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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

1. To test the hypothesis that nociceptors of cutaneous veins mediate cold pain, we studied in man the time course of pain intensity and skin sensibility in relation to both intracutaneous and vein wall temperature during cooling of the dorsum of the hand by ice water before and after perivenous and intravenous nerve block. 2. Upon exposure to cold, intracutaneous temperatures fell exponentially (half-life/45-75s) within 10 min to a median of 4 degrees C (range 2-9 degrees C) and returned to baseline with a similar time course during rewarming (half-life/40-85 s). 3. Skin sensitivity to pin prick disappeared and returned at almost the same intracutaneous temperatures (16-26 degrees C). Pain, however, occurred and eve increased when the skin was already numb. 4. Pain occurred during cooling and disappeared during rewarming at vein wall temperatures between 23 and 28 degrees C and its intensity increased to a maximum of 72-100% of visual analogue scale as vein wall temperature decreased to a minimum of 9 degrees C (range 7-10.5 degrees C). 5. the pain intensity-vein wall temperature relations derived from skin cooling with threshold temperature changes between -5.5 and -9 degrees C and slopes between 2.2 and 3.3 were congruent to those derived from intravenous cooling in a previous study to ours. 6. Perivenous and intravenous nerve block, which did not alter the sensitivity of skin and periosteum, relieved cold pain markedly (perivenous block) or completely (intravenous block). 7. These observations are consistent with the hypothesis that nociceptors of cutaneous veins mediate cold pain in humans.
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PMID:The role of nociceptors of cutaneous veins in the mediation of cold pain in man. 152 27

Anterior knee pain is a frequent musculoskeletal complaint affecting all ages, both sexes, athletes, and nonathletes alike. Numerous theories have been proposed regarding its etiology including patellar malalignment, quadriceps insufficiency, subluxation, quadriceps muscle tightness, and chondral defects. However, the mechanism by which these factors produce this pain is not clear. Knowledge of the distribution of nociceptive nerve fibers around the knee would seem to provide insight in treating these painful conditions. Eleven human patellae--eight specimens from patients with degenerative patellofemoral disease and three normals--were evaluated. Immunohistochemical techniques using monoclonal antibody to substance-P were employed to identify nociceptive fibers. Substance-P is a nociceptive neurotransmitter found in afferent nerve fibers. Substance-P fibers were isolated in the retinaculum, fat pad, periosteum, and subchondral plate of patellae affected with degenerative disease. This study demonstrates that selective tracting of nociceptive pain fibers is possible around the knee both in soft tissue and, in some circumstances, bone. The subchondral plate of normal patellae did not demonstrate erosion channels, but those with chondral defects from degenerative disease did. Nociceptive fibers found in these defects may explain the origin of symptoms in some patients. The distribution of substance-P nerve fibers in the soft tissues around the knee suggests that denervation may be the mechanism by which surgical procedures for anterior knee pain produce favorable results.
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PMID:Innervation of the human knee joint by substance-P fibers. 170 91

Solitary hemangioma located in the skeleton of the hand is a rare tumor, very different from diffuse angiomatosis or benign, hemangioma, located in the two distal phalanges of the right fourth finger. Due to articular stiffness, pain, and cosmetic problem, the treatment consisted of central ray resection. The pathological examination revealed a true benign skeletal hemangioma with marked bone resorption of the phalangeal skeleton. The soft tissues ant the periosteum were not involved.
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PMID:[A rare bone tumor of the hand: a solitary cavernous hemangioma. A case report]. 172 Sep 72

A rare case of cranial fasciitis in a 1-year-old boy arising in the temporoparietal bone has been described. In 1990, Lauer and Endinger first reported cranial fasciitis, which is a benign subcutaneous tumor of the head developing from the deep fascia or the cranial periosteum and showing a pathological finding characterized by proliferation of fibroblasts. They described this tumor as "cranial fasciitis of childhood" in view of a high incident in infants and child. Cranial fasciitis grows rapidly in the scalp without pain, but its mean size is 2.5-3cm. Cranial fasciitis is closely related a clinical course and pathological findings to nodular fasciitis, which is also a benign proliferative fibroblast tumor developing from the subcutaneous muscular layers of the trunk and extremities (especially, the forearms), which was reported by Konwaler in 1955. However, cranial fasciitis differs from nodular fasciitis in that it is associated with the skull bone and, in many cases, the tumor destroys the inner and outer table of the skull and adheres to the dura mater. Cranial fasciitis should be considered to be a variant of nodular fasciitis. Neurosurgeons should be aware of this entity in the differential diagnosis of a firm lesion of the scalp in children. A brief review of the literature disclosed only 17 cases in the world. This case report is the first one of cranial fasciitis in Japan.
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PMID:[Cranial fasciitis of childhood]. 179 24

Large segmental bone grafts are a standard of reconstructing long bone defects. Nonunion or delayed union at the host-graft junction is a major complication of these procedures. In six patients, a nonunion was treated by locally available bone, vascularized by its periosteum as an onlay autograft to improve fixation and speed incorporation of the allograft into the host bone. At three months, all were pain free and using their allografts without limitation. By four months, all had roentgenographic evidence of allograft and autograft incorporation. During the follow-up period from two to four years, all have incorporated the allografts and are pain free.
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PMID:The use of periosteally vascularized autografts to augment the fixation of large segmental allografts. 186 28

The distribution and fine structure of these nerve fibres was examined by immunoelectron microscopy. CGRP-immunoreactive fibres were seen in the nerve bundles, blood vessels and periosteum around the condyle as well as in the disc. These nerve fibres were unmyelinated and had diameters varying from 200 to 600 nm. They were completely or partially enclosed by Schwann cell cytoplasm and did not form synaptic contact with any cells. CGRP-immunoreactive nerve fibres may be sensory nature and this peptide could be involved in pain transmission and neurogenic inflammation.
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PMID:Fine structure of calcitonin gene-related peptide-immunoreactive nerve fibres in the rat temporomandibular joint. 209 91

A 33-year-old woman, para 1001, had pain in the inner right thigh and proximal right leg weakness. At surgery a locally invasive, fibrotic lesion was found encircling the right ureter, right internal iliac vein and obturator nerve. It extended to the periosteum of the ilium. The lesion was dissected successfully without damage to vital structures, and endometriosis was confirmed histologically.
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PMID:Endometriosis of the obturator nerve. A case report. 235 40

Twelve patients with non-small cell lung cancer had tumors that were adherent to the vertebral column and clinically suspected of invading the bone. All were free of mediastinal node involvement as assessed by pretreatment mediastinoscopy. All received 3000 rads of preoperative radiation followed by en bloc resection of the lung and a tangential portion of the involved vertebral bodies. A complete mediastinal lymphadenectomy was also performed. Three patients had true Pancoast's syndrome and in the remaining nine the tumor was located above T6 with the majority in the apex of the chest. Resectability was based on the absence of tumor extension into the costotransverse foramen and the extent of vertebral body involvement. Detailed studies of the decalcified surgical specimen show that the tumor extended into the cortex in two patients, periosteum in six, parietal in three, and up to the visceral pleura in one. Six patients are alive after 1 to 11 years (four beyond 5 years) without evidence of recurrent tumor and arthritic pain. The overall 5- and 10-year survival rate (Kaplan-Meier method) was 42%. In patients with tumors adherent to the vertebral body and no evidence of roentgenographic erosion, the en bloc removal of the lung and the involved portion of the vertebral body is required for complete excision and is associated with long-term survival without sequelae.
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PMID:Management of tumor adherent to the vertebral column. 253 46

There are various substances that mediate or modulate pain, but most of the studies have been in human skin or in laboratory animals. It is not known whether the same substances are involved in the pain of bone metastases, and the tentative conclusions made here are by extrapolation and by inference from the effects of drugs whose actions have been characterized. Prostaglandins E2 and I2 cause hyperalgesia to bradykinin and histamine, and they increase oedema formation. Other lipids may also have a similar potentiating role in pain and inflammation. Pain can be sensed from the periosteum, and from within the bone due to increased pressure. NSAIDs act mainly at peripheral sites to inhibit the formation of prostaglandins, and so lessen the hyperalgesia and oedema production, but a central inhibition of prostaglandin synthesis may also contribute to the analgesia. Opioid peptides have important roles in pain, mainly as analgesic substances, but in contrast some may have a role as algesic agents by an action on different receptors. The importance of these and other possible mediators and modulators of pain has not been fully assessed, but advances will be made when selective antagonists of lipoxygenases and kinins become available for use in humans.
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PMID:The role of biochemical mediators in peripheral nociception and bone pain. 289 91

The value of sonography for diagnosis and therapy planning of bone metastases is shown in 110 affected skeletal regions (60 patients with malignant diseases). Whereas sonography is inferior to conventional x-ray in respect of defects of the spongiosa, it is equal with regard to defects of the cortical layer but superior in respect of changes of the periosteum and the surrounding soft tissue. Moreover, there is an excellent correlation (97%) between pain and the reaction of periosteum and soft-tissue layer. Because of the three dimensional representation of the tumourous processes sonography has proved valuable in radiotherapy planning (field size, radiation method, risk organs etc.).
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PMID:[Real-time sonography. An important imaging procedure in the diagnosis and treatment planning of bone metastases]. 302 32


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