Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 56-yr-old man, two months after an operation for an acoustic neurinoma, gradually developed dyspnea. Massive pulmonary embolism (MPE), with a significant right-to-left (R-L) shunt, was seen in a perfusion scan of the lungs with Tc-99m MAA. Radioactivity was noted in the thyroid, spleen, kidneys and brain. A cardiac ultrasound study did not reveal intracardiac shunting. A few days later, when the patient's condition improved, another perfusion scan of the lungs did not show the shunt, whereas a subsequent digital subtraction angiographic study confirmed the diagnosis of MPE but failed to reveal the cause of the shunt. In the absence of any possible pathophysiological mechanism, to explain the observed R-L shunt, we deduce that the particles of Tc-99m MAA might have passed through the precapillary pulmonary arteriovenous anastomoses and/or through dilated pulmonary capillaries, as a result of highly increased pulmonary vascular pressure due to MPE.
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PMID:Transient right-to-left shunt in massive pulmonary embolism. 1092 88

Despite major advances in skull base surgery and microsurgical techniques, surgery for vestibular schwannoma (VS) carries a risk of complications. Some are inherent to general anesthesia and surgery of any type and include myocardial infarction, pneumonia, pulmonary embolism, and infection. Some are specific to neurosurgery in this area of the brain, and include hydrocephalus, cerebrospinal fluid leak, facial nerve paralysis, facial numbness, hearing loss, ataxia, dysphagia, and major stroke. Even in the hands of very experienced acoustic surgeons, these risks cannot be eliminated. Radiosurgery provides an outpatient, noninvasive alternative for the treatment of small acoustic schwannomas. Initially radiosurgery was undertaken in "high-risk" patients, including the elderly, those with severe medical comorbidities, and those in whom tumors recurred after surgery. Additionally, a high rate of cranial nerve morbidity was reported. With improvements in dosimetry planning and dose selection, however, authors practicing at radiosurgical centers now report very low complication rates, as well as high tumor control rates. In this report the authors specifically review the results of linear accelerator-based radiosurgery for VS and compare these outcomes with the best surgical alternatives.
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PMID:Linear accelerator-based radiosurgery for vestibular schwannoma. 1566 13