Comparison of therapeutic results in sudden sensorineural hearing loss with/without additional hyperbaric oxygen therapy: a retrospective review of 465 audiologically controlled cases.

OBJECTIVE: To investigate the necessity of routine application of hyperbaric oxygen therapy for sudden sensorineural hearing loss. DESIGN/SETTING AND PARTICIPANTS: A retrospective chart review looked at 465 patients, with 353 of them receiving pharmacologic treatments alone. Among these patients, 76 underwent systemic steroid treatment only (steroid group) and 277 received systemic steroids and dextran (steroid-dextran group). The remaining 112 patients were treated with hyperbaric oxygen in addition to pharmacologic agents (steroid-dextran-hyperbaric oxygen group). MAIN OUTCOME MEASURES: The outcome was determined by comparing the difference of pure-tone thresholds and absolute hearing gains after treatment calculated at each audiometric octave frequency or grouped frequencies of audiograms. On the basis of the severity of initial hearing loss, patients were classified at three scales of hearing impairments measured in decibels hearing level (dBHL): ≦ 70 dBHL, less severe; 71-90 dBHL, severe; and ≧ 91 dBHL, profound. The outcomes of their hearing recovery were classified into three recovery grades: good, fair and poor. RESULTS: In those patients with initial hearing loss >90 dBHL, the addition of hyperbaric oxygen to steroid-dextran gave a significant hearing gain difference (P = 0.030) by showing a greater hearing gain of 24.5 ± 2.7 dB compared with steroid only (12.9 ± 3.7 dB) or steroid-dextran (15.6 ± 2.7 dB). This outcome was confirmed when we compared the outcome using the recovery grading; steroid-dextran-hyperbaric oxygen group showed that more patients with initial profound (≧ 91 dBHL) hearing loss responded to hyperbaric oxygen treatment by exhibiting good and fair recoveries (2% and 70%) as compared with steroid only (0% and 42%) or steroid-dextran (8% and 46%) groups (P = 0.043), while the patients with initial severe (71-90 dBHL) and less severe (≦ 70 dBHL) hearing loss responded to the addition of hyperbaric oxygen treatment with less favourable recoveries. Furthermore, the addition of dextran in steroid-dextran group showed no significant benefit compared with the steroid group (P = 0.435). CONCLUSIONS: When applied as an adjuvant to pharmacologic agents, hyperbaric oxygen benefits patients with initial profound sudden sensorineural hearing loss. Therefore, we recommend the routine application of hyperbaric oxygen in conjunction with pharmacologic agents for those patients. The addition of dextran to steroid has no benefit and cannot be recommended.

Composition of flavonoids and phenolic acids in lychee (Litchi Chinensis Sonn.) Flower extracts and their antioxidant capacities estimated with human LDL, erythrocyte, and blood models.

Lychee (Litchi chinensis Sonn.) flower is a major nectar source in Taiwan. Antioxidant activities of acetone, ethanol, and hot-water extracts of the flower were estimated through three biochemical models: inhibition of Cu(2+) -induced oxidation of human low-density lipoprotein, scavenging ability of oxygen radicals in human blood, and inhibition of human erythrocyte hemolysis induced by peroxyl radicals. Composition and content of flavonoids and phenolic acids in these extracts were also determined by high-performance liquid chromatography. Results showed that antioxidant effects of all test models as well as contents of flavonoids and phenolic acids for the lychee flower extracts were in the order: acetone extract > ethanol extract > hot-water extract. Gentistic acid and epicatechin were the major phenolic acid and flavonoid in the extracts, respectively.

The effects of the cyclosporin A, a P-glycoprotein inhibitor, on the pharmacokinetics of baicalein in the rat: a microdialysis study.

1. Baicalein is a bioactive flavonoid isolated from the root of Scutellaria baicalensis Georgi, a medicinal herb that has been used since ancient times to treat bacterial infections. As little is known concerning its pharmacokinetics, this study focussed on its pharmacokinetics as well as the possible roles of the multidrug transporter P-glycoprotein on its distribution and disposition. 2. Three microdialysis probes were simultaneously inserted into the jugular vein, the hippocampus and the bile duct of male Sprague-Dawley rats for sampling in biological fluids following the administration of baicalein (10, 30 and 60 mg kg(-1)) through the femoral vein. The P-glycoprotein inhibitor cyclosporin A was used to help delineate its roles. 3. The study design consisted of two groups of six rats in parallel: control rats which received baicalein alone and the cyclosporin A treated-group in which the rats were injected cyclosporin A, a P-glycoprotein inhibitor, 10 min prior to baicalein administration. 4. Cyclosporin A treatment resulted in a significant increase in elimination half-life, mean residence time and area under the concentration versus time curve (AUC) of unbound baicalein in the brain. However, AUC in the bile was decreased. 5. The decline of baicalein in the hippocampus, blood and bile suggested that there was rapid exchange and equilibration between the peripheral compartment and the central nervous system. In addition, the results indicated that baicalein was able to penetrate the blood-brain barrier as well as undergoing hepatobiliary excretion. 6. Although no direct transport studies were undertaken and multiple factors may affect BBB penetration and hepatobiliary excretion, strong association of the involvement of P-glycoprotein in these processes is indicated.

Portal vein embolization with lipiodol for treatment of HCC--an experimental study.

A suspension of iodized oil and anticancer agent was injected into the portal veins of 20 rats with hepatic carcinoma. Oil drops were seen in tumor cell lines, small blood vessels inside the cancer nest, the sinusoid, and the central veins. After injection of oil suspension through the portal vein the distal small vessels were embolized and necrotic changes of tumor cells and their subordinate normal liver cells were observed. The results obtained in this experiment provided a good anatomical and pathological basis for treating liver cancers with the portal vein embolization with chemotherapeutic agents.

Effect of suramin on the mitogenic response of the human prostate carcinoma cell line PC-3.

BACKGROUND: Suramin is an anthelmintic drug that recently has been shown to have clinical efficacy in the treatment of patients with some advanced malignancies, including prostate carcinoma. The current study was done to assess the effect of suramin at clinically relevant doses on the growth in culture of a human prostatic carcinoma cell line, PC-3. METHODS: The antiproliferative effect of varying doses of suramin on PC-3 was assessed. Northern blot analysis was done to assess the potential changes in genetic expression at different times after the initiation of treatment. RESULTS: Suramin inhibited the proliferation of PC-3 in a dose-related manner (concentration range, 30-300 microM). Compared with fetal calf serum 2%, when the cells were grown in fetal calf serum 10%, higher concentrations of suramin were required to inhibit tritiated thymidine incorporation. When grown in RPMI without supplement, the PC-3 cell number remained the same. When 100 microM suramin was included, the cell number decreased. By contrast, when RPMI was supplemented with insulin, transferrin, and selenium (ITS), PC-3 grew well. The inhibition of the proliferation of PC-3 cells by suramin was decreased when ITS were added to the cells grown under serum-free conditions. CONCLUSIONS: These results were consistent with the hypothesis that in vitro inhibition of the growth of PC-3 cells by suramin may be caused, at least in part, by the growth factor antagonism of the drug. In fetal calf serum 2%, the suramin inhibition was reversible after 3 days. If the treatment was extended to 6 days, however, the PC-3 cells were unable to recover. Cell-cycle analysis revealed that, after 6 days of treatment, there was a decrease in the number of cells in G1 that corresponded with an increased number of cells in G2/M. This suggested that critical antineoplastic events were occurring during this time. Molecular analysis did not detect any altered expression of actin, transforming growth factors alpha or beta, or histone compared with untreated control samples.

Hepatic carcinoma. The possibility of transcatheter chemoembolization through the portal vein.

A suspension of iodized oil and anticancer agent was injected into the portal veins of 20 rats with hepatic carcinoma and of 20 normal rats to observe its distribution in the liver and the effect on cancer tissue and normal cells. Microscopic and transmission electron microscopic examinations were carried out. Oil drops were seen in tumor cell lines, small blood vessels inside the cancer nest, the sinusoids, and the central veins. More oil drops were found in the peripheral parts of the tumor than in the central part. The distal small vessels were embolized with necrotic change of tumor cells and their subordinate normal liver cells. We conclude that portal vein part takes in the blood supply of liver cancer and tumor cell necrosis can be achieved after administration of iodized oil and anticancer agent mixture through the portal vein. Hence transcatheter treatment through the portal vein may be helpful as a supplement to intraarterial treatment of primary liver cancer and transcatheter embolization via the portal vein to reinforce the intraarterial therapy may be recommended. This procedure may cause necrosis of normal liver cells and care must be taken in clinical application.

[Changes in T-lymphocyte subsets in patients with orthopedic trauma and effects of yipanzhu decoction on the impaired immune function].

The effects of yipanzhu decoction (YD) on immune function in 40 patients [2 groups, YD and normal saline (NS) group] with orthopedic trauma by taking T lymphocyte subsets as indexes were observed. The peripheral venous blood samples randomly taken from 30 healthy subjects served as control. The blood were collected within 24 hours after trauma. Then the YD and NS were respectively given to the patients in the 2 groups for 3 days, and the blood were taken 4th, 7th, 14th day after trauma for the observation of T subsets. The results revealed that before administration of YD the percentage of pan-T cells was reduced with an increased percentage of Ts cells and a decreased ratio between Th and Ts cells; 3 days after giving the drugs in YD group the percentage of pan-T cells was slightly increased, and the changed percentage of Ts cells and the ratio of Th/Ts cells mentioned above was recovered to normal, while in NS group all these indexes remained at abnormal range during the period we observed. The results suggested that YD could promote the recovery of abnormal T lymphocyte subsets in traumatized patients, and it possessed to some extent the function of immune regulation that was helpful to reduce the ratio of infection after trauma.

3-Methoxysampangine, a novel antifungal copyrine alkaloid from Cleistopholis patens.

Further examination of the active ethanolic extract of the root bark of Cleistopholis patens by using bioassay-directed fractionation resulted in the isolation of a new alkaloid, 3-methoxysampangine (compound I), together with three known alkaloids, eupolauridine (compound II), liriodenine (compound III), and eupolauridine N-oxide (compound IV). The proposed structure of compound I was based on its physicochemical properties and spectral data. 3-Methoxysampangine exhibited significant antifungal activity against Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans. This is the first report of the isolation of liriodenine (compound III) from the root bark of C. patens.

Anti-shock effects of synthetic effective compositions of fructus aurantii immaturus. Experimental study and clinical observation.

Satisfactory results have been obtained in treating infective shock with injection of natural Fructus Aurantii immaturus (nat-FAI). The results of animal experiments and clinical observations on the anti-shock effects of the synthetic effective compositions of Fructus Aurantii immaturus (syn-FAI) are reported. The cardiac output increased from 0.53 to 0.87 L/min (P less than 0.01), and the cardiac index increased from 0.99 to 1.63 L/m2/min (P less than 0.01) in the endotoxic shock dogs after the treatment with syn-FAI. At the same time the blood stream in bulbar conjunctiva became accelerated and the dilated microvessels began to get smaller in most dogs. Of fifty children with infective shock treated with syn-FAI, forty-eight showed curative effects, with a total effective rate of 96%. The anti-shock effective compositions in FAI have been proved to be synephrine and N-methyltyrosamine. Moreover, syn-FAI has shown a more stable property, less side-effects and better clinical results than nat-FAI.

Antifungal activity of Trillium grandiflorum constituents.

EtOH extracts of the rhizomes and aboveground portion of Trillium grandiflorum showed significant antifungal activity. Bioassay directed fractionation has led to the identification of the active components as the saponin glycosides 1 and 3.

Effects of dietary essential fatty acids on murine mammary gland development.

Removal of unsaturated fatty acids from the diet of female C3H mice resulted in the gradual onset of essential fatty acid deficiency. Upon reaching the deficient state, alveolar components of the mammary gland began to regress as did the ovarian corpora lutea. An increase in the viscosity of microsomal membranes and a decrease in the number of prolactin binding sites also occurred concomitantly as the deficient state increased in severity. Modification of fats with the diet changes the fluidity of cellular membranes. This appears to alter the functionality of the membrane-associated receptors and their subsequent ability to respond to circulating hormones.

DNA repair responses in human skin cells.

Sunlight and some environmental chemical agents produce lesions in the DNA of human skin cells that if unrepaired may interfere with normal functioning of these cells. The most serious outcome of such interactions may be malignancy. It is therefore important to develop an understanding of mechanisms by which the lesions may be repaired or tolerated without deleterious consequences. Our models for the molecular processing of damaged DNA have been derived largely from the study of bacterial systems. Some similarities but significant differences are revealed when human cell responses are tested against these models. It is also of importance to learn DNA repair responses of epidermal keratinocytes for comparison with the more extensive studies that have been carried out with dermal fibroblasts. Our experimental results thus far indicate similarities for the excision-repair of ultraviolet-induced pyrimidine dimers in human keratinocytes and fibroblasts. Both the monoadducts and the interstrand crosslinks produced in DNA by photoactivated 8-methoxypsoralen (PUVA) can be repaired in normal human fibroblasts but not in those from xeroderma pigmentosum patients. The monoadducts, like pyrimidine dimers, are probably the more mutagenic/carcinogenic lesions while the crosslinks are less easily repaired and probably result in more effective blocking of DNA function. It is suggested that a split-dose protocol that maximizes the production of crosslinks while minimizing the yield of monoadducts may be more effective and potentially less carcinogenic than the single ultraviolet exposure regimen in PUVA therapy for psoriasis.