Effect of forced-air warming by an underbody blanket on end-of-surgery hypothermia: a propensity score-matched analysis of 5063 patients.

BACKGROUND: Underbody blankets have recently been launched and are used by anesthesiologists for surgical patients. However, the forced-air warming effect of underbody blankets is still controversial. The aim of this study was to determine the effect of forced-air warming by an underbody blanket on body temperature in anesthetized patients. METHODS: We retrospectively analyzed 5063 surgical patients. We used propensity score matching to reduce the bias caused by a lack of randomization. After propensity score matching, the change in body temperature from before to after surgery was compared between patients who used underbody blankets (Under group) and those who used other types of warming blankets (Control group). The incidence of hypothermia (i.e., body temperature < 36.0 °C at the end of surgery) was compared between the two groups. A p value < 0.05 was considered to indicate statistical significance. RESULTS: We obtained 489 propensity score-matched pairs of patients from the two groups, of whom 33 and 63 had hypothermia in the Under and Control groups, respectively (odds ratio: 0.49, 95% confidence interval: 0.31-0.76, p = 0.0013). CONCLUSIONS: The present study suggests that the underbody blanket may help reduce the incidence of intraoperative hypothermia and may be more efficient in warming anesthetized patients compared with other types of warming blankets. TRIAL REGISTRATION: UMIN Clinical Trials Registry (Identifier: UMIN000022909 ; retrospectively registered on June 27, 2016).

Analysis of human face skin surface molecules in situ by Fourier-transform infrared spectroscopy.

BACKGROUND/PURPOSE: For medical and dermatological researchers, it is important to realize the molecular dynamics and its control in the stratum corneum (SC) of human skin, which may be related to some skin abnormalities such as atopic dermatitis and skin pruritus. We have tried to analyze the periodic molecular dynamics of the outermost layers of SC in vivo. METHODS: We measured the skin surface molecules of human face in situ non-invasively using a Fourier-transform infrared (FTIR) spectroscopy system attached with a newly designed attenuated total reflection (ATR) probe. The water-extracted components from the SC were also analyzed using mass spectrometry, an enzymatic assay and high-performance liquid chromatography characterization. RESULTS: The infrared spectral changes of some components on the face skin at around 1000-1200 cm(-1) with circa-monthly rhythms were observed when monitored for 10 months, and the components also showed a seasonal change. The analysis of different FTIR spectrum of the changeable components with circa-monthly rhythm suggested the presence of a lactate compound. The presence of magnesium lactate in a conjugated form was detected in the water extract of SC. CONCLUSION: We demonstrate that the periodically changed components of the human face skin contained magnesium lactate conjugate as a major component.

[Feasibility of peripheral vein during FOLFOX/FOLFIRI chemotherapy through peripheral venous system].

FOLFOX/FOLFIRI chemotherapy is usually applied through central venous catheters because of possible occurrence of phlebitis during application of these regimen via peripheral vein. However, the exact frequency and degree of the problems at peripheral venous access site during FOLFOX/FOLFIRI chemotherapy via peripheral vein in the clinical setting has not been reported previously. We investigated the frequency of infusion failure and phlebitis in 43 patients with advanced or recurrent colorectal cancer who received FOLFOX4, mFOLFOX6 or FOLFIRI chemotherapy in our institution. After informed consent, FOLFOX/FOLFIRI chemotherapy was applied via peripheral vein in 29 cases; all courses (13.1+/-8.1 (Mean+/-SD)courses, 5-FU: 3,510+/-743 mg/body/course) were completed via peripheral vein in the 20 cases (70%). In the other 9 cases, the access site was converted to the central vein because of the problems of access site following completion of 5.9+/-2.0 courses via peripheral vein. Fifty eight times of phlebitis were recognized during total of 301 courses; severe phlebitis requiring medical treatment was not recognized in any case. Seventy seven times of the change of venous access site were required during total of 301 courses. These data would be essential for the exact informed consent for choosing the access site for FOLFOX/FOLFIRI chemotherapy.

Dai-kenchu-to, a Chinese herbal medicine, improves stasis of patients with total gastrectomy and jejunal pouch interposition.

BACKGROUND: Intestinal motility after gastric surgery frequently is disturbed and results in postoperative intestinal symptoms and poor quality of life (QOL). The purpose of this study was to examine the effects of Dai-kenchu-to on intestinal motility and postoperative QOL of patients. METHODS: Seventeen patients who underwent total gastrectomy with jejunal pouch interposition for gastric cancer in the Department of Surgery of Osaka University Medical Hospital were enrolled. The patients were assigned randomly to the cross-over study with or without 15 g/d of Dai-kenchu-to. Questionnaires and emptying tests using (111)In-labeled liquid and (99m)Tc-labeled solid test meal were performed at the end of each treatment period. A manometric study was performed in 6 patients to measure contractile activity with or without Dai-kenchu-to. RESULTS: Stasis-related symptoms were reduced significantly by Dai-kenchu-to (P = .032). In the emptying test, Dai-kenchu-to accelerated emptying of both liquid (P < .01) and solid (P = .015) meals from the pouch. The pouch showed bursts of contractions, which were increased significantly by oral intake of Dai-kenchu-to (P = .028). CONCLUSIONS: Dai-kenchu-to increased intestinal motility and decreased postoperative symptoms of patients with total gastrectomy with jejunal pouch interposition.

A method for detecting undisplayed regions in virtual colonoscopy and its application to quantitative evaluation of fly-through methods.

RATIONALE AND OBJECTIVES: When virtual endoscopy is used as a diagnostic tool, especially as a tool for detecting colon polyps, the user often performs automated fly-through based on automatically generated paths. In the case of automated fly-through in the colon, there are some blind areas at the backs of folds. The aim of this study is to detect undisplayed regions during fly-through and to perform quantitative evaluation. MATERIALS AND METHODS: Undisplayed regions are detected by marking displayed triangles for surface rendering or displayed voxels for volume rendering. The voxels or triangles not having displayed marks are considered to be undisplayed triangles or voxels. Various kinds of automated fly-through paths generated from medial axes of the colon and flattened views of the colon from the viewpoint of the rate of undisplayed regions are evaluated. RESULTS: The experiment results show that about 30% of colon regions are classified as undisplayed regions by the conventional automated fly-through along the medial axis and that the flattened view results in very few undisplayed regions. CONCLUSION: There is a possibility that the automated fly-through methods may cause many undisplayed regions.

Inhibitory effects of cucurbitane glycosides and other triterpenoids from the fruit of Momordica grosvenori on epstein-barr virus early antigen induced by tumor promoter 12-O-tetradecanoylphorbol-13-acetate.

Two new triterpene benzoates, 5-dehydrokarounidiol dibenzoate (1) and karounidiol dibenzoate (2), and two new triterpene glycosides, 5alpha,6alpha-epoxymogroside IE(1) (8) and 11-oxomogroside A(1) (9), along with 15 known triterpenoids (one triterpene benzoate, 3; three triterpene mono-ols, 4-6; one triterpene aglycon, 7; and 10 triterpene glycosides, 10-19), were isolated from the ethanol extract of the fruit of Momordica grosvenori. The structures of 1, 2, 8, and 9 were determined on the basis of spectroscopic and chemical methods. Among the known triterpene glycosides, mogroside I E(1) (12) was a new naturally occurring compound. Eighteen triterpenoids (2-19) and 11-oxomogrol (20), a hydrolysis product of 9, were evaluated with respect to their inhibitory effects on the induction of Epstein-Barr virus early antigen (EBV-EA) by 12-O-tetradecanoylphorbol-13-acetate (TPA) in Raji cells, which is known to be a primary screening test for antitumor promoters. All of the compounds tested showed potent inhibitory effects on EBV-EA induction (70-100% inhibition at 1 x 10(3) mol ratio/TPA).

Total synthesis of (-)-salinosporamide A.

A detailed description of our second-generation total synthesis of salinosporamide A is presented. Three contiguous stereocenters in the γ-lactam structure seen in the natural product were established by stereoselective functionalization of a D-arabinose scaffold, including an Overman rearrangement to generate a highly congested tetrasubstituted carbon center. One of the definitive reactions in the synthesis was a Lewis acid mediated skeletal rearrangement of a pyranose structure, which enabled the practical conversion of the carbohydrate scaffold to the γ-lactam structure embedded in salinosporamide A. The use of a benzyl ester as a protective group for a sterically hindered carboxylic acid led to a one-pot global deprotection at the end of the synthesis.

Triterpene acids from the leaves of Perilla frutescens and their anti-inflammatory and antitumor-promoting effects.

Nine triterpene acids, viz., six of the ursane type, ursolic acid (1), corosolic acid (2), 3-epicorosolic acid (3), pomolic acid (4), tormentic acid (5) and hyptadienic acid (6), and three of the oleanane type, oleanolic acid (7), augustic acid (8) and 3-epimaslinic acid (9), among which 1 constituted the most predominant triterpene acid, were isolated and identified from ethanol extracts of the leaves of red perilla [Perilla frutescens (L.) Britton var. acuta Kudo] and green perilla [P. frutescens (L.) Britton var. acuta Kudo forma viridis Makino]. These eight compounds, 1, 2, 4-9, were evaluated for their inhibitory effects on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced inflammation (1 microg/ear) in mice. All the compounds tested showed a marked anti-inflammatory effect, with a 50% inhibitory dose (ID50) of 0.09-0.3 mg per ear. In addition, an evaluation against the Epstein-Barr virus early antigen (EBV-EA) activation induced by TPA showed five compounds, 1-3, 5 and 9, with a potent inhibitory effect on EBV-EA induction (91-93% inhibition at 1x10(3) mol ratio/TPA). Furthermore, compound 5 exhibited strong antitumor-promoting activity in an in vivo two-stage carcinogenesis test of mouse tumor by using 7,12-dimethylbenz(a)anthracene (DMBA) as an initiator and TPA as a promoter.