Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Spinal epidural lipomatosis (SEL) is a rare condition affecting the thoracic and lumbar spine, characterized by a hypertrophy and hyperplasia of the rich vascularized fat tissue inside the spinal canal. The etiology of SEL is unknown. A high number of cases are associated with obesity, corticosteroid intake and a dysbalance in adrenocorticotropic hormone (ACTH)-cortisone metabolism. It can be an incidental radiographic finding or present with symptoms, such as low back pain, weakness of the lower limbs, dysesthesia, radiculopathy, claudication or even cauda equina syndrome. The interdisciplinary treatment consists of weight reduction, weaning from corticosteroids and in persisting cases or neurologic alterations in surgical decompression of the spinal canal. The following article presents a current review and a case report of this rare entity.
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PMID:[Spinal epidural lipomatosis]. 2277 44

A 42-year-old man with a history of hypertension and obesity presented with transient dysesthesia in his left upper and lower extremities and was found to have moyamoya syndrome associated with atherosclerosis. He underwent superficial temporal artery-middle cerebral artery anastomosis with pial synangiosis in the right hemisphere 1 month after the onset of symptoms. Prophylactic blood pressure lowering(<130 mmHg)as well as minocycline administration was introduced immediately after surgery to prevent symptomatic cerebral hyperperfusion, but he developed pulmonary edema due to congestive heart failure several hours after surgery. We subsequently allowed his systolic blood pressure to be under 140 mmHg, which dramatically improved his cardiopulmonary condition. The neurologic status of the patient was unremarkable, but (123)I-IMP-SPECT the day after surgery demonstrated an intense increase in the cerebral blood flow at the site of the anastomosis. Moreover, postoperative magnetic resonance angiography demonstrated the bypass as thick, high signal. Together, these results led us to the diagnosis of cerebral hyperperfusion. The patient did not demonstrate any neurological sign during the entire perioperative period, but CT scan performed 7 days after surgery revealed a delayed intra-cerebral hemorrhage in the right temporal lobe due to the cerebral hyperperfusion. We continued to mildly lower his blood pressure, and neither ischemic nor hemorrhagic events were subsequently observed; he was discharged without neurological deficit 2 weeks after surgery. In conclusion, congestive heart failure and pulmonary edema are potential complications of the perioperative management of moyamoya syndrome with atherosclerotic background. Moreover, cardiopulmonary complications should be mentioned as a potential pitfall of the intensive perioperative management of moyamoya disease to counteract with cerebral hyperperfusion.
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PMID:[Cardiopulmonary complication as a pitfall of the perioperative management of moyamoya syndrome with atherosclerosis: conflict to counteract with cerebral hyperperfusion]. 2508 62