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Recent technologic advances in cardiac magnetic resonance (MR) imaging have resulted in images with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MR is a valuable imaging technique for detection and assessment of the morphology and functional characteristics of the nonischemic cardiomyopathy. It has gained acceptance as a standalone imaging modality that can provide further information beyond the capabilities of traditional modalities such as echocardiography and angiography. Black-blood fast spin-echo MR images allow morphologic assessment of the heart with high spatial resolution, while T2-weighted MR images can depict acute myocardial edema. Contrast material-enhanced images can depict and be used to quantify myocardial edema, infiltration, and fibrosis. This review presents recommended cardiac MR protocols for and the spectrum of imaging appearances of the nonischemic cardiomyopathies.

Type 1 diabetics have a well-recognised risk of accelerated cardiovascular disease. Even in the absence of clinical signs there are detectable abnormalities of conduit vessel function. Our group has previously reported reversal of endothelial dysfunction in diabetics with pravastatin. In young asymptomatic smokers, taurine supplementation has a beneficial impact on macrovascular function, assessed by FMD, and shows an up-regulation of nitric oxide from monocyte—endothelial cell interactions. We hypothesise that taurine supplementation reverses early endothelial abnormalities in young male type 1 diabetics, as assessed by applanation tonometry, brachial artery ultrasound and laser Doppler fluximetry. Asymptomatic, male diabetics ( n=9) were scanned prior to treatment and then randomised in a double-blind cross-over fashion to receive either 2 weeks placebo or taurine. Control patients ( n=10) underwent a baseline scan. Assessed diabetics had detectable, statistically significant abnormalities when compared with controls, in both arterial stiffness (augmentation index) and brachial artery reactivity (FMD). Both of these parameters were returned to control levels with 2 weeks taurine supplementation. In conclusion, 2 weeks taurine supplementation reverses early, detectable conduit vessel abnormalities in young male diabetics. This may have important implications in the long-term treatment of diabetic patients and their subsequent progression towards atherosclerotic disease.

Oxidative stress on the renal tubules has been implicated as a mechanism of injury in both stress hyperglycemia and contrast-induced nephrotoxicity. The purpose of this study was to determine whether the combination of these effects has a synergistic effect on accentuating renal tubular apoptosis and therefore increasing the risk of contrast-induced nephrotoxicity.Dog kidney cells were incubated with 5- and 30-mmol/L glucose solutions and no glucose and then exposed for 2 hours to three types of contrast media-high osmolar (370 mg I/mL), low osmolar (300 mg I/mL), and isoosmolar (320 mg I/mL)-and a mannitol control solution. In an identical experiment, each group of cells was pretreated with an antioxidant-N-acetylcysteine or taurine-to evaluate the protective effect, if any. Apoptosis was assessed with fluorescence-activated cell sorter flow cytometry.The high-osmolar contrast medium was associated with significantly elevated levels of apoptosis compared with the mannitol control (percentage apoptosis, 27.98 +/- 1.08 vs 6.19 +/- 0.771; p0.001). This effect was less pronounced after incubation with the low-osmolar agent but was still significant (percentage apoptosis, 20.19 +/- 0.3665 vs 6.19 +/- 0.771; p0.001). The isosmolar agent did not have a significant effect. Both the high- and low-osmolar contrast media coupled with hyperglycemia (30-mmol/L glucose) were associated with a significantly increased level of apoptosis. In all contrast medium groups, taurine had a greater protective effect on attenuation of cell apoptosis than did N-acetylcysteine.The combination of contrast medium and an elevated glucose level has a synergistic effect on apoptosis. Taurine may be a more effective prophylactic antioxidant than the currently advocated antioxidant, N-acetylcysteine.

Background: Hypertonic saline causes a transient elevation of blood osmolality and has been shown to alter cellular inflammatory responses in pro-inflammatory states. Intravascular administration of iodine contrast media also causes a transient elevation of blood osmolarity. Purpose: To investigate the effect of iodine contrast media on leukocyte–endothelial interaction in vivo using intravital microscopy. Material and Methods: Male Sprague-Dawley rats ( n=36) were randomized into six groups and were treated with: saline, high osmolar contrast medium, low osmolar contrast medium, and endotoxin alone and in combination with the high and low osmolar contrast media. The effect on leukocyte–endothelial interaction in the post-mesenteric venules was observed using the technique of intravital microscopy. The sequence of leukocyte rolling velocity, leukocyte–endothelial cell adherence, and transmigration was recorded and analyzed at 10 min intervals to a maximum of 120 min. Results: Endotoxin significantly decreased the rolling velocity and increased the adherence and transmigration of leukocytes in a time-dependent manner. Both types of iodine contrast media attenuated this pro-inflammatory response to endotoxin. This effect began between 60 and 70 min after the onset of the experiment. Conclusion: Hyperosmolar and lower osmolar iodine contrast media attenuate the pro-inflammatory leukocyte–endothelial response to endotoxin in vivo.

OBJECTIVE. This article reviews the optimal cardiac MRI sequences for and the spectrum of imaging appearances of cardiac tumors.CONCLUSION. Recent technologic advances in cardiac MRI have resulted in the rapid acquisition of images of the heart with high spatial and temporal resolution and excellent myocardial tissue characterization. Cardiac MRI provides optimal assessment of the location, functional characteristics, and soft-tissue features of cardiac tumors, allowing accurate differentiation of benign and malignant lesions.

Visceral artery aneurysm is a rare but clinically important form of vascular pathology, showing a high mortality rate in emergency surgery. Most often these aneurysms cause no symptoms and are therefore incidental findings. Reports on ileocolic artery aneurysms are rare and often anecdotal. Therapeutic procedures can be performed either surgically or by interventional therapeutic techniques. This article presents a case of ruptured ileocolic artery aneurysm and reviews the literature on this topic.

A 78-year-old woman presented with a gastrointestinal hemorrhage and palpable abdominal aortic aneurysm. The computed tomography scan of the abdomen showed a primary aortoenteric fistula. The challenging clinical diagnosis of aortoenteric fistulae and their surgical treatment options are discussed.

Acute aortic plaque rupture is an uncommon cause of acute lower limb ischemia. The authors report sequence computed tomographic imaging of a distal aortic plaque rupture in a young man with bilateral lower limb complications. Clinical awareness, prompt recognition and imaging, and appropriate treatment of this uncommon condition are necessary to improve patient outcomes.

Introduction: Cigarette smoking is the main, modifiable risk factor for atherosclerosis. We have previously reported reversal of endothelial dysfunction in young, healthy smokers with taurine supplementation. A heterogeneous population of endothelial cells (shed circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs)) is found in circulation. These correlate with the magnitude of injury and the reparative response respectively. We hypothesise, that taurine decreases structural endothelial injury and restores the reparative mobilisation of EPCs from the bone marrow in young smokers. Methods: We tested this hypothesis with a model of brief upper limb ischaemia, by characterising the response of CECs and EPCs to ischaemia in matched groups of non-smoking (n = 15) and healthy smoking young males (n = 15). Smokers were then treated for five days with Taurine, and the test repeated. Endothelial cell populations were determined by flow cytometry using CD45, CD133 and CD145. TABLE—ABSTRACT P82 . Control (n = 15) Smokers (n = 15) Taurine Tx. (n = 8) CEC EPC CEC EPC CEC EPC Baseline 1.2 ± 0.34 1.2 ± 0.7 λ 3.1 ± 0.54 ∗ 0.53 ± 0.24 γ 1.25 ± 0.4 4.25 ± 0.65 Post IR injury 1.13 ± 0.4 1.7 ± 0.6 5.5 ± 1.0 ∗ , ∧ 1.0 ± 0.44 1.13 ± 0.4 0.88 ± 0.36 ∗ P λ P γ P ∧ P Results: Baseline CECs were increased in smokers who also demonstrated an exaggerated CEC response; both of these observations were restored to control levels with taurine. In addition, taurine increased baseline EPCs in smokers. Conclusion: This study clearly demonstrates increased endothelial injury in smokers, furthermore this injury is attenuated by taurine. These observations may have therapeutic implications given that the doses of the amino-acid used in these studies can be achieved with dietary modification.

A 79-year-old woman presented with colicky abdominal pain on a background of previous aortic aneurysm graft insertion 3 years earlier. Physical examination disclosed hyperactive bowel sounds and epigastric discomfort. Abdominal multidetector computed tomography (MDCT) was performed with …

A 63-year-old man was admitted with intractable angina and underwent elective coronary angiography. He had a history of percutaneous coronary intervention to the left circumflex artery five years previously. Coronary angiography revealed 90% stenosis of the proximal right coronary artery (RCA) (Panel A) and a 3 mm Cypher stent was placed across the lesion. The procedure was complicated by a RCA dissection with retrograde extension to the ostium and subsequently into the ascending aortic wall (Panel B). The patient was referred for urgent surgical repair. Extensive bleeding was encountered at surgery, and the false lumen of …