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At least 487 records · Page 27Linked to original sources
PubMed2002

Martius flap harvest site: patient self-perception.

PURPOSE: We elucidated patient perception of the external genitalia after Martius flap harvesting. MATERIALS AND METHODS: We identified 8 women in whom a Martius interposition flap was used in association with transvaginal urethrolysis. Patients were contacted by an independent nurse and asked to evaluate the cosmetic appearance of the labium majus harvest site. They were also queried on any associated pain, numbness or altered sensation, or perceived interference with vaginal sexual relations. RESULTS: Of the 8 patients 2 (25%) believed that the harvest site appeared to be identical to its preoperative appearance, 2 (25%) believed that there were only minimal changes from the preoperative appearance, 1 (12%) believed that it appeared markedly different from the contralateral side and 3 (38%) stated that they had never performed self-examination. Of the 8 patients 1 (13%) complained of dyspareunia, 3 (38%) had intermittent discomfort in the harvest area 1 year after the operation and 5 (62%) perceived permanently decreased sensation or numbness at the harvest site. CONCLUSIONS: The Martius flap is not associated with a significant amount of perceived cosmetic disfigurement. It has relatively little effect on sexual relations. Postoperatively discomfort is minimal but there may be associated numbness or decreased sensation at the harvest site.

Adult↗
PubMed2002

[Anesthetic management of two patients with the history of SMON].

Patients of subacute myelo-optico-neuropathy (SMON) suffer from neurological disorders for a long time. The authors report anesthetic management of two patients with SMON. One patient was a 82-year-old woman suffering from SMON for 49 years. Sensory examination revealed numbness and hypesthesia in the both lower extremities. She underwent open reduction for femoral neck fracture. The other patient was a 91-year-old man suffered from SMON for 31 years. Sensory examination revealed weakness of leg muscles. He underwent transurethral resection of prostate. We chose general anesthesia for both patients instead of spinal anesthesia because of reported complications related to spinal anesthesia in patients with the disease. Intraoperative courses were uneventful and there were no neurological deteriorations postoperatively in both patients. One of the chief symptoms of patients with SMON is numbness of the lower extremity. Therefore patients of SMON may feel uncomfortable to the numbness by spinal or epidural anesthesia. This is the main reason we recommend general anesthesia for patients with SMON.

Aged↗
PubMed2002

[A case of CIDP with diabetes mellitus who had good response to intravenous immune globulin].

A 64 year-old man began to feel numbness on his bilateral feet in 1990. He was diagnosed as diabetes mellitus with a high fasting glucose level of 580 mg/dl in 1993 and he received oral hypoglycemic agents. Since then, his blood glucose levels had been in good control under diet therapy and medication. However, his numbness worsened and progressive weakness of bilateral lower legs occurred in 1997. Bilateral anterior tibial muscles were atrophic and deep tendon reflexes were decreased on bilateral upper and lower limbs. Protein level of his cerebrospinal fluid was 63 mg/dl. Nerve conduction study fulfilled the electrophysiological diagnostic criteria of CIDP. Superficial peroneal nerve biopsy showed loss of myelinated fibers, small amount of onion bulbs and thickening of the basement membrane of arterioles. Demyelination was predominant in teased fiber study. These findings were compatible with CIDP combined with diabetes mellitus (DM-CIDP). His numbness and leg weakness improved after intravenous high dose immune globulin therapy. DM-CIDP must be distinguished from diabetic peripheral polyneuropathy because immunological therapy may be effective in DM-CIDP patients.

Diabetic Neuropathies↗
PubMed2002

Long-term consequences of upper extremity peripheral neuropathy in former Vietnam prisoners of war.

BACKGROUND: At the time of repatriation in 1973, a substantial number of Vietnam prisoners of war (POWs) were diagnosed with upper extremity peripheral neuropathy (UEPN). OBJECTIVE: To assess the long-term functional consequences of UEPN among former Vietnam POWs diagnosed with UEPN at repatriation. SUBJECTS: Former POWs with an International Classification of Diseases, Eighth Revision, code of peripheral neuropathy identified from a central database registry. METHODS: Cross-sectional survey. Standardized survey instruments and the SF-12 questionnaire were mailed to all subjects. A subsample of subjects completing the mailed survey was contacted by telephone to complete a semistructured questionnaire on current symptoms and physical limitations attributable to peripheral neuropathy. RESULTS: Seventy-nine percent of POWs diagnosed with peripheral neuropathy at repatriation currently experience some numbness or tingling more than 25 years after repatriation, and 63% currently experience pain in one or both hands. Although the average severity rating for numbness and pain was mild, 23% of the POWs still have moderate to severe pain. Ulnar neuropathy was present in more than 30% of the POWs. SF-12 physical composite scores were substantially lower among this group of POWs compared with an age-matched group from the Medical Outcomes Study. CONCLUSIONS: For those POWs diagnosed with UEPN at repatriation, nearly 80% continue to experience symptoms of numbness, tingling, and pain, with nearly 25% reporting a moderate or greater degree of symptoms. The low physical function scores of this cohort are particularly troubling. More research concerning physical symptoms and conditions among former POWs is needed, and this research should also investigate what causes are responsible for the significantly lower physical functional status.

Aged↗
PubMed1992

[A case of common carotid artery stenosis due to hanging].

We report a case of a 50-year-old woman with traumatic dissection of the right common carotid artery secondary to attempted suicidal hanging. Initial examination showed marks of strangulation on the neck, facial edema, and multiple conjunctival petechiae accompanied by difficulty in breathing and loss of consciousness. She gradually recovered except for her left upper limb weakness. Rehabilitation, with a diagnosis of left brachial plexus injury, was started. Two years later, she occasionally felt numbness of the left upper extremity. On her second admission, a bruit was heard on the right side of her neck. Neurological examination did not reveal any change. CT scan showed atrophic changes. Angiography demonstrated approximately 80% stenosis of the right common carotid artery which was thought to be responsible for the attacks of numbness. Right carotid endarterectomy was performed. Histological findings revealed dissection of the medial layer of the arterial wall. Complaints of numbness disappeared postoperatively, and angiography showed good patency at a follow-up examination. We conclude that the stenosis of the common carotid artery was not due to atherosclerosis but due to the dissection as a result of hanging.

Brachial Plexus↗
PubMed2004

[Neurotoxicity of weekly TP (weekly paclitaxel + consecutive low-dose CDDP) therapy].

OBJECTIVES: To evaluate drug-induced neurotoxicity with combination consecutive low-dose CDDP (CLD-CDDP) and weekly paclitaxel in comparison with TJ therapy. Neurotoxicity was judged according to accumulative scores on questionnaires. SUBJECTS AND METHODS: Weekly TP therapy (CDDP: 10 mg/m2, days 1-7, paclitaxel: 60-80 mg/m2, days 1, 8, 15) and TJ therapy (paclitaxel: 170-180 mg/m2, 3 hours, carboplatin AUC 4-5) were given to 24 subjects in 57 courses and 19 subjects in 30 courses as previously reported, respectively. RESULTS: 1. Significant differences were found in numbness accumulative scores (p = 0.011) between weekly TP and TJ therapy, but not in pain accumulative scores (p = 0.926) between weekly TP and TJ therapy. 2. Peak pain at days 3-4 of paclitaxel that appeared during TJ therapy disappeared during weekly TP therapy, while numbness persisted to a lesser extent with weekly TP therapy than with TJ therapy. 3. Numbness was observed to accumulate in some subjects but not in others during weekly TP therapy. CONCLUSION: The patients' subjective symptoms were able to be objectively evaluated with the questionnaires. Weekly paclitaxel was observed to reduce neurotoxicity, which might be reinforced in combination with CDDP.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2004

Identification and characterization of PDZRN3 and PDZRN4 genes in silico.

NUMB and NUMBL are implicated in cell fate determination through the inhibition of Notch signaling. LNX, binding to NUMB and CXADR (CAR), functions as E3 ubiquitin ligase at least for NUMB. LNX is the paralog of PDZRN1 (PDZ domain containing RING finger 1). Here, we identified two novel homologs of LNX and PDZRN1 by using bioinformatics, which were designated PDZRN3 (LNX3 or SEMCAP3) and PDZRN4 (LNX4 or SAMCAP3L), respectively. KIAA1095 cDNA (AB029018) was the representative PDZRN3 cDNA. Complete coding sequence of PDZRN4 cDNA was determined by assembling nucleotide sequences of ESTs (BF059062 and AW297403), FLJ33777 cDNA (AK091096) and IMAGE5767589 cDNA (BC040922). PDZRN4 gene, consisting of 11 exons, was found to encode two isoforms with N-terminal divergence (PDZRN4 and PDZRN4S) due to an alternative promoter. PDZRN3-CNTN3 locus at human chromosome 3p13-p12.3 and PDZRN4-CNTN1 locus at human chromosome 12q12 were paralogous regions within the human genome. PDZRN3 (1066 aa) and PDZRN4 (1036 aa) showed 59.9% total-amino-acid identity. Two bipartite nuclear localization signals (NLS) were located within the C-terminal region of PDZRN3 and PDZRN4. PR34H1 and PR34H2 domains were identified as the regions conserved among PDZRN3, PDZRN4 and Drosophila CG1783. PDZRN3 and PDZRN4 consist of RING, two PDZ, PR34H1, PR34H2 domains and two NLS, while PDZRN1 and LNX consist of RING and four PDZ domains. PDZRN family proteins were classified into the LNX-PDZRN1 subfamily and the PDZRN3-PDZRN4 subfamily. This is the first report on the PDZRN3 and PDZRN4 genes.

Alternative Splicing↗
PubMed2004

Lymphedema following breast cancer treatment, including sentinel lymph node biopsy.

To compare the occurrence, signs, and symptoms of lymphedema (LE) the arms of women after axillary lymph node dissection (ALND), sentinel lymph node biopsy (SLNB), combined SLNB and ALND (Both), or neither as part of breast cancer diagnosis and treatment, a concurrent descriptive-comparative cross-sectional four-group design with retrospective chart review was carried out. In a convenience sample of 102 women treated for breast cancer and receiving follow-up care at a midwestern United States cancer center, sequential circumferential measurements at five selected anatomical sites along both arms and hands were used to determine the presence of LE (> or = 2 cm differences between sites). Participants self-reported LE-related signs and symptoms by interview and completion of the Lymphedema and Breast Cancer Questionnaire (LBCQ). Retrospective chart review was carried out to verify lymph node-related diagnostic and treatment procedures. Based on node group, LE occurred as follows: 43.3% (29 of 67) of women who underwent ALND alone; 22.2% (2 of 9) of those who underwent SLNB alone; 25.0% (3 of 12) of those with combined SLNB and ALND; and 22.2% (2 of 9) with neither SLNB nor ALND. LE-related symptoms were reported by women who underwent ALND alone, SLND alone, combined SLNB and ALND, and neither. Among the node groups, three symptoms were more common: larger arm size, firmness/tightness in past year, and numbness in past year. We conclude that circumferential measurements of the upper arm and forearm may be critical for distinguishing LE from no LE. Overall, the proportion of women who experienced LE-related signs and symptoms was higher among women who underwent ALND versus SLNB. However, numbness and tenderness frequently were reported by those undergoing ALND, SLNB or both; and by women without LE. It is possible that some frequently occurring symptoms, such as numbness and tenderness, may be related to breast cancer surgery and not LE. Findings from this study can assist health professionals in educating women with breast cancer about LE risk factors, as well as early detection and management of LE by using the LBCQ and sequential circumferential arm measurements to evaluate limb changes subjectively and objectively concurrent with each breast cancer survivor's follow-up care.

Adult↗
PubMed1992

[Chin neuropathy of neoplastic origin].

Three patients with mental neuropathy ("numb chin syndrome") secondary to systemic cancer are described. Two patients had malignant lymphoma and one a probable hypernephroma. In 2 patients, facial numbness was a presenting symptom of the malignancy. Investigations disclosed metastatic lesions of the mandible in one patient and cerebrospinal fluid was normal in 2 patients. Two patients died at 1 and 8 months respectively after onset of the neuropathy. Although benign in appearance, numb chin syndrome is most often, and sometimes initially, associated with visceral neoplasia or malignant hemopathy. It is a factor of poor prognosis. The pathogenesis is related either to metastasis of mandible, or neoplastic infiltration of the nerve itself.

Aged↗
PubMed1991

[Two brother cases of late-onset familial amyloidotic polyneuropathy in Kyoto].

Measurement of variant Met30 transthyretin is diagnostic for a patients with familial amyloidotic polyneuropathy (FAP) type I. The elder brother first noticed numbness of the feet at 64 years of age, and developed weakness of the legs. A few years later, he noticed numbness of the hands, and he was admitted to the hospital at 67 years of age. He was emaciated and had hoarseness and macroglossia. He had moderate muscle atrophy and weakness of all extremities with distal predominance. Deep tendon reflexes were hypoactive in the upper limbs and absent in the lower limbs. There was marked sensory loss of pain and temperature in all 4 limbs distally, and position sense was also impaired. He had mild orthostatic hypotension, severe cardiomegaly and arrhythmia. The younger brother noticed cold sensation of the feet and sexual impotence at 59 years of age. Two years later, he had numbness of the feet and developed weakness of the legs. At 65 years of age, he was admitted to the hospital because of the micturition syncope. He was emaciated and had macroglossia. He had moderate muscle atrophy and weakness of all extremities with distal predominance. Deep tendon reflexes were absent. There was marked sensory loss in the extremities which was predominant in pain and temperature. He had severe orthostatic hypotension (112/70 mmHg in supine position, 50/30 mmHg on standing). Plasma NE value was low and showed poor response to standing. He had neither cardiomegaly nor arrhythmia. Their parents were supposed to have no neurological symptom and were not related with any other Japanese foci of FAP.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1996

Conservative treatment of bilateral sural nerve entrapment in an ice hockey player.

Midway through the season, an intercollegiate ice hockey player experienced bilateral numbness in the posterior aspect of the leg along the area of the calcaneal tendon. This numbness corresponded with the distribution of both sural nerves. While obtaining a history of the condition, the athlete admitted that he routinely spiraled his ice hockey laces tightly around the proximal portion of each ice hockey boot before finally tying the laces off. A complete neurological examination was negative except for the bilateral numbness. Based upon this information, a diagnosis of bilateral sural nerve entrapment was made. In addition to frequent follow-up examinations, nonoperative treatment consisted of changing the way the athlete laced his ice hockey skates. The athlete was able to complete the season and, after approximately 4 months, was asymptomatic. Although this appears to be an isolated incident, athletic trainers should be cautious when evaluating patients with paraesthesia in this region. If symptoms such as those described develop, entrapment of the sural nerve should be considered as a possible cause.

Journal Article↗
PubMed2003

Local anesthetic "resistance".

The incidence of inadequate analgesia despite technically well performed injections led our clinic to prospectively test patients for response to a variety of local aesthetics. Skin testing was performed on the skin of the forearm away from the site of pathology. Patients were asked to identify "which is the most numb" of the skin wheals. Although most were equally numb to all three local anesthetics (lidocaine, bupivicaine, and mepivicaine), 7.5% of the patients consistently chose mepivicaine as the local anesthetic resulting in the most hypoesthesia. For patients who had previously undergone an unsuccessful procedure with bupivicaine (the standard local anesthetic used in our practice), the same procedure with mepivicaine provided good relief. Patients are now questioned on their initial evaluation about a history of difficulty getting numb, for instance at the dentist, and preemptively skin tested prior to any invasive procedure.

Journal Article↗
PubMedDate not supplied

Central cord syndrome in a high school wrestler: a case report.

OBJECTIVE: To alert athletic trainers to the importance of recognizing the signs and symptoms of central cord syndrome. BACKGROUND: A 15-year-old high school wrestler was found lying supine on the mat after sustaining a hyperextension injury to his neck while drilling during practice, complaining of numbness, tingling, and a burning sensation in all 4 extremities. Touching the extremities elicited an extreme burning sensation. After in-line stabilization of the cervical spine was performed, palpation of the spinous processes elicited tenderness and an increase in pain. Six weeks before the injury, the athlete had experienced forced lateral flexion of the cervical spine during a match, resulting in an episode of bilateral numbness and burning in his arms. On evaluation by the athletic trainer, symptoms were limited to the right hand, and brachial plexus neurapraxia was diagnosed. DIFFERENTIAL DIAGNOSIS: Central cord syndrome, brachial plexus injury, cervical spine injury, burning hands syndrome, Brown-Séquard syndrome, anterior cord syndrome. TREATMENT: Upon assessment, the athlete's cervical spine was immobilized until emergency medical services arrived and applied a cervical collar. Radiographs taken at the hospital revealed a congenital fusion of C6-7. Magnetic resonance imaging and computed tomography showed evidence of stenosis, a herniated disc at C3-4, and a central cord injury. He was admitted to the hospital for observation and was placed on a corticosteroid protocol. At approximately 1 week after the injury, the athlete underwent a cervical decompression and fusion at C3-4. Subsequently, he underwent extensive rehabilitation and has had some persistent neck stiffness. The athlete is no longer allowed to participate in contact sports as a result of the presence of stenosis at multiple levels. UNIQUENESS: Central cord syndrome is typically seen in an older population with cervical spondylosis and rarely occurs in young adolescents. However, this athlete sustained 2 central cord injuries, 1 mild and 1 severe, in less than 6 weeks' time. CONCLUSIONS: The original injury sustained by the wrestler was thought to be a brachial plexus injury but, in fact, was a mild central cord injury. Central cord syndrome was not suspected in the original injury because the athlete's complaint was of unilateral numbness. With the second injury, the central cord injury was more severe. Proper recognition, assessment, and handling of this situation were crucial in providing optimal care to this athlete.

Journal Article↗
PubMed1989

[Study on climacteric symptoms in relation to ovarian function ageing and psychologic factors].

The present investigation was undertaken to establish the relation between climacteric symptoms, ovarian function, ageing, and psychological factors. The subjects were as follows; 1,270 women who received a screening test for cervical cancer and 247 women following hysterectomy. The methods of investigation were Kupperman menopausal index (K-index), Cornell Medical Index (CMI) and YG character questionnaire (YG test). The following results were obtained: 1) the K-index increased until 39 years of age and was constant after 40 years. Five symptoms (chills, nervousness, melancholia, excitability and vertigo) were not influenced by ageing, and seven symptoms (panting, hypesthesia, insomnia, wakefulness, fatigue, palpitation and formication) increased with age. Hot flushes, perspiration, numbness, shoulder stiffness, lumbago, and headache, occurred at peak frequency in the climacteric period. 2) In hot flushes, perspiration, numbness, hypesthesia, shoulder stiffness, lumbago, and formication, a significant difference was found between the control and those patients who had received bilateral oophorectomy. 3) The K-index and CMI score were significantly correlated, and six symptoms (palpitation, panting, excitability, vertigo, wakefulness and formication) in particular were related to CMI. 4) The K-index was lowest in the patients indicated to be the D type by the YG test, and was highest in the patients of the B.E type. Six symptoms (excitability, palpitation, panting, melanchoria, hypesthesia and formication) were thought to be associated with the character of the patients. Results showed that four symptoms (hot flushes, perspiration, numbness, shoulder stiffness and lumbago) were closely related to ovarian function, and three symptoms (panting, excitability, and palpitation) depended largely on mental factors. The relationship between vasomortor symptoms and gonadotropin was investigated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[A case of repeated hematomyelia caused by cavernous hemangioma in the spinal cord].

A case is reported of repeated hematomyelia caused by cavernous hemangioma in the spinal cord. A 47-year-old woman first noticed a sudden onset of numbness in her thigh and then it gradually disappeared. Four months after the onset, she began to experience weakness and numbness in both of her legs, and difficulty in voiding and defecating. She recovered gradually for several months, but felt numbness in both legs. Myelography showed swelling at Th5 level. T2-weighted MRI showed a reticulated core of mixed intensity with rims of decreased intensity. During the subsequent operation, a dark brown lesion was detected at Th5 level, which consisted of multicystic cavities with old hematoma. But there were no abnormal vessels, or active bleeding. This lesion was almost completely removed and was diagnosed as cavernous hemangioma.

Female↗
PubMed1984

[Vibration hazards in quarry workers].

Vibration hazards were surveyed in a population of quarry workers using chipping hammers and to a lesser extent, rock drills. Sixty-nine male quarry workers, aged 49.1 +/- 8.7 and exposed to vibration for 16.4 +/- 5.1 years, were surveyed in 1981-82. They were exposed to vibration for about 2-4 hours per days, mainly under a piece-work pay system. They had a high prevalence of Raynaud's phenomenon (36.2%) and numbness in upper extremities (53.6%). It is considered that the high prevalence was mainly due to large vibration levels in chipping hammers and rock drills and long daily exposure time. The attacks of Raynaud's phenomenon were found predominantly in the left hand, which held chisels, whereas the restriction of motion in the elbow was predominantly in the right arm which pushed chipping hammers. The same 49 male quarry workers in this population were also surveyed in 1976-77 and the prevalence of their complaints between 1976-77 and 1981-82 was compared. The prevalence of Raynaud's phenomenon was the same, but the frequency of the attacks increased between the two periods. The prevalence of other complaints such as numbness, pain and chills in the upper extremities also increased. Between 1976-77 and 1981-82, the prevalence of Raynaud's phenomenon, numbness, and pain in the upper extremities increased in the population of quarriers exposed to vibration for above 2.6 hours per day and 200 days per year, or 600 hours per year. On the other hand, the prevalence of these complaints mostly decreased in the population of quarriers with less exposure.

Adult↗
PubMed1994

Operating hand-held vibrating tools and prevalence of white fingers.

Hand-transmitted vibration levels (HTVLs) and the prevalence of vibration-induced white finger (VWF) and numbness of the hands were investigated in eight groups of subjects operating various hand-held vibrating tools. The prevalence rates of Raynaud's phenomenon (RP) and numbness of the hands in 1,027 males and 1,301 females not occupationally exposed to vibration were compared to those of the exposed subjects. The prevalence of VWF was in the range of 0.0-4.8% in subjects exposed to HTLVs of between 1.1 to 2.5 m/s2 and reached 9.6% in a group of workers exposed to HTLVs of 2.7-5.1 m/s2. The latter group showed a significant difference (P < 0.05) in the prevalence of VWF compared to the 2.7% prevalence of RP in male subjects of the general population. The prevalence of VWF in female subjects exposed to vibration (4.3%) was not significant compared to the prevalence of RP in females of the general population (3.4%). The prevalence rates of numbness of the hands were between 6.5% and 30.4% in the exposed groups and in the range of 13.4-29.5% in the general population. It was concluded that in decisions concerning quantitative recommendations for vibration exposure, the prevalence of VWF should be employed. To decrease the risk of developing VWF, estimated vibration safety values for 4 h and 2 h daily exposures are discussed.

Adult↗
PubMed1994

Posttraumatic stress disorder and alexithymia in burn patients.

We examined symptoms of posttraumatic stress and alexithymia in a sample of 24 burn patients. Of these burn patients, those in the chronic phase (more than 10 months after the burn) indicated alexithymia more strongly. Among symptoms of Posttraumatic Stress Disorder, symptoms of avoidance and emotional numbing were also stronger in patients in the chronic phase. The manifestation of the alexithymic features was closely related to symptoms of avoidance and emotional numbing. These findings suggest the possibility that alexithymia as a state reaction may be evident when avoidance and emotional numbing appear among symptoms of Posttraumatic Stress Disorder.

Adaptation, Psychological↗