Efficacy of intermittent epidural dexamethasone bolus for zoster-associated pain beyond the acute phase.

Herpes zoster develops when latent varicella zoster virus is reactivated in the trigeminal or dorsal root ganglions. Zoster-associated pain (ZAP) is neuropathic pain caused by the herpes zoster virus. Histological studies of postherpetic neuralgia patients suggest that inflammation is involved in ZAP. The effectiveness of local anesthetic and steroid epidural injections in ZAP patients has been reported. However, most studies included patients with acute herpes zoster, and the safety and therapeutic effects of different doses of epidural steroids in ZAP patients remain elusive. In this study, we randomly assigned 42 patients with severe ZAP beyond the acute phase, as determined by a numeric rating scale (NRS) score ≥7, to receive continuous epidural infusion of local anesthetics with either a one-time 5-mg dose or intermittent repeated doses (15 mg total) of dexamethasone. We found that intermittent repeated epidural dexamethasone bolus resulted in reduced NRS scores and an increased likelihood of complete remission in ZAP patients without any adverse effects. Thus, our results suggest that intermittent repeated epidural dexamethasone administration is safe and effective for treatment of ZAP beyond the acute phase.

Analysis of prenylflavonoids from aerial parts of Epimedium grandiflorum and dietary supplements using HPTLC, UHPLC-PDA and UHPLC-QToF along with chemometric tools to differentiate Epimedium species.

An UHPLC method was developed for the determination of 15 prenylflavonoids from aerial parts of Epimedium grandiflorum and related species (Berberidaceae). The separation was achieved using a reverse phased column and water/acetonitrile gradient as a mobile phase at a temperature of 40°C. The developed analytical method was validated for linearity, limits of detection (LOD) and limits of quantification (LOQ), stability and repeatability. The LOD and LOQ were found to be in the range from 0.1-0.5 µg/mL and 0.3-1 µg/mL, respectively. The wavelength used for quantification with the photodiode array detector was 269 nm. The total content of 15 prenylflavonoids was 9.1-20.6 mg/g for E. grandiflorum (except for sample #2899 and #20862), 5.6-35.4 mg/g for E. brevicornu and 10.8-30.5 mg/g for E. sagittatum. Twenty dietary supplements contained in the range from 0.1 to 81.7 mg/day. The developed method is simple, rapid and especially suitable for quality assessment of E. grandiflorum and dietary supplements containing E. grandiflorum. Liquid chromatography quadrupole time-of-flight-mass spectrometry (LC-QToF) is described for the identification and confirmation of compounds in plant samples and dietary supplements. This technique is also used for chemical profiling of Epimedium samples. This method involved the use of protonated ions in the positive ion mode and deprotonated ions in the negative ion mode with extracted ion chromatogram (EIC). Chemometric analytical tools for visualizing the plant and commercial samples quality were used for discriminating between Epimedium species and dietary supplements with regards to the relative content or presence of components. A HPTLC method was also developed for the fast chemical fingerprint analysis of Epimedium species.

Anatomical characterization and LC-MS profiling of Adenophora roots from Korea

ABSTRACT "Sasam (沙參)" is a crude drug that is defined in the in Korean Herbal Pharmacopoeia as the root of Adenophora triphylla var. japonica (Regel.) Hara or A. stricta Miq., Campanulaceae. The dried roots of the Adenophora spp. are available in markets, and the roots of various species are similar to each other in shape, making it difficult to distinguish one from another using only the outer morphological appearance. Therefore, the present study aimed to establish quality control parameters for pharmacognostic evaluation and differentiation of five Adenophora species and two varieties grown in Korea. Inner morphological evaluation of the root of these plants was accomplished and preliminary chemical analysis was performed by liquid chromatography-mass spectrometry profiling. As a result, significant differences among samples were found in anatomical characteristics such as number and thickness of cork layer, existence of stone cell in cork layer, frequency of vessels, and area of intercellular space. Significant differences were found among the samples in the content of three components including shashenoside I and a new alkyl glycoside, adenophoroside I. These findings could provide the scientific criteria for the proper identification and establishment of standards for the use of "Sasam".

Inner morphological and chemical differentiation of Boehmeria species.

The present study was designed to establish quality control parameters for pharmacognostic evaluation and differentiation of eight locally derived Boehmeria species, B. gracilis, B. nivea, B. pannosa, B. platanifolia, B. quelpaertensis, B. spicata, B. splitgerbera, B. tricuspis, and two varieties named B. japonica var. longispica, B. nivea var. concolor, which have been utilized as the folk medicine, 'Mo-Si-Pool' in Korea. Although the outer morphological study of these species had been reported, there is no pharmacognostical description yet. Therefore, inner morphological evaluation on leaf midrib, petiole and stem of eight Boehmeria species and two varieties was accomplished along with preliminary phytochemical analysis by HPLC-DAD profiling. The microscopic data showed discriminative inner morphological characteristics such as collenchyma cell layer, thickness of cortex and xylem, frequency of druse and hairs, and number of vascular bundles. The HPLC profiles exhibited more than four characteristic peaks. The molecular ions of the four peaks (1-4) were tentatively identified by ESI-MS, and their structures were identified by NMR spectroscopy to be the flavonoids, rutin (1), isoquercetin (2) and kaempferol-3-O-rutinoside (3), and a phenanthroquinolizidine alkaloid, (-)-cryptopleurine (4). While compounds 1 and 2 were detected in all samples, compound 4 was determined only in B. japonica var. longispica, B. pannosa and B. quelpaertensis and B. splitgerbera. These findings provide the initial scientific criteria for proper identification and establishment of standards for use of Boehmeria species in traditional medicine.

Novel Plasminogen Activator Inhibitor-1 Inhibitors Prevent Diabetic Kidney Injury in a Mouse Model.

Diabetic nephropathy is the leading cause of end-stage renal disease worldwide, but no effective therapeutic strategy is available. Because plasminogen activator inhibitor-1 (PAI-1) is increasingly recognized as a key factor in extracellular matrix (ECM) accumulation in diabetic nephropathy, this study examined the renoprotective effects of TM5275 and TM5441, two novel orally active PAI-1 inhibitors that do not trigger bleeding episodes, in streptozotocin (STZ)-induced diabetic mice. TM5275 (50 mg/kg) and TM5441 (10 mg/kg) were administered orally for 16 weeks to STZ-induced diabetic and age-matched control mice. Relative to the control mice, the diabetic mice showed significantly increased (p < 0.05) plasma glucose and creatinine levels, urinary albumin excretion, kidney-to-bodyweight ratios, glomerular volume, and fractional mesangial area. Markers of fibrosis and inflammation along with PAI-1 were also upregulated in the kidney of diabetic mice, and treatment with TM5275 and TM5441 effectively inhibited albuminuria, mesangial expansion, ECM accumulation, and macrophage infiltration in diabetic kidneys. Furthermore, in mouse proximal tubular epithelial (mProx24) cells, both TM5275 and TM5441 effectively inhibited PAI-1-induced mRNA expression of fibrosis and inflammation markers and also reversed PAI-1-induced inhibition of plasmin activity, which confirmed the efficacy of the TM compounds as PAI-1 inhibitors. These data suggest that TM compounds could be used to prevent diabetic kidney injury.

Short-term Treatment of Daumone Improves Hepatic Inflammation in Aged Mice.

Chronic inflammation has been proposed as one of the main molecular mechanisms of aging and age-related diseases. Although evidence in humans is limited, short-term calorie restriction (CR) has been shown to have anti-inflammatory effects in aged experimental animals. We reported on the long-term treatment of daumone, a synthetic pheromone secreted by Caenorhabditis elegans in an energy deficient environment, extends the life-span and attenuates liver injury in aged mice. The present study examined whether late onset short-term treatment of daumone exerts anti-inflammatory effects in the livers of aged mice. Daumone was administered orally at doses of 2 or 20 mg/kg/day for 5 weeks to 24-month-old male C57BL/6J mice. Increased liver macrophage infiltration and gene expression of proinflammatory cytokines in aged mice were significantly attenuated by daumone treatment, suggesting that short-term oral administration of daumone may have hepatoprotective effects. Daumone also dose-dependently suppressed tumor necrosis factor-α (TNF-α)-induced nuclear factor-κB (NF-κB) phosphorylation in HepG2 cells. The present data demonstrated that short-term treatment of daumone has anti-inflammatory effects in aged mouse livers possibly through suppression of NF-κB signaling and suggest that daumone may become a lead compound targeting aging and age-associated diseases.

Effects of ultrasound-guided stellate ganglion block on acute pain after arthroscopic shoulder surgery.

BACKGROUND AND OBJECTIVES: Apart from a few case reports, the effectiveness of stellate ganglion block (SGB) as a monotherapy in acute nociceptive pain has not been determined. We aimed to assess the effects of SGB on postoperative pain after arthroscopic shoulder surgery. STUDY DESIGN: Randomized, blind, controlled, clinical trial SETTING: University Hospital outpatient METHODS: Forty-six patients undergoing arthroscopic shoulder surgery were assigned randomly to 2 groups: group S included patients who underwent SGB prior to surgery and group C did not. In group S, subfascial ultrasound-guided SGB was conducted with 4 mL of 0.375% levobupivacaine. For the first postoperative 48 hours, postoperative visual analog scale (VAS) and analgesic requirements were compared. RESULTS: The results of 40 patients were included in the study. There was no difference between groups with regards to analgesics requirement for the first postoperative 48 hours and no difference in VAS score (P > 0.05). LIMITATIONS: Small number of patients in study. CONCLUSION: Preoperative ultrasound-guided SGB did not reduce postoperative acute pain in arthroscopic shoulder surgery.

Differences in the chemical profiles and biological activities of Paeonia lactiflora and Paeonia obovata.

Paeonia lactiflora and P. obovata are perennial herbs, each root of which has been consumed as a major oriental medicine, Paeoniae Radix and a famous folk medicine, Mountain Paeony Root, respectively. Although morphological studies have been performed comparing these two plants, there is insufficient scientific evidence that characterizes the differences in their chemical profiles and biological activities. Hence, the present study was undertaken to compare these two medicinal foods using a high-performance liquid chromatography-diode-array detector (HPLC-DAD) analysis and a gastric ulcer model in mice. HPLC analysis employed to assess the nine components revealed that P. lactiflora exhibited higher contents of phenolic compounds than P. obovata. Although a monoterpene glycoside, 6'-O-acetylpaeoniflorin was identified in P. obovata, it was not detected in P. lactiflora. Multivariate statistical analysis for HPLC data revealed that the orthogonal projections to latent structure-discriminant analysis is more appropriate than principal component analysis for differentiating the two groups. Moreover, the 50% methanol P. lactiflora extract (PL) was more effective against experimental gastric ulcer than P. obovata extract (PO) in the HCl/ethanol-induced ulcer model. In addition, PL displayed higher 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity and lower nitric oxide production in a murine macrophage cell line, RAW 264.7, than PO. The DPPH radical scavenging activity of PL was as high as that of the positive control, butylated hydroxytoluene, at a concentration of 25 µg/mL.

Daumone fed late in life improves survival and reduces hepatic inflammation and fibrosis in mice.

The liver is one of the most susceptible organs to aging, and hepatic inflammation and fibrosis increase with age. Chronic inflammation has been proposed as the major molecular mechanism underlying aging and age-related diseases, whereas calorie restriction has been shown to be the most effective in extending mammalian lifespan and to have anti-aging effects through its anti-inflammatory action. Thus, it is necessary to develop effective calorie restriction mimetics. Daumone [(2)-(6R)-(3,5-dihydroxy-6-methyltetrahydropyran-2-yloxy)heptanoic acid], a pheromone secreted by Caenorhabditis elegans, forces them to enter the dauer stage when facing inadequate conditions. Because Caenorhabditis elegans live longer during the dauer stage under energy deprivation, it was hypothesized that daumone may improve survival in mammals by mimicking calorie restriction. Daumone (2 mg kg(-1) day(-1) ) was administered orally for 5 months to 24-month-old male C57BL/6J mice. Daumone was found to reduce the risk of death by 48% compared with age-matched control mice, and the increased plasma insulin normally presented in old mice was significantly reduced by daumone. The increased hepatic hypertrophy, senescence-associated ß-galactosidase activity, insulin resistance, lipid accumulation, inflammation, oxidative stress, and fibrosis in old mice were significantly attenuated by daumone. From a mechanistic view, daumone reduced the phosphorylation of the IκBα and upregulation of Rela and Nfkbia mRNA in the livers of old mice. The anti-inflammatory effect of daumone was confirmed in lipopolysaccharide-induced liver injury model. Oral administration of daumone improves survival in mice and delivers anti-aging effects to the aged liver by modulating chronic inflammation, indicating that daumone could be developed as an anti-aging compound.

Human umbilical cord blood-derived mesenchymal stem cells prevent diabetic renal injury through paracrine action.

AIMS: The present study examined renoprotective effect of human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSC) in diabetes. NRK-52E cells were utilized to determine the paracrine effect of hUCB-MSC. METHODS: hUCB was harvested with the mother's consent. MSC obtained from the hUCB were injected through the tail vein. Growth arrested and synchronized NRK-52E cells were stimulated with transforming growth factor-ß1 (TGF-ß1) in the presence of hUCB-MSC conditioned media. RESULTS: At 4 weeks after the streptozotocin (STZ) injection, diabetic rats showed significantly increased urinary protein excretion, renal and glomerular hypertrophy, fractional mesangial area, renal expression of TGF-ß1 and α-smooth muscle actin, and collagen accumulation but decreased renal E-cadherin and bone morphogenic protein-7 expression, confirming diabetic renal injury. hUCB-MSC effectively prevented diabetic renal injury except renal and glomerular hypertrophy without a significant effect on blood glucose. CM-DiI-labeled hUCB-MSC and immunostaining of PKcs, a human nuclei antigen, confirmed a few engraftment of hUCB-MSC in diabetic kidneys. hUCB-MSC conditioned media inhibited TGF-ß1-induced extracellular matrix upregulation and epithelial-to-mesenchymal transition in NRK-52E cells in a concentration-dependent manner. CONCLUSIONS: These results demonstrate the renoprotective effect of hUCB-MSC in STZ-induced diabetic rats possibly through secretion of humoral factors and suggest hUCB-MSC as a possible treatment modality for diabetic renal injury.

Determination of daumone in mouse plasma by HPLC/MS-MS.

Daumone, a pheromone secreted by Caenorhabditis elegans, is an essential regulator of chemosensory processes in development and aging. A quantification method using HPLC/MS-MS was developed for the determination of daumone in mouse plasma. After simple protein precipitation with acetonitrile including methaqualone (an internal standard), the analytes were chromatographed on a reversed-phase column and detected by liquid chromatography/tandem mass spectrometry with electrospray ionization. The accuracy and precision of the assay were in accordance with FDA regulations for validation of bioanalytical methods. This method was applied to measure the plasma daumone concentrations following a 5-week repeated oral administration of daumone in mice.

Rhododendrin, an analgesic/anti-inflammatory arylbutanoid glycoside, from the leaves of Rhododendron aureum.

To identify an analgesic/anti-inflammatory component from the leaves of Rhododendron aureum (Ericaceae), phytochemical isolation and pharmacological assays (writhing assays and vascular permeability assay for analgesic action in mice; carrageenan-induced paw edemaand TPA-induced ear edema assays of anti-inflammatory action in rats) were performed. Four compounds were isolated from the active fraction (BuOH fraction) by silica gel column chromatography and identified as (-)-rhododendrol, (-)-rhododendrin, avicularin and hyperoside by spectroscopic methods. Rhododendrin, the main compound of the BuOH fraction, exhibited significant analgesic actions in mice and anti-inflammatory actions in rats. This compound accounted for 3.1% of the MeOH extract and 0.48% of dried leaves, respectively, on HPLC analysis. These results suggest that rhododendrin is the major biologically active substance in the leaves of R. aureum with analgesic/anti-inflammatory activity.

Quantitative determination of daumone in rat plasma by liquid chromatography-mass spectrometry.

Daumone, 6-(3,5-dihydroxy-6-methyl-tetrahydro-pyran-2-yloxy)-heptanoic acid is a pheromone secreted by Caenorhabditis elegans, and has been known as a pivotal regulator of chemosensory processes in development and ageing. A quantification method using mass spectrometry was developed for the determination of daumone in rat plasma. After simple protein precipitation with acetonitrile including an internal standard, the analytes were chromatographed on a reversed-phase column and detected by liquid chromatography/tandem mass spectrometry with electrospray ionization. The accuracy and precision of the assay were in accordance with FDA regulations for validation of bioanalytical methods. This method was applied to measure the plasma daumone concentrations after a single intravenous administration of daumone in rats.

Alkaloids from Papaver coreanum.

The alkaloid pattern of the endemic plant Papaver coreanum Nakai (Papaveraceae) was determined for the first time. Eight alkaloids could be identified by LC/ESI-MS/MS and high-resolution mass spectrometry. Among them, protopine and allocryptopine represent the main components. Besides norsanguinarine, sanguinarine, dihydrosanguinarine, oxysanguinarine, lincangenine, and cryptopine, some other trace alkaloids were found whose structures remain unknown.

Learning to perceive structure from motion and neural plasticity in patients with Alzheimer's disease.

Recent research has demonstrated that Alzheimer's disease (AD) affects the visual sensory pathways, producing a variety of visual deficits, including the capacity to perceive structure-from-motion (SFM). Because the sensory areas of the adult brain are known to retain a large degree of plasticity, the present study was conducted to explore whether the degradation of a visual function impaired by AD can be reversed or slowed through perceptual learning. Whereas many studies directed at learning in AD examined learning capacities involving the implicit memory system, a largely preserved system in AD, the present study focused on perceptual learning involving visual deficits impaired by AD. Patients with mild or moderately severe AD (N=8 in each group) were presented with computer displays depicting SFM. Participants completed three sessions a day on three consecutive days with each session comprised of 48 trials. Displays showed eight different geometric solids rendered in three densities of a random dot texture. Participants identified the displayed object by pointing to a corresponding wooden object. Results showed impaired capacity for motion perception and SFM perception in both AD groups. However, performance of patients with mild AD improved over the nine sessions, whereas that of patients with moderate AD remained unchanged. These results suggest that the cortical circuits for SFM are still plastic in the mild AD stage.

Two new flavonol glycosides from Lamium amplexicaule L. and their in vitro free radical scavenging and tyrosinase inhibitory activities.

Two new flavonol glycosides, kaempferol 3-O-[beta-D-glucopyranosyl-(1-->4)][alpha-L-rhamnopyranosyl-(1-->6)]-beta-D-glucopyranoside and quercetin 3-O-[beta-D-glucopyranosyl-(1-->4)][alpha-L-rhamnopyranosyl-(1-->6)]-beta-D-glucopyranoside, together with three known flavonoids were isolated using column chromatography from the aerial parts of Lamium amplexicaule (Labiatae). In addition, the five isolates were evaluated for their in vitro free radical scavenging (EC50 values, 14.1-63.9 microg/mL) and tyrosinase inhibitory activities (IC50 values, 110.4-193.5 microg/mL).

Role of reactive oxygen species in the pathogenesis of diabetic nephropathy.

There is an increasing evidence that reactive oxygen species (ROS) play a major role in the development of diabetic complications. Oxidative stress is increased in diabetes and the overproduction of ROS in diabetes is a direct consequence of hyperglycemia. Various types of vascular cells including renal cells are able to produce ROS under hyperglycemic condition. Both NADPH oxidase and mitochondrial electron gradient play roles in hyperglycemia-induced ROS generation. In addition to their ability to directly inflict macromolecular damage, ROS can function as signaling molecules. ROS mediate hyperglycemia-induced activation of signal transduction cascades and transcription factors leading to transcriptional activation of profibrotic genes in the kidney. Furthermore, ROS-activated signaling molecules generate and signal through ROS and thus ROS act as a signal amplifier. Intensive glycemic control and inhibition of angiotensin II delay the onset and progression of diabetic nephropathy, in part, through prevention of overproduction of ROS. Conventional and catalytic antioxidants have been shown to prevent or delay the onset of diabetic nephropathy. Combination of strategies to prevent overproduction of ROS and to increase the removal of preformed ROS may prove to be effective in preventing the development and progression of diabetic nephropathy.

In vitro neuroprotective activities of phenylethanoid glycosides from Callicarpa dichotoma.

Ten phenylethanoid glycosides, forsythoside B, acteoside, 2'-acetylacteoside, poliumoside, brandioside, echinacoside, isoacteoside, cistanoside H and E-tubuloside E as well as a new compound, Z-tubuloside E, were isolated from the n-BuOH fraction of Callicarpa dichotoma Raeuschel (Verbenaceae) by bioactivity-guided fractionation using glutamate-injured primary cultures of rat cortical cells as a screening system. These phenylethanoid glycosides significantly attenuated glutamate-induced neurotoxicity at concentrations ranging from 0.1 to 10 microM.

Antimutagenic constituents from the thorns of Gleditsia sinensis.

Antimutagenic activity-guided fractionation of an extract prepared from the thorns of Gleditsia sinensis LAM. led to the isolation of one triterpenoid and four steroids, which were identified as D:C-friedours-7-en-3-one (1), stigmast-4-ene-3,6-dione (2), stigmastane-3,6-dione (3), stigmasterol (4), and beta-sitosterol (5). Triterpenoid 1 was found for the first time in a natural source and the steroids 2-5 were first isolated from this plant. Stigmasterol was the most active antimutagen, showing 51.2% and 64.2% reduction of the induction factor against the mutagens MNNG and NQO, respectively, in the SOS chromotest. Some NMR data of the steroids 2 and 3 obtained have to be revised.

Two new acylated iridoid glucosides from the aerial parts of Paederia scandens.

Two new acylated iridoid glucosides were isolated from the aerial parts of Paederia scandens along with six known iridoid glucosides. The structures of two new compounds were elucidated as 6'-O-E-feruloylmonotropein (1) and 10-O-E-feruloylmonotropein (2) by spectroscopic methods.