Radiofrequency Catheter Ablation Using Non-Contact Mapping for Inappropriate Sinus Tachycardia

INTRODUCTION: In this report we describe our experience using non-contact mapping for radiofrequency ablation in patients with inappropriate sinus tachycardia. METHODS AND RESULTS: Two female patients with persistent complaints of palpitations and documented inappropriate sinus tachycardia with failed medical management underwent radiofrequency ablation using non-contact mapping. Non-contact mapping provided a continuous determination of the site of earliest breakthrough, facilitating the delivery and the assessment of the results of each radiofrequency application. CONCLUSION: Non-contact mapping is an effective mapping modality in the interventional treatment of inappropriate sinus tachycardia.     

Phytotherapeutic Activity of Euphorbia Cyparissias Extracts on Ixodidae (Acari) Female Ticks

Background

Given its numerous biologically active components, Euphorbiaceae has been found to be a large plant family and polyvalent with quite interesting therapeutic activity that can be studied.

Materials and Methods

The ixodicidal activity of Euphorbia cyparissias extracts was studied in vitro and in vivo. Tested concentrations were 10, 5, 2, 1, 0.5 and 0.25%.

Results

For the in vitro study, conducted on field-collected female specimens of Dermacentor marginatus and Haemaphysalis punctata, the efficacy results showed that the ticks died after exposure in the case of 10, 5, and 2% tincture concentrations. The effects appeared after 30 minutes and became more visible 120 minutes after each exposure. The statistical differences regarding the used concentrations were found to be: F = 6.51, df = 5, P < 0.001. The in vivo study of the efficacy of E. cyparissias concentrations was performed on 35 naturally infested sheep and on 30 bovines parasitized with Ixodes ricinus, sprayed with tincture and glycerinate dilutions (bovines) on days 0 and 7. The results revealed detrimental effects on the survivability of female ticks, the most prominent being the reduction of their movement capacity. In sheep in vivo efficiency observed within 24 hrs varied, between 1 and 23% for D. marginatus and between 7 and 27% for H. punctata and respectively between 2 and 53% after 24 hrs, for I. ricinus, comparable effects being also found 72 hrs after the second administration of Euphorbia extracts.

Conclusion

Extracts from E. cyparissias may be used, with results, as an ecologic alternative tick control management method, being a cheap solution, with a sizeable role in reducing the use of synthetic and/or other harming and resistance source ixodicidal conditionings.     

Clinical and pathological characteristics,pathological reevaluation and recurrence patterns of cellular leiomyomas: a retrospective study in 76 patients

Objectives

To analyze clinical and pathologic features as well as recurrence patterns of cellular leiomyomas (CL) in women who underwent surgical therapy for symptomatic disease.

Study design

This retrospective study was conducted at the Department of Obstetrics and Gynecology, University Women's Clinic, Tuebingen, Germany. We identified all women who had CL on final diagnosis after surgery between January 1, 2000, and December 31, 2010.

Results

Our study sample comprised 76 women with a diagnosis of CL. A single uterine mass was present in 51.3% of the cases; in uteri with both CL and uterine leiomyomas (UL), the CL constituted the largest uterine mass in 20 of 21 (95.2%) cases. Additionally, in 98% of the uteri, CL were either the largest or the only uterine mass. Five women (6.6%; 5/76) had reported surgical procedures for symptomatic leiomyoma before the index surgery in our analysis. Three women underwent hysteroscopic resection of the leiomyomas and 2 women underwent abdominal myomectomy. Mean time to recurrence was 14.0 months (median 6.0; range, 4.0–52.0). Over the follow-up period, 6 women who underwent uterus-conserving surgery (12.0%; 6/50) with CL had leiomyoma recurrence. Five women underwent abdominal myomectomy and one underwent hysteroscopic resection of the CL. One patient had recurrence of a CL 43 months after abdominal myomectomy and underwent vaginal hysterectomy; the other five women had recurrences of UL. Mean time to recurrence was 28.6 months (median 12.5; range, 4.0–83.0).

Conclusions

Recurrence rates of CL in our study group resemble recurrence rates of UL.     

Presence of disseminated tumor cells in bone marrow correlates with tumor stage and nodal involvement in cervical cancer patients

Detection of disseminated tumor cells (DTCs) in the bone marrow (BM) of breast cancer patients is associated with poor outcome. The aim of our study was to evaluate the impact of BM status on survival in a large cohort of cervical cancer patients. Three hundred twenty‐five patients with cervical cancer were included into this prospective two‐center study (University Hospitals Tuebingen, Munich, Germany). BM was collected preoperatively. DTCs were identified by immunocytochemistry using the pancytokeratin antibody A45B/B3. DTCs were detected in 22% of all BM aspirates. The number of CK‐positive cells ranged from 1 to 93 per 2 × 10⁶ mononuclear cells. Eighteen percent of patients with T1 stage presented with DTCs in BM compared to 30% in T2 and 45% in T3/4 patients. Among nodal negative patients, 18% had tumor cells in BM compared to 32% of nodal positive patients. Positive DTC status was associated with tumor size (p = 0.007) and nodal status (p = 0.009) but not with grading (p = 0.426). DTC status did not correlate with overall or disease‐free survival. In the univariate analysis, tumor stage, nodal status, resection status and grading correlated with OS and DFS. In the multivariate analysis, only tumor stage and nodal status were independent predictors of OS and tumor stage, nodal status and grading of DFS. Tumor cell dissemination into BM is thus a common phenomenon in cervical cancer and correlates with higher tumor load but lacks prognostic relevance. Alternative detection methods may be needed to establish prognostic potential.