Background -Myocardial virus persistence is frequently observed in patients w ith cardiomyopathy. Endothelial dysfunction in patients with cardiomyopathy is a ssociated with inflammatory immunoresponses in myocardial ...Background -Myocardial virus persistence is frequently observed in patients w ith cardiomyopathy. Endothelial dysfunction in patients with cardiomyopathy is a ssociated with inflammatory immunoresponses in myocardial biopsies. The aim of t his study was to investigate the impact of myocardial virus persistence on endot helial function. Methods and Results -In 124 patients with suspected cardiomyop athy, myocardial biopsies were examined for virus persistence(by polymerase chai n reaction) and inflammation(by immunohistology). Endothelial function of the ra dial artery was examined by high-resolution ultrasound. Diameter changes in res ponse to reactive hyperemia (flow-mediated dilation[FMD]) compared with glycero l trinitrate(GTN-MD) were measured. Mean age of the patients(55 men, 69 women) was 45±13 years; ejection fraction was 57±17%. In 73 patients, adenovirus, en terovirus, parvovirus, or HHV6 virus(V) was detected; in 51, no virus was detect ed. FMD was significantly impaired in patients with myocardial virus persistence compared with control subjects(Co): FMD-V, 3.38±2.67%; FMD-Co, 7.34±3.44(P < 0.001). In 86 patients, myocardial inflammation was confirmed (Inf). Of those, 57 had virus, and 29 did not. FMD was significantly impaired in patients with v irus compared with controls: FMD-Inf-V, 3.24±2.66%; FMD-Inf-Co, 6.07±3.00 (P< 0.001). In 38 patients, immunohistology of the myocardial biopsies was norma l(Co); of those, 16 had virus, and 22 did not. FMD was impaired in patients with virus compared with control subjects: FMD-Co-V, 3.88±2.72%; FMD-Co-Co, 9. 00±3.32%(P< 0.001). Endothelium-independent vasodilation(GTN-MD) was not sig nificantly affected. Conclusions -Myocardial virus persistence is associated wi th endothelial dysfunction. Endothelial dysfunction in patients with myocardial virus persistence can occur independently of endothelial activation or myocardia l inflammation but is more pronounced in patients with concurrent inflammation.展开更多
McCune-Albright syndrome(MAS)is a rare disease characterized by caféau lait spots,bone fibrous dysplasia,and precocious puberty.Most MAS cases are diagnosed before adolescence.Here,we reported an adolescent girl ...McCune-Albright syndrome(MAS)is a rare disease characterized by caféau lait spots,bone fibrous dysplasia,and precocious puberty.Most MAS cases are diagnosed before adolescence.Here,we reported an adolescent girl underwent mistaken oophorectomy for suspected ovarian tumor,and later,she was diagnosed with MAS.An 11-year-old girl was found to have an irregular pelvic mass measuring 9.74 cm×9.01 cm×7.30 cm with a cyst-solid component and a clear boundary by magnetic resonance imaging.She underwent right oophorectomy for the suspected ovarian tumor.However,histopathological examination showed ovarian tissue with many antral follicles.One week after the surgery,ultrasonography revealed a left pelvic irregular echo-free mass measuring 60 mm×53 mm×48 mm.The patient was then examined by endocrine specialists,and caféau lait spots were found predominantly located on the right side of her waist,hip,and thigh.She had her first period before the surgery,and her serum concentrations of sex hormones were normal.Thus,MAS was diagnosed.The patient has been taking dydrogesterone 20 mg/d for 10 days from the 14th day of her period for 2 years.Ultrasonography performed every 3-6 months revealed no enlargement of her left ovary.Awareness of MAS and careful physical and imaging examination should be emphasized,even in the absence of full classic triad of syndromes.Hence,unnecessary oophorectomy and irreversible loss of fertility potential can be avoided in these patients.展开更多
文摘Background -Myocardial virus persistence is frequently observed in patients w ith cardiomyopathy. Endothelial dysfunction in patients with cardiomyopathy is a ssociated with inflammatory immunoresponses in myocardial biopsies. The aim of t his study was to investigate the impact of myocardial virus persistence on endot helial function. Methods and Results -In 124 patients with suspected cardiomyop athy, myocardial biopsies were examined for virus persistence(by polymerase chai n reaction) and inflammation(by immunohistology). Endothelial function of the ra dial artery was examined by high-resolution ultrasound. Diameter changes in res ponse to reactive hyperemia (flow-mediated dilation[FMD]) compared with glycero l trinitrate(GTN-MD) were measured. Mean age of the patients(55 men, 69 women) was 45±13 years; ejection fraction was 57±17%. In 73 patients, adenovirus, en terovirus, parvovirus, or HHV6 virus(V) was detected; in 51, no virus was detect ed. FMD was significantly impaired in patients with myocardial virus persistence compared with control subjects(Co): FMD-V, 3.38±2.67%; FMD-Co, 7.34±3.44(P < 0.001). In 86 patients, myocardial inflammation was confirmed (Inf). Of those, 57 had virus, and 29 did not. FMD was significantly impaired in patients with v irus compared with controls: FMD-Inf-V, 3.24±2.66%; FMD-Inf-Co, 6.07±3.00 (P< 0.001). In 38 patients, immunohistology of the myocardial biopsies was norma l(Co); of those, 16 had virus, and 22 did not. FMD was impaired in patients with virus compared with control subjects: FMD-Co-V, 3.88±2.72%; FMD-Co-Co, 9. 00±3.32%(P< 0.001). Endothelium-independent vasodilation(GTN-MD) was not sig nificantly affected. Conclusions -Myocardial virus persistence is associated wi th endothelial dysfunction. Endothelial dysfunction in patients with myocardial virus persistence can occur independently of endothelial activation or myocardia l inflammation but is more pronounced in patients with concurrent inflammation.
文摘McCune-Albright syndrome(MAS)is a rare disease characterized by caféau lait spots,bone fibrous dysplasia,and precocious puberty.Most MAS cases are diagnosed before adolescence.Here,we reported an adolescent girl underwent mistaken oophorectomy for suspected ovarian tumor,and later,she was diagnosed with MAS.An 11-year-old girl was found to have an irregular pelvic mass measuring 9.74 cm×9.01 cm×7.30 cm with a cyst-solid component and a clear boundary by magnetic resonance imaging.She underwent right oophorectomy for the suspected ovarian tumor.However,histopathological examination showed ovarian tissue with many antral follicles.One week after the surgery,ultrasonography revealed a left pelvic irregular echo-free mass measuring 60 mm×53 mm×48 mm.The patient was then examined by endocrine specialists,and caféau lait spots were found predominantly located on the right side of her waist,hip,and thigh.She had her first period before the surgery,and her serum concentrations of sex hormones were normal.Thus,MAS was diagnosed.The patient has been taking dydrogesterone 20 mg/d for 10 days from the 14th day of her period for 2 years.Ultrasonography performed every 3-6 months revealed no enlargement of her left ovary.Awareness of MAS and careful physical and imaging examination should be emphasized,even in the absence of full classic triad of syndromes.Hence,unnecessary oophorectomy and irreversible loss of fertility potential can be avoided in these patients.
