Antihyperglycemic effect of short-term arginyl-fructose supplementation in subjects with prediabetes and newly diagnosed type 2 diabetes: randomized, double-blinded, placebo-controlled trial.

BACKGROUND: A previous study reported that arginyl-fructose may have great value as a functional food with antioxidant and antidiabetic activities. However, there have been few clinical studies on the efficacy of arginyl-fructose supplementation for blood glucose control. METHODS: In this double-blind, placebo-controlled study, 60 Korean subjects with prediabetes or type 2 diabetes mellitus were randomly assigned to placebo or test groups. The test group subjects received 1500 mg/day arginyl-fructose. Fasting serum levels of glucose, hemoglobin A1c, insulin, and free fatty acids were measured by 2-hour oral glucose tolerance tests at baseline and after the 6-week intervention. Eleven subjects dropped out or were excluded during the trial. The data for the remaining 49 were statistically analyzed using Student's t-test and paired t-test. RESULTS: After the 6-week intervention, the test group showed significant reductions in serum glucose levels at 30 minutes (-19.4 ± 5.62 mg/dL) and 60 minutes (-15.4 ± 7.01 mg/dL) and reduced glucose area under the curve (-27.4 ± 8.59 mg/dL) compared with those of the placebo control group. The changes (differences from baseline) in serum glucose levels at 60 minutes and glucose area under the curve in the test group differed significantly from those in the control group even after adjusting for baseline values. In contrast, glucose-related biomarkers including hemoglobin A1c, insulin, and C-peptide levels were not significantly improved by the dietary intervention with arginyl-fructose. CONCLUSIONS: Arginyl-fructose supplementation (1500 mg/day) may be beneficial for reducing postprandial blood glucose levels in patients with prediabetes or type 2 diabetes mellitus. TRIAL REGISTRATION: ClinicalTrials.gov NCT02285231 . Registered 11 May 2014.

Comparative Study of Cryostripping and Endovenous Laser Therapy for Varicose Veins: Mid-Term Results.

BACKGROUND: Conventional stripping is considered to be the standard procedure for great saphenous vein (GSV) varicosities, but many other alternative treatments such as cryostripping, endovenous laser therapy (EVLT), radio-frequency ablation, and ultrasound-guided foam sclerotherapy have been developed. Among them, both cryostripping and laser therapy have been reported to be less traumatic, with lower rates of complications and recurrences when compared to conventional stripping. To compare the efficacy of these treatments, we have analyzed and compared the mid-term clinical outcomes of cryostripping and EVLT. METHODS: Patients diagnosed with varicose veins of the GSV and treated with cryostripping or laser therapy between September 2008 and April 2013 were enrolled in this study. Duplex ultrasonography was used for the diagnosis and evaluation of varicosity and reflux, and the clinical-etiology-anatomy-pathophysiology classification was used to measure the clinical severity. The symptoms, Venous Clinical Severity Score (VCSS), recurrence rates, and complication rates of the cryostripping and laser therapy groups were analyzed and compared. RESULTS: A total of 68 patients were enrolled in this study. 32 patients were treated with cryostripping, and 36 patients were treated with laser therapy. The median follow-up period was 29.6 months. Recurrence was noted in three patients from the cryostripping group and in two patients from the EVLT group. There was no difference in the VCSS score, operative time, duration of hospital stay, and complication rate between the cryostripping group and the EVLT group. CONCLUSION: The mid-term clinical outcomes of cryostripping were not inferior to those of EVLT. Further, considering its cost-effectiveness, cryostripping seems to be a safe and feasible method for the treatment of varicose veins.

Thoracic Duct Embolization with Lipiodol for Chylothorax due to Thoracic Endovascular Aortic Repair with Debranching Procedure.

Chylothorax is a rare postoperative complication of a thoracic surgical procedure. Here, we report a case of chylothorax after thoracic endovascular aortic repair with debranching for the distal arch aneurysm of the aorta. First, the patient was treated by a medical method (nil per os, fat-free diet, and octreotide), but this method failed. The patient strongly refused surgical treatment. Therefore, we tried to occlude the thoracic duct by lymphangiography Lipiodol, and this line of treatment was successful.

Effect of long-term dietary arginyl-fructose (AF) on hyperglycemia and HbA1c in diabetic db/db mice.

We have previously reported that Amadori compounds exert anti-diabetic effects by lowering sucrose-induced hyperglycemia in normal Sprague-Dawley rats. In the present study we extended our recent findings to evaluate whether α-glucosidase inhibitor arginyl-fructose (AF) lowers blood glucose level in diabetic db/db mice, a genetic model for type 2 diabetes. The db/db mice were randomly assigned to high-carbohydrate diets (66.1% corn starch) with and without AF (4% in the diet) for 6 weeks. Changes in body weight, blood glucose level, and food intake were measured daily for 42 days. Dietary supplementation of AF resulted in a significant decrease of blood glucose level (p < 0.001) and body weight (p < 0.001). The level of HbA1c, a better indicator of plasma glucose concentration over prolonged periods of time, was also significantly decreased for 6-week period (p < 0.001). Dietary treatment of acarbose® (0.04% in diet), a positive control, also significantly alleviated the level of blood glucose, HbA1c, and body weight. These results indicate that AF Maillard reaction product improves postprandial hyperglycemia by suppressing glucose absorption as well as decreasing HbA1c level.

Porcine dermal collagen (permacol) for sternal reconstruction.

In chest wall reconstruction after wide chest wall resection, the use of a musculocutaneous flap or prosthetic materials is inevitable for maintaining thoracic movement and a closed pleural cavity. We report a case of a 63-year-old male with a large invasive thymic carcinoma in the anterior mediastinum. The mass measured 6.8 cm and involved the sternum, left side of the parasternal area, ribs, and intercostal muscles. The patient underwent subtotal sternectomy, radical thymectomy, and reconstruction with biological mesh (Permacol). Successful chest wall reconstruction without any other complications was achieved, demonstrating the effectiveness of Permacol.

Orbital volume augmentation after injection of human orbital adipose-derived stem cells in rabbits.

PURPOSE: This randomized, controlled animal study investigated the morphologic and histologic properties of rabbit orbital fat following injection of human orbital adipose-derived stem cells (hoADSCs). METHODS: The efficacy of hoADSCs was compared to that of hyaluronic acid gel (HAG) and human orbital stromal vascular fraction (hoSVF). A total of 30 orbits from 15 New Zealand white rabbits (25 weeks postnatal, 2500-3000 g) underwent injection with HAG (molecular weight [MW] 1,000,000, 0.5 mL, n = 10, HAG only), hoSVF (0.25 mL) mixed with HAG (0.25 mL, n = 10, HAG + hoSVF), or hoADSCs (0.25 mL) mixed with HAG (0.25 mL, n = 10, HAG + hoADSCs). The degree of proptosis, and the time course of changes were determined and compared among groups. RESULTS: The difference between the initial exophthalmometric value and that at 4 weeks after injection was 1.77 mm for HAG only and 2.01 mm for HAG + hoSVF. The difference between the initial value and that at 12 weeks decreased to 0.05 mm for HAG only and 0.24 mm for HAG + hoSVF. In contrast, injection of HAG + hoADSCs increased the exophthalmometric value by 2.43 mm at 4 weeks after injection, and this difference was maintained at 2.56 mm at 12 weeks. Histopathologic examination revealed specific inflammation around the injection materials at 4 weeks after injection, and inflammation subsided 8 weeks after injection in all three groups. CONCLUSIONS: Thus, transplantation of hoADSCs with HAG is a safe and effective technique for orbital fat volume expansion. This is a new and promising method for orbital reconstruction and aesthetic orbital volume augmentation.

Anti-inflammatory effect of capsaicin in Helicobacter pylori-infected gastric epithelial cells.

BACKGROUND AND AIM: Capsaicin, the main pungent ingredient of hot red and chilli pepper, has been considered as not only a cytoprotective but also a detrimental agent to the gastric mucosa. However, the effect and mechanism of capsaicin that modulate the induction of pro-inflammatory cytokine in Helicobacter pylori-infected epithelial cells have not been investigated previously. Herein, we demonstrated that capsaicin inhibited the release of pro-inflammatory cytokine, interleukin-8 (IL-8) by H. pylori-infected gastric epithelial cells through nuclear factor-kappaB (NF-kappaB) signal pathway. MATERIALS AND METHODS: AGS or MKN45 cells as gastric epithelial cells and Vac A+, CagA+ wild-type H. pylori strain ATCC 49503 were used. Gastric epithelial cells were pre-treated with various concentrations of capsaicin and infected with H. pylori for different periods of time to determine IL-8 concentrations in culture supernatant by an ELISA assay. We measured IL-8 mRNA transcripts in H. pylori-infected gastric epithelial cells co-treated with capsaicin by reverse transcriptase-polymerase chain reaction analysis. We performed electrophoretic mobility shift assay to examine the NF-kappaB DNA binding activity with capsaicin and immunofluorescence microscopy to examine nuclear staining of p65. We also performed immunoblotting for IkappaB, IKK activity with capsaicin. RESULTS: Capsaicin inhibits H. pylori-induced IL-8 production by gastric epithelial cells in dose- and time-dependent manner. Capsaicin as low as 100 micromol/L significantly inhibited IL-8 production in H. pylori-infected MKN45 cells (43.2% of control) at 24 hours incubation, whereas inhibited IL-8 production in H. pylori-infected AGS cells (70% of control). We confirmed that capsaicin inhibited IL-8 mRNA expression after infection of gastric epithelial cells with H. pylori for 6 hours. The addition of capsaicin (100 micromol/L) suppressed H. pylori-induced NF-kappaB activation in gastric epithelial cells at 1 hour post-infection. We also found that the degradation of IkappaB and IKK activation were inhibited by capsaicin. CONCLUSIONS: Nontoxic dose of capsaicin inhibited H. pylori-induced IL-8 production by gastric epithelial cells through the modulation of IkappaB-, NF-kappaB-, and IL-8 pathways. We conclude that capsaicin can be proposed as a potential anti-inflammatory drug by inhibition of the production of IL-8 in H. pylori-infected gastric epithelium.