Epidural Block Treatment on Postherpetic Neuralgia and Comorbid Spine Metastasis of Malignant Tumor

Despite the high frequency of nerve blocks in the acute phase of herpes zoster, factors associated with intervention, such as response to epidural block, have not been analyzed as predictive factors of postherpetic neuralgia (PHN). To determine the predictive factors of progression to PHN in the presence of interventions, we analyzed the medical records of 145 patients who underwent transforaminal epidural injection (TFEI) in the acute phase of herpes zoster. A total volume of 5 mL (a mixture of 0.5% lidocaine and 5 mg dexamethasone) was injected during TFEI. Corticosteroid was used only for the first TFEI. Clinical data of age, sex, involved dermatome, presence of comorbidity, time from zoster onset to first TFEI, numerical rating scale (NRS) before TFEI, NRS at 1 week and 1, 3, and 6 months after the first TFEI, and number of TFEI were collected and analyzed. Through multivariate logistic regression analysis, pain improvement less than 50% at 1 week after the first TFEI was a strong predictive factor of progression of PHN at all time points. Response to TFEI appears to be a stronger predictive factor of progression to PHN than patient factors of sex, age, degree of initial pain, and presence of co-morbidity.

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Pyogenic spondylitis and epidural abscess distant from the site of continuous epidural block in a patient with postherpetic neuralgia

Journal of Anesthesia ◽

10.1007/s005400170024 ◽

2001 ◽

Vol 15 (3) ◽

pp. 176-178 ◽

Cited By ~ 1

Author(s):

Keisuke Yamada ◽

Mika Ohnari ◽

Reiko Takahashi ◽

Junro Taniguchi ◽

Kazuo Hamatani

Keyword(s):

Postherpetic Neuralgia ◽

Epidural Abscess ◽

Epidural Block ◽

Pyogenic Spondylitis

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Hepatocyte ultrastructural alterations in perimetastatic areas

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100166300 ◽

1996 ◽

Vol 54 ◽

pp. 768-769

Author(s):

H. J. Finol ◽

M. E. Correa ◽

L.A. Sosa ◽

A. Márquez ◽

N.L. Díaz

Keyword(s):

Malignant Tumor ◽

Malignant Tumors ◽

Surrounding Tissue ◽

Ultrastructural Changes ◽

Pancreas Carcinoma ◽

Duct Carcinoma ◽

Tissue Samples ◽

Primary Malignant Tumor ◽

Transmission Electron ◽

Remote Sites

In classical oncological literature two mechanisms for tissue aggression in patients with cancer have been described. The first is the progressive invasion, infiltration and destruction of tissues surrounding primary malignant tumor or their metastases; the other includes alterations produced in remote sites that are not directly affected by any focus of disease, the so called paraneoplastic phenomenon. The non-invaded tissue which surrounds a primary malignant tumor or its metastases has been usually considered a normal tissue . In this work we describe the ultrastructural changes observed in hepatocytes located next to metastases from diverse malignant tumors.Hepatic biopsies were obtained surgically in patients with different malignant tumors which metatastized in liver. Biopsies included tumor mass, the zone of macroscopic contact between the tumor and the surrounding tissue, and the tissue adjacent to the tumor but outside the macroscopic area of infiltration. The patients (n = 5), 36–75 years old, presented different tumors including rhabdomyosarcoma, leiomyosarcoma, pancreas carcinoma, biliar duct carcinoma and colon carcinoma. Tissue samples were processed with routine techniques for transmission electron microscopy and observed in a Hitachi H-500 electron microscope.

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