Development of the endocrine pancreas and novel strategies for β-cell mass restoration and diabetes therapy

Diabetes mellitus represents a serious public health problem owing to its global prevalence in the last decade. The causes of this metabolic disease include dysfunction and/or insufficient number of β cells. Existing diabetes mellitus treatments do not reverse or control the disease. Therefore, β-cell mass restoration might be a promising treatment. Several restoration approaches have been developed: inducing the proliferation of remaining insulin-producing cells, de novo islet formation from pancreatic progenitor cells (neogenesis), and converting non-β cells within the pancreas to β cells (transdifferentiation) are the most direct, simple, and least invasive ways to increase β-cell mass. However, their clinical significance is yet to be determined. Hypothetically, β cells or islet transplantation methods might be curative strategies for diabetes mellitus; however, the scarcity of donors limits the clinical application of these approaches. Thus, alternative cell sources for β-cell replacement could include embryonic stem cells, induced pluripotent stem cells, and mesenchymal stem cells. However, most differentiated cells obtained using these techniques are functionally immature and show poor glucose-stimulated insulin secretion compared with native β cells. Currently, their clinical use is still hampered by ethical issues and the risk of tumor development post transplantation. In this review, we briefly summarize the current knowledge of mouse pancreas organogenesis, morphogenesis, and maturation, including the molecular mechanisms involved. We then discuss two possible approaches of β-cell mass restoration for diabetes mellitus therapy: β-cell regeneration and β-cell replacement. We critically analyze each strategy with respect to the accessibility of the cells, potential risk to patients, and possible clinical outcomes.

Novel retrograde puncture method to establish preperitoneal space for laparoscopic direct inguinal hernia repair with internal ring suturing

The aim of this study was to explore the clinical efficacy of a novel retrograde puncture approach to establish a preperitoneal space for laparoscopic direct inguinal hernia repair with inguinal ring suturing. Forty-two patients who underwent laparoscopic inguinal hernia repair with retrograde puncture for preperitoneal space establishment as well as inguinal ring suturing between August 2013 and March 2014 at our hospital were enrolled. Preperitoneal space was successfully established in all patients, with a mean establishment time of 6 min. Laparoscopic repairs were successful in all patients, with a mean surgical time of 26±15.1 min. Mean postoperative hospitalization duration was 3.0±0.7 days. Two patients suffered from postoperative local hematomas, which were relieved after puncturing and drainage. Four patients had short-term local pain. There were no cases of chronic pain. Patients were followed up for 6 months to 1 year, and no recurrence was observed. Our results demonstrate that preperitoneal space established by the retrograde puncture technique can be successfully used in adult laparoscopic hernioplasty to avoid intraoperative mesh fixation, and thus reduce medical costs.

Characterization of amine-based CO2 adsorbent for Direct Air Capture

Direct air capture technologies extract CO2 from air at a concentration of as low as 400ppm. The captured CO2 can be used for the production of synthetic methane or liquid fuels. In the literature survey of this thesis, results related to direct air capture by using solid sorbents are presented and critically discussed. In the experimental part, a proprietary amine functionalized resin is characterized for direct air capture. Structural comparison is also made to a commercial resin of similar type. Based on the literature survey, the most important parameters in direct air capture process are low adsorption and desorption temperatures, good cyclic stability in dry and humid conditions, high CO2 outlet purity and a high working capacity. Primary amine functionalized solid sorbents are found to often have good qualities for direct air capture, but overall process performance is rarely studied exhaustively. Based on FTIR spectra, both resin adsorbents are found to be consisted of polystyrene functionalized with primary amine, and capture CO2 by forming carbamate. The commercial resin is more porous, has a slightly higher particle size and contains fewer impurities. Important physical parameters are gained of the proprietary resin, such as internal porosity and median particle size. The resin’s amine group is found to endure thermal treatment reasonably well. CO2 adsorption capacity gained by thermal gravimetry from 400ppm CO2 is highest at 25oC, and is found to be reasonable compared to values presented in literature. Thus, the resin is stated to exhibit promising qualities for direct air capture.