Myxoma immediately above the junction of the inferior vena cava and the right atrium: a rare cause of budd-chiari syndrome

The Budd-Chiari syndrome [BCS] is a rare disorder caused by the obstruction of the hepatic veins or the inferior vena cava [IVC] at the suprahepatic level. This syndrome is developed by either hepatic vein thrombosis or mechanical venous obstruction and leads to centrilobular hepatic congestion with the subsequent development of fibrosis and cirrhosis. Intracardiac tumors have been rarely reported as a cause of the BCS. These tumors usually originate from the atrial septum. Very rarely, they arise either from the junction of the IVC and the right atrium or from the Eustachian valve. There are a few case reports in the literature where atrial tumors have caused the BCS. In these cases, the tumors were malignant, and the patients died shortly after being diagnosed. We describe a 71-year-old female patient who presented with a 3-month history of abdominal pain and protrusion. On physical examination, blood pressure and pulse rate were normal. Jugular venous pressure was about 10 cm. Cardiac examination revealed a systolic murmur, grade IV/VI, in the left sternal border without radiation. Echocardiography showed a large mass [about 6×4 cm] in the right atrium with close contact to the origin of the IVC, obstructing it. Cardiac magnetic resonance imaging, with and without gadolinium, also confirmed the diagnosis. The patient underwent surgery, and the myxoma was removed. The tumor was a large solid mass, 5×4 cm in size, which originated immediately above the entrance of the IVC. The patient is in good condition 1 year afterward. We emphasize that atrial myxomas should be considered in the differential diagnosis of tumors that cause chronic BCS

comparison of the effects of acute swimming stress on plasma corticosterone and leptin concentration in male and female rats

The aim of this study was to investigate the effect of acute swimming stress on plasma corticosterone and leptin levels in female and male rats. Thirty- seven adult male [n=20] and female [n=20] Sprague Dawley rats [200-250 g weight] were used. The leptin and corticosterone levels were measured following swimming stress [10 minutes] or no stress. Plasma leptin and corticosterone were measured by ELISA system. The plasma leptin and corticosterone levels were significantly increased in female and male rats by swimming stress. Plasma leptin level was not correlated significantly with plasma corticosterone in all groups. There were no sex differences in leptin level among stressed and non stressed rats. The results suggest that changes in plasma leptin level could not be associated with stimulation of corticosterone secretion from adrenal glands and leptin secretion is not sex dependent

Sequence analysis and phylogenetic study of hemagglutinin gene of H9 N2 subtype of avian influenza virus isolated during 1998-2002 in Iran

Sequence analysis and phylogenetic study of hemagglutinin [HA] gene of H9N2 subtype of avian influenza virus isolates [outbreaks of 1998-2002] in Tehran province [Iran] were studied. Two sets of forward and reverse primers in highly conserved regions, based on sequences of HA gene in Genbank, were designed. PCR products of a 430-bp fragment of 16 isolates were sequenced and then were aligned with the reported sequences in Genbank. Nucleotide sequence comparisons of HA gene from Iranian isolates showed 97-99% identity within the group, and 98% homology with the two isolates [A/Parakeet/Narita/92A/98 [H9N2]] and [A/Parakeet/Chiba/1/97 [H9N2]] from Pakistani parakeets imported to Japan. On the basis of phylogenetic evidence, it is proposed that the emergence of H9N2 avian influenza infection in Iran originated in Pakistan, and it was due to low quarantine measures in the international boundaries. Due to the high percentage of H9N2 homology isolates of Iran with other isolates, namley A/quail/HongKong/G1, in Genbank and based on published reports for high similarity with infecting human H5N1 isolates, it seems that the potential of Iranian avian influenza isolates to infect human should be considered