The screening chest X ray was performed by a 51 years old men without cardiac history, which has shown a mass-like density at the left side of the heart.Echocardiography and cardiac MRI were performed.The global left ventricular function was reduced, Hypokinesis and transmural LGE with MVO were confirmed in the anterior, septal and inferior apical segments and in the apex.Furthermore large (7*6*6 cm) cystic mass was shown in the anterior intreventricular sulcus.The SI in the cyst was high on the T2w images, but in it there were two small hypointens masses.The SI in the cyst on the LGE images was a little bit higher then in the left ventricle.The small masses were not enhaced.Because of the patient was asymptomatic, elective coronary CTA was planned for the differential diagnosis of the cystic mass, and for the diagnosis of coronary artery disease.Unfortunately 3 weeks later the patient had a typical chest pain and STE in the anterior ECG leads.Urgent coronary angiography was performed.Subtotal occlusion In the middle segment of the LAD and large coronary aneurysm were confirmed.Urgent coronary bypass surgery was performed.After the resection of the coronary aneurysm the LAD and the D1 were grafted with SV.Coronary aneurysm and trombus were confirmed by histology.After 1 year the patient is asymptomatic.Coronary artery aneurysms are detected in 1.2-4.9% of patients undergoing coronary angiography and are reportedly present in 1.4% of post-mortem examinations.They occur in males more frequently than females.The most affected coronary artery is the RCA.Our case highlights the potential problems associated with coronary aneurysms.Coronary aneurysm usually remains asymptomatic however they can be complicated by myocardial infarction.

UNLABELLED:Revascularization after long term aortic ischaemia in vascular surgery induces reperfusion injury accompanied with oxidative stress and inflammatory responses. The hypothesis of this study was that the aortic occlusion followed by controlled reperfusion (CR) can reduce the ischaemia-reperfusion injury, the systemic and local inflammatory response induced by oxidative stress.Animal model was used. CONTROL GROUP:animals underwent a 4-hour infrarenal aortic occlusion followed by continuous reperfusion. Treated group: animals were treated with CR: after a 4-hour infrarenal aortic occlusion we made CR for 30 minutes with the crystalloid reperfusion solution (blood: crystalloid solution ratio 1:1) on pressure 60 Hgmm. Blood samples were collected different times. The developing oxidative stress was detected by the plasma levels of malondialdehyde, reduced glutathion, thiol groups and superoxide dismutase. The inflammatory response was measured by phorbol myristate acetate-induced leukocyte reactive oxygen species production and detection of change in myeloperoxidase levels. The animals were anaesthetized one week after terminating ligation and biopsy was taken from quadriceps muscle and large parenchymal organs.CR significantly reduced the postischaemic oxydative stress and inflammatory responses in early reperfusion period. Pathophysiological results: The rate of affected muscle fibers by degeneration was significantly higher in the untreated animal group. The infiltration of leukocytes in muscle and parenchymal tissues was significantly lower in the treatedgroup.CR can improve outcome after acute lower-limb ischaemia. The results confirm that CR might be also a potential therapeutic approach in vascular surgery against reperfusion injury in acute limb ischaemia. Supported by OTKA K108596.

Pituitary adenylate cyclase activating polypeptide (PACAP) is a pleiotropic and multifunctional neuropeptide having important roles in various physiological processes. Recent trends in PACAP research point to the clinical introduction of PACAP or its analogs/fragments possibly in the near future. Recently, we have shown the presence of PACAP in human plasma, milk, placenta, and follicular fluid samples. However, relatively few data are available on PACAP in human tissues from patients with different disorders. The aim of the present study was to determine, by radioimmunoassay, the tissue level of PACAP38-like immunoreactivity (LI) and PACAP27-LI in different primary non-small cell lung cancer, colon tumor samples, and in cardiac muscle samples from patients suffering from ischemic heart disease and valvular disorders. We also labeled the PAC1 receptors in human cardiac cells. All samples showed significantly higher PACAP38-LI compared with PACAP27-LI. We found significantly lower levels of PACAP38-LI and PACAP27-LI in tumoral and peripheral samples compared with normal healthy tissue in both lung and colon cancers. Further investigations are necessary to describe the exact function of PACAP in oncogenesis. We showed that PACAP38-LI and PACAP27-LI are significantly higher in ischemic heart diseases compared with valvular abnormalities, suggesting that PACAP might play a role in ischemic heart disorders.