Objective: Low levels of testosterone in men have been shown to be associated with type 2 diabetes, visceral adiposity, dyslipidaemia and metabolic syndrome. We investigated the effect of testosterone treatment on insulin resistance and glycaemic control in hypogonadal men with type 2 diabetes. Design: This was a double-blind placebo-controlled crossover study in 24 hypogonadal men (10 treated with insulin) over the age of 30 years with type 2 diabetes. Methods: Patients were treated with i.m. testosterone 200 mg every 2 weeks or placebo for 3 months in random order, followed by a washout period of 1 month before the alternate treatment phase. The primary outcomes were changes in fasting insulin sensitivity (as measured by homeostatic model index (HOMA) in those not on insulin), fasting blood glucose and glycated haemoglobin. The secondary outcomes were changes in body composition, fasting lipids and blood pressure. Statistical analysis was performed on the delta values, with the treatment effect of placebo compared against the treatment effect of testosterone.

Key points• Feed arteries and arterioles, respectively, control the magnitude and distribution of blood flow to skeletal muscle but regional differences in the regulation of vasomotor tone are poorly understood.• To provide this insight, we investigated functional roles and molecular expression of the calcium-release channels, ryanodine receptors (RyRs) and inositol 1,4,5-trisphosphate receptors (IP 3 Rs) in smooth muscle cells (SMCs) of isolated pressurized vessels of mice.• In feed arteries, SMCs displayed localized calcium sparks and more global calcium waves. In arterioles, SMCs exhibited only calcium waves.• Calcium signalling and vasomotor tone were governed by both RyRs and IP 3 Rs in feed arteries, while only IP 3 Rs were functional in arterioles. Regional differences were also manifest in the expression profile of RyR isoforms.• This new perspective offers the potential for developing novel strategies to target therapeutic interventions to selective regions of vascular beds.Abstract We tested the hypothesis that vasomotor control is differentially regulated between feed arteries and downstream arterioles from the cremaster muscle of C57BL/6 mice.

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In the decade of the 1830's, Alexis de Tocqueville published a perceptive analysis of America in the Jacksonian era, which focused upon the customs, manners and intellectQal habits of its citizens, and their social condition as seen through its political institutions. He advanced the proposition--a paradox of democracy--that equality of condition was as compatible with tyranny as with freedom. The social consensus, which stemmed from the wide acceptance of doctrine of equality and common wants and interests, when brought to bear upon legislator and judge, public official, The results suggest that, in this period of opportunism and dynamic change, the people's prerogative to interpret the law through jury trial received chilly scrutiny; that the concern of the bench was for stable rules to regulate emergent forms of enterprise, and particular interests of individuals, for the good order and harmony of the nation, though their decisions might overturn the political judgment of the majority. By the end of the period, the judiciary had made a decisive stand regarding the nature and locality 3 of supreme authority, limiting majoritarian encroachments upon vested rights in politics, economics and property. The courts did not, however, safeguard minority rights that impinged upon majoritarian views which the judges shared.In the despotism of this accord--a paradox of Tocqueville's thesis--lies the tyranny of the majority.