Complementary medicine: a review of immunomodulatory effects of Chinese herbal medicines

Normal aging selectively impairs some forms of learning. For example, aging rabbits require more than twice as many trials to acquire 500-ms trace eyeblink conditioning than do young rabbits. N-methyl-D-aspartate (NMDA) receptor antagonists also impair trace conditioning. The effects of daily D-cycloserine (DCS; a partial agonist of the NMDA receptor-glycine site) treatment were tested on trace conditioning of young or aging rabbits using a conservative quantitative approach. DCS dose dependently improved acquisition, maximally reducing trials to criterion by approximately 50%. Dose-response curves were right-shifted by aging (twice the dose was required to achieve the same enhancement compared with controls). DCS did not affect nonassociative performance but sharpened the conditioned stimulus tone intensity discrimination. DCS thus can functionally modulate NMDA receptors in normal aging, enhance associative learning at all ages, and reduce or reverse age-dependent learning deficits.     

Usage and adverse effects of Chinese herbal medicines

Oestrogen receptor (ER) expression in breast cancer is regarded as a phenotype that may change during the natural history of the disease or during endocrine therapy. It has been suggested that in up to 70% of tumours that show acquired resistance the mechanism may be changed in ER status from positive to negative. This paper proposes an alternative hypothesis that ER expression in a stable phenotype in breast cancer. The paper reviews the literature on ER expression during the natural history of breast cancer in patients and also presents data on the effect of endocrine therapy on ER expression. If the alternative hypothesis is true it has important implications for treatment from chemoprevention to acquired endocrine resistance in advanced disease. Equally, if the hypothesis is true, attempts to develop laboratory models of endocrine resistance where ER-positive tumours become ER negative need to be re-evaluated.     

Fifteen cases of atropine poisoning after honey ingestion

Fifteen persons developed atropine poisoning following consumption of wasp honey. Clinical signs, antidotal response and the presence of Datura plants near the wasp nests supported that the intoxications were caused by ingestion of atropine-contaminated honey. Two deaths occurred from heatstroke because of the poisoning and high environment temperatures and intensive physical activity.     

Endosulfan poisoning in Northern India: a report of 18 cases

Eighteen cases of endosulfan poisoning by accidental overexposure during spray, admitted between October 1995 to September 1997, were observed and analyzed. These accounted for approximately one third of the total number of poisoning cases admitted in our unit during this period. Nausea, vomiting abdominal discomfort, tonic and clonic convulsions, confusion, disorientation, and muscular twitchings were cardinal manifestations. None of the patients succumbed to their illness. Analysis of various incriminating factors revealed that accidental overexposure was due to failure to adhere to the instructions for spray either due to ignorance or due to illiteracy. All the patients avoided preventive measures and developed toxicity both due to inhalation and absorption through skin. Endosulfan (a chlordiene derivative) poisoning is gaining up momentum in this part of world and has become an important matter for public health in India.     

Neurotoxicity following the ingestion of a Chinese medicinal plant, Alocasia macrorrhiza

1. A case of poisoning due to the raw root tuber of a Chinese medicinal plant, Alocasia macrorrhiza is presented. 2. The patient developed neurological (severe pain and numbness in the perioral area and throat) and gastrointestinal (nausea, vomiting, abdominal pain) symptoms immediately after eating the root tuber. 3. A macrorrhiza has properties and morphology very similar to another medical plant. A. odora. The root tuber of the latter is known to contain a neurotoxin sapotoxin.     

An epidemic of tetrodotoxin poisoning following ingestion of the horseshoe crab Carcinoscorpius rotundicauda

At certain seasons of the year in Thailand, the horseshoe crab Carcinoscorpius rotundicauda may be toxic to human and fatal poisoning occasionally occur. Tetrodotoxin (TTX) and its derivatives were major toxins in the toxic eggs of the horseshoe crab. An epidemic of poisoning by eating toxic eggs of the horseshoe crab affected 71 persons in Chon Buri which located in the eastern coast of Thailand. Patients generally presented with neurologic symptoms such as paresthesia, vertigo, weakness, respiratory paralysis, altered consciousness with unreactive dilated pupils in addition to gastrointestinal symptoms such as nausea and vomiting. Nineteen patients required artificial ventilation and there were two deaths. This is the first large outbreak of tetrodotoxin poisoning recognized in Thailand.     

Fatal poisoning with propoxyphene: report from 100 consecutive cases

The first 100 deaths caused by propoxyphene and recorded by the Chief Medical Examiner of North Carolina were studied. Victims ranged evenly in age from the second to the seventh decade. Over 65% were suicides with a female to male ratio of 2:1. Blood propoxyphene concentrations of 0.2 mg/dl were fatal, representing rapid ingestion of approximately ten capsules. In North Carolina, deaths due to propoxyphene have increased from five in 1969 to 49 in 1975. Raising physician-awareness of propoxyphene's toxicity and placing the drug in Schedule II are two of the author's recommendations for reducing the number of propoxyphene deaths.     

Phenolphthalein poisoning: a case report

A case of severe poisoning due to the ingestion of phenolphthalein in the form of a patent medication, is described.     

Report of eight cases of humeral fracture following the throwing of hand grenades

A series of eight cases is presented in which similar fractures of the shaft of the humerus occurred during the throwing of hand grenades. Transient paresis of the radial nerve accompanied the fracture in one patient. In seven patients, the fracture healed without complication. In the remaining case, non-union developed, and surgical treatment was instituted. The mechanism of the fracture is discussed with reference to the literature.     

Fatal hydrofluoric acid ingestion: a suicide case report

Numerous reports of poisonings due to various fluoride salts and also to hydrofluoric acid have appeared in the literature. Hydrofluoric acid, which is recognized as a strong acid, is expected to cause severe burns following acute exposure. This case is reported because the expected burns were not observed, but the laboratory analysis (a blood fluoride concentration of 13 mg/L) supported the ruling of death due to ingestion of hydrofluoric acid.     

Cutaneous reactions following herpes zoster infections: report of three cases and a review of the literature

Three patients, one healthy and two immunocompromised, developed cutaneous reactions that histologically mimicked granuloma annulare at sites of resolved varicella-zoster virus (VZV) reactivation infections. Variable latency periods between the infection and the granulomatous reaction were noted. As in other case reports, the presence of VZV DNA in these lesions was inconsistently demonstrated by the polymerase chain reaction (PCR) and appears more common in early, as opposed to late, post-zoster granulomas. In addition to various granulomatous reactions, vasculitic and neoplastic eruptions following resolved VZV infections have been described and are reviewed here. Therapeutically, topical, intralesional and systemic corticosteroids, as well as acyclovir, have been tried with inconsistent results. Although the pathogenesis remains unclear, the presence of VZV DNA in early lesions that histologically do not display viral cytopathic changes, suggests the virus induces an atypical delayed hypersensitivity reaction not affected by antiviral therapy.     

Cavernous sinus thrombosis: a report of eight consecutive comatose patients

Septic thrombosis of the cavernous sinus is a severe and lethal condition if left untreated. The mortality is particularly high in those patients admitted in a comatose state. Eight patients treated successfully in Bulawayo, Zimbabwe in Mpilo Central Hospital over a period of three years are reported. In the discussion, emphasis is placed on the treatment of raised intracranial pressure in this particular group of patients and early treatment with appropriate antibiotics. Clinicians must be aware of this serious complication of infections around the face and must treat them early and aggressively.     

Subdural tension pneumocephalus following head injury: report of five cases

Intracranial air is a radiographic finding not uncommon in head-injured patients. It is a relatively benign complication which usually resolves spontaneously. However, under unclear mechanism, tension pneumocephalus (the entrapment of intracranial air under pressure) may be formed and cause neurological symptoms. Five cases of patients with subdural tension pneumocephalus following head injury were reported. All had a basal skull fracture involving the paranasal sinuses or mastoid air cells with coexisting cerebrospinal fluid leakage. The patients showed symptoms and signs of increased intracranial pressure and compression on frontal lobes. Characteristic computerized tomographic findings were noted. Four patients clinically improved with conservative strategy. Only 1 case needed operative correction.     

Perforation of the sigmoid colon following ingestion of a dental plate

The authors report on the perforation of the sigmoid colon in a 48-year-old male following the accidental ingestion of a partial dental plate. Sharp, pointed objects may perforate the bowel and surgery should be considered. A review of the literature revealed no previously reported cases.     

Lingual osseous choristoma: a study of eight cases and review of the literature

A choristoma is a tumor-like mass of normal tissue in an "abnormal" location. Lingual osseous choristoma, previously known as osteoma of the tongue, is a rare entity: we found documentation of eight cases at our center during the 10-year period between 1987 and 1996. These cases were analyzed along with 50 others reported in the English language literature between 1913 and 1996. Lingual osseous choristoma frequently occurs during the third and fourth decades of life, and predominantly affects women (81%). Most of the osseous choristomas in our review were located in the posterior third of the tongue, primarily at or close to the foramen cecum or circumvallate papillae (87.9%). While 39.7% of the patients were asymptomatic, the remaining patients complained of symptoms including a lump in the throat (25.8%), dysphagia (6.9%), gagging (5.1%), nausea (3.4%) and irritation (3.4%). Treatment of lingual osseous choristoma consists of simple excision. The tumor's origin has been discussed elsewhere.