[A case of pneumothorax during laparoscopic surgery due to latent diaphragmatic defect].

A 38-year-old male healthy donor for renal transplantation was scheduled to undergo laparoscopic nephrectomy of the left kidney. After commencement of the surgery under general anesthesia, his vital signs were stable. When pneumoperitoneum was commenced using CO2, a rapid increase in the airway pressure was observed, and it became difficult to perform mechanical ventilation. After manual ventilation was initiated, the cause of the increased airway pressure was investigated. As a result, a defective pore, 3 cm in diameter, was confirmed in the left diaphragm and it was determined that pneumothorax developed from the pure CO2. A transient decrease in oxygen saturation was easily restored by manual ventilation. The blood pressure was relatively stable, and tension pneumothorax was not observed. For the defective pore in the diaphragm, endoscopic cerclage of the diaphragm was performed after insertion of a thoracostomy tube. Postoperative chest X-ray showed no signs of atelectasis, mediastinal emphysema, or aerodermectasia, suggesting the development of pneumothorax due to pure CO2. In this case, the defective pore in the diaphragm was caused accidentally by pneumoperitoneum, although the subject had had no prior symptoms. Latent diaphragmatic defect may be an important factor in pneumoperitoneum and other surgical procedures.

Antiinflammatory activity of heat-treated Cassia alata leaf extract and its flavonoid glycoside.

Antiinflammatory activities of heat-treated Cassia alata leaf extract and kaempferol 3-O-gentiobioside (K3G) isolated from C. alata as an abundant flavonoid glycoside were studied by comparing their activities with the activities of sun-dried C. alata leaf extract. We observed strong inhibitory effects on Concanavalin A-induced histamine release from rat peritoneal exudate cells both in the extracts of heat-treated and sun-dried C. alata leaves. Furthermore, the heat-treated leaf extract exhibited stronger inhibitory effects than the effects of the sun-dried leaf extract at low concentrations in the studies of Concanavalin A-induced histamine release, 5-lipoxygenase inhibition, and also inhibition of cyclooxygenases (COX-1 and COX-2), whereas K3G showed weak inhibitory effects on Concanavalin A-induced histamine release, 5-lipoxygenase, and COX-1. No anti-hyaluronidase effect was detected in any of the materials tested.

[Vasorelaxant activity of caffeic acid derivatives from Cichorium intybus and Equisetum arvense].

The vasorelaxant activities of chicoric acid (Compound 1) from Cichorium intybus and dicaffeoyl-meso-tartaric acid (Compound 2) from Equisetum arvense L. in isolated rat aorta strips were studied. Compound 1 is a diester composed of (S,S)-tartaric acid and caffeic acid, and 2 is composed of its meso type. Both 1 and 2 showed slow relaxation activity against norepinephrine (NE)-induced contraction of rat aorta with/without endothelium. These compounds did not affect contraction induced by a high concentration of potassium (60 mM K+), while they inhibited NE-induced vasocontraction in the presence of nicardipine. These results show that the inhibition by 1 and 2 of NE-induced vasocontraction is due to a decrease in calcium influx from the extracellular space caused by NE. In addition, dicaffeoyl tartaric acids showed vasorelaxant activity, regardless of their stereochemistry.