Syringaresinol induces mitochondrial biogenesis through activation of PPARß pathway in skeletal muscle cells.

Activation of peroxisome proliferator-activated receptors (PPARs) plays a crucial role in cellular energy metabolism that directly impacts mitochondrial biogenesis. In this study, we demonstrate that syringaresinol, a pharmacological lignan extracted from Panax ginseng berry, moderately binds to and activates PPARß with KD and EC50 values of 27.62±15.76µM and 18.11±4.77µM, respectively. Subsequently, the expression of peroxisome proliferator-activated receptor γ coactivator-1α together with PPARß transcriptional targets, mitochondrial carnitine palmitoyltransferase 1 and uncoupling protein 2, was also enhanced in terms of both mRNA and protein levels. The activation of these proteins induced mitochondrial biogenesis by enrichment of mitochondrial replication and density within C2C12 myotubes. Importantly, knockdown of PPARß reduced the syringaresinol-induced protein expression followed by the significant reduction of mitochondrial biogenesis. Taken together, our results indicate that syringaresinol induces mitochondrial biogenesis by activating PPARß pathway.

One of the origins of modernity and naturalism of French literature in the 19th century.

Authors studied how Claude Bernard, the first founder of experimental medicine, contributed significantly to establishment of modernism and influenced European modern culture. Authors first studied his views on modernity, comparing with Descartes and Magendie, and on the similarity between "Experimental medicine" and the European literature in the 19th century. Bernard was not exclusively against vitalism, but the dogmatic misuse of vitalism. His objective thinking could be a useful model for the authors, who considered science to be an origin of modernity in literature of naturalism. Especially, Emile Zola was strongly influenced by Bernard's "An introduction to the study of Experimental medicine" and published "Experimental novel," a manifesto of naturalism. Although Bernard's experimental methodology and determinism deeply influenced modern European culture, the relationship between his Experimental medicine and modernism have not been fully investigated yet. His experimental medicine also needs to be discussed from the ecological viewpoints. His anthropo-centrism was unique since he emphasized any human theory could not surpass the principle of nature. Conventional anthropo-centrism claims that human beings are superior enough to own and govern the nature. And Bernard's the necessary determinism contains the ecological principle that all life forms and inanimate objects are organically related and intertwined to each other, irrespectively of their usefulness for the human beings. Although there were some ethical debates related to his medical experiments on living bodies of animal, his strict principle to perform experiments only after animal or human body died was worth considering as an effort to sustain ecological viewpoints. He was also unique in terms of being realistic and candid about his situation which was limited by the 19th century's scientific and medical development. In conclusion, the significance of convergence of literature and medical science in Experimental medicine and the importance of Bernard's ecological viewpoints, need to be further studied in the field of medical history.

Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.

BACKGROUND: While transarterial embolization (TAE) is an effective way to control arterial bleeding associated with pelvic fracture, the clinical outcomes according to door-to-embolization (DTE) time are unclear. This study investigated how DTE time affects outcomes in patients with severe pelvic fracture. METHODS: Using a trauma database between November 1, 2015 and December 31, 2019, trauma patients undergoing TAE were retrospectively reviewed. The final study population included 192 patients treated with TAE. The relationships between DTE time and patients' outcomes were evaluated. Multiple binomial logistic regression analyses, multiple linear regression analyses, and Cox hazard proportional regression analyses were performed to estimate the impacts of DTE time on clinical outcomes. RESULTS: The median DTE time was 150 min (interquartile range, 121-184). The mortality rates in the first 24 h and overall were 3.7% and 14.6%, respectively. DTE time served as an independent risk factor for mortality in the first 24 h (adjusted odds ratio = 2.00, 95% confidence interval [CI] = 1.20-3.34, p = 0.008). In Cox proportional hazards regression analyses, the adjusted hazard ratio of DTE time for mortality at 28 days was 1.24 (95% CI = 1.04-1.47, p = 0.014). In addition, there was a positive relationship between DTE time and requirement for packed red blood cell transfusion during the initial 24 h and a negative relationship between DTE time and ICU-free days to day 28. CONCLUSION: Shorter DTE time was associated with better survival in the first 24 h, as well as other clinical outcomes, in patients with complex pelvic fracture who underwent TAE. Efforts to minimize DTE time are recommended to improve the clinical outcomes in patients with pelvic fracture treated with TAE.

Traumatic Tricuspid Regurgitation Treated by the Minimally Invasive Double Orifice Technique.

A 37-year-old man was transferred to our level I trauma center after a road traffic accident, presenting with right acetabular fracture, multiple rib fractures, epidural hemorrhage, and liver contusion. Severe traumatic tricuspid regurgitation was also discovered during the work-up for surgery. Our initial attempt at acetabular surgery failed when the patient experienced near cardiac arrest during anesthetic induction. It was hence decided that tricuspid valve repair should precede orthopedic surgery. Minimally invasive tricuspid valve repair using the double orifice technique was successfully performed. Subsequently, acetabular surgery was performed and he was discharged 35 days post-trauma without any complications.

Prevalence of chronic post-thoracotomy pain in patients with traumatic multiple rib fractures in South Korea: a cross-sectional study.

Chronic post-thoracotomy pain is a debilitating condition after traumatic multiple rib fractures and surgery. We aimed to estimate the prevalence of chronic post-thoracotomy pain after traumatic multiple rib fractures in South Korea and explore factors associated with it. From October 2017 to June 2019, a cross-sectional survey of 100 adults, who had undergone thoracotomy due to traumatic fractures of two or more ribs 2 years to 3 months prior to the survey, was conducted in the regional trauma center in South Korea. In total, 80% and 65% patients reported any level and above moderate chronic pain, respectively. Quality of life was mostly below the normative value of the US general population. Forty-six percent patients had restrictive respiratory dysfunction, and 47% and 59% patients were classified as being at risk of above mild-level anxiety and depression, respectively. More than 70% of patients had a current opioid prescription. Multivariable logistic regression analysis showed weak evidence of association between acute, severe postoperative pain and chronic postsurgical pain (adjusted odds ratio 2.4, 95% confidence intervals 0.9 to 6.4). Collectively, chronic post-thoracotomy pain and associated incomplete recovery regarding respiratory, functional, and psychological outcomes were prevalent in patients with traumatic multiple rib fractures in South Korea.

Traumatic Hemothorax Caused by Thoracic Wall and Intrathoracic Injuries: Clinical Outcomes of Transcatheter Systemic Artery Embolization.

Purpose: We aimed to assess the clinical efficacy of transcatheter arterial embolization (TAE) for treating hemothorax caused by chest trauma. Materials and Methods: Between 2015 and 2019, 68 patients (56 male; mean age, 58.2 years) were transferred to our interventional unit for selective TAE to treat thoracic bleeding. We retrospectively investigated their demographics, angiographic findings, embolization techniques, technical and clinical success rates, and complications. Results: Bleeding occurred mostly from the intercostal arteries (50%) and the internal mammary arteries (29.5%). Except one patient, TAE achieved technical success, defined as the immediate cessation of bleeding, in all the other patients. Four patients successfully underwent repeated TAE for delayed bleeding or increasing hematoma after the initial TAE. The clinical success rate, defined as no need for thoracotomy for hemostasis after TAE, was 92.6%. Five patients underwent post-embolization thoracotomy for hemostasis. No patient developed major TAE-related complications, such as cerebral infarction or quadriplegia. Conclusion: TAE is a safe, effective and minimally invasive method for controlling thoracic wall and intrathoracic systemic arterial hemorrhage after thoracic trauma. TAE may be considered for patients with hemothorax without other concomitant injuries which require emergency surgery, or those who undergoing emergency TAE for abdominal or pelvic hemostasis.

Acupuncture combined with multidisciplinary care for recovery after traumatic multiple rib fractures: a prospective feasibility cohort study.

INTRODUCTION: Acute pain significantly delays early physiological recovery and results in chronic functional disability in patients with traumatic multiple rib fractures (MRFs). This prospective cohort study aimed to investigate the feasibility of acupuncture combined with multidisciplinary care during recovery in patients with traumatic MRFs. METHODS: Twenty patients with traumatic MRFs who were admitted to a regional trauma centre in South Korea were enrolled. A combination of acupuncture and multidisciplinary inpatient ward management was provided at the trauma ward. Patients were permitted to continue acupuncture treatments at outpatient clinics for 3 months after the traumatic events. Clinical outcomes, including pain, acute physiological recovery, quality of life, patient satisfaction with the care provided, respiratory function and use of opioids, were evaluated up to 6 months after trauma. RESULTS: Seventeen (85%) participants completed the 6-month follow-up. One patient withdrew consent during admission due to discomfort after three sessions of acupuncture. The proportion of patients with above-moderate level of pain decreased from 95% at baseline to 41% at 6 months. Quality of life appeared to deteriorate consistently throughout the study period. Around 80% of respondents expressed satisfaction with the acupuncture treatments and stated that they found acupuncture to be acceptable. Over 94% of respondents reported slight or considerable improvement. CONCLUSION: The provision of acupuncture combined with multidisciplinary care for recovery in patients with traumatic MRFs was feasible in a regional trauma centre in South Korea. Randomised trials are needed to investigate the role of acupuncture combined with multidisciplinary care in the future. TRIAL REGISTRATION NUMBER: KCT0002911 (Clinical Research Information Service).

Concomitant Avulsion Injury of the Subclavian Vessels and the Main Bronchus Caused by Blunt Trauma.

Concomitant rupture of the subclavian vessels and the left main bronchus caused by blunt trauma is a serious condition. Moreover, the diagnosis of a tracheobronchial injury with rupture of the subclavian vessels can be difficult. This report describes the case of a 33-year-old man who suffered from blunt trauma that resulted in the rupture of the left subclavian artery and vein. The patient underwent an operation for vascular control. On postoperative day 3, the left main bronchus was found to be transected on a computed tomography scan and bronchoscopy. The transected bronchus was anastomosed in an end-to-end fashion. He recovered without any notable problems. Although the bronchial injury was not detected early, this case of concomitant rupture of the great vessels and the airway was successfully treated after applying extracorporeal membrane oxygenation.

Volatile profiles and involvement step of moisture in bulk oils during oxidation by action of deuterium oxide (D2O).

Volatile formation is an inevitable result of lipid oxidation, which impact the quality of lipid rich foods. In this study, moisture role on the formation of volatiles were evaluated using deuterium oxide (D2O) and possible steps of moisture involvement were suggested. Moisture content in corn oil with deuterium free water (H2O) was significantly (p < 0.05) higher than that in corn oil with D2O. The contents of some volatiles including pentane, hexanal, 2-hexenal, and t-2-heptenal in corn oil with D2O were higher than those in corn oil with H2O for the first 8 days. Volatiles containing deuterium appeared in the order of pentane, t-2-pentenal, and t-2-heptenal during oxidation. Deuterium incorporated volatiles could be formed after the ß-scission of lipid hydroperoxides. Therefore, moisture plays important roles in the formation of volatiles as well as the locations of oxidation in bulk oils.

CsI as Multifunctional Redox Mediator for Enhanced Li-Air Batteries.

We introduce CsI as a multifunctional redox mediator to enhance the performance of Li-air batteries. CsI dissolved in the electrolyte is ionized into Cs(+) and I(-), which perform their roles in the Li anode and air electrode, respectively. The I(-) ions in the electrolyte facilitate the dissolution of Li2O2 in the air electrode as a redox mediator, which reduces the overpotential of the cell. The low overpotential also leads to the suppression of parasitic reactions occurring in the high-voltage range, such as the decomposition of the electrolyte and the reaction between Li2O2 and carbon. At the same time, the Cs(+) ions act as an electrostatic shield at the sharp points of the Li anode, hindering the growth of Li dendrite. The combined effects of reduced parasitic reactions and hindered Li-dendrite growth successfully improve the cyclic performance of Li-air cells.

New Flavonol Glucuronides from the Flower Buds of Syzygium aromaticum (Clove).

Repeated chromatography of the EtOAc-soluble fraction from the 70% EtOH extract of the flower buds of Syzygium aromaticum (clove) led to the isolation and characterization of four new flavonol glucuronides, rhamnetin-3-O-ß-d-glucuronide (1), rhamnazin-3-O-ß-d-glucuronide (2), rhamnazin-3-O-ß-d-glucuronide-6″-methyl ester (3), and rhamnocitrin-3-O-ß-d-glucuronide-6″-methyl ester (4), together with 15 flavonoids (5-19) having previously known chemical structures. The structures of the new compounds 1-4 were determined by interpretation of spectroscopic data, particularly by 1D- and 2D-NMR studies. Six flavonoids (6, 7, 9, 14, 18, and 19) were isolated from the flower buds of S. aromaticum for the first time in this study. The flavonoids were examined for their cytotoxicity against human ovarian cancer cells (A2780) using MTT assays. Among the isolates, pachypodol (19) showed the most potent cytotoxicity on A2780 cells with an IC50 value of 8.02 µM.

Carbon and Binder-Free Air Electrodes Composed of Co3O 4 Nanofibers for Li-Air Batteries with Enhanced Cyclic Performance.

In this study, to fabricate a carbon free (C-free) air electrode, Co3O4 nanofibers were grown directly on a Ni mesh to obtain Co3O4 with a high surface area and good contact with the current collector (the Ni mesh). In Li-air cells, any C present in the air electrode promotes unwanted side reactions. Therefore, the air electrode composed of only Co3O4 nanofibers (i.e., C-free) was expected to suppress these side reactions, such as the decomposition of the electrolyte and formation of Li2CO3, which would in turn enhance the cyclic performance of the cell. As predicted, the Co3O4-nanofiber electrode successfully reduced the accumulation of reaction products during cycling, which was achieved through the suppression of unwanted side reactions. In addition, the cyclic performance of the Li-air cell was superior to that of a standard electrode composed of carbonaceous material.

Polyimide-wrapped carbon nanotube electrodes for long cycle Li-air batteries.

A simple surface modification technique for carbon electrodes in long-cycle Li-air batteries is demonstrated, in which a polyimide coating is used to suppress unwanted side reactions between the electrode and the electrolyte (and/or Li2O2). This is found to result in excellent cycling performance, without any significant loss of capacity.

Resurgence of measles in a country of elimination: interim assessment and current control measures in the Republic of Korea in early 2014.

Since the beginning of 2014, the Republic of Korea has experienced a resurgence of measles cases. Among the 220 cases confirmed as measles during epidemiological weeks 1-20 (December 29, 2013 to May 17, 2014), 10 imported cases were identified. The predominant genotype was B3, which reflects the circulating measles virus in adjacent countries. Even with the verification of measles elimination in March 2014 by the World Health Organization, recent importation has been related to international travel. Targeted control measures have been implemented in addition to proper isolation and patient care. A vigilant surveillance system and high levels of vaccine coverage should be maintained to sustain the measles elimination status.

Thoracic Epidural Anesthesia and Analgesia (TEA) in Patients with Rib Fractures.

BACKGROUND: We analyzed the results of surgical reduction and fixation of ribs under thoracic epidural anesthesia and analgesia (TEA) in patients who had no more than 3 consecutive rib fractures with severe displacement to examine the clinical usefulness of this method. MATERIALS AND METHODS: From May 2008 to March 2010, 35 patients underwent surgical reduction and fixation of ribs under TEA. We reviewed the indications for this technique, number of fixed ribs, combined surgical procedures for thoracic trauma, intraoperative cardiopulmonary events, postoperative complications, reestablishment of enteral nutrition, and ambulation. RESULTS: The indications of TEA were malunion or nonunion of fractured ribs in 29 (82.9%; first operation) and incompletely ribs under previous general anesthesia in 6 (17.1%; second operation). The average number of fixed ribs per patient was 1.7 (range: 1~3). As a combined operation for thoracic trauma, 17 patients (48.6%) underwent removal of intrathoracic hematomas, and we performed repair of lung parenchyma (2), wedge resection of lung (1) for accompanying lung injury and pericardiostomy (1) for delayed hemopericardium. No patient had any intraoperative cardiopulmonary event nor did any need to switch to general anesthesia. We experienced 3 postoperative complications (8.6%): 2 extrapleural hematomas that spontaneously resolved without treatment and 1 wound infection treated with secondary closure of the wound. All patients reestablished oral feeding immediately after awakening and resumed walking ambulation the day after operation. CONCLUSION: Thoracic epidural anesthesia and analgesia (TEA) may positively affect cardiopulmonary function in the perioperative period. Moreover, this technique leads to an earlier return of gastrointestinal function and early ambulation without severe postoperative complications, resulting in a shortened hospital stay and lowered costs.

Surgical treatment of thoracic menigocele associated with neurofibromatosis and kyphoscoliosis.

A 46-year-old man presented with a lateral thoracic meningocele associated with cutaneous neurofibromatosis type I and kyphoscoliosis of the thoracic spine upon medical examination. In the majority of such cases, these meningoceles remain asymptomatic, but surgery is indicated when giant or symptomatic cysts are present. The large thoracic meningocele was successfully extirpated through the transthoracic approach in combination with lumbar puncture and cerebrospinal drainage for decompression of the cyst.