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)

Changes in the peripheral blood leucocyte count, lymphocyte subpopulations, and in 'in vitro' responses of lymphocytes to phytohaemagglutinin and tuberculin after induced labour were investigated in 10 normal parturients and their newborns. Every other parturient was given segmental epidural analgesia at level T 10-12 for pain relief during the first stage of labour. The remaining mothers served as controls. The results of blood samples taken from the mothers before induction of labour and from the newborns immediately after delivery served as basal values against which the results of samples drawn on the 1st and on the 5th day following delivery were compared. A significant (p less than 0.05) increase from the basal values in the total leucocyte count after delivery was found only in those mothers not given epidural analgesia and in their newborns. Similarly, a significant (p less than 0.01) decrease in the T cell count characterized by both E rosette formation and acid alpha-naphthyl acetate esterase staining was found in the peripheral blood only in the mothers (but not the newborns) without epidural analgesia. The differences between the research groups were not, however, significant. The lymphocyte response to phytohaemagglutinin on the 1st and on the 5th day after delivery was also significantly (p less than 0.05) lower in the newborns of the mothers not given epidural analgesia than in those of the mothers given it. The present results show that the depression induced by the stress of parturition in some parameters of cell-mediated immunity of mothers and newborns can be at least partly prevented by using segmental epidural analgesia.
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PMID:Effect of segmental epidural analgesia on changes in peripheral blood leucocyte counts, lymphocyte subpopulations, and in vitro transformation in healthy parturients and their newborns. 660 64

Forty cases of ovarian lymphoma and two of extramedullary leukemia were examined with emphasis on histologic types correlated with age, modes of presentation, operative findings, including frequency of bilaterality and omental spread, clinical course following therapy, and problems in differential diagnosis. Although most cases were referred with diagnoses other than lymphoma (granulosa cell tumor or dysgerminoma, occasionally anaplastic tumor, Krukenberg tumor, or metastatic breast carcinoma), utilization of sections cut at 4 mu and stained with hematoxylin and eosin, or sections stained by the methyl green pyronine (MGP), naphthol-ASD esterase (NASD) or periodic acid-Schiff (PAS) methods helped bring out the lymphoid or hematopoietic nature of the cells. Sixteen patients were under 20 years of age. They had small noncleaved cell lymphoma (undifferentiated Burkitt's and non-Burkitt's, 10 cases), diffuse immunoblastic large cell lymphoma (4 cases), or acute granulocytic leukemia (2 cases). Twenty-six patients were 29 to 74 years of age and had diffuse large cell lymphoma (10 cases), diffuse immunoblastic large cell lymphoma (9 cases), follicular (nodular) lymphoma (6 cases) or small noncleaved cell lymphoma (1 case). Pain with an abdominal or pelvic mass was the most common presentation. Nine tumors were discovered during investigation of other gynecologic complaints. At laparotomy, the tumors in 55% of cases involved both ovaries, and in 64% also involved extragonadal sites (usually omentum, fallopian tubes, or lymph nodes). Seventeen patients had tumor affecting one ovary, seven of these without any evidence of extragonadal spread. Forty-two percent (15) of 37 patients with follow-up were alive after 2 years. Only nine patients survived more than 5 years; two subsequently died of lymphoma. Favorable prognostic features included: (1) FIGO stage IA; (2) unilateral ovarian involvement; (3) focal involvement of one ovary; and (4) follicular (nodular) lymphoma.
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PMID:Lymphomas or leukemia presenting as ovarian tumors. An analysis of 42 cases. 662 8

In 11 patients with Horton's headache morphological investigations (differential white blood cell count), cytoenzymatic determinations (alkaline and acid phosphatase, non-specific esterase) and cytoimmunological tests (IgM and IgG binding) were carried out on capillary blood neutrophils obtained from the area of pain, non-painful area of the skin on the head on the contralateral side, and from the finger. The observed changes suggest an active participation of neutrophils in the pathological mechanism of Horton's headache and anaphylactoidal background of the disease.
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PMID:[Cytoenzymatic and cytoimmunological changes in capillary blood neutrophils of patients with Horton's headache]. 745 19

Chemonucleolysis is a therapeutic procedure whereby a degradative enzyme is injected intradiscally to reduce disc height/width by depolymerisation of extracellular matrix components. This process is considered to diminish disc pressure on inflamed nerve roots, resulting in the alleviation of sciatic pain. In the present study two krill (Euphasia superba) enzyme preparations, a proteinase and an esterase preparation, were evaluated for their potential as chemonucleolytic agents. Initially, their ability to degrade several protein (azocoll, casein, proteoglycans, PGs) and peptide (CBZ-arg-4-nitroanilide, CBZ-lys-thiobenzyl ester) substrates was assessed in vitro. The krill proteinase preparation rapidly converted azocoll, casein and PGs to small peptides. Furthermore, when this degradative enzyme preparation was evaluated in vivo, a relatively low intradiscal dose (0.54 mg/disc) was found to reduce intervertebral disc widths in beagles to 48% +/- 10.5% (mean +/- SEM) of their pre-injection values within 2 weeks of administration. Moreover, the discs injected with this proteinase had reconstituted up to 80% +/- 9% (mean +/- SEM) of their pre-injection widths at the termination of the experiment (32 weeks). These data suggest that the krill protease preparation has potential as a chemonucleolytic agent which would allow disc matrix reconstitution. Conversely, the krill esterase preparation also degraded PGs, but into relatively large fragments. This limited digestion of PGs indicates that the krill esterase would be a less effective chemonucleolytic agent than the corresponding proteinase.
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PMID:Evaluation of digestive proteinases from the Antarctic krill Euphasia superba as potential chemonucleolytic agents. In vitro and in vivo studies. 761 35

In this study the effects of total saponins of Panax notoginseng (TSPN) and electroacupuncture (EA) were compared. Liquid paraffin was intraperitoneally injected (0.1 ml/mouse) to establish the animal model with inflammation. The mice were randomly divided into 4 groups with different treatments for 7 days: EA group, TSPN group (100 mg.kg intraperitoneal administration), Naloxone (Nx) plus TSPN group and EA plus TSPN group. The pain threshold was measured by a detector (EQ-9E) and the nitroblue tetrazolium test (NBT) for polymorphonuclear neutrophil (PMN) bacteriocidal activity and the alpha-naphthyl acetate esterase (ANAE) histochemical staining for detection of the focal pattern lymphocyte subpopulation and the toluidine blue histochemical staining for detection of degranulation rate peritoneal mast cells were performed. The results showed that in TSPN, EA and EA plus TSPN group the pain threshold was elevated significantly, the enumeration of NBT positive PMN and the ANAE-F lymphocyte subpopulation was enhanced. All the above effects could be partially inhibited by naloxone. Between TSPN group and Nx group the degranulation rate of peritoneal mast cells had no significant difference. Since the TSPN and EA have similar effects e.g. anti-inflammatory, analgesic and immunomodulatory action, it suggested that the TSPN might be somewhat agonist of the opioid like peptide receptor without addiction side reactions.
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PMID:[Effects and mechanism of total saponins of Panax Notoginseng on anti-inflammation and analgesia]. 804

Current trends toward outpatient surgery and closed loop computer controlled drug administration have created a demand for short acting anaesthetic agents. Such agents not only provide the anaesthetist with rapid patient recovery after completion of the procedure, but also with almost immediate intra-operative control over the anaesthetic state of the patient. Shorter acting anaesthetic agents are being developed in several therapeutic areas including volatile anaesthetics, neuromuscular blockers as well as injectable anaesthetics. In the injectable anaesthetic area, propofol has been introduced and offers some significant advantages over the previously existing induction agents. Remifentanil is a novel member in the family of the 4-anilidopiperidine opioid analgesics which also include the traditional agents fentanyl, alfentanil, and sufentanil. Remifentanil undergoes widespread extrahepatic metabolism by blood and tissue nonspecific esterases, resulting in an extremely rapid clearance. Because of its unique metabolic pathway among this group of drugs, remifentanil represents a new pharmacokinetic class of opioids which is named esterase metabolised opioid (EMO). Rapid biotransformation to minimally active metabolites results in short and predictable duration of action with no accumulation of effect on repeated dosing or with continuous infusion. Clinical experiences presented so far indicate that remifentanil can be safely administered in different anaesthetic regimens as well as in the great variety of patients including children and patients with renal, hepatic or cardiovascular diseases. However, its use also presents the anaesthetist with a significant challenge. If remifentanil is the only opioid analgesic administered during anaesthesia, it must be remembered that shortly after the end of the surgical procedure, the patient will not benefit from opioid-based analgesia. This problem must be addressed if remifentanil is to be used for procedures associated with significant postoperative pain. Reducing the infusion rate of remifentanil to analgesic doses suitable for the postoperative pain management or immediate administration of longer acting opioids at the end of anaesthesia might solve this problem. At present it is difficult to predict precisely the future ranking of remifentanil. However, the unique pharmacokinetic profile of remifentanil should make it useful in the various surgical settings and in all circumstances where precise control over the analgesic state are desirable.
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PMID:[Is remifentanil an ideal opioid for anesthesiologic management in the 21st century?]. 908 16

We compared Remifentanil, an esterase-metabolized opioid, with Alfentanil as part of the total intravenous anesthesia with propofol and atracurium for out-patient laparoscopic gynaecological procedures in a multicenter randomized, double-blind study. We chose Remifentanil 1 mg./kg.for bolus injection and a continuous infusion of 0.25-0.5 microg./kg./min, compared to Alfentanil 20 microg./kg. For bolus injection and a continuous infusion of 0.5-1 microg./kg./min. Fifty-nine patients received Remifentanil, and sixty-three received Alfentanil. Patients who received Remifetanil experienced significantly fewer stress responses to surgical stimuli (p < 0.05) and required fewer additional boluses of study drugs and propofol (p < 0.05) than Alfentanil during the intraoperative period. Response time to verbal commands, spontaneous respiration, adequate respiration and tracheal extubation, were not significantly different between these two opioids. Remifentanil patients, required more fentanyl for post operative pain control, 40 from 59 cases in the Remifentanil group and 22 from 63 cases in the Alfentanil group (p < 0.05) but still showed significantly better recovery of psychomotor function by Aldrete score of ten at 50 and 60 min (p < 0.05) than Alfentanil patients. The incidence of intraoperative bradycardia was significantly higher with Remifentanil. Other incidences of nausea, emesis, urinary retention and postural hypotension were similar. All patients were ready to be discharged from the hospital within two hours after extubation except for one patient in the Alfentanil group who needed five hours of hospital stay because of urinary retention, nausea and severe emesis.
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PMID:A multicenter randomized double-blind comparison of remifentanil and alfentanil during total intravenous anaesthesia for out-patient laparoscopic gynaecological procedures. 1121 62

A 75-year-old man was admitted because of right knee joint pain in December 1999. He had suffered from acute myelocytic leukemia (AML: M0) in November 1994 and achieved the first complete remission (CR) then. His AML relapsed in August 1996, but fortunately he achieved a second CR. Radiographical bone examination revealed osteolytic lesions in his right knee and bone scintigraphy showed uptake in the right knee and the middle part of the left femur. MRI also revealed a low attenuation signal in the left femur. He had no abnormal findings in peripheral blood or bone marrow. Histological examination of the biopsied bone tissue showed a diffuse proliferation of round cells with medium-sized or large nuclei. These cells were histochemistrically negative for myeloperoxidase and naphtol-ASD-chloroacetate esterase, and were also negative for lysozyme, cytokeratin 7, 9, 20, EMA, CEA, CD3, CD79a on immunohistochemistry, but were positive for CD43, CD56. In immunophenotypic analysis of these cells by flow cytometry, CD7, CD13, CD33, CD41, CD56 were revealed to be strongly positive. On the basis of these findings we diagnosed these tumors as granulocytic sarcomas (GS), extramedullary recurrence of AML M7. Although radiation (36Gy) to these tumors brought a temporary relief of the pain, he died of systemic relapse of AML in February 2001. When presented CD7+ AML M0 had been diagnosed, but GS cells were also positive for CD 56 and CD41. Although CD56 had not been examined initially, he might have been had myeloid/NK cell precursor acute leukemia and CD41 might be acquired later in the course of the disease. It is known that AML M0, M7 and myeloid/NK cell precursor acute leukemia have poor prognoses, nevertheless he survived for 6 years. It may be that intensive and repeated chemotherapy for AML can obtain excellent outcome in the elderly cases in good systemic condition and with favourable prognostic factors.
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PMID:[Acute myelocytic leukemia (M0) in an elderly patient with relapsed granulocytic sarcoma (M7) of bone during the second period of complete remission 5 years after onset]. 1270 54

In a prospective study, from September 2000 to September 2001, all ureteroscopies ( n=140) were performed under local and intravenous patient controlled analgesia using continuous infusion of remifentanil (Ultiva). The dosage of 0.15 micro g/kg/min was adapted to changing intraoperative pain (range 0.08-0.30 micro g/kg/min). Preoperative sedation with midazolam 2 mg was given 5 min prior to ureteroscopy. The efficacy of monitored anesthesia care ("Big MAC") was quantified by the patient using a visual analogue pain scale. A total of 97.1% (136/140) of the procedures were performed and finished under remifentanil. Only four male patients underwent conversion to general anesthesia due to insufficient analgesia. All but one patient would choose remifentanil again for first line anesthesia. Significant differences in pain scale values were noticed for male/female patients and ureteroscopies above/below the iliac vessel crossing. Side effects were rare being mainly hypoxic events (pO(2)<90% in 5.1%). Indication, intraoperative procedure, average surgery time (24 min), complications and primary success rate (96.6/90/63.3% stone free for distal/mid/proximal ureter, respectively) did not differ from the control group under general anesthesia. Ureteroscopies with remifentanil are safe, universally applicable because of refifentanil's organ independent esterase metabolism and as effective as general anesthesia. There is no need for PACU stay for patients due to the ultra-short drug half-life, and therefore remifentanil is cost effective and perfect in an outpatient setting.
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PMID:[Ureteroscopy under intravenous analgesia with remifentanil]. 1510 11

Angioneurotic oedema is a rare disease caused by Cl esterase inhibitor deficiency. Hereditary angioneurotic oedema includes type I (quantitative and functional) deficiency and type 11 (functional) deficiency. Its prophylactic treatment during pregnancy, based on danazol therapy if the fetus is male, may avoid acute attacks of generalized or laryngeal oedema. It must be instituted before delivery and carried into the postpartum period. If the fetus is female, epsilon aminocaproic acid may be used. The acquired form of angioneurotic oedema can be due to antibodies to C1 esterase inhibitor. A prophylactic therapy is not well established, but high doses of corticosteroids are recommended. Operative delivery is best avoided when possible. Regional analgesia is indicated for labour or caesarean section to prevent pain and stress and to avoid the difficulties associated with laryngeal oedema and tracheal intubation. In the treatment of an acute attack, Cl esterase inhibitor concentrates (1500 units) may be given i.v. We present two cases, one of hereditary and one of acquired angioneurotic oedema, both presenting during pregnancy and both delivered vaginally under epidural analgesia with successful outcome.
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PMID:Parturition and angioneurotic oedema. 1532 Nov 58


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