The Effects of Freshwater Clam (Corbicula fluminea) Extract on Activated Hepatic Stellate Cells.

BACKGROUND: The extract of freshwater clams has been used to protect the body against liver diseases in traditional folk medicine. This study aims at investigating the effects of freshwater clam extract on activated hepatic stellate cells (aHSCs), which are critical contributors to liver fibrosis. METHODS: The aHSCs used in this study were derived from hepatic stellate cells that were isolated and purified from the livers of male Wistar rats and then transformed into the activated phenotype by culturing on uncoated plastic dishes. Freshwater clam extract (CE) was collected after the outflow from the live freshwater clams in a water bath at 100°C for 60 min. The effects of CE on aHSCs were analyzed by MTT assay, flow cytometry, Oil Red O (ORO) staining, western blot, and real-time RT-PCR. RESULTS: The results indicated that CE suppressed the proliferation of aHSCs through G0/G1 cell cycle arrest by downregulating cyclin D1 and upregulating p27. The expression levels of a-SMA, collagen I, TGF-ß, and TNF-α were inhibited in the CE-treated aHSCs. In addition, the CE treatment increased the lipid contents in aHSCs by promoting PPARγ expression. Furthermore, CE modulated the expression of ECM-related genes, i.e., by upregulating MMP-9 and downregulating TIMP-II. CONCLUSIONS: These data revealed that CE could induce the deactivation of aHSCs. We therefore suggest that CE has potential as an adjuvant therapeutic agent against hepatic fibrosis.

Proteomic profiling of Ganoderma tsugae ethanol extract-induced adipogenesis displaying browning features.

Ganoderma is classified as a top grade traditional Chinese medicine for promoting human health by regulating 'vital energy'. Its potency towards metabolism and energy homeostasis, particularly, metabolic adaptations of adipocytes, needs to be re-evaluated through an evidence-based study. Here, the triterpenoid-rich Ganoderma tsugae ethanol extract (GTEE) was found to contribute towards adipogenesis accompanied with elevated intracellular lipid metabolic flux. Additionally, proteomic profiling revealed GTEE-upregulated mitochondrial remodeling and chemical energy redox modifications, which display UCP1-positive browning fat-selective features and a NADH-mediated adaptive mechanism. GTEE-treated mice with diet-induced obesity also resulted in the amelioration of white adipocyte hypertrophy and the appearance of UCP1-positive browning adipocytes. Our novel findings unravel that GTEE could promote intracellular metabolic flexibility and plasticity followed by the induction of adipocyte browning.

Inhibitory Effects of Purple Sweet Potato Leaf Extract on the Proliferation and Lipogenesis of the 3T3-L1 Preadipocytes.

Purple sweet potato leaves (PSPLs) are healthy vegetable that is rich in anti-oxidants. A solution of boiling water extract of PSPL (PSPLE) is believed to be able to prevent obesity and metabolic syndrome in the countryside of Taiwan, but its efficacy has not yet been verified. The purpose of this study was to investigate the possible anti-adipogenesis effect of PSPLE in vitro. PSPLE was used to treat the 3T3-L1 cells, and the effects on cell proliferation and adipogenesis were investigated. The results showed that PSPLE caused a dose-dependent decrease in the cell proliferation of 3T3-L1 preadipocytes, but did not alter the cell viability. In addition, PSPLE induced ERK inactivation in the 3T3-L1 preadipocytes. Furthermore, pre-treatment of confluent 3T3-L1 cells with PSPLE led to reduced lipid accumulation in differentiated 3T3-L1 cells. The inhibition of lipogenesis could result from the PSPLE-induced down-regulation of the expression of the C/EBPα and SREBP-1 transcription factors during 3T3-L1 adipocyte differentiation. These results suggest that PSPLE not only inhibits cell proliferation at an early stage but also inhibits adipogenesis at a later stage of the differentiation program.

Clipping of the appendix induced cardiac arrest during appendectomy under spinal anesthesia.

Bradycardia is commonly seen in high spinal anesthesia, however, evolution of cardiac arrest from sudden onset of severe bradycardia is infrequent. Prompt recognization and resuscitative measures are of paramount importance because they may insure a complete recovery without sequela as an aftermath. We report herein a case of severe sinus bradycardia induced by clipping of the appendix during appendectomy under spinal anesthesia with the sensory block up to T5 dermatome. Prompt intravenous atropine failed to regain normal sinus rhythm, and cardiac arrest ensued. Cardiac massage, manual ventilation with oxygen and low-dose epinephrine successfully resuscitated the patient. The possible mechanisms and management of this complication are also discussed.

Conscious sedation in gastrointestinal endoscopy.

In recent years, the incidences of stomach and colon cancers have ranked within the top fives of all malignancies in Taiwan. To say healthwise, regular gastrointestinal (GI) endoscopic examinations are recommended, as they are the best way for early detection. However, unpleasantness of and terrible experience from the examination greatly discourage the acceptance of many people even of the suspected groups. Now, the administration of sedative or analgesic to achieve the so called "conscious sedation" during GI endoscopy which brings about better tolerability and improves general acceptance offers a more satisfactory service. In this article, the related issues about preprocedure evaluation, preparation, medications and complications of conscious sedation in GI endoscopy are discussed after review.

Postoperative transient ischemic attack complicated by CO2 retention and hypoxemia in a patient receiving meperidine injection for postoperative pain relief.

Transient ischemic attack (TIA) or stroke is not a rare complication, particularly in aged patients after surgery and anesthesia. If it is not properly managed, unmendable injury may inevitably occur. Patients who experience postoperative TIA or stroke usually have underlying diseases without resolution or good control. We bring forward here for discussion a fatality due to unappropriately managed TIA, which occurred in a 72-year-old male, within 24 hours after surgery. Besides making accurate diagnosis, selection of drugs for pain relief and appropriate overall management are key points of discussion.

Paraplegia after delayed detection of inadvertent spinal cord injury during thoracic epidural catheterization in an anesthetized elderly patient.

We report a case of permanent paraplegia in an 81-yr-old patient who had thoracic epidural catheterization performed under general anesthesia for abdominal surgery. The epidural needle was introduced at the T9-10 interspace, and 3 passes were made to locate the epidural space with the loss-of-resistance-to-air technique. During the postoperative epidural pump infusion, the patient was unaware of the progressive motor and sensory impairment. Sensory loss below T11 and paraplegia with no movement of either lower extremity were identified 8 h after surgery. Magnetic resonance imaging demonstrated an intramedullary split-like lesion extending from T4 to T12 and an intramedullary air bubble at T9. Spinal cord injury caused by an intracord catheterization with subsequent local anesthetic injection was diagnosed. Little improvement was noted after large-dose IV methylprednisolone for initial treatment and subsequent rehabilitation for 6 mo. The possible causes of the delayed detection of the neurologic deficits and the timing of performing epidural anesthesia are discussed.