Retrospective proof in favor of the articular theory was found in all cases. An explanation for the cyst recurrences was formed based on the articular theory. In addition, a diagnostic and therapeutic protocol is proposed for all atypical peripheral compression neuropathies with the ultimate goal to achieve optimal patient outcome.
Autopsy shows spacing of fistula orifice (arrow) and atrial septal occluder (asterisk).
Central MessageAn atrial septal occluder might be the cause of an atrioesophageal fistula after epicardial radiofrequency ablation for atrial fibrillation.
Dysfunction or failure of the endothelial organ is a heterogenous and often ill-described feature of both cardiovascular and non-cardiovascular disorders. Although seldom recognized as a separate clinical condition, endothelial dysfunction (ECD) is an established catalyst of disease. However, even in recent pathophysiological studies, ECD is frequently oversimplified as a binary state without gradation, based on the assessment of a single function (e.g., synthesis or activity of nitric oxide) and without considering spatio-temporal dimensions (local vs. generalized-acute vs. chronic). In this paper, we suggest a simple scale to grade the severity of ECD and a definition of ECD in three dimensions: space, time, and severity. We also adopt a broader perspective on ECD by integrating and comparing gene expression data of endothelial cells from different organs and diseases, and propose a concept that links common pathophysiological mechanisms. We hope that this will enhance the understanding of the pathophysiology of ECD and stimulate discussion in this field.
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