The suppressive effects of landiolol administration on the occurrence of postoperative atrial fibrillation and tachycardia, and plasma IL-6 elevation in patients undergoing esophageal surgery: A randomized controlled clinical trial.

STUDY OBJECTIVE: To determine whether perioperative landiolol administration suppresses postoperative atrial fibrillation (AF) and the plasma cytokines elevation in patients undergoing esophageal cancer surgery. DESIGN: A prospective, randomized controlled trial. SETTING: Akita University Hospital, Akita, Japan, from April 2012 to January 2015. PATIENTS: Forty American Society of Anesthesiologists grade I-II patients undergoing elective esophagectomy. INTERVENTIONS: Patients were randomly divided into two groups, landiolol group (landiolol: 5µg/kg/min) and control group (the same volume of covered saline). Landiolol or saline was infused continuously from the induction of anesthesia until next morning. MEASUREMENTS: We examined the new onset of AF and sinus tachycardia, and measured plasma concentrations of cytokines (IL-1ß, IL-6, IL-8, IL-10, and TNF-α) just before surgery, at the end of surgery, the next day, and 2days after surgery. Data (mean±SD) were analyzed using two-way ANOVA followed by the Bonferroni"s test for post hoc comparison; a P<0.05 was considered statistically significant. MAIN RESULTS: Demographic data were similar between the landiolol and the control groups. The incidence of AF was significantly lower in the landiolol group (1/19=5.3%) compared with the control group (7/20=35%) as well as sinus tachycardia (landiolol group, 0/19=0% vs. control group, 5/20=25%). Plasma IL-6 level at the end of surgery was significantly lower in the landiolol group compared with the control group, but the other plasma cytokines levels were similar between the two groups during the entire study period. CONCLUSIONS: Perioperative landiolol administration suppressed the incidence of new-onset of AF as well as sinus tachycardia, and the plasma IL-6 elevation in patients undergoing esophageal cancer surgery.

[Comparison of levobupivacaine and ropivacaine for postoperative epidural analgesia].

BACKGROUND: Levobupivacaine is a long acting local anesthetic with less cardiovascular toxicity. Recently we can use levobupivacaine for postoperative analgesia. We retrospectively compared levobupivacaine with ropivacaine for the postoperative epidural analgesia in patients undergoing gynecological abdominal surgery. METHODS: The patients who had received epidural and general anesthesia from October 2008 to April 2009 were allocated into two groups. Analgesia intensity, the time to receive the first analgesic, and the number of times to use the additional analgesics were observed for three postoperative days. RESULTS: There was no difference in demographic data between the levobupivacaine and ropivacaine groups. In the levobupivacaine group (n=23) the patient received epidural 0.24% levobupivacaine and fentanyl, while the patients in the ropivacaine group (n=43) epidural 0.19% ropivacaine and fentanyl, at the rate of 3.5 ml x hr(-1). The volume of epidural fentanyl was similar between the groups. The time from the end of surgery to receive the first analgesic was longer in the levobupivacaine group than in the ropivacaine group. The number of the patients who did not require additional analgesia was greater in the levobupivacaine group than in the ropivacaine group. The patients who received metocropramide to treat nausea were fewer in the levobupivacaine group, compared with the ropivacaine group. CONCLUSIONS: These results suggest that the use of epidural 0.24% levobupivacaine in the patients undergoing the gynecological surgery is superior to the use of 0.19% ropivacaine.

Purification and properties of an aminopeptidase from the mid-gut gland of scallop (Patinopecten yessoensis).

An aminopeptidase was isolated from the mid-gut gland of Patinopecten yessoensis. The enzyme was purified from an acetone-dried preparation by extracting, ammonium sulfate precipitation, Hi-Load Q column chromatography, isoelectric focusing, and POROS HP2 and HQ column chromatography. The molecular weight of the enzyme was estimated to be 61 kDa by SDS-polyacrylamide gel electrophoresis and 59 kDa by gel permeation chromatography. The isoelectric point of the enzyme was 5.2 and the optimum pH was 7.0 toward leucine p-nitroanilide (Leu-pNA). The enzyme was inhibited by o-phenanthroline. The activity of the enzyme treated with o-phenanthroline was completely recovered by adding excess Zn(2+). Relative hydrolysis rates of amino acid-pNAs and amino acid-4-methylcoumaryl-7-amides (amino acid-MCAs) indicated that the enzyme preferred substrates having Ala or Met as an amino acid residue. The enzyme had a K(m) of 32.2 microM and k(cat) of 29.5 s(-1) with Ala-pNA and a K(m) of 11.1 microM and k(cat) of 9.49 s(-1) with Ala-MCA. The enzyme sequentially liberated amino acids from the amino-termini of Ala-Phe-Tyr-Glu.