Laugh syncope as a rare sub-type of the situational syncopes: a case report

<p>Abstract</p> <p>Introduction</p> <p>Laughter is a good medicine; it enhances cardiovascular health and the immune system. What happens, however, if a person laughs too much or the laughter becomes out of control? Laughter-induced syncope is rare and likely goes unrecognized by many health care providers. It is thought to be another form of Valsalva-induced syncope.</p> <p>Case presentation</p> <p>We report the case of a 56-year-old, moderately obese (body mass index of 35) man with a past medical history of sleep apnea, hypertension and hyperlipidemia who suffered from syncope secondary to intense laughter. The patient also had a history of syncope in the distant past when he collapsed on the floor for several seconds. Treadmill stress testing after the incident revealed no arrhythmia or ischemic disease, although he complained of dizziness after the test and a sudden drop in blood pressure was noted.</p> <p>Conclusion</p> <p>Laughter-induced or gelastic syncope is extremely rare. It is thought to be a sub-type of the situational syncopes.</p

Repair Inspection Technique Based on Elastic-Wave Tomography Applied for Deteriorated Concrete Structures

Applying elastic wave tomography as an innovative NDT method, the evaluation of velocity distribution in three-dimensional (3D) before and after the repair is introduced in this study. The increase in the velocity with penetration of the repair material according to the repair effect is identified visually and quantitatively. The 3D tomography technique is newly proposed for one-side access inspection, using drill hammering to generate an elastic wave. Accordingly, the elastic wave velocity distribution result enables to visualize the internal quality of concrete after patch repair is successfully done. In addition, an attempt for reinforced concrete (RC) slab panels is made to confirm the effectiveness of the repair by comparing the velocity distribution of elastic waves obtained from acoustic emission (AE) tomography analysis, before and after the repair. Thus, the velocity recoveries due to injection are found in all the slab panels, and it is confirmed that the elastic wave velocities obtained using this technique can serve as an indicator for examining the state of crack and void filling with injected material. Further, a good correlation is found between the low-velocity region before repair and the amount of injection. These results show the potential of the AE tomography technique to be used as a method for estimating the effect of injection repair

Pulmonary valve endocarditis caused by right ventricular outflow obstruction in association with sinus of valsalva aneurysm: a case report

<p>Abstract</p> <p>Background</p> <p>Right-sided infective endocarditis is uncommon. This is primarily seen in patients with intravenous drug use, pacemaker or central venous lines, or congenital heart disease. The vast majority of cases involve the tricuspid valve. Isolated pulmonary valve endocarditis is extremely rare. We report the first case of a pulmonary valve nonbacterial thrombotic endocarditis caused by right ventricular outlflow tract (RVOT) obstruction in association with a large sinus of Valsalva aneurysm.</p> <p>Case presentation</p> <p>A 60-year-old man with a six-week history of fever, initially treated as pneumonia and sinusitis with levofloxacin, was admitted to the hospital with a new onset of a heart murmur. An echocardiogram showed thickening of the pulmonary valve suggestive of valve vegetation. A dilated aortic root and sinus of Valsalva aneurysm measuring at least 6.4 cm were also identified. The patient was empirically treated for infective endocarditis with vancomycin and gentamycin for 28 days. Four months later, the patient underwent resection of a large aortic root aneurysm and exploration of the pulmonary valve. During the surgery, vegetation of the pulmonary valve was confirmed. Microscopic pathological examination revealed fibrinous debris with acute inflammation and organizing fibrosis with chronic inflammation, compatible with a vegetation. Special stains were negative for bacteria and fungi.</p> <p>Conclusion</p> <p>This is the first case report of a pulmonary valve nonbacterial endocarditis caused by RVOT obstruction in association with a sinus of Valsalva aneurysm. We speculate that jets created by the RVOT obstruction and large sinus of Valsalva aneurysm hitting against endothelium of the pulmonary valve is the etiology of this rare nonbacterial thrombotic endocarditis.</p

Evaluation of Crack Repair Effect for RC Slab Using AE Tomography

Three reinforced concrete (RC) slab-panels are repaired by using the crack injection method. This is because web-shaped crack networks are observed after 46 years in service. In the present research, an attempt is made to confirm the effectiveness of the repair by comparing the velocity distribution of elastic waves obtained from Acoustic Emission (AE) tomography analysis, before and after the repair. Thus, the velocity recoveries due to injection are found in all of the slab panels, and it is confirmed that the elastic wave velocities obtained using this technique can serve as an indicator for examining the state of crack and void filling with injected material. Further, a good correlation is found between the low-velocity region before repair and the amount of injection. These results show the potential of the AE tomography technique to be used as a method for estimating the effect of injection repair