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Query: UMLS:C0027121 (myositis)
 4,538 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Fibromatosis is a heterogenous group of soft tissue neoplasias, only some forms of which occur in the head and neck region. In the pathological classification it takes place between the fibroma and fibrosarcoma. With nodular fasciitis, it's subspecies myositis proliferans and aggressive fibromatosis exist differential diagnostic difficulties, especially as it's difficult to exclude fibrosarcoma. The benign myositis proliferans gives an impression of a malignant process by it's rapid proliferation, cell-polymorphia and high mitotic activity. The monomorphous histological picture and the slower proliferation of the aggressive fibromatosis, however can simulate a benign tumor, although thought to be semimalignant. 3-case-reports point out these characteristics. Complete excision is the therapy advised for all fibromatosis. In aggressive fibromatosis a large enough healthy area is the best condition to prevent recidives.
HNO 1981 Apr
PMID:[Diagnosis and therapy of fibromatosis in head and neck region (author's transl)]. 722 44

A previous study has shown that inflammation of the gastrocnemius-soleus muscle in rats leads to an increase in excitability of dorsal horn neurones particularly in the spinal segment L3. Here, we have blocked the nitric oxide synthase (NOS) in L3 by spinal cord superfusion with NG-monomethyl-L-arginine (L-NMMA) to find out if this effect is due to a release of nitric oxide (NO). L-NMMA had no influence on the excitability of L3 neurones but caused a marked increase in background activity. The L-NMMA effect on background activity was also present in rats with intact muscle. The data show that the myositis-induced increase in spinal excitability is not mediated by NO. The background activity, however, appears to be strongly dependent on NO production.
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PMID:Blockade of nitric oxide synthase differentially influences background activity and electrical excitability in rat dorsal horn neurones. 754 Jul 40

SJL mice spontaneously develop B cell lymphomas (historically described as reticulum cell sarcomas) by 12 months of age and inflammatory muscle disease (myositis) by 6 months of age. Tumors originate in mesenteric lymph nodes and in Peyer's patches and resemble human germinal center lymphomas. The growth of reticulum cell sarcomas is completely dependent on cytokine production by normal T cells. The spontaneous myositis, which resembles human idiopathic myositis, is characterized by various abnormalities in skeletal muscle, including infiltration with inflammatory cells consisting primarily of macrophages. The participation of different cytokines in the pathogenesis of the lymphoma and the massive invasion of macrophages into muscle tissues led us to investigate the possible involvement of nitric oxide (NO.), which is known to be synthesized by activated macrophages under inflammatory conditions. Elevated NO. production, measured by urinary nitrate excretion, by SJL mice in comparison with BALB/c control mice was observed as early as 7 weeks of age. Both aging and degree of spontaneous myositis correlated with increased nitric oxide production. Oral administration of N-monomethyl-L-arginine, an inhibitor of nitric oxide synthase (NOS), reduced urinary nitrate excretion and also the severity of myositis. Immunohistochemical analysis revealed the presence of inducible NOS (iNOS) in cells in the spleen, lymph nodes, and skeletal muscle. The iNOS is primarily responsible for the enhanced nitric oxide production. Morphology of cells that stained positive for iNOS was similar to that of macrophages infiltrating into the affected tissues. Chronic production of elevated amounts of nitric oxide by the SJL mice, therefore, provides a useful in vivo model for future studies of cellular damage resulting from endogenously produced NO.in combination with oxygen radicals.
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PMID:Nitric oxide production in relation to spontaneous B-cell lymphoma and myositis in SJL mice. 754 39

To investigate the possible role of nitric oxide (NO)-induced 'oxidative stress' in the pathogenesis of inclusion-body myositis (IBM), we immunostained muscle biopsies of 12 patients with IBM with isoform-specific antibodies against the neuronal and inducible forms of nitric oxide synthase and with antibodies against nitrotyrosine. Between 70 and 80% of IBM vacuolated muscle fibers contained inclusions strongly immunoreactive with all three antibodies, which by immuno-electronmicroscopy co-localized mainly to cytoplasmic paired-helical filaments, and also to amorphous structures and floccular material. Excess intracellular NO can combine with superoxide to produce highly reactive peroxynitrite which can nitrate tyrosines of proteins. The presence of nitrotyrosine is indicative of NO-induced "oxidative stress'. Our data suggest that this mechanism may play a pathogenic role in IBM.
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PMID:Increase of nitric oxide synthases and nitrotyrosine in inclusion-body myositis. 905 71

There is evidence that muscle fibers in denervating disorders and muscular dystrophies undergo apoptosis. In 21 patients with autoimmune inflammatory myopathies, we found no features of muscle fiber apoptosis such as DNA fragmentation or expression of apoptosis-related proteins. However, muscle fibers in myositis displayed distinct up-regulation of inducible and neuronal nitric oxide synthase (NOS). While inducible NOS was distinctly up-regulated on the sarcolemma of all kinds of muscle fibers neuronal NOS displayed increased expression in the sarcoplasm of damaged as well as atrophic muscle fibers. There were no disease-specific patterns in the different myositis subtypes. Enhanced expression of NOS with production of nitric oxide may contribute to oxidative stress mediating muscle fiber damage and muscle fiber necrosis representing the predominant cell death mechanism in myositis. Nevertheless, inflammatory cells displayed numerous DNA-fragmentation-positive nuclei and expression of apoptosis-related proteins indicating that apoptosis plays a role in the regulation of the inflammatory cellular response.
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PMID:Cell death and oxidative damage in inflammatory myopathies. 964 33

Nitric oxide (NO) production is increased in several inflammatory disorders. We have previously demonstrated higher levels of NO production among patients with rheumatoid arthritis and systemic lupus erythematosus. In this study we measured serum levels of nitrite and citrulline using calorimetric methods as surrogate markers of NO production among patients with inflammatory myositis (IM). Twenty patients with IM and 19 age- and sex-matched controls were studied. Serum nitrite levels were significantly higher among patients than among controls (986.6 +/- 880 and 204.3 +/- 113.9 nmol/ml, respectively; P = 0.001). Serum citrulline levels, too, were significantly higher among patients than among controls (3755.7 +/- 1905.5 and 189 +/- 177.2 nmol/ml, respectively; P < 0.0001). There was a positive correlation between steroid dosage and serum citrulline levels (r = 0.51, P = 0.036) and a negative correlation between steroid dosage and disease duration (r = -0.54, P = 0.025). It was concluded that NO production is increased in patients with IM and those with more active disease, as indicated by higher steroid dosage, have higher serum citrulline levels.
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PMID:Nitric oxide production is increased in patients with inflammatory myositis. 1063 23

Nitric oxide (NO) is an important mediator of diverse physiological and pathological responses. NO-induced oxidative stress has been proposed in the pathogenesis of muscle tissue damage in inclusion-body myositis (IBM), which is characterized by deposition of beta-amyloid protein (Abeta) in vacuolated muscle fibres. To determine whether Abeta can induce NO production in skeletal muscle, we stimulated C2C12 mouse skeletal muscle cells in vitro with Abeta[1-42] or Abeta[25-35] peptides in the presence or absence of interferon gamma (IFN-gamma). Neither Abeta peptides nor IFN-gamma were able to stimulate nitrite (NO(2)(-)) production by C2C12 cells when given alone. However, combination of IFN-gamma with either Abeta[1-42] or Abeta[25-35] resulted in significant NO(2)(-) release into cell-free supernatants. Northern blot analysis of RNA obtained from Abeta/IFN-gamma-stimulated C2C12 cells revealed increased mRNA accumulation of inducible nitric oxide synthase (iNOS). Moreover, approximately 4% of muscle cells incubated with Abeta peptides and IFN-gamma showed ultrastructural features of DNA fragmentation. These findings, taken together, indicate that the association of Abeta with IFN-gamma stimulates NO(2)(-) production via induction of iNOS gene expression in skeletal muscle cells, with occasional evidence for nuclear changes suggesting apoptotic morphology. These data further support a role for Abeta deposition in the pathogenesis of postulated oxidative damage in IBM.
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PMID:Synergistic effect of beta-amyloid protein and interferon gamma on nitric oxide production by C2C12 muscle cells. 1064 44

Orbital myositis is an uncommon subgroup of the nonspecific orbital inflammatory syndromes (previously termed orbital pseudotumor) and presents with eyelid swelling and redness, conjunctival chemosis, pain, proptosis, and diplopia. The disease is to date of unknown origin; autoimmune processes are suspected for the etiology. In the case of an otherwise healthy young male patient (age 28 years), the coexistence of chronic sinusitis primarily led to the diagnosis of sinugen orbital cellulitis. Despite antibiotic drug administration and surgical drainage of the paranasal sinuses the symptoms persisted. A second computed tomography revealed fusiform, inflammatory enlargement of the m. rectus lateralis. This muscle showed a restrictive paresis so that initially the m. rectus medialis was suspected to be paretic. The patient responded dramatically to administration of prednisolone within 2 days. The differential diagnosis between a sinugen orbital complication and orbital myositis is significant because corticosteroids are contraindicated for orbital cellulitis whereas they remain the therapy of choice for orbital myositis.
HNO 2001 Aug
PMID:[Ocular myositis. A rare differential diagnosis of sinus-induced orbital complications]. 1154 88

The present article concentrates on mechanisms that lead to the excitation of nociceptors in soft tissues and nociceptive neurones in the spinal dorsal horn. These mechanisms may contribute to the so-called unspecific low back pain. Properties of nociceptors in soft tissues: A nociceptive ending in soft tissue contains a multitude of receptor molecules in its membrane. The molecular receptors include binding sites for algesic substances that are released during painful stimulation or pathologic alterations of the tissue: bradykinin (BK), serotonin (5-HT), prostaglandin E2 (PG E2), adenosine triphosphate (ATP) and protons (H(+)). The excitation and sensitisation of nociceptors by these substances can be explained by the binding of the substances to the receptor molecules in the membrane of the receptive ending and ensuing opening of ion channels or activation of metabolic cascades. Purinergic receptor molecules in the membrane of nociceptors are activated by ATP. These receptors may be of particular importance for deep somatic pain, because ATP is present in large amounts in muscle tissue and is released during muscle damage. ATP-sensitive nociceptors appear to be distinct from nociceptors that can be excited by protons. The conduction of nociceptive information from muscle to the spinal cord is partly carried by unmyelinated fibres that possess tetrodotoxin-resistant (TTX-r) Na(+)-channels. Therefore, a drug that specifically blocks TTX-r Na(+)-channels would be a new attractive tool in the treatment of patients with deep somatic pain. Chronic muscle lesions such as a myositis have been shown to be associated with a higher innervation density of the tissue with free nerve endings that contain the neuropeptide substance P (SP). Many of these endings are likely to be nociceptors. Since a painful stimulus that acts on a muscle with increased nociceptor density will excite more nociceptors and elicit more pain, the increase in nociceptor density constitutes a peripheral mechanism for hyperalgesia. In muscle free nerve endings - many of which are nociceptive - the neuropeptides SP, calcitonin gene-related peptide (CGRP) and somatostatin have been shown to be present. These substances are released from the receptive endings in muscle when they are stimulated. SP and CGRP have a strong effect on blood vessels and induce local vasodilatation and oedema. The local oedema in the vicinity of the nociceptor is associated with the release of BK from plasma proteins, which increases the excitability of the nerve ending (see below). Thus, a local vicious cycle forms that may contribute to the formation of trigger points. Sensitisation of nociceptors and peripheral hyperalgesia: Nociceptors are easily sensitised, i.e. following a conditioning stimulus they are more sensitive to the unconditioned stimulus. In animals and humans, the responses to injections of BK can be increased by 5-HT or PG E2. The responses of muscle nociceptors to mechanical stimuli are likewise enhanced after administration of BK. During overuse, ischemia or inflammation of soft tissues, the tissue concentrations of BK, PG E2, and 5-HT are elevated and sensitise muscle nociceptors. A sensitised nociceptor is excited and elicits pain when innocuous mechanical stimuli act on the muscle, e.g. during contractions or stretch. Therefore, in chronically altered soft tissues, weak everyday stimuli are likely to cause pain. Mechanisms at the spinal level: In experiments on rats in which a myositis of the gastrocnemius-soleus (GS) muscle was induced experimentally, the effects of a peripheral painful lesion on the discharge behaviour of sensory dorsal horn neurones were studied. One of the main effects of the myositis was an expansion of the input (target) region of the muscle nerve, i.e. the population of dorsal horn neurones responding to an electrical standard stimulus applied to the GS muscle nerve grew larger. One reason for the myositis-induced expansion of the input region is hyperexcitability of the neurones caused by the release of SP and glutamate from the spinal terminals of muscle afferents with ensuing activation of NMDA channels in dorsal horn neurones (central sensitisation). The central sensitisation is of clinical importance because it can explain the hyperalgesia and spread of pain in patients. In contrast to excitability, the resting activity of dorsal horn neurones - which is likely to induce spontaneous pain in patients - does not appear to depend on the release of SP and glutamate but on the concentration of nitric oxide (NO) in the spinal cord. A pharmacological block of the NO synthesis led to a significant increase in background activity without affecting the excitability of the dorsal horn neurones. Such an increase in background activity was observed exclusively in nociceptive neurones, i.e. a local lack of NO in the spinal cord induces spontaneous pain. According to data from animal experiments, a decrease in the spinal NO concentration occurs as a sequel of a chronic muscle lesion; therefore, a lack of NO is a probable factor for the induction of chronic spontaneous pain. Normally, lesion-induced pain subsides and does not develop into chronic pain. The mechanisms governing the return to normal neuronal behaviour after a peripheral lesion are not well studied. Probably, the activation of inhibitory mechanisms, e.g. increased spinal synthesis of GABA or elevated activity of the descending antinociceptive system contribute to the restoration of normal function. The final step in the transition from acute to chronic pain are structural changes that perpetuate the functional changes. In the rat myositis model, an increase in the number of synapses on the surface of NO-snythesizing cells was present 8 h following induction of the myositis. These data show that structural changes appear quite early in the development of a painful disorder. A novel hypothesis for the development of chronic pain states that a strong nociceptive input to the spinal cord leads to cell death predominantly in inhibitory interneurones. Most of these interneurones are assumed to be tonically active; when their number decreases, the nociceptive neurones are chronically disinhibited and elicit continuous pain also in the absence of a noxious stimulus.
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PMID:[Pathophysiology of low back pain and the transition to the chronic state - experimental data and new concepts]. 1179 44

Myositis proliferans is a rare and benign pseudosarcomatous tumour of soft tissue. In most cases it is found in the region of the shoulder and arm and its occurrence in the region of the neck is described in literature in 16 cases in all. For the ear, nose and throat specialist it is an important differential diagnosis in contrast to malignant tumours. In this report we present the cases of two patients, who were suffering from painful cervical swelling that had been increasing for some days. The problems inherent in the diagnosis of this illness are discussed. Due to its rapid growth the tumour is generally falsely diagnosed and radically removed. Therefore, in appropriate case history, this possibility should be considered and excluded in order to prevent the patient from unnecessary radical operation. In addition to clinical symptoms, imaging and trial excision are suitable.
HNO 2002 Apr
PMID:[Myositis proliferans. Differential cervical space-occupying lesion diagnosis]. 1206 95


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