Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thromboembolism (TE) occurs in about 20% of patients with rheumatic mitral valve disease, and platelet survival time in these patients has correlated with TE. In patients with mitral valve prolapse, TE appears to occur very infrequently. Platelet survival (autologous labeling with chromium-51) was performed in 26 patients with mitral prolapse. Five patients had a history of stroke, as well as normal cerebrovascular arteriography and shortened platelet survival (average half-time +/- SEM 2.3 +/- 0.18 days; normal half-time 3.7 +/- 0.03 days; n = 26; p less than 0.01). Platelet survival was shortened in seven of 21 patients without TE (33%) (3.3 +/- 0.06 days; p less than 0.01 vs patients with TE). In 138 patients with rheumatic heart disease, platelet survival was shortened in 40 of 41 (98%) with a history of TE (2.3 +/- 0.08 days) and in 76 of 97 (78%) without TE (2.9 +/- 0.07 days; p less than 0.001 vs patients with TE). In patients with mitral prolapse, sulfinpyrazone increased platelet survival (2.4 +/- 0.16 to 2.7 +/- 0.19 days; n = 7; p less than 0.05). Our results suggest that platelet survival time is shortened in patients with mitral prolapse and rheumatic heart disease who have had TE. Of those without TE there is an increased frequency of shortened platelet survival in patients with rheumatic heart disease (78%) compared with those with mitral prolapse (33%), consistent with the infrequency of TE in mitral prolapse.
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PMID:Platelet survival time and thromboembolism in patients with mitral valve prolapse. 44 32

A total of 80 patients with senile cataract had the anterior eye chamber depth measured optically by means of Haag-Streit's attachment II. The distance to the pupillary border was 2.59 +/- 0.05 mm (mean +/- SEM) preoperatively. It increased gradually after cataract extraction to 3.33 +/- 0.04 mm, measured 4 months after the operation. The increase of depth was the greatest in patients with a flat chamber and in elderly patients. The central chamber depth decreased gradually after the operation (from 2.82 +/- 0.05 mm preoperatively to 1.95 +/- 0.13 mm 4 months postoperatively). The number of vitreous prolapse cases rose from 68 to 87.5% in 4 months. These altered chamber depths were observed to bear no relation to postoperative corneal oedema (neither of parenchyma nor of epithelium), intraocular pressure, or bleeding into the chamber.
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PMID:Depth of anterior chamber after cataract extraction. 67 2

Our review of an entire institutional experience with primary repair of congenital and acquired mitral valve (MV) anomalies in children with concordant atrial-ventricular-arterial connections but without atrioventricular septal defects included 48 patients (1962 to September 1986). Mitral stenosis (MS) was the predominate lesion in 24 patients, mitral incompetence in 22, and mixed in two. Most patients with MS had so-called typical congenital MS (Van Praagh) with abnormalities of all valvular components; virtual or complete absence of chordal development was a consistent finding. Other anatomic substrates (not mutually exclusive) producing MS included supramitral ring with Shone's complex (n = 5), parachute mitral valve (n = 2), hypoplastic mitral ring (n = 3), and rheumatic lesions (n = 3). The anatomic substrates producing mitral incompetence included annular dilatation (n = 16; isolated in seven), leaflet prolapse (n = 7), cleft leaflet (n = 6), leaflet deficiency (n = 3), and rheumatic lesions (n = 2). Concurrent repair of associated lesions was performed in 29 (60%) patients for relief of left ventricular outflow tract obstruction (n = 16) and closure of ventricular septal defects (n = 9; double-outlet right ventricle in three). Six (12.5%) patients had previous repair of coarctation of the aorta. The operative mortality rate was 18.7% (70% confidence limits [CL]; 12.8% to 24.6%), with one death in 35 patients since 1975 (2.9%; 70% CL; 0% to 5.8%). The actuarial freedom from early or late death and reoperation (+/- SEM) was 44.0% +/- 14.8% at 8 years postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical experience with reparative techniques in patients with congenital mitral valvular anomalies. 362 34

Previous studies have shown an association of sickle cell disease with generalized connective tissue disorders such as pseudoxanthoma elasticum. We recently documented an unexpectedly high prevalence of mitral valve prolapse, a connective tissue disorder, in sickle cell disease. To investigate this association, skin biopsies were analyzed from 32 sickle cell disease patients, 11 of whom had mitral prolapse. Total and type III collagen, collagen solubility, and uronic acid were not different between the patients with or without mitral prolapse (p greater than 0.05). Computerized morphometric quantitation of the volume fraction of elastic fibers was greater in sickle cell disease patients than in 10 normals (3.1 +/- 0.1 mean +/- SEM vs 2.0 +/- 0.3%; p less than 0.01) but less than in three patients with pseudoxanthoma elasticum (9.7 +/- 0.6%; p less than 0.001). Desmosine radioimmunoassay (an index of elastic fibers) was greater in sickle cell disease patients with mitral prolapse than those without (239.3 +/- 9.3 vs 171.7 +/- 25.4 ng/mg wet weight; p less than 0.02). Histopathologic grading showed a similar trend (p = 0.07). The combined probabilities of these three independent tests of elastic fiber quantity showed an increased elastic fiber concentration in mitral prolapse patients compared to those without mitral prolapse (p less than 0.02). Thus, there is no evidence for a specific collagen defect; rather, sickle cell disease appears to be associated with a spectrum of elastic tissue disorders, a feature that could predispose to mitral valve prolapse.
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PMID:Mitral valve prolapse in sickle cell disease: manifestation of a generalized connective tissue disorder. 398 3

Blood samples were collected from 53 dairy cows with uterine prolapse and from 53 cows with normal parturition (no uterine prolapse) matched by dairy as controls for various management programs among dairies. Cows with uterine prolapse had significantly lower total serum calcium content than did controls (P less than 0.01). Mean (+/- SEM) serum calcium content (mg/dl) for affected cows and controls were 6.08 (+/- 0.25) and 6.96 (+/- 0.20), respectively. Severe hypocalcemia (less than 4 mg/dl) was found in 10 (19%) of the affected cows, compared with 1 (1.8%) of the controls. Fifteen (28%) of the affected cows had moderate hypocalcemia (4.1 to 6.0 mg/dl), compared with 14 (26%) of the controls; 19 (36%) of the affected cows were mildly hypocalcemic (6.1 to 7.9 mg/dl), compared with 25 (47%) of the controls. Nine (17%) of the affected cows and 13 (25%) of the controls were within the normal range of calcium content (greater than 8 mg/dl). Nine of the affected cows were first-calf cows. The serum of these animals did not have significantly lower calcium concentrations, compared with controls matched by parity. Serum calcium values (mg/dl) for 9 first-calf cows and the 9 matched controls were 7.24 (+/- 0.42) and 7.00 (+/- 0.39), respectively. It was concluded that hypocalcemia was associated with uterine prolapse in multiparous dairy cows and, along with other factors, is involved as an etiologic factor for this puerperal condition.
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PMID:Uterine prolapse and hypocalcemia in dairy cows. 651 23

To ascertain the effects of surgical closure of atrial septal defect on left ventricular geometry and degree of mitral prolapse, 14 patients with atrial septal defect were studied by cross-sectional and M-mode echocardiography preoperatively and 7 days postoperatively. Seven of the 14 patients (50%) had mitral valve prolapse preoperatively by cross-sectional echocardiography. To quantitate the degree of prolapse, we measured the net algebraic area subtended by the apposed mitral valve leaflets in systole (MVAS) with respect to the mitral ring. The mitral valve prolapse group had an MVAS of 0.3 +/- 3.1 units (mean +/- SEM) preoperatively, while the group without mitral valve prolapse had an MVAS of 12.5 +/- 3.1 units (p less than 0.02). Postoperatively, prolapse either decreased in degree or was abolished in six of seven patients (86%), associated with an increase in MVAS to 14.7 +/- 4.4 units (p less than 0.02). In all patients, septal curvature in diastole on short-axis view normalized either partially or completely postoperatively, resulting in decreased left ventricular eccentricity (1.34 +/- 0.06 preop vs. 1.06 +/- 0.07 postop, p less than 0.001). Atrial septal defect closure, therefore, leads to normalization of left ventricular geometry and in patients with evidence of mitral valve prolapse, is associated with a decrease in the degree of prolapse.
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PMID:Effect of atrial septal defect repair on left ventricular geometry and degree of mitral valve prolapse. 736 33

The establishment of a linear relationship between perineal descent (PD) and pudendal nerve motor terminal latency (PNMTL) is important in understanding the pathophysiology of pudendal neuropathy. The amount of stretching of the pudendal nerve resulting from the extent of PD, should correlate with the amount of injury sustained (PNMTL). The two key previous studies which used different techniques to measure PD, have differed on this vital issue. A prospective study was undertaken in 141 consecutive patients with PD (M:F = 57:84; mean age 46.3 SEM 1.6 years) to clarify this discrepancy. The patients had chronic constipation (81), neurogenic faecal incontinence (31), rectal mucosal prolapse (17) or female urinary stress incontinence (9). All underwent measurements of PD (by perineometry), anal sphincter pressures, single fibre anal sphincter electromyography and PNMTL. These variables, as well as age were analyzed for a linear relationship with PD by multiple regression analysis. Age was the only independent variable predicting PD at rest (T = -3.2; p < 0.005). PNMTL was the only independent variable predicting PD on straining (T = -3.0; p < 0.005). In conclusion, a linear relationship between PD on straining and PNMTL was confirmed, supporting the previous study which also measured PD by perineometry. The other study which refuted such a relationship measured PD radiologically, and it is likely that the difference was in the measurement technique.
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PMID:The neurophysiological significance of perineal descent. 763 69

Clinical and manometric results of Delorme's operation and sphincteroplasty were assessed retrospectively in patients undergoing this procedure for fecal incontinence and rectal prolapse. A series of 33 patients (11 males, 22 females; aged 18-83 years, mean 59) with external rectal prolapse were treated by Delorme's operation between 1989 and 1996. Mean follow-up was 39 months (range 7-84). Sphincteroplasty was associated in 12 cases with severe fecal incontinence due to striated muscle defects. Good results were achieved in 27 patients (79%); prolapse recurrence was observed in 6 (21%), the mean recurrence time being 9 months (range 1-24 months). There were no postoperative deaths. Minor complications occurred in 15 patients. Changes in preoperative and postoperative manometric patterns were as follows (mean +/- SEM): voluntary contraction from 59 +/- 6.9 to 66 +/- 7.1 mmHg (P = 0.05), resting tone from 33 +/- 5 to 32 +/- 4.3 mmHg, rectal sensation from 59 +/- 5 to 61 +/- 5.2 ml of air (n.s.). A solitary rectal ulcer syndrome was detected in five patients. The histological pattern demonstrated pathological changes in 40% of cases. Fecal incontinence was resolved in 6 of 20 cases (30%) and chronic constipation in 4 of 9 (44%). Failure (n = 3) was related primarily to postoperative sepsis. The incontinence score showed a mean improvement of 35% decreasing, from 4.5 +/- 0.39 to 2.9 +/- 0.44 after surgery (P < 0.01). In conclusion, Delorme's procedure did not lead to constipation and improved anal continence when associated with sphincteroplasty.
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PMID:Delorme's operation and sphincteroplasty for rectal prolapse and fecal incontinence. 987 Jan 65

The management of rectal internal mucosal prolapse (RIMP) is not based on an accepted classification of the lesion which helps to choose the appropriate treatment. The aim of this prospective study was to report a new endoscopic grading of RIMP and to evaluate its clinical value. Thirty-two patients (7 men, 25 women; mean age 56 years, range 28-72) affected by symptomatic RIMP were prospectively classified as follows: RIMP was defined as first degree when detectable below the anorectal ring on straining, as second degree when it reached the dentate line, and as third degree when it reached the anal verge. Anal manometry was carried out in 26 patients, and anal ultrasound and defecography in 6 prior to surgery. A correlation was found between the occurrence and severity of symptoms and the degree of the prolapse as obstructed defecation, bleeding and fecal soiling affected mainly patients with third-degree RIMP. At manometry the maximal resting tone was 60+/-23 mm Hg and voluntary contraction 96+/-41 mm Hg (mean+/-SEM). At anal ultrasound the mean internal sphincter thickness was 2.1+/-0.2 mm, and external sphincter thickness was 7.0+/-0.8 mm. A significant rectocele and rectal intussusception (n = 2) and a nonrelaxing puborectalis muscle on straining (n = 2) were observed at defecography in cases with third-degree RIMP. The anorectal angle was 100+/-75 degrees at rest, 63+/-20 degrees on squeezing, and 115+/-9 degrees on straining. A conservative treatment with high-fiber diet and/or rubber band ligation was carried out in all cases of first and in most patients with second-degree RIMP (n = 26). Those who required surgery, i.e., stapled transanal excision of the prolapse (n = 6), had either severely symptomatic third-degree RIMP with solitary ulcer syndrome (n = 4) or second-degree RIMP (n = 2). A positive outcome was achieved in 71% of cases. The proposed classification evaluated by the present study may be of clinical value in managing rectal internal mucosal prolapse.
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PMID:A new grading of rectal internal mucosal prolapse and its correlation with diagnosis and treatment. 1064 34

Degradable heart valves based on in situ tissue regeneration have been proposed as potentially durable and non-thrombogenic prosthetic alternatives. We evaluated the acute in vivo function, microstructure, mechanics, and thromboresistance of a stentless biodegradable tissue-engineered heart valve (TEHV) in the tricuspid position. Biomimetic stentless tricuspid valves were fabricated with poly(carbonate urethane)urea (PCUU) by double-component deposition (DCD) processing to mimic native valve mechanics and geometry. Five swine then underwent 24-h TEHV implantation in the tricuspid position. Echocardiography demonstrated good leaflet motion and no prolapse and trace to mild regurgitation in all but one animal. Histology revealed patches of proteinaceous deposits with no cellular uptake. SEM demonstrated retained scaffold microarchitecture with proteinaceous deposits but no platelet aggregation or thrombosis. Explanted PCUU leaflet thickness and mechanical anisotropy were comparable with native tricuspid leaflets. Bioinspired, elastomeric, stentless TEHVs fabricated by DCD were readily implantable and demonstrated good acute function in the tricuspid position.
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PMID:Acute In Vivo Functional Assessment of a Biodegradable Stentless Elastomeric Tricuspid Valve. 3204 Jul 66


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