Current Herbal-medicine News Results

Two new chalcones from leaves of Morus alba L.

Fitoterapia. 2010 Mar 5;
Yang Y, Zhang T, Xiao L, Yang L, Chen R

Two new chalcone derivatives named morachalcone B - C (1 -2) were isolated from the leaves of Morus alba L.. Their structures were elucidated by spectroscopic analysis. Morachalcones B (1) and C (2) represent two examples of chalcones having unusual furan ring which is formed by cyclization between C-alpha-OH and C-2-OH. Compounds 1, 2 displayed only moderate cytotoxic activity against HCT-8 and BGC823 human cancer cell lines.

Integrated Countercurrent Extraction of Natural Products: A Combination of Liquid and Solid Supports.

Anal Chem. 2010 Mar 8;
Lu Y, Hu R, Pan Y

An integrated online column-switching countercurrent chromatography (CCC) with a solid-phase trapping/preconcentration interface is presented. The interface is systematically evaluated in terms of sorbent type, column size, and kinetic factor from the view of the unique CCC process. Results indicate that satisfactory trapping efficiency can be achieved using a 25 mm x 10 mm i.d. column packed with Oasis HLB materials. In addition to the analyte focusing effect, large volume injection is avoided, thereby allowing the use of totally different biphasic liquid systems to enhance the system orthogonality. The present integrated system simply combines the liquid and solid supports and is successfully applied in a one-step preparative separation of four antioxidative compounds from the ethyl acetate extract of traditional Chinese herbal medicine Rubia cordifolia L. (Rubiaceae), exhibiting great advantages in peak resolution, peak capacity, and instrument integration compared with conventional CCC separations.

[Determination of eight metal elements in Cichorium glandulosum Boiss et Huet by microwave digestion-FAAS]

Guang Pu Xue Yu Guang Pu Fen Xi. 2009 Dec; 29(12): 3412-5
Pei LP, Zhou XY, Cui J, Pang ZR, Liu HB, Ge L

The Cichorium glandulosum Boiss et Huet is a traditional Uighur natural herbal medicine, but has not been analyzed and studied in terms of its metal elements. In the experiment, the Cichorium glandulosum Boiss et Huet powder was digested with HNO3 by microwave digestion before determination. The eight metal elements, potassium, nickel, calcium, magnesium, iron, manganese, copper and zinc, in Cichorium glandulosum Boiss et Huet were determined by FAAS. The working conditions, accuracy and precision of the method were studied. The linear correlations of standard curves are good (r = 0.999 1-0.999 9). The recovery (n = 6) is 92.25%-110.5%, and the RSD (n = 6) is 0.7%-3.88%. The results showed that there were comparatively rich metal elements, among which are comparatively high calcium (65.84 mg x g(-1)), iron (24.38 mg x g(-1)), magnesium (278.17 mg x g(-1)) and potassium (18.50 mg x g(-1)), in Cichorium glandulosum Boiss et Huet, and the contents of other elements are nickel of 0.004 38 mg x g(-1), manganese of 0.52 mg x g(-1), copper of 0.016 5 mg x g(-1) and zinc of 0.18 mg x g(-1). This provided useful data for discussing the relationship between the content of the metal elements in Cichorium glandulosum Boiss et Huet and its clinical application in cardiovascular and osteoporosis disease.

[Randomized controlled clinical study on ginger-partitioned moxibustion for patients with cold-damp stagnation type primary dysmenorrhea]

Zhen Ci Yan Jiu. 2009 Dec; 34(6): 398-402
Sun LH, Ge JJ, Yang JJ, She YF, Li WL, Li XH, Yuan J, Li ZB, Lu YJ, Bi XX, Li M, Geng YH, Wang T

OBJECTIVE: To observe the effect of ginger-partitioned moxibustion in the treatment of patients with primary dysmenorrhea (PD) of cold-damp stagnation type. METHODS: A total of 209 PD patients were randomized into moxibustion group (n=105) and control group (medication group, n=104). Patients of the former group were treated with ginger-partitioned moxibustion at Shenque (CV 8) and Guanyuan (CV 4), once daily for 3 days in the first menstrual cycle, and 3 days before menstruation and once daily for 6 days in the 2nd and 3rd menstrual cycles, and those of control group were asked to take Yueyueshu Granules (a Chinese herbal patent drug for relieving PD). Clinical symptom scores were assessed before and after the treatment. RESULTS: After the treatment, of the 105 and 104 cases in the moxibustion and control groups, the cured, markedly effective, effective and failed cases were 58 (55.24%) and 32 (30.77%), 37 (35.24%) and 33 (31.73%), 5 (4.76%) and 24 (23.08%), and 5 (4.76%) and 15 (14.42%), respectively. The total therapeutic effect of moxibustion group wassignificantly better than that of control group (P<0.01). The effects of moxibustion for relieving mild, moderate and severe dysmenorrhea were evidently superior to those of medication (P<0.01). The symptom scores after the treatment and 3 months of post-treatment in moxibustion group were significantly lower than those of control group (P<0.01). CONCLUSION: Ginger-partitioned moxibustion therapy was effective for PD of cold-damp stagnation type.

[Zebrafish--useful model for pharmacodynamics and toxicity screening of traditional Chinese medicine]

Zhongguo Zhong Yao Za Zhi. 2009 Nov; 34(22): 2839-42
Liang A

Zebrafish has been an important model for developmental and genetic studies. In the past ten years, it has also been widely used for environmental toxicity monitoring, additive effect and toxicity of many chemical materials including heavy metals, pesticides, halogenated aromatic hydrocarbon compounds and other carcinogens. Zebrafish is increasingly used in drug screening and toxicological studies in recent years with the advantage of high-throughput handling. It is a useful model of choice for in vivo pharmacodynamic screening and toxicity investigation of Chinese medicine and it has a wide application prospect in the field of new herbal-drug research.

[Microscopic identification study of western herbs. Part I: Three Echinacea-species roots]

Zhongguo Zhong Yao Za Zhi. 2009 Nov; 34(21): 2718-20
Li Q, Chu C, Tan Z, Wang Y, Wei J, Li P, Zhao Z

OBJECTIVE: To make microscopic identification research of three Echinacea-species roots recorded in the United States Pharmacopeia. METHOD: The root transverse section and powder of E. angustifolia, E. pallida, and E. purpurea were observed. The main microscopic features were photographed. RESULT: The main microscopic features of transverse section and powder in three Echinacea-species roots are basically similar, except for some diagnostic differences. The results provide reliable reference for the authentication of raw materials of western herbal studies.

[Review of pharmacological effects of Glycyrrhiza radix and its bioactive compounds]

Zhongguo Zhong Yao Za Zhi. 2009 Nov; 34(21): 2695-700
Gao X, Wang W, Wei S, Li W

Glycyrrhiza Radix is a commonly used Chinese herbal medicine, derived from the dried roots and rhizomes of Glycyrrhiza uralensis, G. glabra and G. inflata. The main bioactive constituents of licorice are triterpene saponins and flavonoids. There are various types of pharmacological properties of licorice are proved, including antiulcer, antiinflammation, spasmolysis, antioxidative, contravariance, antiviral, anticancer activities, hepatoprotective, eliminating phlegm and reinforcing remembrance effects. Triterpene saponins are the main components of Glycyrrhiza Radix and its pharmacological activities are comparatively thorough and clear. In recent years, licorice flavonoids, proved to have a variety of pharmacological activities, become one of the hot of pharmacological studies. In this review, we summarized the latest five-year progress in pharmacological activities of licorice extract, its triterpenoid saponins and flavonoids, and experimental researches indicated that licorice had both accommodation and protection activity on the digestive system, respiratory system, nervous system, and endocrine system, etc.

Herbs in orthodox practice: a view by medical students.

Afr J Tradit Complement Altern Med. 2009; 6(2): 203-6
Enwere OO

Use and opinion of herbs among medical students of Imo State University Nigeria was assessed. Information on herb use, indication and opinion from returned self-administered questionnaire was analyzed. A total of 114 students (91.2%) of 125 responded. 32 (28.1%) students had used herbs before, a significant proportion being males (OR 3.7). Herbal tea was the most popular herb used; maintaining good health and treating malaria were the only indications (50% each). Most students (>90%) believe herbs to be harmful, and generally unsafe especially in pregnancy. Most students (73%) who had used herbs consider them effective in treating hypertension or diabetes mellitus (OR 3.5 & 6.0 respectively). Most students (89.1%) believe there's a lot of misinformation about herbs. Most students view use of herbs with skepticism. Inculcating study of herbs in medical curriculum will provide better information on herbs.

Any Second-Line Therapy for Advanced Pancreatic Cancer? Highlights from the "2010 ASCO Gastrointestinal Cancers Symposium". Orlando, FL, USA. January 22-24, 2010.

JOP. 2010; 11(2): 151-3
Li J, Merl MY, Saif MW

Majority of pancreatic cancers are unresectable upon diagnosis. Palliative chemotherapy is usually administered in an attempt of prolonging survival potentially and providing quality of life. Gemcitabine has been the solo player in the field of pancreatic cancer treatment after replacing 5-FU since 1997. How to treat a patient with advanced pancreatic cancer failing to respond or progressing after gemcitabine is a true challenge. No established second-line treatment exists yet. Chinese herbal medicine PHY906 provides cytoprotective effects without dampening the anti-tumor activity of chemotherapeutic agents. Several combinations such as S-1/gemcitabine, GTX, FOLFIRINOX showed promising results in retrospective studies. Among single agents, erlotinib and Src inhibitor failed to show seemingly benefit, while abraxane and pemetrexed deserve further investigation.

Characterization of antimicrobial resistance and molecular determinants of beta-lactamase in Escherichia coli isolated from chickens in China during 1970-2007.

Vet Microbiol. 2010 Feb 10;
Li L, Jiang ZG, Xia LN, Shen JZ, Dai L, Wang Y, Huang SY, Wu CM

The aim of this study is to investigate the trend of antimicrobial resistance of 696 Escherichia coli strains of chicken origin in China during 1970-2007, and to characterize the beta-lactamase determinants of these strains. Minimum inhibitory concentrations (MICs) of these strains against 11 antimicrobials were determined by the broth microdilution method. Quinolone-resistant, and first-generation cephalosporin-resistant strains have emerged since the 1990s; third-generation cephalosporin-resistant strains were not detected until 2003. Afterwards these resistant strains increased rapidly, and an obvious increase of isolates with decreased susceptibility to forfenicol was also observed. Three classes of beta-lactamase genes in E. coli strains were detected by PCR and confirmed by DNA sequencing. The detection rate of narrow-spectrum beta-lactamase genes decreased from 71.2% in the 1970s to 28.8% during 2004-2007. Extended-spectrum beta-lactamase (ESBL) genes did not emerge until 2004 and the detection rate was 18.5% between 2004 and 2007. The detection rate of bla(CMY-2), which emerged between 2000 and 2003, climbed to 6.6% during 2004-2007. bla(CTX-M) was the dominant genotype (75%) in ESBL gene-harboring E. coli strains. Fifty strains (17.6%), co-harboring multiple kinds of beta-lactamase genes, were detected in 284 beta-lactamase-producing strains. Southern hybridization revealed that two- or three kinds of ESBL and/or CMY-2 genes co-located on one plasmid in 9 strains. The rising trend of antimicrobial resistance and the high prevalence of beta-lactamase determinants in E. coli strains of chicken origin might be attributed to overuse of antimicrobials, especially beta-lactams, in poultry production.

Influence of Ginkgo biloba extract on the pharmacodynamic effects and pharmacokinetic properties of ticlopidine: An open-label, randomized, two-period, two-treatment, two-sequence, single-dose crossover study in healthy Korean male volunteers.

Clin Ther. 2010 Feb; 32(2): 380-390
Kim BH, Kim KP, Lim KS, Kim JR, Yoon SH, Cho JY, Lee YO, Lee KH, Jang IJ, Shin SG, Yu KS

Background:Ginkgo biloba extract is an herbal medicine used in the treatment of vascular disorders that may be coadministered with antiplatelet agents such as ticlopidine. Regulatory authorities requested evaluation of the pharmacodynamic and pharmacokinetic interactions between these entities, according to the drug-development guidance for fixed-dose combination formulations in Korea. Objective: This study was performed to evaluate the potential pharmacodynamic and pharmacokinetic interactions between ticlopidine and Ginkgo biloba extract. Methods: An open-label, randomized, 2-period, 2-treatment, 2-sequence, single-dose crossover study was conducted in healthy Korean male volunteers. All volunteers were randomly assigned to a sequence group for the 2 treatments, which consisted of ticlopidine 250 mg alone and ticlopidine 250 mg with Ginkgo biloba extract 80 mg, separated by a 1-week washout period between the treatments. Bleeding time was determined just before dosing and at 5, 12, and 48 hours after dosing. Platelet aggregation was evaluated before dosing and at 4, 8, 26, and 48 hours after dosing. Blood samples (8 mL) from each of the volunteers were collected from an indwelling intravenous cannula inserted into a forearm vein before dosing and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12, 24, and 48 hours after dosing. Ticlopidine concentrations were determined by a validated method using HPLC and ultraviolet detection. Adverse events were identified using general health-related questions, vital signs, physical examinations, ECGs, and laboratory tests. Results: A total of 24 healthy men participated in the study (mean [SD] age, 24.1 [4.3] years; weight, 66.6 [7.4] kg; height, 174.7 [5.0] cm). The baselinecorrected bleeding times were not significantly different between the ticlopidine-alone and ticlopidine/ Ginkgo biloba groups, and changes in platelet aggregation were not significantly different between the groups. Likewise, the pharmacokinetic parameters of ticlopidine were not significantly different between the groups; the geometric mean ratios of the ticlopidine/ Ginkgo biloba group to the ticlopidine-alone group were 1.03 (90% CI, 0.92-1.16) for C(max), 1.08 (90% CI, 0.98-1.19) for AUC(0-last), and 1.10 (90% CI, 1.00-1.20) for AUC(0-infinity). A total of 28 adverse events were reported: 11 in the ticlopidine-alone group and 17 in the ticlopidine/Ginkgo biloba group. The adverse events judged to be possibly related to ticlopidine in the ticlopidine-alone group were epigastric discomfort (2 cases), diarrhea (1), skin eruption (1), and a feeling of being cold (1) or hot (1). The adverse events judged to be related to ticlopidine or Ginkgo biloba in the ticlopidine/Ginkgo biloba group were epigastric discomfort (2), diarrhea (2), nausea (2), and headache (1). Conclusions: In this small group of healthy Korean men, the addition of a single dose of Ginkgo biloba extract did not prolong the bleeding time and was not associated with additional antiplatelet effects compared with the administration of ticlopidine alone. The coadministration of Ginkgo biloba extract with ticlopidine was not associated with any significant changes in the pharmacokinetic profile of ticlopidine compared with ticlopidine administered alone.

Natural products as lead-structures; a role for biotechnology.

Drug Discov Today. 2010 Mar 2;
John JE

Natural products as lead-structures; a role for biotechnology Natural products play a key role in healthcare and pharma research, as many medicines are either natural products or derivatives thereof. It is estimated that about 40% of all medicines are either natural products or their semi-synthetic derivatives [1]. This may not be surprising as herbal medicine has been a tradition of healthcare since ancient times and natural-extracts screening has been one of the roots of pharma research, where penicillin, erythromycin and rifampicin (bacterial infections), statins (cholesterol lowering/hyperlipidemia), quinine and artimesinin (malaria), paclitaxel, vinblastin and vincristin (cancer), salicylic acid and non-addictive cocaine derivatives (pain relief), are a few well-known natural product-based medicines. For bacterial infections, about 80% of the medicines in clinical use, are either natural products or their derivatives, while about 60% of all anti-cancer agents are either natural products or derivatives thereof [1,2]. Natural products were developed by micro-organisms, plants, marine organisms, amphibians and animals for several purposes including, as building blocks, coenzymes and co-factors, for host-defence against microbial infection and predators (animals), protection of their ecological niche, communication between and within species, pigments, cellular signalling and gene-expression, and homeostasis of organisms. As a consequence of the duplication, conservation and evolution of genes across the animal kingdom, natural products exhibit pharmacological activities over a range of indications among mammalian species, including humans. Some examples include the anti-fungal agents a) cyclosporine, which is an inhibitor of cyclophilin and is used as an immuno-suppressant in humans, and b) statins, which are inhibitors of HMGCoA reductases and are used as cholesterol-lowering agents in humans.

Using Guasha to treat musculoskeletal pain: A systematic review of controlled clinical trials.

Chin Med. 2010; 5: 5
Lee MS, Choi TY, Kim JI, Choi SM

ABSTRACT: BACKGROUND: Guasha is a therapeutic method for pain management using tools to scrape or rub the surface of the body to relieve blood stagnation. This study aims to systematically review the controlled clinical trials on the effectiveness of using Guasha to treat musculoskeletal pain. METHODS: We searched 11 databases (without language restrictions): MEDLINE, Allied and Complementary Medicine (AMED), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Korean Studies Information (KSI), DBPIA, Korea Institute of Science and Technology Information (KISTI), KoreaMed, Research Information Service System (RISS), China National Knowledge Infrastructure (CNKI) and the Cochrane Library. The search strategy was Guasha (OR scraping) AND pain. Risk of bias was assessed with the Cochrane criteria (i.e. sequence generation, blinding, incomplete outcome measures and allocation concealment). RESULTS: Five randomized controlled trials (RCTs) and two controlled clinical trials (CCTs) were included in the present study. Two RCTs compared Guasha with acupuncture in terms of effectiveness, while the other trials compared Guasha with no treatment (1 trial), acupuncture (4 trials), herbal injection (1 trial) and massage or electric current therapy (1 trial). While two RCTs suggested favorable effects of Guasha on pain reduction and response rate, the quality of these RCTs was poor. One CCT reported beneficial effects of Guasha on musculoskeletal pain but had low methodological quality. CONCLUSION: Current evidence is insufficient to show that Guasha is effective in pain management. Further RCTs are warranted and methodological quality should be improved.

Flavonoids of the Genus Iris (Iridaceae).

Curr Drug Discov Technol. 2010 Mar 4; 6(3):
Wang H, Cui Y, Zhao C

Cancer is the second leading cause of death, for which current therapeutic approaches are still very limited. Chemoprevention is an important approach to decrease cancer morbidity and mortality by the use of non-toxic natural or synthetic substances to reverse the processes of initiation and subsequent development of cancer. A substantial amount of evidence from human, animal and cell line studies has shown that many herbal products used for traditional Chinese medicine (TCM) can exert chemopreventive effects. The underlying theory for TCM to treat or prevent cancer is to bring the patient back to a healthy state by modifying multiple cancer-causing events. Since carcinogenesis involves multiple abnormal genes/pathways, using TCM in cancer chemoprevention may be superior to the agents targeting a single molecular target alone. However, before TCM can be accepted universally as complementary and alternative medicine for cancer treatment and prevention, it is crucial to understand the molecular basis for their effects. This review highlights several known molecular mechanisms of selected TCM in chemoprevention. Many TCM products or single active components have been reported to inhibit a variety of processes in cancer cell growth, invasion and metastasis by modulating a wide range of molecular targets, including cyclooxygenase-2 (COX-2), nuclear factor-Kappa B (NF- B) and nuclear factor erythroid 2 -related factor 2 (Nrf2)-mediated antioxidant signaling pathways. The TCM and their active components with potent chemopreventive effects can be considered as promising lead agents for the design of more effective and less toxic agents for cancer chemoprevention.

Identification of nanofibers in the Chinese herbal medicine: Yunnan Baiyao.

J Biomed Nanotechnol. 2009 Oct; 5(5): 472-6
Lenaghan SC, Xia L, Zhang M

Yunnan Baiyao is a traditional Chinese herbal medicine that has been used to treat wounds for over 100 years. Here, we use Atomic Force Microscopy (AFM) to determine nano-scale structures of the Yunnan Baiyao. AFM images revealed uniform nanofibers present in relatively high abundance in a solution of this medicine. Fibers were typically 25.1 nm in diameter and ranged in length from 86-726 nm due to processing. Due to the unique adhesive and structural properties of nanofibers, we concluded that these fibers may play a role in platelet aggregation, leading to clotting, and the sealing of wounds.

Effect of Ayurved Siriraj herbal recipe Chantaleela on platelet aggregation.

J Med Assoc Thai. 2010 Jan; 93(1): 115-22
Itthipanichpong R, Lupreechaset A, Chotewuttakorn S, Akarasereenont P, Onkoksoong T, Palo T, Kongpatanakul S, Chatsiricharoenkul S, Thitilertdecha P, Punpeng P, Laohapand T

INTRODUCTION: Ayurved Siriraj Chantaleela recipe is a traditional Thai remedy consisting of eight medicinal plants, which is employed for the treatment of fever. OBJECTIVE: To investigate the effects of Ayurved Siriraj Herbal recipe Chantaleela on platelet aggregation. STUDY DESIGN: Clinical research; ex vivo with before and after study design. MATERIAL AND METHOD: Twelve healthy male and female volunteers participated in the present study. Platelet aggregation test before Chantaleela ingestion was done as a control. After administration of 750 mg Chantaleela (3 x 250 mg tablets) every 8 hours for 3 doses, platelet aggregation was measured 8 hours following the first dose using an aggregometer and microplate reader. Adrenaline (Adr) and adenosine diphosphate (ADP) were used as platelet stimulants. Platelet aggregation was measured again at 32 hours and 8-10 days after the first dose. RESULTS: All of the participants completed the present study without any adverse event. Ayurved Siriraj Chantaleela did not affect platelet aggregation; neither Adr nor ADP were used as platelet agonists in both aggregometer and microplate reader Subgroup analysis revealed no significant change in platelet aggregation after Chantaleela administration according to the control for both male and female groups. The same results were also obtained in other subgroup analysis including hyperaggregation group, hypo-normal aggregation group. CONCLUSION: From the present study, normal dose of Chantaleela for alleviation of fever does not have an effect on either platelet aggregation or platelet numbers. It may conclude that the present study supports the safety use of Chantaleela for relieving fever as platelet status does not need to be taken into consideration.

5,6,3',4'-Tetrahydroxy-7-methoxyflavone as a Novel Potential Proteasome Inhibitor.

Planta Med. 2010 Mar 1;
Chang TL, Ding HY, Teng KN, Fang YC

Proteasome inhibition is one of the new pharmaceutical approaches to study antitumor activity. Although the active components are not yet identified for either treating or preventing cancer, the low toxicity plant ANISOMELES OVATA R. Br. has been used in traditional herbal medicine for more than 1000 years. In this study, the methanol extract from ANISOMELES OVATA showed potent inhibition of proteasome activity. Twenty compounds, two macrocycylic diterpenoids, six aromatics, seven flavonoids, and five phenylethanoids were isolated from Fang Feng Cao the dried aerial parts of A. OVATA. Their structures have been established on the basis of spectral evidence. Using a proteolysis assay for inhibition of 26S proteasome from pig red blood cells, we found that 5,6,3',4'-tetrahydroxy-7-methoxyflavone inhibited 90.5 %, 85.4 % and 73.1 % the chymotrypsin-like, caspase-like and trypsin-like activities of 26S proteasome with IC (50) values of 14.0, 5.4 and 24.1 microM, respectively, when Suc-LLVY-AMC, Z-LLE-AMC and Ac-RLR-AMC were used as substrates. 5,6,3',4'-Tetrahydroxy-7-methoxyflavone had a higher inhibitory at 15 minutes. A combination of 5,6,3',4'-tetrahydroxy-7-methoxyflavone and 5,6,4'-trihydroxy-7,3'-dimethoxyflavone increased the inhibition ability on 26S enzymatic activity. This combination appears to be a potentially attractive chemotherapy approach. We have found that 5,6,3',4'-tetrahydroxy-7-methoxyflavone has the highest inhibitory effects on 26S proteasome activities when compared to the other 11 flavonoids. These results suggest that both the 6-hydroxy and 7-methoxy positions of the flavone may play an important role in targeting 26S proteasome activity.

Fatal renal failure due to the Chinese herb "GuanMu Tong" (Aristolochia manshuriensis): Autopsy findings and review of literature.

Forensic Sci Int. 2010 Feb 27;
Shaohua Z, Ananda S, Ruxia Y, Liang R, Xiaorui C, Liang L

Herbal remedies have been used since ancient times and it is now known that they are not completely free of adverse effects. We present the case of a 41-year-old Chinese man, who died in renal failure because he consumed a herbal preparation called "Fen Qing Wu Lin Wan", having GuanMu Tong as main ingredient, for about 1 month. GuanMu Tong is derived from the plant Aristolochia manshuriensis which contains aristolochic acid. Aristolochic acid is being reported as the causative agent of what is now called aristolochic acid nephropathy (AAN) which includes Chinese herb nephropathy (CHN) and Balkan endemic nephropathy (BEN), all having renal impairment as hallmark for the disease. The gross autopsy showed multiple punctate hemorrhages over the limbs, pleural effusion, and edematous lungs with consolidation, mild myocardial hypertrophy and normal-looking kidneys. Microscopic renal tissue examination showed severe degeneration, necrosis and desquamation of renal tubular epithelial cells, presence of protein cast and a widened, edematous interstitium with interstitial fibrosis. We also provide the clinical presentation of the deceased as reported in the medical records and briefly review the literature pertinent to similar cases.

Perceived treatment effectiveness, medication compliance, and complementary and alternative medicine use among veterans with bipolar disorder.

J Altern Complement Med. 2010 Mar; 16(3): 251-5
Jarman CN, Perron BE, Kilbourne AM, Teh CF

Abstract Objectives: Recent research shows a high rate of complementary and alternative medicine (CAM) use among persons with mental disorders, although correlates and patterns of CAM use are relatively unknown. This study tested whether CAM use is associated with perceived effectiveness of conventional treatment (i.e., psychotropic medication and psychotherapy) and medication compliance among persons with bipolar disorder. Design: Patients with bipolar disorder (n = 435) were included as part of a naturalistic cohort study. Measures of CAM utilization, medication compliance, and perceptions of the effectiveness of psychotropic medications and psychotherapy were based on previously established questionnaires. Associations were tested using bivariate and multivariate analyses. Results: Bivariate analyses showed that patients who did not perceive psychotherapy as effective at improving social, family, or job functioning reported greater CAM use. However, medication compliance was not significantly associated with use of CAM. Patients who used oral (e.g., herbal therapies) or cognitive (e.g., meditation) CAM were more likely to report that their medications were not effective at relieving manic or depressive symptoms. Users of cognitive CAM were more likely to report that their medications did not help with social, job, or family functioning, and that they did not prevent recurrences of manic or depressive episodes. None of the bivariate associations remained significant in multivariate analyses. Conclusions: Prior research has suggested that persons who are dissatisfied with treatment for medical conditions are more likely to use CAM therapies. However, the results of this study do not show CAM therapies to be associated with perceived effectiveness of treatments for mental health problems among this sample of persons with serious mental illnesses. This suggests that motivations for CAM use may vary by population and condition. Because few correlates of CAM use among persons with serious mental illnesses are known, providers should conduct routine assessments of CAM use.

Hyaluronidase inhibitors from Takuran, Lycopus lucidus.

Chem Pharm Bull (Tokyo). 2010; 58(3): 394-7
Murata T, Watahiki M, Tanaka Y, Miyase T, Yoshizaki F

Takuran is a traditional herbal medicine that is produced from the herbal plant Lycopus lucidas TURCZ. (Lamiaceae). Takuran is used as a treatment for diseases in women. From Takuran, four new phenylpropanoids along with 18 known compounds were isolated, and their structures were elucidated by spectroscopic analyses. Five phenylpropanoids isolated from the plant showed hyaluronidase inhibitory activity comparable to that of rosmarinic acid.