The inhibitory effects of ginsenoside and quercetin on oxidative damage by puromycin aminonucleoside in rat

This study examined the protective effect of two natural antioxidants, ginsenoside Rb-1 and quercetin, on acute nephrosis induced by puromycin aminonucleoside (PA). The protective action of Rb-1 and quercetin were evidenced by their ability to suppress the formation of phosphatidylcholine hydroperoxide in the plasma, liver and kidney. Another beneficial effect noted from these natural antioxidants was increased glutathione peroxidase activity in the blood. Our results suggest that the severity of PA-induced acute nephrosis can be ameliorated by the antioxidative action of these two flavonoids. © 1998 John Wiley & Sons, Ltd.     

The clinical spectrum of humidifier disease in synthetic fiber plants

In a synthetic fiber production site with recirculating cold water humidification systems and small-size-particle (>0.1μ <lμ) oil mist exposure, humidifier disease was diagnosed in several workers. The patients could be divided into three groups illustrating the clinical spectrum of humidifier disease: humidifier fever (toxic inhalation fever) (12 patients); an asthma-like syndrome (8 patients); and allergic alveolitis (4 patients). Natural challenge at the work place, monitored by parameters such as peak-flow, spirometry, blood leucocyte count, and body temperature, provided important diagnostic information. In patients with chronic allergic alveolitis, a gradual recovery during an exposure-free period indicated a work-related causation, more than changes during challenge in normal work. In some patients, the fungus Sporothrix schenckii, hitherto unknown as a sensitizer, may have been at least one of the causative antigens. Measured levels of viable fungi (≤100 CFU/m³) and endotoxin (64 pg/m³) in air samples were much lower than those at which health effects usually are reported. Small-size-particle oil mist exposure may have underestimated the exposure to microorganisms, but otherwise an adjuvant role to this type of co-exposure might also be postulated. In contrast to allergic alveolitis, the asthma-like syndrome appeared to be more common in patients with a history of atopy and of smoking. Am. J. Ind. Med. 31:682–692, 1997. © 1997 Wiley-Liss, Inc.     

Acetylcholinesterase inhibitory potential of a carbazole alkaloid,mahanimbine, from Murraya koenigii

In the search for acetylcholinesterase (AChE) inhibitors from Indian medicinal plants, via bioassay‐guided isolation, a carbazole alkaloid, mahanimbine [3, 5‐dimethyl‐3‐(4‐ methylpent‐3‐enyl)‐11H‐pyrano [5, 6‐a] carbazole], was isolated from the petroleum ether extract of the leaves of Murraya koenigii. Inhibition of AChE was evaluated based on Ellman's method using 96‐well microplate readers. Mahanimbine inhibited AChE activity in a dose‐dependent manner with an IC₅₀ value of 0.03 ± 0.09 mg/mL, while galantamine was used as a standard. The AChE inhibitory activity of this carbazole alkaloid has not been reported so far, and this study is the first to reveal this activity in carbazole alkaloid mahanimbine, isolated from Murraya koenigii. Copyright © 2009 John Wiley & Sons, Ltd.     

Surgical outcomes and complications of sutureless needle-guided intrascleral intraocular lens fixation combined with vitrectomy

Purpose:To analyze the surgical outcomes and complications of sutureless needle-guided intrascleral intraocular lens (IOL) implantation (Yamane technique) combined with pars plana vitrectomy.Methods:Retrospective study of 47 eyes of 46 patients that underwent scleral fixation of IOL by the Yamane technique combined with 3-port pars plana vitrectomy. Demographic data, primary indications for surgery, history of trauma, best corrected visual acuity (BCVA), intraocular pressure (IOP), duration of follow-up, and complications were analyzed.Results:Mean preoperative BCVA was 0.79 logMAR, which improved to 0.39 logMAR at mean 4.21 months (SD: 4.87 D) follow-up. Mean spherical equivalent pre and postoperative was + 7.64 D (SD: 7.74 D) and − 0.47 D (SD: 2.26 D), respectively. Early postoperative complications included hypotony with cyclodialysis cleft (n = 1; 2%), mild vitreous hemorrhage (n = 2; 4%), raised IOP (n = 2; 4%), and transient corneal edema (n = 2; 4%). Late complications included iris optic capture (n = 1; 2%), retinal detachment (n = 1; 2%), cystoid macular edema (CME; n = 2; 4%), IOL decentration (n = 1; 2%), and decentration and tilting of IOL (n = 1; 2%). Management of complications included laser treatment to cyclodialysis cleft, observation for vitreous hemorrhage, topical and oral IOP lowering agents for raised IOP. CME was managed with topical non-steroidal anti-inflammatory drugs. One eye was subjected IOL refixation. The mean number of surgeries per eye was 1.04.Conclusion:Combining needle-guided intrascleral IOL implantation with vitrectomy allows management of other posterior segment complications in the same sitting while obviating the need for the second surgery. It provides satisfactory outcomes that are comparable to published studies. However, a longer follow-up will allow a better understanding of the potential advantages of this approach.     

Evidence-based dexamethasone dosing in malignant brain tumors: what do we really know?

Purpose

The present study aims to conduct a systematic review of literature reporting on the dose and dosing schedule of dexamethasone (DXM) in relation to clinical outcomes in malignant brain tumor patients, with particular attention to evidence-based practice.

Methods

A systematic search was performed in PubMed, Embase, Web of Science, Cochrane, Academic Search Premier, and PsycINFO to identify studies that reported edema volume reduction, symptomatic relief, adverse events and survival in relation to dexamethasone dose in glioma or brain metastasis (BM) patients.

Results

After screening 1812 studies, fifteen articles were included for qualitative review. Most studies reported a dose of 16 mg, mostly in a schedule of 4 mg four times a day. Due to heterogeneity of studies, it was not possible to perform quantitative meta-analysis. For BMs, best available evidence suggests that higher doses of DXM may give more adverse events, but may not necessarily result in better clinical condition. Some studies suggest that higher DXM doses are associated with shorter survival in the palliative setting. For glioma, DXM may lead to symptomatic improvement, yet no studies directly compare different doses. Results regarding edema reduction and survival in glioma patients are conflicting.

Conclusions

Evidence on the safety and efficacy of different DXM doses in malignant brain tumor patients is scarce and conflicting. Best available evidence suggests that low DXM doses may be noninferior to higher doses in certain circumstances, but more comparative research in this area is direly needed, especially in light of the increasing importance of immunotherapy for brain tumors.

     

Cytochemical flow analysis of intracellular G6PD and aggregate analysis of mosaic G6PD expression

Background

Medicines that exert oxidative pressure on red blood cells (RBC) can cause severe hemolysis in patients with glucose‐6‐phosphate dehydrogenase (G6PD) deficiency. Due to X‐chromosome inactivation, females heterozygous for G6PD with 1 allele encoding a G6PD‐deficient protein and the other a normal protein produce 2 RBC populations each expressing exclusively 1 allele. The G6PD mosaic is not captured with routine G6PD tests.

Methods

An open‐source software tool for G6PD cytofluorometric data interpretation is described. The tool interprets data in terms of % bright RBC, or cells with normal G6PD activity in specimens collected from 2 geographically and ethnically distinct populations, an African American cohort (USA) and a Karen and Burman ethnic cohort (Thailand) comprising 242 specimens including 89 heterozygous females.

Results

The tool allowed comparison of data across 2 laboratories and both populations. Hemizygous normal or deficient males and homozygous normal or deficient females cluster at narrow % bright cells with mean values of 96%, or 6% (males) and 97%, or 2% (females), respectively. Heterozygous females show a distribution of 10‐85% bright cells and a mean of 50%. The distributions are associated with the severity of the G6PD mutation.

Conclusions

Consistent cytofluorometric G6PD analysis facilitates interlaboratory comparison of cellular G6PD profiles and contributes to understanding primaquine‐associated hemolytic risk.     

Children with untreated coeliac disease have sub-clinical cardiac dysfunction: a longitudinal observational analysis

Introduction: We assessed cardiac function (CF) in celiac disease (CD) patients and the effect of gluten-free diet (GFD) on CF.

Methods: Prospective evaluation of CF using conventional and tissue doppler echocardiography in 50 CD patients (age 4.2?±?1.1 years) at diagnosis and after a year of GFD (group 1), 100 CD children (group 2; 47 compliant and 53 non-compliant) in follow-up and 25 healthy controls.

Results: Untreated CD (n?=?50) children had larger left ventricle end diastolic dimension (35.33?±?0.87 vs. 32.90?±?0.91 mm; p?=?.04), reduced (<55%) left ventricular ejection fraction (20% vs. 0%; p?=?.01) and a higher (>0.6) myocardial performance index (MPI, 66% vs. 0%; p ≤ .01) as compared to controls. Re-evaluation after one year with good dietary compliance showed changes in isovolumic relaxation time (72.5?±?4.2 vs. 50.62?±?2.69; p?=?.0001) and deceleration time (121.05?±?10.1 vs. 99.87?±?8.5; p?=?.02), reflecting improved cardiac diastolic function. GFD compliant patients had lower MPI than non-compliant (0.60?±?.03 vs. 0.66?±?.08; p?=?.04), reflecting improvement in load-independent echocardiographic parameters.

Conclusions: Subclinical cardiac dysfunction is common in CD children at diagnosis. Improvement

in echocardiographic parameters occurs with GFD and non-compliant children continue to have

persistent cardiac dysfunction.     

Accuracy of a history of blood donation from surrogate witnesses: data from the UK TMER study

Look‐back studies of blood transfusion in Creutzfeldt–Jakob disease commonly rely on reported history from surrogate witnesses. Data from the UK Transfusion Medicine Epidemiology Review have been analysed to determine the accuracy of the blood donation history provided by the relatives of cases. Our results show that only a small percentage of cases were found to be registered as donors on UK Blood Service (UKBS) databases when there was no family report of blood donation. In contrast, a history of reported donation was less accurate.