An antibody of TNF-alpha did not prevent thioacetamide-induced hepatotoxicity in rats.

Tumor necrosis factor (TNF)-α antibodies have been shown to reduce liver damage in different models. We investigated the effects of infliximab (a TNF-α antibody) on liver damage in thioacetamide (TAA)-induced hepatotoxicity in rats. Group 1 (n = 8) was the control group. In group 2 (n = 8), the TAA group, the rats received 300 mg/kg intraperitoneal (ip) TAA daily for 2 days. In group 3 (n = 8), the TAA + Infliximab (INF) group, infliximab (5 mg/kg ip daily) was administered 48 hours before the first dose of TAA daily for 2 days and was maintained for 4 consecutive days. In group 4 (n = 8), the INF group, the rats received only ip infliximab (5 mg/kg) daily. Livers were excised for histopathological and biochemical tests (thiobarbituric-acid-reactive substances [TBARS], and myeloperoxidase [MPO]). Serum ammonia, aspartate transaminase (AST), alanine transaminase (ALT), TNF-α, liver TBARS and MPO levels, and liver necrosis and inflammation scores in the TAA group were significantly higher than in the control and INF groups (all p < 0.01). All parameters except AST were not significantly different between TAA and TAA + INF. In conclusion, our results suggest that oxidative stress plays an important role in TAA-induced hepatotoxicity, and infliximab does not improve oxidative liver damage.

Rapid normalization of a highly thickened pericardium by chemotherapy in a patient with T-cell acute lymphoblastic lymphoma.

The most common tumor that affects the pericardium is malign lymphoma. T-cell lymphoblastic lymphoma (TLL) is a rare type of malign lymphomas. In this manuscript, we are reporting a patient with TLL with pericardial involvement diagnosed incidentally during the evaluation of pleural effusion. Echocardiographic examination showed thickened pericardium and pericardial effusion. The pericardial thickness was found to be 13 mm by computerized tomography and confirmed by echocardiography. The patient had systemic chemotherapy for TLL. On day 30 of chemotherapy, computerized tomography of the thorax and echocardiographic examination revealed normal pericardial thickness and minimal pericardial effusion.

Prognostic significance of ischemia-modified albumin in patients with acute coronary syndrome.

To improve prognosis in acute coronary syndrome, new clinical applications in terms of diagnosis, risk stratification, and treatment strategies are still under investigation. Ischemia-modified albumin was one of the novel markers of myocardial ischemia. In our study, we aimed to determine the prognostic significance of the albumin cobalt binding capacity test in patients with acute coronary syndromes. We compared the ischemia-modified albumin levels of patients with acute coronary syndrome with those of patients with stable coronary artery disease and those of normal individuals and found them to be significantly higher in the first group (P<0.05). A cutoff value of ischemia-modified albumin of 477 U/ml was found by using receiver operating characteristic curve analysis. Mortality in groups of patients whose ischemia-modified albumin levels were above 477 U (50%) was found to be significantly higher than in those whose levels were below 477 U (8.3%) (P<0.05). The sensitivity and specificity of the cutoff value, 477 U/ml, for the 1-year mortality were found to be 70 and 82%, respectively. Using the Cox regression model the relation of albumin cobalt binding capacity test results with mortality was statistically significant (beta=1.013, confidence interval 95%, P=0.01) and independent of the existence of hypertension, diabetes, and advanced age. In conclusion, ischemia-modified albumin was found to be significantly related to 1-year mortality. Prognostic significance of ischemia-modified albumin should be evaluated in large populated and randomized study groups. Afterwards, ischemia-modified albumin could be used in risk stratification modality in patients with acute coronary syndrome.

Abnormal elastic properties of the aorta in the mitral valve prolapse syndrome.

BACKGROUND: Mitral valve prolapse (MVP) is the most common valvular heart disease representing a generalized disease of connective tissue in the primary form. Elastic properties of the aorta with primary MVP may be expected to be increased. We aimed to determine the aortic elasticity in the primary form of MVP. METHODS AND RESULTS: Twenty male patients with a primary form of MVP not having any sign of Marfan syndrome and joint hyperlaxity syndrome and twenty healthy individuals were included in the study. Aortic strain, aortic distensibility index and aortic stiffness index were calculated by using aortic diameters obtained by echocardiography and blood pressures measured by sphygmomanometer. When comparing the MVP group and the control group it was found that the aortic stiffness index was increased (P < 0.05) whereas the aortic distensibility and strain index were decreased (P < 0.05) in the MVP group. There was no significant difference between the characteristics of the groups (P > 0.05). CONCLUSION: We concluded that the elastic properties of the aorta were decreased in the primary form of MVP, unexpectedly.Therefore, results of decreased aortic elasticity should also be followed up in patients with MVP.

Relationship between P-wave dispersion and effective hemodialysis in chronic hemodialysis patients.

OBJECTIVE: To investigate whether or not P-wave dispersion (PWD) can be used as a good indicator of effective hemodialysis. SUBJECTS AND METHODS: The study included 35 patients (20 males, 15 females, mean age 61 +/- 10 years) who regularly received hemodialysis treatment for chronic renal failure. Following hemodialysis, the patients whose hemodynamic parameters were preserved and who reached dry body weight were included. Twelve-lead resting electrocardiogram (ECG) at a speed of 25-50 mm/s, the value of total body fluid (TBF) and bioelectric impedance using bipedal bioelectric impedance equipment were obtained before and immediately after hemodialysis. Blood samples were also taken for the assessment of blood electrolytes, urea and creatinine. PWD was defined as the difference between the maximum and minimum P-wave duration calculated on a standard 12-lead ECG before and after dialysis. RESULTS: The following parameters were obtained before and after hemodialysis: blood pressure 132 +/- 21 vs. 130 +/- 10 mm Hg (p > 0.05), TBF 33.9 +/- 6 vs. 32 +/- 5.6 liters (p = 0.001), impedance 499 +/- 110 vs. 596 +/- 136 Omega (p = 0.001), P-max 103.1 +/- 8.9 vs. 106.3 +/- 12.7 ms (p > 0.05), P-min 70.2 +/- 11 vs. 72.5 +/- 7.9 ms (p > 0.05), PWD 32.2 +/- 11.9 vs. 33.8 +/- 13.4 ms (p > 0.05). Although statistically significant decreases were observed in urea and creatinine levels after hemodialysis, no such changes were observed in blood electrolytes. CONCLUSION: The P-max and PWD did not change significantly after hemodialysis, hence these two parameters can be used as an indicator of effective hemodialysis.

P wave dispersion is increased in pulmonary stenosis.

AIM: The right atrium pressure load is increased in pulmonary stenosis (PS) that is a congenital anomaly and this changes the electrophysiological characteristics of the atria. However, there is not enough data on the issue of P wave dispersion (PWD) in PS. METHODS: Forty-two patients diagnosed as having valvular PS with echocardiography and 33 completely healthy individuals as the control group were included in the study. P wave duration, p wave maximum (p max) and p minimum (p min) were calculated from resting electrocardiography (ECG) obtained at the rate of 50 mm/sec. P wave dispersion was derived by subtracting p min from p max. The mean pressure gradient (MPG) at the pulmonary valve, structure of the valve and diameters of the right and left atria were measured with echocardiography. The data from two groups were compared with the Mann-Whitney U test and correlation analysis was performed with the Pearson correlation technique. RESULTS: There wasn't any statistically significance in the comparison of age, left atrial diameter and p min between two groups. While the MPG at the pulmonary valve was 43.11 +/- 18.8 mmHg in PS patients, it was 8.4 +/- 4.5 mmHg in the control group. While p max was 107.1 +/- 11.5 in PS group, it was 98.2 +/- 5.1 in control group (p=0.01), PWD was 40.4 +/- 1.2 in PS group, and 27.2 +/- 9.3 in the control group (p=0.01). Moreover, while the diameter of the right atrium in PS group was greater than that of the control group, (38.7 +/- 3.9 vs 30.2 +/- 2.5, p=0.02). We detected a correlation between PWD and pressure gradient in regression analysis. CONCLUSION: P wave dispersion and p max are increased in PS. While PWD was correlated with the pressure gradient that is the degree of narrowing, it was not correlated with the diameters of the right and left atria.

QT dispersion in non-apneic simple snoring patients and the effect of surgical therapy on QT dispersion.

AIM: Increased QT dispersion in cases of obstructive sleep apnea, which may induce serious arrhythmias, is a well-known process. However, there is little information about the QT dispersion in patients with simple snoring without apnea. We investigated QT dispersion in snoring and the effect of surgical therapy on QT dispersion. METHODS: One hundred and sixty two patients with simple snoring without apnea were included in this study. Patients had polysomnography and surface electrocardiography (ECG) on the pre-operative 1st week and post-operative 4th week. The patients underwent one of the three surgical procedures, which include uvulopalatopharyngoplasty, laser assisted uvulopalatoplasty, and cautery assisted uvulopalatoplasty. QT dispersion was calculated in each patient from pre-operative and post-operative surface ECG. Pre-operative and post-operative values were compared using the student's t test. P<0.05 was considered statistically significant. RESULTS: One hundred and fourteen of the patients were male, 48 were female, and the mean age was 35.2+/-14.1 years (range: 21-51). No improvements were observed in 9 of the patients. Surgical interventions were successful in 153 patients (94%). Post-operative QTc max and QTc dispersion values were significantly shortened, and QTc min was increased compared to the pre-operative values (449.6+/-6.2 vs. 440.9+/-20.8, and 68.2+/-8.4 vs. 43.8+/-6.2, and 381.3+/-7.8 vs. 397.0+/-5.9 respectively; P=0.001). CONCLUSION: This study shows that QT dispersion is increased in simple snoring patients without apnea and that QT dispersion decreases after surgical interventions.

Papillary fibroelastoma of mitral papillary chordae in a young patient.

Our case is a 38-year-old man, admitted to Cardiology Department with shortness of breath. Echocardiography yields a hyperechogenic mass localized to papillary muscle with severe mitral regurgitation. Coronary angiography demonstrated radiopacity localized to the papillary muscle. The excision of the mass was consistent with elastic tumor, which was reported as papillary fibroelastoma attached to the papillary chordae of the mitral valve. A 29 no St-Jude bileaflet mechanical valve was implanted to mitral position. Papillary fibroelastoma (PF) can be found in young age and originate from the papillary muscle, which the radiopaque angiographic appearance of the mass supports the diagnosis.

[Short-term effect of nebivolol on the left ventricular diastolic function]. / Nebivololün sol ventrikül diyastolik fonksiyonlari üzerine erken dönem etkisi.

OBJECTIVE: To determine the effects of nebivolol on diastolic functions of the left ventricle in the hypertensive patients in the early treatment period. METHODS: Twenty patients with mild to moderate hypertension taking daily 5 mg of nebivolol were assessed by using Doppler echocardiography before and after 6-week drug treatment period. The results were analyzed with Wilcoxon test and p<0.05 was accepted as statistically significant value. RESULTS: The arterial blood pressure and heart rate of the patients significantly decreased after 6 weeks of treatment. Statistically significant decrease was found in the peak of A wave velocity, isovolumetric relaxation time, E wave deceleration time and increase in E/A ratio with Doppler echocardiography after 6-week treatment period. No statistically significant difference was observed in the peak velocity of E wave after treatment period. CONCLUSION: We found that nebivolol improved left ventricular diastolic function in patients with hypertension in the early term.