Pericardial tamponade masking associated pulmonary thrombo embolism in a case of adeno carcinoma of lung

This case report describes a patient admitted with shortness of breath of 15 days duration and found to have cardiac tamponade, which masked concomitant pulmonary embolism that was diagnosed by echocardiographic signs of dilate RA/RV with PAH only after successful pericardiocentesis. Subsequently patient was found to have widely metastatic adenocarcinoma of lungs. This case emphasizes the diagnostic challengewhen cardiac tamponade is associated with pulmonary thromboembolism and requires high index of clinical suspicion in patients with underlying malignancy

Plant-derived tetranortriterpenoid, methyl angolensate activates apoptosis and prevents ehrlich ascites carcinoma induced tumorigenesis in mice

Background: Cancer is a leading health problem throughout the world. For decades, natural plant products have been playing promising roles as anticancer agents. Objective: The present study aims to investigate the chemotherapeutic potential of Methyl Angolensate (MA), purified from Soymida febrifuga in mice bearing carcinoma and examines the molecular basis for its anticancer actions. Study Design: The inhibitory effects of MA treatment on the survival of mice bearing Carcinoma and adverse side effects of MA treatment in mice were analyzed. Methods: Tumor volume, life span, histopathology, Immunohistochemical (IHC) analysis, estimation of liver enzyme, alkaline phosphatase and metabolites, creatinine and urea. Results: Oral administration of MA in mice with Ehrlich Ascites Carcinoma showed significant inhibition of tumor growth compared to untreated mice. We observed a significant increase in the life span (∼4-fold) of tumor bearing animals following treatment with MA. MA affected tumor cell proliferation by activating intrinsic pathway of apoptosis without imparting any side effect on normal cells. MA treatment in mice showed no major side effects. Conclusion: MA treatment showed significant inhibition of tumor growth by inducing apoptosis as well increased life span of mice, with no adverse side effects to normal cells. Altogether, the present in vivo study provides new insights of MA serving as a cancer chemotherapeutic agent

Microhomology-mediated end joining is the principal mediator of double-strand break repair during mitochondrial DNA lesions

Mitochondrial DNA (mtDNA) deletions are associated with various mitochondrial disorders. The deletions identified in humans are flanked by short, directly repeated mitochondrial DNA sequences; however, the mechanism of such DNA rearrangements has yet to be elucidated. In contrast to nuclear DNA (nDNA), mtDNA is more exposed to oxidative damage, which may result in double-strand breaks (DSBs). Although DSB repair in nDNA is well studied, repair mechanisms in mitochondria are not characterized. In the present study, we investigate the mechanisms of DSB repair in mitochondria using in vitro and ex vivo assays. Whereas classical NHEJ (C-NHEJ) is undetectable, microhomology-mediated alternative NHEJ efficiently repairs DSBs in mitochondria. Of interest, robust microhomology-mediated end joining (MMEJ) was observed with DNA substrates bearing 5-, 8-, 10-, 13-, 16-, 19-, and 22-nt microhomology. Furthermore, MMEJ efficiency was enhanced with an increase in the length of homology. Western blotting, immunoprecipitation, and protein inhibition assays suggest the involvement of CtIP, FEN1, MRE11, and PARP1 in mitochondrial MMEJ. Knock-down studies, in conjunction with other experiments, demonstrated that DNA ligase III, but not ligase IV or ligase I, is primarily responsible for the final sealing of DSBs during mitochondrial MMEJ. These observations highlight the central role of MMEJ in maintenance of mammalian mitochondrial genome integrity and is likely relevant for deletions observed in many human mitochondrial disorders

Quercetin, a Natural Flavonoid Interacts with DNA, Arrests Cell Cycle and Causes Tumor Regression by Activating Mitochondrial Pathway of Apoptosis

Naturally occurring compounds are considered as attractive candidates for cancer treatment and prevention. Quercetin and ellagic acid are naturally occurring flavonoids abundantly seen in several fruits and vegetables. In the present study, we evaluate and compare antitumor efficacies of quercetin and ellagic acid in animal models and cancer cell lines in a comprehensive manner. We found that quercetin induced cytotoxicity in leukemic cells in a dose-dependent manner, while ellagic acid showed only limited toxicity. Besides leukemic cells, quercetin also induced cytotoxicity in breast cancer cells, however, its effect on normal cells was limited or none. Further, quercetin caused S phase arrest during cell cycle progression in tested cancer cells. Quercetin induced tumor regression in mice at a concentration 3-fold lower than ellagic acid. Importantly, administration of quercetin lead to -5 fold increase in the life span in tumor bearing mice compared to that of untreated controls. Further, we found that quercetin interacts with DNA directly, and could be one of the mechanisms for inducing apoptosis in both, cancer cell lines and tumor tissues by activating the intrinsic pathway. Thus, our data suggests that quercetin can be further explored for its potential to be used in cancer therapeutics and combination therapy

Quercetin, a Natural Flavonoid Interacts with DNA, Arrests Cell Cycle and Causes Tumor Regression by Activating Mitochondrial Pathway of Apoptosis

Naturally occurring compounds are considered as attractive candidates for cancer treatment and prevention. Quercetin and ellagic acid are naturally occurring flavonoids abundantly seen in several fruits and vegetables. In the present study, we evaluate and compare antitumor efficacies of quercetin and ellagic acid in animal models and cancer cell lines in a comprehensive manner. We found that quercetin induced cytotoxicity in leukemic cells in a dose-dependent manner, while ellagic acid showed only limited toxicity. Besides leukemic cells, quercetin also induced cytotoxicity in breast cancer cells, however, its effect on normal cells was limited or none. Further, quercetin caused S phase arrest during cell cycle progression in tested cancer cells. Quercetin induced tumor regression in mice at a concentration 3-fold lower than ellagic acid. Importantly, administration of quercetin lead to -5 fold increase in the life span in tumor bearing mice compared to that of untreated controls. Further, we found that quercetin interacts with DNA directly, and could be one of the mechanisms for inducing apoptosis in both, cancer cell lines and tumor tissues by activating the intrinsic pathway. Thus, our data suggests that quercetin can be further explored for its potential to be used in cancer therapeutics and combination therapy

Accuracy of Electro Cardiogram (ECG) Interpretation and need for ECG Audit in Emergency Department, A prospective observational study from a tertiary care teaching hospital

In spite of much recent advancement, 12 lead electro cardiogram (ECG) is still the most relied upon tool for diagnosis of cardiac emergencies in the emergency departments, especially in resource poor settings. Studies on accuracy of ECG interpretations, their likely impact in the emergency departments are scarce from India. Objective:To assess the accuracy of the ECG interpretation by CMO/resident doctors and emergency physicians, in emergency department of a tertiary care teaching hospital in south India. Methodology:The study was a prospective observational study conducted in the emergency medicine department of tertiary care teaching hospital. ECG interpretations of CMO/resident doctor and emergency physicians are compared against the blinded, gold standard interpretation by a cardiologist panel. Results:A total of 2857 ECGs of the patients presenting with chest pain were analyzed. The overall concordance as assessed by mean pair agreement index (MPAI) was higher for emergency physician (MPAI=83.75%, Kappa statistic =0.50), compared to CMO/resident doctor (MPAI=75.95%, Kappa statistic =0.48). The concordance rate for abnormal ECG, as assessed by sensitivity of was only 67.2% for CMO/ resident doctor and was 78.3% for emergency physician. The concordance rate for normal ECGs, as assessed by specificity was 81.5% and 87.2% respectively for both the groups. Conclusions:ECG interpretation skills for both normal and abnormal ECGs are better in emergency physicians, compared to CMO/resident doctors and are better for normal ECGs, compared to abnormal ECGs. Many life threatening emergencies, which need immediate intervention, are being missed

Anti-apoptotic Protein BCL2 Down-regulates DNA End Joining in Cancer Cells*

Cancer cells are often associated with secondary chromosomal rearrangements, such as deletions, inversions, and translocations, which could be the consequence of unrepaired/misrepaired DNA double strand breaks (DSBs). Nonhomologous DNA end joining is one of the most common pathways to repair DSBs in higher eukaryotes. By using oligomeric DNA substrates mimicking various endogenous DSBs in a cell-free system, we studied end joining (EJ) in different cancer cell lines. We found that the efficiency of EJ varies among cancer cells; however, there was no remarkable difference in the mechanism and expression of EJ proteins. Interestingly, cancer cells with lower levels of EJ possessed elevated expression of BCL2 and vice versa. Removal of BCL2 by immunoprecipitation or protein fractionation led to elevated EJ. More importantly, we show that overexpression of BCL2 or the addition of purified BCL2 led to the down-regulation of EJ. Further, we found that BCL2 interacts with KU proteins both in vitro and in vivo. Hence, our results suggest that EJ in cancer cells could be negatively regulated by the anti-apoptotic protein, BCL2, and this may contribute toward increased chromosomal abnormalities in cancer