[A Case of Miliary Brain Metastases Molecularly Diagnosed as Silent Lung Adenocarcinoma Origin].

A 60-year-old woman was referred to our hospital because of possible miliary brain metastases of unknown primary origin. On admission, she was alert and had no apparent motor weakness. Neuroradiological examinations revealed more than 100 small enhancing lesions, some of which had undergone cystic changes, suggesting multiple metastases. However, plain chest and abdominal CT revealed no abnormalities, and fluorodeoxyglucose-positron emission tomography could not reveal the primary origin of the cancer. Blood examination revealed no apparent abnormalities, except for tumor markers, including pro-gastrin-releasing peptide and carcinoembryonic antigen. On day 22, the patient underwent a biopsy through right frontal craniotomy. Histopathological findings indicated metastases from cancer. Immunohistochemistry was positive for cytokeratin(CK)7 and thyroid transcription factor-1 while negative for CK20(-), CK5/6, and p40, resulting in the diagnosis of lung adenocarcinoma. Genetic testing showed negative for EGFR mutation and positive for ALK fusion gene. From the day 48, whole brain radiotherapy was started, and the ALK inhibitor was prescribed from day 64. Metastatic brain tumors of unknown primary are rare. Miliary brain metastases from an unknown primary origin are rare. To our knowledge, this is the first case of military brain metastases of an unknown primary origin, which was later determined to have originated from ALK fusion-positive lung cancer.

HPLC analysis of ammonium glycyrrhizate listed in the European, United States, and Japanese Pharmacopoeias under reported and modified conditions: revision of the peak assignment for 18α-glycyrrhizin in the European and United States Pharmacopoeias.

We examined ammonium glycyrrhizate listed in the monographs of the European Pharmacopoeia (EP) and United States Pharmacopoeia (USP) as well as in the reagents and solutions used in the general test of the Japanese Pharmacopoeia by performing HPLC on their sample standards or reference reagents under reported and modified conditions. Comparative experiments involving five authentic samples, namely, 18ß-glycyrrhizin (1), 18α-glycyrrhizin (2), licorice-saponin G2 (3), licorice-saponin H2 (4), and galacturonic acid-replaced glycyrrhizin (the 4″-epimer of 18ß-glycyrrhizin) (5), led us to propose the revision of the peak assignment of 18α-glycyrrhizin (2) and postscript a possible co-existence of galacturonic acid-replaced glycyrrhizin (5) as a hidden component in the EP and USP. We also proposed that the α-configuration used in the nomenclature of the glycosidic bond between aglycone and the sugar units of ammonium glycyrrhizate and impurities in the EP and USP should be revised to the ß-configuration.

Is 18α-Glycyrrhizin a real natural product? Improved preparation of 18α-Glycyrrhizin from 18ß-Glycyrrhizin as a positive standard for HPLC analysis of licorice extracts.

18α-Glycyrrhizin is an epimer of 18ß-glycyrrhizin, a major component of licorice (Glycyrrhiza sp.), which is widely used as a traditional medicine. Whether 18α-glycyrrhizin is a real natural product has been debated in the long history of glycyrrhizin chemistry because 18ß-glycyrrhizin is epimerizable to a more thermodynamically stable 18α-glycyrrhizin under aqueous alkali conditions. We improved the preparation of 18α-glycyrrhizin from 18ß-glycyrrhizin by successive epimerization reactions of 18ß-glycyrrhizin, trimethyl esterification of the resulting epimerized mixture, and alkaline hydrolysis of a purified 18α-glycyrrhizin trimethyl ester. Approaches to the possible presence of 18α-glycyrrhizin in licorice extracts by HPLC using synthetic 18α-glycyrrhizin as a positive standard strongly suggested that 18α-glycyrrhizin could naturally exist as a minor congener of glycyrrhizin derivatives in Glycyrrhiza species.

Kaempferol from the leaves of Apocynum venetum possesses anxiolytic activities in the elevated plus maze test in mice.

The present work evaluated the anxiolytic activity of an aqueous extract of Apocynum venetum L. (Apocynaceae) and bioguided its fractionation using the elevated plus maze (EPM) in mice as a model of anxiety. A single treatment of AV extract markedly increased the percentage time spent on the open arms of the EPM in two distinct concentration ranges of 22.5-30 and 100-125 mg/kg p.o., respectively, indicating a putative anxiolytic-like activity. Fractions showing anxiolytic effects in concentrations equal to 30 or 125 mg/kg of whole extract were antagonized using the benzodiazepine antagonist flumazenil (3 mg/kg i.p.) or the 5-HT(1A) receptor antagonist WAY-100635 (0.5 mg/kg i.p.). All active fractions in a concentration equal to 125 mg/kg were effectively blocked by the benzodiazepine antagonist flumazenil, while the anxiolytic activities of fractions in the lower dose equivalent to 30 mg/kg of whole extract were inhibited by the 5-HT(1A) receptor antagonist WAY-100635. Through further separation of AV fractions it was possible to isolate and characterize the flavonol kaempferol which showed an anxiolytic-like activity in concentrations from 0.02 to 1.0 mg/kg p.o. The anxiolytic activity of kaempferol was partially antagonized by concomitant administration of flumazenil, but not by WAY-100635. In conclusion, our study clearly demonstrates that AV extract possesses anxiolytic-like activity and that at least one of its flavonoids, kaempferol, can elicit the same kind of neuropharmacological activity.

Constituents from leaves of Apocynum venetum L.

An analysis using HPLC-MS revealed that an extract from dried leaves of Apocynum venetum L. contained more than 15 kinds of phenolic constituents. Two malonated flavonol glycosides were further isolated, and their structures were determined to be quercetin 3-O-(6''-O-malonyl)-beta-D-glucoside (1) and quercetin 3-O-(6''-O-malonyl)-beta-D-galactoside (2) by NMR spectroscopic analysis. This is the first report describing the isolation of these malonated flavonol glycosides from A. venetum L. Both glycosides showed strong scavenging activity against 1, 1-diphenyl-2-picrylhydrazyl (DPPH) radical.

Bisindole alkaloids from myxomycetes Arcyria denudata and Arcyria obvelata.

A new bisindole sulfate (1) and arcyroxocin B (2) were isolated from wild fruiting bodies of Arcyria denudate, along with three known bisindoles (4-6). Dihydroarcyriacyanin A (3) was obtained from wild fruiting bodies of Arcyria obvelata, along with a known bisindole (7). The structures of these compounds were elucidated on the basis of spectroscopic data, and this is the first report of full characterizations of arcyroxocin B (2) and dihydroarcyriacyanin A (3). Compounds 2, 3, and 6 showed cytotoxicity against Jurkat cells.

New bisindole alkaloids isolated from Myxomycetes Arcyria cinerea and Lycogala epidendrum.

Two new bisindole alkaloids, named cinereapyrrole A (1) and B (2), were isolated from wild fruit bodies of Arcyria cinerea and three new bisindole alkaloids (3-5) were isolated from wild fruit bodies of Lycogala epidendrum. Seven known bisindoles (6-12) were concomitantly obtained from them. The structures of the new compounds were elucidated by spectral data. Among these bisindole alkaloids, compound 12 showed cytotoxicity against cultured tumor cell lines.