Production of Siamenoside I and Mogroside IV from Siraitia grosvenorii Using Immobilized ß-Glucosidase.

Siraitia grosvenorii is a type of fruit used in traditional Chinese medicine. Previous studies have shown that the conversion of saponins was often carried out by chemical hydrolysis, which can be problematic because of the environmental hazards it may cause and the low yield it produces. Therefore, the purpose of this study is to establish a continuous bioreactor with immobilized enzymes to produce siamenoside I and mogroside IV. The results show that the immobilization process of ß-glucosidase exhibited the best relative activity with a glutaraldehyde (GA) concentration of 1.5%, carrier activation time of 1 h and binding enzyme time of 12 h. After the immobilization through GA linkage, the highest relative activity of ß-glucosidase was recorded through the reaction with the substrate at 60 °C and pH 5. Subsequently, the glass microspheres with immobilized ß-glucosidase were filled into the reactor to maintain the optimal active environment, and the aqueous solution of Siraitia grosvenorii extract was introduced by controlling the flow rate. The highest concentration of siamenoside I and mogroside IV were obtained at a flow rate of 0.3 and 0.2 mL/min, respectively. By developing this immobilized enzyme system, siamenoside I and mogroside IV can be prepared in large quantities for industrial applications.

Anti-cancer therapeutic benefit of red guava extracts as a potential therapy in combination with doxorubicin or targeted therapy for triple-negative breast cancer cells.

Guava extracts purified from leaf and bark have many bio-active molecules with anti-cancer activities. In addition, lycopene-rich extracts obtained from red guava fruit can induce apoptosis in estrogen receptor-positive breast cancers. Triple-negative breast cancer (TNBC) lacks estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2) and, therefore, hormone therapy and targeted therapy are not used in the clinic. The purpose of this study was to determine whether red guava fruit extracts can affect the proliferation of TNBC cells. In this study, cell viability was determined by using the MTT assay. Apoptosis and necrosis were analyzed using flow cytometry. Cleaved caspase-3 and PARP were analyzed by western blotting. We found that red guava extracts can, through caspase-3 activation and PARP cleavage signaling, induce apoptotic and necrotic death in TNBC cells. Our results thus show the therapeutic benefit of red guava extracts as a potential cancer treatment for TNBC in combination with doxorubicin or targeted therapy.

Heart blockage in a patient with cavitary lung lesions.

Cavitary lesions on a chest radiograph can be the manifestations of various diseases. The etiologies include abscess, mycobacterial infections, fungal infections, parasite infection, cavitary tumors, septic pulmonary embolism and vasculitis. While in comparison with the causes that could simultaneously develop a complete heart block, the differential diagnosis is limited. A 43-year-old man presented to the emergency department with a two-week history of dry cough, chest tightness and presyncopal symptoms.A chest radiograph showed patchy opacities in both lower lungs. A computed tomography of the chest revealed cavitary lesions bilaterally. The electrocardiogram showed a complete atrioventricular block. He was later diagnosed with Wegener's granulomatosis that involved nose, lung and heart. Cardiac involvements are not rare in Wegener's granulomatosis, but are not usually clinically apparent. A complete atrioventricular block is a rare but treatable manifestation of cardiac involvement usually indicating early active systemic disease. Patients presenting with cardiac abnormalities and evidence of systemic inflammation should be screened for Wegener's by history, radiographic and laboratory assessment.

Severe Type of Minocycline-Induced Hyperpigmentation Mimicking Peripheral Arterial Occlusive Disease in a Bullous Pemphigoid Patient.

Minocycline is a tetracycline group antibiotic that is known to cause significant antibacterial and anti-inflammatory effects. Minocycline has been widely used to treat systemic infection, acne, dermatitis, and rosacea. However, various dose-related side effects of hyperpigmentation in whole body tissues have been reported. Three main types of minocycline-induced hyperpigmentation have been identified. In rare severe hyperpigmentation cases, drug-induced hyperpigmentation can mimic local cellulitis or peripheral arterial occlusive disease (PAOD). These processes require different therapeutic strategies. Therefore, early diagnosis is extremely important for physicians to determine the etiology of the hyperpigmentation, and subsequently discontinue the minocycline if indicated. We describe a rare case presenting a severe form of type III minocycline-induced hyperpigmentation mimicking peripheral arterial occlusive disease in a bullous pemphigoid patient.

Syncope as Initial Presentation in an Undifferentiated Type Acute Myeloid Leukemia Patient with Acute Intracranial Hemorrhage.

Intracranial hemorrhage (ICH) is a catastrophic complication in patients with acute myeloid leukemia (AML). AML cells, especially in the acute promyelocytic leukemia subtype, may release microparticles (MPs), tissue factor (TF), and cancer procoagulant (CP) to promote coagulopathy. Hyperfibrinolysis is also triggered via release of annexin II, t-PA, u-PA, and u-PAR. Various inflammatory cytokines from cancer cells, such as IL-1ß and TNF-α, activate endothelial cells and promote leukostasis. This condition may increase the ICH risk and lead to poor clinical outcomes. Here, we present a case under a unique situation with acute ICH detected prior to the diagnosis of AML. The patient initially presented with two episodes of syncope. Rapidly progressive ICH was noted in follow-up computed tomography (CT) scans. Therefore, we highlight that AML should be among the differential diagnoses of the etiologies of ICH. Early diagnosis and timely intervention are very important for AML patients.

Pseudomyocardial infarction caused by expansion of colonic tube used for esophageal reconstruction.

Electrocardiography (ECG) is a useful tool for detecting ischemic heart disease. However, it has been pointed out that those ECG abnormalities resembling myocardial ischemia may be induced by extracardiac factors. We describe a 44-year-old man in whom a colonic tube was used for esophageal reconstruction via the anterior mediastinum after esophagectomy and gastrectomy for gastrointestinal corrosive injury. The reconstructive tube filled with gas resulted in compression of the heart and caused angina-like chest pain associated with ST-segment elevation in lead II, III and aVF on the ECG. Coronary angiography revealed no stenosis of arteries. Decompression of the colonic tube by the nasogastric tube resulted in normalization of the ECG.