Glucosamine sulfate reduces experimental osteoarthritis and nociception in rats: association with changes of mitogen-activated protein kinase in chondrocytes.

OBJECTIVE: To study the effects of oral glucosamine sulfate on the development of osteoarthritis (OA) and to examine concomitant changes in the nociceptive behavior of rats. METHODS: OA was induced in Wistar rats by anterior cruciate ligament transection (ACLT) of the right knee; the left knee was untreated. The OA+glucosamine group received oral glucosamine sulfate (250 mg/kg/day) in a 2-g wafer once a day for 10 consecutive weeks starting at week 5 after ACLT. The OA group was treated as above with 2-g wafers (placebo). The control group of naïve rats received 2-g wafers only. The glucosamine alone group comprised naïve rats receiving glucosamine sulfate only. Nociceptive behavior (mechanical allodynia and weight-bearing distribution of hind paws) during OA development was analyzed pre- and 3, 6, 9, 12, 15, and 18 weeks post-ACLT. Macroscopic and histologic studies were then performed on the cartilage and synovia. Immunohistochemical analysis was performed to examine the effect of glucosamine on expression of mitogen-activated protein kinases (MAPKs) in the articular cartilage chondrocytes. RESULTS: OA rats receiving glucosamine showed a significantly lower degree of cartilage degeneration than the rats receiving placebo. Glucosamine treatment also suppressed synovitis. Mechanical allodynia and weight-bearing distribution studies showed significant improvement in the OA+glucosamine group as compared to the OA group. Moreover, glucosamine attenuated p38 and c-Jun N-terminal kinase (JNK) but increased extracellular signal-regulated kinase 1/2 (ERK) expression in OA-affected cartilage. CONCLUSION: Our results indicate that treatment with oral glucosamine sulfate in a rat OA model (1) attenuates the development of OA, (2) concomitantly reduces nociception, and (3) modulates chondrocyte metabolism, possibly through inhibition of cell p38 and JNK and increase of ERK expression.

Comparison of the incidence of postpartum low back pain in natural childbirth and cesarean section with spinal anesthesia.

BACKGROUND: Many parturients and their obstetricians believe that spinal anesthesia will cause low back pain (LBP). MATERIALS & METHODS: We studied prospectively a total of 160 parturients; 80 of them had cesarean section (CS) with spinal anesthesia and another 80 who had natural childbirth. Incidence of LBP was investigated and compared in these patients before pregnancy, during pregnancy and postpartum. RESULTS: Our result showed that before pregnancy, about one third (33.1%) of the parturients already had LBP and the incidence of LBP seemed to increase during pregnancy. The incidence of LBP decreased gradually postpartum. There was no difference in the incidence of postpartum LBP between the CS with spinal anesthesia group and the natural childbirth group. CONCLUSIONS: We concluded that postpartum LBP could be related to changes during pregnancy and not related to spinal anesthesia.

The effect of warm irrigating fluids on the incidence of shivering during transurethral resection of the prostate (TURP).

Twenty-four unpremedicated patients of ASA class II or III undergoing TURP were given esia with 10 mg of tetracaine at level L3-4 or L4-5. These patients were randomly given "warm" or "ambient temperature" irrigating fluids. Those with irrigating fluids of temperature between 25.5 degrees C and 33 degrees C were arranged as Group 1 and those of temperature between 21.5 and 23 degrees C as Group 2. The results failed to show that the incidence of shivering could be decreased by the use of warm irrigating fluids.