Kojic Acid Peptide: A New Compound with Anti-Tyrosinase Potential

BACKGROUND: Kojic acid was used for decades in the cosmetic industry as an antimelanogenic agent. However, there are two major drawbacks of Kojic acid, one is cytotoxicity and second are instability on storage. These limitations led the scientist to synthesize the active Kojic acid peptides. OBJECTIVE: In the present study, we synthesize and investigate the effect of five Kojic acid peptides to overcome the limitation of Kojic acid. METHODS: The peptide was analyzed and purified by high-performance liquid chromatography and matrix-assisted laser desorption ionization time of flight mass spectroscopy. Further, the tyrosinase activities of the Kojic acid and Kojic acid peptides were compared. The toxicity was measured and the melanin content is recorded in B16F10 mouse melanoma cells. RESULTS: Maximum tyrosinase activity was measured by Kojic acid peptides. Therefore, Kojic acid peptides were subjected to melanin assay and cytotoxicity assay and finally the stability of the Kojic acid peptide was measured. CONCLUSION: It was observed that this newly synthesized Kojic acid peptide is stable and potent to inhibit the tyrosinase activity and melanin content of B16F10 mouse melanoma cells without exhibiting cell toxicity. Together, these preliminary results suggest that a further exploration is being needed to establish Kojic acid peptide as antimelanogenic agent.

Primary Hyperaparathyroidism due to Cystic Parathyroid Adenoma not Detected on 99mTc-Sestamibi Scan

Parathyroid cysts, which can be divided into functional and non-functional cysts, are rare causes of primary hyperparathyroidism. A technetium-99m-methoxyisobutylisonitrile (99mTc-sestamibi) parathyroid scan is a sensitive diagnostic tool for the localization, although it sometimes shows a false-negative result. Here we report a case of presumed cystic parathyroid adenoma based on clinical findings and analysis of cystic fluid with negative findings in a parathyroid scan. A 44-year-old male patient visited the hospital due to leg pain and compressive symptoms (dysphagia, hoarseness) that had started 4-5 months before. His serum calcium level was 14.4 mg/dL and his intact parathyroid hormone (iPTH) had increased to 478.1 pg/mL. On neck computed tomography, a cystic nodule measuring 6.2 cm was detected in the inferior part of the right thyroid gland. Sestamibi uptake for this nodule was not detected on 2-h delayed imaging, and fluorodeoxyglucose positron emission tomography showed only subtle uptake. Fine-needle aspiration was performed and intracystic iPTH had increased to 61,600 pg/mL. Focused parathyroidectomy guided by intraoperative iPTH monitoring led to successful enucleation of the right inferior parathyroid gland. A parathyroid adenoma was confirmed, and his laboratory results had normalized. This study shows that cystic parathyroid adenoma can sometimes be difficult to detect on a 99mTc-sestamibi parathyroid scan.

Regional Anesthesia of Lower Extremity using Tibial Nerve and Saphenous Nerve Block

Lower leg reconstruction has been performed with greater frequency under general or spinal anesthesia. But for patients with difficult problem in general or spinal anesthesia such as myocardial ischemia and end-stage renal failure, regional block techniques have been advocated. The regional block involved the tibial and saphenous nerve is performed as the following; two points of insertion of the needle are defined in lateral to popliteal pulsation and posterior to medial femoral condyle. We use 10cc of 0.25% bupivacaine for popliteal area block and 10cc of it for saphenous nerve block. In these techniques the major landmark for needle insertion is the popliteal artery. In all patients(19 cases) the techniques formed part of lower leg block for lower leg reconstruction. It was successful in 18 cases except in one case which failed initially but was successful at the following trial. There were no complications associated with these techniques. There were no incidents of postoperative neuralgia or neuropraxia. Lower leg anesthesia with saphenous nerve block and tibial nerve block offers numerous advantages that make it a suitable anesthetic technique. These facts suggest that the performances of these blocks are safe and effective anesthetic technique for lower leg reconstruction.

A Case of Painless Aortic Dissection Presenting Transient Ischemic Attack

A 34-year old man presented with syncope, a transient right lower extremity weakness and positional blindness of the left eye. Upon admission, the patients pulse and blood pressure was checked asymmetrically on both sides. A CT and MRI revealed no active lesions. A few days later, the patient was administered a diagnostic coronary-aortic angiogram to evaluate his cardiovascular system. A severe aortic dissection was revealed on the angiogram and an emergency operation for the dissection was done.We report a case of painless aortic dissection as a manifestation of TIA. (J Korean Neurol Assoc 19(5):526~528, 2001)

Development of Descending Thoracic Aortomyoplasty for Cardiac Bioassist / 대한흉부외과학회지

BACKGROUND: Thoracic aortomyoplasty is one of the surgical treatment for heart failure and has advantages over artificial heart or intraaortic balloon pumps. It uses autogenous skeletal muscles and solves problems such as energy source. However its use in clinical settings has been limited. This preliminary study was designed to develop surgical technique and to determine the effect of acute descending thoracic aortomyoplsty. MATERIAL AND METHOD: Thirteen adult Mongrel dogs were used. The left latissimus dorsi muscle was wrapped around the descending aorta under general anesthesis. Swan-Ganz and microtipped Millar catheter were used for the hemodynamics and endocaridial viability ratio. Data were collected with myostimulator on and off in normal hearts and the ischemic hearts. RESULT: In normal hearts, the mean aortic diastolic pressure increased from 72+/-15mmHg at baseline to 78+/-13mmHg with stimulator on. Coronary perfusion pressure increased from 61+/-11mmHg to 65+/-9mmHg. Diastolic time increased from 0.288+/-0.003 msec to 0.290+/-0.003msec. Systolic time decreased from 0.164+/-0.002msec to 0.160+/-0.002 msec. Endocardial viability ratio increased from 1.21+/-0.22 to 1.40+/-0.18. In ischemic hearts, mean aortic diastolic pressure incrased from 56+/-21mmHg at baseline to 61+/-15mmHg with stimulator on. Coronary perfusion pressure increased from 48+/-17mmHg to 52+/-15mmHg. Diastolic time increased from 0.290+/-0.003 msec to 0.313+/-0.004msec. Systolic time decreased from 0.180+/-0.002 msec to 0.177+/-0.003 msec. Endovascular viability ratio increased from 0.9+/-0.31 to 1.1+/-0.31. The limited number of cases ruled out the statistic significance. CONCLUSIONS: Descending thoracic aortomyoplasty is a simple operation designed to use patient's own skeletal muscles. It trends to increase diastolic augmentation and coronary perfusion pressure. Modification of surgical technique and stimulator protocol would maximize the effect to assist the heart.

Diffusion Weighted MRI Findings in Two Patients with Hypoxic Brain Damage

It is well-known that vulnerable sites of hypoxic brain damage are the basal ganglia and the periventricular white matters, which are well visualized with CT and conventional MR images. However, there have been several reports about the diffusion of the weighted MR images of hypoxic brain damages. A seventy-nine years old woman and a 61-years old woman were admitted to our hospital due to mental changes, which occurred during sleep as a result of carbon monoxide poisoning. Brain MRIs of the patients showed high signal intensities on the bilateral globus pallidus in both the T2WI and diffusion weighted images. They also revealed high signal intensities on the white matter and bilateral perirolandic cortices in the diffusion-weighted images but not in the T2WI. Therefore, diffusion weighted MR images may be more sensitive to the acute cerebral lesions in hypoxic brain damage than conventional MR images.

Recovery Trajectory in Tachycardia Induced Heart Failure Model / 대한흉부외과학회지

BACKGROUND: Tachycardia induced heart failure model would be the model of choice for the dilated cardiomyopathy. This more closely resembles the clinical syndrome and does not require major surgical trauma, myocardial ischemia and pharmacological or toxic depression of cardiac function. When heart failure is progressive, application of new surgical procedures to the faling heart is highly risky. It has been shown that recovery trajectory from heart failure is a new method in decreasing animal mortality. The purpose is to establish the control datas for recovery trajectory in the canine heart failure model. MATERIAL AND METHOD: 21 mongrel dogs were studied at 4 stages(baseline, at the heart failure, 4 and 8 weeks after recovery). Heart failure was induced during 4 weeks of continuous rapid pacing using a pacemaker. Eight weeks of trajectory of recovery period was allowed. Indices of left ventricular function and dimension were measured every 2 weeks and the hemodynamics were measured by use of Swan-Ganz catheterization and thermodilution method every 4 weeks. Values were expressed as mean+/-standard deviation. RESULT: 4(20%) dogs died due to heart failure. Left ventricular end-diastolic volume at the 4 stages were 40.8+/-7.4, 82.1+/-21.1, 59.9+/-7.7 and 46.5+/-6.5ml. Left ventricular end-systolic volume showed the same trend. Ejection fractions were 50.6+/-4.1, 17.5+/-5.8, 36.3+/-7.3, and 41.5+/-2.4%. Blood pressure and heart rate showed no significant changes. Pressures of central vein, right ventricle, pulmonary artery, and pulmonary capillary wedge showed significant increase during the heart failure period, normalizing at the end of recovery period. Stroke volumes were 21.5+/-8.2, 12.3+/-3.5, 17.9+/-4.6, and 15.5+/-3.4ml. Blood norepinephrine level was 133.3+/-60.0pg/dL at the baseline and 479.4+/-327.3pg/dL at the heart failure stage(p=0.008). CONCLUSION: Development of tachycardia induced heart failure model is of high priority due to ready availability and reasonable amenability to measurements. Recovery trajectory after cessation of tachycardia showed reduction of cardiac dilatation and heart function. Application of new surgical procedures during the recovery period could decrease animal mortality.

Closure of bronchoesophageal fistula with tissue adhesive tisseel: 2 cases report / 대한흉부외과학회지

No abstract available.