SMRT Regulates Metabolic Homeostasis and Adipose Tissue Macrophage Phenotypes in Tandem

The Silencing Mediator of Retinoid and Thyroid Hormone Receptors (SMRT) is a nuclear corepressor, regulating the transcriptional activity of many transcription factors critical for metabolic processes. While the importance of the role of SMRT in the adipocyte has been well-established, our comprehensive understanding of its in vivo function in the context of homeostatic maintenance is limited due to contradictory phenotypes yielded by prior generalized knockout mouse models. Multiple such models agree that SMRT deficiency leads to increased adiposity, although the effects of SMRT loss on glucose tolerance and insulin sensitivity have been variable. We therefore generated an adipocyte-specific SMRT knockout (adSMRT-/-) mouse to more clearly define the metabolic contributions of SMRT. In doing so, we found that SMRT deletion in the adipocyte does not cause obesity-even when mice are challenged with a high-fat diet. This suggests that adiposity phenotypes of previously described models were due to effects of SMRT loss beyond the adipocyte. However, an adipocyte-specific SMRT deficiency still led to dramatic effects on systemic glucose tolerance and adipocyte insulin sensitivity, impairing both. This metabolically deleterious outcome was coupled with a surprising immune phenotype, wherein most genes differentially expressed in the adipose tissue of adSMRT-/- mice were upregulated in pro-inflammatory pathways. Flow cytometry and conditioned media experiments demonstrated that secreted factors from knockout adipose tissue strongly informed resident macrophages to develop a pro-inflammatory, MMe (metabolically activated) phenotype. Together, these studies suggest a novel role for SMRT as an integrator of metabolic and inflammatory signals to maintain physiological homeostasis.

Rapid Gas-Liquid Chromatographic Determination of Phenethyl Alcohol in Alcoholic Distillates Division, National Distillers

A rapid gas-liquid chromatographic method is described for the quantitative determination of phenethyl alcohol in alcoholic distillates. No prior sample preparation is required. Values are presented for 47 samples of bourbon, blended, light, Canadian, and Scotch whiskies as well as for rum, brandy, and tequila. The phenethyl alcohol concentration in these samples varies from zero to 131 g/100 L at 100° proof. The accuracy and precision of the method are demonstrated.

Silencing Mediator of Retinoid and Thyroid Hormone Receptors (SMRT) regulates glucocorticoid action in adipocytes

Local modulation of glucocorticoid action in adipocytes regulates adiposity and systemic insulin sensitivity. However, the specific cofactors that mediate glucocorticoid receptor (GR) action in adipocytes remain unclear. Here we show that the silencing mediator of retinoid and thyroid hormone receptors (SMRT) is recruited to GR in adipocytes and regulates ligand-dependent GR function. Decreased SMRT expression in adipocytes in vivo increases expression of glucocorticoid-responsive genes. Moreover, adipocytes with decreased SMRT expression exhibit altered glucocorticoid regulation of lipolysis. We conclude that SMRT regulates the metabolic functions of GR in adipocytes in vivo. Modulation of GR-SMRT interactions in adipocytes represents a novel approach to control the local degree of glucocorticoid action and thus influence adipocyte metabolic function.

Transient dobutamine-mediated pulsus alternans

Pulsus alternans, alternating weak and strong beats occurring in a heart beating at a constant rate, has most often been reported in patients with severe, end-stage heart failure. This patient with New York Heart Association functional class I heart failure developed pulsus alternans during the inotropic stimulation of dobutamine that subsequently resolved in a time course consistent with dobutamine clearance. Thus, in the setting of mildly impaired myocardial contractility, the inotropic stimulus of dobutamine may precipitate the development of reversible pulsus alternans.

The management of stab wounds to the back

The management of stab wounds to the back is controversial. There are certain clear indications for exploratory laparotomy, but most cases require a diagnostic workup and a period of observation. In this article, different diagnostic modalities are presented, including local wound exploration, diagnostic peritoneal lavage, abdominal computed tomography (CT) scan, triple-contrast abdominal CT scan, and intravenous pyelography (IVP). Recommendations for management are given, with emphasis on abdominal CT scan and observation.

Prospective randomized trial of carotid endarterectomy with primary closure and patch angioplasty with saphenous vein, jugular vein, and polytetrafluoroethylene: long-term follow-up

PURPOSE

This study examines the long-term clinical outcome and the incidence of recurrent stenosis (> or = 50%) after carotid endarterectomy (CEA) with primary closure (PC) versus vein patch closure (VPC), saphenous (SVP), and jugular vein (JVP) and polytetrafluoroethylene patch closure (PTFE-P).

METHODS

A total of 399 CEAs were randomized into the following groups: 135 PC, 134 PTFE-P, and 130 VPC (SVP alternating with JVP). Postoperative duplex ultrasound scans were performed at 1, 6, and 12 months and every year thereafter. The mean follow-up was 30 months with a range of 1 to 62 months, and demographic characteristics were similar in all groups. Kaplan-Meier analysis was used to estimate the risk of restenosis and the stroke-free survival.

RESULTS

The incidence of ipsilateral stroke was 5% (seven of 135) for PC, 1% (one of 134) for PTFE-P, and 0% for VPC (PC vs VPC, p = 0.008; PC vs PTFE-P, p = 0.034). Seven strokes occurred in the perioperative period. All three groups had similar mortality rates. The cumulative stroke-free survival rate at 48 months was 82% for PC, 84% for PTFE-P, and 88% for VPC (p < 0.01 for PC vs PTFE-P or VPC). PC had a higher incidence of recurrent stenosis and occlusion (34%) than PTFE-P (2%) and VPC (9%) (SVP 9%, JVP 8%) (p < 0.001). PTFE-P had a lower recurrent stenosis rate than VPC (p < 0.045). Restenoses necessitating a redo CEA were also higher for PC (11%) than for PTFE-P (1%) and VPC (2%) (p < 0.001). Women with PC had a higher recurrent stenosis rate than men (46% vs 23%, p = 0.008). Kaplan-Meier analysis showed that freedom from recurrent stenosis at 48 months was 47% for PC, 84% for VPC, and 96% for PTFE-P (p < 0.001). The SVP and JVP results were comparable. The mean operative diameter of the internal carotid artery was similar in patients with or without restenosis. Significantly more late internal carotid artery dilatations occurred in the VPC group compared with the PC group.

CONCLUSIONS

Patch closure (VPC or PTFE-P) is less likely than PC to cause perioperative stroke. Patching was also superior in lowering the incidence of late recurrent stenoses, especially in women.

A prospective validation study of inclination, belief, and context predictors of family-focused prevention involvement

Prior research by the authors tested a model of factors influencing parent inclination to participate in parenting interventions. Family context, belief, attitude, and inclination to participate variables from this model were used to predict the actual participation of 1,121 families in assessment and intervention activities of a family-focused preventive intervention research project. Invitations to the project assessment and intervention components were, respectively, about 6 months and 10 months following the initiation of a telephone survey collecting predictor variable data. Logistic regression analyses examining each predictor individually showed that a number of family context, belief, attitude, and inclination variables were predictive of project participation. Subsequently, multiple logistic regressions were conducted, entering variables by blocks corresponding to theoretical model components. These analyses showed that prospectively stated inclination to participate in a parenting intervention and level of education were consistently significant predictors of both assessment participation and intervention enrollment. Implications for both research and practice are discussed.

Collaborative Study of the Quantitative Gas-Liquid Chromatographic Determination of Fusel Oil and Other Components in Whisky

Fifteen chemists participated in a collaborative study for the quantitative pas-liquid chromatographic determination of the individual fusel alcohols and ethyl acetate in whisky. Two levels of congeners represented by 4 coded samples of whisky were analyzed by using t h e proposed method, employing a glycerol-1,2,6-hexanetriol column, and the official AOAC method, 9.063-9.065. Since isobutyl and the atnyl alcohols comprise by far the greatest part of fusel oil, their determination is of major importance to the total fusel oil content . Statistical analyses show that the proposed method is superior to the AOAC method for the determination of these alcohols, whereas the official method is superior for the determination of ethyl acetate and n-propyl alcohol. In general, collaborators employing modern instrumentation preferred the proposed method over the AOAC method. The former method also separates and permits the quantitative measurement of active amyl and isoamyl alcohols. The proposed method has been adopted as official first action as an alternative to 9.063–9.065 for the determination of higher alcohols and ethyl acetate in whisky.

Compounds Identified in Whisky, Wine, and Beer: A Tabulation

Components which have been identified in alcoholic beverages by this laboratory and by other workers are listed with the pertinent references.

Gas Chromatography of Fusel Oils in Alcoholic Distillates

A single gas-liquid chromatographic column is described which will separate all the major fusel oil components rapidly and directly without prior concentration or extraction procedures. Quantitative data obtained using a 1:1 2% 1,2,6-hexanetrio 1:2% glycerol column compare favorably with those of the official AOAC colorimetric fusel oil method. Four additional components may be determined simultaneously and quantitatively.