In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications

In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications.     

Increase in glucose consumption by acetylcysteine during hyperglycemic clamp. A study with healthy volunteers.

Thiols have been shown to be related to insulin secretion and to uptake of glucose into tissues. In the present study the effects of i.v. administration of acetylcysteine (N-acetylcysteine, NAC, CAS 616-91-1) on glucose consumption and plasma free thiols were studied in young healthy volunteers during hyperglycemic clamp. NAC (0.5-2.0 mg/kg) significantly increased glucose consumption. This effect was not obvious at higher doses of NAC. Plasma free NAC depended on the dose of NAC injected. The t1/2 of NAC was 11 min. NAC produced significant increases of plasma cysteine concentrations, and a slight but insignificantly increase of plasma glutathione. These data suggest that a moderate increase in plasma thiols augments glucose consumption during hyperglycemic clamp.     

A system for focal intracavitary irradiation of bladder cancer with remote iridium-192 afterloading.

An afterloading system for remote-control focal intracavitary irradiation of bladder cancer is presented. With 192Ir as radiation source, we demonstrated the practicability of the method in 23 chinchilla rabbits. A system for focal intracavitary irradiation of bladder cancer in humans was developed. A guiding tube with an inflatable balloon led to a reproducible vesical diameter. The intravesical part of the tube was shielded with lead and had a slit for focal radiation exposure. Three variant guiding tubes with different positions of the slit were designed to allow irradiation of any part of the bladder. The application is planned in patients with locally advanced tumors who refuse radical cystectomy or who are medically inoperable.     

Evidence for more than one binding site for sulfonylureas in insulin-secreting cells

Specific binding of both [3H]glibenclamide and [3H]gliquidone has been observed in a particulate fraction of insulin-secreting rat tumour (RIN m5F) cells. The binding of both the labels was time-dependent, of high affinity (including a low affinity binding site), saturable and reversible. The rank order of inhibition of [3H]glibenclamide binding was glibenclamide greater than gliquidone greater than AG-EE 388 = AG-EE 86 = AG-EE 319 greater than AG-EE 436 (AG coded drugs are benzoic acid derivatives which lack the sulfonylurea moiety of sulfonylureas). The Kds of high affinity binding for glibenclamide and gliquidone were 0.08 and 1.3 nM, respectively. When [3H]gliquidone was used as the labelled compound this rank order of binding and the affinities of drugs were different, e.g. glibenclamide was less potent than gliquidone. The Kd values of high affinity binding to the [3H]gliquidone binding site were 810 and 79 nM with respect to glibenclamide and gliquidone. The binding site labelled by [3H]gliquidone, in contrast to that labelled by [3H]glibenclamide, was not able to discriminate between the two enantiomers AG-EE 319 and AG-EE 436. The data indicate that there are different binding sites for glibenclamide and gliquidone in RIN m5F cells. In extension to data of other groups it is speculated that there exists more than one specific binding site for sulfonylureas and other related compounds, e.g. benzoic acid derivatives and that sulfonylureas behave differently not only in quantitative but in qualitative terms as well.     

Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study

This in vitro biomechanical study used cadaveric specimens to compare the rotator cuff repair fixation provided by BioCorkscrew and Bioknotless RC suture anchors. Three cm wide by 1-cm long full-thickness supraspinatus defects were repaired using either two BioCorkscrew suture anchors with combined vertical and horizontal mattress sutures (n = 7) or three Bioknotless RC suture anchors with simple sutures (n = 7). Therefore, the BioCorkscrew suture anchor group had two sutures per anchor (four total sutures), while the Bioknotless RC suture anchor group had one suture per anchor (three total sutures). Two-phase cyclic (5–100 N, 1,000 cycles and 5–180 N, 2,000 cycles) and load to failure tests (31 mm/s) were performed. Non-parametric statistics were used to compare group differences (P < 0.05). All of the BioCorkscrew group specimens (seven of seven) completed the two phase cyclic test regimen without failure or gapping ≥ 5 mm, compared to only three of seven of the Bioknotless RC group (Fisher’s Exact test = 0.03). Groups did not differ for repair site gapping during the 5–100 N cyclic test phase (Fisher’s Exact test = 0.77), however more of the Bioknotless RC group displayed gapping ≥ 5 mm during the 5–180 N cyclic test phase than the BioCorkscrew group (P = 0.02). The BioCorkscrew group also displayed greater yield load during load to failure testing (492.2 ± 204 N vs. 296.4 ± 155 N, P = 0.03). In this in vitro biomechanical study, the BioCorkscrew group with combined vertical and horizontal mattress sutures displayed greater cyclic test survival, less repair site gapping, and superior yield load compared to the Bioknotless RC group with simple sutures. These results in human cadaveric rotator cuff-humerus specimens suggest better immediate post-operative repair site strength and a reduced need for post-operative restrictions. Clinical studies are needed to determine how these rotator cuff repair modes withstand the forces of early rehabilitation and activities of daily living that potentially influence patient outcomes.