A brief bedside visual art intervention decreases anxiety and improves pain and mood in patients with haematologic malignancies.

Treatment of cancer-related symptoms represents a major challenge for physicians. The purpose of this pilot study was to determine whether a brief bedside visual art intervention (BVAI) facilitated by art educators improves mood, reduces pain and anxiety in patients with haematological malignancies. Thirty-one patients (21 women and 10 men) were invited to participate in a BVAI where the goal of the session was to teach art technique for ~30 min. Primary outcome measures included the change in visual analog scale, the State-Trait Anxiety Inventory and the Positive and Negative Affect Schedule scale, from baseline prior to and immediately post-BVAI. Total of 21 patients (19 women and two men) participated. A significant improvement in positive mood and pain scores (p = .003 and p = .017 respectively) as well as a decrease in negative mood and anxiety (p = .016 and p = .001 respectively) was observed. Patients perceived BVAI as overall positive (95%) and wished to participate in future art-based interventions (85%). This accessible experience, provided by artists within the community, may be considered as an adjunct to conventional treatments in patients with cancer-related mood symptoms and pain, and future studies with balanced gender participation may support the generalisability of these findings.

[Persistent swelling after flushing of an abscess with Octenisept®]. / Persistierende Schwellung nach Spülung eines Abszesses mit Octenisept®.

We report the case of a long-lasting cutaneous side effect after inappropriate use of Octenisept® solution (containing octenidine and phenoxyethanol). Following lavage of an abscess in the inguinal region, a painful erythematous induration mimicking cellulitis persisted for several months. Manual lymphatic drainage considerably improved the symptoms. Octenisept® shows considerable tissue toxicity in vivo including - but not restricted to - blood vessel damage. Deterioration of endothelial cells followed by oedema and continued tissue damage can be seen histologically. Despite the fact that there is a circular letter issued by the manufacturer as well as a boxed warning on the bottles, the awareness to avoid this misuse of Octenisept® is still lacking.

The traditional Chinese medicine Cordyceps sinensis and its effects on apoptotic homeostasis.

Cordyceps sinensis is a medicinal fungus of Traditional Chinese Medicine. While there are a wide range of reported uses of Cordyceps sinensis in the literature, the reports that extracts of this fungus may alter apoptotic homeostasis are most intriguing. However, there are significant challenges regarding research surrounding Cordyceps sinensis, such as the difficulty identifying the various species of Cordyceps and the many conflicting reports of pharmacological function in the literature. In this review we outline what is known about the ability of Cordyceps sinensis to alter apoptotic homeostasis, attempt to reconcile the differences in reported function, identify the challenges surrounding future Cordyceps sinensis research, and delineate options for overcoming these critical hurdles.

Bioprospecting Rumphius's Ambonese Herbal: Volume I.

Collaborating with traditional healers remains a valid method for the identification of potential lead compounds for novel pharmaceuticals. However, the knowledge of these traditional healers is rapidly being lost. Historic herbal texts provide a unique window to identify plants whose specific uses are no longer known. We have identified nine plants in the 17th century Ambonese Herbal: Volume I which were documented as having medicinal properties but which have not been examined in the current literature. We demonstrate that by evaluating plant and herb efficacy reports from historic texts, in the context of comprehensive modern databases such as NAPRALERT, we can ultimately identify candidate specimens deserving further pharmacological study.

Cordyceps sinensis extracts do not prevent Fas-receptor and hydrogen peroxide-induced T-cell apoptosis.

Aqueous and alcohol extracts of Cordyceps sinensis (Berk) Succ. are used as a traditional medicine in China for the treatment of a wide range of diseases and are reported to have antioxidant and antiapoptotic properties. We therefore examined the ability of aqueous, organic, and alcohol extracts of Cordyceps sinensis to inhibit apoptosis induced either by hydrogen peroxide or Fas-receptor ligation; both stimuli induce apoptosis dependent on reactive oxygen species. Cells pre-incubated with Cordyceps sinensis extracts were equally sensitive to hydrogen peroxide and Fas-mediated apoptosis. Thus, the putative antioxidant and antiapoptotic properties of Cordyceps sinensis are insufficient to rescue cells from apoptosis induced by these stimuli in vitro.

Herbal therapy: what a clinician needs to know to counsel patients effectively.

The use of herbal medicine in the United States has been increasing at a steady pace over the past decade. Most recent estimates suggest that the US population spends $5 billion per year for herbal supplements alone. Herbal supplements are receiving increasing exposure through national media, in lay journals, and more recently in the scientific press. Interest in herbal medicine has been facilitated by multiple factors, including the perception that pharmaceutical medications are expensive, overprescribed, and often dangerous. Alternatively, herbal medicine is often perceived as being "natural" and is therefore considered safe. While the growth of the herbal medicine industry in the United States can probably not continue at this accelerated pace indefinitely, there is little indication of any major slowing. Therefore, patients will continue to use herbal medications. Knowledge of these preparations (including their potential benefits and risks as well as their ability to interact with pharmaceutical medications) will enable physicians to provide a balanced and objective view to patients seeking information on herbal therapy.

In-vivo measurements of regional acetylcholine esterase activity in degenerative dementia: comparison with blood flow and glucose metabolism.

UNLABELLED: Memory and attention are cognitive functions that depend heavily on the cholinergic system. Local activity of acetylcholine esterase (AChE) is an indicator of its integrity. Using a recently developed tracer for positron emission tomography (PET), C-11-labeled N-methyl-4-piperidyl-acetate (C11-MP4A), we measured regional AChE activity in 4 non-demented subjects, 4 patients with dementia of Alzheimer type (DAT) and 1 patient with senile dementia of Lewy body type (SDLT), and compared the findings with measurements of blood flow (CBF) and glucose metabolism (CMRGlc). Initial tracer extraction was closely related to CBF. AChE activity was reduced significantly in all brain regions in demented subjects, whereas reduction of CMRGlc and CBF was more limited to temporo-parietal association areas. AChE activity in SDLT was in the lower range of values in DAT. Our results indicate that, compared to non-demented controls, there is a global reduction of cortical AChE activity in dementia. KEYWORDS: Dementia, cholinergic system, acetylcholine esterase, positron emission tomography, cerebral blood flow, cerebral glucose metabolism.

Drug-induced headache: long-term results of stationary versus ambulatory withdrawal therapy.

Drug-induced headache is a well-known complication of the treatment of primary headache disorders, and its successful management is only possible by withdrawal therapy. However, it is unknown whether ambulatory or stationary withdrawal is the therapy preferred. We conducted a prospective study on the outcome of stationary versus ambulatory withdrawal therapy in patients with drug-induced headache according to the International Headache Society criteria. Out of 257 patients with the diagnosis of drug-induced headache during the study period, 101 patients (41 after ambulatory and 60 after stationary withdrawal therapy) could be followed up for 5.9 +/- 4.0 years. The total relapse rate after successful withdrawal therapy was 20.8% (14.6% after ambulatory and 25.0% after stationary withdrawal therapy, p < 0.2). The main risk factors for a relapse were male sex (OR = 3.9, CI = 1.3-11.6), intake of combined analgesic drugs (OR = 3.8, CI = 1.4-10.3), administration of naturopathy (OR = 6.0, CI = 1.2-29.3), and a trend to tension-type headache as the primary headache disorder (OR = 1.9, CI = 0.6-53.0). Our data suggest that neither the method of withdrawal therapy nor the kind of analgesic and other antimigraine drugs has a major impact on the long-term result after successful withdrawal therapy. Patients with risk factors according to our findings should be informed and monitored regularly, and combined drugs should be avoided. Furthermore, our data suggest that there is a need for research on individual psychological and behavioral risk factors for relapse after successful withdrawal therapy in drug-induced headache.

Novel glycoinositolphosphosphingolipids, basidiolipids, from Agaricus.

From the edible mushroom, the basidiomycetes Agaricus bisporus and Agaricus campestris, a novel carbohydrate-homologous series of four glyco-inositol-phospho-sphingolipids, designated basidiolipids, was isolated and the constituents purified. The chemical structures of the basidiolipids were elucidated to be: Manpbeta1-2inositol1-phospho-ceramide, Galpalpha-6[Fucpalpha-2]Galpbeta-6Manpbeta-2i nositol1-phospho-ceramide, Galpalpha-6Galpalpha-6[Fucpalpha-2]Galpbeta- 6Manpbeta-2inositol1-phospho-ceramide and Galpalpha-6Galpalpha-6Galpalpha-6[Fucpalpha-2] Galpbeta-6Manpbeta-2ino sitol1-phospho-ceramide. All four glycolipids contained a ceramide which was composed of phytosphingosine and predominantly alpha-hydroxy-behenic and alpha-hydroxy-lignoceric acid.

Extracellular glutathione peroxidase and ascorbic acid in aqueous humor and serum of patients operated on for cataract.

Patients operated on for cataract (32 men/75 women, aged 50-93 years) were studied with respect to antioxidative agents in aqueous humor and serum. Extracellular glutathione peroxidase (eGSHPx) was demonstrated in aqueous humor for the first time by a radioimmunoassay, the concentration of eGSHPx being 0.66(0.18) mg/l (mean(S.D.)). The concentration of eGSHPx in serum was 3.81(0.84) mg/l, and its level in aqueous humor was 18(7)% of that level. Serum selenium had positive correlations with both serum eGSHPx (r = 0.34, P < 0.001) and aqueous humor eGSHPx (r = 0.25, P = 0.011). However, there was no relation between the concentrations of eGSHPx in aqueous humor and in serum, suggesting that the maintenance of eGSHPx levels in the two fluids is controlled by different mechanisms beside selenium status. There was an inverse correlation between age and serum eGSHPx but not with aqueous humor eGSHPx. The concentration of ascorbic acid in aqueous humor was 2.04(0.58) mmol/l, and it was closely correlated to the level of ascorbic acid in serum (0.052(0.032) mmol/l), r = 0.58 (P < 0.001). The ratio between the level of ascorbic acid in aqueous humor and that in serum was 39(17). There was no significant difference among patients with nuclear (n = 39), cortical (n = 20), posterior-subcapsular (n = 23) or mixed (n = 23) lens opacity with respect to levels of eGSHPx and ascorbic acid in serum and aqueous humor. Since serum ascorbic acid is related to ascorbic acid intake, its association to aqueous humor ascorbic acid indicates that dietary habits are important for maintaining that level which could play an important role in protecting ocular tissue against oxidative damage. The role of eGSHPx secreted into aqueous humor in the oxidant defence system needs further study.

Stimulus dimensionality effects in mental rotation.

Do 3-dimensional (3-D) figures require more time to rotate mentally than do 2-dimensional (2-D) figures? This question was examined in 2 experiments incorporating 15 2-D and 15 3-D stimuli. For 3-D stimuli, block figures were used of the type used by R. N. Shepard and J. Metzler in their classic studies. For 2-D stimuli, block figures were also used, but with all cubes in a single plane, resulting in 2-D and 3-D figures matched on surface features. Three-D figures elicited steeper slopes than did 2-D figures, supporting the view that the mental rotation of visual representations is sensitive to stimulus dimensionality. The authors summarize the results of several mental rotation studies that investigated stimulus dimensionality and suggest that the evidence across studies is consistent with the present finding. They discuss 2 plausible loci for the dimensionality effect in S. M. Kosslyn's (1980) theory of mental imagery.

Effects of monophosphoryllipid-A on the immunization of mice with keyhole limpet hemocyanin- and muramyldipeptide-ganglioside Gfpt1 conjugates.

Since it was considered that an active immunization against ganglioside Gfpt1 (IV2Fuc-, II3NeuAc-Gg4Cer) expressed by human small cell lung cancer cells may be beneficial in the treatment of this neoplasm in humans, an optimal mode of vaccination in model mice was investigated. A novel Gfpt1-muramyldipeptide conjugate (Gfpt1-MDP) was synthesized. Its ganglioside carbohydrate-directed immunogenicity in mice as measured by serum antibody titers was comparable to that of the previously described Gfpt1-keyhole limpet hemocyanin conjugate (Gfpt1-KLH). Similar immunogenicity was displayed by free Gfpt1 in muramyldipeptide-phosphoethanolamine-containing phosphatidyl-choline, -serine (PC,PS) liposomes. Immunization with Gfpt1-vaccines in the presence of monophosphoryllipid A (MPL), in general, raised titers of anti-Gfpt1 antibodies effectively. Immunization with PC, PS-liposomes containing unconjugated Gfpt1 and MPL stimulated the highest titers observed, thereby effectively preventing tumor growth in Balbc nu/nu-mice challenged with human small cell lung cancer cells. However, there was a strong crossreaction of these and most other sera with the structurally related and widely distributed ganglioside Gtet1 (II3NeuAc-Gg4Cer). Only immunization with Gfpt1-KLH conjugate in the presence of MPL stimulated selectively high anti-Gfpt1 antibody titers showing comparably low crossreactivity to ganglioside Gtet1.

Malignant transformation of benign gliomas during interstitial irradiation.

Interstitial curietherapy with 125-Iodine is an effective therapeutic option in the treatment of low grade gliomas. Four cases with astrocytoma grade II are presented, where tumour growth characteristics have changed to anaplasia during interstitial irradiation after a primary period of tumour regression. Anaplastic transformation could be due to a radiation effect or an insufficient therapeutic influence of interstitial irradiation on natural tumour progression of glioma growth due to genetic events.

Dorsal column stimulation (DCS): cost to benefit analysis.

In order to analyse the ratio of costs to clinical benefit of the implantation of a neurostimulator (type Medtronic SE-4) we examined a group of 14 patients who required treatment for chronic lumboischialgia after repeated surgery for herniated discs. Over a period of two years we evaluated the pre- and postimplantation costs. The implantation of a DC-Stimulator resulted in a striking decrease in drug requirements, in the total time of clinical treatment, and in the degree of disability. The DCS provides a satisfying method of treatment for chronic lumboischialgia after repeated surgery for herniated discs. Despite relatively high primary costs, treatment with a DCS results in a significant decrease in the accumulated expenses in comparison to other methods of medical treatment in similar cases.