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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinico-pathological data and the topography of the lesions were determined in 13 cases of late radiation encephalopathy. In one case the arterial vascularisation was studied by the translucidation technique after filling of the blood vessels with a colloidal barium sulphate solution. The radiation lesions consisted of areas of focal necrosis and of diffuse demyelination and necrosis of the deep cerebral structures and the brain stem. Demyelination was predominantly present in cases of late appearance of the neurological symptoms while necrosis was found in cases with a short latency period. The cerebral cortex and the arcuate fibres were always the most preserved structures. The topography of the focal lesions in the cerebral hemispheres and in the brain stem corresponded well to the vascular supply areas of the deep perforating arteries, while the diffuse lesions always had a predominant distribution in the periventricular arterial end- and border-zones. These observations were also confirmed by a post mortem angiographic study. The present report argues once more for a vascular aetiology as cause of the late radiation encephalopathy.
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PMID:The anatomy of the late radiation encephalopathy. 119 95

Sixteen patients underwent a modification of the Sugiura procedure for bleeding esophageal varices, involving (a) esophageal transection, (b) splenectomy, (c) selective vagotomy, and (d) pyloroplasty. Five patients died, and the remaining 11 had barium studies of the esophagus and stomach which were compared with the preoperative appearance. Esophageal varices disappeared in 7 patients and persisted in 1. No recurrent bleeding or encephalopathy was seen: however, there were a large number of complications, including pleural effusion, ascites, ileus, pneumonia, and renal failure. Hepatic failure, respiratory failure, and sepsis secondary to gastrointestinal leakage also occurred and were fatal in all cases. As the Sugiura procedure is increasingly being employed in the United States, radiologists should be familiar with the spectrum of postoperative radiographic findings in the esophagus and stomach.
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PMID:Radiographic findings in the esophagus following the Sugiura procedure. 697 61

The evaluation of swallowing function is crucial in the management of dysphagic patients. It includes clinical assessment and laboratory tests that consist of fiberoptic endoscopic examination of swallowing (FEES) and videofluoroscopic examination. The "modified barium swallow" has been regarded as the standard procedure of videofluoroscopic examination since its introduction in 1983. The technique enables the entire process of deglutition to be observed with the benefits of safety, easily performance, and information. However, pitfalls developed in patients with pseudobulbar paralysis. Discrepancy always occurs between barium meals and real food and the refusal of swallow and misswallowing to the airway in videofluoroscopic examination sometimes occurs because of the unsatisfactory taste of barium meal. All these things make the procedure impractical and inaccurate. We developed a barium sulfate pudding that is better tasting, similar to real food as a pudding, is adequate to visualise on videofluoroscopic examination, and has the ability to represent the patient's capacity to swallow solid food. We present a case of hypoxic encephalopathy where the patient was considered to be in danger of aspiration when swallowing any consistency of foods. Barium-pudding study showed the patient had the ability to eat solid food with safety. We removed her nasogastric tube following barium-pudding assessment and successfully restored her oral feeding function within 2 weeks. Barium-Pudding is a better medium of videofluoroscopic examination by which to evaluate the swallowing function of solid food than Barium paste in patient, who have disturbed swallowing.
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PMID:[Barium-pudding: a new medium for videofluoroscopic examination]. 760 74

Exposure of cultured rat cortical astrocytes to increased concentrations of ammonia has been shown to induce morphological and biochemical changes similar to those found in hyperammonemic (e.g., hepatic) encephalopathy in vivo. Alterations of electrophysiological properties are not well investigated. In this study, we examined the effect of ammonia on the astrocyte membrane potential by means of perforated patch recordings. Exposure to millimolar concentrations of NH4Cl induced a slow dose-dependent and reversible depolarization. At steady state, i.e., after several tens of minutes, the cells were significantly depolarized from a resting membrane potential of -96.2 +/- 0.6 mV (n = 83, S.E.M.) to -89.1 +/- 1.6 mV (n = 7, S.E.M.) at 5 mM NH4Cl, -66.3 +/- 3.6 mV (n = 9, S.E.M.) at 10 mM NH4Cl and -50.4 +/- 2.5 mV (n = 12, S.E.M.) at 20 mM NH4Cl, respectively. In order to examine the underlying depolarizing mechanisms we determined changes in the fractional ion conductances for potassium, chloride and sodium induced by 20 mM NH4Cl. No significant changes were found in the fractional sodium or chloride conductances, but the dominating fractional potassium conductance decreased slightly from a calculated 0.86 +/- 0.04 to 0.77 +/- 0.04 (n = 9, S.E.M.). Correspondingly, we found a significant fractional ammonium ion (NH4+) conductance of 0.23 +/- 0.02 (n = 10, S.E.M.) which was blocked by the potassium channel blocker barium and, hence, most likely mediated by barium-sensitive potassium channels. Our data suggest that the sustained depolarization induced by NH4Cl depended on changes in intracellular ion concentrations rather than changes in ion conductances. Driven by the high membrane potential NH4+ accumulated intracellularly via a barium-sensitive potassium conductance. The concomitant decrease in the intracellular potassium concentration was primarily responsible for the observed slow depolarization.
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PMID:Ammonia-induced depolarization of cultured rat cortical astrocytes. 951 72

A prematurely born 5-year-old boy with chronic lung disease, hypoxic-ischemic encephalopathy, cerebral palsy, repeated aspiration pneumonia, and stroke underwent percutaneous endoscopic jejunostomy (PEJ) to alleviate repeated aspiration pneumonia. Studies, including 24-hour esophageal pH monitoring, 99mTc gastric emptying time, upper gastroesophageal barium radiography, and endoscopic examinations showed severe gastroesophageal reflux and prolonged gastric emptying. Percutaneous endoscopic gastrostomy (PEG) was performed first, followed by placement of a polyurethane J-tube (9 French) through the preexisting gastrostomy site. We passed the style-guided J-tube through the pyloric ring endoscopically and advanced it to the jejunum. The position of the J-tube was confirmed by radiologic study. Feeding with an elemental formula, 20 mL/hour, commenced immediately after the procedure, and the rate was gradually increased to 50 mL/hour. No further episodes of aspiration pneumonia have occurred since J-tube placement. Our initial experience with jejunal feeding through a PEJ is encouraging.
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PMID:Pediatric percutaneous endoscopic jejunostomy by J-tube extension through a preexisting gastrostomy site: a preliminary report. 988 93

We report a case with neurologic symptoms which occurred after iterative radiologic examinations of the gastrointestinal tract with barium sulphate, which were related to a barium encephalopathy. Suspected by the presence of barium in the blood, a systematic intoxication was occurred without any evidence for a gut or a vascular leak. This case raises the question about a possible extraluminal diffusion of such a heavy metal, given orally, in normal conditions of use.
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PMID:[Barium sulfate poisoning?]. 1036 9

We report a case of a 40-year-old man presenting with relapsing encephalopathy 4 years post-intestinal transplantation. Each episode was preceded by symptoms suggestive of subacute intestinal obstruction, marked dehydration, and, on one occasion, grade 4 encephalopathy. Physical examination revealed hypertonia, clonus, and hyperreflexia. Biochemistry was consistent with renal impairment, metabolic alkalosis, hyperammonaemia, and normal liver function. Plain radiographs and abdominal computed tomography revealed dilated proximal small bowel loops, and barium radiography demonstrated a strictured distal anastomosis. Hydrogen breath testing indicated bacterial overgrowth. Following rehydration and antibiotic therapy, the patient recovered fully between episodes. Further episodes of encephalopathy did not recur following resection of the distal anastomotic stricture and resolution of bacterial overgrowth. Unfortunately, one year later the patient died of pneumonia. To the best of our knowledge, encephalopathy secondary to intestinal transplant related porto-caval shunt and bacterial overgrowth in strictured bowel has not been previously reported but might have implications for the management of future patients.
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PMID:Relapsing encephalopathy following small bowel transplantation. 1282 21