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At least 847 records · Page 47Linked to original sources
PubMed2004

Intrinsic arteriovenous malformation of the trigeminal nerve in a patient with trigeminal neuralgia: case report.

OBJECTIVE AND IMPORTANCE: Intrinsic arteriovenous malformation (AVM) of the trigeminal nerve is extremely uncommon and may be associated with trigeminal neuralgia. CLINICAL PRESENTATION: A 55-year-old man experienced severe lightning pain in the second and third divisions of the left trigeminal nerve territory. Vertebral angiography demonstrated an AVM fed by the superior cerebellar artery. Magnetic resonance imaging with three-dimensional spoiled gradient recalled acquisition at steady state revealed an AVM intrinsic to the left trigeminal nerve and a small arterial loop causing compression at the root entry zone of the trigeminal nerve. INTERVENTION: Intraoperative inspection revealed an indentation of the root entry zone caused by a small arterial loop but not by the AVM. The offending artery was displaced to decompress the root entry zone using a prosthesis without resection of the AVM. The patient was relieved of the neuralgia immediately after surgery without further neurological deficit. He has been free of trigeminal neuralgia during a follow-up period of 2 years and is scheduled to undergo stereotactic radiosurgery for the treatment of the AVM. CONCLUSION: Intrinsic AVM of the trigeminal nerve may cause trigeminal neuralgia. However, as in the present case, a coexistent vascular lesion rather than the intrinsic AVM could be a cause of the neuralgia.

Humans↗
PubMed2004

[SERS mechanism for rhodium electrode in the ultraviolet region].

Stable and good quality of Surface-Enhanced Raman Scattering (SERS) signal from net rhodium electrode in the ultraviolet region was observed for the first time by our group recently. In this paper, both qualitative and quantitative analyses are given to interpret the new experimental results mainly based on the electromagnetic field theory. The mechanisms of SERS for rhodium electrode in the ultraviolet region are mainly attributed to the lightning rod effect together with the weak surface plasmon resonance. According to the calculation, the surface-averaged enhancement factor (SEF) for rhodium electrode in the ultraviolet region is about two orders of magnitude when the surface of the substrate is roughened properly, which is in good agreement with the experimental results. The authors also give a comparative study to show why silver, which is the best SERS active substrate in the visible and near infrared region, can't give any SERS signal when the 325 nm excitation line is used.

Electrodes↗
PubMed2005

[Dissociation of SF5CF3 under discharge].

SF5CF3 was identified recently as a potent greenhouse gas with strong radiative force and long atmosphere residential life. Spark discharge method was used to take simulative investigation on the elimination of SF5CF3 from atmosphere under discharge here. The results show that SF5CF3 was dissociated under discharge and formed some compounds containing S, F, O and C. The dissociation of SF5CF3 was reduced if the system existed H2O, but it was independent of the amount of H2O. The rate coefficients were estimated to be 0.011s(-1) under moisture circumstance when the system total pressure was about 31 kPa. And the increase of the system pressure would cause exponential decrease of SF5CF3 dissociation. The reactive mechanism was argued based on the experiment results and the sinks of SF5CF3 under lightning (one of the discharge in the atmosphere) was estimated to be 53.6 kg x a(-1).

Air Pollutants↗
PubMed2005

Secondary abdominal compartment syndrome: risk factors and outcomes.

Secondary abdominal compartment syndrome (ACS), defined as intra-abdominal hypertension with associated pulmonary, renal, or hemodynamic compromise in the absence of preceding abdominal operation or injury, can markedly increase surgical morbidity and mortality. We performed a retrospective chart review of the physiologic parameters and outcomes of 10 patients with secondary ACS. Ten patients developed secondary ACS after aggressive resuscitation, at an average of 20.2 hours. Four of the patients sustained burns greater than 40 per cent, three of the patients had penetrating extremity trauma, one patient had blunt abdominal trauma, one patient was struck by lightning, and one patient developed a retroperitoneal bleed while on heparin. The average bladder pressure was 40.6. The average volume given in the first 24 hours was 33,001 cc (range, 12,400 to 69,000). The average base deficit at admission was -12 (range, +1 to -25). Seven of the 10 patients had decreased urine output. Nine of the 10 patients had decreased tidal volumes on pressure control ventilation. All 10 patients were hypotensive, with 7 of the 10 requiring vasopressors. Overall mortality was 60 per cent, with 43 per cent mortality for those decompressed. Prompt recognition and treatment are mandatory for survival of ACS. We recommend routine bladder pressure monitoring for patients with ongoing resuscitation greater than 500 cc/hr.

Abdomen↗
PubMedDate not supplied

[Analysis of accidental deaths in mountain tourism and sport according to statistics from the Republic of Kabardino-Balkariia].

Lethal cases in mountain tourism and sports in the Republic of Kabardino-Balkaria were studied for 1978-1995. A total of 152 accidental deaths were analysed. Most of the victims were males under 30 years of age. The greatest number of the accidents took place on Monday, in July and August. Many amateur visitors from abroad were among the victims. The main cause of death in the mountains of Kabardino-Balkaria for the 18 years studied was multitrauma of the body (69.7%). Hypothermia and obturation asphyxia with snow and compression asphyxia due to snowbreak account for 11.8 and 13.2% deaths, respectively; lightning killed 4%. Combination of high mountain hypoxia with exacerbated chronic somatic disease or hypothermia caused death in 1% victims. The authors propose how to improve forensic-medical expert examination of accidental death and safety in the mountains.

Accidents↗
PubMedDate not supplied

[Neurological sequelae following electrocution. A case report and review of the literature].

INTRODUCTION: Electrocution is the cause of a large number of accidents and, of these, a considerable percentage result in death. Several factors affect the severity and distribution of the injuries. It is known that for low voltages the characteristics of alternating current make it three times more dangerous than continuous current. The high percentage of neurological sequelae can be accounted for by the fact that nerves are the tissue with the lowest resistance in the body and electricity tends to follow the path that offers the least resistance. CASE REPORT: A 16-year-old male who was accidentally electrocuted by an electric guitar and later suffered a cardiorespiratory arrest; the patient required intubation. After withdrawing sedation, the patient was found to be blind in both eyes and could not remember what had happened. FLAIR MR imaging revealed oedema in both occipital lobes and, to a lesser extent, in the junction between the parietooccipital and temporooccipital lobes. Treatment with steroids was established for three days. After approximately one month, the patient had recovered his sight and the brain injuries had disappeared. CONCLUSIONS: The neurological manifestations secondary to accidents caused by electricity are usually divided into two types -immediate and delayed. Blindness has rarely been reported as a sequela in those who have survived fulguration due to a lightning strike. The patient's recovery after administering treatment with steroids and the reversibility of the oedema could lead us to think that the mechanism producing this sequela was the damage to the nervous system caused directly by the electricity, which is known as the 'phenomenon of electroporation'.

Adolescent↗
PubMed1991

Vision and migraine.

Migraine is classified into four basic categories: common, classic, cluster, and complicated. Ocular migraine is a periodic loss of vision in one eye typically lasting 30 minutes or less. Ophthalmoplegia is a severe ipsilateral hemicranial headache that is preceded by aura of lightning flashes and expanding circles of light, accompanied by temporary ocular motor nerve palsies.

Humans↗
PubMed1991

[Abnormal vergence eye movement during eyelid closure caused by a pineal tumor].

A case with abnormal eye movement induced by eyelid closure and selective paralysis of downward gaze was reported. CT scan and MRI imaging revealed a pineal tumor with bilateral involvement of the thalamomesenchephalic junctions without obvious damage to the posterior commissure. Histopathologically, the tumor was a germinoma. The pupillary light reflex was absent and near reflex was reduced. Lightning eye movement, skew deviation and convergence-retraction nystagmus were observed. The horizontal eye movement was normal in both eyes. The eye did not move downward below the level of direct forward gaze spontaneously or on attempted downward gaze. Downward vestibulo-ocular reflex was absent. Bilateral abnormal vergence eye movement with alternating convergence and divergence was observed during eyelid closure. The cycle of the abnormal eye movement was about 3Hz and there was no fast phase. The abnormal eye movement was not observed in the darkened room with both eyes open. After subtotal removal and radiation therapy of the pineal tumor, the abnormal eye movement disappeared.

Adult↗
PubMed1991

[The hemodynamic and metabolic changes following tourniquet release during halothane anesthesia].

We measured the hemodynamic and metabolic changes following the release of lower limb tourniquet during halothane anesthesia, and discussed the cause of reduction in the blood pressure and the effective method for prevention. Cardiac index decreased transiently following the release, and gradually increased afterward. Systemic vascular resistance index decreased continuously and progressively until 10 minutes after the release. These results indicate that the causative factors of reduction in the blood pressure are temporary decrease in cardiac output and subsequent decrease in systemic vascular resistance. In mixed venous blood, pH decreased, PCO2 increased and HCO3- remained unchanged after the release. It seems that pH reduction was chiefly caused by the increase in PO2. Thus, the preventive method for reduction in the blood pressure following the tourniquet release may be as follows; 1) intravenous fluid loading, 2) hyperventilation, 3) elevation of lower limb, 4) lightning the anesthesia, and 5) finally giving vasopressors.

Anesthesia, Inhalation↗
PubMed1990

[A complete relief of intractable postherpetic neuralgia with intrathecal methylprednisolone acetate].

A 72-year-old man, 154 cm tall, weighing 53 kg was suffering from severe herpetic neuralgia on his left 10th intercostal nerve area. His pain continued even he was treated with frequent epidural nerve block (4 to 5 times per week) by an anesthesiologist. He was referred to our hospital on his 105th pain day. He complained severe continuous pain and numbness on his left 10th intercostal nerve area. Touching the painful skin induced lightning pain. His pain was so severe that his sleeping was disturbed and also he could not maintain his usual life. Epidural nerve block at 10th thoracic nerve was done with 20mg methylprednisolone acetate and 5ml of 1% lidocaine. After the treatment, his pain was reduced to 3/10 of the one he had on admission, and also his sleep was not disturbed further. Epidural nerve blocks with methylprednisolone weekly for a month induced no more remission. At his 154th pain day, a dose of 20mg methyl prednisolone acetate and 1% lidocaine 5ml was given intrathecally through 2nd lumber intervertebral space. The pain was relieved completely after the block. And he complained nothing about the skin area which had been disturbing his life for a long time. Auditory brainstem response which was recorded during the block showed prolongation of the latency of phase III and phase V at 40 minutes after the intrathecal injection of lidocaine.

Aged↗
PubMed1989

Estimations of risk from environmental asbestos in perspective.

Because very recent data on asbestos in the environment are available, some fairly firm conclusions can now be drawn regarding current exposure to asbestos fibres. If account is taken of occupational exposure data (where past exposure levels were very high indeed, leading to a very significant risk to workers at the time), it is possible to make some reasoned estimates of the risk from ambient air. In the past, there was considerable confusion regarding the degree of risk for both occupational and environmental conditions. In estimating the risk, account needs to be taken, in particular, of the fact that: (a) occupational exposures in the past were frequently higher than reported; (b) asbestosis (a disease only associated with very heavy occupational exposures) would seem to be mechanistically involved in the development of lung cancer associated with asbestos exposure; (c) chrysotile asbestos is now the commonest form of fibre used unlike in the past, when greater quantities of crocidolite and amosite were used, the latter types being much more closely associated with mesothelioma than chrysotile; (d) overall levels of asbestos in environmental ambient air are lower than they used to be; (e) ingested asbestos seems to be associated with a negligible degree of risk as indicated by animal and human studies. The estimated values of risk provided here are smaller than those published some years ago but are similar to those given in very recent key publications. The level of environmental lifetime risk from exposure to airborne asbestos would appear to be about 1 in 100,000 or even lower. Such a level of risk is exceedingly low, and bearing in mind the criteria of both WHO and the Royal Society of London, it would appear to represent an acceptable 'rare-event' extremely low-level risk, like the cancer risk from the cosmic radiation adsorbed when flying across the Atlantic or from eating charcoal broiled meat, or the risk of being killed by lightning.

Air Pollutants↗
PubMed1989

Electric shock.

The problems of electrical phenomena striking the human body have been with us since early man observed the effect of lightning. The first generator was invented in the early 19th century, and commercial electricity generation began in 1849. By the early 1900s death from electric shock had been well described and its effect was thought to be irreversible. During the 1960s studies began to show that with prolonged resuscitation survival is possible.

Burn Units↗
PubMed1989

[Injury pattern and identification after airplane catastrophies. Cooperation between forensic medicine and federal criminal investigations. An airplane accident in Mühlheim/Ruhr 8 February 1988].

On February 8th 1988, a two-motor passenger aircraft of Metroliner type with 21 people on board entered a front of heavy weather at an altitude of 900 m and crashed after being struck by lightning which led to complete breakdown of the electrical systems on board. The site of the crash was in the marshy Ruhr meadows. The formation of the terrain enabled a subdivision into plan squares for rescue. The identification of the 21 bodies was carried out in the Essen Institute of Forensic Medicine in collaboration with the identification commission of the Federal Criminal Investigation Office. The experience and recommendations for future (possibly larger-scale) disasters derived from this are described. Furthermore, the accident pattern in the casualties typical for this air crash is discussed.

Accidents, Aviation↗
PubMed1986

Evolving ideas on the neurophysiology of myoclonus.

Early observations, made between 1935 and 1947, on the EEG discharges associated with myoclonic jerking are reviewed, together with the contemporary findings on the stimulus-sensitive myoclonus produced in cats under chloralose anesthesia. The accumulating evidence on the relative roles of cortex, brainstem, and cerebellum in producing this type of myoclonus is briefly summarized. The significance of large SEPs and their presence and absence in various clinical types of myoclonus is considered. Three distinctions are drawn with regard to the clinical features of myoclonic jerking: between action myoclonus and myoclonus at rest; between focal and generalized jerking; and between the lightning-like, irregular, stimulus-sensitive jerks of myoclonic epilepsy and the rhythmical, stimulus-insensitive jerking of segmental myoclonus. Some findings bearing on the possible mechanisms of the abnormal discharges responsible at cell membrane level are mentioned.

Adult↗
PubMed1988

Medical politics and Canadian Medicare: professional response to the Canada Health Act.

The Canada Health Act of 1984 served as a lightning rod for profession/government conflict, culminating in a 25-day doctors' strike in Ontario. The act was perceived as threatening medical dominance and professional autonomy in its prohibition of user fees and extra billing. A post-strike survey of 2,397 physicians across the provinces, however, reveals important limits to physicians' ideological support for an unregulated medical market place. Rather, there are divisions within the profession on how to translate commitment to autonomy into appropriate policy objectives and political strategies.

Attitude of Health Personnel↗
PubMed1986

Cacolalia.

To sum up: Communication, particularly oral, would be aided or furthered by abstention from cacolalia. Clichés, redundancies, and expressions battered by overuse should be avoided and the imparting of knowledge by means of precise language should be done audibly and at a reasonable speed. One should speak at scientific meetings only as fast and certainly as simply as one would in ordinary mundane intercourse. Above all, one's audience should not know what words or expressions are going to be used in certain given situations. If this could be attained, the hours in a hospital on rounds or at lectures would be better spent and ultimately, the speaker, too, would derive more satisfaction from his work if he were rewarded with stimulating questions from an appreciative audience instead of the perfunctory applause of somnolent, noncomprehending colleagues, driven almost to distraction by unending cacolalia complicated by lightning speed and rank inaudibility.

Humans↗
PubMed1986

A primer for the novice. Basic computer concepts.

A computer is nothing more than an organized bureaucratic structure that allows one to perform a large number of very simple acts by the issuance of a few simple commands. It has the disadvantage of being a machine and, at the present time, being incapable of interpretive behavior. Such machines can only follow orders blindly. On the other hand, the computer is capable of performing simple tasks at lightning speed. Learning how to take advantage of this ability is no more difficult than learning to reduce a Colle's fracture. Buy a book, obtain some "clinical material" (a computer), and start experimenting. Learn from your mistakes; it only takes time and interest--not genius.

Computer Literacy↗
PubMed1985

Prepaid entitlements. A new challenge for physician-patient relationships.

The transition from a fee-for-service model to a prepaid health care system creates new challenges for both physicians and patients. Occasionally both can feel trapped in the new setting and must rely on new or different strategies to reach sometimes divergent objectives. This may alter the physician-patient relationship in ways that neither likes. Based on our experience in a large multispecialty academic group practice, we have developed management strategies to mitigate such stresses on both parties. These include review of marketing efforts; education of new patients to foster realistic expectations; a physician-generated, prospective internal policy for dealing with dissatisfied patients and physicians; a strong central administrative physician to serve as a "lightning rod" and counselor; and continuing physician orientation and education to improve judgment and attitudes. These strategies promote the physician's role as expert consultant-educator with the best interests of the patient as the first priority.

Chicago↗