Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0344329 (collapse)
 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Three cases of subacute cardiac rupture following acute myocardial infarction are described. All three patients experienced sudden collapse during convalescence and following cardiopulmonary resuscitation were in cardiogenic shock, the shock being due to haemopericardium causing cardiac tamponade. Two of the patients who had electrocardiographic monitoring at the time of their collapse showed nodal bradycardia and were apnoeic and unconscious with no recordable blood pressure (electromechanical dissociation). The diagnosis was confirmed in all three patients by echocardiography which showed pericardial fluid. The patients were referred for urgent cardiac surgery (infarctectomy and Teflon patching) without further investigation. All three patients survived the emergency operation, but two died soon after surgery. The third patient is alive and well five months after the operation.
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PMID:Subacute cardiac rupture: a surgical emergency. 658 94

Atrioventricular nodal reentrant tachycardia (AVNRT) is the most frequent paroxysmal supraventricular tachycardia and results from reentry in the atrioventricular nodal region via slow and fast pathways. The curative treatment of choice consists of selective radio-frequency catheter ablation of the slow pathway. In this retrospective study we report our experience of 73 consecutive patients suffering from AVNRT treated by selective slow pathway ablation and also review some features of AVNRT. AVNRT appeared for the first time at the age of 29 +/- 15 years and lasted for 17 +/- 13 years. In 37% of the patients AVNRT recurred at least weekly, 10% presented with syncope and 15% were admitted to hospital more than 5 times. On average, 2.5+/-1.6 drugs were prescribed to 66 of the 73 patients and 83% of them were drug-refractory. Selective slow pathway ablation was successfully performed in 65 patients (89%). The procedure, although effective, was complicated by atrioventricular block in 2 patients (2.7%) and failed in 6 patients. In 5 of them, fast pathway ablation was attempted and was successful in 2 cases, resulted in atrioventricular block in one case and failed in 2 cases. The complications, apart from atrioventricular block necessitating a pacemaker in all cases, were one pulmonary embolism and 2 pneumothorax. The mean follow-up for the 70 patients for whom ablation was effective (with or without atrioventricular block) is 12.7+/-7.3 months. AVNRT relapsed in 5 patients (7%); all of them underwent a second ablation with 4 successes (slow pathway) and one atrioventricular block (fast pathway after failed slow pathway ablation). 11 patients (16%) developed palpitations: in one case they were due to atrial fibrillation and in 10 cases they remained of unknown origin. The palpitations were of short duration and well tolerated, and these patients nevertheless felt an improvement after the ablation. Therefore, at medium term, 62 patients (85%) remained free from symptoms or only slightly symptomatic and without a pacemaker, and 51 of them (70%) remained completely asymptomatic and without a pacemaker. AVNRT can result in considerable morbidity and antiarrhythmic drugs are frequently ineffective. Slow pathway ablation is a safe and effective treatment for AVNRT. In our opinion, if AVNRT or medical treatment diminish the quality of life, ablation is indicated. When AVNRT presents with hemodynamic collapse, ablation is mandatory. Fast pathway ablation after failed slow pathway ablation is associated with a high incidence of atrioventricular block and is targeted only at very symptomatic patients who accept the possibility of definitive pacemaker implantation.
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PMID:[Lausanne experience in radiofrequency percutaneous ablation of the slow pathway in nodal tachycardia]. 869 12

We describe the case of a patient who, after a binge, had an episode of ventricular fibrillation (holiday heart syndrome) and was successfully resuscitated. In the electrophysiological study, we found dual atrioventricular nodal pathways, an atrioventricular effective refractory period of 210 ms, and an inducible atrial fibrillation with a ventricular response of 210 bpm that produced hemodynamic collapse. Atrioventricular nodal modification by radiofrequency ablation was successfully performed. The patient stopped drinking alcohol and has remained completely asymptomatic. In this case, ventricular fibrillation was probably caused by the fibrillating atria combined with a fast AV node.
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PMID:Cardiac arrest following holiday heart syndrome. 908 33

Apoptosis is a physiological process wherein the cell initiates a sequence of events culminating in the fragmentation of its DNA, nuclear collapse, and finally disintegration of the cell into small, membrane-bound apoptotic bodies. Expression of Fas (APO-1, CD95) Receptor (FasR) and programmed or active cell (PCD) death was studied in childhood astrocytomas (ASTRs) with varying stages of malignancy, including pilocytic ASTR, low grade ASTR, anaplastic ASTR, and glioblastoma multiforme (GBM). The great majority of childhood glial tumors, particularly ASTRs express FasR whereas normal cells in the central nervous system (CNS) do not. FasR represents a transmembrane glycoprotein which belongs to the nerve growth factor/tumor necrosis factor (NGF/TNF) receptor superfamily. Apoptosis within ASTRs is triggered by the binding of FasR to its natural ligand (FasL) or by cross-linking with antibodies developed against FasR. Presence of FasL was also detected in childhood glial tumors. The expression of both FasR and FasL was also observed within the same ASTRs. Therefore, spontaneous, IP regulatory, intratumoral apoptotic cell death (autocrine suicide) is possible in childhood glial tumors. During a systematic, immunocytochemical screening of 42 childhood ASTRs tissues divided according to WHO classification: 6 WHO grade I or pilocytic ASTRs; 14 WHO grade II or low grade ASTRs; 16 WHO grade III or anaplastic ASTRs and 6 WHO grade IV or glioblastoma multiforme (GBM), we detected strong expression (intensity of staining: "A"--the highest possible; number of stained cells: +2 to +4, between 20% to 90%) of FasR, employing 4 microns thick, formalin fixed, paraffin-wax embedded tissue slides. FasR was present on 70% to 90% of tumor cells in pilocytic ASTRs, in 50% to 60% of the tumor cells in low grade ASTRs, in between 30% and 40% of the tumor cells in anaplastic ASTRs, and in between 20% to 35% of GBM cells. The panel of normal tissues employed as positive and negative tissue controls demonstrated presence of FasR in the prenatal thymus, mature tonsils and colonic epithelium. The use of a sensitive, indirect, six step immunoperoxidase or alkaline phosphatase conjugated streptavidin-biotin antigen detection technique provided excellent immunocytochemical results. A broad spectrum of neoplastic cells have been identified to express FasR: 1) carcinomas of epithelial origin, such as breast (ductal invasive, lobular invasive, mucinous), renal cell, gastric, colorectal, endometrial, prostate, pancreas, hepatocellular and large cell and squamous cell lung carcinomas: 2) non-epithelial neoplasms such as B cell mediastinal B cell and nodal non-Hodgkin's lymphomas large granular lymphocytic leukemia of T or NK cell origin malignant fibrous histiocytoma, malignant mesothelioma, leiomyosarcoma, epitheloid sarcoma and alveolar soft part sarcoma, as well as melanomas. Flow cytometry studies have also detected FasR expression on cells of adult T cell, and hairy cell leukemias, as well as in chronic B cell lymphocytic leukemia (BCLL). The coexpression of both FasR and FasL on several malignant cell types may represent an effective mechanism of tumor escape from the cellular immunological response of the host. It has been well established that brain tumors and melanomas produce their autocrine FasL, and even become capable of switching the signal transduction associated with FasL-FasR coupling from the PCD pathway to a tumor growth, proliferative pathway. It seems that the therapeutical use of FasR-FasL (main apoptotic pathway) may represent a new and exciting type of immunotherapy in the treatment of primary childhood glial tumors.
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PMID:Fas (Apo-1, CD95) receptor expression in childhood astrocytomas. Is it a marker of the major apoptotic pathway or a signaling receptor for immune escape of neoplastic cells? 1058 78

Profound hypothermia (core temperature of less than 28 degrees C) is a life threatening state and a medical emergency associated with a high mortality rate. The prognosis depends on underlying diseases, advanced or very early age, the duration prior to treatment, the degree of hemodynamic deterioration, and especially, the methods of treatment, including active external or internal rewarming. This is a case study of an 80-year-old female patient with severe accidental hypothermia (core temperature 27 degrees C). She was found in her home lying immobile on the cold floor after a fall. The patient was in a profound coma with cardiocirculatory collapse, and the medical staff treating her was inclined to pronounce her deceased. On her arrival at the hospital, she was resuscitated, put on a respirator and actively warmed. Very severe metabolic disorders were found, including a marked metabolic acidosis composed of diabetic ketoacidosis (she had suffered from insulin treated type 2 diabetes mellitus) and lactic acidosis with a very high anion gap (42) and a hyperosmotic state (blood glucose 1202 mg/dl). There were pathognomonic electrocardiographic abnormalities, J-wave of Osborn and prolonged repolarization. Slow atrial fibrillation with a ventricular response of 30 bpm followed by a nodal rhythm of 12 bpm and reversible cardiac arrest were recorded. The pulse and blood pressure were unobtainable. Despite the successful resuscitation and hemodynamic and cognitive improvement, rhabdomyolysis (CKP 6580 u/L), renal failure and hepatic damage developed. She was extubated and treated with intravenous fluids containing dopamine, bicarbonate, insulin and antibiotics. Her medical condition gradually improved, and she was discharged clear minded, functioning very well and independent. Renal and liver tests returned eventually to normal limits. Progressive bradycardia, hypotension and death due to ventricular fibrillation or asystole commonly occur during severe hypothermia. Respiratory and metabolic, sometimes lactic, acidosis, lethargy and coma, hypercoagulopathy, hyperosmolar state, acute pancreatitis and renal and hepatic failure are frequent complications of hypothermia. Underlying predisposing causes of hypothermia are diabetic ketoacidosis, cerebrovascular disease, mental retardation, hypothyroidism, pituitary and adrenal insufficiency, malnutrition, acute alcoholism, liver damage, hypoglycemia, sepsis, hypothalamic dysfunction, sepsis and polypharmacy, and especially, the use of sedative and narcotic drugs. Our case demonstrates once again that CPR once begun should continue until the successful rewarming because "no one is dead until warm and dead".
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PMID:[Severe accidental hypothermia in an elderly woman]. 1175 73

An 86-year-old man presented with a painful reddish tumour on the scalp with a 3-month history, mental confusion with recent onset and lymphadenopathies. Histological examination of the lymph node and cutaneous lesion revealed a dense infiltrate of atypical and large B cells. There was no evidence of bone marrow invasion. According to REAL (Revised European-American Classification of Lymphoid Neoplasms), this lymphoma was considered as a diffuse large B-cell lymphoma with concurrent cutaneous and nodal involvement. Cerebral computerized tomography (CT) scan showed bone and dura mater invasion in the right parieto-occipital region with collapse of lateral ventricle. The patient was submitted to systemic chemotherapy with cyclophosphamide, vincristine and prednisolone (CVP). There was a good response with regression of the cutaneous lesion, but the patient died after the third cycle. We point out the unusual clinical presentation and aggressive behaviour of this lymphoma.
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PMID:Scalp tumour as a sign of systemic B-cell lymphoma. 1500 86

An 18-year-old girl had been suffering from palpitations for 3 years. After a normal and asymptomatic pregnancy, she became highly symptomatic with more than 6 tachycardia paroxysms a week, many of them requiring emergency hospitalizations because of hemodynamic collapse. The electrophysiological evaluation revealed dual A-V nodal pathways and the presence of 4 accessory pathways (3 in the left A-V ring: lateral, posterior, and posteroseptal, 1 right posteroseptal) with 5 types of atrioventricular tachycardia and atrial flutter. The 4 accessory pathways and the slow A-V nodal pathway were successfully ablated, and the patient has been asymptomatic for 12 months without taking antiarrhythmic drugs.
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PMID:Six mechanisms of supraventricular tachycardia in the same patient: report of a case. 1609 98

The effect of 3rd-degree atrioventricular block on long-term outcome in cats is unknown. Clinical findings and long-term outcome of 21 cats with 3rd-degree atrioventricular block were studied retrospectively. Median age of cats studied was 14 years (range 7-19 years). Presenting signs included respiratory distress or collapse, but 6 cats had no clinical signs of disease. Eight cats had congestive heart failure (CHF) at the time that 3rd-degree atrioventricular block was detected. Heart rates ranged from 80 to 140 beats per minute (bpm; median 120 bpm) with no difference in heart rate between cats with and those without CHF. Eleven of 18 cats that had echocardiograms had structural cardiac disease, and 6 cats had cardiac changes consistent with concurrent systemic disease. No atrioventricular nodal lesions were detected by echocardiography. One cat had atrioventricular nodal lesions detected on histologic examination. Median survival of 14 cats that died or were euthanized was 386 days (range 1-2,013 days). Survival did not differ between cats with or without CHF or between cats with or without structural cardiac disease. Thirteen cats with 3rd-degree atrioventricular block survived > 1 year after diagnosis, regardless of presenting signs or underlying cardiac disease. Third-degree heart block in cats is often not immediately life threatening. Survival was not affected by the presence of underlying heart disease or congestive heart failure at the time of presentation. Even cats with collapse might survive > 1 year without pacemaker implantation.
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PMID:Third-degree atrioventricular block in 21 cats (1997-2004). 1649 28

Sinus of Valsalva aneurysms are uncommon, especially those in the left sinus of Valsalva. A case of a 45-year-old woman with syncope is presented. She was in complete heart block. Auscultation revealed moderate aortic regurgitation. Transthoracic echocardiography revealed a subaortic membrane attached to the interventricular septum with expansion in diastole and collapse in systole. A diastolic flow was seen at the edge of this membrane. Transesophageal echocardiography revealed a cystic mass that was thought to be a large aneurysm with a parietal thrombus of the left coronary sinus extending into the interventricular septum. Magnetic resonance imaging confirmed the diagnosis. The aneurysm extension to the interventricular septum resulted in complete heart block, presumably through compression of normal atrioventricular nodal function. Case reports of the latter association are extremely rare. The present is a rare report describing the magnetic resonance imaging appearance of a left sinus of Valsalva aneurysm.
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PMID:A large aneurysm of a left sinus of Valsalva invading the interventricular septum--a rare cause of syncope. 1846 50

Hodgkin disease is a nodal disease. Spinal cord or root compression is a rare complication and usually seen in the setting of progressive, advanced disease. We report 2 cases of Hodgkin disease in pediatric patients who presented with neurologic signs. One patient had paravertebral masses and involvement of thoracic vertebrae, which was initially misdiagnosed as spinal tuberculosis. The second patient who presented with paraplegia and bladder and bowel involvement had an epidural mass with collapse of thoracic vertebra. Lymph node biopsy revealed Hodgkin disease, mixed cellularity in both the cases. Both were treated with chemotherapy followed by radiotherapy.
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PMID:Hodgkin disease with spinal cord compression. 1963 73


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