Psychoactive Plant Database - Neuroactive Phytochemical Collection

1. Medicine (Baltimore). 2024 Oct 4;103(40):e39508. doi: 
10.1097/MD.0000000000039508.

Symmetrical peripheral gangrene caused by urosepsis: Case reports and literature 
review.

Chen Y(1), Liu K(2), Xu X(1), Wu G(1), Zhu L(1), Zha J(1), Cheng C(1).

Author information:
(1)Department of Critical Care Medicine, Anqing Municipal Hospital, Anqing City, 
Anhui Provinces, China.
(2)Department of Cardiovascular, Anqing Municipal Hospital, Anqing City, Anhui 
Provinces, China.

RATIONALE: Symmetrical peripheral gangrene (SPG) is a serious and rare 
complication in patients with urosepsis, characterized by distal limb symmetry 
impairment.
PATIENT CONCERNS: In this study, 3 cases of SPG caused by urosepsis were 
reported, and the Chinese and English literature on SPG caused by urosepsis was 
reviewed. The demographic, clinicopathological, treatment, and follow-up data of 
the patients were summarized and analyzed.
DIAGNOSIS: SPG was diagnosed with clinical symptoms.
INTERVENTIONS: We conducted urological invasive surgery, administered 
anti-infective therapy, implemented fluid resuscitation and blood product 
transfusion, provided mechanical ventilation support, optimized myocardial 
contractility, administered heparin and B vitamins, utilized papaverine for 
vasodilation, performed hemodialysis and plasma exchange, peripheral skin 
warming along with other treatment modalities.
OUTCOMES: Two patients died and 1 patient underwent autoamputation.
LESSONS: Our cases and literature review demonstrate that timely and accurate 
diagnosis, effective infection control, correction of hypoperfusion, organ 
function support, early management of disseminated intravascular coagulation, 
avoidance of premature amputation, and multidisciplinary comprehensive treatment 
are crucial for the successful treatment of SPG caused by urosepsis.

Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

DOI: 10.1097/MD.0000000000039508
PMCID: PMC11460895
PMID: 39465777 [Indexed for MEDLINE]

Conflict of interest statement: The authors have no funding and conflicts of 
interest to disclose.


2. BMC Musculoskelet Disord. 2024 Oct 23;25(1):840. doi: 
10.1186/s12891-024-07972-3.

Is the phoenix sign phenomenon due to vasodilation? A double-blinded, randomized 
controlled trial comparing motor function recovery after diagnostic common 
fibular nerve block with lidocaine and papaverine.

Barrett SL(1), Boyd B(#)(2), DuCasse S(#)(2), Nassier W(#)(2), Mitchell N(#)(2), 
Nagra AP(#)(2), Dalmau-Pastor M(#)(3)(4), Yamasaki DS(#)(5), Nickerson S(#)(6).

Author information:
(1)Neuropathy Centers, Marietta, GA, USA. slbarrettpod@me.com.
(2)Neuropathy Centers, Marietta, GA, USA.
(3)Human Anatomy and Embryology Unit, Department of Pathology and Experimental 
Therapeutics, School of Medicine and Health Sciences, University of Barcelona, 
Barcelona, Spain.
(4)MIFAS by GRECMIP (Minimally Invasive Foot and Ankle Society), Merignac, 
France.
(5)Enso Medical Technologies Inc, St. Augustine, FL, USA.
(6)NE Wyoming Wound Care Clinic, Sheridan, WY, USA.
(#)Contributed equally

BACKGROUND: Focal entrapment of the common fibular (peroneal) nerve (CFN) is the 
most common nerve entrapment in the lower extremity. Accurate diagnosis can be 
difficult due to co-existent pathology such as low back pathology. A 1% 
lidocaine block of CFN is often used to confirm the local entrapment pathology 
and demonstrate possibility of pain relief. A surprising, unexpected and 
temporary strengthening of CFN supplied ankle and foot muscles is occasionally 
produced, termed the Phoenix sign. Aetiology of this phenomenon has been 
puzzling, but restoration of neural circulation and nutrition via improved local 
blood flow has been postulated to be responsible.
METHODS: This is a double-blinded, randomized, prospective controlled trial of 
20 patients, comparing 2 vasodilating agents and their ability to produce the 
Phoenix effect. Ultrasound guided infiltration of 0.3 mL 1% lidocaine or 
papaverine HCl 10 mg/mL was executed adjacent to CFN. Motor strength pre- 
infiltration and 4 min post-infiltration were measured for anterior compartment 
muscles utilizing MRC manual motor testing reported on a 0-5 scale. The extensor 
hallucis longus (EHL) muscle proved to be the most significant.
RESULTS: Average motor strength of the EHL improved from 2.2 (+/-0.40) to 4.9 
(+/-0.32).) in the lidocaine group. In the papaverine group, pre-infiltration 
EHL motor strength averaging 2.1 (+/-0.93) improved to 4.4 (+/- 1.01) 
post-infiltration. Papaverine and lidocaine produced similar statistically 
significant increases in muscle strength (p = < 0.05).
CONCLUSION: There was no difference between small local infiltrations of 
lidocaine or papaverine in production of increased anterior compartment EHL 
motor strength. It is most likely that the Phoenix Effect is explained by 
temporary local improvements in the microcirculation of the CFN vasa nervorum.
TRIAL REGISTRATION: NCT06637046 10/10/2024 Retrospectively registered.

© 2024. The Author(s).

DOI: 10.1186/s12891-024-07972-3
PMCID: PMC11520154
PMID: 39443927 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no competing interests.


3. J Trauma Inj. 2024 Sep;37(3):182-191. doi: 10.20408/jti.2022.0041. Epub 2023
May  19.

Experience of vascular injuries at a military hospital in Korea.

Kim D(1), Nam S(1), Lee YH(1), Lee H(1), Kim HC(2).

Author information:
(1)Division of Trauma Surgery, Department of Surgery, Armed Forces Capital 
Hospital, Seongnam, Korea.
(2)Division of Vascular Surgery, Department of Surgery, Armed Forces Capital 
Hospital, Seongnam, Korea.

PURPOSE: Vascular injuries require immediate surgical treatment with standard 
vascular techniques. We aimed to identify pitfalls in vascular surgery for 
trauma team optimization and to suggest recommendations for trauma and vascular 
surgeons.
METHODS: We reviewed 28 victims and analyzed the patterns of injuries, methods 
of repair, and outcomes.
RESULTS: Ten patients had torso injuries, among whom three thoracic aorta 
injuries were repaired with thoracic endovascular aortic repair, one left 
hepatic artery pseudoaneurysm with embolization, and two inferior vena cava with 
venorrhaphy, three iliac arteries with patch angioplasty or embolization, and 
three common femoral arteries with bypass surgery or arterioplasty. Four 
patients had upper extremity injuries, among whom one brachial artery and vein 
was repaired with bypass surgery after temporary intravascular shunt perfusion, 
two radial arteries were repaired with anastomoses, and one ulnar artery was 
repaired with ligation. One radial artery under tension was occluded. Fourteen 
patients had lower extremity injuries, among whom one superficial femoral artery 
and vein was repaired with bypass and concomitant ligation of the deep femoral 
artery and vein, three superficial femoral arteries were repaired with bypass 
(two concomitant femoral veins with bypass or anastomosis), one deep femoral 
artery with embolization, two popliteal arteries with bypass or anastomosis, 
four infrapopliteal transected arteries, one arteriovenous fistula with 
ligation, and one pseudoaneurysm with bypass. However, one superficial femoral 
artery and all femoral veins were occluded. One leg replantation failed.
CONCLUSIONS: There are potential complications of vascular access during 
resuscitative endovascular balloon occlusion of the aorta procedures. Vascular 
repair should be performed without tension or spasm. Preservation of the 
harvested vein in papaverine solution and blood while using a temporary 
intravascular shunt is a method of eliminating spasms.

DOI: 10.20408/jti.2022.0041
PMCID: PMC11495894
PMID: 39428727

Conflict of interest statement: Conflicts of interest The authors have no 
conflicts of interest to declare.


4. J Craniofac Surg. 2024 Oct 7. doi: 10.1097/SCS.0000000000010748. Online ahead
of  print.

Effects of Papaverine on Experimentally Induced Myringosclerosis.

Durna YM(1), Edizer DT(2), Yigit O(3), Yasak AG(3), Kelten Talu EC(4).

Author information:
(1)Ear Nose and Throat Specialist, Private Practice.
(2)Department of Otorhinolaryngology, School of Medicine, Acibadem University.
(3)Department of Ear, Nose and Throat Diseases, Istanbul Sisli Hamidiye Etfal 
Research and Training Hospital, Istanbul.
(4)Department of Medical Pathology, İzmir Faculty of Medicine, University of 
Health Sciences Turkey, İzmir, Türkiye.

OBJECTIVE: This study aims to investigate the effects of papaverine on 
experimentally induced myringosclerosis (MS). MS is characterized by hyaline 
degeneration and calcification of the lamina propria of the tympanic membrane 
and can adversely affect hearing function if left untreated. The study examined 
the potential effects of both systemic and topical applications of papaverine on 
this process.
MATERIALS AND METHODS: In the study, 20 Wistar albino rats were used. The rats 
were divided into 4 groups and different treatment methods were applied in each 
group. In group 1, myringotomy was performed, but no additional intervention was 
performed. In group 2, saline-impregnated gelfoam was applied after myringotomy. 
In groups 3 and 4, topical and systemic applications of papaverine hydrochloride 
were performed. Tympanic membranes were examined under a microscope after 21 
days, and the severity of MS and histopathologic changes were evaluated.
RESULTS: The papaverine-treated groups observed a significant increase in 
otomicroscopic sclerosis, the degree of inflammation, and tympanic membrane 
thickness. The degree of fibrosis was higher in group 3 compared with the other 
groups. The results showed that papaverine administration increased the 
occurrence of MS.
CONCLUSION: This study suggests that papaverine may increase MS through its 
vasodilating effect. Vasodilation is thought to cause an increase in 
oxygen-derived free radicals, which may contribute to the pathogenesis of MS. 
The results suggest that the effects of papaverine on MS should be carefully 
evaluated.

Copyright © 2024 by Mutaz B. Habal, MD.

DOI: 10.1097/SCS.0000000000010748
PMID: 39374410

Conflict of interest statement: The authors report no conflicts of interest.


5. Sci Rep. 2024 Sep 30;14(1):22747. doi: 10.1038/s41598-024-71344-z.

Novel endophytic fungal species Pithoascus kurdistanensis producing morphine 
compounds.

Mohammadi S(1)(2), Bahramnejad B(3), Abdollahzadeh J(4), Bashiri S(5), Vincent 
AT(1)(6), Majdi M(2), Soltani J(7), Levesque RC(8).

Author information:
(1)Institut de Biologie Intégrative et des Systèmes, Université Laval Québec, 
Québec, Canada.
(2)Department of Plant Production and Genetics, Faculty of Agriculture, 
University of Kurdistan, Sanandaj, Iran.
(3)Department of Plant Production and Genetics, Faculty of Agriculture, 
University of Kurdistan, Sanandaj, Iran. b.bahramnejad@uok.ac.ir.
(4)Department of Plant Protection, Faculty of Agriculture, University of 
Kurdistan, Sanandaj, Iran. j.abdollahzadeh@uok.ac.ir.
(5)Department of Plant Protection, Faculty of Agriculture, University of 
Kurdistan, Sanandaj, Iran.
(6)Département des Sciences Animales, Faculté dxes Sciences de l'agriculture et 
de l'alimentation, Université Laval Québec, Québec, Canada.
(7)Department of Plant Protection, Faculty of Agriculture, Bu-Ali Sina 
University, Hamadan, Iran.
(8)Institut de Biologie Intégrative et des Systèmes, Université Laval Québec, 
Québec, Canada. rclevesq@ibis.ulaval.ca.

Papaver genus, commonly known as popies, is a valuable source of alkaloids used 
in medicine, including papaverine, morphine, codeine, and thebaine. We isolated 
six endophytic fungal isolates producing morphinan alkaloids from four Papaver 
species growing in Kurdistan Province, Iran. To do this, a 1:1 mixture of 
methanol and chloroform was used to extract fungal cultures. The contents of 
morphinan alkaloids in the extracts were subsequently determined using phase 
high-performance liquid chromatography. Among the morphinan alkaloid-producing 
fungal isolates, IRAN 4653C had the highest yield giving 23.06 (mg/g) morphine 
and 2.03 (mg/g) codeine when grown in potato dextrose liquid medium. The 
identity of this isolate was examined and recognized as a new fungal species 
named as Pithoascus kurdistanesis sp. nov. based on multi-gene phylogenetic 
analyses of ITS, TEF-1α, and TUB2 sequences data and morphological features. The 
morphinan-producing endophytic fungus and the isolated Pithoascus species from 
Papaver are being reported for the first time. Accordingly, this fungus shows 
promise as a new source of valuable compounds which is illustrated and 
introduced here as a new Microascaceae member belonging to Pithoascus from 
Kurdistan Province, Iran. Moreover, the morphinan productivity of P. 
kurdistanesis was further validated by gas chromatography-mass spectrometry 
(GC-MS).

© 2024. The Author(s).

DOI: 10.1038/s41598-024-71344-z
PMCID: PMC11442975
PMID: 39349517 [Indexed for MEDLINE]

Conflict of interest statement: The authors declare no competing interests.