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1.
Skin Res Technol ; 30(4): e13704, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38627927

ABSTRACT

BACKGROUND/PURPOSE: Because atopic dermatitis (AD) is a chronic inflammatory skin condition that causes structural changes, there is a growing need for noninvasive research methods to evaluate this condition. Hyperspectral imaging (HSI) captures skin structure features by exploiting light wavelength variations in penetration depth. In this study, parameter-based transfer learning was deployed to classify the severity of AD using HSI. Therefore, we aimed to obtain an optimal combination of classification results from the four models after constructing different source- and target-domain datasets. METHODS: We designated psoriasis, skin cancer, eczema, and AD datasets as the source datasets, and the set of images acquired via hyperspectral camera as the target dataset for wavelength-specific AD classification. We compared the severity classification performances of 96 combinations of sources, models, and targets. RESULTS: The highest classification performance of 83% was achieved when ResNet50 was trained on the augmented psoriasis dataset as the source, with the resulting parameters used to train the model on the target Near-infrared radiation (NIR) dataset. The second highest classification accuracy of 81% was achieved when ResNet50 was trained on the unaugmented psoriasis dataset as the source, with the resulting parameters used to train the model on the target R dataset. ResNet50 demonstrated potential as a generalized model for both the source and target data, also confirming that the psoriasis dataset is an effective training resource. CONCLUSION: The present study not only demonstrates the feasibility of the severity classification of AD based on hyperspectral images, but also showcases combinations and research scalability for domain exploration.


Subject(s)
Dermatitis, Atopic , Psoriasis , Humans , Dermatitis, Atopic/diagnostic imaging , Hyperspectral Imaging , Skin/diagnostic imaging , Psoriasis/diagnostic imaging , Machine Learning
2.
Integr Zool ; 2024 Mar 31.
Article in English | MEDLINE | ID: mdl-38556643

ABSTRACT

The tree frog is a prominent amphibian among terrestrial vertebrates known for its ability to adhere to various surfaces through the capillary forces of water in the microchannels between micropillars on its disc-shaped toe pads, a phenomenon known as wet adhesion. However, the secretion pattern of mucus on the attachment surface of living tree frog toe pads and the distribution of active mucus pores (AMPs) have not yet been fully elucidated. In this study, we utilized synchrotron X-ray micro-computed tomography and interference reflection microscopy to obtain the spatial distribution of the entire population of ventral mucus glands on the toe pads of living tree frogs and the real-time mucus secretion patterns from the ventral mucus pores on the contact surface under different environmental conditions. We observed that the number and secretion frequency of AMPs on the toe pad are regulated according to environmental conditions. Such dynamic mucus secretion on the tree frog's toe pad could contribute to the understanding of capillary force regulation for wet adhesion and the development of adhesive surfaces by mimicking the mucus-secreting toe pad.

3.
Dig Dis Sci ; 69(5): 1701-1713, 2024 May.
Article in English | MEDLINE | ID: mdl-38551744

ABSTRACT

BACKGROUND AND AIM: he mixed lineage kinase domain like pseudokinase (MLKL) is known to play a protective role in non-alcoholic fatty liver disease (NAFLD) via inhibition of necroptosis pathway. However, the role of MLKL in alcoholic liver disease (ALD) is not yet clear. METHOD: C57BL/6N wild-type (WT) and MLKL-knockout (KO) mice (8-10 weeks old) were randomly divided into eight groups. To establish ALD model of different durations, ethanol (EtOH) was fed to WT and MLKL KO for 10 days, 4 weeks, and 8 weeks. The control group was fed with Lieber-DeCarli control diet for 8 weeks. Mortality, degree of hepatic inflammation, and steatosis were compared among the groups. Bulk mRNA transcriptome analysis was performed. Abundance of transcript and gene expressions were calculated based on read count or Transcript by Million (TPM) value. RESULTS: Survival rate of MLKL KO mice compared to WT was similar until 4 weeks, but the survival of MLKL KO mice significantly decreased after 8 weeks in ALD model. There was no difference in degree of inflammation, steatosis, and NAS scores between EtOH-fed MLKL KO and EtOH-fed WT mice at 10 days. However, at 4 weeks and 8 weeks, the degree of hepatic steatosis, NAS, and inflammation were increased in MLKL KO mice. RNA transcriptome data showed that fatty acid synthesis, and lipogenesis, mitochondria, and apoptosis-related pathways were upregulated in EtOH-fed MLKL KO mice compared to EtOH-fed WT mice. Although hepatocyte apoptosis (BAX/BCL2 ratio, caspase-3, and TUNEL staining) increased after EtOH intake; however, apoptosis was more significantly increased in EtOH-fed MLKL KO mice compared to the WT group. At the same time, hepatic cFLIP was decreased in EtOH-fed MLKL KO mice compared to the WT group. CONCLUSION: MLKL deletion did not prevent chronic alcohol-induced liver damage independently of necroptosis and exacerbated hepatic steatosis by increasing hepatocyte apoptosis.


Subject(s)
Apoptosis , Liver Diseases, Alcoholic , Mice, Inbred C57BL , Mice, Knockout , Protein Kinases , Animals , Protein Kinases/genetics , Protein Kinases/metabolism , Liver Diseases, Alcoholic/genetics , Liver Diseases, Alcoholic/pathology , Liver Diseases, Alcoholic/metabolism , Mice , Ethanol/toxicity , Liver/pathology , Liver/metabolism , Male , Disease Models, Animal
4.
Biomed Pharmacother ; 172: 116232, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38310652

ABSTRACT

Proinsulin C-peptide, a biologically active polypeptide released from pancreatic ß-cells, is known to prevent hyperglycemia-induced microvascular leakage; however, the role of C-peptide in migration and invasion of cancer cells is unknown. Here, we investigated high glucose-induced migration and invasion of ovarian cancer cells and the inhibitory effects of human C-peptide on metastatic cellular responses. In SKOV3 human ovarian cancer cells, high glucose conditions activated a vicious cycle of reactive oxygen species (ROS) generation and transglutaminase 2 (TGase2) activation through elevation of intracellular Ca2+ levels. TGase2 played a critical role in high glucose-induced ovarian cancer cell migration and invasion through ß-catenin disassembly. Human C-peptide inhibited high glucose-induced disassembly of adherens junctions and ovarian cancer cell migration and invasion through inhibition of ROS generation and TGase2 activation. The preventive effect of C-peptide on high glucose-induced ovarian cancer cell migration and invasion was further demonstrated in ID8 murine ovarian cancer cells. Our findings suggest that high glucose conditions induce the migration and invasion of ovarian cancer cells, and human C-peptide inhibits these metastatic responses by preventing ROS generation, TGase2 activation, and subsequent disassembly of adherens junctions.


Subject(s)
Ovarian Neoplasms , Humans , Animals , Mice , Female , C-Peptide/pharmacology , Reactive Oxygen Species/pharmacology , Ovarian Neoplasms/pathology , Cell Movement , Glucose/pharmacology
5.
Theranostics ; 13(8): 2424-2438, 2023.
Article in English | MEDLINE | ID: mdl-37215567

ABSTRACT

Rationale: Neovascularization is a hallmark of the late stages of diabetic retinopathy (DR) leading to blindness. The current anti-DR drugs have clinical disadvantages including short circulation half-lives and the need for frequent intraocular administration. New therapies with long-lasting drug release and minimal side effects are therefore needed. We explored a novel function and mechanism of a proinsulin C-peptide molecule with ultra-long-lasting delivery characteristics for the prevention of retinal neovascularization in proliferative diabetic retinopathy (PDR). Methods: We developed a strategy for ultra-long intraocular delivery of human C-peptide using an intravitreal depot of K9-C-peptide, a human C-peptide conjugated to a thermosensitive biopolymer, and investigated its inhibitory effect on hyperglycemia-induced retinal neovascularization using human retinal endothelial cells (HRECs) and PDR mice. Results: In HRECs, high glucose conditions induced oxidative stress and microvascular permeability, and K9-C-peptide suppressed those effects similarly to unconjugated human C-peptide. A single intravitreal injection of K9-C-peptide in mice resulted in the slow release of human C-peptide that maintained physiological levels of C-peptide in the intraocular space for at least 56 days without inducing retinal cytotoxicity. In PDR mice, intraocular K9-C-peptide attenuated diabetic retinal neovascularization by normalizing hyperglycemia-induced oxidative stress, vascular leakage, and inflammation and restoring blood-retinal barrier function and the balance between pro- and anti-angiogenic factors. Conclusions: K9-C-peptide provides ultra-long-lasting intraocular delivery of human C-peptide as an anti-angiogenic agent to attenuate retinal neovascularization in PDR.


Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Hyperglycemia , Retinal Neovascularization , Humans , Mice , Animals , Retinal Neovascularization/drug therapy , Diabetic Retinopathy/drug therapy , C-Peptide/pharmacology , C-Peptide/therapeutic use , Endothelial Cells , Neovascularization, Pathologic/drug therapy , Hyperglycemia/drug therapy
6.
Nutrients ; 15(7)2023 Apr 06.
Article in English | MEDLINE | ID: mdl-37049638

ABSTRACT

Platycodon grandiflorus (balloon flower), used as a food reserve as well as in traditional herbal medicine, is known for its multiple beneficial effects. In particular, this plant is widely used as a vegetable in Republic of Korea. We examined the ameliorative effects of P. grandiflorus on alloxan-induced pancreatic islet damage in zebrafish. The aerial part treatment led to a significant recovery in pancreatic islet size and glucose uptake. The efficacy of the aerial part was more potent than that of the root. Eight flavonoids (1-8) were isolated from the aerial part. Structures of two new flavone glycosides, designated dorajiside I (1) and II (2), were elucidated to be luteolin 7-O-α-L-rhamno-pyranosyl (1 → 2)-(6-O-acetyl)-ß-D-glucopyranoside and apigenin 7-O-α-L-rhamnopyranosyl (1 → 2)-(6-O-acetyl)-ß-D-glucopyranoside, respectively, by spectroscopic analysis. Compounds 1, 3, 4 and 6-8 yielded the recovery of injured pancreatic islets in zebrafish. Among them, compound 7 blocked KATP channels in pancreatic ß-cells. Furthermore, compounds 3, 4, 6 and 7 showed significant changes with respect to the mRNA expression of GCK, GCKR, GLIS3 and CDKN2B compared to alloxan-induced zebrafish. In conclusion, the aerial part of P. grandiflorus and its constituents conferred a regenerative effect on injured pancreatic islets.


Subject(s)
Islets of Langerhans , Platycodon , Animals , Flavonoids/chemistry , Zebrafish , Alloxan/analysis , Alloxan/pharmacology , Glycosides/pharmacology , Plant Components, Aerial/chemistry , Molecular Structure
7.
Plants (Basel) ; 12(5)2023 Feb 24.
Article in English | MEDLINE | ID: mdl-36903908

ABSTRACT

Several studies have shown that compounds from Acer pseudosieboldianum (Pax) Komarov leaves (APL) display potent anti-oxidative, anti-inflammatory, and anti-proliferative activities. Prostate cancer (PCa) is the most common cancer among older men, and DNA methylation is associated with PCa progression. This study aimed to investigate the chemopreventive activities of the compounds which were isolated from APL on prostate cancer cells and elucidate the mechanisms of these compounds in relation to DNA methylation. One novel ellagitannin [komaniin (14)] and thirteen other known compounds, including glucose derivatives [ethyl-ß-D-glucopyranose (3) and (4R)-p-menth-1-ene-7,8-diol 7-O-ß-D-glucopyranoside (4)], one phenylpropanoid [junipetrioloside A (5)], three phenolic acid derivatives [ellagic acid-4-ß-D-xylopyranoside (1), 4-O-galloyl-quinic acid (2), and gallic acid (8)], two flavonoids [quercetin (11) and kaempferol (12)], and five hydrolysable tannins [geraniin (6), punicafolin (7), granatin B (9), 1,2,3,4,6-penta-galloyl-ß-D-glucopyranoside (10), and mallotusinic acid (13)] were isolated from APL. The hydrolyzable tannins (6, 7, 9, 10, 13, and 14) showed potent anti-PCa proliferative and apoptosis-promoting activities. Among the compounds, the ellagitannins in the dehydrohexahydroxydiphenoyl (DHHDP) group (6, 9, 13, and 14), the novel compound 14 showed the most potent inhibitory activity on DNA methyltransferase (DNMT1, 3a and 3b) and glutathione S-transferase P1 methyl removing and re-expression activities. Thus, our results suggested that the ellagitannins (6, 9, 13, and 14) isolated from APL could be a promising treatment option for PCa.

8.
BMC Med ; 21(1): 49, 2023 02 13.
Article in English | MEDLINE | ID: mdl-36782199

ABSTRACT

BACKGROUND: Hyperglycemic memory (HGM) is a pivotal phenomenon in the development of diabetic complications. Although coincident diabetic complications are reported, research on their development and treatment is limited. Thus, we investigated whether C-peptide can simultaneously inhibit HGM-induced retinal, pulmonary, and glomerular dysfunctions in diabetic mice supplemented with insulin. METHODS: Insulin-treated diabetic mice were supplemented with human C-peptide by subcutaneous implantation of K9-C-peptide depots for 4 weeks, and reactive oxygen species (ROS) generation, transglutaminase (TGase) activity, and vascular leakage were examined in the retina, lung, and kidney. RESULTS: We found hyperglycemia-induced persistent ROS generation and TGase activation after blood glucose normalization in the retina, lung, and kidney of insulin-supplemented diabetic mice. These pathological events were inhibited by systemic supplementation of human C-peptide via subcutaneous implantation of a thermosensitive biopolymer-conjugated C-peptide depot. ROS generation and TGase activation were in a vicious cycle after glucose normalization, and C-peptide suppressed the vicious cycle and subsequent endothelial permeability in human retinal endothelial cells. Moreover, C-peptide supplementation ameliorated HGM-induced retinal vascular leakage and neurodegeneration, pulmonary vascular leakage and fibrosis, and glomerular adherens junction disruption and vascular leakage. CONCLUSIONS: Overall, our findings demonstrate that C-peptide supplementation simultaneously attenuates vascular and neuronal dysfunctions in the retina, lung, and glomerulus of insulin-supplemented diabetic mice.


Subject(s)
Diabetes Mellitus, Experimental , Diabetic Retinopathy , Humans , Mice , Animals , C-Peptide , Reactive Oxygen Species , Endothelial Cells , Diabetes Mellitus, Experimental/complications , Retina , Transglutaminases/physiology , Insulin/pharmacology , Lung , Diabetic Retinopathy/complications
9.
J Mol Endocrinol ; 68(4): 209-223, 2022 04 29.
Article in English | MEDLINE | ID: mdl-35266881

ABSTRACT

Proinsulin C-peptide has a protective effect against diabetic complications; however, its role in hyperglycemia-induced pulmonary fibrosis is unknown. In this study, we investigated the inhibitory effect of C-peptide on hyperglycemia-induced pulmonary fibrosis and the molecular mechanism of C-peptide action in the lungs of diabetic mice and in human pulmonary microvascular endothelial cells (HPMVECs). We found that, in the lungs of diabetic mice, C-peptide supplementation using osmotic pumps attenuated hyperglycemia-induced pulmonary fibrosis and expression of fibrosis-related proteins. In HPMVECs, C-peptide inhibited vascular endothelial growth factor-induced adherens junction disruption and endothelial cell permeability by inhibiting reactive oxygen species generation and transglutaminase (TGase) activation. In the lungs, C-peptide supplementation suppressed hyperglycemia-induced reactive oxygen species generation, TGase activation, and microvascular leakage. C-peptide inhibited hyperglycemia-induced inflammation and apoptosis, which are involved in the pathological process of pulmonary fibrosis. We also demonstrated the role of TGase2 in hyperglycemia-induced vascular leakage, inflammation, apoptosis, and pulmonary fibrosis in the lungs of diabetic TGase2-null (Tgm2-/-) mice. Furthermore, we demonstrated a long-term inhibitory effect of systemic delivery of C-peptide using K9-C-peptide hydrogels on hyperglycemia-induced fibrosis in diabetic lungs. Overall, our findings suggest that C-peptide alleviates hyperglycemia-induced pulmonary fibrosis by inhibiting TGase2-mediated microvascular leakage, inflammation, and apoptosis in diabetes.


Subject(s)
Diabetes Mellitus, Experimental , Hyperglycemia , Pulmonary Fibrosis , Animals , C-Peptide/pharmacology , Diabetes Mellitus, Experimental/complications , Diabetes Mellitus, Experimental/drug therapy , Diabetes Mellitus, Experimental/metabolism , Endothelial Cells/metabolism , Hyperglycemia/complications , Hyperglycemia/drug therapy , Hyperglycemia/metabolism , Inflammation/metabolism , Mice , Mice, Inbred C57BL , Protein Glutamine gamma Glutamyltransferase 2 , Pulmonary Fibrosis/complications , Pulmonary Fibrosis/etiology , Reactive Oxygen Species/metabolism , Transglutaminases/genetics , Transglutaminases/metabolism , Vascular Endothelial Growth Factor A/metabolism
10.
Int J Mol Sci ; 23(2)2022 Jan 11.
Article in English | MEDLINE | ID: mdl-35054938

ABSTRACT

Midazolam is an anesthetic widely used for anxiolysis and sedation; however, to date, a possible role for midazolam in diabetic kidney disease remains unknown. Here, we investigated the effect of midazolam on hyperglycemia-induced glomerular endothelial dysfunction and elucidated its mechanism of action in kidneys of diabetic mice and human glomerular microvascular endothelial cells (HGECs). We found that, in diabetic mice, subcutaneous midazolam treatment for 6 weeks attenuated hyperglycemia-induced elevation in urine albumin/creatinine ratios. It also ameliorated hyperglycemia-induced adherens junction disruption and subsequent microvascular leakage in glomeruli of diabetic mice. In HGECs, midazolam suppressed high glucose-induced vascular endothelial-cadherin disruption and endothelial cell permeability via inhibition of intracellular Ca2+ elevation and subsequent generation of reactive oxygen species (ROS) and transglutaminase 2 (TGase2) activation. Notably, midazolam also suppressed hyperglycemia-induced ROS generation and TGase2 activation in glomeruli of diabetic mice and markedly improved pathological alterations in glomerular ultrastructure in these animals. Analysis of kidneys from diabetic Tgm2-/- mice further revealed that TGase2 played a critical role in microvascular leakage. Overall, our findings indicate that midazolam ameliorates hyperglycemia-induced glomerular endothelial dysfunction by inhibiting ROS-mediated activation of TGase2.


Subject(s)
Diabetic Nephropathies/etiology , Diabetic Nephropathies/metabolism , Endothelial Cells/metabolism , Hyperglycemia/complications , Kidney Glomerulus/metabolism , Midazolam/pharmacology , Protein Glutamine gamma Glutamyltransferase 2/antagonists & inhibitors , Animals , Biomarkers , Calcium/metabolism , Capillary Permeability/drug effects , Diabetes Mellitus, Experimental , Diabetic Nephropathies/drug therapy , Diabetic Nephropathies/pathology , Disease Management , Disease Models, Animal , Disease Susceptibility , Endothelial Cells/drug effects , Endothelial Cells/pathology , Kidney Glomerulus/pathology , Kidney Glomerulus/ultrastructure , Male , Mice , Mice, Knockout , Models, Biological , Reactive Oxygen Species/metabolism
11.
Article in English | MEDLINE | ID: mdl-36624865

ABSTRACT

Quercus plants are widely distributed in Korea and have been used for their antiallergic and anti-inflammatory properties to treat dermatitis. The phenolic compounds of Quercus acutissima Carruth (QA) are estimated to have antioxidant and anti-inflammatory activities, based on the results of previous studies with Quercus mongilica, Quercus stenophylla, Quercus gilva Blame., and Quercus acuta Thunb. We yield QA extract and the isolated phenolic compounds (hyperoside (1), astragalin (2), kaempferol 3-O-(6″- galloyl)-ß-D-glucopyranoside (KGG) (3), quercetin 3-O-(6″-O-galloyl)-ß-D-glucopyranoside (QGG) (4), pedunculagin (5), and casuarinin (6)) and were identified using NMR. Among them, KGG (3) and QGG (4) were isolated for the first time from QA. QA extract and the isolated phenolic compounds demonstrated antioxidative, anti-inflammatory, and antiacne activities in RAW 264.7 mouse macrophage cells in vitro. 3-6 demonstrated strong inhibitory activities in the DPPH scavenging and NO production assay and anti-inflammatory and antiacne activities through western blotting (NLRP3, IL-1ß, and 5α-reductase). The most outstanding activity in all experiments was casuarinin (6). The study findings suggest potential therapeutic candidates for acne.

12.
Sensors (Basel) ; 21(8)2021 Apr 15.
Article in English | MEDLINE | ID: mdl-33921036

ABSTRACT

With aging, cerebrovascular diseases can occur more often. Stroke cases involve hemiplegia, which causes difficulties in performing activities of daily living. Existing rehabilitation treatments are based on the subjective evaluation of the therapist as the need for non-contact care arises; it is necessary to develop a system that can self-rehabilitate and offer objective analysis. Therefore, we developed rehabilitation tools that enable self-rehabilitation exercises in a virtual space based on haptics. Thirty adults without neurological damage were trained five times in a virtual environment, and the time, number of collisions, and coordinates were digitized and stored in real time. An analysis of variance (ANOVA) of the time and distance similarity changes revealed that as the number of rounds increased, no changes or increases occurred (p ≥ 0.05), and the collisions and paths were stable as the training progressed (p < 0.05). ANOVA showed a high correlation (0.90) with a decrease in the number of crashes and time required. It was meaningful to users when performing rehabilitation training more than four times and significantly impacted the analysis. This study analyzed the upper limb and cognitive rehabilitation of able-boded people in three-dimensional space in a virtual environment; the performance difficulty could be controlled through variations in rehabilitation models.


Subject(s)
Stroke Rehabilitation , Stroke , Virtual Reality , Activities of Daily Living , Adult , Humans , Pilot Projects , Upper Extremity
13.
Mitochondrial DNA B Resour ; 2(1): 221-222, 2017 Apr 12.
Article in English | MEDLINE | ID: mdl-33473776

ABSTRACT

The complete mitochondrial genome of a treefrog (Hyla sp.) was determined. The circular mitochondrial genome is 18,288 bp long and encodes 13 proteins, 22 transfer RNAs, and 2 ribosomal RNAs. Phylogenetic analysis of its full genome sequences showed that H. sp. was closely related to H. ussuriensis and H. japonica rather than Dryophytes suweonensis, consistent with the results from each protein-coding gene and a cluster between 12S rRNA and 16S rRNA. The present study will provide essential genomic information for biogeographical distribution and evolutionary history of an endemic treefrog, H.sp.

14.
PLoS One ; 10(12): e0145181, 2015.
Article in English | MEDLINE | ID: mdl-26692209

ABSTRACT

INTRODUCTION: Initial lactate level, lactate clearance, C-reactive protein, and procalcitonin in critically ill patients with sepsis are associated with hospital mortality. However, no study has yet discovered which factor is most important for mortality in severe sepsis patients with lactic acidosis. We sought to clarify this issue in patients with lactic acidosis who were supplementing with sodium bicarbonate. MATERIALS AND METHODS: Data were collected from a single center between May 2011 and April 2014. One hundred nine patients with severe sepsis and lactic acidosis who were supplementing with sodium bicarbonate were included. RESULTS: The 7-day mortality rate was 71.6%. The survivors had higher albumin levels and lower SOFA, APACHE II scores, vasopressor use, and follow-up lactate levels at an elapsed time after their initial lactate levels were checked. In particular, a decrement in lactate clearance of at least 10% for the first 6 hours, 24 hours, and 48 hours of treatment was more dominant among survivors than non-survivors. Although the patients who were treated with broad-spectrum antibiotics showed higher illness severity than those who received conventional antibiotics, there was no significant mortality difference. 6-hour, 24-hour, and 48-hour lactate clearance (HR: 4.000, 95% CI: 1.309-12.219, P = 0.015) and vasopressor use (HR: 4.156, 95% CI: 1.461-11.824, P = 0.008) were significantly associated with mortality after adjusting for confounding variables. CONCLUSIONS: Lactate clearance at a discrete time point seems to be a more reliable prognostic index than initial lactate value in severe sepsis patients with lactic acidosis who were supplementing with sodium bicarbonate. Careful consideration of vasopressor use and the initial application of broad-spectrum antibiotics within the first 48 hours may be helpful for improving survival, and further study is warranted.


Subject(s)
Acidosis, Lactic , Hospital Mortality , Lactic Acid/blood , Sepsis , Sodium Bicarbonate/administration & dosage , Acidosis, Lactic/blood , Acidosis, Lactic/drug therapy , Acidosis, Lactic/mortality , Aged , C-Reactive Protein/metabolism , Female , Humans , Male , Middle Aged , Retrospective Studies , Sepsis/blood , Sepsis/drug therapy , Sepsis/mortality
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