Inhibition of Interleukin-4 and β-Hexosaminidase Release in RBL-2H3 Cells by Compounds Isolated from Lobelia chinensis

Lobelia chinensis Lour. has commonly been used in traditional Chinese medicine for the treatment of antidote, diuretic, diarrhea, and inflammation. This study aimed to identify the active compounds in an aqueous extract of L. chinensis responsible for its anti-atopic effect in vitro using RBL-2H3 cells. A chemical investigation of secondary metabolites in an aqueous extract of L. chinensis led to the isolation of nine chemical constituents, which included the four marker compounds, and these were evaluated for their inhibitory effects on IL-4 mRNA expression and the release of β-hexosaminidase in propidium iodide-induced RBL-2H3 cells. We found diosmetin and fraxidin inhibited cellular IL-4 mRNA expression, and that diosmetin and 6,8-dimethoxycoumarin inhibited DNP-specific IgE-induced degranulation in these cells. Our study suggests that diosmetin, fraxidin, and 6,8-dimethoxycoumarin are potential candidates for the treatment of atopic diseases.

Computed Tomography Grading for Predicting Esophageal Stricture in Caustic Injury

PURPOSE: The aim of this study was to investigate the ability of thoracic computed tomography (CT) to predict esophageal stricture formation and risk factors associated with the development of stricture induced by ingestion of caustic materials. METHODS:This was a study of 41 patients who had visited an emergency care center following ingestion of caustic substances sometime between January 1998 and August 2008. A retrospective analysis of medical records was performed. Findings for the esophageal lesion were classified according to changes in the esophageal wall and the infiltration of peri-esophageal soft tissue. Also, clinical, laboratory, and endoscopic data from these patients were reviewed. The correlation between the degree of esophageal damage seen on CT scans and esophageal constriction seen on esophagography were then evaluated. RESULTS: A total of 41 cases of caustic ingestion were identified (age range, 20~82 years). The most common caustic agent ingested was acid (70%). The most frequent cause for ingestion was attempted suicide (70%); the other cases (30%) were accidental ingestion. The findings on thoracic CT in the 41 patients were as follows: first-degree esophageal injury in 4 (9.8%), second-degree in 8 (19.5%), third-degree in 17 (41.6%), fourth-degree in 12 (29.3%). Fourteen patients (34.1%) developed caustic esophageal stricture. The closer the degree of esophageal damage was to grade IV, the more prevalent the esophageal constriction became. This correlation was statistically significant (p<0.001). Of the 41 patients, 26 underwent endoscopy at an early stage after they visited an emergency care center. An analysis of the correlation between the degree of esophageal damage seen on endoscopy and that seen on CT scans was performed. This revealed a significant correlation (p=0.002, r=0.585). CONCLUSION: Thoracic CT grading suggesting periesophageal soft tissue infiltration and fluid collection (grade III to IV) rather than only edema (grade I) may be associated with stricture formation. Early CT grading is safe and useful for predicting the development of stricture induced by caustic ingestion.

A Case of Abducens Nerve Palsy and Disc Swelling Complicating Pregnancy-Induced Hypertension

PURPOSE: Abducens nerve palsy complicating pre-eclampsia during pregnancy occurs very rarely. The authors describe right abducens nerve palsy, disc swelling, and hypertensive retinopathy found in both eyes of a pre-eclampsia patient. CASE SUMMARY: A 29-year-old woman, who was in her 31st week of gestation, was admitted to the hospital complaining chiefly of diplopia and abduction limitation in her right eye, which started suddenly 3 weeks prior to admission. Her condition was carefully followed up by a local clinic because this symptom of hypertension manifested one month before her admission to the local clinic. Brain MRI and laboratory tests were performed in order to exclude diseases of the central nervous system and/or other systemic diseases. An alternative prism cover test showed approximately 25PD (prism diopter) right esotropia, with -2 degrees abduction limitation observed in the patient's right eye. Both hypertensive retinopathy and papilledema were observed. Her blood pressure was 155/110 mmHg, and she had moderate proteinuria when she was admitted to the hospital. She was referred to an obstetrician and diagnosed as having pre-eclampsia. Other than pre-eclampsia with proteinuria, the brain imaging examination failed to reveal any particular findings, such as CNS disorders, including brain edema, cerebral infarction, or a brain tumor. In addition, systemic diseases which might have caused papilledema and abducens nerve palsy, including diabetes mellitus, were not evident in this case. Therefore, the patient was diagnosed with ischemic abducens nerve palsy and hypertensive retinopathy complicating moderate pre-eclampsia. The patient's diplopia and right eye abduction limitation were gradually relieved after parturition.

Hypothermic Carotid Arterial Flush for Induction of Selective Cerebral Hypothermia during Cardiac Arrest

PURPOSE: Hypothermia has been demonstrated to protect the brain from reperfusion injury in patients suffering from cardiac arrest. We hypothesized that infusion of normal saline at 4 degrees C into the carotid artery (hypothermic carotid arterial flush, HCAF) during cardiac arrest would achieve selective cerebral hypothermia during cardiac arrest and cardiopulmonary resuscitation (CPR), without a detrimental effect on the rate of return of spontaneous circulation (ROSC) or significant impairment of cardiopulmonary function after ROSC. METHODS: Ventricular fibrillation was induced in 18 dogs weighing 12~18 kg, and circulatory arrest was maintained for 9 minutes. The subjects were then resuscitated using open cardiac massage. Group I (n=6) received no normal saline, while the dogs of group II (n=6) and group III (n=6) received infusions of 15 ml/kg and 30 ml/kg of normal saline solution, respectively, at 4 degrees C into both carotid arteries (cephalad) via 18 gauge catheters. RESULTS: Tympanic temperature decreased from 37.7 (37.5~37.7) degrees C to 34 degrees C within 1.2 (1~2) min and 1.0 (1~2) min from the start of HCAF in groups II and III, respectively. Thereafter, tympanic temperatures were maintained below 34 degrees C to 7.7 (1.5~14.5) min and 21.2 (12~37) min, respectively, from the start of HCAF in groups II and III. There were no significant differences in CPR-related variables or post-ROSC hemodynamic and laboratory variables between the two groups. CONCLUSION: HCAF rapidly induces selective cerebral hypothermia without detrimental effects on the rate of ROSC or significant impairment of cardiopulmonary function after ROSC.

An Experimental Study on the Immune Responses to Regenerating Allografts in the Rat / 대한이식학회지

Partial liver transplantation from a living donor or by splitting the liver was developed to expand the donor pool. Sometimes the small-for-size liver is transplanted into larger recipient and it regenerates shortly to ideal volume for the recipient. The relationship between regeneration and rejection-intensity has not defined clearly yet. In this study the 30% partial liver of DA (Dark-Agauti) rats were transplanted heterotopically to Lewis rats by microsurgical technique. End-to-side cavocaval and end-to-end portoportal (or portomesenteric) anastomoses were performed but the artery and the bile duct were not reconstructed. In regenerating group (R), total portal blood of the recipient was diverted to the graft. In non-regenerating group (N), the superior mesenteric vein below the confluence of the splenic vein was anstomosed to the portal vein of the recipient. Both groups were treated with tacrolimus (FK-506 2 mg/kg/d) and compared with non-treated groups. Transplantations were successful with minimal operative mortality. The animals could survive for the studying period in both groups. When compared on day 3, day 5, and day 7, histologic examination revealed no significant differences of cellular infiltration between two groups. In tacrolimus-treated groups, the cellular infiltration was markedly decreased and there were no significant differences in cellular infiltration between regenerating group treated with tarcrolimus (R-F) and non-regenerating group treated with tarcrolimus (N-F). These findings suggest that immune responses to the allograft are not significantly influenced by the hepatic regeneration process in small-for-size graft. Further immunologic and molecular biologic investigation may be needed.

An Experimental Study on the Immune Responses to Regenerating Allografts in the Rat / 대한이식학회지

Partial liver transplantation from a living donor or by splitting the liver was developed to expand the donor pool. Sometimes the small-for-size liver is transplanted into larger recipient and it regenerates shortly to ideal volume for the recipient. The relationship between regeneration and rejection-intensity has not defined clearly yet. In this study the 30% partial liver of DA (Dark-Agauti) rats were transplanted heterotopically to Lewis rats by microsurgical technique. End-to-side cavocaval and end-to-end portoportal (or portomesenteric) anastomoses were performed but the artery and the bile duct were not reconstructed. In regenerating group (R), total portal blood of the recipient was diverted to the graft. In non-regenerating group (N), the superior mesenteric vein below the confluence of the splenic vein was anstomosed to the portal vein of the recipient. Both groups were treated with tacrolimus (FK-506 2 mg/kg/d) and compared with non-treated groups. Transplantations were successful with minimal operative mortality. The animals could survive for the studying period in both groups. When compared on day 3, day 5, and day 7, histologic examination revealed no significant differences of cellular infiltration between two groups. In tacrolimus-treated groups, the cellular infiltration was markedly decreased and there were no significant differences in cellular infiltration between regenerating group treated with tarcrolimus (R-F) and non-regenerating group treated with tarcrolimus (N-F). These findings suggest that immune responses to the allograft are not significantly influenced by the hepatic regeneration process in small-for-size graft. Further immunologic and molecular biologic investigation may be needed.

A Rat Model of Heterotopic Partial Liver Transplantation with Mesocaval Shunt / 대한이식학회지

Heterotopic partial liver transplantation(HLT) in the rat is relatively simple method to orthotopic liver transplantation. Addition of mesocaval shunt which diverts almost intestinal blood to systemic circulation provides only splenopancreaticoduodenal blood for the graft. The usefulness of our novel model is first, evaluating the pure effect of pancreaticoduodenal blood to liver regeneration, second, evaluating the contribution of splanchnic viscera to liver reperfusion injury. In the first group (conventional HLT, C-HLT), the thirty percent graft liver was transplanted just below the host liver with whole portal blood input. In the second group(mesocaval shunt added HLT, M-HLT), the superior mesenteric vein was diverted to systemic circulation and portal blood from the spleen-pancreas-duodenum supplied the graft. The graft weight at 2 posttransplant weeks was significantly increased in the C-HLT group compared with the M-HLT group, which suggests pancreatic blood alone is not sufficient to regenerate the partial liver grafts. There was no significant difference in the graft survival between two groups, which implies the influence of intestine to postreperfusion injury is negligible.