Serum and tissue glycoconjugates, digoxin and magnesium levels in chronic calcific pancreatitis.

BACKGROUND: Endogenous or exogenous digoxin can lead to membrane Na+,K+-ATPase inhibition and hypomagnesemia. Low magnesium levels can lead to increased glycosaminoglycans (GAG) concentration in many organs. Aim: To measure the serum levels of pancreatic GAG and glycoproteins, two major components of the extracellular matrix, in patients with chronic calcific pancreatitis (CCP). Serum levels of magnesium and digoxin were also assessed. METHODS: Patients with CCP and age- and sex-matched healthy control subjects (15 each) were studied. Serum GAG, Mg and digoxin levels were measured. RBC membrane Na+,K+-ATPase activity was also assessed. Pancreatic tissue obtained at autopsy from seven patients with CCP and sex- and age-matched healthy subjects who had died in accidents were also tested for GAG and glycoproteins. RESULTS: Total GAG levels were significantly increased in the serum and pancreas of patients with CCP. This was associated with lower serum Mg levels, increased serum digoxin levels and decreased RBC membrane Na+,K+-ATPase activity. CONCLUSION: Exogenous or endogenous digoxin-induced hypomagnesemia and the consequent altered glycoconjugate metabolism may be important in the pathogenesis of CCP.

Directional atherectomy for the dilatation of bifurcation stenoses in the coronary arteries.

Although bifurcation lesions in the coronary arteries can be dilated with balloon angioplasty, directional atherectomy is emerging as the treatment of choice in patients with large arteries. In this study, we report the immediate results and acute complications of treating bifurcation lesions in the coronary arteries with directional atherectomy in 9 patients, ranging in age from 33 to 60 (mean 56.7 +/- 10.8) years. All patients had true bifurcation stenoses with luminal diameter narrowing of more than 70 percent in both the primary vessel and the side branch. The lesions involved the left anterior descending (LAD)-diagonal system in 5, left circumflex (LCx)-obtuse marginal (OM) in 2, distal right coronary artery (RCA) in 1 and bifurcation of a large first diagonal branch in one patient. Double-wire atherectomy technique was used in 4 patients, although 7 had an additional wire in the side branch during post-atherectomy balloon angioplasty. The procedure was successful in all patients (100%), with luminal diameter stenosis decreasing from 93 +/- 7.5 percent to 6 +/- 8.6 percent in the primary vessel and from 83 +/- 9.2 percent to 13 +/- 9 percent in the side branch. There were no major complications. Minor complications included non-flow limiting dissection in 4 patients, distal migration of thrombus in one, occlusion of 2 small distal branches of the diagonal in one and entwinement of the guidewires in one. In conclusion, directional atherectomy can be performed safely and successfully for dilatation of complex bifurcation lesions in the coronary arteries without any major complications using the double-wire or sequential atherectomy technique.

Mycological aspects of dermatomycosis in Ludhiana.

159 clinically diagnosed cases of dermatomycosis were examined and subjected to mycological study. In the direct microscopic examination, 78 (49.05%) cases were positive and cultures were positive in 66 (41.5%) cases. The common clinical presentation was T. corporis in 60 (37.7%) cases. The commonest species encountered was T. rubrum (42.42%) followed by Epidermophyton floccusum (15.15%), Candida (13.63%), T. violaceum (12.12%), T. mentagrophyte (6.06%) & T. tonsurans (1.5%) in this study. The prevalence of infection was more in males.