ABSTRACT
Visceral pain, especially in the abdominal region, represents one of the most common types of pain. Its chronic form is usually very hard to treat by conventional analgesic agents and adjuvants. We investigated the antinociceptive effect of botulinum toxin type A (BTX-A) in male Wistar rats in two models of visceral pain: peritonitis induced by intraperitoneal injection of 1% acetic acid and colitis induced by intracolonic instillation of 0.1% capsaicin. Pain was measured as the number of abdominal writhes. Additionally, referred mechanical sensitivity in the ventral abdominal area was evaluated by von Frey test and the extent of spinal c-Fos expression was immunohistochemically examined. BTX-A significantly reduced the number of abdominal writhes in both models of visceral pain after intrathecal application in a dose of 2 U/kg. In the experimental colitis model, BTX-A (2 U/kg) reduced both referred mechanical allodynia and c-Fos expression in the dorsal horn of the spinal cord (S2/S3 segments). In contrast to intrathecal administration, BTX-A (2 U/kg) administered into the cisterna magna had no effect on pain suggesting that the primary site of its action is a spinal cord.
Subject(s)
Abdominal Pain/drug therapy , Analgesics/therapeutic use , Botulinum Toxins, Type A/therapeutic use , Abdominal Pain/etiology , Abdominal Pain/physiopathology , Acetic Acid/toxicity , Analgesics/administration & dosage , Animals , Botulinum Toxins, Type A/administration & dosage , Capsaicin/toxicity , Colitis/complications , Colitis/physiopathology , Disease Models, Animal , Hyperalgesia/drug therapy , Hyperalgesia/etiology , Hyperalgesia/physiopathology , Male , Pain Measurement , Pain, Referred/drug therapy , Pain, Referred/etiology , Pain, Referred/physiopathology , Peritonitis/complications , Peritonitis/physiopathology , Proto-Oncogene Proteins c-fos/metabolism , Rats , Rats, Wistar , Spinal Cord/drug effects , Spinal Cord/physiopathology , Visceral Pain/drug therapy , Visceral Pain/etiology , Visceral Pain/physiopathologyABSTRACT
INTRODUCTION: Loco-regional recurrences of the breast cancer are associated with a bad prognosis. Often costly autologous-tissue treatment as a surgery aiming at repairing the defects is necessary. PATIENTS AND METHODS: Four female patients were treated with the vacuum-assisted closure (VAC)-system in context with the recurrence resection. In all cases a primary local masking was not possible. RESULTS: In the described cases the wounds healed well during the post-operative phase. There occurred no problems either during the radiation treatment or during chemotherapy in the case of lying VAC-Systems. CONCLUSION: Using vacuum-assisted wound closure one can avoid autologous-tissue treatment in the case of extensive loco-regional recurrences.
Subject(s)
Breast Neoplasms/surgery , Carcinoma/surgery , Negative-Pressure Wound Therapy , Neoplasm Recurrence, Local/surgery , Thoracic Wall/surgery , Aged , Female , Humans , Middle AgedABSTRACT
PURPOSE: Breast reconstructions are made autologously, that is with the body's own tissue, or heterologously by means of implants. This either causes donor site morbidity or a foreign body is implanted. Both are disadvantages which could not be avoided up to now. By using tissue of the still remaining (contralateral) breast both could be avoided. The object of this paper is to check whether this technique is feasible. METHOD: By dividing the existing breast and transferring it to the contralateral side, we were able to successfully conduct a single-procedure breast reconstruction with one female patient. RESULTS: The operation technique as well as the post-operative progression of the female patient will be presented. CONCLUSION: Mamma-splitting is a new and promising method of reconstruction with own tissue, without donor site morbidity or implant. The use within a bigger group of female patients will show the method's validity.
Subject(s)
Mammaplasty/methods , Aged , Female , Humans , Mastectomy , Transplantation, AutologousABSTRACT
OBJECTIVES: To evaluate urinary and fecal incontinence symptoms, and occult anal sphincter defects in women after vacuum and spontaneous vaginal delivery. STUDY DESIGN: In a case-control study, 50 primiparous women delivered by vacuum extraction were compared to 50 women delivered spontaneously. Urinary and anal incontinence symptoms, pelvic floor muscle strength and sphincter defects on endoanal ultrasound were evaluated 6-24 weeks postpartum. RESULTS: New anal incontinence symptoms after childbirth were found in 30% of the vacuum group compared to 34% of the controls, new urinary incontinence symptoms in 28 and 42%, respectively (not significant). After excluding Grade III perineal tear, sonographic sphincter defects were found in 11 (27.5%) after vacuum delivery compared to 4 (10%) after spontaneous delivery (P<0.05, chi(2)-test). CONCLUSION: Anal and urinary incontinence symptoms are frequent after vaginal delivery. Vacuum delivery causes more sonographic sphincter defects but appears to cause no more harm to pelvic floor function than spontaneous vaginal delivery.
