A Review of Red Yeast Rice, a Traditional Fermented Food in Japan and East Asia: Its Characteristic Ingredients and Application in the Maintenance and Improvement of Health in Lipid Metabolism and the Circulatory System.

Red yeast rice has been used to produce alcoholic beverages and various fermented foods in China and Korea since ancient times; it has also been used to produce tofuyo (Okinawan-style fermented tofu) in Japan since the 18th century. Recently, monacolin K (lovastatin) which has cholesterol-lowering effects, was found in some strains of Monascus fungi. Since statins have been used world-wide as a cholesterol-lowering agent, processed foods containing natural statins are drawing attention as materials for primary prevention of life-style related diseases. In recent years, large-scale commercial production of red yeast rice using traditional solid-state fermentation has become possible, and various useful materials, including a variety of monascus pigments (polyketides) that spread as natural pigments, in addition to statins, are produced in the fermentation process. Red yeast rice has a lot of potential as a medicinal food. In this paper, we describe the history of red yeast rice as food, especially in Japan and East Asia, its production methods, use, and the ingredients with pharmacological activity. We then review evidence of the beneficial effects of red yeast rice in improving lipid metabolism and the circulatory system and its safety as a functional food.

Divergence of metabolites in three phylogenetically close Monascus species (M. pilosus, M. ruber, and M. purpureus) based on secondary metabolite biosynthetic gene clusters.

BACKGROUND: Species of the genus Monascus are considered to be economically important and have been widely used in the production of yellow and red food colorants. In particular, three Monascus species, namely, M. pilosus, M. purpureus, and M. ruber, are used for food fermentation in the cuisine of East Asian countries such as China, Japan, and Korea. These species have also been utilized in the production of various kinds of natural pigments. However, there is a paucity of information on the genomes and secondary metabolites of these strains. Here, we report the genomic analysis and secondary metabolites produced by M. pilosus NBRC4520, M. purpureus NBRC4478 and M. ruber NBRC4483, which are NBRC standard strains. We believe that this report will lead to a better understanding of red yeast rice food. RESULTS: We examined the diversity of secondary metabolite production in three Monascus species (M. pilosus, M. purpureus, and M. ruber) at both the metabolome level by LCMS analysis and at the genome level. Specifically, M. pilosus NBRC4520, M. purpureus NBRC4478 and M. ruber NBRC4483 strains were used in this study. Illumina MiSeq 300 bp paired-end sequencing generated 17 million high-quality short reads in each species, corresponding to 200 times the genome size. We measured the pigments and their related metabolites using LCMS analysis. The colors in the liquid media corresponding to the pigments and their related metabolites produced by the three species were very different from each other. The gene clusters for secondary metabolite biosynthesis of the three Monascus species also diverged, confirming that M. pilosus and M. purpureus are chemotaxonomically different. M. ruber has similar biosynthetic and secondary metabolite gene clusters to M. pilosus. The comparison of secondary metabolites produced also revealed divergence in the three species. CONCLUSIONS: Our findings are important for improving the utilization of Monascus species in the food industry and industrial field. However, in view of food safety, we need to determine if the toxins produced by some Monascus strains exist in the genome or in the metabolome.

Vasopressin does not raise cardiac enzymes following cardiac surgery: a randomized double-blind clinical trial.

OBJECTIVE: The aim of this study was to investigate the relationship between intraoperative vasopressin infusion and postoperative cardiac enzymes. DESIGN: A prospective, double-blind, randomized, controlled study. SETTING: A single tertiary cardiac center. PARTICIPANTS: One hundred consecutive patients undergoing cardiac surgery with or without cardiopulmonary bypass. INTERVENTIONS: The study was approved by the Institutional Review Board, and patients provided informed consent to participate. Patients were randomized by computer into 2 equal groups: Vasopressin or control. The blinded study included vasopressin administered at a dose of 1.8 U/h or 1.8 mL/h of normal saline, along with catecholamines. The drug was administered continually during surgery while patients needed catecholamines. The intervention was discontinued upon admission to the intensive care unit when information regarding the true character of the drug was reported to the doctor in charge of patients in the intensive care unit by one of the investigators. Primary outcomes were CK-MB and troponin T levels measured at 0, 6, and 12 hours postoperatively. MEASUREMENTS AND MAIN RESULTS: Of the 100 patients, 8 were excluded; the remaining 92 were randomized to either the vasopressin (n = 47) or control (n = 45) group. There were no significant differences in demographic data between the groups. Postoperatively at 0, 6, and 12 hours, there were no differences in CK-MB (U/l) (37.5 ± 57.9 v 32.0 ± 21.5, 29.4 ± 41.1 v 24.4 ± 23.1, and 21.4 ± 21.3 v. 21.8 ± 32.4, respectively) and troponin T (752.4 ± 638.2 v 762.7 ± 557.1, 753.8 ± 507.3 v 777.6 ± 515.0, and 774.6 ± 572.6 v 698.7 ± 540.2, respectively) values. CONCLUSIONS: Vasopressin infusion has been used to treat catecholamine-unresponsive shock. In this study, intraoperative vasopressin was used safely as a possible first-line drug for treating hypotension; however, it did not increase the levels of cardiac enzymes after cardiac surgery.

[Planning of cardiothoracic surgery for chronic kidney disease patients].

Chronic renal failure (CRF) is related to cardiac diseases. Cardiac surgery is also related to postoperative acute kidney injury (AKI). It means heart and kidney have close relationship. We analyzed recent published data to understand how to manage CRF patients undergoing cardiovascular surgeries. We compared endovascular surgery and open procedure for aortic aneurysm, especially about contrast media-related renal damage, On or Off CABG or PCI for ischemic heart disease. We also discussed the relation between cardiopulmonary bypass and AKI and the risk factors causing AKI after CPB. Finally, we discussed prevention and treatment options of CPB related AKI, including furosemide, hANP mannitol, and statin. Published evidence in this area is still insufficient, but many studies are still carried out focusing on postoperative AKI. In the future we may be able to find the best answer for managing CRF patients undergoing cardiovascular surgeries.

[History and current issues of anesthesia in Korea].

We report the history and current issues of anesthesia in Korea. Korean medical doctors have to take 1-year internship and 4-year residency to be qualified to take the national examination for a board-certified anesthesiologist. The national examination began in 1963, and there were 3,050 board-certified anesthesiologists as of 2006. The calculated patients who were managed by a board-certified anesthesiologist were 5.8 patients a day. The Korean government adopted nurse-anesthetists in 1973 because of shortage of board-certified anesthesiologists. The Korean Society of Anesthesiologists is now demanding its amendment.

Appetite-enhancing effects of inhaling cinnamon, clove, and fennel essential oils containing phenylpropanoid analogues.

Cinnamon, clove, and fennel are commonly used as spices and herbal medicines, and one of their medicinal uses is as aromatic stomachics. We investigated the effect on appetite in mice of inhaling volatile compounds contained in essential oils extracted from herbal medicines used as aromatic stomachics. The appetite-enhancing effects of cinnamon and fennel essential oils were similar to those of their main components trans-cinnamaldehyde and trans-anethole, respectively. The appetite-enhancing effects of clove essential oil were observed over a wide range of doses (4.5 × 10-4 to 4.5 × 10-3 mg/cage), even though the active compounds showed effects within a narrow range of doses (eugenol: 4.5 × 10-4 to 2.5 × 10-3 mg/cage; eugenol acetate: 1.1 × 10-3 to 4.5 × 10-3 mg/cage). The increase in appetite at doses that differed by tenfold in mice administered clove oil was due to synergistic effects between eugenol and eugenol acetate in clove oil. Thus, loss of appetite could be treated more effectively using essential oil containing both eugenol and eugenol acetate compared with the active compounds administered separately. Administering essential oils, such as cinnamon and clove, could improve loss of appetite without strict dosage adjustment.

[Complications of internal jugular vein cannulation under ultrasound guidance: report of three].

Internal jugular cannulation with ultrasound guidance has been advocated to decrease its complications. However, there can be serious complications by in-experienced physicians in even ultrasound-guided internal jugular vein cannulation. We report three cases of complications associated with ultrasound-guided internal jugular vein cannulation: puncture of the common carotid artery in two patients and pneumothorax in one.