A previous study demonstrated that alexidine has greater affinity for the major virulence factors of bacteria than chlorhexidine. The aim of this study was to compare the antimicrobial activity of 1% alexidine with that of 2% chlorhexidine using Enterococcus faecalis-infected dentin blocks. Sixty bovine dentin blocks were prepared and randomly divided into six groups of 10 each. E. faecalis was inoculated on 60 dentin blocks using the Luppens apparatus for 24 h and then the dentin blocks were soaked in 2% chlorhexidine or 1% alexidine solutions for 5 and 10 min, respectively. Sterile saline was used as a control. The antimicrobial efficacy was assessed by counting the number of bacteria adhering to the dentin surface and observing the degradation of bacterial shape or membrane rupture under a scanning electron microscope. Significantly fewer bacteria were observed in the 2% chlorhexidine- or 1% alexidine-soaked groups than in the control group (P<0.05). However, there was no significant difference in the number of bacteria adhering to the dentinal surface between the two experimental groups or between the two soaking time groups (P>0.05). Ruptured or antiseptic-attached bacteria were more frequently observed in the 10-min-soaked chlorhexidine and alexidine groups than in the 5-min-soaked chlorhexidine and alexidine groups. In conclusion, 10-min soaking with 1% alexidine or 2% chlorhexidine can be effective against E. faecalis infection.
Animals ; Anti-Bacterial Agents ; pharmacology ; Bacterial Adhesion ; drug effects ; Bacterial Load ; drug effects ; Biguanides ; pharmacology ; Cattle ; Cell Membrane ; drug effects ; Chlorhexidine ; pharmacology ; Dentin ; microbiology ; Enterococcus faecalis ; drug effects ; Microscopy, Electron, Scanning ; Random Allocation ; Time Factors

In an effort to characterize, on the molecular scale, the Acanthamoeba initially isolated from the cornea of an amoebic keratitis patient associated with overnight-wear orthokeratology lens in Korea, we conducted mitochondrial DNA restriction fragment length polymorphism, 18S rDNA sequencing, and drug sensitivity analyses on the isolate (KA/PE1). The patient was treated with polyhexamethylene biguanide, chlorhexidine and oral itraconazole, which resulted in resolution of the patient's ocular inflammation. The majority of the molecular characteristics of the KA/PE1 were determined to be identical, or quite similar, to those of A. castellanii Ma strain, which had been isolated also from amoebic keratitis. The risk of Acanthamoeba keratitis as a potential complication of overnight orthokeratology is briefly discussed.
*Sequence Analysis, DNA ; RNA, Ribosomal, 18S/genetics ; Polymorphism, Restriction Fragment Length ; Parasitic Sensitivity Tests ; Myopia/therapy ; Itraconazole/administration & dosage ; Humans ; Female ; Disinfectants/administration & dosage ; DNA, Ribosomal/analysis ; DNA, Protozoan/analysis ; DNA, Mitochondrial/analysis ; Contact Lenses/*adverse effects ; Chlorhexidine/administration & dosage ; Biguanides/administration & dosage ; Astigmatism/therapy ; Antiprotozoal Agents/administration & dosage ; Animals ; Adolescent ; Acanthamoeba Keratitis/drug therapy/*parasitology ; Acanthamoeba/classification/*genetics/*isolation & purification

The purposes of this study were firstly to investigate the any formation of precipitate after interaction between ALX and NaOCL and secondarily to analyze the PCA formation by using time of flight secondary ion mass (TOF-SIM) spectrometry. Mass spectrometry analysis was performed for the mixture of 0.5% ALX and 5.25% NaOCl. As controls, 2.5% CHX with 5.25% NaOCl and 1% PCA solutions were used. Any formation of precipitates in 10 tested solutions was evaluated by naked eye. Results of mass spectrum showed that the typical peak of PCA was not detected in mixed solution of ALX and NaOCl, whereas CHX/NaOCl mixture showed the same peak that found in the PCA spectrum. Precipitate formation was only observed in CHX/NaOCL mixture. The present TOF-SIM spectrometry results indicated that ALX can be a useful root canal irrigant combined with NaOCl during canal instrumentation. Further study is necessary to confirm the antimicrobial effect of ALX against endodontic pathogen before its clinical application as an endodontic irrigant.
Aniline Compounds ; Biguanides ; Dental Pulp Cavity ; Eye ; Mass Spectrometry ; Passive Cutaneous Anaphylaxis ; Sodium ; Sodium Hypochlorite ; Spectrum Analysis

Individuals who have diabetes should receive individualized medical nutrition therapy (MNT) based on an assessment of the individual's current eating patterns, preferences, and metabolic goals. The dietician should be able to coordinate food choices with the type of diabetes medicine being taken. Knowledge of the actions, side effects, and contraindication of diabetes medicine can help the dietician coordinate appropriate MNT and physical activity, to assist the individual with diabetes to achieve optimal glycemic control without unwanted effects. Carbohydrate consistency is important for diabetic patients on oral diabetes medications. The primary side effects with initial treatment of biguanides, alpha-glucosidase inhibitors, and incretin mimetics include gastrointestinal discomfort, which can be minimized by taking the medication with food, starting at a low dosage, and increasing the dosage slowly. Common side effects from use of insulin and insulin secretagogues (sulfonylureas and meglitinides) are hypoglycemia and weight gain. Consistent meal times and carbohydrate consistency are important to reduce risk of hypoglycemia. Energy restriction, reduced fat intake, regular physical activity, and avoidance of frequent hypoglycemia can be beneficial in preventing or limiting weight gain. The insulin regimen should be fitted to the meal plan and adjusted over time based on the results of blood glucose monitoring.
alpha-Glucosidases ; Biguanides ; Blood Glucose ; Diabetes Mellitus ; Eating ; Humans ; Hypoglycemia ; Incretins ; Insulin ; Meals ; Motor Activity ; Nutrition Therapy ; Nutritionists ; Weight Gain

The prevalence of type 2 diabetes mellitus in the Korea has increased dramatically over the past decade. Clinicians can prescribe the following six currently available classes of oral hypoglycemic agents: sulfonylureas, meglitinides, biguanides, thiazolidinediones, alpha-glucosidase inhibitors and dipeptidyl peptidase inhibitors. The availability of various oral hypoglycemic agents has given rise to several adverse effects and may result in worse outcomes in patients with comorbid conditions such as liver dysfunction, renal impairment and heart failure. When taking a cross-sectional view of hepatic dysfunction, we find that hepatitis B and alcoholic liver disease are most prevalent in Korea. The use of oral hypoglycemic agents in type 2 diabetic patients with hepatic dysfunction requires many considerations.
Administration, Oral ; alpha-Glucosidases ; Biguanides ; Diabetes Mellitus, Type 2 ; Heart Failure ; Hepatitis B ; Humans ; Hypoglycemic Agents ; Korea ; Liver Diseases ; Liver Diseases, Alcoholic ; Prevalence ; Protease Inhibitors ; Thiazolidinediones

The purpose of this study was to assess the efficacy of alexidine (ALX), alone and combined with N-acetylcysteine (NAC), in eradicating two Enterococcus faecalis strain biofilms. The biofilms of E. faecalis ATCC 29212 and the clinical isolate E. faecalis D1 were grown in the MBEC-high-throughput device for 24 h and were exposed to five twofold dilutions of ALX (2%-0.007 8%) alone and combined with 100 mg⋅mL(-1) NAC, for 1 and 5 min. Eradication was defined as 100% kill of biofilm bacteria. The Student's t-test was used to compare the efficacy of the associations of the two irrigants. After 1-min contact time, ALX eradicated the biofilms at all concentrations except for 0.007 8% and 0.015 6%-0.007 8% with E. faecalis ATCC 29212 and E. faecalis D1, respectively. Similar results for eradication and concentration were obtained when it was combined with 100 mg⋅mL(-1) NAC. After 5 min of contact time, ALX alone and combined with NAC eradicated all enterococci biofilms. ALX showed antimicrobial properties against the two E. faecalis strain biofilms tested at very low concentrations, and its combined use with NAC was not seen to enhance its activity.
Acetylcysteine ; pharmacology ; Anti-Infective Agents, Local ; pharmacology ; Biguanides ; pharmacology ; Biofilms ; drug effects ; Dental Pulp Cavity ; microbiology ; Drug Combinations ; Enterococcus faecalis ; drug effects ; Humans

No abstract available.
Metformin

Introduction: Diabetes in the Philippines is a major and growing health issue. From its prevalence of 2.8 million in 2000, it was projected by the World Health Organization to reach 7.8 million by 2030. Glimepiride has been found to be effective and well-tolerated, as monotherapy and in combination with metformin, in managing glycemic levels among type II diabetes mellitus (T2DM) patients. This study aimed to assess the safety and efficacy of a sustained release (SR) fixed-dose combination (FDC) preparation of glimepiride and metformin in the treatment of Filipino patients with T2DM. Methods: This open-label, observational, multicenter, post-marketing study, conducted from April 2012 to December 2013, included 20 to 75-year-old patients with T2DM, presenting with 7% to 11% HbA1c or 110-250 mg/dL fasting blood sugar, insulin-naive, and in consideration for management with a glimepiride-metformin FDC. Baseline data were collected. Patients were prescribed with glimepiride-metformin FDC SR 2/500 mg/tab for a six-month treatment period. Follow-up data were collected on the third and the sixth month of treatment. Patients who missed one follow-up were included in population for safety analysis. Patients who completed both follow-up schedules make up the per-protocol population for efficacy analysis. Adverse events (AEs) were reported in frequencies and percentages. Repeated measures analysis of variance (ANOVA) was used for efficacy analysis on HbA1c and FBG data. Results: From 1,052 enrollees, 795 patients had sufficiently filled data forms and attended at least one follow-up schedule; this is the population whose data was analyzed for this study. Fifty-nine AEs were reported; only 21 incidents of hypoglycemia were assessed to be definitely, probably, or possibly related to the study drug. Repeated measure ANOVA showed that the mean ± SD HbA1c at month three (7.15 ± 1.22%) and month six (6.80 ± 1.17%) were significantly lower than baseline (8.67 ± 1.10%). The mean ± SD FBG at month three (133.20 ± 35.46 mg/dL) and month six (122.47 ± 29.34 mg/dL) were also significantly lower than baseline (176.85 ± 41.24 mg/dL). The differences in HbA1c and FBG changes between those with concomitant OAD and those without were non-significant. Conclusion Fixed-dose combination of glimepiridemetformin is a drug with a tolerable profile and favorable benefits in treating patients with T2DM.
Metformin

Three Acanthamoeba isolates (KA/E9, KA/E17, and KA/E23) from patients with keratitis were identified as Acanthamoeba triangularis by analysis of their molecular characteristics, a species not previously recognized to be a corneal pathogen. Epidemiologic significance of A. triangularis as a keratopathogen in Korea has been discussed. Morphologic features of Acanthamoeba cysts were examined under a microscope with differential interference contrast (DIC) optics. Mitochondrial DNA (mtDNA) of the ocular isolates KA/E9, KA/E17, and KA/E23 were digested with restriction enzymes, and the restriction patterns were compared with those of reference strains. Complete nuclear 18S and mitochondrial (mt) 16S rDNA sequences were subjected to phylogenetic analysis and species identification. mtDNA RFLP of 3 isolates showed very similar patterns to those of SH621, the type strain of A. triangularis. 16S and 18S rDNA sequence analysis confirmed 3 isolates to be A. triangularis. 18S rDNA sequence differences of the isolates were 1.3% to 1.6% and those of 16S rDNA, 0.4% to 0.9% from A. triangularis SH621. To the best of our knowledge, this is the first report, confirmed by 18S and 16S rDNA sequence analysis, of keratitis caused by A. triangularis of which the type strain was isolated from human feces. Six isolates of A. triangularis had been reported from contaminated contact lens cases in southeastern Korea.
Acanthamoeba/classification/genetics/isolation & purification ; Acanthamoeba Keratitis/*drug therapy/*parasitology ; Adolescent ; Adult ; Animals ; Antiprotozoal Agents/therapeutic use ; Biguanides/therapeutic use ; DNA, Mitochondrial/genetics ; DNA, Protozoan/genetics ; Female ; Humans ; Male ; Phylogeny ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 16S/genetics ; RNA, Ribosomal, 18S/genetics

No abstract available.
Humans ; Metformin*