Effect of shin'iseihaito on lung colonization of pneumococcus in murine model

Background: Streptococcus pneumoniae (pneumococcus) causes various serious diseases including sinusitis, pneumonia, and meningitis. One serious problem observed recently with pneumococcal therapy is attenuation of the antibiotic effect because of the emergence of antibiotic-resistant pneumococcus. Shin’iseihaito, a traditional Japanese medicine based on ancient Chinese medicine, has been used for treatment of otolaryngeal diseases in Japan. The objective of this study was to examine the anti-infectious effects of shin’iseihaito and its related mechanism.Materials and Methods: We evaluated the beneficial effect of shin’iseihaito extract (SSHT) against pneumococcus-infected murine model. The colonization of bacteria, blood and bronchoalveolar lavage (BAL) killing activity, the levels of inflammatory cytokine and IgA were investigated.Results: The pneumococcus from blood was not found in both SSHT-treated mice and untreated mice. However, the pneumococcal colonization of lung was significantly (p<0.05) lower after SSHT administration compared with untreated mice. Blood bactericidal assay showed that no significant difference (p=0.07) was observed in the anti-bacterial effect between SSHT-treated mice and untreated mice. However, BAL bactericidal assay showed that the survival rate of pneumococcus using the BAL from SSHT-treated mice was significantly (p<0.05) lower than that using the BAL from untreated mice. We also found increased levels of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, and IgA in pneumococcus-infected mice treated with SSHT.Conclusions: SSHT decreased the colonization rate after pneumococcal infection and up-regulated BAL bactericidal activity through modulation of inflammatory cytokines and IgA. Our data also suggest SSHT may be useful for the treatment of pneumococcal infection.Keywords: shin'iseihito, Streptococcus pneumoniae, murine model, inflammatory cytokine, Ig

EFFECT OF SHIN'ISEIHAITO ON LUNG COLONIZATION OF PNEUMOCOCCUS IN MURINE MODEL

Background: Streptococcus pneumoniae (pneumococcus) causes various serious diseases including sinusitis, pneumonia, and meningitis. One serious problem observed recently with pneumococcal therapy is attenuation of the antibiotic effect because of the emergence of antibiotic-resistant pneumococcus. Shin’iseihaito, a traditional Japanese medicine based on ancient Chinese medicine, has been used for treatment of otolaryngeal diseases in Japan. The objective of this study was to examine the anti-infectious effects of shin’iseihaito and its related mechanism. Materials and Methods: We evaluated the beneficial effect of shin’iseihaito extract (SSHT) against pneumococcus-infected murine model. The colonization of bacteria, blood and bronchoalveolar lavage (BAL) killing activity, the levels of inflammatory cytokine and IgA were investigated. Results: The pneumococcus from blood was not found in both SSHT-treated mice and untreated mice. However, the pneumococcal colonization of lung was significantly (

Comparison of Pentax-AWS Airwayscope and Glidescope for Infant Tracheal Intubation by Anesthesiologists during Cardiopulmonary Arrest Simulation: A Randomized Crossover Trial

Background. Recent guidelines for infant cardiopulmonary resuscitation emphasize that all rescuers should minimize interruption of chest compressions, even for endotracheal intubation. We compared the utility of the Pentax-AWS Airwayscope (AWS) with the Glidescope (GS) during chest compressions on an infant manikin. Methods. Twenty-four anesthesiologists with more than two years of experience performed tracheal intubation on an infant manikin using the AWS and GS, with or without chest compressions. Results. In GS trials, none of the participants failed without compressions, while three failed with compressions. In AWS trials, all participants succeeded regardless of chest compressions. Intubation time was significantly longer with chest compressions with the GS ( < 0.05), but not with the AWS. Difficulty of operation on a visual analog scale (VAS) for laryngoscopy did not increase significantly with chest compressions with either the GS or the AWS, while the VAS for tube passage through the glottis increased with compressions with the GS, but not with the AWS. Conclusion. We conclude that in infant simulations managed by anesthesiologists, the AWS performed better than the GS for endotracheal intubation with chest compressions

Sevoflurane induces cardioprotection through reactive oxygen species-mediated upregulation of autophagy in isolated guinea pig hearts.

PURPOSE: Sevoflurane increases reactive oxygen species (ROS), which mediate cardioprotection against myocardial ischemia-reperfusion injury. Emerging evidence suggests that autophagy is involved in cardioprotection. We examined whether reactive oxygen species mediate sevoflurane preconditioning through autophagy. METHODS: Isolated guinea pigs hearts were subjected to 30 min ischemia followed by 120 min reperfusion (control). Anesthetic preconditioning was elicited with 2 % sevoflurane for 10 min before ischemia (SEVO). The ROS-scavenger, N-(2-mercaptopropionyl) glycine (MPG, 1 mmol/l), was administered starting 30 min before ischemia to sevoflurane-treated (SEVO + MPG) or non-sevoflurane-treated (MPG) hearts. Infarct size was determined by triphenyltetrazolium chloride stain. Tissue samples were obtained after reperfusion to determine autophagy-related protein (microtubule-associated protein light chain I and II: LC3-I, -II) and 5\u27 AMP-activated protein kinase (AMPK) expression using Western blot analysis. Electron microscopy was used to detect autophagosomes. RESULTS: Infarct size was significantly reduced and there were more abundant autophagosomes in SEVO compared with control. Western blot analysis revealed that the ratio of LC3-II/I and phosphorylation of AMPK were significantly increased in SEVO. These effects were abolished by MPG. CONCLUSIONS: Sevoflurane induces cardioprotection through ROS-mediated upregulation of autophagy

Thymoma-associated Graft-versus-Host Disease-like Erythroderma

We report a 40-year-old woman with recurrent thymoma associated with myasthenia gravis, in whom an unusual form of erythroderma developed. A histological examination revealed a graft-versus-host disease (GVHD)-like reaction. After high-dose steroid therapy, the metastatic thymoma lesion in the abdominal cavity was reduced in size from 9.5 × 6 × 7.5 cm to 4 × 3 × 1 cm in diameter. Nevertheless, the GVHD-like erythroderma become aggravated, her condition worsened, and the patient finally suffered from respiratory failure and died of sepsis. A GVHD-like reaction may be a rare presentation of thymoma-associated immunological disorders such as myasthenia gravis or pure red cell aplasia. Herein, we discuss the present case and review pertinent reports of thymoma cases associated with GVHD

Effect of Shin’iseihaito (Xinyiqingfeitang) on Acute Streptococcus pneumoniae

Streptococcus pneumoniae (S. pneumoniae) causes sinusitis. The general treatment of S. pneumonia sinusitis is by using antibiotics; however, one of their serious problems is the attenuation of their effect. Shin’iseihaito (Xinyiqingfeitang), a formula of Japanese traditional Kampo medicine, has been used for the treatment of sinusitis in Japan. In this study, we investigated the efficacy of Shin’iseihaito against S. pneumoniae-caused sinusitis in mice. Oral administration of Shin’iseihaito extract (SSHT) decreased the nasal colonization of S. pneumoniae in both prophylactic and therapeutic treatments, respectively, and the former was more effective than the latter. Histopathological analysis revealed that the epithelial tissue from S. pneumoniae-infected nose under SSHT treatment recovered the tissue destruction in comparison to infected nose. We also confirmed this result by scanning electron microscopic analysis. Murine peritoneal macrophages from SSHT-treated mice had significant phagocytic activity in comparison to those from untreated group. We also found that tumor necrosis factor-α, interleukin-1β, interleukin-6, and monocyte chemotactic protein-1 levels and the migration of macrophages from S. pneumoniae-infected mice with the treatment with SSHT were increased compared to those from untreated group. Our data suggest that Shin’iseihaito may be useful for the treatment of S. pneumoniae-induced sinusitis

The Neutrophil to Lymphocyte Ratio Is Superior to Other Inflammation-Based Prognostic Scores in Predicting the Mortality of Patients with Pneumonia

A neutrophil-to-lymphocyte ratio (NLR) > 7 is reportedly an independent marker of mortality in patients with bacteremia. However, no studies have shown an association between inflammation-based prognostic scores (including the Glasgow Prognostic Score, the NLR, the platelet-to-lymphocyte ratio, the Prognostic Nutritional Index, and the Prognostic Index) and mortality in patients with pneumonia. We retrospectively examined the cases of 33 patients diagnosed with pneumonia who were treated in the ICU of Osaka Medical College Hospital between January 2014 and June 2016. A multivariate analysis revealed that the NLR was a significant predictor of mortality in these pneumonia patients