bluuebunny/crossref_metadata_2025 huggingface dataset:
Sport Nutrition in Childhood: Meeting the Metabolic Demands of Growth and Exercise
Authors: Zanker C.L.
Published: June 2006

The primary goals of childhood are optimal growth and maturation. These developmental processes demand positive energy and nitrogen balance. Regular physical activity can enhance childhood development; however, strenuous physical training may reduce the body’s stores of energy and nitrogen, both of which must be replaced through the diet. Physically active adolescents are susceptible to disordered eating, which can lead to protein-energy malnutrition. The consequences of negative energy and nitrogen balance include delayed, retarded or arrested growth and pubertal maturation. Currently, there is scant evidence to suggest that physical training has a direct negative impact on growth and maturation. A well-balanced diet is essential for the maintenance of physical performance and the preservation of health in all physically active individuals, regardless of age. Food provides the chemical elements required for the production of energy by exercising skeletal muscle, the post-exercise replenishment of fuel stores and the regeneration of damaged muscle. The dietary requirements of physically active children alter with increasing body size and pubertal progression. The maturation state is an important determinant of the metabolic and physiological responses to exercise, and so influences both physical performance capacity and dietary needs. Studies of fuel metabolism in children suggest that they are well equipped for sustained aerobic activity, but that their capacity for anaerobic performance is limited by their maturation state. Importantly, ethical restrictions preclude the type of detailed and invasive research that has identified the nutritional requirements of physically active adults. Nevertheless, it would seem that like such adults, physically active children have greater dietary demands for energy, carbohydrate, protein and water than their sedentary counterparts. This article justifies the nutritional requirements of athletic children on the basis of the physiological and metabolic demands of survival, growth and physical activity.
Effects of Unfractionated Heparin and Low-Molecular-Weight Heparin on Colonic Anastomoses in the Presence of Experimental Peritonitis
Authors: Gunerhan Yusuf , Koksal Neset , Gul Ozden , Uzun Mehmet Ali , Gunes Pembegul , Adaleti Riza
Published: June 2006

Background: We aimed at investigating the effects of unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) on the healing process of colonic anastomoses in the presence of peritonitis which is known to adversely affect the healing process. Study Design: Three groups of Wistar albino rats (n = 15 in each group) with experimental fecal peritonitis were studied. A 1-cm colonic segment was resected, and an end-to-end anastomosis was performed. The control group (group 1) was given no treatment; group 2 animals received 50 IU/kg s.c. UFH twice a day, and group 3 rats received LMWH at a dose of 1.5 mg/kg daily for 7 days postoperatively. Relaparotomy was done on day 7 in the surviving rats. The rats were sacrificed by resection of the colonic segment. The anastomosis bursting pressures were measured and the tissue samples from anastomosis lines were histopathologically examined. Results: The bursting pressures were significantly higher in UFH and LMWH groups as compared with the controls (p = 0.021 and p < 0.001, respectively), while there was no statistically significant difference between UFH and LMWH groups. Positive bacterial culture results were more common in controls (90%) than in the other two groups (p = 0.029 and p = 0.002, respectively). Also the polymorphonuclear leukocyte counts were higher (p = 0.005) and the fibrin formation more common (p = 0.007) in the controls. On the other hand, the number of fibroblasts was higher (p = 0.002) and collagen formation and revascularization more frequent (p = 0.001 and p = 0.001, respectively) in the UFH and LMWH groups. Conclusion: UFH and LMWH may have positive effects on the healing process of colonic anastomoses in the presence of peritonitis.
Elevated Levels of Alkanals, Alkenals and 4-HO-Alkenals in Plasma of Hemodialysis Patients
Authors: Alhamdani Mohamed-Saiel Saeed , Al-Kassir Abdul-Hameed A.M. , Jaleel Nidham A. , Hmood Ammar Muola , Ali Huda Mohammed
Published: June 2006

Background/Aims: Several studies have implicated reactive carbonyl compounds (RCOs), especially those derived from lipid peroxidation, in the development of complications frequently associated with hemodialysis (HD) treatment. However, there is still much unknown regarding the nature and concentration of RCOs in HD patients. This study was designed to evaluate the level of toxic aldehydes in the plasma of HD patients and to determine the extent to which these aldehydes contribute to RCO toxicity among these patients. Methods: 15 aldehydes of the alkanal, alkenal and 4-HO-alkenal type were measured in the plasma of 17 HD patients and 20 healthy controls. In addition, protein modification markers such as carbonyl content (CO), free thiol (SH) and residual free amino groups, as well as amyloid fibrils were also determined. Results: 11 of the 15 aldehydes were significantly elevated in the HD group when compared with the controls. Correlation studies in the HD group revealed high relationships between total alkenals plus total 4-HO-alkenals versus CO, total alkanals versus NH2, total aldehydes versus SH, and total 4-HO-alkenals versus fibril. Conclusion: The increased levels of alkanals, alkenals and 4-HO-alkenals of lipid peroxidation in the plasma of HD patients may greatly contribute to the toxicity of RCOs. The pattern of modification of plasma protein by each group of aldehydes may provide new evidence on the in vivo mechanisms of toxicity triggered by these aldehydes on their target molecules.
A Demonstration That Large-Scale Warming Is Not Urban
Authors: Parker David E.
Published: June 2006

On the premise that urban heat islands are strongest in calm conditions but are largely absent in windy weather, daily minimum and maximum air temperatures for the period 1950–2000 at a worldwide selection of land stations are analyzed separately for windy and calm conditions, and the global and regional trends are compared. The trends in temperature are almost unaffected by this subsampling, indicating that urban development and other local or instrumental influences have contributed little overall to the observed warming trends. The trends of temperature averaged over the selected land stations worldwide are in close agreement with published trends based on much more complete networks, indicating that the smaller selection used here is sufficient for reliable sampling of global trends as well as interannual variations. A small tendency for windy days to have warmed more than other days in winter over Eurasia is the opposite of that expected from urbanization and is likely to be a consequence of atmospheric circulation changes.
Understanding the Mid-Holocene Climate
Authors: Shin Sang-Ik , Sardeshmukh Prashant D. , Webb Robert S. , Oglesby Robert J. , Barsugli Joseph J.
Published: June 2006

Paleoclimatic evidence suggests that during the mid-Holocene epoch (about 6000 yr ago) North America and North Africa were significantly drier and wetter, respectively, than at present. Modeling efforts to attribute these differences to changes in orbital parameters and greenhouse gas (GHG) levels have had limited success, especially over North America. In this study, the importance of a possibly cooler tropical Pacific Ocean during the epoch (akin to a permanent La Niña–like perturbation to the present climate) in causing these differences is emphasized. Systematic sets of atmospheric general circulation model experiments, with prescribed sea surface temperatures (SSTs) in the tropical Pacific basin and an interactive mixed layer ocean elsewhere, are performed. Given the inadequacies of current fully coupled climate models in simulating the tropical Pacific climate, this intermediate coupling model configuration is argued to be more suitable for quantifying the contributions of the altered orbital forcing, GHG levels, and tropical Pacific SST conditions to the different mid-Holocene climates. The simulated responses in this configuration are in fact generally more consistent with the available evidence from paleovegetation and sedimentary records.

Coupling to the mixed layer ocean enhances the wind–evaporation–SST feedback over the tropical Atlantic Ocean. The net response to the orbital changes is to shift the North Atlantic intertropical convergence zone (ITCZ) northward, and make North Africa wetter. The response to the reduced GHG levels opposes, but does not eliminate, these changes. The northward-shifted ITCZ also blocks the moisture supply from the Gulf of Mexico into North America. This drying tendency is greatly amplified by the local response to La Niña–like conditions in the tropical Pacific. Consistent with the paleoclimatic evidence, the simulated North American drying is also most pronounced in the growing (spring) season.
The Termination of the 1997–98 El Niño. Part I: Mechanisms of Oceanic Change*
Authors: Vecchi Gabriel A. , Harrison D. E.
Published: June 2006

The 1997–98 El Niño was both unusually strong and terminated unusually. Warm eastern equatorial Pacific (EEqP) sea surface temperature anomalies (SSTAs) exceeded 4°C at the event peak and lasted well into boreal spring of 1998, even though subsurface temperatures began cooling in December 1997. The oceanic processes that controlled this unusual termination are explored here and can be characterized by three features: (i) eastward propagating equatorial Pacific thermocline (Ztc) shoaling beginning in the central Pacific in November 1997; (ii) persistent warm EEqP SSTA between December 1997 and May 1998, despite strong EEqP Ztc shoaling (and subsurface cooling); and (iii) an abrupt cooling of EEqP SSTA in early May 1998 that exceeded 4°C within two weeks.

It is shown here that these changes can be understood in terms of the oceanic response to changes to the meridional structure of the near-equatorial zonal wind field. Equatorial near-date-line westerly wind anomalies greatly decreased in late 1997, associated with a southward shift of convective and wind anomalies. In the EEqP, equatorial easterlies disappeared (reappeared) in late January (early May) 1998, driving the springtime extension (abrupt termination) of this El Niño event. The authors suggest that the wind changes arise from fundamentally meridional processes and are tied to the annual cycle of insolation.
Spatiotemporal Disaggregation of Remotely Sensed Precipitation for Ensemble Hydrologic Modeling and Data Assimilation
Authors: Margulis Steven A. , Entekhabi Dara , McLaughlin Dennis
Published: June 2006

Historically, estimates of precipitation for hydrologic applications have largely been obtained using ground-based rain gauges despite the fact that they can contain significant measurement and sampling errors. Remotely sensed precipitation products provide the ability to overcome spatial coverage limitations, but the direct use of these products generally suffers from their relatively coarse spatial and temporal resolution and inherent retrieval errors. A simple ensemble-based disaggregation scheme is proposed as a general framework for using remotely sensed precipitation data in hydrologic applications. The scheme generates fine-scale precipitation realizations that are conditioned on large-scale precipitation measurements. The ensemble approach allows for uncertainty related to the complex error characteristics of the remotely sensed precipitation (undetected events, nonzero false alarm rate, etc.) to be taken into account. The methodology is applied through several synthetic experiments over the southern Great Plains using the Global Precipitation Climatology Project 1° daily (GPCP-1DD) product. The scheme is shown to reasonably capture the land-surface-forcing variability and propagate this uncertainty to the estimation of soil moisture and land surface flux fields at fine scales. The ensemble results outperform a case using sparse ground-based forcing. Additionally, the ensemble nature of the framework allows for simply merging the open-loop soil moisture estimation scheme with modern data assimilation techniques like the ensemble Kalman filter. Results show that estimation of the soil moisture and surface flux fields are further improved through the assimilation of coarse-scale microwave radiobrightness observations.
Reconciling Simulated Moisture Fluxes Resulting from Alternate Hydrologic Model Time Steps and Energy Budget Closure Assumptions
Authors: Haddeland Ingjerd , Lettenmaier Dennis P. , Skaugen Thomas
Published: June 2006

Hydrological model predictions are sensitive to model forcings, input parameters, and the parameterizations of physical processes. Analyses performed for the Variable Infiltration Capacity model show that the resulting moisture fluxes are sensitive to the time step and energy balance closure assumptions. In addition, the model results are sensitive to the method of spatial and temporal disaggregation of precipitation. For parameter estimation purposes, it is desirable to do parameter searches in water balance mode (meaning that the effective surface temperature is assumed equal to the surface air temperature; hence no iteration for energy balance closure is performed) at daily time steps. However, transferring these parameters directly to other model modes (e.g., energy balance, in which an iteration for effective surface temperature is performed, and/or different model time steps) results in changes in the simulated moisture fluxes. The simulated differences in moisture fluxes are mainly a result of the parameterization of evapotranspiration at different time steps and model modes. A simple scheme that calculates correction factors for some model parameters is developed. The scheme is used to match simulated moisture fluxes in hourly and 3-hourly energy balance mode to the daily water balance simulation results, and to match hourly energy balance runs using spatially and temporally disaggregated precipitation to 3-hourly energy balance runs using uniformly disaggregated precipitation. For both approaches, the corrected simulations match the baseline simulations quite closely, both over transects across much of the continental United States and for test applications in the Ohio and Arkansas–Red River basins.
SPODOBASE : an EST database for the lepidopteran crop pest Spodoptera
Authors: Nègre Vincent , Hôtelier Thierry , Volkoff Anne-Nathalie , Gimenez Sylvie , Cousserans François , Mita Kazuei , Sabau Xavier , Rocher Janick , López-Ferber Miguel , d'Alençon Emmanuelle , Audant Pascaline , Sabourault Cécile , Bidegainberry Vincent , Hilliou Frédérique , Fournier Philippe
Published: June 2006

Background

The Lepidoptera Spodoptera frugiperda is a pest which causes widespread economic damage on a variety of crop plants. It is also well known through its famous Sf9 cell line which is used for numerous heterologous protein productions. Species of the Spodoptera genus are used as model for pesticide resistance and to study virus host interactions. A genomic approach is now a critical step for further new developments in biology and pathology of these insects, and the results of ESTs sequencing efforts need to be structured into databases providing an integrated set of tools and informations.

Description

The ESTs from five independent cDNA libraries, prepared from three different S. frugiperda tissues (hemocytes, midgut and fat body) and from the Sf9 cell line, are deposited in the database. These tissues were chosen because of their importance in biological processes such as immune response, development and plant/insect interaction. So far, the SPODOBASE contains 29,325 ESTs, which are cleaned and clustered into non-redundant sets (2294 clusters and 6103 singletons). The SPODOBASE is constructed in such a way that other ESTs from S. frugiperda or other species may be added. User can retrieve information using text searches, pre-formatted queries, query assistant or blast searches. Annotation is provided against NCBI, UNIPROT or Bombyx mori ESTs databases, and with GO-Slim vocabulary.

Conclusion

The SPODOBASE database provides integrated access to expressed sequence tags (EST) from the lepidopteran insect Spodoptera frugiperda. It is a publicly available structured database with insect pest sequences which will allow identification of a number of genes and comprehensive cloning of gene families of interest for scientific community. SPODOBASE is available from URL: http://bioweb.ensam.inra.fr/spodobase
Effect of high up front charges on access to surgery for poor patients at a public hospital in New Mexico
Authors: Kaufman Will , Chavez Augustine S , Skipper Betty , Kaufman Arthur
Published: June 2006

Background

A public hospital in New Mexico required collection of 50% of estimated costs prior to elective surgeries for self-pay patients. This study assesses the impact of this policy on access to elective surgical procedures.

Methods

Chi-square tests determined if there was a statistically significant difference between the number of self-pay and insured patient cancellations for financial reasons. A multivariate binomial regression model was used to calculate risk ratios and confidence limits for effects of race/ethnicity, and insurance status, controlling for gender, on these cancellations.

Results

Of the 667 cancellations, there were 99 self-pay and 568 insured patients. Cancellations for financial reasons occurred in 55.6% of self-pay and 9.3% of insured patients (p < 0.0001). Inability to pay 50% up front accounted for 76.4% of self-pay patient cancellations for financial reasons. Self-pay, non-Hispanic whites and minority race/ethnicities were 8.76 and 8.61 times more likely to cancel for financial reasons, respectively, than insured non-Hispanic whites.

Conclusion

Self-pay patients, regardless of race/ethnicity, have elective surgical procedures cancelled for financial reasons significantly more often than insured patients. The hospital's 50% up-front payment policy represents a significant financial barrier to accessing elective surgical procedures for self-pay patients.
Prevention of disease progression in a patient with a gastric cancer-re-recurrence. Outcome after intravenous treatment with the novel antineoplastic agent taurolidine. Report of a case
Authors: Braumann Chris , Winkler Goetz , Rogalla Patrick , Menenakos Charalambos , Jacobi Christoph A
Published: June 2006

Background

Taurolidine (TRD) is a novel agent with multimodal antineoplastic effects. We present the case of a tumor remission after intravenous administration of taurolidine in a patient with gastric cancer re-recurrence.

Case presentation

A 58 years old male patient suffering from a gastric adenocarcinoma was submitted to partial gastrectomy and partial liver resection (pT2, pN1, pM1L (liver segment 2), N0, V0). 24 months later a local recurrence was diagnosed and the patient was reoperated. Postoperatively the patient underwent a palliative chemotherapy with eloxatin, FU, and leucovorin. A subsequent CT-revealed a liver metastasis and a recurrence adjacent to the hepatic artery. After successful radiofrequency ablation of the liver metastasis the patient was intravenously treated with 2% taurolidine. The patient endured the therapy well and no toxicity was observed. CT-scans revealed a stable disease without a tumor progression or metastatic spread. After 39 cycles the patient was submitted to left nephrectomy due to primary urothelial carcinoma and died 2 days later due to myocardial infarction. Postmortem histology of the esophageal-jejunal anastomosis and liver revealed complete remission of the known metastasized gastric adenocarcinoma.

Conclusion

The intravenous treatment with 2% taurolidine led to a histological remission of the tumor growth without any toxicity for the patient.
Pivotal Advance: Activation of cell surface Toll-like receptors causes shedding of the hemoglobin scavenger receptor CD163
Authors: Weaver Lehn K , Hintz-Goldstein Katharine A , Pioli Patricia A , Wardwell Kathleen , Qureshi Nilofer , Vogel Stefanie N , Guyre Paul M
Published: June 2006

The hemoglobin scavenger receptor (HbSR) CD163 is a monocyte/macrophage-specific glycoprotein that binds and facilitates uptake of haptoglobin-hemoglobin (Hp-Hb) complexes, which are rapidly formed in the circulation upon hemolysis of red blood cells. Hemolysis can be caused by a diverse range of infectious agents and provides pathogens a source of iron to enhance their survival and replication. Previous work demonstrated that lipopolysaccharide (LPS) activates monocytes to cleave cell-bound HbSR into a soluble mediator that retains the capacity to bind Hp-Hb complexes. We report that blocking LPS activation of Toll-like receptor 4 prevents LPS-mediated shedding of CD163. Furthermore, activation of two other cell surface Toll-like receptors (TLR), TLR2 and TLR5, induces shedding of the HbSR from human monocytes. In contrast, treatment of monocytes with intracellular TLR3, TLR7, and TLR9 agonists failed to cause HbSR shedding, suggesting that this shedding event is selective to cell surface TLR activation. These data demonstrate that the soluble HbSR is released from monocytic cells in response to TLR signaling as an acute innate immune response to extracellular pathogen infections.
The effect of iron status on vascular health
Authors: Yunker Leanne M , Parboosingh Jillian S , Conradson Heather E , Faris Peter , Bridge Peter J , Buithieu Jean , Title Lawrence M , Charbonneau Francois , Verma Subodh , Lonn Eva M , Anderson Todd J
Published: June 2006

The effect of increased iron stores on the progression of atherosclerosis and endothelial health remains inconclusive. This study was designed to evaluate the relationship between hemochromatosis genotypes, serum ferritin levels and presymptomatic vascular abnormalities in a cohort of healthy subjects. Carotid intima-media thickness (CIMT) and brachial flow-mediated vasodilation (FMD) were assessed by high-resolution ultrasound in 907 male (47 ± 10 years) participants enrolled in the Firefighters and their Endothelium (FATE) study. Analyses of the hemochromatosis C282Y, H63D and S65C alleles were simultaneously determined by a single nucleotide polymorphism (SNP) primer extension method. It was found that brachial FMD was not related to serum ferritin or hemochromatosis genotype status. The presence of a hemochromatosis-associated genotype ( n = 18) or heterozygosity for the C282Y genotype ( n = 98) was not associated with an increased mean CIMT. After adjustment for conventional risk factors, serum ferritin was also not associated with mean CIMT. In conclusion, neither ferritin nor a hemochromatosis genotype was related to brachial endothelial function or carotid atherosclerosis. The present study does not support the hypothesis that mild to moderately increased iron stores are associated with enhanced atherosclerosis risk.
Sarpogrelate, a 5-HT2A receptor antagonist in intermittent claudication. A Phase II European study
Authors: Norgren L , Jawien A , Mátyás L , Rieger H , Arita K ,   European MCI-9042 Study Group
Published: June 2006

This was a multinational, multicentre, double-blind Phase II study in Europe to evaluate the efficacy and safety of two dose regimens (200 mg bid and 200 mg tid) of sarpogrelate (MCI-9042, 5-HT2A receptor antagonist) compared to placebo in patients with stable, moderately severe intermittent claudication. Following a single-blind placebo run-in period of 6 weeks, 364 (309 male and 55 female) patients (59.2 ± 8.4 years, mean SD) were randomized to receive sarpogrelate 200 mg bid, 200 mg tid or placebo for 24 weeks with a follow-up of 8 weeks. The primary objective was the increase of absolute claudication distance (ACD) at the end of treatment (week 24) compared to placebo. Analysis of covariance (ANCOVA) was performed on the log-transformed percentage of baseline ACD: loge (ACD/baseline). A responder analysis (defined as a 50% improvement in ACD) was also performed. There was a marked training/placebo effect on the ACD which persisted up to 16 weeks. At 24 weeks the primary objective did not reach statistical significance (200 mg bid vs placebo, p = 0.225; 200 mg tid vs placebo, p = 0.580). In the responder analysis, 200 mg bid showed a statistically significant difference vs placebo ( p = 0.035). In the exploratory analysis with completers (patients completing all treadmill tests), there was a statistical difference in ACD/baseline change for 200 mg bid ( p = 0.035) and in the responder analysis for 200 mg tid ( p = 0.044) at 24 weeks compared to placebo. Both treatments showed a carry-over effect for ACD during the 8-week follow-up (weeks 28-32). The treatment was well tolerated and no clinically significant safety concerns were reported. In conclusion, the study results confirm that sarpogrelate is well tolerated and although the primary endpoint failed to reach statistical significance, the responder analysis showed an increased absolute walking distance, which makes a further trial warranted, including a larger population, and possibly also a longer treatment period.
Potential role of the Slit/Robo signal pathway in angiogenesis
Authors: Fujiwara Masakazu , Ghazizadeh Mohammad , Kawanami Oichi
Published: June 2006

Intensive investigations on angiogenesis and vasculogenesis have increased our understanding of molecular mechanisms of blood vessel formation during pathologic and developmental conditions. However, endothelial cells (ECs), the main component of vasculature, are heterogeneous, as revealed by our phenotypic and molecular biological studies in the laboratory, and it is still hard to adequately understand the molecular mechanisms of angiogenesis and vasculogenesis. Indeed, there are several major ligand/receptor signal pathways: VEGF/VEGFR, Jagged-1/Notch, Wnt ligand/frizzled receptor, and ephrin/Eph; each of which having distinct and independent roles during vascular formation. In this review, we focus on the angiogenic effect of the Slit and Robo signal pathway that was formally known as neuronal axon guidance. Among the existing vascular signals, this pathway is the most recently found ligand/receptor vascular signal, and may play important physiological roles as other major receptor/ligand signals do. Here, we briefly address: (1) the background of Slit and Robo families; (2) expression patterns of Slit and Robo; (3) functional roles of the Slit/Robo pathway in vascular formation; and (4) confronting tasks of this novel vascular pathway in the near future. Together, a summary of these data suggest the essential role of the Slit/Robo pathway in angiogenesis, and may explain why multiple vascular signals exist in heterogenic endothelial cells.
Repair of a splenic artery aneurysm using a novel balloon-expandable covered stent
Authors: Guller Jeffrey , Samman Mahmoud , Deyer Timothy W , Lookstein Robert , Nowakowski Scott
Published: June 2006

We describe a case of endovascular exclusion of a splenic artery aneurysm. The repair utilized a novel balloon-expandable stent-graft.
Vascular viewpoint
Authors: Lindsay TF , Dueck AD
Published: June 2006

Question: Is duplex scanning superior to clinical vein graft surveillance with respect to amputation rates, quality of life, and cost following femoropopliteal or femorocrural vein bypass graft?

Population: Between 1998 and 2001, patients from 29 centers in the UK and Europe who had a patent vein graft 30 days following femoropopliteal or femorocrural vein bypass surgery for critical ischemia, claudication or symptomatic popliteal aneurysms were recruited for the study.

Methods and results: There were 592 patients included in this multicenter randomized controlled trial. Patients with patent vein grafts at 30 days were randomized to receive or not receive duplex surveillance in addition to clinical examinations and ankle-brachial indices at 6 weeks (time of recruitment), and 3, 6, 9, 12 and 18 months. Stenoses within grafts were defined as slow peak systolic velocity (<45 cm/s), or a ratio of peak systolic velocity in an area of stenosis to any other area within 2 cm of >2. The primary endpoints were time to amputation and time to vascular mortality (MI, CHF, arrhythmia or CVA). Secondary outcomes included graft patency (whether primary or secondary, assisted or unassisted), cost, and quality of life as measured by SF-36 and EuroQol. The primary endpoints were analyzed according to an intention-to-treat analysis using Cox-regression and Kaplan-Meier life tables, while secondary outcomes were analyzed by the Mann-Whitney test and a t-test. Approximately 11% of patients died during the study, while 12% withdrew (45% of which were due to amputations). There were significantly more diagnostic interventions in the clinical follow-up group (31% vs 22%, P = 0.01). Between the clinical follow-up and duplex groups, there was no difference in amputation rate (7% vs 7%) or vascular death rate (3% vs 4%). A greater proportion of patients in the clinical follow-up group had a stenosis in the graft identified at the end of the study (19% vs 12%, p = 0.04). There were no differences in Kaplan-Meier estimates of primary, primary assisted and secondary patency rates between the two groups at 18 months. No differences in quality of life as measured by SF-36 or EuroQol were detected between the two groups. The cost per patient was greater in the duplex group (US$ 1537 vs US$ 2406, p = 0.002).

Conclusion: The authors conclude that surveillance with duplex scanning following femoropopliteal or femorocrural bypass was more costly, but did not result in lower amputation rates.
Folic acid improves endothelial dysfunction in type 2 diabetes - an effect independent of homocysteine-lowering
Authors: Title Lawrence M , Ur Ehud , Giddens Karen , McQueen Matthew J , Nassar Bassam A
Published: June 2006

Diabetes is associated with endothelial dysfunction, which in part may be related to uncoupling of the endothelial nitric oxide (NO) synthase enzyme, thus reducing the availability of NO. As folates may potentially reverse the uncoupling of NO synthase, we wanted to determine whether folic acid supplementation could modulate endothelial function and markers of inflammation in patients with type 2 diabetes without vascular disease. Nineteen patients with type 2 diabetes were treated with folic acid (10 mg/day for 2 weeks) versus placebo in a randomized, placebo-controlled, cross-over study with an 8-week washout period between treatments. Fasting endothelium-dependent flow-mediated dilatation (FMD) of the brachial artery, endothelium-independent nitroglycerin-mediated dilatation (NMD), plasma homocysteine, serum lipids, folate, and inflammatory markers (high-sensitivity C-reactive protein, soluble intercellular adhesion molecule-1 and vascular cell adhesion molecule-1, interleukin-18, tumor necrosis factor-alpha) were assessed after each 2-week treatment period. Folic acid supplementation significantly increased folate levels and lowered plasma homocysteine levels. Folic acid significantly improved FMD compared to placebo (5.8 4.8% vs 3.2 2.7%, p 0.02). There were no significant effects of folic acid supplementation on lipids, NMD, or the inflammatory markers. There was no relationship between the change in homocysteine and the improvement in FMD. Thus, 2 weeks of folic acid supplementation can improve endothelial dysfunction in type 2 diabetics independent of homocysteine-lowering, but does not modulate markers of inflammation.
Ultrasound-detected carotid plaque as a predictor of cardiovascular events
Authors: Wyman Rachael A , Mays Maureen E , McBride Patrick E , Stein James H
Published: June 2006

Ultrasound detection of carotid plaque can be performed with equipment that is available in many clinical settings and can identify patients at increased risk of cardiovascular (CV) disease. We reviewed the literature to determine the CV risk factors associated with the presence of carotid plaque and whether its presence is associated with the presence and extent of coronary artery disease. A MEDLINE search subsequently was performed to determine whether carotid plaque burden predicts future CV events. Studies that had more than 300 subjects and reported hazard ratios or relative risk estimates for CV events, or data from which these values could be calculated, were included. References from identified studies also were examined for inclusion in the review. Nine studies met these criteria. Although there was not a uniform definition of carotid plaque, eight studies found that the presence of carotid plaque predicted incident CV death and/or myocardial infarction. In several studies, this relationship persisted after adjustments for risk factors. Ultrasound detection of carotid plaque is a straightforward, inexpensive, and safe tool that has the potential to be used in an office setting to help clarify a patient’s CV risk.
Type-2 diabetes and carotid stenosis: a proposal for a screening strategy in asymptomatic patients
Authors: Lacroix P , Aboyans V , Criqui MH , Bertin F , Bouhamed T , Archambeaud F , Laskar M
Published: June 2006

The objective of this prospective observational study was to establish the prevalence of carotid atherosclerosis in an asymptomatic diabetic population and to determine predictive factors for a screening optimization. A total of 300 consecutive type-2 diabetic subjects (166 males, 134 females) underwent a physical examination and duplex carotid scanning. Patients with a recent cerebrovascular event (±6 weeks) or previous carotid surgery were excluded. The prevalence of carotid stenosis ≥60% or occlusion was 4.7%; the prevalence of carotid atherosclerosis was 68.3%. Risk factors for stenosis ≤60% or occlusion were the presence of diabetic retinopathy (OR: 3.62; 95% CI: 1.12-11.73), ankle-brachial index (ABI) <0.85 (OR: 3.94; 95% CI: 1.21-12.84) and a personal history of neurological disorders (OR: 4.54; 95% CI: 1.16-17.81). Being female was a protective factor (OR: 0.09; 95% CI: 0.01-0.78). The two factors in the analysis limited to the male population were an ABI < 0.85 (OR: 3.66; 95% CI: 1.04-12.84) and a personal history of coronary heart disease (OR: 3.34; 95% CI: 1.01-11.01). If male diabetics without either of these two factors are excluded, the negative predictive value for carotid stenosis is 96.6%. In conclusion, the prevalence of atherosclerotic carotid disease in diabetic patients is high. In these patients, the probability of finding >60% stenosis is highest among men with a history of coronary heart disease or an ABI <0.85.
Falsely high ankle-brachial index predicts major amputation in critical limb ischemia
Authors: Silvestro Antonio , Diehm Nicolas , Savolainen Hannu , Do Do-Dai , Vögele Jolanda , Mahler Felix , Zwicky Samuel , Baumgartner Iris
Published: June 2006

Falsely high ankle-brachial index (ABI) values are associated with an adverse clinical outcome in diabetes mellitus. The aim of the present study was to verify whether such an association also exists in patients with chronic critical limb ischemia (CLI) with and without diabetes. A total of 229 patients (74 ± 11 years, 136 males, 244 limbs with CLI) were followed for 262 ± 136 days. Incompressibility of lower limb arteries (ABI > 1.3) was found in 45 patients, and was associated with diabetes mellitus ( p = 0.01) and renal insufficiency ( p = 0.035). Limbs with incompressible ankle arteries had a higher rate of major amputation ( p = 0.002 by log-rank). This association was confirmed by multivariate Cox regression analysis (relative risk [RR] 2.67; 95% CI 1.27-5.64, p = 0.01). The relationship between ABI > 1.3 and amputation rate persisted after subjects with diabetes and renal insufficiency had been removed from the analysis (RR 3.85; 95% CI 1.25-11.79, p = 0.018). Dividing limbs with measurable ankle pressure according to tertiles of ABI, the group in the second tertile (0.323 ≤ ABI ≤ 0.469) had the lowest amputation rate (4/64, 6.2%), and a U-shaped association between the occurrence of major amputation and ABI was evident. No association was found between ABI and mortality. In conclusion, this study demonstrates that falsely high ABI is an independent predictor of major amputation in patients with CLI.
Changes in Serum Insulin-Like Factor 3 during Normal Male Puberty
Authors: Ferlin Alberto , Garolla Andrea , Rigon Franco , Rasi Caldogno Lucia , Lenzi Andrea , Foresta Carlo
Published: June 2006

Context: Insulin-like factor 3 (INSL3) is produced by the Leydig cells, and in adults, its secretion is dependent on the state of differentiation of these cells, which, in turn, is dependent on LH. However, the secretion and regulation of INSL3 during puberty is unknown.

Objective: Our objective was to evaluate INSL3 concentrations during normal male puberty and the relation of INSL3 to LH, FSH, and testosterone.

Design and Setting: We conducted a cross-sectional study from January to December 2005 at academic clinics.

Patients: Participating in the study were 75 healthy male subjects aged 9.5–17.5 yr, homogeneously distributed into five pubertal groups of 15 according to Tanner stages.

Main Outcome Measures: We assessed mean testicular volume and LH, FSH, testosterone, and INSL3 concentrations in relation to age and pubertal stage.

Results: We observed an increase of INSL3 and LH levels from Tanner stage 2 to 4, and an increase of FSH from stage 2 to 3. Testosterone levels increased from stage 3 to 4. No differences were seen for all measured hormones between stages 4 and 5. The increase in INSL3 seemed therefore to anticipate the increase in testosterone. However, INSL3 plasma concentrations at pubertal stages 4 and 5 are about one fourth of adult levels, whereas FSH, LH, and testosterone reached adult levels by stage 4. Positive significant correlations were found between INSL3 and LH for all pubertal stages.

Conclusions: This study provides information on the physiological dynamics of INSL3, showing that the serum concentrations of this hormone increased progressively throughout puberty under the differentiating action of LH on Leydig cells. INSL3 is therefore confirmed to represent a marker of Leydig cell differentiation and function. However, a prolonged exposure to LH seems to be necessary to reach INSL3 concentrations of adults. A possible use of INSL3 in puberty disorders is promising.
Estradiol Potentiates Ghrelin-Stimulated Pulsatile Growth Hormone Secretion in Postmenopausal Women
Authors: Veldhuis Johannes D. , Keenan Daniel M. , Iranmanesh Ali , Mielke Kristi , Miles John M. , Bowers Cyril Y.
Published: June 2006

Context: Ghrelin and an estrogen-rich milieu individually amplify pulsatile GH secretion by increasing the amount of hormone released per burst. However, how these distinct agonists interact in controlling pulsatile GH output is not known.

Objective: The objective of the study was to test the hypothesis that elevated estradiol (E2) concentrations potentiate hypothalamo-pituitary responses to a near-physiological ghrelin stimulus.

Design: This was a double-blind, placebo-controlled, prospectively randomized, parallel-cohort study.

Setting: The study was conducted at an academic medical center.

Subjects: Twenty-one postmenopausal women participated in the study.

Interventions: Eleven subjects received placebo (Pl) and 10 others E2 transdermally in escalating doses over 3 wk to mimic late follicular-phase E2 concentrations. Saline or a submaximally stimulatory amount of ghrelin (0.3 μg/kg) was infused iv on separate randomly ordered mornings fasting after 17–21 d of Pl or E2 administration.

Outcomes: Outcomes included serum concentrations of E2, ghrelin, GH, IGF-I, IGF binding protein (IGFBP)-1 and IGFBP-3, and the estimated mass and waveform of stimulated GH secretory bursts.

Results: Administration of E2 yielded late follicular-phase E2 concentrations. Compared with Pl, E2 did not alter ghrelin concentrations but reduced IGF-I and IGFBP-3 and elevated IGFBP-1 concentrations. Compared with saline, ghrelin infusion amplified pulsatile GH secretion by 7.1-fold (P < 0.01). The effect of E2 alone was 2.0-fold placebo and that of combined ghrelin/E2 10.4-fold (P < 0.01). Ghrelin and E2 accelerated initial GH release individually but nonadditively by more than 2-fold (P < 0.01).

Conclusions: Estrogen augments ghrelin’s near-physiological stimulation of pulsatile GH secretion and mimics ghrelin’s acceleration of initial GH release. Thus, we hypothesize that estrogen and a GH secretagogue act via independent as well as convergent mechanisms.
Fluorescence Quenching of Fluorenone by Alcohols
Authors: Fujii Tsuneo , Sano Masayuki , Mishima Shozi , Hiratsuka Hiroshi
Published: June 2006

The absorption and fluorescence spectra of fluorenone have been observed in various solvents. The fluorescence intensity increases with increasing solvent polarity, except in alcoholic solvents. The relative fluorescence intensity of fluorenone in acetonitrile is about 14-times greater than that in methanol. There are isosbestic points in the absorption spectra of fluorenone in mixed solvents comprising ethanol–cyclohexane and ethanol–acetonitrile, indicating the formation of a 1 : 1 hydrogen-bonded complex between fluorenone and ethanol. The equilibrium constants for the complex formation are estimated to be 2.0 ± 0.5 and 0.6 ± 0.2 mol−1 dm3 in ethanol–cyclohexane and ethanol–acetonitrile solvents, respectively. The results indicate that the complex formation changes the relative energy of the singlet and triplet states, which have n–π* and π–π* characters, respectively. The complex formation causes a strong fluorescence quenching of fluorenone in the alcohols. A plot of the fluorescence quenching also shows that there is a route for excited-state quenching. It is concluded that the S1 state has mainly an n–π* character in both nonpolar and alcoholic solvents, while a π–π* character in the S1 state increases in polar and non-hydrogen bonding solvents. CNDO/S calculations support the experimental results.
Ultrasonic Relaxations in Aqueous Solutions of Piperidine and Pyrrolidine
Authors: Nishikawa Sadakatsu , Gouhara Rumi
Published: June 2006

In order to examine ultrasonic absorption mechanisms and dynamical properties in aqueous solutions of heterocyclic amines, the absorption coefficients in a frequency range from 3.0 to 220 MHz were measured in solutions of pyrrolidine and piperidine at 25 °C. In the solution of pyrrolidine, a single relaxational absorption associated with a proton transfer reaction was observed, and the rate and thermodynamic parameters were determined from the concentration dependence of the relaxation frequency and the maximum absorption per wavelength. In the solution of piperidine, another relaxational absorption in addition to that due to the proton transfer reaction was observed in the relatively concentrated solution. It was attributed to a perturbation of an equilibrium associated with an aggregation reaction of nonionized molecules. The mean aggregation number and the rate parameters were estimated from the solute concentration dependence of the relaxation parameters. The results were compared with those observed in aliphatic amine solutions.
β-Molecular Rearrangement Process, But Not an α-Process, as Governing the Homogeneous Crystal-Nucleation Rate in a Supercooled Liquid
Authors: Hikima Takaaki , Hanaya Minoru , Oguni Masaharu
Published: June 2006

The time dependence of the growth rate of homogeneous-nucleation-based (HNB) crystallization in o-terphenyl was tracked by a temperature-jump method through microscopic observations, and HNB crystallization was found to proceed at a steady rate, specified by the tracking temperature just after the jump. Two sets of numerical computations were carried out according to a classical homogeneous nucleation theory for the temperature-jump experiment on alternative assumptions that the homogeneous nucleation process is governed by the α-molecular rearrangement process or by the β-process in the liquid. From a comparison between the experimental and calculated results, the homogeneous nucleation, and thus the crystal growth as well, were concluded to be governed by the β-rearrangement process rather than the α-process, differently from the common recognition that they are governed by the latter.
One-Electron Reductive Cleavage of the C–Cl Bond of ArCF2Cl: Convenient Route for the Synthesis of ArCF2 Derivatives
Authors: Yoshida Masato , Morishima Ayako , Suzuki Daiki , Iyoda Masahiko , Aoki Kozo , Ikuta Shigeru
Published: June 2006

When ArCF2Cl was reacted with PhSeNa in DMF in the presence of light, it was found that a SRN1 type reaction occurred to give ArCF2SePh. As the reaction did not proceed without light, the substitution reaction should be initiated by photo-induced electron transfer from PhSe− to ArCF2Cl. The cleavage of the C–Cl bond of PhCF2Cl by one-electron reduction with samarium(II) iodide to give a PhCF2 radical and chloride ion was also observed. The PhCF2 radical, thus formed, was trapped by styrene and phenylacetylene before it was reduced to PhCF2 anion. UHF/3-21G calculation demonstrated that one-electron reduction in PhCF2Cl led the spontaneous dissociation of the C–Cl bond to the PhCF2 radical and Cl−, but the PhCF3 radical anion existed as a stable form.
Solution Studies of Sulfur-Stabilized Lithiated Allylic Carbanions: HOESY (6Li–1H) NMR Spectroscopy of Lithiated (E)-1-(t-Butylthio)but-2-ene and (E)-1-(Phenylthio)but-2-ene
Authors: Glendenning Lionel , Bampos Nick , Field Leslie D
Published: June 2006

The nature of the lithium counter cations association with sulfur-stabilized allylic carbanions is investigated by 2-D HOESY (6Li–1H) spectroscopy. The association is best described as either an unsymmetrical dihapto(η2)-bonded lithium to the C1 and C2 carbons or a monohapto(η1)-bonded lithium to C1 in a position close to C2. The lithium is spatially closer to C1 than C2 and there is no indication of interaction with the C3 carbon. These structural traits for lithiated (E)-1-(t-butylthio)but-2-ene in THF and in the presence of TMEDA at 220 K differ markedly to those obtained from the low temperature X-ray crystal structure of this anionic system.
Copper-Promoted Reaction of Aryl Iodides with Activated Methine Compounds
Authors: Pivsa-Art Sommai , Fukui Yuka , Miura Masahiro , Nomura Masakatsu
Published: June 2006

The reaction of aryl iodides with an activated methine compound, diethyl acetamidomalonate, can efficiently proceed in the presence of CuI and NaH in DMSO to give diethyl acetamido(aryl)malonates, which may be useful precursors for α-arylglycines, in good yields. Although the reaction with another methine substrate, ethyl 2-cyanopropionate, also affords the expected coupling products, no substitution products are obtained in the case of diethyl methylmalonate, arenes together with an oxidative coupling compound of the ester being formed.
α-Sulfenyl-Directed Ring-Opening Reactions of Epoxides. 1. Highly Regio- and Stereoselective Reaction with Organo-Aluminum Reagents and Application to the Synthesis of an Aggregation Pheromone
Authors: Liu Changqing , Hashimoto Yukihiko , Kudo Kazuaki , Saigo Kazuhiko
Published: June 2006

The reaction of 1-phenylthio-2,3-epoxyalkanes with trialkylaluminum showed definite C-2 selectivity for nucleophilic ring-opening and gave C-2 alkylated products exclusively with the complete retention of the configuration at the C-2. In contrast, upon reacting with alkenyl(dialkyl)aluminum, dialkyl(alkynyl)aluminum, or DIBAL, the nucleophilic attack occurred at the C-1 with concomitant rearrangement of the sulfenyl group to the C-2 with the complete inversion of the configuration at the C-2. The reactions of these epoxides were considered to proceed via an episulfonium ion intermediate. Upon applying the present reaction, an aggregation pheromone of African Palm Weevil was stereoselectively synthesized in short steps.