Clinical Implication of the Acumen Hypotension Prediction Index for Reducing Intraoperative Haemorrhage in Patients Undergoing Lumbar Spinal Fusion Surgery: A Prospective Randomised Controlled Single-Blinded Trial.

We investigated the clinical implication of the Hypotension Prediction Index (HPI) in decreasing amount of surgical haemorrhage and requirements of blood transfusion compared to the conventional method (with vs. without HPI monitoring). A prospective, randomised controlled-trial of 19- to 73-year-old patients (n = 76) undergoing elective lumbar spinal fusion surgery was performed. According to the exclusion criteria, the patients were divided into the non-HPI (n = 33) and HPI (n = 35) groups. The targeted-induced hypotension systolic blood pressure was 80−100 mmHg (in both groups), with HPI > 85 (in the HPI group). Intraoperative bleeding was lower in the HPI group (299.3 ± 219.8 mL) than in the non-HPI group (532 ± 232.68 mL) (p = 0.001). The non-HPI group had a lower level of haemoglobin at the end of the surgery with a larger decline in levels. The incidence of postoperative transfusion of red blood cells was higher in the non-HPI group than in the HPI group (9 (27.3%) vs. 1 (2.9%)). The use of HPI monitoring may play a role in providing timely haemodynamic information that leads to improving the quality of induced hypotension care and to ameliorate intraoperative surgical blood loss and postoperative demand for blood transfusion in patients undergoing lumbar fusion surgery.

Melanogenesis effect of Cordyceps militaris culture broth on the melanin formation of B16F0 melanoma cells.

The effect of Cordyceps militaris culture broth (CMB) on melanogenesis in B16F0 melanoma cells was evaluated by measurement of the melanin concentration after 3 days of incubation. The B16F0 melanoma cells were treated with various concentrations of CMB 10-100 µg/mL and arbutin of 200 µM. Phenolic content and antioxidant activity of CMB were also measured. Phenolic content of CMB was 3.28 mg/g. The DPPH radical scavenging and ferric ion donating activities were 79.64% and 0.16, respectively. The melanin concentration and cell viability of melanoma cells by arbutin treatment decreased to 43% and 91% of the control, respectively. The CMB treatment showed a significant inhibitory effect of melanin production by 29%, 50%, and 56% at 50, 80, and 100 µg/mL concentration treatment, respectively, while over 90% of cells were viable. The CMB treatment at 50, 80, and 100 µg/mL concentrations in cultivation decreased extracellular melanin release induced by 3-isobutyl-1-methylxanthine (IBMX) treatment by 19%, 38%, and 48%, respectively. The CMB showed inhibitory activity against intracellular tyrosinase extracted from melanoma cells, while it had no inhibition on the activity of mushroom tyrosinase. The cellular glutathione contents were enhanced by CMB treatment in a concentration-dependent manner. These results suggested that CMB suppressed cellular tyrosinase activity and total melanin content in cultured B16F0 melanoma cells without any significant effects on cell proliferation and it might be candidate anti-melanogenic agent.