[Diagnostic difficulties and therapeutic options of a giant chest paraganglioma].

Paragangliomas are mostly benign tumors originating from the sympathetic or parasympathetic ganglions, but malignant forms are also known. They are in the region of the head and neck, in the glomus caroticum, intra-abdominally as well as in the thorax. The investigation of the 39-year-old male patient began due to extremely high blood pressure, night sweats and a 10 kg weight loss.

[Analysis of telemetry, on-line and non-telemetry data for characterization of the physical activity of patients with heart failure].

Introduction: Several studies have demonstrated that the prevalence of heart disease can be accounted for between 0.4 and 2% in developed countries.

Aim: The present study aimed to use the PA% of the telemetry data to estimate the 6-minute walk test result.

Monitoring urinary orosomucoid in patients undergoing cardiac surgery: A promising novel inflammatory marker.

Background: Urinary biomarkers might provide non-invasive tool for monitoring of systemic processes. We aimed to investigate the time-course of urinary orosomucoid (u-ORM) excretion after cardiac surgery hypothesizing that u-ORM is an early and sensitive marker of systemic inflammatory activation.

Methods: During a 5-day follow-up study we monitored u-ORM levels in cardiovascular patients who underwent on-pump cardiac surgery (n=38).

[Telemetry data based on comparative study of physical activity in patients with resynchronization device].

Introduction: The effect of regular physical activity on health is widely recognized, but several studies have shown its key importance for heart patients.

Aim: The present study aimed to define the PA % values, and to convert them into metabolic equivalent values (MET), which describes oxygen consumption during physical activity.

Method: A total of seventeen patients with heart disease; 3 females and 14 males; age: 57.

Incisional negative pressure wound therapy in reconstructive surgery of poststernotomy mediastinitis.

The efficacy of negative pressure wound therapy in the treatment of poststernotomy mediastinitis has been revealed in many reports. The present retrospective observational study examined the efficacy of incisional negative pressure wound therapy in the reconstructive surgery of poststernotomy mediastinitis. We retrospectively examined 1034 consecutive patients, who underwent median sternotomy in the period between October 2013 and September 2015.

Pericardial fluid of cardiac patients elicits arterial constriction: role of endothelin-1.

Recently, several vasoactive molecules have been found in pericardial fluid (PF). Thus, we hypothesized that in coronary artery disease due to ischemia or ischemia-reperfusion, the level of vasoconstrictors, mainly endothelin-1 (ET-1), increases in PF, which can increase the vasomotor tone of arteries. Experiments were performed using an isometric myograph.

Elevated Levels of Asymmetric Dimethylarginine (ADMA) in the Pericardial Fluid of Cardiac Patients Correlate with Cardiac Hypertrophy.

Background: Pericardial fluid (PF) contains several biologically active substances, which may provide information regarding the cardiac conditions. Nitric oxide (NO) has been implicated in cardiac remodeling. We hypothesized that L-arginine (L-Arg) precursor of NO-synthase (NOS) and asymmetric dimethylarginine (ADMA), an inhibitor of NOS, are present in PF of cardiac patients and their altered levels may contribute to altered cardiac morphology.

Short-term response of metabolic hormones to coronary artery bypass surgery.

Purpose: To explore the response pattern of plasma adipokine and ghrelin levels to coronary artery bypass graft (CABG) surgery in patients with (on-pump) and without (off-pump) cardiopulmonary bypass (CPB).

Material/methods: Sixteen consecutive patients (age: 62 ± 10 years, male: 10) with obstructive coronary artery disease (CAD) who underwent elective CABG surgery with CPB and intraoperative GIK infusion were selected for on-pump group and 19 CAD patients (age: 63 ± 10 years, male: 16) were included in the off-pump group. Blood samples were taken before, during and after surgery.

Polymorphisms in glutathione S-transferase are risk factors for perioperative acute myocardial infarction after cardiac surgery: a preliminary study.

In the present study we explored glutathione S-transferase (GST) polymorphisms in selected patients who experienced accelerated myocardial injury following open heart surgery and compared these to a control group of patients without postoperative complications. 758 Patients were enrolled from which 132 patients were selected to genotype analysis according to exclusion criteria. Patients were divided into the following groups: Group I: control patients (n = 78) without and Group II.

The assessment of neural injury following open heart surgery by physiological tremor analysis.

Introduction: The appearance of post-operative cognitive dysfunction as a result of open heart surgery has been proven by several studies. Focal and/or sporadic neuron damage emerging in the central nervous system may not only appear as cognitive dysfunction, but might strongly influence features of physiological tremor.

Material And Methods: We investigated 110 patients (age: 34-73 years; 76 male, 34 female; 51 coronary artery bypass grafting (CABG), 25 valve replacement, 25 combined open heart surgery, 9 off-pump CABG) before surgery and after open-heart surgery on the 3(rd) to 5(th) post-operative day.

Heart rate asymmetry follows the inspiration/expiration ratio in healthy volunteers.

Heart rate asymmetry (HRA) quantifies the uneven distribution of points above and below the identity-line in a Poincaré plot of RR-intervals. The authors investigated if HRA could be influenced by the inspiration/expiration ratio. Healthy volunteers (n = 18) were studied in the supine position at 4.

Early post-operative thrombosis of the prosthetic mitral valve in patient with heparin-induced thrombocytopenia.

Heparin-induced thrombocytopenia (HIT) is one of the most common immune-mediated adverse drug reactions, with frequencies as high as 2-3% for certain groups of post-cardiac surgery patients. We report on an 50-year-old woman with early post-operative thrombosis of the prosthetic mitral valve due to heparin-induced thrombocytopenia. Non-invasive imaging (two-dimensional transesophageal echocardiography; 2D-TEE) allowed the exact localisation of thrombotic masses and revealed the increase of the mean diastolic mitral gradient.

Ectopic pancreas tissue appearing in a mediastinal cyst.

Heterotopia of pancreatic tissue is a common developmental anomaly. Although ectopic pancreatic tissue is mostly found in the gastrointestinal tract, localization in the mediastinum is extremely rare. We report a 32-year-old male patient who had an urgent thoracotomy two years ago due to a thoracic surgery.

The effect of clopidogrel besylate and clopidogrel hydrogensulfate on platelet aggregation in patients with coronary artery disease: a retrospective study.

Background: Recently several alternative forms of the original clopidogrel hydrogensulfate (CHS) were spread worldwide. A large amount of such drugs turned out to be clopidogrel besylate (CB). Only three studies, involving healthy volunteers, investigated the antiplatelet effect of CB, whereas its attribute remained unexplored in the case of patients with cardiovascular diseases.

Effects of coronary revascularization with or without cardiopulmonary bypass on plasma levels of asymmetric dimethylarginine.

Objectives: We measured and compared serum asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in patients undergoing coronary artery revascularization.

Methods: Two groups of patients with coronary artery disease were subjected to coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB; n = 20) or with off-pump CABG surgery (OPCABG; n = 21). Blood samples for measurements of ADMA, SDMA, and L-arginine were withdrawn and determined by liquid chromatography-tandem mass spectrometry from the coronary sinus (CS) and from the peripheral vein.

Effects of stent implementation on plasma levels of asymmetric dimethylarginine in patients with or without ST-segment elevation acute myocardial infarction.

The study was designed to compare the response pattern of plasma l-arginine and methylarginines to stent placement in patients with or without ST segment elevation myocardial infarction (STEMI). Two groups of patients with obstructive coronary artery disease (OCAD) undergoing percutaneous coronary intervention (PCI) with stenting were enrolled in the study. Group I consisted of 16 patients with STEMI, whereas group II included 24 patients without STEMI (controls).

Pharmacotechnological pitfalls of priming--possible source of microembolization during open heart surgery.

Objectives: Besides low mortality and morbidity rates in cardiac surgery, the associated cognitive dysfunction is the focus of interest. One possible reason is microembolisation.

Methods And Results: The authors analysed the crystallogenesis in the calcium-containing prime, inspired by their observation that the fluid sometimes becomes turbid during the priming process.

[Vena cava superior syndrome: surgical treatment of the thrombosis of the superior vena cava after implantation of a hemodialysis catheter--a case report and review of the literature].

One of the rare reasons of the non malignant superior vena cava syndrome is the thrombosis of superior vena cava. Obstruction or occlusion of central veins is one of the many complications of the more and more frequently used central venous catheters and pacemaker electrodes. The authors report a case of superior vena cava thrombosis resulting in dialysis catheter insufficiency in case of a young, uraemic, female patient wit Tesio catheter and the surgical treatment of it with the use of cardiopulmonary bypass during the operation.

Magnetic resonance studies in management of adult cases with Bland-White-Garland syndrome.

Bland-White-Garland syndrome (BWG) is a rare congenital anomaly that is predominantly discovered in infancy. BWG is characterized by an anomalous origin of the left coronary trunk from the pulmonary artery that produces a coronary steal phenomenon, left-to-right shunt, and thus an abnormal left ventricular perfusion. The latter may induce myocardial necrosis, left ventricular dysfunction and commonly associated with mitral regurgitation.