Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An unusual case of gastric carcinoma with diffuse intrasinusoidal metastasis to the liver (DIML) presenting as fulminant hepatic failure is reported. The patient was a 59-year-old man admitted to the hospital complaining of dysphagia. Seven weeks after performance of total gastrectomy, he developed jaundice and consciousness disturbance and died 4 days later. The surgical material was diagnosed as advanced cancer (poorly differentiated adenocarcinoma) of the stomach and postmortem examination disclosed massive and diffuse infiltration of the tumor cells into the hepatic sinusoids with no grossly detectable metastatic nodules. It is important to be aware that, although uncommon, gastric carcinomas may cause fulminant hepatic failure attributable to DIML. The clinicopathologic features of such cases are detailed and a review of the relevant literature included.
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PMID:Diffuse intrasinusoidal metastasis of gastric carcinoma to the liver leading to fulminant hepatic failure. A case report. 229 61

A case of the anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms was reported. A 20-year-old female suffered from sudden onset of dysphagia and throat pain. Three days later, she was admitted to our hospital, suffering from sudden onset of headache, nausea, vomiting and consciousness disturbance. On admission, consciousness disturbance, bilateral abducent nerve palsy, and left caudal cranial nerve palsy was observed. CT scan revealed a subarachnoid hemorrhage in the basal cisterns with the densest area in the left ambient cistern. Left vertebral angiogram revealed an aneurysm at the left anterior inferior cerebellar artery (AICA). On the third day after admission, operation was performed. The aneurysm was found near the jugular foramen, surrounded by thick clots. The dome was attached to the caudal cranial nerves, and the neck was located at the bending portion of AICA without branches. Neck ligation and clipping was performed. On the fortieth day after the operation, the patient was discharged from our hospital without neurological deficits. To our knowledge, aneurysm at the AICA is rare and only 33 cases have been reported. However, a case with a sudden onset of caudal cranial nerve symptoms, before evident symptoms due to subarachnoid hemorrhage, has never been reported previously.
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PMID:[Anterior inferior cerebellar artery aneurysm with a sudden onset of caudal cranial nerve symptoms]. 277 Sep 75

Central alveolar hypoventilation syndrome (CAH), or Ondine's curse, is a very rare disease characterized by dysfunction of respiratory center in the brain stem. Here, we report a case of CAH associated with cerebral infarction. A 59-year-old man developed right facial sensory deficit at age 56. Then, the facial sensory deficit spread to the left side and dysarthria and dysphagia also developed. Since age 58, he often developed respiratory failure and consciousness disturbance. Arterial blood gas analysis revealed alveolar hypoventilation and respiratory acidosis. Disorders of peripheral organs such as lung, airway, thorax and neuromuscular diseases were ruled out. Brain MRI showed cerebral infarction in the brain stem. We diagnosed him as CAH associated with brain stem infarction.
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PMID:[A case of central alveolar hypoventilation syndrome associated with cerebral infarction]. 832 22

Acute extrapyramidal movement disorders have rarely been reported in uremic patients. We had previously presented three cases of acute movement disorders with bilateral basal ganglia lesions in uremia, and had proposed that it is not a rare condition. The objective of this study is to establish a more accurate clinical profile of this rarely described clinical syndrome, and to call attention to its common occurrence. We prospectively studied six patients we encountered from March 1996 to June 2001. We also reviewed the clinical records of a large population of uremic patients and identified six more cases. The clinical manifestations, laboratory findings, neuroimages, and clinical outcomes of these 12 patients were analyzed. When possible, each patient was followed up to the present time. Twelve patients had acute onset of movement disorders and bilateral basal ganglia lesions. All of the patients were diabetic. They had acute-onset Parkinsonism or dyskinesias, together with various symptoms such as consciousness disturbance, dysarthria, dysphagia, or ataxia. The main laboratory test results of abnormalities consisted of elevated blood urea nitrogen, creatinine, and metabolic acidosis. They had uniform neuroimaging findings of symmetrical bilateral basal ganglion changes. These changes regressed or disappeared during follow-up. The clinical prognoses were diverse. We believe that this group of patients represents a well-demarcated clinical syndrome, which is not uncommon but has previously been rarely addressed. The underlying mechanism of such lesions may be associated with metabolic, as well as vascular factors.
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PMID:The syndrome of acute bilateral basal ganglia lesions in diabetic uremic patients. 1292 14

We investigated the feeding method and predictors for oral intake difficulty for a month after acute stroke. In 107 consecutive patients, swallowing function was assessed using a bedside screening protocol within 48 h of admission. The method of feeding was followed for 4 weeks, and predictors for "non-oral intake" on admission and 4 weeks later were analyzed. Sixty-two patients (58%) were fed any type of food orally within 48 h of admission, and 91 patients (84%) were fed orally 4 weeks later. Independent predictors for non-oral intake within 48 h of admission were consciousness disturbance (not completely alert; OR = 12.3), absence of gag reflex (OR = 5.34), and NIHSS score (OR = 1.20 per one point). Independent predictors for non-oral intake after 4 weeks were absence of gag reflex (OR = 7.95) and NIHSS score (OR = 1.13 per one point) on admission. Only four (9%) patients in the non-oral intake group within 48 h of admission and no patients in the non-oral intake group 4 weeks after admission were discharged to home. In acute stroke patients, absence of the gag reflex and severe neurologic deficits on admission predict prolonged dysphagia lasting longer than a month. Patients who could not eat orally had poor outcome.
Dysphagia 2010 Sep
PMID:Clinical significance of oral intake in patients with acute stroke. 1965 98

Infectious diseases of the nervous system are a group of diseases; timely diagnosis and treatment for these diseases determines the effect of prognosis on life and functions. Diagnosis itself is not very difficult in cases presenting with typical symptoms. However, if mild and atypical symptoms have been present for long, the underlying disease may not be easily recognized as a neurological disease or infectious disorder, and the diagnosis may be delayed. Furthermore, neurologists may not always be able to examine patients from the first visit itself. In this chapter, I present three cases with mild and atypical initial symptoms. The first case involved a patient with tetanus, whose initial symptom was dysphagia, and the onset of trismus was the turning point for diagnosis. The second case involved a patient with herpes simplex encephalitis. Dyshydrosis and dysosmia were the initial symptoms, and the appearance of disorientation, fever, and consciousness disturbance helped in achieving the final diagnosis. The last case was of a patient with Japanese encephalitis, whose initial symptoms were fever and parkinsonism. A recent history of surgery for gastric cancer, disease onset in the summer season, and living with neighbors on pig farms was indicative of Japanese encephalitis.
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PMID:[The Turning Point of Diagnostic Process for Infectious Disease of Nervous System]. 3228 63