Placing a saline bag underneath the heart enhances transgastric transesophageal echocardiographic imaging during cardiac displacement for off-pump coronary artery bypass surgery.

OBJECTIVE: The authors hypothesized that placing a saline bag (saline-filled surgical glove) underneath a displaced heart would improve ultrasound transmission for transgastric (TG) imaging and transesophageal echocardiography (TEE) to visualize left ventricular regional wall motion (LV-RWM) during cardiac displacement for off-pump coronary artery bypass (OPCAB) surgery. DESIGN: Prospective observational study. SETTING: Tertiary University Hospital. PARTICIPANTS: Adult patients undergoing OPCAB surgery. INTERVENTIONS: Intraoperative TEE examination MEASUREMENT AND MAIN RESULTS: For off-line analyses of LV-readable segments, mid-esophageal (ME, 4-chamber, 2-chamber, and long-axis) and TG (basal- and mid-short-axis) TEE views were recorded under 3 different intraoperative conditions in 13 cases of OPCAB surgery: Before cardiac displacement (Tcontrol), after cardiac displacement (Tdisplaced), and after placing the saline bag underneath the displaced heart (Tsaline-bag). There were more LV-readable segments in the 17-segment model using integrated ME and TG views(ME + TG views) at Tsaline-bag and Tcontrol (mean[95% confidence interval], 17[17-17] and 17[17-17]) than using ME+TG at Tdisplaced (15[15-16], P = 0.002 and P<0.001, respectively). Using ME + TG views provided more LV-readable segments in the 17-segment model than using ME views at Tsaline-bag (vs. 16[14-16], P < 0.001), but not at Tdisplaced (vs. 15[14-15]). Incidences of inadequate RWM monitoring (LV-readable segments<14/17 using ME + TG views) at Tsaline-bag and Tcontrol (all 0/13) were less frequent than at Tdisplaced (3/13, all P = 0.038). There were more LV-readable segments in TG basal- and mid-short-axis views at Tsaline-bag (median [range], 6[5-6] and 5[5-6]) than at Tdisplaced (0[0-2] and 0[0-1], all P < 0.05). CONCLUSIONS: Placing a saline bag underneath the displaced heart enhances the ability of TEE to visualize global LV-RWM by improving TG TEE imaging during OPCAB surgery.

Changes in ginsenoside composition of ginseng berry extracts after a microwave and vinegar process.

MGB-20 findings show that the ginseng berry extracts that had been processed with microwave and vinegar for 20 min peaked in the level of ginsenoside Rg2 (2.28%) and Rh1 (1.28%). MGB-1 peaked in the level of ginsenoside Rg3 (1.13%) in the ginseng berry extract processed with microwave and vinegar for 1 min.

Mechanisms of melanogenesis inhibition by propafenone.

Melanogenesis is a physiological process that results in the synthesis of melanin pigments, which play a crucial protective role against skin photocarcinogenesis. The present study was conducted to determine the inhibitory effects of propafenone on melanogenesis and to elucidate the molecular events involved in the inhibition of melanogenesis by propafenone. To accomplish this, several experiments were conducted using human epidermal melanocyte cells. The melanin content and cAMP production were evaluated, and western blots for proteins involved in melanogenesis were conducted. The melanin content was significantly inhibited by propafenone in a concentration-dependent manner. To clarify the mechanism of the depigmenting property of propafenone, we examined the involvement of propafenone in cAMP signaling. In the cAMP production assay, the intracellular cAMP level was reduced by propafenone. The level of microphthalmia-associated transcription factor (MITF) protein, the upstream transcription factor of tyrosinase, was also reduced by propafenone. In addition, propafenone inhibited the expression of tyrosinase, TRP-1, and TRP-2. Taken together, the results of our study show that propafenone inhibits melanogenesis by suppressing cAMP production, which is involved in the expression of melanogenesis-related proteins and suggests that propafenone may be an effective inhibitor of hyperpigmentation.