Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Coinciding investigations of the 85Sr test and of bone derived serum alkaline phosphatases activity were undertaken in 38 patinets with locomotor system diseases. In 15 patients there was congruence between the positive result of the 85Sr test and an increased activity of B-ALP. In 5 patients there was congruence between negative outcome of B-ALP and negative 85Sr test. The activities of T-ALP, B-ALP, L-ALP and I-ALP were compared with a group of 124 healthy controls. The causes of 18 incongruent results were analysed. In rhizomelic form of ASp, active Paget's disease, osteomalacia and in some forms of osteoporosis there was congruence between increased activity of B-ALP and the positive 85Sr test over the clinically involved area of the locomotor system. In ankylosing spondylitis (without rhizomelic involvement) there may be a moderate fall of B-ALP activity but the 85Sr test is usually positive; this may correspond with metabolic activity in the paravertebral region of the ligaments. Low B-ALP activity and positive 85Sr test in MP may refer to a latent process in the bone apparatus without marked activity of osteoblasts. The fall of B-ALP may be a result of therapy or due to the reduced capacity of B-ALP to be released from the bone. In osteomalacia the rapid fall of 85Sr activity during the test is the cause by the presence of pathological osteoid which may be, even in patients with hypertension, of renal origin. A method was described permitting the evaluation of the process of active incorporation of bone minerals (after 8 days). The activity of the 85Sr test over clinically silent areas (e.g. spine) may indicate a decompensated process in the spine due to an involvement to the large joints. The two methods used in this study are metabolically different (85Sr binds to proteoglycans and inorganic structures of bone tissue, alkaline phosphatase to the activity of osteoblasts) and prove to be clinically valuable. Detailed analysis of the results makes it possible to define the stages of clinical activity of disease and to check more exactly the efficiency of the therapeutic method.
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PMID:[Clinical evaluation of the results of the Sr85 test and of bone alkaline phosphatase isoenzyme activity]. 87 Oct 69

Paget's disease is a common bone disease which usually has little influence on the patient's mobility. Functional symptoms, such as pain, and bone deformation can be controlled partly by treatment. Cardiovascular complications are rare, except for arterial hypertension which seems to be closely related to the skeletal dystrophy. The incidence of sarcoma is difficult to evaluate, but that disease has a frightful prognosis little improved by therapeutics. Neurological manifestations are diverse and due to anatomical alterations and vascular steal syndromes. Bone fractures are frequent and sometimes herald the disease. Pagetic arthropathies may benefit from surgery after medical treatment.
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PMID:[Functional consequences and complications of Paget's disease]. 273 77

We report the case of a true aneurysm of the middle meningeal artery (MMA) associated with no other pathological findings. After a review of the literature, we emphasize that this case is not associated either with skull traumas, with vascular hypertension or with Paget's disease of the skull. Histological examination and neuroradiological findings confirm the suspicion that this is a case of true aneurysm of the middle meningeal artery.
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PMID:True aneurysm of the middle meningeal artery. Case report. 743 Oct 97

Paget's disease is a metabolic disorder of unknown etiology characterized by excessively rapid remolding of bone. We report a case of Paget's disease complicated with Parkinson syndrome. A 69-year-old female patient was scheduled for ventriculo-peritoneostomy due to hydrocephalus. Her manifestations included disability to walk, slight deafness and muscular rigidity of limbs, without symptom of intracranial hypertension. After induction of anesthesia with thiopental and vecuronium, tracheal intubation with Macintosh laryngoscope was attempted but failed because mouth opening was restricted to only 3 cm. Again with Bullard laryngoscope, she was successfully intubated. During neurosurgical operation, the anesthesia was maintained with low concentration of isoflurane (under 0.3%), nitrous oxide and oxygen. The surgery was completed without adverse events such as disorder of autonomic nervous system. However 6-days after operation, ventilatory arrest occurred due to bronchial obstruction with sputum. Immediately, re-intubation was performed without any sequela and tracheostomy was also performed. In conclusion, as reported previously, intubation and postoperative pulmonary dysfunction should be carefully taken care of, and Bullard laryngoscope was useful for this patient.
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PMID:[Anesthetic management of a Paget's disease patient complicated with Parkinson disease]. 853 9

Little is known about how Paget's disease of bone affects quality of life. To better understand the relative impact of factors on quality of life, we mailed a brief survey to 2000 people randomly selected from the Paget's Foundation mailing list. The sample was geographically stratified to examine the effects of specialist availability. Nine hundred and fifty-eight persons responded to the questionnaire (53% response rate after adjustment for death, incorrect addresses, and nondeliverable mailings). The sample had equal proportions of males and females, with a mean age of 74 years (SD = 9.0). Most (97%) were white, with high levels of education (mean 13 years; SD 3.7) and income (60% earned more than $20,000 annually). They reported pagetic bone in the skull (34%), spine (35%), pelvis (49%), and leg (48%). The most frequently mentioned complications were hearing loss (37%) and bowed limbs (31%). Comorbidity included arthritis (64%), hypertension (32%), and heart problems (28%). Nearly half (47%) reported feelings of depression, and 42% said that their health was fair or poor. Only 21% reported that quality of life was very good or excellent. In multiple partial F-test regression analyses, variables were divided into four domains (social, psychological, care, and biomedical). The psychological domain explained 19% of the variance beyond that explained by all other variables; the social domain explained 3%, the biomedical domain explained 3% and the care domain explained 1%. The importance of the psychological aspects of Paget's disease suggests that treatment protocols should include psychological intervention to improve quality of life.
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PMID:Paget's disease of bone and quality of life. 897 Aug 91

This cross-sectional cohort study of 5566 women and 2187 men 50 years of age and older in the population-based Canadian Multicentre Osteoporosis Study was conducted to determine whether reported past diseases are associated with bone mineral density or prevalent vertebral deformities. We examined 12 self-reported disease conditions including diabetes mellitus (types 1 or 2), nephrolithiasis, hypertension, heart attack, rheumatoid arthritis, thyroid disease, breast cancer, inflammatory bowel disease, neuromuscular disease, Paget's disease, and chronic obstructive pulmonary disease. Multivariate linear and logistic regression analyses were performed to determine whether there were associations among these disease conditions and bone mineral density of the lumbar spine, femoral neck, and trochanter, as well as prevalent vertebral deformities. Bone mineral density measurements were higher in women and men with type 2 diabetes compared with those without after appropriate adjustments. The differences were most notable at the lumbar spine (+0.053 g/cm2), femoral neck (+0.028 g/cm2), and trochanter (+0.025 g/cm2) in women, and at the femoral neck (+0.025 g/cm2) in men. Hypertension was also associated with higher bone mineral density measurements for both women and men. The differences were most pronounced at the lumbar spine (+0.022 g/cm2) and femoral neck (+0.007 g/cm2) in women and at the lumbar spine (+0.028 g/cm2) in men. Although results were statistically inconclusive, men reporting versus not reporting past nephrolithiasis appeared to have clinically relevant lower bone mineral density values. Bone mineral density differences were -0.022, -0.015, and -0.016 g/cm2 at the lumbar spine, femoral neck, and trochanter, respectively. Disease conditions were not strongly associated with vertebral deformities. In summary, these cross-sectional population-based data show that type 2 diabetes and hypertension are associated with higher bone mineral density in women and men, and nephrolithiasis may be associated with lower bone mineral density in men. The importance of these associations for osteoporosis case finding and management require further and prospective studies.
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PMID:Associations among disease conditions, bone mineral density, and prevalent vertebral deformities in men and women 50 years of age and older: cross-sectional results from the Canadian Multicentre Osteoporosis Study. 1267 40

Angiotensin II type 1 (AT(1)) receptor belongs to the super-family of G-protein-coupled receptors, and antagonists of the AT(1) receptor are effectively used in the treatment of hypertension. To understand the molecular interactions of these antagonists, such as losartan and telmisartan, with the AT(1) receptor, a homology model of the human AT(1) (hAT(1)) receptor with all connecting loops was constructed from the 2.6 A resolution crystal structure (PDB i.d., 1L9H) of bovine rhodopsin. The initial model generated by MODELLER was subjected to a stepwise ligand-supported model refinement. This protocol involved initial docking of non-peptide AT(1) antagonists in the putative binding site, followed by several rounds of iterative energy minimizations and molecular dynamics simulations. The final model was validated based on its correlation with several structure-activity relationships and site-directed mutagenesis data. The final model was also found to be in agreement with a previously reported AT(1) antagonist pharmacophore model. Docking studies were performed for a series of non-peptide AT(1) receptor antagonists in the active site of the final hAT(1) receptor model. The docking was able to identify key molecular interactions for all the AT(1) antagonists studied. Reasonable correlation was observed between the interaction energy values and the corresponding binding affinities of these ligands, providing further validation for the model. In addition, an extensive unrestrained molecular dynamics simulation showed that the docking-derived bound pose of telmisartan is energetically stable. Knowledge gained from the present studies can be used in structure-based drug design for developing novel ligands for the AT(1) receptor.
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PMID:Ligand-supported homology modeling of the human angiotensin II type 1 (AT(1)) receptor: insights into the molecular determinants of telmisartan binding. 1703 41

Pulsatile tinnitus is a sound from within the body, mostly of vascular origin, that stimulates the patient's hearing in the same way as an external sound does, generally at the same pace as the pulse. Although not frequent, the diagnosis of its cause is crucial because of its potential severity in some cases. This article describes some of the diagnostic clues for arterial causes (arteriosclerosis, aberrant carotid artery, arteriovenous fistula or malformations, increased vascularization in Paget's disease) and venous causes (benign intracranial hypertension, high jugular bulb). In some cases we have to rule out other systemic diseases as hypertension, cardiac arrhythmia or hyperthyroidism. A pathological otoscopy result may be secondary to a tympanic glomus. A guided medical history and an algorithm for complementary tests (magnetic resonance or angio-resonance imaging, computerized tomography, blood test, Doppler ultrasonography) may resolve the diagnostic puzzle of pulsatile tinnitus. We present our experience in 80 cases. The most frequent aetiology has been the arteriosclerosis of the carotid artery (17.5 %) and the benign intracranial hypertension syndrome (10 %).
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PMID:[Diagnostic clues in pulsatile tinnitus (somatosounds)]. 1799 8

Current attention focuses on mechanisms of controlling blood pressure through the inhibition of angiotensin I-converting enzyme (ACE). Bioactive antihypertensive peptides of food origin are increasingly gaining importance as alternates to synthetic drugs in hypertension therapy. The ACE inhibitory property of an enzymatic digest of arachin, the major storage globulin of peanut (Arachis hypogaea) has been demonstrated. The ACE inhibitory activity of a tripeptide (IEY) isolated from these digests has been characterized. Five synthetic structural analogs of this peptide (IEW, IKY, IKW, IEP and IKP) were assembled and their ACE inhibitory activity evaluated. Among these, the tripeptide IKP was a potent competitive inhibitor with an IC(50) of 7+/-1 x 10(-6)M similar to that of the potent whey peptides IPP and VPP. The inhibition data of these peptide analogs have been rationalized through docking simulations using the tACE-lisinopril complex at 2A resolution (PDB: 1086). The best docking poses were located at the tACE catalytic site resembling the mode of inhibition exerted by lisinopril, the synthetic drug. The degree of inhibition by the peptides correlated with the coordination distance between the catalytic Zn(II) and the carbonyl oxygen of the peptide bond between the amino-terminal and middle residue. These studies illustrate that these peptides, like lisinopril, behave as transition state analog inhibitors and are useful in therapeutic intervention for blood pressure management.
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PMID:Arachin derived peptides as selective angiotensin I-converting enzyme (ACE) inhibitors: structure-activity relationship. 2021 46

Skull involvement in Paget's disease of bone can lead to neurological symptoms, prompting treatment. Intravenous zoledronic acid (ZA) has emerged as an effective and safe treatment option for patients with Paget's, leading to sustained remission and improved quality of life. A previously untreated 61-year-old female presented with 2-year history of facial asymmetry with progressive hearing impairment. Serum calcium levels were normal with upper normal levels of PTH and low 25OHD levels. Serum alkaline phosphatase was markedly increased and bone scan showed extensive pagetic involvement of the skull. Head CT and MRI revealed hydrocephalus with cerebellar tonsillar herniation, platybasia and basilar invagination. In the absence of clinical signs or symptoms of intracranial hypertension, she was treated with intravenous ZA after 15-day supplementation with calcium and vitamin D. Twelve hours after the infusion, the patient became confused, agitated and disoriented and developed urinary incontinence; cortical sulci became effaced on CT indicating increased intracranial pressure. Over the following days, she developed frank hypocalcemia requiring intravenous calcium infusion and calcitriol. Neurological status returned to normal within 24 h of onset, except for urinary incontinence. Nine months later she remained incontinent and still required calcitriol to maintain normocalcemia. Zoledronic acid is a first-line option for the treatment of Paget's disease, yet there can be complications in particular clinical scenarios such as pagetic hydrocephalus, as seen in this case. Plentiful supplementation of calcium and vitamin D before bisphosphonate therapy is paramount in order to minimize the risk of prolonged post-treatment hypocalcemia.
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PMID:Symptomatic intracranial hypertension and prolonged hypocalcemia following treatment of Paget's disease of the skull with zoledronic acid. 2307 94


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