Estimating the impact of drug addiction causes heart damage

To date, few studies have investigated the toxicological effects of the combined use of amphetamine and heroin in the heart. Hence, the aim of this study was to identify indicators for clinical evaluation and prevention of cardiac injury induced by the combined use of amphetamine and heroin. Four different groups were analyzed: (1) normal group (n＝25；average age＝35 ± 6.8); (2) heart disease group (n＝25；average age＝58 ± 17.2); (3) drug abusers (n = 27; average age = 37 ± 7.7); (4) drug abstainers (previous amphetamine-heroin users who had been drug-free for more than two weeks; n = 22; average age = 35 ± 5.6). The activity of MMPs, and levels of TNF-α, IL-6, GH, IGF-I, and several serum biomarkers were examined to evaluate the impact of drug abuse on the heart. The selected plasma biomarkers and classic cardiac biomarkers were significantly increased compared to the normal group. The zymography data showed the changes in cardiac-remodeling enzymes MMP-9 and MMP-2 among combined users of amphetamine and heroin. The levels of TNF-α and IL-6 only increased in the heart disease group. Growth hormone was increased; however, IGF-I level decreased with drug abuse and the level was not restored by abstinence. We speculated that the amphetamine-heroin users might pose risk to initiate heart disease even though the users abstained for more than two weeks. The activity change of MMP-9 and MMP-2 can be a direct reason affecting heart function. The indirect reason may be related to liver damage by drug abuse reduce IGF-1 production to protect heart function.

Neuroprotective Effects of Probiotic Lactobacillus reuteri GMNL-263 in the Hippocampus of Streptozotocin-Induced Diabetic Rats

Diabetes-related brain complications have been reported in clinical patients and experimental models. The objective of the present study was to investigate the neuroprotective mechanisms of Lactobacillus reuteri GMNL-263 in streptozotocin (STZ)-induced diabetic rats. In this study, three different groups, namely control group, STZ-induced (55 mg/kg streptozotocin intraperitoneally) diabetic rats (DM), and DM rats treated with Lactobacillus reuteri GMNL-263 (1 × 109 CFU/rat/day), were utilized to study the protective effect of GMNL-263 in the hippocampus of STZ-induced diabetic rats. The results demonstrated that GMNL-263 attenuated diabetes-induced hippocampal damage by enhancing the cell survival pathways and repressing both inflammatory and apoptotic pathways. Histopathological analysis revealed that GMNL-263 prevented structural changes in the hippocampus in the DM group and decreased the level of inflammation and apoptosis in the hippocampus of DM rats. The IGF1R cell survival signaling pathway also improved after GMNL-263 treatment. These results indicate that probiotic GMNL-263 exerts beneficial effects in the brain of diabetic rats and has potential ability for clinical application.

Ginkgolide A improves the pleiotropic function and reinforces the neuroprotective effects by mesenchymal stem cell-derived exosomes in 6-OHDA-induced cell model of Parkinson's disease

Parkinson's disease (PD) is a common disorder attributed to the loss of midbrain dopamine (mDA) neurons and reduced dopamine secretion. Currently, the treatment regimes for PD comprise deep brain stimulations, however, it attenuates the PD progression marginally and does not improve neuronal cell death. We investigated the function of Ginkgolide A (GA) to reinforce Wharton's Jelly-derived mesenchymal stem cells (WJMSCs) for treating the in vitro model of PD. GA enhanced the self-renewal, proliferation, and cell homing function of WJMSCs as assessed by MTT and transwell co-culture assay with a neuroblastoma cell line. GA pre-treated WJMSCs can restore 6-hydroxydopamine (6-OHDA)-induced cell death in a co-culture assay. Furthermore, exosomes isolated from GA pre-treated WJMSCs significantly rescued 6-OHDA-induced cell death as determined by MTT assay, flow cytometry, and TUNEL assay. Western blotting showed that apoptosis-related proteins were decreased following GA-WJMSCs exosomal treatment which further improved mitochondrial dysfunction. We further demonstrated that exosomes isolated from GA-WJMSCs could restore autophagy using immunofluorescence staining and immunoblotting assay. Finally, we used the alpha-synuclein recombinant protein and found that exosomes derived from GA-WJMSCs led to the reduced aggregation of alpha-synuclein compared to that in control. Our results suggested that GA could be a potential candidate for strengthening stem cell and exosome therapy for PD.

Edible folic acid and medicinal folinic acid produce cardioprotective effects in late-stage triple-transgenic Alzheimer's disease model mice by suppressing cardiac hypertrophy and fibrosis

Some clinical studies have indicated the patients with Alzheimer's disease (AD) display an increased risk of cardiovascular disease (CVD). Here, to examine the relationship between AD and CVDs, we investigated the changes in heart function in triple-transgenic late-stage AD model mice (3× Tg-AD; APPSwe, PS1M146V, and tauP301L). We fed the AD mice folic acid (FA) or folinic acid (FN) and analyzed the protective effects of the compounds on the heart; specifically, 20-month-old triple-transgenic AD mice, weighing 34-55 g, were randomly allocated into three groups-the AD, AD + FA, and AD + FN groups-and subject to gastric feeding with FA or FN once daily at 12 mg/kg body weight (BW) for 3 months. Mouse BWs were assessed throughout the trial, at the end of which the animals were sacrificed using carbon dioxide suffocation. We found that BW, whole-heart weight, and left-ventricle weight were reduced in the AD + FA and AD + FN groups as compared with the measurements in the AD group. Furthermore, western blotting of excised heart tissue revealed that the levels of the hypertrophy-related protein markers phospho(p)-p38 and p-c-Jun were markedly decreased in the AD + FA group, whereas p-GATA4, and ANP were strongly reduced in the AD + FN group. Moreover, the fibrosis-related proteins uPA, MMP-2, MEK1/2 and SP-1 were decreased in the heart in both AD + FN group. In summary, our results indicate that FA and FN can exert anti-cardiac hypertrophy and fibrosis effects to protect the heart in aged triple-transgenic AD model mice, particular in FN.

Unintentional injury mortality among indigenous communities of Taiwan: trends from 2002 to 2013 and evaluation of a community-based intervention

INTRODUCTION

Indigenous communities in Taiwan shoulder a disproportionate burden of unintentional injury fatalities. We compare unintentional injury mortality rate trends among Taiwan's indigenous communities and the general population from 2002 to 2013, and evaluate potential impact of a community-based injury prevention programme on indigenous unintentional injury death rates.

METHODS

Standardised and crude unintentional injury mortality rates were obtained from Taiwan government reports. Segmented linear regression was used to estimate and compare unintentional injury mortality rate trends before and after the intervention.

RESULTS

Between 2002 and 2013, unintentional injury mortality rates among Taiwan's indigenous population significantly declined by about 4.5 deaths per 100 000 each year (p<0.0001). During that time, the unintentional injury mortality rate ratio between indigenous Taiwanese and the general population significantly decreased by approximately 1% each successive year (p=0.02). However, we were unable to detect evidence that the 'Healthy and Safe Tribe' programme was associated with a statistically significant decrease in the unintentional injury mortality rate trend among indigenous persons (p=0.81).

CONCLUSION

Taiwanese indigenous communities remain at significantly higher risk of unintentional injury death, though the gap may be slowly narrowing. We found no evidence that the 'Healthy and Safe Tribe' indigenous injury-prevention programme significantly contributed to the nationwide decline in unintentional injury mortality among indigenous Taiwanese communities from 2009 to 2013. Future interventions to address the disproportionate burden of unintentional injury fatalities among indigenous Taiwanese should consider interventions with wider coverage of the indigenous population, and complementing grass roots led community-based interventions with structural policy interventions as well.

The Use of Hypnotics and Mortality--A Population-Based Retrospective Cohort Study

Background

Sleep disorders, especially chronic insomnia, have become major health problem worldwide and, as a result, the use of hypnotics is steadily increasing. However, few studies with a large sample size and long-term observation have been conducted to investigate the relationship between specific hypnotics and mortality.

Methods

We conducted this retrospective cohort study using data from the National Health Insurance Research Database in Taiwan. Information from claims data including basic characteristics, the use of hypnotics, and survival from 2000 to 2009 for 1,320,322 individuals were included. The use of hypnotics was divided into groups using the defined daily dose and the cumulative length of use. Hazard ratios (HRs) were calculated from a Cox proportional hazards model, with two different matching techniques to examine the associations.

Results

Compared to the non-users, both users of benzodiazepines (HR = 1.81; 95% confidence interval [CI] = 1.78–1.85) and mixed users (HR = 1.44; 95% CI = 1.42–1.47) had a higher risk of death, whereas the users of other non-benzodiazepines users showed no differences. Zolpidem users (HR = 0.73; 95% CI = 0.71–0.75) exhibited a lower risk of mortality in the adjusted models. This pattern remained similar in both matching techniques. Secondary analysis indicated that zolpidem users had a reduced risk of major cause-specific mortality except cancer, and that this protective effect was dose-responsive, with those using for more than 1 year having the lowest risk.

Conclusions

The effects of different types of hypnotics on mortality were diverse in this large cohort with long-term follow-up based on representative claims data in Taiwan. The use of zolpidem was associated with a reduced risk of mortality.

Blending of polyethylenimine with a cationic polyurethane greatly enhances both DNA delivery efficacy and reduces the overall cytotoxicity

Three blending methods were introduced to combine a biodegradable cationic- polyurethane (PUg3) and polyethylenimine (PEI) together with DNA by different mixing sequences. Results of gel electrophoresis assays and particle size measurements show that complexes prepared by method 1 and 3 bear an ability to condense DNA into small nanoparticles. On the contrary, the use of method 2 in making complexes produces significantly large particles because of the weaker interaction with DNA and lack of DNA condensation. Moreover, cell proliferation assays show that no cytotoxicity of the DNA/blended-polymers complexes (exhibited by method 1) was found and due to a result of the outer coating of PUg3, reducing cytotoxic PEI exposure outside the complexes. With a new technique in pharmaceutics, the complexes prepared for DNA delivery by mixing of PEI and PUg3 with DNA in a sequence (method 1) could achieve an even better transfection efficiency (reaching 40% higher) than using PEI alone as well as reduce the cytotoxicity substantially. In conclusion, a new class of complexes (non-viral combo-system) made by a skillful blending sequence (method 1) has been designed and demonstrated to obtain the beneficial properties from two useful and individual polymers for gene delivery. This method can be used in greatly improving the transfection efficiency of polymer-based gene vectors. The blended polymers with DNA also have a better biocompatibility and no cytotoxicity, which are the requirements and critical points for great success in performing gene therapy in vivo.

Infected cephalohematoma associated with sepsis and skull osteomyelitis: report of one case

Osteomyelitis is rarely complicated by an infected cephalohematoma. We report a case of an infected cephalohematoma associated with Escherichia coli sepsis and osteomyelitis of the skull. This 37-day-old boy had E. coli sepsis, which had a poor response to antibiotic treatment. An infected cephalohematoma was found when he was 43 days old. Cranial computed tomography (CT) scanning showed cephalohematoma with abscess formation and underlying bony destruction over the left parietal region. Antibiotics alone could not eradicate the infection. Extensive incision, drainage, and debridement of the necrotic bone resulted in prompt improvement. Three weeks of ceftizoxime administered intravenously, followed by 3 weeks of cefixime given orally completed the treatment course.

AO fixateur interne in treating burst fractures of the thoracolumbar spine

BACKGROUND

A burst fracture of the thoracolumbar junction is an unstable spinal fracture, which is caused by high-energy trauma. There are many methods of treatment, both surgical and nonsurgical, in dealing with spinal burst fractures. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) Fixateur Interne (FI) system was introduced in 1985 for posterior spine surgery with a transpedicular screw system.

METHODS

From April, 1989, through December, 1994, we encountered 42 patients with 42 acute burst fractures of the spine; 26 were male and 16 were female, with an average age of 41.2 years. One fracture occurred on T11, seven on T12, 16 on L1, 11 on L2, one on L3, four on L4 and two on L5. According to the Denis classification, there were eight type A, 23 type B, five type C, three type D and three type E fractures. All of these patients received posterior reduction without decompression, posterior short segmental fixation with AO FI instrumentation and posterior fusion.

RESULTS

After follow-up for an average of 66.1 months, all fractures were found to have united with residual back pain in only six patients; five patients, including one with nonunion, had back pain without the necessity of medication, and the other one had occasional back pain that was well controlled by medication. The immediate postoperative Cobb's angle improved by an average of 14.2 degrees, and there was an average loss of 3.3 degrees at final follow-up. All patients were neurologically intact at final follow-up except two patients, who were Frankel D. Seven patients had complications during follow-up; one experienced nonunion; four experienced screw breakage, one had screw pullout, and the other experienced breakage of the connecting rod.

CONCLUSIONS

From our retrospective study, the outcome of burst fracture of the spine treated with AO FI instrumentation system was satisfactory.

Pemphigus vulgaris

Pemphigus vulgaris is an autoimmune vesiculobullous disease of the skin and the mucous membrane. It most commonly involves the population of the fifth and sixth decades, and is extremely rare in children. We report a case of this disease in a 13-year-old boy, who was documented to have pemphigus vulgaris with historical, histopathological, and immunological criterion. He received corticosteroid and immunosuppressive drugs and a good response was achieved. We concluded that pemphigus vulgaris is a rare disease in children, but it should be kept in mind as a differential diagnosis of oral ulceration along with skin manifestation in children.

Pneumonia with pneumatocele formation caused by Mycobacterium tuberculosis: report of one case

Pneumatoceles are usually characteristic of staphylococcal pneumonia. They are rarely formed as one of the complications of Mycobacterium tuberculosis pneumonia. We report a 1-year-and-5-month old male child with pneumonia who was confirmed to have the rare complication, pneumatocele formation, by chest radiography and computed tomography. Since the patient did not respond to empiric antibiotic therapy, gastric larvage through a nasogastric tube was performed on three consecutive mornings and, as a result, acid fast rods were found on the three specimens. The cultures subsequently yielded M. tuberculosis. He was finally cured with a 6-month course of antituberculous chemotherapy. We conclude that tuberculosis should be considered in infants or young children with pneumonia that presents radiologically as pneumatocele formation, especially in whom there has been no response to empiric antibiotic therapy.

Surgical treatment of seat belt type injury of the thoracolumbar spine

BACKGROUND

Seat belt type injury of thoracolumbar spine is an uncommon injury characterized by disruption of the posterior elements of the spine. The fracture has long been treated conservatively, but progressive kyphotic deformity developed frequently.

METHODS

From January, 1991 through December, 1992, 10 cases of seat belt type injury of the thoracolumbar spine were encountered at our hospital with an incidence of 8% in overall spinal fractures. Of these patients, eight patients were male and two were female, average age 30.7 years old. The causes included motor-vehicle accident in five patients, fall from height in four, and stricken by a falling electric pole in one. None of the victims of motor vehicle accidents wore seat belt. All of them received open reduction, posterior internal fixation and posterior fusion.

RESULTS

After follow-up for an average of 42.2 months, the average kyphotic angulation was 5.7 degrees. Back pain and function of these patients were all rated good. None of them suffered from neurologic deficit. One patient with breakage of transpedicular screws was encountered during follow-up, but there was no complaint.

CONCLUSIONS

In treating seat belt type injuries of spinal column, benefits of operation outweigh the risks. Besides, the clinical result is satisfactory and more aggressive surgical approach should be encouraged.

Down-regulation of epidermal growth factor-induced 12-lipoxygenase expression by glucocorticoids in human epidermoid carcinoma A431 cells

The effect of glucocorticoids on epidermal growth factor (EGF)-induced expression of 12-lipoxygenase in human epidermoid carcinoma A431 cells was studied. A significant suppression of the EGF-induced expression of 12-lipoxygenase was observed in cells pretreated with 1 microM dexamethasone for 2 hr. The same pretreatment for 8 hr resulted in 55 and 54% inhibition of EGF-induced 12-lipoxygenase activity and mRNA expression, respectively. Cortisol, but not sex and mineral steroids, had a similar inhibitory effect. The glucocorticoid antagonist RU486 completely blocked the inhibitory effect of dexamethasone, suggesting that the action of dexamethasone was mediated through the ligation of glucocorticoid receptors. The results indicated that pretreatment of A431 cells with glucocorticoids resulted in a down-regulation of the EGF-induced expression of 12-lipoxygenase at the mRNA and enzyme activity level, which was mediated through glucocorticoid receptor activation.

Surgical treatment of extensive discovertebral destruction in ankylosing spondylitis: a report of two cases

Extensive discovertebral destruction in ankylosing spondylitis is rare and difficult in diagnosis and management. We present two such cases who were treated with anterior decompression, autogenous strut iliac bone graft and fixed with anterior locking plate system (ALPS) instrumentation. After operation the patients' symptoms improved and the spinal deformities were corrected. Our experiences in these two patients emphasize the importance of early recognition, early detection and aggressive surgical treatment in the lesion.

Suanzaorentang, and anxiolytic Chinese medicine, affects the central adrenergic and serotonergic systems in rats

Previously, we found that the ancient Chinese remedy of Suanzaorentang was a promising anxiolytic drug (Chen and Hsieh, 1985; Chen and Hsieh, 1985a). We also found that Suanzaorentang decreased the turnover rate of central monoamines and central catecholaminergic activity (Hsieh, et al., 1986). In this study, we found that 5-hydroxytryptophan (5-HTP) induced decrease in locomotor activity was significantly antagonized by Suanzaorentang, p-chlorophenylalanine (p-CPA) induced increase in locomotor activity was significantly inhibited by Suanzaorentang, Suanzaorentang had no significant effects on baclofen, muscimol, aminooxyacetic acid (AOAA) and thiosemicarbazide induced changes in locomotor activity, Suanzaorentang significantly decreased vanillylmandelic acid (VMA) in striatum and hippocampus, homovanillic acid (HVA) in hippocampus and 5-hydroxyindol acetic acid (5-HIAA) in striatum and hypothalamus, Suanzaorentang significantly reversed the alpha-methyltyrosine (alpha-MT) produced decrease in DA concentrations in striatum and hippocampus, and (6) Suanzaorentang significantly reversed the p-CPA produced decrease in 5-HT concentrations on amygdala. These facts implied that Suanzaorentang might decrease the serotonergic activity but have no significant effect on GABAergic activity. The main locus of action might be in the limbic system.