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

A 6-year-old girl with cerebral palsy developed conscious disturbance and generalized convulsion after one-hour hot herb drug bath. Physical examination on admission revealed rectal temperature 41 degrees C, hot skin, respiration 46/min, regular heart beat 98/min, BP 130/60 mmHg, Glascow coma scale 4 (E2M1V1), soft and flat abdomen, no hepatosplenomegaly, no skin rash, no focal neurological sign, increased generalized muscle ton. Laboratory data showed CBC: WBC 20400 cumm (Neutrophils 31%, Lymphocytes 69%), Hb 11.6gm%, ESR 11 mm/hr, arterial blood gas: PH 7.077, PO2 43mmHg, PCO2 57.1mmHg, HCO3- 16 mEq/L, BE-11.5mEq/L, serum sodium 143 mEq./L, potassium 5.2 mEq/L, chloride 101 mEq/L, free calcium ion 3.8mg%, GOT 63IU/L, GPT 263 IU/L, amylase 193 IU/L, alkaline phosphatase 388 IU/L, LDH 1245 IU/L, CPK 677 IU/L, total bilirubin 0.8 mg/dl, direct type 0.1 mg/dl, BUN 18 mg/dl, Glucose 35 mg/dl. Urinalysis revealed proteinuria( ) trace hematuria and pyuria, but no cast. Lumbar puncture is within normal limits. Bacteriology including blood and CSF are normal. Multiple organ failure was noted at that time. Intensive cooling methods were performed including central and peripheral cooling. We used luminal and valium to control the seizure. Condition didn't improve. Afterwards cardiopulmonary arrest developed. Patient expired 8 hours after admission despite of resuscitation. Heat stroke in infancy and childhood is different from that in adulthood. The predisposing factors are high ambient temperature, dehydration, very young baby, sweat gland dysfunction, or ectodermal dysplasia. Definition of heat stroke includes 1) rectal temperature above 41 degrees C, 2) behavioral change, 3) warm skin, wet or dry.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Status epilepticus induced by prolonged immersion in hot herb bath: report of one case]. 263 19

Myonecrosis has been reported to occur in patients with carbon monoxide (CO) poisoning, and last year we reported a case of non-traumatic rhabdomyolysis in a patient with CO poisoning secondary to smoke inhalation. We prospectively studied the association between CO poisoning and rhabdomyolysis by obtaining serum creatine kinase (CPK) levels on 65 of 81 consecutive patients (range 20-1315 IU/L) who presented to the University of Illinois Hospital Emergency Room during a 3-month period with CO levels greater than 5.0% (range 5.0%-63.9%). Thiocyanate levels were obtained on 45 patients (range 0-3.5 mg/dl). We found no statistically significant correlation by linear regression analysis between CO level and CPK level in these patients. A subjective complaint of weakness was obtained in 4 patients and physical evidence of weakness was found in 1 of these (this was felt to be secondary to a cerebrovascular accident). In none of these 4 patients was an elevated CPK level noted. We did, however, note an association between thiocyanate level and CPK level by linear regression analysis (p less than 0.02). A power curve was a better fit for this data (r2 = 0.7). This data suggests that serum CPK levels should not be routinely obtained on patients with CO poisoning and that cyanide may play a more important role in non-traumatic rhabdomyolysis associated with toxic inhalation than had previously been suspected.
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PMID:Carbon monoxide and myonecrosis: a prospective study. 292 21

Methods of clinico-instrumental investigation and biochemical monitoring (CPK and its membranous fraction) were employed for examination of 432 patients with acute myocardial infarction (AMI). Among them there were patients with an uncomplicated course of disease (19.4%), recurrences (13.7%) and AMI spreading (9%). Lung edema, a cardiogenic shock, ventricular fibrillation and complicated cardiac rhythm disorders were not detected on the 1st day of disease. Clinico-anamnestic data provided no opportunity for defining factors promoting AMI recurrences whereas AMI spreading frequently developed in patients with repeated AMI, suffering from essential hypertension, obesity and heart failure. Higher diastolic pressure in the pulmonary artery, an increase in the cardiac volume, a decrease in the ejection fraction and left ventricular stroke work--changes which were most pronounced in AMI spreading, were noted in patients with AMI lingering forms. Signs of disseminated intravascular blood coagulation were noted in the venous and arterial blood of patients with lingering AMI forms. A high blood enzyme level was shown to be accompanied by a low level of antibodies to LDH and CPK.
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PMID:[Clinico-pathogenetic variants of protracted forms of acute myocardial infarct]. 361 39

Sixty-two patients with ischemic stroke were studied over time (1st-12th day) for the activity of enzymes and isoenzymes of energy metabolism (CPK, LDH, SDH). It has been shown that the brain-specific CPK BB-isoenzyme may serve as a marker of the severity and extension of brain damage while the aerobic LDH fractions may be useful in evaluation of the reversibility of hypoxic changes in the brain. The authors consider the employment of the studied enzymes for the prognosis of vascular and tissue damage.
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PMID:[Diagnostic and prognostic role of organ-specific plasma enzymes in the acute period of cerebral circulatory disorders]. 382 84

The effectiveness and safety of diltiazem (DIL), a slow channel calcium blocker, added in cold potassium cardioplegic (CP) solution was evaluated in coronary artery bypass graft (CABG) surgery for 2 purposes; (1) protection of ischemic myocardium during cardiac arrest and (2) prevention of perioperative coronary artery spasm (PCS). Diltiazem of 15 mg was added to a liter of CP which was administered 10 ml/kg B.W. initially and 5mg/kg thereafter. The serum concentration of DIL was 570 ng/ml at the time of aortic declamping, 210 ng/ml at cardioversion and 150 ng/ml one hour after surgery. The left ventricular stroke work index was increased significantly (p less than 0.05) in patients treated by DIL-CP, compared with the patients treated by regular CP without DIL. However, CPK-MB values were not significantly different in either group. The incidence of PCS has decreased from 9.1% to 0.8% (p less than 0.01) after the use of DIL-CP. Perioperative myocardial infarction rate has also decreased from 5.5% to 1.6%. No major or long-lasting side-effects were encountered. We consider that DIL-CP is a safe and excellent CP in CABG surgery and we are now utilizing this CP in all patients requiring CABG surgery.
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PMID:[Evaluation of the effectiveness and safety in the use of cold-diltiazem-potassium cardioplegia in coronary artery bypass surgery: a first clinical trial]. 391 Oct 52

Right ventricular infarction is frequently accompanied by a low output state, but the factors influencing the development of this state remain unknown. To elucidate these factors, clinical findings, hemodynamic findings and left ventricular infarct size (T1-score) calculated from thallium-201 myocardial scintigrams by a circumferential profile method were evaluated in 147 consecutive patients with acute transmural inferior myocardial infarction. They were divided into two groups: 44 patients with right ventricular involvement (RVI group) and 103 patients without right ventricular involvement (IMI group). A low cardiac output state was defined when the cardiac index was less than 2.2 L/min/M2. There was a good correlation between T1-score and any of peak value of serum creatine phosphokinase (CPKmax), total released CPK (CPKr) and left ventricular ejection fraction (LVEF) (r = 0.66, 0.74 and -0.54, respectively), indicating the usefulness of T1-score as an index of left ventricular damage. Compared to the IMI group, the RVI group showed a higher average of age (p less than 0.01), lower systemic blood pressure (p less than 0.01), higher right atrial pressure (p less than 0.001) and lower cardiac index (p less than 0.01). Furthermore, the incidence of a low output state (RVI group : 47.7% vs IMI group : 14.6%, p less than 0.001) and mortality (25.0% vs 7.8%, p less than 0.01) were higher in the RVI group. However, CPKmax, CPKr, LVEF and T1-score, which were considered to reflect the severity of left ventricular damage, were not different between the two groups. T1-score was inversely correlated with cardiac index in the RVI group (r = -0.49, p less than 0.05), and with left ventricular stroke work index in the both groups (RVI group; r = -0.46, p less than 0.01, IMI group; r = -0.64, p less than 0.01). Additionally, age as well as heart rate was correlated significantly with cardiac index (r = -0.45, p less than 0.001 and r = 0.35, p less than 0.001, respectively), and the percentage of elderly patients (age greater than 60 years) and the incidence of bradycardia (heart rate less than 60/min) were both higher in the RVI group than the IMI group (either p less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Factors influencing the development of low output state in patients with right ventricular infarction]. 652 Apr 17

Seventeen patients with poor ventricular function and severe coronary artery obstruction were operated on employing hypothermic potassium cardioplegic solution for myocardial preservation. Preoperatively and postoperatively, serial hemodynamics, electrocardiograms (ECG), MB-CPK studies, and technetium pyrophosphate scans were obtained for all patients. All ECGs and scans were negative for perioperative infarction. Peak MB-CPK levels were 40 +/- 25 units per liter. Two patients had MB-CPK levels suggestive of perioperative myocardial infarction. The preoperative cardiac index was 2.8 +/- 0.8 L/min/m2 and remained the same in the perioperative period. Stroke work index and total peripheral resistance were within normal range and remained constant throughout the period of study. Three patients required epinephrine (0.5 micrograms per minute) during the first 6 hours postoperatively, and in 2 patients an intraaortic balloon was inserted prophylactically and removed on the second postoperative day. Good myocardial preservation can be achieved in patients with severe coronary artery obstruction and preexisting left ventricular dysfunction using hypothermic potassium cardioplegic solution.
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PMID:Perioperative protection of the myocardium in patients with impaired ventricular function. 697 18

In order to evaluate the left ventricular performance during exercise in patients with myocardial infarction, we performed a symptom-limited multistage exercise test using a bicycle ergometer in the supine position on 82 patients with myocardial infarction, and their hemodynamic responses to exercise were analyzed. Patients were subdivided into three groups according to the levels of pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) obtained at the end-point of the exercise: Group I (20 patients) with PCWP less than 18 mmHg and CI greater than or equal to 5.0 L/min/m2; Group II (32 patients) with PCWP greater than or equal to 18 mmHg and CI greater than or equal to 5.0 L/min/m2; Group III (30 patients) with PCWP greater than or equal to 18 mmHg and CI less than 5.0 L/min/m2. Exercise tolerance expressed as the duration of exercise was 11.9 +/- 0.5 (SEM) min in Group I, 10.6 +/- 0.4 in Group II and 7.8 +/- 0.5 in Group III, which was closely correlated with the left ventricular function observed at the end-point of the exercise. During exercise stroke volume index (SVI) decreased slightly in Group III, while it increased significantly in Groups I and II. The extent of coronary artery lesion in Group III was more severe than in Groups I and II. In 50 patients without prior myocardial infarction, infarct size estimated by total released CPK was larger in Group III than in Group I. These findings indicate that coronary artery lesion and infarct size are important factors contributing to left ventricular performance during exercise in patients with myocardial infarction.
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PMID:Clinical evaluation of left ventricular performance in patients with myocardial infarction: comparison of hemodynamic responses to exercise and angiographic findings. 714 99

Virgin and breeder, spontaneously hypertensive and stroke prone rats (SHR/SP) were observed from weaning until 130 +/- 10 days of age. Blood pressure rose rapidly, reaching 230--240 mm Hg. After the birth of the second litter of pups, male and female breeders began to die suddenly, due to myocardial necrosis and congestive heart failure. At autopsy, the brains of virgin and breeder SHR/SP were swollen but were free of any pathologic changes. There were no significant alterations in the blood chemistry of virgin rats but breeder SHR/SP had super-normal enzyme levels, CPK, SGOT, SGPT and LDH, hyperglycemia, hyperlipidemia, and hypersecretion of corticosterone. Breeder SHR/SP developed PAN-like lesions of the mesenteric arcades and adrenal cortex along with severe fibrino-hyalin lesions of the testicular and ovarian arteries. It is suggested that alterations in hypothalamic-pituitary-adrenal function associated with the reproductive effort conditioned these SHR/SP to develop myocardial necrosis rather than stroke and the development of unusual hypertensive arteriopathy.
Stroke
PMID:Myocardial necrosis induced by breeding in stroke-prone/SHR. 721 76

Male and female, spontaneously hypertensive rats (SHR) with blood pressures ranging from 190-210 mmHg were subjected unilateral or bilateral carotid artery ligation. Representative numbers of animals were killed 2, 4, 6, 8, 10, 12, 24 and 48 hours later. Severe cerebral ischemia caused a significant and protracted increase in the pre-existent high blood pressure, the enzymes CPK, SGOT and LDH triglycerides, free fatty acids, glucose, and corticosterone. Despite these marked pathophysiologic changes, the brains of these animals were free of real damage except for cerebral edema and scattered petechiae. Some of the animals developed massive atrial thrombi and myocardial infarcts. It is suggested that severe cerebral ischemia precipitated the myocardial infarcts through the aegis of the hypothalamic-pituitary-adrenal stress response.
Stroke
PMID:Comparative effects of unilateral and bilateral carotid artery ligation in the spontaneously hypertensive rat. 735 34


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