Therapeutic Interventions for Diabetes Mellitus-Associated Complications

BACKGROUND

Diabetes Mellitus (DM) is an alarming health concern, affecting approximately 537 million people worldwide. As a leading cause of morbidity and mortality, DM demands a comprehensive understanding of its diverse pathophysiological mechanisms and disease progression.

METHODS

This traditional review has consolidated literature on the pathogenesis of hyperglycemia, its progression into complications, and advances in optimal treatment strategies. The literature in the last two decades has been reviewed using several keywords, including "diabetes," "diabetes-associated complications", "novel therapeutic interventions for diabetes-associated diseases", "phyto-extracts as antidiabetic drugs", etc. in prominent databases, such as PubMed, Scopus, Google Scholar, Web of Science, and ClinicalTrials.gov.

RESULTS

We have discussed macrovascular and microvascular complications, such as atherosclerosis, cardiovascular disease, Peripheral Arterial Disease (PAD), stroke, diabetic nephropathy, retinopathy, and neuropathy, as well as various pharmacological and non-pharmacological interventions that are currently available for the management of DM. We have also focused on the potential of natural products in targeting molecular mechanisms involved in carbohydrate metabolism, insulin production, repair of pancreatic cells, and reduction of oxidative stress, thereby contributing to their antidiabetic activity. Additionally, novel therapeutic approaches, like genetic, stem cell, and immunomodulatory therapies, have been explored. We have also discussed the benefits and limitations of each intervention, emerging research and technologies, and precision medicine interventions.

CONCLUSION

This review has emphasized the need for an improved understanding of these advancements, which is essential to enhance clinicians' ability to identify the most effective therapeutic interventions.

Scirpusin B isolated from Passiflora edulis Var. flavicarpa attenuates carbohydrate digestive enzymes, pathogenic bacteria and oral squamous cell carcinoma

Passiflora edulis Var. flavicarpa (passion fruit) generates vast waste (60-70%) in the form of peel and seed after the juice extraction. The study aimed to isolate Scirpusin B (SB) from passion fruit (PF) seed waste collected from Northeast India and to analyse its anti-radical, antibacterial, anti-diabetic, and anti-oral cancer activities. Scirpusin B was isolated following hydro-alcoholic extraction, fractionation, and column chromatography. The isolated fraction was further identified through NMR and mass spectroscopy. SB exhibited significant antiradical activity against six standard antioxidant compounds, indicating its commercial application. SB inhibited α-amylase (IC50 Value: 76.38 ± 0.25 µg/mL) and α-glucosidase digestive enzymes (IC50 Value: 2.32 ± 0.04 µg/mL), signifying its antidiabetic properties. In addition, SB showed profound antibacterial activity against eight gram-positive and gram-negative bacteria reported for the first time. Furthermore, SB inhibited SAS and TTN oral cancer cell proliferation up to 95% and 83%, respectively. SB significantly inhibited colonies of SAS and TTn cells in the clonogenic assay, attributing to its anticancer properties. The PI-FACS assay confirmed the ability of SB (75 µM) to kill SAS and TTn cells by 40.26 and 44.3% in 72 h. The mechanism of SB inhibiting oral cancer cell proliferation was understood through western blot analysis, where SB significantly suppressed different cancer hallmark proteins, such as TNF-α, survivin, COX-2, cyclin D1, and VEGF-A. The present study suggests that SB isolated from PF seed can add noteworthy value to the waste biomass for various industrial and medical applications.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13205-023-03876-6.

Role of pinch in Argon impurity transport in ohmic discharges of Aditya-U Tokamak

We present experimental results of the trace argon impurity puffing in the ohmic plasmas of Aditya-U tokamak performed to study the argon transport behaviour. Argon line emissions in visible and Vacuum Ultra Violet (VUV) spectral ranges arising from the plasma edge and core respectively are measured simultaneously. During the experiments, space resolved brightness profile of Ar1+ line emissions at 472.69 nm (3p44s 2P3/2-3p44p 2D3/2), 473.59 nm (3p44s 4P5/2-3p44p 4P3/2), 476.49 nm (3p44s 2P1/2-3p44p 2P3/2), 480.60 nm (3p44s 4P5/2-3p44p 4P5/2) are recorded using a high resolution visible spectrometer. Also, a VUV spectrometer has been used to simultaneously observe Ar13+ line emission at 18.79 nm (2s22p 2P3/2-2s2p2 2P3/2) and Ar14+ line emission at 22.11 nm (2s2 1S0-2s2p 1P1). The diffusivity and convective velocity of Ar are obtained by comparing the measured radial emissivity profile of Ar1+ emission and the line intensity ratio of Ar13+ and Ar14+ ions, with those simulated using the impurity transport code, STRAHL. Argon diffusivities ~ 12 m2/s and ~ 0.3 m2/s have been observed in the edge (ρ > 0.85) and core region of the Aditya-U, respectively. The diffusivity values both in the edge and core region are found to be higher than the neo-classical values suggesting that the argon impurity transport is mainly anomalous in the Aditya-U tokamak. Also, an inward pinch of ~ 10 m/s mainly driven by Ware pinch is required to match the measured and simulated data. The measured peaked profile of Ar density suggests impurity accumulation in these discharges.

Enhanced etching characteristics of Si{100} in NaOH-based two-component solution

Silicon wet bulk micromachining is the most widely used technique for the fabrication of diverse microstructures such as cantilevers, cavities, etc. in laboratory as well as in industry for micro-electromechanical system (MEMS) application. Although, increasing the throughput remains inevitable, and can be done by increasing the etching rate. Furthermore, freestanding structure release time can be reduced by the improved undercutting rate at convex corners. In this work, we have investigated the etching characteristics of a non-conventional etchant in the form of hydroxylamine (NH2OH) added sodium hydroxide (NaOH) solution. This research is focused on Si{100} wafer as this orientation is largely used in the fabrication of planer devices (e.g., complementary metal-oxide semiconductors) and microelectromechanical systems (e.g., inertial sensors). We have performed a systematic and parametric analysis without and with 12% NH2OH in 10 M NaOH for improved etching characteristics such as etch rate, undercutting at convex corners, and etched surface morphology. 3D scanning laser microscope is used to measure average surface roughness (Ra), etch depth (d), and undercutting length (l). Morphology of the etched Si{100} surface is examined using optical and scanning electron microscopes. The addition of NH2OH in NaOH solution remarkably exhibited a two-fold increment in the etching rate of a Si{100} surface. Furthermore, the addition of NH2OH significantly improves the etched surface morphology and undercutting at convex corners. Undercutting at convex corners is highly prudent for the quick release of microstructures from the substrate. In addition, we have studied the effect of etchant age on etching characteristics. Results presented in this article are of large significance for engineering applications in both academic and industrial laboratories.

Initial results from time-resolved LaBr based hard x-ray spectrometer for ADITYA-U tokamak

Runaway electrons (REs) are passively studied by hard x-ray (HX) emissions generated by REs. A LaBr₃(Ce) detector-based HX spectroscopic diagnostic (operational within ∼75 keV to 3.5 MeV) has been set up on the ADITYA-U. The diagnostic acquisition software utility is upgraded to obtain the temporal evolution of the HX spectrum to understand the RE energy distribution in plasma during its various phases. The peak position moves to lower energy for Ohmically heated discharges (200-80 keV), indicating a relative increase in the thermal particle content in the plasma. The peak position of RE energy shows a decreasing tendency with increasing n_e with Ne gas puffing and termination of the electron cyclotron resonance pulse.

Dietary and bioactive properties of the berries and leaves from the underutilized Hippophae salicifolia D. Don grown in Northeast India

The physico-chemical, polyphenols, antioxidant and antibacterial properties of berries and mixture of male and female leaves of Hippophae salicifolia were investigated. The mineral, vitamin C, sugar, total protein, and total tannin contents of the berries and the leaves were evaluated. Further, the extracts of berries and mixture of leaves samples obtained by successive solvent extraction were investigated for their polyphenols, antioxidant and antibacterial properties. Total phenolic content was highest in leaves-methanol extract (157.97 ± 2.09 mg GAE/g) followed by berries-aqueous extract (48.45 ± 1.94 mg GAE/g), while total flavonoid was predominant in leaves-acetone extract (75.64 ± 3.21 mg QE/g) and berries-methanol extract (28.93 ± 2.08 mg QE/g). Gallic acid, caffeic acid, and rutin were the major polyphenols confirmed by HPLC analysis. Berries-aqueous and leaves-methanol extracts showed excellent global antioxidant score. Best antibacterial activity was observed by methanol extracts against eight different strains. Overall, the leaves and berries of Hippophae salicifolia collected from Northeast India exhibited good antioxidant and antibacterial activity and can be utilized by food and pharmaceutical sectors.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10068-021-00988-8.

Practical consensus recommendations on management of HR + ve early breast cancer with specific reference to genomic profiling

Breast cancer is a heterogeneous disease and patients are managed clinically based on ER, PR, HER2 expression, and key risk factors. The use of gene expression assays for early stage disease is already common practice. These tests have found a place in risk stratifying the heterogeneous group of stage I–II breast cancers for recurrence, for predicting chemotherapy response, and for predicting breast cancer-related mortality. Most guidelines for hormone receptor (HR)–positive early breast cancer recommend addition of adjuvant chemotherapy for most women, leading to overtreatment, which causes considerable morbidity and cost. Expert oncologist discussed about strategies of gene expression assays and aid in chemotherapy recommendations for treatment of HR + ve EBC and the expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

An integrated 3D fluidic device with bubble guidance mechanism for long-term primary and secondary cell recordings on multi-electrode array platform

A 3D fluidic device (3D-FD) is designed and developed with the capability of auto bubble guidance via a helical pathway in a 3D geometry. This assembly is integrated to a multi-electrode array (MEA) to maintain secondary cell lines, primary cells and primary retinal tissue explants of chick embryos for continuous monitoring of the growth and electrophysiology recording. The ability to maintain the retinal tissue explant, extracted from day 14 (E-14) and day 21 (E-21) chick embryos in an integrated 3D-FD MEA for long duration (>100 h) and study the development is demonstrated. The enhanced duration of monitoring offered by this device is due to the controlled laminar flow and the maintenance of a stable microenvironment. The spontaneous electrical activity of the retina, including the spike recordings from the retinal ganglion layer, was monitored over a long duration. Specifically, the spiking activity in embryonic chick retinas of different days (E-14 to 21) is studied, and the presence of light-stimulated firings along with a distinct electroretinogram for E-21 mature retina provides the evidence of a stable microenvironment over a sustained period.

Blocking FcRn in humans reduces circulating IgG levels and inhibits IgG immune complex-mediated immune responses

The neonatal crystallizable fragment receptor (FcRn) functions as an intracellular protection receptor for immunoglobulin G (IgG). Recently, several clinical studies have reported the lowering of circulating monomeric IgG levels through FcRn blockade for the potential treatment of autoimmune diseases. Many autoimmune diseases, however, are derived from the effects of IgG immune complexes (ICs). We generated, characterized, and assessed the effects of SYNT001, a FcRn-blocking monoclonal antibody, in mice, nonhuman primates (NHPs), and humans. SYNT001 decreased all IgG subtypes and IgG ICs in the circulation of humans, as we show in a first-in-human phase 1, single ascending dose study. In addition, IgG IC induction of inflammatory pathways was dependent on FcRn and inhibited by SYNT001. These studies expand the role of FcRn in humans by showing that it controls not only IgG protection from catabolism but also inflammatory pathways associated with IgG ICs involved in a variety of autoimmune diseases.

Improved design for Heliotron J soft X-ray diagnostic for tomographic reconstruction studies

Identifications of the plasma boundary shape and mode structure are important problems for the studies of the magnetohydrodynamics equilibrium and stability studies. Imaging diagnostics have the possibility to measure the plasma boundary shape and mode structure directly. The soft X-ray (SX) tomography is an imaging diagnostic for offering these direct measurements. However, SX tomography is by nature a limited angle tomography and provides a challenge as an ill-condition inverse problem. The reconstructed profiles depend heavily on the quality of measurements along with the employed inversion algorithm. This paper provides a detailed description of tomographic reconstruction of simulated SX measurements from the current SX diagnostic design of Heliotron J (H-J), which is a medium size heliotron device. Heliotron J has a unique magnetic geometry, and the quantitative identification of the plasma boundary and mode structure is a critical problem. The Phillip-Tikhonov regularization is employed to address the inversion problem. Finally, a new design for Heliotron J soft X-ray diagnostic is discussed which holds enhanced capabilities for tomographic reconstructions especially for the high poloidal number perturbations.

Vulnerabilities and risks of HIV infection among migrants in the Thane district, India

OBJECTIVES

To explore the vulnerabilities and risks of HIV infection among female migrants compared with male migrants in the Thane district of Maharashtra, India.

STUDY DESIGN

This is a cross-sectional epidemiological study.

METHODS

Data from 35,841 migrants (men 96.2% and women 3.8%) were collected using the web-based 'Migrant Service Delivery System.' The data were then analysed in SPSS, version 23.0. Statistical analysis, including Chi-squared test and multivariate logistic regression, was used to identify factors influencing HIV infection for both male and female migrants.

RESULTS

It was observed that 2.96% of female migrants had HIV infection compared with 0.77% of male migrants. We found that 12.1% of women consumed alcohol compared with 41.9% of men, and access to bars was 1.5% among women and 3.5% in men. We observed an even larger difference between men and women in their previous history of using brothels for sex; only 5.9% of female migrants reported previously having used brothels for sex, compared with 62.9% of male migrants. Approximately 12.3% of married women and 93.6% of married men had sex with someone other than their spouse. We found that 67.0% of married women and 73.9% of married men reported using a condom during their last sexual act compared with 60.9% of unmarried women and 68.1% of unmarried men.

CONCLUSIONS

In Thane, female migrants faced higher vulnerabilities and risks of HIV infection than male migrants. Consequently, innovative strategies are required to address these particular needs of female migrants.

Quantification and localization of mast cells in periapical lesions

Background:

Periapical lesions occur in response to chronic irritation in periapical tissue, generally resulting from an infected root canal. Specific etiological agents of induction, participating cell population and growth factors associated with maintenance and resolution of periapical lesions are incompletely understood. Among the cells found in periapical lesions, mast cells have been implicated in the inflammatory mechanism.

Aim:

Quantifications and the possible role played by mast cells in the periapical granuloma and radicular cyst. Hence, this study is to emphasize the presence (localization) and quantification of mast cells in periapical granuloma and radicular cyst.

Materials and Methods:

A total of 30 cases and out of which 15 of periapical granuloma and 15 radicular cyst, each along with the case details from the previously diagnosed cases in the department of oral pathology were selected for the study. The gender distribution showed male 8 (53.3%) and females 7 (46.7%) in periapical granuloma cases and male 10 (66.7%) and females 5 (33.3%) in radicular cyst cases. The statistical analysis used was unpaired t-test.

Results:

Mean mast cell count in periapical granuloma subepithelial and deeper connective tissue, was 12.40 (0.99%) and 7.13 (0.83%), respectively. The mean mast cell counts in subepithelial and deeper connective tissue of radicular cyst were 17.64 (1.59%) and 12.06 (1.33%) respectively, which was statistically significant. No statistical significant difference was noted among males and females.

Conclusion:

Mast cells were more in number in radicular cyst. Based on the concept that mast cells play a critical role in the induction of inflammation, it is logical to use therapeutic agents to alter mast cell function and secretion, to thwart inflammation at its earliest phases. These findings may suggest the possible role of mast cells in the pathogenesis of periapical lesions.

Quantification and localization of mast cells in periapical lesions

BACKGROUND

Periapical lesions occur in response to chronic irritation in periapical tissue, generally resulting from an infected root canal. Specific etiological agents of induction, participating cell population and growth factors associated with maintenance and resolution of periapical lesions are incompletely understood. Among the cells found in periapical lesions, mast cells have been implicated in the inflammatory mechanism.

AIM

Quantifications and the possible role played by mast cells in the periapical granuloma and radicular cyst. Hence, this study is to emphasize the presence (localization) and quantification of mast cells in periapical granuloma and radicular cyst.

MATERIALS AND METHODS

A total of 30 cases and out of which 15 of periapical granuloma and 15 radicular cyst, each along with the case details from the previously diagnosed cases in the department of oral pathology were selected for the study. The gender distribution showed male 8 (53.3%) and females 7 (46.7%) in periapical granuloma cases and male 10 (66.7%) and females 5 (33.3%) in radicular cyst cases. The statistical analysis used was unpaired t-test.

RESULTS

Mean mast cell count in periapical granuloma subepithelial and deeper connective tissue, was 12.40 (0.99%) and 7.13 (0.83%), respectively. The mean mast cell counts in subepithelial and deeper connective tissue of radicular cyst were 17.64 (1.59%) and 12.06 (1.33%) respectively, which was statistically significant. No statistical significant difference was noted among males and females.

CONCLUSION

Mast cells were more in number in radicular cyst. Based on the concept that mast cells play a critical role in the induction of inflammation, it is logical to use therapeutic agents to alter mast cell function and secretion, to thwart inflammation at its earliest phases. These findings may suggest the possible role of mast cells in the pathogenesis of periapical lesions.

Silicon drift detector based X-ray spectroscopy diagnostic system for the study of non-thermal electrons at Aditya tokamak

Silicon drift detector based X-ray spectrometer diagnostic was developed to study the non-thermal electron for Aditya tokamak plasma. The diagnostic was mounted on a radial mid plane port at the Aditya. The objective of diagnostic includes the estimation of the non-thermal electron temperature for the ohmically heated plasma. Bi-Maxwellian plasma model was adopted for the temperature estimation. Along with that the study of high Z impurity line radiation from the ECR pre-ionization experiments was also aimed. The performance and first experimental results from the new X-ray spectrometer system are presented.

Development of an intra-molecularly shuffled efficient chimeric plant promoter from plant infecting Mirabilis mosaic virus promoter sequence

We developed an efficient chimeric promoter, MUASMSCP, with enhanced activity and salicylic acid (SA)/abscisic acid (ABA) inducibility, incorporating the upstream activation sequence (UAS) of Mirabilis mosaic virus full-length transcript (MUAS, -297 to -38) to the 5' end of Mirabilis mosaic virus sub-genomic transcript (MSCP, -306 to -125) promoter-fragment containing the TATA element. We compared the transient activity of the MUASMSCP promoter in tobacco/Arabidopsis protoplasts and in whole plant (Petunia hybrida) with the same that obtained from CaMV35S and MUAS35SCP promoters individually. The MUASMSCP promoter showed 1.1 and 1.5 times stronger GUS-activities over that obtained from MUAS35SCP and CaMV35S promoters respectively, in tobacco (Xanthi Brad) protoplasts. In transgenic tobacco (Nicotiana tabacum, var. Samsun NN), the MUASMSCP promoter showed 1.1 and 2.2 times stronger activities than MUAS35SCP and CaMV35S(2) promoters respectively. We observed a fair correlation between MUASMSCP-, MUAS35SCP- and CaMV35S(2)-driven GUS activities with the corresponding uidA-mRNA level in transgenic plants. X-gluc staining of transgenic germinating seed-sections and whole seedlings also support above findings. Protein-extracts made from tobacco protoplasts expressing GFP and human-IL-24 genes driven individually by the MUASMSCP promoter showed enhanced expression of the reporters compared to that obtained from the CaMV35S promoter. Furthermore, MUASMSCP-driven protoplast-derived human IL-24 showed enhanced cell inhibitory activity in DU-145 prostate cancer cells compared to that obtained from the CaMV35S promoter. We propose chimeric MUASMSCP promoter developed in the study could be useful for strong constitutive expression of transgenes in both plant/animal cells and it may become an efficient substitute for CaMV35S/CaMV35S(2) promoter.

Occurrence and surgical repair of third degree perineal lacerations in adult female camels (Camelus dromedarius) by one-stage (Goetz) technique

Retrospective analysis of third degree perineal lacerations in 7 female camels (6-17 yrs of age) that were surgically corrected by one stage repair (Goetz technique) is presented. Majority (3/7) of the camels was primiparous and all parturitions had a history of calving assistance. Six (6/7) camels recovered by first intention of healing. Dehiscence of perineal structure occurred in only one camel due to infection and healed by second intention. Subsequent matings resulted in pregnancy in four camels and one camel died due to unrelated causes. We conclude that perineal lacerations can occur in primiparous camels with difficult assisted deliveries and that one stage repair of perineal lacerations in camels improves the perineal conformation and such camels may easily regain normal fertility.

Ankyloglossia and its surgical correction by frenuloplasty in a she-camel calf (Camelus dromedarius)

A rare case of ankyloglossia in a one-humped camel and its successful surgical correction by horizontal to vertical frenuloplasty is reported. Seven-month-old she-camel calf, with a history of excessive salivation and inability to chew and swallow hay, was referred to Al Qattara veterinary hospital. Solid food was regurgitated, whereas milk and water could be swallowed. On examination; the animal could not protrude its tongue which was attached by a thin tissue band between the ventral surface of the tongue and the floor of the oral cavity. The tissue band was corrected by frenuloplasty and the incisions were sutured. The animal recovered well as the salivation and regurgitation stopped and the animal became able to chew and swallow solid food including hay. It was concluded that ankyloglossia can occur in one-humped camel in which a horizontal to vertical frenuloplasty may improve full function of tongue movement.

Hordeum vulgare hull in the design of fast disintegrating tablets

In the present study, fast disintegrating tablets were designed with a view to enhance patient compliance. In this method, the hull of Hordeum vulgare, cross carmellose sodium, and sodium starch glycolate were used as superdisintegrants (4 and 6%), along with microcrystalline cellulose and mannitol, to enhance mouth feel. The prepared batches of tablets were evaluated for hardness, friability, drug content uniformity, wetting time, water absorption ratio and in vitro dispersion time. Based on the in vitro dispersion time, the formulations were tested for the in vitro drug release pattern. Tablets having H. vulgare hull showed the release profile comparable to those tablets having sodium starch glycolate and cross carmellose sodium.

The application of genomic and proteomic technologies in predictive, preventive and personalized medicine

The long asymptomatic period before the onset of chronic diseases offers good opportunities for disease prevention. Indeed, many chronic diseases may be preventable by avoiding those factors that trigger the disease process (primary prevention) or by use of therapy that modulates the disease process before the onset of clinical symptoms (secondary prevention). Accurate prediction is vital for disease prevention so that therapy can be given to those individuals who are most likely to develop the disease. The utility of predictive markers is dependent on three parameters, which must be carefully assessed: sensitivity, specificity and positive predictive value. Specificity is important if a biomarker is to be used to identify individuals either for counseling or for preventive therapy. However, a reciprocal relationship exists between sensitivity and specificity. Thus, successful biomarkers will be highly specific without sacrificing sensitivity. Unfortunately, biomarkers with ideal specificity and sensitivity are difficult to find for many diseases. One potential solution is to use the combinatorial power of a large number of biomarkers, each of which alone may not offer satisfactory specificity and sensitivity. Recent technological advances in genetics, genomics, proteomics, and bioinformatics offer a great opportunity for biomarker discovery. The newly identified biomarkers have the potential to bring increased accuracy in disease diagnosis and classification, as well as therapeutic monitoring. In this review, we will use type 1 diabetes (T1D) as an example, when appropriate, to discuss pertinent issues related to high throughput biomarker discovery.

Possible Role of Neonatal Infection with the Asymptomatic Reassortant Rotavirus (RV) Strain I321 in the Decrease in Hospital Admissions for RV Diarrhea, Bangalore, India, 1988–1999

We sought to determine the proportion of rotavirus (RV) infections among children with severe diarrhea in Bangalore, India, and to determine the role of neonatal infection with the asymptomatic RV strain I321 in protection against subsequent RV diarrhea. At 2 major hospitals, there was a >42% decrease in diarrhea-specific admissions during the study period. At 6 hospitals, asymptomatic infections were found in 25%-50% of neonates, when screening was performed randomly, and in >58% of neonates, when screening was performed daily, with the majority of infections occurring within the first 7 days of life. All the RVs found in asymptomatic neonates were strain I321. A 24-month follow-up of a cohort of 44 children who had been neonatally infected with strain I321 and 28 children who had not (control group) revealed comparable rates of RV detection but a marked decrease in the number of RV diarrhea episodes in the strain I321-infected group (2.3%), compared with the control group (39.3%) (P<.0001). This preliminary study suggests a possible association between neonatal infection with strain I321 and protection against subsequent RV illness.

A laser flash photolysis study of fenofibric acid in aqueous buffered media: unexpected triplet state inversion in a derivative of 4-alkoxybenzophenone

Laser excitation of aqueous solutions of fenofibric acid (FA) at pH 7.4 show the formation of two reaction intermediates, the triplet state and the hydrated electron. The former is longer lived in water than in acetonitrile; its anionic form decays irreversibly by decarboxylation to give a carbanion that protonates before or after rearrangement. Several spectroscopic and quenching studies suggest that in aqueous media the triplet state of FA has a pi,pi* character, in comparison with an n,pi* character in organic media. Further, the known chemistry of the triplet, including decarboxylation and hydrogen abstraction, occurs predominantly from the n,pi* state, and as a consequence, activation energies are higher when the lowest triplet has a pi,pi* character. Photoionization is more important in aqueous than in organic media and involves a biphotonic process. Hydrated electrons are trapped by FA, leading to the corresponding ketyl radical after protonation.

Making hand-assisted laparoscopy easier: preventing CO2 leak

Hand assistance has been a significant advance in making laparoscopy an easier and safer method for certain procedures such as nephrectomy. The value of this technique is realized when comparing patient outcomes (e.g., less postoperative pain, shorter hospital stay, quicker recovery time) with those of the standard open approaches. One reported disadvantage of the Pneumo Sleeve device for hand-assisted laparoscopy is leakage of CO2 gas from around the ring base. We describe in detail our technique to secure the Pneumo Sleeve to the abdomen in such a way as to prevent leakage of intraperitoneal gas and fluid.

Evaluation of a short course on diabetology for practising doctors

A short course on Diabetology, attended by 83 doctors was evaluated. The doctors were divided into three groups. (Group I--basic qualification MBBS, Group II--MD in medicine or allied subject, Group III--Diploma in Diabetes Mellitus). The mean age group of all three groups were comparable. Pre-course evaluation of their knowledge of diabetes showed the best performance in Group III and poorest in Group I. Post-course evaluation showed significant improvement only in Group I and II. Maximal improvement in performance was seen in Group II. Mean time since passing the last professional examination was 14.8, 12.6 and 1.0 year respectively. The performance was not linked to time since passing the last examination. 14.5% of doctors were from a rural or semiurban setting. The precourse performance of rural doctors in the MD group was significantly poorer, but their post course performance was as good as the others. All doctors from rural or semiurban areas improved their performance postcourse, compared to 84% in the urban group. 74% of doctors had not attended any post graduate course after their basic degree. Their performance did not differ significantly from those who had attended such courses. 44.6% were Consultants, 26.6% were general practitioners, 12.0% were attached to institutions, 10.8% were in government service or armed forces and 6% were attached to teaching hospitals. The performance of the doctors was not linked to the type of practice. The doctors attending the course felt that the audiovisual presentation needed improvement.

Histoid, a clinical variant of multibacillary leprosy: report from so-called nonendemic areas

This is a hospital-based study of 25 biopsy-proven cases of histoid leprosy in the arid, northwest Rajasthan region of India. Over an 11-year span, a total of 893 new cases of leprosy were diagnosed at our institution. These 25 histoid cases thus make up 2.8% of our new patients. Various clinical and laboratory observations are summarized and compared to other published series.

Molecular cloning, sequence and structure analysis of hamster apurinic/apyrimidinic endonuclease (chAPE1) gene

We have cloned a 13 kb genomic DNA fragment from the Chinese hamster ovary cell line, CHO-KI, and determined the nucleotide sequence of a 4 kb stretch of DNA which encompasses the complete sequence (2.277 kb) of the hamster apurinic/apyrimidinic endonuclease (chAPE1) gene. The intron/exon boundaries, identified by RT-PCR, follow GT/AG rule. The structure of the chAPE1 gene is similar to other mammalian apurinic/apyrimidinic (AP) endonuclease (hAPE1, BAP1, rAPEN and mAPE1) genes in that it has five exons and four introns with the first exon unexpressed. This structure, however, differs from one of the two structures that have been proposed for mAPE1 gene. Three transcription start sites (TSS) for the chAPE1 gene were identified by primer extension analysis at +1, +14 and +18 positions. The sequence also includes 1.72 kb of the upstream region of the chAPE1 gene. In this region, a CCAAT box but no TATA box that could initiate the transcription at the initiation sites was identified. The upstream region also includes the binding sites for a variety of other transcription factors. A polyadenylation site, 13 nucleotides downstream to the polyadenylation signal, was identified by 3'-RACE analysis. The observed 1.28 kb transcript of the chAPE1 gene is smaller than the 1.5 kb transcript of the human AP endonuclease gene. The translation of chAPE1 gene starts within the second exon with ATG and terminates in the fifth exon with UGA codons, 318 and 2121 nucleotides downstream to the first TSS, respectively. The encoded peptide of 317 amino acid residues is similar in size and is highly homologous in its amino acid sequence to mouse, rat, human, and bovine AP endonucleases.

Mutants of human choriogonadotropin lacking N-glycosyl chains in the alpha-subunit. 1. Mechanism for the differential action of the N-linked carbohydrates

Analogs of human choriogonadotropin (hCG) lacking N-glycosyl chains at alpha52Asn and alpha78Asn were purified from the culture media of insect cells by immunoaffinity chromatography using a monoclonal antibody column. As previously reported, while analogs lacking carbohydrate at alpha52Asn and alpha78Asn had similar receptor binding activities compared with the wild type recombinant hCG (hCGwt), they differed in their signal transduction properties. The mutant lacking carbohydrate at alpha78Asn had 20% less cAMP-stimulating activity than hCGwt, but the absence of glycosylation at alpha52Asn resulted in the reduction of cAMP accumulation by 90-95%. A similar effect of the mutations was observed on the stimulation of steroidogenesis. Circular dichroism spectra of the two mutants showed significant differences. The mutant lacking carbohydrate at alpha52Asn had a much higher negative mean residue ellipticity (MRE) at 200 nm and a lower negative MRE at 220 nm than that lacking carbohydrate at alpha78Asn and hCGwt. The dissociation rates of the alpha52Asn and alpha78Asn carbohydrate deficient mutants at pH 3 and room temperature, measured by using 1-anilino-8-naphthalenesulfonate, were 9.4 x 10(-5) and 3.8 x 10(-5) s-1, respectively, as compared with 1.5 x 10(-5) s-1 for hCGwt. The results of both CD measurements and dissociation studies strongly suggest that the absence of carbohydrate at alpha52Asn results in conformational changes in the mutant which might explain the loss in its signal transduction function. This is further supported by indirect evidence from two other lines of experimentation. Unlike the mutant lacking carbohydrate at alpha78Asn, the one lacking carbohydrate at alpha52Asn cross-reacted with the two subunit specific monoclonal antibodies, anti-hCGalpha and anti-hCGbeta, which normally did not cross-react with the native or the hCGwt. Also, polyclonal anti-hCGbeta but not anti-hCGalpha was able to restore the cAMP-producing activity of the alpha52Asn carbohydrate deficient mutant. From all the data taken together, it appears that the loss of second messenger-producing activity of hCG with the absence of the glycosyl chain at alpha52Asn was probably due to a conformational change in the heterodimer rather than due to the loss of the alpha52Asn-carbohydrate-receptor interaction.

Effect of modification of all loop regions in the alpha- and beta-subunits of human choriogonadotropin on its signal transduction activity

Human choriogonadotropin (hCG), according to its three dimensional structure as determined by X-ray diffraction, has three beta-hairpin loops each in the alpha and beta subunit designated as alpha 1, alpha 2 alpha 3 and beta 1 beta 2 and beta 3, respectively. Since similar beta-hairpin loops in NGF and TNF beta have been implicated in their direct interaction with the receptor, it prompted the present investigation to determine the role of such loops in receptor binding and post-receptor signaling events in hCG. Based on the three dimensional structure of hCG, radical mutations were introduced in the alpha loops by replacing hydrophobic alpha 18Phe and alpha 74Phe by hydrophilic Thr residues in the alpha 1 and alpha 3 loops, respectively, and positively charged alpha 45Lys by negatively charged Asp in the helical segment in the alpha 2 loop. The beta loops were mutated by replacement of the beta 1, beta 2 and beta 3 sequences with the corresponding hFSH sequences. These replacements included beta 22Gly, beta 24Pro and beta 25Val with Glu, Arg and Phe in beta 1, 45Leu Gln Gly Val Leu Pro Ala Leu Pro53 with Tyr Lys Asn Pro Ala Arg Pro Leu Ile in beta 2 and 73Pro Arg Gly with Ala His His in the beta 3 loop. Six mutants, hCG alpha 1 beta, hCG alpha 2 beta and hCG alpha 3 beta and hCG alpha beta 1, hCG alpha beta 2 and h CG alpha beta 3, were obtained by co-infection of the insect High-Five cells with baculovirus containing mutant alpha or beta cDNAs and that containing complimentary wild type beta or alpha cDNAs. The mutants were almost completely secreted in the culture medium and were over expressed at levels ranging between 4.5 to 29 micrograms/ml indicating that mutations had no effect on the secretion or subunit assembly of hCG. In order to remove any contaminating beta-subunit, the culture medium was passed through a column of an hCG beta-specific monoclonal antibody, B158. The receptor binding activity of the mutant hCG alpha 1 beta, in which alpha 18Phe was replaced with Thr, increased almost 200% relative to rehCG. Similarly, increase in the cAMP and progesterone stimulation by the mutant ranged between 150 to 200%. This increase is believed to be due to a short range conformational change in the mutant as a result of the mutation rather than direct involvement of alpha 18Phe in the receptor binding. The evidence in support of this was derived from the fact that the affinity or interaction between the two subunits was impaired as indicated by the first order rate constant of hCG alpha 1 beta (km = 4.1 x 10(-2) min-1) at pH 3.0 at 23 degrees C which is one order of magnitude greater relative to rehCG (kw = 4.6 x 10(-3) min-1). All other mutations had no effect on the receptor binding or signal transduction of hCG indicating that, unlike NGF or TNF beta, beta-hairpin loops in hCG were not directly involved in receptor binding or post-receptor signaling events. However, since the mutation in the alpha 1 loop affects the receptor binding site, its presence in the vicinity of the alpha 1 loop is highly likely.