Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Arteriovenous malformation (AVM) of the tongue is a rare lesion of the cranio-facial vascular anomaly. Decision making concerning the vascular anomaly is not established because there are complex classifications of diagnosis and many treatment options. We report a case of AVM of the tongue, and review vascular anatomy and knowledge for treating this lesion. A 50-year-old man presented with dysarthria, sleep apnea and snoring because of a mass lesion of his sublingual region that had become larger over a two-year period. Neuroradiological examination revealed lingual arteriovenous fistula (AVF) associated with AVM of the tongue base. We performed transfemoral transarterial embolization via both lingual arteries using Polyvinyl alcohol particles and Eudragit-E as non-adhesive glue material. Final angiograms after embolization revealed a small residual nidus fed by the right facial artery mental branch, but shunt flow was markedly reduced. This vascular malformation was removed after a day of TAE (transarterial embolization). The patients symptom was improved and relapse has not been confirmed though 18 months have passed since the surgery. Using classification proposed by Mulliken and Glowacki, vascular anomalies are divided into two groups: hemangiomas and vascular malformations (AVM/F, arterial, venous, capillary, lymphatic and combined). AVM/F is classified into high flow malformation. TAE is useful for high flow malformation and can be used as the sole treatment or as an adjunct. Treatment should be to eradicate nidus or fistula completely, which is the fundamental abnormality because even the smallest residual nidus will expand to cause recurrence. The treatment of Cranio-facial AVM's requires rigorous differential diagnosis and appropriate management. Inadequate treatment is thought to contribute to collateral flow and disease progression in advanced AVM, making further management difficult.
 ...
PMID:[A case report of arteriovenous malformation of the tongue: vascular anatomy and note for transarterial embolization]. 1804 28

Patent foramen ovale (PFO), an embryonic remnant of the fetal circulation, is present in 20-25% of adults. Although recent observational studies and clinical trials have established the link between PFO-mediated right-to-left shunting with cryptogenic stroke and migraine with aura, the role of a PFO in exacerbating hypoxemic medical conditions (ie, sleep apnea, chronic obstructive pulmonary disease, pulmonary hypertension, platypnea-orthodeoxia, pulmonary arteriovenous malformation, high-altitude pulmonary edema, and exercise desaturation) remains less understood. PFO-mediated hypoxemia occurs when deoxygenated venous blood from the right atrium enters and mixes with oxygenated arterial blood in the left atrium. Patients with an intracardiac right-to-left shunt may have profound hypoxemia out of proportion to underlying primary lung disease, even in the presence of normal right-sided pressures. The presence of right-to-left cardiac shunting can exacerbate the degree of hypoxemia in patients with underlying pulmonary disorders. In a subset of these patients, percutaneous PFO closure may result in marked improvement in dyspnea and hypoxemia. This review discusses the association between PFO-mediated right-to-left shunting with medical conditions associated with hypoxemia and explores the role of percutaneous PFO closure in alleviating the hypoxemia.
 ...
PMID:Patent Foramen Ovale and Hypoxemia. 2957 Apr 76