Limonoids and unsaturated fatty acids present in Melia toosendan increase ceramide production in keratinocytes.

The skin barrier prevents moisture evaporation and the entry of foreign substances such as allergens. Ceramides are one of the most important factors for maintaining skin barrier function. Melia toosendan is a plant of the Meliaceae family, and its fruit extracts have been used in Traditional Chinese Medicine as analgesics and anthelmintics; however, its ability to increase ceramide levels has not been reported. In this study, we screened for compounds present in M. toosendan fruit extracts that increase ceramide levels in the skin. We fractionated the extracts based on their activity to identify the active components. Nimbolinins, limonoids such as toosendanin, and hydroxylated unsaturated fatty acids were found to be the major active components. The structure-activity relationship of toosendanin derivatives indicated that the sites around R4 and R5 contributed to the activity. To the best of our knowledge, this is the first report showing that limonoids promote ceramide production in skin cells. Therefore, M. toosendan fruit extracts may be used to develop products for improving the skin barrier function.

Melanogenesis inhibitory activity of components from Salam leaf (Syzygium polyanthum) extract.

In order to identify a novel whitening agent, the methanol extract of S. polyanthum leaf was focused on by the screening test using nine Indonesian medicinal plants for the inhibition of melanogenesis and tyrosinase activity in B16 melanoma cells. Three novel compounds [(1) 1-(2,3,5-trihydroxy-4-methylphenyl)hexane-1-one, (2) 1-(2,3,5-trihydroxy methylphenyl)octane-1-one, and (3) (4E)-1-(2,3,5-trihydroxy-4-methylphenyl)decan-1-one and one known compound [(4) 1-(2,3,5-trihydroxy-4-methylphenyl)decan-1-one were isolated from the methanol extract. Our study demonstrated that S. polyanthum leaf methanol extract at 25-200 µg/mL decreased extracellular melanin formation ca. 20-80%, with high cell viability. Compounds 1-4 were found to be active in melanogenesis and tyrosinase inhibition. Compound 3 was the most active against tyrosinase activity (83.98 µM), particularly when L-tyrosine was the substrate. Compounds 1-4 significantly diminished extracellular melanin formation in B16 melanoma cells (> 80%), with high cell viability. Thus, our study suggested that compounds 1-4 isolated from the methanol extract of S. polyanthum leaf play important roles in decreasing extracellular melanogenesis and inhibiting tyrosinase.

Development of a Time-Intensity Evaluation System for Consumers: Measuring Bitterness and Retronasal Aroma of Coffee Beverages in 106 Untrained Panelists.

In order to develop products that are acceptable to consumers, it is necessary to incorporate consumers' intentions into products' characteristics. Therefore, investigation of consumers' perceptions of the taste or smell of common beverages provides information that should be useful in predicting market responses. In this study, we sought to develop a time-intensity evaluation system for consumer panels. Using our system, we performed time-intensity evaluation of flavor attributes (bitterness and retronasal aroma) that consumers perceived after swallowing a coffee beverage. Additionally, we developed quantitative evaluation methods for determining whether consumer panelists can properly perform time-intensity evaluation. In every trial, we fitted an exponential function to measured intensity data for bitterness and retronasal aroma. The correlation coefficients between measured time-intensity data and the fitted exponential curves were greater than 0.8 in about 90% of trials, indicating that we had successfully developed a time-intensity system for use with consumer panelists, even after just a single training trial using a nontrained consumer. We classified participants into two groups based on their consumption of canned coffee beverages. Significant difference was observed in only AUC of sensory modality (bitterness compared with retronasal aroma) among conventional TI parameters using two-way ANOVA. However, three-way ANOVA including a time course revealed significant difference between bitterness and retronasal aroma in the high-consumption group. Moreover, the high-consumption group more easily discriminated between bitterness and retronasal aroma than the low-consumption group. This finding implied that manufacturers should select consumer panelists who are suitable for their concepts of new products.

The accuracy of non-invasively continuous total hemoglobin measurement by pulse CO-Oximetry undergoing acute normovolemic hemodilution and reinfusion of autologous blood.

BACKGROUND: Non-invasively continuous total hemoglobin (SpHb) measurement has not been assessed adequately in acute bleeding and rapid blood transfusion during surgery. Thus, we have assessed the efficacy of SpHb during both acute normovolemic hemodilution (ANH) and autologous blood transfusion (ABT). METHODS: Twenty-four patients undergoing urological and gynecological surgery were enrolled. ANH was induced by withdrawing blood of 800 g with simultaneous fluid administration. When surgical hemostasis was completed, collected blood was reinfused. Measurement of SpHb, perfusion index (PI) and real total Hb (tHb) were done before and after each 400 ml blood removal (-0, -400, -800 ml) and reinfusion (+0, +400, +800 ml). RESULTS: A Bland-Altman analysis for repeated measurements showed a bias (precision) g/dl of 1.12 (1.25), 1.43 (1.24) and 1.10 (1.23) for all data, during ANH and during ABT, respectively. Additionally, a bias (precision) increased with a reduction in tHb (g/dl): ≥10.0; 0.74 (1.30), 8.0-10.0; 1.15 (1.12) and <8.0; 1.60 (1.28). Although the difference between SpHb and tHb was almost zero before anesthesia induction, it became significant just before ANH and did not change further by ANH and ABT. Significant correlations between SpHb and tHb for all data (r = 0.75, n = 228, p < 0.001) were observed. PI slightly correlated with the difference between SpHb and tHb (r = 0.38, n = 216, p < 0.001). Furthermore, before and after induction of anesthesia, PI also correlated with the difference between SpHb and tHb (r = 0.42, n = 23, p = 0.048 and r = 0.51, n = 22, p = 0.016, respectively). CONCLUSIONS: The present data suggest that SpHb may overestimate tHb during ANH and ABT. In addition, PI and tHb levels had an impact on the accuracy of SpHb measurements.

[Case of Rh (-) patient's right lobectomy of the liver with massive hemorrhage evading allogeneic blood transfusion by hemodilutional autologous blood transfusion].

A 44-year-old man (ASA-PS 1) underwent right lobectomy of the liver under total intravenous anesthesia with propofol, remifentanil, ketamine and rocuronium. In order to evade allogeneic blood transfusion, 1,200 g of the patient's blood was taken and hemodilution was induced for autologous blood transfusion (HAT) after the induction of anesthesia. As intraoperative blood loss amounted to about 4,000 g, Hb level decreased from 13.6 to 6.2 g x dl(-1). However, as intraoperative hemodynamics was relatively stable with crystalloidal and colloidal transfusion with no ischemic change on ECG and no metabolic acidosis, autologous blood transfusion was withheld. After returning the autologous blood, Hb increased to 9.8 g x dl(-1). Any postoperative complications related to the low Hb level were not recognized. HAT is a useful method to evade or at least decrease the amount of allogeneic blood transfusion by anesthesiologists.

[Case of hemoglobinuria following glycerin enema].

A 57-year-old man with lung tumor was scheduled for right middle lobectomy under general anesthesia. The patient received glycerin enema 2 hours before anesthesia. Anesthesia was induced with propofol, fentanyl, ketamine and vecuronium. After the induction, urine of dark-red color was drained through the urinary catheter. Massive (3+) occult blood and few erythrocytes in the urine sediment were observed. Furthermore, blood analysis showed hemolysis with mild renal dysfunction (Cr 1.3 mg x dl(-1)). Although serum CPK and myoglobin increased, there was no apparent symptom that supported the onset of rhabdomyolysis induced by anesthetics, acute myocardial infarction or malignant hyperthermia. At this time, we noticed that blood sample taken before the induction had been hemolysed. With all the above information in mind, we suspected that the main cause of the hemoglobinuria could be the enema and the surgery was canceled. The patient made a good progress with laboratory data normalized on the 4th postanesthesia day. However, rectal ulcer developed as a possible late complication of the enema. Although it is well-known that glycerin enema could cause hemolysis, renal failure and rectal ulcer, the increase of CPK and myoglobin in serum made the diagnosis difficult from other conditions leading to rhabdomyolysis in this case.

Molecular detection of SS18-SSX fusion gene transcripts by cRNA in situ hybridization in synovial sarcoma using formalin-fixed, paraffin-embedded tumor tissue specimens.

SS18-SSX fusion genes resulting from a chromosomal translocation t(X;18)(p11.2;q11.2) are a genetic hallmark of synovial sarcoma. Although such cytogenetic or molecular aberrations have mostly been detected by fluorescence in situ hybridization or reverse transcription-polymerase chain reaction, the expression of SS18-SSX has been poorly investigated at a cellular or tissue level. In this study, biotinylated tyramide (BT)-based in situ hybridization (ISH) was performed to detect SS18-SSX transcripts using formalin-fixed, paraffin-embedded tissues from 15 synovial sarcomas. Digoxigenin-labeled cRNA probes flanking the fusion points of SS18-SSX1 and SS18-SSX2 were generated by in vitro transcription, and hybridized signals were detected by a streptavidin-biotin complex method after chemical enhancement with BT. The localizations of signals were compared with the immunohistochemical expressions of epithelial or neuroectodermal markers and those of cell adhesion including cytokeratins (CAM5.2, AE1/AE3, CK7), epithelial membrane antigen, E-cadherin, beta-catenin, c-erbB-2 (HER2/neu), CD56, and claudin-1. The ISH signals of the SS18-SSX transcripts were identified in 13 synovial sarcomas, and their fusion types correlated with those determined by reverse transcription-polymerase chain reaction. In biphasic tumors, the ISH signals tended to localize to epithelial areas, whereas spindle-cell areas or monophasic fibrous tumors showed a less intense or focal expression pattern. Notably, the expression patterns of AE1/AE3, CK7, and c-erbB-2 often colocalized with the ISH signals (7 of 11 cases positive for each marker). Our results suggest that BT-based ISH can be used as a molecular technique for the detection of SS18-SSX using formalin-fixed, paraffin-embedded tissues.

Structural characterization of calcineurin B homologous protein 1.

Calcineurin B homologous protein 1 (CHP1), also known as p22, is a calcium-binding EF-hand protein that plays a role in membrane trafficking. It binds to multiple effector proteins, including Na(+)/H(+) exchangers, a serine/threonine kinase, and calcineurin, potentially modulating their function. The crystal structure of calcium-bound CHP1 from rat has been determined at 2.2 Angstroms of resolution. The molecule has a compact alpha-helical structure containing four EF-hands. The overall folding topology of the protein is similar to that of the regulatory B subunit of calcineurin and to that of calcium- and integrin-binding protein. The calcium ion is coordinated in typical fashion in the third and fourth EF-hands, but the first and second EF-hands contain no calcium ion. The first EF-hand is maintained by internal interactions, and the second EF-hand is stabilized by hydrophobic interactions. CHP1 contains a hydrophobic pocket on the opposite side of the protein to the EF-hands that has been implicated in ligand binding.

Vertebral fracture and bone mineral density in women receiving high dose glucocorticoids for treatment of autoimmune diseases.

OBJECTIVE: To evaluate the factors influencing the occurrence of vertebral fracture in patients receiving high dose glucocorticoids (GC). METHODS: A cross-sectional study was performed on women who had received at least 0.5 mg/kg of oral glucocorticoid for the treatment of autoimmune diseases for more than 1 month between 1998 and 2003. Logistic regression analysis and chi-square test were used to examine the effects of glucocorticoid dose and other factors on vertebral fractures. Receiver-operating characteristics curve (ROC) analysis was used to determine the bone mineral density (BMD) cutoff value for the risk of vertebral fracture. RESULTS: The study population comprised 160 women, including 35 with vertebral fractures. In ROC analysis, the BMD threshold of the risk of fracture for postmenopausal women (0.787 g/cm2 , T score -2.1) was lower than that for premenopausal women (0.843 g/cm2 , T score -1.7). Among patients with fractures, 7 of 16 premenopausal patients had normal BMD values (T score > -1), whereas only one of 19 postmenopausal patients showed a comparable level of BMD. Additionally, vertebral fracture was more frequent for patients with high total cholesterol values (> 280 mg/dl) than for those with normal total cholesterol values (< 220 mg/dl). Moreover, patients with high total cholesterol values had lower BMD values than those with normal total cholesterol values. CONCLUSION: The fact that vertebral fracture frequently occurred in premenopausal patients with normal BMD and evidence that hyperlipidemia correlated with fracture suggest the pathology of vertebral fracture secondary to high dose glucocorticoid therapy is multifactorial and possibly involves lipid metabolism.

Progressive severe anemia due to copper deficiency five years after subarachnoid hemorrhage.

Patients with neurological illnesses often require prolonged enteral or parenteral nutrition. The complications of this type of feeding may be unfamiliar to neurosurgeons and neurologists, however, these complications may be an important source of ongoing morbidity. We present a case of severe anemia due to copper deficiency in a patient requiring enteral nutrition after SAH. The anemia resolved with copper supplements. A high index of suspicion is needed to recognise and treat complications of enteral nutrition.

[Does a high inspired oxygen concentration consistently play a key role in developing combustion in the airway during fiberoptic bronchoscopy guided laser treatment?--A case of firing in the airway under total intravenous anesthesia].

We experienced combustion of a fiberoptic bronchoscope and an endotracheal tube, as well as tracheo-bronchial burn during a diode laser treatment in a hypoxemic patient requiring continuous oxygen administration. Total intravenous anesthesia and a high concentration of inspired oxygen (FIO2 0.60) were used for the procedure. The complication occurred abruptly at the beginning of the second treatment after the first uneventful 15 min treatment. Several reports suggest that laser treatment can be performed even under FIO2 1.0 without firing in the airway, and a high FIO2 itself would not consistently play a key role in developing combustion in the airway, even though combustion is more vigorous when a higher FIO2 is used. Based on our experience and reports of firing in the airway during laser treatment, the following recommendations are presented. The laser treatment should be done (1) at the FIO2 just enough to maintain adequate oxygenation in each individual patient, (2) at the greatest possible distance between a bronchoscope and an endotracheal tube, and (3) after removing small pieces of carbonized tissues produced by each laser treatment.