Medicine and Health Sciences Commons^™

Two Siblings With Netherton Syndrome, Selma Emre, Ahmet Meti̇n, D. Deni̇z Demi̇rseren, Ahu Yorulmaz, Aykut Onursever, Burçi̇n Kaftan

Turkish Journal of Medical Sciences

Netherton syndrome (NS) is a rare genodermatosis characterized by autosomal recessive inheritance pattern, unknown etiology, ichthyosiform cutaneous changes, atopic diathesis, and alterations in the hair shaft. As a result of aging coupled with immune deficiency, clinical symptoms may vary. Herein, we present 2 siblings with the characteristic cutaneous symptoms of NS, albeit with some differences between the siblings. Materials and methods: Two sisters presented to our clinic with sparse and brittle hair along with pruritic, erythematous, and scaling cutaneous lesions. Both patients underwent a clinical examination and laboratory analyses. Results: Based on the clinical and laboratory findings, both patients were …

Gastric Volvulus Due To Diaphragmatic Eventration And Paraesophageal Hernia, Nuretti̇n Özgür Doğan, Gökhan Aksel, Ahmet Demi̇rcan, Ayfer Keleş, Fi̇kret Bi̇ldi̇k

Turkish Journal of Medical Sciences

Acute gastric volvulus occurs when the stomach or a part of it rotates more than 180 degrees. It is a potentially life-threatening entity and most cases of gastric volvulus occur in association with eventration of left hemidiaphragm or a hiatal hernia. Gastric volvulus is a rare condition and presents with nonspecific epigastric pain and vomiting, and therefore may be missed. Chest x-ray and CT can help the diagnosis. Emergent surgical approach is mandatory. Two elderly patients admitted to ED with epigastric pain and intractable vomiting did not respond to the treatment and we were not able to pass nasogastric tube. …

Incidence And Risk Factors For Bloodstream Infections Stemming From Temporary Hemodialysis Catheters, Hati̇ce Rahmet Çaylan, Gürdal Yilmaz, Ebru Emel Sözen, Kemaletti̇n Aydin, İftahar Köksal

Turkish Journal of Medical Sciences

Catheter-related bloodstream infection (CR-BSI) is considered as an important complication of hemodialysis catheters. The purpose of this prospective study was to evaluate the incidence and risk factors of temporary hemodialysis catheter-related bloodstream infection. Materials and methods: Prospective data related to temporary hemodialysis catheters inserted in our institution were collected for duration of three years. The risk factors of CR-BSI of patients between the CR-BSI group and the control group were compared. Results: A total of 248 temporary hemodialysis catheters were inserted in 201 patients and remained in situ for a cumulative total of 5192 catheter days. There were 3254 dialysis …

Prevalence Of Cardiac Arrhythmia In Obstructive Sleep Apnea Syndrome, Ni̇hal Akar Bayram, Bülent Çi̇ftçi̇, Selma Firat Güven, Hüseyi̇n Bayram, Hasbi̇ Erdem Di̇ker, Tahi̇r Durmaz, Telat Keleş, Engi̇n Bozkurt

Turkish Journal of Medical Sciences

Repetitive transient activation of the parasympathetic and sympathetic systems in obstructive sleep apnea syndrome (OSAS) constitutes the basis for development of cardiac arrhythmias. We aimed to examine the prevalence of arrhythmias in OSAS. Materials and methods: Eighty-eight patients with suspected OSAS were included in the study. Polysomnography was performed overnight in all patients. Patients with apnea-hypopnea index (AHI) < 5 were considered OSAS negative, while patients with AHI >= 5 were OSAS positive. Arrhythmia was defined as sinus bradycardia, sinus tachycardia, > 10/h supraventricular premature beats (SVPBs), > 10/h ventricular premature beats (VEBs), complex VPBs (bigeminal, trigeminal VEB or nonsustained VT), supraventricular tachycardia, ventricular tachycardia, > 2 s sinus arrest, second or third …

Predisposing Factors For Serum Sodium Disturbance In Patients With Severe Traumatic Brain Injury (Sbi), Mohammadreza Safavi, Saied Abrishamkar, Poria Tvakoli, Daruosh Moradi, Azim Honarmand

Turkish Journal of Medical Sciences

Disturbances in the plasma sodium level in patients with severe brain injury (SBI) is not a rare phenomenon and may cause adverse effects on prognosis and treatment outcomes. The knowledge of the prevalence of risk factors helps in early detection and good management of the serum sodium level disturbance. Materials and methods: This is a prospective clinical trial double blind study. The target population included patients with SBI who had disturbances in their plasma sodium level and were admitted at the ICU of Kashani Hospital, Isfahan, Iran, between January and October 2006. The patients with renal insufficiency, diuretic therapy, massive …

The Association Of Tafi (Thrombin-Activatable Fibrinolysis Inhibitor) With Insulin Resistance And Components Of Metabolic Syndrome In Patients With Metabolic Syndrome, Alev Kural, Ahmet Omma, Hati̇ce Seval, Maci̇t Koldaş, Namik Yi̇ği̇t, Tülay Omma

Turkish Journal of Medical Sciences

To investigate the association of TAFI with components of metabolic syndrome and insulin resistance in patients with metabolic syndrome. Materials and methods: Patients between 20 and 70 years of age, who met at least 3 of the metabolic syndrome criteria, and had no known coronary artery disease were included in the study. The control group consisted of 20 healthy subjects with demographic characteristics similar to the patients. Fasting blood glucose, HbA1c, lipid profile, insulin, microalbumin, and TAFI Ag levels were investigated in the patients and controls. Insulin resistance was calculated according to the HOMA-IR [(fasting plasma insulin (\muIU/ml) x fasting …

Vitamin C Modulates Oxidative Stress-Induced Colitis In Rats, Mustafa Zeri̇n, Ali̇ Zi̇ya Karakilçik, Muharrem Bi̇ti̇ren, Davut Musa, Abdullah Özgönül, Şehabetti̇n Selek, Yaşar Nazligül, Ali̇ Uzunköy

Turkish Journal of Medical Sciences

Free radicals are an important factor in the etiopathogenesis of colitis and may increase oxidative damage. The antioxidant vitamin C efficiently scavenges free oxygen radicals. The present study aimed to investigate the probable protective effects of vitamin C on oxidative injury in rats in which colitis was experimentally induced with acetic acid. Materials and methods: This study was conducted with rats for a period of 7 days. Group 1 intrarectally received a placebo (0.9% NaCl) and group 2 intrarectally received 2 mL of 5% acetic acid (AA) and the placebo. Group 3 intrarectally received 2 mL of 5% AA and …

Evaluation Of Oxidant/Antioxidant Status And Ecp Levels In Asthma, Ömer Emecen, Berri̇n Berçi̇k İnal, Füsun Erdenen, Murat Usta, Hale Aral, Güvenç Güvenen

Turkish Journal of Medical Sciences

Inflammatory and immune cells, such as eosinophils, macrophages, and neutrophils, generate more reactive oxygen species in patients with asthma than they do in healthy individuals, and oxygen radicals contribute to tissue injury in asthma. We aimed to measure total oxidant status (TOS) and antioxidant status (TAS) in order to assess oxidative and antioxidative capacity. Eosinophil cationic protein (ECP), total IgE, and eosinophils (%) were measured to evaluate the level of inflammation. Materials and methods: The study included 56 non-smoking asthma patients that were followed-up at the respiratory disease and allergy outpatient clinics, where they received ongoing treatment for 5 months …

Effects Of Aqueous Garlic Extract On Oxidant/Antioxidant Status In 32d And 32dp210 Cell Lines, Aslihan Avci, Asuman Sunguroğlu, İmge B. Ergüder, Güvem Gümüş Akay, Erdi̇nç Devri̇m, Pinar Özkal Baydin, Nuray Varol, İlker Durak

Turkish Journal of Medical Sciences

To investigate the possible effects of aqueous garlic extract on the oxidant/antioxidant status and apoptosis in 32D (wild type mouse myeloid cell = normal) and 32Dp210 (BCR-ABL fusion gene (+) mouse myeloid cell = Chronic Myelocytic Leukemia cells) cell lines. Materials and methods: Aqueous garlic extract (10% w/v) was added into the cell line media with 2 different final concentrations (0.4% and 1%). At 0 h and at 24, 48, and 72 h later, the oxidant (malondialdehyde (MDA) level, and xanthine oxidase (XO) enzyme activity) and antioxidant (superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) enzyme activities) parameters were …

Comparison Of In Vitro Cytotoxicity And Genotoxicity Of Mma-Based Polymeric Materials And Various Metallic Materials, Sultan Gülçe İz, Sai̇me İsmet Gürhan, Bi̇lge Hakan Şen, Tuğba Endoğan, Nesri̇n Hasirci

Turkish Journal of Medical Sciences

To determine the in vitro cytotoxicity and genotoxicity of some polymeric and metallic implant materials used as base materials in dentistry, based on ISO (International Organization for Standardization) and OECD (Organization for Economic Co-Operation and Development) test protocols. Materials and methods: Three different acrylate-based polymeric materials were tested for their in vitro cytotoxicity and genotoxicity (polymethylmethacrylate microspheres [PMMA], a solid cement prepared by mixing PMMA with its monomer methylmethacrylate [PMMA+MMA], a solid cement prepared by mixing PMMA, MMA, and hydroxyapatite [PMMA+MMA+HA], as wells as 4 different metallic materials (titanium [Ti grade 4], nickel alloy 625 [Ni-625], stainless steel alloy 304L …

Dermatoglyphics As Markers Of Prenatal Disturbances In Schizophrenia: A Case-Control Study, Bi̇rsen Özyurt, Ahmet Songur, Mustafa Sarsilmaz, Ömer Akyol, Mustafa Namli, Reha Demi̇rel

Turkish Journal of Medical Sciences

Several studies have reported the importance of dermatoglyphics as markers of a prenatal disturbance in patients with schizophrenia. Due to the fact that finger- and handprints are formed by the end of the second trimester, they may provide clues to disturbances in early development. The aim of this study was to determine specific dermatoglyphical frequencies in a sample of patients with schizophrenia and normal controls. Materials and methods: Fingerprints and palm prints were obtained from 45 schizophrenic patients as well as 45 healthy controls. The dermatoglyphic patterns on the fingers (total finger ridge count [TFRC]) and palms (a-b, b-c, and …

Evaluation Of Coping Strategies, Social Support, And Depressive Symptoms In Spouses Of Patients With Hematological Cancer, Safi̇ye Özkan, Yasemi̇n Kutlu

Turkish Journal of Medical Sciences

The purpose of this study was the evaluation of coping strategies, social support, and depressive symptoms in spouses of patients with hematological cancer. Materials and methods: A descriptive design was used in current study. The study was carried out at the hematology clinic of 2 university hospitals located in İstanbul. The convenience sample consisted of 150 spouses of patients who had hematological cancer. The data were collected through structured face-to-face interviews using a questionnaire form, the "Ways of Coping" Questionnaire, the Multidimensional Perceived Social Support Scale, and Beck Depression Inventory. Percentage t-tests and Pearson's product moment correlation were used to …

Histomorphometric Study On The Effect Of Low Dose Deltamethrin On The Developing Cerebellar Cortex, Mohd Asnizam Asari, Mohammad Shukri Abdullah, Zul Izhar Mohd Ismail

Turkish Journal of Medical Sciences

Deltamethrin is a widely used type II pyrethroid-based insecticide. Studies have indicated that neonatal exposure to deltamethrin, even at relatively low doses, results in behavioral and neurological changes. In the present study, the effect of early neonatal exposure to low doses of deltamethrin on the histogenesis of the cerebellar cortex was investigated. Materials and methods: Sprague Dawley male pups were exposed to deltamethrin daily at a dose of 1 mg/kg via intraperitoneal injection from the 2nd to the 5th postnatal day and sacrificed on postnatal days 6, 14, and 21. Following intracardiac perfusion, the cerebellum was removed, embedded with paraffin …

Levels Of Haemophilus Influenzae Type B (Hib) Antibody In Turkey Before Routine Immunization, Cemi̇le Sönmez, Ni̇lay Çöplü, Demet Kurtoğlu, Berri̇n Esen, Annette Crowley Luke, Lorraine Ransley, Ayşegül Gözalan

Turkish Journal of Medical Sciences

The Haemophilus influenzae type b (Hib) vaccine was introduced into the routine immunization schedule in Turkey on January 1, 2007. This study investigates the immunity to Hib prior to the introduction of the vaccine. Materials and methods: Serum samples were collected from healthy volunteers between the ages of 6 months and 50 + years of age, living in the area of 26 health centers in the Samsun, Antalya, and Diyarbakir provinces during 2000-2001. In total, 1713 sera were selected for this study, and the younger age groups were given priority (range 0-82). A commercial ELISA test was used to measure …

The Effects Of Adjuvant Therapies For Sepsis On Hepatic And Renal Function: A Retrospective Analysis Of 108 Icu Patients, Beri̇t Gökçe Ceylan, Lütfi̇ Yavuz, Füsun Eroğlu, Şenol Gülmen, Ömer Ridvan Tarhan, Adnan Alaca

Turkish Journal of Medical Sciences

As liver and kidney failure have a direct effect on mortality, morbidity, and intensive care unit (ICU) length of stay in sepsis patients, maintaining their functions or minimizing the degree of failure should be one of the most important goals of therapy. In this retrospective study we investigated the effects of recently introduced adjuvant therapies on hepatorenal functions in septic ICU patients. Materials and methods: We conducted comparative and retrospective data analysis of 108 patients with sepsis that were followed-up during a 2-year period in the ICU. We recorded AST, ALT, ALP, albumin, bilirubin, and INR in order to evaluate …

The Prevalence Of Trichomonas Vaginalis Infection Among Patients That Presented To Hospitals In The Kermanshah District Of Iran In 2006 And 2007, Abdolali Chalechale, Isaac Karimi

Turkish Journal of Medical Sciences

To determine the prevalence of Trichomonas vaginalis (Tv) among women that presented to hospitals in the Kermanshah district of Iran in 2006 and 2007. Materials and methods: This retrospective study included 33.690 women that presented to primary pathology laboratories in Kermanshah. Vaginal and cervical swabs were collected, and then stained with Papanicolaou (Pap) stain. Additionally, seasonal variations in the prevalence rate were compared to identify significant differences in the prevalence of Tv according to season. Results: Among the 33,690 women, 300 were infected with Tv (a prevalence rate of 0.9%). The 30-39-year-old age group had a significantly higher prevalence of …

Atypical Clinical Manifestation Of Dementia: A Progressive Visuospatial Deficit, Mehmet Güney Şenol, Hakan Tekeli̇, Erdem Toğrol, Mehmet Saraçoğlu

Turkish Journal of Medical Sciences

Clinically and neuropathologically dementia is a very heterogeneous disease. Alzheimer's disease (Alzheimer disease, AD), the most common cause of dementia, is an acquired cognitive and behavioral impairment of sufficient severity that markedly interferes with social and occupational functioning. This disease may be manifested as progressive memory problems, visuospatial deterioration, aphasia and/or deficits of executive functions. The patient we report here is a 73-year-old female patient with loss of ability of finding directions and understanding the shapes of materials. Her complaints increased progressively during the last two years. Even if she had retired from tailoring, she had deterioration in the visuospatial …

Synthesis And Evaluation Of Conformationally Constrained Peptide Analogues As The Src Sh3 Domain Binding Ligands, Rakesh Tiwari, Alex Brown, Seetha Narramaneni, Gongqin Sun, Keykavous Parang

Pharmacy Faculty Articles and Research

Src kinase activity is regulated by the interaction of SH3 domain with protein sequences that are rich in proline residues. Identification of more potent SH3 domain binding ligands that can regulate Src kinase activity is a subject of major interest. Conformationally constrained peptides have been previously used for improving the binding potency of the Src SH2 domain binding peptide ligands and peptide substrates of the substrate-binding site of Src. A series of peptide analogues of Ac-VSLARRPLPPLP (1, Ac-VSL-12, Kd = 0.34 M) were synthesized by introducing conformational constraints to improve the binding affinity towards the Src SH3 domain. Peptides synthesized …

Familial Amyloidosis Cutis Dyschromica, Ayşe Serap Karadağ, Gülçi̇n Güler Şi̇mşek

Turkish Journal of Medical Sciences

Primary cutaneous amyloidosis is a rare progressive disease that is characterized with the deposition of amyloid under the skin instead of internal organs. Major types are the macular, papular, nodular types. Amyloidosis cutis dyschromica is a very rare specific type of vitiliginous amyloidosis. A 16 year-old female patient and 22 year-old male patient, siblings, referred to the hospital with the complaint of non-pruritic diffuse hyperpigmentation beginning from trunk and spreading to all body. The histopathologic findings and crystal violet stain were consistent with amyloidosis cutis dyschromica. All other investigations were normal. There are few reported cases related with this amyloidosis …

The Clinical And Polysomnographic Features In Complex Sleep Apnea Syndrome, Handan İnönü, Tansu Ulukavak Çi̇ftçi̇, Oğuz Köktürk

Turkish Journal of Medical Sciences

Complex sleep apnea syndrome (CompSAS) is characterized by the onset of central apneas or a Cheyne-Stokes breathing pattern in some patients with obstructive sleep apnea syndrome (OSAS) who were treated with continuous positive airway pressure (CPAP). The etiology of CompSAS is unclear, but derangement of respiratory control has been proposed. We sought to compare clinical and polysomnography (PSG) features of patients with CompSAS and OSAS. Materials and methods: Records of PSG were evaluated in a total of 270 patients, retrospectively. CPAP titration was prescribed in patients with an apnea-hypopnea index (AHI) of >=15. Patients who developed a central AHI of …

Diabetes Mellitus Self-Management: Comparison Of Curricula Using A Promotora, Francigna Rodriguez Bs, Nyann Biery Ms, Cathy Coyne Phd, Robert Motley Md, Edgar Maldonado Md, Abby S. Letcher Md

Department of Medicine

No abstract provided.

Structure Elucidation Of A Glycosylated Benzyl Ester Of Salicylic Acid From The North American Prairie Plant Oligoneuron Rigidum, Sarah Katherine Miesner

Honors Program Theses

The organic extract from Oligoneuron rigidum displayed anti-microbial activity, indicating a potential future use as a natural food preservative. Three novel compounds were isolated from the active extract. The skeletal structure of the three compounds was determined by spectral methods, and the final structural component that remained to be determined was the locations of the acetate groups. Neutral permethylations were performed on the compounds as the first step in determining the locations of the acetate groups; however, the permethylation technique proved to be ineffective, causing cleavage of the native compounds. The structure elucidation will be complete when a non-degradable method …

Prospects And Pits On The Path Of Biomimetics: The Case Of Tooth Enamel, Vuk Uskoković

Pharmacy Faculty Articles and Research

This review presents a discourse on challenges in understanding and imitating the process of amelogenesis in vitro on the molecular scale. In light of the analysis of imitation of the growth of dental enamel, it also impends on the prospects and potential drawbacks of the biomimetic approach in general. As the formation of enamel proceeds with the protein matrix guiding the crystal growth, while at the same time conducting its own degradation and removal, it is argued that three aspects of amelogenesis need to be induced in parallel: a) crystal growth; b) protein assembly; c) proteolytic degradation. A particular emphasis …

Localization Of Angiotensin Converting Enzyme In Rabbit Cornea And Its Role In Controlling Corneal Angiogenesis In Vivo, Ajay Sharma, Daniel I. Bettis, John W. Cowden, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

Purpose: The renin angiotensin system (RAS) has been shown to modulate vascular endothelial growth factor and angiogenesis. In this study we investigated (i) the existence of the RAS components angiotensin converting enzyme (ACE) and angiotensin II receptors (AT1 and AT2) in the rabbit cornea using in vitro and ex vivo models and (ii) the effect of enalapril, an ACE inhibitor, to inhibit angiogenesis in rabbit cornea in vivo.

Methods: New Zealand White rabbits were used. Cultured corneal fibroblasts and corneal epithelial cells were used for RNA isolation and cDNA preparation using standard molecular biology techniques. PCR was performed to …

Aav Serotype Influences Gene Transfer In Corneal Stroma In Vivo, Ajay Sharma, Jonathan C. K. Tovey, Arkasubhra Ghosh, Rajiv R. Mohan

Pharmacy Faculty Articles and Research

This study evaluated the cellular tropism and relative transduction efficiency of three AAV serotypes, AAV6, AAV8 and AAV9, for corneal gene delivery using mouse cornea in vivo and donor human cornea ex vivo. The AAV6, AAV8 and AAV9 serotypes having AAV2 plasmid encoding for alkaline phosphatase (AP) gene were generated by transfecting HEK293 cell line with pHelper, pARAP4 and pRep/Cap plasmids. Viral vectors (109 vg/μl) were topically applied onto mouse cornea in vivo and human cornea ex vivo after removing the epithelium. Human corneas were processed for transgene delivery at day 5 after viral vector application. Mouse corneas were harvested …

Synthesis, Antiviral And Contraceptive Activities Of Nucleoside-Sodium Cellulose Sulfate Acetate And Succinate Conjugates, Hitesh K. Agarwal, Anil Kumar, Gustavo F. Doncel, Keykavous Parang

Pharmacy Faculty Articles and Research

Chemical conjugates between sodium cellulose sulfate (CS), displaying contraceptive and HIV-entry inhibiting properties, and nucleoside reverse transcriptase inhibitors (NRTIs) (3′-azido-2′,3′-dideoxythymidine (AZT), 3′-fluoro-2′,3′-dideoxythymidine (FLT), or 2',3'-dideoxy-3'-thiacytidine (3TC)) were designed to simultaneously provide contraceptive and anti-HIV activity. Two linkers, acetate and succinate, were used to conjugate the nucleoside analogs with CS. The conjugates containing cellulose sulfate-acetate (CSA) (e.g., AZT-CSA and FLT-CSA) were found to be more potent than CS and other conjugates (e.g., AZT-succinate-CS, and FLT-succinate-CS). The presence of both sulfate and the acetate groups on cellulose were critical for generating maximum anti-HIV activity. In addition to showing equal potency against wild-type …

Subcellular Localization Of The Non-Structural Proteins 3c And 3cd Of The Honeybee Virus Deformed Wing Virus, Cierra Nichole Danko

Honors Theses

Apis mellifera L., the European honeybee, is a crucial pollinator of many important agricultural crops in the United States. Recently, honeybee colonies have been affected by Colony Collapse Disorder (CCD), a disorder in which the colony fails due to the disappearance of a key functional group of worker bees. Though no direct causalrelationship has been confirmed, hives that experience CCD have been shown to have a high incidence of Deformed Wing Virus (DWV), a common honeybee virus. While the genome sequence and gene-order of DWV has been analyzed fairly recently, few other studies have been performed to understand the molecular …

Developing A Screen To Identify Small Molecule Inhibitors That Disrupt Protein-Protein Interactions In Mycobacteria, Deborah Mai

All ETDs from UAB

Mycobacterium tuberculosis (Mtb) is the causative agent of tuberculosis (TB) and infects nearly one-third of the world's population. The same TB chemotherapeutic regimen has been administered for more than 50 years, and can be improved by developing innovative methods to discover new anti-TB drugs. This work describes a newly established high-throughput screen (HTS) platform technology based on Mycobacterial-Protein Fragment Complementation (M-PFC) to identify small molecule inhibitors of protein-protein interactions in mycobacteria. M-PFC HTS employs both whole cell and target-based approaches, and offers flexibility in selecting an appropriate protein interaction target for HTS. Selectable drug targets can include interactions of essential …

Evolutionarily Conserved Cis-Acting Elements Regulate Lineage-Specific Expression Of Ifng, Anand Balasubramani

All ETDs from UAB

The ability to differentially manipulate available genetic information in order to generate diverse cellular identities represents an innovation of complex multicellular eukaryotic organisms. Cis-acting modules that regulate transcription play extremely important roles in ensuring lineage-specific expression of genes that define cellular identities. In our studies, using Interferon-gamma (IFN-gamma, a cytokine encoded by the gene Ifng), a cytokine encoded by T, NK and NKT cells as a model, we have identified and characterized the roles of key cis regulatory elements that facilitate T lineage specific induction as well as repression of Ifng transcription. In particular, our studies have highlighted the role …

Molecular Mechanisms Of Breast Cancer Metastasis: Gap Junction Intercellular Communication And The Bone Microenvironment, Thomas Morgan Bodenstine

All ETDs from UAB

Metastatic disease accounts for the overwhelming majority of cancer related deaths. More specifically, breast cancer remains one of the leading causes of death in women and breast cancer cells metastasize to bone more than any other secondary site. Upon arriving within the bone microenvironment, breast cancer cells interact with bone marrow cells, leading to changes in bone biology that favor growth of the cancer cells. Additionally, some cancer cells are capable of direct cellular communication with cells at metastatic sites via dysregulation of a family of proteins known as connexins. This direct, physical communication is known as gap junctional intercellular …