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)

Fifty-nine children with Japanese encephalitis admitted in Maharaj Nakhon Chiang Mai Hospital since 1984-1985 were studied. The male to female ratio was 1.18:1. The age range was between 1 to 14 years old with 74% in the age range of 6-14 years. The symptoms included change of consciousness (100%), fever (96%), headache (76%), convulsions (59%) and vomiting (52%). The neurologic signs, namely positive meningeal signs (61%), hyperreflexia (61%), positive Babinski's sign (49%) hemiplegia (42%), papilledema (22%), and other cranial nerve palsies (23%) were seen. Abnormal respiration were found in 23% and 8% of cases had hypertension. Most children (81%) had blood leukocytosis with predominant neutrophils. The average CSF white blood cell count was 200 cells per mm. with lymphocytosis in 76 percent of the patients. The average CSF protein was higher than normal. Almost all cases had normal CSF sugar levels. The JEV antibody response, mostly primary type, Occurred in about 62 percent of cases. All children received symptomatic and supportive treatment, such as antipyretics, anticonvulsants, anticerebral edema agents, adequate respiration and nutrition and physical and occupational therapies. Associated complications were treated according to the individual's need. The mortality rate and neurological sequelae were found in 17% and 57% of cases respectively. Eighteen percent of the patients suffered severe neurological sequelae. The neurological sequelae included memory deficit (46%), mental retardation (42%), hemiplegia (34%), emotional and behavioral disturbance (24%), epilepsy (20%), motor aphasia (16%), cranial nerve palsies (16%), involuntary limb movement (8%) and blindness (2%).
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PMID:Japanese encephalitis in children in northern Thailand. 256 17

Cerebrospinal fluid was tested for several enzymes (CPK, AST, GGTP, BP, BG, AK) in 97 patients with generalized meningococcal infection with prevalent CNS affliction. Marked changes were detected even in the absence of clinical signs of cerebral lesion that was typical only of meningococcemia. Nevertheless, most pronounced changes were observed in a group of patients with cerebral edema and swelling. The changes in cerebrospinal fluid enzyme levels coincided with a reduced glucose and increased protein contents. In these cases, CSF hypertension increased CSF pressure to maximal levels. Most informative indices were singled out and their levels characteristic of acute phase of the disease established.
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PMID:[Enzymologic diagnosis of cerebral lesions in generalized forms of meningococcal infection in the acute period]. 256 98

Intracerebroventricular infusion of the peptide melittin increases immunoreactive kinins in the cerebrospinal fluid of anesthetized dogs, probably secondary to activation of brain or cerebrospinal fluid kininogenases. Intracerebroventricular melittin also increases blood pressure and heart rate, possibly mediated by brain kinins, since intracerebroventricular bradykinin also increases blood pressure and heart rate. We tested whether the effects of centrally administered melittin on blood pressure and heart rate could be blocked by simultaneous infusion of a kinin receptor antagonist, [DArg0]Hyp3-Thi5,8[DPhe7]bradykinin, in normotensive awake rats. In the controls, intracerebroventricular infusion of kinin receptor antagonist given for 1 hour at a rate of 10 micrograms/hr blocked bradykinin-induced increases in blood pressure and heart rate by 80%. Basal blood pressure and heart rate were not affected by the kinin receptor antagonist alone. After a 30-minute infusion of melittin (8 micrograms/30 min), cerebrospinal fluid kininogenase activity (n = 17) rose from 0.13 +/- 0.05 to 0.43 +/- 0.1 ng/ml/min (p less than 0.02). Although cerebrospinal fluid kinins increased from below sensitivity (0.02 ng/ml, n = 12) to 0.19 +/- 0.1 ng/ml (n = 17), this change was due to drastic increases in three rats, whereas in 12 of them kinins were below sensitivity. Incubation of bradykinin (10 ng) with 0.1 ml rat cerebrospinal fluid for 5 minutes destroyed 70% of kinins, suggesting that rapid destruction may have made detection of increased CSF kinins difficult.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension 1989 Dec
PMID:Role of endogenous brain kinins in the cardiovascular response to intracerebroventricular melittin. 258 99

The purpose of this investigation was to determine the effect of experimental hypertension on the concentrations of phenobarbital required to produce a defined hypnotic effect (loss of righting reflex) in adult, female Lewis rats. Hypertension was induced with deoxycorticosterone acetate (DOCA), administered by im injection (first experiment) or by pellet implant (second experiment), and 1% NaCl in the drinking water. There were two control groups: one that received im injections of water or a drug-free pellet implant plus 1% NaCl in the drinking water, the other that received water injections or drug-free pellet implants and no NaCl in the drinking water. These treatments were carried out for 3 months and resulted in appreciable elevation of blood pressure and increased heart weight in the DOCA + NaCl-treated (but not in the NaCl alone) rats. All animals then received an infusion of phenobarbital until onset of loss of righting reflex. The concentrations of phenobarbital in the serum, serum water, brain, and CSF of the hypertensive rats at the pharmacologic endpoint did not differ significantly from corresponding concentrations in the control groups (except for a marginal difference of the drug concentration in serum water between the DOCA pellet group and the drug-free pellet control group). It is concluded that DOCA-induced hypertension has no apparent effect on the sensitivity of the central nervous system to the hypnotic action of a barbiturate in female rats.
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PMID:Kinetics of drug action in disease states. XXXII: Effect of experimental hypertension on the pharmacodynamics of phenobarbital in rats. 258 67

In a series of 30 older patients shunted for symptomatic hydrocephalus, we found 3 with a head circumference at or greater than the 98th percentile. In 2, we demonstrated deterioration over 6 and 12 months by serial videotaping of gait and neuropsychological testing. In the 3rd, serial lumbar punctures over a 6-month period gave temporary improvement. In each, CTs showed ventriculomegaly without transependymal flow. One patient had an Arnold-Chiari type I abnormality identified by MRI. All had systemic hypertension. CSF pressure monitoring showed CSF pressure greater than 15 mm Hg 39% of the time in 1 patient, and 100% in another. All improved with ventriculoperitoneal shunting. Patients with probable compensated congenital hydrocephalus who functioned well throughout most of their lives may become symptomatic as they age but improve with shunt surgery. The head circumference should be measured in all older hydrocephalic patients.
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PMID:Symptomatic congenital hydrocephalus in the elderly simulating normal pressure hydrocephalus. 258 76

Diffuse leptomeningeal melanoma is an uncommon condition; its diagnosis is difficult, and requires the detection of atypical melanic cells in the CSF or the performance of meningeal biopsy. We report a 34-year-old patient with progressive symptoms of intracranial hypertension of 2 months duration, in whom meningeal biopsy was required for a definitive diagnosis. The patient's age, the neuropathological abnormalities and the images of computed tomography scan (CT), and also a through clinical and paraclinical investigation, led us to the conclusion that the patient had diffuse primary leptomeningeal melanoma.
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PMID:[Diffuse meningeal melanoma]. 262

Evaluation of results observed in a prospective study on the long term follow-up of 100 patients with neurocysticercosis (NC) is reported. Praziquantel (PZQ) was administered to the patients at their admission to the study. Follow-up time was over two years in 63 patients (maximum 118 months). Clinical conditions, TC findings and CSF changes were taken into account for the evaluation. Patients were evaluated periodically during the follow-up. Satisfactory results predominate (72.5%). Satisfactory results maintain a close relationship with clinical forms of the disease: good results predominate among those patients with clinical manifestations of NC which are not marked by intracranial hypertension of progressive character. Results of this long term follow-up evaluation favour the administration of PZQ to patients with NC.
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PMID:[Neurocysticercosis and praziquantel: long-term development in 100 patients]. 263 86

Primary Teratocarcinoma of Pineal Region. A case of a 12 year old boy admitted for intracranial hypertension of sudden onset has been reported. CT scanning and MR showed a triventricular hydrocephalus due to a space-occupying lesion of the pineal region. Tonic-clonic fits of the upper limbs and Parinaud syndrome were followed by loss of consciousness. Intervention I: ventriculo-peritoneal shunt with sampling of CSF and assay for beta-HCG, alpha FP and CEA, which proved negative. Cytology for neoplastic cells in cerebrospinal fluid was negative. Intervention II: grossly total removal of the tumor. This was followed by partial remission of Parinaud syndrome, total remission of the hypertensive symptoms and discharge on day 12. The 3 cm. whitish-pink tumor of rubbery consistency proved on histological examination to be a teratocarcinoma. The patient was further submitted to chemioterapy and irradiation but died 7 months after the second intervention. This is a rare tumor, much more than teratoma of the pineal gland, which is relatively frequent. It is interesting histologically because of the presence not only of chondroid and mesenchymal portions but also of adamantinomatous rudiments and of epithelial zones resembling embryonal carcinoma of the testis.
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PMID:[Primary teratocarcinoma of the pineal region]. 264 Nov 58

The management and evaluation of neurosurgical intracranial catastrophes require a multidisciplinary approach to optimize outcome. Intracranial pathology must be rapidly evaluated. Clinically, the patient's mental status, the degree and extent of focal neurologic deficits, and the dynamic nature of any changes in clinical status are assessed. The CT scan is invaluable for diagnosing and monitoring the progress and extent of intracranial pathology. Medical therapy for the control of intracranial hypertension must be undertaken simultaneously. This begins with provision of an adequate, protected airway and support of cardiopulmonary function. Specific measures to control intracranial hypertension include hyperventilation, osmotherapy, CSF removal, seizure control, autonomic control, sedation (primarily thiopental), muscle relaxation, mild hypothermia, and, if indicated, steroids. The goal of intraoperative management is physiologic support of systemic and cerebral hemodynamics. There should be a smooth transition from the discovery of the patient in extremis through the period of medical stabilization, operative intervention, and ultimate delivery of the patient to the intensive care facility for extended treatment.
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PMID:Perioperative management of intracranial catastrophes. 267 2

Seven patients with supratentorial gliomas developed leptomeningeal gliomatosis (LMG) without symptomatic recurrence at the primary tumor site. In all, severe back and radicular pain, often simulating disc disease, preceded the development of spinal cord or cauda equina dysfunction. In 4 instances, intracranial hypertension due to hydrocephalus developed prior to spinal involvement. Cytological examination of the CSF revealed malignant cells in only 2/7 but a myelogram was diagnostic in all 7. All patients received spinal irradiation (RT) and 5 received chemotherapy. Two patients with low-grade gliomas improved transiently; 5 with malignant gliomas responded poorly, became paraplegic over 4 months and eventually died of LMG. When fatal LMG occurs in young adults suffering from supratentorial glioma, the primary tumor is often quiescent. Hydrocephalus is often the first manifestation of LMG and, when it is detected, a myelogram and CSF cytology study should be performed in the hope that diagnosis and treatment of spinal cord lesion at a very early stage will prove beneficial. Irradiation of the entire spinal canal is probably required as there is a high risk of rapid development of new lesions in non irradiated segments of the spinal canal.
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PMID:Leptomeningeal gliomatosis with spinal cord or cauda equina compression: a complication of supratentorial gliomas in adults. 271 19


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