Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A Japanese patient with systemic amyloidosis associated with a transthyretin (TTR) variant Arg50 is presented. This 41-year-old man became impotent and developed decreased pain sensation in his hands, and then sensory loss and muscle wasting in his lower legs, and cardiomyopathy appeared. The symptoms progressed and he died of congestive heart failure at age 46. There were amyloid deposits in all organs studied and massive amyloid deposition was seen in the peripheral nerves and cardiac muscles. Amyloid fibrils extracted from heart tissue contained TTR. A genetic mutation, causing a Ser50-->Arg substitution of the TTR molecule, was identified in another family member. Plasma TTR was shown to be a mixture of normal TTR Ser50 and mutant TTR Arg50 in the 2 subjects.
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PMID:Amyloid polyneuropathy with transthyretin Arg50 in a Japanese case from Osaka. 133 38

From February to July in 1989, 47 patients came to our O.P.D. with the chief complaint of impotence. The average age was 48.3 +/- 10.7 y/o. We applied intracoporeal injection of prostaglandin PGE1 (20 mg); and evaluated its penile blood flow effect by color duplex scanning (Acuson 128). The erectile responses of the test showed that: 6 patients (12.8%) had normal response: and 16 patients (34%) had imperfect response. Altogether, the total positive response rate was 46.8%, and 25 patients (53.2%) showed impaired response. The onset of response was 9.1 +/- 3.6 minutes and the duration of erection was 59.2 +/- 24.7 minutes. The percentage of diameter change of both deep arteries after injection was Rt: 58.1 +/- 41.5%; left: 52.3 +/- 35.6%. The peak velocity of right cavernosal arterial flow after intracoporeal injection was 35.5 +/- 15.9 cm/sec; and that of the left side was 33.2 +/- 16.9 cm/sec. There was no correlation between the increment of peak velocity of the deep arterial flow and the erection grade. The same phenomenon was also found between the increased change in the diameter of the deep artery and the erection grade. 16 patients (34.1%) experienced tolerable pain during the procedure. Two patients (4.3%) experienced dizzines and discomfort due to venous leakage. No priapism was found. This study suggests PGE1 may be an excellent potential alternative to other vasoactive drug with less complication in the diagnosis and treatment of impotence. But the cost and stability were its shortcoming.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of PGE1 on penile blood flow]. 135 14

Microsurgical penile revascularization is becoming an increasingly applied technique in patients with arteriogenic or mixed arteriogenic and venogenic impotence. Deep dorsal vein arterialization has been used successfully in selected patients. Aside from failure of the procedure and the occasional problems associated with vascular surgery, priapism and glans hypervascularization are specific complications of deep dorsal vein arterialization. Priapism in these cases is 'high-flow'; the functional arterial-cavernous fistula can overcome the maintenance of the flaccid state and cause persistent erection. Glans hypervascularization, a syndrome of glans enlargement, skin changes and pain secondary to excessive retrograde filling of the glans penis and corpus spongiosum, can result in urethral compression and glans ulceration. Along with the presentation of the case of a man who suffered both complications, we discuss their pathophysiology, prevention, and treatment.
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PMID:High-flow priapism and glans hypervascularization following deep dorsal vein arterialization for vasculogenic impotence. 147 66

Between April, 1988 and August, 1990, the OmniPhase penile prosthesis, a non-inflatable self-contained penile prosthesis, was implanted in 34 patients, aged from 37 years to 79 years, averaging 54.2 years. The etiologies of the impotence were radical surgery for bladder cancer or rectal cancer in 17 patients, diabetes mellitus in 7 patients, vascular abnormality in 3 patients, spinal injury in 2 patients, penile disorders in 2 patients and others in 3 patients. Penile prosthesis was implanted by subcoronal incision under spinal or general anesthesia. Clinical results were evaluated 12 weeks after surgery. Thirty-two patients (94.1%) could have intercourse postoperatively. Eighteen patients (52.9%) were completely satisfied and 14 patients (41.2%) were satisfied, whereas one patient (2.9%) had no improvement and another patient (2.9%) deteriorated. There was no serious complication. However, prosthesis was explanted because of skin erosion in one patient. Pain, which lasted for more than 10 days, was seen in 3 patients (8.8%), penile edema in 11 patients (32.4%), and acute epididymitis in one patient. The obtained results showed that implantation of OmniPhase penile prosthesis is a safe and useful procedure for treatment of organic impotence.
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PMID:[Implantation of self-contained non-inflatable penile prosthesis in patients with organic impotence]. 150 23

In a double-blind, crossover designation penile intracavernous prostaglandin E1 and papaverine hydrochloride were compared in regard to effectiveness and safety in 52 patients investigated and treated for sexual erectile dysfunction. In evidence of the reliable effectiveness, prostaglandin E1 (20 micrograms/ml.) induced significant positive erectile response in 42 of 52 patients (81%). This rate reached 100% with neurogenic, hyperprolactinemic and/or psychogenic impotence. However, with papaverine hydrochloride (30 mg./ml.) and exclusively in cases of vasculogenic (most probably arteriogenic) impotence, negative erectile response was revealed as absent erection in 6 of 52 patients (11.5%) and nonrigid tumescence in 13 (25%) versus 2 (3.8%) and 8 (15.4%), respectively, with prostaglandin E1. Moreover, with prostaglandin E1 the regional pain was tolerable and transient, and the positive erectile response was not attended by priapism even in patients who formerly had priapism with papaverine hydrochloride. However, presently with prostaglandin E1 the relatively higher cost and shorter expiration period would probably limit its diagnostic and therapeutic use in Egypt, and probably in other developing countries.
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PMID:Comparative value of prostaglandin E1 and papaverine in treatment of erectile failure: double-blind crossover study among Egyptian patients. 153 43

Pregnancy is a potential cause of hip algodystrophy. Mechanical loco-regional factors, as well as other potential factors, can explain this preference for the hip. This pathology must be always kept in mind when attending a pregnant patient or a patient with inguino-crural pain and functional impotence during the postpartum.
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PMID:[Hip algodystrophy and pregnancy]. 156 51

Actinomycosis is a chronic granulomatous inflammatory disease, with fistulization tendency, caused by Actinomyces. The clinical observation in presented of a patient with intermittent fever of three weeks duration, associated to pain and functional impotence of the right hip, observing with CT Scan an ischium-rectal abscess. After spontaneous fistulization, Actinomyces israelii was isolated in the biopsy sample by culture in anaerobic medium, confirming the diagnosis by anatomo-pathology. The patient was treated with intravenous penicillin for six weeks, followed by six months of oral treatment with which the symptoms disappeared and the radiological images normalized. Bone infection ranges between 1 and 15% of total actinomycosis.
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PMID:[An ischiorectal abscess due to Actinomyces]. 157 98

Sixty-two patients that had consulted for impotence were evaluated by intracavernal injection of prostaglandin E1 and duplex echo-Doppler. The internal diameter and the mean flow of the cavernosal arteries were determined by echo-Doppler in the flaccid state. Thereafter 20 micrograms of PGE 1 was injected intracavernously and the erectile response was evaluated clinically after 5 to 15 minutes. Another Doppler evaluation was performed during tumescence to study the changes of the internal diameter and the mean flow increase of the cavernal arteries. Twenty-nine patients (46.7%) achieved normal erection after intracavernal PGE 1 and the Doppler study was normal in all but 2 patients (3.2%). The remaining 33 patients (53.1%) failed to achieve normal erection following intracavernal injection of PGE 1. The Doppler study, however, was normal in 7 of these patients (11.2%), which indicates venous leak to be the underlying cause of impotence. There were minor complications (19.3%) presented a small hematoma at the site of injection and 12.9% referred moderate pain at the time of injection) and no patient has a sustained erection for more than 3 hours. The hemodynamic mechanisms and the current concepts relative to the neurologic aspects of erection are discussed. We believe duplex echo-Doppler combined with intracavernal PGE 1 to be a very reliable method in the diagnosis of impotence of a vascular origin. It can distinguish those patients that cannot achieve erection following intracavernal PGE 1 with a normal arterial tree whose impotence can be ascribed to venous leak.
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PMID:[Echo-Doppler duplex combined with intracavernous injection of prostaglandin E1 in the diagnosis of impotence]. 158 15

Arteriography of the penile vasculature was performed after intracavernous injection of prostaglandin E1 in five patients. Penile tumescence was obtained in three patients with a dose of 10 micrograms and in the other two patients with a dose of 20 micrograms. Mean duration of penile tumescence was 1 h 36 min. Visualization of the penile vasculature was adequate in all patients. Local pain was a minor side effect in one patient. These preliminary results suggest that prostaglandin E1 might represent an alternative for papaverine in the angiographic study of male impotence.
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PMID:Intracavernosal injection of prostaglandin E1 as an alternative for papaverine in penile angiography. 161 76

Measurement of variant Met30 transthyretin is diagnostic for a patients with familial amyloidotic polyneuropathy (FAP) type I. The elder brother first noticed numbness of the feet at 64 years of age, and developed weakness of the legs. A few years later, he noticed numbness of the hands, and he was admitted to the hospital at 67 years of age. He was emaciated and had hoarseness and macroglossia. He had moderate muscle atrophy and weakness of all extremities with distal predominance. Deep tendon reflexes were hypoactive in the upper limbs and absent in the lower limbs. There was marked sensory loss of pain and temperature in all 4 limbs distally, and position sense was also impaired. He had mild orthostatic hypotension, severe cardiomegaly and arrhythmia. The younger brother noticed cold sensation of the feet and sexual impotence at 59 years of age. Two years later, he had numbness of the feet and developed weakness of the legs. At 65 years of age, he was admitted to the hospital because of the micturition syncope. He was emaciated and had macroglossia. He had moderate muscle atrophy and weakness of all extremities with distal predominance. Deep tendon reflexes were absent. There was marked sensory loss in the extremities which was predominant in pain and temperature. He had severe orthostatic hypotension (112/70 mmHg in supine position, 50/30 mmHg on standing). Plasma NE value was low and showed poor response to standing. He had neither cardiomegaly nor arrhythmia. Their parents were supposed to have no neurological symptom and were not related with any other Japanese foci of FAP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Two brother cases of late-onset familial amyloidotic polyneuropathy in Kyoto]. 164 13


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