Differences between perivascular adipose tissue surrounding the heart and the internal mammary artery: possible role for the leptin-inflammation-fibrosis-hypoxia axis.

Aim: The factors mediating the paracrine effects of perivascular adipose tissue (PVAT) in atherosclerosis are largely unknown. The adipokine leptin has been implicated in the increased cardiovascular risk in obesity and may locally promote neointima formation independently of circulating leptin levels. In patients with established coronary artery disease, we examined the expression of leptin as well as of its possible inducers in 'cardiac' PVAT surrounding the aortic root and coronary arteries (C-PVAT), and compared it to the PVAT surrounding the internal mammary artery (IMA-PVAT), a vessel resistant to atherosclerosis.

Autophagy and Bcl-2/BNIP3 death regulatory pathway in non-small cell lung carcinomas.

We recently showed that non-small cell lung carcinomas (NSCLCs) are of dismal prognosis when encompassing accelerated autophagic activity. The regulation of this abnormally functioning degradation system and its association with hypoxia and apoptosis in lung carcinoma patients is unexplored. In this study we used 115 NSCLC tissues to examine the immunohistochemical expression of four distinct molecules - the major regulator of autophagy Beclin 1, the anti-apoptotic and anti-autophagic protein Bcl-2, the pro-apoptotic and pro-autophagic protein BNIP3, and a marker of hypoxia and glucolysis, the glucose transporter Glut 1.

Re-do aortic operation in a young patient for aggressive Takayasu's arteritis.

Takayasu's arteritis is an inflammatory arteriopathy which involves the aorta and its major branches, causing mainly stenosis of their lumen, though aneurysmal lesions can also occur. A young female with Takayasu's disease presented to our hospital with acute lung oedema due to severe aortic insufficiency and ascending aorta dilatation. She had already undergone distal ascending aorta and hemiarch replacement due to Standford type A aortic dissection five years ago.

Adenocarcinoma in pulmonary sequestration.

A 67-year-old male smoker presented with hemoptysis and recurrent pneumonia. Chest computed tomography showed an emphysematous cyst and air-fluid level cavities in the left lower lobe. A left lower lobectomy was performed.

Acute pressure overload of the right ventricle. Comparison of two models of right-left shunt. Pulmonary artery to left atrium and right atrium to left atrium: experimental study.

Background: In right ventricular failure (RVF), an interatrial shunt can relieve symptoms of severe pulmonary hypertension by reducing right ventricular preload and increasing systemic flow. Using a pig model to determine if a pulmonary artery-left atrium shunt (PA-LA) is better than a right atrial-left atrial shunt (RA-LA), we compared the hemodynamic effects and blood gases between the two shunts.

Methods: Thirty, male Large White pigs weighting in average 21.

Endothelial nitric oxide synthase gene polymorphisms -786T > C and 894G > T in coronary artery bypass graft surgery patients.

Polymorphisms in the endothelial nitric oxide synthase ( eNOS ) gene (- 786T > C and 894G > T ) enhance endothelial dysfunction and have been studied in relation to coronary artery disease (CAD). In the present study, we examined the association of the above polymorphisms with CAD, as well as with myocardial infarction (MI), hypertension, diabetes and smoking in CAD patients. Study subjects consisted of 154 consecutive coronary artery bypass graft (CABG) patients and 155 non-CAD controls.

Coronary artery bypass surgery in a patient with Kartagener syndrome: a case report and literature review.

Kartagener syndrome consists of congenital bronchiectasis, sinusitis, and total situs inversus in half of the patients. A patient diagnosed with Kartagener syndrome was referred to our department due to 3-vessel coronary disease. An off-pump coronary artery bypass operation was performed using both internal thoracic arteries and a saphenous vein graft.

One-lung ventilation and HIF1alpha expression in lung cancer and pneumothorax.

Background/aim: A prospective study was designed to investigate the effects of anesthesia, particularly that of the one-lung ventilation procedure (OLV), on the expression of hypoxia-inducible factor 1alpha (HIF1alpha) in patients with lung carcinomas and pneumothorax.

Materials And Methods: The immunohistochemical expression of HIF1alpha was studied in formalin-fixed paraffin-embedded tissues from 60 patients who had undergone thoracic surgery for lung cancer (n=48) or pneumothorax (n=12) under OLV general anesthesia.

Results: There was a significant, and rather unexpected, association of HIF1alpha expression with high body mass index (BMI) (p=0.

Renin-angiotensin-aldosterone system gene polymorphisms in coronary artery bypass graft surgery patients.

Introduction: Candidates for coronary artery bypass grafting (CABG) represent a group of patients with well documented, severe coronary artery disease (CAD). Genetic polymorphisms of renin-angiotensin-aldosterone system (RAAS) components have been associated with CAD. We examined the association of polymorphisms of angiotensin-converting enzyme (ACE), angiotensinogen (AGT), and angiotensin II type 1 receptor (AT(1) receptor) with severe CAD in CABG patients.

Attenuation of propofol tolerance conferred by remifentanil co-administration does not reduce propofol toxicity in rabbits under prolonged mechanical ventilation.

Background: Prolonged sedation with propofol at high doses may lead to fatal multi-organ dysfunction, know as propofol infusion syndrome. We tested the hypothesis that propofol plus remifentanil co-administration attenuates propofol tolerance to its sedative effect and assessed if such an effect has an impact on propofol toxicity in rabbits under prolonged mechanical ventilation.

Materials And Methods: Eighteen healthy male rabbits were mechanically ventilated and received propofol (group P, n = 6), propofol plus remifentanil (group PR, n = 6), or remifentanil plus sevoflurane (group RS, n = 6) in order to be kept under sedation (group P) or sedation/analgesia (groups PR and RS) for up to 48 h.

A rare case of late right ventricular perforation by a passive-fixation permanent pacemaker lead.

The present paper is an interesting and rare complication of implantation of a permanent pacemaker lead. The rarity of the case is based upon that ventricular perforation is usually present during implantation, whereas in our case, it was presented late--1 month after implantation. Furthermore, in our case, the pacemaker lead had migrated through the left hemidiaphragm into the peritoneal cavity.

Catamenial pneumothorax.

Catamenial pneumothorax is a rare entity of spontaneous, recurrent pneumothorax occurring in synchrony with the menstrual cycle. The etiology is not completely known, but in most cases it is associated with thoracic endometriosis and/or diaphragmatic fenestrations. We report a case of a 35-year-old woman with three episodes of catamenial pneumothorax.

Elective bridging to recovery after repair: the surgical approach to ventricular reverse remodeling.

We described our "surgical approach to reverse ventricular remodeling" in advanced chronic heart failure, based on the unique idea that "downstaging" class IV heart failure by supporting patients with left ventricular assist devices (LVADs) allows treatments mainly indicated for class III patients. The types of surgeries include mitral valve repair, surgical ventricular remodeling, coronary artery bypass grafting, and cardiac resynchronization. This approach has been applied to two patients with class IV chronic heart failure due to idiopathic dilated cardiomyopathy who were supported with the magnetically levitated Levacor LVAD.

Surgical treatment of pulmonary aspergillosis/mycosis in immunocompromised patients.

Invasive pulmonary aspergillosis is a severe complication in immunosuppressed patients. Surgical resection can be curative in certain patients after antifungal treatment. Over a 7-year period, ten patients with suspected invasive pulmonary aspergillosis of two university hospitals were retrospectively reviewed.

The -759C/T polymorphism of the 5-HT2C receptor is associated with type 2 diabetes in male and female Caucasians.

Objectives: Type 2 diabetes mellitus and obesity constitute serious health problems. Studies reveal that the 5-HT2C receptor contributes substantially to the regulation of a wide variety of behavioral and physiological processes including feeding and glucose homeostasis. Our aim was to determine the possible association of the -759C/T polymorphism of the 5-HT2C receptor gene with type 2 diabetes and obesity in male and female individuals Caucasian origin.

Expression of prolyl-hydroxylases PHD-1, 2 and 3 and of the asparagine hydroxylase FIH in non-small cell lung cancer relates to an activated HIF pathway.

The oxygen sensitive prolyl-hydroxylase domain enzymes (PHDs) and the asparagines hydroxylase (FIH, factor inhibiting HIF) regulate the transcriptional activity of HIFs. We assessed the expression of these enzymes in a series of 73 non-small cell lung carcinomas (NSCLC). A direct association of PHDs with FIH and of the PHDs/FIH with HIFs expression was noted.

Feasibility study of a temporary percutaneous left ventricular assist device in cardiac surgery.

Background: The aim of this study is to evaluate a percutaneous left ventricular assist device (Tandem Heart pVAD; Cardiac Assist, Pittsburgh, Pennsylvania) in the postcardiotomy setting.

Methods: Between August 2001 and August 2004, 11 high-risk male patients who had undergone heart failure surgery or surgical revascularization were supported by the TandemHeart postcardiotomy. The major indication for pVAD insertion was failure to wean from cardiopulmonary bypass.

Hypofractionated accelerated radiochemotherapy with cytoprotection (Chemo-HypoARC) for inoperable non-small cell lung carcinoma.

Background: Concurrent radiochemotherapy and altered radiotherapy fractionation are under thorough investigation in locally advanced non-small cell lung carcinoma (NSCLC).

Patients And Methods: The efficacy and tolerance of hypofractionated accelerated radiochemotherapy supported with high dose (up to 1000 mg daily) amifostine cytoprotection (hypoARC) was examined in 31 patients. Fifteen fractions of 3.

Lung cancer: a comparative study of metabolism related protein expression in cancer cells and tumor associated stroma.

Immunohistochemical evaluation of lung carcinomas for key enzymes involved in cellular metabolism (lactate dehydrogenase LDH 1 and 5, pyruvate dehydrogenase PDH, pyruvate dehydrogenase kinase PDHK-1, monocarboxylate transporters MCT 1, 2 and 4, glucose transporter GLUT1, hypoxia inducible factors HIF1alpha and 2alpha) show a complementary metabolic profile between cancer cells and tumor-associated stroma. Cancer cells share enzyme/transporter activities suggestive of an anaerobic metabolism with high affinity for glucose absorption, anaerobic glycolysis and lactate extrusion. On the other hand, the tumour-associated fibroblasts express patterns involved in aerobic pathways and lactate oxidation.

Internal thoracic artery side branch ligation for post coronary surgery ischemia.

Two cases of internal thoracic artery side-branch ligation in patients with recurrent angina after coronary bypass are reported with long-term follow-up. Ligation was performed with clips via a left thoracotomy. Treadmill stress testing after 3 and 4 years did not provoke any myocardial ischemia.

Angiogenic growth factors in the treatment of peripheral arterial disease.

Peripheral arterial disease (PAD) remains a major cause of morbidity. Despite advances in revascularisation procedures and medical treatment, limb salvage and relief of pain are still not satisfactory in patients with severe disease. This has prompted the exploration of alternative modes of treatment including enhancement of new vessel formation (angiogenesis).

Organ toxicity and mortality in propofol-sedated rabbits under prolonged mechanical ventilation.

Background: Prolonged administration of propofol at large doses has been implicated in propofol infusion syndrome in intensive care unit patients. In this study we investigated organ toxicity and mortality of propofol sedation at large doses in prolonged mechanically ventilated rabbits and determined the role of propofol's lipid vehicle.

Methods: Eighteen healthy male rabbits were endotracheally intubated and sedated with propofol 2% (Group P), sevoflurane (Group S) or sevoflurane while receiving Intralipid 10% (Group SI).

Lower extremity compartment sindrome following coronary artery bypass.

Compartment syndrome is a constellation of symptoms and signs associated with abnormally elevated tissue pressure in the skeletal muscle of the extremities. It is manifested in anatomic locations where muscles are enveloped in fasciae. The case of a lower extremity compartment syndrome in a 71-year-old male patient who underwent coronary artery bypass grafting (CABG) and simultaneous aortic valve surgery is reported.

Intramyocardial injection of low-dose basic fibroblast growth factor or vascular endothelial growth factor induces angiogenesis in the infarcted rabbit myocardium.

Background: Myocardial angiogenesis after the systemic administration of basic fibroblast growth factor or vascular endothelial growth factor at high therapeutic doses has been implicated in the occurrence of side effects that may undermine their safety. The aim of this study was to investigate the angiogenic effects of the intramyocardial administration of recombinant human basic fibroblast growth factor or vascular endothelial growth factor protein, at low doses, in the infarcted rabbit myocardium.

Methods And Results: Twenty-five New Zealand White rabbits were divided into five groups (n=5) and subjected to coronary artery ligation after lateral thoracotomy, inducing acute myocardial infarction.

First human implantation of a new rotary blood pump: design of the clinical feasibility study.

Surgical treatment of heart failure is emerging as one of the most challenging clinical dilemmas for patients with end-stage cardiac failure not amenable to medical treatment. One of the most intriguing techniques is the use of implantable left ventricular assist devices (LVADs) as a bridge to recovery. The early experience from our centre has shown that even short term post-cardiotomy mechanical assistance, after heart failure surgery, improves patient outcome; thus, a clinical feasibility study was designed.