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We describe an unusual case of rapid recurrence of a previously excised inflammatory myofibroblastic tumor of the right ventricular outflow tract in a 5-month-old infant. The infant is asymptomatic 18 months after the second surgery. The very rare cardiac involvement, and the early relapse of the inflammatory pseudotumor, to the best of our knowledge, is a unique combination. The inflammatory myofibroblastic tumor, as known as a pseudotumor or plasma cell granuloma is an uncommon reactive lesion with unknown aetiology. It is found most commonly in the lung and a number of visceral organs, such as the spleen, liver, ileum, salivary glands, urinary bladder, larynx or brain or in the retroperitoneum and lymph nodes. To our knowledge only 9 cases have been published of such tumor arising within the heart.

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Straddling of a solitary atrioventricular valve with an absent atrioventricular connection produces a uniatrial but biventricular connection. In this setting, the valve guarding the abnormal solitary atrioventricular junction cannot be classified morphologically as mitral or tricuspid. The markedly variable valvar morphology likely makes these valves prone to insufficiency in the long term.

Tinuvin 770 [bis(2,2,6,6-tetramethyl-4-piperidinyl) sebacate], is a UV light stabilizer plastic additive used worldwide. It is a component of many plastic materials used in medical and food industries. Earlier studies demonstrated its in vitro L-type Ca2+ channel and nicotinic acetylcholine receptor blocking properties. Our previous experiments have proved the toxic effects of Tinuvin 770 on isolated rat cardiomyocytes. The present study investigates the cardiotoxic effects of Tinuvin 770 in vivo. Wistar rats were intraperitoneally injected with increasing doses of Tinuvin 770 (1, 10, 100 microg, and 1 mg) 15 times during a 5-week period. Myocardial samples were analyzed by light, electron, and fluorescent microscopy. The lead-acetate method was used to detect intracellular Ca2+, and glyoxylic acid technique to assess alteration in adrenergic innervation. Focal myocytolysis and hypercontraction necrosis could be observed in rats treated with higher doses of Tinuvin 770. In these groups, intracellular Ca2+ accumulation and increased catecholamine release were detected. Tinuvin 770 not only displays L-type Ca2+ channel blocking properties, but can also lead to catecholamine release, similar to effects of the first generation of L-type Ca2+ channel blockers. Morphological results correspond to catecholamine-induced myocardial damage. Current literature, as well as our study, indicates that more detailed toxicological analysis of Tinuvin 770 should be required, and current regulations in medical and food industries should adopt the new results.

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Enteroviruses (EVs) are the most frequent pathogens in myocarditis and in the subsequently developing dilated cardiomyopathy as well. Furthermore, persistence of other viruses might play a pathogenic role in the evolution from myocarditis to dilated cardiomyopathy. Explanted heart of 28 patients, who underwent heart transplantation were screened for EV, AdV3 and HHV6 sequences in order to assess the incidence of cardiac viral infection that may be implicated in the pathogenesis of cardiomyopathy, and estimate viral distribution in the myocardium. Viral sequences were extracted from five different regions of the hearts. Nested PCR was used to amplify conservative regions of AdV3, HHV6 and EVs. Histological examination was performed on routinely processed myocardial samples. AdV3 was verified in one fourth of the patients. ADV3 and HHV6 sequences coexisted in one case with inflammatory cardiomyopathy. Some patients had more than one positive area of their heart. AdV3 positive right ventricular samples were double in amount compared to the left ones. None of the patients had positive result for EV. This is the first occasion to identify AdV3 (a mainly respiratory infective virus) sequence in explanted hearts of cardiomyopathy patients. Though the clinical importance of our results is still unclear, AdV3 could be a new member of the viral group with possible pathogenic effect on the myocardium. Regional distribution of viral sequence location confirmed that the right ventricular wall as a biopsy sampling site might be adequate for endomyocardial biopsy pro diagnostic purposes.

Infrequently, post-Caesarean endometritis can progress to severe conditions. A case of postCaesarean endometritis caused by Mycoplasma hominis and Ureaplasma urealyticum is reported in a young patient. In therapy-resistant endometritis unusual causative organisms should be considered and special microbiological investigations are recommended. Case reportIn the case of a 14-year-old white Caucasian woman there was a medical history of miscarriages in 6th and 7th weeks of previous pregnancies. She was hospitalized during her third pregnancy because of imminent abortion in the 8th and 11th weeks and premature labour in the 29th week. As a result of treatment [magnesium was used in the first trimester and Saletanol D5 solution (4 . 5 g sodium chloride, 50 g glucose and 50 g alcohol in 1000 ml solution) was used together with magnesium for tocolysis in the 29th week] she became asymptomatic and was discharged. She was admitted again to the department on the 40th week of gestation in ongoing labour. A Caesarean section was performed because of acute foetal asphyxia (heart rate decelerations), and a healthy, 2800 g girl with Apgar score 10/10 was delivered.The mother developed 38 8C fever on the first postoperative day and gentamicin (160 mg), ampicillin (4 g) and metronidazole (1 . 5 g) therapy was started. Despite the combined antibiotic treatment, her temperature increased during the next 2 days and reached 38 . 8 8C. The uterus was soft by palpation with normal lochia at gross inspection and the Caesarean wound did not show signs of a pathological reaction. A lochia sample was sent for microbiological investigation, but failed to demonstrate any pathological aerobic or anaerobic bacteria in the cultures. At this time, the tests did not include a search for genital mycoplasmas.By the fourth postoperative day the fever increased further, reaching 39 . 5 8C. Curettage was performed and histology revealed endometritis. Ceftriaxone (2 g) was added to the antibiotic treatment and the dose of gentamicin was reduced to 80 mg. The condition of the patient improved and in the next 4 days her temperature did not rise above 38 8C. Afterwards, on postoperative day 8, gentamicin and ampicillin were discontinued, and amoxycillin/clavulanic acid (4 . 8 g) and nystatin (1 500 000 IU) were introduced. A day later the body temperature elevated again above 39 8C, and clindamycin (900 mg) was added to the antibiotic therapy. Repeated lochia and blood samples revealed mycoplasmas in the cultures (Mycoplasma hominis and Ureaplasma urealyticum colour-changing units .10 4 ; Mycoplasma Duo, Sanofi Pasteur). Subsequent doxycycline therapy (200 mg on the first day, 100 mg on the following days) rendered the patient afebrile in 4 days and her condition improved rapidly. The standard aerobic and anaerobic cultures of the second lochia and blood samples were negative for bacteria.Chlamydia trachomatis antigen tests (IDEIA Chlamydia, DAKO) of the patient's cervical sample and smears from the newborn's eye and vagina on the third day of doxycyclin...