The mechanism underlying the increased rate of endogenous glucose production from the liver during exercise remains unknown. The cytokine interleukin-6 (IL-6) is known to be released during exercise and is thought that either IL-6 directly or via a "contraction factor" stimulates the release of stored glucose from the liver. Here we show that IL-6 does not directly increase hepatic glucose output (HGO). Moreover, IL-6 infused at the same time as glucagon caused a significant reduction in HGO. IL-6 infused with epinephrine caused no synergenic increase in HGO. To test if an unknown "contraction factor" was needed along with IL-6 to increase HGO, we used human fasted and exercised plasma perfused with or without IL-6 in our isolated liver system. We found that exercised plasma increased HGO, as expected, but when infused with IL-6, reductions in HGO were found. Our results provide evidence that IL-6 works as a negative regulator of HGO.

No abstract

True radial artery aneurysm: A rare cause finger ischaemia A 60-year-old man presented to the emergency department with 48 h of pain in the right hand and fingers including the thumb. Examination revealed dusky fingertips with a capillary refill time of 5 s. Both radial and ulnar pulses were present. The patient denied any previous trauma or arterial punctures to the area. Allen's test suggested radial artery dominant supply.Computed tomography angiography revealed a partially thrombosed aneurysmal segment of radial artery at the wrist (Fig. 1). Duplex ultrasound revealed a heavily calcified 9-mm radial artery aneurysm (RAA) and a 60% ulnar artery stenosis at the wrist.Under regional anaesthetic, the patient underwent a right RAA repair with ipsilateral reversed cephalic vein interposition graft.