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)

A 10-year-old, female poodle was presented with left paresis and vestibular signs, following left enophthalmus and atrophy of the cheek. Magnetic resonance imaging revealed a mass along the base of the brain and extending from the left cerebellopontine angle to the sella turcica. The mass showed isointensity on the T1-weighted image and T2-weighted image, and was enhanced by contrast medium (Gd-DTPA). Although occipital craniotomy was carried out and the mass removed, the dog died without recovering from the anesthesia. The tumor was diagnosed pathologically as fibroblastic meningioma.
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PMID:Cerebellopontine angle meningioma expanding into the sella turcica in a dog. 1496 Aug 21

The orthopedic treatment is the first choice in shaft fractures of the humerus in children. Angulations of more than 10 degrees need reduction, in that case anesthesia should be used for surgical stabilization. The preferred method is the elastic-stable intramedullary nailing (ESIN). In adolescents, even unreamed interlocking medullary nails are used. The primary paresis of the radial nerve is not an indication for nerve exploration in principle, but may be useful in special fracture situations. In subcapital fractures, more distinct angulations can be left untouched because of the highly potent epiphyseal plate. In severe displaced fractures, reduction and stabilization by ESIN is recommended in patients over the age of 10 years. The method is even applicable to pathological fractures in juvenile bone cysts. In adolescents after the start of epiphyseal plate closure, angle-stable implants are an alternative.
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PMID:[Treatment of humeral shaft and subcapital fractures in children. Consensus report of the child trauma section of the DGU]. 1499 73

Local injection of botulinum toxin (BT) is a well-established treatment option for spastic movement disorders in children. BT blocks the release of acetylcholine from the axon terminal into the synaptic cleft of the motor endplate resulting in paresis of the injected musculature. Such localised, temporary chemodenervation of affected muscles can lead to functional gains and may improve the child's daily routine and rehabilitative care. We summarise state-of-the-art treatment of spasticity in children with BT type A, addressing critical issues and introducing recent advances, such as sonography-guided injection of BT and the distal injection of the psoas muscle without the need for general anaesthesia. First-hand experience with BT type B in children is presented.
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PMID:Use of botulinum toxin in pediatric spasticity (cerebral palsy). 1502 70

Brain surgery incurs a significant risk of a new motor deficit in lesions within or adjacent to the motor areas and pathways which, for the patient, presents one of the most disabling complications of such operations. It is a major concern of intracranial procedures to delineate and monitor motor regions in order to preserve their structural and functional integrity, while still achieving maximal cytoreduction. The technique of motor evoked potential recording has had to be adapted to intraoperative recording conditions under general anaesthesia, but has been available for clinical use now for almost ten years. This contribution summarizes the current technique and related methods, as well as our clinical experience in some 400 cases of MEP monitoring in supratentorial tumors, lesions in and around the brainstem, and aneurysm surgery. Intraoperative MEP recordings have been shown to reliably reflect an impending new motor deficit. Irreversible MEP deterioration heralds new paresis, and unaltered recordings predict preserved motor function. This is also true in aneurysm surgery where conventional SEP monitoring may yield false-negative results with regard to development of a new motor deficit. Moreover, if MEP deterioration can be reversed, or halted by early surgical intervention, the presence of only a transient motor deficit, or even the lack of a new postoperative deficit, indicates the success of the MEP monitoring method in the prevention of a significant motor impairment. Certain complicated lesions can only be operated on at all because MEP monitoring is available. In conclusion, intraoperative MEP monitoring is a useful aid in brain surgery with which to avoid a new motor deficit without compromise to the surgical result. Controlled prospective studies will be required to verify the clinical value of the method.
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PMID:Motor evoked potential monitoring for the surgery of brain tumours and vascular malformations. 1503 39

Fomocaine (CAS 56583-43-8) is a local anaesthetic (LA) with good surface anaesthesia and low toxicity, monographed in the German Extra Pharmacopoeia (DAC). In previous experiments it could be shown that both fomocaine and a couple of its derivatives need further pharmaceutical investigations. Therefore, five new C-alkylmorpholine derivatives, (OW 1, OW 3, OW 5, OW 9, and OW 11) and five 2-hydroxypropyl-beta-cyclodextrin inclusion compounds of fomocaine or OE 7000, OE 9000, OL/4, and OL/40, respectively, were compared with fomocaine and/or the respective non-cyclodextrin formulations in rats. Basing on standard methods for testing of LA effects and using two methods to characterising toxicity of LA (paresis of the N. ischiadicus, LD50) it can be concluded that: a) The good surface anaesthesia caused by fomocaine is not surpassed by its alkylmorpholine derivatives OW1-11. Only OW 11 seems to induce longer lasting conductance anaesthesia; the other OW substances (1-9) are in the same range like fomocaine. The toxicity is quite comparable for fomocaine and its OW derivatives. b) Substituted cyclodextrins are often a useful help if the water solubility of compounds is insufficient. The use of these cyclodextrin inclusion compounds resulted in slightly improved LA effects of complexed fomocaine, whereas there were nearly no significant differences between OE 7000 or OE 9000 and their cyclodextrin formulations. The toxicity of the complexed fomocaine was lower compared to fomocaine whereas the toxicity of both OE 7000 and OE 9000 was the same for the original compound and their cyclodextrin formulations. Obviously the paresis of N. ischiadicus is less pronounced after administration of the inclusion compounds. c) The cyclodextrin formulations of the new meta-fomocaines (OL/4 and OL/40) are, compared to the complexed fomocaine, without practically relevant LA effect. But OL/4 complexed is even more toxic than complexed fomocaine. On the basis of the experiments done with altogether five new fomocaine derivatives and five complexed fomocaines it can be summarized that neither the new derivatives nor their inclusion compounds seem to have any therapeutic advantage compared with the known mother substance fomocaine. Only the longer lasting effect of high doses of OW 11 as conductance LA could be of practical relevance.
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PMID:Effects and toxicity of new fomocaine derivatives and of 2-hydroxypropyl-beta-cyclodextrin inclusion compounds in rats. 1521 88

Neurological complications following regional anaesthesia may arise due to compression of the spinal cord or nerve roots secondary to haematoma or abscess, trauma, neurotoxicity or ischaemia. We report a patient who developed prolonged left lower limb paresis following combined spinal epidural (CSE) anaesthesia for emergency caesarean section. Magnetic resonance imaging (MRI) showed marked swelling of the lower end of the spinal cord suggesting traumatic damage of the cord by the spinal needle.
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PMID:Long-term neurological complication following traumatic damage to the spinal cord with a 25 gauge whitacre spinal needle. 1532 Nov 11

In this randomized, double-blind study, we compared the anesthetic characteristics and pulmonary function changes of 0.33% bupivacaine and 0.33% ropivacaine used for interscalene brachial plexus (IBP) anesthesia in patients with chronic renal failure. Forty-two patients undergoing IBP anesthesia for creation of arteriovenous fistulas were randomly allocated to receive either 30 mL of 0.33% bupivacaine (Group B) or 0.33% ropivacaine (Group R). Block onset time, diaphragmatic excursion (ultrasonographic evaluation), and free plasma concentrations of bupivacaine and ropivacaine were evaluated. Negative motion or immobility of the ipsilateral hemidiaphragm and a decrease of >10 mm in positive motion were defined as diaphragmatic paresis. The pulmonary function variables were measured by bedside spirometry equipment. Seven patients needed supplemental local anesthetic, one with total spinal block; these patients were excluded from the study. The success rate was 80.9%. Block quality was similar in the two groups. Ipsilateral hemidiaphragmatic excursion was decreased in both groups compared with baseline values (P < 0.05). Diaphragmatic paresis was identified in 10 of 16 patients and 8 of 18 patients in Groups B and R, respectively (P > 0.05). Pulmonary function significantly decreased from baseline in both groups (forced vital capacity (FVC) 30%, forced expiratory volume at 1 second (FEV(1)) 32%, and peak expiratory flow (PEF) 31% in Group B and FVC 17%, FEV(1) 17%, and PEF 5% in Group R) (P < 0.001). The decreases in Group B were larger than those in Group R (P < 0.05). Three patients in Group B and one in Group R had mild respiratory problems (P > 0.05). Concentrations of bupivacaine and ropivacaine were below toxic levels rather than "normal range." We conclude that pulmonary function decreased more after IBP with 0.33% bupivacaine than with 0.33% ropivacaine.
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PMID:Interscalene brachial plexus block with bupivacaine and ropivacaine in patients with chronic renal failure: diaphragmatic excursion and pulmonary function changes. 1642 91

A pelvic limb paresis of 6 weeks duration in a yearling sheep resulted from protozoan encephalomyelitis involving the spinal cord at the thoracolumbar junction. An elevated lumbosacral cerebrospinal fluid protein concentration but normal cisternal cerebrospinal fluid protein concentration indicated the presence of a thoracolumbar inflammatory lesion resulting in cord compression which obstructed the rostral flow of the cerebrospinal fluid. Under general anaesthesia, myelography at the lumbo-sacral site demonstrated blockage to the rostral flow of contrast medium at T13/L1. At necropsy, there were no gross pathological changes at T13/L1, but histopathology revealed non-tract specific lymphocytic perivascular cuffing, axonal swelling and oedema in the spinal cord, characteristic of a protozoal encephalomyelitis. No parasites were detected in the multiple spinal cord sections examined but immunocytochemistry identified antigens cross-reactive with Sarcocystis spp. antigens in glial cells in these lesions.
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PMID:Protozoan encephalomyelitis causing pelvic limb paresis in a yearling sheep. 1603 13

It is often difficult to evaluate the results of transcranial motor-evoked potential (TCMEP) monitoring in patients under general anesthesia because these results are strongly affected by anesthetics and muscle relaxants. To exclude effects of muscle relaxants on TCMEP, compound muscle action potential (CMAP) by supramaximum stimulation of the median nerve immediately after transcranial stimulation (300 to 600 V) was recorded in 70 neurosurgical operations. A relative amplitude index (RAI) was defined as the amplitude of TCMEP after the operative procedure divided by the amplitude of TCMEP before the operative procedure. The RAI was calculated and was compensated by the amplitude of CMAP in 141 limbs. In 12 limbs of 7 patients with postoperatively progressed motor paresis, the compensated RAI was less than 0.2. The compensated RAI in all other 129 limbs of 63 patients without postoperative motor palsy was more than 0.2. These results suggest that compensation of TCMEP monitoring by CMAP is an easy and accurate method for removing the effects of muscle relaxants in TCMEP.
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PMID:Compensation of intraoperative transcranial motor-evoked potential monitoring by compound muscle action potential after peripheral nerve stimulation. 1609 99

Femoral mononeuropathy has many etiologies and is often quite disabling, causing lower extremity paresthesia, anesthesia, pain, or paresis. Despite its morbidity, few therapies have been described to treat the femoral nerve palsy that does not resolve with conservative management or that is refractory to physical therapy. In this report, we present 3 cases of femoral nerve palsy; one as a complication of local nerve block, one as a complication of laparotomy, and one of idiopathic origin. In each case, symptomatic and objective improvement was achieved with femoral neurolysis. We suggest guidelines for the management of those patients who fail to respond to conservative therapy and indications for surgical intervention.
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PMID:Treatment concepts for idiopathic and iatrogenic femoral nerve mononeuropathy. 1618 7


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