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BACKGROUNDCardiac myxomas are the most frequent cardiac tumors. Although histologically benign, in some cases myxomas may be lethal, due to impairment of cardiac dynamics and their thromboembolic potential. The study aimed to assess the clinical presentation of cardiac myxomas and their correlation with echocardiographic features and to describe the perioperative results and long-term outcome of surgically treated patients.METHODSA prospective study of 53 patients with cardiac myxomas who were operated at Hospital Argerich, followed clinically and with echocardiography from 1993 until 2013. All patients underwent echocardiographic studies.RESULTSThe patient's mean age was 53 ± 16 years (62.3% were women). The most common findings were dyspnea followed by embolic events. Most tumors were localized in the left atrium (77.4%), mainly in the fossa ovalis (63%). Mean size of the tumors was 4.76 x 3.50 cm. Tumors were generally mobile (88%) and went beyond the valve plane, causing mild mitral or tricuspid valve obstruction (58%) and dilation of the respective atrial chamber. Patients whose tumors were obstructive had higher pulmonary artery systolic pressures (50 vs 33 mmHg p < 0.01). According to the echocardiographic appearance 67% of tumors had a smooth surface and the remaining 32% had a villous surface. All patients with embolic manifestations had tumors with a villous surface.CONCLUSIONSClinical presentation relates to the ultrasound characteristics of myxomas. Smooth tumors are larger, occur with obstructive symptoms, and benefit from an elective surgery, whereas villous myxomas entailed a high embolic risk and require prompt surgical treatment.

These data suggest that rhLAMAN may be an encouraging new treatment for patients with alpha-mannosidosis.The study is designed to continue for a total of 18 months. Longer-term follow-up of patients in this study and the future placebo-controlled phase 3 trial are needed to provide greater support for the findings in this study.

Many anonymous communication networks (ACNs) with different privacy goals have been developed. However, there are no accepted formal definitions of privacy and ACNs often define their goals and adversary models ad hoc. However, for the understanding and comparison of different flavors of privacy, a common foundation is needed. In this paper, we introduce an analysis framework for ACNs that captures the notions and assumptions known from different analysis frameworks. Therefore, we formalize privacy goals as notions and identify their building blocks. For any pair of notions we prove whether one is strictly stronger, and, if so, which. Hence, we are able to present a complete hierarchy. Further, we show how to add practical assumptions, e.g. regarding the protocol model or user corruption as options to our notions. This way, we capture the notions and assumptions of, to the best of our knowledge, all existing analytical frameworks for ACNs and are able to revise inconsistencies between them. Thus, our new framework builds a common ground and allows for sharper analysis, since new combinations of assumptions are possible and the relations between the notions are known.