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Sample records for cardiac lesions formed

  1. Post-operative cardiac lesions after cardiac surgery in childhood

    International Nuclear Information System (INIS)

    A new population of patients in cardiology has been growing steadily so that the number of grown-ups with congenital heart disease (GUCH) is almost equal to those under paediatric care. The dramatic improvement in survival should lead to a larger number of GUCH patients than children with CHD in the new millennium. Although echocardiography remains the imaging modality of choice, cross-sectional imaging techniques have a decision-aiding function for the postoperative evaluation of surgical reconstructions as well as in the preparation of complex interventional procedures. Cardiovascular CT and MRI are often complementary in providing comprehensive complex anatomical evaluation, haemodynamic assessment of residual postoperative lesions and complications of surgery. A thorough understanding of postsurgical corrections is a prerequisite for choosing the optimal imaging techniques and achieving an accurate evaluation. (orig.)

  2. Post-operative cardiac lesions after cardiac surgery in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Ou, Phalla [University Paris Descartes, UFR Necker-Enfants Malades, APHP, Department of Pediatric Radiology, Paris (France); University Paris Descartes, UFR Necker-Enfants Malades, APHP, Department of Cardiology, Centre for Congenital Cardiac Malformations-M3C, Paris (France); Hopital Necker-Enfants Malades, Department of Pediatric Radiology, Paris Cedex 15 (France); Iserin, Laurence; Raisky, Oliver; Vouhe, Pascal; Sidi, Daniel; Bonnet, Damien [University Paris Descartes, UFR Necker-Enfants Malades, APHP, Department of Cardiology, Centre for Congenital Cardiac Malformations-M3C, Paris (France); Brunelle, Francis [University Paris Descartes, UFR Necker-Enfants Malades, APHP, Department of Pediatric Radiology, Paris (France)

    2010-06-15

    A new population of patients in cardiology has been growing steadily so that the number of grown-ups with congenital heart disease (GUCH) is almost equal to those under paediatric care. The dramatic improvement in survival should lead to a larger number of GUCH patients than children with CHD in the new millennium. Although echocardiography remains the imaging modality of choice, cross-sectional imaging techniques have a decision-aiding function for the postoperative evaluation of surgical reconstructions as well as in the preparation of complex interventional procedures. Cardiovascular CT and MRI are often complementary in providing comprehensive complex anatomical evaluation, haemodynamic assessment of residual postoperative lesions and complications of surgery. A thorough understanding of postsurgical corrections is a prerequisite for choosing the optimal imaging techniques and achieving an accurate evaluation. (orig.)

  3. Cardiac motion compensation and resolution modeling in simultaneous PET-MR: a cardiac lesion detection study

    Science.gov (United States)

    Petibon, Y.; Ouyang, J.; Zhu, X.; Huang, C.; Reese, T. G.; Chun, S. Y.; Li, Q.; El Fakhri, G.

    2013-04-01

    Cardiac motion and partial volume effects (PVE) are two of the main causes of image degradation in cardiac PET. Motion generates artifacts and blurring while PVE lead to erroneous myocardial activity measurements. Newly available simultaneous PET-MR scanners offer new possibilities in cardiac imaging as MRI can assess wall contractility while collecting PET perfusion data. In this perspective, we develop a list-mode iterative reconstruction framework incorporating both tagged-MR derived non-rigid myocardial wall motion and position dependent detector point spread function (PSF) directly into the PET system matrix. In this manner, our algorithm performs both motion ‘deblurring’ and PSF deconvolution while reconstructing images with all available PET counts. The proposed methods are evaluated in a beating non-rigid cardiac phantom whose hot myocardial compartment contains small transmural and non-transmural cold defects. In order to accelerate imaging time, we investigate collecting full and half k-space tagged MR data to obtain tagged volumes that are registered using non-rigid B-spline registration to yield wall motion information. Our experimental results show that tagged-MR based motion correction yielded an improvement in defect/myocardium contrast recovery of 34-206% as compared to motion uncorrected studies. Likewise, lesion detectability improved by respectively 115-136% and 62-235% with MR-based motion compensation as compared to gating and no motion correction and made it possible to distinguish non-transmural from transmural defects, which has clinical significance given the inherent limitations of current single modality imaging in identifying the amount of residual ischemia. The incorporation of PSF modeling within the framework of MR-based motion compensation significantly improved defect/myocardium contrast recovery (5.1-8.5%, p defect detectability (39-56%, p < 0.01). No statistical difference was found in PET contrast and lesion detectability

  4. Electrocardiographic abnormalities and cardiac arrhythmias in structural brain lesions.

    Science.gov (United States)

    Katsanos, Aristeidis H; Korantzopoulos, Panagiotis; Tsivgoulis, Georgios; Kyritsis, Athanassios P; Kosmidou, Maria; Giannopoulos, Sotirios

    2013-07-31

    Cardiac arrhythmias and electrocardiographic abnormalities are frequently observed after acute cerebrovascular events. The precise mechanism that leads to the development of these arrhythmias is still uncertain, though increasing evidence suggests that it is mainly due to autonomic nervous system dysregulation. In massive brain lesions sympathetic predominance and parasympathetic withdrawal during the first 72 h are associated with the occurrence of severe secondary complications in the first week. Right insular cortex lesions are also related with sympathetic overactivation and with a higher incidence of electrocardiographic abnormalities, mostly QT prolongation, in patients with ischemic stroke. Additionally, female sex and hypokalemia are independent risk factors for severe prolongation of the QT interval which subsequently results in malignant arrhythmias and poor outcome. The prognostic value of repolarization changes commonly seen after aneurysmal subarachnoid hemorrhage, such as ST segment, T wave, and U wave abnormalities, still remains controversial. In patients with traumatic brain injury both intracranial hypertension and cerebral hypoperfusion correlate with low heart rate variability and increased mortality. Given that there are no firm guidelines for the prevention or treatment of the arrhythmias that appear after cerebral incidents this review aims to highlight important issues on this topic. Selected patients with the aforementioned risk factors could benefit from electrocardiographic monitoring, reassessment of the medications that prolong QTc interval, and administration of antiadrenergic agents. Further research is required in order to validate these assumptions and to establish specific therapeutic strategies.

  5. Cardiac motion compensation and resolution modeling in simultaneous PET-MR: a cardiac lesion detection study

    International Nuclear Information System (INIS)

    Cardiac motion and partial volume effects (PVE) are two of the main causes of image degradation in cardiac PET. Motion generates artifacts and blurring while PVE lead to erroneous myocardial activity measurements. Newly available simultaneous PET-MR scanners offer new possibilities in cardiac imaging as MRI can assess wall contractility while collecting PET perfusion data. In this perspective, we develop a list-mode iterative reconstruction framework incorporating both tagged-MR derived non-rigid myocardial wall motion and position dependent detector point spread function (PSF) directly into the PET system matrix. In this manner, our algorithm performs both motion ‘deblurring’ and PSF deconvolution while reconstructing images with all available PET counts. The proposed methods are evaluated in a beating non-rigid cardiac phantom whose hot myocardial compartment contains small transmural and non-transmural cold defects. In order to accelerate imaging time, we investigate collecting full and half k-space tagged MR data to obtain tagged volumes that are registered using non-rigid B-spline registration to yield wall motion information. Our experimental results show that tagged-MR based motion correction yielded an improvement in defect/myocardium contrast recovery of 34–206% as compared to motion uncorrected studies. Likewise, lesion detectability improved by respectively 115–136% and 62–235% with MR-based motion compensation as compared to gating and no motion correction and made it possible to distinguish non-transmural from transmural defects, which has clinical significance given the inherent limitations of current single modality imaging in identifying the amount of residual ischemia. The incorporation of PSF modeling within the framework of MR-based motion compensation significantly improved defect/myocardium contrast recovery (5.1–8.5%, p < 0.01) and defect detectability (39–56%, p < 0.01). No statistical difference was found in PET contrast and

  6. Radionuclide study for cardiac lesion in Duchenne muscular dystrophy

    International Nuclear Information System (INIS)

    Tl-201 myocardial scintigraphy and radionuclide ventriculography with Tc-99m were performed in 10 patients with Duchenne muscular dystropohy (DMD) and 2 siblings with Becker muscular dystrophy (BMD). Perfusion defect especially in the left ventricular posterolateral wall (LVPLW) and cardiac apex was seen on Tl-201 imaging in 6 of the DMD patients and one of the BMD patients. For these patients, Tc-99m imaging also showed left ventricular local wall motion abnormality in 5 patients and a decreased left ventricular ejection fraction in 4 patients. These findings coincided well with fibrosis of the LVPLW found on autopsy. There were individual differences regarding the occurrence of cardiac complications. One of the BMD patients, as well as DMD patients, had also cardiac complications which have long been considered less common. (Namekawa, K.)

  7. Spectrum of cardiac lesions associated with Isolated Cleft Mitral Valve and their impact on therapeutic choices

    Science.gov (United States)

    El hammiri, Ayoub; Drighil, Abdenasser; Benhaourech, Sanaa

    2016-01-01

    Background Isolated cleft mitral valve (ICMV) may occur alone or in association with other congenital heart lesions. The aim of this study was to describe the profile of cardiac lesions associated with ICMV and their potential impact on therapeutic management. Methods We conducted a descriptive study with data retrieved from the Congenital Heart Disease (CHD) single-center registry of our institution, including patients with ICMV registered between December 2008 and November 2014. Results Among 2177 patients retrieved from the CHD registry, 22 (1%) had ICMV. Median age at diagnosis was 5 years (6 days to 36 years). Nine patients (40.9%) had Down syndrome. Seventeen patients (77.3%) had associated lesions, including 11 (64.7%) with accessory chordae in the left ventricular outflow tract (LVOT) with no obstruction, 15 (88.2%) had ventricular septal defect (VSD), three had secundum atrial septal defect, and four had patent ductus arteriosus. Thirteen patients (59.1%) required surgical repair. The decision to proceed with surgery was mainly based on the severity of the associated lesion in eight patients (61.5%) and on the severity of the mitral regurgitation in four patients (30.8%). In one patient, surgery was decided based on the severity of both the associated lesion and mitral regurgitation. Conclusion Our study shows that ICMV is rare and strongly associated with Down syndrome. The most common associated cardiac abnormalities were VSD and accessory chordae in the LVOT. We conclude that cardiac lesions associated with ICMV are of major interest, since in this study patients with cardiac lesions were diagnosed earlier. The decision to operate on these patients must take into account the severity of both mitral regurgitation and associated cardiac lesions. PMID:27096525

  8. Characteristic lesion pattern and echocardiographic findings in extra-cardiac shunt-related stroke.

    Science.gov (United States)

    Mun, Jun Kyu; Park, Sung Ji; Kim, Suk Jae; Bang, Oh Young; Chung, Chin-Sang; Lee, Kwang Ho; Kim, Gyeong-Moon

    2016-10-15

    Among embolic strokes of undetermined source, under-recognized etiology such as extra-cardiac shunt could be a potential risk factor. We sought to characterize infarction patterns on diffusion-weighted imaging (DWI) and transesophageal echocardiography (TEE) findings in extra-cardiac shunt-related stroke. We enrolled 96 consecutive patients with cryptogenic stroke who had an extra- or intra-cardiac shunt. Diagnosis of the shunt was performed using TEE with agitated saline contrast and pulmonary vein isolation. Infarction patterns on DWI and total lesion volume were analyzed. Bubble amounts through the shunt were classified via the International Consensus Criteria (ICC). Short-term prognosis, patterns and size of DWI lesions, and involved vascular territories were not significantly different between two groups. Multivariate analysis revealed that extra-cardiac shunt group has a smaller total infarct volume (odds ratio [OR]=0.427, 95% confidence interval [95% CI] 0.228-0.799, p=0.008), and significantly higher bubble grade during resting state and lower grade during the Valsalva maneuver (OR= 0.539, 95% CI 0.438-0.663, psaline contrast. Further study is needed to confirm whether the extra-cardiac shunt is an independent risk factor. PMID:27653885

  9. Repair of DNA lesions associated with triplex-forming oligonucleotides.

    Science.gov (United States)

    Chin, Joanna Y; Glazer, Peter M

    2009-04-01

    Triplex-forming oligonucleotides (TFOs) are gene targeting tools that can bind in the major groove of duplex DNA in a sequence-specific manner. When bound to DNA, TFOs can inhibit gene expression, can position DNA-reactive agents to specific locations in the genome, or can induce targeted mutagenesis and recombination. There is evidence that third strand binding, alone or with an associated cross-link, is recognized and metabolized by DNA repair factors, particularly the nucleotide excision repair pathway. This review examines the evidence for DNA repair of triplex-associated lesions. PMID:19072762

  10. Terbufos-sulfone exacerbates cardiac lesions in diabetic rats: a sub-acute toxicity study.

    Science.gov (United States)

    Nurulain, Syed M; Shafiullah, Mohamed; Yasin, Javed; Adem, Abdu; Kaabi, Juma Al; Tariq, Saeed; Adeghate, Ernest; Ojha, Shreesh

    2016-06-01

    Organophosphorus compounds (OPCs) have a wide range of applications, from agriculture to warfare. Exposure to these brings forward a varied kind of health issues globally. Terbufos is one of the leading OPCs used worldwide. The present study investigates the cardiac effect of no observable dose of a metabolite of terbufos, terbufos-sulfone (TS), under non-diabetic and streptozotocin-induced diabetic condition. One hundred nanomoles per rat (1/20 of LD50) was administered intraperitoneally to adult male Wister rats daily for fifteen days. The left ventricle was collected for ultrastructural changes by transmission electron microscopy. The blood samples were collected for biochemical tests including RBC acetylcholinesterase, creatinine kinase (CK), lactate dehydrogenase (LDH), cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), triglycerides, ALT, AST, and GGT. The study revealed about 10 % inhibition of RBC-AChE in two weeks of TS treatment in non-diabetic rats whereas RBC-AChE activity was significantly decreased in diabetic TS treated rats. CK, LDH, and triglycerides were significantly higher in diabetic TS treated rats. Electron microscopy of the heart showed derangement and lesions of the mitochondria of cardiomyocytes in the TS treated groups. The present study concludes that a non-lethal dose of TS causes cardiac lesions which exacerbate under diabetic condition. Biochemical tests confirmed the ultrastructural changes. It is concluded that a non-lethal dose of TS may be a risk factor for a cardiovascular disease, which may be fatal under diabetic condition. PMID:27331300

  11. Diffuse infiltrative cardiac tuberculosis

    International Nuclear Information System (INIS)

    We present the cardiac magnetic resonance images of an unusual form of cardiac tuberculosis. Nodular masses in a sheet-like distribution were seen to infiltrate the outer myocardium and pericardium along most of the cardiac chambers. The lesions showed significant resolution on antitubercular therapy

  12. HEART FAILURE WITH LOW CARDIAC OUTPUT AND RISK OF DEVELOPMENT OF LESIONS IN THE CEREBRAL WHITE MATTER

    OpenAIRE

    2005-01-01

    Aim: Diminished cardiac output can lead to the development of white matter lesions. White matter lesions are related to cognitive impairment, stroke risk and vascular death, yet the precise aetiology is uncertain. Methods: In this study we recruited 130 patients attending our medicine and neurology outpatient department, and divided them into those with a history of heart failure (n:24), atrial fibrillation (n:26), and those with atherosclerotic risk factors (n:80). The patients without low o...

  13. Trypanosoma cruzi high infectivity in vitro is related to cardiac lesions during long-term infection in Beagledogs

    Directory of Open Access Journals (Sweden)

    Paulo MM Guedes

    2007-03-01

    Full Text Available Trypanosoma cruzi is a hemoflagelate parasite associated with heart dysfunctions causing serious problems in Central and South America. Beagle dogs develop the symptoms of Chagas disease in humans, and could be an important experimental model for better understanding the immunopathogenic mechanisms involved in the chagasic infection. In the present study we investigated the relation among biological factors inherent to the parasite (trypomastigote polymorphism and in vitro infectivity and immunoglobulin production, inflammation, and fibrosis in the heart of Beagle dogs infected with either T. cruzi Y or Berenice-78 strains. In vitro infectivity of Vero cells as well as the extension of cardiac lesions in infected Beagle was higher for Y strain when compared to Berenice-78 strain. These data suggested that in vitro infectivity assays may correlate with pathogenicity in vivo. In fact, animals infected with Y strain, which shows prevalence of slender forms and high infectivity in vitro, presented cardiomegaly, inflammation, and fibrosis in heart area. Concerning the immunoglobulin production, no statistically significant difference was observed for IgA, IgM or IgG levels among T. cruzi infected animals. However, IgA together IgM levels have shown to be a good marker for the acute phase of Chagas disease.

  14. Cardiac diastolic dysfunction is associated with cerebral white matter lesions in elderly patients with risk factors for atherosclerosis

    International Nuclear Information System (INIS)

    Cerebral white matter lesions on magnetic resonance imaging (MRI) are considered to be the result of brain ischemic injury and a risk factor for clinical stroke. The purpose of this study was to elucidate the relationship between the cardiac diastolic function and cerebral white matter lesions in elderly patients with risk factors for atherosclerosis. The study subjects were 55 patients (75±7 years) with risk factors for atherosclerosis including hypertension, diabetes mellitus, and dyslipidemia. Patients with symptomatic cerebrovascular events were excluded from the study. Cerebral white matter lesions, which were defined as exhibiting high intensity regions on brain MRI, were evaluated with the degrees of periventricular hyperintensity (PVH) according to the Japanese Brain Dock Guidelines of 2003. Peak early diastolic mitral annular velocity (E' velocity) was measured by tissue Doppler echocardiography, and was used as a parameter of cardiac diastolic function. The mean value of E' velocity was decreased due to the cardiac diastolic dysfunction (5.2±1.4 cm/s). In addition, the E' velocity was inversely correlated with the degree of PVH (ρ=-0.701, p<0.001). Stepwise regression analysis showed that the decrease in the E' velocity (β coefficient=-0.42, p<0.001) and the presence of hypertension (β coefficient=0.31, p=0.001) were independent determinants of the degree of PVH. Thus, cardiac diastolic dysfunction is correlated to the severity of cerebral white matter lesions, suggesting the cardio-cerebral connection in elderly patients with risk factors for atherosclerosis. (author)

  15. Repair of DNA lesions associated with triplex-forming oligonucleotides

    OpenAIRE

    Chin, Joanna Y; Glazer, Peter M.

    2009-01-01

    Triplex-forming oligonucleotides (TFOs) are gene targeting tools that can bind in the major groove of duplex DNA in a sequence-specific manner. When bound to DNA, TFOs can inhibit gene expression, can position DNA-reactive agents to specific locations in the genome, or can induce targeted mutagenesis and recombination. There is evidence that third strand binding, alone or with an associated cross-link, is recognized and metabolized by DNA repair factors, particularly the nucleotide excision r...

  16. Toxic interaction between fumonisin B1 and moniliformin for cardiac lesions in Japanese quail.

    Science.gov (United States)

    Sharma, Deepa; Asrani, R K; Ledoux, D R; Rottinghaus, G E; Gupta, V K

    2012-09-01

    mitochondria resulted in widespread separation of muscle fibers in group MX. In addition, the mitochondria were swollen and varied from round to oval to slightly elongated and occasionally forked, and vacuolation was rarely noticed in group MX. In the FM combination group, a significant increase in the number of mitochondria caused muscle fibers to look much thinner and assume a wavy pattern. We conclude that the effect of M on the heart is exaggerated in the presence of FB1. Although the overall interactive effect of FB1 and M was less than additive, the interactive effects between the two toxins for cardiac lesions were greater than additive to synergistic up to the second week, raising serious concerns on early age exposure to a combination of these two mycotoxins.

  17. Cardiac shear-wave elastography using a transesophageal transducer: application to the mapping of thermal lesions in ultrasound transesophageal cardiac ablation.

    Science.gov (United States)

    Kwiecinski, Wojciech; Bessière, Francis; Colas, Elodie Constanciel; N'Djin, W Apoutou; Tanter, Mickaël; Lafon, Cyril; Pernot, Mathieu

    2015-10-21

    Heart rhythm disorders, such as atrial fibrillation or ventricular tachycardia can be treated by catheter-based thermal ablation. However, clinically available systems based on radio-frequency or cryothermal ablation suffer from limited energy penetration and the lack of lesion's extent monitoring. An ultrasound-guided transesophageal device has recently successfully been used to perform High-Intensity Focused Ultrasound (HIFU) ablation in targeted regions of the heart in vivo. In this study we investigate the feasibility of a dual therapy and imaging approach on the same transesophageal device. We demonstrate in vivo that quantitative cardiac shear-wave elastography (SWE) can be performed with the device and we show on ex vivo samples that transesophageal SWE can map the extent of the HIFU lesions. First, SWE was validated with the transesophageal endoscope in one sheep in vivo. The stiffness of normal atrial and ventricular tissues has been assessed during the cardiac cycle (n = 11) and mapped (n = 7). Second, HIFU ablation has been performed with the therapy-imaging transesophageal device in ex vivo chicken breast samples (n  =  3), then atrial (left, n = 2) and ventricular (left n = 1, right n = 1) porcine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. During the cardiac cycle stiffness varied from 0.5   ±   0.1 kPa to 6.0   ±   0.3 kPa in the atrium and from 1.3   ±   0.3 kPa to 13.5   ±   9.1 kPa in the ventricles. The thermal lesions were visible on all SWE maps performed after ablation. Shear modulus of the ablated zones increased to 16.3   ±   5.5 kPa (versus 4.4   ±   1.6 kPa before ablation) in the chicken breast, to 30.3   ±   10.3 kPa (versus 12.2   ±   4.3 kPa) in the atria and to 73.8

  18. Cardiac shear-wave elastography using a transesophageal transducer: application to the mapping of thermal lesions in ultrasound transesophageal cardiac ablation

    Science.gov (United States)

    Kwiecinski, Wojciech; Bessière, Francis; Constanciel Colas, Elodie; Apoutou N'Djin, W.; Tanter, Mickaël; Lafon, Cyril; Pernot, Mathieu

    2015-10-01

    Heart rhythm disorders, such as atrial fibrillation or ventricular tachycardia can be treated by catheter-based thermal ablation. However, clinically available systems based on radio-frequency or cryothermal ablation suffer from limited energy penetration and the lack of lesion’s extent monitoring. An ultrasound-guided transesophageal device has recently successfully been used to perform High-Intensity Focused Ultrasound (HIFU) ablation in targeted regions of the heart in vivo. In this study we investigate the feasibility of a dual therapy and imaging approach on the same transesophageal device. We demonstrate in vivo that quantitative cardiac shear-wave elastography (SWE) can be performed with the device and we show on ex vivo samples that transesophageal SWE can map the extent of the HIFU lesions. First, SWE was validated with the transesophageal endoscope in one sheep in vivo. The stiffness of normal atrial and ventricular tissues has been assessed during the cardiac cycle (n=11 ) and mapped (n= 7 ). Second, HIFU ablation has been performed with the therapy-imaging transesophageal device in ex vivo chicken breast samples (n  =  3), then atrial (left, n= 2 ) and ventricular (left n=1 , right n=1 ) porcine heart tissues. SWE provided stiffness maps of the tissues before and after ablation. Areas of the lesions were obtained by tissue color change with gross pathology and compared to SWE. During the cardiac cycle stiffness varied from 0.5   ±   0.1 kPa to 6.0   ±   0.3 kPa in the atrium and from 1.3   ±   0.3 kPa to 13.5   ±   9.1 kPa in the ventricles. The thermal lesions were visible on all SWE maps performed after ablation. Shear modulus of the ablated zones increased to 16.3   ±   5.5 kPa (versus 4.4   ±   1.6 kPa before ablation) in the chicken breast, to 30.3   ±   10.3 kPa (versus 12.2   ±   4.3 kPa) in the atria and to 73.8   ±   13

  19. Image-based modeling and characterization of RF ablation lesions in cardiac arrhythmia therapy

    Science.gov (United States)

    Linte, Cristian A.; Camp, Jon J.; Rettmann, Maryam E.; Holmes, David R.; Robb, Richard A.

    2013-03-01

    In spite of significant efforts to enhance guidance for catheter navigation, limited research has been conducted to consider the changes that occur in the tissue during ablation as means to provide useful feedback on the progression of therapy delivery. We propose a technique to visualize lesion progression and monitor the effects of the RF energy delivery using a surrogate thermal ablation model. The model incorporates both physical and physiological tissue parameters, and uses heat transfer principles to estimate temperature distribution in the tissue and geometry of the generated lesion in near real time. The ablation model has been calibrated and evaluated using ex vivo beef muscle tissue in a clinically relevant ablation protocol. To validate the model, the predicted temperature distribution was assessed against that measured directly using fiberoptic temperature probes inserted in the tissue. Moreover, the model-predicted lesions were compared to the lesions observed in the post-ablation digital images. Results showed an agreement within 5°C between the model-predicted and experimentally measured tissue temperatures, as well as comparable predicted and observed lesion characteristics and geometry. These results suggest that the proposed technique is capable of providing reasonably accurate and sufficiently fast representations of the created RF ablation lesions, to generate lesion maps in near real time. These maps can be used to guide the placement of successive lesions to ensure continuous and enduring suppression of the arrhythmic pathway.

  20. First experiences with contrast-enhanced first-pass MR perfusion imaging in patients with primary, benign cardiac masses and tumour-like lesions

    Energy Technology Data Exchange (ETDEWEB)

    Mohrs, Oliver K. [Darmstadt Radiology, Department of Cardiovascular Imaging at Alice-Hospital, Darmstadt (Germany); German Cancer Research Center (DKFZ), Department of Radiology, Heidelberg (Germany); Voigtlaender, Thomas [Cardiovascular Center Bethanien (CCB), Frankfurt/Main (Germany); Petersen, Steffen E. [John Radcliffe Hospital, University of Oxford, OCMR, Oxford (United Kingdom); Zander, Matthias [Darmstadt Center of Cardiology, Darmstadt (Germany); Schulze, Thomas [Siemens Medical Solutions, Frankfurt/Main (Germany); Pottmeyer, Anselm [Darmstadt Radiology, Department of Cardiovascular Imaging at Alice-Hospital, Darmstadt (Germany); Kauczor, Hans-Ulrich [German Cancer Research Center (DKFZ), Department of Radiology, Heidelberg (Germany)

    2008-08-15

    The aim of this study was to evaluate the diagnostic value of contrast-enhanced first-pass perfusion MRI in patients with suspected cardiac masses and tumour-like lesions. Twenty patients underwent contrast-enhanced first-pass saturation-recovery steady-state-free-precession perfusion MRI in addition to clinical MRI. Eleven diagnostic parameters were analysed blinded in consensus by three observers: localisation (paracardiac/mural/intracavitary), malignancy (benign/malignant) and first-pass enhancement pattern (homogeneous/heterogeneous as well as non-perfused/hypoperfused/iso-perfused/ hyperperfused). The results were compared to combined references comprising histology, cytology, medical and surgical reports, echocardiography, chest X-ray, coronary angiography and regular MRI. Also, we analysed if additional first-pass perfusion confirmed, changed or reduced the number of differential diagnoses compared to clinical MRI. All cardiac masses or tumour-like lesions were correctly localised and scored as benign lesions. For homogeneous perfused lesions the sensitivity, specificity, positive and negative predictive value was 94/100/100/67%, 100/94/67/100% for heterogeneous perfused lesions, 92/100/100/88% for non-perfused, 100/94/75/100 for hypoperfused, 100/100/100/100% for hyperperfused and for isoperfused lesions. In 17/2/1 cases perfusion MRI confirmed, reduced or increased the number of potential differentials. First-pass perfusion MRI provides valuable information in patients with benign cardiac masses or tumour-like lesions. Further experience is needed to underline these preliminary observations. (orig.)

  1. Lesion-specific coronary artery calcium quantification for predicting cardiac event with multiple instance support vector machines.

    Science.gov (United States)

    Liu, Qingshan; Qian, Zhen; Marvasty, Idean; Rinehart, Sarah; Voros, Szilard; Metaxas, Dimitris N

    2010-01-01

    Conventional whole-heart CAC quantification has been demonstrated to be insufficient in predicting coronary events, especially in accurately predicting near-term coronary events in high-risk adults. In this paper, we propose a lesion-specific CAC quantification framework to improve CAC's near-term predictive value in intermediate to high-risk populations with a novel multiple instance support vector machines (MISVM) approach. Our method works on data sets acquired with clinical imaging protocols on conventional CT scanners without modifying the CT hardware or updating the imaging protocol. The calcific lesions are quantified by geometric information, density, and some clinical measurements. A MISVM model is built to predict cardiac events, and moreover, to give a better insight of the characterization of vulnerable or culprit lesions in CAC. Experimental results on 31 patients showed significant improvement of the predictive value with the ROC analysis, the net reclassification improvement evaluation, and the leave-one-out validation against the conventional methods. PMID:20879266

  2. Cystitis glandularis forming a tumorous lesion in the urinary bladder: A rare appearance of disease

    OpenAIRE

    Shigehara, Kazuyoshi; Miyagi, Tohru; Nakashima, Takao; Shimamura, Masayoshi

    2008-01-01

    We report a rare appearance of cystitis glandularis forming a tumorous lesion with blueberry spots in the urinary bladder. A 49-year-old woman was admitted to our hospital with pollakisuria and recurrent gross hematuria. Urine examination showed no pyuria. Computed tomography (CT) scan showed an extravesical invasive mass and cystoscopy revealed a non-papillary tumor with blueberry spots in the bladder. Transurethral resection (TUR) was performed. Histopathological examination revealed cystit...

  3. Real-time optical monitoring of permanent lesion progression in radiofrequency ablated cardiac tissue (Conference Presentation)

    Science.gov (United States)

    Singh-Moon, Rajinder P.; Hendon, Christine P.

    2016-02-01

    Despite considerable advances in guidance of radiofrequency ablation (RFA) therapies for atrial fibrillation, success rates have been hampered by an inability to intraoperatively characterize the extent of permanent injury. Insufficient lesions can elusively create transient conduction blockages that eventually reconduct. Prior studies suggest significantly greater met-myoglobin (Mmb) concentrations in the lesion core than those in the healthy myocardium and may serve as a marker for irreversible tissue damage. In this work, we present real-time monitoring of permanent injury through spectroscopic assessment of Mmb concentrations at the catheter tip. Atrial wedges (n=6) were excised from four fresh swine hearts and submerged under pulsatile flow of warm (37oC) phosphate buffered saline. A commercial RFA catheter inserted into a fiber optic sheath allowed for simultaneous measurement of tissue diffuse reflectance (DR) spectra (500-650nm) during application of RF energy. Optical measurements were continuously acquired before, during, and post-ablation, in addition to healthy neighboring tissue. Met-myoglobin, oxy-myoglobin, and deoxy-myoglobin concentrations were extracted from each spectrum using an inverse Monte Carlo method. Tissue injury was validated with Masson's trichrome and hematoxylin and eosin staining. Time courses revealed a rapid increase in tissue Mmb concentrations at the onset of RFA treatment and a gradual plateauing thereafter. Extracted Mmb concentrations were significantly greater post-ablation (p<0.0001) as compared to healthy tissue and correlated well with histological assessment of severe thermal tissue destruction. On going studies are aimed at integrating these findings with prior work on near infrared spectroscopic lesion depth assessment. These results support the use of spectroscopy-facilitated guidance of RFA therapies for real-time permanent injury estimation.

  4. Different forms of impairment of the fore-hindlimb coordination after partial spinal lesions in cats.

    Science.gov (United States)

    Górska, T; Bem, T; Majczyński, H; Zmysłowski, W

    1996-01-01

    Effects of large low thoracic (T10-T11) partial spinal lesions involving either the ventral quadrants of the spinal cord and, to a different extent the dorsolateral funiculi, or different extent of the lateral funiculi and/or the dorsal columns, on the fore-hindlimb coordination were examined in cats walking overground at moderate speeds. In both groups of operated cats, except those in which the lesion was essentially confined to dorsal columns, three different forms of impairment of fore-hindlimb coordination were observed, depending on the extent of lesion: (1) a change of locomotion towards pacing with preservation of the equality rhythms in the fore- and the hindlimbs; (2) episodes of fore- and hindlimb rhythm dissociation and (3) a permanent dissociation of the fore- and hindlimb rhythms. A comparison of the results obtained in these two groups of operated cats points to the more important role played by the lateral funiculi, than by other parts of the spinal white matter, in controlling the fore-hindlimb coordination in cats.

  5. Human embryonic stem cell derived mesenchymal progenitors express cardiac markers but do not form contractile cardiomyocytes.

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    Christophe M Raynaud

    Full Text Available Mesenchymal progenitors or stromal cells have shown promise as a therapeutic strategy for a range of diseases including heart failure. In this context, we explored the growth and differentiation potential of mesenchymal progenitors (MPs derived in vitro from human embryonic stem cells (hESCs. Similar to MPs isolated from bone marrow, hESC derived MPs (hESC-MPs efficiently differentiated into archetypical mesenchymal derivatives such as chondrocytes and adipocytes. Upon treatment with 5-Azacytidine or TGF-β1, hESC-MPs modified their morphology and up-regulated expression of key cardiac transcription factors such as NKX2-5, MEF2C, HAND2 and MYOCD. Nevertheless, NKX2-5+ hESC-MP derivatives did not form contractile cardiomyocytes, raising questions concerning the suitability of these cells as a platform for cardiomyocyte replacement therapy. Gene profiling experiments revealed that, although hESC-MP derived cells expressed a suite of cardiac related genes, they lacked the complete repertoire of genes associated with bona fide cardiomyocytes. Our results suggest that whilst agents such as TGF-β1 and 5-Azacytidine can induce expression of cardiac related genes, but treated cells retain a mesenchymal like phenotype.

  6. Newly formed cystic lesions for the development of pneumomediastinum in Pneumocystis jirovecii pneumonia

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    Yoon Sung

    2009-10-01

    Full Text Available Abstract Background Pneumocystis jirovecii, formerly named Pneumocystis carinii, is one of the most common opportunistic infections in human immunodeficiency virus (HIV-infected patients. Case presentations We encountered two cases of spontaneous pneumomediastinum with subcutaneous emphysema in HIV-infected patients being treated for Pneumocystis jirovecii pneumonia with trimethoprim/sulfamethoxazole. Conclusion Clinicians should be aware that cystic lesions and bronchiectasis can develop in spite of trimethoprim/sulfamethoxazole treatment for P. jirovecii pneumonia. The newly formed bronchiectasis and cyst formation that were noted in follow up high resolution computed tomography (HRCT but were not visible on HRCT at admission could be risk factors for the development of pneumothorax or pneumomediastinum with subcutaneous emphysema in HIV-patients.

  7. Pericardial Effusion with Cardiac Tamponade as a Form of Presentation of Primary Hypothyroidism

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    Acir Rachid

    2002-06-01

    Full Text Available The authors describe a case of pericardial effusion accompanied by cardiac tamponade caused by primary hypothyroidism. Diagnosis was made by exclusion, because other causes of cardiac tamponade are more frequent. Emergency treatment of cardiac tamponade is pericardiocentesis (with possible pericardial window, and, after stabilization, performance of hormonal reposition therapy with L-thyroxin.

  8. Chemical–Biological Fingerprinting: Probing the Properties of DNA Lesions Formed by Peroxynitrite

    OpenAIRE

    Delaney, Sarah; James C Delaney; Essigmann, John M.

    2007-01-01

    DNA-damaging agents usually produce a vast collection of lesions within the genome. Analysis of these lesions from the structural and biological viewpoints is often complicated by the reality that some of the lesions are chemically fragile, leading to an even larger set of secondary and tertiary products. In an effort to deconvolute complex DNA-damage spectra, a strategy is presented whereby an oligonucleotide containing a specific target for chemical reaction is allowed to react with a DNA-d...

  9. Comparison of a conventional cardiac-triggered dual spin-echo and a fast STIR sequence in detection of spinal cord lesions in multiple sclerosis

    International Nuclear Information System (INIS)

    The current optimal imaging protocol in spinal cord MR imaging in patients with multiple sclerosis includes a long TR conventional spin-echo (CSE) sequence, requiring long acquisition times. Using short tau inversion recovery fast spin-echo (fast STIR) sequences both acquisition time can be shortened and sensitivity in the detection of multiple sclerosis (MS) abnormalities can be increased. This study compares both sequences for the potential to detect both focal and diffuse spinal abnormalities. Spinal cords of 5 volunteers and 20 MS patients were studied at 1.0 T. Magnetic resonance imaging included cardiac-gated sagittal dual-echo CSE and a cardiac-gated fast STIR sequence. Images were scored regarding number, size, and location of focal lesions, diffuse abnormalities and presence/hindrance of artifacts by two experienced radiologists. Examinations were scored as being definitely normal, indeterminate, or definitely abnormal. Interobserver agreement regarding focal lesions was higher for CSE (κ=0.67) than for fast STIR (κ=0.57) but did not differ significantly. Of all focal lesions scored in consensus, 47 % were scored on both sequences, 31 % were only detected by fast STIR, and 22 % only by dual-echo CSE (n. s.). Interobserver agreement for diffuse abnormalities was lower with fast STIR (κ=0.48) than dual-echo CSE (κ=0.65; n. s.). After consensus, fast STIR showed in 10 patients diffuse abnormalities and dual-echo CSE in 3. After consensus, in 19 of 20 patients dual-echo CSE scans were considered as definitely abnormal compared with 17 for fast STIR. The fast STIR sequence is a useful adjunct to dual-echo CSE in detecting focal abnormalities and is helpful in detecting diffuse MS abnormalities in the spinal cord. Due to the frequent occurrence of artifacts and the lower observer concordance, fast STIR cannot be used alone. (orig.)

  10. Impact of cardiac rehabilitation on angiographic outcomes after drug-eluting stents in patients with de novo long coronary artery lesions.

    Science.gov (United States)

    Lee, Jong-Young; Yun, Sung-Cheol; Ahn, Jung-Min; Park, Duk-Woo; Kang, Soo-Jin; Lee, Seung-Whan; Kim, Young-Hak; Lee, Cheol Whan; Park, Seong-Wook; Yoo, Yeong Sook; Park, Eun-Kyung; Jin, Young-Soo; Kim, Jeongsoon; Nam, Hyo-Jung; Min, Sun-Yang; Park, Seung-Jung

    2014-06-15

    Cardiac rehabilitation (CR) can reduce cardiovascular mortality and morbidity in coronary artery disease. Long coronary artery lesions may be associated with adverse outcomes after drug-eluting stent (DES) implantation. The purpose of this study was to evaluate angiographic outcomes after a comprehensive CR program in patients with DESs for long coronary artery lesions. A total of 576 patients treated with DESs for long (≥25 mm) coronary lesions were enrolled in this prospective CR registry. Comprehensive CR programs were successfully performed in 288 patients (50%). The primary end point was in-stent late luminal loss at the 9-month angiographic follow-up. There were few significant differences between the CR and non-CR groups in terms of baseline characteristics, including clinical, angiographic, and procedural variables. The rate of in-stent late luminal loss in the CR group was 35% less than in the usual care group (0.19 ± 0.33 mm in CR vs 0.29 ± 0.45 mm in non-CR, difference 0.08 mm, 95% confidence interval 0.01 to 0.16, p = 0.02) at the 9-month follow-up. After propensity-matched analysis (224 pairs), the results were consistent (0.18 ± 0.31 mm in CR vs 0.28 ± 0.41 mm in non-CR, difference 0.10 mm, 95% confidence interval 0.02 to 0.18, p = 0.02). The CR group showed a significant improvement in the overall risk profile compared with the non-CR group, including current smoking, biochemical profiles, depression, obesity, and exercise capacity. In conclusion, the comprehensive CR program significantly reduced late luminal loss after DES implantation for long coronary lesions. This may be associated with significant improvements in exercise capacity and overall risk profile.

  11. Bacterial interference with host epithelial junctional complexes: Probiotic bacteria vs. A/E lesion-forming Escherichia coli

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    TANIA TOPOUZOVA-HRISTOVA

    2012-01-01

    Full Text Available During colonization, enteropathogenic (EPEC and enterohaemorrhagic (EHEC Escherichia coli are capable to manipulate host cytoskeleton and colonize gut epithelia by a specific mode of attachment known as the attaching and effacing lesion (A/E lesion. While actin rearrangements during A/E lesion formation have been extensively investigated, the possible alterations of other cytoskeletal elements like those comprising the intercellular junctional complexes (JC of polarized cells during infection have only lately attracted attention. The present mini-review addresses the opposite effects of two groups of bacteria, A/E lesion-forming pathogenic E. coli and probiotic bacterial strains, on JC. JC are important in maintaining gut barrier functions. EPEC and EHEC can disrupt JC which as a consequence leads to reduction in the transepitelial electrical resistance (TER and an increase of the permeability to macromolecules. Probiotic bacteria on the other hand stabilize JC thus increasing TER and reducing permeability to macromolecular markers. Probiotic strains can protect JC integrity of polarized cells from the damage caused by EPEC or EHEC. Together with the promise of these results, of concern is the fact that the outcome of the studies can differ dependent on experimental protocols. Studies with living bacteria and different strain combinations have also put forward strain specific effects. Therefore, an important practical item for future studies is the identification of the molecules synthesized by probiotic bacteria that may be active on JC stability.

  12. Comparison of Different Forms of Exercise Training in Patients With Cardiac Disease: Where Does High-Intensity Interval Training Fit?

    Science.gov (United States)

    Gayda, Mathieu; Ribeiro, Paula A B; Juneau, Martin; Nigam, Anil

    2016-04-01

    In this review, we discuss the most recent forms of exercise training available to patients with cardiac disease and their comparison or their combination (or both) during short- and long-term (phase II and III) cardiac rehabilitation programs. Exercise training modalities to be discussed include inspiratory muscle training (IMT), resistance training (RT), continuous aerobic exercise training (CAET), and high-intensity interval training (HIIT). Particular emphasis is placed on HIIT compared or combined (or both) with other forms such as CAET or RT. For example, IMT combined with CAET was shown to be superior to CAET alone for improving functional capacity, ventilatory function, and quality of life in patients with chronic heart failure. Similarly, RT combined with CAET was shown to optimize benefits with respect to functional capacity, muscle function, and quality of life. Furthermore, in recent years, HIIT has emerged as an alternative or complementary (or both) exercise modality to CAET, providing equivalent if not superior benefits to conventional continuous aerobic training with respect to aerobic fitness, cardiovascular function, quality of life, efficiency, safety, tolerance, and exercise adherence in both short- and long-term training studies. Finally, short-interval HIIT was shown to be useful in the initiation and improvement phases of cardiac rehabilitation, whereas moderate- or longer-interval (or both) HIIT protocols appear to be more appropriate for the improvement and maintenance phases because of their high physiological stimulus. We now propose progressive models of exercise training (phases II-III) for patients with cardiac disease, including a more appropriate application of HIIT based on the scientific literature in the context of a multimodal cardiac rehabilitation program.

  13. Expansion of cardiac ischemia/reperfusion injury after instillation of three forms of multi-walled carbon nanotubes

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    Urankar Rakhee N

    2012-10-01

    Full Text Available Abstract Background The exceptional physical-chemical properties of carbon nanotubes have lead to their use in diverse commercial and biomedical applications. However, their utilization has raised concerns about human exposure that may predispose individuals to adverse health risks. The present study investigated the susceptibility to cardiac ischemic injury following a single exposure to various forms of multi-walled carbon nanotubes (MWCNTs. It was hypothesized that oropharyngeal aspiration of MWCNTs exacerbates myocardial ischemia and reperfusion injury (I/R injury. Methods Oropharyngeal aspiration was performed on male C57BL/6J mice with a single amount of MWCNT (0.01 - 100 μg suspended in 100 μL of a surfactant saline (SS solution. Three forms of MWCNTs were used in this study: unmodified, commercial grade (C-grade, and functionalized forms that were modified either by acid treatment (carboxylated, COOH or nitrogenation (N-doped and a SS vehicle. The pulmonary inflammation, serum cytokine profile and cardiac ischemic/reperfusion (I/R injury were assessed at 1, 7 and 28 days post-aspiration. Results Pulmonary response to MWCNT oropharyngeal aspiration assessed by bronchoalveolar lavage fluid (BALF revealed modest increases in protein and inflammatory cell recruitment. Lung histology showed modest tissue inflammation as compared to the SS group. Serum levels of eotaxin were significantly elevated in the carboxylated MWCNT aspirated mice 1 day post exposure. Oropharyngeal aspiration of all three forms of MWCNTs resulted in a time and/or dose-dependent exacerbation of myocardial infarction. The severity of myocardial injury varied with the form of MWCNTs used. The N-doped MWCNT produced the greatest expansion of the infarct at any time point and required a log concentration lower to establish a no effect level. The expansion of the I/R injury remained significantly elevated at 28 days following aspiration of the COOH and N-doped forms, but

  14. Radiofrequency Ablation of Accessory Pathways in Chil- dren with Complex Congenital Cardiac Lesions: A Report of Three Cases

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    Mohammad Dalili

    2015-10-01

    Full Text Available Catheter ablation is an accepted, highly effective modality of treatment for cardiac arrhythmias in children. The success rate depends on the operator’s experience, especially in cases involving complex anatomies. We hereby report our recent experience of successful ablation of accessory pathways in three children with complex congenital heart diseases.The first case was a 7-year-old girl with tricuspid atresia and a previous Glenn shunt, in whom a sub-epicardial overt accessory pathway was successfully ablated via the coronary sinus. The second case, a 9-year-old girl, received accessory pathway ablation via the fenestration of an extracardiac Fontan pathway. The third case was a 14-year-old boy with dextrocardia, common atrium, common ventricle, and a previous extracardiac Fontan operation, in whom ablation of a concealed accessory pathway was carried out retrogradely from the aorta. All the ablations were done in Rajaie Cardiovascular, Medical and Research Center, Tehran, and all the patients were discharged from the hospital without any complication.

  15. Papulo-pustulosis form rosacea – results of immunohistochemical research of the condition of the lesions

    Directory of Open Access Journals (Sweden)

    Sviatenko T.V.

    2012-01-01

    Full Text Available Studying and the analysis of links pathogenesis papulo-pus tulosis forms of rosacea by means of a wide spectrum of immunohistochemical markers became a research problem. For the decision of tasks in view by the author it is used biopsy a material of 11 diagnosed cases papulo-pus tulosis forms of rosacea at me at the age from 32 till 59 years. Use of immunohis-tochemical methods of research has allowed to reveal new links in pathogenesis of rosacea and to establish a role of some cellular populations of a skin and cages of immune system in progressing of disease and development papulo-pustulosis forms of rosacea. Authors have come to a conclusion that is possible, strengthening of pathological changes at papulo-pustulosis forms of rosacea is caused by presence of pincers which are capable to cause migration in skin CD68+ cages while quantity CD138+ plasmocytes was insignificant and didn't exceed 5-10 % in infiltrates. К i-67+ cages in a considerable quan-tity were as a part of sebaceous glands that specified in progressing hyperplastic changes in these appendages of a skin. Be-sides, the quantity of cages, pos itive on this marker, correlated wi th expressiveness of defeat of sebaceous glands in a greate r degree, than with a disease stage.

  16. Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study

    Directory of Open Access Journals (Sweden)

    Haeusler Karl

    2012-08-01

    Full Text Available Abstract Background Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent brain lesions during and after marathon running are missing. Methods/ Design In the prospective observational “Berlin Beat of Running” study experienced endurance athletes underwent clinical examination (CE, 3 Tesla brain magnetic resonance imaging (MRI, carotid ultrasound imaging (CUI and serial blood sampling (BS within 2-3 days prior (CE, MRI, CUI, BS, directly after (CE, BS and within 2 days after (CE, MRI, BS the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Results Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2% Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Discussion Findings from the “Berlin Beats of Running” study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link

  17. Eritema-papulosis form rosacea – results of immunohistochemical research of the condition of the lesions

    Directory of Open Access Journals (Sweden)

    Haritonova E.G.

    2011-01-01

    Full Text Available Studying and the analysis of links pathogenesis of eritema-papulosis forms of rosacea by means of a wide spec-trum of immunohistochemical markers became a research problem. Fo r the decision of tasks in view by the author it is used a material of 12 diagnosed cases eritema-papulosis forms of rosacea at men at the age from 32 till 64 years. Use of immunohis-tochemical methods of research has allowed to reveal new links in pathogenesis rosacea and to establish a role of some cellu-lar populations of a skin and cages of imm une system in disease progressing. Besides, at use of the offered scheme of treat-ment dynamics of immunohistochemical indicators was observed considerably more expressed at erit ema-papulosis forms. Treatment influence on an immune link was has been confirmed essential, concerning control, reduction of quantity CD4 + cages, and also changes in quantity CD1 а +, CD138 + that CD68 + cages. Essential re sult the offered scheme gives in a di-rection of suppression of fibrous changes in derma and myofib roblastic transformations dendroc ytes. Considerably the meta-bolism extracellular of matrix improves. Influence of treatment on a vascular component proves to be true reduction of densi-ty of vessels in parallel with decrease in expression VEGF.

  18. Cardiac Malpositions

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Shi Joon; Im, Chung Gie; Yeon, Kyung Mo; Hasn, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    Cardiac Malposition refers to any position of the heart other than a left-sided heart in a situs solitus individual. Associated cardiac malformations are so complex that even angiocardiographic and autopsy studies may not afford an accurate information. Although the terms and classifications used to describe the internal cardiac anatomy and their arterial connections in cardiac malpositions differ and tend to be confusing, common agreement exists on the need for a segmental approach to diagnosis. Authors present 18 cases of cardiac malpositions in which cardiac catheterization and angiocardiography were done at the Department of Radiology, Seoul National University Hospital between 1971 and 1979. Authors analyzed the clinical, radiographic, operative and autopsy findings with the emphasis on the angiocardiographic findings. The results are as follows: 1. Among 18 cases with cardiac malpositions, 6 cases had dextrocardia with situs inversus, 9 cases had dextrocardia with situs solitus and 3 cases had levocardia with situs inversus. 2. There was no genuine exception to visceroatrial concordance rule. 3. Associated cardiac malpositions were variable and complex with a tendency of high association of transposition and double outlet varieties with dextrocardia in situs solitus and levocardia in situs inversus. Only one in 6 cases of dextrocardia with situs inversus had pure transposition. 4. In two cases associated pulmonary atresia was found at surgery which was not predicted by angiocardiography. 5. Because many of the associated complex lesions can be corrected surgically provided the diagnosis is accurate, the selective biplane angiocardiography with or without cineradiography is essential.

  19. Cardiac lesions in patients with lethal central nervous system trauma Daño cardíaco en pacientes con trauma mortal del sistema nervioso central

    Directory of Open Access Journals (Sweden)

    María E. Cardona

    1991-03-01

    Full Text Available

    Fifteen men with lethal central nervous system trauma were studied to look for the presence of cardiac lesions. They were between 16 and 60 years of age with an average of 32. There were five gunshot wounds and nine central nervous system contusions; four of these occurred in traffic accidents. The remaining patient was wounded with a machete. AII patients were adequately treated since the beginning of their hospital stay and 14 were surgically managed. Average survival after trauma was 6.6 days. In every case there were ECG alterations, the most frequent being sinusal tachycardia. Creatine phosphokinase levels were high in all and the MB fraction was above normal levels in three patients in whom heart damage was confirmed at autopsy. In 40% of cases heart lesions were found and the most common was subendocardial hemorrhage. In an era of increasing need of organs for transplantation potential donors have to be thoroughly studied to determine if heart lesions have occurred and to decide if they are suitable as transplant organs.

    Analizamos los casos de 15 hombres con trauma mortal del sistema nervioso central. Sus edades fluctuaron entre 16 y 60 años con un promedio de 32. Las lesiones más frecuentes fueron por proyectil de arma de fuego (5 casos y por contusión (9 casos, cuatro de ellos en accidente de tránsito. El paciente restante fue lesionado con arma corto contundente. En todos los pacientes el manejo fue adecuado desde el principio de la hospitalización ya 14 se les hizo tratamiento quirúrgico. El promedio de sobrevida después del trauma fue 6.6 días. Sin excepción el estudio electrocardiográfico mostró alteraciones; la taquicardia sinusal fue la más frecuente. La CPK estuvo elevada en todos los pacientes; en 3 de ellos, con da

  20. Cardiac involvement in patients with systemic lupus erythematosus and correlation of valvular lesions with anti-Ro/SS-A and anti-La/SS-B antibody levels.

    Science.gov (United States)

    Shahin, Amira A; Shahin, Hesham A; Hamid, Magdy A; Amin, Mona A

    2004-01-01

    The aim of this study was to evaluate the incidence of morphologic and functional cardiac abnormalities in patients with systemic lupus erythematosus (SLE) and to correlate the findings with levels of anti-Ro/SS-A, anti-La/SS-B, and anti-cardiolipin antibody (aCL). Sixty-two patients with SLE were enrolled in this study. All patients underwent complete history taking, clinical assessment, and standard two-dimensional and Doppler echocardiography. Anti-Ro/SS-A, anti-La/SS-B, and aCL levels were measured using a standardized ELISA test. The patients were subdivided into two subgroups based on the presence or absence of valvular involvement. The two subgroups were then compared. Valvular involvement was present in 19 patients (30.6%), pericardial effusion in 12 patients (19.4%), impaired left ventricular relaxation abnormalities in 2 patients (3.2%), and pulmonary hypertension in 3 patients (4.8%). More patients in the valvular involvement group had positive anti-Ro/SS-A antibodies than in the valvular noninvolvement group (7/19 vs. 4/43). The difference was significant, with P anti-Ro/SS-A levels were significantly higher in the valvular involvement group (33.7 +/- 36.0 vs. 13.7 +/- 25.1; P anti-Ro/SS-A and anti-La/SS-B antibodies and the pathogenesis of the valvular lesions in SLE patients.

  1. Genistein promotes endothelial colony-forming cell (ECFC bioactivities and cardiac regeneration in myocardial infarction.

    Directory of Open Access Journals (Sweden)

    Sang Hun Lee

    Full Text Available Although stem cell-mediated treatment of ischemic diseases offers significant therapeutic promise, the limitation in the therapeutic efficacy of transplanted stem cells in vivo because of poor engraftment remains a challenge. Several strategies aimed at improving survival and engraftment of stem cells in the ischemic myocardium have been developed, such as cell transplantation in combination with growth factor delivery, genetic modification of stem cells, and/or cell therapy using scaffolds. To improve therapeutic efficacy, we investigated the effects of genistein on the engraftment of transplanted ECFCs in an acute myocardial ischemia model.We found that genistein treatment enhanced ECFCs' migration and proliferation, which was accompanied by increases in the expression of ILK, α-parvin, F-actin, and phospholylation of ERK 1/2 signaling. Transplantation of genistein-stimulates ECFCs (GS-ECFCs into myocardial ischemic sites in vivo induced cellular proliferation and secretion of angiogenic cytokines at the ischemic sites and thereby enhanced neovascularization and decreased myocardial fibrosis as well as improved cardiac function, as shown by echocardiography. Taken together, these data suggest that pretreatment of ECFCs with genistein prior to transplantation can improve the regenerative potential in ischemic tissues, providing a novel strategy in adult stem cell therapy for ischemic diseases.

  2. Stem cells can form gap junctions with cardiac myocytes and exert pro-arrhythmic effects

    Directory of Open Access Journals (Sweden)

    Nicoline Willemijn Smit

    2014-10-01

    Full Text Available Stem cell therapy has been suggested to be a promising option for regeneration of injured myocardium, for example following a myocardial infarction. For clinical use cell-based therapies have to be safe and applicable and are aimed to renovate the architecture of the heart. Yet for functional and coordinated activity synchronized with the host myocardium stem cells have to be capable of forming electrical connections with resident cardiomyocytes. In this paper we discuss whether stem cells are capable of establishing functional electrotonic connections with cardiomyocytes and whether these may generate a risk for arrhythmias. Application of stem cells in the clinical setting with outcomes concerning arrhythmogenic safety and future perspectives will also briefly be touched upon.

  3. Interconnecting smartphone, image analysis server, and case report forms in clinical trials for automatic skin lesion tracking in clinical trials

    Science.gov (United States)

    Haak, Daniel; Doma, Aliaa; Gombert, Alexander; Deserno, Thomas M.

    2016-03-01

    Today, subject's medical data in controlled clinical trials is captured digitally in electronic case report forms (eCRFs). However, eCRFs only insufficiently support integration of subject's image data, although medical imaging is looming large in studies today. For bed-side image integration, we present a mobile application (App) that utilizes the smartphone-integrated camera. To ensure high image quality with this inexpensive consumer hardware, color reference cards are placed in the camera's field of view next to the lesion. The cards are used for automatic calibration of geometry, color, and contrast. In addition, a personalized code is read from the cards that allows subject identification. For data integration, the App is connected to an communication and image analysis server that also holds the code-study-subject relation. In a second system interconnection, web services are used to connect the smartphone with OpenClinica, an open-source, Food and Drug Administration (FDA)-approved electronic data capture (EDC) system in clinical trials. Once the photographs have been securely stored on the server, they are released automatically from the mobile device. The workflow of the system is demonstrated by an ongoing clinical trial, in which photographic documentation is frequently performed to measure the effect of wound incision management systems. All 205 images, which have been collected in the study so far, have been correctly identified and successfully integrated into the corresponding subject's eCRF. Using this system, manual steps for the study personnel are reduced, and, therefore, errors, latency and costs decreased. Our approach also increases data security and privacy.

  4. Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

    Energy Technology Data Exchange (ETDEWEB)

    Widhalm, Harald K.; Marlovits, Stefan; Vecsei, Vilmos [Medical University of Vienna, Center for Joints and Cartilage, Department of Traumatology, Vienna (Austria); Welsch, Goetz H. [Medical University of Vienna, MR Center, Department of Radiology, Vienna (Austria); University Hospital of Erlangen, Department of Trauma Surgery, Erlangen (Germany); Dirisamer, Albert [Medical University of Vienna, Department of Radiology, Vienna (Austria); Neuhold, Andreas [Private Hospital Rudolfinerhaus, Department of Radiology, Vienna (Austria); Griensven, Martijn van [Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Vienna (Austria); Seemann, Rudolf [Medical University of Vienna, Department of Cranio-Maxillofacial and Oral Surgery, Vienna (Austria); Widhalm, Kurt [Medical University of Vienna, Division of Nutrition and Metabolism, Department of Pediatrics, Vienna (Austria)

    2012-03-15

    Overweight and obesity are afflictions that lead to an increased risk of health problems including joint problems. The aim of the study was to assess the condition of articular cartilage in obese adolescent patients suffering from knee pain. MRI of 24 knees of 20 morbidly obese patients, mean age 14.2 years, was performed in an open 1.0 Tesla MR system, where the cartilage, the quality and structure of the menisci, and the presence or absence of surrounding changes was examined. In all patients a cartilage lesion in at least one region of the knee could be detected. Retropatellar cartilage lesions have been found in 19 knees. Ten cartilage lesions grade I, and four lesions grade II have been described in the lateral compartment of the knee, whereas the medial compartment showed in eight cases a grade I, in 13 cases a grade II and in two cases a grade III cartilage lesion. Meniscal changes were assessed in most patients. Morbidly obese children and adolescents show major abnormalities in the articular cartilage of the knee. Whether obesity alone is the causal factor for the development of the pattern of these changes, remains to be seen. (orig.)

  5. Obesity-related juvenile form of cartilage lesions: a new affliction in the knees of morbidly obese children and adolescents

    International Nuclear Information System (INIS)

    Overweight and obesity are afflictions that lead to an increased risk of health problems including joint problems. The aim of the study was to assess the condition of articular cartilage in obese adolescent patients suffering from knee pain. MRI of 24 knees of 20 morbidly obese patients, mean age 14.2 years, was performed in an open 1.0 Tesla MR system, where the cartilage, the quality and structure of the menisci, and the presence or absence of surrounding changes was examined. In all patients a cartilage lesion in at least one region of the knee could be detected. Retropatellar cartilage lesions have been found in 19 knees. Ten cartilage lesions grade I, and four lesions grade II have been described in the lateral compartment of the knee, whereas the medial compartment showed in eight cases a grade I, in 13 cases a grade II and in two cases a grade III cartilage lesion. Meniscal changes were assessed in most patients. Morbidly obese children and adolescents show major abnormalities in the articular cartilage of the knee. Whether obesity alone is the causal factor for the development of the pattern of these changes, remains to be seen. (orig.)

  6. Atypical form of Alzheimer's disease with prominent posterior cortical atrophy: a review of lesion distribution and circuit disconnection in cortical visual pathways

    Science.gov (United States)

    Hof, P. R.; Vogt, B. A.; Bouras, C.; Morrison, J. H.; Bloom, F. E. (Principal Investigator)

    1997-01-01

    In recent years, the existence of visual variants of Alzheimer's disease characterized by atypical clinical presentation at onset has been increasingly recognized. In many of these cases post-mortem neuropathological assessment revealed that correlations could be established between clinical symptoms and the distribution of neurodegenerative lesions. We have analyzed a series of Alzheimer's disease patients presenting with prominent visual symptomatology as a cardinal sign of the disease. In these cases, a shift in the distribution of pathological lesions was observed such that the primary visual areas and certain visual association areas within the occipito-parieto-temporal junction and posterior cingulate cortex had very high densities of lesions, whereas the prefrontal cortex had fewer lesions than usually observed in Alzheimer's disease. Previous quantitative analyses have demonstrated that in Alzheimer's disease, primary sensory and motor cortical areas are less damaged than the multimodal association areas of the frontal and temporal lobes, as indicated by the laminar and regional distribution patterns of neurofibrillary tangles and senile plaques. The distribution of pathological lesions in the cerebral cortex of Alzheimer's disease cases with visual symptomatology revealed that specific visual association pathways were disrupted, whereas these particular connections are likely to be affected to a less severe degree in the more common form of Alzheimer's disease. These data suggest that in some cases with visual variants of Alzheimer's disease, the neurological symptomatology may be related to the loss of certain components of the cortical visual pathways, as reflected by the particular distribution of the neuropathological markers of the disease.

  7. 53BP1 nuclear bodies form around DNA lesions generated by mitotic transmission of chromosomes under replication stress

    DEFF Research Database (Denmark)

    Lukas, Claudia; Savic, Velibor; Bekker-Jensen, Simon;

    2011-01-01

    stress increases the frequency of chromosomal lesions that are transmitted to daughter cells. Throughout G1, these lesions are sequestered in nuclear compartments marked by p53-binding protein 1 (53BP1) and other chromatin-associated genome caretakers. We show that the number of such 53BP1 nuclear bodies...... increases after genetic ablation of BLM, a DNA helicase associated with dissolution of entangled DNA. Conversely, 53BP1 nuclear bodies are partially suppressed by knocking down SMC2, a condensin subunit required for mechanical stability of mitotic chromosomes. Finally, we provide evidence that 53BP1 nuclear...

  8. Multifocal vascular lesions.

    Science.gov (United States)

    Levin, Laura E; Lauren, Christine T

    2016-03-01

    Multifocal vascular lesions are important to recognize and appropriately diagnose. Generally first noticed on the skin, multifocal vascular lesions may have systemic involvement. Distinguishing among the different types of multifocal vascular lesions is often based on clinical features; however, radiological imaging and/or biopsy are frequently needed to identify distinct features and guide treatment. Knowledge of the systemic associations that can occur with different vascular anomalies may reduce life-threatening complications, such as coagulopathy, bleeding, cardiac compromise, and neurologic sequelae. This review provides a synopsis of the epidemiology, pathogenesis, presentation, workup, and treatment of several well-recognized multifocal vascular tumors and malformations. PMID:27607324

  9. [Cardiac amyloidosis].

    Science.gov (United States)

    Hoyer, Caroline; Angermann, Christiane E; Knop, Stefan; Ertl, Georg; Störk, Stefan

    2008-03-15

    Amyloidoses are a heterogeneous group of multisystem disorders, which are characterized by an extracellular deposition of amyloid fibrils. Typically affected are the heart, liver, kidneys, and nervous system. More than half of the patients die due to cardiac involvement. Clinical signs of cardiac amyloidosis are edema of the lower limbs, hepatomegaly, ascites and elevated jugular vein pressure, frequently in combination with dyspnea. There can also be chest pain, probably due to microvessel disease. Dysfunction of the autonomous nervous system or arrhythmias may cause low blood pressure, dizziness, or recurrent syncope. The AL amyloidosis caused by the deposition of immunoglobulin light chains is the most common form. It can be performed by monoclonal gammopathy. The desirable treatment therapy consists of high-dose melphalan therapy twice followed by autologous stem cell transplantation. Due to the high peritransplantation mortality, selection of appropriate patients is mandatory. The ATTR amyloidosis is an autosomal dominant disorder caused by the amyloidogenic form of transthyretin, a plasmaprotein that is synthesized in the liver. Therefore, liver transplantation is the only curative therapy. The symptomatic treatment of cardiac amyloidosis is based on the current guidelines for chronic heart failure according to the patient's New York Heart Association (NYHA) state. Further types of amyloidosis with possible cardiac involvement comprise the senile systemic amyloidosis caused by the wild-type transthyretin, secondary amyloidosis after chronic systemic inflammation, and the beta(2)-microglobulin amyloidosis after long-term dialysis treatment. PMID:18344065

  10. Insights into the clinical and functional significance of cardiac autonomic dysfunction in Chagas disease

    Directory of Open Access Journals (Sweden)

    Luiz Fernando Junqueira Junior

    2012-04-01

    Full Text Available INTRODUCTION: Exclusive or associated lesions in various structures of the autonomic nervous system occur in the chronic forms of Chagas disease. In the indeterminate form, the lesions are absent or mild, whereas in the exclusive or combined heart and digestive disease forms, they are often more pronounced. Depending on their severity these lesions can result mainly in cardiac parasympathetic dysfunction but also in sympathetic dysfunction of variable degrees. Despite the key autonomic effect on cardiovascular functioning, the pathophysiological and clinical significance of the cardiac autonomic dysfunction in Chagas disease remains unknown. METHODS: Review of data on the cardiac autonomic dysfunction in Chagas disease and their potential consequences, and considerations supporting the possible relationship between this disturbance and general or cardiovascular clinical and functional adverse outcomes. RESULTS: We hypothesise that possible consequences that cardiac dysautonomia might variably occasion or predispose in Chagas disease include: transient or sustained arrhythmias, sudden cardiac death, adverse overall and cardiovascular prognosis with enhanced morbidity and mortality, an inability of the cardiovascular system to adjust to functional demands and/or respond to internal or external stimuli by adjusting heart rate and other hemodynamic variables, and immunomodulatory and cognitive disturbances. CONCLUSIONS: Impaired cardiac autonomic modulation in Chagas disease might not be a mere epiphenomenon without significance. Indirect evidences point for a likely important role of this alteration as a primary predisposing or triggering cause or mediator favouring the development of subtle or evident secondary cardiovascular functional disturbances and clinical consequences, and influencing adverse outcomes.

  11. Dogs infected with the blood trypomastigote form of Trypanosoma cruzi display an increase expression of cytokines and chemokines plus an intense cardiac parasitism during acute infection.

    Science.gov (United States)

    de Souza, Sheler Martins; Vieira, Paula Melo de Abreu; Roatt, Bruno Mendes; Reis, Levi Eduardo Soares; da Silva Fonseca, Kátia; Nogueira, Nívia Carolina; Reis, Alexandre Barbosa; Tafuri, Washington Luiz; Carneiro, Cláudia Martins

    2014-03-01

    The recent increase in immigration of people from areas endemic for Chagas disease (Trypanosoma cruzi) to the United States and Europe has raised concerns about the transmission via blood transfusion and organ transplants in these countries. Infection by these pathways occurs through blood trypomastigotes (BT), and these forms of T. cruzi are completely distinct of metacyclic trypomastigotes (MT), released by triatomine vector, in relation to parasite-host interaction. Thus, research comparing infection with these different infective forms is important for explaining the potential impacts on the disease course. Here, we investigated tissue parasitism and relative mRNA expression of cytokines, chemokines, and chemokine receptors in the heart during acute infection by MT or BT forms in dogs. BT-infected dogs presented a higher cardiac parasitism, increased relative mRNA expression of pro-inflammatory and immunomodulatory cytokines and of the chemokines CCL3/MIP-1α, CCL5/RANTES, and the chemokine receptor CCR5 during the acute phase of infection, as compared to MT-infected dogs. These results suggest that infection with BT forms may lead to an increased immune response, as revealed by the cytokines ratio, but this kind of immune response was not able to control the cardiac parasitism. Infection with the MT form presented an increase in the relative mRNA expression of IL-12p40 as compared to that of IL-10 or TGF-β1. Correlation analysis showed increased relative mRNA expression of IFN-γ as well as IL-10, which may be an immunomodulatory response, as well as an increase in the correlation of CCL5/RANTES and its CCR5 receptor. Our findings revealed a difference between inoculum sources of T. cruzi, as vectorial or transfusional routes of T. cruzi infection may trigger distinct parasite-host interactions during the acute phase, which may influence immunopathological aspects of Chagas disease.

  12. Cardiac tumors: optimal cardiac MR sequences and spectrum of imaging appearances.

    LENUS (Irish Health Repository)

    O'Donnell, David H

    2012-02-01

    OBJECTIVE: This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors. CONCLUSION: Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

  13. Genetic Susceptibility to Cardiac and Digestive Clinical Forms of Chronic Chagas Disease: Involvement of the CCR5 59029 A/G Polymorphism.

    Science.gov (United States)

    de Oliveira, Amanda Priscila; Bernardo, Cássia Rubia; Camargo, Ana Vitória da Silveira; Ronchi, Luiz Sérgio; Borim, Aldenis Albaneze; de Mattos, Cinara Cássia Brandão; de Campos Júnior, Eumildo; Castiglioni, Lílian; Netinho, João Gomes; Cavasini, Carlos Eugênio; Bestetti, Reinaldo Bulgarelli; de Mattos, Luiz Carlos

    2015-01-01

    The clinical manifestations of chronic Chagas disease include the cardiac form of the disease and the digestive form. Not all the factors that act in the variable clinical course of this disease are known. This study investigated whether the CCR5Δ32 (rs333) and CCR5 59029 A/G (promoter region--rs1799987) polymorphisms of the CCR5 gene are associated with different clinical forms of chronic Chagas disease and with the severity of left ventricular systolic dysfunction in patients with chronic Chagas heart disease (CCHD). The antibodies anti-T. cruzi were identified by ELISA. PCR and PCR-RFLP were used to identify the CCR5Δ32 and CCR5 59029 A/G polymorphisms. The chi-square test was used to compare variables between groups. There was a higher frequency of the AA genotype in patients with CCHD compared with patients with the digestive form of the disease and the control group. The results also showed a high frequency of the AG genotype in patients with the digestive form of the disease compared to the other groups. The results of this study show that the CCR5Δ32 polymorphism does not seem to influence the different clinical manifestations of Chagas disease but there is involvement of the CCR5 59029 A/G polymorphism in susceptibility to the different forms of chronic Chagas disease. Besides, these polymorphisms do not influence left ventricular systolic dysfunction in patients with CCHD.

  14. Genetic Susceptibility to Cardiac and Digestive Clinical Forms of Chronic Chagas Disease: Involvement of the CCR5 59029 A/G Polymorphism.

    Directory of Open Access Journals (Sweden)

    Amanda Priscila de Oliveira

    Full Text Available The clinical manifestations of chronic Chagas disease include the cardiac form of the disease and the digestive form. Not all the factors that act in the variable clinical course of this disease are known. This study investigated whether the CCR5Δ32 (rs333 and CCR5 59029 A/G (promoter region--rs1799987 polymorphisms of the CCR5 gene are associated with different clinical forms of chronic Chagas disease and with the severity of left ventricular systolic dysfunction in patients with chronic Chagas heart disease (CCHD. The antibodies anti-T. cruzi were identified by ELISA. PCR and PCR-RFLP were used to identify the CCR5Δ32 and CCR5 59029 A/G polymorphisms. The chi-square test was used to compare variables between groups. There was a higher frequency of the AA genotype in patients with CCHD compared with patients with the digestive form of the disease and the control group. The results also showed a high frequency of the AG genotype in patients with the digestive form of the disease compared to the other groups. The results of this study show that the CCR5Δ32 polymorphism does not seem to influence the different clinical manifestations of Chagas disease but there is involvement of the CCR5 59029 A/G polymorphism in susceptibility to the different forms of chronic Chagas disease. Besides, these polymorphisms do not influence left ventricular systolic dysfunction in patients with CCHD.

  15. Giant Cardiac Cavernous Hemangioma.

    Science.gov (United States)

    Unger, Eric; Costic, Joseph; Laub, Glenn

    2015-07-01

    We report the case of an asymptomatic giant cardiac cavernous hemangioma in a 71-year-old man. The intracardiac mass was discovered incidentally during surveillance for his prostate cancer; however, the patient initially declined intervention. On presentation to our institution 7 years later, the lesion had enlarged significantly, and the patient consented to excision. At surgery, an 8 × 6.5 × 4.8 cm intracardiac mass located on the inferior heart border was excised with an intact capsule through a median sternotomy approach. The patient had an uneventful postoperative course. We discuss the diagnostic workup, treatment, and characteristics of this rare cardiac tumor. PMID:26140782

  16. Combined Therapeutic and Monitoring Ultrasonic Catheter for Cardiac Ablation Therapies.

    Science.gov (United States)

    Carias, Mathew; Hynynen, Kullervo

    2016-01-01

    This study evaluated the feasibility of a combined therapeutic and diagnostic ultrasonic catheter for cardiac ablation therapies. Ultrasound can be used to determine when diseased cardiac tissues have become fully coagulated through a method known as local harmonic motion imaging (LHMI). LHMI is an imaging modality for treatment monitoring that uses acoustic radiation force, displacement tracking and the different mechanical properties of viable and ablated tissues. In this study, we developed catheters that are capable of LHMI measurements. Experiments were conducted in phantoms, ex vivo cardiac samples and the in vivo beating hearts of healthy porcine subjects. In vivo experiments revealed that four of four epicardial sonications revealed a decrease in measured displacements from LHMI experiments and that when lower power was used, no lesions formed and there was no corresponding decrease in measured displacement amplitudes. In addition, two of three endocardial lesions were confirmed and corresponded to a decrease in the measured displacement amplitude. PMID:26431798

  17. Cardiac arrest

    Science.gov (United States)

    ... Article.jsp. Accessed June 16, 2014. Myerburg RJ, Castellanos A. Approach to cardiac arrest and life-threatening ... PA: Elsevier Saunders; 2011:chap 63. Myerburg RJ, Castellanos A. Cardiac arrest and audden aardiac death. In: ...

  18. Severe form of radiculo - myelo - neuropathy with meningo - encephalitis secondary to Angiostrongylus cantonensis infection: unusual corpus callosal lesions and serial magnetic resonance imaging findings.

    Science.gov (United States)

    Nalini, Atchayaram; Ramakrishna, Anil; Dekumoy, Paron; Kumar, Raju Ravi; Pakdee, Wallop; Saini, Jitender; Hegde, Vinay S

    2013-01-01

    A 43-year-old man presented with the symptoms of recurrent lower abdominal pain, malaise and loss of appetite of 3-week duration, followed by acute onset of generalized paresthesias, fever and headache which progressed over few days to quadriparesis, altered sensorium, urinary and fecal incontinence. He had consumed raw tongue, liver, gall bladder and testicles of monitor lizard (Varanus bengalensis). Blood picture showed eosinophilia and cerebrospinal fluid (CSF) analysis revealed elevated protein and eosinophilia. Serum and CSF serology was positive for angiostrongyliasis. Magnetic resonance imaging showed focal hyperintense lesions in the corpus callosum and brainstem and an enhancing lesion in the cerebellum. Post-contrast T1-weighted axial images of spine showed evidence of cervical cord hyperintense lesions and root enhancement. Susceptibility weighted images/phase images showed unusual feature of multiple hemorrhagic lesions in the posterior fossa and supratentorial areas. Diffusion showed no restriction of corpus callosal lesions. Patient was treated with the high dose parenteral steroids with albendazole and at 6-month follow-up and had a remarkable recovery. PMID:24005735

  19. Epidermodisplasia verruciforme: apresentação clínica com variadas formas de lesões Epidermodysplasia verruciformis: clinical presentation with varied forms of lesions

    Directory of Open Access Journals (Sweden)

    Naiana Bittencourt de Sá

    2011-08-01

    Full Text Available Epidermodisplasia verruciforme é uma genodermatose rara caracterizada por infecção disseminada por HPV, de caráter recessivo, com casos ligados ao cromossoma X. É caracterizada clinicamente por lesões maculares hipo ou hiperpigmentadas, lesões pitiríase versicolor like, verrugas planas e desenvolvimento precoce de carcinomas cutâneos. Descreve-se um caso de paciente com quadro clínico exuberante, apresentando todas as formas de lesões desta doença, inclusive presença de carcinoma espinocelular agressivo na faceEpidermodysplasia verruciformis is a rare inherited skin disorder spread by HPV, with cases linked to chromosome X. It is characterized by hypo- or hyper-pigmented macular lesions, pityriasis versicolor-like lesions and an early tendency to develop skin malignancies. We present a case of epidermodysplasia verruciformis with a variety of lesions such as multiple plane warts, pityriasis versicolor-like lesions and aggressive squamous cell carcinoma on the face

  20. Evolução e reversibilidade das lesões neurológicas e cardíacas em ovinos intoxicados experimentalmente por Ateleia glazioviana e Tetrapterys multiglandulosa Evolution and reversibility of neurologic and cardiac lesions in sheep caused by Ateleia glazioviana and Tetrapterys multiglandulosa

    Directory of Open Access Journals (Sweden)

    Milton B. Almeida

    2008-03-01

    podem ocorrer sinais nervosos sem evidências de lesões cardíacas.To determine the reversibility of neurological and cardiac lesions in Ateleia glazioviana and Tetrapterys multiglandulosa poisoning, 3 groups of four sheep each were fed orally with the plants. In Group 1, 2 and 3, when sheep with nervous signs showed considerable increase of symptoms and risk of death, the plant administration was suspended. Group 4 with two sheep was used as control. Sheep from Group 1, fed 10g/kg during 6 days of fresh A. glazioviana collected in autumn were euthanized 8, 11, 16, and 21 days after the start of the experiment; they had shown regression of nervous signs, but had progressive cardiac lesions. Sheep from Group 2, fed during 8 days the same dose of fresh A. glazioviana collected in spring, were euthanized on days 9, 23, 38 and 68; they had shown regression of nervous signs and had no cardiac lesions. This suggests that the plant is less toxic in spring. Sheep from Group 3, fed 10g/kg during 11 days dry and ground T. multiglandulosa mixed with concentrated food, were euthanized on days 33, 33, 92 and 92; they had shown regression of nervous signs, and cardiac lesions were less severe on day 33 than on day 92. These results indicate that nervous lesions are reversible after the end of feeding, but cardiac lesions are progressive after discontinuation of the plant administration; these can be afterwards reversible if the animals do not anymore show clinical signs or die as a consequence of the poisoning. Results of those and previous experiments show that lesions of the nervous system are induced by lower doses than cardiac lesions and occur within a shorter period, what suggests that in spontaneous cases cardiac signs are always preceded by nervous signs, and that nervous signs can occur in the absence of cardiac lesions.

  1. Magnetic Resonance Imaging of Benign Cardiac Masses: A Pictorial Essay

    Directory of Open Access Journals (Sweden)

    Thomas J Ward

    2013-01-01

    Full Text Available The differential diagnosis for a cardiac mass includes primary and metastatic neoplasms. While primary cardiac tumors are rare, metastatic disease to the heart is a common finding in cancer patients. Several "tumor-like" processes can mimic a true cardiac neoplasm with accurate diagnosis critical at guiding appropriate management. We present a pictorial essay of the most common benign cardiac masses and "mass-like" lesions with an emphasis on magnetic resonance imaging features.

  2. IS CONSANGUINEOUS MARRIAGE RESPONSIBLE FOR CONGENITAL CARDIAC AND EXTRA-CARDIAC ANOMALIES?

    OpenAIRE

    Nutan Nalini; Sudha

    2016-01-01

    BACKGROUND This article is about the stillbirth in which we found significant numbers of cardiac as well as extracardiac defects, in combination or separately. In this article, we would like to emphasize the anomalies found in consanguineous marriages. AIM To correlate the prevalence of cardiac as well as extracardiac anomalies in consanguineous marriages. Especially, here we would like to focus on the cardiac lesions. MATERIAL AND METHOD The study was ca...

  3. Hematoma disecante intramiocárdico: una forma poco frecuente de rotura cardíaca Intramyocardial dissecting haematoma: an unusual form of cardiac rupture

    Directory of Open Access Journals (Sweden)

    F.J. García Fernández

    2003-08-01

    Full Text Available El hematoma disecante intramiocárdico es una complicación mecánica del infarto agudo de miocardio que consiste en la formación de una neocavitación causada por la disección hemorrágica entre las fibras espirales miocárdicas y que se encuentra contenida dentro del miocardio. Es una rotura de pared libre que aparece en el 9% de las autopsias de roturas cardíacas postinfarto. Su diagnóstico es complejo y aparece en la mayor parte de los pacientes "postmortem". Comentamos el caso de un paciente de 69 años que sufrió un infarto posterolateral y fue tratado con angioplastia primaria/ stent en las primeras horas así como con ácido acetil salicílico, clopidogrel, heparina sódica y antagonistas de GPIIb-IIIa. En las siguientes horas presentó esta rara forma de rotura cardíaca que le llevó al shock cardiogénico y le causó la muerte. Se revisa la fisiopatología, diagnóstico y manejo de esta entidad que presenta una alta letalidad (90% en los pacientes tratados médicamente y cuyo único tratamiento es la cirugía.The intramyocardial dissecting haematoma is an unusual rupture of the left ventricular wall, complicating acute myocardial infarction. The mechanism is an hemorrhagic dissection among the spiral myocardial fibres creating a neocavitation limited by the myocardium. It appears in 9% of left ventricular wall ruptures, complicating acute myocardial infarction. Diagnosis is often difficult and in most of the cases it is post-mortem. We present the case report of a 69 year old patient who suffered a posterolateral acute myocardial infarction treated with primary PTCA/Stent plus AAS, clopidogrel, unfractioned heparin bolus and GP IIb- IIIa inhibitors. In the following few hours he suffered this unusual form of cardiac rupture that took him into cardiogenic shock and finally led to his death. The pathophysiology, diagnosis and management of this lethal complication of acute myocardial infarction (90% mortality in the medically

  4. Increased expression of phosphorylated forms of heat-shock protein-27 and p38MAPK in macrophage-rich regions of fibro-fatty atherosclerotic lesions in the rabbit.

    Science.gov (United States)

    Shafi, Shahida; Codrington, Rosalind; Gidden, Lewis Michael; Ferns, Gordon Ashley Anthony

    2016-02-01

    We aimed to assess the expression and distribution of Hsp27, pHsp27 (Ser82), p38MAPK and p-p38MAPK in fibro-fatty atherosclerotic lesions and the myocardium of hypercholesterolaemic rabbits. Male New Zealand white rabbits were fed a high-cholesterol diet for 18 weeks, maintaining serum cholesterol at approximately 20 mmol/l over this period. Aortic arch and myocardial tissues were analysed by Western blot, immunohistochemistry and double immunofluorescence. Plasma Hsp27 levels were measured by ELISA. There was a significant increase in the expression of monomeric and dimeric forms of Hsp27, together with pHsp27 (Ser82), p38MAPK and p-p38MAPK in the fibro-fatty atherosclerotic lesions (P < 0.01; P < 0.05; P < 0.001; and P < 0.001, respectively) and the myocardial tissues (P < 0.001) from the cholesterol-fed rabbits compared with equivalent tissues from controls when the plasma concentration was low. Immunohistochemical analysis of the fibro-fatty lesions showed marked increases in Hsp27 and pHsp27 (Ser82) immunoreactivity. Double immunostaining showed intense expression of pHsp27 and p-p38MAPK in regions that were rich in macrophages, suggesting a close association with these inflammatory cells, whereas, in regions rich in smooth muscle cells, only p-p38MAPK was found to be strongly expressed. An increased expression of pHsp27 (Ser82) was spatially associated with increased p-p38MAPK within fibro-fatty atherosclerotic lesions and was colocalized to regions rich in macrophages. The initial increase in plasma Hsp27 levels may reflect the increase in systemic inflammation and oxidative stress in the early phases of disease. The falling concentrations subsequently may be coincident with the development of the advanced atherosclerotic lesions.

  5. An overview of cardiac morphogenesis.

    Science.gov (United States)

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile

    2013-11-01

    Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In this article we review the different steps of heart development, focusing on the processes of alignment and septation. We also show, as often as possible, the links between abnormalities of cardiac development and the main congenital heart defects. The development of animal models has permitted the unraveling of many mechanisms that potentially lead to cardiac malformations. A next step towards a better knowledge of cardiac development could be multiscale cardiac modelling. PMID:24138816

  6. Cardiac rehabilitation

    Science.gov (United States)

    ... attack or other heart problem. You might consider cardiac rehab if you have had: Heart attack Coronary heart disease (CHD) Heart failure Angina (chest pain) Heart or heart valve surgery Heart transplant Procedures such as angioplasty and stenting In some ...

  7. Interventional cardiac catheterization.

    Science.gov (United States)

    Pihkala, J; Nykanen, D; Freedom, R M; Benson, L N

    1999-04-01

    Over the past decade, transcatheter interventions have become increasingly important in the treatment of patients with congenital heart lesions. These procedures may be broadly grouped as dilations (e.g., septostomy, valvuloplasty, angioplasty, and endovascular stenting) or as closures (e.g., vascular embolization and device closure of defects). Balloon valvuloplasty has become the treatment of choice for patients in all age groups with simple valvar pulmonic stenosis and, although not curative, seems at least comparable to surgery for congenital aortic stenosis in newborns to young adults. Balloon angioplasty is successfully applied to a wide range of aortic, pulmonary artery, and venous stenoses. Stents are useful in dilating lesions of which the intrinsic elasticity results in vessel recoil after balloon dilation alone. Catheter-delivered coils are used to embolize a wide range of arterial, venous, and prosthetic vascular connections. Although some devices remain investigational, they have been successfully used for closure of many arterial ducts and atrial and ventricular septal defects. In the therapy for patients with complex CHD, best results may be achieved by combining cardiac surgery with interventional catheterization. The cooperation among interventional cardiologists and cardiac surgeons was highlighted in a report of an algorithm to manage patients with tetralogy of Fallot or pulmonary atresia with diminutive pulmonary arteries, involving balloon dilation, coil embolization of collaterals, and intraoperative stent placement. In this setting, well-planned catheterization procedures have an important role in reducing the overall number of procedures that patients may require over a lifetime, with improved outcomes.

  8. Rescue of hereditary form of dilated cardiomyopathy by rAAV-mediated somatic gene therapy: Amelioration of morphological findings, sarcolemmal permeability, cardiac performances, and the prognosis of TO-2 hamsters

    OpenAIRE

    Kawada, Tomie; Nakazawa, Mikio; Nakauchi, Sakura; YAMAZAKI, Ken; Shimamoto, Ryoichi; Urabe, Masashi; Nakata, Jumi; Hemmi, Chieko; Masui, Fujiko; Nakajima, Toshiaki; Suzuki, Jun-ichi; Monahan, John; Sato, Hiroshi; Masaki, Tomoh; Ozawa, Keiya

    2002-01-01

    The hereditary form comprises ≈1/5 of patients with dilated cardiomyopathy (DCM) and is a major cause of advanced heart failure. Medical and socioeconomic settings require novel treatments other than cardiac transplantation. TO-2 strain hamsters with congenital DCM show similar clinical and genetic backgrounds to human cases that have defects in the δ-sarcoglycan (δ-SG) gene. To examine the long-term in vivo supplement of normal δ-SG gene driven by cytomegalovirus promoter, we analyzed the pa...

  9. Plaque vulnerability of coronary artery lesions is related to left ventricular dilatation as determined by optical coherence tomography and cardiac magnetic resonance imaging in patients with type 2 diabetes

    OpenAIRE

    Burgmaier, Mathias; Frick, Michael; Liberman, Ana; Battermann, Simone; Hellmich, Martin; Lehmacher, Walter; Jaskolka, Agnes; Marx, Nikolaus; Reith, Sebastian Berthold

    2013-01-01

    Background Patients with type 2 diabetes are at increased risk for both, left ventricular (LV)-dilatation and myocardial infarction (MI) following the rupture of a vulnerable plaque. This study investigated the to date incompletely understood relationship between plaque vulnerability and LV-dilatation using optical coherence tomography (OCT) and cardiac magnetic resonance imaging (CMR) in patients with type 2 diabetes and stable coronary artery disease. Methods CMR was performed in 58 patient...

  10. Microwave Treatment for Cardiac Arrhythmias

    Science.gov (United States)

    Hernandez-Moya, Sonia

    2009-01-01

    NASA seeks to transfer the NASA developed microwave ablation technology, designed for the treatment of ventricular tachycardia (irregular heart beat), to industry. After a heart attack, many cells surrounding the resulting scar continue to live but are abnormal electrically; they may conduct impulses unusually slowly or fire when they would typically be silent. These diseased areas might disturb smooth signaling by forming a reentrant circuit in the muscle. The objective of microwave ablation is to heat and kill these diseased cells to restore appropriate electrical activity in the heart. This technology is a method and apparatus that provides for propagating microwave energy into heart tissues to produce a desired temperature profile therein at tissue depths sufficient for thermally ablating arrhythmogenic cardiac tissue while preventing excessive heating of surrounding tissues, organs, and blood. A wide bandwidth double-disk antenna is effective for this purpose over a bandwidth of about six gigahertz. A computer simulation provides initial screening capabilities for an antenna such as antenna, frequency, power level, and power application duration. The simulation also allows optimization of techniques for specific patients or conditions. In comparison with other methods that involve direct-current pulses or radio frequencies below 1 GHz, this method may prove more effective in treating ventricular tachycardia. This is because the present method provides for greater control of the location, cross-sectional area, and depth of a lesion via selection of the location and design of the antenna and the choice of microwave power and frequency.

  11. Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary iodine-123 MIBG uptake

    International Nuclear Information System (INIS)

    Primary dysfunction of the autonomic nervous system can be observed in patients with Parkinson's disease and those with multiple system atrophy. However, the fate of the two diseases differs considerably and leads to different strategies for patient management. Differentiation of the two diseases currently requires a combination of several clinical and electrophysiological tests. First studies of myocardial innervation using iodine-123 metaiodobenzylguanidine (MIBG) indicated a possible role of scintigraphy for this purpose. An increase in the pulmonary uptake of 123I-MIBG has been reported in secondary dysautonomias. Whether sympathetic innervation of the lung is affected in primary dysautonomias is currently unknown. Therefore, cardiac and pulmonary uptake of 123I-MIBG was studied in 21 patients with Parkinson's disease, 7 patients with multiple system atrophy and 13 age- and sex-matched controls. Thoracic images were obtained in the anterior view 4 h after intravenous injection of 185 MBq 123I-MIBG, at which time the maximum neuronal uptake is reached. All patients with Parkinson's disease had significantly lower cardiac uptake of 123I-MIBG than patients with multiple system atrophy and controls. Sympathetic innervation of the lung was not affected in either disease. It is concluded that scintigraphy with 123I-MIBG appears to be a useful tool for differentiation between Parkinson's disease and multiple system atrophy early after onset of autonomic dysfunction. (orig.)

  12. Scintigraphic differentiation between two forms of primary dysautonomia early after onset of autonomic dysfunction: value of cardiac and pulmonary iodine-123 MIBG uptake

    Energy Technology Data Exchange (ETDEWEB)

    Reinhardt, M.J.; Juengling, F.D.; Krause, T.M. [Dept. of Nuclear Medicine, Freiburg University Hospital (Germany); Braune, S. [Dept. of Neurology, Freiburg University Hospital (Germany)

    2000-05-01

    Primary dysfunction of the autonomic nervous system can be observed in patients with Parkinson's disease and those with multiple system atrophy. However, the fate of the two diseases differs considerably and leads to different strategies for patient management. Differentiation of the two diseases currently requires a combination of several clinical and electrophysiological tests. First studies of myocardial innervation using iodine-123 metaiodobenzylguanidine (MIBG) indicated a possible role of scintigraphy for this purpose. An increase in the pulmonary uptake of {sup 123}I-MIBG has been reported in secondary dysautonomias. Whether sympathetic innervation of the lung is affected in primary dysautonomias is currently unknown. Therefore, cardiac and pulmonary uptake of {sup 123}I-MIBG was studied in 21 patients with Parkinson's disease, 7 patients with multiple system atrophy and 13 age- and sex-matched controls. Thoracic images were obtained in the anterior view 4 h after intravenous injection of 185 MBq {sup 123}I-MIBG, at which time the maximum neuronal uptake is reached. All patients with Parkinson's disease had significantly lower cardiac uptake of {sup 123}I-MIBG than patients with multiple system atrophy and controls. Sympathetic innervation of the lung was not affected in either disease. It is concluded that scintigraphy with {sup 123}I-MIBG appears to be a useful tool for differentiation between Parkinson's disease and multiple system atrophy early after onset of autonomic dysfunction. (orig.)

  13. Cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Dewey, Marc [Charite - Universitaetsmedizin Berlin (Germany). Inst. fuer Radiologie

    2011-07-01

    Computed tomography of the heart has become a highly accurate diagnostic modality that is attracting increasing attention. This extensively illustrated book aims to assist the reader in integrating cardiac CT into daily clinical practice, while also reviewing its current technical status and applications. Clear guidance is provided on the performance and interpretation of imaging using the latest technology, which offers greater coverage, better spatial resolution, and faster imaging. The specific features of scanners from all four main vendors, including those that have only recently become available, are presented. Among the wide range of applications and issues to be discussed are coronary artery bypass grafts, stents, plaques, and anomalies, cardiac valves, congenital and acquired heart disease, and radiation exposure. Upcoming clinical uses of cardiac CT, such as plaque imaging and functional assessment, are also explored. (orig.)

  14. Cardiac echinococcosis

    Directory of Open Access Journals (Sweden)

    Ivanović-Krstić Branislava A.

    2002-01-01

    Full Text Available Cardiac hydatid disease is rare. We report on an uncommon hydatid cyst localized in the right ventricular wall, right atrial wall tricuspid valve left atrium and pericard. A 33-year-old woman was treated for cough, fever and chest pain. Cardiac echocardiograpic examination revealed a round tumor (5.8 x 4 cm in the right ventricular free wall and two smaller cysts behind that tumor. There were cysts in right atrial wall and tricuspidal valve as well. Serologic tests for hydatidosis were positive. Computed tomography finding was consistent with diagnosis of hydatid cyst in lungs and right hylar part. Surgical treatment was rejected due to great risk of cardiac perforation. Medical treatment with albendazole was unsuccessful and the patient died due to systemic hydatid involvement of the lungs, liver and central nervous system.

  15. Metastatic Breast Cancer or Multiple Myeloma? Camouflage by Lytic Lesions

    OpenAIRE

    Bruce Hough; Adam Brufsky; Suzanne Lentzsch

    2010-01-01

    We report a case of a female with stage I infiltrating ductal carcinoma who received adjuvant therapy including trastuzumab. One year later she developed lytic lesions and was retreated with trastuzumab that was held after she developed symptomatic heart failure. Lytic lesions were attributed to relapse of breast cancer, and cardiac failure attributed to prior trastuzumab therapy. After complications necessitated multiple hospitalizations, a further workup revealed that the lytic lesions were...

  16. An overview of cardiac morphogenesis.

    OpenAIRE

    Schleich, Jean-Marc; Abdulla, Tariq; Summers, Ron; Houyel, Lucile

    2013-01-01

    International audience Accurate knowledge of normal cardiac development is essential for properly understanding the morphogenesis of congenital cardiac malformations that represent the most common congenital anomaly in newborns. The heart is the first organ to function during embryonic development and is fully formed at 8 weeks of gestation. Recent studies stemming from molecular genetics have allowed specification of the role of cellular precursors in the field of heart development. In th...

  17. Cardiac rhabdomyosarcoma

    OpenAIRE

    Chlumský, Jaromír; Holá, Dana; Hlaváček, Karel; Michal, Michal; Švec, Alexander; Špatenka, Jaroslav; Dušek, Jan

    2001-01-01

    Cardiac sarcoma is a very rare neoplasm and is difficult to diagnose. The case of a 51-year-old man with a left atrial tumour, locally recurrent three months after its surgical removal, is presented. Computed tomography showed metastatic spread to the lung parenchyma. On revised histology, the mass extirpated was a sarcoma. Because of the metastatic spread, further therapy was symptomatic only; the patient died 15 months after the first manifestation of his problems. Immunohistochemical stain...

  18. CARDIAC TRANSPLANTATION: AN ANESTHETIC CHALLENGE

    OpenAIRE

    Premalatha; Jayaraman,

    2014-01-01

    : Heart transplantation has emerged as the definitive therapy for patients with end-stage cardiomyopathy. The two most common forms of cardiac disease that lead to transplantation are ischemic cardiomyopathy and dilated cardiomyopathy, which together comprise approximately 90% of cases. The other less common forms of heart disease include viral cardiomyopathy, infiltrative cardiomyopathy, postpartum cardiomyopathy, valvular heart disease and congenital heart disease

  19. Percutaneous coronary angioplasty in a cardiac transplant recipient.

    OpenAIRE

    Gammage, M D; Shiu, M F; English, T A

    1988-01-01

    Two years after an orthotopic cardiac transplant a 28 year old man was found to have clinically significant stenosis of the right coronary artery at routine coronary angiography. This lesion was accompanied by a perfusion defect on exercise thallium scintigraphy. Percutaneous transluminal coronary angioplasty of the lesion improved the angiographic appearance of the stenosis and reduced the exercise thallium perfusion defect.

  20. Photoacoustic characterization of radiofrequency ablation lesions

    Science.gov (United States)

    Bouchard, Richard; Dana, Nicholas; Di Biase, Luigi; Natale, Andrea; Emelianov, Stanislav

    2012-02-01

    Radiofrequency ablation (RFA) procedures are used to destroy abnormal electrical pathways in the heart that can cause cardiac arrhythmias. Current methods relying on fluoroscopy, echocardiography and electrical conduction mapping are unable to accurately assess ablation lesion size. In an effort to better visualize RFA lesions, photoacoustic (PA) and ultrasonic (US) imaging were utilized to obtain co-registered images of ablated porcine cardiac tissue. The left ventricular free wall of fresh (i.e., never frozen) porcine hearts was harvested within 24 hours of the animals' sacrifice. A THERMOCOOLR Ablation System (Biosense Webster, Inc.) operating at 40 W for 30-60 s was used to induce lesions through the endocardial and epicardial walls of the cardiac samples. Following lesion creation, the ablated tissue samples were placed in 25 °C saline to allow for multi-wavelength PA imaging. Samples were imaged with a VevoR 2100 ultrasound system (VisualSonics, Inc.) using a modified 20-MHz array that could provide laser irradiation to the sample from a pulsed tunable laser (Newport Corp.) to allow for co-registered photoacoustic-ultrasound (PAUS) imaging. PA imaging was conducted from 750-1064 nm, with a surface fluence of approximately 15 mJ/cm2 maintained during imaging. In this preliminary study with PA imaging, the ablated region could be well visualized on the surface of the sample, with contrasts of 6-10 dB achieved at 750 nm. Although imaging penetration depth is a concern, PA imaging shows promise in being able to reliably visualize RF ablation lesions.

  1. CENTRAL AMYGDALA LESIONS AFFECT BEHAVIORAL AND AUTONOMIC BALANCE DURING STRESS IN RATS

    OpenAIRE

    Roozendaal, B.; Koolhaas, JM; Bohus, B

    1991-01-01

    The effects of a bilateral electrolytical lesion of the CEA on the behavioral and sympathetically induced cardiac response in the shock-probe/defensive-burying test have been analyzed in male Wistar rats. Lesions in the CEA failed to affect defensive burying and accompanying tachycardiac response as compared to sham-lesioned controls during the presentation of the electrified shock probe (unconditioned test). However, CEA lesioning attenuated the bradycardiac response and the immobility behav...

  2. Cardiac involvement in Erdheim- Chester disease: MRI findings and literature revision

    International Nuclear Information System (INIS)

    Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis, characterized by the involvement of several organs. The lesions may be skeletal or extra-skeletal: in particular, long bones, skin, lungs, and the cardiovascular and the central nervous systems can be affected. In this report, we describe a case of a 34-year-old man, who came to our observation with symptomatic ECD, for a correct assessment of the degree of cardiac involvement through magnetic resonance imaging (MRI)

  3. Study on the effect of collateral circulation on cardiac function in patients receiving percutaneous coronary intervention(PCI)for le-sions in single left anterior descending artery%侧支循环对前降支单支病变冠心病PCI手术患者心脏功能影响的研究

    Institute of Scientific and Technical Information of China (English)

    王微; 孟亮; 田志鹏; 赵鑫

    2015-01-01

    Objective To explore the effect of establishment of collateral circulation on cardiac function in patients receiving percutaneous coronary intervention( PCI)for treatment of lesions in single left anterior descending artery. Methods The clinical data of 284 patients receiving PCI for treatment of lesions in single left anterior descending artery during January 2012 to June 2014 were retrospectively analyzed. These patients were divided into without collateral circulation group(group A,Rentrop grade 0,n=150)and collateral circulation group(group B,Rentrop grades 1,2 and 3,n=134)according to the results of coronary angiography. The above-mentioned 134 patients were further divided into insilat-eral group(group B1,n=20),contralateral group(group B2,n=91)and insilateral﹢contralateral group(group B3,n=23)according to the source of collateral circulation. LVEDD,LVEDS,LVEF,E/A and plasma level of BNP were compared among all these groups immediately,1 month,3 and 6 months after operation. Results Postoperative cardiac function in all patients had been improved,but LVEDD,LVESD and plas-ma level of BNP in patients of group B were significantly lower than those of patients in group A( P ﹤0. 05),while LVEF and E/A were signifi-cantly higher than those of patients in group A( P ﹤0. 05). Among patients in group B,postoperative cardiac function of patients in group B3 was the best,followed by patients in group B2,and that of patients in group B1 was the worst. Conclusion The establishment of collateral circulation can significantly improve the cardiac function of patients receiving PC intervention in a single left anterior descending artery. Postoperative cardiac function of patients with insilateral﹢contralateral collateral circulation is the best,followed by cases with contralateral collateral circulation. The postoperative cardiac function in patients with insilateral collateral circulation is the worst.%目的:探讨侧支循环对前降支单支病变冠

  4. Cardiac autonomic nerve distribution and arrhythmia

    Institute of Scientific and Technical Information of China (English)

    Quan Liu; Dongmei Chen; Yonggang Wang; Xin Zhao; Yang Zheng

    2012-01-01

    OBJECTIVE: To analyze the distribution characteristics of cardiac autonomic nerves and to explore the correlation between cardiac autonomic nerve distribution and arrhythmia.DATA RETRIEVAL: A computer-based retrieval was performed for papers examining the distribution of cardiac autonomic nerves, using "heart, autonomic nerve, sympathetic nerve, vagus nerve, nerve distribution, rhythm and atrial fibrillation" as the key words.SELECTION CRITERIA: A total of 165 studies examining the distribution of cardiac autonomic nerve were screened, and 46 of them were eventually included.MAIN OUTCOME MEASURES: The distribution and characteristics of cardiac autonomic nerves were observed, and immunohistochemical staining was applied to determine the levels of tyrosine hydroxylase and acetylcholine transferase (main markers of cardiac autonomic nerve distribution). In addition, the correlation between cardiac autonomic nerve distribution and cardiac arrhythmia was investigated.RESULTS: Cardiac autonomic nerves were reported to exhibit a disordered distribution in different sites, mainly at the surface of the cardiac atrium and pulmonary vein, forming a ganglia plexus. The distribution of the pulmonary vein autonomic nerve was prominent at the proximal end rather than the distal end, at the upper left rather than the lower right, at the epicardial membrane rather than the endocardial membrane, at the left atrium rather than the right atrium, and at the posterior wall rather than the anterior wall. The main markers used for cardiac autonomic nerves were tyrosine hydroxylase and acetylcholine transferase. Protein gene product 9.5 was used to label the immunoreactive nerve distribution, and the distribution density of autonomic nerves was determined using a computer-aided morphometric analysis system.CONCLUSION: The uneven distribution of the cardiac autonomic nerves is the leading cause of the occurrence of arrhythmia, and the cardiac autonomic nerves play an important role in the

  5. Visceral leishmaniasis with cardiac involvement in a dog: a case report

    Directory of Open Access Journals (Sweden)

    Goicoa Ana

    2009-04-01

    Full Text Available Abstract A dog presented with cutaneous nodules, enlarged lymph nodes and oedema in limbs, face and abdomen. The diagnosis of visceral leishmaniasis was established by identification of Leishmania amastigotes within macrophages from skin and popliteal lymph node biopsies. At necropsy, lesions were found in different organs, but it was particularly striking to observe large areas of pallor in the myocardium. Histological examination revealed an intense chronic inflammatory reaction in many organs, and numerous macrophages were found to contain amastigote forms of Leishmania. The inflammatory reaction was especially severe in the heart, where large areas of the myocardium appeared infiltrated with huge numbers of mononuclear immune cells, causing cardiac muscle atrophy and degeneration. Despite the severe inflammation, the number of parasitized macrophages was low in the myocardium, as revealed by immunohistochemical staining of Leishmania amastigotes. Because cardiac involvement is not usually described in this condition, this dog represents a very rare case of canine visceral leishmaniasis with affection of the myocardium.

  6. Cardiac MRI in Athletes

    NARCIS (Netherlands)

    Luijkx, T.

    2012-01-01

    Cardiac magnetic resonance imaging (CMR) is often used in athletes to image cardiac anatomy and function and is increasingly requested in the context of screening for pathology that can cause sudden cardiac death (SCD). In this thesis, patterns of cardiac adaptation to sports are investigated with C

  7. Relationship between cardiac function and resting cerebral blood flow

    DEFF Research Database (Denmark)

    Henriksen, Otto M; Jensen, Lars T; Krabbe, Katja;

    2014-01-01

    a gender-related inverse association of increased low-to-high-frequency power ratio with CBF and fractional brain flow. The findings do not support a direct effect of cardiac function on CBF, but demonstrates gender-related differences in cardiac output distribution. We propose fractional brain flow......) and 2.4 l min(-1) m(-2), respectively, in females. No effects of cardiac output or cardiac index on CBF or structural signs of brain ageing were observed. However, fractional brain flow defined as the ratio of total brain flow to cardiac output was inversely correlated with cardiac index (r(2) = 0.22, P...... = 0.008) and furthermore lower in males than in females (8.6% versus 12.5%, P = 0.003). Fractional brain flow was also inversely correlated with cerebral white matter lesion grade, although this effect was not significant when adjusted for age. Frequency analysis of heart rate variability showed...

  8. Cardiac connexins and impulse propagation

    NARCIS (Netherlands)

    J.A. Jansen; T.A.B. van Veen; J.M.T. de Bakker; H.V.M. van Rijen

    2010-01-01

    Gap junctions form the intercellular pathway for cell-to-cell transmission of the cardiac impulse from its site of origin, the sinoatrial node, along the atria, the atrioventricular conduction system to the ventricular myocardium. The component parts of gap junctions are proteins called connexins (C

  9. Postmortem cardiac imaging in fetuses and children

    Energy Technology Data Exchange (ETDEWEB)

    Taylor, Andrew M. [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiorespiratory Division, Level 7, Old Nurses Home, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); Arthurs, Owen J. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); UCL Institute of Cardiovascular Science, London (United Kingdom); Sebire, Neil J. [UCL Institute of Cardiovascular Science, London (United Kingdom); Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Histopathology, London (United Kingdom)

    2015-04-01

    Fetal and pediatric cardiac autopsies have a crucial role in the counseling of parents with regard to both the cause of death of their child and the implications of such findings for future pregnancies, as well as for quality assurance of antenatal screening programs and antemortem diagnostic procedures. Postmortem imaging allows an opportunity to investigate the heart in situ prior to dissection, and both postmortem CT and postmortem MRI have shown excellent accuracy in detecting the majority of clinically significant cardiac lesions in the perinatal and pediatric population. As less-invasive autopsy becomes increasingly popular, clinical guidelines for maximal diagnostic yield in specific circumstances can be developed. (orig.)

  10. Unique psoriatic lesion versus multiple lesions

    Directory of Open Access Journals (Sweden)

    Anca Chiriac

    2014-10-01

    Full Text Available Aim: To evaluate the number of lesions of psoriasis and to find risk factors for multiple lesions. Material and Methods: 1,236 patients (male 54.13%, female 45.87% with psoriasis were seen over a period of 8 years in an Outpatient Clinic. Patients filled out questionnaires containing age at onset, number of lesions and location at the beginning of the disease, gender, type and localization of psoriasis at the time of clinical examination, psoriasis family history, previous treatment, comorbidities, and social status. Results: The number of psoriasis lesions correlates with: onset age of psoriasis (F=8.902, p=0.0029; age at the moment of clinical examination (F=8.902, p=0.0029; residence in rural area (χ2=8.589, p=0.00338, 95%CI; alcohol intake (χ2=16.47, p=0.00005, 95%CI; smoking (χ2=8.408, p=0.00373, 95%CI; occupation: workers/pupils/students (χ2=14.11, p=0.0069, 95%CI. Conclusions: There is a correlation between number of psoriatic lesions and some factors. Multiple lesions were observed in older patients, smokers and drinkers, coming from rural area and social active (workers and pupils/students. No correlation was statistically proved between number of lesions and gender, comorbidities and family history of psoriasis.

  11. Myocardial ischemic conditioning: Physiological aspects and clinical applications in cardiac surgery.

    Science.gov (United States)

    Bousselmi, Radhouane; Lebbi, Mohamed Anis; Ferjani, Mustapha

    2014-04-01

    Ischemia-reperfusion is a major determinant of myocardial impairment in patients undergoing cardiac surgery. The main goal of research in cardioprotection is to develop effective techniques to avoid ischemia-reperfusion lesions. Myocardial ischemic conditioning is a powerful endogenous cardioprotective phenomenon. First described in animals in 1986, myocardial ischemic conditioning consists of applying increased tolerance of the myocardium to sustained ischemia by exposing it to brief episodes of ischemia-reperfusion. Several studies have sought to demonstrate its effective cardioprotective action in humans and to understand its underlying mechanisms. Myocardial ischemic conditioning has two forms: ischemic preconditioning (IPC) when the conditioning stimulus is applied before the index ischemia and ischemic postconditioning when the conditioning stimulus is applied after it. The cardioprotective action of ischemic conditioning was reproduced by applying the ischemia-reperfusion stimulus to organs remote from the heart. This non-invasive manner of applying ischemic conditioning has led to its application in clinical settings. Clinical trials for the different forms of ischemic conditioning were mainly developed in cardiac surgery. Many studies suggest that this phenomenon can represent an interesting adjuvant to classical cardioprotection during on-pump cardiac surgery. Ischemic conditioning was also tested in interventional cardiology with interesting results. Finally, advances made in the understanding of mechanisms that underlie the cardioprotective action of ischemic conditioning have paved the way to a new form of myocardial conditioning which is pharmacological conditioning.

  12. Periodontal bone lesions

    International Nuclear Information System (INIS)

    In the course of life the periodontum is subject to changes which may be physiological or pathological. Intraoral radiographs give insight into the hard structures of the dentomaxillar region and provides information on lesions in the bone of the periodontum in that they show radiopacities and radiolucencies caused by such lesions. In this thesis the relation is investigated between the true shape and dimensions of periodontal bone lesions and their radiographic images. A method is developed and tested of making standardized and reproducible radiographs suitable for longitudinal studies of periodontal lesions. Also the possibility is demonstrated of an objective and reproducible interpretation of radiographic characteristics of periodontal bone lesions. (Auth.)

  13. Cardiac perception and cardiac control. A review.

    Science.gov (United States)

    Carroll, D

    1977-12-01

    The evidence regarding specific cardiac perception and discrimination, and its relationship to voluntary cardiac control, is critically reviewed. Studies are considered in three sections, depending on the method used to assess cardiac perception: questionnaire assessment, discrimination procedures, and heartbeat tracking. The heartbeat tracking procedure would appear to suffer least from interpretative difficulties. Recommendations are made regarding the style of analysis used to assess heartbeat perception in such tracking tasks. PMID:348240

  14. Papel do óxido nítrico no desenvolvimento de lesões cardíacas na fase aguda da infecção experimental pelo Trypanosoma cruzi Role of nitric oxide in the development of cardiac lesions during the acute phase of experimental infection by Trypanosoma cruzi

    Directory of Open Access Journals (Sweden)

    Cláudia Renata Bibiano Borges

    2009-04-01

    animals (3.98 vs 1.87%; p = 0.004 and in C57BL/6 animals deficient in inducible nitric oxide synthase (3.99 vs 2.4%; p = 0.013. The cardiac parasite load in inducible nitric oxide synthase-deficient C57BL/6 animals infected with the Colombian strain was significantly greater than in those infected with the Y strain (2.78 vs. 0.17 nests/mm²; p = 0.004, and also significantly greater than in the C57BL/6 infected with both the Colombian strain (2.78 vs 1.33 nests/mm²; p = 0.006 and Y strains (2.78 vs 0.53 nests/mm²; p = 0.005. The data confirm that nitric oxide has a role in parasite load control and suggest that it has a role in tissue protection, through controlling inflammation and potentially reducing cardiac lesions during the acute phase of Chagas disease.

  15. Cardiac fiber inpainting using cartan forms

    DEFF Research Database (Denmark)

    Puize, Emmanuel; Lombaert, Herve; Sporring, Jon;

    2013-01-01

    Recent progress in diffusion imaging has lead to in-vivo acquisitions of fiber orientation data in the beating heart. Current methods are however limited in resolution to a few short-axis slices. For this particular application and others where the diffusion volume is subsampled, partial or even...

  16. Consanguinity and complex cardiac anomalies with situs ambiguus.

    OpenAIRE

    Gatrad, A R; Read, A P; Watson, G. H.

    1984-01-01

    A survey of British born Asian and English populations of children with congenital cardiac anomalies showed an increased incidence in the Muslim Asian population of complex lesions with visceral heterotaxia. There is a very high incidence of parental consanguinity among Muslim Asian children with complex congenital cardiac anomalies that is even higher than in the general Muslim Asian population of the area studied. The evidence suggests an important recessive genetic component in complex car...

  17. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir

    2013-01-01

    Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

  18. Cutaneous alternariosis in a cardiac transplant recipient.

    Science.gov (United States)

    Gilmour, T K; Rytina, E; O'Connell, P B; Sterling, J C

    2001-02-01

    A 55-year-old male cardiac transplant recipient presented with cutaneous nodules on the limbs caused by Alternaria alternata. Oral fluconazole 200 mg daily for 3 weeks was ineffective. Itraconazole 100 mg oral daily was ceased when hyperglycaemia developed. Individual lesions were successfully treated with either curettage and cautery or double freeze-thaw cryotherapy. Alternaria spp. are ubiquitous fungal saprophytes which may cause cutaneous infections particularly in immunocompromised patients. PMID:11233722

  19. Alteration of cardiac progenitor cell potency in GRMD dogs.

    Science.gov (United States)

    Cassano, M; Berardi, E; Crippa, S; Toelen, J; Barthelemy, I; Micheletti, R; Chuah, M; Vandendriessche, T; Debyser, Z; Blot, S; Sampaolesi, M

    2012-01-01

    Among the animal models of Duchenne muscular dystrophy (DMD), the Golden Retriever muscular dystrophy (GRMD) dog is considered the best model in terms of size and pathological onset of the disease. As in human patients presenting with DMD or Becker muscular dystrophies (BMD), the GRMD is related to a spontaneous X-linked mutation of dystrophin and is characterized by myocardial lesions. In this respect, GRMD is a useful model to explore cardiac pathogenesis and for the development of therapeutic protocols. To investigate whether cardiac progenitor cells (CPCs) isolated from healthy and GRMD dogs may differentiate into myocardial cell types and to test the feasibility of cell therapy for cardiomyopathies in a preclinical model of DMD, CPCs were isolated from cardiac biopsies of healthy and GRMD dogs. Gene profile analysis revealed an active cardiac transcription network in both healthy and GRMD CPCs. However, GRMD CPCs showed impaired self-renewal and cardiac differentiation. Population doubling and telomerase analyses highlighted earlier senescence and proliferation impairment in progenitors isolated from GRMD cardiac biopsies. Immunofluorescence analysis revealed that only wt CPCs showed efficient although not terminal cardiac differentiation, consistent with the upregulation of cardiac-specific proteins and microRNAs. Thus, the pathological condition adversely influences the cardiomyogenic differentiation potential of cardiac progenitors. Using PiggyBac transposon technology we marked CPCs for nuclear dsRed expression, providing a stable nonviral gene marking method for in vivo tracing of CPCs. Xenotransplantation experiments in neonatal immunodeficient mice revealed a valuable contribution of CPCs to cardiomyogenesis with homing differences between wt and dystrophic progenitors. These results suggest that cardiac degeneration in dystrophinopathies may account for the progressive exhaustion of local cardiac progenitors and shed light on cardiac stemness in

  20. Cardiac cystic echinococcosis:Report of three cases

    Institute of Scientific and Technical Information of China (English)

    zge Alta; Sabit Sarkaya; Hakan Sal; Onur Yerlikhan; Kaan Krali

    2014-01-01

    We present a retrospective analysis of three cases of cardiac hydatidosis, who underwent surgery between 2010 and 2012. Two patients had a lesion in the interventricular septum, whereas one patient had the lesion in apicoinferior wall of LV. The diagnosis was made by echocardiography, but magnetic resonance imaging was utilized to assess cyst activity and extend of disease. All patients were placed on cardiopulmonary bypass. No postoperative complication or death occurred. The patients discharged uneventfully and all of them were free from hydatid disease at two years follow-up. We concluded that cardiac hydatid cysts should be removed surgically regardless of their location or extent, even in asymptomatic patients.

  1. CENTRAL AMYGDALA LESIONS AFFECT BEHAVIORAL AND AUTONOMIC BALANCE DURING STRESS IN RATS

    NARCIS (Netherlands)

    ROOZENDAAL, B; KOOLHAAS, JM; BOHUS, B

    1991-01-01

    The effects of a bilateral electrolytical lesion of the CEA on the behavioral and sympathetically induced cardiac response in the shock-probe/defensive-burying test have been analyzed in male Wistar rats. Lesions in the CEA failed to affect defensive burying and accompanying tachycardiac response as

  2. Unique type of isolated cardiac valvular amyloidosis

    Directory of Open Access Journals (Sweden)

    Reehana Salma

    2006-10-01

    Full Text Available Abstract Background Amyloid deposition in heart is a common occurrence in systemic amyloidosis. But localised valvular amyloid deposits are very uncommon. It was only in 1922 that the cases of valvular amyloidosis were reported. Then in 1980, Goffin et al reported another type of valvular amyloidosis, which he called the dystrophic valvular amyloidosis. We report a case of aortic valve amyloidosis which is different from the yet described valvular amyloidosis. Case presentation A 72 years old gentleman underwent urgent aortic valve replacement. Intraoperatively, a lesion was found attached to the inferior surface of his bicuspid aortic valve. Histopathology examination of the valve revealed that the lesion contained amyloid deposits, identified as AL amyloidosis. The serum amyloid A protein (SAP scan was normal and showed no evidence of systemic amyloidosis. The ECG and echocardiogram were not consistent with cardiac amyloidosis. Conclusion Two major types of cardiac amyloidosis have been described in literature: primary-myelomatous type (occurs with systemic amyolidosis, and senile type(s. Recently, a localised cardiac dystrophic valvular amyloidosis has been described. In all previously reported cases, there was a strong association of localised valvular amyloidosis with calcific deposits. Ours is a unique case which differs from the previously reported cases of localised valvular amyloidosis. In this case, the lesion was not associated with any scar tissue. Also there was no calcific deposit found. This may well be a yet unknown type of isolated valvular amyloidosis.

  3. Magnetic Resonance Imaging Evaluation of Cardiac Masses

    Energy Technology Data Exchange (ETDEWEB)

    Braggion-Santos, Maria Fernanda, E-mail: ferbraggion@yahoo.com.br [Divisão de Cardiologia do Departamento de Clínica Médica - Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Hospital Universitário - Universidade de Heidelberg, Heidelberg (Germany); Koenigkam-Santos, Marcel [Centro de Ciências das Imagens e Física Médica - Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Hospital Universitário - Universidade de Heidelberg, Heidelberg (Germany); Teixeira, Sara Reis [Centro de Ciências das Imagens e Física Médica - Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Volpe, Gustavo Jardim [Divisão de Cardiologia do Departamento de Clínica Médica - Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Divisão de Cardiologia - Universidade Johns Hopkins, Baltimore (United States); Trad, Henrique Simão [Centro de Ciências das Imagens e Física Médica - Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo, Ribeirão Preto, SP (Brazil); Schmidt, André [Divisão de Cardiologia do Departamento de Clínica Médica - Hospital das Clínicas - Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP (Brazil)

    2013-09-15

    Cardiac tumors are extremely rare; however, when there is clinical suspicion, proper diagnostic evaluation is necessary to plan the most appropriate treatment. In this context, cardiovascular magnetic resonance imaging (CMRI) plays an important role, allowing a comprehensive characterization of such lesions. To review cases referred to a CMRI Department for investigation of cardiac and paracardiac masses. To describe the positive case series with a brief review of the literature for each type of lesion and the role of cardiovascular magnetic resonance imaging in evaluation. Between August 2008 and December 2011, all cases referred for CMRI with suspicion of tumor involving the heart were reviewed. Cases with positive histopathological diagnosis, clinical evolution or therapeutic response compatible with the clinical suspicion and imaging findings were selected. Among the 13 cases included in our study, eight (62%) had histopathological confirmation. We describe five benign tumors (myxomas, rhabdomyoma and fibromas), five malignancies (sarcoma, lymphoma, Richter syndrome involving the heart and metastatic disease) and three non-neoplastic lesions (pericardial cyst, intracardiac thrombus and infectious vegetation). CMRI plays an important role in the evaluation of cardiac masses of non-neoplastic and neoplastic origin, contributing to a more accurate diagnosis in a noninvasive manner and assisting in treatment planning, allowing safe clinical follow-up with good reproducibility.

  4. Presence of satellite cells in a cardiac rhabdomyoma.

    Science.gov (United States)

    Trillo, A A; Holleman, I L; White, J T

    1978-05-01

    Cardiac rhabdomyoma is the most common tumour of the heart in infancy and childhood. The clinical presentation, diagnosis and histopathological characteristics have been extensively studied; however, reports on the ultrastructure and histogenesis of this lesion are scanty and inconclusive. The case to be discussed is that of a 10-year-old male who presented with a cardiac rhabdomyoma occupying almost the entire ventricular apex. Ultrastructurally, the rhabdomyoma cells have a central, deeply-indented nucleus surrounded by an admixture of mitochondria and sarcomeres. The remainder of the cytoplasm is occupied by pools of glycogen granules, randomly-orientated myofibrils and small mitochondria. Intercellular junctions are numerous and consist of alternating zonula occludens and macula adherens. Typical satellite cells, sharing a common basement lamina are seen apposed to the rhabdomyoma cells. It is tempting to postulate that the proliferation of the rhabdomyoma cells is accomplished by differentiation of satellite cells, a process known to occur in skeletal muscle. Ultrastructurally, the rhabdomyoma cells are indistinguishable from Purkinje cells. The presence of Purkinje-like cells in ectopic locations within the heart and their association with satellite cells is likely a form of embryological atavism. PMID:669594

  5. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S;

    2009-01-01

    This chapter focusses on the probability of a caries lesion detected during a clinical examination being active (progressing) or arrested. Visual and tactile methods to assess primary coronal lesions and primary root lesions are considered. The evidence level is rated as low (R(w)), as there are...... response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee. The...... literature suggests that there is a fair agreement between visual/tactile external scripts of caries and the severity/depth of the lesion. The reproducibility of the different systems is, in general, substantial. No single clinical predictor is able to reliably assess activity. However, a combination of...

  6. Cardiac sodium channelopathies

    NARCIS (Netherlands)

    A.S. Amin; A. Asghari-Roodsari; H.L. Tan

    2010-01-01

    Cardiac sodium channel are protein complexes that are expressed in the sarcolemma of cardiomyocytes to carry a large inward depolarizing current (I-Na) during phase 0 of the cardiac action potential. The importance of I-Na for normal cardiac electrical activity is reflected by the high incidence of

  7. Ghost cell lesions

    Directory of Open Access Journals (Sweden)

    E Rajesh

    2015-01-01

    Full Text Available Ghost cells have been a controversy for a long time. Ghost cell is a swollen/enlarged epithelial cell with eosnophilic cytoplasm, but without a nucleus. In routine H and E staining these cells give a shadowy appearance. Hence these cells are also called as shadow cells or translucent cells. The appearance of these cells varies from lesion to lesion involving odontogenic and nonodontogenic lesions. This article review about the origin, nature and significance of ghost cells in different neoplasms.

  8. Cardiac metastasis from colorectal cancer: A case report

    Institute of Scientific and Technical Information of China (English)

    Pyong Wha Choi; Chul Nam Kim; Sun Hee Chang; Woo Ik Chang; Chang Young Kim; Hyun Min Choi

    2009-01-01

    The heart is an unusual site of metastasis from any malignancy. We report a case of cardiac metastasis from colorectal cancer. A 70-year-old woman was referred with a presumptive diagnosis of sigmoid colon cancer with cardiac myxoma. Two-dimensional echocardiography showed a 4 cm × 4.5 cm mobile mass on the lateral right atrial wall, and computed tomography revealed a low attenuated lobulating mass in the right atrium. The patient underwent anterior resection for sigmoid colon cancer (T4N2). Thereafter, she experienced progressive shortness of breath. Therefore, a cardiac operation was performed 2 wk after the colorectal operation.Histological examination revealed adenocarcinoma,which was identical to the primary lesion. Although twodimensional echocardiography has become the diagnostic test of choice for detecting cardiac tumors, in patients with colorectal cancer showing a cardiac mass, further diagnostic evaluation such as a magnetic resonance imaging might be necessary.

  9. Incretin attenuates diabetes-induced damage in rat cardiac tissue.

    Science.gov (United States)

    AbdElmonem Elbassuoni, Eman

    2014-09-01

    Glucagon-like peptide-1 (GLP-1), as a member of the incretin family, has a role in glucose homeostasis, its receptors distributed throughout the body, including the heart. The aim was to investigate cardiac lesions following diabetes induction, and the potential effect of GLP-1 on this type of lesions and the molecular mechanism driving this activity. Adult male rats were classified into: normal, diabetic, 4-week high-dose exenatide-treated diabetic rats, 4-week low-dose exenatide-treated diabetic rats, and 1-week exenatide-treated diabetic rats. The following parameters were measured: in blood: glucose, insulin, lactate dehydrogenase (LDH), total creatine kinase (CK), creatine kinase MB isoenzyme (CK-MB), and CK-MB relative index; in cardiac tissue: lipid peroxide (LPO) and some antioxidant enzymes. The untreated diabetic group displayed significant increases in blood level of glucose, LDH, and CK-MB, and cardiac tissue LPO, and a significant decrease in cardiac tissue antioxidant enzymes. GLP-1 supplementation in diabetic rats definitely decreased the hyperglycemia and abolished the detrimental effects of diabetes on the cardiac tissue. The effect of GLP-1 on blood glucose and on the heart also appeared after a short supplementation period (1 week). It can be concluded that GLP-1 has beneficial effects on diabetes-induced oxidative cardiac tissue damage, most probably via its antioxidant effect directly acting on cardiac tissue and independent of its hypoglycemic effect. PMID:25011640

  10. Hyperkalaemia, cardiac arrhythmias, and cerebral lesions in high risk neonates.

    OpenAIRE

    Shortland, D; Trounce, J Q; Levene, M I

    1987-01-01

    The case notes of 20 infants with hyperkalaemia (defined as two successive serum potassium measurements of greater than 7.5 mmol/l) were reviewed. The incidence of hyperkalaemia was also looked at in an unselected population of 200 low birthweight infants. The mean gestational age of the 20 affected infants was 29 weeks and the mean birth weight 1235 g. The incidence of hyperkalemia in the cohort of 200 infants weighing less than 1500 g at birth was 3.5%. Hyperkalaemia was associated with a h...

  11. Microbiological aspects of endoperiodontal lesion

    Directory of Open Access Journals (Sweden)

    Cristiane Tokunaga

    2013-06-01

    Full Text Available Introduction: The endoperiodontal lesion occurs when a tooth undergoing endodontic disease is united to a periodontal lesion with apical progression. Many times, the differential diagnosis between the endodontic and periodontal disease can be of difficult execution and the correct diagnosis and planing of the treatment is of main importance for a good prognosis Objective: To identify the main microorganisms within the lesion of endodontic and periodontal origin and correlate them with the endoperiodontal lesion. Literature review: The search strategy comprised the electronic studies of databases such as PubMed and Cochrane on the microbiology of the endodontic and periodontal systems through employing the following keywords: microbiology, endodontics, periodontal pocket. Results: There were similarities in the endodontic and periodontal microflora. However, the number of microorganisms within the cross infection is limited, including Bacteroides, Eubacteria, Fusobacteria, spirochaetes, Wolinella. The bacterias forming the red complex are closely related to the severity of the periodontal disease and can also participate in the pathogenesis of the periradicular abscesses. Conclusion: There are many communication routes between the periodontium and pulpal tissue, therefore the contamination from um tissue to another can occur, existing a microbiological inter-relationship between these tissues.

  12. Chronic radiodermatitis following cardiac catheterisation: a report of two cases and a brief review of the literature.

    Science.gov (United States)

    Dehen, L; Vilmer, C; Humilière, C; Corcos, T; Pentousis, D; Ollivaud, L; Chatelain, D; Dubertret, L

    1999-03-01

    Cardiac angiography produces one of the highest radiation exposures of any commonly used diagnostic x ray procedure. Recently, serious radiation induced skin injuries have been reported after repeated therapeutic interventional procedures using prolonged fluoroscopic imaging. Two male patients, aged 62 and 71 years, in whom chronic radiodermatitis developed one to two years after two consecutive cardiac catheterisation procedures are reported. Both patients had undergone lengthy procedures using prolonged fluoroscopic guidance in a limited number of projections. The resulting skin lesions were preceded, in one case, by an acute erythema and took the form of a delayed pigmented telangiectatic, indurated, or ulcerated plaque in the upper back or below the axilla whose site corresponded to the location of the x ray tube during cardiac catheterisation. Cutaneous side effects of radiation exposure result from direct damage to the irradiated tissue and have known thresholds. The diagnosis of radiation induced skin injury relies essentially on clinical and histopathological findings, location of skin lesions, and careful medical history. Interventional cardiologists should be aware of this complication, because chronic radiodermatitis may result in painful and resistant ulceration and eventually in squamous cell carcinoma.

  13. Cardiac tumours in children

    Directory of Open Access Journals (Sweden)

    Parsons Jonathan M

    2007-03-01

    Full Text Available Abstract Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT and Magnetic Resonance Imaging (MRI of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor.

  14. Postmortem MR quantification of the heart for characterization and differentiation of ischaemic myocardial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Zech, Wolf-Dieter; Schwendener, Nicole; Jackowski, Christian [University of Bern, Institute of Forensic Medicine, Bern (Switzerland); Persson, Anders; Warntjes, Marcel J. [University of Linkoeping, Center for Medical Image Science and Visualization (CMIV), Linkoeping (Sweden)

    2015-07-15

    Recently, an MRI quantification sequence has been developed which can be used to acquire T1- and T2-relaxation times as well as proton density (PD) values. Those three quantitative values can be used to describe soft tissue in an objective manner. The purpose of this study was to investigate the applicability of quantitative cardiac MRI for characterization and differentiation of ischaemic myocardial lesions of different age. Fifty post-mortem short axis cardiac 3 T MR examinations have been quantified using a quantification sequence. Myocardial lesions were identified according to histology and appearance in MRI images. Ischaemic lesions were assessed for mean T1-, T2- and proton density values. Quantitative values were plotted in a 3D-coordinate system to investigate the clustering of ischaemic myocardial lesions. A total of 16 myocardial lesions detected in MRI images were histologically characterized as acute lesions (n = 8) with perifocal oedema (n = 8), subacute lesions (n = 6) and chronic lesions (n = 2). In a 3D plot comprising the combined quantitative values of T1, T2 and PD, the clusters of all investigated lesions could be well differentiated from each other. Post-mortem quantitative cardiac MRI is feasible for characterization and discrimination of different age stages of myocardial infarction. (orig.)

  15. Cardiac Assessment.

    Science.gov (United States)

    Fritz, Deborah; McKenzie, Patricia

    2015-10-01

    Heart disease remains the number one cause of mortality in both men and women in the United States and patients with heart failure are at high risk for hospitalization. Thirty-day readmission rates have become a benchmark for hospitals and home healthcare agency reimbursement. Physical exam and history taking are essential to evaluate patients with suspected or known heart disease, and to detect early symptoms of worsening heart failure. Home care clinicians have the opportunity to assess the patient in the home environment, identify significant changes in the patient's status, and form a plan of care for effective intervention to prevent the need for emergency department care or rehospitalization. In this second article of a four-part series, the subjective and objective assessment of the cardiovascular system exam is reviewed. PMID:26418104

  16. Stimulating endogenous cardiac regeneration

    Directory of Open Access Journals (Sweden)

    Amanda eFinan

    2015-09-01

    Full Text Available The healthy adult heart has a low turnover of cardiac myocytes. The renewal capacity, however, is augmented after cardiac injury. Participants in cardiac regeneration include cardiac myocytes themselves, cardiac progenitor cells, and peripheral stem cells, particularly from the bone marrow compartment. Cardiac progenitor cells and bone marrow stem cells are augmented after cardiac injury, migrate to the myocardium, and support regeneration. Depletion studies of these populations have demonstrated their necessary role in cardiac repair. However, the potential of these cells to completely regenerate the heart is limited. Efforts are now being focused on ways to augment these natural pathways to improve cardiac healing, primarily after ischemic injury but in other cardiac pathologies as well. Cell and gene therapy or pharmacological interventions are proposed mechanisms. Cell therapy has demonstrated modest results and has passed into clinical trials. However, the beneficial effects of cell therapy have primarily been their ability to produce paracrine effects on the cardiac tissue and recruit endogenous stem cell populations as opposed to direct cardiac regeneration. Gene therapy efforts have focused on prolonging or reactivating natural signaling pathways. Positive results have been demonstrated to activate the endogenous stem cell populations and are currently being tested in clinical trials. A potential new avenue may be to refine pharmacological treatments that are currently in place in the clinic. Evidence is mounting that drugs such as statins or beta blockers may alter endogenous stem cell activity. Understanding the effects of these drugs on stem cell repair while keeping in mind their primary function may strike a balance in myocardial healing. To maximize endogenous cardiac regeneration,a combination of these approaches couldameliorate the overall repair process to incorporate the participation ofmultiple cell players.

  17. Reversible focal splenial lesions

    Energy Technology Data Exchange (ETDEWEB)

    Gallucci, Massimo; Limbucci, Nicola [University of L' Aquila, Department of Radiology, S. Salvatore Hospital, L' Aquila (Italy); Paonessa, Amalia [Loreto Nuovo Hospital, Department of Neuroradiology, Napoli (Italy); Caranci, Ferdinando [Federico II University, Department of Neurological Sciences, Napoli (Italy)

    2007-07-15

    Reversible focal lesions in the splenium of the corpus callosum (SCC) have recently been reported.They are circumscribed and located in the median aspect of the SCC. On MRI, they are hyperintense on T2-W and iso-hypointense on T1-W sequences, with no contrast enhancement. On DWI, SCC lesions are hyperintense with low ADC values, reflecting restricted diffusion due to cytotoxic edema. The common element is the disappearance of imaging abnormalities with time, including normalization of DWI. Clinical improvement is often reported. The most established and frequent causes of reversible focal lesions of the SCC are viral encephalitis, antiepileptic drug toxicity/withdrawal and hypoglycemic encephalopathy. Many other causes have been reported, including traumatic axonal injury. The similar clinical and imaging features suggest a common mechanism induced by different pathological events leading to the same results. Edema and diffusion restriction in focal reversible lesions of the SCC have been attributed to excitotoxic mechanisms that can result from different mechanisms; no unifying relationship has been found to explain all the pathologies associated with SCC lesions. In our opinion, the similar imaging, clinical and prognostic aspects of these lesions depend on a high vulnerability of the SCC to excitotoxic edema and are less dependent on the underlying pathology. In this review, the relevant literature concerning reversible focal lesions in the SCC is analyzed and hypotheses about their pathogenesis are proposed. (orig.)

  18. Intraosseous osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Adler, C.P.; Wenz, W.

    1981-10-01

    Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

  19. Oral Lesions in Neonates

    Science.gov (United States)

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  20. Intraocular lymphoma after cardiac transplantation: Magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yi Kyung; Kim, Hyung Jin; Woo, Kyung In; Kim, Yoon Duck [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-01-15

    We report a case of intraocular lymphoma in a 65-year-old man, 15 months after cardiac transplantation. On Magnetic Resonance (MR) images, the iris and the anterior chamber of the right eye were found to be involved with an enhancing soft-tissue lesion. To our knowledge, this is the first case of post-transplantation intraocular lymphoma evaluated with MR imaging.

  1. Cardiac ryanodine receptor gene (hRyR2) mutation underlying catecholaminergic polymorphic ventricular tachycardia in a Chinese adolescent presenting with sudden cardiac arrest and cardiac syncope

    Institute of Scientific and Technical Information of China (English)

    Ngai-Shing Mok; Ching-Wan Lam; Nai-Chung Fong; Yim-Wo Hui; Yuen-Choi Choi; Kwok-Yin Chan

    2006-01-01

    @@ Sudden cardiac death (SCD) in children and adolescents is uncommon and yet it is devastating for both victim's family and the society.Recently, it was increasingly recognized that SCD in young patients with structurally normal heart may be caused by inheritable primary electrical diseases due to the malfunction of cardiac ion channels, a disease entity known as the ion channelopathies.Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a specific form of ion channelopathy which can cause cardiac syncope or SCD in young patients by producing catecholamine-induced bi-directional ventricular tachycardia (BiVT), polymorphic VT and ventricular fibrillation (VF) during physical exertion or emotion.1-7 We reported here an index case of CPVT caused by cardiac ryanodine receptor gene (hRyR2)mutation which presented as cardiac syncope and sudden cardiac arrest in a Chinese adolescent female.

  2. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L;

    2016-01-01

    The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental ...

  3. Diffuse cavitary lung lesions

    Energy Technology Data Exchange (ETDEWEB)

    Grunzke, Mindy; Garrington, Timothy [University of Colorado Denver, Department of Pediatrics, Aurora, CO (United States); The Children' s Hospital, Rick Wilson Center for Cancer and Blood Disorders, Aurora, CO (United States); Hayes, Kari [The Children' s Hospital, Pediatric Radiology, Aurora, CO (United States); Bourland, Wendy [Children' s Hospital at St. Francis, Warren Clinic, Inc., Tulsa, OK (United States)

    2010-02-15

    An 11-year-old girl presented with a 2-month history of progressively worsening cough, daily fevers, and weight loss. A chest radiograph revealed multiple cystic cavitary lung lesions. An extensive infectious work-up was negative. Chest CT verified multiple cavitary lung lesions bilaterally, and [F-18]2-fluoro-2-deoxy-D-glucose ({sup 18}F-FDG) positron emission tomography with CT (PET/CT) showed increased uptake in the lung lesions as well as regional lymph nodes. Subsequent biopsy of an involved lymph node confirmed classical Hodgkin lymphoma, nodular sclerosis type. This case represents an unusual presentation for a child with Hodgkin lymphoma and demonstrates a role for {sup 18}F-FDG PET/CT in evaluating a child with cavitary lung lesions. (orig.)

  4. Marketing cardiac CT programs.

    Science.gov (United States)

    Scott, Jason

    2010-01-01

    There are two components of cardiac CT discussed in this article: coronary artery calcium scoring (CACS) and coronary computed tomography angiography (CCTA).The distinctive advantages of each CT examination are outlined. In order to ensure a successful cardiac CT program, it is imperative that imaging facilities market their cardiac CT practices effectively in order to gain a competitive advantage in this valuable market share. If patients receive quality care by competent individuals, they are more likely to recommend the facility's cardiac CT program. Satisfied patients will also be more willing to come back for any further testing.

  5. Andersson Lesion in Ankylosing Spondylitis

    Directory of Open Access Journals (Sweden)

    Manimegalai N, KrishnanKutty K, Panchapakesa Rajendran C, Rukmangatharajan S, Rajeswari S

    2004-04-01

    Full Text Available Andersson lesions are destructive foci that appear at the discovertebral junction in ankylosingspondylitis. We report three cases of ankylosing spondylitis with such lesions. These lesions simulatean infection and in our country, mimic spinal tuberculosis.

  6. Clinical correlations of brain lesion distribution in multiple sclerosis

    DEFF Research Database (Denmark)

    Vellinga, M M; Geurts, J J G; Rostrup, E;

    2009-01-01

    status scale (EDSS) and MS functional composite (MSFC) subdomain scores and demographic characteristics of 325 MS patients. To identify statistically significant locations, a cluster-forming threshold of 3.1 was used. RESULTS: In clusters in the periventricular region, lesion probability correlated...... significantly (P correlate with lesion probability in any location, and did...... not influence correlations with disability when included in its analyses. CONCLUSION: Periventricular lesions were related to disability. LL influenced relations between disability and lesion probability throughout the brain, suggesting interplay between lesional burden and its location in determining...

  7. Mathematical cardiac electrophysiology

    CERN Document Server

    Colli Franzone, Piero; Scacchi, Simone

    2014-01-01

    This book covers the main mathematical and numerical models in computational electrocardiology, ranging from microscopic membrane models of cardiac ionic channels to macroscopic bidomain, monodomain, eikonal models and cardiac source representations. These advanced multiscale and nonlinear models describe the cardiac bioelectrical activity from the cell level to the body surface and are employed in both the direct and inverse problems of electrocardiology. The book also covers advanced numerical techniques needed to efficiently carry out large-scale cardiac simulations, including time and space discretizations, decoupling and operator splitting techniques, parallel finite element solvers. These techniques are employed in 3D cardiac simulations illustrating the excitation mechanisms, the anisotropic effects on excitation and repolarization wavefronts, the morphology of electrograms in normal and pathological tissue and some reentry phenomena. The overall aim of the book is to present rigorously the mathematica...

  8. Biomaterials for cardiac regeneration

    CERN Document Server

    Ruel, Marc

    2015-01-01

    This book offers readers a comprehensive biomaterials-based approach to achieving clinically successful, functionally integrated vasculogenesis and myogenesis in the heart. Coverage is multidisciplinary, including the role of extracellular matrices in cardiac development, whole-heart tissue engineering, imaging the mechanisms and effects of biomaterial-based cardiac regeneration, and autologous bioengineered heart valves. Bringing current knowledge together into a single volume, this book provides a compendium to students and new researchers in the field and constitutes a platform to allow for future developments and collaborative approaches in biomaterials-based regenerative medicine, even beyond cardiac applications. This book also: Provides a valuable overview of the engineering of biomaterials for cardiac regeneration, including coverage of combined biomaterials and stem cells, as well as extracellular matrices Presents readers with multidisciplinary coverage of biomaterials for cardiac repair, including ...

  9. Meniscal Ramp Lesions

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  10. [EVOLUTION OF MINIMALLY INVASIVE CARDIAC SURGERY].

    Science.gov (United States)

    Fujita, Tomoyuki; Kobayashi, Junjiro

    2016-03-01

    Minimally invasive surgery is an attractive choice for patients undergoing major cardiac surgery. We review the history of minimally invasive valve surgery in this article. Due to many innovations in surgical tools, cardiopulmonary bypass systems, visualization systems, and robotic systems as well as surgical techniques, minimally invasive cardiac surgery has become standard care for valve lesion repair. In particular, aortic cross-clamp techniques and methods for cardioplegia using the Chitwood clamp and root cannula or endoballoon catheter in combination with femoro-femoral bypass systems have made such procedures safer and more practical. On the other hand, robotically assisted surgery has not become standard due to the cost and slow learning curve. However, along with the development of robotics, this less-invasive technique may provide another choice for patients in the near future. PMID:27295770

  11. Telocytes in cardiac regeneration and repair.

    Science.gov (United States)

    Bei, Yihua; Zhou, Qiulian; Sun, Qi; Xiao, Junjie

    2016-07-01

    Telocytes (TCs) are a novel type of stromal cells reported by Popescu's group in 2010. The unique feature that distinguishes TCs from other "classical" stromal cells is their extremely long and thin telopodes (Tps). As evidenced by electron microscopy, TCs are widely distributed in almost all tissues and organs. TCs contribute to form a three-dimensional interstitial network and play as active regulators in intercellular communication via homocellular/heterocellular junctions or shed vesicles. Interestingly, increasing evidence suggests the potential role of TCs in regenerative medicine. Although the heart retains some limited endogenous regenerative capacity, cardiac regenerative and repair response is however insufficient to make up the loss of cardiomyocytes upon injury. Developing novel strategies to increase cardiomyocyte renewal and repair is of great importance for the treatment of cardiac diseases. In this review, we focus on the role of TCs in cardiac regeneration and repair. We particularly describe the intercellular communication between TCs and cardiomyocytes, stem/progenitor cells, endothelial cells, and fibroblasts. Also, we discuss the current knowledge about TCs in cardiac repair after myocardial injury, as well as their potential roles in cardiac development and aging. TC-based therapy or TC-derived exosome delivery might be used as novel therapeutic strategies to promote cardiac regeneration and repair. PMID:26826525

  12. Lesiones deportivas Sports injuries

    OpenAIRE

    Isabel Cristina Gallego Ching; Santiago Patiño Giraldo; Elkín Arango V.; Mónica Paola Clavijo Rodríguez; Jorge Alberto Osorio Ciro

    2007-01-01

    El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participa...

  13. The hydantoin lesions formed from oxidation of 7,8-dihydro-8-oxoguanine are potnt sources of replication errors in vivo; Henderson, P.T.; Delaney, J.C.; Muller, J. G.; Neeley, W.L.; Tannenbaum, S.R.; Burrows, C.J.; Essigmann, J.M. Biochemistry (accelerate

    Energy Technology Data Exchange (ETDEWEB)

    Henderson, P; Delaney, J; Muller, J; Neeley, W; Tannenbaum, S; Burrows, C; Essigmann, J

    2003-10-27

    Single-stranded DNA genomes have been constructed that site-specifically contain the 8-oxo-7,8-dihydro-2'-deoxyguanine (8-oxoG) oxidation products guanidinohyndantoin (Gh), and the two stable stereoisomers of spiroiminodihydantoin (Sp1 and Sp2). The circular viral genomes were transfected into wild-type AB1157 Escherichia coli and the efficiency of lesion bypass by DNA polymerase(s) was assessed. Viral progeny were analyzed for mutation frequency and type using the recently developed restriction endonuclease and post-labeling (REAP) assay. Gh was bypassed nearly as efficiently as the parent 8-oxoG, but was highly mutagenic, causing almost exclusive G{yields}C transversions. The stereoisomers Sp1 and Sp2 were, in comparison, much stronger blocks to DNA polymerase extension, and caused a mixture of G{yields}T and G{yields}C transversions. The ratio of G{yields}T to G{yields}C mutations for each Sp lesion was dependent on the stereochemical configuration of the base. All observed mutation frequencies were at least an order of magnitude higher than those caused by 8-oxoG. Were these lesions to be formed in vivo, our data show that they are absolutely miscoding, and may be refractory to repair after translesion synthesis.

  14. [Cardiac evaluation before non-cardiac surgery].

    Science.gov (United States)

    Menzenbach, Jan; Boehm, Olaf

    2016-07-01

    Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices. Application of diagnostic means, should be used adjusted to this risk estimation. Cardiac biomarkers are useful to discover risk of complications or mortality, that cannot be assessed by clinical signs. After preoperative optimization and perioperative cardiac protection, the observation of the postoperative period remains, to prohibit complications or even death. In consideration of limited resources of intensive care department, postoperative ward rounds beyond intensive care units are considered to be an appropriate instrument to avoid or recognize complications early to reduce postoperative mortality. PMID:27479258

  15. Relations among traumatic subdural lesions.

    OpenAIRE

    Lee, K. S.; Doh, J. W.; Bae, H. G.; Yun, I. G.

    1996-01-01

    Acute subdural hematoma (ASDH), chronic subdural hematoma (CSDH) and subdural hygroma (SDG) occur in the subdural space, usually after trauma. We tried to find a certain relationship among these three traumatic subdural lesions in 436 consecutive patients. We included all subdural lesions regardless of whether they were main or not. We evaluated the distribution, age incidence and interval from injury to diagnosis of these lesions, and the frequency of new subdural lesions in each lesion. ASD...

  16. Genital lesions following bestiality

    Directory of Open Access Journals (Sweden)

    Mittal A

    2000-01-01

    Full Text Available A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

  17. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C;

    2016-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants asso...

  18. Cardiac metabolism and arrhythmias

    OpenAIRE

    Barth, Andreas S.; Tomaselli, Gordon F.

    2009-01-01

    Sudden cardiac death remains a leading cause of mortality in the Western world, accounting for up to 20% of all deaths in the U.S.1, 2 The major causes of sudden cardiac death in adults age 35 and older are coronary artery disease (70–80%) and dilated cardiomyopathy (10–15%).3 At the molecular level, a wide variety of mechanisms contribute to arrhythmias that cause sudden cardiac death, ranging from genetic predisposition (rare mutations and common polymorphisms in ion channels and structural...

  19. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O;

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  20. Sudden Death and Myocardial Lesions after Damage to Catecholamine Neurons of the Nucleus Tractus Solitarii in Rat

    OpenAIRE

    Talman, William T.; Dragon, Deidre Nitschke; Jones, Susan Y.; Moore, Steven A.; Lin, Li-Hsien

    2012-01-01

    Lesions that remove neurons expressing neurokinin-1 (NK1) receptors from the nucleus tractus solitarii (NTS) without removing catecholaminergic neurons lead to loss of baroreflexes, labile arterial pressure, myocardial lesions and sudden death. Because destruction of NTS catecholaminergic neurons expressing tyrosine hydroxylase (TH) may also cause lability of arterial pressure and loss of baroreflexes, we sought to test the hypothesis that cardiac lesions associated with lability are not depe...

  1. Morel-Lavallee lesion

    Institute of Scientific and Technical Information of China (English)

    Li Hui; Zhang Fangjie; Lei Guanghua

    2014-01-01

    Objective To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity.Familiarization may decrease missed diagnoses and misdiagnoses.It could also help steer the clinician to the proper treatment choice.Data sources A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords:Morel-Lavallee lesion,closed degloving injury,concealed degloving injury,Morel-Lavallee effusion,Morel-Lavallee hematoma,posttraumatic pseudocyst,posttraumatic soft tissue cyst.Study selection Chinese and English language literatures relevant to the subject were collected.Their references were also reviewed.Results Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury.It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia.Apart from the classic location over the region of the greater trochanter,MLLs have been described in other parts of the body.The natural history of MLL has not yet been established.The lesion may decrease in volume,remain stable,enlarge progressively or show a recurrent pattern.Diagnosis of MLL was often missed or delayed.Ultrasonography,computed tomography,and magnetic resonance imaging have great value in the diagnosis of MLL.Treatment of MLL has included compression,local aspiration,open debridement,and sclerodesis.No standard treatment has been established.Conclusions A diagnosis of MLL should be suspected when a soft,fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury.Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis.Treatment decisions should base on association with fractures,the condition of the lesion,symptom and desire of the patient.

  2. Cardiac Risk Assessment

    Science.gov (United States)

    ... to assess cardiac risk include: High-sensitivity C-reactive protein (hs-CRP) : Studies have shown that measuring ... LDL-C but does not respond to typical strategies to lower LDL-C such as diet, exercise, ...

  3. Sudden Cardiac Arrest

    Science.gov (United States)

    ... Heart Risk Factors & Prevention Heart Diseases & Disorders Atrial Fibrillation (AFib) Sudden Cardiac Arrest (SCA) SCA: Who's At Risk? Prevention of SCA What Causes SCA? SCA Awareness Atrial Flutter Heart Block Heart Failure Sick Sinus Syndrome Substances & Heart Rhythm Disorders Symptoms & ...

  4. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt;

    2012-01-01

    to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social......Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...

  5. Cardiac arrest - cardiopulmonary resuscitation

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Besnik Elshani; Nehat Baftiu; Kelmend Pallaska; Kadir Hyseni; Njazi Gashi; Nexhbedin Karemani; Ilaz Bunjaku; Taxhidin Zaimi; Arianit Jakupi

    2014-01-01

    Objective:To investigate application of cardiopulmonary resuscitation(CPR) measures within the golden minutes inEurope.Methods:The material was taken from theUniversityClinical Center ofKosovo -EmergencyCentre inPristina, during the two(2) year period(2010-2011).The collected date belong to the patients with cardiac arrest have been recorded in the patients' log book protocol at the emergency clinic.Results:During the2010 to2011 in the emergency center of theCUCK inPristina have been treated a total of269 patients with cardiac arrest, of whom159 or59.1% have been treated in2010, and110 patients or40.9% in2011.Of the269 patients treated in the emergency centre,93 or34.6% have exited lethally in the emergency centre, and176 or 65.4% have been transferred to other clinics.In the total number of patients with cardiac arrest, males have dominated with186 cases, or69.1%.The average age of patients included in the survey was56.7 year oldSD±16.0 years.Of the269 patients with cardiac arrest, defibrillation has been applied for93 or34.6% of patients.In the outpatient settings defibrillation has been applied for3 or3.2% of patients.Patients were defibrillated with application of one to four shocks. Of27 cases with who have survived cardiac arrest, none of them have suffered cardiac arrest at home,3 or11.1% of them have suffered cardiac arrest on the street, and24 or88.9% of them have suffered cardiac arrest in the hospital.5 out of27 patients survived have ended with neurological impairment.Cardiac arrest cases were present during all days of the week, but frequently most reported cases have been onMonday with32.0% of cases, and onFriday with24.5% of cases. Conclusions:All survivors from cardiac arrest have received appropriate medical assistance within10 min from attack, which implies that if cardiac arrest occurs near an institution health care(with an opportunity to provide the emergent health care) the rate of survival is higher.

  6. Awareness in cardiac anesthesia.

    LENUS (Irish Health Repository)

    Serfontein, Leon

    2010-02-01

    Cardiac surgery represents a sub-group of patients at significantly increased risk of intraoperative awareness. Relatively few recent publications have targeted the topic of awareness in this group. The aim of this review is to identify areas of awareness research that may equally be extrapolated to cardiac anesthesia in the attempt to increase understanding of the nature and significance of this scenario and how to reduce it.

  7. Cardiac rehabilitation in Germany.

    Science.gov (United States)

    Karoff, Marthin; Held, Klaus; Bjarnason-Wehrens, Birna

    2007-02-01

    The purpose of this review is to give an overview of the rehabilitation measures provided for cardiac patients in Germany and to outline its legal basis and outcomes. In Germany the cardiac rehabilitation system is different from rehabilitation measures in other European countries. Cardiac rehabilitation in Germany since 1885 is based on specific laws and the regulations of insurance providers. Cardiac rehabilitation has predominantly been offered as an inpatient service, but has recently been complemented by outpatient services. A general agreement on the different indications for offering these two services has yet to be reached. Cardiac rehabilitation is mainly offered after an acute cardiac event and bypass surgery. It is also indicated in severe heart failure and special cases of percutaneous coronary intervention. Most patients are men (>65%) and the age at which events occur is increasing. The benefits obtained during the 3-4 weeks after an acute event, and confirmed in numerous studies, are often later lost under 'usual care' conditions. Many attempts have been made by rehabilitation institutions to improve this deficit by providing intensive aftercare. One instrument set up to achieve this is the nationwide institution currently comprising more than 6000 heart groups with approximately 120000 outpatients. After coronary artery bypass grafting or acute coronary syndrome cardiac rehabilitation can usually be started within 10 days. The multidisciplinary rehabilitation team consists of cardiologists, psychologists, exercise therapists, social workers, nutritionists and nurses. The positive effects of cardiac rehabilitation are also important economically, for example, for the improvement of secondary prevention and vocational integration. PMID:17301623

  8. Cardiac tumours in infancy

    OpenAIRE

    Yadava, O.P.

    2012-01-01

    Cardiac tumours in infancy are rare and are mostly benign with rhabdomyomas, fibromas and teratomas accounting for the majority. The presentation depends on size and location of the mass as they tend to cause cavity obstruction or arrhythmias. Most rhabdomyomas tend to regress spontaneously but fibromas and teratomas generally require surgical intervention for severe haemodynamic or arrhythmic complications. Other relatively rare cardiac tumours too are discussed along with an Indian perspect...

  9. Infected cardiac hydatid cyst

    OpenAIRE

    Ceviz, M; Becit, N; Kocak, H.

    2001-01-01

    A 24 year old woman presented with chest pain and palpitation. The presence of a semisolid mass—an echinococcal cyst or tumour—in the left ventricular apex was diagnosed by echocardiography, computed tomography, and magnetic resonance imaging. The infected cyst was seen at surgery. The cyst was removed successfully by using cardiopulmonary bypass with cross clamp.


Keywords: cardiac hydatid cyst; infected cardiac hydatid cyst

  10. [Managing focal incidental renal lesions].

    Science.gov (United States)

    Nicolau, C; Paño, B; Sebastià, C

    2016-01-01

    Incidental renal lesions are relatively common in daily radiological practice. It is important to know the different diagnostic possibilities for incidentally detected lesions, depending on whether they are cystic or solid. The management of cystic lesions is guided by the Bosniak classification. In solid lesions, the goal is to differentiate between renal cancer and benign tumors such as fat-poor angiomyolipoma and oncocytoma. Radiologists need to know the recommendations for the management of these lesions and the usefulness of the different imaging techniques and interventional procedures in function of the characteristics of the incidental lesion and the patient's life expectancy.

  11. Cardiac applications of optogenetics.

    Science.gov (United States)

    Ambrosi, Christina M; Klimas, Aleksandra; Yu, Jinzhu; Entcheva, Emilia

    2014-08-01

    In complex multicellular systems, such as the brain or the heart, the ability to selectively perturb and observe the response of individual components at the cellular level and with millisecond resolution in time, is essential for mechanistic understanding of function. Optogenetics uses genetic encoding of light sensitivity (by the expression of microbial opsins) to provide such capabilities for manipulation, recording, and control by light with cell specificity and high spatiotemporal resolution. As an optical approach, it is inherently scalable for remote and parallel interrogation of biological function at the tissue level; with implantable miniaturized devices, the technique is uniquely suitable for in vivo tracking of function, as illustrated by numerous applications in the brain. Its expansion into the cardiac area has been slow. Here, using examples from published research and original data, we focus on optogenetics applications to cardiac electrophysiology, specifically dealing with the ability to manipulate membrane voltage by light with implications for cardiac pacing, cardioversion, cell communication, and arrhythmia research, in general. We discuss gene and cell delivery methods of inscribing light sensitivity in cardiac tissue, functionality of the light-sensitive ion channels within different types of cardiac cells, utility in probing electrical coupling between different cell types, approaches and design solutions to all-optical electrophysiology by the combination of optogenetic sensors and actuators, and specific challenges in moving towards in vivo cardiac optogenetics.

  12. Metastatic Breast Cancer or Multiple Myeloma? Camouflage by Lytic Lesions

    Directory of Open Access Journals (Sweden)

    Bruce Hough

    2010-01-01

    Full Text Available We report a case of a female with stage I infiltrating ductal carcinoma who received adjuvant therapy including trastuzumab. One year later she developed lytic lesions and was retreated with trastuzumab that was held after she developed symptomatic heart failure. Lytic lesions were attributed to relapse of breast cancer, and cardiac failure attributed to prior trastuzumab therapy. After complications necessitated multiple hospitalizations, a further workup revealed that the lytic lesions were not metastatic breast cancer but multiple myeloma. Her advanced multiple myeloma was associated with systemic amyloidosis involving gut and heart, which ultimately led to her demise. This report addresses the pitfalls of overlapping symptoms and the question of which patients with suspected metastatic disease should undergo a biopsy.

  13. MR findings of the spinal epidural lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Lee, Ho Kyu; Shin, Ji Hoon; Choi, Choong Gon; Suh, Dae Chul; Shin, Myung Jin; Rhim, Seung Chul [Ulsan Univ. College of Midicine, Seoul (Korea, Republic of); Park, Sung Tae [Dongguk Univ. College of Midicine, Kyungju (Korea, Republic of)

    2001-04-01

    The spinal canal takes the form of a series of cylinders designated by their relationship to the meninges and is divided by the dura mater into the epidural or extradural space and intradural space. The epidural space is composed of spinal ligaments, connective and areolar tissue, the epidural venous plexus, lymphatic channels and supporting elements, and various pathologic entities are found there. MR imaging can accurately depict the extent and characteristics of lesions, and in some cases specific diagnosis is possible. In this pictorial essay, we illustrate a variety of spinal epidural lesions and their MR findings.

  14. Asymptomatic ischemic cerebral lesions

    International Nuclear Information System (INIS)

    For the purpose of studying the incidence, pathomorphology and etiology of asymptomatic ischemic cerebral lesions, we carried out a brain MRI study on 65 patients with diabetes mellitus accompanied with hypertension who are thought to belong to a high risk group of ischemic cerebrovascular diseases. Excluding the abnormality of tendon reflex due to diabetic neuropathy, sixty percent of the total patients had some mild neurological signs and symptoms, most of them was discrepancy in tendon reflex. The percentage of the patients in whom MRI disclosed some abnormalities was as high as 70%, they were lacunar stroke, multiple lacunar state, cortical infarct, and patchy high signal lesions visible only in the T2 weighted image. Lacunes or these patchy high signal lesions (considered to be the dilatation of the perivascular space or true lacunes) tended to be found along the border zone or the terminal zone. These results indicate that asymptomatic patients in whom MRI discloses the abnormalities should be considered as candidates for the future onset of multi-infarct. (author)

  15. Atypical idiopathic inflammatory demyelinating lesions

    DEFF Research Database (Denmark)

    Wallner-Blazek, Mirja; Rovira, Alex; Fillipp, Massimo;

    2013-01-01

    Atypical lesions of a presumably idiopathic inflammatory demyelinating origin present quite variably and may pose diagnostic problems. The subsequent clinical course is also uncertain. We, therefore, wanted to clarify if atypical idiopathic inflammatory demyelinating lesions (AIIDLs) can be class...

  16. Exercise, Nrf2 and Antioxidant Signaling in Cardiac Aging.

    Science.gov (United States)

    Narasimhan, Madhusudhanan; Rajasekaran, Namakkal S

    2016-01-01

    Aging is represented by a progressive decline in cellular functions. The age-related deformities in cardiac behaviors are the loss of cardiac myocytes through apoptosis or programmed cell death. Oxidative stress (OS) and its deleterious consequence contribute to age-related mechanical remodeling, reduced regenerative capacity, and apoptosis in cardiac tissue. The pathogenesis of OS in the elderly can predispose the heart to other cardiac complications such as atherosclerosis, hypertension, ischemic heart disease, cardiac myopathy, and so on. At the molecular level, oxidant-induced activation of Nrf2 (Nuclear erythroid-2-p45-related factor-2), a transcription factor, regulates several genes containing AREs (Antioxidant Response Element) and bring the respective translates to counteract the reactive radicals and establish homeostasis. Myriad of Nrf2 gene knockout studies in various organs such as lung, liver, kidney, brain, etc. have shown that dysregulation of Nrf2 severely affects the oxidant/ROS sensitivity and predispose the system to several pathological changes with aberrant cellular lesions. On the other hand, its gain of function chemical interventions exhibited oxidant stress resistance and cytoprotection. However, thus far, only a few investigations have shown the potential role of Nrf2 and its non-pharmacological induction in cardiac aging. Therefore, here we review the involvement of Nrf2 signaling along with its responses and ramifications on the cascade of OS under acute exercise stress (AES), moderate exercise training (MET), and endurance exercise stress (EES) conditions in the aging heart. PMID:27378947

  17. Differential Diagnosis of Cardiac Malposition by Fetal Echocardiography

    Institute of Scientific and Technical Information of China (English)

    Ying WU; Feng TAO; Tao LIU; Ling ZANG; Shi-long LIU

    2009-01-01

    Objectives To explore the method and operating skill of fetal echocardiography in diagnosing cardiac malposition. Methods 91 consecutive fetuses were studied (control: 50 cases, cardiac malposition : 41 cases) between 2003 and 2008. The position of fetal heart was evaluated according to the fetal posture and the visceral situs by fetal routine scan-ning. The detailed echocardiography should be performed in the differential diagnosis of cardiac lesions when the heart was found to be abnormal position. Results In the control group, all fetuses were levocardia. 39 cases of cardiac mal-positions were detected by fetal echocardiography, included 25 fetuses with dextrocardia, 6 mesocard, 5 with levover-sion of heart, 3 common heart of conjoined twins and 2 extrathorax heart. Two of dextroversion were missed by fetal routine scanning, but found by autopsy or operation after birth. Conclusions When the abnormal visceral situs was found by fetal routine scanning, there is exceedingly high incidence of cardiac malpositions. Proficiently operating skill of fetal echocardiography is helpful to detect abnormal fetal cardiac position.

  18. Imaging findings of multiple infantile hepatic hemangioma associated with cardiac insufficiency

    Institute of Scientific and Technical Information of China (English)

    Jing-Jing Ye; Yin-Can Shao; Qiang Shu

    2014-01-01

    Background: Infantile hepatic hemangioma (IHH) as a benign liver tumor in infancy and childhood is commonly associated with high output cardiac failure. The present study aims to describe the imaging findings in a patient who was diagnosed as having multiple IHH with congestive cardiac insuffi ciency. Methods: The imaging findings and clinical manifestations of the patient with multiple IHH associated with cardiac insuffi ciency were retrospectively reviewed. Results: Ultrasonography showed multiple intrahepatic lesions with mixed echoes and markedly expanded hepatic veins and the inferior vena cava of the patient. Echocardiography revealed right heart insufficiency and pulmonary hypertension. Contrast-enhanced MRI showed early mild enhancement of lesions and more obvious delayed enhancement. The patient died after combined therapy of surgery and hormone. Conclusions: The imaging findings of multiple IHH associated with cardiac insufficiency are typical and diagnostic. Early imaging assessment may facilitate the diagnosis and treatment of the disease.

  19. A disappearing neonatal skin lesion.

    LENUS (Irish Health Repository)

    Hawkes, Colin Patrick

    2012-01-31

    A preterm baby girl was noted at birth to have a firm, raised, non-tender skin lesion located over her right hip. She developed three similar smaller lesions on her ear, buttock and right knee. All lesions had resolved by 2 months of age.

  20. Effect of the Spiroiminodihydantoin Lesion on Nucleosome Stability and Positioning.

    Science.gov (United States)

    Norabuena, Erika M; Barnes Williams, Sara; Klureza, Margaret A; Goehring, Liana J; Gruessner, Brian; Radhakrishnan, Mala L; Jamieson, Elizabeth R; Núñez, Megan E

    2016-04-26

    DNA is constantly under attack by oxidants, generating a variety of potentially mutagenic covalently modified species, including oxidized guanine base products. One such product is spiroiminodihydantoin (Sp), a chiral, propeller-shaped lesion that strongly destabilizes the DNA helix in its vicinity. Despite its unusual shape and thermodynamic effect on double-stranded DNA structure, DNA duplexes containing the Sp lesion form stable nucleosomes upon being incubated with histone octamers. Indeed, among six different combinations of lesion location and stereochemistry, only two duplexes display a diminished ability to form nucleosomes, and these only by ∼25%; the other four are statistically indistinguishable from the control. Nonetheless, kinetic factors also play a role: when the histone proteins have less time during assembly of the core particle to sample both lesion-containing and normal DNA strands, they are more likely to bind the Sp lesion DNA than during slower assembly processes that better approximate thermodynamic equilibrium. Using DNase I footprinting and molecular modeling, we discovered that the Sp lesion causes only a small perturbation (±1-2 bp) on the translational position of the DNA within the nucleosome. Each diastereomeric pair of lesions has the same effect on nucleosome positioning, but lesions placed at different locations behave differently, illustrating that the location of the lesion and not its shape serves as the primary determinant of the most stable DNA orientation. PMID:27074396

  1. Iliopsoas compartment lesions: a radiologic evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Leao, Alberto Ribeiro de Souza; Amaral, Raquel Portugal Guimaraes; Abud, Thiago Giansante; Demarchi, Guilherme Tadeu Sauaia; Freire Filho, Edison de Oliveira; Novack, Paulo Rogerio; Campos, Flavio do Amaral; Shigueoka, David Carlos; Fernandes, Artur da Rocha Correa; Szejnfeld, Jacob; D' Ippolito, Giuseppe [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil). Dept. de Diagnostico por Imagem]. E-mail: ar.leao@uol.com.br; Santos, Jose Eduardo Mourao [Universidade Federal de Sao Paulo (UNIFESP-EPM), Sao Paulo, SP (Brazil)

    2007-07-15

    The iliopsoas compartment, a posterior boundary of the retroperitoneum, is comprised of the psoas major, psoas minor and iliac muscles. The symptoms picture in patients presenting with pathological involvement of this compartment may show a wide range of nonspecific clinical presentations that may lead to delayed diagnosis. However, in the search of an etiological diagnosis, it is already known that inflammation, tumors, and hemorrhages account for almost all the lesions affecting the iliopsoas compartment. By means of a retrospective analysis of radiological studies in patients with iliopsoas compartment lesions whose diagnosis was confirmed by anatomopathological evaluation or clinical follow-up, we have reviewed its anatomy as well as the main forms of involvement, with the purpose of identifying radiological signs that may help to narrow down the potential differential diagnoses. As each lesion is approached we will discuss the main radiological findings such as presence of gas in pyogenic abscesses, bone destruction and other bone changes of vertebral bodies in lesions secondary to tuberculosis, involvement of fascial planes in cases of neoplasms, and differences in signal density and intensity of hematomas secondary to hemoglobin degradation, among others. So, we have tried to present cases depicting the most frequent lesions involving the iliopsoas compartment, with emphasis on those signs that can lead us to a more specific etiological diagnosis. (author)

  2. Novel energy modalities for catheter ablation of cardiac arrhythmias : Pitfalls and possibilities of potent power sources

    OpenAIRE

    Neven, K.G.E.J.

    2014-01-01

    The acceptance of catheter ablation as treatment for cardiac arrhythmias is amongst others dependent on its success rate, a high initial success rate will increase physician and patient acceptance. One of the reasons why recurrence of arrhythmia after ablation is substantial is non-transmurality of ablation lesions. Transmurality is essential for conduction block and is depending on many factors, such as tissue ablation duration, thickness of the cardiac wall, ablation technique used, cathete...

  3. Sports injuries Lesiones deportivas

    Directory of Open Access Journals (Sweden)

    Santiago Patiño Giraldo

    2007-04-01

    Full Text Available Stress generated by sports practice has increased the probability that athletes suffer from acute and chronic injuries. Worldwide, there have been many different investigations concerning the incidence of sport injuries. The different ways in which results have been presented makes it difficult to compare among them. Rates of sports injuries vary between 1.7 and 53 per 1.000 hours of sports practice; 0.8 and 90.9 per 1.000 hours of training; 3.1 and 54.8 per 1.000 hours of competition, and 6.1 and 10.9 per 100 games. The great variability among the incidence rates may be explained by differences among sports, countries, competitive levels, ages and methodology used in the studies. Sports injuries have been defined as those occurring when athletes are practicing sports and that result in tissue alterations or damages, affecting the operation of the corresponding structures. Contact sports such as soccer, rugby, martial arts, basketball, handball and hockey generate greater risk of injuries. The probability of lesions is higher during competition than in training. El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participantes o tasas por horas de juego o por número de partidos jugados. Las tasas varían entre 1,7 y 53 lesiones por 1.000 horas de práctica deportiva, entre 0,8 y 90,9 por 1.000 horas de entrenamiento, entre 3,1 y 54,8 por 1.000 horas de competición y de 6,1 a 10,9 por 100 juegos. La gran variación entre las tasas de incidencia se explica por las diferencias existentes entre los deportes

  4. ECLS in Pediatric Cardiac Patients

    Science.gov (United States)

    Di Nardo, Matteo; MacLaren, Graeme; Marano, Marco; Cecchetti, Corrado; Bernaschi, Paola; Amodeo, Antonio

    2016-01-01

    Extracorporeal life support (ECLS) is an important device in the management of children with severe refractory cardiac and or pulmonary failure. Actually, two forms of ECLS are available for neonates and children: extracorporeal membrane oxygenation (ECMO) and use of a ventricular assist device (VAD). Both these techniques have their own advantages and disadvantages. The intra-aortic balloon pump is another ECLS device that has been successfully used in larger children, adolescents, and adults, but has found limited applicability in smaller children. In this review, we will present the “state of art” of ECMO in neonate and children with heart failure. ECMO is commonly used in a variety of settings to provide support to critically ill patients with cardiac disease. However, a strict selection of patients and timing of intervention should be performed to avoid the increase in mortality and morbidity of these patients. Therefore, every attempt should be done to start ECLS “urgently” rather than “emergently,” before the presence of dysfunction of end organs or circulatory collapse. Even though exciting progress is being made in the development of VADs for long-term mechanical support in children, ECMO remains the mainstay of mechanical circulatory support in children with complex anatomy, particularly those needing rapid resuscitation and those with a functionally univentricular circulation. With the increase in familiarity with ECMO, new indications have been added, such as extracorporeal cardiopulmonary resuscitation (ECPR). The literature supporting ECPR is increasing in children. Reasonable survival rates have been achieved after initiation of support during active compressions of the chest following in-hospital cardiac arrest. Contraindications to ECLS have reduced in the last 5 years and many centers support patients with functionally univentricular circulations. Improved results have been recently achieved in this complex subset of patients. PMID

  5. Analysis of pulmonary coin lesions

    Energy Technology Data Exchange (ETDEWEB)

    Kim, O; Kim, K. H.; Oh, K. K.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    For A long time the solitary pulmonary nodule has remained a difficult problem to solve and has attracted a great deal of attension in recent years. Circumscribed coin lesions of the lung were generally peripheral in location with respect to the pulmonary hilus. Because of this, important clinical problem in management and diagnosis arise. Such a lesion is discovered through roentgenologic examination. So the roentgenologists is the first be in a position to offer advise. This presentation is an attempt to correlate a useful diagnosis with roentgenologic findings of pulmonary coin lesion which enables us to get differential diagnosis of benign and malignant lesion. Histologically proven 120 cases of the pulmonary coin lesion during the period of 8 years were reviewed through plain film, tomogram, bronchoscopy, variable laboratory findings, and clinical history. The results are as follows: 1. Male to female sex ratio was 3 : 1. In age distribution, most of the malignant pulmonary coin lesion appeared in 6th decade (39%) and 5th decade (27%). In benign lesion, the most cases were in 3 rd decade. 2. Pathological cell type are as follows: Primary bronchogenic cancer 43.3%, tuberculoma 25.8%, inflammatory lesion 17.5%, benign tumor 10%, and bronchial adenoma, harmartoma, A.V. malformation, mesothelioma, are 1 case respectively. As a result benign and malignant lesion showed equal distribution (49.1% : 50.3%). 3. In symptom analysis ; cough is the most common (43.5%) symptom in malignant lesion, next follows hemoptysis (20.9%) and chest pain (14.5%). In benign lesion, most of the patient (32.7%) did not complain any symptom. 4. In malignant lesion, the most common nodular size was 4 cm (32.3%), and in benign lesion 2 cm sized coin was most common (39.3%). 5. In general, margin of nodule was very sharp and well demarcated in benign lesion (83.3%), and in malignant lesion that was less demarcated and poorly defined. 6. Most case of calcification (82.7%) was seen in benign

  6. Cystic Lesions of the Mediastinum.

    Science.gov (United States)

    Vargas, Daniel; Suby-Long, Thomas; Restrepo, Carlos S

    2016-06-01

    Cystic lesions are commonly seen in the mediastinum, and they may arise from virtually any organ. The vast majority of these lesions are benign and result in no symptoms. When large, cysts may produce symptoms related to compression of adjacent structures. The most common mediastinal cysts are pericardial and foregut duplication cysts. Both computed tomography and magnetic resonance are routinely used to evaluate these lesions. Although computed tomography offers superior spatial resolution, magnetic resonance is useful in differentiating cysts that contain proteinaceous material from solid lesions. Occasionally, cysts arise from solid lesions, such as thymoma or teratoma. Although cysts are alike in appearance, location helps narrowing the differential diagnoses.

  7. Lesiones en corredores amateurs

    OpenAIRE

    Natale, Vanesa

    2011-01-01

    Se realizó un estudio tomando como muestra a 100 corredores amateurs de la ciudad de Mar del Plata, en la cual el objetivo general fue determinar cuáles son las patologías más frecuentes en corredores. Correr no es solo un deporte en si mismo sino que tiene elementos de otras actividades deportivas, es decir, que las lesiones de los corredores también son comunes en otros tipos de deportes. El número de deportistas aumenta diariamente y al mismo tiempo aumentan el número de per...

  8. Percutaneous Coronary Intervention using a Full Metal Jacket with Drug-eluting Stents: Major Adverse Cardiac Events at One Year

    OpenAIRE

    Calé, Rita; Teles, Rui Campante; Almeida, Manuel; do Rosário, Ingrid; Sousa, Pedro Jerónimo; Brito, João; Raposo, Luís; Gonçalves, Pedro Araújo; Gabriel, Henrique Mesquita; Mendes, Miguel

    2013-01-01

    Background The clinical benefit of percutaneous coronary intervention (PCI) for long coronary lesions is unclear; furthermore, concerns have been raised about its safety. Objectives To evaluate the predictors of major adverse cardiac events (MACE) associated with PCI using a full metal jacket (FMJ), defined as overlapping drug-eluting stents (DES) measuring > 60 mm in length, for very long lesions. Methods We enrolled 136 consecutive patients with long coronary lesions requiring FMJ in our si...

  9. Pediatric cardiac postoperative care

    Directory of Open Access Journals (Sweden)

    Auler Jr. José Otávio Costa

    2002-01-01

    Full Text Available The Heart Institute of the University of São Paulo, Medical School is a referral center for the treatment of congenital heart diseases of neonates and infants. In the recent years, the excellent surgical results obtained in our institution may be in part due to modern anesthetic care and to postoperative care based on well-structured protocols. The purpose of this article is to review unique aspects of neonate cardiovascular physiology, the impact of extracorporeal circulation on postoperative evolution, and the prescription for pharmacological support of acute cardiac dysfunction based on our cardiac unit protocols. The main causes of low cardiac output after surgical correction of heart congenital disease are reviewed, and methods of treatment and support are proposed as derived from the relevant literature and our protocols.

  10. The cardiac anxiety questionnaire: cross-validation among cardiac inpatients

    NARCIS (Netherlands)

    Beek, M.H. van; Oude Voshaar, R.C.; Deelen, F.M. van; Balkom, A.J. van; Pop, G.A.; Speckens, A.E.

    2012-01-01

    OBJECTIVE: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  11. THE CARDIAC ANXIETY QUESTIONNAIRE : CROSS-VALIDATION AMONG CARDIAC INPATIENTS

    NARCIS (Netherlands)

    van Beek, M. H. C. T.; Voshaar, R. C. Oude; van Deelen, F. M.; van Balkom, A. J. L. M.; Pop, G.; Speckens, A. E. M.

    2012-01-01

    Objective: General anxiety symptoms are common in patients with cardiac disease and considered to have an adverse effect on cardiac prognosis. The role of specific cardiac anxiety, however, is still unknown. The aim of this study is to examine the factor structure, reliability, and validity of the D

  12. Overexpression of Catalase Diminishes Oxidative Cysteine Modifications of Cardiac Proteins.

    Directory of Open Access Journals (Sweden)

    Chunxiang Yao

    Full Text Available Reactive protein cysteine thiolates are instrumental in redox regulation. Oxidants, such as hydrogen peroxide (H2O2, react with thiolates to form oxidative post-translational modifications, enabling physiological redox signaling. Cardiac disease and aging are associated with oxidative stress which can impair redox signaling by altering essential cysteine thiolates. We previously found that cardiac-specific overexpression of catalase (Cat, an enzyme that detoxifies excess H2O2, protected from oxidative stress and delayed cardiac aging in mice. Using redox proteomics and systems biology, we sought to identify the cysteines that could play a key role in cardiac disease and aging. With a 'Tandem Mass Tag' (TMT labeling strategy and mass spectrometry, we investigated differential reversible cysteine oxidation in the cardiac proteome of wild type and Cat transgenic (Tg mice. Reversible cysteine oxidation was measured as thiol occupancy, the ratio of total available versus reversibly oxidized cysteine thiols. Catalase overexpression globally decreased thiol occupancy by ≥1.3 fold in 82 proteins, including numerous mitochondrial and contractile proteins. Systems biology analysis assigned the majority of proteins with differentially modified thiols in Cat Tg mice to pathways of aging and cardiac disease, including cellular stress response, proteostasis, and apoptosis. In addition, Cat Tg mice exhibited diminished protein glutathione adducts and decreased H2O2 production from mitochondrial complex I and II, suggesting improved function of cardiac mitochondria. In conclusion, our data suggest that catalase may alleviate cardiac disease and aging by moderating global protein cysteine thiol oxidation.

  13. Perioperative management of cardiac disease.

    Science.gov (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S

    2014-01-01

    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  14. Lipid partitioning during cardiac stress.

    Science.gov (United States)

    Kolwicz, Stephen C

    2016-10-01

    It is well documented that fatty acids serve as the primary fuel substrate for the contracting myocardium. However, extensive research has identified significant changes in the myocardial oxidation of fatty acids during acute or chronic cardiac stress. As a result, the redistribution or partitioning of fatty acids due to metabolic derangements could have biological implications. Fatty acids can be stored as triacylglycerols, serve as critical components for biosynthesis of phospholipid membranes, and form the potent signaling molecules, diacylglycerol and ceramides. Therefore, the contribution of lipid metabolism to health and disease is more intricate than a balance of uptake and oxidation. In this review, the available data regarding alterations that occur in endogenous cardiac lipid pathways during the pathological stressors of ischemia-reperfusion and pathological hypertrophy/heart failure are highlighted. In addition, changes in endogenous lipids observed in exercise training models are presented for comparison. This article is part of a Special Issue entitled: Heart Lipid Metabolism edited by G.D. Lopaschuk. PMID:27040509

  15. Churg-Strauss Syndrome with Cardiac Involvement: A Case Report with CT and MRI Findings

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Seong Joo; Cho, Young Jun; Kim, Keum; Hwang, Cheol Mok; Kim, Dae Ho [Dept. of Radiology, Konyang University College of Medicine, Daegu (Korea, Republic of); Choi, Eu Gene [Dept. of Internal Medicine, Konyang University College of Medicine, Daegu (Korea, Republic of)

    2012-02-15

    This is a case report of Churg-Strauss Syndrome (CSS) associated with cardiac involvement which is demonstrated in chest CT and cardiac MRI (CMR) without specific cardiac symptoms. A 32-year-old woman had a 3-year history of bronchial asthma, chronic sinusitis, and otitis media. The patient had various typical findings of CSS. The patient had no specific cardiac symptoms or signs such as chest pain, palpitations, syncope, or murmur, but she had diffuse low attenuation lesions in the inner wall of the left ventricle (LV) in contrast-enhanced CT. This corresponded to the area of subendocardial hyperenhancement in delayed contrast-enhanced CMR images. She was treated with steroids for 2 months. Follow-up delayed contrast-enhanced CMR of the LV showed a decrease in the size of the subendocardial enhancement area, and she had no symptoms. Therefore, the radiologist and clinician both should pay careful attention to observe possible cardiac involvement in case of CSS.

  16. The cardiac malpositions.

    Science.gov (United States)

    Perloff, Joseph K

    2011-11-01

    Dextrocardia was known in the 17th century and was 1 of the first congenital malformations of the heart to be recognized. Fifty years elapsed before Matthew Baillie published his account of complete transposition in a human of the thoracic and abdominal viscera to the opposite side from what is natural. In 1858, Thomas Peacock stated that "the heart may be congenitally misplaced in various ways, occupying either an unusual position within the thorax, or being situated external to that cavity." In 1915, Maude Abbott described ectopia cordis, and Richard Paltauf's remarkable illustrations distinguished the various types of dextrocardia. In 1928, the first useful classification of the cardiac malpositions was proposed, and in 1966, Elliott et al's radiologic classification set the stage for clinical recognition. The first section of this review deals with the 3 basic cardiac malpositions in the presence of bilateral asymmetry. The second section deals with cardiac malpositions in the presence of bilateral left-sidedness or right-sidedness. Previous publications on cardiac malpositions are replete with an arcane vocabulary that confounds rather than clarifies. Even if the terms themselves are understood, inherent complexity weighs against clarity. This review was designed as a guided tour of an unfamiliar subject.

  17. Hepato-cardiac disorders

    Institute of Scientific and Technical Information of China (English)

    Yasser; Mahrous; Fouad; Reem; Yehia

    2014-01-01

    Understanding the mutual relationship between the liver and the heart is important for both hepatologists and cardiologists. Hepato-cardiac diseases can be classified into heart diseases affecting the liver, liver diseases affecting the heart, and conditions affecting the heart and the liver at the same time. Differential diagnoses of liver injury are extremely important in a cardiologist’s clinical practice calling for collaboration between cardiologists and hepatologists due to the many other diseases that can affect the liver and mimic haemodynamic injury. Acute and chronic heart failure may lead to acute ischemic hepatitis or chronic congestive hepatopathy. Treatment in these cases should be directed to the primary heart disease. In patients with advanced liver disease, cirrhotic cardiomyopathy may develop including hemodynamic changes, diastolic and systolic dysfunctions, reduced cardiac performance and electrophysiological abnormalities. Cardiac evaluation is important for patients with liver diseases especially before and after liver transplantation. Liver transplantation may lead to the improvement of all cardiac changes and the reversal of cirrhotic cardiomyopathy. There are systemic diseases that may affect both the liver and the heart concomitantly including congenital, metabolic and inflammatory diseases as well as alcoholism. This review highlights these hepatocardiac diseases

  18. Cardiac effects of vasopressin.

    Science.gov (United States)

    Pelletier, Jean-Sébastien; Dicken, Bryan; Bigam, David; Cheung, Po-Yin

    2014-07-01

    Vasopressin is an essential hormone involved in the maintenance of cardiovascular homeostasis. It has been in use therapeutically for many decades, with an emphasis on its vasoconstrictive and antidiuretic properties. However, this hormone has a ubiquitous influence and has specific effects on the heart. Although difficult to separate from its powerful vascular effects in the clinical setting, a better understanding of vasopressin's direct cardiac effects could lead to its more effective clinical use for a variety of shock states by maximizing its therapeutic benefit. The cardiac-specific effects of vasopressin are complex and require further elucidation. Complicating our understanding include the various receptors and secondary messengers involved in vasopressin's effects, which may lead to various results based on differing doses and varying environmental conditions. Thus, there have been contradictory reports on vasopressin's action on the coronary vasculature and on its effect on inotropy. However, beneficial results have been found and warrant further study to expand the potential therapeutic role of vasopressin. This review outlines the effect of vasopressin on the coronary vasculature, cardiac contractility, and on hypertrophy and cardioprotection. These cardiac-specific effects of vasopressin represent an interesting area for further study for potentially important therapeutic benefits. PMID:24621650

  19. Cardiac potassium channel subtypes

    DEFF Research Database (Denmark)

    Schmitt, Nicole; Grunnet, Morten; Olesen, Søren-Peter

    2014-01-01

    About 10 distinct potassium channels in the heart are involved in shaping the action potential. Some of the K(+) channels are primarily responsible for early repolarization, whereas others drive late repolarization and still others are open throughout the cardiac cycle. Three main K(+) channels...

  20. Cardiac pacemaker power sources

    International Nuclear Information System (INIS)

    A review of chemical and radioisotope batteries used in cardiac pacemakers is presented. The battery systems are examined in terms of longevity, reliability, cost, size and shape, energy density, weight, internal resistance versus time, end-of-life voltage, chemical compatibility, and potential failure mechanisms

  1. Small white matter lesion detection in cerebral small vessel disease

    Science.gov (United States)

    Ghafoorian, Mohsen; Karssemeijer, Nico; van Uden, Inge; de Leeuw, Frank E.; Heskes, Tom; Marchiori, Elena; Platel, Bram

    2015-03-01

    Cerebral small vessel disease (SVD) is a common finding on magnetic resonance images of elderly people. White matter lesions (WML) are important markers for not only the small vessel disease, but also neuro-degenerative diseases including multiple sclerosis, Alzheimer's disease and vascular dementia. Volumetric measurements such as the "total lesion load", have been studied and related to these diseases. With respect to SVD we conjecture that small lesions are important, as they have been observed to grow over time and they form the majority of lesions in number. To study these small lesions they need to be annotated, which is a complex and time-consuming task. Existing (semi) automatic methods have been aimed at volumetric measurements and large lesions, and are not suitable for the detection of small lesions. In this research we established a supervised voxel classification CAD system, optimized and trained to exclusively detect small WMLs. To achieve this, several preprocessing steps were taken, which included a robust standardization of subject intensities to reduce inter-subject intensity variability as much as possible. A number of features that were found to be well identifying small lesions were calculated including multimodal intensities, tissue probabilities, several features for accurate location description, a number of second order derivative features as well as multi-scale annular filter for blobness detection. Only small lesions were used to learn the target concept via Adaboost using random forests as its basic classifiers. Finally the results were evaluated using Free-response receiver operating characteristic.

  2. Mycetoma: Nonvenereal perineal lesions

    Directory of Open Access Journals (Sweden)

    Gupta Shweta

    2010-01-01

    Full Text Available Mycetoma is a chronic, granulomatous disease of the skin, and subcutaneous tissue, which sometimes involves muscle, bones, and neighboring organs. It is characterized by tumefaction, abscess formation, and fistulae with discharge of grains from sinuses. Mycetoma can be caused by various species of fungi (eumycetoma and aerobic actinomycetes (actinomycetoma, which occur as saprophytes in soil or plants. A tentative diagnosis sufficient to initiate treatment may be made on the basis of grain color. For instance, melanoid grains are always caused by fungi and ochroid or pale grains by actinomycetes. Although this is not the thumbrule, there are exceptional reports too. As trauma favors infection, most lesions are on the foot and lower leg but they may occur anywhere on the body mimicking actinomycosis. However, lab investigations and culture are important tool to differentiate apart from the clinical picture. We are reporting atypical case with unusual site of presentation (perineum and thigh of mycetoma.

  3. Invasive strategy in patients with resuscitated cardiac arrest and ST elevation myocardial infarction

    OpenAIRE

    Gorjup, Vojka; Noc, Marko; Radsel, Peter

    2014-01-01

    Coronary artery disease is the most frequent cause of sudden cardiac death. There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in post-resuscitation electrocardiogram. In these patients acute coronary thrombotic lesion (“ACS” lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and ...

  4. Vascular, hepatic and renal lesions by Dirofilaria immitis invasion in dogs

    Directory of Open Access Journals (Sweden)

    S.A. Pasca

    2012-08-01

    Full Text Available Morphological investigations were conducted on four bodies of dogs who died due to severe clinical symptoms following a massive invasion of cardiac and pulmonary Dirofilaria. The subjects were monitored clinically and diagnosed serologically positive for the Heartworm disease. The necropsy examination of the cardiovascular system (right ventricle and pulmonary artery revealed the presence of 25 adult parasites in one dog with length ranging between 8 and 33cm. Macroscopically, lesions consistently observed were represented by the right ventricular dilatation and the diffuse wall thickening of the pulmonary artery. Parasitic invasion secondary lesions were present in the lungs, liver and kidneys (cardiac and vascular lesions. The histological examination mainly revealed myocardial injury, vascular (dystrophic, pulmonary (circulatory and inflammatory, hepatic (degenerative and renal (degenerative and inflammatory damage.

  5. Endometriosis: A Highly Unexpected Skin Lesion

    OpenAIRE

    Tolga Dinc

    2016-01-01

    Endometriosis: A highly unexpected skin lesion Endometriosis is the presence of functional endometrium in anywhere outside of uterin cavity. This clinical entity is relatively common, that 10-15% of fertile women and 6% of post-menopausal women are affected [1,2] . Cutaneous endometriosis is a form of endometriosis and it usually occurs in the incision scar, after gynecological surgeries, cesarean sections and episiotomies [3]. Cutaneous endometriosis is characterized with painful, bluish ...

  6. [Corneal lesions in ichthyosis (author's transl)].

    Science.gov (United States)

    Hammerstein, W; Meiers, H G; Haensch, R

    1975-06-01

    The authors report about observations they made in two sisters. One sister showed a fibroid degeneration of the cornea, the other a band-shaped keratopathy respectively, together with an ichthyosis and an alopecia as a result of capillary fractures due to pili torti. An autosomal recessive hereditary transmission could be determined. The cutaneous lesion is either an ichthyosis vulgaris, the hereditary transmission of which could not yet be confirmed, or it is a transition form of ichthyosis vulgaris and congenita.

  7. Teaching Form as Form

    DEFF Research Database (Denmark)

    Keiding, Tina Bering

    2012-01-01

    means that form serves both as the connective value and as the concept for reflection. In other words, form is observed as form, not anything else. The didactical challenge of teaching form as form is accentuated by students’ everyday-based pre-orientation towards function at the expense of form...... reveal highly-structured courses, which alternates systematically between steering and free experimental activities. Consistent with a strong focus on content and the student’s interaction with content, the contributions hardly address the role of the teacher or the interplay between teachers...... and students. This is not to say that teachers do not engage in teaching. They clearly do and obviously play a major role in the progression in course structure and reflection on the student’s learning. My point is that, by neglecting the role of the teacher and the interplay between the teacher and students...

  8. Pigmented Lesions of the Vulva

    OpenAIRE

    Gürol Açıkgöz; Çağlayan Çağdaş Demirci; Ercan Arca

    2012-01-01

    Pigmented lesions on the vulva are rare and their non specific features cause difficulties in their diagnosis and differential diagnosis. Because of their localization, it is difficult to follow up vulvar lesions, which are generally noticed coincidentally by patients. Vulvar pigmented lesions are classified clinically as macules/papules and patches/plaques to provide ease of the diagnosis. Nevi, angiokeratomas, seborrheic keratosis, melanoma, basal cell carcinoma and squamous cell carcinoma ...

  9. Microbiological aspects of endoperiodontal lesion

    OpenAIRE

    Cristiane Tokunaga; Bruno Monguilhott Crozeta; Mariangela Schmitt Bonato; Beatriz Serrato Coelho; Flares Baratto-Filho; Flávia Sens Fagundes Tomazinho

    2013-01-01

    Introduction: The endoperiodontal lesion occurs when a tooth undergoing endodontic disease is united to a periodontal lesion with apical progression. Many times, the differential diagnosis between the endodontic and periodontal disease can be of difficult execution and the correct diagnosis and planing of the treatment is of main importance for a good prognosis Objective: To identify the main microorganisms within the lesion of endodontic and periodontal origin and correlate them with the en...

  10. MALIGNANCY IN LARGE COLORECTAL LESIONS

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Oliveira dos SANTOS

    2014-09-01

    Full Text Available Context The size of colorectal lesions, besides a risk factor for malignancy, is a predictor for deeper invasion Objectives To evaluate the malignancy of colorectal lesions ≥20 mm. Methods Between 2007 and 2011, 76 neoplasms ≥20 mm in 70 patients were analyzed Results The mean age of the patients was 67.4 years, and 41 were women. Mean lesion size was 24.7 mm ± 6.2 mm (range: 20 to 50 mm. Half of the neoplasms were polypoid and the other half were non-polypoid. Forty-two (55.3% lesions were located in the left colon, and 34 in the right colon. There was a high prevalence of III L (39.5% and IV (53.9% pit patterns. There were 72 adenomas and 4 adenocarcinomas. Malignancy was observed in 5.3% of the lesions. Thirty-three lesions presented advanced histology (adenomas with high-grade dysplasia or early adenocarcinoma, with no difference in morphology and site. Only one lesion (1.3% invaded the submucosa. Lesions larger than 30 mm had advanced histology (P = 0.001. The primary treatment was endoscopic resection, and invasive carcinoma was referred to surgery. Recurrence rate was 10.6%. Conclusions Large colorectal neoplasms showed a low rate of malignancy. Endoscopic treatment is an effective therapy for these lesions.

  11. Radio-induced brain lesions

    Directory of Open Access Journals (Sweden)

    Gorgan Mircea Radu

    2014-03-01

    Full Text Available Introduction : Radiotherapy, an important tool in multimodal oncologic treatment, can cause radio-induced brain lesion development after a long period of time following irradiation.

  12. MRI of fetal acquired brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, Daniela [Department of Radiodiagnostics, Medical University of Vienna (Austria)]. E-mail: daniela.prayer@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, Medical University of Vienna (Austria); Kasprian, Gregor [Department of Radiodiagnostics, Medical University of Vienna (Austria); Witzani, Linde [Department of Radiodiagnostics, Medical University of Vienna (Austria); Helmer, Hanns [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Dietrich, Wolfgang [Department of Neurosurgery, Medical University of Vienna (Austria); Eppel, Wolfgang [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria); Langer, Martin [Department of Obstetrics and Gynecology, Medical University of Vienna (Austria)

    2006-02-15

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images.

  13. MRI of fetal acquired brain lesions

    International Nuclear Information System (INIS)

    Acquired fetal brain damage is suspected in cases of destruction of previously normally formed tissue, the primary cause of which is hypoxia. Fetal brain damage may occur as a consequence of acute or chronic maternal diseases, with acute diseases causing impairment of oxygen delivery to the fetal brain, and chronic diseases interfering with normal, placental development. Infections, metabolic diseases, feto-fetal transfusion syndrome, toxic agents, mechanical traumatic events, iatrogenic accidents, and space-occupying lesions may also qualify as pathologic conditions that initiate intrauterine brain damage. MR manifestations of acute fetal brain injury (such as hemorrhage or acute ischemic lesions) can easily be recognized, as they are hardly different from postnatal lesions. The availability of diffusion-weighted sequences enhances the sensitivity in recognizing acute ischemic lesions. Recent hemorrhages are usually readily depicted on T2 (*) sequences, where they display hypointense signals. Chronic fetal brain injury may be characterized by nonspecific changes that must be attributable to the presence of an acquired cerebral pathology. The workup in suspected acquired fetal brain injury also includes the assessment of extra-CNS organs that may be affected by an underlying pathology. Finally, the placenta, as the organ that mediates oxygen delivery from the maternal circulation to the fetus, must be examined on MR images

  14. Cardiac allograft immune activation: current perspectives

    OpenAIRE

    Chang D; Kobashigawa J

    2014-01-01

    David Chang, Jon Kobashigawa Cedars-Sinai Heart Institute, Los Angeles, CA, USA Abstract: Heart transplant remains the most durable option for end-stage heart disease. Cardiac allograft immune activation and heart transplant rejection remain among the main complications limiting graft and recipient survival. Mediators of the immune system can cause different forms of rejection post-heart transplant. Types of heart transplant rejection include hyperacute rejection, cellular rejection, antibod...

  15. Cardiac fusion and complex congenital cardiac defects in thoracopagus twins: diagnostic value of cardiac CT

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea, Republic of); Park, Jeong-Jun [University of Ulsan College of Medicine, Asan Medical Center, Department of Pediatric Cardiac Surgery, Seoul (Korea, Republic of); Kim, Ellen Ai-Rhan [University of Ulsan College of Medicine, Asan Medical Center, Division of Neonatology, Department of Pediatrics, Seoul (Korea, Republic of); Won, Hye-Sung [University of Ulsan College of Medicine, Asan Medical Center, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of)

    2014-09-15

    Most thoracopagus twins present with cardiac fusion and associated congenital cardiac defects, and assessment of this anatomy is of critical importance in determining patient care and outcome. Cardiac CT with electrocardiographic triggering provides an accurate and quick morphological assessment of both intracardiac and extracardiac structures in newborns, making it the best imaging modality to assess thoracopagus twins during the neonatal period. In this case report, we highlight the diagnostic value of cardiac CT in thoracopagus twins with an interatrial channel and complex congenital cardiac defects. (orig.)

  16. Intra-cardiac distribution of late gadolinium enhancement in cardiac sarcoidosis and dilated cardiomyopathy

    Science.gov (United States)

    Sano, Makoto; Satoh, Hiroshi; Suwa, Kenichiro; Saotome, Masao; Urushida, Tsuyoshi; Katoh, Hideki; Hayashi, Hideharu; Saitoh, Takeji

    2016-01-01

    Cardiac involvement of sarcoid lesions is diagnosed by myocardial biopsy which is frequently false-negative, and patients with cardiac sarcoidosis (CS) who have impaired left ventricular (LV) systolic function are sometimes diagnosed with dilated cardiomyopathy (DCM). Late gadolinium enhancement (LE) in magnetic resonance imaging is now a critical finding in diagnosing CS, and the novel Japanese guideline considers myocardial LE to be a major criterion of CS. This article describes the value of LE in patients with CS who have impaired LV systolic function, particularly the diagnostic and clinical significance of LE distribution in comparison with DCM. LE existed at all LV segments and myocardial layers in patients with CS, whereas it was localized predominantly in the midwall of basal to mid septum in those with DCM. Transmural (nodular), circumferential, and subepicardial and subendocardial LE distribution were highly specific in patients with CS, whereas the prevalence of striated midwall LE were high both in patients with CS and with DCM. Since sarcoidosis patients with LE have higher incidences of heart failure symptoms, ventricular tachyarrhythmia and sudden cardiac death, the analyses of extent and distribution of LE are crucial in early diagnosis and therapeutic approach for patients with CS. PMID:27721933

  17. Characteristics of polypoid lesions in patients undergoing microsurgery of the larynx

    OpenAIRE

    Ido Filho, Jorge Massaaki; Carvalho, Bettina; Mizoguchi, Flavio Massao; Catani, Guilherme Simas do Amaral; Macedo Filho, Evaldo Dacheux de; Malafaia, Osvaldo; Stahlke Jr., Henrique Jorge

    2014-01-01

    Summary Introduction: Dysphonia is the main symptom of lesions that affect the vocal tract. Many of those lesions may require surgical treatment. Polyps are one of the most common forms of vocal cord lesions and the most prevalent indication for laryngeal microsurgery. There are different types of polyps, and their different characteristics can indicate different prognosis and treatments. Aim: To conduct a comparative study of polypoid lesions (angiomatous and gelatinous) in patients undergoi...

  18. Sudden Cardiac Death

    Directory of Open Access Journals (Sweden)

    Yipsy María Gutiérrez Báez

    2015-09-01

    Full Text Available Since the second half of the twentieth century, dying suddenly due to heart-related problems has become the main health issue in all countries where infectious diseases are not prevalent. Sudden death from cardiac causes is an important global health problem. Major databases were searched for the leading causes of sudden cardiac death. It has been demonstrated that there is a group of hereditary diseases with structural alterations or without apparent organic cause that explains many cases of sudden death in young people, whether related or not to physical exertion. Certain population groups are at higher risk for this disease. They are relatively easy to identify and can be the target of primary prevention measures.

  19. Senile dementia of the Binswanger type: a vascular form of dementia in the elderly

    International Nuclear Information System (INIS)

    Computed tomography and magnetic resonance imaging in the elderly have demonstrated the common occurrence of deep white-matter lesions in the aging brain. These radiologic lesions (leukoaraiosis) may represent an early marker of dementia. At autopsy, an ischemic periventricular leukoencephalopathy (Binswanger's disease) has been found in most cases. The clinical spectrum of Binswanger's disease appears to range from asymptomatic radiologic lesions to dementia with focal deficits, frontal signs, pseudobulbar palsy, gait difficulties, and urinary incontinence. The name senile dementia of the Binswanger type (SDBT) is proposed for this poorly recognized, vascular form of subcortical dementia. The SDBT probably results from cortical disconnections most likely caused by hypoperfusion. In contrast, multi-infarct dementia is correlated with multiple large and small strokes that cause a loss of over 50 to 100 mL of brain volume. The periventricular white matter is a watershed area irrigated by long, penetrating medullary arteries. Risk factors for SDBT are small-artery diseases, such as hypertension and amyloid angiopathy, impaired autoregulation of cerebral blood flow in the elderly, and periventricular hypoperfusion due to cardiac failure, arrhythmias, and hypotension. The SDBT may be a potentially preventable and treatable form of dementia

  20. Senile dementia of the Binswanger type: a vascular form of dementia in the elderly

    Energy Technology Data Exchange (ETDEWEB)

    Roman, G.C.

    1987-10-02

    Computed tomography and magnetic resonance imaging in the elderly have demonstrated the common occurrence of deep white-matter lesions in the aging brain. These radiologic lesions (leukoaraiosis) may represent an early marker of dementia. At autopsy, an ischemic periventricular leukoencephalopathy (Binswanger's disease) has been found in most cases. The clinical spectrum of Binswanger's disease appears to range from asymptomatic radiologic lesions to dementia with focal deficits, frontal signs, pseudobulbar palsy, gait difficulties, and urinary incontinence. The name senile dementia of the Binswanger type (SDBT) is proposed for this poorly recognized, vascular form of subcortical dementia. The SDBT probably results from cortical disconnections most likely caused by hypoperfusion. In contrast, multi-infarct dementia is correlated with multiple large and small strokes that cause a loss of over 50 to 100 mL of brain volume. The periventricular white matter is a watershed area irrigated by long, penetrating medullary arteries. Risk factors for SDBT are small-artery diseases, such as hypertension and amyloid angiopathy, impaired autoregulation of cerebral blood flow in the elderly, and periventricular hypoperfusion due to cardiac failure, arrhythmias, and hypotension. The SDBT may be a potentially preventable and treatable form of dementia.

  1. Nonsurgical management of periapical lesions

    Directory of Open Access Journals (Sweden)

    Fernandes Marina

    2010-01-01

    Full Text Available Periapical lesions develop as sequelae to pulp disease. They often occur without any episode of acute pain and are discovered on routine radiographic examination. The incidence of cysts within periapical lesions varies between 6 and 55%. The occurrence of periapical granulomas ranges between 9.3 and 87.1%, and of abscesses between 28.7 and 70.07%. It is accepted that all inflammatory periapical lesions should be initially treated with conservative nonsurgical procedures. Studies have reported a success rate of up to 85% after endodontic treatment of teeth with periapical lesions. A review of literature was performed by using electronic and hand searching methods for the nonsurgical management of periapical lesions. Various methods can be used in the nonsurgical management of periapical lesions: the conservative root canal treatment, decompression technique, active nonsurgical decompression technique, aspiration-irrigation technique, method using calcium hydroxide, Lesion Sterilization and Repair Therapy, and the Apexum procedure. Monitoring the healing of periapical lesions is essential through periodic follow-up examinations.

  2. Inherited cardiac disease

    Directory of Open Access Journals (Sweden)

    Philippe Charron

    2012-06-01

    Full Text Available Major advances have been achieved over the two last decades in the field of genetic cardiovascular diseases, not only through increased recognition and understanding of underlying molecular defects but also through rapid translation of knowledge into clinical practice. Genetic counseling and organization of cardiac family screening has become part of the medical management of these diseases, and these should be performed systematically unless an acquired cause has been diagnosed...

  3. Cardiac Tissue Engineering

    OpenAIRE

    MILICA RADISIC; GORDANA VUNJAK-NOVAKOVIC

    2009-01-01

    We hypothesized that clinically sized (1-5 mm thick),compact cardiac constructs containing physiologically high density of viable cells (~108 cells/cm3) can be engineered in vitro by using biomimetic culture systems capable of providing oxygen transport and electrical stimulation, designed to mimic those in native heart. This hypothesis was tested by culturing rat heart cells on polymer scaffolds, either with perfusion of culture medium (physiologic interstitial velocity, supplementation of p...

  4. Cardiac developmental toxicity

    OpenAIRE

    Mahler, Gretchen J.; Jonathan T Butcher

    2011-01-01

    Congenital heart disease is a highly prevalent problem with mostly unknown origins. Many cases of CHD likely involve an environmental exposure coupled with genetic susceptibility, but practical and ethical considerations make nongenetic causes of CHD difficult to assess in humans. The development of the heart is highly conserved across all vertebrate species, making animal models an excellent option for screening potential cardiac teratogens. This review will discuss exposures known to cause ...

  5. Assessing Depression in Cardiac Patients: What Measures Should Be Considered?

    Directory of Open Access Journals (Sweden)

    M. Ceccarini

    2014-01-01

    Full Text Available It is highly recommended to promptly assess depression in heart disease patients as it represents a crucial risk factor which may result in premature deaths following acute cardiac events and a more severe psychopathology, even in cases of subsequent nonfatal cardiac events. Patients and professionals often underestimate or misjudge depressive symptomatology as cardiac symptoms; hence, quick, reliable, and early mood changes assessments are warranted. Failing to detect depressive signals may have detrimental effects on these patients’ wellbeing and full recovery. Choosing gold-standard depression investigations in cardiac patients that fit a hospitalised cardiac setting well is fundamental. This paper will examine eight well established tools following Italian and international guidelines on mood disorders diagnosis in cardiac patients: the Hospital Anxiety and Depression Scale (HADS, the Cognitive Behavioural Assessment Hospital Form (CBA-H, the Beck Depression Inventory (BDI, the two and nine-item Patient Health Questionnaire (PHQ-2, PHQ-9, the Depression Interview and Structured Hamilton (DISH, the Hamilton Rating Scale for Depression (HAM-D/HRSD, and the Composite International Diagnostic Interview (CIDI. Though their strengths and weaknesses may appear to be homogeneous, the BDI-II and the PHQ are more efficient towards an early depression assessment within cardiac hospitalised patients.

  6. Cine MR imaging-current use in cardiac diagnosis

    International Nuclear Information System (INIS)

    This paper reviews the current status of cine MR imaging of the heart with special attention to the assessment of cardiac function. Cine MR provides tomographic sectional images with clear distinction between myocardium and flowing blood, and allows accurate volumetry of the cardiac chambers at specific points of the cardiac cycle. From these volume measurements parameters for the cardiac function, such as stroke volumem, ejection fraction, regurgitant fraction and shunt volum are calculated. While determination of chamber volumes can be done using any imaging plane, regional wall motion and wall thickening are evaluated with the short axis images. These images are readily obtained by orienting the slice selective gradient perpendicular to the long axis of the left ventricle. Left ventricular meridional wall stress is also calculated from cine MR images and noninvasive measurements of peak- and end-systolic pressure. Wall stress is an indicator of myocardial function in response to after load and can be used for monitoring patients with myocardial disease, regurgitant valvular disease and hypertension, and might be used to quantitatively assess the response of these diseases to therapy. Diseases causing hypertrophy of the ventricles, such as valvular stenosis, systemic or pulmonary hypertension and hypertrophic cardiomyopathy, can be monitored with cine MR by measuring the myocardial mass. A signal void from high velocity jets is caused by regurgitant or stenotic valvular lesion as well as flow across ventricular or atrial septal defects. Measurement of the dimension of the signal void have been correlated with the severity of regurgitation and can be used for semi-quantitation of these lesions. Due to the inherent contrast between blood and myocardium, high temporal resolution, and acquisition of tomographic images encompassing the entire heart, cine MR can serve as a comprehensive cardiac imaging modality that provides quantitative evaluation of anatomy and

  7. Cardiac hybrid imaging

    Energy Technology Data Exchange (ETDEWEB)

    Gaemperli, Oliver [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); University Hospital Zurich, Nuclear Cardiology, Cardiovascular Center, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiac Imaging, Zurich (Switzerland); Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic and Interventional Radiology, Zurich (Switzerland)

    2014-05-15

    Hybrid cardiac single photon emission computed tomography (SPECT)/CT imaging allows combined assessment of anatomical and functional aspects of cardiac disease. In coronary artery disease (CAD), hybrid SPECT/CT imaging allows detection of coronary artery stenosis and myocardial perfusion abnormalities. The clinical value of hybrid imaging has been documented in several subsets of patients. In selected groups of patients, hybrid imaging improves the diagnostic accuracy to detect CAD compared to the single imaging techniques. Additionally, this approach facilitates functional interrogation of coronary stenoses and guidance with regard to revascularization procedures. Moreover, the anatomical information obtained from CT coronary angiography or coronary artery calcium scores (CACS) adds prognostic information over perfusion data from SPECT. The use of cardiac hybrid imaging has been favoured by the dissemination of dedicated hybrid systems and the release of dedicated image fusion software, which allow simple patient throughput for hybrid SPECT/CT studies. Further technological improvements such as more efficient detector technology to allow for low-radiation protocols, ultra-fast image acquisition and improved low-noise image reconstruction algorithms will be instrumental to further promote hybrid SPECT/CT in research and clinical practice. (orig.)

  8. Establishing a clinical cardiac MRI service

    International Nuclear Information System (INIS)

    After several years of research development cardiovascular MRI has evolved into a widely accepted clinical tool. It offers important diagnostic and prognostic information for a variety of clinical indications, which include ischaemic heart disease, cardiomyopathies, valvular dysfunction and congenital heart disorders. It is a safe non-invasive technique that employs a variety of imaging sequences optimized for temporal or spatial resolution, tissue-specific contrast, flow quantification or angiography. Cardiac MRI offers specific advantages over conventional imaging techniques for a significant number of patients. The demand for cardiac MRI studies from cardiothoracic surgeons, cardiologists and other referrers is likely to continue to rise with pressure for more widespread local service provision. Setting up a cardiac MRI service requires careful consideration regarding funding issues and how it will be integrated with existing service provision. The purchase of cardiac phased array coils, monitoring equipment and software upgrades must also be considered, as well as the training needs of those involved. The choice of appropriate imaging protocols will be guided by operator experience, clinical indication and equipment capability, and is likely to evolve as the service develops. Post-processing and offline analysis form a significant part of the time taken to report studies and an efficient method of providing quantitative reports is an important requirement. Collaboration between radiologists and cardiologists is needed to develop a successful service and multi-disciplinary meetings are key component of this. This review will explore these issues from our perspective of a new clinical cardiac MRI service operating over its first year in a teaching hospital imaging department

  9. Biatrial Cardiac Metastases in a Patient with Uterine Cervix Malignant Melanoma

    Directory of Open Access Journals (Sweden)

    Caglayan Geredeli

    2015-01-01

    Full Text Available Primary malignant melanomas of uterine cervix are quite rarely seen neoplasms, and long-life prognosis of patients with this disease is poor. Immunohistochemical methods and exclusion of other primary melanoma sites are used to confirm the diagnosis. As with other melanomas, cervix malignant melanomas may also cause cardiac metastases. Cardiac metastases are among rarely seen but more commonly encountered cases, compared to primary cardiac tumors. Here, we present a case of biatrial cardiac metastases in a 73-year-old patient with uterine cervix malignant melanomas. The patient underwent echocardiography, cardiac magnetic resonance imaging, and computed tomography. Our report shows the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but for a better anatomic definition and tissue characterization. Although the cases of malignant melanomas leading to multiple cardiac metastasis were reported in literature, the metastatic concurrence of malignant melanomas in both right and left atriums is quite rarely encountered as metastatic malignant melanomas. Also, another intriguing point in our case is that the primary lesion of our case was stemmed from uterine cervix, but not skin.

  10. Study of pregnancy outcome in women with cardiac disease: a retrospective analysis

    Directory of Open Access Journals (Sweden)

    Kiran Pandey

    2016-10-01

    Conclusions: Heart disease in pregnancy is a high risk condition and has a major impact on pregnancy outcome. Rheumatic heart disease being the prominent cardiac lesion. Fetomaternal mortality and morbidity can be reduced with proper antenatal, intrapartum and postnatal care in conjunction with cardiologist and neonatologist. [Int J Reprod Contracept Obstet Gynecol 2016; 5(10.000: 3537-3541

  11. Colonic malakoplakia in a cardiac transplant recipient

    Directory of Open Access Journals (Sweden)

    Niamathullah Sadiya

    2014-08-01

    Full Text Available Malakoplakia is a rare inflammatory condition which is usually seen in the urogenital tract and less commonly in the gastrointestinal tract. Gastrointestinal malakoplakia may be associated with organ transplantation. There are previously only three reported cases of malakoplakia in cardiac transplant recipient. We report a case of colonic malakoplakia in a 38‑year‑old male who underwent cardiac transplantation for dilated cardiomyopathy 4 years previously and who had been on tacrolimus and mycophenolate. The patient presented with history of diarrhea associated with fecal incontinence for the past 6 months. Ileocolonoscopic examination was within normal limits. A rectal biopsy was done to exclude microscopic pathology. Microscopy revealed expansion of the lamina propria by histiocytes admixed with a few lymphocytes. The histiocytes showed granular eosinophilic cytoplasm with intracytoplasmic presence of Michaelis‑Gutmann bodies, rounded basophilic laminated structures having central core with a targetoid appearance. These stained positively for Von kossa stain for calcium and were diagnostic for malakoplakia. Although rare, malakoplakia may be associated with chronic diarrhea even if there are no macroscopic lesions seen during colonoscopy. The patient’s symptoms resolved with long‑term ciprofloxacin therapy

  12. Drug-related cardiac valve disease.

    Science.gov (United States)

    2013-12-01

    Cardiac valve disease can involve one or more of the four heart valves. Chronic valve damage may remain asymptomatic for long periods but ultimately leads to haemodynamic overload of the heart. The most common causes of valve disease are rheumatic diseases, infections, chronic renal failure, malformations, and genetic diseases. Valve disease is often attributed to degeneration with no known cause.The frequency of drug-related valve disease has long been underestimated. Most implicated drugs have serotonergic properties, such as fenfluramine-derived amphetamines, including benfluorex. Rye ergot derivatives can also be implicated: these include dopamine agonists (bromocriptine, lisuride, pergolide and cabergoline), migraine treatments (methysergide, ergotamine and dihydroergotamine), and drugs used for cognitive and neurosensory deficits (nicergoline, dihydroergocryptine, etc.). "Ecstasy", an amphetamine, is sometimes also involved. The risk increases after a few months of exposure. Drug withdrawal is sometimes followed by an improvement. Patients exposed to a drug known to cause valve damage should be informed of the risk and receive long-term monitoring to detect these lesions before they become irreversible. The possible role of a drug should always be considered when cardiac valve disease is diagnosed, in order to facilitate active research and to avoid exposing other patients to this risk. PMID:24600729

  13. Systemic juvenile xanthogranuloma with multiple central nervous system lesions

    Directory of Open Access Journals (Sweden)

    Ali Meshkini

    2012-01-01

    Full Text Available Juvenile xanthogranulomatosis (JXG is an uncommon histiocytic disorder that is usually benign and limited to the skin. The systemic form of JXG is rare and may be associated with severe morbidity and mortality especially in central nervous system (CNS involvement. Here, we describe a six-year-old boy with disseminated skin lesions and neurological signs and symptoms. Diagnostic work up revealed multiple brain lesions. A skin biopsy and a stereotactic brain biopsy considered suggestive of systemic JXG. Treatment with prednisolone, vinblastine and methotrexate was successful with regression of skin and CNS lesions. The patient has been in remission for almost three years.

  14. Indeterminacy of Spatiotemporal Cardiac Alternans

    CERN Document Server

    Zhao, Xiaopeng

    2007-01-01

    Cardiac alternans, a beat-to-beat alternation in action potential duration (at the cellular level) or in ECG morphology (at the whole heart level), is a marker of ventricular fibrillation, a fatal heart rhythm that kills hundreds of thousands of people in the US each year. Investigating cardiac alternans may lead to a better understanding of the mechanisms of cardiac arrhythmias and eventually better algorithms for the prediction and prevention of such dreadful diseases. In paced cardiac tissue, alternans develops under increasingly shorter pacing period. Existing experimental and theoretical studies adopt the assumption that alternans in homogeneous cardiac tissue is exclusively determined by the pacing period. In contrast, we find that, when calcium-driven alternans develops in cardiac fibers, it may take different spatiotemporal patterns depending on the pacing history. Because there coexist multiple alternans solutions for a given pacing period, the alternans pattern on a fiber becomes unpredictable. Usin...

  15. [Onychomatricoma, a rare lesion of the nail].

    Science.gov (United States)

    Pommepuy, Isabelle; Roblet, Denis; Blaise, Sophie; Delage-Corre, Manuela; Bonnetblanc, Jean-Marie; Fayol, Jacqueline; Labrousse, François

    2004-09-01

    Onychomatricoma is a rare fibroepithelial lesion of the nail matrix with peculiar clinical and histological features. Clinically, it is characterized by a longitudinal band of yellow thickening of the nail plate with transverse overcurvature and splinter hemorrhages. Nail avulsion exposes a villous tumor of the matrix with filamentous digitations extending into multiple holes of the nail plate. Histologically, a thick keratogenous zone forms a thickened nail plate. The lesion in its proximal portion is characterized by deep epithelial invaginations and by a stroma organized in two layers. The distal zone corresponds to multiple fibroepithelial projections extending into the nail plate. The diagnosis can be difficult in the presence of misleading clinical features or when the specimen is incomplete or examined with an improper orientation. Surgical resection is the recommended treatment. PMID:15567955

  16. Getting to the heel of the problem: plantar fascia lesions

    International Nuclear Information System (INIS)

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  17. Getting to the heel of the problem: plantar fascia lesions

    Energy Technology Data Exchange (ETDEWEB)

    Jeswani, T. [Department of Radiology, Worthing and Southlands Hospitals, West Sussex (United Kingdom); Morlese, J. [Department of Radiology, Royal Free Hospital, Pond street, London, NW3 2QG (United Kingdom); McNally, E.G. [Department of Radiology, Nuffield Orthopaedic Centre, Oxford (United Kingdom)], E-mail: eugene.mcnally@gmail.com

    2009-09-15

    Heel pain is a frequent disabling symptom. Clinical diagnosis is often difficult with a large range of possible diagnoses. Lesions of the plantar fascia form an important group. We present a review describing the common lesions of the plantar fascia, including plantar fasciitis, plantar fascia rupture, plantar fibromatosis, and plantar xanthoma, and illustrate them with appropriate magnetic resonance imaging (MRI) and ultrasound imaging. We also address foreign-body reactions, enthesopathy, and diabetic fascial disease.

  18. Sudden Cardiac Death in Athletes.

    Science.gov (United States)

    Wasfy, Meagan M; Hutter, Adolph M; Weiner, Rory B

    2016-01-01

    There are clear health benefits to exercise; even so, patients with cardiac conditions who engage in exercise and athletic competition may on rare occasion experience sudden cardiac death (SCD). This article reviews the epidemiology and common causes of SCD in specific athlete populations. There is ongoing debate about the optimal mechanism for SCD prevention, specifically regarding the inclusion of the ECG and/or cardiac imaging in routine preparticipation sports evaluation. This controversy and contemporary screening recommendations are also reviewed. PMID:27486488

  19. Comparative Analysis of Telomerase Activity in CD117+CD34+ Cardiac Telocytes with Bone Mesenchymal Stem Cells, Cardiac Fibroblasts and Cardiomyocytes

    Institute of Scientific and Technical Information of China (English)

    Yuan-Yuan Li; Shan-Shan Lu; Ting Xu; Hong-Qi Zhang; Hua Li

    2015-01-01

    Background:This study characterized the cardiac telocyte (TC) population both in vivo and in vitro,and investigated its telomerase activity related to mitosis.Methods:Using transmission electron microscopy and a phase contrast microscope,the typical morphological features of cardiac TCs were observed;by targeting the cell surface proteins CD 1 17 and CD34,CD 117+CD34+ cardiac TCs were sorted via flow cytometry and validated by immunofluorescence based on the primary cell culture.Then the optimized basal nutrient medium for selected population was examined with the cell counting kit 8.Under this conditioned medium,the process of cell division was captured,and the telomerase activity ofCD 117+CD34+ cardiac TCs was detected in comparison with bone mesenchymal stem cells (BMSCs),cardiac fibroblasts (CFBs),cardiomyocytes (CMs).Results:Cardiac TCs projected characteristic telopodes with thin segments (podomers) in alternation with dilation (podoms).In addition,64% of the primary cultured cardiac TCs were composed of CD 117+CD34+ cardiac TCs;which was verified by immunofluorescence.In a live cell imaging system,CD 117+CD34+ cardiac TCs were observed to enter into cell division in a short time,followed by an significant invagination forming across the middle of the cell body.Using a real-time quantitative telomeric-repeat amplification assay,the telomerase concentration in CD117+CD34+ cardiac TCs was obviously lower than in BMSCs and CFBs,and significantly higher than in CMs.Conclusions:Cardiac TCs represent a unique cell population and CD117+CD34+ cardiac TCs have relative low telomerase activity that differs from BMSCs,CFBs and CMs and thus they might play an important role in maintaining cardiac homeostasis.

  20. Comparative Analysis of Telomerase Activity in CD117+CD34+ Cardiac Telocytes with Bone Mesenchymal Stem Cells, Cardiac Fibroblasts and Cardiomyocytes

    Science.gov (United States)

    Li, Yuan-Yuan; Lu, Shan-Shan; Xu, Ting; Zhang, Hong-Qi; Li, Hua

    2015-01-01

    Background: This study characterized the cardiac telocyte (TC) population both in vivo and in vitro, and investigated its telomerase activity related to mitosis. Methods: Using transmission electron microscopy and a phase contrast microscope, the typical morphological features of cardiac TCs were observed; by targeting the cell surface proteins CD117 and CD34, CD117+CD34+ cardiac TCs were sorted via flow cytometry and validated by immunofluorescence based on the primary cell culture. Then the optimized basal nutrient medium for selected population was examined with the cell counting kit 8. Under this conditioned medium, the process of cell division was captured, and the telomerase activity of CD117+CD34+ cardiac TCs was detected in comparison with bone mesenchymal stem cells (BMSCs), cardiac fibroblasts (CFBs), cardiomyocytes (CMs). Results: Cardiac TCs projected characteristic telopodes with thin segments (podomers) in alternation with dilation (podoms). In addition, 64% of the primary cultured cardiac TCs were composed of CD117+CD34+ cardiac TCs; which was verified by immunofluorescence. In a live cell imaging system, CD117+CD34+ cardiac TCs were observed to enter into cell division in a short time, followed by an significant invagination forming across the middle of the cell body. Using a real-time quantitative telomeric-repeat amplification assay, the telomerase concentration in CD117+CD34+ cardiac TCs was obviously lower than in BMSCs and CFBs, and significantly higher than in CMs. Conclusions: Cardiac TCs represent a unique cell population and CD117+CD34+ cardiac TCs have relative low telomerase activity that differs from BMSCs, CFBs and CMs and thus they might play an important role in maintaining cardiac homeostasis. PMID:26168836

  1. Case Report: Penetrating Cardiac Injury

    Directory of Open Access Journals (Sweden)

    Adem Grbolar

    2013-10-01

    Full Text Available Summary: Penetrating cardiac injurys caused by gunshots and penetrating tools have high mortality rates. The way of injury, how the cardiac area is effected and the presence of cardiac tamponadecauses mortality in different rates. However the better treatment quality of hospitals, increasingoperative techniques, and internel care unit quality has not been change during the years. Searching the literature, we want to present a 42 years old male patient whowas injured by knife and had a 1 cm skin wound on chest with cardiac tamponade. After sternotomy a 7 cm laseration was observed in heart. Cardioraphy was performed.

  2. PHAEOHYPHOMYCOSIS: CUTANEOUS, SUBCUTANEOUS, NASOPHARYNGEAL LESIONS

    Directory of Open Access Journals (Sweden)

    M. Rasoolinejad

    1999-06-01

    Full Text Available Phaeohyphomycosis is an amalgam of clinical diseases caused by a wide variety of dematiaceous fungi. We are reporting on a 16 year-old patient from Amol with subcutaneous cervical nodes and nasopharyngeal lesions of phaeohypho"nmycosis that were confirmed by pathological examination, direct smear, and culture. After treatment with an oral triazole (Itraconazole for 4 months, all nodes and lesions disappeared and treatment was stopped A new lesion appeared on his chest wall 8 months, therapy with itraconazole was restarted and commuted for a long time.

  3. Nerve lesioning with direct current

    Science.gov (United States)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  4. Interplay between cardiac function and heart development.

    Science.gov (United States)

    Andrés-Delgado, Laura; Mercader, Nadia

    2016-07-01

    Mechanotransduction refers to the conversion of mechanical forces into biochemical or electrical signals that initiate structural and functional remodeling in cells and tissues. The heart is a kinetic organ whose form changes considerably during development and disease. This requires cardiomyocytes to be mechanically durable and able to mount coordinated responses to a variety of environmental signals on different time scales, including cardiac pressure loading and electrical and hemodynamic forces. During physiological growth, myocytes, endocardial and epicardial cells have to adaptively remodel to these mechanical forces. Here we review some of the recent advances in the understanding of how mechanical forces influence cardiac development, with a focus on fluid flow forces. This article is part of a Special Issue entitled: Cardiomyocyte Biology: Integration of Developmental and Environmental Cues in the Heart edited by Marcus Schaub and Hughes Abriel.

  5. Electrocautery for Precancerous Anal Lesions

    Science.gov (United States)

    Results from a randomized clinical trial conducted in Amsterdam suggest that electrocautery is better than topical imiquimod or fluorouracil at treating potentially precancerous anal lesions in HIV-positive men who have sex with men.

  6. Traumatic lesions of pulmonary parenchyma

    International Nuclear Information System (INIS)

    Five cases of post-traumatic pulmonary lesions (contusion, laceration and hematoma) are presented. The pathophysiology, radiological aspects and differential diagnosis are reviewed. The benign evolution showing the absorption in short time, without medical interference is emphasized. (Author)

  7. Post-radiotherapeutic heart lesions

    International Nuclear Information System (INIS)

    Heart structures have traditionally been considered radioresistant. In fact all tissues subjected to radiotherapy can develop lesions. Possible damage includes: - pericardiac fibrosis, the commonest and best individualized, associated with a constriction this leads to a stoppage pattern usually occurring late, around the 18th month. Its frequency depends directly on the total radiation dose; - fibrous myocarditis by direct damage to the heart muscle; - stenosis type lesions of the large coronary trunks; - in exceptional cases lesions of the aorta: hyperplastic degenerescence of the intima and adventitia or of the aortic sigmoid valvules and the mitral valves. Three observations are reported, concerning a coronary, a pericardiac and a coronary, myocardiac and pericardiac lesion. Following this account the irradiation techniques and main experimental data are reviewed and the prophylactic and therapeutic consequences to be derived from our observations and those of the literature are examined

  8. Cutaneous lesions of the nose

    OpenAIRE

    Altmeyer Peter; Paech Volker; Thrandorf Christina; Sand Daniel; Sand Michael; Bechara Falk G

    2010-01-01

    Abstract Skin diseases on the nose are seen in a variety of medical disciplines. Dermatologists, otorhinolaryngologists, general practitioners and general plastic and dermatologic surgeons are regularly consulted regarding cutaneous lesions on the nose. This article is the second part of a review series dealing with cutaneous lesions on the head and face, which are frequently seen in daily practice by a dermatologic surgeon. In this review, we focus on those skin diseases on the nose where su...

  9. Rosacea with extensive extrafacial lesions

    OpenAIRE

    Pereira, TM; Vieira, AP; Sousa-Basto, A.

    2008-01-01

    Rosacea is a very common skin disorder in the clinical practice that primarily affects the convex areas of the face. Extrafacial rosacea lesions have occasionally been described, but extensive involvement is exceptional. In the absence of its typical clinical or histological features, the diagnosis of extrafacial rosacea may be problematic. We describe an unusual case of rosacea with very exuberant extrafacial lesions, when compared with the limited involvement of the face.

  10. Benign Pediatric Salivary Gland Lesions.

    Science.gov (United States)

    Carlson, Eric R; Ord, Robert A

    2016-02-01

    Salivary gland lesions are rare in pediatric patients. In addition, the types of salivary gland tumors are different in their distribution in specific sites in the major and minor salivary glands in children compared with adults. This article reviews benign neoplastic and nonneoplastic salivary gland disorders in pediatric patients to help clinicians to develop an orderly differential diagnosis that will lead to expedient treatment of pediatric patients with salivary gland lesions.

  11. Apraxia in deep cerebral lesions.

    OpenAIRE

    Agostoni, E; Coletti, A.; G. Orlando; Tredici, G

    1983-01-01

    In a series of 50 patients with cerebrovascular lesions (demonstrated with CT scan), seven patients had lesions located in the basal ganglia and/or thalamus. All these seven patients were apractic. Ideomotor apraxia was present in all patients; five also had constructional apraxia, and one had bucco-facial apraxia. None of the patients had utilisation apraxia. These observations indicated that apraxia is not only a "high cerebral (cortical) function", but may depend also on the integrity of s...

  12. Downregulation of Rho associated coiled-coil forming protein kinase 1 in the process of delayed myocardialization of cardiac proximal outflow tract septum in connexin 43 knockout mice embryo

    Institute of Scientific and Technical Information of China (English)

    QI Chun-hua; ZHAO Xiao-qing; MA Duan; MA Xiao-jing; ZHOU Guo-min; HUANG Guo-ying

    2011-01-01

    Background The connexln43 knockout (Cx43 KO) mouse dies at birth with an enlarged conotruncal region, which leads to the obstruction of the right outflow tract (OFT). Since myocardialization of the proximal OFT septum is one of the key events during heart development, we investigated the process in the Cx43 KO embryo hearts. Rho associated coiled-coil forming protein kinase 1 (ROCK1), is a recently found key molecule to regulate the myocardialization of OFT, but its spatiotemporal expression pattern during myocardialization remains unknown. The objective of this study was to investigate the differentially expressed pattern of ROCK1 between Cx43 KO and wild type embryo hearts, and its relationship with the delayed myocardialization in Cx43 KO embryo hearts.Methods Using immunohistochemistry, the processes of myocardiolization were investigated both in Cx43 KO and wild type embryo hearts. The differentially expressed pattern of ROCK1 between Cx43 KO and wildtype embryo hearts was evaluated both at the mRNA and protein level by real-time RT-PCR and immunohistochemistry.Results The expression of α-sarcomeric actin (α-SCA) in the proximal OFT septum of Cx43 KO embryos was delayed. Meanwhile, it was shown that the downregulation of ROCK1 coincided with delayed myocardialization. The expression of ROCK1 protein was mainly limited to the proximal outflow tract septum from embryo day (E) E11.5 to E15.5. Its expression pattern was similar with that of α-SCA. Real-time RT-PCR found that the expression level of Rock-1 mRNA began at a low level on E11.5 and reached peak at E13.5 and E14.5.Conclusions ROCK1 may have an important role in the process of myocardialization of the proximal OFT septum. Downregulation of ROCK1 is likely to contribute to the aberrant myocardialization in Cx43 KO embryo hearts.

  13. Premalignant Lesions in the Kidney

    Directory of Open Access Journals (Sweden)

    Ziva Kirkali

    2001-01-01

    Full Text Available Renal cell carcinoma (RCC is the most malignant urologic disease. Different lesions, such as dysplasia in the tubules adjacent to RCC, atypical hyperplasia in the cyst epithelium of von Hippel-Lindau syndrome, and adenoma have been described for a number of years as possible premalignant changes or precursor lesions of RCC. In two recent papers, kidneys adjacent to RCC or removed from other causes were analyzed, and dysplastic lesions were identified and defined in detail. Currently renal intraepithelial neoplasia (RIN is the proposed term for classification. The criteria for a lesion to be defined as premalignant are (1 morphological similarity; (2 spatial association; (3 development of microinvasive carcinoma; (4 higher frequency, severity, and extent then invasive carcinoma; (5 progression to invasive cancer; and (6 similar genetic alterations. RIN resembles the neoplastic cells of RCC. There is spatial association. Progression to invasive carcinoma is described in experimental cancer models, and in some human renal tumors. Similar molecular alterations are found in some putative premalignant changes. The treatment for RCC is radical or partial nephrectomy. Preneoplastic lesions may remain in the renal remnant in patients treated by partial nephrectomy and may be the source of local recurrences. RIN seems to be a biologic precursor of some RCCs and warrants further investigation. Interpretation and reporting of these lesions would reveal important resources for the biological nature and clinical significance. The management of RIN diagnosed in a renal biopsy and partial nephrectomy needs to be answered.

  14. Unusual lesions of the mediastinum

    Directory of Open Access Journals (Sweden)

    Fatima Shamsuddin

    2015-01-01

    Full Text Available Objectives: To study unusual lesions in the mediastinum, which do not originate from the thymus, lymph nodes, neural tissues or germ cells, and tissues that normally engender pathologic lesions in the mediastinum. Materials and Methods: Of the 65 cases seen, 12 unusual lesion were encountered in a 5½ year period from 2006 to 2011. Results: Two cases of nodular colloid goiter and one each of the mediastinal cyst, undifferentiated carcinoma, and Langerhans cell histiocytosis (LCH affected the anterosuperior mediastinum. In the middle mediastinum, one case each of the mesothelioma, malignant gastrointestinal stromal tumor (GIST, squamous cell carcinoma (SCC, solitary fibrous tumor (SFT, and pleomorphic sarcoma (PS was seen. One case of meningeal melanocytoma (Mme and primary pleural liposarcoma (PL involved the posterior mediastinum. Persistent disease was seen in LCH after 2 years. Of all the cases with malignant lesions, only the patient with SCC was alive after 1 year. Conclusion: The cases of primary and SCC, LCH, melanocytoma, liposarcoma and PS, and GIST are unexpected and very rarely have paradigms in the mediastinum. Radiologic impression and knowledge of the compartment where these lesions arose from hardly assisted in arriving at a definitive opinion as the lesions were not typical of this location. A high index of suspicion and the immunohistochemical profile facilitated the final diagnosis.

  15. Simulation of spiculated breast lesions

    Science.gov (United States)

    Elangovan, Premkumar; Alrehily, Faisal; Pinto, R. Ferrari; Rashidnasab, Alaleh; Dance, David R.; Young, Kenneth C.; Wells, Kevin

    2016-03-01

    Virtual clinical trials are a promising new approach increasingly used for the evaluation and comparison of breast imaging modalities. A key component in such an assessment paradigm is the use of simulated pathology, in particular, simulation of lesions. Breast mass lesions can be generally classified into two categories based on their appearance; nonspiculated masses and spiculated masses. In our previous work, we have successfully simulated non-spiculated masses using a fractal growth process known as diffusion limited aggregation. In this new work, we have extended the DLA model to simulate spiculated lesions by using features extracted from patient DBT images containing spiculated lesions. The features extracted included spicule length, width, curvature and distribution. This information was used to simulate realistic looking spicules which were attached to the surface of a DLA mass to produce a spiculated mass. A batch of simulated spiculated masses was inserted into normal patient images and presented to an experienced radiologist for review. The study yielded promising results with the radiologist rating 60% of simulated lesions in 2D and 50% of simulated lesions in DBT as realistic.

  16. Double-valve Libman-Sacks endocarditis causing ventricular fibrillation cardiac arrest.

    Science.gov (United States)

    Tanawuttiwat, Tanyanan; Dia, Muhyaldeen; Hanif, Tabassum; Mihailescu, Mihaela

    2011-01-01

    Libman-Sacks endocarditis is a well-known and rather common cardiac manifestation of systemic lupus erythematosus. Transesophageal and transthoracic echocardiography are the definitive imaging methods used to evaluate cardiac valvular involvement in this disease. Valvular masses (vegetations) and valvular thickening are 2 common morphologic echocardiographic patterns. Libman-Sacks lesions are typically characterized by single-valve involvement and their small size of 1 to 4 mm.Herein, we present the unusual case of a 22-year-old woman with newly diagnosed systemic lupus erythematosus who had large, sterile vegetations of Libman-Sacks endocarditis that involved the mitral and aortic valves. This compromised coronary blood flow and resulted in ventricular fibrillation cardiac arrest. The vegetations were surgically excised, and the patient's cardiac function recovered. We discuss the treatment of the patient and that of Libman-Sacks endocarditis.

  17. Collaborative form(s)

    DEFF Research Database (Denmark)

    Gunn, Wendy

    the process of research rather than its object. In its temporal orientation, anthropology by means of design moves, ‘…forward with people in tandem with their desires and aspirations rather than going back over times passed’ (ibid 2013: 141). Doing design by means of anthropology takes as its most fundamental......Gunn asks us to consider beauty as collaborative forms of action generated by moving between design by means of anthropology and anthropology by means of design. Specifically, she gives focus to play-like reflexions on practices of designing energy products, systems and infrastructure. Design...

  18. Cardiac arrest – cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Basri Lenjani

    2014-01-01

    Conclusions: All survivors from cardiac arrest have received appropriate medical assistance within 10 min from attack, which implies that if cardiac arrest occurs near an institution health care (with an opportunity to provide the emergent health care the rate of survival is higher.

  19. Leadership in cardiac surgery.

    Science.gov (United States)

    Rao, Christopher; Patel, Vanash; Ibrahim, Michael; Ahmed, Kamran; Wong, Kathie A; Darzi, Ara; von Segesser, Ludwig K; Athanasiou, Thanos

    2011-06-01

    Despite the efficacy of cardiac surgery, less invasive interventions with more uncertain long-term outcomes are increasingly challenging surgery as first-line treatment for several congenital, degenerative and ischemic cardiac diseases. The specialty must evolve if it is to ensure its future relevance. More importantly, it must evolve to ensure that future patients have access to treatments with proven long-term effectiveness. This cannot be achieved without dynamic leadership; however, our contention is that this is not enough. The demands of a modern surgical career and the importance of the task at hand are such that the serendipitous emergence of traditional charismatic leadership cannot be relied upon to deliver necessary change. We advocate systematic analysis and strategic leadership at a local, national and international level in four key areas: Clinical Care, Research, Education and Training, and Stakeholder Engagement. While we anticipate that exceptional individuals will continue to shape the future of our specialty, the creation of robust structures to deliver collective leadership in these key areas is of paramount importance. PMID:20884217

  20. Ictal Cardiac Ryhthym Abnormalities.

    Science.gov (United States)

    Ali, Rushna

    2016-01-01

    Cardiac rhythm abnormalities in the context of epilepsy are a well-known phenomenon. However, they are under-recognized and often missed. The pathophysiology of these events is unclear. Bradycardia and asystole are preceded by seizure onset suggesting ictal propagation into the cortex impacting cardiac autonomic function, and the insula and amygdala being possible culprits. Sudden unexpected death in epilepsy (SUDEP) refers to the unanticipated death of a patient with epilepsy not related to status epilepticus, trauma, drowning, or suicide. Frequent refractory generalized tonic-clonic seizures, anti-epileptic polytherapy, and prolonged duration of epilepsy are some of the commonly identified risk factors for SUDEP. However, the most consistent risk factor out of these is an increased frequency of generalized tonic-clonic seizures (GTC). Prevention of SUDEP is extremely important in patients with chronic, generalized epilepsy. Since increased frequency of GTCS is the most consistently reported risk factor for SUDEP, effective seizure control is the most important preventive strategy. PMID:27347227

  1. Pneumothorax in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2012-01-01

    AIM: To identify risk factors for pneumothorax treated with a chest tube after cardiac pacing device implantation in a population-based cohort.METHODS AND RESULTS: A nationwide cohort study was performed based on data on 28 860 patients from the Danish Pacemaker Register, which included all Danish...... patients who received their first pacemaker (PM) or cardiac resynchronization device from 1997 to 2008. Multiple logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals for the association between risk factors and pneumothorax treated with a chest tube. The median...... age was 77 years (25th and 75th percentile: 69-84) and 55% were male (n = 15 785). A total of 190 patients (0.66%) were treated for pneumothorax, which was more often in women [aOR 1.9 (1.4-2.6)], and in patients with age >80 years [aOR 1.4 (1.0-1.9)], a prior history of chronic obstructive pulmonary...

  2. Long-term outcomes following drug-eluting stent implantation in unprotected left main bifurcation lesions

    Institute of Scientific and Technical Information of China (English)

    GE Lei; Nicola Corvaja; Antonio Colombo; GE Jun-bo; John Cosgrave; Ioannis Iakovou; QIAN Ju-ying; Pierfrancesco Agostoni; Giuseppe M. Sangiorgi; Flavio Airoldi; Iassen Michev; Alaide Chieffo

    2007-01-01

    Background The safety and efficacy of drug-eluting stents (DES) implantation in unprotected left main (LM)bifurcation lesions has yet to be determined. The aim of the present report was to evaluate the long-term outcome following implantation of DES in unprotected LM bifurcation lesions.Methods We identified 70 consecutive patients treated with DES in unprotected LM bifurcation lesions from April 2003to January 2005. Of them, 42 patients were treated with sirolimus-eluting stent (SES) and 28 patients were treated with paclitaxel-eluting stent (PES).Results Stents to the left anterior descending and to the circumflex were implanted in 62 patients. During 1-year follow-up, 3 (4.3%) patients died of cardiac causes. One of them had myocardial infarction and adjudicated as possibly due to stent thrombosis. Angiographic follow-up was available in 80% of patients. The per lesion restenosis rate was 13.4% in the entire cohort, of which 10.7% occurred in lesions treated with SES and 16.1% in those treated with PES (P=0.58). All restenosis was focal and occurred in the lesions treated with a stent with stent size to post-procedural reference vessel diameter ratio <1.0 (17.6% vs 0, P=0.04). The per patient target lesion revascularization rate at 1 year was 17.1%. One year survival free from major adverse cardiac events was 77.1%.Conclusions Treatment of LM bifurcation lesions using DES is a safe and feasible way with a low one-year mortality.The need for revascularization in 17% of patients demands for improvement.

  3. Ulcerated lesion of the alveolar ridge.

    Science.gov (United States)

    Bokmeyer, T J

    1980-10-01

    Histoplasmosis is a generalized fungal infection that is caused by the organism H capsulatum. In the most common disease-producing mechanism, the organism is inhaled and lodges in the lung, where it initiates an inflammatory focus. The peribronchial lymph nodes are subsequently involved, forming a primary complex that may ultimately calcify and become radiographically evident. From the primary complex, dissemination by the bloodstream may lead to colonization elsewhere. In the less frequent disease-producing complex, the organism is introduced directly into the tissue through a break in its continuity. A primary complex is then formed by involvement of the lymph nodes. Dissemination from such a focus is rare. It is generally believed that oral and pharyngeal lesions of the histoplasmosis represent symptoms of a systemic disease and are not a localized form of the disease. Histoplasmosis can occur at all ages; however, it is more often found in infancy and old age, especially in white males. Any area in the oral cavity may be affected; the most common sites are: larynx, tongue, palate, buccal mucosa. gingiva, and pharynx. The most frequently reported symptoms are pain, hoarseness, loss of weight, ulcer, and sore throat. The appearance of the oral and pharyngeal lesions may vary and may manifest as ulcers, nodules, or verrucous plaques. Deep, indurated ulcers are common, accounting for the predominant clinical impression of squamous carcinoma. PMID:6934220

  4. Affect intensity and cardiac arousal.

    Science.gov (United States)

    Blascovich, J; Brennan, K; Tomaka, J; Kelsey, R M; Hughes, P; Coad, M L; Adlin, R

    1992-07-01

    Relationships between affect intensity and basal, evoked, and perceived cardiac arousal were investigated in 3 experiments. Affect intensity was assessed using Larsen and Diener's (1987) Affect Intensity Measure (AIM). Cardiac arousal was evoked with exercise in the 1st study and with mental arithmetic in the 2nd and 3rd. Perceived cardiac arousal was measured under optimal conditions using a standard heartbeat discrimination procedure. Women as a group scored higher on the AIM. Affect intensity was unrelated to basal or evoked cardiac arousal and was negatively related to perceived cardiac arousal in all 3 studies. Data suggest that affect intensity, although unrelated to actual physiological arousal, is negatively related to the accuracy with which individuals perceive their own arousal. Results are discussed within the context of an expanded arousal-regulation model (Blascovich, 1990). PMID:1494983

  5. Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?

    Science.gov (United States)

    Tan, Alex Y; Ellenbogen, Kenneth

    2016-09-01

    Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain. This article addresses some of the uncertainties and pitfalls in ICD risk stratification in this patient group and explores potential mechanisms for malignant conversion of benign premature ventricular complexes to sustained arrhythmia.

  6. Ventricular Arrhythmias in Apparently Normal Hearts: Who Needs an Implantable Cardiac Defibrillator?

    Science.gov (United States)

    Tan, Alex Y; Ellenbogen, Kenneth

    2016-09-01

    Idiopathic ventricular tachycardia is often considered a benign form of ventricular arrhythmia in patients without apparent structural heart disease. However, a subset of patients may develop malignant ventricular arrhythmias and present with syncope and sudden cardiac arrest. Survivors of cardiac arrest are candidates for implantable cardiac defibrillators (ICDs). The indications for ICDs in patients with less than a full-blown cardiac arrest presentation but with electrocardiographically high-risk ectopy features remain uncertain. This article addresses some of the uncertainties and pitfalls in ICD risk stratification in this patient group and explores potential mechanisms for malignant conversion of benign premature ventricular complexes to sustained arrhythmia. PMID:27521094

  7. Three-dimensional cardiac tissue fabrication based on cell sheet technology.

    Science.gov (United States)

    Masuda, Shinako; Shimizu, Tatsuya

    2016-01-15

    Cardiac tissue engineering is a promising therapeutic strategy for severe heart failure. However, conventional tissue engineering methods by seeding cells into biodegradable scaffolds have intrinsic limitations such as inflammatory responses and fibrosis arising from the degradation of scaffolds. On the other hand, we have developed cell sheet engineering as a scaffold-free approach for cardiac tissue engineering. Confluent cultured cells are harvested as an intact cell sheet using a temperature-responsive culture surface. By layering cardiac cell sheets, it is possible to form electrically communicative three-dimensional cardiac constructs. Cell sheet transplantation onto damaged hearts in several animal models has revealed improvements in heart functions. Because of the lack of vasculature, the thickness of viable cardiac cell sheet-layered tissues is limited to three layers. Pre-vascularized structure formation within cardiac tissue and multi-step transplantation methods has enabled the formation of thick vascularized tissues in vivo. Furthermore, development of original bioreactor systems with vascular beds has allowed reconstruction of three-dimensional cardiac tissues with a functional vascular structure in vitro. Large-scale culture systems to generate pluripotent stem cell-derived cardiac cells can create large numbers of cardiac cell sheets. Three-dimensional cardiac tissues fabricated by cell sheet engineering may be applied to treat heart disease and tissue model construction.

  8. Genetic and physiologic dissection of the vertebrate cardiac conduction system.

    Directory of Open Access Journals (Sweden)

    Neil C Chi

    2008-05-01

    Full Text Available Vertebrate hearts depend on highly specialized cardiomyocytes that form the cardiac conduction system (CCS to coordinate chamber contraction and drive blood efficiently and unidirectionally throughout the organism. Defects in this specialized wiring system can lead to syncope and sudden cardiac death. Thus, a greater understanding of cardiac conduction development may help to prevent these devastating clinical outcomes. Utilizing a cardiac-specific fluorescent calcium indicator zebrafish transgenic line, Tg(cmlc2:gCaMP(s878, that allows for in vivo optical mapping analysis in intact animals, we identified and analyzed four distinct stages of cardiac conduction development that correspond to cellular and anatomical changes of the developing heart. Additionally, we observed that epigenetic factors, such as hemodynamic flow and contraction, regulate the fast conduction network of this specialized electrical system. To identify novel regulators of the CCS, we designed and performed a new, physiology-based, forward genetic screen and identified for the first time, to our knowledge, 17 conduction-specific mutations. Positional cloning of hobgoblin(s634 revealed that tcf2, a homeobox transcription factor gene involved in mature onset diabetes of the young and familial glomerulocystic kidney disease, also regulates conduction between the atrium and the ventricle. The combination of the Tg(cmlc2:gCaMP(s878 line/in vivo optical mapping technique and characterization of cardiac conduction mutants provides a novel multidisciplinary approach to further understand the molecular determinants of the vertebrate CCS.

  9. A Common Polymorphism of the Human Cardiac Sodium Channel Alpha Subunit (SCN5A Gene Is Associated with Sudden Cardiac Death in Chronic Ischemic Heart Disease.

    Directory of Open Access Journals (Sweden)

    Boglárka Marcsa

    Full Text Available Cardiac death remains one of the leading causes of mortality worldwide. Recent research has shed light on pathophysiological mechanisms underlying cardiac death, and several genetic variants in novel candidate genes have been identified as risk factors. However, the vast majority of studies performed so far investigated genetic associations with specific forms of cardiac death only (sudden, arrhythmogenic, ischemic etc.. The aim of the present investigation was to find a genetic marker that can be used as a general, powerful predictor of cardiac death risk. To this end, a case-control association study was performed on a heterogeneous cohort of cardiac death victims (n=360 and age-matched controls (n=300. Five single nucleotide polymorphisms (SNPs from five candidate genes (beta2 adrenergic receptor, nitric oxide synthase 1 adaptor protein, ryanodine receptor 2, sodium channel type V alpha subunit and transforming growth factor-beta receptor 2 that had previously been shown to associate with certain forms of cardiac death were genotyped using sequence-specific real-time PCR probes. Logistic regression analysis revealed that the CC genotype of the rs11720524 polymorphism in the SCN5A gene encoding a subunit of the cardiac voltage-gated sodium channel occurred more frequently in the highly heterogeneous cardiac death cohort compared to the control population (p=0.019, odds ratio: 1.351. A detailed subgroup analysis uncovered that this effect was due to an association of this variant with cardiac death in chronic ischemic heart disease (p=0.012, odds ratio = 1.455. None of the other investigated polymorphisms showed association with cardiac death in this context. In conclusion, our results shed light on the role of this non-coding polymorphism in cardiac death in ischemic cardiomyopathy. Functional studies are needed to explore the pathophysiological background of this association.

  10. Ouabain, a cardiac glycoside, inhibits the Fanconi anemia/BRCA pathway activated by DNA interstrand cross-linking agents.

    Directory of Open Access Journals (Sweden)

    Dong Wha Jun

    Full Text Available Modulation of the DNA repair pathway is an emerging target for the development of anticancer drugs. DNA interstrand cross-links (ICLs, one of the most severe forms of DNA damage caused by anticancer drugs such as cisplatin and mitomycin C (MMC, activates the Fanconi anemia (FA/BRCA DNA repair pathway. Inhibition of the FA/BRCA pathway can enhance the cytotoxic effects of ICL-inducing anticancer drugs and can reduce anticancer drug resistance. To find FA/BRCA pathway inhibitory small molecules, we established a cell-based high-content screening method for quantitating the activation of the FA/BRCA pathway by measuring FANCD2 foci on DNA lesions and then applied our method to chemical screening. Using commercial LOPAC1280 chemical library screening, ouabain was identified as a competent FA/BRCA pathway inhibitory compound. Ouabain, a member of the cardiac glycoside family, binds to and inhibits Na(+/K(+-ATPase and has been used to treat heart disease for many years. We observed that ouabain, as well as other cardiac glycoside family members--digitoxin and digoxin--down-regulated FANCD2 and FANCI mRNA levels, reduced monoubiquitination of FANCD2, inhibited FANCD2 foci formation on DNA lesions, and abrogated cell cycle arrest induced by MMC treatment. These inhibitory activities of ouabain required p38 MAPK and were independent of cellular Ca(2+ ion increase or the drug uptake-inhibition effect of ouabain. Furthermore, we found that ouabain potentiated the cytotoxic effects of MMC in tumor cells. Taken together, we identified an additional effect of ouabain as a FA/BRCA pathway-inhibiting chemosensitization compound. The results of this study suggest that ouabain may serve as a chemosensitizer to ICL-inducing anticancer drugs.

  11. Tomoregulin-1 prevents cardiac hypertrophy after pressure overload in mice by inhibiting TAK1-JNK pathways

    Directory of Open Access Journals (Sweden)

    Dan Bao

    2015-08-01

    Full Text Available Cardiac hypertrophy is associated with many forms of heart disease, and identifying important modifier genes involved in the pathogenesis of cardiac hypertrophy could lead to the development of new therapeutic strategies. Tomoregulin-1 is a growth factor that is primarily involved in embryonic development and adult central nervous system (CNS function, and it is expressed abnormally in a variety of CNS pathologies. Tomoregulin-1 is also expressed in the myocardium. However, the effects of tomoregulin-1 on the heart, particularly on cardiac hypertrophy, remains unknown. The aim of the study is to examine whether and by what mechanism tomoregulin-1 regulates the development of cardiac hypertrophy induced by pressure overload. In this study, we found that tomoregulin-1 was significantly upregulated in two cardiac hypertrophy models: cTnTR92Q transgenic mice and thoracic aorta constriction (TAC-induced cardiac hypertrophy mice. The transgenic overexpression of tomoregulin-1 increased the survival rate, improved the cardiac geometry and functional parameters of echocardiography, and decreased the degree of cardiac hypertrophy of the TAC mice, whereas knockdown of tomoregulin-1 expression resulted in an opposite phenotype and exacerbated phenotypes of cardiac hypertrophy induced by TAC. A possible mechanism by which tomoregulin-1 regulates the development of cardiac hypertrophy in TAC-induced cardiac hypertrophy is through inhibiting TGFβ non-canonical (TAK1-JNK pathways in the myocardium. Tomoregulin-1 plays a protective role in the modulation of adverse cardiac remodeling from pressure overload in mice. Tomoregulin-1 could be a therapeutic target to control the development of cardiac hypertrophy.

  12. Atrial fibrillation after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Nair Suresh

    2010-01-01

    Full Text Available Once considered as nothing more than a nuisance after cardiac surgery, the importance of postoperative atrial fibrillation (POAF has been realized in the last decade, primarily because of the morbidity associated with the condition. Numerous causative factors have been described without any single factor being singled out as the cause of this complication. POAF has been associated with stroke, renal failure and congestive heart failure, although it is difficult to state whether POAF is directly responsible for these complications. Guidelines have been formulated for prevention of POAF. However, very few cardiothoracic centers follow any form of protocol to prevent POAF. Routine use of prophylaxis would subject all patients to the side effects of anti-arrhythmic drugs, while only a minority of the patients do actually develop this problem postoperatively. Withdrawal of beta blockers in the postoperative period has been implicated as one of the major causes of POAF. Amiodarone, calcium channel blockers and a variety of other pharmacological agents have been used for the prevention of POAF. Atrial pacing is a non-pharmacological measure which has gained popularity in the prevention of POAF. There is considerable controversy regarding whether rate control is superior to rhythm control in the treatment of established atrial fibrillation (AF. Amiodarone plays a central role in both rate control and rhythm control in postoperative AF. Newer drugs like dronedarone and ranazoline are likely to come into the market in the coming years.

  13. Physics of Cardiac Arrhythmogenesis

    Science.gov (United States)

    Karma, Alain

    2013-04-01

    A normal heartbeat is orchestrated by the stable propagation of an excitation wave that produces an orderly contraction. In contrast, wave turbulence in the ventricles, clinically known as ventricular fibrillation (VF), stops the heart from pumping and is lethal without prompt defibrillation. I review experimental, computational, and theoretical studies that have shed light on complex dynamical phenomena linked to the initiation, maintenance, and control of wave turbulence. I first discuss advances made to understand the precursor state to a reentrant arrhythmia where the refractory period of cardiac tissue becomes spatiotemporally disordered; this is known as an arrhythmogenic tissue substrate. I describe observed patterns of transmembrane voltage and intracellular calcium signaling that can contribute to this substrate, and symmetry breaking instabilities to explain their formation. I then survey mechanisms of wave turbulence and discuss novel methods that exploit electrical pacing stimuli to control precursor patterns and low-energy pulsed electric fields to control turbulence.

  14. Mediastinitis after cardiac transplantation

    Directory of Open Access Journals (Sweden)

    Noedir A. G. Stolf

    2000-05-01

    Full Text Available OBJECTIVE: Assessment of incidence and behavior of mediastinitis after cardiac transplantation. METHODS: From 1985 to 1999, 214 cardiac transplantations were performed, 12 (5.6% of the transplanted patients developed confirmed mediastinitis. Patient's ages ranged from 42 to 66 years (mean of 52.3±10.0 years and 10 (83.3% patients were males. Seven (58.3% patients showed sternal stability on palpation, 4 (33.3% patients had pleural empyema, and 2 (16.7% patients did not show purulent secretion draining through the wound. RESULTS: Staphylococcus aureus was the infectious agent identified in the wound secretion or in the mediastinum, or both, in 8 (66.7% patients. Staphylococcus epidermidis was identified in 2 (16.7% patients, Enterococcus faecalis in 1 (8.3% patient, and the cause of mediastinitis could not be determined in 1 (8.3% patient. Surgical treatment was performed on an emergency basis, and the extension of the débridement varied with local conditions. In 2 (16.7% patients, we chose to leave the surgical wound open and performed daily dressings with granulated sugar. Total sternal resection was performed in only 1 (8.3% patient. Out of this series, 5 (41.7% patients died, and the causes of death were related to the infection. Autopsy revealed persistence of mediastinitis in 1 (8.3% patient. CONCLUSION: Promptness in diagnosing mediastinitis and precocious surgical drainage have changed the natural evolution of this disease. Nevertheless, observance of the basic precepts of prophylaxis of infection is still the best way to treat mediastinitis.

  15. Platelets and cardiac arrhythmia

    Directory of Open Access Journals (Sweden)

    Jonas S De Jong

    2010-12-01

    Full Text Available Sudden cardiac death remains one of the most prevalent modes of death in industrialized countries, and myocardial ischemia due to thrombotic coronary occlusion is its primary cause. The role of platelets in the occurrence of SCD extends beyond coronary flow impairment by clot formation. Here we review the substances released by platelets during clot formation and their arrhythmic properties. Platelet products are released from three types of platelet granules: dense core granules, alpha-granules, and platelet lysosomes. The physiologic properties of dense granule products are of special interest as a potential source of arrhythmic substances. They are released readily upon activation and contain high concentrations of serotonin, histamine, purines, pyrimidines, and ions such as calcium and magnesium. Potential arrhythmic mechanisms of these substances, e.g. serotonin and high energy phosphates, include induction of coronary constriction, calcium overloading, and induction of delayed after-depolarizations. Alpha-granules produce thromboxanes and other arachidonic acid products with many potential arrhythmic effects mediated by interference with cardiac sodium, calcium and potassium channels. Alpha-granules also contain hundreds of proteins that could potentially serve as ligands to receptors on cardiomyocytes. Lysosomal products probably do not have an important arrhythmic effect. Platelet products and ischemia can induce coronary permeability, thereby enhancing interaction with surrounding cardiomyocytes. Antiplatelet therapy is known to improve survival after myocardial infarction. Although an important part of this effect results from prevention of coronary clot formation, there is evidence to suggest that antiplatelet therapy also induces anti-arrhythmic effects during ischemia by preventing the release of platelet activation products.

  16. Metoclopramide-induced cardiac arrest

    Directory of Open Access Journals (Sweden)

    Martha M. Rumore

    2011-11-01

    Full Text Available The authors report a case of cardiac arrest in a patient receiving intravenous (IV metoclopramide and review the pertinent literature. A 62-year-old morbidly obese female admitted for a gastric sleeve procedure, developed cardiac arrest within one minute of receiving metoclopramide 10 mg via slow intravenous (IV injection. Bradycardia at 4 beats/min immediately appeared, progressing rapidly to asystole. Chest compressions restored vital function. Electrocardiogram (ECG revealed ST depression indicative of myocardial injury. Following intubation, the patient was transferred to the intensive care unit. Various cardiac dysrrhythmias including supraventricular tachycardia (SVT associated with hypertension and atrial fibrillation occurred. Following IV esmolol and metoprolol, the patient reverted to normal sinus rhythm. Repeat ECGs revealed ST depression resolution without pre-admission changes. Metoclopramide is a non-specific dopamine receptor antagonist. Seven cases of cardiac arrest and one of sinus arrest with metoclopramide were found in the literature. The metoclopramide prescribing information does not list precautions or adverse drug reactions (ADRs related to cardiac arrest. The reaction is not dose related but may relate to the IV administration route. Coronary artery disease was the sole risk factor identified. According to Naranjo, the association was possible. Other reports of cardiac arrest, severe bradycardia, and SVT were reviewed. In one case, five separate IV doses of 10 mg metoclopramide were immediately followed by asystole repeatedly. The mechanism(s underlying metoclopramide’s cardiac arrest-inducing effects is unknown. Structural similarities to procainamide may play a role. In view of eight previous cases of cardiac arrest from metoclopramide having been reported, further elucidation of this ADR and patient monitoring is needed. Our report should alert clinicians to monitor patients and remain diligent in surveillance and

  17. Focal parenchymal lesions in community-acquired bacterial meningitis in adults: a clinico-radiological study

    Energy Technology Data Exchange (ETDEWEB)

    Katchanov, Juri [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); University Hospital Charite, Campus Benjamin Franklin, Department of Neurology, Berlin (Germany); Siebert, Eberhard; Klingebiel, Randolf [Campus Charite Mitte, Charite, Department of Neuroradiology, Berlin (Germany); Endres, Matthias [Campus Charite Mitte, Charite, Department of Neurology, Berlin (Germany); Charite-Universitaetsmedizin Berlin, Center for Stroke Research Berlin, Berlin (Germany)

    2009-11-15

    Here, we analyzed the frequency, morphological pattern, and imaging characteristics of focal lesions as a consequence of community-acquired bacterial meningitis. We hypothesized that diffusion-weighted imaging combined with contrast-enhanced imaging, serial scanning, and multimodal vascular studies would provide further insight into the pathological basis of such parenchymal lesions in bacterial meningitis. We reviewed clinical and imaging data (i.e., magnetic resonance tomography, magnetic resonance angiography, computed tomography angiography, digital subtraction angiography) of 68 adult patients admitted to our neurological intensive care unit between March 1998 and February 2009 with the diagnosis of community-acquired bacterial meningitis. We identified seven patients with parenchymal lesions. These lesions could be attributed to four morphological patterns: (1) territorial cerebral ischemia, (2) perforating vessels ischemia, (3) ischemia of presumed cardiac origin, and (4) isolated cortical lesions. Whereas the patterns (1) and (2) were associated with vasculopathy of large- and medium-sized vessels (as shown by cerebral vascular imaging), vessel imaging in (3) and (4) did not show abnormal findings. Our study implies that parenchymal lesions in acute bacterial meningitis are mainly ischemic and due to involvement of large-, medium-, and small-sized arteries of the brain. Diffusion-weighted imaging combined with conventional, CT-, or MR-based cerebral angiography revealed the underlying pathophysiological mechanisms in the majority of patients. Furthermore, we detected two patients with isolated bilateral cortical involvement and normal vessel imaging. These lesions might represent ischemia due to the involvement of small pial and intracortical arteries. (orig.)

  18. Renal lesions of nondomestic felids.

    Science.gov (United States)

    Newkirk, K M; Newman, S J; White, L A; Rohrbach, B W; Ramsay, E C

    2011-05-01

    To comprehensively evaluate the occurrence of renal lesions in a variety of nondomestic felids, necropsy cases from 1978 to 2008 were reviewed from a municipal zoo and a large cat sanctuary for those in which the kidneys were examined histologically. Seventy exotic felids were identified (25 tigers, 18 lions, 6 cougars, 5 leopards, 3 snow leopards, 3 clouded leopards, 3 Canadian lynx, 2 ocelots, 2 bobcats, 2 cheetahs, 1 jaguar), and their histologic renal lesions were evaluated and compared. The most common lesion was tubulointerstitial nephritis (TIN); 36 of 70 (51%) cats were affected to some degree. Lymphocytic interstitial nephritis was the most common lesion in the tigers (9 of 25, 36%) and was rarely seen in other species. Although the renal pelvis was not available for all cats, 28 of 47 (60%) had some degree of lymphocytic pyelitis. There was no significant association between the presence of pyelitis and that of TIN. Only 1 cat had pyelonephritis. Renal papillary necrosis was present in 13 of 70 (19%) cats and was significantly associated with historical nonsteroidal anti-inflammatory drug treatment (odds ratio, 7.1; 95% confidence interval, 1.9 to 26.8). Only 1 cat (lion) had amyloid accumulation, and it was restricted to the corticomedullary junction. Primary glomerular lesions were absent in all cats. Intraepithelial pigment was identified in many of the cats but was not correlated with severity of TIN. Despite several previous reports describing primary glomerular disease or renal amyloidosis in exotic felids, these lesions were rare to absent in this population. PMID:20876911

  19. Epigenetic regulation in cardiac fibrosis

    Institute of Scientific and Technical Information of China (English)

    Li-Ming; Yu; Yong; Xu

    2015-01-01

    Cardiac fibrosis represents an adoptive response in the heart exposed to various stress cues. While resolution of the fibrogenic response heralds normalization of heart function, persistent fibrogenesis is usually associated with progressive loss of heart function and eventually heart failure. Cardiac fibrosis is regulated by a myriad of factors that converge on the transcription of genes encoding extracellular matrix proteins, a process the epigenetic machinery plays a pivotal role. In this minireview, we summarize recent advances regarding the epigenetic regulation of cardiac fibrosis focusing on the role of histone and DNA modifications and non-coding RNAs.

  20. Music Therapy for Post Operative Cardiac Patients

    DEFF Research Database (Denmark)

    Schou, Karin

    Background This study is the first controlled research study undertaken in the early phase of rehabilitation after cardiac surgery investigating the effect of a receptive music therapy method. Various forms of music therapy interventions including both active and receptive methods were reported...... to be significantly more effective than music treatment with music medicine. Music listening and receptive music therapy (such as Guided Imagery and Music) have been proposed to help patients both before heart surgery and during the recovery phase. This study therefore intended to explore both a music therapy...

  1. Cardiac perioperative complications in noncardiac surgery

    OpenAIRE

    Radovanović Dragana; Kolak Radmila; Stokić Aleksandar; Radovanović Zoran; Jovanović Gordana

    2008-01-01

    Anesthesiologists are confronted with an increasing population of patients undergoing noncardiac surgery who are at risk for cardiac complications in the perioperative period. Perioperative cardiac complications are responsible for significant mortality and morbidity. The aim of the present study was to determine the incidence of perioperative (operative and postoperative) cardiac complications and correlations between the incidence of perioperative cardiac complications and type of surgical ...

  2. Lesions of juxtacortical origin (surface lesions of bone)

    Energy Technology Data Exchange (ETDEWEB)

    Kenan, S. (Dept. of Orthopaedics, Mount Sinai School of Medicine, New York, NY (United States)); Abdelwahab, I.F. (Dept. of Radiology, Mount Sinai School of Medicine, New York, NY (United States)); Klein, M.J. (Dept. of Pathology, Mount Sinai School of Medicine, New York, NY (United States)); Hermann, G. (Dept. of Radiology, Mount Sinai School of Medicine, New York, NY (United States)); Lewis, M.M. (Dept. of Orthopaedics, Mount Sinai School of Medicine, New York, NY (United States))

    1993-01-01

    A large variety of tumor and tumor-like conditions have been shown to originate from the surface of bone. Most surface lesions are associated with periosteal reaction. The periosteum is a multipotential membrane. Its cellular composition may give rise to a variety of both neoplasms and tumor-like conditions. To avoid misinterpretation, the orthopedist, radiologist, and pathologist should be familiar with the entire spectrum of surface lesions. A better understanding of the natural history and biological behavior at different lesional maturity stages and correlation of the history with the radiographic and pathological findings is essential to establish the correct diagnosis. A history of injury of blunt trauma is very important. A stress fracture may produce a periosteal reaction acd callus that can be difficult to distinguish from osteosarcoma. In this review article, the authors wish to describe and define each term by its anatomy and radiographic features while discussing the entire spectrum of surface lesions. All the illustrative cases in this review article have been proven histologically. (orig.)

  3. Detection of Herplex Simplex Virus-1 and -2 in Cardiac Myxomas

    Directory of Open Access Journals (Sweden)

    Ioannis S. Pateras

    2012-01-01

    Full Text Available The etiology of sporadic cardiac myxomas remains elusive. The tendency for these lesions to recur following resection, their immunopathological characteristics, along with their histological and molecular profile, may implicate the presence of an infective agent in this type of tumor. In this study, we investigated the presence of herpes simplex virus (HSV DNA in a cohort of cardiac myxomas in a tertiary referral centre. Twenty-nine formalin-fixed paraffin-embedded (FFPE sporadic cardiac myxomas were obtained, 17 of which were shown to be informative. These were compared to 19 macroscopically and microscopically normal heart tissue specimens. The detection of HSV-1 and -2 genomic sequences was achieved with the use of a combined nested PCR-Restriction Fragment Length Polymorphism methodology. The presence of HSV-1 and/or -2 DNA was demonstrated in 6 of 17 (35% informative sporadic cardiac myxomas, whereas no HSV DNA was detected in normal heart tissues (P<0.01. The existence of HSV-1/2 DNA in sporadic cardiac myxomas, along with its absence from normal heart tissues, reinforces the possibility that HSV infection might be involved in the development of these lesions. Our findings raise the point of anti-HSV medication postsurgically with a potential benefit in reducing the rate of recurrences.

  4. Lesion detectability in digital radiography

    Science.gov (United States)

    Gagne, Robert M.; Boswell, Jonathan S.; Myers, Kyle J.; Peter, Guillaume

    2001-06-01

    The usefulness of Fourier-based measures of imaging performance has come into question for the evaluation of digital imaging systems. Figures of merit such as detective quantum efficiency are relevant for linear, shift-invariant systems with stationary noise. However, no digital imaging system is shift invariant, and realistic images do not satisfy the stationarity condition. Our methods for task- based evaluation of imaging systems, based on lesion detectability, do not require such assumptions. We have computed the performance of Hotelling and nonprewhitening matched-filter observers for the task of lesion detection in digital radiography.

  5. Lesiones frecuentes en atletas profesionales

    OpenAIRE

    Doyel, Crevecoer

    2015-01-01

    Durante la práctica del atletismo frecuentemente ocurren lesiones, afectando principalmente a los miembros inferiores. Las causas que las originan son muy diversas y tienen diferentes características de acuerdo al tipo de modalidad realizada dentro del atletismo. Objetivo: Analizar las características de las lesiones más frecuentes en miembros inferiores, en atletas corredores profesionales, de diferentes distancias, de ambos sexos, de entre 18 y 40 años de edad, que practican atletismo en...

  6. Flexibilidad y lesiones de futbolistas

    OpenAIRE

    Gocebate, Verónica

    2014-01-01

    Cabe destacar que en deporte se requiere de una correcta preparación física y el caso del fútbol no es diferente a cualquier otro. Este es un deporte en equipo que genera un desgaste físico y mental en cada partido en el cual se pueden sufrir diferentes lesiones. Son varios los factores que predisponen a que se produzcan lesiones, por lo que es importante un correcto entrenamiento diario. Objetivo: Determinar la relación entre los niveles de flexibilidad de la cadena muscula...

  7. Pediatric Knee Osteochondritis Dissecans Lesions.

    Science.gov (United States)

    Cruz, Aristides I; Shea, Kevin G; Ganley, Theodore J

    2016-10-01

    Osteochondritis dissecans (OCD) can cause knee pain and dysfunction in children. The etiology of OCD remains unclear; theories on causes include inflammation, ischemia, ossification abnormalities, genetic factors, and repetitive microtrauma. Most OCD lesions in skeletally immature patients will heal with nonoperative treatment. The success of nonoperative treatment decreases once patients reach skeletal maturity. The goals of surgical treatment include maintenance of articular cartilage congruity, rigid fixation of unstable fragments, and repair of osteochondral defects with cells or tissues that can adequately replace lost or deficient cartilage. Unsalvageable OCD lesions can be treated with various surgical techniques. PMID:27637663

  8. Isolated cystic lesion of the callosal genu after traumatic brain injury.

    Science.gov (United States)

    Kato, Toru; Okumura, Akihisa; Tsuji, Takeshi; Emi, Misugi; Natsume, Jun

    2012-06-01

    We report the case of a 17-month-old infant who developed an isolated cystic lesion of the callosal genu as a unique lesion of traumatic axonal injury (TAI). Although one of the most common sites of TAI is the corpus callosum, there have been no reports describing the lesion seen in our patient. Brain computed tomography findings were normal on the day of the traffic accident. After 3 months, brain magnetic resonance imaging showed an isolated cystic lesion of the callosal genu that had the appearance of a cystic cavity. This lesion decreased in size 16 months later. The neuroimaging findings of this patient suggest that an isolated cystic lesion of the callosal genu could appear as a unique form of TAI in infants after traumatic brain injury (TBI), but it is nevertheless important to attend to such lesions in children with TBI.

  9. Disseminated paracoccidioidomycosis diagnosis based on oral lesions

    Directory of Open Access Journals (Sweden)

    Liana Preto Webber

    2014-01-01

    Full Text Available Paracoccidioidomycosis (PCM is a deep mycosis with primary lung manifestations that may present cutaneous and oral lesions. Oral lesions mimic other infectious diseases or even squamous cell carcinoma, clinically and microscopically. Sometimes, the dentist is the first to detect the disease, because lung lesions are asymptomatic, or even misdiagnosed. An unusual case of PCM with 5 months of evolution presenting pulmonary, oral, and cutaneous lesions that was diagnosed by the dentist based on oral lesions is presented and discussed.

  10. MR-Based Cardiac and Respiratory Motion-Compensation Techniques for PET-MR Imaging.

    Science.gov (United States)

    Munoz, Camila; Kolbitsch, Christoph; Reader, Andrew J; Marsden, Paul; Schaeffter, Tobias; Prieto, Claudia

    2016-04-01

    Cardiac and respiratory motion cause image quality degradation in PET imaging, affecting diagnostic accuracy of the images. Whole-body simultaneous PET-MR scanners allow for using motion information estimated from MR images to correct PET data and produce motion-compensated PET images. This article reviews methods that have been proposed to estimate motion from MR images and different techniques to include this information in PET reconstruction, in order to overcome the problem of cardiac and respiratory motion in PET-MR imaging. MR-based motion correction techniques significantly increase lesion detectability and contrast, and also improve accuracy of uptake values in PET images.

  11. Primary Right Atrial Sarcoma Presenting with Cardiac Tamponade and Massive Pleural Effusion

    Directory of Open Access Journals (Sweden)

    Shahram Momtahen

    2016-07-01

    Full Text Available Primary cardiac sarcomas are very rare and there is no consensus on management. Clinical presentation is usually late. Despite newer diagnostic technology, prognosis remains dismal. We report a case of right atrial sarcoma in a 28-year-old man who presented with acute cardiac tamponade. Emergency subxiphoid pericardial drainage stabilized the patient's critical condition. The lesion was advanced. Therefore, we only performed a suboptimal surgical resection. Despite planning for radiation, the patient's status deteriorated. Only palliative measures continued during the next four months before his death due to disseminated metastasis and progressive cardiopulmonary failure.

  12. Fatal secondary pulmonary hypertension due to cardiac involvement in AIDS-associated Burkitt′s lymphoma

    Directory of Open Access Journals (Sweden)

    Singh Ashutosh

    2006-09-01

    Full Text Available Primary cardiac lymphomas are rare lesions in children with acquired immunodeficiency syndrome (AIDS. Most of them are high-grade Burkitt′s or Burkitt-like lymphomas. They usually present with congestive cardiac failure, pericardial effusion or tamponade, arrhythmias, with predominant systemic ′B′ symptoms and often with widespread extranodal involvement. The clinical profile and operative and pathological findings of a 4-year-old boy with AIDS-associated Burkitt′s lymphoma of the heart presenting with acute right heart failure and fatal secondary pulmonary hypertension is reported.

  13. Robot-assisted cardiac surgery.

    Science.gov (United States)

    Ishikawa, Norihiko; Watanabe, Go

    2015-01-01

    Recognition of the significant advantages of minimizing surgical trauma has resulted in the development of minimally invasive surgical procedures. Endoscopic surgery offers patients the benefits of minimally invasive surgery, and surgical robots have enhanced the ability and precision of surgeons. Consequently, technological advances have facilitated totally endoscopic robotic cardiac surgery, which has allowed surgeons to operate endoscopically rather than through a median sternotomy during cardiac surgery. Thus, repairs for structural heart conditions, including mitral valve plasty, atrial septal defect closure, multivessel minimally invasive direct coronary artery bypass grafting (MIDCAB), and totally endoscopic coronary artery bypass graft surgery (CABG), can be totally endoscopic. Robot-assisted cardiac surgery as minimally invasive cardiac surgery is reviewed. PMID:26134073

  14. Recent developments in cardiac pacing.

    Science.gov (United States)

    Rodak, D J

    1995-10-01

    Indications for cardiac pacing continue to expand. Pacing to improve functional capacity, which is now common, relies on careful patient selection and technical improvements, such as complex software algorithms and diagnostic capabilities.

  15. Robotic Applications in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alan P. Kypson

    2008-11-01

    Full Text Available Traditionally, cardiac surgery has been performed through a median sternotomy, which allows the surgeon generous access to the heart and surrounding great vessels. As a paradigm shift in the size and location of incisions occurs in cardiac surgery, new methods have been developed to allow the surgeon the same amount of dexterity and accessibility to the heart in confined spaces and in a less invasive manner. Initially, long instruments without pivot points were used, however, more recent robotic telemanipulation systems have been applied that allow for improved dexterity, enabling the surgeon to perform cardiac surgery from a distance not previously possible. In this rapidly evolving field, we review the recent history and clinical results of using robotics in cardiac surgery.

  16. Right inferior longitudinal fasciculus lesions disrupt visual-emotional integration.

    Science.gov (United States)

    Fischer, David B; Perez, David L; Prasad, Sashank; Rigolo, Laura; O'Donnell, Lauren; Acar, Diler; Meadows, Mary-Ellen; Baslet, Gaston; Boes, Aaron D; Golby, Alexandra J; Dworetzky, Barbara A

    2016-06-01

    The mechanism by which the brain integrates visual and emotional information remains incompletely understood, and can be studied through focal lesions that selectively disrupt this process. To date, three reported cases of visual hypoemotionality, a vision-specific form of derealization, have resulted from lesions of the temporo-occipital junction. We present a fourth case of this rare phenomenon, and investigate the role of the inferior longitudinal fasciculus (ILF) in the underlying pathophysiology. A 50-year-old right-handed male was found to have a right medial temporal lobe tumor following new-onset seizures. Interstitial laser ablation of the lesion was complicated by a right temporo-parieto-occipital intraparenchymal hemorrhage. The patient subsequently experienced emotional estrangement from visual stimuli. A lesion overlap analysis was conducted to assess involvement of the ILF by this patient's lesion and those of the three previously described cases, and diffusion tensor imaging was acquired in our case to further investigate ILF disruption. All four lesions specifically overlapped with the expected trajectory of the right ILF, and diminished structural integrity of the right ILF was observed in our case. These findings implicate the ILF in visual hypoemotionality, suggesting that the ILF is critical for integrating visual information with its emotional content. PMID:26940563

  17. Estrogen Stimulates Homing of Endothelial Progenitor Cells to Endometriotic Lesions.

    Science.gov (United States)

    Rudzitis-Auth, Jeannette; Nenicu, Anca; Nickels, Ruth M; Menger, Michael D; Laschke, Matthias W

    2016-08-01

    The incorporation of endothelial progenitor cells (EPCs) into microvessels contributes to the vascularization of endometriotic lesions. Herein, we analyzed whether this vasculogenic process is regulated by estrogen. Estrogen- and vehicle-treated human EPCs were analyzed for migration and tube formation. Endometriotic lesions were induced in irradiated FVB/N mice, which were reconstituted with bone marrow from FVB/N-TgN (Tie2/green fluorescent protein) 287 Sato mice. The animals were treated with 100 μg/kg β-estradiol 17-valerate or vehicle (control) over 7 and 28 days. Lesion growth, cyst formation, homing of green fluorescent protein(+)/Tie2(+) EPCs, vascularization, cell proliferation, and apoptosis were analyzed by high-resolution ultrasonography, caliper measurements, histology, and immunohistochemistry. Numbers of blood circulating EPCs were assessed by flow cytometry. In vitro, estrogen-treated EPCs exhibited a higher migratory and tube-forming capacity when compared with controls. In vivo, numbers of circulating EPCs were not affected by estrogen. However, estrogen significantly increased the number of EPCs incorporated into the lesions' microvasculature, resulting in an improved early vascularization. Estrogen further stimulated the growth of lesions, which exhibited massively dilated glands with a flattened layer of stroma. This was mainly because of an increased glandular secretory activity, whereas cell proliferation and apoptosis were not markedly affected. These findings indicate that vasculogenesis in endometriotic lesions is dependent on estrogen, which adds a novel hormonally regulated mechanism to the complex pathophysiology of endometriosis. PMID:27315780

  18. The Relation of Endodontic-Periodontal Lesion and Therapy

    Directory of Open Access Journals (Sweden)

    Trijani Suwandi

    2013-07-01

    Full Text Available The correlation between endodontic-periodontal lesion has been documented well be researches. Endodontic lesion originates from pulp, while periodontal lesion originates from periodontal tissues. Anatomically they are connected by apical foramen, lateral canal and accessories, as well as dentin tubules. The correlation appeared as the endodontic defect can be from periodontal lesion, or a periodontal defect is from a pulp tissue. Together they can emerge and form a combination lesion. Endodontic infections have been highly correlated with deeper periodontal pockets and furcation involvement in mandibular, the causal relationship between the two pathoses has not yet been established. This consensus supports the influence of degenerated or inflamed pulp that can happen on the periodontium; but not all researchers agree about the effect of periodontal disease on the pulp. Conclusion: The mechanism of endo-perio lesion need to taken care in order to have appropriate diagnostic so that the right therapy would be able to keep the teeth in the oral cavity.

  19. Cystic Lesions in Autoimmune Pancreatitis

    Directory of Open Access Journals (Sweden)

    Macarena Gompertz

    2015-11-01

    Full Text Available Autoimmune pancreatitis (AIP can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered after corticosteroid therapy. One year later, he presented with a recurrent episode of AIP with elevated IgG4 levels, accompanied by the appearance of multiple intrapancreatic cystic lesions. All but 1 of these cysts disappeared after steroid treatment, but the remaining cyst in the pancreatic head was even somewhat larger 1 year later. Pancreatoduodenectomy was finally performed. Histology showed the wall of the cystic lesion to be fibrotic; the surrounding pancreatic tissue presented fibrosis, atrophy and lymphoplasmacytic infiltration by IgG4-positive cells, without malignant elements. Our case illustrates the rare possibility that cystic lesions can be part of AIP. These pseudocysts appear in the pancreatic segments involved in the autoimmune disease and can be a consequence of the local inflammation or related to ductal strictures. Steroid treatment should be initiated, after which these cysts can completely disappear with recovery from AIP. Surgical intervention may be necessary in some exceptional cases.

  20. Pigmented Lesions of the Vulva

    Directory of Open Access Journals (Sweden)

    Gürol Açıkgöz

    2012-06-01

    Full Text Available Pigmented lesions on the vulva are rare and their non specific features cause difficulties in their diagnosis and differential diagnosis. Because of their localization, it is difficult to follow up vulvar lesions, which are generally noticed coincidentally by patients. Vulvar pigmented lesions are classified clinically as macules/papules and patches/plaques to provide ease of the diagnosis. Nevi, angiokeratomas, seborrheic keratosis, melanoma, basal cell carcinoma and squamous cell carcinoma are classified under the macules/papules, and post-inflammatory hyperpigmentation, physiological hyperpigmentation, melanosis and acanthosis nigricans are classified under the patch/plaque. Dermatoscopic examination, which is increasing recently, is very valuable for avoiding possible cosmetic and functional complications of surgical procedures. However, epidermal pigmentations such as vulvar melanosis and vulvar intraepitelyal neoplazi are dermatoscopically indistinguishable. It may also be difficult to diagnose vulvar melanoma clinically and dermatoscopically. Histological examination is the gold standard for the diagnosis of pigmented vulvar lesions, which are clinically and dermatoscopically indistinguishable. (Turk J Dermatol 2012; 6: 39-44

  1. CARDIAC RESYNCHRONIZATION THERAPY OF CHRONIC HEART FAILURE AS «BRIDGE» TO CARDIAC TRANSPLANTATION

    Directory of Open Access Journals (Sweden)

    D. V. Shumakov

    2009-01-01

    Full Text Available Cardiac transplantation (CTX remains the gold standard for treatment of terminal forms of heart failure. Nevertheless, all over the world shortage of donors and postoperative complications leads to search of alternative therapeutic strategy. Cardiac resynchronization therapy is discussed alternative CTX. Besides, now it is not clear, whether it is possible to prevent CRT CTX in long-term prospect. Thus, we aspired to estimate long-term clinical results in the big group of candidates to CTX which have received CRT-systems in Institute of Transplantation last years. In total 70 patients are operated, from them 5 patients in connection with condition deterioration heart transplantation has been executed. The received experience shows that at patients with left ventricular dissinhroniсity, which are in a waiting list to heart transplantation, application of method CRT may to prevent or delay necessity for heart transplantation, or to become a link as «bridge» to transplantation. 

  2. Cardiac Biomarkers in Hyperthyroid Cats

    OpenAIRE

    Sangster, Jodi Kirsten

    2013-01-01

    Background: Hyperthyroidism has substantial effects on the circulatory system. The cardiac biomarkers NT-proBNP and troponin I (cTNI) have proven useful in identifying cats with myocardial disease but have not been as extensively investigated in hyperthyroidism.Hypothesis: Plasma NT-proBNP and cTNI concentrations are higher in cats with primary cardiac disease than in cats with hyperthyroidism and higher in cats with hyperthyroidism than in healthy control cats.Animals: Twenty-three hyperthyr...

  3. Cardiac manifestations in systemic sclerosis

    Institute of Scientific and Technical Information of China (English)

    Sevdalina; Lambova

    2014-01-01

    Primary cardiac involvement, which develops as a direct consequence of systemic sclerosis(SSc), may manifest as myocardial damage, fibrosis of the conduction system, pericardial and, less frequently, as valvular disease. In addition, cardiac complications in SSc may develop as a secondary phenomenon due to pulmonary arterial hypertension and kidney pathology. The prevalence of primary cardiac involvement in SSc is variable and difficult to determine because of the diversity of cardiac manifestations, the presence of subclinical periods, the type of diagnostic tools applied, and the diversity of patient populations. When clinically manifested, cardiac involvement is thought to be an important prognostic factor. Profound microvascular disease is a pathognomonic feature of SSc, as both vasospasm and structural alterations are present. Such alterations are thought to predict macrovascular atherosclerosis over time. There are contradictory reports regarding the prevalence of atherosclerosis in SSc. According to some authors, the prevalence of atherosclerosis of the large epicardial coronary arteries is similar to that of the general population, in contrast with other rheumatic diseases such as rheumatoid arthritis and systemic lupus erythematosus. However, the level of inflammation in SSc is inferior. Thus, the atherosclerotic process may not be as aggressive and not easily detectable in smaller studies. Echocardiography(especially tissue Doppler imaging), single-photon emission computed tomography, magnetic resonance imaging and cardiac computed tomography are sensitive techniques for earlier detection of both structural and functional scleroderma-related cardiac pathologies. Screening for subclinical cardiac involvement via modern, sensitive tools provides an opportunity for early diagnosis and treatment, which is of crucial importance for a positive outcome.

  4. Computational Modeling of Cardiac Electromechanics

    OpenAIRE

    Krishnamoorthi, Shankarjee

    2013-01-01

    Cardiac arrhythmias are a leading cause of death worldwide. Notably, the electrophysiologiy and microstructural requirements for a fatal ventricular arrhythmia remain incompletely understood, thereby the treatment remains largely empirical. Standard antiarrhythmic drug therapy has failed to reduce, and in some instances has increased, the incidence of Sudden Cardiac Death (SCD). Hence, a more complete understanding of the mechanisms that foment a fatal arrhythmia is needed and computational m...

  5. Current trends in cardiac rehabilitation

    OpenAIRE

    Dafoe, W; Huston, P

    1997-01-01

    Cardiac rehabilitation can reduce mortality and morbidity for patients with many types of cardiac disease cost-effectively, yet is generally underutilized. Rehabilitation is helpful not only for patients who have had a myocardial infarction but also for those with stable angina or congestive heart failure or those who have undergone myocardial revascularization procedures, a heart transplant or heart valve surgery. The beneficial effects of rehabilitation include a reduction in the rate of de...

  6. Physiological and pathological cardiac hypertrophy.

    Science.gov (United States)

    Shimizu, Ippei; Minamino, Tohru

    2016-08-01

    The heart must continuously pump blood to supply the body with oxygen and nutrients. To maintain the high energy consumption required by this role, the heart is equipped with multiple complex biological systems that allow adaptation to changes of systemic demand. The processes of growth (hypertrophy), angiogenesis, and metabolic plasticity are critically involved in maintenance of cardiac homeostasis. Cardiac hypertrophy is classified as physiological when it is associated with normal cardiac function or as pathological when associated with cardiac dysfunction. Physiological hypertrophy of the heart occurs in response to normal growth of children or during pregnancy, as well as in athletes. In contrast, pathological hypertrophy is induced by factors such as prolonged and abnormal hemodynamic stress, due to hypertension, myocardial infarction etc. Pathological hypertrophy is associated with fibrosis, capillary rarefaction, increased production of pro-inflammatory cytokines, and cellular dysfunction (impairment of signaling, suppression of autophagy, and abnormal cardiomyocyte/non-cardiomyocyte interactions), as well as undesirable epigenetic changes, with these complex responses leading to maladaptive cardiac remodeling and heart failure. This review describes the key molecules and cellular responses involved in physiological/pathological cardiac hypertrophy. PMID:27262674

  7. FGF21 and cardiac physiopathology

    Directory of Open Access Journals (Sweden)

    Anna ePlanavila

    2015-08-01

    Full Text Available The heart is not traditionally considered either a target or a site of fibroblast growth factor-21 (FGF21 production. However, recent findings indicate that FGF21 can act as a cardiomyokine; that is, it is produced by cardiac cells at significant levels and acts in an autocrine manner on the heart itself. The heart is sensitive to the effects of FGF21, both systemic and locally generated, owing to the expression in cardiomyocytes of β-Klotho, the key co-receptor known to confer specific responsiveness to FGF21 action. FGF21 has been demonstrated to protect against cardiac hypertrophy, cardiac inflammation, and oxidative stress. FGF21 expression in the heart is induced in response to cardiac insults, such as experimental cardiac hypertrophy and myocardial infarction in rodents, as well as in failing human hearts. Intracellular mechanisms involving PPARα and Sirt1 mediate transcriptional regulation of the FGF21 gene in response to exogenous stimuli. In humans, circulating FGF21 levels are elevated in coronary heart disease and atherosclerosis, and are associated with a higher risk of cardiovascular events in patients with type 2 diabetes. These findings provide new insights into the role of FGF21 in the heart and may offer potential therapeutic strategies for cardiac disease.

  8. [Stem cells and cardiac regeneration].

    Science.gov (United States)

    Perez Millan, Maria Ines; Lorenti, Alicia

    2006-01-01

    Stem cells are defined by virtue of their functional attributes: absence of tissue specific differentitated markers, capable of proliferation, able to self-maintain the population, able to produce a large number of differentiated, functional progeny, able to regenerate the tissue after injury. Cell therapy is an alternative for the treatment of several diseases, like cardiac diseases (cell cardiomyoplasty). A variety of stem cells could be used for cardiac repair: from cardiac and extracardiac sources. Each cell type has its own profile of advantages, limitations, and practicability issues in specific clinical settings. Differentiation of bone marrow stem cells to cardiomyocyte-like cells have been observed under different culture conditions. The presence of resident cardiac stem cell population capable of differentiation into cardiomyocyte or vascular lineage suggests that these cells could be used for cardiac tissue repair, and represent a great promise for clinical application. Stem cells mobilization by cytokines may also offer a strategy for cardiac regeneration. The use of stem cells (embryonic and adult) may hold the key to replacing cells lost in many devastating diseases. This potential benefit is a major focus for stem cell research.

  9. Cardiac Regeneration and Stem Cells.

    Science.gov (United States)

    Zhang, Yiqiang; Mignone, John; MacLellan, W Robb

    2015-10-01

    After decades of believing the heart loses the ability to regenerate soon after birth, numerous studies are now reporting that the adult heart may indeed be capable of regeneration, although the magnitude of new cardiac myocyte formation varies greatly. While this debate has energized the field of cardiac regeneration and led to a dramatic increase in our understanding of cardiac growth and repair, it has left much confusion in the field as to the prospects of regenerating the heart. Studies applying modern techniques of genetic lineage tracing and carbon-14 dating have begun to establish limits on the amount of endogenous regeneration after cardiac injury, but the underlying cellular mechanisms of this regeneration remained unclear. These same studies have also revealed an astonishing capacity for cardiac repair early in life that is largely lost with adult differentiation and maturation. Regardless, this renewed focus on cardiac regeneration as a therapeutic goal holds great promise as a novel strategy to address the leading cause of death in the developed world.

  10. Cardiac involvement in myotonic dystrophy

    DEFF Research Database (Denmark)

    Lund, Marie; Diaz, Lars Jorge; Ranthe, Mattis Flyvholm;

    2014-01-01

    genetic testing for DM1. Information on incident cardiac diseases was obtained from the NPR. We estimated standardized incidence ratios (SIRs) of cardiac disease compared with the background population, overall and according to selected diagnostic subgroups (cardiomyopathy, heart failure, conduction...... disorders, arrhythmias, and device implantation). In the DM cohort, SIR for any cardiac disease was 3.42 [95% confidence interval (CI) 3.01-3.86]; for a cardiac disease belonging to the selected subgroups 6.91 (95% CI: 5.93-8.01) and for other cardiac disease 2.59 (95% CI: 2.03-3.25). For a cardiac disease...... belonging to the selected subgroups, the risk was particularly high in the first year after DM diagnosis [SIR 15.4 (95% CI: 10.9-21.3)] but remained significantly elevated in subsequent years [SIR 6.07 (95% CI: 5.11-7.16]). The risk was higher in young cohort members [e.g. 20-39 years: SIR 18.1 (95% CI: 12...

  11. Cardiac imaging. A multimodality approach

    Energy Technology Data Exchange (ETDEWEB)

    Thelen, Manfred [Johannes Gutenberg University Hospital, Mainz (Germany); Erbel, Raimund [University Hospital Essen (Germany). Dept. of Cardiology; Kreitner, Karl-Friedrich [Johannes Gutenberg University Hospital, Mainz (Germany). Clinic and Polyclinic for Diagnostic and Interventional Radiology; Barkhausen, Joerg (eds.) [University Hospital Schleswig-Holstein, Luebeck (Germany). Dept. of Radiology and Nuclear Medicine

    2009-07-01

    An excellent atlas on modern diagnostic imaging of the heart Written by an interdisciplinary team of experts, Cardiac Imaging: A Multimodality Approach features an in-depth introduction to all current imaging modalities for the diagnostic assessment of the heart as well as a clinical overview of cardiac diseases and main indications for cardiac imaging. With a particular emphasis on CT and MRI, the first part of the atlas also covers conventional radiography, echocardiography, angiography and nuclear medicine imaging. Leading specialists demonstrate the latest advances in the field, and compare the strengths and weaknesses of each modality. The book's second part features clinical chapters on heart defects, endocarditis, coronary heart disease, cardiomyopathies, myocarditis, cardiac tumors, pericardial diseases, pulmonary vascular diseases, and diseases of the thoracic aorta. The authors address anatomy, pathophysiology, and clinical features, and evaluate the various diagnostic options. Key features: - Highly regarded experts in cardiology and radiology off er image-based teaching of the latest techniques - Readers learn how to decide which modality to use for which indication - Visually highlighted tables and essential points allow for easy navigation through the text - More than 600 outstanding images show up-to-date technology and current imaging protocols Cardiac Imaging: A Multimodality Approach is a must-have desk reference for cardiologists and radiologists in practice, as well as a study guide for residents in both fields. It will also appeal to cardiac surgeons, general practitioners, and medical physicists with a special interest in imaging of the heart. (orig.)

  12. Effect of a puzzle on the process of students' learning about cardiac physiology.

    Science.gov (United States)

    Cardozo, Lais Tono; Miranda, Aline Soares; Moura, Maria José Costa Sampaio; Marcondes, Fernanda Klein

    2016-09-01

    The aim of the present study was to evaluate the effects of using a puzzle to learn about cardiac physiology. Students were divided into control and game groups. In class 1, the control group had a 2-h theoretical class about cardiac physiology, including a detailed description of the phases of the cardiac cycle, whereas the game group had a 50-min theoretical class without the description of the cardiac cycle. In class 2, the control group did an assessment exercise before an activity with the cardiac puzzle and the game group answered questions after the above-mentioned activity. While solving the puzzle, the students had to describe the cardiac cycle by relating the concepts of heart morphology and physiology. To evaluate short-term learning, the number of wrong answers and grades in the assessment exercise were compared between the control and game groups. To evaluate medium-term learning, we compared the grades obtained by students of the control and game groups in questions about cardiac physiology that formed part of the academic exam. In the assessment exercise, the game group presented a lower number of errors and higher score compared with the control group. In the academic exam, applied after both groups had used the puzzle, there was no difference in the scores obtained by the control and game groups in questions about cardiac physiology. These results showed a positive effect of the puzzle on students' learning about cardiac physiology compared with those not using the puzzle. PMID:27516391

  13. SLAP lesions: a treatment algorithm.

    Science.gov (United States)

    Brockmeyer, Matthias; Tompkins, Marc; Kohn, Dieter M; Lorbach, Olaf

    2016-02-01

    Tears of the superior labrum involving the biceps anchor are a common entity, especially in athletes, and may highly impair shoulder function. If conservative treatment fails, successful arthroscopic repair of symptomatic SLAP lesions has been described in the literature particularly for young athletes. However, the results in throwing athletes are less successful with a significant amount of patients who will not regain their pre-injury level of performance. The clinical results of SLAP repairs in middle-aged and older patients are mixed, with worse results and higher revision rates as compared to younger patients. In this population, tenotomy or tenodesis of the biceps tendon is a viable alternative to SLAP repairs in order to improve clinical outcomes. The present article introduces a treatment algorithm for SLAP lesions based upon the recent literature as well as the authors' clinical experience. The type of lesion, age of patient, concomitant lesions, and functional requirements, as well as sport activity level of the patient, need to be considered. Moreover, normal variations and degenerative changes in the SLAP complex have to be distinguished from "true" SLAP lesions in order to improve results and avoid overtreatment. The suggestion for a treatment algorithm includes: type I: conservative treatment or arthroscopic debridement, type II: SLAP repair or biceps tenotomy/tenodesis, type III: resection of the instable bucket-handle tear, type IV: SLAP repair (biceps tenotomy/tenodesis if >50 % of biceps tendon is affected), type V: Bankart repair and SLAP repair, type VI: resection of the flap and SLAP repair, and type VII: refixation of the anterosuperior labrum and SLAP repair.

  14. Risk factors and the effect of cardiac resynchronization therapy on cardiac and non-cardiac mortality in MADIT-CRT

    DEFF Research Database (Denmark)

    Perkiomaki, Juha S; Ruwald, Anne-Christine; Kutyifa, Valentina;

    2015-01-01

    causes, 108 (63.9%) deemed cardiac, and 61 (36.1%) non-cardiac. In multivariate analysis, increased baseline creatinine was significantly associated with both cardiac and non-cardiac deaths [hazard ratio (HR) 2.97, P ...AIMS: To understand modes of death and factors associated with the risk for cardiac and non-cardiac deaths in patients with cardiac resynchronization therapy with implantable cardioverter-defibrillator (CRT-D) vs. implantable cardioverter-defibrillator (ICD) therapy, which may help clarify...... the action and limitations of cardiac resynchronization therapy (CRT) in relieving myocardial dysfunction. METHODS AND RESULTS: In Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT), during 4 years of follow-up, 169 (9.3%) of 1820 patients died of known...

  15. Minimum Information about a Cardiac Electrophysiology Experiment (MICEE)

    DEFF Research Database (Denmark)

    Quinn, T A; Granite, S; Allessie, M A;

    2011-01-01

    (MICEE). The ultimate goal is to develop a useful tool for cardiac electrophysiologists which facilitates and improves dissemination of the minimum information necessary for reproduction of cardiac electrophysiology research, allowing for easier comparison and utilisation of findings by others....... It is hoped that this will enhance the integration of individual results into experimental, computational, and conceptual models. In its present form, this draft is intended for assessment and development by the research community. We invite the reader to join this effort, and, if deemed productive, implement...

  16. Invasive strategy in patients with resuscitated cardiac arrest and ST elevation myocardial infarction.

    Science.gov (United States)

    Gorjup, Vojka; Noc, Marko; Radsel, Peter

    2014-06-26

    Coronary artery disease is the most frequent cause of sudden cardiac death. There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in post-resuscitation electrocardiogram. In these patients acute coronary thrombotic lesion ("ACS" lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and safe but highly effective and there is evidence of improved survival with good neurological outcome. PCI of the culprit lesion is the primary goal while PCI of stable obstructive lesions may be postponed unless post-resuscitation cardiogenic shock is present.

  17. Cardiac output during exercise

    DEFF Research Database (Denmark)

    Siebenmann, C; Rasmussen, P.; Sørensen, H.;

    2015-01-01

    Several techniques assessing cardiac output (Q) during exercise are available. The extent to which the measurements obtained from each respective technique compares to one another, however, is unclear. We quantified Q simultaneously using four methods: the Fick method with blood obtained from...... the right atrium (Q(Fick-M)), Innocor (inert gas rebreathing; Q(Inn)), Physioflow (impedance cardiography; Q(Phys)), and Nexfin (pulse contour analysis; Q(Pulse)) in 12 male subjects during incremental cycling exercise to exhaustion in normoxia and hypoxia (FiO2  = 12%). While all four methods reported...... a progressive increase in Q with exercise intensity, the slopes of the Q/oxygen uptake (VO2) relationship differed by up to 50% between methods in both normoxia [4.9 ± 0.3, 3.9 ± 0.2, 6.0 ± 0.4, 4.8 ± 0.2 L/min per L/min (mean ± SE) for Q(Fick-M), Q(Inn), QP hys and Q(Pulse), respectively; P = 0...

  18. Petrous apex lesions in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Radhakrishnan, Rupa [University of Cincinnati College of Medicine, Department of Radiology, Cincinnati, OH (United States); Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Son, Hwa Jung [University of Cincinnati College of Medicine, Department of Otolaryngology-Head and Neck Surgery, Cincinnati, OH (United States); Koch, Bernadette L. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-03-15

    A variety of abnormal imaging findings of the petrous apex are encountered in children. Many petrous apex lesions are identified incidentally while images of the brain or head and neck are being obtained for indications unrelated to the temporal bone. Differential considerations of petrous apex lesions in children include ''leave me alone'' lesions, infectious or inflammatory lesions, fibro-osseous lesions, neoplasms and neoplasm-like lesions, as well as a few rare miscellaneous conditions. Some lesions are similar to those encountered in adults, and some are unique to children. Langerhans cell histiocytosis (LCH) and primary and metastatic pediatric malignancies such as neuroblastoma, rhabomyosarcoma and Ewing sarcoma are more likely to be encountered in children. Lesions such as petrous apex cholesterol granuloma, cholesteatoma and chondrosarcoma are more common in adults and are rarely a diagnostic consideration in children. We present a comprehensive pictorial review of CT and MRI appearances of pediatric petrous apex lesions. (orig.)

  19. Imaging of Chest Wall Lesions in Children

    Directory of Open Access Journals (Sweden)

    A. Hekmatnia

    2008-01-01

    Full Text Available Chest wall lesions in childhood include a wide range of pathologies; Benign lesions include lipoma, neurofibroma, lymphangioma, hemangioma, and mesenchymal hamartoma."nMalignant lesions include Neuroblastoma, Rhabdo-myosarcoma, Ewing sarcoma, and Askin tumor."nSystemic diseases such as leukemia, lymphoma, Langerhans cell histiocytosis, and also infections such as tuberculosis, and actinomycosis may also cause chest wall lesions."nThe imaging characteristics of these lesions are re-viewed, but only a minority of the lesions shows diagnostic imaging features, and most of lesions re-quire biopsy and histopathological examination for "ndefinitive diagnosis."nThe role of different modalities is discussed with an emphasis on magnetic resonance imaging for demonstrating lesion morphology and local spread. Computed tomography and neuclear medicine being used mainly to assess remote disease."nIn this lecture, we discuss about imaging of chest wall lesions in children.

  20. Sleep Apnea and Nocturnal Cardiac Arrhythmia: A Populational Study

    Directory of Open Access Journals (Sweden)

    Fatima Dumas Cintra

    2014-11-01

    Full Text Available Background: The mechanisms associated with the cardiovascular consequences of obstructive sleep apnea include abrupt changes in autonomic tone, which can trigger cardiac arrhythmias. The authors hypothesized that nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea. Objective: To analyze the relationship between obstructive sleep apnea and abnormal heart rhythm during sleep in a population sample. Methods: Cross-sectional study with 1,101 volunteers, who form a representative sample of the city of São Paulo. The overnight polysomnography was performed using an EMBLA® S7000 digital system during the regular sleep schedule of the individual. The electrocardiogram channel was extracted, duplicated, and then analyzed using a Holter (Cardio Smart® system. Results: A total of 767 participants (461 men with a mean age of 42.00 ± 0.53 years, were included in the analysis. At least one type of nocturnal cardiac rhythm disturbance (atrial/ventricular arrhythmia or beat was observed in 62.7% of the sample. The occurrence of nocturnal cardiac arrhythmias was more frequent with increased disease severity. Rhythm disturbance was observed in 53.3% of the sample without breathing sleep disorders, whereas 92.3% of patients with severe obstructive sleep apnea showed cardiac arrhythmia. Isolated atrial and ventricular ectopy was more frequent in patients with moderate/severe obstructive sleep apnea when compared to controls (p < 0.001. After controlling for potential confounding factors, age, sex and apnea-hypopnea index were associated with nocturnal cardiac arrhythmia. Conclusion: Nocturnal cardiac arrhythmia occurs more frequently in patients with obstructive sleep apnea and the prevalence increases with disease severity. Age, sex, and the Apnea-hypopnea index were predictors of arrhythmia in this sample.

  1. High Glucose Causes Human Cardiac Progenitor Cell Dysfunction by Promoting Mitochondrial Fission: Role of a GLUT1 Blocker

    Science.gov (United States)

    Choi, He Yun; Park, Ji Hye; Jang, Woong Bi; Ji, Seung Taek; Jung, Seok Yun; Kim, Da Yeon; Kang, Songhwa; Kim, Yeon Ju; Yun, Jisoo; Kim, Jae Ho; Baek, Sang Hong; Kwon, Sang-Mo

    2016-01-01

    Cardiovascular disease is the most common cause of death in diabetic patients. Hyperglycemia is the primary characteristic of diabetes and is associated with many complications. The role of hyperglycemia in the dysfunction of human cardiac progenitor cells that can regenerate damaged cardiac tissue has been investigated, but the exact mechanism underlying this association is not clear. Thus, we examined whether hyperglycemia could regulate mitochondrial dynamics and lead to cardiac progenitor cell dysfunction, and whether blocking glucose uptake could rescue this dysfunction. High glucose in cardiac progenitor cells results in reduced cell viability and decreased expression of cell cycle-related molecules, including CDK2 and cyclin E. A tube formation assay revealed that hyperglycemia led to a significant decrease in the tube-forming ability of cardiac progenitor cells. Fluorescent labeling of cardiac progenitor cell mitochondria revealed that hyperglycemia alters mitochondrial dynamics and increases expression of fission-related proteins, including Fis1 and Drp1. Moreover, we showed that specific blockage of GLUT1 improved cell viability, tube formation, and regulation of mitochondrial dynamics in cardiac progenitor cells. To our knowledge, this study is the first to demonstrate that high glucose leads to cardiac progenitor cell dysfunction through an increase in mitochondrial fission, and that a GLUT1 blocker can rescue cardiac progenitor cell dysfunction and downregulation of mitochondrial fission. Combined therapy with cardiac progenitor cells and a GLUT1 blocker may provide a novel strategy for cardiac progenitor cell therapy in cardiovascular disease patients with diabetes. PMID:27350339

  2. Detection of telornerase activity and cytology in diagnosis of cardiac cancer

    Institute of Scientific and Technical Information of China (English)

    Qiang Wang; Qing Ming Wu; Sheng Bao Li

    2000-01-01

    AIM To investigate the diagnostic significance of cytology and telomerase activity in the exfoliated cells ofcardia obtained from endoscopic brushing in the cardiac cancer.METHODS The techniques of the qualitative TRAP-silver staining and quantitative TRAP-PCR-ELISAwere employed to detect telomerase activity in the exfoliated cells of cardia obtained from endoscopicbrushing in 72 cases with cardial lesions, cytological diagnosis was made at the same time.RESULTS Telomerase activity with cardiac cancer group (1.521 ± 0. 192) was significantly higher than thatwith cardialitis group (0.065± 0.014). Positive rate of telomerase activity detected in cardiac cancer group(88.89%) was significantly higher than that with cardialitis group (11.11%), the former was significantlyhiger than cytological examination (77.78%). The diagnostic rate of cardiac cancer reached 93.33% iftelomerase activity and cytology were examined at the same time.CONCLUSION Cytology and telomerase activity in the exfoliated cardiac cells may be an effective andsensitive methods in the diagnosis of cardiac cancer. This research can be a basis for the mass screening ofcardiac cancer.

  3. Insulin Cannot Induce Adipogenic Differentiation in Primary Cardiac Cultures.

    Science.gov (United States)

    Parameswaran, Sreejit; Sharma, Rajendra K

    2016-09-01

    Cardiac tissue contains a heterogeneous population of cardiomyocytes and nonmyocyte population especially fibroblasts. Fibroblast differentiation into adipogenic lineage is important for fat accumulation around the heart which is important in cardiac pathology. The differentiation in fibroblast has been observed both spontaneously and due to increased insulin stimulation. The present study aims to observe the effect of insulin in adipogenic differentiation of cardiac cells present in primary murine cardiomyocyte cultures. Oil Red O (ORO) staining has been used for observing the lipid accumulations formed due to adipogenic differentiation in murine cardiomyocyte cultures. The accumulated lipids were quantified by ORO assay and normalized using protein estimation. The lipid accumulation in cardiac cultures did not increase in presence of insulin. However, addition of other growth factors like insulin-like growth factor 1 and epidermal growth factor promoted adipogenic differentiation even in the presence of insulin and other inhibitory molecules such as vitamins. Lipid accumulation also increased in cells grown in media without insulin after an initial exposure to insulin-containing growth media. The current study adds to the existing knowledge that the insulin by itself cannot induce adipogenic induction in the cardiac cultures. The data have significance in the understanding of cardiovascular health especially in diabetic patients. PMID:27574386

  4. Male and female hypertrophic rat cardiac myocyte functional responses to ischemic stress and β-adrenergic challenge are different

    OpenAIRE

    Bell, James R.; Curl, Claire L.; Harding, Tristan W.; Vila Petroff, Martin; Harrap, Stephen B.; Delbridge, Lea M D

    2016-01-01

    Background Cardiac hypertrophy is the most potent cardiovascular risk factor after age, and relative mortality risk linked with cardiac hypertrophy is greater in women. Ischemic heart disease is the most common form of cardiovascular pathology for both men and women, yet significant differences in incidence and outcomes exist between the sexes. Cardiac hypertrophy and ischemia are frequently occurring dual pathologies. Whether the cellular (cardiomyocyte) mechanisms underlying myocardial dama...

  5. System for the diagnosis and monitoring of coronary artery disease, acute coronary syndromes, cardiomyopathy and other cardiac conditions

    Science.gov (United States)

    Schlegel, Todd T. (Inventor); Arenare, Brian (Inventor)

    2008-01-01

    Cardiac electrical data are received from a patient, manipulated to determine various useful aspects of the ECG signal, and displayed and stored in a useful form using a computer. The computer monitor displays various useful information, and in particular graphically displays various permutations of reduced amplitude zones and kurtosis that increase the rapidity and accuracy of cardiac diagnoses. New criteria for reduced amplitude zones are defined that enhance the sensitivity and specificity for detecting cardiac abnormalities.

  6. Lethal, potentially lethal lesion model

    Energy Technology Data Exchange (ETDEWEB)

    Curtis, S.B.

    1983-07-01

    A theoretical framework to describe the formation of lethal mutations by radiation is presented. Lesions that are repaired (and misrepaired) in each type of experiment described (delayed plating and split dose) are assumed to be the same. In this model the same (potentially lethal) lesions cause both sublethal and potentially lethal damage. Potentially lethal damage is defined as damage which may be modified by alterations in postirradiation conditions. Sublethal damage is cellular damage whose accumulation may lead to lethality. A crucial consideration in the expression of the damage is the kind of medium in which the cells are placed during the repair period. Fresh or growth medium (F-medium) is assumed to cause fixation of damage after about 3 hours, while no fixation (only misrepair) occurs in conditioned medium (C-medium).

  7. Cytologic diagnosis of pulmonary lesions.

    Science.gov (United States)

    Rossi, Esther Diana; Mulè, Antonino; Maggiore, Claudia; Miraglia, Antonella; Lauriola, Libero; Vecchio, Fabio Maria; Fadda, Guido

    2004-01-01

    The major types of cytologic preparations used in most laboratories to detect the lesions of the lower respiratory tract (LRT) are examined. These methods include sputum, bronchial washing, bronchial brushing, bronchoalveolar lavage (BAL) and fine-needle aspiration biopsy (FNAB). Sputum represents the simplest and most cost-effective sampling method even though fiberoptic bronchoscopy and radiologic guided FNAB are superseding it as the first diagnostic choice in most cases. There are advantages and disadvantages associated with each technique:bronchial brushing and FNABs tend to preserve both the cellular details and their architectural arrangement whereas sputum and bronchial washing often cause a variable degree of cellular degeneration and fragmentation. As a result, most pulmonary lesions may be detected and correctly diagnosed if multiple techniques are used to acquire diagnostic material. CT-guided FNAB represents the most effective method to achieve a correct diagnosis in pulmonary tumors. PMID:15852720

  8. Real time assessment of RF cardiac tissue ablation with optical spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Demos, S G; Sharareh, S

    2008-03-20

    An optical spectroscopy approach is demonstrated allowing for critical parameters during RF ablation of cardiac tissue to be evaluated in real time. The method is based on incorporating in a typical ablation catheter transmitting and receiving fibers that terminate at the tip of the catheter. By analyzing the spectral characteristics of the NIR diffusely reflected light, information is obtained on such parameters as, catheter-tissue proximity, lesion formation, depth of penetration of the lesion, formation of char during the ablation, formation of coagulum around the ablation site, differentiation of ablated from healthy tissue, and recognition of micro-bubble formation in the tissue.

  9. A case report of odontogenic myxoma with characteristic multilocular lesion

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Byung Do; Lee, Wan; Paeng, Jun Young [Department of Oral and Maxillofacial Radiology, School of Dentistry, Wonkwang University, Iksan (Korea, Republic of); Son, Hyun Jin [Department of Pathology, Eulji University School of Medicine, Daejeon (Korea, Republic of)

    2009-03-15

    Although odontogenic myxoma (OM) has various radiographic appearances, the characteristic features of OM are the multilocular radiolucent lesion, straight bony septa along the margin forming either square or triangular spaces. We present a case of OM in a 25-year old-male patient. Multilocular radiolucent lesion on the left mandible body showed tennis racket appearance. Cone beam computed tomography (CBCT) showed straight bony septa along the margin and cortical perforation. This CBCT features would have significantly contributed to allowing a diagnosis of OM. We think that this case shows characteristic radiographic features of odontogenic myxoma.

  10. Post-traumatic cystic lesion following fracture of the radius

    International Nuclear Information System (INIS)

    Post-traumatic cystic lesions are an uncommon complication of fractures in children. They are benign, asymptomatic, non-expansive and tend to resolve spontaneously. Their cause seems to be the invasion of bone-marrow fat by subperiosteal hematoma, which may be visible on radiographs during fracture consolidation of the newly formed subperiosteal bone. The case we present is of cyst formation following a fracture of the distal radius and we evaluate the role of yellow bone marrow in the pathogenesis of the cyst. Its typical features clear differentiation from other lesions, preventing unnecessary and, possibly, invasive examinations. (orig.)

  11. Patch in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Alireza Alizadeh Ghavidel

    2014-06-01

    Full Text Available Introduction: Excessive bleeding presents a risk for the patient in cardiovascular surgery. Local haemostatic agents are of great value to reduce bleeding and related complications. TachoSil (Nycomed, Linz, Austria is a sterile, haemostatic agent that consists of an equine collagen patchcoated with human fibrinogen and thrombin. This study evaluated the safety and efficacy of TachoSil compared to conventional technique.Methods: Forty-two patients scheduled for open heart surgeries, were entered to this study from August 2010 to May 2011. After primary haemostatic measures, patients divided in two groups based on surgeon’s judgment. Group A: 20 patients for whom TachoSil was applied and group B: 22 patients that conventional method using Surgicel (13 patients or wait and see method (9 cases, were performed in order to control the bleeding. In group A, 10 patients were male with mean age of 56.95±15.67 years and in group B, 9 cases were male with mean age of 49.95±14.41 years. In case group 70% (14/20 of the surgeries were redo surgeries versus 100% (22/22 in control group.Results: Baseline characteristics were similar in both groups. In TachoSil group 75% of patients required transfusion versus 90.90% in group B (P=0.03.Most transfusions consisted of packed red blood cell; 2±1.13 units in group A versus 3.11±1.44 in group B (P=0.01, however there were no significant differences between two groups regarding the mean total volume of intra and post-operative bleeding. Re-exploration was required in 10% in group A versus 13.63% in group B (P=0.67.Conclusion: TachoSil may act as a superior alternative in different types of cardiac surgery in order to control the bleeding and therefore reducing transfusion requirement.

  12. Cardiac output monitoring

    Directory of Open Access Journals (Sweden)

    Mathews Lailu

    2008-01-01

    Full Text Available Minimally invasive and non-invasive methods of estimation of cardiac output (CO were developed to overcome the limitations of invasive nature of pulmonary artery catheterization (PAC and direct Fick method used for the measurement of stroke volume (SV. The important minimally invasive techniques available are: oesophageal Doppler monitoring (ODM, the derivative Fick method (using partial carbon dioxide (CO 2 breathing, transpulmonary thermodilution, lithium indicator dilution, pulse contour and pulse power analysis. Impedance cardiography is probably the only non-invasive technique in true sense. It provides information about haemodynamic status without the risk, cost and skill associated with the other invasive or minimally invasive techniques. It is important to understand what is really being measured and what assumptions and calculations have been incorporated with respect to a monitoring device. Understanding the basic principles of the above techniques as well as their advantages and limitations may be useful. In addition, the clinical validation of new techniques is necessary to convince that these new tools provide reliable measurements. In this review the physics behind the working of ODM, partial CO 2 breathing, transpulmonary thermodilution and lithium dilution techniques are dealt with. The physical and the physiological aspects underlying the pulse contour and pulse power analyses, various pulse contour techniques, their development, advantages and limitations are also covered. The principle of thoracic bioimpedance along with computation of CO from changes in thoracic impedance is explained. The purpose of the review is to help us minimize the dogmatic nature of practice favouring one technique or the other.

  13. Cystic Lesions in Autoimmune Pancreatitis

    OpenAIRE

    Gompertz, Macarena; Morales, Claudia; Aldana, Hernán; Castillo, Jaime; Berger, Zoltán

    2015-01-01

    Autoimmune pancreatitis (AIP) can be chronic or recurrent, but frequently completely reversible after steroid treatment. A cystic lesion in AIP is a rare finding, and it can mimic a pancreatic cystic neoplasm. Difficulties in an exact diagnosis interfere with treatment, and surgery cannot be avoided in some cases. We report the history of a 63-year-old male presenting with jaundice and pruritus. AIP was confirmed by imaging and elevated IgG4 blood levels, and the patient completely recovered ...

  14. Symmetrical thalamic lesions in infants.

    OpenAIRE

    Eicke, M.; Briner, J; Willi, U; Uehlinger, J; Boltshauser, E

    1992-01-01

    Clinical observations and findings on imaging are reported in six newborns with symmetrical thalamic lesions (STL). In three cases the diagnosis was confirmed by postmortem examination. Characteristic observations in this series and 17 previously reported cases include no evidence of perinatal asphyxia, high incidence of polyhydramnios, absent suck and swallow, absent primitive reflexes, appreciable spasticity at or within days of birth, lack of psychomotor development, and death within days ...

  15. Cardiac allograft immune activation: current perspectives

    Directory of Open Access Journals (Sweden)

    Chang D

    2014-12-01

    Full Text Available David Chang, Jon Kobashigawa Cedars-Sinai Heart Institute, Los Angeles, CA, USA Abstract: Heart transplant remains the most durable option for end-stage heart disease. Cardiac allograft immune activation and heart transplant rejection remain among the main complications limiting graft and recipient survival. Mediators of the immune system can cause different forms of rejection post-heart transplant. Types of heart transplant rejection include hyperacute rejection, cellular rejection, antibody-mediated rejection, and chronic rejection. In this review, we will summarize the innate and adaptive immune responses which influence the post-heart transplant recipient. Different forms of rejection and their clinical presentation, detection, and immune monitoring will be discussed. Treatment of heart transplant rejection will be examined. We will discuss potential treatment strategies for preventing rejection post-transplant in immunologically high-risk patients with antibody sensitization. Keywords: heart transplant, innate immunity, adaptive immunity, rejection, immunosuppression

  16. Computed tomography of cardiac pseudotumors and neoplasms.

    Science.gov (United States)

    Anavekar, Nandan S; Bonnichsen, Crystal R; Foley, Thomas A; Morris, Michael F; Martinez, Matthew W; Williamson, Eric E; Glockner, James F; Miller, Dylan V; Breen, Jerome F; Araoz, Philip A

    2010-07-01

    Important features of cardiac masses can be clearly delineated on cardiac computed tomography (CT) imaging. This modality is useful in identifying the presence of a mass, its relationship with cardiac and extracardiac structures, and the features that distinguish one type of mass from another. A multimodality approach to the evaluation of cardiac tumors is advocated, with the use of echocardiography, CT imaging and magnetic resonance imaging as appropriately indicated. In this article, various cardiac masses are described, including pseudotumors and true cardiac neoplasms, and the CT imaging findings that may be useful in distinguishing these rare entities are presented. PMID:20705174

  17. Follicular-patterned thyroid lesions

    Directory of Open Access Journals (Sweden)

    F. Fulya KÖYBAŞIOĞLU

    2009-01-01

    Full Text Available Aim: Our aim is to determine the minimal cytopathologic criteria needed to make differential diagnosis in follicular-patterned lesions of the thyroid gland.Materials and Methods: We reviewed 56 fine needle aspiration cytology specimens which were reported as “suspicious for follicular-patterned lesions of thyroid” between years 2001 and 2005 in our hospital and their histological slides. Parameters for cytopathologic assesment are cellularity, colloid formation, multilayered rosette formation, follicular cell rings, monolayered sheets, intact follicles, hyperplastic papillae, hyaline stromal fragments, intranuclear inclusions, nuclear grooves, angulated nuclei, nucleoli, cerebriform nuclei, nuclear size, macrophages, flame cells and Hurthle cells. Statistical analysis was performed using χ2 and Fisher's-exact tests and Kolmogorov-Simirnov test.Results: Four cytopathologic features–cerebriform nuclei, angulated nuclei, nuclear grooves and intranuclear inclusion- were constantly observed in the follicular variant of papillary carcinoma (p< 0.05. Diluted colloid, monolayered sheet, nuclear size, macrophage and nucleoli were frequently seen in nodular hyperplasia (p< 0.05. The nuclear size was the sole differential cytopathologic criteria between follicular adenoma and follicular carcinoma (p<0.05.Conclusion: Detailed cytopathologic examination was found to be important in differentiating follicular variant of papillary carcinoma from nodular hyperplasia. On the other hand, none of the cytopathologic findings were sufficient to distinguish follicular adenoma from follicular carcinoma. Therefore, cytopathologists should report such lesions as “follicular neoplasms”.

  18. Radiological diagnosis of adrenal lesions

    International Nuclear Information System (INIS)

    Among all the radiological examination techniques, CT is today, besides scintigraphy, the method of choice as far as the detection of functional adrenal lesions is concerned. In primary aldosteronism, CT classification of the syndrome is based on the detection of an adenoma which can be reliably detected in adenoma sizes up to 8-10 mm. Thus, 70 to 80% of Conn's syndromes can be classified. In adrenal Cushing's syndrome, the distinction between adenoma and carcinoma of the adrenal gland is up to CT and can usually be easily made due to the characteristic morphology of each type of lesion. In case of a typcial adrenal or juxtaadrenal tumor location, detection of a pheochromocytoma is likewise easy. In ectopic and multiple pheochromocytomas or such as occur as part of a MEN-syndrome, the situation is quite different. If lesions of the adrenal gland are found by accident in examinations otherwise indicated, the question arises whether the process is malignant or benign. In this respect, all the traditional imaging methods, including CT, involve a considerable factor or uncertainity, especially if a malignant tumor is anamnestically known and the question of metastases arises. According to recent information, MR-imaging seems to be advantageous concerning this difficult differential diagnosis. (orig.)

  19. A vertical approach to cardiac arrhythmias.

    Science.gov (United States)

    Vaughan Williams, E M

    1987-10-01

    Study of cardiac arrhythmia may be pursued vertically, as up the rungs of a ladder, from symptom to ECG, to EPS, to local lesion, to intracellular metabolism and to alterations of the latter and their effects on charge-transfer by ions across the cell membrane. Raised intracellular cAMP and calcium concentrations are responses to normal physiological controls, and highly abnormal ECGs occur in normal people under stress without progressing to life threatening arrhythmias, yet do so in susceptible individuals. Conversely, appropriate stimulation can precipitate ventricular fibrillation in normal myocardium. Selective stimulation of different types of adrenoceptor has differing electrophysiological effects. Beta 1-adrenoceptors increase contraction and calcium current, and shorten action potential duration (APD) by increasing potassium conductance. Beta 2-adrenoceptors do not increase calcium entry, but shorten APD by stimulating electrogenic Na/K pumping, alpha-adrenoceptors prolong contractions and lengthen APD. It is suggested that the tachycardia, extrasystoles and shortening of APD occurring in response to adrenergic stimuli and hypoxia, are accessory factors, not primary causes, in the development of arrhythmias, and constitute a danger when there is an appropriate anatomical substrate for re-entry. Serious arrhythmias are of multifactorial origin, of which "calcium overload" is but one, not proven to be a frequent one.

  20. Clinical Outcomes from Unselected “Real-World” Patients with Long Coronary Lesion Receiving 40 mm Biodegradable Polymer Coated Sirolimus-Eluting Stent

    Directory of Open Access Journals (Sweden)

    Anurag Polavarapu

    2015-01-01

    Full Text Available Background. Long lesions being implanted with drug-eluting stents (DES are associated with relatively high restenosis rates and higher incidences of adverse events. Objectives. We aimed to examine the safety and efficacy of the long (40 mm biodegradable polymer coated Indolimus sirolimus-eluting stent (SES in real-world patients with long coronary lesions. Methods. This study was observational, nonrandomized, retrospective, and carried out in real-world patients. A total of 258 patients were enrolled for the treatment of long coronary lesions, with 40 mm Indolimus. The primary endpoints in the study were incidence of major adverse cardiac events (MACE, a miscellany of cardiac death, myocardial infarction (MI, target lesion revascularization (TLR or target vessel revascularization (TVR, and stent thrombosis (ST up to 6-month follow-up. Results. The study population included higher proportion of males (74.4% and average age was 53.2 ± 11.0 years. A total of 278 lesions were intervened successfully with 280 stents. The observed MACE at 6-month follow-up was 2.0%, which included 0.8% cardiac death and 1.2% MI. There were no TLR or TVR and ST observed during 6-month follow-up. Conclusions. The long (40 mm Indolimus stent demonstrated low MACE rate and was proven to be safe and effective treatment for long lesions in “real-world” patients.

  1. Cardiac Penetrating Injuries and Pseudoaneurysm

    Institute of Scientific and Technical Information of China (English)

    CHEN Shifeng

    2002-01-01

    Objective To discuss the early diagnosis and treatment of cardiac penetrating injuries and pseudoaneurysm. Methods 18 cases of cardiac penetrating injuries, in which 2 cases were complicated with pseudoaneurysm, were diagnosed by emergency operation and color Doppler echocardiography between May 1973 and Dec. 2001 in our hospital. The basis for emergency operation is the injured path locating in cardiac dangerous zone, severe shock or pericardial tamponade. ResultsAmong 18 cases of this study, 17 cases underwent emergency operation. During the operation, 11 cases were found injured in right ventricle, 2 cases were found injured in right atrium, 1 case was found injured in pulmonary artery,4 cases were found injured in left ventricle, 2 cases were found complicated with pseudoaneurysm. 17cases underwent cardiac repair including 1 case of rupture of aneurysm. 1 case underwent elective aneurysm resection. In whole group, 15 cases survived(83.33% ), 3 cases died( 16.67%). The cause of death is mainly hemorrhagic shock. Conclusion Highly suspicious cardiac penetrating injuries or hemopericaridium should undergo direct operative exploration. Pseudoaneurysm should be resected early,which can prevent severe complications.

  2. Vitamin D and Cardiac Differentiation.

    Science.gov (United States)

    Kim, Irene M; Norris, Keith C; Artaza, Jorge N

    2016-01-01

    Calcitriol (1,25-dihydroxycholecalciferol or 1,25-D3) is the hormonally active metabolite of vitamin D. Experimental studies of vitamin D receptors and 1,25-D3 establish calcitriol to be a critical regulator of the structure and function of the heart. Clinical studies link vitamin D deficiency with cardiovascular disease (CVD). Emerging evidence demonstrates that calcitriol is highly involved in CVD-related signaling pathways, particularly the Wnt signaling pathway. Addition of 1,25-D3 to cardiomyocyte cells and examination of its effects on cardiomyocytes and mainly Wnt11 signaling allowed the specific characterization of the role of calcitriol in cardiac differentiation. 1,25-D3 is demonstrated to: (i) inhibit cell proliferation without promoting apoptosis; (ii) decrease expression of genes related to the regulation of the cell cycle; (iii) promote formation of cardiomyotubes; (iv) induce expression of casein kinase-1-α1, a negative regulator of the canonical Wnt signaling pathway; and (v) increase expression of noncanonical Wnt11, which has been recognized to induce cardiac differentiation during embryonic development and in adult cells. Thus, it appears that vitamin D promotes cardiac differentiation through negative modulation of the canonical Wnt signaling pathway and upregulation of noncanonical Wnt11 expression. Future work to elucidate the role(s) of vitamin D in cardiovascular disorders will hopefully lead to improvement and potentially prevention of CVD, including abnormal cardiac differentiation in settings such as postinfarction cardiac remodeling. PMID:26827957

  3. Cardiac factors in orthostatic hypotension

    Science.gov (United States)

    Löllgen, H.; Dirschedl, P.; Koppenhagen, K.; Klein, K. E.

    Cardiac function is determined by preload, afterload, heart rate and contractility. During orthostatic stress, the footward blood shift is compensated for by an increase of afterload. LBNP is widely used to analyze effects of volume displacement during orthostatic stress. Comparisons of invasive ( right heart catheterization) and non-invasive approach (echocardiography) yielded similar changes. Preload and afterload change with graded LBNP, heart rate increases, and stroke volume and cardiac output decrease. Thus, the working point on the left ventricular function curve is shifted to the left and downward, similar to hypovolemia. However, position on the Frank-Starling curve, the unchanged ejection fraction, and the constant Vcf indicate a normal contractile state during LBNP. A decrease of arterial oxygen partial pressure during LBNP shwos impaired ventilation/perfusion ratio. Finally, LBNP induced cardiac and hemodynamic changes can be effectively countermeasured by dihydroergotamine, a potent venoconstrictor. Comparison of floating catheter data with that of echocardiography resulted in close correlation for cardiac output and stroke volume. In addition, cardiac dimensions changed in a similar way during LBNP. From our findings, echocardiography as a non-invasive procedure can reliably used in LBNP and orthostatic stress tests. Some informations can be obtained on borderline values indicating collaps or orthostatic syncope. Early fainters can be differentiated from late fainters by stroke volume changes.

  4. Animal models of cardiac cachexia.

    Science.gov (United States)

    Molinari, Francesca; Malara, Natalia; Mollace, Vincenzo; Rosano, Giuseppe; Ferraro, Elisabetta

    2016-09-15

    Cachexia is the loss of body weight associated with several chronic diseases including chronic heart failure (CHF). The cachectic condition is mainly due to loss of skeletal muscle mass and adipose tissue depletion. The majority of experimental in vivo studies on cachexia rely on animal models of cancer cachexia while a reliable and appropriate model for cardiac cachexia has not yet been established. A critical issue in generating a cardiac cachexia model is that genetic modifications or pharmacological treatments impairing the heart functionality and used to obtain the heart failure model might likely impair the skeletal muscle, this also being a striated muscle and sharing with the myocardium several molecular and physiological mechanisms. On the other hand, often, the induction of heart damage in the several existing models of heart failure does not necessarily lead to skeletal muscle loss and cachexia. Here we describe the main features of cardiac cachexia and illustrate some animal models proposed for cardiac cachexia studies; they include the genetic calsequestrin and Dahl salt-sensitive models, the monocrotaline model and the surgical models obtained by left anterior descending (LAD) ligation, transverse aortic constriction (TAC) and ascending aortic banding. The availability of a specific animal model for cardiac cachexia is a crucial issue since, besides the common aspects of cachexia in the different syndromes, each disease has some peculiarities in its etiology and pathophysiology leading to cachexia. Such peculiarities need to be unraveled in order to find new targets for effective therapies. PMID:27317993

  5. Epicardial Lineages and Cardiac Repair

    Directory of Open Access Journals (Sweden)

    Manvendra K. Singh

    2013-08-01

    Full Text Available The death of cardiac myocytes resulting from myocardial infarction is a major cause of heart failure worldwide. Effective therapies for regenerating lost cardiac myocytes are lacking. Recently, the epicardium has been implicated as a source of inflammatory cytokines, growth factors and progenitor cells that modulate the response to myocardial injury. During embryonic development, epicardially-derived cells have the potential to differentiate into multiple cardiac lineages, including fibroblasts, vascular smooth muscle and potentially other cell types. In the healthy adult heart, epicardial cells are thought to be generally quiescent. However, injury of the adult heart results in reactivation of a developmental gene program in the epicardium, which leads to increased epicardial cell proliferation and differentiation of epicardium-derived cells (EPDCs into various cardiac lineages. Recent work suggests that epicardial reactivation after injury is accompanied by, and contributes to, a robust inflammatory response. In this review, we describe the current status of research related to epicardial biology in cardiac development and regeneration, highlighting important recent discoveries and ongoing controversies.

  6. 3D engineered cardiac tissue models of human heart disease: learning more from our mice.

    Science.gov (United States)

    Ralphe, J Carter; de Lange, Willem J

    2013-02-01

    Mouse engineered cardiac tissue constructs (mECTs) are a new tool available to study human forms of genetic heart disease within the laboratory. The cultured strips of cardiac cells generate physiologic calcium transients and twitch force, and respond to electrical pacing and adrenergic stimulation. The mECT can be made using cells from existing mouse models of cardiac disease, providing a robust readout of contractile performance and allowing a rapid assessment of genotype-phenotype correlations and responses to therapies. mECT represents an efficient and economical extension to the existing tools for studying cardiac physiology. Human ECTs generated from iPSCMs represent the next logical step for this technology and offer significant promise of an integrated, fully human, cardiac tissue model.

  7. Identification of genes regulated during mechanical load-induced cardiac hypertrophy

    Science.gov (United States)

    Johnatty, S. E.; Dyck, J. R.; Michael, L. H.; Olson, E. N.; Abdellatif, M.; Schneider, M. (Principal Investigator)

    2000-01-01

    Cardiac hypertrophy is associated with both adaptive and adverse changes in gene expression. To identify genes regulated by pressure overload, we performed suppressive subtractive hybridization between cDNA from the hearts of aortic-banded (7-day) and sham-operated mice. In parallel, we performed a subtraction between an adult and a neonatal heart, for the purpose of comparing different forms of cardiac hypertrophy. Sequencing more than 100 clones led to the identification of an array of functionally known (70%) and unknown genes (30%) that are upregulated during cardiac growth. At least nine of those genes were preferentially expressed in both the neonatal and pressure over-load hearts alike. Using Northern blot analysis to investigate whether some of the identified genes were upregulated in the load-independent calcineurin-induced cardiac hypertrophy mouse model, revealed its incomplete similarity with the former models of cardiac growth. Copyright 2000 Academic Press.

  8. Cardiac perioperative complications in noncardiac surgery

    Directory of Open Access Journals (Sweden)

    Radovanović Dragana

    2008-01-01

    Full Text Available Anesthesiologists are confronted with an increasing population of patients undergoing noncardiac surgery who are at risk for cardiac complications in the perioperative period. Perioperative cardiac complications are responsible for significant mortality and morbidity. The aim of the present study was to determine the incidence of perioperative (operative and postoperative cardiac complications and correlations between the incidence of perioperative cardiac complications and type of surgical procedure, age, presence of concurrent diseases. A total of 100 patients with cardiac diseases undergoing noncardiac surgery were included in the prospective study (Group A 50 patients undergoing intraperitoneal surgery and Group B 50 patients undergoing breast and thyroid surgery. The patients were followed up during the perioperative period and after surgery until leaving hospital to assess the occurrence of cardiac events. Cardiac complications (systemic arterial hypertension, systemic arterial hypotension, abnormalities of cardiac conduction and cardiac rhythm, perioperative myocardial ischemia and acute myocardial infarction occurred in 64% of the patients. One of the 100 patients (1% had postoperative myocardial infarction which was fatal. Systemic arterial hypertension occurred in 57% of patients intraoperatively and 33% postoperatively, abnormalities of cardiac rhythm in 31% of patients intraoperatively and 17% postoperatively, perioperative myocardial ischemia in 23% of patients intraoperatively and 11% of postoperatively. The most often cardiac complications were systemic arterial hypertension, abnormalities of cardiac rhythm and perioperative myocardial ischemia. Factors independently associated with the incidence of cardiac complications included the type of surgical procedure, advanced age, duration of anaesthesia and surgery, abnormal preoperative electrocardiogram, abnormal preoperative chest radiography and diabetes.

  9. Characterization of troponin responses in isoproterenol-induced cardiac injury in the Hanover Wistar rat.

    Science.gov (United States)

    York, Malcolm; Scudamore, Cheryl; Brady, Sally; Chen, Christabelle; Wilson, Sharon; Curtis, Mark; Evans, Gareth; Griffiths, William; Whayman, Matthew; Williams, Thomas; Turton, John

    2007-06-01

    The investigations aimed to evaluate the usefulness of cardiac troponins as biomarkers of acute myocardial injury in the rat. Serum from female Hanover Wistar rats treated with a single intraperitoneal (IP) injection of isoproterenol (ISO) was assayed for cardiac troponin I (cTnI) (ACS: 180SE, Bayer), cTnI (Immulite 2000, Diagnostic Products Corporation) and cardiac troponin T (cTnT) (Elecsys 2010, Roche). In a time-course study (50.0 mg/kg ISO), serum cTnI (ACS:180SE) and cTnT increased above control levels at 1 hour postdosing, peaking at 2 hours (cTnI, 4.30 microg/L; cTnT, 1.79 microg/L), and declined to baseline by 48 hours, with histologic cardiac lesions first seen at 4 hours postdosing. The Immulite 2000 assay gave minimal cTnI signals, indicating poor immunoreactivity towards rat cTnI. In a dose-response study (0.25 to 20.0 mg/kg ISO), there was a trend for increasing cTnI (ACS:180SE) values with increasing ISO dose levels at 2 hours postdosing. By 24 hours, cTnI levels returned to baseline although chronic cardiac myodegeneration was present. We conclude that serum cTnI and cTnT levels are sensitive and specific biomarkers for detecting ISO induced myocardial injury in the rat. Serum troponin values reflect the development of histopathologic lesions; however peak troponin levels precede maximal lesion severity.

  10. Surgical treatment of gallbladder polypoid lesions

    OpenAIRE

    Pejić Miljko A.; Milić Dragan J.

    2003-01-01

    INTRODUCTION Polypoid lesions of the gallbladder can be divided into benign and malignant categories. Malignant polypoid lesions include carcinomas of the gallbladder, which is the fifth most common malignancy of the gastrointestinal tract and the most common malignancy of the biliary tract. Benign polypoid lesions of the gallbladder are divided into true tumors and pseudotumors. Pseudotumors account for most of polypoid lesions of the gallbladder, and include polyps, hyperplasia, and other m...

  11. Unusual cause of generalized osteolytic vertebral lesions: a case report

    Directory of Open Access Journals (Sweden)

    Nanda Sudip

    2007-06-01

    Full Text Available Abstract Background Vertebral sarcoidosis is an extremely rare form of osseous sarcoidosis. Although osseous sarcoidosis is almost always an incidental finding of sarcoidosis elsewhere in the body, vertebrae may be the primary disease site. Involvement of vertebrae is usually localized and sclerotic or lytic. Case presentation We describe a case of extensive asymptomatic vertebral involvement by sarcoid with osteolytic lesions. Making the diagnosis requires biopsy and ruling out other commoner causes of osteolytic vertebral lesions. Conclusion We report this case in the hope of expanding the knowledge of osseous sarcoidosis. Our patient was unique in that all involvement was axial with sparing of the peripheral skeleton, near absence of any other organ involvement, diffuse involvement of the whole spine and osteolytic bone lesions.

  12. In Vivo Tracking of Cell Therapies for Cardiac Diseases with Nuclear Medicine

    Science.gov (United States)

    Moreira, Mayra Lorena; da Costa Medeiros, Priscylla; de Souza, Sergio Augusto Lopes; Rosado-de-Castro, Paulo Henrique

    2016-01-01

    Even though heart diseases are amongst the main causes of mortality and morbidity in the world, existing treatments are limited in restoring cardiac lesions. Cell transplantations, originally developed for the treatment of hematologic ailments, are presently being explored in preclinical and clinical trials for cardiac diseases. Nonetheless, little is known about the possible efficacy and mechanisms for these therapies and they are the center of continuous investigation. In this scenario, noninvasive imaging techniques lead to greater comprehension of cell therapies. Radiopharmaceutical cell labeling, firstly developed to track leukocytes, has been used successfully to evaluate the migration of cell therapies for myocardial diseases. A substantial rise in the amount of reports employing this methodology has taken place in the previous years. We will review the diverse radiopharmaceuticals, imaging modalities, and results of experimental and clinical studies published until now. Also, we report on current limitations and potential advances of radiopharmaceutical labeling for cell therapies in cardiac diseases. PMID:26880951

  13. Anaesthetic management of patients with congenital heart disease presenting for non-cardiac surgery.

    OpenAIRE

    Mohindra R; Beebe David; Belani Kumar

    2002-01-01

    The incidence of congenital heart disease is about one percent of all live births in the United States. Treatment is being performed at a younger age and these children are showing improved survival. It is not unusual for children with congenital heart disease to present for non-cardiac surgery. Their management depends on their age, type of lesion, extent of corrective procedure, the presence of complications and other congenital anomalies. Each patient needs a detailed pre-operative evaluat...

  14. Electrophysiological Cardiac Modeling: A Review.

    Science.gov (United States)

    Beheshti, Mohammadali; Umapathy, Karthikeyan; Krishnan, Sridhar

    2016-01-01

    Cardiac electrophysiological modeling in conjunction with experimental and clinical findings has contributed to better understanding of electrophysiological phenomena in various species. As our knowledge on underlying electrical, mechanical, and chemical processes has improved over time, mathematical models of the cardiac electrophysiology have become more realistic and detailed. These models have provided a testbed for various hypotheses and conditions that may not be easy to implement experimentally. In addition to the limitations in experimentally validating various scenarios implemented by the models, one of the major obstacles for these models is computational complexity. However, the ever-increasing computational power of supercomputers facilitates the clinical application of cardiac electrophysiological models. The potential clinical applications include testing and predicting effects of pharmaceutical agents and performing patient-specific ablation and defibrillation. A review of studies involving these models and their major findings are provided.

  15. Lesion Contrast Enhancement in Medical Ultrasound Imaging

    DEFF Research Database (Denmark)

    Stetson, Paul F.; Sommer, F.G.; Macovski, A.

    1997-01-01

    Methods for improving the contrast-to-noise ratio (CNR) of low-contrast lesions in medical ultrasound imaging are described. Differences in the frequency spectra and amplitude distributions of the lesion and its surroundings can be used to increase the CNR of the lesion relative to the background...

  16. Is Training Essential for Interpreting Cardiac Computed Tomography

    International Nuclear Information System (INIS)

    Background: Cardiac computed tomography (CT) has gained increasing acceptance for diagnosing obstructive coronary artery disease (CAD). Several guidelines have been published on required education for proficiency in the interpretation of these examinations. Purpose: To describe the learning-curve effect of the interpretation of 100 consecutive cardiac CT examinations aimed at diagnosing CAD. The diagnostic accuracy of radiologists and radiographers was also compared. Material and Methods: Two radiologists and two radiographers, all with no prior experience in evaluation of cardiac CT, independently underwent a dedicated training program of 100 examinations randomized into 10 blocks (sessions), with 10 cases in each. They independently evaluated the coronary arteries regarding significant obstructive CAD. After every session, individual feedback on diagnostic accuracy and comparison with the corresponding invasive coronary angiography (currently regarded as the gold standard to detect coronary lesions) was given. The time required for interpretation was recorded. Results: The mean review time decreased (P<0.0001) successively during the 10 sessions for all the observers together. The first session had a mean review time of 32 min, and the last session 16 min. No significant improvement in sensitivity, specificity, or negative predictive value (NPV) was observed. For positive predictive value (PPV), there was an improvement for the radiologists (P<0.05), but not for the radiographers. The radiographers had a higher total specificity compared to the radiologists (P<0.01). Conclusion: The review time for novices in cardiac CT was approximately halved during the first 100 cases, with maintained accuracy. There was a learning-curve effect in PPV for the radiologists. The diagnostic accuracy of dedicated radiographers indicates that they might be considered to be included as part of the evaluation team

  17. Complications after cardiac implantable electronic device implantations

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nohr, Ellen Aagaard;

    2013-01-01

    Complications after cardiac implantable electronic device (CIED) treatment, including permanent pacemakers (PMs), cardiac resynchronization therapy devices with defibrillators (CRT-Ds) or without (CRT-Ps), and implantable cardioverter defibrillators (ICDs), are associated with increased patient...

  18. Sudden Cardiac Arrest (SCA) Risk Assessment

    Science.gov (United States)

    ... Find a Specialist Share Twitter Facebook SCA Risk Assessment Sudden Cardiac Arrest (SCA) occurs abruptly and without ... of all ages and health conditions. Start Risk Assessment The Sudden Cardiac Arrest (SCA) Risk Assessment Tool ...

  19. An update on insertable cardiac monitors

    DEFF Research Database (Denmark)

    Olsen, Flemming J; Biering-Sørensen, Tor; Krieger, Derk W

    2015-01-01

    Continuous cardiac rhythm monitoring has undergone compelling progress over the past decades. Cardiac monitoring has emerged from 12-lead electrocardiograms being performed at the discretion of the treating physician to in-hospital telemetry, Holter monitoring, prolonged external event monitoring...

  20. Elevated sensitivity to cardiac ischemia in proteinuric rats is independent of adverse cardiac remodeling

    NARCIS (Netherlands)

    Szymanski, Mariusz K.; Hillege, Hans L.; Danser, A. H. Jan; Garrelds, Ingrid M.; Schoemaker, Regien G.

    2013-01-01

    Objectives: Chronic renal dysfunction severely increases cardiovascular risk. Adverse cardiac remodeling is suggested to play a major role as predisposition for increased cardiac ischemic vulnerability. The aim of the present study was to examine the role of adverse cardiac remodeling in cardiac sen

  1. Cardiac myxoma: A surgical experience of 38 patients over 9 years, at SSKM hospital Kolkata, India

    Directory of Open Access Journals (Sweden)

    Mohammad Shahbaaz Khan

    2013-01-01

    Full Text Available Background: Cardiac myxoma is the most common benign intracardiac tumor. We studied its clinical presentation, morbidity, mortality and recurrence following surgery over a period of 9 years. Materials and Methods: This study was performed at cardiothoracic and vascular surgery department of a tertiary level hospital of eastern India, Seth Sukhlal Karnani Memorial hospital, Institute of Post Graduate Medical Education and Research Kolkata. Near 6000 cardiac cases were operated at our center over this period. Preoperative diagnosis was made with clinical presentation and preoperative echocardiography. Complete tumor excision was done and all patients were followed up for recurrence and complications. Result: A total of 38 cases of cardiac myxoma were operated over a period from October 2002 to October 2011. Cardiac myxoma constituted about 0.6% of all cardiac cases operated at our institute. This most commonly presented at fifth decade of life. Of these, 35 cases were left atrial and 2 cases were right atrial, and 1 case was having both atrial involvements. The left atrial myxoma mostly presented as mitral stenosis and very few presented with embolic and constitutional symptoms. No death or recurrence was observed during the follow up period. Conclusion: Cardiac myxomas form a very small percentage of the cardiac cases. A high index of suspicion is essential for diagnosis. Echocardiography is the ideal diagnostic tool as also for follow-up. Immediate surgical treatment is indicated in all patients. Cardiac myxomas can be excised with a low rate of mortality and morbidity.

  2. [Cardiac output monitoring by impedance cardiography in cardiac surgery].

    Science.gov (United States)

    Shimizu, H; Seki, S; Mizuguchi, A; Tsuchida, H; Watanabe, H; Namiki, A

    1990-04-01

    The cardiac output monitoring by impedance cardiography, NCCOM3, was evaluated in adult patients (n = 12) who were subjected to coronary artery bypass grafting. Values of cardiac output measured by impedance cardiography were compared to those by the thermodilution method. Changes of base impedance level used as an index of thoracic fluid volume were also investigated before and after cardiopulmonary bypass (CPB). Correlation coefficient (r) of the values obtained by thermodilution with impedance cardiography was 0.79 and the mean difference was 1.29 +/- 16.9 (SD)% during induction of anesthesia. During the operation, r was 0.83 and the mean difference was -14.6 +/- 18.7%. The measurement by impedance cardiography could be carried out through the operation except when electro-cautery was used. Base impedance level before CPB was significantly lower as compared with that after CPB. There was a negative correlation between the base impedance level and central venous pressure (CVP). No patients showed any signs suggesting lung edema and all the values of CVP, pulmonary artery pressure and blood gas analysis were within normal ranges. From the result of this study, it was concluded that cardiac output monitoring by impedance cardiography was useful in cardiac surgery, but further detailed examinations will be necessary on the relationship between the numerical values of base impedance and the clinical state of the patients. PMID:2362347

  3. Health Literacy Predicts Cardiac Knowledge Gains in Cardiac Rehabilitation Participants

    Science.gov (United States)

    Mattson, Colleen C.; Rawson, Katherine; Hughes, Joel W.; Waechter, Donna; Rosneck, James

    2015-01-01

    Objective: Health literacy is increasingly recognised as a potentially important patient characteristic related to patient education efforts. We evaluated whether health literacy would predict gains in knowledge after completion of patient education in cardiac rehabilitation. Method: This was a re-post observational analysis study design based on…

  4. Regulation of Cardiac Hypertrophy: the nuclear option

    OpenAIRE

    Kuster, Diederik

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, cardiac hypertrophy is an independent risk factor for the development of heart failure and is therefore called pathological hypertrophy. That hypertrophy is not bad per se, is illustrated by the hyp...

  5. Structure and mechanism for DNA lesion recognition

    Institute of Scientific and Technical Information of China (English)

    Wei Yang

    2008-01-01

    A fundamental question in DNA repair is how a lesion is detected when embedded in millions to billions of normal base pairs. Extensive structural and functional studies reveal atomic details of DNA repair protein and nucleic acid interactions. This review summarizes seemingly diverse structural motifs used in lesion recognition and suggests a general mechanism to recognize DNA lesion by the poor base stacking. After initial recognition of this shared struc-tural feature of lesions, different DNA repair pathways use unique verification mechanisms to ensure correct lesion identification and removal.

  6. Solitary lucent epiphyseal lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gardner, D.J.; Azouz, E.M.

    1988-10-01

    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  7. Self-inflicted skin lesions

    DEFF Research Database (Denmark)

    Ring, Hans Christian; Smith, Matthias Nybro; Jemec, Gregor B E

    2014-01-01

    The current literature on the management of self-inflicted skin lesions points to an overall paucity of treatments with a high level of evidence (randomized controlled trials, controlled trials, or meta-analyses). In order to improve the communication between dermatologists and mental health...... the previous plethora of terms is covered by the new classification. This may aid physicians and mental health professionals in understanding how the new classification relates to the prior plethora of psychodermatological diagnoses and thereby facilitate the future use of the new classification....

  8. Pancreatic Lesion: Malignancy or Abscess?

    Science.gov (United States)

    Shulik, Oleg; Cavanagh, Yana; Grossman, Matthew

    2016-01-01

    BACKGROUND Pancreatic abscesses are rare. They may be seen in patients with pancreatic inflammation or pancreatitis. Patients with pancreatic abscesses may have abdominal pain, fever, chills, and nausea/vomiting or an inability to eat. Presentation with alternate symptomatology is extremely unusual. CASE REPORT A 67-year-old Asian male presented with painless, afebrile obstructive jaundice and a CA 19-9 of 1732 IU. He was found to have a 3.1×2.4 cm low-density lesion in the head of the pancreas and the right lobe of the liver, suggesting malignancy. Surgical management was considered, however additional diagnostic workup, including an endoscopic retrograde cholangiopancreatography (ERCP), was performed to complete staging of the presumed mass. A smooth, 3-cm-long, tapering stricture was found it the common bile duct. It was stented from the common hepatic duct to the duodenum. Subsequent endoscopic ultrasound (EUS) evaluation of the pancreatic head lesion revealed a drainable fluid collection that was aspirated and found to contain pyogenic material on pathology. The patient's symptoms resolved, and he was subsequently managed conservatively. A repeat ERCP confirmed complete resolution of the previously visualized cystic lesion. Interestingly, laboratory values showed concomitant normalization of CA 19-9 to 40 IU. CONCLUSIONS EUS-guided biopsy is not widely regarded as a required step before surgery, in the management of patients with pancreatic masses. It is generally reserved for determination of resectability or staging, and only utilized when clinically indicated. However, this practice may be associated with an inherently significant risk of misdiagnosis and subsequent unnecessary surgery, as illustrated by this case. Malignancy was initially suspected in our patient and surgical resection was recommended. Endoscopic measures were only pursued to complete staging. We propose that EUS-guided biopsy may be a crucial diagnostic step in the management algorithm

  9. MRI of cardiac rhabdomyoma in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Kivelitz, Dietmar E.; Muehler, Matthias [Institut fuer Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Rake, Annett; Chaoui, Rabih [Klinik fuer Gynaekologie und Geburtshilfe, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany); Scheer, Ianina [Klinik fuer Strahlenheilkunde, Abteilung Paediatrische Radiologie, Medizinische Fakultaet, Humboldt-Universitaet zu Berlin, Charite, Schumannstrasse 20/21, 10098, Berlin (Germany)

    2004-08-01

    Primary cardiac tumors are rarely diagnosed in utero and are usually seen on prenatal echocardiography. Cardiac rhabdomyomata can be associated with tuberous sclerosis. Prenatal MRI can be performed to assess associated malformations. This case report illustrates the ability of fetal MRI to image cardiac rhabdomyata and compares it with prenatal and postnatal echocardiography. (orig.)

  10. Regulation of Cardiac Hypertrophy: the nuclear option

    NARCIS (Netherlands)

    D.W.D. Kuster (Diederik)

    2011-01-01

    textabstractCardiac hypertrophy is the response of the heart to an increased workload. After myocardial infarction (MI) the surviving muscle tissue has to work harder to maintain cardiac output. This sustained increase in workload leads to cardiac hypertrophy. Despite its apparent appropriateness, c

  11. Childhood cancer survivors: cardiac disease & social outcomes

    NARCIS (Netherlands)

    E.A.M. Feijen

    2015-01-01

    The thesis is divided in two parts; Cardiac health problems and healthcare consumption & social outcomes in CCS. The general aims of part 1 creates optimal conditions for the evaluation of cardiac events in 5-year childhood cancer survivors, evaluation of the long term risk of cardiac events, and to

  12. Dieulafoy's lesion of duodenum: a case report

    Directory of Open Access Journals (Sweden)

    Wagholikar Gajanan D

    2003-01-01

    Full Text Available Abstract Background Dieulafoy's lesion is an uncommon but important cause of recurrent upper gastrointestinal bleeding. Extragastric location of Dieulafoy's lesion is rare. We report two cases of Dieulafoy's lesion of the duodenum and discuss the management of this extremely uncommon entity. Case presentation Two cases of massive upper gastro-intestinal bleeding in young adults due to Dieulafoy's lesion of the duodenum are reported. Endoscopic diagnosis was possible in both cases. Hemostasis was achieved successfully by endoscopic adrenaline injection. The endoscopic appearance, pitfalls in the diagnosis and management of this rare lesion are discussed. Conclusions Endoscopic diagnosis of extragastric Dieulafoy's lesion can be difficult because of the small size and obscure location of the lesion. Increased awareness and careful and early endoscopic evaluation following the bleeding episode are the key to accurate diagnosis. Adrenaline injection is one of the important endoscopic modalities for control of bleeding.

  13. Cardiac abnormalities after subarachnoid hemorrhage

    NARCIS (Netherlands)

    Bilt, I.A.C. van der

    2016-01-01

    Aneurysmal subarachnoid hemorrhage(aSAH) is a devastating neurological disease. During the course of the aSAH several neurological and medical complications may occur. Cardiac abnormalities after aSAH are observed often and resemble stress cardiomyopathy or Tako-tsubo cardiomyopathy(Broken Heart Syn

  14. Molecular therapies for cardiac arrhythmias

    NARCIS (Netherlands)

    G.J.J. Boink

    2013-01-01

    Despite the ongoing advances in pharmacology, devices and surgical approaches to treat heart rhythm disturbances, arrhythmias are still a significant cause of death and morbidity. With the introduction of gene and cell therapy, new avenues have arrived for the local modulation of cardiac disease. Th

  15. Historical highlights in cardiac pacing.

    Science.gov (United States)

    Geddes, L A

    1990-01-01

    The benchmarks in cardiac pacing are identified, beginning with F. Steiner (1871), who rhythmically stimulated the chloroform-arrested hearts of 3 horses, 1 donkey, 10 dogs, 14 cats, and 8 rabbits. The chloroform-arrested heart in human subjects was paced by T. Greene in the following year (1872) in the UK. In 1882, H. Ziemssen in Germany applied cardiac pacing to a 42-year old woman who had a large defect in the anterior left chest wall subsequent to resection of an enchondroma. Intentional cardiac pacing did not occur until 1932, when A.A. Hyman in the US demonstrated that cardiac pacing could be clinically practical. Hyman made a batteryless pacemaker for delivery in induction shock stimuli (60-120/min) to the atria. His pacemaker was powered by a hand-wound, spring-driven generator which provided 6 min of pacemaking without rewinding. Closed-chest ventricular pacing was introduced in the US in 1952 by P.M. Zoll et al. Zoll (1956) also introduced closed-chest ventricular defibrillation. W.L. Weirich et al. (1958) demonstrated that direct-heart stimulation in closed-chest patients could be achieved with slender wire electrodes. S. Furman and J.B. Schwedel (1959) developed a monopolar catheter electrode for ventricular pacing in man. In the same year, W. Greatbatch and W.M. Chardack developed the implantable pacemaker. PMID:18238328

  16. Cardiac resynchronization therapy in China

    Institute of Scientific and Technical Information of China (English)

    Wei HUA

    2006-01-01

    @@ Congestive heart failure (HF) is a major and growing public health problem. The therapeutic approach includes non-pharmacological measures, pharmacological therapy,mechanical devices, and surgery. Despite the benefits of optimal pharmacologic therapy, the prognosis is still not ideal. At this time, cardiac resynchronization therapy (CRT)has gained wide acceptance as an alternative treatment for HF patients with conduction delay.1

  17. Cardiac pacemakers and nuclear batteries

    International Nuclear Information System (INIS)

    Following the introduction giving the indications for cardiac pacemaker therapy with special regard to the use of pacemakers powered by nuclear batteries, reference is made to the resulting radiation exposure of the patient. The activities of the Federal Health Office in this field such as recommendations and surveys including the entire Federal Republic are outlined. (orig.)

  18. Epidural analgesia for cardiac surgery

    NARCIS (Netherlands)

    V. Svircevic; M.M. Passier; A.P. Nierich; D. van Dijk; C.J. Kalkman; G.J. van der Heijden

    2013-01-01

    Background A combination of general anaesthesia (GA) with thoracic epidural analgesia (TEA) may have a beneficial effect on clinical outcomes by reducing the risk of perioperative complications after cardiac surgery. Objectives The objective of this review was to determine the impact of perioperativ

  19. Collecting Duct Carcinoma With Cardiac Metastases: A Case Report & Literature Review

    Directory of Open Access Journals (Sweden)

    James N. Voss

    2016-03-01

    Full Text Available Collecting duct carcinoma (CDC, is a rare and aggressive form of renal cell carcinoma (RCC accounting for around 1% of all renal malignancy. It affects younger patients and is associated with rapid progression, distant spread and poor prognosis. Cardiac metastases from all types of RCC, without involvement of the inferior vena cava are very rare. We present the case of a 54 year old man with a history of CDC, who presents with collapse and ventricular tachycardia secondary to multifocal cardiac metastases. We are not aware of any other reports in the literature of CDC and cardiac metastases.

  20. Randomized Comparison of the Crush Versus the Culotte Stenting for Coronary Artery Bifurcation Lesions

    Institute of Scientific and Technical Information of China (English)

    Xu-Wei Zheng; Dong-Hui Zhao; Hong-Yu Peng; Qian Fan; Qin Ma; Zhen-Ye Xu; Chao Fan

    2016-01-01

    Background:The crush and the culotte stenting were both reported to be effective for complex bifurcation lesion treatment.However,their comparative performance remains elusive.Methods:A total of 300 patients with coronary bifurcation lesions were randomly assigned to crush (n =150) and culotte (n =150) treatment.The primary endpoint was the occurrence of major adverse cardiac events (MACEs) at 12 months including cardiac death,myocardial infarction,stent thrombosis,and target vessel revascularization.Index lesion restenosis at 12 months was a secondary endpoint.The surface integrals of time-averaged wall shear stress at bifurcation sites were also be quantified.Results:There were no significant differences in MACE rates between the two groups at 12-month follow-up:Crush 6.7%,culotte 5.3% (P =0.48).The rates of index lesion restenosis were 12.7% versus 6.0% (P =0.047) in the crush and the culotte groups,respectively.At 12-month follow-up,the surface integrals of time-averaged wall shear stress at bifurcation sites in the crush group were significantly lower than the culotte group ([5.01 ± 0.95] × 10-4 Newton and [6.08 ± 1.16] × 10 4 Newton,respectively;P =0.003).Conclusions:Both the crush and the culotte bifurcation stenting techniques showed satisfying clinical and angiographic results at 12-month follow-up.Bifurcation lesions treated with the culotte technique tended to have lower restenosis rates and more favorable flow patterns.

  1. Cardiac tissue ablation with catheter-based microwave heating.

    Science.gov (United States)

    Rappaport, C

    2004-11-01

    The common condition of atrial fibrillation is often treated by cutting diseased cardiac tissue to disrupt abnormal electrical conduction pathways. Heating abnormal tissue with electromagnetic power provides a minimally invasive surgical alternative to treat these cardiac arrhythmias. Radio frequency ablation has become the method of choice of many physicians. Recently, microwave power has also been shown to have great therapeutic benefit in medical treatment requiring precise heating of biological tissue. Since microwave power tends to be deposited throughout the volume of biological media, microwave heating offers advantages over other heating modalities that tend to heat primarily the contacting surface. It is also possible to heat a deeper volume of tissue with more precise control using microwaves than with purely thermal conduction or RF electrode heating. Microwave Cardiac Ablation (MCA) is used to treat heart tissue that allows abnormal electrical conduction by heating it to the point of inactivation. Microwave antennas that fit within catheter systems can be positioned close to diseased tissue. Specialized antenna designs that unfurl from the catheter within the heart can then radiate specifically shaped fields, which overcome problems such as excessive surface heating at the contact point. The state of the art in MCA is reviewed in this paper and a novel catheter-based unfurling wide aperture antenna is described. This antenna consists of the centre conductor of a coaxial line, shaped into a spiral and insulated from blood and tissue by a non-conductive fluid filled balloon. Initially stretched straight inside a catheter for transluminal guiding, once in place at the cardiac target, the coiled spiral antenna is advanced into the inflated balloon. Power is applied in the range of 50-150 W at the reserved industrial, scientific and medical (ISM) frequency of 915 MHz for 30-90 s to create an irreversible lesion. The antenna is then retracted back into the

  2. Percutaneous acetabuloplasty for metastatic acetabular lesions

    Directory of Open Access Journals (Sweden)

    Logroscino Giandomenico

    2008-05-01

    Full Text Available Abstract Background Osteolytic metastases around the acetabulum are frequent in tumour patients, and may cause intense and drug-resistant pain of the hip. These lesions also cause structural weakening of the pelvis, limping, and poor quality of life. Percutaneous acetabuloplasty is a mini-invasive procedure for the management of metastatic lesions due to carcinoma of the acetabulum performed in patients who cannot tolerate major surgery, or in patients towards whom radiotherapy had already proved ineffective. Methods We report a retrospective study in 25 such patients (30 acetabuli who were evaluated before and after percutaneous acetabuloplasty, with regard to pain, mobility of the hip joint, use of analgesics, by means of evaluation forms: Visual Analog Scale, Harris Hip Score, Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC, Eastern Cooperative Oncology Group (ECOG. The results obtained were analysed using the χ2 Test and Fisher's exact test. Significance was sent at P Results Marked clinical improvement was observed in all patients during the first six post-operative months, with gradual a worsening thereafter from deterioration of their general condition. Complete pain relief was achieved in 15 of our 25 (59% of patients, and pain reduction was achieved in the remaining 10 (41% patients. The mean duration of pain relief was 7.3 months. Pain recurred in three patients (12% between 2 weeks to 3 months. No major complications occurred. There was transient local pain in most cases, and 2 cases of venous injection of cement without clinical consequences. Conclusion Percutaneous acetabuloplasty is effective in improving the quality of life of patients with osteolytic bone tumours, even though the improvement is observed during the first 6 months only. It can be an effective aid to chemo- and radiotherapy in the management of acetabular metastases.

  3. Transthyretin Cardiac Amyloidosis in Black Americans.

    Science.gov (United States)

    Shah, Keyur B; Mankad, Anit K; Castano, Adam; Akinboboye, Olakunle O; Duncan, Phillip B; Fergus, Icilma V; Maurer, Mathew S

    2016-06-01

    Transthyretin-related cardiac amyloidosis is a progressive infiltrative cardiomyopathy that mimics hypertensive and hypertrophic heart disease and often goes undiagnosed. In the United States, the hereditary form disproportionately afflicts black Americans, who when compared with whites with wild-type transthyretin amyloidosis, a phenotypically similar condition, present with more advanced disease despite having a noninvasive method for early identification (genetic testing). Although reasons for this are unclear, this begs to consider the inadequate access to care, societal factors, or a biological basis. In an effort to improve awareness and explore unique characteristics, we review the pathophysiology, epidemiology, and therapeutic strategies for transthyretin amyloidosis and highlight diagnostic pitfalls and clinical pearls for identifying patients with amyloid heart disease. PMID:27188913

  4. Filters in 2D and 3D Cardiac SPECT Image Processing

    Directory of Open Access Journals (Sweden)

    Maria Lyra

    2014-01-01

    Full Text Available Nuclear cardiac imaging is a noninvasive, sensitive method providing information on cardiac structure and physiology. Single photon emission tomography (SPECT evaluates myocardial perfusion, viability, and function and is widely used in clinical routine. The quality of the tomographic image is a key for accurate diagnosis. Image filtering, a mathematical processing, compensates for loss of detail in an image while reducing image noise, and it can improve the image resolution and limit the degradation of the image. SPECT images are then reconstructed, either by filter back projection (FBP analytical technique or iteratively, by algebraic methods. The aim of this study is to review filters in cardiac 2D, 3D, and 4D SPECT applications and how these affect the image quality mirroring the diagnostic accuracy of SPECT images. Several filters, including the Hanning, Butterworth, and Parzen filters, were evaluated in combination with the two reconstruction methods as well as with a specified MatLab program. Results showed that for both 3D and 4D cardiac SPECT the Butterworth filter, for different critical frequencies and orders, produced the best results. Between the two reconstruction methods, the iterative one might be more appropriate for cardiac SPECT, since it improves lesion detectability due to the significant improvement of image contrast.

  5. Assessment of factors that influence weaning from long-term mechanical ventilation after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Emília Nozawa

    2003-03-01

    Full Text Available OBJECTIVE: To analyze parameters of respiratory system mechanics and oxygenation and cardiovascular alterations involved in weaning tracheostomized patients from long-term mechanical ventilation after cardiac surgery. METHODS: We studied 45 patients in their postoperative period of cardiac surgery, who required long-term mechanical ventilation for more than 10 days and had to undergo tracheostomy due to unsuccessful weaning from mechanical ventilation. The parameters of respiratory system mechanics, oxigenation and the following factors were analyzed: type of surgical procedure, presence of cardiac dysfunction, time of extracorporeal circulation, and presence of neurologic lesions. RESULTS: Of the 45 patients studied, successful weaning from mechanical ventilation was achieved in 22 patients, while the procedure was unsuccessful in 23 patients. No statistically significant difference was observed between the groups in regard to static pulmonary compliance (p=0.23, airway resistance (p=0.21, and the dead space/tidal volume ratio (p=0.54. No difference was also observed in regard to the variables PaO2/FiO2 ratio (p=0.86, rapid and superficial respiration index (p=0.48, and carbon dioxide arterial pressure (p=0.86. Cardiac dysfunction and time of extracorporeal circulation showed a significant difference. CONCLUSION: Data on respiratory system mechanics and oxygenation were not parameters for assessing the success or failure. Cardiac dysfunction and time of cardiopulmonary bypass, however, significantly interfered with the success in weaning patients from mechanical ventilation.

  6. Automatic differentiation of melanoma and clark nevus skin lesions

    Science.gov (United States)

    LeAnder, R. W.; Kasture, A.; Pandey, A.; Umbaugh, S. E.

    2007-03-01

    Skin cancer is the most common form of cancer in the United States. Although melanoma accounts for just 11% of all types of skin cancer, it is responsible for most of the deaths, claiming more than 7910 lives annually. Melanoma is visually difficult for clinicians to differentiate from Clark nevus lesions which are benign. The application of pattern recognition techniques to these lesions may be useful as an educational tool for teaching physicians to differentiate lesions, as well as for contributing information about the essential optical characteristics that identify them. Purpose: This study sought to find the most effective features to extract from melanoma, melanoma in situ and Clark nevus lesions, and to find the most effective pattern-classification criteria and algorithms for differentiating those lesions, using the Computer Vision and Image Processing Tools (CVIPtools) software package. Methods: Due to changes in ambient lighting during the photographic process, color differences between images can occur. These differences were minimized by capturing dermoscopic images instead of photographic images. Differences in skin color between patients were minimized via image color normalization, by converting original color images to relative-color images. Relative-color images also helped minimize changes in color that occur due to changes in the photographic and digitization processes. Tumors in the relative-color images were segmented and morphologically filtered. Filtered, relative-color, tumor features were then extracted and various pattern-classification schemes were applied. Results: Experimentation resulted in four useful pattern classification methods, the best of which was an overall classification rate of 100% for melanoma and melanoma in situ (grouped) and 60% for Clark nevus. Conclusion: Melanoma and melanoma in situ have feature parameters and feature values that are similar enough to be considered one class of tumor that significantly differs from

  7. A case report of primary cardiac myxofibrosarcoma presenting with severe congestive heart failure

    OpenAIRE

    Ujihira, Kosuke; Yamada, Akira; Nishioka, Naritomo; Iba, Yutaka; Maruyama, Ryushi; Nakanishi, Katsuhiko; Shimizu, Ai; Hatanaka, Kanako C.; Mitsuhashi, Tomoko; Shinohara, Toshiya; Ueda, Hatsue Ishibashi

    2016-01-01

    Background Primary cardiac sarcomas are extremely rare. Furthermore, the myxofibrosarcomas are one of the rarest forms of cardiac sarcomas, and its prognosis is known to be quite poor. Case presentation This is a case of a 23-year-old man who presented with acute severe congestive heart failure caused by almost complete obstruction of the mitral valve due to a large left atrial tumor. The patient required endotracheal intubation before his arrival to the hospital, and underwent an emergent su...

  8. Electrical Stimulation Promotes Cardiac Differentiation of Human Induced Pluripotent Stem Cells

    OpenAIRE

    Damián Hernández; Rodney Millard; Priyadharshini Sivakumaran; Wong, Raymond C. B.; Crombie, Duncan E.; Hewitt, Alex W.; Helena Liang; Hung, Sandy S. C.; Alice Pébay; Shepherd, Robert K.; Gregory J Dusting; Lim, Shiang Y

    2016-01-01

    Background. Human induced pluripotent stem cells (iPSCs) are an attractive source of cardiomyocytes for cardiac repair and regeneration. In this study, we aim to determine whether acute electrical stimulation of human iPSCs can promote their differentiation to cardiomyocytes. Methods. Human iPSCs were differentiated to cardiac cells by forming embryoid bodies (EBs) for 5 days. EBs were then subjected to brief electrical stimulation and plated down for 14 days. Results. In iPS(Foreskin)-2 cell...

  9. Experience of cardiac rehabilitation after coronary artery surgery: effects on health and risk factors

    OpenAIRE

    Lindsay, G.; Hanlon, W.P; Smith, L.N.; Belcher, P.R.

    2003-01-01

    Objective:Cardiac rehabilitation (CR) programs are provided to support the recovery process following acute myocardial infarction and coronary artery bypass grafting (CABG). Attendance varies. We related attendance following CABG to severity of cardiac symptoms, general health status (Short Form-36) and prevalence of modifiable coronary artery disease (CAD) risk factors. METHODS: 209 patients due to undergo CABG were recruited and assessed preoperatively as well as at a mean of 16.4 months po...

  10. Detection and classification of cardiac ischemia using vectorcardiogram signal via neural network

    OpenAIRE

    Ali Reza Mehri Dehnavi; Iman Farahabadi; Hossain Rabbani; Amin Farahabadi; Mohamad Parsa Mahjoob; Nasser Rajabi Dehnavi

    2011-01-01

    Background: Various techniques are used in diagnosing cardiac diseases. The electrocardiogram is one of these tools in common use. In this study vectorcardiogram (VCG) signals are used as a tool for detection of cardiac ischemia. Methods: VCG signals used in this study were obtained form 60 patients suspected to have ischemia disease and 10 normal candidates. Verification of the ischemia had done by the cardiologist during strain test by the evaluation of electrocardiogram (ECG) records ...

  11. Random forest learning of ultrasonic statistical physics and object spaces for lesion detection in 2D sonomammography

    Science.gov (United States)

    Sheet, Debdoot; Karamalis, Athanasios; Kraft, Silvan; Noël, Peter B.; Vag, Tibor; Sadhu, Anup; Katouzian, Amin; Navab, Nassir; Chatterjee, Jyotirmoy; Ray, Ajoy K.

    2013-03-01

    Breast cancer is the most common form of cancer in women. Early diagnosis can significantly improve lifeexpectancy and allow different treatment options. Clinicians favor 2D ultrasonography for breast tissue abnormality screening due to high sensitivity and specificity compared to competing technologies. However, inter- and intra-observer variability in visual assessment and reporting of lesions often handicaps its performance. Existing Computer Assisted Diagnosis (CAD) systems though being able to detect solid lesions are often restricted in performance. These restrictions are inability to (1) detect lesion of multiple sizes and shapes, and (2) differentiate between hypo-echoic lesions from their posterior acoustic shadowing. In this work we present a completely automatic system for detection and segmentation of breast lesions in 2D ultrasound images. We employ random forests for learning of tissue specific primal to discriminate breast lesions from surrounding normal tissues. This enables it to detect lesions of multiple shapes and sizes, as well as discriminate between hypo-echoic lesion from associated posterior acoustic shadowing. The primal comprises of (i) multiscale estimated ultrasonic statistical physics and (ii) scale-space characteristics. The random forest learns lesion vs. background primal from a database of 2D ultrasound images with labeled lesions. For segmentation, the posterior probabilities of lesion pixels estimated by the learnt random forest are hard thresholded to provide a random walks segmentation stage with starting seeds. Our method achieves detection with 99.19% accuracy and segmentation with mean contour-to-contour error lesions.

  12. Staged re-evaluation of non-culprit lesions in ST segment elevation myocardial infarction: a retrospective study

    OpenAIRE

    Thim, Troels; Egholm, Gro; Olesen, Kevin Kris Warnakula; Kaltoft, Anne; Terkelsen, Christian Juhl; Krusell, Lars Romer; Kristensen, Steen Dalby; Bøtker, Hans Erik; Christiansen, Evald Høj; Maeng, Michael

    2016-01-01

    Objective It remains unknown whether complete revascularisation is optimally performed in patients with ST segment elevation myocardial infarction (STEMI) during the index or at staged procedures. The aims of this study were to quantify the number of primary percutaneous coronary intervention (PCI) procedures in which non-culprit lesions needed further evaluation, to determine the consequence of the re-evaluation and to quantify adverse cardiac events during the waiting time for re-evaluation...

  13. Imaging findings of various calvarial bone lesions witha focus on osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Young Hee; Moon, Won Jin; An, Hyeong Su; Cho, Joon [Konkuk University Medical Center, Konkuk University School of Medicine, Seoul (Korea, Republic of); Rho, Myung Ho [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    In this review, we present computed tomography (CT) and magnetic resonance imaging (MRI) findings of various calvarial lesions on the basis of their imaging patterns and list the differential diagnoses of the lesions. We retrospectively reviewed 256 cases of calvarial lesion (122 malignant neoplasms, 115 benign neoplasms, and 19 non-neoplastic lesions) seen in our institutions, and classified them into six categories based on the following imaging features: generalized skull thickening, focal skull thickening, generalized skull thinning, focal skull thinning, single lytic lesion, and multiple lytic lesions. Although bony lesions of the calvarium are easily identified on CT, bone marrow lesions are better visualized on MRI including diffusion-weighted imaging or fat-suppressed T2-weighted imaging. Careful interpretation of calvarial lesions based on pattern recognition can effectively narrow a range of possible diagnoses.

  14. Characteristic findings in images of extra-pancreatic lesions associated with autoimmune pancreatitis

    Energy Technology Data Exchange (ETDEWEB)

    Fujinaga, Yasunari, E-mail: fujinaga@shinshu-u.ac.jp [Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 (Japan); Kadoya, Masumi [Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 (Japan); Kawa, Shigeyuki [Center of Health, Safety and Environmental Management, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 (Japan); Hamano, Hideaki [Department of Medicine, Gastroenterology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 (Japan); Ueda, Kazuhiko; Momose, Mitsuhiro; Kawakami, Satoshi; Yamazaki, Sachie; Hatta, Tomoko; Sugiyama, Yukiko [Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621 (Japan)

    2010-11-15

    Purpose: Autoimmune pancreatitis is a unique form of chronic pancreatitis characterized by a variety of extra-pancreatic involvements which are frequently misdiagnosed as lesions of corresponding organs. The purpose of this study was to clarify the diagnostic imaging features of extra-pancreatic lesions associated with autoimmune pancreatitis. Materials and methods: We retrospectively analyzed diagnostic images of 90 patients with autoimmune pancreatitis who underwent computer-assisted tomography, magnetic resonance imaging, and/or gallium-67 scintigraphy before steroid therapy was initiated. Results: AIP was frequently (92.2%) accompanied by a variety of extra-pancreatic lesions, including swelling of lachrymal and salivary gland lesions (47.5%), lung hilar lymphadenopathy (78.3%), a variety of lung lesions (51.2%), wall thickening of bile ducts (77.8%), peri-pancreatic or para-aortic lymphadenopathy (56.0%), retroperitoneal fibrosis (19.8%), a variety of renal lesions (14.4%), and mass lesions of the ligamentum teres (2.2%). Characteristic findings in CT and MRI included lymphadenopathies of the hilar, peri-pancreatic, and para-aortic regions; wall thickening of the bile duct; and soft tissue masses in the kidney, ureters, aorta, paravertebral region, ligamentum teres, and orbit. Conclusions: Recognition of the diagnostic features in the images of various involved organs will assist in the diagnosis of autoimmune pancreatitis and in differential diagnoses between autoimmune pancreatitis-associated extra-pancreatic lesions and lesions due to other pathologies.

  15. Characterizing iron deposition in multiple sclerosis lesions using susceptibility weighted imaging

    Science.gov (United States)

    Haacke, E. Mark; Makki, Malek; Ge, Yulin; Maheshwari, Megha; Sehgal, Vivek; Hu, Jiani; Selvan, Madeswaran; Wu, Zhen; Latif, Zahid; Xuan, Yang; Khan, Omar; Garbern, James; Grossman, Robert I.

    2009-01-01

    Purpose To investigate whether the variable forms of putative iron deposition seen with susceptibility weighted imaging (SWI) will lead to a set of multiple sclerosis (MS) lesion characteristics different than that seen in conventional MR imaging. Materials and Methods Twenty-seven clinically definite MS patients underwent brain scans using magnetic resonance imaging including: pre- and post-contrast T1-weighted, T2-weighted, FLAIR, and SWI at 1.5T, 3T and 4T. MS lesions were identified separately in each imaging sequence. Lesions identified in SWI were re-evaluated for their iron content using the SWI filtered phase images. Results There were a variety of new lesion characteristics identified by SWI and these were classified into six types. A total of 75 lesions were seen only with conventional imaging, 143 only with SWI and 204 by both. From the iron quantification measurements, a moderate linear correlation between signal intensity and iron content (phase) was established. Conclusion The amount of iron deposition in the brain may serve as a surrogate biomarker for different MS lesion characteristics. SWI showed many lesions missed by conventional methods and six different lesion characteristics. SWI was particularly effective at recognizing the presence of iron in MS lesions and in the basal ganglia and pulvinar thalamus. PMID:19243035

  16. Morphogenesis of the demyelinating lesions in Baló's concentric sclerosis.

    Science.gov (United States)

    Barz, Helmut; Barz, Ulrich; Schreiber, Almut

    2016-06-01

    In tissues with elastic properties, an edema causes a raised tissue pressure and therefore a diminished blood flow. The authors assume that an increased tissue pressure due to local and/or relapsing edema may be the cause for incomplete necrosis (e.g. demyelinated lesions) or seldom complete necrosis in the brain. Newly forming demyelinating lesions seldom show small tissue bands with normal appearing myelin sheaths in the immediate vicinity of precursor lesions (Baló type of MS). The small myelinated bands are the result of a "protected zone" on the edge of previous demyelinated lesions. The authors explain this protected zone with two arguments. Firstly, the resorptive granulation tissue of more or less older lesions is relatively rich in capillaries. These capillaries may act as an energy reservoir that can nourish not only the plaque, but also a narrow adjacent myelinated tissue band by diffusion, even if the capillary blood flow in this tissue band is limited due to the greater tissue pressure of a new developing lesion in the neighborhood. Secondly, another protective mechanism may act simultaneously: older or more sclerosed lesions and small adherent bands of myelinated tissue with them may swell less in cases of an edema than in normal tissue. The hardening of the older lesions is caused by proliferated fiber-forming astrocytes in the sense of scarring. In an area with an increased tissue pressure, the capillaries are less compressed in a sclerosed lesion than in regions of normal grey and white matter. In addition, the adherent myelinated tissue band closest to the edge of a hardened plaque is better protected against swelling and compression than the further away tissue. Theoretically, this protection zone is comparable with protected blood vessels in the Haversian canals or the medullary spaces of bones. Both theses of protecting mechanisms at the edges of demyelinated lesions support the assumption of a hypoxic causation principle of demyelinating

  17. [Management of the meniscal lesion].

    Science.gov (United States)

    Baillon, B; Cermak, K; Vancabeke, M

    2011-01-01

    About 1,5 million arthroscopies are each year performed in the world, 50 % for meniscal affections. The menisci participate in the femoro-tibial load transmission and in the joint shock absorption; they contribute to the knee stability and play a role in the joint lubrication. The menisci are therefore important structures, and, in the case of a lesion, surgical abstention or repair should be favoured. When a meniscectomy has to be performed, it should be economical, preserving the meniscal wall. Meniscectomy is contra-indicated in the child and in the case of knee osteoarthrosis. Meniscal healing is compromised if the knee is unstable. If after total meniscectomy a patient presents symptomatic early osteoarthrosis, without marked loss of alignment, meniscal allografting is a therapeutic option, especially at the lateral compartment.

  18. Anaesthetic management of patients with congenital heart disease presenting for non-cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Mohindra R

    2002-01-01

    Full Text Available The incidence of congenital heart disease is about one percent of all live births in the United States. Treatment is being performed at a younger age and these children are showing improved survival. It is not unusual for children with congenital heart disease to present for non-cardiac surgery. Their management depends on their age, type of lesion, extent of corrective procedure, the presence of complications and other congenital anomalies. Each patient needs a detailed pre-operative evaluation to understand the abnormal anatomy and physiology, and related anaesthetic implications. No anaesthetic agent is an absolute contraindication, although drugs beneficial for one lesion may be detrimental for another. Regional anaesthesia has also been safely used in children with congenital heart disease. However the anaesthesiologist must have a detailed understanding of the pathophysiology of the lesion and the pharmacology of drugs being used to be able to provide safe anaesthesia for children with congenital heart disease.

  19. Radiographical resolution of renal lymphangiomatosis following cardiac transplantation.

    Science.gov (United States)

    Slater, Rick C; Iheagwara, Uzoma; Chen, Mang L

    2014-04-01

    Renal lymphangiomatosis is a disease characterized by abnormal formation of perirenal lymphatic vessels that fail to communicate with other retroperitoneal lymphatics; as a result, perirenal lymphatics dilate and form cysts. While typically an asymptomatic incidental finding, renal lymphangiomatosis rarely presents as flank or abdominal pain, ascites, impaired renal function, hypertension, hematuria, or proteinuria. Here we present the first known case of renal lymphangiomatosis found to spontaneously resolve following cardiac transplantation.

  20. The anatomy of the cardiac veins in mice

    Science.gov (United States)

    Ciszek, Bogdan; Skubiszewska, Daria; Ratajska, Anna

    2007-01-01

    Although the cardiac coronary system in mice has been the studied in detail by many research laboratories, knowledge of the cardiac veins remains poor. This is because of the difficulty in marking the venous system with a technique that would allow visualization of these large vessels with thin walls. Here we present the visualization of the coronary venous system by perfusion of latex dye through the right caudal vein. Latex injected intravenously does not penetrate into the capillary system. Murine cardiac veins consist of several principal branches (with large diameters), the distal parts of which are located in the subepicardium. We have described the major branches of the left atrial veins, the vein of the left ventricle, the caudal veins, the vein of the right ventricle and the conal veins forming the conal venous circle or the prepulmonary conal venous arch running around the conus of the right ventricle. The venous system of the heart drains the blood to the coronary sinus (the left cranial caval vein) to the right atrium or to the right cranial caval vein. Systemic veins such as the left cranial caval, the right cranial caval and the caudal vein open to the right atrium. Knowledge of cardiac vein location may help to elucidate abnormal vein patterns in certain genetic malformations. PMID:17553104

  1. Fabrication and characterization of bio-engineered cardiac pseudo tissues

    Energy Technology Data Exchange (ETDEWEB)

    Xu Tao; Boland, Thomas [Department of Bioengineering, 420 Rhodes Hall, Clemson University, Clemson, SC 29634 (United States); Baicu, Catalin; Aho, Michael; Zile, Michael, E-mail: tboland@clemson.ed [Department of Medicine, Medical University of South Carolina, Charleston, SC 29425 (United States)

    2009-09-15

    We report on fabricating functional three-dimensional (3D) tissue constructs using an inkjet based bio-prototyping method. With the use of modified inkjet printers, contractile cardiac hybrids that exhibit the forms of the 3D rectangular sheet and even the 'half heart' (with two connected ventricles) have been fabricated by arranging alternate layers of biocompatible alginate hydrogels and mammalian cardiac cells according to pre-designed 3D patterns. In this study, primary feline adult and H1 cardiomyocytes were used as model cardiac cells. Alginate hydrogels with controlled micro-shell structures were built by spraying cross-linkers in micro-drops onto un-gelled alginic acid. The cells remained viable in constructs as thick as 1 cm due to the programmed porosity. Microscopic and macroscopic contractile functions of these cardiomyocyte constructs were observed in vitro. These results suggest that the inkjet bio-prototyping method could be used for hierarchical design of functional cardiac pseudo tissues, balanced with porosity for mass transport and structural support.

  2. Cutaneous lesions in new born

    Directory of Open Access Journals (Sweden)

    Sachdeva Meenakshi

    2002-11-01

    Full Text Available Five hundred unselected newborn babies delivered in the Department of Obstetrics and Gynaecology, Unit II of SGBT Hospital attached to Government Medical College, Amritsar during April 2000 to October 2000 were examined for cutaneous lesions daily for the first five days after birth. Different cutaneous lesions were seen in 474(94. 8% newborns. The physiological skin changes observed in order of frequency were Epstein pearls in 305(61%, Mongolian spot in 301(60. 2%, superficial cutaneous desquamation in 200(40%, icterus in 128(25. 6%, milia in 119(23. 8%, sebaceous gland hyperplasia in 107 (21. 4%, occipital alopecia in 94(18. 8%, lanugo in 72(14. 4%, peripheral cyanosis in 47(9. 4%, breast hypertrophy in 29(5. 8% and miniature puberty in 28(5. 6% newborns. Of the transient non-infective skin diseases, erythema toxicum neonatorum was observed most commonly in 105(21 %, followed by miliaria rubra in 103(20. 6% and acne neonatorum in 27(5. 4% newborns. The naevi and other developmental defects in the descending order were salmon patch in 69(13. 8%, congenital melanocytic noevi in 10(2%, accessory tragi in 3(0.6%, spina bifida in 2(0.4%, hydrocephalus in 1(0.2% and poliosis in 1(0.2% newborns. Cradle cap was the only dermatitis observed in 50(10% newborns. One (0.2% case each of Harlequin ichthyosis and labial cyst was seen.

  3. Benign Lesions of The Vocal Fold

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    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  4. Abnormal vulval lesions: diagnosis and management

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    Aarti Kothari

    2016-09-01

    Full Text Available Vulval symptoms are commonly found and cause considerable distress for women. Symptoms are often chronic and can significantly affect the quality of womens lives including sexual function and wellbeing. Despite the frequency of vulval symptoms, women often find it difficult to seek medical advice due to multiple reasons, mostly cultural and emotional. This part is not easily self-observable neither are women aware of the fact that a vulvar lesion could also be a manifestation of a systemic disease. The idea behind this study was to identify whether presenting vulval lesion is dermatological or non-dermatological and to control the symptoms, to identify nature of the various vulvar lesions (inflammatory or neoplastic and to identify those skin lesions not responding to treatment which require biopsy and further management. It was a clinical descriptive study. Cases included women with vulvar lesions who attended Gynaec OPD at Dhiraj General Hospital affiliated to S.B.K.S. Medical Institute and Research Centre of Vadodara. After taking their informed consent ,all the women who had symptoms like vaginal discharge, itching or discomfort associated a with vulvar lesion, visible lesion or growth over vulva were thoroughly investigated to rule out any systemic illness causing vulvar lesion following which biopsy was taken if solid growth or a non-healing lesion was present. Treatment was done according to the lesions. In the presence of vulvar complains, a diagnostic pathway including systematic physical examination is always mandatory to detect SCC early. A non-healing lesion must be subjected to biopsy mandatorily. Women should be educated to avoid ODC drugs or creams when they face vulval lesions. [Int J Reprod Contracept Obstet Gynecol 2016; 5(9.000: 3242-3248

  5. Management of Anal Squamous Intraepithelial Lesions

    OpenAIRE

    Pineda, Carlos E.; Welton, Mark L.

    2009-01-01

    Anal squamous intraepithelial lesions include both low-grade squamous intraepithelial lesions (LSIL) and high-grade squamous intraepithelial lesions (HSIL) and are caused by chronic infection with the human papillomavirus (HPV). The disease is increasing in both incidence and prevalence, especially among patients with the following risk factors: homosexual men, acquired or iatrogenic immunosuppression, and presence of other HPV-related diseases. Although the natural history of the disease is ...

  6. ATYPICAL BULLOUS PYODERMA GANGRENOSUM WITH EARLY LESIONS MIMICKING CHICKEN POX

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    Ramesh

    2013-10-01

    Full Text Available ABSTRACT : Pyoderma Gangrenosum (PG rare neutrophilic dermatoses (1/100,00 0, of which Bullous Pyoderma gangrenosum is an atypical form, which is very rare. Bullous PG is usually associated with haematological disorders like myeloproliferative disorders, haematological malignancies specially AML and several other haematological disorders. It presents as a superficial haemorrhagic bulla which ulcerates, ulcers increase in size and heal with scarring. Treatment is mainly to identify and treat the cause. Pyoderma Gangrenosum shows rapid response to oral corticosteroid therapy. 1 , 3 . Clinical presentation: A 32yr old female presented with fever, multiple vesicles on face, upper limb, lower limb and trunk, and these early lesions looked like chicken pox lesions. Lesions increased in size to form haemorrhagic bullas which eroded to form ulcers, ulcers rapidly increased in size with necrotic base and erythematous to violaceous border. Investigation: Haemoglobin: 5.7gm%, Peripheral smear: normocytic and normochromic anaemia. Skin Biopsy: Sub corneal blisters with dermal and perifollicular n eutrophilic infiltrate. A diagnosis of Bullous Pyoderma gangrenosum was made. Patient’s anaemia was treated; oral prednisolone and topical steroids were started. Patient showed marked improvement to treatment.

  7. Molecular and immunohistochemical analyses of cardiac troponin T during cardiac development in the Mexican axolotl, Ambystoma mexicanum.

    Science.gov (United States)

    Zhang, C; Pietras, K M; Sferrazza, G F; Jia, P; Athauda, G; Rueda-de-Leon, E; Rveda-de-Leon, E; Maier, J A; Dube, D K; Lemanski, S L; Lemanski, L F

    2007-01-01

    The Mexican axolotl, Ambystoma mexicanum, is an excellent animal model for studying heart development because it carries a naturally occurring recessive genetic mutation, designated gene c, for cardiac nonfunction. The double recessive mutants (c/c) fail to form organized myofibrils in the cardiac myoblasts resulting in hearts that fail to beat. Tropomyosin expression patterns have been studied in detail and show dramatically decreased expression in the hearts of homozygous mutant embryos. Because of the direct interaction between tropomyosin and troponin T (TnT), and the crucial functions of TnT in the regulation of striated muscle contraction, we have expanded our studies on this animal model to characterize the expression of the TnT gene in cardiac muscle throughout normal axolotl development as well as in mutant axolotls. In addition, we have succeeded in cloning the full-length cardiac troponin T (cTnT) cDNA from axolotl hearts. Confocal microscopy has shown a substantial, but reduced, expression of TnT protein in the mutant hearts when compared to normal during embryonic development.

  8. Lesion localization in aphasia without hemiparesis

    Energy Technology Data Exchange (ETDEWEB)

    Komatsu, Midori; Senoh, Yoko; Okamoto, Koichi; Morimatsu, Mitsunori; Hirai, Shunsaku (Gunma Univ., Maebashi (Japan). School of Medicine)

    1983-06-01

    The distribution of the lesions responsible for aphasia unassociated with right-sided hemiparesis was evaluated by cranial computed tomography (CT) among stroke patients. In the Broca aphasia group were observed atypical aphasic symptoms, and the lesions were far more localized than in ordinary Broca one. In the Wernicke aphasia group showed relatively large lesions in the left superior temporal gyrus, sometimes extending to supramarginal and angular gyri, which caused such additional symptoms as apraxia without motor paresis in some cases. In the Transcortical motor aphasia group showed the occlusion of the left internal carotid artery, though without obvious abnormality at CT. In another patient a circumscribed low density lesion was disclosed in the area anterior and superior to so-called Broca's area. In the Transcortical sensory aphasia group, the lesion involved the borderzone supplied by the left middle and posterior cerebral arteries. In the Amnestic aphasia group showed a lesion in the left parietal lobe, while in another no remarkable change was demonstrated. In the Global aphasia group, one had multiple isolated lesions in both anterior and posterior speech areas. Another showed a large lesion involving the whole territory of the left middle cerebral artery. In the remaining one a high density area was observed in the left superior temporal, supramarginal and angular gyri, not extending to the frontal lobe beyond with sylvian fissure. Therefore, in interpreting CTs of such aphasic patients we must take account of not only the extent of the lesion but also the severity of destruction.

  9. Polypoid Lesions of the Gallbladder in Children

    Science.gov (United States)

    Beneck, Debra; Bostwick, Howard E.

    1997-01-01

    Polypoid lesions of the gallbladder in children are rare. We report a case of a gallbladder polyp in a 14-year-old boy who presented with recurrent right upper quadrant abdominal pain. Ultrasound examination of the abdomen revealed a polypoid lesion of the gallbladder. His symptoms resolved after laparoscopic cholecystectomy. Histological examination of the gallbladder demonstrated a benign adenomatous polyp. Although the experience with polypoid lesions of the gallbladder in children is limited, we currently recommend cholecystectomy because these lesions are associated with acalculous cholecystitis, and because their long-term effects are unknown. PMID:9876680

  10. Nutritional Status and Cardiac Autophagy

    Directory of Open Access Journals (Sweden)

    Jihyun Ahn

    2013-02-01

    Full Text Available Autophagy is necessary for the degradation of long-lasting proteins and nonfunctional organelles, and is activated to promote cellular survival. However, overactivation of autophagy may deplete essential molecules and organelles responsible for cellular survival. Lifelong calorie restriction by 40% has been shown to increase the cardiac expression of autophagic markers, which suggests that it may have a cardioprotective effect by decreasing oxidative damage brought on by aging and cardiovascular diseases. Although cardiac autophagy is critical to regulating protein quality and maintaining cellular function and survival, increased or excessive autophagy may have deleterious effects on the heart under some circumstances, including pressure overload-induced heart failure. The importance of autophagy has been shown in nutrient supply and preservation of energy in times of limitation, such as ischemia. Some studies have suggested that a transition from obesity to metabolic syndrome may involve progressive changes in myocardial inflammation, mitochondrial dysfunction, fibrosis, apoptosis, and myocardial autophagy.

  11. [Cardiac support and replacement therapies].

    Science.gov (United States)

    Lotz, Christopher; Roewer, Norbert; Muellenbach, Ralf M

    2016-09-01

    Circulatory support represents an integral part within the treatment of the critically ill patient. Sophisticated pharmacologic regimens help to maintain systemic perfusion pressure by increasing vascular tone as well as mediating positive inotropic effects. Besides the administration of catecholamines and phosphodiesterase-III-inhibitors, in particular the administration of levosimendan represents a promising alternative during low-cardiac-output. Nevertheless, sufficient evidence demonstrating a survival benefit for any pharmacologic regimen is nonexistent. In case pharmacological measures do not suffice mechanical cardiopulmonary support (MCS) may be used. MCS may be used during cardiopulmonary resuscitation or a "low-cardiac-output-syndrome" as bridging towards decision, recovery or long-term support. Venoarterial extracorporeal membrane oxygenation (vaECMO) may take over cardiopulmonary function and may improve survival as well as neurological outcome after cardiogenic shock or cardiopulmonary resuscitation. PMID:27631451

  12. Heart fields and cardiac morphogenesis.

    Science.gov (United States)

    Kelly, Robert G; Buckingham, Margaret E; Moorman, Antoon F

    2014-10-01

    In this review, we focus on two important steps in the formation of the embryonic heart: (i) the progressive addition of late differentiating progenitor cells from the second heart field that drives heart tube extension during looping morphogenesis, and (ii) the emergence of patterned proliferation within the embryonic myocardium that generates distinct cardiac chambers. During the transition between these steps, the major site of proliferation switches from progenitor cells outside the early heart to proliferation within the embryonic myocardium. The second heart field and ballooning morphogenesis concepts have major repercussions on our understanding of human heart development and disease. In particular, they provide a framework to dissect the origin of congenital heart defects and the regulation of myocardial proliferation and differentiation of relevance for cardiac repair.

  13. Brain Embolism Secondary to Cardiac Myxoma in Fifteen Chinese Patients

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    Youming Long

    2014-01-01

    Full Text Available Background. Heart myxoma-related embolisms commonly involve the central nervous system, but data are lacking in Chinese patients. Methods. 27 patients diagnosed with myxoma were reviewed retrospectively. Results. Among 27 patients, fourteen (51.9% patients were women. Fifteen (55.6% patients had brain embolisms. Rarely, patients were misdiagnosed with central nervous system vasculitis (n = 2, moyamoya disease (n = 1, and neuromyelitis optica (n = 1. We found positive associations between mRS (>3 and female gender (r = 0.873, P10 × 109/L (r = 0.722, P = 0.002, tumour size (r = 0.866, P0.05. Conclusions. Neurologic manifestations in Chinese patients with cardiac myxoma-related stroke were complicated and multifarious. Female gender, infection, other severe complications, low SBP, tumour size, bilateral brain lesions, TACI, and high WBC counts could be associated with a poor prognosis.

  14. [INFLAMMATION AND CARDIAC INSUFFICIENCY ASSOCIATED WITH INFECTIOUS ENDOCARDITIS].

    Science.gov (United States)

    Fedorova, T A; Tazina, S Ya; Kaktursky, L V; Kanareitseva, T D; Stefanenko, N I; Burtsev, V I; Semenenko, N A

    2016-01-01

    The study included 62 patients with uncomplicated primary and secondary infectious endocarditis admitted to S.PBotkin city hospital from 2011 to 2014. The emphasis is laid on diagnostic significance of dynamic measurements of the levels of C-reactive protein, tumour necrosis factor and highly sensitive troponin-1 for the evaluation of activity of the infectious/toxic process, severity of the disease, and detection of complications. The study revealed the relationship of the enhanced level of troponin-1 with changes of inflammation markers, morphofunctional characteristics of myocardium, and circulatory failure. Morphologicl study demonstrated inflammatory and dystrophic changes in myocardium, focal and diffuse cardiofibrosis suggesting development of non-coronarogenic myocardial lesions that play an important role in the progress of cardiac failure associated with infectious endocarditis.

  15. Cardiac Biomarkers in Hyperthyroid Cats

    OpenAIRE

    Sangster, J.K.; Panciera, D L; Abbott, J.A.; Zimmerman, K.C.; Lantis, A.C.

    2013-01-01

    Background Hyperthyroidism has substantial effects on the circulatory system. The cardiac biomarkers NT‐proBNP and troponin I (cTNI) have proven useful in identifying cats with myocardial disease but have not been extensively investigated in hyperthyroidism. Hypothesis Plasma NT‐proBNP and cTNI concentrations are higher in cats with primary myocardial disease than in cats with hyperthyroidism and higher in cats with hyperthyroidism than in healthy control cats. Animals Twenty‐three hyperthyro...

  16. Historical perspectives of cardiac electrophysiology.

    Science.gov (United States)

    Lüderitz, Berndt

    2009-01-01

    The diagnosis and treatment of clinical electrophysiology has a long and fascinating history. From earliest times, no clinical symptom impressed the patient (and the physician) more than an irregular heart beat. Although ancient Chinese pulse theory laid the foundation for the study of arrhythmias and clinical electrophysiology in the 5th century BC, the most significant breakthrough in the identification and treatment of cardiac arrhythmias first occurred in this century. In the last decades, our knowledge of electrophysiology and pharmacology has increased exponentially. The enormous clinical significance of cardiac rhythm disturbances has favored these advances. On the one hand, patients live longer and thus are more likely to experience arrhythmias. On the other hand, circulatory problems of the cardiac vessels have increased enormously, and this has been identified as the primary cause of cardiac rhythm disorders. Coronary heart disease has become not just the most significant disease of all, based on the statistics for cause of death. Arrhythmias are the main complication of ischemic heart disease, and they have been directly linked to the frequently arrhythmogenic sudden death syndrome, which is now presumed to be an avoidable "electrical accident" of the heart. A retrospective look--often charming in its own right--may not only make it easier to sort through the copious details of this field and so become oriented in this universe of important and less important facts: it may also provide the observer with a chronological vantage point from which to view the subject. The study of clinical electrophysiology is no dry compendium of facts and figures, but rather a dynamic field of study evolving out of the competition between various ideas, intentions and theories. PMID:19196616

  17. Cardiac Biomarkers and Cycling Race

    OpenAIRE

    Caroline Le Goff, Jean-François Kaux, Sébastien Goffaux, Etienne Cavalier

    2015-01-01

    In cycling as in other types of strenuous exercise, there exists a risk of sudden death. It is important both to understand its causes and to see if the behavior of certain biomarkers might highlight athletes at risk. Many reports describe changes in biomarkers after strenuous exercise (Nie et al., 2011), but interpreting these changes, and notably distinguishing normal physiological responses from pathological changes, is not easy. Here we have focused on the kinetics of different cardiac bi...

  18. Functiogenesis of cardiac pacemaker activity.

    Science.gov (United States)

    Sakai, Tetsuro; Kamino, Kohtaro

    2016-07-01

    Throughout our investigations on the ontogenesis of the electrophysiological events in early embryonic chick hearts, using optical techniques to record membrane potential probed with voltage-sensitive dyes, we have introduced a novel concept of "functiogenesis" corresponding to "morphogenesis". This article gives an account of the framework of "functiogenesis", focusing on the cardiac pacemaker function and the functional organization of the pacemaking area. PMID:26719289

  19. Cardiac involvement in tuberous sclerosis.

    OpenAIRE

    Mühler, E G; Turniski-Harder, V; Engelhardt, W.; von Bernuth, G

    1994-01-01

    OBJECTIVE--To assess the incidence, importance, and history of cardiac involvement in infants and children with tuberous sclerosis. DESIGN--Prospective study; clinical examination, sector and Doppler echocardiography, standard and ambulatory electrocardiography. SETTING--A tertiary referral centre. PATIENTS--21 patients with tuberous sclerosis aged 1 day to 16 years (mean 6.3 years); follow up investigations were available in 14 cases (10 retrospective, 4 prospective; mean follow up 4.3 years...

  20. Praxial disorders in focal lesions of cerebral hemispheres

    Directory of Open Access Journals (Sweden)

    Jorge Murillo Duran

    2007-11-01

    Full Text Available The purpose of this work is to analyze paraxial difficulties i.e, functional disorders in movementresulting from cerebral tissue lesions. In accordance with the literature on the subject, the following definition, the following definition of apraxia has been accepted: “Apraxia is inability in properly executing kinetic tasks without impairment or loss of motor or sensory functions or ataxia with would condition such inability”. “Proper execution” used in this definition concerns not only the effect of the action but also means of its realization. “Kinetic tasks” signify all aspects of motor activity defined by instructions, irrespective of the type of instruction (verbal or gestures, and regardless of whether it required −in the final effect− imitating the movement of the investigator or whether they were performed independently. The methodology has been based in the principle on Luria’s works.Deliberations on praxial disorders were based on investigation results embracing 90 patients with focal cerebral lesions. In fifty cases, changes were localized in the left cerebral hemisphere, in forty cases−in the right hemisphere. The summing up the results concerning a global comparison between cerebral hemispheres, indicate the following regularities: Results achieved made it possible to form the opinion that not all of the generally accepted tests investigating praxia in persons with cerebral lesions are solved faultlessly by healthy individuals; thus, a faulty execution should not always be regarded as a sign of pathological functioning of the cerebral tissue as a result of lesion.

  1. Clinical-histopathological concordance in head and neck lesions.

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    Sahily Espino Otero

    2009-03-01

    Full Text Available Background: Clinical-histopathological data contributes to a better diagnosis, assessment and treatment of head and neck lesions. Objective: To determine clinical-histopathological correlation of head and neck lesions. Methods: a descriptive, retrospective, observational study was developed in a series of cases (360 patients to determine the clinical diagnostic scope in relation to the histopathological techniques used in the Maxillary Surgery Service of “Gustavo Aldereguía Lima” hospital between June 2006 and 2007. Required data was taken from clinical histories and records from Pathological Anatomy, which were transferred to a form design for that purpose. Results: The age group of 0-19 years had the higher concordance among the studied groups (72,4%. 59, 7% of the studied cases had clinical-histopathological concordance, mainly in extra-oral lesions (60, 4% particularly in the vermilion border (82, 4 % and among the intra-oral the most common were those in the vestibular duct (100%. The most important lesions where clinical diagnosis did not coincide with histopathological diagnosis were fibroma with 23 in the intra-oral and warts and a total of 34 in extra-oral, followed by basal carcinomas. Conclusions: There is a significant correlation between clinical and histopathological diagnosis, suggesting high attention quality and correct application of the clinical method as central element in patients’ management.

  2. Brain lesion induced by 1319nm laser radiation

    Science.gov (United States)

    Yang, Zaifu; Chen, Hongxia; Wang, Jiarui; Chen, Peng; Ma, Ping; Qian, Huanwen

    2010-11-01

    The laser-tissue interaction has not been well defined at the 1319 nm wavelength for brain exposure. The goal of this research effort was to identify the behavioral and histological changes of brain lesion induced by 1319 nm laser. The experiment was performed on China Kunming mice. Unilateral brain lesions were created with a continuous-wave Nd:YAG laser (1319nm). The brain lesions were identified through behavioral observation and histological haematoxylin and eosin (H&E) staining method. The behavior change was observed for a radiant exposure range of 97~773 J/cm2. The histology of the recovery process was identified for radiant exposure of 580 J/cm2. Subjects were sacrificed 1 hour, 1 week, 2 weeks, 3 months, 7 months and 13 months after laser irradiation. Results showed that after laser exposure, behavioral deficits, including kyphosis, tail entasia, or whole body paralysis could be noted right after the animals recovered from anesthesia while gradually disappeared within several days and never recurred again. Histologically, the laser lesion showed a typical architecture dependent on the interval following laser treatment. The central zone of coagulation necrosis is not apparent right after exposure but becomes obvious within several days. The nerotic tissue though may persist for a long time, will finally be completely resorbed. No carbonization granules formed under our exposure condition.

  3. Histopathological study of healing in periapical lesions following endodontic treatments

    Directory of Open Access Journals (Sweden)

    A. Khayat

    1987-08-01

    Full Text Available This study was perfomed on twenty five teeth which showed radiographic lesions( 6mm over 25 mm. the teeth were arranged in seven different groups and root canal therapy ( by warm Gutta-percha technique as surgical intervention were performed at various time intervals. In this investigation, histologic studies of the periapical tissues begin shortly after elimination of the root canal system with or without root  canal obturation. This healing demonstrated with a replacement of granulation tissue by connective tissue, inflammatory cells diminish in number and densityb fibroblastic activity and their differentiation of osteoblastc osteoblastic activity forming osteoid and trabecular bone. The newly formed trabeculae extend from the periphery of the lesion to the center and root surfacesd nonorganized periodontal ligament fibers return to their original orientation soon after the newly formed trabeculae reach the apical root surface and form lamina duraInflammatory responses may continue simultaneously with periapical tissue regeneration and bone formation. Chronic inflammatory cells seem to be present occasionally in marrow spaces of the newly formed bone. Cellular activity and bone formation are demonstrated in the presence of the lining epithelium. This is seen between newly formed bone and apical root tip and might be suggestive of healing of the periapical cyst. 

  4. Sudden cardiac death risk stratification.

    Science.gov (United States)

    Deyell, Marc W; Krahn, Andrew D; Goldberger, Jeffrey J

    2015-06-01

    Arrhythmic sudden cardiac death (SCD) may be caused by ventricular tachycardia/fibrillation or pulseless electric activity/asystole. Effective risk stratification to identify patients at risk of arrhythmic SCD is essential for targeting our healthcare and research resources to tackle this important public health issue. Although our understanding of SCD because of pulseless electric activity/asystole is growing, the overwhelming majority of research in risk stratification has focused on SCD-ventricular tachycardia/ventricular fibrillation. This review focuses on existing and novel risk stratification tools for SCD-ventricular tachycardia/ventricular fibrillation. For patients with left ventricular dysfunction or myocardial infarction, advances in imaging, measures of cardiac autonomic function, and measures of repolarization have shown considerable promise in refining risk. Yet the majority of SCD-ventricular tachycardia/ventricular fibrillation occurs in patients without known cardiac disease. Biomarkers and novel imaging techniques may provide further risk stratification in the general population beyond traditional risk stratification for coronary artery disease alone. Despite these advances, significant challenges in risk stratification remain that must be overcome before a meaningful impact on SCD can be realized.

  5. Review Article of Cardiac Amyloidosis

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    Jittiporn PURATTANAMAL

    2010-06-01

    Full Text Available Cardiac amyloidosis is a term that means the deposit of abnormal proteins in the myocardium leading to global thickening of the heart walls. The clinical character is that of infiltrative cardiomyopathy. AL amyloidosis is the most common type that involves cardiac failure. Cardiac amyloid precedes clinical congestive heart failure, especially right-sided heart failure. Laboratory investigations have identified the amyloid fibril proteins deposited in the organ tissues. Immunofixation tests are the most sensitive that recognize the paraprotein mean light chain protein or immunoglobulin subtype deposit. Prognosis is poor if AL amyloidosis is untreated. Treatment of systemic involvement in AL amyloidosis is via chemotherapy such as melphalan and prednisolone. UK experts have reported the results of treatment in AL amyloidosis. Regardless of the use of adjunctive chemotherapy, the five-year survival after heart transplantation was generally poorer for AL (20 % at five years, but similar for non-AL amyloidosis (64 % at five years, than heart transplants in other cases. Progression of the systemic disease contributed to increased mortality. A specific treatment that increases the chances of survival is unknown.

  6. Cardiac MRI in restrictive cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, A. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Singh Gulati, G., E-mail: gulatigurpreet@rediffmail.com [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Seth, S. [Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India); Sharma, S. [Department of Cardiovascular Radiology, All India Institute of Medical Sciences, Ansari Nagar, Delhi (India)

    2012-02-15

    Restrictive cardiomyopathy (RCM) is a specific group of heart muscle disorders characterized by inadequate ventricular relaxation during diastole. This leads to diastolic dysfunction with relative preservation of systolic function. Although short axis systolic function is usually preserved in RCM, the long axis systolic function may be severely impaired. Confirmation of diagnosis and information regarding aetiology, extent of myocardial damage, and response to treatment requires imaging. Importantly, differentiation from constrictive pericarditis (CCP) is needed, as only the latter is managed surgically. Echocardiography is the initial cardiac imaging technique but cannot reliably suggest a tissue diagnosis; although recent advances, especially tissue Doppler imaging and spectral tracking, have improved its ability to differentiate RCM from CCP. Cardiac catheterization is the reference standard, but is invasive, two-dimensional, and does not aid myocardial characterization. Cardiac magnetic resonance (CMR) is a versatile technique providing anatomical, morphological and functional information. In recent years, it has been shown to provide important information regarding disease mechanisms, and also been found useful to guide treatment, assess its outcome and predict patient prognosis. This review describes the CMR features of RCM, appearances in various diseases, its overall role in patient management, and how it compares with other imaging techniques.

  7. Gastrointestinal Polypoid Lesions: The Albanian Reality

    Directory of Open Access Journals (Sweden)

    Gentiana Cekodhima

    2015-12-01

    Full Text Available Background: Gastrointestinal polypoid lesions are a well-known cause of possible future malignant lesions. Screening for these lesions, especially for colon polyps, has reduced morbidity and mortality from malignant tumors. To our best knowledge, no screening program on gastrointestinal polypoid lesions exists in Albania and no former study has been performed to check the distribution of these lesions. Therefore, our aim was to study the distribution of gastrointestinal polypoid lesions in a symptomatic outpatient population. Methods: This study included five hundred seventy five consecutive patients referred to perform an endoscopic examination, regardless of their specific complains and of their possible diagnosis, to one of the two Endoscopy Centers in Tirana in the period between January 1st 2008 and December 31st 2013. At least one polyp was resected and histologically examined in all included patients. Results: A total of 575 patients, of which 345 males (60.0%, aged 51.9 years (standard deviation 16.97 years, were examined and their data inserted in the statistical analysis. In total, 88 cases were identified with malignant pathologies of which 50 cases (56.8% were males. No case of malignancy was diagnosed among the nine esophageal specimens, but among the specimens resected from the stomach, small intestine and large intestine, were respectively diagnosed 21 (20.0%, 9 (40.9% and 58 (13.2% malignant lesions. Patients with malignant lesions were older (57.4 ± 16.8 years old in contrast to those with benign lesions (50.5 ± 17.0 years old (p = 0.004. Conclusion: Our study is the first one to offer figures on the polypoid lesions distribution and characteristics in the Albanian population. Large intestine is the main site where such lesions occur, but anyhow the small intestine presented a larger proportion of malignancy.

  8. Consequences of cardiac myocyte-specific ablation of KATP channels in transgenic mice expressing dominant negative Kir6 subunits

    OpenAIRE

    Tong, XiaoYong; Porter, Lisa M.; Liu, GongXin; Dhar-Chowdhury, Piyali; Srivastava, Shekhar; Pountney, David J.; Yoshida, Hidetada; Artman, Michael; Fishman, Glenn I.; Yu, Cindy; Iyer, Ramesh; Morley, Gregory E.; Gutstein, David E.; Coetzee, William A.

    2006-01-01

    Consequences of cardiac myocyte-specific ablation of KATP channels in transgenic mice expressing dominant negative Kir6 subunits. Am J Physiol Heart Circ Physiol 291: H543–H551, 2006. First published February 24, 2006; doi:10.1152/ajpheart.00051.2006.—Cardiac ATP-sensitive K+ (KATP) channels are formed by Kir6.2 and SUR2A subunits. We produced transgenic mice that express dominant negative Kir6.x pore-forming subunits (Kir6.1-AAA or Kir6.2-AAA) in cardiac myocytes by driving their expression ...

  9. Characteristics of in-hospital cardiac arrest and cardiopulmonary resuscitation

    Directory of Open Access Journals (Sweden)

    Josip Ivić

    2009-02-01

    Full Text Available Aim We have studied epidemiology of in-hospital cardiac arrest, characteristics of organizing a reanimationand its,procedures as well as its documenting.Methods We analyzed all resuscitation procedure data where anesthesiology reanimation teams (RT providedcardiopulmonary resuscitation (CPR during one-year period. We included resuscitation attemptsthat were initiated outside the Department of Anesthesiology, excluding incidents in operation rooms andIntensive Care Unit (ICU. Data on every cardiac arrest and CPR were entered in a special form.Results During one-year period 87 CPR were performed. Victims of cardiac arrest were principallyelderly patients (age 60 – 80, mostly male (60%. Most frequent victims were neurological patients(42%, surgical patients (21% and neurosurgical patients (10%. The leading cause of cardiac arrestwas primary heart disease, following neurological diseases and respiration disorders of severe etiology.In over 90% cases CPR was initiated by medical personnel in their respective departments, RT arrivedwithin 5 minutes in 73,56% cases. Initially survival was 32%, but full recovery was accomplished in 4patients out of 87 (4,6%.Conclusion Victims of cardiac arrest are patients whose primary disease contributes to occurrence ofcardiorespiratory complications. High mortality and low percentage of full recovery can be explainedby characteristics of patients (old age, nature and seriousness of primary disease which significantly affectthe outcome of CPR. In some cases a question is raised whether to initiate the CPR at all. We wouldlike to point out that continous monitoring of potentially critical patients may prevent cardiorespiratoryincidents whereas the quality and success of CPR may be improved by training of staff and better technicalequipment on the relevant locations in the in the hospital where such incidents usually occur.

  10. Noninvasive Fractional Flow Reserve for the Diagnosis of Lesion-specific Ischemia: A Case Example

    Directory of Open Access Journals (Sweden)

    Jesper Møller Jensen

    2015-01-01

    Full Text Available A physically active 52-year-old male with atypical chest pain was referred to our department. A coronary computed tomography angiography (CCTA showed a stenotic plaque in the mid left anterior descending coronary artery (LAD. A rest-stress Rubidium-82 myocardial perfusion was normal. One year later the patient sustained a cardiac arrest and percutaneous coronary intervention of the mid-LAD was successfully performed. The original CCTA data were submitted for noninvasive determination of fractional flow reserve (FFR CT revealing an ischemia-producing lesion in the mid-LAD. This case demonstrates the inherent limitations of assessing lesion-specific ischemia. FFR CT shows promise as a new method for future selection of patients for coronary angiography.

  11. Modulatory effect of semelil (ANGIPARS™) on isoproterenol induced cardiac injury.

    Science.gov (United States)

    Joukar, Siyavash; Najafipour, Hamid; Mirzaeipour, Fateme; Nasri, Hamidreza; Ahmadi, Mahboubeh Yeganeh Haj; Badinloo, Marziyeh

    2013-01-01

    Administration of semelil (ANGIPARS™) has been successful in the treatment of diabetic foot ulcer. Considering the improvement of blood flow and anti-inflammatory effect that are attributed to this drug, we investigated its effect on cardiovascular performance in rabbits with isoproterenol (ISO) induced myocardial injury. Animal groups included: control group; ISO group, received ISO 50 mg/kg s.c. for two consecutive days; S1+ISO, S5+ISO and S10+ISO groups, received semelil 1, 5, and 10 mg/kg/day i.p. respectively, 30 min before ISO. On the 3(rd) day, electrocardiogram (ECG) and hemodynamic parameters were recorded; blood samples were taken and hearts were removed for lab investigations. ISO induced heart injury, ECG disturbance, raise of cardiac troponin I and significant decrease in LVSP (p<0.05), +dp/dt max (p<0.01), -dp/dt max (p<0.05) along with increase of LVEDP (p<0.01). Semelil had no significant effects on ECG and plasma cardiac troponin I. Impairment of +dp/dt max and -dp/dt max was significantly improved in S5+ISO and S10+ISO groups (P<0.05 versus ISO). In addition, LVSP and LVEDP was somewhat recovered in these groups, although semelil (1 mg/kg/day) to some extent exacerbated the myocardial lesions induced by ISO (P<0.05). Therefore, in stressful conditions, semelil may improve myocardial contractility; however, it may aggravate the severity of injury. PMID:26417221

  12. Hepatoma with cardiac metastasis: An advanced cancer requiring advanced treatment

    Institute of Scientific and Technical Information of China (English)

    Yu-Sheng Lin; Shih-Ming Jung; Feng-Chun Tsai; Chun-Nan Yeh; Tzu-Fang Shiu; Hsueh-Hua Wu; Pyng-Jing Lin; Pao-Hsien Chu

    2007-01-01

    AIM: To investigate the clinical and pathologic findings,and to discuss the pathophysiology of hepatocellular carcinoma with cardiac metastasis.METHODS: Eight hepatoma patients with cardiac metastasis, who were treated by surgical excision from 1993 to 2006, were retrospectively studied. Detailed clinical parameters were analyzed.RESULTS: Of those eight patients, two (25%) were women and six (75%) were men, with the mean age of 50 years (range, 40-70 years). The presentations included: asymptomatic (75%), heart failure (25%), and pulmonary embolism (12.5%). All lesions involved the right atrium, and extended to the lung (12.5%), inferior vena cava (25%), and left atrium (12.5%). The level of tumor marker, alpha-fetal protein, was not correlated with the severity of metastasis or disease prognosis.Moreover, the availably estimated doubling time was less than 3 mo. The pathological findings included variable hemorrhage and necrosis. The survival time following surgery also varied from one month to more than 30 mo.CONCLUSION: Hepatoma metastasis to the heart was detected in all eight patients. This study demonstrates that surgery might help the outcome in such cases.

  13. Angiomatous lesion and delayed cyst formation after gamma knife surgery for intracranial meningioma: case report and review of literatures

    OpenAIRE

    Liu, Zhiyong; He, Min; Chen, Hongxu; Liu, Yi; Li, Qiang; Li, Lin; Li, Jin; Chen, Haifeng; Xu, Jianguo

    2015-01-01

    Gamma Knife has become a major therapeutic method for intracranial meningiomas, vascular malformations and schwannomas with exact effect. In recent years an increasing number of delayed complications after Gamma Knife surgery have been reported, such as secondary tumors, cystic changes or cyst formation. But angiomatous lesion and delayed cyst formation after Gamma Knife for intracranial lesion has rarely been reported. Here we report the first case of angiomatous lesion and delayed cyst form...

  14. Sudden death of cardiac origin and psychotropic drugs

    Directory of Open Access Journals (Sweden)

    Quadiri eTimour

    2012-05-01

    Full Text Available Mortality rate is high in psychiatric patients versus general population. An important cause of this increased mortality is sudden cardiac death (SCD as a major side-effect of psychotropic drugs. These SCDs generally result from arrhythmias occurring when the posology is high and may attain a toxic threshold but also at dosages within therapeutic range, in the presence of risk factors. There are three kinds of risk factors: physiological (e.g.: low cardiac rate of sportsmen, physiopathological (e.g.: hepatic insufficiency, hypothyroidism and "therapeutic" (due to interactions between psychotropic drugs and other medicines. Association of pharmacological agents may increase the likelihood of SCDs either by i a pharmacokinetic mechanism (e.g.: increased torsadogenic potential of a psychotropic drug when its destruction and/or elimination are compromised or ii a pharmacodynamical mechanism (e.g.: mutual potentiation of proarrhythmic properties of two drugs. In addition, some psychotropic drugs may induce sudden death in cases of pre-existing congenital cardiopathies such as i congenital long QT syndrome, predisposing to torsade de pointes that eventually cause syncope and sudden death. ii a Brugada syndrome, that may directly cause ventricular fibrillation due to reduced sodium current through Nav1.5 channels. Moreover, psychotropic drugs may be a direct cause of cardiac lesions also leading to SCD. This is the case, for example, of phenothiazines responsible for ischemic coronaropathies and of clozapine that is involved in the occurrence of myocarditis. The aims of this work are to delineate: i the risk of SCD related to the use of psychotropic drugs; ii mechanisms involved in the occurrence of such SCD; iii preventive actions of psychotropic drugs side effects, on the basis of the knowledge of patient-specific risk factors, documented from clinical history, ionic balance and ECG investigation by the psychiatrist.

  15. 右心房血管肉瘤1例与心电门腔CT%Right atrial angiosarcoma and electrocardiogram-gated cardiac computed tomography: a case report

    Institute of Scientific and Technical Information of China (English)

    Jing Gong; Jianming Tian; Yi Xiao

    2009-01-01

    Primary cardiac tumors are quite rare and most of these tumors are benign. In this report, a patient presented with chest distress and shortness of breath after activity. Echocardiography of other hospital showed a hyperechoic right atrial mass. Electrocerdiogram-gated cardiac computed tomography (ECG-Gated CT) of our hospital provided accurate information about the site and extent of the tumor, and the involvement of neighboring structures, even about the malignant nature of the lesion. The pathological study indicated angiosarcorna. The role of ECG-Gated CT in the assessment of cardiac masses and tumors was discussed. Cardiac tumors are extremely rare and can be divided into benign and malignant lesions. Myxomas are the most common type of cardiac benign tumor, while angiosarcomas are the most common type of cardiac malignant tumor.Imaging studies play an important role in the diagnosis of cardiac angiosarcomas. Echocardiogram, computed tomography (CT) and magnetic resonance imaging (MRI) are the most common imaging studies for tumors evaluation. However, the precise tumor location is often difficult to evaluate precisely on the basis of two-dimensional source images. We conducted ECG-gated cardiac CT examination with 3D reconstruction for preoperative assessment in a patient with a angiosarcorna arising in the right atrium.

  16. Evaluation of Known or Suspected Cardiac Sarcoidosis.

    Science.gov (United States)

    Blankstein, Ron; Waller, Alfonso H

    2016-03-01

    Sarcoidosis is a multisystem disorder of unknown cause, and cardiac sarcoidosis affects at least 25% of patients and accounts for substantial mortality and morbidity from this disease. Cardiac sarcoidosis may present with heart failure, left ventricular systolic dysfunction, AV block, atrial or ventricular arrhythmias, and sudden cardiac death. Cardiac involvement can be challenging to detect and diagnose because of the focal nature of the disease, as well as the fact that clinical criteria have limited diagnostic accuracy. Nevertheless, the diagnosis of cardiac sarcoidosis can be enhanced by integrating both clinical and imaging findings. This article reviews the various roles that different imaging modalities provide in the evaluation and management of patients with known or suspected cardiac sarcoidosis. PMID:26926267

  17. [Asterixis in focal brain lesions].

    Science.gov (United States)

    Velasco, F; Gomez, J C; Zarranz, J J; Lambarri, I; Ugalde, J

    2004-05-01

    Asterixis is a motor control disorder characterized by the presence of abnormal movements of the lower limbs in the vertical plane during posture maintenance. Asterixis is usually bilateral and associated with toxic-metabolic metabolic encephalopathies. Unilateral asterixis is less frequent and it normally indicates focal brain damage. We report the cases of four patients (two males/two females), aged 57 to 83 years, suffering from uni or bilateral asterixis associated with focal brain damage. All patients underwent CT brain scan and a neurophysiological study (parietal EMG and/or PES). In addition, any toxic-metabolic cause that could be produced by this clinical phenomenon was ruled out with the appropriate testing. Unilateral asterixis is a clinical symptom that may indicate the presence of focal brain damage. Often, it is ignored or overlooked during routine neurological examinations. On the other hand, the presence of a bilateral asterixis is not always indicative of a toxic-metabolic encephalopathy.Rarely, such as in one of the cases herein presented, bilateral asterixis can also appear associated with structural brain lesions. Although asterixis diagnosis is fundamentally clinical, the neurophysiological study contributes to verify the diagnosis.

  18. Cerebral CT of ischaemic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Aulich, A.

    1981-11-25

    The diagnosis of stroke must first be established by clinical examination. CT has proved useful for confirmation of the diagnosis and provides a global intracranial picture of morphological changes in cerebral vascular diseases. A hemorrhage can be recognized with certainty at the first CT examination as the cause of the stroke, but in the detection of a lesion due to ischemia an important role is played by the correct choice of the time of examination, and in some cases also of the check-up with contrast medium. The differential diagnosis between infarct in the acute stage and encephalitis or gliomas of low-grade malignity can be difficult. A decision can often only be made after a series of examinations. Postmalacial conditions are often difficult to differentiate from defects due to other causes, such as hemorrhage, head injury, postoperative states and after encephalitis. A knowledge of the anamnesis and the clinical findings is indispensable for CT evaluation. In assessing the prognosis before vascular surgery on the extracranial brain-supplying vessels the performance of a CT examination should be advised. A warning is given against the use of CT as a screening method.

  19. Sensing Cardiac Electrical Activity With a Cardiac Myocyte--Targeted Optogenetic Voltage Indicator

    NARCIS (Netherlands)

    Chang Liao, Mei-Ling; de Boer, Teun P; Mutoh, Hiroki; Raad, Nour; Richter, Claudia; Wagner, Eva; Downie, Bryan R; Unsöld, Bernhard; Arooj, Iqra; Streckfuss-Bömeke, Katrin; Döker, Stephan; Luther, Stefan; Guan, Kaomei; Wagner, Stefan; Lehnart, Stephan E; Maier, Lars S; Stühmer, Walter; Wettwer, Erich; van Veen, Toon; Morlock, Michael M; Knöpfel, Thomas; Zimmermann, Wolfram-Hubertus

    2015-01-01

    RATIONALE: Monitoring and controlling cardiac myocyte activity with optogenetic tools offer exciting possibilities for fundamental and translational cardiovascular research. Genetically encoded voltage indicators may be particularly attractive for minimal invasive and repeated assessments of cardiac

  20. Spindle cell melanocytic lesions: part II--an approach to intradermal proliferations and horizontally oriented lesions.

    Science.gov (United States)

    Sade, Shachar; Al Habeeb, Ayman; Ghazarian, Danny

    2010-05-01

    Melanocytic lesions show great morphological diversity in their architecture and the cytomorphological appearance of their composite cells. Whereas functional melanocytes show a dendritic cytomorphology and territorial isolation, lesional nevomelanocytes and melanoma cells typically show epithelioid, spindled or mixed cytomorphologies, and a range of architectural arrangements. Spindling is common to melanocytic lesions, and may either be a characteristic feature or a divergent appearance. The presence of spindle cells may mask the melanocytic nature of a lesion, and is often disconcerting, either due to its infrequent appearance in a particular lesion or its interpretation as a dedifferentiated phenotype. Spindle cell melanocytic lesions follow the full spectrum of potential biological outcomes, and difficulty may be experienced judging the nature of a lesion due to a lack of consistently reliable features to predict biological behaviour. Over time, recognition of numerous histomorphological features that may portend a more aggressive lesion have been identified; however, the translation of these features into a diagnostic entity requires a gestalt approach. Although most spindle cell melanocytic lesions may reliably be resolved through this standard approach, problem areas do exist for the surgical pathologist or dermatopathologist. With this review (part II of II), we complete our discussion of spindle cell melanocytic lesions, in order to: (1) model a systematic approach to such lesions; and (2) provide familiarity with those melanocytic lesions which either typically or occasionally display a spindled cytomorphology.

  1. Imaging granulomatous lesions with optical coherence tomography

    DEFF Research Database (Denmark)

    Banzhaf, Christina; Jemec, Gregor B E

    2012-01-01

    To investigate and compare the presentation of granulomatous lesions in optical coherence tomography (OCT) images and compare this to previous studies of nonmelanoma skin tumors.......To investigate and compare the presentation of granulomatous lesions in optical coherence tomography (OCT) images and compare this to previous studies of nonmelanoma skin tumors....

  2. Elementary lesions in dermatological semiology: literature review*

    Science.gov (United States)

    Cardili, Renata Nahas; Roselino, Ana Maria

    2016-01-01

    Discrepancies in the terminology of elementary lesions persist when texts from Dermatology and Semiology books are compared, which can cause some confusion in both the teaching of undergraduate medical students and the learning acquired by professionals in the field. This review aims to compare and clarify the differences in the description of elementary lesions by many authors, used as references for specialists in dermatology.

  3. The Post-Ureteroscopic Lesion Scale (PULS)

    DEFF Research Database (Denmark)

    Schoenthaler, Martin; Buchholz, Noor; Farin, Erik;

    2014-01-01

    The Post-Ureteroscopic Lesion Scale (PULS) offers a simple grading system for the description of ureteral lesions after ureteroscopy. In this article, we present the results of a video-based multicenter evaluation of the inter-rater reliability of clinically important PULS grades 0-3....

  4. Principal component analysis of psoriasis lesions images

    DEFF Research Database (Denmark)

    Maletti, Gabriela Mariel; Ersbøll, Bjarne Kjær

    2003-01-01

    A set of RGB images of psoriasis lesions is used. By visual examination of these images, there seem to be no common pattern that could be used to find and align the lesions within and between sessions. It is expected that the principal components of the original images could be useful during future...

  5. Common oral lesions associated with HIV infection.

    Science.gov (United States)

    Navazesh, M; Lucatorto, F

    1993-09-01

    More than 40 different lesions involving head and neck areas have been associated with HIV infection. The oral cavity may manifest the first sign of HIV infection. Early detection of these conditions can lead to early diagnosis of HIV infection and subsequent appropriate management. Signs, symptoms and management of the most common HIV-associated oral lesions are discussed.

  6. Methods in pharmacology: measurement of cardiac output

    OpenAIRE

    Geerts, Bart F; Aarts, Leon P; Jansen, Jos R.

    2011-01-01

    Many methods of cardiac output measurement have been developed, but the number of methods useful for human pharmacological studies is limited. The ‘holy grail’ for the measurement of cardiac output would be a method that is accurate, precise, operator independent, fast responding, non-invasive, continuous, easy to use, cheap and safe. This method does not exist today. In this review on cardiac output methods used in pharmacology, the Fick principle, indicator dilution techniques, arterial pul...

  7. Cardiac tumours simulating collagen vascular disease.

    OpenAIRE

    Fitzpatrick, A. P.; Lanham, J. G.; Doyle, D V

    1986-01-01

    Cardiac tumours can mimic collagen vascular disease and they are often accompanied by profound systemic upset. Both benign and malignant tumours may present in this way. Three cases of cardiac tumour, two malignant and one benign, are reported with just such a presentation. A review of fifteen similar case reports showed that a spectrum of different collagen vascular diseases was diagnosed and treated before the true diagnosis emerged. In half of these cases the cardiac tumour was only diagno...

  8. Disseminated cysticercosis with pulmonary and cardiac involvement

    OpenAIRE

    Jain Bharat; Sankhe Shilpa; Agrawal Mukta; Naphade Prashant

    2010-01-01

    Pulmonary and cardiac involvement by cysticercosis is extremely rare, and is usually asymptomatic. We report the case of a 19-year-old boy who presented with a history of headache and vomiting and was found to have disseminated cysticercosis with pulmonary and cardiac involvement; the emphasis is on the rare occurrence of pulmonary, cardiac, pancreatic, intraocular, and extradural spinal canal involvement in the same patient. This case demonstrates the extent to which cysticercosis can be dis...

  9. Electrocardiographically Determination of Cardiac Enlargements in Dogs

    OpenAIRE

    Gönül, Remzi; OR, Mehmet Erman; DODURKA, Tamer

    2002-01-01

    In this study, the electrocardiographic parameters necessary to determine cardiac enlargements and to establish and distinguish such complaints from each other in the early stage in dogs with circulatory problems were assessed. The material of the study consisted of 33 dogs 1.5-15 years of age with cardiac enlargements determined from 140 dogs suspected of having cardiac disease based on clinical, radiographic and electrocardiographic analyses. In these dogs, 12 cases of left atrial hypert...

  10. Primary Prevention of Sudden Cardiac Death in Adults with Transposition of the Great Arteries: A Review of Implantable Cardioverter-Defibrillator Placement.

    Science.gov (United States)

    Sodhi, Sandeep S; Cedars, Ari M

    2015-08-01

    Transposition of the great arteries encompasses a set of structural congenital cardiac lesions that has in common ventriculoarterial discordance. Primarily because of advances in medical and surgical care, an increasing number of children born with this anomaly are surviving into adulthood. Depending upon the subtype of lesion or the particular corrective surgery that the patient might have undergone, this group of adult congenital heart disease patients constitutes a relatively new population with unique medical sequelae. Among the more common and difficult to manage are cardiac arrhythmias and other sequelae that can lead to sudden cardiac death. To date, the question of whether implantable cardioverter-defibrillators should be placed in this cohort as a preventive measure to abort sudden death has largely gone unanswered. Therefore, we review the available literature surrounding this issue. PMID:26413012

  11. Cardiac Relapse of Acute Myeloid Leukemia after Allogeneic Hematopoietic Stem Cell Transplantation

    Science.gov (United States)

    Sánchez-Quintana, Ana; Quijada-Fumero, Alejandro; Laynez-Carnicero, Ana; Breña-Atienza, Joaquín; Poncela-Mireles, Francisco J.; Llanos-Gómez, Juan M.; Cabello-Rodríguez, Ana I.; Ramos-López, María

    2016-01-01

    Secondary or metastatic cardiac tumors are much more common than primary benign or malignant cardiac tumors. Any tumor can cause myocardial or pericardial metastasis, although isolated or combined tumor invasion of the pericardium is more common. Types of neoplasia with the highest rates of cardiac or pericardial involvement are melanoma, lung cancer, and breast and mediastinal carcinomas. Acute myeloid leukemia (AML) is the most common type of acute leukemia in adults. Initial treatment involves chemotherapy followed by consolidation treatment to reduce the risk of relapse. In high-risk patients, the treatment of choice for consolidation is hematopoietic stem cell transplantation (HSCT). Relapse of AML is the most common cause of HSCT failure. Extramedullary relapse is rare. The organs most frequently affected, called “sanctuaries,” are the testes, ovaries, and central nervous system. We present a case with extramedullary relapse in the form of a solid cardiac mass. PMID:27642531

  12. Reentrant Supraventricular Tachycardia in a Pediatric Trauma Patient Masquerading as a Cardiac Contusion

    Directory of Open Access Journals (Sweden)

    Bradbum, Christopher

    2005-01-01

    Full Text Available Establishing the etiology of tachycardia in a trauma patient is often difficult. Pediatric trauma patients present an even tougher challenge. Cardiac contusion should be suspected when other more common traumatic injuries that produce hypoxia and blood loss are excluded. The diagnosis of cardiac contusion is notoriously difficult to make largely due to the controversy over the definition of the disease, and the lack of a true gold standard confirmatory test. Atrioventricular nodal reentrant tachycardia (AVNRT is a common form of supraventricular tachycardia (SVT that can also present a diagnostic challenge to emergency physicians. While electrophysiologic studies are the gold standard for confirming the diagnosis, there are certain aspects of the history, electrocardiogram (ECG, and responses to cardiac maneuvers that strongly suggest the diagnosis. We present the case of a pediatric trauma patient that presented with new onset AVNRT masquerading as cardiac contusion.

  13. Reentry Near the Percolation Threshold in a Heterogeneous Discrete Model for Cardiac Tissue

    Science.gov (United States)

    Alonso, Sergio; Bär, Markus

    2013-04-01

    Arrhythmias in cardiac tissue are related to irregular electrical wave propagation in the heart. Cardiac tissue is formed by a discrete cell network, which is often heterogeneous. A localized region with a fraction of nonconducting links surrounded by homogeneous conducting tissue can become a source of reentry and ectopic beats. Extensive simulations in a discrete model of cardiac tissue show that a wave crossing a heterogeneous region of cardiac tissue can disintegrate into irregular patterns, provided the fraction of nonconducting links is close to the percolation threshold of the cell network. The dependence of the reentry probability on this fraction, the system size, and the degree of excitability can be inferred from the size distribution of nonconducting clusters near the percolation threshold.

  14. Polyunsaturated fatty acid analogs act antiarrhythmically on the cardiac IKs channel

    DEFF Research Database (Denmark)

    Liin, Sara I.; Silverå Ejneby, Malin; Barro-Soria, Rene;

    2015-01-01

    Polyunsaturated fatty acids (PUFAs) affect cardiac excitability. Kv7.1 and the β-subunit KCNE1 form the cardiac IKs channel that is central for cardiac repolarization. In this study, we explore the prospects of PUFAs as IKs channel modulators. We report that PUFAs open Kv7.1 via an electrostatic...... charge at neutral pH, restore the sensitivity to open IKs channels. PUFA analogs with a positively charged head group inhibit IKs channels. These different PUFA analogs could be developed into drugs to treat cardiac arrhythmias. In support of this possibility, we show that PUFA analogs act...... mechanism. Both the polyunsaturated acyl tail and the negatively charged carboxyl head group are required for PUFAs to open Kv7.1. We further show that KCNE1 coexpression abolishes the PUFA effect on Kv7.1 by promoting PUFA protonation. PUFA analogs with a decreased pKa value, to preserve their negative...

  15. Evaluation of apical subtype of hypertrophic cardiomyopathy using cardiac magnetic resonance imaging with gadolinium enhancement.

    Science.gov (United States)

    Kebed, Kalie Y; Al Adham, Raed I; Bishu, Kalkidan; Askew, J Wells; Klarich, Kyle W; Araoz, Philip A; Foley, Thomas A; Glockner, James F; Nishimura, Rick A; Anavekar, Nandan S

    2014-09-01

    Apical hypertrophic cardiomyopathy (HC) is an uncommon variant of HC. We sought to characterize cardiac magnetic resonance imaging (MRI) findings among apical HC patients. This was a retrospective review of consecutive patients with a diagnosis of apical HC who underwent cardiac MRI examinations at the Mayo Clinic (Rochester, MN) from August 1999 to October 2011. Clinical and demographic data at the time of cardiac MRI study were abstracted. Cardiac MRI study and 2-dimensional echocardiograms performed within 6 months of the cardiac MRI were reviewed; 96 patients with apical HC underwent cardiac MRI examinations. LV end-diastolic and end-systolic volumes were 130.7 ± 39.1 ml and 44.2 ± 20.9 ml, respectively. Maximum LV thickness was 19 ± 5 mm. Hypertrophy extended beyond the apex into other segments in 57 (59.4%) patients. Obstructive physiology was seen in 12 (12.5%) and was more common in the mixed apical phenotype than the pure apical (19.3 vs 2.6%, p = 0.02). Apical pouches were noted in 39 (40.6%) patients. Late gadolinium enhancement (LGE) was present in 70 (74.5%) patients. LGE was associated with severe symptoms and increased maximal LV wall thickness. In conclusion, cardiac MRI is well suited for studying the apical form of HC because of difficulty imaging the cardiac apex with standard echocardiography. Cardiac MRI is uniquely suited to delineate the presence or absence of an apical pouch and abnormal myocardial LGE that may have implications in the natural history of apical HM. In particular, the presence of abnormal LGE is associated with clinical symptoms and increased wall thickness. PMID:25037678

  16. The neural basis of body form and body action agnosia.

    Science.gov (United States)

    Moro, Valentina; Urgesi, Cosimo; Pernigo, Simone; Lanteri, Paola; Pazzaglia, Mariella; Aglioti, Salvatore Maria

    2008-10-23

    Visual analysis of faces and nonfacial body stimuli brings about neural activity in different cortical areas. Moreover, processing body form and body action relies on distinct neural substrates. Although brain lesion studies show specific face processing deficits, neuropsychological evidence for defective recognition of nonfacial body parts is lacking. By combining psychophysics studies with lesion-mapping techniques, we found that lesions of ventromedial, occipitotemporal areas induce face and body recognition deficits while lesions involving extrastriate body area seem causatively associated with impaired recognition of body but not of face and object stimuli. We also found that body form and body action recognition deficits can be double dissociated and are causatively associated with lesions to extrastriate body area and ventral premotor cortex, respectively. Our study reports two category-specific visual deficits, called body form and body action agnosia, and highlights their neural underpinnings.

  17. Contact with Fluoride-Releasing Restorative Materials Can Arrest Simulated Approximal Caries Lesion

    Directory of Open Access Journals (Sweden)

    Camila de Almeida Brandão Guglielmi

    2015-01-01

    Full Text Available Previous studies have suggested that the presence of white-spot lesion is very probable when adjacent surface is affected by cavitated lesions. This study evaluated the potential of different fluoride-releasing restorative materials in arresting enamel white-spot lesions in approximal surface in contact with them, in vitro (I and in situ (II. White-spot lesions were formed in 240 primary enamel specimens via pH-cycling. They were put in contact with cylindrical blocks of 6 materials (n=20: composite resin, 2 high-viscous glass ionomer cements (HVGIC, resin-modified GIC, resin-modified nanoionomer, and polyacid-modified resin. In both studies I and II, these settings were designed to simulate the contact point between the restoration and simulated approximal lesion. For study I, they were subjected to a new pH-cycling cariogenic challenge for 7 or 14 days (n=10. For study II, a randomized double-blind in situ design was conducted in two phases (7/14 days to promote cariogenic challenge. At the end of both studies, specimens were collected for mineral analysis by cross-sectional microhardness. Higher mineral loss was observed for lesions in contact with resin (p<0.001. HVGICs were the most efficient in preventing mineral loss, whereas other materials presented an intermediate behavior. It is concluded that fluoride-releasing materials can moderately reduce white-spot lesions progression, and HVGIC can arrest enamel lesion in approximal surface in contact with them.

  18. [Out-of-hospital cardiac arrest].

    Science.gov (United States)

    Virkkunen, Ilkka; Hoppu, Sanna; Kämäräinen, Antti

    2011-01-01

    Cardiac arrest as the first symptom of coronary artery disease is not uncommon. Some of previously healthy people with sudden cardiac arrest may be saved by effective resuscitation and post-resuscitative therapy. The majority of cardiac arrest patients experience the cardiac arrest outside of the hospital, in which case early recognition of lifelessness, commencement of basic life support and entry to professional care without delay are the prerequisites for recovery. After the heart has started beating again, the clinical picture of post-resuscitation syndrome must be recognized and appropriate treatment utilized. PMID:22204143

  19. Detecting deterministic dy namics of cardiac rhythm

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Under the acceptable hypothesis that cardiac rhythm is an approximately deterministic process with a small scale noise component, an available way is provided to construct a model that can reflect its prominent dynamics of the deterministic component. When applied to the analysis of 19 heart rate data sets, three main findings are stated. The obtained model can reflect prominent dynamics of the deterministic component of cardiac rhythm; cardiac chaos is stated in a reliable way; dynamical noise plays an important role in the generation of complex cardiac rhythm.``

  20. Cosmic Forms

    CERN Document Server

    Kleman, Maurice

    2011-01-01

    The continuous 1D defects of an isotropic homogeneous material in an Euclidean 3D space are classified by a construction method, the Volterra process (VP). We employ the same method to classify the continuous 2D defects (which we call \\textit{cosmic forms}) of a vacuum in a 4D maximally symmetric spacetime. These defects fall into three different classes: i)- $m$-forms, akin to 3D space disclinations, related to ordinary rotations and analogous to Kibble's global cosmic strings (except that being continuous any deficit angle is allowed); ii)- $t$-forms, related to Lorentz boosts (hyperbolic rotations); iii)- $r$-forms, never been considered so far, related to null rotations. A detailed account of their metrics is presented. Their inner structure in many cases appears as a non-singular \\textit{core} separated from the outer part by a timelike hypersurface with distributional curvature and/or torsion, yielding new types of geometrical interactions with cosmic dislocations and other cosmic disclinations. Whereas...

  1. 42 CFR 410.49 - Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage.

    Science.gov (United States)

    2010-10-01

    ... and intensive cardiac rehabilitation program: Conditions of coverage. (a) Definitions. As used in this... 42 Public Health 2 2010-10-01 2010-10-01 false Cardiac rehabilitation program and intensive cardiac rehabilitation program: Conditions of coverage. 410.49 Section 410.49 Public Health CENTERS...

  2. Tumors of the cardiac conduction system: are they an explanation for otherwise unexplained sudden cardiac death?

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ Cardiac tumors are well described in the literature. The first reports of cardiac tumors date back hundreds of years.The prevalence of primary cardiac tumors at autopsy ranges from 0.001% to 0.3% with secondary tumors more common than in primary tumors.

  3. The mechanism of lesion formation by focused ultrasound ablation catheter for treatment of atrial fibrillation

    Science.gov (United States)

    Sinelnikov, Y. D.; Fjield, T.; Sapozhnikov, O. A.

    2009-10-01

    The application of therapeutic ultrasound for the treatment of atrial fibrillation (AF) is investigated. The results of theoretical and experimental investigation of ultrasound ablation catheter are presented. The major components of the catheter are the high power cylindrical piezoelectric element and parabolic balloon reflector. Thermal elevation in the ostia of pulmonary veins is achieved by focusing the ultrasound beam in shape of a torus that transverses the myocardial tissue. High intensity ultrasound heating in the focal zone results in a lesion surrounding the pulmonary veins that creates an electrical conduction blocks and relief from AF symptoms. The success of the ablation procedure largely depends on the correct choice of reflector geometry and ultrasonic power. We present a theoretical model of the catheter’s acoustic field and bioheat transfer modeling of cardiac lesions. The application of an empirically derived relation between lesion formation and acoustic power is shown to correlate with the experimental data. Developed control methods combine the knowledge of theoretical acoustics and the thermal lesion formation simulations with experiment and thereby establish dosimetry that contributes to a safe and effective ultrasound ablation procedure.

  4. Polymer fraction of Aloe vera exhibits a protective activity on ethanol-induced gastric lesions.

    Science.gov (United States)

    Park, Chul-Hong; Nam, Dong-Yoon; Son, Hyeong-U; Lee, Si-Rim; Lee, Hyun-Jin; Heo, Jin-Chul; Cha, Tae-Yang; Baek, Jin-Hong; Lee, Sang-Han

    2011-04-01

    For centuries, Aloe has been used as a herbal plant remedy against skin disorders, diabetes, and for its cardiac stimulatory activity. Here, we examined the gastroprotective effects of an Aloe vera polymer fraction (Avpf; molecular weight cut-off ≥50 kDa; 150 mg/kg body weight, p.o.) on an ethanol-induced gastric lesion mouse model. Mice pre-treated with Avpf had significantly fewer gastric lesions than their respective controls. To further examine the potential mechanism underlying this effect, we used reverse transcription-polymerase chain reaction to examine nitric oxide synthase and matrix metalloproteinase (MMP)mRNA expression on tissues from gastric lesions. Our results revealed that the mRNA expressions of inducible nitric oxide synthase (iNOS) and neuronal nitric oxide synthase (nNOS) were each reduced by ~50% in Avpf-treated mice vs. the controls, whereas, the mRNA expression levels of endothelial nitric oxide synthase remained unchanged. MMP-9, an index for gastric lesions, also alleviated the ethanol-treated gastric ulceration during Avpf treatment. These findings collectively suggest that Avpf significantly protects the gastric mucosa against ethanol-induced gastric damage, at least in part, by decreasing mRNA expression levels of not only iNOS and nNOS, but also MMP-9. PMID:21286662

  5. Treatment of lesions of the rotator cuff.

    Science.gov (United States)

    Saggini, R; Cavezza, T; Di Pancrazio, L; Pisciella, V; Saladino, G; Zuccaro, M C; Bellomo, R G

    2010-01-01

    The impingement syndrome and tendinopathy of the rotator cuff are the most common causes (complaints) of pain and disability of the shoulder. The aim of this study is to evaluate the efficacy of a specific rehabilitative protocol, integrated with the administration of a nutritional supplement, in the conservative rehabilitative treatment, as well as in post-surgery, of patients with lesions of the rotator cuff. Two groups with syndrome of the rotator cuff were formed to follow different therapeutic courses, in relation to the choice of each subject to undergo the conservative treatment (Arm A) or the surgical one (Arm B). In Arm A the study included the association of therapy with ESWT (shock waves) with the proprioceptive Multi Joint System, for rehabilitating joint movement and muscle strength of the shoulder, and a specific nutritional supplement to reduce the pain and conserve the cartilage tissue. Between February 2009 and June 2009, we enrolled 30 subjects (randomized into three homogenous groups A1, A2, A3), average age 45±10 years, with rotator cuff syndrome with calcification of the shoulder, diagnosed through clinical examination and investigative instruments (X-ray, echography or NMR). In Arm B, from September 2009 to January 2010, we enrolled 50 patients (randomized into two groups, B1 and B2), 24 male (average age 58.4: min 28 and max 78) and 26 females (average age 59.5: min 30 and max 80), who had undergone rotator cuff operations and acromionplasty for non-massive lesions without important gleno-humeral instability, with either open or arthroscopic procedures. The analysis of the results of Arm A highlights that in terms of reducing pain the main benefits were found in Group A1 where the supplement was given. From the analysis of the data of Arm B, in both groups an improvement of the first 4 items evaluated was evident. In Group B1, 84 percent of the patients declared to be satisfied and improved and 16 percent were dissatisfied; in Group B2

  6. Impact of cardiac rehabilitation on health related quality of life.

    LENUS (Irish Health Repository)

    Riaz, A

    2012-02-01

    Cardiac rehabilitation (CR) programs are recognized as integral part of the comprehensive care of patients with cardiovascular disease and are recommended as useful and effective (Class I) by the American Heart Association (AHA). In this study we used serial administration of the short form 36 (SF36) to evaluate patient\\'s response to CR in terms of improvement in Health related Quality of Life. A total of 49 patients were included in the analysis. There was a significant improvement observed after CR in the Physical Capacity Score (42.3 vs 49.9 p = 0.0005). There was no significant improvement in the Mental Capacity Score (54.8 vs 54.9 p = 0.96). We conclude that Cardiac Rehabilitation Program causes a significant improvement in the health related quality of life of patients by improving their physical health and well being but does not improve the mental capacity which is already at a healthy level before CR.

  7. Optical control of excitation waves in cardiac tissue

    Science.gov (United States)

    Burton, Rebecca A. B.; Klimas, Aleksandra; Ambrosi, Christina M.; Tomek, Jakub; Corbett, Alex; Entcheva, Emilia; Bub, Gil

    2015-12-01

    In nature, macroscopic excitation waves are found in a diverse range of settings including chemical reactions, metal rust, yeast, amoeba and the heart and brain. In the case of living biological tissue, the spatiotemporal patterns formed by these excitation waves are different in healthy and diseased states. Current electrical and pharmacological methods for wave modulation lack the spatiotemporal precision needed to control these patterns. Optical methods have the potential to overcome these limitations, but to date have only been demonstrated in simple systems, such as the Belousov-Zhabotinsky chemical reaction. Here, we combine dye-free optical imaging with optogenetic actuation to achieve dynamic control of cardiac excitation waves. Illumination with patterned light is demonstrated to optically control the direction, speed and spiral chirality of such waves in cardiac tissue. This all-optical approach offers a new experimental platform for the study and control of pattern formation in complex biological excitable systems.

  8. Autopsy study of small cardiac scars in Japanese men who lived in Hiroshima, Japan and Honolulu, Hawaii

    International Nuclear Information System (INIS)

    Japanese men long resident in Honolulu, Hawaii have significantly more ischemic heart disease, but significantly fewer small cardiac scars than men in Hiroshima, Japan. These scars occur in three forms: 1) small scars in the mural myocardium which account for the difference in frequency of small lesions in the two cities, and are of uncertain etiology; 2) areas of diffuse fibrosis in the papillary muscles. These are equally frequent in the two cities, and are associated with advancing age and sclerosis of papillary muscle arteries; and 3) focal scars in the papillary muscles. These are more frequent in Honolulu than Hiroshima. They are healed infarcts due to ischemic heart disease and are associated with a severe degree of extramural coronary artery sclerosis. Small mural myocardial scars, when present, are usually found in multiple sites, and are not related to age at death or heart weight. They are more common in the presence of sclerosis of intramural small arteries, but this association does not explain their more frequent occurrence in Hiroshima. There is no evidence that they are related to A-bomb radiation exposure. (author)

  9. White Lesions Of The Oral Ca vity -diagnostic appraisal & management strategies

    Directory of Open Access Journals (Sweden)

    Hari S

    2010-07-01

    Full Text Available White lesions of the oral cavity constitute a rather common group of lesions that areencountered during routine clinical dental practice. The process of clinical diagnosis and treatmentplanning is of great concern to the patient as it determines the nature of future follow up care.There is a strong felt need for a rational and functional classification which will enable betterunderstanding of the basic disease process as well as in formulating a differential diagnosis. Clinicaldiagnostic skills and good judgment forms the key to successful management of white lesions of theoral cavity.

  10. Osteolytic bone lesions – A rare presentation of AML M6.

    Directory of Open Access Journals (Sweden)

    Geetha N.

    2015-02-01

    Full Text Available Acute myeloid leukemia (AML M6 is a rare form of AML  accounting  for < 5 % of all AML.  Extramedullary involvement  is very rarely seen in this entity.  Skeletal lesion has not been described in AML M6 before. We discuss the case of  a 17 year old boy with AML M6 who presented with  osteolytic lesion of right humerus.  He was treated with  induction and consolidation chemotherapy. The present case is the first report in literature of AML M6 presenting with skeletal lesions.

  11. Crush stenting in treating coronary bifurcate lesions: paclitaxel eluting stents versus sirolimus eluting stents

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; SUN Xue-wen; HU Da-yi; Tak W. Kwan; ZHANG Jun-jie; YE Fei; CHEN Yun-dai; ZHU Zhong-sheng; LIN Song; TIAN Nai-liang; LIU Zhi-zhong; FANG Wei-yi

    2008-01-01

    Background Because no data regarding the comparison of crush stenting with pactitaxel(PES)or sirolimus eluting stents(SES)for coronary bifurcate lesions have been reported,we compared the clinical outcomes of these two types of stents.Methods Two hundred and thirty patients with 242 bifurcate lesions were enrolled in a prospective,nonrandomized trial.Primary endpoints included myocardial infarction,cardiac death and target vessel revascularization at 8 months.Results All patients were followed up clinically and 82%angiographically at 8 months.Final kissing balloon inflation was performed in 72%in the PES and 75%in the SES groups(P>0.05).Compared to the SES group,PES group had a higher late loss and incidence of restenosis(P=0.04)in the prebifurcation vessel segment.The postbifurcation vessel segment in the PES group had a greater late loss((0.7+0.6)mm vs(0.3±0.4)mm,P<0.001)and higher restenosis in the side branch(25.5%vs 15.6%,P=0.04)when compared to the SES group.There was significant difference of insegment restenosis in the entire main vessel between PES and SES groups (P=0.004).Target lesion revascularization was more frequently seen in the PES group as compared to the SES group(P=0.01).There was significant difference in the accumulative MACE between these two groups(P=0.01).The survival rate free from target lesion revascularization was significantly higher in the SES group when compared to the PES group(P<0.001).Conclusion SES is superior to PES in reducing restenosis and target lesion revascularization by 8-month follow-up after crush stenting for bifurcate lesions.

  12. COMPLEJIDAD DE LAS LESIONES CORONARIAS EN PACIENTES DIABÉTICOS / Complexity of coronary lesions in diabetic patients

    Directory of Open Access Journals (Sweden)

    Héctor Conde Cerdeira

    2012-03-01

    Full Text Available Resumen Introducción y objetivos: La enfermedad coronaria en los pacientes diabéticos se presenta de forma muy agresiva con una excesiva progresión de la aterosclerosis y con mayor riesgo de reestenosis o trombosis de stent, en el intervencionismo coronario percutáneo. El objetivo de esta investigación fue determinar la relación entre la diabetes mellitus y determinadas características de las lesiones coronarias, así como su relación con la reestenosis, la trombosis y el desarrollo de nuevas lesiones después del procedimiento percutáneo. Método: Se realizó un estudio descriptivo-retrospectivo. De los 1.464 pacientes revascularizados en el Centro de Investigaciones Médico-Quirúrgicas de La Habana, Cuba, entre agosto de 1997 y febrero de 2009, se seleccionaron 270 pacientes diabéticos. Resultados: La diabetes mellitus fue un factor de riesgo para las lesiones de circunfleja (OR* = 1,48; de los ostium aorto-coronario (OR = 3,58, de descendente anterior (OR = 2,41 y de circunfleja (OR = 4,89; y para las lesiones de tronco con extensión a descendente anterior (OR = 9,79. Los diabéticos tuvieron más riesgo de desarrollar lesiones complejas tipo B2 y C (OR = 1,36, en curvaturas mayores de 90º (OR = 3,03, con curvaturas previas superiores de 90º (OR = 6,13, lesiones de más de 20 mm (OR = 2,0, en ramificaciones (OR = 1,69 y lesiones por ausencia de flujo coronario (OR = 4,15. Se caracterizaron también por tener arterias menores de 3 mm (OR =1,32 y mayor riesgo de desarrollar nuevas lesiones (OR = 2,11, reestenosis (OR = 2,11 y trombosis (OR = 3,06 del stent. Conclusiones: La diabetes mellitus se comportó como un factor de riesgo para el desarrollo de lesiones coronarias complejas y con un elevado riesgo de desarrollar nuevas lesiones, reestenosis y trombosis de los stents. / Abstract Introduction and Objectives: Coronary artery disease in diabetic patients is presented in a very aggressive form with excessive progression of

  13. EVALUATION OF NEONATAL CARDIAC MURMURS

    Directory of Open Access Journals (Sweden)

    Somaiah

    2014-09-01

    Full Text Available Cardiovascular malformations are the most common cause of congenital malformations, the diagnosis of which requires a close observation in the neonatal period. Early recognition of CHD is important in the neonatal period, as many of them may be fatal if undiagnosed and may require immediate intervention. The objectives of this study are to study the epidemiology of neonatal cardiac murmurs, to identify clinical characteristics which differentiate pathological murmur from functional murmurs and to assess the reliability of clinical evaluation in diagnosing CHD. Method of study included all neonates admitted to the NICU, postnatal ward, attending pediatric OPD or neonatal follow up clinic and were detected to have cardiac murmurs. It was a cross sectional study over a period of 16months. A clinical diagnosis was made based on history and clinical examination. Then Chest X-ray and ECG, Echocardiography was done in all neonates for confirmation of the diagnosis. These neonates were again examined daily till they were in hospital and during the follow-up visit at 6 weeks. The results of 70 neonates in this study conducted over a period of 24 months included the incidence of cardiac murmurs among intramural neonates which was 13.5 for 1000 live births. Most frequent symptom was fast breathing in 10(14.3% cases. VSD was the most common diagnosis clinically in 23 (33% babies. The most frequent Echo diagnosis was acyanotic complex congenital heart disease in 25(36% cases followed by 12(17% cases each of VSD and ASD respectively. Overall in our study 77.1% (54cases of the murmurs were diagnosed correctly and confirmed by Echocardiography The study concluded that it is possible to make clinical diagnosis in many cases of congenital heart diseases, the functional murmurs could be differentiated from those arising from structural heart disease and evaluation of the infants based only on murmurs, few congenital heart diseases can be missed.

  14. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

    Vretzakis, George; Georgopoulou, Stauroula; Stamoulis, Konstantinos; Stamatiou, Georgia; Tsakiridis, Kosmas; Katsikogianis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Mpakas, Andreas; Beleveslis, Thomas; Koletas, Alexander; Siminelakis, Stavros N.; Zarogoulidis, Konstantinos

    2014-01-01

    Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients. PMID:24672700

  15. Cardiac leiomyosarcoma, a case report

    DEFF Research Database (Denmark)

    Andersen, Rikke; Kristensen, Bjarne W; Gill, Sabine

    2013-01-01

    In this case report we present the history of a patient admitted with recurrent pulmonary edema. Transesophageal chocardiography showed a tumour in the left atrium, occluding the ostium of the mitral valve and mimicking intermittent mitral stenosis. Cardiac surgery followed by pathological...... examination revealed that the tumour was a leiomyosarcoma. Images from the echocardiography as well as the pathological findings are shown and discussed. The present case report illustrates that atrial tumors comprise also sarcomas, suggesting the use of careful, rapid diagnostic procedures and treatment...

  16. Cardiac imaging: does radiation matter?

    Science.gov (United States)

    Einstein, Andrew J.; Knuuti, Juhani

    2012-01-01

    The use of ionizing radiation in cardiovascular imaging has generated considerable discussion. Radiation should not be considered in isolation, but rather in the context of a careful examination of the benefits, risks, and costs of cardiovascular imaging. Such consideration requires an understanding of some fundamental aspects of the biology, physics, epidemiology, and terminology germane to radiation, as well as principles of radiological protection. This paper offers a concise, contemporary perspective on these areas by addressing pertinent questions relating to radiation and its application to cardiac imaging. PMID:21828062

  17. Autologous Transfusion in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Radmehr H

    2003-11-01

    Full Text Available Preoperative autologous blood donation is commonly used to reduce exposure to homologous blood transfusions among patients undergoing elective cardiac surgery. The aim of this study was to evaluate the effect of autologous transfusion on patients' hematocryte value, intra and postoperative blood loss, hospitalization time, the development of infective complications and other factors. Materials and Methods: Between June 2001 to April 2002, 208 patients were underwent cardiac surgery in cardiac surgery ward in Imam Khomeini Medical Center. One or more blood units donate from 104 Patients before cardiopulmonary bypass and heparin injection, and transfused to them after CPB and Protamin injection (autologous Group, group 1. 104 patients underwent cardiac surgery routinely (control group, group 2."nResults: Mean of age was 55.9±8.6 in group 1 and 56.6±9.3 in group 2 (P=NS. 73 male and 31 females were in group 1 and 79 males and 25 females were in group 2 (P=NS. Smoking, familial history, hyperlipidemia, diabetes mellitus, renal failure, hypertension, stroke, and history of myocardial infarction was similar in two groups."nSeverity of angina, urgency operation, number vessels disease, duration of cardiopulmonary bypass, duration of aortic cross clamp time, use of internal thoracic artery graft, and number of grafts was similar in both groups. Mean of bleeding post operation was 548 cc in group 1 and 803 cc in-group 2 (P=0.003. Bleeding that need to operation was 1.8% in group 1 and 8.6% in group 2 (P=0.002. Wound infection, mediastinitis, renal failure, ventilatory prolonged, stroke, need to Intra-aortic Balloon Pump (IABP, intraoperative bleeding, and hospital stay was similar in both groups. Mean of extubationt time was 10.2 hours in group 1 and 14.8 hours in group 2 (P=0.001."nConclusion: Preoperative and intra-operative donations are safe and continue to contribute uniquely to blood conservation, providing important options in comprehensive

  18. [Acute cardiac failure in pheochromocytoma.

    DEFF Research Database (Denmark)

    Jønler, Morten; Munk, Kim

    2008-01-01

    Pheochromocytoma (P) is an endocrine catecholamine-secreting tumor. Classical symptoms like hypertension, attacks of sweating, palpitations, headache and palor are related to catecholamine discharge. We provide a case of P in a 71 year-old man presenting with acute cardiac failure, severe reduction...... in left ventricular function and elevated myocardial enzymes. No coronary stenoses were found. The myocardium regained nearly normal systolic function in one and a half month. A renal P was laparoscopicaly removed. We discuss the pathophysiology of catecholamine cardiomyopathy. Udgivelsesdato: 2008-Jun-2...

  19. Introduction to noninvasive cardiac mapping.

    Science.gov (United States)

    Bear, Laura; Cuculich, Phillip S; Bernus, Olivier; Efimov, Igor; Dubois, Rémi

    2015-03-01

    From the dawn of the twentieth century, the electrocardiogram (ECG) has revolutionized the way clinical cardiology has been practiced, and it has become the cornerstone of modern medicine today. Driven by clinical and research needs for a more precise understanding of cardiac electrophysiology beyond traditional ECG, inverse solution electrocardiography has been developed, tested, and validated. This article outlines the important progress from ECG development, through more extensive measurement of body surface potentials, and the fundamental leap to solving the inverse problem of electrocardiography, with a focus on mathematical methods and experimental validation. PMID:25784020

  20. 10.2.Cardiac arrhythmias

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    930257 Electrophysiologic study of reperfu-sion arrhythmias.YIN Hong (尹红),et al.Af-fil Hosp,Shandong Med Univ,Jinan.Chin CirJ 1993;8(1):37—39.Twenty dogs of experimental ischemic reper-fusion were studied with a three-dimensionalmapping system of cardiac electric activity andmultiple—level myocardial recordings by bipolarplunge—needle electrodes.27% of the nonsus-tained ventricular tachycardia (NSVT) of intra-mural reentry occurred in the ischemic subendo-

  1. Clinical outcomes after treatment of multiple lesions with zotarolimus-eluting versus sirolimus-eluting coronary stents (a SORT OUT III substudy

    Directory of Open Access Journals (Sweden)

    Thim Troels

    2012-03-01

    Full Text Available Abstract Background Data on clinical outcomes among patients treated with the zotarolimus-eluting Endeavor™ stent versus the sirolimus-eluting Cypher™ stent favor the sirolimus-eluting stent. However, a separate comparison of clinical outcome among patients treated for multiple lesions with these stents is lacking. We performed this comparison within the SORT OUT III trial data set. Methods Among 2332 patients randomized in SORT OUT III, 695 were treated for multiple lesions with zotarolimus-eluting (n = 350 or sirolimus-eluting (n = 345 stents and followed for 18 months. Major adverse cardiac events (MACE; composite of cardiac death, myocardial infarction, or target vessel revascularization (TVR; was the primary endpoint. Results Zotarolimus-eluting compared to sirolimus-eluting stent treatment was associated with increased MACE rate (13.2% vs. 2.6%; hazard ratio 5.29 with 95% confidence interval: 2.59-10.8. All secondary endpoints; all cause death, cardiac death, myocardial infarction, TVR, target lesion revascularization, in-stent restenosis, and definite stent thrombosis; were observed more frequently among zotarolimus-eluting stent treated patients. For all endpoints, hazard ratios were 1.6 to 4.6 times higher than in the overall results of the SORT OUT III trial. Conclusions We observed better clinical outcomes among patients treated for multiple lesions with the sirolimus-eluting stent compared to those treated with the zotarolimus-eluting stent.

  2. Diagnostic Concordance Characteristics of Oral Cavity Lesions

    Directory of Open Access Journals (Sweden)

    Ufuk Tatli

    2013-01-01

    Full Text Available Purpose. The objective of this study was to evaluate the diagnostic concordance characteristics of oral cavity lesions by comparing the clinical diagnosis of the lesions with the histopathologic diagnosis. Material and Method. A retrospective analysis was conducted on the patients, who were admitted with oral cavity pathology and underwent biopsy procedure between 2007 and 2011. The oral cavity lesions were classified into 6 different groups as odontogenic cysts, nonodontogenic cysts, odontogenic tumors, nonodontogenic tumors, malignant tumors, and precancerous lesions in accordance with the 2005 WHO classification. The diagnoses were also recategorized into 3 groups expressing prognostic implications as benign, precancerous, and malignant. The initial clinical diagnoses were compared with the histopathologic diagnoses. Data were analyzed statistically. Results. A total of 2718 cases were included. Histopathologic diagnosis did not match the clinical diagnosis in 6.7% of the cases. Nonodontogenic tumors and malignant tumors had the highest misdiagnosis rates (11.5% and 9%, resp., followed by odontogenic tumors (7.7%, precancerous lesions (6.9%, and odontogenic cysts (4.4%. Clinicians were excelled in diagnosis of benign and precancerous lesions in clinical setting. Conclusion. The detailed discordance characteristics for each specific lesion should be considered during oral pathology practice to provide early detection without delay.

  3. Usefulness of acoustic radiation force impulse elastography in the differential diagnosis of benign and malignant solid pancreatic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Park, Min Kyoung; Jo, Jeong Hyun; Kwon, Hee Jin; Cho, Jin Han; Oh, Jong Young; Noh, Myung Hwan; Nam, Kyung Jin [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2014-03-15

    The aim of this study was to evaluate the tissue stiffness of solid pancreatic lesions by using acoustic radiation force impulse (ARFI) elastography to differentiate benign from malignant pancreatic lesions. ARFI elastography was performed in 26 patients who had 27 focal solid pancreatic lesions, including 8 benign lesions (mass-forming pancreatitis, 5; autoimmune pancreatitis, 3) and 19 malignant lesions (pancreatic adenocarcinoma, 16; metastasis from colorectal cancer, 2; malignant neuroendocrine tumor, 1). On the elastographic images of virtual touch tissue imaging (VTI), the echogenicity of the mass was categorized on a 5-grade scale. On the elastographic image of virtual touch tissue quantification (VTQ), the shear wave velocities (SWVs) of the lesion and surrounding parenchyma were measured. On the VTI images, the mean echogenicity score of the malignant lesions (3.7±1.0) was higher than that of the benign lesions (3.1±0.4; P=0.023). On the VTQ images, there were no statistical differences in the mean SWV between the benign (2.4±1.1 m/sec) and malignant (3.3±1.0 m/sec) lesions (P=0.101). However, the mean SWV difference values between the lesion and background parenchyma of the malignant lesions (1.5±0.8 m/sec) were higher than those of the benign lesions (0.4±0.3 m/sec; P=0.011). ARFI elastography can determine the relative stiffness between a lesion and the background pancreatic parenchyma using VTI and VTQ, which is helpful in the differentiation between benign and malignant solid pancreatic lesions.

  4. Assessment of cardiac sympathetic nerve integrity with positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Raffel, David M. E-mail: raffel@umich.edu; Wieland, Donald M

    2001-07-01

    The autonomic nervous system plays a critical role in the regulation of cardiac function. Abnormalities of cardiac innervation have been implicated in the pathophysiology of many heart diseases, including sudden cardiac death and congestive heart failure. In an effort to provide clinicians with the ability to regionally map cardiac innervation, several radiotracers for imaging cardiac sympathetic neurons have been developed. This paper reviews the development of neuronal imaging agents and discusses their emerging role in the noninvasive assessment of cardiac sympathetic innervation.

  5. The Cardiac Conduction System: Generation and Conduction of the Cardiac Impulse.

    Science.gov (United States)

    Kennedy, Alan; Finlay, Dewar D; Guldenring, Daniel; Bond, Raymond; Moran, Kieran; McLaughlin, James

    2016-09-01

    In this article, the authors outline the key components behind the automated generation of the cardiac impulses and the effect these impulses have on cardiac myocytes. Also, a description of the key components of the normal cardiac conduction system is provided, including the sinoatrial node, the atrioventricular node, the His bundle, the bundle branches, and the Purkinje network. Finally, an outline of how each stage of the cardiac conduction system is represented on the electrocardiogram is described, allowing the reader of the electrocardiogram to translate background information about the normal cardiac conduction system to everyday clinical practice. PMID:27484656

  6. Macromolecular lesions and cellular radiation chemistry

    International Nuclear Information System (INIS)

    Our studies of the interaction of densely ionizing particles with macromolecules in the living cell may be divided into four parts: characterization of lesions to cellular DNA in the unmodified Bragg ionization curve; characterization of lesions to cellular DNA in the spread Bragg curve as used in radiation therapy; elucidation of the cellular radiation chemistry characteristic of high vs. low LET radiation qualities; and the introduction of novel techniques designed to give a better understanding of the fundamental properties of induction of lesions and their repair potentials in high LET radiation

  7. Tibial cortical lesions: A multimodality pictorial review

    Energy Technology Data Exchange (ETDEWEB)

    Tyler, P.A., E-mail: philippa.tyler@rnoh.nhs.uk [Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP (United Kingdom); Mohaghegh, P., E-mail: pegah1000@gmail.com [Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP (United Kingdom); Foley, J., E-mail: jfoley1@nhs.net [Department of Radiology, Glasgow Royal Infirmary, 16 Alexandra Parade, Glasgow G31 2ES (United Kingdom); Isaac, A., E-mail: amandaisaac@doctors.org.uk [Department of Radiology, King' s College Hospital, Denmark Hill, London SE5 9RS (United Kingdom); Zavareh, A., E-mail: ali.zavareh@gmail.com [Department of Radiology, North Bristol NHS Trust, Frenchay, Bristol BS16 1LE (United Kingdom); Thorning, C., E-mail: cthorning@doctors.org.uk [Department of Radiology, East Surrey Hospital, Canada Avenue, Redhill, Surrey RH1 5RH (United Kingdom); Kirwadi, A., E-mail: anandkirwadi@gmail.com [Department of Radiology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL (United Kingdom); Pressney, I., E-mail: ipressney@hotmail.com [Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP (United Kingdom); Amary, F., E-mail: fernanda.amary@rnoh.nhs.uk [Department of Histopathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore HA7 4LP (United Kingdom); Rajeswaran, G., E-mail: grajeswaran@gmail.com [Department of Radiology, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH (United Kingdom)

    2015-01-15

    Highlights: • Multimodality imaging plays an important role in the investigation and diagnosis of shin pain. • We review the multimodality imaging findings of common cortically based tibial lesions. • We also describe the rarer pathologies of tibial cortical lesions. - Abstract: Shin pain is a common complaint, particularly in young and active patients, with a wide range of potential diagnoses and resulting implications. We review the natural history and multimodality imaging findings of the more common causes of cortically-based tibial lesions, as well as the rarer pathologies less frequently encountered in a general radiology department.

  8. Oncocytic lesions of the ophthalmic region

    DEFF Research Database (Denmark)

    Østergaard, Jens; Prause, Jan U; Heegaard, Steffen

    2011-01-01

    Purpose: This study aimed to make a nationwide clinicopathological study of oncocytic lesions in the ophthalmic region and to characterize their cytokeratin (CK) expression. Methods: All histologically diagnosed oncocytic lesions in the ophthalmic region registered in Denmark over a 25-year period...... expression. Basal-type oncocytic cells reacted with antibodies against CK 5/6, CK 7, CK 8, CK 13, CK 14, CK 17, CK 18 and CK 19, and suprabasal cells with CK 4, CK 7, CK 8, CK 18 and CK 19. Antibodies against CK 1+10 and CK 20 showed no reaction. Conclusions: Oncocytic lesions of the ophthalmic region most...

  9. A cardiac hemangioma treated by a right minithoracotomy approach with thoracoscopic assistance.

    Science.gov (United States)

    Sakai, Katsuaki; Tanigawa, Kazuyoshi; Odate, Tomohiro; Miura, Takashi; Tsuneto, Akira; Abe, Kuniko; Hashizume, Koji; Eishi, Kiyoyuki

    2016-01-01

    Cardiac hemangiomas are extremely rare tumors, accounting for only 2.5% of all cardiac tumors. Most of these develop in the ventricles, and obtaining a good field of view is, therefore, the key to successful operation. A 40-year-old female visited a local hospital due to palpitation. Transthoracic echocardiography revealed a spherical high-echo mass (13.5 × 10.7 mm in diameter) between the papillary muscles. She was referred to our hospital to undergo close examination. Cardiac contrast-enhanced magnetic resonance imaging was performed to differentiate between malignant and benign lesions. However, this did not provide any findings leading to a definite diagnosis. To make a diagnosis and prevent embolism, the mass was excised using a right minithoracotomy approach with thoracoscopic assistance. The post-operative pathological diagnosis was a cardiac capillary-cavernous hemangioma. A right minithoracotomy approach combined with thoracoscopy allowed accurate evaluation of the mass in the left ventricle beyond the mitral valve and its accurate excision.

  10. Cardiac cell proliferation assessed by EdU, a novel analysis of cardiac regeneration.

    Science.gov (United States)

    Zeng, Bin; Tong, Suiyang; Ren, Xiaofeng; Xia, Hao

    2016-08-01

    Emerging evidence suggests that mammalian hearts maintain the capacity for cardiac regeneration. Rapid and sensitive identification of cardiac cellular proliferation is prerequisite for understanding the underlying mechanisms and strategies of cardiac regeneration. The following immunologically related markers of cardiac cells were analyzed: cardiac transcription factors Nkx2.5 and Gata 4; specific marker of cardiomyocytes TnT; endothelial cell marker CD31; vascular smooth muscle marker smooth muscle myosin IgG; cardiac resident stem cells markers IsL1, Tbx18, and Wt1. Markers were co-localized in cardiac tissues of embryonic, neonatal, adult, and pathological samples by 5-ethynyl-2'-deoxyuridine (EdU) staining. EdU was also used to label isolated neonatal cardiomyocytes in vitro. EdU robustly labeled proliferating cells in vitro and in vivo, co-immunostaining with different cardiac cells markers. EdU can rapidly and sensitively label proliferating cardiac cells in developmental and pathological states. Cardiac cell proliferation assessed by EdU is a novel analytical tool for investigating the mechanism and strategies of cardiac regeneration in response to injury. PMID:25480318

  11. Automorphic Forms

    DEFF Research Database (Denmark)

    von Essen, Flemming Brændgaard

    -functions for Hecke characters in the points 4 and 6. It is well known, that all zeros of the Eisenstein series Ek wrt. SL2(Z) in the standard fundamental domain has modulus 1. We show that this is also true for #n Ek, where # is a certain differential operator. We then proceed to study logarithms of multiplier...... systems. For automorphic forms wrt. Hecke triangle groups and Fuchsian groups with no elliptic elements and genus 0, we show that some logarithms of multiplier systems can be interpreted as a linking number. Finally we show a "twisted" version of the prime geodesics theorem, and logarithms of multiplier...

  12. Cardiac hydatid cyst revealed by ventricular tachycardia

    OpenAIRE

    Ibn Elhadj, Zied; Boukhris, Marouane; Kammoun, Ikram; Halima, Afef Ben; Addad, Faouzi; Kachboura, Salem

    2013-01-01

    Hydatid disease is a human parasitic infestation caused by the larval stage of Echinococcus Granulosus. The liver and the lungs are the most common locations. Cardiac involvement is rare and accounts for 0.5–2% of all hydatid disease. We report an unusual presentation of cardiac hydatid cyst revealed by ventricular tachycardia in a patient with a history of cerebral hydatid cyst.

  13. Acute cardiac failure in neuroleptic malignant syndrome.

    LENUS (Irish Health Repository)

    Sparrow, Patrick

    2012-02-03

    We present a case of rapid onset acute cardiac failure developing as part of neuroleptic malignant syndrome in a 35-year-old woman following treatment with thioridazine and lithium. Post mortem histology of cardiac and skeletal muscle showed similar changes of focal cellular necrosis and vacuolation suggesting a common disease process.

  14. Cardiac MRI of the athlete's heart

    NARCIS (Netherlands)

    Prakken, N.H.J.

    2010-01-01

    The increase in pre-participation cardiovascular screening using the Lausanne protocol will ultimately lead to an increased use of cardiac MRI and MDCT in the cardiovascular work-up of athletes. The role of cardiac MRI is well established in the evaluation of cardiomyopathies, myocarditis, aortic st

  15. The Western Denmark Cardiac Computed Tomography Registry

    DEFF Research Database (Denmark)

    Nielsen, Lene Hüche; Nørgaard, Bjarne Linde; Tilsted, Hans Henrik;

    2015-01-01

    BACKGROUND: As a subregistry to the Western Denmark Heart Registry (WDHR), the Western Denmark Cardiac Computed Tomography Registry (WDHR-CCTR) is a clinical database established in 2008 to monitor and improve the quality of cardiac computed tomography (CT) in Western Denmark. OBJECTIVE: We...

  16. Fetal cardiac interventions: clinical and experimental research.

    Science.gov (United States)

    Yuan, Shi-Min; Humuruola, Gulimila

    2016-01-01

    Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block. The therapeutic options are advocated as prenatal aortic valvuloplasty, pulmonary valvuloplasty, creation of interatrial communication and fetal cardiac pacing. Experimental research on fetal cardiac intervention involves technical modifications of catheter-based cardiac clinical interventions and open fetal cardiac bypass that cannot be applied in human fetuses for the time being. Clinical fetal cardiac interventions are plausible for midgestation fetuses with the above-mentioned congenital heart defects. The technical success, biventricular outcome and fetal survival are continuously being improved in the conditions of the sophisticated multidisciplinary team, equipment, techniques and postnatal care. Experimental research is laying the foundations and may open new fields for catheter-based clinical techniques. In the present article, the clinical therapeutic options and experimental fetal cardiac interventions are described. PMID:27279868

  17. Is fetal cardiac function gender dependent?

    NARCIS (Netherlands)

    Clur, S. A. B.; Rengerink, K. Oude; Mol, B. W.; Ottenkamp, J.; Bilardo, C. M.

    2011-01-01

    Introduction An increased nuchal translucency (NT) is more common in males. A delayed diastolic cardiac function maturation has been proposed to explain this and the reported gender-related differences in ductus venosus (DV) flow. Objective To investigate gender-related differences in fetal cardiac

  18. Is fetal cardiac function gender dependent?

    NARCIS (Netherlands)

    S.A.B. Clur; K. Oude Rengerink; B.W. Mol; J. Ottenkamp; C.M. Bilardo

    2011-01-01

    An increased nuchal translucency (NT) is more common in males. A delayed diastolic cardiac function maturation has been proposed to explain this and the reported gender-related differences in ductus venosus (DV) flow. To investigate gender-related differences in fetal cardiac function. One hundred a

  19. Preoperative respiratory physical therapy in cardiac surgery

    NARCIS (Netherlands)

    Hulzebos, H.J.

    2006-01-01

    Cardiac surgery is one of the most common surgical procedures and accounts for more resources expended in cardiovascular medicine than any other single procedure. Because cardiac surgery involves sternal incision and cardiopulmonary bypass, patients usually have a restricted respiratory function in

  20. Cardiac Diseases in People with Intellectual Disability

    Science.gov (United States)

    van den Akker, M.; Maaskant, M. A.; van der Meijden, R. J. M.

    2006-01-01

    Background: In people with ID there is more morbidity than in the general population, including cardiac diseases. Dutch figures on this subject are scarce. Methods: Descriptive study of the prevalence of cardiac diseases in 436 residential clients in Echt, the Netherlands, and comparisons between men and women, age groups, and level and aetiology…

  1. Coagulopathy and hemostatic monitoring in cardiac surgery

    DEFF Research Database (Denmark)

    Johansson, Pär I; Sølbeck, Sacha; Genet, Gustav;

    2012-01-01

    Cardiac surgery with cardiopulmonary bypass (CPB) causes severe derangements in the hemostatic system, which in turn puts the patient at risks of microvascular bleeding. Excessive transfusion and surgical re-exploration after cardiac surgery are potentially associated with a number of adverse...

  2. Athletes at Risk for Sudden Cardiac Death

    Science.gov (United States)

    Subasic, Kim

    2010-01-01

    High school athletes represent the largest group of individuals affected by sudden cardiac death, with an estimated incidence of once or twice per week. Structural cardiovascular abnormalities are the most frequent cause of sudden cardiac death. Athletes participating in basketball, football, track, soccer, baseball, and swimming were found to…

  3. CARDIAC SIZE IN THE SUPINE CHESTFILM

    NARCIS (Netherlands)

    VANDERJAGT, EJ; SMITS, HJ

    1992-01-01

    The aim of this study was to find a normal value for the cardiac size in the supine position because such a standard is hardly known in the literature. Cardiac size in the erect and supine positions were compared in 165 patients in whom both chest radiographs were performed prior to kidney transplan

  4. Using the Trajectory Framework: reconceptualizing cardiac illness.

    Science.gov (United States)

    Hawthorne, M H

    1991-01-01

    Cardiac disease is known to be the leading cause of premature morbidity and mortality in the United States. Nursing management of cardiac illnesses, as such, is a primary concern for most practicing nurses. Dramatic changes in cardiac patient populations and associated technology available for treatment indicate a need to reconceptualize the nature of cardiac illness and to consider alternative approaches to guide the care of these patients. Traditional care, to a large degree, has focused upon acute illness, consequently limiting needed attention to the increasing group of patients suffering chronic illness and disability. In the present paper, the major changes in the cardiac patient population and in utilization of available technology are presented. The application of the Corbin and Strauss trajectory framework as an appropriate and useful framework for conceptualizing cardiac illness and care is then discussed. Five characteristics of the framework which render the model particularly well suited to address cardiac care are identified and discussed. These characteristics are: 1) comprehensiveness of care, 2) patient-centered care, 3) gender issues in care, 4) family-focused care, 5) technology and cardiac care. PMID:1763241

  5. Cardiac arrhythmia classification using autoregressive modeling

    OpenAIRE

    Srinivasan Narayanan; Ge Dingfei; Krishnan Shankar M

    2002-01-01

    Abstract Background Computer-assisted arrhythmia recognition is critical for the management of cardiac disorders. Various techniques have been utilized to classify arrhythmias. Generally, these techniques classify two or three arrhythmias or have significantly large processing times. A simpler autoregressive modeling (AR) technique is proposed to classify normal sinus rhythm (NSR) and various cardiac arrhythmias including atrial premature contraction (APC), premature ventricular contraction (...

  6. Conditional shape models for cardiac motion estimation

    DEFF Research Database (Denmark)

    Metz, C.T.; Baka, N.; Kirisli, H.A.;

    2010-01-01

    We propose a conditional statistical shape model to predict patient specific cardiac motion from the 3D end-diastolic CTA scan. The model is built from 4D CTA sequences by combining atlas based segmentation and 4D registration. Cardiac motion estimation is, for example, relevant in the dynamic al...

  7. Drugs, QTc prolongation and sudden cardiac death

    NARCIS (Netherlands)

    S.M.J.M. Straus (Sabine)

    2005-01-01

    textabstract__Abstract__ The term sudden cardiac death pertains to an unexpected death from cardiac causes within a short time period and has been described throughout history. The ancient Egyptians inscribed on the tomb of a nobleman some 4500 years ago that he had died suddenly and without appare

  8. Clinical study of cardiac diseases during pregnancy

    Directory of Open Access Journals (Sweden)

    Amitha Vijay Kamat

    2016-03-01

    Conclusions: Cardiac diseases in pregnancy constitute high risk pregnancy and require special attention during antepartum, intrapartum and postpartum period. Rheumatic heart disease was the major contribution of cardiac diseases in pregnancy and is seen to be associated with increased maternal morbidity. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 855-859

  9. Primary cardiac hemangioendothelioma: a case report

    Institute of Scientific and Technical Information of China (English)

    WANG Li-feng; LIU Ming; ZHU Hong; HAN Wei; HU Cheng-yi; QI Ji-ping; MEI Huan-lin; GE Re-le; ZHOU Min

    2006-01-01

    @@ Primary cardiac hemangioendothelioma is extremely rare.1-3 Up to now less than twenty cases have been reported in English literature, the data about this kind of cardiac tumors are scanty. In this report, a case of a huge hemangio-endothelioma that arose from the right atrium and was successfully resected is presented.

  10. Cardiac manifestations of inborn errors of metabolism.

    NARCIS (Netherlands)

    Evangeliou, A.; Papadopoulou-Legbelou, K.; Daphnis, E.; Ganotakis, E.; Vavouranakis, I.; Michailidou, H.; Hitoglou-Makedou, A.; Nicolaidou, P.; Wevers, R.A.; Varlamis, G.

    2007-01-01

    AIM: The aim of the study was to investigate the frequency and type of cardiac manifestations in a defined group of patients with inborn errors of metabolism. This paper also explores the key role of cardiac manifestations in the diagnosis of inborn errors of metabolism in daily practice. METHODS: O

  11. Ultrasound Imaging in Teaching Cardiac Physiology

    Science.gov (United States)

    Johnson, Christopher D.; Montgomery, Laura E. A.; Quinn, Joe G.; Roe, Sean M.; Stewart, Michael T.; Tansey, Etain A.

    2016-01-01

    This laboratory session provides hands-on experience for students to visualize the beating human heart with ultrasound imaging. Simple views are obtained from which students can directly measure important cardiac dimensions in systole and diastole. This allows students to derive, from first principles, important measures of cardiac function, such…

  12. Stem cell sources for cardiac regeneration

    NARCIS (Netherlands)

    Roccio, M.; Goumans, M. J.; Sluijter, J. P. G.; Doevendans, P. A.

    2008-01-01

    Cell-based cardiac repair has the ambitious aim to replace the malfunctioning cardiac muscle developed after myocardial infarction, with new contractile cardiomyocytes and vessels. Different stem cell populations have been intensively studied in the last decade as a potential source of new cardiomyo

  13. Cardiac Vagal Regulation and Early Peer Status

    Science.gov (United States)

    Graziano, Paulo A.; Keane, Susan P.; Calkins, Susan D.

    2007-01-01

    A sample of 341 5 1/2-year-old children participating in an ongoing longitudinal study was the focus of a study on the relation between cardiac vagal regulation and peer status. To assess cardiac vagal regulation, resting measures of respiratory sinus arrhythmia (RSA) and RSA change (suppression) to 3 cognitively and emotionally challenging tasks…

  14. Cardiac cachexia: hic et nunc

    Science.gov (United States)

    Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram

    2016-01-01

    Abstract Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF. PMID:27386168

  15. Cardiac cachexia: hic et nunc.

    Science.gov (United States)

    Loncar, Goran; Springer, Jochen; Anker, Markus; Doehner, Wolfram; Lainscak, Mitja

    2016-06-01

    Cardiac cachexia (CC) is the clinical entity at the end of the chronic natural course of heart failure (HF). Despite the efforts, even the most recent definition of cardiac cachexia has been challenged, more precisely, the addition of new criteria on top of obligatory weight loss. The pathophysiology of CC is complex and multifactorial. A better understanding of pathophysiological pathways in body wasting will contribute to establish potentially novel treatment strategies. The complex biochemical network related with CC and HF pathophysiology underlines that a single biomarker cannot reflect all of the features of the disease. Biomarkers that could pick up the changes in body composition before they convey into clinical manifestations of CC would be of great importance. The development of preventive and therapeutic strategies against cachexia, sarcopenia, and wasting disorders is perceived as an urgent need by healthcare professionals. The treatment of body wasting remains an unresolved challenge to this day. As CC is a multifactorial disorder, it is unlikely that any single agent will be completely effective in treating this condition. Among all investigated therapeutic strategies, aerobic exercise training in HF patients is the most proved to counteract skeletal muscle wasting and is recommended by treatment guidelines for HF. PMID:27386168

  16. Cardiac involvement in rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    V. De Gennaro Colonna

    2011-06-01

    Full Text Available Rheumatoid arthritis (RA is a systemic disease of unknown etiology characterized by a chronic inflammatory process mainly leading to destruction of synovial membrane of small and major diarthrodial joints. The prevalence of RA within the general adult population is about 1% and female subjects in fertile age result mostly involved. It’s an invalidating disease, associated with changes in life quality and a reduced life expectancy. Moreover, we can observe an increased mortality rate in this population early after the onset of the disease. The mortality excess can be partially due to infective, gastrointestinal, renal or pulmonary complications and malignancy (mainly lung cancer and non- Hodgkin lymphoma. Among extra-articular complications, cardiovascular (CV involvement represents one of the leading causes of morbidity and mortality. Every cardiac structure can be affected by different pathogenic pathways: heart valves, conduction system, myocardium, endocardium, pericardium and coronary arteries. Consequently, different clinical manifestations can be detected, including: pericarditis, myocarditis, myocardial fibrosis, arrhythmias, alterations of conduction system, coronaropathies and ischemic cardiopathy, valvular disease, pulmonary hypertension and heart failure. Considering that early cardiac involvement negatively affects the prognosis, it is mandatory to identify high CV risk RA patients to better define long-term management of this population.

  17. [Technologies for cardiac valve prostheses].

    Science.gov (United States)

    Nakano, Kiyoharu

    2009-07-01

    To show the technological development of cardiac valve prostheses, a historical review of both mechanical and biological valve prostheses and a current overview of modern cardiac valve devices are provided. Scince the 1st implantation of Starr-Edwards ball valve in 1960, both mechanical and biological valve prostheses have advanced. The valve design, the material of the leaflet and the hausing of mechanical prostheses have improved. Currently, the majority of the mechanical prostheses are bileaflet tilting disc valves made of pyrolytic carbon, which is antithromboembolic. However, anticoagulation therapy with warfarin is still required. As for the bioprostheses, although the fixation and anti-mineralization methods of the tissues improved, the durability of these valves is still limited. For the material of the current biological valves, the porcine aortic valve or bovine pericardium are used. The tissues are fixed by non-pressure or low-pressure method in glutaraldehyde solution. A stented and non-stented valves are available. Epoch-making events in this field are the implantation of new bioprosthetic valves using tissue engineering methods and the development of the transcatheter valve replacement therapies.

  18. Cardiac Rehabilitation in Older Adults.

    Science.gov (United States)

    Schopfer, David W; Forman, Daniel E

    2016-09-01

    The biology of aging and the pathophysiology of cardiovascular disease (CVD) overlap, with the effect that CVD is endemic in the growing population of older adults. Moreover, CVD in older adults is usually complicated by age-related complexities, including multimorbidity, polypharmacy, frailty, and other intricacies that add to the risks of ambiguous symptoms, deconditioning, iatrogenesis, falls, disability, and other challenges. Cardiac rehabilitation (CR) is a comprehensive lifestyle program that can have particular benefit for older patients with cardiovascular conditions. Although CR was originally designed primarily as an exercise training program for younger adults after a myocardial infarction or coronary artery bypass surgery, it has evolved as a comprehensive lifestyle program (promoting physical activity as well as education, diet, risk reduction, and adherence) for a broader range of CVD (coronary heart disease, heart failure, and valvular heart disease). It provides a valuable opportunity to address and moderate many of the challenges pertinent for the large and growing population of older adults with CVD. Cardiac rehabilitation promotes physical function (cardiorespiratory fitness as well as strength and balance) that helps overcome disease and deconditioning as well as related vulnerabilities such as disability, frailty, and falls. Similarly, CR facilitates education, monitoring, and guidance to reduce iatrogenesis and promote adherence. Furthermore, CR fosters cognition, socialization, and independence in older patients. Yet despite all its conceptual benefits, CR is significantly underused in older populations. This review discusses benefits and the paradoxical underuse of CR, as well as evolving models of care that may achieve greater application and efficacy. PMID:27297002

  19. Endogenous resident c-Kit cardiac stem cells increase in mice with an exercise-induced, physiologically hypertrophied heart

    Directory of Open Access Journals (Sweden)

    Camila Ferreira Leite

    2015-07-01

    Full Text Available Physical activity evokes well-known adaptations in the cardiovascular system. Although exercise training induces cardiac remodeling, whether multipotent stem cells play a functional role in the hypertrophic process remains unknown. To evaluate this possibility, C57BL/6 mice were subjected to swimming training aimed at achieving cardiac hypertrophy, which was morphologically and electrocardiographically characterized. Subsequently, c-Kit+Lin− and Sca-1+Lin− cardiac stem cells (CSCs were quantified using flow cytometry while cardiac muscle-derived stromal cells (CMSCs, also known as cardiac-derived mesenchymal stem cells were assessed using in vitro colony-forming unit fibroblast assay (CFU-F. Only the number of c-Kit+Lin− cells increased in the hypertrophied heart. To investigate a possible extracardiac origin of these cells, a parabiotic eGFP transgenic/wild-type mouse model was used. The parabiotic pairs were subjected to swimming, and the wild-type heart in particular was tested for eGFP+ stem cells. The results revealed a negligible number of extracardiac stem cells in the heart, allowing us to infer a cardiac origin for the increased amount of detected c-Kit+ cells. In conclusion, the number of resident Sca-1+Lin− cells and CMSCs was not changed, whereas the number of c-Kit+Lin− cells was increased during physiological cardiac hypertrophy. These c-Kit+Lin− CSCs may contribute to the physiological cardiac remodeling that result from exercise training.

  20. Lesion Expansion in Experimental Demyelination Animal Models and Multiple Sclerosis Lesions.

    Science.gov (United States)

    Große-Veldmann, René; Becker, Birte; Amor, Sandra; van der Valk, Paul; Beyer, Cordian; Kipp, Markus

    2016-09-01

    Gray matter pathology is an important aspect of multiple sclerosis (MS) pathogenesis and disease progression. In a recent study, we were able to demonstrate that the higher myelin content in the white matter parts of the brain is an important variable in the neuroinflammatory response during demyelinating events. Whether higher white matter myelination contributes to lesion development and progression is not known. Here, we compared lesion size of intra-cortical vs. white matter MS lesions. Furthermore, dynamics of lesion development was compared in the cuprizone and lysophosphatidylcholine models. We provide clear evidence that in the human brain, white matter lesions are significantly increased in size as compared to intra-cortical gray matter lesions. In addition, studies using the cuprizone mouse model revealed that the autonomous progression of white matter lesions is more severe compared to that in the gray matter. Focal demyelination revealed that the application of equal amounts of lysophosphatidylcholine results in more severe demyelination in the white compared to the gray matter. In summary, lesion progression is most intense in myelin-rich white matter regions, irrespective of the initial lesion trigger mechanism. A better understanding of myelin debris-triggered lesion expansion will pave the way for the development of new protective strategies in the future. PMID:26363796