Stilbene compound trans-3,4,5,4´-tetramethoxystilbene, a potential anticancer drug, regulates constitutive androstane receptor (Car) target genes, but does not possess proliferative activity in mouse liver

The constitutive androstane receptor(CAR) activation is connected with mitogenic effects leading to liver hyperplasia and tumorigenesis in rodents. CAR activators, including phenobarbital, are considered rodent non-genotoxic carcinogens. Recently, trans-3,4,5,4´-tetramethoxystilbene(TMS), a potential anticancer drug (DMU-212), have been shown to alleviate N-nitrosodiethylamine/phenobarbital-induced liver carcinogenesis. We studied whether TMS inhibits mouse Car to protect from the PB-induced tumorigenesis. Unexpectedly, we identified TMS as a murine CAR agonist in reporter gene experiments, in mouse hepatocytes, and in C57BL/6 mice in vivo. TMS up-regulated Car target genes Cyp2b10, Cyp2c29 and Cyp2c55 mRNAs, but down-regulated expression of genes involved in gluconeogenesis and lipogenesis. TMS did not change or down-regulate genes involved in liver proliferation or apoptosis such as Mki67, Foxm1, Myc, Mcl1, Pcna, Bcl2, or Mdm2, which were up-regulated by another Car ligand TCPOBOP. TMS did not increase liver weight and had no significant effect on Ki67 and Pcna labeling indices in mouse liver in vivo. In murine hepatic AML12 cells, we confirmed a Car-independent proapoptotic effect of TMS. We conclude that TMS is a Car ligand with limited effects on hepatocyte proliferation, likely due to promoting apoptosis in mouse hepatic cells, while controlling Car target genes involved in xenobiotic and endobiotic metabolism.

Correlation between fetal blood oxygen saturation and umbilical blood pH values

AIM

The aim of the study was to find out whether there is correlation between the fetal blood oxygen saturation values detected by intrapartum fetal pulse oximetry and the umbilical blood pH values taken postpartum, and what is the effect of intrapartum fetal pulse oximetry on the mode of delivery.

BACKGROUND

Seventy six women were examined in the study.

METHODS

Intrauterine fetal well-being was monitored with cardiotocography equipment (FC 700), intrapartum fetal pulse oximetry (Nellcor OxiFirst, TYCO Inc, Pleasanton, CA), and the neonatal umbilical blood pH values were taken postpartum using an acid-base analyzer (AVL Compact 3). Descriptive statistics, Shapiro-Wilk normality test, Spearman rank correlation test and Mann-Whitney test were used for statistical data processing.

RESULTS

The study results showed a highly significant correlation between the fetal blood oxygen saturation values and the neonatal umbilical blood pH values (rS = 0.54; p < 0.0001), and between the fetal blood oxygen saturation values and Caesarean section rate (rS = -0.68; p < 0.0001).

CONCLUSION

In the light of the results of the study the authors recommend monitoring the fetal status using intrapartum fetal pulse oximetry in cases of non-reassuring or pathological cardiotocography, which allows a significant reduction in the Caesarean section rate for an imminent fetal hypoxia (Tab. 5, Fig. 1, Ref. 17). Full Text (Free, PDF) www.bmj.sk.

Statins and sepsis

Severe sepsis and septic shock is common and frequently fatal. Over the last few years, the primary treatments demonstrated to improve outcome from several major clinical trials have finally emerged. However, translating these recent therapeutic advances to routine clinical practice has proven controversial, and new approaches of additional strategies are continued to be developed. Given their pleiotropic effects related to many pathophysiological determinants of sepsis, statin therapy could be the next step in the search for adjuvant therapy. A future challenge may be to test both the efficacy and the safety by large randomized controlled clinical trials ascertaining the effects of statins administered at the onset of sepsis and in patients with severe sepsis or septic shock admitted into intensive care units.

Hyperpyrexia and prolonged postoperative disorientation following methylene blue infusion during parathyroidectomy

A 65-year-old man underwent parathyroidectomy for hyperparathyroidism secondary to renal failure. Intra-operatively he received methylene blue infusion (7.5 mg.kg(-1), a total of 650 mg in 500 ml 0.9% sodium chloride) for visualisation of parathyroid glands. At the end of surgery, following extubation he developed agitation, intense shivering and hyperpyrexia, and his level of consciousness decreased to a Glasgow Coma score of 7. The differential diagnoses included methylene blue toxicity or malignant hyperpyrexia. His lungs were ventilated, and intravenous dantrolene was administered to control hyperpyrexia. Haemodialysis was started to remove the methylene blue dye. We review the literature on the pharmacological actions of methylene blue, and discuss the differential diagnosis and management of this patient.