-photoaging protective effects of Pyrus pyrifolia (Burm.f.) Nakai seed components have not been studied. Ultraviolet light (UV) causes skin inflammation, damages the skin barrier, and is an important cause of skin photoaging. Therefore, UV light with a wavelength of 365 nm was used to irradiate HaCaT and mice. Western blot, real-time quantitative polymerase chain reaction, and fluorescence imaging system were used to explore its anti-UVA mechanism. Dialysis membrane and nuclear magnetic resonance were used for the chemical constituent analysis of pear seed water extract (PSWE). We found that PSWE can significantly reduce UVA-induced skin cell death and mitogen-activated protein kinase phosphorylation and can inhibit the mRNA expression of UVA-induced cytokines (including IL-1ß, IL-6, and TNF-α). In addition, PSWE can also reduce the generation of oxidative stress within skin cells. In vivo experimental studies found that PSWE pretreatment effectively reduced transepidermal water loss, inflammation, redness, and dryness in hairless mice. The molecular weight of the active part of pear water extract is approximately 384. Based on the above results, we first found that pear seeds can effectively inhibit oxidative stress and damage caused by UVA. It is a natural extract with antioxidant properties and anti-aging activity that protects skin cells and strengthens the skin barrier.

Cost analysis of three anesthetic regimens under auditory evoked potentials monitoring in gynecologic laparoscopic surgery.

BACKGROUND: Cost analyses of different anesthetic techniques have not been investigated in Taiwan. We compared propofol-based total intravenous anesthesia (TIVA), sevoflurane (SEVO) and desflurane (DES) anesthesias for cost and outcome under A-line auditory evoked potentials (AEP) monitoring. METHODS: We studied 90 consecutive female patients (ASAI-II) scheduled to undergo elective gynecologic laparoscopic surgery. The study was prospective, randomized, and single-blind in design. All patients were randomly divided into 3 groups: i.e. groups TIVA, SEVO and DES. The A-line auditory evoked potential index (AAI) was maintained between 15-25. At the start of skin closure, the applied anesthetic was discontinued, and time of recovery from anesthesia was thenceforth reckoned until spontaneous opening of eyes and extubation. The costs of drugs were counted in New Taiwan (NT) dollars. RESULTS: The total cost was significantly higher in the SEVO and DES groups than in the TIVA group (NT 1,243, 1028, and 889, respectively) (P < 0.001). In addition, the cost of the principal anesthetic drug was significantly higher in the SEVO than in the DES and TIVA groups (NT 756, 530, and 468, respectively) (P < 0.01). Faster recovery was seen in the TIVA group than in the DES group and SEVO group (8.2, 13.7, 16.2 min, respectively) (P < 0.001). Incidences of postoperative nausea, vomiting, and pain were not significantly different among 3 groups. CONCLUSIONS: The cost of TIVA with propofol was less than SEVO or DES anesthesia and moreover, propofol TIVA offered benefit of faster recovery in our study.

Bradycardia and hypotension refractory to ephedrine and atropine treatment: severe autonomic dysfunction with abnormal heart rate variability.

Diabetic patients with autonomic dysfunction are potentially poor risks for anesthesia and particular care is needed during and after surgery. We here report a 48-year-old male patient with diabetes mellitus who suffered from intraoperative hypotension and bradycardia which did not respond to ephedrine and atropine treatment and eventuated in cardiac arrest. A heart rate variability study confirmed the diagnosis of autonomic dysfunction after the event. Possible predisposing mechanisms and anesthetic considerations are discussed.