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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 42 year old woman who had been on oral contraceptives (OCs) for 10 years was admitted to the hospital for pains in the hepatic region. Laparoscopy showed an enlarged liver, and biopsy confirmed the diagnosis of primary carcinoma. The patient died. The literature on the subject has reported on 22 similar cases; common signs of alarm are pain and enlarged liver. The length of contraception and the type of contraceptive do not seem to be of primary importance. It is impossible to state that OCs are carcinogenic although it is highly probable. Hepatic lesions are usually benign, but sometimes they are malignant, and it is possible that genetic predisposition plays a role in such cases. It is also possible that OCs, by diminishing biliar excretion, may augment the hepatic concentration of toxic metabolites. The essential argument against OCs is the regression of benign tumors after use of contraceptives is stopped. Women on OCs should be checked routinely for early recognition of benign or malignant lesions. A national register of cases would be helpful in determining the prevalence of tumors.
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PMID:[Primary malignant tumour of the liver associated with the ingestion of oral contraceptives (author's transl)]. 23 79

A 42-year-old woman presented with the acute onset of bilateral blurred vision that occurred immediately after bending over. She denied pain or any other associated symptoms. Markedly increased intraocular pressure readings were found. Treatment for acute narrow-angle glaucoma was initiated, and normal vision returned. This case represents an atypical presentation of acute narrow-angle glaucoma, a true ophthalmological emergency. The pathophysiology and treatment options of this disease process are summarized.
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PMID:Narrow-angle glaucoma presenting as acute, painless visual impairment. 187 68

A 42-year-old woman developed an abrupt onset of severe headache, nausea, vomiting, unstable gait and numbness around the right side of her mouth and in her right hand. Neurological examination revealed bilateral pyramidal tract signs and hypesthesia of her right palmar tip and the right side of her mouth. However, pain and temperature sensibility was preserved. Cerebrospinal fluid was clear and colorless. CT scan showed an enhancing mass in the prepontine cistern compressing the pontine base. Vertebral angiography revealed irregular narrowing of bilateral vertebral arteries (string sign) proximal to a fusiform aneurysm on the entire length of the basilar artery. MRI showed double lumina in the wall of the aneurysm. The medial lemniscus conducts the discriminatory tactile and the deep sensory impulses from the extremities. The ventral ascending tract of the trigeminal nerve conducts the discriminatory tactile sensory impulses from the face. These two tracts lie close together in the pontine tegmentum, which is also a watershed area of the paramedian branches and circumferential branches of the basilar artery. We suggest that in this case the dissecting aneurysm caused ischemia of these two tracts in the left pontine tegmentum, presenting right cheiro-oral syndrome.
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PMID:[A mechanism of cheiro-oral syndrome due to brainstem lesions, a case of a dissecting aneurysm of the basilar artery]. 193 69

Findings of the cervical axial MRI are discussed in a case of spontaneous cervical vertebral artery dissection resulting in Wallenberg's syndrome. A 42-year-old male was hospitalized because of sudden onset of severe occipital pain. Cerebral angiography performed on the day of admission revealed severe tapering stenosis of the right vertebral artery at the C-5 level of the vertebra. Angiography repeated 50 days later showed partial resolution of the narrowing. T-1 weighted axial MRI of the neck demonstrated significantly narrowing flow void of the right vertebral artery when compared with the contralateral side. A crescent-like high intensity area was also seen surrounding the lumen. These findings were consistent with hematoma within the dissected wall of the vertebral artery. MRI is considered useful in identifying such vascular lesions as cerebral artery dissection.
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PMID:[A case of spontaneous cervical vertebral artery dissection resulting in Wallenberg's syndrome--diagnostic value of the cervical axial MRI]. 206 Feb 45

A 42-year-old Korean man with a fibrolamellar carcinoma of the liver is described. His initial symptom was an epigastric mass without pain, which resulted in a left lobectomy of the liver. A whitish and hard tumor, 10 cm in maximum diameter, without any cirrhotic features was noted in the resected liver. Histologically, the tumor was composed of lamellarly distributed fibrous stroma and polyhedral large cancer cells, which showed eosinophilic granular cytoplasm and rounded nuclei. Prominent nucleoli, scattered pale bodies and numerous copper-binding protein deposits were seen in the cancer cells. Orcein-stain failed to show HBsAg-laden cells in both the cancerous and non-cancerous tissues, and alpha-fetoprotein was not seen in the cancer cells by an immuno-peroxidase staining. Fibrolamellar carcinoma has been found almost exclusively in Caucasians and is very rare in Orientals. We describe this rare case with a review of the literature.
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PMID:Fibrolamellar carcinoma of the liver in a middle-aged Korean man. 217 92

A 42-year-old patient had undergone total hip replacement for aseptic femoral head necrosis 9 years previously. He now presented with loosening of the prosthesis and pseudoarthrosis sustained following a femoral shaft fracture 7 months earlier. A total hip replacement was carried out in general anaesthesia combined with an epidural catheter. The epidural catheter was removed on the third postoperative day, after which the patient complained of persistent lumbar pain which was associated with meningismus, fever, leucocytosis and a raised erythrocyte sedimentation rate. In spite of intensive laboratory and radiological investigation, 15 weeks elapsed before a radiological diagnosis of spondylitis of L1 and L2 could be made. Aspiration biopsy of the L1/L2 disc space yielded a growth of Pseudomonas aeruginosa. Antibiotic therapy was begun immediately but could not prevent spread of infection to the adjacent disc-space T12/L1 and the vertebral body T12. The patient made a slow recovery and was discharged in a satisfactory condition wearing a lumbar brace some 9 months after the operation. No evidence of epidural abscess formation was found at any stage and no direct connection between the use of the epidural catheter and spondylitis could be established.
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PMID:Spondylitis without epidural abscess formation following short-term use of an epidural catheter. 230 20

The authors described a case of multiple arteriovenous malformations of the left parietal lobe and the left cerebellar hemisphere, and presented a review of literature. A 42-year-old right-handed man was admitted to our Dept. of Neurosurgery on October 20, 1983, with left facial pain and occipitalgia. He had an episode of subarachnoid hemorrhage ten years ago, however, its etiology was not clear at neurological examination. This brief episode of pain began on the left side of his face about 9 years ago and has been gradually increasing. Although he has been treated with trigeminal nerve blocks several times, relapses were almost always evident within 6 months after those nerve blocks. On admission, there were no abnormal findings at neurological and physical examination. A CT scan with contrast medium infusion revealed two small AVMs on the left parietal region and on the left cerebellar hemisphere. A four-vessels cerebral angiogram confirmed the presence of two AVMs and fenestration of the left vertebral artery. The angiogram also revealed that his severe left trigeminal neuralgia had been caused by elongation of the anterior pontine segment of left SCA which was the main feeder of the cerebellar AVM. Two stages of surgical operations were carried out at two months interval. The first operation was total removal of the cerebellar AVM and microvascular decompression for the left trigeminal nerve. The second was total removal of the left parietal AVM. The postoperative course was uneventful, and angiographically the AVMs completely disappeared. The patient was discharged without any neurological deficits on March 11, 1984.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Multiple arteriovenous malformations of left parietal lobe and left cerebellar hemisphere with symptomatic trigeminal neuralgia: a case report]. 304 2

A 42-year-old Latin American female with acute lymphocytic leukemia in second relapse developed a small ecthymic lesion around the entrance site of a left subclavian line. This was followed by development of left-sided hemiparesis with contralateral loss of pain and temperature sensation. CT of the neck revealed a diffuse inflammatory process with soft tissue involvement and several bubbles of air in the anterior paraspinal muscles and within the spinal canal in the epidural location.
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PMID:Brown Sequard syndrome secondary to soft tissue infection in a patient with acute lymphocyte leukemia. 317 77

A 42-year-old man had rapidly progressing metastasis to the tongue 3 months after nephrectomy due to renal cell carcinoma. He visited an otolaryngeal clinic with the chief complaint of bleeding and pain on his tongue. Biopsy of the tongue revealed metastasis from the renal cell carcinoma. After treatment with radiation and chemotherapy, the tongue tumor was disappeared macroscopically. Renal cell carcinoma metastasizing to the tongue is rare. Statistical studies on the report of metastasis to the tongue of renal cell carcinoma are reviewed.
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PMID:[A renal cell carcinoma with metastasis to the tongue]. 332 57

A 42-year-old female visited our hospital because of left breast tumor and left arm swelling with severe pain. She had had right radical mastectomy and bilateral oophorectomy at 27 and 29 years of age, respectively. On admission, she had a hard mass, which seemed to be a severe invasion of the chest wall, on her left breast with a severe nipple ulcer. We inserted a catheter operatively through the thyrocervical truncus to the subclavian artery for the arterial infusion therapy. She was administered 250 mg of 5-FU daily, and 10 mg of ADM, 10 mg of CDDP, 10 KE of OK-432, every other week. During 70 days, 10,000 mg of 5-FU, 50 mg of ADM, 50 mg of CDDP and 50 KE of OK-432 were administered. As soon as the breast tumor became smaller, showed some mobility and the nipple ulcer healed, we carried out left mastectomy and axillary lymph node dissection. Pathological findings showed severe degeneration and necrosis of cancer cells. Lymphocytes surrounded necrotic tissue, and there was a follicular pattern of invasion. This phenomenon was considered to result from the promotion of cellular immunological reaction by OK-432.
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PMID:[A case report of the effective arterial infusion for advanced recurrence breast cancer with 5-FU, ADM, CDDP and OK-432]. 339 41


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