bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evolutionary selection pressure and family relationships among connexin genes
Authors: Cruciani Véronique , Mikalsen Svein-Ole 
Published: March 2007

AbstractWe suggest an extension ofconnexinorthology relationships across the major vertebrate lineages. We first show that the conserved domains of mammalianconnexins(encoding the N-terminus, four transmembrane domains and two extracellular loops) are subjected to a considerably more strict selection pressure than the full-length sequences or the variable domains (the intracellular loop and C-terminal tail). Therefore, the conserved domains are more useful for the study of family relationships over larger evolutionary distances. The conserved domains ofconnexinswere collected from chicken,Xenopus tropicalis, zebrafish, pufferfish, green spotted pufferfish,Ciona intestinalisandHalocynthia pyriformis(two tunicates). A total of 305connexinsequences were included in this analysis. Phylogenetic trees were constructed, from which the orthologies and the presumed evolutionary relationships between the sequences were deduced. The tunicateconnexinsstudied had the closest, but still distant, relationships to vertebrateconnexin36,39.2,43.4,45and47. The main structure in theconnexinfamily known from mammals pre-dates the divergence of bony fishes, but some additional losses and gains ofconnexinsequences have occurred in the evolutionary lineages of subsequent vertebrates. Thus, theconnexingene family probably originated in the early evolution of chordates, and underwent major restructuring with regard to gene and subfamily structures (including the number of genes in each subfamily) during early vertebrate evolution.
High Blood Pressure as Risk Factor in Diabetic Retinopathy Development in NIDDM Patients
Authors: Ishihara Masaki , Yukimura Yaichiro , Aizawa Toru , Yamada Takashi , Ohto Ken , Yoshizawa Kunio 
Published: March 2007

The correlation between diabetic retinopathy and blood pressure was analyzed in 742 type II diabetic patients. Systolic and pulse blood pressures were significantly higher in the patients with retinopathy than in those without (mean systolic pressure 142 vs. 139 mmHg, P &lt; .01; mean pulse pressure 60.5 vs. 56.4 mmHg, P &lt; .001). There was no difference in the diastolic blood pressure between these two groups. The correlation between blood pressure and the components of retinopathy (including microaneurysms, hemorrhages, and exudates) was also analyzed. Even when the patient with microaneurysms or dot hemorrhages, blot hemorrhages, or hard or soft exudates were separately evaluated, systolic and pulse blood pressures were higher in those with one of these diabetic changes than in patients without them.
To avoid the influence of nephropathy, the patients were divided into nonproteinuric or proteinuric groups. In the nonproteinuric group, pulse blood pressure was higher in patients with retinopathy than in those without. In the proteinuric group, systolic blood pressure was also higher in patients with retinopathy than in those without. However, these observed differences in blood pressure were slight after the division of the patients. With respect to the components of retinopathy, systolic and pulse blood pressures were significantly higher in the patient with blot hemorrhages than in those without in both nonproteinuric and proteinuric groups (nonproteinuric: systolic pressure 142 vs. 137 mmHg, P &lt; .005, and pulse pressure 60.4 vs. 55.5 mmHg, P &lt; .001; proteinuric: systolic pressure 155 vs. 146 mmHg, P &lt; 0.01, and pulse pressure 69.0 vs. 63.5 mmHg, P &lt; .05) In regard to other components (microaneurysms, dot hemorrhages, or hard or soft exudates), no significant difference was found in blood pressure when analyzed in both nonproteinuric and proteinuric patients.
Systolic, diastolic, and pulse blood pressures did not correlate with blood glucose level in any of our patients. These data revealed that systolic hypertension is a risk for diabetic retinopathy, especially for blot hemorrhage.
Risk of Ketosis During Intensive Insulin Therapy in Pre-School-Age Diabetic Children
Authors: Brambilla Paolo , Artavia-Loria Efrain , Chaussain Jean-Louis , Bougneres Pierre-François 
Published: March 2007

The risk of ketosis and its relationship to the mode of insulin therapy were studied in a subset of pre-school-age diabetic children. These five children, who initially responded poorly to standard in-hospital diabetes management, were selected for a program of intensified therapy directed at achieving more stable blood glucose control. Optimized conventional therapy was first employed for 16 ± 5 mo and did not improve substantially blood glucose level or stability. During this period, there was an average of almost one episode of ketonuria per patient per month, and three diabetic ketoacidosis episodes were observed. Because of its limited efficacy, the treatment was then changed to continuous subcutaneous insulin infusion. This mode of therapy had a rapid favorable effect on blood glucose control, with no concomitant increase of the frequencies of ketonuria or diabetic ketoacidosis, most of which occurred during the first months of insulin pump therapy.
Deliberate cessation of either conventional or subcutaneous insulin infusion therapy for 7 h under close in-hospital control resulted in similar metabolic changes: a slight nonconstant increase of blood glucose, and an abrupt rise of blood 3-hydroxybutyrate to 3 mM, with massive ketonuria.
The management of these young diabetic children with insulin pump therapy was thus not associated with an increased frequency or an accelerated rate of development of ketosis. However, the possible failures originating from the infusing device and the rapid increase of ketosis in young ages require special vigilance from the parents, based on twice-daily urine testing for ketones and appropriate insulin supplementation.
Enhancing Blood Glucose Awareness in Adolescents and Young Adults With IDDM
Authors: Nurick Michael A , Johnson Suzanne Bennett 
Published: March 2007

Objective
To determine the effectiveness of an intervention program designed to improve blood glucose awareness.

Research Design and Methods
Eight young-adult outpatients (mean age 22 yr) and six adolescent inpatients (mean age 14.5 yr) with insulin-dependent diabetes mellitus participated in the intervention program. Nine adolescent inpatients (mean age 13.9 yr) served as an untreated comparison group. One adult outpatient with unreliable data was removed. Before treatment, each patient completed a minimum of 40 blood glucose estimations, blood glucose tests, and symptom-rating checklists. Symptoms of hypo- or hyperglycemia were identified for each patient. The three-session intervention focused on internal (e.g., personal symptoms) and external (e.g., timing and amount of insulin, food, and exercise) cues that could be used to enhance blood glucose awareness. At postintervention, patients completed a minimum of 40 additional blood glucose estimates and tests. Comparison subjects completed the pre-postassessments but did not receive the intervention.

Results
Blood glucose estimation accuracy was evaluated with error grid analysis. All estimated-actual blood glucose values were plotted into one of five zones: accurate estimates (zone A), benign errors (zone B), and clinically dangerous errors (zones C, D, and E). An overall accuracy index (AI) was calculated by subtracting the summed percentage of clinically dangerous estimates (zones C, D, and E) from the percentage of accurate estimates (zone A). At study entry, the adolescent inpatients' mean AI of 7% was significantly poorer than the 32% mean AI exhibited by the outpatient young-adult sample (P &lt; 0.02). At postintervention, the adolescents' mean AI improved to 30% (P &lt; 0.02) and the young adults' mean outpatient AI improved to 45% (P &lt; 0.06). The treated sample as a whole exhibited increased sensitivity to both hypo- (P &lt; 0.005) and hyperglycemia (P &lt; 0.05). Similar improvements did not occur in the untreated comparison sample.

Conclusions
Adolescents may exhibit poorer blood glucose awareness than adults. Although this intervention program improved blood glucose awareness in both adolescent and adult patients, postintervention blood glucose estimation accuracy remained far from ideal.
Relationship of Limited Joint Mobility to Abnormal Foot Pressures and Diabetic Foot Ulceration
Authors: Fernando Devaka JS , Masson Ewan A , Veves Aristidis , Boulton Andrew JM 
Published: March 2007

Objective
To investigate the role of limited joint mobility (LJM) in causing abnormal foot pressures and foot ulceration.

Research Design and Methods
The subjects were recruited from a general diabetes clinic where patients were screened for neuropathy, retinopathy, and elevated plantar foot pressure. Sixty-four patients in five groups were matched by age and sex in the following groups: group 1, patients with LJM and neuropathy; group 2, nonneuropathic diabetic patients with LJM; group 3, patients with neuropathy and no LJM; group 4, diabetic control subjects; and group 5, nondiabetic control subjects. Joint mobility was assessed in the foot at subtalar and metatarsophalangeal joints; plantar foot pressures were assessed by optical pedobarography and neuropathic status by a Biothesiometer and electrophysiology.

Results
Joint mobility was reduced at both sites in groups 1 and 2 compared with groups 3, 4, and 5 (P &lt; 0.001). Plantar foot pressures were significantly higher in groups 1 and 2 compared with groups 3, 4, and 5 (P &lt; 0.001). No differences in plantar foot pressures were observed between groups 1 and 2. There were strong correlations between plantar foot pressures and joint mobility in the foot (r = −0.7, P &lt; 0.001). Previous foot ulceration was present in 65% of patients in group 1, none in group 2, and 5% in group 3.

Conclusions
1) LJM may be a major factor in causing abnormally high plantar foot pressures, 2) abnormal plantar foot pressures alone do not lead to foot ulceration, and 3) LJM contributes to foot ulceration in the susceptible neuropathic foot.
Effects of Cyclosporin A and Low Dosages of Steroid on Posttransplantation Diabetes in Kidney Transplant Recipients
Authors: Yamamoto Hidefumi , Akazawa Shoichi , Yamaguchi Yoshihiko , Yokota Atsushi , Yamasaki Hironori , Nakanishi Toshiaki , Tahara Daigo , Matsuya Fukuzo , Saito Yutaka , Nagataki Shigenobu 
Published: March 2007

Objective
To investigate the adverse effects of cyclosporin A (CsA) on pancreatic beta-cell function in kidney transplant recipients.

Research Design and Methods
The study consisted of 73 patients without a history of diabetes mellitus who had undergone kidney transplantation in our clinic.

Results
We experienced a higher incidence of posttransplantation diabetes mellitus (PTDM) in patients receiving CsA and low dosages of methylprednisolone (6/20, 30%, P &lt; 0.05) than in patients receiving conventional therapy of azathioprine methylprednisolone (4/53, 7.5%) since the introduction of CsA. In all 6 patients in the CsA-treated group, PTDM occurred within 3 mo after transplantation. The CsA level during the initial 3 mo posttransplant was significantly higher in diabetic than nondiabetic subjects, and the highest CsA level was observed shortly (1 mo) before the development of PTDM. After an average of 71 days of insulin therapy, there was complete remission of PTDM in 5 of 6 diabetic patients, with a corresponding decrease in CsA level. For the patients who were in remission for &gt; 1 yr, a significant improvement of glucose intolerance was observed in association with a significantly higher insulin response to oral glucose load; however, their glycemic profile still showed a significantly higher plasma glucose concentration and a prolonged continuous elevation without initial peak of the insulin-response curve in contrast to the normal pattern found in nondiabetic subjects in the CsA-treated group.

Conclusions
This study suggests that CsA in combination with low dosages of steroid may have adverse effects on glucose metabolism, which may lead to effects similar to those in non-insulin-dependent diabetes mellitus.
Effect of New Oral Antidiabetic Agent CS-045 on Glucose Tolerance and Insulin Secretion in Patients with NIDDM
Authors: Iwamoto Yasuhiko , Kuzuya Takeshi , Matsuda Ayako , Awata Takuya , Kumakura Shinobu , Inooka Gen , Shiraishi Ikuo 
Published: March 2007

Objective
To study the effects of CS-045, a newly developed thiazolidine analogue, on glucose tolerance and insulin response to oral glucose load in patients with non-insulin-dependent diabetes mellitus (NIDDM).

Research Design and Methods
Nineteen NIDDM patients (mean ± SD age 48.9 ± 9.4 yr) whose previous glycemic control on diet and/or sulfonylurea (SU) therapy was judged stable but unsatisfactory (&gt; 7.8 mM) were selected for this study. CS-045 (400 mg/day p.o.) was given alone or together with the previous SU drugs for 12 wk. A 75-g oral glucose tolerance test (OGTT) was performed before and after CS-045 treatment.

Results
The following results were found after CS-045 treatment. 1) Fasting plasma glucose (FPG) and HbA1c decreased (n = 19, FPG, 11.0 ± 2.4 vs. 8.4 ± 2.7 mM [before vs. after], P &lt; 0.001; HbA1c, 8.0 ± 1.1 vs. 7.4 ± 1.3%, P &lt; 0.005), and glucose tolerance markedly improved. 2) Fasting insulin (immunoreactive insulin [IRI]) and insulin response during OGTT decreased (n = 19, fasting IRI, 77.4 ± 49.8 vs. 56.5 ± 24.6 pM [before vs. after], P &lt; 0.05; area under the curve of IRI, 540.3 ± 350.5 vs. 426.4 ± 216.3 pM.h, P &lt; 0.05).

Conclusions
CS-045 is effective in improving glucose tolerance without stimulation of insulin secretion in NIDDM, suggesting an effect in improving insulin sensitivity.
Evidence Against Association Between Parity and NIDDM From Five Population Groups
Authors: Collins Veronica R , Dowse Gary K , Zimmet Paul Z 
Published: March 2007

Objective
To determine whether a reported positive association between parity and the development of non-insulin-dependent diabetes mellitus (NIDDM) and impaired glucose tolerance (IGT) is reproducible in other populations.

Research Design and Methods
We investigated the relationship in data from population-based surveys in four Pacific and Indian Ocean island nations. Women ≥ 40 yr of age at the time of the survey, excluding those in whom diabetes developed before 40 yr of age, were included in this study of Micronesians from Nauru (n = 204) and Kiribati (n = 562), Fiji Melanesians (n = 390), Fiji Indians (n = 247), and mixed-ethnic Mauritians (n = 1333). Subjects in each survey underwent a 75-g oral glucose tolerance test, and glucose tolerance status was ascertained with 1985 World Health Organization criteria. Obstetric information and family history of diabetes were determined by interview.

Results
Age and body mass index (BMI)-adjusted mean parity increased slightly with worsening glucose tolerance in only two groups, decreased in one group, and was inconsistent in the other two (none were statistically significant). We also found an inconsistent relationship between the number of full-term pregnancies and the prevalence of IGT and NIDDM, although in each population, there was a higher prevalence of NIDDM in the highest parity group (≥ 10 pregnancies) compared with the lowest parity group (1-3 pregnancies). In logistic regression analyses accounting for age, BMI, and family history of diabetes, odds ratio estimates for NIDDM and IGT associated with each pregnancy were not significantly greater than unity.

Conclusions
The results indicate that there is little if any independent association between parity and the development of abnormal glucose tolerance in these populations.
Increased Incidence of Type II Diabetes Mellitus in Mexican Americans
Authors: Haffner Steven M , Hazuda Helen P , Mitchell Braxton D , Patterson Judith K , Stern Michael P 
Published: March 2007

Objective
To determine whether Mexican Americans have an increased incidence of non-insulin-dependent (type II) diabetes mellitus relative to non-Hispanic whites. Currently, no study has reported on the incidence of this disorder in Mexican Americans.

Research Design and Methods
We determined the 8-yr incidence of type II diabetes in 617 Mexican Americans and 306 non-Hispanic whites who participated in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. Forty Mexican Americans (6.5%) and 6 non-Hispanic whites (2%) developed type II diabetes, as defined by World Health Organization criteria. The age-adjusted ethnic odds ratio (OR; Mexican Americans/non-Hispanic whites) for diabetes incidence was 8.13 (95% confidence interval [C1] 1.10–59.9) in men and 3.62 (95% CI 1.37–9.55) in women. We adjusted for age, sex, ethnicity, body mass index, and level of educational attainment with multiple logistic regression analyses.

Results
Mexican Americans continued to show a statistically significant increase in diabetes incidence (OR 2.72, 95% CI 1.02–7.28). Obesity and age were also positively related to diabetes incidence in this analysis (P &lt; 0.001). In addition, subjects with at least some college education had a lower incidence of diabetes than those with less than a high school education (OR 0.51, 95% CI 0.26–0.99).

Conclusions
The incidence of type II diabetes in Mexican Americans is greater than in non-Hispanic whites, a difference that is not explained by ethnic differences in obesity, age, or level of educational attainment.
Association of Cigarette Smoking With Diabetic Retinopathy
Authors: Moss Scot E , Klein Ronald , Klein Barbara EK 
Published: March 2007

Objective
To determine whether cigarette smoking is associated with the incidence and progression of diabetic retinopathy.

Research Design and Methods
Younger-onset diabetic subjects who had been diagnosed at &gt;30 yr of age and taking insulin (n = 1210) and a random sample of older-onset diabetic subjects diagnosed at ≥30 yr of age (n = 1780) were selected. Baseline examinations were conducted on 996 youngerand 1370 older-onset subjects. Incidence of retinopathy was based on 138 younger-onset and 154 older-onset insulin-taking subjects and 321 older-onset non-insulintaking subjects who were free of retinopathy at baseline. Progression of retinopathy was based on 530 youngeronset and 418 older-onset insulin-taking subjects and 486 older-onset non-insulin-taking subjects with less than proliferative diabetic retinopathy at baseline.

Results
Baseline smoking history was categorized by status (nonsmoker, ex-smoker, current smoker) and pack-years smoked while diabetic. Retinopathy was documented by stereoscopic fundus photography. In univariate analyses, the only significant association was between pack-years and progression to proliferative diabetic retinopathy in older-onset insulin-taking subjects (P &lt; 0.01). After controlling for known risk factors for the incidence and progression of retinopathy, pack-years smoked was borderline significant (P = 0.052) in predicting incidence of retinopathy in youngeronset subjects. Smoking was not associated with incidence in older-onset subjects or with progression or progression to proliferative diabetic retinopathy in any of the groups.

Conclusions
Smoking is not likely to be an important risk factor for diabetic retinopathy.
Major Role for Arterial Disease in Morbidity and Mortality After Kidney Transplantation in Diabetic Recipients
Authors: Lemmer Michael J , Barry John M 
Published: March 2007

Objective
To identify clinical characteristics of diabetic end-stage renal disease patients that place individual transplant candidates at high risk for arterial morbidity and mortality after transplantation.

Research Design and Methods
We studied the course of 101 sequential renal allograft recipients with insulin-dependent diabetes mellitus, transplanted between 10 November 1980 and 1 April 1986. Arterial disorders were tabulated from medical records and interviews with individual patients, their families, and their private physicians. Documentation of discrete arterial events included recorded physical examinations, radiographic studies, laboratory data, electrocardiograms, peripheral vascular flow studies, and operative reports. The prevalence of preoperative arterial disease was compared with the occurrence of new arterial events after kidney transplantation.

Results
Within a mean follow-up period of 47 mo, a 30% absolute mortality rate was observed. Of these deaths, 57% resulted from arterial disorders. Clinical manifestations of arterial disease were recognized in 41% of recipients before transplantation, and 78% of these patients suffered new vascular events after transplantation. Of the entire sample, 57% developed at least one new complication of arterial disease after transplantation, whereas only 34% had no vascular diagnosis before or after transplantation. Cerebral, coronary, and peripheral arterial complications after transplantation occurred in 14, 28, and 36% of the patients, respectively. The corresponding incidences of stroke, myocardial infarction, and amputation were 12, 14, and 25%. Pretransplant coronary artery disease predisposed to new coronary eventsafter transplantation, but only peripheral arterial complications occurred more often after transplantation compared with the preoperative period. The probability of arterial complications or death correlated with patient age at first transplant and duration of diabetes but not with sex or smoking history.

Conclusions
Intrinsic arterial disease in diabetic renal allograft recipients contributes heavily to the long-term morbidity and mortality after transplantation and poses the major threat to survival. Diabetic transplant candidates &gt;35 yr of age or with clincial evidence of arterial disease should undergo an extensive vascular assessment, including stress thallium myocardial imaging and/or coronary arteriography. Such recipients should receive careful preoperative counseling about their excess risk for subsequent arterial disorders.
Role of Height and Glycosylated Hemoglobin in Abnormal Nerve Conduction in Pediatric Patients With Type I Diabetes Mellitus After 4–9 yr of Disease
Authors: Duck Stephen C , Wei Feifei F , Parke Julie , Swick Herbert M 
Published: March 2007

Objective
To determine the role of height and glycosylated hemoglobin in abnormal nerve conduction in pediatric patients with insulin-dependent (type I) diabetes mellitus.

Research Design And Methods
Sixty-six pediatric patients (aged 6.3–18.2 yr) with a duration of diabetes from 4 to 8.5 yr but free of clinical neuropathy were evaluated for abnormal nerve conduction.

Results
Mean HbA1 values for 1 and 2 yr before study were available. Electroneurographic findings were significantly different from control subjects in upper and lower extremities and included all five measured velocities, three sensory latencies, and one amplitude. Stepwise regression analysis identified an adverse effect of height on latency (5 of 6) and of mean HbA1 concentration on decreasing velocity (4 of 5). The data analysis from 52 patients who were restudied and who had a duration of diabetes from 5.3 to 9.6 yr confirmed that all velocity values slowed; one of five values did so significantly. The coefficients associated with mean HbA1 concentration usually increased in both upper- and lower-extremity velocity analyses at the follow-up examination. The change in peroneal motor velocity between the first and last examinations was significantly related to the increasing time interval between examinations.

Conclusions
Prospective evaluation of nerve conduction parameters in pediatric patients with diabetes should include both height (the most significant independent variable in latency analysis) and mean glycemic control (the most consistent variable in velocity analyses) as variables in the assessment of the natural history of evolving peripheral neuropathy.