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Thesis (M.Sc. (Clinical Pathology))--Mahidol University, 1983.

Thesis (M.S.)--University of Wisconsin--Madison, 1982. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 92-98).

Objetivo: Determinar la relación entre mal control glicémico y bacteriuria asintomática (BA) en pacientes diabéticos tipo 2. Materiales y Métodos: Se llevó a cabo un estudio transversal analítico que incluyó 356 pacientes diabéticos atendidos en el Hospital Nacional Alberto Sabogal Sologuren (HNASS)durante el 2011 y 2012. Las variables bacteriuria asintomática, hemoglobina glicosilada (HbA1c), creatinina sérica, microalbuminuria, tiempo de diagnóstico, índice de masa corporal (IMC), fecha de última menstruación, antecedente de patología prostática e incontinencia urinaria se obtuvieron de las historias clínicas. Resultados: De 356 pacientes con DM2 se encontró presencia de BA en 51,9% de la población estudiada. Se halló asociación entre HbA1c mayor o igual a 6,5% y la presencia de BA (RP= 3,4, IC 95% 2,2 – 5,2). En el análisis multivariado, la variable control metabólico, ajustada por las variables IMC, género y tiempo de diagnóstico de DM2, estuvo asociada con BA (RP= 3,3, IC 95% 2,2 – 5). Conclusiones: Los valores de HbA1c elevados se encuentran asociados a la presencia de bacteriuria asintomática, por lo cual se recomienda mantener niveles inferiores a 6,5%; con la finalidad de reducir el riesgo de BA y su predisposición a infección urinaria y daño renal. . / Objective: To determine the relationship between bad glycemic control and asymptomatic bacteriuria (AB) in type 2 diabetic patients. Materials and Methods: a cross-sectional study, including 356 diabetic patients treated at NationalHospital Alberto Sabogal Sologuren (HNASS) during the years 2011 and 2012. The variables are asymptomatic bacteriuria, Hemoglobin A glycosylated (HbA1c), serum creatinine, microalbuminuria, time to diagnosis, date last menstrual period, history of prostate pathology and urinary incontinence were obtained from medical records. Results: From 356 patients with DM2 was found 51.9% presence of AB in the study population. Association was found between HbA1c greater than or equal to 6.5% and AB (PR= 3.4, CI95% 2.2 – 5.2). In addition, male gender was found between AB and prostatic syndrome (p <0.05). In multivariate analysis, the variable metabolic control adjusted for BMI variables, gender and time of diagnosis of type 2 diabetes mellitus was associated with AB (PR = 3.3, CI 95% 2.2 – 5). Conclusions: elevated HbA1c values were associated with the presence of AB, so we recommend keeping HbA1c levels <6.5% because AB may predispose the patient to urinary tract infection and possible kidney damage.

Introdução- A hiperglicemia (HG), durante o infarto agudo do miocárdio (IAM), está associada com aumento de mortalidade hospitalar em pacientes diabéticos e não diabéticos. Entretanto, não é conhecido o mecanismo responsável por esta associação. Assim estudou-se, simultaneamente, a correlação entre a glicemia e marcadores bioquímicos relacionados ao sistema neuro-humoral de estresse, metabolismo glicídico e lipídico, sistema de coagulação e inflamatório. Métodos- 80 pacientes foram incluídos consecutiva e prospectivamente. Foram realizadas duas coletas de sangue, a primeira com 24h a 48h do início dos sintomas do IAM (fase aguda) e a segunda após 3 meses do IAM (fase crônica), sempre com 12h de jejum. Foram analisados os seguintes parâmetros: glicose, cortisol, noradrenalina, hemoglobina glicada (HbA1c), insulina, LDL minimamente modificada eletronegativa, ácidos graxos livres (AGL), adiponectina, factor VII da coagulação, fibrinogênio, inibidor do ativação do plasminogênio tipo 1, proteína C reativa ultra-sensível (PCRus), colesterol total (c) e frações e triglicérides. Nas correlações univariadas entre glicemia e as variáveis contínuas empregou-se o teste de correlação de Pearson. As análises multivariadas foram feitas através de regressão logística (variáveis qualitativas) e modelo linear generalizado (quando as variáveis independentes incluídas foram quantitativas e nominais). Resultados- Na fase aguda, a glicemia correlacionou-se significativamente com HbA1c (r=0,75, p<0,001), insulina (r=0,25, p<0,001), AGL (r=0,3, p=0,01), adiponectina (r=-0,22, p=0,05), LDL-c (r=-0,25, p=0,03), VLDL-c (r=0,24, p=0,03) e triglicérides (r=0,27, p=0,01). No modelo multivariado, as variáveis correlacionadas de forma independente com a glicemia, na fase aguda, foram: HbA1c (p<0,001), insulina (p<0,001), e AGL (p=0,013). Para analisar uma variável de confusão, a história de diabetes mellitus (DM), incluiu-se esta variável num modelo, juntamente com as variáveis acima e todas mostraram associação significativas com glicose: HbA1c (p<0,001), insulina (p=0,001), AGL (p=0,013) e história de DM (p=0,027). Na fase crônica, glicose correlacionou-se com: cortisol (r=0,31, p=0,01), noradrenalina (r=0,54, p<0,001), HbA1c (r=0,78, p<0,001) e PCRus (r=0,46, p<0,001). Na análise multivariada, somente HbA1c (p<0,001) e noradrenalina (p<0,001) mantiveram correlação independente. Conclusão- A HbA1c foi a única variável que correlacionou-se de forma significativa e independente com a glicemia, tanto na fase aguda, quanto na crônica, mostrando que a hiperglicemia, durante o IAM, pode representar uma alteração crônica, sub-diagnosticada, do metabolismo glicídico. / Introduction- Hyperglycemia (HG) is an important prognostic factor in acute myocardial infarction (AMI). However, the pathophysiology is poorly understood. So we proposed a simultaneous correlation between glycemia and biochemical markers of stress, glucose and lipid metabolism, coagulation and inflammation system. Methods- Eighty AMI patients were included prospectively. Blood were collected between 24h and 48h from the pain (acute phase), and 3 months post AMI (chronic phase), with 12-h fasting. These parameters were analyzed: glucose, cortisol, norepinephrine, hemoglobin glycated (HbA1c), insulin, minimally modified electronegative LDL, free fatty acids (FFA), adiponectin, factor VII coagulant, fibrinogen, plasminogen activator inhibitor-1, high sensitive C reaction protein (hsCRP), total cholesterol (c) and fractions and triglyceride. The relationships between glucose and continuous variables were assessed by Pearsons correlation coefficient (r) and multivariate analysis with linear regression. Results- At acute phase, glucose correlated significantly with HbA1c (r=0.75, p<0.001), insulin (r=0.25, p<0.001), FFA (r=0.3, p=0.01), adiponectin (r=-0.22, p=0.05), LDL-c (r=-0.25, p=0.03), VLDL-c (r=0.24, p=0.03) and triglyceride (r=0.27, p=0.01). In a multivariate model, variables correlated were: HbA1c (p<0.001), insulin (p<0.001), and FFA (p=0.013). At the chronic phase, glucose correlated significantly with cortisol (r=0.31, p=0.01), norepinephrine (r=0.54, p<0.001), HbA1c (r=0.78, p<0.001) and hsCRP (r=0.46, p<0,001). By multivariable analysis, only HbA1c (p<0.001) and norepinephrine (p<0.001) remained correlated. Conclusion- HbA1c was the main variable that correlated significantly and independently with glycemia at acute and chronic phases, suggesting that HG during AMI can represent an exacerbation of abnormal glucose metabolism previously not diagnosed.

Due to the technology development, the diet habit has completely changed. It accompanied by the metabolite diseases relevant to blood glucose and lipids, which are dependent with the atherosclerosis and cardiovascular disease. In this study, we using matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF/MS) to characterize triglycerides in human plasma. In the other, the glycosylated hemoglobin in human whole blood was detected by liquid electrospray laser desorption ionization (Liquid ELDI/MS). Triglycerides are energy source (9 kcal/g) in human body, derived from glycerol and three fatty acids. It is a main constituent of vegetable oil and animal fats. In clinical diagnosis, human plasma was mixed with triglyceride Kit to react to the final 520 nm UV-absorbing substance, then the concentration was quantified consistent with the calibration line by UV/Visible spectrometry. By the way, it needed Kit chemicals for one trial. MALDI-TOF/MS is a simple and easy method to operate to detect complex compounds in human plasma, only need to optimize the parameters (solvent collection, sample dilution, matrix selection, sample pretreatment ) to form a homogeneous crystals. The developed ¡§seed layer¡¨ method can reduce the sweet spot effect and cause a lower with-in spot variation (RSD < 20%) compared to ¡§premix¡¨ method (RSD >30%). Combined with statistic software 2D peak distribution, a semi-quantification can be observe of 24 different triglyceride concentration human plasmas. The level of glycosylated hemoglobin (HbA1c) in whole blood is currently the most important measurement of long-term control of the glycemic state of diabetes. As a result of the interferences of high concentrations of metabolites, proteins and salts in whole blood, tedious sample cleanup procedures must be performed prior to subjecting the sample solutions to conventional LC/MS and MALDI analyses for the detection of HbA1c. Electrospray laser desorption ionization mass spectrometry (ELDI/MS), a two-step ambient ionization technique, has been developed to characterize analytes directly from the liquid sample surface. One drop of the diluted hole blood (1/10, v/v in water) was placed on the stainless steel plate. The sample droplet was irradiated with a pulse laser, the desorbed analytes were post-ionized in an electrospray (ESI) plume (ESI solution: 70% methanol in water, 0.1% acetic acid), and the analyte ions were detected by a ion trap mass analyzer. Through this study, the protocol for efficiently characterizing HbA1c present in a drop of diluted whole blood with ELDI/MS was established. We successfully detected the ion signal of HbA1c with ELDI/MS. Quantification of the level of HbA1c in the whole blood of diabetic patients was achieved by calculating the ratio of the ion peak area of the glycosylated and non-glycosylated hemoglobin ions. A linear relationship exists for the quantitative results of HbA1c in whole blood of 20 diabetic patients obtained between ELDI/MS and that through conventional spectroscopic measurement.

published_or_final_version / Nursing Studies / Master / Master of Philosophy

Thesis (M.S.) -- University of Texas Southwestern Medical Center at Dallas, 2005. / Vita. Bibliography: 104-117.

Dans la communauté scientifique, la glycosylation suscite un vif intérêt tant les relations existantes entre les sucres et les protéines sont étroites et sont impliquées dans de nombreux processus biologiques. De nombreuses méthodologies de synthèse ont été développées pour permettre la production de glycoprotéines sous forme homogènes nécessaires pour leur étude. Les formes S-glycosidiques sont d’un intérêt particulier grâce notamment à la réactivité de l’atome de soufre qui permet le couplage spécifique sucre – acide aminé et qui confère à la liaison une relative résistance à l’hydrolyse acido/basique et enzymatique. Dans le cadre de ce projet nous avons souhaité utiliser des outils biocatalytiques pour proposer une nouvelle voie d’accès aux protéines S-glycosylées en s’appuyant sur le concept des thioglycoligases. Pour répondre à ce challenge, nous nous sommes intéressés à la production d’une banque de glycosidases natives à partir du génome de la bactérie thermophile Dictyoglomus thermophilum. Trois protéines originales ont pu être produites, caractérisées et criblées en activité transglycosylase. Parmi ces dernières la β-glycosidase DtGly s’est révélée être un biocatalyseur efficace en favorisant la synthèse d’une variété de glycosides d’alkyle et de glycosyl glycérol. Par la suite, neuf mutants thioglycoligases ont été produits par mutagénèse dirigée à partir des glycosidases natives. A l’issue de leur criblage en activité thioligase, le mutant de DtGly E159Q a été retenu pour la synthèse de S-glycoconjugués. Une étude de relation structure/activité menée sur l’enzyme mutée nous a conduit à la synthèse d’un acide aminé non-naturel, la Thiotyrosine. L’essai de glycosylation de l’analogue estérifié de cette Thiotyrosine par DtGly E159Q a été suivi par LC-MS et a permis de mettre en évidence la formation du produit de thioglucosylation. Ce premier résultat préliminaire s’avère très prometteur pour la validation du concept de S-glycosylation d’un acide aminé catalysée par une thioglycoligase. / Glycosylation, one of the most complex co- and post-translationnal modifications of proteins, is of utmost importance for the scientific community as carbohydrates and proteins are closely related and involved in numerous diseases. The need to access homogeneous glycoproteins allows the development of a wide range of synthetic methods. Among them S-glycosidic forms have been attractive thanks to the reactivity of sulfur atom which allows the specific sugar – amino acid conjugation and confers a relative resistance through acido/basic or enzymatic hydrolysis. In this project we attempt to take advantage of natural tools to develop an enzymatic methodology to prepare S-glycosylated proteins through the thioglycoligase concept. In order to take up this challenge we first generate an enzymatic pool of wild type glycosidases from the thermophilic bacteria Dictyoglomus thermophilum. Activity screening of the three proteins produced and characterized allows the isolation of the β-glycosidase DtGly with good transglycosylation activity, thus affording a variety of alkyl glycosides and glyceroglycosides. Next we generate nine thioglycoligase mutants through site-directed mutagenesis and after screening of activity, the variant DtGly E159Q was selected to produce S-glycoconjugates. Finally, DtGly E159Q relation structure/activity studies led us to synthesize the unnatural amino acid Thiotyrosine. Enzymatic thioglucosylation assay catalyzed by DtGly E159Q was monitored by LC-MS and gave converging evidence of the successful formation of the S-glucosylated Thiotyrosine. This tremendous preliminary result is promising for further investigations of enzymatic S-glycosylation of amino acid using thioglycoligases as toolbox.