Cor triatriatum sinister in a 43-year-old man with syncope.

Cor triatriatum sinister, a congenital cardiac anomaly involving a fibromuscular membrane that partitions the left atrium into 2 chambers, has been reported in only 0.1% to 0.4% of patients with congenital heart disease. The posterosuperior chamber receives blood from the pulmonary veins, and the anteroinferior chamber contains the left atrial appendage and mitral valve orifice. Most patients are diagnosed with the condition in infancy or childhood; adult cases are rare. We describe a case of cor triatriatum sinister in a 43-year-old man whose only presenting symptom was recurrent syncope. He underwent corrective resection of the membrane and was asymptomatic thereafter. In addition to discussing the patient\u27s case, we review the relevant medical literature

Maintaining control over illness : a model of partner activity in prostate cancer

Prostate cancer demonstrates particular characteristics and potential stresses for both patient and partner, yet its consequences for the couple are often inadequately addressed in the clinical setting. One-to-one interviews have shown areas of partner need but do not address the dynamic of the couple which itself holds implications for clinical practice. The participation of nine out of a possible 15 women in interviews with men taking part in a study of information needs suggested the extent of involvement by partners in prostate cancer. Secondary analysis of the verbal interaction and thematic content of the interviews authenticated the representation by members of the couple of the struggle against cancer as a shared experience. The women were shown to exercise authority, accepted by men in relation to illness-related issues and assumed responsibility for the management of information, care and the continuation of normal day-to-day life. Findings suggest a model of partner activity in prostate cancer conceptualized as 'maintaining control over illness'. In the clinical setting, attention to the interaction between partners may facilitate appropriate communication strategies by health professionals, leading to more effective information exchange. Encouragement of the attendance and involvement of partners in the planning of care would support their contribution

rVλ6Wil fibrils cause a decrease in cardiomyocytes MTT reduction without inducing cell death.

<p>(A) Fluorescence microscopy demonstrating the increase in binding of Alexa Fluor-488 labeled rVλ6Wil fibrils (1 μM) over 24 h of incubation (blue, nuclei; red, f-actin). (B) Quantitation of rVλ6Wil fibril binding to cardiomyocytes (μm²/cell; closed circles) correlated inversely, over 24 h, with MTT reduction (open circles). (C) Cell number, quantified using crystal violet (black) did not decrease over 72 h of incubation with 1 μM rVλ6Wil fibrils despite a decrease in MMT reduction (grey; n = 3 samples per time point). (D) Fluorescence micrographs of AC10 cardiomyocytes incubated with or without non-fluorescent 1 μM rVλ6Wil fibrils (blue, nuclei; green, f-actin; numbers represent cell count in 10x objective field of view). (E) Cell viability of AC10 grown in culture for 4 days in the presence or absence of 1 μM rVλ6Wil fibrils for 24, 48, or 72 h, was assessed by CMFDA fluorescence (original objective, 20x. Images were cropped and digitally magnified 4x. Numbers represent the mean live/dead cells, <i>n = 4</i> independent fields of view).</p

rVλ6Wil fibrils bind cultured cardiomyocytes.

<p>(A) Fluorescent synthetic fibrils composed of rVλ6Wil (Alexa Fluor-488, green; arrow) bound specifically to cultured AC10 cardiomyocytes (blue, nuclei; red, f-actin). (B) Confocal micrographs of cultured cardiomyocytes (blue, nuclei; purple, f-actin) after incubation with 1 μM fluorescent rVλ6Wil fibrils (green). Optical sections at the surface (Z-slice 20), center (Z-slice 45), and bottom (Z-slice 55) demonstrated the presence of fibrils on the cell surface (arrow) and rare intracellular material (arrowhead). All images were enhanced equivalently by increasing the brightness.</p

Metabolic dysfunction of cardiomyocytes is dependent on the presence of rVλ6Wil fibrils.

<p>(A) Supernatants from a suspension of rVλ6Wil fibrils generated by centrifugation of a fibril suspension at either 435,000 x g or 16,000 x g do not decrease MTT reduction by cardiomyocytes (supernatants were used at a 1x or 10x volume equivalent [vol. eq] to the unfractionated fibril suspension). Filtrate from a suspension of rVλ6Wil fibrils passed through a 100,000 (100K) MWCO filter did not contain material that affected MTT reduction (n = 3, per assay). (B) HPLC analysis of supernatant samples from the 435,000 x g (435K) and 16, 000 x g (16K) centrifugation as compared to the same volume of starting rVλ6Wil monomer (M) material. (C) Over the course of rVλ6Wil fibrillogenesis, only samples of the reaction mixture containing ThT-positive material significantly decreased MTT reduction when added for 24 h to AC10 cardiomyocytes. Gray circles, thioflavin T fluorescence (excitation = 450 nm; emission = 490 nm); black circles, MTT reduction (n = 3 sample per time point).</p