Antibacterial Evaluation of Zirconia Coated with Plasma-Based Graphene Oxide with Photothermal Properties.

The alternative antibacterial treatment photothermal therapy (PTT) significantly affects oral microbiota inactivation. In this work, graphene with photothermal properties was coated on a zirconia surface using atmospheric pressure plasma, and then the antibacterial properties against oral bacteria were evaluated. For the graphene oxide coating on the zirconia specimens, an atmospheric pressure plasma generator (PGS-300, Expantech, Suwon, Republic of Korea) was used, and an Ar/CH4 gas mixture was coated on a zirconia specimen at a power of 240 W and a rate of 10 L/min. In the physiological property test, the surface properties were evaluated by measuring the surface shape of the zirconia specimen coated with graphene oxide, as well as the chemical composition and contact angle of the surface. In the biological experiment, the degree of adhesion of Streptococcus mutans (S. mutans) and Porphyromonas gingivalis (P. gingivalis) was determined by crystal violet assay and live/dead staining. All statistical analyzes were performed using SPSS 21.0 (SPSS Inc., Chicago, IL, USA). The group in which the zirconia specimen coated with graphene oxide was irradiated with near-infrared rays demonstrated a significant reduction in the adhesion of S. mutans and P. gingivalis compared with the group not irradiated. The oral microbiota inactivation was reduced by the photothermal effect on the zirconia coated with graphene oxide, exhibiting photothermal properties.

Assessment of Inhibition of Biofilm Formation on Non-Thermal Plasma-Treated TiO2 Nanotubes.

Peri-implantitis is an inflammatory disease similar to periodontitis, caused by biofilms formed on the surface of dental implants. This inflammation can spread to bone tissues and result in bone loss. Therefore, it is essential to inhibit the formation of biofilms on the surface of dental implants. Thus, this study examined the inhibition of biofilm formation by treating TiO2 nanotubes with heat and plasma. Commercially pure titanium specimens were anodized to form TiO2 nanotubes. Heat treatment was performed at 400 and 600 °C, and atmospheric pressure plasma was applied using a plasma generator (PGS-200, Expantech, Suwon, Republic of Korea). Contact angles, surface roughness, surface structure, crystal structure, and chemical compositions were measured to analyze the surface properties of the specimens. The inhibition of biofilm formation was assessed using two methods. The results of this study showed that the heat treatment of TiO2 nanotubes at 400 °C inhibited the adhesion of Streptococcus mutans (S. mutans), associated with initial biofilm formation, and that heat treatment of TiO2 nanotubes at 600 °C inhibited the adhesion of Porphyromonas gingivalis (P. gingivalis), which causes peri-implantitis. Applying plasma to the TiO2 nanotubes heat-treated at 600 °C inhibited the adhesion of S. mutans and P. gingivalis.

Synthesis of Long Alkyl and Fluoroalkyl Substituted Siloxane Copolymers for the Water Repellency of Rammed Earth Walls.

Rammed earth in a built environment has vapor diffusion characteristics and humidity control abilities, each of which is respectively attributed to the porous structures and the hydrophilic properties. Indeed, these structures and properties allow for the easy absorbance of water particles, hence affecting the durability of a rammed earth wall. This paper presents the water-repellency method for rammed earth walls, which utilizes siloxane copolymers containing fluorine. The water-repellent properties are investigated by measuring the contact angle, water absorption rate, and compressive strength after spray-coating with the synthesized siloxane copolymers on the surface of the rammed earth specimens under study. The water contact angle of the specimen, coated with a siloxane copolymer containing 10 mol.% of a silane monomer with a fluorine group, is about 140°. The water absorption of the specimen obtained after immersing in water for 24 h is low, at about 3.5 wt.%. In addition, the compressive strength remains more than 80% of the corresponding strength of the specimen which is not immersed in water. It is confirmed that the use of a 10% by volume of the siloxane copolymer containing the fluorine group may enhance the water-repellent performance and economic competitiveness.

Antibacterial Effect of Zirconia Nanoparticles on Polyethyl Methacrylate Resin for Provisional Crowns.

Objective: Mid-to-long term use of provisional crowns in the oral cavity is associated with bacterial adhesion and biofilm formation, thus necessitating provisional crowns exhibiting antibacterial properties to prevent the occurrence of gingivitis and periodontal disease. This study aimed to evaluate the antibacterial effect of zirconia nanoparticle-containing polyethyl methacrylate (PEMA) resin for provisional restorations. Methods: Zirconia nanoparticles were added to the monomer of PEMA resin for provisional restorations, and the mixture was stirred for 2 h using a magnetic stirrer. Disk-shaped specimens were prepared by mixing the polymer with the nanoparticle solution. The control group contained pure PEMA resin samples, and the experimental groups Group Z2, Group Z4, and Group Z8 included PEMA resin specimens containing 2, 4, and 8% w/v zirconia nanoparticles, respectively. After analyzing the sample surfaces, the antibacterial effect of the specimens was evaluated using Streptococcus mutans. Statistical analysis was performed using Tukey's test and Mann-Whitney U-test, according to the normality result in the Shapiro-Wilk test. Results: FE-SEM and EDX analyses revealed the successful addition of zirconia nanoparticles. Results showed no significant difference in the measured values for surface roughness and contact angle between the experimental and control groups; however, adhesion and biofilm thickness of S. mutans were significantly decreased in Group Z2, Group Z4, and Group Z8 compared to the control group (P < 0.05, P < 0.01, P < 0.01, respectively). Conclusion: The addition of zirconia nanoparticles can lower the incidence of adhesion and biofilm thickness of S. mutans on PEMA resin used for provisional crowns. Thus, incorporating zirconia nanoparticles in repair materials for provisional crowns and PEMA resin can produce an antibacterial effect and prevent gingivitis, periodontal disease, and dental caries.

Biological Effects of the Novel Mulberry Surface Characterized by Micro/Nanopores and Plasma-Based Graphene Oxide Deposition on Titanium.

PURPOSE: This paper presents a technique for developing a novel surface for dental implants using a combination of nitriding and anodic oxidation, followed by the deposition of graphene oxide using atmospheric plasma. The effects of various surface treatments on bacterial adhesion and osteoblast activation were also evaluated. METHODS: CP titanium (control) was processed into disk-shaped specimens. Nitriding was conducted using vacuum nitriding, followed by anodic oxidation, which was performed in an electrolyte using a DC power supply, to form the novel "mulberry surface." Graphene oxide deposition was performed using atmospheric plasma with an inflow of carbon sources. After analyzing the sample surfaces, antibacterial activity was evaluated using Streptococcus mutans and Porphyromonas gingivalis bacteria. The viability, adhesion, proliferation, and differentiation of osteoblasts were also assessed. Analysis of variance (ANOVA) with Tukey's post-hoc test was used to calculate statistical differences. RESULTS: We observed that the mulberry surface was formed on samples treated with nitriding and anodic oxidation, and these samples exhibited more effective antibacterial activity than the control. We also found that the samples with additional graphene oxide deposition exhibited better biocompatibility, which was validated by osteoblast adhesion, proliferation, and differentiation. CONCLUSION: The development of the mulberry surface along with graphene oxide deposition inhibits bacterial adhesion to the implant and enhances the adhesion, proliferation, and differentiation of osteoblasts. These results indicate that the mulberry surface and graphene oxide deposition together can inhibit peri-implantitis and promote osseointegration.

Direct-Deposited Graphene Oxide on Dental Implants for Antimicrobial Activities and Osteogenesis.

OBJECTIVE: To determine the effects of graphene oxide (GO) deposition (on a zirconia surface) on bacterial adhesion and osteoblast activation. METHODS: An atmospheric pressure plasma generator (PGS-300) was used to coat Ar/CH4 mixed gas onto zirconia specimens (15-mm diameter × 2.5-mm thick disks) at a rate of 10 L/min and 240 V. Zirconia specimens were divided into two groups: uncoated (control; Zr) group and GO-coated (Zr-GO) group. Surface characteristics and element structures of each specimen were evaluated by field emission scanning electron microscope (FE-SEM), X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, and contact angle. Additionally, crystal violet staining was performed to assess the adhesion of Streptococcus mutans. WST-8 and ALP (Alkaline phosphatase) assays were conducted to evaluate MC3T3-E1 osteoblast adhesion, proliferation, and differentiation. Statistical analysis was calculated by the Mann-Whitney U-test. RESULTS: FE-SEM and Raman spectroscopy demonstrated effective GO deposition on the zirconia surface in Zr-GO. The attachment and biofilm formation of S. mutans was significantly reduced in Zr-GO compared with that of Zr (P < 0.05). While no significant differences in cell attachment of MC3T3-1 were observed, both proliferation and differentiation were increased in Zr-GO as compared with that of Zr (P < 0.05). SIGNIFICANCE: GO-coated zirconia inhibited the attachment of S. mutans and stimulated proliferation and differentiation of osteoblasts. Therefore, GO-coated zirconia can prevent peri-implantitis by inhibiting bacterial adhesion. Moreover, its osteogenic ability can increase bone adhesion and success rate of implants.

Effect on Cell Viability with the Passage of Time After Atmospheric Plasma Treatment on Titanium Dioxide Surface.

Various attempts to modify the surface of dental implants have been made in order to improve the adhesion of osteocytes. Plasma treatment on dental implants has been suggested to improve osseointegration. This study examined the effect on cell viability with the passage of time after atmospheric plasma treatment. An atmospheric plasma generator (PGS-200 Plasma generator, Expantech Co., Korea) was used and the gas was mixed with the Ar2(99%)/O2(1%) composition and applied to the specimens. The passage of time was set to 7 immediately after treatment, after 30 minutes of treatment, after 60 minutes of treatment, after 90 minutes of treatment, after 24 hours of treatment, and after 48 hours of treatment. Surface property change with the passage of time after plasma treatment were confirmed by FE-SEM, surface roughness and X-ray photoelectron spectroscopy. Cell viability was evaluated by the WST-8 assay. The data were analyzed statistically using a 1-way ANOVA and Tukey's multiple comparisons test (α = .05). It was confirmed that the chemical composition of the surface changes as the passage of time increases after plasma treatment. The viability of L-929 cells was the highest immediately after plasma treatment, and cell viability decreased with increasing the passage of time. As a result of this study, it was confirmed that passage of time is a very important factor for the plasma treated surface.

Assessment of Inhibition of Biofilm Formation on TiO2 Nanotubes According to Non-Thermal Plasma Treatment Conditions and the Elapsed Time in the Atmosphere.

Periimplantitis is an inflammation similar to periodontitis, and is caused by biofilms formed on the surface of dental implants. Application of plasma on biomaterials has been reported to decrease the initial adhesion of microorganism by causing chemical changes without changing the surface morphology. The purpose of this study is to evaluate the effect of inhibition of biofilm formation on the elapsed time after plasma treatment. Non thermal plasma generator (PGS-200 Plasma generator, Expantech Co., Korea) was applied to the specimens. The elapsed time in the atmosphere was set to 5 immediately after treatment, after 30 minutes of treatment, after 60 minutes of treatment, after 90 minutes of treatment. Surface property change with the elapsed time in the atmosphere after plasma treatment were confirmed by X-ray photoelectron spectroscopy and contact angle. Inhibition of biofilm formation was evaluated by the fluorescent nucleic acid staining. It was confirmed that the chemical composition and bonding state of the surface changes as the elapsed time in the atmosphere increases after plasma treatment. The adhesion of Porphyromonas gingivalis was the lowest immediately after plasma treatment, and increased again with increasing elapsed time in the atmosphere after plasma treatment. As a result of this study, it was confirmed that elapsed time in the atmosphere is a very important factor for inhibition of biofilm formation.

Screening Moringa species focused on development of locally available sustainable nutritional supplements.

BACKGROUND/OBJECTIVES: The leaves of Moringa oleifera (MO) and Moringa stenopetala (MS) commonly grown in Ethiopia possess potential nutritional and medicinal value. The aim of this study was to evaluate the nutritional and functional characteristics of the dried leaf powder from two Moringa species to develop sustainable nutritional supplements for Ethiopians from locally grown plant sources. SUBJECTS/METHODS: Freshly harvested and air-dried MO and MS leaves were authenticated and the nutritional contents, such as protein, ash, lipids, and selected vitamins and minerals, were analyzed using standard analytical procedures. Amino acid compositions were also determined by an amino acid analyzer. Nine-week-old mice were randomly divided into four groups to investigate the anti-obesity effects of Moringa. The first group was fed a basal diet, the second group a high-fat diet, and the others were fed a high-fat diet containing 0.1% Moringa leaf powder from each species. After seven weeks, serum indices related to lipid profiles from each mouse were analyzed. RESULTS: The present study revealed high protein (28-29%) and ash (7-11%) contents. Glutamic acid, aspartic acid, proline, and leucine were the most abundantly found amino acids in both species. The predominant minerals in the leaf powder were calcium (826-1,530 mg/100 g), potassium (794-904 mg/100 g), and magnesium (286-431 mg/100 g). Pyridoxine (475.06 mg/100 g) and vitamin E (34.2 mg/100 g) were found only in MS. Niacin was found only in MO at 32.21 mg/100 g, whereas ascorbic acid was found in both species (3.89 and 6.19 mg/100 g dry weight for MO and MS, respectively). The results of the animal study showed that mice on a high-fat diet containing 0.1% MO leaf powder alleviated the elevation of cholesterol, triglycerides, and low-density lipoprotein cholesterol induced by the high fat diet. MO was more effective than MS in preventing hypercholesterolemia and fat deposition. CONCLUSIONS: The findings in this work confirmed that Moringa leaves of both MO and MS possessed high nutritional value but MO was better at preventing the harmful effects of the high-fat diet than MS.

Nutritional status of Korean elderly with dementia in a long-term care facility in Hongseong.

BACKGROUND/OBJECTIVES: This study investigated nutritional status of the elderly with dementia in a care facility with the aim of improving the meal quality of the facility. SUBJECTS/METHODS: Data were collected from 30 dementia patients aged more than 65 years in a long-term care facility in Hongseong. The data were obtained from questionnaires and medical records. The food intake data was obtained using food photographs and the nutrient intakes were calculated using the CAN-Pro 5.0. The data were compared with the dietary reference intakes for Koreans (KDRIs). The nutrient density, diet quality such as nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ), as well as dietary diversity score (DDS) were evaluated. The data were analyzed using SPSS statistical programs. RESULTS: The average daily energy intakes for men and women were much lower than the estimated energy requirements of the KDRIs. The average intakes of energy and most nutrients in the general diet group were significantly higher than those of the other two groups. Significant differences in diet quality and diet diversity were observed according to the meal type groups. The NARs of some minerals (calcium, iron, and zinc) and vitamins (vitamin B6 and folic acid) were less than 0.5 in all study groups. The NARs of protein, iron and MAR of the general diet group were significantly higher than those of the liquid diet group. The DDS scores of meats, fruits and diary food group were very low in all meal type groups, meaning that the diet qualities of the study subjects were not appropriate in all meal type groups. CONCLUSIONS: The food intakes of the study groups showed some limitations by a direct comparison with KDRIs because of the very low physical activities of the study subjects. The diet quality and diet diversity indices suggest the need for improvements in the nutritional quality in all types of diet. Overall, new intervention strategies targeting facility residents with dementia in Korea are needed as soon as possible.

Nutritional Status and Dietary Management According to Hemodialysis Duration.

As the incidence of chronic diseases such as diabetes and hypertension increases, complications such as decreased renal function are also increasing in many patients. Nutritional management in hemodialysis patients is a very important factor for prognosis and quality of life. The purpose of this study was to investigate the differences in nutritional status and dietary management according to hemodialysis duration. A total of 145 patients were divided into 4 groups according to hemodialysis duration: less 1 year (D1), 1-5 years (D2), and above 5 years (D3). The rates of protein-energy wasting were 31.1% in D1 group, 49.5% in D2 group, and 47.6% in D3 group. However, there was no significant difference between the 3 groups. Nutrient intake analysis showed that protein, iron, and vitamin C were significantly lower in the D3 group than in the D1 group. Protein intake in all 3 groups was insufficient compared to the recommended dietary amount for dialysis patients. The most difficult aspect in dietary management was cooking with low sodium. In the D3 group, which had the longest duration of dialysis, the practice of diet therapy and self-perceived need for nutrition education was lowest. Observations of nutritional status are necessary to maintain the health status of dialysis patients. In addition, education plans should be prepared to mediate the nutrient intakes and identify the patient's difficulties and provide practical help.

The development of a mobile u-Health program and evaluation for self-diet management for diabetic patients.

BACKGROUND/OBJECTIVES: This study aims to develop a mobile nutritional management program for integration into the already developed web-based program, Diabetes Mellitus Dietary Management Guide (DMDMG) for diabetic patients. Further, we aim to evaluate the amended DMDMG program. SUBJECTS/METHODS: The mobile application based on an Android operating system includes three parts: 1) record of diet intake, which allows users to take pictures of the meal and save to later add diet records into DMDMG; 2) an alarm system that rings at each meal time, which reminds users to input the data; 3) displays the diet record and the results of nutrient intake, which can be also viewed through the web program. All three parts are linked to the web-based program. A survey was conducted to evaluate the program in terms of nutrition knowledge, dietary attitude, eating behavior and diet intake by non-equivalent control group design among diabetic patients with 14 DMDMG users and 12 non-user controls after a one-month trial of DMDMG. RESULTS: Non-users did not use the program, but participated in the weekly off-line nutrition classes for one month. The program users showed increased healthful dietary behavior (P < 0.01) and dietary attitude scores (P < 0.05). More DMDMG users had higher nutrition knowledge scores after one-month trial than non-users. However, dietary intake significantly increased in non-user group for calcium and sodium (P < 0.05) while the user group did not show significant changes. CONCLUSIONS: The program has created positive changes in patients' dietary life. All the users were satisfied with the program, although some expressed minor difficulties with an unfamiliar mobile app.

Identification of anthocyanins in black soybean (Glycine max (L.) Merr.) varieties.

Anthocyanin pigments in black soybean (Glycine max (L.) Merr.) varieties as Tawonkong (TW) and Geomjeongkong-2 (G2) were identified to evaluate their potentials as nutritional function, natural colorant or functional foods. Anthocyanin extraction was conducted with acidified methanol with 0.1 M HCl (85:15, v/v). Identification of anthocyanin was conducted by comparison with purified standards by HPLC and mass spectrometry (MS). G2 showed six different types of pigments by HPLC, whereas TW showed seven pigments. Three major anthocyanins (peaks 1, 3, 4) were detected in both varieties and peak 1 was characterized as delphinidin-3-O-ß-D-glucoside, peak 3 as cyanidin-3-O-ß-D-glucoside (C3G), and peak 4 as petunidin-3-O-ß-D-glucoside by comparison of chromatographic properties with authentic standards and MS. Minor peaks 5, 6 and 7 in TW were tentatively identified as pelargonidin-3-O-glucoside, pelargonidin-3-O-(6″-malonylglucoside) and cyanidin on the basis of MS. MS with major ions at 287 and 449 of peak 2 were exactly same as those of peak 3 meaning that peak 2 has cyanidin and other hexose different from glucose. After acid hydrolysis of fractioned peak 2, HPLC showed the hexose as galactose, and peak 2 was identified as C3Glactose. The most abundant anthocyanin in black soybean (Glycine max (L.) Merr.) was C3G and G2 showed the higher amount of total anthocyanins than TW (p < 0.001).

The cultivation of wild food and medicinal plants for improving community livelihood: The case of the Buhozi site, DR Congo.

This study aims to demonstrate the effect of farming technology on introducing medicinal plants (MP) and wild food plants (WFP) into a traditional agricultural system within peri-urban zones. Field investigations and semi-structured focus group interviews conducted in the Buhozi community showed that 27 health and nutrition problems dominated in the community, and could be treated with 86 domestic plant species. The selected domestic MP and WFP species were collected in the broad neighboring areas of the Buhozi site, and introduced to the experimental field of beans and maize crops in Buhozi. Among the 86 plants introduced, 37 species are confirmed as having both medicinal and nutritional properties, 47 species with medicinal, and 2 species with nutritional properties. The field is arranged in a way that living hedges made from Tithonia diversifolia provide bio-fertilizers to the plants growing along the hedges. The harvest of farming crops does not disturb the MP or WFP, and vice-versa. After harvesting the integrated plants, the community could gain about 40 times higher income, than from harvesting farming crops only. This kind of field may be used throughout the year, to provide both natural medicines and foods. It may therefore contribute to increasing small-scale crop producers' livelihood, while promoting biodiversity conservation. This model needs to be deeply documented, for further pharmaceutical and nutritional use.

A Methanol Extract of Adansonia digitata L. Leaves Inhibits Pro-Inflammatory iNOS Possibly via the Inhibition of NF-κB Activation.

This study examined the total polyphenol content of eight wild edible plants from Ethiopia and their effect on NO production in Raw264.7 cells. Owing to its relatively high polyphenol concentration and inhibition of NO production, the methanol extract of Adansonia digitata L. leaf (MEAD) was subjected to detailed evaluation of its antioxidant and anti-inflammatory effects. Antioxidant effects were assessed by measuring free-radical-scavenging activity using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and oxygen-radical-absorbance capacity (ORAC) assays, while anti-inflammatory effects were assessed by measuring inducible nitric oxide synthase (iNOS) expression in lipopolysaccharide (LPS)-stimulated RAW264.7 cells. In the ORAC assay, MEAD was 10.2 times more potent than vitamin C at eliminating peroxyl radicals. In DPPH assay, MEAD also showed a strong ROS scavenging effect. MEAD significantly inhibited iNOS activity (IC50=28.6 µg/ml) of LPS-stimulated Raw264.7 cells. We also investigated the relationship between iNOS expression and nuclear factor kappa B (NF-κB) activation. MEAD inhibited IκBα degradation and NF-κB translocation from the cytosol to the nucleus in LPS-induced RAW264.7 cells without significant cytotoxic effects, as confirmed by MTT assay. These results suggest that MEAD inhibits anti-inflammatory iNOS expression, which might be related to the elimination of peroxyl radicals and thus the inhibition of IκBα-mediated NF-κB signal transduction.

Oral supplementation with NaFeEDTA reduces blood lead in postmenopausal but not premenopausal Korean women with anemia.

OBJECTIVE: The objective was to evaluate the effect of iron supplementation for 6 mo on blood lead (PbB) concentration in populations of premenopausal (PRE-M) and postmenopausal (POST-M) Korean women. METHODS: We conducted a community intervention trial in Asan, Republic of Korea. Of the 137 enrolled women with hemoglobin (Hb) levels lower than 12 g/dL, 37 were PRE-M and 100 were POST-M. Each woman received the equivalent of 9 mg of supplemental iron per day in the form of sodium-iron ethylene-diaminetetra-acetic acid (NaFeEDTA) syrup for a period of 6 mo. RESULTS: The initial PbB concentrations were 2.56 +/- 0.99 microg/dL (mean +/- SD) for the PRE-M women and 3.27 +/- 1.24 microg/dL for the POST-M women. The differences were statistically significant (P < 0.01). After 6 mo of NaFeEDTA supplementation, the PbB concentration decreased in the POST-M group but no change was observed in the PRE-M group. When age and baseline Hb levels were adjusted for, PbB concentrations decreased by 0.10 and 0.31 microg/dL in the PRE-M and POST-M groups, respectively, and the results were significant using a multivariate model (P = 0.016). Iron status determined by zinc protoporphyrin, transferrin saturation, and Hb improved significantly in both groups, but serum ferritin decreased significantly in the POST-M women (P < 0.001), with no change in the PRE-M group. CONCLUSION: After 6 mo of supplementation with the equivalent of 9 mg of iron/d in the form of NaFeEDTA, the PbB concentrations in Korean women with anemia appeared to depend on their menopausal status.

Initial thrombocytopenia as a simple, valuable predictor for clinical manifestation in acute hepatitis A.

OBJECTIVE: Although acute hepatitis A (AH-A) is usually self-limited, the clinical manifestations can vary from mild to severe liver dysfunction. However, little is known about the simple, valuable predictors for clinical manifestation in AH-A. The objective of this study was to identify the simple clinical predictors for severe liver dysfunction and its clinical course. MATERIAL AND METHODS: A total of 162 IgM anti-hepatitis A virus (HAV) positive patients were enrolled in the study. Severe AH-A was defined as a prothrombin time <40% of control activity. Various liver-unrelated and liver-related parameters at presentation were compared separately between the severe AH-A group and the non-severe group. RESULTS: Mean age (+/-SD) was 27.5 (+/-7.1) years and the proportion of males was 54% (88/162). Fourteen patients (8.7%) experienced severe AH-A. Of the liver-unrelated parameters, leukopenia (<4000/microl), thrombocytopenia (<150,000/microl), and high serum C-reactive protein levels (>8 mg/l) at presentation were significant predictors for severe AH-A in a univariate analysis (p<0.05). On multivariate analysis, only thrombocytopenia was an independent predictor for severe AH-A (odds ratio (OR) 5.562, 95% confidence interval (CI) 1.153-26.834, p=0.033). Of the liver-related parameters, there were no independent predictors, as shown by multivariate analysis. The thrombocytopenia group (33%, 54/162) not only had a longer recovery time (28 days (range, 14-140) versus 37 days (20-128), p<0.001), but also more frequent complications (OR 4.632, 95% CI 1.886-11.372, p=0.001) than the non-thrombocytopenia group. CONCLUSIONS: Initial thrombocytopenia may be a simple, valuable predictor for severity and clinical course in AH-A.

Major dietary patterns, ethnicity, and prevalence of type 2 diabetes in rural Hawaii.

OBJECTIVE: The association of type 2 diabetes (T2DM) with the overall dietary pattern and its relation with ethnicity was examined. METHODS: A cross-sectional study with 1257 participants with four ethnicities (Caucasian, Filipino, Native Hawaiian, and Japanese) in the North Kohala region of Hawaii was conducted. Participants 18-95 y of age were surveyed for their ethnic and demographic backgrounds, dietary intakes, and biochemical indexes of glucose intolerance between 1997 and 2000. RESULTS: Three dietary patterns from the food-frequency questionnaire were identified by factor analysis. Factor 1 was characterized by a healthy diet with a frequent intake of vegetables and fruits, and factor 2 was dominated by animal foods and local ethnic dishes. Factor 3 was characterized by a Western diet, which was dominated by French fries, fast-food hamburgers, pizza, and chips. Multivariate logistic regression model for T2DM prevalence included ethnicity and three dietary factors after adjustment for age, sex, income, physical activity, smoking status, and energy intake. Ethnicity was significantly associated with T2DM, with an odds ratio of 1.83 (95% confidence interval [CI] 1.12-3.00) for Native Hawaiians and 1.92 (95% CI 1.12-3.29) for Filipinos compared with Caucasians 1.92 (95% CI 1.12-3.29). Among the three dietary factors, factor 2 was positively associated with T2DM (odds ratio 1.30, 95% CI 1.03-1.68), but the significance disappeared after adjustment for energy intake. CONCLUSION: The findings show that ethnicity is a stronger risk factor for T2DM than dietary patterns when energy intake is adjusted for. Reducing energy intake to prevent T2DM deserves more attention during health promotion for the multiethnic population of Hawaii.

Pre- and post-initiation modulating effects of green tea ingestion on rat hepatocarcinogenesis.

The purpose of this study was to investigate the effects of green tea ingestion on hepatocarcinogenesis before and after its initiation. Male Sprague-Dawley rats were fed an AIN76A diet with or without green tea. Initiation was induced by a single dose (200 mg/kg) of diethylnitrosamine at week 4 and 0.02% (w/w) 2-acetylaminofluorene was supplied in the diets. The control group had free access to water for 13 weeks (CTR13). Tea infusion was provided from the beginning of the experiment for 13 weeks (PRE13) or from the post-initiation stage until week 13 (POST13). Three other groups (CTR24, PRE24 and POST24) were added to examine the longer-term effects (24 weeks) with the same experimental design. The percentage area of liver sections that were positive for hepatic placental glutathione S-transferase (GST-P), which was used as a marker of preneoplastic lesions, was smaller in PRE13 (20.2 +/- 5.0%, mean +/- SD) and POST13 (26.0 +/- 4.8%) than in CTR13 (33.2 +/- 5.8%, p<0.05). Over the longer period, the GST-P lesions were significantly smaller for both PRE24 and POST24 (21.6 +/- 8.5% and 22.2 +/- 4.0%, respectively) than for CTR24 (28.6 +/- 5.1%, p<0.05), but there was no significant difference between PRE24 and POST24. The liver content of thiobarbituric acid reactive substances was significantly lower in the tea groups than in the controls (p<0.05). However, no significant differences were observed among groups of GST activity. The results show that tea consumption exhibits a stronger short-term initiation-inhibiting ability in liver carcinogenesis, but over a longer period, the preventive effects of green tea ingestion do not differ in post- and pre-initiation.

Cross-sectional study on the prevalence of anemia among rural elderly in Asan.

The objective of this study was to assess the prevalence and clinical characteristics of anemia and to define the risk factors for anemia in older Koreans in Asan. From January to February 2002, five hundred sixty two community-dwelling older adults aged over 60 years were selected from a cross sectional study. All subjects underwent laboratory tests, which included a complete blood cell count, reticulocyte, liver and renal functional tests, lipid profiles and iron status tests. The median age was 68.6 years (range, 60-92 years). The mean levels of hemoglobin were 14.4 +/- 1.3 g/dL in men and 12.9 +/- 1.0 g/dL in women, and the overall prevalence of anemia was 12.5% in all subjects, 10.8% in men and 13.6% in women. The prevalence of anemia was the lowest among age group of 60-69 (10.0%) followed by 70-79 (15.5%), and the highest among age over 80 (20.7%), but the difference was significant only for men. The age difference was more distinct in men than in women (p<0.05). The mean hemoglobin level was significantly lower in the subjects aged over 80 y than those in the 60-69 y group (p<0.05). According to a logistic regression analysis, lower albumin and higher creatinine levels were identified as independent risk factors of anemia among older adults in Asan. In conclusion, the overall prevalence of anemia in our study group was 12.5% and the highest (20.7%) among those aged over 80 y.