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1.
J Med Case Rep ; 13(1): 339, 2019 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-31747964

RESUMO

BACKGROUND: This case series describes, for the first time, to the author's knowledge, a novel treatment for coccydynia. Tarsal tunnel block with lignocaine only brought relief of chronic coccydynia lasting more than 6 months in three patients. The author adopts the theory that the myelin sheath of the posterior tibial nerve will convey the lipid-soluble lignocaine upward toward the dorsal root ganglia and the nerve roots of the lumbar spine through the uninterrupted myelin sheath, which is itself mainly formed of lipids. The author thinks that most coccyx pain is actually a radiating pain from the lumbar spine, which is not always apparent on magnetic resonance imaging of the lumbar spine. Certainly, the author acknowledges that large-scale studies need to be done to prove the efficacy of this new technique and to prove that the myelin sheath can convey the lignocaine chemical upward. CASE PRESENTATION: Three Arab patients presented with chronic coccydynia of more than 6 months' duration in whom conservative management had failed to control their symptoms. They had no past medical history of significance and no history of trauma. The results of physical examination of all of the patients were normal apart from tenderness on palpation of the coccyx. They all received local coccyx injection with steroids on two occasions, which failed to relieve their pain. One patient underwent manipulation under anesthesia, and one underwent coccygectomy with no pain relief. Magnetic resonance imaging results were reported to be normal in two of them, whereas the other one had a prolapsed disc at the L4/L5 level. The three patients described pain relief 30 minutes after tarsal tunnel block with lignocaine only lasting more than 6 months. All patients had heel anesthesia 15 minutes after the tarsal tunnel injection, which lasted only 1 hour. CONCLUSIONS: Tarsal tunnel block with lignocaine can relieve coccyx pain for a long time. Tarsal tunnel block can be done to achieve heel anesthesia before injection of lignocaine into the plantar fascia in patients with plantar fasciitis.


Assuntos
Anestésicos Locais , Cóccix/patologia , Lidocaína , Dor Lombar/tratamento farmacológico , Bloqueio Nervoso , Nervo Tibial/efeitos dos fármacos , Adulto , Anestésicos Locais/administração & dosagem , Doença Crônica , Humanos , Lidocaína/administração & dosagem , Dor Lombar/etiologia , Dor Lombar/fisiopatologia , Masculino , Nervo Tibial/fisiopatologia , Resultado do Tratamento
2.
PLoS One ; 14(2): e0210978, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30759106

RESUMO

Pressure ulcers, by definition, are caused by external forces on the tissues, often in the regions of bony prominences. Wheelchair users are at risk to develop sitting-acquired pressure ulcers, which occur in the regions of the ischial tuberosities, sacrum/coccyx or greater trochanters. As a means to prevent pressure ulcers, instruction on performing pressure reliefs or weight shifts are a part of the rehabilitation process. The objective of this study was to monitor the weight shift activity of full-time wheelchair users with acute spinal cord injury over multiple epochs of time in order to determine consistency or routine within and across epochs. A second objective was to evaluate the accuracy of self-reported pressure relief frequency within each measurement epoch. A wheelchair in-seat activity monitor was used to measure weight shifts and other in-seat movement. The data was classified into multiple in-seat activity metrics using machine learning. Seventeen full-time wheelchair users with spinal cord injury were measured within multiple epochs, each lasting more than 1 week. Across all in-seat activity metrics, no consistent pattern of activity changes emerged. None of the in-seat activity metric changed in any one direction across a majority of subjects. Subjects tended to over-estimate their frequency of performing pressure reliefs. Self-reported pressure relief behaviors are not reliable, and therefore, cannot be used to evaluate preventative behaviors either clinically or within research. This study had the capability of fully investigating in-seat movements of wheelchair users. The results indicated that in-seat movement does not reflect a routine, either in pressure reliefs, weight shifts or other functional in-seat movements. This study has illustrated the complexity of assigning causation of pressure ulcer occurrence to seated behaviors of wheelchair users and identifies the need for improved clinical techniques designed to develop routine behaviors to prevent pressure ulcers.


Assuntos
Aprendizado de Máquina , Modelos Biológicos , Lesão por Pressão , Pressão/efeitos adversos , Traumatismos da Medula Espinal , Cadeiras de Rodas/efeitos adversos , Adulto , Cóccix/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Lesão por Pressão/etiologia , Lesão por Pressão/patologia , Lesão por Pressão/fisiopatologia , Lesão por Pressão/prevenção & controle , Sacro/patologia , Traumatismos da Medula Espinal/patologia , Traumatismos da Medula Espinal/fisiopatologia , Traumatismos da Medula Espinal/reabilitação
5.
Med Hypotheses ; 121: 70-73, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30396497

RESUMO

The aim of this study is to develop an alternative way to locate the sacral hiatus for blind caudal block from the anthropometrical data measured on 3D pelvic CT. The intersection of the line connecting two sacral cornua and the midline is considered the ideal point (IP) for caudal block. The mean length from the coccyx tip to the IP was measured using 3D pelvic CT images in 30 men and 30 women and was 6.5 cm and 6.0 cm, respectively. For the conventional method group, we used the conventional equilateral triangle method to find the sacral hiatus, which was named conventional method group needling point (CNP). For the experimental method group, the point 6.5 cm or 6.0 cm (mean length from the coccyx tip to the IP) away from the coccyx tip was called the experimental method group needling point (ENP). Drawing the three points of the IP, CNP, and ENP on the same patient's 3D pelvic CT, we compared the distance from the IP to the CNP with the distance from the IP to the ENP. We propose that the experimental method is comparable to the conventional method in locating the sacral hiatus, which is crucial for a successful caudal block procedure. Anthropometric measurements and virtual comparative test between two methods were done on the 3D pelvis CT. In men, the distance from the CNP to the IP was 0.8 ±â€¯0.5 cm in the conventional method group, while the distance from the ENP to the IP was 0.5 ±â€¯0.4 cm in the experimental method group (p < 0.05). In women, the same distances were 1.5 ±â€¯0.8 cm and 0.7 ±â€¯0.3 cm, respectively (p < 0.05). In conclusion, finding a point of 6.5 cm from the coccyx tip in men and 6.0 cm in women could be an alternative way to find the sacral hiatus for blind caudal block.


Assuntos
Antropometria , Imageamento Tridimensional/métodos , Bloqueio Nervoso/métodos , Sacro/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Anestesia Epidural , Cóccix/patologia , Feminino , Humanos , Modelos Lineares , Masculino , Agulhas , Pelve/diagnóstico por imagem , Estudos Retrospectivos
6.
Ann Ital Chir ; 72018 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-29766907

RESUMO

INTRODUCTION: Rectal duplication cysts are rare cystic lesions, arising from the hindgut and classified as congenital/developmental tumors of the presacral space. Their clinical presentation is nonspecific, the diagnosis remains difficult and their management is aided by a multidisciplinary evaluation. CASE REPORT: We report the case of a 55-year-old woman with a cystic mass located in the retrorectal space and identified incidentally on a CT scan. Following imaging studies, surgical resection by a posterior approach (Kraske procedure) was carried out and an adenocarcinoma arising in a duplication cyst of the rectum was present an uncommon case of a rectal duplication cyst with malignant transformation and distant metastasis, describe the clinical, radiologic and pathologic findings and discuss tidentified by microscopy. CONCLUSION: We phe embryological basis of rectal duplication cysts and the surgical anatomy of the presacral space. Key Words: Rectal adenocarcinoma, rectal duplication cyst, Retrorectal space.


Assuntos
Adenocarcinoma Mucinoso/secundário , Cistos/complicações , Neoplasias Retais/etiologia , Reto/anormalidades , Adenocarcinoma Mucinoso/diagnóstico por imagem , Adenocarcinoma Mucinoso/etiologia , Apendicectomia , Apendicite/complicações , Apendicite/cirurgia , Transformação Celular Neoplásica , Cóccix/patologia , Cistos/diagnóstico por imagem , Cistos/embriologia , Feminino , Humanos , Achados Incidentais , Neoplasias Pulmonares/secundário , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Invasividade Neoplásica , Neoplasias Retais/diagnóstico por imagem , Reto/diagnóstico por imagem , Reto/embriologia , Tomografia Computadorizada por Raios X
7.
Phys Med Rehabil Clin N Am ; 28(3): 539-549, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28676363

RESUMO

Coccyx (tailbone) pain substantially decreases the quality of life for patients who suffer with this condition. Classic symptoms include midline pain located below the sacrum and above the anus. Symptoms are worse while sitting or during transitions from sitting to standing. Physical examination typically reveals focal tenderness during palpation of the coccyx. Diagnostic tests include radiographs. Advanced studies may include MRI, computerized tomography scans, or nuclear medicine bone scans. Treatments may include the use of cushions, medications by mouth, topical medications, local pain management injections, pelvic floor physical therapy, and (in rare cases) surgical removal of the coccyx (coccygectomy).


Assuntos
Cóccix/patologia , Dor Lombar/diagnóstico , Manejo da Dor , Humanos , Dor Lombar/etiologia , Dor , Qualidade de Vida , Radiografia
9.
J Pediatr Endocrinol Metab ; 30(4): 475-478, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28328532

RESUMO

BACKGROUND: Adenocorticotropic hormone (ACTH)-dependent Cushing's syndrome in infancy is extremely rare. We describe the case of a sacro-coccygeal ectopic ACTH-secreting immature teratoma in an infant who also presented the triad of defects characteristic of Currarino syndrome. CASE PRESENTATION: A girl was born with a large immature teratoma in the sacro-coccygeal region associated with anal atresia. At the age of 7 days, the concentration of α-fetoprotein (AFP) was above the age-specific normal range. Two non-radical surgical excisions of the tumour were performed. At the age of 7 months, she developed polyphagia, acne, hirsutism, hypertension and hypokalemia with elevated ACTH and absence of serum cortisol circadian rhythm. Immunostaining of tumour tissue showed ACTH-immunoreactive cells. Due to unsuccessful therapy with ketoconazole and resistance to antihypertensive medications [blood pressure (BP) 210/160 mmHg], metyrapone was administered, which controlled her ACTH and cortisol levels in the normal range. Following further removal of tumour bulk after three operations during the first year of life, there was a decrease of BP to normal values. CONCLUSIONS: A rare case of ectopic ACTH syndrome causing Cushing's syndrome in infancy in the context of Currarino syndrome is reported. Radical surgery has resulted in excision of the tumour and current control of Cushing's syndrome.


Assuntos
Síndrome de ACTH Ectópico/complicações , Hormônio Adrenocorticotrópico/metabolismo , Cóccix/patologia , Síndrome de Cushing/etiologia , Sacro/patologia , Teratoma/patologia , Síndrome de ACTH Ectópico/sangue , Síndrome de ACTH Ectópico/terapia , Adulto , Pré-Escolar , Cóccix/metabolismo , Síndrome de Cushing/sangue , Síndrome de Cushing/terapia , Feminino , Humanos , Prognóstico , Sacro/metabolismo , Teratoma/metabolismo
10.
J Clin Neurosci ; 23: 149-152, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26602601

RESUMO

We report a 46-year-old man who presented with a 2week history of worsening headaches and acute onset left sided hemiplegia. He had undergone a surgical resection of a sacral chordoma 13years prior, followed by adjuvant radiotherapy and chemotherapy. MRI revealed multiple enhancing lesions in the brain, and the two largest were resected. The histopathology was consistent with chordoma. Sacrococcygeal chordomas are locally invasive notochord-related sarcomas. They rarely metastasize to the brain, and only eight patients have been reported. While currently available adjuvant radiotherapy and systemic chemotherapeutic regimens can be implemented in the management of these rare patients, they have shown limited success. The newer strategies that are reported here have also been disappointing.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/secundário , Cordoma/diagnóstico , Cóccix/patologia , Sacro/patologia , Neoplasias da Coluna Vertebral/diagnóstico , Neoplasias Encefálicas/cirurgia , Cordoma/cirurgia , Cóccix/cirurgia , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Sacro/cirurgia , Neoplasias da Coluna Vertebral/cirurgia
12.
Orthop Traumatol Surg Res ; 101(7): 871-3, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26470803

RESUMO

A case report and literature review. To present a rare case of facture dislocation of the sacro-coccygeal joint in a 12-year-old boy who was treated conservatively. Fracture dislocations of the sacrum or the sacro-coccygeal joint are infrequent injuries and are rarely reported. The treatment for these disorders is usually conservative. Detailed description of the anterior dislocation (Salter-Harris type I) of the sacro-coccygeal joint in this child and its management are presented, with review of the relevant literature. A conservative treatment was performed, with excellent clinical and radiological result at three years after the injury. MR imaging obtained at two years showed very good healing and alignment. Fracture dislocation of the sacro-coccygeal joint in the pediatric population should be treated conservatively, as the potential of healing and remodeling is great. Closed reduction should not be attempted.


Assuntos
Cóccix/lesões , Consolidação da Fratura , Luxações Articulares/diagnóstico , Sacro/lesões , Fraturas da Coluna Vertebral/diagnóstico , Criança , Cóccix/diagnóstico por imagem , Cóccix/patologia , Humanos , Masculino , Radiografia , Região Sacrococcígea , Sacro/diagnóstico por imagem , Sacro/patologia
14.
Int J Clin Exp Pathol ; 8(5): 5650-7, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26191277

RESUMO

Primary extragonadal malignant germ cell tumors (EMGCTs) are rare and characterized by the location in the midline of the body, including mediastinum, CNS, retroperitoneum and coccyx. EMGCTs present with different clinical and biologic characteristics in different tumor locations. Accurately diagnosing MEGCTs would be very difficult by performing on HE staining alone, and requires immunohistochemical verification. This study was to investigate the biological feature of EMGCTs and diagnostic value of immunohistochemical markers OCT3/4, CD117, PLAP, AFP, ß-HCG and CD30 in EMGCTs. A retrospective study was performed on 48 patients with EMGCTs. EMGCTs were found to occur predominantly in males, especially for mediastinal MGCTs. The tumor locations included mediastinum, CNS and retroperitoneum. The mediastinum and CNS were the most common sites of EMGCTs. Seminoma/germinomas (64.6%) was the most common histological subtypes of EMGCTs. Chest pain, dyspnea, cough and fever were the most common clinical presentations in mediastinal MGCTs. Headache, visual disturbances, endocrine abnormalities, and signs of increased intracranial pressure were common clinical symptoms in CNS MGCTs. Abdominal mass with or without pain, backache and weight loss were common clinical presentations in retroperitoneal MGCTs. PLAP, CD117 and OCT3/4 were highly expressed in seminomas/gernimomas. CD30, EMA and CK AE1/3 staining were positive in embryonal carcinoma. AFP and ß-HCG positive staining are characteristic in yolk sac tumors and choriocarcinoma, respectively. Patients with seminomas/germinomas had a better prognosis than those with NS/G-GCTs. Our finding suggests that the accurate diagnosis of EMGCTs is critical not only for predicting the tumor progression but also for patient management. Immunohistochemical markers have become an important tool in the diagnosis and differential diagnosis of EMGCTs.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias do Sistema Nervoso Central/química , Cóccix/química , Imuno-Histoquímica , Neoplasias do Mediastino/química , Neoplasias Embrionárias de Células Germinativas/química , Neoplasias Retroperitoneais/química , Neoplasias da Coluna Vertebral/química , Adolescente , Adulto , Biópsia , Neoplasias do Sistema Nervoso Central/complicações , Neoplasias do Sistema Nervoso Central/patologia , Criança , Pré-Escolar , China , Cóccix/patologia , Diagnóstico Diferencial , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Neoplasias do Mediastino/complicações , Neoplasias do Mediastino/patologia , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/complicações , Neoplasias Embrionárias de Células Germinativas/patologia , Valor Preditivo dos Testes , Prognóstico , Neoplasias Retroperitoneais/complicações , Neoplasias Retroperitoneais/patologia , Estudos Retrospectivos , Neoplasias da Coluna Vertebral/complicações , Neoplasias da Coluna Vertebral/patologia , Adulto Jovem
15.
Ugeskr Laeger ; 177(12): V08140436, 2015 Mar 16.
Artigo em Dinamarquês | MEDLINE | ID: mdl-25786844

RESUMO

Constipation is a common disease among patients in all age groups, and the pathology can vary. This case report describes a 26-year-old female with severe constipation for six years. She was referred to a centre for spine surgery with a coccyx compressing her rectum causing constipation. The symptoms developed six years previously after a trauma, progressed during pregnancy and after giving birth. X-ray showed a 90-degree anterior angulated coccyx compressing the rectum. She was treated with resection of the coccyx, and symptoms disappeared after surgery.


Assuntos
Cóccix , Constipação Intestinal/etiologia , Adulto , Cóccix/diagnóstico por imagem , Cóccix/patologia , Cóccix/cirurgia , Feminino , Humanos , Radiografia , Reto/patologia
16.
Diagn Cytopathol ; 43(3): 243-6, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24962168

RESUMO

Intraosseous notochordal rest is a rare intravertebral lesion of notochord origin which is presumably benign. It is usually an incidental finding in microscopic examination of vertebrectomy due to unrelated lesions or autopsy cases. Chordoma is a malignant neoplasm originating from notochord with a different clinicoradiographic presentation, prognosis, and treatment. However, the histology of intraosseous notochordal rest and chordoma is almost identical. Herein, we report cytomorphologic findings of a case of intraossous notochordal rest on touch preparation.


Assuntos
Cordoma/patologia , Cóccix/patologia , Notocorda/patologia , Adulto , Cordoma/diagnóstico por imagem , Cóccix/diagnóstico por imagem , Humanos , Masculino , Notocorda/diagnóstico por imagem , Radiografia
17.
J Comp Pathol ; 151(2-3): 195-201, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25005671

RESUMO

Congenital teratomas arising in the coccygeal region have not been reported in domestic animals. This report describes a congenital coccygeal teratoma in a male Burmese cat. A round to oval expansile mass with solid and cystic areas was found ventral to the 5th to 7th caudal vertebrae. Microscopically, the tumour was composed of derivatives of all three primordial germ layers with neuroectodermal predominance. Immunohistochemical double labelling identified immature tissue components in combination with Sox2, a regulator of stem cell proliferation and differentiation. Few Sox2-positive cells co-expressed the neural crest stem cell markers vimentin and neurotrophin receptor p75(NTR). Not all Sox2- and p75(NTR)-positive cells expressed vimentin. An overlapping expression of vimentin-negative and Sox2-, p75(NTR)-positive cells and GFAP- and p75(NTR)-positive cells may indicate a transition stage from immature to mature non-myelinating Schwann cells. Periaxin-positive myelinating Schwann cells surrounding neurofilament-positive axons were observed. Sox2 was additionally expressed in immature odontogenic epithelial cells and in immature cells of endodermal origin. Sox2 was not observed in mature cells, with the exception of satellite glial cells and mucous glands. Despite the presence of immature tissue components, no recurrence was observed 1 year after surgical removal.


Assuntos
Doenças do Gato/patologia , Cóccix/patologia , Teratoma/veterinária , Animais , Biomarcadores Tumorais/análise , Gatos , Imuno-Histoquímica , Masculino , Região Sacrococcígea , Teratoma/patologia
18.
J Pediatr Surg ; 49(7): 1113-5, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24952799

RESUMO

BACKGROUND: Neurological involvement due to intraspinal extension in sacrococcygeal malignant germ cell tumors (SC-MGCTs) has rarely been reported. AIM: To evaluate the incidence, presentation, management and the outcome of patients of SC-MGCT with intraspinal extension. MATERIALS AND METHODS: Case records of all cases of SC-MGCT from 2001 to 2008, were reviewed to identify cases with vertebral involvement and intraspinal extension. They were evaluated in terms of their presentation, response to therapy, extent of surgical resection, recovery of neurological symptoms and outcome. RESULTS: Of the 31 cases of SC-MGCT, 5 (16%) had intraspinal extension. Age ranged from 12 to 84 months (median 24 months). Four patients had Altman type 4 disease (stage 4) and 1 had Altman type 3 (stage 3) disease. The intraspinal extension in all patients was detected on contrast CT scan. Patients presented with neurological symptoms in the form of lower limb paresis (80%), bowel and bladder (20%) incontinence. All the tumors responded to pre-operative chemotherapy. Gross complete local resection could be achieved in 4(80%). Neurological recovery was complete in all except for persisting neurogenic bladder in one. During follow up of 3-32 months, all were alive with no recurrence. CONCLUSIONS: SC-MGCT presenting with neurological deficits due to intraspinal extension is usually advanced disease. These patients respond to chemotherapy and surgical resection and most have complete neurological improvement.


Assuntos
Cóccix/patologia , Região Sacrococcígea/patologia , Sacro/patologia , Neoplasias da Coluna Vertebral/patologia , Teratoma/patologia , Quimioterapia Adjuvante , Criança , Pré-Escolar , Cóccix/cirurgia , Incontinência Fecal/etiologia , Humanos , Lactente , Neoplasias Pulmonares/secundário , Terapia Neoadjuvante , Invasividade Neoplásica , Estudos Retrospectivos , Região Sacrococcígea/cirurgia , Sacro/cirurgia , Neoplasias da Coluna Vertebral/tratamento farmacológico , Neoplasias da Coluna Vertebral/cirurgia , Teratoma/tratamento farmacológico , Teratoma/secundário , Teratoma/cirurgia , Resultado do Tratamento , Incontinência Urinária/etiologia
19.
Pain Physician ; 17(2): E229-33, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24658491

RESUMO

BACKGROUND: Treating pain associated with acute coccyx fractures can be challenging. Intranasal calcitonin has been used to treat acute pain after vertebral fracture, and may even accelerate fracture healing. However, intranasal calcitonin has never previously been published as part of the treatment of acute coccyx fractures. OBJECTIVE: To examine a series of cases in which intranasal calcitonin was used to treat coccydynia related to coccyx fractures. STUDY DESIGN: Case series and literature review. SETTING: Outpatient university-based coccyx pain center. RESULTS: After use of intranasal calcitonin, pain levels decreased, adverse events were minimal, and the medication was generally well tolerated. LIMITATIONS: As this is not a randomized control trial, the patients treated with intranasal calcitonin were not compared to a control group. Additionally, the sample size of 8 patients is relatively small. CONCLUSIONS: We propose that clinicians consider use of intranasal calcitonin for the treatment of pain due to acute coccyx fractures.


Assuntos
Conservadores da Densidade Óssea/administração & dosagem , Calcitonina/administração & dosagem , Cóccix/patologia , Fraturas da Coluna Vertebral/complicações , Fraturas da Coluna Vertebral/tratamento farmacológico , Administração Intranasal , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
Mol Pain ; 10: 6, 2014 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-24456903

RESUMO

BACKGROUND: In the present study, we examined spinal glial cell activation as a central nervous system mechanism of widespread mechanical hyperalgesia in rats that experienced chronic post-cast pain (CPCP) 2 weeks after cast immobilization. Activated spinal microglia and astrocytes were investigated immunohistologically in lumbar and coccygeal spinal cord segments 1 day, 5 weeks, and 13 weeks following cast removal. RESULTS: In the lumbar cord, astrocytes were activated after microglia. Astrocytes also were activated after microglia in the coccygeal cord, but with a delay that was longer than that observed in the lumbar cord. This activation pattern paralleled the observation that mechanical hyperalgesia occurred in the hindleg or the hindpaw before the tail. The activating transcription factor 3 (ATF3) immune response in dorsal root ganglia (DRG) on the last day of cast immobilization suggested that nerve damage might not occur in CPCP rats. The neural activation assessed by the phosphorylated extracellular signal-regulated kinase (pERK) immune response in DRG arose 1 day after cast removal. In addition, L-α-aminoadipate (L-α-AA), an inhibitor of astrocyte activation administered intrathecally 5 weeks after cast removal, inhibited mechanical hyperalgesia in several body parts including the lower leg skin and muscles bilaterally, hindpaws, and tail. CONCLUSIONS: These findings suggest that activation of lumbar cord astrocytes is an important factor in widespread mechanical hyperalgesia in CPCP.


Assuntos
Astrócitos/patologia , Moldes Cirúrgicos , Dor Crônica/patologia , Hiperalgesia/patologia , Microglia/patologia , Medula Espinal/patologia , Ácido 2-Aminoadípico/administração & dosagem , Ácido 2-Aminoadípico/farmacologia , Fator 3 Ativador da Transcrição/metabolismo , Animais , Astrócitos/efeitos dos fármacos , Astrócitos/metabolismo , Antígeno CD11b/metabolismo , Dor Crônica/metabolismo , Cóccix/patologia , MAP Quinases Reguladas por Sinal Extracelular/metabolismo , Gânglios Espinais/efeitos dos fármacos , Gânglios Espinais/enzimologia , Gânglios Espinais/patologia , Membro Posterior/patologia , Hiperalgesia/metabolismo , Imobilização , Injeções Espinhais , Masculino , Microglia/efeitos dos fármacos , Microglia/metabolismo , Ratos , Ratos Sprague-Dawley , Medula Espinal/efeitos dos fármacos , Medula Espinal/metabolismo , Fatores de Tempo
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