Selective TNFR1 blockade in inflammatory diseases is emerging as a clinical strategy. We studied the roles of the two TNF-α receptors, TNFR1 and TNFR2, in human monocytes, the principal producer of TNF-α and central to many TNF-α driven diseases. We hypothesised that TNF-α has pro- and anti-inflammatory effects on monocytes, occurring differentially via TNFR1 and TNFR2. Monocytes were isolated ...

EPIDURAL catheters are commonly used in today’s anesthetic practice, and complications are rare. However, hematomas within the spinal canal leading to compression of the spinal cord remain a major concern. In particular, anticoagulation and bleeding disorders are considered to be risk factors for hematoma formation after neuroaxial blockade. We report a case of paraplegia that developed after r...

Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown etiology. There is evidence that Tumor Necrosis Factor alpha (TNF-α) antagonists are useful in the treatment of advanced or refractory disease. However, sarcoidosis-like reaction has been reported with TNF-α blockade in other inflammatory conditions. Here we report a case of sarcoid-like reaction in a patient with psoria...

STUDY DESIGN Prospective randomized trial. OBJECTIVE To examine the effect of the tumor necrosis factor alpha (TNF-α) inhibitor, etanercept, on radicular pain by its epidural administration onto spinal nerves in patients with lumbar spinal stenosis. SUMMARY OF BACKGROUND DATA TNF-α is thought to play a crucial role in the radicular pain caused by lumbar disc herniation and spinal stenosis. ...

OBJECTIVES Effective analgesia and blockade of the perioperative stress response may improve outcome and epidural analgesia plays a role in the reduction of pulmonary complications following thoracic surgery. In this study, we assessed preoperative and postoperative thoracic epidural analgesia (Preop-TEA and Postop-TEA) techniques on post-thoracotomy pain in 61 patients undergoing posterolatera...

Intubated general anesthesia with single-lung ventilation has been considered mandatory for thoracoscopic lobectomy for nonsmall cell lung cancer. Few reports of thoracoscopic lobectomy without tracheal intubation are published, using either thoracic epidural anesthesia (TEA) or intercostal blockade. The comparisons of perioperative outcomes of nonintubated thoracoscopic lobectomy using epidura...

Objective. Our aim was to investigate the effects of IL-6 blockade on the progression of Mycobacterium tuberculosis (TB) and compare them with those of TNF-α blockade in mice. Methods. Mice were intravenously infected with TB and injected with antibodies. Survival was monitored and histological and immunological studies were carried out. Results. All anti-IL-6R Ab-treated mice and 8 of 10 contr...

In a previous study, we showed that a deep thoracic incision induces the segmental upregulation of interleukin-1β (IL-1β) in the spinal cord. However, whether the cytokines tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) are also activated in response to surgical incision remains to be determined. The present study aimed to investigate the expression pattern of TNF-α and IL-6 in the sp...

Thoracic paravertebral block was widely practised at the beginning of the 20th century. It has enjoyed a renaissance in the past decade. This form of afferent blockade is the technique of injecting local anaesthetic into the thoracic paravertebral space. Thoracic paravertebral analgesia is mostly indicated for unilateral surgical procedures of the thorax and abdomen. Compared to the other avail...

We read with great interest the editorial by Kamming and Davies [1] regarding the choice of thoracic epidural anaesthesia in cardiac surgery. While the authors provided an interesting analysis, we believe their conclusion regarding the 50% chance of this technique’s failure warrants further comment. Kamming and Davies reported that in two large studies [2,3] ‘epidurals have failed to achieve ad...