P2-Purinoceptor Mediated Inhibition of Adenylate Cyclase Activity

Abstract

In 1972 Burnstock proposed that adenosine 5′-triphosphate (ATP) is the principal neurotransmitter in non-adrenergic, non-cholinergic nerves through an interaction with P,-purinergic receptors. In 1985 Burnstock and Kennedy suggested a subdivision of this class of receptors into a Pk- and a Pzy-subclass on the basis of rank order of potency of various ATP-analogues in pharmacological studies. The potency order on the Pa-purinoceptor is αβ-methyleneATP (AMP.CPP) = p,y- methyleneATP (AMP.PCP) < ATP = 2-methylthioATP (2MeSATP), whereas the potency order on the P-purinoceptor is 2MeSATP << ATP < AMP.CPP = AMP.PCP. Derivatization of ATF at various positions resulted in a more pronounced definition of the structure-activity requirements for both subtypes of the purinoceptor. The P-purinoceptor is rather tolerant to modifications at the ribose moiety and the phosphate chain and the activity of adenine modified analogues is not affected. On the P-purinoceptor the activity almost disappears when ribosemodified analogues are applied, but modification of the adenine ring results in enhancement, and modification of the phosphate chain results in a small decrease in activity.     

Doppler sonography of the uterine and ovarian arteries during a superovulatory program in horses

The aim of the present study was to investigate the effects of a gonadotropin treatment to induce superovulation on ovarian and uterine blood flow and its relationship with steroid hormone levels and ovarian response in mares, using color Doppler sonography. Each of six mares were examined sonographically in five cycles for 3 d (t1 to t3) during the follicular development phase (FDP) beginning at a follicle size of ≥ 22 mm, and for 4 d (D-4 to D-1; D0 = Ovulation) in the preovulatory phase (POP). After each examination, total estrogens (E_tot) and progesterone (P₄) levels were determined in peripheral plasma. Cycles 1, 3, and 5 (c₁, c3, c5) were unstimulated cycles (USC); in c2 and c4, the mares were stimulated (SC) with eFSH and inseminated when in estrus at 12 and 24 h after hCG administration. Embryo recovery was performed 6.5 d post ovulation. Cycle 5 c5 was an unstimulated cycle with hCG treatment, insemination, and embryo recovery. Ovarian and uterine blood flow was quantified by the blood flow volume (BFV) and the pulsatility index (PI) in ovarian and uterine arteries. The mean number of ovulations and developing CL was 1.3 ± 0.4 in USC and 4.4 ± 3.1 in stimulated cycles (SC) with no difference (P ≥ 0.05) between the ovaries within mares. No difference (P > 0.05) was observed in utBFV and utPI during FDP between USC and SC, but during POP, utPI was lower (P < 0.05) and utBFV higher (P < 0.001) in SC than USC. The ovBFV was higher (P < 0.01) and ovPI lower (P < 0.05) in SC compared to USC. All uterine and ovarian blood flow parameters were related to the number of developing follicles in SC. Parameters utPI (r = −0.67; P < 0.001) and ovPI (r = −0.53; P < 0.001) were negatively correlated with the number of ovulations on t3, and with the number of collected embryos on t3 (utPI: r = −0.81; P < 0.001), D-4 (utPI: r = −0.64; P < 0.0001), and D-1 (ovPI: r = −0.41; P < 0.01). P₄ levels were not positively correlated with utBFV (P > 0.05), but E_tot concentrations (D-4: r = 0.790; D3: r = 0.639; P < 0.001; D-1: r = 0.48; P < 0.001) and ovBFV from D-4 to D-1 (r = 0.64; P < 0.001) in SC were. The results of the present study show that in mares treatment with gonadotropins to induce superovulation is associated with a marked increase in uterine and ovarian perfusion, concurrent with the development of multiple follicles and an increase in E_tot levels. The increased blood flow seems to be related to the effectiveness of ovarian response to stimulation.     

Impact d’une réduction d’activité sur la mesure de la fraction d’éjection du ventricule gauche sur caméra D-SPECT

IntroductionRadionuclide ventriculography provides a reproducible measurement of the left ventricular fraction ejection (LVEF) but with a significant body radiation (effective dose of 5,9 mSv for the injection of 850 Mbq of ^99mTc). The highly sensitive semi-conductor (CZT) cameras could allow decreasing the injected activity by a factor 3, similarly to that of myocardial perfusion imaging. Our study was aimed to determine whether the LVEF measurement provided by radionuclide ventriculography on the CZT D-SPECT camera is impacted by a 70% reduction in recorded counts.Materials and methodsAfter the in vivo labeling of red blood cells with 850 MBq of ^99mTc, 49 patients completed a conventional 2D recording (Conv-2D) on Anger camera followed by a 3D recording on the D-SPECT camera (3D-100%). The CZT recordings of all projections were subsequently shortened to 30% of their initial durations (3D-30%) in order to assess the LVEF measured with a 70% reduction in recorded counts.ResultsMean LVEF values were 62.7 ± 11.1% on Conv-2D and higher on both 3D-100% (66.8 ± 14.8%, P < 0.001) and 3D-30% (66.3 ± 15.7%, P < 0.001). The correlation coefficients with the LVEF determined with the reference Conv-2D method were equivalents for 3D-100% (r² = 0.73) and 3D-30% (r² = 0.70) and with a similar level of overestimation for the highest LEVF values.ConclusionA 70% reduction in recorded counts does not significantly impact the LVEF measured with radionuclide ventriculography on the CZT D-SPECT camera. These values are coherent with those obtained with the reference 2D method but with a clear overestimation for the highest LVEF values.     

Clusterin stimulates the chemotactic migration of macrophages through a pertussis toxin sensitive G-protein-coupled receptor and Gβγ-dependent pathways

Clusterin induces the expression of various chemotactic cytokines including tumor necrosis factor-α (TNF-α) in macrophages and is involved in the cell migration. According to the results of this study, clusterin induced the directional migration (chemotaxis) of macrophages based on a checkerboard analysis. The chemotactic activity of clusterin was prevented by pretreatment with pertussis toxin (PTX), indicating that the G_αi/o-protein coupled receptor (GPCR) was involved in the chemotactic response of clusterin. Clusterin-stimulated chemotaxis was abrogated in a dose-dependent manner by pretreatment with gallein (a G_βγ inhibitor), indicating the involvement of G_βγ released from the GPCR. In addition, inhibitors of phospholipase C (PLC, U73122) and phosphoinositide 3-kinase (PI3K, LY294002), the key targets of G_βγ binding and activation, suppressed chemotactic migration by clusterin. The phosphorylation of Akt induced by clusterin was blocked by pretreatment with gallein or LY294002 but not with U73122, indicating that G_βγ released from the PTX-sensitive G_i protein complex activated PLC and PI3K/Akt signaling pathways separately. The activation of cellular MAP kinases was essential in that their inhibitors blocked clusterin-induced chemotaxis, and G_βγ was required for the activation of MAP kinases because gallein reduced their phosphorylations induced by clusterin. In addition, the inflammation-induced migration of macrophages was greatly reduced in clusterin-deficient mice based on a thioglycollate-induced peritonitis model system. These results suggest that clusterin stimulates the chemotactic migration of macrophages through a PTX-sensitive GPCR and G_βγ-dependent pathways and describe a novel role of clusterin as a chemoattractant of monocytes/macrophages, suggesting that clusterin may serve as a molecular bridge between inflammation and its remodeling of related tissue by recruiting immune cells.     

Identification of Functionally Important Cysteines in the α-Subunit of Transducin by Chemical Cross-Linking Techniques

Transducin (T), the G-protein in the visual system, is a heterotrimer arranged as two functional units, T_α and T_βγ. N, N′-1, 2-phenylenedimaleimide (o-PDM) and N, N′-1, 4-phenylenedimaleimide (p-PDM), two cysteine specific-homobifunctional agents, were used to covalently cross-link T and its units. A complete inhibition in T function was observed in the presence of these compounds. Incubation of T_α with o-PDM or p-PDM resulted in the formation of high-molecular-weight oligomers of 70-, 105-, 140-, and ≥200 kDa, as well as intramolecular cross-linked polypeptides that migrated as 35- and 37-kDa bands. Additionally, the treatment of T_βγ with both reagents produced a major species of 46-kDa. The combination of intact T_α and o-PDM- or p-PDM-treated T_βγ reconstituted T native activities. On the contrary, when o-PDM- or p-PDM-modified T_α was incubated with intact T_βγ, more than 90% inhibition on T function was observed. Hence, the cysteines modified and/or cross-linked on T_α represent functionally important residues of T.     

Differential effects of genetically-encoded Gβγ scavengers on receptor-activated and basal Kir3.1/Kir3.4 channel current in rat atrial myocytes

Opening of G-protein-activated inward-rectifying K⁺ (GIRK, Kir3) channels is regulated by interaction with βγ-subunits of Pertussis-toxin-sensitive G proteins upon activation of appropriate GPCRs. In atrial and neuronal cells agonist-independent activity (I_basal) contributes to the background K⁺ conductance, important for stabilizing resting potential. Data obtained from the Kir3 signaling pathway reconstituted in Xenopus oocytes suggest that I_basal requires free G_βγ. In cells with intrinsic expression of Kir3 channels this issue has been scarcely addressed experimentally. Two G_βγ-binding proteins (myristoylated phosducin — mPhos — and G_αi1) were expressed in atrial myocytes using adenoviral gene transfer, to interrupt G_βγ-signaling. Agonist-induced and basal currents were recorded using whole cell voltage-clamp. Expression of mPhos and G_αi1 reduced activation of Kir3 current via muscarinic M₂ receptors (I_K(ACh)). Inhibition of I_K(ACh) by mPhos consisted of an irreversible component and an agonist-dependent reversible component. Reduction in density of I_K(ACh) by overexpressed G_αi1, in contrast to mPhos, was paralleled by substantial slowing of activation, suggesting a reduction in density of functional M₂ receptors, rather than G_βγ-scavenging as underlying mechanism. In line with this notion, current density and activation kinetics were rescued by fusing the α_i1-subunit to an Adenosine A₁ receptor. Neither mPhos nor G_αi1 had a significant effect on I_basal, defined by the inhibitory peptide tertiapin-Q. These data demonstrate that basal Kir3 current in a native environment is unrelated to G-protein signaling or agonist-independent free G_βγ. Moreover, our results illustrate the importance of physiological expression levels of the signaling components in shaping key parameters of the response to an agonist.     

Identification of new Gβγ interaction sites in adenylyl cyclase 2

The role of Gβγ in adenylyl cyclase (AC) signaling is complicated due to its role as a conditional activator (AC2, AC4 and AC7) and an inhibitor (AC1, AC3 and AC8). AC2 is stimulated by Gα_s and if Gβγ is present the stimulation is synergistic. The precise mechanism of this synergistic activation is still not known. In order to further elucidate the role of Gβγ in AC2 activation by Gα_s, peptides derived from the C1 domains of AC2 were synthesized and the ability of the various peptides to regulate AC2 function was tested. Our results identify two new Gβγ-binding sites in the AC2 C1 domain, AC2 C1a 339-360 and AC2 C1b 578-602 that are involved with stimulation of AC2 by Gβγ. These two regions are different from the previously described QEHA motif in the C2 domain of AC2. Further, the recently discovered PFAHL motif was confirmed to bind and to be involved with stimulation of AC2 by Gβγ. These functional studies indicate that multiple regions of AC2 are involved in the interaction with Gβγ.     

A G-Protein Subunit Translocation Embedded Network Motif Underlies GPCR Regulation of Calcium Oscillations

G-protein βγ subunits translocate reversibly from the plasma membrane to internal membranes on receptor activation. Translocation rates differ depending on the γ subunit type. There is limited understanding of the role of the differential rates of G_βγ translocation in modulating signaling dynamics in a cell. Bifurcation analysis of the calcium oscillatory network structure predicts that the translocation rate of a signaling protein can regulate the damping of system oscillation. Here, we examined whether the G_βγ translocation rate regulates calcium oscillations induced by G-protein-coupled receptor activation. Oscillations in HeLa cells expressing γ subunit types with different translocation rates were imaged and quantitated. The results show that differential G_βγ translocation rates can underlie the diversity in damping characteristics of calcium oscillations among cells. Mathematical modeling shows that a translocation embedded motif regulates damping of G-protein-mediated calcium oscillations consistent with experimental data. The current study indicates that such a motif may act as a tuning mechanism to design oscillations with varying damping patterns by using intracellular translocation of a signaling component.     

Assay of Free Thyroxine and Free Triiodothyronine in Fine-Needle Aspiration of Thyroid Nodules: a Useful and Low-Cost Assessment

ObjectiveTo evaluate whether analysis of thyroid hormones in fine-needle aspiration (FNA) of thyroid nodules can provide information about the functional status and the nature of the nodules.MethodsWe studied 4 groups of patients: group 1, 17 patients with autonomous hyperfunctioning thyroid nodules; group 2, 52 patients with cold nonfunctioning thyroid nodules; group 3, 12 patients with malignant thyroid nodules; and group 4 (control group), 10 patients with nonthyroid nodular lesions (enlarged parathyroid glands or lymph nodes). The assay of thyroid hormones was performed in FNA after the washing of needles and, with patient consent, also in normal thyroid parenchyma.ResultsThe free thyroxine (FT₄) and free triiodothyronine (FT₃) values were remarkably high in group 1 (mean, 5.5 ± 0.53 ng/dL and 27.6 ± 3.1 pg/mL, respectively; P < 0.05 versus group 2 and group 4, the control group). The levels of FT₄ and FT₃ were very low in group 3 (< 0.2 ng/dL and < 1.0 pg/mL, respectively; P < 0.05 versus group 2). Thyroglobulin values in FNA specimens were much higher than the normal range in human serum, but no significant differences were found between the various groups. The control group had low levels of FT₄ and FT₃ (< 0.2 ng/dL and < 1.0 pg/mL, respectively) in conjunction with low levels of thyroglobulin, whereas parathyroid hormone levels were high in parathyroid nodules.ConclusionThese results show that assay of FT₄ and FT₃ in FNA can yield information about the functional status of thyroid nodules and, indirectly, about the nature of nodules. In this era of sophisticated new molecular markers in FNA cytology, this low-cost diagnostic method can be readily performed in every laboratory. (Endocr Pract. 2004;10:311-316)     

Structure–activity relationship study of copper(II) complexes with 2-oxo-1,2-dihydroquinoline-3-carbaldehyde (4′-methylbenzoyl) hydrazone: synthesis, structures, DNA and protein interaction studies, antioxidative and cytotoxic activity

Novel 2-oxo-1,2-dihydroquinoline-3-carbaldehyde (4′-methylbenzoyl) hydrazone (H₂L) (1) and its two copper(II) complexes have been synthesized. Single-crystal X-ray diffraction studies revealed that the structure of the new copper(II) chloride complex, [Cu(H₂L)Cl₂]·2H₂O (2), is square pyramidal and that of the copper(II) nitrate complex, [Cu(HL)NO₃]·DMF (3), is square planar. In 2, the copper atom is coordinated by the ligand with ONO donor atoms, one chloride ion in the apical position, and the other chloride in the basal plane. In 3, the ligand coordinates as a uninegative tridentate ONO⁻ species and with one nitrate ion in the basal plane. DNA binding experiments indicated that the ligand and copper(II) complexes can interact with DNA through intercalation. Bovine serum albumin binding studies revealed that the compounds strongly quench the intrinsic fluorescence of bovine serum albumin through a static quenching process. Antioxidative activity tests showed that 1 and its copper(II) complexes have significant radical scavenging activity against free radicals. Cytotoxic activities of the ligand and copper(II) complexes showed that the two copper(II) complexes exhibited more effective cytotoxic activity against HeLa and HEp-2 cells than the corresponding ligand. The entire biological activity results showed that the activity order was 1 < 2 < 3.     

Dietas ricas en grasa y composición corporal a lo largo de dos generaciones. Estudio experimental

Introduction and objectiveDespite recent findings reported on the nutritional factors that induce epigenetic changes, little information is available at early ages. This study analyzed in an experimental model, over two generations, potential changes in body composition and potential expression of epigenetic changes as the result of the intake of isoenergetic diets with different fat levels.Materials and methodsAt weaning, Wistar female rats were divided into two groups that were fed either a control diet (fat = 7% w/w) or a high-fat diet (15% w/w). Rats were mated at 70 days (M₁) and their pups (P₁) were the first generation; P₁ rats were mated at 70 days (M₂) and their pups (P₂) represented the second generation. At weaning, mothers and pups (M₁, M₂ and P₁, P₂) were measured body weight (W) and composition (% body fat, %BF), and total skeleton bone mineral content (BMC), expressed as %BMC, using chemical and DXA methods respectively.ResultsAt weaning, high-fat diet groups M₂ and P₂ showed significant increases in W and %BF (p < 0.05); increased %BF values were already found in the M₁ and P₁ groups (p < 0.001). By contrast, %BMC significantly decreased in M₂ and P₂ rats (p < 0.001).ConclusionThis study demonstrates the need to review certain eating habits to avoid perpetuation of unhealthy patterns generation after generation.     

Boronated phosphonium salts containing arylboronic acid, closo-carborane, or nido-carborane: synthesis, X-ray diffraction, in vitro cytotoxicity, and cellular uptake

The preparation of boronated triaryl and tetraaryl phosphonium salts of the type [PPh₃CH₂R]Br [R is 4-boronophenyl (1), 4-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-yl)phenyl (2), 3-boronophenyl (3), 3-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-yl)phenyl (4), 2-boronophenyl (5), 2-(4,4,5,5-tetramethyl-1,3,2-dioxaborolan-yl)phenyl (6), and closo-1,2-carboran-1-yl (7)] is described. These compounds were prepared by the reaction of triphenylphosphine with benzylic bromides or 1-bromomethyl-closo-1,2-carborane in acetonitrile solution at 85 °C. The zwitterionic nido-7,8-carborane derivative PPh₃CH₂C₂B₉H₁₁ (8) was prepared by treatment of 7 with cesium fluoride in refluxing ethanol. All compounds were fully characterized by multinuclear (¹H, ¹¹B, ¹³C, and ³¹P) 1D- and 2D-NMR spectroscopy, electrospray ionization mass spectrometry, and elemental analysis, and single-crystal X-ray structures were determined for compounds 1, 3, 7, and 8. The cytotoxicities and boron uptake of selected derivatives were investigated in vitro using human glioblastoma (T98G) and canine kidney tubule (MDCK II) cells. The zwitterionic species 8 was found to be the least cytotoxic agent while also delivering the greatest amount of boron to the T98G cells, peaking at 9.15 ± 2.65 μg B/mg protein.     

Superoxide dismutase enhances chain-breaking antioxidant capability of hydroquinones

2-tert-butyl-(1), 2,6-dimethyl-(2), 2,5-dimethyl-(3), trimethyl-(4), and 2,3-dimethoxy-5-methyl-(5) substituted p-hydroquinones (QH₂) were tested as a chainbreaking antioxidant during the oxidation of methyl linoleate (ML) in dodecyl sulfate micellar solution, pH 7.40, at 37°C. In the absence of superoxide dismutase (SOD), all the studied QH₂ displayed very moderate if any antioxidant capability. When 5–25 U/ml SOD was added, QH₂ showed a pronounced ability to inhibit ML oxidation. The stoichiometric factor of inhibition was found to be about one for all the tested QH₂ in the presence of SOD. The reactivities of QH₂ to the ML peroxy radical increase in the order QH₂5 < QH₂ 3 < QH₂1≈QH₂2 < QH₂4; reactivity of QH₂4 exceds that reported for the majority of phenolic antioxidants. The features of QH₂ as an antioxidant in aqueous environment is likely associated with the reactivity of semiquinone (O^·-) formed due to attack of the peroxy radical to QH₂. O^·- reacts readily with molecular oxygen with formation of superoxide (O^·-₂); in turn, O^·-₂ attacks both to QH₂ and ML (likely, as HO^·₂) that results in fast depleting QH₂ and chain propagation, respectively. The addition of SOD results in purging a reaction mixture from O^·-₂ and, as a corollary, in depressing undesirable reactions with the participation of O^·-₂. Under these conditions, QH₂ displays the theoretically highest inhibitory activity which is determined solely by the reactivity of QH₂ to the peroxy radical.     

Finding safe dose-volume constraints for re-irradiation with SBRT of patients with prostate cancer relapse: The IEO experience

AimThe primary aim of this study is to provide preliminary indications for safe constraints of rectum and bladder in patients re-irradiated with stereotactic body RT (SBRT).MethodsData from patients treated for prostate cancer (PCa) and intraprostatic relapse, from 1998 to 2016, were retrospectively collected. First RT course was delivered with 3D conformal RT techniques, SBRT or volumetric modulated arc therapy (VMAT). All patients underwent re-irradiation with SBRT with heavy hypofractionated schedules. Cumulative dose-volume values to organs at risk (OARs) were computed and possible correlation with developed toxicities was investigated.ResultsTwenty-six patients were included. Median age at re-irradiation was 75 years, mean interval between the two RT courses was 5.6 years and the median follow-up was 47.7 months (13.4–114.3 months). After re-irradiation, acute and late G ≥ 2 GU toxicity events were reported in 3 (12%) and 10 (38%) patients, respectively, while late G ≥ 2 GI events were reported in 4 (15%) patients. No acute G ≥ 2 GI side effects were registered. Patients receiving an equivalent uniform dose of the two RT treatments < 131 Gy appeared to be at higher risk of progression (4-yr b-PFS: 19% vs 33%, p = 0.145). Cumulative re-irradiation constraints that appear to be safe are D_30% < 57.9 Gy for bladder and D_30% < 66.0 Gy, D_60% < 38.0 Gy and V_{122.1 Gy} < 5% for rectum.ConclusionPreliminary re-irradiation constraints for bladder and rectum have been reported. Our preliminary investigation may serve to clear some grey areas of PCa re-irradiation.     

Assessment of AACE/ACE Recommendations for Initial Dual Antihyperglycemic Therapy Using the Fixed-Dose Combination of Sitagliptin and Metformin Versus Metformin

ObjectiveThe American Association of Clinical Endocrinologists and American College of Endocrinology (AACE/ACE) diabetes algorithm recommends a stratified approach to initial therapy to achieve a glycated hemoglobin (HbA_1c) goal of <6.5% in patients with type 2 diabetes mellitus (T2DM) who have inadequate glycemic control. Data from a double-blind study in drug-naïve T2DM patients comparing initial monotherapy with metformin (MET) with initial dual therapy with a fixed-dose combination of sitagliptin and MET (SITA/MET FDC) was used to determine AACE/ACE HbA_1c goal attainment in these treatment groups.MethodsA total of 1,250 patients (mean baseline HbA_1c = 9.9%) were randomized 1:1 to SITA/MET FDC 50/500 mg twice daily (b.i.d.) or MET 500 mg b.i.d. for 18 weeks. SITA/MET FDC and MET were uptitrated over 4 weeks to 50/1,000 mg b.i.d. and 1,000 mg b.i.d., respectively.ResultsAt week 18, a higher percentage of patients receiving SITA/MET FDC had HbA_1c levels <6.5% and <7% than those receiving MET alone within each of the 3 AACE/ACE HbA_1c categories (6.5-7.5%, >7.5-9.0%, and >9.0%). Of patients with a baseline HbA_1c >7.5-9.0% who initiated SITA/MET FDC, 48.6% achieved an HbA_1c <6.5% at week 18 compared with 23.1% of patients who initiated MET monotherapy (P<.001). In patients with a baseline HbA >9.0%, 24.0% on SITA/MET FDC achieved an HbA_1c <6.5% compared with 12.8% on MET alone (P<.001).ConclusionIn T2DM patients with a baseline HbA_1c >7.5-9.0%, substantially more achieved the HbA_1c goal of <6.5% with initial dual therapy (SITA/MET FDC) than with initial monotherapy (MET), which is in agreement with the AACE/ACE diabetes algorithm.(Endocr Pract. 2013;19:751-757)     

Structure and absolute configuration of a secolignan from Peperomia blanda

A secolignan, (−)-2-methyl-3-[bis(3′,4′-methylenedioxy-5′-methoxyphenyl) methyl]butyrolactone (1), with a rare cis configuration was isolated from the aerial parts of Peperomia blanda (Piperaceae). The structure of this compound was elucidated by a combination of spectroscopic methods, including ultraviolet, infrared, 1D- and 2D- nuclear magnetic resonance as well as high resolution mass spectrometry data. The absolute configuration of (−)-1 was determined as (2R,3S) by the comparison of experimental electronic circular dichroism (ECD) spectroscopy and time-dependent density functional theory (TDDFT) calculations.     

Nonobese Young Females with Polycystic Ovary Syndrome Have Nutritive Microvascular Dysfunction: A Pilot Study

ObjectiveTo investigate nutritive microvascular function in young nonobese females with polycystic ovary syndrome (PCOS) and to correlate microvascular reactivity with sex steroids, inflammatory markers, and metabolic variables.MethodsFourteen nonobese females with PCOS (24.6 ± 2.7 years, body mass index [BMI] 23.7 ± 3.1 kg/ m²) and 13 age- and BMI-matched controls (22.8 ± 2.3 years, 22.5 ± 3.4kg/m2) underwent anthropometric, hormonal, and microvascular evaluations. The main outcome measures were capillary density, red blood cell velocity (RBCV) at resting and peak during postocclusive reactive hyperemia (RBCV_max), and time taken to reach RBCV_max (TRBCV_max).ResultsSubjects with PCOS had lower RBCV and higher TRBCV_max compared to controls, respectively (0.237 [0.220-0.324] vs. 0.362 [0.297-0.382] mm/s, F < .01) and (5 [5-6] vs. 4 [3-5] s, P < .05]. The free androgen index (FAI) and sex hormone-binding globulin (SHBG) level were different between groups. FAI correlated to RBCV_max (ρ = -0.49, P < .05) and to TRBCV_max (ρ = 0.41, P < .05). SHBG correlated with RBCV_max (ρ = 0.52, P < .01) while estradiol (E₂) levels correlated with RBCV (ρ = 0.80, P < .001) and RBCV_max (ρ = 0.46, P < .05).ConclusionMicrovascular dysfunction characterized by reduced RBCV_maxand prolonged TRBCV_maxwas present in young, nonobese PCOS subjects. FAI was associated with observed impairments, suggesting a possible common mechanism linking sex hormones and microvascular dysfunction. (Endocr Pract. 2014;20:1281-1289)     

Treatment with 50000 IU Vitamin D2 Every Other Week and Effect on Serum 25-Hydroxyvitamin D2, 25-Hydroxyvitamin D3, and Total 25-Hydroxyvitamin D in Aclinical Setting

ObjectiveTo examine the effect of 50 000 IU-vitamin D₂ supplementation in a clinical setting on serum total 25-hydroxyvitamin D (25[OH]D), 25-hydroxyvitamin D₂ (25[OH]D₂), and 25-hydroxyvitamin D₃ (25[OH]D₃).MethodsThis retrospective cohort study was performed in an urban tertiary referral hospital in Boston, Massachusetts. Patients who had been prescribed 50 000 IU vitamin D₂ repletion and maintenance programs were identified through a search of our electronic medical record. Baseline and follow-up total serum 25(OH)D, 25(OH)D₂, and 25(OH)D₃ levels were compared.ResultsWe examined the medical records of 48 patients who had been prescribed 50 000 IU vitamin D₂ in our clinic. Mean ± standard deviation baseline total 25(OH) D was 31.0 ± 10.6 ng/mL and rose to 48.3 ± 13.4 ng/mL after treatment (P <.001). 25(OH)D₂ increased from 4.2 ± 4.3 ng/mL to 34.6 ± 12.3 ng/mL after treatment (P <.001), for an average of 158 days (range, 35-735 days). Serum 25(OH)D3 decreased from 26.8 ± 10.8 ng/mL to 13.7 ± 7.9 ng/mL (P <.001).ConclusionsFifty thousand IU vitamin D₂ repletion and maintenance therapy substantially increases total 25(OH)D and 25(OH)D2 despite a decrease in serum 25(OH)D3. This treatment program is an appropriate and effective strategy to treat and prevent vitamin D deficiency.(Endocr Pract. 2012;18:399-402)     

Patient exposure data and operator dose in coronary interventional procedures: Impact of body-mass index and procedure complexity

PurposeThe aim of this study was to assess patient exposure data and operator dose in coronary interventional procedures, when considering patient body-mass index and procedure complexity.MethodsTotal air kerma area product (P_KA), Air-Kerma (AK), Fluoroscopy time (FT), operator dose and patient body-mass index (BMI) from 97 patients’ procedures (62 coronary angiography (CA) and 35 Percutaneous Coronary Intervention (PCI) were collected for one year. For PCI procedures, also the complexity index-CI was collected. Continuous variables for each of the 2 groups procedures (CA and PCI) were compared as medians with interquartile range and using Mann-Whitney U test. Multiple group data were compared using Kruskal-Wallis test (significance: p < 0.05).ResultsMedian P_KA was 63 and 125 Gy cm² for CA and PCI respectively (p < 0.001); FT was 3 and 14 min, respectively (p < 0.001). P_KA and FT significantly increased (p < 0.05) with BMI class for CA procedures. P_KA and FT also increased in function of CI class for PCI, thought significantly only for FT (p < 0.001), possibly because of the low number of PCI procedures included; cine mode contributed most to P_KA. Significant dose variability was observed among cardiologists for CA procedures (p < 0.001).ConclusionsDose references levels for P_KA and FT in interventional cardiology should be defined - on a sufficient number of procedures- in function of CI and BMI classes. These could provide an additional tool for refining a facility’s quality assurance and optimization processes. Dose variability associated with cardiologists underlines the importance of continuous training.     

Nonlinear Analysis of Stride Interval Time Series in Gait Maturation Using Distribution Entropy

ObjectivesThis study aimed to investigate whether DistEn was capable of identifying complexity or irregularity for gait data and whether having low parameter-dependency sensitivity by comparing with the Approximate Entropy (ApEn) and Sample Entropy (SampEn).Material and methodsThe data were divided into three groups according to gait maturation. Firstly, the mean amplitude histogram, standard deviation (SD), and the power spectrum were calculated for each group. Secondly, ApEn, SampEn, and DistEn algorithms were calculated. Statistical analyses were then performed to compare groups.ResultsFor m=3 with M= 256 and M=512 parameters, DistEn showed a statistically significant difference between in pairwise comparisons between all groups (P_a, P_b, and P_c < 0.05). DistEn consistently decreased from Group1, to Group2, and to Group 3. For m=2 with r=0.30 values, SampEn showed a statistically significant difference only in pairwise comparisons between Group1 and Group3 (P_b < 0.05). For with m=3 and r=0.30 parameters, SampEn also showed a statistically significant difference in pairwise comparisons between Group1 and Group3 (P_c < 0.05) as well as Group2 and Group3 (P_c < 0.05) SampEn increased from Group1 to Group3 and from Group2 to Group3. There was not any statistically significant difference in pairwise comparisons of groups for ApEn. Furthermore, DistEn showed less parameter consistency than ApEn and SampEn.ConclusionDistEn showed the best performance in capture the complexity changes in gain patterns with growth.