Journal of Nippon Medical School = Nippon Ika Daigaku zasshi
-
Lumbar spinal canal stenosis (LSCS) was first described in 1954 by Verbiest, followed by the currently accepted international classification of LSCS in 1976 by Arnoldi. Briefly, LSCS is a nervous system syndrome that is characterized by neural symptoms in the lower extremities due to tightened cauda equina and spinal nerve root involvement. LSCS international classification consists of: (1) degenerative, (2) congenital developmental, (3) combined, (4) spondylolytic spondylolisthesis, (5) iatrogenic and (6) post traumatic stenosis. ⋯ LSCS patients may also report dysaesthesia in the perineum area, and may also report urinary dysfunction ranging from extreme urgency to urinary delay. Patients who present with symptoms of LSCS should be seen by an orthopedic surgeon. Correct diagnosis by imaging and clinical examination, with appropriate conservative or operative treatment in a timely fashion should be encouraged in order to prevent irreversible nerve damage.
-
The effects of pain stimulant and transcutaneous electrical nerve stimulation (TENS) on changes in substance P (SP) levels were investigated in the dorsal root ganglion (DRG) and dorsal horn of the spinal cord of Sprague-Dawley rats. The rats were divided into three groups: control, formalin stimulation and formalin+TENS. In all rats, the right sciatic nerve was attached to a hook electrode for recording, and the right lower leg was connected to a ring electrode. ⋯ Using an NIH image, the SP grains in the nerve ends, which were seen as dark brown stains on the Rexed laminae I and II in the dorsal horn of the spinal cord, were counted within a 450 micrometer (2) area. The results showed that SP-LI levels of both the DRG and the dorsal horn of the spinal cord in the formalin+TENS group were significantly reduced as compared with formalin stimulation group. Based on the fact that SP is a nociceptive neurotransmitter, the present study suggests that TENS reduces production of SP in the DRG, and shows analgesic effects by suppressing nociception via C-fiber in the peripheral nerves.
-
The effect of neoadjuvant hormonal therapy (NHT) prior to radical prostatectomy (RP) on pathological downstaging of prostate cancer and biochemical relapse of serum prostate specific antigen (PSA) level was evaluated. ⋯ A significant decrease in the rate of penetration could be observed after NHT, though it was not so effective for pathological downstaging, and changes in the preoperative PSA level did not predict those patients who might have a favorable result.
-
Two male cleaning workers aged 62 (patient 1) and 28-(patient 2) presented with red, swollen, aching hands and fingers. At the first interview, the fingers of the right hand of both patients were swollen from the proximal interphalangeal joint to the tip of the finger. The fingers were red and intensely painful. ⋯ Had the words "poison" and "hydrogen fluoride" been printed in large characters, the examining doctors in the emergency ward would probably not have overlooked the presence of hydrofluoric acid, and the patients would perhaps have been more careful when using it. Hydrofluoric acid can be easily obtained by anyone through the Internet, although general consumers could not obtain industrial quantities. Therefore, the number of burn patients who are not familiar with hydrofluoric acid may increase in the future.
-
Overproduction of nitric oxide (NO) by inducible NO synthase (iNOS) plays a role in the pathophysiology of septic shock. The depression of cardiac contractility in such situations is mediated by proinflammatory cytokines, including interleukin-1beta (IL-1beta), and tumor necrosis factor-alpha (TNF-alpha). The effects of two NOS inhibitors with different isoform selectivity were compared in isolated working rat hearts. ⋯ In contrast, when L-NAME was administered in the absence of IL-1beta and TNF-alpha, it depressed contractility over the 2h perfusion period by significantly reducing coronary flow. These results support current thinking that the depression of myocardial function by IL-1beta and TNF-alpha is mediated, at least in part, by an intracardiac increase in inducible nitric oxide synthase, and that in contrast to L-NAME, the decline in coronary conductance seen in cytokine-treated is not prevented by L-canavanine hearts. L-canavanine shows selective inhibition of inducible nitric oxide synthase unlike the vasopressor action of L-NAME in cytokine-treated hearts.