Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The article presents the group of five patients with clinical and radiological symptoms of trigeminal neurinoma that were operated on in the Neurosurgical Clinic of Central Clinical Hospital of Military Medical Academy in the five-years period (1995-2000). Three of them were operated in a single step procedure from subtemporal and suboccipital approach. Two other were operated in two steps, also from subtemporal and suboccipital approaches. Four neurinomas were removed radically, as confirmed by CT, and MRI scans. All the patients are independent and professionally active. Complications observed after the operation were: persistent anaesthesia in the trigeminal area, atrophy of the masseter muscle, transient paresis of the facial nerve with ulceration and opacification of the cornea, and transient paresis of the abducens nerve.
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PMID:[Surgical treatment of trigeminal neurinoma]. 1218 14

A 76-yr-old woman was scheduled for left upper extremity orthopedic procedure. Preoperative examinations were within normal limits except forced vital capacity. Interscalene brachial plexus block with 0.25% bupivacaine 15 ml, was performed under general anesthesia. Her intraoperative course was uneventful. She, however, complained of the dyspnea after removal of a tracheal tube, and Spo2 dropped to 89%. A chest X-ray demonstrated the elevation of hemidiaphragm. She was diagnosed as ipsilateral hemidiaphragmatic paresis, treated with oxygen inhalation under deep breathing for approximately one hour, and then transferred to the common ward. We conclude that respiratory movement should be carefully observed following interscalene brachial plexus block especially in geriatric patients.
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PMID:[A case report of hemidiaphragmatic paresis caused by interscalene brachial plexus block]. 1222 42

A 25-year-old female developed permanent, fluctuating sensorineural hearing loss (SNHL), disabling vertigo, and tinnitus following an uneventful spinal anesthesia for cesarean section. At her first visit to the ear-nose-throat (ENT) department approximately 2 months postoperatively, pure-tone thresholds revealed profound SNHL on the right side whereas thresholds were within normal limits on the left side. The recruitment score (SISI) was 95% at 2000 Hz on the right side. Directional preponderance towards the right and the right canal paresis were evidenced by bithermal caloric testing. At follow ups the pure tone thresholds have shown some improvement, but fluctuating SNHL, disabling vertigo attacks, and tinnitus have remained. These findings imply a cochlear pathology causing endolymphatic hydrops possibly induced by lumbar puncture for spinal anesthesia.
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PMID:Permanent sensorineural hearing loss following spinal anesthesia. 1236 13

Anesthetic management of cardiac patients with complete transposition of the great arteries (TGA) undergoing arterial switch operation (ASO) is challenging. The anesthetic course and perioperative problems were studied. A prospective data collection study of 87 patients was performed between January 1991 and February 2002. The patients were divided into 3 groups: Group 1; 27 neonates with TGA with an intact ventricular septum (IVS), Group 2; 21 with TGA, with IVS who underwent two-stage ASO, and Group 3; 39 with TGA, with a large VSD. The anesthesia consisted of low-dose fentanyl, thiopental, atracurium and isoflurane. Monitoring included ECG, radial or femoral arterial pressure, CVP, LAP, core temperature, SpO2, P(E)CO2, urine output, ABG's, Hct, ACT, serum glucose and potassium. Fortunately the courses of anesthesia were uneventful. Usual vasoactive medication administered following CPB included nitroglycerin, dobutamine and dopamine. Groups I, 2 and 3 contained 18.5 per cent, 14.3 per cent and 33.3 per cent of patients who required adrenaline respectively. And only 7.7 per cent of patients in Group 3 had milrinone as an inotrope. Early tracheal extubation, 2 hours after admission to ICU was performed in 3 patients. Perioperative complications included bleeding, low cardiac output, diaphragmatic paresis, digitalis intoxication, metabolic alkalosis, convulsion, pulmonary hypertensive crisis and death. Two patients who developed a pulmonary hypertensive crisis were successfully managed with inhaled nitric oxide. The overall hospital mortality rate was 19.54 per cent. In conclusion, the anesthetic management for ASO in 87 simple dTGA patients was uneventful at Siriraj Hospital. The major perioperative morbidity and hospital mortality were not directly anesthetic contribution.
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PMID:Anesthesia for arterial switch operation in simple transposition of the great arteries: experience at Siriraj Hospital. 1245 17

Fomocaine (CAS 56583-43-8) is a local anaesthetic (LA) with long lasting surface effect and low toxicity. Nevertheless, it is not optimal yet. Therefore, 7 newly synthesised derivatives, 4 diethanolamines (OE 6000, OE 7000, OE 8000, OE 9000) and 3 morpholines (OE 500, OE 1000, OE 5000) were compared with procaine-HCl (CAS 51-05-8) and tetracaine-HCl (CAS 136-47-0) in rats. Based on standard methods for the testing of LA effects and using two methods for characterising side effects and toxicity of LA (paresis of the N. ischiadicus, LD50) it can be concluded that: a) The very good surface anaesthesia caused by especially fomocaine and tetracaine could be stated but concerning conduction anaesthesia procaine is better qualified. b) Concerning conduction anaesthesia, diethanolamine derivatives are more potent compared to morpholine derivatives. c) Surface anaesthesia shows a different picture: the effect of fomocaine is in between. d) The paresis of the N. ischiadicus as a first sign of toxic side effects indicated that low effect is combined with short paresis. e) Compared to the LD50 of fomocaine, the toxicity of OE 500 and OE 5000 is only one half. On the basis of the experiments with fomocaine derivatives, distinct structure-activity relationships could be demonstrated for fomocaine derivatives concerning a) LA effects and b) toxicity. Altogether OE 9000 could be a promising candidate for systemic use.
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PMID:Local anaesthetic effects and toxicity of seven new diethanolamine and morpholine derivatives of fomocaine. Testing in rats compared with procaine and tetracaine. 1270 79

We revised the charts of first interventions of refractive surgery with LASIK and PRK in order to evaluate the results and to analyze the incidents and complications we encountered as beginners in photorefractive surgery. In total 50 eyes of 29 patients (7 men and 22 women) were operated. 42 eyes were myopic (21 with astigmatism) and 8 eyes were hyperopic (6 with astigmatism). LASIK was performed in 45 cases and PRK in 5 cases all myopias. The intervention was performed with AESCULAP MEDITEC MEL 70G-Scan laser. The follow-up period was between 3 and 12 months. Per total the results were as follows: Average pre-operative non-corrected visual acuity was 0.23 Average pre-operative corrected visual acuity was 0.8 Average post-operative non-corrected visual acuity was 0.74 Average post-operative corrected visual acuity was 0.77 We noted some minor intra-operative incidents: insufficient anesthesia (6%) and some important intra-operative incidents: free cap (6%), flap desepithelization (4%). Minor post-operative complications were: mild corneal edema, corneal desepitelisation (14%), and some severe post-operative complications: corneal ulcer (4%), comeal mycosis (2%), pupilary paresis (2%). Under-correction was present per total in 52% of cases, but mainly in myopias over 10 dpt (30%), as well as induced astigmatism (10%). Major complicated cases were only 5 (10%) and were consecutive to some mechanical problems (vacuum failure, system decentration). An interesting observation is related to IOP evolution. In average a decrease of IOP was noted from pre-operative medium of 14.43 mmHg to a post-operative medium value of 10.73 mmHg.
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PMID:[Complications at the beginning of refractive surgery]. 1272 4

Neuro-ophthalmologic complications from cataract surgery are uncommon and include central nervous system toxicity, binocular diplopia, traumatic optic neuropathy and ischemic optic neuropathy. Retrobulbar blocks may be accidentally injected into the subarachnoid space with diffusion to the brainstem. This leads to cardiovascular, respiratory, and mental status compromise. Most patients have complete recovery with adequate support. Post-operative, binocular diplopia may occur secondary to anisometropia or previously unrecognized misalignment. Periocular injection may cause paresis or fibrosis of extraocular muscles. Anterior or posterior ischemic optic neuropathy can occur in the first 6 weeks after cataract surgery with or without periocular injection. The risk to the other eye is high with subsequent contralateral cataract extraction. Post-operative vision loss associated with direct traumatic needle injury is recognized immediately. Therefore, an orbital MRI may be warranted for a patient with an optic neuropathy in the first 24 hours after cataract surgery using periocular anesthesia. If evidence of needle injury is present on neuroimaging, a trial of steroids should be considered.
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PMID:Neuro-ophthalmologic complications of cataract surgery. 1275 44

The purpose of this study was to evaluate the efficacy of radiofrequency trigeminal rhizotomy in treating 135 patients harboring trigeminal neuralgia, and to introduce a technical modification to guide the puncture of the foramen ovale. A hundred and one (74.8%) patients were treated with a single surgical procedure whereas the 34 (25.2%) remaining patients required two procedures. Follow-up ranges from 6 months to 15 years. Pain relief in the immediate postoperative was achieved in 131 (97.0%) patients. After the initial procedure, recurrence happened in 33 (24.5%) patients. The complications included decrease corneal reflex (4.4%), masseter paresis (2.2%), painful dysesthesia (1.5%) and anesthesia dolorosa (0.7%). The radiofrequency trigeminal rizhotomy is a low risk, highly effective and minimally invasive procedure. The use of the computerized tomography guided fluoroscopy turns foramen ovale's puncture easier, fast and precise.
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PMID:[Trigeminal radiofrequency rhizotomy for the treatment of trigeminal neuralgia: results and technical modification]. 1289 80

Early recognition of limb ischemia may allow prompt, effective therapy for peripheral arterial injuries. A review of cases of peripheral arterial trauma at the Toronto General Hospital since 1953 revealed that 50% of the injuries were not immediately recognized. An expanding hematoma, pulsatile hemorrhage or the onset of a bruit and thrill signifies arterial damage in penetrating wounds. Ischemia may be difficult to recognize in patients with soft tissue or skeletal trauma, but the presence of distal pallor, coolness, paresis, cyanosis, anesthesia, poor capillary refill and disproportionate pain indicates significant arterial damage and necessitates surgical exploration. The diagnosis of arterial "spasm" in such instances is untenable and can only be made after direct inspection, or on the return of pulses after reduction of a fracture or release of a tight cast. Restoration of arterial continuity by end-to-end anastomosis is the recommended technique for all arterial injuries, since after ligation of even minor vessels, ischemia may ensue, and amputation may occasionally be necessary.
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PMID:THE RECOGNITION AND MANAGEMENT OF PERIPHERAL ARTERIAL INJURIES. 1428 3

A 52-year-old female, scheduled for rectal cancer resection, had no history of central nervous system abnormality. Anesthesia was maintained with general anesthesia combined with epidural anesthesia. Her only hemodynamic change was a rise in arterial pressure to 140 mmHg just after the start of the operation. However, postoperatively she failed to be aroused and she exhibited a positive Babinski's sign, anisocoria, an absent light reflex and paresis of the left lower extremity. Cerebral vascular accident was suspected and a CT scan revealed a cerebral hematoma which was immediately removed surgically. Upon exploration, abnormal vessels were recognized and we diagnosed an acute rupture of arteriovenous malformation. She fully recovered consciousness immediately after the operation. Her postoperative course was uneventful, except for a residual paresis of the left lower extremity.
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PMID:[A case of silent rupture of a cerebral arteriovenous malformation during laparotomy]. 1459 72


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