Bee venom is used as a traditional medicine for treatment of arthritis. The anti-inflammatory activity of the n-hexane, ethyl acetate, and aqueous partitions from bee venom (Apis mellifera) was studied using cyclooxygenase (COX) activity and pro-inflammatory cytokines (TNF-$\alpha and IL-1\beta$) production, in vitro. COX-2 is involved in the production of prostaglandins that mediate pain and support the inflammatory process. The aqueous partition of bee venom showed strong dose-dependent inhibitory effects on COX-2 activity ($IC_{50} = 13.1 \mu$ g/mL), but did not inhibit COX-1 activity. The aqueous partition was subfractionated into three parts by molecular weight differences, namely, B-F1 (above 20 KDa), B-F2 (between 10 KDa and 20 KDa) and BF-3 (below 10 KDa). B-F2 and B-F3 strongly inhibited COX-2 activity and COX-2 mRNA expression in a dose-dependent manner, without revealing cytotoxic effects. TNF-$\alpha and IL-1\beta$ are potent pro-inflammatory cytokines and are early indicators of the inflammatory process. We also investigated the effects of three subfractions on TNF-$\alpha and IL-1\beta$ production using ELISA method. All three subfractions, B-F1, B-F2 and B-F3, inhibited TNF-$\alpha and IL-1\beta$production. These results suggest the pharmacological activities of bee venom on anti-inflammatory process include the inhibition of COX-2 expression and the blocking of pro-inflammatory cytokines (TNF-$\alpha and IL-1\beta$) production.
The main purpose of this study is to develop a ratio scale measuring level of pain using Korean pain terms. The specific purposes of this study are to identify the degree of pain of each pain term in each subclass: to classify each subclass in terms of dimensions of pain; and to analyze factors of the Korean pain ratio scale clustering together. One hundred an4 fifty eight pain terms which were originally identified as representative terms and their synonyms were used for data collection. Fifty eight nursing professors ana sixty one medical doctors who have contacted with patients having pain were asked to rate the weight of each pain term on a visual analogue scale. Subclasses in which ranks of pain terms were same f s findings in two previous studies were 1) thermal 3 am 2) cavity pressure, 3) single stimulating pain, 4) radiation pain. and 5) chemical pain. Subclasses in which ranks of pain terms were confused were 1) incisive pressure, and 2) cold pain. Subclasses in which one new pain term was added were 1) inflammatory-repeated pain, 2) punctuate pressure, 3) constrictive pressure, 4) fatigue-related pressure, and 5) suffering-relate4 pain. Subclasses in which two new pain terms were added were 1) traction pressure, 2) peripheral nerve pain, 3) dull pain, 4) pulsation-related pain, 5) digestion-related pain, 6) tract pain, and 7) punishment-related pain. Subclass in which 3 new pain terms were included was fear-related pain. Rating scores of 5 words in 4 subclasses were significantly different between the normal group and the extreme group of subjects in terms of subjective rating. Only one word among 6 words was that newly added to the scale. Rating scores of 12 words in 9 subclasses were significantly different between doctor group and nursing professor group. Among these 12 words, only 3 were those newly added to the scale. In comparison of these 12 words, mean scores of the nursing professors were always 7 to 16 points higher than those of the medical doctors. In the analysis of judgement of subjects in terms of dimensions of pain terms, subclasses of dull pain, cavity pressure, tract pain and cold pain were suggested to be included in the miscellaneous dimension. As a result of factor analysis of the ratings given to 96 pain words using principal components analysis without iteration and with varimax rotation limiting the number of factors to 4, factors of severe pain (factor I) mild-moderate pain (factor II) , causative pain (factor III) and temperature-related pain(factor IV) were extracted with the factor loading above 0.388. When the pain words were re-arranged on the bases of factor loading above 0.368, number of factors decreased to only first two factors. Maximum score of pain word in factor II was 46.17 and the minimum score of the factor I was 45.36. Further studies are needed to identify the validity, reliability, sensitivity and practicability of this ratio scale using patients having various sources of pain.
Background: This study was conducted to evaluate the efficacy of a parenteral nonsteroidal anti-inflammatory agent for management of post-surgical pain and its effect on hospital stay and long-term surgical outcome. Methods: Total of 40 patients undergoing lumbar discectomy were randomly assigned to two groups, receiving either 1) 30 mg intravenous ketorolac upon surgical closure, every 6 hours for 36 hours, and morphine IV PCA (intravenous patient controlled analgesia), or 2) only morphine PCA. A blinded investigator recorded; the visual analog pain scores, total postoperative narcotic consumption, complications by morphine PCA, length of hospitalization (from surgery to discharge), and long-term outcome at 6 weeks. Results: The patients who received IV ketorolac and morphine PCA reported significantly lower visual analog pain scores than patients receiving only morphine PCA. Cumulative morphine doses were significantly lower in the ketorolac group (P<0.001). There was no significant difference between groups in the frequency of side effects related to morphine PCA. Mean length of hospitalization was longer for patients receiving only morphine PCA, but there was no statistical significance. Six weeks after surgery, four (20.0%) patients who received only morphine PCA suffered persistent back pain. In contrary, all those patients who received ketorolac were free of back pain at follow-up (P<0.05). Conclusions: These results suggest that intermittent IV bolus ketorolac, when used with opioid IV PCA is more effective than opioid IV PCA alone for postoperative pain following lumbar disc surgery. However, this strategy did not contribute to early discharge from hospital after lumbar disc surgery. The effect to long-term surgical outcome was not conclusive.
Kim, Yang Hyun;Gu, Mi Sook;Lee, Eun Hyung;Joh, Ju Yeon;Han, Sun Sook;Lee, Chul Joong;Lee, Sang Chul
The Korean Journal of Pain
/
v.18
no.2
/
pp.271-274
/
2005
Cervical radicular pain has been recognized as a common cause of neck, shoulder and arm pain. The initial recommended therapy is based on the medical treatment by anti-inflammatory, analgesic agents, rest, traction and physical therapy. In the case of failure with these therapies, the classical alternative is a surgical discectomy, but this is associated with numerous risks inherent to invasive procedures. As a result, a number of percutaneous intradiscal therapies have developed over the last 3 decades, which have specifically focused on the pathology of the disc. However, these treatments have considerable limitations and success rates, and none allow for the extraction of a quantifiable amount of nucleus pulposus via a 17 gauge introducer using fluoroscopic guidance alone. Herein, we describe our experience using a $Dekompressor^{(R)}$ on a 52 year-old female patient with a cervical disc herniation. Percutaneous decompression in the treatment of cervical disc herniation was successfully performed, with a good outcome.
Background: The new drug HP228 is a cytokine restraining agent with a broad spectrum of anti-inflammatory, analgesic, and antipyretic activity. Six healthy, adult, male volunteers were studied to determine the independent and interactive effects of HP228 and morphine on pain perception. Methods: Two groups of stimuli were applied to each volunteers before drug administration as control, 20 min after morphine and HP228 administration, and 20 min after combined administration of these two drugs. Two adhesive electrically-conducting pads were applied on opposite sides of the arm approximately 8 cm apart. The electrode were connected to an electrical impulse generator and 50 Hz 1 msec pulses of incrementally increasing intensity were delivered at 1 sec intervals. The analgesic endpoints were the current intensity (mA) at which the subject first detected the stimulus (THRESH), the intensity at which the stimulus was first idenfied as being painful (PAIN), and the intensity at which the subject requested that the stimulus be terminated due to discomfort (LIMIT). A second series of stimuli were applied immediately thereafter using 1-sec duration 50 Hz tetanus pulses with increasing intensities at 2~5 sec intervals. Results: There were significant differences between drug treatments (Morphine, HP228, HP228/Morphine) and control (No drugs) in any of the measurements (PAIN, LIMIT) except THRESH with the twitch and tetanus test. Conclusions: The data suggests that HP228 is an analgesic, but it does not appear to interact with morphine in an additive manner.
Recently, many researches regarding the natural products which alternate with chemical products have been done. Among them, boswellia is well known for effect on anti-oxidative effect and inflammation. The aim was the effect boswellia of formalin- induced orofacial and temporomandibular joint (TMJ) pain on experimental animals was investigated. Experiments were carried out using subcutaneous (SC) pain model and TMJ pain model that were induced by the injection of 5% formalin into the right vibrissa pad (SC, $50{\mu}L$) or TMJ ($30{\mu}L$) of rats, respectively. In both models, formalin (5%), formalin after distilled water (vehicle), formalin after boswellia extract (p.o., concentrations of 15, 30 mg/kg) (n=6). The number of scratching on the injected region was scored during the 9 successive periods of 5 min intervals following injection of formalin. Oral administration of boswellia (15, 30 mg / kg) reduced formalin-induced SC orofacial pain behavioral responses. SC orofacial pain behavioral responses was significantly reduced at 20~35 min. In the experimental group injected into temporomandibular joints, the pain response was significantly reduced by $276.2{\pm}8.20$ and $78.3{\pm}4.7$ after oral administration of boswellia (15, 30 mg / kg) at $398.3{\pm}24.8$ times. As a result of the passage of time, the oral administration of boswellia showed a significant effect of reducing the temporomandibular joint pain 30 minutes after the injection of formalin. This study confirmed that oral administration of boswellia modulated the pain behavior in both models. In conclusion, boswellia extract may be a potential therapeutic treatment for orofacial pain.
Background: The purpose of this research was to assess the role of heparanase (HPSE)/syndecan1 (SDC1)/nerve growth factor (NGF) on cancer pain from melanoma. Methods: The influence of HPSE on the biological function of melanoma cells and cancer pain in a mouse model was evaluated. Immunohistochemical staining was used to analyze HPSE and SDC1. HPSE, NGF, and SDC1 were detected using western blot. Inflammatory factors were detected using ELISA assay. Results: HPSE promoted melanoma cell viability, proliferation, migration, invasion, and tumor growth, as well as cancer pain, while SST0001 treatment reversed the promoting effect of HPSE. HPSE up-regulated NGF, and NGF feedback promoted HPSE. High expression of NGF reversed the inhibitory effect of HPSE down-regulation on melanoma cell phenotype deterioration, including cell viability, proliferation, migration, and invasion. SST0001 down-regulated SDC1 expression. SDC1 reversed the inhibitory effect of SST0001 on cancer pain. Conclusions: The results showed that HPSE promoted melanoma development and cancer pain by interacting with NGF/SDC1. It provides new insights to better understand the role of HPSE in melanoma and also provides a new direction for cancer pain treatment.
Background: Sodium salicylate (SS) is a nonsteroidal anti-inflammatory drug (NSAID) for the treatment of neuralgia or pain from rheumatoid arthritis. When abused or used in excess, SS can induce cytotoxicity. The present study examined whether SS has a neurotoxic effect. Methods: Cell viability was examined by MTT [3-(4,5-dimethylthiazol-2,5-dipheny ltetrazolium bromide] assay and Sulforhodamine (SRB) assay after cultivating dorsal root ganglion (DRG) neurons derived from neonatal mouse. These cells were treated with various concentrations of SS for 24 hours. In addition, the amount of protein synthesis against SS was measured in these cultures. Results: Cell viability (20, $40{\mu}g/ml$ SS) significantly decreased in a dose-dependent manner. Additionally, SS inhibited protein synthesis after the exposure of cultured mouse DRG neurons to $30{\mu}g/ml$ of SS for 24 hours. Conclusions: The present study suggests that SS is toxic in cultured DRG neurons derived from neonatal mouse by decreasing cell viability and the amount of protein synthesis.
Fifty-one cases of acute herpes zoster infection were analyzed to search for the most effective management strategy of the disease, including pain relief and decreasing the incidence of postherpetic neuralgia. Anti-viral treatment was not included. Analgesics and nerve blocks, such as stellate ganglion block or epidural block, were helpful. Corticosteroid was administered in most of the cases either systemically or epidurally or both. Epidural administration of local anesthetic in combination with corticosteroid seemed to have certain advantages of excellent pain relief as a result of sympathetic blockade and regional plus systemic anti-inflammatory effects of the steroid, although this was not proved by definite statistical evidence.
Expression of c-fos, an immediate early gene, has accepted to be a marker of functional activity in neurons. This study was aimed to investigate the effects of cold therapy on the expression of spinal cord c-fos in rats of carrageenan-induced muscle pain. Muscle pain was induced in male Sprague-Dawley rats by intra-muscular injection of gastrocnemius with $2\%$ carrageenan. The paw withdrawal latency (PWL) and tail flick test (TFT) responses to heat stimuli were used to detect secondary hyperalgesia produced by the muscle pain and measured to assess the effects of cold. The expression of c-fos was determined in the lumbar regions of the spinal cord by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry assays. The secondary hyperalgesia to heat simuli (PWL and TFT) were significantly reduced in cold therapy compared with that in the controls. In RT-PCR assays the expression of c-fos mRNA was down-regulated in the lumbar spinal cord in cold group. In addition, Fos immunoreactivity in the dorsal horn of the lumbar spinal cord was decreased in cold group. These results suggested that application of cold attributed to increase PWL and TFT responses and to decrease expression of the c-fos produced by muscle pain.
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