Primary cardiac hydatid cyst presenting as noncompaction cardiomyopathy

We report a case of cyst was initially labeled as left ventricular noncompaction cardiomyopathy. An accurate diagnosis is essential to establish the most effective treatment strategy. In particular, echocardiographic examination assists in identifying the correct diagnosis. In this case, two‐dimensional and three‐dimensional echocardiography and computed tomography were used for definitive diagnosis of cardiac hydatid cyst.     

Vaginal removal of prolapsed pedunculated submucosal myoma during pregnancy

Pedunculated submucosal myomas are generally associated with infertility and are most often encountered during the preconception period. This report describes a 38-y-old pregnant woman in whom a pedunculated submucosal myoma resulted in preterm labor and was successfully removed vaginally at 26 wk gestation. The procedure described here is simple and quick and can be performed during pregnancy, if necessary.     

Epicardial Adipose Tissue Thickness Is an Independent Predictor of Critical and Complex Coronary Artery Disease by Gensini and Syntax Scores

Epicardial adipose tissue thickness is associated with the severity and extent of atherosclerotic coronary artery disease. We prospectively investigated whether epicardial adipose tissue thickness is related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and whether the thickness predicts critical disease.After performing coronary angiography in 183 patients who had angina or acute myocardial infarction, we divided them into 3 groups: normal coronary arteries, noncritical disease (≥1 coronary lesion with <70% stenosis), and critical disease (≥1 coronary lesion with <70% stenosis). We used transthoracic echocardiography to measure epicardial adipose tissue thickness, then calculated Gensini and Syntax scores by reviewing the angiograms.Mean thicknesses were 4.3 ± 0.9, 5.2 ± 1.5, and 7.5 ± 1.9 mm in patients with normal coronary arteries, noncritical disease, and critical disease, respectively (P <0.001). At progressive thicknesses (<5, 5–7, and >7 mm), mean Gensini scores were 4.1 ± 5.5, 19.8 ± 15.6, and 64.9 ± 32.4, and mean Syntax scores were 4.7 ± 5.9, 16.6 ± 8.5, and 31.7 ± 8.7, respectively (both P <0.001). Thickness had strong and positive correlations with both scores (Gensini, r =0.82, P <0.001; and Syntax, r =0.825, P <0.001). The cutoff thickness value to predict critical disease was 5.75 mm (area under the curve, 0.875; 95% confidence interval, 0.825–0.926; P <0.001).Epicardial adipose tissue thickness is independently related to coronary artery disease extent and complexity as denoted by Gensini and Syntax scores, and it predicts critical coronary artery disease.     

Bone mineral density is not related to severity of osteoarthritis in the knee in postmenopausal women

Although some studies have suggested that osteoporosis and osteoarthritis are inversely related in epidemiologic terms, a spectrum of relations between the two diseases has been described in this study. In 95 postmenopausal women (mean age 64.4 ± 8.49 years, range 49–83 years), we investigated the relation between bone mineral density (BMD) in the femoral neck and lumbar vertebrae (L2–L4) and osteoarthritis in the knee. BMD was measured with dual X-ray absorptiometry. Osteoarthritis was evaluated with anterior–posterior weight-bearing radiographs with the knee in extension, and these were graded for severity on a 5-point scale according to the Kellgren–Lawrence criteria. We found no clear statistical relation between BMD in the femoral neck or lumbar vertebrae and osteoarthritis in the knee. Given that some studies have found BMD to be significantly higher in patients with osteoarthritis, the lack of such relation in our patients may be due to environmental and/or genetic factors.