Comparison of Non-ephedrine Constituents from Ephedra Plants Cultivated in Japan.

Ephedra plants, the main components of which are ephedrine alkaloids, are used as traditional medicines in Eastern Asian countries. In this study, we isolated non-ephedrine constituents from various Ephedra plant species cultivated in Japan. HPLC analysis suggested that kynurenic acid and its derivatives accumulated in a wide range of Ephedra plant species. Furthermore, a large amount of (2R,3S)-O-benzoyl isocitrate has been isolated from E. intermedia. This study suggests that Ephedra plants have diverse non-ephedrine constituents.

[Review of 197 cases of urgent cesarean section performed in 2010 using NICE classification].

BACKGROUND: NICE (National Institute for Health and Clinical Excellence) of UK introduced a new classification of urgent cesarean section consisting of four categories. We classified 197 cases of urgent cesarean section performed at our institution between April 1st, 2010 and March 31, 2011, using the NICE classification. METHODS: Clinical records including obstetric record and anesthetic record were reviewed to identify possible cases as candidates of category 1 and 2, from 197 cases. Final classification was then decided at a case conference with four anesthesiologists and one obstetrician. RESULTS: Five cases were classified into category 1, and 51 cases were into category 2. There were 9 cases with umbilical pH < 7.2 among 51 cases of category 2. In these cases, quicker decision to delivery accompanies worse umbilical pH of the delivered neonate. CONCLUSIONS: The present review classifying urgent cesarean section using NICE classification revealed that most cases of urgent cesarean section were treated appropriately at our hospital. NICE guideline seems to be useful to improve anesthetic management of urgent cesarean section.

Cloning of the cytochrome P450 enzyme from Perilla frutescens involved in nothoapiole biosynthesis.

Phenylpropanoid volatile components are found in various plants and are useful in medicines, health foods, and fragrances. While the pharmacological actions and toxicities of these compounds have been investigated, there are few reports of the cloning of genes that encode biosynthetic enzymes involved in substituent formation at diverse positions and numbers. Previously, using the expressed sequence tag (EST) libraries of pure perilla strains that have been maintained for over 30 years for their oil type, we characterized the P450 enzyme that produces an intermediate for dillapiole by adding a hydroxy group to myristicin. In this study, we selected a P450 enzyme involved in nothoapiole biosynthesis from the EST library. Heterologous expression of this enzyme in yeast showed that it is a hydroxylase that synthesizes an intermediate to produce nothoapiole from apiole and dillapiole. The enzyme has high amino acid sequence similarity with a previously cloned enzyme and is categorized into the CYP71D subfamily. Furthermore, we investigated the presence or absence of essential oil components and intermediates believed to be involved in nothoapiole biosynthesis by component analysis of perilla essential oil using GC-MS to help elucidate the biosynthetic pathway of nothoapiole. Only a small number of plant species contain nothoapiole as their principal component and thus few studies have reported the biosynthetic genes involved or the drug efficacy and toxicity of nothoapiole. The present study will aid in understanding the biosynthesis of phenylpropanoid volatile compounds, thereby contributing to further research on potentially useful compounds such as nothoapiole.

Tracheal intubation using Airway Scope in two patients with difficult airway during cardiopulmonary resuscitation.

The Airway Scope AWS-S100 (AWS, Pentax, Tokyo), a rigid video laryngoscope with integrated tube guidance that has recently become commercially available, helped the authors to establish airways in two patients with in-hospital cardiopulmonary arrest, after failed attempts to intubate the patients using the Macintosh laryngoscope (that only commanded the Cormack-Lehane grade 4 glottic views), the laryngeal mask airway, and even surgical cricothyroidotomy for the second case. This showed the utility of the AWS in the management of difficult airway cases even in emergency settings.

Cloning and Expression of a Perilla frutescens Cytochrome P450 Enzyme Catalyzing the Hydroxylation of Phenylpropenes.

Phenylpropanoid volatile components in plants are useful and valuable not only as flavorings, but also as medicines and food supplements. The pharmacological actions and toxicities of these compounds have been well studied but their synthetic pathways are generally unclear. In this study, we mined expressed sequence tag libraries of pure strains of perilla maintained for over 30 years for their oil type and conducted gas chromatography-mass spectrometry analyses of the perilla oils to confirm the presence of monohydrates speculated to be intermediates of the phenylpropene synthetics pathways. These putative monohydrate intermediates and their regioisomers were synthesized to identify the reaction products of assays of heterologously expressed enzymes. An enzyme involved in the synthesis of a phenylpropanoid volatile component was identified in perilla. Expression of this enzyme in Saccharomyces cerevisiae showed that it is a member of the cytochrome P450 family and catalyzes the introduction of a hydroxy group onto myristicin to form an intermediate of dillapiole. The enzyme had high sequence similarity to a CYP71D family enzyme, high regiospecificity, and low substrate specificity. This study may aid the elucidation of generally unexploited biosynthetic pathways of phenylpropanoid volatile components.

[Current status of HIV/AIDS anesthetic experiences in Japan--questionnaire for anesthesia teaching hospitals].

BACKGROUND: As the number of HIV-infected patients in Japan increases every year, the opportunity for a HIV-positive patient to undergo an operation is also increasing. METHODS: Authors sent questionnaire to 952 anesthesia teaching hospitals, in order to investigate the experience and management of the HIV-positive anesthetic cases. RESULTS: The reply was obtained from 480 teaching hospitals. One hundred and nine hospitals (22.7%) experienced HIV-positive operation, 367 hospitals (76.5%) had no experience. With regard to the number of experienced HIV-positive cases, only one case was the most numerous answer and most of the hospitals had fewer than ten cases. General anesthesia was selected in 74% of cases, regional anesthesia (spinal or/and epidural anesthesia) were selected in 26% of cases. Preoperative HIV examination for almost all scheduled cases were carried out in 24% of the hospitals, but 23% of the hospitals did not carry out the examination at all. Eighteen percent of the hospitals had a severe rule for the management of a HIV-positive case, and 58% of the hospitals had a rule almost the same as for HBV-HCV positive cases. CONCLUSIONS: Almost one fourth of anesthesia teaching hospitals experienced HIV-positive cases. Anesthesiologists should know how to manage HIV-positive surgical patients and be prepared for the cases.