Effect of a Prodrug of the Green Tea Polyphenol (-)-Epigallocatechin-3-Gallate on the Growth of Androgen-Independent Prostate Cancer In Vivo

Epigallocatechin-3-gallate (EGCG) is the major and most potent polyphenol compound of green tea that has been shown to have anticancer effects against various types of cancers. In this study, in addition to the EGCG compound, a synthetic derivative, the peracetate of EGCG (EGCG-P), was used to investigate the inhibitory effects on growth of androgen-independent prostate cancer in vivo. The advantage of EGCG-P is that it may act as a prodrug, leading to higher bioavailability than EGCG itself. The aim of our study was to compare the differences between EGCG and EGCG-P on their inhibitory effect on androgen-independent prostate cancer, CWR22R, xenograft model in nude mice. The mice were administrated daily with solvent dimethyl sulfoxide, EGCG, and EGCG-P separately through intraperitoneal injection for 20 days. Tumor volume and body weight of nude mice were recorded daily. Serum prostate-specific antigen (PSA) levels were also measured before and after the treatment. The effects of both EGCG and EGCG-P on tumor cell proliferation were assessed by immunohistochemical (IHC) method using antibodies against Ki-67 and proliferating cell nuclear antigen. The apoptotic effect was evaluated by IHC against B-cell non-Hodgkin lymphoma-2 and terminal deoxynucleotidyl transferase dUTP nick-end labeling assay by in situ apoptosis detection kit. Moreover, the potential suppression of angiogenesis by EGCG and EGCG-P on prostate cancer was examined by IHC against CD31. Our results revealed that treatment of EGCG and EGCG-P compounds suppressed the growth of CWR22R xenografts without causing any detectable side effects in nude mice. The suppression of growth of the tumor was correlated with the decrease of serum PSA level together with the reduction in tumor angiogenesis and an increase in apoptosis on prostate cancer cells. The results showed that treatment of EGCG and EGCG-P inhibited tumor growth and angiogenesis while promoting apoptosis of the prostate cancer cells in vivo. Our results suggest that EGCG-P may be a more stable and useful compound for increasing the therapeutic anticancer effects in androgen-independent prostate cancer.     

Induced Cardiac Arrest in Intracardiac Operations

Frigidity may be either true frigidity or pseudo f rigidity, the latter implying capability of sexual arousal with or without orgasm. Gynecologists may diagnose true frigidity but rarely can treat it. Pseudo f rigidity, resulting from psycho- sexual problems, constitutes most frigidity in women and is a condition that physicians must recognize and hope to treat. Educational treatment is best and usually is most effective in postpartum frigidity. Hypnotherapy and psychiatric treatment are suggested if other therapeutic measures fail.     

Choledochal cysts in adults

HYPOTHESIS: Choledochal cyst is rarely diagnosed in adulthood. When complicated by biliary tract malignancy, the disease has a distinct presentation and carries a dismal prognosis despite radical surgical resection. DESIGN: Retrospective study. SETTING: Tertiary referral center. PATIENTS: A retrospective study was performed on 30 adult patients who presented with choledochal cyst from January 1, 1989, to December 31, 2000. MAIN OUTCOME MEASURES: The clinical presentation, management, and outcome of patients with and without biliary tract malignancy. RESULTS: Nine patients (30%) had biliary tract malignancy complicating choledochal cyst (group A). Compared with 21 patients without malignancy (group B), group A patients had a significantly higher incidence of previous internal drainage operations for choledochal cyst (P =.049) and presentation with cholangitis (P =.03). Four patients in group A underwent pancreaticoduodenectomy and 3 received a palliative biliary drainage operation. The overall median survival of patients in group A was 12 months. Complete excision of choledochal cyst and Roux-en-Y hepaticojejunostomy were performed for all patients in group B, among whom 2 underwent concomitant hemihepatectomy. The operative morbidity and mortality were 14% and 0%, respectively, and there were no long-term complications with a median follow-up of 66 months. CONCLUSIONS: Biliary tract malignancy complicating choledochal cyst in adults should be suspected in patients with a history of internal drainage of choledochal cyst and presentation with cholangitis. Complete excision of choledochal cyst with Roux-en-Y hepaticojejunostomy is the treatment of choice for patients without malignancy and can be performed with low operative morbidity and absence of long-term complications in adult patients.     

Cushing's syndrome secondary to adrenal adenoma during pregnancy

Cushing's syndrome during pregnancy is rare because of the suppressive effect of excessive glucocorticoid on the female reproductive system. Adrenal adenoma is the most common cause of Cushing's syndrome during pregnancy. Surgical treatment by unilateral adrenalectomy was preferred during pregnancy before the advent of laparoscopic adrenalectomy. We describe two patients with Cushing's syndrome secondary to adrenal adenoma diagnosed during the first and second trimester, respectively, and successfully managed by different approaches of laparoscopic adrenalectomy--one patient upon diagnosis and one after pregnancy.