RESUMO
PURPOSE: To investigate the effects of dorsal root ganglion destruction in patients with postherpetic neuralgia (PHN). METHODS: Seventy-two patients with PHN selected were randomly divided into two groups (n=36). Group A was the control group (treated by injection) and group B was the group of dorsal root ganglion destruction by adriamycin. Visual analog scale scores (VAS), SAS, SF-MPQ scores. Clinical effects and therapy safety were evaluated before therapy, one week, three and six months after therapy. Forty-four patients were available for intention-to-treat analysis. RESULTS: The average pain scores on the Likert scale were significantly reduced at each point in group B. Patients in group B reported clinical effectiveness at six months as excellent response, good response, improved but unsatisfactory or unchanged 16, 12 and 8.VAS scores at each time point after the operation were lower than that before operation and in group A, there was significant difference. Patients showed significant improvement in sleep scores in group B. There was significant difference at T2 in group A than T1. There was no significant difference in group A at T3, T4 after the operation than that before operation. Between group comparison: there was significant difference between group A and group B at each time point after the operation. CONCLUSIONS: Dorsal root ganglion destruction by adriamycin under guidance of C-arm perspective, the puncture operation was accurate without any adverse reaction or serious complications, which could effectively relieve pain of patients with postherpetic neuralgia, but the long-term effects needed further study.(AU)
OBJETIVO: Investigar os efeitos da destruição da raiz dorsal ganglionar em pacientes com neuralgia pós-herpética. MÉTODOS: Setenta e dois pacientes selecionados com neuralgia pós-herpética foram randomicamente distribuídos em dois grupos (n=36). Grupo A foi o grupo controle (tratado por injeção) e o grupo B foi o grupo com destruição da raiz dorsal do gânglio pela adriamicina. Os escores da Escala Analógica Visual (VAS), SAS, SF-MPQ escores, efeitos clínicos e segurança terapêutica foram avaliados as antes da terapia, uma semana, três e seis meses após a terapia. Quarenta e quatro pacientes foram avaliados pela análise de intenção-em-tratar. RESULTADOS: A média dos escores de dor na escala de Likert foi significativamente reduzida em cada ponto no grupo B. Pacientes no grupo B relataram efetividade clínica aos seis meses com excelente resposta (16), boa resposta (12), melhora mais insatisfatória ou sem modificações (8). Escores VAS a cada tempo após o procedimento foram melhores em comparação ao pré-operatório. No grupo A não foi observada diferença significativa. Pacientes mostraram melhora nos escores de dormir no grupo B. Houve diferença significante no T2 no grupo A que T1. Não houve diferença significante no grupo A nos tempos T3 e T4 após a cirurgia em relação a antes. Comparação entre os grupos: houve diferença significante entre os grupos A e B a cada tempo após a cirurgia. CONCLUSÕES: A destruição da raiz dorsal ganglionar pela adriamicina sob perspectiva guiada pelo C-arm, a cirurgia pontual foi acurada sem qualquer reação adversa ou complicação séria, que pode efetivamente aliviar a dor em pacientes com neuralgia pós-herpética, mas os efeitos de longo prazo necessitam mais estudos.(AU)
Assuntos
Humanos , Bloqueadores Ganglionares/análise , Doxorrubicina/administração & dosagem , Neuralgia/patologia , Gânglios Espinais/anatomia & histologiaRESUMO
In the present study we investigated the effects of infantile/prepubertal chronic oestrogen treatment, chemical sympathectomy with guanethidine and combined sympathectomy and chronic oestrogen treatment on developing sensory nerves of the rat uterus. Changes in sensory innervation were assessed quantitatively on uterine cryostat tissue sections stained for calcitonin gene-related peptide (CGRP). Uterine levels of NGF protein, using immunohistochemistry and ELISA, and mRNA, using Northern blots and in situ hybridization, were also measured. Finally, levels of TrkA NGF receptor in sensory neurons of T13 and L1 dorsal root ganglia (DRG), which supply the uterus, were assessed using densitometric immunohistochemistry. These studies showed that: (1) chronic oestrogen treatment led to an 83% reduction in the intercept density of CGRP-immunoreactive nerves; (2) sympathectomy had no effect on the density of uterine sensory nerves or on the pattern of oestrogen-induced changes; (3) NGF mRNA and protein increased following sympathectomy or chronic oestrogen treatment; and (4) oestrogen produced increased intensity of labelling (28%) for TrkA receptors in small-diameter sensory neurons, but decreased labelling (13%) in medium-sized neurons, which represent the large majority of the DRG neurons supplying the upper part of the uterine horn. Contrary to expectations, increased levels of NGF after sympathectomy and oestrogen treatment did not lead to increased sensory innervation of the uterus. The possibility that alterations in neuronal levels of TrkA contribute to the lack of response of uterine sensory nerves to the oestrogen-induced increase in NGF levels is discussed.
Assuntos
Estrogênios/farmacologia , Fator de Crescimento Neural/metabolismo , Plasticidade Neuronal , Neurônios Aferentes/fisiologia , Receptor trkA/metabolismo , Útero/inervação , Adrenérgicos/farmacologia , Animais , Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Ensaio de Imunoadsorção Enzimática , Estrogênios/metabolismo , Feminino , Gânglios Espinais/anatomia & histologia , Gânglios Espinais/citologia , Guanetidina/farmacologia , Imuno-Histoquímica , Hibridização In Situ , Neurônios Aferentes/efeitos dos fármacos , Neurônios Aferentes/metabolismo , RNA Mensageiro/biossíntese , Ratos , Ratos Wistar , Simpatectomia Química , Útero/crescimento & desenvolvimento , Útero/metabolismoRESUMO
To identify sensory and motor neurons associated with the sciatic nerve in adult mice, three methods for applying fluorescent tracers (Fluorogold and Dil) were investigated: direct application, intraneural injection and impregnation of a sectioned nerve in a silicone chamber. Most accurate localization of the neurons on the dorsal root ganglia and spinal cord was accomplished by introducing the proximal stump of a transected sciatic nerve into a silicone chamber, filled with tracers and then decalcifying the tissue. Fluorogold was an effective tracing agent, in contrast to Dil, which was not. In addition to associations with cephalic ganglia L4, L5 and L6, as seen in rats, contributory neurons to the sciatic nerve were located in other ganglia in the mouse. These findings show that the silicone chamber-tissue decalcification technique is a viable tool for obtaining comparative neuroanatomical information in the mouse model.
Assuntos
Carbocianinas/administração & dosagem , Corantes Fluorescentes/administração & dosagem , Gânglios Espinais/anatomia & histologia , Nervo Isquiático/anatomia & histologia , Estilbamidinas , Animais , Gânglios Espinais/patologia , Injeções , Camundongos , Neurônios Motores/citologia , Neurônios Aferentes/citologia , RatosRESUMO
Wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP) was injected unilaterally into the pretectocollicular region of opossums (Didelphis marsupialis aurita), primarily to investigate the existence of a commissural subcortical pathway but also to reveal afferents and efferents of the nucleus of the optic tract (NOT) and dorsal terminal nucleus (DTN) in this species. Labelled cells and terminals were observed in the contralateral NOT-DTN. Furthermore, HRP was injected bilaterally in the region of the inferior olive (IO) to verify if the distribution of labelled cells in the NOT-DTN overlapped the region of commissural labelled cells. The two subpopulations of retrogradely labelled cells coincided, being distributed within the retinal terminal field attributed to the NOT-DTN, as revealed by contralateral eye injections of HRP. The commissural cells were located slightly more ventral than the olivary cells in the optic tract. The pretectocollicular WGA-HRP injections also labelled cells and terminals bilaterally in the lateral terminal nucleus (LTN), interstitial nucleus of the superior fasciculus, posterior fibers (INSFp), ventral lateral geniculate nucleus (vLGN), and superior colliculus (SC) and ipsilaterally in the medial terminal nucleus (MTN). In addition, further caudally, labelled cells and terminals were observed bilaterally in the nuclei prepositus hypoglossi (PH) and in the medial (MVN) and lateral (LVN) vestibular nuclei. Labelled terminals were found in the ipsilateral nucleus reticularis tegmenti pontis (NRTP) and in the IO with ipsilateral predominance. This study allowed an anatomical delimitation of the NOT-DTN in this opossum species, as defined by the olivary and commissural subpopulations, as well as a hodological evaluation of this region. The existence of some common anatomical aspects with other mammalian species is discussed.