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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The interaction between neuroleptics and an anticholinergic, biperiden, in the antiavoidance, catalepsy and ptosis tests was investigated in mice for the purpose of predicting the extrapyramidal side-effects of neuroleptics. The cataleptic effect of most neuroleptics used was antagonized to some extent by biperiden, while the ptotic effect was hardly influenced. The antiavoidance effect of haloperidol, trifluperidol and perphenazine was markedly antagonized and that of chlorpromazine moderately. However, the effect of thioridazine, chlorprothixene, levomepromazine and clozapine was little antagonized. In neuropharmacological tests, haloperidol, trifluperidol and perphenazine exhibited a selective antidopaminergic activity, while chlorprothixene, levomepromazine and clozapine showed antidopaminergic, antiadrenergic and also anticholinergic activities when similar doses were given. These results indicate that biperiden antagonism may be marked in the tests related to the extrapyramidal symptoms and in drugs liable to induce extrapyramidal side effects, however, there would be little or no antagonism in drugs possessing the anticholinergic property and eliciting few extrapyramidal side-effects.
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PMID:Differential antagonism of antiavoidance, cataleptic and ptotic effects of neuroleptics by biperiden. 4 13

Ambulatory monitoring and maximal treadmill exercise were compared in 40 normal subjects and 31 patients with mitral prolapse. A variable arrhythmia spectrum was observed in prolapse during monitoring: premature ventricular contractions in 18 (58%), supraventricular arrhythmias in 11 (35%), and bradyarrhythmias in 9 (29%). Significantly less arrhythmias occurred in normal subjects during monitoring: 10 (25%, P greater than 0.001), 3 (8%, P less than 0.001), 4 (10%, P less than 0.05), and 2 (5%, P less than 0.02), respectively. In patients with prolapse, arrhythmias occurred on resting electrocardiogram (ECG), 35% premature ventricular contractons, 6% supraventricular arrhythmias, and 10% bradyarrhythmias, and on treadmill exercise, 45%, 10%, and 3%; therefore, ambulatory monitoring was the most sensitive method of arrhythmia detection. No correlation existed between clinical features of prolapse and arrhythmias. Thus, arrhythmias occur in most patients with mitral prolapse, are not predictable by clinical characteristics, comprise a spectrum of ventricular and supraventricular tachyarrhythmias and bradyarrhythmias, and are best detected by ambulatory ECG monitoring.
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PMID:Arrhythmias in the mitral valve prolapse syndrome. Prevalence, nature, and frequency. 5 63

Detrusor hyperreflexia (DH) is a frequently occurring condition. The symptomatology is characterized by frequency, urgency and urge incontinence. DH is defined as involuntary, uninhibited detrusor contractions. The physiology and pathophysiology of the micturition reflex is reviewed. The balance between cerebral stimulation and supraspinal inhibition is discussed. DH is caused by disturbances in this balance. Whereas increased afferent impulses to the central nervous system due to local disorders in bladder and/or urethra may produce DH, a neurological disorder affecting the inhibitory nervous pathways from cortical and subcortical centres always result in uninhibited detrusor contractions. DH was found in 25% of 2000 patients. In the majority of the patients the DH was caused by a neurological disorder. The incidence of DH in patients with enuresis, gynecological patients with urinary incontinence and/or genital prolapse and patients with benign prostatic hyperplasia (BPH) is reported. In 62% of the patients with BPH the DH was eliminated after adequate surgical treatment of the infravesical obstruction. By contrast, DH in women with genital prolapse and/or incontinence persisted despite operative treatment. In a retrospective investigation of 152 patients with DH, the cause of the DH was unknown in 32 patients (21%). A clinical neurological examination revealed no evidence of neurological disease in 45% of the 22 patients examined. Voiding symptoms were the only complaint in these patients as well as in 30-40% of the patients in the other groups mentioned. This calls for improved investigatory methods in the evaluation of the balance between stimulation and inhibition of the micturition reflex. The presence of uninhibited detrusor contractions in apparently healthy patients should indicate a neurological examination since DH may be the first sign of a neurological disorder. The micturition reflex is conducted through long, uninterrupted neurons with a marked central integration. Therefore cystometry may be used as a supplement to the clinical neurological examination in the early diagnosis of pyramidal or extrapyramidal central nervous system disorders.
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PMID:Detrusor hyperreflexia. A survey on its etiology and treatment. 5 48

During a prospective trial of platelet-inhibiting drugs in patients with transient ischaemic attacks (T.I.A.s), 14 patients had serious neurological dysfunction and normal cerebral angiograms. The patients (mean age 37 years) had neurological episodes over a period of 1-4 years consisting of acute non-progressive strokes with residual symptoms. In 3 patients, the two cerebral hemispheres were involved on different occasions. Cerebral angiograms showed no significant atheromatous disease in the intracranial or extracranial vessels. 3 patients had mid-systolic clicks, 5 had systolic murmurs, and 2 patients had both a click and a murmur. Holter electrocardiographic monitoring revealed atrial, junctional, or ventricular extrasystoles (5 patients), paroxysmal atrial fibrillation (3), and paroxysmal ventricular tachycardia (1). Left ventricular angiography confirmed mitral-leaflet prolapse in all the patients. The focal nature of the T.I.A.s suggests an embolic event, the embolus arising from the abnormal mitral valve. In a patient not included in this series, a small antemortem left atrial thrombus was found at necropsy.
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PMID:Strokes: A complication of mitral-leaflet prolapse? 6 31

The fibrinolytic activity in biopsy specimens of superficial veins obtained from postmenopausal women before and after treatment with a nonsteroidal estrogen (P 1496) was determined as well as the coagulation factors antithrombin 3 and components of the fibrinolytic system. Patients were given P 1496, 50 mg/day for 3 weeks before surgery for uterine prolapse. The prothrombin + factor 7 + factor 10 (P and P), factor 8, antithrombin 3, alpha-1-antitrypsin, anti(-2)-macroglobulin, and inhibitors of urokinase induced plasminogen activation were measured. Vein biopsy specimens were taken from the dorsal side of the hand. Fibrinolysis was measured after incubation. The fibrinolytic activity of the specimens was normal and unchanged with treatment.
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PMID:Coagulative and fibrinolytic studies on postmenopausal women treated with a new non-steroidal oestrogen. 7 33

This case report affords the dynamic understanding of a patient's conversion reaction of unilateral ptosis of the eye. The specificity of this manifestation of psychopathology is shaped by the patient's unconscious ideas about disease and the suitability of this symptom for the symbolic representation of her primary conflict.
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PMID:Unilateral ptosis as a conversion reaction. 7 84

A protruding auricle is usually associated with a defect in development or function of the posterior auricular muscle, which normally draws the pinna towards the calvarium. Hence, a protruding auricle may be a sign of a neuromuscular disorder, as is ptosis.
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PMID:Protruding auricle: A neuromuscular sign. 7 51

Left ventricular endomyocardial biopsy specimens were obtained at cardiac catheterisation in 11 patients with mitral-leaflet prolapse, chest pain, and normal coronary arteries. Specimens were examined for birefringence before and after contraction induced by adenosine triphosphate and were also subjected to histochemical analysis. Biopsy specimens from a control group of patients with rigorously defined normal left ventricular function and another control group with poor left ventricular function were also studied. Biopsy specimens from patients with mitral-leaflet prolapse showed a markedly subnormal birefringence response to adenosine triphosphate, with the group mean value intermediate between values for controls with normal and poor left ventricular function. Histochemical studies in the prolapse group also revealed an abnormal pattern, particularly for monoamine-oxidase activity. This is further evidence of a cardiomyopathy in this symptomatic subgroup of patients with mitral-leaflet prolapse.
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PMID:Biopsy evidence of left ventricular myocardial abnormality in patients with mitral-leaflet prolapse and chest pain. 8 76

Four cases of gastric diverticula following subtotal gastrectomy are described. This type of diverticula associated with partial gastrectomy are probably true, acquired, pulsion diverticula. In two of our patients the diverticula were associated with significant prolapse of gastric mucosa causing obstruction at the anastomosis.
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PMID:Gastric diverticula following subtotal gastrectomy. 9 88

This report concerns 9 patients in whom rupture of the cordae of the mitral valve was suspected from the echocardiogram. The authors recall the clinical, echocardiographic, arteriographic, haemodynamic and anatomical findings in patients with rupture of the chordae; they emphasise the importance of echocardiograpy in the pre-operative diagnosis of this condition. In this series, the most frequent clinical sign was a loud pan-systolic murmur at the apex. The electrocardiographic abnormalities were nonspecific. Cardiomegaly was present in most cases. The main echocardiographic findings were those of additional echoes between the two cusps of the mitral valve during diastole, or an abnormally posterior or anterior position of the posterior cusp during diastole, or the presence of mitral prolapse. Other nonspecific signs were frequently present. Left cineangioventriculography showed a significant degree of mitral leakage during diastole in all patients. All 9 patients had an operation or came to post mortem; rupture of the chordae was confirmed in 6 of them. As far as the other 3 cases were concerned, two of them had lengthening of the mitral cordae, and the last had mitral prolapse associated with endocardial vegetation. A further group of 60 patients undergoing surgery for mitral incompetence without rupture of the chordae allowed us to establish that there were no false negative results on the echocardiogram.
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PMID:[Rupture of the mitral valve chordae. Electrocardiographic, clinical and angiographic findings]. 10 74


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