effect of timing of decompression on neurologic recovery and histopathologic findings after spinal cord compression in a rat model

Prior animal models have shown that rats sustaining 3-second immediate spinal cord compression had significantly better functional recovery and smaller lesion volumes than rats subjected to compression times of 1 hour, 6 hours, 3 weeks, and 10 weeks after spinal cord injury. We compare locomotor rating scales and spinal cord histopathology after 3 seconds and 10 minute compression times. Ten rats were assigned into two early [3-second] and late [10-minute] compressive surgery groups. Compressive injury was produced using an aneurysmal clip method. Rats were followed-up for 11 weeks, and behavioral assessment was done by inclined plane test and tail-flick reflex. At the end of the study, the rats were sacrificed, and spinal cord specimens were studied in light and EM. Basso, Beattie and Bresnahan [BBB] locomotor rating scales were significantly better in the early compression group after the 4th week of evaluation [P<0.05] and persisted throughout the remainder of the study. Histopathology demonstrated decreased normal tissue, more severe gliosis and cystic formation in the late group compared to the early group [P<0.05]. In EM study, injuries in the late group including injury to the myelin and axon were more severe than the early compression group, and there was more cytoplasmic edema in the late compression group. Spinal cord injury secondary to 3-second compression improves functional motor recovery, spares more functional tissue, and is associated with less intracellular edema, less myelin and axon damage and more myelin regeneration in rats compared to those with 10 minutes of compression. Inclined plane test and tail-flick reflex had no significant difference

Percutaneous mitral balloon valvotomy; single center experience: a review of outcome

Percutaneous balloon mitral valvotomy [BMV] has been accepted as an alternative to surgical mitral commissurotomy in the treatment of patients with symptomatic rheumatic mitral stenosis. Despite the worldwide use of the BMV technique, no studies have been hitherto designed to assess the outcome of the patients undergoing BMV in Iran. The present study reports the outcome of 3138 BMV procedures at Shaheed Rajaei Cardiovascular, Medical and Research Center during a 15-year time period. A total of 2531 patients underwent 3138 BMV procedures at Shaheed Rajaei Cardiovascular, Medical and Research Center between 1992 and 2006. Seventy-three percent [2278] of the cases were followed for 48 +/- 41 months. Recurrent stenosis in 802 [25.8%], mitral valve replacement [MVR] in 213 [6.9%], immediate good result in 3110 [99.1%], and successful outcome in 2000 [72.9%] cases were the outcome of the BMV procedures in the current study. Concordant to the similar studies, we concluded that BMV produces a good clinical outcome in a high percentage of patients. The recent study demonstrated that the successful outcome of BMV was multi factorial and the selection of patients with rheumatic mitral stenosis is recommended to be based on both anatomic and clinical characteristics of the individuals. The procedure-related variables must also be considered in order to predict the outcome

Hydatid cyst mimicking heart tumor

We present two women who lived in a rural community. The presence of a semi-solid mass, a hydatid cyst or tumor, in the heart was diagnosed by echocardiography, computed tomography, and Magnetic Resonance Imaging. The hydatid cyst was seen during surgery. Pathological examination confirmed an infected hydatid cyst

Post-surgical right ventricular pseudoaneurysm presenting as and epigastric pulsatile mass

We report a case of right ventricular pseudoaneurysm three weeks after open mitral valve commissurotomy. Transthoracic echocardiography showed a cavity of approximately 5 x 3 cm contiguous to the right ventricular inflow, communicating with the right ventricle by a small neck. Doppler study showed the presence of systolic and diastolic flow at the site of the rupture. Pseudoaneurysm is an infrequent surgical complication involving right ventriculotomy and often increases progressively in size. The association with open mitral valve commissurotomy has not been previously reported

Endothelial nitric oxide synthase gene Glu298Asp polymorphism in patients with coronary artery disease

Endo-derived nitric oxide [NO] is synthesized from L-arginine by endothelial nitric oxide synthase [NOS3]. Since reduced NO synthesis in endothelial cells has been implicated in the development of coronary atherosclerosis, we investigated the association of NOS3 gene polymorphisms and coronary artery disease [CAD] in an Iranian population. We studied the NOS3 gene Glu298Asp polymorphism in 241 CAD patients with positive coronary angiograms [i.e., >50% stenosis affecting at least one coronary vessel] in Shahid Rajaee Heart Hospital and 261 control subjects without a history of symptomatic CAD. The NOS3 gene polymorphism was analyzed by polymerase chain reaction and restriction fragment length polymorphism. Lipid profile and other risk factors were also determined. The genotype frequencies of Glu298Asp polymorphism for Glu/Glu, Glu/Asp, and Asp/Asp were 61.3%, 32.2%, and 6.5%, respectively, in control subjects, and 46.5%, 42.7%, and 10.8% in CAD patients, respectively. The genotype frequencies differed significantly between the two groups [P=.003]. The frequencies of the Asp alleles were 32.2% and 22.6% for CAD patients and control subjects, respectively; the difference between the two groups was statistically significant [P=.001; odds ratio=1.6]. Plasma lipids, except HDL-C, were also significantly increased in the CAD groups. These results suggest that CAD is associated with Glu298Asp polymorphism of the NOS3 gene in our population and that this polymorphism is an independent risk factor for CAD

Evaluation of the ventricular mechanical dyssynchrony in patients with artrial septal detect

There is some evidence indicating improvement in myocardial performance after atrial septal defect closure, either device closure or surgical, but ventricular dyssynchrony has not been evaluated before and after surgical closure. The aim of this study was to evaluated ventricular mechanical dyssynchrony in patients with artrial septal defect before and after surgical closure. Twenty patients [mean age: 23 +/- 11 years] with isolated secundum or sinus venosus type artrial septal defect, unsuitable for device closure, were evaluated before and after successful surgical closure. Interventricular and intraventricular dyssynchrony [using 6 basal and 6 mid-segmental models] were determined. A significant reduction in the right atrial and right ventricular dimensions and the tricuspid regurgitation peak gradient was noted after atrial septal defect closure [3.6 +/- 0.54 cm versus 4.2 +/- 0.7, P=0.009; 3.5 +/- 0.29 cm versus 4.3 +/- 0.41, P=0.02; and 20.4 +/- 10.5 mmHg versus 35.3 +/- 6.5, P<0.002; respectively]. There was no significant difference in the maximum difference in time-to-peak systolic velocity and the standard deviation of time-to-peak systolic velocity of the 12 left ventricular myocardial segments in the patients with atrial septal defect before and after surgical closure in comparison with the normal subjects [normal; 26 +/- 10.64 ms versus before closure: 21.0 +/- 33.9 versus after closure: 27 +/- 29.5, both P=0.68] and the left ventricular asynchrony index after atrial septal defect closure [normal: 14.9 +/- 8.7 versus before closure: 11.46 +/- 8.5 versus after closure: 18.12 +/= 13.6, both P=0.2]. There was a significant positive relation between the tricuspid regurgitation peak gradient and the left ventricular asynchrony index [r= 0.67, P=0.03] and an insignificant negative relation between the left ventricular ejection fraction and the asynchrony index before atrial septal defect closure [r= -0.53, P= 0.11]. No significant relation was found between the total asynchrony index and the atrial septal defect size, the degree of left-to-right shunt, and the tricuspid regurgitation peak gradient. There was no significant ventricular dyssynchrony in the patients with atrial septal defect before and after surgical closure

role of behavior pattern and emotional risk factors in coronary heart disease

For evaluating the role of behavior pattern and emotional factors in coronary heart disease [CHD], 86 patients were followed for one to three years [average 20 months]. The behavior pattern itself was not considered as a main risk factor, rather it was found to be an aggravating and predisposing factor, especially in morbidity rate. Both behavior patterns were more common in males than in females. 73% of male type A patients and 60% of male type B patients smoked, whereas smoking rate was equal among the female patients, amounting to 20% for both types. Thus smoking was considered as a major and prevalent risk factor in males especially those with type A behavior. 62% of patients included in the type A group had acute MI, while 56% of type B patients had the same condition. Thus, MI and its complications occured more commonly in type A than type B patients. However, the mortality rate, which was mainly due to anterior MI [90%], was the same in both groups