Water Sorption and Solubility of Flowable Giomers

The objective of this study is the characterization of a novel experimental flowable giomer (G) regarding water sorption, water solubility, and the microstructural characteristics, in comparison to three commercial giomers: Beautifil flow Plus X F00 (B-F00), Beautifil flow F02 (B-F02) and Beautifil flow Plus X F03 (B-F03), Shofu, Kyoto, Japan. Methods: Water sorption/solubility was performed by weighing the specimens before and after water immersion for 1, 2, 3, 14, 21 and 30 days. Data analysis was carried out with the software Origin2019b Graphing & Analysis using the ANOVA test and the Tukey test for post hoc comparison of the groups of materials. The microstructural analyses were done with a scanning electron microscope (SEM) and an atomic force microscope (AFM). The results showed significant differences between the tested materials (p < 0.05). For sorption, the Tukey test indicated differences between all four sample groups, except between B-F02 and B-F03, which exhibited no differences in any of the investigation days. The Tukey test also showed significant differences regarding solubility between all sample groups in the 30-day interval. SEM images and roughness showed that after 30 days of immersion in water, the experimental giomer G had the roughest surface.     

Enhancing Toughness and Reducing Volumetric Shrinkage for Bis-GMA/TEGDMA Resin Systems by Using Hyperbranched Thiol Oligomer HMDI-6SH

In order to improve the toughness and reduce polymerization shrinkage of traditional bisphenol A-glycidyl methacrylate (Bis-GMA)/triethylene glycol dimethacrylate (TEGDMA) based dental resin system, a hyperbranched thiol oligomer (HMDI-6SH) was synthesized via thiol-isocyanate click reaction using pentaerythritol tetra(3-mercaptopropionate (PETA) and dicyclohexylmethane 4,4′-diisocyanate (HMDI) as raw materials. Then HMDI-6SH was mixed with 1,3,5-Triallyl-1,3,5-Triazine-2,4,6(1H,3H,5H)-Trione (TTT) to prepare thiol-ene monomer systems, which were added into Bis-GMA/TEGDMA resins with different mass ratio from 10 wt% to 40 wt% to serve as anti-shrinking and toughening agent. The physicochemical properties of these thiol-ene-methacrylate ternary resins including functional groups conversion, volumetric shrinkage, flexural properties, water sorption, and water solubility were evaluated. The results showed that the incorporation of HMDI/TTT monomer systems into Bis-GMA/TEGDMA based resin could improve C=C double bond conversion from 62.1% to 82.8% and reduced volumetric shrinkage from 8.53% to 4.92%. When the mass fraction of HMDI/TTT monomer systems in the resins was no more than 20 wt%, the flexural strength of the resin was higher or comparable to Bis-GMA/TEGDMA based resins (p > 0.05). The toughness (it was measured from the stress–strain curves of three-point bending test) of the resins was improved. Water sorption and water solubility tests showed that the hydrophobicity of resin was enhanced with increasing the content of thioester moiety in resin.     

Gastrointestinal hemorrhage in the setting of gastrointestinal cancer: Anatomical prevalence,predictors, and interventions

BACKGROUND Gastrointestinal hemorrhage(GIH) is a common complication with gastrointestinal cancers(GIC). There is no comprehensive research that examines GIH in different types of GIC.AIM To study the prevalence, predictors, and interventions of GIH based on the anatomical location of GIC.METHODS This is a retrospective analysis of the 2016-2018 National Inpatient Sample database, the largest inpatient care database in the United States. All adult inpatients(≥ 18-year-old) were included. ICD-10-CM codes were used to identify patients with GIH and GIC. Prevalence of GIH was obtained based on the anatomical location of GIC. Predictors of GIH in the GIC population were studied using multivariate analysis. Interventions including endoscopy were compared to the non-intervention group to determine the differences in inpatient mortality.RESULTS Out of a total of 18173885 inpatients, 321622(1.77%) cases had a diagnosis of GIC.Within GIC patients, 30507(9.5%) inpatients had GIH, which was significantly(P 0.001) more than the prevalence of GIH in patients without GIC(3.4%). The highest to lowest GIH rates are listed in the following order: Stomach cancer(15.7%), liver cancer(13.0%), small bowel cancer(12.7%), esophageal cancer (9.1%), colorectal cancer(9.1%), pancreatic cancer(7.2%), bile duct cancer(6.0%), and gallbladder cancer(5.1%). Within gastric cancer, the GIH rate ranged from 14.8% in cardia cancer to 25.5% in fundus cancer. Within small bowel cancers, duodenal cancers had a higher GIH rate(15.6%) than jejunal(11.1%) and ileal cancers(5.7%). Within esophageal cancers, lower third cancers had higher GIH(10.7%) than the middle third(8.0%) or upper third cancers(6.2%). When studying the predictors of GIH in GIC, socioeconomic factors such as minority race and less favorable insurances(Medicaid and self-pay) were associated with significantly higher GIH on multivariate analysis(P 0.01). Chemotherapy and immunotherapy were also identified to have a lower risk for GIH [odds ratios(OR) = 0.74(0.72-0.77), P 0.001]. Out of 30507 GIC inpatients who also had GIH, 16267(53.3%) underwent an endoscopic procedure, i.e., upper endoscopy or colonoscopy. Inpatient mortality was significantly lower in patients who underwent endoscopy compared to no endoscopy [5.5% vs 14.9%, OR = 0.42(0.38-0.46), P 0.001].CONCLUSION The prevalence of GIH in patients with GIC varies significantly based on the tumor's anatomical location. Endoscopy, which appears to be associated with a substantial reduction in inpatient mortality, should be offered to GIC patients with GIH. Nevertheless, the decision on intervention in the GIC population should be tailored to individual patient's goals of care, the benefit on overall care, and long-term survival.     

Effect of Different Luting Agents on the Retention of Lithium Disilicate Ceramic Crowns

No studies are available that evaluate the retention of disilicate crowns according to different cementation procedures. The purpose of this study was to measure the retention of lithium disilicate crowns cemented using two different cementation systems. Twenty extracted mandibular premolars were prepared. Anatomic crowns were waxed and hot pressed using lithium disilicate ceramic. Teeth were divided into two groups (n = 10): (1) self-curing luting composite and (2) glass-ionomer cement (GIC). After cementation, the crowns were embedded in acrylic resin block with a screw base. Each specimen was pulled along the path of insertion in Universal Testing Machine. Failure load in Newtons (N) and failure mode were recorded for each specimen. Failure mode was classified as decementation or fracture. Failure load data were analyzed using one-way analysis of variance (ANOVA). Failure modes were compared using Pearson’s Chi-square test. Mean failure load was 306.6(±193.8) N for composite group and 94.7(±48.2) N for GIC group (p = 0.004). Disilicate crown cemented with luting composite most often failed by fracture; otherwise, crown cemented with glass-ionomer cement most often failed by decementation (p = 0.02). Disilicate full crown cemented with luting composite showed higher failure load compared with conventional cementation with glass-ionomer cement.     

3D-Printed vs. Heat-Polymerizing and Autopolymerizing Denture Base Acrylic Resins

The aim of this work was to investigate the effect of two post-curing methods on the mechanical properties of a 3D-printed denture base material. Additionally, to compare the mechanical properties of that 3D-printed material with those of conventional autopolymerizing and a heat-cured denture base material. A resin for 3D-printing denture base (Imprimo^®), a heat-polymerizing acrylic resin (Paladon^® 65), and an autopolymerizing acrylic resin (Palapress^®) were investigated. Flexural strength, elastic modulus, fracture toughness, work of fracture, water sorption, and water solubility were evaluated. The 3D-printed test specimens were post-cured using two different units (Imprimo Cure^® and Form Cure^®). The tests were carried out after both dry and 30 days water storage. Data were collected and statistically analyzed. Resin type had a significant effect on the flexural strength, elastic modulus, fracture toughness, and work of fracture (p < 0.001). The flexural strength and elastic modulus for the heat-cured polymer were significantly the highest among all investigated groups regardless of the storage condition (p < 0.001). The fracture toughness and work of fracture of the 3D-printed material were significantly the lowest (p < 0.001). The heat-cured polymer had the lowest significant water solubility (p < 0.001). The post-curing method had an impact on the flexural strength of the investigated 3D-printed denture base material. The flexural strength, elastic modulus, fracture toughness, work of fracture of the 3D-printed material were inferior to those of the heat-cured one. Increased post-curing temperature may enhance the flexural properties of resin monomers used for 3D-printing dental appliances.     

Conformation and anion binding properties of cyclic hexapeptides containing L-4-hydroxyproline and 6-aminopicolinic acid subunits

Two cyclic hexapeptides containing alternating all R and all S configured Ll-(4R/S)-hydroxyproline and 6-aminopicolinic acid subunits are presented, and the influence of the hydroxyl groups on the solubility, conformation, and receptor properties is investigated. Cyclopeptide 2, containing the natural 4R configured hydroxyproline, adopts a conformation similar to that of the unsubstituted peptide 1, which is able to bind anions such as halides and sulfate in aqueous solution. 2 also interacts with these anions, but whereas 1 forms sandwich type 2:1 complexes, in which the anion is bound by two cyclopeptide moieties, 2 forms 1:1 complexes. The stabilities of the halide and sulfate complexes of 2 range between 10(0) and 10(2) M(-1) in 80% D(2)O/CD(3)OD. Complex formation is detectable even in water, but with slightly smaller stability constants. Using this information a quantitative evaluation of the stability of the 2:1 complexes of 1, for which overall stability constants in the order 10(4) to 10(5) M(-2) in 80% D(2)O/CD(3)OD were observed, was made. In contrast to 2, the conformation of 3, containing the non-natural 4S configured hydroxyproline, is strongly affected by the presence of the hydroxyl groups. In d(6)-DMSO and methanol/water mixtures a slow conformational equilibrium between two C(3)-symmetrical conformers is observed, and 3 is thus much less preorganized for anion binding than either 1 or 2.     

Bioactivity of sea grass against the malarial fever mosquito Culex quinquefasciatus

ObjectiveTo identify the larvicidal activity of the seagrass extracts against Culex quinquefasciatus (Cx. quinquefasciatus)MethodsSeagrass extracts, Halodule pinifolia (H. pinifolia), Cymodocea serrulata (C. serrulata) and Thalasia testudinum (T. testudinum) were dissolved in dimethylsulfoxide to prepare a graded series of concentration. Batches of 25 early 4th instars larvae of Cx. quinquefasciatus were transferred to 250 mL enamel bowl containing 199 mL of distilled water and 1 mL of plant extracts (0.01 mg−0.1 mg). After 24 h the mortality rate was identified with the formulae [(% of test mortality − % of control mortality)/(100 − % of control mortality)]×100. Each experiment was conducted with three replicates and a concurrent control group. A control group consisted of 1 mL of dimethylsulfoxide and 199 mL of distilled water only.ResultsThe root extract of H. pinifolia showed maximum larvicidal activity with minimum concentration of extract of LC₅₀ value of (0.614±0.006) μg/mL with lower confidence limit-upper confidence limit value of (0.052–0.072) and LC₉₀ value of 0.9120 μg/mL followed by leaf extract of C. serrulata LC₅₀ value of (0.074±0.008) μg/mL and LC₉₀ value of 0.1487 μg/mL. T. testudinum leaf extract showed LC₅₀ value of (0.082±0.006) μg/mL. The regression equation of root and leaf extract of H. pinifolia for 4 th instar larvae of Cx. quinquefasciatus were Y=5.229+1.36x (R²=0.993) and Y=2.369+1.21x (R²=0.878) respectively and analysis of variation was significant at P<0.05 level. The result of the preliminary phytochemical constituents showed the presence of saponin, steroids, terpenoid, phenols, protein and sugars.ConclusionsFrom the present study the ethanolic extracts of seagrass of H. pinifolia possess lead compound for development of larvicidal activity.     

Distinctive clinical, radiographic, and functional characteristics of patients with sarcoidosis-related pulmonary hypertension

STUDY OBJECTIVE: To differentiate the clinical, radiographic, and physiologic profile in patients with sarcoidosis with and without pulmonary hypertension. DESIGN: Retrospective survey. SETTING: Tertiary care center. PATIENTS: One hundred six patients with sarcoidosis were classified by two-dimensional echocardiography into two groups: group 1, 54 patients with pulmonary hypertension; group 2, 52 patients without pulmonary hypertension. INTERVENTIONS: Patients underwent two-dimensional and Doppler echocardiography, chest radiography (CXR), pulmonary function testing, and arterial oxygen saturation determination, and the test results were compared between the two groups. Statistical analysis was performed using independent-sample t test and chi2 test, as appropriate; p < 0.05 was considered to be significant. RESULTS: Predicted spirometric values and lung diffusing capacity were significantly lower in patients in group 1 compared to patients in group 2: FVC, 54% vs 64% (p = 0.0065), FEV(1), 47% vs 61% (p = 0.0005), forced expiratory flow, midexpiratory phase, 35% vs 52% (p = 0.0363), and single-breath diffusing capacity of the lung for carbon monoxide (D(LCO)sb), 39% vs 54% (p = 0.0001). Sixty percent of patients in group 1 had radiographic Scadding stage 4 sarcoidosis, while no radiographic stage predominated in group 2. Arterial oxygen saturation, need for oxygen supplementation, and degree of desaturation after exercise did not differ between groups. CONCLUSIONS: The presence of pulmonary hypertension in patients with sarcoidosis is associated with higher prevalence of stage 4 sarcoidosis by CXR and lower predicted spirometric and D(LCO)sb measurements.     

Evaluation of the lemongrass plant (Cymbopogon citratus) extracted in different solvents for antioxidant and antibacterial activity against human pathogens

ObjectiveTo test antibacterial and antioxidant activity of the lemongrass plant Cymbopogon citratus (C. citratus) leaves extracted serially by the solvents (chloroform, methanol and water).MethodsThe plant leaves extracts were used for antibacterial activity on Bacillus subtilis, Pseudomonas aeruginosa, Proteus vulgaris, Staphylococcus aureus, Nocardia sp., Serratia sp., and Enterobacter aeruginosa microorganisms by the Kirby Bauer agar disc diffusion method. This study was carried out on lemongrass plant leaf extracts in different concentration of all solvents. The leaf extracts from different solvents were tested for their scavenging activity against the stable free radical DPPH in quantization using a spectrophotometric assay. Oxidative damage was induced in vitro by treating blood DNA and analyzing the effects of the leaf extracts.ResultsThe results showed that C. citratus extracts exhibited maximum zones of inhibition in chloroform, methanol and water extracts. It was Observed that the C. citratus extracts exhibited maximum zone of inhibition against Bacillus subtilis, Pseudomonas aeruginosa and Proteus vulgaris. Analyzed data in the present work suggested that antibacterial activity of C. citratus plant leaf extracts showed good results for Gram-positive and Gram-negative organisms. DPPH scavenging activity was highly elicited by the extract of C. citratus. Chloroform, methanol and water extracts of C. citratus leaves effectively decreased the extent of DNA damage.ConclusionsThe present study suggested that the lemongrass plant extracts could offer various health benefits.     

Therapy after single oral agent failure: adding a second oral agent or an insulin mixture?

AIM: to compare the glycemic response to an insulin lispro mixture (25% insulin lispro and 75% NPL) twice daily plus metformin (Mix25+M) with glibenclamide plus metformin (G+M), in patients with type 2 diabetes inadequately controlled with a single oral agent. METHODS: 597 patients treated in a randomized, open-label, 16-week parallel study. Variables evaluated: hemoglobin A1C (A1C), patient symptoms, hypoglycemia rate (episodes/patient/30 days), and incidence (% patients experiencing > or =1 episode). For a subset of patients (N=120), fasting, 1-h, and 2-h postprandial plasma glucose (FPG, 1-h ppPG, 2-h ppPG) in response to a standardized test meal (STM) and self-monitored blood glucose (BG) profiles were measured. RESULTS: improved A1C at endpoint for both groups, and A1C changes from baseline to endpoint were not significantly different between treatments (Mix25+M, -1.87+/-1.35% vs. G+M, -1.98+/-1.28%; p=0.288). Among patients completing STM; endpoint 2-h ppPG was significantly lower with Mix25+M (9.05+/-3.32 mmol/l vs. 12.31+/-3.65 mmol/l; p<0.001), as was 2-h ppPG excursion (2-h ppPGex)(0.38+/-3.23 mmol/l vs. 2.88+/-1.98 mmol/l; p<0.001). Percentage of patients achieving postprandial BG targets (<10 mmol/l) at endpoint was significantly greater with Mix25+M (80% vs. 48%; p<0.001). Although, overall hypoglycemia rates were similar, percentage of patients experiencing and rate of nocturnal hypoglycemia was less with Mix25+M (1% vs. 5%; p<0.01, and 0.01 vs. 0.08 episodes/pt/30 d; p=0.007). Patients reported less polyuria with Mix25+M (p<0.001). CONCLUSION: in patients with type 2 diabetes failing on metformin or a sulfonylurea, Mix25+M provided similar overall glycemic control, lower ppPG, reduced nocturnal hypoglycemia, and fewer hyperglycemic symptoms compared to G+M.     

Premedication with pronase or N-acetylcysteine improves visibility during gastroendoscopy： An endoscopist-blinded, prospective, randomized study

AIM： To assess the efficacy of premedicaton with pronase or N-acetylcysteine （NAC） at 20 min before upper gastrointestinal （UGI） endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test.
METHODS： A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility （MV） with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility （TMV） score. Identification of Hpylori was performed using CLO test, histology, and serology.
RESULTS： The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water （P 〈 0.001 and P 〈 0.01, respectively）. The group with NAC had a significantly lower TMV score than the group with gascon （P 〈 0.01） and a trend of a lower MV score than the group with gascon water （P = 0.06）. The THV score did not significantly differ between the group with pronase and the group with NAC （P = 0.39 and P = 0.14, respectively）. The sensitivity and specifidty of the CLO test were 92.5% and 93.9%, respectively, in groups premedicated with pronase and NAC together.
CONCLUSION： Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.     

Analysis of antioxidant prenylflavonoids in different parts of Macaranga tanarius,the plant origin of Okinawan propolis

Objective:To analyze the antioxidant prenylilavonoids in different parts of Macaranga tanarius(M.tanarius)(Euphorbiaceae)including the leaf,petiole,stem,leaflet,flower and fruit(only in female plant),and to evaluate their antioxidant properties.Methods:Methanol extracts of each part of M.tanarius were prepared and five prenylilavonoids in them were quantitatively analyzed using HPLC.The fruits from female plant were further separated into seed,pericarp,and glandular trichome.After the quantitative analyses of prenylflavonoids in each part of M.tanarius,antioxidant activity of the extracts was evaluated by 2,2-diphenyl-l-picryI-hydrazyl(DPPH)radical scavenging assay.Results:The leaf of M.tanarius contained two prenylflavonoids as main components in both male and female plants.Both flowers(male and female)contained five kinds of prenylflavonoids.In the petiole,stem and leaflet of both male and female plants,the prenylflavonoids were not delected or their amounts were very low.Five kinds of prenylflavonoids were detected in the seed,pericarp and glandular trichome of female M.tanarius.In particular,the glandular trichome had the highest level of total prenylflavonoids(235 mg/g of fresh plant).DPPH radical scavenging activity of all parts was more than 30%.Conclusions:We found that different parts of M.tanarius contained antioxidant prenylflavonoids.In particular,not only the glandular trichome but also the leaf contained prenylflavonoids,which indicated that M.tanarius may be developed as a functional plant,because the leaves of this plant can be easily collected.     

Faecal pyruvate kinase isoenzyme type M2 for colorectal cancer screening: a meta-analysis

AIM: To present a critical discussion of the efficacy of the faecal pyruvate kinase isoenzyme type M2 (faecal M2-PK) test for colorectal cancer (CRC) screening based on the currently available studies.METHODS: A literature search in PubMed and Embase was conducted using the following search terms: fecal Tumor M2-PK, faecal Tumour M2-PK, fecal M2-PK, faecal M2-PK, fecal pyruvate kinase, faecal pyruvate kinase, pyruvate kinase stool and M2-PK stool.RESULTS: Stool samples from 704 patients with CRC and from 11 412 healthy subjects have been investigated for faecal M2-PK concentrations in seventeen independent studies. The mean faecal M2-PK sensitivity was 80.3%; the specificity was 95.2%. Four studies compared faecal M2-PK head-to-head with guaiac-based faecal occult blood test (gFOBT). Faecal M2-PK demonstrated a sensitivity of 81.1%, whereas the gFOBT detected only 36.9% of the CRCs. Eight independent studies investigated the sensitivity of faecal M2-PK for adenoma (n = 554), with the following sensitivities: adenoma < 1 cm in diameter: 25%; adenoma > 1 cm: 44%; adenoma of unspecified diameter: 51%. In a direct comparison with gFOBT of adenoma > 1 cm in diameter, 47% tested positive with the faecal M2-PK test, whereas the gFOBT detected only 27%.CONCLUSION: We recommend faecal M2-PK as a routine test for CRC screening. Faecal M2-PK closes a gap in clinical practice because it detects bleeding and non-bleeding tumors and adenoma with high sensitivity and specificity.     

Clinical evidence to demonstrate that simultaneous growth of epithelial and fibroblast cells is essential for deep wound healing

Objective

The aim of this study was to evaluate the chronic wound healing properties of tannin rich plant extracts.

Methods

The cell growth stimulating potential of 128 procyanidin rich plant extracts was evaluated in in vitro cell culture models. For clinical trial, a 3% solution of two plant extracts having synergistic effect on cell growth was prepared in glycerol and honey. Placebo test product contained only glycerol and honey. 93 adult patients with one or more lower extremity deep wounds were divided at randomly in two groups. 41 patients in the placebo (AS-22) and 52 in the active treatment (AS-21) groups having respectively 49 and 69 wounds of a mean surface area of 56.70 and 52.03 cm², and volume of 57.22 and 52.15 cm³, were treated by applying the test products topically for a period of 6-weeks.

Results

A statistically significant difference was observed between the placebo and the AS-21 treated groups with respect to reduction in the wound surface area (33.37 vs 97.87%) and wound volume (29.45 vs 94.17%) after 6-weeks of treatment. Mean wound humidity and pain scores were also reduced.

Conclusion

Tannin rich plant extracts are highly interesting for the treatment of chronic wounds.     

Hydrophobically Modified Isosorbide Dimethacrylates as a Bisphenol-A (BPA)-Free Dental Filling Material

A series of bio-based hydrophobically modified isosorbide dimethacrylates, with para-, meta-, and ortho- benzoate aromatic spacers (ISBGBMA), are synthesized, characterized, and evaluated as potential dental restorative resins. The new monomers, isosorbide 2,5-bis(4-glyceryloxybenzoate) dimethacrylate (ISB4GBMA), isosorbide 2,5-bis(3-glyceryloxybenzoate) dimethacrylate (ISB3GBMA), and isosorbide 2,5-bis(2-glyceryloxybenzoate) dimethacrylate (ISB2GBMA), are mixed with triethylene glycol dimethacrylate (TEGDMA) and photopolymerized. The resulting polymers are evaluated for the degree of monomeric conversion, polymerization shrinkage, water sorption, glass transition temperature, and flexural strength. Isosorbide glycerolate dimethacrylate (ISDGMA) is synthesized, and Bisphenol A glycerolate dimethacrylate (BisGMA) is prepared, and both are evaluated as a reference. Poly(ISBGBMA/TEGDMA) series shows lower water sorption (39–44 µg/mm³) over Poly(ISDGMA/TEGDMA) (73 µg/mm³) but higher than Poly(BisGMA/TEGDMA) (26 µg/mm³). Flexural strength is higher for Poly(ISBGBMA/TEGDMA) series (37–45 MPa) over Poly(ISDGMA/TEGDMA) (10 MPa) and less than Poly(BisGMA/TEGDMA) (53 MPa) after immersion in phosphate-buffered saline (DPBS) for 24 h. Poly(ISB2GBMA/TEGDMA) has the highest glass transition temperature at 85 °C, and its monomeric mixture has the lowest viscosity at 0.62 Pa·s, among the (ISBGBMA/TEGDMA) polymers and monomer mixtures. Collectively, this data suggests that the ortho ISBGBMA monomer is a potential bio-based, BPA-free replacement for BisGMA, and could be the focus for future study.     

Decrement of postprandial insulin secretion determines the progressive nature of type-2 diabetes

OBJECTIVE: Type-2 diabetes is a progressive disease. However, little is known about whether decreased fasting or postprandial pancreatic beta-cell responsiveness is more prominent with increased duration of diabetes. The aim of this study was to evaluate the relationship between insulin secretion both during fasting and 2 h postprandial, and the duration of diabetes in type-2 diabetic patients. DESIGN: Cross-sectional clinical investigation. METHODS: We conducted a meal tolerance test in 1466 type-2 diabetic patients and calculated fasting (M0) and postprandial (M1) beta-cell responsiveness. RESULTS: The fasting C-peptide, postprandial C-peptide, M0, and M1 values were lower, but HbA1c values were higher, in patients with diabetes duration > 10 years than those in other groups. There was no difference in the HbA1c levels according to the tertiles of their fasting C-peptide level. However, in a group of patients with highest postprandial C-peptide tertile, the HbA1c values were significantly lower than those in other groups. After adjustment of age, sex, and body mass index (BMI), the duration of diabetes was found to be negatively correlated with fasting C-peptide (gamma = -0.102), postprandial C-peptide (gamma = -0.356), M0 (gamma = -0.263), and M1 (gamma = -0.315; P < 0.01 respectively). After adjustment of age, sex, and BMI, HbA1c was found to be negatively correlated with postprandial C-peptide (gamma = -0.264), M(0) (gamma = -0.379), and M1 (gamma = -0.522), however, positively correlated with fasting C-peptide (gamma = 0.105; P < 0.01 respectively). In stepwise multiple regression analysis, M0, M1, and homeostasis model assessment for insulin resistance (HOMA-IR) emerged as predictors of HbAlc after adjustment for age, sex, and BMI (R2 = 0.272, 0.080, and 0.056 respectively). CONCLUSIONS: With increasing duration of diabetes, the decrease of postprandial insulin secretion is becoming more prominent, and postprandial beta-cell responsiveness may be a more important determinant for glycemic control than fasting beta-cell responsiveness.     

Potassium Complexes of Quercetin-5′-Sulfonic Acid and Neutral O-Donor Ligands: Synthesis,Crystal Structure,Thermal Analysis,Spectroscopic Characterization and Physicochemical Properties

The coordination ability of QSA⁻ ligand towards potassium cations was investigated. Potassium complex of quercetin-5’-sulfonate of the general formula [KQSA(H₂O)₂]_n was obtained. The [KQSA(H₂O)₂] (1) was a starting compound for solvothermal syntheses of acetone (2) and dimethylsulfoxide (3) complexes. For the crystalline complexes 1–3, crystals morphology was analyzed, IR and Raman spectra were registered, as well as thermal analysis for 1 was performed. Moreover, for 1 and 3, molecular structures were established. The potassium cations are coordinated by eight oxygen atoms (KO₈) of a different chemical nature; coordinating groups are sulfonic, hydroxyl, and carbonyl of the QSA⁻ anion, and neutral molecules—water (1) or DMSO (3). The detailed thermal studies of 1 confirmed that water molecules were strongly bonded in the complex structure. Moreover, it was stated that decomposition processes depended on the atmosphere used above 260 °C. The TG–FTIR–MS technique allowed the identification of gaseous products evolving during oxidative decomposition and pyrolysis of the analyzed compound: water vapor, carbon dioxide, sulfur dioxide, carbonyl sulfide, and carbon monoxide. The solubility studies showed that 1 is less soluble in ethanol than quercetin dihydrate in ethanol, acetone, and DMSO. The exception was aqueous solution, in which the complex exhibited significantly enhanced solubility compared to quercetin. Moreover, the great solubility of 1 in DMSO explained the ease of ligand exchange (water for DMSO) in [KQSA(H₂O)₂].     

Belonging to a diabetes patients' association is predictive of better metabolic control

AIM: Diabetes mellitus (DM) management requires the patient's involvement, but it is unknown whether belonging to a patient's association leads to better metabolic control. METHODS: A total of 323 type 1 (T1) and 494 type 2 (T2) outpatient diabetics were analyzed according to whether or not they were members of a diabetes patients' association. RESULTS: T1 members (M; N=138) were older and had longer diabetes durations than non-members (nM; N=185). Both groups had similar BP, kidney function, lipid profile, BMI and socioeducational status. HbA(1c) (means+/-SD) were lower in M than in nM: 8.1+/-1.2% versus 8.4+/-1.4%, respectively; P<0.04. T1M practised more frequent self-monitoring of blood glucose (SMBG). T2M (N=97) were also older and had longer diabetes durations than nM (N=397), and both groups had similar BP, kidney function, BMI and socioeducational status. Although M had lower HOMA beta-cell function (50.6+/-31.5% versus 63.5+/-44.3%; P<0.01), they had a similar HbA(1c) and a better lipid profile. T2M practised more frequent SMBG and were more likely to use insulin. Oral antidiabetic, antihypertensive and dyslipidaemic drug use was also similar, except for a higher use of calcium-channel blockers in T2M. CONCLUSION: Belonging to a patients' organization was associated with better HbA(1c) in T1DM. In T2DM, which progresses relentlessly, similar HbA(1c) levels and better lipid profiles were observed, despite longer known disease durations and lower beta-cell function. These were not explained by gender, clinical, renal, therapeutic or educational parameters, but might reflect more responsibility, empowerment and/or compliance in terms of the condition or its management.     

Antibacterial activity of leaves and inter-nodal callus extracts of Mentha arvensis L

ObjectiveTo determine the anti-bacterial efficacy of chloroform, ethanol, ethyl acetate and water extracts of inter-nodal and leaves derived calli extracts from Mentha arvensis (M. arvensis) against Salmonella typhi(S. typhi), Streptococcus pyogenes(S. pyogenes), Proteus vulgaris(P. vulgaris) and Bacillus subtilis(B. subtilis).MethodsThe inter-nodal and leaves segments of M. arvensis were cut into 0.5-0.7 cm in length and cultured on Murashige and Skoog solid medium supplemented with 3% sucrose, gelled with 0.7% agar and different concentration of 2, 4-Dichlorophenoxyacetie acid (2,4-D) either alone or in combinations. The preliminary phytochemical screening was performed by Brindha et al method. Antibacterial efficacy was performed by disc diffusion method and incubated for 24 h at 37 °C.ResultsMaximum percentage of callus formation (inter-nodal segments 84.3 ± 0.78; leaves segments 93.8 ± 1.27) was obtained on Murashige and Skoog's basal medium supplemented with 3% sucrose and 1.5 mg/L of 2, 4-D. The ethanol extracts of leaves derived calli showed the maximum bio-efficacy than other solvents. The leaves and stem derived calli extracts on Proteus sp. showed that the plants can be used in the treatment of urinary tract infection associated with Proteus sp. Through the bacterial efficacy studies, it is confirmed that the in vitro raised calli tissue was more effective compared to in vivo tissue.ConclusionsThe bio-efficacy study confirmed that the calli mediated tissues showed the maximum zone of inhibition. The present study paved a protocol to establish high potential cell lines by in vitro culture.     

Differential phosphorylation of IRS-1 by insulin and insulin-like growth factor I receptors in Chinese hamster ovary cells

This study was conducted to evaluate the responsiveness of human nonpregnant myometrium to endothelin 1 (ET1) (10(-10) M-10(-6 )M) and KCl (80 mM) in relation to the hormonal profile of the women, who were allocated into three groups: group 1, premenopausal follicular phase, n=14, group 2, premenopausal luteal phase, n=20, and group 3, postmenopausal women, n=12. At a concentration of 10(-6 )M, ET1 in both groups 1 and 2 induced very low ripples of high frequency (group 1: 80+/-14%, n=5, group 2: 314+/-63%, n=11; P<0.05 compared with the pretreatment frequency) which lasted significantly longer in group 2 (29+/-2 min, n=10, P<0.05) than in group 1 (20+/-2 min, n=5), increasing the basal tone (group 1: 57.9+/-6%, n=5, group 2: 64.4+/-4%, n=6), the amplitude of myometrial contractility (group 1: 1.2+/-0.07 g, n=5, group 2: 1.6+/-0.1 g, n=7, P<0.05) and the area under the contractility curve (AUC; group 1: 8.4+/-1.1 gxmin, n=6, group 2: 11.9+/-1.6 g x min, n=11). In group 3, ET1 (10(-6 )M) created a sustained long-lasting contraction (initial phase: 43+/-6 min, n=6) characterized by the complete obliteration of spontaneous contractility with no ripples at all, and increasing significantly (P<0.05) the amplitude of myometrial contractility (2.8+/-0.5 g, n=6), the AUC (24.7+/-3.3 g x min, n=6), as well as the basal tone (183.6+/-21%, n=6) compared with the two premenopausal groups. In all three groups KCl exposure induced an initial rise (mean amplitude value: 1.1 g) followed by a relaxation phase to the primal baseline level (mean duration value: 12 min). Addition of ET1 (10(-6 )M) to KCl (80 mM) induced a similar pattern of contractility to that evoked by ET1 alone which, compared with KCl alone lasted significantly longer (P<0.05) in all three groups (group 1: 20+/-2 min, n=6; group 2: 23+/-2 min, n=6; group 3: 35+/-3 min, n=5). In group 3, the percentage change in basal tone was significantly smaller following KCl than after the combination of KCl plus ET1 (149+/-16%, n=5; P<0.01), indicating a different mechanism of contractility between KCl and ET1. These results demonstrate for the first time differences in myometrial response to ET1 between pre- and postmenopausal women. It is suggested that KCl and ET1 affect uterine contractility through different mechanisms and that ovarian steroids may play a regulatory role in human uterine responsiveness to ET1.