Eclipta prostrata is an annual herb, belonging to Asteraceae family, and has been traditionally used to improve immunity and treat hepatitis and bacterial disease in Korea. In this study, a new coumestan glucoside (1) along with ten known compounds (2 – 11) was isolated from E. prostrata. The chemical structures of isolates were elucidated to be wedelolactone-9-O-β-D-glucopyranoside (1), wedelolactone (2), demethylwedelolactone (3), apigenin (4), apigenin-7-sulfate (5), luteolin (6), luteolin-7-sulfate (7), luteolin-7-O-β-D-glucopyranoside (8), pratensein-7-O-β-D-glucopyranoside (9), 3,4-di-O-caffeoylquinic acid (10) and 3,5-di-O-caffeoylquinic acid (11) based on the spectroscopic evidence.

Eclipta prostrata is an annual herb, belonging to Asteraceae family, and has been traditionally used to improve immunity and treat hepatitis and bacterial disease in Korea. In this study, a new coumestan glucoside (1) along with ten known compounds (2 – 11) was isolated from E. prostrata. The chemical structures of isolates were elucidated to be wedelolactone-9-O-β-D-glucopyranoside (1), wedelolactone (2), demethylwedelolactone (3), apigenin (4), apigenin-7-sulfate (5), luteolin (6), luteolin-7-sulfate (7), luteolin-7-O-β-D-glucopyranoside (8), pratensein-7-O-β-D-glucopyranoside (9), 3,4-di-O-caffeoylquinic acid (10) and 3,5-di-O-caffeoylquinic acid (11) based on the spectroscopic evidence.

There are severe soft tissue defects associated with intercalary segmental or distal loss of bone in the crushing injury of the hand by high-energy machine such as presser, electrical saw, and agricultural machine. Bone grafting to restore the skeletal scaffold is essential for reconstruction of the soft tissue and preservation of the digit function. However, non-vascularized free bone grafts are not desirable, because recipient sites often have a poorly vascularized bed. We described 12 cases, which were reconstructed by the lateral arm osteofasciocutaneous or osteofascial free flap from 1997 to 2001. The bone was harvested from the distal humeral bone as an osteofasciocutaneous lateral arm flap that has constant osseous branches from the main pedicle of the posterior radial collateral artery along the lateral intermuscular septum. Lateral arm osteofasciocutaneous flap is able to provide well vascularized bone and soft tissue for hand reconstruction. All flaps survived and had acceptable shape and function without bone resorption. We consider that lateral arm osteofasciocutaneous flap is a useful method for reconstruction of the composite tissue defect containing the bone in one-stage operation of the hand.
Arm* ; Arteries ; Bone Resorption ; Bone Transplantation ; Free Tissue Flaps* ; Hand* ; Transplants

Reconstruction of a finger-pulp defect is one of the most difficult procedures. The reasons are that the identical donor tissue is not easy to obtain and the reducing the donor site morbidity is not easy to achieve. Particularly, reconstruction of multiple digit pulp defect is more difficult. We propose toe partial pulp free flaps for the replacement of defects of multiple fingertip. It can provide identical color matching to donor defect, and cut down the morbidity of donor site. The 33 digits of 15 patients were treated with this method. The donor sites were medial aspect of the second toe or third toe and lateral aspect of big toe. The neurovascular pedicles were composed of medial plantar digital artery, medial plantar digital nerve, and superficial plantar vein of the second toe, third toe or big toe. All flaps were survived. The average of static two-point discrimination was 5.9 mm. Primary closure of donor sites was possible in all cases. Toe partial pulp free flaps has many advantages in multiple digit reconstruction. It can provide excellent color and texture matching, excellent sensory recovery. It avoids long term immobilization. Vascular anatomy was so consistent that vessels were easily dissected. Primary closure of donor site was possible. However, there were some restrictions. The flap could not be applied to a large defect, and to patients with vascular disease and old age. It also required skillful technique in anastomosis of pedicle. In conclusion, we consider that toe partial-pulp free flaps are useful method to reconstruct the defects of multiple fingertips.
Arteries ; Discrimination (Psychology) ; Free Tissue Flaps* ; Humans ; Immobilization ; Tissue Donors ; Toes* ; Vascular Diseases ; Veins

We experienced one case of anesthesia for liver transplantation in a 14 year old girl with Wilson's disease. The liver was donated from a patient with a brain tumor who was diagnosed as brain death. We monitored blood pressure, heart rate, cardiac output, pulmonary capillary wedge pressure, systemic vascular resistance, arterial pH, arterial PCO2, serum potassium, ionized calcium, glucose, and blood coagulation states including platelet count, prothrombin time, activated partial thromboplastin time and coagulation factor assay. We used isoflurane and nitrous oxide as the main inhalation anesthetics. The operation was performed without serious problem. The patient became conscious three hours after the operation.
Adolescent ; Anesthesia* ; Anesthetics, Inhalation ; Blood Coagulation ; Blood Coagulation Factors ; Blood Pressure ; Brain Death ; Brain Neoplasms ; Calcium ; Cardiac Output ; Female ; Glucose ; Heart Rate ; Hepatolenticular Degeneration ; Humans ; Hydrogen-Ion Concentration ; Isoflurane ; Liver Transplantation* ; Liver* ; Nitrous Oxide ; Partial Thromboplastin Time ; Platelet Count ; Potassium ; Prothrombin Time ; Pulmonary Wedge Pressure ; Vascular Resistance

Free muscle flap for the simultaneous coverage of two anatomically distant sites has previously entailed the harvest of tissue from separate donor areas, Although it may be possible to achieve this goal with a variety of available donor site, the transfer of a single donor muscle to two different sites has been considered. The gracilis muscle is commonly usef by reconstructive surgeon in a variety of application as pedicled muscle or musculocutaneous flap and as a free tissue transfer for soft tissue coverage or a functioning muscle transfer. The gracilis muscle is classified as having a type II blood supply that anatomy is reliable. The main arterial supply to the gracilis muscle is a branch of the profunda femoris, which enters the muscle 10+/-1cm from its attachment to the pubis on its deep(lateral) surface. The distal portion of muscle between the main arterial pedicle and musculotendinous junction is supplied by one to three small arterial branches of the superficial femoral artery. The first minor pedicle located approximately 20 cm from the pubis. In 1990 Tadeusz reported the successful treatment of patient with bilateral calcaneal fractures and posttraumatic osteomyelitis using a longitudinal single split free gracilis muscle transfer. In 2001 We performed a transversely dividing gracilis muscle free flap in the patient with two soft tissue defects and osteomyelitis in anterior tibial region and foot.
Femoral Artery ; Foot ; Free Tissue Flaps* ; Humans ; Myocutaneous Flap ; Osteomyelitis ; Tissue Donors

Salvia plebeia R. Br. is a plant which has been used as an edible crop and traditional medicine in Asian countries. In this study, HPLC-PDA analysis and countercurrent chromatography (CCC) coupled with reversed-phase (RP) HPLC method were applied to isolate ten isolates from 3.3 g of n-butanol soluble extract from hot-water extract of S. plebeia. The use of CCC enabled us to efficiently fractionate the starting material with less sample loss and facilitate the isolation of compounds from S. plebeia extract using RP-HPLC. The isolates were determined to be caffeic acid (1), 6-hydroxyluteolin 7-O-β-D-glucoside (2), eudebeiolide B (3), (R)-rosmarinic acid (4), homoplantaginin (5), eudebeiolide D (6), plebeiolide C (7), salpleflavone (8), eupafolin (9) and hispidulin (10) based on the spectroscopic evidence.

Purpose: This study evaluated how artificial intelligence-based computer-assisted diagnosis (AICAD) for breast ultrasonography (US) influences diagnostic performance and agreement between radiologists with varying experience levels in different workflows. Methods: Images of 492 breast lesions (200 malignant and 292 benign masses) in 472 women taken from April 2017 to June 2018 were included. Six radiologists (three inexperienced [<1 year of experience] and three experienced [10-15 years of experience]) individually reviewed US images with and without the aid of AI-CAD, first sequentially and then simultaneously. Diagnostic performance and interobserver agreement were calculated and compared between radiologists and AI-CAD. Results: After implementing AI-CAD, the specificity, positive predictive value (PPV), and accuracy significantly improved, regardless of experience and workflow (all P<0.001, respectively). The overall area under the receiver operating characteristic curve significantly increased in simultaneous reading, but only for inexperienced radiologists. The agreement for Breast Imaging Reporting and Database System (BI-RADS) descriptors generally increased when AI-CAD was used (κ=0.29-0.63 to 0.35-0.73). Inexperienced radiologists tended to concede to AI-CAD results more easily than experienced radiologists, especially in simultaneous reading (P<0.001). The conversion rates for final assessment changes from BI-RADS 2 or 3 to BI-RADS higher than 4a or vice versa were also significantly higher in simultaneous reading than sequential reading (overall, 15.8% and 6.2%, respectively; P<0.001) for both inexperienced and experienced radiologists. Conclusion Using AI-CAD to interpret breast US improved the specificity, PPV, and accuracy of radiologists regardless of experience level. AI-CAD may work better in simultaneous reading to improve diagnostic performance and agreement between radiologists, especially for inexperienced radiologists.