RESUMO
Few studies have been conducted to explain the pain patterns resulting from osteoporotic vertebral compression fractures (OVCF). We analyzed pain patterns to elucidate the pain mechanism and to provide initial guide for the management of OVCFs. Sixty-four patients underwent percutaneous vertebroplasty (N=55) or kyphoplasty (N=9). Three pain patterns were formulized to classify pains due to OVCFs: midline paravertebral (Type A), diffuse paravertebral (Type B), and remote lumbosacral pains (Type C). The degree of compression was measured using scale of deformity index, kyphosis rate, and kyphosis angle. Numerical rating scores were serially measured to determine the postoperative outcomes. As vertebral body height (VBH) decreased, paravertebral pain became more enlarged and extended anteriorly (p<0.05). Type A and B patterns significantly showed the reverse relationship with deformity index (p<0.05), yet Type C pattern was not affected by deformity index. Postoperative pain severity was significantly improved (p<0.05), and patients with a limited pain distribution showed a more favorable outcome (p<0.05). The improvement was closely related with the restoration of VBH, but not with kyphosis rate or angle. Thus, pain pattern study is useful not only as a guide in decision making for the management of patients with OVCF, but also in predicting the treatment outcome.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fixação Interna de Fraturas/métodos , Fraturas por Compressão/etiologia , Cifose/terapia , Imageamento por Ressonância Magnética , Osteoporose/complicações , Dor/etiologia , Medição da Dor , Dor Pós-Operatória/etiologia , Polimetil Metacrilato/administração & dosagem , Inquéritos e Questionários , Perfil de Impacto da Doença , Fraturas da Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Assuntos
Proteínas de Fase Aguda , Adenocarcinoma , Adenoma Pleomorfo , Adesivos , Plaquetas , Carcinoma Adenoide Cístico , Carcinoma Mucoepidermoide , Células Endoteliais , Hipogonadismo , Hibridização In Situ , Megacariócitos , Doenças Mitocondriais , Metástase Neoplásica , Oftalmoplegia , RNA Mensageiro , Glândulas Salivares , Fator A de Crescimento do Endotélio Vascular , Fator de von WillebrandRESUMO
Assuntos
Feminino , Humanos , Masculino , Seguimentos , Cabeça , Côndilo Mandibular , Fraturas Mandibulares , Osteoartrite , Osteotomia , Estudos Retrospectivos , Articulação TemporomandibularRESUMO
Assuntos
Humanos , Carbamatos , Tecido Conjuntivo , Eosinófilos , Seio Maxilar , Sinusite Maxilar , Mucosa , Necrose , Neutrófilos , Compostos Organometálicos , Plasmócitos , Pólipos , PrognósticoRESUMO
Assuntos
Humanos , Masculino , Ameloblastoma , Seguimentos , Mandíbula , Osteogênese por Distração , TransplantesRESUMO
There are currently no initial guides for the diagnosis of somatic referred pain of lumbar zygapophyseal joint (LZJ) or sacroiliac joint (SIJ). We developed a classification system of LZJ and SIJ pain, the "pain distribution pattern template (PDPT)" depending on the pain distribution patterns from a pool of 200 patients whose spinal pain source was confirmed. We prospectively applied the PDPT to determine its contribution to clinical decision-making for 419 patients whose pain was presumed to arise from the LZJs (259 patients) or SIJs (160 patients). Forty-nine percent (128/259) of LZJ and 46% (74/160) of SIJ arthopathies diagnosed by PDPT were confirmed by nerve blocks. Diagnostic reliabilities were significantly higher in Type A and C patterns in LZJ and Type C in SIJ arthropathies, 64%, 80%, and 68.4%, respectively. For both LZJ and SIJ arthropathies, favorable outcome after radiofrequency (RF) neurotomies was similar to the rate of positive responses to diagnostic blocks in Type A to Type D, whereas the outcome was unpredictable in those with undetermined type (Type E). Considering the paucity of currently available diagnostic methods for LZJ and SIJ arthropathies, PDPT is useful in clinical decision- making as well as in predicting the treatment outcome.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomada de Decisões , Artropatias/diagnóstico , Dor Lombar/diagnóstico , Imageamento por Ressonância Magnética , Medição da Dor , Articulação Sacroilíaca , Resultado do Tratamento , Articulação ZigapofisáriaRESUMO
We report a case of pilocytic astrocytoma and atypical meningioma occurred within the field of gamma knife surgery for the management of preexisting meningioma. A 76-year old woman received gamma knife surgery for the management of meningioma in the right parietal convexity 9 years ago. Three weeks before admission, left hemiparesis and speech disturbance were developed and magnetic resonance image showed cystic mass with nodular enhancement in the right parietal area. Craniotomy and total removal of mass was performed and the histological diagnosis of atypical meningioma and pilocytic asrtocytoma were done.
Assuntos
Idoso , Feminino , Humanos , Astrocitoma , Craniotomia , Diagnóstico , Meningioma , Paresia , RabeprazolRESUMO
OBJECTIVE: Vascular endothelial growth factor(VEGF)-C is involved in lymphangiogenesis and spreading of cancer cells via lymphatic vessels. The aim of the present study is to investigate the relationship between the absence of cerebral lymphatic vessels and low metastatic rate of brain tumors. METHODS: Immunohistochemical stains were performed for VEGF-C and VEGF in surgically resected specimens from 57 patients with primary(38 cases, low grade : 10 cases, high grade : 28 cases) and metastatic(19 cases) brain tumor. RESULTS: The expression of VEGF-C was higher in metastatic carcinoma(68%) than in high-grade primary tumor(29%). There was no difference for VEGF expression between high grade brain tumor (71%) and metastatic carcinoma(58%). CONCLUSION: Low VEGF-C expression of primary brain tumors may play a role in low metastatic rate of brain tumors.