Efficacy of a povidone-iodine foam dressing (Betafoam) on diabetic foot ulcer.

This study aimed to assess the efficacy of a new povidone-iodine (PVP-I) foam dressing (Betafoam) vs foam dressing (Medifoam) for the management of diabetic foot ulcers. This study was conducted between March 2016 and September 2017 at 10 sites in Korea. A total of 71 patients (aged ≥19 years) with type 1/2 diabetes and early-phase diabetic foot ulcers (Wagener classification grade 1/2) were randomised to treatment with PVP-I foam dressing or foam dressing for 8 weeks. Wound healing, wound infection, patient satisfaction, and adverse events (AEs) were assessed. The PVP-I foam and foam dressing groups were comparable in the proportion of patients with complete wound healing within 8 weeks (44.4% vs 42.3%, P = .9191), mean (±SD) number of days to complete healing (31.00 ± 15.07 vs 33.27 ± 12.60 days; P = .6541), and infection rates (11.1% vs 11.4%; P = 1.0000). Median satisfaction score (scored from 0 to 10) at the final visit was also comparable between groups (10 vs 9, P = .2889). There was no significant difference in AE incidence (27.8% vs 17.1%, P = .2836), and none of the reported AEs had a causal relationship with the dressings. The results of this study suggest that PVP-I foam dressing has wound-healing efficacy comparable with foam dressing, with no notable safety concerns. This study was funded by Mundipharma Korea Ltd and registered at ClinicalTrials.gov (identifier NCT02732886).

Chronic toxicity and endocrine disruption of naproxen in freshwater waterfleas and fish, and steroidogenic alteration using H295R cell assay.

Naproxen is a non-steroidal anti-inflammatory drug (NSAID) and has been frequently detected in surface waters around the world. Although endocrine disruption and reproduction related effects of NSAIDs are of increasing concern, the ecotoxicity of naproxen in aquatic organisms is limited primarily to acute lethal effects. In this study, chronic toxicity of naproxen was evaluated employing two daphnids (Daphnia magna and Moina macrocopa) and a fish (Oryzias latipes). The effects of naproxen on sex steroid hormones and gene transcription related to steroidogenesis were also evaluated in H295R cells. The chronic no observed effect concentrations (NOECs) of naproxen for reproduction were determined to be 10 mg L-1 in D. magna and 0.3 mg L-1 in M. macrocopa. At concentrations of 0.5 mg L-1, the survival of juvenile medaka fish was significantly decreased and transcription of erß2 gene was significantly increased. Concentration of 17ß-estradiol (E2) and the ratio of E2 and testosterone were significantly increased in H295R cells at 10 mg L-1, suggesting that naproxen could modulate sex hormone production. The current detected levels of naproxen in ambient Korean rivers are far lower than the effective levels, however potential adverse effects cannot be ignored in some highly polluted areas. Endocrine disruption effects in fish warrant further investigation particularly for their ecological implications.

Urinary phthalate metabolites among elementary school children of Korea: sources, risks, and their association with oxidative stress marker.

Phthalates have been used in a variety of consumer products and hence frequently been detected in humans. Children are susceptible to endocrine disrupting chemicals such as phthalates, but only limited information is available on the sources of exposure and potential adverse health effects among children. In this study, elementary school students (n=39, aged 9-12 years) were recruited in Seoul, and first void urine samples were collected twice in three-day intervals. Then six phthalate metabolites were analyzed by high performance liquid chromatography with triple quadrupole tandem mass spectrometry. In addition, malondialdehyde (MDA) as an oxidative stress marker was measured. A questionnaire was conducted and information on food consumption and the use of plastic packaging or storage materials was gathered. The concentrations of phthalate metabolites varied substantially by sampling time even within the same subject, but all target metabolites were detected in 100% of the samples with the highest geometric mean of 107 µg/g-creatinine for mono-n-butyl phthalate (MnBP). Urinary levels of mono-isobutyl phthalate (MiBP), and MnBP among Korean children were 8 and 3 times greater than those reported for US children, but those of monoethyl phthalate (MEP) were about 5 times lower than those of US children. Estimated phthalate intakes were generally in safe range, but in 3-8% of the participating children, the hazard quotients greater than one were noted. Urinary MDA concentrations were significantly associated with several metabolite levels after adjusting covariates in regression model. Consumption of dairy products or meat, and use of a plastic material were significantly associated with the DEHP metabolites or MnBP levels in multivariate model. The results of this study provide evidence of the association between phthalate exposure and oxidative stress especially among the early teenagers, and identified major sources that can be applied to development of management plan for phthalate exposure among children.

Urinary levels of N-acetyl-S-(2-carbamoylethyl)-cysteine (AAMA), an acrylamide metabolite, in Korean children and their association with food consumption.

Acrylamide (AA), a probable human carcinogen, is present in high-temperature-processed foods, and has frequently been detected in humans worldwide. In the present study, the levels of a major AA metabolite, N-acetyl-S-(2-carbamoylethyl)-cysteine (AAMA) were measured in urine samples collected in two separate events with 3d interval from Korean children (n=31, 10-13 years old), and their diets were surveyed for 4d period prior to the second urine sampling. Daily AA intake was estimated from AAMA urinary levels and the influence of food consumption on urinary AAMA levels was investigated. The concentrations of metabolite AAMA in urine ranged between 15.4 and 196.3 ng/mL, with a median level of 68.1 ng/mL, and the levels varied by day considerably even in a given child. Children who were exposed to environmental smoke at home exhibited significantly higher levels of AAMA in urine, suggesting the importance of passive smoking as a source of AA exposure among children. Median (95th percentile) values of daily AA intake in Korean children were 1.04 (2.47)µg/kgbodyweight/day, which is higher than those reported elsewhere. After adjustment for gender, body mass index, and smoking status of family members, the consumptions of cracker and chocolate were identified to be significantly associated with the concentrations of AAMA in urine. The result of this study will provide information useful for developing public health and safety management for AA.

Determination of mRNA expression of DMRT93B, vitellogenin, and cuticle 12 in Daphnia magna and their biomarker potential for endocrine disruption.

We explored the use of molecular genetic biomarkers for endocrine disruption in Daphnia magna after the exposure to fenoxycarb (FOC), a model juvenile hormone analog. For this purpose, the mRNA expression patterns of DMRT93B (DMRT, sex determination), cuticle 12 (CUT, molting), and vitellogenin (VTG, embryo development) were determined in D. magna. Furthermore, these results were compared with developmental abnormality and reproduction performance. The fold changes of CUT and VTG mRNA expression showed significant dose-response relationship with FOC exposure. Relative mRNA expressions of DMRT and CUT showed notable changes at as low as 1 ng/l FOC. After chronic exposure FOC significantly delayed the first day of reproduction and decreased the number of young and growth rate even at 10 ng/l FOC. A concentration-dependant trend in reproduction effect was also observed. Developmental abnormality such as poorly developed second antennae and curved or unextended shell spines were observed. These results suggest that the three mRNAs, i.e., DMRT, CUT, and VTG can be used as biomarkers of endocrine disrupting effects in D. magna.