Wernekinck Commissure Syndrome with Holmes Tremor: A Report of Two Cases and Review of Literature.

Wernekinck commissure syndrome is a rare midbrain infarction, it consists of several symptoms including bilateral cerebellar ataxia, ophthalmoplegia, and palatal tremor. Holmes tremor is a rare clinical syndrome characterized by a combination of resting, postural, and action tremors. We describe two cases of Wernekinck commissure syndrome with Holmes tremor. To the best of our knowledge, it has been rarely reported in the literature to date. Both of the cases were presented with acute onset of bilateral cerebellar ataxia, dysarthria, and Holmes tremor. In the treatment, one patient was given "clonazepam and benheisol," the other was received acupuncture therapy, both of them showed a marked improvement in ataxia and tremor.

Development of a solid-supported cysteinyl probe for the isolation of electrophiles from plant pollen extracts.

Recent research showed that plant secondary metabolites in pollen may exacerbate the protein-mediated allergic reaction in pollen allergy. It was found that allergenic pollen from various plant families contain significant amounts of electrophiles which may covalently bind to nucleophilic groups of proteins, such as thiol moieties. Electrophiles in pollen of the Asteraceae species are typically sesquiterpene lactones, but the nature of electrophilic metabolites in allergenic pollen of other plant families is unknown. We developed a solid-supported cysteinyl probe in order to selectively extract physiologically relevant electrophiles from pollen extracts, and to enable their subsequent characterization by on-line and off-line spectroscopic analysis. The validity of this approach was evaluated with a selection of structurally different model compounds and with a spiked model extract.

Absence of herb-drug interactions of mistletoe with the tamoxifen metabolite (E/Z)-endoxifen and cytochrome P450 3A4/5 and 2D6 in vitro.

BACKGROUND: Women diagnosed with breast cancer frequently seek complementary and alternative (CAM) treatment options that can help to cope with their disease and the side effects of conventional cancer therapy. Especially in Europe, breast cancer patients use herbal products containing mistletoe (Viscum album L.). The oldest and one of the most prescribed conventional drugs for the treatment of estrogen receptor positive breast cancer is tamoxifen. Aside from positive clinical experience with the combination of tamoxifen and mistletoe, little is known about possible herb-drug interactions (HDIs) between the two products. In the present in vitro study, we investigated the effect of standardized commercial mistletoe preparations on the activity of endoxifen, the major active metabolite of tamoxifen. METHODS: The estrogen receptor positive human breast carcinoma cell line MCF-7 was treated with (E/Z)-endoxifen hydrochloride in the presence and absence of a defined estradiol concentration. Each concentration of the drug was combined with fermented Viscum album L. extracts (VAE) at clinically relevant doses, and proliferation, apoptosis and cell cycle were analyzed. In parallel, possible inhibition of CYP3A4/5 and CYP2D6 was investigated using 50-donor mixed gender pooled human liver microsomes (HLMs). RESULTS: VAE did not inhibit endoxifen induced cytostasis and cytotoxicity. At higher concentrations, VAE showed an additive inhibitory effect. VAE preparations did not cause inhibition of CYP3A4/5 and CYP2D6 catalyzed tamoxifen metabolism. CONCLUSIONS: The in vitro results suggest that mistletoe preparations can be used in combination with tamoxifen without the risk of HDIs.

Cardiocerebral protective effects of dexmedetomidine as anesthetic in colorectal cancer surgery.

OBJECTIVE: To explore the cardiocerebral protective effect of dexmedetomidine as an anesthetic in colorectal cancer surgery. PATIENTS AND METHODS: A total of 246 colorectal cancer patients were enrolled in this retrospective analysis. Those patients were admitted to the Affiliated Hospital of Qingdao University and underwent surgery from July 2014 to July 2016. The patients were divided into observation group and control group according to the anesthetic used in surgery. The conventional anesthetic was administered to patients in control group, whereas conventional anesthetic supplemented with dexmedetomidine was administered to patients in the observation group. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), jugular venous oxygen saturation (Sj-vO2), cerebral oxygen extraction ratio (ERO2), and cerebral arterial partial pressure of oxygen (PaO2) were recorded before dexmedetomidine administration (T0), 30 min after start of surgery (T1), and 2 h after surgery (T2). Central venous blood (4 ml) was withdrawn 6 hours and 24 hours after surgery. Following centrifugation, the serum was collected and stored at -70°C. After collection of all the blood samples, concentrations of creatine kinase (CK-MB), troponin I (cTnI), TNF-α and S100ß in serum were measured using ELISA, and differences between the two groups were compared. RESULTS: Differences of the parameters measured at T0 were not statistically significant between observation group and control group (p>0.05), whereas the parameters measured at T1 and T2 were significantly better in the observation group than those in the control group (p<0.05). The post-surgery blood test showed that indicators of cardiocerebral hemodynamics were better in the observation group than those in the control group (p<0.05). CONCLUSIONS: Administration of dexmedetomidine in colorectal cancer surgery can provide effective cardiocerebral protection and it is worth popularizing in clinical practice.

[Effects of both folic acid, p16 protein expression and their interaction on progression of cervical cancerization].

Objective: To explore the effects of both folic acid, p16 protein expression and their interaction on progression of cervical cancerization. Methods: Participants were pathologically diagnosed new cases, including 80 women with normal cervical (NC), 55 patients with low-grade cervical intraepithelial neoplasia (CINⅠ), 55 patients with high-grade cervical intraepithelial neoplasia (CINⅡ/Ⅲ) and 64 patients with cervical squamous cell carcinoma (SCC). Serum folate levels were detected by microbiological assay method while p16 protein expression levels were measured by Western-blot. In vitro, cervical cancer cell lines C33A (HPV negative) and Caski (HPV16 positive) were treated with different concentrations of folate. Proliferation and apoptosis of cells and the levels of p16 protein expression were measured in groups with different folic acid concentrations. Results: Results showed that the levels of serum folate were (5.96±3.93) ng/ml, (5.08±3.43) ng/ml, (3.92±2.59) ng/ml and (3.18±2.71) ng/ml, and the levels of p16 protein were 0.80±0.32, 1.33±0.52, 1.91±0.77, and 2.09±0.72 in the group of NC, CINⅠ, CINⅡ/Ⅲ and SCC, respectively. However, the levels of serum folate decreased (trend χ2=32.71, P<0.001) and p16 protein expression increased (trend χ2=56.06, P<0.001) gradually along with the severity of cervix lesions. An additive interaction was seen between serum folate deficiency and high expression of p16 protein in the CINⅠ, CINⅡ/Ⅲ and SCC group. Results in vitro showed that, with the increase of folate concentration, the inhibition rate of cell proliferation (C33A: r=0.928, P=0.003; Caski: r=0.962, P=0.001) and the rate on cell apoptosis (C33A: r=0.984, P<0.001; Caski: r=0.986, P<0.001) all increased but the levels of p16 protein expression (C33A: r=-0.817, P=0.025; Caski: r=-0.871, P=0.011) reduced. The proliferation inhibition rate (C33A: r=-0.935, P=0.002; Caski: r=-0.963, P=0.001) and apoptosis rate of cells (C33A: r=-0.844, P=0.017; Caski: r=-0.898, P=0.006) were negatively correlated with the levels of p16 protein expression. Conclusions: Our findings indicated that both serum folate deficiency and high expression of p16 protein could increase the risk of cervical cancer and cervix precancerous lesion, and there was an additive interaction between them. Our findings suggested that folic acid supplementation could reverse the abnormal expression of p16 protein, and effectively promote apoptosis and inhibit proliferation in cervical carcinoma cells.

Adding moxifloxacin is associated with a shorter time to culture conversion in pulmonary tuberculosis.

OBJECTIVE: To investigate whether adding moxifloxacin (MXF) to the standard anti-tuberculosis regimen can shorten the time to sputum culture conversion in pulmonary tuberculosis (PTB). METHODS: Adults with culture-positive PTB were divided into two treatment groups by their choice: standard regimen alone (HERZ group) and standard regimen plus daily 400 mg MXF in the first 2 months (MXF group). Sputum samples were collected thrice weekly in the first 8 weeks. The propensity score was calculated to estimate the conditional probability of entering the MXF group. Factors influencing time to culture conversion were investigated using Cox proportional hazards regression analysis stratified by propensity score. RESULTS: Sixty-two patients were enrolled in the MXF group and 88 in the HERZ group; respectively 51 and 72 completed the study. The regimen was modified before culture conversion in respectively 6 (12%) and 12 (16%; P = 0.47) patients, due to adverse effects. The time to culture conversion was shorter in the MXF group (HR 2.1, 95%CI 1.4-3.2). The culture conversion rate after 6 weeks of treatment was respectively 82% and 61% (P = 0.011, <0.05/4, calculated using the modified Bonferroni method). CONCLUSIONS: Adding MXF to the standard anti-tuberculosis regimen in the first 2 months was associated with a shorter time to culture conversion, a higher 6-week culture conversion rate and reduced transmission of tuberculosis.

Effects of cold stress on the messenger ribonucleic acid levels of corticotrophin-releasing hormone and thyrotropin-releasing hormone in hypothalami of broilers.

In this study, seventy 1-d-old male broiler chicks were randomly allocated to 10 groups to investigate the effect of cold stress on the messenger RNA (mRNA) levels of corticotrophin-releasing hormone (CRH) and thyrotropin-releasing hormone (TRH) in hypothalami. The chicks were maintained at 30 +/- 2 degrees C temperature and given free access to standard chow and water. Until 15 d old, the 6 treatment groups were maintained at 12 +/- 1 degrees C. Hypothalami were collected for the assessment of the mRNA levels by semiquantitative reverse transcription-PCR after stress termination. Cold stress significantly decreased the mRNA levels of CRH in 6 and 12 h treatment groups and significantly increased the mRNA levels of TRH in 1, 6, and 12 h treatment groups during acute cold stress. There were no significant differences in the mRNA levels of CRH and TRH among different control groups during chronic cold stress. However, chronic cold stress resulted in a significant increase of the mRNA levels of CRH and a significant decrease of the mRNA levels of TRH compared with the corresponding control groups. The results indicate that the 2 genes show different response to cold stress at the mRNA levels, and on the other hand, the different degree of cold stress also produces different effects on the identical gene.

Comparisons of amino acid availability by different methods and metabolizable energy determination of a Chinese variety of high oil corn.

TME, true amino acid availability (TAAA), AME, and apparent amino acid availability (AAAA) were determined in Chinese high oil corn (CHOC) and conventional corn (CC). The CC and CHOC contained 4.58 and 8.44% ether extract (DM basis), respectively. A precision-fed rooster assay was used in which each corn sample was tube-fed (50 g) to 16 roosters and excreta were collected for 48 h. A N-free diet and fasting methods were used to evaluate endogenous amino acid (AA) losses. Endogenous losses of 10 AA were different (P < 0.05) with the N-free and fasting methods; in most cases the mean value for the N-free treatment was greater (P < 0.05) than for the fasting treatment. The TME value for CHOC was greater than for CC (4,193 vs. 3,961 cal/g DM; P < 0.05). The true availability of aspartic acid, threonine, isoleucine, and leucine of CC and CHOC was higher (P < 0.05) for the N-free method than for the fasting method. When compared within the N-free or within the fasting method, the true availabilities of lysine, methionine, and proline were higher (P < 0.05) in CHOC than in CC, but the true availability of phenylalanine was lower (P < 0.05) in CHOC than in CC. The AAAA values, although lower, followed similar patterns as the TAAA values. The results of this study indicated that availability of AA in CHOC is equal or superior to that in CC and that the available energy for poultry is higher in CHOC than in CC.

[Studies on the chemical constituents from Chrysanthemum morifolium Ramat].

OBJECTIVE: To study the chemical constituents of Chrysanthemum morifolium. METHOD: Separated the constituents by means of chromatography and identified their structures by chemical and spectroscopic analysis. RESULT: Three compounds of flavonoid were identified as acacetin-7-O-beta-D-glucoside, apigenin-7-O-beta-D-glucoside and luteolin-7-O-beta-D-glucoside. CONCLUSION: These compounds were obtained from C. morifolium for the first time.

Spontaneous bacterial empyema caused by Aeromonas veronii biotype sobria.

Spontaneous bacterial empyema is a complication of hepatic hydrothorax in cirrhotic patients. The pathogen, clinical course and treatment strategy are different to the empyema secondary to pneumonia. A 54-year-old man, who was a cirrhotic patient with hepatic hydrothorax, was admitted to National Taiwan University Hospital for fever, dyspnea and right side pleuritic pain. The image study revealed massive right pleural effusion and no evidence of pneumonia. The culture of pleural effusion yielded Aeromonas veronii biotype sobria. The diagnosis of spontaneous bacterial empyema caused by Aeromonas veronii biotype sobria was established. To our best knowledge, Aeromonas veronii biotype sobria had never been reported in English literature as the causative pathogen of spontaneous bacterial empyema.

Expression of proliferating cell nuclear antigen (PCNA) in oral submucous fibrosis, oral epithelial hyperkeratosis and oral epithelial dysplasia in Taiwan.

To test whether the oral epithelia of oral submucous fibrosis (OSF), epithelial hyperkeratosis (EH) and epithelial dysplasia (ED) may have increased proliferative activity under the long-term exposure to areca quid ingredients and whether there is an increased expression of proliferating cell nuclear antigen (PCNA) in oral premalignant lesions with disease progression, we used an immunohistochemical technique with the mouse monoclonal antibody PC10 to investigate PCNA expression in histologic sections of OSF, EH, ED and normal oral mucosa (NOM). Positive PCNA staining was found mainly in basal and parabasal epithelial cells in all specimens of OSF, EH, ED and NOM. The mean PCNA labeling indices (LI) in NOM, OSF, EH and ED were 8.8+/-2.7%, 22.1+/-12.5%, 25.5+/-5. 2% and 44.9+/-15.4%, respectively. Significant differences in the PCNA LI were noted between NOM and OSF (P<0.01), EH (P<0.001) or ED (P<0.001), as well as between ED and OSF (P<0.001) or EH (P<0.01). The gradual increase of PCNA expression with the morphologic transformation of normal epithelial cells into dysplastic epithelial cells suggests that there is increased proliferative activity in oral premalignant lesions with disease progression. However, no significant correlation was found between PCNA LI in OSF epithelium and the clinicohistologic parameters of OSF. In addition, the mean PCNA LI of p53-positive OSF cases (23.7+/-12.0%) was very close to that of p53-negative OSF cases (23.9+/-13.1%), suggesting that there was no association between PCNA and p53 expression in OSF.

Expression of p53 protein in oral submucous fibrosis, oral epithelial hyperkeratosis, and oral epithelial dysplasia.

BACKGROUND AND PURPOSE: In our previous study, positive p53 staining was observed in 47 of 81 (58%) cases of oral squamous cell carcinoma associated with areca quid (AQ) chewing and cigarette smoking. This study looked for expression of p53 protein in premalignant oral lesions in patients who chewed AQ or smoked cigarettes, or both. METHODS: Expression of p53 protein was examined in histologic sections of oral submucous fibrosis (OSF, n = 50), epithelial hyperkeratosis (EH, n = 10), epithelial dysplasia (ED, n = 10), and normal oral mucosa (NOM, n = 10) with antibodies against p53 protein using an immunoperoxidase technique. RESULTS: Positive p53 staining was observed in 30 (60%) OSF specimens, four (40%) EH specimens, seven (70%) ED specimens, and none of the NOM specimens. Only four (8%) of the OSF specimens and none of the EH specimens had more than 25% p53-positive keratinocytes. However, in four (40%) of the ED specimens, more than 50% of the keratinocytes were p53-positive. The degree of p53 staining increased with the morphologic transformation of normal-appearing epithelial cells into dysplastic epithelial cells. There was no significant correlation between expression of p53 in OSF epithelium and the clinicohistologic parameters of patients with OSF. CONCLUSIONS: These results demonstrate that p53 is often present in precancerous lesions of patients who chew AQ and smoke cigarettes. We suggest that p53 may play a role in dysplastic cell transformation in premalignant oral lesions.

Expression of p53 protein correlates with decreased survival in patients with areca quid chewing and smoking-associated oral squamous cell carcinomas in Taiwan.

Expression of p53 protein was examined in oral squamous cell carcinoma (SCC) from patients who were areca quid (AQ) chewers and/or tobacco smokers, using anti-p53 antibodies with an immunoperoxidase technique. Positive p53 stain was observed in 47 of 81 (58%) cases of oral SCC. p53 overexpression was found to be higher in patients without AQ chewing and smoking habits than in patients with these two habits (80% vs 52%, P=0.076). No significant correlation was found between p53 expression and the patients' age, sex, cancer location, clinical staging, primary tumor TNM status, or histological differentiation of SCC. The Kaplan-Meier analysis showed that the prognosis for patients with p53-negative tumors was significantly better than that for patients with p53-positive tumors (P<0.05). A significant correlation was also observed between positive lymph node status and poor prognosis (P<0.05). These results suggest that p53 may serve as an adjuvant marker of poor survival in patients with oral SCCs in Taiwan.

[Clinical and experimental study of danfukang granule in treating cholecystitis and cholelithiasis].

In order to evaluate the clinical effect of Danfukang Granule (DFKG) in treating cholecystitis and cholelithiasis, 200 patients were treated with DFKG and observed with ultrasonography before and after treatment. Results showed 48 cases (24%) among the 200 patients were cured, 76 (38%) were marked effective, 70(35%) were improved and 6 (3%) ineffective, the effective rate being 97%. The lithagogue rate of cholelithiasis patients with diameter of gallstone < 0.5 cm, or those with sandy stone was 62%. In 50 post-operative patients received DFKG treatment, 28 (56%) were cured, 18 (36%) marked effective, 2 (4%) improved and 2 (4%) were ineffective, the total effective rate being 96%, while in the other 50 cases did not receive DFKG, the numbers were 8 (16%), 12(24%), 15 (30%), 15 (30%) and 70% respectively. The difference of total effective rate between the two groups were significant (analyzed by chi 2 test, P < 0.05). Experimental study-showed that the flow of hepatic bile in experimental group of guinea-pig was 3.7 +/- 0.4 ml/h, which was significantly higher than that of control group (2.7 +/- 0.1 ml/h), P < 0.05. The bile stone formation rate in experimental group was 32.4%, which was markedly lower than that of control group (93.8%), P < 0.01, suggesting the bile stone formed in experimental guinea-pigs could be evacuated by the rinsing effect of DFKG.

Elevated ras p21 expression in oral premalignant lesions and squamous cell carcinoma in Taiwan.

Expression of ras p21 oncoproteins was examined in histological sections of oral squamous cell carcinoma (SCC), epithelial dysplasia, epithelial hyperkeratosis and normal oral mucosa using antibodies to ras p21 with an immunoperoxidase technique. Ras p21-positive staining was found in 47 of 51 (92.2%) cases of oral SCC, 4 of 4 (100%) cases of epithelial dysplasia, 7 of 7 (100%) cases of epithelial hyperkeratosis, and 1 of 6 (16.7%) cases of normal oral mucosa. The positive staining rate of ras p21 in oral SCC, epithelial dysplasia or epithelial hyperkeratosis was significantly higher than that in normal oral mucosa (P < 0.05). No correlation was found between ras p21 expression and patient age, tumour location, tumour size, clinical staging or histological differentiation of SCC. However, a significant positive correlation was found between ras p21 expression and patients' sex (P < 0.05) or regional lymph node status (P < 0.05). A significant positive correlation was also discovered between ras p21 expression and patients' smoking habits (P < 0.01), as well as daily or total betel quid (BQ) consumption (P < 0.05). Of the 47 immunostain-positive SCC patients, specimens from 6 patients were also obtained after chemotherapy, when ras p21 expression was found to be reduced. These results indicate that ras p21 overexpression may play an important role in the initiation and progression of oral SCCs in patients who are smokers and BQ chewers.

Establishment of a radioimmunoassay of somatostatin in human plasma and in rat hypothalamus.

Synthetic cyclic somatostatin-14 (SRIF-14) was conjugated with carbodiimide onto hemocyanin to immunize rabbits, and anti-sera with high titers (1:5,000-100,000) and good sensitivity and specificity were obtained. 125I-Tyr1-SRIF was made and purified on CM-52 cation exchange column. The immunoreactive specific activity (SP.AC.) of the tracer was around 1013 mCi/mg, which was much higher than the commercial products and other reports. The sensitivity of the assay was around 16 pg/ml, and the detectable range 20-2000 pg/ml. Human plasma was freshly prepared in the presence of aprotinin. Rat hypothalamus was homogenized and extracted with HC1 followed by heating at 95 degrees C then centrifuged, and the supernatant assayed. The standard curves of the acetate buffer (ph 5.2), plasma doses, plasma recovery doses, hypothalamic extract doses, and hypothalamic extract recovery doses were all in good parallelism with each other. The recovery of SRIF from human plasma and from rat hypothalamus were 98.8 +/- 6.3% and 86.9 +/- 6.8%, respectively. The specificity of the antisera were very high, and they only cross-react with H2-SRIF and Tyr1-SRIF at 15% and 170%, respectively, of the immunoreactivity to cyclic SRIF-14. The Scatchard plot of the binding data showed a straight line with a Kd of 3.52 X 10(-12)M and binding capacity of 4.06 X 10(-10)M. The intra- and inter-assay coefficient of variation were 4.5% and 12%, respectively. When the synthetic cyclic SRIF (Stilamin) was infused intravenously into normal volunteers, there were reproducible plasma time-dose curves of SRIF-LI (SRIF Like Immunoreactivity), which revealed its plasma half life around 1.5 minutes, and metabolic clearance rate about 50 ml/kg/min.