Phytochemical Analysis and Evaluation of Antifungal and Antioxidant Activities of Essential Oil of Fruits from Juniperus oxycedrus L. Obtained from Morocco

Abstract The present study was aimed at conducting phytochemical analysis and evaluating the in vitro antifungal and antioxidant activities of the essential oil obtained from the fruits of J. oxycedrus L. Hydro-distillation was used to extract the essential oil from the fruits of Juniper oxycedrus. The essential oil was analyzed using gas chromatography with a flame ionization detector (GC-FID) and gas chromatography coupled with mass spectrometry (GC/MS). The antioxidant activity of the essential oil against 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals was determined in vitro using varying concentrations of the essential oil and vitamin C as a standard antioxidant compound. A disc diffusion test was employed to evaluate the antifungal activity of the essential oil against two test fungal strains, Penicillium citrinum, and Aspergillus niger. The results revealed that 49 constituents were identified in fruit oil, representing 91.56% of the total oil and the yield was 1.58%. Juniper fruit oil was characterized by having high contents of ß-pinene (42.04%), followed by limonene (15.45%), sabinene (9.52%), α-pinene (5.21%), (E)-caryophyllene (3.77%), ρ-cymene (1.56%), caryophyllene oxide (2.02%), and myrcene (1.02%). The radical scavenging activity (% inhibition) of the essential oil was highest (81.87± 2.83%) at a concentration of 200 µg/mL. The essential oil of J. oxycedrus exhibited antifungal activity against A. niger and P. citrinum with minimum inhibitory concentration values (MIC) ranging from 2.89 to 85.01 µl/mL. The findings of the study reveal that the antioxidant and antifungal properties of J. oxycedrus essential oil and their chemical composition are significantly correlated

Sensitization characteristics of Juniperus chinensis pollen in Beijing area / 中华耳鼻咽喉头颈外科杂志

Objective: To investigate the sensitization characteristics of Juniperus chinensis pollen in patients with allergic rhinitis and/or allergic asthma in Beijing area, and to explore the characteristics of Juniper chinensis pollen sensitized population. Methods: Patients with suspected allergic rhinitis and/or asthma from January 2017 to December 2019 in the outpatient department of Allergy Department of Beijing Shijitan Hospital were selected in this study. Skin prick test (SPT) was performed with Juniper chinensis pollen allergen reagent to compare different age and disease allergen distribution, and to observe the sensitization characteristics of its population. All of the analyses were performed using SAS software version 9.4. Results: A total of 8 380 patients were enrolled in the end. The total positive rate of Juniper chinensis pollen SPT reached 49.92% (4 183/8 380). The positive rate of Juniper chinensis pollen SPT was highest in the 10-14 age group, reaching 60.99% (283/464). Compared with other age groups, there was a statistical difference (χ²=266.77, P<0.01). The SPT positive rate of patients aged less than 10 years increased with the increase of age, while the SPT positive rate of patients aged over 40 years decreased with the increase of age. Single Juniper chinensis pollen was less allergenic, accounting for about 25.05% (1 048/4 183), and the patients' age was (35.21±12.39) years. Regardless of single Juniper chinensis pollen or other pollen allergies, allergic rhinitis was the main disease. Among the patients with SPT positive Juniper chinensis pollen combined with other inhaled pollen allergens, willow pollen accounted for the first (74.99%). The positive rate of Juniper chinensis pollen was the highest in patients with single allergic rhinitis, accounting for 52.05% (3 797/7 295), and the rate in patients with single allergic asthma was the lowest, accounting for 17.49% (53/303), with statistically difference (χ²=138.99, P<0.01). Conclusions: Juniper chinensis pollen is highly sensitized in patients with allergic rhinitis and/or allergic asthma in Beijing . The positive rate of SPT is highest among 10-14 age group, most of which showed strong positive reaction, and allergic rhinitis is more common in Juniper chinensis pollen sensitization diseases.

Juniperus communis extract induces cell cycle arrest and apoptosis of colorectal adenocarcinoma in vitro and in vivo

Juniperus communis (JCo) is a well-known traditional Chinese medicinal plant that has been used to treat wounds, fever, swelling, and rheumatism. However, the mechanism underlying the anticancer effect of JCo extract on colorectal cancer (CRC) has not yet been elucidated. This study investigated the anticancer effects of JCo extract in vitro and in vivo as well as the precise molecular mechanisms. Cell viability was evaluated using the MTT assay. Cell cycle distribution was examined by flow cytometry analysis, and cell apoptosis was determined by the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. Protein expression was analyzed using western blotting. The in vivo activity of the JCo extract was evaluated using a xenograft BALB/c mouse model. The tumors and organs were examined through hematoxylin-eosin (HE) staining and immunohistochemistry. The results showed that JCo extract exhibited higher cytotoxicity against CRC cells than against normal cells and showed synergistic effects when combined with 5-fluorouracil. JCo extract induced cell cycle arrest at the G0/G1 phase via regulation of p53/p21 and CDK4/cyclin D1 and induced cell apoptosis via the extrinsic (FasL/Fas/caspase-8) and intrinsic (Bax/Bcl-2/caspase-9) apoptotic pathways. In vivo studies revealed that JCo extract suppressed tumor growth through the inhibition of proliferation and induction of apoptosis. In addition, there was no obvious change in body weight or histological morphology of normal organs after treatment. JCo extract suppressed CRC progression by inducing cell cycle arrest and apoptosis in vitro and in vivo, suggesting the potential application of JCo extract in the treatment of CRC.

Remineralizing Effect of Xilitol, Juniperus Communis and Camellia Sinensis Added to a Toothpaste: An In Vitro Study / Efecto remineralizante del Xilitol, Juniperus Communis y Camellia Sinensis adicionados en pastas dentales: Estudio in vitro

ABSTRACT The aim of this study was to explore the remineralizing effect of toothpastes based on Xilitol, Camellia Sinensis and Juniperus Communis. An in vitro experimental study was carried out in an 18 human premolars sample, which were treated with one of the 3 evaluated toothpastes and a control fluoride one. The atomic percentages of Ca and P were evaluated by Energy Dispersive X-ray Spectroscopy (EDS). In addition, the enamel surface of treated teeth was visualized by Scanning Electron Microscopy (SEM). The evaluations were carried out in three stages: pre-treatment, after an artificial demineralization process and after the treatment with the toothpastes. In the statistical analysis, the one-way ANOVA and Pearson correlation tests were used. Xilitol and Juniperus Communis showed the greatest gain of P ions compared to the control group (p<0.01). As for Ca, the group treated with xylitol-based toothpaste showed more ion gain compared with the control group (p<0.01). In the Pearson correlation test between Ca and P, statistically significant correlations were observed in all groups (p<0.01), ranging between r=0.7413 (Xylitol Group) and r=0.9510 (Control Group). We concluded that Xylitol paste showed the highest remineralizing property, both in the EDS analysis and in the SEM images.

RESUMEN El objetivo de este studio fue explorer el efecto remineralizante de las cremas dentales compuestas de Xilitol, Camelia Sinensis y Juniperus Communis. Se llevó a cabo un estudio experimental in vitro en una muestra de 18 premolares humanos, los cuales fueron tratados con una de las tres pastas dentales evaluadas y una fluorada. Los porcentajes atomicos de Ca y P fueron evaluados por Espectroscopia de rayos X de energía dispersive (EDS). Además, la superficie del esmalte de los dientes tratados fue examinada por Microscopia Electronica de Barrido (SEM). Las evaluaciones fueron llevadas a cabo en tres etapas: pre-tratamiento, despues de un proceso artificial de desmineralizacion y después del tratamiento con las pastas dentales. Se usaron ANOVA de una via y correlacion de Pearson para el analisis estadistico. Xilitol y Juniperus Communis mostraron la mayor ganancia de iones P comparados con el grupo control (p<0.01), con rangos entre r=0.7413 (Grupo con Xylitol) and r=0.9510 (Group Control). Se concluyó que la pasta con Xilitol mostró las mayores propiedades remineralizantes, tanto en el analisis EDS y las imágenes SEM.

Tree Pollen Sensitization and Cross-Reaction of Children with Allergic Rhinitis or Asthma / 고신대학교의과대학학술지

OBJECTIVES: Tree pollen causes allergic rhinitis and asthma. We investigated children who diagnosed as rhinitis or asthma, living in Busan, for tree allergen sensitization, component allergen, oral allergy syndrome, and the relationship between pollen counts and allergen sensitization.METHODS: Pollen were collected in Busan, from January 1 to December 31, 2017, using a Rotorod sampler and enumerated using a microscope. We conducted a study of children with rhinitis or asthma at Busan St. Mary's Hospital in 2017, administered an ISAAC questionnaire, and an oral allergy syndrome survey. Serum specific Ig E tests were performed.RESULTS: Among the 57 patients, the mean age was 9.3 years. The pollen counts in decreasing order were as follows: pine, alder, oak, juniper, beech, ginkgo, and birch. For sensitization, birch and alder 35.1%, Japanese cedar 19.3%, juniper 17.5%, pine 10.5%, and Japanese cypress 8.2%. The component Ig E was tested in 27 patients. Bet v 1 had a high correlation with birch, alder, and peach. Bet v 2 showed a statistically significant correlation with all tree pollen except cypress. Bet v 4 did not have any apparent correlation. Bet v 6 had the same pattern as Bet v 2, but correlation coefficient was higher than that of Bet v 2. Oral allergy syndrome was noted in 7 patients, including peach, peanut, apple, tomato, kiwi, and sesame.CONCLUSIONS: Alder and juniper are clinically important tree pollens in Busan. These pollens cause sensitization to birch and Japanese cedar by cross-reaction.

Chemical Composition and Antioxidant Activity of Algerian Juniperus Phoenicea Essential Oil

Berries and branches essential oil of Juniperus phoenicea were obtained by electromagnetic induction heating assisted extraction and by hydrodistillation with a yield varied from (1.2 ± 0.3 to 2.4 ± 0.7%) and from (0.6 ± 0.1% to 1.1 ± 0.1%), respectively. forty eight compounds were identified representing (97.2 – 99.7%) of the oil. α-Pinene (40.3 – 67.8%) and δ-3-carene (13.5 – 26.8%) were the main compounds in berries and branches essential oils. Antioxidant activity was evaluated by three means: inhibition of 2, 2-diphenyl-1-picryl hydrazyl (DPPH) free radical, reducing power and β-Carotene/linoleic acid bleaching. The antioxidant activity of essential oils showed IC₅₀ ranging from 67.6 ± 1.02 µg/mL to 131.5 ± 0.8 µg/mL for berries and from 98 ± 1.25 µg/mL to 166.8 ± 0.29 µg/mL for the branches. Berries oil show more potent antioxidant activity compared to branches. This result is supported by the three methods investigated in this work.

Real-life Efficacy of Omalizumab After 9 Years of Follow-up

Omalizumab is frequently used as add-on treatment to inhaled corticosteroids (ICS) and long-acting β2-agonists in patients with suboptimal control of severe asthma. Patients with severe asthma will typically require chronic treatment, although due to the limited amount of data available there are still some concerns about the safety and efficacy of long-term therapy with omalizumab. Herein, in an extension of a previous 4-year study, we report disease-related outcomes of 8 patients with severe persistent allergic asthma who have been followed for a total of 9 years in a real-life setting. Both quality of life (QoL) (evaluated using the Juniper Asthma-Related QoL Questionnaire [AQLQ]) and forced expiratory volume in 1 second (FEV1) showed sustained improvement at 9 years. The median values of AQLQ and FEV1 at 4 years were 5.5 and 82.0% compared to 5.9 and 85.5%, respectively, at 9 years, which were all significantly increased from baseline. After 9 years, the mean annual number of severe exacerbations was 0.63 compared to 5 at baseline. There also appeared to be a trend toward use of a lower dose of ICS at longer follow-up times. After 9 years, there were no safety concerns for continued use of omalizumab, and no asthma-related hospitalizations or emergency department visits were documented over the last 5 years. The present analysis is the longest reported clinical follow-up of omalizumab. Long-term maintenance treatment with omalizumab for up to 9 years is associated with continued benefits in reducing symptoms, exacerbations, and medication burden without any safety concerns.

Sesquiterpenoids from the heartwood of Juniperu s chinensis

A new sesquiterpenoid, 11-hydroxy-valenc-1(10),3(4)-dien-2-one (3), two chemically synthesized but first isolate from nature, 3-oxocedran-8β-ol (1) and valenc-1(10),3(4),11(12)-trien-2-one (2) along with four known compounds, sugiol (4), (+)-nootkatone (5), 11-hydroxy-valenc-1(10)-en-2-one (6), and clovandiol (7), were isolated from the heartwood of Juniperus chinensis. All chemical structures were elucidated using extensive spectroscopic analysis including 1D and 2D NMR spectroscopy. Valenc-1(10),3(4),11(12)-trien-2-one (2) exhibited significant inhibitory activity against butyrylcholinesterase with an IC₅₀ value of 68.45 µM.

The correlation between allergy sensitization rate in pediatric and aerobiological study for airborne pollen in Busan for 15 years

PURPOSE: Airborne pollen is the most common causative agents of allergic disease. Since 2000, there isn't no more report about airborne pollen in Busan. This study is that pollen in one area of Busan was collected to investigate species, particle counts, seasonal distribution, and of its correlation with reactivity to skin prick test in children during 1998-2012. METHODS: Rotorod sampler was installed on the rooftop of St. Mary Hospital in Busan. A 24-hour sampling of airborne allergens over a fifteen-year period was conducted 6 days/wk from January 1, 1998 to December 31, 2012. After staining they were identified, counted and recorded with the weather in Busan. RESULTS: Major pollens collected were Pine, Alder, Oak, Juniperus, Humulus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen, from April to September in case of grass pollen and from August to October in case of weed pollen. Total annual pollen count ranged from 36,412 grains/m3 (2002) to 1,342 grains/m3 (2006). The peak pollen season was seen for spring and autumn, especially in May and September during 1998-2012. In skin prick tests, birch was the highest sensitization rate (15.1%), followed by alder (14.7%), hazel (14.1%) in the tree for 15 years. And in weed, mugwort and ragweed were the highest sensitization rate (10.6%, 10.3%), followed by humulus (5.5%) for 15 years, but since 2008, was increased. CONCLUSION: Analysis of pollens sampled in the atmosphere of Busan, Korea, for a 15-year period identified 24 species of pollens with seasonal variation of some clinically important pollen load. Analysis of data, it showed that alder and birch are main allergen in spring for 15 years, and in 1998-2008, ragweed and artemisia was main allergen in fall, since 2009, followed by humulus.

Actividad antifúngica del aceite esencial de cinco especies de Juniperus de Argentina / Antifungal activities of the essential oil of five species of Juniperus from Argentina

The chemical composition of the leaf oils of five Juniperus species (Juniperus sabina L., Juniperus communis Lam., Juniperus scopulorum Sarg., Juniperus virginiana L., Juniperus chinensis L., Cupressaceae) was determined by co-chromatography with authentic samples, GC-MS and Kováts retention indices. Sabinene was the most abundant component in the oils of Juniperus from western Patagonia Argentina. However, limonene and germacrene B constituted 25.1 percent and 11.5 percent of the oil of J. sabina. J. virginiana showed high concentration of alpha-humulene and limonene (31.4 and 15.9 percent respectively), while isobornyl acetate and germacrene B were also the main compounds of J. chinensis. Essential oils extracted of Juniperus were evaluated in vitro for their efficacy against Fusarium verticillioides, Aspergillus flavus, Aspergillus parasiticus, Candida albicans and Rhodotorula infection. Candida albicans was not inhibited for the essential oils of Juniperus. However, F. verticillioides, A. flavus, A. parasiticus and Rhodotorula were inhibited for these oils.

La composición de los aceites esenciales de la hoja de cinco especies de Juniperus (Juniperus sabina L., Juniperus communis Lam., Juniperus scopulorum Sarg., Juniperus virginiana L., Juniperus chinensis L., Cupressaceae), se determinó mediante una co-cromatografía con muestras auténticas de dos columnas de diferente polaridad, CG-EM y los índices de retención de Kovats. El sabineno fue el componente más abundante en los aceites de Juniperus del oeste de la Patagonia Argentina. Sin embargo, el limoneno y el germacreno B son otros componentes importantes del aceite esencial de J. sabina con el 25,1 por ciento y 11,5 por ciento respectivamente. En J. virginiana el alfa-humuleno y el limoneno (con el 31,4 por ciento y 15.9 por ciento respectivamente) mostraron ser también importantes, mientras que el acetato de isobornilo y el germacreno B fueron también los principales componentes de la J. chinensis. Los aceites esenciales extraídos de Juniperus se evaluaron in vitro para determinar su eficacia contra Fusarium verticillioides, Aspergillus flavus, Aspergillus parasiticus, Candida albicans y Rhodotorula. Candida albicans no se inhibió por la acción de los aceites esenciales de Juniperus. Sin embargo, F. verticillioides, A. flavus, A. parasiticus y Rhodotorula fueron inhibidos.

Screening of some ethnobotanically important plants of Nagar area Gilgit-Baltistan, Pakistan

Certain species of ethnobotanical importance belonging to families Asteraceae, Berberidaceae, Cupressaceae, Elaeagnaceae, Gentianaceae, Salicaceae and Tamaricaceae, were collected from Gilgit during the months of June and July 2008 and were investigated for the presence of alkaloids, amino acids, anthraquinone [free and as glycosides] ascorbic acid, carbohydrates, coumarins, flavonoids, phenolics, proteins, saponins and steroids in their aqueous, ethanol and benzene extracts. Artemisia maritime L. [leaves] showed positive results for carbohydrates, coumarins, phenolics and proteins. Ephedra gerardiana Wall ex. Stapf. [stem] tested positive for alkaloids, ascorbic acid, coumarins, phenolics, proteins, saponins and steroids. Tamarix gallica L. tested positive for alkaloids, amino acids, anthraquinone as glycoside, ascorbic acid, carbohydrates, flavonoids, phenolics, proteins and steroids in stems, roots and leaves. Salix acmophylla Boiss. showed positive results for alkaloids, amino acids, anthraquinone [free and as glycosides] ascorbic acid, carbohydrates, flavonoids, phenolics, proteins, saponins and natural steroids. Hippophae rhamnoides L. showed positive results for alkaloids, amino acids, anthraquinone [free as glycosides] ascorbic acid, carbohydrates, coumarins, flavonoids, phenolics, proteins, saponins and steroids. Berberis glycocarpa Stapf. showed positive results for alkaloids, amino acids, ascorbic acid, carbohydrates, flavonoids, phenolics, proteins and steroids in stem, roots and leaves. Similarly Juniperus excelsa Wall ex. C.A. Meyer showed positive result for anthraquinone [both free and as glycosides], carbohydrates, phenolics, proteins, saponins and natural steroids

Effect of terracing on rainwater harvesting and growth of Juniperus procera Hochst. ex Endlicher

The present study was conducted in two forests in Abha [Capital of Asir Region] and two forests in Al Namas [130 kim north of Abha], south western Saudi Arabia [Asir region] to investigate the effect of terraces on rainwater harvesting and growth of Juniperus procera Hochst. ex Endlicher. Farmers grow their crops within Juniper forests and woodlots by constructing terraces from soil and stones to harvest rainwater. Juniper forests and woodlots present important watersheds and sources for water. Study plots were established in our forests, two of which contained maintained terraces and the other two have been covered by abandoned and damaged terraces. The results showed that maintained terraces served as important means for rainwater harvesting, whereas abandoning of terraces resulted in increased soil loss, surface runoff, bulk density and reduced infiltration rates. Significant correlations and regression between soil loss, total runoff, soil bulk density and infiltration rate were provided. Diameter at breast height, total height, basal area, volume, number of trees, crown coverage and regeneration/ha of J. procera were significantly [P < 0.0001] higher in forests with maintained terraces compared with abandoned terraces Finally, maintained terraces improved rainwater harvesting and growth performance of J. procera

Evaluation of growth potential of Crimean juniper (Juniperus excelsa Bieb.) seedlings for the first growing season under Tekir forest nursery conditions in Kahramanmaras, Turkey.

In this study, growth potential of Crimean juniper (Juniperus excelsa Bieb.) seedlings for the first growing season under Tekir Forest Nursery conditions in Kahramanmaras was evaluated. The height growth of Crimean juniper seedlings was relatively close to that of Lebanon cedar (Cedrus libani A. Rich.) seedlings produced in the same nursery, but their root collar diameters were fairly lower than that of Lebanon cedar seedlings. According to coniferous seedling standards of Turkish Standards Institute, the height growth of Crimean juniper seedlings was fairly good, but their root collar diameters were slightly small. In this respect, that 2+0 or 1+1 Crimean juniper seedlings are used in reforestation activities in the region would be more useful than 1+0 seedlings.

Aerobiological Study for Airborne Pollen and Mold in Pusan / 소아알레르기및호흡기학회지

PURPOSE: Airborne pollen and mold spores are common causative agents of allergic disease. Atmospheric pollen and spores in one area of Pusan were collected to investigate species, particle amount, seasonal distribution, and of its association with reactivity to skin prick test in children. METHODS: Rotorod sampler was installed on the rooftop of St. Benedict Hospital in Pusan. 24 hour sampling of airborne allergens over a two year period was conducted 6 days/week from July 1, 1997 to June 30, 1999. Those samples were stained with Calberla's fuchsin and were identified, counted under the light microscope (400xfor pollen, 1000xfor mold). The data were compared with the daily weather report and allergy skin test. RESULTS: Major pollens collected were Pinus, Alnus, Juniperus, Betula, Quercus, Artemisia, Ambrosia, and Chenospodium-Amaranthus. The pollen season is relatively short and the pollen dispersed mainly during the period from March to May in case of tree pollen and from August to October in case of grass pollen. Total pollen count ranged from 0 to 1000 grains/m3/day (May 14, 99). The peak pollen season was seen during Spring and Autumn, especially in March and September. Major mold spores counted were Cladosporium, Leptospheria and Alternaria. Mold spore count ranged from 0 to 2,360 spores/m3/day (Oct. 8, 98). Cladosporium was dispersed year-round, but mainly in the October and November, while Leptospheria was dispersed mainly in the period from July to September and Alternaria counts tended to be higher around July. The concentration of mold is roughly correlated with the amount of rainfall, having high spore count in July and August, especially in case of Leptospheria. In terms of positive reaction to skin prick test in children, Alnus and Artemisia were found to be allergen source in early spring and late summer season, respectively. CONCLUSION: Analysis of pollens and mold spores sampled in the atmosphere of Pusan, Korea, for a 2 year period identified 19 species of pollens and 22 species of mold spores with seasonal variation of some clinically important pollen/mold load. Cladosporium, Leptospheria and Alternaria are found to be three major molds, especially from June to October.

Factors influencing quality of life of asthmatic patients in Korea / 천식및알레르기

BACKGROUND: The effectiveness of treatment of asthma has been assessed by lung function test, airway responsiveness and symptoms. But, they rarely capture the emotional and social impairment. Recently, questionnaires that reflect the quality of life (QOL) in asthma patients were developed. In this study, we evaluated the impairment on quality of life in Korean adult asthmatic patients cross-sectionally by using the QOL questionnaires of Juniper EF. METHODS: One hundred eighty nine adult patients with over 1 year history of asthma were enrolled. The patients were asked to choose the five most important daily activities among 40 daily activities which were important in Korea. The QOL questionnaire was composed of 32 items in 4 domains (activity, symptom, emotion and exposure to environmental stimuli) and the response option was scored on a 7-point scale. RESULTS: 45.5% of patients who participated in this study were men, and 48.3% had atopy. The disease severities of asthma evaluated by physician were mild intermittent (31%), mild persistent (35%), moderate persistent (21%) and severe persistent (12%). Among 40 items of general daily activities, 19 items were chosen by more than 20 patients. Among them, running, walking uphills, hurried movement were most impaired daily activities. The QOL of our asthma patients showed statistical difference on disease severity, control state and symptom status during the last 3 months. The QOL was not influenced by sex, age or atopy score. Occupational asthma showed the lowest score on QOL in all 4 domains. On grouping with medications, the group with oral steroid noted statistically lower scores of QOL in all domains. The QOL score of asthma was well correlated with average symptom attacks during the last 3 months. CONCLUSION: According to our study, rapid control of asthma and lowering of the diseaseseverity are essential for improvement of QOL. A QOL questionnaire in Korea should be ... (continue)

Prolongation of Succinylcholine Neuromuscular Blockade by Lithium Carbonate / 대한마취과학회지

Lithium, first used by Cade in 1949 for the treatment of mania, is now commonly used in several affective disorders. The precise mechanism of its action is not clearly understood but the side effects may be severe. Prolongation of succinylcholine and pancuronium which possible mechanism of interaction involves impaired acetylcholine synthesis and release at nerve terminal has been reported. The present report describes a case of prolonged neuromuscular blockade induced by succinylcholine in a manic depressive patient being treated with oral lithium carbonate.