Atypical Abnormal Pulmonary Vein Drainage with Atrial Septal Defect: Surgical Treatment

Sinus venosus atrial septal defect (SV‐ASD) usually coexists with partial anomalous pulmonary vein connection (PAPVC). It is a difficult diagnosis in transthoracic echocardiography (TTE) due to eccentric position of defects. We present a rare case of atypical anatomical variation in PAPVC, which was never described before. Two right pulmonary veins drained into superior vena cava, which overrode SV‐ASD and interatrial septum, a third pulmonary vein into the right atrium. Complete diagnosis could not be set after TTE, nor transesophageal echocardiography, whereas angio‐CT was finally conclusive. This diagnostic approach allowed the surgical planning.     

A comparative study of angiogenic and cytokine responses after laparoscopic cholecystectomy performed with standard- and low-pressure pneumoperitoneum

Background  Surgical procedures enhance production of pro- and anti-inflammatory cytokines and angiogenic factors that play a pivotal role in the immunological response to surgical trauma and take part in the pathogenesis of tumor growth and adhesions formation. The purpose of the study was to access the influence of low-pressure CO₂ pneumoperitoneum on the inflammatory and angiogenic responses during the postoperative period after laparoscopy. Methods  The study group consisted of 40 patients, operated on due to cholelithiasis using standard-pressure (n = 20) and low-pressure (n = 20) CO₂ pneumoperitoneum. Serum concentration of interleukin (IL)-6, IL-8, IL-10, vascular endothelial growth factor (VEGF)-A, and endostatin were measured before and at 6, 24, and 48 h after surgery with commercially available enzyme-linked immunosorbent assay (ELISA). Results  Concentrations of IL-6 increased significantly after the operations in both groups. No differences were observed between the groups in regards to IL-6, IL-8, and IL-10 levels. Concentrations of VEGF-A measured at 6 and 48 h were significantly lower in patients who underwent laparoscopies performed with low-pressure pneumoperitoneum. No significant variations were observed in endostatin serum concentration. Concentrations of the studied parameters were not influenced by duration of surgery or by age, gender, or body mass index (BMI) of the patients. Conclusions  The results obtained in our study do not show any significant differences between studied operative procedures with regards to systemic inflammatory response. Changes in the concentrations of VEGF-A and endostatin observed in the studied population may suggest this technique is more favorable with regards to angiogenesis process intensity, along with all its consequences and implications.     

Aortic pulse wave velocity and carotid-femoral pulse wave velocity: similarities and discrepancies.

The objectives of this study were to determine the relationship between carotid-femoral (cfPWV) and aortic pulse wave velocity (aPWV) and to compare their modulators and association with coronary artery disease (CAD). We studied 107 consecutive patients (68 men) with a mean age of 60.49+/-8.31 years who had stable angina and had been referred for coronary angiography. cfPWV and aPWV were measured simultaneously during cardiac catheterization using the Complior device and aortic pressure waveform recordings, respectively. Based on the presence or absence of significant coronary artery stenosis (CAS) patients were subdivided into a CAS+ or CAS- group. The mean values of cfPWV and aPWV were 10.65+/-2.29 m/s and 8.78+/-2.24 m/s, respectively. They were significantly higher in the CAS+ (n=71) compared with the CAS- (n=36) group and predicted significant CAS independently of cardiovascular risk factors and mean or systolic aortic blood pressure. aPWV and cfPWV were significantly correlated (r=0.70; p<0.001) but the degree of correlation differed significantly (p<0.03) between the CAS+ (r=0.74, p<0.001) and CAS- group (r=0.46, p=0.003). Age and mean aortic blood pressure were independent predictors for aPWV as well as cfPWV. In the receiver operating characteristic (ROC) analysis, aPWV and cfPWV had similar accuracy in identification of significant CAS (AUC [area under the ROC curve]=0.76 and 0.69, respectively; p=0.13). However, neither cfPWV nor aPWV was effective at differentiating the extent of CAD. In conclusion, aPWV and cfPWV are highly correlated parameters with similar determinants and comparable accuracy in predicting significant CAS. The strength of correlation between these two indices differed significantly between subjects with and those without CAS.     

Arthroscopic verification of meniscus repair]

The purpose of this study was to verify the arthroscopic meniscus repair by second-look arthroscopy. From November 2001 to October 2005, 28 meniscus (18 medial and 10 lateral) were repaired in 26 patients (two patients had both menisci in one knee repaired). There were 11 females and 15 males. The average age at surgery was 25.5 (range, 13 to 52 years of age). The indication for repair was a full-thickness, vertical tear > or = 8 mm. Meniscus repair was combined with partial meniscectomy of posterior horn because of horizontal tear in 3 cases. In 1 zone 14 meniscus were injured and in 2 zone--also 14 meniscus, according to Cooper's classification. All patients had anterior cruciate ligament rupture. The average time interval between the injury and the repair was 22 weeks (range, 2 weeks to 2 years). The inside-out suture was used in 18 repairs, all inside--3 repairs, outside-in--2 repairs and a mixed technique--5 repairs. Arthroscopic evaluation of meniscus repair was performed on average after 15 weeks (range, 2 months to 37 weeks) since the suture. That was done during the second stage of treatment--ACL reconstruction. There were 78.6% of completely healed repairs, 10.7% of incompletely healed and 10.7% were not healed.     

New data on straggled eyeworm <Emphasis Type="Italic">Oxyspirura chabaudi</Emphasis> (Baruš, 1965) (Nematoda,Thelaziidae) in Europe

Three male specimens of the eyeworm, Oxyspirura chabaudi, were found during the post mortem examination of one individual of Turdus merula L. (Passeriformes). This is the first record of Turdus merula as a host for O. chabaudi.     

False positive results of mitochondrial DNA depletion/deletion due to single nucleotide substitutions causing appearance of additional PvuII restriction sites.

Human mitochondrial diseases are usually caused by dysfunction of mitochondrial DNA (mtDNA), particularly by point mutations, deletions, or depletions. In commonly used procedures for molecular diagnostics of mitochondrial dysfunction, one of the first steps is linearization of circular mitochondrial genomes with either BamHI or PvuII restriction endonulease, which cuts human mtDNA at a unique site. Here, we describe a case of false positive results, which suggested mtDNA depletion or a large deletion in a patient's tissue sample. More detailed analysis (mtDNA sequencing) revealed that these false positive results were caused by the presence of the 12753A>G substitution in the gene coding for NADH dehydrogenase subunit 5 (ND5). This substitution results in no change in amino acid sequence of the gene product but creates an additional PvuII site. Investigating a population of 200 patients not affected by mitochondrial diseases, we found an additional case of 12753A>G, and also another substitution, 12804T>C, which also results in no change in amino acid sequence of ND5 but creates an additional PvuII site. A few cases of 12753A>G and 12804T>C substitutions were found previously in Asian, American, African, and European populations (though they were not reported to date in the MITOMAP), but those samples were used in population studies and not tested for mtDNA deletion or depletion. Therefore, we present a cautionary report indicating that these mtDNA polymorphisms exist in various human populations (and thus, they are panethnic) and may cause false positive results of standard molecular analyses, including molecular diagnostics, of human mtDNA.     

Aging of the erythrocyte. X. Immunoelectrophoretic studies on the denaturation of superoxide dismutase

Superoxide dismutase (SOD) content estimated by rocket immunoelectrophoresis did not differ in various density (age) fractions of bovine erythrocytes though its specific activity decreased with increasing cell density. No changes were found, either, in the crossed immunoelectrophoretic pattern of SOD with increasing red cell age. Effects of different denaturing agents on the immunoelectrophoretic pattern and activity of the enzyme were compared, including H₂O₂ and free radicals generated by ionizing radiation. The yield for inactivation was higher than that for loss of antigenic properties in all cases studied which could correspond to the in vivo situation. However, changes in electro-phoretic mobility were revealed for all the denaturing agents, which is contrary to a main causative role of these agents in the in vivo inactivation of SOD. The results suggest spontaneous “subtle denaturation” as a chief cause for the SOD inactivation during erythrocyte aging.