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)

Since November 1988, 28 patients with lumbar L5 radiculopathy refractory to conservative care and with a radiologically verified central or mediolateral disc herniation at the level of L4/L5 had had a percutaneous discectomy. Radiological verification consisted of spinal CT +/- myelography, +/- myelo-CT, +/- MRI. A short-term follow-up analysis of at least 2 months taking the clinical and functional status as well as the professional reintegration into account revealed a 64.3% (18/28 patients) satisfactory outcome and a 32.1% (10/28 patients) failure rate. Of the latter 28.6% (8/28 patients) required further open surgery. One patient whose pain had only partially in regressed was shown at open operation to have a sequestered cranial prolapse as revealed by spinal CT after the percutaneous procedure. There were no major complications. One patient developed a sequestered extraforaminal herniation through the nucleotomy canal three weeks after the procedure. One patient bled for 2 minutes. There were no major vessel injuries. One patient reported local muscular pain, and enhanced nerve root pain after introduction of the trocar sleeve.
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PMID:Lumbar percutaneous discectomy. Initial experience in 28 cases. 174 70

MR tomography is now considered to be the examination method of choice in diagnosis of thoracic vertebral disk prolapses, since all the other imaging methods do not lend themselves easily to this task. The advantages of MR are that it is non-invasive, that the soft parts yield strong contrasts, and that multiplanar sections are possible; sagittal section is particularly useful in the preoperatively important correct localisation of the height. CT proved of equal value only in calcified disk prolapse. However, since calcification does not entail any additional therapeutic consequences, MR can be used in this case too as a leading imaging method. If MR can be applied, myelography and myelo-CT should be set aside.
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PMID:[Thoracic intervertebral disk prolapse--the place of imaging procedures]. 187 81

The incidence of neurological deficits in achondroplastic subject is by no means negligible. We considered the clinico-radiological and therapeutic data of 35 achondroplasic patients (5 personal cases and 30 published in the available literature) harbouring myelo-radicular deficits related to narrowing of thoraco-lumbar canal. There was no significant sex prevalence. The clinical symptoms appear most frequently in the III or IV decades of life. Actually morphological anomalies of the spinal canal are already present at birth in achondroplasic dwarfs, and signs of cervical cord involvement are not uncommon in achondroplasic children. The delayed occurrence of clinical symptoms related to narrow toracho-lumbar canal may be explained by the pathogenetic role of acquired cofactors as prolapse of intervertebral disks and for degenerative spondyloartrosis. The clinical history is usually of insidious onset. Most frequent symptoms are motor weakness of the lower limbs (82.8%) and low-back pain (77.1%). Sensory and/or sphincter disturbances appeared to be less frequent (about 40% of the examined subjects). Plain X-rays, myelography, CT, CT-myelography and MRI are the diagnostic examination of choice. Surgical treatment consists of anterior decompression with fusion, when thoraco-lumbar kyphosis is prevalent, and/or posterior decompression, when the symptoms are mainly caused by canal stenosis. From the prognostic point of view, two groups of patients are recognized, in relationship to the presence of marked dorsal kyphosis. Those with kyphosis showed almost invariably poor functional results. In the remaining ones the results were satisfactory, provided that the clinical history lasted less than 3 years and the symptomatology was not already too advanced.
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PMID:Narrowing of thoraco-lumbar spinal canal in achondroplasia. 267 64

The diagnostic value of computed tomography (CT), myelography, myelo-CT and magnetic resonance imaging (MRI) was retrospectively investigated in 94 patients in whom Cloward's operation had been performed due to symptoms of cervical myelopathy (CM). In 55 patients with "classical" cervical spondylotic myelopathy all investigated diagnostic procedures demonstrated a comparably high degree of sensitivity and specificity, thus proving comparable for diagnosing pathological alterations of the cervical spine. In 39 patients with CM as a consequence of an acute cervical disk prolapse, however, MRI was superior and offered the highest diagnostic accuracy. The following general diagnostic strategy in patients with CM can be suggested: Conventional plain film radiography of the cervical spine, axial CT of the involved segments and MRI of the cervical spine in sagittal and transversal orientation, using T1 and T2 weighted pulse sequences. The combined use of these techniques allows the exact evaluation of any relevant structure alterations of the cervical spine that determine differential therapeutic approaches.
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PMID:[Value of neuroradiologic procedures in preoperative assessment of cervical myelopathy]. 848 11

We describe our experience of mitral valve surgery in a 74-year-old man with rheumatoid arthritis (RA). RA had been diagnosed 12 years previously and his symptoms were being controlled by drugs including methotrexate (MTX), which is potentially immuno- and myelo-suppressive. He was admitted for dyspnea, and surgery was indicated for severe mitral insufficiency due to posterior leaflet prolapse. According to the recommendations of orthopedic surgeons, the administration of the MTX was discontinued at two weeks prior to the operation, in which the prolapsed leaflet was excised, repaired, and annuloplasty were performed with a 30 mm prosthetics ring. The patient recovered uneventfully and MTX was resumed one week after surgery. Since MTX has been recently approval for treatment of RA in Japan, Japanese surgeons should pay attention to the appropriate perioperative use of this drug.
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PMID:Mitral valve surgery in a patient with rheumatoid arthritis being treated with methotrexate. 1277 53

Genital prolapse in the newborn is a rare clinical condition often times seen in association with congenital myelo-meningocele, or this could occur following shigellosis infection. We therefore report two neonates with rectal prolapse following diarrhea and utero-vaginal prolapse associated with congenital spinal bifida.
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PMID:Rectal and genital prolapse in Nigerian newborns: case reports and review of the literature. 2432 21