Impact of metabolic syndrome on postoperative outcomes of transsphenoidal pituitary surgery: analysis of U.S. nationwide inpatient sample data 2005-2018

Introduction

Transsphenoidal surgery (TSS) is the preferred surgical method for most pituitary adenomas owing to high efficacy and low mortality. This study aimed to evaluate the influence of metabolic syndrome (MetS) on postoperative outcomes of TSS for pituitary adenoma.

Methods

This population-based, retrospective observational study extracted data of adults 20-79 y receiving TSS for pituitary adenoma from the US Nationwide Inpatient Sample (NIS) between 2005-2018. Primary outcomes were pituitary-related complications, poor outcomes (i.e., in-hospital mortality or unfavorable discharge), prolonged length of stay (LOS), and patient safety indicators (PSIs). Univariate and multivariate regressions were performed to determine the associations between study variables and outcomes.

Results

19,076 patients (representing a 93,185 US in-patient population) were included, among which 2,109 (11.1%) patients had MetS. After adjustment, pre-existing MetS was not significantly associated with presence of pituitary-related complications and poor outcomes. In contrast, MetS was significantly associated with an increased risk for prolonged LOS (adjusted OR (aOR) = 1.19; 95% CI: 1.05-1.34), PSIs (aOR = 1.31; 95% CI: 1.07-1.59) and greater hospital costs (adjusted β = 8.63 thousand USD; 95% CI: 4.98-12.29). Among pituitary-related complications, MetS was independently associated with increased risk of cerebrospinal fluid (CSF) rhinorrhea (aOR = 1.22, 95% CI: 1.01, 1.47) but lowered diabetes insipidus (aOR = 0.83, 95% CI: 0.71, 0.97).

Discussion

MetS does not pose excessive risk of in-hospital mortality or unfavorable discharge. However, MetS independently predicted having PSIs, prolonged LOS, greater hospital costs, and CSF rhinorrhea. Study findings may help clinicians achieve better risk stratification before TSS.

P1569The Impact of Multidisciplinary Cardio-Oncology Program on the Cardiovascular Outcomes in Breast Cancer Patients

Background

Chemo- and target therapies may induce myocardial dysfunction and lead to poor prognoses. Early detection of minor myocardial dysfunction is important for the prevention of subsequent cardiotoxicity. Cardio-oncology is a multidisciplinary field focusing on managing and preventing cardiovascular complications in cancer patients. However, whether Cardio-oncology program truly makes difference in cardiovascular outcomes remains unknown. Herein, we are sharing our experiences in our Medical Center.

Methods

Since 2014 till 2017, we recruited 154 patients with newly diagnosed breast cancer preparing for Epirubicin therapy. Echocardiography, biomarkers, six minute walking distance and cardiovascular adverse events including new onset of hypertension, stroke, myocardial infarction (MI) and mortality were recorded at baseline, three months, six months and one year. Any functional decline was reported to oncologists for the consideration of changing regimens. Otherwise, cardiologists would be consulted for cardiovascular educations and therapies. The echocardiographic and clinical records of 450 breast patients receiving Epirubicin therapy during 2010 to 2013 were also collected as comparison.

Results

Compared with the ratio of 20% patients receiving echocardiography prior to 2014, the ratio increased to 100% since Cardio-Oncology program started. Also, the drop of left ventricular ejection fraction (LVEF) from 25% attenuated to 5%. Before Cardio-Oncology Program, there were 1.7% of new onset hypertension, 0.8% of MI, 0.8% of stroke and 16.8% of mortality. Conversely, after the program, there were only 0.6% of new onset hypertension while no other cardiovascular complications were reported. Furthermore, compared with previous reports of the effectiveness of Cardio-Oncology Program, our result also displayed a superior impact on the cardiovascular outcomes.

Conclusions

Collectively, through a comprehensive monitoring and an early intervention of myocardial dysfunction post chemotherapies, Cardio-Oncology Program truly decreased the cardiovascular complications in breast cancer patients.

Acknowledgement/Funding

Chi-Mei Medical Center

A parallel fuzzy inference model with distributed prediction scheme for reinforcement learning

This paper proposes a three-layered parallel fuzzy inference model called reinforcement fuzzy neural network with distributed prediction scheme (RFNN-DPS), which performs reinforcement learning with a novel distributed prediction scheme. In RFNN-DPS, an additional predictor for predicting the external reinforcement signal is not necessary, and the internal reinforcement information is distributed into fuzzy rules (rule nodes). Therefore, using RFNN-DPS, only one network is needed to construct a fuzzy logic system with the abilities of parallel inference and reinforcement learning. Basically, the information for prediction in RFNN-DPS is composed of credit values stored in fuzzy rule nodes, where each node holds a credit vector to represent the reliability of the corresponding fuzzy rule. The credit values are not only accessed for predicting external reinforcement signals, but also provide a more profitable internal reinforcement signal to each fuzzy rule itself. RFNN-DPS performs a credit-based exploratory algorithm to adjust its internal status according to the internal reinforcement signal. During learning, the RFNN-DPS network is constructed by a single-step or multistep reinforcement learning algorithm based on the ART concept. According to our experimental results, RFNN-DPS shows the advantages of simple network structure, fast learning speed, and explicit representation of rule reliability.

Isocupressic acid blocks progesterone production from bovine luteal cells

The needles of ponderosa pine (Pinus ponderosa Laws.) were reported to induce abortions when fed to late-term pregnant beef cows in North America. An in vivo study of pregnant cows suggested that isocupressic acid (IA) was the main abortifacient isolated from needles and bark of the pine. However, the mechanism of abortifacient activity of IA is not clear yet. In a pregnant cow, the corpus luteum of the ovary helps the maintenance of pregnancy by its progesterone production. This study involved the IA extracted from the root of the Taiwan cypress (Juniperus formosana) and used a frozen-thawed bovine luteal cell culture system to investigate the action of IA on progesterone production. Thawed bovine luteal cells (1 x 10(5) cells/ml/well) in M199 medium were cultured in 24-well culture plates at 37 degrees C in a 5% CO2 incubator. Ten ml of tested drugs, IA at 1 to 1000 ng/ml and/or ovine luteinizing hormone (oLH) at 1 to 100 ng/microl or 8-bromo-cyclic adenosine monophosphate (8-Br-cAMP) with 0.1-10 mM, were added into each well. After 4 hours of incubation, the media were harvested and assayed for progesterone by an enzyme immunoassay. Progesterone production from cells was the indicator used to evaluate the action of IA. All tested doses of IA significantly inhibited progesterone production in both basal and oLH stimulating conditions. Also those dosages inhibited cyclic adenosine-3',5'- monophosphate (cAMP) stimulation, suggesting a post-cAMP mechanism is involved in the IA action. We concluded that IA can induce pregnant cows to abort partly through blocking luteal function and may be identified as a new abortifacient chemical.

Effects of single nucleotide polymorphisms in the 5'-flanking region of heat shock protein 70.2 gene on semen quality in boars

This study aims to elucidate the effects of single nucleotide polymorphisms (SNPs) in the 5'-flanking region of porcine heat shock protein 70.2 gene (HSP70.2) on semen quality in boars. Genomic DNA isolated from 55 boars (41 Duroc, nine Landrace, and five Yorkshire) was subjected to PCR amplification of the 5'-flanking region of HSP70.2. The nucleotide sequences were determined by automated sequencing. Five SNPs (sites 44, 232, 250, 345, and 393) were detected in this region. Semen quality was evaluated in terms of sperm motility, percentage of normal sperm, percentage of sperm with proximal plasma droplet, percentage of abnormal sperm, sperm concentration, semen volume per ejaculate and total sperm number per ejaculate. The effect of the SNPs on semen quality was evaluated based on breed-corrected data within a season. During the cool season, the sperm motility of boars with AA genotype at the 232 site was significantly higher than that of boars with CC genotype (P<0.05). Meanwhile, boars with AC genotype at the 232 site had higher total sperm number per ejaculate than did those with CC genotype. In the hot season, heterozygotes at both the 232 and 250 sites had significantly higher total sperm number of per ejaculate than AA homozygotes (P<0.05). Semen volume of boars with TT and TC genotypes at the 345 site was significantly larger than that of those with CC genotype (P<0.05). Meanwhile, semen quality for boars with TT genotype at the 345 site was significantly higher than that of boars with TC or CC genotype (P<0.05), that is the semen contained higher percentages of normal sperm and lower percentages of abnormal sperm or sperm with proximal plasma droplets. Results herein suggest that the SNPs in the 5'-flanking region of porcine HSP70.2 are associated with semen quality traits in the hot season.

Intravitreous tissue plasminogen activator injection and pneumatic displacement in the management of submacular hemorrhage complicating scleral buckling procedures

PURPOSE

To evaluate the efficacy of recombinant tissue plasminogen activator (rTPA) and sulfur hexafluoride (SF6) in displacing submacular hemorrhage in patients who had scleral buckling procedures complicated by the development of submacular hemorrhage. Final visual acuity and complications of the procedures were evaluated.

METHODS

Sequential intravitreal injections of 50 microg rTPA in 0.1 mL and 0.4 cc SF6 were performed in eight patients who showed submacular hemorrhage 1 day after a scleral buckling procedure. The fundus was checked daily for 3 days after the injection of TPA and gas, and then was followed every week for 1 month and then every 2 months. Patients were observed for at least 6 months. Visual acuity and the status of complications were evaluated.

RESULTS

Submacular hemorrhage was totally or partially displaced extramacularly in all patients on the day after rTPA and SF6 injection. Vitreous hemorrhage was present in all patients. The retina was attached in all patients and no recurrent retinal detachment was noted. Visual acuity was improved at 6 months after treatment in all seven of the patients with macula-off retinal detachments compared to the preoperative visual acuity. The last patient who had a macula-sparing retinal detachment had decreased vision (20/25) at 6 months compared to preoperatively.

CONCLUSIONS

Recombinant tissue plasminogen activator and SF6 injection is an easy procedure that is less complicated than and as effective as internal drainage in patients with submacular hemorrhage developing as a complication of scleral buckling procedures.

Identification and quantification of natural isoxazolinone compounds by capillary zone electrophoresis

A capillary zone electrophoresis (CZE) method that is specific, simple, rapid and also cheap was developed to analyse some natural UV-absorbing isoxazolinone compounds with toxic potential present in legume seedlings. The six most common natural isoxazolinone compounds were separated within 10 min with 25 mM potassium phosphate (pH 7.5) containing 8% 1-propanol as running buffer. A 60 cm coated fused-silica capillary (52.6 cm effective length x 75 microm I.D.), with an electric field of 375 V/cm at 30 degrees C was used. The limit of detection ranged from 0.01 mM (3.0 microg/ml) to 0.03 mM (7.7 microg/ml). Linearity between peak areas and concentrations ranging from 0.05 mM to 1.75 mM were determined for each isoxazolinone. The correlation coefficient was 0.9954 or greater. Both relative migration time and peak area were reproducible. The RSD of relative migration time is between 0.44 and 1.94% and RSD of peak area is between 1.26 and 6.86%. The concentrations of isoxazolinones in Lathyrus odoratus and L. sativus seedlings obtained by CZE were in agreement with the previous results from HPLC.

Depression among Alzheimer's caregivers: identifying risk factors

PURPOSE

The purpose of this study was to reveal risk factors contributing to the development of depression among caregivers of Alzheimer's disease patients.

METHODS

In a cross-sectional study, all caregivers of consecutive Alzheimer's disease patients were asked to participate in the study. Patient and caregiver depression was evaluated by using the Yesavage Geriatric Depression Scale (GDS). Information regarding patients' functional status, driving status, and type of behavioral abnormalities was obtained from caregivers. Patients' functional status was evaluated by using the Katz Activity of Daily Living (ADL) scale. The Folstein Mini-Mental Status Examination (MMSE) was used to evaluate cognition. Risk factors for Alzheimer's caregiver depression were assessed by means of logistic regression analysis.

RESULTS

A total of 92 patients and caregivers were evaluated. Fifteen were excluded due to incomplete data. A total of 77 pairs were included in this analysis. The age of caregivers ranged from 28 to 88 years. Mean (standard deviation [SD]) age was 63.1 (SD = 16.3) years old. Husbands and wives (caregivers) accounted for 49.4 percent; daughters or sons (or daughters- or sons-in-law) accounted for 42.9 percent. There were 29 caregivers (38 percent) found to be depressed. By using multivariate analysis, the following factors have been identified as risk factors for depression in Alzheimer 's caregivers: depression in the dementia patient; ADL functional scores of 12 or greater; and the presence of hallucinations.

CONCLUSION

Three risk factors were found to have a strong association with Alzheimer's caregiver depression. Early recognition of such risk factors may help to identify Alzheimer's caregivers with depression.

Retinal vasculitis associated with chickenpox

PURPOSE

To report retinal vasculitis in a young, immunocompetent Asian female adult with chickenpox.

METHODS

Interventional case report. A 32-year-old woman had chickenpox 2 weeks before blurred vision in the left eye. The visual acuity was 20/20 for the right eye and 30/50 for the left eye. The left eye presented keratic precipitates, moderate (2+) cells in the anterior chamber and numerous cells (3+) in the vitreous. The disk was normal. Perivenous exudation was noted mainly in the inferior retina. The sheathed retinal vessels showed late staining but no remarkable leakage on fluorescein angiography. The right eye was normal.

RESULTS

After treatment with acyclovir for 10 days, the visual acuity in the left eye improved to 20/20, and the vasculitis resolved.

CONCLUSION

Retinal vasculitis may present as a complication of primary varicella infection in an immunocompetent adult.

Homocyclotirucallane and two dihydrophenanthrenes from Spiranthes sinensis

A novel homocyclotirucallane, sinetirucallol (1), and two additional new dihydrophenanthrenes, sinensols G (2) and H (3), were isolated from the aerial parts of Spiranthes sinensis (Pers.) Ames. Their structures were determined by various spectral analyses, including MS and two-dimentional nuclear magnetic resonance techniques. The structure of compound 1 was further confirmed by single-crystal X-ray analysis. The absolute configuration of 1 was determined by modified Mosher's method.

Amino acids in seeds and seedlings of the genus Lens

The amino acid content of seeds and 4-day-old seedlings were studied in five species of lentil: Lens culinaris, L. orientalis, L. ervoides, L. nigricans and L. odemensis. Free amino acid and also total protein amino acid content after HCl hydrolysis were determined by HPLC. The nonprotein UV-absorbing amino acids were determined by capillary zone electrophoresis (CZE). The content of free protein amino acids in seeds varied among species and increased dramatically after germination. Asparagine is quantitatively most important in both seed and seedling. The content of free nonprotein amino acids is variable in seeds and seedlings. gamma-Hydroxyarginine, gamma-hydroxyornithine, alpha-aminobutyric acid and taurine were found in both seeds and seedlings. Homoarginine was found in four species but not in L. orientalis while gamma-aminobutyric acid (GABA), alpha-aminoadipic acid (alpha-aaa) and three isoxazolinone derivatives: beta-(isoxazolin-5-on-2-yl)-alanine (BIA), gamma-glutamyl-BIA (gamma-glu-BIA) and 2-carboxymethyl-isoxazolin-5-one (CMI) were found exclusively in the seedlings. CMI was identified for the first time in lentil species. Lathyrine, beta-(2-amino-pyrimidine-4-yl)-alanine, which was reported to be in the seeds of some Lathyrus species was confirmed to be present also in the seedling of L. culinaris (trace amount), L. nigricans and L. odemensis. Trigonelline (N-methyl-nicotinic acid), a plant hormone, is present both in seeds and seedlings in different concentrations except in L. ervoides. The different combination of nonprotein amino acids among the species gives indication of their genetic relationship and might partly explain the varying compatibility for interspecies crossing.

Quinone-type podocarpanes from the bark of Taiwania cryptomerioides

Three quinone-type podocarpanes, 3beta-hydroxy-13-methoxy-8,12-podocarpadiene-11,14-dione (1), 18-hydroxy-13-methoxy-8,12-podocarpadiene-11,14-dione (2), and 13-methoxy-8,12-podocarpadiene-2,11,14-trione (3) were isolated from the bark of Taiwania cryptomerioides. Their structures were elucidated using spectral methods.

Taxane diterpenoids from the stem bark of Taxus mairei

Three new 11(15-->1)-abeo-taxanes, taxumairols U-W (1-3), have been isolated from extracts of the stem bark of Formosan Taxus mairei. The structures of 1-3 were identified as 5alpha,7beta,9alpha,13alpha,20-pentaacetoxy-2alpha,10beta,15-trihydroxy-11(15-->1)-abeo-taxene, 5alpha,7beta,9alpha,20-tetraacetoxy-2alpha,10beta,13alpha,15-tetrahydroxy-11(15-->1)-abeo-taxene, and 2alpha,4alpha,7beta,10beta-tetraacetoxy-5beta,20-epoxy-9alpha,13alpha,15-trihydroxy-11(15-->1)-abeo-taxene, respectively, on the basis of 2D NMR techniques including COSY, HSQC, HMBC, and NOESY experiments as well as chemical reactions of compounds 1-3 to give 4 (5alpha,7beta,9alpha,10beta,13alpha,20-hexaacetoxy-2alpha,15-dihydroxy-11(15-->1)-abeo-taxene) and 5 (4alpha,7beta,10beta-triacetoxy-9alpha,13alpha-dibenzoxy-5beta,20-epoxy-2alpha,15-dihydroxy-11(15-->1)-abeo-taxene), which are also novel taxane derivatives. Taxumairols U (1) and V (2) exhibited significant cytotoxicities against human hepatoma tumor cells, while taxumairol W (3) was inactive.

New sesquiterpene hydroquinones from a Taiwanese marine sponge, Hippospongia metachromia

In addition to metachromins A (1), B (2), and E (9), two new sesquiterpene hydroquinones, hippochromins A and B (3, 4), were isolated from the Taiwanese marine sponge Hippospongia metachromia. The structures of 4--6 were established by extensive 2D NMR analysis. Metachromins A (1) and B (2), hippochromin A diacetate (5), and metachromin B monoacetate (8) exhibited potent cytotoxicities against human colon (COLO-205) and nasopharyngeal (KB) tumor cells, while compounds 6, 7, and 9 were inactive.

Allelopathic prenylflavanones from the fallen leaves of Macaranga tanarius

Two new prenylflavanones, tanariflavanones A (1), and B (2), and one known compound, (-)-nymphaeol-C (3), were isolated from the fallen leaves of Macaranga tanarius. Compounds 1 and 2 showed inhibition of radical growth of lettuce seedlings at 200 ppm. Their structures were elucidated primarily by NMR, circular dichroism, and mass spectroscopic methods.

Progression of hydroxychloroquine retinopathy after discontinuation of therapy: case report

Chloroquine and its derivative, hydroxychloroquine sulfate, have been used in treating malaria, dermatitides of systemic lupus erythematosus and rheumatoid arthritis. Hydroxychloroquine retinopathy is uncommon in Taiwan. Here we report a patient with hydroxychloroquine retinopathy which progressed even after discontinuation of hydroxychloroquine. A 42-year-old woman had systemic lupus erythematosus for twenty years. She had been treated with 200 to 400 mg of hydroxychloroquine per day (4 to 8 mg/kg of body weight/day) with a cumulative dose of 657 g. After bull's-eye maculopathy was found, hydroxychloroquine was discontinued. Her medical history revealed no chloroquine administration and no other systemic disease. Five years after cessation of the therapy, her visual acuity and visual fields continued to deteriorate. Ophthalmoscopic examination revealed the hydroxychloroquine retinopathy had advanced. To the best of our knowledge, the progression of hydroxychloroquine retinopathy after discontinuation of medications is a rare phenomenon. Regular ophthalmologic examinations should be performed for patients on hydroxychloroquine regimens because there is no satisfactory treatment for hydroxychloroquine retinal toxicity. Ophthalmologists, dermatologists and rheumatologists should monitor for ocular toxicity of hydroxychloroquine carefully.

New cyclopropyl-triterpenoids from the aerial roots of Ficus microcarpa

Four new cyclopropyl-triterpenes, 27-nor-3beta-hydroxy-25-oxocycloartane (1), (22E)-25,26,27-trinor-3beta-hydroxycycloart-22-en-24-al (2), 3beta-acetoxy-15alpha-hydroxy-13,27-cyclours-11-ene (3), 3beta-acetoxy-12alpha-formyloxy-13,27-cycloursan-11alpha-ol (4), together with (23E)-27-nor-3beta-hydroxycycloart-23-en-25-one (5) were isolated from the aerial roots of Ficus microcarpa. Compounds 3 and 4 are rare 13,27-cycloursane-type triterpenes. Their structures were elucidated by spectroscopic and chemical methods.

New peroxy triterpenes from the aerial roots of Ficus microcarpa

Six new triterpenes, 3 beta-acetoxy-12 beta,13 beta-epoxy-11 alpha-hydroperoxyursane (1), 3 beta-acetoxy-11 alpha-hydroperoxy-13 alpha H-ursan-12-one (2), 3 beta-acetoxy-1 beta,11 alpha-epidioxy-12-ursene (3), (20S)-3 beta-acetoxylupan-29-oic acid (4), (20S)-3 beta-acetoxy-20-hydroperoxy-30-norlupane (5), and 3 beta-acetoxy-18 alpha-hydroperoxy-12-oleanen-11-one (6), together with 3 beta-acetoxy-12-oleanen-11-one (7), were isolated from the aerial roots of Ficus microcarpa. Compounds 1-3, 5, and 6 were characterized as new peroxytriterpenes. The structures of 3 and 6 were confirmed by X-ray crystallography, and their structures were elucidated by spectroscopic and chemical methods.

Bilateral diffuse uveal melanocytic proliferation in a woman with uterine leiomyoma: case report

Bilateral diffuse uveal melanocytic proliferation (BDUMP) associated with systemic carcinoma is a rare paraneoplastic syndrome. It was reported to be associated with primary carcinomas of the lung, ovary, colon, gall bladder, esophagus, pancreas, uterus, and cervix. We report a case of BDUMP that occurred in a woman with cervical leiomyoma. The 79-year-old woman experienced bilateral progressive visual loss to hand motion within 2 weeks. Fundus examination showed bilateral exudative retinal detachment and multiple oval red patches. Echographic study showed diffuse thickening of the uveal tracts. Fluorescein angiography showed multiple patches of window defect without late leakage, which was correlated with the oval red patches. After screening for tumor markers and meticulous examinations, an elevated serum level of CA-125 was noted. The only neoplasm found in this patient was a cervical leiomyoma, which has never been reported to be associated with BDUMP. One month after the onset of symptoms, accidental head injury due to poor vision led to right parietal intracerebral hemorrhage and left hemiplegia. Prompt diagnosis of this paraneoplastic syndrome is important to discover the underlying malignancy in patients with no history of cancer. For those cases without malignant neoplasm, attention should be directed to the disability caused by the severe visual loss, which led to accidental head injury and intracerebral hemorrhage in this case.

Schizanrins [corrected] B, C, D, and E, four new lignans from Kadsura matsudai and their antihepatitis activities

Bioassay-directed fractionation of ethanolic extract of Kadsura matsudai Hayata has resulted in the isolation of four novel C(18) dibenzocyclooctadiene lignans, schizanrin B (1), schizanrin C (2), schizanrin D (3), and schizanrin E (4). Schizanrin B (1) showed moderate to strong activity for antihepatitis in both anti-HBsAg and anti-HBeAg assays, and 3 and 4 also were active in the latter assay [corrected]. Compounds 1--4 were inactive in vitro against HIV replication in H9 lymphocytes. All new structures were elucidated using spectral analysis. Their structural elucidation by spectral and structure--activity relationships is also discussed.

Three new furan derivatives and a new fatty acid from a Taiwanese marine sponge Plakortis simplex

Three new furan derivatives, plakorsins A-C (6-8), together with a new fatty acid, plakortic acid (9), have been isolated from the Taiwanese marine sponge Plakortis simplex in addition to the known metabolites chondrillin (1), 6-epi-chondrillin (2), 2-oxo-2,5-dihydrofuran-5-acetic acid methyl ester (methyl 1,4-epoxy-1-oxo-2-hexenoate) (3), dimethyl beta-ketoadipate (4), and the monomethyl ester of cis,cis-muconic acid (5). The structures of these compounds were established mainly on the basis of spectral data and chemical methods. Biological studies revealed that compound 7 exhibited cytotoxic activity against COLO-250 and KB-16 cells, and compound 1 is active against KB-16 cells.

Antagonism of free-radical-induced damage of adlay seed and its antiproliferative effect in human histolytic lymphoma U937 monocytic cells

The goal of our current research was to investigate the antioxidative effects of methanolic extracts from different parts of adlay seed and their antiproliferative activity in malignant human cells. The methanolic extracts from different parts of adlay seeds were from the hull (AHM), testa (ATM), bran (ABM), and polished adlay (PAM). AHM exhibited greater capacity to scavenge superoxide anion radicals in the PMS-NADH system than ATM, ABM, or PAM. The scavenging capacities of AHM and ATM on hydrogen peroxides were about 20% at a dose of 250 microg/mL. Using the method of deoxyribose degradation to assess damage caused by hydroxyl radicals, AHM was found to inhibit damage in deoxyribose at a higher concentration. However, ATM, ABM, and PAM exhibited prooxidative activity at the same concentration. The inhibitory effect on enzymatic oxidation of xanthine to uric acid was found to follow the order AHM > ATM =. ABM. However, PAM was inactive. All test samples were positive for inhibition of TPA-induced free radical formation on neutrophil-like leukocytes and were found to follow the order AHM > ATM > ABM > PAM. When human histolytic lymphoma U937 monocytic cells were exposed to tert-butyl hydroperoxide, AHM protected the cells against the cytotoxicity caused by tert-butyl hydroperoxide. In addition, AHM exhibited antiproliferative activity against human histolytic lymphoma U937 monocytic cells in a dose-dependent manner. The antiproliferative properties of AHM appear to be attributable to its induction of apoptotic cell death as determined by flow cytometry. These results show that AHM displays multiple antioxidant effects and induces apoptosis of malignant human cells.

Nonprotein amino acids in edible lentil and garden pea seedlings

Commercial edible seedlings of garden pea (Pisum sativum L.) and lentil (Lens culinaris L.) contain high concentration of nonprotein amino acids and trigonelline. Both seedlings grown in the laboratory or purchased in a supermarket were studied by HPLC. Samples from both origins contained trigonelline, alpha-aminoadipic acid, homoserine, beta-(isoxazolin-5-on-2-yl)-alanine (BIA), and gamma-glutamyl-BIA. Garden pea seedlings also contained a uracil-alanine derivative (isowillardiine) in substantial amount. Some of these compounds such as BIA and alpha-aminoadipic acid have neurotoxic activity.

A novel anti-HBeAg homolignan, taiwanschirin D from Kadsura matsudai

A novel C19 homolignan, taiwanschirin D (1), possessing a 3,4-(1-[(Z)-2-methoxy-2-oxoethylidenel)pentano (2,3-dihydrobenzo[b]furan)-3(2-oxoacetate) skeleton, was isolated from the stem of Kadsura matsudai Hayata. Its structure was determined from physical and spectral data including 2D NMR spectra. The Anti-HBeAg test revealed that taiwanschirin D (1) had moderate activity at a concentration of 94.3 microM (50 microg/ml).

Four new compounds, ficusal, ficusesquilignan A, B, and ficusolide diacetate from the heartwood of Ficus microcarpa

Three new lignans, ficusal (1) and ficusesquilignans A (2), B (3) and one new gamma-lactone, ficusolide diacetate (4), were isolated from the wood of Ficus microcarpa L.f. Their structures were determined by spectral evidence.

Dihydrophenanthrenes from Spiranthes sinensis

Six novel dihydrophenanthrene derivatives, sinensols A-F (1-6), were isolated from the aerial parts of Spiranthesis sinensis. Their structures were determined on the basis of various spectroscopic data, in particular those yielded by MS and 2D NMR techniques.

Association of heat shock protein 70 with semen quality in boars

This study attempted to clarify the relationship between the levels of 70kDa heat shock protein (HSP70) and semen quality in boars. Semen samples from 29 (13 Duroc, 9 Landrace, and 7 Yorkshire) boars (mean age=25.2+/-2.2 months) were examined. Three to four ejaculates per boar, collected during cool and hot seasons, were evaluated in terms of the sperm concentration, sperm motility, percentage of normal and abnormal sperm, as well as percentage of sperm with proximal and distal plasma droplets. Significant seasonal and breed differences in semen quality were observed. Experimental results indicate that the semen quality of Landrace boars was better than those of Yorkshire and Duroc boars (P<0.05) and semen quality declined significantly during the hot season (P<0.05). One-dimensional SDS-PAGE analysis of spermatozoa proteins indicated that protein profiles did not significantly differ between seasons and among breeds. Both constitutive and stress-inducible form of HSP70 were detected in boar spermatozoa by Western blot analysis. The level of HSP70, which revealed no difference among breeds within a season, was significantly lower during the hot season in all the three breeds (P<0.05). Although there appeared to be low correlation coefficients between the level of HSP70 and semen quality traits, the semen quality tended to decline significantly in samples with a lower level of HSP70. Results in this study suggest that the levels of HSP70 in boar spermatozoa are significantly lower during the hot season and might be associated with semen quality.

Synthesis of 60- and 72 kDa heat shock proteins in early porcine embryogenesis

Proteins of selected embryonic stages were metabolically labeled with [(35)S]-methionine and analyzed by two-dimensional SDS-polyacrylamide gel electrophoresis (2-D PAGE) to study protein expression from 4- to 8-cell to blastocyst stage of porcine embryos. Two proteins with molecular weights of 60 and 72kDa were de novo synthesized during the 4- to 8-cell stage were the earliest that were detected. They were identified as HSP60 and HSP72 according to their locations on 2-D autoradiography and the immunoblotting result of anti-HSP 60 and HSP 72 antibodies of 1-cell stage of porcine embryos. In protein translation in early pig embryogenesis the timing of their synthesis suggests that HSP60 and HSP72 play significant roles as chaperones.

Inducible nitric oxide synthase inhibitors from Saposhnikovia divaricata and Panax quinquefolium

A series of polyacetylenes, falcarinone, panaxynol, falcarindiol, panaxydol, and panaxytriol, were isolated from Saposhnikovia divaricata (Turcz.) Schischk and Panax quinquefolium L. These polyacetylenes were identified as active principles on the inhibition of nitrite production by inducible nitric oxide synthase (iNOS). Treatment with 10 microM of panaxynol, falcarindiol, panaxydol and panaxytriol decreased the LPS/IFN-gamma-stimulated accumulation of nitrite by 71.92 +/- 3.07, 69.95 +/- 3.68, 45.48 +/- 6.11 and 36.85 +/- 8.80%, respectively. The IC50 value of falcarinone, panaxynol, falcarindiol, panaxydol and panaxytriol was > 20, 2.23, 1.98, 6.58 and 9.85 microM, respectively.

Cytotoxicity of extractives from Taiwania cryptomerioides heartwood

The cytotoxicity of the dominant lignans and sesquiterpenoids from Taiwania (Taiwania cryptomerioides Hayata) was investigated. Three human tumor cells including A-549 lung carcinoma. MCF-7 breast adenocarcinoma and HT-29 colon adenocarcinoma were selected to illustrate the structure-cytotoxicity relationships of Taiwania's dominant compounds. Taiwanin A, taiwanin E and dimethylmatairesinol exhibited significant cytotoxicity against three human tumor cells. Among them, taiwanin A possesses the strongest cytotoxic activity. In addition, the morphology-based evaluation, flow cytometric analysis, and DNA fragmentation assays demonstrated that the tumor cell death induced by taiwanin A was due to apoptosis.

Six new compounds from the heartwood of Diospyros maritima

Six new compounds, diospyrolide (1), diospyrolidone (2), diethyl (2R)-malate (3), 3-(E)-coumaroylbetulin-28-yl ethyl nonanedioate (4), 3-(E)-coumaroylbetulin-28-yl ethyl succinate (5), and 3-(E)-coumaroylbetulin-28-yl ethyl (2R)-2-hydroxysuccinate (6), have been isolated from the heartwood of Diospyros maritima. Compounds 1 and 2 are novel trinorlupanes, and 4, 5 and 6 are lupane derivatives. Their structures were determined using spectral and chemical methods.

Taraxastane-type triterpenes from the aerial roots of Ficus microcarpa

Seven new taraxastane-type triterpenes-20-taraxastene-3beta, 22alpha-diol (1), 3beta-acetoxy-20-taraxasten-22alpha-ol (2), 3beta-acetoxy-22alpha-methoxy-20-taraxastene (3), 3beta-acetoxy-20alpha,21alpha-epoxytaraxastan-22alp ha-ol (4), 3beta-acetoxy-19alpha-methoxy-20-taraxastene (5), 3beta-acetoxy-19alpha-hydroperoxy-20-taraxastene (6), 3beta-acetoxy-20alpha,21alpha-epoxytaraxastane (7)-were isolated from the aerial roots of Ficus microcarpa. Their structures were elucidated by spectroscopic and chemical methods.

Selection of drug-resistant variants in the female genital tract of human immunodeficiency virus type 1-infected women receiving antiretroviral therapy

We investigated human immunodeficiency virus (HIV) type 1 RNA, proviral DNA, and antiretroviral drug-resistant variants in cervicovaginal secretions of HIV-1-infected women receiving antiretroviral therapy. The prevalence of detectable HIV-1 RNA in genital secretions was inversely related to the number of antiretroviral drugs taken by the patients. Proviral DNA was detected in approximately half of all samples of cervicovaginal secretions from HIV-1-infected women, regardless of the presence or absence of HIV-1 RNA in cervicovaginal secretions and of the antiretroviral regimen. In cervicovaginal secretions of most women with persisting genital viral replication, HIV variants exhibiting mutations associated with drug resistance against protease and reverse-transcriptase pol genes were found. Our observations indicate that antiretroviral therapy is not effective in purging the female genital tract of cell-associated provirus and that antiretroviral drugs that penetrate the female genital tract at suboptimal concentrations exert a potent selective pressure on genital HIV variants when local replication of free HIV-1 RNA persists.

Four new terpenes from the pericarp of Platycladus orientalis

A new monoterpene, platydiol (1), and three new diterpenes, platyclolactonic acid (2), 14,15-bisnor-8(17)-labdene-16,19-dioic acid (3), and 6,7-dehydrosandaracopimaric acid (4), were isolated from the pericarp of Platycladus orientalis. Their structures were elucidated by spectral and chemical methods.

Six new ursane- and oleanane-type triterpenes from the aerial roots of Ficus microcarpa

Four new ursane-type triterpenes, 3beta-acetoxy-11alpha-methoxy-12-ursene (1), 3beta-acetoxy-11alpha-ethoxy-12-ursene (2), 3beta-acetoxy-11alpha-hydroperoxy-12-ursene (3), 3beta-hydroxy-11alpha-hydroperoxy-12-ursene (4), and two new oleanane-type triterpenes, 3beta-acetoxy-11alpha-ethoxy-12-oleanene (5), 3beta-acetoxy-111alpha-hydroperoxy-12-oleanene (6), together with 3beta-acetoxy-11alpha-hydroxy-12-ursene (7), 3beta,11alpha-diacetoxy-12-ursene (8), 3beta-acetoxy-11alpha-hydroxy-12-oleanene (9), were isolated from the aerial roots of Ficus microcarpa L. f. Their structures were elucidated by spectroscopic and chemical methods.

Podocarpane-type trinorditerpenes from the bark of Taiwania cryptomerioides

Five new podocarpane-type trinorditerpenes were isolated from the bark of Taiwania cryptomerioides. Structures of 1beta, 14-dihydroxy-13-methoxy-6,8,11,13-podocarpatetraene (1), 1beta, 14-dihydroxy-13-methoxy-8,11,13-podocarpatriene (2), 13-hydroxy-12-methoxy-8,11,13-podocarpatrien-3-one (3), 14-hydroxy-13-methoxy-1,8,11,13-podocarpatetraen-3-one (4), and 13-methoxy-8,12-podocarpatriene-11,14-dione (5) were determined by NMR, MS, and other spectral and chemical evidence.

New taxanes with an opened oxetane ring from the roots of Taxus mairei

Two novel taxoids, taxumairols N (1) and O (2), have been isolated from extracts of the roots of Taxus mairei. The structures of 1 and 2 were identified as 7beta,9alpha,10beta,13alpha-tetraacetoxy-2alp ha, 4alpha,5alpha,20-tetrahydroxytax-11-ene and 7beta,9alpha,10beta, 13alpha-tetraacetoxy-1beta,2alpha,4alpha,5alp ha, 20-pentahydroxytax-11-ene on the basis of 1D and 2D NMR techniques including COSY, HMQC, HMBC, and NOESY experiments.

Six podocarpane-type trinorditerpenes from the bark of Taiwania cryptomerioides

Six podocarpane-type trinorditerpenes were isolated from the bark of Taiwania cryptomerioides. Their structures, 14-hydroxy-13-methoxy-8,11,13-podocarpatrien-7-one (1), 13-hydroxy-12-methoxy-8,11,13-podocarpatriene (2), 12-hydroxy-13-methoxy-8,11,13-podocarpatriene (3), 14-hydroxy-13-methoxy-8,11,13-podocarpatriene (4), 13-hydroxy-8,11,13-podocarpatriene (5), and 13,14-dihydroxy-8,11,13-podocarpatrien-7-one (6), were determined principally from spectral evidence.

The decline of porcine sperm motility by geldanamycin, a specific inhibitor of heat-shock protein 90 (HSP90)

Sperm motility is an important parameter for fertility. The molecular mechanisms of mammalian sperm motility are still largely undefined. Our previous observations suggested that heat shock protein 90 (HSP90) may be associated with porcine sperm motility. The aim of the present study was to further characterize the plausible novel function of HSP90 on sperm motility. Semen from normal, sexually mature boars with sperm motility higher than 80% was used. An HSP90-specific inhibitor, geldanamycin (GA), was added to diluted semen at 0.5, 1.0, 2.5 or 5.0 microg/mL and the semen was then incubated at 37 degrees C for 15, 30, 45 or 60 min. Sperm motility was determined by using computer-assisted semen analyzer at the end of incubation. The results indicated that GA significantly reduced sperm motility in a dose and time dependent manner. Moreover, incubation of semen with 5.0 microg/mL GA for 15 min completely stopped sperm motility. To test the reversibility of the GA effect on sperm motility, GA was removed after 30 min incubation and was replaced with fresh extender alone or with extender plus 5 mM caffeine, then incubated for another 15, 30, 45 or 60 min. The results showed that simply removing GA did not reverse the inhibitory effect on sperm motility, while adding caffeine partially reversed this inhibitory effect. However, the effect of 2.5 or 5.0 microg/mL GA was not reversed by caffeine. Considering the specificity of GA targeting to HSP90, the above observations suggested that HSP90 may play a crucial role in regulating porcine sperm motility.

Free amino acids present in commercially available seedlings sold for human consumption. A potential hazard for consumers

The importance of fresh seedlings for human consumption on European markets continues to increase. Although the contents of free amino acids and potentially toxic free nonprotein amino acids in these fresh and supposedly healthy seedlings is very different from those of the seeds, the crude composition is never mentioned on commercial packages. A commercial product containing seven different kinds of fresh seedlings including kamut, adzuki bean, chickpea, mungbean, pinto bean, garden pea, and lentil has been analyzed by HPLC. Per 100 g of fresh product, 548.2 mg of total free amino acids was found, of which 56.7 mg is free nonprotein amino acids including beta-(isoxazolin-5-on-2-yl)alanine, homoserine, and isowillardiine and the plant hormone trigonelline (N-methylnicotinic acid). The highest amounts of free nonprotein amino acids and trigonelline are found in garden pea (28.3 mg/100 g), mungbean (9.59 mg/100 g), and lentil (7.50 mg/100 g) seedlings. Trigonelline is present in all legume seedlings examined.

A novel cytotoxic C-methylated biflavone from the stem of Cephalotaxus wilsoniana

Bioassay-directed fractionation of an ethanolic extract of Cephalotaxus wilsoniana has resulted in the isolation of a novel C-methylated biflavone, taiwanhomoflavone-A (1). Its structure was elucidated on the basis of spectroscopic analysis. Taiwanhomoflavone-A is cytotoxic with ED50 values of 3.4, 1.0, 2.0 and 2.5 microg/ml, respectively, against KB epidermoid carcinoma of nasopharynx, COLO-205 colon carcinoma, Hepa-3B hepatoma, and Hela cervix tumor cells.

Stage III colon cancers: why adjuvant chemotherapy is not offered to elderly patients

HYPOTHESIS

Adjuvant chemotherapy is not offered to elderly patients with stage III colon cancer.

DESIGN

A retrospective review of hospital and office records.

SETTING

A suburban community hospital.

PATIENTS

The medical records of 69 patients with stage III colon cancer were reviewed. All identified from the Tumor Registry at Jersey Shore Medical Center, Neptune, NJ, were included in this study.

RESULTS

Thirty-five patients (51%) did not receive adjuvant chemotherapy. After adjusting for age, women were 5.8 times less likely to receive chemotherapy (P = .002). Patients not receiving chemotherapy were significantly older (78.7 vs 70.4 years; P = .003) than those who received adjuvant chemotherapy. There was no relation found between the year of diagnosis and the administration of chemotherapy. There were 4 major reasons for not receiving chemotherapy: (1) not offered (n = 12, 34%), (2) refused (n = 11, 31%), (3) too old (n = 7, 20%), and (4) significant concomitant disease (n = 5, 14%).

CONCLUSIONS

A large group of elderly patients who had been surgically treated for colon cancer and who were eligible for adjuvant chemotherapy either were not referred for treatment or refused treatment. This suggests a bias on the part of surgeons, primary care physicians, and patients against the use of chemotherapy in elderly patients.