Supervivencia a mediano plazo de pacientes críticamente enfermos con función renal normal, lesión renal aguda y enfermedad renal crónica / Medium-term survival of critically ill patients with normal renal function, acute kidney injury and chronic kidney disease / Sobrevivência a médio prazo de pacientes criticamente doentes com função renal normal, lesão renal aguda e doença renal crônica

Resumen: Introducción: La falla renal es la tercera disfunción orgánica más frecuente en pacientes ingresados al hospital y la Unidad de Cuidados Intensivos; la supervivencia de pacientes críticamente enfermos con lesión renal aguda es aproximadamente 70%, pero los datos en pacientes críticamente enfermos con enfermedad renal crónica son escasos. Objetivo: Contrastar la supervivencia a mediano plazo de pacientes críticamente enfermos con función renal normal, lesión renal aguda y enfermedad renal crónica. Material y métodos: Se eligieron todos los pacientes ingresados de forma consecutiva a la Unidad de Cuidados Intensivos de enero 01 a diciembre 31 de 2018, se diagnosticó la función renal al ingreso, fueron seguidos a 90 días y se contrastó la supervivencia entre los tres grupos. Resultados: De los 355 pacientes para el análisis final, a 184 (51.8%) se les diagnosticó función renal normal, 96 (27.1%) lesión renal aguda y 75 (21.1%) enfermedad renal crónica al ingreso a la Unidad de Cuidados Intensivos. La edad fue mayor en los grupos de lesión renal aguda y enfermedad renal crónica que en el grupo de función renal normal (64.0 ± 17.6 y 67.8 ± 16.3 vs 56.7 ± 18.5 años, p = 0.000), el porcentaje de mujeres fue menor en el grupo de lesión renal aguda y enfermedad renal crónica que en el grupo de función renal normal (46/96 [47.9%] y 25/75 [47.6% vs 122//184 [63.3%], p = 0.001). La supervivencia fue menor en los grupos de lesión renal aguda y enfermedad renal crónica contrastada con el grupo de función renal normal (66/96 [68.75%] y 49/75 [65.33%] vs 150/184 [81.5%], Logrank test = 0.007). Conclusiones: La supervivencia a mediano plazo de pacientes críticamente enfermos con lesión renal aguda y enfermedad renal crónica al ingreso a la Unidad de Cuidados Intensivos es baja contrastada con el grupo de función renal normal.

Abstract: Introduction: Renal failure is the third most frequent organ dysfunction in patients admitted to the hospital and Intensive Care Unit; survival of critically ill patients with acute kidney injury is approximately 70%, but data in critically ill patients with chronic kidney disease are scarce. Objective: To contrast the medium-term survival of critically ill patients with normal renal function, acute kidney injury and chronic kidney disease. Material and methods: All patients consecutively admitted to the Intensive Care Unit from January 01 to December 31, 2018, were chosen, renal function was diagnosed on admission, they were followed up for 90 days and survival between the three groups was contrasted. Results: Of the 355 patients for the final analysis, 184 (51.8%) were diagnosed with normal renal function, 96 (27.1%) acute kidney injury, and 75 (21.1%) chronic kidney disease on admission to the Intensive Care Unit. Age was higher in the acute kidney injury and chronic kidney disease groups than in the normal renal function group (64.0 ± 17.6 and 67.8 ± 16.3 vs 56.7 ± 18.5 years, p = 0.000), the percentage of women was lower in the group acute kidney injury and chronic kidney disease than in the normal renal function group (46/96 [47.9%] y 25/75 [47.6% vs 122//184 [63.3%], p = 0.001). Survival was lower in the acute kidney injury and chronic kidney disease groups compared to the normal kidney function group (66/96 [68.75%] and 49/75 [65.33%] vs 150/184 [81.5%], Logrank test = 0.007). Conclusions: The medium-term survival of critically ill patients with acute kidney injury and chronic kidney disease on admission to the intensive care unit is low compared to the group with normal kidney function.

Resumo: Introdução: A insuficiência renal é a terceira disfunção orgânica mais frequente em pacientes internados no hospital e na Unidade de Terapia Intensiva; a sobrevivência de pacientes críticos com lesão renal aguda é de aproximadamente 70%, mas os dados em pacientes críticos com doença renal crônica são escassos. Objetivo: Compare a sobrevivência a médio prazo de pacientes críticos com função renal normal, lesão renal aguda e doença renal crônica. Material e métodos: Todos os pacientes admitidos consecutivamente na Unidade de Cuidados Intensivos de 1º de Janeiro a 31 de Dezembro de 2018 foram escolhidos, a função renal foi diagnosticada na admissão, foram acompanhados por 90 dias e a sobrevivência entre os 3 grupos foi contrastada. Resultados: Dos 355 pacientes para a análise final, 184 (51.8%) foram diagnosticados com função renal normal, 96 (27.1%) lesão renal aguda e 75 (21.1%) doença renal crônica na admissão na unidade de terapia intensiva. A idade foi maior nos grupos lesão renal aguda e doença renal crônica do que no grupo função renal normal (64.0 ± 17.6 e 67.8 ± 16.3 vs 56.7 ± 18.5 anos, p = 0.000), o percentual de mulheres foi menor no grupo agudo lesão renal e doença renal crônica do que no grupo com função renal normal (46/96 [47.9%] y 25/75 [47.6% vs 122//184 [63.3%], p = 0.001). A sobrevivência foi menor nos grupos de lesão renal aguda e doença renal crônica em comparação com o grupo de função renal normal (66/96 [68.75%] e 49/75 [65.33%] vs 150/184 [81.5%], teste Logrank = 0.007). Conclusões: A sobrevivência em médio prazo de pacientes críticos com lesão renal aguda e doença renal crônica na admissão na unidade de terapia intensiva é baixa em comparação com o grupo com função renal normal.

A comparative study on the short- and medium-term effects of Leonardo da Vinci robot-assisted and traditional mitral valvuloplasty / 中国胸心血管外科临床杂志

@#Objective    To compare short- and medium-term effects of Leonardo da Vinci robot-assisted and traditional mitral valvuloplasty. Methods    We conducted a retrospective analysis of 74 patients who underwent mitral valvuloplasty in our hospital from January 2015 to March 2017. The patients were divided into two groups according to the mode of operation: a da Vinci group (n=29, 13 males, 16 females at an average age of 52 years) and a routine group (n=45, 18 males, 27 females at an average age of 53 years). The perioperative data of patients in the two groups were compared and analyzed. Results    There was no significant difference in sex, age, weight, height, body mass index (BMI), cardiac function (NYHA), hypertension, diabetes, postoperative blood transfusion and postoperative complications between the two groups (P>0.05). The tracheal intubation time, ICU retention time, hospital stay time, blood loss and postoperative drainage in the da Vinci group were shorter or less than those in the routine group (P<0.05). The operation time, cardiopulmonary bypass time and aortic clamping time in the da Vinci group were longer than those in the routine group (P<0.05). Different surgical procedures had no significant effect on left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) and mitral regurgitation (MR) 3 years after operation. There was no interaction between the mode of operation and the time of follow-up. There was no significant difference in echocardiographic evaluation in the same period (P>0.05). Conclusion    Da Vinci operation shortens the rehabilitation process of patients compared with traditional surgery. For short- and medium-term follow-up results, there is no difference between Leonardo da Vinci and traditional mitral valve surgeries, and the clinical effect of da Vinci robot-assisted mitral valvuloplasty is satisfactory, which is worthy of further clinical promotion.

Transcatheter pulmonary valve replacement in sheep:medium-term evaluation of a novel polymeric prosthetic heart valve / 中华胸心血管外科杂志

Objective To evaluate medium-term valvular functionality after transcatheter pulmonary valve replacement in sheep using a novel polymeric prosthetic pulmonary valve(PPHV). Methods In this study, we designed a novel polymeric trileaflet transcatheter pulmonary valve with a balloon-expandable stent, and the valve leaflet was made of 0. 1mm expanded polytetrafluoroethylene( ePTFE) . We chose bovine pericardium valve as control. Pulmonary valve stents were implanted in situ by right ventricular apical approach in 12 healthy sheep(10 for polymeric valve and 2 for bovine pericardium valve) weighing anaverageof(22.1±2.3)kg. Echocardiography,angiography,64-rowcomputedtomography(CT),andautopsywereusedto assess valvular function 12 weeks after implantation. Results Two PPHVs failed to be implanted in situ of pulmonary valve po-sition. Implantation was successful in the other 10 sheep. One sheep died of pneumonia, and the other 9 sheep survived at the end of follow-up. Echocardiography 12 weeks after implantation showed all the PPHVs exhibited good functionality and no sig-nificant insufficiency. The peak-peak transvalvular pressure gradient of the PPHVs was(28.2 ±8.0)mmHg(16-38 mmHg) (1 mmHg=0. 133 kPa), while that of two bovine pericardium valves were 16 and 21 mmHg. Angiography and CT 12 weeks after implantation demonstrated orthotopic position and normal operation of the valves,and no deformation of the valved stents. Pathological examination of the explanted PPHVs 12 weeks after implantation showed no degradation or damage of the ePTFE leaflets and most of the leaflets were thin and pliable, without significant thrombus or calcification, while visible pannus over-growth was found at the bottom of the valve leaflets, in the commissural areas and on the sealing cuff. Conclusion The medi-um-term effects of the novel ePTFE pulmonary valve after transcatheter pulmonary valve implantation in sheep is good. The no-vel PPHV exhibits good anti-adhesion, anti-degradation, anti-thrombus, anti-calcification performance and good biomechanical property. The hemodynamic parameter of PPHV is comparable to bovine pericardium valve. Optimizing the valve design might eliminate the problem about pannus overgrowth.

Viability of 7 kinds of medicinal plant seeds stored in medium-term gene bank of the National Medicinal Plant Gene Bank / 中国中药杂志

In order to evaluate seed viability of Platycodon grandiflorum, Schizonepeta tenuifolia, Andrographis paniculat, Codonopsis pilosula, Scutellaria baicalensis, Leonurus japonicus, Rabdosia rubescens, stored in the medium-term gene bank of the National Medicinal Plant Gene Bank for 4 years, we tested seed germination rate of 7 species of medicinal plant and analyzed the change of significance of levels of the germination rate in pre and post store. Seed germination rates of 7 species of medicinal plants were all decreased after 4 years, and the decrease of S. tenuifolia and S. baicalensis germination rates were much smaller than other species. The higher initial germination rate of P. grandiflorum, C. pilosula, R. rubescens seed has the smaller decline of germination rate, but the data of A. paniculata showed the opposite trend. The rate decline of the germination of S. tenuifolia and S. baicalensis was roughly the same in different germination rate interval. The results showed that low temperature storage could effectively prolong the seed longevity, and maintain the seed vigor. Moreover, it is necessary to study on the storage characteristics of the main medicinal plant seeds, and establish the monitoring plan and regeneration standard.

Medium-term follow-up of clinically insignificant residual fragments after minimally invasive percutaneous nephrolithotomy lithotripsy / 中国医师进修杂志

Objective To discuss the medium-term follow-up of clinically insignificant residual fragments (CIRF) after minimally invasive percutaneous nephrolithotomy lithotripsy (MPCNL).Methods The clinical data of 72 patients with CIRF medium-term follow-up were analyzed retrospectively.Results Seventy-two patients with CIRF.The anatomical distribution of CIRF was 10 at upper pole,15 at middle,35 at lower,10 at renal ureteropelvie junction and 2 at upper and lower pole.Stone analysis showed that 41 cases of calcium oxalate calculi,16 of calcium oxalate calculi mixed with carbonate calculi,3 calcium oxalate calculi mixed with uric acid,4 calcium oxalate calculi mixed with struvite stone,3 struvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Fifteen cases had clinical symptoms,including 2 renal colic pain,8 hematuria,5 lower urinary tract symptoms,4 cases CIRF located in upper pole,1 case in middle pole,4 cases in lower pole,6 cases in ureteropelvic junction,the incidence of clinical symptoms in ureteropelvic junction was significantly higher than that in other locations (6/10 vs.4/12,1/15,4/37,P ＜0.05).Eight cases required surgical procedure,5 cases underwent extracorporeal shock wave lithotripsy,3 cases with ureteral CIRF were performed with ureteroscopic lithotripsy.CIRF were clear after surgery,7 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or extracorporeal shock wave lithotripsy are more likely to get CIRF.Medium-term follow-up of CIRF reveals that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Medium-term cryopreservation of rabies virus samples

Introduction The cryopreservation of rabies virus has been described in detail in the literature. To date, little information is available on the use of cryoprotective agents for cold preservation of this virus, and the available data focus only on short-term virus preservation. In this study, we investigated the medium-term cryopreservation of samples of rabies virus using different cryopreservation protocols. Methods The cryopreservation protocols for the rabies virus samples were performed at -20°C and were divided according to the variables of time and cryoprotectant type used. The laboratory tests (intracerebral inoculation of mice, viral titration and direct immunofluorescence) were performed at regular intervals (360 and 720 days) to assess the viability of the viral samples according to the different preservation techniques used. Results After 1 year of cryopreservation, the fluorescence intensity of intracellular corpuscles of the rabies virus and the median survival time of the mice differed between the positive controls and the treatments with the cryoprotectants. After 2 years, most of the samples subjected to the cryopreservation protocols (including the controls) did not produce fluorescence. However, the virus samples exposed to the cryoprotectant sucrose (68% solution) responded positively in the direct immunofluorescence assay and in the intracerebral inoculation of the mice. Conclusions Medium-term cryopreservation of the rabies virus inactivates the viral sample. However, the cryoprotectant agent sucrose (68%) produces a preservative effect in cryopreserved rabies virus samples. .

Optimization of Yam In Vitro Genebanking: Effects of Activated Charcoal and Darkness on Plantlets of Three Accessions from Benin.

The aim of this study was to optimize the in vitro preservation of yam genetic resources through reduction of the number of subcultures. Effects of different concentrations of activated charcoal (1 g.l-1, 2 g.l-1and 3 g.l-1) and temporary darkness were tested on the in vitro morphogenesis of three beninese yam accessions (Dcr28, Dcr164 and Da93G1). Galzy glutamine was used as basis culture medium and explants were microcuttings obtained from four months old plantlets. The results indicated that the activated charcoal, alone or combined with temporary darkness has an inhibitory effect on the aerial organs formation but favors root development with a greater mean number of root shoots (9.3±1.67 with 3 g.l-1 of activated charcoal) than the subtract without activated charcoal (2.5±0.17). A significant interaction was noted between accessions and concentration of activated charcoal indicating genotypic variability from the activated charcoal effect. The different accession plantlets growing in high concentration of activated charcoal culture media combined with temporary darkness were vigorous after eight month without subculture and subsequently allow doing one subculture per year.

Procedimientos neuroquirúrgicoscerebrales guiados por estereotaxiarealizados en el Hospital Universitario de San Ignacio (HUSI): evolución a corto y mediano plazo / Neurosurgical Brain Estereotactic- Guided Procedures Performed at Hospital Universitario San Ignacio (HUSI): Development in the Short and Medium Term

Objetivo: Describir los resultados postoperatorios de los pacientes a los que se lesrealizaron procedimientos neuroquirúrgicos cerebrales guiados por estereotaxia enel Hospital Universitario de San Ignacio durante el periodo julio del 2009-julio del2011. Materiales y métodos: Se revisaron las historias clínicas de 78 pacientes,sus características clínicas, la localización de las lesiones en las neuroimágenes,el tipo de procedimiento, los resultados funcionales y los desenlaces a corto ymediano plazo. Resultados: 78 pacientes tuvieron procedimientos neuroquirúrgicosguiados por estereotaxia entre julio del 2009 y julio del 2011. El 64,1 % (n = 50)eran hombres. La localización de las lesiones fue en orden de frecuencia: gangliossubtalámicos, lóbulo frontal, lóbulo temporal, tálamo, unión córtico-subcortical, tallocerebral, ubicación frontotemporal, lóbulo occipital, ubicación parieto-occipital ybase del cráneo. Discusión: La implementación de procedimientos neuroquirúrgicosguiados por estereotaxia sigue siendo una de las mejores opciones en el abordaje depatologías cerebrales profundas o de difícil acceso. Tanto en Colombia como en elresto del mundo son procedimientos con una baja tasa de morbilidad y mortalidad.Conclusiones: Independientemente del tipo de procedimiento guiado por estereotaxiala tasa de complicaciones no excede el 5 %, tasas similares a las obtenidas en laliteratura mundial...

Objective: Retrospective description of postoperativeoutcomes of patients who underwentneurosurgical brain stereotactic guided proceduresat the Hospital Universitario San Ignacioduring the period July 2009-July 2011. Materialsand Methods: A review of medical recordsof 78 patients who were taken to neurosurgicalstereotactic guided procedures at the HospitalUniversitario San Ignaci. We reviewed the clinicalcharacteristics of patients, the location of thelesions on neuroimaging, management, type ofprocedure of each patient, functional results andoutcomes in the short and medium term. Results:78 patients who underwent neurosurgical brainstereotactic guided procedures between July2009 to July 2011 at the Hospital UniversitarioSan Ignacio. The 64.1 % (n = 50) were men. Thelocation of the lesions were in order of frequencysub-thalamic ganglia, frontal lobe, temporallobe, thalamus, cortico-subcortical junction, brainstem,fronto-temporal location, occipital lobe,parieto-occipital location, and at the skull’s base.Discussion: Implementing guided stereotacticneurosurgical procedures remains one of the bestoptions in dealing with deep brain pathologies ordifficult access. In both Colombia and the rest ofthe world, these are procedures with low morbidityand mortality. It must, however, developmulticenter studies that allow us to observe thedevelopment of stereotactic neurosurgery in ourcountry, also develop studies with a larger continuityto assess the long-term outcomes. Conclusions:Whatever type of stereotactic guidedprocedure the rate of complications does not exceed5 %, similar rates to those obtained from theglobal literature...

Medium-term follow-up of clinically insignificant residual fragments after minimally invasive percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To discuss the outcomes of the clinically insignificant residual fragments after minimally invasive percutaneous nephrolithotomy. Methods 75 patients (11％) with CIRF among 655 who underwent initial MPCNL from January 2008 to December 2010 were diagnosed by CT scan.Clinical data of 68 patients (39 male and 29 female) were analyzed retrospectively.Previous open surgery hadbeen performed in 13 and ESWL in 20 cases.The median residual fragment size was 1.8 mm.The anatomical distribution of CIRF was 9 at upper pole,14 at middle,34 at lower,9 at renal ureteropelvic junction and 2 at upper and lower pole.Stone analysis showed 40 cases of calcium oxalate calculi,15 of calcium oxalate calculi mixed with carbonate calculi,2 calcium oxalate calculi mixed with uric acid,3 calcium oxalate calculi mixed with struuvite stone,3 struuvite stone,2 uric acid stone and 3 carbonate apatite mixed with struvite stone.Mean follow up was 23 months (12-36).Follow-up consisted of physical examination,serum routine,urine routine and CT imaging. Results 14(21％) patients (3 upper pole,1 middle pole,4 lower pole and 6 ureteropelvic junction) had symptomatic episodes,including 9 hematuria,2 renal colic pain,5 lower urinary tract symptoms,12 with size of CIRF ＞ 4 rmm.8 patients required surgical procedures.5 patients (1 middle,2 upper pole and 2 renal pelvis) underwent ESWL.3 patients with ureteral CIRF were performed ureteroscopic lithotripsy.The CIRF were clear after surgeries.4 paticnts with CIRF ＞ 4 mm did not have symptoms.These patients were recommended to conservational treatments.2 patients with ureteral CIRF had renal colic pains.The stones were excluded after spasmolytic analgesic treatments.27％ (3/11)CIRF located in upper pole had symptom,compared with 4％ (1/14) in middle pole,11％ (4/36) in lower pole and 67％ (6/9) in ureteropelvic junction. Conclusions CIRF can be located variously in the kidney and ureter.Most CIRF are calcium oxalate calculi and locate in the lower pole.Patients with the history of previous open surgery or SWL are more likely to get CIRF.Medium-term follow-up of CIRF revealed that CIRF located in the renal ureteropelvis junction are more likely to have clinical symptoms.

Cuequinha de homem-aranha / Spiderman underpants / Calzoncillo de hombre-araña

Neste relato, que privilegia as últimas sessões de um menino de quatro anos, em vias de interromper sua análise, a analista exercita os três tempos analíticos preconizados por Fabio Herrmann. No tempo longo, "A história do paciente cai como uma sombra sobre o campo transferencial" (Herrmann, 2004), condensando tal interrupção outras impossibilidades de sua curta vida, vivida intensamente. O tempo médio: jogo da transferência, da relação viva. É o tempo dos dramas transferenciais. "Você não é boa para os meus medos de cinco anos, só os de quatro", conclui o pequeno paciente, tentando entender mais uma separação na sua vida. Tempo curto "é o tempo da palavra analítica, da sessão enquanto acontecimento em si". É também o tempo da técnica - aqui, o trabalho com crianças talvez mereça uma diferenciação. A palavra analítica: poderíamos pensar em gesto justo. Nesse tempo curto, surge "a cuequinha do homem-aranha".

In this report, which focuses on the final sessions of a four year-old boy about to interrupt his analysis, the analyst employs the three analytical periods advocated by Fabio Herrmann. In the long-term, “The patient's history falls like a shadow on the field of transference” (Herrmann, 2004), condensing within this interruption other impossibilities of his short, intensively lived life. The medium-term: the game of transference, in the living relationship. This is the period in which the dramas of transference are played out. “You are no good for my five year-old fears, only my four year old-ones”, the young patient concludes, trying to understand yet another separation in his life. Short-term “is the period of the analytical word, of the session as an event in itself ”. It is also a period for technique - here, working with children may deserve some differentiation. The analytical word: we can think of the appropriate gesture. It is in this short term that Spiderman underpants appear.

En este relato, que privilegia las últimas sesiones de un niño de cuatro años, a punto de interrumpir su análisis, el analista ejercita los tres campos analíticos propuestos por Fabio Herrmann. A largo tiempo, “La historia del paciente cae como una sombra sobre el campo transferencial” (Herrmann, 2004), condensando tal interrupción otras imposibilidades de su corta vida, vivida intensamente. A medio tiempo: juego de transferencia, de la relación viva. Es el tiempo de los dramas transferenciales: “Usted no es buena para los mis miedos de cinco años, sólo para los de cuatro”, concluye el pequeño paciente, intentando entender otra separación en su vida. En corto tiempo “es el tiempo de la palabra analítica, de la sesión como un acontecimiento en sí”. Es también el tiempo de la técnica- aquí, el trabajo con niños tal vez merezca una diferenciación. La palabra analítica: podríamos pensar en gesto justo. En ese tiempo corto surge “el calzoncillo del hombre araña”.

Five Year Follow up of One Stage Bilateral Total HipArthroplasty

We report on the medium term outcome of five patients (ten hips) who underwent one stage bilateral total hip arthroplasty. Both Harris Hip Scores and Oxford Hip Scores improved postoperatively as did range of motion. There was no radiographic evidence of loosening in any hip arthroplasty involved in this study, however one revision surgery was needed due to periprosthetic fracture. There were no increased medical complications. Based on our limited experience, we believe that one stage bilateral total hip

A medium-term follow-up for deep venous thrombosis after total knee arthroplasty / 中华创伤骨科杂志

Objective To report the medium-term follow-up results for deep venous thrombosis(DVT) after total knee arthroplasty(TKA).Methods Between July 2003 and March 2004,55 patients(63 knees)who had had TKA were followed up for DVT.In follow-ups 1 to 2 weeks after TKA,their clinic symptoms,Doppler ultrasonograms and venograms were analyzed.In the following out-patient follow-ups done at every six months,we observed their clinic symptoms and Doppler uhrasonograms for the operated lower extremity.Venography was done only for those who had severe DVT symptoms.Results The venography one week after TKA conformed that DVT occurred in 34 patients(41 knees,61.8%).Two weeks after operation,DVT vanished in 12 cases,but deterio- rated to the proximal part in two cases.The follow-ups averaged 36.6 months(range,32 to 40 months).The results at five time points showed that the incidence of DVT did no decrease with lapse of time(P＞0.05).Conclusion No matter whether DVT occurs in the perioperative period,incidence of DVT in the medium term varies little.

Anticarcinogenic Effect of Panax ginseng C.A. Meyer and Identification of Active Compounds

The failure to improve the five-year survival rate of cancer patients, from one in three in the 1960s to one in two in the 1970s, stimulated awareness of the importance of primary prevention of cancer. Korean investigators carried out extensive long-term anticarcinogenicity experiments with 2000 newborn mice to investigate whether Panax ginseng C.A. Meyer inhibited carcinogenesis induced by several chemical carcinogens in 1978. There was a 22% decrease (p<0.05) in the incidence of urethane induced lung adenoma by the combined use of red ginseng extract. In the group sacrificed at 56 weeks after the treatment with aflatoxin B1, the incidence of hepatoma significantly decreased to 75% by the addition of red ginseng extract (p<0.05). The result showed that natural products can provide hope for human cancer prevention. By the newly established '9 week medium-term anticarcinogenicity test model of lung tumors in mice' (Yun's model), we confirmed significant anticarcinogenic effects of powders and extracts of the 6- yr-old dried fresh ginseng, 5- and 6-yr old white ginsengs, and 4-, 5-, and 6-yr old red ginseng. We also demonstrated that the anticarcinogencity of ginseng was more prominent in aged or heat treated extracts of ginseng and red ginseng made by steaming. To investigate the active components for cancer prevention, several fractions of 6-yr old fresh ginseng and red ginseng, four semi-synthetic ginsenoside Rh1, Rh2, Rg3 and Rg5, major saponin components in red ginseng, were prepared. Among the ginsenosides, Rg3 and Rg5 showed statistically significant reduction of lung tumor incidence and Rh2 had a tendency of decreasing the incidence. Ginsenoside Rg3, Rg5 and Rh2 were found to be active anticarcinogenic compounds. Rg3, Rg5 and Rh2 are active components in red ginseng, and they prevent cancer either singularly or synergistically.