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 25-year-old woman was admitted in our hospital with back pain and both hip joint pain. Pain was abruptly occurred from the beginning of March 1990. Physical examination revealed wide spread pain (occipital area, both shoulder, lumber area, bilateral gluteal area, inguinal area, both Achilles-plantar area) and more than 12 tender points (occiput, trapezius, second rib, supraspinatus, gluteal, greater trochanter, hip joints, pubic bone). Laboratory examination showed no abnormal findings except ANF (1:160). Any examination including X-ray, bone scintigraphy, CT and MRI did not disclose spondylitis, sacroiliitis and enthesopathy. She was diagnosed as primary fibromyalgia/fibrositis syndrome. Treatment with maprotine hydrochloride (30 mg/day) and phenobarbital (120 mg/day) brought approximately 1/3 reduction of pain and tenderness. Psychoanalysis revealed that she had psychological conflicts against her parents and her colleagues at the work. EEG showed a borderline record with irregular basic pattern and 14 & 6 Hz positive burst at the sleep stage. Although the newly proposed criteria for the classification of fibromyalgia was proposed by ACR, fibromyalgia/fibrositis syndrome has been seldom discussed in the Japanese literature. As this syndrome is frequently associated with various rheumatic diseases, hypothyroidism and malignant diseases, we should pay much more attention to understand this syndrome.
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PMID:[Fibromyalgia (fibrositis) syndrome--a case report]. 192

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

Adenoid cystic carcinoma of the lacrimal gland is rarely reported in Japan compared with other countries in Europe and the U.S.A. Here is a report of this rare case. A 26-year-old female had complained of left visual disturbance and left exophthalmos with orbital pain. CT scan and MRI revealed a lacrimal gland tumor in that eye. The tumor was removed via a left frontal craniotomy, and diagnosed as adenoid cystic carcinoma. After operation, she was locally irradiated with a total dose of 5,000 rads using 15 MeV Lineac source. Chemotherapy was started with 5-FU after radiation therapy. An abnormal uptake was observed in the sternum in the bone scintigraphy performed after operation, suggesting metastasis. Visual disturbance improved and exophthalmos and orbital pain disappeared. At the last follow-up at 8 months after operation, she had no signs and symptoms of recurrence or metastasis. Adenoid cystic carcinoma is reported to be the most frequent among the malignant tumors of the lacrimal gland in the Western countries. Prognosis is generally unfavorable with the mortality of 45% to 70%. The 5-year and 10-year survival rate are 45% and 25%, respectively. The mean post-operative survival time is 4.5 years. Since the tumor grows infiltratively into the surrounding tissues, radical excision with total exenteration of the orbit is the treatment of choice. However, it is a difficult decision whether or not to remove the eye with the intact visual function. As for operation, an approach from above through the frontal craniotomy provides a wider operative field and an easier access to the tumor than the lateral approach employed by ophthalmologists.
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PMID:[Adenoid cystic carcinoma of the lacrimal gland: report of a case]. 196 65

Osteoblastoma is an infrequent but important cause of pain in the back and neurological findings in children and young adults. Its diagnosis may be difficult and often delayed (in one series, 23% of patients had not been diagnosed after 2 years of symptoms). MRI may be useful to noninvasively image the lesion, its soft tissue and bony extent and its relationship, if any, to the spinal cord.
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PMID:Case report 647: Benign osteoblastoma causing spinal cord compression and spastic paresis. 200 May 6

Since the early study of Halliday and Wakefield (1963) it has generally been agreed that scalp somatosensory evoked potentials (SEPs) are normal in patients with dissociated loss of pain and temperature sensation. Up to now a few patients with abnormal spinal N13 and preserved scalp P14 and N20 have been reported in the literature, but there is no firm evidence, based on group data, that this dissociation can be related to any form of dissociated sensory loss. We studied median nerve SEPs in 24 patients with syringomyelia documented by CT scan or MRI. For the recording of the cervical N13 we used a Cv6 anterior cervical montage, which cancels the potentials generated above the foramen magnum and enhances the amplitude of N13. Scalp far-field and early cortical SEPs were recorded using a noncephalic reference electrode. Since N13 pathological changes are mainly changes in amplitude we measured the N13/P9 amplitude ratio in normal subjects and patients and found that it was a reliable index to quantify the amplitude decrease of N13. Absent or reduced N13 was observed in 40 median nerve SEPs (83%) in conjunction with normal P14 and N20 in 30 SEPs. Thus the dissociated loss of the cervical N13 was identified as the most conspicuous SEP feature in syringomyelia. A significant correlation was found between abnormal N13 and loss of pain and temperature sensations, whereas P14 abnormalities correlated well only with loss of joint and touch sensations. In the median nerve territory, sensation was either normal (6 cases) or lost only for pain and temperature (24 cases) when SEPs showed abnormal N13 and normal P14. Although it does not directly reflect the postsynaptic activity of spinal cells receiving their inputs from A delta and C fibres the N13 potential proved to be a reliable index of spinal cord grey matter dysfunction in syringomyelia.
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PMID:The contribution of median nerve SEPs in the functional assessment of the cervical spinal cord in syringomyelia. A study of 24 patients. 200 47

A case of isolated unilateral extraocular muscle myositis following an acute upper respiratory tract infection is reported. Painful eye movements, restricted eye motility and exophthalmus but a normal visual acuity are the most important clinical findings. High resolution contrast enhanced CT and MRI are the imaging modalities of choice to differentiate from other orbital pathologies. The solitary enlarged muscle was clearly seen on both the contrast enhanced CT and the MR examination. Preseptal cellulitis was better seen on MRI, whereas high resolution CT was superior in the demonstration of periscleritis. Graves' ophthalmopathy and orbital cellulitis first have to be excluded. Corticosteroids are the therapy of choice in orbital myositis. A control, contrast enhanced CT after 4 weeks showed an almost normal muscle.
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PMID:Orbital myositis following an upper respiratory tract infection: contribution of high resolution CT and MRI. 202 8

The most common cause of the idiopathic trigeminal neuralgia are tortuous arteries in the prepontine space. The trigeminal nerve can be compressed by the superior cerebellar artery, the inferior cerebellar artery, or the basilar artery. Seldom the nerve is traumatised by an enlarged vein. Because an operative decompression of the nerve can relieve pain, a preoperative evaluation is needed. Angiography of the vertebral arteries is able to predict a tortuous artery close to the trigeminal nerve but cannot show the nerve itself. MRI can show tortuous vessels and the trigeminal nerve together on one single image by means of a 3D gradient-echo FLASH sequence with an effective slice thickness of approximately 1 mm and secondary reconstructions in every desired plane. MRI thus provides an efficient tool for the evaluation of patients with trigeminal neuralgia.
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PMID:MRI of trigeminal neuralgia: initial clinical results in patients with vascular compression of the trigeminal nerve. 203 Aug 31

A 55-year-old woman developed the sudden onset of headache and diplopia. The neurological findings showed the left 3rd and 4th cranial nerve palsies, loss of pain and temperature sensation in the region innervated by the ophthalmic nerve, and bruit on the left orbit. The mixed type of dural arteriovenous malformation (AVM) in the region of the cavernous sinus was diagnosed by MRI and cerebral angiography. The Matas procedure in which the patient was guided to compress the cervical carotid artery herself for 10 minutes three times a day was performed. Neurological signs and symptoms disappeared completely 3 months after starting the Matas procedure, and MRI revealed the regression of AVM. These results suggest that Matas procedure may promote its spontaneous regression of dural AVM occurred in the region of the cavernous sinus.
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PMID:[A case of dural arteriovenous malformation in the region of the cavernous sinus improved by Matas procedure]. 204 6

Tactile stimulation of a coin-sized area in a T-2 dermatome consistently triggered a lancinating pain in the ipsilateral C-8 dermatome in a 38-year-old woman. The SEP and an MRI led to a diagnosis of a tumor at the left cervico-medullary junction, much higher than the clinically suspected level. Surgical exploration revealed an exophytic glioma, and the pain was abolished postoperatively. Ephaptic transmission at the tumor site was suspected as a pathophysiologic mechanism.
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PMID:Somato-somatic referred pain caused by suprasegmental spinal cord tumor. 204 44

Transcatheter arterial embolization therapy was performed in fifteen patients with hypervascular metastatic bone and soft-tissue tumors (7 from renal carcinoma, 5 from hepatocellular carcinoma, and one each from breast, thyroid, and cholangiocarcinoma). Sites of metastasis were spine (7), pelvis (5), skull (2), paraspine (2), chest wall (1), and thigh (1). Five patients had not responded to previous radiation therapy and hyperthermia. Embolization of feeding arteries was performed superselectively with long tapered catheters or coaxial microcatheters. Emulsion of Lipiodol and anticancer agent, polyvinyl alcohol sponge, gelatin sponge, and microcoils were used as embolic materials in various combinations. Relief of pain was experienced in 14 of 15 patients. Two patients were operated following embolization with minimal blood loss. Change in tumor size was evaluated by CT or MRI in ten patients. Reduction of tumor size were more than 50% in five patients, from 25% to 50% in two, and no change in three patients. Especially, patients embolized with microcatheter and microcoils showed excellent long-term results. No serious complications were seen. In conclusion, superselective arterial embolization therapy with coaxial microcatheter and microcoils was proved to be an useful treatment for hypervascular metastatic bone and soft-tissue tumors.
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PMID:[Arterial embolization therapy for metastatic bone and soft-tissue tumors with microcatheter and microcoils]. 204 1


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