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Background The gender disparity in cardiovascular disease (CVD) risk is greatest between young men and women. However, the causes of that are not fully understood. The objective of this study was to evaluate the relationship between insulin resistance and the presence of coronary artery calcium (CAC) to identify risk factors that may predispose young men and women to CVD. Methodology/Principal Findings Insulin resistance and CVD risk factors were examined in 8682 Korean men and 1829 women aged 30–45 years old. Insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR), and CAC was measured using computed tomography. Women were less likely to be insulin resistant (upper quartile of HOMA-IR, 18% vs. 27%, p

Prediabetes is defined by elevations of plasma glucose concentration, and is aimed at identifying individuals at increased risk of type 2 diabetes and coronary heart disease (CHD). However, since these individuals are also insulin resistant and hyperinsulinemic, we evaluated the association between several facets of carbohydrate metabolism and CHD risk profile in apparently healthy, nondiabetic individuals.Plasma glucose and insulin concentrations were measured before and at hourly intervals for eight hours after two test meals in 281 nondiabetic individuals. Insulin action was quantified by determining the steady-state plasma glucose (SSPG) concentration during the insulin suppression test. CHD risk was assessed by measurements of blood pressure and fasting lipoprotein profile.For purposes of analysis, the population was divided into tertiles, and the results demonstrated that the greater the 1) fasting plasma glucose (FPG) concentration, 2) incremental plasma insulin response to meals, and 3) SSPG concentration, the more adverse the CHD risk profile (p0.05). In contrast, the CHD risk profile did not significantly worsen with increases in the incremental plasma glucose response to meals.In nondiabetic individuals, higher FPG concentrations, accentuated daylong incremental insulin responses to meals, and greater degrees of insulin resistance are each associated with worse CHD risk profile (higher blood pressures, higher triglycerides, and lower high density lipoprotein cholesterol concentrations). Interventional efforts aimed at decreasing CHD in such individuals should take these abnormalities into consideration.

C-reactive protein (CRP) is an inflammatory marker associated with obesity, insulin resistance, and cardiovascular disease. A recent study found CRP levels to be higher in individuals treated with certain antipsychotic medications such as olanzapine; however, it is not clear whether this is associated directly with drug intake or indirectly with drug-associated weight gain and insulin resistance. The objective of this study was to explore the potential predictors of CRP including insulin resistance, components of the metabolic syndrome, psychiatric diagnosis, and antipsychotic medication in patients treated with antipsychotics. Sixty-four outpatients without diabetes being treated with a single second generation antipsychotic medication had direct measurements of insulin resistance at the end of a 180-min infusion of glucose, insulin, and octreotide (insulin suppression test) as well as components of the metabolic syndrome. Insulin resistance was the strongest predictor of CRP (r=0.52, P

Lamniformes is a small shark group consisting of 15 extant species with remarkably diverse lifestyles and a wide range in heterocercal tail morphology. The caudal fin morphology must be related to their lifestyle because the tail is a main locomotive structure in sharks, but such relationships have remained largely uninvestigated. Here, the morphology-lifestyle relationship in lamniforms is examined through phylogenetic mapping. This study suggests that, within Lamniformes, caudal fins with a more horizontally directed curvature of the vertebral column are plesiomorphic, whereas those with a large dorsally directed curvature of the vertebral column are apomorphic. It also shows that caudal fins with posteriorly directed hypochordal rays are plesiomorphic, and that those with ventrally directed hypochordal rays are apomorphic within Lamniformes. Four basic caudal fin types are recognized in lamniforms on the basis of these skeletal variables in which one corollary is that the evolution of external morphology of caudal fin does not necessarily correspond to the evolution of its skeletal anatomy. This study also demonstrates that specific lifestyles seen in different lamniforms are indeed correlative with different caudal fin types in which a less asymmetrical heterocercal tail is a derived feature in lamniforms that evolved for fast swimming to capture fast swimming prey.

OBJECTIVE It is unclear how well homeostasis model assessment of β-cell function (HOMA-β) predicts diabetes development beyond its components, especially glucose. RESEARCH DESIGN AND METHODS We identified 12,924 nondiabetic Koreans who had fasting plasma glucose and insulin concentrations measured in 2003 and again in 2008. To minimize the impact of differences in baseline glucose concentration, individuals were divided into three glucose categories: normal fasting glucose (NFG, glucose RESULTS Diabetes developed in 29% of individuals in the IFG-110 group, compared with 5% in IFG-100 and 0.3% in NFG groups. Within each glucose category, those who progressed to diabetes had higher baseline glucose concentrations (P ≤ 0.04). Baseline HOMA-β, however, was not lower but higher in individuals who developed diabetes in the NFG group (P = 0.009) and similar in the IFG-100 and IFG-110 groups. CONCLUSIONS These data question the utility of using HOMA-β to predict the development of diabetes.

Using computed tomography, we discovered labial cartilages (splanchnocranial components) in an enigmatic lamniform shark, Odontaspis ferox (smalltooth sandtiger). We demonstrate that the presence of labial cartilages is plesiomorphic in Lamniformes, affirming that their "reduction" cannot be used as a synapomorphy for the order. Rather, their loss occurred through lamniform phylogeny.

To explore the relationship of insulin resistance (IR) and adipokines (leptin, adiponectin, RBP4) to anti-Mullerian hormone (AMH) levels in women without polycystic ovary syndrome (PCOS).We recruited 120 healthy, reproductive age women without PCOS. An overnight fasting blood draw, anthropometric measurements, analyses of serum levels of AMH, adipokines (leptin, adiponectin and RBP4) and total testosterone, a homeostasis model assessment for insulin resistance (HOMA-IR) and a transvaginal ultrasound scan were performed between the third and fifth day of their spontaneous menstrual cycles.Higher HOMA-IR levels were associated with lower levels of AMH. After adjustment for age, serum AMH levels negatively correlated with insulin, fasting glucose, HOMA-IR and RBP4. However, a positive correlation was identified between serum AMH and adiponectin. A final multiple stepwise linear regression demonstrated that HOMA-IR was independently associated with AMH.An independent relationship exists between HOMA-IR and AMH in women without PCOS, possibly due to the effect of abnormal insulin action on AMH secretion by granulosa cells.

Although moderate alcohol consumption has been associated with a decrease in plasma insulin concentrations, relatively few studies have been conducted to evaluate the effect of alcohol on insulin sensitivity, particularly in nondiabetic, insulin-resistant individuals. Because enhanced insulin sensitivity could contribute to the reported association between moderate alcohol consumption and reduced risk of heart disease and diabetes, we believed it is important to address this issue. Consequently, we evaluated the ability of moderate alcohol consumption to improve insulin sensitivity, as measured by determining the steady-state plasma glucose (SSPG) concentration during the insulin suppression test, in 20 nondiabetic, insulin-resistant individuals. Measurements were made of SSPG, glucose, insulin, and lipoprotein concentrations before and after consuming 30 g of alcohol for 8 weeks, either as vodka (n = 9) or red wine (n = 11). The SSPG concentrations (insulin resistance) decreased by approximately 8% in the total group (P = .08), and high-density lipoprotein cholesterol concentration increased by a mean of 0.09 mmol/L (P = .02). Trends were similar in individuals who consumed vodka or red wine. Men tended to have greater decline in SSPG and increase in high-density lipoprotein cholesterol compared with women. There were no other metabolic changes in fasting plasma glucose, insulin, and triglyceride concentrations. These data demonstrate that 8 weeks of moderate alcohol consumption had minimal impact on enhancing insulin sensitivity in nondiabetic, insulin-resistant individuals, raising questions as to the role, if any, of improved insulin sensitivity in the purported clinical benefits associated with moderate alcohol consumption.

In a recent consensus statement, the American Diabetes Association (ADA) concluded that individuals with impaired fasting glucose (IFG) have "normal muscle insulin sensitivity." To subject this conclusion to further validation, we evaluated the relationship between glucose tolerance categories and peripheral insulin sensitivity in a large nondiabetic population.Insulin sensitivity was directly quantified by determining the steady-state plasma glucose (SSPG) concentration during an insulin suppression test in 446 nondiabetic individuals divided into four groups: normal glucose tolerance (NGT, n = 318), isolated IFG (n = 63), isolated impaired glucose tolerance (IGT, n = 33), and combined IFG and IGT (IFG/IGT, n = 32).Insulin sensitivity was significantly different in all three groups with pre-diabetes (IFG, IGT, IFG/IGT) as compared with NGT (P0.05). Using tertiles of SSPG concentration in the NGT group as operational definitions of insulin resistance (highest tertile) and insulin sensitivity (lowest tertile), there was considerable heterogeneity within the pre-diabetic groups. Thus, 57% of IFG individuals were insulin resistant, and 13% were insulin sensitive. The IFG/IGT group was most homogeneous, with 94% classified as insulin resistant and only 3% as insulin sensitive.Peripheral insulin sensitivity varies considerably in nondiabetic individuals, with IFG individuals showing the most heterogeneity within the pre-diabetes group. We believe that this heterogeneity in insulin sensitivity, and the relatively few patients in whom insulin sensitivity has been measured directly in the past, explain the discrepancy between our findings and those of the recent ADA consensus statement.

Switching antipsychotic regimen to agents with low weight gain potential has been suggested in patients who gain excessive weight on their antipsychotic therapy. In an open-label pilot study, we evaluated the metabolic and psychiatric efficacy of switching to aripiprazole in 15 (9 men, 6 women) outpatients with schizophrenia who had gained at least 10 kg on their previous antipsychotic regimen. Individuals had evaluation of glucose tolerance, insulin resistance (insulin suppression test), lipid concentrations, and psychiatric status before and after switching to aripiprazole for 4 months. A third of the individuals could not psychiatrically tolerate switching to aripiprazole. In the remaining individuals, psychiatric symptoms significantly improved with decline in Clinical Global Impression Scale (by 26%, P = 0.015) and Positive and Negative Syndrome Scale (by 22%, P = 0.023). Switching to aripiprazole did not alter weight or metabolic outcomes (fasting glucose, insulin resistance, and lipid concentrations) in the patients of whom 73% were insulin resistant and 47% had impaired or diabetic glucose tolerance at baseline. In conclusion, switching to aripiprazole alone does not ameliorate the highly prevalent metabolic abnormalities in the schizophrenia population who have gained weight on other second generation antipsychotic medications.

Using the cross gain modulation (XGM) characteristics of semiconductor optical amplifiers (SOAs), all-optical multi-functional logic gates including XOR, NOR, and NAND gates are successfully demonstrated at 10 Gbps by using VPI simulation tool.

The goals of this study were to assess the effect of the 2003 American Diabetes Association definition of impaired fasting glucose (IFG) on prevalence of IFG, coronary heart disease (CHD) risk factors, and CHD compared with the 1997 IFG definition.Although IFG is viewed as increasing CHD risk, this association is unclear and has not been well studied after changing the IFG criterion, especially in a clinical practice setting.This was a cross-sectional evaluation of 8,295 members (3,763 men and 4,532 women) of a community medical center who were between the ages of 30 and 69 years, without a history of diabetes mellitus, and who had available measurements of fasting plasma glucose and lipid concentrations within the past 2 years. The prevalence of IFG, CHD risk factors, and CHD with the 1997 and 2003 IFG definition was compared.The prevalence of IFG increased from 8% to 35% with the 2003 criterion. Individuals with glucose of 100 to 109 mg/dl had lower prevalence of most CHD risk factors (hypertension, triglycerideor =150 mg/dl, high-density lipoprotein cholesterol40 mg/dl, meeting 2 components of the metabolic syndrome criteria, CHD riskor =10% by Framingham score) compared with individuals with glucose 110 to 125 mg/dl. Individuals identified with the 2003 IFG definition did not have an increase in known CHD when adjusted for covariates (odds ratio 1.4 [95% confidence interval (CI) 0.7 to 2.3] vs. 3.2 [95% CI 1.8 to 5.9]).One-third of the population has IFG with the 2003 definition, yet many of these individuals do not have increased prevalence of CHD risk factors or CHD.

Objectives The influence of cigarette smoking on blood antioxidant status in teenage girls with a history of short-term smoking was followed over 18 mo. Methods Data obtained from female senior high school students (ages 14 to 18 y) in Korea were compared with data obtained from adult male smokers (ages 36 to 51 y) with a long history of smoking and living in the same geographic areas as the teenage subjects. A smoker was a person who had smoked at least three cigarettes a day for at least 1 y for teenagers ( n = 35) or at least 10 cigarettes a day for at least 13 y for adults ( n = 20). Serum, urine, and anthropometric data were obtained from teenagers every 6 mo over an 18-mo period. Samples were collected once from adults. Data were analyzed by Student's t test and Fisher's protected least significant difference test for comparing smokers and non-smokers and for analyzing period effects in each group. Results Serum nicotine and cotinine concentrations were higher in smokers than in non-smokers. Blood pressures were higher in teenage (at 0 and 12 mo) and adult smokers than in non-smokers. Extracellular superoxide dismutase activities and concentrations of serum vitamin C and folate were lower in smokers in the teenage (at 0, 12, or 18 mo) and adult groups. Serum ceruloplasmin activities and thiobarbituric acid-reactive substance production were not influenced by smoking. In adults, serum copper concentrations were higher in smokers than in non-smokers. This parameter for teenagers did not change consistently throughout the study. Conclusions Similar to adults, cigarette smoking by teenagers has a negative effect on oxidant defense systems.

By using gain nonlinearity characteristics of semiconductor optical amplifier, an all-optical binary half adder at 10 Gbps is demonstrated. The half adder operates in single mechanism, which is XGM.

Neurotrophins promote the differentiation, growth, and survival of neurons in the nervous system. Specifically, neurotrophins promote neuronal survival by interfering with programmed cell death or apoptosis. In addition to roles of neurotrophins as survival factors, neurotrophins can act as risk factors of neuronal injury under various pathological conditions. Neurotrophins markedly potentiate neuronal cell necrosis induced by activation of N-methyl-D-aspartate receptors, deprivation of oxygen and glucose, and free radicals. Moreover, prolonged exposure to neurotrophins results in widespread neuronal necrosis through free radical-mediated mechanisms. Whereas cellular and molecular mechanisms underlying antiapoptosis action of neurotrophins have been well documented, extensive study will be needed to delineate mechanisms for the neurotrophin-induced neuronal necrosis through activation of Trk tyrosine kinase receptors.

Various types of dietary supplements (DS) are popularly taken by young individuals. We surveyed 1,190 Korean senior high school third grade students for their DS use, motivational factors for this use, and potential dietary consequences of vitamin/mineral supplement (VMS) use. The use prevalence of DS-including VMS, tonic medicines, manufactured health food supplements, cordial food supplements, and drink rehabilitators-was 54%. VMS were taken most frequently, followed by tonic medicines and manufactured health food supplements. VMS use was highest in individuals who had a significant concern for their overall health and in those from families with a high socioeconomic level and with parental use of DS. Total daily study time of DS users was only slightly longer than that of nonusers. The VMS most frequently used were vitamin C and multivitamins. More than 46% of other DS users, and 58% of VMS users, had increased their intake of supplements during third grade relative to the previous year. VMS users had a more positive view of the potential health benefit of VMS than did nonusers. Vitamin and mineral intakes from VMS occurred over a wide range, with mean intakes typically exceeding the Korean and Canadian-U.S. Recommended Dietary Allowances. For a significant number of individuals, intakes of vitamin A, niacin, folic acid, vitamin C, calcium, iron, and zinc exceeded the Tolerable Upper Intake Levels. Given the widespread use of DS by older teenagers, the contribution of these supplements to their overall health and well-being is a subject that clearly merits additional study.

In acromegaly, the combination of somatostatin (SS) and dopamine (DA) agonists has been shown to enhance suppression of GH secretion. In the present study, a new chimeric molecule, BIM-23A387, which selectively binds to the SS subtype 2 receptor (sst2; Ki = 0.10 nm) and to the DA D2 receptor (D2DR; Ki = 22.1 nm) was tested in cultures prepared from 11 human GH-secreting tumors for its ability to suppress GH and prolactin (PRL) secretion. The chimeric compound was compared with individual sst2 and D2DR agonists of comparable activity at the individual receptors. All tumors expressed both sst2 and D2DR mRNAs (0.8 ± 0.2 and 4.7 ± 0.7 copy/copy β-glucuronidase mRNA, respectively). In cell cultures from seven octreotide-sensitive tumors, the maximal inhibition of GH release induced by the individual sst2 and D2DR analogs and by BIM-23A387 was similar. However, the mean EC50 for GH suppression by BIM-23A387 (0.2 pm) was 50 times lower than that of the individual sst2 and D2DR analogs, either used individually or combined. Similar data were obtained in four tumors that were only partially responsive to octreotide. The inhibition of GH release by BIM-23A387 was only partially reversed by the D2R2 antagonist, sulpiride, or by the sst2 antagonist, BIM-23454. Only when both antagonists were combined was the GH suppressive effect of BIM-23A387 totally reversed. Finally, BIM-23A387 produced a mean 73 ± 6% inhibition of PRL in six mixed GH plus PRL tumors. These data demonstrate an enhanced potency of the chimeric molecule, BIM-23A387, in suppressing GH and PRL secretion from acromegalic tumors, which cannot be explained merely on the basis of binding affinity for SS and/or DA receptors.

The described teleradiology system is implemented on public telephone lines such as PSTN and ISDN. It uses a progressive image transmission technique to make fast surgical decisions when urgent communication between the house staff and attending physician is required. It is based on the iterative residual coding technique using DCT. To obtain the fastest solution, the DSP unit is designed using the principle of multiprocessing. To satisfy the computational time requirement for a given network bandwidth, a single-processor system with a host, a two-processor system with a host and a DSP, and a three-processor system with a host and two DSPs are implemented. Experimental results show that the single-processor system can be used on a 9600 bps PSTN, and the two- and three-processor systems can be adapted to 64 kbps and 128 kbps ISDNs respectively.

During time-critical brain surgery, the detection of developing cerebral ischemia is particularly important because early therapeutic intervention may reduce the mortality of the patient. The purpose of this system is to provide an efficient means of remote teleconsultation for the early detection of ischemia, particularly when subspecialists are unavailable. The hardware and software design architecture for the multimedia brain function teleconsultation system including the dedicated brain function monitoring system is described. In order to comprehensively support remote teleconsultation, multi-media resources needed for ischemia interpretation were included: EEG signals, CSA, CD-CSA, radiological images, surgical microscope video images and video conferencing. PC-based system integration with standard interfaces and the operability over the Ethernet meet the cost-effectiveness while the modular software was customized with a diverse range of data manipulations and control functions necessary for shared workspace and standard interfaces.

Although the adverse effects of excess adiposity on insulin-mediated glucose uptake (IMGU) are well-recognized (1,2), the mechanism and/or mechanisms that explain this relationship continue to be debated. The article by Kursawe et al. (3) in this issue of Diabetes provides another, and potentially important, mechanism linking excess adiposity and IMGU. However, to put their findings into perspective, it might be helpful to provide a brief history of other approaches to this issue. The experimental methods utilized in earlier mechanistic studies are reminiscent of the study by Kursawe et al. (3) and led to the view that metabolic abnormalities associated with obesity were related to changes in fat cell size rather than number (4–7). For example, ex vivo studies on adipose tissue isolated from obese humans demonstrated that the larger the fat cell, the more diminished the response to insulin (4). Furthermore, insulin sensitivity of isolated fat improved following weight loss-associated decreases in fat cell size. Although these data indicated that differences in fat cell size affected insulin action, the fat cell is not a major consumer of glucose (8). Thus, these data do not necessarily explain why large fat cells would have an adverse effect on whole-body IMGU. Furthermore, why some individuals had large fat cells and …

Three-dimensional reconstruction of the carpal bones was performed by using GE CT/T 9800, IBM PC/AT, and three-dimensional reconstruction software of hierarchical representation which was developed in our colleges. Four carpal reconstructions were performed: one normal wrist (elbow disarticulation specimen), one lunate volar dislocation with carpal tunnel syndrome (preoperative and postoperative evaluations), and one naviculocapitate syndrome which was associated with trans-scaphoid dorsal perilunate dislocation and carpal tunnel syndrome. After reconstruction, we observed the carpus from the dorsal and volar sides and from the radiocarpal and carpometacarpal joints. We then seperated the proximal and distal carpal rows, observed the midcarpal joint surface of both carpal rows, and removed the three ulnar-sided carpal bones (triangular, pisiform, and hamate) to evaluate the radioluno-capitate-third metacarpal axis.

A rigid analogue of promazine, 3-(dimethylamino)-1,2,3,4-tetrahydroazepino[3,2,1-kl]phenothiazine (1), was prepared by reductive amination of the corresponding ketone 4. An X-ray crystallographic study revealed that the seven-membered ring of the hydrochloride salt of 1 exists as a half-chair-like form with the dimethylammonium group in an equatorial-like conformation. Compound 1 was approximately one-half as active as promazine as an inhibitor of [3H]spiperone binding in rat corpus striatal homogenates. In homogenates obtained from calf caudate tissue, however, 1 was only about one-twentieth as active as promazine as an inhibitor of [3H] spiperone binding. As a stimulator of homovanilic acid (HVA) synthesis in rat corpus striatum in vivo, it was about one-tenth as active as promazine.

A rigid analogue of promazine, 3-(dimethylamino)-1,2,3,4-tetrahydroazepino[3,2,1-kl]phenothiazine (1), was prepared by reductive amination of the corresponding ketone 4. An X-ray crystallographic study revealed that the seven-membered ring of the hydrochloride salt of 1 exists as a half-chair-like form with the dimethylammonium group in an equatorial-like conformation. Compound 1 was approximately one-half as active as promazine as an inhibitor of [3H]spiperone binding in rat corpus striatal homogenates. In homogenates obtained from calf caudate tissue, however, 1 was only about one-twentieth as active as promazine as an inhibitor of [3H] spiperone binding. As a stimulator of homovanilic acid (HVA) synthesis in rat corpus striatum in vivo, it was about one-tenth as active as promazine.

The synthesis of 1,2,3,4-tetrahydroazepine[3,2,1-kl]phenothiazin-4-one was accomplished by cyclization of phenothiazine-10-butanoic acid using phosphorus pentoxide and absolute ethanol. The title compound represents the first reported example of the azepino[3,2,1-kl]phenothiazine ring system. A vastly improved malonic ester-type synthesis of the precursor acid has also been developed.