The Clear and the Dark side of the Ginkgo Biloba.
 

 

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The Clear and the Dark side oh the Ginkgo Biloba.

El Lado Claro y Oscuro del Ginkgo Biloba.

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****** DATA-MÉDICOS *********
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EL LADO CLARO Y OSCURO DEL GINKGO BILOBA.
THE CLEAR AND THE DARK SIDE OF GINKGO BILOBA.
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***** DERMAGIC-EXPRESS No (2)-78 ******* 
** 03 NOVIEMBRE 1.999 / 03 NOVEMBER 1999** 

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EDITORIAL ESPAÑOL:
=====================
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 plástico de Venezuela) sobre el GINKGO BILOBA.

El me comento que esta popular Hierba de origen Chino podía PRODUCIR HEMORRAGIAS cuando se tomaba crónicamente, y que él, particularmente le mandaba a SUSPENDER 2 SEMANAS ANTES de las cirugías la ingestión de GINKGO BILOBA 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 información fresca sobre el TEMA. 

En estas 56 referencias encontré que es COMPLETAMENTE VERDAD lo que el Dr. Borges me comento, pero además de ello encontré también QUE EL GINKGO BILOBA, tiene muchos efectos beneficiosos en algunas enfermedades de origen DERMATOLÓGICO y NO DERMATOLÓGICO.
 
Entre ellas: MEJORA la MEMORIA, la APATÍA SEXUAL, ESTRÉS OXIDATIVO, CLAUDICACIÓN INTERMITENTE, la VIDA DE LOS COLGAJOS EN CIRUGÍA DE PIEL, protege LA RETINA contra los EFECTOS DE LA CLOROQIUINA, util en la enfermedad de ALZHEIMER, y otros.

De modo que el GINKGO BILOBA tiene su lado CLARO y OSCURO realmente. 

Espero que disfruten esta revisión y ... pregunten por el GINKGO BILOBA antes de practicar cirugías !!! 

====================CORREO E-MAIL ======================== 
From: "Jorge F. Padilla Henríquez" <[email protected]

Subject: RE: DERMAGIC/EXPRESS 2-(77) 27/10/99 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 

 ==========================================================


PRÓXIMA EDICIÓN: EL ERBIUM-YAG-LASER...Y LA PIEL 

Saludos a todos !!! 

Dr. José Lapenta R.,,,



EDITORIAL ENGLISH:
=====================
Hello friends of the network. DERMAGIC is back with you. Last week I was talking with one of the list members, Dr. Borges (a plastic surgeon from Venezuela), about GINKGO BILOBA.

He told me that this popular herb of Chinese origin could CAUSE HEMORRHAGES when taken chronically, and that he, in particular, instructed his patients to STOP taking GINKGO BILOBA two weeks before surgery, if they were taking it, to avoid bleeding.

The topic MOTIVATED ME, and I went on a trip on Sunday at midnight to find THE CLEAR AND DARK SIDE OF GINKGO, to bring you fresh information on the topic.

In these 56 references, I found that what Dr. Borges told me was COMPLETELY TRUE, but in addition, I also discovered that GINKGO BILOBA has many beneficial effects on some DERMATOLOGICAL and NON-DERMATOLOGICAL diseases.

Among them: it IMPROVES MEMORY, SEXUAL APATHY, OXIDATIVE STRESS, INTERMITENT CALUDICATION, the LIFE OF FLAPS IN SKIN SURGERY, protects the RETINA AGAINST the effects of CHLOROQUINE, in ALZHEIMER'S disease, and others.

So, GINKGO BILOBA truly has its CLEAR and DARK sides.

I hope you enjoy this review and... ask about GINKGO BILOBA before performing surgery!!!

=====================E-MAIL =========================
From: "Jorge F. Padilla Henríquez" <[email protected]>

Subject: RE: DERMAGIC/EXPRESS 2-(77) 27/10/99 LA ISOTRETINOINA, LO BUENO LO MALO Y LO FEO / THE ISOTRETINOIN, THE GOOD, THE BAD AND THE UGLY.

Dr. Lapenta:

I congratulate you on the excellent content of DERMAGIC/EXPRESS. I was unaware that a Venezuelan dermatologist was making such a great effort online and of such high quality.

I reiterate my appreciation and consideration

Dr. Jorge F. Padilla Henríquez. Dermatologist

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

Greetings to all!!!

Dr. José Lapenta R.,,,


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DERMAGIC/EXPRESS (78)
================================================================
REFERENCIAS BIBLIOGRÁFICAS / MBIBLIOGRAPHICAL 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 therapeutic strategies. 
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. 

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49.)A Ginkgo biloba extract (EGb 761) prevents mitochondrial aging by  protecting against oxidative stress. 
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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. 

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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. 
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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. 

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51.)Enhancement of radiation effect by Ginkgo biloba extract in C3H mouse  fibrosarcoma. 
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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. 

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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. 
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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. 
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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. 

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54.)Effects on skeletal muscle fibres of diabetes and Ginkgo biloba  extract treatment. 
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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. 

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55.)The effects of prostaglandin E2 indomethacin & Ginkgo biloba extract  on resistance to experimental sepsis. 
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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. 

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56.) Ginkgo biloba extract protects brain neurons against oxidative stress  induced by hydrogen peroxide. 
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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-MÉDICOS/DERMAGIC-EXPRESS No 2-(78) 03/11/99 DR. JOSÉ LAPENTA R. 
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Produced by Dr. José Lapenta R. Dermatologist  
Maracay Estado Aragua Venezuela 1998-2026
Telf.: 04142976087 - 04127766810