Connexin 30 mediated rewiring of glucose metabolism in rat C6 xenograft and grades of glioma

Connexin 30 (Cx30), a tumour-suppressive gap junctional protein, impacts on insulin-like growth factor receptor 1-mediated progression and stemness of glioma. Of late, metabolic reprogramming, a recently adjudged hall mark of malignancy, could reasonably associated with the changes in gap junctional communication in glioma. This newly recognized hallmark of reprogramming of metabolism to maintain the rapid proliferation necessitates further probing to establish the stronger hall marks. Hence, the current study attempted to link the association between the expression of Cx30 with glucose uptake and glucose metabolism in glioma. We have transfected Cx30 in C6 glioma cells, characterized by a low level of intercellular communication and developed xenografts to study the status of glucose transporters (GLUTs), hexokinase 2 and Pyruvate dehydrogenase kinase 1 (PDK 1) along with human glioma tissues by RT-PCR and immunoblotting. The results showed a significant increase in the levels of GLUTs, hexokinase 2 and PDK 1 in C6-implanted rat xenografts and high grades compared to their respective controls, whereas Cx30-transfected C6-implanted rat xenograft and low grades show no significant change compared to that of controls supporting the association between Gap junctional communications and glucose metabolism. We strongly speculate the impact of Cx30 over the glucose metabolism that might provide therapeutic prospects and challenges for anti-glycolytic cancer therapy.

Extracorporeal shock wave lithotripsy and endotherapy for pancreatic calculi-a large single center experience

AIM

Large pancreatic ductal calculi and pain are a feature of chronic calcific pancreatitis (CCP) in the tropics. This large single center study evaluates the role of extracorporeal shock wave lithotripsy (ESWL) in fragmentation of large pancreatic stones and relief of pain in patients with CCP.

METHODS

Patients with CCP presenting with pain and large pancreatic duct (PD) calculi (>5 mm diameter) not amenable to extraction at routine endoscopic retrograde cholangio pancreatography (ERCP) were taken up for ESWL using a 3rd generation lithotripter. Stones in the head and body of pancreas were targeted at ESWL; 5,000 shocks were given per session. The calculi were fragmented to <3 mm size and then cleared by endotherapy. Pancreatic duct stents were deployed when indicated. A total of 1,006 patients underwent ESWL. Complete clearance was achieved in 762 (76%), partial clearance in 173 (17%) and unsuccessful in the rest. More than 962 (90%) of patients needed less than three sessions of ESWL. At 6 months, 711 (84%) of 846 patients who returned for follow up had significant relief of pain with a decrease in analgesic use. Complications were mild and minimal.

CONCLUSION

ESWL is an effective and safe modality for fragmentation of large PD calculi in patients with CCP.

Ultrasound promoted regioselective synthesis of beta-iodoethers from olefin-I2-alcohol

Regioselective synthesis of beta-iodoethers in high yields by sonicating alkene and alcohol in the presence of iodine in a bath at 35 kHz is reported.

Labial gland biopsy--a simple diagnostic procedure for Sjogren's syndrome

Sjogren's syndrome is a collagen vascular disorder with multisystem. Its presentation may be similar to other diseases from which it can be differentiated by certain investigations--one of the most important being the labial salivary gland biopsy. A case report of Sjogren's syndrome is presented and the technique of the labial salivary gland biopsy is described.

Duplex-guided compression of iatrogenic femoral artery pseudoaneurysms

The purpose of this report is to review our experience with duplex-guided compression in the management of iatrogenic femoral artery pseudoaneurysms. From February 1991 to July 1992, 13 consecutive asymptomatic femoral artery pseudoaneurysms were managed initially with duplex-guided compression. Twelve of these complications followed interventional cardiac procedures; the remaining case followed lysis of a femoral to tibial bypass. A Quantum Angiodynograph I duplex imager with a 5-MHz probe was used during this study. After the origin of the pseudoaneurysm was identified, compression was applied with the transducer head to obliterate flow in the pseudoaneurysm, while maintaining flow in the parent artery. Successful thrombosis was accomplished in 12 patients. The mean interval between the original femoral puncture and duplex-guided compression was 9.0 days (range, 1-22 days). The mean compression time was 30 minutes (range, 15-45 minutes). Pseudoaneurysm size ranged from 1.0 to 5.0 cm. Follow-up imaging, performed within 72 hours after compression, demonstrated sustained pseudoaneurysm thrombosis and patent femoral artery segments. Four patients were managed as out-patients, without the need for anesthesia or sedation. Eight patients were managed in the hospital, seven following interventional cardiac procedures, and one following bypass revision. Duplex-guided compression failed in one case. This patient was successfully treated operatively, at which time repair of both the profunda and superficial femoral artery was required. Asymptomatic iatrogenic femoral artery pseudoaneurysms can be successfully managed with duplex-guided compression. This maneuver appears to be a simple and cost-effective approach for initial management of these lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Bilateral internal carotid artery agenesis: a case study and review of the literature

Bilateral internal carotid artery agenesis is a rare lesion, with only 18 cases previously reported. Blood supply to the anterior cerebral circulation is most commonly through enlarged basilar and posterior communicating arteries. Occasionally collateral flow is through abnormal transsellar anastomoses or anastomoses between the external carotid and intracranial systems. Associated intracranial aneurysms occur in 25% of patients, accounting for a significant incidence of intracranial hemorrhage as the initial symptom. Diagnosis is best made by cerebral arteriography with computed tomography to verify the congenital nature of the abnormality by demonstrating the absence of carotid canals. This is the second case to begin with transient ischemic attacks suggestive of carotid territory ischemia but originating from the vertebral system. Angiographic findings included absent internal carotid arteries, small common carotid arteries, and bilateral high-grade stenoses at the origins of large vertebral arteries. This is the first such case to be treated with reimplantation of the vertebral artery with resolution of symptoms.

Influence of arterial access sites and interventional procedures on vascular complications after cardiac catheterizations

The purpose of this study is to define the incidence of complications at the arterial access site after cardiac catheterization. The influence of the arterial access site on these complications was identified, as were the clinical characteristics of these problems. A total of 8,797 cardiac catheterizations were performed over the 3-year period of this study. Diagnostic catheterizations and percutaneous transluminal coronary angioplasties (PTCAs) were included, and the arterial access site was identified. Diagnostic catheterizations were performed via the brachial artery (group I, n = 3,137) or the femoral artery (group II, n = 4,055). PTCAs were also performed via the brachial artery (group III, n = 32) or the femoral route (group IV, n = 1,573). Ninety-five major vascular complications occurred during the course of this study. The frequency of complications was higher with brachial artery catheterization when compared with the femoral route. PTCA was associated with a higher complication rate than diagnostic studies. Brachial artery complications were primarily arterial thromboses, which were easily diagnosed and treated. Femoral artery complications were more complicated, difficult to identify, and associated with significant morbidity.

Thermal laser assisted balloon angioplasty in lower extremity occlusive disease

Results of Nd:Yag thermal laser assisted balloon angioplasty (LABA) in lower extremity occlusive disease were reviewed retrospectively in 23 patients and 28 lesions over a 1 year period. Indications for intervention were progressive claudication in 74 per cent and gangrene and/or rest pain in 26 per cent. Twenty-four (86%) procedures were technically successful; however, there were only 15 (54%) clinical successes during the follow-up period (0.5-12.5 months). Complications occurred following ten (36%) procedures with one mortality (4%) unrelated to the procedure. Analysis of the nature and location of the lesions revealed five angiographic patterns with varying degrees of success. These are: Superficial Femoral and Popliteal: 1) short segment stenosis--2/3, 2) long multisegment stenosis--1/6, 3) total occlusion--7/9, 4) stenosis and occlusion--2/4; Iliac: 5) stenosis--3/4. The only subsets of patients who appeared to benefit from LABA were those with short segment stenosis or isolated occlusions. Patients with good runoff also did well. Patients with poor runoff or multiple stenoses associated with diffuse disease did poorly. It is concluded that LABA has limited applications in the treatment of lower extremity occlusive disease.

Femoral arteriovenous fistula as a complication of percutaneous transluminal coronary angioplasty. A report of five cases

Arteriovenous fistula (AVF) associated with invasive and diagnostic angiographic procedures is rare. The incidence is increased with procedures such as percutaneous transluminal coronary angioplasty (PTCA) but is still quite low. We report five cases of AVF within a 17-month period, representing 0.15 per cent of all cardiac catheterizations and 0.87 per cent of PTCAs. All five patients presented with groin bruits. There were two associated pseudoaneurysms and one patient with deep vein thrombosis. All patients underwent uneventful division of the fistula. A thorough understanding of the anatomy of the femoral triangle is necessary in order to avoid this complication. That all fistulas were in the superficial or profunda femoris arteries emphasizes the importance of avoiding a low groin puncture. Early angiography and surgical intervention are recommended for optimal results.