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 71-year-old woman with diabetic neuropathy who had undergone amputation of the right lower leg for diabetic gangrene 4 years previously, experienced severe lightning pain in both legs during spinal anesthesia. She was scheduled for skin grafting for a burn ulcer on her left foot. Her preoperative physical examination revealed hypesthesia in both legs due to diabetic neuropathy. Spinal anesthesia was performed with a combined spinal-epidural needle at the L 4-5 interspace using 2.0 ml of 0.3% hyperbaric dibucaine in the left lateral position. The region of hypesthesia was spread below Th 4. Ten minutes later, she complained of severe lightning pain in both legs and midazolam 1 mg was administered intravenously against agitation. The severe lightning pain diminished after the administration of pentazocine 7.5 mg intravenously in the recovery room. There was no worsening of neurological findings 5 hours later when the effect of spinal anesthesia disappeared. This clinical picture seems to be different from that of reported cases of phantom limb pain during spinal anesthesia in which severe lightning pain occurred in both legs. This case suggests that patients with diabetic neuropathy might develop severe lightning pain during spinal anesthesia using dibucaine.
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PMID:[Severe lightning pain during spinal anesthesia in a patient with diabetic neuropathy]. 1102 60

We encountered a patient with polymyalgia rheumatica (PMR) who exhibited fever as the main symptom for a long period without muscular pain. As an etiological factor, the condition may have been associated with nonsteroidal anti-inflammatory drugs (NSAIDs). A 71-year-old man consulted our Department of Orthopedics for fever and lumbar pain, which initially developed in early September 2000. Administration of NSAIDs resulted in the disappearance of lumbar pain. However, fever persisted. The C-reactive protein (CRP) level was persistently high. Therefore, on October 5, 2000, the patient was referred to our department. At the outpatient clinic, a detailed examination was performed. However, the etiology could not be determined. Repeated administration of NSAIDs resulted in pyretolysis, and the dose of NSAIDs was decreased from January 31, 2001. Severe fever appeared again, and inflammatory reaction also exacerbated. On March 11, 2001, muscular pain involving the bilateral shoulders and forearms suddenly developed. For diagnostic treatment, administration of prednisolone (PSL) at 10 mg/day was started. Muscular pain rapidly disappeared. According to Bird's criteria, PMR was diagnosed. After the dose of PSL was decreased to 7.5 mg/day, the course is good. PMR should be considered as the etiology of idiopathic fever in elderly patients.
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PMID:[A patient with polymyalgia rheumatica who exhibited fever as the main symptom for a long period]. 1246 22

We report three cases of inverted papilloma of the urinary bladder. Case 1. A 19-year-old male complained of pollakisuria, gross hematuria and micturition pain. Cystoscopy revealed a smooth-surfaced tumor on a stalk at the bladder neck. The tumor was removed transurethrally. Histological diagnosis was inverted papilloma. As a safe guard, intravesical chemotherapy (Adriamycin) was performed, since pathological findings revealed a small region with mild atypical cells in the removed tumor. The patients has been subsequently followed up for ten years without any evidence of recurrence. Case 2. A 63-year-old male was admitted to our hospital because of a bladder tumor incidentally found by abdominal ultrasonography. The tumor was removed transurethrally. Histological diagnosis was inverted papilloma. The patient has been subsequently followed up for one year without any evidence of recurrence. Case 3. A 71-year-old male complained of pollakisuria, loss of urinary force and interruption of the urinary stream. A smooth-surfaced tumor found at the bladder neck was removed transurethrally. Histological diagnosis was inverted papilloma. Three months later, cystoscopy revealed two sessile papillary tumors on the left lateral wall of the urinary bladder. Pathological diagnosis was transitional cell carcinoma (G2, pTa). Although the inverted papilloma is a benign tumor, there is a possibility of recurrence or development of transitional cell carcinoma. Therefore, we advocate periodical follow-up examinations.
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PMID:[Inverted papilloma of the urinary bladder: three case reports]. 1249 19

A 71-year-old Japanese woman complained of right upper abdominal fullness and pain. Computed tomography revealed a huge cyst in the right lobe of the liver, measuring 16 cm in diameter. She underwent laparoscopic deroofing of the liver cyst. On operation, needle aspiration of the cyst yielded clear serous fluid without any bile contamination. However, after the cyst was deroofed with laparoscopic coagulating shears, bile leakage was recognized from a tiny orifice in the cyst cavity. A catheter was inserted via the orifice for cholangiography, which demonstrated a communication with the biliary tract. The orifice was easily closed with a laparoscopic suturing device. Operation time was 5 hours and 30 minutes, and blood loss was 300 grams. Pathological examination of the liver cyst was consistent with a simple cyst. The postoperative course was uneventful, and the patient has had no recurrence to date at 13 months. Laparoscopic deroofing is a recommended treatment for a liver cyst even in the presence of cystobiliary communication.
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PMID:Liver cyst with biliary communication successfully treated with laparoscopic deroofing: a case report. 1455 14

Malignant peripheral nerve sheath tumors (MPNST) are rare. We report a case of a MPNST of the proximal sciatic nerve in the thigh, unassociated with pre-existing type 1 neurofibromatosis or history of radiation therapy. A 71-year-old man had a 6 month history of constant, severe, burning pain affecting the sole of the left foot. One month after the onset, the pain radiated to the left calf, posterior aspect of the thigh and buttock, and distal leg weakness followed. Three months prior to admission, the patient developed a large and painful mass in the buttock, that occupied the entire left gluteal region on examination. There was severe weakness of ankle and toe dorsiflexion and plantarflexion, decreased sensation on the lateral and posterior aspect of the left leg as well as on the dorsal and plantar surfaces of the foot, and absent ankle jerk. EMG showed denervation and motor unit loss in the short head of biceps femoris and muscles supplied by tibial and peroneal nerves on the left side. Magnetic resonance imaging revealed a 10-cm enhancing mass of the left sciatic nerve from the upper thigh to the greater sciatic notch. In surgery, a large MPNST with a high Ki67 labeling index (> 60 %) was subtotally removed from the sciatic nerve, and adjuvant radiation therapy was administered. In the ensuing months the tumor invaded the entire pelvic region. A high sciatic malignant tumor can present with a rapidly growing buttock mass and unilateral, neuropathic foot pain imitating the tarsal tunnel syndrome.
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PMID:[Buttock mass and malignant sciatic nerve tumor]. 1476 32

A 71-year-old woman presented with an acute onset of interscapular pain due to an intramural haematoma of the ascending part of the aorta. She was treated with an emergency ascending aorta graft replacement.
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PMID:[Diagnostic image (200). A woman with acute pain between the scapulae]. 1536 23

We report three cases of endometrioid adenocarcinoma of the prostate. Case 1: A 71-year-old male was admitted with a complaint of micturition pain. Serum prostatic specific antigen (PSA) was 12 ng/ml. Radical prostatectomy following needle biopsy was performed in May 1998. Histopathological diagnosis was prostatic endometrioid adenocarcinoma (pT2bpN0M0). Case 2: A 71-year-old male was admitted with a complaint of macrohematuria. PSA was 18 ng/ml. Cystoprostatectomy and ileal conduit construction following needle biopsy were performed in July 2002. The tumor that was diagnosed as endometrioid adenocarcinoma, invaded the bladder neck (pT4pN0M0). Case 3: An 86-year-old male was referred to our department for elevated PSA (16.8 ng/ml). Prostatic needle biopsy was performed and histopathological diagnosis was endometrioid adenocarcinoma with a part of well differentiated adenocarcinoma (T2bN0M0). PSA dropped to an undetectable range after total androgen blockade therapy.
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PMID:[Endometrioid adenocarcinoma of the prostate: report of 3 cases]. 1562 48

A case of primary and exclusive gingival localization of a non-Hodgkin lymphoma (NHL) personally observed at the Surgical Out-patients Unit of the Department of Dentistry at the Umberto I Hospital in Rome, is described. A 71 year-old caucasian male was referred by his private dentist because of a severe pain at the soft tissue of the mandible even after dental, neurologic and parodontal treatments. At clinical examination, a severe gingival swelling in the symphysis region with hard bleeding, palpable lymph nodes and no important evidence in radiographic and CT examinations were found. After incisional biopsy and its examination, a diagnosis of NHL was made. Further examinations did not show metastasis dissemination. The patient was referred to the Hematology Department and after 4 chemotherapy cycles over 12 months, he completely recovered. After an introduction on NHL, the clinical case is described as well as how to make a correct diagnosis; moreover, the importance of the dentist in identifying diseases even not strictly related to oral cavity but whose signs and manifestations appear over there, is stressed.
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PMID:Primary and exclusive gingival localization of non-Hodgkin lymphomas. Case report. 1590 64

This case report clarifies an adverse reaction of antiplatelet therapy which has been a standard prophylactic method for patients harboring significant risks of thromboembolic events. A 71-year-old Japanese man who had been taking aspirin tablets (81 mg) for a year presented with sudden colic pain in the left flank region. An abdominal computed tomography scan revealed a significant perirenal hematoma of the left kidney. There were no pathological kidney conditions, such as renal tumors, calculi or vascular diseases, found by magnetic resonance imaging examination. After cessation of aspirin administration followed by conservative management, the hematoma completely disappeared 6 months later. This is the first documented case of spontaneous perirenal hematoma secondary to low-dose aspirin treatment. While such unpleasant events occur extraordinarily, this should be noted as a severe risk of antiplatelet therapy.
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PMID:Antiplatelet therapy and spontaneous perirenal hematoma. 1594 29

Acute colonic pseudo-obstruction or Ogilvie syndrome refers to the occurrence of colonic obstruction without the presence of any mechanical cause. A 71-year-old male patient developed abdominal distension, nausea, vomiting, and pain on the second postoperative day of total hip arthroplasty. Radiographs showed bowel dilatation. Oral intake was immediately ceased and nasogastric decompression was performed, after which all the symptoms and signs disappeared within four days. This syndrome should be borne in mind following major orthopedic interventions and be diagnosed and treated without delay.
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PMID:[A case of acute colonic pseudo-obstruction following total hip arthroplasty]. 1614 34


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