Incidental finding of a giant intracardiac angioma infiltrating both ventricles in a 35-year-old woman: a case report

Background

Primary cardiac tumors are rare and often asymptomatic or present with unspecific symptoms. Benign cardiac tumors of vascular origin are especially rare, with only few existing data in the literature.

Case presentation

A 35-year-old Caucasian female patient presented to our department with an asymptomatic giant intracardiac angioma infiltrating both ventricles. Evaluation of this tumor involved electrocardiography, echocardiography, cardiac magnetic resonance imaging, coronary angiography, an open myocardial biopsy, and histological examination of the resected specimen. Because our patient was asymptomatic, she was managed conservatively with regular follow-up. We discuss the treatment options available in comparison with similar cases.

Conclusion

Diagnosis and therapy of benign cardiac tumors, especially of asymptomatic lesions, can be a challenge. There is no evidence available to help in the management of such patients. An extensive evaluation is needed with different imaging modalities, and case-specific decisions should be made that involve experts in cardiology, cardio-oncology, and heart surgery.

Electronic supplementary material

The online version of this article (doi:10.1186/s13256-016-0860-4) contains supplementary material, which is available to authorized users.

Origin and compensation of imaging artefacts in localization-based super-resolution microscopy

Interpretation of high resolution images provided by localization-based microscopy techniques is a challenge due to imaging artefacts that can be categorized by their origin. They can be introduced by the optical system, by the studied sample or by the applied algorithms. Some artefacts can be eliminated via precise calibration procedures, others can be reduced only below a certain value. Images studied both theoretically and experimentally are qualified either by pattern specific metrics or by a more general metric based on fluorescence correlation spectroscopy.

Microphysical properties of carbonaceous aerosol particles generated by laser ablation of a graphite target

Abstract. In this work various microphysical properties including mass concentration, size distribution and morphology of aerosol particles generated by laser ablation of a high purity graphite sample were investigated in detail. Supplementary chemical analysis of the generated particles including microstructure investigation by high-resolution transmission electron microscopy (HRTEM) and Raman spectroscopy were also made. These measurements proved that the proposed method can be used to model the real atmospheric carbonaceous particulate under various climate relevant conditions regarding its specific properties investigated here. However, to introduce the presented methodology as a novel BC surrogate, further improvement and investigation including simplification in experimental setup, comprehensive analysis of thermochemical refractiveness and optical responses of the generated particles as well as comparative study with the presently available concurrent surrogates are required. The related results of these issues are planned to be demonstrated in other studies.

Exhaled methane concentration profiles during exercise on an ergometer

Exhaled methane concentration measurements are extensively used in medical investigation of certain gastrointestinal conditions. However, the dynamics of endogenous methane release is largely unknown. Breath methane profiles during ergometer tests were measured by means of a photoacoustic spectroscopy based sensor. Five methane-producing volunteers (with exhaled methane level being at least 1 ppm higher than room air) were measured. The experimental protocol consisted of 5 min rest--15 min pedalling (at a workload of 75 W)--5 min rest. In addition, hemodynamic and respiratory parameters were determined and compared to the estimated alveolar methane concentration. The alveolar breath methane level decreased considerably, by a factor of 3-4 within 1.5 min, while the estimated ventilation-perfusion ratio increased by a factor of 2-3. Mean pre-exercise and exercise methane concentrations were 11.4 ppm (SD:7.3) and 2.8 ppm (SD:1.9), respectively. The changes can be described by the high sensitivity of exhaled methane to ventilation-perfusion ratio and are in line with the Farhi equation.

Matching of feedback inhibition with excitation ensures fidelity of information flow in the anterior piriform cortex

Odor-evoked responses in mitral cells of the olfactory bulb are characterized by prolonged patterns of action potential (spike) activity. If downstream neurons are to respond to each spike in these patterns, the duration of the excitatory response to one spike should be limited, enabling cells to respond to subsequent spikes. To test for such mechanisms, we performed patch-clamp recordings in slices of the mouse anterior piriform cortex. Mitral cell axons in the lateral olfactory tract (LOT) were stimulated electrically at different intensities and with various frequency patterns to mimic changing input conditions that the piriform cortex likely encounters in vivo. We found with cell-attached measurements that superficial pyramidal (SP) cells in layer 2 consistently responded to LOT stimulation across conditions with a limited number (1-2) of spikes per stimulus pulse. The key synaptic feature accounting for the limited spike number appeared to be somatic inhibition derived from layer 3 fast-spiking cells. This inhibition tracked the timing of the first spike in SP cells across conditions, which naturally limited the spike number to 1-2. These response features to LOT stimulation were, moreover, not unique to SP cells, also occurring in a population of fluorescently labeled interneurons in glutamic acid decarboxylase 65-eGFP mice. That these different cortical cells respond to incoming inputs with 1-2 spikes per stimulus may be especially critical for relaying bulbar information contained in synchronized oscillations at beta (15-30Hz) or gamma (30-80Hz) frequencies.

Addition of vardenafil into storage solution protects the endothelium in a hypoxia-reoxygenation model

OBJECTIVE

Based upon the well known protective effect of intracellular cyclic guanosine monophosphate (cGMP) accumulation, we tested the hypothesis that storage solution enriched with optimal concentration of the phosphodiestherase-5 inhibitor vardenafil could provide better protection of vascular grafts against reperfusion injury after long-term cold ischaemic storage.

METHODS

Isolated thoracic aorta obtained from rats underwent 24-h cold ischaemic preservation in physiological saline or vardenafil (10(-11) M)-supplemented saline solution. Reperfusion injury was simulated by hypochlorite (200 μM) exposure for 30 minutes. Endothelium-dependent vasorelaxation was assessed, and histopathological and molecular-biological examination of the aortic tissue were performed.

RESULTS

Compared with the control group, the saline group showed significantly attenuated endothelium-dependent maximal relaxation (Rmax) to acetylcholine after hypoxia-reoxygenation, which was significantly improved by vardenafil supplementation (Rmax control: 98 ± 1%; saline: 48 ± 6%; vardenafil: 75 ± 4%; p < .05). Vardenafil treatment significantly reduced DNA strand breaks (control: 10.6 ± 6.2%; saline: 72.5 ± 4.0%; vardenafil: 14.2 ± 5.2%; p < .05) and increased cGMP score in the aortic wall (control: 8.2 ± 0.6; saline: 4.5 ± 0.3; vardenafil: 6.7 ± 0.6; p < .05).

CONCLUSIONS

Our results support the view that impairment of intracellular cGMP signalling plays a role in the pathogenesis of the endothelial dysfunction induced by cold storage warm reperfusion, which can be effectively reversed by pharmacological phosphodiesterase-5 inhibition.

PP004. Study of the methylenetetrahydrofolate reductase and the reduced-folate carrier-1 gene polymorphism in healthy and severe pre-eclamptic patients

INTRODUCTION

One-carbon cycle is involved in two essential physiological processes: The synthesis of purins and pyrimidines required for DNA synthesis and repair. The other is the methylation with the methionine cycle. These one-carbon groups are served by the tetrahydrofolate and the S-adenosylmethionine. Deficiencies of the folate, or other abnormalities within the methionine pathway lead to elevated homocysteine levels. These disorders have been implicated in placental diseases. Earlier studies have shown that homocysteine levels are elevated by patients with severe pre-eclampsia than by healthy pregnant normotensive women. Methylenetetrahydrofolate reductase (MTHFR) gene C677T missense mutation has a high frequency by patients with HELLP syndrome and connected with elevated serum homocysteine levels. The reduced-folate carrier (RFC-1) facilitates the internalization of 5-methyltetrahydrofolate from the blood into peripheral cells. The mutation G80A this gene leads to higher plasma folate.

OBJECTIVES

Our aim was to identify the polymorphism of these two genes in samples of severe pre-eclamptic patients and healthy controls.

METHODS

Blood samples were collected from healthy pregnant normotensive women (n=82) and women with pre-eclampsia (n=75). DNA was isolated and quantitative real-time PCR method combined with melting curve analysis was performed for the detection of the two polymorphisms. Statistical analysis was performed with the STATISTICA software package.

RESULTS

The frequency of the A allele in the RFC-1 gene was 46.57% by healthy pregnant and 41% by severe pre-eclamptic patients. The overall distribution of genotypes was not significantly different between the control and pre-eclamptic groups (p=0.58). In the study groups by the MTHFR gene the frequency of the T was 32% in pre-eclamptics, and 35.92% in controls. Similarly the overall distribution of genotypes was not significantly different between the two study groups (p=0.15).

CONCLUSION

In hypertensive disorders of the pregnancy the one-carbon cycle is disturbed. We studied single nucleotide mutations in the genes of two enzymes involved in the cycle. We determined the allele and genotype frequencies in healthy control and pre-eclamptic patients and found no significant differences. Further examinations of other genetical compounds can help to understand the elevated homocysteine levels in pre-eclampsia.