ABSTRACT
BACKGROUND: A neuropathic component to chronic ischemic pain in peripheral arterial disease (PAD) has recently been shown using quantitative sensory testing (QST) and pain questionnaires. The aim of this study was to examine correlations between QST and pain questionnaires in patients with chronic ischemic pain. METHODS: A total of 10 patients with severe PAD (Fontaine stages III and IV) without diabetes mellitus answered a questionnaire and were examined with QST. The questionnaire consisted of several validated instruments which were used to examine the intensity of pain, quality of pain and neuropathic pain (VAS, SF-MPQ, S-LANSS, NPSI). RESULTS: The results of the QST confirmed previously published data. Several terms of the SF-MPQ showed a correlation with parameters of the QST, such as Allodynia (QST) which correlated with the term tender (SF-MPQ) (Spearman's correlation coefficient 0.911; p< or =0.001) and the NPSI subscore evoked pain correlated with the QST parameter wind-up ratio (0.683; p=0.042). CONCLUSION: The results suggest that there might be correlations between psychophysical tests (QST) and pain questionnaires. Subjective perceptions of pain might be represented by a certain pattern in the QST. These connections could contribute to further clarify the pathophysiologic mechanisms leading to the perception of pain.
Subject(s)
Arterial Occlusive Diseases/physiopathology , Ischemia/physiopathology , Leg/blood supply , Neuralgia/classification , Neuralgia/diagnosis , Neurologic Examination/statistics & numerical data , Nociceptors/physiology , Pain Measurement/statistics & numerical data , Pain/classification , Pain/diagnosis , Surveys and Questionnaires , Afferent Pathways/physiopathology , Aged , Arterial Occlusive Diseases/diagnosis , Female , Humans , Intermittent Claudication/classification , Intermittent Claudication/diagnosis , Intermittent Claudication/physiopathology , Ischemia/diagnosis , Male , Neuralgia/physiopathology , Pain/physiopathology , Pain Threshold/physiology , Psychometrics/statistics & numerical data , Psychophysics , Reproducibility of Results , Sensory Thresholds/physiology , Statistics as Topic , Thermosensing/physiologyABSTRACT
We present a rare manifestation of chronic lymphatic leukemia with progressive bilateral visual loss and the typical fundoscopic picture of anterior ischemic optic nerve neuropathy (AION). Clinical symptoms were due to meningeal metastases and tumor cell infiltration of the optic nerve. The diagnostic clue was provided by lumbar puncture with pressure measurement, which made it possible to differentiate AION from papillitis and papilledema. In this case the patient was able to regain his initial visual activity after intrathecal and systemic polychemotherapy.
Subject(s)
Anticoagulants/administration & dosage , Atrial Fibrillation/drug therapy , Atrial Fibrillation/etiology , Atrial Flutter/drug therapy , Atrial Flutter/etiology , Blindness/etiology , Lymphatic Diseases/complications , Humans , Male , Rare DiseasesABSTRACT
AIM: The aim of this study was to analyze the intermediate results of selective stenting of superficial femoral artery (SFA) lesions after a suboptimal balloon angioplasty result. METHODS: We analyzed 70 consecutive patients with claudication or critical limb ischemia due to peripheral arterial occlusive disease who underwent stent implantation of the SFA after unsuccessful balloon-angioplasty. All patients were followed-up immediately after the procedure and 3, 6 and 12 months thereafter. Restenosis was defined as an increase of peak systolic velocity-index >2 as determined by duplex sonography. RESULTS: Primary patency rates at 3, 6 and 12 months were 83.4%, 66.2% and 59%, respectively. Successful reinterventions were performed for 17 reobstructions, resulting in a secondary patency rate at 3, 6 and 12 months of 91%, 89.3%, and 83.8%, respectively. At 12 months 68.6% of the patients were asymptomatic, 21.6% complained of mild (Fontaine class II a), 5.9% of severe (Fontaine class II b) claudication and 2.9% were in critical limb ischemia. CONCLUSIONS: Our data indicate that selective stenting of the SFA after suboptimal balloon angioplasty results in intermediate patency rates similar to that reported for primarily successful PTA, thereby supporting the widely accepted policy of selective stenting as a rescue procedure after unsuccessful balloon angioplasty.
Subject(s)
Angioplasty, Balloon/methods , Arterial Occlusive Diseases/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Femoral Artery , Stents , Aged , Angiography , Arterial Occlusive Diseases/diagnostic imaging , Female , Femoral Artery/diagnostic imaging , Femoral Artery/surgery , Follow-Up Studies , Humans , Male , Reoperation , Retrospective Studies , Treatment Outcome , Ultrasonography, Doppler, DuplexABSTRACT
Pathogenic bacteria of the genus Yersinia counteract host defense by interfering with eukaryotic signal transduction pathways. YpkA of Yersinia pseudotuberculosis shares significant homology with eukaryotic Ser/Thr protein kinases, is translocated into the host cell and has been shown to be an essential virulence factor in a mouse infection model. In this study, we identify the small GTPases RhoA and Rac-1 as eukaryotic binding partners of YpkA and its homolog YopO of Yersinia enterocolitica. We demonstrate that the interaction is independent of phosphorylation of YpkA and nucleotide loading state of the GTPases. The interaction with RhoA and Rac-1 might provide an important clue to how YpkA interferes with eukaryotic signaling on a molecular level.
