Since the first-in-man transcatheter delivery of an aortic valve prosthesis in 2002, the landscape of aortic stenosis therapeutics has shifted dramatically. While initially restricted to non-surgical cases, progressive advances in transcatheter aortic valve replacement and our understanding of its safety and efficacy have expanded its use in intermediate and possibly low surgical risk patients. In this review, we explore the past, present, and future of transcatheter aortic valve replacement.
Aortic Valve ; Aortic Valve Stenosis ; Humans ; Prostheses and Implants ; Transcatheter Aortic Valve Replacement*

Background and Objectives: Virtual reality (VR) users have prevalently experienced motion sickness called cybersickness. Recently, it has been suggested that stimulating the mastoid by vibration relieves cybersickness. This study aimed to verify this proposition.Subjects and Method Fifty-four young male adults (aged 18 to 27 years) without any experience of severe motion sickness or cybersickness participated in this study. Participants were divided in half into two groups, the experimental group and control group. The experimental group used VR with mastoid vibration, and the control group experienced VR without mastoid vibration. Participants responded to the simulator sickness questionnaire (SSQ) to quantify cybersickness. Results: The total severity scores of cybersickness in the experimental group ranged from 0 to 183.3 with the mean value of 46.7±49.0. The total severity scores of cybersickness in the control group ranged from 0 to 194.9 with the mean value of 44.9±45.1. There were no significant differences between the two groups. Conclusion There was no improvement of cybersickness in the VR participants when the mastoid was stimulated by vibration. However, cybersickness might be relieved with changes in the VR condition or vibration settings.

Binder syndrome, also called the congenital flat nose syndrome, is a rare congenital malformation with a flat facial profile, intermaxillary hypoplasia and malocclusion. Rhinoplasty plays an important part in the multidisciplinary surgical protocol for this syndrome, for which weak nasal framework and soft tissue underdevelopment have been considered a great challenge. We present a case of Binder syndrome of a 27-year-old male. The nose was reconstructed with a caudal septum replacement graft and bilateral extended spreader grafts using costal cartilage.
Adult ; Costal Cartilage ; Humans ; Male ; Malocclusion ; Nose ; Rhinoplasty ; Transplants

Binder syndrome, also called the congenital flat nose syndrome, is a rare congenital malformation with a flat facial profile, intermaxillary hypoplasia and malocclusion. Rhinoplasty plays an important part in the multidisciplinary surgical protocol for this syndrome, for which weak nasal framework and soft tissue underdevelopment have been considered a great challenge. We present a case of Binder syndrome of a 27-year-old male. The nose was reconstructed with a caudal septum replacement graft and bilateral extended spreader grafts using costal cartilage.

Primary malignant neoplasm of the pericardium is very rare. Neoplastic involvement of the pericardium may result in rapidly developing hemorrhagic effusion. A 30-year-old male who occasionally suffered from chest tightness was referred to our hospital under the diagnosis of unstable angina. He presented with acute chest pain and severe dyspnea that had developed one day previously. The diagnostic investigations such as echocardiography, chest CT and magnetic resonance image suggested cardiac tamponade that was caused by rupture of the pericardial teratoma. An operation to remove the tumor and effusion was performed. The pericardial mass was completely excised, and the result of the frozen biopsy favored malignancy. The final pathologic report was malignant fibrosarcoma of the pericardium and no malignant cells were found on the cytology of the pericardial effusion. The patient had a smooth postoperative course and was referred to another hospital for additional radiation therapy. We report here on this case of cardiac tamponade that was caused by primary pericardial fibrosarcoma, and this required urgent diagnosis and surgical management.
Adult ; Angina, Unstable ; Biopsy ; Cardiac Tamponade* ; Chest Pain ; Diagnosis ; Dyspnea ; Echocardiography ; Fibrosarcoma* ; Heart Neoplasms ; Humans ; Male ; Pericardial Effusion ; Pericardium ; Rupture ; Teratoma ; Thorax ; Tomography, X-Ray Computed

Hypersensitivity myocarditis may result from an allergic reaction to a variety of agents such as antibiotics, anticonvulsants and diuretics. A diagnosis of hypersensitivity myocarditis should be considered in any patient with an ongoing allergic reaction to a drug, evidence of peripheral eosinophilia, an appearance of new electrocardiographic changes, mildly elevated cardiac enzyme, mild cardiomegaly on chest X-ray or unexplained tachycardia. This condition is rarely recognized clinically although it is occasionally diagnosed on endomyocardial biopsy. We report a 25 year-old woman with hypersensitivity myocarditis, which was diagnosed by endomyo-cardial biopsy and successfully treated by immunosuppression therapy with corticosteroids.
Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Anticonvulsants ; Biopsy ; Cardiomegaly ; Diagnosis ; Diuretics ; Electrocardiography ; Eosinophilia ; Female ; Glucocorticoids ; Humans ; Hypersensitivity* ; Immunosuppression ; Myocarditis* ; Tachycardia ; Thorax

A 34-year-old woman was admitted to the hospital because of recently aggravated right heart failure without angina for 5 months. When she was 25 years old, patch repair with Polytetrafluoroethylene (PTFE) was performed for the secondum type of atrial septal defect (ASD) with moderate pulmonary hypertension. The chest PA, echocardiography and cardiac catheterization at current admission revealed Eisenmenger syndrome without intracardiac shunt. Chest CT scan with contrast revealed markedly dilated pulmonary trunk, both pulmonary arteries and concave disfigurement of the left side of the ascending aorta suggesting extrinsic compression, as well as total occlusion of the ostium of the left main coronary artery that was retrogradly filled with collateral circulation from the right coronary artery. The coronary angiography showed normal right coronary artery and the collaterals that come out from the conus branch to the mid-left anterior descending artery (LAD) and that from distal right coronary artery to the left circumflex artery (LCX) and to the distal LAD, respectively. On aortography, the left main coronary artery was not visualized with no stump, suggestive of total occlusion of the ostium of the left main coronary artery. From our experience, it is possible to say that the occlusion of the ostium of the left main coronary can be induced by the dilated pulmonary artery trunk due to ASD with pulmonary hypertension and that, if the ASD closure was too late, the narrowing or obstruction of the left coronary artery could not be resolved even after operation owing to irreversible pulmonary hypertension.
Adult ; Case Report ; Constriction, Pathologic/etiology/radiography ; Coronary Disease/*etiology/radiography ; Dilatation, Pathologic/etiology ; Eisenmenger Complex/diagnosis ; Female ; Heart Septal Defects, Atrial/*complications ; Human ; Hypertension, Pulmonary/*complications ; *Pulmonary Artery/radiography