ABSTRACT
STUDY DESIGN: A Multicenter double-blind randomized clinical study comparing Neurotropin and Aceclofenac. OBJECTIVE: To evaluate the analgesic effect, efficacy and safety of Neurotropin in patients with low back pain. SUMMARY OF LITERATURE REVIEW: Non steroidal anti inflammatory analgesics are used as the main medical treatment in patients with low back pain. However, complications, such as gastrointestinal or cardiovascular problems, have been well documented. Neurotropin acts to recover the analgesic state arising from a decrease in pain threshold and has a completely different mechanism to that of existing anti-inflammatory and narcotic analgesics, with its action of restoring the immune system having been confirmed. MATERIALS & METHOD: 376 patients with back pain were randomly divided into two groups; one group was administered Neurotropin and the other Aceclofenac. The overall improvement after 4 weeks was used as the first efficacy variable, and with the second efficacy variable the improvements in spontaneous pain, tenderness, motion pain, radiating pain, severity, pain intensity, and the overall severity and Oswestry Disability Indices were used as the evaluation criteria. To evaluate safety, the abnormal clinical response and alternations on physical examination and the clinical laboratory values were used. RESULTS: A total of 358 patients received the experimental and comparison drugs, of which 351 were evaluated for safety. The overall improvement after 4 weeks, severity of symptoms, overall severity, and the pain intensity and Oswestry Disability Indices were decreased in both groups, but the differences between the two groups were not statistically significant. The overall decrease in the severity was greater in the Aceclofenac group, but both groups had statistically meaningful decreases after the administration of the drugs. i.e. Adverse drug reactions were less in the Neurotropin group, but these showed no significant statistical difference. CONCLUSIONS: Neurotropin and Aceclofenac are equally effective in patients with low back pain, but in terms of safety from a clinical view point Neurotropin is more reliable.
Subject(s)
Humans , Analgesics , Back Pain , Drug-Related Side Effects and Adverse Reactions , Immune System , Low Back Pain , Narcotics , Pain Threshold , Physical ExaminationABSTRACT
Hereditory Sensory Automnomic Neuropathy (HSAN) is a rare disorder. Five types of HSAN have been described by Dyck et al. Congenital insensitivity to pain with anhidrosis is classified HSAN Type IV. The clinical features include inability to sweat, causing defective thermoregulation, and congenital analgesia, which leads to orthopedic complications such as osteomyelitis, fractures, self mutilation and neuropathic arthropathies. Abnormal findings on nerve biopsy, virtual absence of unmyelinated nerve fibers, have been reported. We report a 5-year-old boy who presented with congenital insensitivity to pain, anhidrosis with fracture of lateral condyle of humerus and its complication.
Subject(s)
Child, Preschool , Humans , Male , Biopsy , Body Temperature Regulation , Hereditary Sensory and Autonomic Neuropathies , Humerus , Hypohidrosis , Nerve Fibers, Unmyelinated , Orthopedics , Osteomyelitis , Pain Insensitivity, Congenital , Self Mutilation , SweatABSTRACT
BACKGROUND AND OBJECTIVES: Fine needle aspiration cytology (FNAC) is a safe and economical biospy technique which is widely applicable to palpable masses as a first-line procedure. Successful FNAC, however, demands high specimen quality and experience on the part of both the aspirator and the pathologist. We compared cytological diagnosis with histopathological diagnosis in the head and neck region, in order to increase accuracy and solve any discrepancy in the two types of diagnoses. MATERIALS AND METHODS: From July 1996 through to July 1998, FNAC were carried out in 830 cases in palpable mass of the head and neck region in the Department of Pathology, Chonnam University Hospital. The major target sites were lymph nodes (61.4%), soft tissues (22.2%), and salivary glands (16.4%). Histopathological diagnoses were performed in 267 cases by surgical methods. Cytological reports were classified into the following diagnostic categories: non-tumor, tumor (benign, malignant: primary or metastatic). RESULTS: In a series of 267 cases, there were 70 non-tumor lesions (26.2%), 197 tumor lesions (73.8%), (benign: 77, malignant: 120). Lymph nodes were the most common anatomic sites for FNAC. The overall diagnostic accuracy, sensitivity and specificity of FNAC were 95.5%, 98.8%, and 94.2% allowed an correct diagnosis between FNAC and histopathology. CONCLUSION: FNAC of the head and neck region is a sensitive and specific diagnostic tool, especially when diagnosing metastatic carcinomas. Four major causes of error were identified: material adequacy criteria, sampling technique, cytological interpretation and limitations in the procedure. In particular, attention must be paid to subtle morphological changes when making detailed clinical pathological observations; this may help avoid discrepancies and achieve the right diagnosis.
Subject(s)
Biopsy , Biopsy, Fine-Needle , Cytological Techniques , Diagnosis , Head , Lymph Nodes , Neck , Pathology , Salivary Glands , Sensitivity and SpecificityABSTRACT
Histiocytic necrotizing lymphadenitis(HNL), also known as Kikuchi-Fujimoto Disease(KFD) is a disease which mainly invades cervical lymph node without any particular reason. Lymphadenopathy can be unilaterally or bilaterally with mild pain and be accompanied with high fever, malaise and skin rashes. At times it shows hepatosplenomegaly, leukopenia and lymphatic cyst. These symptoms will be gone spontaneously without any specific treatments in several weeks or months, so the prognosis is comparatively satisfactory. It is confirmed only by excisional biopsy and must be differentiated from other diseases such as lymphoma, inflammatory and granulomatous lymphadenopathy, etc. Authors report the clinicopathologic findings of 4 cases of HNL with a review of literature.
Subject(s)
Biopsy , Exanthema , Fever , Histiocytic Necrotizing Lymphadenitis , Leukopenia , Lymph Nodes , Lymphatic Diseases , Lymphocele , Lymphoma , PrognosisABSTRACT
BACKGROUND: Airway secretions partly arise from the interstitial fluid and partly from the secretory activities of respiratory epithelium and submucosal gland. The flow of water across the tracheobronchial epithelium is likely to be an important determinant of the efficiency of mucociliary clearance. Water movement across the epithelium is thought to follow active ion transport passively by means of the osmotic gradients created. OBJECTIVES: The aim of this study was to determine whether Na, K, and Cl are transported actively by the epithelium of nasal mucosa and to evaluate an effect of the tracheostomy on changes of pH and electrolytes in nasal secretum. MATERIALS AND METHODS: pH and Na, K, and Cl values were estimated in 35 samples (20 tracheostomized patients and 15 normal persons) of nasal secretum and plasma. RESULTS: On 15 normal persons, Mean pH value was 7.43, Na 143.2, K 4.2 and Cl 109.1(mEq/L) in plasma and Mean pH value was 7.81, Na 139.7, K 11.5 and Cl 127.5(mEq/L) in nasal secretion. On 20 tracheostomized patients, pH 7.49, Na 140.2, K 3.8, and Cl 108.7(mEq/L) in plasma were estimated, and pH 7.88, Na 128.5, K 12.0, and Cl 121.5(mEq/L) were estimated in nasal secretum. In nasal secretum pH, K, and Cl were higher than in plasma by +0.39, +8.2 and +12.8(mEq/L) respectively, while Na was lower -11.6(mEq/L). We had the same result on normal persons as on tracheostomized patients. The results show that pH, K and Cl were higher in nasal secretion and Na was lower than in plasma. CONCLUSION: Significant difference of pH and electrolyte values in nasal secretion was not observed between normal person and tracheostomized patient.
Subject(s)
Humans , Biological Transport, Active , Electrolytes , Epithelium , Extracellular Fluid , Hydrogen-Ion Concentration , Ion Transport , Mucociliary Clearance , Nasal Mucosa , Plasma , Respiratory Mucosa , Tracheostomy , Water MovementsABSTRACT
No abstract available.