Mobola plum seed methanolic extracts exhibit mixed type inhibition of angiotensin -converting enzyme in vitro

Objective To explore the possible inhibitory potentials and mechanism by Mobola plum (Parinari curatellifolia) seeds crude methanol (CE) and flavonoid-rich (FE) extracts on angiotensin-1-converting enzyme (ACE ). Methods The sensitivity and kinetic model of inhibition of CE and FE on ACE using N-[3-(2-furyl)-acryloyl]-Phe-Gly-Gly as enzyme substrate for ACE was evaluated by Michealis Menten approach. The inhibition mechanism was explored from Lineweaver–Burk model and IC

Clinicopathological characteristics and prognostic factors analysis of combined hepatocellular-cholangiocarcinoma / 中华消化外科杂志

Objective To analyze the clinicopathological characteristics and prognostic factors of combined hepatocellular-cholangiocarcinoma (cHCC-CC).Methods The retrospective cohort study was conducted.The clinicopathological data of 72 patients with primary hepatocellular carcinoma (HCC) who were admitted to the Xiangya Hospital of Central South University between January 2005 and December 2014 were collected.Thirty-two patients who were diagnosed with cHCC-CC by postoperative pathological examination were allocated into the cHCC-CC group and 40 patients who were diagnosed with HCC by postoperative pathological examination were allocated into the HCC group.Observation indicators:(1) clinicopathological characteristics:male,age ＞ 60 years,positive hepatitis B surface antigen (HBsAg),positive alpha-fetoprotein (AFP),positive CA19-9,positive carcinoembryonic antigen (CEA),liver cirrhosis,Child-Pugh grade A,tumor diameter ＞ 5 cm,tumor with capsule,solitary tumor,portal vein tumor thrombus (PVTT),cancer thrombus of the bile duct,positive lymph node metastasis,stage Ⅰ-Ⅱ of TNM stage,Edmondson-Steiner stage Ⅰ-Ⅱ;(2) pathological features of surgical incision specimens;(3) follow-up situations:median survival time,1-,3-,5-year survival rates and tumor-free survival rate;(4) prognostic factors analysis of patients with cHCC-CC:AFP,CA19-9,liver cirrhosis,tumor diameter,tumor capsule,number of tumor,PVTT,cancer thrombus of the bile duct,lymph node metastasis,Edmondson-Steiner stage,volume of intraoperative blood loss,intraoperative blood transfusion,distant from surgical margin.Follow-up using outpatient examination and telephone interview was performed to detect survival of patients and tumor recurrence or metastasis up to October 2015.Comparison of count data was analyzed using the chi-square test.The survival curve was drawn by the Kaplan-Meier method,and the survival analysis was done using the Log-rank test.The prognostic analysis was done using the COX regression model.Results (1) Clinicopathological characteristics:positive CA19-9,tumor with capsule,cancer thrombus of the bile duct and positive lymph node metastasis were detected in 16,4,12,6 patients in the cHCC-CC group and 5,17,1,1 patients in the HCC group,respectively,with statistically significant differences between the 2 groups (x2=10.471,9.723,13.005,4.009,P ＜ 0.05).(2) Pathological features of surgical incision specimens:pathological results showed that surgical incision specimens in the cHCC-CC group had characteristics of HCC tissues and cholangiocarcinoma tissues.The antigenic activity of hepatic cells in paraffin sections,Cytokeratin 7,Cytokeratin 19 and progenitor cell markers were positive by immunohistochemical staining detection.Patients in the HCC group had characteristics of HCC tissues,with positive AFP using immunohistochemical staining detection.(3) Follow-up situations:all the 72 patients were followed up for 5.0-74.0 months with a median time of 41.0 months.The median survival time,1-,3-,5-year survival rates,1-,3-,5-year tumor-free survival rates were 14.5 months,62.3％,38.9％,19.1％,50.0％,23.9％,4.0％ in the cHCC-CC group and 46.8 months,82.3％,57.4％,38.6％,72.9％,35.6％,17.6％ in the HCC group,respectively,with statistically significant differences in overall survival and tumor-free survival between the 2 groups (x2=4.231,3.881,P ＜ 0.05).(4) Prognostic factors analysis of patients with cHCC-CC:results of univariate analysis showed that CA19-9,tumor capsule,number of tumor,cancer thrombus of the bile duct,lymph node metastasis and Edmondson-Steiner stage were related factors affecting prognosis of patients with cHCC-CC [HR =1.824,0.227,0.441,1.421,1.887,2.745,95％ confidence interval (CI):1.126-2.172,0.118-0.654,0.318-0.764,1.071-4.231,1.017-5.643,1.223-6.421,P ＜ 0.05].Results of multivariate analysis showed that lymph node metastasis and stage Ⅲ-Ⅳ of Edmondson-Steiner stage were independent risk factors affecting prognosis of patients with cHCC-CC (RR =1.658,2.912,95％ CI:1.027-7.542,1.143-6.582,P ＜0.05).Conclusions The positive CA19-9,tumor without capsule,cancer thrombus of the bile duct and positive lymph node metastasis can partly predict cHCC-CC.The prognosis of patients with cHCC-CC is worse than that with HCC.The positive lymph node metastasis and stage Ⅲ-Ⅳof Edmondson-Steiner stage are independent risk factors affecting prognosis of patients with cHCC-CC.

Mobola plum seed methanolic extracts exhibit mixed type inhibition of angiotensin Ⅰ-converting enzyme in vitro

Objective:To explore the possible inhibitory potentials and mechanism by Mobola plum (Parinari curatellifolia) seeds crude methanol (CE) and flavonoid-rich (FE) extracts on angiotensin-1-converting enzyme (ACE I).Methods:The sensitivity and kinetic model of inhibition of CE and FE on ACE I using N-[3-(2-furyl)-acryloyl]-Phe-Gly-Gly as enzyme substrate for ACE I was evaluated by Michealis Menten approach.The inhibition mechanism was explored from LineweaverBurk model and IC50 was determined from Cheng-Prusoff empirical analysis.Results:The IC50 of CE and FE were 13.54 and 39.38 μg/mL,respectively.Both extracts exhibited mixed type inhibition with the inhibitory constant (Ki) of CE was between 0.38 and 0.37 μg/mL while that of FE showed a two-fold increase (1.62 μg/mL and 0.28 μg/mL).FE on ACE I demonstrated positive cooperativity with a Hill's coefficient of 1.89.Conclusions:The study reveals the superior ACE I inhibitory potential of CE over FE and suggest that mixed inhibition pattern of the enzyme might be the underlying mechanism of antihypertensive activity.

Clinical profile of patients with Total Anomalous Pulmonary Venous Return and their short term outcome in pediatric cardiac centre at Dhaka Shishu Hospital.

A5Background: Total anomalous pulmonary venous return (TAPVR) is an uncommon congenital cardiovascular anomaly with poor natural prognosis without proper intervention. It has been detected more frequently in recent year due to the advent of echocardiography. The aim of this study is to evaluate the clinical manifestations, age at diagnosis and short term outcomes in TAPVR patients. Methods: From 1st January 2013 to 31st December 2013, a total of 34 cases with TAPVR were admitted in pediatric cardiac centre at Dhaka Shishu Hospital, Dhaka, Bangladesh. All of them were evaluated with 2-dimensional (2-D) and color Doppler echocardiography examination. CXR and ECG were also done. Patient’s sex, age at diagnosis, types of TAPVR, clinical manifestations, radiological finding, ECG findings and outcomes were compiled and analyzed. Results: In 34 patients with TAPVR, 23 (67.6%) were male and 11 (32.4%) were female with male to female ratio of 2.09:1. Most of the patients were diagnosed between 0-6 months of age that is 13 (38.2%) cases were in 0-2 month’s age group, 14 (41.2%) cases were in more than 2 month’s to 6 month’s age group. Tachypnea and cyanosis were more common symptoms. The types of TAPVR was supra-cardiac 18 (52.9%), cardiac 11 (32.4%), infra-cardiac 3 (8.8%) and mixed in 2 (5.9%) cases. Pulmonary hypertension was present in 31 (91.2%) of 34 cases. Among them, 20 (58.8%) patients had severe pulmonary hypertension. The most common associated intra-cardiac lesions of TAPVR patients were ASD 13 (38.2%) and PFO 13 (38.2%). ECG findings of TAPVR, 18 (52.9%) patient had right axis deviation (RAD), right ventricular hypertrophy (RVH) and 14 (41.2%) had right axis deviation (RAD), right ventricular hypertrophy (RVH), right atrial enlargement (RAE). X-ray findings of TAPVR patients, 32 (94.1%) patients had Cardiomegaly and increased pulmonary vascularity. Among admitted patient, 3 (8.8%) patients died due to pneumonia and intractable heart failure, 31 (91.2%) patients referred to advanced cardiac centre for operative treatment. Conclusions: Tachypnea and Cyanosis were an obvious clinical symptom of TAPVR. 2-D and color Doppler echocardiography can provide quick and accurate diagnostic information of TAPVR. Death rate is high in TAPVR patient in spite of adequate medical management. So, early detection and definitive surgical treatment of TAPVR is much needed.

Primary subcutaneous mixed-type liposarcoma of the thigh showing three simultaneous dedifferentiations: Report of an unusual case.

Liposarcoma most commonly occurs in deep soft tissues of the limb and the retroperitoneum; however, its occurrence in the subcutaneous tissue is rare. Mixed-type liposarcoma (MTL) is the rarest subtype. We herein describe a unique case of MTL with three simultaneous dedifferentiations occurring in subcutaneous tissue of left thigh in a 45-year-old male. We briefl y review the pertinent literature and report this case because of extreme rarity.

A Patient with Mixed Type Evans Syndrome: Efficacy of Rituximab Treatment

Mixed type Evans syndrome is a very rare hematologic disease. Although mixed type Evans syndrome may initially respond well to steroids, this disease usually runs a chronic course with intermittent exacerbations. We describe here a 46-yr-old female with the steroid-refractory, mixed type Evans syndrome, and she had a prompt response to rituximab. She was diagnosed as having the mixed type Evans syndrome with the clinical features of symptomatic anemia, jaundice and thrombocytopenia. Prednisone therapy was commenced and her hemoglobin and platelet level returned to the normal. However, after 15 weeks, she relapsed with hemolytic anemia and thrombocytopenia. We started rituximab at the dose of 375 mg/m2 once weekly for a total of 4 doses, which was well-tolerated and this induced the normalization of hemoglobin, bilirubin and lactic dehydrogenase, and there was also a significant increase of the platelet count.

Influence of Qingzhifugan Pellet on fatty liver animal model with chronic hyperlipemia and alcoholized hepatic damage / 中华中医药杂志

Objective:To observe influence of qingzhifugan pellet on mixed-type animal model of fatty liver with chronic hyperlipemia and alcoholized hepatic damage. Methods:The mixed-type animal model of fatty liver was established by administering with high lipids and alcohol feeds. Therapeutic experiments were conducted with a self-made new drug the qingzhifugan pellet. The efficacy of the tested drug was evaluated comprehensively by such measures as sero-level of lipids and ferments,as well as the histological pathology of liver. Results:It was shown that the tested drug can decrease the sero-level of lipids,promote the metabolism of lipids in liver,recover the alcoholized hepatic damage,and relieve the liver fat denaturation. Conclusion:It suggested that the tested drug possessed certain effect for treating or improving chronic hyperlipemia and alcoholized hepatic damage in the animal model.

A Case of Mixed-type Autoimmune Hemolytic Anemia / 대한혈액학회지

We report a case of mixed-type autoimmune hemolytic anemia in a 73-year-old female. At first, she visited at Pusan National University Hospital, complaining of dizziness and dyspnea for 3 months. Her hemoglobin level was 5.5g/dL, so red blood transfusion was requested by her physician. In ABO blood grouping, a discrepancy between cell and serum typing was observed. Also all of donor cells for crossmatching were reactive with patient's serum. High mean corpuscular volume (MCV) value was not normalized after warming. The cold agglutinin titer was 1 : 64 at 4degrees C, and was increased up to 1 : 1,024 at room temperature and 37degrees C, suggesting mixed-type autoimmune hemolytic anemia. The patient's symptoms and signs were improved progressively with corticosteroid therapy, and also ABO discrepancy was disappeared.

An immunohistochemical study of mixed hepatocarcinoma / 中华消化杂志

Objective Pathologically, sometimes it is rather difficult to make differential diagnosis among hepatocellular, cholangiocellular and mixed type of hepatic tumors. The aim of this study was to analyze the immunohistochemical features of mixed type of hepatocarcinoma and to propose some useful diagnostic criteria. Methods Fifteen cases of the hepatic tumor were examined by routine histological and immunohistochemical methods with S P technique. Results The mixed type of hepatic tumor accounted for 3.39% of all cases of primary hepatocarcinoma in the same period. Histologically, all the mixed type of hepatic tumors revealed some characteristics of hepatocellular and cholangiocellular carcinomas, one of them was collision tumor. Immunohistochemically, 10 cases of the tumor were positive for ? fetal protein(AFP) in the hepatocellular carcinoma area, while all 15 tumors were negative for AFP in all cholangiocellular carcinoma areas. Cytokeratin(CK8) was positive in the hepatocellular carcinoma areas of all mixed tumor, whereas positive in cholangiocellular carcinoma areas of 13 cases; CK19 was positive in cholangiocellular carcinoma areas of all the tumors, while positive in hepatocellular carcinoma areas of 13 cases. Bcl 2 gene product was positive in 66.7% of this tumor, in which it was mainly expressed in cholangiocellular tumor area and in hepatocellular areas of five cases. AB/PAS stain for mucin was positive in cholangiocellular tumor regions of all the tumors. Conclusions Diagnosis of mixed hepatocarcinoma should be made mainly based on combined analysis of the data from pathological features, immunohistochemical phenotypes and histochemical stain for mucinous material.

A Case of Bilateral Mixed Type Laryngocele / 대한이비인후과학회지

A laryngocele is an uncommon, air-filled dilatation of the laryngeal saccule or appendix of the laryngeal ventricle with an unclear etiology. This abnormality is generally classified into internal, external, or mixed type depending on their relationship to the thyrohyoid membrane. Many laryngoceles are asymptomatic and are discovered incidentally when radiographs of the neck or endolaryngeal examinations are performed for unrelated symptoms. We have experienced a case of bilateral mixed type laryngocele.

Availability of CD34 Monoclonal Antibody in Chronic Myelogenous Leukemia / 대한혈액학회지

BACKGROUND: In general, chronic myelogenous leukemia (CML) are classified according to the criteria established by the International Bone Marrow Transplant Registry. However, when a marrow aspirate cannot be obtained because of myelofibrosis or other causes, bone marrow biopsy specimens can be used to provide diagnostic information. As compared with the marrow aspirate, the assessment of the blasts is a major difficulty with biopsy specimen. Anti-CD34 is a monoclonal antibody that reacts with leukemic blasts and bone marrow progenitor cells, immunohistochemical staining for CD34 can be used to classify three phases of CML when the aspirates of bone marrow is inadequate. METHODS: The authors studied 38 bone marrow biopsy specimens, it were diagnosed as CML, representing three phases of disease (chronic, accelerated, and blastic crisis). Immunohistochemical staining for CD34 was performed using CD34 monoclonal antibody in paraffin- embedded tissue. We assess a correlation between the clinical phases of CML and the proportion of CD34 positive cells. RESULTS: The proportion of CD34 positive cells among chronic, accelerated, blastic phases, and indeterminate group of CML were 4.3 (1.7~9.0)%, 10.1 (7.4~12.7)%, 31.2 (10.2~87.3)%, and 13.35 (8.7~20.0)%, respectively. The differences in CD34 positivity between various phases of CML were highly significant (P=0.0001). We classified CML according to bone marrow histology; granulocytic types and granulocytic/megakaryocytic (mixed) type. The differences in CD34 positivity among histologic types were significant high proportion of CD34 positive cells (P=0.0191) in granulocytic type of blastic phase. CONCLUSION: This study demonstrated that CD34 immunohistochemical staining represents a reliable method for classifying CML in cases in where a bone marrow aspirate is not available, and further studies are needed in order to find out the relationship between a degree of CD34 positivity and histologic classification.

Castleman's Disease (Giant Lymph Node Hyperplasia): Report of 2 cases and review of the literature

Two cases of Castleman's disease (Giant lymph node hyperplasia) are reported. The first case was a multicentric cervical giant lymph node hyperplasia. Excisional biopsy confirmed the diagnosis of Castleman's disease of the plasma-cell type. Despite repeated dissection of the cervical lymph nodes, complete removal of the lymph nodes was impossible, and the type was changed into mixed type, and regrowth of the tumor was noted. Prednisolone was of no benefit. The patient is now living with cervical masses in situ without general symptoms, 4 years after the initial diagnopsis. The second case was a solitary retroperitoneal giant lymph node hyperplasia, incidentally found. Complete excision was performed and biopsy confirmed the diagnosis of Castleman's disease of hyaline-vascular type. No recurrence was found at 2 years after the excision.