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 scientific for the treatment of arthritis with locally applied heat or cold is reviewed. Experimental studies in vitro, in animals, in healthy subjects, and in patients are considered. Results of investigations of the effects of locally applied heat or cold on the deeper tissues of joints and on joint temperature in patients are not consistent. In general, locally applied heat increases and locally applied cold decreases the temperature of the skin, superficial and deeper tissues, and joint cavity. Most studies dealing with the effects of heat and cold on pain, joint stiffness, grip strength, and joint function in inflamed joints report beneficial effects. In vitro studies show that higher temperatures increase the breakdown of articular cartilage and tissues that contain collagen. Therefore, one goal of physical therapy should be to decrease intraarticular temperature in actively inflamed arthritic joints.
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PMID:Treating arthritis with locally applied heat or cold. 783 57

The features and outcome of 21 children (12 boys, nine girls) with idopathic juvenile osteoporosis (IJO) followed for up to 23 yr are described. The mean age of onset was 7 yr (range 1-13 yr) with no sex difference; the main presenting symptoms were long bone fractures, pain in the back and difficulty in walking. Typically, radiographs demonstrated compression of the vertebrae and metaphyses of the long bones; bone histology sometimes showed an excess of osteocytes associated with woven bone; routine biochemistry was normal for age; and with three exceptions no abnormalities of extracted dermal collagen or collagen synthesized by fibroblasts were detected. Where circulating vitamin D metabolites were measured they were within the normal range; and hip and spine bone mineral density (measured by DXA) was strikingly low. Five patients are still growing and two are currently untraceable. Of the remaining 14 who are now adults, 11 have substantially or completely recovered and three are disabled. Since spontaneous recovery occurs it remains impossible to assess the many forms of treatment given.
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PMID:Idiopathic juvenile osteoporosis: experience of twenty-one patients. 788 43

The displacing temporomandibular joint disc presents an enigma. Modern imaging techniques of arthrography, CT, and MRI, as well as arthroscopy show that a displaced or even totally dislocated disc is not necessarily associated with disease, and such a joint can function quite without symptoms. Conversely these techniques, and notably arthroscopy, show that in some cases trauma initiates a cascade of events affecting not only the disc but also synovium, capsule, ligaments, and cartilage. Changes in synovial fluid, alterations in collagen, and associated release of pain-producing substances, cause alteration in joint dynamics. Reversible at early stages, these processes can produce adhesions which alter joint movement, including disc displacement. There is no single cause of disc displacement, but rather the effect of trauma on the interplay between structural, behavioural, and orthopaedic factors. Clinical diagnosis, excluding imaging, is briefly discussed emphasizing the concept of the barrier, and the use of diagnostic manipulation.
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PMID:Aetiology and management of the anterior dislocated disc. The anterior dislocated disc: some considerations of aetiology and clinical diagnosis. 799 47

Angioleiomyoma is a solitary subcutaneous tumor characterized by pain in about half of patients with this tumor, and the pathogenesis of this pain has been a cause of much debate. To clarify the mechanism of pain and cytoskeletal property of tumor cells, 50 angioleiomyomas were studied clinicopathologically and immunohistochemically. The tumors occurred preferentially on the extremities, particularly the lower leg (46%), and the female to male ratio was 1.9:1. They were classified into three histological subtypes: (i) solid (30 cases); (ii) venous (15 cases); and (iii) cavernous (five cases). The pain and/or tenderness were present in 26 out of 49 patients (52%), in which small nerve fibers immunoreactive for S-100 protein and PGP9.5 were identified within the capsule of 20 tumors (77%) and the tumor stroma of 18 (69%), irrespective of the histological subtypes. In 24 patients where the pain was absent or unknown, nerves were observed within the capsule of 19 tumors (79%) and tumor parenchyma of 10 (42%). Many cells in all 50 tumors were positive for alpha-smooth muscle actin, and a relatively large number of cells in many tumors were positive for vimentin, desmin and collagen type IV. Also, cytokeratin (CAM5.2) reactivity was scattered in a few cells of four tumors. From these findings, the peculiar pain of angioleiomyomas could be mediated by the nerve fibers especially located within the tumor parenchyma. Although the expression of intermediate filaments in angioleiomyomas was heterogeneous, the overall cytoskeletal features were of smooth muscle cell differentiation.
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PMID:Mechanism of pain and cytoskeletal properties in angioleiomyomas: an immunohistochemical study. 802 50

Extravascular activation of thrombocytes may contribute to nociceptor excitation and pain, since platelets store and, upon stimulation, release potential algogenic substances such as serotonin, histamine and precursor molecules of bradykinin. To test this hypothesis, a skin-nerve preparation of rat hairy skin, in vitro, was used that allows to record and characterize single afferent nerve fibers. In a first protocol, receptive fields of nociceptive C-fibers, at the corium side of the skin patch, were exposed to adenosine diphosphate (ADP), to heparinized human platelet-rich plasma (PRP) and to PRP activated by ADP. Such activated platelets excited 9/11 units characterized as mechano-heat responsive C-nociceptors (CMH); peak discharges of more than 10 spikes/s were observed. After application of activated PRP, 4/5 high threshold mechanosensitive C-units and 4/5 mechano-cold sensitive C-units became responsive to heat stimulation but only few of these fibers were excited (1/5 in each group). In a second series of experiments the exposure to native PRP was prolonged to test for the effect of spontaneous platelet activation resulting from cutaneous collagen. Prolonged exposure did, but not significantly, enhance fiber discharge. During subsequent exposure to activated PRP, the discharge commenced, on average, after a significant delay of about three minutes. With this protocol 5/7 CMH units were driven by activated platelets. Following both protocols, mechanical (v.Frey) and thermal thresholds of the CMH units were not significantly altered. The findings demonstrate that nociceptors can indeed be driven and sensitized by activated platelets. This pain inducing mechanism may be relevant to certain clinical conditions, and it appears promising to scrutinize the chemical factors involved.
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PMID:Activated human platelets in plasma excite nociceptors in rat skin, in vitro. 804 82

Symptomatic occlusive disease of the subclavian arteries, not associated with thoracic outlet syndrome, is an uncommon problem with a paucity of literature related to the appropriateness of bypass graft selection and long-term patency for revascularization. Between 1985 and 1993, 9 patients (3 men and 6 women) underwent 13 carotid brachial bypasses for chronic severe upper-extremity ischemia. Ages ranged from 47 to 75 years (mean 65). Three patients had documented collagen vascular disease, 1 had radiation arteritis, and 4 had bilateral disease requiring staged arterial reconstruction. Indications for operation included severe exercise-induced ischemia in two limbs (15%), rest pain in eight (62%), and gangrene or infection, or both, in three (23%). Two bypasses were performed for failed prior reconstructions. Inflow originated from the carotid artery (4 proximal and 9 bifurcation), and distal anastomoses were made to a disease-free section of brachial artery. Reinforced 6 mm thin-wall polytetrafluoroethylene (PTFE) grafts were used in all operations. No operative mortality or major upper-extremity amputation was associated with the procedure, although digital amputations were performed in four instances. Follow-up ranged from 4 to 83 months with a mean of 38 months. The 5-year primary patency rate, by life-table analysis, was 92%. Our results showed excellent long-term patency when prosthetic grafts were used for carotid brachial bypass, because of excellent runoff and the relatively short graft length required.
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PMID:Carotid brachial bypass for treating proximal upper-extremity arterial occlusive disease. 805 29

Spinal pain often is thought to be due to degeneration and mechanical failure of the intervertebral disc. Since the mechanical strength of the tissue depends on collagen fibers, the present study was designed to investigate the reactions in collagen metabolism after an experimentally induced disc injury. Five domestic pigs underwent an incision in the anterior part of the annulus fibrosus of disc L4-L5 through a retroperitoneal approach. The animals were killed 3 months postoperatively, and the injured discs and intact discs (controls) from different animals were removed for chemical analysis. Slices were cut from seven different parts across the disc. The concentration of total collagen (hydroxyproline [Hyp]), the activities of the two key enzymes in collagen biosynthesis (prolyl 4-hydroxylase [PH] and galactosylhydroxylysyl glucosyltransferase [GGT]), and the concentration of mature collagen crosslinks (hydroxypyridinium [HP]) were determined. In all experimental discs, the morphology had changed considerably: the nucleus pulposus was small, fibrous, and yellowish. The annular lamellar structure was partially destroyed and had been replaced by granulation tissue in the region of the injury. Large osteophytes had formed at the ventral edges of the vertebral bodies. In the nucleus pulposus, the Hyp concentration and the activities of PH and GGT were significantly increased, whereas the water content had decreased. The concentration of HP crosslinks was decreased in the anterior annulus fibrosus.
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PMID:Collagens in the injured porcine intervertebral disc. 811 47

Textured silicone expanders are alleged to be less painful in the filling process, to have less capsular contracture, and to stay in position better than smooth silicone expanders. To test these three hypotheses, 6 patients undergoing bilateral simultaneous expander implant placement for breast reconstruction after mastectomy were studied. In a double-blind fashion, after smooth and textured implant placement (one in each side) and initial wound healing, each patient was sequentially expanded with equal volumes of saline. In each patient, at each expansion, pressure data, discomfort scores, and implant placement measurements were made. At implant removal, smooth and textured capsule tissues were studied for collagen type content and ability to contract the patient's own fibroblast-populated collagen lattice. In 4 of 6 patients the smooth expander was associated with lower injection pressures and less discomfort. In all patients the expanders maintained their position, except in 1 patient whose smooth implant shifted laterally. The capsular collagen typing and fibroblast-populated collagen lattice studies demonstrated no difference between smooth and textured capsules. In this double-blind clinical study in simultaneous bilateral breast reconstruction patients we could not confirm the suggestion that textured silicone expanders produce less capsular contracture and cause less pain with injection.
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PMID:Smooth versus textured expander implants: a double-blind study of capsule quality and discomfort in simultaneous bilateral breast reconstruction patients. 779 8

The main "shock absorbing" molecule in cartilage is the proteoglycan, aggrecan, which is trapped within a meshwork of collagen fibrils. Articular cartilage damage in osteoarthritis is associated with damage to the aggrecan protein moiety. This results in abnormal loss of aggrecan which in turn increases the propensity of the joint surface to be damaged. Presently, the treatment for arthritis, pain-relieving drugs, affects the symptoms. End-stage osteoarthritis requires joint replacement surgery. To a certain extent, both the degradation and the repair of cartilage can be understood at the level of the biochemistry of cartilage matrix and the biology of the chondrocyte.
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PMID:Cartilage aggrecan. Biosynthesis, degradation and osteoarthritis. 819 77

A randomized, prospective, multicenter study evaluated the efficacy and safety of using collagen shields to deliver drugs after cataract surgery. Collagen shields saturated with an antibiotic and a steroid were placed in 90 eyes postoperatively. A control group of 93 eyes received the same drugs through a peribulbar/retrobulbar injection. One day after surgery, the shield group had significantly less corneal edema, conjunctival hemorrhaging, and postoperative pain and fewer corneal opacities. All symptoms except the conjunctival hemorrhaging disappeared by day seven. Our study suggests that using collagen shields for drug delivery after cataract surgery decreases tissue damage and increases patient comfort without adverse side effects.
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PMID:Use of collagen shields in cataract surgery. 783 90


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