Dear Hope4the best -
Sorry for being the last one in. Since you mentioned in a previous post that you would be going to UCSF to see your specialist, I thought I would give "The Farm" a try. Turns out that while there is some amazing work being done by anesthesiologist and others associated with Stanford, almost all of them work at the Stanford affilated Veterans Affairs Palo Alto Health Care System, which treats, well, veterans. And just because I can never resist a good abstract, check out this one:
Glucocorticoid inhibition of vascular abnormalities in a tibia fracture rat model of complex regional pain syndrome type I, Guo TZ, Wei T, Kingery WS, Pain 2006 Mar;121(1-2):158-67.
Physical Medicine and Rehabilitation Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
Tibia fracture in rats evokes chronic hindpaw warmth, spontaneous extravasation, edema, allodynia, and periarticular bone loss, a syndrome resembling complex regional pain syndrome type I (CRPS I). Glucocorticoids such as methylprednisolone (MP) are probably effective analgesic and anti-edematous agents in patients suffering from CRPS and this study examined the effects of chronic MP treatment in the rat CRPS I model. Bilateral hindpaw thickness, temperature, and nociceptive thresholds were determined, and the hindlimb bone density was measured using dual-energy X-ray absorptiometry (DXA). Spontaneous cutaneous extravasation and substance P infusion evoked extravasation were determined using an Evans blue vascular permeability assay. After baseline testing, the distal tibia was fractured and the hindlimb casted for 4 weeks. At 2 weeks post-fracture MP infusion was started (1 mg/kg/day for 28 days). The rats were retested at 4, 6, and 8 weeks post-fracture. Hindpaw edema and warmth after fracture were reversed by MP infusion and these effects persisted after discontinuing treatment. Furthermore, there was an increase in spontaneous protein extravasation and an enhanced substance P evoked extravasation and edema response in the hindpaw at 4 weeks that was inhibited by MP infusion. Glucocorticoid treatment had no effect on the allodynia, hindpaw unweighting, or the periarticular bone loss observed after tibia fracture. We postulate that post-junctional facilitation of substance P signaling contributes to the hindpaw warmth, edema, and the enhanced spontaneous protein extravasation observed in this CRPS I model, and that the anti-edematous effects of glucocorticoid treatment are due to inhibition of post-junctional neuropeptide signaling.
For the rest of us, there's the Stanford Pain Center
http://paincenter.stanford.edu/ It's now overseen by by Sean Mackey, MD, PhD, Chief, Pain Management Division, who co-authored Pharmacologic Therapies for Complex Regional Pain Syndrome, Mackey S, Feinberg S,
Curr Pain Headache Rep. 2007; 11:38-43, full test at
http://www.rsds.org/2/library/articl...harma_crps.pdf
And here's a page about goings on in Dr. Mackey's lab:
http://snapl.stanford.edu/ as well as a nice summary of one of his recent articles, Fibromyalgia Symptoms are reduced by low-dose naltrexone: A pilot study, Jarred W. Younger and Sean C. Mackey,
Pain Medicine (2009)
http://snapl.stanford.edu/research/ldn.html an issue very much of the hour, to be sure.
That said, when I went through the Pain Management Center's site, I was struck by the fact that only Dr. Mackey had published or listed any particular expertise with CRPS, and I don't know how easy it would be to get into see him. That and I'm not sure that everyone ther plays for our team, where the Center's hottest clinical professor, Timothy Dawson, M.D., identifies himself as a "Qualified Medical Examiner" on his personal website
http://www.norcalpaincare.com/PhysicianProfile.htm and another lists herself as an employee of Limerick BioPharma, Inc.
http://med.stanford.edu/profiles/pai...endye_Robbins/
And while Dr. Makey profile on the Center's site provides what sound like cool areas of cuurent research
http://med.stanford.edu/profiles/pai...y/Sean_Mackey/ I note that the first study listed is being undertaken with two other principals, one of them being the amazing now 43 year old boy genius of neuroscience, Christopher deCharms, among other things, founder of Omneuron, a life sciences company focusing on novel MRI technologies
http://en.wikipedia.org/wiki/Christopher_deCharms now Dr. Mckey's principal area of interest as well.
It's all just so
Stanford. But then so too are three of the course listings of its Department of Medicine:
MED 272B. Biodesign Innovation Core: Concept Development and Implementation
(Same as ME 368B, BIOE 374B, OIT 584) Two quarter sequence. How to take a medical device invention forward from early concept to technology translation and development. Topics include prototyping; patent strategies; advanced planning for reimbursement and FDA approval; choosing translation route (licensing versus start-up); ethical issues including conflict of interest; fundraising approaches and cash requirements; essentials of writing a business or research plan; strategies for assembling a development team. May be taken alone (2 units) or in combination with the project component (4 units). Prerequisite: MED 272A, ME368A, or BIOE 374A.
2 to 4 units, Spr (P. Yock, J. Miilroy, S. Zenios,T. Brinton)
MED 275. Introduction to Biopharmaceutical Innovation
Open to all students. Biotechnology and the pharmaceutical industry. Topics include the biopharmaceutical industry, historical trends, and experiences; research and development; intellectual property; drug approval: regulatory issues and agencies; business development; marketing; manufacturing; capital structure and financing; careers in biopharmaceutical industry. 2-unit option, lectures and weekly assignments, MED or S/NC grading only. 3-unit option, including a group project and final presentation, may be taken for a letter grade. May be repeated for credit.
2 to 3 units, Win (P. Gardner)
MED 276. Careers in Medical Technology
Career tracks in biomedical technology for medical, life science, engineering, business, and law students of all levels. Industry professionals describe career tracks, current roles, and industry perspectives. 2-unit option, lectures and weekly assignments, MED or S/NC grading only. 3-unit option, including a group project and final presentation, may be taken for a letter grade. May be repeated for credit.
2 to 3 units, Spr (P. Gardner) [Emphasis added.]
http://medcatalog.stanford.edu/php/c...st.php?DNo=831
Sorry in the end that I couldn't have been more helpful. I was honestly hoping to generate a better option for you. (At least I hope you are mildly amused, somewhere in the realms of dark humor.)
Mike