Title page Simultaneous Absolute Protein Quantification of Carboxylesterases 1 and 2 in Human Liver Tissue Fractions using Liquid Chromatography Tandem Mass Spectrometry

Abstract The aims of this study were to develop a robust method for simultaneous quantification of carboxylesterases (CESs) 1 and 2 and to quantify those absolute protein levels in human liver tissue fractions. Unique peptide fragments of CES1 and CES2 in tryptically digested human liver microsomes (HLMs) and cytosol (HLC) were simultaneously quantified by liquid chromatography equipped with tandem mass spectrometry (LC-MS/MS) using corresponding stable isotope-labeled peptides as internal standards. Bovine serum albumin was used as a blank matrix for the calibration curve samples. Our procedure showed good digestion efficiency, sensitivity, linearity of calibration curve, and reproducibility. The protein levels of CES1 an

Simultaneous absolute protein quantification of carboxylesterases 1 and 2 in human liver tissue fractions using liquid chromatographytandem mass spectrometry. Drug Metab Dispos 40:1389–1396.

ABSTRACT: The aims of this study were to develop a robust method for simultaneous quantification of carboxylesterases (CESs) 1 and 2 and to quantify those absolute protein levels in human liver tissue fractions. Unique peptide fragments of CES1 and CES2 in tryptically digested human liver microsomes (HLMs) and cytosol (HLC) were simultaneously quantified by liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) using corresponding stable isotope-labeled peptides as internal standards. Bovine serum albumin was used as a blank matrix for the calibration curve samples. Our procedure showed good digestion efficiency, sensitivity, linearity of calibration curve, and reproducibility. The protein levels of CES1 and CES2 in 16 individual HLMs varied 4.7-fold (171-801 pmol/mg) and 3.5-fold (16.3-57.2 pmol/mg), respectively, that are approximately 10 times higher than the expression levels in HLC. The CES1/CES2 level ratio varied substantially from 3.0 to 25, and the correlation between the protein levels of CES1 and CES2 was negative, indicating significant interindividual variability and independence in their expression levels. CES1 levels significantly correlated with hydrolysis of the CES1 substrates, clopidogrel (5 M) and oxybutynin (10 M), whereas CES2 levels correlated strongly with hydrolysis of the CES2 substrate, irinotecan (1 M), indicating that quantified protein levels are highly reliable. This is the first report to demonstrate the absolute protein levels of CESs quantified by LC-MS/MS

Artery ascending between the scalenus anterior and medius muscles. Accessory ascending cervical artery

Dissection of 25 adult Japanese cadavers revealed an artery that consistently arose from the subclavian artery and ascended between the scalenus anterior and medius muscles. This accessory ascending cervical artery, when developed, issued the dorsal scapular artery which penetrated the scalenus medius muscle. Typological discussion suggested that the accessory ascending cervical artery was a remnant of the longitudinal anastomoses along the embryonic intersegmental arteries

Artery ascending between the scalenus anterior and medius muscles. Accessory ascending cervical artery

Dissection of 25 adult Japanese cadavers revealed an artery that consistently arose from the subclavian artery and ascended between the scalenus anterior and medius muscles. This accessory ascending cervical artery, when developed, issued the dorsal scapular artery which penetrated the scalenus medius muscle. Typological discussion suggested that the accessory ascending cervical artery was a remnant of the longitudinal anastomoses along the embryonic intersegmental arteries

Usefulness of Airway Scope for intubation of infants with cleft lip and palate–comparison with Macintosh laryngoscope: a randomized controlled trial

Abstract Background Airway Scope (AWS) with its plastic blade does not require a head-tilt or separate laryngoscopy to guide intubations. Therefore, we hypothesized that its use would reduce the intubation time (IT) and the frequency of airway complication events when compared with the use of Macintosh Laryngoscope (ML) for infants with cleft lip and palate (CLP). Methods The parents of all patients provided written consents; we enrolled 40 infants with CLP (ASA-PS 1). After inducing general anesthesia using sevoflurane and rocuronium, we performed orotracheal intubations using either AWS (n = 20) or ML (n = 20), randomly. We define the duration between manual manipulation using cross finger for maximum mouth opening and the first raising motion of the chest following intubation by artificial ventilation as “IT;” further, the measured IT as primary outcomes. Airway complications were considered secondary outcomes. Moreover, we looked for associations between IT and the patient’s characteristics: extensive clefts, age, height, and weight. We used the Mann–Whitney test and Fisher’s exact probability test for statistical analysis; p < 0.05 was considered as statistically significant. Results The mean IT was 31.5 ± 8.3 s in AWS group and 26.4 ± 8.9 s in ML group. Statistical significant difference was not found in IT between the two groups. The IT of AWS group was statistically related to extensive clefts. Airway complications were detected in ML group. Conclusion AWS could be useful for intubation of infants with CLP; it required IT similar to that required using ML, with a lower rate of airway complications. Trial registration UMIN-CTR Registration number UMIN000024763. Registered 8 November 2016

The usefulness of the McGrath MAC laryngoscope in comparison with Airwayscope and Macintosh laryngoscope during routine nasotracheal intubation: a randomaized controlled trial

Abstract Background McGrath MAC video laryngoscope offers excellent laryngosopic views and increases the success rate of orotracheal intubation in some cases. The aim of this study was to determine the usefulness of McGrath MAC for routine nasotracheal intubation by comparing McGrath MAC with Airway scope and Macintosh laryngoscope. Methods A total of 60 adult patients with ASA physical status class 1 or 2, aged 20–70 years were enrolled in this study. Patients were scheduled for elective oral surgery under general anesthesia with nasotracheal intubation. Exclusion criteria included lack of consent and expected difficult airway. Patients were randomly allocated to three groups: McGrath MAC (n = 20), Airway scope (n = 20), and Macintosh laryngoscope (n = 20). After induction, nasotracheal intubation was performed by six expert anesthesiologists with more than 6 years of experience. Results There were no significant differences in preoperative airway assessment among the three groups. Successful tracheal intubation time was 26.8 ± 5.7 (mean ± standard deviation) s for McGrath MAC, 36.4 ± 11.0 s for Airway scope, and 36.5 ± 8.9 s for Macintosh laryngoscope groups. The time for successful tracheal intubation for McGrath MAC group was significantly shorter than that for Airway scope and Macintosh laryngoscope (p < 0.01). McGrath MAC significantly improved the Cormack Lehane grade for nasotracheal intubation compared with Macintosh laryngoscope (p < 0.05). Conclusion McGrath MAC significantly facilitates routine nasotracheal intubation compared with Airwayscope and Macintosh laryngoscope by shortening the tracheal intubation time and improving the Cormack Lehane grade. Trial registration UMINCTR Registration number UMIN000023506 . Registered 5 Aug 2016

General anesthetic management of a patient with multiple chemical sensitivity for oral surgery: a case report

Abstract Background Multiple chemical sensitivity (MCS) was first described in 1987. It is said that MCS is caused by neurological and immunological mechanisms in addition to psychosomatic mechanisms. When performing general anesthesia in patients with MCS, careful perioperative management is necessary. Case presentation The patient was a 32-year-old man. Wisdom teeth extraction under general anesthesia was scheduled under the diagnosis of pericoronitis. In 2015, he was diagnosed with MCS. Since then, he experienced sweating and urticaria when exposed to artificial fragrances. We prepared the surgical surroundings by letting the patient touch every possible equipment. In selecting the anesthetic drugs, a completely intravenous route was selected because of the possibility that artificial fragrance of inhalation anesthesia could induce symptoms. There was no allergic reaction during the preoperative period. Conclusions It is important to reduce psychological burden of patient and to eliminate all possible reactive substances to prevent symptom onset