Friday, 1 November 2013

Chinese Herbs – Xi Xin (Herba cum Radice Asari)

Xi Xin is also known as Wild Ginger. The acrid, warm and toxic (especially to the kidney) herb has been used in TCM as anti histamine, antipyretic, sedative, anti bacterial agent and promote sweating, treat ingrown eye lashes, sinus, etc., as it expels Wind, disperses Cold,  calms pain, warms the Lungs, get rid of Phlegm, etc. by enhancing the functions of heart, lung and liver channels.

Ingredients
1. Methyl eugenol
2. A-pinene
3.  camphene
4. β–pinene
5. Myrcene
6. Sabinene
7. Llimonene
8. 1, 8-cineole, p-cymene
9. G-terpinene
10. Terpinolene
11. Estragole
12. 3, 5-dimethoxytoluene
13. Etc.

Health Benefits
1. Anti fungal effects
In the study the anti fungal effect from from the methanol extracts of Asarum sieboldii (Miq) Maek rhizomesactive against Colletotrichum, showed that  Kakuol also completely inhibited the mycelial growth of Botrytis cinerea Pers ex Fr and Cladosporium cucumerinum Ellis & Arthur at 50 microg ml(-1) and 30 microg ml(-1), respectively. However, no antimicrobial activity was found against yeast and bacteria even at 100 microg ml(-1). Kakuol exhibited a protective activity against the development of anthracnose disease on cucumber plants(1).
2. Anti-nociceptive and anti inflammatory effects 
in the study to gain insights into the mechanism of actions regarding anti-nociceptive and anti-inflammatory activities of AR, researchers at the Kyung Hee University, indicated that the methanol extract of AR exerts anti-nociceptive and anti-inflammatory effects by activating opioid receptor as well as by inhibiting bradykinin and histamine-mediated actions(2).
3. Etc.

Side Effects
1. Do not use the herb in case of cold sweet as a result of Qi deficiency and headache due to Yin deficiency and hyper Yang
2. Do not use the herb in case of cough caused by lung heat and Yin deficiency
3. Overdose can cause damage to the kidney
4. Do not use the herb in newborn, children or if you are pregnant or breast feeding without first consulting with the related field specialist
5, Etc.


Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/15846774
(2) http://www.ncbi.nlm.nih.gov/pubmed/12902045

Chinese Herbs – Xi Yang Shen (Radix Panacis Quinque Folii)

Xi Yang Shen is also known as American Ginseng Root. The sweet, bitter and cool herb has been used in TCM

Ingredients
1. Octanol
2. Hexanoic acid
3. Undecane
4. Pinocarveol
5. Octanoic acid
6. Dodecane
7. 3-phenylhexane
8.  1-phenylhexane
9.  1, 3, 5- triisopropylphene
10. Beta-gurjunene
11. Piperitene
12. Beta-farnesene
13. 2, 6-diterbutyl-4-methylphenol
14. 3-phenyldecane
15. 6-phenylundecane
16. Etc.

Health Benefits
1. Colorectal cancer
In the investigation of American ginseng (Panax quinquefolius L., Araliaceae) and its anti-cancer potentialfound that three genes were up-regulated (AKAPA8L, PMPCB and PDE5A) and three were down-regulated (PITPNA, DUS2L and RIC8A). Although further studies are needed to elucidate the mechanisms of action, our findings should expand the understanding of the molecular framework of American ginseng as an anti-cancer agent, according to “Characterization of gene expression regulated by American ginseng and ginsenoside Rg3 in human colorectal cancer cells” by Luo X, Wang CZ, Chen J, Song WX, Luo J, Tang N, He BC, Kang Q, Wang Y, Du W, He TC, Yuan CS.(1)
2. Cardiovascular disease
In the demonstration of emerging evidence suggests ginseng has therapeutic potential in cardiovascular disease found that ginseng treatment significantly decreased infarct size and myocardial apoptosis following I/R in WT mice, but not in either eNOS(-/-) mice or WT mice treated with LY294002. We conclude that ginseng treatment protects the heart from I/R injury via upregulation of eNOS expression. Our study suggests that ginseng may serve as a potential therapeutic agent to limit myocardial I/R injury, according to “North American ginseng protects the heart from ischemia and reperfusion injury via upregulation of endothelial nitric oxide synthase” by Wu Y, Lu X, Xiang FL, Lui EM, Feng Q.(2)
3. Pediatric upper respiratory tract infection
In the evaluation of Panax quinquefolius (American ginseng root extract) standardized to contain 80% poly-furanosyl-pyranosyl-saccharides and theirs effect on upper respiratory tract infections in childdren found that standard doses of ginseng were well tolerated and merit additional evaluation with regard to treatment of pediatric upper respiratory tract infection, according to “Safety and tolerability of North American ginseng extract in the treatment of pediatric upper respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules” by Vohra S, Johnston BC, Laycock KL, Midodzi WK, Dhunnoo I, Harris E, Baydala L.(3)
4. Glycemia and insulinemia
In the assessment the evidence indicates that the glycemia-lowering effect of American ginseng root may be batch dependent. found that American ginseng decreased postprandial glycemia and insulinemia; however, 40% of the batches did not reduce glycemia with the anticipated magnitude, irrespective of their saponin composition, according to “Five batches representative of Ontario-grown American ginseng root produce comparable reductions of postprandial glycemia in healthy individuals” by
Dascalu A, Sievenpiper JL, Jenkins AL, Stavro MP, Leiter LA, Arnason JT, Vuksan V.(4)
5. Etc.

Side Effects
1. The herb can cause tremors, nervousness, headache, vomiting, insomnia, nose bleeding, etc.
2. Please do not use Xi Yang Shen, if you have heart disease or taken heart problem medicine
3. Xi Yang Shen may interact with other medication, including aspirin, Warfarin/Coumadin, etc.
4. Do not use the herb if you are pregnant
5. Etc.

Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/18425323
(2) http://www.ncbi.nlm.nih.gov/pubmed/21621617
(3) http://www.ncbi.nlm.nih.gov/pubmed/18676527
(4) http://www.ncbi.nlm.nih.gov/pubmed/18066131

Chinese Herbs– Xia Ku Cao (Spica Prunellae Vulgaris)

Xia Ku Cao is also known as Common Selfheal plant. The acrid, bitter and slightly cold herb has been used in TCM to treat goiter. tuberculosis of lymph nodes (scrofula), breast cancer, headache and dizziness. hypertension. vaginal infection,  bleeding during menopause, pain and ache of the muscles and bone, acute hepatitis,Herpes simplex I & II, etc., as it disperses Liver-Fire and nodules, etc. by enhancing the functions of liver and gallbladder channels.

Ingredients
1. Oleanolic acid
2. Ursolic acid
3. Rutin
4. Hyperoside
5. Caffeic acid
6. Vitamin B11
7. Vitamin C and K
8. Tanin
9. Etc.

Health Benefits
1. Immunosuppressive activity
in the study to evaluate the immunosuppressive activity of the ethanol extract of Spica Prunellae (Prunella vulgaris fruiting spikes) (EESP) consisting of a mixture of triterpenoids, flavonoids, tannins and polysaccharide, showed that the total IgG, IgG1 and IgG2b levels in the immunized mice were significantly reduced by EESP. Moreover, the suppressing effects on the antibody responses to OVA in the immunized mice were dose-dependently enhanced according to the increase of EESP. The results suggest that EESP could suppress the cellular and humoral response in mice(1).
2.  Etc.

Side Effects
1. Do not use the herb in case of spleen deficiency
2. Prolonged period of usage can cause stomach irritation.
3. Do not use the herb in newborn, children or if you are pregnant or breast feeding without first consulting with the related field specialist.
4. Etc.

Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed?term=Spica%20Prunellae%20Vulgaris

Chinese Herbs – Xian He Cao (Herba Agrimoniae Pilosae)

Xian He Cao is also known as Hairyvein Agrimonia Herb. The acrid, bitter and neutral herb has been used in TCM to stop bleeding, inhibits Gram-Positive Bacteria, rids of tape worm, etc., as it promotes hemostasis, stops bleeding, treats dysentery, eliminates parasites, etc. by enhancing the functions of spleen, lung and liver channels.

Ingredients
1. Agrimophol
2. Agrimonolide
3. Luteoloside
4. Agrimonin A,B,C
5. Agrimol A~E
6. Tannin acid
7. Sterol
8. Saponin
9. Etc.

Health Benefits
1. Anti anti inflammatory effects
In the study of the effects of Agrimoniae Herba on lipopolysaccharide-induced nitric oxide and proinflammatory cytokine production in BV2 microglial cells by nitric oxide assay, enzyme-linked immunosorbent assay and western blotting, showed that agrimoniae Herba had no cytotoxicity and suppressed lipopolysaccharide-induced nitric oxide production in BV2 microglial cells. Agrimoniae Herba also suppressed lipopolysaccharide-induced production of proinflammatory cytokines such as tumor necrosis factor, interleukin 1 beta and interleukin 6 in a dose-dependent manner. Agrimoniae Herba inhibited the expression of inducible nitric oxide synthase(1).
2. Anti-mite activities
In the study to explore traditional Chinese medicines (TCMs) with anti-mite activities for Dernodex folliculorum in vitro, researchers at the Anhui University of Science and Technology, Huainan, found that Cortex Phellodendri, Herba Taraxac and Herba Agrimoniae et al. had remarkable anti-mite activities to Demodex folliculorum(2).
3. Antinociception
Agrimonia pilosa Ledeb extract shows an antinociceptive property in various pain models. Furthermore, this antinociceptive effect of Agrimonia pilosa Ledeb extract may be mediated by α(2)-adrenergic receptor, but not opioidergic and serotonergic receptors, according to the Hallym University(3).
4. Anti-inflammatory and anti-allergic effects
In the study of the anti-inflammatory and anti-allergic effects of Agrimonia pilosa Ledeb (AP) extract in in vitro cell lines and in vivo mouse model of inflammation and the molecular mechanisms, researchers at the Konkuk University, showed that AP attenuated the activation of macrophages, basophils, and inhibited the OVA-induced airway inflammation. The molecular mechanisms leading to AP’s potent anti-inflammatory and anti-allergic effects might be through regulation of TRIF-dependent and Syk-PLCγ/AKT signaling pathways, suggesting that AP may provide a valuable therapeutic strategy in treating various inflammatory diseases including asthma(4).
5. Antioxidant activities
In the study of Antioxidant activities of aqueous extract from Agrimonia pilosa Ledeb and its fractions indicated that AE shows a moderate antioxidant activity to scavenge DPPH*, O2(-)* and *OH and inhibit beta-carotene bleaching with IC(50) values of 13.0, 33.2, 351, and 11.9 microg/ml, respectively, while its AcOEt-soluble fraction (ESF) and BuOH soluble fraction (BSF) exhibit remarkable efficiencies. The ESF’s IC(50) values of scavenging DPPH*, O2(-)*, and *OH, and inhibiting beta-carotene bleaching are 5.6, 5.8, 171, and 7.6 mircog/ml, respectively(5).
6. Etc.

Side Effects
1. Xian He Cao may cause allergic effect, including nausea and vomiting
2. Etc.

Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/20034446
(2) http://www.ncbi.nlm.nih.gov/pubmed/17326398
(3) http://www.ncbi.nlm.nih.gov/pubmed/22563257
(4) http://www.ncbi.nlm.nih.gov/pubmed/22289347
(5) http://www.ncbi.nlm.nih.gov/pubmed/19842137

Chinese Herbs– Xiang Fu (Rhizoma Cyperi Rotundi)

Xiang Fu is also known as Nutgrass Galingale Rhizome. The acrid, sweet, slightly bitter and neutral herb has been used in TCM as antibiotic, anti-inflammation, anti-pyretic agent and to lower blood pressure,  inhibit the contraction of uterus, regulates menses, treat ulcers, etc. by enhancing the functions of liver and the triple burner channels.

Ingredients
1. Cyperene
2. β-Scliene
3.  α-Cyperone
4.  β- Cyperene
5.  Patchoulenone
6. Limonene
7. 1,8-Cineol
8. β-Pinene
9. P-Cymene
10. Camphene
11. Etc.

Health Benefits
1. Sedative properties
In the study to to determine scientifically the pharmacological properties of Cyperus rotundus, showed that rhizome of C. articulatus has pharmacological properties similar to those of sedatives. The sedative actions probably explain at least part of the therapeutic efficiency claimed for this plant in traditional medicine(1).
2. Analgesic activity
In the study to observe the analgesic effect and analysis the chemical components of essential oil (EOC) from fresh rhizome of Cyperus rotundus, researchers at the Shanghai Jiao Tong University, found that the essential oil from fresh rhizome of Cyperus rotundus shows structure diversity and good analgesic effect(2).
3. Anti-allergic activity
Sesquiterpenes isolated from the Cyperus rotundus (CRE) strongly inhibited 5-lipoxygenase-catalyzed leukotrienes production. In addition, they inhibited β-hexosaminidase release by antigen-stimulated RBL-2H3 cells, with valencene having the highest inhibitory effect. CRE inhibited leukotrienes production and β-hexosaminidase release at 300 μg/mL. It was also found that the most active sesquiterpene (valencene) and CRE inhibited β-hexosaminidase degranulation by inhibiting the initial activation reaction, Lyn phosphorylation, in IgE-stimulated RBL-2H3 cells, according to the study of the Kangwon National University(3).
4. Hepatoprotective activity
In the study to determine the methanol extract of Cyperus tegetum rhizome (MECT)  for its effect on paracetamol-induced liver damage in Wistar rats, found that MECT had remarkable hepatoprotective effect against paracetamol-induced liver damage in rats(4).
5. Neuroprotective effects
In the study to evaluate the neuroprotective effects of a water extract of Cyperi rhizoma (CRE) against 6-hydroxydopamine (6-OHDA)-induced neuronal damage in an experimental model of PD. In PC12 cells, found that CRE inhibited generation of reactive oxygen species and nitric oxide, reduction of mitochondrial membrane potential, and caspase-3 activity, which were induced by 6-OHDA. CRE also showed a significant protective effect against damage to dopaminergic neurons in primary mesencephalic culture(5).
6. Etc.

Side Effects
1. Do not use the herb in case of blood or Qi deficiency
2. Do not use the herb in case of Yin deficiency
3. Etc.

Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/11163936
(2) http://www.ncbi.nlm.nih.gov/pubmed/22233038
(3) http://www.ncbi.nlm.nih.gov/pubmed/21380805
(4) http://www.ncbi.nlm.nih.gov/pubmed/22754940
(5) http://www.ncbi.nlm.nih.gov/pubmed/20521982

Chinese Herbs – Xiang Ru (Herba Elsholtziae seu Moslae)

Xiang Ru is also known as Nutgrass Galingale Rhizome. The acrid and slightly warm herb has been used in TCM to treat chill and fever, headache with no sweat, stomach ache, vomiting and diarrhea, edema, etc., as it drains the Liver, regulates the Qi and menstruation, calm pain, etc. by enhancing the functions of lung and stomach channels.

Ingredients
1. Acacetin-7-O-β-D- glucoside
2. β-sitosterol
3.  β-sitosterol-3-O-β-D-glucoside
4. Triterpenoids
5. Ursolic acid
6. Tormentic acid
7. α-hydroxyursolic acid
8. 5-hydroxy-6,7-dime- thoxyflavone
9. -dihydroxy-4-me-thoxyflavone
10. 5-hydroxy-7,4- di-methoxyflavanonol
11. Etc.

Health Benefits
1. Anti bacterial effects
Mosla chinensis Maxim. and Pogostemon cablin Benth., and five terpenoids, hinokitiol, thymol, carvacrol, patchoulialcohol and pogostone, showed antibacterial activity. The terpenoids were especially effective against Bacteroides species, according to the study of the Tokyo Dental College(1).
2. Etc.

Side Effects
1. Do not use the herb in case of Yin deficiency with heat
2. Do not use the herb in case of  physical weakness with sweat
3. Etc.
Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/2133438

Thursday, 31 October 2013

Phytochemicals in Foods - 13 Health Benefits of Dithiolthiones (isothiocyanates)

Dithiolthiones are phytochemicals in the class of Organosulfides, found abundantly in cruciferous vegetables, garden sorrel, horseradish, etc.

Health Benefits
1. Anti acetaminophen hepatotoxicity
In the investigation of Anethol dithiolthione (ADT), usually prescribed as a choleretic drug, given orally 1 hour prior to acetaminophen (AAP) (450 mg/kg intraperitoneally) in Swiss female mice, found that ADT exhibited an hepatoprotective potency at doses as low as 10 mg/kg relative to serum aminotransferase activities and hepatic glutathione related enzyme system (glutathione reductase, peroxidase, transferase), according to "Protective effect of anethol dithiolthione against acetaminophen hepatotoxicity in mice" by Warnet JM, Christen MO, Thevenin M, Biard D, Jacqueson A, Claude JR.(1)

2. Chemopreventive efficacy
in the observation of two exposure regimens used to compare the efficacies of early (Regimen-A) versus late (Regimen-B) intervention in prevention of lung tumorigenesis in A/J mice, indicated that Evaluation of lung tumor multiplicity following exposure to oltipraz showed that oltipraz inhibited the tumor development in a dose-dependent manner (10-100 mg/m(3)) with inhibition ranging from 37 to 53% in Regimen A and 51% in Regimen B, when compared with the B[a]P group. Analysis of the tumor incidence showed that 81.5% of the animals had 10 or more tumors in the B[a]P group, whereas, in oltipraz exposure groups, there was a significant decrease in Regimen A (24-36%) and in Regimen B (42%), according to "The chemopreventive efficacy of inhaled oltipraz particulates in the B[a]P-induced A/J mouse lung adenoma model" by Sharma S, Gao P, Steele VE.(2)

3. Detoxication of xenobiotics
In the testing The dithiolthiones, oltipraz, ADT, 116L and 129L, in mice and in rats, oltipraz. Intragastric administration of dithiolthiones (oltipraz, ADT or 116L; two doses each of 1 g/kg body weight) found that Dithiolthiones present in cabbage may play a role in the protective actions of diets high in vegetables against the toxic actions of xenobiotics, according to "Biochemical effects of dithiolthiones' by Ansher SS, Dolan P, Bueding E.(3)

4. Antioxidants
In the examination of the role of glutathione (GSH) in the regulation of this adhesion phenomenon and in the increased tyrosine phosphorylation induced by ROS, found that ADT reduced both PMN adhesion to ROS-stimulated human umbilical vein endothelial cells (HUVEC) and tyrosine phosphorylation of p125FAK and paxillin. ADT increased redox status by increasing intracellular GSH content in oxidized cells. These results show that GSH can reverse the effect of oxidation on tyrosine kinase activation and phosphorylation, and thus plays an important role in cell signaling. They also confirm the antioxidant activity of ADT, according to "Anethole dithiolethione regulates oxidant-induced tyrosine kinase activation in endothelial cells" by Ben-Mahdi MH, Gozin A, Driss F, Andrieu V, Christen MO, Pasquier C.(4)

5. Aflatoxin B1 contamination
In the study of the influence of oltipraz and a second dithiolthione, (1,2) dithiolo (4,3-c)-1,2-dithiole-3,6 dithione (DDD) on bovine hepatic aflatoxin B1 biotransformation, found that Oltipraz inhibited aflatoxin B1 metabolism as no aflatoxin M1 and no aflatoxin B1-dihydrodiol, the second metabolite found in bovine hepatocytes, was formed. DDD did not significantly inhibit aflatoxin B1 metabolism. It could be demonstrated that the inhibition of aflatoxin B1 metabolism was due to the inhibition of several cytochrome P450 enzyme activities by oltipraz. In contrast, DDD inhibited only ethoxyresorufin O-deethylation activity, according to "Inhibition of aflatoxin M1 production by bovine hepatocytes after intervention with oltipraz" by Kuilman ME, Maas RF, Woutersen-van Nijnanten FM, Fink-Gremmels J.(5)

6. Cancer prevention
In the investigation of The critical role of the glutathione S-transferase (GST) and their importance in cancer prevention and susceptibility, clinical studies revealed that the GST activity of blood lymphocytes from individuals with either a personal or family history of colorectal cancer or a personal history of colon polyps was decreased significantly when compared to that of healthy controls. Phase 1 clinical evaluation of oltipraz has demonstrated its ability to induce GST activity as well as the level of transcripts encoding gamma-glutamylcysteine synthetase (gamma-GCS) and DT-diaphorase in the colon mucosa of individuals at increased risk for colorectal cancer. The observed correlation between the posttreatment response in blood lymphocytes and colon mucosa suggested that blood lymphocytes may be used in future trials as a surrogate biomarker of the responsiveness of colon tissue to chemopreventive regimens, according to "Glutathione S-transferases--biomarkers of cancer risk and chemopreventive response" by Clapper ML, Szarka CE.(6)

7. Anti nephrotoxicity
in the determination of s the effects of ADT on hexachloro-1,3-butadiene (HCBD)-induced nephrotoxicity in the rat and the mechanism of its action, found that ADT protects rats against HCBD-induced nephrotoxicity by a mechanism that does not involve the modulation of HCBD conjugation with liver GSH, nor the modulation of the kidney NPSH level and beta-lyase activity. The mechanism of protection conferred to rats by an ADT pretreatment against HCBD-induced nephrotoxicity appears to take place in the kidney at a step beyond the generation of ultimate toxic metabolites derived from PCBC, according to 'Assessment of the role of glutathione conjugation in the protection afforded by anethol dithiolthione against hexachloro-1,3-butadiene-induced nephrotoxicity" by Bouthillier L, Charbonneau M, Brodeur J.(7)

8. Inhibition of platelet aggregation
in the investigation of Anethole dithiolthione (ADT) (10 mumol/l) inhibition of platelet aggregation and the formation of thromboxane (Tx)B2 in plasma in response to adenosine diphosphate (ADP), epinephrine and arachidonic acid (AA), indicated that ADT had no additive effect on the inhibition of thrombin-induced platelet aggregation by acetylsalicylic acid. ADT was a more effective inhibitor of AA-induced platelet aggregation than butylated hydroxytoluene. ADT inhibited the release of 3H-AA from platelet phospholipids in response to ADP and collagen. It is suggested that ADT inhibits platelet aggregation by inhibiting thromboxane synthesis and preventing AA release, according to "Effect of anethole dithiolthione on human platelet aggregation" by Selley ML, McGuiness JA, Bartlett MR, Ardlie NG.(8)

9. Early colon carcinogenesis
in the study of the effect of dietary oltipraz on liver and colonic mucosal enzymes and DNA adducts in evaluating the modulating role of this agent during the early period of azoxymethane (AOM)-induced carcinogenesis, showed that dietary oltipraz enhances the colonic and liver glutathione S-transferase activity and reduced the formation of DNA adducts. In addition, dietary oltipraz modulates liver and colonic ODC and TPK activities that have been shown to play a role in tumor promotion, according to "Effect of oltipraz [5-(2-pyrazinyl)-4-methyl-1,2-dithiol-3-thione] on azoxymethane-induced biochemical changes related to early colon carcinogenesis in male F344 rats" by Rao CV, Nayini J, Reddy BS.(9)

10. Lipid peroxidation
in the observation of the drug anisyldithiolthione (ADT) acted as a good inhibitor of lipid peroxidation induced in rat liver microsomes either chemically by FeSO4 and reducing agents (cysteine or ascorbate) or enzymatically by NADPH and CC14, showed that at doses as low as 5 mg per kg it completely suppressed ethane exhalation by acetaminophen-intoxicated mice and also protected them very efficiently against mortality caused by acetaminophen overdose. The inhibitory effect of ADT toward lipid peroxidation seems to be linked to the presence of its dithiolthione function, according to "A new potent inhibitor of lipid peroxidation in vitro and in vivo, the hepatoprotective drug anisyldithiolthione" by Mansuy D, Sassi A, Dansette PM, Plat M.(10)

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Sources
(1) http://www.ncbi.nlm.nih.gov/pubmed/2780509
(2) http://carcin.oxfordjournals.org/content/27/8/1721.abstract
(3) http://www.ncbi.nlm.nih.gov/pubmed/3744194
(4) http://www.ncbi.nlm.nih.gov/pubmed/11213483
(5) http://www.ncbi.nlm.nih.gov/pubmed/10682385
(6) http://www.ncbi.nlm.nih.gov/pubmed/9679568
(7) http://www.ncbi.nlm.nih.gov/pubmed/8685901
(8) http://www.ncbi.nlm.nih.gov/pubmed/1497692
(9) http://www.ncbi.nlm.nih.gov/pubmed/2020672
(10) http://www.ncbi.nlm.nih.gov/pubmed/3964266