Quantifying midbrain serotonin transporter in depression: a preliminary study of diagnosis and naturalistic treatment outcome.

INTRODUCTION: Serotonin may play an important role in the pathology of major depressive disorder (MDD). However, the relationship between serotonin transporter (SERT) availability and the medical outcome of antidepressant treatment is uncertain. METHODS: In this naturalistic study, SERT availability (expressed as the specific uptake ratio, SUR) in the midbrain of 17 drug-free patients with MDD and 17 controls matched for age and gender was measured using SPECT with [(123)I]ADAM. The severity of MDD was measured by the Hamilton Depression Rating Scale before, and after 6 weeks of non-standardized antidepressant treatment. RESULTS: A total of 12 patients completed the study. The SUR of the patients with MDD was significantly lower than that of the healthy controls. The SUR of SERT was not found to have a linear relationship with the treatment outcome; however, supplemental analysis found a curvilinear relationship between treatment outcome and the SUR of SERT. DISCUSSION: The findings indicate that the SUR of SERT is lower in patients with MDD; however it did not predict treatment outcome in a linear fashion. Studies with larger sample sizes are required.

Characteristics of traditional Chinese medicine use in children with asthma: a nationwide population-based study.

Asthma is a chronic inflammatory airway disease accounting for severe morbidity and mortality in children. To determine the characteristics of traditional Chinese medicine (TCM) used to treat pediatric asthma, we conducted a nationwide population-based study by analyzing a cohort of one million randomly sampled patients from the beneficiaries of the National Health Insurance Program in Taiwan from 2002 to 2010. Children under 18 years of age with newly diagnosed asthma (ICD-9-CM code: 493, N = 45 833) were enrolled, and 57.95% (N = 26 585) of them had used TCM. The number of TCM users was significantly more than that of non-TCM users in school-age children. The most commonly prescribed TCM formula is Ding-chuan-tang, or Xing-ren (Semen Armeniacae Amarum) for the single herb. Our study is the first to reveal characteristics and prescription patterns of the use of TCM in children with asthma. Further research is needed to elucidate the efficacy and safety of these Chinese herbal products.

Cardiac iron measurement and iron chelation therapy in patients with ß thalassaemia major: experience from Taiwan.

BACKGROUND: The aims of our study were to evaluate (i) the relationship between cardiac T2* values and cardiac complications in Asian ß-thalassaemia major (TM) patients, and (ii) the association between cardiac T2* values and other parameters currently used to predict cardiac complications as a result of transfusion iron overload. METHODS: We examined the myocardial iron loads of 88 TM patients from Taiwan with cardiac T2* magnetic resonance imaging (MRI) and assessed the correlation between cardiac T2* values and serum ferritin levels, liver iron concentration and left ventricular ejection fraction (LVEF). We also determined the predictive value of these measurements for the development of arrhythmia. RESULTS AND CONCLUSION: In our group of Taiwanese patients, the relative risk for arrhythmia was 10·36 when cardiac T2* values were less than 10 ms (compared with ≥10 ms) and 1·98 when serum ferritin levels increased >2500 ng mL(-1) (compared with ≤2500 ng mL(-1) ). Serum ferritin levels correlated with cardiac T2* values in patients with abnormal myocardial iron loads (T2* < 20 ms, r = -0·48, P = 0·004, n = 34), but LVEF (measured by echocardiography) gave no indication of excess myocardial iron deposition (r = -0·07, P = 0·52) or of the risk of developing arrhythmia.

Acupuncture versus topiramate in chronic migraine prophylaxis: a randomized clinical trial.

BACKGROUND: The aim of this study was to investigate the efficacy and tolerability of acupuncture compared with topiramate treatment in chronic migraine (CM) prophylaxis. METHODS: A total of 66 consecutive and prospective CM patients were randomly divided into two treatment arms: 1) acupuncture group: acupuncture administered in 24 sessions over 12 weeks (n = 33); and 2) topiramate group: a 4-week titration, initiated at 25 mg/day and increased by 25 mg/day weekly to a maximum of 100 mg/day followed by an 8-week maintenance period (n = 33). RESULTS: A significantly larger decrease in the mean monthly number of moderate/severe headache days (primary end point) from 20.2 ± 1.5 days to 9.8 ± 2.8 days was observed in the acupuncture group compared with 19.8 ± 1.7 days to 12.0 ± 4.1 days in the topiramate group (p < .01) Significant differences favoring acupuncture were also observed for all secondary efficacy variables. These significant differences still existed when we focused on those patients who were overusing acute medication. Adverse events occurred in 6% of acupuncture group and 66% of topiramate group. CONCLUSION: We suggest that acupuncture could be considered a treatment option for CM patients willing to undergo this prophylactic treatment, even for those patients with medication overuse.

The pharmacological chaperone 1-deoxygalactonojirimycin increases alpha-galactosidase A levels in Fabry patient cell lines.

Fabry disease is an X-linked lysosomal storage disorder caused by mutations in the gene encoding alpha-galactosidase A (alpha-Gal A), with consequent accumulation of its major glycosphingolipid substrate, globotriaosylceramide (GL-3). Over 500 Fabry mutations have been reported; approximately 60% are missense. The iminosugar 1-deoxygalactonojirimycin (DGJ, migalastat hydrochloride, AT1001) is a pharmacological chaperone that selectively binds alpha-Gal A, increasing physical stability, lysosomal trafficking, and cellular activity. To identify DGJ-responsive mutant forms of alpha-Gal A, the effect of DGJ incubation on alpha-Gal A levels was assessed in cultured lymphoblasts from males with Fabry disease representing 75 different missense mutations, one insertion, and one splice-site mutation. Baseline alpha-Gal A levels ranged from 0 to 52% of normal. Increases in alpha-Gal A levels (1.5- to 28-fold) after continuous DGJ incubation for 5 days were seen for 49 different missense mutant forms with varying EC(50) values (820 nmol/L to >1 mmol/L). Amino acid substitutions in responsive forms were located throughout both structural domains of the enzyme. Half of the missense mutant forms associated with classic (early-onset) Fabry disease and a majority (90%) associated with later-onset Fabry disease were responsive. In cultured fibroblasts from males with Fabry disease, the responses to DGJ were comparable to those of lymphoblasts with the same mutation. Importantly, elevated GL-3 levels in responsive Fabry fibroblasts were reduced after DGJ incubation, indicating that increased mutant alpha-Gal A levels can reduce accumulated substrate. These data indicate that DGJ merits further evaluation as a treatment for patients with Fabry disease with various missense mutations.

Objective auscultation for traditional chinese medical diagnosis using novel acoustic parameters.

The goal of this work is to propose novel acoustic parameters of voice for the purpose of providing a quantitative analysis of auscultation in traditional Chinese medical diagnosis. There is rare amount of available literature related to this topic. Four novel acoustic parameters, the average number of zero-crossings, the variations in local peaks and valleys, the variations in first and second formant frequencies, and the spectral energy ratio, are presented to analyze and identify the characteristics among non-vacuity, qi-vacuity, and yin-vacuity subjects. Among these acoustic parameters, two temporal parameters, the average number of zero-crossings and the variations in local peaks and valleys, outperformed other parameters in classifying both non-vacuity and deficient subjects. The spectral energy ratio was adequate for the classification between qi-vacuity and yin-vacuity patients. This research is a first step in an ongoing effort to modernize the auscultation in traditional Chinese medical diagnosis.

Ascorbate is depleted by smoking and repleted by moderate supplementation: a study in male smokers and nonsmokers with matched dietary antioxidant intakes.

BACKGROUND: Lack of reliable dietary data has hampered the ability to effectively distinguish between effects of smoking and diet on plasma antioxidant status. As confirmed by analyses of comprehensive food-frequency questionnaires, the total dietary intakes of fruit and vegetables and of dietary antioxidants were not significantly different between the study groups in the present study, thereby enabling isolation of the effect of smoking. OBJECTIVE: Our objective was to investigate the effect of smoking on plasma antioxidant status by measuring ascorbic acid, alpha-tocopherol, gamma-tocopherol, beta-carotene, and lycopene, and subsequently, to test the effect of a 3-mo dietary supplementation with a moderate-dose vitamin cocktail. DESIGN: In a double-blind, placebo-controlled design, the effect of a vitamin cocktail containing 272 mg vitamin C, 31 mg all-rac-alpha-tocopheryl acetate, and 400 microg folic acid on plasma antioxidants was determined in a population of smokers (n = 37) and nonsmokers (n = 38). The population was selected for a low intake of fruit and vegetables and recruited from the San Francisco Bay area. RESULTS: Only ascorbic acid was significantly depleted by smoking per se (P < 0.01). After the 3-mo supplementation period, ascorbic acid was efficiently repleted in smokers (P < 0.001). Plasma alpha-tocopherol and the ratio of alpha- to gamma-tocopherol increased significantly in both supplemented groups (P < 0.05). CONCLUSIONS: Our data suggest that previous reports of lower concentrations of plasma vitamin E and carotenoids in smokers than in nonsmokers may primarily have been caused by differences in dietary habits between study groups. Plasma ascorbic acid was depleted by smoking and repleted by moderate supplementation.

Therapeutic effect of sheng-ji-san on pressure ulcers.

In the present study, the effectiveness of sheng-ji-san (SJS) in promoting the healing of pressure ulcers was evaluated. Thirty-two patients with pressure ulcers were divided into two groups. The treated group received routine medical care combined with SJS treatment and the control group received only routine medical care. After three weeks, the treated group showed a significant reduction in both surface area and depth grade, while the control group showed no significant change. The reduction ratio of the surface area of the ulcer and the effectiveness ratio for the treated group were significantly higher than for the control group. Multiple Linear Regression Analysis revealed that only the SJS treatment was significantly associated with the reduction of surface area and that the use of SJS could independently explain the observed high effectiveness ratio and a relatively high Odds Ratio of 9.539. These results indicate that SJS is effective in promoting the healing of pressure ulcers and should be considered as an adjuvant to routine therapy.

The association between postmenopausal osteoporosis and kidney-vacuity syndrome in traditional Chinese medicine.

The aim of this study was to evaluate the association between postmenopausal osteoporosis and kidney-vacuity syndrome. Eighty-one postmenopausal women were enrolled; their age were between 40 to 65 years old. The mean ages of the non-osteoporosis group and osteoporosis group were 54.0 +/- 4.8 and 58.9 +/- 5.9 years old, respectively. Bone density examination was performed by DEXA technique and the diagnosis of osteoporosis was made by finding 2.5 standard deviations below the bone density of healthy youths. Kidney-vacuity syndrome was deduced according to the diagnostic criteria developed in the National Congress on Chinese Medicine and Sino-Western Combined Geriatric Medicine held in the People's Republic of China in 1986. The results showed that patients with kidney-qi-vacuity and kidney-yin-vacuity were more likely to have osteoporosis than those who were not. No significant difference in the rates of osteoporosis between the kidney-yang-vacuity group and non-kidney-yang-vacuity group was found. The kidney-qi-yin-vacuity group had a higher probability of developing osteoporosis than the kidney-qi-vacuity or kidney-yin-vacuity group. By logistic regression analysis, patients with kidney-qi-vacuity or kidney-yin-vacuity were more likely to develop osteoporosis than those who were not. In conclusion, a marked association between kidney-vacuity syndrome and postmenopausal osteoporosis was observed. Patients with kidney-qi-yin-vacuity syndrome were more likely to get osteoporosis than those with kidney-qi-vacuity syndrome or kidney-yin-vacuity syndrome.

The correlation between skin electrical conductance and the score of qi vacuity.

In traditional Chinese medicine, the syndrome of qi vacuity means that the patient's body has a low level of energy to react to stress. Recently, we used a score, the QV score, by scaling the severity of symptoms and signs of qi vacuity in patients with tiredness. The aim of this study was to investigate the relationship between QV score and skin electrical conductance in patients with tiredness. One hundred and forty-three healthy controls and 103 patients with tiredness were involved. Each subject received a weak electrical stimulation with constant voltage (1.75 volt), and conductance was measured between two different limbs. The mean value of skin conductance among four limbs was calculated and expressed by a special unit, namely Chin. The correlation between the skin conductance and QV score was analyzed by a linear regression analysis. The results showed that skin electrical conductance of healthy controls was negatively correlated with age (r-coefficient = -0.51, P = 0.000). The skin conductance of patients with tiredness was significantly lower than that of healthy controls with matching age (P = 0.000 by Student's t-test). Moreover, there was a positive correlation between the decrease of skin conductance and the QV score in patients with tiredness (r-coefficient = +0.68, P = 0.000). These results suggest that a decrease in skin electrical conductance may be closely related to the severity of qi vacuity. The skin conductance test is a simple, reliable, and quantitative method for detection of syndrome of qi vacuity.

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.

Identification and characterization of epitopes on Cyn d I, the major allergen of Bermuda grass pollen.

BACKGROUND: We identified three epitopes on Cyn d I by using four anti-Cyn d I monoclonal antibodies (MoAbs). METHODS: In a cross-inhibition binding assay, the binding of MoAbs 1-61 and 10-7 to Cyn d I was completely blocked by each other but not by MoAbs 4-37 and 11-7; the binding of MoAb 4-37 and MoAb 11-7 to Cyn d I was inhibited by themselves but not by other MoAbs. The epitope recognized by MoAbs 1-61 and 10-7 is designated as E1, and those recognized by MoAbs 4-37 and 11-7 are designated as E2 and E3, respectively. RESULTS: In a radioallergosorbent inhibition assay, we found that MoAbs 1-61 and 4-37 (1:50 diluted) can inhibit the binding of human Immunoglobulin Es to Cyn d I by more than 30%, whereas MoAb 11-7 was less efficient (reduced by only 6%). These results suggest that both E1 and E2 are major allergenic epitopes but that E3 is only a minor one. Further characterization of E1 and E2 reveals that they are labile in alkaline but resistant to acid and sodium periodate treatments. Moreover, E1 is heat-labile, but guanidine- and urea-sensitive, whereas E2 is not. Both E1 and E2 lost their antigenicity after reduction and alkylation. CONCLUSIONS: Results of the present study provide important information on the physicochemical properties of major allergenic epitopes on Cyn d I, which may be useful for future development of therapeutic peptides for patients allergic to Bermuda grass pollen.

Medecine chinoise et homeopathie: analyse de Bryonia / Chinese medicine and homeopathy: analisys of Bryonia

La pathogenesie et les grands tableaux cliniques de BRYONIA font l'objet dans cette etude d'une lecture conduite selon les regles tres strictes de la Medecine Traditionnelle Chinoise. Apres une presentation du remede, l'analyse energetique permet de definir le cadre ou s'exercent ses effets therapeutiques et d'etablir une equivalence entre le stade exsudatif des inflammations sereuses ou il est expressement recommande et certains syndromes dits de la "Couche du Qi", selon la terminologie des Traites chinois des "Maladies de la Chaleur". Puis des comparaisons therapeutiques viennent eclairer sa pharmacodynamique ainsi que ses points d'impacts specifiques. Affine pour les Meridiens des Poumons et du Gros intestin, BRYONIA trouverait avec Estomac 25, son point de Weihe, un repondant partiel de ses vertus therapeutiques

Medecine chinoise et homeopathie: analyse de Veratrum album / Chinese medicine and homeopathie: analysis of Veratrum album

Dans cet article Veratrum album est presente comme exemple d'une lecture energetique des pathogenesies homeopathiques. Ses grandes caracteristiques sont rappelees ainsi que ses indications principales. Puis la semiologie comparee permet de definir en termes de Medecine Traditionnelle Chinoise le cadre general des manifestations morbides ou son action therapeutique peut s'exercer. Il est alors possible de lui opposer la decoction polymedicamenteuse dite des Quatre Froideurs ainsi que diverses modalites de traitement acupunctural. Une hypothese est emise quant a son mode d'action: Veratrum album se comporte comme un medicament reanimateur du YANG, possedant une energie chaude et une affinite pour les Meridiens du Coeur, des Reins et de la Rate