Apparent acute reversible right ventricular pacing-induced left ventricular dysfunction.

We report the case of a 70-year-old Caucasian male with a dual chamber (right atrium/right ventricle) pacemaker implanted for sinus node dysfunction and not pacemaker (PM) dependent who was found to have an apparent acute worsening of left ventricular (LV) function with right ventricular (RV) apical pacing caused by the mode switch to VVI pacing as battery depletion occurred. LV dysfunction resolved immediately with RV pacing turned off. To our knowledge, this is the first report of this phenomenon.

Development and validation of a prognostic index for risk stratification of patients with early repolarization.

Background: Early repolarization (ER) is associated with increased mortality in the general population. We sought to develop and validate a prognostic index (PI) of mortality in patients with ER.

Methods: We identified 852 consecutive patients (mean age 49 ± 12 years) with ER (J-point elevation ≥0.

Prolonged postsurgical survival without a pulmonic valve: case report and review of the literature.

Pulmonic valve stenosis is usually congenital and causes right-sided heart failure secondary to pressure overload. We report the case of a 56-year-old male with congenital pulmonary valve stenosis who presented with severe right heart failure 32 years after pulmonary valvectomy. He subsequently underwent pulmonary valve replacement and did well.

Famciclovir-induced leukocytoclastic vasculitis.

Objective: To report a case of famciclovir-induced leukocytoclastic vasculitis (LCV).

Case Summary: A 67-year-old white female presented to the hospital for evaluation of large, bilateral palpable purpura; coalescing ulcers with central eschars; and small, red violaceous papules on her legs and groin. Approximately 2 months prior to this hospitalization, the woman was diagnosed with shingles of her left T1-T2 nerve distribution and was treated with famciclovir 500 mg 3 times daily, which was her first exposure to this medication.

Recurrent malignant melanoma of the penis.

We report the case of a 72-year-old man with arcal-lentiginous type melanoma of the penis who had undergone local excision and bilateral inguinal lymphadenectomy but developed recurrence at the subcoronal ridge of the glans penis. To our knowledge, this is the 10th reported case in English published studies. We believe this case demonstrates the importance of close follow-up postoperatively and to beware of the recurrence of penile melanoma in patients without total penectomy.

Percutaneous cystolithotomy of large urinary-diversion calculi using a combination of laparoscopic and endourologic techniques.

Background And Purpose: Patients with urinary diversions are at higher risk for bladder urolithiasis. Often, the stone burden is large, necessitating open stone removal. We describe our technique for removing such stones using a combination of laparoscopic and endourologic instrumentation.