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At least 397 records · Page 22Linked to original sources
PubMed2007

[Cancer pain treatment with nerve blocks and neuroablative procedures].

The management of opioid resistant cancer pain is a significant issue for palliative medicine. Certain types of pain can be relieved effectively using nerve blocks without exacerbating and sometimes improving daily activity as long as proper patient selection and technique are employed. Continuous epidural and subarachnoid block, celiac plexus block, superior hypogastric plexus block, subarachnoid phenol block and percutaneous cervical cordotomy are common pain treatment procedures. In our pain clinic, these procedures were performed on about 20% of cancer pain patients, most of whom experienced pain relief without serious complications. Proper use of nerve blocks and neuroablative procedures can undoubtedly improve the management of cancer pain and should be a significant component of the strategy for cancer pain relief.

Humans↗
PubMed1991

[Blood flow in the gastric mucosa and components of the kallikrein- kinin system in patients with duodenal ulcer].

The results of study of the blood flow rate in the gastric mucosa by means of intraoperative rheography and content of the main components of kallikrein-kinin system in the systemic and regional blood flow were compared. It was established that increase in the volumetric blood flow rate in patients with a complicated duodenal ulcer disease was caused by activation of the kallikrein-kinin system in the regional blood flow. Blockade of the celiac plexus has a pronounced effect on the state of a kallikrein-kinin system.

Blood Flow Velocity↗
PubMed1991

[Inhibition of the cysteamine-induced gastric ulcer by the sympathoadrenal medullary system in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY)].

We previously reported that cysteamine induces severe gastric ulcers in WKY, but very mild in SHR. The aim of this study is to elucidate the role on the sympathoadrenal medullary system in the pathogenesis of the cysteamine-induced gastric ulcer. Catecholamine (CA) contents in the stomach and adrenal gland were significantly higher in the non-treated SHR than in the non-treated WKY, suggesting that the sympathetic nervous system is more facilitated in SHR. Cysteamine decreased the noradrenaline and adrenaline contents in these tissues in both strains, however the values of CA was still higher in the treated SHR than the non-treated WKY. Histologically the adrenal medulla was severely damaged by cysteamine administration in WKY than in SHR. In contrast an immunohistological study revealed that chromogranin reactivity of the adrenal medulla was significantly stronger in the treated SHR than in the treated WKY. The celiac plexus was well preserved morphologically even in the cysteamine treatment in both strains. These results suggest that the capacity of the sympathetic nervous system in both the adrenal medulla and the stomach plays an important role in preventing the cysteamine-induced gastric ulcer in SHR.

Adrenal Medulla↗
PubMed1991

[Effect of bile salt in duodenum on gastric myoelectric activity and motility of mouse with a preliminary study of its neuromechanism].

Changes of gastric myoelectric fast wave, slow wave and gastric motility were studied after intraduodenal infusion of sodium taurocholate (ST) in an attempt to search the concerned neuromechanism. Frequency and total amplitude of the fast wave and slow wave of gastric myoelectric activity and of gastric contractile wave were recorded every five minutes before and after intraduodenal infusion of ST under the background action of various drugs. The frequency and amplitude were expressed in percentage change of the respective premedication value. After intraduodenal infusion of ST (n = 10) the frequency and the amplitude of fast wave and gastric contractile wave were suppressed. Blocking anesthesia of celiac plexus, reserpinization and intravenous infusion of carbachol could eliminate the inhibition induced by ST, which could be partly eliminated by intravenous infusion of propranolol but not affected by phentolamine at all. The results demonstrate that intraduodenal infusion of bile salt suppresses the fast wave of gastric myoelectric activity and gastric motility, most probably controlled by efferent sympathetic adrenergic fibres through beta-receptor.

Animals↗
PubMed1991

[Corticoid secretion and patho-histological changes in the adrenal glands in hypertension].

Hydrocortisone, 11-hydroxycorticosteroids and aldosterone were measured in 74 patients with a history of surgery on the sympathoadrenal system for stable essential hypertension. Morphologic structure of the sympathetic ganglia of the celiac plexus and adrenals removed during surgery was under study. The studies have revealed a relationship between pathohistologic changes in operation material and adrenocortical functional activity. The authors suggest a possibility of a relationship between morphofunctional changes in the adrenals and sympathetic ganglia, and enhanced nervous system efferent effects with the progress of the disease.

11-Hydroxycorticosteroids↗
PubMed1990

Effects of lidocaine on the excitability and membrane properties of the nerve cell soma.

The effects of lidocaine, an amide local anesthetic, on the electrophysiologic properties of the nerve cell soma were studied on isolated superfused superior cervical ganglia of rats. Administration of 400 nmol of lidocaine to the preparation evoked significant reversible changes in the membrane properties of the nerve cell soma. The firing threshold, the action potential duration and the intracellular current threshold for firing the cells increased significantly (p less than 0.01), while the action potential amplitude decreased significantly (p less than 0.01). The resting membrane potential change was not significant. The membrane resistance decreased by 20% (p less than 0.01). The change in membrane resistance, and the spike potential evoked by excitatory postsynaptic potential or intracellular current injection were the last to recover after application of lidocaine. The results show that the postsynaptic cell body is a major site of action of the local anesthetic lidocaine, and that it is more sensitive to the action of lidocaine than the presynaptic nerve fibers. The implication of the results is that when local anesthetics are injected to areas where cell bodies and processes (axons and dendrites) are present together, such as during stellate ganglion block, lumbar sympathetic block, celiac plexus block and intrathecal administration for spinal anesthesia, the cell bodies and the processes are all affected, and their excitability and function suppressed. Further, the duration of the block will be determined by the duration of lidocaine-induced cell block rather than the duration of lidocaine-induced nerve fiber block.

Animals↗
PubMed1990

[A case of mediastinal schwannoma originating from the thoracic vagal nerve complicated by early stomach cancer].

Most of primary tumors of the nerves arising in the mediastinum originate from the sympathetic or intercostal nerves. Schwannoma developing from the vagal nerve is very rare. The patient was a 73-year-old male referred to us with abnormal chest X-rays and stomach cancer. One-staged operation was performed by thoracic and upper abdominal median incision. The tumor was removed, which measured 6 X 5 X 4 cm and involved the origin of the left recurrent nerve, by neurectomy. To our knowledge, this was the 18th reported case of schwannoma of the intrathoracic vagal nerve in Japan. A similar schwannoma was observed also in the celiac plexus, and this case was also a rare instance of multiple schwannoma.

Aged↗
PubMed1990

[Effect of mobilization of the posterior cardial wall on the completeness of selective proximal vagotomy].

On the basis of the revealed on 76 cadavers by means of preparation neural + connections of the posterior wall of the gastric cardia and celiac plexus and results of the selective proximal vagotomy (SPV) performed in 111 patients with the duodenal ulcer disease, it was established that mobilization of the posterior wall of the cardia provided the full-value denervation of the stomach and prevented the ulcer recurrency.

Adult↗
PubMed1987

[Acute pancreatitis. Neurovascular and microcirculatory changes. Pathogenic and therapeutic study].

A group of 159 dogs divided in 8 sub-groups were studied, in regard to pancreatitis, the purpose of the study was to investigate the participation of the automatic nervous system in the course of acute pancreatitis. The procedures and the results were as follows: 1. Pancreatitis was induced in two forms: a) Injection of gallbladder bile, from the same animal to the pancreatic duct. b) Blind duodenal loop with exclusion of the distal duodenum through the pylorus. In both cases acute pancreatitis was obtained. Fat necrosis was predominant in type a, and hemorrhagic lesions in type b. 2. The anesthetic block of the celiac plexus controlled the pain and shock. The animals were in good general conditions but there were no changes in the pathological process of the pancreas. The same results were noted in surgical resections of splanchnic trunks. 3. When the surgical resections of splanchnic nerves was followed by a waiting period of 20 days from the production of pancreatitis there were no changes in the gland. 5. Vagotomy previous to pancreatitis does not have protector effects in the induction of pancreatitis. 6. Continuous perfusion of E.V. novocaine was of extreme utility. The animals remained without pain and the process remained stable when it was given in the initial face of edema. 7. The enzyme inhibitor (Trasylol) given in the first 24 hs. does not prove to be valuable. Due to the fermentative derangement the condition of the animals was better maintained in relation to the comparative animals.

Acute Disease↗
PubMed1989

[New approach to the treatment of status asthmaticus caused by hiatal hernia].

From 1986 to 1988, 170 patients with asthmatic state were observed. Of them in 13, the X-ray study revealed hiatal hernia (HH) and reflux-esophagitis. The analysis of observations of 1173 patients with HH was carried out. In a number of patients together with the symptoms of pathology of the respiratory system, the vegetative, cardial and other disorders were found. All these disorders the authors consider a consequence of irritation of the vagus and celiac plexus occurring in HH. A complex of medicamentous therapy of the asthmatic state caused by HH is suggested.

Adult↗
PubMedDate not supplied

Diagnostic investigation and special treatment of chronic abdominal ischaemia.

Chronic abdominal ischaemia (C.A.I.)--abdominal angina--is a neglected gastrointestinal vascular condition, with chronic complaints and symptoms for the patient posing severe diagnostic and therapeutic problems. In the angiologic department of the Interunion Scientific Center of Surgery during the past 25 years, chronic intestinal ischaemia was diagnosed in 150 patients, a number representing 2.5% of the whole population with pathology form the aorta and its branches. Etiological factors of disease of the celiac axis, superior mesenteric artery and inferior mesenteric artery occlusion were the intravascular factors in 99 patients, atherosclerosis in 63 and nonspecific aorto-arteritis in 36. Extravascular factors: median arcuate ligament of the diaphragm, celiac plexus, periarterialfibrous, nerve fibers and tumor of pancreas were found in 51 patients. Of the 150 patients with C.A.I., 84 (56%) were operated and 87 operations were performed; of these 6 (4%) had a transluminal dilatation. A left thoraco-diaphragmatic approach to these vessels, via a lumbar incision through the last intercostal space in 62 patients was carried out. In those cases where the operation on the inferior mesenteric artery was combined with an operation on the abdominal aorta, the vessels were approached through a typical laparotomy (16 patients). In C.A.I. we perform 2 types of operations: partially reconstructive (decompressive) and reconstructive operations. Partially reconstructive (decompressive) operations were performed in case of compression of unpaired branches of the abdominal aorta in order to free the artery from extraluminal causes of pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1987

[Several endocrine aspects of duodenal stasis in the process of therapeutic gymnastics].

The levels of TTH, T3, T4 and testosterone were studied in 65 female patients suffering from chronic duodenitis with concomitant hypertensive duodenal stasis, stages I and II. A significant increase in the content of the hormones under study was revealed. Subclinical hyperthyroidism was determined by the formation of the irritative autonomic (sympathicotonic) syndrome as a result of irritation of the sympathetic nerve fibers of the celiac plexus due to the presence of inflammation at the duodenojejunal junction. This condition was attended by the predominance of catabolic processes (thyroid hormones) and a compensatory rise of the secretion of the hormones from the anabolic group (testosterone). The use of a special program of exercises led to the lessening of the clinicofunctional symptoms of disease with the normalization of hormonal homeostasis.

Adult↗
PubMed1982

Pancreatic cancer: approach to diagnosis, selection for surgery and choice of operation.

The physician must suspect pancreatic cancer in patients older than age 40 years who present with minimal vague symptoms. The presence of common disorders such as gallstones, hiatal hernia and diverticulosis coli, does not exclude pancreatic cancer. Ultrasonography, computed tomography, ERCP and cytology are the essential diagnostic tools. Angiography delineates anatomic variations of the foregut vasculature and detects nonresectability of some tumors. Percutaneous fine needle aspiration of pancreatic masses for cytologic examination is recommended for lesions of the body and tail. Percutaneous transhepatic biliary drainage is advised preoperatively in patients whose serum bilirubin exceeds 20 mg/dl. Total pancreatoduodenectomy is recommended for all resectable pancreatic cancers. Surgical palliative procedures include biliary bypass, duodenal bypass and celiac plexus nerve block. Currently, only 30% of all pancreatic cancers seen are resectable and they are confined to the head of the pancreas. About 10% of all pancreatic cancers are potentially curable at the time of presentation. The operative mortality should be under 10%.

Biopsy↗
PubMedDate not supplied

[Tumor of the pancreas. Support treatment].

Carcinoma of the pancreas has a poor prognosis with a short survival time. Despite diagnostic advances, diagnosis is often delayed because early symptoms are frequently vague and non-specific. Symptomatic treatment is the only possibility in the large majority of patients with pancreatic cancer since curative surgical excision of the tumor is only possible in few cases. Symptoms managed, in the aim to improve the quality of life, include weight loss and anorexia, abdominal pain, jaundice secondary to biliary compression and digestives consequences of pancreatic surgery. Anorexia is a frequent complaint in patients with pancreatic cancer, and contributes to decreased caloric intake, weight loss and malnutrition. Patients who are unable to eat, due to obstruction or dysfunctional gastrointestinal tract, may benefit from enteral or parenteral nutrition. Patients whose main reason to not obtain adequate food intake is anorexia may benefit from recently developed pharmacologic strategies. Megestrol acetate often produce an improvement in appetite and weight gain in patients with advanced cancer. Jaundice can be treated by surgical biliary drainage or better still by palliative biliary endoprosthesis. Percutaneous transhepatic or endocopic biliary drainage are now well established methods for decompressing malignant biliary obstruction. Pain occurs in 80-85% of patients with advanced disease. Abdominal pain should be treated by oral non-narcotic analgesics, or, if necessary, potent narcotic analgesics, and sometimes by percutaneous block of the celiac ganglion, splancnicectomy or abdominal radiotherapy. Celiac plexus block with alcohol is the most common and well described therapy for the specific pain from carcinoma of the pancreas. Digestive consequences of pancreatic surgery also require symptomatic treatment.

Anorexia↗
PubMedDate not supplied

[The rhythm of protein synthesis in denervated rat liver].

Using the radiochemical method, we found a circahoralian rhythm of protein synthesis in slices of rat liver two weeks after transection of the vagus nerve anterior stem or bilateral subphrenic vagotomy with simultaneous transection of the celiac plexus hepatic branches. The rhythm was similar to those found in slices of normal liver or in a monolayer culture of hepatocytes. The incorporation of leucine in proteins and the pool of free leucine were similar in the denervated and normal liver. The self-synchronization of individual cell oscillations in protein synthesis intensity was shown earlier in experiments performed on cell cultures. A study of protein synthesis in the denervated liver suggests that cell interactions are also the main mechanism underlying the synchronization of oscillating cellular functions in the organ in situ.

Animals↗
PubMed1993

[Role of the splanchnic nerve in hypotension induced by acute obstructive suppurative cholangitis].

A model of acute suppurative cholangitis with septicemia but without shock was made in 14 rabbits. Fourty-eight hours afterwards, reoperation was performed with the right major splanchnic nerve and right celiac plexus exposed for monitoring. A catheter with an inflatable rubber bag was inserted into the common bile duct via the duodenum for injection with water into the rubber bag to produce a biliary high pressure of 20 kPa, which was subsequently maintained for 2 hours. The right major splanchnic nerve impulse frequency was found significantly increased (P < 0.01). The study shows that the fall of blood pressure or shock in the early stage of acute obstructive suppurative cholangitis is induced predominantly by acute biliary hypertension, and our findings would be complementary to Reynolds' hypothesis of the production of shock.

Animals↗
PubMed1997

[Computerized tomography-guided neurolytic block of the splanchnic nerve].

CT-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. CT yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. Forty-eight hours after alcoholization, 14 patients (66%) had complete pain regression; 52% of the patients needed no analgesics for 6 to 54 days and only 9 patients (42%) needed another low opioid therapy. Complications included hypotension and diarrhea in all cases. One had a cardiac arrest and died 8 days after the procedure. There were no other complications. The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with severe chronic abdominal pain. It is used as a second line treatment when large lesions change celiac anatomy and complicate the percutaneous block of the celiac plexus.

Abdominal Neoplasms↗