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)

The upper and lower surface of the vertebral bodies are covered with a thick cartilaginous plate in which the secondary ossification centres develop at puberty and continue to grow throughout adolescence. Congenital indentations in the cartilaginous plates are not uncommon and they constitute regions of diminished resistance, which yield under physical stress. Prolapse of disc tissue occurs into the vertebral body, causing a disturbance of growth but little if any pain. The vertebrae in the mid-thoracic region become wedge-shaped, and a kyphotic deformity results, the so-called Scheuermann's disease, or adolescent kyphosis. A plea is made for the screening of children exposed to risk.
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PMID:The vulnerable, rapidly growing thoracic spine of the adolescent. 238 79

Between January 1982 and March 1987, 23 patients (26 orbits) were treated for orbital pseudotumor with radiation therapy at the Department of Radiation Oncology, Hospital of the University of Pennsylvania. The patients were referred for clinical relapse after steroid taper in 70%, no response to steroids in 17%, and no steroid treatment (refused or contraindicated) in 13%. Presenting symptoms/signs included soft tissue swelling in 92% of orbits, pain in 92%, proptosis in 85%, and extraocular muscle dysfunction or ptosis in 69%. Decreased visual acuity was seen in only 19% of orbits. Biopsy was performed in nine patients. Treatment consisted of 2000 cGy in 2 weeks in 10 fractions for all patients. Median follow-up was 41 months, with a mean of 53 months, and a range of 21-92 months. Complete response was documented in 87% of orbits with soft tissue swelling, 82% with proptosis, 78% with extraocular muscle dysfunction, and 75% with pain. Of the five patients with visual acuity defects, three experienced complete recovery. There was no difference in complete response in patients biopsied versus those not biopsied. Overall, 17 orbits have remained in complete orbital response with no further steroid requirement (66%). Three orbits suffered local relapse at some point following radiation therapy and were retreated with steroids. These three orbits had durable local control off steroids at last follow-up (11%). Therefore, 77% of orbits attained durable local control and were steroid independent with radiation therapy alone or radiation therapy followed by steroids for relapse. Only one patient developed systemic lymphoma with follow-up. No pretreatment clinical factor reached statistical significance with respect to prognosis following radiation therapy at the less than or equal to .05 level. There were no significant acute or chronic side effects secondary to treatment. Steroids should continue to be first line treatment for orbital pseudotumor, but radiation therapy has a well-defined role in cases of steroid failure or in patients unable to tolerate steroid therapy.
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PMID:The results of radiotherapy for orbital pseudotumor. 240 29

The problems of nociception and the development of pain in radicular syndromes of the spine may be summarized as follows: 1. The anatomic complex nerve root/dorsal ganglion is a key structure in the pain physiology of disk prolapse and spinal stenosis. 2. Chronic compression of nerve tissue causes structural changes. 3. These structural changes are associated with a change in the electrical properties of the nerve root membrane. 4. The change in membrane properties in the nociceptive pathways of nerve roots is one of the preconditions for perception of pain. As the authors' remark indicate, a better understanding of the pathophysiology of pain will lead to a more differentiated therapeutic approach.
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PMID:[Pain and the spine. A review. 1. On the pathophysiology of radicular pain syndromes. Current concepts explaining pain in nerve entrapment syndromes]. 254 64

In 1963, Calverley and Mohnac reported four cases with sensory disturbance of the mental nerve region. They emphasized the symptomatological significance of that finding because of the underlying ominous diseases. The purpose of this paper is to emphasize the clinical importance of this symptom especially as the initial manifestation of the underlying malignant diseases. A 56-year-old Japanese female was seen in consultation because of complaints of the paresthesia over the distribution of the right mental nerve, diplopia and ptosis of the right side. The patient had been well until a hundred days prior to admission, when she noted numbness with pain of the right mental nerve region. This symptom was followed by ptosis of the right side and diplopia after five weeks. MRI-CT scan revealed an abnormally low intensity echo (in T1 weighted image) of the bone around sphenoid sinus and tumor of the cavernous sinus (in T2 weighted image) compressing the right internal carotid artery. The patient was transferred to this hospital 100 days after the occurrence of the initial symptom. Physical examination revealed neither superficial lymph node swelling nor buccal tumor. Abnormal findings were restricted to the cranial nerve regions such as diplopia, adduction disturbance, sluggish light reflex of the right side and hypesthesia on the right chin, lower lip and buccal mucous membrane. Other neurological findings were not significant. Laboratory findings showed elevated LDH (1,503 IU/L). Leucocyte cell count was 7,500/mm3 with almost normal composition. CSF was normal. A diagnosis of Burkitt's lymphoma stage IV was done by nasopharynx and bone marrow biopsies.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of Burkitt's lymphoma with numb chin syndrome as the initial manifestation]. 258 91

The clinical and pathological features of 11 cases of large bowel endometriosis are reported, one of which also had lesions in the small intestine. All of the cases had rectal or rectosigmoid involvement. Altered bowel habit and pain were common symptoms but were rarely associated with the menstrual cycle. Sigmoidoscopy was generally unhelpful. Rectal or vaginal examination and barium enema often revealed a mass which was usually diagnosed preoperatively as a malignancy. A correct diagnosis was made preoperatively in only two cases; carcinoma was suspected in four and carcinoid in one case. Histological evidence of recent hemorrhage was confined to those cases where endometriosis seemed to be the major cause of intestinal symptoms. The colonic mucosa overlying the endometriotic deposits was commonly histologically abnormal. It showed a range of changes resembling colitis, solitary ulcer, prolapse or even neoplasm. An appreciation of these mucosal alterations is important to those reporting colonic and rectal biopsies; when observed to be focal in a female patient they should arouse a suspicion of endometriosis.
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PMID:Endometriosis of the large bowel: a report of 11 cases. 263 15

We report the results of a procedure aimed at correcting the disorders of rectal and perineal tone responsible for the descending perineum syndrome (DPS). The procedure, carried out by the perineal approach, combines a posterior intersphincteric sacro-rectopexy, an anterior perineoplasty via a pre-anal levator myorraphie, a posterior perineoplasty using a post anal repair technique and a mucosal resection aimed at freeing the anal canal. 22 F and 1 M, mean age 68 years, with DPS were operated on. Digitised rectography demonstrated pathological perineal descent (greater than 3 cm) in all cases and posterior rectal angulation at rest of more than 25 degrees (normal less than 10 degrees) confirming an important deterioration in perineal tone. Results after a mean follow up of 12 months (6 to 30 months) were excellent, with objective improvement in rectal bleeding, pain, mucosal prolapse and anal incontinence. In spite of an almost constant return to normal in the number of stools and their facility of evacuation improvement in the dyschesic syndrome (78% of patients) was subjectively variable. Improvement was judged to be very good in 34%, good in 33%, fair in 11%. Healing of mucosal lesions: solitary ulcer (n = 2), rectal inflammation (n = 2), ulcerated mucosal prolapse (n = 3) occurred in all cases within 1 month. Post operative rectography demonstrated a significant decrease in posterior rectal angulation and ano-coccygeal distance confirming the efficacy of the anatomical correction. No serious complications, in particular, infections, were noted under appropriate prophylactic antibiotic cover (Piperacillin) continued up to D5.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Sacro-rectopexy by a posterior intersphincteric approach with anteroposterior perineoplasty and mucosal resection. Therapeutic proposal in descending peritoneum syndrome. Apropos of 23 cases]. 265 13

Tubular aggregates (TA) are unusual intramuscular structures stained basophilic on hematoxilin and eosin (HE) staining and red on modified Gomori trichrome (GT) staining. The structures are said to be originated from sarcoplasmic reticulum and are collections of tubules with double membranes on electron microscopic studies. The TA are usually seen in biopsy muscles from patients with muscle pain and cramps but without muscle weakness, periodic paralysis or alcoholic myopathy. In addition, there are five reports on families with progressive myopathy and tubular aggregates in the literature. We presented here a 48-year-old postman without any family history, who had had progressive muscle weakness for 17 years. He had never noticed pain or cramps in his muscles, not taken any particular medicine, and not had regular alcoholic beverages. There was no ptosis, facial weakness, masticatory muscle weakness or dysphagia. Muscle wasting, started from the proximal part of four extremities had progressed to the distal part of them. He could not walk on heels or toes and walked with waddling gait. He stood up with Gowers' maneuver. Serum GOT, GPT and CK were elevated. EMG showed myogenic pattern and MCV was normal. The muscle biopsies were performed; the first one taken from quadriceps femoris muscle at 42 years old showed myopathic changes including marked variation in fiber sizes, with scattered necrotic fiber splitting and TA in type 2B fibers. The second biopsy from biceps brachii muscle at the age of 48 years, showed densely proliferated fibrous tissues, marked variation fiber sizes and scattered split fibers. The TA were rarely seen and type 2B fibers were decreased in number.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of progressive myopathy with tubular aggregates]. 268 70

Rubber band ligation was used in 160 patients with internal hemorrhoids; 43 of them also had rectal anterior mucosal prolapse; 13 had prolapse alone. Two thirds of the patients underwent a single rubber band ligation and one third a double rubber band ligation in one session without anesthesia. Ninety-four required repeated ligations. A follow-up of 25 +/- 16 months (mean +/- SD) was carried out in 153 of them. Rubber band ligation was followed by prolonged bleeding in six patients and severe pain requiring removal of the rubber band in 12 patients. The complication rate decreased significantly (P less than .05) in the last 80 patients. Compared with multiple ligation, single rubber band ligation in one sitting was followed by a lower complication rate (P less than .01). Long-term results were good in 71 percent of the patients. (A formal hemorrhoidectomy was needed within two years in 6 percent.) A significantly lower recurrence rate of 9 percent was noted in those with normal bowel habits, when compared with constipated subjects whose symptoms recurred in 85 percent (P less than .001). Constipation seems to be a predictable factor in worsening the outcome of rubber band ligation. Rubber band ligation is followed by a lower complication rate when performed in a single ligation.
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PMID:Rubber band ligation of hemorrhoids and rectal mucosal prolapse in constipated patients. 271 26

Six cases of internal ophthalmoplegia due to direct head injury are presented. All six patients had a dilated, nonreactive pupil. Four had no extraocular palsies or ptosis and two had partial extraocular palsies or ptosis. Disturbance of consciousness was absent or very mild, and all patients fully recovered within 1 to 7 days after the traumatic event. No patient had a history that suggested a cause for oculomotor nerve palsy, and emergency CTscans showed no mass lesions. The internal ophthalmoplegia was recognized immediately after trauma. Although minimal oculomotor nerve palsies due to unruptured intracranial aneurysms have been described, none of our patients complained of periorbital or retroorbital pain either before or after the trauma, which rules out intracranial aneurysms as the cause of the internal ophthalmoplegia. Therefore, we concluded that the internal ophthalmoplegia was due to direct head injury. The pathophysiological mechanism of the internal ophthalmoplegia appeared to be slight injury of the pupillomotor fibres on the ventromedial surface of the third nerve at the posterior petroclinoid ligament, which acted as the fulcrum due to the downward displacement of the brainstem at the time of impact.
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PMID:Primary internal ophthalmoplegia due to head injury. 271 3

We report the case of a woman with short nocturnal attacks of peri- and retro-orbital pain, diplopia, ptosis, rhinorrhea and lacrimation of five months evolution. Neurological examination was normal between attacks. The latter presented with partial third nerve palsy, which finally became complete and permanent. Brain CT showed a sellar and supraseller tumor with parasellar extension to the right side. We stress the atypical clinical presentation and evolution of this case, and discuss its pathophysiology.
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PMID:Pituitary adenoma presenting as painful intermittent third nerve palsy. 275 52


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