Molecular Weight Affected Antioxidant, Hypoglycemic and Hypotensive Activities of Cold Water Extract from Pleurotus citrinopileatus.

Cold water extract of P. citrinopileatus (CWEPC) was fractioned into 4 fractions, PC-I (<1 kDa), PC-II (1-3.5 kDa), PC-III (3.5-10 kDa), and PC-IV (>10 kDa), by ultrafiltration. The antioxidant activities, the inhibition of pancreatic α-amylase, intestinal α-glucosidase, and hypertension-linked angiotensin converting enzyme (ACE), as well as the contents of polysaccharides, protein, and phenolic compounds of 4 fractions were determined. The results showed that lower MW fractions exerted a higher antioxidant activity, which was correlated to phenolic contents. The high molecular fraction (PC-IV) exhibited significantly higher inhibitory activity on α-amylase, α-glucosidase, and ACE compared to CWEPC and the other 3 lower MW fractions (<10 kDa), which was more related to protein contents. The inhibition capability of CWEPC and PC-IV on α-amylase activity was 1/13.4 to 1/2.7 relative to that of acarbose, respectively. Kinetic data revealed that PC-IV fraction followed a noncompetitive inhibition pattern on α-glucosidase activity. The study demonstrated that various MW fractions and types of components contribute to different biological functions of P. citrinopileatus and it is protein constituents but not peptides responsible for the hypoglycemic potential of CWEPC.

Extraction temperature affects the activities of antioxidation, carbohydrate-digestion enzymes, and angiotensin-converting enzyme of Pleurotus citrinopileatus extract.

Extraction temperature can potentially affect the chemical compositions and bioactivities of the extracts obtained. The objective of this study was to investigate the effect of extraction temperature on the distribution of bioactive compounds and the bioactivities of Pleurotus citrinopileatus. The antioxidant activities (2,2-diphenyl-1-picrylhydrazyl and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)+ scavenging capabilities) and the inhibitory capabilities on pancreatic α-amylase, intestinal α-glucosidase, and hypertension-linked angiotensin-converting enzyme of hot water P. citrinopileatus extract and cold water P. citrinopileatus extract were determined. The results showed that the antioxidant capabilities and inhibitory effects on α-amylase, α-glucosidase, and angiotensin-converting enzyme of cold water P. citrinopileatus extract were significantly higher than those of hot water P. citrinopileatus extract. The cold water P. citrinopileatus extracted was further precipitated with 100% ammonium sulfate to obtain a polysaccharide fraction or with 75% ethanol to obtain a protein fraction. The inhibitory activities of the protein fraction of the cold water P. citrinopileatus extract on α-amylase, α-glucosidase, and angiotensin-converting enzyme were significantly higher than those of the polysaccharide fraction. In conclusion, the protein fraction of the cold water P. citrinopileatus extract could be responsible for its bioactivities.

Metastases from gastric carcinoma to colon in the form of multiple flat elevated lesions: a case report.

Gastric carcinoma is a common malignancy worldwide. Advanced stages of the disease may result in metastases to many other organs of the body. However, colonic metastases are rare. We report a case of gastric carcinoma with symptoms of abdominal fullness and weight loss. The serum carcinoembryonic antigen level was elevated. Esophagogastroduodenoscopy revealed giant folds occupying the whole gastric body and poor expansion of the stomach. Histologic examination of biopsy specimens from the giant fold demonstrated poorly differentiated adenocarcinoma with signet ring-cell differentiation. Total colonoscopy revealed five or six discrete flat elevated lesions in the distal transverse, descending, and sigmoid colons. These lesions were characterized by a clear margin of 3-5 mm in diameter and erosions on the tips. Polypectomy specimens demonstrated signet ring-cell carcinoma, which was histologically similar to the specimens taken from the gastric lesion. We conclude that this was a rare case in which gastric signet ring-cell carcinoma had metastasized to the colon in the form of flat elevated lesions, combined with rapid and wide lymphatic spread to the thorax and abdomen in a clinical course as short as 46 days.

Clinical significance of plasma D-dimer levels and serum VEGF levels in patients with hepatocellular carcinoma.

BACKGROUND/AIMS: Angiogenesis and coagulation system activation are associated with tumor growth and metastasis. Vascular endothelial growth factor (VEGF) has been reported to play a major role in tumor angiogenesis. The elevation of plasma D-dimer level indicates the activation of coagulation and fibrinolysis. The purpose of this study was to: (a) evaluate the correlation between serum VEGF and plasma D-dimer level; (b) analyze the clinical features that might affect the VEGF and D-dimer levels in patients with hepatocellular carcinoma. METHODOLOGY: Twenty patients with hepatocellular carcinoma were included prior to treatment. Serum VEGF levels were measured by enzyme-linked immunosorbent assay. Plasma D-dimer levels were measured by quantitative latex microparticle enhanced turbidimetric immunoassay. RESULTS: The presence of a high plasma D-dimer level was found to be correlated with the presence of central necrosis, higher Child's grade, advanced TNM stage, and the presence of portal vein thrombosis when plasma D-dimer levels were compared between different clinicopathologic groups. Tumors larger than 2 cm in diameter had higher median serum VEGF levels than tumors less than 2cm in diameter. No correlation was found between plasma D-dimer level and serum VEGF level in hepatocellular carcinoma patients (r=0.126, p=0.598). CONCLUSIONS: No correlation was found between the plasma D-dimer level and the serum VEGF level in hepatocellular carcinoma patients. The plasma D-dimer level appeared to reflect the tumor stage and vascular invasion of hepatocellular carcinoma. Serum VEGF level in hepatocellular carcinoma patients showed a positive correlation with tumor size.

Carbon dioxide-enhanced sonographically guided percutaneous ethanol injection: treatment of patients with viable and recurrent hepatocellular carcinoma.

OBJECTIVE: Viable portions of tumors can persist and recurrent tumors sometimes appear in patients with hepatocellular carcinoma who have undergone transcatheter arterial chemoembolization, percutaneous ethanol injection, or a combination of the two. Some of these tumors are difficult to treat or do not respond to additional treatment using the same protocol. In this article, we examine the use of carbon dioxide (CO(2))-enhanced sonographically guided percutaneous ethanol injection to treat patients with such tumors. SUBJECTS AND METHODS. Our study population was 44 patients with 53 viable portions of tumors or recurrent hepatocellular carcinomas that had developed after the initial treatment of the primary tumor. The tumors were treated with CO(2)-enhanced sonographically guided percutaneous ethanol injection via the catheter that had been placed in the hepatic artery for angiography. Thirty-seven (84.1%) of the 44 patients had cirrhosis. Of these 37 patients, 23 had Child-Pugh class A cirrhosis, and 14 had Child-Pugh class B. RESULTS: Overall, thirty-four (64.2%) of the 53 tumors showed complete necrosis after treatment, eight (15.1%) of the 53 showed partial necrosis, and 11 (20.8%) of the 53 showed no response. The cumulative survival rates of patients who underwent CO(2)-enhanced sonographically guided percutaneous ethanol injection were 81%, 71%, and 44% for 1, 2, and 3 years, respectively. The small tumors were more responsive to the treatment. The tumor recurrence rate was 56.8%. In 9.1% of these cases, carcinoma had metastasized to other organs. CONCLUSION: CO(2)-enhanced sonographically guided percutaneous ethanol injection is effective for patients with viable portions of a treated tumor or new tumors who have undergone transcatheter arterial chemoembolization, percutaneous ethanol injection, or a combination of the two treatments. This finding is especially true of patients who are not good candidates for repeated treatments.

Long-term survival of Taiwanese patients with hepatocellular carcinoma after combination therapy with transcatheter arterial chemoembolization and percutaneous ethanol injection.

BACKGROUND AND PURPOSE: Several studies have shown a superior effect of combination therapy with transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection (PEI) compared with either monotherapy for the treatment of advanced hepatocellular carcinoma (HCC), but there have been no reports on combination treatment from Taiwan. This study investigated the long-term survival and prognostic factors of HCC patients treated with TACE/PEI combination therapy. METHODS: A total of 153 consecutive HCC patients, with tumor sizes between 2 and 3 cm in 47 patients, between 3 and 5 cm in 66 patients, and between 5 and 13 cm in 40 patients, who received TACE/PEI combination therapy were included in this retrospective study. The mean follow-up duration was 23 +/- 17 months (range, 1 to 78 months). RESULTS: The 1-, 2-, 3-, 4-, 5-, and 6-year cumulative survival rates for the patients were 78%, 54%, 40%, 22%, 12%, and 5%, respectively. Multivariate analysis using Cox's proportional hazards model showed that the stage of cirrhosis (Child's class B or C vs class A) was the only factor that significantly affected the survival rate (p = 0.02) [relative risk, 2.10; 95% confidence interval, 1.12 to 3.96]. Univariate analysis showed that survival was poorer in patients with tumors greater than 5 cm than in patients with tumors 2 to 5 cm in largest dimension; this difference was not significant in the multivariate analysis. No serious complications were observed during or after treatment. CONCLUSIONS: TACE combined with PEI is an alternative treatment for patients with larger HCC who are not suitable for surgical resection. A superior outcome can be expected in patients with Child's class A cirrhosis.

Genotypic and phenotypic characterization of a putative tumor susceptibility gene, GNMT, in liver cancer.

Glycine N-methyltransferase (GNMT), a multifunctional protein involved in the maintenance of the genetic stability, is often down-regulated in hepatocellular carcinoma (HCC). Using genotypic characterization of GNMT in hepatoma cell lines and in a Taiwanese population with a high incidence of liver cancer we have investigated the role of this gene in the progression of liver cancer. Six novel polymorphisms, including two short tandem repeats, one 4-nucleotide insertion/deletion polymorphism, and three single nucleotide polymorphisms, in GNMT were identified in this study. The rates of loss of heterozygosity at the GNMT locus in pairs of normal and tumor tissue from the HCC patients were approximately 36-47%. In addition, the observed heterozygosity of GNMT decreases in tumor adjacent liver DNA from HCC patients compared with that observed in blood DNA from normal individuals and HCC patients. This may result from the early event of loss of heterozygosity within the GNMT gene in the liver tissues of HCC patients. However, in this study, we did not observe the association of polymorphic GNMT alleles as inherited risk factors for HCC. We also elucidated the functional impact of genetic markers in the GNMT promoter by performing luciferase reporter gene and gel mobility shift assays. The results indicate that two polymorphisms, short tandem repeat 1 and insertion/deletion polymorphism, in the promoter region could cause allelic specific effects on the transcriptional activity of GNMT. The risk genotypes of GNMT, which presumably have a lower expression level, as estimated from in vitro functional studies, are over-represented in tumor-adjacent tissues from HCC patients. In summary, our results suggest that GNMT alteration may be an early event in HCC development and that GNMT could be a new tumor susceptibility gene for HCC.

Assessment of vascularity in hepatic tumors: comparison of power Doppler sonography and intraarterial CO(2)-enhanced sonography.

OBJECTIVE: The purpose of the study was to compare power Doppler sonography with intraarterial CO(2)-enhanced sonography for revealing vascularity in treated and untreated hepatic tumors. SUBJECTS AND METHODS: Fifty-five patients with 93 liver tumors were prospectively examined with power Doppler sonography and CO(2)-enhanced sonography. These tumors included 29 hepatocellular carcinomas in patients with no previous treatment, 26 treated hepatocellular carcinomas, and 38 hemangiomas. The vascular depiction of power Doppler sonography was compared with that obtained in the early phase of CO(2)-enhanced sonography. The results of angiography were also recorded for comparison. RESULTS: In the hepatocellular carcinomas, power Doppler sonography was the same as CO(2)-enhanced sonography in 18 (62%) of 29 tumors, was inferior to CO(2)-enhanced sonography in nine (31%) of 29 tumors, and was superior to CO(2)-enhanced sonography in two (7%) of 29 tumors. In the treated hepatocellular carcinomas, power Doppler sonography was the same as CO(2)-enhanced sonography in 15 (58%) of 26 tumors and was inferior in 11 (42%) of 26 tumors. In hemangiomas, the same vascularity was found in both studies in 15 (39%) of 38 tumors, CO(2)-enhanced sonography was superior in 22 (58%) of 38 tumors, and power Doppler sonography was superior in one (3%) of 38 tumors. As a whole, 45% of the 93 tumors showed better vascular depiction on CO(2)-enhanced sonography. However, 19.4% of tumors were hypovascular using power Doppler sonography but hypervascular using CO(2)-enhanced sonography. CONCLUSION: Power Doppler sonography is a useful technique for screening hepatic tumor vascularity. CO(2)-enhanced sonography is superior to power Doppler sonography in depicting tumor vascularity in treated hepatocellular carcinomas and in hemangiomas, especially small hemangiomas.