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  Journal of US-China Medical Science

Volume 10, Number 5-6, June 2013

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ISSN:1548-6648
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Volume 10, Number 5-6, June 2013
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pp121-127

Diabetes Mellitus: Too Many Controversies Affecting Care

Anil Kumar Mandal and Linda Marie Hiebert


  

Abstract: Diabetes care is in disarray mainly due to a lack of consensus among professionals in the diagnosis and management of diabetes. The most common trend is the use of HbA1c (glycosylated hemoglobin) above 6.5% in making the diagnosis of diabetes. Similarly, the most common prescription written for treatment of diabetes is metformin, 500 mg to 1000 mg twice daily. FBG (Fasting blood glucose) above 126 mg/dL is a common accompaniment of HbA1c, but 2hPPG (2-h postprandial glucose) or 4-h oral glucose tolerance tests are not included in the diagnosis of diabetes. In the early stage of diabetes or impaired glucose tolerance associated with obesity, FBG or HbA1c may be useful, but with rising FBG or HbA1c despite dual or triple oral antidiabetic therapy, 2hPPPG becomes the mainstay to determine the severity of diabetes and the need for initiation of insulin therapy. It is needless to underscore that 2hPPG relates to outcome measures such as cardiovascular disorders, nephropathy and death. Thus the cornerstone of therapy when 2hPPG is above 200 mg/dL (= 11.1 mmol/L) is insulin with a goal to reduce the risk of complications. There is no or only subtle evidence that oral antidiabetic agents will affect 2hPPG or reduce the risk of complications of diabetes. Therefore, the optimal goal of therapy in diabetes is not limited to merely glycemic control, but the intent of glycemic control which is prevention of diabetes complications.

 

Key words: Diabetes mellitus, 2 h postprandial glucose, insulin therapy.

pp128-133

Two Successful Successive Pregnancies in a Woman with CML Treated with Dasatinib and Temporary Peg-Interferon

Grard Dine, Marc Levert, Yves Rehn, Nadia Ali Amar, Said Brahimi, Baptiste Gaillard, Isabelle Bocq and Gabriela Fumagalli


  

Abstract: With TKIs, the management of CML has radically changed. Here we present the case of a woman diagnosed with CML during two pregnancies. Medullary and complete cytogenetic remission was achieved with Imatinib. However, she developed major muscular intolerance. This patient expressed the wish to have children. Hematology experts advised to delay her plan to become pregnant. According to BCR/ABL transcripts levels, they also decided to substitute Imatinib for Dasatinib. A major molecular response was subsequently observed with disappearance of muscular toxicity. It was then decided to interrupt Dasatinib treatment and to substitute with pegylated interferon for the duration of the pregnancy. After a normal full term pregnancy, she gave birth to a baby boy. Dasatinib treatment was reintroduced. A year later, the patient became pregnant for a second time. Dasatinib treatment was interrupted and substituted with pegylated interferon. After a normal pregnancy, she gave birth to a baby girl. Dasatinib treatment was then reintroduced. This case report highlights the possibility for CML patients whose disease is stabilized to interrupt Dasatinib treatment and substitute with pegylated interferon during pregnancy without jeopardizing the patient outcome or exposing the fetus to TKI associated teratogen risks.

 

Key words: CML, TKIs, pregnancy, Dasatinib, BCR-ABL.

pp134-138
  

Abstract: Vulvar cancer has not been well studied in Bangladesh. This retrospective review reports on the experience of ten women with vulvar cancer who were treated at the National Institute of Cancer Research Hospital and Delta Private Hospital from October 2010 through March 2011. Survival was analyzed by age, stage and grade of the cancers. The ages of ten women with vulvar cancer ranged from 45 years to 70 years with a median of 59 years. The majority of patients (nine) presented with stage III disease. One patient had a stage II cancer. Nine women had squamous cell cancers and one had an adenocarcinoma of the Bartholins gland. All patients underwent surgery and nine underwent either preoperative or postoperative radiation therapy. At 24 months of follow-up, eight patients are currently alive and disease free.

 

Key words: Vulvar cancer, squamous cell cancer of the vulva, surgery and radiation for vulva cancer.

pp139-145
  

Abstract: The study aims to investigate the relationship of genotypes and dynamics of drug resistance of MBT (Mycobacterium Tuberculosis) in North-West territories. Patients with pulmonary tuberculosis from areas with similar epidemical situation but different trends were selected using random sampling technique: the first group90 patients from the Pskov region, and the second90 patients from the Kaliningrad region. Genotyping of Mycobacterium tuberculosis strains was performed by test system of CJSC Syntol Russia Amplitub-Beijing. Drug sensitivity of MBT was determined by the method of absolute concentrations on Lowenstein medium. The frequency of determination of MBT Beijing family is found equal in 45.6% of cases in the Pskov and Kaliningrad regions. Excretion of drug-resistant MBT in the Pskov region was higher (61.1%) than that in Kaliningrad (45.6%). Beijing strains identified in similar high proportion of drug resistance (85.4% and 80.5%), including MDR (multidrug resistance) (58.5% or 65.9%) in the territories. Among not Beijing family strains in the Pskov region drug resistance was in 40.8%, which is 2.5 times more than that in Kaliningrad region (16.3%, P < 0.01). More significant differences are obtained in MDR cases: 32.7% and 6.1%, P < 0.001. MBT Beijing family dominates in the Northwest and growth of DR (drug resistance) and MDR of MBT is mainly due to this family MBT. But not Beijing strains also significantly often acquire drug resistance. Along with the MBT genotype, the differences in the epidemiological trends may be associated with problems in TB treatment organization.

 

Key words: Tuberculosis, drug resistance of MBT, Beijing genotype.

pp146-152

Does Aliskiren Influence the Changes of Global Longitudinal Strain in Patients with Diastolic Dysfunction?

Emil Ivanov Manov, Nikolay Margaritov Runev, Stefan Naydenov Naydenov, Rabhat Ahmed Shabani and Temenuga Ivanova Donova


  

Abstract: The aim of our study was to investigate the effects of Aliskiren on the blood pressure values as well as on the myocardial function, assessed by GLS (global longitudinal strain) in patients with uncontrolled ?H (arterial hypertension) and diastolic dysfunction. Forty five nondiabetic patients (29 men and 16 women, mean age 58.7 12.4 years) with BP (blood pressure) > 140/90 mm Hg despite of combined antihypertensive therapy (diuretic, calcium channel blockers, beta-blockers) were evaluated. All of them had echocardiographic data for diastolic dysfunction: ?/? ratio = 8, ?/? ratio < 0.8, DT (deceleration time) > 200 ms. Aliskiren 2 150 mg per day was added to the previous therapy. The follow-up period was 1 year, including monthly clinical visits. Echocardiographic assessment of the left ventricular function by longitudinal strain and Doppler analysis of the transmitral blood flow was performed at months 1, 6 and 12. The baseline mean measurements of systolic and diastolic BP values showed (153.4 14.4)/(99.2 6.7) mmHg for males and (157.6 12.5)/(97.3 8.2) mmHg for females. The systolic and diastolic BP values at the end of the 1st month were (131.7 7.4)/(83.6 5.2) mmHg in men and (132.4 5.3)/(81.8 6.9) mmHg in women (? < 0.05, compared to the initial BP values). The baseline ratio of ?/? was found to be 6.5 0.9, ?/?0.6 0.01 and DT258 32.7 ms. The values of these parameters at month 12 were as follows: ?/?7.0 0.64, ?/?0.7 0.05, DT239 16.5 ms (? = NS). Baseline global longitudinal strain in men was -10.4 0.7% and -11.0 0.9% in women, whereas GLS at month 12 showed values of: (-16.3 0.9%) and (-17.5 0.7%) for males and females respectively (? < 0.05). During the whole period of treatment with Aliskiren and follow-up no adverse effects were registered. Aliskiren, added to a combined antihypertensive therapy (without RAASrenin-angiotensin-aldosterone system blocker) in patients with uncontrolled AH and diastolic dysfunction provides not only a better BP control, but also a significant improvement of the myocardial function, assessed by global longitudinal strain. The 12 months treatment with Aliskiren was safe and well tolerated.

 

Key words: Aliskiren, arterial hypertension, diastolic dysfunction, global longitudinal strain.

pp153-161

Emotional Consequence of Telling a Lie

Megumi Sato and Syoichi Iwasaki


  

Abstract: Generally, arousal increases when telling a lie, as indicated in psychophysiological studies about lie detection. But the emotional valence induced by lying is unknown, though intuition indicates that it may be negative. Indeed, the EDA (electrodermal activity), used in such studies, only shows arousal changes during an emotional response. In this study, we used two tasks in order to examine the emotional valence induced by lying. At the beginning, in the deceptive task, participants answered no to every question regarding the nature of displayed playing cards. Therefore, they told a lie about specific cards. Their EDA was recorded all along the task. Secondly, in the figure estimation task, they assessed pictures positively or negatively after looking at playing cards visibly or subliminally as prime stimuli. We expected them to tend to estimate figures negatively when cards relevant to deception had been previously shown. This would mean that an affective priming effect due to telling a lie actually occurred. All in all, this effect was found only when prime stimuli had been displayed visibly. This result suggests that lying per se induces negative emotions even without motivation or punishment due to lying. Furthermore, we found that such effect was all the more obvious in participants whose EDA changes were salient while lying.

 

Key words: Lie detection, emotion, affective priming.

pp162-169
  

Abstract: It had been found that interleukin-8 (IL-8) was associated with drug resistance. We previously demonstrated that the resistance to 1, 3-bis (2-chloroethyl)-1-nitrosourea (BCNU) of glioma cell line SWOZ1 was much higher than that of cell line SOWZ2, which were both cloned from the same parental glioma cell line SWO38. In this study, IL-8 was found to be upregulated both in SWOZ1 and SWOZ2-BCNU, a BCNU-resistant glioma cell line. To further investigate the function of IL-8, the BCNU-resistant cell lines SWOZ1 and SWOZ2-BCNU were treated with siRNAs targeting IL-8. The results of quantitative RT-PCR showed that a decreased level of IL-8 mRNA expression in SWOZ1 and SWOZ2-BCNU for more than 90% compared to negative control and was confirmed by western blot assay (P < 0.05) after treated by siRNAs targeting IL-8. Subsequently, the cytotoxicity of BCNU to these cell lines was detected using the cell counting kit-8 assay. As a result, the BCNU resistance was reversed for about 50% both in these two cell lines (P < 0.05). Our data demonstrated that inhibition of IL-8 with specific siRNAs can reverse the BCNU resistant phenotype in glioma cell lines, indicating that IL-8 may play an important role in BCNU-resistance in glioma.

 

Key words: Glioma, IL-8, siRNA, drug resistance, BCNU.

pp170-173

Histological Study of Ovarian Interstitial Glands in IRAQI Buffaloes at Six and Nine Years Old

Abdul Hadi Sallal Mohammed, Tawfeeq Jawad Ali and Zainab Jawad Naki


  

Abstract: The present study was revealed some histological observations of interstitial glands in Iraqi buffalos ovaries. This study was conducted on (24) ovaries collected from Al-Najaf slaughter house. The ovarian tissue specimens was fixed in (10%) formalin and histological preparations were carried out, then stained with H and E. Histologically the overian buffalo cortex at six year old that revaled single glands were lined by simple cuboidal epithelial cells. The glands were surrounded by collagen fibers, blood vessels and fibroblasts. The ovarian cortex at nine years old consisted of group of interstitial glands, lined by cuboidal cells. The epithelial lining single and group of interstitial glands were filled with fat droplets. The lumen of groups of interstitial glands contains acidophilic secretion. The present study was suggested that the present of fat droplets in the cells of interstitial glands due to androgens (steroid hormones) and that ensure less fertility in the female buffaloes. 

 

Key words: Histology, ovarian interstitial glands, buffaloes.

 
 

 

 

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Journal of US-China Medical Science is an international, scholarly and peer-reviewed journal (print and online) published monthly. It publishes papers in any medical related area, such as Clinical Medicine, Basic Medical Sciences, Experimental Medicine, Preventive Medicine, and Social Medicine.

The Journal seeks to bridge and integrate the intellectual, methodological, and substantive diversity of medical science scholars, and to encourage a vigorous dialogue between medical science scholars and practitioners. The journal is published in English. The e-journal provides free and open access to all of its content on our website. Accepted papers will immediately appear online followed by printed in hard copy.

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