Pharmacological activity of Mentha longifolia and its phytoconstituents

Current paper reviews the pharmacological activities, therapeutic indications and phytochemicals of M. longifolia. This herb has been consumed traditionally for the treatment of various diseases, including gastrointestinal disorders, respiratory disorders, infectious diseases, inflammatory diseases, as well as menstrual disorders. In the modern era, various pharmacological activities have been confirmed for M. longifolia, such as anti-parasitic, antimicrobial, anti-insect, antimutagenic, antinociceptive, anti-inflammatory, antioxidant, keratoprotective, hepatoprotective, anti-diarrhea, and spasmolytic effects. The plant showed therapeutic benefits in irritable bowel syndrome, amenorrhea and oligomenorrhea, and oxidative stress-associated diseases as well. A vast variety of natural components such as flavonoids, phenolic acids, cinnamates, ceramides, sesquiterpenes, terpenes, and terpenoids have been suggested to be responsible for the pharmacological action of M. longifolia. These natural products can be considered as novel medicinal sources for developing new drugs. Further investigations to explore therapeutic efficacy, tolerability, and pharmaceutical properties of M. longifolia phytochemical agents are recommended.     

Thermal Damage of the Inner Vein Wall During Endovenous Laser Treatment: Key Role of Energy Absorption by Intravascular Blood

BACKGROUND: Despite the clinical efficacy of endovenous laser treatment (EVLT), its mode of action is incompletely understood. OBJECTIVE: To evaluate the role of intravascular blood for the effective transfer of thermal damage to the vein wall through absorption of laser energy. METHODS: Laser energy (15 J/pulse, 940 nm) was endovenously administered to explanted greater saphenous vein (GSV) segments filled with blood (n = 5) or normal saline (n = 5) in addition to GSVs under in vivo conditions immediately prior to stripping. Histopathology was performed on serial sections to examine specific patterns of damage. Furthermore, in vitro generation of steam bubbles by different diode lasers (810, 940, and 980 nm) was examined in saline, plasma, and hemolytic blood. RESULTS: In saline-filled veins, EVLT-induced vessel wall injury was confined to the site of direct laser impact. In contrast, blood-filled veins exhibited thermal damage in more remote areas including the vein wall opposite to the laser impact. Steam bubbles were generated in hemolytic blood by all three lasers, while no bubbles could be produced in normal saline or plasma. CONCLUSION: Intravascular blood plays a key role for homogeneously distributed thermal damage of the inner vein wall during EVLT.     

Chemically modified tetracycline (CMT-8) and estrogen promote wound healing in ovariectomized rats: Effects on matrix metalloproteinase-2, membrane type 1 matrix metalloproteinase, and laminin-5 γ2-chain

Estrogen deficiency is associated with impaired cutaneous wound healing. Remodeling of the extracellular matrix in wound healing involves the action of matrix metalloproteinases on basement membrane zone components, especially laminin-5. We studied the effects of estrogen and a potent matrix metalloproteinase inhibitor, chemically modified non-antimicrobial tetracycline, CMT-8, on wound healing in ovariectomized rats. At the tissue level, laminin-5 gamma2-chain expression was decreased and the migration-inductive 80 kDa form of laminin-5 gamma2-chain was absent in ovariectomized rats when compared with sham and CMT-8- or estrogen-treated ovariectomized animals as detected by Western blotting. The highest levels of gelatinolytic activity (matrix metalloproteinase-2 and -9) were found in sham animals. Levels were reduced in ovariectomized rats and were lowest after treating ovariectomized rats with CMT-8 or estrogen as analyzed by functional activity assay and zymography. The total amount of membrane type 1-matrix metalloproteinase was unchanged in all groups. We conclude that CMT-8 and estrogen can promote wound healing in ovariectomized rats, not only by normalizing wound bed total collagen content and structure, but also by recovering the expression and processing of key molecules in wound healing, i.e., laminin-5 gamma2-chain. This study shows, for the first time, the role of estrogen and CMT-8 in laminin-5 gamma2-chain modulation in vivo.     

Measurement of the humeral head retroversion angle. A new radiographic method

BACKGROUND: In this study, a simple and reliable radiographic method is described to determine the torsional profile of the humeral head. METHODS: First, by using a specially developed frame, the humeral head retroversion angles (HRAs) of 20 dry humeri were measured by an anatomist and an orthopedist. Then the HRA of these humeri were measured by two orthopedists on radiographs taken in semi-axial view when the humeri were in 20 degrees abduction. RESULTS: The results were assessed with the SPSS 9.05 program, and the repeatability coefficient of both methods was 98%. The average difference in angle determination between the two methods was 0.9 degrees; the maximum difference was 3 degrees. After that, posteroanterior semi-axial radiographs of both humerus bones of 40 healthy volunteers were taken by positioning their arms in 20 degrees abduction to the X-ray axis. The mean HRA difference between the right and left sides was 0.4 degrees (maximum difference 3 degrees ) and is of no clinical significance. It was determined that left and right HRAs can be taken as a reference to each other. For measurement of the HRA in the planning of proximal humeral rotation osteotomy and prosthesis replacement arthroplasty, the presented radiographic method can be used with a high rate of accuracy.     

A population-based study of the extent of surgical resection of potentially curable colon cancer

Background We attempted to determine factors contributing to the extent of initial curative resection for colon cancer in a population-based cohort. Total abdominal colectomy with ileorectal anastomosis (TAC-IR) may be considered for young patients or those with a colorectal cancer family history to prevent metachronous lesions and facilitate surveillance. Methods All Ontario patients newly diagnosed with colon cancer over 12 months beginning in July 1997 were staged at the time of surgery. The extent of resection was compared with variables, including familial risk obtained from the Ontario Familial Colon Cancer Registry. Results Complete staging was possible for 86% of patients. A total of 1223 patients had a potentially curative resection: 17%, 46%, and 36% were stage I, II, and III, respectively. Patients were more likely to receive a TAC-IR if they were ≤50 years old (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.8–6.6), if they had a synchronous lesion (OR, 28.37; 95% CI, 12.2–61.2), or if they were at a teaching hospital (OR, 2.8; 95% CI, 1.6–4.7), but not if they had a family history (OR, 7; 95% CI, 3–1.5). Conclusions Young age, teaching hospital, and multiple cancers but not family history were important factors for performing a TAC-IR.     

Characterization of intensive care unit acquired hyponatremia and hypernatremia following cardiac surgery

Purpose

Although intensive care unit (ICU) acquired sodium disturbances are common in critically ill patients, few studies have examined sodium disturbances in patients following cardiac surgery. The objective of this study was to describe the epidemiology of ICU-acquired hyponatremia and hypernatremia in patients following cardiac surgery.

Methods

We identified 6,727 adults (≥18 yr) who were admitted consecutively to a regional cardiovascular intensive care unit (CVICU) from January 1, 2000 to December 31, 2006 and were documented as having normal serum sodium levels (133 to 145 mmol·L^?1) during the first day of ICU admission. ICU-acquired hyponatremia and hypernatremia were defined as a change in serum sodium concentration to <133 mmol·L^?1 or >145 mmol·L^?1, respectively, following ICU day one.

Results

A first episode of ICU-acquired hyponatremia and hypernatremia developed in 785 (12%) and 242 (4%) patients, respectively, (95% confidence interval [CI] 11-12% and 95% CI 3-4%, respectively), with a respective incidence density of 4.2 and 1.3 patients per 100 days of ICU admission (95% CI 4.0-4.5 and 95% CI 1.2-1.5). The incidence of ICU-acquired sodium disturbances varied according to the patients’ demographic and clinical variables for both hyponatremia (age, diabetes, Acute Physiology and Chronic Health Evaluation [APACHE II] score, mechanical ventilation, length of ICU stay, serum glucose level, and serum potassium level) and hypernatremia (APACHE II score, mechanical ventilation, length of hospital stay prior to ICU admission, length of ICU stay, serum glucose level, and serum potassium level). Compared with patients with normal serum sodium levels, hospital mortality was increased in patients with ICU-acquired hyponatremia (1.6% vs 10%, respectively; P < 0.001) and ICU-acquired hypernatremia (1.6% vs 14%, respectively; P < 0.001).

Conclusion

ICU-acquired hyponatremia and hypernatremia are common complications in critically ill patients following cardiac surgery. They are associated with patient demographic and clinical characteristics and an increased risk of hospital mortality.     

Promoter Methylation of Specific Genes is Associated with the Phenotype and Progression of Colorectal Adenocarcinomas

Background

Promoter methylation of colorectal cancer-related genes were examined with respect to phenotype and tumor progression.

Materials and Methods

We assayed promoter methylation of 11 genes including established CpG island methylator phenotype (CIMP) markers (MLH1, MINT1, MINT2, MINT31, p16 ^INK4a , p14 ^ARF , and CACNA1G) and four genes (COX2, DAPK, MGMT, and APC) frequently methylated in colorectal cancer in 285 patients with sporadic colorectal cancer.

Results

CIMP+ tumors were more than two times more frequent among high-frequency microsatellite instability tumors (MSI-H) than in tumors without MSI (P ≤ .0001–.002). COX2 and DAPK methylation were significantly associated with CIMP+ and MSI. KRAS showed tendency toward more frequent codon 12-13 mutations identified in tumors with APC and p16 ^INK4a methylation than in those with unmethylation (P = .033 and .05, respectively). Additionally, tumors with synchronous adenoma were associated with p16 ^INK4a methylation (P = .004). The p16 ^INK4a methylation was significantly associated with poor overall and disease-free survival in 131 rectal cancer patients who underwent curative operation, according to multivariate analyses (relative risk [RR] = 0.317 and 0.349; P = .033 and .024, respectively). Specifically, in 175 stage II and III patients receiving adjuvant-based fluoropyrimidine chemotherapy, p16 ^INK4a methylation and MINT31 unmethylation showed a significant or tendency toward an association with recurrence and DFS (P = .007–.032).

Conclusions

The study suggests that specific CIMP markers, such as p16 ^INK4a and MINT31, should be further verified as potential epigenetic targets for the design of efficient chemotherapy regimens. We also identified a subset of colorectal cancer, possibly comprising APC methylation-KRAS mutation-p16 ^INK4a methylation.     

Comparison of complications and results of early versus delayed surgery for Gartland type III supracondylar humeral fractures in pediatric patients

Objective: To investigate the effect of timing of surgery on clinical results and perioperative complications in pediatric patients with Gartland III type supracondylar humeral fractures without neurovascular compromise. Methods: Eighty‐six c onsecutive children treated surgically at our hospital from April 2005 to June 2007 for displaced supracondylar humeral fractures were reviewed. All these patients were treated by the same group of doctors. The children were divided into two groups: early if treated within 12 hours after injury and delayed if treated later than that. Perioperative complications and clinical results, especially for open surgery, were compared between the two groups. Results: Forty pediatric patients underwent surgery in the early group and 46 in the delayed group. There were no significant differences between the two groups in perioperative complications such as pin tract infection, iatrogenic nerve injury, compartment syndrome and conversion to open surgery. For open surgery, both the clinical results and perioperative complications were not affected by delaying for more than 12 hours after injury. However, blood loss and operation time were greater in the early than in the delayed group, possibly due to relatively more edema. Conclusion: Delay in surgery, regardless of whether it is closed or open, for more than 12 hours after injury does not influence the perioperative complications and clinical results for displaced supracondylar humeral fractures in children. However early open reduction and pinning may increase intra‐operative blood loss and take longer.