Peanuts as a source of beta-sitosterol, a sterol with anticancer properties.

Work from our laboratory, as well as others, suggests a protective role of phytosterols (PS), especially beta-sitosterol, from colon, prostate, and breast cancer. Asians and vegetarians consume higher amounts of PS than Western societies. The latter societies have a higher incidence of these cancers than Asians and vegetarians. The aim of this study was to evaluate peanuts and its products as sources of PS in the American diet. Roasted peanuts contain 61-114 mg PS/100 g depending on the peanut variety, 78-83% of which is in the form of beta-sitosterol. Unrefined peanut oil contains 207 mg PS/100 g, which is similar to that of the US Department of Agriculture Nutrient Database. This value is higher than that of unrefined olive oil. Refining these oils results in reduction in PS concentration in the oil. This loss is greater in the case of olive oil than peanut oil. Further refining, such as deodorization, results in significant loss in PS, but hydrogenation after refining has a minimal effect on PS loss. Peanut butter, which represents 50% of the peanuts consumed in the United States, contains 144-157 mg PS/100 g. Peanut flour, which results from partial removal of oil from peanuts, contains 55-60 mg PS/100 g. The data suggest that peanuts and its products, such as peanut oil, peanut butter, and peanut flour, are good sources of PS.

Inhibition of growth and stimulation of apoptosis by beta-sitosterol treatment of MDA-MB-231 human breast cancer cells in culture.

Epidemiological and experimental studies have suggested a protective role of phytosterols (PS) in the development of some types of cancer such as colon and prostate cancer. No work has been reported on the role of PS in the development of breast cancer, the second leading cancer in woman. The present study was designed to examine the effect of the two most common dietary PS, beta-sitosterol (SIT) and campesterol, as compared to cholesterol, the main sterol in the Western diet, on growth, apoptosis and cytotoxicity of MDA-MB-231 human breast cancer cells in culture. In addition, we investigated the possible role of protein phosphatase 2A (PP2A), an enzyme that has been shown to regulate growth and apoptosis in tumor parameters studied. Breast cancer cell growth was found to be inhibited by 66% after 3 days and 80% after 5 days with 16 microM SIT. Both campesterol and cholesterol sustained tumor growth at levels comparable to that of the vehicle control. None of the sterols tested at this level (16 microM) induced cytotoxicity as measured by lactic dehydrogenase release. SIT supplementation for 3 days at 16 microM resulted in a 6-fold increase in apoptosis in cells when compared to cholesterol treated cells. SIT treatment was found to have no effect on the level and content of tumor cell PP2A. It is concluded that SIT, by a still unknown mechanism, may offer protection from breast cancer by inhibiting growth and stimulating apoptosis.

Short communication: tunnelled central venous catheter insertion via the internal jugular vein using a dedicated portable ultrasound device.

We describe the use of a purpose-built portable ultrasound device to assist puncture of the internal jugular vein during percutaneous insertion of tunnelled central venous catheters such as Hickman lines. In many situations the internal jugular route is safer, faster and less costly in comparison with the subclavian approach. The use of ultrasound allows an accurate initial venous puncture with fewer complications, in the hands of both experienced operators and those less familiar with the internal jugular vein approach.

Case report: prolonged contrast enhancement of the inner ear on magnetic resonance imaging in Ramsay Hunt syndrome.

There have been recent reports of enhancement of the inner ear in acute labyrinthitis on gadolinium enhanced magnetic resonance imaging (MRI). However, none has described persistence of enhancement beyond 6 weeks. We report a case of Ramsay Hunt syndrome with labyrinthitis, sensorineural hearing loss and facial nerve palsy in which marked enhancement of the inner ear structures was observed on MRI 6 months after the onset of symptoms. Enhancement on delayed or repeated imaging after a period of months does not exclude labyrinthitis from the differential diagnosis of the small intracanalicular acoustic neuroma, and care should be taken not to confuse them.

MRI of an unusual case of peduncular hallucinosis (Lhermitte's syndrome).

We report a case of peduncular hallucinosis (Lhermitte's syndrome), unusual in that there were no associated neurological signs and the symptoms persisted over many years. Magnetic resonance imaging demonstrated the typical midbrain lesion.

Bedside measurement of creatine kinase to guide thrombolysis on the coronary care unit.

Thrombolysis is effective in treating patients with acute myocardial infarction when started within 12 h of onset, and thus is in widespread use. Early diagnosis is essential but some patients admitted to the coronary care unit with myocardial infarction do not meet the diagnostic criteria on arrival, and thus do not undergo thrombolysis. We studied 117 patients admitted consecutively to our coronary care unit with suspected but unproven myocardial infarction; normally none would have received thrombolytic agents. In each patient creatine kinase levels were measured on admission and after intervals by nurses using capillary blood samples and a dry chemistry system. Infarction was subsequently confirmed in 29 patients. Of these, 17 (59%) were correctly diagnosed and underwent thrombolysis within 12 h on the basis of a raised creatine kinase measured at the bedside. Our findings suggest that use of a bedside assay by nurses allows additional patients with myocardial infarction to receive the benefit of thrombolytic therapy within the first 12 h.