Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We determined the oxidative phenotype and metabolic ratio of debrisoquine in 96 Chinese patients with Alzheimer's disease (n = 12), Parkinson's disease (n = 55), and using patients with stroke and cervical spondylosis as controls (n = 29). We did not find any difference in debrisoquine metabolic phenotype among Parkinson's disease, Alzheimer's disease, and control patients as judged by chi-square analysis. In addition, the metabolic ratio of all our patients was less than 12.6. The result suggested that Chinese patients with Parkinson's disease and Alzheimer's disease metabolize debrisoquine at a velocity not different from that of their Western counterparts even though the frequency distribution of debrisoquine metabolism phenotyping in these two populations is quite different.
 ...
PMID:Debrisoquine metabolism in Chinese patients with Alzheimer's and Parkinson's diseases. 138 49

The new techniques of percutaneous electric and magnetic stimulation of the motor cortex in conscious man provide a unique opportunity of functional testing of the central motor pathways. These techniques seem to be safe and no immediate or delayed adverse reactions have been reported. The physiological studies so far performed suggest that the structures which are preferentially excited by these methods are the fast conducting pyramidal neurones. It has been shown that a single cortical stimulus is able to activate spinal motoneurones repeatedly. This phenomenon can easily be explained if the cortical stimulus generates multiple descending volleys in the central motor pathways. By comparison with experiments of stimulation of the exposed motor cortex in animals, it is likely that electric brain stimulation directly activates the axons of the pyramidal neurons at their origin and to a lesser extent also recruits these neurons transsynaptically, via some cortical interneurones. Magnetic stimulation of the brain at the vertex seems to act mostly by the latter mechanism. These different modes of action of the two methods of cortical stimulation explain the latency differences of the EMG responses obtained with either technique. Increased excitability of the spinal motoneurones and the existence of multiple descending volleys in response to a single cortical stimulus result in shortening of the latencies and greater amplitude of the responses recorded during voluntary contraction of the target muscle. Stimulation of the motor cortex has been used in pilot studies conducted on patients suffering from various disorders of the central motor pathways, such as multiple sclerosis, cervical spondylosis, motor neurone disease or stroke. The sensitivity of the technique looks promising. In M.S., the EMG responses usually show an increased central conduction latency, a reduced amplitude and a prolonged duration. The severity of the electrophysiological abnormalities is not very well correlated with clinical weakness, but the correlations seems to be better with hyperreflexia and the presence of brisk finger flexor jerks. The same abnormalities are observed in cervical spondylosis, although to a lesser extent. In motor neurone disease, the responses have a moderately increased latency and their size and duration are markedly reduced. Patients with acute hemispheric stroke usually show absent responses on the contralateral side. Finally, electric cortical stimulation can be very useful in monitoring the functional integrity of descending motor tracts during surgical operations performed on the spinal cord.
 ...
PMID:[Percutaneous electric and magnetic stimulation of the motor cortex in man. Physiological aspects and clinical applications]. 264 78

Cost effective treatment is needed for common self limiting rheumatological conditions. Periarthritis of the shoulder is an example. There is no consensus for one type of treatment, though local steroids or physiotherapy are conventionally used. Their cost and efficacy were compared in a prospective randomised observer-blind trial--in essence a medical audit of the treatment of a common rheumatological problem. Sixty two consecutive patients presenting with a painful stiff shoulder were studied. Patients with coexistent diseases like cervical spondylosis or a stroke were excluded. They were randomly allocated to receive local steroids, six weeks' physiotherapy, or both. The three groups were of similar age, sex, and disease severity. Assessments of pain and shoulder movement were made initially, at six weeks, and at six months by a 'blinded' observer. Physiotherapy was given by one therapist and injections by one physician. All three groups showed significant improvements by six weeks, with further improvement at six months. Improvements were identical in all three groups. No treatment gave complications. The costs of treatment varied: an injection of triamcinolone cost 2.10 pounds; a six week course of physiotherapy cost 48.50 pounds; combination treatment cost 50.60 pounds. Patients expect treatment for a painful stiff shoulder. The results show that local steroid injections are as effective as physiotherapy alone or a combination. They provide rapid treatment and are less expensive. In the uncomplicated case a local steroid injection is the most cost effective treatment.
 ...
PMID:Injections and physiotherapy for the painful stiff shoulder. 271 13

Analysis of 422 patients with clinical diagnoses of motoneurone disease (MND), multiple sclerosis, cervical spondylosis with myelopathy, or stroke, from two referral centres, suggested a simple four-step algorithm for diagnosing MND. The algorithm provided a 98% sensitivity (true positive diagnosis) and 86% specificity, and therefore gives a baseline for diagnostic criteria suitable for use in clinical research of MND.
 ...
PMID:Differential diagnosis of motoneurone disease from other neurological conditions. 287 97

SEPs may be recorded over the spine and scalp to stimulation of any accessible mixed or sensory nerve in the extremities. SEP abnormalities are useful in detecting lesions in central somatosensory pathways. They do not establish a specific diagnosis, but they may suggest or support a diagnosis made on clinical grounds. They have been used particularly to detect subclinical lesions in multiple sclerosis, but their role in following the course of this disorder is unclear. SEPs have been used as a prognostic guide in patients with hemispheric stroke and in patients who are comatose following head injury or severe cerebral anoxia; in such instances, however, the SEP often adds little to what can be determined by clinical examination. Their role in the evaluation of patients with brain death is controversial. Preserved SEPs or their early return after a spinal injury suggests an incomplete lesion, and therefore a better prognosis than otherwise. SEPs have been used to minimize or prevent intraoperative neurologic complications by monitoring spinal cord function, but their role in this regard awaits adequate validation. In patients with cervical spondylosis, SEPs elicited by stimulation of a nerve in the lower extremities may be helpful in indicating which patients are liable to develop a significant cord deficit, so that surgical treatment can be considered at an early stage. SEP abnormalities have been described in a number of other neurologic contexts, but the findings may be of more academic than clinical relevance in that they help to define the extent of neuropathologic involvement without altering the management of individual patients.
 ...
PMID:The use of somatosensory evoked potentials in the evaluation of the central nervous system. 307 Mar 40

Using technetium-99m-labeled hexamethylpropyleneamineoxime [( 99mTc]HM-PAO) and single-photon emission computed tomography, we measured changes in regional cerebral blood flow in a 58-year-old man during an attack of vertebrobasilar insufficiency. Angiography demonstrated compression of the left vertebral artery by the osteophytes of cervical spondylosis when the patient turned his head to the left. Measured in the orthostatic position while turning his head to the left during a typical attack of vertebrobasilar insufficiency, regional cerebral blood flow was significantly reduced in the left cerebellum and the right occipital region. Our study illustrates the capability of [99mTc]HM-PAO single-photon emission computed tomography to measure transient reductions in regional cerebral blood flow and to relate these changes to the pathophysiology of vertebrobasilar insufficiency.
Stroke 1988 Nov
PMID:Regional cerebral blood flow during an attack of vertebrobasilar insufficiency. 326 19

Previous case reports of vertebral-basilar system infarction following chiropractic cervical manipulation have emphasized the role of predisposing factors such as cervical spondylosis, atherosclerosis, and congenital asymmetry of the posterior circulation. Ten patients without prior neurologic symptoms had vertebral-basilar system infarction promptly after chiropractic maneuvers. One patient, who was free of clinical and radiographic evidence of predisposing factors, subsequently died. Autopsy studies revealed massive nonhemorrhagic brainstem infarction due to bilateral vertebral artery thrombosis. Nine patients survived with residual neurologic deficits due to lesions in various locations of the posterior circulation. No patient received anticoagulants. Previous case reports are summarized and the kinetic anatomy of the vertebral arteries is reviewed to clarify the potential mechanisms involved in the pathogenesis of this entity. Although a causal relationship may be difficult to establish in individual cases, cervical manipulation seems to be the major identifiable factor in the pathogenesis of stroke in some patients.
 ...
PMID:Vertebral-basilar distribution infarction following chiropractic cervical manipulation. 737 18

We report a case of bow hunter's stroke caused by simultaneous bilateral vertebral artery occlusive changes at the right C3-4 and the left C1-2 level on head rotation to the right side. The pathogenesis and surgical treatment for this particular case are discussed. A 61-year-old male with cervical spondylosis repeatedly experienced vertebrobasilar insufficiency when he rotated his head over 60 degree from the mid-position to the right side. Bilateral vertebral angiography demonstrated severe compression of the right vertebral artery by a lateral osteophyte and instability at the C3-4 level accompanied with the mechanical stenosis of the left vertebral artery at the C1-2 level only at the time of turning his head to the right. As the surgical treatment we performed osteophytectomy of the right uncovertebral joint at the C3-4 level in addition to anterior decompression with fusion using hydroxyapatite spacer and titanium plate at that level. Postoperatively, the patient had no ischemic episodes and there was angiographical resolution of the rotational stenosis at the C3-4 level. For the clinical manifestation of bow hunter's stroke on head rotation, it is indispensable that simultaneous severe occlusive changes present on bilateral vertebral arteries. In case of a vertebral occlusive change caused by lateral osteophyte at the unstable vertebral joint, anterior decompression and fusion with osteophytectomy may be a wiser approach than arterial decompression or posterior fusion at the C1-2 level to another vertebral artery occlusive lesion.
 ...
PMID:[A case of bow hunter's stroke caused by bilateral vertebral artery occlusive change on head rotation to the right]. 962 55

Bow hunter's stroke results from vertebrobasilar insufficiency caused by mechanical occlusion or stenosis of the vertebral artery at the C 1-2 level on head rotation. Commonly it is seen in elder people with cervical spondylosis. Here we reports a case of bow hunter's stroke in a 25-year-old male who complained of visual disturbance and syncope on rotation of the head 90 degrees or more to the left. This problem was frequently seen on driving a car. A cervical x-ray and MRI of the head revealed no abnormal findings such as atlantoaxial dislocation. Angiograms demonstrated obstruction of the right vertebral artery at the C 1-2 level on left rotation of the head. The hemodynamics on the circle of Willis were evaluated and surgical treatment was planned. The posterior fusion involving C 1-2 has long been used to limit atlantoaxial rotational movements. However, it has the serious disadvantage because the range of head motion is severely reduced. Recently decompression of the atlantoaxial portion of the affected vertebral artery has been used, but recurrence of occlusion with head rotation can be seen postoperatively. Since the patient could predict the onset of attack, we managed him conservatively, and no traffic accident reported during this period of observation. Due to several surgical disadvantages, we propose that whenever possible, patients with bow hunter's stroke should be managed conservatively especially in young patients.
 ...
PMID:[A case of juvenile bow hunter's stroke]. 1084 13

Chinese medicine practitioners apply the differentiation reasoning for decision-making. The wide scope of Chinese medicine intervention provides coverage of methods and techniques with applications to primary, secondary and tertiary levels of prevention. The rapid evolution of mathematical and computational techniques allowed the implementation of several models for pattern differentiation that were tested for several physiologic systems. Concurrently, it is argued that pattern differentiation might improve the efficacy of either traditional or conventional medical interventions. This article reviewed the influence of pattern differentiation into clinical practice organized by medical field: general pattern differentiation; genitourinary (recurrent cystitis); cardiovascular (coronary heart disease; arterial hypertension; angina pectoris); neurology (stroke); surgery; metabolic (diabetes mellitus); hepatic (cirrhosis); gastrointestinal (chronic superficial gastritis); orthopedic (low back pain; rheumatoid arthritis; cervical spondylosis; elbow arthritis); oncology (gastric mucosal dysplasia; lung cancer); gynecologic and obstetric manifestations (nausea and vomiting). The reviewed studies presented achievements that have contributed to the integration of Chinese medicine and evidence-based medicine in the treatment of many mild and severe diseases. Target diseases considered as major public health problems were also investigated and the results are promising regarding the possibility to treat guided by pattern differentiation.
 ...
PMID:Chinese medicine pattern differentiation and its implications for clinical practice. 2205 10


1 2 Next >>