Protective Effects of Diets Supplemented with Omega-3 Polyunsaturated Fatty Acids and Calcium Against Colorectal Tumor Formation

This study is to evaluate the effect of dietary omega-3 polyunsaturated fatty acid (ω-3 PUFA) and/or calcium supplementation on colon tissue of the carcinogenic N -methyl- N -nitrosurea (NMU)-injected rats and to investigate this effect by the assessment of the oxidative stress. The rats were divide...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Digestive diseases and sciences 2008-08, Vol.53 (8), p.2177-2182
Hauptverfasser: Kenar, Levent, Karayilanoglu, Turan, Aydin, Ahmet, Serdar, Muhittin, Kose, Songul, Erbil, M. Kemal
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 2182
container_issue 8
container_start_page 2177
container_title Digestive diseases and sciences
container_volume 53
creator Kenar, Levent
Karayilanoglu, Turan
Aydin, Ahmet
Serdar, Muhittin
Kose, Songul
Erbil, M. Kemal
description This study is to evaluate the effect of dietary omega-3 polyunsaturated fatty acid (ω-3 PUFA) and/or calcium supplementation on colon tissue of the carcinogenic N -methyl- N -nitrosurea (NMU)-injected rats and to investigate this effect by the assessment of the oxidative stress. The rats were divided into four groups: those fed with a standard diet, with a diet supplemented by ω-3 PUFA, those fed with a diet with calcium, and those fed with a standard diet with the combination of ω-3 PUFA and calcium. Rats were injected with an intrarectal NMU. After 32 weeks, colon tissue specimens and plasma were taken to histopathologically investigate and analyze tissue superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) activities and erythrocyte MDA levels. The tumor incidences in supplemented-diet groups II and IV were found to be significantly lower when compared with those of the controls ( P  
doi_str_mv 10.1007/s10620-007-0107-8
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_20796304</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1507562261</sourcerecordid><originalsourceid>FETCH-LOGICAL-c430t-1ab31d0e8394032b37ece510b13e7d6f203a1a09c7ca2e4a5e1ce286c8bf2c793</originalsourceid><addsrcrecordid>eNp1kUGL1EAQhYMo7rj6A7xII-gtWtWddJLjMO6osLALrudQ6VTGXpL02N1ZmZs_3R5mcEHwUvWgvnpV8LLsNcIHBKg-BgQtIU8yB0ylfpKtsKxULktdP81WgDppRH2RvQjhHgCaCvXz7AJrKLCs9Sr7fetdZBPtA4urYUgqCDeIT5aT-Lbs9yNPPEfuxS8bf4ibiXeUK3HrxsMyB4qLp-NwSzEexNrYPgiae7Gh0dhlEusd2TlEsXGj88mcRnG3TM6LrfMTRevml9mzgcbAr879Mvu-vbrbfMmvbz5_3ayvc1MoiDlSp7AHrlVTgJKdqthwidCh4qrXgwRFSNCYypDkgkpGw7LWpu4GaapGXWbvT757734uHGI72WB4HGlmt4RWQtVoBUUC3_4D3rvFz-m3VmKhpNQACcITZLwLwfPQ7r2dyB9ahPaYTXvKpj3KYzZtnXbenI2XbuL-ceMcRgLenQEKhsbB02xs-MtJKGVRKZk4eeJCGs079o8f_v_6Hzrepys</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>214322600</pqid></control><display><type>article</type><title>Protective Effects of Diets Supplemented with Omega-3 Polyunsaturated Fatty Acids and Calcium Against Colorectal Tumor Formation</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Kenar, Levent ; Karayilanoglu, Turan ; Aydin, Ahmet ; Serdar, Muhittin ; Kose, Songul ; Erbil, M. Kemal</creator><creatorcontrib>Kenar, Levent ; Karayilanoglu, Turan ; Aydin, Ahmet ; Serdar, Muhittin ; Kose, Songul ; Erbil, M. Kemal</creatorcontrib><description>This study is to evaluate the effect of dietary omega-3 polyunsaturated fatty acid (ω-3 PUFA) and/or calcium supplementation on colon tissue of the carcinogenic N -methyl- N -nitrosurea (NMU)-injected rats and to investigate this effect by the assessment of the oxidative stress. The rats were divided into four groups: those fed with a standard diet, with a diet supplemented by ω-3 PUFA, those fed with a diet with calcium, and those fed with a standard diet with the combination of ω-3 PUFA and calcium. Rats were injected with an intrarectal NMU. After 32 weeks, colon tissue specimens and plasma were taken to histopathologically investigate and analyze tissue superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) activities and erythrocyte MDA levels. The tumor incidences in supplemented-diet groups II and IV were found to be significantly lower when compared with those of the controls ( P  &lt; 0.05). Superoxide dismutase and glutathione peroxidase antioxidative enzyme activities in colorectal tissue were increased in the study groups when compared with control rats ( P  &lt; 0.001) and MDA levels were significantly lower than in the controls ( P  &lt; 0.001) while the levels in group IV were rather decreased than those in group III ( P  = 0.011). These results suggest that the dietary supplementation of PUFA and/or calcium may be useful in the prevention of colorectal tumor formation.</description><identifier>ISSN: 0163-2116</identifier><identifier>EISSN: 1573-2568</identifier><identifier>DOI: 10.1007/s10620-007-0107-8</identifier><identifier>PMID: 18041586</identifier><identifier>CODEN: DDSCDJ</identifier><language>eng</language><publisher>Boston: Springer US</publisher><subject>Animals ; Anticarcinogenic Agents - pharmacology ; Biochemistry ; Biological and medical sciences ; Calcium Compounds - pharmacology ; Colon - drug effects ; Colon - enzymology ; Colon - metabolism ; Colorectal Neoplasms - chemically induced ; Colorectal Neoplasms - metabolism ; Colorectal Neoplasms - prevention &amp; control ; Dietary Supplements ; Disease Models, Animal ; Fatty Acids, Omega-3 - pharmacology ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Gastroenterology ; Glutathione Peroxidase - metabolism ; Hepatology ; Male ; Malondialdehyde - blood ; Medicine ; Medicine &amp; Public Health ; Methylnitrosourea ; Oncology ; Original Paper ; Oxidative Stress - drug effects ; Rats ; Rats, Inbred F344 ; Superoxide Dismutase - metabolism ; Transplant Surgery ; Up-Regulation ; Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><ispartof>Digestive diseases and sciences, 2008-08, Vol.53 (8), p.2177-2182</ispartof><rights>Springer Science+Business Media, LLC 2007</rights><rights>2008 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-1ab31d0e8394032b37ece510b13e7d6f203a1a09c7ca2e4a5e1ce286c8bf2c793</citedby><cites>FETCH-LOGICAL-c430t-1ab31d0e8394032b37ece510b13e7d6f203a1a09c7ca2e4a5e1ce286c8bf2c793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10620-007-0107-8$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10620-007-0107-8$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=20524732$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18041586$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kenar, Levent</creatorcontrib><creatorcontrib>Karayilanoglu, Turan</creatorcontrib><creatorcontrib>Aydin, Ahmet</creatorcontrib><creatorcontrib>Serdar, Muhittin</creatorcontrib><creatorcontrib>Kose, Songul</creatorcontrib><creatorcontrib>Erbil, M. Kemal</creatorcontrib><title>Protective Effects of Diets Supplemented with Omega-3 Polyunsaturated Fatty Acids and Calcium Against Colorectal Tumor Formation</title><title>Digestive diseases and sciences</title><addtitle>Dig Dis Sci</addtitle><addtitle>Dig Dis Sci</addtitle><description>This study is to evaluate the effect of dietary omega-3 polyunsaturated fatty acid (ω-3 PUFA) and/or calcium supplementation on colon tissue of the carcinogenic N -methyl- N -nitrosurea (NMU)-injected rats and to investigate this effect by the assessment of the oxidative stress. The rats were divided into four groups: those fed with a standard diet, with a diet supplemented by ω-3 PUFA, those fed with a diet with calcium, and those fed with a standard diet with the combination of ω-3 PUFA and calcium. Rats were injected with an intrarectal NMU. After 32 weeks, colon tissue specimens and plasma were taken to histopathologically investigate and analyze tissue superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) activities and erythrocyte MDA levels. The tumor incidences in supplemented-diet groups II and IV were found to be significantly lower when compared with those of the controls ( P  &lt; 0.05). Superoxide dismutase and glutathione peroxidase antioxidative enzyme activities in colorectal tissue were increased in the study groups when compared with control rats ( P  &lt; 0.001) and MDA levels were significantly lower than in the controls ( P  &lt; 0.001) while the levels in group IV were rather decreased than those in group III ( P  = 0.011). These results suggest that the dietary supplementation of PUFA and/or calcium may be useful in the prevention of colorectal tumor formation.</description><subject>Animals</subject><subject>Anticarcinogenic Agents - pharmacology</subject><subject>Biochemistry</subject><subject>Biological and medical sciences</subject><subject>Calcium Compounds - pharmacology</subject><subject>Colon - drug effects</subject><subject>Colon - enzymology</subject><subject>Colon - metabolism</subject><subject>Colorectal Neoplasms - chemically induced</subject><subject>Colorectal Neoplasms - metabolism</subject><subject>Colorectal Neoplasms - prevention &amp; control</subject><subject>Dietary Supplements</subject><subject>Disease Models, Animal</subject><subject>Fatty Acids, Omega-3 - pharmacology</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Gastroenterology</subject><subject>Glutathione Peroxidase - metabolism</subject><subject>Hepatology</subject><subject>Male</subject><subject>Malondialdehyde - blood</subject><subject>Medicine</subject><subject>Medicine &amp; Public Health</subject><subject>Methylnitrosourea</subject><subject>Oncology</subject><subject>Original Paper</subject><subject>Oxidative Stress - drug effects</subject><subject>Rats</subject><subject>Rats, Inbred F344</subject><subject>Superoxide Dismutase - metabolism</subject><subject>Transplant Surgery</subject><subject>Up-Regulation</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><issn>0163-2116</issn><issn>1573-2568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUGL1EAQhYMo7rj6A7xII-gtWtWddJLjMO6osLALrudQ6VTGXpL02N1ZmZs_3R5mcEHwUvWgvnpV8LLsNcIHBKg-BgQtIU8yB0ylfpKtsKxULktdP81WgDppRH2RvQjhHgCaCvXz7AJrKLCs9Sr7fetdZBPtA4urYUgqCDeIT5aT-Lbs9yNPPEfuxS8bf4ibiXeUK3HrxsMyB4qLp-NwSzEexNrYPgiae7Gh0dhlEusd2TlEsXGj88mcRnG3TM6LrfMTRevml9mzgcbAr879Mvu-vbrbfMmvbz5_3ayvc1MoiDlSp7AHrlVTgJKdqthwidCh4qrXgwRFSNCYypDkgkpGw7LWpu4GaapGXWbvT757734uHGI72WB4HGlmt4RWQtVoBUUC3_4D3rvFz-m3VmKhpNQACcITZLwLwfPQ7r2dyB9ahPaYTXvKpj3KYzZtnXbenI2XbuL-ceMcRgLenQEKhsbB02xs-MtJKGVRKZk4eeJCGs079o8f_v_6Hzrepys</recordid><startdate>20080801</startdate><enddate>20080801</enddate><creator>Kenar, Levent</creator><creator>Karayilanoglu, Turan</creator><creator>Aydin, Ahmet</creator><creator>Serdar, Muhittin</creator><creator>Kose, Songul</creator><creator>Erbil, M. Kemal</creator><general>Springer US</general><general>Springer</general><general>Springer Nature B.V</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7QP</scope></search><sort><creationdate>20080801</creationdate><title>Protective Effects of Diets Supplemented with Omega-3 Polyunsaturated Fatty Acids and Calcium Against Colorectal Tumor Formation</title><author>Kenar, Levent ; Karayilanoglu, Turan ; Aydin, Ahmet ; Serdar, Muhittin ; Kose, Songul ; Erbil, M. Kemal</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-1ab31d0e8394032b37ece510b13e7d6f203a1a09c7ca2e4a5e1ce286c8bf2c793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Animals</topic><topic>Anticarcinogenic Agents - pharmacology</topic><topic>Biochemistry</topic><topic>Biological and medical sciences</topic><topic>Calcium Compounds - pharmacology</topic><topic>Colon - drug effects</topic><topic>Colon - enzymology</topic><topic>Colon - metabolism</topic><topic>Colorectal Neoplasms - chemically induced</topic><topic>Colorectal Neoplasms - metabolism</topic><topic>Colorectal Neoplasms - prevention &amp; control</topic><topic>Dietary Supplements</topic><topic>Disease Models, Animal</topic><topic>Fatty Acids, Omega-3 - pharmacology</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Gastroenterology</topic><topic>Glutathione Peroxidase - metabolism</topic><topic>Hepatology</topic><topic>Male</topic><topic>Malondialdehyde - blood</topic><topic>Medicine</topic><topic>Medicine &amp; Public Health</topic><topic>Methylnitrosourea</topic><topic>Oncology</topic><topic>Original Paper</topic><topic>Oxidative Stress - drug effects</topic><topic>Rats</topic><topic>Rats, Inbred F344</topic><topic>Superoxide Dismutase - metabolism</topic><topic>Transplant Surgery</topic><topic>Up-Regulation</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kenar, Levent</creatorcontrib><creatorcontrib>Karayilanoglu, Turan</creatorcontrib><creatorcontrib>Aydin, Ahmet</creatorcontrib><creatorcontrib>Serdar, Muhittin</creatorcontrib><creatorcontrib>Kose, Songul</creatorcontrib><creatorcontrib>Erbil, M. Kemal</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing &amp; Allied Health Database</collection><collection>Health &amp; Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><jtitle>Digestive diseases and sciences</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kenar, Levent</au><au>Karayilanoglu, Turan</au><au>Aydin, Ahmet</au><au>Serdar, Muhittin</au><au>Kose, Songul</au><au>Erbil, M. Kemal</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Protective Effects of Diets Supplemented with Omega-3 Polyunsaturated Fatty Acids and Calcium Against Colorectal Tumor Formation</atitle><jtitle>Digestive diseases and sciences</jtitle><stitle>Dig Dis Sci</stitle><addtitle>Dig Dis Sci</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>53</volume><issue>8</issue><spage>2177</spage><epage>2182</epage><pages>2177-2182</pages><issn>0163-2116</issn><eissn>1573-2568</eissn><coden>DDSCDJ</coden><abstract>This study is to evaluate the effect of dietary omega-3 polyunsaturated fatty acid (ω-3 PUFA) and/or calcium supplementation on colon tissue of the carcinogenic N -methyl- N -nitrosurea (NMU)-injected rats and to investigate this effect by the assessment of the oxidative stress. The rats were divided into four groups: those fed with a standard diet, with a diet supplemented by ω-3 PUFA, those fed with a diet with calcium, and those fed with a standard diet with the combination of ω-3 PUFA and calcium. Rats were injected with an intrarectal NMU. After 32 weeks, colon tissue specimens and plasma were taken to histopathologically investigate and analyze tissue superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) activities and erythrocyte MDA levels. The tumor incidences in supplemented-diet groups II and IV were found to be significantly lower when compared with those of the controls ( P  &lt; 0.05). Superoxide dismutase and glutathione peroxidase antioxidative enzyme activities in colorectal tissue were increased in the study groups when compared with control rats ( P  &lt; 0.001) and MDA levels were significantly lower than in the controls ( P  &lt; 0.001) while the levels in group IV were rather decreased than those in group III ( P  = 0.011). These results suggest that the dietary supplementation of PUFA and/or calcium may be useful in the prevention of colorectal tumor formation.</abstract><cop>Boston</cop><pub>Springer US</pub><pmid>18041586</pmid><doi>10.1007/s10620-007-0107-8</doi><tpages>6</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0163-2116
ispartof Digestive diseases and sciences, 2008-08, Vol.53 (8), p.2177-2182
issn 0163-2116
1573-2568
language eng
recordid cdi_proquest_miscellaneous_20796304
source MEDLINE; SpringerNature Journals
subjects Animals
Anticarcinogenic Agents - pharmacology
Biochemistry
Biological and medical sciences
Calcium Compounds - pharmacology
Colon - drug effects
Colon - enzymology
Colon - metabolism
Colorectal Neoplasms - chemically induced
Colorectal Neoplasms - metabolism
Colorectal Neoplasms - prevention & control
Dietary Supplements
Disease Models, Animal
Fatty Acids, Omega-3 - pharmacology
Feeding. Feeding behavior
Female
Fundamental and applied biological sciences. Psychology
Gastroenterology
Glutathione Peroxidase - metabolism
Hepatology
Male
Malondialdehyde - blood
Medicine
Medicine & Public Health
Methylnitrosourea
Oncology
Original Paper
Oxidative Stress - drug effects
Rats
Rats, Inbred F344
Superoxide Dismutase - metabolism
Transplant Surgery
Up-Regulation
Vertebrates: anatomy and physiology, studies on body, several organs or systems
title Protective Effects of Diets Supplemented with Omega-3 Polyunsaturated Fatty Acids and Calcium Against Colorectal Tumor Formation
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-29T17%3A09%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Protective%20Effects%20of%20Diets%20Supplemented%20with%20Omega-3%20Polyunsaturated%20Fatty%20Acids%20and%20Calcium%20Against%20Colorectal%20Tumor%20Formation&rft.jtitle=Digestive%20diseases%20and%20sciences&rft.au=Kenar,%20Levent&rft.date=2008-08-01&rft.volume=53&rft.issue=8&rft.spage=2177&rft.epage=2182&rft.pages=2177-2182&rft.issn=0163-2116&rft.eissn=1573-2568&rft.coden=DDSCDJ&rft_id=info:doi/10.1007/s10620-007-0107-8&rft_dat=%3Cproquest_cross%3E1507562261%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=214322600&rft_id=info:pmid/18041586&rfr_iscdi=true