Post-treatment serial serum squamous cell carcinoma antigen (SCC) in the monitoring of squamous cell carcinoma of the cervix

Serum squamous cell carcinoma antigen (SCC) was raised in 62% of 308 patients with squamous cell carcinoma of the cervix before treatment. Post-treatment SCC levels were raised in 69 patients (22.4%). Retrospective review showed that persistently raised SCC level after treatment was significantly associated with persistent or recurrent disease in squamous cell carcinoma of the cervix. The specificity of persistently raised SCC level in association with recurrent disease was 98.2%. The sensitivity in association with recurrent disease was 74.7%. The positive predictive values was 94.2%. The median lead time for recurrence was 4 months. SCC was raised in 38% of patients with clinical evidence of disease in the vagina. One patient had raised SCC one month prior to clinical detection of vaginal metastasis and was salvaged by an exenterative procedure. SCC was raised in 71–91% of patients with metastatic disease in the lung, lymph nodes or other distant sites. Thus, persistently raised SCC level after treatment of squamous cell carcinoma should alert the clinician to look for recurrent disease especially in distant metastatic sites. Post-treatment raised SCC level was associated with less than 5% 5-year survival rate whereas in patients with normal SCC level, the 5-year survival rate was 87%.     

Inhibitory effects of oleanane-type triterpenes and saponins from the stem bark of Kalopanax pictus on LPS-stimulated pro-inflammatory cytokine production in bone marrow-derived dendritic cells

Kalopanax pictus (Araliaceae) is a deciduous tree distributed in Korea, Japan, and China. The stem bark of K. pictus has been functionally used as a traditional crude drug for the treatment of various inflammatory diseases. In the present study, we describe the inhibitory effects of oleanane-type triterpenes and saponins isolated from the stem bark of K. pictus on production of pro-inflammatory cytokines in LPS-stimulated bone marrow-derived dendritic cells. Of the compounds tested, 16,23,29-trihydroxy-3-oxo-olean-12-en-28-oic acid (1), 4,23,29-trihydroxy-3,4-seco-olean-12-en-3-oate-28-oic acid (2), 3β,6β,23-trihydroxyolean-12-en-28-oic acid 28-O-β-D-glucopyranoside (3), nipponogenin E (6), 3β,6β,23-trihydroxyolean-12-en-28-oic acid (7), and caulophyllogenin (19) significantly inhibited the production of IL-12 p40 and IL-6 with IC₅₀ values ranging from 3.3 to 9.1 μM. Compounds 2, 3, 7, and 19 significantly suppressed the secretion of TNF-α with IC₅₀ ranging from 8.8 to 20.0 μM. These data provide scientific support for the use of K. pictus stem bark and its triterpene and saponin components in the inhibition of pro-inflammatory cytokine secretion, including IL-12 p40, IL-6, and TNF-α, and for prevention and treatment of inflammatory diseases.     

Mechanism of the prostanoid TP receptor agonist U46619 for inducing emesis in the ferret

U46619 is a potent thromboxane A₂ mimetic with emesis-inducing actions that are mediated via prostanoid TP receptors. We investigated its emetic mechanism of action in more detail using the ferret as model animal. The emesis induced by U46619 (30 μg/kg, intraperitoneal) was antagonized significantly by (+)-(2S,3S)-3-(2-methoxybenzylamino)-2-phenylpiperidine hydrochloride (CP-99,994; 1 and 10 mg/kg; P < 0.05) and metoclopramide (0.3 and 3 mg/kg), but not by domperidone (3 mg/kg), sulpiride (0.1 mg/kg), ondansetron (0.1 and 1 mg/kg) alone or combined with droperidol (3 mg/kg), GR125487 (1 mg/kg), promethazine (3 mg/kg), or scopolamine (3 mg/kg); GR 125487 (1 mg/kg) prevented the anti-emetic action of metoclopramide (3 mg/kg). U46619 0.3 μg administered into the fourth ventricle rapidly induced emesis. However, bilateral abdominal vagotomy was ineffective in reducing the emetic response (P > 0.05). Our data suggests that U46619 induces emesis via an extra-abdominal mechanism, probably within the brain. Metoclopramide probably has a mechanism of action to prevent U46619-induced emesis via 5-HT₄ receptor activation and NK₁ tachykinin receptor antagonists could be useful to prevent emesis induced by TP receptor activation in man.     

Constituents from the leaves of <Emphasis Type="Italic">Clausena lansium</Emphasis> and their anti-inflammatory activity

Five new acyclic amides, clausenalansamides C-G (1–5), clausenaline G (6) and (±)-5-(4-methylphenyl)-γ-valerolactone (7) reported from the natural source for the first time, were characterized from the leaves of Clausena lansium. Their structures were established by spectroscopic and spectrometric methods, and the absolute configurations of new compounds 1–5 were determined by electronic circular dichroism and single-crystal X-ray diffraction analyses. Eighteen compounds were evaluated for their anti-inflammatory activity and only imperatorin (11) and wampetin (12) displayed significant inhibition of fMLP/CB-induced superoxide anion generation with IC₅₀ values of 1.7 ± 0.3 and 6.8 ± 1.1 μM, respectively.     

New dianthramide and cinnamic ester glucosides from the roots of Aconitum carmichaelii

Four new compounds N-salicyl-3-hydroxyanthranilic acid methyl ester (1), N-(2′-dehydroxysalicyl)-3-hydroxyanthranilic acid methyl ester (2), methyl-4-β-D-allopyranosyl-ferulate (3), and methyl-4-β-D-gulopyranosyl-cinnamate (4), along with six known compounds (5–10), were isolated from the roots of Aconitum carmichelii Debx. Their structures were elucidated on the basis of spectral data analysis, including 1D, 2D-NMR, and HR-ESI-MS. Compounds 1 and 2 showed the inhibition of nitric oxide (NO) production with IC₅₀ values of 9.13 and 19.94 μM, respectively.     

Barriers to Screening for Intimate Partner Violence

Background: Health care providers play a vital role in the detection of intimate partner violence among their patients. Despite the recommendations for routine intimate partner violence screening in various medical settings, health care providers do not routinely screen for intimate partner violence. The authors wanted to identify barriers to intimate partner violence screening and improve the understanding of intimate partner violence screening barriers among different health care providers. Methods: The authors conducted a systematic review to examine health care providers' perceived barriers to screening for intimate partner violence. By grouping the studies into two time periods, based on date of publication, they examined differences in the reported barriers to intimate partner violence screening over time. Results: The authors included a total of 22 studies in this review from all examined sources. Five categories of intimate partner violence screening barriers were identified: personal barriers, resource barriers, perceptions and attitudes, fears, and patient-related barriers. The most frequently reported barriers included personal discomfort with the issue, lack of knowledge, and time constraints. Provider-related barriers were reported more often than patient-related barriers. Conclusions: Barriers to screening for intimate partner violence are numerous among health care providers of various medical specialties. Increased education and training regarding intimate partner violence is necessary to address perceptions and attitudes to remove barriers that hinder intimate partner violence screening by health care providers.