Data-Medicos 
Dermagic/Express No. 2-(81) 
03 Noviembre 1.999. 03 November 1.999. 

~ A la Medianoche II ~ 
~ El lado Claro y Oscuro del Ginkgo... ~ 
~ At the Midnight II ~ The Clear and the Dark side of the Ginkgo...~ 


EDITORIAL ESPANOL 
================= 
Hola amigos de la red. DERMAGIC de nuevo con ustedes. La semana pasada estuve 
hablando con uno de los miembros de la lista, Dr. Borges (cirujano plastico
de 
Venezuela) sobre el GINKGO BILOBA, el me comento que esta popular Hierba de 
origen Chino podia PRODUCIR HEMORRAGIAS cuando se tomaba cronicamente, 
y que él, particularmente le mandaba a SUSPENDER 2 SEMANAS ANTES de las 
cirugias la ingestion de GINKGO a sus pacientes SI lo estaban tomando, para
evitar 
sangramientos. El tema ME MOTIVO y me fui de viaje el 
Domingo A LA MEDIANOCHE a buscar EL LADO CLARO Y OSCURO DEL 
GINKGO,,, para llevarles informacion fresca sobre el TEMA. 

En estas 56 referencias encontre que es COMPLETAMENTE VERDAD lo que el Dr 
Borges me comento, pero ademas de ello encontre tambien QUE EL GINKGO 
BILOBA, tiene muchos efectos beneficiosos en algunas enfermedades de origen 
DERMATOLOGICO y NO DERMATOLOGICO. 
Entre ellas: mejora la memoria, la apatia sexual, estress oxidativo,
claudicacion 
intermitente, la vida de los colgajos de piel, protege la retina contra los
efectos 
de la cloroquina, en la enfermedad de Alzheimer, y otros. De modo que el 
GINKGO tiene su lado CLARO y OSCURO realmente. 

Espero que disfruten esta revision y ... pregunten por el GINKGO antes de
practicar 
cirugias !!! 

PROXIMA EDICION: EL ERBIUM-YAG-LASER...Y LA PIEL 

Saludos a todos !!! 

Dr. Jose Lapenta R.,,, 
====================CORREO E-MAIL ======================== 
From: "Jorge F. Padilla Henríquez" <[email protected]> 
Subject: RE: DERMAGIC/EXPRESS 2-(80) 271/10/99 LA ISOTRETINOINA, LO 
BUENO 
LO MALO Y LO FEO / THE ISOTRETINOIN, THE GOOD, THE BAD AND THE 
UGLY. 

Dr. Lapenta: 

Le felicito por el excelente contenido de DERMAGIC/EXPRESS, no
tenía 
conocimiento que un dermatólogo venezolano estuviese haciendo tan gran
esfuerzo en la 
red y de tan alta calidad. 

Le reitero mi aprecio y consideración 

Dr. Jorge F. Padilla Henríquez 
Dermatólogo 

EDITORIAL ENGLISH 
================= 
Hello friends of the net. DERMAGIC again with you. Last week I was speaking
with one 
of the members of the list, Dr. Borges (plastic surgeon from Venezuela) on
the GINKGO 
BILOBA, he comment to myself that this popular Herb of Chinese origin could 
PRODUCE HEMORRHAGES when it took chronically, and that he, particularly sent 
him to SUSPEND BEFORE 2 WEEKS before the surgeries the ingestion from 
GINKGO to its patients IF they were taking it, 
to avoid bleeding. The topic MOTIVATES MYSELF and I went on a trip the Sunday 
AT THE MIDNIGHT to look for THE CLEAR AND DARK SIDE OF THE 
GINKGO, 
to take all of you, fresh information on the TOPIC. 

In these 56 references I found that it is COMPLETELY TRUE what the Dr. Borges 
comments myself, but besides I also found it THAT THE GINKGO BILOBA, has many 
beneficial effects in some origin illnesses DERMATOLOGIC and NON 
DERMATOLOGIC. 
Among them: it improves the memory, the sexual apathy, oxidative stress, 
intermittent claudication, the life of skin flaps, protects the retina
against the 
effects of the chloroquine, in Alzheimer disease, and others. So that the
GINKGO 
has its SIDE CLEAR and DARK really. 

I hope you enjoy this revision and... ask for the GINKGO before practicing
surgeries !!! 

NEXT EDITION: THE ERBIUM-YAG-LASER...AND THE SKIN 

Greetings to ALL, !! 
Dr. Jose Lapenta R.,,, 
=================================================================== 
REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES 
=================================================================== 
1.) [Ginkgo biloba extract (EGb 761). State of knowledge in the dawn ofthe
year 2000] 
2.)[Preparation and definition of Ginkgo biloba extract]. 
3.) Subarachnoid haemorrhage associated with Ginkgo biloba. 
4.) Extracts of Ginkgo biloba and bleeding or haemorrhage. 
5.) Association of Ginkgo biloba with intracerebral hemorrhage. 
6.) Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. 
7.) Spontaneous bilateral subdural hematomas associated with chronic Ginkgo
biloba 
ingestion. 
8.) Antiplatelet and antithrombotic effects of a combination of ticlopidine
and ginkgo 
biloba ext (EGb 761). 
9.) [Paroxysmal non-hereditary angioedema]. 
10.)Dietary supplement-drug interactions. 
11.)Herbal remedies: adverse effects and drug interactions. 
12.)Herbal medicinals: selected clinical considerations focusing on known
or potential 
drug-herb interactions. 
13.)The protective effect of Ginkgo biloba extract on CCl4-induced
hepaticdamage. 
14.)Ginkgo biloba for antidepressant-induced sexual dysfunction. 
15.)The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. 
16.) Medicinal plants and Alzheimer's disease: from ethnobotany to
phytotherapy. 
17.)Free radicals in Alzheimer's dementia: currently available
therapeuticstrategies. 
18.)Proof of efficacy of the ginkgo biloba special extract EGb 761
inoutpatients suffering 
from mild to moderate primary degenerative dementia of the Alzheimer type or 
multi-infarct dementia. 
19.)The relevance of herbal treatments for psychiatric practice. 
20.)[The effect of gingko biloba on cochleovestibulary pathology of vascular 
origin]. 
21.)Effects of Ginkgo biloba extract on the cochlear damage induced by
local gentamicin 
installation in guinea pigs. 
22.)Ginkgo biloba for tinnitus: a review. 
23.)[Contribution of a combination of alpha and beta benzopyrones,
flavonoidsand 
natural terpenes in the treatment of lymphedema of the lower limbs at the
2d stage of the 
surgical classification]. 
24.)[Gingko biloba extract EGb 761 and pentoxifylline in intermittent
claudication. 
Secondary analysis of the clinical effectiveness]. 
25.)[Placebo-controlled double-blind study of the effectiveness of Ginkgo
biloba special 
extract EGb 761 in trained patients with intermittent claudication] 
26.)[Ginkgo biloba in treatment of intermittent claudication. A systematic
research based 
on controlled studies in the literature] 
27.)Effect of Gingko biloba extract (EGb 761) on chloroquine induced
retinal alterations. 
28.)Ginkgo biloba extract increases ocular blood flow velocity. 
29.)Pretreatment of skin with a Ginkgo biloba extract/sodium 
carboxymethyl-beta-1,3-glucan formulation appears to inhibit the
elicitation of allergic 
contact dermatitis in man. 
30.)The effect of Gingko biloba extract (Egb 761) as a free radical
scavenger on the 
survival of skin flaps in rats. A comparative study. 
31.)Induction of superoxide dismutase and catalase activity in different
rattissues and 
protection from UVB irradiation after topical application of Ginkgo biloba
extracts. 
32.)In vivo regulation of peripheral-type benzodiazepine receptor and
glucocorticoid 
synthesis by Ginkgo biloba extract EGb 761 and isolated ginkgolides. 
33.)Reactive oxygen metabolites, antioxidants and head and neck cancer. 
34.)Protective effects of Gingko biloba extract EGb 761 on myocardium of 
experimentally diabetic rats. I: ultrastructural and biochemical
investigation on 
cardiomyocytes. 
45.)Identification of Gingko biloba flavonol metabolites after oral
administration to 
humans. 
46.)Solid-phase extraction and gas chromatography-mass spectrometry
determination of 
kaempferol and quercetin in human urine after consumption of Ginkgo biloba
tablets. 
47.)Ginkgo biloba extract (EGb 761) independently improves changes in passive 
avoidance learning and brain membrane fluidity in the aging mouse. 
48.)Lipid peroxidation in experimental spinal cord injury. Comparison of
treatment with 
Ginkgo biloba, TRH and methylprednisolone. 
49.)A Ginkgo biloba extract (EGb 761) prevents mitochondrial aging by
protecting 
against oxidative stress. 
50.)The correlation of cytophotometrically and biochemically measured
enzyme activities: 
changes in the myocardium of diabetic and hypoxic diabetic rats, with and
without Ginkgo 
biloba extract treatment. 
51.)Enhancement of radiation effect by Ginkgo biloba extract in C3H mouse 
fibrosarcoma. 
52.)Platelet-activating factor is an important mediator in hypoxic ischemic
brain injury in 
the newborn rat. Flunarizine and Ginkgo biloba extract reduce PAF
concentration in the 
brain. 
53.)The effect of meclofenoxate with ginkgo biloba extract or zinc on lipid
peroxide, 
some free radical scavengers and the cardiovascular system of aged rats. 
54.)Effects on skeletal muscle fibres of diabetes and Ginkgo biloba extract
treatment. 
55.)The effects of prostaglandin E2 indomethacin & Ginkgo biloba extract on
resistance 
to experimental sepsis. 
56.)Ginkgo biloba extract protects brain neurons against oxidative stress
induced by 
hydrogen peroxide. 
=========================================================== 
1.) [Ginkgo biloba extract (EGb 761). State of knowledge in the dawn of 
the year 2000] 
=========================================================== 
Author 
Clostre F 
Address 
Institut Henri Beaufour, Les Ulis. 
Source 
Ann Pharm Fr, 57 Suppl 1():1S8-88 1999 Jul 
Abstract 
EGb 761 is a standardized extract of dried leaves of Ginkgo biloba 
containing 24% 
ginkgo-flavonol glycosides, 6% terpene lactones such as ginkgolides A, 
B, C, J and 
bilobalide. Its broad spectrum of pharmacological activities allows it 
to be in adequacy to the 
numerous pathological requirements--hemodynamic, hemorheological, 
metabolic--which 
occur in cerebral, retinal, cochleovestibular, cardiac or peripheral 
ischemia. Moreover, EGb 
761 has direct effects against necrosis and apoptosis of neurons and 
improves neural plasticity 
as evidenced in vestibular compensation. At the molecular and the 
cellular levels, some 
evidence obtained with animal models indicates that EGb 761 can 
interact as a free 
radical-scavenger and a inhibitor of lipid peroxidation with all, or 
nearly all reactive oxygen 
species; maintains ATP content by a protection of mitochondrial 
respiration and preservation 
of oxidative phosphorylations; exerts arterial and venous 
vasoregulator effects involving the 
release of endothelial factors and the catecholaminergic system. 
Moreover, EGb 761 
regulates ionic balance in damaged cells and exerts a specific and 
potent Platelet-activating 
factor antagonist activity. Numerous well-controlled clinical studies, 
realized in Europe and in 
USA, have revealed that EGb 761 is an effective therapy for a wide 
variety of disturbances of 
cerebral function, ranging from cerebral impairment of ischemic 
vascular origins (i.e. multi 
infarct dementia), early cognitive decline to mild-to-moderate cases 
of the more severe types 
of senile dementias (including Alzheimer's disease) or mixed origins 
(i.e. psychoorganic origin). 
Improvement of signs and symptoms have been demonstrated for cognitive 
functions, 
particularly for memory loss, attention, alertness, vigilance, arousal 
and mental fluidity. Some 
clinical studies have showed that EGb 761 treatment may improve the 
capacity of geriatric 
patients to cope with the stressful demands of daily life. The 
explanation is a dual 
stress-alleviating action of EGb 761: its facilitates behavioral 
adaptation to stress and may 
decrease the excess of cortisol release to stress. Moreover, EGb 761 
shows a specific 
neuroprotective effects to hippocampic cells. Regarding the visual 
system, experimental 
studies have shown that EGb 761 can inhibit or reduce the functional 
retinal impairments 
resulting from ischemia-reperfusion, photo-degeneration, diabetic or 
proliferative retinopathy. 
Clinical studies have revealed that EGb 761 may be useful in treating 
visual activity 
impairments and damages to the visual field associated with chronic 
cerebrovascular 
insufficiency, senile macular degeneration and diabete mellitus. 
Regarding the vestibular and 
auditory systems, experimental and clinical studies have shown the 
efficacy of EGb 761 in 
treating hypoacusis, tinnitus, vertigo, dizziness and other symptoms 
of vestibulocochlear 
disorders. At least, adequatly controlled studies in patients with 
peripheral arterial occlusive 
disease have provided good evidence for therapeutic efficacy in 
intermittent claudication. The 
future of EGb 761 is undoubtedly in the promise in slowing the 
progression of Alzheimer's 
disease. Indeed, two recent american clinical studies have shown the 
efficacy and safety of 
EGb 761 in patients with mild to severe Alzheimer's disease and 
multi-infarct dementia. In 
clinical terms, progression of symptoms was delayed by approximately 6 
months. Actually 
new clinical studies are undertaken in USA and Europe. At the dawn of 
the third millenium 
(the Sixth for Ginkgo biloba) we propose a state of art about it. 

=========================================================== 
2.)[Preparation and definition of Ginkgo biloba extract]. 
=========================================================== 
Presse Med 1986 Sep 25;15(31):1455-7 

Drieu K 
Ginkgo biloba extract is a well-defined and complex product prepared from 
green leaves of Ginkgo biloba. The leaves are harvested from trees growing 
in plantations in South Corea, Japan and France. The mode of culture, 
harvesting and extraction are perfectly standardized and controlled. 
Analysis of Ginkgo biloba extract makes it possible to confirm that 
undesirable substances have been eliminated and to measure the amount of 
active principles. The extract contains flavonoid substances, such as the 
Ginkgo-flavone glycosides and terponoids which are characteristic of Ginkgo 
and have a unique structure (ginkgolides, bilobalide). 

=========================================================== 
3.) Subarachnoid haemorrhage associated with Ginkgo biloba. 
=========================================================== 
Lancet 1998 Jul 4;352(9121):36 

Vale S 
Letter 
=========================================================== 
4.) Extracts of Ginkgo biloba and bleeding or haemorrhage. 
=========================================================== 
Lancet 1998 Oct 3;352(9134):1145-6 

Skogh M 
Publication Types: 
Letter 
=========================================================== 
5.) Association of Ginkgo biloba with intracerebral hemorrhage. 
=========================================================== 
Neurology 1998 Jun;50(6):1933-4 

Matthews MK Jr 
Publication Types: 
Letter 
=========================================================== 
6.) Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. 
=========================================================== 
N Engl J Med 1997 Apr 10;336(15):1108 

Rosenblatt M, Mindel J 
Publication Types: 
Letter 
=========================================================== 
7.) Spontaneous bilateral subdural hematomas associated with chronic Ginkgo 
biloba ingestion. 
=========================================================== 
Neurology 1996 Jun;46(6):1775-6 

Rowin J, Lewis SL 
Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical 
Center, Chicago, IL 60612, USA. 

Comment in: Neurology 1997 Mar;48(3):789-90 
Comment in: Neurology 1997 Apr;48(4):1137 
Comment in: Neurology 1998 Jun;50(6):1933-4 
=========================================================== 
=========================================================== 
8.) Antiplatelet and antithrombotic effects of a combination of ticlopidine
and ginkgo 
biloba ext (EGb 761). 
=========================================================== 
Thromb Res 1998 Jul 1;91(1):33-8 

Kim YS, Pyo MK, Park KM, Park PH, Hahn BS, Wu SJ, Yun-Choi HS 
Natural Products Research Institute, Seoul National University, Korea. 

The antiplatelet and antithrombotic effects of the oral combination 
treatment of ticlopidine and Ginkgo biloba extract (EGb 761) were studied 
in normal and thrombosis-induced rats. The ex vivo inhibitory effect on 
ADP-induced platelet aggregation of a small dose of ticlopidine (50 
mg/kg/day) in combination with EGb 761 (40 mg/kg/day) was comparable to a 
larger dose of only ticlopidine (200 mg/kg/day). Bleeding time was also 
prolonged by 150%. Thrombus weight was also consistently decreased by a 
combination of ticlopidine and EGb 761 in an arterio-venous shunt model at 
two doses of ticlopidine (50 mg/kg) plus EGb 761 (20 mg/kg) and ticlopidine 
(50 mg/kg) plus EGb 761 (40 mg/kg). A combinatory treatment in acute 
thrombosis model in mice also showed a higher recovery than a single 
treatment. 

=========================================================== 
9.) [Paroxysmal non-hereditary angioedema]. 
=========================================================== 
Dtsch Med Wochenschr 1990 Oct 19;115(42):1586-90 
[Article in German] 

Steurer J, Siegenthaler-Zuber G, Siegenthaler W, Suter S, Kessler FJ, 
Vahlensieck M, Streuli R, Lingg G 
Departement fur Innere Medizin, Universitatsspital Zurich. 

Recurrent hypovolaemic shock had been occurring over the last five and four 
years, respectively, in a 53-year-old woman and a 46-year-old man who had 
previously been healthy. The attacks were characterized by a tension 
feeling and sometimes oedema in the limbs, as well as increased thirst. 
Within a few hours sweating, tachycardia, orthostatic complaints and shock 
would occur. The woman's systolic blood pressure would fall to 70 mm Hg and 
the pulse rate rise to 150/min. The man's blood pressure was not measurable 
by sphygmomanometer during his first attack. Haematocrit rose to 61 and 
71.5%, haemoglobin concentration to 20.7 and 21.3 g/dl, respectively. On 
administration of plasma expanders all abnormal clinical and biochemical 
changes quickly disappeared, only to recur within weeks or months. The 
cause of the condition is an increased permeability of the tissue 
capillaries, while renal, pulmonary and cerebral vessels apparently are 
unaffected. During ketotifen and tebonin (gingko biloba extract) 
administration to the man, he required no further hospitalization for nine 
months, after which he had three severe attacks. The woman had a severe 
attack of hypovolaemic shock one month on this treatment. The prognosis of 
capillary leak syndrome is bad. 

=========================================================== 
10.)Dietary supplement-drug interactions. 
=========================================================== 
J Am Med Womens Assoc 1999 Fall;54(4):191-2 

Smolinske SC 
Children's Hospital of Michigan Regional Poison Control Center, USA. 

Recent surveys show that 18% of adults in the United States use 
prescription drugs concurrently with herbal or vitamin products, placing an 
estimated 15 million patients at risk of potential drug-supplement 
interactions. Despite this widespread concurrent use of conventional and 
alternative medicines, documented drug-herb interactions are sparse. This 
review focuses on possible interactions between drugs and herbal medicines 
used for phytoestrogen-hormone and antiplatelet-oral anticoagulant therapy. 
Interactions with phytoestrogens are purely speculative, based on 
competitive estrogen-receptor binding or antiestrogenic effects. In 
contrast, several case reports document bleeding complications with Ginkgo 
biloba, with or without concomitant drug therapy. Case reports are also 
suggestive of interaction between warfarin and dong quai or Panax ginseng. 
Recommendations for counseling patients at highest risk of adverse 
interactions are given. 

=========================================================== 
11.)Herbal remedies: adverse effects and drug interactions. 
=========================================================== 
Am Fam Physician 1999 Mar 1;59(5):1239-45 

Cupp MJ 
Drug Information Center, West Virginia University School of Pharmacy, 
Morgantown 26506-9550, USA. 

A growing number of Americans are using herbal products for preventive and 
therapeutic purposes. The manufacturers of these products are not required 
to submit proof of safety and efficacy to the U.S. Food and Drug 
Administration before marketing. For this reason, the adverse effects and 
drug interactions associated with herbal remedies are largely unknown. 
Ginkgo biloba extract, advertised as improving cognitive functioning, has 
been reported to cause spontaneous bleeding, and it may interact with 
anticoagulants and antiplatelet agents. St. John's wort, promoted as a 
treatment for depression, may have monoamine oxidase-inhibiting effects or 
may cause increased levels of serotonin, dopamine and norepinephrine. 
Although St. John's wort probably does not interact with foods that contain 
tyramine, it should not be used with prescription antidepressants. 
Ephedrine-containing herbal products have been associated with adverse 
cardiovascular events, seizures and even death. Ginseng, widely used for 
its purported physical and mental effects, is generally well tolerated, but 
it has been implicated as a cause of decreased response to warfarin. 
Physicians must be alert for adverse effects and drug interactions 
associated with herbal remedies, and they should ask all patients about the 
use of these products. 

=========================================================== 
12.)Herbal medicinals: selected clinical considerations focusing on known or 
potential drug-herb interactions. 
=========================================================== 

Arch Intern Med 1998 Nov 9;158(20):2200-11 

Miller LG 
Department of Pharmacy Practice, Texas Tech University Health Sciences 
Center, Amarillo 79121, USA. 

Herbal medicinals are being used by an increasing number of patients who 
typically do not advise their clinicians of concomitant use. Known or 
potential drug-herb interactions exist and should be screened for. If used 
beyond 8 weeks, Echinacea could cause hepatotoxicity and therefore should 
not be used with other known hepatoxic drugs, such as anabolic steroids, 
amiodarone, methotrexate, and ketoconazole. However, Echinacea lacks the 
1,2 saturated necrine ring associated with hepatoxicity of pyrrolizidine 
alkaloids. Nonsteroidal anti-inflammatory drugs may negate the usefulness 
of feverfew in the treatment of migraine headaches. Feverfew, garlic, 
Ginkgo, ginger, and ginseng may alter bleeding time and should not be used 
concomitantly with warfarin sodium. Additionally, ginseng may cause 
headache, tremulousness, and manic episodes in patients treated with 
phenelzine sulfate. Ginseng should also not be used with estrogens or 
corticosteroids because of possible additive effects. Since the mechanism 
of action of St John wort is uncertain, concomitant use with monoamine 
oxidase inhibitors and selective serotonin reuptake inhibitors is ill 
advised. Valerian should not be used concomitantly with barbiturates 
because excessive sedation may occur. Kyushin, licorice, plantain, uzara 
root, hawthorn, and ginseng may interfere with either digoxin 
pharmacodynamically or with digoxin monitoring. Evening primrose oil and 
borage should not be used with anticonvulsants because they may lower the 
seizure threshold. Shankapulshpi, an Ayurvedic preparation, may decrease 
phenytoin levels as well as diminish drug efficacy. Kava when used with 
alprazolam has resulted in coma. Immunostimulants (eg, Echinacea and zinc) 
should not be given with immunosuppressants (eg, corticosteroids and 
cyclosporine). Tannic acids present in some herbs (eg, St John wort and saw 
palmetto) may inhibit the absorption of iron. Kelp as a source of iodine 
may interfere with thyroid replacement therapies. Licorice can offset the 
pharmacological effect of spironolactone. Numerous herbs (eg, karela and 
ginseng) may affect blood glucose levels and should not be used in patients 
with diabetes mellitus. 

=========================================================== 
13.)The protective effect of Ginkgo biloba extract on CCl4-induced hepatic 
damage. 
=========================================================== 
Author 
Ozenirler S; Din¸cer S; Akyol G; Ozo¨gul C; Oz E 
Address 
Department of Gastroenterology, Gazi University Faculty of Medicine, 
Be¸sevler, Ankara, 
Turkey. 
Source 
Acta Physiol Hung, 85(3):277-85 1997-98 
Abstract 
The aim of this study was to evaluate the protective effect of Ginkgo 
biloba extract on 
CCl4-induced hepatic damage in rats. Hepatic malondialdehyde, 
glutathione and 
hydroxyproline levels and histopathologic alterations in liver 
specimens were assessed. 200 
mg/kg/day Ginkgo biloba extract were given orally to the animals for 
10 days, then a single 
dose of 2 ml/kg b.w. carbon tetrachloride was, administered 
intraperitoneally. Ginkgo biloba 
extract treatment reduced hepatic malondialdehyde levels significantly 
(p < 0.05), but did not 
alter glutathione (p > 0.05) and hydroxyproline levels (p > 0.05). The 
light and electron 
microscopic findings showed that Ginkgo biloba extract limited the 
CCl4-induced hepatocyte 
necrosis and atrophy. These results suggest that this extract may 
protect the hepatocytes from 
carbon tetrachloride-induced liver injury. 

=========================================================== 
14.)Ginkgo biloba for antidepressant-induced sexual dysfunction. 
Author 
=========================================================== 
Cohen AJ; Bartlik B 
Address 
University of California, San Francisco, California, USA. 
Source 
J Sex Marital Ther, 24(2):139-43 1998 Apr-Jun 
Abstract 
In an open trial ginkgo biloba, an extract derived from the leaf of 
the Chinese ginkgo tree and 
noted for its cerebral enhancing effects, was found to be 84% 
effective in treating 
antidepressant-induced sexual dysfunction predominately caused by 
selective serotonin 
reuptake inhibitors (SSRIs, N = 63). Women (n = 33) were more 
responsive to the sexually 
enhancing effects of ginkgo biloba than men (N = 30), with relative 
success rates of 91% 
versus 76%. Ginkgo biloba generally had a positive effect on all 4 
phases of the sexual 
response cycle: desire, excitement (erection and lubrication), orgasm, 
and resolution 
(afterglow). This study originated from the observation that a 
geriatric patient on ginkgo 
biloba for memory enhancement noted improved erections. Patients 
exhibited sexual 
dysfunction secondary to a variety of antidepressant medications 
including selective serotonin 
reuptake inhibitor (SSRIs), serotonin and nonrepinephrine reuptake 
inhibitor (SNRIs) 
monoamine oxidase inhibitor (MAOIs), and tricyclics. Dosages of ginkgo 
biloba extract 
ranged from 60 mg qd to 120 mg bid (average = 209mg/d). The common 
side effects were 
gastrointestinal disturbances, headache, and general central nervous 
system activation. The 
article includes a discussion of presumed pharmacologic mechanisms, 
including effects on 
platelet activating factor, prostaglandins, peripheral vasodilatation, 
and central serotonin and 
norepinephrine receptor factor modulation. 

=========================================================== 
15.)The efficacy of Ginkgo biloba on cognitive function in Alzheimer disease. 
=========================================================== 
Arch Neurol 1998 Nov;55(11):1409-15 

Oken BS, Storzbach DM, Kaye JA 
Department of Neurology, Oregon Health Sciences University, Portland 97201, 
USA. [email protected] 

OBJECTIVE: To determine the effect of treatment with Ginkgo biloba extract 
on objective measures of cognitive function in patients with Alzheimer 
disease (AD) based on formal review of the current literature. METHODS: An 
attempt was made to identify all English and non-English-language articles 
in which G. biloba extract was given to subjects with dementia or cognitive 
impairment. Inclusion criteria for the meta-analysis were (1) sufficiently 
characterized patients such that it was clearly stated there was a 
diagnosis of AD by either Diagnostic and Statistical Manual of Mental 
Disorders, Revised Third Edition, or National Institute of Neurological 
Disorders and Stroke-Alzheimer's Disease and Related Disorders Association 
criteria, or there was enough clinical detail to determine this by our 
review; (2) clearly stated study exclusion criteria, ie, those studies that 
did not have stated exclusions for depression, other neurologic disease, 
and central nervous system-active medications were excluded; (3) use of 
standardized ginkgo extract in any stated dose; (4) randomized, 
placebo-controlled and double-blind study design; (5) at least 1 outcome 
measure was an objective assessment of cognitive function; and (6) 
sufficient statistical information to allow for meta-analysis. RESULTS: Of 
more than 50 articles identified, the overwhelming majority did not meet 
inclusion criteria, primarily because of lack of clear diagnoses of 
dementia and AD. Only 4 studies met all inclusion criteria. In total there 
were 212 subjects in each of the placebo and ginkgo treatment groups. 
Overall there was a significant effect size of 0.40 (P<.0001). This modest 
effect size translated into a 3% difference in the Alzheimer Disease 
Assessment Scale-cognitive subtest. CONCLUSIONS: Based on a quantitative 
analysis of the literature there is a small but significant effect of 3- to 
6-month treatment with 120 to 240 mg of G. biloba extract on objective 
measures of cognitive function in AD. The drug has not had significant 
adverse effects in formal clinical trials but there are 2 case reports of 
bleeding complications. In AD, there are limited and inconsistent data that 
preclude determining if there are effects on noncognitive behavioral and 
functional measures as well as on clinician's global rating scales. Further 
research in the area will need to determine if there are functional 
improvements and to determine the best dosage. Additional research will be 
needed to define which ingredients in the ginkgo extract are producing its 
effect in individuals with AD. 

=========================================================== 
16.) Medicinal plants and Alzheimer's disease: from ethnobotany to
phytotherapy. 
=========================================================== 
J Pharm Pharmacol 1999 May;51(5):527-34 

Perry EK, Pickering AT, Wang WW, Houghton PJ, Perry NS 
Medical Research Council, Newcastle General Hospital, Newcastle upon Tyne. 
[email protected] 

The use of complementary medicines, such as plant extracts, in dementia 
therapy varies according to the different cultural traditions. In orthodox 
Western medicine, contrasting with that in China and the Far East for 
example, pharmacological properties of traditional cognitive- or 
memory-enhancing plants have not been widely investigated in the context of 
current models of Alzheimer's disease. An exception is Gingko biloba in 
which the gingkolides have antioxidant, neuroprotective and cholinergic 
activities relevant to Alzheimer's disease mechanisms. The therapeutic 
efficacy of Ginkgo extracts in Alzheimer's disease in placebo controlled 
clinical trials is reportedly similar to currently prescribed drugs such as 
tacrine or donepezil and, importantly, undesirable side effects of Gingko 
are minimal. Old European reference books, such as those on medicinal 
herbs, document a variety of other plants such as Salvia officinalis (sage) 
and Melissa officinalis (balm) with memory-improving properties, and 
cholinergic activities have recently been identified in extracts of these 
plants. Precedents for modern discovery of clinically relevant 
pharmacological activity in plants with long-established medicinal use 
include, for example, the interaction of alkaloid opioids in Papaver 
somniferum (opium poppy) with endogenous opiate receptors in the brain. 
With recent major advances in understanding the neurobiology of Alzheimer's 
disease, and as yet limited efficacy of so-called rationally designed 
therapies, it may be timely to re-explore historical archives for new 
directions in drug development. This article considers not only the value 
of an integrative traditional and modern scientific approach to developing 
new treatments for dementia, but also in the understanding of disease 
mechanisms. Long before the current biologically-based hypothesis of 
cholinergic derangement in Alzheimer' s disease emerged, plants now known 
to contain cholinergic antagonists were recorded for their amnesia- and 
dementia-inducing properties. 

=========================================================== 
17.)Free radicals in Alzheimer's dementia: currently available therapeutic 
strategies. 
=========================================================== 
J Neural Transm Suppl 1998;54:211-9 

Rosler M, Retz W, Thome J, Riederer P 
Psychiatric Department, University of Wurzburg, Federal Republic of Germany. 

Substantial evidence now exists that oxidative stress may play an important 
role in the etiopathogenesis of DAT. The different sources of oxidative 
stress in DAT are suggesting several pharmacological opportunities for 
influencing the disease. It is possible to distinguish 2 major types of 
possible therapeutic agents according to their pharmacological point of 
attack. 1. Radical scavengers, agents directly interacting with free 
radicals. Candidates of this type are gingko biloba, vitamins A, C, E and 
estrogen. 2. Antioxidants, which are able to prevent or decrease the 
production of free radicals by use of specific neuropharmacological 
properties. Candidates are selegiline, a MAO-B inhibitor well established 
in the therapy of Parkinson's disease, and tenilsetam, which is believed to 
be an AGE-inhibitor. Recent in vitro studies have demonstrated the efficacy 
of both types of therapeutic agents by preventing or delaying oxidative 
neural damage. Some clinical data exist regarding the antidementive 
properties particularly in terms of gingko biloba, selegiline and vitamin 
E. The efficacy studies about these compounds seem to indicate a promising 
future strategy in the therapy of DAT. But it is too early to draw definite 
conclusions since it is well known that all of our candidate substances do 
not act specifically as radical scavengers or antioxidants. 


=========================================================== 
18.)Proof of efficacy of the ginkgo biloba special extract EGb 761 in 
outpatients suffering from mild to moderate primary degenerative dementia 
of the Alzheimer type or multi-infarct dementia. 
=========================================================== 
Author 
Kanowski S; Herrmann WM; Stephan K; Wierich W; H¨orr R 
Address 
Department of Gerontopsychiatry, Free University Berlin, Germany. 
Source 
Pharmacopsychiatry, 29(2):47-56 1996 Mar 
Abstract 
The efficacy of the ginkgo biloba special extract EGb 761 in outpatients 
with presenile and senile primary degenerative dementia of the Alzheimer 
type (DAT) and multi-infarct dementia (MID) according to DSM-III-R was 
investigated in a prospective, randomized, double-blind, 
placebo-controlled, multi-center study. After a 4-week run-in period, 216 
patients were included in the randomized 24-week treatment period. These 
received either a daily oral dose of 240 mg EGb 761 or placebo. In 
accordance with the recommended multi-dimensional evaluation approach, 
three primary variables were chosen: the Clinical Global Impressions (CGI 
Item 2) for psychopathological assessment, the Syndrom-Kurztest (SKT) for 
the assessment of the patient's attention and memory, and the N¨urnberger 
Alters-Beobachtungsskala (NAB) for behavioral assessment of activities of 
daily life. Clinical efficacy was assessed by means of a responder 
analysis, with therapy response being defined as response in at least two 
of the three primary variables. The data from the 156 patients who 
completed the study in accordance with the study protocol were taken into 
account in the confirmatory analysis of valid cases. The frequency of 
therapy responders in the two treatment groups differed significantly in 
favor of EGb 761, with p < 0.005 in Fisher's Exact Test. The 
intent-to-treat analysis of 205 patients led to similar efficacy results. 
Thus, the clinical efficacy of the ginkgo biloba special extract EGb 761 in 
dementia of the Alzheimer type and multi-infarct dementia was confirmed. 
The investigational drug was found to be well tolerated. 

=========================================================== 
19.)The relevance of herbal treatments for psychiatric practice. 
=========================================================== 
Aust N Z J Psychiatry 1999 Aug;33(4):482-9; discussion 490-3 

Walter G, Rey JM 
Department of Psychological Medicine, University of Sydney, New South 
Wales, Australia. [email protected] 

OBJECTIVE: The aim of this paper is to inform psychiatrists about the basic 
priniciples, terminology, schools of thought, efficacy, safety and 
regulatory issues regarding herbal treatments for mental illness. METHOD: 
Information was obtained by computerised and manual searching of medical 
and botanical data bases, and by discussions with experts in herbal 
medicine and regulatory aspects of the pharmaceutical industry. RESULTS: 
Herbal medicines are commonly used in developed and developing countries 
for psychiatric illness. The main schools of herbal medicine in Australia 
are Western herbal medicine, traditional Chinese medicine and 'Ayurveda' 
(Indian herbal medicine). Herbs used for psychiatric or neurological 
disorders are termed 'nervines'. Three nervines which have attracted 
considerable attention recently are St John's Wort, Gingko biloba and 
Valeriana officinalis. In Australia, most herbal drugs are classed as 
'listed drugs' which are required to satisfy less rigorous safety and 
efficacy criteria than 'registered drugs'. The popularity of herbal 
remedies has a number of clinical and research implications for psychiatry. 
CONCLUSIONS: Psychiatrists should not endorse treatments that are 
unsupported by sound research, nor remain ignorant about alternative 
approaches to mental illness. The extent of use of herbal treatments for 
mental illness suggests that psychiatrists should become more knowledgeable 
about developments in this area. 

=========================================================== 
20.)[The effect of gingko biloba on cochleovestibulary pathology of vascular 
origin]. 
=========================================================== 
An Otorrinolaringol Ibero Am 1995;22(6):619-29 
[Article in Spanish] 

Cano Cuenca B, Marco Algarra J, Perez del Valle B, Pellicer Pascual FJ 

The AA. of the present paper recall the clinical and functional results of 
this therapy in a group of 70 patients complaining of vertigo. The Gingko 
biloba extract (4 ml/12 h per mouth) has been continued during 6 months. 
Neck and vertebrobasilar insufficiency were predominant causes. Six months 
later statistically significant changes regarding the decrease of intensity 
of tinnitus and vertigo crises were confirmed. Besides favorable 
alterations in the peripherical symptomatology as a relative hearing 
improvement turned up. 

=========================================================== 
21.)Effects of Ginkgo biloba extract on the cochlear damage induced by local 
gentamicin installation in guinea pigs. 
=========================================================== 
Author 
Jung HW; Chang SO; Kim CS; Rhee CS; Lim DH 
Address 
Department of Otorhinolaryngology - Head & Neck Surgery, Seoul National 
University College of Medicine, Korea. 
Source 
J Korean Med Sci, 13(5):525-8 1998 Oct 
Abstract 
Investigations evaluating the protective effect of Ginkgo biloba extract 
(EGb) on gentamicin (GM) ototoxicity were undertaken. Guinea pigs treated 
with 5 mg/kg gentamicin sulfate on the round window niche (RWN) showed 
acute changes on electrocochleogram and hair cell or microvilli damage on 
scanning electron microscopy (SEM). There was accumulation of GM in the 
whole cochlea, especially in the organ of Corti, stria vascularis, and type 
III fibrocyte on immunohistochemical study. However, the guinea pigs 
pretreated with local or systemic EGb revealed no significant changes by 
local GM installation. From these results, we concluded that EGb has a 
protective effect on the development of GM ototoxicity in the cochlea. 
Language 

=========================================================== 
22.)Ginkgo biloba for tinnitus: a review. 
=========================================================== 
Clin Otolaryngol 1999 Jun;24(3):164-7 

Ernst E, Stevinson C 
Department of Complementary Medicine, School of Postgraduate Medicine and 
Health Sciences, University of Exeter, UK. [email protected] 
=========================================================== 
=========================================================== 
23.)[Contribution of a combination of alpha and beta benzopyrones, flavonoids 
and natural terpenes in the treatment of lymphedema of the lower limbs at 
the 2d stage of the surgical classification]. 
=========================================================== 
Minerva Cardioangiol 1996 Sep;44(9):447-55 
[Article in Italian] 

Vettorello G, Cerreta G, Derwish A, Cataldi A, Schettino A, Occhionorelli 
S, Donini I 
Istituto di Clinica Chirurgica, Universita degli Studi, Ferrara. 

HYPOTHESIS: To create a phlebolymphologic therapy in order: to activate 
venous system; to activate lymphatic system; to activate macrophagic 
system; to reduce the proteic lymphatic load. EXPERIMENTAL: A study was 
performed on the use of an ideal phlebolymphological association (Tonka 
Beans, Gingko Biloba, Melilotus Officinalis) as a practical standpoint in 
the treatment of lymphedema of lower limbs in order to create an 
efficacious dose of Coumarin, Benzopyrones and Ginkolidi. CLINICAL: We 
investigated a population of 76 patients treated in an open-label study for 
six-eight months with a dosage of Coumarin 60 mg/daily + Gingko Biloba 40 
mg/daily + Melilotus 40 mg/daily. CONCLUSION: This trilogy induced a very 
significant improvement in lymphedema (centimeter-aspect) both in 
functional symptoms (pain heaviness in affected limbs) and physical signs 
(edema, episodes of infection). Tolerance of long term treatment was good 
and the improvement was observed from the third month of treatment. 

=========================================================== 
24.)[Gingko biloba extract EGb 761 and pentoxifylline in intermittent 
claudication. Secondary analysis of the clinical effectiveness]. 
=========================================================== 
Vasa 1992;21(4):403-10 

Letzel H, Schoop W 
Clinical trials on the efficacy of EGb 761 and pentoxifylline are 
summarized in the context of their methods and results and compared with 
each other. All placebo-controlled, randomized and double-blind studies 
with the major target objective of "pain-free walking distance" were 
selected. The pentoxifylline studies were adopted from a survey of the 
existing literature in the English language, which has been brought up to 
date via DIMDI research. The studies on both active substances are fraught 
with similar difficulties as to method, and are not different as regards 
their quality. The increase in walking distance is highly variable, 
especially in the pentoxifylline studies. On average through each and all 
of the studies on both preparations, an increase of 45% (EGb 761) or 57% 
(pentoxifylline) in relation to initial values is here found. No 
differences in the documentation of efficacy and the clinical efficacy were 
discovered between the two substances, both of which are registered as 
effective substances in the treatment of peripheral arterial occlusion 
(pAO) in accordance with the Federal German Drugs Law (Arzneimittelgesetz, 
AMG) of 1976. 

=========================================================== 
25.)[Placebo-controlled double-blind study of the effectiveness of Ginkgo 
biloba special extract EGb 761 in trained patients with intermittent
claudication] 
=========================================================== 
Author 
Blume J; Kieser M; H¨olscher U 
Address 
Angiologische Gemeinschaftspraxis, Aachen. 
Source 
Vasa, 25(3):265-74 1996 
Abstract 
This monocenter, randomized, placebo-controlled double-blind study 
with parallel-group 
comparison was carried out in order to demonstrate the efficacy of 
Ginkgo biloba special 
extract EGb 761 on objective and subjective parameters of the walking 
performance in 
trained patients suffering from peripheral arterial occlusive disease 
in Fontaine stage IIb. In 
total 60 patients were recruited (42 men; aged 47-82 years) with 
angiographically proven 
peripheral arterial occlusive disease of the lower extremities and an 
intermittent claudication 
existing for at least 6 months. No improvement had been shown despite 
consistent walking 
training and a maximum pain-free walking distance on the treadmill of 
less than 150 m was 
recorded at the beginning of the study. The therapeutic groups were 
treated with either 
Ginkgo biloba special extract EGb 761 at a dose of 3 times 1 
film-coated tablet of 40 mg 
per day by oral route or placebo over a duration of 24 weeks following 
a two-week placebo 
run-in phase. The main outcome measure was the difference of the 
walking distance between 
the start of treatment and after 8, 16 and 24 weeks of treatment as 
measured on the treadmill 
(walking speed 3 km/h and slope of 12%). As secondary parameters the 
corresponding 
differences for the maximum walking distance, the relative increase of 
the pain-free walking 
distance, the Doppler index and the subjective evaluation of the 
patients were analyzed. The 
absolute changes in the pain-free walking distance in treatment weeks 
8, 16 and 24 as against 
the treatment beginning (median values with 95% confidence interval) 
led to the following 
values for the patients treated with Ginkgo biloba special extract EGb 
761:19 m (14, 33), 34 
m (18, 50) and 41 m (26, 64). The corresponding values in the placebo 
group were as 
follows: 7 m (-4, 12), 12 m (5, 22) and 8 m (-1, 21). The advantage of 
the EGb 761-treated 
group as compared to the placebo group could be verified statistically 
at the 3 time points 
with p < 0.0001, p = 0.0003 and p < 0.0001. The test for the presence 
of a clinically relevant 
difference of 20% between EGb 761 and placebo also produced a 
statistically significant 
result (p = 0.008). The Doppler index remained unchanged in both 
therapeutic groups: A 
corresponding statistically significant advantage for the EGb 761 
group was observed on a 
descriptive level for the other parameters tested. The tolerance of 
the treatment was very 
good. The results of this placebo-controlled study show that treatment 
with Ginkgo biloba 
special extract EGb 761 produces a statistically highly significant 
and clinically relevant 
improvement of the walking performance in trained patients suffering 
from intermittent 
claudication with very good tolerance of the study preparation. 

=========================================================== 
26.)[Ginkgo biloba in treatment of intermittent claudication. A systematic 
research based on controlled studies in the literature] 
=========================================================== 
Author 
Ernst E 
Address 
Postgraduate Medical School, University of Exeter/UK. 
Source 
Fortschr Med, 114(8):85-7 1996 Mar 20 
Abstract 
The aim of this systematic review was to evaluate the effectiveness of 
ginkgo biloba in the 
treatment of intermittent claudication. A Medline-search identified 
ten controlled trials on the 
subject. These were heterogeneous in all respects and, with only few 
exceptions, of poor 
methodological quality. All the studies implied that ginkgo biloba is 
an effective therapy for 
intermittent claudication. This hypothesis should be confirmed in 
further trials employing 
meticulous methodology. Furthermore it would also be important to 
determine whether oral 
ginkgo biloba can be usefully combined with walking exercise. 

=========================================================== 
27.)Effect of Gingko biloba extract (EGb 761) on chloroquine induced retinal 
alterations. 
=========================================================== 
Lens Eye Toxic Res 1992;9(3-4):521-8 

Droy-Lefaix MT, Vennat JC, Besse G, Doly M 
Laboratoire de Biophysique, Unite INSERM U71, Facultes de Medecine et de 
Pharmacie, Clermont-Ferrand, France. 

Electroretinography was used to investigate the preventive action of Ginkgo 
biloba extract (EGb 761) in experimental chloroquine-induced retinopathy in 
rats. EGb 761 contains flavones and anthocyanosides known for their 
oxygenated radical scavenging properties. Chronic administration of 
chloroquine (20 days) caused an overall lengthening of the duration of the 
ERG b-wave, together with delayed peaking. These anomalies became more 
marked with increased duration of treatment. In rats treated simultaneously 
with chloroquine and EGb 761 no such modification of the electroretinogram 
(ERG) was observed. These results suggest that retinal toxicity may be 
related to a localized inflammation releasing oxygenated free radicals 
and/or PAF. EGb 761 may thus afford a useful preventive treatment for 
chloroquine-induced retinopathy, and generally for xenobiotic 
retinotoxicities. 

=========================================================== 
28.)Ginkgo biloba extract increases ocular blood flow velocity. 
=========================================================== 
Author 
Chung HS; Harris A; Kristinsson JK; Ciulla TA; Kagemann C; Ritch R 
Address 
Glaucoma Research and Diagnostic Center, Department of Ophthalmology, 
Indiana University Medical Center, Indianapolis 46202, USA. 
Source J Ocul Pharmacol Ther, 15(3):233-40 1999 Jun 
Abstract 
We evaluated a possible therapeutic effect of Ginkgo biloba extract 
(GBE) on glaucoma patients that may benefit from improvements in ocular
blood flow. A 
Phase I cross-over trial of GBE with placebo control in 11 healthy
volunteers (8 women, 
3 men: Age; 34 +/- 3 years, mean +/- SE) was performed. Patients were
treated with 
either GBE 40 mg or placebo three 
times daily orally, for 2 days. Color Doppler imaging (Siemens Quantum 
2000) was used to measure ocular blood flow before and after treatment.
There was a 
two week washout period between GBE and placebo treatment. Ginkgo biloba
extract 
significantly increased end diastolic velocity (EDV) in the ophthalmic
artery (OA) 
(baseline vs GBE-treatment; 6.5 +/- 0.5 vs 7.7 +/- 0.5 cm/sec, 23% change,
p=0.023), 
with no change seen in placebo (baseline vs GBE-treatment; 7.2 +/- 0.6 vs
7.1 +/- 0.5 
cm/sec, 3% change, 
p=0.892). No side effects related to GBE were found. Ginkgo biloba extract
did not alter 
arterial blood pressure, heart rate, or IOP. Ginkgo biloba extract
significantly increased 
EDV in the OA and deserves further investigation in ocular blood flow and 
neuroprotection for possible application to the treatment of glaucomatous
optic 
neuropathy as well as other ischemic ocular diseases. 

=========================================================== 
29.)Pretreatment of skin with a Ginkgo biloba extract/sodium 
carboxymethyl-beta-1,3-glucan formulation appears to inhibit the 
elicitation of allergic contact dermatitis in man. 
=========================================================== 
Author 
Castelli D; Colin L; Camel E; Ries G 
Address 
RoC Laboratoires de Dermo-esth´etique, Colombes, France. 
Source 
Contact Dermatitis, 38(3):123-6 1998 Mar 
Abstract 
The clinical efficiency of mitigating contact dermatitis with a Ginkgo 
biloba extract and carboxymethyl-beta-1,3-glucan formulation was 
investigated in a double-blind versus placebo study using 22 subjects 
(Caucasian women aged 22-55 years) with allergic contact dermatitis from 
various substances in the European standard series. The formulation was 
applied to intact skin 2X a day for 2 weeks ("in use" application) prior to 
a single application of a selected contact allergen under a Finn Chamber 
for 24 h. Readings were carried out in a blind study by a dermatologist 2 
and 3 days after patch removal. Representative photographs were taken of 
treated, placebo and untreated test areas. 68.2% of the panelists showed 
significantly reduced skin reactivity (p = 0.037*) on the treated site 2 
days after patch removal, versus untreated and/or placebo sites. This 
finding indicates that the Ginkgo biloba/carboxymethyl-beta-1,3-glucan 
formulation can mitigate against allergic contact dermatitis. 
Language 

=========================================================== 
30.)The effect of Gingko biloba extract (Egb 761) as a free radical scavenger 
on the survival of skin flaps in rats. A comparative study. 
=========================================================== 
Scand J Plast Reconstr Surg Hand Surg 1998 Jun;32(2):135-9 

Bekerecioglu M, Tercan M, Ozyazgan I 
Department of Plastic and Reconstructive Surgery, Faculty of Medicine, 
Yuzuncu Yil University, Van, Turkey. 

Free radicals may have a role in pedicle flap necrosis. We undertook this 
study to compare the effect of various antioxidants and scavengers of free 
radicals such as vitamin E, vitamin C, deferoxamine, and Gingko biloba 
extract (Egb 761) on McFarlane caudal-based dorsal rat flaps. Fifty rats 
were divided into five groups of 10 animals each. One group served as a 
control (saline) group. The remaining four groups were given vitamin C 340 
mg/kg, deferoxamine 150 mg/kg, Egb 761 100 mg/kg, and vitamin E 20 mg/kg. 
The necrosed area of flap was significantly reduced in the deferoxamine (p 
< 0.001), Egb 761 (p < 0.001), and vitamin C (p < 0.05) groups compared 
with the control group. Vitamin E had no effect on distal flap necrosis (p 
= 0.20). 

=========================================================== 
31.)Induction of superoxide dismutase and catalase activity in different rat 
tissues and protection from UVB irradiation after topical application of 
Ginkgo biloba extracts. 
=========================================================== 
Author 
Lin SY; Chang HP 
Address 
Department of Medical Research and Education, Veterans General Hospital, 
Taipei, Taiwan, Republic of China. 
Source 
Methods Find Exp Clin Pharmacol, 19(6):367-71 1997 Jul-Aug 
Abstract 
Ginkgo biloba extract (GBE) prepared from the leaves of Ginkgo biloba with 
50% diluted alcohol was found to locally induce superoxide dismutase (SOD) 
and catalase (CAT) enzyme activity in epidermis after topical application, 
and also to systemically increase the activity of both enzymes in the 
liver, heart and kidney of Sprague Dawley rats. Skin pretreated with 50% 
diluted alcohol-extracted liquid formulation was protected from 
exacerbation of UVB damage. Changes in the lipid structure of the skin of 
rats determined by ATR/FT-IR spectroscopy demonstrated penetration of 
active components from GBE dosage formulations. 


=========================================================== 
32.)In vivo regulation of peripheral-type benzodiazepine receptor and 
glucocorticoid synthesis by Ginkgo biloba extract EGb 761 and isolated 
ginkgolides. 
=========================================================== 
Author 
Amri H; Ogwuegbu SO; Boujrad N; Drieu K; Papadopoulos V 
Address 
Department of Cell Biology, Georgetown University Medical Center, 
Washington, District of Columbia 20007, USA. 
Source 
Endocrinology, 137(12):5707-18 1996 Dec 
Abstract 
Glucocorticoid excess has broad pathogenic potential including 
neurotoxicity, neuroendangerment, and immunosuppression. Glucocorticoid 
synthesis is regulated by ACTH, which acts by accelerating the transport of 
the precursor cholesterol to the mitochondria where steroidogenesis begins. 
Ginkgo biloba is one of the most ancient trees, and extracts from its 
leaves have been used in traditional medicine. A standardized extract of 
Ginkgo biloba leaves, termed EGb 761 (EGb), has been shown to have 
neuroprotective and antistress effects. In vivo treatment of rats with EGb, 
and its bioactive components ginkgolide A and B, specifically reduces the 
ligand binding capacity, protein, and messenger RNA expression of the 
adrenocortical mitochondrial peripheral-type benzodiazepine receptor (PBR), 
a key element in the regulation of cholesterol transport, resulting in 
decreased corticosteroid synthesis. As expected, the ginkgolide-induced 
decrease in glucocorticoid levels resulted in increased ACTH release, which 
in turn induced the expression of the steroidogenic acute regulatory 
protein. Because ginkgolides reduced the adrenal PBR expression and 
corticosterone synthesis despite the presence of high levels of 
steroidogenic acute regulatory protein, these data demonstrate that PBR is 
indispensable for normal adrenal function. In addition, these results 
suggest that manipulation of PBR expression could control circulating 
glucocorticoid levels, and that the antistress and neuroprotective effects 
of EGb are caused by to its effect on glucocorticoid biosynthesis. 

=========================================================== 
33.)Reactive oxygen metabolites, antioxidants and head and neck cancer. 
Author 
=========================================================== 
Seidman MD; Quirk WS; Shirwany NA 
Address 
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, 
6777 W. Maple Road, W. Bloomfield, MI 48323, USA. 
Source 
Head Neck, 21(5):467-79 1999 Aug 
Abstract 
This manuscript will review the probable role of reactive oxygen 
metabolites (ROM) in the etiopathogenesis of head and neck cancer (HNC). 
Cancer is a heterogeneous disorder with multiple etiologies including 
somatic and germ-line mutations, cellular homeostatic disturbances, and 
environmental triggers. Certain etiologies are characteristic of HNC and 
include infectious agents such as the Epstein-Barr virus, the use of 
tobacco, and consumption of alcohol. A large body of evidence implicates 
ROM in tumor formation and promotion. ROM species are formed in the process 
of cellular respiration, specifically during oxidative phosphorylation. 
These ubiquitous molecules are highly toxic in the cellular environment. Of 
the many effects of ROM, especially important are their effect on DNA. 
Specifically, ROM cause a variety of DNA damage, including insertions, 
point mutations, and deletions. Thus, it is hypothesized that ROM may be 
critically involved in the etiology of malignant disease through their 
possible impact on protooncogenes and tumor suppressor genes. Additionally, 
empirical evidence suggests that ROM may also affect the balance between 
apoptosis and cellular proliferation. If apoptotic mechanisms are 
overwhelmed, uncontrolled cellular proliferation may follow, potentially 
leading to tumor formation. Thus, this manuscript will critically review 
the evidence that supports the role of ROM in tumorigenesis. ROM scavengers 
and blockers have shown both in vivo and in vitro effects of attenuating 
the toxicity of ROM. Such compounds include the antioxidant vitamins (A, C, 
and E), nutrient trace elements (selenium), enzymes (superoxide dismutase, 
glutathione peroxidase, and catalase), hormones (melatonin), and a host of 
natural and synthetic compounds (lazaroids, allopurinol, gingko extract). 
Thus, this paper will also review the possible benefit derived from the use 
of such scavengers/blockers in the prevention of HNC. Copyright 1999 John 
Wiley & Sons, Inc. Head Neck 21: 467-479, 1999. 

=========================================================== 
34.)Protective effects of Gingko biloba extract EGb 761 on myocardium of 
experimentally diabetic rats. I: ultrastructural and biochemical 
investigation on cardiomyocytes. 
=========================================================== 
Exp Toxicol Pathol 1999 May;51(3):189-98 

Fitzl G, Martin R, Dettmer D, Hermsdorf V, Drews H, Welt K 
Institute of Anatomy, University Leipzig, Germany. 

Chronic diabetes in man and animal models develops cardiomyopathic 
alterations which cannot be absolutely avoided by insuline therapy. Since 
diabetic damage is partly attributed to oxidative stress antioxidative 
treatment could be able to reduce the alterations. Aim of this study was to 
investigate the cardioprotective effects of EGb 761, known as a radical 
scavenger, against diabetic alterations in rats. The diabetes was induced 
by i.p. injection of 60 mg/kg body weight streptozotocin. Duration of 
diabetes was 4 months, the protected group received 100 mg/kg body weight 
EGb 761 with the drinking water over 3 months. Electron and light 
microscopic morphometry of left-ventricular samples revealed typical 
diabetic alterations consisting in decrease of volume fraction of 
myofibrils, SR and t-tubules and diminishing of cardiomyocyte diameter, 
increase of interstitial volume, mitochondrial size and volume fraction, 
and of vacuoles and of lipid drops. EGb treatment could gradually prevent 
the loss of myofibrils and reduction of myocyte diameter but has only 
little influence on interstitial and mitochondria volume. The 
diabetic-induced increase of lipid and vacuoles and the decrease of SR and 
t-tubules were not influenced. Biochemical parameters of oxidative stress: 
malondialdehyde (MDA) was only insignificantly altered by diabetes and EGb. 
The superoxide dismutase (SOD) activity was increased by diabetes and more 
increased by EGb treatment. Creatine kinase (CK) activity was diminished by 
diabetes but slightly increased by EGb. The polymerase chain reaction (PCR) 
of i-NOS was not different between the diabetic and protected diabetic 
groups. 

=========================================================== 
45.)Identification of Gingko biloba flavonol metabolites after oral 
administration to humans. 
=========================================================== 
J Chromatogr B Biomed Sci Appl 1997 May 23;693(1):249-55 

Pietta PG, Gardana C, Mauri PL 
CNR-ITBA, Milan, Italy. 

An extract of Ginkgo biloba leaves (EGb) was given to healthy volunteers. 
Urine samples were collected for 3 days, and blood samples were withdrawn 
every 30 min for 5 h. The samples were purified through SPE C18 cartridges 
and analyzed by reversed-phase LC-diode array detection for the presence of 
EGb metabolites. Only urine samples contained detectable amounts of 
substituted benzoic acids, i.e., 4-hydroxybenzoic acid conjugate, 
4-hydroxyhippuric acid, 3-methoxy-4-hydroxyhippuric acid, 
3,4-dihydroxybenzoic acid, 4-hydroxybenzoic acid, hippuric acid and 
3-methoxy-4-hydroxybenzoic acid (vanillic acid). In contrast to rats no 
phenylacetic acid or phenylpropionic acid derivatives were found in urine, 
thus indicating that in humans a more extensive metabolism takes place. As 
for rats the metabolites found in human urines accounted for less than 30% 
of the flavonoids given. The same procedure was applied to blood samples, 
and no metabolites could be detected. 

=========================================================== 
46.)Solid-phase extraction and gas chromatography-mass spectrometry 
determination of kaempferol and quercetin in human urine after consumption 
of Ginkgo biloba tablets. 
=========================================================== 
Author 
Watson DG; Oliveira EJ 
Address 
Department of Pharmaceutical Sciences, University of Strathclyde, 
Strathclyde Institute of Biomedical Sciences, Glasgow, UK. 
[email protected] 
Source 
J Chromatogr B Biomed Sci Appl, 723(1-2):203-10 1999 Feb 19 
Abstract 
A method was developed for the quantification of the flavonoids quercetin 
and kaempferol in human urine using a solid-phase extraction procedure 
followed by gas chromatography-mass spectrometry. Deuterated internal 
standards of the analytes were spiked into the samples prior to extraction. 
The limit of detection of the method was ca. 10 pg on column and precision 
of the method for quantification in a sample of urine was +/-9.40% for 
kaempferol and +/-7.34% for quercetin (n = 6). The levels of quercetin and 
kaempferol found in urine samples were only a small fraction of the amount 
ingested. The treatment of urine samples with beta-glucuronidase markedly 
increased the levels of flavonoids detected, supporting the view that 
kaempferol and quercetin are eliminated in the urine as glucuronides. 
Language 

=========================================================== 
47.)Ginkgo biloba extract (EGb 761) independently improves changes in passive 
avoidance learning and brain membrane fluidity in the aging mouse. 
=========================================================== 
Pharmacopsychiatry 1996 Jul;29(4):144-9 

Stoll S, Scheuer K, Pohl O, Muller WE 
Central Institute for Mental Health, Section Psychopharmacology, Mannheim, 
Germany. 

Decreases in cell membrane fluidity may be a major mechanism of age-related 
functional decline. A prime cause for the decline of membrane fluidity may 
be the presence of free radicals. Gingko biloba extract EGb 761 protects 
neuronal cell membranes from free radical damage in vitro. Further, EGb 761 
has repeatedly been shown to improve cognitive functions in man and in 
laboratory animals. To test if there is a link between these two actions we 
assessed the effects of EGb 761 on passive avoidance learning and on 
neuronal membrane fluidity in vivo in young (three-month-old), middle-aged 
(12-month-old) and aged (22 to 24-month-old) female NMRI mice. The animals 
were treated daily with 100 mg/kg EGb 761 for three weeks. There was a 
significant improvement in short-term memory, measured by the avoidance 
latency 60 seconds after the aversive stimulus (p < 0.0311), and of 
membrane fluidity (p < 0.01) in the aged animals, but no improvement in 
long-term memory as measured by the avoidance latency 24 hours after shock. 
However, no significant correlation between membrane fluidity and 
short-term memory performance was found. Taken together, these results 
indicate that EGb 761 independently improves changes in passive avoidance 
learning and brain membrane fluidity. 

=========================================================== 
48.)Lipid peroxidation in experimental spinal cord injury. Comparison of 
treatment with Ginkgo biloba, TRH and methylprednisolone. 
=========================================================== 
Res Exp Med (Berl) 1995;195(2):117-23 

Koc RK, Akdemir H, Kurtsoy A, Pasaoglu H, Kavuncu I, Pasaoglu A, Karakucuk I 
Department of Neurosurgery, Erciyes University, School of Medicine, 
Kayseri, Turkey. 

Ischaemia-induced lipid peroxidation is one of the most important factors 
producing tissue damage in spinal cord injury. In our study, the protective 
effects of Ginkgo biloba, thyroid releasing hormone (TRH) and 
methylprednisolone (MP) on compression injury of the rat spinal cord were 
investigated. For this study 45 rats in four groups, including control, MP, 
TRH and Gingko biloba, were used to determine the formation of 
malondialdehyde (MDA). All the animals were made paraplegic by the 
application clip method of Rivlin and Tator. Rats were divided randomly and 
blindly to one of four treatment groups (ten animals in each). MP and 
Ginkgo biloba treatments significantly decreased MDA levels (F = 54.138, P 
< 0.01). These results suggest that MP and Ginkgo biloba may have a 
protective effect against ischaemic spinal cord injury by the antioxidant 
effect. 

=========================================================== 
49.)A Ginkgo biloba extract (EGb 761) prevents mitochondrial aging by 
protecting against oxidative stress. 
=========================================================== 
Author 
Sastre J; Mill´an A; Garc´ia de la Asunci´on J; Pl´a R; Juan G; Pallard´o; 
O'Connor E; Martin JA; Droy-Lefaix MT; Vi~na J 
Address 
Departamento de Fisiolog´ia, Facultad de Medicina, Univ. Valencia, Spain. 
Source 
Free Radic Biol Med, 24(2):298-304 1998 Jan 15 
Abstract 
The effect of aging on indices of oxidative damage in rat mitochondria and 
the protective effect of the Ginkgo biloba extract EGb 761 was 
investigated. Mitochondrial DNA from brain and liver of old rats exhibited 
oxidative damage that is significantly higher than that from young rats. 
Mitochondrial glutathione is also more oxidized in old than in young rats. 
Peroxide formation in mitochondria from old animals was higher than in 
those from young ones. According to morphological parameters (size and 
complexity), there are two populations of mitochondria. One is composed of 
large, highly complex mitochondria, and the other population is smaller and 
less complex. Brain and liver from old animals had a higher proportion of 
the large, highly complex mitochondria than seen in organs from young 
animals. Treatment with the Ginkgo biloba extract EGb 761 partially 
prevented these morphological changes as well as the indices of oxidative 
damage observed in brain and liver mitochondria from old animals. 

=========================================================== 
50.)The correlation of cytophotometrically and biochemically measured enzyme 
activities: changes in the myocardium of diabetic and hypoxic diabetic 
rats, with and without Ginkgo biloba extract treatment. 
=========================================================== 
Author 
Punkt K; Adams V; Linke A; Welt K 
Address 
Institute of Anatomy, University of Leipzig, Germany. 
Source 
Acta Histochem, 99(3):291-9 1997 Aug 
Abstract 
Changes of enzyme activities in the myocardium of rats from 6 different 
experimental groups (normal rats, diabetic rats, hypoxic diabetic rats, 
each with and without Ginkgo biloba extract treatment) were measured by 
using both cytophotometric and biochemical methods. The activity of 
succinate dehydrogenase, a marker of oxidative capacity, and of 
menadione-dependent glycerol-3-phosphate dehydrogenase and total lactate 
dehydrogenase, both markers of glycolytic capacity were measured to 
characterize changes of the metabolic profile in myocardium. A strong 
correlation between cytophotometric and biochemical data were found by 
linear regression analysis, justifying the use of cytophotometrical enzyme 
activity measurements in cells of organized tissue, where biochemistry 
cannot provide topographical information. The comparison of the results 
obtained from the different groups revealed the following: Enzyme 
activities in the myocardium of rats with streptozotocin-induced diabetes 
were significantly increased by 10-30% as compared to the normal 
myocardium. This effect was interpreted as a metabolic compensation of the 
diabetic heart with reduced performance. When diabetic rats were exposed to 
acute hypoxia of 20 min duration, enzyme activities decreased under the 
normal level, to 56% of the succinate dehydrogenase activity, to 87% of 
glycerol-3-phosphate dehydrogenase activity and to 69% of lactate 
dehydrogenase activity. Treatment of rats with the oxygen radical scavenger 
Ginkgo biloba extract (EGb 761) over 3 months resulted primarily in an 
increase by 10% of oxidative capacity and in a decrease by 30% of 
glycolytic capacity. Under diabetic conditions a shift to more glycolytic 
metabolism was observed by increasing the glycolytic activity by 39% and 
remaining the oxidative activity. 

=========================================================== 
51.)Enhancement of radiation effect by Ginkgo biloba extract in C3H mouse 
fibrosarcoma. 
=========================================================== 
Author 
Ha SW; Yi CJ; Cho CK; Cho MJ; Shin KH; Park CI 
Address 
Laboratory of Radiation Biology, Seoul National University Medical College, 
South Korea. 
Source 
Radiother Oncol, 41(2):163-7 1996 Nov 
Abstract 
BACKGROUND AND PURPOSE: Ginkgo biloba leaf extract (GBE) is known to 
increase peripheral blood circulation. The hypothesis that GBE may be able 
to enhance radiosensitivity of tumor by improving tumor blood flow and thus 
decreasing hypoxic fraction was tested. MATERIALS AND METHODS: Fibrosarcoma 
(FSaII) growing in C3H mouse leg muscle was used as a tumor model. GBE was 
given i.p. 1 h before irradiation with or without priming dose given 1 day 
earlier. Effect on tumor and normal tissue radiation reaction was 
investigated. RESULTS: Tumor growth delay by radiation was more elongated 
after two doses (1-day interval) of GBE than after a single dose. Radiation 
dose for 3-day tumor growth delay was decreased from 12.45 (10.97-13.93) Gy 
to 6.06 (3.89-8.22) Gy by two doses of GBE [enhancement ratio = 2.06 
(1.32-2.79)]. Hypoxic cell fraction was 10.6% (6.3-18.2%) for control, 7.2% 
(3.8-14.0%) after a single dose (P = 0.18) and 2.7% (1.5-5.0%) after two 
doses (P < 0.001). Radiation effect on normal tissue, estimated by acute 
skin reaction and jejunal crypt assay, was not affected by GBE. CONCLUSION: 
Ginkgo biloba extract enhances radiation effect on tumor without increasing 
acute normal tissue radiation damage in this model system probably by 
increasing tumor blood flow and further investigation for this possible 
radiosensitizer is needed. 

=========================================================== 
52.)Platelet-activating factor is an important mediator in hypoxic ischemic 
brain injury in the newborn rat. Flunarizine and Ginkgo biloba extract 
reduce PAF concentration in the brain. 
=========================================================== 
Author 
Akis¨u M; K¨ult¨ursay N; Coker I; H¨useyinov A 
Address 
Department of Pediatrics, Ege University Medical School, Izmir, Turkey. 
[email protected] 
Source 
Biol Neonate, 74(6):439-44 1998 Dec 
Abstract 
Hypoxic-ischemic encephalopathy is still a very important cause of neonatal 
mortality and morbidity. Recently, platelet-activating factor (PAF) has 
been accused of being responsible for the neuronal damage in 
hypoxic-ischemic brain. We investigated tissue PAF concentrations in 
hypoxic-ischemic brain injury in immature rats. Endogenous PAF 
concentration in brain tissue showed a marked increase in hypoxic-ischemic 
pups (85.6 +/- 15.5 pg/mg protein) when compared to that of control (9.05 
+/- 3.1 pg/mg protein). In addition, we examined the effects of 
flunarizine, a selective calcium channel blocker, and Ginkgo biloba extract 
(EGb 761) on endogenous PAF concentration in hypoxic-ischemic brain injury. 
Endogenous PAF concentrations in both flunarizine-pretreated (16.6 +/- 4.8 
pg/mg protein) and EGb 761-pretreated (33.5 +/- 8.9 pg/mg protein) pups 
were significantly lower than the untreated group. These results indicate 
that PAF is an important mediator in immature rat model of cerebral 
hypoxic-ischemic injury. The suppressor effect of flunarizine and EGb 761 
on PAF production may open new insight into the treatment of 
hypoxic-ischemic brain injury. 

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53.)The effect of meclofenoxate with ginkgo biloba extract or zinc on lipid 
peroxide, some free radical scavengers and the cardiovascular system of 
aged rats. 
=========================================================== 
Author 
al-Zuhair H; Abd el-Fattah A; el-Sayed MI 
Address 
Pharmacology Department, Faculty of Pharmacy, King Saud University, Riyadh, 
Saudi Arabia. 
Source 
Pharmacol Res, 38(1):65-72 1998 Jul 
Abstract 
Aged rats are highly prone to many physiological changes such as blood 
pressure and heart rate. These changes could be due to modification in 
membrane phospholipid composition of their blood vessels. Lipid peroxide in 
vivo has been identified as a basic deteriorative reaction in cellular 
mechanisms of aging in human. The effect of a nootropic drug, meclofenoxate 
(MF) or its combination with extract of ginkgo biloba (EGb-761) or zinc 
(Zn) on malondialdehyde (MDA) product as an index of endogenous lipid 
peroxidation; phospholipid; glutathione (GSH) and protein thiols (PrSHs) 
contents as well as superoxide dismutase (SOD) activity in blood, brain, 
heart and liver of 24-month-old male rats was investigated. Aged rats were 
treated with MF once daily at oral doses of 100 mg kg-1 body wt. alone or 
with either EGb at a dose of 150 mg kg-1 body wt. or Zn at 10.5 mg kg-1 
body wt. for 4 weeks. This study showed that aging caused a higher 
increment in MDA level of brain and heart than liver and plasma accompanied 
with reduction in brain and heart phospholipid contents as well as 
alteration of the antioxidant systems as compared to 4-month-old rats. 
Treatment of aged rats with MF alone or combined with either EGb or Zn 
caused improvement in the measured free radical scavengers especially in 
brain and heart tissues. Our results also showed that both EGb and Zn 
induced a significant potential effect of MF action on blood pressure and 
heart rate. The results were explained in the light of the antioxidant 
properties of EGb and Zn. Thus it is concluded that EGb and Zn have a 
beneficial role with MF in diminishing cumulative oxidative changes in aging. 

=========================================================== 
54.)Effects on skeletal muscle fibres of diabetes and Ginkgo biloba 
extract treatment. 
=========================================================== 
Author 
Punkt K; Psinia I; Welt K; Barth W; Asmussen G 
Address 
Institute of Anatomy, University of Leipzig, Germany. 
Source 
Acta Histochem, 101(1):53-69 1999 Feb 
Abstract 
Combined cytophotometric and morphometric analysis of muscle fibre 
properties and myosin 
heavy chain electrophoresis were performed on extensor digitorum 
longus and soleus muscles 
from healthy rats and rats with streptozotocin-induced diabetes. 
Moreover, the protective 
effect of Ginkgo biloba extract, a potent oxygen radical scavenger, on 
diabetic muscles was 
investigated. Changes in fibre type-related enzyme activities, fibre 
type distribution, fibre cross 
areas and myosin isoforms were found. In muscles of diabetic rats, a 
metabolic shift was 
measured mainly in fibres with oxidative metabolism. Fast-oxidative 
glycolytic fibres showed a 
shift to more glycolytic metabolism and about a third transformed into 
fast-glycolytic fibres. 
Slow-oxidative fibres became more oxidative. Fibre atrophy was 
measured in diabetic 
muscles dependent on fibre type and muscle. Different fibre types 
atrophied to a different 
degree. Therefore, a decreased area percentage of slow fibres and an 
increased area 
percentage of fast fibres of the whole muscle cross section in both 
muscles were found. This is 
supported by reduced slow and increased fast myosin heavy chain 
isoforms. These alterations 
of diabetic muscle fibres could be due to less motion of diabetic rats 
and diabetic neuropathy. 
After treatment with Ginkgo biloba extract, enzyme activities were 
increased mainly in 
oxidative fibres of diabetic muscles, which was interpreted as 
protective effect. Generally, the 
soleus muscle with predominant oxidative metabolism was more 
vulnerable to diabetic 
alterations and Ginkgo biloba extract treatment than the extensor 
digitorum longus muscle 
with predominant glycolytic metabolism. 

=========================================================== 
55.)The effects of prostaglandin E2 indomethacin & Ginkgo biloba extract 
on resistance to experimental sepsis. 
=========================================================== 
Author 
Cant¨urk NZ; Utkan NZ; Cant¨urk Z; Yenisey C; Yildirir C; D¨ulger M 
Address 
Kocaeli University, Faculty of Medicine, Department of Surgery, 
Kocaeli, Turkey. 
Source 
Indian J Med Res, 108():88-92 1998 Sep 
Abstract 
We investigated the effect of 16,16-dimethyl prostaglandin E2 
indomethacin and Ginkgo 
biloba extract on the survival in two experimental sepsis models in 
rats due to administration 
of 1 x 10(7) cfu and 1 x 10(9) cfu Escherichia coli. Animals in each 
model were then 
randomly divided (10/group) into four groups, administered saline, 
indomethacin, G. biloba 
extract and prostaglandin E2 respectively. When compared, there was no 
significant 
difference in the survival period between the two sepsis models (P > 
0.05). The best survival 
rate was observed in the PGE2-administered animals in the first major 
model (P < 0.05). 
Indomethacin appeared not to decrease the mortality rates. There was 
no significant 
difference in PGE2 levels between two sepsis models (P > 0.05). Our 
results suggest that 
elevated prostaglandin E2 levels following major trauma are not 
responsible for the postinjury 
increased susceptibility to infectious complications. Our observations 
should also discourage 
aggressive use of cyclo-oxygenase inhibitors for protection against 
infectious complications 
after major trauma. 

=========================================================== 
56.)Ginkgo biloba extract protects brain neurons against oxidative stress 
induced by hydrogen peroxide. 
=========================================================== 
Author 
Oyama Y; Chikahisa L; Ueha T; Kanemaru K; Noda K 
Address 
Laboratory of Cell Signaling (Pharmacology), Faculty of Integrated 
Arts and Sciences, 
University of Tokushima, Japan. 
Source 
Brain Res, 712(2):349-52 1996 Mar 18 
Abstract 
Effect of Ginkgo biloba extract was examined on dissociated rat 
cerebellar neurons suffering 
from oxidative stress induced by hydrogen peroxide using a flow 
cytometer and ethidium 
bromide. Hydrogen peroxide at a concentration of 3 mM increased the 
number of neurons 
stained with ethidium (presumably dead neurons) in a time-dependent 
manner. Pretreatment 
of neurons with G. biloba extract (10 micrograms/ml) greatly delayed a 
time-dependent 
increase in number of dead neurons during exposure to hydrogen 
peroxide. It was true, but 
less effective, in the case of treatment with G. biloba extract 
immediately or 60 min after start 
of oxidative stress. Results implicate G. biloba extract as a 
potential agent in protecting the 
neurons suffering from oxidative stress induced by hydrogen peroxide. 
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DATA-MEDICOS/DERMAGIC-EXPRESS No 2-(81) 03/11/99 DR. JOSE 
LAPENTA R. 
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