Sasa veitchii extract protects against carbon tetrachloride-induced hepatic fibrosis in mice

BACKGROUND@#The current study aimed to investigate the hepatoprotective effects of Sasa veitchii extract (SE) on carbon tetrachloride (CCl)-induced liver fibrosis in mice.@*METHODS@#Male C57BL/6J mice were intraperitoneally injected with CCl dissolved in olive oil (1 g/kg) twice per week for 8 weeks. SE (0.1 mL) was administered orally once per day throughout the study, and body weight was measured weekly. Seventy-two hours after the final CCl injection, mice were euthanized and plasma samples were collected. The liver and kidneys were collected and weighed.@*RESULTS@#CCl administration increased liver weight, decreased body weight, elevated plasma alanine aminotransferase, and aspartate aminotransferase and increased liver oxidative stress (malondialdehyde and glutathione). These increases were attenuated by SE treatment. Overexpression of tumor necrosis factor-α was also reversed following SE treatment. Furthermore, CCl-induced increases in α-smooth muscle actin, a marker for hepatic fibrosis, were attenuated in mice treated with SE. Moreover, SE inhibited CCl-induced nuclear translocation of hepatic nuclear factor kappa B (NF-κB) p65 and phosphorylation of mitogen-activated protein kinase (MAPK).@*CONCLUSION@#These results suggested that SE prevented CCl-induced hepatic fibrosis by inhibiting the MAPK and NF-κB signaling pathways.

A case of severe constipation caused by morphine administration that bowel movement was well controlled by misoprostol

<b>Objective</b>: We experienced a case with recurring constipation and diarrhea caused by morphine for relieving cancer pain, who were well managed with oral administration of misoprostol. <b>Subject</b>: The patient was a male in his 70s with recurrent bladder cancer following primary surgery, developed bone metastasis to right side pelvis and exhibited cancer-related pain. To alleviate the resting pain, he underwent radiotherapy and received a sustained preparation of morphine sulfate, that lead to difficulty in bowel movements (repeated constipation and diarrhea) and abdominal distension which was intractable with routine administration of laxatives. Misoprostol, a prostaglandin E1 derivatives, which was reported to have an ability to control the bowel movement was administered at a dose of 800μg/day, and the patient subsequently achieved the improvement of bowel dysfunction and resumed regular self-defecation. <b>Discussion</b>: Misoprostol do not only accelerate small intestine movement but also inhibits water and sodium absorption. In this case, it is suggested that the pharmacological properties of misoprostol enabled to improve bowel movement. We consider that misoprostol is useful as one of the medications for refractory constipation caused by opioid administration. Palliat Care Res 2008:3(1);301-304

Effectiveness of a flow chart of medication for cancer pain treatment with controlled-release oxycodone tablets

<b>Purpose</b>: The effectiveness of a flow chart of medication for cancer pain treatment was investigated. This flow chart was developed at Sasebo Chuo Hospital, and calls for the early introduction of controlled-release oxycodone tablets in combination with prescribing of a rescue dose and agents to prevent adverse reactions such as nausea, vomiting, and constipation. <b>Method</b>: The flow chart was used with a group of 29 patients (FC group), but not with a group of 35 patients (non-FC group). The rate of titration, which was adjustment of opioid dosage to achieve cancer pain control, and time required to achieve titration were compared between these two groups. <b>Results</b>: The titration rate of the FC group was 93.1% and that of the non-FC group was 80.0%. Medication was changed to another opioid for 4 patients in the non-FC group because of nausea and vomiting. The time required to achieve titration was 3.8±2.2 days in the FC group and 5.3±3.0 days in the non-FC group, and a significant difference was noted (<I>p</I>=0.048). <b>Conclusion</b>: The use of this flow chart with its early introduction of opioid controlled-release oxycodone tablets appears to be effective in achieving cancer pain control at an early stage.