Chemical composition and mechanisms underlying the spasmolytic and bronchodilatory properties of the essential oil of Nepeta cataria L.

Aim of the study

The study was aimed to investigate the chemical composition and pharmacological basis for traditional use of essential oil of Nepeta cataria L. (Limiaceae) (Nc.Oil) in gastrointestinal and respiratory disorders.

Materials and methods

Chemical analysis was carried out through GC-EIMS, ¹³C NMR and Kovats Retention Indices while pharmacological study was carried out in isolated tissues preparations.

Results

Four major components; 1,8-cineol (21.00%), α-humulene (14.44%), α-pinene (10.43%) and geranyl acetate (8.21%) were identified among the 27 compounds in Nc.Oil. In isolated rabbit jejunum, Nc.Oil, papaverine and verapamil inhibited spontaneous and high K⁺(80 mM) precontractions, as well as shifted the Ca⁺⁺ concentration–response curves (CRCs) to right, indicating calcium channel blocking activity. In isolated guinea-pig trachea, Nc.Oil and papaverine inhibited carbachol (1 μM) and K⁺ precontractions with similar potency, while verapamil was more potent against K⁺. Nc.Oil also potentiated isoprenaline inhibitory CRCs, similar to papaverine, indicating papaverine-like PDE inhibitor activity. In isolated guinea-pig atria, Nc.Oil caused cardiodepression at around 25–80 times higher concentrations, similar to papaverine.

Conclusions

These data indicate that Nepeta cataria possesses spasmolytic and myorelaxant activities mediated possibly through dual inhibition of calcium channels and PDE, which may explain its traditional use in colic, diarrhea, cough and asthma.     

Recurrent endometrial carcinoma regression with the use of the aromatase inhibitor anastrozole

Recurrent/metastatic endometrial adenocarcinoma that is not amenable to cure with local or regional therapy and/or chemotherapy represents a discouraging clinical entity for the clinician. We report the case of 58-year-old woman with recurrent endometrial carcinoma that was resistant to chemotherapy that was treated successfully with the aromatase inhibitor anastrozole.     

Reconstruction surgery in head and neck cancer patients amidst the COVID-19 pandemic: Current practice and lessons for the future

The coronavirus disease 2019(COVID-19) pandemic has imposed a radical change in daily life and work routine. In this context, health systems have suffered important and serious repercussions in all fields. Among the changes brought about by the state of global health emergency, adjustments to guidelines, priorities, structures, professional teams, and epidemiological data stand out. In light of this, the oncological field has witnessed several changes in the approach to cancer, whether due to de...     

Arthroscopic management of postoperative arthrofibrosis of the knee joint: Indication, technique, and results

From October 1987 through March 1991, 58 patients with postoperative joint stiffness underwent arthroscopic fibroarthrolysis. Forty-six knees in 46 patients were followed. The indication for arthroscopic management was decreased range of motion after surgery. Eighty-seven percent had been treated by arthrotomy. Thirteen percent had been managed by arthroscopic surgery. The indication for primary surgery was a torn anterior cruciate ligament in 74%. The mean interval between arthroscopic fibroarthrolysis and follow-up was 22.1 months. The average age was 32.7 years. A modified Blauth and Jäger score was used for classification of fibroarthrosis: grade I (mild 17.4%), grade II (moderate 63%), grade III (severe 15.2%), and grade IV (bad 4.3%). The gain in range of motion was evaluated by the Cauchoix index: the results were excellent in 54.5%, good in 21.7%, and fair and poor in 23.8%. Pain was evaluated according to a modification of the Lysholm score: 80.4% of the patients experienced a reduction in pain. The sports activity level in the Tegner activity scale increased from 2.3 to 4.8. Patient satisfaction was excellent or good in 56.5% (n = 26), fair in 39.1% (n = 18), and poor in 4.3% (n = 2). On the basis of our retrospective study, we feel that arthroscopic fibroarthrolysis is of benefit to the patients with postoperative joint stiffness even after a prolonged period.     

Structure-activity relationships leading to WAY-121,520, a tris aryl-type,indomethacin-based,phospholipase A2 (PLA2)/leukotriene biosynthesis inhibitor

We were intrigued by reports of the inhibition of phospholipase A₂ (PLA₂) by indomethacin. In order to increase the potency of the indomethacin system as an inhibitor of PLA₂, it was decided to make more lipophilic analogs. Indeed, covalent attachment of a quinoline ring to the methoxy substituent of indomethacin affords WAY-122,220 which is almost an order of magnitude more potent than indomethacin in inhibiting human synovial fluid PLA₂ (IC₅₀=15 and 145 μM, respectively). TheN−p-chloro-benzyl analog of this compound, WAY-121,520, was an even more potent inhibitor of PLA₂ (IC₅₀=4 μM). Structural analyses and molecular modeling suggest that these compounds may inhibit PLA₂ by mimicking arachidonic acid. WAY-121,520 is also a potent leukotriene biosynthesis inhibitor both in the rat PMN and mouse macrophage assays (IC₅₀=10 and 4 nM, respectively), possibly acting via a 5-LO (5-lipoxygenase) translocation inhibition mechanism. The multiple actions of WAY-121,520 may contribute to its favorable anti-inflammatory profile.

     

Widespread ground-glass opacity of the lung in consecutive patients undergoing CT: Does lobular distribution assist diagnosis?

OBJECTIVE: Our purpose was to establish the most frequent diagnoses associated with widespread ground-glass opacity on CT and to determine if the distribution of ground-glass opacity at a lobular level affects the likelihood of a given diagnosis. MATERIALS AND METHODS: A retrospective search of our department's CT database from January 1998 through December 2000 revealed 153 cases of ground-glass opacity. Patients evaluated using bronchoscopy or open biopsy within 30 days (mean, 6.9 days) of imaging with ground-glass opacity as the predominant high-resolution CT finding were selected. There were 21 men and 16 women with a mean age of 51.4 years. Two chest radiologists, unaware of the clinical diagnoses, independently recorded lobular distributions. Consensus interpretation was used for discrepancies. Primary distributions were recorded as lobular (geographic ground-glass opacity marginated by septal anatomy), centrilobular (ground-glass opacity related to bronchovascular anatomy), or random. RESULTS: Infectious and other histologic diagnoses fell into four diagnostic groups: atypical pneumonia, chronic infiltrative interstitial disease, acute air-space filling, and drug toxicity. Ground-glass opacity was most frequently associated with acute atypical pneumonia (n = 12, 32%), chronic infiltrative disease (n = 10, 27%), acute air-space filling (n = 6, 16%), and drug toxicity (n = 4, 11%). In five patients, a definitive diagnosis was not established. Ground-glass opacity was most commonly randomly distributed (n = 16, 43%), followed by lobular (n = 15, 41%) and centrilobular (n = 6, 16%) distributions. Distribution did not correlate with diagnostic group. CONCLUSION: In unselected cases of ground-glass opacity evaluated at a tertiary institution, atypical infection and chronic infiltrative interstitial disease accounted for 59% of diagnoses. Distribution at a lobular level did not differentiate underlying causes.     

FDG-PET Detected Thyroid Incidentalomas: Need for Further Investigation?

Background Incidental thyroid abnormalities are increasingly detected in patients undergoing PET scans. The aim of this study was to review our experience with the management of PET detected thyroid incidentalomas in a large single institution series. Methods All PET scans performed from May 2003 to July 2005 were reviewed and patients with incidental thyroid abnormalities were identified. From this group, patients that underwent further investigation were analyzed. Data relating to PET scan findings, FNA diagnoses, operative details, and histopathology was reviewed. Results In 8,800 patients, 16,300 PET scans were performed of whom 263 patients (2.9% of patients and 1.6% of PET scans) had findings positive for thyroid abnormality. Thyroid malignancy was noted in 42% (24 patients) of the 57 patients that underwent FNA. In the group of 27 patients that were subjected to operative intervention, 74% (20 patients) were noted to have a malignant diagnosis. The final histopathology revealed primary thyroid carcinoma in all these 20 patients (19 patients with papillary carcinoma and one patient with primary thyroid lymphoma). The factors that correlated with an increased risk of malignancy were the presence of physical finding (p = 0.01) and focal (p < 0.01) or unilateral uptake (p < 0.01) on PET scan. The average SUV was not useful in differentiating benign (9.2) from malignant lesions (8.2, p = 0.7). Conclusions PET detected incidental thyroid abnormalities are rare. In patients with positive PET scan findings and suspicious features, the incidence of primary thyroid malignancy is very high. These patients warrant further investigation followed by possible operative intervention.