PMC3350298_01
PGP9.5 immunostaining of skin biopsies at the distal leg. The patient with painful diabetic neuropathy (b) showed reduced intraepidermal nerve fibers (red arrow), in comparison to a normal subject (a) who showed many intraepidermal nerve fibers (red arrows).
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PMC3350298_01_CRIM.ANESTHESIOLOGY2012-285328.001.jpg
fig1
Intraepidermal nerve fiber density was significantly reduced at the distal leg as compared to normal control (Figure 1), which indicates a distal small fiber sensory neuropathy.
Sympathetic block-induced changes in temperature and NRS pain scores. (a) The peak temperatures, monitored at the plantar surface of the toes with an electronics device, increased significantly in both sides after bilateral lumbar sympathetic blocks (post) compared to the baseline values taken before the blocks (pre). (b) The NRS pain scores, evaluated in the preprocedure room before the blocks (pre) and in the recovery room after the block (post), decreased significantly after each lumbar sympathetic block.
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PMC3350298_01_CRIM.ANESTHESIOLOGY2012-285328.002.jpg
fig2
Triamcinolone on each side. The temperatures, monitored in the plantar surface of the big toes (LS 14000 Temperature Monitor and Skin Temperature Probe, NovaMed, NY, USA), increased significantly, and NRS pain scores decreased substantially after the procedure as shown in Table 1 (initial block) and Figure 2. Subsequent temperature and pain score changes were again noted as shown in Table 1 (2 months) and Figure 2. The intervals of each block are shown in Table 1 (Figure 2) with the corresponding temperature changes and the NRS pre- and postblock pain scores.