Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

Coronary artery fistula is an unusual anomaly in elderly patients that consists of a communication bet- ween one of the coronary arteries and other cardiac chambers or veins. It causes many cardiac compli- cations due to hemodynamic changes, and thus has recognized its clinical significance. It occurs usually in congenital origin, but also occurs secondarily in traumatic or neoplastic or artherosclerotic coronary diseases. Congenital coronary artery fistula is a very rare congenital anomaly that results in multiple hemodynamic complications. It has reported rarely in elderly patients, that induces myocardial ischemia due to coronary steal syndrome and heart failure that caused by diastolic volume overload via a left to left shunt. We observed a 68-year-old male patient with exertional chest pain and dyspnea, in whom selective coronary angiography revealed abnormal reticular communication between left anterior descending artery and left circumflex artery and drained to left ventricle through multiple microfistulous channels. We report this patient case who complicated by myocardial ischemia and left ventricular failure those caused by hemodynamic complication due to multiple coronary artery-left ventricular fistulae.
Aged ; Arteries ; Cations ; Chest Pain ; Coronary Angiography ; Coronary Disease ; Coronary Vessels ; Dyspnea ; Fistula ; Heart Failure* ; Heart Ventricles ; Heart* ; Hemodynamics ; Humans ; Male ; Myocardial Ischemia ; Veins

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

BACKGROUND: The recent studies shows that LV relaxation abnormalities are the important factors of heart failure in elders. To determine the association between LV diastolic functions and heart failure, we assessed LV diastolic functions in elderly patients with pulmonary congestion and in asymptomatic elders by using pulsed doppler echocardiography. METHODS: In order to assess LV diastolic function, we performed pulsed doppler echocardiography to elderly patients with pulmonary congestion and asymptomatic elders from Mar.2001 to Sep.2001. The following parameters were used as indices of LV diastolic function; Mitral E wave(E), Mitral A wave(A), Deceleration time(DT), Isovolumic relaxation time(IVRT), Systolic pulmonary venous flow(PVs), Diastolic pulmonary venous flow(PVd). RESULTS: In elderly patients groups, there was significant increase in deceleration time compared with asymptomatic elders(255.83+/-54.41 vs 210.80+/-48.53, p<0.05). There was significant increase in isovolumic relaxation time in elderly patient group compared with asymptomatic elders(123.06+/-25.07 vs 98.78+/-15.12, p<0.01). Although there was no significant difference, decreased E/A ratio and increased PVs/PVd were noted in both groups. CONCLUSIONS: The results shows that the impairments of LV diastolic function were noted in both groups. Especially DT and JVRT were significant increase in elderly patient group with pulmonary congestion. Therefore these parameters, such as DT, IVRT, can be helpful as predictive indices of diastolic heart failure in elders.
Aged* ; Deceleration ; Echocardiography, Doppler, Pulsed ; Estrogens, Conjugated (USP)* ; Heart Failure ; Heart Failure, Diastolic ; Humans ; Relaxation

BACKGROUND AND OBJECTIVES: Alterations of olfactory function among patients with cirrhosis of the liver, acute viral hepatitis or alcoholic liver disease have been reported. The goal of this study is to evaluate the alteration of olfactory function among chronic viral hepatitis patients. MATERIALS AND METHODS: The study group consisted of 21 patients with chronic active viral hepatitis and 32 normal subjects. Between December 2006 and January 2008, olfactory function among the study groups was evaluated using the Connecticut Chemosensory Clinical Research Center and the Cross Cultural Smell Identification Test. Then, correlations between the olfactory function test scores and serological data were analyzed. RESULTS: Hepatitis patients had significantly lower smell identification test scores. Only serum total bilirubin level had negative correlation with smell identification test scores. CONCLUSION: Chronic viral hepatitis appears to influence olfactory function.
Bilirubin ; Connecticut ; Fibrosis ; Hepatitis ; Humans ; Liver ; Liver Diseases ; Liver Diseases, Alcoholic ; Smell

BACKGROUND: Metabolic syndrome, a concurrence of disturbed glucose and insulin metabolism, over- weight and abdominal fat distribution, dyslipidemia and hypertension, is associated with subsequent de- velopment of type 2 diabetes mellitus and cardiovascular disease, especially coronary heart disease. The aim of the study is to assess the relationship between metabolic syndrome and coronary heart disease in elderly greater than 65 years old. METHODS: Eighty two elderly patients greater than 65 years old who underwent coronary angiography were divided into two groups with metabolic syndrome or without metabolic syndrome, and assessed the association with coronary angiographic finding. The metabolic syndrome factors and cardiovascular risk factors of JNC 7 were investigated to assess the relationship with coronary heart disease in elderly. Coronary heart disease was defined as 50% or greater diameter in stenosis of coronary artery in coronary angiography. RESULTS: In elderly patients with metabolic syndrome, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p<0.05) were presented significantly higher than non metabolic syndrome patients. In elderly patients with 3 and more cardiovascular risk factors of JNC 7, coronary angiographically abnormal findings(p<0.05) and multi vessel disease findings(p=0.059) were presented more than the other patients. Diabetes mellitus was related significantly with coronary heart disease(p value 0.044). CONCLUSION: In elderly patients, metabolic syndrome was significantly related with coronary heart disease and diabetes mellitus had strong relationship with coronary heart disease. Metabolic syndrome and cardiovascular risk factors of JNC 7 should be further evaluated to assess the relationship with coronary heart disease in the future.
Abdominal Fat ; Aged* ; Cardiovascular Diseases ; Constriction, Pathologic ; Coronary Angiography ; Coronary Disease* ; Coronary Vessels ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Dyslipidemias ; Glucose ; Heart ; Humans ; Hypertension ; Insulin ; Metabolism ; Risk Factors

Truncus arteriosus is a rare congenital heart disease which is diagnosed in from 1 to 2 percent of congenital cardiac birth. Whithout surgical intervention, survival beyond infancy is unusual. Unoperated patients who survive to adult life have associated pulmonary stenosis or have developed pulmonary arteriolar disease. We report a case of truncus arteriosus in a 17-year-old man with a review of literature.
Adolescent ; Adult ; Heart Defects, Congenital ; Humans ; Parturition ; Pulmonary Valve Stenosis ; Truncus Arteriosus*

No abstract available.
Aortic Coarctation*

BACKGROUND AND OBJECTIVES: The presence of ectopic tooth in the sinonasal cavity is an unusual phenomenon and the underlying etiology remains unclear. Because of its rarity, clinical observation studies about sinonasal ectopic tooth are very rare. The aim of this study was to analyze the clinical characteristics of ectopic tooth occurring in the sinonasal cavity. SUBJECTS AND METHOD: Medical records and radiologic studies of 11 patients, who were treated between January 2006 and June 2012 for ectopic nasal teeth were reviewed retrospectively, with regard to sex, age, location, symptoms and treatment methods. RESULTS: Among 11 patients, 8 patients were male and 3 patients were female. The average age was 24.2 years. Among 7 patients who had symptoms, nasal obstruction was the most common followed by rhinorrhea, postnasal drip, facial swelling or pain, headache. The nasal cavity was the most frequently affected site. Among 14 ectopic teeth from eleven patients, 7 were removed by intrasnasal endoscopy and 2 by external premaxillary approach. Five teeth which were unerupted within the hard palate or maxillary sinus were offered conservative treatment with periodic follow-up. CONCLUSION: Removal of ectopic nasal tooth is generally advocated to alleviate the symptoms and prevent complications; if conservative treatment is decided, periodic monitoring of the patient is recommended. We suggest that treatment be carefully planned based on the symptoms of patients, location of the ectopic tooth, and whether the tooth is erupted or not.
Endoscopy ; Female ; Headache ; Humans ; Male ; Maxillary Sinus ; Medical Records ; Nasal Cavity ; Nasal Obstruction ; Palate, Hard ; Paranasal Sinuses ; Retrospective Studies ; Tooth ; Tooth, Supernumerary

BACKGROUND AND OBJECTIVES: Although systemic steroid is widely used, there is no established standard treatment for patients with sensorineural olfactory disorder. The aim of this study was to prospectively investigate the effect of stellate ganglion block (SGB) in patients with sensorineural olfactory disorders unresponsive to systemic steroids. SUBJECTS AND METHOD: Twenty patients with anosmia or hyposmia following upper respiratory tract infection (URI) that was unresponsive to systemic steroid treatments were included in this study from February 2009 through December 2009. Nine patients were treated with SGB (the treatment group) and compared with the 11 untreated patients (the control group). Except for SGB, both groups were treated the same otherwise (with topical steroids, vitamins, peripheral vasodilators) during the treatment period. We evaluated the olfactory function using Korean Version of Sniffin' Sticks test II (KVSS II) and the subjective symptom questionnaire (SSQ). RESULTS: The KVSS II scores improved significantly only in the treatment group, showing a significant difference between the two groups, whreas the SSQ scores were improved in both groups and did not show significant differences. KVSS II and SSQ scores showed a significant correlation. CONCLUSION: These results suggest that SGB may be effective in the treatment for patients with sensorineural olfactory disorder following URI unresponsiveness to systemic steroid treatments.
Humans ; Olfaction Disorders ; Prospective Studies ; Surveys and Questionnaires ; Respiratory System ; Respiratory Tract Infections ; Smell ; Stellate Ganglion ; Steroids ; Vitamins