Gene/Protein
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Enzyme
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Pivot Concepts:
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Target Concepts:
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Query: UMLS:C0011168 (
dysphagia
)
15,644
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Mixed connective tissue disease (MCTD) is a rare connective tissue disorder with clinical features that overlap with systemic
lupus
erythematous, systemic sclerosis, and polymyositis. We report the case of a patient who presented with
dysphagia
, 25-lb weight loss, difficulty opening her mouth, and joint pain.
Dysphagia
workup showed a normal barium swallow and normal-appearing EGD but esophageal manometry consistent with severe dysmotility. Through further laboratory and imaging studies, the patient met the diagnostic criteria for MCTD. She had marked improvement in her
dysphagia
with steroids, biologic therapy, and intravenous immunoglobulin.
...
PMID:A Rare Cause of Dysphagia and Weight Loss. 3048 43
Cerebral cavernous malformations are common vascular anomalies consisting of a cluster of capillaries without intervening brain tissue.1 A variety of approaches for resection have been undertaken,2 and a handful of case reports have described the endoscopic, endonasal, transclival approach.3 We present a case of a 51-yr-old woman with
lupus
and hepatitis B-associated cirrhosis who presented with diplopia,
dysphagia
, and ataxia. She had a left abducens nerve palsy and magnetic resonance imaging (MRI) showed a left pontine cavernous malformation. After a repeat hemorrhage, she consented to surgical resection. The lesion appeared to come to the medial pontine pial surface. Tractography indicated a rightward displacement of the left corticospinal tract. Therefore, an endoscopic, transnasal, transclival approach was chosen. A lumbar drain was placed preoperatively. The clivus and ventral petrous bone were drilled using the vidian canal to help identify the anterior genu of the petrous carotid artery. The clival dura was opened, revealing the abducens nerve exiting the ventral pons. The cavernoma was visible on the surface lateral to the nerve. It was removed using blunt dissection and the remaining cavity inspected. The skull base was reconstructed using an abdominal dermal-fat graft and Alloderm covered by a nasoseptal flap. Postoperatively she had transient swallowing difficulty. The lumbar drain was kept open for 5 d. Cerebrospinal fluid (CSF) leak was ruled out using an intrathecal fluorescein injection. She was discharged home, but presented 2 wk postoperatively with aseptic meningitis, which was treated supportively. Postoperative imaging did not show residual cavernoma.
...
PMID:Transclival Approach for Resection of a Pontine Cavernous Malformation: 2-Dimensional Operative Video. 3204 6
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