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)

A computerized statistical analysis of 3,000 implanted electrode (multi-contact, quadripolar) combinations for epidural spinal cord stimulation therapy for the management of pain was carried out in three groups: spinal levels (20 different levels, C2-L2), spinal placement (midline and lateral) and contact separation (unipolar, bipolar with a separation of 10, 20 and 30 mm) to investigate the clinically required usage ranges (difference between the perception threshold and tolerance threshold). The usage range is relatively higher at midthoracic levels (T4-T10), and for the combinations located in midline. As the contact separation increases, the usage range increases in bipolar combinations. The usage range of unipolar combinations is higher than that of bipolar combinations with 10 and 20 mm separation, and is less than that of bipolar combinations having a separation of 30 mm.
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PMID:Analysis of parameters for epidural spinal cord stimulation. 2. Usage ranges resulting from 3,000 combinations. 780 Sep 79

1. The HRP labeled method was used to study the segmental distribution of sympathetic afferent neurons of the heart. 10%-20% HRP 150 microliters solution was injected around the left coronary artery of 18 cats. The HRP labeled cells were observed in the C8-T10 spinal ganglions, therefore the segmental distribution of sympathetic afferent neurons of the heart were in C8-T10 spinal cord. 2. The segmental distribution of cardiac nerve's afferent neurons was studied, 30% HRP 15 microliters was injected into the cardiac nerve of 18 cats. The HRP labeled cells were observed in the C8-T9 spinal ganglions. 3. CB-HRP 10 microliters was injected into the medium and inferior cardiac nerves. The cardiac nerve's fibers project into T1-5 spinal cord, the HRP labeled fibers were observed in III-VII lamina of spinal cord, and there were connections with III, IV, V, VI, VII laminas. 4. The segmental distribution of sympathetic afferent neurons of heart and cardiac nerve, projection of the cardiac nerve the III-VII laminae of spinal cord and the connection of fibers in the III-VII laminae were the morphologic foundations of referred pain and the heart disease. (tachycordia, angina etc.) treated with acupuncture.
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PMID:[The segmental distribution of sympathetic afferent neurons of the heart, cardiac nerve, and projection of the cardiac nerve to the central nervous system]. 792 29

In this prospective, randomized study, 23 patients having spinal anaesthesia for transurethral prostatectomy (TURP) were evaluated for the adequacy of their block using a visual analog pain score (VAPS). Each patient with a "standard" (> or = T10) block level (n = 5) or "intermediate" (L1 or T12) block level (n = 5) found the block adequate. Sixty-two percent (8/13) of patients with a "low" (< or = L3) block level found their block adequate. The VAPS was assessed every five minutes or whenever pain abruptly increased during TURP; an "inadequate block" was defined as a VAPS > or = 5/10 during prostatic resection. Intravesical pressure was monitored and kept < 15 mmHg to distinguish between pain from bladder distension and from prostatic resection. "Low" block patients (LBP) who found their block inadequate (n = 5) received supplemental intrathecal local anaesthetic given through a spinal catheter. The subsequent L1 block level was adequate for TURP. In LBP, who found their block adequate (n = 8), a higher (P < 0.01) VAPS was observed than in patients with a "standard" block level. However, a smaller (P < 0.05) maximum percent decrease in diastolic blood pressure was found in LBPs, than in "intermediate" or "standard" block patients. It is concluded that a spinal block > or = L1 is adequate during TURP when bladder pressure is monitored and kept low. Mid-lumbar block levels should be reserved for patients in whom the benefit of minimizing haemodynamic changes outweighs the risk of a "less complete" anaesthetic.
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PMID:Does a mid-lumbar block level provide adequate anaesthesia for transurethral prostatectomy? 795 98

Chronic scrotal pain is most commonly explained by the radiculitis that is caused by low back strain. The diagnosis is made chiefly by taking a careful history and by excluding other causes. Treatment directed to relieve sensory nerve root irritation at the T10 to L1 levels is often successful.
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PMID:Phantom orchalgia. 796 26

Twenty-six patients undergoing abdominal hysterectomy (ASA 1-2) were entered into a double-blind randomised trial to determine: (a) whether diclofenac given intravenously could influence the effective duration of a continuous epidural infusion of bupivacaine 0.5%, and (b) whether morphine given intravenously altered the height of the regressing block. A block to T4 was established pre-operatively and a continuous infusion of 0.5% bupivacaine 8 ml.h-1 ran for 14 h. Thirteen patients received 50 mg diclofenac intramuscularly before surgery repeated at 4 and 10 h later and 13 patients received saline intramuscularly. The height of blockade and pain scores were measured hourly. Effective block duration was defined as regression to T10 or lower and/or a pain score of 2 or more. At this point 10 mg of morphine was given intravenously and the height of the block reassessed. Duration of blockade was not significantly prolonged (p > 0.05), but pain scores were significantly reduced with diclofenac (p < 0.01). Morphine did not alter blockade height. It is concluded that epidural bupivacaine and diclofenac act additively on postoperative pain.
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PMID:The effect of parenteral diclofenac and morphine on duration and height of blockade of continuous epidural infusion of bupivacaine 0.5%. 804 24

Twenty-three children, aged 8 to 14 years, with postoperative pain, were randomly assigned to receive a fixed 250-mg dose (4.66-7.58 mg/kg) of naproxen as either a liquid suspension or tablet. After an overnight fast, the serum concentrations were measured before and at 0.5, 1, 2, 3, 4, 8, 12, 18, and 24 hours after administration of naproxen. The concentration versus time data were best fit to a one-compartment open model. The area under the concentration versus time curve, apparent volume of distribution (VDss/F), and elimination parameters (CL/F, Ke, elimination half-life) were similar in children who received suspension or tablets. Although the apparent maximum peak plasma concentration (Cmax) was greater in children who received tablets compared with those who received the suspension, Cmax/area under the curve (AUC), apparent time to maximum peak concentration (tmax), Ka, and estimated time to 10%, 50%, and 90% absorption (T10, T50, T90) were not different. The dose range was relatively narrow; hence, direct relationships between dose and elimination parameters, VDss/F, apparent tmax, Ka, T10, T50 or T90 were not observed. Neither VDss/F or CL/F were age related over the relatively narrow range of ages that were studied. Elimination of naproxen in our patients was more rapid than has previously been reported in children or adults, however. From a practical standpoint, naproxen tablets and suspension seem to be bioequivalent in fasting children ages 8 to 14 years.
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PMID:Comparison of the pharmacokinetics of naproxen tablets and suspension in children. 813 49

Sixty-six dogs suffering from intervertebral disk diseases on cervical and/or thoracolumbar disks were treated by a ventral fenestration. The breeds affected with disk diseases were Dachshund (65.1%), Beagle (15.2%), Shih Tsu (4.5%), Pekingese (4.5%), and others (18.2%). Sites suffered from disk diseases and received disk fenestration most frequently were from T10-11 to L2-3. However, other disks were also needed the operation in some cases. An average number of disks received fenestration was 6.0. Days to walk after the fenestration in 51 cases varied 1 to 120 days (average: 14.9 +/- 22.0 days, mean +/- S.D.) depending on their severity. The recovery rates from the follow-up study were as follows: In grade I (3 cases, able to walk with back pain) and grade II (14 cases, slight ataxia and paresis) it was 100%, respectively. The rates in grade III (23 cases, paraplegia with positive deep pain) and grade IV (26 cases, paraplegia with lack of deep pain) were 73.9% and 65.4%, respectively. A few recurrence after the operation were observed in this study. As a result, the ventral fenestration was extremely effective as a treatment for disk diseases in the dog.
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PMID:A retrospective study of ventral fenestration for disk diseases in dogs. 828 31

We report a patient who developed ipsilateral referred pain following unilateral percutaneous cervical cordotomy (PCC). A right-sided PCC was performed on a 44-year-old woman who had been suffering from left groin and thigh pain caused by a fibrosarcoma. PCC produced analgesia below T7 on the left side, and the pain disappeared. A novel spontaneous pain with prominent allodynia occurred postoperatively in the right infraclavicular region (C3-C4). Strong pressure on the left groin where severe spontaneous pain and tenderness had been before PCC increased the new pain, and an epidural block which produced analgesia below T10 relieved the new pain. These facts indicate that the new pain was induced by afferent inputs from the originally painful region.
Pain 1993 Nov
PMID:Ipsilateral referral of pain following cordotomy. 830 15

The optimal surgical approach for thoracic disk herniation is controversial, and long-term follow-up is poorly documented. We retrospectively reviewed the records of 31 patients who underwent surgery for herniated thoracic disks at our institution during a 17-year period (1975-1992). Two patients had multiple disk herniations; 16 of 33 herniated disks occurred at or below the T10-11 level. There were three surgical approaches to diskectomy: laminectomy in four patients, transpedicular surgery in 12, and costotransversectomy in 15. Weakness resolved postsurgery in nine of 18 patients. One patient transiently deteriorated neurologically after a laminectomy, three had wound infections, and two required second operations for their herniated disks. Postsurgery half the patients with symptoms continued to have pain or weakness.
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PMID:Herniated thoracic disks: treatment and outcome. 834 71

Vertebral eosinophilic granuloma is a rare condition frequently associated with vertebra plana. In this paper we present six patients with eosinophilic granuloma of the spine; three were without vertebra plana, which represents a diagnostic problem. The mean follow-up was 9 years, (range 2 to 23) and the mean age was 10.8 years at diagnosis. All complained of pain with no neurological deficit. The lesions were located on the vertebral bodies of C4, T9, T10, L1, L2, and L5, respectively. Histologic confirmation of diagnosis was obtained in all patients, two by puncture and four by open biopsy. The patients with vertebra plana (T10, L1, and L5, respectively) were treated conservatively. Long-term follow-up demonstrated total healing of the vertebral body in two and partial rebuilding 8 years after diagnosis in one. Patients without vertebra plana (C4, T9, and L2, respectively) underwent curettage and bone grafting. In the patient with T9 location, a T8-10 anterior arthrodesis with autogenous rib graft was performed. The outcome was satisfactory in all.
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PMID:Eosinophilic granuloma of the spine with and without vertebra plana: long-term follow-up of six cases. 834 79


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