ABSTRACT
PURPOSE: The aim of this study is to observe glycemic changes after emphasizing the importance of lifestyle modification in patients with mild or moderately uncontrolled type 2 diabetes. MATERIALS AND METHODS: We examined 51 type 2 diabetic patients with 7.0-9.0% hemoglobin A1c (HbA1c) who preferred to change their lifestyle rather than followed the recommendation of medication change. At the enrollment, the study subjects completed questionnaires about diet and exercise. After 3 months, HbA1c levels were determined and questionnaires on the change of lifestyle were accomplished. We divided the study subjects into 3 groups: improved (more than 0.3% decrease of HbA1c), aggravated (more than 0.3% increase of HbA1c) and not changed (-0.3% Subject(s)
Aged
, Female
, Humans
, Male
, Middle Aged
, Blood Glucose
, Diabetes Mellitus, Type 2/drug therapy
, Diet
, Exercise
, Glycated Hemoglobin/metabolism
, Life Style
, Patient Compliance
ABSTRACT
We describe herein a case of life-threatening hypoglycemia due to spurious elevation of glucose concentration during the administration of ascorbic acid in a type 2 diabetic patient. A 31-year-old female was admitted for proliferative diabetic retinopathy treatment and prescribed high dose ascorbic acid. During hospitalization, she suddenly lost her consciousness and her glucose concentration was 291 mg/dL, measured using self-monitoring blood glucose (SMBG) device, while venous blood glucose concentration was 12 mg/dL. After intravenous injection of 50% glucose solution, the patient became alert. We reasoned that glucose measurement by SMBG device was interfered by ascorbic acid. Physicians should be aware of this interference; high dose ascorbic acid may cause spurious elevation of glucose concentration when measuring with SMBG devices.
Subject(s)
Adult , Female , Humans , Ascorbic Acid/administration & dosage , Blood Glucose , Blood Glucose Self-Monitoring/instrumentation , Diabetes Mellitus, Type 2/blood , Hypoglycemia/diagnosis , Renal DialysisABSTRACT
BACKGROUND: We investigated the prevalence of diabetic autonomic neuropathy (DAN) and vestibular dysfunction (VD) in diabetic patients with peripheral neuropathy. METHODS: Thirty-five diabetic patients with peripheral neuropathy were enrolled from August 2008 to July 2009. All subjects underwent autonomic function tests. Nineteen of the patients (54.3%) underwent videonystagmography. RESULTS: Diabetic autonomic neuropathy was observed in 28 patients (80%). A mild degree of autonomic failure was observed in 18 patients (64.3%), and a moderate degree of autonomic failure was observed in ten patients (35.7%). Factors related to DAN included diabetic nephropathy (P=0.032), degree of chronic kidney disease (P=0.003), and duration of diabetes (P=0.044). Vestibular dysfunction was observed in 11 of 19 patients (57.9%). There was no significant association between DAN and VD. CONCLUSION: Diabetic autonomic neuropathy was observed in 28 diabetic patients (80%) with peripheral neuropathy. Vestibular dysfunction was observed in nearly 60% of diabetic patients with peripheral neuropathy who complained of dizziness but showed no significant association with DAN. Diabetic patients who complained of dizziness need to examine both autonomic function and vestibular function.
Subject(s)
Humans , Diabetic Nephropathies , Diabetic Neuropathies , Dizziness , Peripheral Nervous System Diseases , Prevalence , Renal Insufficiency, ChronicABSTRACT
Subject(s)
Bone and Bones , Carbocyanines , Cell Culture Techniques , Coculture Techniques , Collagen , Collagenases , Drug Combinations , Durapatite , Endothelial Cells , Laminin , Lipoproteins , Magnetics , Magnets , Mandible , Mesenchymal Stem Cells , Molar, Third , Nylons , Osteoblasts , Osteogenesis , Perchlorates , Periosteum , ProteoglycansABSTRACT
INTRODUCTION: Skeletal homeostasis is normally maintained by the stability between bone formation by osteoblasts and bone resorption by osteoclasts. However, the correlation between the inflammatory reaction and osteoblastic differentiation of cultured osteoprogenitor cells has not been fully investigated. This study examined the effects of inflammatory cytokines on the osteoblastic differentiation of cultured human periosteal-derived cells. MATERIALS AND METHODS: Periosteal-derived cells were obtained from the mandibular periosteum and introduced into the cell culture. After passage 3, the periosteal-derived cells were further cultured in an osteogenic induction Dulbecco's modified Eagle's medium (DMEM) medium containing dexamethasone, ascorbic acid, and beta-glycerophosphate. In this culture medium, tumor necrosis factor (TNF)-alpha with different concentrations (0.1, 1, and 10 ng/mL) or interleukin (IL)-1beta with different concentrations (0.01, 0.1, and 1 ng/mL) were added. RESULTS: Both TNF-alpha and IL-1beta stimulated alkaline phosphatase (ALP) expression in the periosteal-derived cells. TNF-alpha and IL-1beta increased the level of ALP expression in a dose-dependent manner. Both TNF-alpha and IL-1beta also increased the level of alizarin red S staining in a dose-dependent manner during osteoblastic differentiation of cultured human periosteal-derived cells. CONCLUSION: These results suggest that inflammatory cytokines TNF-alpha and IL-1beta can stimulate the osteoblastic activity of cultured human periosteal-derived cells.
Subject(s)
Humans , Alkaline Phosphatase , Anthraquinones , Ascorbic Acid , Bone Resorption , Cell Culture Techniques , Cytokines , Dexamethasone , Durapatite , Glycerophosphates , Homeostasis , Interleukins , Osteoblasts , Osteoclasts , Osteogenesis , Periosteum , Tumor Necrosis Factor-alphaABSTRACT
Subject(s)
Humans , Collagen , Drug Combinations , Durapatite , Endothelial Cells , Laminin , ProteoglycansABSTRACT
Subject(s)
Adult , Humans , Adipose Tissue , Ascorbic Acid , Bone Development , Bone Marrow , Cell Culture Techniques , Cell Separation , Collagen , Collagenases , Drug Combinations , Durapatite , Endothelial Cells , Epidermal Growth Factor , Flow Cytometry , Heparin , Hydrocortisone , Laminin , Magnetics , Magnets , Mesenchymal Stem Cells , Microspheres , Nylons , Osteoblasts , Osteotomy, Sagittal Split Ramus , Prognathism , Proteoglycans , Skin , Stem Cells , Vascular Endothelial Growth Factor AABSTRACT
Subject(s)
Humans , Alkaline Phosphatase , Ascorbic Acid , Calcium , Cell Culture Techniques , Cell Proliferation , Dexamethasone , Durapatite , Mandible , Molar, Third , Osteoblasts , Osteocalcin , Phenotype , RNA, Messenger , StrontiumABSTRACT
PURPOSE: The development of a microvascularization is important for the homeostasis of normal bone. Vascular endothelial growth factor (VEGF) is one of the most important factors in vessel formation. The purpose of this study was to examine VEGF-related autocrine growth in periostealderived cells. MATERIALS AND METHODS: Periosteal-derived cells were obtained from mandibular periosteums and introduced into the cell culture. After passage 3, the periosteal-derived cells were further cultured for 21 days in an osteogenic inductive culture medium containing dexamethasone, ascorbic acid, and beta-glycerophosphate. RESULTS: The expression of four VEGF isoforms and VEGFRs was observed in periosteal-derived cells. Treatment with cultures with VEGFR-1 and VEGFR-2 Kinase Inhibitor inhibited osteoblastic differentiation and alkaline phosphatase (ALP) activity of periosteal-derived cells. In addition, exogenous VEGF treatment increased calcium content in the periosteal-derived cells. CONCLUSION: These results suggest that VEGF might act as an autocrine growth molecule during osteoblastic differentiation of cultured human periosteal-derived cells.
Subject(s)
Humans , Alkaline Phosphatase , Ascorbic Acid , Calcium , Cell Culture Techniques , Dexamethasone , Durapatite , Glycosaminoglycans , Homeostasis , Osteoblasts , Periosteum , Phosphotransferases , Protein Isoforms , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor Receptor-1 , Vascular Endothelial Growth Factor Receptor-2ABSTRACT
PURPOSE: The development of a microvascularization is important for the homeostasis of normal bone. Vascular endothelial growth factor (VEGF) is one of the most important factors in vessel formation. The purpose of this study was to examine VEGF-related autocrine growth in periostealderived cells. MATERIALS AND METHODS: Periosteal-derived cells were obtained from mandibular periosteums and introduced into the cell culture. After passage 3, the periosteal-derived cells were further cultured for 21 days in an osteogenic inductive culture medium containing dexamethasone, ascorbic acid, and beta-glycerophosphate. RESULTS: The expression of four VEGF isoforms and VEGFRs was observed in periosteal-derived cells. Treatment with cultures with VEGFR-1 and VEGFR-2 Kinase Inhibitor inhibited osteoblastic differentiation and alkaline phosphatase (ALP) activity of periosteal-derived cells. In addition, exogenous VEGF treatment increased calcium content in the periosteal-derived cells. CONCLUSION: These results suggest that VEGF might act as an autocrine growth molecule during osteoblastic differentiation of cultured human periosteal-derived cells.
Subject(s)
Humans , Alkaline Phosphatase , Ascorbic Acid , Calcium , Cell Culture Techniques , Dexamethasone , Durapatite , Glycosaminoglycans , Homeostasis , Osteoblasts , Periosteum , Phosphotransferases , Protein Isoforms , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor Receptor-1 , Vascular Endothelial Growth Factor Receptor-2ABSTRACT
PURPOSE : The purpose of this study was to examine the expression of various angiogenic factors during osteoblastic differentiation of periostealderived cells and the effects of osteogenic inductive medium of periosteal-derived cells on the proliferation of endothelial progenitor cells. MATERIALS AND METHODS : Periosteal-derived cells were obtained from mandibular periosteums and introduced into the cell culture. After passage 3, the cells were divided into two groups and cultured for 21 days. In one group, the cells were cultured in the DMEM supplemented with osteogenic inductive agent, including 50g/ml L-ascorbic acid 2-phosphate, 10 nM dexamethasone and 10 mM -glycerophosphate. In the other group, they were cultured in DMEM supplemented without osteogenic inductive agent. VEGF isoforms, VEGFR-1, VEGFR-2, and neuropilin-1 mRNA expression was observed. Human umbilical cord blood-derived endothelial progenitor cell proliferation was also observed. RESULTS : The expression of VEGF isoforms was higher in osteogenic inductive medium than in non-osteogenic inductive medium. The expression of VEGFR-2 was also higher in osteogenic inductive medium than in non-osteogenic inductive medium. However, the expression of VEGFR-1 and neuropilin-1 was similar in both osteogenic inductive medium and non-osteogenic inductive medium. In addition, conditioned medium from differentiated periosteal-derived cells stimulated human umbilical cord blood-derived endothelial progenitor cell numbers compared to conditioned medium from non-differentiated periosteal-derived cells. CONCLUSION : These results suggest that in vitro osteoblastic differentiation of periosteal-derived cells has angiogenic capacity to support endothelial progenitor cell numbers.
Subject(s)
Humans , Angiogenesis Inducing Agents , Ascorbic Acid , Cell Culture Techniques , Culture Media, Conditioned , Dexamethasone , Durapatite , Neuropilin-1 , Osteoblasts , Periosteum , Protein Isoforms , RNA, Messenger , Stem Cells , Umbilical Cord , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor Receptor-1 , Vascular Endothelial Growth Factor Receptor-2ABSTRACT
Subject(s)
Humans , Bone and Bones , Calcium , Durapatite , Osteoblasts , Osteocalcin , Polyethylenes , Polymers , Polypropylenes , RNA, Messenger , Tissue Engineering , TransplantsABSTRACT
Subject(s)
Humans , Alkaline Phosphatase , Calcium , Cell Culture Techniques , Cell Proliferation , Dexamethasone , Durapatite , Glucocorticoids , Osteoblasts , Osteogenesis , Osteonecrosis , Osteoporosis , Periosteum , PhenotypeABSTRACT
Tropomyosin-related kinase A (TrkA) plays an important role in cell survival, differentiation, and apoptosis in various neuronal and nonneuronal cell types. Here we show that TrkA overexpression by the Tet-On system mimics NGF-mediated activation pathways in the absence of nerve growth factor (NGF) stimulation in U2OS cells. In addition, p53 upregulation upon DNA damage was inhibited by TrkA, and p21 was upregulated by TrkA in a p53-independent manner. TrkA overexpression caused cell death by interrupting cell cycle progression, and TrkA-induced cell death was diminished in the presence of its specific inhibitor GW441756. Interestingly, TrkA-mediated cell death was strongly related to gammaH2AX production and poly (ADP-ribose) polymerase cleavage in the absence of DNA damage inducer. In this study, we also reveal thatgammagammaH2AX production by TrkA is blocked by TrkA kinase inhibitors K-252a and GW441756, and it is also significantly inhibited by JNK inhibitor SP600125. Moreover, reduction of cell viability by TrkA was strongly suppressed by SP600125 treatment, suggesting a critical role of JNK in TrkA-induced cell death. We also found that gammaH2AX and TrkA were colocalized in cytosol in the absence of DNA damage, and the nuclear localization of gammaH2AX induced by DNA damage was partly altered to cytosol by TrkA overexpression. Our results suggest that the abnormal cytosolic accumulation of gammaH2AX is implicated in TrkA-induced cell death in the absence of DNA damage.
Subject(s)
Humans , Anthracenes/pharmacology , Apoptosis/drug effects , Carbazoles/pharmacology , Cell Cycle/drug effects , Cell Line, Tumor , Cyclin-Dependent Kinase Inhibitor p21/biosynthesis , Cytosol/drug effects , DNA Damage/drug effects , Doxorubicin/pharmacology , Histones/metabolism , Indole Alkaloids/pharmacology , MAP Kinase Kinase 4/antagonists & inhibitors , Nerve Growth Factor/antagonists & inhibitors , Phosphorylation/drug effects , Protein Binding , Protein Transport/drug effects , Receptor, trkA/antagonists & inhibitors , Signal Transduction , TransfectionABSTRACT
Subject(s)
Humans , Ascorbic Acid , Bone Development , Bone Marrow , Dexamethasone , Durapatite , Fractures, Bone , Gene Expression , Glycerophosphates , Neuropilin-1 , Osteoblasts , Osteocalcin , Osteogenesis , Phenotype , Protein Isoforms , Receptors, Vascular Endothelial Growth Factor , Stromal Cells , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor Receptor-1 , Vascular Endothelial Growth Factor Receptor-2ABSTRACT
This study was to evaluate the expression of vascular endothelial growth factor receptors (VEGFRs) in tumor and stromal cells of tougue squamous cell carcinoma (SCC). We also wanted to characterize the differences, from the angiogenic aspect, between cancer-associated stromal cells and non-malignant stromal cells. Paraffin-embedded tumor specimens from eleven patients with tongue SCCs were studied. Immunohistochemical staining for VEGFR-1,-2, and -3 was performed on the tumor cells, stromal fibroblasts and tumor-associated macrophages of the specimens. The expression of all 3 receptors was detected in the tumor cells themselves of the biopsy specimens. All 3 receptors were also expressed on stromal cells, except that VEGFR-2 was not expressed in stromal fibroblasts. In radical excision specimens, the staining intensity for VEGFR-1, -2 in the tumor cells and VEGFR-1,-3 in the tumor-associated macrophages was significantly lower than that in the biopsy specimens (P < 0.05). By using the general marker of fibroblast and macrophage, 5B5 and CD68, respectively, we performed double immunofluorescence staining for 5B5 and each VEGFR in the stromal fibroblasts and for CD68 and each VEGFR in the tumor-associated macrophages of the radical excision specimens. We used 4 cases of fibroma and 4 cases of chronic inflammation tissue as the controls. It was found that only each marker was expressed in the control group, however, 5B5/VEGFR-1 and 5B5/VEGFR-3 in the stromal fibroblasts, and CD68/VEGFR-1 and CD68/VEGFR-3 in the tumor-associated macrophages were double stained in the radical excision specimens. Although our study used small number of specimens, the results of our study showed that in tongue SCC, in association with the angiogenesis, the stromal cells showed the activated phenotype and this was different from the nonmalignant stromal cells.
Subject(s)
Humans , Biopsy , Carcinoma, Squamous Cell , Fibroblasts , Fibroma , Fluorescent Antibody Technique , Inflammation , Macrophages , Phenotype , Receptors, Vascular Endothelial Growth Factor , Stromal Cells , Tongue , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factor Receptor-1 , Vascular Endothelial Growth Factor Receptor-2ABSTRACT
Subject(s)
Humans , Young Adult , Alkaline Phosphatase , Ascorbic Acid , Bone Matrix , Dental Papilla , Dental Sac , Dentin , Dexamethasone , Enamel Organ , Mandible , Molar, Third , Osteoblasts , Osteocalcin , RNA, Messenger , Stem Cells , Tooth , Tooth Germ , TrypsinABSTRACT
Subject(s)
Humans , Adult Stem Cells , Alkaline Phosphatase , Angiogenesis Inducing Agents , Ascorbic Acid , Bone Transplantation , Cell Culture Techniques , Dexamethasone , Endothelial Cells , Fractures, Bone , Mandible , Molar, Third , Osteoblasts , Osteocalcin , Osteogenesis , Periosteum , Stem Cells , Vascular Endothelial Growth Factor AABSTRACT
Hyperglycemic hyperosmolar state (HHS) is an acute complication mostly occurring in elderly type 2 diabetes mellitus (DM). Thyrotoxicosis causes dramatic increase of glycogen degradation and/or gluconeogenesis and enhances breakdown of triglyc-erides. Thus, in general, it augments glucose intolerance in diabetic patients. A 23-yr-old female patient with Graves' disease and type 2 DM, complying with methimazole and insulin injection, had symptoms of nausea, polyuria and generalized weakness. Her serum glucose and osmolarity were 32.7 mM/L, and 321 mosm/kg, respectively. Thyroid function tests revealed that she had more aggravated hyperthyroid status; 0.01 mU/L TSH and 2.78 pM/L free T3 (reference range, 0.17-4.05, 0.31-0.62, respectively) than when she was discharged two weeks before (0.12 mU/L TSH and 1.41 pM/L free T3). Being diagnosed as HHS and refractory Graves' hyperthyroidism, she was treated successfully with intravenous fluids, insulin and high doses of methimazole (90 mg daily). Here, we described the case of a woman with Graves' disease and type 2 DM developing to HHS.
Subject(s)
Humans , Female , Adult , Thyroid Function Tests , Methimazole/therapeutic use , Insulin/therapeutic use , Hyperthyroidism/complications , Hyperglycemic Hyperosmolar Nonketotic Coma/etiology , Graves Disease/complications , Fluid Therapy , Diabetes Mellitus, Type 2/complicationsABSTRACT
Rheumatoid arthritis (RA) is a chronic inflammatiory disease that mainly destroys cartilages or bones at the joints. This inflammatory disorder is initiated by self-attack using own immune system, but the detail of pathological mechanism is unclear. Features of autoantigens leading to autoimmune disease are also under veil although several candidates including type II collagen have been suggested to play a role in pathogenesis. In this report, we tried to identify proteins responding to antibodies purified from RA patients and screen proteins up-regulated or down-regulated in RA using proteomic approach. Fibronectin, semaphorin 7A precursor, growth factor binding protein 7 (GRB7), and immunoglobulin mu chain were specifically associated with antibodies isolated from RA synovial fluids. In addition, some metabolic proteins such as adipocyte fatty acid binding protein, galectin-1 and apolipoprotein A1 precursor were overexpressed in RA synovium. Also, expression of peroxiredoxin 2 was up-regulated in RA. On the contrary, expression of vimentin was severely suppressed in RA synoviocytes. Such findings might give some insights into understanding of pathological mechanism in RA.