Thoracic Outlet Syndrome Thoracic Outlet Syndrome/Brachial Plexopathy. In Memory Of DeAnne Marie.


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Old 02-12-2007, 11:50 AM #1
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Hi Everyone,

Mike posted both of these articles from the RSD site. I was DX with Severe Nerve, Subclavilce and Vein involvement. But why do some get the RSD/TOS DX. Their has to be a root for all this.


This is perhaps the single most important article I've seen thus far.

It does nothing less than give strong evidence of a link between the mechanism of pro-inflammatory cytokines (including IL6) with vasodilation in patients with chronic CRPS-1. Or as set forth in the abstract, "the aim of [the] study was to determine the involvement of vasoactive substances endothelin-1 (ET-1) and nitric oxide (NO) during early chronic CRPS1."

From the "discussion" portion of the article:

In a previous study we observed that treatment with anti-TNF-α initiates recovery during the inflammatory stage of CRPS1. The effect of this intervention on the release of ET-1 and NOx is still unclear. Assuming a diminished blood flow, inhibition of the NO synthase is not advisable; on the contrary, NO donors should be supplemented. Besides the smooth muscle constrictive effects of ET-1, hyperalgesia and pain could also be the result of ET receptor stimulation. Therefore, specific ETA receptor antagonists (such as atrasentan) could provide remission. In pulmonary arterial hypertension, after treatment with the ET receptor antagonist bosentan, the suppression of NO synthesis was abolished and reversed to normal values of controls.

During the acute stage of CRPS1 large amounts of NO will be formed through activation of the inducible NO synthetase (iNOS). In that stage, the blood distribution has been increased which causes an increase of local skin temperature. In the endothelial cell [from the endothelium, "the layer of epithelial cells that lines the cavities of the heart and of the blood and lymph vessels and the serous cavities of the body, originating from the mesoderm"] NO will be formed from L-arginine through eNOS activation. Formation of NO could also occur after receptor stimulated activation of constitutive NOS (cNOS) or activation of neuronal NOS (nNOS) in nerve endings. In all cases this will result in increased vasodilation. TNF-α counteracts the activation of eNOS, whereas induction of iNOS in smooth muscle cells will be stimulated to generate NO. In the trophic phase of CRPS1 there will be a decline in the contribution of inflammatory mediators. Consequently, in combination with disuse of the extremity, less NO could be generated, resulting in diminished basal relaxation and retarded blood distribution, after which signs of the 'cold dystrophy' will become apparent.
[Citations omitted.]
Check it out. "Increased endothelin-1 and diminished nitric oxide levels in blister fluids of patients with intermediate cold type complex regional pain syndrome type 1," J. George Groeneweg , et al, BMC Musculoskelet Disord., (2006) 7: 91. 2006 November 30

http://www.pubmedcentral.nih.gov/art...medid=17137491
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Old 02-12-2007, 12:39 PM #2
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Hi Everyone,
Just a thought, but I am wondering if their is a connection between IL-6 and scar tissue build up. Hugs, Roz
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Old 02-12-2007, 02:13 PM #3
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Default scar tissue

the scar matter can come from various means Roz, from what Dr T explained.
Blood can pull after surgery, truma to soft tissue in the area makes it die and become white/grayish matter attaching to any near by structure, even and especially the cervical nerves.

The adhisions and scar tissue can devlope before surgery too. If the il-6 is the release of a chemicl due to truma that would make sense to contribute., But I think many things contribute to scarring.

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Old 02-12-2007, 03:29 PM #4
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I used to know the abbrevs for some of this - here it is-
CRPS Complex Regional Pain Syndrome

NO Nitric Oxide

iNOS, eNOS, inducible, endothelial,

cNOS, nNOS constitutive and neuronal Nitric Oxide Synthetase

Nox Nitrite and Nitrate

ET-1 Endothelin

ETA Endothelin type A

ETB Endothelin type B

TNF-α Tumour Necrosis Factor alpha

IL-6 Interleukin 6

ISDN Isosorbidedinitrate

mRNA messenger Ribo Nucleid Acid

RLU Relative Light Unit

RSDSA Reflex Sympathetic Dystrophy Syndrome Association

TREND Trauma Related Neuronal Dysfunction

[NOS was first identified by Furchgott (1980) who experimented on the aortas of Rabbits. Since then, the different forms of NO synthase have been classified as

* Neuronal NOS (nNOS or NOS1) which produces NO in neuronal tissue in both the central and peripheral nervous system. Neuronal NOS also performs a role in cell communication and is associated with plasma membranes.
* Inducible NOS (iNOS or NOS2) which can be found in the immune system but is also found in the cardiovascular system. It uses the oxidative stress of NO (a free radical) to be used by macrophages in immune defence against pathogens.
* Endothelial NOS (eNOS or NOS3 or Constitutive / cNOS) generates NO in blood vessels and is involved with regulating vascular function. A constitutive Ca2+ dependent NOS provides a basal release of NO. eNos is associated with plasma membranes surrounding cells and the membranes of Golgi bodies within cells.
]
http://en.wikipedia.org/wiki/Nitric_oxide_synthase
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Old 02-14-2007, 01:21 AM #5
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I've had RSD for 8 1/2 years and found this site through a google alert.

It's interesting that scar tissue is mentioned.

I'm coming to wonder if this disease might be a bacterium which lives primarily in scar tissue (and nerves). It achieves a quorum in an accident and primarily lives in the nerves and reproduces on the skin. The shock achieved in an accident and resultant sustained changes alert the bacteria to a quorum. It travels to different areas in different individuals and tends to spread. It probably lives in the finger or toe nails as part of its life cycle. It attacks older people and women because they have more scar tissue. There may actually be more than one disease and/ or more than one bacteria causing RSD.

I've only been treating it this way very briefly and have mixed results.

There is not great supporting evidence except circumstantial and experiential. There is an irregular apparent skin infection with a three to ten day cycle.

I'm interested in opinions. I've been desperate for years and this is hardly my craziest idea.
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Old 02-14-2007, 12:17 PM #6
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Hi Their,

I want to welcome you here. I have had RSD for 5 years.

Like you, I am keeping a open mind about everything. Big Hugs, Roz
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Old 02-14-2007, 01:23 PM #7
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Hi Imahotep,

What an interesting idea you have. This definitely warrants investigation I wonder if there is a way to put this into a clinical trial!!! I think I might ask my boyfriend about it tonight and see what he thinks [he is a radiation oncologist but he does a lot of research].......

Open minds are often would cause new discoveries!! There's nothing crazy in that!!!

Curious to know why you chose your name wondering if it's Egyptian????

Take care welcome!

Victoria rn
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Old 02-14-2007, 05:38 PM #8
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Quote:
Originally Posted by gibbrn View Post
Hi Imahotep,

What an interesting idea you have. This definitely warrants investigation I wonder if there is a way to put this into a clinical trial!!! I think I might ask my boyfriend about it tonight and see what he thinks [he is a radiation oncologist but he does a lot of research].......

Open minds are often would cause new discoveries!! There's nothing crazy in that!!!

Curious to know why you chose your name wondering if it's Egyptian????

Take care welcome!

Victoria rn
I'll be sure to keep up with this thread and this site if anyone finds anything or I do. So far the biggest thing is just an apparent infection around the fingertips and nearby scars revealed by soaking in a 4% solution of hydrogen peroxide.

Thanks all for the warm welcome. Frequently crackpots (and newbies) have to fight their way in and then fight their way back out.



As far as the name:

I didn't expect to be asked or wouldn't have used it.

It's a very convoluted inside joke. I go by a name which is coincidentially similar to a Pharaoh's name on a message board related to my expertise.

About five months ago I became interested in the Egyptian pyramids and came up with a real crackpot theory about their manufacture, use, and cause. Since the name was so appropriate I continued using it on the Egyptological websites.

Imehotep is often credited with the design of the senufru pyramid south of the Great Pyramid so my friends and I make the joke "I'm a hotep, wouldn't you like to be one too?". Ok, it's a poor joke unless you were there. Maybe you have to "walk like an Egyptian" to make it work.

I'd rather not the people at the other website find out about my disability so changed the name I use here. This place would show up on a search and I'd be quickly recognized. The only good thing about this disease is you don't get much pity but I don't want even that much.

One thing I've learned well since getting sick is that time flies. There's an old proverb that man fears time, and time fears the pyramids and an old John Prine lyric that time don't fly, it bounds and leaps. It seems a lot of themes and ideas are in search of me.

Tempus fugit (time flies).
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