Data regarding the optimal therapeutic approach of patients with primary mediastinal B-cell lymphoma and cardia c involvement are limited. Reports suggest that multi-agent systemic chemotherapy, along with radiation therapy, may be effective in the treatment of these patients. However, a subgroup of patients do die suddenly due to myocardial rupture following the initiation of treatment. We report on the successful management of a patient with primary mediastinal large B-cell lymphoma with extensive cardiac involvement.

Cardiovascular diseases are the leading cause of death in Brazil The pulse wave velocity is an independent cardiovascular risk factor detecting arterial

The problem of synchronization of oscillations of various physical nature is discussed. From the standpoint of the theory of synchronism, the model of the heart is considered as a system of four interconnected between self-oscillatory objects: two atria and two ventricles. The synchronous and asynchronous modes of operation with sinusoidal and relaxation oscillations are considered. A computer program simulating the electrical oscillations occurring in the heart has been compiled using four differential equations. Examples of calculation by the program are given for asynchronous and synchronous modes of operation. The possibility of evaluating the ablation procedure from the standpoint of a computer model mate is discussed.

A rare tumor, esophageal schwannoma, was fi rst described by Chaterlin and Fissore in 1967 [1]. These tumors are commonly found incidentally in patients presenting with symptoms of GERD, dysphagia, or dyspnea with the fi rst evidence being an abnormal chest radiograph. Histologically the tissue presents as bundles of bland spindle cells with elongated nuclei without evidence of mitotic activity that typically appear in palisade arrangements. Stains S100 and SOX-10 are positive and STAT6 is negative. Axons are missing on neurofi lament stains. Histologically, Antoni A tissue demonstrates this palisading cellular arrangement and associated Verocay bodies refl ecting prominence of an extracellular matrix and secretion of laminin. Antoni B tissue is more loosely organized and most likely refl ects degenerated Antoni A tissue. The presence of these histological markers is indicative of a Schwannoma tumor that is amenable to excision without need of adjunctive therapy as these tumors are rarely malignant. We present the case of a 46 year old Caucasian female whose tumor was incidentally discovered during workup for surgical laminectomy.

During the last years metalloproteinases as a family of proteases have been implicated in various human diseases and catalytic mechanisms of pathological disorders. Metalloproteinases can be divided into two subgroups, matrix metalloproteinases (MMPs) and adamalysins (ADAMs). The MMPs consist of 6 basic subgroups which are inhibited by the tissue inhibitors of metalloproteinase (TIMP), while ADAMs consists of approximately 40 members. It is confi rmed that metalloproteinases are an important factor for the cardiac remodeling process, interfering with the alteration of the cardiac structure induced by cardiac injury or increased haemodynamic load. The aim of this review is the analysis of the impact of metalloproteinases on cardiac remodeling and the factors affecting metalloproteinase activity. Metalloproteinases induce the remodeling process of the cardiac tissue in both benefi cial and detrimental ways. TIMPs and various administered pharmacological agents may limit the effectiveness of metalloproteinases, therefore interfering in cardiac remodeling.

Ventricular tachycardia (VT) storm continues to be an important challenge for the cardiologists all over the globe. VT storm usually occurs in a structurally diseased heart with low left ventricular ejection fraction (LVEF) but may also occur in patients with arrhythmic syndromes like long QT syndrome, Brugada syndrome and catecholaminergic polymorphic VT who have structurally normal heart. Despite its life threatening consequences, the guidelines and literature regarding management of incessant VT is sparse. Here we present a middle age male who presented with scar related refractory VT. Unfortunately we lost the patient; but this case highlights the diffi culty and challenges faced in management of hemodynamically unstable VT storm.