is defined as a cerebrovascular disorder causes of the blood vessel to bulge or balloon out of
the wall of a blood vessel as a result of the weaken of blood vessels and veins and occurred mostly at the bifurcations and branches of the large arteries located at the Circle of Willis.
Dr. Pritz MB. at the Indiana University School of Medicine, suggested that Only aneurysms in which preoperative imaging studies and operative findings were sufficient for
were included. All 329 reviewed aneurysms could be divided into 2
groups:
(n=313).
.
Each of these categories of aneurysms could be
classified further based on its
aneurysms according to this scheme adequately described all reviewed
aneurysms. Grouping aneurysms according to this approach focuses on
similarities in angioarchitecture and potential rheologic properties
that should prove useful for evaluation of
Others researchers suggested that Cerebral aneurysms are classified both by size and shape
3. Giant aneurysms with size from 25 to 50 mm
4. Super giant aneurysms for any aneurysms with size over 50 mm.
Saccular aneurysms are the most common form of cerebral aneurysm and refers to any aneurysm with a saccular outpouching, including berry aneurysms. Berry aneurysm, is a saccular aneurysm with a neck or stem resembling a berry.
is defined as a condition of splitting or dissection of an arterial wall as a result of bleeding into the weakened wall splits the wall.
is also known as Richet's aneurysma is a localized dilation of an artery in which the entire circumference of
the vessel is distended. The result is an elongated, tubular, or
spindlelike swelling(2).
People may have an aneurysm without experiencing any symptoms at all, but if a cerebral aneurysm begins to leak it can cause certain symptoms. Dr. Lyrer P, and Gratzl O. at the Neurologische Universitätsklinik, indicated that approximately two fifth of the patients with
prior to the major hemorrhage. The complaints may be
including the muscles of the face, and people's faces change as a result of the palsy. A patient may find it difficult to smile, to control eye movements, and to engage in other facial expressions.
, including the interference of the following, including thought, emotion, memory, comprehension, perception, purpose, etc.
In the report of Dr. Henry J. Kaminski, M.D and the team at Cleveland Veterans Affairs Medical Center showed that transient neurologic deficits are an unusual presentation of chronic
subdural hematoma. Presented herein are three patients with transient
aphasia and right-sided sensory-motor abnormalities caused by subdural
hematoma. Review of the literature revealed 32 cases similar to ours.
Presenting complaints were
(3%). Fifteen
patients underwent cerebral angiography(4)
Cerebral aneurysms develop as a result of the weaken of blood vessels and veins of which exhibit the risk of ruptured
. Aneurysms often occur mostly at the bifurcations and branches of the large arteries located at the Circle of Willis based of the brain.
for intraoperative rupture (IOA) of aneurysms, which will reduce the
incidence of this complication and improve the outcome of treatment, Dr.Taylor CL, and the research team at Case Western Reserve University indicated that for patients with an unruptured
ratio: 0.29, 95% CI: 0.09-0.97) had a significant protective effect.
Advancing age had a small but significant protective effect in both
groups. Elderly patients identified with unruptured aneurysms are more
likely to have coexisting hypertension than the general hospitalized
population. In elderly patients hospitalized with an unruptured
factor for subsequent SAH, whereas surgical treatment is a protective factor against SAH(5).
of SAH within the second degree of consanguinity. Forty-one unruptured
were found in 34 (13.9%) of 244 patients. This incidence was
significantly higher than that found in a control group of healthy
volunteers (6%). Furthermore, patients who had a
of SAH combined with multiple systemic risk factors were found to have the highest incidence of unruptured
a. Old age is considered as one of risk factor of Cerebral aneurysm. In the study of the complication of Three hundred fifty-five patients underwent 394 endovascular procedures treating 75
recurrences and 319 untreated aneurysms. One hundred eight (30%) were elderly(7)
b. Women are at increased risk of Cerebral aneurysm than men,
aneurysms and of SAH. Degree of
was investigated in 182 patients with SAH and in 123 patients with an unruptured
1.7.
especially increased the occurrence of SAH in women and in youngsters. However,
Disruption of the entire arterial wall may be a critical event in the
development of IDA and result in the medial disruption and
subadventitial haemorrhage. Non-atheromatous intima might function as a
protective factor in arterial wall disruption. On the other hand,
atherosclerosis may predispose to intra-atheromatous plaque haemorrhage
type of IDA through intramural haemorrhage originating from the newly
formed vessels(9).
Dr. Vannemreddy P, and the team at the Louisiana State University Health Sciences Center suggested that Aneurysms were significantly smaller and ruptured at a younger age among
users compared with nonusers. Although the poor clinical grade was not
significantly different between the 2 groups, outcome was significantly
worse in
. These cases were all young men with closed
impairs outcome mainly through severe rebleeding and delayed ischaemia
and to a lesser extent through a poor initial condition and presence of
intracerebral haematoma
". Dr. Juvela S. at the Helsinki University Hospital said(12).
Certain blood infections may increased the risk of Cerebral aneurysm, including Streptococcus sanguinis(13), endocarditis(14), Etc.
Researchers at the Affiliated ZhongShan Hospital, DaLian University, in the study of The role of
may play an inhibitory role by decreasing expression of MMP-2 and MMP-9 synthesis(15).
is defined as a condition characterized by its clinical manifestations, which
are easy bruising, thin skin with visible veins, and rupture of
arteries, uterus, etc. There is a report of report a case presented with cervical radiculopathy due to a segmental fusiform
. Other suggested that
,
but not popliteal. The patient's marfanoid habitus also may have played
a part. This case emphasises the mixed aetiology of popliteal
aneurysms(18).
, the large blood vessel that delivers oxygen-rich blood from the heart to the body. There is a report of the frequency of IA among patients with CoA is approximately 5-fold that
of the general population. Although no risk factors were identified in
this cohort, additional prospective evaluation is warranted. These data
suggest that noninvasive cerebral imaging to screen for IA should be
considered in patients with CoA(19).
(von Recklinghausen's disease) are reported. A 30-year-old male
patient (case 1) had been diagnosed as having neurofibromatosis type I
due to
. He suffered from
. He also had
e. Etc.
embolization continue to occur even at high volume experienced centers.
Such situations are unexpected, complex and can have devastating
consequences(21). Others indicated that Systemic
are common (40%) and the mortality attributable to them (23%) is
comparable to mortality from the primary lesion, rebleeding, or
vasospasm(22). Dr. Chen M. suggested that the two most serious neuroendovascular procedural
aims to propose a role based checklist(23). Other complications include
fifty-three of 236 consecutive patients (22.5%) who suffered a proved
aneurysmal subarachnoid hemorrhage and who were admitted within 72 hours
after subarachnoid hemorrhage to a primary emergency hospital had at
least one rebleed within 6 months after the primary bleed. Two patients
later had a rebleed within a mean of 3 years follow-up. Rebleeding was
recorded if there was a sudden loss of consciousness and a verification
by computed tomography, autopsy, lumbar puncture, or angiography. The
peak incidence of rebleeding was within the first 24 hours and at the
end of the first week after subarachnoid hemorrhage. The rebleed
mortality rate was 74%, and only 19% of patients with a rebleed had a
good outcome. The grade on admission, age, and sex do not affect the
incidence nor the time of rebleeding(24).
after aneurysmal subarachnoid haemorrhage, originally published in 1994 and partially updated at the ninth
conference in Turkey. The incidence of delayed ischaemic deficit (DID) or symptomatic
reported in 1994 was 32.5% in over 30,000 reported cases. In recent
years, 1994-2009, it was 6,775/23,806, or 28.5%. Many of the recent
reports did not specify whether a calcium antagonist was used routinely,
and when this was stated (usually nimodipine or nicardipine), DID was
noted in 22.0% of 10,739 reported patients. The outcome of delayed
ischaemia in the earlier survey was a death rate of 31.6%, with
favourable outcomes in 36.2%. In recent reports, though with fewer than
1,000 patients, the outcome is possibly better, with death in 25.6% and
good outcome in 54.1%. It thus appears likely that delayed
an average of 47.4 hours after admission and received an average total
dose of 40.6 g of EACA. The mean length of time of administration of
EACA was 35.6 hours. There was a total of 5
per 24-hour
period of 0.71%. Overall, the rates of
was 42.3%. Patients who were treated with coiling had higher rates of
following subarachnoid hemorrhage (SAH) therefore appears to be the result of increased
natriuresis, due to the inappropriate elevation of ANP rather than
SIADH. In this situation, water restriction should not be recommended,
since the circulatory volume is decreased(27).
5. Etc.
Dr. J Baldauf and the research team at the Department of Neurosurgery, Helios Hospital Berlin report a case of an intracranial aneurysm associated with
von Recklinghausen's neurofibromatosis. A 34-year-old woman presented
with a history of headaches, unconsciousness and neck rigidity.
Widespread cutaneous neurofibromas were found. Investigations revealed
an aneurysm of the anterior communicating artery(28)
Although Cerebral aneurysms in Behçet's disease are very rare. Dr.
a 57 year old man with Behçet's disease is described, who had a
subarachnoid hemorrhage due to rupture of a peripheral
middle cerebral artery aneurysm. He
underwent a successful aneurysmal clipping. Three years later he had
seizures and was
found to have a new aneurysm on the
contralateral peripheral middle cerebral artery as well as some
radiological features
of vasculitis. After 3 months of
steroid therapy, the aneurysm disappeared. Although surgical treatment
is the first choice
for ruptured aneurysms, steroid therapy
may be effective for unruptured small aneurysms in patients with
Behçet's disease(29).
is an autosomal dominant connective tissue disorder commonly due to
mutation of the fibrillin-1 (FBN-1) gene that causes disruption of
elastic fibers in large- and medium-size arteries and predisposes to
formation and arterial dissection. Cardiovascular complications occur in most patients with
Although intracranial aneurysms have been associated with many
hereditary collagen disorders, the incidence of brain aneurysms in
(PXE) appears to be exceedingly low and uncertain. There is a rare
case of a sisters with PXE who both developed intracranial aneurysms.
This report supports the previously questioned hypothetical association
between PXE and intracranial aneurysms(31).
Type IV is a heritable connective tissue disorder with frequent
neurovascular manifestations, such as intracranial aneurysms. Patients
with this
have notoriously fragile blood vessels, and the reported mortality rate
for any type of vascular surgical procedure is 40%. This
represents one of the more common types of arterial fibrodysplasia, a
heterogeneous group of nonatherosclerotic vascular occlusive and
aneurysmal diseases. There is a report of the first case, to the knowledge, of an elderly man with infrarenal aortic
associated with aortic hypoplasia, without involvement of renal arteries, and contiguous aortoiliac
The aim of Cerebrospinal fluid (CSF) collection is a test to look at the fluid that surrounds the brain and spinal cord. University of Wisconsin School of Medicine and Public Health, Madison in the study comprised 648 patients who had TAA or TAAA repair from 1987 to 2008, found that Spinal drains were used in 486 patients. Spinal
fluid pressure was measured continuously, except when draining fluid,
and was reduced to <6 mm Hg during thoracic aortic occlusion and
reperfusion. After surgery, spinal
fluid pressure was kept <10 mm Hg until patients were awake with
normal leg lift. Drains were removed 48 hours after surgery. Spinal and head computed tomography (CT) scans were performed in patients with bloody spinal fluid or neurologic deficit(37).
5. Electroencephalogram (EEG)
There is areport of the
Electroencephalogram (EEG) of 151 patients whose ruptured
aneurysm
was confirmed by CT scan and angiography was recorded on the first day
(D1) and the fifth day (D5). On D1, EEG had a prognostic value: among 46
patients with normal EEG, 72% presented neither further electrical
ischaemic features nor delayed angiographic vasospasm; on the other
hand, when bilateral bursts of slow waves, "axial bursts" or slow delta
waves were recorded (78 cases), 97% exhibited EEG signs of ischaemia and
angiographic vasospasm a few days later(38).
6. MRI of the head
Different
Magnetic Resonance (MR)
imaging
techniques are used to evaluate intracranial aneurysms.
• At 3T MR, 3D-TOF and CE-MRA appear
equivalent for evaluating coiled aneurysms..
• Coils are better visualised on 3D-TOF than on CE-MRA.
• Combined analysis of 3D-TOF
and CE-MRA does not seem helpful.
• At 3T, 3D-TOF techniques are recommended for monitoring patients
with coiled aneurysms(39).
5. Etc.
VI. Preventions
A.1. The Do's and Do not's list
1. Reduce intake saturated fat and trans fat
Intake of high amount of saturated fat and trans fat increase the risk of cholesterol building up in the arteries of that can cause increased risk of hypertension and arteriosclerosis
causes of cerebral aneurysm.
2. Quick smoking
There are some report indicated that smoking is associated with increased risk of Cerebral Aneurysm. Smoking also enhance the deposit of cadmium to cause hardened arteries of that causing increased risk of the diseases.
3. Moderate drinking
Moderate drinking can increase blood circulation and pressure to move blood, it is considered healthy for normal person. But for people with Cerebral Aneurysm, alcohol can cause increased risk of rebleeding and rupture Cerebral Aneurysm
4. Eat your fruits and veggies
Fruits and veggies contains high amount antioxidants and phytochemicals of that enhance the immune system and decrease the risk of lipid peroxidation and infection causes of Cerebral Aneurysm.
5. Exercise
Exercise decrease the risk of Abdominal aortic
aneurysm (AAA), a vascular disease resulting in a permanent, localized enlargement of the abdominal aorta(40)
6. Wear your seat belt and protective hat
Wear your seat belt and protective hat to prevent head injure if there is an auto accidence and accidence at work for people with the risk of falling objects.
7. Prevent bacterial blood infection
People who work in the health care service should wash their hand when deal with patient blood to avoid infection to the patient and themselves.
8. No drug
Drug used reduce the function of immune function of which enhances the risk of Cerebral Aneurysm(41)
9. Etc.
A.2. Diet against Cerebral Aneurysm
The aim of the diet is to enhance the immune function, prevent cholesterol and Lower estrogen levels after menopause
causes of Cerebral Aneurysm
1. Tofu or bean curd is soft white blocks made by coagulating soy milk
with substance such as salt or acid or enzyne, a stable emulsion of
oil, water, and protein that can be made into tofu, originated from
Chinese and part of East and Southeast Asian. Since it is proven to be
one of many healthy foods, it become synonymous with vegetarianism and
others.
a. Metabolic syndrome
In the assessment
of the effect of low daily intake of soybeans in oxidative stress and
it effects on the metabolic syndrome (MS) found that Low intake of soy
protein for 90 days, besides being well tolerated by the patients,
was able to improve several parameters related to the pathophysiology
of MS, according to the study of "
[Evaluation
of the intake of a low daily amount of soybeans in oxidative stress,
lipid and inflammatory profile, and insulin resistance in patients
with metabolic syndrome].[Article in Portuguese] by Bahls LD, Venturini D, Scripes Nde A, Lozovoy MA, Simão TN, Simão AN, Dichi I, Morimoto HK.(42)
b. Cardiovascular Benefits
Research
found that protein of tofu significantly decreases the serum
cholesterol by decreasing the levels of bad cholesterol (LDL) but
leaving the good cholesterol (HDL) remain the same According to the
study of "Effect of
soy and milk
protein supplementation on serum lipid levels: a randomized controlled trial" by
Wofford MR, Rebholz CM, Reynolds K, Chen J, Chen CS, Myers L, Xu J, Jones DW, Whelton PK, He J.(43). It also benefits the cardiovascular health (according to the study of "
Soy protein, isoflavones, and
cardiovascular health:
an American Heart Association Science Advisory for professionals from
the Nutrition Committee" by Sacks FM, Lichtenstein A, Van Horn L,
Harris W, Kris-Etherton P, Winston M (44)
c. Superoxide dismutase
Superoxide
dismutase are an important antioxidant defense in nearly all cells
exposed to oxygen as a class of enzymes that catalyzes the dismutation
of free radicals due to existence of copper and Zn in tofu (according to
the study of "Cu,Zn-superoxide dismutase gene dosage and cell resistance to oxidative stress: a review" by Peskin AV., posted in Pubmed, researchers found thatt here
are data that increasing only Cu,Zn-SOD can be toxic, and the balance
between Cu,Zn-SOD and peroxide-removing enzymes is supposed to be of
prime importance in the antioxidant defense. Role of Cu,Zn-SOD
deregulation in carcinogenesis is discussed(45).
d. Selenium
Selenium is
classified as one of antioxidant trace mineral that helps to increase
the immune function to fight the forming of free radicals, infection
and inflammation caused by oxidation, irregular cells growth, virus and
bacteria, etc., according tothe study of "Protective role of
intraperitoneally administrated vitamin E and selenium on the levels of total lipid, total cholesterol, and fatty acid composition of muscle and liver tissues in rats" by Yilmaz O, Celik S, Cay M, Naziroğlu M.(46), researchers found that the level of total lipid and cholesterol
in muscle and liver tissues were reduced by administrating vitamin E
and Se together. Additionally, the fatty acid synthesis in the muscle
and liver tissues was decreased by this process) and prevent plague
accumulated cause of Atherosclerosis (according to the study of
'Vitamin-mineral supplementation and the progression of atherosclerosis:
a meta-analysis of randomized controlled trials" by Bleys J, Miller ER
3rd, Pastor-Barriuso R, Appel LJ, Guallar E.(47), thus reducing the risk of heart diseases and hypertension.
2. Dulse
Dulse is a red seaweed of genus Palmaria, belong to Family
Palmariaceae that grows attached to rocks by a "holdfast" in the North
Atlantic and Northwest Pacific. It is commonly used in Ireland and
Atlantic Canada both as food and medicinally and is now shipped around
the globe. Dulse is found in many health food stores or fish markets or
can be ordered directly from local distributors.
a.
Health benefits
In the
assessment of nutritional and physiological properties of edible
seaweeds is presented. Seaweeds are traditionally consumed in Asia as
sea vegetables found that Seaweeds showed important functional
activities, such as antioxidant, antimutagenic and anticoagulant
effect, antitumor activity, and an important role in the modification
of lipid metabolism in human body. In conclusion, seaweeds have a high
nutritional value, therefore an increase in their consumption, would
elevate the foods offer to population, according to "
[Nutritional evaluation and physiological effects of edible seaweeds].[Article in Spanish]" by
Jiménez-Escrig A, Goñi Cambrodón I.(48)
b. Antioxidant
In assessment of polyphenol content of the
dulse extract of two grades of
dulse
harvested from Canadian Maritime locations differing in UV radiation
exposure (i.e. west versus east coasts of Grand Manan Island, New
Brunswick) and their antiodant effects found that The 1-butanol soluble
extract from Grade 1
dulse (reduced UV-exposure) exhibited lower reducing activity versus Grade 2
dulse (greater UV exposure) reflecting a lower requirement for endogenous antioxidant protection. Grade 1 and 2
dulse
extracts both inhibited (p0.03) AAPH-induced lipid peroxidation, but
had no effect on AMVN-induced lipid peroxidation, demonstrating the
aqueous nature of the antioxidants involved, according to "
Extracts from dulse (Palmaria palmata) are effective antioxidants and inhibitors of cell proliferation in vitro" by Yuan YV, Carrington MF, Walsh NA.(49)
c. Chlorophyll
Chlorophyll, a green pigment found in almost all plants, algae, and cyanobacteria, beside it is best known for its cleansing body and healing to vital organs properties. It also
reduces the binding of carcinogens to DNA in the liver and other
organs, thus reducing the risk of cancer according to the study of
"Natural compounds in the human diet and their ability to bind mutagens
prevents DNA-mutagen intercalation" by Osowski A, Pietrzak M, Wieczorek Z, Wieczorek J.(50),
researchers indicated that in order to bind 50% of the mutagen in a
complex, less than twice the concentration of chlorophyllin was
needed......
3. Raspberries are perennial, the
edible fruit of a multitude of plant species in the genus Rubus belong
to the family Rosaceae, originated from Europe. Because of their
commercial values and health benefits, they have been grown for
processing of quick frozen (IQF) fruit, purée, juice, or as dried fruit
used in a variety of grocery products.
a. Human healthIn the investigation of Raspberries and its effect on human health found that the nutritional and phytochemical compositions of red raspberries
and their absorption, metabolism, and biological activity are
reviewed. Finally, future directions of research are also identified,
according to "Raspberries and human health: a review" by Rao AV, Snyder DM.(51)
b. Bioavailability of anthocyanins and ellagitannins
In the assessment of raspberries and its Bioavailability
of anthocyanins and ellagitannins effects found that no intact or
conjugated forms of ellagitannins were detected in urine from either
healthy subjects or ileostomy volunteers. However, in healthy subjects,
but not the ileostomists, ellagitannins were catabolized with the
appearance of urolithin A-O-glucuronide, two of its isomers, and
urolithin B-O-glucuronide in urine collected 7-48 h after raspberry
consumption. There was marked variation in the urolithin profile of
individual volunteers, indicating differences in the colonic microflora
responsible for ellagitannin degradation, according to "Bioavailability of anthocyanins and ellagitannins following consumption of raspberries by healthy humans and subjects with an ileostomy" by
González-Barrio R, Borges G, Mullen W, Crozier A.(52)
c. Degenerative diseases of ageing
Long-term vitamin K
inadequacy may reduce the function of supporting the carboxylation
of at least some of these Gla-protein that can
lead the development of degenerative diseases of ageing including osteoporosis and atherosclerosis, according to the study of "Vitamin K, osteoporosis and degenerative diseases of ageing" by Cees Vermeer and Elke Theuwissen(53)
d. Intracranial bleeding
In
a study in the 4-year study period, 16/64 (25%) of the infants
admitted with intracranial bleeding had late intracranial VKDB,
resulting in an overall incidence of 2.1/100,000 live births (95%
confidence interval 1.2-3.5) conducted by University Medical Center
Utrecht(54) indicated that Intracranial bleeding may be associated with
vitamin K deficiency
4.
Flax seed
Flax seed is native to the region
of the eastern Mediterranean to India and also known as common flax or
linseed. Flax is an erect annual plant, it can grow to 1.2 m tall. The
leaves are 20–40 mm long and 3 mm broad.
a. Hyperlipidemia
In the examination of the effects of flax and sesame seeds mixture on Hyperlipidemia
found that Diet supplemented with flax and sesame seeds
mixture in pregnant diabetic rats ameliorated lipid parameters,
antioxidant enzyme activities, level of reduced glutathione and
significantly decreased malonaldialdehyde levels, according to "Dietary
polyunsaturated fatty acid prevents hyperlipidemia and hepatic
oxidant status in pregnant diabetic rats and their macrosomic
offspring" by Makni M, Sefi M, Garoui el M, Fetoui H, Boudawara T, Zeghal N.(55)
b. Hypolipidemic and hepatoprotective effects
In the evaluation of a rich source of unsaturated fatty acids of Flax and pumpkin seedsand theirs anti-atherogenic and hepatoprotective activities. found that flax
and pumpkin seed mixture had anti-atherogenic and hepatoprotective
effects which were probably mediated by unsaturated fatty acids present
in seed mixture, according to "Hypolipidemic and hepatoprotective effects of flax and pumpkin seed mixture rich in omega-3 and omega-6 fatty acids in hypercholesterolemic rats" by Makni M, Fetoui H, Gargouri NK, Garoui el M, Jaber H, Makni J, Boudawara T, Zeghal N.(56)
c. Cardiovascular diseases
In the research of Flaxseed and its effect on cardiovascular risk found that
flaxseed can modestly reduce serum total and low-density lipoprotein
cholesterol concentrations, reduce postprandial glucose absorption,
decrease some markers of inflammation, and raise serum levels of the
omega-3 fatty acids, ALA and eicosapentaenoic acid. Data on the
antiplatelet, antioxidant, and hypotensive effects of flaxseed, however,
are inconclusive. More research is needed to define the role of this
functional food in reducing cardiovascular risk, according to "Flaxseed and cardiovascular risk' by Bloedon LT, Szapary PO.(57)
d. Hypercholesterolemic atherosclerosis
In the evaluation of Flaxseed
(Type I flaxseed) and CDC-flaxseed (Type II flaxseed) and theirs
effect onhypercholesterolemic atherosclerosis found that Type II
flaxseed reduced the development of atherosclerosis by 69%, according to
"Reduction of hypercholesterolemic atherosclerosis by CDC-flaxseed with very low alpha-linolenic acid" by Prasad K, Mantha SV, Muir AD, Westcott ND.(58)
e. Anti- hormono-dependant cancers
In the observation of Flax
lignans belonging to the phytoestrogens, metabolised after ingestion
into enterolignans and its protective effect against the onset and
development of hormono-dependant cancers
found that in vitro studies based on mammalian cellular models tend to
confirm their beneficial effects observed during epidemiological
studies and give us insights about their mechanisms of action,
according to "[Interest of lignans in prevention and treatment of cancers].[Article in French]" by Lamblin F, Hano C, Fliniaux O, Mesnard F, Fliniaux MA, Lainé E.(59)
5. Green tea
Green tea contains
more amount of antioxidants than any drinks or food with the same
volume, and is the leaves of Camellia sinensis, undergone minimal
oxidation during processing, originated from China. Green tea has been a
precious drink in traditional Chinese culture and used exceptional in
socialization for more than 4000 thousand years. Because of their
health benefits, they have been cultivated for commercial purposes all
over the world.
a. Immune system
Polyphenols,
one of more powerful form of antioxidant not only helps to improve the
immune system fighting against the forming of free radicals and
guarding our body from foreign invasion, such as virus and bacteria,
thus reducing the risk of inflammation and lessening the risk of
oxidation of low-density lipoprotein (LDL) cause coronary heart
disease, according to the study of "Plant polyphenols as dietary
antioxidants in human health and disease" by Kanti Bhooshan Pandey and
Syed Ibrahim Rizvi, (60
)
b. Tannins
A
group of simple and complex phenol, polyphenols, and flavonoid
compounds, once are considered anti nutritional but it is now known of
their beneficial depending to their chemical structure and dosage for
its anti-inflammatory, antibacterial, antiviral, and antiparasitic
effects due oxidative stress, according tothe study of "Effects of green
tea tannin on cisplatin-induced nephropathy in LLC-PK1 cells and rats"
Yokozawa T, Nakagawa T, Lee KI, Cho EJ, Terasawa K, Takeuchi S.(61)
c. Catechins
Catechins
are a category of polyphenols contained epicatechin (EC),
epigallocatechin (EGC), epicatechin gallate (ECG) and epigallocatechin
gallate (EGCG) and 25-100 times more potent than vitamins C and E that
help to protect the body from oxidative damage by enhancing the immune
function in fighting against forming of free radicals cause of cancer,
according to the study of "Green tea catechins augment the antitumor
activity of doxorubicin in an in vivo mouse model for chemoresistant
liver cancer" by Liang G, Tang A, Lin X, Li L, Zhang S, Huang Z, Tang H,
Li QQ.(62)
d. Flavonoids
Flavonoids
are best known as an antioxidant that help to protect our body from
forming free-radical scavenging capacity, coronary heart disease,
irregular cell causes of cancer activity and immunodeficiency virus
functions, according to the study of "Vegetable flavonoids and
cardiovascular disease" by Terao J, Kawai Y, Murota K.(63
)
6. Etc.
A.3. Antioxidants against Cerebral Aneurysm
1. Bioflavonoids or vitamin P
Discovered by Szent-Gyorgyi and his colleagues back in the 1930`s. In Laboratory tests, B
bioflavonoids
help to reduce the fragility and “permeability” in capillaries and
prevent the clotting up of arterial as a result of oxidation.
2. Vitamins C and E, beta-carotene
Recent
research findings have suggested that antioxidants such as vitamin C, E
and beta carotene play an important role in the prevention of
atherosclerosis. Data from animal studies showed they are able to
prevent oxidative modification of low density lipoproteins (LDL).
3. Alpha-tocopherol
Alpha-tocopherol,
a antioxidant found abundant in vitamin E, helps to decrease lipid
peroxidation and platelet aggregation, adhesion and inflammatory.
Epidemiological studies suggest that low levels of antioxidants are
associated with increased risk for cardiovascular disease.
4. Vitamin C and E
Studies showed in take of 500mg of vitamin C and 400 IU of vitamin E helps to retard the progression of coronary atherosclersis.
5. Chlorophyl
Antioxidant
chorophyll in the green algae shows to inhibit the chemical cadmium of
smoking, by preventing from oxidation that cause building up of plaque
along the walls of arteries.
6. Nitric oxide (NO)
Nitric oxide (NO), one of the antioxidant and
peroxynitrite can inhibit pathways of oxygen radical generation, and,
in turn, oxidants can inhibit NO synthesis from NOS.
7. Glutathione and vitamin E
Reduced
form of glutathione may act as a first line of defense against
oxidative stress during ischemia–reperfusion while vitamin E may act
later on during severe oxidative stress by rendering resistance to the
heart against the ischemic–reperfusion injury
8. 2-dithiole-3-thione (D3T)
Researcher
found that in rat cardiac H9c2 cells, D3T and time-dependent induction
of a number of cellular antioxidants and phase 2 enzymes, including
catalase, reduced glutathione (GSH), GSH peroxidase, glutathione
reductase (GR), GSH S-transferase (GST), and NADH:quinone oxidoreduc-
tase-1 (NQO1) help to protect against H9c2 cell injury caused by various
oxidants and simulated ischemia-reperfusion. D3T pretreatment also
resulted in decreased intracellular accumulation of reactive oxygen in
H9c2 cells after exposure to the oxidants as well as simulated
ischemia-reperfusion.
9. Selenium
Deficiency of of a co-enzyme
selenium, which is required in maintaining the glutathione redox
cycle, also promote more susceptible to oxidative injure.
10. Thymus
The declining of the thymus function contributes a direct
effect on the immune system due to diminish of quantity of T cells
and immune factors.
11. Lipid peroxidation
Researchers found
that lipid peroxidation are able to attack immune cells membrane,
leading to the impediment of cells membrane activities, causing
susceptibility diseases found in aging person.
12. NADHP oxidase
NADHP
oxidase (nicotinamide adenine dinucleotide phosphate-oxidase) is a
membrane-bound enzyme complex found in the plasma membrane. Free
radicals cause damage to membrane, leading to diminish of its function
in fighting against foreign invasion.
13. Cytokine
Free
radicals damage immune cells that affect the function of cytokines in
transmitting intercellular signals, leading to many disease states and
conditions ranging from major depression and Alzheimer's disease to cancer.
14. Etc.
A.4. Phytochemicals against Cerebral Aneurysm
1.
Catechin is phytochemical of
Flavan-3-ols, in the group of Flavonoids (polyphenols), found abundantly
in white tea, green tea, black tea, grapes, wine, apple juice, cocoa,
lentils, etc.
a.
Cholesterol
In a systematic
review and meta-analysis of randomized controlled trials evaluating
the relationship between GTCs and serum lipid levels, including total,
low-density lipoprotein (LDL), high-density lipoprotein (HDL)
cholesterol, and triglycerides, found that the consumption of GTCs is
associated with a statistically significant reduction in total and LDL
cholesterol levels; however, there was no significant effect on HDL
cholesterol or triglyceride levels, according to "
Green tea catechins decrease total and low-density lipoprotein cholesterol: a systematic review and meta-analysis" by Kim A, Chiu A, Barone MK, Avino D, Wang F, Coleman CI, Phung OJ.(64)
b.
Antioxidant activity
In the
research on polyphenolic compounds (included catechins) in the berries
of edible honeysuckle and their biological effects, including
recommended utilization, are reviewed found that These berries seem to
be prospective sources of health-supporting phytochemicals that
exhibit beneficial anti-adherence and chemo-protective activities,
thus they may provide protection against a number of
chronic conditions, e.g., cancer, diabetes mellitus, tumour growth or cardiovascular and neurodegenerative diseases, according to
"Phenolic profile of edible honeysuckle berries (genus lonicera) and their biological effects" by Jurikova T, Rop O, Mlcek J, Sochor J, Balla S, Szekeres L, Hegedusova A, Hubalek J, Adam V, Kizek R.(65)
c.
Neuroprotective effects
In the evaluation the neuroprotective effects of theanine and
catechins
contained in green tea , found that the mechanism of the
neuroprotective effect of theanine is related not only to the glutamate
receptor but also to other mechanisms such as the glutamate
transporter, although further studies are needed. One of the onset
mechanisms for arteriosclerosis, a major factor in ischemic
cerebrovascular disease, is probably the oxidative alteration of
low-density lipoprotein (LDL) by active oxygen species. The oxidative
alterations of LDL were shown to be prevented by tea
catechins. Scavenging of *O(2)(-) was also exhibited by tea
catechins. The neuroprotective effects of theanine and
catechins contained in green tea are a focus of considerable attention, and further studies are warranted, according to "
Neuroprotective effects of the green tea components theanine and catechins" by Kakuda T.(66)
2.
Tangeritin, one of the
flavones, is found in tangerine and many citrus peels
a.
Cholesterol
In the
investigation of the formulations containing citrus polymethoxylated
flavones (PMFs), mainly tangeretin, or citrus flavanone glucosides,
hesperidin and naringin and theirs anti hypercholesterolemia effect
found that PMFs are novel flavonoids with cholesterol- and
triacylglycerol-lowering potential and that elevated levels of PMF
metabolites in the liver might be directly responsible for their
hypolipidemic effects in vivo, according to "
Hypolipidemic Effects and Absorption of Citrus Polymethoxylated Flavones in Hamsters with Diet-Induced Hypercholesterolemia" by Elzbieta M. Kurowska and John A. Manthey, KGK Synergize Inc.(67)
b. Neuroprotective effects
In the evaluation of neuroprotective effects of a natural antioxidant
tangeretin, a citrus flavonoid and its effect on Parkinson's disease found that
tangeretin crosses the blood-brain barrier. The significant protection of striato-nigral integrity and functionality by
tangeretin suggests its potential use as a neuroprotective agent, according to "
Tissue distribution and neuroprotective effects of citrus flavonoid tangeretin in a rat model of Parkinson's disease" by
Datla KP, Christidou M, Widmer WW, Rooprai HK, Dexter DT.(68)
c.
Antioxidants
In the
comparison of hand-pressed juice of polymethoxylated flavones (PMFs)
and flavanone glycosides (FGs) and the peeled fruit of 'Sainampueng'
tangerines ( Citrus reticulata Blanco cv. Sainampueng) antioxidant
effects found that hand-pressed juice of C. reticulata Blanco cv.
Sainampueng serves as a rich source of PMFs, FGs, carotenoids, and
antioxidants:
4-5 tangerine fruits ( approximately 80 g of each fruit) giving one
glass of 200 mL hand-pressed juice would provide more than 5 mg of
nobiletin and
tangeretin
and 36 mg of hesperidin, narirutin, and didymin, as well as 30 mg of
ascorbic acid, >1 mg of provitamin A active beta-cryptoxanthin, and
200 microg of alpha-tocopherol, according to "
Polymethoxylated flavones, flavanone glycosides, carotenoids, and antioxidants in different cultivation types of tangerines ( Citrus reticulata Blanco cv. Sainampueng) from Northern Thailand" by Stuetz W, Prapamontol T, Hongsibsong S, Biesalski HK.(69)
d.
Antimicrobial activity
In
the study of antibacterial and antifungal properties of wax and hexane
extracts of Citrus spp. peels found that antimicrobial activity
especially against M. canis and T. mentagrophytes:
4',5,6,7,8-pentamethoxyflavone (tangeritin) and
3',4',5,6,7,8-hexamethoxyflavone (nobiletin) from C. reticulata; and
6,7-dimethoxycoumarin (also known as escoparone, scoparone or scoparin)
from C. limon, according to "
Antimicrobial activity of wax and hexane extracts from Citrus spp. peels" by Johann S, Oliveira VL, Pizzolatti MG, Schripsema J, Braz-Filho R, Branco A, Smânia Jr A.(70)
3.
Rosemarinol, is a phytochemical
monophenols, found in essential oil of labiate herbs like Rosemary and also in variety of other plants.
a.
Antimicrobial activity
In
the observation of the essential oils from clove (Syzygium aromaticum
(L.) Merr. et Perry) and rosemary (Rosmarinus officinalis L.) and their
anti,icrobial effects found that The antimicrobial activity of
combinations of the two essential oils indicated their additive,
synergistic or antagonistic effects against individual microorganism
tests. The time-kill curves of clove and rosemary essential oils
towards three strains showed clearly bactericidal and fungicidal
processes of (1)/(2) x MIC, MIC, MBC and 2 x MIC, according to "
Antimicrobial activity of clove and rosemary essential oils alone and in combination" by Fu Y, Zu Y, Chen L, Shi X, Wang Z, Sun S, Efferth T.(71)
b.
Anti-inflammatory effects
In the research of the
extract of
rosemary
leaves from supercritical fluid extraction and its anti inflammatory
effects found that the yield of 3.92% and total phenolics of 213.5 mg/g
extract
obtained from the most effective extraction conditions showed a high
inhibitory effect on lipid peroxidation (IC(50) 33.4 μg/mL). Both the
SC-CO(2)
extract and CA markedly suppressed the LPS-induced production of nitric oxide (NO) and
tumor
necrosis factor-α (TNF-α), as well as the expression of inducible
nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2),
phosphorylated inhibitor-kappaB (P-IκB), and nuclear factor-kappaB
(NF-κB)/p65 in a dose-dependent manner, according to the study of "
Anti-inflammatory effects of supercritical carbon dioxide extract and its isolated carnosic acid from Rosmarinus officinalis leaves" by
Kuo CF, Su JD, Chiu CH, Peng CC, Chang CH, Sung TY, Huang SH, Lee WC, Chyau CC.(72)
4.
Rutin also known as rutoside, quercetin-3-O-rutinoside and sophorin is a
Flavonols, belong to Flavonoids (polyphenols) of Phenolic compounds found orange, grapefruit, lemon, lime, berries
mulberry, cranberries, buckwheat etc.
a. Anti-inflammatory activity
In the investigation of
Rutin, a natural flavone derivative and its anti inflammatory effect found that Oral administration of
rutin reduced rat paw swelling starting 2 hours after lambda-carrageenan injection.
Rutin
reduced significantly (p < 0.05) and in a dose-dependant manner
the polymorphonuclear neutrophils chemotaxis to fMet-Leu-Phe,
according to the study of "
Anti-inflammatory effect of rutin on rat paw oedema, and on neutrophils chemotaxis and degranulation" by Selloum L, Bouriche H, Tigrine C, Boudoukha C.(73)
b.
Diabetes, Hyperglycemia and dyslipidemia
In the analyzing Dietary antioxidant compounds such as flavonoids and its protection against early-stage
diabetes mellitus, found that Rutin
(50 mg kg(-1)) reduced (p<0.05) blood glucose and improved the
lipid profile in STZ-induced diabetic rats and concluded that that
rutin
can improve hyperglycemia and dyslipidemia while inhibiting the
progression of liver and heart dysfunction in STZ-induced diabetic
rats, acccording to "
Influence of rutin treatment on biochemical alterations in experimental diabetes" by
Fernandes AA, Novelli EL, Okoshi K, Okoshi MP, Di Muzio BP, Guimarães JF, Fernandes Junior A.(74)
c.
Cardiovascular health
In the testing the hypothesis of the consumption of a diet rich in flavonoids can be associated with a reduced risk for
cardiovascular disease found that hamster fed with 2% cranberry concentrate powder (HFHC+CE); a HFHC with 0.1%
rutin (HFHC+
Rutin);
and a HFHC with 30 mg/kg vitamin E (HFHC+Vit.E) diet for either 12 or
20 weeks, found that Ratios of plasma high-density lipoprotein
cholesterol (HDL-C) to very-low-density lipoprotein cholesterol and of
plasma HDL-C to low-density lipoprotein cholesterol were significantly
higher in animals consuming HFHC+Vit.E, according to the strudy of "
Effects of a flavonol-rich diet on select cardiovascular parameters in a Golden Syrian hamster model" by Kalgaonkar S, Gross HB, Yokoyama W, Keen CL.(75)
d. Ischemia-reperfusion brain injury-related disorders
In
the investigation of rutin's effect on cerebral ischemia-reperfusion
(IR) injury caused by free radical induced neural damage found that the
elevated level of thiobarbituric acid reactive species (TBARS),
H(2)O(2) and protein carbonyl (PC) in MCAO group was attenuated
significantly in
rutin-pretreated group and concluded that
rutin
treatment may represent a novel approach in lowering the risk or
improving the function of ischemia-reperfusion brain injury-related
disorders, according to
Rutin protects the neural damage induced by transient focal ischemia in rats" by Khan MM, Ahmad A, Ishrat T, Khuwaja G, Srivastawa P, Khan MB, Raza SS, Javed H, Vaibhav K, Khan A, Islam F.(76)
5.
Glycitein is a
phytochemical in the Isoflavones, belonging to the group of Flavonoids
(polyphenols), found abundantly in food of the family of legumes,
soy, peanuts, chick peas, fava beans, alfalfa, kudzu, etc.
a.
Antioxidants
in the
evaluation of the antioxidant activity and contents of various
polyphenol classes in the seeds of seven soybean varieties of different
seed color and one yellow seed cultivar, found that antioxidant
activity of seed extracts was evaluated by the
2,2-diphenyl-1-picrylhydrazyl free radical scavenging activity assay. A
positive linear correlation between antioxidant activity and contents
of total polyphenols and anthocyanins was established. The highest
antioxidant activity was observed in the extracts of black and brown
varieties, which also showed high levels of all polyphenol classes
examined. Yellow seed had the highest total isoflavone content
(3.62 mg/g of dry material). The highest concentration of total daidzein
was determined in black seeds (>2.0 mg/g of dry material), and the
highest total
glycitein
and genistein contents occurred in the yellow cultivar (0.53 and
1.49 mg/g of dry material, respectively). According to our results,
varieties of black and brown seeds could be of special interest not only
for their large content of total polyphenols, ranging from 4.94 to
6.22 mg of gallic acid equivalents/g of dry material, but also for their
high content of natural antioxidants such as anthocyanins, according
to "
Polyphenol content and antioxidant properties of colored soybean seeds from central europe" by Malenčić D, Cvejić J, Miladinović J.(77)
b.
Hypolipidemic effects
In the
comprison of whether Monascus-fermented soybean extracts (MFSE)
enriched with bioactive mevinolins (natural statins) and aglycone
isoflavones (daidzein,
glycitein,
and genistein) perform an additive hypolipidemic effect in
hyperlipidemic ratsand unfermented soybean extracts (UFSE), which have a
higher level of glucoside isoflavones (daidzin, glycitin, and
genistin) without mevinolin, found that treatment with both MFSE200 and
MFSE400 groups for 40 days significantly reduced the activities of
serum aspartate aminotransferase and alanine aminotransferase by
averages of 35.6 and 43.2%, respectively, as compared to the high-fat
diet group (p < 0.01). The results indicate that MFSE performs a
more potent hypolipidemic action via improvement of the lipid profiles
and down-regulated HMG-CoA reductase activity than UFSE in
hyperlipidemic rats, according to "
Hypolipidemic effects of Monascus-fermented soybean extracts in rats fed a high-fat and -cholesterol diet" by Pyo YH, Seong KS.(78)
c.
Post-menopausal effects
found
that high-dose isoflavones is associated with improved QOL among women
who have become menopausal recently. Hence, the timing of isoflavone
supplementation with regards to the onset of menopause appears to be
important. The use of isoflavones, as an alternative to estrogen
therapy, may be potentially useful and seemingly safe in this group of
women who are looking for relief from menopausal symptoms, according to
"
Effect of high-dose isoflavones on cognition, quality of life, androgens, and lipoprotein in post-menopausal women" by Basaria S, Wisniewski A, Dupree K, Bruno T, Song MY, Yao F, Ojumu A, John M, Dobs AS.(79)
VII. Treatments
A.1. In conventional medicine perspective
Treatment for a symptomatic aneurysm is to repair the blood vessels to prevent blood to enter the aneurysm
to cause further growth or
blood leakage.
1. Surgical Clipping was introduced by Walter Dandy of the Johns Hopkins Hospital in 1937
Clopping is the operation of the brain by cutting open the skull to find the damaged blood vessel and putting a clip across the aneurysm.
2. Endovascular coiling was introduced by Guido Guglielmi at UCLA in 1991
The operation passes a catheter into the femoral artery in the groin, through the
aorta, into the brain arteries to the aneurysm and fill the aneurysm with coils of
platinum wire or with latex.
Depending to he severity of the patient's condition, the EEG
changes, an
intracranial
hematoma, and correspondence of the region of the operation with the
zone of the vascular spasm were the most informative preoperative signs
of the prognosis of the
outcome
of early operations. Bleeding during the operation and the duration of
the arrest of the blood flow in the main vessel were the most
informative intraoperative signs(80). Other study of One hundred and sixty of the aneurysms had
ruptured; for 150 "typical" supratentorial aneurysms, the operative case
fatality rate was 10%, and a satisfactory
outcome
was obtained in 85%. There were no deaths and little morbidity in 108
operations on grade 0 or 1 patients. Among a number of factors
influencing
outcome,
the most obvious were age, hypertension, cerebral arterial spasm, and
the clinical condition of the patient at the time of operation. The
timing of surgery had no effect on results(81).
In a study to compare the quality of life (QOL) of surgically versus endovascularly treated patients with ruptured
cerebral aneurysms.Methods We treated 45 patients surgically (surgical
clipping [SC] group) and 44 by endovascular therapy (coil embolization [CE] group), the differences in QOL in the patients treated by either coiling or
clipping were small and nonsignificant(82).
A.2. In herbal medicine perspective
1,
Black Cohosh is a
herbaceous
perennial plant, genus Actaea, belonging to the family Ranunculaceae,
native to eastern North America. The herb has been used in traditional
medicine as analgesic, sedative, diuretic, emmenagogue
anti-inflammatory agent and to treat rheumatism, symptoms of menopause,
uterine cramps and muscle pain, etc.. Native Americans have used the
root of the herb to treat snake bite.
a.
Alternative to hormone replacement therapy
Black
cohosh contains high amount of phytoestrogen of which helps to
occupied the estrogen receptors or enhances the estrogen levels in the
women in the stage of menopause, thus it may be considered as
alternative to estrogen therapy, according to the study of "
Black cohosh: an alternative therapy for menopause?" by Mahady GB, Fabricant D, Chadwick LR, Dietz B., posted in PubMed(83)
b.
Antioxidants
Polyphenols in
Black cohosh may be considered as an antioxidant which help to fight
against the forming of free radicals cause of DNA damage and guarding
our body against foreign invasion such as bacteria and virus, according
to the study of "
Black cohosh (Cimicifuga
racemosa L.) protects against menadione-induced DNA damage through
scavenging of reactive oxygen species: bioassay-directed isolation and
characterization of active principles" by Burdette JE, Chen SN,
Lu ZZ, Xu H, White BE, Fabricant DS, Liu J, Fong HH, Farnsworth NR,
Constantinou AI, Van Breemen RB, Pezzuto JM, Bolton JL., posted in
PubMed(84)
c.
Anti-inflammation
Cimicifuga racemosa (
Actaea racemosa,
black cohosh)have exerted inflammatory activity by inhibiting nitric
oxide production by reducing iNOS expression without affecting activity
of the enzyme, according to the study of "
Inhibition of inducible nitric oxide synthesis by Cimicifuga racemosa (Actaea racemosa, black cohosh) extracts in LPS-stimulated RAW 264.7 macrophages" by Schmid D, Gruber M, Woehs F, Prinz S, Etzlstorfer B, Prucker C, Fuzzati N, Kopp B, Moeslinger T., posted in PubMed(85)
2.
Dang Qui (Angelica sinensis) is a herb of Genus
Angelica from
the family Apiaceae, indigenous to China. The herb has been used as a
Queen herb in traditional Chinese medicine antispasmodic and
vasodilatory agent, and to balance the hormones in women for a normal
menstrual cycle and menstruation and strengthen heart, spleen, kidneys,
and liver for both men and women, etc. In other words, it is used to
treat gynecological ailments,
fatigue, mild anemia and
high blood pressure. It has analgesic, anti-inflammatory, etc.
a,
Inflammatory effect
In the investigation of ethyl acetate (EtOAc) fraction from
Angelica sinensis
(Oliv.) and its anti-inflammatory effort found that AS EtOAc extract
significantly inhibited NF-kappaB luciferase activity and TNF-alpha,
IL-6, macrophage inflammatory protein-2 (MIP-2) and NO secretions from
LPS/IFN-gamma-stimulated RAW 264.7 cells. The AS1 and PDTC groups, but
not AS2, had significantly higher survival rate than the control
group. This was characterized by the inhibition of the serum TNF-alpha
and IL-12p40 levels after LPS injection (p<0.05). The major
compounds of AS, ferulic acid and Z-ligustilide, also significantly
decreased NF-kappaB luciferase activity, which may contribute to the
anti-inflammatory activity of AS, according to "
Inhibitory effects of Angelica sinensis ethyl acetate extract and major compounds on NF-kappaB trans-activation activity and LPS-induced inflammation" by Chao WW, Hong YH, Chen ML, Lin BF.(86)
b. Ischemia and Neurodegeneration
In the observation of 4 medical plants: astragali, ligusticum wallichii,
angelica sinensis
and carthamus tinctorius (saffron) have been the major medicines to
treat ischemia for hundreds of years in China, Korea and Japan and
theirs effects on Ischemia and Neurodegeneration found that The herbs
have demonstrated the neuroprotective efficacy of the combination of
these phyotmedicines on mitigating brain infarction and global ischemia
as well as preventing the neurodegeneration following ischemia. Owing
to their multi-function, including improving cerebral blood
circulation, they therefore have the potential to alleviate the
symptoms of degenerative diseases, Alzheimer's disease (AD) and
Parkinson's disease (PD), according to the study of
"Polyphenols and Neuroprotection against Ischemia and Neurodegeneration" by Lin B.(87)
c.
Immunomodulatory functions
In the evaluation of Ganoderma tsugae (Ganodermataceae), Codonopsis pilosula (Campanulaceae) and
Angelica sinensis
(Apiaceae) and their effects on immune system found that RG-CMH, which
represents a mixture of rose geranium and extracts of G. tsugae, C.
pilosula and A.
sinensis,
can improve the immune cell count of cancer patients receiving
chemotherapy and/or radiotherapy to prevent leucopenia and immune
impairment that usually occurs during cancer therapy. A total of
fifty-eight breast cancer patients who received chemotherapy or
radiotherapy were enrolled, according to "
Effects of a Chinese medical herbs complex on cellular immunity and toxicity-related conditions of breast cancer patients' by Zhuang SR, Chiu HF, Chen SL, Tsai JH, Lee MY, Lee HS, Shen YC, Yan YY, Shane GT, Wang CK.(88)
d.
Hypertension
In the
investigation of Z-ligustilide, the main lipophilic component of the
essential oil of Danggui on aortic tension induced by phenylephrine of
Radix
Angelica sinensis,
and its anti-hypertensive effect found that ligustilide can
significantly reduce the phenylephrine-induced aortic tension in vitro
with IC(50) about 64 mug/ml, but has no in vivo effect on systolic
blood pressure in SHR rats when administrated orally. The data on
transport of ligustilide across Caco-2 monolayer suggested an efficient
intestinal absorption of ligustilide in vivo, implying that the
non-effectiveness of ligustilide in vivo is not due to the poor
absorption in the gastrointestinal tract, according to "
Ligustilide
reduces phenylephrine induced-aortic tension in vitro but has no
effect on systolic pressure in spontaneously hypertensive rats" by Du JR, Yu Y, Yao Y, Bai B, Zong X, Lei Y, Wang CY, Qian ZM.(89)
3.
Hawthorn is a shrubs and
trees of the genus Crataegus, belonging to the family Rosaceae, native
to temperate regions of the Northern Hemisphere in Europe, Asia and
North America. The herb has been used in traditional medicine to treat
heart disease and symptoms of heart diseases such as irregular
heartbeat, high blood pressure, chest pain, hardening of the arteries,
etc., circulatory disorders and respiratory illnesses.
a, Hypotensive effects
In the investigation of
Hawthorn (
Crataegus laevigata) leaves, flowers and berries used by herbal practitioners in the UK to treat
hypertension
in conjunction with prescribed drugs indicated that this is the first
randomised controlled trial to demonstrate a hypotensive effect of
hawthorn in patients with diabetes takin, according to "
Hypotensive effects of hawthorn for patients with diabetes taking prescription drugs: a randomised controlled trial" by
Walker AF, Marakis G, Simpson E, Hope JL, Robinson PA, Hassanein M, Simpson HC(90)
b. Cardiac effects
In the evaluation of the potential cardiac effects of two alcohol extracts of commercially available
hawthorn found that the mechanism of cardiac activity of
hawthorn is via the Na(+),K(+)-ATPase and intracellular calcium concentrations are influenced, according to "
A comparison of the effects of commercially available hawthorn preparations on calcium transients of isolated cardiomyocytes" by Rodriguez ME, Poindexter BJ, Bick RJ, Dasgupta A.(91)
c. Cardiovascular disease
In
the analyzing the effect of hawthorn in prevention and protection of
cardiovascular disease indicated that these beneficial effects may in
part be due to the presence of antioxidant flavonoid components. While a
number of studies have been performed to evaluate the clinical
efficacy of
hawthorn,
an international, multicenter, prospective clinical study including a
large number of New York Heart Association (NYHA) class II/III heart
failure patients is ongoing to test
hawthorn's long-term therapeutic effects, according to "
Hawthorn: potential roles in cardiovascular disease"by Chang WT, Dao J, Shao ZH.(92)
4.
Maitake Mushroom is an edible
mushroom in the genus Grifola, belonging to the family Meripilaceae,
native to Japan. The herb has been used as liver protector and to
enhance immune function, maintain health, preserve youth, increase
longevity, etc.
a. Hypertension
In the assessment of effect of two commercially-available fractions labeled SX and D derived from the edible
maitake mushroom in overcoming many age-associated metabolic perturbations, found that
maitake mushroom
fractions lessen age-related hypertension, at least in part, via
effects on the RAS; enhance insulin sensitivity; and reduce some aspects
of inflammation--actions that should lead to a longer, healthier life
span, according to "
Maitake mushroom extracts ameliorate progressive hypertension and other chronic metabolic perturbations in aging female rats" by Preuss HG, Echard B, Bagchi D, Perricone NV.(93)
b. Hyperlipidemia, hypertension, and hepatitis
In the investigation of Maitake (
Grifola frondosa)
and the effect of polysaccharide compounds in health-promoting
potential, found that the D-fraction, the MD-fraction, and other
extracts, often in combination with whole maitake powder, have shown
particular promise as immunomodulating agents, and as an adjunct to
cancer and
HIV therapy. They may also provide some benefit in the treatment of hyperlipidemia, hypertension, and hepatitis(94)
c. Antioxidant properties
In
the The optimization of solid-state fermentation conditions for
mycelial growth in wheat by culinary-medicinal maitake mushroom and its
health benefits found that that fermented wheat was effective in
antioxidant activity, reducing power, scavenging ability on
1,1-diphenyl-2-picrylhydrazyl radicals, and chelating ability on
ferrous ions. Total phenol contents of both extracts were 13.35 and
23.01 mg/g, respectively. according to "
Preparation of culinary-medicinal maitake mushroom, Grifola frondosa (Dicks.: Fr.) S.F. Gray (Aphyllophoromycetideae)-fermented wheat and its antioxidant properties" by Huang SJ, Tsai SY, Lin SY, Liang CH, Lian PY, Mau JL.(95)
5. Motherwort is a perennial plant in the genus Leonurus, belonging to
the family Lamiaceae, native to the Central Asia. The herb has been
used in traditional medicine in Central Europe, Asia and North America
as relaxed agent to treat nervousness, insomnia, heart palpitation,
promote milk flow, uterine contractions, menstrual flow and to relieve
menopausal symptoms and menstrual complaints.
a.
Cardiac and electrophysiological effects
In the investigation of European Lamiaceae
Leonurus cardiaca
(Ph.Eur.) used for centuries as a remedy against tachyarrhythmia and
other cardiac disorders with aqueous Soxhlet extract, found that mapping
experiments with 256 electrodes on the heart surface showed a
reduction of left ventricular pressure and an increase of relative
coronary flow at concentrations of 1.0 and 2.0 mg/mL LCRE. Furthermore,
the PQ-interval was prolonged and both the basic cycle length and the
activation recovery interval increased, according to "
Cardiac and electrophysiological effects of primary and refined extracts from Leonurus cardiaca L. (Ph.Eur.)" by Ritter M, Melichar K, Strahler S, Kuchta K, Schulte J, Sartiani L, Cerbai E, Mugelli A, Mohr FW, Rauwald HW, Dhein S.(96)
b.
Cerebral protection
In the
analyzing neuroprotective effects of purified Herba Leonuri (pHL) were
evaluated in Wistar rats undergone middle cerebral artery occlusion
(MCAO) found that Under the treatment of pHL, the infarct volume was
reduced significantly from 20.75+/-0.03% to 15.19+/-0.02% (p<0.05).
The neurological impairment was alleviated to 1.82 as compared to
vehicle (2.43). Plasma antioxidant concentration was increased from
0.31+/-0.03 mM to 0.42+/-0.05 mM (p<0.05). DNA oxidative damage was
reduced to 1.19+/-0.03 in stroke pHL treated
group (p<0.05 as compared to vehicle
group,
1.78+/-0.03). pHL could reduce the level of apoptosis and also the
pro-apoptotic proteins, but increase the level of anti-apoptotic
proteins, according to "
Cerebral protection of purified Herba Leonuri extract on middle cerebral artery occluded rats" by Loh KP, Huang SH, Tan BK, Zhu YZ.(97)
6. Etc.
A.3. In traditional Chinese medicine perspective
1. Dr. Wang C, and the research team of the Department of Neurology, Beijing Tiantan Hospital, in the study of Management of SAH with traditional Chinese medicine in China showed that the main cause of SAH in China is
aneurysm which takes up 30-50%, while over 90%
aneurysm locates at Willis circle. Early surgery for SAH after
aneurysm
rupture is the dominant procedure to deal with SAH in China. Moreover,
calcium antagonists rank the absolute leading position for
cerebral
vascular spasm (CVS) among medication-based treatment options. However,
traditional Chinese medicine such as
Salvia miltiorrhiza, Acanthopanax
senticosus, Ginkgo biloba, Pueraria lobata, Liguisticum chuanxiong, cow
bezoar, Diospyros kaki and Gynostemma pentaphyllum have been proven
beneficial in CVS prevention and treatment, while
Salvia miltiorrhiza
and TCM soup have unique effects on
bleeding absorption. In addition,
aescine and
some TCM soup might relieve strong headache after SAH. In
general, TCM integrated with western medicine have shown unique
advantages in the current treatment of SAH in China. However, it is a
pity that China still lacks larger scale randomized controlled trials
and research on SAH treatment focusing on TCM and the related mechanism
of TCM on SAH still need to be investigated further(98).
2. Other suggested that
red yeast rice (RYR) extract administration suppressed AngII-induced AAA and
atherosclerosis associated with regulating inflammation responses
independent of lipid-lowering effects. Red yeast rice may have
preventive potential for patients with Abdominal aortic
aneurysm (AAA)(99).
3. In fact, in the comparison of the a total of 32 patients with acute subarachnoid haemorrhage were randomly assigned to either a
Chinese herbs extra group (CH) in which the patients were given complementary therapies of
Chinese medicine and standard treatment, or a standard treatment only group (ST) in which patients were given standard treatment only, found that the average Glasgow Outcome Scale score 3 months after admission was
3.7±1.4 in the CH was greater than 3.0±1.7 in the ST (p=0.041). Average
total admission days were 53.9±28.6 (median 61) in the ST longer than
28.1±19.1 (median 20.5) in the CH (p=0.004) and concluded that
TCM for the treatment of patients with acute subarachnoid haemorrhage is of
value because they can increase Glasgow Outcome Scale scores 3 months
after admission and also because they can reduce total admission days(100).
4. Etc.
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