Acute pulmonary thromboemboli due to a giant mobile thrombus

No abstract available.

investigation of tenascin-c levels in rheumatic mitral stenosis and their response to percutaneous mitral balloon valvuloplasty

The purpose of this study was to evaluate the tenascin-C levels in severe rheumatic mitral stenosis before and after percutaneous mitral balloon valvuloplasty [PMBV]. Forty patients with severe mitral stenosis requiring PMBV and 20 age-matched healthy subjects were included in the study. The mitral valve areas, mitral gradients and systolic pulmonary artery pressure [sPAP] were measured by echocardiography. The sPAP values and mitral gradients were also measured by catheterization before and after PMBV. The blood tenascin-C levels were measured before PMBV and 1 month after the procedure. The echocardiographic mean mitral gradients had a significant decrease after PMBV [11.7 +/- 2.8 vs. 5.6 +/- 1.7 mm Hg; p < 0.001] and also those of catheterization [13.9 +/- 4.4 vs. 4.0 +/- 2.4 mm Hg; p < 0.001]. Mitral valve areas increased significantly after PMBV [from 1.1 +/- 0.1 to 1.8 +/- 0.2 cm[2], p < 0.001]. Tenascin-C levels decreased significantly in patients after PMBV [from 15.0 +/- 3.8 to 10.9 +/- 3.1 ng/ml; p < 0.001]. Tenascin-C levels were higher in patients with mitral stenosis before PMBV than in healthy subjects [15.0 +/- 3.8 and 9.4 +/- 2.9 ng/ml; p < 0.001, respectively]. There were no significant differences between patients with mitral stenosis after PMBV and healthy subjects [10.9 +/- 3.1 and 9.4 +/- 2.9 ng/ml; p = 0.09, respectively]. There was a significant positive correlation between tenascin-C levels and sPAP [r = 0.508, p < 0.001]. In multivariant analysis, tenascin-C predicted mitral stenosis [p = 0.004, OR: 2.31]. Tenascin-C was an independent predictor for rheumatic mitral stenosis

Relationship between renal stone formation, mitral annular calcification and bone resorption markers

Mitral annular calcification [MAC] is associated with osteoporosis and there is evidence of reduced bone mineral density [BMD] in patients with renal stone formation [RSF]. Therefore, we designed this study to test if RSF was associated with MAC and if this association could be linked to bone resorption. Fifty-nine patients [mean age, 41.5 years] with RSF and 40 healthy subjects [mean age, 44.2 years] underwent screening for MAC and BMD, and measuurements were taken of serum and urine electrolytes, parathyroid hormone, alkaline phosphatase and urine dypyridoline. MAC was diagnosed in 11 [18%] patients with RSF compared with 1 [2.5%] control [P=.01]. Urine phosphorus, magnesium, sodium, potassium and chloride levels were lower [P<.001, P=.02, P<.001, P<.001 and P<.001, respectively], but serum alkaline phosphatase, calcium and potassium levels were higher [P=.008, P=.007 and P=.001, respectively] in patients with RSF versus those without RSF. None of these abnormalities were found in patients or subjects with MAC. Urine pyridoline levels were higher and T-scores were more negative [more osteopenic] in patients and subjects with MAC than in those without MAC [P=.01 and P=.004, respectively]. In a multivariate analysis, only T-scores and urine dipyridoline level were predictive of MAC [P=.03 and P=.04, respectively]. Screening for MAC and bone resorption markers in patients with RSF demonstrated a high incidence of MAC in these patients. The presence of MAC in patients with RSF was associated with bone resorption markers. This seemingly complex interrelationship between RSF, MAC and bone loss needs to be clarified in further studies

Increased levels of nitric oxide, cortisol and adrenomedullin in patients with chronic schizophrenia

To investigate the levels of serum cortisol, dehydroepiandrosterone sulfate [DHEA-S], nitric oxide [NO] and adrenomedullin [AM] in schizophrenic patients. Sixty-six male patients with chronic schizophrenia and 28 normal male subjects participated in this study. The duration of disease was 145 +/- 120 [mean +/- SD] months. Serum levels of cortisol and DHEA-S were measured by electrochemiluminescence; plasma nitrite levels as an index of NO were measured with the Griess reaction, while plasma AM concentration was measured by using high-performance liquid chromatography. Patients [12.48 +/- 3.2 micro g/dl], as compared to controls [10.31 +/- 3.1 micro g/dl], had higher levels of baseline cortisol [p < 0.05]. DHEA-S levels were lower in patients though this did not reach statistical significance [302 +/- 156 micro g/dl compared to control, 322 +/- 96 micro g/dl, p > 0.05]. The mean levels of plasma AM and NO in the schizophrenic group [44.33 +/- 5.07 pmol/l and 36.27 +/- 17.6 micro mol/l] were significantly higher than the levels in the control group [14.56 +/- 4.03 pmol/l and 32.54 +/- 7.14 micro mol/l; p < 0.001, p < 0.03, respectively]. There was a positive association between duration of disease and cortisol/DHEA-S ratio and cortisol level. The data show that schizophrenia is associated with abnormal levels of cortisol, DHEA-S, NO and AM