Microglia from neurogenic and non-neurogenic regions display differential proliferative potential and neuroblast support

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Gregory Paul Marshall

2014-07-01

Full Text Available Microglia isolated from the neurogenic subependymal zone (SEZ and hippocampus (HC are capable of massive in vitro population expansion that is not possible with microglia isolated from non-neurogenic regions. We asked if this regional heterogeneity in microglial proliferative capacity is cell intrinsic, or is conferred by interaction with respective neurogenic or non-neurogenic niches. By combining SEZ and cerebral cortex (CTX primary tissue dissociates to generate heterospatial cultures, we find that exposure to the SEZ environment does not enhance CTX microglia expansion; however, the CTX environment exerts a suppressive effect on SEZ microglia expansion. Furthermore, addition of purified donor SEZ microglia to either CTX- or SEZ-derived cultures suppresses the expansion of host microglia, while the addition of donor CTX microglia enhances the over-all microglia yield. These data suggest that SEZ and CTX microglia possess intrinsic, spatially restricted characteristics that are independent of their in vitro environment, and that they represent unique and functionally distinct populations. Finally, we determined that the repeated supplementation of neurogenic SEZ cultures with expanded SEZ microglia allows for sustained levels of inducible neurogenesis, provided that the ratio of microglia to total cells remains within a fairly narrow range.

Arthropathy of neonatal onset multisystem inflammatory disease (NOMID/CINCA)

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Hill, Suvimol C.; Dwyer, Andrew [Warren G. Magnuson Clinical Center, Diagnostic Radiology, National Institutes of Health (NIH), Bethesda, MD (United States); Namde, Madjimbaye; Canna, Scott; Goldbach-Mansky, Raphaela [National Institutes of Health (NIH), National Institute of Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD (United States); Poznanski, Andrew [Northwestern University, Department of Radiology, Medical Imaging, Children' s Memorial Hospital, Chicago, IL (United States)

2007-02-15

Neonatal onset multisystem inflammatory disease (NOMID), an autoinflammatory disease, is characterized by fever, chronic urticarial rash, CNS manifestations, and arthropathy. Approximately 50% of patients with NOMID have de novo missense mutations in CIAS1, which is associated with modulation of the IL-1b and apoptotic pathways. Approximately 60% of NOMID patients have prominent arthropathy, most commonly involving the knees, the cause of which remains poorly understood. To more fully describe the findings of NOMID arthropathy on MRI and radiography and to provide a better understanding of the origin of the bony lesions. We imaged 20 patients with NOMID to further investigate NOMID-associated bony lesions. Bony abnormalities were seen in the knees of 11/20 patients. The knee findings included enlarged, deformed femora and patellae in all and tibiae in the majority, without evidence of synovitis. Some patients had other joint involvement. Most had short stature and valgus or varus knee deformities. No association was noted between bony abnormalities and CIAS1 mutations. The abnormalities appeared to be the result of a mass-producing process. The resulting heterogeneously calcified masses appeared to originate in the physis and deformed the adjacent metaphysis and epiphysis. These findings suggest that the arthropathy of NOMID is the result of abnormal endochondral bone growth. Further investigation is needed to determine whether this deformity is triggered by inflammation early in development or by CIAS1 mutations causing abnormal chondrocyte apoptosis. (orig.)

Arthropathy of neonatal onset multisystem inflammatory disease (NOMID/CINCA)

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Hill, Suvimol C.; Dwyer, Andrew; Namde, Madjimbaye; Canna, Scott; Goldbach-Mansky, Raphaela; Poznanski, Andrew

2007-01-01

Neonatal onset multisystem inflammatory disease (NOMID), an autoinflammatory disease, is characterized by fever, chronic urticarial rash, CNS manifestations, and arthropathy. Approximately 50% of patients with NOMID have de novo missense mutations in CIAS1, which is associated with modulation of the IL-1b and apoptotic pathways. Approximately 60% of NOMID patients have prominent arthropathy, most commonly involving the knees, the cause of which remains poorly understood. To more fully describe the findings of NOMID arthropathy on MRI and radiography and to provide a better understanding of the origin of the bony lesions. We imaged 20 patients with NOMID to further investigate NOMID-associated bony lesions. Bony abnormalities were seen in the knees of 11/20 patients. The knee findings included enlarged, deformed femora and patellae in all and tibiae in the majority, without evidence of synovitis. Some patients had other joint involvement. Most had short stature and valgus or varus knee deformities. No association was noted between bony abnormalities and CIAS1 mutations. The abnormalities appeared to be the result of a mass-producing process. The resulting heterogeneously calcified masses appeared to originate in the physis and deformed the adjacent metaphysis and epiphysis. These findings suggest that the arthropathy of NOMID is the result of abnormal endochondral bone growth. Further investigation is needed to determine whether this deformity is triggered by inflammation early in development or by CIAS1 mutations causing abnormal chondrocyte apoptosis. (orig.)

Integrative Approach in Haemophillic Arthropathy of The Knee: a Case Report

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Andri Maruli T Lubis

2016-05-01

Full Text Available Haemophilic arthropathy is the most prevalent joint disorder in haemophilia. This disorder is characterized by chronic synovitis and progressive destruction of joint cartilage. We report a case of arthroscopic synovectomy to reduce bleeding frequency in haemophilic arthropathy of the knee. Patient was a 15 years old male with haemophilic arthropathy of the left knee. We performed an arthroscopic synovectomy under tightly regulated factor VIII replacement therapy. There were villous synovial hypertrophy at all part of the joint, multiple bone and cartilage defect, and also anterior cruciate ligament (ACL and posterior cruciate ligament (PCL deficiency found intraoperatively. After 6 month follow up, subjective complain and bleeding frequency decreased significantly. The visual analog scale improved from 5-6 to 1-2, and the International Knee Documentation Committee Score increased from 49 to 66. Bleeding frequency decreased from 4-8 times per month to less than 1 time per month. Arthroscopic synovectomy performed in this case could reduce the pain, decrease the frequency of bleeding, and improve patient’s functional outcome. Key words: arthroscopic synovectomy, haemophilic arthropathy, haemophilia, anterior cruciate ligament, posterior cruciate ligament.

Lead arthropathy: radiographic, CT and MRI findings

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Fernandes, Joao Luiz; Lopes Rocha, Arthemizio Antonio; Veloso Ayrimoraes Soares, Mayra; Lopes Viana, Sergio

2007-01-01

Lead arthropathy is a well-known complication of gunshot injuries with retained intra-articular bullets. Although several previous reports have discussed the radiological findings of this entity, computed tomography (CT) and magnetic resonance imaging (MRI) findings have never been described before in this setting. In this paper the authors review the imaging findings of 11 patients with lead arthropathy (1 of whom had clinical signs of lead poisoning as well), all of them studied by means of radiographs. In addition, non-enhanced CT scans were obtained in 3 patients and gadolinium-enhanced MRI in 1. Classic findings of intra-articular speckled lead deposits (occasionally with a ''lead arthrogram'' appearance), joint space narrowing and preserved bone density were found at radiographs in the great majority of cases. Furthermore, extension of intra-articular lead to adjacent tendon sheaths was observed in almost half of the patients, an observation rarely reported in the literature. CT scans and MRI, in their turn, were superior with regard to soft tissue abnormalities, accurately depicting joint effusion and the thickened synovium with lead particles embedded in it. Post-gadolinium MRI had the advantage of showing the enhancement pattern of the inflamed synovium and associated bone marrow edema pattern. Although it is not possible to establish the role of axial imaging in lead arthropathy from the small number of cases studied, this initial experience shows that both methods hold promise in this setting and may be useful, at least in selected cases. (orig.)

Manual therapy in the treatment of ankle hemophilic arthropathy. A randomized pilot study.

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Cuesta-Barriuso, Rubén; Gómez-Conesa, Antonia; López-Pina, José-Antonio

2014-11-01

Although physiotherapy has demonstrated effectiveness in preventing ankle arthropathy compared to prophylaxis treatment from early ages, there have been no conclusive studies examining physiotherapy intervention once hemophilic arthropathy of the ankle has been established. The aim of this study was to evaluate the effectiveness of two physiotherapy interventions, in patients with hemophilic arthropathy of the ankle that had not been operated on previously. Nine patients with hemophilia (mean age of 35.7 SD 11.9 years) were randomized to a mobilization group (n = 5) and manual therapy group (n = 4). The two physiotherapy interventions were: (1) passive mobilization and stretching; and (2) manual orthopaedic therapy, both with proprioception training. The study lasted for six weeks, with two sessions a week. Ankle mobility and pain perception, lower limb proprioception and quality of life were the outcome measures. Both treatments improved all ankle movements (p ankle arthropathy. No haemarthrosis was recorded during treatment or during the follow-up period.

The radiological residua of healed diabetic arthropathies

International Nuclear Information System (INIS)

Reinhardt, K.

1981-01-01

Diabetic arthropathy is a relatively rare manifestation of neuropathic disease, occurring in fewer than 5% of cases. Abnormalities of this type are confined largely to the small joints of the feet, although the larger joints of the lower limbs and the spine occasionally are affected. Some lesions, particularly in the feet, repair spontaneously, leaving radiological residua sufficiently characteristic to prompt suspicion of an unrecognised diabetic state. These include deformity of the head of the second metatarsal (akin to a Freiberg lesion), shortening of the great toe, painless deforming arthrosis of the knee, and ankylosis of interphalangeal joints. In the presence of these signs the patient should be interrogated concerning diabetes and blood sugar estimates, with provocation if necessary, obtained. Should such a diagnosis be sustained, appropriate protective measures may be undertaken to avoid a relapse of the arthropathy. (orig.)

Neurogenic Pulmonary Edema (A Case Report

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Funda Gümüş

2012-08-01

Full Text Available Neurogenic pulmonary edema is a life threatening complication of severe central nervous system injury. The most common cause of neurogenic pulmonary edema is subarachnoid hemorrhage followed by head trauma and epilepsy. The rare causes are cervical spine trauma, multiplesclerosis, cerebellar hemorrhage and intracranial tumors. Neurogenic pulmonary edema is characterized by an increase in extravascular lung water in patients who have sustained a sudden change in neurologic condition. The exact pathophysiology is unclear but it probably involves an adrenergic response to the central nervous system injury which leads to increased catecholamine, pulmonary hydrostatic pressure and increased lung capillary permeability. The presenting symptoms are nonspecific and often include dyspnea, tachypnea, tachycardia, hypoxemia, pinkfroty secretion, bilateral pulmonary infiltrates and crackles. These symptoms start within minutes or hours and resolves 48-72 hours that typically for neurogenic pulmonary edema. Basic principles of treatment, surgical decompression, reduce intracranial pressure, controlled ventilation with suplemental oxygen, positive end expiratory pressure and diuresis. We report a case with neurogenic pulmonary edema that occured after head trauma. (Journal of the Turkish Society Intensive Care 2012; 10: 59-62

Occurrence of crystal arthropathy in patients presenting with ...

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musculo-skeletal) diseases associated with the deposition of mineralized material within joints and periarticular soft tissues. Gout is the most common and pathogenetically best understood crystal arthropathy, followed by basic calcium ...

Haemophilic arthropathy of the knee. Gd-DTPA enhanced MRT. Clinical and radiological correlation

International Nuclear Information System (INIS)

Naegele, M.; Kunze, V.; Hamann, M.; Eickhoff, H.; Koch, W.; Oldenburg, J.; Reiser, M.

1994-01-01

17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRT before and after i.v. bolus injection of Gadolinium-DTPA (0,1 mmol/kg body weight). After contrast enhancement, synovial proliferations exhibited an increase of signal intensity (SI) of FFE and SE images of 47.7% and 37.4% respectively, whereas muscle and fatty tissue, tendons, bone marrow and joint effusion revealed only minor increase in SI. The gradient of signal intensity (ratio SI/time) of pannus was 39,6% min. Gd-DTPA enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.) [de

[Acute neurogenic pulmonary edema].

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Roquefeuil, B

1975-01-01

Neurogenic edema, in the strict sense of the term, has at the present time practically not benefitted from precise hemodynamic investigations in human clinical practice, and owing to this fact, authors still classify them under the heading "mixed edema or of unknown pathogenesis". In contrast with this lack of information in man, animal experimental works are surprising by their coherence and the experimental facility of producing neurogenic edema (cranial hypertension by a small inflatable balloon and cisternal infection of fibrin). If one excludes the now ancient vagal theories (CAMERON 1949; CAMPBELL, 1949) which were never confirmed, all of the most recent experimental works (SARNOFF, 1952; DUCKER, 1968; LUISADA, 1967; MORITZ, 1974) confirm the adrenergic disorder of central origin during neurogenic A.P.E. which from the hemodynamic standpoint is like an authentic hemodynamic A.P.E. with raised left atrial pressure, pulmonary venous pressure and pulmonary capillary pressure.

Angiographic assessment of atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy.

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Çildağ, Mehmet B; Ertuğrul, Bülent M; Köseoğlu, Ömer Fk; Çildağ, Songül; Armstrong, David G

2018-06-01

The aim of this study was to investigate atherosclerotic load at the lower extremity in patients with diabetic foot and charcot neuro-arthropathy and compare them with patients with diabetic foot without charcot neuro-arthropathy. This retrospective study consists of 78 patients with diabetic foot who had lower extremity angiography with antegrade approach. All patients were classified into two groups; neuro ischemic wounds with charcot neuro-arthropathy (30/78) and without charcot neuro-arthropathy (48/78).Atherosclerotic load at the side of diabetic foot was determined by using the Bollinger angiogram scoring method. Comparison of atherosclerotic load between the two groups was performed. The mean of total and infrapopliteal level angiogram scoring of all patients was 33.3 (standard deviation, sd:±17.2) and 29.3 (sd:±15.6), respectively. The mean of total and infrapopliteal level angiogram scoring of neuroischemic wounds with charcot neuro-arthropathy group was 18.1 (sd:±11.6) and 15.7 (sd:±10.4), respectively. The mean of total and infrapopliteal level angiogram scoring of neuroischemic wounds without charcot neuro-arthropathy group was 42.8 (sd:±12.7) and 37.7 (sd:±12.0), respectively. There was a statistically significant difference between the two groups of mean total and infrapopliteal angiogram scoring (p diabetic foot and chronic charcot neuro-arthropathy is significantly less than in patients with neuroischemic diabetic foot wounds without chronic charcot neuro-arthropathy. Copyright © 2017. Published by Elsevier Taiwan LLC.

Arthropathie destructrice des epaules au cours d�une acromegalie

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Nessrine Akasbi

2011-10-01

Full Text Available L�acromegalie est une maladie endocrinienne rare, en rapport avec une hypersecretion d�hormone de croissance. Elle a des consequences rhumatologiques: l�arthropathie peripherique, l�atteinte rachidienne et les syndromes canalaires. L�atteinte articulaire accompagne une acromegalie active, sa survenue apres un traitement radical et une remission complete est rare. Nous presentons le cas d�une patiente de 70 ans ayant un antecedent d�acromegalie sur adenome hypophysaire il y a 25 ans, traitee chirurgicalement et declaree en remission complete, a developpe une arthropathie destructrice des deux epaules. Le but de notre observation est de mettre le point sur la possibilite d�une atteinte articulaire au cours de l�acromegalie et de son retentissement fonctionnelle.

Spondylo-arthropathies or ossifying polyenthesites. Scintigraphic and scannographic results

International Nuclear Information System (INIS)

Gaucher, A.; Pere, P.; Regent, D.; Grandhaye, P.; Aussedat, R.; Vivard, T.

1987-01-01

Ossifying enthesites present an undeniable diagnostic value in every chronic inflammatory rheumatism at an early stage, not only in adults but also in children. Bony scintigraphy discovers them in most localizations at a preradiological stage, as soon as they cause pain. The scanner examination enables to follow the anatomical evolution of the ossifications. It is perfectly suitable for the study of sacro-iliac and interapophyseal joints. Ossifying enthesites, the evolution of which spreads over several years, often depend on mechanical, professional or athletic constraints. Ossifying enthesitis is a common characteristics of ''classic'' spondylo-arthropathies which are all ossifying polyenthesites: ankylosing spondylarthritis, psoriasic rheumatism, rheumatism of enteropathies, Fiessinger-Leroy-Reiter syndrome and juvenile spondylo-arthropathies [fr

Adverse reaction to metal debris with concomitant incidental crystalline arthropathy in hip arthroplasty

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Edward J. Testa, BS

2017-03-01

Full Text Available Adverse reaction to metal debris (ARMD is a known cause of failed metal in hip arthroplasty. Diagnosis of this type of prosthesis failure may be difficult, and the hallmark is an abnormally elevated serum cobalt level. Concomitant diagnoses may also be present, such as infection, instability, and loosening, and this may confuse interpretation of abnormal laboratories. We present here, for the first time, 2 patients with ARMD and crystalline arthropathy. In each case, the patient chose surgery for ARMD, with resolution of symptoms and no recurrence of the crystalline arthropathy. We present these cases to alert the orthopaedist that crystalline arthropathy may be present at the same time as ARMD, but is likely not the primary cause of symptoms.

What determines neurogenic competence in glia?

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Costa, Marcos Romualdo; Götz, Magdalena; Berninger, Benedikt

2010-05-01

One of the most intriguing discoveries during the last decade of developmental neurobiology is the fact that both in the developing and adult nervous system neural stem cells often turn out to have a glial identity: Radial glia generates neurons in the developing telencephalon of fish, birds and mammals and astro/radial glial stem cells in specialized neurogenic zones give rise to new neurons throughout life. What are the extrinsic signals acting on and the intrinsic signals acting within these glial populations endowing these with a neurogenic potential, whilst most other glia seemingly lack it? Studies on postnatal astroglia shed interesting light on this question as they are the intermediate between neurogenic radial glia and mature parenchymal astrocytes. At least in vitro their decision to acquire a glial fate is not yet irrevocable as forced expression of a single neurogenic transcription factor enables them to transgress their lineage and to give rise to fully functional neurons acquiring specific subtype characteristics. But even bona fide non-neurogenic glia in the adult nervous system can regain some of their radial glial heritage following injury as exemplified by reactive astroglia in the cerebral cortex and Müller glia in the retina. In this review first we will follow the direction of the physiological times' arrow, along which radial glia become transformed on one side into mature astrocytes gradually losing their neurogenic potential, while some of them seem to escape this dire destiny to settle in the few neurogenic oases of the adult brain where they generate neurons and glia throughout life. But we will also see how pathophysiological conditions partially can reverse the arrow of time reactivating the parenchymal astroglia to re-acquire some of the hallmarks of neural stem cells or progenitors. We will close this review with some thoughts on the surprising compatibility of the co-existence of a neural stem cell and glial identity within the very

Neurogenic bladder in Hunter's syndrome.

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Koyama, K; Moda, Y; Sone, A; Tanaka, H; Hino, Y

1994-01-01

We encountered a rare patient with Hunter's syndrome who exhibited urinary retention as a result of a neurogenic bladder, uninhibited detrusor contractions, and detrusor-sphincter dyssynergia. Neurological findings were consistent with cervical myelopathy and cervical MR imaging showed very narrow segments at the cord level C2-4. We speculate that this Hunter's syndrome patient has cervical myelopathy and that this neurological dysfunction causes the neurogenic bladder. PMID:8014981

Shoulder arthropathy in primary hyperparathyroidism

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Nussbaum, A.J.; Doppman, J.L.

1982-01-01

An erosive arthropathy of the hands and wrists has been recognized in patients with primary and secondary hyperparathyroidism. Recently, intra-articular erosions of the humeral head were described in six patients who had been on chronic long-term hemodialysis with secondary hyperparathyroidism. We would like to present the finding of shoulder erosions in four patients with primary hyperparathyroidism and one patient with renal osteodystrophy and suggest that the humeral erosion can occur in both an intra-articular and peri-articular location. (orig.)

Charcot arthropathy of the lumbar spine treated using one-staged posterior three-column shortening and fusion.

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David, Kenny Samuel; Agarwala, Amit Omprakash; Rampersaud, Yoga Raja

2010-06-15

Case report. We present a case of lumbar Charcot arthropathy successfully treated surgically using posterior 3-column resection, spinal shortening, and fusion. The operative treatment of Charcot arthropathy of the spine has conventionally been a combination of anterior and posterior surgery. The morbidity associated with these surgical procedures can be considerable. A posterior-only approach to the problem would avoid the additional morbidity associated with an anterior approach. We present a case of lumbar Charcot arthropathy with deformity treated successfully using such a procedure. Discussion of the patient's clinical and radiologic history, the technical merits of the operative intervention and a review of the relevant background literature are presented. A multilevel, single-stage, posterior 3-column resection with primary shortening and instrumented fusion augmented with rhBMP2 in a multiply operated patient with deformity provided a optimal biologic and mechanical environment for healing of the Charcot arthropathy and improved the sagittal and coronal profile of the spine. A single-stage, multilevel, posterior 3-column resection and primary shortening can be a useful surgical strategy in symptomatic patients with Charcot arthropathy of the spine.

Neurogenic Stuttering and Lateralized Motor Deficits Induced by Tranylcypromine

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J. D. Duffy

1994-01-01

Full Text Available A case of neurogenic stuttering induced by the monoamine oxidase inhibitor tranylcypromine is described. The association of neurogenic stuttering with acquired lateralized motor deficits in the patient described is discussed with reference to current theories regarding the pathogenesis of neurogenic stuttering.

Preoperative neurogenic pulmonary edema: A dilemma for decision making

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Siva Kumar Reddy Lakkireddigari

2012-01-01

Full Text Available Neurogenic pulmonary edema may be a less-recognized consequence of obstructive hydrocephalus. The authors report a patient with acute obstructive hydrocephalus due to cerebellar metastatic lesion, who presented with neurogenic pulmonary edema. The edema resolved on placement of the ventriculoperitonial shunt. This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure and the issues involved with anesthetic management of co-existing neurogenic pulmonary edema and intracranial hypertension.

The effect of radiation therapy on hemophilic arthropathy

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Kang, Jin Oh; Hong, Seong Eon; Kim, Sang Gi; Shin, Dong Oh [School of Medicine, KyungHee University, Seoul (Korea, Republic of)

2005-06-15

Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at KyungHee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900 cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. There was a tendency of frequent bleeding for the patients younger than 11 ({rho} 0.051) but there was also a tendency for more improvement in this group ({rho} 0.057). The number of joint bleedings was related with joint pain ({rho} 0.012) and joint swelling ({rho} = 0.033) but not with the Arbold-Hilgartner stage ({rho} 0.739),cartilage destruction ({rho} = 0.718) and synovial hypertrophy ({rho} = 0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy ({rho} = 0.017). Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy.

The effect of radiation therapy on hemophilic arthropathy

International Nuclear Information System (INIS)

Kang, Jin Oh; Hong, Seong Eon; Kim, Sang Gi; Shin, Dong Oh

2005-01-01

Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at KyungHee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900 cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. There was a tendency of frequent bleeding for the patients younger than 11 (ρ 0.051) but there was also a tendency for more improvement in this group (ρ 0.057). The number of joint bleedings was related with joint pain (ρ 0.012) and joint swelling (ρ = 0.033) but not with the Arbold-Hilgartner stage (ρ 0.739),cartilage destruction (ρ = 0.718) and synovial hypertrophy (ρ = 0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy (ρ = 0.017). Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy

Neurogenic stuttering: a review of the literature.

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Cruz, C; Amorim, H; Beca, G; Nunes, R

2018-01-16

Neurogenic stuttering is a disorder of neurologic origin in the rhythm of speech during which the patient knows exactly what he wants to say but is unable to because of an involuntary prolongation, cessation or repetition of a sound. To assemble new insights regarding the epidemiology, pathophysiology, diagnosis, evaluation and treatment of neurogenic stuttering. A review of all PubMed and Scopus published articles between January 2000 and September 2016 was performed. Thirty-three publications were analyzed. Neurogenic stuttering is a rare entity whose epidemiological incidence is yet not fully established. It is correlated with several neurological diseases and with several possible localizations within the nervous system. Notwithstanding the recent advances in the understanding of the underlying mechanism, it is not yet possible to establish a single pathophysiological mechanism of neurogenic stuttering. The differential diagnosis is complex and requires the detailed knowledge of other language disorders. The treatment is currently based on specific speech language therapy strategies. Neurogenic stuttering is a complex disorder which is not fully understood. Additional studies might help to better explain the underlying pathophysiological mechanism and to open doors to novel therapeutic methods.

Neuropathic arthropathy of the shoulder interpreted as neoplasic lesion (reports of two cases)

International Nuclear Information System (INIS)

Galvis Ramirez, Javier Fernando; Soto, Camilo; Escandon, Santiago

2006-01-01

The neuropathic arthropathy is an illness that destroys the articulation, associated to loss of the propiocepcion. Inside the main causes they are the syringomyelia, tertiary syphilis and diabetes mellitus. In the superior member the frequently affected articulation is the glen humeral. In this report two patients are presented with neuropathic arthropathy from the shoulder secondary to syringomyelia and remitted to orthopedic oncology with diagnosis of condrosarcoma. The clinical radiological presentation and the differential diagnosis are analyzed

Septic arthritis and arthropathy of the rotator cuff: remember this association

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Danilo Sobreira

2016-08-01

Full Text Available ABSTRACT OBJECTIVE: To describe occurrences of septic glenohumeral arthritis among patients with arthropathy of the rotator cuff, and to highlight the importance of correct diagnosis and surgical procedures. METHODOLOGy: Eight surgical drains were installed in seven patients with glenohumeral pyoarthritis. All the patients presented arthropathy of the rotator cuff (four males and three females. Six patients presented pyoarthritis in the dominant shoulder. The age range was from 53 to 93 years (mean: 74 years. The mean duration of the symptoms before the surgical lavage was six weeks. Six patients underwent treatment consisting of a combination of arthroscopic irrigation and debridement, and one patient was treated by means of open arthrotomy. All the patients received systemic antibiotic therapy in accordance with their bacterial sensitivity. RESULTS: All seven patients achieved satisfactory results, taking into consideration especially the improvement of pain and the patients' satisfaction. The functional assessment was performed using the University of California Los Angeles (UCLA scale. Only one patient needed to go through another arthroscopic procedure. Staphylococcus aureus was isolated from four cultures and Escherichia coli from one culture. There were two situations in which the patients used empirical antibiotic therapy and the cultures showed negative results. Among the associated procedures, tenotomy of the biceps was performed in four cases, resection of the lateral third of the clavicle due to osteomyelitis in one case and arthrotomy of the knee in one case. CONCLUSION: Surgical treatment was effective in the cases of arthritis associated with arthropathy of the rotator cuff. In patients with arthropathy of the rotator cuff and subclinically altered laboratory signs, the possibility of pyoarthritis should always be suspected.

PHYSICAL THERAPY AND FUNCTIONAL REHABILITATION IN PATIENTS WITH HAEMOPHILIC ARTHROPATHY SURGICALLY TREATED

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Dan V. Poenaru

2016-09-01

Full Text Available Patients with haemophilia type A or B may develop, over time, haemophilic arthropathy with different degrees of joint dysfunction. This disorder is a consequence of repeated episodes of intraarticular bleeding, with either spontaneous or traumatic aetiology. In the recent years, the therapeutic management of these patients has changed, still, without prompt early diagnosis and prophylactic treatment, the joints deteriorate to such a degree that only a complex multi-disciplinary approach can offer an optimal outcome. Modern high resolution MRI and prophylaxis treatment can detect and delay early signs of haemophilic arthropathy, but, not all patients have access to these types of early interventions. As a result, there are still patients presenting with different of degrees haemophilic arthropathy, which require surgical treatment. Despite the use of modern, minimal invasive approaches, surgical treatment alone can’t offer a good symptom relief and can’t provide a good functional outcome. Thus, the integration of physical therapy and functional rehabilitation in the therapeutic scheme can provide a good support in order for these patients to be socio-economically re-integrated.

Jaccoud's arthropathy and pulmonary fibrosis in CREST syndrome

International Nuclear Information System (INIS)

Spinel B, Nestor; Montenegro, Pablo; Rondon Federico; Restrepo, Jose F; Iglesias G, Antonio

2010-01-01

We report a case of a 48 years old patient with diagnosis of incomplete CREST syndrome (variant limited systemic sclerosis) in who we documented the presence of Jaccoud's arthropathy of the hands and pulmonary involvement by pulmonary fibrosis type usual interstitial pneumonia, with positivity for rheumatoid factor and anti-cyclic citrullinated peptide antibody.

Preoperative neurogenic pulmonary edema: A dilemma for decision making

OpenAIRE

Lakkireddigari, Siva Kumar Reddy; Durga, Padmaja; Nayak, Madhukar; Ramchandran, Gopinath

2012-01-01

Neurogenic pulmonary edema may be a less-recognized consequence of obstructive hydrocephalus. The authors report a patient with acute obstructive hydrocephalus due to cerebellar metastatic lesion, who presented with neurogenic pulmonary edema. The edema resolved on placement of the ventriculoperitonial shunt. This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure and the iss...

Equilibrium blood pool scanning in the evaluation of hemophilic arthropathy

International Nuclear Information System (INIS)

Spies, S.; Green, D.; Rana, N.A.; Milgram, J.W.; Mintzer, R.

1978-01-01

Arthropathy was evaluated in six patients with severe hemophilia (factor VIII<1%) using the technique of blood pool scanning. Employing an in vivo method for erythrocyte labelling with technetium-99m, a dynamic perfusion sequence was obtained using a scintillation camera over the joint(s) to be examined. Subsequently, equilibrium blood pool images of the joints were obtained to determine regional blood volume. In young patients with repeated episodes of acute hemarthrosis, increased vascularity and increased blood pool in the affected joints were demonstrated. In older patients with fixed, contracted joints and degenerative arthropathy, vascularity and regional blood volume were not abnormal. Blood pool scanning is a safe, non-invasive technique that augments the clinical and radiographic examination of the joints. The method is helpful in distinguishing acute joint bleeding from chronic synovitis and arthritis, and may prove useful in selecting patients for synovectomy. (author)

Psoriatic arthropathy in a 17th century archaeological protestant ...

African Journals Online (AJOL)

Besides a plague epidemic that appeared as soon as 1636 or even before in the area of the Marne mander, and more precisely in Saint-Maurice, psoriatic arthropathy (or psoriatic arthritis) lesions were diagnosed on the skeletons of an important population that had never been described before. The lesion symptoms of this ...

Neuropeptides, neurogenic inflammation and complex regional pain syndrome (CRPS).

Science.gov (United States)

Birklein, Frank; Schmelz, Martin

2008-06-06

This review explains symptoms and nature of neuropeptide signaling and its importance for clinical symptoms of CRPS. Neurogenic inflammation regularly accompanies excitation of primary afferent nociceptors. It has two major components-plasma extravasation and vasodilatation. The most important mediators are the calcitonin gene-related peptide (CGRP) and substance P (SP). After peripheral trauma immune reaction (e.g. cytokines) and the attempts of the tissue to regenerate (e.g. growth factors) sensitize nociceptors and amplify neurogenic inflammation. This cascade of events has been demonstrated in rat models of CRPS. Clinical findings in these animals strongly resemble clinical findings in CRPS, and can be prevented by anti-cytokine and anti-neuropeptide treatment. In CRPS patients, there is meanwhile also plenty of evidence that neurogenic inflammation contributes to clinical presentation. Increased cytokine production was demonstrated, as well as facilitated neurogenic inflammation. Very recently even "non-inflammatory" signs of CRPS (hyperhidrosis, cold skin) have been linked to neuropeptide signaling. Surprisingly, there was even moderately increased neurogenic inflammation in unaffected body regions. This favors the possibility that CRPS patients share genetic similarities. The future search for genetic commonalities will help us to further unravel the "mystery" CRPS.

MR imaging in hemophilic arthropathy

International Nuclear Information System (INIS)

Baunin, C.; Railhac, J.J.; Younes, I.; Gaubert, J.; DuBoullay, C.; Dirat, G.; Robert, A.

1990-01-01

This paper reports on twenty children with hemophilia examined to determine if MR imaging could be used to assess hemophilic arthropathy. Twenty-eight joints were imaged (17 knees, 10 ankles, 1 elbow) with plain radiography, US, CT, and MR imaging. The results were compared with the surgical view and histologic study of the articular components when synovectomy was done. These results show the usefulness of MR imaging: fluid collections in the joint space were evaluated, and it was possible to distinguish blood from inflammatory fluid. Synovial hypertrophy was appreciated, and findings correlated well with histologic study. Anomalies of articular cartilage, joint-space narrowing, and bone lesions were demonstrated early, when plain radiography findings were still normal

Reliability of AOFAS diabetic foot questionnaire in Charcot arthropathy: stability, internal consistency, and measurable difference.

Science.gov (United States)

Dhawan, Vibhu; Spratt, Kevin F; Pinzur, Michael S; Baumhauer, Judith; Rudicel, Sally; Saltzman, Charles L

2005-09-01

The development of Charcot changes is known to be associated with a high rate of recurrent ulceration and amputation. Unfortunately, the effect of Charcot arthropathy on quality of life in diabetic patients has not been systematically studied because of a lack of a disease-specific instrument. The purpose of this study was to develop and test an instrument to evaluate the health-related quality of life of diabetic foot disease. Subjects diagnosed with Charcot arthropathy completed a patient self-administered questionnaire, and clinicians completed an accompanying observational survey. The patient self-administered questionnaire was organized into five general sections: demographics, general health, diabetes-related symptoms, comorbidities, and satisfaction. The scales measured the effect in six health domains: 1) general health, 2) care, 3) worry, 4) sleep, 5) emotion, and 6) physicality. The psychometric properties of the scales were evaluated and the summary scores for the Short-Form Health Survey (SF-36) were compared to published norms for other major medical illnesses. Of the 89 enrolled patients, 57 who completed the questionnaire on enrollment returned a second completed form at 3-month followup. Over the 3-month followup period most of the patients showed an improvement in the Eichenholtz staging. The internal consistency of most was moderate to high and, in general, the scale scores were stable over 3 months. However, several of the scales suffered from low-ceiling or high-floor effects. Patients with Charcot arthropathy had a much lower physical component score on enrollment than the reported norms for other disease conditions, including diabetes. Quality of life represents an important set of outcomes when evaluating the effectiveness of treatment for patients with Charcot arthropathy. This study represents an initial attempt to develop a standardized survey for use with this patient population. Further studies need to be done with larger groups of

Etiopathogenesis of neurogenic pulmonary edema

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří

2010-01-01

Roč. 160, 5-6 (2010), s. 152-154 ISSN 0043-5341 Institutional research plan: CEZ:AV0Z50390512 Keywords : neurogenic pulmonary edema * intracranial pressure * sympathetic system Subject RIV: FH - Neurology

Peripheral tumor and tumor-like neurogenic lesions

Energy Technology Data Exchange (ETDEWEB)

Abreu, Evandro [Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et Imagerie de l’Appareil Locomoteur, CHRU de Lille, 59037 Lille (France); Aubert, Sébastien, E-mail: sebastien.aubert@chru-lille.fr [Institut de Pathologie, Centre de Biologie-Pathologie, CHRU de Lille, 59037 Lille (France); Wavreille, Guillaume, E-mail: guillaume.wavreille@chru-lille.fr [Service d’Orthopédie B, Hôpital R Salengro, CHRU de Lille, 59037 Lille (France); Gheno, Ramon; Canella, Clarissa [Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et Imagerie de l’Appareil Locomoteur, CHRU de Lille, 59037 Lille (France); Cotten, Anne, E-mail: anne.cotten@chru-lille.fr [Service de Radiologie et Imagerie Musculosquelettique, Centre de Consultation et Imagerie de l’Appareil Locomoteur, CHRU de Lille, 59037 Lille (France)

2013-01-15

Neoplasms of neurogenic origin account for about 12% of all benign and 8% of all malignant soft tissue neoplasms. Traumatic neuroma, Morton neuroma, lipomatosis of a nerve, nerve sheath ganglion, perineurioma, benign and malignant peripheral nerve sheath tumors (PNST) are included in this group of pathologies. Clinical and radiologic evaluation of patients with neurogenic tumors and pseudotumors often reveals distinctive features. In this context, advanced imaging techniques, especially ultrasound (US) and magnetic resonance (MR) play an important role in the characterization of these lesions. Imaging findings such as location of a soft tissue mass in the region of a major nerve, nerve entering or exiting the mass, fusiform shape, abnormalities of the muscle supplied by the nerve, split-fat sign, target sign and fascicular appearance should always evoke a peripheric nerve sheath neoplasm. Although no single imaging finding or combination of findings allows definitive differentiation between benign from malign peripheric neurogenic tumors, both US and MR imaging may show useful features that can lead us to a correct diagnosis and improve patient treatment. Traumatic neuromas and Morton neuromas are commonly associated to an amputation stump or are located in the intermetatarsal space. Lipomatosis of a nerve usually appears as a nerve enlargement, with thickened nerve fascicles, embedded in evenly distributed fat. Nerve sheath ganglion has a cystic appearance and commonly occurs at the level of the knee. Intraneural perineuroma usually affects young people and manifests as a focal and fusiform nerve enlargement. In this article, we review clinical characteristics and radiologic appearances of these neurogenic lesions, observing pathologic correlation, when possible.

Case report 475: Hemophilic arthropathy of the hip in a woman with hemophilia A

Energy Technology Data Exchange (ETDEWEB)

Farsoe Nielsen, F.; Christensen, S.E.; Carvalho, A. de

1988-04-01

In summary, a case has been presented of a 31-year-old woman with a history of mild trauma at the age of 14 years and recurrent periods of pain in the hip becoming increasingly more severe. The radiological features were those of marked arthropathy of the affected hip with suggested features of ischemic necrosis. The patient was an example of hemophilia A which occurs rarely in females. The nature of the laboratory and clinical features of deficiency in hemophilia was considered and the clinical and radiological manifestations were described. The differential diagnosis was discussed. The radiological features in the background of the clinical information strongly suggest that the diagnosis of hemophilic arthropathy of the hip is justified. (orig./SHA).

Case report 475: Hemophilic arthropathy of the hip in a woman with hemophilia A

International Nuclear Information System (INIS)

Farsoe Nielsen, F.; Christensen, S.E.; Carvalho, A. de

1988-01-01

In summary, a case has been presented of a 31-year-old woman with a history of mild trauma at the age of 14 years and recurrent periods of pain in the hip becoming increasingly more severe. The radiological features were those of marked arthropathy of the affected hip with suggested features of ischemic necrosis. The patient was an example of hemophilia A which occurs rarely in females. The nature of the laboratory and clinical features of deficiency in hemophilia was considered and the clinical and radiological manifestations were described. The differential diagnosis was discussed. The radiological features in the background of the clinical information strongly suggest that the diagnosis of hemophilic arthropathy of the hip is justified. (orig./SHA)

Hemophilic arthropathy of the knee joint: static and dynamic Gd-DTPA - enhanced MRI

Energy Technology Data Exchange (ETDEWEB)

Naegele, M. [Dept. of Radiology, Univ. Bonn (Germany); Bruening, R. [Dept. of Radiology, Univ. Muenchen (Germany); Kunze, V. [Dept. of Radiology, Univ. Bonn (Germany); Eickhoff, H. [Dept. of Orthopedic Surgery, Troisdorf (Germany); Koch, W. [Dept. of Orthopedic Surgery, Troisdorf (Germany); Reiser, M. [Dept. of Radiology, Univ. Muenchen (Germany)

1995-12-31

A total of 17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRI before and after an IV bolus injection of Gadolinium-DTPA (Gd-DTPA; 0.1 mmol/kg body weight). The T1-weighted spin-echo (SE) and gradient-echo (fast-field echo [FFE]) sequences were applied. The FFE sequences of eight consecutive scans carried out over a time interval of 160 s were used in order to determine the time to signal intensity (SI) curves of the synovial proliferations surrounding soft tissue, bone marrow, and joint effusion. After the administration of a contrast agent, synovial proliferations exhibited an increase on FFE and SE images of 47.7% (SD {+-} 14.3%) and 37.4% (SD {+-} 11.2%), respectively, whereas muscle and fatty tissue, tendons, bone marrow, and joint effusion revealed only a minor increase in SI. The gradient of SI (ratio SI/time) of pannus was 39.6%/min (SD {+-} 7.7%/min) and differed significantly (P < 0.001) from that of bone marrow, fatty tissue, muscle tissue, tendons, and joint effusion (P < 0.05). In contrast to synovial proliferations in rheumatoid arthritis, no differentiation between various pannus vascularities based on the degree of enhancement was possible. The Gd-DTPA-enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.)

Hemophilic arthropathy of the knee joint: static and dynamic Gd-DTPA -enhanced MRI

International Nuclear Information System (INIS)

Naegele, M.; Bruening, R.; Kunze, V.; Eickhoff, H.; Koch, W.; Reiser, M.

1995-01-01

A total of 17 patients with hemophilic arthropathy of the knee joint were studied with static and dynamic MRI before and after an IV bolus injection of Gadolinium-DTPA (Gd-DTPA; 0.1 mmol/kg body weight). The T1-weighted spin-echo (SE) and gradient-echo (fast-field echo [FFE]) sequences were applied. The FFE sequences of eight consecutive scans carried out over a time interval of 160 s were used in order to determine the time to signal intensity (SI) curves of the synovial proliferations surrounding soft tissue, bone marrow, and joint effusion. After the administration of a contrast agent, synovial proliferations exhibited an increase on FFE and SE images of 47.7% (SD ± 14.3%) and 37.4% (SD ± 11.2%), respectively, whereas muscle and fatty tissue, tendons, bone marrow, and joint effusion revealed only a minor increase in SI. The gradient of SI (ratio SI/time) of pannus was 39.6%/min (SD ± 7.7%/min) and differed significantly (P < 0.001) from that of bone marrow, fatty tissue, muscle tissue, tendons, and joint effusion (P < 0.05). In contrast to synovial proliferations in rheumatoid arthritis, no differentiation between various pannus vascularities based on the degree of enhancement was possible. The Gd-DTPA-enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynamic studies in hemophilic arthropathy do not provide qualitative assessment of the inflammatory process. (orig.)

The impact of HSV for inflammatory arthropathy patients.

LENUS (Irish Health Repository)

O'Connor, Mortimer B

2012-02-01

Herpes simplex virus type 1 (HSV-1), also known as herpes labialis, is the etiologic agent of vesicular lesions of the oral mucosa commonly referred to as "cold sores". HSV-1 can also cause clinical disease in a wide variety of other anatomic locations including the genitalia, liver, lung, eye, and central nervous system. These infections can be severe, particularly in the setting of immunosuppression, such as inflammatory arthropathy patients on Methotrexate ± biological therapies. Here, we highlight the importance of physician awareness of HSV due to its potential impact for rheumatology patients.

Bibliometric profile of neurogenic bladder in the literature: a 20-year bibliometric analysis

Directory of Open Access Journals (Sweden)

Yuan Gao

2015-01-01

Full Text Available Neurogenic bladder is a dysfunction of the lower urinary tract caused by nervous system disorder. We investigated the trends in publication of articles under the topic "neurogenic bladder" using bibliometric analysis. Articles on neurogenic bladder, published between 1995 and 2014, were retrieved from the ISI Web of Science citation database. We analyzed the search results for authors, countries, institutions, journals, and top-cited papers. A total of 1,904 articles were retrieved. There was a small increase in the number of articles on neurogenic bladder from 1995 (n = 43 to 2014 (n = 117. The USA was the leading country in the total number of articles (n = 598. However, the number of publications from China has rapidly increased, and China was ranked second in 2014. Emmanuel Chartier-Kastler (n = 65 was the most productive author, and University of Paris VI (Paris 6 (n = 61 was the most productive institution. The Journal of Urology published the greatest number of articles on this topic (n = 285. Articles on neurogenic bladder were often published in a professional journal under the category Urology & Nephrology, Neurosciences & Neurology, or Rehabilitation. Visualization analysis based on co-citation networks was conducted using CiteSpace III. Visualization analysis revealed that the hot spots in neurogenic bladder were botulinum toxin-A, prazosin, bethanechol, and afferent pathways. These findings provide new insight into the publication trends and hot spots in neurogenic bladder.

Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

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Zuhal Ozisler

2015-01-01

Full Text Available In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems (constipation, difficult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysreflexia and bowel evacuation methods (digital stimulation, oral medication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identified in 44 (80% of the 55 patients before bowel program. Constipation (56%, 31/55 and incontinence (42%, 23/55 were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before (76%, 42/55 and after (73%, 40/55 bowel program. Oral medication, enema and manual evacuation application rates were significantly decreased and constipation, difficult intestinal evacuation, abdominal distention, and abdominal pain rates were significantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

Ageing with neurogenic bowel dysfunction

DEFF Research Database (Denmark)

Nielsen, S D; Faaborg, Pia Møller; Finnerup, Nanna Brix

2017-01-01

The aim of this longitudinal study with postal survey was to describe changes in the patterns of neurogenic bowel dysfunction and bowel management in a population of people with spinal cord injury (SCI) followed for two decades. In 1996, a validated questionnaire on bowel function was sent to the...

Effect of intra-articular yttrium-90 on chronic pyrophosphate arthropathy of the knee

International Nuclear Information System (INIS)

Doherty, M.; Dieppe, P.A.

1981-01-01

Fifteen patients with bilateral, symmetrical chronic pyrophosphate arthropathy of the knee were given intra-articular injections of yttrium-90 (5 mCi) plus steroid (triamcinolone hexacetonide, 20 mg) into one knee, and saline plus steroid into the other (control) knee. Allocation of the 90 Y injection was random and double blind. After 6 months there was significantly less pain, inactivity stiffness, joint-line tenderness, and effusion in the 90 Y-injected knees than in the controls (p 90 Y-injected and control knees in the changes in range of movement (p 90 Y may be of benefit in chronic pyrophosphate arthropathy, a disease for which there is no treatment. The predilection of this condition to affect the knees of the elderly makes such treatment highly suitable because the joint lends itself readily to injection and the procedure carries very few actual or potential risks in this age group. (author)

Neurogenic myopathies and imaging of muscle denervation; Neurogene Myopathien und Bildgebung der Muskeldenervation

Energy Technology Data Exchange (ETDEWEB)

Wolf, M. [Universitaetsklinikum Heidelberg, Abteilung fuer Neuroradiologie, Heidelberg (Germany); Wolf, C. [Reha-Zentrum Gernsbach, Neurologie, Gernsbach (Germany); Weber, M.A. [Universitaetsklinikum Heidelberg, Abteilung fuer Diagnostische und Interventionelle Radiologie, Heidelberg (Germany)

2017-12-15

Neurogenic myopathies are primary diseases of the nervous system, which secondarily result in denervation of the target musculature. The spectrum of potential causes is manifold ranging from acute traumatic injuries and chronic compression to neurodegenerative, inflammatory, metabolic and neoplastic processes. The medical history, clinical neurological examination, and electrophysiological tests including electromyography and nerve conduction studies are crucial in diagnosing neuropathic myopathies. Electromyography is the gold standard for diagnosing muscle denervation. Additional imaging methods and magnetic resonance imaging (MRI) in particular, are capable of contributing valuable information. The MRI examination of denervated musculature shows edema, an increase in the apparent diffusion coefficient (ADC) and hyperperfusion. Chronic denervation results in fatty degeneration and atrophy of affected muscles, which are also detectable by MRI. Although the MRI findings in muscle denervation are relatively unspecific, they show a high sensitivity, comparable to electromyography. Dedicated MR neurography may often visualize the underlying lesion(s) of the innervating nerve(s). Besides high sensitivity, comparable to electromyography, MRI is capable of evaluating muscles which are inaccessible for needle electromyography. Due to its non-invasive character, MRI is ideal for follow-up examinations. The use of MRI is often a meaningful addition to the diagnostics of neurogenic myopathies. The extent and distribution pattern of muscular alterations often provide information on the localization of the causative nerve damage. A correct diagnosis or at least a narrowing down of possible differential diagnoses can often be achieved using MRI. (orig.) [German] Neurogene Myopathien sind Erkrankungen des Nervensystems, die sekundaer zur Denervierung der Zielmuskulatur fuehren. Das Spektrum potenzieller Ursachen ist vielfaeltig und umfasst akute traumatische Verletzungen

Post-irradiation arthropathy of hip

Energy Technology Data Exchange (ETDEWEB)

Tomimatsu, T; Nagatsuka, Y; Horibe, K; Amino, K; Furuya, K [Kawaguchi Kogyo Tobu Byoin (Japan)

1976-06-01

Three cases in which arthropathy of hip occurred by irradiation therapy were reported. After receiving the depth dose of 500 to 600 rads at the inguinal region, a severe coxalgia occurred suddenly after a definite latent period. There were increases of sedimentation rate and ..gamma.. globulin. In roentgenogram, narrowing of articular space, bone atrophy, central dearticulation, and bone destruction and osteosclerosis occurred rapidly in order. As pathological findings, vascular occlusion, hemorrhage, hemolysis, osteonecrosis, abrasion of cartilage, fibrosis, and infectious cellular infiltration were observed. First, blood vessels were damaged by irradiation. Thereafter, circulatory insufficiency occurred in cotyloid cavity and femoral head, to which the influence of load was added. Thus, it is considered that the disease occurred. It seems that an articular cartilage is not always radioresistant. It is considered that the narrowing of articular space in roentgenogram is due to the degenerative necrosis of cartilage. Much attention should be paid to complications such as this disease etc. in radiation therapy.

Exosomes as novel regulators of adult neurogenic niches

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Luis Federico Batiz

2016-01-01

Full Text Available Adult neurogenesis has been convincingly demonstrated in two regions of the mammalian brain: the sub-granular zone (SGZ of the dentate gyrus (DG in the hippocampus, and the sub-ventricular zone (SVZ of the lateral ventricles. SGZ newborn neurons are destined to the granular cell layer of the DG, while new neurons from the SVZ neurons migrate rostrally into the olfactory bulb. The process of adult neurogenesis persists throughout life and is supported by a pool of neural stem cells (NSCs, which reside in a unique and specialized microenvironment known as neurogenic niche. Neurogenic niches are structured by a complex organization of different cell types, including the NSC-neuron lineage, glial cells and vascular cells. Thus, cell-to-cell communication plays a key role in the dynamic modulation of homeostasis and plasticity of the adult neurogenic process. Specific cell-cell contacts and extracellular signals originated locally provide the necessary support and regulate the balance between self-renewal and differentiation of NSCs. Furthermore, extracellular signals originated at distant locations, including other brain regions or systemic organs, may reach the niche through the cerebrospinal fluid or the vasculature and influence its nature. The role of several secreted molecules, such as cytokines, growth factors, neurotransmitters, and hormones, in the biology of adult NSCs, has been systematically addressed. Interestingly, in addition to these well-recognized signals, a novel type of intercellular messengers has been identified recently: the extracellular vesicles (EVs. EVs, and particularly exosomes, are implicated in the transfer of mRNAs, microRNAs (miRNAs, proteins and lipids between cells and thus are able to modify the function of recipient cells. Exosomes appear to play a significant role in different stem cell niches such as the mesenchymal stem cell niche, cancer stem cell niche and pre-metastatic niche; however, their roles in adult

Clinical And Radiological Assessment Of Deferiprone Related Knee Arthropathy In Children With P-Thalassemia Major

International Nuclear Information System (INIS)

Mokhtar, G.M.; Tantawy, A.A.; Abdelmaksoud, A.A.; Shams, M.A.; Tantawy, W.; Sakr, H.; Nassar, N.

2013-01-01

Objectives: To evaluate deferiprone related knee arthropathy in patients with fi-thalassemia major undergoing chelation therapy with deferiprone (LI). Materials and Methods. This study included 40 patients with β- thalassemia major on deferiprone; their ages ranged from 8 to 18 years with a mean age of 12.6 ± 3 years. Forty age and sex matched patients on desferal served as controls. Patients were subjected to clinical knee joint examination using the modified hemophilia joint health score (JHS), bilateral knee joint X-ray and bilateral knee joint ultrasound. Twenty patients of the deferiprone group with positive knee joint ultrasound findings were subjected to knee MRI. Data collected included age, sex, transfusion index, chelation history (dose, duration, and adverse effects), history of splenectomy and symptoms of knee or other joints arthropathy. Weight, height, BMI and Tanner staging of the patients were recorded. Laboratory investigations included CBC, ALT, serum ferritin, viral hepatitis markers (B,C) and echocardiography. Results: Among deferiprone group; 25 patients (62.5%) had knee symptoms while; 93.3% of the asymptomatic patients had evidence of knee joint affection by JHS compared to 17 symptomatic patients (42.5%) among desferal group (ρ> 0.05). Among deferiprone group 7 patients (17.5%) had symptoms of other joints arthropathy. Knee symptoms were more prevalent with longer duration of deferiprone therapy (ρ<0.05), knee joint effusion in US (ρ< 0.05) and Higher platelet count (ρ<0.05), while in desferal group it was related to poor compliance (ρ< 0.01) and higher serum ferritin levels (ρ=<0.01). JHS ranged from 0-33 with 39 (97.5%) affected patients. JHS was positively correlated to age, weight, height, BMI, Tanner staging and platelet count (ρ<0.01), and negatively correlated to transfusion index (ρ<0.01) with no significant correlation to ultrasound or MRI findings. JHS was higher among splenectomized patients in both groups (ρ<0.01). No

Neurogenic bladder in spinal cord injury patients

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Al Taweel W

2015-06-01

Full Text Available Waleed Al Taweel, Raouf SeyamDepartment of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaAbstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.Keywords: neurogenic bladder, spinal cord injury, urodynamics, intestine, intermittent catheterization

MicroRNA-15b Modulates Molecular Mediators of Blood Induced Arthropathy in Hemophilia Mice

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Dwaipayan Sen

2016-04-01

Full Text Available The development of arthropathy is a major co-morbidity in patients with hemophilia. The present study was designed to study the role of a microRNA biomarker (miR-15b in the development of joint disease. To investigate the expression profile of miR-15b during the development of arthropathy, we first isolated and studied small RNA from the acute and chronic hemarthrosis model of hemophilia A mice. We observed that miR-15b was consistently repressed (~1- to 4-fold from the onset of joint bleeding (1, 3, 7 and 24 h until six bleeding episodes (up to 90 days. To test if reconstitution of miR-15b modulates biomarkers of joint damage in a chronic hemarthrosis model, we administered an adeno-associated virus (AAV 5-miR-15b vector intra-articularly alone or in combination with systemic administration of AAV2-factor VIII. miR-15b overexpression downregulated markers of angiogenesis and hypoxia (vascular epithelial growth factor α (VEGF-α and hypoxia inducing factor 2α (HIF-2α, ~70% and ~34%, respectively in the affected joints. In addition, the co-administration of miR-15b and factor VIII vectors reduced the levels of the chondrodegenerative matrix-metalloproteinases (MMPs 1, 3, 9 and 14 (~14% to 60% in the injured joints. These data demonstrate for the first time the role of a miR-15b in the development of hemophilic arthropathy and has implications in development of miR based therapies for joint disease.

Effects of electrotherapy in treatment of neurogenic bladder in children with occult spinal dysraphism

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Ćirović Dragana

2009-01-01

Full Text Available Introduction Neurogenic bladder can develop as a result of various degrees of neurogenic lesion in spina bifida. The degree of bladder dysfunction depends on the level and type of spina bifida. Due to results upon complete diagnostic protocols, treatment options are applied. Objective Comparison of therapy results of patients with occult spinal dysraphism with neurogenic bladder that under-went medicamentous therapy and medicamentous with electrotherapy treatment. Methods We had 49 patients with neurogenic bladder that were treated at the University Children's Hospital in Belgrade in the period 2003-2008. The first group of children received medicamentous therapy and the second group received medicamentous therapy with transcutaneous electric nerve stimulation. In both groups we evaluated 4 symptoms: daily enuresis, enuresis nocturna, urgency and frequency and 4 urodynamic parameters: lower bladder capacity, unstable contractions and residual urine and detrusor sphincter dyssynergia. Follow-up urodynamic evaluation was done after 3, 6 and 12 months respectively. Results Our findings pointed out a high statistical significance of improvement in all evaluated urodynamic parameters of neurogenic bladder (predominantly in bladder capacity in the group of children with combined therapy as well in resolution of symptoms (predominantly enuresis nocturna, urgency and frequency. Conclusion Combined therapy is more efficient in treatment of children with neurogenic bladder. Electrotherapy is non-invasive, easily applicable and has had a significant place in treatment of children with dysfunctional voiding.

Unilateral phrenic nerve stimulation for neurogenic hypoventilation in Arnold Chiari malformation

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Nitin Garg

2013-01-01

Full Text Available Long- term ventilator dependence in patients with neurogenic hypoventilation is associated with significant morbidity and restricts mobility. Diaphragmatic pacing by phrenic nerve stimulation (PNS is a viable alternative. This is a case report of patient with Arnold-Chiari malformation with extensive syrinx who had neurogenic hypoventilation during sleep even after foramen magnum decompression and resolution of the syrinx. Unilateral PNS was done using spinal cord stimulator. With intermittent stimulation for 8 h while asleep, patient could be weaned off the ventilator completely. At 2 years follow- up, patient is ambulant and has returned to his routine activities. PNS is a good treatment tool in patients with neurogenic hypoventilation. Spinal cord stimulator can be used with optimal results. This is first such reported case of using spinal cord stimulator for PNS from India.

Radiologic findings of hemophilic arthropathy of the knee : Focusing on MR imaging and plain radiography

International Nuclear Information System (INIS)

Lee, Byung Jin; Choi, Jae Young; Cha, Sung Suk; Eun, Choong Kie; Park, Dong Woo

1996-01-01

To evaluate the characteristic MR findings of hemophilic arthropathy of the knee. Seven keens in six patients with hemophilia (five hemophilia A and one hemophilia B) were retrospectively studied with MR images and plain radiographs. Patients were aged between 2 and 20 years (mean, 11) and all had a clinical history of repeated hemarthrosis. MR images of the knee were analyzed with respect to intra- and extra-articular hemorrhage, the state of synovial tissue, articular cartilage, bone, menisci, and ligaments. Synovial hypertrophy and articular cartilage destruction were revealed in all seven knees ; pannus was found in four, and was seen as low signal intensity on T1-weighted image and high signal intensity on T2-weighted images. All five instances of synovial hypertrophy and pannus were enhanced. Joint effusion, presented in five of seven knees, demonstrated slightly low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, and was associated with peripheral low signal intensity of hemosiderin. Subchondral and marginal erosion was seen in six cases, patellar deformity in three, meniscal damage in four and cruciate ligament damage in one case. MR is superior to radiography in demonstrating chronic repeated hemarthrosis (manifested as thick intra-articular effusion), hemosidering, synovial hypertrophy, erosion or destruction of articular cartilage and bone, and meniscal or cruciate ligament injury of hemophilic arthropathy of the knee. MR is therefore thought to be a useful imaging study for accurate evaluation of hemophilic arthropathy of the knee

Radiologic findings of hemophilic arthropathy of the knee : Focusing on MR imaging and plain radiography

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Lee, Byung Jin; Choi, Jae Young; Cha, Sung Suk; Eun, Choong Kie [Inje Univ., College of Medicine, Pusan (Korea, Republic of); Park, Dong Woo [Hanyang Univ., College of Medicine, Seoul (Korea, Republic of)

1996-12-01

To evaluate the characteristic MR findings of hemophilic arthropathy of the knee. Seven keens in six patients with hemophilia (five hemophilia A and one hemophilia B) were retrospectively studied with MR images and plain radiographs. Patients were aged between 2 and 20 years (mean, 11) and all had a clinical history of repeated hemarthrosis. MR images of the knee were analyzed with respect to intra- and extra-articular hemorrhage, the state of synovial tissue, articular cartilage, bone, menisci, and ligaments. Synovial hypertrophy and articular cartilage destruction were revealed in all seven knees ; pannus was found in four, and was seen as low signal intensity on T1-weighted image and high signal intensity on T2-weighted images. All five instances of synovial hypertrophy and pannus were enhanced. Joint effusion, presented in five of seven knees, demonstrated slightly low signal intensity on T1-weighted image and high signal intensity on T2-weighted images, and was associated with peripheral low signal intensity of hemosiderin. Subchondral and marginal erosion was seen in six cases, patellar deformity in three, meniscal damage in four and cruciate ligament damage in one case. MR is superior to radiography in demonstrating chronic repeated hemarthrosis (manifested as thick intra-articular effusion), hemosidering, synovial hypertrophy, erosion or destruction of articular cartilage and bone, and meniscal or cruciate ligament injury of hemophilic arthropathy of the knee. MR is therefore thought to be a useful imaging study for accurate evaluation of hemophilic arthropathy of the knee.

The role of extended scope physiotherapists in managing patients with inflammatory arthropathies: a systematic review

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Stanhope J

2012-05-01

Full Text Available Jessica Stanhope,1 Kate Beaton,1 Karen Grimmer-Somers,1 Joanne Morris21International Centre for Allied Health Evidence (iCAHE, University of South Australia, Adelaide, South Australia; 2ACT Government Health Directorate, Canberra, Australian Capital Territory, AustraliaObjectives: To review the literature to identify whether, and how, physiotherapists working in extended scope of practice (ESP engage with patients with inflammatory arthropathies. Measures of effectiveness of ESP were particularly sought.Methods: A comprehensive library database search was conducted to identify English language studies published in full text in peer-reviewed journals during the years 2002–2012. Studies were allocated into the National Health and Medical Research Council hierarchy of evidence, but were not critically appraised. Data was extracted on conditions treated, ESP roles and responsibilities, and effectiveness. Data was analyzed and reported descriptively.Results: We identified 123 studies, and included four. All were low hierarchy (highest being one level III_2 study. Commonly reported conditions were rheumatoid arthritis and ankylosing spondylitis. Information was provided on activities of role extension, such as triaging patients, monitoring and recommending changes to medications, referring to other health and medical professionals, and ordering and interpreting imaging. There was blurring between ESP and non-ESP roles. No study reported measures of effectiveness.Conclusion: There are descriptors of ESP physiotherapy activities, but no evidence of effectiveness of ESP physiotherapy in managing patients with inflammatory arthropathies.Keywords: ESP, extended scope, rheumatoid arthritis, ankylosing spondylitis, inflammatory arthropathy, physiotherapy

The pre-vertebrate origins of neurogenic placodes.

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Abitua, Philip Barron; Gainous, T Blair; Kaczmarczyk, Angela N; Winchell, Christopher J; Hudson, Clare; Kamata, Kaori; Nakagawa, Masashi; Tsuda, Motoyuki; Kusakabe, Takehiro G; Levine, Michael

2015-08-27

The sudden appearance of the neural crest and neurogenic placodes in early branching vertebrates has puzzled biologists for over a century. These embryonic tissues contribute to the development of the cranium and associated sensory organs, which were crucial for the evolution of the vertebrate "new head". A previous study suggests that rudimentary neural crest cells existed in ancestral chordates. However, the evolutionary origins of neurogenic placodes have remained obscure owing to a paucity of embryonic data from tunicates, the closest living relatives to those early vertebrates. Here we show that the tunicate Ciona intestinalis exhibits a proto-placodal ectoderm (PPE) that requires inhibition of bone morphogenetic protein (BMP) and expresses the key regulatory determinant Six1/2 and its co-factor Eya, a developmental process conserved across vertebrates. The Ciona PPE is shown to produce ciliated neurons that express genes for gonadotropin-releasing hormone (GnRH), a G-protein-coupled receptor for relaxin-3 (RXFP3) and a functional cyclic nucleotide-gated channel (CNGA), which suggests dual chemosensory and neurosecretory activities. These observations provide evidence that Ciona has a neurogenic proto-placode, which forms neurons that appear to be related to those derived from the olfactory placode and hypothalamic neurons of vertebrates. We discuss the possibility that the PPE-derived GnRH neurons of Ciona resemble an ancestral cell type, a progenitor to the complex neuronal circuit that integrates sensory information and neuroendocrine functions in vertebrates.

The contribution of thoracic vertebral deformity and arthropathy to trunk pain in patients with chronic obstructive pulmonary disease (COPD).

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Chen, Yi-Wen; Coxson, Harvey O; Coupal, Tyler M; Lam, Stephen; Munk, Peter L; Leipsic, Jonathon; Reid, W Darlene

2018-04-01

Pain, commonly localized to the trunk in individuals with COPD, may be due to osteoporosis-related vertebral deformity and chest wall hyper-expansion causing misalignment of joints between the ribs and vertebrae. The purpose of this study was to determine if thoracic vertebral deformity and arthropathy were independent contributors to trunk pain in COPD patients compared to people with a significant smoking history. Participants completed the Brief Pain Inventory (BPI) on the same day as chest CT scans and spirometry. Current and ex-smokers were separated into COPD (n = 91) or non-COPD (n = 80) groups based on spirometry. Subsequently, CT images were assessed for thoracic vertebral deformity, bone attenuation values, and arthropathy of thoracic vertebral joints. The trunk area was the most common pain location in both COPD and non-COPD groups. Thoracic vertebral deformity and costotransverse joint arthropathy were independent contributors to trunk pain in COPD patients (adjusted OR = 3.55 and 1.30, respectively) whereas alcohol consumption contributed to trunk pain in the non-COPD group (adjusted OR = 0.35 in occasional alcohol drinkers; 0.08 in non-alcohol drinkers). The spinal deformity index and the number of narrowed disc spaces were significantly positively related to the BPI intensity, interference, and total scores significantly in COPD patients. Trunk pain, at least in part, is caused by thoracic vertebral deformity, and costotransverse and intervertebral arthropathy in patients living with COPD. The results of this study provided the foundation for the management of pain, which requires further exploration. Copyright © 2018 Elsevier Ltd. All rights reserved.

Spinal involvement in Camptodactyly Arthropathy Coxa-vara Pericarditis (CACP) syndrome in two Yemeni sisters

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Emad, Yasser; Ragab, Yasser; Ibrahim, Osama; Khalifa, Maher; Dawood, Ahmed; Rasker, Johannes J.

2017-01-01

Aim of the work The objective of this clinical report is to describe the detailed magnetic resonance imaging (MRI) findings of the spine, knee and hip joints in two young sisters with Camptodactyly Arthropathy Coxa-vara Pericarditis (CACP) syndrome. Cases report In two young sisters, both had normal

Surgical procedures in patients with haemophilic arthropathy of the ankle.

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Barg, A; Morris, S C; Schneider, S W; Phisitkul, P; Saltzman, C L

2016-05-01

In haemophilia, the ankle joint is one of the most common and earliest joints affected by recurrent bleeding, commonly resulting in end-stage ankle osteoarthritis during early adulthood. The surgical treatment of haemophilic ankle arthropathy is challenging. This review aims to highlight the literature addressing clinical outcomes following the most common approaches for different stages of haemophilia-induced ankle osteoarthritis: arthroscopic debridement, joint distraction arthroplasty, supramalleolar osteotomies, total ankle replacement, and ankle arthrodesis. A systematic literature review was performed using established medical literature databases. The following information was retrieved from the literature: patients' demographics, surgical technique, duration of follow-up, clinical outcome including pain relief and complication rate. A total of 42 clinical studies published between 1978 and 2015 were included in the systematic literature review. Eight and 34 studies had prospective and retrospective design, respectively. The most common studies were level IV studies (64.3%). The orthopaedic treatment of patients with haemophilic ankle osteoarthritis is often challenging and requires complete and careful preoperative assessment. In general, both joint-preserving and joint non-preserving procedure types can be performed. All specific relative and absolute contraindications should be considered to achieve appropriate postoperative outcomes. The current literature demonstrated that orthopaedic surgeries, with appropriate indication, in patients with haemophilic ankle arthropathy result in good postoperative results comparable to those observed in non-haemophiliacs. The surgical treatment should be performed in a setting with the ability to have multidisciplinary management, including expertise in haematology. © 2016 John Wiley & Sons Ltd.

Pathogenetic Mechanisms of Neurogenic Pulmonary Edema

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří; Kuneš, Jaroslav; Zicha, Josef

2015-01-01

Roč. 32, č. 15 (2015), s. 1135-1145 ISSN 0897-7151 R&D Projects: GA ČR(CZ) GAP304/12/0259 Institutional support: RVO:67985823 Keywords : baroreflex-induced bradycardia * blood pressure rise * blood volume redistribution * neurogenic pulmonary edema * spinal cord injury * sympathetic nervous system Subject RIV: ED - Physiology Impact factor: 4.377, year: 2015

MR imaging of arthropathies of juvenile arthritis and hemophilia

International Nuclear Information System (INIS)

Yulish, B.S.; Lieberman, J.; Mulopoulos, G.P.; Strandjord, S.; Newman, A.; Goodfellow, D.; Bryan, P.J.; Modic, M.T.

1986-01-01

The arthropathies of juvenile arthritis and hemophilia have in common abnormal hyperplastic synovium leading to marginal bone erosion, articular cartilage destruction, subchondral bone exposure, and dissolution and ultimately collapse of the affected joint. The authors examined children and young adults with juvenile arthritis and hemophilia by MR imaging and found that they could identify hyperplastic synovium, articular cartilage lesions, bone erosions, and joint effusions. This has therapeutic implications since identification of progressive synovial hyperplasia and/or early cartilage or marginal bone erosion may lead to earlier synovectomy in patients with hemophilia or switch to second line drugs in patients with juvenile arthritis, in an attempt to prevent progressive joint destruction

Two cases of neurogenic paralysis in medieval skeletal samples from Croatia.

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Novak, Mario; Čavka, Mislav; Šlaus, Mario

2014-12-01

Osteological changes consistent with neurogenic paralysis were observed in one male and one female skeleton recovered from two Croatian medieval sites - Virje and Zadar. Both skeletons display limb asymmetry typical of neurogenic paralysis that occurs during the childhood. The male skeleton displays atrophy and shortening of the right arm and the right femur, while the female skeleton exhibits identical changes on the right arm and both legs. Additionally, both skeletons exhibit scoliotic changes of the spine, and the female skeleton also displays bilateral hip dysplasia. Differential diagnosis included disorders such as cerebral palsy, poliomyelitis, cerebrovascular accident, and Rasmussen's encephalitis. These are the first cases of neurogenic paralysis (cerebral palsy and/or paralytic poliomyelitis) identified in Croatian archeological series. The Virje skeleton is only the third case of hemiplegia identified from archeological contexts (first with spinal scoliosis), while the Zadar skeleton represents the first case of triplegia reported in the paleopathological literature. Copyright © 2014 Elsevier Inc. All rights reserved.

The reliability of differentiating neurogenic claudication from vascular claudication based on symptomatic presentation.

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Nadeau, Mélissa; Rosas-Arellano, M Patricia; Gurr, Kevin R; Bailey, Stewart I; Taylor, David C; Grewal, Ruby; Lawlor, D Kirk; Bailey, Chris S

2013-12-01

Intermittent claudication can be neurogenic or vascular. Physicians use a profile based on symptom attributes to differentiate the 2 types of claudication, and this guides their investigations for diagnosis of the underlying pathology. We evaluated the validity of these symptom attributes in differentiating neurogenic from vascular claudication. Patients with a diagnosis of lumbar spinal stenosis (LSS) or peripheral vascular disease (PVD) who reported claudication answered 14 questions characterizing their symptoms. We determined the sensitivity, specificity and positive and negative likelihood ratios (PLR and NLR) for neurogenic and vascular claudication for each symptom attribute. We studied 53 patients. The most sensitive symptom attribute to rule out LSS was the absence of "triggering of pain with standing alone" (sensitivity 0.97, NLR 0.050). Pain alleviators and symptom location data showed a weak clinical significance for LSS and PVD. Constellation of symptoms yielded the strongest associations: patients with a positive shopping cart sign whose symptoms were located above the knees, triggered with standing alone and relieved with sitting had a strong likelihood of neurogenic claudication (PLR 13). Patients with symptoms in the calf that were relieved with standing alone had a strong likelihood of vascular claudication (PLR 20.0). The classic symptom attributes used to differentiate neurogenic from vascular claudication are at best weakly valid independently. However, certain constellation of symptoms are much more indicative of etiology. These results can guide general practitioners in their evaluation of and investigation for claudication.

Neurogenic Stunned Myocardium Associated with Acute Spinal Cord Infarction: A Case Report

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Gillian A. Beauchamp

2012-01-01

Full Text Available Introduction. Neurogenic stunned myocardium (NSM is a reversible cardiomyopathy resulting in transient left ventricular apical ballooning presumed to result from catecholamine surge occurring under physiologic stress. Acute spinal cord ischemia is a rare ischemic vascular lesion. We report a case of neurogenic stunned myocardium occurring in the setting of acute spinal cord infarction. Methods. Singe case report was used. Results. We present the case of a 63-year-old female with a history of prior lacunar stroke, hypertension, chronic back pain, and hypothyroidism who presented with a brief episode of diffuse abdominal and bilateral lower extremity pain which progressed within minutes to bilateral lower extremity flaccid paralysis. MRI of the spinal cord revealed central signal hyperintensity of T2-weighted imaging from conus to T8 region, concerning for acute spinal cord ischemia. Transthoracic echocardiogram was performed to determine if a cardiac embolic phenomenon may have precipitated this ischemic event and showed left ventricular apical hypokinesis and ballooning concerning for NSM. Conclusion. Neurogenic stunned myocardium is a reversible cardiomyopathy which has been described in patients with physiologic stress resulting in ventricular apical ballooning. Our case suggests that it is possible for neurogenic stunned myocardium to occur in the setting of acute spinal cord ischemia.

What do standard radiography and clinical examination tell about the shoulder with cuff tear arthropathy?

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Favard Luc

2011-01-01

Full Text Available Abstract Background This study evaluates the preoperative conventional anteroposterior radiography and clinical testing in non-operated patients with cuff tear arthropathy. It analyses the radiological findings in relation to the status of the rotator cuff and clinical status as also the clinical testing in relation to the rotator cuff quality. The aim of the study is to define the usefulness of radiography and clinical examination in cuff tear arthropathy. Methods This study analyses the preoperative radiological (AP-view, (Artro-CT-scan or MRI-scan and clinical characteristics (Constant-Murley-score plus active and passive mobility testing and the peroperative findings in a cohort of 307 patients. These patients were part of a multicenter, retrospective, consecutive study of the French Orthopaedic Society (SOFCOT-2006. All patients had no surgical antecedents and were all treated with prosthetic shoulder surgery for a painful irreparable cuff tear arthropathy (reverse-(84% or hemi-(8% or double cup-bipolar prosthesis (8%. Results A positive significancy could be found for the relationship between clinical testing and the rotator cuff quality; between acromiohumeral distance and posterior rotator cuff quality; between femoralization and posterior rotator cuff quality. Conclusion A conventional antero-posterior radiograph can not provide any predictive information on the clinical status of the patient. The subscapular muscle can be well tested by the press belly test and the teres minor muscle can be well tested by the hornblower' sign and by the exorotation lag signs. The upward migration index and the presence of femoralization are good indicators for the evaluation of the posterior rotator cuff. An inferior coracoid tip positioning suggests rotator cuff disease.

Introduction to Neurogenic Communication Disorders. Fifth Edition.

Science.gov (United States)

Brookshire, Robert H.

This book provides an overview of the causes and symptoms, and the typical courses, treatments, and outcomes of neurogenic communication disorders. Chapter 1 reviews the human nervous system and neurologic causes of adult communication disorders. Chapter 2 discusses the neurologic assessment and arriving at a diagnosis, including the neurologist's…

Neurogenética en el Perú, ejemplo de investigación traslacional

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Pilar Mazzetti

Full Text Available La neurogenética es una disciplina emergente en el Perú que vincula la investigación básica con la práctica clínica. El Centro de Investigación Básica en Neurogenética, es el único centro en el Perú dedicado a la atención especializada de enfermedades neurogenéticas. La investigación en esta área está estrechamente ligada a la enfermedad de Huntington, desde la genotipificación del gen HTT por PCR, hasta los actuales estudios de haplogrupos en esta enfermedad. La investigación en otras enfermedades monogénicas permitió la implementación de metodologías alternativas para la genotipificación del síndrome X frágil y distrofia miotónica tipo 1. Esfuerzos colaborativos nacionales e internacionales han permitido conocer nuevas variantes genéticas en enfermedades complejas, como la enfermedad de Parkinson y Alzheimer. El entrenamiento multidisciplinario y la mentoría fomentan la formación de nuevos especialistas en neurogenética, permitiendo el crecimiento sostenido de esta disciplina en el país. El impulso de la investigación en el Perú ha impulsado el crecimiento de la investigación en neurogenética; sin embargo, las limitaciones en infraestructura, tecnología y capacitación aún son un reto para el crecimiento de investigación en esta disciplina

Radiological evaluation of chronic hemophilic arthropathy by the Pettersson score: Problems in correlation in adult patients

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Hamel, J.; Pohlmann, H.; Schramm, W.

1988-01-01

This study deals with the distribution and extent of hemophilic arthropathy (HA) in 52 adult patients suffering from severe hemophilia A. A clinical and radiological evaluation was undertaken and the results were compared. The limitations of the currently used radiological scoring system are discussed. (orig.)

Detrusor Arreflexia as an End Stage of Neurogenic Bladder in HAM/TSP?

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Matheus Tannus

2011-01-01

Full Text Available The HTLV-1 virus is a known agent involved in the development of HAM/TSP. Past studies have typically observed patients with autonomic dysfunction consisting of detrusor overactivity and detrusor-sphincter dyssynergia, with the occasional observation of underactive detrusor or detrusor arreflexia. However, studies have not yet evaluated the progression of neurogenic bladder over time. In this paper, we describe a HAM/TSP patient with the initial development of overactive detrusor, and subsequent development of detrusor arreflexia. Given a paucity of studies characterizing the effects of HTLV-1 on the autonomic nervous system, particularly aspects controlling continence, this patient's clinical course may represent one type of end point for patients with HAM/TSP and neurogenic bladder. Further cohort or case-series studies, with particular emphasis on the progression of neurogenic bladder, are needed to evaluate the significance of this described case in relation to typical disease progression patterns.

Artropatia ocronótica Ochronotic arthropathy

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Fernando Peres A. Gonçalves

2006-01-01

Full Text Available Os autores apresentam o relato de caso de um paciente com artropatia ocronótica. A ocronose é uma doença rara, de herança autossômica recessiva, manifestação clínica da alcaptonúria. O paciente apresenta clinicamente dor crônica lombar, fraqueza e limitação funcional dos ombros e joelhos, associada a urina de cor escura. O objetivo do tratamento ortopédico é o controle da dor e melhora das funções das articulações acometidas, realizando artroplastias quando necessário.The authors report the case of a patient with ochronotic arthropathy. This rare, inherited disease of autossomal recessive trait is the clinical manifestation of alkaptonuria. The patient presented clinically with chronic low back pain, disability, pain and weakness / stiffness in his shoulders and knees associated with dark urine. The main purpose of the orthopaedic approach in this disease is to control the pain and improve the function of the affected joints by performing arthroplasties when necessary.

Neurogenic pulmonary edema due to ventriculo-atrial shunt dysfunction: a case report.

Science.gov (United States)

Cruz, Ana Sofia; Menezes, Sónia; Silva, Maria

2016-01-01

Pulmonary edema is caused by the accumulation of fluid within the air spaces and the interstitium of the lung. Neurogenic pulmonary edema is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system insult. It may be a less-recognized consequence of raised intracranial pressure due to obstructive hydrocephalus by blocked ventricular shunts. It usually appears within minutes to hours after the injury and has a high mortality rate if not recognized and treated appropriately. We report a patient with acute obstructive hydrocephalus due to ventriculo-atrial shunt dysfunction, proposed to urgent surgery for placement of external ventricular drainage, who presented with neurogenic pulmonary edema preoperatively. She was anesthetized and supportive treatment was instituted. At the end of the procedure the patient showed no clinical signs of respiratory distress, as prompt reduction in intracranial pressure facilitated the regression of the pulmonary edema. This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure. If not recognized and treated appropriately, neurogenic pulmonary edema can lead to acute cardiopulmonary failure with global hypoperfusion and hypoxia. Therefore, awareness of and knowledge about the occurrence, clinical presentation and treatment are essential. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Neurogenic pulmonary edema due to ventriculo-atrial shunt dysfunction: a case report

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Ana Sofia Cruz

2016-04-01

Full Text Available ABSTRACT BACKGROUND AND OBJECTIVES: Pulmonary edema is caused by the accumulation of fluid within the air spaces and the interstitium of the lung. Neurogenic pulmonary edema is a clinical syndrome characterized by the acute onset of pulmonary edema following a significant central nervous system insult. It may be a less-recognized consequence of raised intracranial pressure due to obstructive hydrocephalus by blocked ventricular shunts. It usually appears within minutes to hours after the injury and has a high mortality rate if not recognized and treated appropriately. CASE REPORT: We report a patient with acute obstructive hydrocephalus due to ventriculo-atrial shunt dysfunction, proposed to urgent surgery for placement of external ventricular drainage, who presented with neurogenic pulmonary edema preoperatively. She was anesthetized and supportive treatment was instituted. At the end of the procedure the patient showed no clinical signs of respiratory distress, as prompt reduction in intracranial pressure facilitated the regression of the pulmonary edema. CONCLUSIONS: This report addresses the importance of recognition of neurogenic pulmonary edema as a possible perioperative complication resulting from an increase in intracranial pressure. If not recognized and treated appropriately, neurogenic pulmonary edema can lead to acute cardiopulmonary failure with global hypoperfusion and hypoxia. Therefore, awareness of and knowledge about the occurrence, clinical presentation and treatment are essential.

Precocious Degenerative Arthropathy And Bluish Patches On Ears : Ochronosis And Alkaptonuria

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Mahajan Vikram K

2004-01-01

Full Text Available Alkaptonuria is a rare, autosomal recessive disorder of phenylalanin/tyrosine metabolism due to congenital deficiency of the enzyme homogentisic acid oxidase. The diagnosis is clinical and the triad of homogentisic aciduria, ochronosis and precocious degenerative arthritis is characteristic. Its diagnosis in infancy and early therapeutic intervention help delaying its complications. These patients may remain undiagnosed until the darkening of urine soaked diapers is noticed or the early degenerative arthropathy develops. This paper describes two cases of alkaptonuria presenting late in life; one of them had associated hyperthyroidism.

Advanced imaging techniques show progressive arthropathy following experimentally induced knee bleeding in a factor VIII-/- rat model

DEFF Research Database (Denmark)

Sorensen, K. R.; Roepstorff, K.; Petersen, M.

2015-01-01

Background: Joint pathology is most commonly assessed by radiogra-phy, but ultrasonography (US) is increasingly recognized for its acces-sibility, safety and ability to show soft tissue changes, the earliestindicators of haemophilic arthropathy (HA). US, however, lacks theability to visualize...

Case report 471: Hemophilic pseudotumors (presumptive diagnosis) and hemophilic arthropathy of elbow

Energy Technology Data Exchange (ETDEWEB)

Hermann, G.; Gilbert, M.

1988-03-01

A case has been presented of a 72-year-old man on whom an excretory urogram showed the incidental findings of two soft tissue masses in the abdomen containing considerable deposits of calcium. The history was interesting in that the patient was classic hemophiliac with Factor VIII level less than 1%, who first developed symptoms and signs of multiple hemarthroses affecting the knees, ankles, elbows, and shoulders at the age of nine years. Secondary hemophilic arthropathy followed, particularly advanced in the right elbow. Total knee replacements were performed within the last 10 years. A mass within the muscles of the right chest wall, superficial to the ribs, was surgically removed. The abdominal masses in this case were studied with CT and showed considerable calcification with a fibrous wall. Surgical removal of pseudotumors is usually undertaken following diagnosis because the natural history includes continuous enlargement and destruction of the adjacent tissues. Because of the age of the patient and the significant cardiac history, it was considered inappropriate to undertake surgery for the masses in the abdomen which were considered presumptively to be pseudotumors. The clinical, radiological, and pathological aspects of pseudotumor of hemophilia were reviewed. In this case, besides the masses in the abdomen, hemophilic arthropathy of an elbow was illustrated and a soft tissue mass in the right chest wall was demonstrated radiologically and the pathological specimen shown after surgical excision.

[Neurogenic communication disorders: how effective are relaxation therapy and acupuncture?].

Science.gov (United States)

Ptok, M

2008-12-01

Not only neurologists but also ENT-physicians and phoniatricians have to prescribe speech and language therapy for patients with communication disorders. Complementary and alternative medicine (CAM) has gained increasing popularity among patients. Many studies have investigated these procedures and positive effects on certain physical e. g., chronic pain and anxiety disorders could be validated. Unfortunately only few empirical investigations have targeted the use of CAM to treat neurogenic disorders of communication or cognition. In this review we provide an overview over general therapeutical principals of two widely used approaches, relaxation therapy and acupuncture. Then we survey the literature and summarize existent research literature regarding the effects of the treatment of neurogenic disorders including dementia.

Low CD4/CD8 T-cell ratio associated with inflammatory arthropathy in human T-cell leukemia virus type I Tax transgenic mice.

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Takeo Ohsugi

Full Text Available BACKGROUND: Human T-cell leukemia virus type I (HTLV-1 can cause an aggressive malignancy known as adult T-cell leukemia/lymphoma (ATL as well as inflammatory diseases such as HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP. A transgenic mouse that expresses HTLV-1 Tax also develops T-cell leukemia/lymphoma and an inflammatory arthropathy that resembles rheumatoid arthritis. The aim of this study was to identify the primary T-cell subsets involved in the development of arthropathy in Tax transgenic mice. PRINCIPAL FINDINGS: By 24 months of age, Tax transgenic mice developed severe arthropathy with a cumulative incidence of 22.8%. The pathological findings of arthropathy in Tax transgenic mice were similar to those seen in human rheumatoid arthritis or mouse models of rheumatoid arthritis, with synovial proliferation and a positive rheumatoid factor. Before the onset of spontaneous arthropathy, young and old Tax transgenic mice were not sensitive to collagen and did not develop arthritis after immunization with type II collagen. The arthropathic Tax transgenic mice showed a significantly decreased proportion of splenic CD4(+ T cells, whereas the proportion of splenic CD8(+ T cells was increased. Regulatory T cells (CD4(+CD25(+Foxp3(+ were significantly decreased and CD8(+ T cells that expressed the chemokine receptor CCR4 (CD8(+CCR4(+ were significantly increased in arthropathic Tax transgenic mice. The expression of tax mRNA was strong in the spleen and joints of arthropathic mice, with a 40-fold increase compared with healthy transgenic mice. CONCLUSIONS: Our findings reveal that Tax transgenic mice develop rheumatoid-like arthritis with proliferating synovial cells in the joints; however, the proportion of different splenic T-cell subsets in these mice was completely different from other commonly used animal models of rheumatoid arthritis. The crucial T-cell subsets in arthropathic Tax transgenic mice appear to resemble

A One Year Prospective Study of Neurogenic Stuttering Following Stroke: Incidence and Co-Occurring Disorders

Science.gov (United States)

Theys, C.; van Wieringen, A.; Sunaert, S.; Thijs, V.; De Nil, L. F.

2011-01-01

In this prospective study, data on incidence, stuttering characteristics, co-occurring speech disorders, and recovery of neurogenic stuttering in a large sample of stroke participants were assessed. Following stroke onset, 17 of 319 participants (5.3%; 95% CI, 3.2-8.3) met the criteria for neurogenic stuttering. Stuttering persisted in at least…

Scoring haemophilic arthropathy on X-rays: improving inter- and intra-observer reliability and agreement using a consensus atlas

Energy Technology Data Exchange (ETDEWEB)

Foppen, Wouter; Schaaf, Irene C. van der; Beek, Frederik J.A. [University Medical Center Utrecht, Department of Radiology (Netherlands); Verkooijen, Helena M. [University Medical Center Utrecht, Department of Radiology (Netherlands); University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); Fischer, Kathelijn [University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht (Netherlands); University Medical Center Utrecht, Van Creveldkliniek, Department of Hematology, Utrecht (Netherlands)

2016-06-15

The radiological Pettersson score (PS) is widely applied for classification of arthropathy to evaluate costly haemophilia treatment. This study aims to assess and improve inter- and intra-observer reliability and agreement of the PS. Two series of X-rays (bilateral elbows, knees, and ankles) of 10 haemophilia patients (120 joints) with haemophilic arthropathy were scored by three observers according to the PS (maximum score 13/joint). Subsequently, (dis-)agreement in scoring was discussed until consensus. Example images were collected in an atlas. Thereafter, second series of 120 joints were scored using the atlas. One observer rescored the second series after three months. Reliability was assessed by intraclass correlation coefficients (ICC), agreement by limits of agreement (LoA). Median Pettersson score at joint level (PS{sub joint}) of affected joints was 6 (interquartile range 3-9). Using the consensus atlas, inter-observer reliability of the PS{sub joint} improved significantly from 0.94 (95 % confidence interval (CI) 0.91-0.96) to 0.97 (CI 0.96-0.98). LoA improved from ±1.7 to ±1.1 for the PS{sub joint}. Therefore, true differences in arthropathy were differences in the PS{sub joint} of >2 points. Intra-observer reliability of the PS{sub joint} was 0.98 (CI 0.97-0.98), intra-observer LoA were ±0.9 points. Reliability and agreement of the PS improved by using a consensus atlas. (orig.)

X-ray diagnostic sign for the differentiation of neurogenic and primary muscular diseases

International Nuclear Information System (INIS)

Palvoelgyi, R.; Gallai, M.

1981-01-01

The authors give an account of X-ray examinations of the limb musculature of 70 patients suffering from neurogenic muscular diseases, 42 suffering from primary muscular diseases and 45 suffering from senile degeneration of the muscles. Different degree of damage to different parts of the same muscle could only been observed in one case of neurogenic atrophy (in the postpoliomyelitic states) and in two cases of senile degeneration, while it was found in 11 cases (20%) for the other muscular diseases. In the latter cases the more severe muscle damage, which could be demonstrated radiographically, was always found in the part of the muscle adjacent to a tendon. On the above reasons the authors consider that radiographically demonstrable partial or uneven damage to any particular muscle can be used as a new diagnostical information in distinguishing muscular diseases from neurogenic muscular atrophy. (orig.) [de

Clinical and Treatment Features of Orbital Neurogenic Tumors

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Pınar Bingöl Kızıltunç

2013-10-01

Full Text Available Purpose: To evaluate the clinical and treatment features of orbital neurogenic tumors. Material and Method: The records of 35 patients with orbital neurogenic tumors who were diagnosed and treated at Ankara University Faculty of Medicine, Department of Ophthalmology, between 1998 and 2011 were evaluated retrospectively. Results: Orbitotomy via a cutaneous approach was performed in 21 (60% cases and orbitotomy via a transconjunctival approach was performed in 7 (20% cases. Three (8% cases had been operated at different centers. Four (12% cases were diagnosed clinically. Total excisional biopsy was performed in 11 (31.4% cases, subtotal excisional biopsy was performed in 7 (20%, and incisional biopsy was performed in 10 (28.6% cases. 14 (40% 35 cases were diagnosed as meningioma, 12 (34% as peripheral nerve sheath tumor, and 9 (26% cases were diagnosed as optic nerve glioma. Six (43% meningioma cases were optic nerve sheath meningioma, 5 (36% were sphenoid wing meningioma, 2 (14% were ectopic meningioma, and 1 (7% was perisellar meningioma. Six (50% of peripheral nerve sheath tumors were schwannoma, 2 (16% were solitary neurofibroma, 4 (34% were plexiform neurofibroma. External beam radiotherapy was performed in 15 (42.8% cases, cyberknife radiosurgery in 1 (2.8% , chemotherapy in 1 (2.8%, and enucleation ( because of neovascular glaucoma and vitreous hemorrhage was performed in 1 (2.8% case. Discussion: The most common orbital neurogenic tumors are meningioma, peripheral nerve sheath tumor, and optic nerve glioma. For meningioma and glioma, external beam radiotherapy is required; for schwannoma and solitary neurofibroma, total excisional biopsy is the preferred treatment. The success of visual and anatomic results are high after treatment. (Turk J Ophthalmol 2013; 43: 335-9

Effect of 1-year anti-TNF-α therapy on aortic stiffness, carotid atherosclerosis, and calprotectin in inflammatory arthropathies: a controlled study.

Science.gov (United States)

Angel, Kristin; Provan, Sella A; Fagerhol, Magne K; Mowinckel, Petter; Kvien, Tore K; Atar, Dan

2012-06-01

Premature arterial stiffening and atherosclerosis are increased in patients with inflammatory arthropathies such as rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA). The proinflammatory protein calprotectin is associated with inflammatory arthropathies, vascular pathology, and acute coronary events. We examined the long-term effects of treatment with tumor necrosis factor (TNF)-α antagonists on aortic stiffness and carotid intima media thickness (CIMT) in patients with inflammatory arthropathies, and the relationships to the levels of calprotectin. Fifty-five patients with RA, AS, or PsA and a clinical indication for anti-TNF-α therapy were included and followed with regular examinations for 1 year. Thirty-six patients starting with anti-TNF-α therapy were compared with a nontreatment group of 19 patients. Examinations included assessments of aortic stiffness (aortic pulse wave velocity, aPWV), CIMT, and plasma calprotectin. After 1 year, aPWV (mean (s.d.)) was improved in the treatment group, but not in the control group (-0.54 [0.79] m/s vs. 0.06 [0.61] m/s, respectively; P = 0.004), and CIMT progression (median (quartile cut-points, 25th and 75th percentiles)) was reduced in the treatment group compared to the control group (-0.002 [-0.038, 0.030] mm vs. 0.030 [0.011, 0.043] mm, respectively; P = 0.01). In multivariable analyses, anti-TNF-α therapy over time was associated with improved aPWV (P = 0.02) and reduced CIMT progression (P = 0.04), and calprotectin was longitudinally associated with aPWV (P = 0.02). Long-term anti-TNF-α therapy improved aortic stiffness and CIMT progression in patients with inflammatory arthropathies. Calprotectin may be a soluble biomarker reflecting aortic stiffening in these patients.

Intravesical prostatic protrusion correlates well with storage symptoms in elderly male patients with non-neurogenic overactive bladder

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Shih-Yen Lu

2016-03-01

Conclusion: In elderly male patients with non-neurogenic OAB, more severe storage symptoms are associated with a lower maximum flow rate and a more prominent IPP, indicating that a significant cause of male non-neurogenic OAB is prostate associated.

Case report 471: Hemophilic pseudotumors (presumptive diagnosis) and hemophilic arthropathy of elbow

International Nuclear Information System (INIS)

Hermann, G.; Gilbert, M.

1988-01-01

A case has been presented of a 72-year-old man on whom an excretory urogram showed the incidental findings of two soft tissue masses in the abdomen containing considerable deposits of calcium. The history was interesting in that the patient was classic hemophiliac with Factor VIII level less than 1%, who first developed symptoms and signs of multiple hemarthroses affecting the knees, ankles, elbows, and shoulders at the age of nine years. Secondary hemophilic arthropathy followed, particularly advanced in the right elbow. Total knee replacements were performed within the last 10 years. A mass within the muscles of the right chest wall, superficial to the ribs, was surgically removed. The abdominal masses in this case were studied with CT and showed considerable calcification with a fibrous wall. Surgical removal of pseudotumors is usually undertaken following diagnosis because the natural history includes continuous enlargement and destruction of the adjacent tissues. Because of the age of the patient and the significant cardiac history, it was considered inappropriate to undertake surgery for the masses in the abdomen which were considered presumptively to be pseudotumors. The clinical, radiological, and pathological aspects of pseudotumor of hemophilia were reviewed. In this case, besides the masses in the abdomen, hemophilic arthropathy of an elbow was illustrated and a soft tissue mass in the right chest wall was demonstrated radiologically and the pathological specimen shown after surgical excision. (orig.)

Mechanisms of neurogenic pulmonary edema development

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří; Zicha, Josef; Kuneš, Jaroslav; Jendelová, Pavla; Syková, Eva

2008-01-01

Roč. 57, č. 4 (2008), s. 499-506 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) LC554; GA ČR GA309/06/1246; GA MŠk 1M0538 Grant - others:GA MZd(CZ) 1A8697; GA MZd(CZ) NR8339 Institutional research plan: CEZ:AV0Z50390512; CEZ:AV0Z50110509 Keywords : Neurogenic pulmonary edema * Rat * Lung Subject RIV: FH - Neurology Impact factor: 1.653, year: 2008

Cross-sectional imaging of adult crystal and inflammatory arthropathies

International Nuclear Information System (INIS)

Soldatos, Theodoros; Pezeshk, Parham; Ezzati, Fatemeh; Karp, David R.; Taurog, Joel D.; Chhabra, Avneesh

2016-01-01

This article highlights the key aspects and current perspectives of the role of cross-sectional imaging in adult crystal and inflammatory arthropathies in adults, briefly discussing CT, and particularly focusing on MRI and US imaging as it supplements the conventional radiography. The role of conventional and advanced MR imaging techniques and imaging findings in this domain is discussed and illustrated with case examples. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article contains images and data, which were collected from patients as a part of a retrospective IRB from the institutional teaching files and informed consent was waived. (orig.)

Notch receptor expression in neurogenic regions of the adult zebrafish brain.

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Vanessa de Oliveira-Carlos

Full Text Available The adult zebrash brain has a remarkable constitutive neurogenic capacity. The regulation and maintenance of its adult neurogenic niches are poorly understood. In mammals, Notch signaling is involved in stem cell maintenance both in embryonic and adult CNS. To better understand how Notch signaling is involved in stem cell maintenance during adult neurogenesis in zebrafish we analysed Notch receptor expression in five neurogenic zones of the adult zebrafish brain. Combining proliferation and glial markers we identified several subsets of Notch receptor expressing cells. We found that 90 [Formula: see text] of proliferating radial glia express notch1a, notch1b and notch3. In contrast, the proliferating non-glial populations of the dorsal telencephalon and hypothalamus rarely express notch3 and about half express notch1a/1b. In the non-proliferating radial glia notch3 is the predominant receptor throughout the brain. In the ventral telencephalon and in the mitotic area of the optic tectum, where cells have neuroepithelial properties, notch1a/1b/3 are expressed in most proliferating cells. However, in the cerebellar niche, although progenitors also have neuroepithelial properties, only notch1a/1b are expressed in a high number of PCNA [Formula: see text] cells. In this region notch3 expression is mostly in Bergmann glia and at low levels in few PCNA [Formula: see text] cells. Additionally, we found that in the proliferation zone of the ventral telencephalon, Notch receptors display an apical high to basal low gradient of expression. Notch receptors are also expressed in subpopulations of oligodendrocytes, neurons and endothelial cells. We suggest that the partial regional heterogeneity observed for Notch expression in progenitor cells might be related to the cellular diversity present in each of these neurogenic niches.

Spontaneous Bladder Perforation in an Infant Neurogenic Bladder: Laparoscopic Management

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Daniel Cabezalí Barbancho

2013-01-01

Full Text Available Spontaneous bladder perforation is an uncommon event in childhood. It is usually associated with bladder augmentation. We are presenting a case of bladder rupture in an infant with neurogenic bladder without prior bladder surgery. Three days after lipomyelomeningocele excision the patient showed signs and symptoms of acute abdomen. The ultrasound exploration revealed significant amount of intraperitoneal free fluid and therefore a laparoscopic exploration was performed. A posterior bladder rupture was diagnosed and repaired laparoscopically. Currently, being 3 years old, she keeps successfully dry with clean intermittent catheterization. Neurogenic bladder voiding function can change at any time of its evolution and lead to complications. Early diagnosis of spontaneous bladder rupture is of paramount importance, so it is essential to think about it in the differential diagnosis of acute abdomen.

Malignant neurogenic neoplasms of the head and neck

International Nuclear Information System (INIS)

Kuczkowski, J.; Starzynska, A.

1996-01-01

The authors present 17 cases of malignant neurogenic neoplasms of the head and neck observed in the Department of Otolaryngology in the years 1948-1993. The latest opinions on etiopathology, diagnosis and treatment of these tumors were described. Age and sex of patients, localization of tumor, symptoms histopathology and treatment were analyzed. Progressions of the disease were estimated retrospectively. It has been proved that these tumors develop quickly, give pain and paresthesia. Their diagnosis is very difficult because of their submucosal growth and difficult histopathological interpretation. A characteristic feature of these neurogenic tumors is the ability to give distant metastases. This feature differentiates them from squamous neoplasms, which give mainly nodal metastases. All the patients were subjected to surgery combined with conventional or high voltage radiotherapy. The positive effect of combined chemotherapy in cases of esthesioneuroblastoma is worthy of note. The prognosis in these tumors is often unfavorable. In the group under discussion 13 patients died because of recurrences, two patients are considered to be cured and the remaining 2 patients have had no recurrence for 2 and 3 years. (author)

Neurogenic bladder from occult herpes zoster.

Science.gov (United States)

Rothrock, J F; Walicke, P A; Swenson, M R

1986-11-01

Active infection with herpes zoster may cause acute urinary retention, especially when it involves sacral dermatomes. Although frank retention usually develops days to weeks after eruption of the typical rash, bladder incompetence infrequently develops first, raising concern over other, more ominous etiologies. In the case presented, rash appearance was delayed until six weeks after the initial onset of urinary retention, a much longer interval than previously reported. Occult herpes zoster infection should be considered in patients presenting with an acute neurogenic bladder of obscure cause.

Patient reported activities after reverse total shoulder arthroplasty in rotator cuff arthropathy patients.

Science.gov (United States)

Alcobía-Díaz, B; Lópiz, Y; García-Fernández, C; Rizo de Álvaro, B; Marco, F

Reverse total shoulder arthroplasty in rotator cuff arthropathy patients, improves anteversion and abduction, but not rotational, outcomes. The main aim of this study is to determine its repercussions on daily life activities in our patients. Between 2009 and 2011 we implanted 210 shoulder arthroplasties, 126 of them were reverse total shoulder arthroplasty in a rotator cuff arthropathy context. About 88% were women, with a mean age at time of surgery of 81 years, 95% were retired. The mean follow up was 53 months. The Constant scale, Visual Analogue Scale, Charlson Comorbidity Index, range of motion were measured for each patient and whether they could manage 40 daily life activities by means of a new questionnaire, classifying them according toshoulder functional demand. Mean normalized by sex and age Constant value was 81.2%. Mean Visual Analogue Scale and Charlson Index were 3.56 and 1.69 respectively. Improvement in anteversion and abduction, not in rotational range of motion. Limitation was found in low and high functional demand activities in 20% and 51% respectively, especially those which involved internal rotation. Reverse total shoulder arthroplasty treatment for RCA in the elderly, achieves adequate pain management and good functional outcomes. Nevertheless, an important risk of DLA limitation must be accepted in those which involve internal rotation or shoulder high functional demand. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Patients with Black Hip and Black Knee Due to Ochronotic Arthropathy: Case Report and Review of Literature

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Mehmet Ali Acar

2013-11-01

Full Text Available Ochronotic arthropathy is a manifestation of longstanding alkaptonuria. With increasing age, an accumulation of pigment deposits of homogentisic acid in the joint cartilage results in ochronotic osteoarthritis. We present a case of a 62-year-old female who underwent staged left uncemented total hip and right cemented total knee arthroplasty for osteoarthritis secondary to ochronosis.

Botulinum toxin A for treatment of neurogenic detrusor overactivity and incontinence in patients with spinal cord lesions

DEFF Research Database (Denmark)

Bagi, Per; Biering-Sørensen, Fin

2004-01-01

To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs).......To evaluate the efficacy of intravesical botulinum toxin A (BTA) in the treatment of severe neurogenic detrusor overactivity (NDO) with incontinence in patients with spinal cord lesions (SCLs)....

The treatment of erectile dysfunction in patients with neurogenic disease.

Science.gov (United States)

Shridharani, Anand N; Brant, William O

2016-02-01

Erectile dysfunction (ED) related to compromise of the nervous system is an increasingly common occurrence. This may be due to the multifactorial nature of ED, the myriad of disorders affecting the neurotransmission of erectogenic signals, and improved awareness and diagnosis of ED. Nevertheless, neurogenic ED remains poorly understood and characterized. Disease related factors such as depression, decreased physical and mental function, the burden of chronic illness, and loss of independence may preclude sexual intimacy and lead to ED as well. The amount of data regarding treatment options in subpopulations of differing neurologic disorders remains scarce except for men with spinal cord injury. The treatment options including phosphodiesterase inhibitors, intracavernosal or intraurethral vasoactive agents, vacuum erection devices (VED) and penile prosthetic implantation remain constant. This review discusses the options in specific neurologic conditions, and briefly provides insight into new and future developments that may reshape the management of neurogenic ED.

Inhibition by ketamine and amphetamine analogs of the neurogenic nitrergic vasodilations in porcine basilar arteries

International Nuclear Information System (INIS)

Chen, Mei-Fang; Lai, Su-Yu; Kung, Po-Cheng; Lin, Yo-Cheng; Yang, Hui-I; Chen, Po-Yi; Liu, Ingrid Y.; Lua, Ahai Chang; Lee, Tony Jer-Fu

2016-01-01

The abuse of ketamine and amphetamine analogs is associated with incidence of hypertension and strokes involving activation of sympathetic activities. Large cerebral arteries at the base of the brain from several species receive dense sympathetic innervation which upon activation causes parasympathetic-nitrergic vasodilation with increased regional blood flow via axo-axonal interaction mechanism, serving as a protective mechanism to meet O 2 demand in an acutely stressful situation. The present study was designed to examine effects of ketamine and amphetamine analogs on axo-axonal interaction-mediated neurogenic nitrergic vasodilation in porcine basilar arteries using techniques of blood-vessel myography, patch clamp and two-electrode voltage clamp, and calcium imaging. In U46619-contracted basilar arterial rings, nicotine (100 μM) and electrical depolarization of nitrergic nerves by transmural nerve stimulation (TNS, 8 Hz) elicited neurogenic nitrergic vasodilations. Ketamine and amphetamine analogs concentration-dependently inhibited nicotine-induced parasympathetic-nitrergic vasodilation without affecting that induced by TNS, nitroprusside or isoproterenol. Ketamine and amphetamine analogs also concentration-dependently blocked nicotine-induced inward currents in Xenopus oocytes expressing α3β2-nicotinic acetylcholine receptors (nAChRs), and nicotine-induced inward currents as well as calcium influxes in rat superior cervical ganglion neurons. The potency in inhibiting both inward-currents and calcium influxes is ketamine > methamphetamine > hydroxyamphetamine. These results indicate that ketamine and amphetamine analogs, by blocking nAChRs located on cerebral perivascular sympathetic nerves, reduce nicotine-induced, axo-axonal interaction mechanism-mediated neurogenic dilation of the basilar arteries. Chronic abuse of these drugs, therefore, may interfere with normal sympathetic-parasympathetic interaction mechanism resulting in diminished neurogenic

Inhibition by ketamine and amphetamine analogs of the neurogenic nitrergic vasodilations in porcine basilar arteries

Energy Technology Data Exchange (ETDEWEB)

Chen, Mei-Fang [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Tzu Chi Center for Vascular Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Tzu Chi University of Science and Technology, Hualien, Taiwan (China); Lai, Su-Yu; Kung, Po-Cheng; Lin, Yo-Cheng [Department of Pharmacology and Toxicology, College of Medicine, Tzu Chi University, Hualien, Taiwan (China); Yang, Hui-I [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Chen, Po-Yi [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Department of Pharmacology and Toxicology, College of Medicine, Tzu Chi University, Hualien, Taiwan (China); Liu, Ingrid Y. [Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan (China); Lua, Ahai Chang [Department of Laboratory Medicine and Biotechnology & Graduate Institute of Medical Biotechnology, Tzu Chi University, Hualien, Taiwan (China); Lee, Tony Jer-Fu, E-mail: tlee@mail.tcu.edu.tw [Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Tzu Chi Center for Vascular Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan (China); Department of Life Sciences, College of Life Sciences, Tzu Chi University, Hualien, Taiwan (China); Department of Pharmacology and Toxicology, College of Medicine, Tzu Chi University, Hualien, Taiwan (China); Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, IL (United States)

2016-08-15

The abuse of ketamine and amphetamine analogs is associated with incidence of hypertension and strokes involving activation of sympathetic activities. Large cerebral arteries at the base of the brain from several species receive dense sympathetic innervation which upon activation causes parasympathetic-nitrergic vasodilation with increased regional blood flow via axo-axonal interaction mechanism, serving as a protective mechanism to meet O{sub 2} demand in an acutely stressful situation. The present study was designed to examine effects of ketamine and amphetamine analogs on axo-axonal interaction-mediated neurogenic nitrergic vasodilation in porcine basilar arteries using techniques of blood-vessel myography, patch clamp and two-electrode voltage clamp, and calcium imaging. In U46619-contracted basilar arterial rings, nicotine (100 μM) and electrical depolarization of nitrergic nerves by transmural nerve stimulation (TNS, 8 Hz) elicited neurogenic nitrergic vasodilations. Ketamine and amphetamine analogs concentration-dependently inhibited nicotine-induced parasympathetic-nitrergic vasodilation without affecting that induced by TNS, nitroprusside or isoproterenol. Ketamine and amphetamine analogs also concentration-dependently blocked nicotine-induced inward currents in Xenopus oocytes expressing α3β2-nicotinic acetylcholine receptors (nAChRs), and nicotine-induced inward currents as well as calcium influxes in rat superior cervical ganglion neurons. The potency in inhibiting both inward-currents and calcium influxes is ketamine > methamphetamine > hydroxyamphetamine. These results indicate that ketamine and amphetamine analogs, by blocking nAChRs located on cerebral perivascular sympathetic nerves, reduce nicotine-induced, axo-axonal interaction mechanism-mediated neurogenic dilation of the basilar arteries. Chronic abuse of these drugs, therefore, may interfere with normal sympathetic-parasympathetic interaction mechanism resulting in diminished neurogenic

Hand deforming arthropathy (Jaccoud’s syndrome in systemic lupus erythematosus

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A. P. Zhornyak

2005-01-01

Full Text Available Objective. To characterize Jaccoud’s syndrome - hand deforming arthropathy (HDA in systemic lupus erythematosus (SLE. Material and vethods. Analysis of 235 case histories of pts with SLE followed up in the Institute of Rheumatology of RAMS from 1982 to 2002 was performed. 26 from them had HDA according to D. Alarcon-Segovia criteria (1988. SLE activity was determined according to V.A Nassonova and SLEDAI-I scale. Results. 26 from 235 SLE pts (11 % had H DA. More than in 25% from them this damage formed during the first year of the disease and included nonerosive joint damage with the development of finger deformities such as "swan neck", "boutonniere", Z-deformity of thumb, muscle atrophia and ulnar deviation. Longer treatment with glucocorticoids put off HDA development (r=0,64, p=0,0003

Neurogenic muscle hypertrophy in a 12-year-old girl.

Science.gov (United States)

Zutelija Fattorini, Matija; Gagro, Alenka; Dapic, Tomislav; Krakar, Goran; Marjanovic, Josip

2017-01-01

Muscular hypertrophy secondary to denervation is very rare, but well-documented phenomena in adults. This is the first report of a child with neurogenic unilateral hypertrophy due to S1 radiculopathy. A 12-year-old girl presented with left calf hypertrophy and negative history of low back pain or trauma. The serum creatinine kinase level and inflammatory markers were normal. Magnetic resonance imaging showed muscle hypertrophy of the left gastrocnemius and revealed a protruded lumbar disc at the L5-S1 level. The protruded disc abuts the S1 root on the left side. Electromyography showed mild left S1 radiculopathy. Passive stretching and work load might clarify the origin of neurogenic hypertrophy but there is still a need for further evidence. Clinical, laboratory, magnetic resonance imaging and electromyography findings showed that S1 radiculopathy could be a cause of unilateral calf swelling in youth even in the absence of a history of back or leg pain. Copyright © 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Two phenotypes of arthropathy in long-term controlled acromegaly? A comparison between patients with and without joint space narrowing (JSN)

NARCIS (Netherlands)

Claessen, K. M. J. A.; Kloppenburg, M.; Kroon, H. M.; Romijn, J. A.; Pereira, A. M.; Biermasz, N. R.

2013-01-01

Arthropathy is an invalidating complication of acromegaly, also in long-term controlled patients, and is radiographically characterized by osteophytes and preserved joint spaces. However, joint space narrowing (JSN) is observed in the minority of patients. It is unknown whether JSN is the end-stage

Enhanced Dentate Neurogenesis after Brain Injury Undermines Long-Term Neurogenic Potential and Promotes Seizure Susceptibility

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Eric J. Neuberger

2017-09-01

Full Text Available Hippocampal dentate gyrus is a focus of enhanced neurogenesis and excitability after traumatic brain injury. Increased neurogenesis has been proposed to aid repair of the injured network. Our data show that an early increase in neurogenesis after fluid percussion concussive brain injury is transient and is followed by a persistent decrease compared with age-matched controls. Post-injury changes in neurogenesis paralleled changes in neural precursor cell proliferation and resulted in a long-term decline in neurogenic capacity. Targeted pharmacology to restore post-injury neurogenesis to control levels reversed the long-term decline in neurogenic capacity. Limiting post-injury neurogenesis reduced early increases in dentate excitability and seizure susceptibility. Our results challenge the assumption that increased neurogenesis after brain injury is beneficial and show that early post-traumatic increases in neurogenesis adversely affect long-term outcomes by exhausting neurogenic potential and enhancing epileptogenesis. Treatments aimed at limiting excessive neurogenesis can potentially restore neuroproliferative capacity and limit epilepsy after brain injury.

Diagnostic difficulties in the differentiation of neurogenic tumors of the parapharyngeal space in helical CT evaluations: A case report

International Nuclear Information System (INIS)

Czerniewicz-Kaminska, A.; Nowicki, J.; Jazwiec, P.; Kedzierski, B.; Janeczek, T.; Wilczynski, K.; Prudlak, E.

2005-01-01

Computerized tomography (CT) with contrast infusion and magnetic resonance imaging (MRI) play important roles in establishing the place of origin of neurogenic tumors. In this article we do not compare these two methods, but focus on the crucial role of CT imaging in the estimation and differential diagnosis of these tumors. We present the case of a 50-year-old man with clinical symptoms of peritonsillar abscess, which appeared to be a neurogenic tumor. The images obtained were deemed ambiguous. The possibility of a parotid gland tumor or a tumor of neurogenic origin was assumed. In this case we observed atypical clinical and radiological symptoms. The final diagnosis was based on a combination of radiological, clinical, and microbiological features of the tumor. Thanks to the cooperation of many professionals, we managed to establish the diagnosis of neuroangiofibroma, which exemplifies a tumor of the borderline, including elements of the neurogenic sheath and connective and chromaffin tissue. (author)

MR image of an extreme type of tophous gout arthropathy of the hand

International Nuclear Information System (INIS)

Luttke, G.; Rothdauscher, G.

1990-01-01

As the high-resolution MR imaging technique yields pictures with a high soft-tissue contrast and a good spatial resolution, and offers the possibility of multiplane imaging, it allows particularly good visualisation of the anatomy of the hand, including finest tissue compartments. The case report shows that MRI is a diagnostic technique that significantly contributes to an optimum therapy planning for patients suffering from an extreme type of tophous gout arthropathy, which is a disease less frequently met nowadays, thanks to new means of treatment and an enhanced interest in preventive health care on the part of the population. (orig.) [de

99m-Tc HMDP bone scintigraphic findings of gouty arthropathy of both hands

International Nuclear Information System (INIS)

Shih, Wei-Jen; Domstad, P.A.; Purcell, M.; DeLand, F.H.

1988-01-01

The 99m Tc hydroxy methylene diphosphonate scintigraphic findings of both hands are correlated to the radiographic findings in a patient with a 30-year history of gouty arthropathy. Scintigraphic differentiation of the type of arthritis on the basis of uptake pattern is difficult. However, the findings of rheumatoid arthritis are confined to the joints and usually the involvement is symmetrical. With gout there is a tendency toward asymmetrical, bilateral, multifocal joint involvement with areas of intense abnormal uptake; because of the associated soft tissue swelling, the intense uptake usually extends beyond the involved joints. (author)

Ochronotic Arthropathy: Two Case Reports from a Developing Country

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Farooq A. Rathore

2016-01-01

Full Text Available Alkaptonuria is a rare inborn error of metabolism, which is classified as an orphan disease. It is due to the lack of an enzyme homogentisate 1,2-dioxygenase, which results in an accumulation of homogentisic acid in different areas of the body, including sclera, skin, cardiac valves, articular cartilage of the large joints and intervertebral disks. We present two cases of alkaptonuria resulting in ochronotic arthropathy with advanced secondary generalized osteoarthritis, intervertebral disk calcifications, skin and scleral pigmentation. In these case reports, both patients had symptoms for >10 years before being diagnosed. Conservative management in the form of high-dose ascorbic acid, exercises, and gait aids was offered to both of them, which resulted in some symptomatic improvement in the first case, while the second case was lost to follow-up. Alkaptonuria is a rare disease, and although it does not clearly impact mortality, early diagnosis may improve the quality of life.

A systematic review and comparison of questionnaires in the management of spinal cord injury, multiple sclerosis and the neurogenic bladder.

Science.gov (United States)

Tsang, B; Stothers, L; Macnab, A; Lazare, D; Nigro, M

2016-03-01

Validated questionnaires are increasingly the preferred method used to obtain historical information. Specialized questionnaires exist validated for patients with neurogenic disease including neurogenic bladder. Those currently available are systematically reviewed and their potential for clinical and research use are described. A systematic search via Medline and PubMed using the key terms questionnaire(s) crossed with Multiple Sclerosis (MS) and Spinal Cord Injury (SCI) for the years 1946 to January 22, 2014 inclusive. Additional articles were selected from review of references in the publications identified. Only peer reviewed articles published in English were included. 18 questionnaires exist validated for patients with neurogenic bladder; 14 related to MS, 3 for SCI, and 1 for neurogenic bladder in general; with 4 cross-validated in both MS and SCI. All 18 are validated for both male and female patients; 59% are available only in English. The domains of psychological impact and physical function are represented in 71% and 76% of questionnaires, respectively. None for the female population included elements to measure symptoms of prolapse. The last decade has seen an expansion of validated questionnaires to document bladder symptoms in neurogenic disease. Disease specific instruments are available for incorporation into the clinical setting for MS and SCI patients with neurogenic bladder. The availability of caregiver and interview options enhances suitability in clinical practice as they can be adapted to various extents of disability. Future developments should include expanded language validation to the top 10 global languages reported by the World Health Organization. © 2015 Wiley Periodicals, Inc.

[A swollen, painless calf caused by neurogenic muscle (pseudo)-hypertrophy

NARCIS (Netherlands)

Warrenburg, B.P.C. van de; Zwarts, M.J.; Engelen, B.G.M. van

2003-01-01

Neurogenic muscle (pseudo) hypertrophy of the calf was diagnosed in a 60-year-old man, who presented with chronic, painless and unilateral calf enlargement caused by a chronic S1 radiculopathy due to a lumbar disc hernia in the L5-S1 interspace. The differential diagnosis of a swelling of the calf

Urinary Tract Infection and Neurogenic Bladder.

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McKibben, Maxim J; Seed, Patrick; Ross, Sherry S; Borawski, Kristy M

2015-11-01

Urinary tract infections (UTIs) are frequent, recurrent, and lifelong for patients with neurogenic bladder and present challenges in diagnosis and treatment. Patients often present without classic symptoms of UTI but with abdominal or back pain, increased spasticity, and urinary incontinence. Failure to recognize and treat infections can quickly lead to life-threatening autonomic dysreflexia or sepsis, whereas overtreatment contributes to antibiotic resistance, thus limiting future treatment options. Multiple prevention methods are used but evidence-based practices are few. Prevention and treatment of symptomatic UTI requires a multimodal approach that focuses on bladder management as well as accurate diagnosis and appropriate antibiotic treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

Neurogenic transdifferentiation of human adipose-derived stem cells? A critical protocol reevaluation with special emphasis on cell proliferation and cell cycle alterations.

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Kompisch, Kai Michael; Lange, Claudia; Steinemann, Doris; Skawran, Britta; Schlegelberger, Brigitte; Müller, Reinhard; Schumacher, Udo

2010-11-01

Adipose-derived stem cells (ASCs) are reported to display multilineage differentiation potential, including neuroectodermal pathways. The aim of the present study was to critically re-evaluate the potential neurogenic (trans-)differentiation capacity of ASCs using a neurogenic induction protocol based on the combination of isobutylmethylxanthine (IBMX), indomethacin and insulin. ASCs isolated from lipo-aspirate samples of five healthy female donors were characterized and potential neurogenic (trans-)differentiation was assessed by means of immunohistochemistry and gene expression analyses. Cell proliferation and cell cycle alterations were studied, and the expression of CREB/ATF transcription factors was analyzed. ASCs expressed CD59, CD90 and CD105, and were tested negative for CD34 and CD45. Under neurogenic induction, ASCs adopted a characteristic morphology comparable to neur(on)al progenitors and expressed musashi1, β-III-tubulin and nestin. Gene expression analyses revealed an increased expression of β-III-tubulin, GFAP, vimentin and BDNF, as well as SOX4 in induced ASCs. Cell proliferation was significantly reduced under neurogenic induction; cell cycle analyses showed a G2-cell cycle arrest accompanied by differential expression of key regulators of cell cycle progression. Differential expression of CREB/ATF transcription factors could be observed on neurogenic induction, pointing to a decisive role of the cAMP-CREB/ATF system. Our findings may point to a potential neurogenic (trans-)differentiation of ASCs into early neur(on)al progenitors, but do not present definite evidence for it. Especially, the adoption of a neural progenitor cell-like morphology must not automatically be misinterpreted as a specific characteristic of a respective (trans-)differentiation process, as this may as well be caused by alterations of cell cycle progression.

Noninvasive Evaluation of Cellular Proliferative Activity in Brain Neurogenic Regions in Rats under Depression and Treatment by Enhanced [18F]FLT-PET Imaging.

Science.gov (United States)

Tamura, Yasuhisa; Takahashi, Kayo; Takata, Kumi; Eguchi, Asami; Yamato, Masanori; Kume, Satoshi; Nakano, Masayuki; Watanabe, Yasuyoshi; Kataoka, Yosky

2016-08-03

Neural stem cells in two neurogenic regions, the subventricular zone and the subgranular zone (SGZ) of the hippocampal dentate gyrus, can divide and produce new neurons throughout life. Hippocampal neurogenesis is related to emotions, including depression/anxiety, and the therapeutic effects of antidepressants, as well as learning and memory. The establishment of in vivo imaging for proliferative activity of neural stem cells in the SGZ might be used to diagnose depression and to monitor the therapeutic efficacy of antidepressants. Positron emission tomography (PET) imaging with 3'-deoxy-3'-[(18)F]fluoro-l-thymidine ([(18)F]FLT) has been studied to allow visualization of proliferative activity in two neurogenic regions of adult mammals; however, the PET imaging has not been widely used because of lower accumulation of [(18)F]FLT, which does not allow quantitative assessment of the decline in cellular proliferative activity in the SGZ under the condition of depression. We report the establishment of an enhanced PET imaging method with [(18)F]FLT combined with probenecid, an inhibitor of drug transporters at the blood-brain barrier, which can allow the quantitative visualization of neurogenic activity in rats. Enhanced PET imaging allowed us to evaluate reduced cell proliferation in the SGZ of rats with corticosterone-induced depression, and further the recovery of proliferative activity in rats under treatment with antidepressants. This enhanced [(18)F]FLT-PET imaging technique with probenecid can be used to assess the dynamic alteration of neurogenic activity in the adult mammalian brain and may also provide a means for objective diagnosis of depression and monitoring of the therapeutic effect of antidepressant treatment. Adult hippocampal neurogenesis may play a role in major depression and antidepressant therapy. Establishment of in vivo imaging for hippocampal neurogenic activity may be useful to diagnose depression and monitor the therapeutic efficacy of

Botulinum Neurotoxin Injection for the Treatment of Recurrent Temporomandibular Joint Dislocation with and without Neurogenic Muscular Hyperactivity

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Kazuya Yoshida

2018-04-01

Full Text Available The aim of this study was to compare treatment outcomes following intramuscular injection of botulinum neurotoxin (BoNT in patients with recurrent temporomandibular joint dislocation, with and without muscle hyperactivity due to neurological diseases. Thirty-two patients (19 women and 13 men, mean age: 62.3 years with recurrent temporomandibular joint dislocation were divided into two groups: neurogenic (8 women and 12 men and habitual (11 women and 1 man. The neurogenic group included patients having neurological disorders, such as Parkinson’s disease or oromandibular dystonia, that are accompanied by muscle hyperactivity. BoNT was administered via intraoral injection to the inferior head of the lateral pterygoid muscle. In total, BoNT injection was administered 102 times (mean 3.2 times/patient. The mean follow-up duration was 29.5 months. The neurogenic group was significantly (p < 0.001 younger (47.3 years than the habitual group (84.8 years and required significantly (p < 0.01 more injections (4.1 versus 1.7 times to achieve a positive outcome. No significant immediate or delayed complications occurred. Thus, intramuscular injection of BoNT into the lateral pterygoid muscle is an effective and safe treatment for habitual temporomandibular joint dislocation. More injections are required in cases of neurogenic temporomandibular joint dislocation than in those of habitual dislocation without muscle hyperactivity.

Neurogenic gene regulatory pathways in the sea urchin embryo.

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Wei, Zheng; Angerer, Lynne M; Angerer, Robert C

2016-01-15

During embryogenesis the sea urchin early pluteus larva differentiates 40-50 neurons marked by expression of the pan-neural marker synaptotagmin B (SynB) that are distributed along the ciliary band, in the apical plate and pharyngeal endoderm, and 4-6 serotonergic neurons that are confined to the apical plate. Development of all neurons has been shown to depend on the function of Six3. Using a combination of molecular screens and tests of gene function by morpholino-mediated knockdown, we identified SoxC and Brn1/2/4, which function sequentially in the neurogenic regulatory pathway and are also required for the differentiation of all neurons. Misexpression of Brn1/2/4 at low dose caused an increase in the number of serotonin-expressing cells and at higher dose converted most of the embryo to a neurogenic epithelial sphere expressing the Hnf6 ciliary band marker. A third factor, Z167, was shown to work downstream of the Six3 and SoxC core factors and to define a branch specific for the differentiation of serotonergic neurons. These results provide a framework for building a gene regulatory network for neurogenesis in the sea urchin embryo. © 2016. Published by The Company of Biologists Ltd.

Urinary tract infection in the neurogenic bladder

Science.gov (United States)

Vigil, Humberto R.

2016-01-01

There is a high incidence of urinary tract infection (UTI) in patients with neurogenic lower urinary tract function. This results in significant morbidity and health care utilization. Multiple well-established risk factors unique to a neurogenic bladder (NB) exist while others require ongoing investigation. It is important for care providers to have a good understanding of the different structural, physiological, immunological and catheter-related risk factors so that they may be modified when possible. Diagnosis remains complicated. Appropriate specimen collection is of paramount importance and a UTI cannot be diagnosed based on urinalysis or clinical presentation alone. A culture result with a bacterial concentration of ≥103 CFU/mL in combination with symptoms represents an acceptable definition for UTI diagnosis in NB patients. Cystoscopy, ultrasound and urodynamics should be utilized for the evaluation of recurrent infections in NB patients. An acute, symptomatic UTI should be treated with antibiotics for 5–14 days depending on the severity of the presentation. Antibiotic selection should be based on local and patient-based resistance patterns and the spectrum should be as narrow as possible if there are no concerns regarding urosepsis. Asymptomatic bacteriuria (AB) should not be treated because of rising resistance patterns and lack of clinical efficacy. The most important preventative measures include closed catheter drainage in patients with an indwelling catheter and the use of clean intermittent catheterization (CIC) over other methods of bladder management if possible. The use of hydrophilic or impregnated catheters is not recommended. Intravesical Botox, bacterial interference and sacral neuromodulation show significant promise for the prevention of UTIs in higher risk NB patients and future, multi-center, randomized controlled trials are required. PMID:26904414

The Efficacy of Magnetic Resonance Imaging and X-Ray in the Evaluation of Response to Radiosynovectomy in Patients with Hemophilic Arthropathy

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Tamer Özülker

2011-08-01

Full Text Available Objective: We aimed to assess the role of Magnetic Resonance Imaging (MRI and X-Ray in the evaluation of response to radiosynovectomy (RS in patients with hemophilic arthropathy. Material and Methods: Eleven patients who suffered from hemophilic arthropathy with a mean age of 11.7 (range between 7-15 were included in this study. 148-185 MBq Yttrium 90 silicate (Y-90 was administered intraarticularly to ten knee joints and one patient was treated with intraarticular 74 MBq Rhenium 186 (Re-186 injection into his ankle. Before radiosynovectomy, plain anteroposterior and lateral X-rays of the target joints were obtained by standard technique. The follow-up MRI and X-ray studies of the patients were done 6 months after RS. Pettersson hemophilic arthropathy scales were utilized to stage the condition of the joints on plain X-ray and classification of the investigated joints on MRI were done according to Denver score. The clinical assessment of the efficacy of the RS was made with the comparison of the average bleedings before and after the intervention. Results: During the 6-month follow-up period after RS, an improvement in number of hemarthrosis 75% or greater compared with the prior six months occurred in six joints (54.5%. The Pettersson scores worsened in 1/11 (9%, remained unchanged in 9/11 (81.8%, and improved in 1/11 (9% joints. At the 6-month follow-up, the MRI score worsened in one (9% and was unchanged in 10/11 joints (90.9%. Conclusion: MRI is a more sensitive tool than plain radiography for evaluating and follow-up of joint disease in persons with hemophilia, but both methods don’t show correlation with the therapeutic response. (MIRT 2011;20:38-44

Neurogenic inflammation: a study of rat trigeminal ganglion

DEFF Research Database (Denmark)

Kristiansen, Kim Anker; Edvinsson, Lars

2010-01-01

Calcitonin gene-related peptide (CGRP) is linked to neurogenic inflammation and to migraine. Activation of the trigeminovascular system plays a prominent role during migraine attacks with the release of CGRP. The trigeminal ganglion (TG) contains three main cell types: neurons, satellite glial...... cells (SGC) and Schwann cells; the first two have before been studied in vitro separately. Culture of rat TG provides a method to induce inflammation and the possibility to evaluate the different cell types in the TG simultaneously. We investigated expression levels of various inflammatory cytokines...

A Clinician Survey of Speech and Non-Speech Characteristics of Neurogenic Stuttering

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Theys, Catherine; van Wieringen, Astrid; De Nil, Luc F.

2008-01-01

This study presents survey data on 58 Dutch-speaking patients with neurogenic stuttering following various neurological injuries. Stroke was the most prevalent cause of stuttering in our patients, followed by traumatic brain injury, neurodegenerative diseases, and other causes. Speech and non-speech characteristics were analyzed separately for…

Chronic Renal Failure Secondary to Unrecognized Neurogenic Bladder in A Child with Myelodysplasia.

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Ahmed, Shameem; Paul, Siba Prosad

2017-01-01

Myelodysplasia includes a group of developmental anomalies resulting from defects that occur during neural tube closure. Urological morbidity in patients with myelodysplasia is significant and if not treated appropriately in a timely manner can potentially lead to progressive renal failure, requiring dialysis or transplantation. We report the case of a 13-year old girl with neurogenic bladder who presented chronic renal failure secondary to lipomyelomeningocele with retethering of cord. She was managed with urinary indwelling catheterization until optimization of renal function and then underwent detethering of cord with excision and repair of residual lipomeningomyelocele. Her renal parameters improved gradually over weeks and then were managed on self clean intermittent catheterization. The case emphasizes the need for considering retethering of spinal cord in children with myelodysplasia where symptoms of neurogenic bladder and recurrent urinary tract infections occur.

Neurogenic period of ascending tract neurons in the upper lumbar spinal cord of the rat

International Nuclear Information System (INIS)

Nandi, K.N.; Beal, J.A.; Knight, D.S.

1990-01-01

Although the neurogenic period for neurons in the lumbar spinal cord has been clearly established (Days 12 through 16 of gestation), it is not known when the neurogenesis of ascending tract neurons is completed within this period. The purpose of the present study was to determine the duration of the neurogenic period for projection neurons of the ascending tracts. To label neurons undergoing mitosis during this period, tritiated thymidine was administered to fetal rats on Embryonic (E) Days E13 through E16 of gestation. Ascending tract neurons of the lumbar cord were later (Postnatal Days 40-50) labeled in each animal with a retrograde tracer, Fluoro-Gold, applied at the site of a hemisection at spinal cord segment C3. Ascending tract neurons which were undergoing mitosis in the upper lumbar cord were double labeled, i.e., labeled with both tritiated thymidine and Fluoro-Gold. On Day E13, 89-92% of the ascending tract neurons were double labeled; on Day E14, 35-37%; and on Day E15, 1-4%. Results showed, then, that some ascending tract neurons were double labeled through Day E15 and were, therefore, proliferating in the final one-third of the neurogenic period. Ascending tract neurons proliferating on Day E15 were confined to laminae III, IV, V, and X and the nucleus dorsalis. Long tract neurons in the superficial dorsal horn (laminae I and II), on the other hand, were found to have completed neurogenesis on Day E14 of gestation. Results of the present study show that spinal neurogenesis of ascending projection neurons continues throughout most of the neurogenic period and does not completely follow the well-established ventral to dorsal gradient

Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population

International Nuclear Information System (INIS)

Seipel, R.; Langner, S.; Lippa, M.; Kuehn, J.P.; Hosten, N.; Platz, T.

2012-01-01

To retrospectively evaluate neurogenic heterotopic ossification in an early neurological rehabilitation population (phases B and C) with respect to epidemiology and morphology on conventional radiographs. Over a 4-year period, 1,463 patients treated at a clinic for early neurological rehabilitation were evaluated for clinical symptoms of neurogenic heterotopic ossification. In case of clinical suspicion, plain radiographs of the expected sites were obtained. If heterotopic ossification was detected, the initial and subsequent radiographs were retrospectively analyzed for sites, size, and morphology. Immature lesions were categorized as small (<10 mm) or large (10-100 mm). The prevalence rate of neurogenic heterotopic ossification was 2.05%. The condition was most common in young male adults. The hip was the most common site accounting for more than half of the cases. Two or more ossifications were seen in 56.7% of the affected patients with approximately two-thirds showing bilateral symmetric involvement of corresponding joint regions. The size of ossifications strongly varied interindividually. Small immature lesions demonstrated less progression in size than large lesions during maturation (P < 0.05). Standard radiographs, as a fast and inexpensive technique, allow the expected size progression of heterotopic ossifications during maturation to be estimated, which is relevant in terms of therapeutic decisions, patient mobilization, and neurological rehabilitation. (orig.)

bicaudal-C is required for the formation of anterior neurogenic ectoderm in the sea urchin embryo.

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Yaguchi, Shunsuke; Yaguchi, Junko; Inaba, Kazuo

2014-10-31

bicaudal-C (bicC) mRNA encodes a protein containing RNA-binding domains that is reported to be maternally present with deflection in the oocytes/eggs of some species. The translated protein plays a critical role in the regulation of cell fate specification along the body axis during early embryogenesis in flies and frogs. However, it is unclear how it functions in eggs in which bicC mRNA is uniformly distributed, for instance, sea urchin eggs. Here, we show the function of BicC in the formation of neurogenic ectoderm of the sea urchin embryo. Loss-of-function experiments reveal that BicC is required for serotonergic neurogenesis and for expression of ankAT-1 gene, which is essential for the formation of apical tuft cilia in the neurogenic ectoderm of the sea urchin embryo. In contrast, the expression of FoxQ2, the neurogenic ectoderm specification transcription factor, is invariant in BicC morphants. Because FoxQ2 is an upstream factor of serotonergic neurogenesis and ankAT-1 expression, these data indicate that BicC functions in regulating the events that are coordinated by FoxQ2 during sea urchin embryogenesis.

Neurogenic bladder evaluation and management after spinal cord injury: Current practice among urologists working in Saudi Arabia

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Waleed Al Taweel

2011-01-01

Full Text Available Aim: The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. Materials and Methods: A cross-sectional study was conducted using a 12-points questionnaire distributed to urologists working in Saudi Arabia and registered at the Saudi medical association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry. Results: Of the 272 urologists surveyed, 105 responded, yielding a response rate of 38%. Eighty-nine percent of respondents said that ultrasound was their diagnostic tool of choice for upper tract evaluation. Sixty-one percent of respondents said that they would follow their patients with a multichannel urodynamic study. Forty percent of urologists stated that they would treat asymptomatic bacteriuria. Clean intermittent catheterization (CIC was the most common modality chosen for the management of neurogenic bladder in patients with emptying difficulties. Conclusion: This study confirms that most urologists in Saudi Arabia involved with neurogenic bladder management. However, more than one third of the urologists do not have urodynamic machine and only two of the reporting practitioners has a videourodynamic machine. The results emphasize the need for clear guidelines in this field of urology in Saudi Arabia. Highly specialized rehabilitation centers for neurogenic bladder secondary to SCI are required for optimal care and urologist teaching.

Neurogenic bladder evaluation and management after spinal cord injury: Current practice among urologists working in Saudi Arabia.

Science.gov (United States)

Al Taweel, Waleed; Alkhayal, Abdullah

2011-01-01

The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI) or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. A cross-sectional study was conducted using a 12-points questionnaire distributed to urologists working in Saudi Arabia and registered at the Saudi medical association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry. Of the 272 urologists surveyed, 105 responded, yielding a response rate of 38%. Eighty-nine percent of respondents said that ultrasound was their diagnostic tool of choice for upper tract evaluation. Sixty-one percent of respondents said that they would follow their patients with a multichannel urodynamic study. Forty percent of urologists stated that they would treat asymptomatic bacteriuria. Clean intermittent catheterization (CIC) was the most common modality chosen for the management of neurogenic bladder in patients with emptying difficulties. This study confirms that most urologists in Saudi Arabia involved with neurogenic bladder management. However, more than one third of the urologists do not have urodynamic machine and only two of the reporting practitioners has a videourodynamic machine. The results emphasize the need for clear guidelines in this field of urology in Saudi Arabia. Highly specialized rehabilitation centers for neurogenic bladder secondary to SCI are required for optimal care and urologist teaching.

Effectiveness of two modalities of physiotherapy in the treatment of haemophilic arthropathy of the ankle: a randomized pilot study.

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Cuesta-Barriuso, R; Gómez-Conesa, A; López-Pina, J-A

2014-01-01

Although different techniques of physiotherapy have been described for the treatment of haemophilic arthropathy (HA) of ankle, hardly any studies have been applied manual therapy or educational physiotherapy and home exercises. The aim of this study was to assess the effectiveness of manual therapy and educational physiotherapy in the treatment of HA of the ankle. Thirty-one patients with HA of the ankle with a mean age of 35.29 (SD: 12.877) years randomized to manual therapy group (n = 11), educational group (n = 10) and a control group (n = 10). The two physiotherapy programmes were one with manual therapy articular traction, passive stretching of the gastrocnemius muscles, and exercises for muscle strength and proprioception (MT group) and the other with educational sessions and home exercises (E group). The study lasted for 12 weeks. The treatment with manual therapy improved the gastrocnemius muscle circumference, and the pain of ankle (P < 0.05). Six months later, MT group still enjoyed improvement. In the educational group there were improvements, but not significant, in the measured variables. No patient had ankle haemarthrosis during the study. The treatment with manual therapy improved the circumference of gastrocnemius and lessened pain in the patients with haemophilic arthropathy of the ankle. © 2013 John Wiley & Sons Ltd.

[Giant prostatic calculus with neurogenic bladder disease and prostate diverticulum: a case report and review of the literature].

Science.gov (United States)

Li, Xiao-Shi; Quan, Chang-Yi; Li, Gang; Cai, Qi-Liang; Hu, Bin; Wang, Jiu-Wei; Niu, Yuan-Jie

2013-02-01

To study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum. We retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus. The patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream. Prostate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.

Radiosynoviorthesis in hemophilic arthropathy: pathologic blood pool imaging on pre-therapeutic bone scintigraphy is not a predictor of treatment success

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Sabet, Amir [University Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); University Hospital, Department of Nuclear Medicine, Bonn (Germany); Strauss, Andreas Christian; Schmolders, Jan; Bornemann, Rahel; Pennekamp, Peter Hans [University of Bonn, Department of Orthopaedics and Trauma Surgery, Bonn (Germany); Sabet, Amin; Biersack, Hans Juergen [University Hospital, Department of Nuclear Medicine, Bonn (Germany); Oldenburg, Johannes [University of Bonn, Department of Experimental Hematology and Transfusion Medicine, Bonn (Germany); Ezziddin, Samer [University Duisburg-Essen, Department of Nuclear Medicine, Essen (Germany); Saarland University, Department of Nuclear Medicine, Homburg (Germany)

2017-03-15

Increased articular {sup 99m}Tc MDP uptake on blood pool imaging (BPI) of patients with rheumatologic conditions is indicative of active inflammatory changes, and has been suggested as a strong predictor of response to radiosynoviorthesis (RSO). In this study, we aimed to assess the value of pretreatment BPI positivity (i.e. scintigraphic-apparent hyperemia) for successful RSO in hemophilic arthropathy. Thirty-four male patients with painful hemophilic arthropathy underwent RSO after failure of conservative treatment. Treated joints comprised the knee in eight, elbow in five, and ankle in 21 patients. Pretreatment triple-phase bone scintigraphy showed hyperemic joints (pathologic BPI) in 17 patients, whereas 17 patients had no increased tracer uptake on BPI. Response to RSO was evaluated 6 months post-treatment by measuring changes in intensity of arthralgia according to the visual analog scale (VAS), bleeding frequency, and range of motion. The association between hyperemia (pathologic BPI) and treatment outcome was examined using nonparametric tests for independent samples. Clinically evident pain relief occurred in 26 patients (76.5 %), and the mean VAS decreased from 7.7 ± 1.1 to 4.6 ± 2.7 (p < 0.001). Joint bleeding frequency (hemarthrosis) decreased from 4.5 ± 0.6 to 2.1 ± 0.4 during the first 6 months after RSO (p < 0.001). For both parameters (pain relief and bleeding frequency), patients experienced a similar benefit from RSO regardless of pretreatment BPI: arthralgia (p = 0.312) and frequency of hemarthrosis (p = 0.396). No significant improvement was observed for range of motion, but it was significantly more restricted in hyperemic joints both before (p = 0.036) and after treatment (p = 0.022). Hemophilic arthropathy can be effectively treated with RSO regardless of pre-therapeutic BPI. Patients in whom articular hyperemia is not detectable by scintigraphy may have similar (outstanding) outcomes, and thus should not be excluded from treatment. (orig.)

Radiologic features of a pyrophosphate-like arthropathy associated with long-term dialysis

Energy Technology Data Exchange (ETDEWEB)

Braunstein, E.M.; Martel, W.; Menerey, K.; Fox, I.H.; Swartz, R.

1987-08-01

In a series of 28 long-term dialysis patients with musculoskeletal complaints, the radiologic findings in six cases resembled those occurring in the arthropathy of idiopathic calcium pyrophosphate dihydrate deposition (CPPD) disease. These findings included osteophytes, subchondral cysts, and cartilage loss in the metacarpophalangeal joints, patellofemoral joints, wrists, and shoulders. Chondrocalcinosis was present in three of the six cases. There were no significant differences in renal function or levels of serum calcium, phosphorus, iron, ferritin, aluminum, or parathormone between these patients and a control group matched for sex and age. Long-term dialysis may be associated with a metabolic arthritis similar to the arthritis which occurs in CPPD deposition disease. The etiology may include deposition of CPPD crystals, hydroxyapatite, or other calcium-containing substances in joints, or it may be related to a number of dialysis-induced metabolic abnormalities.

Radiologic features of a pyrophosphate-like arthropathy associated with long-term dialysis

International Nuclear Information System (INIS)

Braunstein, E.M.; Martel, W.; Menerey, K.; Fox, I.H.; Swartz, R.

1987-01-01

In a series of 28 long-term dialysis patients with musculoskeletal complaints, the radiologic findings in six cases resembled those occurring in the arthropathy of idiopathic calcium pyrophosphate dihydrate deposition (CPPD) disease. These findings included osteophytes, subchondral cysts, and cartilage loss in the metacarpophalangeal joints, patellofemoral joints, wrists, and shoulders. Chondrocalcinosis was present in three of the six cases. There were no significant differences in renal function or levels of serum calcium, phosphorus, iron, ferritin, aluminum, or parathormone between these patients and a control group matched for sex and age. Long-term dialysis may be associated with a metabolic arthritis similar to the arthritis which occurs in CPPD deposition disease. The etiology may include deposition of CPPD crystals, hydroxyapatite, or other calcium-containing substances in joints, or it may be related to a number of dialysis-induced metabolic abnormalities. (orig.)

Musculoskeletal Disease in MDA5-Related Type I Interferonopathy: A Mendelian Mimic of Jaccoud's Arthropathy.

Science.gov (United States)

de Carvalho, Luciana Martins; Ngoumou, Gonza; Park, Ji Woo; Ehmke, Nadja; Deigendesch, Nikolaus; Kitabayashi, Naoki; Melki, Isabelle; Souza, Flávio Falcäo L; Tzschach, Andreas; Nogueira-Barbosa, Marcello H; Ferriani, Virgínia; Louzada-Junior, Paulo; Marques, Wilson; Lourenço, Charles M; Horn, Denise; Kallinich, Tilmann; Stenzel, Werner; Hur, Sun; Rice, Gillian I; Crow, Yanick J

2017-10-01

To define the molecular basis of a multisystem phenotype with progressive musculoskeletal disease of the hands and feet, including camptodactyly, subluxation, and tendon rupture, reminiscent of Jaccoud's arthropathy. We identified 2 families segregating an autosomal-dominant phenotype encompassing musculoskeletal disease and variable additional features, including psoriasis, dental abnormalities, cardiac valve involvement, glaucoma, and basal ganglia calcification. We measured the expression of interferon (IFN)-stimulated genes in the peripheral blood and skin, and undertook targeted Sanger sequencing of the IFIH1 gene encoding the cytosolic double-stranded RNA (dsRNA) sensor melanoma differentiation-associated protein 5 (MDA-5). We also assessed the functional consequences of IFIH1 gene variants using an in vitro IFNβ reporter assay in HEK 293T cells. We recorded an up-regulation of type I IFN-induced gene transcripts in all 5 patients tested and identified a heterozygous gain-of-function mutation in IFIH1 in each family, resulting in different substitutions of the threonine residue at position 331 of MDA-5. Both of these variants were associated with increased IFNβ expression in the absence of exogenous dsRNA ligand, consistent with constitutive activation of MDA-5. These cases highlight the significant musculoskeletal involvement that can be associated with mutations in MDA-5, and emphasize the value of testing for up-regulation of IFN signaling as a marker of the underlying molecular lesion. Our data indicate that both Singleton-Merten syndrome and neuroinflammation described in the context of MDA-5 gain-of-function constitute part of the same type I interferonopathy disease spectrum, and provide possible novel insight into the pathology of Jaccoud's arthropathy. © 2017, American College of Rheumatology.

Neurogenic Bladder in Lyme Disease

Directory of Open Access Journals (Sweden)

Mi-hwa Kim

2012-12-01

Full Text Available Lyme disease is a multi-systemic, tick-borne infectious disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with Lyme disease, which can be primary or late manifestations of the disease. Although voiding dysfunction is a rarely reported symptom in patients with Lyme disease, it is one of the most disabling complications of Lyme disease. Korea is not an endemic area of Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 32-year-old man with rapidly progressive bilateral ptosis, dysphagia, spastic paraparesis, and voiding difficulty in whom Lyme disease was diagnosed through serologic tests for antibodies and Western blot testing. A urodynamic study demonstrated detrusor areflexia and bulbocavernosus reflex tests showed delayed latency, indicating demyelination at S2-S4 levels. He received a 4-week course of intravenous ceftriaxone (2 g/day. The patient has recovered from the bilateral ptosis and spastic paraparesis but still suffers from neurogenic bladder.

Surgical Management of Anatomic Bladder Outlet Obstruction in Males with Neurogenic Bladder Dysfunction: A Systematic Review.

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Noordhoff, Toscane C; Groen, Jan; Scheepe, Jeroen R; Blok, Bertil F M

2018-03-15

Surgical treatment of anatomic bladder outlet obstruction (BOO) may be indicated in males with neurogenic bladder dysfunction. A bothersome complication after surgery is urinary incontinence. To identify the optimal practice in the surgical treatment of anatomic BOO in males with neurogenic bladder dysfunction, due to multiple sclerosis, Parkinson disease, spinal cord injury (SCI), spina bifida, or cerebrovascular accident (CVA). A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. Medline, Embase, Cochrane controlled trial databases, Web of Science, and Google Scholar were searched for publications until January 2017. A total of 930 abstracts were screened. Eight studies were included. The types of anatomic BOO discussed were benign prostate obstruction, urethral stricture, and bladder neck sclerosis. The identified surgical treatments were transurethral resection of the prostate (TURP) in patients with Parkinson, CVA or SCI, endoscopic treatment of urethral stricture by laser ablation or urethrotomy (mainly in SCI patients), and bladder neck resection (BNR) in SCI patients. The outcome of TURP may be highly variable, and includes persistent or de novo urinary incontinence, regained normal micturition control, and urinary continence. Good results were seen in BNR and endoscopic urethrotomy studies. Laser ablation and cold knife urethrotomy resulted in restarting intermittent catheterization or adequate voiding. Overall, a high risk of bias was found. This systematic review provides an overview of the current literature on the outcome of several surgical approaches of different types of anatomic BOO in males with neurogenic bladder dysfunction. Identifying the optimal practice was impossible due to limited availability of high-quality studies. The outcome of several surgical approaches in males with neurogenic bladder dysfunction with benign prostate obstruction, urethral stricture

Environmental enrichment, age and PPARα interact to regulate proliferation in neurogenic niches

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Margarita ePerez-Martin

2016-03-01

Full Text Available Peroxisome proliferator-activated receptor alpha (PPARα ligands have been shown to modulate recovery after brain insults such as ischemia and irradiation by enhancing neurogenesis. In the present study, we investigated the effect of the genetic deletion of PPARα receptors on the proliferative rate of neural precursor cells (NPC in the adult brain. The study was performed in aged Pparα-/- mice exposed to nutritional (treats and environmental (games enrichments for 20 days. We performed immunohistochemical analyses of cells containing the replicating cell DNA marker 5-bromo-2’-deoxyuridine (BrdU+ and the immature neuronal marker doublecortin (Dcx+ in the main neurogenic zones of the adult brain: subgranular zone of dentate gyrus (SGZ, subventricular zone of lateral ventricles (SVZ and/or hypothalamus. Results indicated a reduction in the number of BrdU+ cells in the neurogenic zones analyzed as well as Dcx+ cells in the SGZ during aging (2, 6, 18 months. Pparα deficiency alleviated the age-related reduction of NPC proliferation (BrdU+ cells in the SVZ of the 18-months-old mice. While no genotype effect on NPC proliferation was detected in the SGZ during aging, an accentuated reduction in the number of Dcx+ cells was observed in the SGZ of the 6-months-old Pparα-/- mice. Exposing the 18-months-old mice to nutritional and environmental enrichments reversed the Pparα-/--induced impairment of NPC proliferation in the neurogenic zones analyzed. The enriched environment did not modify the number of SGZ Dcx+ cells in the 18 months old Pparα-/- mice. These results identify PPARα receptors as a potential target to counteract the naturally observed decline in adult NPC proliferation associated with aging and impoverished environments.

Sarcopenia, a Neurogenic Syndrome?

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Ping Kwan

2013-01-01

Full Text Available Sarcopenia is an aging-associated condition, which is currently characterized by the loss of muscle mass and muscle strength. However, there is no consensus regarding its characterization hitherto. As the world older adult population is on the rise, the impact of sarcopenia becomes greater. Due to the lack of effective treatments, sarcopenia is still a persisting problem among the global older adults and should not be overlooked. As a result, it is vital to investigate deeper into the mechanism underlying the pathogenesis of sarcopenia in order to develop more effective therapeutic interventions and to inscribe a more uniform characterization. The etiology of sarcopenia is currently found to be multifactorial, and most of the pharmacological researches are focused on the muscular factors in aging. Although the complete mechanism underlying the development of sarcopenia is still waiting to be elucidated, we propose in this article that the primary trigger of sarcopenia may be neurogenic in origin based on the intimate relationship between the nervous and muscular system, namely, the motor neuron and its underlying muscle fibers. Both of them are affected by the cellular environment and their physiological activity.

Development of the adult neurogenic niche in the hippocampus of mice

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Zeina eNicola

2015-05-01

Full Text Available When does adult hippocampal neurogenesis begin? We describe the development of the neurogenic niche in the subgranular zone (SGZ of the hippocampal dentate gyrus. We did so from the perspective of the situation in the adult.Ontogeny of the dentate gyrus is complex and results in an ectopic neurogenic niche that lifelong generates new granule cells. Neurogenesis during the fetal and early postnatal periods builds the dentate gyrus and gives way to activity-dependent adult neurogenesis. We used markers most relevant to adult neurogenesis research to describe this transition: Nestin, Sox2, BLBP, GFAP, Tbr2, Doublecortin (DCX, NeuroD1 and Prox1. We found that massive changes and a local condensation of proliferating precursor cells occurs between postnatal day 7 (P7, near the peak in proliferation, and P14. Before and around P7, the spatial distribution of cells and the co-localization of markers were distinct from the situation in the adult. Unlike the adult SGZ, the marker pair Nestin/Sox2 and the radial glial marker BLBP were not overlapping during embryonic development, presumably indicating different types of radial glia-like cells. Before P7 GFAP-positive cells in the hilus lacked the radial orientation that is characteristic of the adult type-1 cells. DCX, which is concentrated in type-2b and type-3 progenitor cells and early postmitotic neurons in the adult, showed diffuse expression before P7. Intermediate progenitor cell marker Tbr2 became restricted to the SGZ but was found in the granule cell layer and hilus before. Lineage markers NeuroD1 and Prox1 confirmed this pattern.We conclude that the neurogenic niche of adult neurogenesis is in place well before true adulthood. This might indicate that consistent with the hypothesized function of adult neurogenesis in activity-dependent plasticity, the early transition from postnatal neurogenesis to adult neurogenesis coincides with the time, when the young mice start to become active themselves.

Surgical Management of Neurogenic Lower Urinary Tract Dysfunction.

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Gor, Ronak A; Elliott, Sean P

2017-08-01

Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function. Complications are common in this subgroup of patients requiring enduring commitments from surgeons, patients, and their caretakers. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of radiography, CT and MR imaging in detection of arthropathies in patients with hemophilia

International Nuclear Information System (INIS)

Yu Wei; Lin Qiang; Shang Wei; Zhu Haifeng; Meng Wei; Xu Ruiyi; Zhao Yongqiang; Shi Yongsheng

2007-01-01

Objective: To compare MR, CT, and radiography in the detection of arthropathies in patients with hemophilia. Methods: Forty-one symptomic joint images in the 14 patients with hemophilia, aged from 11 to 24 years, were used in this study. Each joint had the examinations of radiography, CT and MR within one day. The severity of each joint was staged using conventional radiographic classification. Severe HA patients with stage 5 were excluded from the study. Imaging findings of soft tissue swelling, osteoporosis, epiphyseal overgrowth, joint erosion, cyst, joint space narrowing, bone marrow, joint effusion, hemorrhage, synovial hypertrophy, widened intercondylar notch as well as anterior and posterior cruciate ligaments (only for knee joint) were used for the all imaging comparison. Results: The 41 symptomatic joints in 14 patients with hemophilia were classified by radiographic criteria into stage 0 (n=5), stage 1 (n=7), stage 2 (n=6), stage 3 (n=8) and stage 4 (n=15). Soft tissue swelling or joint effusion was observed in 33 joints by radiographs, in 34 joints by both CT and MR. Joint erosions were demonstrated in 34 joints by MR, in 33 joints by CT and 20 joints by radiographs. Joint cysts were shown in 21 joints by MR, in 18 joints by CT and 9 joints by radiographs. Significant differences in detection of erosion and cyst were found between radiography with either CT (P 0.05). MR showed improvement for detecting more foci of both erosion and cyst than CT and radiography, and also CT showed the improvement than radiography. Bone marrow edema 14 joints, hemorrhage in 34 joints and synovial hypertrophy in 27 joints were revealed on MR images. Conclusion: MRI is superior to CT and conventional radiography in detecting the abnormal changes and should be considered as the first choice among the imaging modalities in evaluating hemophilic arthropathies. (authors)

MRI study in spondyloepiphyseal dysplasia tarda with progressive arthropathy

International Nuclear Information System (INIS)

Tan Lihua; Liao Eryuan; Xiao Enhua; Ma Cong; Du Wanping; Li Jian

2005-01-01

Objective: To study the MRI features and the cartilaginous pathology of the spondyloepiphyseal dysplasia tarda with progressive arthropathy (SEDT-PA). Methods: MRI of spine, bilateral hips, and knees was taken in 2 cases with clinically and radiographically proven SEDT-PA, who were sister and brother and whose parents were healthy and not inbreeding. The sister's femoral heads were resected bilaterally and the tissues were used for pathological study. Results: MRI showed that the kyphosis and lateroflexion of the spine, and the degenerative signs of the intervertebral discs became more evident along with the growth of the patients. The anterior annular secondary ossification centers of cartilaginous epiphyses of some vertebral bodies didn't appear. So the affected vertebral bodies were like 'inverted vase' or the end p late like 'steps'. Bilateral acetabular cartilage and medial epicondylian cartilaginous epiphyses of the femurs in the young brother showed regional high signal intensity on coronal fat-saturated proton density weighted MR images and degenerative signs on the elder sister. The regional hyperplasia and hypogenesis of the femoral head cartilage could be seen by microscope. Conclusion: There are characteristic features on MRI in SEDT-PA and this is due to the regional hyperplasia and hypogenesis of the cartilage pathologically. (authors)

Neurogenic plasma exudation mediates grain dust-induced tissue injury in vivo.

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Gao, X P; Von Essen, S; Rubinstein, I

1997-02-01

The purpose of this study was to determine whether an aqueous extract of grain sorghum dust (GDE) elicits neurogenic plasma exudation in the oral mucosa in vivo. Using intravital microscopy, we found that GDE elicited significant, concentration-dependent leaky site formation and an increase in clearance of fluorescein isothiocyanate-labeled dextran (FITC-dextran; mol mass 70 kDa) from the hamster cheek pouch (P grain sorghum dust elicits immediate oral mucosa inflammation in vivo.

Radiocolloids in the management of hemophilic arthropathy in children and adolescents

International Nuclear Information System (INIS)

Erken, E.H.

1991-01-01

Radiocolloids have been used in the treatment of hemophilic arthropathy. Fifty-eight joints of 35 patients were injected with 2-5 mCi of yttrium-90 silicate under local anesthesia. A preinjection arthrogram was performed to ensure correct placement of the needle. Plaster of paris cast immobilization of the joint was used for three days. After a mean follow-up period of seven years (range, two to 12 years), 47 joints were pain free, and 13 joints had not experienced another hemorrhagic episode. The mean hemorrhagic frequency had decreased from four per month to two per year. The radiation risk was far outweighed by the benefits of the procedure. Forty-seven of the 58 joints were rated as improved by the patients. The roentgenographic appearance of the joints had changed little. Only five complications occurred: three needle-track necroses because of extravasation of the radiocolloid, two severely painful joints immediately after injection, and one massive hemorrhagic episode. This form of treatment is suggested for hemophiliacs who have failed to respond to intensive physical and hematologic therapy, and for those patients who have inhibitors

[Clinical application and optimization of HEAD-US quantitative ultrasound assessment scale for hemophilic arthropathy].

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Li, J; Guo, X J; Ding, X L; Lyu, B M; Xiao, J; Sun, Q L; Li, D S; Zhang, W F; Zhou, J C; Li, C P; Yang, R C

2018-02-14

Objective: To assess the feasibility of HEAD-US scale in the clinical application of hemophilic arthropathy (HA) and propose an optimized ultrasound scoring system. Methods: From July 2015 to August 2017, 1 035 joints ultrasonographic examinations were performed in 91 patients. Melchiorre, HEAD-US (Hemophilic Early Arthropathy Detection with UltraSound) and HEAD-US-C (HEAD-US in China) scale scores were used respectively to analyze the results. The correlations between three ultrasound scales and Hemophilia Joint Health Scores (HJHS) were evaluated. The sensitivity differences of the above Ultrasonic scoring systems in evaluation of HA were compared. Results: All the 91 patients were male, with median age of 16 (4-55) years old, including 86 cases of hemophilia A and 5 cases hemophilia B. The median ( P 25 , P 75 ) of Melchiorre, HEAD-US and HEAD-US-C scores of 1 035 joints were 2(0,6), 1(0,5) and 2(0,6), respectively, and the correlation coefficients compared with HJHS was 0.747, 0.762 and 0.765 respectively, with statistical significance ( P cases of asymptomatic joints, the positive rates of Melchiorre, HEAD-US-C and HEAD-US scale score were 25.0% (95% CI 20.6%-29.6%), 17.0% (95% CI 12.6%-21.1%) and 11.9% (95% CI 8.4%-15.7%) respectively, and the difference was statistically significant ( P joints of 40 patients. The difference in variation amplitude of HEAD-US-C scores and HEAD-US scores before and after joint bleeding was statistically significant ( P <0.001). Conclusion: Compared with Melchiorre, there were similar good correlations between HEAD-US, HEAD-US-C and HJHS. HEAD-US ultrasound scoring system is quick, convenient and simple to use. The optimized HEAD-US-C scale score is more sensitive than HEAD-US, especially for patients with HA who have subclinical state, which make up for insufficiency of sensitivity in HEAD-US scoring system.

Congenital contractural arachnodactyly with neurogenic muscular atrophy: case report

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Scola Rosana Herminia

2001-01-01

Full Text Available We report the case of a 3-1/2-year-old girl with hypotonia, multiple joint contractures, hip luxation, arachnodactyly, adducted thumbs, dolichostenomelia, and abnormal external ears suggesting the diagnosis of congenital contractural arachnodactyly (CCA. The serum muscle enzimes were normal and the needle electromyography showed active and chronic denervation. The muscle biopsy demonstrated active and chronic denervation compatible with spinal muscular atrophy. Analysis of exons 7 and 8 of survival motor neuron gene through polymerase chain reaction did not show deletions. Neurogenic muscular atrophy is a new abnormality associated with CCA, suggesting that CCA is clinically heterogeneous.

Are neural crest stem cells the missing link between hematopoietic and neurogenic niches?

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Cécile eCoste

2015-06-01

Full Text Available Hematopoietic niches are defined as cellular and molecular microenvironments that regulate hematopoietic stem cell (HSC function together with stem cell autonomous mechanisms. Many different cell types have been characterized as contributors to the formation of HSC niches, such as osteoblasts, endothelial cells, Schwann cells, and mesenchymal progenitors. These mesenchymal progenitors have themselves been classified as CXC chemokine ligand (CXCL12-abundant reticular (CAR cells, stem cell factor expressing cells, or nestin-positive mesenchymal stem cells (MSCs, which have been recently identified as neural crest-derived cells (NCSCs. Together, these cells are spatially associated with HSCs and believed to provide appropriate microenvironments for HSC self-renewal, differentiation, mobilization and hibernation both by cell-to-cell contact and soluble factors. Interestingly, it appears that regulatory pathways governing the hematopoietic niche homeostasis are operating in the neurogenic niche as well. Therefore, this review paper aims to compare both the regulation of hematopoietic and neurogenic niches, in order to highlight the role of NCSCs and nervous system components in the development and the regulation of the hematopoietic system.

Are neural crest stem cells the missing link between hematopoietic and neurogenic niches?

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Coste, Cécile; Neirinckx, Virginie; Gothot, André; Wislet, Sabine; Rogister, Bernard

2015-01-01

Hematopoietic niches are defined as cellular and molecular microenvironments that regulate hematopoietic stem cell (HSC) function together with stem cell autonomous mechanisms. Many different cell types have been characterized as contributors to the formation of HSC niches, such as osteoblasts, endothelial cells, Schwann cells, and mesenchymal progenitors. These mesenchymal progenitors have themselves been classified as CXC chemokine ligand (CXCL) 12-abundant reticular (CAR) cells, stem cell factor expressing cells, or nestin-positive mesenchymal stem cells (MSCs), which have been recently identified as neural crest-derived cells (NCSCs). Together, these cells are spatially associated with HSCs and believed to provide appropriate microenvironments for HSC self-renewal, differentiation, mobilization and hibernation both by cell-cell contact and soluble factors. Interestingly, it appears that regulatory pathways governing the hematopoietic niche homeostasis are operating in the neurogenic niche as well. Therefore, this review paper aims to compare both the regulation of hematopoietic and neurogenic niches, in order to highlight the role of NCSCs and nervous system components in the development and the regulation of the hematopoietic system.

The L-arginine/asymmetric dimethylarginine ratio is improved by anti-tumor necrosis factor-α therapy in inflammatory arthropathies. Associations with aortic stiffness.

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Angel, Kristin; Provan, Sella Aarrestad; Mowinckel, Petter; Seljeflot, Ingebjørg; Kvien, Tore Kristian; Atar, Dan

2012-11-01

Anti-Tumor Necrosis Factor (TNF)-α therapy improves vascular pathology in inflammatory arthropathies such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis. The l-arginine/ADMA ratio is important for modulation of the nitric oxide synthase activity. We examined the effect of TNF-α antagonists on ADMA and l-arginine/ADMA, and associations between ADMA, L-arginine/ADMA, aortic stiffness and carotid intima media thickness (CIMT) in patients with inflammatory arthropathies. Forty-eight patients who started with anti-TNF-α therapy were compared with a non-treated group of 32 patients. Plasma ADMA and L-arginine were assessed at baseline, 3 and 12 months. In a subgroup of 55 patients, aortic pulse wave velocity (aPWV) was measured at baseline, 3 and 12 moths, and CIMT was examined at baseline and 12 months. Anti-TNF-α therapy increased the L-arginine/ADMA ratio (mean [SD]) in the treatment group compared to the control group after 3 months (12 [29] vs. -13 [20], P < 0.001) and 12 months (7 [27] vs. -8 [19], P = 0.008), but did not affect ADMA (3 months: 0.00 [0.09] μmol/L vs. 0.02 [0.07] μmol/L, P = 0.42, 12 months: 0.01 [0.08] μmol/L vs. 0.01 [0.09] μmol/L, P = 0.88). Baseline aPWV was associated with ADMA (P = 0.02) and L-arginine/ADMA (P = 0.02) in multiple regression analyses, and the L-arginine/ADMA ratio was continuously associated with aPWV after initiation of anti-TNF-α therapy (P = 0.03). ADMA and L-arginine/ADMA were not correlated with CIMT. Anti-TNF-α therapy improved the L-arginine/ADMA ratio in patients with inflammatory arthropathies. ADMA and the L-arginine/ADMA ratio were associated with aPWV, and might have a mechanistic role in the aortic stiffening observed in these patients. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[Clonazepam in therapy of neurogenic syncopal states].

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Musaeva, Z A

2001-01-01

27 patients with frequent neurogenic syncopes (NS) resistant to conventional therapy were treated with clonazepam. The average age of the patients was 29.8 +/- 11.6 years. There were 1-2 syncopes in a month. Both before and after the treatment an active orthostatic test was performed with ECG registration and following analysis of variability of the cardiac rhythm. Clonazepam was administered in a dose of 2-2.5 mg/day during 8-9 weeks. Clinical improvement in the form of a lack of syncopes was observed in 20 patients (74%); 3 patients (10%) had isolated lipothymic states; 2 patients discontinued the treatment because of side-effects (dizziness). The results of the examination of 23 patients 6 months after clonazepam therapy testified the stability of the therapeutic effect.

[Electromyographic differential diagnosis in cases of abducens nerve paresis with nuclear or distal neurogenic sive myogenic origine (author's transl)].

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Heuser, M

1979-09-01

Abducens nerve paresis may be of nuclear, of peripheral distal neurogenic origine, or is simulated by a myogenic weakness of abduction. Polygraphic emg analysis of the oculoauricularphenomenon (oap) permits a differentiation. In the emg, the oap proved to be a physiologic and constant automatic and always bilateral interaction between the hemolateral abducens nerve and both Nn. faciales with corresponding and obligatory coinnervation of the Mm. retroauricularis of the external ear. In case of medullary, nuclear or internuclear lesions, the oap is disturbed, instable, diminished or abolished, whereas in distal neurogenic or myogenic paresis, even in complete paralysis the oap is bilaterally well preserved.

Examining Reactive Arthropathy in Military Skeletal Assemblages: A Pilot Study Using the Mass Grave Assemblage from the Battle of Towton (1461

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Meghan Elizabeth Banton

2014-10-01

Full Text Available Military personnel are often subjected to physical exertion, sleep deprivation, deficient diets, overcrowding, and stress. All of these influences are capable of compromising the immune system’s ability to ward off disease-causing bacteria, thus explaining why the historical narrative of war is frequently accompanied by reports of death and suffering due to epidemics of infectious diseases. Historically some of the most common infections included: diarrhoea, dysentery, typhoid fever, gonorrhoea, and streptococcal tonsillitis. The bacteria which cause these diseases are also capable of triggering arthritis. When an arthritic condition is triggered by an infectious microbe it can broadly be referred to as “reactive arthropathy,” of which the spondyloarthritides (SpAs are of great interest. Since the bacteria associated with these arthritic conditions are responsible for the epidemics which have plagued combatants for centuries, it is reasonable to assume that reactive arthropathy was present in past military populations. This assertion can be tested through a prevalence study of military related skeletal assemblages. To test the methodology and gain preliminary results for this research project, a pilot study was carried out using remains from the 1461 Battle of Towton. The methodology was deemed to be sound and the statistical results, while not significant, were promising.

Longterm quiescent cells in the aged human subventricular neurogenic system specifically express GFAP-delta

NARCIS (Netherlands)

van den Berge, S.A.; Middeldorp, J.; Zhang, C.E.; Curtis, M.A.; Leonard, B.W.; Mastroeni, D.; Voorn, P.; van de Berg, W.D.J.; Huitinga, I.; Hol, E.M.

2010-01-01

A main neurogenic niche in the adult human brain is the subventricular zone (SVZ). Recent data suggest that the progenitors that are born in the human SVZ migrate via the rostral migratory stream (RMS) towards the olfactory bulb (OB), similar to what has been observed in other mammals. A

[Major influential factors of the micturition alert device dedicated to neurogenic bladders].

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Wang, Jianhuo; Hou, Chunlin; Zheng, Xianyou; Xu, Zhen; Wang, Wanhong; Lin, Haodong

2008-08-01

To study major influential factors of the micturition alert device dedicated to neurogenic bladders for the product design and clinical application of the device. One ferrite permanent magnet with thickness and diameter of 3 mm and 10 mm, respectively, and three NdFeB permanent magnets with the thickness of 3 mm and diameter of 10, 15 and 20 mm, respectively, were used. The effects of thickness of the abdominal wall as well as the position and type of permanent magnets on the micturition alert device dedicated to neurogenic bladders were measured in vitro simulated test, when the abdominal wall was set to 2, 3, 4, 5, 6, 7, 8 and 9 cm, respectively, and the position of permanent magnets was 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 cm, respectively. The effect of the geomagnetic field on the device was measured under the condition that the thickness of the simulated abdominal wall was set to 2, 3, 4 and 5 cm, respectively, and the position of permanent magnets was 2, 3, 4, 5, 6, 7, 8, 9 and 10 cm, respectively. The value showed in the warning unit was positively correlated with the position of the ferrite permanent magnet only when the thickness of the simulated abdominal wall was 2 cm (r=0.632, P NdFeB permanent magnets was significant (r > 0.622, P NdFeB permanent magnets, but weakened with the increasing thickness of the simulated abdominal wall. The effect of the geomagnetic field was correlated with the exposition of the body, the position of the permanent magnet and the thickness of the abdominal wall. The major influential factors of the micturition alert device dedicated to neurogenic bladder include the magnetism and location of the permanent magnet, the thickness of the abdominal wall and the geomagnetic field. These factors are correlated with and affect each other. Reasonable allocation of these factors may optimize the device.

Gout on CT of the feet: A symmetric arthropathy

International Nuclear Information System (INIS)

Doyle, Anthony J.; Boyer, Lucinda; Dong, Jing; Dalbeth, Nicola; McQueen, Fiona; Rome, Keith; Frecklington, Mike

2016-01-01

The aim of this study was to assess the distribution of bone erosions in the feet of patients with gout using CT and thereby to test the hypothesis that gout is an asymmetric arthropathy. CT scans of both feet were obtained from 25 patients with chronic gout. CT scans were scored for bone erosion using a semi-quantitative method based on the rheumatoid arthritis MRI scoring system (RAMRIS). CT bone erosion was assessed at 22 bones in each foot (total 1,100 bones) by two independent radiologists. Symmetry was assessed by two methods: (i) comparing right and left foot scores for each patient; and (ii) calculating the proportion of paired joints with or without erosions. Observer agreement was excellent (intra-class correlation coefficient 0.92). In the group overall, the difference in scores between the feet was not significant (Student's t-test P = 0.8). In 17 of 25 patients, the difference in erosion scores between the two feet was less than the inter-observer difference. In 24 of 25 patients, the proportion of paired joints was greater than 0.5, indicating symmetric disease. Erosive disease from gout is, in fact, a symmetric process in our patient group. This finding is contrary to the established view of gout as an asymmetric arthritis and lends new insight into the behaviour of this common disease.

Lineage analysis of quiescent regenerative stem cells in the adult brain by genetic labelling reveals spatially restricted neurogenic niches in the olfactory bulb.

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Giachino, Claudio; Taylor, Verdon

2009-07-01

The subventricular zone (SVZ) of the lateral ventricles is the major neurogenic region in the adult mammalian brain, harbouring neural stem cells within defined niches. The identity of these stem cells and the factors regulating their fate are poorly understood. We have genetically mapped a population of Nestin-expressing cells during postnatal development to study their potential and fate in vivo. Taking advantage of the recombination characteristics of a nestin::CreER(T2) allele, we followed a subpopulation of neural stem cells and traced their fate in a largely unrecombined neurogenic niche. Perinatal nestin::CreER(T2)-expressing cells give rise to multiple glial cell types and neurons, as well as to stem cells of the adult SVZ. In the adult SVZ nestin::CreER(T2)-expressing neural stem cells give rise to several neuronal subtypes in the olfactory bulb (OB). We addressed whether the same population of neural stem cells play a role in SVZ regeneration. Following anti-mitotic treatment to eliminate rapidly dividing progenitors, relatively quiescent nestin::CreER(T2)-targeted cells are spared and contribute to SVZ regeneration, generating new proliferating precursors and neuroblasts. Finally, we have identified neurogenic progenitors clustered in ependymal-like niches within the rostral migratory stream (RMS) of the OB. These OB-RMS progenitors generate neuroblasts that, upon transplantation, graft, migrate and differentiate into granule and glomerular neurons. In summary, using conditional lineage tracing we have identified neonatal cells that are the source of neurogenic and regenerative neural stem cells in the adult SVZ and occupy a novel neurogenic niche in the OB.

Joint lavage followed by intra-articular injection of hyaluronic acid and/or corticosteroids in patients with severe hemophilic arthropathy of the knee: Is this intervention really effective?

Science.gov (United States)

Rodriguez-Merchan, E Carlos; Valentino, Leonard A

2018-05-10

The aim of this review is to explore the scientific rationale and evidence for a potential benefit of joint lavage followed by intra-articular injection of hyaluronic acid and/or corticosteroids in patients with severe hemophilic arthropathy of the knee (SHAK). Areas covered: This article is a narrative review of the evidence for potential benefits of joint lavage followed by intra-articular injection of hyaluronic acid and corticosteroids in SHAK compared with osteoarthritis of the knee in non-hemophilia patients. Expert commentary: Although some reports on hemophilic arthropathy with a low-grade of evidence seem to indicate a benefit of joint lavage followed by intra-articular injection of hyaluronic acid and/or corticosteroids in patients with SHAK, the short-lived improvements afforded by hyaluronic acid, and the doubtful benefits of corticosteroids and joint lavage in hemophilia, do not warrant their use in hemophilic patients. The scientific rationale of these procedures is poor and they are not recommended.

Neurogenic stunned myocardium following hemorrhagic cerebral contusion

International Nuclear Information System (INIS)

Deleu, D.; Miyares, F.; Kettern, M.; Kumar, S.; Hassens, Y.; Salim, K.

2007-01-01

Neurogenic stunned myocardium NSM is a well-known complication of subarachnoidal hemorrhage, but has been reported rarely in association with other central nervous system disorders. A case of NSM is described in a patient with hemorrhagic brain contusion associated with cerebral edema. An 18-year-old man was admitted with severe cranial trauma following a car roll-over. Six days after admission, he developed findings suggestive for NSM. The troponin T and creatine kinase-MB level were elevated and echocardiogram showed apical and inferoposterior hypokinesis and diffuse left ventricular akinesis with severely reduced ejection fraction 18%. Invasive measurements confirmed low cardiac output. His cardiac function resolved completely within 6 days after decompressive craniotomy. This case supports the presumed unifying role of the increased intracranial pressure, probably triggering a vigorous sympathetic outflow hyperactivity leading to NSM. (author)

Ceftolozane/tazobactam for febrile UTI due to multidrug-resistant Pseudomonas aeruginosa in a patient with neurogenic bladder.

Science.gov (United States)

Dinh, Aurélien; Davido, Benjamin; Calin, Ruxandra; Paquereau, Julie; Duran, Clara; Bouchand, Frédérique; Phé, Véronique; Chartier-Kastler, Emmanuel; Rottman, Martin; Salomon, Jérôme; Plésiat, Patrick; Potron, Anaïs

2017-01-01

Urinary tract infections (UTI) are a major public health problem among spinal cord injury (SCI) patients. They frequently involve multidrug-resistant (MDR) bacteria. Ceftolozane/tazobactam (C/T) is a novel antibiotic combination approved for complicated intra-abdominal and UTI caused by Gram-positive and Gram-negative organisms, including some MDR strains. Little is known about the use of this agent for complicated febrile UTI occurring among SCI patients with neurogenic bladder due to MDR Pseudomonas aeruginosa (PSA). We describe the case of a 35-year-old man with SCI due to multiple sclerosis, with a neurogenic bladder necessitating a bilateral nephrostomy and double J catheter, who developed a febrile UTI due to a MDR PSA, which was susceptible only to amikacin and colistin. Because of this MDR phenotype and the underlying kidney disease, a 1000 mg (1000 mg per 500 mg) dose of C/T was given as monotherapy every 8 h for 7 days, after 3 days of colistin and amikacin. Thanks to this treatment, the patient had a favorable outcome with no clinical signs of UTI or positive urine culture up to 1 month after diagnosis. C/T seems to be an effective and safe therapeutic option for febrile UTI due to MDR PSA in SCI patients with neurogenic bladder, even when administered in monotherapy for 10 days.

Transient receptor potential ankyrin 1 channel localized to non-neuronal airway cells promotes non-neurogenic inflammation

DEFF Research Database (Denmark)

Nassini, Romina; Pedretti, Pamela; Moretto, Nadia

2012-01-01

The transient receptor potential ankyrin 1 (TRPA1) channel, localized to airway sensory nerves, has been proposed to mediate airway inflammation evoked by allergen and cigarette smoke (CS) in rodents, via a neurogenic mechanism. However the limited clinical evidence for the role of neurogenic...... inflammation in asthma or chronic obstructive pulmonary disease raises an alternative possibility that airway inflammation is promoted by non-neuronal TRPA1.By using Real-Time PCR and calcium imaging, we found that cultured human airway cells, including fibroblasts, epithelial and smooth muscle cells express...... functional TRPA1 channels. By using immunohistochemistry, TRPA1 staining was observed in airway epithelial and smooth muscle cells in sections taken from human airways and lung, and from airways and lung of wild-type, but not TRPA1-deficient mice. In cultured human airway epithelial and smooth muscle cells...

Follow-up of Long-term Treatment with Clean Intermittent Catheterization for Neurogenic Bladder in Children

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Panuwat Lertsithichai

2004-04-01

Conclusions: For most patients and with close long-term follow-up, early treatment of neurogenic bladder using CIC in children born with myelomeningocele yields better results than late treatment. In our experience, treatment is recommended as soon as possible, especially during the first year of life.

Cost-effectiveness analyses of elective orthopaedic surgical procedures in patients with inflammatory arthropathies

DEFF Research Database (Denmark)

Osnes-Ringen, H.; Kvamme, M. K.; Sønbø Kristiansen, Ivar

2011-01-01

. The health benefit from surgery was subsequently translated into QALYs. The direct treatment costs in the first year were, for each patient, derived from the hospital's cost per patient accounting system (KOSPA). The costs per QALY were estimated and future costs and benefits were discounted at 4%. Results......Objective: To examine the costs per quality-adjusted life year (QALY) gained for surgical interventions in patients with inflammatory arthropathies, and to compare the costs per QALY gained for replacement versus non-replacement surgical interventions. Methods: In total, 248 patients [mean age 57......: Improvement in utility at 1-year follow-up was 0.10 with EQ-5D and 0.03 with SF-6D (p cost per QALY gained was EUR 5000 for hip replacement surgery (EUR18 600 using SF-6D) and EUR 10 500 (EUR 48 500 using SF-6D) for all replacement procedures. The 5-year cost per QALY was EUR 17...

What lessons can history teach us about the Charcot foot?

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Sanders, Lee J

2008-01-01

Regrettably, physicians today receive very little instruction in the history of medicine. Most health care providers have a very limited, contemporary knowledge of the condition that we know of as the Charcot foot. Yet, historical concepts of the pathogenesis and natural history of this condition provide us with important lessons that enhance our understanding, recognition, and management of this rare but debilitating neurogenic arthropathy. It is my belief that knowledge of the history of medicine provides us with a better understanding of present-day issues and clearer vision as we look to the future. This article describes some of the important lessons learned from the history of the Charcot foot.

Systemic application of rhenium-186 hydroxyethylidenediphosphonate (186Re HEDP) as an option for the treatment of chronic arthritis and arthropathy

International Nuclear Information System (INIS)

Bucerius, J.; Biersack, H.J.; Palmedo, H.; Wallny, T.; Brackmann, H.H.

2006-01-01

Chronic arthritis is very common and is associated with a variety of systemic diseases whereas hemophilic arthropathy is one of the most common clinical manifestations of hemophilia, mainly of hemophilia type A. All of these polyarticular diseases are associated with progressive pain and increasing lack of mobility. Therapy is based on conservative treatment such as medication with non-steroidal anti-inflammatory drugs, selective therapy strategies such as intraarticular injections of e.g. radioactive substances (radiosynoviorthesis) or surgical interventions. However, in some cases, the disease does not respond to one of these treatment options or cannot be continued due to important side-effects. Systemic application of radioisotopes like 186 Re HEDP has been successfully administered for pain palliation of osseous metastases. Today, only few data exist for systemic therapy with 186 Re HEDP in patients suffering from benign polyarticular disease. In a prospective study with patients suffering from chronic arthritis a single systemic application of 186 Re HEDP led to a reduction of disease activity in six of eight and to a reduction of the number of painful or swollen joints in five of eight included patients. In a further prospective study with 12 patients with hemophilic arthropathy, 19 of 36 (52.7%) most painful joints could be successfully treated with one systemic 186 Re HEDP therapy. Furthermore, a reduction of global pain could be observed in those patients. However, further randomized studies with larger study populations are necessary in order to confirm this promising results. (orig.)

Conditioning pain stimulation does not affect itch induced by intra-epidermal histamine pricks but aggravates neurogenic inflammation in healthy volunteers

DEFF Research Database (Denmark)

Andersen, Hjalte Holm; Imai, Yosuke; Petersen, Kristian Kjær

2016-01-01

This study investigated whether itch induced by intra-epidermal histamine is subjected to modulation by a standardized conditioned pain modulation (CPM) paradigm in 24 healthy volunteers. CPM was induced by computer-controlled cuff pressure algometry and histamine was introduced to the volar...... forearm by skin prick test punctures. Moreover, neurogenic inflammation and wheal reactions induced by histamine and autonomic nervous system responses (heart rate variability and skin conductance) were monitored. CPM did not modulate the intensity of histamine-induced itch suggesting that pruriceptive...... signaling is not inhibited by pain-recruited endogenous modulation, however, CPM was found to aggravate histamine-induced neurogenic inflammation, likely facilitated by efferent sympathetic fibers....

Females have stronger neurogenic response than males after non-specific nasal challenge in patients with seasonal allergic rhinitis.

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Tomljenovic, Dejan; Baudoin, Tomislav; Megla, Zeljka Bukovec; Geber, Goran; Scadding, Glenis; Kalogjera, Livije

2018-07-01

Epidemiological studies show female predominance in the prevalence of non- allergic rhinitis (NAR) and local allergic rhinitis (LAR). Experimental studies show female patients with allergic rhinitis (AR) demonstrate higher levels of sensitivity to irritants and airway hyperresponsiveness than males. Bronchial asthma shows female predominance in post-puberty patients, and gender interaction with severe asthma endotypes. Fibromyalgia, chronic fatigue syndrome, migraine and chronic cough, syndromes, which are commonly related to neurokinin substance P (SP) in the literature, also show strong female predominance. Studies have demonstrated that sex hormones, primarily oestrogens, affect mast cell activation. Mast cell proteases can amplify neurogenic inflammatory responses including the release of SP. Based on human epidemiological data and animal experimental data we hypothesized that female patients have different interaction between mast cell activation and neurogenic inflammation, i.e. substance P release, resulting in a different nasal symptom profile. To test the hypothesis we performed allergen and non-specific nasal challenges in patients with seasonal allergic rhinitis (SAR) out of season and looked for gender differences in subjective and objective responses. The interaction between subjective and objective reactivity was evaluated through the comparison of subjective symptom scores, concentrations of neurokinin substance P (SP) and cellular markers in nasal lavages after low doses of nasal allergen challenges. Female allergic subjects tended to have higher substance P (SP) concentrations both before and after non-specific challenges. The difference between post-allergen and post - hypertonic saline (HTS) challenge was highly significant in female patients (p = 0.001), while insignificant in male subjects (p = 0.14). Female patients had significantly stronger burning sensation after HTS challenge than male. These data indicate difference in the

Effectiveness of interspinous implant surgery in patients with intermittent neurogenic claudication: a systematic review and meta-analysis

NARCIS (Netherlands)

Moojen, W.A.; Arts, M.P.; Bartels, R.H.M.A.; Jacobs, W.C.; Peul, W.C.

2011-01-01

INTRODUCTION: Despite an increasing implantation rate of interspinous process distraction (IPD) devices in the treatment of intermittent neurogenic claudication (INC), definitive evidence on the clinical effectiveness of implants is lacking. The main objective of this review was to perform a

Malignant neurogenic neoplasms of the head and neck; Zlosliwe nowotwory neurogenne glowy i szyi

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Kuczkowski, J.; Starzynska, A. [Akademia Medyczna, Gdansk (Poland)

1996-12-31

The authors present 17 cases of malignant neurogenic neoplasms of the head and neck observed in the Department of Otolaryngology in the years 1948-1993. The latest opinions on etiopathology, diagnosis and treatment of these tumors were described. Age and sex of patients, localization of tumor, symptoms histopathology and treatment were analyzed. Progressions of the disease were estimated retrospectively. It has been proved that these tumors develop quickly, give pain and paresthesia. Their diagnosis is very difficult because of their submucosal growth and difficult histopathological interpretation. A characteristic feature of these neurogenic tumors is the ability to give distant metastases. This feature differentiates them from squamous neoplasms, which give mainly nodal metastases. All the patients were subjected to surgery combined with conventional or high voltage radiotherapy. The positive effect of combined chemotherapy in cases of esthesioneuroblastoma is worthy of note. The prognosis in these tumors is often unfavorable. In the group under discussion 13 patients died because of recurrences, two patients are considered to be cured and the remaining 2 patients have had no recurrence for 2 and 3 years. (author) 15 refs, 2 figs, 2 tabs

Effectiveness of interspinous implant surgery in patients with intermittent neurogenic claudication : a systematic review and meta-analysis

NARCIS (Netherlands)

Moojen, Wouter A.; Arts, Mark P.; Bartels, Ronald H. M. A.; Jacobs, Wilco C. H.; Peul, Wilco C.

2011-01-01

Despite an increasing implantation rate of interspinous process distraction (IPD) devices in the treatment of intermittent neurogenic claudication (INC), definitive evidence on the clinical effectiveness of implants is lacking. The main objective of this review was to perform a meta-analysis of all

Visualization of haemophilic arthropathy in F8(-/-) rats by ultrasonography and micro-computed tomography

DEFF Research Database (Denmark)

Christensen, K R; Roepstorff, K; Petersen, M

2017-01-01

opportunities. Recently, a F8(-/-) rat model of HA was developed. The size of the rat allows for convenient and high resolution imaging of the joints, which could enable in vivo studies of HA development. AIM: To determine whether HA in the F8(-/-) rat can be visualized using ultrasonography (US) and micro......-computed tomography (μCT). METHODS: Sixty F8(-/-) and 20 wild-type rats were subjected to a single or two induced knee bleeds. F8(-/-) rats were treated with either recombinant human FVIII (rhFVIII) or vehicle before the induction of knee bleeds. Haemophilic arthropathy was visualized using in vivo US and ex vivo μCT......, and the observations correlated with histological evaluation. RESULTS: US and μCT detected pathologies in the knee related to HA. There was a strong correlation between disease severity determined by μCT and histopathology. rhFVIII treatment reduced the pathology identified with both imaging techniques. CONCLUSION: US...

Edema pulmonar neurogênico: relato de dois casos Neurogenic pulmonary edema: report of two cases

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Desanka Dragosavac

1997-06-01

Full Text Available O edema pulmonar neurogênico é rara e grave complicação de pacientes com traumatismo craniencefálico (TCE. Pode ocorrer também em outras patologias do sistema nervoso central, tais como acidentes vasculares cerebrais (AVC, tumores ou após crises epilépticas, entre outras. Foram avaliados 36 casos com TCE grave e quatro pacientes com AVC, internados na UTI geral, no período de janeiro a setembro 1995. Nesse intervalo de tempo foram diagnosticados dois casos de edema pulmonar neurogênico, um ocorrendo em paciente com TCE grave e outro em paciente com AVC hemorrágico. O diagnóstico foi estabelecido pelo rápido desenvolvimento de edema pulmonar, com hipoxemia grave, queda da complacência pulmonar e infiltrados difusos bilaterais sem história prévia de aspiração traqueal ou outro fator de risco para o desenvolvimento de síndrome de angústia respiratória aguda. No primeiro paciente com trauma craniencefálico, o edema neurogênico foi diagnosticado na internação, uma hora após o trauma, com concomitante reação inflamatória grave e boa evolução em três dias. O outro caso, com AVC hemorrágico, desenvolveu edema neurogênico no quarto dia após drenagem de hematoma intraparenquimatoso, evoluindo para o óbito.Neurogenic pulmonary edema is a rare and serious complication in patients with head injury. It also may develop after a variety of cerebral insults such as subarachnoid hemorrhage, brain tumors and after epileptic seizures. Thirty six patients with severe head injury and four patients with cerebrovascular insults treated in Intensive Care Unit of HC-UNICAMP from January to September 1995 were evaluated. In this period there were two patients with neurogenic pulmonary edema, one with head injury and other with intracerebral hemorrhage. Diagnosis was made by rapid onset of pulmonary edema, severe hypoxemia, decrease of pulmonary complacence and diffuse pulmonary infiltrations, without previous history of tracheal

Botulinum Toxin in Neurogenic Detrusor Overactivity

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Carlos Arturo Levi D'Ancona

2012-09-01

Full Text Available Purpose To evaluate the effects of botulinum toxin on urodynamic parameters and quality of life in patients with neurogenic detrusor overactivity. Methods Thirty four adult patients with spinal cord injury and detrusor overactivity were selected. The patients received 300 units of botulinum toxin type A. The endpoints evaluated with the episodes of urinary incontinence and measured the maximum cystometric capacity, maximum amplitude of detrusor pressure and bladder compliance at the beginning and end of the study (24 weeks and evaluated the quality of life by applying the Qualiveen questionnaire. Results A significant decrease in the episodes of urinary incontinence was observed. All urodynamic parameters presented a significant improvement. The same was observed in the quality of life index and the specific impact of urinary problems scores from the Qualiveen questionnaire. Six patients did not complete the study, two due to incomplete follow-up, and four violated protocol and were excluded from the analyses. No systemic adverse events of botulinum toxin type A were reported. Conclusions A botulinum toxin type A showed a significantly improved response in urodynamics parameters and specific and general quality of life.

Co-effects of matrix low elasticity and aligned topography on stem cell neurogenic differentiation and rapid neurite outgrowth

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Yao, Shenglian; Liu, Xi; Yu, Shukui; Wang, Xiumei; Zhang, Shuming; Wu, Qiong; Sun, Xiaodan; Mao, Haiquan

2016-05-01

The development of novel biomaterials that deliver precise regulatory signals to direct stem cell fate for nerve regeneration is the focus of current intensive research efforts. In this study, a hierarchically aligned fibrillar fibrin hydrogel (AFG) that was fabricated through electrospinning and the concurrent molecular self-assembly process mimics both the soft and oriented features of nerve tissue, thus providing hybrid biophysical cues to instruct cell behavior in vitro and in vivo. The electrospun hydrogels were examined by scanning electron microscopy (SEM), polarized light microscopy, small angle X-ray scattering assay and atomic force microscopy (AFM), showing a hierarchically linear-ordered structure from the nanoscale to the macroscale with a soft elastic character (elasticity ~1 kPa). We found that this low elasticity and aligned topography of AFG exhibit co-effects on promoting the neurogenic differentiation of human umbilical cord mesenchymal stem cells (hUMSCs) in comparison to random fibrin hydrogel (RFG) and tissue culture plate (TCP) control after two week cell culture in growth medium lacking supplementation with soluble neurogenic induction factors. In addition, AFG also induces dorsal root ganglion (DRG) neurons to rapidly project numerous long neurite outgrowths longitudinally along the AFG fibers for a total neurite extension distance of 1.96 mm in three days in the absence of neurotrophic factor supplementation. Moreover, the AFG implanted in a rat T9 dorsal hemisection spinal cord injury model was found to promote endogenous neural cell fast migration and axonal invasion along AFG fibers, resulting in aligned tissue cables in vivo. Our results suggest that matrix stiffness and aligned topography may instruct stem cell neurogenic differentiation and rapid neurite outgrowth, providing great promise for biomaterial design for applications in nerve regeneration.The development of novel biomaterials that deliver precise regulatory signals to

[Laparoscopic cystectomy and transileal ureterostomy for neurogenic vesicosphincteric disorders. Evaluation of morbidity].

Science.gov (United States)

Guillotreau, Julien; Gamé, Xavier; Castel-Lacanal, Evelyne; Mallet, Richard; De Boissezon, Xavier; Malavaud, Bernard; Marque, Philippe; Rischmann, Pascal

2007-04-01

To evaluate the morbidity and mortality of laparoscopic cystectomy combined with transileal ureterostomy to treat neurogenic vesicosphincteric disorders. Prospective study performed between february 2004 and april 2006 on 26 consecutive patients with a mean age of 55.0 +/- 12.7 years treated by laparoscopic cystectomy for neurogenic vesicosphincteric disorders. The underlying neurological disease was multiple sclerosis (MS) in 20 cases, spinal cord injury in 4 cases and transverse myelitis in 2 cases. The median preoperative ASA score was 3 (range: 2-3). No open conversion was necessary. One intraoperative complication was observed (vascular injury). No perioperative death was observed. The nasogastric tube was maintained postoperatively for an average of 8.69 +/- 5.9 hours. The mean time to resumption of oral fluids was 1.4 +/- 0.7 days and mean time to resumption of solids was 2.6 +/- 1.0 days. The mean time to resumption of bowel movements was 3.8 +/- 3.2 days. The mean intensive care stay was 3.9 +/- 1.1 days. Two postoperative complications were observed in the same patient (ileus and bronchial congestion). Postoperative narcotic analgesics were necessary in 60% of cases. The mean hospital stay was 10.3 +/- 4.1 days. Two late postoperative complications were observed in the same patient (two episodes of pyelonephritis). Laparoscopic cystectomy has a low morbidity in neurological patients, allowing early return of feeding and a moderate length of hospital stay.

Synostosis Between Pubic Bones due to Neurogenic, Heterotopic Ossification

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Subramanian Vaidyanathan

2006-01-01

Full Text Available Neurogenic, heterotopic ossification is characterised by the formation of new, extraosseous (ectopic bone in soft tissue in patients with neurological disorders. A 33-year-old female, who was born with spina bifida, paraplegia, and diastasis of symphysis pubis, had indwelling urethral catheter drainage and was using oxybutynin bladder instillations. She was prescribed diuretic for swelling of feet, which aggravated bypassing of catheter. Hence, suprapubic cystostomy was performed. Despite anticholinergic therapy, there was chronic urine leak around the suprapubic catheter and per urethra. Therefore, the urethra was mobilised and closed. After closure of the urethra, there was no urine leak from the urethra, but urine leak persisted around the suprapubic catheter. Cystogram confirmed the presence of a Foley balloon inside the bladder; there was no urinary fistula. The Foley balloon ruptured frequently, leading to extrusion of the Foley catheter. X-ray of abdomen showed heterotopic bone formation bridging the gap across diastasis of symphysis pubis. CT of pelvis revealed heterotopic bone lying in close proximity to the balloon of the Foley catheter; the sharp edge of heterotopic bone probably acted like a saw and led to frequent rupture of the balloon of the Foley catheter. Unique features of this case are: (1 temporal relationship of heterotopic bone formation to suprapubic cystostomy and chronic urine leak; (2 occurrence of heterotopic ossification in pubic region; (3 complications of heterotopic bone formation viz. frequent rupture of the balloon of the Foley catheter by the irregular margin of heterotopic bone and difficulty in insertion of suprapubic catheter because the heterotopic bone encroached on the suprapubic track; (4 synostosis between pubic bones as a result of heterotopic ossification..Common aetiological factors for neurogenic, heterotopic ossification, such as forceful manipulation, trauma, or spasticity, were absent in this

A step-wise approach to sperm retrieval in men with neurogenic anejaculation

DEFF Research Database (Denmark)

Fode, Mikkel; Ohl, Dana A; Sønksen, Jens

2015-01-01

Normal fertility is dependent on intravaginal delivery of semen through ejaculation. This process is highly dependent on an intact ejaculatory reflex arc, which can be disrupted through any type of trauma or disease causing damage to the CNS and/or peripheral nerves. Neurogenic anejaculation...... is most commonly associated with spinal cord injury. This aetiology is especially relevant because most men with spinal cord injuries are injured at reproductive age. Assisted ejaculation in the form of penile vibratory stimulation is the first choice for sperm retrieval in such patients because...

Neurogenic Radial Glia-like Cells in Meninges Migrate and Differentiate into Functionally Integrated Neurons in the Neonatal Cortex.

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Bifari, Francesco; Decimo, Ilaria; Pino, Annachiara; Llorens-Bobadilla, Enric; Zhao, Sheng; Lange, Christian; Panuccio, Gabriella; Boeckx, Bram; Thienpont, Bernard; Vinckier, Stefan; Wyns, Sabine; Bouché, Ann; Lambrechts, Diether; Giugliano, Michele; Dewerchin, Mieke; Martin-Villalba, Ana; Carmeliet, Peter

2017-03-02

Whether new neurons are added in the postnatal cerebral cortex is still debated. Here, we report that the meninges of perinatal mice contain a population of neurogenic progenitors formed during embryonic development that migrate to the caudal cortex and differentiate into Satb2 + neurons in cortical layers II-IV. The resulting neurons are electrically functional and integrated into local microcircuits. Single-cell RNA sequencing identified meningeal cells with distinct transcriptome signatures characteristic of (1) neurogenic radial glia-like cells (resembling neural stem cells in the SVZ), (2) neuronal cells, and (3) a cell type with an intermediate phenotype, possibly representing radial glia-like meningeal cells differentiating to neuronal cells. Thus, we have identified a pool of embryonically derived radial glia-like cells present in the meninges that migrate and differentiate into functional neurons in the neonatal cerebral cortex. Copyright © 2016 Elsevier Inc. All rights reserved.

Introduction of the radio synoviorthesis in Cuba for the treatment of the rheumatic and haemophilic arthropathy

International Nuclear Information System (INIS)

Garcia Rodriguez, Enrique; Sagarra Veranes, Marta; Fundora Sarraff, Teresa A

2006-01-01

It is offered a modernized revision of the topic that includes a brief historical review, the general and specific indications of the Radiosynoviorthesis in the rheumatic and haemophilic arthropathy, their advantages and disadvantages, secondary reactions and contraindications. The complementary studies are analyzed to carry out previous to the treatment and later to the same one. They are also exposed the characteristics of the procedure, the main used radionuclides, as well as the general handling of the patients before and after their realization. The advantages of the introduction of this treatment method in our country are exposed as well as the statistics of their use during 5 years in the Hospital Carl Gustav Carus, of the Technical University of Dresden, Germany. It is also carried out a presentation of the new Service of Nuclear Medicine of the Educational General Hospital Enrique Goatherd (Author)

Cocaine and MDMA Induce Cellular and Molecular Changes in Adult Neurogenic Systems: Functional Implications

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Vivian Capilla-Gonzalez

2011-06-01

Full Text Available The capacity of the brain to generate new adult neurons is a recent discovery that challenges the old theory of an immutable adult brain. A new and fascinating field of research now focuses on this regenerative process. The two brain systems that constantly produce new adult neurons, known as the adult neurogenic systems, are the dentate gyrus (DG of the hippocampus and the lateral ventricules/olfactory bulb system. Both systems are involved in memory and learning processes. Different drugs of abuse, such as cocaine and MDMA, have been shown to produce cellular and molecular changes that affect adult neurogenesis. This review summarizes the effects that these drugs have on the adult neurogenic systems. The functional relevance of adult neurogenesis is obscured by the functions of the systems that integrate adult neurons. Therefore, we explore the effects that cocaine and MDMA produce not only on adult neurogenesis, but also on the DG and olfactory bulbs. Finally, we discuss the possible role of new adult neurons in cocaine- and MDMA-induced impairments. We conclude that, although harmful drug effects are produced at multiple physiological and anatomical levels, the specific consequences of reduced hippocampus neurogenesis are unclear and require further exploration.

Radiological consideration of neurogenic bladder in patients with traumatic spinal injury

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Kim, Soo Han; Yu, Yun Jeong; Shin, Hyun Ja [Korea Veterans Hospital, Seoul (Korea, Republic of)

1987-10-15

We evaluated 104 patients of neurogenic bladder secondary to traumatic spinal cord injury. Those were diagnosed by I. V. P. and V. C. U. at Korea Veterans Hospital during 9 years from January, 1978 to May, 1987. The type of neurogenic bladder, complications and urethral configuration, according to the level of spinal cord injury were discusses. The result were as follows: 1. The incidence of patient according to the level of spinal cord injury was 49 out of 104 in those with vertebral level T7 or above, 15 out of 104 in those with T8-T10 level, and 40 in those with vertebral level T11 or below. The incidence of UMNB was 67.3% in those with vertebral T7 or above, 53.3% in T8-T10. The incidence of LMNB was 62.5% in those with vertebral level T11 or below. 2. Overall incidence of urinary tract calculus was 32.7%. Highest incidence of calculus was 46.7% in those with vertebral level T8-T10. 3. Overall incidence of vesicoureteral reflux was 23.1%. Highest incidence of reflux was 46.7% in those with vertebral level T11 or below. 4. Overall incidence of pyelonephritis was 26.9%. 5. Overall incidence of hydronephrosis was 20.2%. Highest incidence of hydronephrosis was 27.5% in those with vertebral level T11 or below. 6. Almost entire urethra was shown funnel type in 66 out of 73 cases. Saccular dilatation of posterior urethra was 7 cases. Saccular dilatation of posterior urethra with LMNB was 4 cases, which were occurred only in those with vertebral level T11 or below.

Radiological consideration of neurogenic bladder in patients with traumatic spinal injury

International Nuclear Information System (INIS)

Kim, Soo Han; Yu, Yun Jeong; Shin, Hyun Ja

1987-01-01

We evaluated 104 patients of neurogenic bladder secondary to traumatic spinal cord injury. Those were diagnosed by I. V. P. and V. C. U. at Korea Veterans Hospital during 9 years from January, 1978 to May, 1987. The type of neurogenic bladder, complications and urethral configuration, according to the level of spinal cord injury were discusses. The result were as follows: 1. The incidence of patient according to the level of spinal cord injury was 49 out of 104 in those with vertebral level T7 or above, 15 out of 104 in those with T8-T10 level, and 40 in those with vertebral level T11 or below. The incidence of UMNB was 67.3% in those with vertebral T7 or above, 53.3% in T8-T10. The incidence of LMNB was 62.5% in those with vertebral level T11 or below. 2. Overall incidence of urinary tract calculus was 32.7%. Highest incidence of calculus was 46.7% in those with vertebral level T8-T10. 3. Overall incidence of vesicoureteral reflux was 23.1%. Highest incidence of reflux was 46.7% in those with vertebral level T11 or below. 4. Overall incidence of pyelonephritis was 26.9%. 5. Overall incidence of hydronephrosis was 20.2%. Highest incidence of hydronephrosis was 27.5% in those with vertebral level T11 or below. 6. Almost entire urethra was shown funnel type in 66 out of 73 cases. Saccular dilatation of posterior urethra was 7 cases. Saccular dilatation of posterior urethra with LMNB was 4 cases, which were occurred only in those with vertebral level T11 or below

Short-term results of the reverse Total Evolutive Shoulder System (TESS) in cuff tear arthropathy and revision arthroplasty cases.

Science.gov (United States)

von Engelhardt, Lars Victor; Manzke, Michael; Filler, Timm J; Jerosch, Joerg

2015-07-01

The aim of this study was to evaluate the clinical and radiological outcome of the Total Evolutive Shoulder System (TESS) in patients with cuff tear arthropathy and patients in need of a revision arthroplasty. In this sequential study, 67 patients (56 non-stemmed, 11 stemmed) were evaluated after a mean follow-up of 17.5 months. The relative Constant and DASH scores, radiological joint geometry changes, complications and postoperative problems, which are not likely to affect the outcome, were evaluated. A significant increase was noticed for the relative Constant (11.3 vs. 78.8 %) and DASH scores (73.7 vs. 31.8) without significant differences between both etiology groups. Complication rates were similar to previous studies. An aseptic loosening of the non-stemmed humeral component was not noticed in the cuff tear arthropathy group, whereas one case with a loosening was noticed in the revision arthroplasty group. With nine cases (13.4 %), scapular notching rates were very low. On average, the acromiohumeral distance increased by 17 mm and the humeral offset by 13.9 mm; the height of the center of rotation decreased by 4.6 mm and the lateral glenohumeral offset by 6.1 mm, p TESS system provided adequate distalization and medialization of the humerus and the center of rotation. This corresponds to a good clinical outcome. The use of the surgical opportunity to implant the prosthesis with a relatively low neck-shaft angle might explain the low rates of scapular notching in our series. Regarding the case with a loosening of the humeral component, the surgeon should carefully indicate a stemless version for metaphyseal press-fit fixation in patients with revision arthroplasty.

Expression of neurotransmitters and neurotrophins in neurogenic inflammation of the rat retina

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E Bronzetti

2009-08-01

Full Text Available Antidromic stimulation of the rat trigeminal ganglion triggers the release of substance P (SP and calcitonin gene-related peptide (CGRP from sensory nerve terminals of the capsaicin sensitive C-fibers. These pro-inflammatory neuropeptides produce a marked hyperemia in the anterior segment of the eye, accompanied by increased intraocular pressure, breakdown of the blood-aqueous barrier and myosis. To assess the effects of neurogenic inflammation on the retina, specifically on the immunostaining of neurotransmitters and neurotrophins, as well as on the expression of neurotrophin receptors in the retina. RT-PCR was also accomplished in control and stimulated animals to confirm the immunohistochemical results. In the electrically stimulated eyes, immunostaining for SP, CGRP, VIP and nNOS demonstrated a marked increase in the RPE/POS (Retinal Pigment Epithelium/Photoreceptor Outer Segments, in the inner and outer granular layers and in the ganglion cells in comparison to the control eyes. CGRP and SP were found increased in stimulated animals and this result has been confirmed by RT- PCR. Changes in neurotrophin immunostaining and in receptor expression were also observed after electric stimulation of trigeminal ganglia. Decrease of BDNF and NT4 in the outer and inner layers and in ganglion cells was particularly marked. In stimulated rat retinas immunostaining and RT-PCR showed a NGF expression increase. Neurotrophin receptors remained substantially unchanged. These studies demonstrated, for the first time, that antidromic stimulation of the trigeminal ganglion and subsequent neurogenic inflammation affect immunostaining of retinal cell neurotransmitter/ neuropeptides and neurotrophins as well as the expression of neurotrophin receptors.

Urofacial syndrome: A subset of neurogenic bladder dysfunction syndromes?

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K N Stamatiou

2010-01-01

Full Text Available The urofacial syndrome is probably a subset of neurogenic bladder dysfunction syndromes characterized by detrusor-sphincter discoordination along with a characteristic inversion of facial expression with laughing. This characteristic facial expression can facilitate early detection of this disorder, which leads to poor bladder emptying with high residual urine, hydro-nephrosis with vesico-ureteral reflux and potentially renal failure if left untreated. The etiology of the urofacial syndrome is unknown. In our case, a 12-year-old boy of Middle-Eastern origin presented to the Outpatient Department of our hospital with left pyelonephritis, hydronephrosis and bladder dilatation. Voiding cystourethrography performed 15 days later revealed left vesicoureteral reflux. Cystoscopy revealed bladder trabeculation however an anatomic urethral obstruction was not noticed. Both, neurological examination and radiography of the lumbosacral spine were normal. Urodynamic evaluation revealed the typical findings of detrusor-sphincter discoordination.

Molecular profiling of aged neural progenitors identifies Dbx2 as a candidate regulator of age-associated neurogenic decline.

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Lupo, Giuseppe; Nisi, Paola S; Esteve, Pilar; Paul, Yu-Lee; Novo, Clara Lopes; Sidders, Ben; Khan, Muhammad A; Biagioni, Stefano; Liu, Hai-Kun; Bovolenta, Paola; Cacci, Emanuele; Rugg-Gunn, Peter J

2018-06-01

Adult neurogenesis declines with aging due to the depletion and functional impairment of neural stem/progenitor cells (NSPCs). An improved understanding of the underlying mechanisms that drive age-associated neurogenic deficiency could lead to the development of strategies to alleviate cognitive impairment and facilitate neuroregeneration. An essential step towards this aim is to investigate the molecular changes that occur in NSPC aging on a genomewide scale. In this study, we compare the transcriptional, histone methylation and DNA methylation signatures of NSPCs derived from the subventricular zone (SVZ) of young adult (3 months old) and aged (18 months old) mice. Surprisingly, the transcriptional and epigenomic profiles of SVZ-derived NSPCs are largely unchanged in aged cells. Despite the global similarities, we detect robust age-dependent changes at several hundred genes and regulatory elements, thereby identifying putative regulators of neurogenic decline. Within this list, the homeobox gene Dbx2 is upregulated in vitro and in vivo, and its promoter region has altered histone and DNA methylation levels, in aged NSPCs. Using functional in vitro assays, we show that elevated Dbx2 expression in young adult NSPCs promotes age-related phenotypes, including the reduced proliferation of NSPC cultures and the altered transcript levels of age-associated regulators of NSPC proliferation and differentiation. Depleting Dbx2 in aged NSPCs caused the reverse gene expression changes. Taken together, these results provide new insights into the molecular programmes that are affected during mouse NSPC aging, and uncover a new functional role for Dbx2 in promoting age-related neurogenic decline. © 2018 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

N-Cadherin Upregulation Promotes the Neurogenic Differentiation of Menstrual Blood-Derived Endometrial Stem Cells.

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Liu, Yanli; Yang, Fen; Liang, Shengying; Liu, Qing; Fu, Sulei; Wang, Zhenyu; Yang, Ciqing; Lin, Juntang

2018-01-01

Peripheral nerve injuries are typically caused by either trauma or medical disorders, and recently, stem cell-based therapies have provided a promising treatment approach. Menstrual blood-derived endometrial stem cells (MenSCs) are considered an ideal therapeutic option for peripheral nerve repair due to a noninvasive collection procedure and their high proliferation rate and immunological tolerance. Here, we successfully isolated MenSCs and examined their biological characteristics including their morphology, multipotency, and immunophenotype. Subsequent in vitro studies demonstrated that MenSCs express high levels of neurotrophic factors, such as NT3, NT4, BDNF, and NGF, and are capable of transdifferentiating into glial-like cells under conventional induction conditions. Moreover, upregulation of N-cadherin (N-cad) mRNA and protein expression was observed after neurogenic differentiation. In vivo studies clearly showed that N-cad knockdown via in utero electroporation perturbed the migration and maturation of mouse neural precursor cells (NPCs). Finally, a further transfection assay also confirmed that N-cad upregulation in MenSCs results in the expression of S100. Collectively, our results confirmed the paracrine effect of MenSCs on neuroprotection as well as their potential for transdifferentiation into glial-like cells and demonstrated that N-cad upregulation promotes the neurogenic differentiation of MenSCs, thereby providing support for transgenic MenSC-based therapy for peripheral nerve injury.

SVCT2 vitamin C transporter expression in progenitor cells of the postnatal neurogenic niche

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Pastor, Patricia; Cisternas, Pedro; Salazar, Katterine; Silva-Alvarez, Carmen; Oyarce, Karina; Jara, Nery; Espinoza, Francisca; Martínez, Agustín D.; Nualart, Francisco

2013-01-01

Known as a critical antioxidant, recent studies suggest that vitamin C plays an important role in stem cell generation, proliferation and differentiation. Vitamin C also enhances neural differentiation during cerebral development, a function that has not been studied in brain precursor cells. We observed that the rat neurogenic niche is structurally organized at day 15 of postnatal development, and proliferation and neural differentiation increase at day 21. In the human brain, a similar subventricular niche was observed at 1-month of postnatal development. Using immunohistochemistry, sodium-vitamin C cotransporter 2 (SVCT2) expression was detected in the subventricular zone (SVZ) and rostral migratory stream (RMS). Low co-distribution of SVCT2 and βIII-tubulin in neuroblasts or type-A cells was detected, and minimal co-localization of SVCT2 and GFAP in type-B or precursor cells was observed. Similar results were obtained in the human neurogenic niche. However, BrdU-positive cells also expressed SVCT2, suggesting a role of vitamin C in neural progenitor proliferation. Primary neurospheres prepared from rat brain and the P19 teratocarcinoma cell line, which forms neurospheres in vitro, were used to analyze the effect of vitamin C in neural stem cells. Both cell types expressed functional SVCT2 in vitro, and ascorbic acid (AA) induced their neural differentiation, increased βIII-tubulin and SVCT2 expression, and amplified vitamin C uptake. PMID:23964197

The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures

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Yong Guan

2015-10-01

Full Text Available ABSTRACT Erectile dysfunction (ED is a common complication of pelvic fractures. To identify the vascular and neurogenic factors associated with ED, 120 patients admitted with ED after traumatic pelvic fracture between January 2009 and June 2013 were enrolled in this study. All patients answered the International Index of Erectile Function (IIEF-5 questionnaire. Nocturnal penile tumescence (NPT testing confirmed the occurrence of ED in 96 (80% patients on whom penile duplex ultrasound and neurophysiological testing were further performed. Of these ED patients 29 (30% were demonstrated only with vascular abnormality, 41 (42.7% were detected only with neural abnormality, 26 (27.1% revealed mixed abnormalities. Of the 55 patients (29+26 with vascular problems, 7 patients (12.7% with abnormal arterial response to intracavernous injection of Bimix (15mg papaverine and 1mg phentolamine, 31 (56.4% with corporal veno-occlusive dysfunction and 17 (30.9% had both problems. Of the 67 (41+26 patients with abnormal neurophysiological outcomes, 51 (76.1% with abnormal bulbocavernosus reflex (BCR, 20 (29.9% with pathological pudendal nerve evoked potentials (PDEPs and 25 (37.3% with abnormal posterior tibial somatosensory nerve evoked potentials (PTSSEPs. Our observation indicated that neurogenic factors are important for the generation of ED in patients with pelvic fracture; venous impotence is more common than arteriogenic ED.

Neurogenic pulmonary edema induced by spinal cord injury in spontaneously hypertensive and Dahl salt hypertensive rats

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří; Kuneš, Jaroslav; Zicha, Josef

2011-01-01

Roč. 60, č. 6 (2011), s. 975-979 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) 1M0510; GA ČR(CZ) GA305/09/0336; GA AV ČR(CZ) IAA500110902 Institutional research plan: CEZ:AV0Z50110509 Keywords : hypertension * neurogenic pulmonary edema * Dahl salt-sensitive rats * SHR Subject RIV: ED - Physiology Impact factor: 1.555, year: 2011

The 'ventral organs' of Pycnogonida (Arthropoda) are neurogenic niches of late embryonic and post-embryonic nervous system development.

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Brenneis, Georg; Scholtz, Gerhard

2014-01-01

Early neurogenesis in arthropods has been in the focus of numerous studies, its cellular basis, spatio-temporal dynamics and underlying genetic network being by now comparably well characterized for representatives of chelicerates, myriapods, hexapods and crustaceans. By contrast, neurogenesis during late embryonic and/or post-embryonic development has received less attention, especially in myriapods and chelicerates. Here, we apply (i) immunolabeling, (ii) histology and (iii) scanning electron microscopy to study post-embryonic ventral nerve cord development in Pseudopallene sp., a representative of the sea spiders (Pycnogonida), the presumable sister group of the remaining chelicerates. During early post-embryonic development, large neural stem cells give rise to additional ganglion cell material in segmentally paired invaginations in the ventral ectoderm. These ectodermal cell regions - traditionally designated as 'ventral organs' - detach from the surface into the interior and persist as apical cell clusters on the ventral ganglion side. Each cluster is a post-embryonic neurogenic niche that features a tiny central cavity and initially still houses larger neural stem cells. The cluster stays connected to the underlying ganglionic somata cortex via an anterior and a posterior cell stream. Cell proliferation remains restricted to the cluster and streams, and migration of newly produced cells along the streams seems to account for increasing ganglion cell numbers in the cortex. The pycnogonid cluster-stream-systems show striking similarities to the life-long neurogenic system of decapod crustaceans, and due to their close vicinity to glomerulus-like neuropils, we consider their possible involvement in post-embryonic (perhaps even adult) replenishment of olfactory neurons - as in decapods. An instance of a potentially similar post-embryonic/adult neurogenic system in the arthropod outgroup Onychophora is discussed. Additionally, we document two transient posterior

Milrinone therapy for enterovirus 71-induced pulmonary edema and/or neurogenic shock in children: a randomized controlled trial.

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Chi, Chia-Yu; Khanh, Truong Huu; Thoa, Le Phan Kim; Tseng, Fan-Chen; Wang, Shih-Min; Thinh, Le Quoc; Lin, Chia-Chun; Wu, Han-Chieh; Wang, Jen-Ren; Hung, Nguyen Thanh; Thuong, Tang Chi; Chang, Chung-Ming; Su, Ih-Jen; Liu, Ching-Chuan

2013-07-01

Enterovirus 71-induced brainstem encephalitis with pulmonary edema and/or neurogenic shock (stage 3B) is associated with rapid mortality in children. In a small pilot study, we found that milrinone reduced early mortality compared with historical controls. This prospective, randomized control trial was designed to provide more definitive evidence of the ability of milrinone to reduce the 1-week mortality of stage 3B enterovirus 71 infections. Prospective, unicenter, open-label, randomized, controlled study. Inpatient ward of a large tertiary teaching hospital in Ho Chi Minh City, Vietnam. Children (≤ 18 yr old) admitted with proven enterovirus 71-induced pulmonary edema and/or neurogenic shock. Patients were randomly assigned to receive intravenous milrinone (0.5 μg/kg/min) (n = 22) or conventional management (n = 19). Both groups received dopamine or dobutamine and intravenous immunoglobulin. The primary endpoint was 1-week mortality. The secondary endpoints included length of ventilator dependence and hospital stay and adverse events. The median age was 2 years with a predominance of boys in both groups. The 1-week mortality was significantly lower, 18.2% (4/22) in the milrinone compared with 57.9% (11/19) in the conventional management group (relative risk = 0.314 [95% CI, 0.12-0.83], p = 0.01). The median duration of ventilator-free days was longer in the milrinone treatment group (p = 0.01). There was no apparent neurologic sequela in the survivors in either group, and no drug-related adverse events were documented. Milrinone significantly reduced the 1-week mortality of enterovirus 71-induced pulmonary edema and/or neurogenic shock without adverse effects. Further studies are needed to determine whether milrinone might be useful to prevent progression of earlier stages of brainstem encephalitis.

Co-effects of matrix low elasticity and aligned topography on stem cell neurogenic differentiation and rapid neurite outgrowth.

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Yao, Shenglian; Liu, Xi; Yu, Shukui; Wang, Xiumei; Zhang, Shuming; Wu, Qiong; Sun, Xiaodan; Mao, Haiquan

2016-05-21

The development of novel biomaterials that deliver precise regulatory signals to direct stem cell fate for nerve regeneration is the focus of current intensive research efforts. In this study, a hierarchically aligned fibrillar fibrin hydrogel (AFG) that was fabricated through electrospinning and the concurrent molecular self-assembly process mimics both the soft and oriented features of nerve tissue, thus providing hybrid biophysical cues to instruct cell behavior in vitro and in vivo. The electrospun hydrogels were examined by scanning electron microscopy (SEM), polarized light microscopy, small angle X-ray scattering assay and atomic force microscopy (AFM), showing a hierarchically linear-ordered structure from the nanoscale to the macroscale with a soft elastic character (elasticity ∼1 kPa). We found that this low elasticity and aligned topography of AFG exhibit co-effects on promoting the neurogenic differentiation of human umbilical cord mesenchymal stem cells (hUMSCs) in comparison to random fibrin hydrogel (RFG) and tissue culture plate (TCP) control after two week cell culture in growth medium lacking supplementation with soluble neurogenic induction factors. In addition, AFG also induces dorsal root ganglion (DRG) neurons to rapidly project numerous long neurite outgrowths longitudinally along the AFG fibers for a total neurite extension distance of 1.96 mm in three days in the absence of neurotrophic factor supplementation. Moreover, the AFG implanted in a rat T9 dorsal hemisection spinal cord injury model was found to promote endogenous neural cell fast migration and axonal invasion along AFG fibers, resulting in aligned tissue cables in vivo. Our results suggest that matrix stiffness and aligned topography may instruct stem cell neurogenic differentiation and rapid neurite outgrowth, providing great promise for biomaterial design for applications in nerve regeneration.

The effect of intravesical oxybutynin on the ice water test and on electrical perception thresholds in patients with neurogenic detrusor overactivity.

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Van Meel, Tom David; De Wachter, Stefan; Wyndaele, Jean Jacques

2010-03-01

The C-fiber-mediated bladder-cooling reflex and the determination of the current perception thresholds (CPTs) permit to investigate afferent LUT pathways. They have both been proposed to detect and differentiate neurologic bladder dysfunction. This study evaluates, prospectively, the effect of oxybutynin, an antimuscarinic with direct antispasmodic effect on smooth muscle, on repeated ice water test (IWT) and CPTs in patients with a known incomplete neurogenic bladder. Patients with a known incomplete lesion of the bladder innervation, detrusor overactivity during cystometric bladder filling and a continuous positive response to repeated IWT were included. After the initial tests, 30 mg intravesical oxybutynin (1 mg/ml) was instilled and left in the bladder for 15 min. Afterwards CPTs and IWT were re-assessed. After the drug application, the bladder-cooling reflex could not be initiated, even after three instillations, in 16/17 patients. The bladder CPT increased from 29.7 +/- 11.3 to 39.1 +/- 15.7 mA after oxybutynin (P = 0.001). No difference was found in CPT of the left forearm (P = 0.208). Intravesical oxybutynin blocks the bladder-cooling reflex and increases but does not block CPT sensation in the bladder in most patients with incomplete neurogenic lesion and detrusor overactivity. These results help explain the clinical effect of intravesical oxybutynin in neurogenic patients. They also indicate that a pharmacological local influence on C-fiber-related activity can give different clinical effects. (c) 2009 Wiley-Liss, Inc.

Failure of botulinum toxin injection for neurogenic detrusor overactivity: Switch of toxin versus second injection of the same toxin.

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Peyronnet, Benoit; Castel-Lacanal, Evelyne; Manunta, Andréa; Roumiguié, Mathieu; Marque, Philippe; Rischmann, Pascal; Gamé, Xavier

2015-12-01

To evaluate the efficacy of a second injection of the same toxin versus switching to a different botulinum toxin A after failure of a first detrusor injection in patients with neurogenic detrusor overactivity. The charts of all patients who underwent detrusor injections of botulinum toxin A (either abobotulinumtoxinA or onabotulinumtoxinA) for the management of neurogenic detrusor overactivity at a single institution were retrospectively reviewed. Patients in whom a first detrusor injection had failed were included in the present study. They were managed by a second injection of the same toxin at the same dosage or by a new detrusor injection using a different botulinum toxin A. Success was defined as a resolution of urgency, urinary incontinence and detrusor overactivity in a patient self-catheterizing seven times or less per 24 h. A total of 58 patients were included for analysis. A toxin switch was carried out in 29 patients, whereas the other 29 patients received a reinjection of the same toxin at the same dose. The success rate was higher in patients who received a toxin switch (51.7% vs. 24.1%, P = 0.03). Patients treated with a switch from abobotulinumtoxinA to onabotulinumtoxinA and those treated with a switch from onabotulinumtoxinA to abobotulinumtoxinA had similar success rates (52.9% vs. 50%, P = 0.88). After failure of a first detrusor injection of botulinum toxin for neurogenic detrusor overactivity, a switch to a different toxin seems to be more effective than a second injection of the same toxin. The replacement of onabotulinumtoxin by abobotulinumtoxin or the reverse provides similar results. © 2015 The Japanese Urological Association.

[Indices of 24-hour monitoring of arterial blood pressure in patients with neurogenic syncope and patients with chronic constitution- dependent hypotension].

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Musaeva, Z A; Khapaev, B A; Fedotova, A V; Oknin, V Iu

1999-01-01

Clinical-psychologic study, spectral analysis of heart rate variability, 24-h monitoring of arterial pressure (AP) were performed in 20 patients with chronic constitutional arterial hypotension and in 18 patients with neurogenic syncopal states. Both groups were characterised by considerable manifestations of the syndrome of autonomic dystonia, by emotional-personal disorders that correlated with elevated level of slow-waves of the second order in heart rhythms' spectrum. That testified activation of supersegmental sympathetic-adrenal systems. Disorders in sympathetic-parasympathetic correlations were specific in each group. In patients with arterial hypotension disorder of circadian rhythm was observed in the form of superfluous decrease of diastolic AP during sleep. Circadian rhythms in patients with neurogenic syncopes have parameters characteristic for normals showing a preverved chronobiologic AP regulation. A role of the alterations revealed in pathogenesis of arterial hypotensionis discussed.

Cardiac stroke following total knee replacement in an ochronotic arthropathy: Case report and literature review

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Saurabh Jain

2016-01-01

Full Text Available Alkaptonuria is a rare autosomal recessive disorder caused by defective metabolism of homogentisic acid (HGA which on accumulation in the connective tissues causes arthritis, darkening of urine and connective tissue pigmentation. Knee is most commonly affected joint whereas pigment deposition is seen in entire body causing cardiovascular, genitourinary, ocular, cutaneous, and musculoskeletal complications. We here report such a case of bilateral ochronotic arthropathy, who was diagnosed to be alkaptonuric only during joint exploration. He sustained a cardiac catastrophic stroke on 3 rd post operative day of the left knee replacement which was done one week after the right knee replacement. With prompt treatment and good hospital care, the patient was revived successfully, without valvulotomy or valvular replacement. The spectrum of clinical manifestations are discussed in the report with emphasis on thorough history and clinical examination of the patient, before taking the patient to the total knee replacement to make accurate diagnosis before hand and be prepared for the complications or catastrophic by a multidisciplinary approach.

Prospective evaluation of antibiotic treatment for urological procedure in patients presenting with neurogenic bladder.

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Weglinski, L; Rouzaud, C; Even, A; Bouchand, F; Davido, B; Duran, C; Salomon, J; Perronne, C; Denys, P; Chartier-Kastler, E; Dinh, A

2016-09-01

Patients presenting with neurogenic bladder often require urological procedures (urodynamic testing and botulinum toxin injections) and a preventive antibiotic therapy. We aimed to assess the efficacy of this little known strategy in a cohort of patients. All patients presenting with neurogenic bladder who underwent urological procedure were included in the study. They received an antibiotic therapy in accordance with the urine cytobacteriological examination results. The antibiotic therapy was initiated two days before the procedure and prolonged up until two days after the procedure if the culture was positive. Patients were treated with a single dose of fosfomycin-trometamol in case of a negative culture. The main study outcome was the occurrence of urinary tract infection (UTI), defined by a positive urine culture and symptoms, up until 14 days after the procedure. A total of 80 urological procedures were performed. Mean patient age was 47±13.1 years (sex ratio 1.22); 59 (73.8%) presented with asymptomatic bacteriuria before the procedure. Nine (11.1%) UTIs were recorded on Day 14, of which one (1.2%) was febrile. Two patients required an additional curative antibiotic therapy. No patient was hospitalized. Overall, 77.8% of UTIs were cured without antibiotic therapy. Screening and treating asymptomatic bacteriuria before urological procedures seems unnecessary and vainly exposes this population at high risk of infectious diseases to antibiotic therapies. This data should be confirmed by a randomized clinical trial. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Neurogenic function in rats with unilateral hippocampal sclerosis that experienced early-life status epilepticus

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Dunleavy, Mark; Schindler, Clara K; Shinoda, Sachiko; Crilly, Shane; Henshall, David C

2014-01-01

Status epilepticus in the adult brain invariably causes an increase in hippocampal neurogenesis and the appearance of ectopic cells and this has been implicated as a causal factor in epileptogenesis. The effect of status epilepticus on neurogenesis in the developing brain is less well characterized and models of early-life seizures typically do not reproduce the hippocampal damage common to human mesial temporal sclerosis. We recently reported that evoking status epilepticus by intra-amygdala microinjection of kainic acid in post-natal (P) day 10 rats caused substantial acute neuronal death within the ipsilateral hippocampus and rats later developed unilateral hippocampal sclerosis and spontaneous recurrent seizures. Here, we examined the expression of a selection of genes associated with neurogenesis and assessed neurogenic function in this model. Protein levels of several markers of neurogenesis including polysialic acid neural cell adhesion molecule, neuroD and doublecortin were reduced in the hippocampus three days after status epilepticus in P10 rats. In contrast, protein levels of neurogenesis markers were similar to control in rats at P55. Pulse-chase experiments using thymidine analogues suggested there was a reduction in new neurons at 72 h after status epilepticus in P10 rats, whereas numbers of new neurons labelled in epileptic rats at P55 with hippocampal sclerosis were similar to controls. The present study suggests that status epilepticus in the immature brain suppresses neurogenesis but the neurogenic potential is retained in animals that later develop hippocampal sclerosis. PMID:25755841

Can adult neural stem cells create new brains? Plasticity in the adult mammalian neurogenic niches: realities and expectations in the era of regenerative biology.

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Kazanis, Ilias

2012-02-01

Since the first experimental reports showing the persistence of neurogenic activity in the adult mammalian brain, this field of neurosciences has expanded significantly. It is now widely accepted that neural stem and precursor cells survive during adulthood and are able to respond to various endogenous and exogenous cues by altering their proliferation and differentiation activity. Nevertheless, the pathway to therapeutic applications still seems to be long. This review attempts to summarize and revisit the available data regarding the plasticity potential of adult neural stem cells and of their normal microenvironment, the neurogenic niche. Recent data have demonstrated that adult neural stem cells retain a high level of pluripotency and that adult neurogenic systems can switch the balance between neurogenesis and gliogenesis and can generate a range of cell types with an efficiency that was not initially expected. Moreover, adult neural stem and precursor cells seem to be able to self-regulate their interaction with the microenvironment and even to contribute to its synthesis, altogether revealing a high level of plasticity potential. The next important step will be to elucidate the factors that limit this plasticity in vivo, and such a restrictive role for the microenvironment is discussed in more details.

Anterior Trans Cervicothoracic Approach for Complete Resection of Cervicothoracic Mediastinal Neurogenic Tumors

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Reza Bagheri

2013-10-01

Full Text Available Introduction:Neurogenic mediastinal tumors comprise a wide range of benign and malignant diseases. A group of these tumors, located at thoracic apex, sometimes spread to cervical spaces causing numerous surgical difficulties. In thoracotomy approaches, due to proximity of the tumors to major blood vessels, complete removal of these tumors from cervical spaces is impossible or may cause intraoperative severe bleeding or other dangerous incidents Because of the adjacent major vessels  that are not visible.The aim of this study is to report cases of surgical treatment of such tumors using Anterior Trans Cervicothoracic Approach (ATCA. Materials and Methods:All patients with neurogenic tumors and cervicomediastinal (CM spread who underwent surgey with ATCA technique during 2005-2011 were included in our study. Then they were evaluated in terms of age, sex, clinical symptoms, radiological and pathological findings, technical success rate of the surgery, surgical complications and first-year relapse rate after the surgery. Results:Our study included 10 patients from whom 9 were female and 1 was male (M/F= 1/9 and the mean age was 27 years. The most common symptoms were pain and feeling of a lump. All patients were operated by this technique successfully. The most common pathological finding was neurofibroma (in 5 patients and surgical complications occurred in 2 patients (20% (Wound infection in 1 patient and brachial plexus injury in another patient. There was no mortality. Disease relapse was reported in 1 patient  ganglioneuroblastoma who underwent surgical resection for the second time. Conclusion: Considering the successful removal of the tumors and favorable exposure of major vessels in cervicomediastinal spaces, this technique is recommended to resect mediastinal tumors with spread to cervical spaces. However, a more definite conclusion requires further studies.

Reconstitution of experimental neurogenic bladder dysfunction using skeletal muscle-derived multipotent stem cells.

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Nitta, Masahiro; Tamaki, Tetsuro; Tono, Kayoko; Okada, Yoshinori; Masuda, Maki; Akatsuka, Akira; Hoshi, Akio; Usui, Yukio; Terachi, Toshiro

2010-05-15

BACKGROUND.: Postoperative neurogenic bladder dysfunction is a major complication of radical hysterectomy for cervical cancer and is mainly caused by unavoidable damage to the bladder branch of the pelvic plexus (BBPP) associated with colateral blood vessels. Thus, we attempted to reconstitute disrupted BBPP and blood vessels using skeletal muscle-derived multipotent stem cells that show synchronized reconstitution capacity of vascular, muscular, and peripheral nervous systems. METHODS.: Under pentobarbital anesthesia, intravesical pressure by electrical stimulation of BBPP was measured as bladder function. The distal portion of BBPP with blood vessels was then cut unilaterally (experimental neurogenic bladder model). Measurements were performed before, immediately after, and at 4 weeks after transplantation as functional recovery. Stem cells were obtained from the right soleus and gastrocnemius muscles after enzymatic digestion and cell sorting as CD34/45 (Sk-34) and CD34/45 (Sk-DN). Suspended cells were autografted around the damaged region, whereas medium alone and CD45 cells were transplanted as control groups. To determine the morphological contribution of the transplanted cells, stem cells obtained from green fluorescent protein transgenic mouse muscles were transplanted into a nude rat model and were examined by immunohistochemistry and immunoelectron microscopy. RESULTS.: At 4 weeks after surgery, the transplantation group showed significantly higher functional recovery ( approximately 80%) than the two controls ( approximately 28% and 24%). The transplanted cells showed an incorporation into the damaged peripheral nerves and blood vessels after differentiation into Schwann cells, perineurial cells, vascular smooth muscle cells, pericytes, and fibroblasts around the bladder. CONCLUSION.: Transplantation of multipotent Sk-34 and Sk-DN cells is potentially useful for the reconstitution of damaged BBPP.

Vagotomy decreases the neuronal activities of medulla oblongata and alleviates neurogenic inflammation of airways induced by repeated intra-esophageal instillation of HCl in guinea pigs.

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Chen, Zhe; Chen, Hui; Chen, Fagui; Gu, Dachuan; Sun, Lejia; Zhang, Weitao; Fan, Linfeng; Lin, Yong; Dong, Rong; Lai, Kefang

2017-12-20

Neuronal activity in the medulla oblongata and neurogenic inflammation of airways were investigated in a guinea pig model induced by repeated intra-esophageal instillation of hydrochloric acid (HCl) after vagotomy. Unilateral vagotomy was performed in the vagotomy group, while a sham-operation was performed in the sham group. Operation was not conducted in sham control group. Airway inflammation was observed with hematoxylin and eosin (HE) staining. C-fos protein was measured by immunohistochemistry (IHC) and Western blot (WB). Substance P was examined by IHC and enzyme-linked immuno sorbent assay (ELISA). Airway microvascular permeability was detected by evans blue dye (EBD) fluorescence. Inflammation of airway was observed in the trachea and bronchi after chronic HCl perfusion into the lower esophagus, and was alleviated after unilateral vagotomy. C-fos expression in the medulla oblongata was lower in the vagotomy group compared to the sham control and sham groups. Substance P-like immunoreactivity (SP-li), concentration and microvascular leakage in airway were lower in the vagotomy group than that in the other groups. Our results suggest that vagotomy improved neurogenic inflammation of airways and decreased neuronal activities, the afferent nerves and neurons in medulla oblongata may be involved in neurogenic inflammation of airways mediated by esophageal-bronchial reflex.

Usefulness of a simple self-administered joint condition assessment sheet to predict the need for orthopaedic intervention in the management of haemophilic arthropathy.

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Masaoka, T; Amano, K; Takedani, H; Suzuki, T; Otaki, M; Seita, I; Tateiwa, T; Shishido, T; Yamamoto, K; Fukutake, K

2017-03-01

Detecting signs of joint deterioration is important for early effective orthopaedic intervention in managing haemophilic arthropathy. We developed a simple, patient self-administered sheet to evaluate the joint condition, and assessed the predictive ability of this assessment sheet for the need for an orthopaedic intervention. This was a single-centre, cross-sectional study. The association between the score of each of the four items of the assessment sheet (bleeding, swelling, pain and physical impairment) and the results of radiological findings and physical examinations based on Haemophilia Joint Health Score 2.1 was assessed. An optimal scoring system was explored by the area under the curve (AUC). The cut-off value for the need for surgery or physiotherapy was determined using the receiver operating characteristic curve procedure. Forty-two patients were included. The 'physical impairment' item showed the highest correlation coefficient with the results of radiographic and physical examinations (range: 0.57-0.76). The AUC of finally adjusted scoring indicates good ability to discriminate between patients with and without a need for orthopaedic intervention. The positive predictive value was the highest at a cut-off value of 4 points for knees (63.0%) and ankles (70.0%), at 5 points for elbows (66.7%) and the highest predictive accuracy at the cut-off value of 4 points for all the joints. The linear trend of the need for an orthopaedic intervention was observed with an increasing score. The joint condition assessment sheet can help clinicians assess the need for orthopaedic intervention for haemophilic arthropathy in Japanese patients with haemophilia. © 2016 John Wiley & Sons Ltd.

Effectiveness of interspinous implant surgery in patients with intermittent neurogenic claudication: a systematic review and meta-analysis

OpenAIRE

Moojen, Wouter A.; Arts, Mark P.; Bartels, Ronald H. M. A.; Jacobs, Wilco C. H.; Peul, Wilco C.

2011-01-01

Introduction Despite an increasing implantation rate of interspinous process distraction (IPD) devices in the treatment of intermittent neurogenic claudication (INC), definitive evidence on the clinical effectiveness of implants is lacking. The main objective of this review was to perform a meta-analysis of all systematic reviews, randomized clinical trials and prospective cohort series to quantify the effectiveness of IPDs and to evaluate the potential side-effects. Methods Data from all stu...

EVALUATING THE EFFECTIVENESS OF PROPHYLACTIC REPLACEMENT THERAPY IN CHILDREN WITH HEMOPHILIC ARTHROPATHY IN DYNAMICS ON MAGNETIC RESONANCE IMAGING

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I. S. Remzantseva

2015-01-01

Full Text Available Modifications in treatment guidelines of hemophilic arthropathy changed the role of diagnostic X-ray imaging methods. Diagnostic methods are used both for determination of the degree of joint destruction and long-term evaluation of the joint conditions and therapy adequacy and effectiveness. Aim. Magnetic resonance imaging (MRI dynamics for joint condition assessment in children with hemophilic arthropathy receiving prophylactic factor replacement therapy concentrated rolling VIII. Materials and methods. We studied 13 boys aged 5 to 14 years (mean age 8.9 years with hemophilia type A severe form of the disease (factor VIII deficiency <1% at the baseline. The average age of appearance of hemarthrosis is 2.1 years (from 1.8 to 2.9 years. The frequency of bleeding into the joints of patients older than 1 year was 2-3 times per year. Magnetic resonance imaging (ToshibaExcelArtVantage, 1,5 T was performed in 13 patients, 35 joints were examined, 57 studies were executed. Control study of joints was conducted in 1, 2 or 3 years depending on the frequency of hemarthrosis during the year and the severity of joint damage primarily identified. Results. The results included both the improvement along with the stabilization of intra-state structures and the negative dynamic shifts. MRI showed that the reduction of bleeding in the joints on the background of hemostatic replacement therapy led to subsiding inflammation in the joints and significant decrease in the amount of intra-articular effusion (n = 11; p = 0.03, decrease in the number of joints with symptoms of bone marrow edema (n = 8, the absence of observations with negative changes in the form of increasing the thickness of the synovial membrane. Negative dynamics of joint condition presented as increasing of the depth and length of erosive process (n = 5; 22.7%, degenerative changes in ligaments and menisci (n = 2; 9% under the condition of regular administration of clotting factors was associated

Hemophilic arthropathy. A scoring system for magnetic resonance imaging

International Nuclear Information System (INIS)

Soler, R.; Rodriguez, E.; Marini, M.; Lopez-Fernandez, F.

2002-01-01

The aim of this study was to define a system for scoring hemophilic arthropathy (HA) based on MR findings, providing for objective evaluation of the degree of joint involvement and evolution after on-demand administration of FVIII substitutional therapy or prophylactic treatment. A total of 133 MR examinations (89 basal and 44 during follow-up) were performed in 25 patients. Patients were divided in two groups depending on the therapy received and the length of time that the disease had been evolving at the start of the study. Group I was composed of 10 patients with secondary prophylaxis and group II was composed by 15 treated on demand. T1-weighted and T2*-weighted images performed on a 0.5-T unit were prospectively evaluated. The joint involvement was established on a scale of 0 (no abnormalities), I (minimal amount of hemosiderin), II (large amount of hemosiderin and isolated cartilaginous erosion), III (cartilage destruction, bone erosions, and subchondral cysts) to IV (large internal joint derangement, secondary osteoarthritis and/or ankylosis). At basal MR examination, patients of group I showed no abnormalities (n=28, 75.6%), grade I (n=3), and grade II (n=6) of HA. Patients of group II corresponded to MR grades III (n=21) and IV (n=11) of HA. The MR follow-up showed improvement in three joints of group I and worsening in 5 joints in group I and 2 joints in group II. Early signs of HA were detected in 10 joints with MR imaging but were underestimated on plain radiographs. Advanced degrees of HA were classified as severe under both imaging techniques. Magnetic resonance is the preferred imaging technique to assess HA. The earliest signs of joint damage, detected by MR, are overlooked by plain radiography. The MR scoring system can be used for evaluating HA. Follow-up MR should be performed to evaluate regression or worsening of the abnormalities, primarily in the case of patients with prophylaxis who usually suffer normal or early joint involvement not

Hemophilic arthropathy. A scoring system for magnetic resonance imaging

Energy Technology Data Exchange (ETDEWEB)

Soler, R.; Rodriguez, E.; Marini, M. [Department of Radiology, Hospital Juan Canalejo, Coruna (Spain); Lopez-Fernandez, F. [Department of Hematology, Hospital Juan Canalejo, Coruna (Spain)

2002-04-01

The aim of this study was to define a system for scoring hemophilic arthropathy (HA) based on MR findings, providing for objective evaluation of the degree of joint involvement and evolution after on-demand administration of FVIII substitutional therapy or prophylactic treatment. A total of 133 MR examinations (89 basal and 44 during follow-up) were performed in 25 patients. Patients were divided in two groups depending on the therapy received and the length of time that the disease had been evolving at the start of the study. Group I was composed of 10 patients with secondary prophylaxis and group II was composed by 15 treated on demand. T1-weighted and T2*-weighted images performed on a 0.5-T unit were prospectively evaluated. The joint involvement was established on a scale of 0 (no abnormalities), I (minimal amount of hemosiderin), II (large amount of hemosiderin and isolated cartilaginous erosion), III (cartilage destruction, bone erosions, and subchondral cysts) to IV (large internal joint derangement, secondary osteoarthritis and/or ankylosis). At basal MR examination, patients of group I showed no abnormalities (n=28, 75.6%), grade I (n=3), and grade II (n=6) of HA. Patients of group II corresponded to MR grades III (n=21) and IV (n=11) of HA. The MR follow-up showed improvement in three joints of group I and worsening in 5 joints in group I and 2 joints in group II. Early signs of HA were detected in 10 joints with MR imaging but were underestimated on plain radiographs. Advanced degrees of HA were classified as severe under both imaging techniques. Magnetic resonance is the preferred imaging technique to assess HA. The earliest signs of joint damage, detected by MR, are overlooked by plain radiography. The MR scoring system can be used for evaluating HA. Follow-up MR should be performed to evaluate regression or worsening of the abnormalities, primarily in the case of patients with prophylaxis who usually suffer normal or early joint involvement not

Syringomyelia with Chiari I Malformation Presenting as Hip Charcot Arthropathy: A Case Report and Literature Review

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Roya Memarpour

2015-01-01

Full Text Available Neuroarthropathy (neuropathic osteoarthropathy, also known as Charcot joint, is a condition characterized by a progressive articular surface destruction in the setting of impaired nociceptive and proprioceptive innervation of the involved joint. It is seen most commonly in the foot and ankle secondary to peripheral neuropathy associated with diabetes mellitus. Cases of hip (Charcot neuroarthropathy are rare and almost exclusively reported in patients with neurosyphilis (tabes dorsalis. We report a case of a 36-year-old man who presented to the emergency department complaining of right hip pain. On physical examination, pain and thermal sensory deficits were noted in the upper torso with a cape-like distribution, as well as signs of an upper motor neuron lesion in the left upper and lower extremities. A magnetic resonance imaging study (MRI of the right hip showed evidence of early articular surface destruction and periarticular edema consistent with hip Charcot arthropathy. An MRI of the spine revealed an Arnold-Chiari type I malformation with extensive syringohydromyelia of the cervical and thoracic spine.

Rapid but not slow spinal cord compression elicits neurogenic pulmonary edema in the rat

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří; Zicha, Josef; Kuneš, Jaroslav; Jendelová, Pavla; Syková, Eva

2009-01-01

Roč. 58, č. 2 (2009), s. 269-277 ISSN 0862-8408 R&D Projects: GA MŠk(CZ) LC554; GA ČR GA309/06/1246 Grant - others:EC FP6 projekt RESCUE(FR) LSHB-CT-2005-518233; GA MZd(CZ) 1A8697; GA MZd(CZ) NR8339; GA MŠk(CZ) 1M0538; GA MŠk(CZ) 1M0510 Program:1M; 1M Institutional research plan: CEZ:AV0Z50390512; CEZ:AV0Z50110509 Keywords : neurogenic pulmonary edema * rat * spinal cord injury Subject RIV: FH - Neurology Impact factor: 1.430, year: 2009

The role of sympathetic nervous system in the development of neurogenic pulmonary edema in spinal cord-injured rats

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří; Zicha, Josef; Nedvídková, J.; Kuneš, Jaroslav

2012-01-01

Roč. 112, č. 1 (2012), s. 1-8 ISSN 8750-7587 R&D Projects: GA MŠk(CZ) 1M0510; GA ČR(CZ) GA305/08/0139; GA AV ČR(CZ) IAA500110902 Institutional research plan: CEZ:AV0Z50110509 Keywords : neurogenic pulmonary edema * sympathetic nervous system * baroreflex Subject RIV: FA - Cardiovascular Diseases incl. Cardiotharic Surgery Impact factor: 3.484, year: 2012

The 'ventral organs' of Pycnogonida (Arthropoda are neurogenic niches of late embryonic and post-embryonic nervous system development.

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Georg Brenneis

Full Text Available Early neurogenesis in arthropods has been in the focus of numerous studies, its cellular basis, spatio-temporal dynamics and underlying genetic network being by now comparably well characterized for representatives of chelicerates, myriapods, hexapods and crustaceans. By contrast, neurogenesis during late embryonic and/or post-embryonic development has received less attention, especially in myriapods and chelicerates. Here, we apply (i immunolabeling, (ii histology and (iii scanning electron microscopy to study post-embryonic ventral nerve cord development in Pseudopallene sp., a representative of the sea spiders (Pycnogonida, the presumable sister group of the remaining chelicerates. During early post-embryonic development, large neural stem cells give rise to additional ganglion cell material in segmentally paired invaginations in the ventral ectoderm. These ectodermal cell regions - traditionally designated as 'ventral organs' - detach from the surface into the interior and persist as apical cell clusters on the ventral ganglion side. Each cluster is a post-embryonic neurogenic niche that features a tiny central cavity and initially still houses larger neural stem cells. The cluster stays connected to the underlying ganglionic somata cortex via an anterior and a posterior cell stream. Cell proliferation remains restricted to the cluster and streams, and migration of newly produced cells along the streams seems to account for increasing ganglion cell numbers in the cortex. The pycnogonid cluster-stream-systems show striking similarities to the life-long neurogenic system of decapod crustaceans, and due to their close vicinity to glomerulus-like neuropils, we consider their possible involvement in post-embryonic (perhaps even adult replenishment of olfactory neurons - as in decapods. An instance of a potentially similar post-embryonic/adult neurogenic system in the arthropod outgroup Onychophora is discussed. Additionally, we document two

Reactive Arthritis Secondary to Cauda Equina Injury following Spine Fracture: A Case Report

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Xiao Li

2011-01-01

Full Text Available A 38-year-old man presented with a one-month history of muscle weakness and dysesthesia in the lower extremities, urinary retention, and urinary tract infection after lumbar burst fracture resulted from high fall. During the rehabilitation in our hospital, he had arthritis in both the ankle and knee. However, the patient was treated as gouty arthropathy initially. The arthritis was completely remitted in a few days after the patient was diagnosed as reactive arthritis and started with sulfasalazine therapy and there was no recurrence during 4 months of follow-up. Based on this case, early recognition of reactive arthritis is of major importance to avoid delayed initiation of appropriate treatment in the patients with polyarthritis secondary to neurogenic bladder following cauda equina injury after spine fracture.

Characteristics of neurogenic bowel in spinal cord injury and perceived quality of life.

Science.gov (United States)

Pardee, Connie; Bricker, Diedre; Rundquist, Jeanine; MacRae, Christi; Tebben, Cherisse

2012-01-01

To investigate the association between characteristics of individuals with spinal cord injury and neurogenic bowel and their perceived quality of life. The study design is an exploratory, descriptive correlational design. To measure the variables of the study the Quality of Life Survey developed by Randell et al. (2001) was used to measure perceived quality of life related to bowel management. Individual bowel management preferences and subjective costs and benefits of the preferences were gathered through the Neurogenic Bowel Characteristics Survey. PARTICIPANTS/METHOD: Data were collected from a random half of the individuals who met the inclusion criteria from the patient database (n=1193). Two hundred and forty one surveys were analyzed for this study. More than half of the sample (n=134) provided their own bowel management consisting of digital stimulation, suppositories, and other aids; 8% (n=19) had a colostomy. Regardless of the bowel management program 54% (n=127) were satisfied with current methods. Although time reported to complete bowel programs ranged from 1 to 120 minutes, there was no difference in rating of satisfaction with time. There was a statistically significant difference between those satisfied and dissatisfied with current bowel management and quality of life; those satisfied demonstrated a higher quality of life on three subscales, work function (p= .021), bowel problems (p< .001), and social function (p< .001). Those dissatisfied with their bowel program perceived a lower quality of life and indicated problems of time (p= .001), pain or discomfort (p= .033), and poor results (p< .001). Research data provide the patient's perspective on bowel management characteristics, complications, satisfaction, and their perceived quality of life. Results of this research will be incorporated into bowel management education and possible modification of the current inpatient bowel management program. © 2012 Association of Rehabilitation Nurses.

Kinin B1 Receptor Promotes Neurogenic Hypertension Through Activation of Centrally Mediated Mechanisms.

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Sriramula, Srinivas; Lazartigues, Eric

2017-12-01

Hypertension is associated with increased activity of the kallikrein-kinin system. Kinin B1 receptor (B1R) activation leads to vasoconstriction and inflammation. Despite evidence supporting a role for the B1R in blood pressure regulation, the mechanisms by which B1R could alter autonomic function and participate in the pathogenesis of hypertension remain unidentified. We sought to explore whether B1R-mediated inflammation contributes to hypertension and investigate the molecular mechanisms involved. In this study, we tested the hypothesis that activation of B1R in the brain is involved in the pathogenesis of hypertension, using the deoxycorticosterone acetate-salt model of neurogenic hypertension in wild-type and B1R knockout mice. Deoxycorticosterone acetate-salt treatment in wild-type mice led to significant increases in B1R mRNA and protein levels and bradykinin levels, enhanced gene expression of carboxypeptidase N supporting an increase in the B1R ligand, associated with enhanced blood pressure, inflammation, sympathoexcitation, autonomic dysfunction, and impaired baroreflex sensitivity, whereas these changes were blunted or prevented in B1R knockout mice. B1R stimulation was further shown to involve activation of the ASK1-JNK-ERK1/2 and NF-κB pathways in the brain. To dismiss potential developmental alterations in knockout mice, we further used B1R blockade selectively in the brain of wild-type mice. Supporting the central origin of this mechanism, intracerebroventricular infusion of a specific B1R antagonist, attenuated the deoxycorticosterone acetate-salt-induced increase in blood pressure in wild-type mice. Our data provide the first evidence of a central role for B1R-mediated inflammatory pathways in the pathogenesis of deoxycorticosterone acetate-salt hypertension and offer novel insights into possible B1R-targeted therapies for the treatment of neurogenic hypertension. © 2017 American Heart Association, Inc.

Endobronchial neurogenic tumor: A combination of traumatic neuroma and neurofibroma

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Amit Tandon

2017-01-01

Full Text Available Traumatic neuromas are uncommon and benign lesions arising from a peripheral nerve injury during surgery. Here we describe a case with histopathologic features of both a traumatic neuroma and neurofibroma in a patient without integumentary physical exam findings nor prior surgical history. A 54 year old male was admitted for surgical debridement of a foot ulcer. During pre-operative evaluation and review of imaging multiple CT scans revealed a stable, 4 mm endobronchial lesion in the left lower lobe. Given history of nicotine abuse, bronchoscopy was performed. Bronchoscopy showed a pearly, polypoid lesion. Histopathological results showed strong positivity for S-100 protein and spindle cell proliferation. Repeat CT chest showed no new lesions in the bronchial tree. The rarity of this case is noted not only by the limited number of bronchial neurogenic tumors, but the combined features in this case of a traumatic neuroma and neurofibroma which has not been described.

The ‘Ventral Organs’ of Pycnogonida (Arthropoda) Are Neurogenic Niches of Late Embryonic and Post-Embryonic Nervous System Development

Science.gov (United States)

Brenneis, Georg; Scholtz, Gerhard

2014-01-01

Early neurogenesis in arthropods has been in the focus of numerous studies, its cellular basis, spatio-temporal dynamics and underlying genetic network being by now comparably well characterized for representatives of chelicerates, myriapods, hexapods and crustaceans. By contrast, neurogenesis during late embryonic and/or post-embryonic development has received less attention, especially in myriapods and chelicerates. Here, we apply (i) immunolabeling, (ii) histology and (iii) scanning electron microscopy to study post-embryonic ventral nerve cord development in Pseudopallene sp., a representative of the sea spiders (Pycnogonida), the presumable sister group of the remaining chelicerates. During early post-embryonic development, large neural stem cells give rise to additional ganglion cell material in segmentally paired invaginations in the ventral ectoderm. These ectodermal cell regions – traditionally designated as ‘ventral organs’ – detach from the surface into the interior and persist as apical cell clusters on the ventral ganglion side. Each cluster is a post-embryonic neurogenic niche that features a tiny central cavity and initially still houses larger neural stem cells. The cluster stays connected to the underlying ganglionic somata cortex via an anterior and a posterior cell stream. Cell proliferation remains restricted to the cluster and streams, and migration of newly produced cells along the streams seems to account for increasing ganglion cell numbers in the cortex. The pycnogonid cluster-stream-systems show striking similarities to the life-long neurogenic system of decapod crustaceans, and due to their close vicinity to glomerulus-like neuropils, we consider their possible involvement in post-embryonic (perhaps even adult) replenishment of olfactory neurons – as in decapods. An instance of a potentially similar post-embryonic/adult neurogenic system in the arthropod outgroup Onychophora is discussed. Additionally, we document two transient

Transcutaneous stimulation of the posterior tibial nerve for treating refractory urge incontinence of idiopathic and neurogenic origin.

Science.gov (United States)

Valles-Antuña, C; Pérez-Haro, M L; González-Ruiz de L, C; Quintás-Blanco, A; Tamargo-Diaz, E M; García-Rodríguez, J; San Martín-Blanco, A; Fernandez-Gomez, J M

2017-09-01

To assess the efficacy of treatment with transcutaneous posterior tibial nerve stimulation (TPTNS) in patients with urge urinary incontinence, of neurogenic or nonneurogenic origin, refractory to first-line therapeutic options. We included 65 patients with urge urinary incontinence refractory to medical treatment. A case history review, a urodynamic study and a somatosensory evoked potentials (SEP) study were conducted before the TPTNS, studying the functional urological condition by means of a voiding diary. The treatment consisted of 10 weekly sessions of TPTNS lasting 30minutes. Some 57.7% of the patients showed abnormal tibial SEPs, and 42% showed abnormal pudendal SEPs. A statistically significant symptomatic improvement was observed in all clinical parameters after treatment with TPTNS, and 66% of the patients showed an overall improvement, regardless of sex, the presence of underlying neurological disorders, detrusor hyperactivity in the urodynamic study or SEP disorders. There were no adverse effects during the treatment. TPTNS is an effective and well tolerated treatment in patients with urge incontinence refractory to first-line therapies and should be offered early in the treatment strategy. New studies are needed to identify the optimal parameters of stimulation, the most effective treatment protocols and long-term efficacy, as well as its applicability to patients with a neurogenic substrate. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Effects and Safety of Aqueous Extract of Poncirus fructus in Spinal Cord Injury with Neurogenic Bowel

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Ji Hee Kim

2016-01-01

Full Text Available Objective. To investigate the effects and safety of the aqueous extract of the dried, immature fruit of Poncirus trifoliata (L. Raf., known as Poncirus fructus (PF, in spinal cord injury (SCI patients with neurogenic bowel. Methods. Thirty-one SCI patients with neurogenic bowel were recruited. Patients were evaluated based on clinical information, constipation score, Bristol Stool Form Scale, stool retention score using plain abdominal radiograph, and colon transit time. PF was administered in dosages of 800 mg each prior to breakfast and lunch for 14 days. Results. The morphological feature of the stool before and after administration indicated a statistically significant difference from 3.52 ± 1.33 to 4.32 ± 1.44 points (p<0.05. Stool retention score before and after administration of PF was represented with low significance (7.25 ± 1.60 to 6.46 ± 1.53 points in the whole colon (p<0.05, and the colon transit time was significantly shortened (57.41 ± 20.7 to 41.2 ± 25.5 hours in terms of the whole transit time (p<0.05. Side effects were observed in 7 people (28.0% consisting of 2 people with soft stools and 5 people with diarrhea. Conclusion. For SCI patients, PF administration significantly improved defecation patterns, defecation retention, and colon transit time. PF could be an effective aid to improve colonic motility and constipation.

PET-scan shows peripherally increased neurokinin 1 receptor availability in chronic tennis elbow: visualizing neurogenic inflammation?

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Magnus Peterson

Full Text Available In response to pain, neurokinin 1 (NK1 receptor availability is altered in the central nervous system. The NK1 receptor and its primary agonist, substance P, also play a crucial role in peripheral tissue in response to pain, as part of neurogenic inflammation. However, little is known about alterations in NK1 receptor availability in peripheral tissue in chronic pain conditions and very few studies have been performed on human beings. Ten subjects with chronic tennis elbow were therefore examined by positron emission tomography (PET with the NK1 specific radioligand [(11C]GR205171 before and after treatment with graded exercise. The radioligand signal intensity was higher in the affected arm as compared with the unaffected arm, measured as differences between the arms in volume of voxels and signal intensity of this volume above a reference threshold set as 2.5 SD above mean signal intensity of the unaffected arm before treatment. In the eight subjects examined after treatment, pain ratings decreased in all subjects but signal intensity decreased in five and increased in three. In conclusion, NK1 receptors may be activated, or up-regulated in the peripheral, painful tissue of a chronic pain condition. This up-regulation does, however, have moderate correlation to pain ratings. The increased NK1 receptor availability is interpreted as part of ongoing neurogenic inflammation and may have correlation to the pathogenesis of chronic tennis elbow.ClinicalTrials.gov NCT00888225 http://clinicaltrials.gov/

Myopathy in CRPS-I: disuse or neurogenic?

Science.gov (United States)

Hulsman, Natalie M; Geertzen, Jan H B; Dijkstra, Pieter U; van den Dungen, Jan J A M; den Dunnen, Wilfred F A

2009-08-01

The diagnosis Complex Regional Pain Syndrome type I (CRPS-I) is based on clinical symptoms, including motor symptoms. Histological changes in muscle tissue may be present in the chronic phase of CRPS-I. Aim of this study was to analyze skeletal muscle tissue from amputated limbs of patients with CRPS-I, in order to gain more insight in factors that may play a role in changes in muscles in CRPS-I. These changes may be helpful in clarifying the pathophysiology of CRPS-I. Fourteen patients with therapy resistant and longstanding CRPS-I, underwent an amputation of the affected limb. In all patients histological analysis showed extensive changes in muscle tissue, such as fatty degeneration, fibre atrophy and nuclear clumping, which was not related to duration of CRPS-I prior to amputation. In all muscles affected, both type 1 and type 2 fibre atrophy was found, without selective type 2 fibre atrophy. In four patients, type grouping was observed, indicating a sequence of denervation and reinnervation of muscle tissue. In two patients even large group atrophy was present, suggesting new denervation after reinnervation. Comparison between subgroups in arms and legs showed no difference in the number of changes in muscle tissue. Intrinsic and extrinsic muscles were affected equally. Our findings show that in the chronic phase of CRPS-I extensive changes can be seen in muscle tissue, not related to duration of CRPS-I symptoms. Signs of neurogenic myopathy were present in five patients.

Gamma-Secretase Inhibitors Attenuate Neurotrauma and Neurogenic Acute Lung Injury in Rats by Rescuing the Accumulation of Hypertrophic Microglia

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Hung-Jung Lin

2017-12-01

Full Text Available Background/Aims: In response to traumatic brain injury (TBI, activated microglia exhibit changes in their morphology from the resting ramified phenotype toward the activated hypertrophic or amoeboid phenotype. Here, we provide the first description of the mechanism underlying the neuroprotective effects of γ-secretase inhibitors on TBI outcomes in rats. Methods: The neuroprotective effects of γ-secretase inhibitors such as LY411575 or CHF5074 on TBI-induced neurotoxicity were analysed using a neurological motor function evaluation, cerebral contusion assay, immunohistochemical staining for microglia phenotypes, lung injury score and Evans Blue dye extravasation assay of brain and lung oedema. Results: Hypertrophic or amoeboid microglia accumulated in the injured cortex, the blood-brain-barrier was disrupted and neurological deficits and acute lung injury were observed 4 days after TBI in adult rats. However, a subcutaneous injection of LY411575 (5 mg/kg or CHF5074 (30 mg/kg immediately after TBI and once daily for 3 consecutive days post-TBI significantly attenutaed the accumulation of hypertrophic microglia in the injured brain, neurological injury, and neurogenic acute lung injury. Conclusion: Gamma-secretase inhibitors attenuated neurotrauma and neurogenic acute lung injury in rats by reducing the accumulation of hypertrophic microglia in the vicinity of the lesion.

Neurogenic vision loss: Causes and outcome. An experience from a tertiary center in Northern India

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Rajesh Verma

2014-01-01

Full Text Available Introduction: Vision loss can be a consequence of numerous disorders of eye and neural pathway conveying visual input to brain. A variety of conditions can affect visual pathway producing neurogenic vision loss. The presentation and course of vision loss depends on the site of involvement and underlying etiology. We conducted this unprecedented study to evaluate the characteristics and outcome of various diseases of the visual pathway. Materials and Methods: In this prospective cohort study, we evaluated 64 patients with neurogenic visual impairment. Ophthalmological causes were excluded in all of them. Their presentation, ophthalmological characteristics and investigation findings were recorded. These patients were followed up till 6 months. Results: Out of 69 patients evaluated, 5 were excluded as they had ophthalmological abnormalities. The remaining 64 cases (113 eyes were enrolled. 54 cases were due to diseases of anterior visual pathway and rest 10 had cortical vision loss. The etiologic distribution is as follows: Isolated optic neuritis- 12 (19%, multiple sclerosis- 4 (6.3%, neuromyelitis optica- 5 (7.9%, tubercular meningitis- 15 (23.8%, non-arteritic ischemic optic neuropathy, ischemic optic neuropathy complicating cavernous sinus thrombosis, cryptococcal meningitis, malignant infiltration of optic nerve, Crouzon′s syndrome, calvarial thickening and traumatic occipital gliosis- 1 (1.6% case each, idiopathic intracranial hypertension, pituitary adenoma, acute disseminated encephalomyelitis, posterior reversible leukoencephalopathy- 3 (4.8% cases each, cortical venous thrombosis 5 (7.9%, subacute scleroing panencephalitis- 4 (6.3% cases. Conclusions: The diseases of anterior visual pathway were much more common than cortical vision loss. A majority of our patients had severe impairment of vision at presentation.

CRMP5 regulates generation and survival of newborn neurons in olfactory and hippocampal neurogenic areas of the adult mouse brain.

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Alexandra Veyrac

Full Text Available The Collapsin Response Mediator Proteins (CRMPS are highly expressed in the developing brain, and in adult brain areas that retain neurogenesis, ie: the olfactory bulb (OB and the dentate gyrus (DG. During brain development, CRMPs are essentially involved in signaling of axon guidance and neurite outgrowth, but their functions in the adult brain remain largely unknown. CRMP5 has been initially identified as the target of auto-antibodies involved in paraneoplasic neurological diseases and further implicated in a neurite outgrowth inhibition mediated by tubulin binding. Interestingly, CRMP5 is also highly expressed in adult brain neurogenic areas where its functions have not yet been elucidated. Here we observed in both neurogenic areas of the adult mouse brain that CRMP5 was present in proliferating and post-mitotic neuroblasts, while they migrate and differentiate into mature neurons. In CRMP5(-/- mice, the lack of CRMP5 resulted in a significant increase of proliferation and neurogenesis, but also in an excess of apoptotic death of granule cells in the OB and DG. These findings provide the first evidence that CRMP5 is involved in the generation and survival of newly generated neurons in areas of the adult brain with a high level of activity-dependent neuronal plasticity.

Evaluation of educational content of YouTube videos relating to neurogenic bladder and intermittent catheterization.

Science.gov (United States)

Ho, Matthew; Stothers, Lynn; Lazare, Darren; Tsang, Brian; Macnab, Andrew

2015-01-01

Many patients conduct internet searches to manage their own health problems, to decide if they need professional help, and to corroborate information given in a clinical encounter. Good information can improve patients' understanding of their condition and their self-efficacy. Patients with spinal cord injury (SCI) featuring neurogenic bladder (NB) require knowledge and skills related to their condition and need for intermittent catheterization (IC). Information quality was evaluated in videos accessed via YouTube relating to NB and IC using search terms "neurogenic bladder intermittent catheter" and "spinal cord injury intermittent catheter." Video content was independently rated by 3 investigators using criteria based on European Urological Association (EAU) guidelines and established clinical practice. In total, 71 videos met the inclusion criteria. Of these, 12 (17%) addressed IC and 50 (70%) contained information on NB. The remaining videos met inclusion criteria, but did not contain information relevant to either IC or NB. Analysis indicated poor overall quality of information, with some videos with information contradictory to EAU guidelines for IC. High-quality videos were randomly distributed by YouTube. IC videos featuring a healthcare narrator scored significantly higher than patient-narrated videos, but not higher than videos with a merchant narrator. About half of the videos contained commercial content. Some good-quality educational videos about NB and IC are available on YouTube, but most are poor. The videos deemed good quality were not prominently ranked by the YouTube search algorithm, consequently user access is less likely. Study limitations include the limit of 50 videos per category and the use of a de novo rating tool. Information quality in videos with healthcare narrators was not higher than in those featuring merchant narrators. Better material is required to improve patients' understanding of their condition.

Neurogenic bowel dysfunction in patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease

Institute of Scientific and Technical Information of China (English)

Richard A Awad

2011-01-01

Exciting new features have been described concerning neurogenic bowel dysfunction, including interactions between the central nervous system, the enteric nervous system, axonal injury, neuronal loss, neurotransmission of noxious and non-noxious stimuli, and the fields of gastroenterology and neurology. Patients with spinal cord injury, myelomeningocele, multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation, incontinence, gastrointestinal motor dysfunction and altered visceral sensitivity. Spinal cord injury is associated with severe autonomic dysfunction, and bowel dysfunction is a major physical and psychological burden for these patients. An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease. Multiple sclerosis is a neurodegenerative disorder in which axonal injury, neuronal loss, and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability. Parkinson's disease is a multisystem disorder involving dopaminergic, noradrenergic, serotoninergic and cholinergic systems, characterized by motor and non-motor symptoms. Parkinson's disease affects several neuronal structures outside the substantia nigra, among which is the enteric nervous system. Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease, even before the involvement of the central nervous system. This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease, as it could represent the point of entry for a putative environmental factor to initiate the pathological process. This review covers the data related to the etiology, epidemiology, clinical expression, pathophysiology, genetic aspects, gastrointestinal motor dysfunction, visceral sensitivity, management, prevention and prognosis of neurogenic bowel

Dorsal Vagal Complex Modulates Neurogenic Airway Inflammation in a Guinea Pig Model With Esophageal Perfusion of HCl

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Zhe Chen

2018-05-01

Full Text Available Neurogenic airway inflammation in chronic cough and bronchial asthma related to gastroesophageal reflux (GER is involved in the esophageal–bronchial reflex, but it is unclear whether this reflex is mediated by central neurons. This study aimed to investigate the regulatory effects of the dorsal vagal complex (DVC on airway inflammation induced by the esophageal perfusion of hydrochloric acid (HCl following the microinjection of nuclei in the DVC in guinea pigs. Airway inflammation was evaluated by measuring the extravasation of Evans blue dye (EBD and substance P (SP expression in the airway. Neuronal activity was indicated by Fos expression in the DVC. The neural pathways from the lower esophagus to the DVC and the DVC to the airway were identified using DiI tracing and pseudorabies virus Bartha (PRV-Bartha retrograde tracing, respectively. HCl perfusion significantly increased plasma extravasation, SP expression in the trachea, and the expression of SP and Fos in the medulla oblongata nuclei, including the nucleus of the solitary tract (NTS and the dorsal motor nucleus of the vagus (DMV. The microinjection of glutamic acid (Glu or exogenous SP to enhance neuronal activity in the DVC significantly potentiated plasma extravasation and SP release induced by intra-esophageal perfusion. The microinjection of γ-aminobutyric acid (GABA, lidocaine to inhibit neuronal activity or anti-SP serum in the DVC alleviated plasma extravasation and SP release. In conclusion, airway inflammation induced by the esophageal perfusion of HCl is regulated by DVC. This study provides new insight for the mechanism of airway neurogenic inflammation related to GER.

Use of cuff tear arthroplasty head prosthesis for rotator cuff arthropathy treatment in elderly patients with comorbidities.

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Carvalho, Cassiano Diniz; Andreoli, Carlos Vicente; Pochini, Alberto de Castro; Ejnisman, Benno

2016-01-01

To evaluate the clinical and functional behavior of patients undergoing cuff tear arthroplasty at different stages of the disease. Cuff tear arthroplasty hemiarthroplasties were performed in 34 patients with rotator cuff arthropathy and associated comorbidities, classified according to Seebauer. The mean age was 76.3 years, and the sample comprised 23 females (67.6%) and 11 males (32.4%). The mean follow-up period was 21.7 months, and evaluations were performed using the Visual Analog Scale for pain and the Constant scale. There were no statistically significant differences in the mean reduction in the Visual Analog Scale or in the Constant scale increase between the female and male groups. The variation between the pre- and postoperative Visual Analog Scale and Constant scale evaluations was significant. There was also no statistically significant difference between the Seebauer classification groups regarding the mean Visual Analog Scale reduction, or the mean Constant scale increase. Cuff tear arthroplasty shoulder hemiarthroplasty is a good option for rotator cuff arthropathy in patients with comorbidities. Avaliar o comportamento clínico e funcional dos pacientes submetidos à artroplastia do tipo cuff tear arthroplasty para o tratamento da artropatia do manguito rotador em diferentes estágios da afecção. Foram realizadas 34 hemiartroplastias do tipo cuff tear arthroplasty em 34 pacientes com artropatia do manguito rotador e comorbidades associadas, classificadas de acordo com Seebauer. A média de idade foi de 76,3 anos, sendo 23 pacientes do sexo feminino (67,6%) e 11 do sexo masculino (32,4%). O seguimento médio foi de 21,7 meses e a avaliação foi realizada por meio da Escala Visual Analógica da dor e pela escala de Constant. Não houve diferença estatisticamente significante entre os grupos feminino e masculino, tanto nas médias de redução na Escala Visual Analógica quanto nas de aumento na escala de Constant. A variação entre as avalia

Preoperative Duplex Scanning is a Helpful Diagnostic Tool in Neurogenic Thoracic Outlet Syndrome.

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Orlando, Megan S; Likes, Kendall C; Mirza, Serene; Cao, Yue; Cohen, Anne; Lum, Ying Wei; Freischlag, Julie A

2016-01-01

To evaluate the diagnostic role of venous and arterial duplex scanning in neurogenic thoracic outlet syndrome (NTOS). Retrospective review of patients who underwent duplex ultrasonography prior to first rib resection and scalenectomy (FRRS) for NTOS from 2005 to 2013. Abnormal scans included ipsilateral compression (IC) with abduction of the symptomatic extremity (>50% change in subclavian vessel flow), contralateral (asymptomatic side) compression (CC) or bilateral compression (BC). A total of 143 patients (76% female, average age 34, range 13-59) underwent bilateral preoperative duplex scanning. Ipsilateral compression was seen in 44 (31%), CC in 12 (8%), and BC in 14 (10%). Seventy-three (51%) patients demonstrated no compression. Patients with IC more often experienced intraoperative pneumothoraces (49% vs. 25%, P duplex ultrasonography can assist in NTOS diagnosis. Ipsilateral compression on abduction often correlates with Adson testing. © The Author(s) 2016.

[Posttraumatic stress disorder in patients with neurogenic amnesia for the traumatic event].

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Podoll, K; Kunert, H J; Sass, H

2000-10-01

The development of symptoms of posttraumatic stress disorder (PTSD) in patients with neurogenic amnesia for the traumatic event is recorded in 2 own patients and in 19 cases from the clinical literature. With a single exception, all patients were accident victims with closed head injuries. Only about three quarters of the patients completely fulfilled DSM-III-R criteria of PTSD. Nineteen patients displayed involuntary conscious memories of aspects of the traumatic event (presenting as recurrent intrusive thoughts, images or dreams) co-existent with a complete or partial lack of voluntary conscious memories of the trauma, suggesting that different memory systems and distinct brain mechanisms subserve these phenomena. The said clinical observations are discussed against the background of current neuropsychological models of multiple memory systems. The recorded cases demonstrate that declarative episodic memory is not necessary for symptoms of PTSD to emerge, whereas preserved functions of non-declarative memory systems represent a sufficient condition for the development of PTSD symptoms.

Is Melanoma a stem cell tumor? Identification of neurogenic proteins in trans-differentiated cells

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Chan Linda S

2005-03-01

Full Text Available Abstract Background Although several genes and proteins have been implicated in the development of melanomas, the molecular mechanisms involved in the development of these tumors are not well understood. To gain a better understanding of the relationship between the cell growth, tumorigenesis and differentiation, we have studied a highly malignant cat melanoma cell line that trans-differentiates into neuronal cells after exposure to a feline endogenous retrovirus RD114. Methods To define the repertoire of proteins responsible for the phenotypic differences between melanoma and its counterpart trans-differentiated neuronal cells we have applied proteomics technology and compared protein profiles of the two cell types and identified differentially expressed proteins by 2D-gel electrophoresis, image analyses and mass spectrometry. Results The melanoma and trans-differentiated neuronal cells could be distinguished by the presence of distinct sets of proteins in each. Although approximately 60–70% of the expressed proteins were shared between the two cell types, twelve proteins were induced de novo after infection of melanoma cells with RD114 virus in vitro. Expression of these proteins in trans-differentiated cells was significantly associated with concomitant down regulation of growth promoting proteins and up-regulation of neurogenic proteins (p = 95% proteins expressed in trans-differentiated cells could be associated with the development, differentiation and regulation of nervous system cells. Conclusion Our results indicate that the cat melanoma cells have the ability to differentiate into distinct neuronal cell types and they express proteins that are essential for self-renewal. Since melanocytes arise from the neural crest of the embryo, we conclude that this melanoma arose from embryonic precursor stem cells. This model system provides a unique opportunity to identify domains of interactions between the expressed proteins that halt the

MILD® Is an Effective Treatment for Lumbar Spinal Stenosis with Neurogenic Claudication: MiDAS ENCORE Randomized Controlled Trial.

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Benyamin, Ramsin M; Staats, Peter S; MiDAS Encore, Investigators

2016-05-01

Lumbar spinal stenosis (LSS) is a common degenerative condition of the spine, which is a major cause of pain and functional disability for the elderly. Neurogenic claudication symptoms are a hallmark of LSS, where patients develop low back or leg pain when walking or standing that is relieved by sitting or lumbar flexion. The treatment of LSS generally begins with conservative management such as physical therapy, home exercise programs, and oral analgesics. Once these therapies fail, patients commonly move forward with interventional pain treatment options such as epidural steroid injections (ESIs) or MILD® as the next step. To assess improvement of function and reduction in pain for Medicare beneficiaries following treatment with MILD (treatment group) in LSS patients with neurogenic claudication and verified ligamentum flavum hypertrophy and to compare to a control group receiving ESIs. Prospective, multi-center, randomized controlled clinical trial. Twenty-six US interventional pain management centers. Patients in this trial were randomized one to one into 2 study arms. A total of 302 patients were enrolled, with 149 randomized to MILD and 153 to the active control. Outcomes are assessed using the Oswestry Disability Index (ODI), Numeric Pain Rating Scale (NPRS) and Zurich Claudication Questionnaire (ZCQ). Primary efficacy is the proportion of ODI responders, tested for statistical superiority of the MILD group versus the ESI group. ODI responders are defined as patients achieving the validated Minimal Important Change (MIC) of = 10 point improvement in ODI from baseline to follow-up. Similarly, secondary efficacy is the proportion of NPRS and ZCQ responders using validated MIC thresholds. Primary safety is the incidence of device- or procedure-related adverse events in each group. This report presents safety and efficacy results at 1-year follow-up. Outcomes at 2 years will be collected and reported for patients in the MILD group only. At 1-year follow-up, ODI

Artropatia de charcot do mediopé no paciente diabético: complicação de uma doença epidêmica Mid-foot charcot arthropathy in diabetic patients: complication of an epidemic disease

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Ricardo Cardenuto Ferreira

2012-10-01

Full Text Available OBJETIVOS: Traçar o perfil epidemiológico dos pacientes diabéticos portadores de artropatia de Charcot acometendo exclusivamente o mediopé ou estendendo-se do mediopé ao retropé. Avaliar, a médio prazo, o resultado do tratamento a que esses pacientes são submetidos seguindo um protocolo preestabelecido. MÉTODOS: Avaliamos, retrospectivamente, 88 pacientes (110 extremidades portadores de artropatia de Charcot do mediopé, com seguimento mínimo de 12 meses. Incluímos os pacientes portadores de artropatia de Charcot acometendo as articulações tarsometatársicas, 45 pacientes (51%; as articulações talonavicular, calcaneocuboide e subtalar, 20 pacientes (23%; e aqueles com envolvimento do mediopé e retropé, 23 pacientes (26%, segundo Brodsky e Trepman. Definimos como sucesso a preservação de um pé funcional e insucesso como amputação do pé. RESULTADOS: O tratamento da artropatia de Charcot envolvendo primariamente o mediopé foram satisfatórios em 75 pacientes (85% tratados seguindo nosso protocolo. Nos pacientes com lesões graves, acometendo tanto o mediopé quanto o retropé, foi necessário maior número de cirurgias complexas do tipo artrodese para se obter o mesmo índice global de resultados satisfatórios. A lesão osteoarticular originada no mediopé provavelmente estende-se progressivamente ao retropé devido à demora no diagnóstico no início do tratamento adequado. CONCLUSÃO: Foi possível preservar uma extremidade funcional em 85% dos pacientes. Lesões graves envolvendo o mediopé e estendendo-se ao retropé necessitaram maior número de cirurgias para o tratamento.OBJECTIVES: To outline the epidemiological profile of diabetic patients with Charcot arthropathy affecting the midfoot alone or extending from the midfoot to the hindfoot; To assess the results from the treatment that these patients undergo, according to a preestablished protocol, over the medium term. METHODS: We retrospectively evaluated 88

Botulinum Toxin Is Effective in the Management of Neurogenic Dysphagia. Clinical-Electrophysiological Findings and Tips on Safety in Different Neurological Disorders

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Alfonsi, Enrico; Restivo, Domenico A.; Cosentino, Giuseppe; De Icco, Roberto; Bertino, Giulia; Schindler, Antonio; Todisco, Massimiliano; Fresia, Mauro; Cortese, Andrea; Prunetti, Paolo; Ramusino, Matteo C.; Moglia, Arrigo; Sandrini, Giorgio; Tassorelli, Cristina

2017-01-01

Background and Aims: Neurogenic dysphagia linked to failed relaxation of the upper esophageal sphincter (UES) can be treated by injecting botulinum toxin (BTX) into the cricopharyngeal (CP) muscle. We compared the effects of this treatment in different neurological disorders with dysphagia, to evaluate its efficacy over time including the response to a second injection. Materials and Methods: Sixty-seven patients with neurogenic dysphagia associated with incomplete or absent opening of the UES (24 with brainstem or hemispheric stroke, 21 with parkinsonian syndromes, 12 with multiple sclerosis, and 10 with spastic-dystonic syndromes secondary to post-traumatic encephalopathy) were treated with the injection of IncobotulinumtoxinA (dose 15–20 U) into the CP muscle under electromyographic guidance. The patients were assessed at baseline and after the first and second treatment through clinical evaluation and fiberoptic endoscopy of swallowing, while their dysphagia was quantified using the Dysphagia Outcome and Severity Scale (DOSS). An electrokinesiographic/electromyographic study of swallowing was performed at baseline. Results: Most patients responded to the first BTX treatment: 35 patients (52.2%) were classified as high responders (DOSS score increase >2 levels), while other 19 patients (28.4%) were low responders (DOSS score increase of ≤2 levels). The effect of the first treatment usually lasted longer than 4 months (67%), and in some cases up to a year. The treatment efficacy remained high also after the second injection: 31 patients (46.3%) qualified as high responders and other 22 patients (32.8%) showed a low response. Only in the parkinsonian syndromes group we observed a reduction in the percentage of high responders as compared with the first treatment. Side effects were mostly mild and reported in non-responders following the first injection. A severe side effect, consisting of ingestion pneumonia, was observed following the second BTX injection in

Cancer stem cells from a rare form of glioblastoma multiforme involving the neurogenic ventricular wall

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Li Shengwen

2012-09-01

Full Text Available Abstract Background The cancer stem cell (CSC hypothesis posits that deregulated neural stem cells (NSCs form the basis of brain tumors such as glioblastoma multiforme (GBM. GBM, however, usually forms in the cerebral white matter while normal NSCs reside in subventricular and hippocampal regions. We attempted to characterize CSCs from a rare form of glioblastoma multiforme involving the neurogenic ventricular wall. Methods We described isolating CSCs from a GBM involving the lateral ventricles and characterized these cells with in vitro molecular biomarker profiling, cellular behavior, ex vivo and in vivo techniques. Results The patient’s MRI revealed a heterogeneous mass with associated edema, involving the left subventricular zone. Histological examination of the tumor established it as being a high-grade glial neoplasm, characterized by polygonal and fusiform cells with marked nuclear atypia, amphophilic cytoplasm, prominent nucleoli, frequent mitotic figures, irregular zones of necrosis and vascular hyperplasia. Recurrence of the tumor occurred shortly after the surgical resection. CD133-positive cells, isolated from the tumor, expressed stem cell markers including nestin, CD133, Ki67, Sox2, EFNB1, EFNB2, EFNB3, Cav-1, Musashi, Nucleostemin, Notch 2, Notch 4, and Pax6. Biomarkers expressed in differentiated cells included Cathepsin L, Cathepsin B, Mucin18, Mucin24, c-Myc, NSE, and TIMP1. Expression of unique cancer-related transcripts in these CD133-positive cells, such as caveolin-1 and −2, do not appear to have been previously reported in the literature. Ex vivo organotypic brain slice co-culture showed that the CD133+ cells behaved like tumor cells. The CD133-positive cells also induced tumor formation when they were stereotactically transplanted into the brains of the immune-deficient NOD/SCID mice. Conclusions This brain tumor involving the neurogenic lateral ventricular wall was comprised of tumor-forming, CD133-positive cancer

Botulinumtoxin-A in der Behandlung neurogener Blasenfunktionsstörungen bei Kindern: Funktionelle und histomorphologische Langzeitergebnisse

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Schulte-Baukloh H

2004-01-01

Full Text Available Die etablierte Therapie der neurogenen Detrusorhyperaktivität bei Kindern besteht in der Gabe von Anticholinergika und begleitendem intermittierendem Einmalkatheterismus. Eine hohe Nebenwirkungsrate der Anticholinergika oder eine nicht ausreichende Dämpfung der Detrusoraktivität limitiert jedoch die Anwendung und zwingt nicht selten zu einem operativen Vorgehen. Wir untersuchten deshalb die Wirksamkeit von Botulinumtoxin-A (BTX-A auf die neurogene Detrusorhyperaktivität bei Kindern mit neurogener Blasenfunktionsstörung. Hierzu wurden 24 Kinder (11 Mädchen, 13 Jungen; 2,5–20 (Ø 11,9 Jahre mit maximalem Detrusordruck 40 cm H2O trotz anticholinerger Medikation in die Studie eingeschlossen. Nach urodynamischer Evaluierung wurden gewichtsadaptiert 85–300 U BTX-A (Botox(R zystoskopisch an 30–40 Stellen in den M. detrusor injiziert. Urodynamische Kontrollen erfolgten nach 1, 3 und 6 Monaten. Urodynamisch fand sich ein erhöhtes Reflexvolumen nach 1 Monat um +84 %, nach 3 Monaten um +68 % und nach 6 Monaten um +23 %. Entsprechend verhielten sich die Maximalkapazitäten: +35 % (nach 1 Monat, +23 % (nach 3 Monaten und +36 % (nach 6 Monaten. Die Maximaldrücke veränderten sich im o.g. Zeitraum um –41 %, –22 % bzw. +4 %. Die korrespondierenden Veränderungen der Inkontinenzrate betrug –46 %, –15 % bzw. –13 %. Bei 5 Kindern konnte jedoch auch mit dieser Therapie keine zufriedenstellende Drucksituation sichergestellt werden; nach der daraufhin durchgeführten Blasenaugmentation fanden sich in den Blasenresektaten histomorphologisch typische BTX-A bedingte Veränderungen, die jedoch in ihrer Ausprägung keinen signifikanten Gradienten aufwiesen. Zusammenfassend läßt sich festhalten, daß es nach Botulinumtoxin-A-Injektion in den Detrusormuskel bei der Mehrzahl der Patienten zu einer ausgeprägten und therapeutisch relevanten Verbesserung sämtlicher urodynamischer Parameter bei sehr guter Verträglichkeit des Medikamentes kommt

Chondrosarcoma of right 1st rib presenting as neurogenic thoracic outlet syndrome; A 13th case report in world literature

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Ravisagar Patel

2016-07-01

Full Text Available Thoracic outlet syndrome [TOS] caused by a tumor of the rib is rare and has been reported only 12 times in the literature over the past one and one-half centuries, with the majority of cases due to osteochondroma. We report a case of chondrosarcoma of right 1st rib causing neurogenic TOS that was resected via posterolateral thoracotomy and biopsy confirmed a grade I chondrosarcoma. In the treatment of chondrosarcoma, chemotherapy and radiotherapy are less effective, and appropriate surgery is needed.

Neurogenic bowel dysfunction (NBD) translation and linguistic validation to classical Arabic.

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Mallek, A; Elleuch, M H; Ghroubi, S

2016-09-01

To translate and linguistically validate in classical Arabic; the French version of the neurogenic bowel dysfunction (NBD). Arabic translation of the NBD score was obtained by the "forward translation/backword translation" method. Patients with multiple sclerosis (MS) and spinal cord injury were included. Evaluation of intestinal and anorectal disorders was conducted by the self-administered questionnaire NBD, which was filled twice two weeks apart. An item-by-item analysis was made. The feasibility, acceptability, internal consistency using Cronbach's alpha, and test-retest repeatability by non-parametric Spearman correlation were studied. Twenty-three patients with colorectal disorders secondary to neurological disease were included, the average age was 40.79±9.16years and the sex-ratio was 1.85. The questionnaire was feasible and acceptable, no items were excluded. The spearman correlation was of 0.842. Internal consistency was judged good through the Cronbach's alpha was of 0.896. The Arabic version of NBD was reproducible and construct validity was satisfactory. The study of its responsiveness to change with a larger number of patients will be the subject of further work. 4. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

DYRK1A-mediated Cyclin D1 Degradation in Neural Stem Cells Contributes to the Neurogenic Cortical Defects in Down Syndrome

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Sònia Najas

2015-02-01

Full Text Available Alterations in cerebral cortex connectivity lead to intellectual disability and in Down syndrome, this is associated with a deficit in cortical neurons that arises during prenatal development. However, the pathogenic mechanisms that cause this deficit have not yet been defined. Here we show that the human DYRK1A kinase on chromosome 21 tightly regulates the nuclear levels of Cyclin D1 in embryonic cortical stem (radial glia cells, and that a modest increase in DYRK1A protein in transgenic embryos lengthens the G1 phase in these progenitors. These alterations promote asymmetric proliferative divisions at the expense of neurogenic divisions, producing a deficit in cortical projection neurons that persists in postnatal stages. Moreover, radial glial progenitors in the Ts65Dn mouse model of Down syndrome have less Cyclin D1, and Dyrk1a is the triplicated gene that causes both early cortical neurogenic defects and decreased nuclear Cyclin D1 levels in this model. These data provide insights into the mechanisms that couple cell cycle regulation and neuron production in cortical neural stem cells, emphasizing that the deleterious effect of DYRK1A triplication in the formation of the cerebral cortex begins at the onset of neurogenesis, which is relevant to the search for early therapeutic interventions in Down syndrome.

Neurogenic lower urinary tract dysfunction: Clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013.

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Drake, Marcus John; Apostolidis, Apostolos; Cocci, Andrea; Emmanuel, Anton; Gajewski, Jerzy B; Harrison, Simon C W; Heesakkers, John P F A; Lemack, Gary E; Madersbacher, Helmut; Panicker, Jalesh N; Radziszewski, Piotr; Sakakibara, Ryuji; Wyndaele, Jean Jacques

2016-08-01

Evidence-based guidelines for the management of neurological disease and lower urinary tract dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world-wide relevance. To update clinical management of neurogenic bladder dysfunction from the recommendations of the fourth ICI, 2009. A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and consequently amended to deliver evidence-based conclusions and recommendations in 2013. The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic lower urinary tract dysfunction. The pathophysiology is categorized according to the nature of onset of neurological disease and the part(s) of the nervous system affected. Assessment requires clinical evaluation, general investigations, and specialized testing. Treatment primarily focuses on ensuring safety of the patient and optimizing quality of life. Symptom management covers conservative and interventional measures to aid urine storage and bladder emptying, along with containment of incontinence. A multidisciplinary approach to management is essential. The review offers a pragmatic review of management in the context of complex pathophysiology and varied evidence base. Neurourol. Urodynam. 35:657-665, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Properties of doublecortin-(DCX-expressing cells in the piriform cortex compared to the neurogenic dentate gyrus of adult mice.

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Friederike Klempin

Full Text Available The piriform cortex receives input from the olfactory bulb and (via the entorhinal cortex sends efferents to the hippocampus, thereby connecting the two canonical neurogenic regions of the adult rodent brain. Doublecortin (DCX is a cytoskeleton-associated protein that is expressed transiently in the course of adult neurogenesis. Interestingly, the adult piriform cortex, which is usually considered non-neurogenic (even though some reports exist that state otherwise, also contains an abundant population of DCX-positive cells. We asked how similar these cells would be to DCX-positive cells in the course of adult hippocampal neurogenesis. Using BAC-generated transgenic mice that express GFP under the DCX promoter, we studied DCX-expression and electrophysiological properties of DCX-positive cells in the mouse piriform cortex in comparison with the dentate gyrus. While one class of cells in the piriform cortex indeed showed features similar to newly generated immature granule neurons, the majority of DCX cells in the piriform cortex was mature and revealed large Na+ currents and multiple action potentials. Furthermore, when proliferative activity was assessed, we found that all DCX-expressing cells in the piriform cortex were strictly postmitotic, suggesting that no DCX-positive "neuroblasts" exist here as they do in the dentate gyrus. We conclude that DCX in the piriform cortex marks a unique population of postmitotic neurons with a subpopulation that retains immature characteristics associated with synaptic plasticity. DCX is thus, per se, no marker of neurogenesis but might be associated more broadly with plasticity.

Evaluation of neurogenic dysphagia in Iraqi patients with acute stroke.

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Hasan, Zeki N; Al-Shimmery, Ehsan K; Taha, Mufeed A

2010-04-01

To clinically assess neurogenic dysphagia, and to correlate its presence with demographic features, different stroke risk factors, anatomical arterial territorial stroke types, and pathological stroke types. Seventy-two stroke inpatients were studied between July 2007 and February 2008, at the Departments of Medicine and Neurology at Al-Yarmouk Teaching Hospital, Baghdad, and Rizgary Teaching Hospital, Erbil, Iraq. All patients were assessed using the Mann Assessment of Swallowing Ability score (MASA), Modified Rankin Scale, and the Stroke Risk Scorecard. All patients were reassessed after one month. There were 40 males and 32 females. Sixty-eight patients had ischemic stroke, and 4 had primary intracerebral hemorrhage (ICH). According to the MASA score, 55% of anterior circulation stroke (ACS) cases were associated with dysphasia, and 91% of lateral medullary syndrome cases were associated with dysphagia. Fifty-six percent of ACS dysphagic cases improved within the first month. Forty percent of dysphagic patients died in the one month follow up period, and in most, death was caused by aspiration pneumonia. We observed no significant differences regarding demographic features of dysphagia. Dysphagia can be an indicator of the severity of stroke causing higher mortality and morbidity in affected patients. It was not related to the stroke risk factors and the type of stroke. It is essential from a prognostic point of view to assess swallowing, and to treat its complications early.

Viscossuplementação em pacientes com artropatia hemofílica Viscosupplementation in patients with hemophilic arthropathy

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Flávio Zelada

2013-02-01

Full Text Available OBJETIVO: Avaliar se a viscossuplementação com ácido hialurônico em pacientes com artropatia hemofílica grave associada com triancinolona após a lavagem articular com soro fisiológico melhora a dor, a rigidez, a função e a qualidade de vida. MÉTODOS: Onze pacientes com artrite hemofílica de joelhos com e sem acometimento de outras articulações (tornozelos e cotovelos foram submetidos a lavagem articular com soro fisiológico e subsequente infiltração de hilano e triancinolona em todas as articulações acometidas. Responderam os questionários algo-funcionais (WOMAC e Lequesne, escala analógica visual para dor (VAS e SF-36, no pré-operatório, e com um e três meses de pós-operatório. RESULTADOS: A dor (VAS e WOMAC dor e a rigidez (WOMAC rigidez não apresentaram melhora significativa (p=0,3; p=0,2; p=0,1, respectivamente. Porém a função apresentou uma melhora significativa dada pelo WOMAC função e total (11 pontos em média, p=0,04 e p=0,001, respectivamente. A pontuação no questionário de Lequesne não variou significativamente (p=0,1. Porém tantos os componentes mental como físico do SF 36 tiveram melhoras clinicamente relevantes e significativas (p=0,002. CONCLUSÃO: A lavagem articular com soro fisiológico seguida pela infiltração de corticosteroide e hilano é efetiva no tratamento da artropatia hemofílica, sobretudo na melhora funcional e na qualidade de vida. Nível de Evidência IV, Série de casos.OBJECTIVE: To assess whether viscosupplementation with hyaluronic acid in patients with severe hemophilic arthropathy associated with triamcinolone after washing with saline improves joint pain, stiffness, function and quality of life. METHODS: Eleven patients with hemophilic arthritis of the knee with and without involvement of other joints (elbows and ankles underwent joint lavage with saline and subsequent injection of Hylan and triamcinolone in all affected joints. The patients answered the algo

Efficacy and Safety of Tamsulosin for the Treatment of Non-neurogenic Voiding Dysfunction in Females: A 8-Week Prospective Study

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Lee, Kyu-Sung; Han, Deok Hyun; Lee, Young-Suk; Choo, Myung-Soo; Yoo, Tag Keun; Park, Heung Jae; Yoon, Hana; Jeong, Hyeon; Lee, Sun Ju; Kim, Hayoung

2010-01-01

We evaluated the therapeutic effects of tamsulosin for women with non-neurogenic voiding dysfunction. Women who had voiding dysfunctions for at least 3 months were included. Inclusion criteria were age ≥18 yr, International Prostate Symptom Score (IPSS) of ≥15, and maximum flow rate (Qmax) of ≥12 mL/sec and/or postvoid residuals (PVR) of ≥150 mL. Patients with neurogenic voiding dysfunction or anatomical bladder outlet obstruction were excluded. All patients were classified according to the Blaivas-Groutz nomogram as having no or mild obstruction (group A) or moderate or severe obstruction (group B). After 8 weeks of treatment, treatment outcomes and adverse effects were evaluated. One hundred and six patients were evaluable (70 in group A, 36 in group B). After treatments, mean IPSS, bother scores, Qmax, PVR, diurnal and nocturnal micturition frequencies and scored form of the Bristol Female Lower Urinary Tract Symptoms questionnaire (BFLUTS-SF) were changed significantly. Eighty-nine patients (84%) reported that the treatment was beneficial. The proportion of patients reported that their bladder symptoms caused "moderate to many severe problems" were significantly decreased. No significant difference were observed between the groups in terms of IPSS, bother score, Qmax, PVR, micturition frequency, and BFLUTS-SF changes. Adverse effects related to medication were dizziness (n=3), de novo stress urinary incontinence (SUI) (n=3), aggravation of underlying SUI (n=1), fatigue (n=1). Tamsulosin was found to be effective in female patients with voiding dysfunction regardless of obstruction grade. PMID:20052356

Conversion of MyoD to a Neurogenic Factor: Binding Site Specificity Determines Lineage

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Abraham P. Fong

2015-03-01

Full Text Available MyoD and NeuroD2, master regulators of myogenesis and neurogenesis, bind to a “shared” E-box sequence (CAGCTG and a “private” sequence (CAGGTG or CAGATG, respectively. To determine whether private-site recognition is sufficient to confer lineage specification, we generated a MyoD mutant with the DNA-binding specificity of NeuroD2. This chimeric mutant gained binding to NeuroD2 private sites but maintained binding to a subset of MyoD-specific sites, activating part of both the muscle and neuronal programs. Sequence analysis revealed an enrichment for PBX/MEIS motifs at the subset of MyoD-specific sites bound by the chimera, and point mutations that prevent MyoD interaction with PBX/MEIS converted the chimera to a pure neurogenic factor. Therefore, redirecting MyoD binding from MyoD private sites to NeuroD2 private sites, despite preserved binding to the MyoD/NeuroD2 shared sites, is sufficient to change MyoD from a master regulator of myogenesis to a master regulator of neurogenesis.

Aspiration in children and adolescents with neurogenic dysphagia: comparison of clinical judgment and fiberoptic endoscopic evaluation of swallowing.

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Beer, Sabrina; Hartlieb, Till; Müller, Arnd; Granel, Michael; Staudt, Martin

2014-12-01

A total of 30 children and adolescents with dysphagia due to various chronic neurological disorders were assessed for their risk of aspiration. This assessment was performed clinically by experienced speech and swallowing therapists, and verified thereafter by fiberoptic endoscopy. We found the clinical judgment to be correct in only 70% (for aspiration of saliva), 55% (of puree), and 67% (of thin liquids). We conclude that, because of this unacceptably high error rate of clinical assessment, a fiberoptic evaluation of swallowing is a necessary diagnostic step both for the planning of therapy and for the development of feeding strategies in children and adolescents with neurogenic dysphagia. Georg Thieme Verlag KG Stuttgart · New York.

Serum Biomarkers for Discrimination between Hepatitis C-Related Arthropathy and Early Rheumatoid Arthritis.

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Siloşi, Isabela; Boldeanu, Lidia; Biciuşcă, Viorel; Bogdan, Maria; Avramescu, Carmen; Taisescu, Citto; Padureanu, Vlad; Boldeanu, Mihail Virgil; Dricu, Anica; Siloşi, Cristian Adrian

2017-06-19

In the present study, we aimed to estimate the concentrations of cytokines (interleukin 6, IL-6, tumor necrosis factor-α, TNF-α) and auto-antibodies (rheumatoid factor IgM isotype, IgM-RF, antinuclear auto-antibodies, ANA, anti-cyclic citrullinated peptide antibodies IgG isotype, IgG anti-CCP3.1, anti-cardiolipin IgG isotype, IgG anti-aCL) in serum of patients with eRA (early rheumatoid arthritis) and HCVrA (hepatitis C virus-related arthropathy) and to assess the utility of IL-6, TNF-α together with IgG anti-CCP and IgM-RF in distinguishing between patients with true eRA and HCVrA, in the idea of using them as differential immunomarkers. Serum samples were collected from 54 patients (30 diagnosed with eRA-subgroup 1 and 24 with HCVrA-subgroup 2) and from 28 healthy control persons. For the evaluation of serum concentrations of studied cytokines and auto-antibodies, we used immunoenzimatique techniques. The serum concentrations of both proinflammatory cytokines were statistically significantly higher in patients of subgroup 1 and subgroup 2, compared to the control group ( p < 0.0001). Our study showed statistically significant differences of the mean concentrations only for ANA and IgG anti-CCP between subgroup 1 and subgroup 2. We also observed that IL-6 and TNF-α better correlated with auto-antibodies in subgroup 1 than in subgroup 2. In both subgroups of patients, ROC curves indicated that IL-6 and TNF-α have a higher diagnostic utility as markers of disease. In conclusion, we can say that, due to high sensitivity for diagnostic accuracy, determination of serum concentrations of IL-6 and TNF-α, possibly in combination with auto-antibodies, could be useful in the diagnosis and distinguishing between patients with true eRA and HCV patients with articular manifestation and may prove useful in the monitoring of the disease course.

Fertility, pregnancy planning, and pharmacotherapy during the pregnancy, postpartum and breastfeeding period in patients with rheumatoid arthritis and other inflammatory arthropathies

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Marzena Olesińska

2014-03-01

Full Text Available The peak in incidence of the majority of inflammatory arthropathies (IAs is observed in the 2 nd –4 th decades of life. Thus the diseases affect patients at reproductive age. The results of population studies have demonstrated that these diseases can exert effects on the fertility of the patients, family planning, course of pregnancy and further development of the baby. It has also been shown that female patients with IAs, compared with healthy women, less frequently decide to have the first and other babies and the interval between successive pregnancies is longer. The aim of pharmacotherapy in a patient with IA who plans to become pregnant is to effectively inhibit the inflammatory activity and to maintain remission/low activity of the disease during pregnancy and after its termination. Disease-modifying drugs suitable for administration in the preconception period and pregnancy include: chloroquine, hydroxychloroquine, sulfasalazine, azathioprine, ciclosporin A, glucocorticosteroids and non-steroidal anti-inflammatory drugs. The following should not be administered: out of the synthetic disease-modifying drugs – methotrexate, leflunomide, cyclophosphamide and mycophenolate mofetil; and out of biological drugs – abatacept, tocilizumab and rituximab.

The Felix-trial. Double-blind randomization of interspinous implant or bony decompression for treatment of spinal stenosis related intermittent neurogenic claudication

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Brand Ronald

2010-05-01

Full Text Available Abstract Background Decompressive laminotomy is the standard surgical procedure in the treatment of patients with canal stenosis related intermittent neurogenic claudication. New techniques, such as interspinous process implants, claim a shorter hospital stay, less post-operative pain and equal long-term functional outcome. A comparative (cost- effectiveness study has not been performed yet. This protocol describes the design of a randomized controlled trial (RCT on (cost- effectiveness of the use of interspinous process implants versus conventional decompression surgery in patients with lumbar spinal stenosis. Methods/Design Patients (age 40-85 presenting with intermittent neurogenic claudication due to lumbar spinal stenosis lasting more than 3 months refractory to conservative treatment, are included. Randomization into interspinous implant surgery versus bony decompression surgery will take place in the operating room after induction of anesthesia. The primary outcome measure is the functional assessment of the patient measured by the Zurich Claudication Questionnaire (ZCQ, at 8 weeks and 1 year after surgery. Other outcome parameters include perceived recovery, leg and back pain, incidence of re-operations, complications, quality of life, medical consumption, absenteeism and costs. The study is a randomized multi-institutional trial, in which two surgical techniques are compared in a parallel group design. Patients and research nurses are kept blinded of the allocated treatment during the follow-up period of 1 year. Discussion Currently decompressive laminotomy is the golden standard in the surgical treatment of lumbar spinal stenosis. Whether surgery with interspinous implants is a reasonable alternative can be determined by this trial. Trial register Dutch Trial register number: NTR1307

Application of transpulmonary thermodilution monitoring (PiCCO) in patient with neurogenic pulmonary edema and acute obstructive hydrocephalus due to a central neurocytoma: A case report

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Ryoichi Iwata; Kunikazu Yoshimura; Yoko Fujita; Tatsuo Uesaka; Hideyuki Oshige; Akio Asai

2017-01-01

Neurogenic pulmonary edema (NPE) is an acute life-threatening complication associated with many forms of central nervous system injury. Its pathophysiology is still debated. We report a patient with acute obstructive hydrocephalus due to a central neurocytoma who also had NPE, for which serial transpulmonary thermodilution monitoring (PiCCO) was performed. Insertion of the PiCCO, which provides information about the patient's cardiac output, preload status and amount of lung water, revealed a...

Women's experiences of living with neurogenic bladder and bowel after spinal cord injury: life controlled by bladder and bowel.

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Nevedal, Andrea; Kratz, Anna L; Tate, Denise G

2016-01-01

Neurogenic bladder and bowel (NBB) is a chronic condition hindering the functioning and quality of life (QOL) of people with spinal cord injury (SCI). NBB research has focused on men with SCI leaving unanswered questions about women's experiences of living with NBB. The purpose of this study was to identify and describe women's experiences of living with SCI and NBB. Secondary analysis of semi-structured interviews from a larger qualitative study of women with SCI (N = 50) was carried out. Transcripts were coded for bowel and bladder content. Pile-sorting techniques were used to identify emergent themes related to NBB. Meta-themes were categorized under the International Classification of Functioning, Disability and Health. Bladder and bowel topics were spontaneously discussed by 46 out of 50 study participants suggesting the salience of this issue for women with SCI. We identified 6 meta-themes: life controlled by bladder and bowel, bladder and bowel accidents, women's specific challenges, life course disruption, bladder and bowel medical management, and finding independence. Findings describe concerns, strategies, and the detrimental impact of NBB in the lives of women with SCI. Findings inform policy makers, health care and rehabilitation professionals to improve accessibility and quality of life for women with NBB. Women with spinal cord injury (SCI) reported gender specific challenges to living with neurogenic bladder and bowel (NBB). Interventions designed for women with SCI can address these problems and provide recommendations for prevention and treatment. Women described the detrimental impact of NBB on life course expectations, emotional, social, physical health, and quality of life domains. Psychosocial and educational programs can be developed to address these challenges and improve overall quality of life. Recommendations for special treatment and policy considerations are needed to maximize women's independence and health while living with NBB

Midbrain dopamine neurons associated with reward processing innervate the neurogenic subventricular zone.

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Lennington, Jessica B; Pope, Sara; Goodheart, Anna E; Drozdowicz, Linda; Daniels, Stephen B; Salamone, John D; Conover, Joanne C

2011-09-14

Coordinated regulation of the adult neurogenic subventricular zone (SVZ) is accomplished by a myriad of intrinsic and extrinsic factors. The neurotransmitter dopamine is one regulatory molecule implicated in SVZ function. Nigrostriatal and ventral tegmental area (VTA) midbrain dopamine neurons innervate regions adjacent to the SVZ, and dopamine synapses are found on SVZ cells. Cell division within the SVZ is decreased in humans with Parkinson's disease and in animal models of Parkinson's disease following exposure to toxins that selectively remove nigrostriatal neurons, suggesting that dopamine is critical for SVZ function and nigrostriatal neurons are the main suppliers of SVZ dopamine. However, when we examined the aphakia mouse, which is deficient in nigrostriatal neurons, we found no detrimental effect to SVZ proliferation or organization. Instead, dopamine innervation of the SVZ tracked to neurons at the ventrolateral boundary of the VTA. This same dopaminergic neuron population also innervated the SVZ of control mice. Characterization of these neurons revealed expression of proteins indicative of VTA neurons. Furthermore, exposure to the neurotoxin MPTP depleted neurons in the ventrolateral VTA and resulted in decreased SVZ proliferation. Together, these results reveal that dopamine signaling in the SVZ originates from a population of midbrain neurons more typically associated with motivational and reward processing.

Intra-articular injection of Botulinum toxin A reduces neurogenic inflammation in CFA-induced arthritic rat model.

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Wang, Lin; Wang, Kaile; Chu, Xiao; Li, Tieshan; Shen, Nana; Fan, Chenglei; Niu, Zhenyuan; Zhang, Xiaochen; Hu, Luoman

2017-02-01

Currently, administration of Botulinum toxin Type A (BoNT/A) to treat arthritic pain has promising efficacy in clinical research. However, the mechanisms underlying anti-neurogenic inflammation mediated by BoNT/A remains unclear. The aim of this study was to demonstrate the effectiveness in macro and micro levels and to explore the causal mechanism of BoNT/A. Wistar rats (n = 60) were injected with 50ul complete Freund's adjuvant (CFA) in the left ankle joint capsule to establish a model of chronic monoarthritis. Pain behaviour (Evoked pain assessment) and infrared thermal imaging testing were performed at the macroscopic level to assess the effectiveness of analgesia and anti-inflammation. Western blotting and immunofluorescence staining were used at the microscopic level in an attempt to determine the mechanisms of anti-nociceptive or anti-inflammatory effects of BoNT/A. Additionally, hematoxylin-eosin staining was also used to visualise the cartilage and the synovial degenerative conditions of arthritis. By comparing the outcome of the evoked pain test and immunofluorescence staining, there was a significant improvement in BoNT/A compared with the normal saline (NS) injected control group. In addition, thermal variations showed that the temperature of ipsilateral ankle joint increased between 1 and 2 weeks following injection of CFA, but decreased after 3 weeks (still above the contralateral side). However, the temperature showed no difference between the BoNT/A group and NS group after treatment. The expression of IL-1β or TNF-α in the ankle synovial tissue was significantly decreased in the BoNT/A group compared to the NS group (p < 0.05). Based on the HE assessment, cartilage degeneration and infiltration of inflammatory cells in the BoNT/A group was alleviated compared to the NS group after treatment. In conclusion, we proposed the hypothesis that intra-articular BoNT/A administration does play an important role in anti-neurogenic inflammation. The

The nuclear receptor TLX is required for gliomagenesis within the adult neurogenic niche.

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Zou, Yuhua; Niu, Wenze; Qin, Song; Downes, Michael; Burns, Dennis K; Zhang, Chun-Li

2012-12-01

Neural stem cells (NSCs) continually generate functional neurons in the adult brain. Due to their ability to proliferate, deregulated NSCs or their progenitors have been proposed as the cells of origin for a number of primary central nervous system neoplasms, including infiltrating gliomas. The orphan nuclear receptor TLX is required for proliferation of adult NSCs, and its upregulation promotes brain tumor formation. However, it is unknown whether TLX is required for gliomagenesis. We examined the genetic interactions between TLX and several tumor suppressors, as well as the role of TLX-dependent NSCs during gliomagenesis, using mouse models. Here, we show that TLX is essential for the proliferation of adult NSCs with a single deletion of p21, p53, or Pten or combined deletion of Pten and p53. While brain tumors still form in Tlx mutant mice, these tumors are less infiltrative and rarely associate with the adult neurogenic niches, suggesting a non-stem-cell origin. Taken together, these results indicate a critical role for TLX in NSC-dependent gliomagenesis and implicate TLX as a therapeutic target to inhibit the development of NSC-derived brain tumors.

Human dental pulp stem cells with highly angiogenic and neurogenic potential for possible use in pulp regeneration.

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Nakashima, Misako; Iohara, Koichiro; Sugiyama, Masahiko

2009-01-01

Dental caries is a common public health problem, causing early loss of dental pulp and resultant tooth loss. Dental pulp has important functions to sustain teeth providing nutrient and oxygen supply, innervation, reactionary/reparative dentin formation and immune response. Regeneration of pulp is an unmet need in endodontic therapy, and angiogenesis/vasculogenesis and neurogenesis are critical for pulp regeneration. Permanent and deciduous pulp tissue is easily available from teeth after extraction without ethical issues and has potential for clinical use. In this review, we introduce some stem cell subfractions, CD31(-)/CD146(-) SP cells and CD105(+) cells with high angiogenic and neurogenic potential, derived from human adult dental pulp tissue. Potential utility of these cells is addressed as a source of cells for treatment of cerebral and limb ischemia and pulp inflammation complete with angiogenesis and vasculogenesis.

Hemorrhagic onset of hemangioblastoma located in the dorsal medulla oblongata presenting with tako-tsubo cardiomyopathy and neurogenic pulmonary edema: a case report.

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Gekka, Masayuki; Yamaguchi, Shigeru; Kazumata, Ken; Kobayashi, Hiroyuki; Motegi, Hiroaki; Terasaka, Shunsuke; Houkin, Kiyohiro

2014-01-01

Here, we present a case of dorsal medulla oblongata hemangioblastoma with fourth ventricular hemorrhage. A 23-year-old female developed sudden consciousness disturbance, and CT revealed hemorrhage in all cerebral ventricles and a hyperdense mass in the cisterna magna. Although the reddish tumor located in the dorsal medulla oblongata was successfully removed, she suffered from severe tako-tsubo cardiomyopathy (TTC) and neurogenic pulmonary edema (NPE) because of baroreflex failure and damage to the solitary tract nuclei. After intensive care for 12 weeks following surgery, she was discharged without any neurological or radiological deficits. Pathogenesis of TTC/NPE is discussed in this paper.

Resultados do tratamento cirúrgico da artropatia degenerativa do manguito rotador utilizando hemiartroplastia-CTA® Results of surgical treatment of denerative arthropathy of the rotator cuff using hemiarthroplasty-CTA®

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Rômulo Brasil Filho

2012-02-01

Full Text Available OBJETIVO: Avaliar os resultados da artroplastia parcial de ombro tipo CTA® para o tratamento da artropatia degenerativa do manguito. MÉTODOS: De dezembro de 2006 a junho de 2009, 23 ombros de 23 pacientes foram submetidos à artroplastia parcial tipo CTA® para o tratamento de artropatia por lesão do manguito rotador. O tempo de seguimento pós-operatório variou de seis a 35 meses. A idade média foi de 74,1 anos. Houve predomínio do sexo feminino em 78,3% dos casos. O membro direito foi acometido em 18 pacientes. Todos os pacientes foram submetidos, sem melhora dos sintomas, ao tratamento fisioterápico prévio por pelo menos seis meses e foram submetidos à cirurgia pela mesma equipe cirúrgica. Nenhum dos pacientes havia realizado cirurgia prévia no ombro afetado. A avaliação dos pacientes no seguimento pós-operatório seguiu os critérios do escore da UCLA. RESULTADOS: Verificou-se melhora da dor em todos pacientes após a artroplastia. Pelo escore da UCLA, a média de pontos em relação à dor foi de 9,22 (variando de 10 a oito. Quanto à função, a média foi de seis (10 a dois. Encontramos nesses pacientes média de 2,39 na flexão frontal ativa (quatro a zero. Na força de flexão frontal a média foi de 4,09 com máxima de cinco e mínima de três. A média de pontos do escore da UCLA foi de 26,52. Noventa e cinco porcento dos pacientes ficaram satisfeitos com a cirurgia. CONCLUSÃO: A artroplastia parcial de ombro tipo CTA® tem resultados satisfatórios no tratamento da artropatia degenerativa do manguito rotador e apresenta baixa taxa de complicação.OBJECTIVE: To assess results of CTA® partial shoulder arthroplasty for treatment of degenerative arthropathy of the rotator cuff. METHODS: Between December 2006 and June 2009, 23 shoulders of 23 patients were submitted to CTA® type partial shoulder arthroplasty for treatment of arthropathy secondary to rotator cuff injury. Post-operative follow up time ranged from 6 to 35

Effects of Physiotherapy in the Treatment of Neurogenic Bladder in Patients Infected With Human T-Lymphotropic Virus 1.

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Andrade, Rosana C P; Neto, José A; Andrade, Luciana; Oliveira, Tatiane S; Santos, Dislene N; Oliveira, Cassius J V; Prado, Márcio J; Carvalho, Edgar M

2016-03-01

To evaluate the efficacy of physiotherapy for urinary manifestations in patients with human T-lymphotropic virus 1-associated lower urinary tract dysfunction. Open clinical trial was conducted with 21 patients attending the physiotherapy clinic of the Hospital Universitário, Bahia, Brazil. Combinations of behavioral therapy, perineal exercises, and intravaginal or intra-anal electrical stimulation were used. The mean age was 54 ± 12 years and 67% were female. After treatment, there was an improvement in symptoms of urinary urgency, frequency, incontinence, nocturia, and in the sensation of incomplete emptying (P Physiotherapy was effective in cases of human T-lymphotropic virus 1-associated neurogenic bladder, reducing symptoms, increasing perineal muscle strength, and improving urodynamic parameters and quality of life. Copyright © 2016 Elsevier Inc. All rights reserved.

Effects of Physiotherapy in the Treatment of Neurogenic Bladder in Patients Infected with Human T-Lymphotropic Virus 1 (HTLV-1)

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Andrade, Rosana C.P.; Neto, José A.; Andrade, Luciana; Oliveira, Tatiane S. S.; Santos, Dislene N.; Oliveira, Cassius J.V.; Prado, Márcio J.; Carvalho, Edgar M.

2016-01-01

Objective To evaluate the efficacy of physiotherapy for urinary manifestations in patients with HTLV-1-associated lower urinary tract dysfunction. Methods Open clinical trial with 21 patients attending the physiotherapy clinic of the Hospital Universitário, Bahia, Brazil. Combinations of behavioral therapy, perineal exercises and intravaginal/intra-anal electrical stimulation were used. Results The mean age was 54±12 years and 67% were female. After treatment, there was an improvement in symptoms of urinary urgency, frequency, incontinence, nocturia and in the sensation of incomplete emptying (pPhysiotherapy was effective in cases of HTLV-1-associated neurogenic bladder, reducing symptoms, increasing perineal muscle strength, improving urodynamic parameters and quality of life. PMID:26724409

Cytoarchitecture and ultrastructure of neural stem cell niches and neurogenic complexes maintaining adult neurogenesis in the olfactory midbrain of spiny lobsters, Panulirus argus.

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Schmidt, Manfred; Derby, Charles D

2011-08-15

New interneurons are continuously generated in small proliferation zones within neuronal somata clusters in the olfactory deutocerebrum of adult decapod crustaceans. Each proliferation zone is connected to a clump of cells containing one neural stem cell (i.e., adult neuroblast), thus forming a "neurogenic complex." Here we provide a detailed analysis of the cytoarchitecture of neurogenic complexes in adult spiny lobsters, Panulirus argus, based on transmission electron microscopy and labeling with cell-type-selective markers. The clump of cells is composed of unique bipolar clump-forming cells that collectively completely envelop the adult neuroblast and are themselves ensheathed by a layer of processes of multipolar cell body glia. An arteriole is attached to the clump of cells, but dye perfusion experiments show that hemolymph has no access to the interior of the clump of cells. Thus, the clump of cells fulfills morphological criteria of a protective stem cell niche, with clump-forming cells constituting the adult neuroblast's microenvironment together with the cell body glia processes separating it from other tissue components. Bromodeoxyuridine pulse-chase experiments with short survival times suggest that adult neuroblasts are not quiescent but rather cycle actively during daytime. We propose a cell lineage model in which an asymmetrically dividing adult neuroblast repopulates the pool of neuronal progenitor cells in the associated proliferation zone. In conclusion, as in mammalian brains, adult neurogenesis in crustacean brains is fueled by neural stem cells that are maintained by stem cell niches that preserve elements of the embryonic microenvironment and contain glial and vascular elements. Copyright © 2011 Wiley-Liss, Inc.

Systemic application of rhenium-186 hydroxyethylidenediphosphonate ({sup 186}Re HEDP) as an option for the treatment of chronic arthritis and arthropathy[Radiosynoviorthesis]; Systemische Applikation von Rhenium-186 Hydroxyethylidendiphosphonat ({sup 186}Re HEDP) als Therapieoption bei chronischen Arthritiden und Arthropathien

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Bucerius, J.; Biersack, H.J.; Palmedo, H. [Klinik und Poliklinik fuer Nuklearmedizin, Universitaetsklinikum Bonn (Germany); Wallny, T. [Orthopaedische Klinik l, Klinik fuer Orthopaedische Chirurgie, St. Bernhard-Hospital Kamp-Lintfort (Germany); Klinik und Poliklinik fuer Orthopaedie, Universitaetsklinikum Bonn (Germany); Brackmann, H.H. [Inst. fuer experimentelle Haematologie und Transfusionsmedizin, Universitaetsklinikum Bonn (Germany)

2006-03-15

Chronic arthritis is very common and is associated with a variety of systemic diseases whereas hemophilic arthropathy is one of the most common clinical manifestations of hemophilia, mainly of hemophilia type A. All of these polyarticular diseases are associated with progressive pain and increasing lack of mobility. Therapy is based on conservative treatment such as medication with non-steroidal anti-inflammatory drugs, selective therapy strategies such as intraarticular injections of e.g. radioactive substances (radiosynoviorthesis) or surgical interventions. However, in some cases, the disease does not respond to one of these treatment options or cannot be continued due to important side-effects. Systemic application of radioisotopes like {sup 186}Re HEDP has been successfully administered for pain palliation of osseous metastases. Today, only few data exist for systemic therapy with {sup 186}Re HEDP in patients suffering from benign polyarticular disease. In a prospective study with patients suffering from chronic arthritis a single systemic application of {sup 186}Re HEDP led to a reduction of disease activity in six of eight and to a reduction of the number of painful or swollen joints in five of eight included patients. In a further prospective study with 12 patients with hemophilic arthropathy, 19 of 36 (52.7%) most painful joints could be successfully treated with one systemic {sup 186}Re HEDP therapy. Furthermore, a reduction of global pain could be observed in those patients. However, further randomized studies with larger study populations are necessary in order to confirm this promising results. (orig.)

Regionally-specified second trimester fetal neural stem cells reveals differential neurogenic programming.

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Yiping Fan

Full Text Available Neural stem/progenitor cells (NSC have the potential for treatment of a wide range of neurological diseases such as Parkinson Disease and multiple sclerosis. Currently, NSC have been isolated only from hippocampus and subventricular zone (SVZ of the adult brain. It is not known whether NSC can be found in all parts of the developing mid-trimester central nervous system (CNS when the brain undergoes massive transformation and growth. Multipotent NSC from the mid-trimester cerebra, thalamus, SVZ, hippocampus, thalamus, cerebellum, brain stem and spinal cord can be derived and propagated as clonal neurospheres with increasing frequencies with increasing gestations. These NSC can undergo multi-lineage differentiation both in vitro and in vivo, and engraft in a developmental murine model. Regionally-derived NSC are phenotypically distinct, with hippocampal NSC having a significantly higher neurogenic potential (53.6% over other sources (range of 0%-27.5%, p<0.004. Whole genome expression analysis showed differential gene expression between these regionally-derived NSC, which involved the Notch, epidermal growth factor as well as interleukin pathways. We have shown the presence of phenotypically-distinct regionally-derived NSC from the mid-trimester CNS, which may reflect the ontological differences occurring within the CNS. Aside from informing on the role of such cells during fetal growth, they may be useful for different cellular therapy applications.

Whole-tumor apparent diffusion coefficient (ADC) histogram analysis to differentiate benign peripheral neurogenic tumors from soft tissue sarcomas.

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Nakajo, Masanori; Fukukura, Yoshihiko; Hakamada, Hiroto; Yoneyama, Tomohide; Kamimura, Kiyohisa; Nagano, Satoshi; Nakajo, Masayuki; Yoshiura, Takashi

2018-02-22

Apparent diffusion coefficient (ADC) histogram analyses have been used to differentiate tumor grades and predict therapeutic responses in various anatomic sites with moderate success. To determine the ability of diffusion-weighted imaging (DWI) with a whole-tumor ADC histogram analysis to differentiate benign peripheral neurogenic tumors (BPNTs) from soft tissue sarcomas (STSs). Retrospective study, single institution. In all, 25 BPNTs and 31 STSs. Two-b value DWI (b-values = 0, 1000s/mm 2 ) was at 3.0T. The histogram parameters of whole-tumor for ADC were calculated by two radiologists and compared between BPNTs and STSs. Nonparametric tests were performed for comparisons between BPNTs and STSs. P histogram parameters except kurtosis and entropy differed significantly between BPNTs and STSs. 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018. © 2018 International Society for Magnetic Resonance in Medicine.

Hemorrhagic Onset of Hemangioblastoma Located in the Dorsal Medulla Oblongata Presenting with Tako-Tsubo Cardiomyopathy and Neurogenic Pulmonary Edema: A Case Report

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Masayuki Gekka

2014-03-01

Full Text Available Here, we present a case of dorsal medulla oblongata hemangioblastoma with fourth ventricular hemorrhage. A 23-year-old female developed sudden consciousness disturbance, and CT revealed hemorrhage in all cerebral ventricles and a hyperdense mass in the cisterna magna. Although the reddish tumor located in the dorsal medulla oblongata was successfully removed, she suffered from severe tako-tsubo cardiomyopathy (TTC and neurogenic pulmonary edema (NPE because of baroreflex failure and damage to the solitary tract nuclei. After intensive care for 12 weeks following surgery, she was discharged without any neurological or radiological deficits. Pathogenesis of TTC/NPE is discussed in this paper.

Reverse Total Shoulder Arthroplasty as Treatment for Rotator Cuff-Tear Arthropathy and Shoulder Dislocations in an Elderly Male with Parkinson’s Disease

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John G. Skedros

2017-01-01

Full Text Available We report the case of a 70-year-old male with Parkinson’s disease (PD and recurrent traumatic left shoulder dislocations. This case is rare because (1 he had a massive irreparable rotator cuff tear and end-stage arthritis (i.e., rotator cuff-tear arthropathy of the same shoulder and (2 his shoulder was ultimately reconstructed with a reverse total shoulder arthroplasty (RTSA. His first dislocation occurred after a fall. Recurrent shoulder dislocations occurred despite successful closed reduction and physical therapy. Initial surgical treatment included an open capsular-labral reconstruction; RTSA was not an ideal option because of the presumed risk of failure from PD-related dyskinesias. However, the capsular-labral reconstruction failed after he lost balance and stumbled but did not fall. A RTSA was then done which restored the patient’s shoulder stability and greatly improved his pain. At final follow-up two years later, he reported pain relief and improved function. This was partially attributed to the fact that he had moved to an assisted living center. He also began using an electric wheelchair one year after the RTSA. We report this case because of the unusual set of conditions and circumstances, namely, the implantation of a RTSA in a patient with PD and shoulder instability.

Feline dry eye syndrome of presumed neurogenic origin: a case report

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Lionel Sebbag

2017-12-01

Full Text Available Case summary A 14-year-old female spayed Abyssinian cat, which about 1 year previously underwent thoracic limb amputation, radiotherapy and chemotherapy for an incompletely excised vaccine-related fibrosarcoma, was presented for evaluation of corneal opacity in the left eye (OS. The ocular surface of both eyes (OU had a lackluster appearance and there was a stromal corneal ulcer OS. Results of corneal aesthesiometry, Schirmer tear test-1 (STT-1 and tear film breakup time revealed corneal hypoesthesia, and quantitative and qualitative tear film deficiency OU. Noxious olfactory stimulation caused increased lacrimation relative to standard STT-1 values suggesting an intact nasolacrimal reflex. Various lacrimostimulants were administered in succession; namely, 1% pilocarpine administered topically (15 days or orally (19 days, and topically applied 0.03% tacrolimus (47 days. Pilocarpine, especially when given orally, was associated with notable increases in STT-1 values, but corneal ulceration remained/recurred regardless of administration route, and oral pilocarpine resulted in gastrointestinal upset. Tacrolimus was not effective. After 93 days, the cat became weak and lame and a low thyroxine concentration was detected in serum. The cat was euthanized and a necropsy performed. Both lacrimal glands were histologically normal, but chronic neutrophilic keratitis and reduced conjunctival goblet cell density were noted OU. Relevance and novel information The final diagnosis was dry eye syndrome (DES of presumed neurogenic origin, associated with corneal hypoesthesia. This report reinforces the importance of conducting tearfilm testing in cats with ocular surface disease, as clinical signs of DES were different from those described in dogs.

Feline dry eye syndrome of presumed neurogenic origin: a case report.

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Sebbag, Lionel; Pesavento, Patricia A; Carrasco, Sebastian E; Reilly, Christopher M; Maggs, David J

2018-01-01

A 14-year-old female spayed Abyssinian cat, which about 1 year previously underwent thoracic limb amputation, radiotherapy and chemotherapy for an incompletely excised vaccine-related fibrosarcoma, was presented for evaluation of corneal opacity in the left eye (OS). The ocular surface of both eyes (OU) had a lackluster appearance and there was a stromal corneal ulcer OS. Results of corneal aesthesiometry, Schirmer tear test-1 (STT-1) and tear film breakup time revealed corneal hypoesthesia, and quantitative and qualitative tear film deficiency OU. Noxious olfactory stimulation caused increased lacrimation relative to standard STT-1 values suggesting an intact nasolacrimal reflex. Various lacrimostimulants were administered in succession; namely, 1% pilocarpine administered topically (15 days) or orally (19 days), and topically applied 0.03% tacrolimus (47 days). Pilocarpine, especially when given orally, was associated with notable increases in STT-1 values, but corneal ulceration remained/recurred regardless of administration route, and oral pilocarpine resulted in gastrointestinal upset. Tacrolimus was not effective. After 93 days, the cat became weak and lame and a low thyroxine concentration was detected in serum. The cat was euthanized and a necropsy performed. Both lacrimal glands were histologically normal, but chronic neutrophilic keratitis and reduced conjunctival goblet cell density were noted OU. The final diagnosis was dry eye syndrome (DES) of presumed neurogenic origin, associated with corneal hypoesthesia. This report reinforces the importance of conducting tearfilm testing in cats with ocular surface disease, as clinical signs of DES were different from those described in dogs.

Overexpression of tissue-nonspecific alkaline phosphatase increases the expression of neurogenic differentiation markers in the human SH-SY5Y neuroblastoma cell line.

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Graser, Stephanie; Mentrup, Birgit; Schneider, Doris; Klein-Hitpass, Ludger; Jakob, Franz; Hofmann, Christine

2015-10-01

Patients suffering from the rare hereditary disease hypophosphatasia (HPP), which is based on mutations in the ALPL gene, tend to develop central nervous system (CNS) related issues like epileptic seizures and neuropsychiatric illnesses such as anxiety and depression, in addition to well-known problems with the mineralization of bones and teeth. Analyses of the molecular role of tissue-nonspecific alkaline phosphatase (TNAP) in transgenic SH-SY5Y(TNAPhigh) neuroblastoma cells compared to SH-SY5Y(TNAPlow) cells indicate that the enzyme influences the expression levels of neuronal marker genes like RNA-binding protein, fox-1 homolog 3 (NEUN) and enolase 2, gamma neuronal (NSE) as well as microtubule-binding proteins like microtubule-associated protein 2 (MAP2) and microtubule-associated protein tau (TAU) during neurogenic differentiation. Fluorescence staining of SH-SY5Y(TNAPhigh) cells reveals TNAP localization throughout the whole length of the developed projection network and even synapsin Ι co-localization with strong TNAP signals at some spots at least at the early time points of differentiation. Additional immunocytochemical staining shows higher MAP2 expression in SH-SY5Y(TNAPhigh) cells and further a distinct up-regulation of tau and MAP2 in the course of neurogenic differentiation. Interestingly, transgenic SH-SY5Y(TNAPhigh) cells are able to develop longer cellular processes compared to control cells after stimulation with all-trans retinoic acid (RA). Current therapies for HPP prioritize improvement of the bone phenotype. Unraveling the molecular role of TNAP in extraosseous tissues, like in the CNS, will help to improve treatment strategies for HPP patients. Taking this rare disease as a model may also help to dissect TNAP's role in neurodegenerative diseases and even improve future treatment of common pathologies. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the efficacy of radiosynovectomy in rheumatoid arthritis and haemophilic arthropathy (CERAHA): First results of an IAEA co-ordinated research project (CRP)

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Vereb, M.; Kaliska, L.

2005-01-01

Full text: The main objective of the study was to determine the therapeutic efficacy of radiosynovectomy. Rheumatoid arthritis is a Chronic or sub-acute, systemic inflammatory disorder principally involving the joints with peripheral symmetrical inflammatory non-suppurative arthritis. It usually has a prolonged course with relapse and remissions. Haemophilia is a congenital blood disease that produces abnormal bleeding at musculoskeletal level. The origin of this abnormal bleeding is the lack of a coagulation factor, Factor VIII for haemophilia A and Factor IX for haemophilia B or Christmas disease. The overall goals of therapy in rheumatoid arthritis are: alleviation of pain, control of disease activity, slowing down the rate of damage and improvement in the quality of life. On the other hand the aim of the orthopaedic treatment in haemophilic haemarthrosis is to avoid recurrence of the haemarthrosis by acting on the synovial membrane, by fibrosing it, in addition to pain alleviation and improving the quality of life. Radionuclide therapy, commonly known as 'Radiosynovectomy', is a very useful procedure, which if used appropriately may form an effective tool in the management of rheumatoid arthritis and haemophilic haemoarthropathy. With the help received from the IAEA under the auspices of a coordinated research project, for the first time in our hospital we introduced radiosynovectomy in the year 2003. Until now, a total number of 40 patients of rheumatoid arthritis and one patient of haemophilic arthritis have been treated following a protocol designed by the IAEA under the CRP. The diagnosis of rheumatoid arthritis and haemophilic arthropathy was established by standard well established findings of clinical examination and laboratory investigations. All patients underwent a two phase bone soft tissue scintigraphy to assess the inflammatory activity in the joints prior to therapy. A radiosynovectomy team was formed in the hospital consisting of a nuclear

On occurrence of a neurogenic sarcoma in irradiation area after combined operative-radiogenic therapy of an adenosarcoma in kidney during childhood

International Nuclear Information System (INIS)

Eberhardt, H.J.; Friedrich, S.; Herrmann, T.; Roy, U.

1990-01-01

Malignant neoplasias in childhood generally are an increased risk for the patient to fall ill with a second tumor. Second tumors in former irradiation field are seldom, but are acknowledged radiogenically if histology is different to that of the first tumor and a sufficiently long period is between the two tumors. A patient is presented who had been operated and irradiated because of an adenosarcoma of the kidney at the age of seven and who has fallen ill with a neurogenic sarcoma in the irradiation area more than 30 years later. The same patient had to suffer from radiogenic retardation during differentiation of the lumbar apparatus of attitude and locomotion and on the other hand be became father of a healthy daughter at the age of 32. (author)

An International Continence Society (ICS) report on the terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD).

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Gajewski, Jerzy B; Schurch, Brigitte; Hamid, Rizwan; Averbeck, Márcio; Sakakibara, Ryuji; Agrò, Enrico F; Dickinson, Tamara; Payne, Christopher K; Drake, Marcus J; Haylen, Bernie T

2018-03-01

The terminology for adult neurogenic lower urinary tract dysfunction (ANLUTD) should be defined and organized in a clinically based consensus Report. This Report has been created by a Working Group under the auspices and guidelines of the International Continence Society (ICS) Standardization Steering Committee (SSC) assisted at intervals by external referees. All relevant definitions for ANLUTD were updated on the basis of research over the last 14 years. An extensive process of 18 rounds of internal and external review was involved to exhaustively examine each definition, with decision-making by collective opinion (consensus). A Terminology Report for ANLUTD, encompassing 97 definitions (42 NEW and 8 CHANGED, has been developed. It is clinically based with the most common diagnoses defined. Clarity and user-friendliness have been key aims to make it interpretable by practitioners and trainees in all the different groups involved not only in lower urinary tract dysfunction but additionally in many other medical specialties. A consensus-based Terminology Report for ANLUTD has been produced to aid clinical practice and research. © 2017 Wiley Periodicals, Inc.

Fluoxetine treatment ameliorates depression induced by perinatal arsenic exposure via a neurogenic mechanism

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Tyler, Christina R.; Solomon, Benjamin R.; Ulibarri, Adam L.; Allan, Andrea M.

2014-01-01

Several epidemiological studies have reported an association between arsenic exposure and increased rates of psychiatric disorders, including depression, in exposed populations. We have previously demonstrated that developmental exposure to low amounts of arsenic induces depression in adulthood along with several morphological and molecular aberrations, particularly associated with the hippocampus and the hypothalamic–pituitary–adrenal (HPA) axis. The extent and potential reversibility of this toxin-induced damage has not been characterized to date. In this study, we assessed the effects of fluoxetine, a selective serotonin reuptake inhibitor antidepressant, on adult animals exposed to arsenic during development. Perinatal arsenic exposure (PAE) induced depressive-like symptoms in a mild learned helplessness task and in the forced swim task after acute exposure to a predator odor (2,4,5-trimethylthiazoline, TMT). Chronic fluoxetine treatment prevented these behaviors in both tasks in arsenic-exposed animals and ameliorated arsenic-induced blunted stress responses, as measured by corticosterone (CORT) levels before and after TMT exposure. Morphologically, chronic fluoxetine treatment reversed deficits in adult hippocampal neurogenesis (AHN) after PAE, specifically differentiation and survival of neural progenitor cells. Protein expression of BDNF, CREB, the glucocorticoid receptor (GR), and HDAC2 was significantly increased in the dentate gyrus of arsenic animals after fluoxetine treatment. This study demonstrates that damage induced by perinatal arsenic exposure is reversible with chronic fluoxetine treatment resulting in restored resiliency to depression via a neurogenic mechanism. PMID:24952232

Management of urinary tract infections in patients with neurogenic bladder: challenges and solutions.

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Pannek, Jürgen; Wöllner, Jens

2017-01-01

Urinary tract infections (UTIs) are one of the most common morbidities in persons with neurogenic lower urinary tract dysfunction (NLUTD). They are associated with a significant morbidity and mortality, and they affect the quality of life of the affected patients. Diagnosis and treatment of UTI in this group of patients are challenging. In this review, the current strategies regarding diagnosis, treatment, and prevention are summarized. it is important to correctly diagnose a UTI, as treatment of bacteriuria should strictly be avoided. A UTI is defined as a combination of laboratory findings (leukocyturia and bacteriuria) and symptoms. Laboratory findings without symptoms are classified as asymptomatic bacteriuria. Routine urine screening is not advised. Only UTI should be treated; treatment of asymptomatic bacteriuria is not indicated. Prior to treatment, urine for a urine culture should be obtained. Antibiotic treatment for ~7 days is advised. In recurrent UTI, bladder management should be optimized and morphologic causes for UTI should be excluded. If UTIs persist, medical prophylaxis should be considered. Currently, no prophylactic measure with evidence-based efficacy exists. Long-term antibiotic prophylaxis should be used merely as an ultimate measure. Among the various mentioned innovative approaches for UTI prevention, bacteriophages, intravesical instillations, complementary and alternative medicine techniques, and probiotics seem to be most promising. Recently, several promising innovative options for UTI prophylaxis have been developed which may help overcome the current therapeutic dilemma. However, further well designed studies are necessary to evaluate the safety and efficacy of these approaches.

Amyloid arthropathy of the hip joint: MR demonstration of presumed amyloid lesions in 152 patients with long-term hemodialysis

International Nuclear Information System (INIS)

Otake, S.; Yamana, D.; Tsuruta, Y.; Mizutani, H.; Ohba, S.

1998-01-01

The aim of this study was to determine the spectrum of MR findings of presumed amyloid arthropathy of the hip joints in patients on long-term hemodialysis. We prospectively performed T1- and T2-weighted spin-echo imaging on 152 consecutive patients on hemodialysis. The duration of hemodialysis ranged from 5 months to 24 years, 2 months (mean: 8 years, 8 months). The frequency, location, and signal intensity of bone lesions were assessed. In 12 cases with contrast-enhanced MR examination, enhancement pattern of bone lesions, synovial lesions, and intra-articular lesions were characterized. Bone lesions presumed to be amyloid deposits were identified in 60 patients (39 %). Magnetic resonance imaging revealed that amyloid lesions were more extensive than anticipated by plain radiographs. All bone lesions showed decreased signal intensity on T1-weighted images. On T2-weighted images, bone lesions showed increased signal intensity in 32 patients (54 %), decreased signal intensity in 11 patients (18 %), and both increased and decreased signal intensity in 17 patients (28 %). Following intravenous injection of gadolinium-based contrast, all bone lesions showed moderate enhancement. Synovial thickening could not be identified on T1- and T2-weighted images. However, contrast-enhanced images showed thickened synovial membrane, which could be differentiated from joint fluid. Intra-articular nodules showed decreased or intermediate signal intensity on T1-weighted images and decreased signal intensity on T2-weighted images; the intra-articular nodules were contiguous with subchondral bone lesions. Magnetic resonance imaging is useful for evaluating the distribution and extent of amyloidosis of the hip joints in patients undergoing long-term hemodialysis. (orig.) (orig.)

MDM2 inhibition rescues neurogenic and cognitive deficits in a mouse model of fragile X syndrome.

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Li, Yue; Stockton, Michael E; Bhuiyan, Ismat; Eisinger, Brian E; Gao, Yu; Miller, Jessica L; Bhattacharyya, Anita; Zhao, Xinyu

2016-04-27

Fragile X syndrome, the most common form of inherited intellectual disability, is caused by loss of the fragile X mental retardation protein (FMRP). However, the mechanism remains unclear, and effective treatment is lacking. We show that loss of FMRP leads to activation of adult mouse neural stem cells (NSCs) and a subsequent reduction in the production of neurons. We identified the ubiquitin ligase mouse double minute 2 homolog (MDM2) as a target of FMRP. FMRP regulates Mdm2 mRNA stability, and loss of FMRP resulted in elevated MDM2 mRNA and protein. Further, we found that increased MDM2 expression led to reduced P53 expression in adult mouse NSCs, leading to alterations in NSC proliferation and differentiation. Treatment with Nutlin-3, a small molecule undergoing clinical trials for treating cancer, specifically inhibited the interaction of MDM2 with P53, and rescued neurogenic and cognitive deficits in FMRP-deficient mice. Our data reveal a potential regulatory role for FMRP in the balance between adult NSC activation and quiescence, and identify a potential new treatment for fragile X syndrome. Copyright © 2016, American Association for the Advancement of Science.

Potential Therapies by Stem Cell-Derived Exosomes in CNS Diseases: Focusing on the Neurogenic Niche

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Alejandro Luarte

2016-01-01

Full Text Available Neurodegenerative disorders are one of the leading causes of death and disability and one of the biggest burdens on health care systems. Novel approaches using various types of stem cells have been proposed to treat common neurodegenerative disorders such as Alzheimer’s Disease, Parkinson’s Disease, or stroke. Moreover, as the secretome of these cells appears to be of greater benefit compared to the cells themselves, the extracellular components responsible for its therapeutic benefit have been explored. Stem cells, as well as most cells, release extracellular vesicles such as exosomes, which are nanovesicles able to target specific cell types and thus to modify their function by delivering proteins, lipids, and nucleic acids. Exosomes have recently been tested in vivo and in vitro as therapeutic conveyors for the treatment of diseases. As such, they could be engineered to target specific populations of cells within the CNS. Considering the fact that many degenerative brain diseases have an impact on adult neurogenesis, we discuss how the modulation of the adult neurogenic niches may be a therapeutic target of stem cell-derived exosomes. These novel approaches should be examined in cellular and animal models to provide better, more effective, and specific therapeutic tools in the future.

Suprapubic cystostomy for neurogenic bladder using Lowsley retractor method: a procedure revisited.

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Edokpolo, Leonard U; Foster, Harris E

2011-11-01

To report our experience with the Lowsley retractor method for suprapubic cystostomy (SPC) in patients with neurogenic bladder (NGB). A retrospective study was performed of 44 patients with NGB who underwent SPC with the Lowsley retractor method. The subjects were selected from 90 patients undergoing SPC by 1 surgeon from 1995 to 2010. The age, sex, indication, anesthesia type, catheter type, blood loss, fluids administered, and duration and complications were recorded. A total of 49 primary catheter placements were performed in 44 patients. A total of 23 men and 21 women were included. The etiology of NGB was spinal cord injury and multiple sclerosis in 38 subjects (86%). The mean age was 44 years (range 18-86). The cases were performed under general anesthesia, except for 8 (16%) that were successfully performed with local and monitored anesthesia. The operation time documented in 19 cases (39%) was 20.2 ± 5.5 minutes (range 11-31). The Foley catheter size ranged from 16F to 22F. The blood loss was minimal, and there were no intraoperative complications or incorrect catheter placements. One patient returned with significant hematuria 1 day after the procedure. No other minor or major complications were noted. Patients with NGB have been shown to have a greater risk of complication during percutaneous suprapubic catheter placement. SPC using the Lowsley retractor was described by Zeidman et al in 1988. Their report did not detail the patient characteristics or operative experience. To our knowledge, no other institutional experience with the technique has been reported. The present report describes the Lowsley retractor method as a quick and safe ambulatory procedure for patients with NGB. Published by Elsevier Inc.

Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears.

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Yoon, Jong Pil; Seo, Anna; Kim, Jeong Jun; Lee, Chang-Hwa; Baek, Seung-Hun; Kim, Shin Yoon; Jeong, Eun Taek; Oh, Kyung-Soo; Chung, Seok Won

2017-01-01

We aimed to estimate the interrelation between preoperative deltoid muscle status by measuring the 3-dimensional deltoid muscle volume and postoperative functional outcomes after reverse total shoulder arthroplasty(RTSA). Thirty-five patients who underwent RTSA participated in this study. All patients underwent preoperative magnetic resonance imaging(MRI) as well as pre- and postoperative radiography and various functional outcome evaluations at least 1 year. The primary outcome parameter was set as age- and sex-matched Constant scores. The 3-dimensional deltoid muscle model was generated using a medical image processing software and in-house code, and the deltoid muscle volume was calculated automatically. Various clinical and radiographic factors comprising the deltoid muscle volume adjusted for body mass index(BMI) were analyzed, and their interrelation with the outcome parameters was appraised using a multivariate analysis. As a result, all practical consequences considerably improved following surgery(all pmuscle volume adjusted for BMI(p = 0.009), absence of a subscapularis complete tear (p = 0.040), and greater change in acromion-deltoid tuberosity distance(p = 0.013) were associated with higher matched Constant scores. Multivariate analysis indicated that the deltoid muscle volume was the single independent prognostic factor for practical consequences(p = 0.011). In conclusion, the preoperative deltoid muscle volume significantly affected the functional outcome following RTSA in patients with cuff tear arthropathy or irreparable cuff tears. Therefore, more attention should be paid to patients with severe atrophied deltoid muscle who are at a high risk for poor practical consequences subsequent to RTSA.

Deletion of protein tyrosine phosphatase 1b in proopiomelanocortin neurons reduces neurogenic control of blood pressure and protects mice from leptin- and sympatho-mediated hypertension.

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Bruder-Nascimento, Thiago; Butler, Benjamin R; Herren, David J; Brands, Michael W; Bence, Kendra K; Belin de Chantemèle, Eric J

2015-12-01

Protein tyrosine phosphatase 1b (Ptp1b), which represses leptin signaling, is a promising therapeutic target for obesity. Genome wide deletion of Ptp1b, increases leptin sensitivity, protects mice from obesity and diabetes, but alters cardiovascular function by increasing blood pressure (BP). Leptin-control of metabolism is centrally mediated and involves proopiomelanocortin (POMC) neurons. Whether these neurons contribute to leptin-mediated increases in BP remain unclear. We hypothesized that increasing leptin signaling in POMC neurons with Ptp1b deletion will sensitize the cardiovascular system to leptin and enhance neurogenic control of BP. We analyzed the cardiovascular phenotype of Ptp1b+/+ and POMC-Ptp1b-/- mice, at baseline and after 7 days of leptin infusion or sympatho-activation with phenylephrine. POMCPtp1b deletion did not alter baseline cardiovascular hemodynamics (BP, heart rate) but reduced BP response to ganglionic blockade and plasma catecholamine levels that suggests a decreased neurogenic control of BP. In contrast, POMC-Ptp1b deletion increased vascular adrenergic reactivity and aortic α-adrenergic receptors expression. Chronic leptin treatment reduced vascular adrenergic reactivity and blunted diastolic and mean BP increases in POMC-Ptp1b-/- mice only. Similarly POMC-Ptp1b-/- mice exhibited a blunted increased in diastolic and mean BP accompanied by a gradual reduction in adrenergic reactivity in response to chronic vascular sympatho-activation with phenylephrine. Together these data rule out our hypothesis but suggest that deletion of Ptp1b in POMC neurons protects from leptin- and sympatho-mediated increases in BP. Vascular adrenergic desensitization appears as a protective mechanism against hypertension, and POMC-Ptp1b as a key therapeutic target for the treatment of metabolic and cardiovascular dysfunctions associated with obesity. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Prediction of outcome in neurogenic oropharyngeal dysphagia within 72 hours of acute stroke.

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Ickenstein, Guntram W; Höhlig, Carolin; Prosiegel, Mario; Koch, Horst; Dziewas, Rainer; Bodechtel, Ulf; Müller, Rainer; Reichmann, Heinz; Riecker, Axel

2012-10-01

Stroke is the most frequent cause of neurogenic oropharyngeal dysphagia (NOD). In the acute phase of stroke, the frequency of NOD is greater than 50% and, half of this patient population return to good swallowing within 14 days while the other half develop chronic dysphagia. Because dysphagia leads to aspiration pneumonia, malnutrition, and in-hospital mortality, it is important to pay attention to swallowing problems. The question arises if a prediction of severe chronic dysphagia is possible within the first 72 hours of acute stroke. On admission to the stroke unit, all stroke patients were screened for swallowing problems by the nursing staff within 2 hours. Patients showing signs of aspiration were included in the study (n = 114) and were given a clinical swallowing examination (CSE) by the swallowing/speech therapist within 24 hours and a swallowing endoscopy within 72 hours by the physician. The primary outcome of the study was the functional communication measure (FCM) of swallowing (score 1-3, tube feeding dependency) on day 90. The grading system with the FCM swallowing and the penetration-aspiration scale (PAS) in the first 72 hours was tested in a multivariate analysis for its predictive value for tube feeding-dependency on day 90. For the FCM level 1 to 3 (P dysphagia scales to prevent aspiration pneumonia and malnutrition. A dysphagia program can lead to better communication within the stroke unit team to initiate the appropriate diagnostics and swallowing therapy as soon as possible. Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Long-Term Cost-Effectiveness of Transanal Irrigation in Patients with Neurogenic Bowel Dysfunction.

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Anton Emmanuel

Full Text Available People suffering from neurogenic bowel dysfunction (NBD and an ineffective bowel regimen often suffer from fecal incontinence (FI and related symptoms, which have a huge impact on their quality of life. In these situations, transanal irrigation (TAI has been shown to reduce these symptoms and improve quality of life.To investigate the long-term cost-effectiveness of initiating TAI in patients with NBD who have failed standard bowel care (SBC.A deterministic Markov decision model was developed to project the lifetime health economic outcomes, including quality-adjusted life years (QALYs, episodes of FI, urinary tract infections (UTIs, and stoma surgery when initiating TAI relative to continuing SBC. A data set consisting of 227 patients with NBD due to spinal cord injury (SCI, multiple sclerosis, spina bifida and cauda equina syndrome was used in the analysis. In the model a 30-year old individual with SCI was used as a base-case. A probabilistic sensitivity analysis was applied to evaluate the robustness of the model.The model predicts that a 30-year old SCI patient with a life expectancy of 37 years initiating TAI will experience a 36% reduction in FI episodes, a 29% reduction in UTIs, a 35% reduction in likelihood of stoma surgery and a 0.4 improvement in QALYs, compared with patients continuing SBC. A lifetime cost-saving of £21,768 per patient was estimated for TAI versus continuing SBC alone.TAI is a cost-saving treatment strategy reducing risk of stoma surgery, UTIs, episodes of FI and improving QALYs for NBD patients who have failed SBC.

Actions of rilmenidine on neurogenic hypertension in BPH/2J genetically hypertensive mice.

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Jackson, Kristy L; Palma-Rigo, Kesia; Nguyen-Huu, Thu-Phuc; Davern, Pamela J; Head, Geoffrey A

2014-03-01

BPH/2J hypertensive mice have an exaggerated sympathetic contribution to blood pressure (BP). Premotor sympathetic neurons within the rostroventrolateral medulla (RVLM) are a major source of sympathetic vasomotor tone and major site of action of the centrally acting sympatholytic agent, rilmenidine. The relative cardiovascular effect of rilmenidine in BPH/2J versus normotensive BPN/3J mice was used as an indicator of the involvement of the RVLM in the sympathetic contribution to hypertension in BPH/2J mice. BPH/2J and BPN/3J mice were pre-implanted with telemetry devices to measure BP in conscious unrestrained mice. Rilmenidine was administered acutely (n=7-9/group), orally for 14 days, at a wide range of doses (n=5/group), and also infused intracerebroventricularly for 7 days (n=6/group). Acute intraperitoneal rilmenidine induced greater depressor and bradycardic responses in BPH/2J than BPN/3J mice (PstrainBPH/2J mice during the dark (active) period (-6.5 ± 2 mmHg; P=0.006). Chronic orally administered rilmenidine (1-12 mg/kg per day) also had minimal effect on 24-h BP in both strains (P>0.16). The sympathetic vasomotor inhibitory effect of rilmenidine is minimal in both strains and similar in hypertensive BPH/2J and BPN/3J mice. Thus, hypertension in BPH/2J mice is not likely mediated by greater neuronal activity in the RVLM, and agents such as rilmenidine would be an ineffective treatment for this form of neurogenic hypertension.

PATHOPHYSIOLOGY AND PRINCIPLES OF THERAPY OF A NEUROGENIC HYPERACTIVE URINARY BLADDER IN PATIENTS AFTER CEREBROVASCULAR ACCIDENT

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P. G. Shchvartz

2017-01-01

Full Text Available Neurogenic hyperactiv e bladder in different clinical variations is a characteristic com plication of restorativ e and residual periods of ischemic stroke and an important diagnostic criterion in vascular dementia. Mechanisms of formation of individual symptoms included in this syndrome is due to ischemic damage to cortical, subcortical and brainstem (the nucleus of Barrington centres of urination and associative areas of the brain, and the functional dissociation of these structures due to demyelination of the Central conductors of the afferent and efferent impulses. As a result of deficit of cerebral effects (such as brake and activating, is a violation of the implementation of the reflexes of urination (including carrying out continence, ongoing spinal (sympathetic, parasympathetic and somatic. The article presents a new concept of formation of the syndrome of hyperactive bladder on the basis of violations of the implementation of the 4 reflexes of urination, which provides the normal retention of urine and are responsible for the accumulation function of the bladder. First we analyzed the main point of application of drugs of anticholinergic and sympathomimetic actions in the reflexes of urination and mechanisms of restoration of function of the lower urinary tract in patients with acute and chronic v ascular diseases of the brain.

Benign and malignant neurogenic tumors of nerve sheath origin on FDG PET

International Nuclear Information System (INIS)

Yun, M. J.; Go, D. H.; Yoo, Y. H.; Shin, K. H.; Lee, J. D

2004-01-01

The differentiation between benign and malignant nerve sheath tumors is difficult based on conventional radiological imaging. This study was undertaken to investigate the value of FDG PET in distinguishing benign from malignant neurogenic tumors of nerve sheath origin. We performed a retrospective review of the medical record to select patients with nerve sheath tumors who had underdone FDG PET imaging. Fifteen patients (7F: 8M) with benign or malignant nerve sheath tumors were included in this study. Of the 15 patients, 9 were diagnosed with the known neurofibromatosis type I. A total of 19 nerve sheath tumors were included from the 15 patients. All patients had undergone FDG PET to evaluate for malignant potential of the known lesions. Images of FDG PET were semi-quantitatively analyzed and a region of interest (ROI) was placed over the area of the maximum FDG uptake and an average standardized uptake value was taken for final analysis. There were 5 malignant peripheral nerve sheath tumors, 5 schwannomas, and 9 neurofibromas. The mean SUV was 2 (ranged from 1.6 to 3.3) for schwannomas, 1.3 (0.7 to 2.5) for neurofibromas, and 8.4 (4.6 to 12.2) for malignant peripheral nerve sheath tumors. Of 14 benign tumors, all except one schwannoma showed a SUV less than 3. When a cutoff SUV of 4 was used to differentiate the nerve sheath tumors, all tumors were correctly classified as benign or malignant, respectively. Among the 9 patients diagnosed with neurofibromatosis type I. 4 had malignant peripheral nerve sheath tumors and FDG PET accurately detected all the 4 lesions with malignant transformation. According to our results, FDG PET seems to have a great potential for accurately characterizing benign versus malignant nerve sheath tumors. It appears to be extremely useful for patients with neurofibromatosis to localize the lesion with malignant transformation

The role of calcified cartilage and subchondral bone in the initiation and progression of ochronotic arthropathy in alkaptonuria.

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Taylor, A M; Boyde, A; Wilson, P J M; Jarvis, J C; Davidson, J S; Hunt, J A; Ranganath, L R; Gallagher, J A

2011-12-01

focal changes in calcified cartilage. Ochronosis spreads throughout the cartilage, altering the mechanical properties. In advanced ochronosis, there is aggressive resorption of the underlying calcified cartilage leading to an extraordinary phenotype in which there is complete loss of the subchondral plate. These findings should contribute to better understanding of cartilage-subchondral interactions in arthropathies. Copyright © 2011 by the American College of Rheumatology.

Neurogenic differentiation of human umbilical cord mesenchymal stem cells on aligned electrospun polypyrrole/polylactide composite nanofibers with electrical stimulation

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Zhou, Junfeng; Cheng, Liang; Sun, Xiaodan; Wang, Xiumei; Jin, Shouhong; Li, Junxiang; Wu, Qiong

2016-09-01

Adult central nervous system (CNS) tissue has a limited capacity to recover after trauma or disease. Recent medical cell therapy using polymeric biomaterialloaded stem cells with the capability of differentiation to specific neural population has directed focuses toward the recovery of CNS. Fibers that can provide topographical, biochemical and electrical cues would be attractive for directing the differentiation of stem cells into electro-responsive cells such as neuronal cells. Here we report on the fabrication of an electrospun polypyrrole/polylactide composite nanofiber film that direct or determine the fate of mesenchymal stem cells (MSCs), via combination of aligned surface topography, and electrical stimulation (ES). The surface morphology, mechanical properties and electric properties of the film were characterized. Comparing with that on random surface film, expression of neurofilament-lowest and nestin of human umbilical cord mesenchymal stemcells (huMSCs) cultured on film with aligned surface topography and ES were obviously enhanced. These results suggest that aligned topography combining with ES facilitates the neurogenic differentiation of huMSCs and the aligned conductive film can act as a potential nerve scaffold.

Association between human parvovirus B19 and arthropathy in Belém, Pará, north Brazil Associação entre parvovírus B19 e artropatias em Belém, Pará, norte do Brasil

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Ronaldo B. FREITAS

2002-02-01

Full Text Available A total of 220 patients with arthropathy were selected in Belém, Pará between January 1994 and December 2000, and screened for the presence of human parvovirus B19 IgM and IgG antibodies by enzyme-linked immunosorbent assay (ELISA. A subgroup (n = 132 of patients with high levels of antibodies (either IgM+/IgG+ or IgM-/IgG+ were examined for the presence of DNA by polymerase chain reaction/nested PCR. Recent/active infection (detection of IgM and/or IgG-specific antibodies and presence of viral DNA was identified in 47.7% of the 132 individuals with arthropathy. In our study, women were significantly more affected (59.7% than men (35.4% (P = 0.0006. The age group of 11-20 years (84.6%, among female patients, and 21-30 years (42.1%, among male, were those with the highest incidence rates. The analysis of the temporal distribution of B19-associated arthropaties showed a cyclic pattern, with peak incidence rates occuring at 3-5 year intervals. Significant diference (P = 0.01 was observed when comparing both the highest (39.0% and the lowest (11.0% seropositivity rates for the years of 1995 and 2000, respectively. The interfalangial joints of hands and feet were mostly affected, with 50.0% and 48.0% of cases among both women and men, respectively. In a smaller proportion, other joints such as those of knee, ankle, pulse and shoulder were affected. As for the duration, symptoms lasted 1 to 5 days in 54.0% of the individuals, whereas in 46.0% of them the disease lasted 6-10 days, if considered the subgroup (n = 63 of patients with recent/active infection by parvovirus B19. In our study, joint clinical manifestations occurred symmetrically. Our results indicate that B19 may be an important agent of arthropathies in our region, and this underscores the need for specific laboratory diagnosis when treating patients suffering from acute arthropathy, mainly pregnant women.Um total de 220 indivíduos portadores de artropatias foi selecionado em Belém, Par

An electrophysiological approach to the diagnosis of neurogenic dysphagia: implications for botulinum toxin treatment.

Science.gov (United States)

Alfonsi, E; Merlo, I M; Ponzio, M; Montomoli, C; Tassorelli, C; Biancardi, C; Lozza, A; Martignoni, E

2010-01-01

Botulinum toxin (BTX) injection into the cricopharyngeal (CP) muscle has been proposed for the treatment of neurogenic dysphagia due to CP hyperactivity. The aim was to determine whether an electrophysiological method exploring oropharyngeal swallowing could guide treatment and discriminate responders from non-responders, based on the association of CP dysfunction with other electrophysiological abnormalities of swallowing. Patients with different neurological disorders were examined: Parkinson disease, progressive supranuclear palsy, multiple system atrophy-Parkinson variant, multiple system atrophy cerebellar variant, stroke, multiple sclerosis and ataxia telangiectasia. All patients presented with clinical dysphagia, and with complete absence of CP muscle inhibition during the hypopharyngeal phase of swallowing. Each patient underwent clinical and electrophysiological investigations before and after treatment with BTX into the CP muscle of one side (15 units of Botox). Clinical and electrophysiological procedures were performed in a blind manner by two different investigators. The following electrophysiological measures were analysed: (1) duration of EMG activity of suprahyoid/submental muscles (SHEMG-D); (2) duration of laryngopharyngeal mechanogram (LPM-D); (3) duration of the inhibition of the CP muscle EMG activity (CPEMG-ID); and (4) interval between onset of EMG activity of suprahyoid/submental muscles and onset of laryngopharyngeal mechanogram (I-SHEMG-LPM). Two months after treatment, 50% of patients showed a significant improvement. Patients with prolonged or reduced SHEMG-D values and prolonged I-SHEMG-LPM values did not respond to BTX. Therefore, values for which BTX had no effect (warning values) were identified. This electrophysiological method can recognise swallowing abnormalities which may affect the outcome of the therapeutic approach to dysphagia with BTX treatment.

Endovascular Treatment for Aneurysmal Subarachnoid Hemorrhage with Neurogenic Pulmonary Edema in the Acute Stage.

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Meguro, Toshinari; Tanabe, Tomoyuki; Muraoka, Kenichiro; Terada, Kinya; Hirotsune, Nobuyuki; Nishino, Shigeki

2016-01-01

Severe neurogenic pulmonary edema (NPE) can occur in a variety of brain insults, including subarachnoid hemorrhage (SAH), and severe case of NPE can cause devastating consequences. But the literature on the treatment strategy about aneurysmal SAH with NPE is very scant. We present that SAH patients with severe NPE, who were treated first by embolization of aneurysm followed by insertion of lumbar spinal drainage, had comparatively good outcome. We present 12 consecutive cases of aneurysmal SAH with NPE in the acute stage, which were treated by endovascular treatment between April 2002 and December 2012. We classified the patients according to the Hunt and Hess grading system as follows: grade-3 (1 patient), grade-4 (4 patients), and grade-5 (7 patients). All patients needed respiratory management, with the assistance of a ventilator, and underwent endovascular treatment for the ruptured aneurysms within 72 hours from onset. For all the patients, immediately after the endovascular treatment, we performed lumbar spinal drainage. The pulmonary edema disappeared rapidly after respiratory management and endovascular treatment. The outcomes were as follows: good recovery (GR; 3 patients), moderate disability (MD; 4 patients), severe disability (SD; 3 patients), and death (D; 2 patients). Five patients (42%) developed pneumonia, and we postponed extubation until recovery from pneumonia. The cause for severe disability and death was symptomatic vasospasm and primary brain damage. No patients had rebleeding from ruptured aneurysms. Endovascular treatment for ruptured aneurysm and placement of lumbar spinal drainage is an excellent treatment option for severe SAH with NPE.

Sciatic nerve compression by neurogenic heterotopic ossification: use of CT to determine surgical indications

International Nuclear Information System (INIS)

Salga, Marjorie; Jourdan, Claire; Durand, Marie-Christine; Hangard, Chloe; Carlier, Robert-Yves; Denormandie, Philippe; Genet, Francois

2015-01-01

To describe the characteristics of neurogenic heterotopic ossification (NHO) based on clinical tests, electroneuromyography (ENMG) and CT in a database of patients with lesions of the central nervous system who required sciatic nerve neurolysis along with posterior hip NHO resection, and to determine the respective roles of ENMG and CT in the management of posterior hip NHOs in patients who are unable to communicate or express pain. The consistency of the ENMG results with clinical findings, CT results and macroscopic signs of lesions was retrospectively assessed after sciatic nerve neurolysis and ablation of 55 posterior hip NHOs. Sciatic nerve neurolysis was necessary in 55 cases (47.4 %; 55 out of 116). CT showed contact of the NHO with the nerve in all cases: 5 in contact with no deflection, 3 in contact with deflection, 21 moulded into a gutter and 26 entrapped in the NHO. There were clinical signs of sciatic nerve lesion in 21.8 % of cases (12 out of 55). ENMG showed signs of sciatic nerve lesions in only 55.6 % (10 out of 18), only 4 of whom presented with clinical signs of a nerve lesion. No significant relationship was found between clinical symptoms and ENMG findings of sciatic nerve compression (n = 13, p = 0.77). Nerve compression by NHO is likely an underdiagnosed condition, particularly in patients who are unable to communicate. Diagnosis of sciatic compression by NHO should be based on regular clinical examinations and CT. ENMG is not sufficiently sensitive to be used alone for surgical decision-making. (orig.)

Sciatic nerve compression by neurogenic heterotopic ossification: use of CT to determine surgical indications

Energy Technology Data Exchange (ETDEWEB)

Salga, Marjorie [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Jourdan, Claire [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Handi-Resp, (EA4047), Versailles (France); Durand, Marie-Christine [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Neurophysiology, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Hangard, Chloe; Carlier, Robert-Yves [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Medical Imaging, Garches (France); Denormandie, Philippe [Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Orthopaedic Surgery, Garches (France); Genet, Francois [Hopital Raymond Poincare, APHP, CIC-IT 805, Department of Physical Medicine and Rehabilitation, Garches (France); Universite de Versailles Saint Quentin en Yvelines, Groupement de Recherche Clinique et Technologique sur le Handicap (GRCTH, EA 4497), Versailles (France); Military Medical Service, Hopital d' Instruction des Armees Percy, Department of Physical Medicine and Rehabilitation, Clamart (France)

2014-09-14

To describe the characteristics of neurogenic heterotopic ossification (NHO) based on clinical tests, electroneuromyography (ENMG) and CT in a database of patients with lesions of the central nervous system who required sciatic nerve neurolysis along with posterior hip NHO resection, and to determine the respective roles of ENMG and CT in the management of posterior hip NHOs in patients who are unable to communicate or express pain. The consistency of the ENMG results with clinical findings, CT results and macroscopic signs of lesions was retrospectively assessed after sciatic nerve neurolysis and ablation of 55 posterior hip NHOs. Sciatic nerve neurolysis was necessary in 55 cases (47.4 %; 55 out of 116). CT showed contact of the NHO with the nerve in all cases: 5 in contact with no deflection, 3 in contact with deflection, 21 moulded into a gutter and 26 entrapped in the NHO. There were clinical signs of sciatic nerve lesion in 21.8 % of cases (12 out of 55). ENMG showed signs of sciatic nerve lesions in only 55.6 % (10 out of 18), only 4 of whom presented with clinical signs of a nerve lesion. No significant relationship was found between clinical symptoms and ENMG findings of sciatic nerve compression (n = 13, p = 0.77). Nerve compression by NHO is likely an underdiagnosed condition, particularly in patients who are unable to communicate. Diagnosis of sciatic compression by NHO should be based on regular clinical examinations and CT. ENMG is not sufficiently sensitive to be used alone for surgical decision-making. (orig.)

[Features of daily rhythm of arterial pressure in patients with primary arterial hypertension and neurogenic syncope conditions].

Science.gov (United States)

Musaeva, Z A; Oknin, V Iu; Khapaev, B A; Fedotova, A V; Veĭn, A M

2002-01-01

A comparative analysis of parameters of systemic BP in patients with primary arterial hypotension (PAH) and in patients with neurogenic syncopes (NS) in the cycle sleep-awake. Blood pressure was investigated in 20 patients with PAH aged 16-44 years and 18 patients with NS aged 16-49 years. 24-h ambulatory monitoring of BP was made on the monitor ABPM-02/M (Meditech, Hungary). Rhythm indices of BP in NS patients corresponded to age normal criteria. 24-h arrhythmia of BP in PAH patients manifests with excessive drop of diastolic BP in sleep (55% patients were overdippers). PAH and NS patients differ maximally by hypotonic load in sleep: 1.0 +/- 0.7% in NS vs 15.4 +/- 3.2% in PAH. Hypotonia episodes in awake PAH patients were registered at each 4th-5th measurement of BP, in NS patients--at each 11th-13th. Heart rate in awake PAH patients is higher than in healthy subjects. Hypotonic load in sleep carries the highest differentially-diagnostic importance. This makes more perspective examinations of such patients in the cycle sleep-awake. The changes observed in PAH patients evidence for activation of cerebral sympathico-adrenal systems participating in baroreflex regulation.

Factors that influence the urodynamic results of botulinum toxin in the treatment of neurogenic hyperactivity.

Science.gov (United States)

Gutiérrez-Martín, P; Vírseda-Chamorro, M; Salinas Casado, J; Gómez-Rodríguez, A; Esteban-Fuertes, M

2015-05-01

To determine the urodynamic efficacy and factors that influence the urodynamic results of treatment of neurogenic detrusor hyperactivity with intradetrusor injection of botulinum toxin type A (BTX-A) in patients with spinal cord injury (SCI). A retrospective study was conducted with a cohort of 70 patients composed of 40 men and 30 women with stable SCI (mean age, 39 ± 13.3 years) who underwent an intradetrusor injection of 300 IUs of BTX-A. A urodynamic study was conducted prior to the injection and 6 ± 4.3 months after the treatment. New urodynamic studies were subsequently performed up to an interval of 16 ± 12.2 months. The BTX-A significantly increased (p bladder capacity, the bladder volume of the first involuntary contraction of the detrusor and the postvoid residue. We observed a decrease that tended towards statistical significance (p bladder accommodation nor the urethral resistance index (bladder outlet obstruction index) varied significantly. The increase in vesical capacity was maintained in 50% of the sample for more than 32 months. Age, sex, anticholinergic treatment and lesion age showed no influence in terms of the increase in bladder capacity. The indwelling urinary catheter (IUC) was the only statistically significant negative factor. The urodynamic effect of BTX-A is maintained for a considerable time interval. The IUC negatively influences the result of the treatment. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

The Intensive Dysphagia Rehabilitation Approach Applied to Patients With Neurogenic Dysphagia: A Case Series Design Study.

Science.gov (United States)

Malandraki, Georgia A; Rajappa, Akila; Kantarcigil, Cagla; Wagner, Elise; Ivey, Chandra; Youse, Kathleen

2016-04-01

To examine the effects of the Intensive Dysphagia Rehabilitation approach on physiological and functional swallowing outcomes in adults with neurogenic dysphagia. Intervention study; before-after trial with 4-week follow-up through an online survey. Outpatient university clinics. A consecutive sample of subjects (N=10) recruited from outpatient university clinics. All subjects were diagnosed with adult-onset neurologic injury or disease. Dysphagia diagnosis was confirmed through clinical and endoscopic swallowing evaluations. No subjects withdrew from the study. Participants completed the 4-week Intensive Dysphagia Rehabilitation protocol, including 2 oropharyngeal exercise regimens, a targeted swallowing routine using salient stimuli, and caregiver participation. Treatment included hourly sessions twice per week and home practice for approximately 45 min/d. Outcome measures assessed pre- and posttreatment included airway safety using an 8-point Penetration Aspiration Scale, lingual isometric pressures, self-reported swallowing-related quality of life (QOL), and level of oral intake. Also, patients were monitored for adverse dysphagia-related effects. QOL and adverse effects were also assessed at the 4-week follow-up (online survey). The Intensive Dysphagia Rehabilitation approach was effective in improving maximum and mean Penetration Aspiration Scale scores (PDysphagia Rehabilitation approach was safe and improved physiological and some functional swallowing outcomes in our sample; however, further investigation is needed before it can be widely applied. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Osteoarthropathy in dialysis amyloidosis

International Nuclear Information System (INIS)

Baldrati, L.; Feletti, C.; Capponcini, C.; Docci, D.; Rocchi, A.; Balbi, B.; Bonsanto, R.; Mughetti, M.; Pasini, A.

1991-01-01

Many long-term (>60 months) hemodialysis patients develop a severe osteoarticular disease, called 'dialysis arthropathy', which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of β 2 -microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1±13 years) undergoing chronic hemodialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases; dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majoriry of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p<0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p<0.0005) and shoulder pain (p<0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients end the value of diagnostic imaging in screening such patients for those lesions

Osteoarthropathy in dialysis amyloidosis; Radiological and clinical findings. Aspetti radiologici e clinici dell'amiloidosi osteoarticolare da dialisi

Energy Technology Data Exchange (ETDEWEB)

Baldrati, L; Feletti, C; Capponcini, C; Docci, D [Ospedale M. Bufalini, Cesena (Italy). Serv. di Radiologia; Rocchi, A; Balbi, B; Bonsanto, R; Mughetti, M [Ospedale M. Bufalini, Cesena (Italy). Serv. di Nefrologia e Dialisi; Pasini, A [Ospedale M. Bufalini, Cesena (Italy) Serv. di Neuroradiologia

1991-01-01

Many long-term (>60 months) hemodialysis patients develop a severe osteoarticular disease, called 'dialysis arthropathy', which is characterized by the deposition in bone and synovia of a new type of amyloid made mainly of {beta}{sub 2}-microglobulin. In the present study, 31 patients (17 males, 14 females; age 54.1{+-}13 years) undergoing chronic hemodialysis arthropathy by means of clinics and of radiological investigations (conventional radiography and computed tomography). Sixteen patients (51.6%) had radiographic evidence of dialysis arthropathy: geodes (shoulders, 12 cases; wrists, 11; hips, 2; knees, 2) and/or destructive arthropathies (cervical spine, 13 cases; dorsolumbar spine, 2; hands, 2; hips, 1). Within 24 months, these lesions were found to progress slowly in the majoriry of cases. In the diagnostic process, CT should be employed in the study of spine, shoulders and hips when the lesions have not been sufficiently demonstrated by conventional radiography in the presence of evident clinical signs. Patients with dialysis arthropathy had undergone dialysis for longer periods than those without it (p<0.005) and showed a significantly higher incidence of both carpal tunnel syndrome (p<0.0005) and shoulder pain (p<0.005). Our findings confirm the high incidence and clinical importance of dialysis arthropathy in long-term hemodialysis patients end the value of diagnostic imaging in screening such patients for those lesions.

Deltoid muscle volume affects clinical outcome of reverse total shoulder arthroplasty in patients with cuff tear arthropathy or irreparable cuff tears.

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Jong Pil Yoon

Full Text Available We aimed to estimate the interrelation between preoperative deltoid muscle status by measuring the 3-dimensional deltoid muscle volume and postoperative functional outcomes after reverse total shoulder arthroplasty(RTSA. Thirty-five patients who underwent RTSA participated in this study. All patients underwent preoperative magnetic resonance imaging(MRI as well as pre- and postoperative radiography and various functional outcome evaluations at least 1 year. The primary outcome parameter was set as age- and sex-matched Constant scores. The 3-dimensional deltoid muscle model was generated using a medical image processing software and in-house code, and the deltoid muscle volume was calculated automatically. Various clinical and radiographic factors comprising the deltoid muscle volume adjusted for body mass index(BMI were analyzed, and their interrelation with the outcome parameters was appraised using a multivariate analysis. As a result, all practical consequences considerably improved following surgery(all p<0.01. Overall, 20 and 15 indicated a higher and a lower practical consequence than the average, respectively, which was assessed by the matched Constant scores. The deltoid muscle volume adjusted for BMI(p = 0.009, absence of a subscapularis complete tear (p = 0.040, and greater change in acromion-deltoid tuberosity distance(p = 0.013 were associated with higher matched Constant scores. Multivariate analysis indicated that the deltoid muscle volume was the single independent prognostic factor for practical consequences(p = 0.011. In conclusion, the preoperative deltoid muscle volume significantly affected the functional outcome following RTSA in patients with cuff tear arthropathy or irreparable cuff tears. Therefore, more attention should be paid to patients with severe atrophied deltoid muscle who are at a high risk for poor practical consequences subsequent to RTSA.

Evolution of the Imaging Tests in Hemophilia with Emphasis on Radiography and Magnetic Resonance Imaging

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Kilcoyne, R.F. [Univ. of Colorado Health Sciences Center, Denver, CO (United States). Dept. of Radiology; Lundin, B.; Pettersson, H. [Univ. Hospital of Lund (Sweden). Dept. of Radiology

2006-04-15

Even before the discovery of X-rays in 1895 attempts were being made to classify the joint destruction that occurs in hemophilic arthropathy. The advent of radiography added impetus to the search for the optimum classification system. Subsequent attempts have included advanced imaging methods, especially magnetic resonance imaging (MRI). Because of its high spatial resolution and ability to visualize soft tissue abnormalities, MRI is ideally suited as the best way to classify arthropathy. A literature search was carried out to document and list all the imaging methods for hemophilic arthropathy that have been published up to the present. All published classification systems are discussed and listed in tables. MRI has superior imaging capability and will probably become the most important modality for radiological classification of hemophilic arthropathy in the future.

Evolution of the Imaging Tests in Hemophilia with Emphasis on Radiography and Magnetic Resonance Imaging

International Nuclear Information System (INIS)

Kilcoyne, R.F.; Lundin, B.; Pettersson, H.

2006-01-01

Even before the discovery of X-rays in 1895 attempts were being made to classify the joint destruction that occurs in hemophilic arthropathy. The advent of radiography added impetus to the search for the optimum classification system. Subsequent attempts have included advanced imaging methods, especially magnetic resonance imaging (MRI). Because of its high spatial resolution and ability to visualize soft tissue abnormalities, MRI is ideally suited as the best way to classify arthropathy. A literature search was carried out to document and list all the imaging methods for hemophilic arthropathy that have been published up to the present. All published classification systems are discussed and listed in tables. MRI has superior imaging capability and will probably become the most important modality for radiological classification of hemophilic arthropathy in the future

Botulinum toxin A for the treatment of neurogenic detrusor overactivity in multiple sclerosis patients

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S. Deffontaines-Rufin

2011-10-01

Full Text Available PURPOSE: Neurogenic detrusor overactivity (NDO is common in patients who suffer from multiple sclerosis (MS. When the usual pharmacological treatment fails, botulinum toxin type A (BTX-A injections can be proposed. The safety and efficacy of this treatment are already well known, but only a few studies focus on its use in patients with MS. MATERIALS AND METHODS: Seventy-one patients with MS underwent their first BTX-A injection for refractory NDO. They had clinical and urodynamic cystometry assessment before and three months after injection. The patients were divided in three groups according to treatment efficacy: full success (total urinary continence, no overactive detrusor, improvement, or total failure (urge incontinence and overactive detrusor. RESULTS: 77% of the patients had clinical improvement or full success of the treatment with a reduction of their urgency and incontinence. Significant urodynamic improvement after treatment was shown on different parameters: volume at first involuntary bladder contraction (p = 0.0000001, maximum cystometric capacity (p = 0.0035, maximum detrusor pressure (p = 0.0000001. 46% of the patients were in the "full success" group. 31% of the patients had a partial improvement. 23% of the patients had no efficacy of the treatment. Duration of MS was a predictive factor of treatment failure (p = 0.015. CONCLUSIONS: Despite that a full success was obtained in 46% of the cases, BTX-A injection therapy failed to treat refractory NDO in 23% of patients suffering from MS. Duration of the disease was a predictive factor for an inefficient treatment. The injection therapy should be considered as soon as oral anticholinergic drugs fail to reduce NDO.

Minocycline treatment ameliorates interferon-alpha-induced neurogenic defects and depression-like behaviors in mice

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Lian-Shun eZheng

2015-01-01

Full Text Available Interferon-alpha (IFN-α is a proinflammatory cytokine that is widely used for the treatment of chronic viral hepatitis and malignancy, because of its immune-activating, antiviral, and antiproliferative properties. However, long-term IFN-α treatment frequently causes depression, which limits its clinical utility. The precise molecular and cellular mechanisms of IFN-α-induced depression are not currently understood. Neural stem cells (NSCs in the hippocampus continuously generate new neurons, and some evidence suggests that decreased neurogenesis plays a role in the neuropathology of depression. We previously reported that IFN-α treatment suppressed hippocampal neurogenesis and induced depression-like behaviors via its receptors in the brain in adult mice. However, it is unclear how systemic IFN-α administration induces IFN-α signaling in the hippocampus. In this study, we analyzed the role of microglia, immune cells in the brain, in mediating the IFN-α-induced neurogenic defects and depressive behaviors. In vitro studies demonstrated that IFN-α treatment induced the secretion of endogenous IFN-α from microglia, which suppressed NSC proliferation. In vivo treatment of adult mice with IFN-α for five weeks increased the production of proinflammatory cytokines, including IFN-α, and reduced neurogenesis in the hippocampus. Both effects were prevented by simultaneous treatment with minocycline, an inhibitor of microglial activation. Furthermore, minocycline treatment significantly suppressed IFN-α-induced depressive behaviors in mice. These results suggest that microglial activation plays a critical role in the development of IFN-α-induced depression, and that minocycline is a promising drug for the treatment of IFN-α-induced depression in patients, especially those who are low responders to conventional antidepressant treatments.

Charcots artropati som årsag til hypoparatyroid hyperkalcæmi

DEFF Research Database (Denmark)

Engberg, Susanne; Jensen, Jens-Erik Beck; Kønig, Karen Bay

2012-01-01

hyperthyroidism. Charcots arthropathy is not a recognized cause of hypoparathyroid hypercalcaemia, but the mechanism might be increased boneresorption. We recommend that Charcots arthropathy is considered a cause of hypoparathyroid hypercalcaemia in patients with diabetic neuropathy....

Avaliação dos resultados da artroplastia parcial de ombro para tratamento da artropatia por lesão do manguito rotador Evaluating the results of partial shoulder arthroplasty for the treatment of arthropathy due to rotator cuff lesion

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Sérgio Luiz Checchia

2008-06-01

Full Text Available OBJETIVO: Avaliar os resultados obtidos com a artroplastia parcial de ombro para o tratamento da artropatia por lesão do manguito rotador. MÉTODOS: No período de junho de 1989 a março de 2004, 11 ombros de 11 pacientes foram submetidos a artroplastia parcial de ombro para o tratamento de artropatia por LMR. O tempo de seguimento variou de 27 a 183 meses, com média de 69 meses. A idade média foi de 69,1 anos, variando de 44 a 78 anos. Houve predomínio do sexo feminino em 90,9% dos casos (10 pacientes. O membro dominante foi acometido em 10 pacientes. Os métodos escolhidos para avaliação dos pacientes, no seguimento pós-operatório, basearam-se nos critérios da UCLA; no índice de satisfação dos pacientes em relação ao alívio da dor; e no método de avaliação de objetivos limitados, proposto por Neer et al. RESULTADOS: O índice de satisfação dos pacientes em relação ao alívio da dor foi de 81,8%. Com o método de avaliação da UCLA, observamos média de 22,7 pontos. Por meio do método de avaliação de objetivos limitados, proposto por Neer et al, obtivemos seis pacientes com resultados satisfatórios e cinco insatisfatórios. CONCLUSÃO: A artroplastia parcial de ombro para o tratamento da artropatia por lesão do manguito rotador promove alívio do quadro doloroso e permite alguma melhora na função do membro para realização das atividades diárias; entretanto, é uma técnica que leva a altos índices de resultados insatisfatórios.OBJECTIVE: To evaluate the results achieved with partial arthroplasty of the shoulder to treat arthropathy due to rotator cuff lesion. METHODS: From June 1989 to March 2004, 11 shoulders of 11 patients were submitted to partial arthroplasty of the shoulder to treat an arthropathy due to rotator cuff lesion. Follow-up time varied from 27 to 182 months, with a mean of 69 months. Mean age was 69.1 years, ranging from 44 to 78 years. There was a predominance of the female gender, in 90.9% of

Clinical profile of motor neuron disease patients with lower urinary tract symptoms and neurogenic bladder.

Science.gov (United States)

Vázquez-Costa, Juan Francisco; Arlandis, Salvador; Hervas, David; Martínez-Cuenca, Esther; Cardona, Fernando; Pérez-Tur, Jordi; Broseta, Enrique; Sevilla, Teresa

2017-07-15

Lower urinary tract symptoms (LUTS) are frequent in motor neuron disease (MND) patients, but clinical factors related to them are unknown. We describe differences in LUTS among MND phenotypes and their relationship with other clinical characteristics, including prognosis. For this study, we collected clinical data of a previously published cohort of patients diagnosed with classical amyotrophic lateral sclerosis (cALS), progressive muscular atrophy (PMA) or primary lateral sclerosis (PLS) with and without LUTS. Familial history was recorded and the C9ORF72 expansion was analysed in the entire cohort. Patients were followed-up for survival until August 2016. Fifty-five ALS patients (37 cALS, 10 PMA and 8 PLS) were recruited. Twenty-four reported LUTS and neurogenic bladder (NB) could be demonstrated in nine of them. LUTS were not influenced by age, phenotype, disability, cognitive or behavioural impairment, or disease progression, but female sex appeared to be a protective factor (OR=0.39, p=0.06). Neither family history nor the C9ORF72 expansion was linked to LUTS or NB. In the multivariate analysis, patients reporting LUTS early in the disease course tended to show poorer survival. In this study, LUTS appear to be more frequent in male MND patients, but are not related to age, clinical or genetic characteristics. When reported early, LUTS could be a sign of rapid disease spread and poor prognosis. Further prospective longitudinal and neuroimaging studies are warranted to confirm this hypothesis. Copyright © 2017 Elsevier B.V. All rights reserved.

Effect of fenspiride, a non-steroidal antiinflammatory agent, on neurogenic mucus secretion in ferret trachea in vitro.

Science.gov (United States)

Khawaja, A M; Liu, Y C; Rogers, D F

1999-01-01

Neural mechanisms contribute to control of mucus secretion in the airways. Fenspiride is a non-steroidal antiinflammatory agent which has a variety of actions, including inhibition of neurogenic bronchoconstriction. The effect of fenspiride on neurally-mediated mucus secretion was investigated in vitro in electrically-stimulated ferret trachea, using(35)SO(4)as a mucus marker. Cholinergic secretory responses were isolated using adrenoceptor and tachykinin receptor antagonists. Tachykinin responses were isolated using cholinoceptor and adrenoceptor antagonists. Electrical stimulation increased cholinergic secretion by;90% and tachykininergic secretion by;40%. Fenspiride (1 microM-1 mM) tended to inhibit cholinergic secretion in a concentration-dependent manner, although only at 1 mM was inhibition (by 87%) significant. Inhibition by fenspiride of tachykininergic secretion was not concentration-dependent, and again significant inhibition (by 85%) was only at 1 mM. Inhibition was not due to loss of tissue viability, as assessed by restitution of secretory response after washout. Fenspiride also inhibited secretion induced by acetylcholine, but did not inhibit substance P-induced secretion. Histamine receptor antagonists increased basal secretion by 164%, whereas fenspiride did not affect basal secretion. We conclude that, in ferret trachea in vitro, fenspiride inhibits neurally-mediated mucus secretion, with antimuscarinic action the most plausible mechanism of action, but not necessarily the only mechanism. Copyright 1999 Academic Press.

Prevention of the Musculoskeletal Complications of Hemophilia

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E. C. Rodriguez-Merchan

2012-01-01

Full Text Available Hemophilia is an inherited disorder of clotting factor deficiencies resulting in musculoskeletal bleeding, including hemarthroses, leading to musculoskeletal complications. The articular problems of hemophiliac patients begin in infancy. These include: recurrent hemarthroses, chronic synovitis, flexion deformities, hypertrophy of the growth epiphyses, damage to the articular cartilage, and hemophilic arthropathy. The most commonly affected joints are the ankle, the knee, and the elbow. Hematologic prophylactic treatment from ages 2 to 18 years could avoid the development of hemophilic arthropathy if the concentration of the patient's deficient factor is prevented from falling below 1% of normal. Hemarthroses can be prevented by the administration of clotting factor concentrates (prophylaxis. However, high costs and the need for venous access devices in younger children continue to complicate recommendations for universal prophylaxis. Prevention of joint arthropathy needs to focus on prevention of hemarthroses through prophylaxis, identifying early joint disease through the optimal use of cost-effective imaging modalities and the validation of serological markers of joint arthropathy. Screening for effects on bone health and optimal management of pain to improve quality of life are, likewise, important issues. Major hemarthrosis and chronic hemophilic synovitis should be treated aggressively to prevent hemophilic arthropathy.

Validation of a new pediatric joint scoring system from the International Hemophilia Prophylaxis Study Group: validity of the hemophilia joint health score

NARCIS (Netherlands)

Feldman, Brian M.; Funk, Sharon M.; Bergstrom, Britt-Marie; Zourikian, Nichan; Hilliard, Pamela; van der Net, Janjaap; Engelbert, Raoul; Petrini, Pia; van den Berg, H. Marijke; Manco-Johnson, Marilyn J.; Rivard, Georges E.; Abad, Audrey; Blanchette, Victor S.

2011-01-01

Repeated hemarthrosis in hemophilia causes arthropathy with pain and dysfunction. The Hemophilia Joint Health Score (HJHS) was developed to be more sensitive for detecting arthropathy than the World Federation of Hemophilia (WFH) physical examination scale, especially for children and those using

Comparison of efficacies of vegetable oil based and polyethylene glycol based bisacodyl suppositories in treating patients with neurogenic bowel dysfunction after spinal cord injury: a meta-analysis.

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Yi, Zhu; Jie, Cheng; Wenyi, Zhang; Bin, Xie; Hongzhu, Jin

2014-10-01

We performed a meta-analysis to compare the efficacies of vegetable oil based bisacodyl (VOB) and polyethylene glycol based bisacodyl (PGB) suppositories in treating patients with neurogenic bowel dysfunction (NBD) after spinal cord injury (SCI). Relevant clinical studies (up to February 2014) were retrieved through the following databases: PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CCTR), Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang, and VIP database for Chinese Technical Periodicals. Data were analyzed using the standardized weighted mean difference (SMD) and its 95% confidence interval (CI). P-values 0.05) between patients in the PGB and VOB groups. Based on the results, we conclude that the PGB suppository could act faster than the VOB suppository in the treatment of NBD in patients with SCI.

What do we know about neurogenic bladder prevalence and management in developing countries and emerging regions of the world?

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Przydacz, Mikolaj; Denys, Pierre; Corcos, Jacques

2017-09-01

To summarize information on Neurogenic Bladder (NB) epidemiology, management and access to patient treatment in developing countries and emerging regions of the world in order to propose future interventions and help governmental as well as non-governmental organizations design their action plans. Different search methods were used to gather the maximum available data. They included strategic searches; reference checks; grey literature searches (reports, working papers, government documents, civil society information); contacting professional societies, registries, and authors; requesting unpublished data from organizations; and browsing related websites and journals. The incidence and prevalence rates of NB in developing countries are difficult to establish because epidemiological reports are few and far between. The frequency of bladder dysfunction in neurologically impaired populations can be approximately estimated in some of these countries. Similar information paucity affects diagnostic and therapeutic approaches to NB patients living in less-developed regions of the world. The assessment and management of NB seems to vary markedly between countries, and care of patients from emerging regions of the world is often inadequate. Strong concerted efforts are needed on the part of international scientific societies, non-governmental organizations and local governments to work together to change the prognosis for these patients and to improve their quality of life. Copyright © 2017. Published by Elsevier Masson SAS.

Diagnostic value of "dysphagia limit" for neurogenic dysphagia: 17 years of experience in 1278 adults.

Science.gov (United States)

Aydogdu, Ibrahim; Kiylioglu, Nefati; Tarlaci, Sultan; Tanriverdi, Zeynep; Alpaydin, Sezin; Acarer, Ahmet; Baysal, Leyla; Arpaci, Esra; Yuceyar, Nur; Secil, Yaprak; Ozdemirkiran, Tolga; Ertekin, Cumhur

2015-03-01

Neurogenic dysphagia (ND) is a prevalent condition that accounts for significant mortality and morbidity worldwide. Screening and follow-up are critical for early diagnosis and management which can mitigate its complications and be cost-saving. The aims of this study are to provide a comprehensive investigation of the dysphagia limit (DL) in a large diverse cohort and to provide a longitudinal assessment of dysphagia in a subset of subjects. We developed a quantitative and noninvasive method for objective assessment of dysphagia by using laryngeal sensor and submental electromyography. DL is the volume at which second or more swallows become necessary to swallow the whole amount of bolus. This study represents 17 years experience with the DL approach in assessing ND in a cohort of 1278 adult subjects consisting of 292 healthy controls, 784 patients with dysphagia, and 202 patients without dysphagia. A total of 192 of all patients were also reevaluated longitudinally over a period of 1-19 months. DL has 92% sensitivity, 91% specificity, 94% positive predictive value, and 88% negative predictive value with an accuracy of 0.92. Patients with ALS, stroke, and movement disorders have the highest sensitivity (85-97%) and positive predictive value (90-99%). The clinical severity of dysphagia has significant negative correlation with DL (r=-0.67, pdysphagia and it can be performed in an EMG laboratory. Our study provides specific quantitative features of DL test that can be readily utilized by the neurologic community and nominates DL as an objective and robust method to evaluate dysphagia in a wide range of neurologic conditions. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Value of 18F-FDG PET/MRI for the outcome of CT-guided facet block therapy in cervical facet syndrome: initial results

International Nuclear Information System (INIS)

Sawixki, Lino M.; Schaarscjmidt, Benedikt M.; Heusch, Philipp; Buchbender, Christian; Antoch, Gerald; Rosenbaum-Krumme, Sandra; Bockisch, Andreas; Umutlu, Lale; Eicker, Sven O.; Floeth, Frank W.

2017-01-01

The aim of this study was to evaluate the ability of 18 F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging ( 18 F-FDG PET/MRI) to detect PET-positive cervical facet arthropathy and identify patients who benefit from facet block therapy. Ten patients with cervical facet syndrome (mean age: 65 ± 12 years) underwent 18 F-FDG PET/MRI of the neck. Focal 18 F-FDG uptake in PET-positive facet joints served as target for computed tomography (CT)-guided facet blocks. In PET-negative patients, the target joint for facet block therapy was selected by current clinical standards considering the level of maximum facet arthrosis and pain. Neck pain was measured on visual analogue scale (VAS) before and after therapy. Bone marrow signal intensity (SI) ratio on turbo inversion recovery magnitude (TIRM) images and maximum standard uptake values (SUVmax) was calculated for each facet joint. Pearson's correlation coefficient (r) was calculated between bone marrow SI ratios on TIRM and SUVmax. 18 F-FDG PET/MRI detected PET-positive facet arthropathy in six patients. Patients with PET-positive facet arthropathy had significantly less pain compared with the pretreatment pain 3 h (P = 0.002), 4 weeks (P = 0.002) and 3 months (P = 0.026) after facet block therapy. Pain did not change significantly in patients with PET-negative facet arthropathy. TIRM SI ratio was higher in PET-positive facet arthropathy than in PET-negative facet arthropathy (P < 0.001). Correlation was strong between bone marrow SI ratio on TIRM images and SUVmax (r = 0.7; P < 0.001).

A systematic review of the diagnosis and treatment of patients with neurogenic hyperactivity of the detrusor muscle.

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Borau, A; Adot, J M; Allué, M; Arlandis, S; Castro, D; Esteban, M; Salinas, J

Neurogenic detrusor hyperactivity (NDH) is a urodynamic observation characterised by involuntary detrusor contractions during the filling phase that are caused by an underlying neurological disease. The common and severe complications that can result from NDH warrant the preparation of healthcare protocols for the proper management of patients with NDH. The aim of this study is to standardise the criteria for the decision-making process in the management of patients with diagnosed or suspected NDH, providing personalised medical care. We performed a systematic noncomprehensive literature review on the aspects of the diagnosis and treatment of NDH. Based on the review, recommendations were issued by nominal consensus of a group of urology specialists. In general, the diagnosis of NDH is arrived at by a proper review of the medical history, physical examination and voiding diary before performing any diagnostic study. The main treatment objectives are to protect the upper urinary tract, restore function of the lower tract and improve these patients' continence and quality of life. The treatment consists of several steps aimed at obtaining proper bladder storage that allows for sufficiently spaced voidings. The follow-up should be personalised based on each patient's needs. The identification and management of NDH is important for positively redirecting the function of the lower urinary tract, in terms of filling and voiding, thereby improving the patients' quality of life. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Application of transpulmonary thermodilution monitoring (PiCCO in patient with neurogenic pulmonary edema and acute obstructive hydrocephalus due to a central neurocytoma: A case report

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Ryoichi Iwata

2017-06-01

Full Text Available Neurogenic pulmonary edema (NPE is an acute life-threatening complication associated with many forms of central nervous system injury. Its pathophysiology is still debated. We report a patient with acute obstructive hydrocephalus due to a central neurocytoma who also had NPE, for which serial transpulmonary thermodilution monitoring (PiCCO was performed. Insertion of the PiCCO, which provides information about the patient's cardiac output, preload status and amount of lung water, revealed a high pulmonary vascular permeability index (PVPI and low global end-diastolic volume (GEDV without cardiac dysfunction, indicating permeability edema, which led to our changing the therapeutic strategy. Using PiCCO monitoring to balance the preload and extent of pulmonary edema enabled achievement of an optimal cardiac preload for organ perfusion, resulting in normalization of pulmonary edema by day 2. PiCCO facilitates understanding of the mechanism of NPE, guiding the management of fluid balance and the choice of vasopressors in patients with life-threatening NPE.

5-HT1A receptor-dependent modulation of emotional and neurogenic deficits elicited by prolonged consumption of alcohol.

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Belmer, Arnauld; Patkar, Omkar L; Lanoue, Vanessa; Bartlett, Selena E

2018-02-01

Repeated episodes of binge-like alcohol consumption produce anxiety, depression and various deleterious effects including alterations in neurogenesis. While the involvement of the serotonin receptor 1 A (5-HT 1A ) in the regulation of anxiety-like behavior and neurogenesis is well documented, its contribution to alcohol withdrawal-induced anxiety and alcohol-induced deficits in neurogenesis is less documented. Using the Drinking-In-the-Dark (DID) paradigm to model chronic long-term (12 weeks) binge-like voluntary alcohol consumption in mice, we show that the selective partial activation of 5-HT 1A receptors by tandospirone (3 mg/kg) prevents alcohol withdrawal-induced anxiety in a battery of behavioral tests (marble burying, elevated-plus-maze, open-field), which is accompanied by a robust decrease in binge-like ethanol intake (1 and 3 mg/kg). Furthermore, using triple immunolabelling of proliferation and neuronal differentiation markers, we show that long-term DID elicits profound deficits in neurogenesis and neuronal fate specification in the dorsal hippocampus that are entirely reversed by a 2-week chronic treatment with the 5-HT 1A partial agonist tandospirone (3 mg/kg/day). Together, our results confirm previous observations that 5-HT 1A receptors play a pivotal role in alcohol drinking behavior and the associated emotional and neurogenic impairments, and suggest that 5-HT 1A partial agonists represent a promising treatment strategy for alcohol abuse.

A comparative study of zoledronic acid and once weekly Alendronate in the management of acute Charcot arthropathy of foot in patients with diabetes mellitus

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R Bharath

2013-01-01

Full Text Available Aim: The aim of this study was to assess and compare the response to two forms of treatment-immobilization with zoledronic acid injection and immobilization with oral weekly Alendronate, in patients with diabetes mellitus and acute Charcot arthropathy (CA of foot in terms of clinical and radiological parameters. Material and Methods: Patients attending the endocrinology and podiatry clinic with history of diabetes mellitus and Acute CA were taken for study. The patients were randomized into two treatment groups. Group Z-zoledronic acid injection along with total contact cast (TCC. Group A-Tab. Alendronate 70 mg. once a week till the complete clinical resolution of acute CA along with TCC. Forty-five patients were randomized and 40 of them completed the study. The primary end point was complete clinical resolution of acute CA-defined as temperature difference between normal and affected foot <1oF. Results: Among the 40 patients, 30 (75% had complete clinical resolution. The mean number of days taken for complete clinical resolution since the initiation of treatment (either Zoledronic acid or Alendronate was approximately 122 days. There was no significant difference in a number of days required for complete clinical resolution, between the two forms of therapy. There was more than 50% reduction in the visual score between the baseline and the final scan. The target to non-target ratio in the skeletal phase also showed an average of 40% reduction from the baseline to the final skeletal scintigraphy. Conclusion: Both Intravenous Zoledronic acid and oral alendronate had comparable efficacy with respect to the time taken for attaining complete clinical resolution of acute CA of foot. However, Alendronate therapy was cost effective among the two. 99m Tc MDP bone scan can be used as an adjuvant to the clinical parameters in assessing the response to therapy.

Synoviorthesis with radioactive gold in hemophiliacs

International Nuclear Information System (INIS)

Ahlberg, Aa.; Petterson, H.

1979-01-01

Twenty-seven patients with hemophilia treated with intra-articular injection of radioactive gold were followed up clinically and radiologically for 3 to 9 years after treatment. To assess the radiological changes, a new classification was designed, with a score describing the severity of the changes in a more accurate manner than the methods previously used. The treatment decreased the bleeding frequency and stopped the progress of the arthropathy if applied at an early stage when the arthropathy was still reversible. If the treatment was begun at a later stage, the arthropathy seemed to progress independently of the effect on the bleeding frequency. No negative effect of the radioactive gold was observed on the joint or the growing zone. (author)

TRPV1 and TRPA1 in cutaneous neurogenic and chronic inflammation: pro-inflammatory response induced by their activation and their sensitization

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Olivier Gouin

2017-03-01

Full Text Available ABSTRACT Cutaneous neurogenic inflammation (CNI is inflammation that is induced (or enhanced in the skin by the release of neuropeptides from sensory nerve endings. Clinical manifestations are mainly sensory and vascular disorders such as pruritus and erythema. Transient receptor potential vanilloid 1 and ankyrin 1 (TRPV1 and TRPA1, respectively are non-selective cation channels known to specifically participate in pain and CNI. Both TRPV1 and TRPA1 are co-expressed in a large subset of sensory nerves, where they integrate numerous noxious stimuli. It is now clear that the expression of both channels also extends far beyond the sensory nerves in the skin, occuring also in keratinocytes, mast cells, dendritic cells, and endothelial cells. In these non-neuronal cells, TRPV1 and TRPA1 also act as nociceptive sensors and potentiate the inflammatory process. This review discusses the role of TRPV1 and TRPA1 in the modulation of inflammatory genes that leads to or maintains CNI in sensory neurons and non-neuronal skin cells. In addition, this review provides a summary of current research on the intracellular sensitization pathways of both TRP channels by other endogenous inflammatory mediators that promote the self-maintenance of CNI.

Toward Self-Control Systems for Neurogenic Underactive Bladder: A Triboelectric Nanogenerator Sensor Integrated with a Bistable Micro-Actuator.

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Arab Hassani, Faezeh; Mogan, Roshini P; Gammad, Gil G L; Wang, Hao; Yen, Shih-Cheng; Thakor, Nitish V; Lee, Chengkuo

2018-04-24

Aging, neurologic diseases, and diabetes are a few risk factors that may lead to underactive bladder (UAB) syndrome. Despite all of the serious consequences of UAB, current solutions, the most common being ureteric catheterization, are all accompanied by serious shortcomings. The necessity of multiple catheterizations per day for a physically able patient not only reduces the quality of life with constant discomfort and pain but also can end up causing serious complications. Here, we present a bistable actuator to empty the bladder by incorporating shape memory alloy components integrated on flexible polyvinyl chloride sheets. The introduction of two compression and restoration phases for the actuator allows for repeated actuation for a more complete voiding of the bladder. The proposed actuator exhibits one of the highest reported voiding percentages of up to 78% of the bladder volume in an anesthetized rat after only 20 s of actuation. This amount of voiding is comparable to the common catheterization method, and its one time implantation onto the bladder rectifies the drawbacks of multiple catheterizations per day. Furthermore, the scaling of the device for animal models larger than rats can be easily achieved by adjusting the number of nitinol springs. For neurogenic UAB patients with degraded nerve function as well as degenerated detrusor muscle, we integrate a flexible triboelectric nanogenerator sensor with the actuator to detect the fullness of the bladder. The sensitivity of this sensor to the filling status of the bladder shows its capability for defining a self-control system in the future that would allow autonomous micturition.

Efficacy of peripheral lidocaine application (neural therapy) in the treatment of neurogenic detrusor overactivity in multiple sclerosis patients.

Science.gov (United States)

Tamam, Yusuf; Özdemir, Hasan Hüseyin; Gedik, Abdullah; Tamam, Cüneyt; Nazlıkul, Hüseyin

2017-09-01

Many agents and treatments are used in the treatment of neurogenic detrusor overactivity (NDO) in MS patients, but no study has been conducted on the use of peripheric lidocaine (neural therapy-NT) on MS patients. We evaluated the effects of local administration of lidocaine on NDO in Multiple Sclerosis (MS) patients. For each patient local anesthetic lidocaine was injected at each session. Sessions were held once a week for 5 weeks. At each session, Th 10-L1, urogenital segment intradermal injections, Frankenhauser, and sacral epidural injections were given. The patients had clinical and urodynamic assessment 1 month before and 3, 9, and 12 months after NT. In addition, multiple sclerosis quality of life inventory (MSQL-54) and bladder control scale (BLCS) was performed for patients. Twenty-eight patients were included in the study (8 males, 20 females). The patients' average age was 31.7 ± 8.1 years. The injection therapy significantly improved volume at first involuntary bladder contraction (FCV), maximal detrusor pression during filling (P det. max.), maximal cystometric bladder capacity (MCC) after 3 months. Also, the MSQL-54 and BLCS scores were improved with treatment. However, these improvements reached a maximum 3 months after treatment, but from the 9 month a regression was seen in the parameters, and after 12 months the findings were seen to be slightly above their basal levels. These results suggest that NDO treatment in MS patients could be an effective treatment which is easy and has very few side effects, and is cost effective. © 2017 Wiley Periodicals, Inc.

A Bivalent Securinine Compound SN3-L6 Induces Neuronal Differentiation via Translational Upregulation of Neurogenic Transcription Factors

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Yumei Liao

2018-04-01

Full Text Available Developing therapeutic approaches that target neuronal differentiation will be greatly beneficial for the regeneration of neurons and synaptic networks in neurological diseases. Protein synthesis (mRNA translation has recently been shown to regulate neurogenesis of neural stem/progenitor cells (NSPCs. However, it has remained unknown whether engineering translational machinery is a valid approach for manipulating neuronal differentiation. The present study identifies that a bivalent securinine compound SN3-L6, previously designed and synthesized by our group, induces potent neuronal differentiation through a novel translation-dependent mechanism. An isobaric tag for relative and absolute quantitation (iTRAQ-based proteomic analysis in Neuro-2a progenitor cells revealed that SN3-L6 upregulated a group of neurogenic transcription regulators, and also upregulated proteins involved in RNA processing, translation, and protein metabolism. Notably, puromycylation and metabolic labeling of newly synthesized proteins demonstrated that SN3-L6 induced rapid and robust activation of general mRNA translation. Importantly, mRNAs of the proneural transcription factors Foxp1, Foxp4, Hsf1, and Erf were among the targets that were translationally upregulated by SN3-L6. Either inhibition of translation or knockdown of these transcription factors blocked SN3-L6 activity. We finally confirmed that protein synthesis of a same set of transcription factors was upregulated in primary cortical NPCs. These findings together identify a new compound for translational activation and neuronal differentiation, and provide compelling evidence that reprogramming transcriptional regulation network at translational levels is a promising strategy for engineering NSPCs.

Fluid collections and juxta-articular cystic lesions of the shoulder: spectrum of MRI findings

Energy Technology Data Exchange (ETDEWEB)

Mellado, J.M.; Salvado, E.; Camins, A.; Ramos, A.; Sauri, A. [Institut de Diagnostic per la Imatge, Hospital Joan XXIII, Tarragona (Spain); Merino, X. [Institut de Diagnostic per la Imatge, Hospital Vall' Ebron, Barcelona (Spain); Calmet, J. [Orthopaedic Surgery, Hospital Joan XXIII, Carrer Doctor Mallafre Guasch, Tarragona (Spain)

2002-03-01

The MR imaging features of fluid collections and juxta-articular cystic lesions of the shoulder are discussed, with special focus on those related to subacromial impingement and rotator cuff tears. Other more unusual fluid collections and cystic lesions are described, including rice-bodies bursitis, idiopathic synovial osteochondromatosis, dialysis-related amyloid arthropathy, hemophilic arthropathy, infectious conditions, non-infectious inflammatory arthritis, and paralabral cysts. (orig.)

Hip arthroplasty for ochronosis

International Nuclear Information System (INIS)

Kerimoglu, S.; Onder, C.; Aynaci, O.; Malkoc, C. H.

2005-01-01

Alkaptonuria is a metabolic disorder in which homogentisic acid oxidase is absent. Therefore, homogentisic acid accumulates in cartilage and connective tissues. We can diagnose ochronotic arthropathy, a manifestation of long standing alkaptonuria, through careful radiological, physical, and laboratory examination. In this report, we describe 4 cases of ochronotic arthropathy to which we applied cementless total hip prosthesis due to severe hip involvement. (author)

Radiation synovectomy in hemophilic hemarthrosis

International Nuclear Information System (INIS)

Wong, C.P.; Auyong, T.K.; Tong, C.M.; Luk, C.W.

2003-01-01

Radiation Synovectomy is an effective treatment for various kinds of arthropathies with a long history. It is a routine practice in many countries. One of the indications is hemophilic arthropathy, which is caused by repeated hemarthroses and resulting synovial hypertrophy and inflammation. The joints will subsequently be damaged and deformed, leading to significant functional disability. Synovectomy is needed to treat the hypertrophied and inflamed synovium. In this article, the procedure of radiation synovectomy will be elaborated, and a proposed working protocol for hemophilic hemarthrosis will be introduced. Moreover, efficacy (including example of cost effectiveness) of radiation synovectomy will be discussed and showed that the procedure can safely improve patients' symptoms, bleeding episodes, and can control further deterioration of the hemophilic arthropathy

Prevalence of Charcot Arthropathy in Type 2 Diabetes Patients Aged over 50 Years with Severe Peripheral Neuropathy: A Retrospective Study in a Tertiary Care South Indian Hospital.

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Salini, Dharmadas; Harish, Kumar; Minnie, Pillay; Sundaram, Karimassery R; Arun, Bal; Sandya, Chirukandath J; Mangalanandan, Thacho S; Vivek, Lakshmanan; Praveen, Valiyaparambil P

2018-01-01

Available literature on the prevalence of Charcot arthropathy (CA) represents mainly Western population. No study has been reported from India so far. Hence we attempted to study the prevalence of CA in patients with type 2 diabetes mellitus and severe peripheral neuropathy (T2DMPN), belonging to Indian population amongst whom type 2 diabetes is on the rise in alarming proportions. Medical records of 3387 patients who performed an objective vibration perception threshold test during the year 2015 were screened for T2DMPN. Out of these, 1475 T2DMPN patients above 50 years were selected and analyzed in detail for CA. CA was diagnosed based on clinical features and/or radiological investigations. The anatomical localization of the disease distribution of the affected foot was done according to Brodsky's classification. The prevalence of CA in T2DMPN patients was found to be 9.8%. The mean age of patients diagnosed with CA was 63 ± 8.36 years, and mean duration of DM for CA to develop was 18.01 ± 8.23 years. About 62.5% of the patients were male and 37.5% female. Bilateral presentation of CA was observed in 20.8% of patients. Multiple sites of the foot were affected in 48.6% of patients and belonged to type 4 classification of Brodsky. A high prevalence of CA (9.8%) was observed in the present study conducted on T2DMPN patients who presented to the endocrinology department of a tertiary care South Indian hospital. In the majority of patients, the area of foot affected belonged to type 4 classification of Brodsky.

Spinal and sacroiliac gouty arthritis: report of a case and review of the literature

International Nuclear Information System (INIS)

Cardoso, Fabiano Nassar; Omoumi, Patrick; Wieers, Gregoire; Maldague, Baudouin; Malghem, Jacques; Lecouvet, Frédéric E; Vande Berg, Bruno C

2014-01-01

In this case report, we describe an “uncommon” case of axial gouty arthropathy in a 69-year-old woman with bilateral sciatica that was thoroughly evaluated with conventional radiography, CT scan, magnetic resonance imaging, bone scintigraphy, and PET-CT. Axial gouty arthropathy should be included in the differential diagnosis of chronic low back pain, mainly when several risk factors for gout are present

Al-Aqeel Sewairi Syndrome, a new autosomal recessive disorder with multicentric osteolysis, nodulosis and arthropathy. The first genetic defect of matrix metalloproteinase 2 gene

International Nuclear Information System (INIS)

Al-Aqeel, Aida I.

2005-01-01

We report a distinctive autosomal recessive multicentric osteolysis in Saudi Arabian families with distal arthropathy of the metacarpal, metatarsal and interphalangeal joints, with ultimate progression to the proximal joints with decreased range of movements and deformities with ankylosis and generalized osteopenia. In addition, they had large, painful to touch palmar and plantar pads. Hirsutism and mild dysmorphic facial features including proptosis, a narrow nasal bridge, bulbous nose and micrognathia. Using a genome-wide search for microsatellite markers from 11 members of the family from the Armed Forces Hospital and King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia, localized the disease gene to chromosome 16q12-21. Haplotype analysis with additional markers narrowed the critical region to 1.2cM and identified the matrix metalloproteinase 2 (MMP-2), (gelatinase A, collagenase type IV, EC 3.4, 24,24) gene as a disease candidate at Mount Sinai School of Medicine, New York, United States of America in April 2000. Some affected individuals were homoallelic for a nonsense mutation (TCA>TAA) in codon 244 of exon 5, predicting the replacement of a tyrosine residue by a stop codon in the first fibronectin type II domain (Y244X). Other affected members had a missense mutation in exon 2 arginine 101-histidine (R101H) leading to no MMP-2 enzyme activity in serum or fibroblast or both of affected individuals. In other affected members, a non-pathogenic homoallelic GT transversion resulted in the substitution of an aspartate with a tyrosine residue in codon 210 of exon 4 (D210Y). The MMP-2-null mouse has no developmental defects, but are small, which may reflect genetic redundancy. The discovery that deficiency of this well-characterized gelatinase/collagenase results in an inherited form of an osteolytic and arthritic disorder provides an invaluable insights for the understanding of osteolysis and arthritis and is the first genetic

[Laparoscopic cystectomy and ileal conduit urinary diversion for neurogenic bladders and related conditions. Morbidity and better quality of life].

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Sakhri, R; Seigle-Murandi, F; Jacqmin, D; Lang, H; Saussine, C

2015-05-01

To assess morbidity and functional consequences of laparoscopic cystectomy with ileal conduit urinary diversion: in neurologic patients. We reviewed the records of forty-two patients (ten men and thirty-two women) who underwent surgery between August 2007 and October 2013. The median age of the patient was 54 years old (range between 21-79 years). A laparoscopic cystectomy was performed followed by a short laparotomy to perform the ileal conduit urinary diversion. Records were reviewed to retrieve the indications and describe the postoperative and functional course. Patients and GPs were interviewed during phone calls to appreciate the quality of life by the PGII scale in order to assess the functional outcome. The operation was performed on 42 patients, of whom 18 had multiple sclerosis, nine a post-traumatic neurogenic bladder. Among the total population, 10 patients (23.81%) required a transfusion of at least one packed red blood cells (1-7). The overall rate of early complications was 35.71%. Belated complications were seen in 52.38% of the population. The median duration of hospital stay was 16 days (range between 9-70 days). The median follow up was 34 months (range between 1-76 months). For patients, the PGII scale rating had a median value of 6 (2-7). All referring physicians described a better functional status. The laparoscopic cystectomy can make postoperative course smoother for the neurological patients. However, the surgeon must weigh individually the benefit of performing the operation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Clinical course of a cohort of children with non-neurogenic daytime urinary incontinence symptoms followed at a tertiary center

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Adrienne Lebl

2016-04-01

Full Text Available Abstract Objective: To characterize a cohort of children with non-neurogenic daytime urinary incontinence followed-up in a tertiary center. Methods: Retrospective analysis of 50 medical records of children who had attained bladder control or minimum age of 5 years, using a structured protocol that included lower urinary tract dysfunction symptoms, comorbidities, associated manifestations, physical examination, voiding diary, complementary tests, therapeutic options, and clinical outcome, in accordance with the 2006 and 2014 International Children's Continence Society standardizations. Results: Female patients represented 86.0% of this sample. Mean age was 7.9 years and mean follow-up was 4.7 years. Urgency (56.0%, urgency incontinence (56.0%, urinary retention (8.0%, nocturnal enuresis (70.0%, urinary tract infections (62.0%, constipation (62.0%, and fecal incontinence (16.0% were the most prevalent symptoms and comorbidities. Ultrasound examinations showed alterations in 53.0% of the cases; the urodynamic study showed alterations in 94.7%. At the last follow-up, 32.0% of patients persisted with urinary incontinence. When assessing the diagnostic methods, 85% concordance was observed between the predictive diagnosis of overactive bladder attained through medical history plus non-invasive exams and the diagnosis of detrusor overactivity achieved through the invasive urodynamic study. Conclusions: This subgroup of patients with clinical characteristics of an overactive bladder, with no history of urinary tract infection, and normal urinary tract ultrasound and uroflowmetry, could start treatment without invasive studies even at a tertiary center. Approximately one-third of the patients treated at the tertiary level remained refractory to treatment.

Is non-invasive neuromuscular electrical stimulation effective in severe chronic neurogenic dysphagia? Reporton a post-traumatic brain injury patient.

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Calabrò, Rocco Salvatore; Nibali, Valeria Conti; Naro, Antonino; Floridia, Daniela; Pizzimenti, Maria; Salmeri, Lucia; Salviera, Carlo; Bramanti, Placido

2016-01-01

Neurogenic dysphagia is a difficulty in swallowing induced by nervous system disease. It often causes serious complications, which are preventable if dysphagia is properly managed. There is growing debate concerning the usefulness of non-invasive neuromuscular electrical stimulation (NMES) in treating swallowing dysfunction. Aim of this study was to assess the effectiveness of Vitalstim© device, and to investigate the neurophysiological mechanisms underlying functional recovery. A 34-year-old man, affected by severe chronic dysphagia following traumatic brain injury, underwent two different intensive rehabilitation trainings, including either conventional rehabilitation alone or coupled to Vitalstim training. We evaluated patient swallowing function in two separate sessions (i.e. before and after the two trainings) by means of ad hoc swallowing function scales and electrophysiological parameters (rapid paired associative stimulation). The overall Vitalstim program was articulated in 6 weekly sessions for 6 weeks. The patient did not report any side-effect either during or following both the intensive rehabilitation trainings. We observed an important improvement in swallowing function only after Vitalstim training. In fact, the patient was eventually able to safely eat even solid food. This is the first report objectively suggesting (by means of rPAS) a correlation between the brain neuroplastic changes induced by Vitalstim and the swallowing function improvement. It is hypothesizable that Vitalstim may have targeted cortical (and maybe subcortical) brain areas that are recruited during the highly coordinated function of swallowing, and it may have thus potentiated the well-known neuroplastic changes induced by repetitive and intensive swallowing exercises, probably thanks to metaplasticity phenomena.

Knee Fat Pad Volumes in Patients with Hemophilia and Their Relationship with Osteoarthritis

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Annette von Drygalski

2017-01-01

Full Text Available Hemophilic arthropathy is a progressive, disabling condition with poorly understood pathobiology. Since there is an emerging interest to study the role of intra-articular fat pad size and biology in arthritic conditions, we explored fat pad volume changes in hemophilic arthropathy and to what extent they differed from osteoarthritis. We matched a cohort of 13 adult patients with hemophilic arthropathy of the knee with age- and gender-matched cohorts without osteoarthritis (“control cohort” and with the same degree of radiographic osteoarthritis (“OA cohort” in 1 : 2 fashion. Infrapatellar fat pad (IPFP and suprapatellar fat pad (SPFP volumes were calculated based on magnetic resonance imaging and differences in fat pad volumes, demographics, height, weight, and osteoarthritis scores were evaluated. Fat pad volumes were positively associated with body size parameters in all three cohorts but were unaffected by the degree of osteoarthritis. While IPFP volumes did not differ between cohorts, SPFP volumes expanded disproportionally with weight in hemophilia patients. Our observations indicate that IPFPs and SPFPs behave biologically differently in response to different arthritic stimuli. The exaggerated expansion of the SPFP in hemophilia patients highlights the importance of further studying the implications of fat pad biology for progression of hemophilic arthropathy.

Our experience with orthopedic surgery in hemophiliacs

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Poenaru Dan V.

2006-01-01

Full Text Available Introduction: Patients having severe hemophilia (levels of deficient factor below 1% frequently suffer from disabling chronic arthropathy. An adequate substitution treatment using the coagulation factor VIII or IX concentrates renders an elective surgery feasible. Objective: The objective of the study was to check the results of different surgical procedures in the treatment of hemophilic arthropathies, and to propose the best protocol of their treatment. Methods: This is a retrospective study on 26 hemophilic patients operated in the Orthopedics and Trauma Clinic II, Timisoara, from 2002 to 2005. Elective surgical procedures were mainly performed in the knee (21 arthroscopic procedures, 1 open arthrodesis, elbow (2 open synovectomies, 2 radial head excisions, ankle (1 arthroscopic synovectomy and debridement and thigh (1 giant pseudo tumor excision, other minor procedures. The results after operations on moderate and severe chronic knee, elbow and ankle arthropathy were evaluated, with approximately 24-month follow-up period. Results: Arthroscopic procedures (22 yielded good and satisfactory results with significant improvement according to the evaluation criteria recommended by the World Hemophilia Federation (Gilbert clinical score, Pettersson radiological score, NUSS MRI score. Conclusion: Mini-invasive elective surgery in moderate to severe chronic arthropathy produces good results when performed in a specialized center and with multi-disciplinary approach.

Psoriasis and psoriasic arthritis

International Nuclear Information System (INIS)

Cortes Vera, Sandra Liliana; Iglesias Gamarra, Antonio; Restrepo Suarez, Jose Felix

2003-01-01

The psoriasis is an skin inflammatory disease characterized by chronic and recurrent red skin covered with silver scales. In their pathogenesis, immunogenetic and environmental factors are conjugated. Psoriatic arthritis. That is a seronegative arthropathy. In the greater part of cases follow to a chronic course of cutaneous psoriasis. In this paper, we analyzed the most frequent forms of presentation of cutaneous psoriasis and we revised the psoriatic arthropathy, with some indications about its treatment

[Definition of botulinum toxin failure in neurogenic detrusor overactivity: Preliminary results of the DETOX survey].

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Peyronnet, B; Sanson, S; Amarenco, G; Castel-Lacanal, E; Chartier-Kastler, E; Charvier, K; Damphousse, M; Denys, P; de Seze, M; Egon, G; Even, A; Forin, V; Karsenty, G; Kerdraon, J; le Normand, L; Loche, C-M; Manunta, A; Mouracade, P; Phe, V; Previnaire, J-G; Ruffion, A; Saussine, C; Schurch, B; Game, X

2015-12-01

There is currently no guideline regarding the management of neurogenic detrusor overactivity (NDO) refractory to intra-detrusor botulinum toxin injections. The primary objective of the present study was to find a consensus definition of failure of botulinum toxin intra-detrusor injections for NDO. The secondary objective was to report current trends in the managment of NDO refractory to botulinum toxin. A survey was created, based on data drawn from current literature, and sent via e-mail to all the experts form the Group for research in neurourology in french language (GENULF) and from the comittee of neurourology of the French urological association (AFU). The experts who did not answer to the first e-mail were contacted again twice. Main results from the survey are presented and expressed as numbers and proportions. Out of the 42 experts contacted, 21 responded to the survey. Nineteen participants considered that the definition of failure should be a combination of clinical and urodynamics criteria. Among the urodynamics criteria, the persistence of a maximum detrusor pressure>40 cm H2O was the most supported by the experts (18/21, 85%). According to the vast majority of participants (19/21, 90.5%), the impact of injections on urinary incontinence should be included in the definition of failure. Regarding the management, most experts considered that the first line treatment in case of failure of a first intra-detrusor injection of Botox(®) 200 U should be a repeat injection of Botox(®) at a higher dosage (300 U) (15/20, 75%), regardless of the presence or not of urodynamics risk factors of upper tract damage (16/20, 80%). This work has provided a first overview of the definition of failure of intra-detrusor injections of botulinum toxin in the management of NDO. For 90.5% of the experts involved, the definition of failure should be clinical and urodynamic and most participants (75%) considered that, in case of failure of a first injection of Botox(®) 200 U

Molecular Targets of Chromatin Repressive Mark H3K9me3 in Primate Progenitor Cells within Adult Neurogenic Niches

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Michael R Foret

2014-07-01

Full Text Available Histone 3 Lysine 9 (H3K9 methylation is known to be associated with pericentric heterochromatin and important in genomic stability. In this study, we show that trimethylation at H3K9 (H3K9me3 is enriched in an adult neural stem cell niche- the subventricular zone (SVZ on the walls of the lateral ventricle in both rodent and non-human primate baboon brain. Previous studies have shown that there is significant correlation between baboon and human regarding genomic similarity and brain structure, suggesting that findings in baboon are relevant to human. To understand the function of H3K9me3 in this adult neurogenic niche, we performed genome-wide analyses using ChIP-Seq (chromatin immunoprecipitation and deep-sequencing and RNA-Seq for in vivo SVZ cells purified from baboon brain. Through integrated analyses of ChIP-Seq and RNA-Seq, we found that H3K9me3-enriched genes associated with cellular maintenance, post-transcriptional and translational modifications, signaling pathways, and DNA replication are expressed, while genes involved in axon/neuron, hepatic stellate cell, or immune-response activation are not expressed. As neurogenesis progresses in the adult SVZ, cell fate restriction is essential to direct proper lineage commitment. Our findings highlight that H3K9me3 repression in undifferentiated SVZ cells is engaged in the maintenance of cell type integrity, implicating a role for H3K9me3 as an epigenetic mechanism to control cell fate transition within this adult germinal niche.

Consensus statement on the definition of neurogenic supine hypertension in cardiovascular autonomic failure by the American Autonomic Society (AAS) and the European Federation of Autonomic Societies (EFAS) : Endorsed by the European Academy of Neurology (EAN) and the European Society of Hypertension (ESH).

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Fanciulli, Alessandra; Jordan, Jens; Biaggioni, Italo; Calandra-Buonaura, Giovanna; Cheshire, William P; Cortelli, Pietro; Eschlboeck, Sabine; Grassi, Guido; Hilz, Max J; Kaufmann, Horacio; Lahrmann, Heinz; Mancia, Giuseppe; Mayer, Gert; Norcliffe-Kaufmann, Lucy; Pavy-Le Traon, Anne; Raj, Satish R; Robertson, David; Rocha, Isabel; Struhal, Walter; Thijs, Roland; Tsioufis, Konstantinos P; van Dijk, J Gert; Wenning, Gregor K

2018-05-15

Patients suffering from cardiovascular autonomic failure often develop neurogenic supine hypertension (nSH), i.e., high blood pressure (BP) in the supine position, which falls in the upright position owing to impaired autonomic regulation. A committee was formed to reach consensus among experts on the definition and diagnosis of nSH in the context of cardiovascular autonomic failure. As a first and preparatory step, a systematic search of PubMed-indexed literature on nSH up to January 2017 was performed. Available evidence derived from this search was discussed in a consensus expert round table meeting in Innsbruck on February 16, 2017. Statements originating from this meeting were further discussed by representatives of the American Autonomic Society and the European Federation of Autonomic Societies and are summarized in the document presented here. The final version received the endorsement of the European Academy of Neurology and the European Society of Hypertension. In patients with neurogenic orthostatic hypotension, nSH is defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg, measured after at least 5 min of rest in the supine position. Three severity degrees are recommended: mild, moderate and severe. nSH may also be present during nocturnal sleep, with reduced-dipping, non-dipping or rising nocturnal BP profiles with respect to mean daytime BP values. Home BP monitoring and 24-h-ambulatory BP monitoring provide relevant information for a customized clinical management. The establishment of expert-based criteria to define nSH should standardize diagnosis and allow a better understanding of its epidemiology, prognosis and, ultimately, treatment.

Lack of efficacy during the switch from brand to generic allopurinol.

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De Vuono, Antonio; Scicchitano, Francesca; Palleria, Caterina; Russo, Emilio; De Sarro, Giovambattista; Gallelli, Luca

2013-07-01

We report for the first time the lack of therapeutic effects after the switch from a brand formulation of allopurinol to a generic one. A 56-year-old man, with a 5 years history of well-treated gout arthropathy with allopurinol (Zyloric(®) 300 mg/die), developed acute gout arthropathy after the switch from the brand formulation of allopurinol to a generic one. Clinical evaluation and laboratory findings confirmed the diagnosis of acute gout arthropathy. Generic formulation of the drug was dismissed and Zyloric(®) was administered with an improvement of both clinical symptoms and laboratory findings. In conclusion, even if generic formulations are considered to have the same effects in comparison to the brand one, more data are necessaries in order to well define their effectiveness and rationale use. Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Acute anterior uveitis as the initial presentation of alkaptonuria.

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John, S S; Padhan, P; Mathews, J V; David, S

2009-01-01

Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

Influence of enrichment on behavioral and neurogenic effects of antidepressants in Wistar rats submitted to repeated forced swim test.

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Possamai, Fernanda; dos Santos, Juliano; Walber, Thais; Marcon, Juliana C; dos Santos, Tiago Souza; Lino de Oliveira, Cilene

2015-04-03

Repeated forced swimming test (rFST) may detect gradual effects of antidepressants in adult rats. Antidepressants, as enrichment, affected behavior and neurogenesis in rats. However, the influence of enrichment on behavioral and neurogenic effects of antidepressants is unknown. Here, effects of antidepressants on rFST and hippocampal neurogenesis were investigated in rats under enriched conditions. Behaviors of male Wistar rats, housed from weaning in standard (SE) or enriched environment (EE), were registered during rFST. The rFST consisted of 15min of swimming (pretest) followed by 5min of swimming in the first (test), seventh (retest 1) and fourteenth (retest 2) days after pretest. One hour before the test, rats received an intraperitoneal injection of saline (1ml/kg), fluoxetine (2.5mg/kg) or imipramine (2.5 or 5mg/kg). These treatments were performed daily until the day of the retest 2. After retest 2, rats were euthanized for the identification of markers for neurogenesis in the hippocampus. Fluoxetine or imipramine decreased immobility in retests 1 and 2, as compared to saline. EE abolished these differences. In EE, fluoxetine or imipramine (5mg/kg) reduced immobility time in retest 2, as compared to the test. Independent of the housing conditions, fluoxetine and imipramine (5mg/kg) increased the ratio of immature neurons per progenitor cell in the hippocampus. In summary, antidepressants or enrichment counteracted the high immobility in rFST. Enrichment changed the effects of antidepressants in rFST depending on the type, and the dose of a substance but failed to change neurogenesis in control or antidepressant treated-rats. Effects of antidepressants and enrichment on rFST seemed neurogenesis-independent. Copyright © 2014 Elsevier Inc. All rights reserved.

Clinical and radiological study of osteoarticular manifestations of systemic lupus erythematosus

International Nuclear Information System (INIS)

Kubota, E.S.; Rocha Correa Fernandes, A. da; Wichrowski, M.

1990-01-01

The ostearticular involvement in systemic lupus erythematosus (SLE) is the most frequent manifestation of this illness, which develops with activity and remission periods. In spite of the recurrence, it presents without clinic sequelae in great part of the cases. The objective of this study was to evaluate patients with prolonged osteoarticular involvement, remaining with or without sequelae. Within a total of 115 patients with SLE there have been studied 21 patients that presented clinic evidences of chronic synovitis, deforming arthropathy with the presence of cysts, erosions, narrowing of the articular space, periepiphyseal osteopenia, and 4 cases with deforming arthropathy alone. In just 2 cases of chronic synovitis with radiologic changes there have been association with deforming arthropathy. Asseptic necrosis occurred in 8 cases being multiple and symmetric in 7 cases. The association with previous corticosteroid use was found in all patients, as well as an important systemic activity of the illness in the precedent period of the asseptic necrosis diagnosis. (author) [pt

Magnetic resonance imaging in acute and chronic rotator cuff tears

International Nuclear Information System (INIS)

Buirski, G.

1990-01-01

Magnetic resonance imaging has been assessed in patients with acute rotator cuff tears and normal radiographs (9 cases) and those with chronic tears and changes of cuff arthropathy (9 cases). All images were obtained using a low field strength system (FONAR 0.3 T). Particular attention was placed on the appearances of the tendon and the cuff muscles themselves. Six complete acute tears were clearly identified, but MRI failed to demonstrate two partial tears. Muscle bulk was preserved in all patients in this group. In contrast, all patients with cuff arthropathy had complete tears of the supraspinatus tendon with marked tendon retraction and associated muscle atrophy: These changes precluded primary surgical repair. MRI should be used to assess muscle atrophy preoperatively in those patients with acute tears. When plain radiographs demonstrate cuff arthropathy, the MRI appearances are predictable and primary repair is unlikely to be successful. Further imaging is therefore not indicated. (orig.)

Acute anterior uveitis as the initial presentation of alkaptonuria

Directory of Open Access Journals (Sweden)

Padhan P

2009-01-01

Full Text Available Alkaptonuria is a rare autosomal recessive metabolic disorder that may present with multi-system involvement such as ochronotic arthropathy, renal, urethral and prostatic calculi, cardiac valvular lesions and pigmentation of the skin, sclera, cartilage and other connective tissues. An association of the disease with uveitis has never been reported. We report the first case of alkaptonuria with ochronotic arthropathy presenting with recurrent acute anterior uveitis as the initial manifestation. The possible common link with the HLA-B27 gene is discussed.

Generalised pustular psoriasis, psoriatic arthritis and nephrotic syndrome associated with systemic amyloidosis.

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David, M; Abraham, D; Weinberger, A; Feuerman, E J

1982-09-01

The case report is presented of a psoriatic patient with arthropathy, generalised pustular psoriasis and nephrotic syndrome, in whom systemic amyloidosis developed. The literature reports 13 cases of psoriasis associated with amyloidosis, 3 of whom suffered from pustular psoriasis as does our case. With the addition of our case, 12 of these 14 had concomitant arthropathy. This seems to suggest that arthritis is an important factor in the appearance of amyloidosis. Rectal biopsy and/or renal biopsy may be helpful in establishing the diagnosis of amyloidosis relatively early in patients with psoriatic arthritis.

Neurogenic detrusor overactivity is associated with decreased expression and function of the large conductance voltage- and Ca(2+-activated K(+ channels.

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Kiril L Hristov

Full Text Available Patients suffering from a variety of neurological diseases such as spinal cord injury, Parkinson's disease, and multiple sclerosis often develop neurogenic detrusor overactivity (NDO, which currently lacks a universally effective therapy. Here, we tested the hypothesis that NDO is associated with changes in detrusor smooth muscle (DSM large conductance Ca(2+-activated K(+ (BK channel expression and function. DSM tissue samples from 33 patients were obtained during open bladder surgeries. NDO patients were clinically characterized preoperatively with pressure-flow urodynamics demonstrating detrusor overactivity, in the setting of a clinically relevant neurological condition. Control patients did not have overactive bladder and did not have a clinically relevant neurological disease. We conducted quantitative polymerase chain reactions (qPCR, perforated patch-clamp electrophysiology on freshly-isolated DSM cells, and functional studies on DSM contractility. qPCR experiments revealed that DSM samples from NDO patients showed decreased BK channel mRNA expression in comparison to controls. Patch-clamp experiments demonstrated reduced whole cell and transient BK currents (TBKCs in freshly-isolated DSM cells from NDO patients. Functional studies on DSM contractility showed that spontaneous phasic contractions had a decreased sensitivity to iberiotoxin, a selective BK channel inhibitor, in DSM strips isolated from NDO patients. These results reveal the novel finding that NDO is associated with decreased DSM BK channel expression and function leading to increased DSM excitability and contractility. BK channel openers or BK channel gene transfer could be an alternative strategy to control NDO. Future clinical trials are needed to evaluate the value of BK channel opening drugs or gene therapies for NDO treatment and to identify any possible adverse effects.

Neurogenic bladder

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... cause skin to break down and lead to pressure sores Kidney damage if the bladder becomes too full, ... dysfunction; NBSD Patient Instructions Multiple sclerosis - discharge Preventing pressure ulcers Images Voiding cystourethrogram References Chapple CR, Osman NI. ...

A preliminary investigation on the effect of extracorporeal shock wave therapy as a treatment for neurogenic heterotopic ossification following traumatic brain injury. Part II: Effects on function.

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Reznik, J E; Biros, E; Sacher, Y; Kibrik, O; Milanese, S; Gordon, S; Galea, M P

2017-01-01

Neurogenic heterotopic ossification (NHO) occurs as a complication of traumatic brain injury (TBI). Management of clinically significant NHO remains variable. Complications of mature NHO include limitation of mobility. The effect of the extracorporeal shock wave therapy (ESWT) on range of motion at hip and knee, and function in patients with TBI with chronic NHO was investigated. A series of single-case studies applying ESWT to chronic NHO at the hip or knee of 11 patients with TBI were undertaken at a rehabilitation hospital. Participants received four applications of high-energy EWST delivered to the affected hip or knee over a period of 8 weeks. Two-weekly follow- up assessments were carried out; final assessments were made 3 and 6 months post-intervention. Range of motion (ROM) and Functional Reach (FR) or Modified Functional Reach (MFR) were measured. Application of high-energy ESWT was associated with significant improvement in ROM (flexion) of the NHO-affected knee (Tau = 0.833, 95% CI 0.391-1.276, p = 0.002) and significant improvement of FR (Overall Tau 0.486, 95% CI 0.141-0.832, p = 0.006); no significant improvement in hip ROM or MFR. ESWT may improve mobility and balance of patients with TBI who have chronic NHO.

Rapidly Progressive Osteoarthritis: a Review of the Clinical and Radiologic Presentation.

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Flemming, Donald J; Gustas-French, Cristy N

2017-07-01

The purpose of this paper is to review the distinct clinical and radiographic features that may lead to prompt diagnosis of rapidly progressive osteoarthritis (RPOA) and thus obviate unnecessary and costly diagnostic workup. RPOA is uncommon but is more frequently seen in practice because of the aging population. RPOA is a destructive arthropathy that occurs most commonly in elderly women but can also be seen in patients that have sustained trauma. The dramatic radiologic manifestations of RPOA can lead to diagnostic confusion with other arthropathies, infection, and osteonecrosis. RPOA was originally described in the hip but may also involve the shoulder. The etiology of RPOA is not well understood, but subchondral fracture probably plays a role in the development of dramatic destruction of the joint that is seen in affected patients. Early diagnosis may reduce the complexity of surgical management. RPOA is an uncommon condition that occurs most frequently in elderly woman or in patients who have sustained trauma. Prompt recognition of the clinical and radiologic features of this arthropathy can reduce unnecessary diagnostic workup and complexity of surgical intervention.

Incidental finding of knee osteoarthritis in bone scans performed in obese patients with neoplasia

International Nuclear Information System (INIS)

Regalado R, R.; Morales G, R.; Cano P, R.; Mendoza P, G.; Vidal N, L.

1996-01-01

Bone scanning performed in the Nuclear Medicine Center (IPEN-INEN) to patients with neoplastic diagnosis between January 1995 and June 1996, permitted the incidental finding of increased uptake images in the knees of 28 patients associated to an asymptomatic arthropathy: osteoarthritis. The histories and bone scanning of this patients were reviewed obtaining their weight, occupation, symptomatology, neoplastic diagnosis and previous scan diagnosis. Patients under 66 years old, asymptomatic, were included, not presenting secondary focuses, without arthropathia antecedent and with a body mass index equal or above class I. The arthropathy was classified according to the localization of the compromised compartment of the knee. >From the body mass index assessment of every patient it was obtained: Class I=12, Class II=11, Class III=3 and Class IV=1. The predominant localization of the osteoarthritic lesions was the patellar zone. We discuss factors that may influence the absence of symptoms of this disease, the relation obesity-osteoarthritis and the usefulness of bone scanning in the diagnosis of this arthropathy in these patients. (authors). 16 refs., 1 fig., 3 tabs

The detrimental effects of iron on the joint: a comparison between haemochromatosis and haemophilia.

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van Vulpen, Lize F D; Roosendaal, Goris; van Asbeck, B Sweder; Mastbergen, Simon C; Lafeber, Floris P J G; Schutgens, Roger E G

2015-08-01

Joint damage due to (recurrent) joint bleeding in haemophilia causes major morbidity. Although the exact pathogenesis has not been fully elucidated, a central role for iron is hypothesised. Likewise, in hereditary haemochromatosis joint destruction is caused by iron overload. A comparison between these types of arthropathy could provide more insight in the influence of iron in inducing joint damage. A literature review was performed to compare both disorders with respect to their clinical and histological characteristics, and preclinical studies on the influence of iron on different joint components were reviewed. Similarities in the features of arthropathy in haemochromatosis and haemophilia are cartilage degeneration, subchondral bone changes with osteophyte and cyst formation, and osteoporosis. In both disorders synovial inflammation and proliferation are seen, although this is much more explicit in haemophilia. Other substantial differences are the age at onset, the occurrence of chondrocalcinosis radiographically and calcium pyrophosphate dihydrate deposition disease in haemochromatosis, and a rapid progression with joint deformity and neovascularisation in haemophilia. Preclinical studies demonstrate detrimental effects of iron to all components of the joint, resulting in synovial inflammation and hyperplasia, chondrocyte death, and impaired osteoblast function. These effects, particularly the synovial changes, are aggravated in the presence of a pro-inflammatory signal, which is prominent in haemophilic arthropathy and minimal in haemochromatosis. Additional research is needed to further specify the role of iron as a specific target in treating these types of arthropathy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Hyaline cartilage involvement in patients with gout and calcium pyrophosphate deposition disease. An ultrasound study.

Science.gov (United States)

Filippucci, E; Riveros, M Gutierrez; Georgescu, D; Salaffi, F; Grassi, W

2009-02-01

The main aim of the present study was to determine the sensitivity, specificity and accuracy of ultrasonography (US) in detecting monosodium urate and calcium pyrophosphate dihydrate crystals deposits at knee cartilage level using clinical definite diagnosis as standard reference. A total of 32 patients with a diagnosis of gout and 48 patients with pyrophosphate arthropathy were included in the study. Fifty-two patients with rheumatoid arthritis (RA), psoriatic arthritis or osteoarthritis (OA) were recruited as disease controls. All diagnoses were made using an international clinical criterion. US examinations were performed by an experienced sonographer, blind to clinical and laboratory data. Hyaline cartilage was assessed to detect two US findings recently indicated as indicative of crystal deposits: hyperechoic enhancement of the superficial margin of the hyaline cartilage and hyperechoic spots within the cartilage layer not generating a posterior acoustic shadow. Hyperechoic enhancement of the chondrosynovial margin was found in at least one knee of 14 out of 32 (43.7%) patients with gout and in a single knee of only one patient affected by pyrophosphate arthropathy (specificity=99%). Intra-cartilaginous hyperechoic spots were detected in at least one knee of 33 out of 48 (68.7%) patients with pyrophosphate arthropathy and in two disease controls one with OA and the second with RA (specificity=97.6%). The results of the present study indicate that US may play a relevant role in distinguishing cartilage involvement in patients with crystal-related arthropathy. The selected US findings were found to be highly specific.

Patients With Neurogenic Lower Urinary Tract Dysfunction Following Spinal Cord Injury Are at Increased Risk of Developing Type 2 Diabetes Mellitus: A Population-Based Cohort Study.

Science.gov (United States)

Lien, Wei-Chih; Kuan, Ta-Shen; Lin, Yu-Ching; Liang, Fu-Wen; Hsieh, Pei-Chun; Li, Chung-Yi

2016-01-01

To investigate whether patients with neurogenic lower urinary tract dysfunction (NLUTD) following spinal cord injury (SCI) are at increased risk of developing type 2 diabetes mellitus (T2DM).The retrospective cohort study used a subset of the Taiwan National Health Insurance Research Database (NHIRD) comprising information on 2 million beneficiaries randomly sampled from the general population. A total of 3515 patients with newly diagnosed SCI were identified during the period of 2001 to 2008. Among them, 170 developed NLUTD following SCI. The control group was consisted of 656 patients without NLUTD over the study period randomly selected by matching NLUTD cases on the date of NLUTD incidence, age, sex, and duration since diagnosis of SCI. The study groups were then followed to the end of 2009. T2DM was the end-point.The incidence rate ratios of T2DM were higher in the NLUTD group than in the control group (4.94 vs. 2.61 per 10,000 person-years), representing an adjusted hazard ratio (AHR) of 1.70 (95% confidence interval [CI] 1.11-2.61). Age-specific AHR was significantly elevated only in patients aged > = 60 years (AHR = 2.52 (95% CI 1.35-4.70)).This study showed that the NLUTD following SCI may significantly increase the risk of developing T2DM.

Radiologic findings of hemophilic arthropathy

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Jun, Young Hwan; Yeon, Kyung Mo; Kim, Chu Wan [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

1980-12-15

Hemophilia is a primary disorder of coagulation complicated by spontaneous intra-articular hemorrhage. This paper is to describe and analyze the radiographic findings of involved bone and joints of hemophilic patients for past 5 years. The results were as follows: 1. Age distribution of the total 28 patients was ranging from 1 year to 42 years. 86% of patients was below the age of 20 years. 2. The incidence of joint involvement was in next order; knee joint (25), elbow joint (4), ankle joint (2), hip joint (1). 3. The radiologic findings of involved joint were characterized by irregularity of articular cortices (22), joint space change (19), soft tissue swelling (19), subchondral or intra-osseous cyst (12), periarticular osteoporosis (19), degenerative change (10), condylar enlargement (11) intercondylar notch widening (21) and flexion deformity (13)

Radiologic findings of hemophilic arthropathy

International Nuclear Information System (INIS)

Jun, Young Hwan; Yeon, Kyung Mo; Kim, Chu Wan

1980-01-01

Hemophilia is a primary disorder of coagulation complicated by spontaneous intra-articular hemorrhage. This paper is to describe and analyze the radiographic findings of involved bone and joints of hemophilic patients for past 5 years. The results were as follows: 1. Age distribution of the total 28 patients was ranging from 1 year to 42 years. 86% of patients was below the age of 20 years. 2. The incidence of joint involvement was in next order; knee joint (25), elbow joint (4), ankle joint (2), hip joint (1). 3. The radiologic findings of involved joint were characterized by irregularity of articular cortices (22), joint space change (19), soft tissue swelling (19), subchondral or intra-osseous cyst (12), periarticular osteoporosis (19), degenerative change (10), condylar enlargement (11) intercondylar notch widening (21) and flexion deformity (13)

Hemophilic arthropathy of the knee

International Nuclear Information System (INIS)

Idy-Peretti, I.; LeBalch, T.

1990-01-01

This paper classifies the subchondral cysts of the knee joint in young hemophiliacs and studies the evolution of the cyst. Both knees of 64 patients with severe hemophilia A (mean age, 16 years) were assessed with MR imaging (1.5-T Signa, General Electric). Twenty-five patients underwent MR follow-up for 1-4 years. The 258 cysts observed were classified into four types. The LL cysts were seen as areas of low (L) signal intensity on both T1- and T2-weighted images. The LH cysts demonstrated a decreased signal intensity on T1-weighted images and a high (H) signal intensity on T2-weighted images. The HH cysts showed an intermediate to high signal intensity on T1-weighted images and an increased signal intensity on T2-weighted images. The C cysts were complex, showing variable intensity spread out irregularly over the cyst

Study of kidney damage in paediatric patients with neurogenic bladder and its relationship with the pattern of bladder function and treatment received.

Science.gov (United States)

Rodríguez-Ruiz, M; Somoza, I; Curros-Mata, N

2016-01-01

Kidney failure is the main cause of morbidity and mortality in patients with myelodysplasia. We analysed the presence of renal lesions in these patients using dimercaptosuccinic acid scintigraphy and related their presence with the type of vesical function and the delay in receiving appropriate management. We performed a retrospective study of patients with myelodysplasia treated in our hospital since 2004. We analysed the epidemiological and clinical data and the pattern of bladder function according to urodynamic studies. We classified the patients into 4 urodynamic patterns according to detrusor and sphincter behaviour. We linked this behaviour to renal function in the scintigraphy and the care received since birth. The study included 39 patients with myelodysplasia. The most common bladder pattern was type A (61.5%), with sphincter and detrusor hyperactivity, followed by type D (20.5%), C (7.8%) and B (5.1%). Some 38% of our patients (n=15) had some type of nephropathy. Some 92.9% of the children who were properly treated during the first year of their life had no renal lesions in the scintigraphy. We found some type of nephropathy in 56% of the patients for whom appropriate treatment was delayed for more than a year. The nephropathy was more severe the later the management was started. There is a statistically significant relationship between a delay in treatment and impairment in renal scintigraphy in patients with neurogenic bladders. The early study and treatment of patients is essential for decreasing renal impairment, reducing the need for surgery and improving the continence options. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Haemophilia imaging: a review

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Maclachlan, Jody; Gough-Palmer, Antony; Hargunani, Rikin; Farrant, Joanna; Holloway, Brian [Royal Free Hospital, London (United Kingdom)

2009-10-15

Haemophilia disorders are characterised by a blood coagulation anomaly leading to prolonged and excessive bleeding. Imaging provides an essential role in the investigation of both the musculoskeletal and the non-musculoskeletal complications of haemophilia. Our institution is home to a large tertiary referral centre for haemophilia treatment. Using our broad experience, we present a multi-modality pictorial review of the musculoskeletal manifestations of haemophilia, including haemophilic arthropathy, intra-muscular haemorrhage and haemophilic pseudotumour. The main imaging features of haemophilic arthropathy are described, including synovial hypertrophy, haemosiderin deposition, sub-chondral cyst formation and loss of joint space. (orig.)

Haemophilia imaging: a review

International Nuclear Information System (INIS)

Maclachlan, Jody; Gough-Palmer, Antony; Hargunani, Rikin; Farrant, Joanna; Holloway, Brian

2009-01-01

Haemophilia disorders are characterised by a blood coagulation anomaly leading to prolonged and excessive bleeding. Imaging provides an essential role in the investigation of both the musculoskeletal and the non-musculoskeletal complications of haemophilia. Our institution is home to a large tertiary referral centre for haemophilia treatment. Using our broad experience, we present a multi-modality pictorial review of the musculoskeletal manifestations of haemophilia, including haemophilic arthropathy, intra-muscular haemorrhage and haemophilic pseudotumour. The main imaging features of haemophilic arthropathy are described, including synovial hypertrophy, haemosiderin deposition, sub-chondral cyst formation and loss of joint space. (orig.)

Tet2 Rescues Age-Related Regenerative Decline and Enhances Cognitive Function in the Adult Mouse Brain

Directory of Open Access Journals (Sweden)

Geraldine Gontier

2018-02-01

Full Text Available Restoring adult stem cell function provides an exciting approach for rejuvenating the aging brain. However, molecular mechanisms mediating neurogenic rejuvenation remain elusive. Here we report that the enzyme ten eleven translocation methylcytosine dioxygenase 2 (Tet2, which catalyzes the production of 5-hydroxymethylcytosine (5hmC, rescues age-related decline in adult neurogenesis and enhances cognition in mice. We detected a decrease in Tet2 expression and 5hmC levels in the aged hippocampus associated with adult neurogenesis. Mimicking an aged condition in young adults by abrogating Tet2 expression within the hippocampal neurogenic niche, or adult neural stem cells, decreased neurogenesis and impaired learning and memory. In a heterochronic parabiosis rejuvenation model, hippocampal Tet2 expression was restored. Overexpressing Tet2 in the hippocampal neurogenic niche of mature adults increased 5hmC associated with neurogenic processes, offset the precipitous age-related decline in neurogenesis, and enhanced learning and memory. Our data identify Tet2 as a key molecular mediator of neurogenic rejuvenation.

Identification of eight new mutations in familial neurogenic diabetes insipidus supports the concept that defective folding of the mutant provasopressin-neurophysin causes the disease

Energy Technology Data Exchange (ETDEWEB)

Rittig, S.; Siggaard, C.; Pedersen, E.B. [University Hospital in Aarhus (Denmark)] [and others

1994-09-01

Familial neurogenic diabetes insipidus (FNDI) is an autosomal dominant disorder with a uniform phenotype characterized by polyuria, polydipsia and a severe deficiency of arginine vasopressin (AVP). These abnormalities develop postnatally and appear to be due to progressive degeneration of AVP producing neurons. Previous studies in 8 FNDI kindreds have identified 5 different mutations in the gene that codes for the AVP-neurophysin (NP) precursor, AVP-NP. Four kindreds had the same missense mutation in the part of exon 1 that codes for the C-terminal amino acid of the signal peptide (SP). The other 4 had different missense mutations or a codon deletion in exon 2 which codes for the highly conserved part of NP. In the present study, the AVP-NP genes from 8 other kindreds with FNDI were sequenced bidirectionally using sequence and single-stranded DNA amplified by PCR with biotinylated primers flanking each of the 3 exons. We find that each of the 8 kindreds has a different, previously unreported mutation in either the SP coding part of exon 1, in exon 2 or in the variable, NP-coding part of exon 3. Combining these 8 new mutations with the 5 described previously reveals a distribution pattern that corresponds closely to the domains involved in the mutually interactive processes of AVP binding, folding and dimerization of NP. Based on these findings and the clinical features of FNDI, we postulate that the precursors produced by the mutant alleles are cytotoxic because they do not fold or dimerize properly for subsequent packaging and processing.

Radiological findings in NAO syndrome

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Al-Otaibi, Leftan; Hugosson, Claes O. [Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia); Al-Mayouf, Sulalman M.; Majeed, Mahmoud; Al-Eid, Wea' am; Bahabri, Sultan [Department of Paediatrics, King Faisal Specialist Hospital and Research Center, Riyadh (Saudi Arabia)

2002-07-01

Background: Diseases exhibiting osteolysis in children are rare hereditary conditions. Several types have been recognised with different clinical manifestations. One type includes subcutaneous nodules, arthropathy and osteolysis and has been termed NAO syndrome. Previous radiological reports have described the affected bones, usually the carpal and tarsal regions, but a detailed analysis of the radiological findings of both the axial as well as the appendicular skeleton has not been reported. Objectives: To describe the radiological findings in a large group of children with an autosomal recessive disease characterized by nodules, familial arthropathy and osteolysis. Materials and methods: The study comprises 14 patients from 9 families and all patients had the triad of nodulosis, arthropathy and osteolysis (NAO). Results: The most common radiological manifestations were osteopenia, undertubulation of long bones, arthritic changes, sclerotic sutures of the calvaria, osteolysis and muscle contractures. Other common findings were squared vertebrae, broad medial clavicles and brachycephaly. Progress of disease was documented in more than half of the patients. Conclusions: Our study is the first report of the detailed radiological findings of NAO syndrome. In NAO syndrome, both the axial and appendicular skeleton are involved (orig.)

Radiological findings in NAO syndrome

International Nuclear Information System (INIS)

Al-Otaibi, Leftan; Hugosson, Claes O.; Al-Mayouf, Sulalman M.; Majeed, Mahmoud; Al-Eid, Wea'am; Bahabri, Sultan

2002-01-01

Background: Diseases exhibiting osteolysis in children are rare hereditary conditions. Several types have been recognised with different clinical manifestations. One type includes subcutaneous nodules, arthropathy and osteolysis and has been termed NAO syndrome. Previous radiological reports have described the affected bones, usually the carpal and tarsal regions, but a detailed analysis of the radiological findings of both the axial as well as the appendicular skeleton has not been reported. Objectives: To describe the radiological findings in a large group of children with an autosomal recessive disease characterized by nodules, familial arthropathy and osteolysis. Materials and methods: The study comprises 14 patients from 9 families and all patients had the triad of nodulosis, arthropathy and osteolysis (NAO). Results: The most common radiological manifestations were osteopenia, undertubulation of long bones, arthritic changes, sclerotic sutures of the calvaria, osteolysis and muscle contractures. Other common findings were squared vertebrae, broad medial clavicles and brachycephaly. Progress of disease was documented in more than half of the patients. Conclusions: Our study is the first report of the detailed radiological findings of NAO syndrome. In NAO syndrome, both the axial and appendicular skeleton are involved (orig.)

Efficacy of holmium laser enucleation of the prostate (HoLEP) in men with bladder outlet obstruction (BOO) and non-neurogenic bladder dysfunction.

Science.gov (United States)

Pyun, Jong Hyun; Kang, Sung Gu; Kang, Seok Ho; Cheon, Jun; Kim, Je Jong; Lee, Jeong Gu

2017-09-01

We aimed to compare the short-term outcomes of men who had urodynamic evidence of detrusor underactivity (DU) or detrusor overactivity (DO) of a non-neurogenic etiology as well as bladder outlet obstruction (BOO) and who underwent Holmium Laser Enucleation of the prostate (HoLEP). A database of 322 patients who underwent HoLEP between 2010 and 2014 was analyzed. Patients were classified into three groups according to the results of a preoperative urodynamic study. Preoperative parameters such as International Prostate Symptom Score (IPSS), Quality of Life (QoL) index, IPSS grade, uroflowmetry were compared with postoperative parameters measured at 6 months. There were 138 patients with BOO-only and 89 patients with BOO and detrusor dysfunction including 56 with DO and 33 with DU. The degree of improvement in IPSS-total (BOO: 10.7, DO: 8.3, DU: 7.0; p = 0.023) was greater in the BOO-only group than in the DU group. There were more patients whose IPSS grade improved in the BOO-only group (71%) than in the detrusor dysfunction group (DO: 53.6% and DU: 45.5%). Postoperative IPSS-voiding (4.5 vs 7.0), and Qmax (18 vs 13.7) in the BOO-only group were significantly better than those in the DU group. Additionally, postoperative IPSS-storage (4.7 vs 6.7), and IPSS-total (9.1 vs 12.3) in the BOO-only group were significantly better than in the DO group (all p < 0.05). In conclusion, early surgical management for men with severe LUTS and associated BPH before secondary degeneration occurs may be beneficial for preserving detrusor function and yield better treatment outcomes. Copyright © 2017. Published by Elsevier Taiwan.

Knee and Ankle Arthroplasty in Hemophilia

Directory of Open Access Journals (Sweden)

Luigi Piero Solimeno

2017-11-01

Full Text Available Today, major surgical procedures can be safely performed in hemophilic patients with chronic arthropathy, using available factor concentrates. In this setting, total knee replacement is considered the “gold standard”, while the use of total ankle replacement is still debated. Indeed, the unsatisfactory results obtained with the previous available design of implants did not raise enthusiasm as knee or hip replacement. Recently, the introduction of new implant designs and better reported outcomes have renewed the interest in total ankle replacement in people with hemophilia. In this review, the role of replacement surgery in the treatment of chronic hemophilic arthropathy will be described.

Investigation of carbachol and PACAP38 in a human model of migraine

DEFF Research Database (Denmark)

Schytz, Henrik Winther

2011-01-01

and VIP in migraine and head pain. In study I-III we investigated acetylcholine, via the analogue carbachol, and PACAP38 in a human model of migraine. In study IV we studied if PACAP38 and VIP might induce central sensitization, neurogenic inflammation and mast cell degranulation in a cutaneous model...... in migraine patients as well as sustained dilatation of cephalic vessels. In study IV VIP and PACAP38 evoked skin pain, central sensitization, neurogenic inflammation and mast cell degranulation, but VIP showed to be more potent than PACAP38 in inducing neurogenic inflammation and mast cell degranulation...... that neurogenic inflammation and mast cell degranulation are unlikely to cause PACAP38 induced migraine. The present thesis contributes to our knowledge on migraine pathophysiology and suggests PAC1 receptor antagonism as a new target for migraine treatment....

Fasciculation potentials in high-density surface EMG.

NARCIS (Netherlands)

Drost, G.; Kleine, B.U.; Stegeman, D.F.; Engelen, B.G.M. van; Zwarts, M.J.

2007-01-01

Fasciculation potentials (FPs) are observed in healthy individuals, but also in patients with neurogenic disorders. The exact site of origin and the clinical relevance in distinguishing, for example, amyotrophic lateral sclerosis (ALS) from other neurogenic diseases based on specific characteristics

A randomized clinical trial of prophylaxis in children with hemophilia A (the ESPRIT Study).

Science.gov (United States)

Gringeri, A; Lundin, B; von Mackensen, S; Mantovani, L; Mannucci, P M

2011-04-01

Prevention of arthropathy is a major goal of hemophilia treatment. While studies in adults have demonstrated an impact of prophylaxis on the incidence of joint bleeds and patients' well-being in terms of improved quality of life (QoL), it is unclear whether or not prophylaxis influences the outcome and perception of well- of children with hemophilia. This randomized controlled study compared the efficacy of prophylaxis with episodic therapy in preventing hemarthroses and image-proven joint damage in children with severe hemophilia A (factor VIII <1%) over a 10-year time period. Forty-five children with severe hemophilia A, aged 1-7 years (median 4), with negative clinical-radiologic joint score at entry and at least one bleed during the previous 6 months, were consecutively randomized to prophylaxis with recombinant factor VIII (25 IU kg(-1) 3 × week) or episodic therapy with ≥25 IU kg(-1) every 12-24 h until complete clinical bleeding resolution. Safety, feasibility, direct costs and QoL were also evaluated. Twenty-one children were assigned to prophylaxis, 19 to episodic treatment. Children on prophylaxis had fewer hemarthroses than children on episodic therapy: 0.20 vs. 0.52 events per patient per month (P < 0.02). Plain-film radiology showed signs of arthropathy in six patients on prophylaxis (29%) vs. 14 on episodic treatment (74%) (P < 0.05). Prophylaxis was more effective when started early (≤36 months), with patients having fewer joint bleeds (0.12 joint bleeds per patient per month) and no radiologic signs of arthropathy. This randomized trial confirms the efficacy of prophylaxis in preventing bleeds and arthropathy in children with hemophilia, particularly when it is initiated early in life. © 2011 International Society on Thrombosis and Haemostasis.

Prevalence of the different Axis I clinical subtypes in a sample of patients with orofacial pain and temporomandibular disorders in the Andalusian Healthcare Service

Science.gov (United States)

Blanco-Aguilera, Antonio; Blanco-Aguilera, Elena; Serrano-del-Rosal, Rafael; Biedma-Velázquez, Lourdes; Rodríguez-Torronteras, Alejandro; Segura-Saint-Gerons, Rafael

2016-01-01

Background The main objective of this paper is to analyze the prevalence of each of the different clinical subtypes of temporomandibular disorders (TMD) in a sample of patients with this pathology. In addition, a second objective was to analyze their distribution according to gender. Material and Methods To this end, the results of 1603 patients who went to the Unit of Temporomandibular Disorders in the Córdoba Healthcare District because they suffered from this pathology were analyzed. In order to diagnose them, the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were applied, analyzing the different Axis I subtypes (myopathy, discopathy and arthropathy) and obtaining the combined Axis I for each patient and the relation of all these variables according to gender. The null-hypothesis test confirmed the lack of connection between the gender variable and the different subtypes in the clinical analysis, and between the former and the combined Axis I of the RDC/TMD. Results The prevalence was high for the muscle disorders subtype in general, showing an 88.7% prevalence, while the presence of discopathies or arthropathies was much lower. Among discopathies, the most frequent ones were disc displacements with reduction, with 39.7% and 42.8% for the left and right temporomandibular joints (TMJ), respectively, while the prevalence of arthropathies was 26.3% for the right TMJ and 32.9% for the left TMJ. The bivariate analysis on the connection with gender reveals a p≥ 0.05 value for the muscle and arthralgia subtypes. Conclusions The patients seen at the TMD Unit where mostly middle-aged women whose main clinical axis subtype was the muscle disorder subtype. For their part, both discopathies and arthropathies, although present, are much less prevalent. Key words:RDCTMD, axis I, orofacial pain, temporomandibular disorders, gender. PMID:26615508

MRI findings in thoracic outlet syndrome

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Aralasmak, Ayse; Sharifov, Rasul; Kilicarslan, Rukiye; Alkan, Alpay [Bezmialem Vakif University, Department of Radiology, Fatih/Istanbul (Turkey); Cevikol, Can; Karaali, Kamil; Senol, Utku [Akdeniz University, Department of Radiology, Antalya (Turkey)

2012-11-15

We discuss MRI findings in patients with thoracic outlet syndrome (TOS). A total of 100 neurovascular bundles were evaluated in the interscalene triangle (IS), costoclavicular (CC), and retropectoralis minor (RPM) spaces. To exclude neurogenic abnormality, MRIs of the cervical spine and brachial plexus (BPL) were obtained in neutral. To exclude compression on neurovascular bundles, sagittal T1W images were obtained vertical to the longitudinal axis of BPL from spinal cord to the medial part of the humerus, in abduction and neutral. To exclude vascular TOS, MR angiography (MRA) and venography (MRV) of the subclavian artery (SA) and vein (SV) in abduction were obtained. If there is compression on the vessels, MRA and MRV of the subclavian vessels were repeated in neutral. Seventy-one neurovascular bundles were found to be abnormal: 16 arterial-venous-neurogenic, 20 neurogenic, 1 arterial, 15 venous, 8 arterial-venous, 3 arterial-neurogenic, and 8 venous-neurogenic TOS. Overall, neurogenic TOS was noted in 69%, venous TOS in 66%, and arterial TOS in 39%. The neurovascular bundle was most commonly compressed in the CC, mostly secondary to position, and very rarely compressed in the RPM. The cause of TOS was congenital bone variations in 36%, congenital fibromuscular anomalies in 11%, and position in 53%. In 5%, there was unilateral brachial plexitis in addition to compression of the neurovascular bundle. Severe cervical spondylosis was noted in 14%, contributing to TOS symptoms. For evaluation of patients with TOS, visualization of the brachial plexus and cervical spine and dynamic evaluation of neurovascular bundles in the cervicothoracobrachial region are mandatory. (orig.)

Effect of spinal anterior root stimulation and sacral deafferentation on bladder and sexual dysfunction in spinal cord injury

DEFF Research Database (Denmark)

Zaer, Hamed; Rasmussen, Mikkel Mylius

2018-01-01

Spinal cord injury (SCI) is a highly devastating injury with a variety of complications; among them are neurogenic bladder, bowel, and sexual dysfunction. We aimed to evaluate the effect of sacral anterior root stimulation with sacral deafferentation (SARS-SDAF) on neurogenic bladder and sexual d...

Radiographic symptoms of peripheral joints; Allgemeine radiologische Symptomatologie peripherer Gelenke

Energy Technology Data Exchange (ETDEWEB)

Klauser, Andrea Sabine [Medizinische Univ. Innsbruck (Austria). Bereich Rheuma und Sportbildgebung; Woertler, Klaus [TU Muenchen (Germany). Inst. fuer Roentgendiagnostik; Jaschke, Werner R. [Klinikum Mannheim (Germany). Inst. fur Klinische Radiologie

2010-09-15

Diagnosis of inflammatory rheumatic diseases is besides clinical parameters mainly based on the potential for differential diagnosis of radiographic symptoms obtained by systematic analysis. The initial analysis should emphasize which part of the joint is involved referring to synovial disease, cartilage disease or disease of the enthesis. Synovial arthropathies are assessed regarding soft tissue swelling, soft tissue opacification and the presence of erosions. Cartilaginous pathology is reflected by reduced or increased joint space, calcifications and subchondral bone changes. Enthesopathy is typically located at tendon-ligament and joint capsule attachment, where osteoproliferative but also erosive changes might occur. Lastly, differential diagnosis of arthropathies is mainly based on distribution and allocation of affected joints. (orig.)

Homogentisate 1,2 dioxygenase is expressed in human osteoarticular cells: implications in alkaptonuria.

Science.gov (United States)

Laschi, Marcella; Tinti, Laura; Braconi, Daniela; Millucci, Lia; Ghezzi, Lorenzo; Amato, Loredana; Selvi, Enrico; Spreafico, Adriano; Bernardini, Giulia; Santucci, Annalisa

2012-09-01

Alkaptonuria (AKU) results from defective homogentisate1,2-dioxygenase (HGD), causing degenerative arthropathy. The deposition of ochronotic pigment in joints is so far attributed to homogentisic acid produced by the liver, circulating in the blood and accumulating locally. Human normal and AKU osteoarticular cells were tested for HGD gene expression by RT-PCR, mono- and 2D-Western blotting. HGD gene expression was revealed in chondrocytes, synoviocytes, osteoblasts. Furthermore, HGD expression was confirmed by Western blotting, that also revealed the presence of five enzymatic molecular species. Our findings indicate that AKU osteoarticular cells produce the ochronotic pigment in loco and this may strongly contribute to induction of ochronotic arthropathy. Copyright © 2011 Wiley Periodicals, Inc.

MRI demonstrates the extension of juxta-articular venous malformation of the knee and correlates with joint changes

Energy Technology Data Exchange (ETDEWEB)

Jans, L. [University of Melbourne, Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Victoria (Australia); Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium); Ditchfield, M.; Jaremko, J.L.; Stephens, N. [University of Melbourne, Royal Children' s Hospital, Department of Medical Imaging, Melbourne, Victoria (Australia); Verstraete, K. [Ghent University Hospital, Department of Radiology and Medical Imaging, Gent (Belgium)

2010-07-15

Juxta-articular venous malformations (VMs) are uncommon, but may cause early arthropathy of the knee in children and adolescents. We sought to describe the prevalence, extent and initial magnetic resonance imaging (MRI) features of knee arthropathy in children with VM adjacent to the knee joint. Thirty-five patients with VM adjacent to the knee who had MRI performed between 2000 and 2009 were identified through a keyword search of the radiology information system. VM extended to the joint in 17 of the 35 patients (5.4-21.5 years, mean 11.8 years). Most of these 17 patients had joint changes (15/17, 88%), most commonly haemosiderin deposition (14/17, 82%). Other findings included the presence of subchondral bone lesions (eight, 47%), cartilage loss (six, 35%), synovial thickening (six, 35%), marrow oedema (six, 35%), joint effusion (five, 29%), subchondral cysts (five, 29%) and one loose body (6%). VM location and size did not correlate with the degree of articular involvement. Joint changes were present in focal as well as non-discrete VM. We found that the frequency of arthropathy increased with extension of VM into the joint itself. This finding stresses the importance of early MRI evaluation of all juxta-articular VM. (orig.)

The opioid ketobemidone has a NMDA blocking effect

DEFF Research Database (Denmark)

Andersen, S; Dickenson, A H; Kohn, M

1996-01-01

There are clinical observations that neurogenic pain can respond well to the opioid ketobemidone, in contrast to pethidine and morphine. This has led us to the hypothesis that the analgesic effect of ketobemidone in neurogenic pain may be due to both opioid as well as additional non-opioid effect...

Functional Magnetic Resonance Imaging with Concurrent Urodynamic Testing Identifies Brain Structures Involved in Micturition Cycle in Patients with Multiple Sclerosis.

Science.gov (United States)

Khavari, Rose; Karmonik, Christof; Shy, Michael; Fletcher, Sophie; Boone, Timothy

2017-02-01

Neurogenic lower urinary tract dysfunction, which is common in patients with multiple sclerosis, has a significant impact on quality of life. In this study we sought to determine brain activity processes during the micturition cycle in female patients with multiple sclerosis and neurogenic lower urinary tract dysfunction. We report brain activity on functional magnetic resonance imaging and simultaneous urodynamic testing in 23 ambulatory female patients with multiple sclerosis. Individual functional magnetic resonance imaging activation maps at strong desire to void and at initiation of voiding were calculated and averaged at Montreal Neuroimaging Institute. Areas of significant activation were identified in these average maps. Subgroup analysis was performed in patients with elicitable neurogenic detrusor overactivity or detrusor-sphincter dyssynergia. Group analysis of all patients at strong desire to void yielded areas of activation in regions associated with executive function (frontal gyrus), emotional regulation (cingulate gyrus) and motor control (putamen, cerebellum and precuneus). Comparison of the average change in activation between previously reported healthy controls and patients with multiple sclerosis showed predominantly stronger, more focal activation in the former and lower, more diffused activation in the latter. Patients with multiple sclerosis who had demonstrable neurogenic detrusor overactivity and detrusor-sphincter dyssynergia showed a trend toward distinct brain activation at full urge and at initiation of voiding respectively. We successfully studied brain activation during the entire micturition cycle in female patients with neurogenic lower urinary tract dysfunction and multiple sclerosis using a concurrent functional magnetic resonance imaging/urodynamic testing platform. Understanding the central neural processes involved in specific parts of micturition in patients with neurogenic lower urinary tract dysfunction may identify areas

Cranio-osteoarthropathy in sibs

NARCIS (Netherlands)

Dabir, Tabib; Sills, A. M.; Hall, Christine M.; Bennett, Chris; Wilson, Louise C.; Hennekam, Raoul C. M.

2007-01-01

Primary hypertrophic osteoarthropathy is a condition characterized by clubbing, arthropathy and periostosis of long tubular bones. Three variants of primary hypertrophic osteoarthropathy are distinguished: pachydermoperiostosis, which shows as additional symptom pachydermia; cranio-osteoarthropathy,

[Sulphureous mud-bath therapy and changes in blood pressure: observational investigation].

Science.gov (United States)

Costantino, M; Marongiu, M B; Russomanno, G; Conti, V; Manzo, V; Filippelli, A

2015-01-01

The chronic arthropathies currently appear to be a major cause of disability with a negative impact on quality of life and health care spending. The mud-bath therapy is a spa treatment that induces benefic effects in chronic rheumatic diseases. It has long been debated on the assumption that the mud-bath spa therapy could have adverse cardiovascular effects which often induce caution and even a contraindication to the use of this treatment in chronic arthropathies associated with cardiovascular alterations such as hypertension. The aim of this observational study was to investigate, in arthrorheumatic subjects, the effects of sulphureous mud-bath cycle on blood pressure and the possible appearance of adverse drug reaction. 169 patients, with age range 42-86 years, suffering by chronic arthropathies were treated with sulphureous mud-bath therapy for 2 weeks. According to the arterial pressure values, measured before the spa treatment, the patients considered were divided in three groups: with normal blood pressure (NOR group); with high blood pressure, after, the latter group was divided in IPET (patients in treatment with antihypertensive drugs) and IPENT (patients not in antihypertensive therapy). The arterial pressure values, maximum and minimum, expressed in mmHg, were detected in the first (T1) - sixth (T6) and twelfth (T12) day of spa treatment. The media arterial pressure values collected before and after T1, before and after T6, before and after T12 , before T1 and after T12 were compared. The data, presented as mean±SD, were compared with the paired Student t test. A p value ≤0.05 was considered significant. The comparison between the mean values detected in pre and post T1, pre and post T6, pre and post T12 have showed that sulphureous mud-bath therapy induced a significant (pmud-bath therapy (post-T12) vs baseline (pre-T1) have demonstrated: in IPET and IPENT groups a significant (pmud-bath therapy in interdisciplinary therapeutic p rotocol of patients

Manifestações articulares nas viroses exantemáticas Joint complaints in exanthematic diseases

Directory of Open Access Journals (Sweden)

Solange Artimos de Oliveira

1999-04-01

Full Text Available A freqüência de manifestações articulares foi avaliada em 251 pacientes com diagnóstico clínico e laboratorial (detecção de IgM por ensaio imunoenzimático de virose exantemática. As artropatias (artralgia e/ou artrite foram mais observadas nos casos de dengue (49% e de rubéola (38,2% do que naqueles com parvovirose humana (30% e sarampo (28,1%. Com exceção do sarampo, as artropatias predominaram nos adultos (315 anos de idade, sendo tal diferença estatisticamente significativa. A ocorrência maior de artropatias em adultos foi mais evidente nos pacientes com parvovirose (75%, rubéola (65% e dengue (57,7% do que naqueles com sarampo (31%. As queixas articulares também predominaram nos pacientes do sexo feminino para todas as viroses avaliadas. Os resultados encontrados demonstram o freqüente acometimento articular nas doenças estudadas, e indicam a necessidade de comprovação laboratorial para o diagnóstico diferencial entre elas.The frequency of arthropathy was evaluated in 251 patients with clinical and serological diagnosis (specific IgM detection by enzyme immunoassay of exanthematic disease. Arthropathy (arthralgia and/or arthritis was more frequent in dengue fever (49% and rubella (38.2% cases than in human parvovirus (30% and measles (28.1% cases. Except for measles cases, joint complaints prevailed in adults (315 years of age and this difference was significant. The higher frequency of arthropathy in adults was more evident in human parvovirus (75%, rubella (65% and dengue fever (57.7% cases than in measles cases (31%. Arthropathy was also more frequent in females for all rash diseases studied. The results of this study showed the high occurrence of joint complaints in the diseases described here and the importance of laboratory confirmation for their differential diagnosis.

HDAC4 preserves skeletal muscle structure following long-term denervation by mediating distinct cellular responses.

Science.gov (United States)

Pigna, Eva; Renzini, Alessandra; Greco, Emanuela; Simonazzi, Elena; Fulle, Stefania; Mancinelli, Rosa; Moresi, Viviana; Adamo, Sergio

2018-02-24

Denervation triggers numerous molecular responses in skeletal muscle, including the activation of catabolic pathways and oxidative stress, leading to progressive muscle atrophy. Histone deacetylase 4 (HDAC4) mediates skeletal muscle response to denervation, suggesting the use of HDAC inhibitors as a therapeutic approach to neurogenic muscle atrophy. However, the effects of HDAC4 inhibition in skeletal muscle in response to long-term denervation have not been described yet. To further study HDAC4 functions in response to denervation, we analyzed mutant mice in which HDAC4 is specifically deleted in skeletal muscle. After an initial phase of resistance to neurogenic muscle atrophy, skeletal muscle with a deletion of HDAC4 lost structural integrity after 4 weeks of denervation. Deletion of HDAC4 impaired the activation of the ubiquitin-proteasome system, delayed the autophagic response, and dampened the OS response in skeletal muscle. Inhibition of the ubiquitin-proteasome system or the autophagic response, if on the one hand, conferred resistance to neurogenic muscle atrophy; on the other hand, induced loss of muscle integrity and inflammation in mice lacking HDAC4 in skeletal muscle. Moreover, treatment with the antioxidant drug Trolox prevented loss of muscle integrity and inflammation in in mice lacking HDAC4 in skeletal muscle, despite the resistance to neurogenic muscle atrophy. These results reveal new functions of HDAC4 in mediating skeletal muscle response to denervation and lead us to propose the combined use of HDAC inhibitors and antioxidant drugs to treat neurogenic muscle atrophy.

Comparative evaluation of the efficacy of radiosynovectomy with conventional intra-articular therapy in rheumatoid arthritis and haemophilic arthropathy (CERAHA)

International Nuclear Information System (INIS)

Barrenechea, E.A.; Navarra, S.; Chua, M.

2005-01-01

Full text: The objective of this study is to determine the therapeutic efficacy of radiosynovectomy on rheumatoid and hemophilic arthropathy as compared to the usual intra-articular steroids on painful joints. Rheumatoid arthritis is a chronic, systemic and inflammatory disease that involves the joints and is quite disabling. It has a worldwide prevalence of 1%. Hemophilia is a congenital blood disease that produces abnormal bleeding at the musculoskeletal level. It is a sex-linked trait that cause coagulation defects brought about by lack of Factor Vlll for Hemophilia A and Factor lX for Hemophilia B. In this study, under the auspices of IAEA, we used Yttrium 90 colloids and Rhenium 188 intra-articularly in the knee in the experimental group and steroids on the control group. Radioactive colloids (beta radiation) create fibrosis of the hypertrophic and highly vascularized synovium. It leads to coagulation necrosis and sloughing of the cells, destroying diseased pannus and inflamed synovium with the hope that the regenerating synovium, after destruction, will be free of the disease. Included in this study were established cases of RA set by the American Rheumatoid Assn which are stage 1, 2, and 3 by Larsen classification, no ankylosis, non-responders for NSAIDS and DMARDS for at least 6 months and with their informed consent. For the hemophilic group, they should have at least 3 bleeding episodes for the last six months and at least with 30% coagulopathy at the time of the procedure. Exclusion criteria included being pregnant or lactating, with infection on site of injection, beyond stage 3 and presence Baker's cyst. Baseline radiography and two-phase bone scans were taken as well as repeating these procedures at 6 an 12 months post-treatment. There were 39 evaluable patients under the experimental group consisting of 18 RA patients (mostly females) and 21 HA patients (all males). Thirty-eight patients were given Yttrium-90 colloid with doses ranging from 60 Mbq to

Ekstraintestinale manifestationer ved inflammatorisk tarmsygdom

DEFF Research Database (Denmark)

Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen

2009-01-01

Extraintestinal manifestations are relatively common in chronic inflammatory bowel disease and affect joints, skin, eyes and bile ducts. The most frequent rheumatologic manifestations are peripheral arthritis and axial arthropathies. Erythema nodosum and pyoderma gangraenosum are common...

Managing neurogenic bowel dysfunction: what do patients prefer? A discrete choice experiment of patient preferences for transanal irrigation and standard bowel management

Directory of Open Access Journals (Sweden)

Nafees B

2016-02-01

��. Conclusion: Participants with bowel dysfunction regarded “risk of FI”, “frequency of use”, and “avoiding UTIs” as the most important features of a TAI device. These preferences are valuable in informing decision makers and clinicians regarding different bowel management solutions as well as for development of future devices. Keywords: neurogenic bowel dysfunction, UK, transanal irrigation, patient preference, discrete choice

Nootropic agents stimulate neurogenesis. Brain Cells, Inc.: WO2007104035.

Science.gov (United States)

Taupin, Philippe

2009-05-01

The application is in the field of adult neurogenesis, neural stem cells and cellular therapy. It aims to characterize the activity of nootropic agents on adult neurogenesis in vitro. Nootropic agents are substances improving cognitive and mental abilities. AMPA (alpha-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate) and nootropic agents were assessed for the potential to differentiate human neural progenitor and stem cells into neuronal cells in vitro. They were also tested for their behavioural activity on the novel object recognition task. AMPA, piracetam, FK-960 and SGS-111 induce and stimulate neuronal differentiation of human-derived neural progenitor and stem cells. SGS-111 increases the number of visits to the novel object. The neurogenic activity of piracetam and SGS-111 is mediated through AMPA receptor. The neurogenic activity of SGS-111 may contribute and play a role in its nootropic activity. These results suggest that nootropic agents may elicit some of their effects through their neurogenic activity. The application claims the use of nootropic agents for their neurogenic activity and for the treatment of neurological diseases, disorders and injuries, by stimulating or increasing the generation of neuronal cells in the adult brain.

Fournier gangrene in spinal cord injury: a case report.

Science.gov (United States)

Nambiar, Prabhakaran K; Lander, Stuart; Midha, Meena; Ha, Chang

2005-01-01

Fournier gangrene is a necrotizing fasciitis of the perineal and genital region resulting from polymicrobial infection in which infection spreads along fascial planes, causing soft-tissue necrosis. If surgical debridement and control of infection are delayed, the disease can progress and result in septic shock, multiorgan failure, and death. Initial symptoms are severe pain in the genital region followed by swelling and erythema. In patients with spinal cord injury (SCI), lack of pain sensation could cause delay in seeking medical attention. SCI patients are at higher risk for Fournier gangrene secondary to neurogenic bladder, neurogenic bowel, and impaired sensation. A literature search resulted in only 1 report of Fournier gangrene with localized necrosis of the scrotum in a patient with SCI. Case report of a 47-year-old man with C4 tetraplegia. Patient presented with a necrotic ulceration on the ventral aspect of the penis and scrotum of 2 days duration and was diagnosed with fulminant Fournier gangrene. Patients with SCI are at higher risk for Fournier gangrene secondary to neurogenic bladder, neurogenic bowel, and impaired sensation. Mortality is high. Prevention and early diagnosis are essential. Prompt aggressive intervention is warranted to maximize outcomes.

urinary tract infections in symptomatic pregnant women attending

African Journals Online (AJOL)

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bacterial infections in the elderly but also the most common and ... For pregnant women, urinary tract infection is the most common ... causing arthropathy in children. Urinary tract ... resistance in our environment, resistance such as β-. Urinary ...

The Effect of an Experimental Missile Wound to the Brain on Brain Electrolytes, Regional Cerebral Blood Flow and Blood Brain Barrier Permeability.

Science.gov (United States)

1987-02-10

lung: 2 of 76 missile-wounded cats died from fulminant lung failure - C and probable neurogenic pulmonary edema. Phenomena affecting lung function w...have observed at least 3 mild cases of pulmonary decompensation plus 2 fulminating , fatal instances of neurogenic pulmonary edema. These findings suggest...can be artificially elevated owing to their rapid synthesis following decapitation and before freezing. This process itself subjects brain cells to

Radiologic evaluation of spinal epidural mass

International Nuclear Information System (INIS)

Lee, Ho Kyu; Lee, Moon Kyu; Chang, Kee Hyun

1987-01-01

It is often difficult to differentiate each pathologic entity among various spinal epidural masses on the radiologic basis. We retrospectively analysed radiologic findings of 67 cases of pathologically proven spinal epidural mass to find out any specific findings of each epidural mass. The results are as follows : 1. Of 67 cases, metastasis (16 cases), epidural abscess (15 cases), neurogenic tumor (16 cases) and meningioma (8 cases) are most common. The others consist of epidural angioma (3 cases), vertebral hemangioma (2 cases), chondrosarcoma (2 cases), fibrosarcoma (1 case), eosinophilic granuloma (1 case), lymphoma (1 case), lipoma (1 case) and lymphoid hyperplasia (1 case). 2. Destruction of the adjacent bone was commonly associated with the epidural mass in metastasis (75%) and epidural abscess (67%). It was also noted in 2 cases of chondrosarcoma, 1 fibrosarcoma and 1 eosinophilic granuloma. 3. Pressure erosion of adjacent bone was demonstrated in neurogenic tumor (75%) and meningioma (25%). 4. Narrowing of intervertebral space was seen in only 27% of epidural abscess. 5. The paraspinal tumor was associated in 67% of metastasis, 80% of epidural abscess, 75% of neurogenic tumor, 33% of meningioma. It was also seen in 2 cases of chondrosarcoma, 1 fibrosarcoma and 1 eosinophilic granuloma. 6. The intradural tumor was associated in 50% of neurogenic tumor and 67% of meningioma. 7. On axial CT image, most of the epidural mass shows eccentric location with displacing dural sac to the opposite side. The diseases that occasionally show encircling location are metastasis, epidural abscess, vertebral hemangioma, chondrosarcoma, eosinophilic granuloma, and lymphoma. Neurogenic tumor only shows multicentric location. 8. The disease extent more than height of one vertebral body was seen in 80% of epidural abscess, 58% of neurogenic tumor, 100% of epidural angioma. It was also seen in 2 cases of chondrosarcoma, 1 fibrosarcoma, 1 eosinophilic granuloma, 1 lymphoma, 1

Rheumatological manifestations of diabetes mellitus - a review ...

African Journals Online (AJOL)

... strongly associated with diabetes mellitus including limited joint mobility, specific arthropathies of the hand (carpal tunnel syndrome, Dupytrens contracture, flexor tenosynovitis and diabetic sclerodactyly), shoulder (adhesive capsulitis-frozen shoulder, and calcific periarthritis) and spontaneous infarction of skeletal muscle.

Radionuclide synovectomy – essentials for rheumatologists

Directory of Open Access Journals (Sweden)

Marek M. Chojnowski

2016-07-01

Full Text Available Radionuclide synovectomy is a minimally invasive method of treating persistent joint inflammation. It involves intra-articular injection of radioactive colloids which induce necrosis and fibrosis of hypertrophic synovial membrane. The most common indication for radiosynovectomy is rheumatoid arthritis, although patients with seronegative spondyloarthropathies, unclassified arthritis, haemophilic arthropathy and other less common arthropathies can also benefit from this method. Radiosynovectomy is safe, well tolerated and efficacious. About 70–80% of patients respond well to the therapy. However, the therapeutic effects are considerably worse in patients with co-existent osteoarthritis and advanced joint degeneration. Despite its advantages, radionuclide synovectomy is not performed as often as it could be, so greater knowledge and understanding of this method are needed. The authors present the most important facts about radiosynovectomy that may help rheumatologists in their daily clinical practice.

Hemochromatosis: abnormalities of bones and joints: a case report and literature review

International Nuclear Information System (INIS)

Farao, S.R.F.; Pereira, E.M.; Harima, H.A.; Rocha Correa Fernandes, A. da; Pavin, A.E.

1989-01-01

The authors report a case of a 49 years-old male patient with emphasis in the arthropathy of hemochromatosis. The arthropathy was the first manifestation: the patient had been complaining of pain on the right hip for eight years. The other specific clinical manifestations: diabetes, abnormal pigmentation appeared after six years. The roentgenographic features of bone and joint involvement include abnormalites at metacarpophalangeal joints with osteophytes on the metacarpal heads and in the hip, joint space narrowing, was seen. In the knee involvement is characterized by subchondral cyst and osteophytosis. Laboratory analysis are: serum iron = 191 mg/dl (normal value: 50-150 mg/dl), ferritin > 400 ng/ml (normal value: 42-26 ng/ml). Iron within the parenchymal cells of the liver cirrhosis was detected by hepatic biopsy. Hemochromatosis was pathologically characterized by tissue damage produced by iron deposition. (author) [pt

Ingesta oral do paciente hospitalizado com disfagia orofaríngea neurogênica Oral Intake of hospitalized patient with neurogenic oropharyngeal dysphagia

Directory of Open Access Journals (Sweden)

Carolina Castelli Silvério

2010-12-01

Full Text Available OBJETIVO: verificar a evolução na ingesta oral e a ocorrência de broncopneumonias (BCP em pacientes hospitalizados com disfagia orofaríngea neurogênica, após atuação fonoaudiológica. MÉTODOS: 50 pacientes adultos, divididos em grupos: I: 31 pacientes pós-acidente vascular encefálico; II: sete pacientes pós-traumatismo crânio-encefálico; III: 12 pacientes com demência. Foram levantadas as informações antes e após a atuação fonoaudiológica: nível da Functional Oral Intake Scale (FOIS, ocorrência de BCP; número de atendimentos fonoaudiológicos e motivo de interrupção destes. RESULTADOS: houve aumento significativo dos níveis da escala FOIS e redução do percentual de ocorrência de BCP nos três grupos estudados. Nos grupos pós-AVE e demência a interrupção da fonoterapia ocorreu devido à alta hospitalar, enquanto que no grupo pós-TCE devido à alta fonoaudiológica. CONCLUSÃO: os pacientes deste estudo demonstraram avançar das consistências alimentares na ingesta oral, e redução da ocorrência de BCP, após a intervenção fonoaudiológica com relação à disfagia.PURPOSE: to investigate the development in oral intake and the incidence of bronchopneumonia (BCP in hospitalized patients with neurogenic oropharyngeal dysphagia, after speech and language therapy intervention. METHODS: 50 adult patients, divided in three groups: I: 31 post stroke patients; II: seven brain injury patients ; III: 12 dementia patients. Data collected before and after the speech and language therapy intervention were: staff classification in Functional Oral Intake Scale (FOIS, incidence of BCP, number of therapies and reason for their interruption. RESULTS: significant increase in the levels of FOIS scale and reduction in incidence of pneumonia in the three studied groups. In the post stroke and dementia groups the reason for therapy interruption was hospital discharge, and in the group of brain injury the reason was speech and

Arthropathy of the abnormal temporo-mandibular joint

Energy Technology Data Exchange (ETDEWEB)

Stampfel, G.; Gausch, K.; Waldhart, E.

1984-05-01

Arthrography provides accurate information concerning abnormal changes and function of the soft tissue components of the T.M.J. It is superior to all other clinical and radiological methods of examination for elucidating functional abnormalities. The increasing incidence of functional T.M.J. abnormalities and improvements in treatment make arthrography of the T.M.J. of increasing importance. The importance of views in the sagittal plane and of video recordings is stressed. 3 figs.

Ochronosis: a case of severe ochronotic arthropathy

Directory of Open Access Journals (Sweden)

Berat Meryem Alkan

2011-10-01

Full Text Available Ochronosis involves primarily the large cartilaginous joint surfaces, ribs, intervertebral discs, ear cartilage etc. We report on a 52-year-old woman with typical alkaptonuric ochronosis with dark urine, blue-black pigmentation of the auriculae and hands, spondylarthropathy and severe hip and shoulder joints involvement. The differential diagnosis of this rare condition is discussed with a review of the literature.

Arthropathy and proteinuria: nail-patella syndrome revisited

Directory of Open Access Journals (Sweden)

Albishri, Jamal

2014-11-01

Full Text Available [english] Nail-patella syndrome (NPS is a pleiotropic autosomal-dominant disorder due to mutations in the gene LMX1B. It has traditionally been characterized by a tetrad of dermatologic and musculoskeletal abnormalities. However, one of the most serious manifestations of NPS is kidney disease, which may be present in up to 40% of affected individuals. Although diagnosis can be made at birth, it is often missed, presumably due to the rarity of the condition. A 35-year-old female presented to our clinic with history of small joint pain of 6 months duration. In addition she complained of pedal edema off and on for the last 12 years. Prior to her current presentation she had been managed by a local doctor symptomatically. On evaluation, a nephrotic syndrome was obvious, but no secondary cause could be found. However, her physical examination was characteristic of NPS and keeping in view the autosomal dominant nature of the disorder all her three siblings were screened who too showed classical features of NPS. This rare syndrome as a cause of nephrotic range proteinuria is discussed in this report. The report underlines the importance of a good physical examination in a given clinical setting.

The success of dietary protein restriction in alkaptonuria patients is age-dependent

NARCIS (Netherlands)

de Haas, V.; Carbasius Weber, E. C.; de Klerk, J. B.; Bakker, H. D.; Smit, G. P.; Huijbers, W. A.; Duran, M.; Poll-The, B. T.

1998-01-01

Alkaptonuria is characterized by an increased urinary excretion of homogentisic acid, pigmentation of cartilage and connective tissues, and ultimately the development of inflammatory arthropathy. Various diets low in protein have been designed to decrease homogentisic acid excretion and to prevent

A comparison of the treatment recommendations for neurogenic lower urinary tract dysfunction in the national institute for health and care excellence, European Association of Urology and international consultations on incontinence guidelines.

Science.gov (United States)

Jaggi, Ashley; Drake, Marcus; Siddiqui, Emad; Fatoye, Francis

2018-04-17

Healthcare guidelines are an important vehicle in establishing up-to-date evidence based medicine (EBM) in clinical practice. Due to varying development processes, clinical guidelines created by different institutions can often contain contrasting recommendations. This can have implications for optimal and standardized patient care across management settings. The similarities and differences of treatment recommendations made in the National Institute for Health and Care Excellence (NICE), The European Association of Urology (EAU), and the International Consultation on Continence (ICI) guidelines for neurogenic lower urinary tract dysfunction (NLUTD) were assessed. The guidelines generally agree on their approach to conservative management, including behavioral therapies, and catheterization techniques. There was discrepancy on the benefit of using an alpha blocker in NLUTD and bladder outlet obstruction (BOO) and administering Botulinum toxin A (Onabotulinum-A) in NLUTD. The highest degree of divergence was seen in recommendations for surgical treatments, where the EAU made gender-specific recommendations, and gave continent urinary diversion higher preference than given in the NICE and ICI guidelines. In the absence of high-quality clinical evidence, many of the recommendations made across all three guidelines are based on expert opinion. NICE, the EAU and ICI have similarities but they place differing emphasis on costs and expert opinion, which translated in notably different recommendations. It is evident that increased research efforts, possibly in the form of prospective registries, pragmatic trials, and resource utilization studies are necessary to improve the underlying evidence base for NLUTD, and subsequently the strength and concordance of recommendations across guidelines. © 2018 Wiley Periodicals, Inc.

Neuro-urological consequences of gynaecological surgery (endometriosis, simple hysterectomy, radical colpohysterectomy), colorectal surgery and pelvic radiotherapy

International Nuclear Information System (INIS)

Vidait, A.; Mozer, P.; Chartier-Kastler, E.; Ruffion, A.

2007-01-01

Apart from damage to bladder innervation, a number of local diseases and treatments such as radiotherapy can induce lower urinary tract functional disorders. Some of these disorders can be treated according to the principles used in the management of neurogenic bladder. The purpose of this review is to report the functional consequences of pelvic endometriosis, radiotherapy, colorectal surgery and urinary incontinence surgery with particular emphasis on situations in which a neurogenic mechanism is suspected. (authors)

A new light on Alkaptonuria: A Fourier-transform infrared microscopy (FTIRM) and low energy X-ray fluorescence (LEXRF) microscopy correlative study on a rare disease.

Science.gov (United States)

Mitri, Elisa; Millucci, Lia; Merolle, Lucia; Bernardini, Giulia; Vaccari, Lisa; Gianoncelli, Alessandra; Santucci, Annalisa

2017-05-01

Alkaptonuria (AKU) is an ultra-rare disease associated to the lack of an enzyme involved in tyrosine catabolism. This deficiency results in the accumulation of homogentisic acid (HGA) in the form of ochronotic pigment in joint cartilage, leading to a severe arthropathy. Secondary amyloidosis has been also unequivocally assessed as a comorbidity of AKU arthropathy. Composition of ochronotic pigment and how it is structurally related to amyloid is still unknown. We exploited Synchrotron Radiation Infrared and X-Ray Fluorescence microscopies in combination with conventional bio-assays and analytical tools to characterize chemical composition and morphology of AKU cartilage. We evinced that AKU cartilage is characterized by proteoglycans depletion, increased Sodium levels, accumulation of lipids in the peri-lacunar regions and amyloid formation. We also highlighted an increase of aromatic compounds and oxygen-containing species, depletion in overall Magnesium content (although localized in the peri-lacunar region) and the presence of calcium carbonate fragments in proximity of cartilage lacunae. We highlighted common features between AKU and arthropathy, but also specific signatures of the disease, like presence of amyloids and peculiar calcifications. Our analyses provide a unified picture of AKU cartilage, shedding a new light on the disease and opening new perspectives. Ochronotic pigment is a hallmark of AKU and responsible of tissue degeneration. Conventional bio-assays have not yet clarified its composition and its structural relationship with amyloids. The present work proposes new strategies for filling the aforementioned gap that encompass the integration of new analytical approaches with standardized analyses. Copyright © 2017 Elsevier B.V. All rights reserved.

Osteoporosis in haemophilia - an underestimated comorbidity?

Science.gov (United States)

Wallny, T A; Scholz, D T; Oldenburg, J; Nicolay, C; Ezziddin, S; Pennekamp, P H; Stoffel-Wagner, B; Kraft, C N

2007-01-01

A relationship between haemophilia and osteoporosis has been suggested, leading to the initiative for a larger study assessing this issue. Bone mineral density (BMD) was measured by osteodensitometry using dual energy X-ray absorptiometry (DEXA) in 62 male patients with severe haemophilia A; mean age 41 +/- 13.1 years, mean body mass index (BMI) 23.5 +/- 3.6 kg m(-2). Using the clinical score suggested by the World Federation of Hemophilia, all patients were assessed to determine the severity of their arthropathy. A reduced BMD defined as osteopenia and osteoporosis by World Health Organization criteria was detected in 27/62 (43.5%) and 16/62 (25.8%) patients, respectively. Fifty-five of sixty-two (88.7%) patients suffered from haemophilic arthropathy. An increased number of affected joints and/or an increased severity were associated with lower BMD in the neck of femur. Pronounced muscle atrophy and loss of joint movement were also associated with low BMD. Furthermore, hepatitis C, low BMI and age were found to be additional risk factors for reduced BMD in the haemophiliac. Our data shows that in haemophilic patients osteoporosis represents a frequent concomitant observation. The main cause for reduced bone mass in the haemophiliac is most probably the haemophilic arthropathy being typically associated with chronic pain and loss of joint function subsequently leading to inactivity. Further studies including control groups are necessary to elucidate the impact of comorbidities such as hepatitis C or HIV on the development of osteoporosis in the haemophiliac.

Reliability of MRI findings in candidates for lumbar disc prosthesis

International Nuclear Information System (INIS)

Berg, Linda; Espeland, Ansgar; Neckelmann, Gesche; Gjertsen, Oeivind; Hellum, Christian; Johnsen, Lars G.; Eide, Geir E.

2012-01-01

Limited reliability data exist for localised magnetic resonance imaging (MRI) findings relevant to planning of treatment with lumbar disc prosthesis and later outcomes. We assessed the reliability of such findings in chronic low back pain patients who were accepted candidates for disc prosthesis. On pretreatment MRI of 170 patients (mean age 41 years; 88 women), three experienced radiologists independently rated Modic changes, disc findings and facet arthropathy at L3/L4, L4/L5 and L5/S1. Two radiologists rerated 126 examinations. For each MRI finding at each disc level, agreement was analysed using the kappa statistic and differences in prevalence across observers using a fixed effects model. All findings at L3/L4 and facet arthropathy at L5/S1 had a mean prevalence <10% across observers and were not further analysed, ensuring interpretable kappa values. Overall interobserver agreement was generally moderate or good (kappa 0.40-0.77) at L4-S1 for Modic changes, nucleus pulposus signal, disc height (subjective and measured), posterior high-intensity zone (HIZ) and disc contour, and fair (kappa 0.24) at L4/L5 for facet arthropathy. Posterior HIZ at L5/S1 and severely reduced subjective disc height at L4/L5 differed up to threefold in prevalence between observers (p < 0.0001). Intraobserver agreement was mostly good or very good (kappa 0.60-1.00). In candidates for disc prosthesis, mostly moderate interobserver agreement is expected for localised MRI findings. (orig.)

Reliability of MRI findings in candidates for lumbar disc prosthesis

Energy Technology Data Exchange (ETDEWEB)

Berg, Linda; Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Surgical Sciences, Bergen (Norway); Neckelmann, Gesche [Haukeland University Hospital, Department of Radiology, Bergen (Norway); Gjertsen, Oeivind [Oslo University Hospital, Department of Neuroradiology, Oslo (Norway); Hellum, Christian [Oslo University Hospital, Department of Orthopaedics, Oslo (Norway); University of Oslo, Department of Orthopaedics, Oslo (Norway); Johnsen, Lars G. [University Hospital of Trondheim, National Centre for Diseases of the Spine, Trondheim (Norway); University Hospital of Trondheim, Orthopaedic Department, Trondheim (Norway); Eide, Geir E. [Haukeland University Hospital, Centre for Clinical Research, Bergen (Norway); University of Bergen, Department of Public Health and Primary Health Care, Bergen (Norway)

2012-07-15

Limited reliability data exist for localised magnetic resonance imaging (MRI) findings relevant to planning of treatment with lumbar disc prosthesis and later outcomes. We assessed the reliability of such findings in chronic low back pain patients who were accepted candidates for disc prosthesis. On pretreatment MRI of 170 patients (mean age 41 years; 88 women), three experienced radiologists independently rated Modic changes, disc findings and facet arthropathy at L3/L4, L4/L5 and L5/S1. Two radiologists rerated 126 examinations. For each MRI finding at each disc level, agreement was analysed using the kappa statistic and differences in prevalence across observers using a fixed effects model. All findings at L3/L4 and facet arthropathy at L5/S1 had a mean prevalence <10% across observers and were not further analysed, ensuring interpretable kappa values. Overall interobserver agreement was generally moderate or good (kappa 0.40-0.77) at L4-S1 for Modic changes, nucleus pulposus signal, disc height (subjective and measured), posterior high-intensity zone (HIZ) and disc contour, and fair (kappa 0.24) at L4/L5 for facet arthropathy. Posterior HIZ at L5/S1 and severely reduced subjective disc height at L4/L5 differed up to threefold in prevalence between observers (p < 0.0001). Intraobserver agreement was mostly good or very good (kappa 0.60-1.00). In candidates for disc prosthesis, mostly moderate interobserver agreement is expected for localised MRI findings. (orig.)

Atrofia muscular proximal neurogenica hereditaria (doença de Wohlfart-Kugelberg-Welander: estudo clinico, eletromiografico e anatomo-patologico de 3 irmãos Hereditary proximal neurogenic muscular atrophy (Wohlfart-Kugelberg-Welander disease: report of three cases

Directory of Open Access Journals (Sweden)

Marcos R. G. de Freitas

1976-03-01

Full Text Available Os autores relatam os casos de três irmãos com fraqueza e amiotrofia proximal dos membros de início na infância. Os estudos eletromiográficos e de biópsias musculares revelaram alterações do tipo neurogênico de permeio com alterações miogênicas. Fazem consideração sobre esta singular associação, considerando as alterações do tipo miopático como secundárias à denervação de longa duração. O estudo histopatológico medular, em um dos pacientes, revelou degeneração das células motoras das pontas anteriores, constituindo, assim, o 4.° estudo de autópsia da doença de Wohlfart-Kugelberg-Welander, na literatura.The cases of three brothers with proximal weakness and muscles atrophies beginning in childhood are reported. Muscles biopsies and electromyographic studies have shown neurogenic pattern of atrophy and a dystrophy-like picture. It is concluded that this histological and eletromyographic picture can occur in pure partial denervation of long standing. The histopathologic study of the spinal cord of one patient revealed degenerative changes and loss of anterior horn ganglion cells. This is the fourth case of Wohlfar -Kugelberg-Welander disease with postmortem examination.

Clinical osteoarthritis predicts physical and psychological QoL in acromegaly patients

NARCIS (Netherlands)

Wassenaar, M. J. E.; Biermasz, N. R.; Kloppenburg, M.; van der Klaauw, A. A.; Tiemensma, J.; Smit, J. W. A.; Pereira, A. M.; Roelfsema, F.; Kroon, H. M.; Romijn, J. A.

2010-01-01

Quality of life is decreased in patients with long-term control of acromegaly. In addition, these patients suffer from irreversible osteoarthritis. The aim of this study was to assess the impact of joint-specific complaints, clinical and radiological signs of arthropathy on different aspects of

78 FR 69324 - Revised Medical Criteria for Evaluating Hematological Disorders

Science.gov (United States)

2013-11-19

...://www.regulations.gov , or in person, during regular business hours, by arranging with the contact... rehospitalizations for sickle cell disease, Journal of the American Medical Association, Apr;303(13), 1288-1294 (2010... radiographic review of hemophilic shoulder arthropathy, Clinical Orthopaedics and Related Research, Jun;423...

Den diabetiske Charcots fod

DEFF Research Database (Denmark)

Christensen, T.M.; Yderstraede, K.; Ejskjaer, N.

2008-01-01

Charcot's arthropathy is a rare complication to diabetes with peripheral neuropathy. The diagnosis is based on a red, oedematous foot with 2 degrees C difference in skin temperature between the affected foot compared to the unaffected foot. The condition is characterised by fractures, dislocation...

Break-through bleeding in relation to predicted factor VIII levels in patients receiving prophylactic treatment for severe hemophilia A

NARCIS (Netherlands)

Collins, P. W.; Blanchette, V. S.; Fischer, K.; Bjorkman, S.; Oh, M.; Fritsch, S.; Schroth, P.; Spotts, G.; Astermark, J.; Ewenstein, B.

Background: The role of prophylactic factor VIII (FVIII) to decrease hemophilic bleeding and arthropathy is well established. The rationale for this strategy is to convert patients with severe hemophilia A to a moderate clinical phenotype by reducing time spent with a FVIII level <1 IU dL(-1).

Thermal nociception as a measure of non-steroidal anti-inflammatory drug effectiveness in broiler chickens with articular pain☆

Science.gov (United States)

Caplen, Gina; Baker, Laurence; Hothersall, Becky; McKeegan, Dorothy E.F.; Sandilands, Victoria; Sparks, Nick H.C.; Waterman-Pearson, Avril E.; Murrell, Joanna C.

2013-01-01

Pain associated with poultry lameness is poorly understood. The anti-nociceptive properties of two non-steroidal anti-inflammatory drugs (NSAIDs) were evaluated using threshold testing in combination with an acute inflammatory arthropathy model. Broilers were tested in six groups (n = 8 per group). Each group underwent a treatment (saline, meloxicam (3 or 5 mg/kg) or carprofen (15 or 25 mg/kg)) and a procedure (Induced (arthropathy-induction) or sham (sham-handling)) prior to testing. Induced groups had Freund’s complete adjuvant injected intra-articularly into the left intertarsal joint (hock). A ramped thermal stimulus (1 °C/s) was applied to the skin of the left metatarsal. Data were analysed using random-intercept multi-level models. Saline-induced birds had a significantly higher skin temperature (± SD) than saline-sham birds (37.6 ± 0.8 °C vs. 36.5 ± 0.5 °C; Z = −3.47, P carprofen: Z = 2.58, P = 0.010) in induced birds. Saline-induced birds also had significantly lower TT than saline-sham birds (Z = −2.17, P = 0.030). This study found direct evidence of an association between inflammatory arthropathies and thermal hyperalgesia, and showed that NSAID treatment maintained baseline thermal sensitivity (via anti-nociception). Quantification of nociceptive responsiveness in a predictable broiler pain model identified thermal anti-hyperalgesic properties of two NSAIDs, which suggested that therapeutically effective treatment was provided at the doses administered. Such validation of analgesic strategies will increase the understanding of pain associated with specific natural broiler lameness types. PMID:24129110

MRI findings in the lumbar spines of asymptomatic elite junior tennis players

International Nuclear Information System (INIS)

Rajeswaran, G.; Healy, J.C.; Turner, M.; Gissane, C.

2014-01-01

To evaluate the MRI findings in the lumbar spines of asymptomatic elite junior tennis players. The lumbar spine MRI studies of 98 asymptomatic junior elite tennis players (51 male, 47 female) with a mean age of 18 years (age range 11.2-26.3 years; standard deviation 3.1) was reviewed by two consultant musculoskeletal radiologists using consensus opinion. Images were assessed using accepted classification systems. Four players (4 %) had no abnormality. Facet joint arthropathy occurred in 89.7 % of the players, being mild in 84.5 % of cases. There were 41 synovial cysts in 22.4 % of the cohort all occurring in the presence of facet arthropathy. Disc degeneration was noted in 62.2 % of players, being mild in 76.2 % of those affected. Disc herniation was noted in 30.6 % of players, with 86.1 % of these being broad based and 13.9 % being focal. There was nerve root compression in 2 %. There were 41 pars interarticularis abnormalities in 29.6 % of patients, 63.4 % of these being grades 1-3. There was grade 1 spondylolisthesis in 5.1 % of players. The prevalence of facet joint arthropathy, disc degeneration, disc herniation and pars interarticularis fracture was lower in female players than in male and lower in the under 16-year-olds compared with the over 20-year-olds. There is a significant amount of underlying pathology that would normally go undetected in this group of asymptomatic elite athletes. Whilst these findings cannot be detected clinically, their relevance is in facilitating appropriate prehabilitation to prevent loss of playing time and potentially career-ending injuries. (orig.)

A case of extensive synovial involvement by tophaceous gout | Khan ...

African Journals Online (AJOL)

Gout is the most common form of microcrystal arthropathy that results in deposition of uric acid crystals in and around the joints and soft tissues. The most common cause is decreased uric acid clearance by the kidneys. The radiological manifestations of gout are generally well known and have remained unchanged.

Radiology of haemophilic arthropathies. 2. rev., enl. ed.

International Nuclear Information System (INIS)

Forrai, J.

1979-01-01

Radiology plays an important role in confirming the diagnosis of haemophilia, in solving differential diagnostic problems, in the indication of surgical intervention and in the care of haemophiliacs. A detailed and accurate description of the X-ray symptomatology is given in this monograph. The author tries to fit the single radiomorphological signs into the entire, long pathological process. (Auth.)

Genetics Home Reference: multicentric osteolysis, nodulosis, and arthropathy

Science.gov (United States)

... bones ( osteoporosis ) throughout the skeleton. These abnormalities make bones brittle and more prone to fracture. The bone abnormalities ... information about a genetic condition can statistics provide? Why are some genetic conditions more common in particular ...

Neurogenic Changes In Myasthenia Gravis

African Journals Online (AJOL)

~(IQ c:: ~. Electron microscopic f'eatures loss of myofibrils. Areas of floccu- lar change. Dilated .... occurred at a presynaptic level, and he was able to show ... The brain and spinal cord were found ... The Spread of Tumours in the Human Body.

Schwannoma of the sublingual gland: report of a case

Energy Technology Data Exchange (ETDEWEB)

Lee, Eun Sook; Choi, Soon Chul; Park, Tae Won; You, Dong Soo [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Seoul National University, Seoul (Korea, Republic of)

1994-08-15

Schwannoma, also referred to as neurilemmoma, is a solitary, benign and slow growing tumor of nerve sheath origin. This rare lesion originates from Schwann cell of peripheral, autonomic and cranial nerve. Extracranial neurogenic tumor of the head and neck is uncommon. Schwannoma of the salivary gland is a particularly rare form of an extracranial neurogenic tumor, with most presenting in the parotid gland originating from a peripheral branch of the facial nerve. In this report, an unusual case of schwannoma in the sublingual region is presented and the literature concerning this subject is reviewed.

Brothers with constrictive pericarditis – A novel mutation in a rare disease

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Devendra V. Patil

2016-09-01

Full Text Available Familial constrictive pericarditis is extremely rare. We report a case of two brothers both suffering constrictive pericarditis along with having multiple painless joint deformities. Genetic workup confirmed the clinical diagnosis of camptodactyly-arthropathy-coxa vara-pericarditis (CACP syndrome CACP syndrome and also revealed a rare mutation in the causative gene.

POST ABORTION

African Journals Online (AJOL)

MRS. ADESHIYUN

Introduction. Septic sacroilitis is a rare complication of abortion. 1 . Pregnant women are often at risk of developing varying degree of sacroiliac joint dysfunction due to laxity of the ligaments; this laxity is hormonally induced. Pregnancy arthropathy, which is the commonest cause of hip and pelvic pain in pregnancy, must be ...

Overview and experience with the use of fluoroquinolone in children ...

African Journals Online (AJOL)

The use of fluoroquinolone is contraindicated in children because of the potential complication of arthropathy. In spite of this, the role of ciprofloxacin is becoming increasingly significant. We report two cases in which organisms that did not respond to the use of some other potent antibiotics clearly responded to the use of ...

Successful use of guanfacine in a patient with chronic refractory cough: A case report

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Gregory W. Kirschen

2017-01-01

Full Text Available Chronic idiopathic cough is a common and often frustrating complaint for patients as well as providers. When common etiologies of cough are ruled out and/or do not respond to usual treatments, neurogenic cough should be considered as a diagnosis of exclusion. Here, we report on a 58-year-old woman with an 8-year history of chronic, treatment-refractory cough of unknown etiology that we diagnosed as neurogenic cough and successfully treated with guanfacine monotherapy, with rapid and durable improvement in symptoms. This case was particularly challenging for a number of reasons, including a distant past smoking history and previous pneumonia, a significant psychiatric history, and a mildly deviated nasal septum and nasal osteophyte, all or some of which could have contributed to the etiology of the cough. This case illustrates that neurogenic cough should be a diagnostic consideration in patients presenting with chronic cough in whom other treatment modalities have failed, and also suggests that the therapeutic use of guanfacine in this clinical setting warrants future investigation.

Pathogenesis of cranial neuropathies in Moebius syndrome: Electrodiagnostic orofacial studies.

Science.gov (United States)

Renault, Francis; Flores-Guevara, Roberto; Sergent, Bernard; Baudon, Jean Jacques; Aouizerate, Jessie; Vazquez, Marie-Paule; Gitiaux, Cyril

2018-02-09

We designed a retrospective study of 59 patients with congenital sporadic nonprogressive bilateral facial and abducens palsies. Examinations included needle electromyography (EMG) of facial and oral muscles, facial nerve motor latency and conduction velocity (FNCV), and blink responses (BR). Neurogenic EMG changes were found in 1 or more muscles in 55 of 59 patients, with no abnormal spontaneous activity. EMG changes were homogeneously neurogenic in 17 patients, homogeneously myopathic in 1 patient, and heterogeneous in 41 of 59 patients. Motor latency was increased according to recordings from 52 of 137 facial muscles. An increase of motor latency was not associated with neurogenic EMG (Fischer's test: right, P = 1; left, P = 0.76). FNCV was slowed in 19 of 36 patients. BR was absent bilaterally in 35 of 58 patients; when present, R1 and R2 latencies were normal. Our results support the hypothesis of an early developmental defect localized in motor cranial nerves with spared V-VII internuclear pathways. Muscle Nerve, 2018. © 2018 Wiley Periodicals, Inc.

Pleural and pulmonary alterations caused by rheumatoid arthritis

International Nuclear Information System (INIS)

Bankier, A.A.; Fleischmann, D.; Kiener, H.P.; Wiesmayr, M.N.; Herold, C.J.

1996-01-01

Pulmonary complications caused by rheumatoid arthritis are a clinically relevant aspect of this chronic arthropathy. This article reviews pulmonary abnormalities induced by rheumatoid arthritis and their clinical and radiological findings. In addition, the role of different imaging modalities in the diagnostic work-up of pulmonary complications caused by rheumatoid arthritis is discussed. (orig./MG) [de

Certolizumab effect in a cohort of 60 Libyan patients with rheumatic ...

African Journals Online (AJOL)

They were 60 patients, 43 of them had RA, 14 patients had Ankylosing Spondylitis (AS), 2 patients had Psoriatic Arthropathy (PsA) and 1 patient had enteropathic arthritis. Certolizumab 400mg subcutaneous was given at week 0, 2, 4 and then 400mg every 4 weeks. Demographic details such as age and sex were recorded.

Complications of ankle fracture in patients with diabetes.

Science.gov (United States)

Chaudhary, Saad B; Liporace, Frank A; Gandhi, Ankur; Donley, Brian G; Pinzur, Michael S; Lin, Sheldon S

2008-03-01

Ankle fractures in patients with diabetes mellitus have long been recognized as a challenge to practicing clinicians. Complications of impaired wound healing, infection, malunion, delayed union, nonunion, and Charcot arthropathy are prevalent in this patient population. Controversy exists as to whether diabetic ankle fractures are best treated noninvasively or by open reduction and internal fixation. Patients with diabetes are at significant risk for soft-tissue complications. In addition, diabetic ankle fractures heal, but significant delays in bone healing exist. Also, Charcot ankle arthropathy occurs more commonly in patients who were initially undiagnosed and had a delay in immobilization and in patients treated nonsurgically for displaced ankle fractures. Several techniques have been described to minimize complications associated with diabetic ankle fractures (eg, rigid external fixation, use of Kirschner wires or Steinmann pins to increase rigidity). Regardless of the specifics of treatment, adherence to the basic principles of preoperative planning, meticulous soft-tissue management, and attention to stable, rigid fixation with prolonged, protected immobilization are paramount in minimizing problems and yielding good functional outcomes.

Lingual nerve injury in third molar surgery I. Observations on recovery of sensation with spontaneous healing

DEFF Research Database (Denmark)

Hillerup, S; Stoltze, Kaj

2007-01-01

, thermal stimuli and location of stimulus, as well as two-point discrimination, pain and the presence of a neuroma at the lesion site. Neurogenic signs and symptoms related to the injury and their variation over time were registered. Females were more often referred than males. Most lingual nerve injuries...... exhibited a significant potential for recovery, but only a few patients made a full recovery with absence of neurogenic symptoms. The recovery rate was highest during the first 6 months. Recovery was not influenced by gender, and only slightly by age. The presence of a neuroma was associated with a more...

Schwannoma Originating From the Periphereral Intercostal Nerves

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Yunus Aksoy

2017-06-01

Full Text Available Schwannomas are usually solitary, encapsulated, and asymptomatic, benign neurogenic tumors originating from the nerve sheath. Schwannomas rarely show malignant transformation, however, require close monitoring. They are primarily located in the thorax in the costovertebral sulcus, may rarely originate from peripheral intercostal nerves. Less than 10% of primary thoracic neurogenic tumors originate from the peripheral intercostal nerves. The main treatment and diagnosis of schwannomas are complete surgical resection. We report a rare case of a 40-year-old male with asymptomatic schwannoma originating from an intercostal nerve which was found incidentally on his chest X-ray and was treated with surgery.

[Imaging features of pubalgia].

Science.gov (United States)

Sans, N; Lhoste-Trouilloud, A; Sethom, S; Camara, P-Y; Jirari, M; Ponsot, A; Railhac, J-J

2011-06-01

Pubalgia is a generic term used to describe groin pain due to a multitude of different etiologies such as skeletal (microtraumatic pubic symphysis arthropathy), muscular (adductor or rectus abdominis disorders), or abdominal wall (inguinal hernia) disorders. Diagnosis relies mainly on MRI for musculoskeletal disorders and ultrasound for abdominal wall disorders. Copyright © 2011. Published by Elsevier Masson SAS.

Clinical FDG PET CT in the Investigation of Suspected Inflammatory and Infective Conditions

DEFF Research Database (Denmark)

Lorenz, Eleanor; Wig, Surabhi; Prakash, Vineet

scanning after multiple diagnostic investigations failed to determine a diagnosis.                   RESULTS          PET CT was useful in all 59 cases; revealing malignancy in 11 (2 of whom had associated myositis), systemic vasculitis in 9, inflammatory arthropathy in 5, infectious/other inflammatory...

Hemodynamic parameters and neurogenic pulmonary edema following spinal cord injury: an experimental model Parâmetros hemodinâmicos e edema pulmonar neurogênico após traumatismo raquimedular: modelo experimental

Directory of Open Access Journals (Sweden)

Manoel Baldoino Leal Filho

2005-12-01

Full Text Available Neurogenic pulmonary edema is a serious and always life-threatening complication following several lesions of the central nervous system. We report an experiment with 58 Wistar-Hanover adult male rats. Two groups were formed: control (n=4 and experimental (n=54. The experimental group sustained acute midthoracic spinal cord injury by Fogarty’s balloon-compression technique containing 20µL of saline for 5, 15, 30 or 60 seconds. The rats were anesthetized by intraperitoneal (i.p. sodium pentobarbital (s.p. 60 mg/Kg. The quantitative neurological outcome was presented at 4, 24 and 48 hours from compression to characterize the injury graduation in different groups. Poor outcome occurred with 60 seconds of compression. Six animals died suddenly with pulmonary edema. Using the procedure to investigate the pulmonary edema during 60 seconds of compression, followed by decompression and time-course of 60 seconds, 20 rats were randomly asigned to one of the following groups: control (1, n=4, anesthetized by i.p. s.p., 60 mg/Kg but without compression and experimental (2, n=7, anesthetized by i.p. xylazine 10 mg/Kg and ketamine 75 mg/Kg and (3, n=9, anesthetized by i.p. s.p., 60 mg/Kg. The pulmonary index (100 x wet lung weight / body weight was 0.395 ± 0.018 in control group, rose to 0.499 ± 0.060 in group 2, and was 0.639 ± 0.14 in group 3. Histologic examination of the spinal cord showed parenchymal ruptures and acute hemorrhage. Comparison of the pulmonary index with morphometric evaluation of edema fluid-filled alveoli by light microscopy showed that relevant intra-alveolar edema occurred only for index values above 0.55. The results suggest that the pulmonary edema induced by spinal compression is of neurogenic nature and that the type of anesthesia used might be important for the genesis of lung edema.Edema pulmonar neurogênico é complicação séria e aumenta o risco de vida em pacientes com várias lesões do sistema nervoso central

Eficácia da fonoterapia em disfagia neurogênica usando a escala funcional de ingestão por via oral (FOIS como marcador Efficacy of speech therapy in neurogenic dysphagia using functional oral intake scale (FOIS as a parameter

Directory of Open Access Journals (Sweden)

Ana Maria Furkim

2008-12-01

, using the functional oral intake scale as parameter of safe progression for oral feeding. METHODS: We carried out a retrospective study on forty-nine patients with neurogenic dysphagia under speech therapy sessions while in the wards and a comparison between the results of the functional oral intake scale before and after the therapy sessions(measuring the amount and type of orally-taken food in a safe manner by the patients. Possible factors affecting the therapy such as etiology of the neurologic disease, age, respiratory and clinical conditions, alertness, time and duration of the therapy sessions were studied. RESULTS: over the 49 studied patients, 36 showed improvement in the FOIS after speech therapy sessions. Regarding possible factors affecting the therapy, statistical analysis showed that deterioration of clinical condition, clinical intercurrences and decreased level of alertness were significant factors for the lack of progress to oral feeding during the speech therapy sessions. The other factors, etiology of disease, age, respiratory condition, time and number of sessions, did not demonstrate statistical significance. However, they did not interfere in improving or worsening the patients' clinical condition. CONCLUSION: there is an effective improvement in feeding by oral intake in patients with neurogenic dysphagia being treated by speech therapy sessions in the hospital wards. However, it cannot be achieved if the patient shows clinical intercurrences and decreased alertness level.

Surgical treatment of hip ankylosis due to heterotopic ossification secondary to spinal cord injury.

Science.gov (United States)

Romero-Muñoz, L M; Barriga-Martín, A; DeJuan-García, J

2018-02-21

To expose our experience in the diagnostic and surgical treatment of neurogenic heterotopic ossification of the hip. We designed an observational retrospective descriptive study including 20 patients (30 hips) with neurogenic heterotopic ossification of the hip secondary to spinal cord injury attended in our institution in the last 10 years, with a minimum of one year follow-up. Medical files and imaging studies were reviewed. The study variables analyzed were: type and localization of neurogenic heterotopic ossification, pre-post excision range of motion, level and aetiology of spinal cord injury, ASIA score, smoking history, surgical approach and complications associated with surgery. A total of 20 patients were treated with resection of heterotopic ossification in 30 hips. 16 patients presented ASIA A spinal cord injury and 4 ASIA B spinal cord injury. Preoperatively all the patients had severe ankylosis in the hip that made sitting in a wheel chair and activities such as repositioning and hygiene difficult. The average postoperative motion at the follow-up evaluation was 90° in flexion, 20° of internal rotation and 40° of external rotation. Immediately after surgery all the patients followed a specific intensive physiotherapy regime for the hip and celecoxib 200 mg was administrated daily orally for a month to prevent recurrence of heterotopic bone formation. None of the patients reviewed suffered a recurrence of heterotopic bone formation. Surgical excision of hip ossification in order to achieve functional ROM of the hip is the best treatment for patients with neurogenic heterotopic ossification of the hip. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Vesicoureteric reflux in children

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Jameela A Kari

2013-01-01

Full Text Available Aim: This study aimed to identify the differences between primary and secondary vesicoureteric reflux (VUR and the effect of associated bladder abnormalities on kidney function. Patients and Methods: We retrospectively reviewed the medical records of children with VUR who were followed up at King Abdulaziz University Hospital from January 2005 to December 2010. The review included results of radiological investigations and kidney function tests. We used Chi-square test for statistical analysis and paired t-test to compare group means for initial and last creatinine levels. Results: Ninety-nine children were included in this study. Twenty (20.2% had primary VUR, 11 had high-grade VUR, while 9 had low-grade reflux. All children with low-grade VUR had normal dimercaptosuccinic acid (DMSA. Renal scars were present in 72% of the children with high-grade VUR. The mean creatinine levels (initial and last for both groups were normal. Seventy-nine (79.8% children had secondary VUR, which was due to posterior urethral valves (PUV (46.8%, neurogenic bladder caused by meningomyelocele (25.3%, non-neurogenic neurogenic bladder (NNB (21.5%, or neurogenic bladder associated with prune belly syndrome (6.3%. Children with NNB, meningomyelocele and PUV had high creatinine at presentation with no considerable worsening of their kidney functions during the last visit. Renal scars were present in 49.4% of the children with secondary VUR. Conclusion: Children with primary VUR and normal bladder had good-functioning kidneys, while those with secondary VUR associated with abnormal bladder caused by NNB, spina bifida or PUV had abnormal kidney functions. DMSA scans were useful in predicting higher grades of VUR in children with primary reflux.

Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up study

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Marcia Eli Girotti

2011-12-01

Full Text Available PURPOSE: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC. MATERIALS AND METHODS: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. RESULTS: Sixty patients (50.4 ± 19.9 years old were trained to perform CISC (21 female and 39 male. Out of them, 30 (50% had neurogenic and 30 (50% had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively. In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. CONCLUSION: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.

Electromyography findings of the cricopharyngeus in association with ipsilateral pharyngeal and laryngeal muscles.

Science.gov (United States)

Halum, Stacey L; Shemirani, Nima L; Merati, Albert L; Jaradeh, Safwan; Toohill, Robert J

2006-04-01

We reviewed a large series of cricopharyngeal (CP) muscle electromyography (EMG) results and compared them with the EMG results from the inferior constrictor (IC), thyroarytenoid, (TA), cricothyroid (CT), and posterior cricoarytenoid (PCA) muscles. We performed a retrospective review of all CP muscle EMG reports from studies performed between January 1996 and June 2003. All of the tested elements from the CP muscle EMG reports were recorded. The EMG results were recorded for the ipsilateral IC, TA, CT, and PCA muscles if they were simultaneously tested. Each muscle result was classified as normal, neurogenic inactive axonal injury (IAI), or neurogenic active axonal injury (AAI), and the muscle findings were compared. A patient chart review was performed to determine a clinical correlation. Fifty-nine patients underwent CP muscle EMG. Eighteen patients had bilateral EMG studies, making a total of 77 CP muscle studies. Nineteen sets of CP muscle results were normal, 43 demonstrated neurogenic IAI, and 15 demonstrated neurogenic AAI. The ipsilateral IC and CP muscles had the same innervation status in 27 of 28 studies (p muscle was studied simultaneously with the CP muscle, 31 of 50 studies had the same innervation status (p = .005). The ipsilateral CT and CP muscles demonstrated the same innervation status in 40 of 50 studies (p muscle findings and between the CP and CT muscle findings were both stronger than the correlation between the CP and TA muscle findings (p muscle findings have the strongest correlation with IC muscle findings, followed by the CT and TA muscles. This outcome does not support theories indicating that the recurrent laryngeal nerve innervates the CP muscle in all cases.

Treatment of autonomic dysfunction in Parkinson disease and other synucleinopathies.

Science.gov (United States)

Palma, Jose-Alberto; Kaufmann, Horacio

2018-03-01

Dysfunction of the autonomic nervous system afflicts most patients with Parkinson disease and other synucleinopathies such as dementia with Lewy bodies, multiple system atrophy, and pure autonomic failure, reducing quality of life and increasing mortality. For example, gastrointestinal dysfunction can lead to impaired drug pharmacodynamics causing a worsening in motor symptoms, and neurogenic orthostatic hypotension can cause syncope, falls, and fractures. When recognized, autonomic problems can be treated, sometimes successfully. Discontinuation of potentially causative/aggravating drugs, patient education, and nonpharmacological approaches are useful and should be tried first. Pathophysiology-based pharmacological treatments that have shown efficacy in controlled trials of patients with synucleinopathies have been approved in many countries and are key to an effective management. Here, we review the treatment of autonomic dysfunction in patients with Parkinson disease and other synucleinopathies, summarize the nonpharmacological and current pharmacological therapeutic strategies including recently approved drugs, and provide practical advice and management algorithms for clinicians, with focus on neurogenic orthostatic hypotension, supine hypertension, dysphagia, sialorrhea, gastroparesis, constipation, neurogenic overactive bladder, underactive bladder, and sexual dysfunction. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

Astrocytes at the Hub of the Stress Response: Potential Modulation of Neurogenesis by miRNAs in Astrocyte-Derived Exosomes.

Science.gov (United States)

Luarte, Alejandro; Cisternas, Pablo; Caviedes, Ariel; Batiz, Luis Federico; Lafourcade, Carlos; Wyneken, Ursula; Henzi, Roberto

2017-01-01

Repetitive stress negatively affects several brain functions and neuronal networks. Moreover, adult neurogenesis is consistently impaired in chronic stress models and in associated human diseases such as unipolar depression and bipolar disorder, while it is restored by effective antidepressant treatments. The adult neurogenic niche contains neural progenitor cells in addition to amplifying progenitors, neuroblasts, immature and mature neurons, pericytes, astrocytes, and microglial cells. Because of their particular and crucial position, with their end feet enwrapping endothelial cells and their close communication with the cells of the niche, astrocytes might constitute a nodal point to bridge or transduce systemic stress signals from peripheral blood, such as glucocorticoids, to the cells involved in the neurogenic process. It has been proposed that communication between astrocytes and niche cells depends on direct cell-cell contacts and soluble mediators. In addition, new evidence suggests that this communication might be mediated by extracellular vesicles such as exosomes, and in particular, by their miRNA cargo. Here, we address some of the latest findings regarding the impact of stress in the biology of the neurogenic niche, and postulate how astrocytic exosomes (and miRNAs) may play a fundamental role in such phenomenon.

Astrocytes at the Hub of the Stress Response: Potential Modulation of Neurogenesis by miRNAs in Astrocyte-Derived Exosomes

Directory of Open Access Journals (Sweden)

Alejandro Luarte

2017-01-01

Full Text Available Repetitive stress negatively affects several brain functions and neuronal networks. Moreover, adult neurogenesis is consistently impaired in chronic stress models and in associated human diseases such as unipolar depression and bipolar disorder, while it is restored by effective antidepressant treatments. The adult neurogenic niche contains neural progenitor cells in addition to amplifying progenitors, neuroblasts, immature and mature neurons, pericytes, astrocytes, and microglial cells. Because of their particular and crucial position, with their end feet enwrapping endothelial cells and their close communication with the cells of the niche, astrocytes might constitute a nodal point to bridge or transduce systemic stress signals from peripheral blood, such as glucocorticoids, to the cells involved in the neurogenic process. It has been proposed that communication between astrocytes and niche cells depends on direct cell-cell contacts and soluble mediators. In addition, new evidence suggests that this communication might be mediated by extracellular vesicles such as exosomes, and in particular, by their miRNA cargo. Here, we address some of the latest findings regarding the impact of stress in the biology of the neurogenic niche, and postulate how astrocytic exosomes (and miRNAs may play a fundamental role in such phenomenon.

Susceptibility and HLA-B27 in post-dysenteric arthropathies

NARCIS (Netherlands)

van Bohemen, C. G.; Lionarons, R. J.; van Bodegom, P.; Dinant, H. J.; Landheer, J. E.; Nabbe, A. J.; Grumet, F. C.; Zanen, H. C.

1985-01-01

A recent outbreak of bacillary dysentery in The Netherlands revealed that, despite the close association of HLA-B27 with post-dysenteric or reactive arthritis (ReA), not even in one family did all HLA-B27 positive patients infected by an arthritogenic bacterium, develop ReA. This dissociation shows

A preliminary case series evaluating the safety and immediate to short-term clinical benefits of joint mobilization in hemophilic arthritis of the lower limb.

Science.gov (United States)

Scaddan, Emma; Rowell, John; O'Leary, Shaun

2017-09-01

Arthritis resulting from recurrent intra-articular bleeding in individuals with hemophilia can be severely debilitating due to joint pain and stiffness with subsequent loss of mobility and function. Very limited studies have investigated the potential benefits of joint mobilization for this condition. This case series is a preliminary investigation of safety, as well as immediate and short-term clinical benefits, associated with gentle knee and ankle joint mobilization in people with hemophilic arthropathy. A single intervention of joint mobilization was applied to the affected knees and/or ankles of 16 individuals with severe or moderate hemophilia within a public hospital setting. Adverse events, as well as immediate (pain-free passive joint range, Timed Up and Go Test with maximum pain numerical rating scale) and short-term (Lower Extremity Functional Scale) effects of the intervention were evaluated with a repeated measures ANOVA. There were no adverse events. An immediate significant increase was observed in pain-free passive ankle joint range of motion ( p  < 0.05) following the joint mobilization intervention. The findings of this case series suggest that gentle joint mobilization techniques may be safely considered as part of a multimodal management approach for hemophilic arthropathy.

Prevalence of juvenile idiopathic arthritis in children aged 6 to 12 years in Embu das Artes, state of Sao Paulo, Brazil.

Science.gov (United States)

Yamashita, Edson; Terreri, Maria Teresa R A; Hilário, Maria Odete E; Len, Claudio A

2013-01-01

The aim of the study was to study the prevalence of juvenile idiopathic arthritis (JIA) in school children in the city of Embu das Artes in São Paulo State. 2880 school children from seven public schools, aged between 6 and 12 years, were evaluated (clinical findings) by a pediatric rheumatologist. A board certified Pediatric Rheumatologist evaluated the subjects with suspected inflammatory arthropathy. Children with higher suspicion were referred to a specialized service. One hundred and forty-one children have presented abnormalities on examination of musculoskeletal system, with isolated pain on palpation the most common finding in the first evaluation (60.9%), with improvement in almost all cases in the second examination. Most of the abnormalities were related to recent injuries or congenital malformations. Six children have clinical findings suggestive of chronic arthropathy and were referred to a specialized pediatric rheumatology clinic. Of these, a 12 year-old girl fulfilled the criteria for JIA. The other diagnoses were aseptic necrosis of the hip (P = 1) of and post-trauma synovitis (P = 4). The prevalence of JIA in children aged between 6 and 12 years was 1/2.880 (or 0.34/1.000).

A Review of Neurogenic Stunned Myocardium

Science.gov (United States)

Wongrakpanich, Supakanya; Agrawal, Akanksha; Yadlapati, Sujani; Kishlyansky, Marina; Figueredo, Vincent

2017-01-01

Neurologic stunned myocardium (NSM) is a phenomenon where neurologic events give rise to cardiac abnormalities. Neurologic events like stroke and seizures cause sympathetic storm and autonomic dysregulation that result in myocardial injury. The clinical presentation can involve troponin elevation, left ventricular dysfunction, and ECG changes. These findings are similar to Takotsubo cardiomyopathy and acute coronary syndrome. It is difficult to distinguish NSM from acute coronary syndrome based on clinical presentation alone. Because of this difficulty, a patient with NSM who is at high risk for coronary heart disease may undergo cardiac catheterization to rule out coronary artery disease. The objective of this review of literature is to enhance physician's awareness of NSM and its features to help tailor management according to the patient's clinical profile. PMID:28875040

A Review of Neurogenic Stunned Myocardium

OpenAIRE

Biso, Sylvia; Wongrakpanich, Supakanya; Agrawal, Akanksha; Yadlapati, Sujani; Kishlyansky, Marina; Figueredo, Vincent

2017-01-01

Neurologic stunned myocardium (NSM) is a phenomenon where neurologic events give rise to cardiac abnormalities. Neurologic events like stroke and seizures cause sympathetic storm and autonomic dysregulation that result in myocardial injury. The clinical presentation can involve troponin elevation, left ventricular dysfunction, and ECG changes. These findings are similar to Takotsubo cardiomyopathy and acute coronary syndrome. It is difficult to distinguish NSM from acute coronary syndrome bas...

Natural History Study of Synucleinopathies

Science.gov (United States)

2018-01-23

Patients With Synucleinopathies; Neurogenic Orthostatic Hypotension; Pure Autonomic Failure; REM Sleep Behavior Disorder; Parkinson Disease; Dementia With Lewy Bodies; Multiple System Atrophy; Shy-Drager Disease

Genotyping of human parvovirus B19 in clinical samples from Brazil and Paraguay using heteroduplex mobility assay, single-stranded conformation polymorphism and nucleotide sequencing

Directory of Open Access Journals (Sweden)

Marcos César Lima de Mendonça

2011-06-01

Full Text Available Heteroduplex mobility assay, single-stranded conformation polymorphism and nucleotide sequencing were utilised to genotype human parvovirus B19 samples from Brazil and Paraguay. Ninety-seven serum samples were collected from individuals presenting with abortion or erythema infectiosum, arthropathies, severe anaemia and transient aplastic crisis; two additional skin samples were collected by biopsy. After the procedure, all clinical samples were classified as genotype 1.

Case report

African Journals Online (AJOL)

raoul

10 avr. 2012 ... (retrouvaient Mycobacterium tuberculosis. Une chimiothérapie antituberculeuse a été administrée pendant 12 mois. À 24 mois, la patiente ne présentait pas de récidive mais une arthropathie dégénérative secondaire subtalienne. Il nous semble intéressant de rappeler que tout tableau clinique traînant ou ...

Syncope in children and adolescents as asudden, transient, short-term and spontaneously reversible loss of consciousness caused by adecrease in cerebral perfusion

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Ewa Nowakowska

2014-09-01

Full Text Available Syncope is a common symptom in adolescents who come to the hospital emergency wards. The most common form of syncope is neurogenic type caused by impaired autoregulation of the circulatory system. This syncope is not generally life-threatening condition in a contrast to the less common but most dangerous cardiogenic type (e.g. cardiac arrhythmias due to Wolff–Parkinson–White syndrome, long QT time interval, atrioventricular blocks, haemodynamic obstructions in the outflow tract of the left or right ventricle, cardiomyopathy or coronary abnormalities. This paper refers to a new term, i.e. transient loss of consciousness. According to the new definition of syncope from 2009, temporary loss of consciousness has four components: a sudden occurrence, transient nature, short duration, and spontaneous regression. Currently, there are three main types of syncope associated with the cardiovascular system: neurogenic, orthostatic hypotension and a cardiac. The most common form in adolescents are neurogenic fainting which are often preceded by prodromal symptoms, i.e. decrease in blood pressure and heart rate. They can also occur in response to the stress or unusual situations. In the orthostatic syncope the loss of consciousness occurs in a very short time after the upright position and unlike neurogenic form, usually there are no prodromal symptoms, but tachycardia is present. The rarest, but also the most dangerous form of syncope is a cardiogenic type caused by arrhythmias or structural heart disease. This form may be the first sign of serious heart disease or even precede sudden cardiac death.

Cost-Effectiveness of Reverse Total Shoulder Arthroplasty Versus Arthroscopic Rotator Cuff Repair for Symptomatic Large and Massive Rotator Cuff Tears.

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Makhni, Eric C; Swart, Eric; Steinhaus, Michael E; Mather, Richard C; Levine, William N; Bach, Bernard R; Romeo, Anthony A; Verma, Nikhil N

2016-09-01

To compare the cost-effectiveness within the United States health care system of arthroscopic rotator cuff repair versus reverse total shoulder arthroplasty in patients with symptomatic large and massive rotator cuff tears without cuff-tear arthropathy. An expected-value decision analysis was constructed comparing the costs and outcomes of patients undergoing arthroscopic rotator cuff repair and reverse total shoulder arthroplasty for large and massive rotator cuff tears (and excluding cases of cuff-tear arthropathy). Comprehensive literature search provided input data to extrapolate costs and health utility states for these outcomes. The primary outcome assessed was that of incremental cost-effectiveness ratio (ICER) of reverse total shoulder arthroplasty versus rotator cuff repair. For the base case, both arthroscopic rotator cuff repair and reverse total shoulder were superior to nonoperative care, with an ICER of $15,500/quality-adjusted life year (QALY) and $37,400/QALY, respectively. Arthroscopic rotator cuff repair was dominant over primary reverse total shoulder arthroplasty, with lower costs and slightly improved clinical outcomes. Arthroscopic rotator cuff repair was the preferred strategy as long as the lifetime progression rate from retear to end-stage cuff-tear arthropathy was less than 89%. However, when the model was modified to account for worse outcomes when reverse shoulder arthroplasty was performed after a failed attempted rotator cuff repair, primary reverse total shoulder had superior outcomes with an ICER of $90,000/QALY. Arthroscopic rotator cuff repair-despite high rates of tendon retearing-for patients with large and massive rotator cuff tears may be a more cost-effective initial treatment strategy when compared with primary reverse total shoulder arthroplasty and when assuming no detrimental impact of previous surgery on outcomes after arthroplasty. Clinical judgment should still be prioritized when formulating treatment plans for these

Ofloxacin induces apoptosis via β1 integrin-EGFR-Rac1-Nox2 pathway in microencapsulated chondrocytes

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Sheng, Zhi-Guo; Huang, Wei; Liu, Yu-Xiang; Yuan, Ye; Zhu, Ben-Zhan

2013-01-01

Quinolones (QNs)-induced arthropathy is an important toxic side-effect in immature animals leading to the restriction of their therapeutic use in pediatrics. Ofloxacin, a typical QN, was found to induce the chondrocytes apoptosis in the early phase (12–48 h) of arthropathy in our previous study. However, the exact mechanism(s) is unclear. Microencapsulated juvenile rabbit joint chondrocytes, a three-dimensional culture system, is utilized to perform the present study. Ofloxacin, at a therapeutically relevant concentration (10 μg/ml), disturbs the interaction between β1 integrin and activated intracellular signaling proteins at 12 h, which is inhibited when supplementing Mg 2+ . Intracellular reactive oxygen species (ROS) significantly increases in a time-dependent manner after exposure to ofloxacin for 12–48 h. Furthermore, ofloxacin markedly enhances the level of activated Rac1 and epidermal growth factor receptor (EGFR) phosphorylation, and its inhibition in turn reduces the ROS production, apoptosis and Rac1 activation. Silencing Nox2, Rac1 or supplementing Mg 2+ inhibits ROS accumulation, apoptosis occurrence and EGFR phosphorylation induced by ofloxacin. However, depletion of Nox2, Rac1 and inhibition of EGFR do not affect ofloxacin-mediated loss of interaction between β1 integrin and activated intracellular signaling proteins. In addition, ofloxacin also induces Vav2 phosphorylation, which is markedly suppressed after inactivating EGFR or supplementing Mg 2+ . These results suggest that ofloxacin causes Nox2-mediated intracellular ROS production by disrupting the β1 integrin function and then activating the EGFR-Vav2-Rac1 pathway, finally resulting in apoptosis within 12–48 h exposure. The present study provides a novel insight regarding the potential role of Nox-driven ROS in QNs-induced arthropathy. - Highlights: ► Ofloxacin induces Nox2-driven ROS in encapsulated chondrocyte at 12–48 h. ► Ofloxacin stimulates ROS production via the β1

Ofloxacin induces apoptosis via β1 integrin-EGFR-Rac1-Nox2 pathway in microencapsulated chondrocytes

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Sheng, Zhi-Guo [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, 18 Shuangqing Road, Beijing 100085 (China); Huang, Wei [Department of Chemical Biology, School of Pharmaceutical Sciences, Peking University Health Science Center, Beijing 1000191 (China); Liu, Yu-Xiang [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, 18 Shuangqing Road, Beijing 100085 (China); Yuan, Ye [Beijing Institute of Pharmacology and Toxicology, 27 Taiping Road, Beijing 100850 (China); Zhu, Ben-Zhan, E-mail: bzhu@rcees.ac.cn [State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, 18 Shuangqing Road, Beijing 100085 (China); Linus Pauling Institute, Oregon State University, Corvallis, OR 97331 (United States)

2013-02-15

Quinolones (QNs)-induced arthropathy is an important toxic side-effect in immature animals leading to the restriction of their therapeutic use in pediatrics. Ofloxacin, a typical QN, was found to induce the chondrocytes apoptosis in the early phase (12–48 h) of arthropathy in our previous study. However, the exact mechanism(s) is unclear. Microencapsulated juvenile rabbit joint chondrocytes, a three-dimensional culture system, is utilized to perform the present study. Ofloxacin, at a therapeutically relevant concentration (10 μg/ml), disturbs the interaction between β1 integrin and activated intracellular signaling proteins at 12 h, which is inhibited when supplementing Mg{sup 2+}. Intracellular reactive oxygen species (ROS) significantly increases in a time-dependent manner after exposure to ofloxacin for 12–48 h. Furthermore, ofloxacin markedly enhances the level of activated Rac1 and epidermal growth factor receptor (EGFR) phosphorylation, and its inhibition in turn reduces the ROS production, apoptosis and Rac1 activation. Silencing Nox2, Rac1 or supplementing Mg{sup 2+} inhibits ROS accumulation, apoptosis occurrence and EGFR phosphorylation induced by ofloxacin. However, depletion of Nox2, Rac1 and inhibition of EGFR do not affect ofloxacin-mediated loss of interaction between β1 integrin and activated intracellular signaling proteins. In addition, ofloxacin also induces Vav2 phosphorylation, which is markedly suppressed after inactivating EGFR or supplementing Mg{sup 2+}. These results suggest that ofloxacin causes Nox2-mediated intracellular ROS production by disrupting the β1 integrin function and then activating the EGFR-Vav2-Rac1 pathway, finally resulting in apoptosis within 12–48 h exposure. The present study provides a novel insight regarding the potential role of Nox-driven ROS in QNs-induced arthropathy. - Highlights: ► Ofloxacin induces Nox2-driven ROS in encapsulated chondrocyte at 12–48 h. ► Ofloxacin stimulates ROS production via

[Human myopathy and animal muscular dystrophy].

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Schapira, G; Dreyfus, J C; Schapira, F

1977-08-01

Two hereditary muscular dystrophies similar to human progressive muscular dystrophy (P.M.D. Duchenne type) have been isolated in animals, one in mouse, the other in chicken. The decrease in the activity of glycogenolytic enzymes is similar to that observed in denervated muscle. Isozymic fetal types for several muscular enzymes have been observed as well in chicken as in man, but this fetal type may also be found in neurogenic atrophy. The release in circulation of muscle enzymes seems more specific. But the origin of the genetic lesion is still unknown. We describe here the three different theories about this problem: i.e. neurogenic, vascular, or myogenic. This last theory implies a trouble of membrane permeability.

Impaired neurogenesis, learning and memory and low seizure threshold associated with loss of neural precursor cell survivin

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Eisch Amelia

2010-01-01

Full Text Available Abstract Background Survivin is a unique member of the inhibitor of apoptosis protein (IAP family in that it exhibits antiapoptotic properties and also promotes the cell cycle and mediates mitosis as a chromosome passenger protein. Survivin is highly expressed in neural precursor cells in the brain, yet its function there has not been elucidated. Results To examine the role of neural precursor cell survivin, we first showed that survivin is normally expressed in periventricular neurogenic regions in the embryo, becoming restricted postnatally to proliferating and migrating NPCs in the key neurogenic sites, the subventricular zone (SVZ and the subgranular zone (SGZ. We then used a conditional gene inactivation strategy to delete the survivin gene prenatally in those neurogenic regions. Lack of embryonic NPC survivin results in viable, fertile mice (SurvivinCamcre with reduced numbers of SVZ NPCs, absent rostral migratory stream, and olfactory bulb hypoplasia. The phenotype can be partially rescued, as intracerebroventricular gene delivery of survivin during embryonic development increases olfactory bulb neurogenesis, detected postnatally. SurvivinCamcre brains have fewer cortical inhibitory interneurons, contributing to enhanced sensitivity to seizures, and profound deficits in memory and learning. Conclusions The findings highlight the critical role that survivin plays during neural development, deficiencies of which dramatically impact on postnatal neural function.

Association between iris constitution and apolipoprotein e gene polymorphism in hypertensives.

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Um, Jae-Young; Hwang, Chung-Yeon; Hwang, Woo-Jun; Kang, Sung-Do; Do, Keum-Rok; Cho, Ju-Jang; Cho, Jae-Woon; Kim, Sung-Hoon; Shin, Tae-Yong; Kim, Yun-Kyung; Kim, Hyung-Min; Hong, Seung-Heon

2004-12-01

Iridology is a complementary and alternative medicine (CAM) that involves the diagnosis of medical conditions by noting irregularities of the pigmentation in the iris. Iris constitution has a strong familial aggregation and heredity is implicated. Apolipoprotein E (apoE) gene polymorphism is one of the most well-studied genetic markers for vascular diseases, including hypertension. In this study, we investigated the relationship between iris constitution and apoE polymorphism in hypertensives. We classified 87 hypertensives and 79 controls according to iris constitution and determined the apoE genotype of each individual. A significantly higher percentage of individuals with neurogenic constitutions was found in the hypertensive group when compared with the control group (chi(2) = 40.244, p < 0.001). In addition, a neurogenic constitution increased the relative risk for hypertension for subjects with an apo epsilon2 or an epsilon4 allele (chi(2) = 4.086, p = 0.049, odds ratio = 2.633, confidence interval = 1.004-6.905). Our results imply that a neurogenic iris constitution enhances the relative risk for hypertension in subjects with the apo epsilon2 or epsilon4 allele. Furthermore, we attempted to evaluate the efficacy of iris constitutional medicine and to find an association with hypertension.

Mast cell-neural interactions contribute to pain and itch.

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Gupta, Kalpna; Harvima, Ilkka T

2018-03-01

Mast cells are best recognized for their role in allergy and anaphylaxis, but increasing evidence supports their role in neurogenic inflammation leading to pain and itch. Mast cells act as a "power house" by releasing algogenic and pruritogenic mediators, which initiate a reciprocal communication with specific nociceptors on sensory nerve fibers. Consequently, nerve fibers release inflammatory and vasoactive neuropeptides, which in turn activate mast cells in a feedback mechanism, thus promoting a vicious cycle of mast cell and nociceptor activation leading to neurogenic inflammation and pain/pruritus. Mechanisms underlying mast cell differentiation, activation, and intercellular interactions with inflammatory, vascular, and neural systems are deeply influenced by their microenvironment, imparting enormous heterogeneity and complexity in understanding their contribution to pain and pruritus. Neurogenic inflammation is central to both pain and pruritus, but specific mediators released by mast cells to promote this process may vary depending upon their location, stimuli, underlying pathology, gender, and species. Therefore, in this review, we present the contribution of mast cells in pathological conditions, including distressing pruritus exacerbated by psychologic stress and experienced by the majority of patients with psoriasis and atopic dermatitis and in different pain syndromes due to mastocytosis, sickle cell disease, and cancer. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as septic arthritis of the shoulder

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Donovan, Andrea; Schweitzer, Mark E.; Nomikos, George [NYU Hospital for Joint Diseases, New York, NY (United States); Garcia, Roberto A. [Bellevue Hospital Center, New York, NY (United States)

2008-11-15

We report a case of a 53-year-old man presenting with shoulder pain mimicking septic arthritis. Laboratory findings were atypical. Biopsy performed to assess for possible osteomyelitis demonstrated chronic lymphocytic leukemia/small lymphocytic lymphoma. Intra-articular lymphoma is a rare but important consideration in patients with atypical clinical presentation. Imaging alone may be insufficient to render diagnosis as lymphoma can mimic infection, synovial hypertrophic processes, and depositional arthropathy. (orig.)

Autoantibodies directed to centromere protein F in a patient with BRCA1 gene mutation

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Moghaddas, Fiona; Joshua, Fredrick; Taylor, Roberta; Fritzler, Marvin J.; Toh, Ban Hock

2016-01-01

Background Autoantibodies directed to centromere protein F were first reported in 1993 and their association with malignancy has been well documented. Case We present the case of a 48-year-old Caucasian female with a BRCA1 gene mutation associated with bilateral breast cancer. Antinuclear autoantibody immunofluorescence performed for workup of possible inflammatory arthropathy showed a high titre cell cycle related nuclear speckled pattern, with subsequent confirmation by addressable laser be...

Genetics Home Reference: adult polyglucosan body disease

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... Additional NIH Resources (1 link) National Institute of Neurological Disorders and Stroke: Spasticity Information Page Educational Resources (6 links) Boston Children's Hospital: Neurogenic Bladder Disease InfoSearch: Polyglucosan body disease, ...

Painful percutaneous transthoracic needle biopsy of Schwannoma: a case report

International Nuclear Information System (INIS)

Kim, Sung Hoon; Chun, Kyung Ah; Kim, Young Joo; Park, Seog Hee; Shin, Kyung Sub; Lee, Eun Jung

1995-01-01

Percutaneous aspiration needle biopsy of the intrathoracic disease is a safe, easy, and accurate diagnostic method. It usually causes mild pain or discomfort during the procedure. We had a patient who complained of severe sharp pain, well localized at the biopsy site of the target mass during CT-guided transthoracic aspiration biopsy. It was pathologically confirmed as an intrathoracic schwannoma after special staining. To our knowledge, there has been no published report of such a painful percutaneous needle biopsy in a patient with schwannoma in Korea. Two cases were reported in other radiologic journals. The severe sharp pain developed during the transthoracic aspiration needle biopsy is a reliable sign of neurogenic tumor, therefore the participating radiologist should recommend specific immumochemical stain for neurogenic tumor to pathologist

Pediatric Urinary Tract Infection

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SBA National Resource Center: 800-621-3141 Pediatric Urinary Tract Infections and Catheterization in Children with Neurogenic Bladder and Bowel Why is it important to begin urologic care in infancy and ...

Periarticular uptake of /sup 99m/technetium diphosphonate in psoriatics. Correlation with cutaneous activity

International Nuclear Information System (INIS)

Namey, T.C.; Rosenthall, L.

1976-01-01

The periarticular uptake of /sup 99m/technetium-labeled diphosphonate (/sup 99m/TcDP) was compared in 12 patients hospitalized for psoriasis and in 12 hospitalized for other dermatoses not associated with arthropathy. The 12 patients with psoriasis had recent onset disease of less than 5 years duration; neither group had historical or clinical evidence of arthritis. All psoriatics had markedly abnormal scans with symmetrically increased periarticular uptake about the imaged joints. None of the controls had similar findings. In 4 patients scanned with /sup 99m/technetium-pertechnetate within 24 hours of their /sup 99m/TcDP scan, no evidence of inflammatory synovitis was found. Three of these patients were serially imaged with /sup 99m/TcDP at intervals of 2 weeks to 3 months after their initial study, when obvious clinical improvement in their psoriasis was apparent. Improvement in the radionuclide joint images was demonstrated in some of the patients, but none reverted to normal during the study period. In light of recent evidence for the preferential binding of /sup 99m/TcDP to immature collagen, it is suggested that psoriasis may represent a generalized, but uncharacterized, collagen disorder present in bone as well as skin, linking the cutaneous disease with the potential for arthropathy

The value of HEAD-US system in detecting subclinical abnormalities in joints of patients with hemophilia.

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De la Corte-Rodriguez, Hortensia; Rodriguez-Merchan, E Carlos; Alvarez-Roman, M Teresa; Martin-Salces, Mónica; Martinoli, Carlo; Jimenez-Yuste, Víctor

2018-03-01

Prevention of hemarthrosis is the key factor in the adequate management of people with hemophilia (PWH). If hemarthrosis occurs, early diagnosis of joint damage is essential to make personalized treatments. This study is aimed at gaining an understanding of the ability of point-of-care ultrasound (US) using the `Hemophilia Early Arthropathy Detection with Ultrasound´ (HEAD-US) protocol to detect abnormalities in joints without history of hemarthrosis and clinically asymptomatic joints of PWH. The sample included 976 joints from 167 PWH (mean age 24.86 years). Data were collected from routine practice over a 3-year period and analyzed based on history of hemarthrosis and results of clinical (HJHS 2.1) and HEAD-US examinations. In our series, 14% of patients exhibited HEAD-US signs of incipient arthropathy in joints with no history of bleeding and with a HJHS 2.1 score of 0. The most severely involved joint was the right ankle. Synovitis, articular cartilage and subchondral bone damage scores in joints with subclinical findings were slower than in joints with previous hemarthroses or HJHS 2.1 > 1 Conclusions: Our study demonstrates that HEAD-US is better than hemarthrosis records and the HJHS 2.1 scale in detecting the early signs of joint damage in PWH.

Diabetic Foot Complications Despite Successful Pancreas Transplantation.

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Seo, Dong-Kyo; Lee, Ho Seong; Park, Jungu; Ryu, Chang Hyun; Han, Duck Jong; Seo, Sang Gyo

2017-06-01

It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed. Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02). Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes. Level III, comparative study.

Tertiary syphilis in the lumbar spine: a case report.

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Bai, Yang; Niu, Feng; Liu, Lidi; Sha, Hui; Wang, Yimei; Zhao, Song

2017-07-24

The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression. A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot's arthropathy was formed between L4 and L5. It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot's arthropathy should be considered as an operative complication.

In vitro and in vivo spin echo diffusion imaging characteristics of synovial fluid: potential non-invasive differentiation of inflammatory and degenerative arthritis

International Nuclear Information System (INIS)

Eustace, S.; DiMasi, M.; Adams, J.; Ward, R.; Caruthers, S.; McAlindon, T.

2000-01-01

Objective. This study was undertaken to analyse the diffusion characteristics of synovial fluid in degenerative and inflammatory arthropathies.Design and patients. Ten in vitro specimens of synovial fluid from patients with both degenerative and inflammatory arthropathy were studied at body temperature with a navigator-corrected spin echo diffusion sequence (B values 0-512 s/mm 2 ), on a Philips 1.5-T Gyroscan. Subsequently synovial fluid from knee joint effusions of 25 patients (10 patients with osteoarthritis, 10 patients with effusions following trauma and 5 patients with effusions secondary to inflammatory arthritis) was evaluated with the same navigator-corrected spin echo diffusion sequence.Results. Both in vitro and in vivo study demonstrated decreased diffusion in patients with effusions secondary to degenerative joint disease (less than 2.40 x 10 -5 cm 2 /s) relative to patients with effusions accompanying knee trauma (greater than 2.75 x 10 -5 cm 2 /s) and inflammatory arthritis (in vitro and in vivo greater than 3.00 x 10 -5 cm 2 /s).Conclusion. Synovial fluid in degenerative arthritis shows less diffusion or free water movement than synovial fluid in inflammatory arthritis. Diffusion characteristics of synovial fluid may be used to predict the nature of the underlying form of arthritis in patients presenting with knee joint effusions. (orig.)

Gouty Arthropathy of the Cervical Spine in a Young Adult

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Yi-Jie Kuo

2007-04-01

Full Text Available We report a young man with gouty discitis of the cervical spine. To our knowledge, our patient is the youngest patient with cervical gouty discitis reported in the literature. The clinical manifestation was similar to that of cervical spondylosis with radiculopathy. Gouty discitis was diagnosed only when tophi in the disc were found during surgery and proved by pathologic study. Surgical decompression followed by optimization of pharmacologic treatment enabled good recovery from neurologic complications.

The F8(-/-) rat as a model of hemophilic arthropathy

DEFF Research Database (Denmark)

Christensen, Kristine Rothaus; Roepstorff, K.; Wiinberg, B.

2016-01-01

. Methods Wild-type and F8(-/-) rats were treated with vehicle or recombinant human factor VIII (rhFVIII) prior to a needle-induced joint bleed. Joint swelling was measured prior to injury, the following 7 days and upon euthanasia. Histologic sections of the joint were stained, and athropathic changes...

Progressive Muscle Atrophy and Weakness After Treatment by Mantle Field Radiotherapy in Hodgkin Lymphoma Survivors

International Nuclear Information System (INIS)

Leeuwen-Segarceanu, Elena M. van; Dorresteijn, Lucille D.A.; Pillen, Sigrid; Biesma, Douwe H.; Vogels, Oscar J.M.; Alfen, Nens van

2012-01-01

Purpose: To describe the damage to the muscles and propose a pathophysiologic mechanism for muscle atrophy and weakness after mantle field radiotherapy in Hodgkin lymphoma (HL) survivors. Methods and Materials: We examined 12 patients treated by mantle field radiotherapy between 1969 and 1998. Besides evaluation of their symptoms, the following tests were performed: dynamometry; ultrasound of the sternocleidomastoid, biceps, and antebrachial flexor muscles; and needle electromyography of the neck, deltoid, and ultrasonographically affected arm muscles. Results: Ten patients (83%) experienced neck complaints, mostly pain and muscle weakness. On clinical examination, neck flexors were more often affected than neck extensors. On ultrasound, the sternocleidomastoid was severely atrophic in 8 patients, but abnormal echo intensity was seen in only 3 patients. Electromyography of the neck muscles showed mostly myogenic changes, whereas the deltoid, biceps, and antebrachial flexor muscles seemed to have mostly neurogenic damage. Conclusions: Many patients previously treated by mantle field radiotherapy develop severe atrophy and weakness of the neck muscles. Neck muscles within the radiation field show mostly myogenic damage, and muscles outside the mantle field show mostly neurogenic damage. The discrepancy between echo intensity and atrophy suggests that muscle damage is most likely caused by an extrinsic factor such as progressive microvascular fibrosis. This is also presumed to cause damage to nerves within the radiated field, resulting in neurogenic damage of the deltoid and arm muscles.

Human Periodontal Ligament- and Gingiva-derived Mesenchymal Stem Cells Promote Nerve Regeneration When Encapsulated in Alginate/Hyaluronic Acid 3D Scaffold.

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Ansari, Sahar; Diniz, Ivana M; Chen, Chider; Sarrion, Patricia; Tamayol, Ali; Wu, Benjamin M; Moshaverinia, Alireza

2017-12-01

Repair or regeneration of damaged nerves is still a challenging clinical task in reconstructive surgeries and regenerative medicine. Here, it is demonstrated that periodontal ligament stem cells (PDLSCs) and gingival mesenchymal stem cells (GMSCs) isolated from adult human periodontal and gingival tissues assume neuronal phenotype in vitro and in vivo via a subcutaneous transplantation model in nude mice. PDLSCs and GMSCs are encapsulated in a 3D scaffold based on alginate and hyaluronic acid hydrogels capable of sustained release of human nerve growth factor (NGF). The elasticity of the hydrogels affects the proliferation and differentiation of encapsulated MSCs within scaffolds. Moreover, it is observed that PDLSCs and GMSCs are stained positive for βIII-tubulin, while exhibiting high levels of gene expression related to neurogenic differentiation (βIII-tubulin and glial fibrillary acidic protein) via quantitative polymerase chain reaction (qPCR). Western blot analysis shows the importance of elasticity of the matrix and the presence of NGF in the neurogenic differentiation of encapsulated MSCs. In vivo, immunofluorescence staining for neurogenic specific protein markers confirms islands of dense positively stained structures inside transplanted hydrogels. As far as it is known, this study is the first demonstration of the application of PDLSCs and GMSCs as promising cell therapy candidates for nerve regeneration. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

[Laparoscopic vs opened appendicovesicostomy in pediatric patients].

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Landa-Juárez, Sergio; Montes de Oca-Muñoz, Lorena Elizabeth; Castillo-Fernández, Ana María; de la Cruz-Yañez, Hermilo; García-Hernández, Carlos; Andraca-Dumit, Roxona

2014-01-01

Appendicovesicostomy is commonly employed to facilitate drainage of urine through the catheter. Due to the tendency to less invasive procedures for the treatment of patients with neurogenic bladder, laparoscopy has been used as an alternative to open surgery, with the immediate advantages of postoperative recovery, shorter postoperative ileus, better cosmetic results, lower postoperative pain and early reintegration into everyday life. Compare the results of laparoscopic procedure with open appendicovesicostomy. We conducted an observational, analytical, longitudinal, ambispective cohort study, which included patients from 6-16 years of age diagnosed with neurogenic bladder, operated through laparoscopic and open appendicovesicostomy from January 2009 to June 2013. Information was obtained from clinical records. Six patients were operated laparoscopically and 14 by open approach. Surgical time was longer and statistically significant in the laparoscopic group with a median of 330 min (300-360 min) compared to open procedure of 255 min (180-360 min). Seven patients had complications in the open group and only one in the laparoscopic group. The difference in the dose of analgesics and time of use was statistically significant in favor of the laparoscopic group. The degree of urinary continence through the stoma was higher for laparoscopic (100%) compared to the open procedure (64%). In neurogenic bladder with urodynamic bladder capacity and leak point pressure bladder within acceptable values, laparoscopic appendicovesicostomy was a better alternative.

Urinary Tract Infection among Renal Transplant Recipients in Yemen.

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Adnan S Gondos

Full Text Available Urinary tract infection (UTI is the most common complication following kidney transplantation (KT, which could result in losing the graft. This study aims to identify the prevalence of bacterial UTI among KT recipients in Yemen and to determine the predisposing factors associated with post renal transplantation UTI. A cross sectional study included of 150 patients, who underwent KT was conducted between June 2010 and January 2011. A Morning mid-stream urine specimen was collected for culture and antibiotic susceptibility test from each recipient. Bacterial UTI was found in 50 patients (33.3%. The prevalence among females 40.3% was higher than males 29%. The UTI was higher in the age group between 41-50 years with a percentage of 28% and this result was statistically significant. Predisposing factors as diabetes mellitus, vesicoureteral reflux, neurogenic bladder and polycystic kidney showed significant association. High relative risks were found for polycystic kidney = 13.5 and neurogenic bladder = 13.5. The most prevalent bacteria to cause UTI was Escherichia coli represent 44%, followed by Staphylococcus saprophyticus 34%. Amikacin was the most effective antibiotic against gram-negative isolates while Ciprofloxacin was the most effective antibiotic against Staphylococcus saprophyticus. In conclusion, there is high prevalence of bacterial UTI among KT recipients in Yemen. Diabetes mellitus, vesicoureteral reflux, neurogenic bladder, polycystic kidney and calculi were the main predisposing factors.

Urinary Tract Infection among Renal Transplant Recipients in Yemen.

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Gondos, Adnan S; Al-Moyed, Khaled A; Al-Robasi, Abdul Baki A; Al-Shamahy, Hassan A; Alyousefi, Naelah A

2015-01-01

Urinary tract infection (UTI) is the most common complication following kidney transplantation (KT), which could result in losing the graft. This study aims to identify the prevalence of bacterial UTI among KT recipients in Yemen and to determine the predisposing factors associated with post renal transplantation UTI. A cross sectional study included of 150 patients, who underwent KT was conducted between June 2010 and January 2011. A Morning mid-stream urine specimen was collected for culture and antibiotic susceptibility test from each recipient. Bacterial UTI was found in 50 patients (33.3%). The prevalence among females 40.3% was higher than males 29%. The UTI was higher in the age group between 41-50 years with a percentage of 28% and this result was statistically significant. Predisposing factors as diabetes mellitus, vesicoureteral reflux, neurogenic bladder and polycystic kidney showed significant association. High relative risks were found for polycystic kidney = 13.5 and neurogenic bladder = 13.5. The most prevalent bacteria to cause UTI was Escherichia coli represent 44%, followed by Staphylococcus saprophyticus 34%. Amikacin was the most effective antibiotic against gram-negative isolates while Ciprofloxacin was the most effective antibiotic against Staphylococcus saprophyticus. In conclusion, there is high prevalence of bacterial UTI among KT recipients in Yemen. Diabetes mellitus, vesicoureteral reflux, neurogenic bladder, polycystic kidney and calculi were the main predisposing factors.

The innovative therapeutic application of botulinum toxin type A in urology patients

Directory of Open Access Journals (Sweden)

Chrysoula Belai

2016-06-01

Full Text Available In the history of medical science the use of botulinum toxin was impressive. In the early 18th century it was defined as the neurotoxin implicated in the deadly disease botulism. Today, despite the toxic action finds application in the treatment of various diseases in a wide range of Medicine. Its use in urology was revolutionary in the treatment of neurogenic bladder, refractory idiopathic detrusor overactivity and other painful syndromes. The purpose of this review was to describe the treatment option of intravesical injection of botulinum toxin, in diseases of the urinary tract. The review showed that after many test applications under the experimental studies, the botulinum toxin type A has already established itself as the new treatment of choice after failure of conservative drug dealing in patients with neuro-urological symptoms of lower urinary tract. Cases of application of botulinum toxin in Urology are related to overactive bladder, neurogenic or idiopathic etiology, as bladder pain syndrome and chronic pelvic pain syndrome. According to the guidelines of the European Union directives Urology, the intravesical botulinum toxin injections are the most effective, minimally invasive treatment which results in reducing neurogenic hyperactivity of detrusor. In conclusion, this is a safe, easy and effective method that can be applied by health professionals, helping improve patients’ quality of life with neuro-urological diseases.

Examination of validity in spoken language evaluations: Adult onset stuttering following mild traumatic brain injury.

Science.gov (United States)

Roth, Carole R; Cornis-Pop, Micaela; Beach, Woodford A

2015-01-01

Reports of increased incidence of adult onset stuttering in veterans and service members with mild traumatic brain injury (mTBI) from combat operations in Iraq and Afghanistan lead to a reexamination of the neurogenic vs. psychogenic etiology of stuttering. This article proposes to examine the merit of the dichotomy between neurogenic and psychogenic bases of stuttering, including symptom exaggeration, for the evaluation and treatment of the disorder. Two case studies of adult onset stuttering in service members with mTBI from improvised explosive device blasts are presented in detail. Speech fluency was disrupted by abnormal pauses and speech hesitations, brief blocks, rapid repetitions, and occasional prolongations. There was also wide variability in the frequency of stuttering across topics and conversational situations. Treatment focused on reducing the frequency and severity of dysfluencies and included educational, psychological, environmental, and behavioral interventions. Stuttering characteristics as well as the absence of objective neurological findings ruled out neurogenic basis of stuttering in these two cases and pointed to psychogenic causes. However, the differential diagnosis had only limited value for developing the plan of care. The successful outcomes of the treatment serve to illustrate the complex interaction of neurological, psychological, emotional, and environmental factors of post-concussive symptoms and to underscore the notion that there are many facets to symptom presentation in post-combat health.

Tratamento da dor associada à osteoartrose de joelho em idosos: um ensaio clínico aleatório e duplamente encoberto com o clonixinato de lisina

OpenAIRE

Santos, Fânia Cristina; Souza, Polianna Mara Rodrigues de; Toniolo Neto, João; Atallah, Álvaro Nagib

2011-01-01

BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) is the most common arthropathy and one of the major causes of chronic pain in the elderly population, which may lead to major functional incapacity of these individuals. Aiming at treating pain of elderly patients with knee OA, we have used lysine clonixinate (LC) and have evaluated its effectiveness METHOD: Randomized, double-blind, placebo-controlled clinical trial with 109 elderly patients with knee OA-related pain. Participants were distribut...

Treatment of pain associated to knee osteoarthritis in the elderly: a randomized double-blind clinical trial with lysine clonixinate

OpenAIRE

Santos,Fânia Cristina; Souza,Polianna Mara Rodrigues de; Toniolo Neto,João; Atallah,Álvaro Nagib

2011-01-01

BACKGROUND AND OBJECTIVES: Osteoarthritis (OA) is the most common arthropathy and one of the major causes of chronic pain in the elderly population, which may lead to major functional incapacity of these individuals. Aiming at treating pain of elderly patients with knee OA, we have used lysine clonixinate (LC) and have evaluated its effectiveness METHOD: Randomized, double-blind, placebo-controlled clinical trial with 109 elderly patients with knee OA-related pain. Participants were distribut...

Chromic phosphate synoviortheses without age restriction, as a firsts option for treatment of chronic active haemophilic synovitis

International Nuclear Information System (INIS)

Llinas, Adolfo; Silva, Mauricio; Duarte, Monica; Cuervo, Pilar; Ninno, Dora; Ucros, Gonzalo; Cerquera, Angela Maria; Bernal, Patricia

2003-01-01

The aim of the work was to demonstrate that clinical results obtained with synovectomies using active chromic phosphate without receiving dose of prophylactic factor concentrate before or after procedure are comparable to those obtained by a 3-month of post procedure prohylasis. the effectiveness of the synovectomy using chromic phosphate (32P) in the control of chronic hemarthroses in haemophilic patients to prevent the evolution of the arthropathy and its complications was also assessed

Synovial cyst of the hip joint as a rare cause of unlateral leg edema; A case report

Energy Technology Data Exchange (ETDEWEB)

Kang, Ji Hun; Chang, Il Soo; Park, Sang Woo; Yun, Ik Jin; Park, Hyung Kyu; Kim, Wan Seop; Lee, Hui Jin; Kim, Na Ra; Moon, Sung Gyu [Konkuk University School of Medicine, Seoul (Korea, Republic of)

2015-06-15

A synovial cyst of the hip joint is a rare cause of unilateral leg edema, and it is usually associated with arthropathies such as rheumatoid arthritis and osteoarthritis. An asymptomatic synovial cyst of the hip joint that is not associated with an arthritic condition occurs infrequently. In this paper, we described the case of a 52-year-old woman who presented with unilateral right leg edema caused by a synovial cyst of the hip joint.

Research Article Special Issue

African Journals Online (AJOL)

2016-05-15

May 15, 2016 ... corrective exercises to improve static and dynamic balance of supinate ... improve the ability to maintain balance and postural control in ..... Gupta, D., & Nair, M. D. Neurogenic orthostatic hypotension: Chasing "the fall".

L-carnitine contributes to enhancement of neurogenesis from mesenchymal stem cells through Wnt/β-catenin and PKA pathway.

Science.gov (United States)

Fathi, Ezzatollah; Farahzadi, Raheleh; Charoudeh, Hojjatollah Nozad

2017-03-01

The identification of factors capable of enhancing neurogenesis has great potential for cellular therapies in neurodegenerative diseases. Multiple studies have shown the neuroprotective effects of L-carnitine (LC). This study determined whether neuronal differentiation of rat adipose tissue-derived mesenchymal stem cells (ADSCs) can be activated by LC. In this study, protein kinase A (PKA) and Wnt/β-catenin pathways were detected to show if this activation was due to these pathways. The expression of LC-induced neurogenesis markers in ADSCs was characterized using real-time PCR. ELISA was conducted to assess the expression of cyclic adenosine monophosphate (cAMP) and PKA. The expression of β-catenin, reduced dickkopf1 (DKK1), low-density lipoprotein receptor-related protein 5 (LRP5), Wnt1, and Wnt3a genes as Wnt/β-catenin signaling members were used to detect the Wnt/β-catenin pathway. It was observed that LC could promote neurogenesis in ADSCs as well as expression of some neurogenic markers. Moreover, LC causes to increase the cAMP levels and PKA activity. Treatment of ADSCs with H-89 (dihydrochloride hydrate) as PKA inhibitor significantly inhibited the promotion of neurogenic markers, indicating that the PKA signaling pathway could be involved in neurogenesis induction. Analyses of real-time PCR data showed that the mRNA expressions of β-catenin, DKK1, LRP5c-myc, Wnt1, and Wnt3a were increased in the presence of LC. Therefore, the present study showed that LC promotes ADSCs neurogenesis and the LC-induced neurogenic markers could be due to both the PKA and Wnt/β-catenin signaling pathway. Impact statement Neural tissue has long been believed as incapable of regeneration and the identification of cell types and factors capable of neuronal differentiation has generated intense interest. Mesenchymal stem cells (MSCs) are considered as potential targets for stem cell-based therapy. L-carnitin (LC) as an antioxidant may have neuroprotective effects in

[Scoliosis: the bent spine].

Science.gov (United States)

Radl, R; Maafe, M; Ziegler, S

2011-05-01

Scoliosis, a permanent abnormal curvature of the spine to the side, is divided into four forms: idiopathic (infantile, juvenile and adolescent, accounting for 80% of cases), neurogenic, congenital and adult scoliosis. Most patients with adolescent idiopathic scoliosis initially have mainly cosmetic problems. However, neurogenic, congenital and adult scoliosis can lead to severe clinical symptoms. The leading symptom is back pain caused by secondary changes. In recent years the Lenke classification has been proven to be a reliable tool for disease classification. Non-progressive scoliosis is usually treated conservatively. In the case of Cobb angles of greater than 50°, surgical therapy is recommended in patients presenting before adulthood. Technical improvements in implants and the optimisation of surgical methods have set a trend in the direction of surgical therapy.

Posttraumatic stress disorder in patients with traumatic brain injury and amnesia for the event?

Science.gov (United States)

Warden, D L; Labbate, L A; Salazar, A M; Nelson, R; Sheley, E; Staudenmeier, J; Martin, E

1997-01-01

Frequency of DSM-III-R posttraumatic stress disorder (PTSD) was studied in 47 active-duty service members (46 male, 1 female; mean age 27 = 7) with moderate traumatic brain injury and neurogenic amnesia for the event. Patients had attained "oriented and cooperative" recovery level. When evaluated with a modified Present State Examination and other questions at various points from study entry to 24-month follow-up, no patients met full criteria for PTSD or met criterion B (reexperience); 6 (13%) met both C (avoidance) and D (arousal) criteria. Five of these 6 also had organic mood disorder, depressed type, and/or organic anxiety disorder. Posttraumatic amnesia following moderate head injury may protect against recurring memories and the development of PTSD. Some patients with neurogenic amnesia may develop a form of PTSD without the reexperiencing symptoms.

Diagnosis of pelvic wall tumor on multislice CT

International Nuclear Information System (INIS)

Zhang Keyun; Deng Lequn; Lei Hongwei

2011-01-01

Objective: To evaluate the value of multi-slice CT (MSCT) in diagnosing pelvic wall tumors. Methods: MSCT of 21 cases of pelvic wall tumors including metastasis (10), neurogenic tumor (5), chondrosarcoma (2), chordoma (1), aneurysmal bone cyst (1), giant cell tumor (1), and osteochondroma (1) was retrospectively analyzed. Results: CT appearances of pelvic wall tumors include bony destruction and soft tissue masses. Common features were bone destruction in metastasis, expansion of the neuroforamen in neurogenic tumor, pleomorphic calcification in chondrosarcoma, lower sacral vertebral location of chordoma, iliac crest bone destruction in giant cell tumor, cauliflower-like nodules in osteochondroma. Conclusion: MSCT with three-dimensional volume rendering demonstrates well the tumor shape, size, extent, internal structure and relationship with the surrounding organs to aid diagnosis of pelvic wall tumors. (authors)

A substance P antagonist, [D-Pro2, D-Trp7,9]SP, inhibits inflammatory responses in the rabbit eye

International Nuclear Information System (INIS)

Holmdahl, G.; Hakanson, R.; Leander, S.; Rosell, S.; Folkers, K.; Sundler, F.

1981-01-01

Neurogenic factors released by antidromic nerve stimulation are thought to be in part responsible for the vasodilation and breakdown of the blood-aqueous barrier that follows trauma to the eye. Substance P is one candidate for the mediation of the inflammatory response since it is thought to be a neurotransmitter in sensory afferents and since exogenous substance P is capable of eliciting a response characteristic of inflammation. In rabbits, intravitreal or topical application onto the eye of a specific substance P antagonist, [d-Pro2, D-Trp7,9]SP, inhibited not only the irritant effects of exogenous substance P but also the inflammatory response to a standardized trauma (infrared irradiation of the iris). These observations suggest that substance P, or a related peptide, is a neurogenic mediator of the inflammatory response in the eye

Neurogenomics and the role of a large mutational target on rapid behavioral change.

Science.gov (United States)

Stanley, Craig E; Kulathinal, Rob J

2016-11-08

Behavior, while complex and dynamic, is among the most diverse, derived, and rapidly evolving traits in animals. The highly labile nature of heritable behavioral change is observed in such evolutionary phenomena as the emergence of converged behaviors in domesticated animals, the rapid evolution of preferences, and the routine development of ethological isolation between diverging populations and species. In fact, it is believed that nervous system development and its potential to evolve a seemingly infinite array of behavioral innovations played a major role in the successful diversification of metazoans, including our own human lineage. However, unlike other rapidly evolving functional systems such as sperm-egg interactions and immune defense, the genetic basis of rapid behavioral change remains elusive. Here we propose that the rapid divergence and widespread novelty of innate and adaptive behavior is primarily a function of its genomic architecture. Specifically, we hypothesize that the broad diversity of behavioral phenotypes present at micro- and macroevolutionary scales is promoted by a disproportionately large mutational target of neurogenic genes. We present evidence that these large neuro-behavioral targets are significant and ubiquitous in animal genomes and suggest that behavior's novelty and rapid emergence are driven by a number of factors including more selection on a larger pool of variants, a greater role of phenotypic plasticity, and/or unique molecular features present in large genes. We briefly discuss the origins of these large neurogenic genes, as they relate to the remarkable diversity of metazoan behaviors, and highlight key consequences on both behavioral traits and neurogenic disease across, respectively, evolutionary and ontogenetic time scales. Current approaches to studying the genetic mechanisms underlying rapid phenotypic change primarily focus on identifying signatures of Darwinian selection in protein-coding regions. In contrast

Interspinous process device versus standard conventional surgical decompression for lumbar spinal stenosis: Randomized controlled trial

NARCIS (Netherlands)

W.A. Moojen (Wouter); M.P. Arts (Mark); W.C.H. Jacobs (Wilco); E.W. van Zwet (Erik); M.E. van den Akker-van Marle (Elske); B.W. Koes (Bart); C.L.A.M. Vleggeert-Lankamp (Carmen); W.C. Peul (Wilco)

2013-01-01

markdownabstractAbstract Objective To assess whether interspinous process device implantation is more effective in the short term than conventional surgical decompression for patients with intermittent neurogenic claudication due to lumbar spinal stenosis. Design Randomized controlled

Neurogenní plicní edém

Czech Academy of Sciences Publication Activity Database

Šedý, Jiří

2011-01-01

Roč. 150, č. 3 (2011), s. 147-155 ISSN 0008-7335 Institutional research plan: CEZ:AV0Z50390703 Keywords : neurogenic pulmonary edema * brain injury * spinal cord injury Subject RIV: FJ - Surgery incl. Transplants

Myopathy in CRPS-I : Disuse or neurogenic?

NARCIS (Netherlands)

Hulsman, Natalie M.; Geertzen, Jan H. B.; Dijkstra, Pieter U.; van den Dungen, Jan J. A. M.; den Dunnen, Wilfred F. A.

The diagnosis Complex Regional Pain Syndrome type I (CRPS-I) is based on clinical symptoms, including motor symptoms. Histological changes in muscle tissue may be present in the chronic phase of CRPS-L Aim of this Study was to analyze skeletal muscle tissue from amputated limbs of patients with

Caudal Regression Syndrome/neurogenic bladder presented as ...

African Journals Online (AJOL)

Burhan M. Edrees

Impaired development in the caudal region will affect the general health status of ... mities within the spinal cord, brain, or nervous supply. A number .... The parenchyma of left ... The findings have shown non-functioning right kidney; however,.

Glehnia littoralis Extract Promotes Neurogenesis in the Hippocampal Dentate Gyrus of the Adult Mouse through Increasing Expressions of Brain-Derived Neurotrophic Factor and Tropomyosin-Related Kinase B

Directory of Open Access Journals (Sweden)

Joon Ha Park

2018-01-01

Conclusion: G. littoralis extract promots cell proliferation, neuroblast differentiation, and neuronal maturation in the hippocampal DG, and neurogenic effects might be closely related to increases of BDNF and TrkB proteins by G. littoralis extract treatment.

Formulaic speech in disorders of language

Directory of Open Access Journals (Sweden)

Diana Sidtis

2014-04-01

Formulaic language studies remain less well recognized in language disorders. Profiles of differential formulaic language abilities in neurological disease have implications for cerebral models of language and for clinical evaluation and treatment of neurogenic language disorders.

The paediatric neuropathic bladder

African Journals Online (AJOL)

pathophysiological terms, a neurogenic bladder is caused by a spinal reflex arc that occurs when ... and potential progressive renal damage because of high bladder ... creatinine level, can also be used to assess kidney function. Urodynamic ...

X-ray semiotics of changes in the osteoarticular system in diabetes mellitus

International Nuclear Information System (INIS)

Spuzyak, M.I.; Bajzul'dina, A.N.

1987-01-01

The frequency and nature of the involvement of different parts of the skeleton were established on the basis of an X-ray study of the osteoarticular system in 274 patients with diabetes mellitus, X-ray changes in the bones and joints occurred in 98.7% of the patients and manifested themselves in osteoporosis (88%), cyst-like structural rearrangement (54%), osteolysis and destruction (12%), hyperosis (78%), degenerative-dystrophic articular changes (37.6%), vertebral changes (90.2%) and arthropathy (4.4%)

Arthritis associated with calcium oxalate crystals in an anephric patient treated with peritoneal dialysis

International Nuclear Information System (INIS)

Rosenthal, A.; Ryan, L.M.; McCarty, D.J.

1988-01-01

The authors report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid