Genome-wide kinase-MAM interactome screening reveals the role of CK2A1 in MAM Ca2+ dynamics linked to DEE66.

The endoplasmic reticulum (ER) and mitochondria form a unique subcellular compartment called mitochondria-associated ER membranes (MAMs). Disruption of MAMs impairs Ca2+ homeostasis, triggering pleiotropic effects in the neuronal system. Genome-wide kinase-MAM interactome screening identifies casein kinase 2 alpha 1 (CK2A1) as a regulator of composition and Ca2+ transport of MAMs. CK2A1-mediated phosphorylation of PACS2 at Ser207/208/213 facilitates MAM localization of the CK2A1-PACS2-PKD2 complex, regulating PKD2-dependent mitochondrial Ca2+ influx. We further reveal that mutations of PACS2 (E209K and E211K) associated with developmental and epileptic encephalopathy-66 (DEE66) impair MAM integrity through the disturbance of PACS2 phosphorylation at Ser207/208/213. This, in turn, causes the reduction of mitochondrial Ca2+ uptake and the dramatic increase of the cytosolic Ca2+ level, thereby, inducing neurotransmitter release at the axon boutons of glutamatergic neurons. In conclusion, our findings suggest a molecular mechanism that MAM alterations induced by pathological PACS2 mutations modulate Ca2+-dependent neurotransmitter release.

Ceramide promotes lytic reactivation of Epstein-Barr virus in gastric carcinoma.

Epstein-Barr virus (EBV) has a lifelong latency period after initial infection. Rarely, however, when the EBV immediate early gene BZLF1 is expressed by a specific stimulus, the virus switches to the lytic cycle to produce progeny viruses. We found that EBV infection reduced levels of various ceramide species in gastric cancer cells. As ceramide is a bioactive lipid implicated in the infection of various viruses, we assessed the effect of ceramide on the EBV lytic cycle. Treatment with C6-ceramide (C6-Cer) induced an increase in the endogenous ceramide pool and increased production of the viral product as well as BZLF1 expression. Treatment with the ceramidase inhibitor ceranib-2 induced EBV lytic replication with an increase in the endogenous ceramide pool. The glucosylceramide synthase inhibitor Genz-123346 inhibited C6-Cer-induced lytic replication. C6-Cer induced extracellular signal-regulated kinase 1/2 (ERK1/2) and CREB phosphorylation, c-JUN expression, and accumulation of the autophagosome marker LC3B. Treatment with MEK1/2 inhibitor U0126, siERK1&2, or siCREB suppressed C6-Cer-induced EBV lytic replication and autophagy initiation. In contrast, siJUN transfection had no impact on BZLF1 expression. The use of 3-methyladenine (3-MA), an inhibitor targeting class III phosphoinositide 3-kinases (PI3Ks) to inhibit autophagy initiation, resulted in reduced beclin-1 expression, along with suppressed C6-Cer-induced BZLF1 expression and LC3B accumulation. Chloroquine, an inhibitor of autophagosome-lysosome fusion, increased BZLF1 protein intensity and LC3B accumulation. However, siLC3B transfection had minimal effect on BZLF1 expression. The results suggest the significance of ceramide-related sphingolipid metabolism in controlling EBV latency, highlighting the potential use of drugs targeting sphingolipid metabolism for treating EBV-positive gastric cancer.IMPORTANCEEpstein-Barr virus remains dormant in the host cell but occasionally switches to the lytic cycle when stimulated. However, the exact molecular mechanism of this lytic induction is not well understood. In this study, we demonstrate that Epstein-Barr virus infection leads to a reduction in ceramide levels. Additionally, the restoration of ceramide levels triggers lytic replication of Epstein-Barr virus with increase in phosphorylation of extracellular signal-regulated kinase 1/2 (ERK1/2) and CREB. Our study suggests that the Epstein-Barr virus can inhibit lytic replication and remain latent through reduction of host cell ceramide levels. This study reports the regulation of lytic replication by ceramide in Epstein-Barr virus-positive gastric cancer.

Amodiaquine promotes testosterone production and de novo synthesis of cholesterol and triglycerides in Leydig cells.

Testosterone is a hormone essential for male reproductive function. It is produced primarily by Leydig cells in the testicle through activation of steroidogenic acute regulatory protein and a series of steroidogenic enzymes, including a cytochrome P450 side-chain cleavage enzyme (cytochome P450 family 11 subfamily A member 1), 17α-hydroxylase (cytochrome P450 family 17 subfamily A member 1), and 3ß-hydroxysteroid dehydrogenase. These steroidogenic enzymes are mainly regulated at the transcriptional level, and their expression is increased by the nuclear receptor 4A1. However, the effect on Leydig cell function of a small molecule-activating ligand, amodiaquine (AQ), is unknown. We found that AQ effectively and significantly increased testosterone production in TM3 and primary Leydig cells through enhanced expression of steroidogenic acute regulatory protein, cytochome P450 family 11 subfamily A member 1, cytochrome P450 family 17 subfamily A member 1, and 3ß-hydroxysteroid dehydrogenase. Concurrently, AQ dose-dependently increased the expression of 3-hydroxy-3-methylglutaryl-CoA reductase, a key enzyme in the cholesterol synthesis pathway, through induction of the transcriptional and DNA-binding activities of nuclear receptor 4A1, contributing to increased cholesterol synthesis in Leydig cells. Furthermore, AQ increased the expression of fatty acid synthase and diacylglycerol acyltransferase and potentiated de novo synthesis of fatty acids and triglycerides (TGs). Lipidomics profiling further confirmed a significant elevation of intracellular lipid and TG levels by AQ in Leydig cells. These results demonstrated that AQ effectively promotes testosterone production and de novo synthesis of cholesterol and TG in Leydig cells, indicating that AQ may be beneficial for treating patients with Leydig cell dysfunction and subsequent testosterone deficiency.

Slc25a17 acts as a peroxisomal coenzyme A transporter and regulates multiorgan development in zebrafish.

Slc25a17 is known as a peroxisomal solute carrier, but the in vivo role of the protein has not been demonstrated. We found that the zebrafish genome contains two slc25a17 genes that function redundantly, but additively. Notably, peroxisome function in slc25a17 knockdown embryos is severely compromised, resulting in an altered lipid composition. Along the defects found in peroxisome-associated phenotypic presentations, we highlighted that development of the swim bladder is also highly dependent on Slc25a17 function. As Slc25a17 showed substrate specificity towards coenzyme A (CoA), injecting CoA, but not NAD+ , rescued the defective swim bladder induced by slc25a17 knockdown. These results indicated that Slc25a17 acts as a CoA transporter, involved in the maintenance of functional peroxisomes that are essential for the development of multiple organs during zebrafish embryogenesis. Given high homology in protein sequences, the role of zebrafish Slc25a17 may also be applicable to the mammalian system.

Laparoscopic liver resection for segment VII lesion using a combination of rubber band retraction method and flexible laparoscope.

INTRODUCTION: Laparoscopic liver resection (LLR) for tumors involving segment VII has been considered a contraindication. Herein, our proposed laparoscopic technique for segment VII lesions using a rubber band retraction method and flexible laparoscope is introduced. METHODS: A combination of elastic rubber band retraction method and flexible laparoscope was applied to access segment VII lesion. The perioperative outcomes and pathologic results were compared between patients with segment VII lesions (group 1) and patients with tumors in other segments (group 2) to evaluate feasibility and safety of the proposed laparoscopic approach for segment VII lesions. RESULTS: Among 167 patients who underwent LLR from May 2014 to October 2017, the study population included 17 patients with tumors in segment VII (group 1) and 66 patients with tumors in other segments (group 2). The demographics of the two groups were comparable. One open conversion occurred in group 2 due to bleeding. The mean tumor size was 2.6 ± 1.0 and 2.5 ± 1.5 cm (p = 0.392) and surgical margin was 1.2 ± 0.7 and 1.3 ± 1.2 cm (p = 0.344) in group 1 and group 2, respectively. The mean operation time was 151 ± 63 and 131 ± 57 min (p = 0.596) and estimated mean blood loss was 294 ± 281 and 306 ± 405 mL (p = 0.610), in group 1 and group 2, respectively. The mean postoperative hospital stay was 6.1 ± 1.5 and 6.4 ± 2.7 days (p = 0.064) in group 1 and group 2. Two postoperative complications in both groups and no postoperative mortality occurred. CONCLUSION: The combination technique of rubber band retraction and flexible laparoscopic camera allowed feasible and safe LLR for segment VII lesions that showed postoperative outcomes comparable to other segment lesions.

Characterization and Antioxidant Activity Determination of Neutral and Acidic Polysaccharides from Panax Ginseng C. A. Meyer.

Panax ginseng (P. ginseng) is the most widely consumed herbal plant in Asia and is well-known for its various pharmacological properties. Many studies have been devoted to this natural product. However, polysaccharide's components of ginseng and their biological effects have not been widely studied. In this study, white ginseng neutral polysaccharide (WGNP) and white ginseng acidic polysaccharide (WGAP) fractions were purified from P. ginseng roots. The chemical properties of WGNP and WGAP were investigated using various chromatography and spectroscopy techniques, including high-performance gel permeation chromatography, Fourier-transform infrared spectroscopy, and high-performance liquid chromatography with an ultra-violet detector. The antioxidant, anti-radical, and hydrogen peroxide scavenging activities were evaluated in vitro and in vivo using Caenorhabditis elegans as the model organism. Our in vitro data by ABTS (2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid), reducing power, ferrous ion chelating, and hydroxyl radical scavenging activity suggested that the WGAP with significantly higher uronic acid content and higher molecular weight exhibits a much stronger antioxidant effect as compared to that of WGNP. Similar antioxidant activity of WGAP was also confirmed in vivo by evaluating internal reactive oxygen species (ROS) concentration and lipid peroxidation. In conclusion, WGAP may be used as a natural antioxidant with potent scavenging and metal chelation properties.

Z-Ajoene Inhibits Growth of Colon Cancer by Promotion of CK1α Dependent ß-Catenin Phosphorylation.

Aberrant activation of a Wnt/ß-catenin pathway results in nuclear accumulation of ß-catenin in colon cancer. Inhibiting ß-catenin is one strategy for treating colon cancer. Here, we identified Z-ajoene, a sulfur containing compound isolated from crushed garlic, as an inhibitor of colon cancer cell growth. Z-Ajoene repressed ß-catenin response transcriptional activity, intracellular ß-catenin levels, and its representative target protein levels (c-Myc and cyclin D1) in SW480 colon cancer cells. To clarify the regulatory mechanism of decreased ß-catenin levels, we examined the effect of Z-ajoene on ß-catenin phosphorylation, which is involved in ß-catenin degradation. Z-Ajoene promoted the phosphorylation of ß-catenin at Ser45 in a casein kinase 1α (CK1α)-dependent manner, which is an essential step in ß-catenin degradation in the cytosol. These findings indicate that Z-ajoene from garlic may be a potential chemotherapeutic agent by modulating CK1α activity and the Wnt/ß-catenin signaling pathway.

Accumulation of Saponins in Underground Parts of Panax vietnamensis at Different Ages Analyzed by HPLC-UV/ELSD.

Panax vietnamensis (PV), a wild Panax species discovered in Vietnam in 1973, has been increasingly overexploited due to its economic value and therapeutic uses. This resulted in the development of PV cultivation to meet the market demand. There is little information on the accumulation of saponins in PV during cultivation, but this information could serve as an indication of the appropriate harvest time. In this study we developed an HPLC-UV/ELSD method to simultaneously determine the content of 10 characteristic saponins in PV from 2-7 years old, including G-Rb1, G-Rd, G-Rg1, G-Re, N-R1, M-R1, M-R2, V-R2, V-R11, and p-RT4. The result indicated that from 2 to 5 years, the content of saponins in PV rhizome and radix increase 3.02 and 4.2 times, respectively, whereas from 5 to 7 years, no significant changes were observed. Hence, our study suggests that after 5 years of growth could be considered as an appropriate time for PV to be harvested. Among the analyzed saponins, G-Rg1, G-Rb1, G-Rd, and especially M-R2 were the major saponins that contributed to the change of PV's saponin content through the years. In addition, the developed and validated HPLC method was proven to be reliable and effective for quality control of PV.

Systemic and Local Metabolic Alterations in Sleep-Deprivation-Induced Stress: A Multiplatform Mass-Spectrometry-Based Lipidomics and Metabolomics Approach.

Sleep deprivation (SD) is known to be associated with metabolic disorders and chronic diseases. Complex metabolic alterations induced by SD at omics scale and the associated biomarker candidates have been proposed. However, in vivo systemic and local metabolic shift patterns of the metabolome and lipidome in acute and chronic partial SD models remain to be elucidated. In the present study, the serum, hypothalamus, and hippocampus CA1 of sleep-deprived rats (SD rats) from acute and chronic sleep restriction models were analyzed using three different omics platforms for the discovery and mechanistic assessment of systemic and local SD-induced dysregulated metabolites. We found a similar pattern of systemic metabolome alterations between two models, for which the area under the curve (AUC) of receiver operating characteristic curves was AUC = 0.847 and 0.930 with the pseudotargeted and untargeted metabolomics approach, respectively. However, SD-induced systemic lipidome alterations were significantly different and appeared to be model-dependent (AUC = 0.374). Comprehensive pathway analysis of the altered lipidome and metabolome in the hypothalamus indicated the abnormal behavior of eight metabolic and lipid metabolic pathways. The metabolic alterations of the hippocampus CA1 was subtle in two SD models. Collectively, these results extend our understanding of the quality of sleep and suggest metabolic targets in developing diagnostic biomarkers for better SD control.

Integrative lipidomic and transcriptomic analysis of X-linked adrenoleukodystrophy reveals distinct lipidome signatures between adrenomyeloneuropathy and childhood cerebral adrenoleukodystrophy.

Precise pathophysiology with respect to the phenotypic variations and severity of X-ALD, specifically between adrenomyeloneuropathy (AMN) and childhood cerebral adrenoleukodystrophy (CCALD), has not been fully discovered. Herein, a systematic analysis using multi-layered lipidomics and transcriptomics was conducted to elucidate distinctive metabolic biosignatures among healthy control, AMN, and CCALD. Significant alterations regarding the accumulation of very long chain fatty acids were found in various lipid species such as phospholipids, glycerolipids, and sphingolipids. Remarkably, TG and CER that are physiologically essential were markedly down-regulated in CCALD than AMN. Transcriptomic analysis further supported the robustness of our findings by providing valuable information on the gene expressions of the regulatory factors. For instance, regulators of sphingolipid catabolism (SMPD1, CERK, and SPHK1) and TG anabolism (GPAM, GPAT2, and MBOAT2) were more up-regulated in AMN than in CCALD. These observations, among others, were in line with the recognized alterations of the associated lipidomes. In conclusion, the homeostatic imbalance of the complex lipid networks may be pathogenically important in X-ALD and the particular dysregulations of TG and CER may further influence the severity of CCALD among X-ALD patients.

Adiponectin-Secretion-Promoting Phenylethylchromones from the Agarwood of Aquilaria malaccensis.

The therapeutic potential of adiponectin regulation has received interest because of its association with diverse human disease conditions, such as diabetes, obesity, atherosclerosis, and cancer. Phenylethylchromone derivatives from Aquilaria malaccensis-derived agarwood promoted adiponectin secretion during adipogenesis in human bone marrow mesenchymal stem cells, and 5,6-dihydroxy-2-(2-phenylethyl)chromone (1) was identified as a new chromone derivative. A target identification study with the most potent adiponectin-secretion-promoting phenylethylchromones, 6-methoxy-2-(2-phenylethyl)chromone (3) and 7-methoxy-2-(2-phenylethyl)chromone (4), showed that they are PPARγ partial agonists. Therefore, the diverse therapeutic effects of agarwood are associated with a PPARγ-mediated adiponectin-secretion-promoting mechanism.

Laparoscopic Central Bisectionectomy and Right Anterior Sectionectomy Using Two Retraction Methods: Technical Aspects with Video.

BACKGROUND: Laparoscopic central bisectionectomy and right anterior sectionectomy for centrally located tumors are technically demanding surgeries. Here, we introduce our laparoscopic technique and present the associated perioperative outcomes relative to an open approach. METHODS: From April 2014 to November 2017, 26 patients underwent central bisectionectomy or right anterior sectionectomy. A total of 17 patients underwent the laparoscopic approach and nine underwent an open approach. We used a perihilar Glissonian approach to determine each anatomical resection plane and employed a rubber band self-retraction technique to ensure proper exposure of the two resection planes. Detailed descriptions, illustrations, video, and perioperative outcomes of the approach are presented. RESULTS: Among patients who underwent the laparoscopic approach, there were no cases of conversion to open surgery. The mean operative times for the laparoscopic and open groups were similar (333 ± 76 vs. 305 ± 62 min, respectively, p = 0.345). Intraoperative blood loss (535 ± 443 vs. 966 ± 650, p = 0.056) and postoperative complications (1 vs. 3, p = 0.065) were slightly less in the laparoscopic group, but the difference was not statistically significant. Surgical margins of both approaches were comparable (0.8 ± 0.6 vs. 0.7 ± 0.2 cm, p = 0.671). The length of hospital stay after surgery was significantly shorter in the laparoscopic group (8.8 ± 2.6 vs. 17.1 ± 12.7 days, p = 0.015). CONCLUSION: The laparoscopic approach for central bisectionectomy and right anterior sectionectomy described in this study is feasible and safe with respect to short-term perioperative outcomes and may provide several benefits commonly attributed to minimally invasive surgery in selected patients.

High-Throughput Omics and Statistical Learning Integration for the Discovery and Validation of Novel Diagnostic Signatures in Colorectal Cancer.

The advancement of bioinformatics and machine learning has facilitated the discovery and validation of omics-based biomarkers. This study employed a novel approach combining multi-platform transcriptomics and cutting-edge algorithms to introduce novel signatures for accurate diagnosis of colorectal cancer (CRC). Different random forests (RF)-based feature selection methods including the area under the curve (AUC)-RF, Boruta, and Vita were used and the diagnostic performance of the proposed biosignatures was benchmarked using RF, logistic regression, naïve Bayes, and k-nearest neighbors models. All models showed satisfactory performance in which RF appeared to be the best. For instance, regarding the RF model, the following were observed: mean accuracy 0.998 (standard deviation (SD) < 0.003), mean specificity 0.999 (SD < 0.003), and mean sensitivity 0.998 (SD < 0.004). Moreover, proposed biomarker signatures were highly associated with multifaceted hallmarks in cancer. Some biomarkers were found to be enriched in epithelial cell signaling in Helicobacter pylori infection and inflammatory processes. The overexpression of TGFBI and S100A2 was associated with poor disease-free survival while the down-regulation of NR5A2, SLC4A4, and CD177 was linked to worse overall survival of the patients. In conclusion, novel transcriptome signatures to improve the diagnostic accuracy in CRC are introduced for further validations in various clinical settings.

Integrated metabolomics signature for assessing the longevity of Panax ginseng seeds.

BACKGROUND: Panax ginseng seeds have strong dormancy and a prolonged germination period in comparison to other seeds; thus, it is a great challenge to propagate ginseng. Seed longevity is closely associated with germination rate and viability, so we assumed that if a seed loses its viability, specific metabolic alterations regarding plant growth factors might occur. In this study, we divided ginseng seeds into normal and accelerated-aging groups. Both groups were treated with gibberellic acid, which is one of the most important plant-growth regulators. Afterward, gas chromatography-mass spectrometry (GC-MS) was used to analyze the samples, to identify the metabolic alterations between the two groups. RESULTS: Forty-four endogenous metabolites in normal and accelerated aging groups were putatively identified. To determine the differential significance of these metabolites, t-tests and fold-change analysis were conducted followed by principal component analysis and partial least-squares discriminant analysis to determine the metabolites that showed distinct responses between the groups. Among the differentially expressed metabolites (P value < 0.05 and FDR < 0.1), nine metabolites were selected as potential biomarker candidates for the prediction of seed longevity. CONCLUSION: Nine metabolites related to ginseng seed longevity were identified by comparing metabolomes. Our findings suggest that ginseng propagation can be facilitated by the regulation of these distinctive metabolic features of the seeds. © 2019 Society of Chemical Industry.

A systematic review on metabolomics-based diagnostic biomarker discovery and validation in pancreatic cancer.

INTRODUCTION: Metabolomics is an emerging approach for early detection of cancer. Along with the development of metabolomics, high-throughput technologies and statistical learning, the integration of multiple biomarkers has significantly improved clinical diagnosis and management for patients. OBJECTIVES: In this study, we conducted a systematic review to examine recent advancements in the oncometabolomics-based diagnostic biomarker discovery and validation in pancreatic cancer. METHODS: PubMed, Scopus, and Web of Science were searched for relevant studies published before September 2017. We examined the study designs, the metabolomics approaches, and the reporting methodological quality following PRISMA statement. RESULTS AND CONCLUSION: The included 25 studies primarily focused on the identification rather than the validation of predictive capacity of potential biomarkers. The sample size ranged from 10 to 8760. External validation of the biomarker panels was observed in nine studies. The diagnostic area under the curve ranged from 0.68 to 1.00 (sensitivity: 0.43-1.00, specificity: 0.73-1.00). The effects of patients' bio-parameters on metabolome alterations in a context-dependent manner have not been thoroughly elucidated. The most reported candidates were glutamic acid and histidine in seven studies, and glutamine and isoleucine in five studies, leading to the predominant enrichment of amino acid-related pathways. Notably, 46 metabolites were estimated in at least two studies. Specific challenges and potential pitfalls to provide better insights into future research directions were thoroughly discussed. Our investigation suggests that metabolomics is a robust approach that will improve the diagnostic assessment of pancreatic cancer. Further studies are warranted to validate their validity in multi-clinical settings.

Association between the symptoms of benign prostatic hyperplasia and social disparities: Does social capital promote prostate health?

This cross-sectional study investigated the relationships between socioeconomic factors and social capital and benign prostatic hyperplasia symptoms. The participants were 100,000 adult men who participated in the Korea Community Health Survey. The surveyors used the International Prostate Symptom Score. As regards occupation, the prevalence of benign prostatic hyperplasia was higher in men with blue-collar occupations or those who were unemployed than in those with white-collar jobs. In terms of marital status, the prevalence of benign prostatic hyperplasia was 1.319 times higher among divorced men than married men. As regards social capital, the prevalence of benign prostatic hyperplasia in men with positive attitudes towards one's community scores that reflected good, poor and very poor community scores was 1.228, 1.246 and 1.447 times higher than that of men who had very good scores respectively. The groups with good, poor, and very poor community participation scores had 1.115, 1.202 and 1.364 times higher prevalence of benign prostatic hyperplasia than the group with very good scores. Social disparities and social capital of a community were associated with the prevalence of benign prostatic hyperplasia. Thus, the use of social capital in the community setting will be effective in the management of the condition.

The Dominant Role of Forkhead Box Proteins in Cancer.

Forkhead box (FOX) proteins are multifaceted transcription factors that are significantly implicated in cancer, with various critical roles in biological processes. Herein, we provide an overview of several key members of the FOXA, FOXC, FOXM1, FOXO and FOXP subfamilies. Important pathophysiological processes of FOX transcription factors at multiple levels in a context-dependent manner are discussed. We also specifically summarize some major aspects of FOX transcription factors in association with cancer research such as drug resistance, tumor growth, genomic alterations or drivers of initiation. Finally, we suggest that targeting FOX proteins may be a potential therapeutic strategy to combat cancer.

Effect of Adipose-Derived Mesenchymal Stem Cell Administration and Mild Hypothermia Induction on Delayed Neuronal Death After Transient Global Cerebral Ischemia.

OBJECTIVES: Global cerebral ischemia is a cause of poor prognosis after resuscitation from cardiac arrest. Various attempts have been made to minimize global cerebral ischemia but none been more effective than mild hypothermia induction. A few studies have shown the effect of mesenchymal stem cells on global cerebral ischemia, but no studies have compared this effect with mild hypothermia or assessed any possible interaction. We aimed to show the effect of mesenchymal stem cells on delayed neuronal death after global cerebral ischemia and to compare this effect with mild hypothermia. DESIGN: Experimental study. SETTING: Animal research laboratory. SUBJECTS: Adult male Sprague-Dawley rats weighing 250-300 g. INTERVENTIONS: Rats were subjected to 7 minutes of transient global cerebral ischemia and randomized into four groups: control, mild hypothermia, injection of human adipose-derived mesenchymal stem cells, and combined application of mild hypothermia and mesenchymal stem cells, along with four sham groups treated identically. Rats were euthanized 7 days after global cerebral ischemia. MEASUREMENTS AND MAIN RESULTS: Degree of neuronal death in hippocampus was significantly higher in control than in other groups. The number of activated microglia was higher in control group than in other groups and was higher in mild hypothermia than shams, mesenchymal stem cells, mild hypothermia/mesenchymal stem cells. Degree of blood-brain barrier disruption and the count of infiltrated neutrophils were significantly higher in control than in other groups. Degree of oxidative injury was significantly higher in control than other groups. It was higher in mild hypothermia than sham groups, mesenchymal stem cells, mild hypothermia/mesenchymal stem cells and was higher in mesenchymal stem cells group than sham groups. Significantly, worse functional results were found in control than in other groups. CONCLUSIONS: Administration of mesenchymal stem cells after transient global cerebral ischemia has a prominent protective effect on delayed neuron death, even compared with mild hypothermia.

Laparoscopic Right Hepatectomy: Toward Protocolization and Simplification.

BACKGROUND: Major hurdles for laparoscopic right hepatectomy (LapRH) include difficulties in (1) mobilization and (2) applying hanging maneuver and (3) lack of experienced assistants. We discuss the protocolization of lapRH, introducing our simplified technique. METHODS: The procedure was disassembled into six steps: (1) curtailed mobilization of the right liver so as to align the resection plane with the laparoscopic camera view, (2) inflow vascular control, (3) setting up the parenchymal resection applying the rubber band retraction method, (4) parenchymal resection approaching the caudate lobe, (5) a lifting-up maneuver using a laparoscopic grasper or retractor instead of the hanging maneuver, and (6) completion of resection dividing the caudate lobe, right hepatic vein, and remaining ligament. RESULTS: Between March 2014 and August 2015, 13 LapRH surgeries were attempted. The patients consisted of eight males and five females with a mean age of 58.5 ± 11.6 years. Final pathological diagnoses were hepatocellular carcinoma in seven patients, intrahepatic duct stone in 4, and colorectal liver metastasis in 2. The mean total operative time was 381 ± 66 minutes, and the mean intraoperative estimated blood loss was 633 ± 619 ml. One patient was converted to open surgery. There was no clinically significant complication, and the mean length of stay after surgery was 9.1 ± 2.3 days. CONCLUSIONS: Protocolization and simplification of the procedure may allow professionals to better understand the respective process and determine appropriate port placements, resulting in safe and successful minimally invasive hepatectomy procedures.

Aquilanols A and B, Macrocyclic Humulene-Type Sesquiterpenoids from the Agarwood of Aquilaria malaccensis.

Four new and five known sesquiterpenoids were isolated from the agarwood of Aquilaria malaccensis. Aquilanols A and B (1 and 2) have an unprecedented macrocyclic humulene structure with a bicyclic 7/10 ring system. Compound 2 was obtained as a scalemic mixture that was resolved by HPLC analysis using a chiral column. Their structures were deduced based on spectroscopic data analysis, and the absolute configurations were unambiguously determined by X-ray crystallographic data and ECD spectroscopic analysis. A putative biosynthetic pathway of these sesquiterpenoids is proposed.