A atrial flutter consisted of two different conduction pathways

Thiazolidinediones (TZDs) represent insulin-sensitizing agents that have several pleiotropic properties, possibly related to their favorable effects on cardiovascular remodeling. We briefly describe 2 diabetic patients who experienced a remarkable improvement in their paroxysmal atrial fibrillation (AF) after treatment with rosiglitazone. Current evidence suggests that atrial remodeling represents a prominent mechanism of AF development and perpetuation while inflammation and oxidative stress are possibly implicated in this process. It could therefore be speculated that the pleiotropic effects of TZDs favorably affect atrial remodeling reducing the arrhythmia burden. Further studies are needed in order to elucidate the merit of this pharmacological approach in AF.     

Application of in Vivo Microdialysis to Transdermal Absorption of Methotrexate in Rats

Microdialysis was applied to determine the in vivo transdermal absorption of methotrexate (MTX) in rats with or without a new penetration enhancer, l-[2-(decylthio)ethyl]azacyclopentan-2-one (HPE-101). A solution composed of 2.5 mM MTX and 3% (w/v) HPE-101 was applied to the shaved abdomen, in which a semipermeable membrane cannula of 10-mm length was inserted intracutaneously with the use of an L-shaped needle. Intradermal microdialysis was performed at a flow rate of 1.0 µL/min for 12 hr. The concentration of MTX in the dialysate was measured by fluorescence polarization immunoassay (FPIA). HPE-101 (3%, w/v) significantly increased the dermal MTX concentration from 0.06±0.04 µM in the control to 56±26 µM in the dialysate from 8 to 12 hr. HPE-101 at concentrations of 0.75, 1.5, 2.25, and 3% (w/v) enhanced the total recovery of MTX in dermal dialysate from 0 to 10 hr by approximately 5, 18, 42, and 500 times compared with the control, respectively. The microdialysis system is useful for assessing in vivo transdermal drug absorption.     

A congenital absence of the pericardium diagnosed by echocardiography

A 29-year-old man visited our office after experiencing palpitations at night. The electrocardiogram revealed premature ventricular contractions (PVCs), and he was admitted to our hospital for further tests. The echocardiography revealed paradoxical motion of the interventricular septum. After considering results from a previous cardiac catheter test, we suspected that the patient may have a congenital absence of the pericardium. A CT scan and magnetic resonance imaging were inconclusive, but through echocardiography and ECG performed during three positional changes we diagnosed a congenital absence of the pericardium.