Transient Worsening of Photosensitivity due to Cholelithiasis in a Variegate Porphyria Patient.

Variegate porphyria (VP) is an autosomal dominant disease caused by mutations of the protoporphyrinogen oxidase (PPOX) gene. This porphyria has unique characteristics which can induce acute neurovisceral attacks and cutaneous lesions that may occur separately or together. We herin report a 58-years-old VP patient complicated with cholelithiasis. A sequencing analysis indicated a novel c.40G>C mutation (p.G14R) in the PPOX gene. His cutaneous photosensitivity had been worsening for 3 years before the emergence of cholecystitis and it then gradually improved after cholecystectomy and ursodeoxycholic acid treatment with a slight decline in the porphyrin levels in his blood, urine and stool. In VP patients, a worsening of photosensitivity can thus be induced due to complications associated with some other disease, thereby affecting their porphyrin-heme biosynthesis.

[Evaluation of the quality of cancer pain-McGill Pain Questionnaire, Yatabe-Guilford test].

In evaluating cancer pain, a comprehensive viewpoint for the so-called total pain, i. e., physical, mental, social as well as spiritual pains is required. The McGill pain questionnaire, which is often used to evaluate cancer pain, helps physicians understand the characteristics of the pain by asking each patient to express his/ her pain using verbal indicators. The Yatabe-Guilford test is also useful in evaluating the pain and QOL of the cancer patient, as it is a test designed to grasp the patient's personality.

Botanical origin of mei-gui hua (petal of a Rosa species).

Mei-gui hua has been used as a crude drug in traditional medicine and as herbal tea in China. The scientific name of Mei-gui is Rosa rugosa thunb. However, the morphological characteristics and botanical ecology of Mei-gui were different from those of R. rugosa. Since the botanical origins of Mei-gui cultivated in China have not yet been clarified, we compared Mei-gui and R. rugosa in terms of their morphological characteristics, phylogenetic analysis, and phytochemical studies. Our research suggested that Mei-gui cultivated around Tarim Basin in Xinjiang Province showed homology to Rosa gallica, while those cultivated in the northeastern parts of China are considered to be hybrids of R. rugosa.

Inhibitory effects of Rosa gallica on the digestive enzymes.

The 50% aqueous ethanol extracts of petals of Rosa gallica collected in Xinjiang province, China, exhibited potent inhibitory effects against alpha-amylase and alpha-glucosidase. As the active principles, seven hydrolysable tannins were isolated from this species for the first time and elucidated by NMR and ESI-TOF-MS analysis. Quantitative analysis by ultra-performance liquid chromatography demonstrated that the contents of these hydrolysable tannins were 3-5% of the dry weight of the petals, and the hydrolysable tannins must be related to the medicinal utilization of this species.

[Usefulness of fentanyl patch (Durotep) in cancer patients when rotated from morphine preparations].

BACKGROUND: [corrected] The transdermal fentanyl patch (Durote patch) is an opioid preparation requiring replacement once in three days, which is occasionally prescribed to replace morphine preparations. The conversion ratio from morphine to fentanyl has been claimed to be 100:1 or 150:1, but there may exist individual variations. METHODS: We retrospectively evaluated the analgesic effects and adverse effects of fentanyl patch in 24 cases among 22 patients (11 men and 11 women). RESULTS: There were some reasons for switching; the major one was for home-care. In most cases rotation was completed in a few days and the side effects disappearance or were reduced, but 4 cases of them showed severe diarrhea or exhibited exacerbation of the pain, and had to go back to morphine. There were a wide variations of conversion ratio with a mean of 96.6. CONCLUSIONS: The fentanyl patch is a useful agent to control severe cancer pain because of excellent analgesic effect, less adverse effects and more convenience as well as itsundesirable characteristics when transition of patients to home-care is considered or oral administration should be avoided. Above all it offers a great possibility to improve cancer patient's quality of life.