Predictor variables and an equation for estimating HbA1c attainable by initiation of basal supported oral therapy.

UNLABELLED: Aims/Introduction: A method of estimating HbA1c attained after initiation of basal supported oral therapy (BOT) has not been reported previously. The aim of the present study was to determine which characteristics of patients could influence the effectiveness of BOT introduction, and to obtain an equation to estimate HbA1c after BOT initiation. MATERIALS AND METHODS: Sixty consecutive insulin-naive type 2 diabetic patients with poor glycemic control (HbA1c ≥7.5%) started once-daily injections of insulin glargine. Simple correlations were calculated between parameters such as HbA1c at baseline, HbA1c at week 24, reduction rate of HbA1c over 24 weeks (calculated as: [HbA1c level at baseline - HbA1c level at week 24]/HbA1c level at baseline), duration of diabetes, and the number of classes of coadministered oral antidiabetic drugs. Using multiple linear regression models, the independent effects of these parameters on HbA1c at week 24 were evaluated separately. RESULTS: Multiple linear regression analysis revealed that duration of diabetes (ß = 0.561; P < 0.001) and HbA1c at baseline (ß = 0.284; P = 0.006) were significant predictors of HbA1c at week 24. The best fitting multiple regression equation was: HbA1c at week 24 = 0.078 × duration of diabetes + 0.218 × HbA1c at baseline + 4.628 (r (2) = 0.437). CONCLUSIONS: The equation based on the multiple linear regression models indicates necessary conditions for type 2 diabetic patients to achieve target HbA1c. The present findings emphasize the principle that early initiation of BOT in type 2 diabetes effectively achieves good glycemic control. (J Diabetes Invest, doi: 10.1111/j.2040-1124.2011.00164.x, 2011).

Sulcus depth reproduction with polyvinyl siloxane impression material: effects of hydrophilicity and impression temperature.

OBJECTIVE: To determine the sulcus penetration ability of hydrophilic and hydrophobic polyvinyl siloxane (PVS) impression materials by impression technique, temperature, and sulcus width. METHOD AND MATERIALS: Hydrophilic Flexitime (FLE; Heraeus Kulzer) and its hydrophobic counterpart (EXP) without surfactant were investigated, using light (L), monophase (M), and heavy (H) consistencies. A truncated steel cone surrounded by a 2-mm-deep and 50-, 100-, or 200-microm-wide sulcus, simulating the gingival tissue with agar, served as the test model. Impressions were made with single-mix (L or M) and double-mix (LM or LH) techniques at 23 degrees C and 37 degrees C, respectively. The reproduced sulcus heights were measured with a 3D laser scanner. Data were analyzed by ANOVA and Tukey HSD (P < .05). RESULTS: Irrespective of sulcus widths and temperature FLE-L penetrated deepest (> 1.9 mm); FLE-M, -LM, and-LH reproductions were shorter with narrow sulci. Reproductions of 50- and 100-microm sulci with EXP-L were shallower than with FLE-L. The shortest reproduction was, however, greater than 1.6 mm. CONCLUSIONS: In spite of some significant differences found in sulcus-reproducing ability with hydrophilic and hydrophobic impression materials applied at different impression-making temperatures and with different techniques, the practical relevance is limited.

Thyroid follicular adenoma producing parathyroid hormone-related protein with a normal serum calcium level.

A 64-year-old woman had normal serum calcium and plasma parathyroid hormone levels, despite an extremely high plasma parathyroid hormone-related protein (PTHrP) level. She underwent medical screening at our hospital and several neck tumors were detected by ultrasonography. After surgical resection of these tumors, her plasma PTHrP level was normalized. Histological examination showed that the resected tumors were thyroid follicular adenomas, while immunohistochemistry revealed positive staining with a monoclonal antibody for PTHrP. This is a rare case of thyroid follicular adenoma producing PTHrP in a patient with a normal serum calcium level despite elevation of plasma PTHrP.

Sulcus reproduction with elastomeric impression materials: a new in vitro testing method.

OBJECTIVES: Aim of this study was to investigate the depth reproduction of differently wide sulci with elastomeric impression materials by single- and double-mix techniques using a tooth and sulcus model, simulating clinical conditions. METHODS: Impressions with one vinyl polysiloxane (VPS; FLE), two polyethers (PE; IMP and P2), and one hybrid VPS/PE elastomer (FUS) were taken from a truncated steel cone with a circumferential 2 mm deep sulcus, 50, 100 or 200 microm wide. The "root surface" was in steel and the "periodontal tissue" in reversible hydrocolloid. Single-mix impressions were taken with light-body (L) or monophase (M) pastes, double-mix impressions with L as syringe and M or heavy-body (H) as tray materials (n=8). Sulcus reproduction was determined by 3D laser topography of impressions at eight locations, 45 degrees apart. Statistical data analysis by ANOVA and multiple comparison tests (p<0.05). RESULTS: For 200 microm wide sulci, significant differences were found between impression materials only: FLE=IMP>FUS=P2. At 50 and 100 microm width, significant differences were found between materials (IMP>FUS=FLE>P2) and techniques (L+H=L+M>M>L). SIGNIFICANCE: The sulcus model is considered useful for screening evaluation of elastomeric impression materials ability to reproduce narrow sulci. All tested materials and techniques reproduced 200 microm wide sulci to almost nominal depth. Irrespective of the impression technique used, IMP showed the best penetration ability in 50 and 100 microm sulci. Double-mix techniques are more suitable to reproduce narrow sulci than single-mix techniques.

Interactions of self-etch adhesives with resin composites.

OBJECTIVE: Aim of this in vitro study was to investigate the correlation of shear bond strength and marginal cavity adaptation, together with polymerization shrinkage and contraction stress, using the combination of four self-etch adhesives and three resin composites. MATERIALS AND METHODS: Interactions were studied between one two-step and three one-step adhesives, and the hybrid-type resin composites, Beautifil (BEU, Shofu) and Venus (VEN, Heraeus), and an experimental nano-hybrid resin composite NEUN (NEU, Heraeus). For all 12 combinations shear bond strengths (SBS) were determined on human dentin. Marginal adaptation (MGW) was assessed in cylindrical butt-joint dentin cavities. Further, polymerization contraction and contraction stress of the resin restoratives were measured. RESULTS: Significant determinants of SBSs on dentin were time of testing (10min or 24h) and adhesives (p<0.001). Marginal adaptation was best for NEU, followed by VEN and BEU. Only the resin composite used was a highly significant determinant of cavity adaptation. Polymerization shrinkage after 5min was 2.58, 2.74, and 1.53% for BEU, VEN, and NEU, respectively. Polymerization contraction stresses were largest for BEU, less for VEN, and smallest for NEU (p<0.05). CONCLUSIONS: No correlation was found between bond strength and marginal cavity adaptation. In contrast, reduced shrinkage and low polymerization contraction stress of resin composites were identified as important determinants of marginal cavity adaptation.

The PLEXIN PLX-2 and the ephrin EFN-4 have distinct roles in MAB-20/Semaphorin 2A signaling in Caenorhabditis elegans morphogenesis.

Semaphorins are extracellular proteins that regulate axon guidance and morphogenesis by interacting with a variety of cell surface receptors. Most semaphorins interact with plexin-containing receptor complexes, although some interact with non-plexin receptors. Class 2 semaphorins are secreted molecules that control axon guidance and epidermal morphogenesis in Drosophila and Caenorhabditis elegans. We show that the C. elegans class 2 semaphorin MAB-20 binds the plexin PLX-2. plx-2 mutations enhance the phenotypes of hypomorphic mab-20 alleles but not those of mab-20 null alleles, indicating that plx-2 and mab-20 act in a common pathway. Both mab-20 and plx-2 mutations affect epidermal morphogenesis during embryonic and in postembryonic development. In both contexts, plx-2 null mutant phenotypes are much less severe than mab-20 null phenotypes, indicating that PLX-2 is not essential for MAB-20 signaling. Mutations in the ephrin efn-4 do not synergize with mab-20, indicating that EFN-4 may act in MAB-20 signaling. EFN-4 and PLX-2 are coexpressed in the late embryonic epidermis where they play redundant roles in MAB-20-dependent cell sorting.

C. elegans PlexinA PLX-1 mediates a cell contact-dependent stop signal in vulval precursor cells.

PLX-1 is a PlexinA transmembrane protein in Caenorhabditis elegans, and the transmembrane-type semaphorin, SMP-1, is a ligand for PLX-1. The SMP-1/PLX-1 system has been shown to be necessary for proper epidermal morphogenesis in the male tail and seam cells. Here, we show that the SMP-1/PLX-1 system also regulates vulval morphogenesis. In plx-1 and smp-1 mutants, hermaphrodites sometimes exhibit a protruding vulva or multiple vulva-like protrusions. Throughout the vulval development of plx-1 and smp-1 mutants, the arrangement of vulval cells is often disrupted. In the initial step of vulval morphogenesis, vulval precursor cells (VPCs) are generated normally but are subsequently arranged abnormally in mutants. Continuous observation revealed that plx-1 VPC fails to terminate longitudinal extension after making contact with neighbor VPCs. The arrangement defects of VPCs in plx-1 and smp-1 mutants are rescued by expressing the respective cDNA in VPCs. plx-1::egfp and smp-1::egfp transgenes are both expressed in all vulval cells, including VPCs, throughout vulval development. We propose that the SMP-1/PLX-1 system is responsible for a cell contact-mediated stop signal for VPC extension. Analyses using cell fate-specific markers showed that the arrangement defects of VPCs also affect cell fate specification and cell lineages, but in a relatively small fraction of plx-1 mutants.