Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An autopsy case of a 52-year-old man suffering from chronic manganese poisoning (CMP) is reported with determination of the manganese distribution in the brain. The patient had been working in a manganese ore crushing plant since 1965. In 1967 he began to complain of difficulties in walking and diminished libido. Later, he developed various neuropsychiatric symptoms including euphoria, emotional incontinence, masked face, monotonous speech, "cock-walk", increased muscle tone, weakness of upper and lower extremities, tremor of the eye lids, and exaggeration of knee jerks. The major neuropathological change was degeneration of the basal ganglia, in which the pallidum was severely affected. The pallidum disclosed a loss and degeneration of nerve cells, which was especially marked in the medial segment, a prominent decrease of myelinated fibers, and moderate astrocytic proliferation. The substantia nigra was intact. Distribution of manganese in the brain of the present case of CMP was determined using flameless atomic absorption spectrometry and compared with control cases and also a case of Parkinson's disease (PD). There was no significant difference between the control cases and the case of PD in average concentration of manganese and its distribution in the brain. The present case of CMP showed no elevation in average concentration of manganese in the brain. However, there were some changes in its distribution. Thus, the continuance of neurological disorders in CMP is not linked to an elevated manganese concentration itself in the brain. CMP appears to be different from PD in neuropathology and manganese behavior in brain.
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PMID:Chronic manganese poisoning: a neuropathological study with determination of manganese distribution in the brain. 376 27

Three patients with normal pressure hydrocephalus and Parkinson's disease are reported. The recognition of this association is important because these two entities require specific therapeutic approaches. The presence of Parkinson's disease does not preclude an excellent response of the hydrocephalus to a shunting procedure. Although several reports of cases with the characteristic clinical manifestations of normal pressure hydrocephalus--progressive dementia, gait difficulty and urinary incontinence--have been published earlier, it was Adams and Hakim who emphasized the clinical triad and the effect of shunting the cerebrospinal fluid as a means of treatment. Messert and Baker stressed that the gait disturbance had a close resemblance to the freezing gait of parkinsonism. We are reporting three patients who had both conditions. Recognition of the existence of both disorders in the same patients is important since appropriate treatment of each of them led to marked improvement of their symptoms.
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PMID:Normal pressure hydrocephalus and Parkinson's disease. 658 9

To control frequency, urgency and urge incontinence, transcutaneous electrical stimulation was applied to the tibial nerve, the pudendal nerve or the anal sphincter in 79 patients. All patients were refractory to any medications for the control of frequency, nocturia, urgency and urge incontinence from a variety of causes including disk protrusion, Parkinson's disease and idiopathic conditions. The parameters of stimulation were 0.1 to 0.5 msec. duration for each stimulus, frequency 10 to 40 Hz, amplitude 5 to 500 voltage. Cystometrography was repeated during and after electrical stimulation and showed increased bladder capacity, measured at first and/or at maximum desire to void, increased compliance, decreased bladder pressure and/or disappearance of uninhibited contractions in 79% of the patients examined. At least one of these changes was observed in 64, 72 and 85% of the patients who underwent stimulation of the tibial nerve, the pudendal nerve and the anal sphincter, respectively. In some patients inhibition of bladder contraction persisted for more than 2 or 3 days after stimulation. Electromyographic activity of the pelvic floor muscles increased in all of the patients during the stimulation of the pudendal nerve or the anal sphincter, but did not increase and rather decreased during stimulation of the tibial nerve. Urethral pressure measured during electrical stimulation, did not change in many cases. Clinical success was also obtained in 19 of 22 patients who underwent two electrical stimulation program; one was continuous daily use of a portable stimulator, and the other was periodic anal stimulation once or twice a week.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Transcutaneous electrical stimulation for the control of frequency and urge incontinence]. 661 Feb 98

Clinical and urodynamic examinations were carried out in 63 patients with Parkinson's disease presenting with disorders of the urinary bladder sphincters with no detectable other neurological or urological cause. The incidence of these disorders varies greatly according to different authors this being likely due to a lack of their recognition in routine examinations. In many cases of the present series they were the initial symptom of the disease. The most frequent complaint was urgency of micturition, alone or associated with dysuria, the latter alone being much rarer. Urinary incontinence as a result of one or the other of these disturbances was a frequent feature. Overall clinical characteristics confirm the central neurologic origin of these disorders. Cystometry demonstrated detrusor hyperactivity in 60 p. cent of cases and hypoactivity in 35 p. cent. An electromyogram of the striated sphincter muscle and/or a urethral pressure graph were recorded in some patients. On the whole urodynamic data indicated detrusor muscle dysfunction as being the cause of the micturition disorders. L-Dopa could modify these disorders by increasing detrusor hypoactivity, probably through a central action. Anticholinergic agents provided good therapeutic results when detrusor hypoactivity was involved but it was much more difficult to improve hypoactivity. Data suggesting the role of basal ganglia lesions in detrusor dysfunction in Parkinson's disease are discussed.
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PMID:[Bladder sphincter disorders in Parkinson's disease]. 661 41

We report about a 67-year-old woman presenting with progressive orthostatic vertigo, urinary incontinence and clinical signs of Parkinson's disease. The Schellong test revealed deficient sympathetic orthostatic pressure response without an increase of plasma norepinephrine; therefore, a Shy-Drager syndrome was diagnosed. Because of inefficiency of the general measures (compressive pantyhose), the sympathomimetic agonists, and the centrally active alpha-2-antagonists, norepinephrine was administered via a miniature dosing pump. By this therapeutic regimen a marked improvement of orthostatic hypotension was achieved.
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PMID:[Orthostatic hypotension]. 789 55

The clinical features and natural history of 100 patients diagnosed as probable multiple system atrophy (MSA) are described. In all 14 (of 41 deceased) cases who underwent post-mortem examination of the brain, the diagnosis was confirmed pathologically, providing some validation of the clinical diagnostic criteria used. There were 67 men and 33 women. Median age at onset (at time of first reported symptom) was 53 (range 33-76) years. Autonomic symptoms were the initial feature in 41% of the patients, but had subsequently developed in 97% at latest follow-up. The most frequent autonomic symptom in men was impotence, and in women was urinary incontinence. Symptomatic orthostatic hypotension, although present in 68%, was severe in only 15% of patients. Parkinsonism was the initial feature in 46%, but had subsequently developed in 91% of subjects at latest follow-up. It was the predominant motor disorder [striatonigral degeneration (SND) type] in 82% of the patients, and was usually asymmetric (74%). Although akinesia and rigidity predominated, tremor was present at rest in 29% of patients, but in only 9% had a classical pill-rolling parkinsonian rest tremor been recorded. Twenty-nine percent of MSA patients had a good or excellent levodopa response at some stage. However, only 13% maintained this response. Prominent orofacial dyskinesias and dystonias occurred in a quarter of treated patients with MSA. Early onset (before age 49 years) MSA patients tended to have a good levodopa response. Cerebellar symptoms or signs were the only initial feature in 5%. Although subsequently developing in a further 47% of cases, in only 18% was a cerebellar syndrome the only (9%) or predominant (9%) motor disorder [olivopontocerebellar (OPCA) type]. Pyramidal involvement at latest follow-up was noted in 61% of all cases. In a further seven patients the initial features involved more than one system, and one other had presented as a parasomnia. Multiple system atrophy of the OPCA type most commonly presented with gait ataxia. Tremor, pyramidal signs and myoclonus were less common than in MSA of the SND type. Cerebellar signs were present in 42% of patients with MSA of the SND type and parkinsonian signs in 50% of patients with MSA of the OPCA type. Disease progression was faster than in idiopathic Parkinson's disease, so that > 40% of patients were markedly disabled or wheelchair bound within 5 years of onset of motor disturbance. Median survival of the whole group as calculated by Kaplan-Meier analysis was 9.5 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical features and natural history of multiple system atrophy. An analysis of 100 cases. 792 69

Pressure sores are a serious medical problem that is most commonly found in nursing homes and hospitals. Most sores can be prevented. To prevent pressure sores in nursing homes through intervention, it is first necessary to identify factors associated with sore formation. Factors associated with the formation of pressure sores relate to skin susceptibility combined with the presence of moisture, constant pressure, and shear force or friction on the skin. This paper is the first to study the correlates of pressure sores for a nationally representative sample of nursing home residents. The paper estimates the relative contribution of resident health characteristics to the probability of having had a pressure sore during a nursing home stay for a cross-sectional sample of residents. Data are from 699 facilities and 2803 residents in nursing homes included in the 1987 Institutional Population Component of the National Medical Expenditure Survey. The principal caregiver in the facility was asked if "during the current stay" the resident had a "bed sore (decubitus ulcer)." Findings indicate that having diagnoses of Parkinson's disease, diabetes, or paraplegia, being underweight, older, male, unable to walk, needing help feeding or unable to feed, having frequent fecal and urinary incontinence accidents, and being admitted from a hospital increase the likelihood of having had a pressure sore during the stay. Cognitively impaired residents who could feed themselves independently or with help were less likely to have had a sore, but cognitively impaired residents who were unable to feed themselves at all were at more risk than cognitively intact residents.
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PMID:Correlates of pressure sores in nursing homes: evidence from the National Medical Expenditure Survey. 800 35

A clinicopathological study of senile dementia of Alzheimer's type (SDAT) accompanied by the white matter lesions of Binswanger's type was carried out. Fifty-seven patients, who were diagnosed as suffering from SDAT based on clinical and pathological criteria, were classified into two groups based on the white matter lesions of Binswanger's type. Namely, group 1 consisted of the SDAT patients without any subcortical or white matter lesions (30 cases); group 2 consisted of those with white matter lesions of Binswanger's type (11 cases). The other 9 cases included those with vascular lesions and 4 with some of the same pathological changes found in Parkinson's disease. Clinically, group 2 patients showed subcortical symptoms such as urinary incontinence, Parkinsonian gait, being accompanied by hypertension and arrhythmias. Periventricular lucency (CT) were common in group 2. Macroscopically, both groups showed moderately to severe atrophy, and the width of the corpus callosum of group 2 was narrower than that of group 1. There was no difference in cerebral arteriosclerosis between the groups. In microscopic findings, patients in group 2 showed diffuse distribution of cortical changes such as senile plaques as well as Alzheimer's senile plaques as well as Alzheimer's neurofibrillary tangles while those in group 1 showed various types of diffuse or local distribution. Arteriolosclerosis of the white matter were found in both groups. There was no difference in aortic atherosclerosis and/or heart disease. The complication of white matter lesions of Binswanger's type was not a rare finding in SDAT.
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PMID:[A clinicopathological study of senile dementia of Alzheimer's type (SDAT) and white matter lesions of Binswanger's type]. 820 74

Detailed micturitional histories were taken from nine patients with progressive supranuclear palsy (PSP), and eight of them (89%) had micturitional symptoms including urinary incontinence in seven. Urodynamic studies were performed in six patients and the results were as follows. Three had residual urine of 100 ml on average. Four had detrusor hyperreflexia and one had a low compliance cystometrogram. One had detrusor-sphincter dyssynergia. Motor unit analysis of external sphincter was performed in four patients and two had neurogenic changes. The results were compared with our previous findings in Parkinson's disease and in striato-nigral degeneration (SND), and we found that a severe degree of micturitional disturbance in PSP seems to be as common as in SND, especially in the urinary storage phase, and more frequent than in Parkinson's disease. Supranuclear types of pelvic and pudendal nerve dysfunctions seemed to be mainly responsible for micturitional disturbance in PSP.
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PMID:Micturitional disturbance in progressive supranuclear palsy. 828 45

We compared the vesicourethral function between progressive supranuclear palsy (7 cases) and Parkinson's disease (vesicourethral function study in 8 patients with dysuria and questionnaire study in 44 patients). The frequency of urinary incontinence in the 44 patients with Parkinson's disease was 38.7%. Vesicourethral function study showed hypersensitivity, low bladder capacity, detrusor hyperreflexia and normal sphincter EMG. The frequency of urinary incontinence in supranuclear palsy was 85.7%. Vesicourethral function study showed hyposensitivity and detrusor hyperreflexia in 6 cases, and 4 of these 6 cases had residual urine due to impaired detrusor contraction in micturition phase and/or abnormal sphincter EMG. Compliance was normal, but bladder capacity was decreased in progressive cases. Impaired contraction and hyposensitivity made it more difficult to control the urinary incontinence in supranuclear palsy than in Parkinson's disease. Dementia and lower ADL were frequently accompanied with supranuclear palsy (rare in Parkinson's disease). These were other factors that worsen the control of incontinence.
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PMID:[Comparison of the vesicourethral function between progressive supranuclear palsy and Parkinson's disease]. 833 78


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