1560 The role of type A botulinum toxin in relieving pain in cervical dystonia
1
$496 Friday, November 11, 2005 Poster Abstracts Zalnani, B 1 Mehrpoor, M :. llran University Of Medical Sciences, Iran Background: Stroke is more common in patients with cerebral microembolism. Frequency of cerebral microembolism (high intensity transient siguals-HITS) in acute myocardial infarction was about 17"/o in one study. Streptokinase doesn't increase the risk of stroke following acute MI, we wanted to study the frequency of cerebral microembolism in acute MI patients who were treated with streptokinase. Methods: We have selected 65 patients with acute MI who were treated with streptokinase as a SK group and 65 patients with acute MI without thrombolytic therapy as a control group, during 72 hours of admission to coronary care unit. We used TCD to monitor for cerebral microembolism in both groups. All patients had 2-dimensional echo- cardiogram during study. Excluding criteria were prosthetic heart valves, carotid stenosis > 50"/o, poor window for TCD monitoring. Results: Mean age of SK group (158) was significantly lower than control group (65) p -- 0.003 but frequency of anterolateral MI, hypokinetic LV segments and ejection fraction were not significantly different between both groups. HITS were detected in 20% of SK group (mean 0.66 ± 0.99) and 10% of control group (mean 0.33 ± 0.71), so there is a significant increase of frequency of cerebral microembolism in SK group( p -- 0.034 ) Conclusion: HITS are detected in 30% of acute MI that were increased with streptokinase therapy although clinically there is no increment of stroke after thrombolytic therapy but maybe there is some difference in silent and asymptomatic stroke following thrombolytic therapy. 1558 Impact of low backache on health workers at Kenyatta National Hospital Anmyo, E 1, Mutiso, V 1, Kwasa, T 1. 1University of Nairobi, Kenya Background: Low back pain is a major problem that affects workers all over the world. It not only leads to absenteeism from but also loss in productivity. The economic, cost of the ailments is one of the highest of all medical conditions among workers. The aim of the study was to determine the prevalence of low back pain and its impact on workers at the Kenyatta National Hospital Method: A cross sectional survey of randomly selected health workers was performed using validated and pre-tested, self -administered close ended questionnaire. Results: 315(59°4) out of 527 workers recruited had low back ache . The mean age was 37.5 + 8 years with a range of 23 to 60.55.4 percent were females while the rest were males. Only 13"/o of the workers were able to perform their activities when they had backache while 3% required bed rest. 24 % of the worker had missed work in the last year due to backache compared to 12.7% due to other illness there being a statistical significant difference at a p value of 0.035. The mean duration of missed workdays was 15 +7 days. 90 °4 Of the workers had their social activities affected by the backache. Conclusion: There is a very high prevalence of low backache amongst hospital workers. The backache results in significant loss of man-days and sodal aspects of the worker. 1559 Es~tablishment and biological characterization of an immortalized rat astrocyte line by SV40 large T antigen An, K 1. ~Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Wuhan, PR China Objective: To establish an immortalized rat astrocyte line and study its biological characterization for transgenic cellular implantation used for pain therapy. Methods: Rat cerebral cortical astrocytes were cultured according to the method of differential cell adhesiveness and then transfected with plasmJd pCMVSV40T/PUR which containing the simian virus 40 large tumour antigen (SV40Tag) gene. The positive colonies were isolated by puromycin 1.5 ug/ml selection and expanded to many passages. PCR, RT-PCR and inmmnohistochenaJcal method were used to detect the integtating and expression of large T antigen gene and its immuno- reactivity of GFAP. Morphology feature of cells was observed by light and electron microscopy. Growth curve, culturing in soft agar, nude mice transplantation, immunhistochemistry and flow cytometry were used to investigate its biological characterization. Results: Cell colonies transformed with SV40Tag eDNA were isolated and subcultured, the SV40Tag gene has been transduced into their genome stably, the expression of SV40Tag gene in the cells was demonstrated in both the gene and protein level. An immortalized rat astrocyte line(IAST)was established and maintained for more than 50 passages. The cells remained monolayer, anchorage dependent and attachinent-inhJbited growth. Subculture, freezing and recovering had no effect on cellular shape and proliferation of IAST. Proliferation capability of IAST was stronger than that of non-transformed cells, proliferation index and population doubling time were 29.17% and 19.58 hour respectively(P < 0.05). It could not form clone in soft agar and tumor in nude mice, but it still remained the same differentiated phenotypes as its original cells and inmmnostained positively for GFAP. Conclusion: Rat astrocytes can be immortalized by transferring exogenous SV40Tag gene, IAST immortalized with SV40Tag prolif- erates vigorously in vitro and is not belong to malignant transformed cells, so IAST could be used as cell carrier in transgenic cellular implantation for pain therapy. 1560 The role of Type A Botulinum Toxin in relieving pain in Cervical Dys~tonia Bertolasi, L ~ , Bottanelli, M l, Vicentini, S ~ . 1Depar tment of Neurological Sciences and Vision, Section of Clinical Neurology', University of Verona, Italy Cervical dystonia is the most common form of the focal dystonias, and is characterized by an involuntary twisting and turning of the neck caused by abnormal involuntary sustained muscle contractions. Dystonic muscle activity can be mainly tonic, myoclonic, tremulous or a complex mixture. The clinical features of cervical dystonia are now well clarified. The vast majority of cases are idiopathic. Secondary cervical dystonia has been considered uncommon and could be associated with vascular, traumatic, infectious and toxic processes of the central and peripheral nervous systems. It could accompany degenerative disease such as progressive supranuclear palsy and cortical-basal ganglionic degeneration. An important clinical feature in cervical dystonia is pain, often severe. Today is well known that botulinum toxin is the most effective treatment for cervical dystonia. Several recent studies had demonstrated that type A botulinum toxin could block the release not only of acethilcoline from neuro-muscular junction but also of pain neu ro-mediators such as P substance and NO. In patients with cervical dystonia treated with botulinum toxin a relief of pain is usually observed, typically before than the muscular spasm is resolved, and lasts more. A possible analgesic role per s6 of botulinum toxin has been suggested. To test this hypothesis we administered a questionnaire (Neck Pain Questionnaire NPQ) to 15 consecutive patients treated with type A botulinmn toxin (Dyspor(rM) in our Department for cervical dystonia. 80 % of our patients experimented a complete relief of pain with the treatment. The remaining 20°4 showed a marked reduction of it. Our results confirm that pain is the first symptom to improve (1-2 days after the treatment), while sustained muscle contractions resolve later (range: 4-10 days after). Patients referee a long-lasting pain effect of botulinum toxin (range: 10-16 weeks), while involuntary postures appear after 8-12 weeks from the treatment. Our study suggests that botulinmn toxin could work in two ways, relieving pain and reducing muscular spasms.
Transcript of 1560 The role of type A botulinum toxin in relieving pain in cervical dystonia
$496 Friday, November 11, 2005 Poster Abstracts
Zalnani, B 1 Mehrpoor, M :. llran University Of Medical Sciences, Iran
Background: Stroke is more common in patients with cerebral microembolism. Frequency of cerebral microembolism (high intensity transient siguals-HITS) in acute myocardial infarction was about 17"/o in one study. Streptokinase doesn' t increase the risk of stroke following acute MI, we wanted to s tudy the frequency of cerebral microembolism in acute MI patients who were treated with streptokinase. Methods: We have selected 65 patients with acute MI who were treated with streptokinase as a SK group and 65 patients with acute MI without thrombolytic therapy as a control group, during 72 hours of admission to coronary care unit. We used T C D to moni tor for cerebral microembolism in both groups. All patients had 2-dimensional echo- cardiogram during study. Excluding criteria were prosthetic heart valves, carotid stenosis > 50"/o, poor window for T C D monitoring. Results: Mean age of SK group (158) was significantly lower than control group (65) p -- 0.003 but frequency of anterolateral MI, hypokinetic LV segments and ejection fraction were not significantly different between both groups. HITS were detected in 20% of SK group (mean 0.66 ± 0.99) and 10% of control group (mean 0.33 ± 0.71), so there is a significant increase of frequency of cerebral microembolism in SK group( p -- 0.034 ) Conclusion: HITS are detected in 30% of acute MI that were increased with streptokinase therapy al though clinically there is no increment of stroke after thrombolytic therapy but maybe there is some difference in silent and asymptomatic stroke following thrombolytic therapy.
1558 Impact of low backache on health workers at Kenyatta National Hospital
Anmyo, E 1, Mutiso, V 1, Kwasa, T 1. 1University of Nairobi, Kenya
Background: Low back pain is a major problem that affects workers all over the world. It no t only leads to absenteeism from but also loss in productivity. The economic, cost of the ailments is one of the highest of all medical conditions among workers. The aim of the study was to determine the prevalence of low back pain and its impact on workers at the Kenyat ta National Hospital Method: A cross sectional survey of randomly selected heal th workers was performed using validated and pre-tested, self -administered close ended questionnaire. Results: 315(59°4) out of 527 workers recruited had low back ache . The mean age was 37.5 + 8 years with a range of 23 to 60.55.4 percent were females while the rest were males. Only 13"/o of the workers were able to perform their activities when they had backache while 3% required bed rest. 24 % of the worker had missed work in the last year due to backache compared to 12.7% due to other illness there being a statistical significant difference at a p value of 0.035. The mean durat ion of missed workdays was 15 +7 days. 90 °4 Of the workers had their social activities affected by the backache. Conclusion: There is a very high prevalence of low backache amongst hospital workers. The backache results in significant loss o f man-days and sodal aspects of the worker.
1559 Es~tablishment and biological characterization of an immortalized rat astrocyte line by SV40 large T antigen
An, K 1. ~Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Wuhan, PR China
Objective: To establish an immortalized rat astrocyte line and study its biological characterization for transgenic cellular implantat ion used for pain therapy. Methods: Rat cerebral cortical astrocytes were cultured according to the method of differential cell adhesiveness and then transfected with plasmJd pCMVSV40T/PUR which containing the simian virus 40 large
tumour antigen (SV40Tag) gene. The positive colonies were isolated by puromycin 1.5 ug/ml selection and expanded to many passages. PCR, RT-PCR and inmmnohistochenaJcal method were used to detect the integtating and expression of large T antigen gene and its immuno- reactivity of GFAP. Morphology feature of cells was observed by light and electron microscopy. Growth curve, culturing in soft agar, nude mice transplantation, immunhistochemistry and flow cytometry were used to investigate its biological characterization. Results: Cell colonies transformed with SV40Tag e D N A were isolated and subcultured, the SV40Tag gene has been transduced into their genome stably, the expression of SV40Tag gene in the cells was demonstrated in both the gene and protein level. An immortalized rat astrocyte line(IAST)was established and maintained for more than 50 passages. The cells remained monolayer, anchorage dependent and attachinent-inhJbited growth. Subculture, freezing and recovering had no effect on cellular shape and proliferation of IAST. Proliferation capability of IAST was stronger than that of non- t ransformed cells, proliferation index and populat ion doubling time were 29.17% and 19.58 hour respectively(P < 0.05). It could not form clone in soft agar and tumor in nude mice, but it still remained the same differentiated phenotypes as its original cells and inmmnosta ined positively for GFAP. Conclusion: Rat astrocytes can be immortalized by transferring exogenous SV40Tag gene, IAST immortalized with SV40Tag prolif- erates vigorously in vitro and is not belong to malignant transformed cells, so IAST could be used as cell carrier in transgenic cellular implantat ion for pain therapy.
1560 The role of Type A Botulinum Toxin in relieving pain in Cervical Dys~tonia
Bertolasi, L ~ , Bottanelli, M l, Vicentini, S ~ . 1Depar tment of Neurological Sciences and Vision, Section of Clinical Neurology', University of Verona, Italy
Cervical dystonia is the most common form of the focal dystonias, and is characterized by an involuntary twisting and turning of the neck caused by abnormal involuntary sustained muscle contractions. Dystonic muscle activity can be mainly tonic, myoclonic, tremulous or a complex mixture. The clinical features of cervical dystonia are now well clarified. The vast majority of cases are idiopathic. Secondary cervical dystonia has been considered u n c o m m o n and could be associated with vascular, traumatic, infectious and toxic processes of the central and peripheral nervous systems. It could accompany degenerative disease such as progressive supranuclear palsy and cortical-basal ganglionic degeneration. An important clinical feature in cervical dystonia is pain, often severe. Today is well known that botul inum toxin is the most effective treatment for cervical dystonia. Several recent studies had demonstrated that type A botul inum toxin could block the release not only of acethilcoline from neuro-muscular junct ion but also of pain neu ro-mediators such as P substance and NO. In patients with cervical dystonia treated with botul inum toxin a relief of pain is usually observed, typically before than the muscular spasm is resolved, and lasts more. A possible analgesic role per s6 of botul inum toxin has been suggested. To test this hypothesis we administered a questionnaire (Neck Pain Questionnaire NPQ) to 15 consecutive patients treated with type A botul inmn toxin (Dyspor(rM) in our Department for cervical dystonia. 80 % of our patients experimented a complete relief of pain with the treatment. The remaining 20°4 showed a marked reduction of it. Our results confirm that pain is the first symptom to improve (1-2 days after the treatment), while sustained muscle contractions resolve later (range: 4-10 days after). Patients referee a long-lasting pain effect of botul inum toxin (range: 10-16 weeks), while involuntary postures appear after 8-12 weeks from the treatment. Our study suggests that botul inmn toxin could work in two ways, relieving pain and reducing muscular spasms.
![Dystonia, Spasticity and Botulinum Toxin Therapy ...segmental and suprasegmental levels (4) ; [j] Ma y lead to posturing and cosmesis issues, and [k] hygiene, quality of life and social](https://static.fdocuments.net/doc/165x107/5e5a6bc6d2dcfa3236382c6a/dystonia-spasticity-and-botulinum-toxin-therapy-segmental-and-suprasegmental.jpg)
