New Furanocembranoids from Briareum violaceum.

Three new furanocembranoids-briaviodiol F (1) and briaviotriols A (2) and B (3)-along with a known analogue, briaviodiol A (4), were obtained from a cultured-type octocoral Briareum violaceum. The structures of cembranoids 1⁻3 were elucidated by using spectroscopic methods. In vitro study demonstrated that compounds 2 and 4 exerted inhibition effects on inducible nitric oxide synthase (iNOS) release from RAW 264.7, a macrophage cell line that originated from a mouse monocyte macrophage, stimulated with lipopolysaccharides.

Panspinal epidural abscess concomitant with meningitis.

Panspinal epidural abscess is an extremely rare condition that can potentially lead to major permanent neurological deficits if treatment is delayed or suboptimal. Most patients with spinal epidural abscess have a short segment of vertebrae involved and classically present with fever, low back pain, and focal neurologic deficit. In severe cases, meningitis and septic shock may occur and lead to death. Therefore, the condition requires prompt recognition and proper intervention. Herein, we report the case of a 41-year-old diabetic man who presented at our hospital with the symptoms of headache, quadriplegia with respiratory distress and low back pain. Panspinal epidural abscess and meningitis were diagnosed by carrying out detailed neurologic examinations and neuroimaging studies, which expedited the correct diagnosis and treatment.

Intrasinus thrombolysis by mechanical and urokinase for severe cerebral venous sinus thrombosis : a case report.

PURPOSE: Cerebral venous and sinus thrombosis (CVST) is a rare stroke disorder, which requires prompt recognition and appropriate intervention to prevent a devastating outcome. Intrasinus thrombolysis is an alternative and effective method to anticoagulant therapy for the treatment of CVST, but is rarely used in Taiwan. CASE REPORT: A 46-year-old man presented with a one-week history of intractable headache and progressive weakness of his right lower limb. Magnetic resonance venography of the brain confirmed a diagnosis of extensive venous sinus thrombosis. The patient was successfully treated by direct intrasinus thrombolysis with urokinase. CONCLUSION: This case highlights the benefit of early intrasinus thrombolysis for the treatment of CVST.

Neurogenic stunned myocardium as a manifestation of encephalitis involving cerebellar tonsils.

Neurogenic stunned myocardium is defined as a myocardial injury or dysfunction after neurological insults. It is most commonly reported in patients with subarachnoid hemorrhage, and the presenting symptoms may mimic an acute myocardial infarction or myocarditis. In severe cases, cardiogenic shock and acute pulmonary edema may occur and lead to a devastating event. Therefore, it requires prompt recognition and proper intervention. We herein report the case of a 25-year-old woman who presented to our hospital with the symptoms of acute pulmonary edema, shock, and consciousness disturbance. The diagnosis of encephalitis of cerebellar tonsils complicated with acute hydrocephalus and neurogenic stunned myocardium was made. Detailed neurologic examinations, neuroimaging studies, and characteristic echocardiographic changes expedite the correct diagnosis and treatment.

Glucose/Glutathione Co-triggered Tumor Hypoxia Relief and Chemodynamic Therapy to Enhance Photothermal Therapy in Bladder Cancer.

Photothermal therapy (PTT) is a potential treatment for cancer that makes use of near-infrared (NIR) laser irradiation and is expected to assist traditional anti-cancer drug therapies; however, the therapeutic efficacy of PTT is restricted by thermal resistance due to the overexpression of heat shock proteins and insufficient penetration depth of lasers. Thus, PTT needs to be combined with additional therapeutic methods to obtain the optimal therapeutic efficacy for cancer. Herein, a multifunctional therapeutic platform combining PTT with glucose-triggered chemodynamic therapy (CDT) and glutathione (GSH)-triggered hypoxia relief was developed via GOx@MBSA-PPy-MnO2 NPs (GOx for glucose oxidase, M for Fe3O4, BSA for bovine serum albumin, and PPy for polypyrrole). GOx@MBSA-PPy-MnO2 NPs have excellent photothermal efficiency and can release Mn2+, which catalyzes the transformation of H2O2 into hydroxyl radicals (·OH) and O2 via a Fenton-like reaction, effectively destroying cancer cells and relieving tumor hypoxia. Meanwhile, a high content of H2O2 was produced via GOx catalysis of glucose, further enhancing the CDT efficiency. In addition, in vitro and in vivo experiments showed that the inhibition of cancer cell proliferation and effective inhibition of tumors could be caused by the combined PTT/glucose-triggered CDT effects and hypoxia relief of the GOx@MBSA-PPy-MnO2 NPs. Overall, this work provides evidence of a synergistic therapy that remarkably improves therapeutic efficacy and significantly prolongs the lifetime of mice compared with controls.

Neurological melioidosis (Burkholderia pseudomallei) in a chronic psychotic patient treated with antipsychotics: A case report.

RATIONALE: Neurological melioidosis, an extremely rare condition, is caused by the gram-negative bacterium Burkholderia pseudomallei. If treatment is suboptimal or delayed, this infection can produce diverse clinical symptoms and result in death. PATIENT CONCERNS: A healthy 65-year-old female who had been treated with antipsychotic medication for neurotic depression for over 2 years presented with acute-onset fever, headache, lead-pipe rigidity of all limbs, and delirium. DIAGNOSES: Melioidosis meningitis was diagnosed by performing blood examinations and cerebrospinal fluid analysis and cultures. INTERVENTIONS: Intravenous ceftazidime (2 g/8 h for 3 weeks) was administered in-hospital and 240 mg trimethoprim/1200 mg sulfamethoxazole and 100 mg minocycline twice daily administered out-hospital. OUTCOMES: The patient fully recovered after antibiotic therapy without cognitive deficits and associated neurological complications. LESSONS: Because melioidosis is endemic in Southern Taiwan and the use of antipsychotics might mask the symptoms, physicians dealing with patients from endemic areas with a medical history of antipsychotics should always consider the possibility of neurological melioidosis and provide prompt empirical management to suspicious cases.