Chinese medicinal herbs as source of antioxidant compounds--where tradition meets the future.

Medicinal plants are an essential part of Traditional Chinese Medicine (TCM), an ancient complex therapy considered today as one of the most complete complementary medicine system. Chinese Herbal Medicines (CHM) listings included in Chinese Materia Medica cover more than 1500 plants and a great number of composite preparations. Recently, several TCM herbs have been included into European Pharmacopoeia and many more are on the waiting list. The efficiency of TCM is based on the reinforcing of an organism's natural healing power and the ability to restore the energy homoeostasis. A likely mechanism of at least some of the activities is interacting with redox balance and prevention of oxidative stress. During the past two decades, hundreds of crude herbs, extracts, and isolated compounds have been screened for their antioxidant properties in vitro and in vivo. Consequently, some of traditional Chinese herbs can be regarded as source of very efficient antioxidant compounds, and this activity could explain some of their therapeutic and preventive usefulness. In this review, we outline the recent achievements in the worldwide quest for more efficient antioxidants, with Chinese medicinal and food plants in the central point. Various classes of antioxidant compounds will be mentioned, such as polyphenols or terpenoids that can act either as direct reactive oxygen species scavengers, transition metal reducers and chelators, or as chain breaking antioxidants. Some methodological considerations will be also discussed, with emphasis on the potential importance of the results obtained with antioxidant assays for human health and disease prevention. In this context, several examples of selected, most promising Chinese medicinal plants will be also presented in more detail.

Serum 1-84 and 7-84 parathyroid hormone concentrations and bone in patients with primary hyperparathyroidism.

BACKGROUND AND AIMS: Parathyroid hormone (PTH) acts on bone as both anabolic and catabolic factor. It includes two fractions: 1-84 (cyclase activating PTH, CAP) which increases bone turnover and serum calcium, and 7-84 (cyclase inactivating PTH, CIP) acting the opposite way. The aim of this study was to establish whether bone mineral density (BMD) and turnover in patients' primary hyperparathyroidism (HPT) are dependent on CAP and CIP concentrations. PATIENTS/METHODS: Thirty-one patients with HPT and 29 appropriately matched controls were examined. Parameters of calcium-phosphate homeostasis and BMD were estimated. RESULTS: BMD of radius shaft was lower in patients with HPT as compared with controls, whereas BMD of spine and ultradistal radius were similar. Serum calcium, bone alkaline phosphatase, total PTH, 1-84 PTH, and 7-84 PTH were higher in HPT patients, whereas serum phosphate was lower and beta cross-laps similar. Both total PTH and CAP correlated significantly with BMD of radius shaft and serum calcium concentration, but not with other examined parameters. CONCLUSION: Total and 1-84 PTH are similarly associated with examined parameters in patients with HPT. Thus, determination of serum CAP concentration does not seem to have advantages over total PTH with regard to bone mineral density and bone turnover assessment in those patients.

A solution to organ shortage: vascular reconstructions for pancreas transplantation.

Multiorgan harvesting (MOH) accounts for approximately 40% of all organ procurements in Poland. Simultaneous procurement of the pancreas and liver necessitates division of the vessels supplying both organs. Therefore, reconstruction of the pancreas vasculature is mandatory for proper function of the transplanted organ. The aim of this study was to present various methods of vascular reconstruction to prepare the pancreas for transplantation. Between January 1999 and April 2005, among 42 whole pancreas transplantations, 35 came from MOH necessitating arterial reconstruction. In 32 cases, the splenic artery (SA) and superior mesenteric artery (SMA) were sewn into a single trunk using the common iliac arterial bifurcation. Occasionally, the iliac Y-graft was unsuitable for vascular reconstruction due to atherosclerosis or iatrogenic injury. Therefore, the SA was anastomosed to the side of the SMA in two cases. In one case we utilized the brachiocephalic trunk bifurcation. Portal vein elongation employed an external iliac vein procured from the donor in all 35 cases. Good perfusion was achieved in all transplanted pancreata. During the early follow-up period, two venous and one arterial thromboses were noted. No negative effects of pancreatic vessel reconstruction were observed in postoperative graft function. Reconstruction of the pancreas vasculature did not affect the long-term function of the allograft while significantly increasing the available donor organ pool.

Surgery for primary hyperparathyroidism.

OBJECTIVE: To define the role of surgery for organic primary hyperparathyroidism and to evaluate the diagnostic and operative methods applied. DESIGN: Retrospective, non-randomized, non-blinded evaluation. Case series. SETTING: Tertiary referral center. Department of Surgery. SUBJECTS AND METHODS: The report documents experience in surgical management at a single institution of 312 patients with primary (and 498 patients with secondary) hyperparathyroidism in a period from 1974 to 2000. Patient symptoms, clinical features, diagnostic and localization methods, operative management, and postoperative results were evaluated by retrospective medical record review with special attention to surgical management strategy. RESULTS: Of 321 patients with primary hyperparathyroidism 312 underwent 348 operations. There were 312 primary procedures and 36 multiple reoperations on 25 patients. The permanent success rate for primary (312) operations was achieved in 287 patients (92%). The permanent success rate for 36 secondary reoperations was achieved in 19 out of 25 reoperated patients (76%). The overall full recovery was obtained in 306 operated patients (98%). There were no postoperative emergency reoperations. There were 2 postoperative hospital deaths (0.6%) of patients with sustained hypercalcemic crisis after excision one cervical adenoma, but functioning second one in mediastinum.

Effect of surgical technique in subtotal and bilateral thyroidectomy on risk of postoperative parathyroid insufficiency development--our experience.

One of the postoperative complications after strumectomy is hypoparathyroidism. Therefore, the purpose of our study was to evaluate the effect of the surgical technique on the development of parathyroid gland insufficiency in our group of patients. Subtotal, bilateral strumectomies were performed according to Rothmund's suggestions. Randomized controlled trial was performed in two groups. In the first group of 19 patients, main trunk of the inferior thyroid artery was ligated and in the second one consisting of 18 patients, only the branches of this artery were ligated. Total calcium and PTH levels were evaluated pre- and postoperatively. Based on the biochemical and clinical data, no statistically significant differences in the development of postoperative hypoparathyroidism in relation to performed surgical techniques were observed.

Cultured parathyroid cells allotransplantation without immunosuppression for treatment of intractable hypoparathyroidism.

Cultured, viable and functioning ABO compatible parathyroid cells were allografted in 18 nonimmunosuppressed patients with a postoperative hypoparathyroidism. Variable, but promising biochemical and clinical results were obtained. Clinical and biochemical observations have documented graft function up to 14 months. The mechanism of cessation of function of implanted cultured cell suspension remains unknown. Some parameters, suggest a rejection mechanism but other mechanisms can not be excluded. This suggests that some form of immune modulation may be necessary to improve further PT allograft survival in recipients off immunosuppressive therapy.

[Allotransplantation of the parathyroid in patients without immunosuppression]. / Allotransplantacja przytarczyc u chorych bez immunosupresji.

Eighteen patients with postoperative insufficiency (after thyroid operations) have been treated with cultured, hormonally active, living and ABO the same group type parathyroid cells. Explants had been taken from 2 operated patients with secondary hyperparathyroidism. Hormonal activity of the transplanted parathyroid cells under the fascia of the brachio-radialis muscle has been confirmed by clinical, biochemical tests and the level of PTH in blood serum from the vein of non-grafted arm. Hormonal activity of the graft was variable but lasted up to 14 months.

[Results of conservative treatment in patients with atheromatous obstruction of arteries in the leg]. / Ocena leczenia zachowawczego chorych z miazdzycowa niedroznoscia tetnic podudzi.

Late results of the treatment of 107 patients with crural arteries occlusion (21 (20%) with isolated lesions and 86 (80%) with multisegmental lesions) were evaluated. Favourable result of the conservative treatment was achieved in 38% of patients with isolated lesions, no improvement in 38%, and worsening in one patient were noted during a 5-year follow up. Percentage in the group of patients with multisegmental lesions (including crural arteries) was 23%, 50%, and 27%, respectively. No patients with isolated lesions died during follow up period, whereas 11 (13%) patients with multisegmental lesions died.