Painful post-traumatic trigeminal neuropathy (PPTTN) is a distinctive facial pain syndrome characterized by facial and/or oral pain along the sensory distribution of the fifth cranial nerve with a clear history of a traumatic event. To our knowledge, PPTTN after endoscopic sinus surgery (ESS) has not been reported in the literature. We present a case of an elderly woman who experienced unilateral neuralgic pain after undergoing ESS. Following ESS of the left sphenoid sinus to remove suspicious fungus balls, the patient complained of intermittent facial pain occurring in the left periorbital and forehead area. Clinical diagnosis of PPTTN was established after a comprehensive multidisciplinary assessment. The pain disappeared completely after a 5-week medical treatment with gabapentin. Since PPTTN cases associated with ESS are extremely rare, our case demonstrates that PPTTN should be considered in the differential diagnosis of facial pain developing after ESS and can be successfully treated with medical therapy.

Coronary artery fistula draining into lung parenchymal vasculature has not been reported. Herein, we describe a case of an 81-year-old woman who presented with a localized pulmonary edema on right upper lobe associated with coronary fistula emptied into vasculature in right upper lobe. She underwent transcatheter closure of the fistula with an Amplatzer Vascular Plug 4, which resulted in complete occlusion and improved localized pulmonary edema.
Aged, 80 and over ; Coronary Vessels* ; Female ; Fistula* ; Humans ; Lung* ; Pulmonary Edema*

OBJECTIVES: We investigated the significance of interoceptive fear in assessment of panic disorder (PD) patients. METHODS: 102 patients affected by PDs with (n=68) or without (n=34) agoraphobia according to DSM-IV criteria completed self-report questionnaires, such as Albany Panic and Phobia Questionnaire (APPQ), The Expanded Anxiety Sensitivity Index (ASI-R), Agoraphobic Cognitions Questionnaire (ACQ), Body Sensation Questionnaire (BSQ), Beck Anxiety Inventory (BAI), and Panic Disorder Severity Scale (PDSS). Pearson correlation analysis, stepwise regression analysis, paired t-test and independent t-test were used. RESULTS: All variables except BSQ were significantly correlated with panic severity. In stepwise regression analysis, interoceptive fear and catastrophic cognition were the most significant predicting variables for panic severity. After 3-months medication, all variables significantly diminished, but interoceptive fear and catastrophic cognition of panic patients were still significantly higher than normal control. CONCLUSION: Interoceptive fear is the fear of automatic sensations that are similar to those of a panic attack and is the most significant variable in predicting panic severity. After 3-months medication, interoceptive fear significantly decreased, but still was higher than the control group.
Agoraphobia ; Anxiety ; Cognition ; Diagnostic and Statistical Manual of Mental Disorders ; Humans ; Panic Disorder* ; Panic* ; Phobic Disorders ; Surveys and Questionnaires ; Sensation

The risk for venous thromboembolism (VTE) in total hip arthroplasty and hip fracture surgery is much higher than that of any other surgery. There is a general agreement that prevention of VTE in hip surgery patients is necessary due to concerns regarding symptomatic deep vein thrombosis or fatal pulmonary embolism. Optimal strategies for prevention of VTE include pharmacologic and mechanical approaches; however, the ideal prophylactic regimen has not been identified. Selection of a prophylactic regimen should be balanced between efficacy and safety. This article discusses the different prophylactic options available today for prevention of VTE in hip surgery patients.
Arthroplasty, Replacement, Hip ; Hip* ; Humans ; Pulmonary Embolism ; Venous Thromboembolism* ; Venous Thrombosis

Noncompaction of the ventricular myocardium is a rare congenital cardiomyopathy caused by arrest of normal endomyocardial embryogenesis. Isolated right ventricular noncompaction (IRNC) is an even rarer form of this disease. We report herein on a 68 year-old male diagnosed with IRNC who presented with right-sided heart failure, without involvement of the left ventricle. Diagnosis was achieved with the aid of echocardiography and ventriculography. Medical treatment including prescription of diuretics, a calcium channel blocker, and digitalis, improved both the symptoms and right ventricular function.
Calcium Channels ; Cardiomyopathies ; Diagnosis ; Digitalis ; Diuretics ; Echocardiography ; Embryonic Development ; Female ; Heart Failure ; Heart Ventricles ; Humans ; Male ; Myocardium ; Pregnancy ; Prescriptions ; Ventricular Function, Right

Background and Objectives: The diagnosis of hearing impairment is based on repeated audiometry, including pure tone audiometry (PTA), speech reception threshold test (SRT), and speech discrimination test (SDT). SDT results particularly show a wide discrepancy upon repeated testing, while malingering is suspected when having more than 12% difference between 3 individual SDT results. Therefore, in this study, we compared the proportion of malingering found in repeated SDT with that found in other audiometric tests and analyzed the characteristics of malingering group in order to reevaluate the current criteria of defining malingering.Subjects and Method We retrospectively assessed the audiometry results of 113 patients (226 ears) with hearing impairment. Each ear was divided into a malingering group and a true hearing loss group. The proportion of ears corresponding to each malingering criterion was compared using a chi-square test. An independent sample t-test was performed to identify the differences between the characteristics between the two groups. Results: The number of ears that met the malingering criteria were 19 (8.41%) in PTA, 15 (6.64%) in SRT, and 75 (33.19%) in SDT. There was a significant difference in the proportion of malingering between the 3 hearing test modalities (p<0.001). There was no significant difference in auditory brainstem response, mean age and sex distribution between the malingering group and the true hearing loss group. Conclusion When conducting repeated SDT, there is a risk of misdiagnosing an actual hearing loss patient as a malingering patient under the current malingering criteria. Therefore, the current criteria on SDT requires reevaluation.

Background and Objectives: There is no clear standard for the difference in the thresholds of auditory brainstem response (ABR) and pure tone audiometry (PTA) when using ABR to evaluate the reliability of PTA. Therefore, we assessed the difference in the thresholds of ABR and PTA for each frequency. Consequently, we present here the actual difference values between the two tests that can be used as a reference in the clinic.Subjects and Method We retrospectively assessed the audiometry results of 129 ears. Ears in which the hearing thresholds of each frequency continuously declined were classified as the downward group. We compared the average of differences between the two tests by frequency. The differences were compared for each hearing level from 50 dB or higher. Results: For all ears, the appropriate range of difference value was ±5 dB at 2 kHz. At 1 kHz, the ABR threshold was 10 dB higher than PTA, and it was 10 dB less than PTA at 4 kHz. In the downward group, the difference value increased by 10 dB at 1 kHz and 4 kHz. In the subgroups at each hearing level, the difference value showed similar results (p<0.05). Conclusion The difference in the threshold, regardless of the severity or tendency of hearing loss, was the smallest at 2 kHz and the range was ±5 dB. ABR was 10 dB higher at 1 kHz and and 10 dB lower at 4 kHz than PTA. In the downward group, the difference at 1 kHz and 4 kHz increased by 10 dB each.

Background and Objectives: Patients with hearing loss and tinnitus experience difficulty in engaging in daily conversations. However, only few studies have examined how tinnitus affects individual speech discrimination to comprehend speech. This study aimed to analyze the correlation between tinnitus frequency and speech discrimination in patients with hearing loss and tinnitus.Subjects and Method A total of 275 ears with hearing impairment were retrospectively analyzed via audiometry and tinnitogram. The ears were divided into three groups depending on the frequency of their tinnitus. Average pure tone audiometry (PTA), hearing threshold of tinnitus frequency, speech discrimination test (SDT), degree of discrepancy between tinnitus frequency and worst PTA frequency were collected and compared among the three groups. Results: No significant difference was observed in PTA in the three patient groups. Hearing threshold of tinnitus frequency was the highest at 78.27 dB in the high-frequency group and the lowest at 45.14 dB in the low-frequency group. SDT was significantly lower (53.69%) in the low-frequency group. The correlation between tinnitus loudness and SDT was the strongest in the low-frequency group. The degree of discrepancy between tinnitus frequency and worst PTA frequency was also significantly observed in the low-frequency group. Conclusion Patients who are severely affected by tinnitus are found to have significant discrepancy between tinnitus frequency and worst PTA frequency, indicating decreased SDT.