Giant pericardial cyst with a growing feature

Pericardial cysts are rare and benign lesions of the heart. They are usually asymptomatic and diagnosed incidentally on echocardiography or chest X-ray. In this report, we present an extremely rare case of a symptomatic giant pericardial cyst (11.6 cm × 10.6 cm × 8 cm) of a 55-year-old male patient who was admitted to our cardiology clinic. A thoracic computed tomography (CT) in 2013 revealed a giant pericardial cyst. However, at that time, the patient was asymptomatic and follow-up was recommended. Recent thoracic CT and magnetic resonance imaging demonstrated a significantly growing feature of this cyst with impending possible complications.

Plasminogen activator inhibitor-1 levels in patients with primary varicose vein

AIM

Plasmin is involved in extracellular matrix remodeling by activating some matrix metallo-proteinases and degrading extracellular matrix; therefore component of fibrinolytic system such as tissue plasminogen activator and plasminogen activators inhibitors (PAI-1) might have a role in the pathogenesis of vascular remodeling. In our study we aimed to investigate the levels of PAI-1 levels in patients with primary varicose veins (VV) and in their age and gender matched control group.

METHODS

Forty-one consecutive patients with peripheral varicose veins and 37 healthy age and gender-matched control subjects were included in the study from the outpatient cardiology and cardiovascular surgery clinic. Study population consisted of 41 consecutive patients who met the inclusion criteria and diagnosed as having class II primary VV according to CEAP classification. Routine biochemical and hematological analysis were performed in all patients and control subjects.

RESULTS

Plasma levels of PAI-1 were found to be lower in patients than those in control subjects (5.19±2.2 ng/mL vs. 6.47±2.6 ng/mL, P=0.025). Logistic regression analysis revealed that only the plasma levels of PAI-1 were found to be independently but inversely associated with the presence of primary VVs (Odds ratio: 0.80 CI: 0.64-0.99, P=0.04).

CONCLUSION

We have shown that PAI-1 levels are significantly decreased in patients with pVVs and it has an independent association with the presence of pVVs. However, its exact relation and role via matrix metlalloproteinases on the pathogenesis of the disease remains to be elucidated in further studies.

Radiofrequency catheter ablation treatment of a child with dilated cardiomyopathy secondary to chronic ectopic atrial tachycardia

Ectopic atrial tachycardia (EAT) is a rare but reversible cause of dilated cardiomyopathy (DCMP). The diagnosis and the definite control of the arrhythmia are essential for the regression of DCMP. Unfortunately, conventional antiarrhythmic drugs usually fail to control the arrhythmia, and the results of surgery or direct current ablation are suboptimal. Recently, radiofrequency (RF) catheter ablation has been evolving as a safe and effective therapy for EAT. This report describes the RF ablation treatment of a 14-year-old boy with DCMP secondary to chronic EAT. Activation mapping was used for the purpose of identifying the focus origin located just anterior to the coronary sinus os. RF energy applied at this focus successfully terminated the tachycardia. No complications related to the procedure were observed. RF ablation not only caused elimination of the EAT but also led to improvement in left ventricular function as early as two weeks after the procedure, and complete resolution of DCMP in three months.

[The effect of aminoglycosides on the serum magnesium level]

In this study we investigated that the effect of aminoglycoside on the serum magnesium level. Therefore 3 mg/kg/day gentamicin was given during 10 days. Serum and urine magnesium levels were studied with the method of Titan yellow. 60 per of the patients were women and 40 per were men. Their ages were between 20 and 82. We observed that serum magnesium level began to fall down from the early period of our study. Serum magnesium level was found explicitly lower before the treatment. At the end of the treatment discharge of magnesium with urine found higher than the initial valve. We didn't observe the symptoms of hypomagnesemia in any of the patients. We thought that hypomagnesemia developed in the patients who were given aminoglycoside as a result of increasing magnesium lost. While the lowest effective dose is applied, it ran not reach the level of giving hypomagnesemia symptom but while aminoglycoside is applied on the patients under risk. We agree that developing of symptoms belonging to hypomagnesemia should not be ignored and if possible the level of serum magnesium should be checked.