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1.
Mod Rheumatol ; 34(3): 439-443, 2024 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-37632764

RESUMEN

Frozen shoulder (FS) is a common disorder characterized by spontaneous onset of shoulder pain accompanied by progressive loss of range-of-motions. The cause of FS is still unclear, and radical therapy has not been established. With the final aim of preventing or curing FS at an earlier stage, we reviewed the pathological and biological features of this disease. Many studies indicate that the main pathology of FS is inflammation initially and fibrosis later. There are inflammatory cytokines, immune cells, fibrotic growth factors, and type-III collagen in the synovium and the joint capsule. The immune cell landscape switches from the macrophages to T cells. Activated fibroblasts seem to regulate the inflammatory and fibrotic processes. The imbalance between matrix metalloproteinases and tissue inhibitors of metalloproteases might promote fibrosis. Additionally, advanced glycation end-products are noted in the FS synovium. Diabetes mellitus and hypothyroidism are closely related to the development of FS. In terms of nonsurgical treatment, oral or intra-articular glucocorticoids are the only drugs that provide early benefit. Some other anti-inflammatory or antifibrotic drugs may potentially control the FS, but have not been proven effective in the clinical setting. Future studies should be targeted to develop steroid-sparing agents that inhibit biological events in FS.


Asunto(s)
Bursitis , Articulación del Hombro , Humanos , Bursitis/tratamiento farmacológico , Bursitis/metabolismo , Citocinas/metabolismo , Inflamación/patología , Fibrosis , Biología , Articulación del Hombro/patología
2.
PLoS One ; 16(7): e0254221, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34214141

RESUMEN

OBJECTIVES: Dry socket and post-extraction pain are typical discomforts experienced by patients after tooth extraction. In this study, we inserted gauze coated with oxytetracycline-hydrocortisone ointment into the extraction socket immediately after lower third molar extraction and then evaluated the occurrence of dry socket and post-extraction pain compared with gauze non-insertion. METHODS: This retrospective study was carried out on patients undergoing lower third molar extraction in the Department of Oral Surgery at Shizuoka Prefectural General Hospital in Shizuoka, Japan from November 2018 to October 2019. A comparison was carried out between a gauze-insertion group and a non-insertion group. The occurrence versus non-occurrence of dry socket was determined, and degree of pain was assessed based on a visual analogue scale (VAS) and on patients reporting the number of loxoprofen sodium oral analgesic tablets (60mg/tablet) that they had taken. Dry socket was defined as patient-reported spontaneous pain that did not subside 1 to 3 days postoperatively. Spontaneous post-extraction pain was recorded four times: on the operative day, on the first postoperative day (POD1), on POD3, and during suture removal (POD7). RESULTS: The occurrence of dry socket was lower in the gauze-insertion group than in the non-insertion group (0.9%, 2/215 vs. 19.6%, 9/46, p<0.001). The results also showed that both VAS-defined pain level and the number of analgesic tablets taken were lower in the gauze-insertion group than in the non-insertion group on POD3 and POD7. CONCLUSIONS AND CLINICAL RELEVANCE: Inserting gauze coated with oxytetracycline-hydrocortisone ointment into the extraction socket immediately after third molar extraction reduces the occurrence of both dry socket and post-extraction pain.


Asunto(s)
Alveolo Seco/tratamiento farmacológico , Hidrocortisona/uso terapéutico , Tercer Molar/efectos de los fármacos , Pomadas/uso terapéutico , Oxitetraciclina/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Adulto , Antibacterianos/uso terapéutico , Atención Odontológica/métodos , Combinación de Medicamentos , Femenino , Humanos , Japón , Masculino , Mandíbula , Estudios Retrospectivos , Extracción Dental/métodos , Diente Impactado/tratamiento farmacológico
3.
J Pain ; 8(7): 588-97, 2007 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-17481957

RESUMEN

UNLABELLED: The present study was undertaken to determine the role of P2X3 receptor (P2X3R) on heat hyperalgesia in a newly developed rat model of trigeminal neuropathic pain. The unilateral infraorbital nerve (IoN) was partially ligated by 6-0 silk. To assess heat sensitivity, a vibrissal pad (VP) was placed on a hot plate and the latency until the rats withdrew their head was measured. Mechanical sensitivity of VP was also assessed by the use of von Frey filament. Both heat and mechanical hyperalgesia were observed at the VP ipsilateral to the IoN ligation. The latency to heat stimuli was prolonged after subcutaneous administration of pyridoxal-phosphate-6-azophenyl-2',4'-disulfonic acid (PPADS, P2X1,2,3,5,7,1/5,2/3R antagonist) and 2',3'-O-(2,4,6-trinitrophenyl) adenosine 5'-triphosphate (TNP-ATP, P2X1,3,2/3,1/5R antagonist). The latency was shortened after administration of alpha,beta-methylene ATP (alpha,beta-meATP, P2X1,3,2/3R agonist), although no changes appeared after administration of beta,gamma-methylene-L-ATP (beta,gamma-me-L-ATP, P2X1R agonist). The protein gene product-9.5 and calcitonin gene-related peptide immunoreactive nerve fibers significantly decreased in the VP skin of ipsilateral to the IoN ligation. In the ipsilateral trigeminal ganglion, the number of P2X3-immunoreactive neurons significantly increased in the small cell group. In this study, we developed an experimental model of trigeminal neuropathic pain by partial ligation of IoN, which produced heat and mechanical hyperalgesia in the VP. Pharmacological and immunohistochemical studies revealed that the P2X3R plays an important role in the heat hyperalgesia observed in this model. PERSPECTIVE: The study describes the development of a novel model of trigeminal neuropathic pain. Heat hyperalgesia in this model was inhibited by peripheral injection of P2XR antagonists. The results suggest that P2X3R is a potential target for development of a novel therapy for trigeminal neuropathic pain.


Asunto(s)
Hiperalgesia/metabolismo , Nociceptores/metabolismo , Receptores Purinérgicos P2/metabolismo , Nervio Trigémino/metabolismo , Neuralgia del Trigémino/metabolismo , Adenosina Trifosfato/análogos & derivados , Adenosina Trifosfato/farmacología , Animales , Péptido Relacionado con Gen de Calcitonina/metabolismo , Modelos Animales de Enfermedad , Hiperalgesia/fisiopatología , Inmunohistoquímica , Ligadura , Masculino , Neuronas Aferentes/efectos de los fármacos , Neuronas Aferentes/metabolismo , Nociceptores/efectos de los fármacos , Nociceptores/fisiopatología , Dimensión del Dolor/efectos de los fármacos , Dimensión del Dolor/métodos , Umbral del Dolor/efectos de los fármacos , Umbral del Dolor/fisiología , Antagonistas del Receptor Purinérgico P2 , Fosfato de Piridoxal/análogos & derivados , Fosfato de Piridoxal/farmacología , Ratas , Ratas Endogámicas Lew , Tiempo de Reacción/efectos de los fármacos , Tiempo de Reacción/fisiología , Receptores Purinérgicos P2X3 , Ganglio del Trigémino/efectos de los fármacos , Ganglio del Trigémino/metabolismo , Nervio Trigémino/fisiopatología , Neuralgia del Trigémino/fisiopatología , Ubiquitina Tiolesterasa/metabolismo
4.
Nihon Hotetsu Shika Gakkai Zasshi ; 51(3): 572-81, 2007 Jul.
Artículo en Japonés | MEDLINE | ID: mdl-17717410

RESUMEN

PURPOSE: The purpose of this study was to analyze the difference in educational effect on students who experienced both lecture-based learning (LBL) and problem-based learning (PBL) in a complete denture course. The analysis focused on differences between the two methods concerning self study, ability to understand clinical inference, and appraisal of class contents and tutors. METHODS: In the complete denture preclinical course, the class of 2003 received LBL in 3rd grade and PBL in 4th grade. PBL was planned to present five cases in five consecutive classes. Group discussion was carried out for each case, and a summary was required to be produced two times as a group, two times as an individual report and one time by group presentation. A questionnaire regarding the educational effect of LBL and PBL and assessment of tutors was administered. Factor analysis was carried out to classify the questionnaire items and each item was analyzed between LBL and PBL (Paired-t test). RESULTS: Factor analysis revealed that the questionnaire items could be classified into four components. Comparing lecture type and PBL: "study attitude" (4 out of 7 items), "clinical inference ability" (all items), "class contents" (5 out of 7 items) and "tutor appraisal" (2 out of 5 items) showed significant assessment with PBL. Eighteen of 27 items (66.6%) indicated the significant usefulness of PBL. CONCLUSION: PBL improves the educational effect of self study and clinical inference ability, in comparison with LBL. However, since students are passive about taking the same system class repeatedly, a strategy to improve their attitude needs to be considered.


Asunto(s)
Dentadura Completa , Educación en Odontología/métodos , Aprendizaje , Aprendizaje Basado en Problemas , Prostodoncia/educación , Encuestas y Cuestionarios
5.
J Pain ; 7(9): 659-70, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16942952

RESUMEN

UNLABELLED: We developed a rat model of oral cancer pain by inoculating cancer cells into the lower gingiva. A squamous cell carcinoma (SCC) derived from Fisher rats, SCC-158, was inoculated into the subperiosteal tissue on the lateral side of the lower gingiva in male Fisher rats. Inoculation of cancer cells induced marked mechanical allodynia and thermal hyperalgesia in the ipsilateral maxillary and mandibular nerve area. Infiltration of the tumor cells into the mandible and the completely encompassed inferior alveolar nerve was observed. Calcitonin gene-related peptide (CGRP)-, substance P (SP)-, ATP receptor (P2X(3))-, and capsaicin receptor (TRPV1)-immunoreactive cells strikingly increased in the small-cell group of trigeminal ganglia (TGs) after tumor cell inoculation. The TRPV1-immunoreactive cells also increased in the medium- and large-cell groups. Retrograde tracing combined with immunofluorescence techniques revealed the increased expression of peptides and the receptors in maxillary nerve afferent neurons. These results suggest that inoculation of SCC cells into the lower gingiva produces mechanical allodynia and thermal hyperalgesia, indicating the establishment of a novel rat model of oral cancer pain. Increased expression of CGRP, SP, P2X(3), and TRPV1 in the TG may be involved in the behavioral changes in this model. PERSPECTIVE: To clarify the mechanisms of oral cancer pain, we examined the expression of calcitonin gene-related peptide, substance P, ATP receptor P2X(3), and capsaicin receptor TRPV1 in trigeminal ganglia. Characterizations of these molecular systems which mediate pain perception are important to develop novel clinical tools for promoting relief of oral cancer pain.


Asunto(s)
Carcinoma de Células Escamosas/complicaciones , Encía/fisiopatología , Hiperalgesia/etiología , Neoplasias de la Boca/complicaciones , Animales , Péptido Relacionado con Gen de Calcitonina/metabolismo , Carcinoma de Células Escamosas/fisiopatología , Línea Celular Tumoral , Modelos Animales de Enfermedad , Encía/inervación , Encía/patología , Calor/efectos adversos , Hiperalgesia/fisiopatología , Inmunohistoquímica , Masculino , Mucosa Bucal/inervación , Mucosa Bucal/patología , Mucosa Bucal/fisiopatología , Neoplasias de la Boca/fisiopatología , Neuronas Aferentes/metabolismo , Nociceptores/metabolismo , Estimulación Física/efectos adversos , Ratas , Ratas Endogámicas F344 , Receptores Purinérgicos P2/metabolismo , Receptores Purinérgicos P2X3 , Sustancia P/metabolismo , Canales Catiónicos TRPV/metabolismo , Ganglio del Trigémino/citología , Ganglio del Trigémino/metabolismo , Nervio Trigémino/metabolismo
6.
Pain ; 116(1-2): 42-51, 2005 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15936887

RESUMEN

The pathophysiological mechanisms of orofacial deep-tissue pain is still unclear. Previously, P2X receptors (P2XR) in sensory neurons have been shown to play a role in the signal transduction of cutaneous pain. We investigated the functional significance of P2X3R in relation to orofacial deep-tissue pain caused by monoarthritis of the temporomandibular joint (TMJ). Monoarthritis was induced by the injection of complete Freund's adjuvant (CFA) into the unilateral TMJ of the rat. The pain associated with monoarthritis was assessed by the pressure pain threshold (PPT), which was defined as the amount of pressure required to induce vocalization. Fifteen days after CFA-treatment, changes in PPT were examined after injection of P2XR agonists or antagonists into the TMJ. The number of cells expressing P2X3R in trigeminal ganglia (TG) was investigated by immunohistochemistry. Inflamed TMJ showed a continuous decline in PPT during the experimental period (P<0.001). Injection of alpha,beta-meATP, an agonist of P2X1,3,2/3R, dramatically reduced the bilateral PPTs of both inflamed and non-inflamed TMJs (P<0.01) although beta,gamma-me-l-ATP, a selective agonist of P2X1R, did not. The decreased PPTs of inflamed TMJ were reversed either by PPADS, an antagonist of P2X1,2,3,5,1/5,4/5R, or by TNP-ATP, an antagonist of P2X1,3,2/3,1/5R. Immunohistochemically, the number of P2X3R-positive cells increased in the small cell group in TG (P<0.01), whereas there was no change in medium or large cell groups after the CFA-injection. Retrograde tracing confirmed that TMJ neurons in the TG exhibited P2X3R immunoreactivity. Our results suggested that P2X3R plays an important role in orofacial pressure pain caused by monoarthritis of TMJ.


Asunto(s)
Artritis/metabolismo , Receptores Purinérgicos P2/metabolismo , Trastornos de la Articulación Temporomandibular/metabolismo , Ganglio del Trigémino/metabolismo , Adenosina Trifosfato/administración & dosificación , Adenosina Trifosfato/análogos & derivados , Adenosina Trifosfato/farmacología , Análisis de Varianza , Animales , Artritis/inducido químicamente , Artritis/complicaciones , Artritis/patología , Recuento de Células/métodos , Interacciones Farmacológicas , Dolor Facial/etiología , Dolor Facial/metabolismo , Dolor Facial/patología , Adyuvante de Freund/efectos adversos , Lateralidad Funcional , Inmunohistoquímica/métodos , Masculino , Neuronas/efectos de los fármacos , Neuronas/metabolismo , Umbral del Dolor/efectos de los fármacos , Umbral del Dolor/fisiología , Agonistas del Receptor Purinérgico P2 , Antagonistas del Receptor Purinérgico P2 , Fosfato de Piridoxal/análogos & derivados , Fosfato de Piridoxal/farmacología , Ratas , Ratas Endogámicas Lew , Receptores Purinérgicos P2X3 , Estilbamidinas/metabolismo , Trastornos de la Articulación Temporomandibular/inducido químicamente , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/patología , Factores de Tiempo , Ganglio del Trigémino/citología , Ganglio del Trigémino/fisiopatología
7.
Pain ; 117(1-2): 19-29, 2005 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16043290

RESUMEN

We developed a mouse model of cancer pain to investigate its underlying mechanisms. SCC-7, squamous cell carcinoma (SCC) derived from C3H mice, was inoculated subcutaneously into either the plantar region or thigh in male C3H/Hej mice. Heat and mechanical sensitivity as well as spontaneous behavior were measured at the plantar surface of the ipsilateral hind paw after the inoculation. Inoculated sites were histologically examined, and the expression of capsaicin receptors (TRPV1) was examined in the dorsal root ganglia (DRG) to clarify their potential contribution to pain sensitivity. Inoculation of cancer cells induced marked heat hyperalgesia and mechanical allodynia in the ipsilateral hind paw for two weeks in both plantar- and thigh-inoculation models. Signs of spontaneous pain, such as lifting, licking and flinching of the paw were also observed. However, further growth of the tumor reversed the mechanical allodynia in both plantar- and thigh-inoculation models, and heat hyperalgesia in thigh-inoculation models. Histologically, no infiltration of the tumor cells into the nerve was observed. TRPV1 immunoreactive cells increased in the L5 DRG on day 7, but returned to the control level on day 15 post-inoculation. Intraperitoneal administration of the competitive TRPV1 antagonist capsazepine inhibited hyperalgesia induced by tumor cell-inoculation in either plantar- or thigh-inoculated animals. This study indicated that inoculation of SCC resulted in spontaneous pain, heat hyperalgesia and mechanical allodynia. The altered expression of TRPV1 in the DRG may be involved in behavioral changes in this model.


Asunto(s)
Capsaicina/análogos & derivados , Modelos Animales de Enfermedad , Hiperalgesia/fisiopatología , Neoplasias/complicaciones , Dolor/etiología , Animales , Temperatura Corporal , Capsaicina/farmacología , Recuento de Células/métodos , Línea Celular Tumoral , Tamaño de la Célula , Relación Dosis-Respuesta a Droga , Ganglios Espinales/patología , Ganglios Espinales/cirugía , Humanos , Inmunohistoquímica/métodos , Masculino , Ratones , Ratones Endogámicos C3H , Trasplante de Neoplasias/métodos , Neoplasias/patología , Dolor/patología , Dimensión del Dolor/métodos , Umbral del Dolor/fisiología , Tiempo de Reacción/efectos de los fármacos , Coloración y Etiquetado/métodos , Canales Catiónicos TRPV/metabolismo , Factores de Tiempo
8.
Radiat Med ; 20(2): 59-67, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12041700

RESUMEN

PURPOSE: To clarify the CT characteristics and histopathological findings of pancreatic ductal adenocarcinomas that are not detected in early-phase contrast-enhanced CT images. MATERIALS AND METHODS: The CT findings of eight patients with histopathologically proven pancreatic carcinomas that were not detected in early-phase images following the rapid injection of contrast material were reviewed. The examinations consisted of pre-contrast-enhanced CT and multi-phase contrast-enhanced CT, with thin-section scanning in each patient. The CT findings were compared with those of the resected specimens. RESULTS: In all cases but one, the lesion was in the pancreatic head. In seven cases, the tumor did not appear as a focal area of hypoattenuation compared with surrounding pancreatic parenchyma in early-phase images, and in the remaining case, small areas of poor enhancement were observed. In late-phase images, hyperattenuated and isoattenuated areas were seen in six and two cases, respectively. In all but one case, the lesion was less than 40 mm in size. All lesions were composed of acinar tissues and tumor cells, and contained small amounts of mucin, necrotic tissue, and pus. The fibrous tissues were not abundant and were interlobular and/or relatively loose. CONCLUSION: Pancreatic ductal adenocarcinomas showing isoattenuation in early-phase images tend to be relatively mild lesions with scirrhous and/or desmoplastic changes.


Asunto(s)
Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/patología , Carcinoma Ductal de Mama/diagnóstico por imagen , Carcinoma Ductal de Mama/patología , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/patología , Tomografía Computarizada por Rayos X/métodos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad
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