Yonago acta medica最新文献

{"title":"A Case of High-Dose Intravenous MgSO₄ and Hemoperfusion for Aconite Poisoning with Chronic Kidney Disease.","authors":"Yoshiaki Oshima, Akira Tanaka, Masaharu Fukuki, Akihiro Otsuki, Ichiro Hisatome","doi":"10.33160/yam.2024.08.012","DOIUrl":"10.33160/yam.2024.08.012","url":null,"abstract":"<p><p>Aconite contains four highly toxic diester-diterpene alkaloids, including aconitine, mesaconitine, hypaconitine, and jesaconitine, in all plant parts. Aconite has been used as for suicide, murder, and as an arrow poison since ancient Greek and Roman times. Ventricular tachyarrhythmias are the most common cause of death in aconite poisoning, and antiarrhythmic drugs and cardioversion are ineffective. A 61-year-old woman ingested the crushed raw roots of a single aconite plant. An ambulance brought her to the Tottori University Hospital 30 min after ingestion. She had a history of chronic stage 5 kidney disease but was not on dialysis. Her heart rate (HR) was 120 bpm upon arrival. The patient developed sustained supraventricular tachycardia (SVT) at an HR of 165 bpm with frequent premature ventricular contractions (PVCs) 15 min after arrival. She then developed sustained monomorphic ventricular tachycardia (VT) at an HR of 200 bpm 20 min after arrival, which progressed to pulseless polymorphic VT. Cardioversion was unsuccessful. External cardiac massage restored spontaneous circulation; however, her underlying rhythm remained sustained SVT with frequent PVCs. These arrhythmias repeatedly led to circulatory arrest. She was administered six intravenous boluses of 2 g of MgSO₄ in the emergency department, which prevented her from going into sustained pulseless VT. Hemoperfusion (HP) with activated charcoal was performed 1.5 h after arrival. The aconitine, mesaconitine, and hypaconitine plasma concentrations were high at 8.9, 23.5, and 5.5 ng/mL, respectively, before the start of HP but decreased to 1.7, 4.0, and 2.7 ng/mL, respectively, after 7 h of HP. She returned to sinus rhythm on the second day of hospitalization; however, the patient required maintenance hemodialysis. We concluded that high-dose IV MgSO₄ is an effective treatment for fatal tachyarrhythmias due to aconite poisoning, and that in cases of renal failure, HP may be required to remove aconite toxins from the body.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"270-279"},"PeriodicalIF":0.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excellent Response to 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy in a Patient with Treatment-Related Neuroendocrine Prostate Cancer with Urinary Retention and Rectal Obstruction: A Case Report.","authors":"Ryusei Yasukawa, Bunya Kawamoto, Kuniyasu Muraoka, Kazuhiko Nakamura, Masashi Honda, Atsushi Takenaka","doi":"10.33160/yam.2024.08.010","DOIUrl":"10.33160/yam.2024.08.010","url":null,"abstract":"<p><p>Treatment-related neuroendocrine prostate cancer (tNEPC) occurs after androgen deprivation therapy and has a poor prognosis; however, there are few effective treatments for tNEPC. Therefore, tNEPC management is often challenging. This is a case of a 65-year-old Asian male patient with prostate adenocarcinoma who had metastases at initial presentation. After prostate biopsy revealed neuroendocrine prostate cancer (NEPC), he was treated with platinum-based systemic chemotherapy followed by pembrolizumab treatment. The primary tumor regions temporarily regressed, but progression of the primary tumor resulted in urinary retention and rectal obstruction; therefore, a transverse colostomy was performed, and a urethral catheter was inserted. Following somatostatin receptor scintigraphy (SRS), it was determined that the primary tumor expressed somatostatin receptors. Based on these results, treatment with 177Lu-DODATATE peptide receptor radionuclide therapy was prescribed. Subsequently, the primary tumor regressed remarkably, and the urethral catheter was removed. 177Lu-DOTATATE peptide receptor radionuclide therapy may be an effective option for tNEPC, which has few effective treatment options.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"266-269"},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Mediastinal Gastric Perforation in Hiatal Hernia with Difficult Surgical Technique Selection: A Case Report.","authors":"Tomohiro Takahashi, Tomoyuki Matsunaga, Shota Shimizu, Yuji Shishido, Kozo Miyatani, Naruo Tokuyasu, Teruhisa Sakamoto, Yoshiyuki Fujiwara","doi":"10.33160/yam.2024.08.007","DOIUrl":"10.33160/yam.2024.08.007","url":null,"abstract":"<p><p>Emergency surgery for a hiatal hernia (HH) is uncommon. However, mediastinal gastric perforation may occasionally present as the initial symptom of HH and demonstrate high mortality rates. Managing mediastinal gastric perforation in HH has no established standard surgical technique, and the selection of surgical techniques may be challenging. A 78-year-old female patient was referred to our department because of an upper gastrointestinal perforation in HH based on computed tomography (CT) results. Determining the possibility of esophageal perforation and intrathoracic penetration was difficult according to CT results alone, and whether a transthoracic or transabdominal approach was preferable. We diagnosed the patient with a mediastinal gastric perforation in HH without intrathoracic penetration based on an additional gastrointestinal contrast study and a right thoracentesis. We treated the patient with laparotomy, involving the perforation site and esophageal hiatus closure and gastropexy. Postoperatively, the patient experienced complications associated with delayed gastric emptying and aspiration pneumonia. Fortunately, no severe infections, such as residual abscess formation or empyema, were observed, and the recovery progressed favorably. Mediastinal gastric perforation should be considered a differential diagnosis for elderly patients with sudden-onset chest pain and dyspnea, and the threshold for imaging should be lowered. Identifying the perforation site and the presence of intrathoracic penetration based on preoperative results is useful for determining the appropriate surgical technique. Postoperative quality of life to the extent feasible needs to be considered, as the selection of surgical technique may cause subsequent recurrence or reflux symptoms.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"259-265"},"PeriodicalIF":0.9,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exposure-Based Online Intervention and Behavioral Parent Training for a Child with Selective Mutism: A Case Report.","authors":"Tomohisa Yamanaka, Ryuki Kadekaru, Masahiko Inoue","doi":"10.33160/yam.2024.08.004","DOIUrl":"10.33160/yam.2024.08.004","url":null,"abstract":"<p><p>Although exposure-based practices are effective in treating selective mutism, difficulties arise when the child refuses to visit a clinical center. In this situation, it is important to intervene using remote technology and to support parents who have children with selective mutism. In this patient report, an exposure-based intervention using online technology was implemented for an 8-year-old girl with selective mutism. In addition, her mother was also experiencing increased parenting stress. Therefore, the mother received behavioral parent training specifically designed for parents of children with selective mutism. As a result, the child's nervousness decreased during the intervention, and the frequency of their speech, facial expression, and body motion improved. Initially, the child refused to visit our clinical center. However, they eventually agreed and managed to communicate non-verbally with the primary author in our clinical center. Behavioral parent training for selective mutism improved her mother's understanding of the condition, the way she interacts with her child, and reduced her parenting stress. Implementing Internet-based interventions is highly beneficial because it significantly reduces the fear of clinic or hospital visits among children with selective mutism. Furthermore, behavioral parent training tailored to selective mutism to improve parental stress and interaction can be a valuable support option for parents of children with selective mutism.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"246-253"},"PeriodicalIF":0.9,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Image Follow-Up After Flow Diverter Treatment Using Only Ultra-High Resolution CT Angiography with Model-Based Iterative Reconstruction: A Case Report.","authors":"Naoki Iwata, Makoto Sakamoto, Toshio Sakou, Tetsuji Uno, Masamichi Kurosaki","doi":"10.33160/yam.2024.08.006","DOIUrl":"10.33160/yam.2024.08.006","url":null,"abstract":"<p><p>Follow-up examinations using magnetic resonance imaging or digital subtraction angiography are mandatory after flow diverter treatment of cerebral aneurysms. However, flow diverter features metal artifacts on magnetic resonance imaging and ischemic complications with digital subtraction angiography. Ultra-high-resolution computed tomography systems have recently become available in clinical practice. The combined use of ultra-high-resolution computed tomography and a reconstruction technique called model-based iterative reconstruction is expected to replace follow-up magnetic resonance imaging and digital subtraction angiography of flow diverter placement. Here, we report a case of ultra-high-resolution computed tomography with model-based iterative reconstruction after flow diverter treatment.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"254-258"},"PeriodicalIF":0.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microduplication of <i>SCN2A</i> Gene in a Child with Drug-Resistant Epilepsy and Developmental/Epileptic Encephalopathy with Spike Wave Activation During Sleep.","authors":"Shun Akaboshi, Tohru Okanishi, Masaki Iwasaki, Takashi Saito, Yoshihiro Maegaki","doi":"10.33160/yam.2024.08.003","DOIUrl":"10.33160/yam.2024.08.003","url":null,"abstract":"<p><p>Duplications in chromosomal locus 2q24.3 region that solely involve <i>SCN2A</i> remain less explored. Favorable outcomes have been reported in patients with <i>SCN2A</i> gene duplications in cases of mild epilepsy with onset during the neonatal to infantile period, or in infantile epileptic spasm syndrome. Herein, we report a case of microduplications, including <i>SCN2A</i> gene duplications, wherein developmental/epileptic encephalopathy with spike-wave activation during sleep (D/EE-SWAS) developed. A 3-day-old girl without birth complications exhibited tonic seizures in her right limb with eye deviation to the right. She developed drug-resistant seizures, including atypical absence seizures, at 1 year and 6 months old. Despite achieving seizure freedom at 9 years old, she experienced academic difficulties. D/EE-SWAS was diagnosed based on the long-term electroencephalogram findings. Following a corpus callosotomy at 11 years old, her academic performance and emotional expression improved. Comprehensive genetic analysis at 10 years old revealed a microduplication spanning approximately 300 kb within the 2q24.3 region, which included a segment of the <i>SCN2A</i> gene and an adjacent <i>CSRNP3</i> gene. In conclusion, we reported a rare case of duplications solely encompassing <i>SCN2A</i>. Corpus callosotomy resolved the D/EE-SWAS.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"242-245"},"PeriodicalIF":0.9,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Current Status of Postpartum Menstrual Resumption Delay and Associated Risk Factors in Japanese Women: An Adjunct Study of the Japan Environment and Children's Study.","authors":"Atsuko Samejima, Noriko Motoki, Akiko Haga, Chitaru Tokutake, Satoko Nakagomi, Teruomi Tsukahara, Tetsuo Nomiyama, Makoto Kanai","doi":"10.33160/yam.2024.08.005","DOIUrl":"10.33160/yam.2024.08.005","url":null,"abstract":"<p><strong>Background: </strong>Prolonged postpartum amenorrhea is a sign of secondary infertility. However, there are no reports on postpartum menstrual resumption delay in Japanese women. We conducted an Adjunct Study of the Japan Environment and Children's Study (JECS) to elucidate the actual state of postpartum menstrual resumption delay in Japan and related factors.</p><p><strong>Methods: </strong>An Adjunct Study questionnaire was sent to 2,729 mothers who participated in the study of Shinshu Subunit Center in the JECS, and 762 mothers were included in the analysis. The participants were categorized into the normal and delayed groups based on the weeks of postpartum menstrual resumption. To investigate the factors associated with postpartum menstrual resumption delay, a multiple logistic regression analysis was conducted with the weeks of postpartum menstrual resumption as the dependent variable.</p><p><strong>Results: </strong>The study included 762 women, of which 61 (8.0%) had delayed menstruation, not occurring until 72 weeks postpartum. The multivariate analysis revealed a significant correlation between postpartum menstrual resumption delay and age at delivery, past history of irregular menstruation, history of taking oral contraceptives, breastfeeding at 18 months, and the level of satisfaction with the husband's participation in childcare.</p><p><strong>Conclusion: </strong>Postpartum menstruation in Japanese women occurred later than before. In addition to previous findings, another factor was the husband's satisfaction with his participation in childcare. We should not only focus on the physical aspects of mothers, but also provide midwifery care that proposes and supports family planning suitable for each family.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"201-212"},"PeriodicalIF":0.9,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stimulation of Calcium/NOS/CK1α Signaling by Cedrol Triggers Eryptosis and Hemolysis in Red Blood Cells.","authors":"Iman A Alajeyan, Jawaher Alsughayyir, Mohammad A Alfhili","doi":"10.33160/yam.2024.08.002","DOIUrl":"10.33160/yam.2024.08.002","url":null,"abstract":"<p><strong>Background: </strong>Cedrol (CRL) is a sesquiterpene alcohol present in the essential oils of coniferous trees including <i>Cupressus</i> and <i>Juniperus</i> genera. CRL has shown potent anticancer activity by virtue of apoptosis. Red blood cells (RBCs), although devoid of mitochondria and nucleus, can undergo hemolysis and eryptosis which contribute to chemotherapy-induced anemia (CIA). In this work, we explored the hemolytic and eryptotic potential of CRL in human RBCs as a safety assessment of the sesquiterpene as an anticancer agent.</p><p><strong>Methods: </strong>RBCs from healthy donors were treated with anticancer concentrations of CRL for 24 h at 37°C with varying experimental manipulations. Hemolysis was photometrically assessed by measuring hemoglobin release whereas flow cytometry was employed to detect phosphatidylserine (PS) exposure by annexin-V-FITC, intracellular Ca²⁺ by Fluo4/AM, cell volume by forward scatter (FSC), and oxidative stress by 2',7'-dichlorodihydrofluorescein diacetate (H2DCFDA).</p><p><strong>Results: </strong>Significant, concentration-responsive hemolysis was noted upon CRL exposure with concomitant K⁺, LDH, and AST leakage. CRL also significantly increased annexin-V-positive cells and Fluo4 fluorescence and reduced FSC. Moreover, the cytotoxicity of CRL was significantly ameliorated in the presence of L-NAME, D4476, and PEG 8,000 but was aggravated by urea and sucrose.</p><p><strong>Conclusion: </strong>CRL stimulates hemolysis and eryptosis characterized by PS exposure, Ca²⁺ overload, and cell shrinkage. The hemolytic activity of CRL was mediated through nitric oxide synthase and casein kinase 1α. Blocking either enzyme may attenuate the toxicity of CRL to RBCs and prevent undesirable side effects associated with its anticancer applications.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"191-200"},"PeriodicalIF":0.9,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Benefits of Adjuvant Chemotherapy for Upper Tract Urothelial Carcinoma Require at Least Three Cycles.","authors":"Tetsuya Yumioka, Shuichi Morizane, Kuniyasu Muraoka, Hirofumi Oono, Tadahiro Isoyama, Naoyuki Sakaridani, Koji Ono, Takehiro Sejima, Hiroyuki Kadowaki, Katsuya Hikita, Masashi Honda, Atsushi Takenaka","doi":"10.33160/yam.2024.08.001","DOIUrl":"10.33160/yam.2024.08.001","url":null,"abstract":"<p><strong>Background: </strong>Upper urinary tract urothelial carcinoma (UTUC) is uncommon. In advanced cases, radical nephroureterectomy (RNU) alone is not curative, and recurrence and metastasis are likely to occur. Adjuvant chemotherapy (AC) is an evidence-based treatment. However, the optimal number of AC cycles is not clear. This multicenter study investigated the number of cycles required for the beneficial effects of AC in Japanese patients with UTUC.</p><p><strong>Methods: </strong>Patients who were diagnosed with UTUC and underwent RNU at our hospital and affiliated hospitals from January 2010 to September 2020 were included in the study. Patients with pathological T3 or higher or lymph node metastasis were observed or given AC, and their responses were compared. The AC regimens included gemcitabine and cisplatin or carboplatin. Patients were also classified into two groups: the observation and two cycles of AC group and the three to four cycles of AC group. The survival curves for recurrence-free survival (RFS) and cancer-specific survival (CSS) were evaluated using Kaplan-Meier analyses.</p><p><strong>Results: </strong>Of the 133 patients enrolled in the study, 24 received 2 cycles of AC, 37 received 3-4 cycles, and 72 were observed only. The 5-year RFS was 67.1% for the 3-4 cycles of AC group and 41.7% for the observation and two cycles of AC group. The 5-year CSS was 72.2% for the 3-4 cycles of AC group and 35.9% for the observation and two cycles of AC group. RFS and CSS were significantly longer in the 3-4 cycles of AC group compared to the observation and 2 cycles group (<i>P</i> = 0.048 and <i>P</i> = 0.005 respectively).</p><p><strong>Conclusion: </strong>AC prolonged RFS and CSS in the real-world setting. However, at least three cycles of AC are required to achieve beneficial effects in patients with UTUC.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 3","pages":"183-190"},"PeriodicalIF":0.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Acute Liver Damage: Slimming Health Foods and CYP3A4 Induction.","authors":"Makiko Adachi, Takeshi Kumagai, Keiko Hosho, Kiyoshi Nagata, Masachika Fujiyoshi, Miki Shimada","doi":"10.33160/yam.2024.05.004","DOIUrl":"10.33160/yam.2024.05.004","url":null,"abstract":"<p><strong>Background: </strong>Patients taking multiple drugs and various health foods often develop acute hepatitis. We hypothesized that the interaction between health foods and drug metabolism was the cause of severe liver injury in these patients. Therefore, we studied changes in the activity of the drug-metabolizing enzyme, cytochrome P450 (CYP), using slimming health food extracts and elucidated the molecular mechanism of liver injury onset through hepatotoxicity evaluation.</p><p><strong>Methods: </strong>For cytotoxicity testing, health food extract samples were added to HepG2 cells derived from hepatic parenchymal cells and culture medium, and cell viability was calculated 48 h after culture. To evaluate CYP3A4 induction, 3-1-10 cells constructed with a reporter linked to CYP3A4 gene were used, and reporter activity was measured 48 h after culture.</p><p><strong>Results: </strong>In the chronological order of the slimming health food intake history of the patient, niacinamide and <i>Gymnema sylvestre</i> extracts strongly inhibited HepG2 cell viability. In contrast, dietary supplements A and <i>Coleus forskohlii</i> extract strongly induced CYP3A4 reporter activity.</p><p><p>To confirm CYP3A4 induction in humans, humanized CYP3A/pregnane X receptor (PXR) mice were treated with forskolin. CYP3A4 mRNA expression levels were elevated 3.9 times compared to that of the control group (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong><i>Coleus forskohlii</i> extract showed the strongest transcriptional activation of CYP3A4 gene. In a mouse model of human-type drug metabolism, forskolin induced CYP3A4 transcription. Thus, we concluded that CYP3A4 induction by <i>Coleus forskohlii</i> is one of the causes of crucial hepatocellular injury, which is a type of liver injury caused by the active metabolite of acetaminophen produced by CYP3A4.</p>","PeriodicalId":23795,"journal":{"name":"Yonago acta medica","volume":"67 2","pages":"124-134"},"PeriodicalIF":1.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11128086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}