Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The records of 102 patients operated on by one of the authors for Crohn's disease during the past 15 years were reviewed. Twenty-seven patients with confined (abscess present) or free perforation were evaluated. The average age was 31 years and the mean duration of disease was four years. Only two of the 27 patients had had previous surgery. All patients presented with a combination of pain, weight loss, and diarrhea. Twenty-three patients were afebrile, 17 had abdominal tenderness, and 6 had an abdominal mass. The average serum albumin was 3.7, the average hematocrit was 35 per cent and the average WBC was 13,000. Radiologic tests were abnormal in 23 of the 27 patients. All patients had been on medical treatment for Crohn's disease, and 19 of 27 were on high-dose steroids at the time of surgery. Ten of the 27 had a bowel prep before surgery and all had preoperative and postoperative antibiotics. All patients were surgically managed by resection and primary anastomosis without proximal diversion or delayed reconstruction. Drains were used in one third of the patients. Intraoperative cultures revealed gram-negative rods with Escherichia coli, enterococcus, and Enterobacter the most common. One enterocutaneous fistula, two superficial wound infections, and one death were recorded. Based on these results, the authors believe that an aggressive one-stage surgical approach for these complicated problems can be recommended. The low morbidity and mortality justifies this approach that results in considerable improvement in lost work time, length of hospital stay, number of readmissions, and significant cost control.
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PMID:Surgical management of perforated Crohn's disease. 230 51

Plasma and cerebrospinal fluid (CSF) concentrations of indomethacin have been determined in 52 patients hospitalized for nerve-root compression pain. Samples of blood and CSF were collected at the same time in each subject, 0.5 to 12 h after a single intramuscular injection of 50 mg indomethacin. Analgesic effect was assessed by the absolute and percentage variation in Huskisson's visual analogue scale between dosing and sampling. According to its high lipid solubility, indomethacin rapidly crossed the blood-brain barrier, being detected in CSF 0.5 h after administration. After attainment of equilibrium within 2 h, the CSF level exceeded the free plasma level. Since the drug was extensively bound to serum albumin (99.7 +/- 0.1%), this phenomenon may represent a slight degree of binding of indomethacin in CSF. The analgesic activity was not related to either the plasma or CSF concentration of indomethacin.
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PMID:Plasma and cerebrospinal fluid concentrations of indomethacin in humans. Relationship to analgesic activity. 234 58

Esophageal variceal ulcers have been held responsible for most postsclerotherapy complaints. To investigate a possible relation between these ulcers and symptoms, we followed for 4 weeks 40 patients with portal hypertension who had received a single course of intravariceal sclerotherapy. All 40 patients were found to have mucosal variceal ulcers on the day after sclerotherapy. One or more symptoms were given by 26 (65%) patients; dysphagia by 53% (mean duration 4.6 +/- 2.2 days), retrosternal pain by 28% (mean duration 3.0 +/- 2.5 days), and fever by 15% (mean duration 2.1 +/- 0.4 days). A gastric variceal ulcer was responsible for bleeding in one (2.2%) patient. We found no correlation between the occurrence and duration of symptoms and the presence of variceal ulcers. While symptoms were transient, ulcers persisted for several days to weeks in most patients. Patients who had received a higher amount of sclerosant developed larger ulcers (greater than 1 cm) with more symptoms and healing was more delayed than in those who had received lesser amounts and developed smaller ulcers (less than 1 cm). In patients with a serum albumin level greater than 3.0 g/dl, ulcers healed more often than in those with a less than 3.0 g/dl albumin (72 versus 18%, p less than 0.05). Development of mucosal ulcers is a natural consequence of intravariceal sclerotherapy and it appears unrelated to symptoms. The chemical nature and the volume of the injected sclerosant are probably responsible for the symptoms after sclerotherapy. Further, postsclerotherapy ulcers heal spontaneously, more often in patients with good nutritional status.
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PMID:Ulcers after intravariceal sclerotherapy: correlation of symptoms and factors affecting healing. 236 93

Enhanced vascular permeability in tumor tissue has profound pathological consequences in tumor biology. However, details of the mechanism involved are not clear. The present work on tumor vascular permeability has led to the following three findings. (i) Ascitic tumor fluid contained kinin (about 1-40 ng/ml), which is known to enhance vascular permeability and induce pain in vivo. (ii) Kinin is generated via the kallikrein-dependent cascade in the ascitic tumor fluid. By blocking this kinin-generating cascade with Kunitz-type soybean trypsin inhibitor the formation of ascites was suppressed. (iii) Blocking of kinin-degrading enzymes (kininases I and II) by an appropriate kininase inhibitor (e.g., captopril) may result in increased permeability, leading to accumulation of the ascitic fluid. This phenomenon was verified by an about 1.2-1.5 fold increase in leakage of 51Cr-labeled bovine serum albumin into the ascites when kininase inhibitors had been administered orally 30 min before intravenous administration of the bovine serum albumin.
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PMID:Involvement of the kinin-generating cascade in enhanced vascular permeability in tumor tissue. 314 3

Twenty-four otherwise healthy patients scheduled for elective major abdominal surgery received general anaesthesia plus lumbar extradural analgesia. A loading dose of 0.5% plain bupivacaine was given to produce sensory analgesia (pin prick) from T4 to S5 and followed by a continuous infusion of 0.5% plain bupivacaine 8 ml h-1. Pain, scored on a 5-point scale, and sensory analgesia were assessed hourly for 16 h after skin incision. If sensory analgesia decreased by more than 5 segments from its preoperative level, or if the pain score reached 2 (moderate pain), the patients were removed from the study, and pain was treated otherwise. Only three patients maintained their initial levels of sensory analgesia and a pain score of less than 2. In the remaining patients sensory analgesia decreased at least 5 segments or pain score reached 2 between 4 and 16 h after skin incision. We found a weak correlation between increasing age and the duration of sensory analgesia (r = 0.46, P less than 0.05), but no significant correlations between duration of sensory analgesia and sex, weight, height, body surface area, serum albumin concentration, duration or site of operation.
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PMID:Unpredictability of regression of analgesia during the continuous postoperative extradural infusion of bupivacaine. 337 27

It has recently been demonstrated that prostaglandins (PGs) play an important role in the ovulation, the onset of menstruation and labor pain and other reproductive phenomena. The purpose of this study is to develop the enzyme immunoassay (EIA) for PGF2 alpha to estimate the PGF2 alpha level in body fluids. beta-Galactosidase-PGF2 alpha conjugate and bovine serum albumin-PGF2 alpha conjugate were prepared by a mixed anhydride method. PGF2 alpha was extracted with ethylacetate from an acidified sample. EIA was carried out using a double antibody method. As for the conjugation ratio of PGF2 alpha and beta-Galactosidase, 5, 10, 20, 40 and 80 were examined. Recovered enzyme activity and sensitivity of the method were better in the enzyme of conjugation ratio 10 than in the other conjugation ratios, 5, 20, 40, 80. Values measured by RIA and EIA were well correlated. The correlation rate was 0.84. The recovery rate was 102.3%. The sensitivity of the standard curve was 5-100 pg/tube. PGF2 alpha in the menstrual blood of the 18 women was determined with the EIA method. The mean value for PGF2 alpha in menstrual blood is 20.9 ng/ml (S.D. = 11.4).
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PMID:[The development of enzyme immunoassay for prostaglandin F2 alpha]. 354 38

The analgesic effect of topically applied pranoprofen-gel (1% and 3%) was investigated in comparison with indomethacin-gel in experimental animals. Applied topically, 1% and 3% pranoprofen-gel inhibited the inflammatory pain induced by Randall and Selitto's method and the pain response (abnormal gait) of concanavalin A-induced arthritis in rats dose-dependently. Furthermore, in antigen (methylated bovine serum albumin)-induced arthritis in rats, pranoprofen-gel had a concentration and application-dependent therapeutic effect on knee joint swelling and the pain response. Pranoprofen-gel had a stronger analgesic effect than indomethacin-gel in these experimental models. Both drugs inhibited the flexor reflexes of the hind limb induced by injecting bradykinin (BK) in combination with arachidonic acid into the common iliac artery of the spinal rat, but failed to do so with BK combined with prostaglandin E2 (PGE2). Moreover, pranoprofen-gel inhibited the BK-induced increase in the firing rate of the saphenous nerve of the spinal cat. These results show that pranoprofen-gel, applied topically, permeates well from the skin to the nociceptor site, relieving the hyperalgesia caused by PGs-induced sensitization of pain receptors by inhibiting their production. As a topical anti-inflammatory and analgesic agent, pranoprofen-gel is at least as effective as indomethacin-gel, so that it should have good clinical potential.
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PMID:[Analgesic effect of topically applied pranoprofen-gel]. 387 32

Intra-arterial chemotherapy of pelvic tumors may be complicated by coincident flow to the buttocks. Transcatheter occlusion of both the superior and inferior gluteal arteries may have a role in directing the flow of chemotherapeutic agents away from the buttocks and toward the true pelvis. The results of flow studies using technetium-99m-labeled macroaggregated human serum albumin were compared in 12 consecutive patients examined before and after transcatheter arterial occlusion, and the best results were obtained by selective occlusion of those arteries that demonstrated increased flow to the buttock on the initial study. Without the preselection of patients in whom the initial flow went mainly to the buttock, the results were inconsistent. Because of the increase in the procedure time and the occurrence of minor complications, such as local pain during or after the occlusion procedure, in all patients, proper patient selection is important.
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PMID:Gluteal artery occlusion: intra-arterial chemotherapy of pelvic neoplasms. 398 83

Strictureplasty recently has been advocated in the treatment of obstructive strictures of the small bowel in patients with Crohn's disease. In contrast to conventional methods of treatment, such as conservative therapy with total parenteral nutrition (TPN) or surgical resection of the involved bowel, strictureplasty eliminates the obstruction without loss of small bowel. The possibility of creating a short-bowel syndrome is of special concern in patients with diffuse Crohn's jejunoileitis. These patients usually present for surgery with chronic obstruction, anemia, weight loss, and malnutrition with folate and other vitamin deficiencies. The authors report the results of 12 strictureplasties for extensive Crohn's jejunoileitis in three patients presenting with chronic obstruction secondary to multiple small-bowel strictures. Both Heineke-Mikulicz and Finney strictureplasties were performed. In two patients, resection of an acutely inflamed phlegmonous segment was also performed. Symptoms (pain, abdominal distention, and nausea) were markedly improved postoperatively in all patients. Nutritional parameters, including serum albumin and total lymphocyte count, improved postoperatively. Dramatic rises in weight were noted also. All three patients were symptom-free six months postoperatively.
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PMID:Strictureplasty in diffuse Crohn's jejunoileitis. 401 13

A consecutive series of 14 patients with hepatic malignant disease treated by palliative hepatic arterial embolisation was reviewed. Twelve patients had hepatic pain from their tumour and two were suffering from the carcinoid syndrome. Six patients died within four weeks of the procedure (group 1) and eight survived for at least 10 weeks (group 2). Factors were sought that might permit prediction of a high risk of early death (group 1). The pre-embolisation angiograms reviewed by a "blind" observer showed no differences in vascularity or tumour size between the groups and no difference in the extent of arterial occlusion after embolisation. The portal vein was patent in all patients. No significant difference was seen between the groups in the pre-embolisation biochemical values, with the exception of lower serum albumin concentrations and higher alkaline phosphatase activities in group 1. All those who died early had serum alkaline phosphatase activities of 45 KAU or above, while six of the eight who survived longer had activities below this value (p less than 0.02). These findings suggest that serum alkaline phosphatase activity of 45 KAU or more (normal range 3-13) might alone be a useful predictor of early death. Stepwise discriminant analysis using a weighted combination of serum alkaline phosphatase activity and albumin concentration predicted the outcome in all but one of the patients studied (p less than 0.002).
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PMID:Prediction of early death after therapeutic hepatic arterial embolisation. 620 Dec 26


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