Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0231807 (exertional dyspnea)
 3,402 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adults, especially high-aged patients with tetralogy of Fallot (TOF) are said to have a higher operative risk than younger ones because of fragility of their myocardium, bleeding from rich collateral circulation to lungs, and other complications such as brain abscess and endocarditis. It is often difficult to determine the surgical risk for total correction in cases of high-aged patients who have such complications. We report a successfully operated high-aged case of TOF with marked left ventricular dysfunction. A 52-year-old male was referred to our hospital because of exertional dyspnea and cyanosis. He had a history of cerebral embolism and meningitis several months prior to admission. On admission, he was NYHA class 3, and cyanosis and clubbed fingers were present. Cardiac catheterization showed a large VSD, 50% over-riding of the aorta and an infundibular pulmonary stenosis. Right to left shunt was 60% and Qp/Qs was 0.38. The left ventricular end diastolic volume index was 109 ml/m2, slightly larger than normal, and the ejection fraction was only 30%. This left ventricular dysfunction was thought to be caused by fibrosis of the myocardium due to longstanding hypoxemia and hypoxemia itself. There is no previous case report dealing with a successful total correction for a high-aged patient with TOF associated with such a severe left ventricular dysfunction. Congestive heart failure in the post-operative period was successfully treated by catecholamine for two weeks. Postoperative cardiac catheterization showed a small left-to-right shunt, and an improvement of left ventricular ejection fraction from 30% to 38%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A successfully operated case of tetralogy of Fallot with marked left ventricular dysfunction in adult]. 223 64

Cryptococcal infections are caused by encapsulated fungi Cryptococcus gattii and C. neoformans. Inhalation commonly causes innocuous colonization but may cause meningitis or disseminated disease via hematogenous spread. Cryptococcosis occurs most commonly in immunocompromised patients including those with acquired immunodeficiency syndrome, meningoencephalitis or disseminated disease. However, cryptococcosis can occur as asymptomatic isolated pulmonary nodules in immunocompetent patients. Here we present a unique retrospective case report of a 55-year-old immunocompetent man who presented with pleuritic chest pain, productive cough, dyspnea on exertion, chills, night sweats, and weight loss. A computed tomography scan of his chest revealed multiple ground-glass opacities throughout both lung fields. The results of his autoimmune evaluation and human immunodeficiency virus tests were negative. A biopsy obtained through video-assisted thoracoscopic surgery revealed mucicarmine staining capsules confirming Cryptococcus, requiring treatment with amphotericin, flucytosine, and fluconazole. This case highlights the rarely studied presentation of symptomatic diffuse pulmonary cryptococcal infection in an immunocompetent patient requiring treatment.
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PMID:An Unusual Case of Pulmonary Cryptococcus. 3078 96