AIM: Previous studies have demonstrated that the dysregulated-secretion of adipokines by adipocytes may contribute to obesity-associated atherosclerosis (As) and high density lipoprotein (HDL) may protect against atherogenesis through multiple pathways. This study was to explore the effect of HDL on the oxLDL uptake in inflammatory adipocytes stimulated by endotoxin lipopolysaccharide (LPS) and the possible mechanism. METHODS AND RESULTS: 3T3-L1 adipocytes were cultured and induced to differentiation and maturation. Acute inflammation in adipocytes was induced by LPS (100 ng/ml) for 6 hours. The adipocytes were pretreated with HDL in various concentrations (10, 50, 100 μg/ml) for 16 hours or with specific PPARγ antagonist (GW9662, 10 μM) or agonist (Rosiglitazone, 10 μM) for 30 min before administration of LPS. The results showed that LPS significantly increased the release of inflammation-related adipokines, such as monocyte chemoattractant protein-1 (MCP-1), plasminogen activator inhibitor 1 (PAI-1), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-8 and IL-6, while decreasing the release of leptin and adiponectin. Meanwhile, LPS reduced the uptake and degradation of 125I-oxLDL, and down-regulated the expression of PPARγ and CD36. Pretreatment with HDL dose-dependently affected the release of IL-8 and IL-6 and the reduced uptake and degradation of oxLDL of adipocytes stimulated by LPS, accompanied with marked upregulation of PPARγ and CD36 expression. Pretreatment with GW9662 markedly inhibited the upregulation of CD36 expression mediated by HDL (100 μg/ml), while the effects of Rosiglitazone were opposite to GW9662. CONCLUSIONS: HDL may increase oxLDL uptake of inflammatory adipocytes stimulated by LPS via upregulation of PPARγ/CD36 pathway, which may be a new mechanism of anti-atherosclerosis mediated by HDL.

BACKGROUND: A gender-neutral threshold aneurysm diameter (AD) of more than 5.5 cm for surgical intervention in abdominal aortic aneurysms (AAA) ignores the fact that women have a smaller baseline AD. We hypothesized that women have a greater AD relative to body surface area (BSA) at the time of surgery and that this worsens outcome. METHODS: The Vascular Study Group of New England database was queried for elective AAA repairs performed from 2003 to 2011 to compare BSA-indexed AD, ie, aortic size index (ASI), between men and women at the time of surgery and the impact of ASI on outcome. RESULTS: Women were older and had higher ASI among both open-repair (n = 1,566) and endovascular repair (n = 2,172) patients (P .001). Among open-repair patients, mean ASI for men undergoing repair at AD of 5.5 cm (2.75 cm/m²) was used to subdivide women into 2 categories: women with ASI of 2.75 or more were older (P .001), had a larger aneurysm size (P .001), and had a higher 1-year mortality (P = .042) than women with ASI less than 2.75. CONCLUSIONS: When indexed to BSA, women have a larger aneurysm size than men at the time of AAA repair.

OBJECTIVES: Teaching transesophageal echocardiography (TEE) remains challenging. The authors hypothesized that using online modules with live teaching in an echo training course would be feasible and result in superior knowledge acquisition to live teaching only. DESIGN: In this prospective cohort study, the authors implemented a TEE course with online modules and live teaching and compared it to a live-teaching-only version. SETTING: The online-and-live-teaching version of the course consisted of online modules and live sessions at Beth Israel Deaconess Medical Center (BIDMC), an academic medical center. The live-teaching-only version consisted of live sessions at BIDMC. PARTICIPANTS: Course participants included anesthesia trainees at BIDMC. INTERVENTIONS: Trainees taking the online-and-live-teaching version viewed online modules before live review lectures and simulation. Trainees taking the live-teaching-only version viewed live lectures before simulation. MEASUREMENTS AND MAIN RESULTS: Twenty-seven trainees completed the online-and-live-teaching version; six completed the live-teaching-only version. Trainees took a course exam after the first and last live sessions. For the online-and-live-teaching version, average pretest and posttest scores were 62.0%±13.7% and 77.5%±8.1%, respectively; pretest and posttest passing (≥70%) rates were 29.6% and 85.2%, respectively. Compared to the live-teaching-only version, the average pretest score was not significantly different (p=0.17), but the average posttest score was significantly higher (p=0.01). Trainee comfort with, and knowledge of, TEE increased after both versions. Trainees rated the utility of the live lectures and online modules similarly. CONCLUSIONS: A multimodal TEE curriculum increased trainees' knowledge of TEE concepts and had a positive reception from trainees.