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Peripheral degenerative joint diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Osteoarthritis, a degenerative joint disease, is the most commonrheumatic disorder mainly in a geriatric population. Manifestationsare pain, stiffness and functional loss in the affected joint.According to etiology it is classifi ed as primary (or idiopathic)and secondary. Some risk factors for disease development aregenetics, race, age, sex, obesity, occupational activities andarticular biomechanics. Pathogenesis is the same for any cause orlocalization, being catabolic alterations, with synthesis, inhibitionand reparing intent of the cartilage matrix. Metalloproteinases andcytokines (IL-1,IL-6,TNF-?) actions promote infl ammatory reactionand cartilage degradation. Pain, the most important symptom,does not correlate with radiologic fi ndings. Peripheral osteoarthritisoccurs predominantly in the knee, hip and hand. Diagnosis is basedon clinical features, laboratorial tests and radiological changes.Rheumatological associations’ guidelines for treatment includenon-pharmacologic (education, physiotherapy, assistive devices),and pharmacologic (analgesics, anti-infl ammatory drugs) therapyand surgery. Arthroplasty seems to work better than medicines, butshould be used if other treatments have failed.

Nilzio Antonio da Silva; Ana Carolina de Oliveira e Silva Montandon; Michelle Vasconcelos da Silva Prado Cabral

2008-01-01

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Etiology, pathophysiology and conservative management of degenerative joint disease  

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Full Text Available Etiology of degenerative joint diseases Etiology of degenerative joint diseases is still not clearly understood and there is no specific management for this group of diseases. Various pathological conditions cause damage of the articular cartilage and lead to clinically and radiographically recognized impairment. Biomechanical, metabolic, genetic factors inflammation and other risk factors contribute to development of osteoarthrosis. Pathophysiology of degenerative joint diseases Osteoarthrosis is characterized by progressive erosion of articular cartilage and bone overgrowth at the joint margins. Cartilage integrity requires balance between synthesis and degradation of matrix components. Chondrocytes react to various mechanical and chemical stresses in order to stabilize and restore the tissue. Failures in stabilizing and restoring the tissue lead to cartilage degeneration that may be irreversibile. For better understanding of conservative management of degenerative joint diseases it is important to know the impact of pathophysiology mechanisms on development of degenerative joint diseases. There is great variability in the rate of progression of erosive processes in articular cartilage in clinical radiographic signs and course of the disease. This is in relation with many factors, as well as with management and response to therapy. Treatment of degenerative joint diseases Treatment should vary depending on the severity of disease and patient's expectations and level of activity. Besides analgesic and anti-inflammatory drugs, conventional and not conventional treatment and techniques can be used for management of osteoarthrosis. Physical therapy and exercises are very important for maintaining muscle strength, joint stability and mobility, but should be closely monitored for optimal efficacy.

Jandri? Slavica

2002-01-01

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Degenerative joint disease. Part I: Diagnosis and management considerations.  

UK PubMed Central (United Kingdom)

Degenerative joint disease, primarily in the form of osteoarthrosis, affects the temporomandibular joints (TMJs) with symptoms similar to those found in other body joints. These symptoms include stiffness, pain, restriction of movement, inflammation, crepitus and radiographic changes. Symptoms can occur in both males and females at any age, starting with pre-adolescent, but most often occur in females age 30 and over. Most symptoms will last nine to 18 months (followed by remission) and are managed using anti-inflammatory medications, physical therapy, occlusal splints and dietary changes. Major areas for consideration in this article include epidemiology, signs and symptoms, radiography, etiopathology and symptom management.

Bates RE Jr; Gremillion HA; Stewart CM

1993-10-01

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Degenerative joint disease. Part I: Diagnosis and management considerations.  

Science.gov (United States)

Degenerative joint disease, primarily in the form of osteoarthrosis, affects the temporomandibular joints (TMJs) with symptoms similar to those found in other body joints. These symptoms include stiffness, pain, restriction of movement, inflammation, crepitus and radiographic changes. Symptoms can occur in both males and females at any age, starting with pre-adolescent, but most often occur in females age 30 and over. Most symptoms will last nine to 18 months (followed by remission) and are managed using anti-inflammatory medications, physical therapy, occlusal splints and dietary changes. Major areas for consideration in this article include epidemiology, signs and symptoms, radiography, etiopathology and symptom management. PMID:8118899

Bates, R E; Gremillion, H A; Stewart, C M

1993-10-01

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Feline degenerative joint disease: a genomic and proteomic approach.  

UK PubMed Central (United Kingdom)

The underlying disease mechanisms for feline degenerative joint disease (DJD) are mostly unidentified. Today, most of what is published on mammalian arthritis is based on human clinical findings or on mammalian models of human arthritis. However, DJD is a common occurrence in the millions of domestic felines worldwide. To get a better understanding of the changes in biological pathways that are associated with feline DJD, this study employed a custom-designed feline GeneChip, and the institution's unique access to large sample populations to investigate genes and proteins from whole blood and serum that may be up- or down-regulated in DJD cats. The GeneChip results centered around three main pathways that were affected in DJD cats: immune function, apoptosis and oxidative phosphorylation. By identifying these key disease-associated pathways it will then be possible to better understand disease pathogenesis and diagnose it more easily, and to better target it with pharmaceutical and nutritional intervention.

Gao X; Lee J; Malladi S; Melendez L; Lascelles BD; Al-Murrani S

2013-06-01

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Degenerative Joint Disease of the Acromioclavicular Joint: A Review.  

UK PubMed Central (United Kingdom)

Osteoarthritis of the acromioclavicular (AC) joint is a common condition causing anterior or superior shoulder pain, especially with overhead and cross-body activities. This most commonly occurs in middle-aged individuals because of degeneration to the fibrocartilaginous disk that cushions the articulations. Diagnosis relies on history, physical examination, imaging, and diagnostic local anesthetic injection. Diagnosis can be challenging given the lack of specificity with positive physical examination findings and the variable nature of AC joint pain. Of note, symptomatic AC osteoarthritis must be differentiated from instability and subtle instability, which may have similar symptoms. Although plain radiographs can reveal degeneration, diagnosis cannot be based on this alone because similar radiographic findings can be seen in asymptomatic individuals. Nonoperative therapy can provide symptomatic relief, whereas patients with persistent symptoms can be considered for resection arthroplasty by open or arthroscopic technique. Both techniques have proven to provide predictable pain relief; however, each has its own unique set of potential complications that may be minimized with an improved understanding of the anatomical and biomechanical characteristics of the joint along with meticulous surgical technique.

Mall NA; Foley E; Chalmers PN; Cole BJ; Romeo AA; Bach BR Jr

2013-05-01

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Degenerative joint disease. Part II: Symptoms and examination findings.  

UK PubMed Central (United Kingdom)

From a pool of 1,279 consecutive patients referred to the Parker E. Mahan Facial Pain Center for complaints of head/neck pain, a subset of 215 patients with the diagnosis of osteoarthrosis of the temporomandibular joint (TMJ-DJD) have been identified. Data regarding patient age and sex, reported symptoms and examination results are presented from this subset of TMJ-DJD patients. From this data, common signs and symptoms of TMJ-DJD are proposed.

Bates RE Jr; Gremillion HA; Stewart CM

1994-04-01

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Degenerative joint disease. Part II: Symptoms and examination findings.  

Science.gov (United States)

From a pool of 1,279 consecutive patients referred to the Parker E. Mahan Facial Pain Center for complaints of head/neck pain, a subset of 215 patients with the diagnosis of osteoarthrosis of the temporomandibular joint (TMJ-DJD) have been identified. Data regarding patient age and sex, reported symptoms and examination results are presented from this subset of TMJ-DJD patients. From this data, common signs and symptoms of TMJ-DJD are proposed. PMID:8055593

Bates, R E; Gremillion, H A; Stewart, C M

1994-04-01

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Degenerative joint disease on MRI and physical activity: a clinical study of the knee joint in 320 patients  

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We examined 320 patients with MRI and arthroscopy after an acute trauma to evaluate MRI in diagnosis of degenerative joint disease of the knee in relation to sports activity and clinical data. Lesions of cartilage and menisci on MRI were registered by two radiologists in consensus without knowledge of arthroscopy. Arthroscopy demonstrated grade-1 to grade-4 lesions of cartilage on 729 of 1920 joint surfaces of 320 knees, and MRI diagnosed 14 % of grade-1, 32 % of grade-2, 94 % of grade-3, and 100 % of grade-4 lesions. Arthroscopy explored 1280 meniscal areas and showed degenerations in 10 %, tears in 11.4 %, and complex lesions in 9.2 %. Magnetic resonance imaging was in agreement with arthroscopy in 81 % showing more degenerations but less tears of menisci than arthroscopy. Using a global system for grading the total damage of the knee joint into none, mild, moderate, or severe changes, agreement between arthroscopy and MRI was found in 82 %. Magnetic resonance imaging and arthroscopy showed coherently that degree of degenerative joint changes was significantly correlated to patient age or previous knee trauma. Patients over 40 years had moderate to severe changes on MRI in 45 % and patients under 30 years in only 22 %. Knee joints with a history of trauma without complete structural or functional reconstitution showed marked changes on MRI in 57 %, whereas stable joints without such alterations had degenerative changes in only 26 %. There was no correlation of degenerative disease to gender, weight, type, frequency, and intensity of sports activity. Therefore, MRI is an effective non-invasive imaging method for exact localization and quantification of chronic joint changes of cartilage and menisci that recommends MRI for monitoring in sports medicine. (orig.) (orig.)

1999-01-01

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Role of Chondroitin sulfate in the modulation of Degenerative Joint Disease  

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Full Text Available The main aim of degenerative Joint Disease (DJD) therapy is to decrease pain and to maintain or improve joint function. Now days, numerous studies had investigated the potential role of chondroprotective agent, Chondroitin sulfate in repairing articular cartilage and decelerating the degenerative process.Chondroitin sulfate’s primary biological role in halting or reversing joint degeneration appears to be directly due to its ability to act as an essential substrate for the formation of proteoglycans found in the structural matrix of joints. Also, Chondroitin sulfate either absorbed as a whole or as a broken down constituent components, it provides additional substrate for the formation of healthy joint matrix. herefore, this article explores the role of exogenously administered Chondroitin sulfate in the management of DJD. The detailed mechanism behind the treatment was also explained in addition to clinical experiences with human volunteers. These clinical trials revealed that the combination of Chondroitin sulfate and glucosamine sulfate was found to be more effective than either substance alone in inhibiting progression of DJD.

Vikas Rana; Jyoti

2007-01-01

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Segment-specific association between cervical pillar hyperplasia (CPH) and degenerative joint disease (DJD)  

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Full Text Available Abstract Background Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown etiology and clinical significance. Global assessment of pillar hyperplasia of the cervical spine as a unit has not shown a relationship with degenerative joint disease, but a more sensible explanation of the architectural influence of CPH on cervical spine biomechanics may be segment-specific. Objective The objective of this study was to determine the level of association between degenerative joint disease (DJD) and cervical pillar hyperplasia (CPH) in an age- and gender-matched sample on a [cervical spine] by-level basis. Research Methods Two-hundred and forty radiographs were collected from subjects ranging in age between 40 and 69 years. The two primary outcome measures used in the study were the segmental presence/absence of cervical pillar hyperplasia from C3 to C6, and segment-specific presence/absence of degenerative joint disease from C1 to C7. Contingency Coefficients, at the 5% level of significance, at each level, were used to determine the strength of the association between CPH and DJD. Odds Ratios (OR) with their 95% Confidence Intervals (95% CI) were also calculated at each level to assess the strength of the association. Results Our study suggests that an approximately two-to-one odds, or a weak-to-moderate correlation, exists at C4 and C5 CPH and adjacent level degenerative disc disease (DDD); with the strongest (overall) associations demonstrated between C4 CPH and C4–5 DDD and between C5 CPH and C5–6 DDD. Age-stratified results demonstrated a similar pattern of association, even reaching the initially hypothesized OR ? 5.0 (95% CI > 1.0) or "moderately-strong correlation of C ? .4 (p ? .05)" in some age categories, including the 40–44, 50–59, and 60–64 years of age subgroups; these ORs were as follows: OR = 5.5 (95% CI 1.39–21.59); OR = 6.7 (95% CI 1.65–27.34); and OR = 5.3 (95% CI 1.35–21.14), respectively. Conclusion Our results suggest that CPH has around two-to-one odds, that is, only a weak-to-moderate association with the presence of DJD (DDD component) at specific cervical spine levels; therefore, CPH may be but one of several factors that contributes (to a clinically important degree) to the development of DJD at specific levels in the cervical spine.

Stupar Maja; Peterson Cynthia K

2006-01-01

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Preliminary results of automated removal of degenerative joint disease in bone scan lesion segmentation  

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Whole-body bone scintigraphy (or bone scan) is a highly sensitive method for visualizing bone metastases and is the accepted standard imaging modality for detection of metastases and assessment of treatment outcomes. The development of a quantitative biomarker using computer-aided detection on bone scans for treatment response assessment may have a significant impact on the evaluation of novel oncologic drugs directed at bone metastases. One of the challenges to lesion segmentation on bone scans is the non-specificity of the radiotracer, manifesting as high activity related to non-malignant processes like degenerative joint disease, sinuses, kidneys, thyroid and bladder. In this paper, we developed an automated bone scan lesion segmentation method that implements intensity normalization, a two-threshold model, and automated detection and removal of areas consistent with non-malignant processes from the segmentation. The two-threshold model serves to account for outlier bone scans with elevated and diffuse intensity distributions. Parameters to remove degenerative joint disease were trained using a multi-start Nelder-Mead simplex optimization scheme. The segmentation reference standard was constructed manually by a panel of physicians. We compared the performance of the proposed method against a previously published method. The results of a two-fold cross validation show that the overlap ratio improved in 67.0% of scans, with an average improvement of 5.1% points.

Chu, Gregory H.; Lo, Pechin; Kim, Hyun J.; Auerbach, Martin; Goldin, Jonathan; Henkel, Keith; Banola, Ashley; Morris, Darren; Coy, Heidi; Brown, Matthew S.

2013-03-01

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Relationship of orthopedic examination, goniometric measurements, and radiographic signs of degenerative joint disease in cats  

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Full Text Available Abstract Background Available information suggests a mismatch between radiographic and orthopedic examination findings in cats with DJD. However, the extent of the discrepancy between clinical and radiographic signs of OA in companion animals has not been described in detail. This study aimed to evaluate the relationship between orthopedic examination findings, joint goniometry, and radiographic signs of DJD in 100 cats, in a prospective observational design. Cat temperament, pain response to palpation, joint crepitus, effusion and thickening were graded. Radiographs of appendicular joints and the axial skeleton were made under sedation. Joint motion was measured by use of a plastic goniometer before and after sedation. Associations between radiographic degenerative joint disease (DJD) and examination findings were assessed to determine sensitivity, specificity and likelihood estimations. Results Pain response to palpation was elicited in 0-67% of the joints with DJD, with a specificity ranging from 62-99%; crepitus was detected in 0-56% of the joints and its specificity varied between 87 and 99%; for effusion, values ranged between 6 and 38% (specificity, 82-100%), and thickening, 0-59% (specificity, 74-99%). Joints with DJD tended to have a decreased range of motion. The presence of pain increased the odds of having DJD in the elbow (right: 5.5; left: 4.5); the presence of pain in the lower back increased the odds of spinal DJD being present (2.97 for lumbar; 4.67 for lumbo-sacral). Conclusions Radiographic DJD cannot be diagnosed with certainty using palpation or goniometry. However, negative findings tend to predict radiographically normal joints. Palpation and goniometry may be used as a tool to help to screen cats, mostly to rule out DJD.

Lascelles B Duncan X; Dong Yaa-Hui; Marcellin-Little Denis J; Thomson Andrea; Wheeler Simon; Correa Maria

2012-01-01

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Patient self-assessment of health status and function in glenohumeral degenerative joint disease.  

UK PubMed Central (United Kingdom)

One hundred three consecutive patients with primary glenohumeral degenerative joint disease completed standard questionnaires regarding their general health status (Short Form-36) and the function of their shoulder (Simple Shoulder Test). These patients' self-assessed health status indicated overall bodily pain, physical functioning, and physical role fulfillment scores that were significantly below those of population-based control groups. Self-assessed shoulder functions were likewise consistently below those of patients with normal shoulders. These deficits clearly indicated the problems that the patients desired to have resolved by treatment. The use of self-assessment questionnaires to routinely characterize patients with shoulder conditions is practical in the context of a busy practice. These data enable surgeons to understand the condition from the patient's perspective. This understanding should be central to the planning of treatment and to the evaluation of treatment effectiveness.

Matsen FA 3rd; Ziegler DW; DeBartolo SE

1995-09-01

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MR and MR arthrography to identify degenerative and posttraumatic diseases in the shoulder joint  

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MR imaging provides a comprehensive evaluation of a wide spectrum of both intraarticular and extraarticular pathology of the shoulder. MR imaging enables the detection or exclusion of degenerative and posttraumatic diseases of the shoulder with a reasonable accuracy. MR arthrography is useful in the visualization of subtle anatomic details and further improves the differentiation. In this article, findings of MR imaging and MR arthrography of degenerative and posttraumatic shoulder diseases (impingement syndrome, rotator cuff tears, and glenohumeral instability) has been reviewed.

2000-01-01

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Supramalleolar osteotomies for degenerative joint disease of the ankle joint: indication, technique and results.  

UK PubMed Central (United Kingdom)

Patients with varus or valgus hindfoot deformities usually present with asymmetric ankle osteoarthritis. In-vitro biomechanical studies have shown that varus or valgus hindfoot deformity may lead to altered load distribution in the tibiotalar joint which may result in medial (varus) or lateral (valgus) tibiotalar joint degeneration in the short or medium term. The treatment of asymmetric ankle osteoarthritis remains challenging, because more than half of the tibiotalar joint surface is usually preserved. Therefore, joint-sacrificing procedures like total ankle replacement or ankle arthrodesis may not be the most appropriate treatment options. The short- and midterm results following realignment surgery, are very promising with substantial pain relief and functional improvement observed post-operatively. In this review article we describe the indications, surgical techniques, and results from of realignment surgery of the ankle joint in the current literature.

Barg A; Pagenstert GI; Horisberger M; Paul J; Gloyer M; Henninger HB; Valderrabano V

2013-08-01

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Neuroradiology of spine degenerative diseases.  

UK PubMed Central (United Kingdom)

Degenerative disease of the spine is one of the most common clinical entities and affects the intervertebral discs, including opposing vertebral endplates, the intervertebral posterior joints and the ligaments. The most severe primary spinal degenerative changes are found in the lower cervical and lumbar spine regions. The spine contains three different types of joints, each of which presents its own pattern of degenerative disease: (i) cartilaginous joints, represented by the intervertebral disc or, more specifically, the functional unit defined as the 'vertebro-disc connection'; (ii) synovial joints, represented by the posterior intervertebral joints, sacro-iliac and costovertebral joints; (iii) fibrous joints, mainly found in the principal ligaments such as the posterior longitudinal ligament and the yellow ligaments. With regard to radicular pain, root compression alone does not fully account for root pain following disc-root conflict, but it is, nevertheless, considered to be the main cause of pain. We will try to explain that the origin of pain is multi-factorial and that inflammation probably predominates over merely mechanical mechanisms. To conclude, we will consider whether vertebral arthrosis can be construed as the body's decision to favour the spine's static function over its dynamic role when joint 'hypermobility' linked to chronic load in old age could cause severe structural damage to the bony vertebral structures. This hypothesis should also embrace a further concept: ageing of the spine is not merelychronological. Themostaccurate interpretation tha tcan account for similar degenerative phenomena encountered in the young is that of abnormal static and dynamic loading stress.

Leonardi M; Simonetti L; Agati R

2002-01-01

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Effect of Age on the Hemostatic Function in Patients with Degenerative Diseases of the Large Joints  

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Full Text Available Background: Aging is associated with an increased hypercoagulable state. Degenerative diseases of the large joints are also accompanied by increased coagulation activity. We investigated the effect of age on the hemostatic function in patients with osteoarthritis. Material and Methods: The study included 192 patients with osteoarthritis admitted to the clinic for primary hip or knee arthroplasty. The patients were categorized into 5 age groups: the age group under 40 years, the 41–to-50 -year age group, the 51–to-60-year age group, the 61-to-70- year age group, and the age group over 70 years. The general blood clotting tests, platelet number, fibrinogen, antithrombin, protein C, TAT, D-dimer, vonWillebrand factor (vWF), PAI-1, ß-thromboglobulin were determined. Results: Among patients with osteoarthritis, the antithrombin III level significantly decreased by the age of 50; however, above the age of 60 there was a distinct decrease in platelet count, and over the age of 70 the activity of the extrinsic coagulation pathway and the plasminogen level dropped significantly. TAT and D-dimer levels were elevated in most of the patients. Conclusion: The decrease in platelet count coupled with the activity of the extrinsic coagulation pathway in elderly osteoarthritic patients may increase blood loss during total arthroplasty; also, the drop in the anticoagulant and fibrinolytic potential may play a negative role in strengthening the prothrombotic state during the postoperative period.

Irina P. Antropova, PhD¹; Boris G. Yushkov, PhD, ScD²'³; Igor L. Shlykov, PhD¹, ScD¹

2013-01-01

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Functional interrelations between the lumbosacral, sacroiliac and coxofemoral complex in dogs as denoted by degenerative joint diseases  

International Nuclear Information System (INIS)

Functional interrelations between coxofemoral joint, sacroiliac joint and the lumbosacral junction were investigated in Rottweilers, Golden Retriever and German Shepherd dogs. The study was based on sample of 120 ventrodorsal radiographs of the pelvis, which was assessed for evidence of hip dysplasia, alterations of the synovial and extrasynovial components of the sacroiliac joints, and osteophyte formation at the lumbosacral junction. Alteration of the extrasynovial component of the sacroiliac joint was the disease most commonly observed. Such degenerative alterations of the sacroiliac joint were noted to be associated with osteophyte formation at the lumbosacral junction. Both diseases were associated with age and German Shepherd dogs were most frequently affected. Results obtained by the additional evaluation of the coxofemoral joints suggest two mechanisms inducing degenerative alterations at the joint complex investigated. Based on changes in collagen composition, congenitally determined insufficiency of the supporting connective tissue may be responsible for the coincidence of alterations of all joint components of the lumbosacral - sacroilia - coxofemoral complex as noted in one group of dogs. In contrast, pre-dominant affection of the sacroiliac amphiarthosis and the lumbosacral intervertebral disc space is supposed to result from cumulative overloading. (author)

2002-01-01

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Neuroradiology of spine degenerative diseases.  

Science.gov (United States)

Degenerative disease of the spine is one of the most common clinical entities and affects the intervertebral discs, including opposing vertebral endplates, the intervertebral posterior joints and the ligaments. The most severe primary spinal degenerative changes are found in the lower cervical and lumbar spine regions. The spine contains three different types of joints, each of which presents its own pattern of degenerative disease: (i) cartilaginous joints, represented by the intervertebral disc or, more specifically, the functional unit defined as the 'vertebro-disc connection'; (ii) synovial joints, represented by the posterior intervertebral joints, sacro-iliac and costovertebral joints; (iii) fibrous joints, mainly found in the principal ligaments such as the posterior longitudinal ligament and the yellow ligaments. With regard to radicular pain, root compression alone does not fully account for root pain following disc-root conflict, but it is, nevertheless, considered to be the main cause of pain. We will try to explain that the origin of pain is multi-factorial and that inflammation probably predominates over merely mechanical mechanisms. To conclude, we will consider whether vertebral arthrosis can be construed as the body's decision to favour the spine's static function over its dynamic role when joint 'hypermobility' linked to chronic load in old age could cause severe structural damage to the bony vertebral structures. This hypothesis should also embrace a further concept: ageing of the spine is not merelychronological. Themostaccurate interpretation tha tcan account for similar degenerative phenomena encountered in the young is that of abnormal static and dynamic loading stress. PMID:11987932

Leonardi, M; Simonetti, L; Agati, R

2002-01-01

 
 
 
 
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Imaging of degenerative and posttraumatic disease in the shoulder joint with ultrasound  

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This article reviews the examination technique of shoulder ultrasound, normal and abnormal ultrasound findings in acute (posttraumatic) and chronic (degenerative) lesions. Moreover, it reviews the effectiveness of ultrasound in relation to magnetic resonance (MR) imaging. Most authors report that full-thickness tears of the supraspinatus can reliably be diagnosed by ultrasound. However, the simple diagnosis of a full-thickness rotator cuff tear is no longer sufficient for surgical management. The precise localization and size of rotator cuff tears as well as the extent of muscle degeneration is important for surgical planning. For this aspect and for partial-thickness tears of the supraspinatus, for subscapularis lesions as well as for lesions of the long biceps tendons there is no consensus regarding the diagnostic value of ultrasound. To the present, ultrasound (contrary to MR imaging) has failed to demonstrate that it consistently influences the clinician's degree of confidence in the clinical diagnosis or the treatment plan. Therefore, some orthopedic surgeons prefer MR imaging to ultrasound in the evaluation of rotator cuff tears and other abnormalities of the glenohumeral joint. Moreover, MR imaging, especially when combined with arthrography, represents a one-step investigation, which not only allows for assessment of rotator cuff lesion but also of lesions of the labrum (Bankart lesions, SLAP lesions), the joint capsule and the biceps tendon. It also demonstrates muscle atrophy, which represents an important predictor of surgical outcome in rotator cuff repair.

Zanetti, Marco E-mail: mzanetti@balgrist.unizh.ch; Hodler, Juerg

2000-08-01

22

Regenerative injection therapy with whole bone marrow aspirate for degenerative joint disease: a case series.  

UK PubMed Central (United Kingdom)

Regenerative therapeutic strategies for joint diseases usually employ either enriched concentrates of bone marrow-derived stem cells, chondrogenic preparations such as platelet-rich plasma, or irritant solutions such as hyperosmotic dextrose. In this case series, we describe our experience with a simple, cost-effective regenerative treatment using direct injection of unfractionated whole bone marrow (WBM) into osteoarthritic joints in combination with hyperosmotic dextrose. Seven patients with hip, knee or ankle osteoarthritis (OA) received two to seven treatments over a period of two to twelve months. Patient-reported assessments were collected in interviews and by questionnaire. All patients reported improvements with respect to pain, as well as gains in functionality and quality of life. Three patients, including two whose progress under other therapy had plateaued or reversed, achieved complete or near-complete symptomatic relief, and two additional patients achieved resumption of vigorous exercise. These preliminary findings suggest that OA treatment with WBM injection merits further investigation.

Hauser RA; Orlofsky A

2013-01-01

23

[Assessing the treatment for sacroiliac joint dysfunction, piriformis syndrome and tarsal tunnel syndrome associated with lumbar degenerative disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: Sacroiliac joint (SIJ) dysfunction, piriformis syndrome (PFS) and tarsal tunnel syndrome (TTS) produce symptoms similar to lumbar degenerative disease (LDD). Patients who have these diseases plus LDD sometimes experience residual symptoms after surgery for LDD. We therefore assessed the results of treatment of SIJ dysfunction, PFS and TTS associated with LDD. PATIENTS AND METHODS: We assessed 25 patients who underwent surgery for LDD and were affected with SIJ dysfunction (12 patients), PFS (7 patients) or TTS (6 patients). SIJ dysfunction was treated with rest, drugs, pelvic band and sacroiliac joint block. PFS was treated with rest, drugs, physical exercise, injection of local anesthetic into the piriformis muscle, and surgical resection of the piriformis muscle. TTS was treated with drugs and tarsal tunnel opening. We analyzed the improvement score and recovery rate (JOA score) for both LDD surgery and the treatment of SIJ dysfunction, PFS and TTS. RESULTS: Symptom improvement was observed in all patients with SIJ dysfunction and PFS and in 4 patients with TTS. The improvement score and recovery rate of treatments for SIJ dysfunction, PFS and TTS were lower than those of surgery for LDD. CONCLUSION: The improvement score and recovery rate of treatment for SIJ dysfunction, PFS and TTS were not as high as those for LDD. To enhance patient satisfaction, it is important to consider these complicating diseases when designing treatments for LDD.

Morimoto D; Isu T; Shimoda Y; Hamauchi S; Sasamori T; Sugawara A; Kim K; Matsumoto R; Isobe M

2009-09-01

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Individual Replacement of Bones and Joints the Foot in the Treatment of Degenerative Dystrophic Diseases  

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Full Text Available The aim of the investigation is to increase the efficiency of treatment of osteoarthrosis deformans of foot and ankle joints by developing and applying new hi-tech methods of treatment – individual replacement of the foot bones and joints. Materiales and methods. 39 patients with the specified pathology were surveyed. Standard total ankle replacement was performed in two of them (STAR, W. Link), 16 patients underwent the first MTP joint replacement with Total toe system. In five cases with the 1st MTPJ arthrosis there was observed total, subtotal and polylocal aseptic necrosis of the head of the first metatarsal bone. 10 patients had a similar picture of damage of the talus due to trauma. For these patients individual artificial implants of the talus and endoprostheses of the first MTPJ were developed. Modern techniques (CT, MRT) were used to early radiodiagnosis of posttraumatic talus damage. Results and Discussion. There were developed new methods of surgical treatment of such consequences of trauma of the talus as total, subtotal and polylocal aseptic necrosis — individual total replacement of the talus by original patented technique and replacement of the first MTP joint in cases of severe aseptic necrosis of the 1st metatarsal bone’s head with the implant with the long stem (when standard joint replacement is noneffective). Pre-production models of implants and tools were made, and technical tests of designs were carried out.

?.Yu. Ezhov

2012-01-01

25

Diclofenac concentrations in synovial fluid and plasma after cutaneous application in inflammatory and degenerative joint disease.  

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1. Ten patients with bilateral knee joint effusions were treated topically with a gel containing 1 g diclofenac/100 g (80 mg three times daily). They were randomized to receive diclofenac gel to one knee and a placebo gel preparation to the other knee. 2. Diclofenac was assayed in synovial fluid and...

Radermacher, J; Jentsch, D; Scholl, M A; Lustinetz, T; Frölich, J C

26

Low back pain and degenerative disc disease  

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Full Text Available Introduction. Various clinical conditions can cause low back pain, and in most cases it is of a degenerative origin. Degenerative disc disease is a common condition which affects young to middle-aged men and women equally. Changes in the mechanical properties of the disc lead to degenerative arthritis in the intervertebral joints, osteophytes, and narrowing the intervertebral foramen or the spinal canal. Pathophysiology. Degenerative cascade, described by Kirkaldy-Willis, is the widely accepted pathophysiologic model describing the degenerative process as it affects the lumbar spine in 3 phases. Diagnosis. There are two forms of low back pain secondary to degenerative disc disease: a) lumbalgia and b) lumbar radiculopathy. Limitation of movement, problems with balance, pain, loss of reflexes in the extremities, muscle weakness, loss of sensation or other signs of neurological damage can be found on physical examination. For accurate diagnosis, it is often necessary to combine clinical examination and sophisticated technology. Treatment. Coservative treatment consists of rest, physical therapy, pharmacological therapy and injection therapy. Physical rehabilitation with active patient participation is a key approach to treatment of patients with discogenic pain. Physical therapy, occupational therapy and kinesitherapy are important for improving muscle strength, endurance, and flexibility. Disc surgery is performed if surgical intervention is required. .

Jandri? Slavica; Anti? Branislav

2006-01-01

27

Degenerative Achilles tendon disease  

International Nuclear Information System (INIS)

[en] As Magnetic Resonance (MR) imaging and Ultrasound (US) allow the evaluation of soft-tissue structures not previously possible with other imaging techniques, a clinical study has been undertaken to determine the value of these 2 modalities in the detection of lesions in the Achilles tendon (AT), other than acute total rupture. Seven healthy subjects and 28 symptomatic patients with Achillodynia and/or signs of thickening of the AT were investigated with MR and US; all results were compared with the clinical features. Surgical findings were available in 14 patients. Patients were divided into 3 groups; those with tendon thickening, incomplete and complete ruptures. Thickening of the AT was easily detected with both methods. MR was superior in the detection of incomplete tendon rupture and in the evaluation of various stages of chronic degenerative changes. It is concluded that only if US remains unclear, an additional MR study should be performed and together with the clinical diagnosis indication for surgery can be made more efficient. (author). 24 refs.; 4 figs

1992-01-01

28

Degenerative disease of the spine  

International Nuclear Information System (INIS)

With few exceptions, magnetic resonance imaging (MRI) is becoming the modality of choice for the evaluation of degenerative disorders of the entire spine. With the implementation of surface coils and continued refinement and development of new pulse sequences, osseous and soft tissue structures of the spine can now be studied in great detail. The introduction of paramagnetic contrast agents has made it possible to differentiate epidural scar from recurrent disc herniation in the postoperative setting and to discern previously undetected degenerative changes within the intervertebral disc itself. This paper discusses the spectrum of degenerative diseases of the spine, including disc degeneration (intervertebral osteochondrosis), disc herniation, spinal stenosis, spondylosis deformans, and osteoarthritis. A brief description of the MR techniques and strategies used to evaluate these disorders is also.

1991-01-01

29

Genetic and somatic radiation doses in radiotherapy of inflammatory and degenerative diseases of bones, joints and soft parts  

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Dose measurements were performed in several body regions of patients suffering from inflammatory degenerative diseases (humeral epicondylitis, humeroscapular periarthritis, gonarthrosis, axillary hidradenitis, rheumatoid arthritis, coxarthrosis, parotitis). The problem of the radiation induction of neoplasms is predominant concerning somatic as well as genetic risk, discussed by example of the most frequently occurring organ cancer. Compared to the rate of breast cancer in the highly developed industrial states (5,000 to 6,000 cancers/100,000 women) the 'radiation induction' calculated according to a mathematical model of ICRP 26 (1.25 cases of death for breast cancers/100,000 women following for example irradiation of epicondylitis) is behind several powers of ten and not demonstrable. The genetic radiation exposure is also low. Derived from the measurements it is wrong to give up reliable and approved indications of radiotherapy of non-malignant diseases because of unfounded radiophobia.

Kirsch, M.; Keinert, K.; Schumann, E. (Medizinische Akademie, Erfurt (German Democratic Republic). Radiologische Klinik)

1983-01-01

30

On the genetic and somatic radiation doses in radiotherapy of inflammatory and degenerative diseases of bones, joints and soft parts  

International Nuclear Information System (INIS)

[en] Dose measurements were performed in several body regions of patients suffering from inflammatory degenerative diseases (humeral epicondylitis, humeroscapular periarthritis, gonarthrosis, axillary hidradenitis, rheumatoid arthritis, coxarthrosis, parotitis). The problem of the radiation induction of neoplasms is predominant concerning somatic as well as genetic risk, discussed by example of the most frequently occurring organ cancer. Compared to the rate of breast cancer in the highly developed industrial states (5,000 to 6,000 cancers/100,000 women) the 'radiation induction' calculated according to a mathematical model of ICRP 26 (1.25 cases of death for breast cancers/100,000 women following for example irradiation of epicondylitis) is behind several powers of ten and not demonstrable. The genetic radiation exposure is also low. Derived from the measurements it is wrong to give up reliable and approved indications of radiotherapy of non-malignant diseases because of unfounded radiophobia. (author)

1983-01-01

31

In vitro release of prostaglandins and leukotrienes from synovial tissue, cartilage, and bone in degenerative joint diseases.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the major source of eicosanoid release in arthritic joint tissues and to examine the modulation of this release by indomethacin and diclofenac. METHODS: Release of prostaglandin E2 (PGE2), 6-keto-PGF1 alpha, leukotriene B4 (LTB4), and LTC4 was measured in supernatants of synovial tissue, cartilage, and bone incubates from patients with osteoarthritis, active rheumatoid arthritis (RA), inactive RA, and pseudogout. Radioimmunoassay (RIA) was used to determine the levels of the eicosanoids. RESULTS: Addition of the divalent cation ionophore A23187 resulted in significant release of all eicosanoids measured from synovial tissue, but not from cartilage, cortical bone, or cancellous bone. PG release was significantly inhibited by the addition of indomethacin or diclofenac at either 10(-5) moles/liter or 10(-7) moles/liter. The amount of LTC4 released from cartilage and bone was only slightly above the detection limit of the RIA, whereas large amounts were released from synovial tissue. Neither indomethacin nor diclofenac had an effect on LTC4 release. LTC4 release from synovial tissue of patients with inactive RA was significantly decreased in comparison with the levels from synovial tissue of patients with the other joint diseases. There was no significant difference in PG release among patients in the various disease groups. CONCLUSION: Synovial tissue appears to be the major source of eicosanoids in synovial fluid. Indomethacin and diclofenac inhibit the release of PG, but not LT, from various joint tissues.

Wittenberg RH; Willburger RE; Kleemeyer KS; Peskar BA

1993-10-01

32

Lumbar facet joint motion in patients with degenerative spondylolisthesis.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Controlled laboratory study. OBJECTIVE: To investigate the in vivo biomechanical effect of degenerative lumbar spondylolisthesis (DLS) on the motion of the facet joint during various functional weight-bearing activities. SUMMARY OF BACKGROUND DATA: Although the morphologic changes of the facet joints in patients with DLS have been reported in a few studies, no data have been reported on the kinematics of these facet joints. METHODS: Ten patients with DLS at L4-L5 were studied. Each patient underwent a magnetic resonance imaging scan to obtain 3-dimensional models of the lumbar vertebrae from L2-L5 and a dual fluoroscopic imaging scan in different postures: flexion-extension, left-right bending, and left-right torsion. The positions of the vertebrae were reproduced by matching the magnetic resonance imaging-based vertebral models to the fluoroscopic images. The kinematics of the facet joint and the ranges of motion were compared with those of healthy subjects and those of patients with degenerative disk diseases (DDD) previously published. RESULTS: In DLS patients, the range of rotation of the facet joints was significantly less at the DLS level (L4-L5) than that at the adjacent levels (L2-L3 and L3-L4), whereas the range of translation was similar at all levels. The range of rotation at the facet joints of the DLS level decreased compared with those of both the DDD patients and healthy subjects at the corresponding vertebral level (L4-L5), whereas no significant difference was found in the range of translation. The range of motion of facet joints in DLS and in DDD patients was similar at the adjacent levels (L2-L3 and L3-L4). CONCLUSIONS: The range of rotation decreased at the facet joints at the DLS level (L4-L5) in patients compared with those in healthy subjects and DDD patients. This decrease in range of rotation implies that the DLS disease may cause restabilization of the joint. The data may help the selection of conservative treatment or different surgical techniques for the DLS patients.

Yao Q; Wang S; Shin JH; Li G; Wood KB

2013-02-01

33

Neuro degenerative diseases: clinical concerns  

International Nuclear Information System (INIS)

Idiopathic Parkinson's disease (PD) and Alzheimer's disease (AD) are the main neuro-degenerative diseases (NDDs) seen clinically. They share some common clinical symptoms and neuro-pathological findings. The increase of life expectancy in the developed countries will inevitably contribute to enhance the prevalence of these diseases. Behavioral disorders, common in NDDs, will produce major care management challenges. Idiopathic Parkinson's disease corresponds to a histopathological diagnosis, based on the observation of a de-pigmentation and a neuronal loss in the substantia nigra, as well as on the presence of intra-neuronal inclusion bodies. AD is insidious with slowly progressive dementia in which the decline in memory constitutes the main complaint. The diagnosis of definite AD requires the presence of clinical criteria as well as the histopathological confirmation of brain lesions. The two main lesions are the presence of senile plaques and neuro-fibrillary tangles. Positron emission tomography (PET) explores cerebral metabolism and neurotransmitter kinetics in NDDs using principally [18F]-deoxyglucose and [18F]-dopa. Nigrostriatal dopaminergic function is altered in PD, as evidenced by the low uptake of [18F]-dopa in the posterior putamen as compared to anterior putamen and caudate nucleus. In contrast, [18F]-dopa uptake is equally depressed in all striatal structures in progressive supra-nuclear palsy. Regional glucose metabolism at rest is preserved in elderly once cerebral atrophy is taken into account. On the contrary, glucose metabolism is globally reduced in AD, with marked decrease in the parietal and temporal regions. PET has proved to be useful to study in vivo neurochemical processes in patients suffering from NDDs. The potential of this approach is still largely unexploited, and depends on new ligand production to establish early diagnosis and treatment follow-up. (author)

2005-01-01

34

Reliability and discriminatory testing of a client-based metrology instrument, feline musculoskeletal pain index (FMPI) for the evaluation of degenerative joint disease-associated pain in cats.  

UK PubMed Central (United Kingdom)

The objective of this study was to test the readability, reliability, repeatability and discriminatory ability of an owner-completed instrument to assess feline degenerative joint disease (DJD)-associated pain (feline musculoskeletal pain index, FMPI). Readability was explored using four different formulas (Flesch, Fry, SMOG and FOG) and the final FMPI instrument was produced. To assess the instrument, client-owned cats that were defined as normal (normal group) or as having DJD-associated pain and mobility impairment (pain-DJD group) were recruited. A total of 32 client-owned cats were enrolled in the study (normal, n=13; pain-DJD, n=19). Owners completed the FMPI on two occasions, 14days apart. Internal consistency (reliability) and repeatability (test-retest) were explored using Cronbach's ? and weighted ? statistic, respectively. Data from the two groups were compared using analysis of covariance (controlling for age) to evaluate discriminatory ability. The FMPI was constructed with 21 questions covering activity, pain intensity and overall quality of life. It had a 6th grade readability score. Reliability of the FMPI was excellent (Cronbach's ?>0.8 for all groupings of questions in normal and pain-DJD cats) and repeatability was good (weighted ? statistic >0.74) for normal and pain-DJD cats. All components of the FMPI were able to distinguish between normal cats and cats with DJD (P<0.001 for all components). This initial evaluation of the FMPI suggests that this instrument is worthy of continued investigation.

Benito J; Depuy V; Hardie E; Zamprogno H; Thomson A; Simpson W; Roe S; Hansen B; Lascelles BD

2013-06-01

35

Comparative evaluation of the direct analgesic efficacy of selected physiotherapeutic methods in subjects with knee joint degenerative disease - preliminary report.  

UK PubMed Central (United Kingdom)

BACKGROUND: The goals of the study were to evaluate the efficacy of two physiotherapeutic procedures: low energy laser therapy and low frequency transcutaneous electric nerve stimulation (TENS) and to compare these modalities with regard to their therapeutic effects in patients with knee osteoarthritis. MATERIAL AND METHODS: Fifty (50) subjects were enrolled into the study and divided into two groups of 25 subjects. Group A received 10 MLS laser therapy sessions with a synchronised laser beam at doses of 12 J per treated site. Group B received ten sessions of low frequency TENS. The procedures were carried out every day for two weeks (5 times a week). All patients completed a personal data questionnaire and underwent an examination of knee joint motion range and circumference. Subjective pain intensity was assessed using the VAS pain scale and the modified Laitinen questionnaire. RESULTS: An analysis of the results of the treatment demonstrated statistically significant pain reduction in both groups. This improvement was significantly higher in the two-phase laser therapy group vs. the LF-TENS group. No statistically significant improvement was noted in either of the groups regarding the knee joint range of motion. CONCLUSIONS: 1. Synchronised laser beam (MLS) therapy and low-frequency TENS contribute to direct pain relief effects in subjects with knee osteoarthritis. 2. The study confirmed better analgesic effects of two-phase laser therapy vs. LF-TENS.

K?dzierski T; Sta?czak K; Gworys K; Gasztych J; Sibi?ski M; Kujawa J

2012-11-01

36

Correction of collapsed occlusion with degenerative joint disease focused on the mandibular arch and timely relocation of a miniplate.  

UK PubMed Central (United Kingdom)

This report describes a novel concept of 3-dimensional tooth movement by using biocreative therapy to provide unrestricted distal movement of the full mandibular dentition. The patient was a 26-year-old Korean woman with multiple problems, including a collapsed occlusion, a full-step Class III relationship with posterior open bite, a crossbite, temporomandibular joint pain, and a tendency for root resorption. Two orthodontic miniplates with tubes were initially placed on both retromolar pads for distalization; 1 miniplate was relocated to the anterior region for angulation and vertical control of the anterior teeth. The total treatment period was 13 months. The occlusion was finished in Class I molar and canine relationships with optimal overjet and overbite. Posttreatment records 2.5 years later showed a stable treatment outcome. The results suggest that an orthodontic miniplate is an efficient tool for the treatment of a collapsed occlusion by changing the affected arch only.

Chung KR; Ahn HW; Kim SJ; Lee KB; Kim SH

2012-03-01

37

Inter-examiner reliability of the diagnosis of cervical pillar hyperplasia (CPH) and the correlation between CPH and spinal degenerative joint disease (DJD)  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Cervical pillar hyperplasia (CPH) is a recently described phenomenon of unknown aetiology. Its clinical importance is poorly understood at the present time; therefore, the objective of this study was to determine (1) the inter-examiner reliability of detecting CPH and (2) if there is a clinically important correlation (r > 0.4) between the number of cervical spine levels showing signs of degenerative joint disease (DJD) and CPH. Methods The sample consisted of 320 radiographs of human male and female subjects who ranged from 40 to 79 years of age. The inter-examiner reliability of assessing the presence/absence of pillar hyperplasia was evaluated on 50 neutral lateral radiographs by two examiners using line drawings and it was quantified using the kappa coefficient of concordance. To determine the presence/absence of hyperplastic pillars as well as the presence/absence of DJD at each intervertebral disc and zygapophysial joint, 320 AP open mouth, AP lower cervical and neutral lateral radiographs were then examined. The unpaired t-test at the 5% level of significance was performed to test for a statistically significant difference between the number of levels affected by DJD in patients with and without hyperplasia. The Spearman's rho at the 5% level of significance was performed to quantify the correlation between DJD and age. Results The inter-examiner reliability of detecting cervical pillar hyperplasia was moderate with a kappa coefficient of 0.51. The unpaired t-test indicated that there was no statistically significant difference (p > 0.05) between the presence/absence of cervical pillar hyperplasia and the number of levels affected by DJD in an age-matched population, regardless of whether all elements were considered together, or the discs and facets were analyzed separately. A Spearman correlation rank of 0.67 (p Conclusion Cervical pillar hyperplasia is a reasonable concept that requires further research. Its evaluation is easy to learn and acceptably reliable. Previous research has suggested that CPH may affect the cervical lordosis, and therefore, alter biomechanics which may result in premature DJD. This current study, however, indicates that, globally, CPH does not appear to be related to the development of DJD.

Stupar Maja; Mauron Damien; Peterson Cynthia

2003-01-01

38

The sternoclavicular joint: can imaging differentiate infection from degenerative change?  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this study was to determine if there are imaging and clinical findings that can differentiate a septic sternoclavicular joint from a degenerative one. Search of radiology reports from 2000-2007 revealed 460 subjects with imaging of the sternoclavicular joint, of whom 38 had undergone aspiration or biopsy. The final study group consisted of nine subjects with pathologic proof of sternoclavicular joint infection and ten subjects with pathologic and clinical findings excluding infection consistent with degenerative change. Available ultrasound, computed tomography (CT), and magnetic resonance (MR) images were retrospectively reviewed, and echogenicity, capsular distention, erosions, cysts, hyperemia or enhancement, and intensity of bone marrow signal were recorded. Clinical data were also reviewed. The findings significantly associated with sternoclavicular joint infection included degree and extent of capsular distention. With infection, average joint distention was 14 mm (range 10-20 mm) and extended over the sternum and clavicle in 60% compared to 5 mm (range 3-8 mm) with degeneration only extending over the clavicle. Other findings significantly associated with infection included bone marrow fluid signal on magnetic resonance imaging (MRI), elevated Westergren red blood cell sedimentation rate, and fever. The two findings significantly associated with degeneration were subchondral cysts on CT and female gender. Other imaging and clinical variables showed no significant differences between infection and degenerative change. The clinical and imaging findings significantly associated with sternoclavicular joint infection included joint capsule distention of 10 mm or greater, extension over both the clavicle and sternum, adjacent fluid signal bone marrow replacement, elevated Westergren red blood cell sedimentation rate, and fever. (orig.)

Johnson, Mark C.; Jacobson, Jon A.; Fessell, David P.; Kim, Sung Moon; Brandon, Catherine; Caoili, Elaine [University of Michigan, Department of Radiology, Ann Arbor, MI (United States)

2010-06-15

39

Spinal fusion in degenerative disc disease.  

Science.gov (United States)

Low back pain caused by degenerative disc disease is of such intensity in a low percentage of cases that surgery is indicated. Surgery must not only stabilize, but it must above all correct the deformity, recovering the disc space. Among all of the methods available circumferential fusion with a double combined approach, that is, anterior and posterior, is held to be the most effective. PMID:8076465

Gallinaro, P; Indemini, E; Tabasso, G; Abbate, M

40

Imaging and translational research: neuro degenerative diseases  

Energy Technology Data Exchange (ETDEWEB)

Advances in neuroimaging of neuro-degenerative diseases over the past two decades are the product of breakthroughs in imaging technology, more powerful computers, image-processing software, and expanding knowledge in basic and clinical neuro-science. In addition to the insights into normal brain structure and function that such methods provide, and the information that can be gained from disease-related changes in structure and function, functional imaging offers the promise of monitoring brain lesions and quantifying the therapeutic efficacy of innovative treatments for these largely incurable disorders. (author)

Hantraye, P. [CEA Fontenay-aux-Roses, MIRC, 92 (France)

2009-07-01

 
 
 
 
41

Magnetic resonance imaging of degenerative disk disease of the spine.  

UK PubMed Central (United Kingdom)

MRI has undergone an incredibly rapid evolution, and technical advances are continually occurring. MRI allows for high resolution imaging that can clearly demonstrate a variety of degenerative processes of the spine. High-resolution MRI that gives detailed anatomic information, coupled with the use of MR contrast agents, promises to change our diagnostic approach significantly for degenerative disk disease of the spine.

Lee SH; Coleman PE; Hahn FJ

1988-09-01

42

Computed tomography in lumbar degenerative disease  

International Nuclear Information System (INIS)

We reported the 18 patients which underwent surgical exploration and reviewed these CT findings. Method All CT scans were obtained on Somatom II, high resolution CT scanner, with the patient in the supine position. A lateral localizer image (Topogram) was used to select the appropriate intervertebral disk space. The slice thickness was 4 mm. Results 1) CT findings in lumbar degenerative diseases include bony canal stenosis (central canal stenosis, narrowed lateral recess), soft tissue abnormalities (herniated nucleus pulposus, bulging annulus, hypertrophy and/or ossification of ligamentum flavum, no delineation of nerve root in lateral recess), and spinal instability (spondylolisthesis, vacuum phenomenon). 2) The above three factors contribute to narrowing of spinal canal. 3) No delineation of nerve root or soft tissue replacement of epidural fat in lateral recess suggests that the nerve root may be compressed by some factors. 4) Herniated nucleus pulposus may cause nerve root compression with or without canal stenosis. Conclusion This study revealed that the CT findings correlated closely with the surgical findings and the site of nerve root compression could be determined. (author).

1984-01-01

43

Scaphocapitolunate Arthrodesis and Radial Styloidectomy for Posttraumatic Degenerative Wrist Disease  

Science.gov (United States)

Long-standing scaphoid nonunion, scaphoid malunion, and chronic scapholunate dissociation result in malalignment of the carpal bones, progressive carpal collapse, instability, and osteoarthritis of the wrist. The most commonly used procedures to treat scaphoid nonunion advanced collapse (SNAC) and scapholunate advanced collapse (SLAC) wrists are the four-corner fusion (4CF) and the proximal row carpectomy (PRC). The purpose of this study was to evaluate the clinical outcome of a different treatment modality: radial styloidectomy and scaphocapitolunate (SCL) arthrodesis. This treatment option is chosen in an effort to maintain the joint contact surface and load transmission across the radiocarpal joint. We conducted a retrospective review of 20 patients (average age 62 years, range: 27 to 75 years) treated from 1994 to 2010. Seven patients were treated for SNAC, 12 patients for SLAC wrists, and 1 for degenerative joint disease following a transscapho-transcapitate perilunar dislocation. Sixteen patients had Herbert screw fixation, and four had Spider plate fixation. All patients had autologous bone graft used for the arthrodesis. The mean follow-up was 4.6 years (range: 2 to 9.6 years). Patients were evaluated clinically and radiographically. Nineteen of 20 arthrodeses healed on an average of 9.6 weeks. One patient was reoperated 8 months after the initial operation with salvage of the SCL arthrodesis with a spider plate with an adequate result. The mean active flexion–extension arc was 70 degrees and the radioulnar deviation arc was 23 degrees. Pain decreased in all patients, 13 of whom were pain free postoperatively. The average postoperative disabilities of arm, shoulder, and hand score was 24. Radiographically, neither radiolunate nor radioscaphoid arthritis was noted on follow-up. SCL arthrodesis with radial styloidectomy resulted in an adequate residual range of motion and pain relief. This method preserves the normal ulnar sided joints of the carpus and maintains a more physiologic joint surface for radiocarpal load sharing.

Klausmeyer, Melissa A.; Fernandez, Diego L.; Caloia, Martin

2012-01-01

44

Treatment of Degenerative Diseases of the Spine by Physiotherapy.  

Science.gov (United States)

Three methods of treating degenerative diseases of the spine by physiotherapy are reviewed. Specific examples involving patients are discussed which demonstrate the effectiveness of different heat, physiotherapy, and exercise treatments. The uses of physi...

W. Koch A. Lynn

1985-01-01

45

Skipping posterior dynamic transpedicular stabilization for distant segment degenerative disease.  

Science.gov (United States)

Objective. To date, there is still no consensus on the treatment of spinal degenerative disease. Current surgical techniques to manage painful spinal disorders are imperfect. In this paper, we aimed to evaluate the prospective results of posterior transpedicular dynamic stabilization, a novel surgical approach that skips the segments that do not produce pain. This technique has been proven biomechanically and radiologically in spinal degenerative diseases. Methods. A prospective study of 18 patients averaging 54.94 years of age with distant spinal segment degenerative disease. Indications consisted of degenerative disc disease (57%), herniated nucleus pulposus (50%), spinal stenosis (14.28%), degenerative spondylolisthesis (14.28%), and foraminal stenosis (7.1%). The Oswestry Low-Back Pain Disability Questionnaire and visual analog scale (VAS) for pain were recorded preoperatively and at the third and twelfth postoperative months. Results. Both the Oswestry and VAS scores showed significant improvement postoperatively (P < 0.05). We observed complications in one patient who had spinal epidural hematoma. Conclusion. We recommend skipping posterior transpedicular dynamic stabilization for surgical treatment of distant segment spinal degenerative disease. PMID:23091736

Solmaz, Bilgehan; Aydin, Ahmet Levent; Gomleksiz, Cengiz; Ataker, Yaprak; Sasani, Mehdi; Oktenoglu, Tunc; Ozer, Ali Fahir

2012-10-03

46

Skipping posterior dynamic transpedicular stabilization for distant segment degenerative disease.  

UK PubMed Central (United Kingdom)

Objective. To date, there is still no consensus on the treatment of spinal degenerative disease. Current surgical techniques to manage painful spinal disorders are imperfect. In this paper, we aimed to evaluate the prospective results of posterior transpedicular dynamic stabilization, a novel surgical approach that skips the segments that do not produce pain. This technique has been proven biomechanically and radiologically in spinal degenerative diseases. Methods. A prospective study of 18 patients averaging 54.94 years of age with distant spinal segment degenerative disease. Indications consisted of degenerative disc disease (57%), herniated nucleus pulposus (50%), spinal stenosis (14.28%), degenerative spondylolisthesis (14.28%), and foraminal stenosis (7.1%). The Oswestry Low-Back Pain Disability Questionnaire and visual analog scale (VAS) for pain were recorded preoperatively and at the third and twelfth postoperative months. Results. Both the Oswestry and VAS scores showed significant improvement postoperatively (P < 0.05). We observed complications in one patient who had spinal epidural hematoma. Conclusion. We recommend skipping posterior transpedicular dynamic stabilization for surgical treatment of distant segment spinal degenerative disease.

Solmaz B; Aydin AL; Gomleksiz C; Ataker Y; Sasani M; Oktenoglu T; Ozer AF

2012-01-01

47

Stem cell-based therapeutic applications in retinal degenerative diseases.  

UK PubMed Central (United Kingdom)

Retinal degenerative diseases that target photoreceptors or the adjacent retinal pigment epithelium (RPE) affect millions of people worldwide. Retinal degeneration (RD) is found in many different forms of retinal diseases including retinitis pigmentosa (RP), age-related macular degeneration (AMD), diabetic retinopathy, cataracts, and glaucoma. Effective treatment for retinal degeneration has been widely investigated. Gene-replacement therapy has been shown to improve visual function in inherited retinal disease. However, this treatment was less effective with advanced disease. Stem cell-based therapy is being pursued as a potential alternative approach in the treatment of retinal degenerative diseases. In this review, we will focus on stem cell-based therapies in the pipeline and summarize progress in treatment of retinal degenerative disease.

Huang Y; Enzmann V; Ildstad ST

2011-06-01

48

Stem cell-based therapeutic applications in retinal degenerative diseases.  

Science.gov (United States)

Retinal degenerative diseases that target photoreceptors or the adjacent retinal pigment epithelium (RPE) affect millions of people worldwide. Retinal degeneration (RD) is found in many different forms of retinal diseases including retinitis pigmentosa (RP), age-related macular degeneration (AMD), diabetic retinopathy, cataracts, and glaucoma. Effective treatment for retinal degeneration has been widely investigated. Gene-replacement therapy has been shown to improve visual function in inherited retinal disease. However, this treatment was less effective with advanced disease. Stem cell-based therapy is being pursued as a potential alternative approach in the treatment of retinal degenerative diseases. In this review, we will focus on stem cell-based therapies in the pipeline and summarize progress in treatment of retinal degenerative disease. PMID:20859770

Huang, Yiming; Enzmann, Volker; Ildstad, Suzanne T

2011-06-01

49

Inflammation and the degenerative diseases of aging.  

UK PubMed Central (United Kingdom)

Chronic inflammation is associated with a broad spectrum of neurodegenerative diseases of aging. Included are such disorders as Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis, the Parkinson-dementia complex of Guam, all of the tauopathies, and age-related macular degeneration. Also included are such peripheral conditions as osteoarthritis, rheumatoid arthritis, atherosclerosis, and myocardial infarction. Inflammation is a two-edged sword. In acute situations, or at low levels, it deals with the abnormality and promotes healing. When chronically sustained at high levels, it can seriously damage viable host tissue. We describe this latter phenomenon as autotoxicity to distinguish it from autoimmunity. The latter involves a lymphocyte-directed attack against self proteins. Autotoxicity, on the other hand, is determined by the concentration and degree of activation of tissue-based monocytic phagocytes. Microglial cells are the brain representatives of the monocyte phagocytic system. Biochemically, the intensity of their activation is related to a spectrum of inflammatory mediators generated by a variety of local cells. The known spectrum includes, but is not limited to, prostaglandins, pentraxins, complement components, anaphylotoxins, cytokines, chemokines, proteases, protease inhibitors, adhesion molecules, and free radicals. This spectrum offers a huge variety of targets for new anti-inflammatory agents. It has been suggested, largely on the basis of transgenic mouse models, that stimulating inflammation rather than inhibiting it can be beneficial in such diseases as AD. If this were the case, administration of NSAIDs, or other anti-inflammatory drugs, would be expected to exacerbate conditions such as AD, PD, and atherosclerosis. However, epidemiological evidence overwhelmingly demonstrates that the reverse is true. This indicates that, at least in these diseases, the inflammation is harmful. So far, advantage has not been taken of opportunities indicated by these epidemiological studies to treat AD and PD with appropriate anti-inflammatory agents. Based on this evidence, classical NSAIDs are the most logical choice. Dosage, though, must be sufficient to combat the inflammation. Analysis of mRNA levels of inflammatory mediators indicates that the intensity of inflammation is considerably higher in AD hippocampus and in PD substantia nigra than in osteoarthritic joints. Thus, full therapeutic doses of NSAIDs, or combinations of anti-inflammatory agents, are needed to achieve the suggested neurological benefits.

McGeer PL; McGeer EG

2004-12-01

50

Dysfunction of the pisotriquetral joint: degenerative arthritis treated by excision of the pisiform.  

UK PubMed Central (United Kingdom)

From 1995 to 2000, 21 patients (14 women and 7 men) with a mean age of 42 were treated with excision of the pisiform for a dysfunction of the pisotriquetral joint. Follow-up ranged from 6 to 36 months (average: 30 months). The diagnoses included degenerative arthritis of the pisotriquetral joint (15 patients), degenerative arthritis associated with a ganglion (3 patients), and calcifications caused by flexor carpi ulnaris tendinopathy (3 patients). All patients had pain secondary to direct pressure on the pisiform. Side-to-side passive motion of the pisiform occasionally led to pain and crepitus. Degenerative arthritis and calcifications in the pisotriquetral joint were confirmed by a wrist radiograph (lateral view in 30 degrees supination). In five patients, local injection with anesthetic temporarily resolved the symptoms. Excision of the pisiform resulted in complete relief of pain without functional deficit.

Gómez CL; Renart IP; Pujals JI; Palou EC; Busquets RC

2005-04-01

51

Dysfunction of the pisotriquetral joint: degenerative arthritis treated by excision of the pisiform.  

Science.gov (United States)

From 1995 to 2000, 21 patients (14 women and 7 men) with a mean age of 42 were treated with excision of the pisiform for a dysfunction of the pisotriquetral joint. Follow-up ranged from 6 to 36 months (average: 30 months). The diagnoses included degenerative arthritis of the pisotriquetral joint (15 patients), degenerative arthritis associated with a ganglion (3 patients), and calcifications caused by flexor carpi ulnaris tendinopathy (3 patients). All patients had pain secondary to direct pressure on the pisiform. Side-to-side passive motion of the pisiform occasionally led to pain and crepitus. Degenerative arthritis and calcifications in the pisotriquetral joint were confirmed by a wrist radiograph (lateral view in 30 degrees supination). In five patients, local injection with anesthetic temporarily resolved the symptoms. Excision of the pisiform resulted in complete relief of pain without functional deficit. PMID:15887588

Gómez, Claudia Lamas; Renart, Ignasi Proubasta; Pujals, Joan Itarte; Palou, Enric Cáceres; Busquets, Romà Curell

2005-04-01

52

Genome-wide association study of degenerative bony changes of the temporomandibular joint.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To identify susceptibility genes underlying degenerative bony changes of the temporomandibular joint (TMJ). MATERIALS AND METHODS: Bony changes of the TMJ condylar head were diagnosed by examination of panoramic radiographs and/or magnetic resonance images and/or computed tomography images. We conducted a genome-wide association study (GWAS) of 146 cases with TMJ degeneration and 374 controls from East Asian populations using an Illumina HumanOmniExpress BeadChip. After rigorous quality-control filtering, approximately 550 000 single nucleotide polymorphisms (SNPs) were used for tests of associations with disease status. RESULTS: Forty-one SNPs at 22 independent loci showed association signals at P < 1 × 10(-4) . The SNP rs878962, which maps on an intron of TSPAN9 on chromosome 12, showed the strongest association (combined OR = 1.89, 95% confidence interval = 1.43-2.50, P = 8.1 × 10(-6) ). According to in silico predictions of the 41 SNPs, two intronic SNPs of APOL3 (rs80575) and MRC2 (rs2460300) may fall within regulatory elements and affect DNA-protein interactions. We could not replicate SNPs located on genes that have been reported to be associated with temporomandibular disorder or temporomandibular osteoarthritis in previous studies at P < 1 × 10(-4) . CONCLUSIONS: Our GWAS identified 22 independent loci showing suggestive association signals with degenerative bony changes of the TMJ. These loci provide good candidates for future follow-up studies.

Yamaguchi T; Nakaoka H; Yamamoto K; Fujikawa T; Kim YI; Yano K; Haga S; Katayama K; Shibusawa T; Park S; Maki K; Kimura R; Inoue I

2013-05-01

53

Radiotherapy of degenerative joint disorders. Indication, technique and clinical results  

International Nuclear Information System (INIS)

From 1984 to 1994, 85 patients with painful osteoarthritis were treated. The mean follow-up was 4 (1 to 10) years. Seventy-three patients (103 joints) were available for long-term analysis: 17 patients (27 joints) with omarthrosis, 19 (20 joints) with rhizarthrosis, 31 (49 joints) with osteoarthritis of the knee and 6 patients (7 joints) with osteoarthritis of the hip. All patients were intensively pretreated over long time. Mean symptom duration prior to radiotherapy was 4 (1 to 10) years. Orthovoltage or linac photons were applied using some technical modifications depending upon the joint. Two radiotherapy series (6 x 1 Gy, total dose: 12 Gy, 3 weekly fractions) were prescribed. The interval between the 2 series was 6 weeks. The subjective pain profil was assessed prior to and 6 months after radiotherapy and at last follow-up. Forty-six (63%) patients (64 joints) achieved a reduction of pain symptoms; 16 of those had a 'major pain relief' and 14 'complete pain relief'. Large joints - knee and hip - responded better (64% each) than the rhizarthrosis (53%). All pain categories and grades and their combined pain score were significantly reduced. The pain reduction was mostly pronounced for the symptom 'pain at rest'. The orthopedic score correlated well with the subjective response of the patients. The thumb score improved in 11 (57%) joints, the shoulder score of Constant and Murley in 16 (59%), the Japonese knee score of Sasaki et al. in 33 (67%), the hip score of Harris in 5 (71%) joints. Only 9 of 19 patients which were treated to avoid surgery, had to be operated, and 3 of those received a total arthroplasty of the hip or knee. In multivariate analysis for the endpoint 'complete' or 'major pain relief' only the criterion 'symptom duration ?2 years prior to radiotherapy' was an independent negative prognostic parameter. (orig./MG)

1998-01-01

54

MRI in degenerative diseases of the cervical spine  

International Nuclear Information System (INIS)

MRI has grown increasingly important in recent years in diagnosis of degenerative diseases of the cervical spine, due to improvements of method that have made it a valuable diagnostic tool. The following contribution gives a brief introduction to the pathophysiology of degenerative changes in the cervical vertebral column and to the indications for MRI, describing within the framework of imaging the present state of MR examination technique. The ranking of the various gradient echo sequences, of the 3D methods and of the administration of contrast media in cervical myelopathy and radiaculopathy is discussed. (orig.).

1994-01-01

55

Effects of interspinous spacers on lumbar degenerative disease.  

UK PubMed Central (United Kingdom)

The present study aimed to evaluate the early effects of interspinous spacers on lumbar degenerative disease. The clinical outcomes of 23 patients with lumbar degenerative disease, treated using interspinous spacer implantation alone or combined with posterior lumbar fusion, were retrospectively studied and assessed with a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Pre-operative and post-operative interspinous distance, disc space height, foraminal width and height and segmental lordosis were determined. The early effects and complications associated with the interspinous spacers were recorded. The surgical procedures performed with the in-space treatment were easy and minimally invasive. The VAS scores and ODI were improved post-operatively compared with pre-operatively. Significant changes in the interspinous distance, disc space height, foraminal width and height and segmental lordosis were noted. In-space treatment for degenerative lumbar disease is easy and safe, with good early effects. The in-space system provides an alternative treatment for lumbar degenerative disease.

Zhou D; Nong LM; DU R; Gao GM; Jiang YQ; Xu NW

2013-03-01

56

Effects of interspinous spacers on lumbar degenerative disease.  

Science.gov (United States)

The present study aimed to evaluate the early effects of interspinous spacers on lumbar degenerative disease. The clinical outcomes of 23 patients with lumbar degenerative disease, treated using interspinous spacer implantation alone or combined with posterior lumbar fusion, were retrospectively studied and assessed with a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Pre-operative and post-operative interspinous distance, disc space height, foraminal width and height and segmental lordosis were determined. The early effects and complications associated with the interspinous spacers were recorded. The surgical procedures performed with the in-space treatment were easy and minimally invasive. The VAS scores and ODI were improved post-operatively compared with pre-operatively. Significant changes in the interspinous distance, disc space height, foraminal width and height and segmental lordosis were noted. In-space treatment for degenerative lumbar disease is easy and safe, with good early effects. The in-space system provides an alternative treatment for lumbar degenerative disease. PMID:23407682

Zhou, Dong; Nong, Lu-Ming; DU, Rui; Gao, Gong-Ming; Jiang, Yu-Qing; Xu, Nan-Wei

2013-01-15

57

Sulfato de condroitina e hialuronato de sódio no tratamento da doença articular degenerativa experimental em cães: aspectos clínicos e radiológicos Chondroitin sulfate and sodium hialuronate in treatment of the degenerative joint disease in dogs: clinical and radiological aspects  

Directory of Open Access Journals (Sweden)

Full Text Available Avaliaram-se clínica e radiograficamente os efeitos do sulfato de condroitina e do hialuronato de sódio no tratamento da articulação femorotibiopatelar de cães com doença articular degenerativa (DAD) induzida experimentalmente. Foram utilizados 15 cães, sem raça definida, de ambos os sexos, pesando entre 18 e 25 kg, submetidos à secção artroscópica do ligamento cruzado cranial (LCCr) para desestabilização articular e indução da DAD. Após três semanas de instabilidade articular, o LCCr foi substituído utilizando-se a técnica intra-articular com emprego da fáscia lata. Os animais foram divididos em três grupos de cinco. Nos do grupo I fez-se somente a substituição do LCCr. Os do grupo II receberam 24mg/animal de sulfato de condroitina, via IM, de cinco em cinco dias, totalizando seis aplicações. Os do grupo III foram tratados com hialuronato de sódio na dose de 20mg/animal, via IV, de cinco em cinco dias, num total de três aplicações. Os animais foram observados por 90 dias, e avaliados clinicamente quanto à claudicação, à capacidade de suportar peso no membro afetado, à mensuração da atrofia muscular e à amplitude de movimento articular. Ao final, foram encaminhados para novo exame radiográfico. Os resultados demonstraram que os animais que receberam hialuronato de sódio apresentaram menor grau de claudicação quando comparados com os demais. Ao exame radiográfico observaram-se osteofitose periarticular e esclerose óssea subcondral. Essas alterações foram evidenciadas de forma mais acentuada nos animais tratados com hialuronato de sódio. Clinicamente, pôde-se observar melhor resultado com o hialuronato de sódio do que nos demais grupos, possivelmente devido à sua maior ação na membrana sinovial, reduzindo a dor e o grau de claudicação. O exame radiográfico não foi compatível com a sintomatologia clínica nos cães tratados com hialuronato de sódio.The aim of this study was the evaluation of the effects of chondroitin sulfate and sodium hyaluronate in the knee joint of dogs with experimentally induced degenerative joint disease (DJD). Fifteen mongrel dogs, weighing 18 to 25kg were used. DJD was induced by cranial cruciate ligament (CCL) arthroscopical transection. After three weeks, CCL was repaired by an intrarticular technique, which uses fascia lata. The dogs were then divided into three groups as follows: group I received no other treatment, but the CCL reconstitution, group II received 24mg/animal of chondroitin sulfate/IM every five days, totaling six injections, and group III received 20mg/animal of sodium hyaluronate /IV every five days, totaling three injections. All dogs were examined clinically and radiographically for 90 days after the repairment surgery. The clinical evaluation was performed by assessment of lameness, weight-bearing, limb muscle atrophy and range of motion. The results demonstrated that the group treated with sodium hyaluronate had lower degree of lameness in comparison with other groups. The radiographic evaluation showed marginal osteophytes and subchondral bone sclerosis. These changes were more severe in the group treated with sodium hyaluronate. The better clinical results observed in this group, compared with the others, was probably due to the greater action of the drug in the synovium, decreasing the pain and lameness. Radiographic findings correlated poorly with the clinical signs in the group treated with sodium hyaluronate.

E.G. Melo; C.M.F. Rezende; M.G. Gomes; P.M. Freitas; S.A. Arias S.

2003-01-01

58

Degenerative disease in lumbar spine of military parachuting instructors.  

UK PubMed Central (United Kingdom)

Parachuting, be it static line or skydiving, places enormous stresses on the human spine. It is, therefore, important to determine the prevalence and severity of degenerative changes in the lumbar spine of subjects who practice this sport activity. Seventy four parachuting instructors, mean age 33 years and with an average of 410 static line and skydiving jumps, were included in the study. Past radiographs were examined and compared to current anterolateral and lateral views of the lumbar spine, in order to determine the prevalence of degenerative changes and document possible progression. Doubtful radiographic changes in the lumbar spine were identified in 47.4 percent of the parachuting instructors, mild degeneration in 9.6 percent, moderate degenerative disease in 10.9 percent and severe radiographic changes in 5.5 percent. Schmorll nodes were found in 8.1 percent of the subjects. Traction spurs--osteophytes were identified in 6.8 percent. The degenerative changes correlated with age and the number of jumps. Spondylolysis of L5-S1 and L3-L4 segments were observed in 12.2 and 1.4 percent respectively. Progressive spondylolisthesis was found in 2 subjects. No correlation was found between the severity of radiographic changes and either the prevalence and the severity of low back pain. The present findings provide a rational for considering repeated sheer stress as an etiology of degenerative changes in the spinal cord, and as a possible contributing factor to the pathogenesis of spondylolysis. Further study has to be done comparing parachuting instructors to a non-parachuting group, or equivalent physically active individuals, in order to assess the effect of sport-background on the development of degenerative changes.

Bar-Dayan Y; Weisbort M; Bar-Dayan Y; Velan GJ; Ravid M; Hendel D; Shemer J

2003-12-01

59

CALCITONIN PRODUCTS AND THERAPIES FOR TREATING INFLAMMATORY OR DEGENERATIVE DISEASES  

UK PubMed Central (United Kingdom)

Calcitonin products and therapies for treating inflammatory or degenerative diseases are disclosed herein. The pharmaceutical compositions disclosed herein include a first therapeutic agent that is calcitonin, in free or salt form a second therapeutic agent selected from the group consisting of a protease inhibitor, an antibiotic, a non-steroidal anti-inflammatory agent, a COX-2 inhibitor and a steroidal anti-inflammatory agent other than glucocorticoid and a pharmaceutically acceptable excipient, carrier or diluent. The methods disclosed herein for treating inflammatory or degenerative diseases in a subject include administering a therapeutically effective amount of calcitonin, in free or salt form, to the subject and co-administering, as part of a combination therapy, a therapeutically effective amount of a second therapeutic agent selected from the group consisting of a protease inhibitor, an antibiotic, a non-steroidal anti-inflammatory agent, a COX-2 inhibitor and a steroidal anti-inflammatory agent other than glucocorticoid to the subject.

MEHTA NOZER M; GILLIGAN JAMES P

60

Localization of degenerative changes of the acromioclavicular joint: a cadaveric study.  

UK PubMed Central (United Kingdom)

PURPOSE: It has not been fully clarified yet how degenerative changes occur within the acromioclavicular (AC) joint, including their localizations. The aim of this study was to clarify the localization of degenerative changes in the AC joint using cadaveric specimens. METHODS: Thirty-eight cadaveric AC joints with the sections were cut in the coronal plane. For both the acromion and the clavicle, the joint surface was divided into upper and lower halves. Histological features including the mean thickness of cartilage, reduction of proteoglycan staining and the extent of damaged tidemark were evaluated. The shapes of intraarticular discs as well as their histological structures were also assessed, which were compared between the upper and lower halves. RESULTS: Articular cartilage in the lower half was significantly thinner than that in the upper half for both the acromion and the clavicle (p < 0.01). Similarly, the lower half of cartilage was more degenerated than the upper half. Intraarticular discs were absent in nine joints and the meniscoid-like type in 29, which contained rich fibrocartilaginous tissues in the upper half, whereas it mainly consisted of the fibrous tissues with granulation in the lower half. CONCLUSION: The lower half of the AC joint demonstrated more advanced degeneration than the upper half, which might reflect the greater repetitive mechanical stress. The present study revealed both the localization and the extent of degenerative changes in AC joint, which might be useful information for surgeons to determine the proper amount of bony resection in the surgical treatment for osteoarthritis of this joint.

Hatta T; Sano H; Zuo J; Yamamoto N; Itoi E

2013-03-01

 
 
 
 
61

Comparación de los efectos de dos técnicas de electroanalgesia en la enfermedad articular degenerativa tarsometatarsiana del equino/ Comparison between the effects of two electroanalgesical technics in the tarsometatarsal degenerative joint disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se realizó una experiencia para comparar los resultados analgésicos entre TENS (cuyas siglas derivan de la expresión en inglés: transcutaneus electrical neuromuscular stimulation) y el EMAR (estimulación mecánica por acción refleja) de efectividad comprobada en medicina equina, sobre un modelo clínico de 10 equinos afectados por enfermedad articular degenerativa tarsometatarsiana con un protocolo diagnóstico estandarizado. Sobre la misma población se hicieron lo (more) s dos tratamientos con intervalos de 6 meses entre uno y otro comparándose luego los resultados. Las aplicaciones en cada tratamiento fueron diarias y el control clínico se realizó post-tratamientos cada dos días (5 controles totales) por los mismos tres profesionales para mantener el mismo esquema de evaluación, considerándose como parámetros: a- Trote en línea recta y en círculo, terreno blando y duro b­Flexión forzada c- Test del tarso (test de Churchill). Se realizó la prueba de Mc Nemar para comparar los grados de claudicación y respuestas a la flexión forzada, observados durante el 5to control, obtenidos luego de aplicar EMAR y TENS, y no se encontraron diferencias significativas entre ambos tratamientos (p=0,2568). También, se comparó el resultado del Test del Tarso (Test de Churchill) luego de aplicar EMAR y TENS, con la prueba de Mc Nemar, no encontrándose diferencias significativas entre ambos (p= 0,7055). Se determina que hay muy poca diferencia entre ambos tratamientos fisioterápicos, observándose una disminución importante a partir del control 2. De estos resultados podemos inferir que ambos métodos pueden utilizarse con éxito en forma indistinta, seleccionándolos de acuerdo con las ventajas y desventajas de su aplicación. Abstract in english A clinical model was designed in order to compare the analgesic effects of TENS (transcutaneous electrical neuromuscular stimulation) and RAME (reflex action mechanical electrostimulation), since both methods have been proven effective in equine medicine. The clinical model consisted of 10 horses with a standardized diagnostic protocol of tarsometatarsial degenerative joint disease; these were subjected to both treatments with an interval of 6 months, then results were co (more) mpared. Treatments were performed every day and the clinic evaluation every two days (five controls). The clinic parameters considered were: a- straight and circle trot, in hard and soft surface. b- Tarsus Flexion test c- Tarsus Test (Churchill test). McNemar's test was performed in order to compare lameness and forced flexion tests at 'control 5' stage, after applying TENS and RAME treatments; no significant differences were found between both treatments (p=0,2568). The Mc Nemar's test also used to compare tarsal flexion tests (Churchill's Test) after TENS and RAME treatments, showed no significant differences between Both (p=0,7055). It was therefore concluded that there is little difference between the two methods, while there is an important decrease as from 'control 2'. This situation lets us assume that both methods may be used indistinctly in an effective manner, choosing to use one or the other according to the advantages and disadvantages of its applications.

García Liñeiro, J.A.; Scipioni, H; Argibay Quiroga, M.T.; Petrone, N.; Pidal, G.; Roccatagliata, C.; Spina, J.; Vaccaro, M.

2006-12-01

62

Comparación de los efectos de dos técnicas de electroanalgesia en la enfermedad articular degenerativa tarsometatarsiana del equino Comparison between the effects of two electroanalgesical technics in the tarsometatarsal degenerative joint disease  

Directory of Open Access Journals (Sweden)

Full Text Available Se realizó una experiencia para comparar los resultados analgésicos entre TENS (cuyas siglas derivan de la expresión en inglés: transcutaneus electrical neuromuscular stimulation) y el EMAR (estimulación mecánica por acción refleja) de efectividad comprobada en medicina equina, sobre un modelo clínico de 10 equinos afectados por enfermedad articular degenerativa tarsometatarsiana con un protocolo diagnóstico estandarizado. Sobre la misma población se hicieron los dos tratamientos con intervalos de 6 meses entre uno y otro comparándose luego los resultados. Las aplicaciones en cada tratamiento fueron diarias y el control clínico se realizó post-tratamientos cada dos días (5 controles totales) por los mismos tres profesionales para mantener el mismo esquema de evaluación, considerándose como parámetros: a- Trote en línea recta y en círculo, terreno blando y duro b­Flexión forzada c- Test del tarso (test de Churchill). Se realizó la prueba de Mc Nemar para comparar los grados de claudicación y respuestas a la flexión forzada, observados durante el 5to control, obtenidos luego de aplicar EMAR y TENS, y no se encontraron diferencias significativas entre ambos tratamientos (p=0,2568). También, se comparó el resultado del Test del Tarso (Test de Churchill) luego de aplicar EMAR y TENS, con la prueba de Mc Nemar, no encontrándose diferencias significativas entre ambos (p= 0,7055). Se determina que hay muy poca diferencia entre ambos tratamientos fisioterápicos, observándose una disminución importante a partir del control 2. De estos resultados podemos inferir que ambos métodos pueden utilizarse con éxito en forma indistinta, seleccionándolos de acuerdo con las ventajas y desventajas de su aplicación.A clinical model was designed in order to compare the analgesic effects of TENS (transcutaneous electrical neuromuscular stimulation) and RAME (reflex action mechanical electrostimulation), since both methods have been proven effective in equine medicine. The clinical model consisted of 10 horses with a standardized diagnostic protocol of tarsometatarsial degenerative joint disease; these were subjected to both treatments with an interval of 6 months, then results were compared. Treatments were performed every day and the clinic evaluation every two days (five controls). The clinic parameters considered were: a- straight and circle trot, in hard and soft surface. b- Tarsus Flexion test c- Tarsus Test (Churchill test). McNemar's test was performed in order to compare lameness and forced flexion tests at 'control 5' stage, after applying TENS and RAME treatments; no significant differences were found between both treatments (p=0,2568). The Mc Nemar's test also used to compare tarsal flexion tests (Churchill's Test) after TENS and RAME treatments, showed no significant differences between Both (p=0,7055). It was therefore concluded that there is little difference between the two methods, while there is an important decrease as from 'control 2'. This situation lets us assume that both methods may be used indistinctly in an effective manner, choosing to use one or the other according to the advantages and disadvantages of its applications.

J.A. García Liñeiro; H Scipioni; M.T. Argibay Quiroga; N. Petrone; G. Pidal; C. Roccatagliata; J. Spina; M. Vaccaro

2006-01-01

63

Distal interphalangeal joint arthrodesis for degenerative osteoarthritis with compression screw: results in 102 digits.  

UK PubMed Central (United Kingdom)

PURPOSE: To assess objective and subjective outcomes of distal interphalangeal joint arthrodesis with a headless compression screw for degenerative osteoarthritis. METHODS: We retrospectively analyzed 102 cases of distal interphalangeal joint arthrodesis performed with headless compression screws on 59 patients. We included only primary cases of degenerative osteoarthritis with a minimum follow-up of 7 months. We identified appropriate bone coaptation and hardware positioning on postoperative radiographs in all digits. The mean follow-up period was 26 months (range, 7-67 mo). RESULTS: In 89 of 102 cases, patients were fully satisfied; in 9 cases, they were satisfied. Four complications occurred: 2 cases of prominent hardware, 1 complex regional pain syndrome type 1, and 1 symptomatic bony callus on the fused joint. Secondary surgery was required in each of these 4 cases. No nonunion, malunion, nail dystrophy, pseudarthrosis, or infection occurred. All arthrodeses healed. CONCLUSIONS: Distal interphalangeal joint arthrodesis with headless compression screws was shown to be safe and effective in cases of degenerative osteoarthritis, with a low complication rate.

Villani F; Uribe-Echevarria B; Vaienti L

2012-07-01

64

[Progress on dynamic neutralization system in treating lumbar degenerative diseases].  

Science.gov (United States)

Dynamic stabilization technology has increasingly become the hot spot in basic and clinical research for treating lumbar degenerative diseases. As one kind of dynamic stabilization technology,dynamic neutralization system (Dynesys) keeps the spinal motion ability and improve clinical symptoms of patients, moreover, it shows a certain advantage in delaying the degeneration of adjacent segments. From the available documents,the preliminary biomechanical and clinical results of Dynesys were optimistically, it has become another choice in treating the lumbar degenerative diseases besides the lumbar fusion, and it primarily applies to the treatment of mild to moderate lumbar degenerative disease. However, it lacks a mechanism to maintain and restore the lumbar lordosis and patients need active stretching to achieve lordosis. What's more, how to extend the service life and prevent complications remain to be solved, the long-term effect and the mechanism of delaying the adjacent segment degeneration need further investigation. In this article, the design principle, biomechanical research, clinical outcome and clinical application of Dynesys was reviewed. PMID:24015664

Chen, Xi-Jun; Fan, Shun-Wu

2013-06-01

65

[Progress on dynamic neutralization system in treating lumbar degenerative diseases].  

UK PubMed Central (United Kingdom)

Dynamic stabilization technology has increasingly become the hot spot in basic and clinical research for treating lumbar degenerative diseases. As one kind of dynamic stabilization technology,dynamic neutralization system (Dynesys) keeps the spinal motion ability and improve clinical symptoms of patients, moreover, it shows a certain advantage in delaying the degeneration of adjacent segments. From the available documents,the preliminary biomechanical and clinical results of Dynesys were optimistically, it has become another choice in treating the lumbar degenerative diseases besides the lumbar fusion, and it primarily applies to the treatment of mild to moderate lumbar degenerative disease. However, it lacks a mechanism to maintain and restore the lumbar lordosis and patients need active stretching to achieve lordosis. What's more, how to extend the service life and prevent complications remain to be solved, the long-term effect and the mechanism of delaying the adjacent segment degeneration need further investigation. In this article, the design principle, biomechanical research, clinical outcome and clinical application of Dynesys was reviewed.

Chen XJ; Fan SW

2013-06-01

66

Motion characteristics of the lumbar spinous processes with degenerative disc disease and degenerative spondylolisthesis.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Recently, interspinous process devices have attracted much attention since they can be implanted between the lumbar spinous processes (LSP) of patients with degenerative disc disease (DDD) and degenerative spondylolisthesis (DLS) using a minimally invasive manner. However, the motion characters of the LSP in the DLS and DDD patients have not been reported. This study is aimed at investigating the kinematics of the lumbar spinous processes in patients with DLS and DDD. METHODS: Ten patients with DDD at L4-S1 and ten patients with DLS at L4-L5 were studied. The positions of the vertebrae (L2-L5) at supine, standing, 45° trunk flexion, and maximal extension positions were determined using MRI-based models and dual fluoroscopic images. The shortest ISP distances were measured and compared with those of healthy subjects that have been previously reported. RESULTS: The shortest distance of the interspinous processes (ISP) gradually decreased from healthy subjects to DDD and to DLS patients when measured in the supine, standing, and extension positions. During supine-standing and flexion-extension activities, the changes in the shortest ISP distances in DDD patients were 2 ± 1.2 and 4.8 ± 2.1 mm at L4-L5; in DLS patients they were 0.5 ± 0.4 and 2.8 ± 1.7 mm at L4-L5, respectively. The range of motion is increased in DDD patients but decreased in DLS patients when compared with those of the healthy subjects. No significantly different changes were detected at L2-L3 and L3-L4 levels. CONCLUSION: At the involved level, the hypermobility of the LSP was seen in DDD and hypomobility of the LSP in DLS patients. The data may be instrumental for improving ISP surgeries that are aimed at reducing post-operative complications such as bony fracture and device dislocations.

Yao Q; Wang S; Shin JH; Li G; Wood K

2013-08-01

67

Neuro degenerative diseases: clinical concerns; Les maladies neuro-degeneratives: problemes cliniques  

Energy Technology Data Exchange (ETDEWEB)

Idiopathic Parkinson's disease (PD) and Alzheimer's disease (AD) are the main neuro-degenerative diseases (NDDs) seen clinically. They share some common clinical symptoms and neuro-pathological findings. The increase of life expectancy in the developed countries will inevitably contribute to enhance the prevalence of these diseases. Behavioral disorders, common in NDDs, will produce major care management challenges. Idiopathic Parkinson's disease corresponds to a histopathological diagnosis, based on the observation of a de-pigmentation and a neuronal loss in the substantia nigra, as well as on the presence of intra-neuronal inclusion bodies. AD is insidious with slowly progressive dementia in which the decline in memory constitutes the main complaint. The diagnosis of definite AD requires the presence of clinical criteria as well as the histopathological confirmation of brain lesions. The two main lesions are the presence of senile plaques and neuro-fibrillary tangles. Positron emission tomography (PET) explores cerebral metabolism and neurotransmitter kinetics in NDDs using principally [{sup 18}F]-deoxyglucose and [{sup 18}F]-dopa. Nigrostriatal dopaminergic function is altered in PD, as evidenced by the low uptake of [{sup 18}F]-dopa in the posterior putamen as compared to anterior putamen and caudate nucleus. In contrast, [{sup 18}F]-dopa uptake is equally depressed in all striatal structures in progressive supra-nuclear palsy. Regional glucose metabolism at rest is preserved in elderly once cerebral atrophy is taken into account. On the contrary, glucose metabolism is globally reduced in AD, with marked decrease in the parietal and temporal regions. PET has proved to be useful to study in vivo neurochemical processes in patients suffering from NDDs. The potential of this approach is still largely unexploited, and depends on new ligand production to establish early diagnosis and treatment follow-up. (author)

Ibanez, V. [Hopitaux Universitaires de Geneve (HUG), Unite de Neuroimagerie, Dept. de Psychiatrie (Switzerland)

2005-04-15

68

Durability of mitral valve repair for degenerative disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: Degenerative mitral valve disease is the most common cause of mitral regurgitation in the United States. Mitral valve repair is applicable in the majority of these patients and has become the procedure of choice. OBJECTIVE: This study was undertaken to identify factors influencing the durability of mitral valve repair. PATIENTS AND METHODS: Between 1985 and 1997, 1072 patients underwent primary isolated mitral valve repair for valvular regurgitation caused by degenerative disease. Repair durability was assessed by multivariable risk factor analysis of reoperation. It was supplemented by a search for valve-related risk factors for death before reoperation. Three hospital deaths occurred (0.3%); complete follow-up (4152 patient-years) was available in 1062 of 1069 hospital survivors (99.3%). RESULTS: At 10 years, freedom from reoperation was 93%. Among 30 patients who required reoperation for late mitral valve dysfunction, the repair failed in 16 (53%) as a result of progressive degenerative disease. Durability of repair was adversely affected by pathologic conditions other than posterior leaflet prolapse, use of chordal shortening, annuloplasty alone, and posterior leaflet resection without annuloplasty. Durability was greatest after quadrangular resection and annuloplasty for posterior leaflet prolapse and was enhanced by the use of intraoperative echocardiography. Death before reoperation was increased in patients having isolated anterior leaflet prolapse or valvular calcification and by use of chordal shortening or annuloplasty alone. CONCLUSIONS: Repair durability is greatest in patients with isolated posterior leaflet prolapse who have posterior leaflet resection and annuloplasty. Chordal shortening, annuloplasty alone, and leaflet resection without annuloplasty jeopardize late results.

Gillinov AM; Cosgrove DM; Blackstone EH; Diaz R; Arnold JH; Lytle BW; Smedira NG; Sabik JF; McCarthy PM; Loop FD

1998-11-01

69

[Locomotive syndrome and frailty. Locomotive syndrome due to the underlying disease of degenerative arthritis].  

UK PubMed Central (United Kingdom)

Japan became a superaging society. We have been putting a new focus on locomotive syndrome and frailty. The prevention and treatment of locomotive syndromes, such as osteoarthritis, degenerative spondylosis, lumbar canal stenosis, osteoporosis, upper extremity diseases, rheumatoid arthritis, and many other disorders of the locomotive organs are important. Because, the locomotive syndrome results in deterioration of the exercise function and loss of mental and physical health. The aim of locomotive syndrome exercises are: to reduce pain, to restore and improve joint function. We need to take a comprehensive approach to locomotive syndrome, including lifestyle modification, muscle exercise, stretching and therapeutic exercise.

Chosa E

2012-04-01

70

[Inappropriate prescribing in older adults with chronic-degenerative disease].  

UK PubMed Central (United Kingdom)

Background: potentially inappropriate prescribing (IP) includes the use of drugs that represent greater risk than benefi t to the patient, the STOPP-START instrument, allows its detection, the aim was to evaluate its utility. Methods: a descriptive cross-sectional study was performed. Randomly selecting records of older adults with at least one chronic degenerative disease, as last query had more than two months and have completed their monthly meeting at least four citations in the last 6 months were analyzed. Results: the files from 285 patients were reviewed, females were 60 %, and the mean age was 74 ± 6 years. A total of 1749 prescriptions included 126 different drugs. The prevalence of inappropriate prescribing was 55 % (95 % CI = 49-61) and 87 % polypharmacy (95 % CI = 83-91). The cardiovascular, endocrine and skeletal muscle system diseases had the highest number of prescriptions and inappropriate prescribing. It was detected the omission of one or more drugs listed in 72 % of 75 % specific clinical circumstances. Conclusions: the STOPP-START instrument is useful for detecting inappropriate prescribing. Also, the omission of indicated preventive treatments required for older adults with chronic degenerative diseases.

Luna-Medina MA; Peralta-Pedrero ML; Pineda-Aquino V; Durán-Fernández YC; Avalos-Mejía A; Aguirre-García Mdel C

2013-03-01

71

Outer retinal tubulation in inherited retinal degenerative disease.  

UK PubMed Central (United Kingdom)

PURPOSE: To investigate the prevalence and characteristics of outer retinal tubulation (ORT) seen in inherited retinal degenerative diseases. METHODS: A total of 354 eyes of 177 patients were examined with spectral domain optical coherence tomography. One hundred and twelve patients had retinitis pigmentosa, 58 patients had cone dystrophy, and 7 patients had the Bietti crystalline dystrophy. The images obtained by horizontal and vertical scans were analyzed to explore the possible presence of ORT, estimate their prevalence, morphologic character, and their location in the retinal layers. RESULTS: With spectral domain optical coherence tomography, ORT was identified in 0 of 112 patients with retinitis pigmentosa, unilaterally in 3 of 58 patients with cone dystrophy, and bilaterally in 5 of 7 patients with the Bietti crystalline dystrophy. Outer retinal tubulation was detected under the fovea, and in the outer nuclear layer, ORT was detected in the Bietti crystalline dystrophy with a significantly higher frequency than in cone dystrophy (P < 0.001). CONCLUSION: There was a higher rate of ORT in the Bietti crystalline dystrophy among inherited retinal degenerative diseases.

Iriyama A; Aihara Y; Yanagi Y

2013-07-01

72

Sporadic Inclusion Body Myositis: Inflammatory and Degenerative Disease Mechanisms Die sporadische Inclusion body myositis: entzündliche und degenerative Mechanismen  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Sporadic inclusion body myositis (sIBM) is an enigmatic disease resistant to immunomodulatory treatment and featuring autoimmune and degenerative aspects: clonally expanded CD8+ T cells focally infiltrate uniformly HLA-I+ myofibers that harbor beta-amyloid deposits. In a non-hypothesis-driven approa...

Ivanidze, Jana

73

Instability and Degenerative Arthritis of the Sternoclavicular Joint: A Current Concepts Review.  

UK PubMed Central (United Kingdom)

BACKGROUND:Injuries to the sternoclavicular (SC) joint typically occur with high-energy mechanisms such as those obtained in automobile accidents or contact sports. Many disorders of the SC joint can be treated nonoperatively. However, surgical treatment may be indicated for locked posterior dislocations; symptomatic, chronic instability; or persistent, painful osteoarthritis that fails nonoperative therapy. PURPOSE:To provide an updated review on the current diagnosis and management of instability and degenerative arthritis of the SC joint. STUDY DESIGN:Current concepts review. METHODS:A preliminary PubMed database search using the terms sternoclavicular instability, dislocation, arthritis, resection, and stabilization was performed in August 2012. All anatomic and biomechanical studies, review articles, case reports, case series, and technique papers that were relevant to the topic were included. RESULTS:The search identified 929 articles, 321 of which, after screening of the titles and abstracts, were considered potentially relevant to this study. Of the 321 articles, 30 were anatomic or imaging studies, 2 were biomechanical studies, 69 were review papers, 189 were case series or reports, and 31 were technique papers. The majority of these studies were classified as evidence level 4, with a few scattered level 3 studies. Because the level of evidence obtained from this search was not adequate for systematic review (or meta-analysis), a current concepts review of the diagnosis and management of SC joint instability and degenerative arthritis is presented. CONCLUSION:Injuries to the SC joint are uncommon. Recognition and classification of these injuries are critical to proper management, thus minimizing potential long-term sequelae such as posttraumatic arthritis and recurrent instability. Although nonoperative therapy is the modality of choice in anterior dislocations, posterior dislocations require special attention because of the presence of vulnerable posterior hilar structures. Surgical management of chronic instability and degenerative arthritis of the SC joint includes resection arthroplasty of the medial clavicle with or without reconstruction of the sternoclavicular ligaments with graft material. Although resection is typically performed open, an arthroscopic technique is described that theoretically decreases operating and recovery times while also decreasing the risk of iatrogenic injury. Currently, when reconstruction is needed for stability, a figure-of-8 graft reconstruction is the recommended method based on biomechanical data and small clinical series.

Martetschläger F; Warth RJ; Millett PJ

2013-08-01

74

Ecdysterone and its activity on some degenerative diseases.  

UK PubMed Central (United Kingdom)

Beside ecdysone (1), ecdysterone (2) is one of the most common 5beta-cholest-7-en-6-one (ecdysteroid) derivatives, which, besides having a hormonal effect on invertebrates, possesses a number of favorable non-hormonal biological effects on mammals. The most interesting of these is that on degenerative diseases, one of which, up to now not clarified in detail, is the so-called adaptogenic effect (protection of the organism against adverse stress factors) associated with anabolic, gastroprotective, and antioxidant effects. A second group of favorable effects is the possibility of suppression of neurodegenerative processes and protection of the cardiovascular system (metabolic syndrome symptom suppression, antidiabetic activity, and protection of heart and blood vessels). Because of these properties, ecdysterone has the potential to be developed as a medicinal agent.

Cahlíková L; Macáková K; Chlebek J; Host'álková A; Kulhánková A; Opletal L

2011-05-01

75

Ecdysterone and its activity on some degenerative diseases.  

Science.gov (United States)

Beside ecdysone (1), ecdysterone (2) is one of the most common 5beta-cholest-7-en-6-one (ecdysteroid) derivatives, which, besides having a hormonal effect on invertebrates, possesses a number of favorable non-hormonal biological effects on mammals. The most interesting of these is that on degenerative diseases, one of which, up to now not clarified in detail, is the so-called adaptogenic effect (protection of the organism against adverse stress factors) associated with anabolic, gastroprotective, and antioxidant effects. A second group of favorable effects is the possibility of suppression of neurodegenerative processes and protection of the cardiovascular system (metabolic syndrome symptom suppression, antidiabetic activity, and protection of heart and blood vessels). Because of these properties, ecdysterone has the potential to be developed as a medicinal agent. PMID:21615037

Cahlíková, Lucie; Macáková, Katerina; Chlebek, Jakub; Host'álková, Anna; Kulhánková, Andrea; Opletal, Lubomír

2011-05-01

76

Regenerative nanomedicine and the treatment of degenerative retinal diseases.  

UK PubMed Central (United Kingdom)

Regenerative medicine deals with the repair or the replacement of tissues and organs using advanced materials and methodologies. Regenerative nanomedicine uses nanoparticles containing gene transcription factors and other modulating molecules that allow reprogramming of cells in vivo as well as nanomaterials to induce selective differentiation of neural progenitor cells and to create neural-mechanical interfaces. In this article, we consider some applications of nanotechnology that may be useful for the treatment of degenerative retinal diseases, for example, use of nanoparticles for drug and gene therapy, use of nanomaterials for neural interfaces and extracellular matrix construction for cell-based therapy and neural prosthetics, and the use of bionanotechnology to re-engineer proteins and cell behavior for regenerative medicine.

Zarbin MA; Montemagno C; Leary JF; Ritch R

2012-01-01

77

Imaging techniques for diagnosis after surgery for degenerative disc disease  

International Nuclear Information System (INIS)

The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computer tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis. (orig.)

1993-01-01

78

Chinese medicinal composition for treating degenerative pathologic changes of knee joint  

UK PubMed Central (United Kingdom)

The invention discloses a Chinese traditional medicine preparation, in particular a Chinese traditional medicine composition for treating degenerative knee joint pathological process. The Chinese traditional medicine composition for treating the degenerative knee joint pathological process is characterized by consisting of the following raw materials in portion by weight: 0.5 to 1 portion of prepared nux vomica, 3 to 5 portions of herba epimedii, 3 to 5 portions of radix salviae miltiorrhizae, 2 to 4 portions of frankincense, 2 to 4 portions of myrrh, 3 to 5 portions of buck grass, 2 to 4 portions of radix paeoniae rubra, 2 to 4 portions of processed acontum fischeri, 2 to 4 portions of processed radix aconiti, 2 to 4 portions of processed radix aconiti kusnezoffii, 3 to 5 portions of radix clematidis, 3 to 5 portions of Chinese mugwort leaves, 2 to 3 portions of herba asaricum radice, 3 to 5 portions of chaff flower root, and 3 to 5 portions of balsamine. The Chinese traditional medicine composition does not contain any hormone and chemical medicaments, does not have any toxic side effects at all, and has the advantages of simple preparation, remarkable curative effect, and convenient popularization and application.

XINHUA CHEN; SUJUAN HOU

79

Lumbar facet joint effusion in MRI: a sign of instability in degenerative spondylolisthesis?  

UK PubMed Central (United Kingdom)

PURPOSE: The term "segmental instability" of the lumbar spine is not clearly defined, especially as it relates to degenerative spondylolisthesis (DS) and rotational translation (RT). We investigated whether facet joint effusion on conventional supine MRI indicated increased abnormal motion in DS and RT. METHODS: 160 patients (119 female, 41 male, mean age 68.8 years, range 38.8-89.3 years) who had undergone decompression only or decompression with instrumented fusion for degenerative spondylolisthesis with different degrees of narrowing of the spinal canal were identified retrospectively from our spine surgery database. All had preoperative upright X-rays in AP and lateral views as well as supine MRI. The imaging studies were assessed for the following parameters: percent of slippage, absolute value of facet joint effusion, facet angles, degree of facet degeneration and spinal canal central narrowing, disc height, presence of facet cysts and the presence of rotational translation in the AP X-ray. RESULTS: 40/160 patients showed no facet joint effusion, and in these the difference in the values for the % slip on upright X-ray and % slip on supine MRI was ?3%. A further 12 patients also showed a difference ?3%, but had some fluid in the joints (0.44 ± 0.38 mm). In 108 patients, the difference in the % slip measured on X-ray and on MRI was >3% (mean 10.6%, range 4-29%) and was associated with a mean facet effusion size of 2.15 ± 0.85 mm. The extent of effusion correlated significantly with the relative slippage difference between standing and supine positions (r = 0.64, p < 0.001), and the extent of the left/right difference in effusion was associated with the presence of rotational translation (RT 1.31 ± 0.8 mm vs. no-RT 0.23 ± 0.17 mm, p < 0.0001). CONCLUSIONS: Facet joint effusion is clearly correlated with spontaneous reduction of the extent of slippage in the supine position compared to the upright position. Also, the greater the difference in right and left facet effusion, the higher the likelihood of having a RT. Future studies should assess whether analysis of facet joint effusion measured on routine MRI can help in decision-making regarding the optimal surgical treatment to be applied (decompression alone or combined with fusion).

Lattig F; Fekete TF; Grob D; Kleinstück FS; Jeszenszky D; Mannion AF

2012-02-01

80

Alternative Medicine and Molecular Mechanisms in Chronic Degenerative Diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Knowledge of healing plants worldwide properties it has been extensively studied by their biological activities. The increasing number of plant users for healthcare originated the Research Center in Complementary Alternative Medicine, National Institute of Health (NIH) whose primary function is to be alert with a strictly scientific sense about de use of plants as main source of Complementary Alternative Medicine. It is currently about the synergy known that Is achieved on the hepatoprotective, antioxidant and hypoglycaemic activities with mixtures formed by selected plants and combined. These plants are characterized by their content of hidroxyphenolic compounds as cynarin, rosmarinic acid, flavonoids silybin and among others. Actually this kind of herbal preparations are investigated in patients with cirrhosis, type II diabetes mellitus, breast cancer and arthritis diseases. Patients with Chronic Degenerative Diseases are in state of stress and Its metabolism produces free radicals such as superoxide ºO2, hydroxyl ºOH and peroxynitrite highly reactive with unsaturated fatty acids of cell membranes producing lipid peroxidation. The main product of this process is the peroxyl, that when it’s reduced forms hydroxiperoxyle its decomposition forms MDA and 4-hidroxialquenal. These substances bind to R-SH2 of the aminoacids of the proteins and to the thymine of DNA, altering their biological function. Before the treatments with selected and micropulverized plants to patients, it is necessary and required in animal models demonstrate that plants do not produce toxic effects. Using mixtures of plants micropulverized is good choice because these microparticles behave as micro-releasing their constituents with increased activity and bioavailability to target cells so it will be possible to achieve greater power to control their activity and perhaps cure the disease, and provide patients an effective herbal medicine safe, free of toxic effects and low cost.

Alma Lorena López Velazquez; María de la Luz Miranda Beltrán; Arturo Panduro; Luis Huacuja Ruiz

2011-01-01

 
 
 
 
81

Cell-based therapies for retinal degenerative diseases: a thousand strategies.  

UK PubMed Central (United Kingdom)

Retinal neuronal death causes a severe and irreversible loss of visual function in the patients of retinitis pigmentosa, age-related macular degeneration and glaucoma, but these degenerative diseases currently still lack effective medical treatments. The restorative properties of stem cells hold the promise in the treatment of these retinal degenerative diseases. The exciting progress has been made on stem cell research in the last decade. Many different stem cell types have been explored for their potential in treating the retinal degenerative diseases, including embryonic stem cells, induced pluripotent stem cells, mesenchymal stem cells and retinal stem cells. This review will summarize the recent progress in this exciting area.

Lewallen M; Xie T

2013-06-01

82

Cell-based therapies for retinal degenerative diseases: a thousand strategies.  

Science.gov (United States)

Retinal neuronal death causes a severe and irreversible loss of visual function in the patients of retinitis pigmentosa, age-related macular degeneration and glaucoma, but these degenerative diseases currently still lack effective medical treatments. The restorative properties of stem cells hold the promise in the treatment of these retinal degenerative diseases. The exciting progress has been made on stem cell research in the last decade. Many different stem cell types have been explored for their potential in treating the retinal degenerative diseases, including embryonic stem cells, induced pluripotent stem cells, mesenchymal stem cells and retinal stem cells. This review will summarize the recent progress in this exciting area. PMID:23733127

Lewallen, Michelle; Xie, Ting

83

Frying process in the relation fat/degenerative diseases.  

Directory of Open Access Journals (Sweden)

Full Text Available Among the various components of the diet, fat receives very dose attention because of its relationship to several chronic degenerative diseases (CDD). Currently most of the available information on these relationships is derived from epidemiologic or experimental studies in which lipid intake is calculated using food composition tables. In most of these tables the quoted lipid content is that of raw food, whereas most foods are usually consumed only after being subjected to several culinary processes. Often there is no indication of the type of fat used in food processing in general or in frying in particular. But as it known, in the course of these processes the lipid content undergoes important qualitative and quantitative changes and not keeping them in mind may be the underlying cause of the difficulties an the confounding results in studies trying to establish the relationship between lipid intake an health. In the Mediterranean diet, about 50% of total dietary fat is derived not from the food itself but from the cooking fat, of which only a small fraction is eaten raw (as dressings) and the greatest proportion is used in thermal culinary processes, mainly deep-frying. The scientific study of the process whereby fat penetrates into fried foods has shown the benefits of this cooking method. If the process is correctly carried out, the amount of fat ingested with fried foodstuffs is not greater than when other procedures involving fat are used (for example, sautening, stewing or canning in oil). Very schematically deep-frying is a technique that replaces a fraction of the water content of food by cooking fat. Consecuently, the fat composition of the fried lean foods will be the same as that cooking fat. The process is more complex with fatty foods, and there are not great changes in the total quantity of fat in the fried food before and after frying. However, there are notable quality changes and these depend on the concentration gradients between frying oil and food. In deep-frying the cooking fat is usually used more than once, and there comes a moment when one considers subjectively that the oil is not longer suitable for frying and is discarded. This can be of practical significance for the total lipid intake, since a not determined quantity of oil is discarded and is not ingested. Consecuently the theoretical lipid intake has been decreased and, at the same time, some compounds, included saturated fats, are eliminated from diet whit the discarded oil. For example, the lipid composition of meats is substantially improved because of the highly favorable monounsaturated fatty acids penetration into them from the frying olive oil. In of the most important features is the possibility of manipulating fat intake by reducing it and improving the quality of the fat really consumed, this is of special interest in the possible relation to degenerative diseases. These changes in the fatty acids composition of oils and foods are repeatedly seen in laboratory experiments. However, their interpretation is not easy, in part because of the complexity of the deep-frying process used in the test. On the other hand, you would have to see the results obtained in the laboratory coincide with the results at practical level as well in the households as in catering, and, in this sense, some of the first results which we are obtaining in the population of Madrid are presented in the second part of this report.

Varela, G.; Ruiz-Rosso, B.

1998-01-01

84

Assessment of temporomandibular joint disease.  

UK PubMed Central (United Kingdom)

The diagnosis of temporomandibular joint (TMJ) disorders consists of clinical (Reaserch Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD) and additional (computer tomography, CT or magnetic resonance imaging, and MRI) examinations. Due to the growing knowledge of pathologic changes within the TMJ, the researches become more aware of the difficulty in detection the early symptoms of disorders using conventional examination. Therefore, it is now expected that the collected samples of synovial fluid, serum, or urine samples could enable easier identification of inflammatory process course, and degenerative cartilage changes state.

Kostrzewa-Janicka J; Mierzwinska-Nastalska E; Jurkowski P; Okonski P; Nedzi-Gora M

2013-01-01

85

Assessment of temporomandibular joint disease.  

Science.gov (United States)

The diagnosis of temporomandibular joint (TMJ) disorders consists of clinical (Reaserch Diagnostic Criteria for Temporomandibular Disorders, RDC/TMD) and additional (computer tomography, CT or magnetic resonance imaging, and MRI) examinations. Due to the growing knowledge of pathologic changes within the TMJ, the researches become more aware of the difficulty in detection the early symptoms of disorders using conventional examination. Therefore, it is now expected that the collected samples of synovial fluid, serum, or urine samples could enable easier identification of inflammatory process course, and degenerative cartilage changes state. PMID:23835980

Kostrzewa-Janicka, J; Mierzwinska-Nastalska, E; Jurkowski, P; Okonski, P; Nedzi-Gora, M

2013-01-01

86

Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle  

Energy Technology Data Exchange (ETDEWEB)

This paper summarizes the anatomical basics of the shoulder, their variations, and precise definitions, including differential diagnoses. It also describes the characteristic degenerative changes caused by aging. A typical variation (7-15%) is the os acromiale, which forms the triangular epiphysis of the scapular spine. This abnormality must be differentiated from a fracture of the acromion or a pseudarthrosis. Because ossification of the acromion is complete after age 25, the os acromiale should be diagnosed only after this age. The shape of the acromion is a further important feature. In a recent anatomical study, the following frequencies of the Bigliani-types of the acromial shape were anatomically determined - type 1 (flat), 10.2% and type 2 (curved), 89.8%. Type 3 (hooked) was not observed, which indicates that this type is probably a misinterpretation of the so-called acromial spur. Minor dehiscences and perforations in the infraspinate or supraspinate fossa should not be confused with malignant osteolyses. The scapula has three ligaments of its own, (1) the coracoacromial ligament and its osseous fixations form an osteofibrous arch above the shoulder joint, which plays a part in impingement syndrome; (2) the superior transverse scapular ligament or its ossified correlate arches the scapular incisure and can cause a typical compression syndrome of the suprascapular nerve; (3) the inferior transverse scapular ligament is of no great clinical importance. Two intraarticular structures (glenoid labrum and tendon of the long bicipital head) must be mentioned. The glenoid labrum consists of dense connective tissue and surrounds the margin of the glenoid cavity. Two areas exhibit specialized conditions, cranial at the supraglenoid tubercle an intimate relationship exists to the tendon of the long bicipital head and in about 55% of cases, the labrum is stretched over the glenoid rim at the ventral side. At the area of the biceps-tendon-labrum complex, so-called SLAP-lesions may occur and at the glenoid rim, where the labrum is often not fixed to the bony margin, avulsions of the labrum may occur. This well-established anatomical condition must not be mistaken for a manifest Bankart-lesion. The glenohumeral ligaments, which are located in the ventral articular capsule, have a stabilizing function for the ventral part of the glenoid labrum. The glenohumeral ligaments lift the articular lip where it crosses the glenoid notch. This 'labrum-lift effect' supports the stabilizing features of the articular lip and the glenohumeral ligaments. The rotator cuff is composed of the tendons of the teres minor, infraspinatus, supraspinatus, and subscapularis muscles. This cuff has a poorly vascularized area, due to mechanical conditions, about 1.5 cm from the major tubercle, which causes degenerative changes and eventually may lead to ruptures. Results of the impingement-syndrome and the osteoarthrotic changes of the shoulder and acromioclavicular joint are also presented and discussed. Finally, the coracoclavicular joint, which probably represents no congenital entity but appears due to a changed, lowered position of the shoulder girdle, is discussed. The paper also presents instructive figures of anatomical preparations that can be used to make more precise radiological and differential diagnoses. All preparations were done by the author and are part of a series of more than 300 preparations of the shoulder joint and girdle.

Prescher, Andreas E-mail: dkeyserlingk@post.klinikum.rwth-aachen.de

2000-08-01

87

Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle  

International Nuclear Information System (INIS)

[en] This paper summarizes the anatomical basics of the shoulder, their variations, and precise definitions, including differential diagnoses. It also describes the characteristic degenerative changes caused by aging. A typical variation (7-15%) is the os acromiale, which forms the triangular epiphysis of the scapular spine. This abnormality must be differentiated from a fracture of the acromion or a pseudarthrosis. Because ossification of the acromion is complete after age 25, the os acromiale should be diagnosed only after this age. The shape of the acromion is a further important feature. In a recent anatomical study, the following frequencies of the Bigliani-types of the acromial shape were anatomically determined - type 1 (flat), 10.2% and type 2 (curved), 89.8%. Type 3 (hooked) was not observed, which indicates that this type is probably a misinterpretation of the so-called acromial spur. Minor dehiscences and perforations in the infraspinate or supraspinate fossa should not be confused with malignant osteolyses. The scapula has three ligaments of its own, (1) the coracoacromial ligament and its osseous fixations form an osteofibrous arch above the shoulder joint, which plays a part in impingement syndrome; (2) the superior transverse scapular ligament or its ossified correlate arches the scapular incisure and can cause a typical compression syndrome of the suprascapular nerve; (3) the inferior transverse scapular ligament is of no great clinical importance. Two intraarticular structures (glenoid labrum and tendon of the long bicipital head) must be mentioned. The glenoid labrum consists of dense connective tissue and surrounds the margin of the glenoid cavity. Two areas exhibit specialized conditions, cranial at the supraglenoid tubercle an intimate relationship exists to the tendon of the long bicipital head and in about 55% of cases, the labrum is stretched over the glenoid rim at the ventral side. At the area of the biceps-tendon-labrum complex, so-called SLAP-lesions may occur and at the glenoid rim, where the labrum is often not fixed to the bony margin, avulsions of the labrum may occur. This well-established anatomical condition must not be mistaken for a manifest Bankart-lesion. The glenohumeral ligaments, which are located in the ventral articular capsule, have a stabilizing function for the ventral part of the glenoid labrum. The glenohumeral ligaments lift the articular lip where it crosses the glenoid notch. This 'labrum-lift effect' supports the stabilizing features of the articular lip and the glenohumeral ligaments. The rotator cuff is composed of the tendons of the teres minor, infraspinatus, supraspinatus, and subscapularis muscles. This cuff has a poorly vascularized area, due to mechanical conditions, about 1.5 cm from the major tubercle, which causes degenerative changes and eventually may lead to ruptures. Results of the impingement-syndrome and the osteoarthrotic changes of the shoulder and acromioclavicular joint are also presented and discussed. Finally, the coracoclavicular joint, which probably represents no congenital entity but appears due to a changed, lowered position of the shoulder girdle, is discussed. The paper also presents instructive figures of anatomical preparations that can be used to make more precise radiological and differential diagnoses. All preparations were done by the author and are part of a series of more than 300 preparations of the shoulder joint and girdle

2000-01-01

88

Use of autologous conditioned serum (Orthokine(R)) for the treatment of the dege-nerative osteoarthritis of the temporomandibular joint. Review of the literature  

Science.gov (United States)

Objectives: Treatment of osteoarthritis (OA) using autologous conditioned serum (ACS) has become in recent years an alternative to consider in the approach of the degenerative joint disease of the knee. There is no support in the literature for the use of ACS for the treatment of OA of the temporomandibular joint (TMJ), although the promising results obtained in human patients with knee joint disease as well as in animal studies are opening the way for its use at the TMJ. The aim of this paper is to conduct a review of the published literature regarding the use of the ACS for the treatment of OA in humans, considering the level of scientific evidence, and following the principles of the evidence-based medicine and dentistry. Material and Methods: A PubMed-MEDLINE search was carried out of articles published between 1980 and 2011. After an initial search, a total of 102 articles were obtained, followed by a selection of the most relevant articles according to the topic; a total of 8 articles were selected, which were stratified according to their level of scientific evidence using SORT criteria (Strength of Recommendation Taxonomy). Results: At the time of this review, there is no available literature referring the use of ACS at the TMJ. However, the use of the ACS in other joints is well documented, both experimentally and clinically, in humans and animals. The reviewed articles, with a level of evidence 1 and 2 according to the SORT criteria, have generally promising results. Discussion and Conclusions: The use of ACS in the treatment of OA in joints other than the TMJ, is endorsed by the level of evidence found in the literature, which opens the door to future studies to determine the feasibility of the use of the ACS in the treatment of degenerative OA that affects TMJ. Key words:Osteoarthritis, temporomandibular joint, autologous conditioned serum.

Alvarez-Camino, Juan C.; Vazquez-Delgado, Eduardo

2013-01-01

89

Analysis of postmarket complaints database for the iFuse SI Joint Fusion System(R): a minimally invasive treatment for degenerative sacroiliitis and sacroiliac joint disruption  

Science.gov (United States)

Background The sacroiliac joint is a common but under-recognized source of low back and gluteal pain. Patients with degenerative sacroiliitis or sacroiliac joint disruption resistant to nonsurgical treatments may undergo open surgery with sacroiliac joint arthrodesis, although outcomes are mixed and risks are significant. Minimally invasive sacroiliac joint arthrodesis was developed to minimize the risk of iatrogenic injury and to improve patient outcomes compared with open surgery. Methods Between April 2009 and January 2013, 5319 patients were treated with the iFuse SI Joint Fusion System® for conditions including sacroiliac joint disruption and degenerative sacroiliitis. A database was prospectively developed to record all complaints reported to the manufacturer in patients treated with the iFuse device. Complaints were collected through spontaneous reporting mechanisms in support of ongoing mandatory postmarket surveillance efforts. Results Complaints were reported in 204 (3.8%) patients treated with the iFuse system. Pain was the most commonly reported clinical complaint (n = 119, 2.2%), with nerve impingement (n = 48, 0.9%) and recurrent sacroiliac joint pain (n = 43, 0.8%) most frequently cited. All other clinical complaints were rare (?0.2%). Ninety-six revision surgeries were performed in 94 (1.8%) patients at a median follow-up of four (range 0–30) months. Revisions were typically performed in the early postoperative period for treatment of a symptomatic malpositioned implant (n = 46, 0.9%) or to correct an improperly sized implant in an asymptomatic patient (n = 10, 0.2%). Revisions in the late postoperative period were performed to treat symptom recurrence (n = 34, 0.6%) or for continued pain of undetermined etiology (n = 6, 0.1%). Conclusion Analysis of a postmarket product complaints database demonstrates an overall low risk of complaints with the iFuse SI Joint Fusion System in patients with degenerative sacroiliitis or sacroiliac joint disruption.

Miller, Larry E; Reckling, W Carlton; Block, Jon E

2013-01-01

90

Analysis of postmarket complaints database for the iFuse SI Joint Fusion System®: a minimally invasive treatment for degenerative sacroiliitis and sacroiliac joint disruption.  

UK PubMed Central (United Kingdom)

BACKGROUND: The sacroiliac joint is a common but under-recognized source of low back and gluteal pain. Patients with degenerative sacroiliitis or sacroiliac joint disruption resistant to nonsurgical treatments may undergo open surgery with sacroiliac joint arthrodesis, although outcomes are mixed and risks are significant. Minimally invasive sacroiliac joint arthrodesis was developed to minimize the risk of iatrogenic injury and to improve patient outcomes compared with open surgery. METHODS: Between April 2009 and January 2013, 5319 patients were treated with the iFuse SI Joint Fusion System® for conditions including sacroiliac joint disruption and degenerative sacroiliitis. A database was prospectively developed to record all complaints reported to the manufacturer in patients treated with the iFuse device. Complaints were collected through spontaneous reporting mechanisms in support of ongoing mandatory postmarket surveillance efforts. RESULTS: Complaints were reported in 204 (3.8%) patients treated with the iFuse system. Pain was the most commonly reported clinical complaint (n = 119, 2.2%), with nerve impingement (n = 48, 0.9%) and recurrent sacroiliac joint pain (n = 43, 0.8%) most frequently cited. All other clinical complaints were rare (?0.2%). Ninety-six revision surgeries were performed in 94 (1.8%) patients at a median follow-up of four (range 0-30) months. Revisions were typically performed in the early postoperative period for treatment of a symptomatic malpositioned implant (n = 46, 0.9%) or to correct an improperly sized implant in an asymptomatic patient (n = 10, 0.2%). Revisions in the late postoperative period were performed to treat symptom recurrence (n = 34, 0.6%) or for continued pain of undetermined etiology (n = 6, 0.1%). CONCLUSION: Analysis of a postmarket product complaints database demonstrates an overall low risk of complaints with the iFuse SI Joint Fusion System in patients with degenerative sacroiliitis or sacroiliac joint disruption.

Miller LE; Reckling WC; Block JE

2013-01-01

91

Induced pluripotent stem cells for retinal degenerative diseases: a new perspective on the challenges.  

UK PubMed Central (United Kingdom)

Retinal degenerative diseases, including age-related macular degeneration and retinitis pigmentosa, are the prodominant causes of human blindness in the world; however, these diseases are difficult to treat. Currently, knowledge on the mechanisms of these diseases is still very limited and no radical drugs are available. Induced pluripotent stem (iPS) cells are an innovative technology that turns somatic cells into embryonic stem (ES)-like cells with pluripotent potential via the exogenous expression of several key genes. It can be used as an unlimited source for cell differentiation or tissue engineering, either of which is a promising therapy for human degenerative diseases. Induced pluripotent cells are both an unlimited source for retinal regeneration and an expectant tool for pharmaprojects and developmental or disease modelling. In this review, we try to summarize the advancement of iPS-based technologies and the potential utility for retinal degenerative diseases. We also discuss the challenges of using this technology in the retinology field.

Jin ZB; Okamoto S; Mandai M; Takahashi M

2009-12-01

92

Characterization of Degenerative Changes in the Temporomandibular Joint of the Bengal Tiger (Panthera tigris tigris) and Siberian Tiger (Panthera tigris altaica).  

Science.gov (United States)

The articulation of the temporomandibular joint (TMJ) is composed of the temporal bone dorsally, the mandibular condyle ventrally and a fibrous articular disc. The TMJ disc plays an essential role in distributing load between the two articular surfaces. Degeneration of the disc in the presence of joint pathology has been shown in man; however, TMJ pathology has not been documented previously in tigers (Panthera tigris). The mandibular condyle and TMJ disc of a Bengal tiger (P. tigris tigris) and a Siberian tiger (P. tigris altaica) were evaluated grossly and the TMJ disc was characterized biochemically and mechanically. Characterization of the TMJ disc verified region- and direction-dependent biochemical and mechanical properties, reflective of the functional demands on the joint. Degenerative joint disease was observed in both cases and this was more severe in the Siberian tiger. Simultaneous evaluation of joint pathology, biochemical composition and mechanical properties of the TMJ disc revealed a loss in functional properties (tensile anisotropy) of the disc as joint pathology advanced from moderate to severe. TMJ degeneration may compromise the ability of the animal to eat and thrive and may be a factor contributing to the endangered status of these species. PMID:23809909

Murphy, M K; Arzi, B; Vapniarsky-Arzi, N; Athanasiou, K A

2013-06-25

93

Sulfato de condroitina e hialuronato de sódio no tratamento da doença articular degenerativa em cães: estudo histológico da cartilagem articular e membrana sinovial Chondroitin sulfate and sodium hyaluronate in the treatment of the degenerative joint disease in dogs: histological features of articular cartilage and synovium  

Directory of Open Access Journals (Sweden)

Full Text Available Quinze cães, sem raça definida, de ambos os sexos, de peso entre 18 e 25kg, foram submetidos à secção artroscópica do ligamento cruzado cranial (LCCr) para indução da doença articular degenerativa (DAD). Após três semanas de instabilidade articular, o LCCr foi substituído pela fáscia lata segundo a técnica de Schwalder (1989) e os animais foram distribuídos em três grupos de cinco. Os animais do grupo I, controle, não receberam tratamento medicamentoso; os do grupo II, 24mg/animal de sulfato de condroitina, por via IM, de cinco em cinco dias, totalizando seis aplicações; e os do grupo III foram tratados com hialuronato de sódio na dose de 20mg/animal, por via IV, de cinco em cinco dias num total de três administrações. Ao final de 90 dias, os animais foram eutanasiados e procedeu-se à colheita e ao processamento histológico da membrana sinovial e da cartilagem articular para avaliações morfológica e morfométrica. No grupo I foram observadas alterações degenerativas de DAD mais acentuadas que nos demais grupos, como redução do número de condrócitos, presença de pânus, fibrilações, fissuras, erosões e irregularidades na superfície articular. No grupo II observou-se elevação do número de condrócitos com aumento da atividade de síntese da matriz e redução das lesões na superfície da cartilagem. No grupo III houve aumento do número de condrócitos que eram, muitas vezes, morfologicamente inviáveis. Todos os grupos apresentaram proliferação da membrana sinovial e presença de infiltrado linfoplasmocitário na subíntima e na perivascular. Nos grupos I e III, a proliferação da membrana sinovial era exuberante com formação de pânus, presença de sinoviócitos achatados ou ausência de sinóvia com tecido de granulação. Os resultados sugerem que o sulfato de condroitina estimulou a cartilagem articular, diminuindo ou retardando as alterações da DAD e o hialuronato de sódio não interferiu no processo degenerativo da cartilagem articular. Não foi constatada ação favorável das drogas na membrana sinovial.Fifteen mongrel dogs, both genders, weighting from 18 to 25kg were used and Degenerative Joint Disease (DJD) was induced through cranial cruciate ligament (CCrL) artroscopical section. After three weeks, CCrL was reconstructed by Schawalder's (1989) technique. Then, dogs were distributed in three groups and the following protocols were used: group I, control, no other treatment but the CCrL reconstruction; group II received chondroitin sulfate 24mg per animal every five days, intramuscularly, in a total of six injections; and group III received sodium hyaluronate 20mg per animal every five days, intravenously, in a total of three injections. Clinical observation was done until 90 days after treatments. By that time, the articular cartilage and synovium were collected and their morphology was evaluated. In group I, the degenerative alterations of the DJD were the most intense. Thus, decrease of chondrocytes number, pannus, fibrillations, grooves, erosion, and irregular articular surface were observed on the cartilage. In group II, raise of chondrocytes number was observed, with increase of synthesis activity of matrix and decrease of lesions on the articular surface. There was an increase of chondrocytes in group III, but the cells were morphologically unviable. All the groups showed proliferation of the synovial membrane, with limpho-plasma cells infiltrated in subintim and perivascular. In groups I and III, the proliferation of synovium was abundant, with formation of pannus, flattened synoviocytes or synovium absent with granulation tissue. Those results suggest that the chondroitin sulfate stimulated the articular cartilage; decreasing or delaying the alterations of DJD, as well as, the sodium hyaluronate did not interfere on degenerative process in articular cartilage. No favorable action of these drugs in the synovial membrane was verified.

E.G. Melo; V.A. Nunes; C.M.F. Rezende; M.G. Gomes; C. Malm; V.A. Gheller

2008-01-01

94

Avaliação radiológica e artroscópica e histologia da membrana sinovial do joelho de cães tratados com associação de sulfato de condroitina e hialuronato de sódio, após doença articular degenerativa induzida experimentalmente Radiological, arthroscopical evaluation and synovial membrane histology of the knee of dogs treated with chondroitin sulphate- sodium hialuronate association after experimental degenerative joint disease  

Directory of Open Access Journals (Sweden)

Full Text Available O presente trabalho objetivou avaliar a associação de hialuronato de sódio e sulfato de condroitina no tratamento da doença articular degenerativa (DAD) em cães. Dez cães sem raça definida foram submetidos à secção artroscópica do ligamento cruzado cranial visando o desenvolvimento da DAD. Após 21 dias, foi substituído cirurgicamente o ligamento cruzado cranial em todos os animais e iniciado o tratamento com associação de hialuronato de sódio e sulfato de condroitina em cinco cães, sendo os remanescentes utilizados como grupo-controle. Avaliações artroscópica e radiológica do membro posterior esquerdo foram realizadas antes da secção do ligamento, no dia da sua substituição e 90 dias após a cirurgia. Histologicamente, o efeito da associação de hialuronato de sódio e sulfato de condroitina foi mais evidente na membrana sinovial, observando-se regeneração da camada íntima e diminuição da infiltração linfoplasmocitária na sub-íntima. Artroscópica e macroscopicamente não houve prevenção das lesões cartilaginosas decorrentes da DAD.The aim of this study was the assessment of hyaluronic acid and chondroitin sulphate association in the therapy of degenerative joint disease (DJD) in dogs. Ten mongrel dogs underwent arthroscopic section of cruciate cranial ligament aiming the development of DJD. Twenty one days after the procedure, surgical substitution of cruciate cranial ligament was carried out in all animals. Then five animals were treated with the combination of hyaluronic acid and chondroitin sulphate. The other five dogs were used as controls. Arthroscopical and radiological evaluations of the left fore limb were carried out before arthroscopic section at the some day and 90 days after cruciate cranial ligament substitution. Histologically the effect of the association of hyaluronic acid and chondroitin sulphate was more evident in the synovial membrane that had regeneration of the intimal layer and reduced lympho-plasmocitic infiltrate in the sub-intimal layer. However, the treatment did not prevent DJD cartilage lesions evaluated by arthroscopy and radiology.

S.A. Arias S.; C.M.F. Rezende; E.G. Melo; V.A. Nunes; J.C. Correa

2003-01-01

95

Avaliação radiológica e artroscópica e histologia da membrana sinovial do joelho de cães tratados com associação de sulfato de condroitina e hialuronato de sódio, após doença articular degenerativa induzida experimentalmente/ Radiological, arthroscopical evaluation and synovial membrane histology of the knee of dogs treated with chondroitin sulphate- sodium hialuronate association after experimental degenerative joint disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese O presente trabalho objetivou avaliar a associação de hialuronato de sódio e sulfato de condroitina no tratamento da doença articular degenerativa (DAD) em cães. Dez cães sem raça definida foram submetidos à secção artroscópica do ligamento cruzado cranial visando o desenvolvimento da DAD. Após 21 dias, foi substituído cirurgicamente o ligamento cruzado cranial em todos os animais e iniciado o tratamento com associação de hialuronato de sódio e sulfato de (more) condroitina em cinco cães, sendo os remanescentes utilizados como grupo-controle. Avaliações artroscópica e radiológica do membro posterior esquerdo foram realizadas antes da secção do ligamento, no dia da sua substituição e 90 dias após a cirurgia. Histologicamente, o efeito da associação de hialuronato de sódio e sulfato de condroitina foi mais evidente na membrana sinovial, observando-se regeneração da camada íntima e diminuição da infiltração linfoplasmocitária na sub-íntima. Artroscópica e macroscopicamente não houve prevenção das lesões cartilaginosas decorrentes da DAD. Abstract in english The aim of this study was the assessment of hyaluronic acid and chondroitin sulphate association in the therapy of degenerative joint disease (DJD) in dogs. Ten mongrel dogs underwent arthroscopic section of cruciate cranial ligament aiming the development of DJD. Twenty one days after the procedure, surgical substitution of cruciate cranial ligament was carried out in all animals. Then five animals were treated with the combination of hyaluronic acid and chondroitin sulp (more) hate. The other five dogs were used as controls. Arthroscopical and radiological evaluations of the left fore limb were carried out before arthroscopic section at the some day and 90 days after cruciate cranial ligament substitution. Histologically the effect of the association of hyaluronic acid and chondroitin sulphate was more evident in the synovial membrane that had regeneration of the intimal layer and reduced lympho-plasmocitic infiltrate in the sub-intimal layer. However, the treatment did not prevent DJD cartilage lesions evaluated by arthroscopy and radiology.

Arias S., S.A.; Rezende, C.M.F.; Melo, E.G.; Nunes, V.A.; Correa, J.C.

2003-08-01

96

Analysis of postmarket complaints database for the iFuse SI Joint Fusion System®: a minimally invasive treatment for degenerative sacroiliitis and sacroiliac joint disruption  

Directory of Open Access Journals (Sweden)

Full Text Available Larry E Miller,1,2 W Carlton Reckling,3 Jon E Block21Miller Scientific Consulting Inc, Arden, NC, 2The Jon Block Group, San Francisco, CA, 3SI-BONE Inc, San Jose, CA, USABackground: The sacroiliac joint is a common but under-recognized source of low back and gluteal pain. Patients with degenerative sacroiliitis or sacroiliac joint disruption resistant to nonsurgical treatments may undergo open surgery with sacroiliac joint arthrodesis, although outcomes are mixed and risks are significant. Minimally invasive sacroiliac joint arthrodesis was developed to minimize the risk of iatrogenic injury and to improve patient outcomes compared with open surgery.Methods: Between April 2009 and January 2013, 5319 patients were treated with the iFuse SI Joint Fusion System® for conditions including sacroiliac joint disruption and degenerative sacroiliitis. A database was prospectively developed to record all complaints reported to the manufacturer in patients treated with the iFuse device. Complaints were collected through spontaneous reporting mechanisms in support of ongoing mandatory postmarket surveillance efforts.Results: Complaints were reported in 204 (3.8%) patients treated with the iFuse system. Pain was the most commonly reported clinical complaint (n = 119, 2.2%), with nerve impingement (n = 48, 0.9%) and recurrent sacroiliac joint pain (n = 43, 0.8%) most frequently cited. All other clinical complaints were rare (?0.2%). Ninety-six revision surgeries were performed in 94 (1.8%) patients at a median follow-up of four (range 0–30) months. Revisions were typically performed in the early postoperative period for treatment of a symptomatic malpositioned implant (n = 46, 0.9%) or to correct an improperly sized implant in an asymptomatic patient (n = 10, 0.2%). Revisions in the late postoperative period were performed to treat symptom recurrence (n = 34, 0.6%) or for continued pain of undetermined etiology (n = 6, 0.1%).Conclusion: Analysis of a postmarket product complaints database demonstrates an overall low risk of complaints with the iFuse SI Joint Fusion System in patients with degenerative sacroiliitis or sacroiliac joint disruption.Keywords: arthrodesis, iFuse, lumbar, minimally invasive, sacroiliac

Miller LE; Reckling WC; Block JE

2013-01-01

97

MRI in degenerative diseases of the cervical spine. MRT bei degenerativen Halswirbelsaeulenerkrankungen  

Energy Technology Data Exchange (ETDEWEB)

MRI has grown increasingly important in recent years in diagnosis of degenerative diseases of the cervical spine, due to improvements of method that have made it a valuable diagnostic tool. The following contribution gives a brief introduction to the pathophysiology of degenerative changes in the cervical vertebral column and to the indications for MRI, describing within the framework of imaging the present state of MR examination technique. The ranking of the various gradient echo sequences, of the 3D methods and of the administration of contrast media in cervical myelopathy and radiaculopathy is discussed. (orig.)

Schubeus, P. (Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany)); Sander, B. (Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany)); Hosten, N. (Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany)); Mayer, H.M. (Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany)); Weber, U. (Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany)); Felix, R. (Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Berlin (Germany))

1994-01-01

98

A meta-analysis of artificial total disc replacement versus fusion for lumbar degenerative disc disease  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Lumbar fusion has been developed for several decades and became the standard surgical treatment for symptomatic lumbar degenerative disc disease (DDD). Artificial total disc replacement (TDR), as an alternative for spinal arthrodesis, is becoming more commonly employed treating lumbar DDD. It is sti...

Yajun, Wu; Yue, Zhu; Xiuxin, Han; Cui, Cui

99

Treatment of advanced CMC joint disease: trapeziectomy and implant arthroplasty (silastic-metal-synthetic allograft).  

Science.gov (United States)

Osteoarthritis of the basal joint of the thumb is a common and frequently debilitating condition, most often affecting middle-aged women. Nonoperative treatment with activity modification, splinting, oral anti-inflammatory medication, and intraarticular steroid injection frequently leads to acceptable control of symptoms. If nonoperative treatment fails, many surgical techniques have been described for management of symptomatic advanced degenerative joint changes. This article reviews the literature related to various arthroplasty options for advanced disease. Treatment decisions must clearly be tempered by the surgeon's experience, the patient's goals and expectations, and the extent of degenerative disease. PMID:18675719

Earp, Brandon E

2008-08-01

100

Subchondral bone grafting reduces degenerative change of knee joint in patients of giant cell tumor of bone.  

UK PubMed Central (United Kingdom)

BACKGROUND: Giant cell tumors (GCTs) most commonly occur around the knee. The most beneficial procedure for this disease has been extensive curettage with reconstruction. However, since many GCTs may compromise the subchondral bone, surgery can further jeopardize the articular cartilage and result in secondary osteoarthritis. In this study, we aimed to determine the factors associated with the development of degenerative arthritis and the effect of bone grafting on the prevention of secondary osteoarthritis. METHODS: We retrospectively analyzed 76 patients with GCT around the knee. The mean age at first diagnosis was 31.1 years. Surgical treatments included extensive curettage and cementation with or without bone grafting in the subchondral bone. Patient follow-up was a median duration of 35 months, ranging from 18 to 113 months. RESULTS: The local recurrence rate was 5.3% (4/76). Secondary degenerative changes occurred in 30.3% (23/76) of the patients. Less than 10 mm of the residual thickness of the remaining subchondral bone was correlated with secondary degenerative changes in 57 patients (P < 0.001). Of these 57 patients, 56.5% (13/23) treated with bone cement reconstruction alone developed secondary degenerative changes; following bone grafting, the rate decreased to 29.4% (10/34), with a statistically significant difference (P = 0.041). CONCLUSIONS: GCT patients with less residual thickness of the subchondral bone are more likely to develop degenerative arthritis after curettage. Bone grafting in the subchondral bone area is recommended when the residual thickness of the subchondral bone is less than 10 mm.

Xu HR; Niu XH; Zhang Q; Hao L; Ding Y; Li Y

2013-08-01

 
 
 
 
101

Effects of chondroitin sulfate and sodium hyaluronate on chondrocytes and extracellular matrix of articular cartilage in dogs with degenerative joint disease Efeitos do sulfato de condroitina e do hialuronato de sódio nos condrócitos e na matriz extracelular na cartilagem articular de cães com doença articular degenerativa  

Directory of Open Access Journals (Sweden)

Full Text Available Samples of articular cartilage of femur, tibia and patella of 15 dogs with experimentally induced degenerative joint disease (DJD) were microscopically analyzed. Animals were distributed into three groups (n=5): the control group received no medication; the second group was treated with chondroitin sulfate and the third received sodium hyaluronate. Samples were processed and stained with HE and toluidine blue for morphological evaluation. The metabolic and proliferative activity of the chondrocytes was evaluated by the measurement of nucleolar organizer regions (NORs) after impregnation by silver nitrate. Significant differences were not observed (P>0.05) in the morphology among the groups, however, the group treated with sodium hyaluronate had a higher score suggesting a trend to a greater severity of the lesions. Significant differences were not observed (P>0.05) in the measurement of NORs, cells and NORs/cells among the groups. Although differences were not significant, sodium hyaluronate group showed higher NOR and cell counts which suggested an increase of the proliferation rate of chondrocytes. In addition, a higher NOR/cell ratio in the group treated with chondroitin sulfate suggested that this drug may have stimulated the metabolic activity of the chondrocytes, minimizing the lesions resulting from DJD.Foram utilizadas amostras de cartilagem articular do fêmur, tíbia e patela de 15 cães com doença articular degenerativa (DAD), induzida experimentalmente. Foram constituídos três grupos de cinco animais: grupo 1 - controle, não medicado; grupo 2 - tratado com sulfato de condroitina e grupo 3 - tratado com hialuronato de sódio. As amostras foram processadas e coradas pelas técnicas de HE e de azul de toluidina para avaliação das alterações morfológicas, e impregnadas pelo nitrato de prata para análise da atividade metabólica e/ou proliferativa dos condrócitos, por meio da visualização e quantificação de regiões organizadoras do nucléolo (NORs). Não foram notadas diferenças significativas (P0,05) na contagem de NORs, células e NORs/célula entre os grupos. As maiores contagens de NORs e de células no grupo tratado com hialuronato de sódio sugeriram aumento da taxa de proliferação dos condrócitos. A maior relação de NORs/célula obtida no grupo tratado com sulfato de condroitina sugere que essa droga estimula a atividade metabólica do condrócito, minimizando as lesões ocorridas durante a DAD.

G. Gonçalves; E.G. Melo; M.G. Gomes; V.A. Nunes; C.M.F. Rezende

2008-01-01

102

PET studies in Alzheimer disease and other degenerative dementias  

Energy Technology Data Exchange (ETDEWEB)

Neurodegenerative disorders cause a variety of dementia including Alzheimer disease, frontotemporal dementia, dementia with Lewy bodies, corticobasal degeneration, progressive supranuclear palsy, and Huntington's disease. PET scan is useful for early detection and differential diagnosis of theses dementing disorders. Also, it provides valuable information about clinico-anatomical correlation, allowing better understanding of function of brain. Here we discuss recent achievements PET studies regarding these dementing disorders. Future progress in PET technology, new tracers, and image analysis will play an important role in further clarifying the disease pathophysiology and brain functions.

Jeong, Yong; Na, Duk L. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2003-02-01

103

PET studies in Alzheimer disease and other degenerative dementias  

International Nuclear Information System (INIS)

[en] Neurodegenerative disorders cause a variety of dementia including Alzheimer disease, frontotemporal dementia, dementia with Lewy bodies, corticobasal degeneration, progressive supranuclear palsy, and Huntington's disease. PET scan is useful for early detection and differential diagnosis of theses dementing disorders. Also, it provides valuable information about clinico-anatomical correlation, allowing better understanding of function of brain. Here we discuss recent achievements PET studies regarding these dementing disorders. Future progress in PET technology, new tracers, and image analysis will play an important role in further clarifying the disease pathophysiology and brain functions

2003-01-01

104

Lumbar spine degenerative disease : effect on bone mineral density measurements in the lumbar spine and femoral neck  

Energy Technology Data Exchange (ETDEWEB)

To determine the effect of degenerative disease of the lumbar spine on bone mineral density in the lumbar spine and femoral neck. We reviewed radiographs and dual energy x-ray absorptiometry scans of the lumbar spine and hip in 305 Caucasian women with suspected osteoporosis. One hundred and eight-six patient remained after excluding women less than 40 years of age (n=18) and those with hip osteoarthritis, scoliosis, lumbar spine fractures, lumbar spinal instrumentation, hip arthroplasty, metabolic bone disease other than osteoporosis, or medications known to influence bone metabolism (n=101). On the basis of lumbar spine radiographs, those with absent/mild degenerative disease were assigned to the control group and those with moderate/severe degenerative disease to the degenerative group. Spine radiographs were evaluated for degenerative disease by two radiologists working independently; discrepant evaluations were resolved by consensus. Lumbar spine and femoral neck bone mineral density was compared between the two groups. Forty-five (24%) of 186 women were assigned to the degenerative group and 141 (76%) to the control group. IN the degenerative group, mean bone mineral density measured 1.075g/cm? in the spine and 0.788g/cm{sup 2} in the femoral neck, while for controls the corresponding figures were 0.989g/cm{sup 2} and 0.765g/cm{sup 2}. Adjusted for age, weight and height by means of analysis of variance, degenerative disease of the lumbar spine was a significant predictor of increased bone mineral density in the spine (p=0.0001) and femoral neck (p=0.0287). Our results indicate a positive relationship between degenerative disease of the lumbar spine and bone mineral density in the lumbar spine and femoral neck, and suggest that degenerative disease in that region, which leads to an intrinsic increase in bone mineral density in the femoral neck, may be a good negative predictor of osteoporotic hip fractures.

Juhng, Seon Kwan [Wonkwang Univ. School of Medicine, Iksan (Korea, Republic of); Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon [Wake Forest Univ. School of Medicine, Winston-salem (United States)

2001-04-01

105

Induced pluripotent stem cells for retinal degenerative diseases: a new perspective on the challenges.  

Science.gov (United States)

Retinal degenerative diseases, including age-related macular degeneration and retinitis pigmentosa, are the prodominant causes of human blindness in the world; however, these diseases are difficult to treat. Currently, knowledge on the mechanisms of these diseases is still very limited and no radical drugs are available. Induced pluripotent stem (iPS) cells are an innovative technology that turns somatic cells into embryonic stem (ES)-like cells with pluripotent potential via the exogenous expression of several key genes. It can be used as an unlimited source for cell differentiation or tissue engineering, either of which is a promising therapy for human degenerative diseases. Induced pluripotent cells are both an unlimited source for retinal regeneration and an expectant tool for pharmaprojects and developmental or disease modelling. In this review, we try to summarize the advancement of iPS-based technologies and the potential utility for retinal degenerative diseases. We also discuss the challenges of using this technology in the retinology field. PMID:20090205

Jin, Zi-Bing; Okamoto, Satoshi; Mandai, Michiko; Takahashi, Masayo

2009-12-01

106

Gadolinium DTPA-enhanced MRI of degenerative cervical spine disease  

Energy Technology Data Exchange (ETDEWEB)

Thirty-two patients with 30 disc herniations and 5 bony stenoses were investigated together with 5 control subjects, using plain and contrast-enhanced Magnetic resonance imaging. Compared with the control group, additional non-enhancing epidural tissue was found in all patients. The enhancing epidural structures demonstrated characteristic changes. Compared with plain images, disease definition was improved in 7 of 35 cases after contrast administration. This was especially true for lateral and intraforaminal disc herniations, whereas no diagnostic benefit was seen in cases of posterior and posterolateral herniations or bony changes. (orig.)

Schubeus, P. [Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Schoerner, W. [Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Sander, B. [Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Heim, T. [Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Hosten, N. [Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany); Felix, R. [Strahlenklinik mit Poliklinik, Universitaetsklinikum Rudolf Virchow, Freie Univ. Berlin (Germany)

1992-12-01

107

Gadolinium DTPA-enhanced MRI of degenerative cervical spine disease  

International Nuclear Information System (INIS)

Thirty-two patients with 30 disc herniations and 5 bony stenoses were investigated together with 5 control subjects, using plain and contrast-enhanced Magnetic resonance imaging. Compared with the control group, additional non-enhancing epidural tissue was found in all patients. The enhancing epidural structures demonstrated characteristic changes. Compared with plain images, disease definition was improved in 7 of 35 cases after contrast administration. This was especially true for lateral and intraforaminal disc herniations, whereas no diagnostic benefit was seen in cases of posterior and posterolateral herniations or bony changes. (orig.).

1992-01-01

108

BACTERIAL COMPOSITIONS FOR PROPHYLAXIS AND TREATMENT OF DEGENERATIVE DISEASE  

UK PubMed Central (United Kingdom)

The disclosure provides an oral composition for reducing serum cholesterol, serum lipids, body fat, or atherogenic index or for prophylaxis or treatment of atherosclerosis, cardiovascular or cerebrovascular diseases, comprising a highly bsh active bacteria, isolate or supernatant thereof wherein the highly bsh active bacteria degrades >50[mu]mol glycodeoxycholic acid (GDCA)/gram/hour and >2[mu]mol taurodeoxycholic acid (TDCA)/gram/hour when measured over 1 hour and 5 hours, respectively, or degrades >65 [mu]mol GDCA/g/hr and >7 [mu]mol TDCA/g/hr when measured over 30 minutes.

PRAKASH SATYA; JONES MITCHELL LAWRENCE; MARTONI CHRISTOPHER

109

BACTERIAL COMPOSITIONS FOR PROPHYLAXIS AND TREATMENT OF DEGENERATIVE DISEASE  

UK PubMed Central (United Kingdom)

The disclosure provides an oral composition for reducing serum cholesterol, serum lipids, body fat, or atherogenic index or for prophylaxis or treatment of atherosclerosis, cardiovascular or cerebrovascular diseases, comprising a highly bsh active bacteria, isolate or supernatant thereof wherein the highly bsh active bacteria degrades >50 [mu]mol glycodeoxycholic acid (GDCA)/gram/hour and >2 [mu]mol taurodeoxycholic acid (TDCA)/gram/hour when measured over 1 hour and 5 hours, respectively, or degrades >65 [mu]mol GDCA/g/hr and >7 [mu]mol TDCA/g/hr when measured over 30 minutes.

PRAKASH SATYA; JONES MITCHELL LAWRENCE; MARTONI CHRISTOPHER

110

Bacterial compositions for prophylaxis and treatment of degenerative disease  

UK PubMed Central (United Kingdom)

The disclosure provides an oral composition for reducing serum cholesterol, serum lipids, body fat, or atherogenic index or for prophylaxis or treatment of atherosclerosis, cardiovascular or cerebrovascular diseases, comprising a highly active bacteria, isolate or supernatant thereof wherein the highly active bacteria degrades >50[mu]mol glycodeoxycholic acid (GDCA)/gram/hour and >2[mu]mol taurodeoxycholic acid (TDCA)/gram/hour when measured over 1 hour and 5 hours, respectively, or degrades >65 [mu]mol GDCA/g/hr and >7 [mu]mol TDCA/g/hr when measured over 30 minutes.

SATYA PRAKASH; LAWRENCE JONES MITCHELL; CHRISTOPHER MARTONI

111

Vitamin A Derivatives as Treatment Options for Retinal Degenerative Diseases  

Science.gov (United States)

The visual cycle is a sequential enzymatic reaction for vitamin A, all-trans-retinol, occurring in the outer layer of the human retina and is essential for the maintenance of vision. The central source of retinol is derived from dietary intake of both retinol and pro-vitamin A carotenoids. A series of enzymatic reactions, located in both the photoreceptor outer segment and the retinal pigment epithelium, transform retinol into the visual chromophore 11-cis-retinal, regenerating visual pigments. Retina specific proteins carry out the majority of the visual cycle, and any significant interruption in this sequence of reactions is capable of causing varying degrees of blindness. Among these important proteins are Lecithin:retinol acyltransferase (LRAT) and retinal pigment epithelium-specific 65-kDa protein (RPE65) known to be responsible for esterification of retinol to all-trans-retinyl esters and isomerization of these esters to 11-cis-retinal, respectively. Deleterious mutations in these genes are identified in human retinal diseases that cause blindness, such as Leber congenital amaurosis (LCA) and retinitis pigmentosa (RP). Herein, we discuss the pathology of 11-cis-retinal deficiency caused by these mutations in both animal disease models and human patients. We also review novel therapeutic strategies employing artificial visual chromophore 9-cis-retinoids which have been employed in clinical trials involving LCA patients.

Perusek, Lindsay; Maeda, Tadao

2013-01-01

112

Neurochemical imaging of Alzheimer's disease and other degenerative dementias  

International Nuclear Information System (INIS)

A wide variety of neurochemical and functional imaging approaches have been applied to the study of progressive dementias, particularly Alzheimer's disease (Ad) and related disorders. Despite considerable progress in the past decade, the cause((s) of most cases of Ad remain undetermined and preventive or protective therapies are lacking. Specifically-designed imaging procedures have permitted the testing of pathophysiological hypotheses of the etiology and progression of Ad, and have yielded important insights in several areas including the potential roles of cerebral cortical cholinergic lesions, cellular inflammation, and losses of cortical synapses. From the perspective of clinical diagnosis, PET glucose metabolism imaging with use of (18F)2-fluorodeoxyglucose (FDG) is the most sensitive and specific imaging modality yet identified. The overall performance of PET FDG is favorable for routine clinical evaluation of suspected Ad, and will likely gain increasing utilization in the near future. Assessments of glucose metabolism and other, specific aspects of neurochemistry in Ad will provide direct measures of therapeutic drug actions and may permit distinction of symptomatic versus disease-modifying therapies as they are developed and introduced in clinical trials

1998-01-01

113

Vitamin A derivatives as treatment options for retinal degenerative diseases.  

UK PubMed Central (United Kingdom)

The visual cycle is a sequential enzymatic reaction for vitamin A, all-trans-retinol, occurring in the outer layer of the human retina and is essential for the maintenance of vision. The central source of retinol is derived from dietary intake of both retinol and pro-vitamin A carotenoids. A series of enzymatic reactions, located in both the photoreceptor outer segment and the retinal pigment epithelium, transform retinol into the visual chromophore 11-cis-retinal, regenerating visual pigments. Retina specific proteins carry out the majority of the visual cycle, and any significant interruption in this sequence of reactions is capable of causing varying degrees of blindness. Among these important proteins are Lecithin:retinol acyltransferase (LRAT) and retinal pigment epithelium-specific 65-kDa protein (RPE65) known to be responsible for esterification of retinol to all-trans-retinyl esters and isomerization of these esters to 11-cis-retinal, respectively. Deleterious mutations in these genes are identified in human retinal diseases that cause blindness, such as Leber congenital amaurosis (LCA) and retinitis pigmentosa (RP). Herein, we discuss the pathology of 11-cis-retinal deficiency caused by these mutations in both animal disease models and human patients. We also review novel therapeutic strategies employing artificial visual chromophore 9-cis-retinoids which have been employed in clinical trials involving LCA patients.

Perusek L; Maeda T

2013-07-01

114

Vitamin A Derivatives as Treatment Options for Retinal Degenerative Diseases  

Directory of Open Access Journals (Sweden)

Full Text Available The visual cycle is a sequential enzymatic reaction for vitamin A, all-trans-retinol, occurring in the outer layer of the human retina and is essential for the maintenance of vision. The central source of retinol is derived from dietary intake of both retinol and pro-vitamin A carotenoids. A series of enzymatic reactions, located in both the photoreceptor outer segment and the retinal pigment epithelium, transform retinol into the visual chromophore 11-cis-retinal, regenerating visual pigments. Retina specific proteins carry out the majority of the visual cycle, and any significant interruption in this sequence of reactions is capable of causing varying degrees of blindness. Among these important proteins are Lecithin:retinol acyltransferase (LRAT) and retinal pigment epithelium-specific 65-kDa protein (RPE65) known to be responsible for esterification of retinol to all-trans-retinyl esters and isomerization of these esters to 11-cis-retinal, respectively. Deleterious mutations in these genes are identified in human retinal diseases that cause blindness, such as Leber congenital amaurosis (LCA) and retinitis pigmentosa (RP). Herein, we discuss the pathology of 11-cis-retinal deficiency caused by these mutations in both animal disease models and human patients. We also review novel therapeutic strategies employing artificial visual chromophore 9-cis-retinoids which have been employed in clinical trials involving LCA patients.

Lindsay Perusek; Tadao Maeda

2013-01-01

115

Enhancement of chondrocyte autophagy is an early response in the degenerative cartilage of the temporomandibular joint to biomechanical dental stimulation.  

UK PubMed Central (United Kingdom)

Autophagy is a cell protective mechanism for maintaining cellular homeostasis. The present study aimed to investigate whether autophagy is enhanced in the biomechanically induced degenerative cartilage of the temporomandibular joint (TMJ) and the potential role of mitogen-activated protein kinase kinase kinase kinase 3 (MAP4K3) and mammalian Target of rapamycin (mTOR) in this observation. To induce degenerative changes in the TMJs, rats were subjected to biomechanical dental stimulation by moving 4 molars away from their original position as we previously reported. The ultrastructure of autophagosome was observed by transmission electron microscopy. The number of lysosomes was analyzed by flow cytometry. The expression levels of Beclin1 and LC3 and the involvement of MAP4K3 activity were detected by immunohistochemistry, real-time PCR and western blot. The activity of the mTOR pathway indicated by p-mTOR and p-p70S6 K was assayed by western blot. TMJ degeneration, characterized by irregular cell arrangement and cell-free area, was induced in the experimental groups. Under transmission electron microscopy, we observed the presence of autophagosomes, small patches of condensed chromatin, abundant rough endoplasmic reticulum and Golgi apparatus. The number of lysosomes and the expression levels of Beclin1 and LC3 increased, while the activity of mTOR and the expression level of MAP4K3 decreased in the experimental groups. Cartilage in TMJ which was induced to be degenerative biomechanically exhibited autophagy accompanied by reduced mTOR and MAP4K3 activity.

Zhang M; Zhang J; Lu L; Qiu ZY; Zhang X; Yu SB; Wu YP; Wang MQ

2013-04-01

116

[3-Tesla MRI vs. arthroscopy for diagnostics of degenerative knee cartilage diseases: preliminary clinical results].  

UK PubMed Central (United Kingdom)

BACKGROUND: The literature contains only a few studies investigating the magnetic resonance imaging (MRI) diagnostics of degenerative cartilage diseases. Studies on MRI diagnostics of the cartilage using field strengths of 3-Tesla demonstrate promising results. To assess the value of 3-Tesla MRI for decision making regarding conservative or operative treatment possibilities, this study focused on patients with degenerative cartilage diseases. METHODS: Thirty-two patients with chronic knee pain, a minimum age of 40 years, a negative history of trauma, and at least grade II degenerative cartilage disease were included. Cartilage abnormalities detected at preoperative 3-Tesla MRI (axial/koronar/sagittal PD-TSE-SPAIR, axial/sagittal 3D-T1-FFE, axial T2-FFE; Intera 3.0T, Philips Medical Systems) were classified (grades I-IV) and compared with arthroscopic findings. RESULTS: Thirty-six percent (70/192) of the examined cartilage surfaces demonstrated no agreement between MRI and arthroscopic grading. In most of these cases, grades II and III cartilage lesions were confounded with each other. Regarding the positive predictive values, the probability that a positive finding in MRI would be exactly confirmed by arthroscopy was 39-72%. In contrast, specificities and negative predictive values of different grades of cartilage diseases were 85-95%. CONCLUSIONS: Regarding the high specificities and negative predictive values, 3-Tesla MRI is a reliable method for excluding even slight cartilage degeneration. In summary, in degenerative cartilage diseases, 3-Tesla MRI is a supportive, noninvasive method for clinical decision making regarding conservative or operative treatment possibilities. However, the value of diagnostic arthroscopy for a definitive assessment of the articular surfaces and for therapeutic planning currently cannot be replaced by 3-Tesla MRI. This applies especially to treatment options in which a differentiation between grade II and III cartilage lesions is of interest.

von Engelhardt LV; Schmitz A; Burian B; Pennekamp PH; Schild HH; Kraft CN; von Falkenhausen M

2008-09-01

117

Advances in Susceptibility Genetics of Intervertebral Degenerative Disc Disease  

Directory of Open Access Journals (Sweden)

Full Text Available The traditional view that the etiology of lumbar disc herniation is primarily due to age, gender, occupation, smoking and exposure to vehicular vibration dominated much of the last century. Recent research indicates that heredity may be largely responsible for the degeneration as well as herniation of intervertebral discs. Since 1998, genetic influences have been confirmed by the identification of several genes forms associated with disc degeneration. These researches are paving the way for a better understanding of the biologic mechanisms. Now, many researchers unanimously agree that lumbar disc herniation appears to be similar to other complex diseases, whose etiology has both environmental and hereditary influence, each with a part of contribution and relative risk. Then addressing the etiological of lumbar disc herniation, it is important to integrate heredity with the environment factors. For the purpose of this review, we have limited our discussion to several susceptibility genes associated with disc degeneration.

Yin'gang Zhang, Zhengming Sun, Jiangtao Liu, Xiong Guo

2008-01-01

118

Inter- and intraobserver reliability in radiographic assessment of degenerative disk disease.  

Science.gov (United States)

Clinicians use descriptive classification systems when treating patients with low back pain as an adjunct to surgical decision making. Magnetic resonance imaging (MRI) changes, including Modic changes, the presence of a high-intensity zone, and internal disk desiccation, are commonly used descriptors. The question remains whether different clinicians interpret these terms similarly. This study evaluated the inter- and intraobserver reliability of commonly used MRI classifications in patients presenting with low back pain.Sixty-six patients who underwent lumbar spine fusion surgery at a single multiphysician spine specialty practice for degenerative disk disease were identified. For each surgical level, the following MRI variables were determined independently by 3 fellowship-trained spine surgeons: presence or absence of high-intensity zone and/or internal disk desiccation, presence and classification of disk herniation, Modic grade, and disk height. Each surgeon reviewed the same set of MRI studies a second time at least 2 weeks from the first reading. Inter- and intraobserver reliability was determined using multiobserver Kappa coefficients. Intraobserver reliability ranged from 0.563 to 0.988, with greatest agreement in determining disk height. The greatest interobserver agreement was for determining Modic changes (0.819).Controversy remains on the criteria for diagnosing degenerative disk disease. In patients presenting with low back pain diagnosed with degenerative disk disease, the inter- and intraobserver reliability with use of several common MRI diagnostic tools was substantial. These data imply that clinicians interpret these findings in a reproducible fashion and interpret these terms similarly. PMID:21469633

Zook, Jason; Djurasovic, Mladen; Crawford, Charles; Bratcher, Kelly; Glassman, Steven; Carreon, Leah

2011-04-11

119

Inter- and intraobserver reliability in radiographic assessment of degenerative disk disease.  

UK PubMed Central (United Kingdom)

Clinicians use descriptive classification systems when treating patients with low back pain as an adjunct to surgical decision making. Magnetic resonance imaging (MRI) changes, including Modic changes, the presence of a high-intensity zone, and internal disk desiccation, are commonly used descriptors. The question remains whether different clinicians interpret these terms similarly. This study evaluated the inter- and intraobserver reliability of commonly used MRI classifications in patients presenting with low back pain.Sixty-six patients who underwent lumbar spine fusion surgery at a single multiphysician spine specialty practice for degenerative disk disease were identified. For each surgical level, the following MRI variables were determined independently by 3 fellowship-trained spine surgeons: presence or absence of high-intensity zone and/or internal disk desiccation, presence and classification of disk herniation, Modic grade, and disk height. Each surgeon reviewed the same set of MRI studies a second time at least 2 weeks from the first reading. Inter- and intraobserver reliability was determined using multiobserver Kappa coefficients. Intraobserver reliability ranged from 0.563 to 0.988, with greatest agreement in determining disk height. The greatest interobserver agreement was for determining Modic changes (0.819).Controversy remains on the criteria for diagnosing degenerative disk disease. In patients presenting with low back pain diagnosed with degenerative disk disease, the inter- and intraobserver reliability with use of several common MRI diagnostic tools was substantial. These data imply that clinicians interpret these findings in a reproducible fashion and interpret these terms similarly.

Zook J; Djurasovic M; Crawford C 3rd; Bratcher K; Glassman S; Carreon L

2011-04-01

120

Is there a role for wine in cancer and the degenerative diseases of aging?  

Directory of Open Access Journals (Sweden)

Full Text Available Creina S StockleyThe Australian Wine Research Institute, Adelaide, South Australia, AustraliaAbstract: Population aging is associated with the increased incidence cancer and of degenerative diseases. Population aging is occurring on a global scale, with faster aging projected for the coming decades than has occurred in the past. Globally, the population aged 60 years and over is projected to nearly triple by 2050, while the population aged 80 years and over is projected to experience a more than fivefold increase. Increased numbers of older individuals may have implications for associated expenditure on income support, housing and health services, although a healthy, independent older population can also form a valued social resource, for example in providing care for others, sharing skills and knowledge, and engaging in volunteer activities. Simple dietary measures such as moderate wine consumption to supplement a healthy exercise and nutrition routine, or as an adjunct to prescription medicines when appropriate, are thus needed to maintain an aging population. The role of wine in cancer and the degenerative diseases of aging is thus discussed.Keywords: population aging, wine, degenerative disease, cancer

Creina S Stockley

2009-01-01

 
 
 
 
121

Differentiation of malignant and degenerative benign bone disease using 99mTc-citrate scintigraphy  

International Nuclear Information System (INIS)

Objective: To differentiate malignant and degenerative benign bone disease using 99mTc- citrate scintigraphy. Methods: Thirty-nine patients (92 lesions) with confirmed malignant bone disease or degenerative benign bone disease were studied, for which the results of 99mTe-methylene diphosphonate(99mTc- MDP) scintigraphy were positive. 99mTc-citrate scintigraphy was performed within a time interval of 2-7 days after 99mTc-MDP scintigraphy. Visual analysis and semiquantitative analysis were applied. Each lesion was scored as malignant or benign, which was independently verified, using conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up). Results: In visual analysis of 99mTc-citrate imaging, most malignant lesions (35/48, 72.92%) clearly showed high radioactivity accumulation, while most benign lesions (39/44, 88.64%) had not obviously visible uptake of 99mTc-citrate. In semiquantitative analysis of 99mTc- citrate image, malignant lesions demonstrated a higher lesion-to-background radioisotope uptake ratio (RUR) than that of benign degenerative lesions (1.47 ± 0.42 vs. 1.09 ± 0.38, t=2.887, P99mTc-MDP in the two groups is of the same (1.96 ± 0.25 vs. 1.87 ± 0.21, t=1.178, P>0.20). Conclusion: 99mTc- citrate scintigraphy is a promising method to differentiate malignant from benign degenerative lesions seen as areas of increased activity on 99mTc-MDP bone scintigraphy. (authors)

2008-01-01

122

MRI of degenerative bone marrow lesions in experimental osteoarthritis of canine knee joints  

Energy Technology Data Exchange (ETDEWEB)

Objective. The objective of this study was to determine the value of MRI in the detection of degenerative bone marrow abnormalities in an animal osteoarthritis model. Design. In 10 dogs with experimentally induced unilateral osteoarthritis of the knee, MRI was performed using two-dimensional spin-echo (2D-SE) and three-dimensional gradient-echo (3D-GE) imaging. Contrast enhanced T1-weighted 2D-SE sequences were also obtained after injection of gadolinium-DTPA. The results were compared with the gross and histopathologic findings and with radiography. Results. Histopathologic specimens revealed 21 osteosclerotic lesions and 5 intraosseous cysts. On 2D-SE images, 24 of 26 lesions were detected, while 21 of 26 lesions were identified on 2D-GE sequences. Radiography, including conventional tomography, demonstrated 9 of 26 lesions. Regardless of the sequence weighting, all osteosclerotic lesions appeared hypointense on MRI. Signal loss in bone sclerosis resulted primarily from the reduction of intact fat marrow, the increased bone density being of secondary importance. Quantitative signal analysis allowed approximate estimation of the grade of sclerosis. On postcontrast images, sclerotic bone remained hypointense, although significant but non-specific enhancement relative to the normal fat marrow was observed. The extent of contrast enhancement did not correlate with the grade of osteosclerosis. All five cysts were readily diagnosed by MRI. Cysts displayed either central or marginal contrast enhancement within their cavities. Conclusions. MRI provides a sensitive method for the diagnosis of osteoarthritic bone abnormalities, allowing their differentiation from most non-degenerative subarticular lesions. (orig.). With 1 tab.

Nolte-Ernsting, C.C.A. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Adam, G. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Buehne, M. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany); Prescher, A. [Department of Anatomy, University of Technology, Aachen (Germany); Guenther, R.W. [Department of Diagnostic Radiology, University of Technology, Aachen, Pauwelsstrasse 30, D-52057 Aachen (Germany)

1996-07-01

123

Static and dynamic roentgenography in the diagnosis of degenerative disc disease: a review and comparative assessment.  

UK PubMed Central (United Kingdom)

The use of static-postural and dynamic-bending roentgenography by the medical and chiropractic professions was reviewed and a retrospective study of 30 symptomatic subjects was conducted to compare the diagnostic discrimination of dynamic lateral bending (DLB) procedures to that of a previously-reported static-postural method (Farfan) in determining the lumbar spine level which is most predisposed to the eventual development of degenerative disc disease. The level of correspondence in the sample was not found to be statistically significant and it was concluded, with some reservations regarding sample size, that present chiropractic DLB analysis of lumbosacral instability does not match the reliability of static analysis of morpho-anatomical configurations in predicting the eventual site of a degenerative disc disorder. The characteristics of vertebral motion segment (VMS) abnormalities are discussed, a refined DLB analysis scoring system is provided, and suggestions for improvement in such studies are given.

Vernon H

1982-12-01

124

Joint Modeling of Disease Pairs  

Directory of Open Access Journals (Sweden)

Full Text Available Aim: Exploring the spatial patterns in joint distribution of incidences of two diseases. Material and method: A Poisson-Binomial regression model was used in analysing hospitalisation counts data in Hungary, 2008. Model parameters were estimated by MCMC implemented in WinBUGS. Results: Spatial patterns of laryngeal and hypopharyngeal cancer differ significantly from that of their ratio. Conclusion: The Poisson-Binomial model proposed here might help clarify us the different spatial dependencies of the sum and the ratio of incidences of two diseases.

Gergely TÓTH; Sándor KABOS; György SURJÁN

2012-01-01

125

[Physical exercise and its prescription in patients with chronic degenerative diseases].  

UK PubMed Central (United Kingdom)

Chronic degenerative diseases constitute one of the main causes of death at a global level, and their significant increase has alerted many countries, which are taking measures to reduce risk factors, some of which are modifiable; being the regular exercise a means of prevention and rehabilitation of these diseases. The objective of this revision is to analyze the necessary parameters to take into account for the prescription of an exercise program in patients with obesity, high blood pressure dyslipidemia and diabetes mellitus type 2.

Gómez R; Monteiro H; Cossio-Bolaños MA; Fama-Cortez D; Zanesco A

2010-09-01

126

Analysis of crucial molecules involved in herniated discs and degenerative disc disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english OBJECTIVES: Herniated discs and degenerative disc disease are major health problems worldwide. However, their pathogenesis remains obscure. This study aimed to explore the molecular mechanisms of these ailments and to identify underlying therapeutic targets. MATERIAL AND METHODS: Using the GSE23130 microarray datasets downloaded from the Gene Expression Omnibus database, differentially co-expressed genes and links were identified using the differentially co-expressed gene (more) and link method with a false discovery rate ,0.25 as a significant threshold. Subsequently, the underlying molecular mechanisms of the differential co-expression of these genes were investigated using Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. In addition, the transcriptional regulatory relationship was also investigated. RESULTS: Through the analysis of the gene expression profiles of different specimens from patients with these diseases, 539 differentially co-expressed genes were identified for these ailments. The ten most significant signaling pathways involving the differentially co-expressed genes were identified by enrichment analysis. Among these pathways, apoptosis and extracellular matrix-receptor interaction pathways have been reported to be related to these diseases. A total of 62 pairs of regulatory relationships between transcription factors and their target genes were identified as critical for the pathogenesis of these diseases. CONCLUSION: The results of our study will help to identify the mechanisms responsible for herniated discs and degenerative disc disease and provides a theoretical basis for further therapeutic study.

Qu, Zhigang; Miao, Weiwei; Zhang, Qi; Wang, Zhenyu; Fu, Changfeng; Han, Jinhua; Liu, Yi

2013-01-01

127

Dynamic stabilisation in the treatment of degenerative disc disease with modic changes.  

UK PubMed Central (United Kingdom)

Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP) and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs) were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI) analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS) score and Oswestry Disability Index (ODI) preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P < 0.001). However, the mean 1 and 2 postoperative IVS ratio was not significantly different (P > 0.05). Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P > 0.05). The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P = 0.000). Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

Eser O; Gomleksiz C; Sasani M; Oktenoglu T; Aydin AL; Ataker Y; Suzer T; Ozer AF

2013-01-01

128

Dynamic stabilisation in the treatment of degenerative disc disease with modic changes.  

Science.gov (United States)

Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP) and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs) were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI) analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS) score and Oswestry Disability Index (ODI) preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P IVS ratio was not significantly different (P > 0.05). Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P > 0.05). The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P = 0.000). Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective. PMID:23781343

Eser, Olcay; Gomleksiz, Cengiz; Sasani, Mehdi; Oktenoglu, Tunc; Aydin, Ahmet Levent; Ataker, Yaprak; Suzer, Tuncer; Ozer, Ali Fahir

2013-05-20

129

Dynamic Stabilisation in the Treatment of Degenerative Disc Disease with Modic Changes  

Science.gov (United States)

Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD) of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP) and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs) were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI) analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS) score and Oswestry Disability Index (ODI) preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P 0.05). Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P > 0.05). The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P = 0.000). Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

Eser, Olcay; Gomleksiz, Cengiz; Sasani, Mehdi; Oktenoglu, Tunc; Aydin, Ahmet Levent; Ataker, Yaprak; Suzer, Tuncer; Ozer, Ali Fahir

2013-01-01

130

Degenerative disease of the lumbar spine. Role of CT-myelography in the MR era.  

UK PubMed Central (United Kingdom)

One hundred patients with degenerative disease of the lumbar spine on whom both magnetic resonance (MR) and computed tomography (CT)-myelography were performed were reviewed. In one-third of the cases, the CT-myelogram provided additional useful information. This included definition of the extent of large disc herniations, demonstration of focal neural compression by small herniations, and clarifying abnormalities of the facets, including synovial cysts. These results should help to refine the indications for CT-myelography, which continues to be requested extensively.

Goldberg AL; Soo MS; Deeb ZL; Rothfus WE

1991-01-01

131

[Spinal fusion combined with dynamic interspinous fixation with Coflex system for lumbar degenerative disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To summarize the effect of the implantation of Coflex interspious stabilization device combined with pinal fusion for the treatment of lumbar degenerative disease. METHODS; From March 2008 to March 2010, 18 patients with two levels lumbar degenerative disease were treated with spinal fusion and dynamic interspinous fixation with Coflex system. There were 11 males and 7 females. The average age was 50.2 years (range 41 to 62 years). The VAS and the Oswestry Disability Index (ODI) were used to assess clinical symptoms preoperatively and postoperatively. All patients underwent flexion/extension radiographs examinations before surgery and at last follow-up. Range of motion (ROM) and disc height index (DHI) were recorded. RESULTS: All patients were followed up for 12 months averagely (range 6-30 months). At final follow-up, leg VAS, back VAS and ODI functional score were significant improved than those of preoperation [back VAS: 1.50 +/- 0.90 vs 7.20 +/- 0.90; leg VAS: 1.10 +/- 0.80 vs 5.20 +/- 0.90; ODI functional score: (15.90 +/- 5.80)% vs (52.50 +/- 5.90)%]. The DHI increased from 0.23 +/- 0.05 preoperatively to 0.35 +/- 0.06 postoperatively and to 0.33 +/- 0.04 at final follow-up, the height of intervertebral space were not found significant loss. The ROM at the Coflex stabilized levels on the X-ray views was (8.90 +/- 1.80) degrees preoperatively, (8.30 +/- 1.90) degrees postoperatively, and (8.10 +/- 1.80) degrees at final follow-up. There was no significant difference between final follow-up and preoperative (P = 0.19). The ROM of the lumbar spine (L2-S1) was (20.20 +/- 5.60) degrees preoperatively, (14.40 +/- 5.70) degrees postoperatively, and (15.50 +/- 5.20) degrees at final follow-up. There was significant reduction of the [E-S, ROM at final follow-up (P = 0.01). CONCLUSION: Posterior interspinous stabilization with Coflex system combined with spinal fusion can obtain satisfactory outcomes for patients with two levels lumbar degenerative disease in the short follow-up duration. Nevertheless,no overwhelming evidence suggested that the system is better than traditional fusion at present. The selection of surgical indication is important for the treatment of lumbar degenerative disease.

Li ZH; Wang SY; Tang H; Ma H; Zhang QL; HoU TS

2011-04-01

132

Identification of low circulatory transforming growth factor beta-1 in patients with degenerative heart valve disease.  

Science.gov (United States)

Transforming growth factor ?-1 (TGF-?1) is an immunosuppressive cytokine. It exerts cardioprotection during acute myocardial ischaemia, promoting healing of the injured myocytes. Lower plasma concentrations of TGF-?1 have been identified in patients with coronary artery disease (CAD) compared to those with normal coronary arteries. We measured plasma TGF-?1 concentrations in patients with CAD compared to those with degenerative heart valves (DHVs) and normal coronary arteries. The mean concentration of TGF-?1 in patients with valvular heart disease was significantly lower (18.67 ?g/l) than the mean in the coronary artery bypass graft (CABG) group (26.46 ?g/l). There was no correlation between the patient characteristics and preoperative concentration of TGF-?1. It is possible that the lower plasma concentration of TGF-?1 in patients with valvular heart disease and the lack of its regulatory effect results in the increased inflammation and calcification seen in DHVs. PMID:20736227

Attaran, Saina; Sherwood, Roy; Dastidar, Michael Ghosh; El-Gamel, Ahmed

2010-08-24

133

Identification of low circulatory transforming growth factor beta-1 in patients with degenerative heart valve disease.  

UK PubMed Central (United Kingdom)

Transforming growth factor ?-1 (TGF-?1) is an immunosuppressive cytokine. It exerts cardioprotection during acute myocardial ischaemia, promoting healing of the injured myocytes. Lower plasma concentrations of TGF-?1 have been identified in patients with coronary artery disease (CAD) compared to those with normal coronary arteries. We measured plasma TGF-?1 concentrations in patients with CAD compared to those with degenerative heart valves (DHVs) and normal coronary arteries. The mean concentration of TGF-?1 in patients with valvular heart disease was significantly lower (18.67 ?g/l) than the mean in the coronary artery bypass graft (CABG) group (26.46 ?g/l). There was no correlation between the patient characteristics and preoperative concentration of TGF-?1. It is possible that the lower plasma concentration of TGF-?1 in patients with valvular heart disease and the lack of its regulatory effect results in the increased inflammation and calcification seen in DHVs.

Attaran S; Sherwood R; Dastidar MG; El-Gamel A

2010-12-01

134

Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging.  

UK PubMed Central (United Kingdom)

The authors reviewed magnetic resonance (MR) images of 474 consecutive patients referred for lumbar spine MR imaging. Type 1 changes (decreased signal intensity on T1-weighted spin-echo images and increased signal intensity on T2-weighted images) were identified in 20 patients (4%) and type 2 (increased signal intensity on T1-weighted images and isointense or slightly increased signal intensity on T2-weighted images) in 77 patients (16%). In all cases there was evidence of associated degenerative disk disease at the level of involvement. Histopathologic sections in three cases of type 1 change demonstrated disruption and fissuring of the end plates and vascularized fibrous tissue, while in three cases of type 2 change they demonstrated yellow marrow replacement. In addition, 16 patients with end-plate changes documented with MR were studied longitudinally. Type 1 changes in five of six patients converted to a type 2 pattern in 14 months to 3 years. Type 2 changes in ten patients remained stable over a 2-3-year period. These signal intensity changes appear to reflect a spectrum of vertebral body marrow changes associated with degenerative disk disease.

Modic MT; Steinberg PM; Ross JS; Masaryk TJ; Carter JR

1988-01-01

135

[Chronic-degenerative diseases in health care activities: data from health surveillance of Federico II University General Hospital in Naples].  

Science.gov (United States)

Recent average life increase, as well as new habits and lifestyles assumption, has determined a change in population health profiles, as a result of progressive increase in chronic-degenerative diseases prevalence. Among these latter; musculoskeletal and cardiovascular diseases are the most frequent ones. Health care workers also suffered from this change in health profiles. This study, performed thanks to the extension of Health Surveillance to all health care workers, aimed at evaluating chronic-degenerative diseases risk among three main welfare activities (medical, nursing and auxiliary). In conclusion, data showed that nurses, mainly the shift workers, are exposed to a higher risk of chronic-degenerative diseases. All other health care workers have not significant work risk factors, because of a greater burden of aging and lifestyles effects. PMID:18409865

Farina, A; Cavaliere, L; Boggia, B; Esposito, A; Ferrucci, R; Romano, L; Barletta, R; Carbone, U

136

[Chronic-degenerative diseases in health care activities: data from health surveillance of Federico II University General Hospital in Naples  

UK PubMed Central (United Kingdom)

Recent average life increase, as well as new habits and lifestyles assumption, has determined a change in population health profiles, as a result of progressive increase in chronic-degenerative diseases prevalence. Among these latter; musculoskeletal and cardiovascular diseases are the most frequent ones. Health care workers also suffered from this change in health profiles. This study, performed thanks to the extension of Health Surveillance to all health care workers, aimed at evaluating chronic-degenerative diseases risk among three main welfare activities (medical, nursing and auxiliary). In conclusion, data showed that nurses, mainly the shift workers, are exposed to a higher risk of chronic-degenerative diseases. All other health care workers have not significant work risk factors, because of a greater burden of aging and lifestyles effects.

Farina A; Cavaliere L; Boggia B; Esposito A; Ferrucci R; Romano L; Barletta R; Carbone U

2007-07-01

137

Lumbar Facet Joint Effusion on MRI as a Sign of Unstable Degenerative Spondylolisthesis: Should it Influence the Treatment Decision?  

Science.gov (United States)

STUDY DESIGN:: Retrospective study. OBJECTIVE:: To examine whether the outcomes of decompression alone or decompression with fusion differed depending on the presence or absence of the facet effusion sign in degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA: There is ongoing discussion as to whether fusion in addition to decompression (D&F) is superior to decompression alone (D) in the surgical treatment of patients with lumbar degenerative spondylolisthesis (LDS) and symptoms of spinal or radicular claudication. Previous studies have shown that a positive facet joint effusion sign on MRI correlates with the spontaneous reduction of slip when comparing upright and supine postures and might represent a sign of instability, guiding treatment decisions. PATIENTS AND METHODS:: 160 patients (age 69 (SD10) y; 119 women, 41 men) with a diagnosis of LDS were identified retrospectively from our Spine Center Registry (linked to the SSE Spine Tango). They were categorised regarding the presence/absence of the facet effusion sign and the type of treatment received. 44 patients had effusion and underwent D; 76 effusion, and D&F; 19 no effusion, and D; and 21 no effusion, and D&F. Before surgery, and 3, 12 and 24 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI) questionnaire. At follow-up, they rated the global treatment outcome (1-5 scale). Multiple regression analyses evaluated the factors influencing outcome. RESULTS:: When age and gender was controlled for, there was no significant difference in outcome dependent on the presence of the facet effusion sign and/or the treatment received (D vs D&F). CONCLUSIONS:: Whilst mindful of the limitations of this retrospective study, we conclude that the effusion sign alone does not appear to be an indication for adding fusion to decompression in the treatment of LDS. Hence, the presence of the facet effusion sign should not, in itself, deter the surgeon from performing decompression alone. However, the phenomenon should be investigated in larger samples of patients, ideally within a randomised trial. PMID:22832556

Lattig, Friederike; Fülöp Fekete, Tamás; Kleinstück, Frank S; Porchet, François; Jeszenszky, Dezsö; Mannion, Anne F

2012-07-24

138

Lumbar Facet Joint Effusion on MRI as a Sign of Unstable Degenerative Spondylolisthesis: Should it Influence the Treatment Decision?  

UK PubMed Central (United Kingdom)

STUDY DESIGN:: Retrospective study. OBJECTIVE:: To examine whether the outcomes of decompression alone or decompression with fusion differed depending on the presence or absence of the facet effusion sign in degenerative spondylolisthesis. SUMMARY OF BACKGROUND DATA: There is ongoing discussion as to whether fusion in addition to decompression (D&F) is superior to decompression alone (D) in the surgical treatment of patients with lumbar degenerative spondylolisthesis (LDS) and symptoms of spinal or radicular claudication. Previous studies have shown that a positive facet joint effusion sign on MRI correlates with the spontaneous reduction of slip when comparing upright and supine postures and might represent a sign of instability, guiding treatment decisions. PATIENTS AND METHODS:: 160 patients (age 69 (SD10) y; 119 women, 41 men) with a diagnosis of LDS were identified retrospectively from our Spine Center Registry (linked to the SSE Spine Tango). They were categorised regarding the presence/absence of the facet effusion sign and the type of treatment received. 44 patients had effusion and underwent D; 76 effusion, and D&F; 19 no effusion, and D; and 21 no effusion, and D&F. Before surgery, and 3, 12 and 24 months after surgery, patients completed the multidimensional Core Outcome Measures Index (COMI) questionnaire. At follow-up, they rated the global treatment outcome (1-5 scale). Multiple regression analyses evaluated the factors influencing outcome. RESULTS:: When age and gender was controlled for, there was no significant difference in outcome dependent on the presence of the facet effusion sign and/or the treatment received (D vs D&F). CONCLUSIONS:: Whilst mindful of the limitations of this retrospective study, we conclude that the effusion sign alone does not appear to be an indication for adding fusion to decompression in the treatment of LDS. Hence, the presence of the facet effusion sign should not, in itself, deter the surgeon from performing decompression alone. However, the phenomenon should be investigated in larger samples of patients, ideally within a randomised trial.

Lattig F; Fülöp Fekete T; Kleinstück FS; Porchet F; Jeszenszky D; Mannion AF

2012-07-01

139

METHOD OF TREATING INFLAMMATORY-DEGENERATIVE SPINE AND INTERVERTEBRAL DISK DISEASES  

UK PubMed Central (United Kingdom)

FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, namely to vertebrology, traumatology, orthopaedics, neurosurgery and rehabilitation, and can be used for treating inflammatory-degenerative spine and intervertebral disk diseases. The treatment is at least two-staged. The first stage involves at least one course of an integrated therapy including microwave heating of a musculo-ligamentous apparatus in the involved area, drug ionophoresis, electrical myostimulation of an involved nerve by interference currents and drug-induced anti-inflammatory therapy. The second stage include at least one session of focused extracorporeal shock wave therapy directed on a spinal pathological centre area. ^ EFFECT: method provides high clinical effectiveness leading to pain management with eliminated causes of the disease and low probability in this regard of a relapse, as well as eliminated gastrointestinal, cerebrospinal and suprarenal complications. ^ 11 cl, 3 ex, 1 tbl

KRAVCHIK MAKSIMIL JAN GRIGOR EVICH

140

[Comparative study of dynamic neutralization system and posterior lumbar interbody fusion in treating lumbar degenerative disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare the short-term effectiveness between dynamic neutralization system (Dynesys) and posterior lumbar interbody fusion (PLIF) in the treatment of lumbar degenerative disease. METHODS: The clinical data were retrospectively analyzed, from 14 patients undergoing Dynesys and 18 patients undergoing PLIF to treat lumbar degenerative disease between February 2009 and March 2011. No significant difference in gender, age, duration of disease, and lesion segments was found between 2 groups (P > 0.05). The visual analogue scale (VAS) score, Oswestry disability index (ODI), and radiographic results were compared between 2 groups at preoperation and last follow-up. RESULTS: Thirty-one cases were followed up 12-21 months (mean, 17 months). No internal fixation loosening, broken screws, and broken rods was found during follow-up. The mean interbody fusion time was 15 months (range, 13-19 months) in PLIF group. The VAS score and ODI were significantly improved in 2 groups at last follow-up when compared with the preoperative ones (P < 0.05); but there was no signficant difference between 2 groups (P > 0.05). Imaging assessment: the range of motion (ROM) of operated segment in PLIF group was (0.1 +/- 0.4) degrees at last follow-up, showing significant difference when compared with preoperative ROM (7.8 +/- 0.6) degrees (t=28.500, P=0.004); the ROM in Dynesys group (5.0 +/- 1.5) degrees decreased, but showing no significant difference when compared with preoperative ROM (7.5 +/- 0.8) degrees (t=0.480, P=0.113); and significant difference was found between 2 groups (t=5.260, P=0.008) at last follow-up. The ROM of adjacent segment in Dynesys group at last follow-up (7.2 +/- 0.7) degrees decreased when compared with preoperative ROM (7.3 +/- 1.8) degrees, but showing no significant difference (t=0.510, P=0.108); however, ROM of adjacent segment in PLIF group (8.7 +/- 0.4) degrees increased significantly when compared with preoperative ROM (7.0 +/- 1.6) degrees, showing signifcant difference (t=3.440, P=0.042); and there was significant difference between 2 groups (t=2.100, P=0.047) at last follow- up. CONCLUSION: Dynesys and PLIF have equivalent short-term effectivness in the treatment of lumbar degenerative disease. However, the Dynesys could retain ROM of operated segment without increased ROM of the adjacent segment, which will promote the disc recovery of operated segment and prevent degeneration of adjacent segment.

Yang B; Jiang T

2013-02-01

 
 
 
 
141

Stemming the Degeneration: IVD Stem Cells and Stem Cell Regenerative Therapy for Degenerative Disc Disease.  

UK PubMed Central (United Kingdom)

The intervertebral disc (IVD) is immensely important for the integrity of vertebral column function. The highly specialized IVD functions to confer flexibility and tensile strength to the spine and endures various types of biomechanical force. Degenerative disc disease (DDD) is a prevalent musculoskeletal disorder and is the major cause of low back pain and includes the more severe degenerative lumbar scoliosis, disc herniation and spinal stenosis. DDD is a multifactorial disorder whereby an imbalance of anabolic and catabolic factors, or alterations to cellular composition, or biophysical stimuli and genetic background can all play a role in its genesis. However, our comprehension of IVD formation and theetiology of disc degeneration (DD) are far from being complete, hampering efforts to formulate appropriate therapies to tackle DD. Knowledge of the stem cells and various techniques to manipulate and direct them to particular fates have been promising in adopting a stem-cell based regenerative approach to DD. Moreover, new evidence on the residence of stem/progenitor cells within particular IVD niches has emerged holding promise for future therapeutic applications. Existing issues pertaining to current therapeutic approaches are also covered in this review.

Sivakamasundari V; Lufkin T

2013-01-01

142

[Clinical evaluation of interspinous process device Coflex for degenerative disk diseases].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study indications and complications of interspinous process device Coflex for degenerative disk diseases. METHODS: One hundred and eight patients with degenerative lumbar disc diseases were underwent procedures of surgical decompression and additional fixation of Coflex between November 2007 and October 2010. Sixty-eight patients were male and the other fourty were female, and their average age was 53.5 years (range from 37 to 75 years). Fifty-nine patients were underwent surgery of excision of nucleus pulposus and Coflex fixation, 41 patients were underwent surgery of decompression by fenestration and Coflex fixation, 6 patients were underwent surgery of topping-off, and 2 patients were underwent surgery of Coflex fixation for two level. Preoperative and postoperative visual analogue scales (VAS) and Oswestry disability index (ODI) were recorded, as well as height of ventral intervertebral space (HV), height of dorsal intervertebral space (HD), height of intervertebral foramen (HIF) and segmental range of motion (ROM). One-way ANOVA was used for statistical analysis. Surgical complications were also recorded. RESULTS: The average follow-up time was 28.8 months. All groups had apparent improvement of VAS and ODI, and maintained well to last follow-up (F = 6.16-25.92, P = 0.00). Statistical analysis showed that HD and HIF increased significantly in group with excision of nucleus pulposus and Coflex fixation and group with decompression by fenestration and Coflex fixation (F = 7.37 - 11.68, P < 0.05). Although both HD and HIF decreased one-year after surgery, they were still higher than those preoperatively (F = 6.31 and 7.05, P = 0.00). Preoperative segmental ROM was respectively 6.3° ± 1.8° and 6.2° ± 1.7° in group with excision of nucleus pulposus and Coflex fixation and group with decompression by fenestration and Coflex fixation, and 3.1° ± 0.6° and 3.0° ± 0.8° at last follow-up. Three cases were found with device-related complications and five with non-device-related complications, and all five cased were cured after appropriate treatment. CONCLUSIONS: Surgical method assisted with Coflex has significant clinical efficacy for degenerative disc disease, it can maintain segmental stability, simultaneously, partly reserve movement. It's key to strictly master indications and precisely choose patients.

Ni WF; Xu HZ; Zhou Y; Chi YL; Huang QS; Wang XY; Lin Y; Mao FM; Wu LJ

2012-09-01

143

[Retrospective study of complication of interspinous implants for degenerative lumbar disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To summarize and analyze the complications of interspinous implants for degenerative lumbar disease. METHODS: From September 2007 to September 2011, 177 cases with degenerative lumbar diseases were treated with interspinous implants. There were 99 male patients and 78 female patients, the average age was 44.5 years (26 - 71 years). According to the application interspinous dynamic stabilization system type were divided into the Wallis group (136 cases) and Coflex group (41 cases). The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopedic Association (JOA) score and Prolo functional score. The radiological results including segmental lodosis and segement movement degree were assessed by lumbar X ray and dynamic X ray. Summarize and analyze the complications both during operation and post operation. Quantitative datas were compared by paried-samples t test and complication rate was compared by ?(2) test. RESULTS: There were 168 cases had completed follow-up and the average time was 34.7 months (3 - 50 months). In the final follow-up, lumbar pain VAS, lower limber pain VAS, lumbar JOA score and Prolo functional score were better than pre-operation (t = 10.7, 7.9, 13.4 and 8.8, P < 0.01). Segment lodosis angles was 14° ± 4° which was less than pre-operation 19° ± 4° (t = 9.4, P < 0.01).Segment movement degree was larger in Coflex group (12.6° ± 3.1°) than in Wallis group (9.7° ± 2.7°) (t = 8.6, P < 0.05). Complication rate was 10.7% (18/168), which of Wallis group was 6.2% (8/130) and Coflex group was 26.3% (10/38) (?(2) = 12.5, P < 0.01). In Wallis group, there were 3 cases with dura tear and cerebrospinal fluid leakage, 1 case with nerve root injury and foot drop, 2 cases with spacer breakage when implantation and change the implants and 2 cases with recurrence of lumbar disc herniation. In Coflex group, there was 1 case with dura tear and cerebrospinal fluid leakage, 2 cases with mild displacement post operation, 1 case with debridement for aseptic wound exudates, 1 case with implant removal for breakage 1 week post operation, 4 cases with recurrence of lumbar disc herniation and 1 case with lumbar disc herniation 6 months post operation of lumbar stenosis. CONCLUSIONS: The application of interspinous implants for degenerative lumbar diseases is effective and relative safe, but would suffer from the risk of complications.

Sun HL; Li CD; Liu XY; Yi XD; Lin JR; Liu H; Lu HL; Li H; Yu ZR

2013-01-01

144

Neurophysiological evaluation of patients with degenerative diseases of the cervical spine  

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Full Text Available Bacground/Aim. Diagnostic protocol for patients with degenerative diseases of the cervical spine demands, in parallel with neuroimaging methods, functional evaluation through neurophysiological methods (somatosensitive and motor evoked potentials and electromyoneurography) aiming to evaluate possible subclinical affection of spinal medula resulting in neurological signs of long tract abnormalities. Considering diversities of clinical outcomes for these patients, complex diagnostic evaluation provides a prognosis of the disease progression. Methods. The study included 21 patients (48.24 ± 11.01 years of age) with clinical presentation of cervical spondylarthropathy, without neuroradiological signs of myelopathy. For each patient, in addition to conventional neurophysiological tests (somatisensory evoked potentials - SSEP, motor evoked potentials - MEP, electromyoneurography - EMG, nerve conduction studies), we calculated central motor conduction time (CMCTF), as well the same parameter in relation to a different position of the head (maximal anteflexion and retroflexion), so-called dynamic tests. Results. Abnormalities of the peripheral motor neurone by conventional EMNeG was established in 2/3 of the patients, correponding to the findings of root condution time. Prolonged conventional CVMPF were found in 29% of the patients, comparing to 43% CVMPF abnormalities found with the dynamic tests. In addition, the SSEP findings were abnormal in 38% of the patients with degenerative diseases of the cervical spine. Conclusion. An extended neurophysiological protocol of testing corticospinal functions, including dynamic tests of central and periheral motor neurons are relevant for detection of subclinical forms of cervical spondylothic myelopathy, even at early stages. In addition to the conventional neurophysiological tests, we found usefull to include the dynamic motor tests and root conduction time measurement in diagnostic evaluation.

Ili? Tihomir V.; Stankovi? Snežana; Ili? Nela V.; Kosti? Sanja V.; ?aji? Vlado; Dominovi?-Kova?evi? Aleksandra

2011-01-01

145

Pelvic parameters of sagittal balance in extreme lateral interbody fusion for degenerative lumbar disc disease.  

Science.gov (United States)

There is increasing interest in the use of pelvic indices to evaluate sagittal balance and predict outcomes in patients with spinal disease. Conventional posterior lumbar fusion techniques may adversely affect lumbar lordosis and spinal balance. Minimally invasive fusion of the lumbar spine is rapidly becoming a mainstay of treatment of lumbar degenerative disc disease. To our knowledge there are no studies evaluating the effect of extreme lateral interbody fusion (XLIF) on pelvic indices. Hence, our aim was to study the effect of XLIF on pelvic indices related to sagittal balance, and report the results of a prospective longitudinal clinical study and retrospective radiographic analyses of patients undergoing XLIF in a single centre between January 2009 and July 2011. Clinical outcomes are reported for 30 patients and the retrospective analyses of radiographic data is reported for 22 of these patients to assess global and segmental lumbar lordosis and pelvic indices. Effect of XLIF on the correction of scoliotic deformity was assessed in 15 patients in this series. A significant improvement was seen in the visual analogue scale score, the Oswestry Disability Index and the Short Form-36 at 2months and 6months (p0.2). Global lumbar lordosis was not affected by XLIF (p>0.4). XLIF significantly increased segmental lumbar lordosis by 3.3° (p<0.0001) and significantly decreased the scoliotic Cobb angle by 5.9° (p=0.01). We found that XLIF improved scoliosis and segmental lordosis and was associated with significant clinical improvement in patients with lumbar degenerative disc disease. However, XLIF did not change overall lumbar lordosis or significantly alter pelvic indices associated with sagittal balance. Long-term follow-up with a larger cohort will be required to further evaluate the effects of XLIF on sagittal balance. PMID:23375396

Johnson, R D; Valore, A; Villaminar, A; Comisso, M; Balsano, M

2013-01-30

146

Mesenchymal stem cells in joint disease and repair.  

UK PubMed Central (United Kingdom)

Osteoarthritis (OA), a prevalent chronic condition with a striking impact on quality of life, represents an enormous societal burden that increases greatly as populations age. Yet no approved pharmacological intervention, biologic therapy or procedure prevents the progressive destruction of the OA joint. Mesenchymal stem cells (MSCs)-multipotent precursors of connective tissue cells that can be isolated from many adult tissues, including those of the diarthrodial joint-have emerged as a potential therapy. Endogenous MSCs contribute to maintenance of healthy tissues by acting as reservoirs of repair cells or as immunomodulatory sentinels to reduce inflammation. The onset of degenerative changes in the joint is associated with aberrant activity or depletion of these cell reservoirs, leading to loss of chondrogenic potential and preponderance of a fibrogenic phenotype. Local delivery of ex vivo cultures of MSCs has produced promising outcomes in preclinical models of joint disease. Mechanistically, paracrine signalling by MSCs might be more important than differentiation in stimulating repair responses; thus, paracrine factors must be assessed as measures of MSC therapeutic potency, to replace traditional assays based on cell-surface markers and differentiation. Several early-stage clinical trials, initiated or underway in 2013, are testing the delivery of MSCs as an intra-articular injection into the knee, but optimal dose and vehicle are yet to be established.

Barry F; Murphy M

2013-10-01

147

Dynamic stabilization for challenging lumbar degenerative diseases of the spine: a review of the literature.  

UK PubMed Central (United Kingdom)

Fusion and rigid instrumentation have been currently the mainstay for the surgical treatment of degenerative diseases of the spine over the last 4 decades. In all over the world the common experience was formed about fusion surgery. Satisfactory results of lumbar spinal fusion appeared completely incompatible and unfavorable within years. Rigid spinal implants along with fusion cause increased stresses of the adjacent segments and have some important disadvantages such as donor site morbidity including pain, wound problems, infections because of longer operating time, pseudarthrosis, and fatigue failure of implants. Alternative spinal implants were developed with time on unsatisfactory outcomes of rigid internal fixation along with fusion. Motion preservation devices which include both anterior and posterior dynamic stabilization are designed and used especially in the last two decades. This paper evaluates the dynamic stabilization of the lumbar spine and talks about chronologically some novel dynamic stabilization devices and thier efficacies.

Kaner T; Ozer AF

2013-01-01

148

Emerging technologies for degenerative disk disease: potential synergy between biochemical signaling and spinal biomechanics.  

UK PubMed Central (United Kingdom)

Interventional spinal procedures are performed with increasing frequency, and they remain an important tool for physiatrists treating patients with spine pain. As the potential treatment options expand with novel technologies on the horizon, such as gene- and cell-based therapies, the physiatrist will be uniquely poised to deliver such treatments in conjunction with exercise-based therapies. Therefore, the development of novel technologies requires particular attention to the potential synergy between biochemical signaling and spinal biomechanics. It is hoped that such insight will result in improved treatment options for patients with pain related to degenerative disk disease, leading to improved nonoperative outcomes. This article reviews the current knowledge of precipitants of disk degeneration, the effects of beneficial and traumatic levels of disk loading, and how each of these can be impacted by novel treatment options.

Leckie S; Sowa G

2009-05-01

149

Emerging technologies for degenerative disk disease: potential synergy between biochemical signaling and spinal biomechanics.  

Science.gov (United States)

Interventional spinal procedures are performed with increasing frequency, and they remain an important tool for physiatrists treating patients with spine pain. As the potential treatment options expand with novel technologies on the horizon, such as gene- and cell-based therapies, the physiatrist will be uniquely poised to deliver such treatments in conjunction with exercise-based therapies. Therefore, the development of novel technologies requires particular attention to the potential synergy between biochemical signaling and spinal biomechanics. It is hoped that such insight will result in improved treatment options for patients with pain related to degenerative disk disease, leading to improved nonoperative outcomes. This article reviews the current knowledge of precipitants of disk degeneration, the effects of beneficial and traumatic levels of disk loading, and how each of these can be impacted by novel treatment options. PMID:19627934

Leckie, Steven; Sowa, Gwendolyn

2009-05-01

150

Positive outcomes of oil palm phenolics on degenerative diseases in animal models.  

UK PubMed Central (United Kingdom)

It is well established that plant phenolics elicit various biological activities, with positive effects on health. Palm oil production results in large volumes of aqueous by-products containing phenolics. In the present study, we describe the effects of oil palm phenolics (OPP) on several degenerative conditions using various animal models. OPP reduced blood pressure in a NO-deficient rat model, protected against ischaemia-induced cardiac arrhythmia in rats and reduced plaque formation in rabbits fed an atherogenic diet. In Nile rats, a spontaneous model of the metabolic syndrome and type 2 diabetes, OPP protected against multiple aspects of the syndrome and diabetes progression. In tumour-inoculated mice, OPP protected against cancer progression. Microarray studies on the tumours showed differential transcriptome profiles that suggest anti-tumour molecular mechanisms involved in OPP action. Thus, initial studies suggest that OPP may have potential against several chronic disease outcomes in mammals.

Sambanthamurthi R; Tan Y; Sundram K; Hayes KC; Abeywardena M; Leow SS; Sekaran SD; Sambandan TG; Rha C; Sinskey AJ; Subramaniam K; Fairus S; Wahid MB

2011-12-01

151

Imaging techniques for diagnosis after surgery for degenerative disc disease. Bildgebende Diagnostik nach spinaler Diskushernienoperation  

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The magnetic resonance imaging findings recorded in patients after surgery for degenerative disc disease in the lumbar and cervical spine are discussed in comparison with conventional radiographs and computed tomography findings. In the lumbar spine normal postoperative findings in the immediate postoperative period can be demonstrated by MR imaging. Contrast-enhanced MR imaging can differentiate disc herniation from postoperative scar formation with a greater degree of confidence than other imaging modalities. MR imaging improves differentiation between other causes of failed back syndrome such as postoperative hematoma and infection, lateral spinal stenosis and arachnoiditis. In the cervical spine types of operative approaches, the appearance of bony stenosis and disc herniations by MR imaging are discussed. Computer tomography still has a role in the assessment of osseous complications such as central or foraminal stenosis. (orig.)

Trattnig, S. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Kramer, J. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Muehlbauer, M. (Neurochirurgische Univ.-Klinik, Vienna (Austria)); Kainberger, F. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria)); Imhof, H. (Abt. fuer Osteologie, MR-Inst., Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria))

1993-10-01

152

[Algorithm of diagnostics and surgery of trauma and degenerative diseases of cervical spine].  

Science.gov (United States)

A retrospective analysis of diagnostics and surgery in 240 patients was made. The vertebral spinal trauma took place in 168 patients (average age 31 +/- 5 years), degenerative dystrophic diseases of spine were in 72 patients (average age 52 +/- 7 years). The clinicodiagnostic complex included survey and functional radiography of the spine, magnetic resonance image and helical computer tomography of the spine with spondylometric measurements and color duplex scanning of the vertebral artery. Stabilization of the spine was performed in 137 (57%) cases. The variants were determined on the basis of predominate injury of 1 out of 3 supporting complexes. The rigid and dynamic methods and their combination were used for fixation of the spine. More favorable results were registered using dynamic fixation and the arthroplasty of intervertebral disks with nitinol constructions. An algorithm of radiodiagnostics and surgery methods were proposed. PMID:23808231

Shchedrenok, V V; Zakhmatova, T V; Zuev, I V; Moguchaia, O V; Tiul'kin, O N; Topol'skova, N V; Sebelev, K I

2013-01-01

153

[Algorithm of diagnostics and surgery of trauma and degenerative diseases of cervical spine].  

UK PubMed Central (United Kingdom)

A retrospective analysis of diagnostics and surgery in 240 patients was made. The vertebral spinal trauma took place in 168 patients (average age 31 +/- 5 years), degenerative dystrophic diseases of spine were in 72 patients (average age 52 +/- 7 years). The clinicodiagnostic complex included survey and functional radiography of the spine, magnetic resonance image and helical computer tomography of the spine with spondylometric measurements and color duplex scanning of the vertebral artery. Stabilization of the spine was performed in 137 (57%) cases. The variants were determined on the basis of predominate injury of 1 out of 3 supporting complexes. The rigid and dynamic methods and their combination were used for fixation of the spine. More favorable results were registered using dynamic fixation and the arthroplasty of intervertebral disks with nitinol constructions. An algorithm of radiodiagnostics and surgery methods were proposed.

Shchedrenok VV; Zakhmatova TV; Zuev IV; Moguchaia OV; Tiul'kin ON; Topol'skova NV; Sebelev KI

2013-01-01

154

When dialogue fails. Music therapy with elderly with neurological degenerative diseases  

DEFF Research Database (Denmark)

When dialogue fails. Music therapy with elderly with neurological degenerative diseases. In persons suffering from neurological degenerative diseases we often see the following symptoms: difficulties in remembering, concentrating, perceiving input, and controlling and timing movements. Normal every day conversation is building on abilities to remember facts or episodes, to sustain attention, to listen, and to time a response. Without these fundamental cognitive abilities it is difficult to communicate with others – unless the communication is adjusted to the person. Clients with a neurological degenerative disease like e.g. dementia are often socially isolated because of their failing abilities to communicate. Even if they live in a facility and are surrounded by care staff and peer residents, they might experience the environment as chaotic and the people as non-comprehensible. A missing meaningful interaction with others means that psychosocial needs are not met, and this leads to secondary symptoms of the neurological degeneration. Secondary symptoms might be expressed as repetitive behaviour, catastrophic reactions and situationally inappropriate behaviour. In a music therapeutical setting it is possible to adjust the communication in order to enter dialogue. The dialogue is the potential for sharing emotions and meeting psychosocial needs. The core of the music therapy is seen as the moments where interaction and dialogue occurs. But these moments are only “highlights” of the sessions, and before they can happen, the music therapist must build up a structure for the therapy that compensates for missing cognitive abilities of the client. This is illustrated by the following steps that integrate neuropsychological and psychodynamic theories: 1. Focus attention 2. Regulate arousal level 3. Dialogue 4. Conclusion 1. In order to compensate for missing short-term memory it is important to work deliberately with cuing. A specific song in the beginning of the music therapy session will e.g. signalise that the music therapy is to start. Using songs as cues activates cortical memory function, and work as memory traces in the brain. Using the same “hello-song” in the beginning of a session - session after session - gives stability. Stability is constancy and familiarity of cues over time (Roberts & Algase 1988), and even people with severe memory deficits are capable of creating new memory traces and of learning the meaning of new cues. The first step in music therapy is to focus attention, e.g. with stability and cues, and the next step is to regulate arousal level towards environmental attention. 2. Environmental attention depends on levels of arousal. There is a relation between medium arousal levels and the ability to understand ‘what is going on’. “You need to have just the right level of activation to perform optimally” (LeDoux 1998, p. 289). Stimulating and sedating effects of music or songs are obtained by musical parameters, such as tempo, rhythm, timbre, volume, pitch, phrasing, dynamic, and timing. By communicative parameters such as proximity, touch, movements, rhythmic rocking or “dancing”, the music therapist can apply his/her presence to stimulate or calm down the person. Altogether these techniques are inherent in our communicative musicality (Trevarthen 1999). 3. On some occasions the therapist needs many sessions in order to build up a structure and bring the person to a moderate arousal level, where the conditions for interacting and entering dialogue are at their optimum. When these conditions are created it is possible to meet psychosocial needs and decrease secondary symptoms of the degenerative disease. At this level the therapist might work with psychotherapeutic strategies such as validation, holding and facilitation (Kitwood 1997). 4. By marking and cuing the end of the session stability is established. A timeframe is given, and the client can trust that more sessions will follow in spite of the separation. Ending a music therapy session with a specific song might summarize and c

Ridder, Hanne Mette Ochsner

2004-01-01

155

Complications in degenerative lumbar disease treated with a dynamic interspinous spacer (Coflex).  

UK PubMed Central (United Kingdom)

PURPOSE: The purpose of this study was to quantify the intra- and postoperative complications of an interspinous process device (Coflex) in managing degenerative lumbar diseases and to investigate corresponding therapeutic strategies. METHODS: Between January 2008 and December 2012, we retrospectively analysed a total of 131 patients who underwent decompressive surgery along with the Coflex system for the treatment of degenerative lumbar diseases. The related complications were reported, and appropriate measures were taken. Clinical outcomes and radiological data were collected and analysed, and clinical outcomes were evaluated with paired-samples T test. RESULTS: Related complications occurred in 11 patients. Among them, six cases were found with surgical technique-related complications, including device-related complications in three cases: spinal process fracture (n?=?1), Coflex loosening (n?=?1), fixed-wing breakage (n?=?1), dura mater tear in two cases and superficial wound infection in one case. All of them received corresponding conservative treatment and obtained a good result. The other five cases had non-device-related complications and required additional spinal surgery. The conservative therapy group had apparent improvement of VAS score and ODI, and remained well to final follow-up (P?

Xu C; Ni WF; Tian NF; Hu XQ; Li F; Xu HZ

2013-07-01

156

Postoperative urinary retention following anterior cervical spine surgery for degenerative cervical disc diseases.  

UK PubMed Central (United Kingdom)

BACKGROUND: Postoperative urinary retention (POUR) may cause bladder dysfunction, urinary tract infection, and catheter-related complications. It is important to be aware and to be able to identify patients at risk of developing POUR. However, there has been no study that has investigated the incidence and risk factors for the development of POUR following anterior cervical spine surgery for degenerative cervical disc disease. METHODS: We included 325 patients (164 male and 161 female), who underwent anterior cervical spine surgery for cervical radiculopathy or myelopathy due to primary cervical disc herniation and/or spondylosis, in the study. We did not perform en bloc catheterization in our patients before the operation. RESULTS: There were 36 patients (27 male and 9 female) that developed POUR with an overall incidence of 11.1%. The mean numbers of postoperative in-and-out catheterizations was 1.6 times and mean urine output was 717.7 mL. Thirteen out of 36 POUR patients (36%) underwent indwelling catheterization for a mean 4.3 days after catheterization for in-and-out surgery, because of persisting POUR. Seven out of 36 POUR patients (19%) were treated for voiding difficulty, urinary tract irritation, or infection. Chi-square test showed that patients who were male, had diabetes mellitus, benign prostate hypertrophy or myelopathy, or used Demerol were at higher risk of developing POUR. The mean age of POUR patients was higher than non-POUR patients (68.5 years vs. 50.8 years, p < 0.01). CONCLUSIONS: To avoid POUR and related complications as a result of anterior cervical spine surgery for degenerative cervical disc disease, we recommend that a catheter be placed selectively before the operation in at-risk patients, the elderly in particular, male gender, diabetes mellitus, benign prostate hypertrophy, and myelopathy. We recommend that Demerol not be used for postoperative pain control.

Jung HJ; Park JB; Kong CG; Kim YY; Park J; Kim JB

2013-06-01

157

Predictive diagnostics and personalized medicine for the prevention of chronic degenerative diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Progressive increase of mean age and life expectancy in both industrialized and emerging societies parallels an increment of chronic degenerative diseases (CDD) such as cancer, cardiovascular, autoimmune or neurodegenerative diseases among the elderly. CDD are of complex diagnosis, difficult to treat and absorbing an increasing proportion in the health care budgets worldwide. However, recent development in modern medicine especially in genetics, proteomics, and informatics is leading to the discovery of biomarkers associated with different CDD that can be used as indicator of disease’s risk in healthy subjects. Therefore, predictive medicine is merging and medical doctors may for the first time anticipate the deleterious effect of CDD and use markers to identify persons with high risk of developing a given CDD before the clinical manifestation of the diseases. This innovative approach may offer substantial advantages, since the promise of personalized medicine is to preserve individual health in people with high risk by starting early treatment or prevention protocols. The pathway is now open, however the road to an effective personalized medicine is still long, several (diagnostic) predictive instruments for different CDD are under development, some ethical issues have to be solved. Operative proposals for the heath care systems are now needed to verify potential benefits of predictive medicine in the clinical practice. In fact, predictive diagnostics, personalized medicine and personalized therapy have the potential of changing classical approaches of modern medicine to CDD.

Licastro Federico; Caruso Calogero

2010-01-01

158

Spontaneous degenerative polioencephalomyelopathy in feeder pigs--a new motor neuron disease?  

UK PubMed Central (United Kingdom)

A central nervous disorder occurred spontaneously in a herd of feeder pigs characterized by muscle fasciculations, convulsions, squealing, and acute death in numerous animals. Histopathology revealed a degenerative poliomyeloencephalopathy of brain stem and spinal cord consisting of neuronal hypertrophy, chromatolysis, neuronophagia, and satellitosis associated with Wallerian degeneration of ventral rootlets and neurogenic muscle atrophy of limb musculature. The sudden onset of clinical signs and the pattern of morphological findings were suggestive of intoxication. Though parathion was found in two animals, serum acetylcholine esterase activity and morphological findings were not compatible with an organophosphate poisoning. A hereditary disorder was excluded by genetic analysis. Summarized findings in the present cases are reminiscent of changes observed in ruminants suffering from patulin poisoning, a neuromycotoxicosis caused by Aspergillus clavatus. However, toxicological and microbiological investigations failed to identify the cause of this unusual and so far not described disease in pigs. Morphologically, lesion distribution and alterations of motor neurons resemble changes observed in equine motor neuron disease, spinal muscular atrophy of certain canine breeds, and amyotrophic lateral sclerosis (Lou Gehrig's disease) in man. Therefore, the term spontaneous porcine motor neuron disease (SPMND) is proposed for this new and unique entitiy.

Wohlsein P; Brügmann M; Pfeiffer I; Ammer H; Wolf P; Baumgartner W; Peters M

2012-11-01

159

Spontaneous degenerative polioencephalomyelopathy in feeder pigs--a new motor neuron disease?  

Science.gov (United States)

A central nervous disorder occurred spontaneously in a herd of feeder pigs characterized by muscle fasciculations, convulsions, squealing, and acute death in numerous animals. Histopathology revealed a degenerative poliomyeloencephalopathy of brain stem and spinal cord consisting of neuronal hypertrophy, chromatolysis, neuronophagia, and satellitosis associated with Wallerian degeneration of ventral rootlets and neurogenic muscle atrophy of limb musculature. The sudden onset of clinical signs and the pattern of morphological findings were suggestive of intoxication. Though parathion was found in two animals, serum acetylcholine esterase activity and morphological findings were not compatible with an organophosphate poisoning. A hereditary disorder was excluded by genetic analysis. Summarized findings in the present cases are reminiscent of changes observed in ruminants suffering from patulin poisoning, a neuromycotoxicosis caused by Aspergillus clavatus. However, toxicological and microbiological investigations failed to identify the cause of this unusual and so far not described disease in pigs. Morphologically, lesion distribution and alterations of motor neurons resemble changes observed in equine motor neuron disease, spinal muscular atrophy of certain canine breeds, and amyotrophic lateral sclerosis (Lou Gehrig's disease) in man. Therefore, the term spontaneous porcine motor neuron disease (SPMND) is proposed for this new and unique entitiy. PMID:23227771

Wohlsein, Peter; Brügmann, Michael; Pfeiffer, Ina; Ammer, Hermann; Wolf, Petra; Baumgartner, Wolfgang; Peters, Martin

160

Outcome of the L5-S1 Segment after Posterior Instrumented Spinal Surgery in Degenerative Lumbar Diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Posterior decompression, instrumentation, and posterolateral fusion are surgicalprocedures for the treatment of degenerative lumbar diseases. Solidfusion usually causes adjacent problems. This study investigated the clinicaloutcome and radiographic fate of the L5-S1 segment in patients who underwentposterior instrumented surgery for degenerative lumbar diseases.Methods: From January 1999 to December 2000, 181 patients (average age 59.4 years,range 45-79 years) underwent posterior decompression, posterior instrumentation,and posterolateral fusion for degenerative lumbar diseases (includingdegenerative spondylolisthesis and degenerative lumbar scoliosis) withspinal stenosis. Modified Brodsky’s criteria and the Oswestry disabilityindex were used to evaluate patients before surgery and at the final followup.Degenerative changes in the L5-S1 intervertebral disc were evaluatedwith the University of California at Los Angeles (UCLA) grading scale.Adjacent L5-S1 segmental instability was defined as the appearance ofretrolisthesis, anterolisthesis, or lateral listhesis in the static or dynamic radiographsat the final follow-up.Results: Only 1 of these 181 patients developed inferior adjacent instability, but therewere no symptoms related to this instability. The mean pre-operative L5-S1disc degenerative score was 1.73 ± 0.66 and at the last follow-up, 1.87 ±0.72 (p = 0.006). There was no symptomatic disc degeneration necessitatingfurther L5-S1 fusion during follow-up. One hundred fifty-six patients (86%)exhibited satisfactory results (good or excellent). The mean Oswestry scorewas 21.8 ± 6.0 preoperatively, which improved to 9.6 ± 7.4 at the last follow-up (p = 0.001).Conclusions: The L5-S1 disc degenerated more after posterolateral lumbar floating fusion.However, there was no symptomatic inferior adjacent instability or symptomaticL5-S1 disc degeneration requiring further L5-S1 fusion at a mean 5.1years follow-up.

Jen-Chung Liao; Wen-Jer Chen; Lih-Huei Chen; Chi-Chien Niu

2009-01-01

 
 
 
 
161

[Application of robotic assistance in surgical treatment of degenerative disease of lumbosacral spine].  

Science.gov (United States)

Robotic assistance has gained increasing popularity in spinal surgery recently. Robotic assistance provides higher effectiveness and safety especially in conditions of complicated anatomy. It also enables the novel, previously unavailable surgical techniques, such as GO-Lif for lumbar spine fusion. The aim of the study is to assess the applicability and effectiveness of the robotic assistance in surgical treatment of degenerative lesion of lumbar spine. 16 patients were operated with robotic assistance device (SpineAssist; MAZOR Surgical Technologies, Caesarea, Israel) between August 2009 and February 2010 in Spinal Department of Burdenko Neurosurgical Institute (Moscow, Russia) with degenerative disc disease. Preoperative assessment included MRI, X-rays and high-resolution CT (slice < 1 mm). The CT is essential for preoperative planning using computed work station SpineAssist. The robot was utilized for automated intraoperative positioning of the instruments according to preoperatively planned trajectories. Basic parameters of surgeries were thoroughly recorded: overall surgery time, radiation dose (all manipulations were performed under fluoroscopic control), accuracy of screw placement relative to preoperative planning, which was assessed using postoperative high-resolution CT with 3D reconstruction. Particular interest of the study was focused on the novel fusion technique for lumbar spine: Go-Lif (Guided Oblique Lumbar Interbody Fusion). This fusion modality enables segment fixation with two screws only, it is comparable with pedicular screws in terms of stability, being far less invasive. It may be used standalone or together with TLIF techniques. Robotic assistance enabled optimal screw placement even in complex anatomical cases (thin pedicles and rotational deformity). No implant-related complications were recorded. Surgery time was much longer in first 2 cases, though in further it decreased nearly to conventional (without robot) surgery time. For radiation dose same tendency was observed--in first 2 cases all surgical steps were fluoroscopically controlled, in further cases--only for primary anatomy registration. Based on control CT, accuracy of implant placement with robotic assistance is 1 mm. PMID:21260933

Konovalov, N A; Shevelev, I N; Kornienko, V N; Nazarenko, A G; Zelenkov, P V; Isaev, K A; Asiutin, D S

162

[Application of robotic assistance in surgical treatment of degenerative disease of lumbosacral spine].  

UK PubMed Central (United Kingdom)

Robotic assistance has gained increasing popularity in spinal surgery recently. Robotic assistance provides higher effectiveness and safety especially in conditions of complicated anatomy. It also enables the novel, previously unavailable surgical techniques, such as GO-Lif for lumbar spine fusion. The aim of the study is to assess the applicability and effectiveness of the robotic assistance in surgical treatment of degenerative lesion of lumbar spine. 16 patients were operated with robotic assistance device (SpineAssist; MAZOR Surgical Technologies, Caesarea, Israel) between August 2009 and February 2010 in Spinal Department of Burdenko Neurosurgical Institute (Moscow, Russia) with degenerative disc disease. Preoperative assessment included MRI, X-rays and high-resolution CT (slice < 1 mm). The CT is essential for preoperative planning using computed work station SpineAssist. The robot was utilized for automated intraoperative positioning of the instruments according to preoperatively planned trajectories. Basic parameters of surgeries were thoroughly recorded: overall surgery time, radiation dose (all manipulations were performed under fluoroscopic control), accuracy of screw placement relative to preoperative planning, which was assessed using postoperative high-resolution CT with 3D reconstruction. Particular interest of the study was focused on the novel fusion technique for lumbar spine: Go-Lif (Guided Oblique Lumbar Interbody Fusion). This fusion modality enables segment fixation with two screws only, it is comparable with pedicular screws in terms of stability, being far less invasive. It may be used standalone or together with TLIF techniques. Robotic assistance enabled optimal screw placement even in complex anatomical cases (thin pedicles and rotational deformity). No implant-related complications were recorded. Surgery time was much longer in first 2 cases, though in further it decreased nearly to conventional (without robot) surgery time. For radiation dose same tendency was observed--in first 2 cases all surgical steps were fluoroscopically controlled, in further cases--only for primary anatomy registration. Based on control CT, accuracy of implant placement with robotic assistance is 1 mm.

Konovalov NA; Shevelev IN; Kornienko VN; Nazarenko AG; Zelenkov PV; Isaev KA; Asiutin DS

2010-07-01

163

Does anterior cruciate ligament reconstruction lead to degenerative disease?: Thirteen-year results after bone-patellar tendon-bone autograft.  

UK PubMed Central (United Kingdom)

BACKGROUND: Reporting of long-term outcome of anterior cruciate ligament (ACL) reconstruction with the patellar tendon (bone-patellar tendon-bone [BTB]) autograft is limited. There are concerns that degenerative joint disease is common in the long term, which may be associated with the procedure itself. HYPOTHESES: (1) ACL reconstruction with BTB provides good long-term outcome. (2) There are additional factors to surgical reconstruction that can be associated with the development of degenerative disease. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Of 161 patients, 114 were eligible. Patient-centered outcome was by Lysholm and subjective International Knee Documentation Committee (IKDC) score; objective outcome measures were clinical examination and IKDC radiological grade. RESULTS: Mean average follow-up was 13 years. The IKDC radiological grades in the worst compartment were A = 15%, B = 51%, C = 19%, and D = 14% (n = 83). There was a significant difference between the injured versus contralateral uninjured knee (n = 42, P = .003). In a subgroup with no meniscal or chondral injury the IKDC grades were A = 38%, B = 55%, C = 7%, and D = 0% (n = 29). The mean subjective scores were 89 ± 11 (Lysholm) and 83 ± 15 (IKDC) (n = 114). Poor IKDC subjective outcome was associated with chondral injury (P = .001), previous surgery (P = .022), return to sport (P = .013), and poor radiological grade in the ipsilateral medial compartment (P = .004). A poor IKDC radiological grade was associated with chondral injury (P = .002), meniscal injury (P = .010) and meniscectomy (P = .012), an IKDC subjective score of <85 (P = .01), and poor radiological grade in the contralateral medial compartment (P = .041). CONCLUSION: At 13 years, BTB ACL reconstruction provides a good outcome. Chondral and meniscal damage at surgery were associated with a poor radiological outcome, indicating that injuries sustained during ACL rupture may be the main predictors of degenerative bone disease.

Murray JR; Lindh AM; Hogan NA; Trezies AJ; Hutchinson JW; Parish E; Read JW; Cross MV

2012-02-01

164

Heparanase isoform expression and extracellular matrix remodeling in intervertebral disc degenerative disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english OBJECTIVE: To determine the molecules involved in extracellular matrix remodeling and to identify and quantify heparanase isoforms present in herniated and degenerative discs. INTRODUCTION: Heparanase is an endo-beta-glucuronidase that specifically acts upon the heparan sulfate chains of proteoglycans. However, heparanase expression in degenerative intervertebral discs has not yet been evaluated. Notably, previous studies demonstrated a correlation between changes in the (more) heparan sulfate proteoglycan pattern and the degenerative process associated with intervertebral discs. METHODS: Twenty-nine samples of intervertebral degenerative discs, 23 samples of herniated discs and 12 samples of non-degenerative discs were analyzed. The expression of both heparanase isoforms (heparanase-1 and heparanase-2) was evaluated using immunohistochemistry and real-time RT-PCR analysis. RESULTS: Heparanase-1 and heparanase-2 expression levels were significantly higher in the herniated and degenerative discs in comparison to the control tissues, suggesting a possible role of these proteins in the intervertebral degenerative process. CONCLUSION: The overexpression of heparanase isoforms in the degenerative intervertebral discs and the herniated discs suggests a potential role of both proteins in the mediation of inflammatory processes and in extracellular matrix remodeling. The heparanase-2 isoform may be involved in normal metabolic processes, as evidenced by its higher expression in the control intervertebral discs relative to the expression of heparanase-1.

Rodrigues, Luciano Miller Reis; Theodoro, Thérèse Rachell; Matos, Leandro Luongo; Mader, Ana Maria; Milani, Carlo; Pinhal, Maria Aparecida da Silva

2011-01-01

165

A long-term follow-up study of radiographically evident degenerative changes in the temporomandibular joint with different conditions of disk displacement.  

Science.gov (United States)

The purpose of this retrospective study is to assess the relationship between an initial and persisting condition of disk displacement (DD) and the long-term course of radiographically evident degenerative changes of the temporomandibular joint (TMJ). Nineteen patients agreed to a radiographic follow-up examination of 29 joints and were included in this study. The joints were radiographically assessed at the first visit and at least 46 months after the first visit (mean 89.3 months). At the time of the follow-up, all subjects had a good clinical course after a favorable response to the treatments. There were significant relationships between the initial diagnosis of DD and the interval change in the morphology of the articular eminence. The articular eminence became flattened or deformed only in the joints with persistent DD without reduction. And there was a tendency that the condyle became smaller in the joints initially with permanent DD and in the joints which show a progression in the disk-condylar relationship. The results of this study suggested that, in the joints with persisting non-reducing disk displacement, flattening and deformation of the articular eminence and regression of the condylar size were likely to happen even after symptoms and signs of TMJ disorders were resolved or reduced. PMID:15961278

Kurita, H; Uehara, S; Yokochi, M; Nakatsuka, A; Kobayashi, H; Kurashina, K

2005-06-14

166

[Clinical analysis of interspinous dynamic internal fixation with the Coflex system in treating lumbar degenerative disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare the clinical effects between interspinous dynamic internal fixation with Coflex system and posterior lumbar interbody fusion in treating lumbar degenerative disease. METHODS: From Jan. 2007 to Jan. 2010, 42 patients with lumbar degenerative disease were treated with interspinous dynamic internal fixation with Coflex system (non-fusion group, 21 cases) and posterior lumbar interbody fusion (fusion group, 21 cases), including 19 males and 23 females with an average age of (46.5 +/- 8.5) years (range, 33 to 62 years). The range of course of disease was from 6 to 84 months with an average of 36 months. All pathological changes were single segment in L4.5 by X-ray films or CT scanning, among them, single lumbar disc herniation was in 14 cases,combined with lumbar spinal stenosis in 28 cases. The clinical effects of all patients were evaluated according to Japanese orthopaedic association (JOA, 29 points) and Oswestry disability index (ODI); range of motion (ROM) of lumbar segments were measured by X-ray films; operative time, intraoperative blood loss,hospital stay were compared between two groups. RESULTS: All patients were followed up for 10 months at least. In non-fusion group, JOA increased from 13.8 +/- 3.7 preoperatively to 24.6 +/- 4.6 at final follow-up (P < 0.01); ODI decreased from 65.8 +/- 7.5 to 25.6 +/- 5.1 (P < 0.01), ROM improved from 4.2 +/- 0.7 to 5.3 +/- 0.6 at L4,5 (P < 0.01 ). In fusion group,JOA increased from 13.2 +/- 3.2 preoperatively to 24.5 +/-4.3 at final follow-up (P < 0.01); ODI decreased from 65.5 +/- 8.2 to 26.5 +/- 6.1 (P < 0.01); all ROM at L.4,5 had lose (decreased from 4.2 +/- 3.2 to 0). There were significant differences in the operative time, intraoperative blood loss, hospital stay between two groups (P < 0.01), in non-fusion group was respectively (71.2 +/- 12.8) min, (56.6 +/- 25.5) ml, (4.4 +/- 1.3) d and in fusion group was respectively (121.0 +/- 23.2) min, (135.8 +/- 19.8) ml, (12.6 +/- 2.4) d. No complications were found with the Coflex system. CONCLUSION: Interspinous dynamic internal fixation with Coflex system in treating lumbar degenerative disease is better than that of posterior lumbar interbody fusion in some aspects. Coflex system have high safety, less trauma, and can reserve lumbar mobility, which is effective in preventing adjacent intervertebral disc degeneration.

Du FT

2011-04-01

167

Pelvic parameters of sagittal balance in extreme lateral interbody fusion for degenerative lumbar disc disease.  

UK PubMed Central (United Kingdom)

There is increasing interest in the use of pelvic indices to evaluate sagittal balance and predict outcomes in patients with spinal disease. Conventional posterior lumbar fusion techniques may adversely affect lumbar lordosis and spinal balance. Minimally invasive fusion of the lumbar spine is rapidly becoming a mainstay of treatment of lumbar degenerative disc disease. To our knowledge there are no studies evaluating the effect of extreme lateral interbody fusion (XLIF) on pelvic indices. Hence, our aim was to study the effect of XLIF on pelvic indices related to sagittal balance, and report the results of a prospective longitudinal clinical study and retrospective radiographic analyses of patients undergoing XLIF in a single centre between January 2009 and July 2011. Clinical outcomes are reported for 30 patients and the retrospective analyses of radiographic data is reported for 22 of these patients to assess global and segmental lumbar lordosis and pelvic indices. Effect of XLIF on the correction of scoliotic deformity was assessed in 15 patients in this series. A significant improvement was seen in the visual analogue scale score, the Oswestry Disability Index and the Short Form-36 at 2months and 6months (p<0.0001). The mean pelvic index was 48.6°±11.9° (± standard deviation, SD) with corresponding mean sacral slopes and pelvic tilt of 32.0°±10.6° (SD) and 18.0°±9.5 (SD), respectively. XLIF did not significantly affect sacral slope or pelvic tilt (p>0.2). Global lumbar lordosis was not affected by XLIF (p>0.4). XLIF significantly increased segmental lumbar lordosis by 3.3° (p<0.0001) and significantly decreased the scoliotic Cobb angle by 5.9° (p=0.01). We found that XLIF improved scoliosis and segmental lordosis and was associated with significant clinical improvement in patients with lumbar degenerative disc disease. However, XLIF did not change overall lumbar lordosis or significantly alter pelvic indices associated with sagittal balance. Long-term follow-up with a larger cohort will be required to further evaluate the effects of XLIF on sagittal balance.

Johnson RD; Valore A; Villaminar A; Comisso M; Balsano M

2013-04-01

168

Short-term clinical observation of the Dynesys neutralization system for the treatment of degenerative disease of the lumbar vertebrae.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To explore the safety and short-term efficacy of the posterior approach of the Dynesys dynamic neutralization system for degenerative disease of the lumbar vertebrae. METHODS: ? From March 2008 to March 2010, 32 cases of degenerative lumbar vertebral disease, 19 men and 13 women, (mean age 58 ± 5.2, range, 43-78 years), were treated with posterior laminectomy and Dynesys internal fixation. All patients had a history of over 3 months waist or leg pain that had not been relieved by conservative treatment. There were 10 cases of single lumbar intervertebral disc protrusion, 14 of degenerative lumbar spinal stenosis, 5 of degenerative lumbar isthmic spondylolisthesis, and 3 of recurrent lumbar disc protrusion after surgery. A visual analogue score (VAS) was used for pain assessment, and the Oswestry disability index (ODI) for functional evaluation of clinical outcomes. RESULTS: All patients were followed up for 6-23 months (mean, 16.4 ± 5.5 months). Forty-one segments in 32 patients were stabilized; 23 cases (71.9%) underwent single-segmental stabilization, and 9 (28.1%) two-segmental stabilization. VAS of leg pain, root and low back pain was significantly improved postoperatively. The ODI improved from preoperative 69% ± 12.6% to postoperative 28% ± 15.7% (P < 0.001). On the stabilized segment and adjacent segments above and below, the range of movement showed no statistical difference; no loosening of screws, cord and polyester spacer occurred. CONCLUSION: ? The Dynesys dynamic neutralization system combined with decompression can achieve satisfactory short-term clinical results in lumbar degenerative disease. This procedure system not only reduces back and leg pain, but also preserves the mobility of fixed segments, minimizes tissue injury and avoids taking bone for spinal fusion.

Hu Y; Gu YJ; Xu RM; Zhou LJ; Ma WH

2011-08-01

169

[Surgical treatment of degenerative cervical spine diseases: analyses of 90 patients clinical study].  

UK PubMed Central (United Kingdom)

The effect of degenerative cervical spine surgery depends on good understanding of the pathogenesis and clinical course of disease with a detailed neurological and neuroradiological examination. Surgical approach should be considered separately for each pathological substrate in order to avoid additional morbidity. The aim of our study is to present the results of treatment through analysis of large clinical series focusing on anterior surgical approach with iliac crest graft fusion without cervical plating. The retrospective analysis of 90 patients operated on Neurosurgery of CHC Zemun, from 2008 to 2011, was done. In 81 patients cervical disc herniation was found in one or two levels, and 9 patients had spinal canal stenosis with polydiscopathy. Preoperatively 50 patients had cervical myelopathy, and 40 patients had radiculopathy as dominating clinical sign. Anterior cervical approach was performed in 79 patients, and 11 patients were operated by posterior approach. The treatment outcome was as follows: good outcome 16 (16.8%) patients, improved condition 65 (72.2%), without improvement 6 (6.7%), bad outcome 3 (4.3%). The anterior cervical approach with iliac crest autologous graft fusion, and without additional cervical plating, is reliable treatment option with results comparable to reported clinical series with sintetic graft placement and anterior cervical plate stabilisation.

Markovi? M; Zivkovi? N; Stojanovi? D; Samardzi? M

2012-01-01

170

Radiopharmaceuticals for SPECT exploration of dopaminergic systems. Diagnosis and surveillance of neuro-degenerative diseases  

International Nuclear Information System (INIS)

New radiopharmaceuticals were developed to explore the pre- or post-synaptic slopes of the dopaminergic terminations. At present, their interest is recognized for the differential diagnosis of the extra-pyramidal syndromes. Other various applications in neurology and psychiatry are in view. On the pre-synaptic slope, implied in the Parkinson's disease, the dopamine carrier, able to be visualized due to its iodine derivatives of cocaine, is localized. The ?CIT, which is presently the best known specificity-free derivative, has actually an equivalent affinity for the dopamine carrier and the serotonin carrier. Besides, its kinetic does not allow its imaging in the day of injection. We have developed and validated another derivative, the PE2I: N-(3-Iodoprop-(2E)-enyl) -2?-carbometoxy -3?-(4'-methyl-phenyl) nortropane which displays the properties required by kinetic and specificity. On the post-synaptic slope the type-D2 dopaminergic receptors were localized, which can be explored by means of (iodolisuride) ergolenes and benzamide derivatives (IBZM). These ligands have not an AMM yet, therefore their utilization may be approached by magistral preparation. The scintigraphy of the D2 receptors and dopamine carrier could be useful for the earlier diagnosis and the therapeutic surveillance of the neuro-degenerative decease. The coupling of the pre- and post-synaptic scintigraphies may be taken into consideration to augment diagnosis potentiality

1997-01-01

171

Red blood cell distribution width in dogs with chronic degenerative valvular disease.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate RBC distribution width (RDW) in dogs with chronic degenerative valvular disease (CDVD) with compensated or decompensated heart failure. DESIGN: Retrospective case-control study. ANIMALS: 27 healthy dogs and 135 dogs with CDVD (87 dogs with compensated heart failure and 48 dogs with decompensated heart failure). PROCEDURES: The RDW and various CBC and serum biochemical variables were compared among groups. Correlations between RDW and various echocardiographic variables were evaluated. RESULTS: Mean ± SD RDW in dogs with CDVD (13.1% ± 1.0%) was not significantly different from that of healthy dogs (12.8% ± 0.8%). The RDW of dogs with CDVD and compensated heart failure (13.0% ± 1.0%) was not significantly different from that of dogs with CDVD and decompensated heart failure (13.2% ± 1.1%). The RDW had a significant, weak, negative correlation with Hct (correlation coefficient, -0.250), hemoglobin concentration (correlation coefficient, -0.219), and mean corpuscular volume (correlation coefficient, -0.211). The RDW had a significant, weak, positive correlation with 1 echocardiographic index of CDVD severity (ie, the left atrium-to-aorta ratio [correlation coefficient, 0.183]). CONCLUSIONS AND CLINICAL RELEVANCE: In this study population, RDW did not seem to be associated with the presence of heart failure or CDVD.

Guglielmini C; Poser H; Pria AD; Drigo M; Mazzotta E; Berlanda M; Luciani A

2013-09-01

172

Quantitative analysis of CT scan in degenerative diseases of the nervous system  

Energy Technology Data Exchange (ETDEWEB)

Quantitative analysis was made on cranial CT scans of 142 patients with spinocerebellar degeneration (SCD), 16 with dentato-rubro-pallido-luysian atrophy (DRPLA), 12 with Huntington's chorea (HC), and four with chorea-acanthocytosis (CA). One hundred sex- and age-matched persons without any neurologic signs served as controls. Regarding parameters for atrophy in the infratentorial brain tissue, there was statistically significant difference between the SCD group and the control group. This indicated remarkable atrophy in the cerebellum and brain stem in SCD. According to subgroups of SCD, both bilateral atrophy of the pons and dilation of the prepontine cistern were significantly greater in the group of sporadic olivo-ponto-cerebellar atrophy than the group of Menzel type of olivo-ponto-cerebellar atrophy. The subgroup of hereditary spastic paraplegia had the mildest atrophy of the brain on CT, although there was still a significant atrophy compared with controls. In the DRPLA group, finding in the infratentorial brain tissue were similar to those in the SCD group. The HC group was characterized by having the greatest atrophy in the lateral ventricle, especially the caudate nuclei. Similar findings were seen in the CA group, although atrophy was generally mild. The results indicate the usefulness of quantitative analysis on CT in the diagnosis of degenerative diseases of the nervous system. (Namekawa, K.).

Matsuoka, Yukihiko; Yamamoto, Hiroko; Sobue, Itsuro.

1988-05-01

173

Mutations in RPGR and RP2 Account for 15% of Males with Simplex Retinal Degenerative Disease  

Science.gov (United States)

Purpose. To determine the proportion of male patients presenting simplex retinal degenerative disease (RD: retinitis pigmentosa [RP] or cone/cone-rod dystrophy [COD/CORD]) with mutations in the X-linked retinal degeneration genes RPGR and RP2. Methods. Simplex males were defined as patients with no known affected family members. Patients were excluded if they had a family history of parental consanguinity. Blood samples from a total of 214 simplex males with a diagnosis of retinal degeneration were collected for genetic analysis. The patients were screened for mutations in RPGR and RP2 by direct sequencing of PCR-amplified genomic DNA. Results. We identified pathogenic mutations in 32 of the 214 patients screened (15%). Of the 29 patients with a diagnosis of COD/CORD, four mutations were identified in the ORF15 mutational hotspot of the RPGR gene. Of the 185 RP patients, three patients had mutations in RP2 and 25 had RPGR mutations (including 12 in the ORF15 region). Conclusions. This study represents mutation screening of RPGR and RP2 in the largest cohort, to date, of simplex males affected with RP or COD/CORD. Our results demonstrate a substantial contribution of RPGR mutations to retinal degenerations, and in particular, to simplex RP. Based on our findings, we suggest that RPGR should be considered as a first tier gene for screening isolated males with retinal degeneration.

Branham, Kari; Othman, Mohammad; Brumm, Matthew; Karoukis, Athanasios J.; Atmaca-Sonmez, Pelin; Yashar, Beverly M.; Schwartz, Sharon B.; Stover, Niamh B.; Trzupek, Karmen; Wheaton, Dianna; Jennings, Barbara; Ciccarelli, Maria Laura; Jayasundera, K. Thiran; Lewis, Richard A.; Birch, David; Bennett, Jean; Sieving, Paul A.; Andreasson, Sten; Duncan, Jacque L.; Fishman, Gerald A.; Iannaccone, Alessandro; Weleber, Richard G.; Jacobson, Samuel G.; Heckenlively, John R.; Swaroop, Anand

2012-01-01

174

Red blood cell distribution width in dogs with chronic degenerative valvular disease.  

Science.gov (United States)

Objective-To evaluate RBC distribution width (RDW) in dogs with chronic degenerative valvular disease (CDVD) with compensated or decompensated heart failure. Design-Retrospective case-control study. Animals-27 healthy dogs and 135 dogs with CDVD (87 dogs with compensated heart failure and 48 dogs with decompensated heart failure). Procedures-The RDW and various CBC and serum biochemical variables were compared among groups. Correlations between RDW and various echocardiographic variables were evaluated. Results-Mean ± SD RDW in dogs with CDVD (13.1% ± 1.0%) was not significantly different from that of healthy dogs (12.8% ± 0.8%). The RDW of dogs with CDVD and compensated heart failure (13.0% ± 1.0%) was not significantly different from that of dogs with CDVD and decompensated heart failure (13.2% ± 1.1%). The RDW had a significant, weak, negative correlation with Hct (correlation coefficient, -0.250), hemoglobin concentration (correlation coefficient, -0.219), and mean corpuscular volume (correlation coefficient, -0.211). The RDW had a significant, weak, positive correlation with 1 echocardiographic index of CDVD severity (ie, the left atrium-to-aorta ratio [correlation coefficient, 0.183]). Conclusions and Clinical Relevance-In this study population, RDW did not seem to be associated with the presence of heart failure or CDVD. (J Am Vet Med Assoc 2013;243:858-862). PMID:24004234

Guglielmini, Carlo; Poser, Helen; Pria, Angela Dalla; Drigo, Michele; Mazzotta, Elisa; Berlanda, Michele; Luciani, Alessia

2013-09-15

175

A multimarker study of degenerative aortic valve disease: stenoinsufficiency shows more indices of bad prognosis.  

UK PubMed Central (United Kingdom)

OBJECTIVES: It was the aim of this study to assess the pathophysiological, prognostic role of aortic regurgitation (AR) in the 'mixed pictures' of degenerative aortic valve stenoinsufficiency (ASI) by a multimarker clinical approach. METHODS: We enrolled 112 consecutive surgical PATIENTS: 19 with pure valve stenosis (PAS), 39 with mild regurgitation, 29 with severe regurgitation, and 25 controls with annulo-ectatic AR. All underwent complete echocardiography, carotid ultrasound and aortic/coronary multislice computed tomography calcium score evaluation. We determined tissue semiquantitative osteopontin, metalloproteinases (MMPs), tissue inhibitors of MMPs (TIMPs) and circulating brain natriuretic peptide. We evaluated major adverse cardiac events and cardiovascular early, long-term mortality after bioprosthetic valve implantation. RESULTS: Tissue calcification, carotid and coronary atherosclerotic disease were prevalent in PAS versus ASI and AR patients. The multislice computed tomography calcium score (Agatston) was comparable between PAS and ASI (PAS 3,507.3 + 2,442.6; mild AR 4,270.7 + 2,213.5; severe AR 3,568.5 + 1,823.4), but much lower in AR (1,247.8 + 2,708.6). In ASI, a plasma/tissue 'profibrotic' MMP/TIMP balance prevailed, with circulating and echocardiographic indices of myocardial dysfunction. Percentages of major adverse cardiac events and early, long-term mortality were higher in ASI. Conclusions: In ASI, different, still unknown, genetic and dysplastic factors could work synergically with cardiovascular risk factors, determining a much more adverse myocardial and valve remodeling, resulting in worse clinical outcome.

Vianello A; Perlini S; Cappelli S; Palladini G; Epistolato MC; Della Latta D; Cerillo A; Berti S; Chiappino D; Tanganelli P; Glauber M; Mazzone A

2013-01-01

176

Effect of TENS on pain relief in patients with degenerative disc disease in lumbosacral spine.  

UK PubMed Central (United Kingdom)

BACKGROUND: The study sought to evaluate the impact of long-term TENS therapy on pain relief in patients with degenerative disc disease in the lumbosacral spine. MATERIAL AND METHOD: The study involved 39 patients with lumbosacral pain who were receiving treatment in the Regional Hospital No 2 in Rzeszów and in Winsen Hospital. The experimental group consisted of 16 patients who were fitted with L-S orthoses with a built-in OmniTens plus mini-device for long-term application (3 times a day, for 20 minutes) of TENS currents with a frequency of 35 Hz and impulse duration of 150µsec. The control group consisted of 23 patients who received conventional TENS therapy once a day for 20 minutes, with a frequency of 35 Hz and impulse duration of 150 µsec. The results were assessed with the Oswestry Questionnaire, a visual analogue scale (VAS), as well as Schober's Test. Tests were performed before and on completion of the therapy. RESULTS: All participants reported pain relief and improved spinal function and mobility. Statistically significant differences were obtained in the group of patients treated with low frequency pulsed TENS currents administered via the orthosis. CONCLUSIONS: 1. TENS therapy contributed to pain relief and improvement of function and mobility of the lumbosacral spine 2. Representing an appropriate and effective technique, TENS stimulation via an orthosis should be more commonly prescribed.

Pop T; Austrup H; Preuss R; Niedzia?ek M; Zaniewska A; Sobolewski M; Dobrowolski T; Zwoli?ska J

2010-07-01

177

Yoga and disc degenerative disease in cervical and lumbar spine: an MR imaging-based case control study.  

UK PubMed Central (United Kingdom)

The objective of the current study was to find out whether yoga practice was beneficial to the spine by comparing degenerative disc disease in the spines of long-time yoga practitioners and non-yoga practicing controls, using an objective measurement tool, magnetic resonance imaging. This matched case-control study comprised 18 yoga instructors with teaching experience of more than 10 years and 18 non-yoga practicing asymptomatic individuals randomly selected from a health checkup database. A validated grading scale was used to grade the condition of cervical and lumbar discs seen in magnetic resonance imaging of the spine, and the resulting data analyzed statistically. The mean number of years of yoga practice for the yoga group was 12.9 ± 7.5. The overall (cervical + lumbar) disc scores of the yoga group were significantly lower (indicating less degenerative disc disease) than those of the control group (P < 0.001). The scores for the cervical vertebral discs of the yoga group were also significantly lower than those of the control group (P < 0.001), while the lower scores for the yoga group in the lumbar group approached, but did not reach, statistical significance (P = 0.055). The scores for individual discs of yoga practitioners showed significantly less degenerative disease at three disc levels, C3/C4, L2/L3 and L3/L4 (P < 0.05). Magnetic resonance imaging showed that the group of long-term practitioners of yoga studied had significantly less degenerative disc disease than a matched control group.

Jeng CM; Cheng TC; Kung CH; Hsu HC

2011-03-01

178

[The effect of complications on the quality of life after surgery for lumbar spine degenerative disease  

UK PubMed Central (United Kingdom)

PURPOSE OF THE STUDY: To evaluate the effect of complications on the quality of life in patients after elective stabilisation surgery on the lumbar spine. MATERIAL AND METHODS: Between January 2005 and June 2007, 208 patients (120 women and 88 men) were included in the prospective study carried out at our department. These patients were undergoing elective surgery for lumbar spinal disease, namely, central and lateral stenosis, degenerative disc disease and degenerative and isthmic spondylolisthesis. All patients were treated by transpedicular fixation and fusion involving transforaminal lumbar interbody fusion (TLIF) in 165 patients, anterior lumbar interbody fusion (ALIF) in five and posterolateral fusion (PLF) in 38 patients. Satisfaction of the patients with surgery outcomes was assessed on a three-point scale, using the Visual Analogue Scale (VAS), and the Short Form health survey questionnaire (SF-36v2) for life quality evaluation. The follow-up period ranged from 6 months to 2 years. The results were statistically analysed using the chi-square test and t-test. RESULTS: A total of 30 complications were recorded in 28 patients (13.5 %). Revision surgery was necessary in 18 patients (8.7%). Pedicle screw misplacement was found in eight patients and permanent neurological deficit with paresis of the unilateral lower limb in three patients. Carbon cage break-down during surgery occurred in one patient, misinsertion of the cage was in one patient. The dural sac was damaged in five patients, superficial and deep wound infection was found in four and two patients, respectively. Broken screws were detected in seven patients. Donor-site pain persisted in two patients. The patients free from complications were more satisfied (partial or full satisfaction in 86%) than the patients with complications, who reported satisfaction in 78%. However, the difference was not statistically significant. The complications had no significant effect on either any of the SF-36v2 health domains or the total physical and mental score or pain intensity. The ALIF procedure was associated with no complications, PLF with three (13%) and TLIF with 23 (14%) complications, but the differences were not statistically significant. DISCUSSION: Complications and revision surgery were relatively frequent in our group, but not excessive compared with the published data which report their occurrence from 3% to 30%. This large range is related to an ambiguous definition and specification of complications. A significantly fewer complications have been reported in the studies supported by companies, or in those in which the author/s participate in instrumentation development. Some studies suggest that novel and more complex techniques bring about a higher risk of complications and repeat surgery, others report better results and fewer reoperations following a 360-degree fusion than after PLF. The difference in complications between TLIP and PLF in our group was not significant. CONCLUSIONS: Complications are a serious issue of spinal surgery. The majority of complications in our group were associated instrumentation--most frequently with incorrect screw misinsertion. On the whole, the complications did not significantly influence the quality of life and pain intensity after surgery. Most of them were treated successfully with no permanent consequences. The permanent neurological deficit in three patients, because of the small number, had no effect on the whole group results. A reduction in the number of complications would not produce any expected improvement of functional out- come.

Jurícek M; Rehák L; Tisovský P; Horváth J

2010-04-01

179

Renal resistive index in 55 dogs with degenerative mitral valve disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: Azotemia occurs frequently in dogs with degenerative mitral valve disease (DMVD). It could indicate changes in renal hemodynamics. HYPOTHESIS/OBJECTIVES: To assess the renal resistive index (RI) in dogs with DMVD, and the statistical link between heart failure class, azotemia, echo-Doppler parameters, several plasma variables, and RI. ANIMALS: Fifty-five dogs with naturally occurring DVMD were used (ISACHC class 1 [n = 28], 2 [n = 19], and 3 [n = 8]). METHODS: Observational, blinded study, performed under standardized conditions. Physical examination, renal ultrasonography, and echo-Doppler examinations were performed in awake dogs. The RI of the renal, interlobar, and arcuate arteries were measured. Plasma creatinine, urea, and N-terminal pro-B-type natriuretic peptide concentrations (NT-proBNP) were determined. Statistical links between variables and RI were tested by means of a general linear model. RESULTS: Although the RI of renal and arcuate arteries were unaffected by ISACHC class, the left interlobar RI increased (P < .001) from 0.62 ± 0.05 (mean ± SD) in class 1 to 0.76 ± 0.08 in class 3. It was also higher (P < .001) in azotemic (0.74 ± 0.08) than in non-azotemic (0.62 ± 0.05) dogs. Similar findings were observed for right interlobar RI. Univariate analysis showed a positive statistical link between NT-proBNP (P = .002), urea (P < .001), creatinine (P = .002), urea-to-creatinine ratio (P < .001), left atrium-to-aorta ratio (P < .001), regurgitation fraction (P < .001), systolic pulmonary arterial pressure (P < .001), shortening fraction (P = .035), and RI. CONCLUSION AND CLINICAL IMPORTANCE: In dogs with DMVD, interlobar RI increases with heart failure severity and azotemia but a cause and effect relationship remains to be established.

Chetboul V; Daste T; Gouni V; Concordet D; Trehiou-Sechi E; Serres F; Pouchelon JL; Germain CA; Layssol-Lamour C; Lefebvre HP

2012-01-01

180

The Efficacy of Intradiscal Steroid Injections in Degenerative Lumbar Disc Disease  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: We aimed to investigate the efficacy of intradiscal steroid injection in patients with chronic low back pain due to degenerative disc disease.Materials and Methods: A total of 18 patients (9 female, 9 male) with chronic low back pain of discogenic origin were enrolled in the study. The intervertebral disc level which met the diagnostic criteria for provocative discography was defined as discogenic pain level. After identification of positive disc level, 1 cc betamethasone was injected into the disc. The outcome measures (visual analog pain scale and Quebec Back Pain Disability Scale scores, finger-tip-to-floor distance and duration of sitting without pain) were assessed before the treatment and at second week and third month post injection. Results: The reduction in low back pain intensity between the baseline and second week, and between the baseline and third month was statistically significant (p=0.001 and p=0.002). Besides, statistically significant improvement was observed in Quebec Disability Scores between the baseline and second week, and between the baseline and third month (p=0.001 and p=0.002). The finger-tip-to-floor distance between the baseline and second week, and between the baseline and third month showed a statistically significant improvement (p=0.002 and p=0.02). The duration of sitting without pain between the baseline and second week, and between the baseline and third month showed a statistically significant increase (p=0.001 and p=0.009). Conclusion: As a result, we suggest that intradiscal steroid injection may be effective in short-term and mid-term for reducing the intensity of spinal pain and the proportion of disability due to chronic discogenic low back pain in patients who do not respond to conservative treatment. Turk J Phys Med Re­hab 2012;58:88-92.

Ferdi Yavuz; Mehmet Ali Ta?kaynatan; Koray Aydemir; Ahmet Özgül; Arif Kenan Tan

2012-01-01

 
 
 
 
181

Celiac disease of the joint.  

UK PubMed Central (United Kingdom)

A 42-year-old woman presented with a 3-week history of left knee pain and swelling. She had suffered dermatitis herpetiformis for 12 years, proved by skin biopsy. She had never been on gluten-free diet. Knee pain increased with motion and her gait was antalgic. On admission, she was mainly dependent on wheelchair due to pain and limitation. Treatment plan consisted of gluten-free diet, stretching and strengthening exercises, analgesic or nonsteroidal anti-inflammatory drugs when needed. She responded well to gluten-free diet. Association of joint involvement and dermatitis herpetiformis is more than just coincidental. Possible immunopathogenesis and role of gluten-free diet on arthritis treatment are discussed.

Ozyemisci-Taskiran O; Cengiz M; Atalay F

2011-05-01

182

Lumbar spine fusion for chronic low back pain due to degenerative disc disease: a systematic review.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Systematic literature review. OBJECTIVE: To categorize published evidence systematically for lumbar fusion for chronic low back pain (LBP) in order to provide an updated and comprehensive analysis of the clinical outcomes. SUMMARY OF BACKGROUND DATA: Despite a large number of publications of outcomes of spinal fusion surgery for chronic LBP, there is little consensus on efficacy. METHODS: A MEDLINE and Cochrane database search was performed to identify published articles reporting on validated patient-reported clinical outcomes measures (2 or more of visual analogue scale, Oswestry Disability Index, Short Form [36] Health Survey [SF-36] PCS, and patient satisfaction) with minimum 12 months of follow-up after lumbar fusion surgery in adult patients with LBP due to degenerative disc disease. Twenty-six total articles were identified and stratified by level of evidence: 18 level 1 (6 studies of surgery vs. nonoperative treatment, 12 studies of alternative surgical procedures), 2 level 2, 2 level 3, and 4 level 4 (2 prospective, 2 retrospective). Weighted averages of each outcomes measure were computed and compared with established minimal clinically important difference values. RESULTS: Fusion cohorts included a total of 3060 patients. The weighted average improvement in visual analogue scale back pain was 36.8/100 (standard deviation [SD], 14.8); in Oswestry Disability Index 22.2 (SD, 14.1); in SF-36 Physical Component Scale 12.5 (SD, 4.3). Patient satisfaction averaged 71.1% (SD, 5.2%) across studies. Radiographical fusion rates averaged 89.1% (SD, 13.5%), and reoperation rates 12.5% (SD, 12.4%) overall, 9.2% (SD, 7.5%) at the index level. The results of the collective studies did not differ statistically in any of the outcome measures based on level of evidence (analysis of variance, P > 0.05). CONCLUSION: The body of literature supports fusion surgery as a viable treatment option for reducing pain and improving function in patients with chronic LBP refractory to nonsurgical care when a diagnosis of disc degeneration can be made.

Phillips FM; Slosar PJ; Youssef JA; Andersson G; Papatheofanis F

2013-04-01

183

Minimally invasive unilateral pedicle screw fixation and lumbar interbody fusion for the treatment of lumbar degenerative disease.  

UK PubMed Central (United Kingdom)

Minimally invasive unilateral pedicle screw fixation for the treatment of degenerative lumbar diseases has won the support of many surgeons. However, few data are available regarding clinical research on unilateral pedicle screw fixation associated with minimally invasive techniques for the treatment of lumbar spinal diseases. The purpose of this study was to evaluate clinical outcomes in a selected series of patients with lumbar degenerative diseases treated with minimally invasive unilateral vs classic bilateral pedicle screw fixation and lumbar interbody fusion. Patients in the unilateral group (n=43) underwent minimally invasive unilateral pedicle screw fixation with the Quadrant system (Medtronic, Memphis, Tennessee). The bilateral group (n=42) underwent bilateral instrumentation via the classic approach. Visual analog scale pain scores, Oswestry Disability Index scores, fusion rate, operative time, blood loss, and complications were analyzed. Mean operative time was 75 minutes in the unilateral group and 95 minutes in the bilateral group. Mean blood loss was 220 mL in the unilateral group and 450 mL in the bilateral group. Mean postoperative visual analog scale pain score was 3.10±0.16 in the unilateral group and 3.30±1.10 in the bilateral group. Mean postoperative Oswestry Disability Index score was 15.67±2.3 in the unilateral group and 14.93±2.6 in the bilateral group. Successful fusion was achieved in 92.34% of patients in the unilateral group and 93.56% of patients in the bilateral group. Minimally invasive unilateral pedicle screw fixation is an effective and reliable option for the surgical treatment of lumbar degenerative disease. It causes less blood loss, requires less operative time, and has a fusion rate comparable with that of conventional bilateral fixation.

Lin B; Xu Y; He Y; Zhang B; Lin Q; He M

2013-08-01

184

Minimally invasive unilateral pedicle screw fixation and lumbar interbody fusion for the treatment of lumbar degenerative disease.  

Science.gov (United States)

Minimally invasive unilateral pedicle screw fixation for the treatment of degenerative lumbar diseases has won the support of many surgeons. However, few data are available regarding clinical research on unilateral pedicle screw fixation associated with minimally invasive techniques for the treatment of lumbar spinal diseases. The purpose of this study was to evaluate clinical outcomes in a selected series of patients with lumbar degenerative diseases treated with minimally invasive unilateral vs classic bilateral pedicle screw fixation and lumbar interbody fusion. Patients in the unilateral group (n=43) underwent minimally invasive unilateral pedicle screw fixation with the Quadrant system (Medtronic, Memphis, Tennessee). The bilateral group (n=42) underwent bilateral instrumentation via the classic approach. Visual analog scale pain scores, Oswestry Disability Index scores, fusion rate, operative time, blood loss, and complications were analyzed. Mean operative time was 75 minutes in the unilateral group and 95 minutes in the bilateral group. Mean blood loss was 220 mL in the unilateral group and 450 mL in the bilateral group. Mean postoperative visual analog scale pain score was 3.10±0.16 in the unilateral group and 3.30±1.10 in the bilateral group. Mean postoperative Oswestry Disability Index score was 15.67±2.3 in the unilateral group and 14.93±2.6 in the bilateral group. Successful fusion was achieved in 92.34% of patients in the unilateral group and 93.56% of patients in the bilateral group. Minimally invasive unilateral pedicle screw fixation is an effective and reliable option for the surgical treatment of lumbar degenerative disease. It causes less blood loss, requires less operative time, and has a fusion rate comparable with that of conventional bilateral fixation. PMID:23937756

Lin, Bin; Xu, Yang; He, Yong; Zhang, Bi; Lin, Qiuyan; He, Mingchang

2013-08-01

185

Systematic review of anterior interbody fusion techniques for single- and double-level cervical degenerative disc disease.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: A systematic review of randomized controlled trials. OBJECTIVE: To determine which technique of anterior cervical interbody fusion (ACIF) gives the best outcome in patients with cervical degenerative disc disease. SUMMARY OF BACKGROUND DATA: The number of surgical techniques for decompression and ACIF as treatment for cervical degenerative disc disease has increased rapidly, but the rationale for the choice between different techniques remains unclear. METHODS: From a comprehensive search, we selected randomized studies that compared anterior cervical decompression and ACIF techniques, in patients with chronic single- or double-level degenerative disc disease or disc herniation. Risk of bias was assessed using the criteria of the Cochrane back review group. RESULTS: Thirty-three studies with 2267 patients were included. The major treatments were discectomy alone and addition of an ACIF procedure (graft, cement, cage, and plates). At best, there was very low-quality evidence of little or no difference in pain relief between the techniques. We found moderate quality evidence for few secondary outcomes. Odom's criteria were not different between iliac crest autograft and a metal cage (risk ratio [RR]: 1.11; 95% confidence interval [CI]: 0.99-1.24). Bone graft produced more fusion than discectomy (RR: 0.22; 95% CI: 0.17-0.48). Complication rates were not different between discectomy and iliac crest autograft (RR: 1.56; 95% CI: 0.71-3.43). Low-quality evidence was found that iliac crest autograft results in better fusion than a cage (RR: 1.87; 95% CI: 1.10-3.17); but more complications (RR: 0.33; 95% CI: 0.12-0.92). CONCLUSION: When fusion of the motion segment is considered to be the working mechanism for pain relief and functional improvement, iliac crest autograft appears to be the golden standard. When ignoring fusion rates and looking at complication rates, a cage as a golden standard has a weak evidence base over iliac crest autograft, but not over discectomy.

Jacobs W; Willems PC; Kruyt M; van Limbeek J; Anderson PG; Pavlov P; Bartels R; Oner C

2011-06-01

186

Clinical results of posterolateral fusion for degenerative lumbar spinal diseases. A follow-up study of more than 10 years  

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The objective of this retrospective study was to evaluate the long-term clinical outcomes and the effects on unfused motion segments of posterolateral fusion. This study involved 35 cases (37 intervertebral levels) of posterolateral fusion performed to treat degenerative lumbar spinal diseases. There were 20 male and 15 female patients ranging in age from 30 to 67 years, with a mean age of 49 years. The postoperative period ranged from 10 years to 17 years and 8 months, with a mean period of 13 years. The clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) score for assessment of treatment for low back pain. The effects on unfused motion segments were investigated with radiographic and magnetic resonance (MR) imaging. Postoperative satisfactory improvement (mean recovery rate, 66.9%) reached a plateau at 1 year and was maintained at final follow-up. Radiographically, the union rate was 86.5%. There were few cases of induced instability of unfused motion segments. On MR imaging, increased signal intensity in both T{sub 1}- and T{sub 2}-weighted images was seen in the paravertebral muscles in 15 of 20 cases (75.0%). Posterolateral fusion is a useful technique for the treatment of degenerative lumbar spinal diseases. Clinical outcomes were stable throughout follow-up. Instability of unfused motion segments rarely occurred. (author)

Kuroki, Hiroshi; Tajima, Naoya; Kubo, Shinichiro [Miyazaki Medical Coll., Kiyotake (Japan)

2002-07-01

187

The p.A382T TARDBP gene mutation in Sardinian patients affected by Parkinson's disease and other degenerative parkinsonisms.  

Science.gov (United States)

Based on our previous finding of the p.A382T founder mutation in ALS patients with concomitant parkinsonism in the Sardinian population, we hypothesized that the same variant may underlie Parkinson's disease (PD) and/or other forms of degenerative parkinsonism on this Mediterranean island. We screened a cohort of 611 patients with PD (544 cases) and other forms of degenerative parkinsonism (67 cases) and 604 unrelated controls for the c.1144G > A (p.A382T) missense mutation of the TARDBP gene. The p.A382T mutation was identified in nine patients with parkinsonism. Of these, five (0.9 % of PD patients) presented a typical PD (two with familiar forms), while four patients (6.0 % of all other forms of parkinsonism) presented a peculiar clinical presentation quite different from classical atypical parkinsonism with an overlap of extrapyramidal-pyramidal-cognitive clinical signs. The mutation was found in eight Sardinian controls (1.3 %) consistent with a founder mutation in the island population. Our findings suggest that the clinical presentation of the p.A382T TARDBP gene mutation may include forms of parkinsonism in which the extrapyramidal signs are the crucial core of the disease at onset. These forms can present PSP or CBD-like clinical signs, with bulbar and/or extrabulbar pyramidal signs and cognitive impairment. No evidence of association has been found between TARDBP gene mutation and typical PD. PMID:23546887

Cannas, Antonino; Borghero, Giuseppe; Floris, Gian Luca; Solla, Paolo; Chiò, Adriano; Traynor, Bryan J; Calvo, Andrea; Restagno, Gabriella; Majounie, Elisa; Costantino, Emanuela; Piras, Valeria; Lavra, Loredana; Pani, Carla; Orofino, Gianni; Di Stefano, Francesca; Tacconi, Paolo; Mascia, Marcello Mario; Muroni, Antonella; Murru, Maria Rita; Tranquilli, Stefania; Corongiu, Daniela; Rolesu, Marcella; Cuccu, Stefania; Marrosu, Francesco; Marrosu, Maria Giovanna

2013-04-02

188

The p.A382T TARDBP gene mutation in Sardinian patients affected by Parkinson's disease and other degenerative parkinsonisms.  

UK PubMed Central (United Kingdom)

Based on our previous finding of the p.A382T founder mutation in ALS patients with concomitant parkinsonism in the Sardinian population, we hypothesized that the same variant may underlie Parkinson's disease (PD) and/or other forms of degenerative parkinsonism on this Mediterranean island. We screened a cohort of 611 patients with PD (544 cases) and other forms of degenerative parkinsonism (67 cases) and 604 unrelated controls for the c.1144G > A (p.A382T) missense mutation of the TARDBP gene. The p.A382T mutation was identified in nine patients with parkinsonism. Of these, five (0.9 % of PD patients) presented a typical PD (two with familiar forms), while four patients (6.0 % of all other forms of parkinsonism) presented a peculiar clinical presentation quite different from classical atypical parkinsonism with an overlap of extrapyramidal-pyramidal-cognitive clinical signs. The mutation was found in eight Sardinian controls (1.3 %) consistent with a founder mutation in the island population. Our findings suggest that the clinical presentation of the p.A382T TARDBP gene mutation may include forms of parkinsonism in which the extrapyramidal signs are the crucial core of the disease at onset. These forms can present PSP or CBD-like clinical signs, with bulbar and/or extrabulbar pyramidal signs and cognitive impairment. No evidence of association has been found between TARDBP gene mutation and typical PD.

Cannas A; Borghero G; Floris GL; Solla P; Chiò A; Traynor BJ; Calvo A; Restagno G; Majounie E; Costantino E; Piras V; Lavra L; Pani C; Orofino G; Di Stefano F; Tacconi P; Mascia MM; Muroni A; Murru MR; Tranquilli S; Corongiu D; Rolesu M; Cuccu S; Marrosu F; Marrosu MG

2013-05-01

189

Ultrasonographic evaluation of degenerative changes in the distal radioulnar joint: Correlation of findings with gross anatomy and MR arthrography in cadavers  

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Objective: To determine the accuracy of ultrasonography (US) in the evaluation of degenerative changes in the distal radioulnar joint (DRUJ). Methods and materials: Ten cadaveric specimens were obtained. US evaluation of cartilage degeneration and thickness was performed by two independent and blinded readers (R1 and R2). Gross anatomy and MR arthrography evaluated by two readers in consensus served as the reference standard. The joint surface not accessible to US was measured. Results: US interreader agreement was non-existent for cartilage thickness measurements and moderate for cartilage degeneration grading (weighted kappa = 0.41). Comparing US and MR imaging evaluation, there was no correlation between US R1 and MR imaging (Pearson correlation coefficient [PCC] = 0.352) and a moderate correlation between US R2 and MR imaging (PCC = 0.570) concerning cartilage thickness measurements. Concerning cartilage degeneration grading, there was a moderate to strong (R1 Spearman correlation coefficient [SCC] = 0.729)/R2 SCC = 0.767) correlation concerning cartilage degeneration grading. Comparing US and gross anatomic evaluation, there was no correlation for US R1 (PCC = 0.220) and a strong correlation for US R2 (PCC = 0.922) concerning cartilage thickness measurements, and a strong to moderate correlation (R1 SCC = 0.808/R2 SCC = 0.597) concerning cartilage degeneration grading. The mean sector of the articular surface of the ulna head not accessible to US was 13{sup o}. Conclusion: In conclusion the DRUJ is accessible to US except in the central 13{sup o} sector of the joint surface. US was approved to be sufficient in demonstrating advanced stages of cartilage degeneration. Thus, US of the DRUJ is recommended in patients suffering from ulnar-sided wrist pain.

Buck, Florian M., E-mail: florian.buck@gmail.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Nico, Marcelo A.C., E-mail: nico.marcelo@gmail.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Gheno, Ramon, E-mail: ramon.gheno@yahoo.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Trudell, Debra J., E-mail: debtrudell@hotmail.com [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States); Resnick, Donald, E-mail: dresnick@ucsd.edu [Department of Radiology, Veterans Administration Medical Center, 3350 La Jolla Village Dr., San Diego, CA 92161 (United States)

2011-02-15

190

Ultrasonographic evaluation of degenerative changes in the distal radioulnar joint: Correlation of findings with gross anatomy and MR arthrography in cadavers  

International Nuclear Information System (INIS)

Objective: To determine the accuracy of ultrasonography (US) in the evaluation of degenerative changes in the distal radioulnar joint (DRUJ). Methods and materials: Ten cadaveric specimens were obtained. US evaluation of cartilage degeneration and thickness was performed by two independent and blinded readers (R1 and R2). Gross anatomy and MR arthrography evaluated by two readers in consensus served as the reference standard. The joint surface not accessible to US was measured. Results: US interreader agreement was non-existent for cartilage thickness measurements and moderate for cartilage degeneration grading (weighted kappa = 0.41). Comparing US and MR imaging evaluation, there was no correlation between US R1 and MR imaging (Pearson correlation coefficient [PCC] = 0.352) and a moderate correlation between US R2 and MR imaging (PCC = 0.570) concerning cartilage thickness measurements. Concerning cartilage degeneration grading, there was a moderate to strong (R1 Spearman correlation coefficient [SCC] = 0.729)/R2 SCC = 0.767) correlation concerning cartilage degeneration grading. Comparing US and gross anatomic evaluation, there was no correlation for US R1 (PCC = 0.220) and a strong correlation for US R2 (PCC = 0.922) concerning cartilage thickness measurements, and a strong to moderate correlation (R1 SCC = 0.808/R2 SCC = 0.597) concerning cartilage degeneration grading. The mean sector of the articular surface of the ulna head not accessible to US was 13o. Conclusion: In conclusion the DRUJ is accessible to US except in the central 13o sector of the joint surface. US was approved to be sufficient in demonstrating advanced stages of cartilage degeneration. Thus, US of the DRUJ is recommended in patients suffering from ulnar-sided wrist pain.

2011-01-01

191

Development of PET tracers for neuro inflammation imaging in neuro degenerative diseases  

International Nuclear Information System (INIS)

[en] Inflammatory processes such as micro-glial or endothelial activation are involved in many neuro-degenerative conditions. Neuro-inflammation imaging is considered an attractive tool for fundamental research, diagnosis and therapeutic evaluation in neuro-pathologies. First, an aptamer was selected against a recombinant fragment of the endothelial target VCAM-1, but proved unable to bind the target protein in native conformation, as expressed by a cell line. Second, five radioligands of the peripheral benzodiazepine receptor (PBR), a marker of micro-glial activation, were evaluated in vivo using PET (Positron Emission Tomography) imaging in a rat model of neuro-inflammation, and were compared to [11C]PK11195. Four radiotracers displayed a better contrast than [11C]PK11195. In a competitive field of research, this work demonstrates the efficiency of in vivo screening of radiotracers for fast selection of clinically relevant molecules. (author)

2007-01-01

192

Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine.  

UK PubMed Central (United Kingdom)

In the treatment of multilevel degenerative disorders of the lumbar spine, spondylodesis plays a controversial role. Most patients can be treated conservatively with success. Multilevel lumbar fusion with instrumentation is associated with severe complications like failed back surgery syndrome, implant failure, and adjacent segment disease (ASD). This retrospective study examines the records of 70 elderly patients with degenerative changes or instability of the lumbar spine treated between 2002 and 2007 with spondylodesis of more than two segments. Sixty-four patients were included; 5 patients had died and one patient was lost to follow-up. We evaluated complications, clinical/radiological outcomes, and success of fusion. Flexion-extension and standing X-rays in two planes, MRI, and/or CT scans were obtained pre-operatively. Patients were assessed clinically using the Oswestry disability index (ODI) and a Visual Analogue Scale (VAS). Surgery performed was dorsolateral fusion (46.9%) or dorsal fusion with anterior lumbar interbody fusion (ALIF; 53.1%). Additional decompression was carried out in 37.5% of patients. Mean follow-up was 29.4±5.4 months. Average patient age was 64.7±4.3 years. Clinical outcomes were not satisfactory for all patients. VAS scores improved from 8.6±1.3 to 5.6±3.0 pre- to post-operatively, without statistical significance. ODI was also not significantly improved (56.1±22.3 pre- and 45.1±26.4 post-operatively). Successful fusion, defined as adequate bone mass with trabeculation at the facets and transverse processes or in the intervertebral segments, did not correlate with good clinical outcomes. Thirty-five of 64 patients (54%) showed signs of pedicle screw loosening, especially of the screws at S1. However, only 7 of these 35 (20%) complained of corresponding back pain. Revision surgery was required in 24 of 64 patients (38%). Of these, indications were adjacent segment disease (16 cases), pedicle screw loosening (7 cases), and infection (one case). At follow-up of 29.4 months, patients with radiographic ASD had worse ODI scores than patients without (54.7 vs. 36.6; P<0.001). Multilevel fusion for degenerative disease still has a high rate of complications, up to 50%. The problem of adjacent segment disease after fusion surgery has not yet been solved. This study underscores the need for strict indication guidelines to perform lumbar spine fusion of more than two levels.

Röllinghoff M; Schlüter-Brust K; Groos D; Sobottke R; Michael JW; Eysel P; Delank KS

2010-03-01

193

Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine  

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Full Text Available In the treatment of multilevel degenerative disorders of the lumbar spine, spondylodesis plays a controversial role. Most patients can be treated conservatively with success. Multilevel lumbar fusion with instrumentation is associated with severe complications like failed back surgery syndrome, implant failure, and adjacent segment disease (ASD). This retrospective study examines the records of 70 elderly patients with degenerative changes or instability of the lumbar spine treated between 2002 and 2007 with spondylodesis of more than two segments. Sixty-four patients were included; 5 patients had died and one patient was lost to follow-up. We evaluated complications, clinical/radiological outcomes, and success of fusion. Flexion-extension and standing X-rays in two planes, MRI, and/or CT scans were obtained pre-operatively. Patients were assessed clinically using the Oswestry disability index (ODI) and a Visual Analogue Scale (VAS). Surgery performed was dorsolateral fusion (46.9%) or dorsal fusion with anterior lumbar interbody fusion (ALIF; 53.1%). Additional decompression was carried out in 37.5% of patients. Mean follow-up was 29.4±5.4 months. Average patient age was 64.7±4.3 years. Clinical outcomes were not satisfactory for all patients. VAS scores improved from 8.6±1.3 to 5.6±3.0 pre- to post-operatively, without statistical significance. ODI was also not significantly improved (56.1±22.3 pre- and 45.1±26.4 post-operatively). Successful fusion, defined as adequate bone mass with trabeculation at the facets and transverse processes or in the intervertebral segments, did not correlate with good clinical outcomes. Thirty-five of 64 patients (54%) showed signs of pedicle screw loosening, especially of the screws at S1. However, only 7 of these 35 (20%) complained of corresponding back pain. Revision surgery was required in 24 of 64 patients (38%). Of these, indications were adjacent segment disease (16 cases), pedicle screw loosening (7 cases), and infection (one case). At follow-up of 29.4 months, patients with radiographic ASD had worse ODI scores than patients without (54.7 vs. 36.6; P less than 0.001). Multilevel fusion for degenerative disease still has a high rate of complications, up to 50%. The problem of adjacent segment disease after fusion surgery has not yet been solved. This study underscores the need for strict indication guidelines to perform lumbar spine fusion of more than two levels.

Marc Röllinghoff; Klaus Schlüter-Brust; Daniel Groos; Rolf Sobottke; Joern William-Patrick Michael; Peer Eysel; Karl Stefan Delank

2010-01-01

194

Distinct patterns of medial temporal impairment in degenerative dementia: a brain SPECT perfusion study in Alzheimer's disease and frontotemporal dementia.  

UK PubMed Central (United Kingdom)

PURPOSE: Medial temporal impairment can be detected clinically and by morphological imaging during Alzheimer's disease (AD), but the existence of a functional impairment in this area seems to be less well established. Yet such functional impairment is classically found in other degenerative cortical dementias, such as the frontal variant of frontotemporal dementia (fv-FTD). The aim of this study was to characterize and compare brain SPECT perfusion of the medial temporal lobe in AD and fv-FTD. METHODS: Voxel-based comparisons were performed using SPM8 between cerebral SPECT images from 85 AD patients, 25 fv-FTD patients and 12 healthy controls at the whole-brain level and the medial temporal lobe level using a region of interest approach (p < 0.001, corrected for the cluster). RESULTS: In the free and cued selective reminding test, used to evaluate medial temporal memory function, AD patients had significantly lower scores than the fv-FTD patients (p < 0.005). AD and fv-FTD patients showed hypoperfused medial temporal structures in comparison to normal controls. However, fv-FTD patients had more pronounced hypoperfusion in this area, with a different topography, more anterior and more parahippocampal. CONCLUSION: These results show that medial temporal hypoperfusion can be detected in degenerative dementias by SPECT. Paradoxically, the hypoperfusion is more severe in fv-FTD than in AD patients, even though the mnesic profile of AD is more altered, suggesting the existence of inefficient compensatory mechanisms.

Basely M; Ceccaldi M; Boyer L; Mundler O; Guedj E

2013-06-01

195

Magnetic resonance imaging of glenohumeral joint diseases  

International Nuclear Information System (INIS)

Through the application of oblique planes and flexible surface coil techniques, magnetic resonance imaging (MRI) promises to be of great clinical value in the evaluation of a variety of pathologic conditions affecting the shoulder. In patients with joint effusions, the tendinous portion of the rotator cuff, glenoid labrum, and bicipital tendon can be readily visualized. This capability has particular relevance in patients with inflammatory disease and traumatic conditions. Rotator cuff atrophy and impingement of the coracoacromial arc upon the supraspinatus muscle and tendon can also be demonstrated. MRI is also useful in the evaluation of shoulder instability. (orig.)

1987-01-01

196

Magnetic resonance imaging of glenohumeral joint diseases  

Energy Technology Data Exchange (ETDEWEB)

Through the application of oblique planes and flexible surface coil techniques, magnetic resonance imaging (MRI) promises to be of great clinical value in the evaluation of a variety of pathologic conditions affecting the shoulder. In patients with joint effusions, the tendinous portion of the rotator cuff, glenoid labrum, and bicipital tendon can be readily visualized. This capability has particular relevance in patients with inflammatory disease and traumatic conditions. Rotator cuff atrophy and impingement of the coracoacromial arc upon the supraspinatus muscle and tendon can also be demonstrated. MRI is also useful in the evaluation of shoulder instability.

Kieft, G.J.; Bloem, J.L.; Obermann, W.R.; Rozing, P.; Doornbos, J.; Sartoris, D.J.; Hajek, P.C.; Baker, L.L.; Resnick, D.

1987-06-01

197

The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles.  

Science.gov (United States)

The aim of this study was to obtain, using Magnetic Resonance Imaging (MRI), muscle volume measurements for the gluteus maximus (upper: UGM and lower: LGM portions) and tensor fascia lata (TFL) muscles in both healthy subjects (n=12) and those with unilateral osteoarthritis (OA) of the hip (mild: n=6, and advanced: n=6). While control group subjects were symmetrical between sides for the muscles measured, subjects with hip joint pathology showed asymmetry in GM muscle volume dependent on stage of pathology. The LGM demonstrated atrophy around the affected hip in subjects with advanced pathology (pUGM (pUGM and LGM, and the similarities of the UGM and TFL, both superficial abductors appearing to maintain their size around the affected hip. Further research is required to determine the specific changes occurring in the deeper abductor muscles. This information may assist in the development of more targeted and effective exercise programmes in the management of OA of the hip. PMID:19121974

Grimaldi, Alison; Richardson, Carolyn; Durbridge, Gail; Donnelly, William; Darnell, Ross; Hides, Julie

2009-01-03

198

LEECH ON THE DEGENERATIVE KNEE  

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Full Text Available A common form of arthritis in the elderly, being a major cause of localised pain and functional disability is Sandhigata Vata. This osteoarticular disorder when confined to the knee is termed as Janusandhigata vata. The clinical manifestations of Sandhigata Vata simulate the condition of degenerative joint disorder. The reported prevalence of Osteoarthritis from a study in rural India is 5.78%. Leech therapy has been practiced successfully in musculoskeletal diseases in Ayurveda and other systems of medicine like Unani. It has also become the area of curiosity and interest in the research world. This study was intended to find out the effect of Jaloukavacharana in Janusandhigata Vata. Screening of patients suffering from Janusandhigata Vata was done at arthritis camps and finally 30 patients who fulfilled all necessary criteria and gave a written consent for the clinical trial were enrolled for the trial as study volunteers. It was a single centre, Repeated Measures study design with single sitting of Jaloukavacharana followed up for a period of 4 weeks (1st day, 7th day, 14th day and 28th day). Concurrent analgesics/NSAIDs and steroids in any form were not allowed. Lifestyle and /or dietary restrictions were not imposed. Pain, crepitus and modified WOMAC were the primary efficacy variables. Pain and WOMAC showed significant improvement (P<0.001, ANOVA) after treatment. Crepitus remained unchanged after treatment. The study showed remarkable improvement in symptoms like pain, stiffness and functional ability of knee joint /joints.

D’souza Zenica; Acharya G.S

2013-01-01

199

[Joint manifestations in connective tissue diseases].  

UK PubMed Central (United Kingdom)

Joint manifestations are common and often constitute the first symptoms or signs of a connective tissue disease, which should be carefully looked for, according to the clinic, in particular with ultrasound and the research of autoantibodies. Articular manifestations are often severe and must be treated accordingly. In lupus, one can distinguish non-deforming non-erosive arthropathy, Jaccoud's arthropathy (deforming non-erosive) and erosive arthropathy (rhupus). Ultrasound has recently shown that destructive forms are in fact more frequent than initially considered. In addition, lupus can be complicated by necrosis or fractures, which are characterized by mechanical pain. In other connective tissue diseases, similar forms of arthropathies and complications are found, with some distinctions.

Guerne PA

2013-03-01

200

The association between degenerative hip joint pathology and size of the gluteus maximus and tensor fascia lata muscles.  

UK PubMed Central (United Kingdom)

The aim of this study was to obtain, using Magnetic Resonance Imaging (MRI), muscle volume measurements for the gluteus maximus (upper: UGM and lower: LGM portions) and tensor fascia lata (TFL) muscles in both healthy subjects (n=12) and those with unilateral osteoarthritis (OA) of the hip (mild: n=6, and advanced: n=6). While control group subjects were symmetrical between sides for the muscles measured, subjects with hip joint pathology showed asymmetry in GM muscle volume dependent on stage of pathology. The LGM demonstrated atrophy around the affected hip in subjects with advanced pathology (p<0.05), however asymmetry of the UGM (p<0.01) could be attributed largely to hypertrophy on the unaffected side, based on between group comparisons of muscle volume. TFL showed no significant asymmetry, or difference compared to the normal control group. This study highlights the functional separation of UGM and LGM, and the similarities of the UGM and TFL, both superficial abductors appearing to maintain their size around the affected hip. Further research is required to determine the specific changes occurring in the deeper abductor muscles. This information may assist in the development of more targeted and effective exercise programmes in the management of OA of the hip.

Grimaldi A; Richardson C; Durbridge G; Donnelly W; Darnell R; Hides J

2009-12-01

 
 
 
 
201

Myelography as a stand-alone diagnostic procedure for degenerative spine disease in developing nations.  

UK PubMed Central (United Kingdom)

The use of "stand-alone" contrast myelography (i.e., without computed tomography) has a proven track record in developing nations where few patients have access to magnetic resonance imaging, whether on the basis of prohibitive cost or the absence of such a modality altogether. To substantiate the author's 12-year experience with more than 300 myelograms performed in 16 different countries (plus some 1500 studies during 30 years of practice in the United States), a prospective pilot study was undertaken over 1 month in a community-based neurosurgical setting in western Kenya. Forty patients underwent cervical or lumbar myelography at Tenwek Hospital under the auspices of the Neurosurgery Training Program for East, Central, and South Africa (NSTP-ECSA) following failure of conservative measures to treat spine-related pathology. Thirty-five of the forty patients (88%) came to definitive surgery on the basis of a positive study that correlated with their clinical history and physical examination. There were no significant complications from the procedures, and no false-positive studies, with virtually all patients returning to normal activity and/or gainful employment within 3 weeks of their surgery. Myelography as a stand-alone diagnostic procedure is a sensitive, specific, and cost-effective means of diagnosing symptomatic degenerative spine disorders. Accordingly, its use should be encouraged at every NSTP-ECSA training site to address such ubiquitous pathology.

Park BE; Kitya D

2010-04-01

202

Intradiscal pulsed radiofrequency application following provocative discography for the management of degenerative disc disease and concordant pain: a pilot study.  

Science.gov (United States)

The development of diagnostic criteria and the use of provocative discography allow identifying the degenerative disc as causative structure for chronic low-back pain. Unfortunately, none of the available interventional treatment options have been demonstrated to be effective over a prolonged period of time for a considerable number of patients. Pathophysiological studies indicate sprouting of sensory nerves and inflammatory processes as underlying pain mechanisms. Pulsed radiofrequency (PRF) treatment in small and larger joints was described to reduce pain and improve healing by stimulating the immunology. Earlier findings of PRF applied in the disc annulus were promising. It is assumed that PRF applied in the nucleus would change the conductivity of nerve endings and provide a clinically relevant pain reduction. The application of the electric field of PRF in the disc may also activate the immune system, thus reducing the inflammation process of chronic pain. Pulsed radiofrequency in the nucleus was studied in 76 patients with discogenic pain confirmed by magnetic resonance imaging and provocative discography. At 3-month follow-up, 38% of the patients had > 50% pain reduction, at 12 month the effect is maintained in 29%. In patients with unsatisfactory pain relief 3 months after the intervention, secondary pain sources may have been revealed. The latter were treated accordingly. Of all patients, 56% had > 50% pain reduction 1 year after first treatment. Our findings suggest that PRF in the nucleus may be considered for patients with proven discogenic pain. A randomized controlled trial to confirm our findings is justified.? PMID:22008239

Rohof, Olav

2011-10-19

203

Intradiscal pulsed radiofrequency application following provocative discography for the management of degenerative disc disease and concordant pain: a pilot study.  

UK PubMed Central (United Kingdom)

The development of diagnostic criteria and the use of provocative discography allow identifying the degenerative disc as causative structure for chronic low-back pain. Unfortunately, none of the available interventional treatment options have been demonstrated to be effective over a prolonged period of time for a considerable number of patients. Pathophysiological studies indicate sprouting of sensory nerves and inflammatory processes as underlying pain mechanisms. Pulsed radiofrequency (PRF) treatment in small and larger joints was described to reduce pain and improve healing by stimulating the immunology. Earlier findings of PRF applied in the disc annulus were promising. It is assumed that PRF applied in the nucleus would change the conductivity of nerve endings and provide a clinically relevant pain reduction. The application of the electric field of PRF in the disc may also activate the immune system, thus reducing the inflammation process of chronic pain. Pulsed radiofrequency in the nucleus was studied in 76 patients with discogenic pain confirmed by magnetic resonance imaging and provocative discography. At 3-month follow-up, 38% of the patients had > 50% pain reduction, at 12 month the effect is maintained in 29%. In patients with unsatisfactory pain relief 3 months after the intervention, secondary pain sources may have been revealed. The latter were treated accordingly. Of all patients, 56% had > 50% pain reduction 1 year after first treatment. Our findings suggest that PRF in the nucleus may be considered for patients with proven discogenic pain. A randomized controlled trial to confirm our findings is justified.?

Rohof O

2012-06-01

204

Epidemiological trends in cervical spine surgery for degenerative diseases between 2002 and 2009.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Retrospective analysis of a population-based database. OBJECTIVE: To investigate national epidemiological trends of cervical spine surgical procedures from 2002-2009. SUMMARY OF BACKGROUND DATA: Anterior cervical fusion (ACF), posterior cervical fusion (PCF), and posterior cervical decompression (PCD) are procedures routinely performed for cervical degenerative pathology. Studies regarding epidemiological trends of these procedures is currently lacking in the literature. METHODS: Data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project was obtained for each year between 2002 and 2009. Patients undergoing ACF, PCF, and PCD for the diagnosis of cervical radiculopathy and myelopathy were identified. Demographics, costs, and mortality were assessed in the surgical subgroups. A P value of 0.001 was used to denote significance. RESULTS.: An estimated 1,323,979 cervical spine surgical procedures were performed between 2002 and 2009. There was a significant upward trend in the mean age of patients undergoing cervical spine surgery during this time period. ACF and PCF cohorts demonstrated statistically significant increases in comorbidities and costs from 2002-2009. The PCF group had the greatest mortality, comorbidities, costs, and longest hospitalizations compared with ACF and PCF cohorts across all time periods. CONCLUSION: Our study demonstrates that cervical spine surgical procedures have increased between 2002 and 2009 (P = 0.001). The primary increase in volume is due to the increasing number of ACFs. Despite older patients with more comorbidities undergoing ACF and PCF procedures, mortality has not changed. However, this patient population trended significant increases in costs during this time period. We hypothesize that these increased costs are due to an increased comorbidity burden in patients undergoing ACF or PCF. Results of this study can be used to set benchmarks for future epidemiological investigations in cervical spine surgery.Level of Evidence: 4.

Oglesby M; Fineberg SJ; Patel AA; Pelton MA; Singh K

2013-06-01

205

The torn meniscus, the torn anterior cruciate ligament, and their relationship to degenerative joint disease.  

Science.gov (United States)

A retrospective review of 350 knees was carried out to determine the effect, if any, of a torn meniscus and a torn anterior cruciate ligament on the articular surfaces of the knee. There were no professional or college athletes in this group, although a few were enthusiastic sandlot-type players. The time interval between injury and surgery was known, as was the state of the articular surfaces, which were graded from 1 to 4. As the time interval between injury and surgery increased, so did the incidence of lesions of the articular surfaces, although in most cases these lesions were quite minor. On the basis of this and other studies, it was concluded that the torn meniscus does not pose a significant threat to the integrity of the articular cartilage; this was also true in those patients in whom the anterior cruciate ligament was torn. PMID:4091906

Casscells, S W

1985-01-01

206

The torn meniscus, the torn anterior cruciate ligament, and their relationship to degenerative joint disease.  

UK PubMed Central (United Kingdom)

A retrospective review of 350 knees was carried out to determine the effect, if any, of a torn meniscus and a torn anterior cruciate ligament on the articular surfaces of the knee. There were no professional or college athletes in this group, although a few were enthusiastic sandlot-type players. The time interval between injury and surgery was known, as was the state of the articular surfaces, which were graded from 1 to 4. As the time interval between injury and surgery increased, so did the incidence of lesions of the articular surfaces, although in most cases these lesions were quite minor. On the basis of this and other studies, it was concluded that the torn meniscus does not pose a significant threat to the integrity of the articular cartilage; this was also true in those patients in whom the anterior cruciate ligament was torn.

Casscells SW

1985-01-01

207

Measurement of Intervertebral Motion Using Quantitative Fluoroscopy: Report of an International Forum and Proposal for Use in the Assessment of Degenerative Disc Disease in the Lumbar Spine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Quantitative fluoroscopy (QF) is an emerging technology for measuring intervertebral motion patterns to investigate problem back pain and degenerative disc disease. This International Forum was a networking event of three research groups (UK, US, Hong Kong), over three days in San Francisco in Augus...

Breen, Alan C.; Teyhen, Deydre S.; Mellor, Fiona E.; Breen, Alexander C.; Wong, Kris W. N.; Deitz, Adam

208

Wallis interspinous implantation to treat degenerative spinal disease: description of the method and case series.  

UK PubMed Central (United Kingdom)

The Wallis interspinous implant is most commonly used in the treatment of intervertebral disc herniation and for tears in the outer layer of the disc. The dynamic vertebral fixation concept was first initiated in 1984 with the goal of imitating the physiologic spinal kinetic. A total of 15 years later, a second generation of implant has been developed, termed the 'Wallis interspinous Implant', which aims to preserve the mobility of the operated spinal segment. To underline our own experience, a retrospective review of 15 patients that were treated with 'Wallis implantation' at our institution between January 2006 and March 2008. Our main inclusion criterion for Wallis implantation was low back pain because of degenerative lumbar spinal stenosis associated with segmental instability along with Modic changes 0-1 and with UCLA arthritic grade II in the adjacent two segments cephalad to implantation. The outcome was analyzed according to clinical and radiological parameters. One (n = 9), two (n = 4) and three levels (n = 2) were operated on using Wallis implantation, ranging from L2-L3 to L5-S1. We used implants of 8-14 mm in size. There was a reduction in low back pain (73 vs 43%) and gait disturbances (73 vs 14%) at the 3-month follow-up compared with preoperative values. In line with these results, the modified Japan Orthopedic Association Score (mJAOS) was increased from 12 preoperatively to 18 at 3 months and 20 at 12 months postoperatively. A reduction in low back pain could only be demonstrated for implants that were 10 mm in size or greater at 3 months and 12-15 months postoperatively. An improvement was seen in Modic grades after the operations as compared with those observed at preoperative MRI. The outcome in our patients was rated as good or excellent according to Odom's criteria in all cases, independent of the levels that were used. Wallis implantation is therefore a safe procedure with a good to excellent outcome in the short- and mid-term follow-up and can lead to disc rehydration, as confirmed by postoperative MRI. Principal postoperative (clinical) success is based on the correct implant size.

Sandu N; Schaller B; Arasho B; Orabi M

2011-06-01

209

Wallis interspinous implantation to treat degenerative spinal disease: description of the method and case series.  

Science.gov (United States)

The Wallis interspinous implant is most commonly used in the treatment of intervertebral disc herniation and for tears in the outer layer of the disc. The dynamic vertebral fixation concept was first initiated in 1984 with the goal of imitating the physiologic spinal kinetic. A total of 15 years later, a second generation of implant has been developed, termed the 'Wallis interspinous Implant', which aims to preserve the mobility of the operated spinal segment. To underline our own experience, a retrospective review of 15 patients that were treated with 'Wallis implantation' at our institution between January 2006 and March 2008. Our main inclusion criterion for Wallis implantation was low back pain because of degenerative lumbar spinal stenosis associated with segmental instability along with Modic changes 0-1 and with UCLA arthritic grade II in the adjacent two segments cephalad to implantation. The outcome was analyzed according to clinical and radiological parameters. One (n = 9), two (n = 4) and three levels (n = 2) were operated on using Wallis implantation, ranging from L2-L3 to L5-S1. We used implants of 8-14 mm in size. There was a reduction in low back pain (73 vs 43%) and gait disturbances (73 vs 14%) at the 3-month follow-up compared with preoperative values. In line with these results, the modified Japan Orthopedic Association Score (mJAOS) was increased from 12 preoperatively to 18 at 3 months and 20 at 12 months postoperatively. A reduction in low back pain could only be demonstrated for implants that were 10 mm in size or greater at 3 months and 12-15 months postoperatively. An improvement was seen in Modic grades after the operations as compared with those observed at preoperative MRI. The outcome in our patients was rated as good or excellent according to Odom's criteria in all cases, independent of the levels that were used. Wallis implantation is therefore a safe procedure with a good to excellent outcome in the short- and mid-term follow-up and can lead to disc rehydration, as confirmed by postoperative MRI. Principal postoperative (clinical) success is based on the correct implant size. PMID:21651328

Sandu, Nora; Schaller, Bernhard; Arasho, Belachew; Orabi, Michael

2011-06-01

210

Degenerative diseases of the spine. Rare and often unrecognized causes of pain syndromes  

International Nuclear Information System (INIS)

The aim of this article is to describe rare and often unrecognized causes of spinal pain syndromes. Intervertebral disc degeneration frequently appears in early adulthood and can have a symptomatic or asymptomatic course. This article discusses incidence, pathophysiology, imaging, and pain symptomatology involved in the origin of back pain. Anulus tears are often found in asymptomatic individuals but could be implicated in lumbar pain symptomatology in correlation with the provocative discography. Transient disorders can lead to pseudarthrosis of the iliac bone and to degeneration or to a reactive hypermobility with intervertebral disc degeneration in the level above. Modic type 1 erosive osteochondrosis is characterized by bone marrow edema near the hyaline cartilage end plate, which mostly elicits severe pain and results in serious limitations in everyday activities. The most important differential diagnosis is spondylodiscitis. Schmorl's nodes can exhibit considerable surrounding bone marrow edema that can be mistaken for metastases. A combination of MRI and CT should be employed for the diagnostic work-up of fatigue fracture of the interarticular portion, which is often overlooked due to its location. Synovial cysts of the facet joints can lead to radicular symptoms. Insufficiency fracture of the sacrum is frequently mistaken for metastasis due to intense scintigraphic enhancement and its signal behavior in MRI. CT provides instructive information. Differential diagnosis should include less common causes such as anulus tears, transient disorders, activated Schmorl's nodes, synovial cysts of the facet joints, fatigue fractures of the interarticular portion of the spine and the sacrum and distinguish from metastases in particular. (orig.)

2006-01-01

211

Identification of gene co-regulatory modules and associated cis-elements involved in degenerative heart disease  

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Full Text Available Abstract Background Cardiomyopathies, degenerative diseases of cardiac muscle, are among the leading causes of death in the developed world. Microarray studies of cardiomyopathies have identified up to several hundred genes that significantly alter their expression patterns as the disease progresses. However, the regulatory mechanisms driving these changes, in particular the networks of transcription factors involved, remain poorly understood. Our goals are (A) to identify modules of co-regulated genes that undergo similar changes in expression in various types of cardiomyopathies, and (B) to reveal the specific pattern of transcription factor binding sites, cis-elements, in the proximal promoter region of genes comprising such modules. Methods We analyzed 149 microarray samples from human hypertrophic and dilated cardiomyopathies of various etiologies. Hierarchical clustering and Gene Ontology annotations were applied to identify modules enriched in genes with highly correlated expression and a similar physiological function. To discover motifs that may underly changes in expression, we used the promoter regions for genes in three of the most interesting modules as input to motif discovery algorithms. The resulting motifs were used to construct a probabilistic model predictive of changes in expression across different cardiomyopathies. Results We found that three modules with the highest degree of functional enrichment contain genes involved in myocardial contraction (n = 9), energy generation (n = 20), or protein translation (n = 20). Using motif discovery tools revealed that genes in the contractile module were found to contain a TATA-box followed by a CACC-box, and are depleted in other GC-rich motifs; whereas genes in the translation module contain a pyrimidine-rich initiator, Elk-1, SP-1, and a novel motif with a GCGC core. Using a naïve Bayes classifier revealed that patterns of motifs are statistically predictive of expression patterns, with odds ratios of 2.7 (contractile), 1.9 (energy generation), and 5.5 (protein translation). Conclusion We identified patterns comprised of putative cis-regulatory motifs enriched in the upstream promoter sequence of genes that undergo similar changes in expression secondary to cardiomyopathies of various etiologies. Our analysis is a first step towards understanding transcription factor networks that are active in regulating gene expression during degenerative heart disease.

Danko Charles G; Pertsov Arkady M

2009-01-01

212

[Mid-term follow-up and analysis of the failure cases of interspinous implants for degenerative lumbar diseases].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the indications,efficacy and safety of application of interspinous implants for degenerative lumbar diseases by mid-term follow-up and analysis of the failure cases. METHODS: In our study, 52 cases of degenerative lumbar diseases treated with interspinous implants From September 2007 to September 2008 were divided into Wallis group (25 cases) and Coflex group (27 cases). The clinical results were assessed by lumbar pain visual analog score (VAS) and lower limber pain VAS, lumbar Japanese Orthopedic Association (JOA) score and Prolo functional score; the radiological results including implant positon, segmental lodosis and segment movement degree were assessed by lumbar X ray post-operation compared with pre-operation. For cases of discogenic low back pain, lumbar disc changes were assessed by lumbar MRI 12 months post operation. RESULTS: Fifty-two cases had complete follow-up and the average time was 30.4 months. In the final follow up, lumbar pain VAS,lower limber pain VAS,lumbar JOA score and Prolo functional score of Wallis group were (2.5 ± 1.7),(2.7 ± 1.4),(23.4 ± 3.1)and(8.9 ± 1.4), which were better than pre-operation (5.3 ± 3.0),(7.4 ± 2.6),(13.5 ± 4.6)and(4.5 ± 2.6 ),lumbar pain VAS P=0.027, all others P<0.001 ;lumbar pain VAS,lower limber pain VAS,lumbar JOA score and Prolo functional score of Coflex group were (2.6 ± 2.9),(3.8 ± 1.9),(21.2 ± 3.5)and(8.5 ± 1.8),which were better than pre-operation (5.5 ± 3.2),(7.1 ± 2.8), (13.1 ± 4.8)and(4.2 ± 2.5), lumbar pain VAS P=0.036, all others P<0.001;in the final follow up,lower limber pain VAS of Wallis group was (2.7 ± 1.4), which was better than (3.8 ± 1.9) of Coflex group(P=0.039);in the final follow up, Segment lodosis angles of Wallis group was 14.3° ± 3.9°, which was larger than 13.2° ± 3.5° of Coflex group (P=0.028); Segment movement degree of Wallis group was 9.6° ± 2.8°, which was smaller than 12.8°±3.0°of Coflex group (P=0.019).In Coflex group,four cases of lumbar disc herniation relapsed and three cases received second operation. One case with lumbar stenosis suffered from lumbar disc herniation of the same segments and received second revision operation. CONCLUSION: Treatments with interspinous implants for the degenerative lumbar diseases are effective, but we should pay attention to the indication and apply them for lumbar disc herniation with caution.

Sun HL; Li CD; Liu XY; Lin JR; Yi XD; Liu H; Lu HL

2011-10-01

213

Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine.  

Science.gov (United States)

In the treatment of multilevel degenerative disorders of the lumbar spine, spondylodesis plays a controversial role. Most patients can be treated conservatively with success. Multilevel lumbar fusion with instrumentation is associated with severe complications like failed back surgery syndrome, implant failure, and adjacent segment disease (ASD). This retrospective study examines the records of 70 elderly patients with degenerative changes or instability of the lumbar spine treated between 2002 and 2007 with spondylodesis of more than two segments. Sixty-four patients were included; 5 patients had died and one patient was lost to follow-up. We evaluated complications, clinical/radiological outcomes, and success of fusion. Flexion-extension and standing X-rays in two planes, MRI, and/or CT scans were obtained pre-operatively. Patients were assessed clinically using the Oswestry disability index (ODI) and a Visual Analogue Scale (VAS). Surgery performed was dorsolateral fusion (46.9%) or dorsal fusion with anterior lumbar interbody fusion (ALIF; 53.1%). Additional decompression was carried out in 37.5% of patients. Mean follow-up was 29.4±5.4 months. Average patient age was 64.7±4.3 years. Clinical outcomes were not satisfactory for all patients. VAS scores improved from 8.6±1.3 to 5.6±3.0 pre- to post-operatively, without statistical significance. ODI was also not significantly improved (56.1±22.3 pre- and 45.1±26.4 post-operatively). Successful fusion, defined as adequate bone mass with trabeculation at the facets and transverse processes or in the intervertebral segments, did not correlate with good clinical outcomes. Thirty-five of 64 patients (54%) showed signs of pedicle screw loosening, especially of the screws at S1. However, only 7 of these 35 (20%) complained of corresponding back pain. Revision surgery was required in 24 of 64 patients (38%). Of these, indications were adjacent segment disease (16 cases), pedicle screw loosening (7 cases), and infection (one case). At follow-up of 29.4 months, patients with radiographic ASD had worse ODI scores than patients without (54.7 vs. 36.6; Plumbar spine fusion of more than two levels. PMID:21808698

Röllinghoff, Marc; Schlüter-Brust, Klaus; Groos, Daniel; Sobottke, Rolf; Michael, Joern William-Patrick; Eysel, Peer; Delank, Karl Stefan

2010-03-20

214

[Acute reversible degenerative myopathy complicating Lyme disease: description of a case  

UK PubMed Central (United Kingdom)

Lyme's disease is a commonly found disorder whose etiological agent is a spirochete named Borrelia burgdorferi. Its clinical presentation is usually well known, and three stages are described. However it may present symptoms which may resemble many infectious or autoimmune diseases as well. The aim of the present study is to describe a case of first stage Lyme's disease whose main clinical picture is muscoloskeletal involvement, which may mimic dermatomyositis. Many subtle characteristics (age of onset, atypical cutaneous rash) together with the involvement of muscular masses other than scapular or pelvic ones, and the bio-humoral positivity for anti-Borrelia antibodies allowed correct diagnosis to be made. We emphasize that instrumental and invasive examinations, such as electromyography and muscular biopsy, were not diagnostic in such cases.

Scarti L; Baldoni D; Morelli C; Francini V; Bisogni B; Cecchi L

1998-01-01

215

Degenerative diseases of the central nervous system transmissible to experimental animals  

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The clinical features and the pathological changes in the central nervous system of scrapie and kuru are described and attention is drawn to the similarities between these conditions. In both, inoculation of tissues into experimental animals reproduces a similar disease after a prolonged latent peri...

Beck, Elisabeth; Daniel, P. M.

216

Mid-range outcomes in 64 consecutive cases of multilevel fusion for degenerative diseases of the lumbar spine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the treatment of multilevel degenerative disorders of the lumbar spine, spondylodesis plays a controversial role. Most patients can be treated conservatively with success. Multilevel lumbar fusion with instrumentation is associated with severe complications like failed back surgery syndrome, impl...

Röllinghoff, Marc; Schlüter-Brust, Klaus; Groos, Daniel; Sobottke, Rolf; Michael, Joern William-Patrick; Eysel, Peer

217

[Significance of nuclear magnetic resonance tomography for the diagnosis of degenerative diseases of the lumbar spine  

UK PubMed Central (United Kingdom)

The authors report on the diagnosis value of magnetic resonance imaging (MRI) in diseases of the lumbar spine, assessed on the basis of 960 cases treated at Düsseldorf University Orthopedic clinic since 1982. Diseases can be differentiated by changes in shape (vertebral collapse due to tumors, spondylitides, disk prolapse etc.) as well as by structural and pathomorphologic changes (disk degeneration, upper plate reactions etc.). Seventy-four patients were examined for upper plate reactions, which were detected in particular with the partial saturation and the short-time inversion recovery sequences. On the basis of prospective studies the authors comment on the value of MRI as compared to computerized tomography for diagnosing disk prolapses and disk sequestra. It can be shown that the sensitivity and specificity of MRI are very good.

Schulitz KP; Assheuer J

1988-05-01

218

METHOD OF PREVENTING DORSAL PAIN BY MEANS OF MECHANICAL VIBRATIONS IN THE SPINE’S DEGENERATIVE DISEASES OF DISCAL ORIGIN  

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Full Text Available The purpose of this study is to emphasize the therapeutic value of mechanical vibrations. It is known that the Health Service, after studying their effect on the health of operators, incriminates the effect of vibrations and imposes a series of rules regarding the limitation of their pathogen effect on people’s health and also on the environment. In these cases the mechanical vibrations are considered to be noxae because of long-term exposure. From the studies on people exposed to vibrations also results that these have also benefic effects, depending on the control of their parameters: frequency, amplitude, time and the particular way of applying them on the human body.There are well known vibration-producing appliances on the market which are addressed to the muscle tonifiation or relaxation, in body-building or even in medical treatment as bronchial drainage, osteoporosis etc. The use of mechanical vibrations for the optimization of the intervertebral disc’s functions in the pathology of the degenerative diseases of the spine is a new idea and has become a wide research field on the different mobile areas of the spine. In order to do so we have tested the input of low and medium frequency mechanical vibrations for pain management in dorsal rheumatic affections as compared to the kinetic treatment in order to quantify the separate role of each form of treatment to find out their exact input.

Vasile Pâncotan

2011-01-01

219

Clinical potential and limitation of MRI for degenerative lumbar spinal diseases. Comparison of MRI, myelography, CT and selective nerve root infiltration  

International Nuclear Information System (INIS)

[en] To assess the clinical potential and limitations of magnetic resonance imaging (MRI) in degenerative lumbar spinal diseases, the findings of MR imaging were compared with those of myelography and CT. The subjects were 80 patients with intervertebral disc herniation (46), spondylosis (28), degenerative spondylolisthesis (5), and spondylolysis (one). There was a good correlation between sagittal MRI (T1-weighted images) and myelography in measuring the anteroposterior diameter and the compression rate of the injured dural canal in all disease categories. However, MRI was inferior, irrespective of sagittal and coronal images, to myelography in detecting blocking of the dural canal and intradural findings such as redundant nerve roots. MRI was inferior to selective nerve root infiltration in visualizing the compression of the nerve root, irrespective of diseases; however, there was no difference in abnormal findings of the running of nerve root between the two modalities. Transverse MRI was superior to CT in visualizing the nerve root. Thus, MRI alone is insufficient for the diagnosis of degenerative lumbar spinal diseases, and the other modalities should be supplementary for pathophysiological understanding of these diseases. (N.K.)

1994-01-01

220

Clinical potential and limitation of MRI for degenerative lumbar spinal diseases. Comparison of MRI, myelography, CT and selective nerve root infiltration  

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To assess the clinical potential and limitations of magnetic resonance imaging (MRI) in degenerative lumbar spinal diseases, the findings of MR imaging were compared with those of myelography and CT. The subjects were 80 patients with intervertebral disc herniation (46), spondylosis (28), degenerative spondylolisthesis (5), and spondylolysis (one). There was a good correlation between sagittal MRI (T1-weighted images) and myelography in measuring the anteroposterior diameter and the compression rate of the injured dural canal in all disease categories. However, MRI was inferior, irrespective of sagittal and coronal images, to myelography in detecting blocking of the dural canal and intradural findings such as redundant nerve roots. MRI was inferior to selective nerve root infiltration in visualizing the compression of the nerve root, irrespective of diseases; however, there was no difference in abnormal findings of the running of nerve root between the two modalities. Transverse MRI was superior to CT in visualizing the nerve root. Thus, MRI alone is insufficient for the diagnosis of degenerative lumbar spinal diseases, and the other modalities should be supplementary for pathophysiological understanding of these diseases. (N.K.).

Seki, Michihiro; Kikuchi, Shinichi [Fukushima Medical Coll. (Japan)

1994-12-01

 
 
 
 
221

Neurochemical imaging of Alzheimer`s disease and other degenerative dementias  

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A wide variety of neurochemical and functional imaging approaches have been applied to the study of progressive dementias, particularly Alzheimer`s disease (Ad) and related disorders. Despite considerable progress in the past decade, the cause(s) of most cases of Ad remain undetermined and preventive or protective therapies are lacking. Specifically-designed imaging procedures have permitted the testing of pathophysiological hypotheses of the etiology and progression of Ad, and have yielded important insights in several areas including the potential roles of cerebral cortical cholinergic lesions, cellular inflammation, and losses of cortical synapses. From the perspective of clinical diagnosis, PET glucose metabolism imaging with use of ({sup 18}F)2-fluorodeoxyglucose (FDG) is the most sensitive and specific imaging modality yet identified. The overall performance of PET FDG is favorable for routine clinical evaluation of suspected Ad, and will likely gain increasing utilization in the near future. Assessments of glucose metabolism and other, specific aspects of neurochemistry in Ad will provide direct measures of therapeutic drug actions and may permit distinction of symptomatic versus disease-modifying therapies as they are developed and introduced in clinical trials.

Frey, K.A.; Minoshima, S.; Kuhl, D.E. [Ann Arbor, Univ. of Michigan, MI (United States). Dept. of Internal Medicine. Division of Nuclear Medicine

1998-09-01

222

Primary joint disease in the shoulder of the beagle dog  

International Nuclear Information System (INIS)

Shoulder joints of 149 beagle dogs, whose ages were over 8 years at the time of death, were examined to document primary joint disease. Clinical histories of the dogs suggested no underlying causes, i.e. no evidence of osteochondrosis, trauma or joint infection. Radiographic examinations revealed normally developing shoulders in the first years of their lives. Radiographic changes were progressive with age. Bilateral involvement was common. The changes consisted of osteophyte formation on the caudal aspect of the humeral head and glenoid. Postmortem findings included: subchondral bone sclerosis (thin-section radiographs), cartilage wearing, joint capsule thickening, and pannus formation. The authors believe that the changes occurring in the shoulder joints are those of primary joint disease. 12 references.

1985-01-01

223

Degenerative diseases of the spine. Rare and often unrecognized causes of pain syndromes; Degenerative Erkrankungen der Wirbelsaeule. Seltene und oft verkannte Ursachen von Schmerzsyndromen  

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The aim of this article is to describe rare and often unrecognized causes of spinal pain syndromes. Intervertebral disc degeneration frequently appears in early adulthood and can have a symptomatic or asymptomatic course. This article discusses incidence, pathophysiology, imaging, and pain symptomatology involved in the origin of back pain. Anulus tears are often found in asymptomatic individuals but could be implicated in lumbar pain symptomatology in correlation with the provocative discography. Transient disorders can lead to pseudarthrosis of the iliac bone and to degeneration or to a reactive hypermobility with intervertebral disc degeneration in the level above. Modic type 1 erosive osteochondrosis is characterized by bone marrow edema near the hyaline cartilage end plate, which mostly elicits severe pain and results in serious limitations in everyday activities. The most important differential diagnosis is spondylodiscitis. Schmorl's nodes can exhibit considerable surrounding bone marrow edema that can be mistaken for metastases. A combination of MRI and CT should be employed for the diagnostic work-up of fatigue fracture of the interarticular portion, which is often overlooked due to its location. Synovial cysts of the facet joints can lead to radicular symptoms. Insufficiency fracture of the sacrum is frequently mistaken for metastasis due to intense scintigraphic enhancement and its signal behavior in MRI. CT provides instructive information. Differential diagnosis should include less common causes such as anulus tears, transient disorders, activated Schmorl's nodes, synovial cysts of the facet joints, fatigue fractures of the interarticular portion of the spine and the sacrum and distinguish from metastases in particular. (orig.) [German] Darstellung seltener und oft verkannter Ursachen von Wirbelsaeulenschmerzsyndromen. Eine Bandscheibendegeneration tritt haeufig im fruehen Erwachsenenalter auf und kann symptomatisch oder asymptomatisch verlaufen. Diskutiert werden Inzidenz, Pathophysiologie, Bildgebung und Schmerzsymptomatik der Rueckenschmerzursachen. Anulusrisse werden haeufig bei asymptomatischen Individuen gefunden, konnten aber in Korrelation mit der provokativen Diskographie mit einer lumbalen Schmerzsymptomatik in Verbindung gebracht werden. Uebergangsstoerungen koennen zu einem Nearthros zum Os sacrum/Os ileum und zur Degeneration fuehren oder zu einer reaktiven Hypermobilitaet mit Bandscheibendegeneration in der darueber liegenden Hoehe. Die erosive Osteochondrose, Typ Modic I, zeichnet sich durch ein abschlussplattennahes Knochenmarkoedem aus, das meist starke Schmerzen hervorruft und zu starken Einschraenkungen im taeglichen Leben fuehrt. Die wichtigste Differenzialdiagnose ist die Spondylodiszitis. Schmorl-Knoten koennen ein erhebliches umgebendes Knochenmarkoedem aufweisen und mit Metastasen verwechselt werden. Zur Diagnostik der akuten Ermuedungsfraktur der Interartikularportion, die aufgrund ihrer Lage haeufig uebersehen wird, sollte eine Kombination aus MRT und CT erfolgen. Synoviale Zysten der Facettengelenke koennen zu radikulaeren Symptomen fuehren. Die Insuffizienzfraktur des Sakrums wird aufgrund einer starken szintigraphischen Anreicherung und ihres Signalverhaltens in der MRT haeufig mit einer Metastasierung verwechselt. Wegweisend ist die CT. In die Differenzialdiagnostik sollten seltenere Ursachen wie Anulusrisse, Uebergangsstoerungen, aktivierte Schmorl-Knoten, synoviale Zysten der Facettengelenke, Ermuedungsfrakturen der Interartikularportion und des Sakrums einbezogen und insbesondere zur Metastasierung abgegrenzt werden. (orig.)

Baur-Melnyk, A.; Triantafyllou, M.; Reiser, M. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet, Institut fuer Klinische Radiologie, Muenchen (Germany); Birkenmaier, C. [Klinikum Grosshadern der Ludwig-Maximilians-Universitaet Muenchen, Orthopaedische Klinik und Poliklinik (Germany)

2006-06-15

224

Additive scales in degenerative disease - calculation of effect sizes and clinical judgment  

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Full Text Available Abstract Background The therapeutic efficacy of an intervention is often assessed in clinical trials by scales measuring multiple diverse activities that are added to produce a cumulative global score. Medical communities and health care systems subsequently use these data to calculate pooled effect sizes to compare treatments. This is done because major doubt has been cast over the clinical relevance of statistically significant findings relying on p values with the potential to report chance findings. Hence in an aim to overcome this pooling the results of clinical studies into a meta-analyses with a statistical calculus has been assumed to be a more definitive way of deciding of efficacy. Methods We simulate the therapeutic effects as measured with additive scales in patient cohorts with different disease severity and assess the limitations of an effect size calculation of additive scales which are proven mathematically. Results We demonstrate that the major problem, which cannot be overcome by current numerical methods, is the complex nature and neurobiological foundation of clinical psychiatric endpoints in particular and additive scales in general. This is particularly relevant for endpoints used in dementia research. 'Cognition' is composed of functions such as memory, attention, orientation and many more. These individual functions decline in varied and non-linear ways. Here we demonstrate that with progressive diseases cumulative values from multidimensional scales are subject to distortion by the limitations of the additive scale. The non-linearity of the decline of function impedes the calculation of effect sizes based on cumulative values from these multidimensional scales. Conclusions Statistical analysis needs to be guided by boundaries of the biological condition. Alternatively, we suggest a different approach avoiding the error imposed by over-analysis of cumulative global scores from additive scales.

Riepe Matthias W; Wilkinson David; Förstl Hans; Brieden Andreas

2011-01-01

225

Second metatarsophalangeal joint pathology and freiberg disease.  

UK PubMed Central (United Kingdom)

Pain in the second metatarsophalangeal joint (MTPJ) is a complaint frequently encountered by foot and ankle specialists. The pathology associated with this joint is often painful and debilitating for the patient. In the past, typical treatment protocols for second MTPJ pathology were aimed at relief of patient symptoms. Conservative treatment and offloading devices have historically dominated treatment options for the clinician. However, recent surgical techniques and procedures have been developed to correct the mechanical and structural defects that can affect this joint. The aim of this review was to outline recent developments and treatment options for common second MTPJ pathologies.

Shane A; Reeves C; Wobst G; Thurston P

2013-07-01

226

Second metatarsophalangeal joint pathology and freiberg disease.  

Science.gov (United States)

Pain in the second metatarsophalangeal joint (MTPJ) is a complaint frequently encountered by foot and ankle specialists. The pathology associated with this joint is often painful and debilitating for the patient. In the past, typical treatment protocols for second MTPJ pathology were aimed at relief of patient symptoms. Conservative treatment and offloading devices have historically dominated treatment options for the clinician. However, recent surgical techniques and procedures have been developed to correct the mechanical and structural defects that can affect this joint. The aim of this review was to outline recent developments and treatment options for common second MTPJ pathologies. PMID:23827490

Shane, Amber; Reeves, Christopher; Wobst, Garrett; Thurston, Paul

2013-07-01

227

Intradural Lumbar Disc Herniation Associated With Degenerative Spine Disease and Rheumatoid Arthritis.  

UK PubMed Central (United Kingdom)

Study Design. A case report by Kara Krajewski and Jan Regelsberger.Objective. To demonstrate a case of intradural lumbar disc herniation including imaging studies, intraoperative imaging and an intraoperative video.Summary of Background Data. The first case of lumbar intradural disc herniation was reported as early as 1942; since then over 150 cases have been reported, mostly in the lumbar spine. Gadolinium-enhanced MRI is considered the gold standard for diagnosing this entity, though it is rarely peformed routinely in lumbar disc disease and diagnosis is often made intraoperatively.Methods. A 70-year-old man presented to the emergency department as a referral complaining of lower back pain, loss of sensation in the right thigh and difficulty walking. On examination, he showed uneven gait, right-sided foot drop (1/5), hypesthesias in the right inguinal area and ventral thigh and a positive straight leg raise test on the right. Anal sphincter tone was within normal limits. An MRI of the lumbar spine showed a large mediolateral herniated disc at L3/4, with caudal displacement and unclear signal changes intradurally.Results. Intraoperatively, the herniated disc was found upon opening the dural sac.Conclusion. Intradural disc herniations are a rare entity. The opening and inspection of the dural sack should be considered when the correct spinal level can be confirmed and insufficient herniated disc material can be visualized extradurally.

Krajewski K; Regelsberger J

2013-03-01

228

Intradural Lumbar Disc Herniation Associated With Degenerative Spine Disease and Rheumatoid Arthritis.  

Science.gov (United States)

Study Design. A case report by Kara Krajewski and Jan Regelsberger.Objective. To demonstrate a case of intradural lumbar disc herniation including imaging studies, intraoperative imaging and an intraoperative video.Summary of Background Data. The first case of lumbar intradural disc herniation was reported as early as 1942; since then over 150 cases have been reported, mostly in the lumbar spine. Gadolinium-enhanced MRI is considered the gold standard for diagnosing this entity, though it is rarely peformed routinely in lumbar disc disease and diagnosis is often made intraoperatively.Methods. A 70-year-old man presented to the emergency department as a referral complaining of lower back pain, loss of sensation in the right thigh and difficulty walking. On examination, he showed uneven gait, right-sided foot drop (1/5), hypesthesias in the right inguinal area and ventral thigh and a positive straight leg raise test on the right. Anal sphincter tone was within normal limits. An MRI of the lumbar spine showed a large mediolateral herniated disc at L3/4, with caudal displacement and unclear signal changes intradurally.Results. Intraoperatively, the herniated disc was found upon opening the dural sac.Conclusion. Intradural disc herniations are a rare entity. The opening and inspection of the dural sack should be considered when the correct spinal level can be confirmed and insufficient herniated disc material can be visualized extradurally. PMID:23462573

Krajewski, K; Regelsberger, J

2013-03-01

229

The anatomical basis of bradycardia-tachycardia syndrome in elderly dogs with chronic degenerative valvular disease.  

UK PubMed Central (United Kingdom)

The hearts of seven elderly dogs in which bradycardia-tachycardia syndrome (BTS) had been diagnosed electrocardiographically were examined post mortem. The clinical basis of the underlying heart disease was invariably mitral or mitral and tricuspid regurgitation. Microscopical examination of the sinoatrial (SA) node and the SA junctional region consistently revealed depletion of SA nodal cells, with a corresponding increase in fibrous or fibro-fatty tissue that interrupted contiguity between the SA node and the surrounding atrial myocardium. The left and right atrial walls showed an increased amount of fibrous tissue in the myocardium and disruption of the muscle bundle architecture (interstitial myocardial fibrosis) to varying degrees. Qualitatively, these changes in the SA node and the SA node region resembled those associated with ageing in elderly people with or without BTS. Thus, it is possible that the pathological process affecting the SA node in these dogs was fundamentally related to ageing and may have caused BTS, in combination with atrial myocardial lesions caused by mitral and tricuspid regurgitation.

Nakao S; Hirakawa A; Fukushima R; Kobayashi M; Machida N

2012-02-01

230

BEST1-related autosomal dominant vitreoretinochoroidopathy: a degenerative disease with a range of developmental ocular anomalies.  

UK PubMed Central (United Kingdom)

PURPOSE: To describe the spectrum of phenotypic characteristics of BEST1-related autosomal dominant vitreoretinochoroidopathy (ADVIRC) in a family with p.V86M mutation. METHODS: A retrospective review of the clinical, psychophysical, and electrophysiological phenotypes of six subjects with ADVIRC. Five family members were sequenced for mutations in the BEST1 gene. RESULTS: A heterozygous change, p.V86M (c.256G > A), was identified in the BEST1 gene in the three affected subjects tested, and was shown to segregate with the disease phenotype. The distance visual acuity ranged from ? 20/25 to absent perception of light. Clinical features observed included angle closure glaucoma (n = 2), microcornea with shallow anterior chamber (n = 1), iris dysgenesis (n = 2), cataracts (n = 4), classical peripheral concentric band of retinal hyperpigmentation (n = 5), and optic nerve dysplasia (n = 1). Full-field electroretinogram response amplitudes ranged from low normal (two cases; 27 and 32 years) to non-recordable (two cases; 42 and 63 years). Goldmann fields were normal in two (27 and 28 years) but were abnormal in two older subjects. Optical coherence tomography showed macular thinning in the proband, whereas his affected daughter had normal macular thickness. Electro-oculography showed borderline Arden's ratio (1.50) in the lone case tested (27 years). CONCLUSION: ADVIRC is a slowly progressive vitreoretinal degeneration that demonstrates marked intra-familial phenotypic variability. Optic nerve dysplasia and iris dysgenesis are novel observations that extend the ocular phenotype of ADVIRC.

Vincent A; McAlister C; Vandenhoven C; Héon E

2011-01-01

231

Deciphering structural intermediates and genotoxic fibrillar aggregates of albumins: a molecular mechanism underlying for degenerative diseases.  

UK PubMed Central (United Kingdom)

The misfolding and aggregation of proteins is involved in some of the most prevalent neurodegenerative disorders. The importance of human serum albumin (HSA) stems from the fact that it is involved in bio-regulatory and transport phenomena. Here the effect of acetonitrile (ACN) on the conformational stability of HSA and by comparison, ovalbumin (OVA) has been evaluated in the presence and absence of NaCl. The results show the presence of significant amount of secondary structure in HSA at 70% ACN and in OVA at 50% ACN, as evident from far-UV Circular Dichroism (CD) and Attenuated Total Reflection Fourier transformed infra red spectroscopy (ATR-FTIR). Tryptophan and 8-Anilino-1-Naphthalene-Sulphonic acid (ANS) fluorescence indicate altered tryptophan environment and high ANS binding suggesting a compact "molten globule"-like conformation with enhanced exposure of hydrophobic surface area. However, in presence of NaCl no intermediate state was observed. Detection of aggregates in HSA and OVA was possible at 90% ACN. Aggregates possess extensive ?-sheet structure as revealed by far-UV CD and ATR-FTIR. These aggregates exhibit increase Thioflavin T (Th T) fluorescence with a red shift of Congo red (CR) absorption spectrum. X-ray diffraction (XRD) and Scanning Electron Microscopy (SEM) analysis confirmed the presence of fibrillar aggregates. Single cell gel electrophoresis (SCGE) assay of these fibrillar aggregates showed the DNA damage resulting in cell necrosis confirming their genotoxic nature. Some proteins not related to any human disease form fibrils in vitro. In the present study ACN gives access to a model system to study the process of aggregation.

Naeem A; Amani S

2013-01-01

232

[Clinical study on unilateral pedicle screw fixation and interbody fusion for the treatment of lumbar degenerative diseases under Quadrant system].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare the clinical effects of unilateral pedicle screw fixation (uni-PS) assisted by Quadrant system and bilateral pedicle screw fixation (bi-PS) for the treatment of lumbar degenerative diseases. METHODS: From October 2008 to October 2010,102 patients with lower back pain, unilateral lower limb radiating pain or paraesthesia were treated with pedicle screw fixation and lumbar interbody fusion. There were 67 males and 35 females with an average age of 51.5 years ranging from 34 to 69 years. The patients were randomly divided into two groups (group A and group B) according to the internal fixation type. The patients of group A (n=50) underwent with minimally transforaminal lumbar interbody fusion (TLIF) and unilateral pedicle screw fixation with one single cage placement assisted by Quadrant system;and the patients of group B (n = 52) underwent with posterior lumbar interbody fusion (PLIF) and bilateral pedicle screw fixation with one single cage placement. There were no significant differences between two groups in general information (P > 0.05). VAS score and ODI score system were used to evaluate the preoperative and postoperative pain and function recovery. Operative time, volume of blood loss, fusion rate and complication rate were compared and analyzed by statistical test. RESULTS: All the patients were followed up from 12 to 21 months with an average of 18.2 months. In the group A,operative time and volume of blood loss were (87.6 +/- 25.5) min and (105.7 +/- 27.2) ml, respectively; VAS score of low back pain and leg pain, ODI score decreased respectively from preoperative 7.2 +/- 1.4, 7.9 +/- 1.1, 42.2 +/- 11.8 to 3.2 +/- 0.6, 3.0 +/- 0.7,15.6 +/- 2.3 at one month after operation; the fusion rate was 96.0% (48/50) and the complication rate was 4.00% (2/50). In the group B,operative time and volume of blood loss were (160.3 +/- 20.5) min and (220.6 +/- 25.5) ml, respectively; VAS score of low back pain and leg pain, ODI score decreased respectively from preoperative 7.3 +/- 1.1, 8.1 +/- 0.9, 43.1 +/- 12.0 to 3.3 +/- 0.4, 3.2 +/- 0.3, 14.9 +/- 2.6; the fusion rate was 96.2% (50/52) and the compli- cation rate was 5.77% (3/52). There were no statistically significant differences between the two groups in fusion rate, complication rate, VAS pain and ODI score. Whereas the operative time and blood loss in group A were significantly lower than that of group B. CONCLUSION: Minimally invasive unilateral pedicle screw fixation is a safe and feasible method for the treatment of lumbar degenerative diseases. It is as effective as the bilateral fixation in lumbar spinal fusion. In addition, it has the advantages of short operative time, less volume of blood loss, high fusion rate, etc.

Lin B; Lin QY; He MC; Liu H; Guo ZM; Lin KS

2012-06-01

233

Degenerative Suspensory Ligament Desmitis – A New Reality  

Directory of Open Access Journals (Sweden)

Full Text Available Degenerative suspensory ligament desmitis (DSLD) is a chronic, debilitating disease occurring primarily in Peruvian Pasos and Peruvian Paso crosses. However, many other breeds are afflicted as well. DSLD is characterized by a slowly progressing bilateral or quadrilateral lameness. Typically, the owner does not recall any trauma or performance related injury. Fetlock effusion, static and dynamic hyperextension and degenerative joint disease are hallmarks on physical examination. Ultrasonography of affected ligaments reveals diffuse loss of echogenicity, and an irregular fiber pattern. Though until recently DSLD was considered a collagen disorder strictly limited to suspensory ligaments (SLs), our data show that it is a systemic disease involving tissues with high content of collagen. We have identified abnormal accumulations of proteoglycans not only in the SLs, but also in the superficial and deep digital flexor tendons, patellar and nuchal ligaments, aorta, coronary arteries and sclerae of DSLD-affected horses. Our most recent data point to the presence of an abnormal form of decorin in these proteoglycan deposits. This decorin also exhibited altered biological activity. Treatment for DSLD-affected horses is empirical and directed at minimizing musculoskeletal pain and providing support for the suspensory apparatus. Restricted exercise, supportive bandages and nonsteroidal anti-inflammatory drugs provide some, but usually only temporary relief. Unfortunately, unrelenting pain, severe lameness and suffering require all too often humane euthanasia.

Jaroslava Halper*, Ahrar Khan1 and P. O. Eric Mueller2

2011-01-01

234

Fusion rates in multilevel, instrumented anterior cervical fusion for degenerative disease with and without the use of bone morphogenetic protein.  

UK PubMed Central (United Kingdom)

OBJECT: The goal of this study was to compare the rates of solid arthrodesis and complications following multilevel, instrumented anterior cervical fusion in patients treated with and without bone morphogenetic protein (BMP). METHODS: The authors conducted a retrospective cohort study of patients who underwent multilevel (2+ level) anterior cervical fusions performed for degenerative disc disease with or without the concurrent use of BMP-2 from 1997 to 2012. The dosage throughout the study ranged from 2.1 to 0.26 mg/level (mean 1.0 mg/level). All patients were evaluated postoperatively by means of radiographs and CT scans to determine fusion status. RESULTS: The overall fusion rate for the patients treated without BMP (n = 23) was 82.6% compared with a 100% fusion rate in the group treated with BMP (n = 22) (p = 0.04). The pseudarthrosis rates increased with number of fusion levels in patients who did not receive BMP, whereas all patients in the group treated with BMP had solid arthrodesis. Furthermore, there were 2 instrumentation failures in the non-BMP group. There was a direct correlation between the incidence of complications and the dosage of BMP used per level, with no complications reported at doses equal to or less than 1.1 mg/level. CONCLUSIONS: The overall rate of bony arthrodesis was increased following the use of BMP in multilevel anterior cervical fusion. Traditional methods without BMP had a high rate of pseudarthrosis. The complications associated with the use of BMP appeared to be dose related and of low incidence when BMP is used in doses equal to or less than 1.1 mg/level.

Frenkel MB; Cahill KS; Javahary RJ; Zacur G; Green BA; Levi AD

2013-03-01

235

Degenerative Change at the Pseudarthrosis After Trapeziectomy at 6-year Followup.  

UK PubMed Central (United Kingdom)

BACKGROUND: Simple trapeziectomy has a well-documented history of success for the management of osteoarthritis at the trapeziometacarpal joint. There is concern, however, that late-onset failure can occur as a result of the development of degenerative disease at the scaphoid-metacarpal pseudarthrosis. QUESTIONS/PURPOSES: The purpose of this study was to determine whether (1) radiographic changes of degenerative joint disease progressed; (2) the pseudarthrosis height diminished between 1 year and 6 years after either simple trapeziectomy or trapeziectomy with ligament reconstruction and tendon interposition (LRTI); and 3) the presence of degenerative changes were associated with inferior scores on standardized outcomes instruments. METHODS: Using cases from an earlier randomized trial, the 1-year and 6-year stress radiographs of the pseudarthrosis between the distal pole of the scaphoid and the base of the thumb metacarpal were assessed for degenerative change in 25 thumbs that had undergone simple excision of the trapezium and 29 that had undergone trapeziectomy + LRTI for painful trapeziometacarpal joint osteoarthritis. Degenerative change was graded according to a Kellgren and Lawrence system, and clinical results were assessed using the Patient Evaluation Measure (PEM), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires, and thumb key pinch strength. RESULTS: One of the 29 thumbs treated with trapeziectomy + LRTI and seven of the 25 thumbs treated by simple excision of the trapezium exhibited increased degenerative change at their final followup. A pseudarthrosis space was preserved in 22 of the 25 simple trapeziectomies and 28 of the 29 trapeziectomies + LRTI. The presence of degenerative change did not adversely affect the outcome as measured by the PEM, the DASH, or thumb key pinch strength. CONCLUSIONS: Increased degenerate-like changes were observed after simple excision of the trapezium but these did not influence the clinical outcome. LEVEL OF EVIDENCE: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Salem HM; Davis TR

2013-04-01

236

Degenerative Change at the Pseudarthrosis After Trapeziectomy at 6-year Followup.  

Science.gov (United States)

BACKGROUND: Simple trapeziectomy has a well-documented history of success for the management of osteoarthritis at the trapeziometacarpal joint. There is concern, however, that late-onset failure can occur as a result of the development of degenerative disease at the scaphoid-metacarpal pseudarthrosis. QUESTIONS/PURPOSES: The purpose of this study was to determine whether (1) radiographic changes of degenerative joint disease progressed; (2) the pseudarthrosis height diminished between 1 year and 6 years after either simple trapeziectomy or trapeziectomy with ligament reconstruction and tendon interposition (LRTI); and 3) the presence of degenerative changes were associated with inferior scores on standardized outcomes instruments. METHODS: Using cases from an earlier randomized trial, the 1-year and 6-year stress radiographs of the pseudarthrosis between the distal pole of the scaphoid and the base of the thumb metacarpal were assessed for degenerative change in 25 thumbs that had undergone simple excision of the trapezium and 29 that had undergone trapeziectomy + LRTI for painful trapeziometacarpal joint osteoarthritis. Degenerative change was graded according to a Kellgren and Lawrence system, and clinical results were assessed using the Patient Evaluation Measure (PEM), Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires, and thumb key pinch strength. RESULTS: One of the 29 thumbs treated with trapeziectomy + LRTI and seven of the 25 thumbs treated by simple excision of the trapezium exhibited increased degenerative change at their final followup. A pseudarthrosis space was preserved in 22 of the 25 simple trapeziectomies and 28 of the 29 trapeziectomies + LRTI. The presence of degenerative change did not adversely affect the outcome as measured by the PEM, the DASH, or thumb key pinch strength. CONCLUSIONS: Increased degenerate-like changes were observed after simple excision of the trapezium but these did not influence the clinical outcome. LEVEL OF EVIDENCE: Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:23568674

Salem, Hatem M; Davis, Tim R C

2013-04-01

237

Proximal Vertebral Body Fracture after 4-Level Fusion Using L1 as the Upper Instrumented Vertebra for Lumbar Degenerative Disease: Report of 2 Cases with Literature Review  

Directory of Open Access Journals (Sweden)

Full Text Available Some cases with lumbar degenerative diseases require multi-level fusion surgeries. At our institute, 27 and 4 procedures of 3- and 4-level fusion were performed out of a total 672 posterior lumbar interfusions (PLIFs) on patients with lumbar degenerative disease from 2005 to 2010. We present 2 osteoporotic patients who developed proximal vertebral body fracture after 4-level fusion. Both cases presented with gait disability for leg pain by degenerative lumbar scoliosis and canal stenosis at the levels of L1/2-4/5. After 4-level fusion using L1 as the upper instrumented vertebra, proximal vertebral body fractures were found along with the right pedicle fractures of L1 in both cases. One of these patients, aged 82 years, was treated as an outpatient using a hard corset for 24 months, but the fractures were exacerbated over time. In the other patient, posterolateral fusion was extended from Th10 to L5. Both patients can walk alone and have been thoroughly followed up. In both cases, the fracture of the right L1 pedicle might be related to the subsequent fractures and fusion failure. In consideration of multi-level fusion, L1 should be avoided as an upper instrumented vertebra to prevent junctional kyphosis, especially in cases with osteoporosis and flat back posture.

Yasuhara,Takao; Takahashi,Yuichi; Kumamoto,Shinji; Nakahara,Masayuki; Yoneda,Kotaro; Niimura,Tatsuomi; Tanoue,Takashi; Kusumegi,Akira; Sennari,Takashi; Hijikata,Yasukazu; Manabe,Hiroaki; Miyoshi,Yasuyuki; Date,Isao; Ogawa,Koichi; Nishida,Kenki

2013-01-01

238

Tophaceous calcium pyrophosphate dihydrate deposition disease of the temporomandibular joint.  

Science.gov (United States)

Tophaceous pseudogout is a rare manifestation of calcium pyrophosphate dihydrate (CPPD) deposition disease that particularly affects the temporomandibular joint (TMJ). We describe a case of tophaceous pseudogout and review the literature. Thirty-four cases of chronic CPPD deposition disease affecting the TMJ are described. Symptoms usually included pain and swelling. Most patients required surgery because of extensive crystal deposits, usually localized to the joint and adjacent structures but occasionally invasive. For many patients, malignancy was the preoperative diagnosis. Although patients with acute pseudogout of the TMJ may have involvement of other joints, tophaceous pseudogout was predominantly isolated to the TMJ. PMID:18398950

Reynolds, Jennifer L; Matthew, Ian R; Chalmers, Andrew

2008-04-01

239

Lumbar degenerative classification study.  

Science.gov (United States)

The purpose of this study was to develop and validate a classification of indications for fusion in lumbar degenerative disease. Nineteen spine surgeons reviewed a series of 32 case histories and selected the indication for fusion based on an outlined classification system. To determine the degree of interrater variability, K coefficients were calculated (K for all 32 cases, 0.63). Results from this study show the significant difficulty in classifying the indication for fusion in lumbar degenerative disease. The level of the 19 surgeons' agreement regarding surgical indication was only moderate, despite a study design that eliminated controversial issues of patient and procedure selection. To a significant extent, the difficulty in classifying indication for fusion underlines the importance of the process. If we cannot agree on why a specific patient is selected for fusion, it is then impossible to accurately compare outcomes for a given disease process or surgical technique. For this reason, an ongoing effort to refine nomenclature and classification is necessary. PMID:16689515

Glassman, Steven D; Carreon, Leah Y; Dimar, John R; Campbell, Mitchell J; Johnson, John R; Puno, Rolando M

2006-04-01

240

Knee joint replacement - series (image)  

Science.gov (United States)

The knee is a complex joint. It contains the distal end of the femur (the femoral condyles) and the ... The most common cause of knee damage that leads to knee replacement ... is a degenerative disease of the bones of the knee. It causes ...

 
 
 
 
241

Two-year follow-up results of the Isobar TTL Semi-Rigid Rod System for the treatment of lumbar degenerative disease.  

UK PubMed Central (United Kingdom)

We retrospectively assessed the indications, safety and efficacy of a new dynamic stabilization system (the Isobar TTL Semi-Rigid Rod System, Scient'x, Bretonneux, France) for the treatment of lumbar degenerative disease in 37 consecutive patients (M:F=16:21, mean age 40.2 years) with lumbar degenerative disease who underwent surgery between June 2006 and May 2009. One patient was lost to follow-up. Clinical outcomes were evaluated using the Oswestry Disability Index (ODI) and the Visual Analogue Scale (VAS); range-of-motion (ROM) and disc height index (DHI) were assessed with radiography. Patients were followed for a mean of 24 months (range: 12-36 months). At the 3-month follow-up, there was significant improvement in VAS and ODI (p<0.05); at long-term follow-up VAS showed additional significant improvement (p<0.05) and ODI remained stable. At short-term follow-up, DHI was significantly restored (p<0.05) and ROM declined slightly (but not significantly); however, at long-term follow-up DHI was significantly reduced (p<0.05) compared to short-term follow-up and ROM was significantly decreased compared to the preoperative values (p<0.05). There were new signs of degeneration at adjacent levels in 14 patients (39%) on long-term follow-up MRI. Revision was required in three patients (8%) 24 months after the first operation due to adjacent segment disease. Screw loosening was observed in four patients (11%). The Isobar System after microsurgical decompression for lumbar degenerative disease provided excellent improvement in leg and back pain and patient satisfaction at late follow-up; however, evidence to suggest that Isobar outperforms traditional fusion is lacking. Larger studies of longer duration are warranted.

Li Z; Li F; Yu S; Ma H; Chen Z; Zhang H; Fu Q

2013-03-01

242

Degenerative myelopathy in dogs  

Directory of Open Access Journals (Sweden)

Full Text Available One of the chronic progressive disorders of the spinal cord in dogs is the degenerative myelopathy (DM). The most predisposed age in dog is 5 to 14 years, while rarely noted in younger, there is no gender predisposition. This disorder most commonly appears in dogs of the German shepherd breed, but it can appear in other breeds too. The main changes about this disease are degeneration of the myelin, especially in the thoracic-lumbar segments of the spinal cord and the dorsal nerve roots. The progression of the disease is slow and can last months to years. Undoubtedly, diagnosis is made by examinations of the CSF and establishing elevated level of protein segments.

Nikolovski Goran; Atanaskova Elena

2010-01-01

243

CT evaluation of chronic hip joint diseases: avascular necrosis vs. osteoarthritis  

Energy Technology Data Exchange (ETDEWEB)

Computed tomography (CT) of the hip was done on 37 patients those who have been suffered from chronic hip joint pain. There were 18 patients of avascular necrosis of hip (AVN), 67% of whom were affected bilaterally, 15 patients of degenerative arthritis (DA), 33% bilaterally; one patient of tuberculous arthritis, rheumatoid arthritis and traumatic arthritis respectively. Comparison of the staging by means of the CT and plain film showed good correlation between the two methods. The CT findings of the AVN and OA were also compared; crescent sign or fissure, loss of congruity, and loss or change of normal asterisk sign were more commonly seen in AVN. Acetabular change especially associated cystic appearance, osteophytes formation and joint narrowing were more frequent in OA. CT showed primary and secondary change of AVN and OA more clearly without confusion than plain film. We think that CT can be helpful in evaluation and understanding of each disease process and differentiation of the two lesions in difficult case000.

Kim, Myeong Jin; Suh, Jin Seok; Lee, Jong Doo; Park, Chang Yoon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1988-12-15

244

ProDisc-C versus fusion with Cervios chronOS prosthesis in cervical degenerative disc disease: Is there a difference at 12 months?  

UK PubMed Central (United Kingdom)

Study design: ?Prospective cohort study. Objective: ?The aim of the study was to compare clinical results and to determine differences in outcomes between anterior cervical discectomy and fusion (ACDF) and disc arthroplasty in patients treated for symptomatic cervical degenerative disc disease. Methods: ?Forty patients with cervical degenerative disc disease were treated with ProDisc-C disc arthroplasty and 40 patients with fusion using an intervetebral spacer with integrated fixation (Cervios chronoOS) implants without additional anterior fixation. Fifty disc prostheses were placed in the first group and 52 intervertebral spacers were implanted in the second group. Clinical outcomes were assessed before and 12 months following the procedure using the neck disability index (NDI) and visual analog scale (VAS) for neck and arm pain, with 15% improvement in NDI and 20% in VAS defined as a clinically significant. Results: ?Eighty patients with cervical degenerative disc disease with a mean age of 49.7 years were included in the study with a minimum follow-up of 12 months. The groups were similar at baseline both clinically and statistically (P?>?.05) except for age and VAS for arm pain. Both groups had a statistically significant improvement in NDI and VAS for neck and arm pain (P?

Vorsic M; Bunc G

2010-05-01

245

Temporomandibular joint arthritis in sickle cell disease: a case report.  

Science.gov (United States)

We report a rare case of aseptic arthritis in the temporomandibular joint of a patient with sickle cell anemia. A 22-year-old woman with sickle cell disease, in the 18th week of gestation, was referred by her hematologist to investigate a sudden mouth opening limitation and severe pain on her left cheek. The patient received a standard pain assessment protocol, clinical examination, and complementary exams (complete blood count, hemoglobin electrophoresis, blood solubility test, panoramic radiograph, and magnetic resonance imaging [MRI]). The blood results were consistent with a sickle cell crisis and the MRI showed an inflammatory process around the left temporomandibular joint. Treatment with opioid analgesics and blood transfusion provided good results. Sickle cell anemia is a disease that can cause arthritis of the temporomandibular joint, and although it is rare, clinicians should be attentive to the differential diagnosis in patients with this disease. PMID:23021926

Caracas, Maíra da Silva; Jales, Sumatra P; Jales Neto, Levi H; da Silva Castro, Joice Carla; Suganuma, Liliana Mitie; Fonseca, Guilherme Henrique Hencklain; Gualandro, Sandra Fatima Menosi; de Siqueira, José Tadeu Tesseroli

2012-09-28

246

[Short-term effectiveness of nano-hydroxyapatite/polyamide-66 intervertebral cage for lumbar interbody fusion in patients with lower lumbar degenerative diseases].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the short-term effectiveness of nano-hydroxyapatite/polyamide-66 (n-HA/PA66) intervertebral cage for lumbar interbody fusion in the patients with lower lumbar degenerative diseases. METHODS: Between January and October 2011, 20 patients with lower lumbar degenerative diseases underwent transforaminal lumbar interbody fusion with n-HA/PA66 intervertebral cage. There were 8 males and 12 females, aged 22-80 years (mean, 51 years). The disease duration was 1 to 24 months (mean, 4 months). L4,5 fusion was performed in 8 cases, L5, S1 fusion in 9 cases, and L4-S1 fusion in 3 cases. Among 20 cases, 3 were diagnosed as having recurrent lumbar disc protrusion, 5 as having lumbar degenerative spondylolisthesis, 9 as having lumbar isthmic spondylolisthesis, and 3 as having lumbar spinal stenosis. The intervertebral height and lordosis were measured on X-ray film to assess the surgical correction and postoperative sustain while osseous fusion was observed on 3-dimensional CT. The Oswestry disability index (ODI) and short-form 36 health survey scale (SF-36) scores were obtained to assess the status of clinical recovery. RESULTS: All patients had incision healing by first intention. The pain and numb were relieved in varying degrees after operation. No cerebrospinal leakage, nerve root injury, or wound infection was occurred. All patients were followed up 6-9 months (mean, 7 months). No cage displacement or collapse was found. The intervertebral height and lordosis of single fusion segment were significantly improved at 3 days and 3, 6 months after operation when compared with those at preoperation (P < 0.01); there was no significant difference among each time point after operation (P > 0.05). The fusion rate was 74% at 3 months after operation and 96% at 6 months after operation, with an average of 4 months (range, 3-9 months) for interbody fusion. The ODI and SF-36 scores were significantly improved at 3 days and 6 months after operation when compared with the scores at preoperation (P < 0.01); there was no significant difference among each time point after operation (P > 0.05). CONCLUSION: The interbody fusion with n-HA/PA intervertebral cage is effective and safe to treat the lower lumbar degenerative diseases. The n-HA/PA66 intervertebral cage is an ideal device of interbody fusion with high fusion rate, low subsidence rate, and high transmission X-ray, but the long-term effectiveness need further observation.

Yang X; Song Y; Kong Q; Gong Q; Pei F; Tu C

2012-12-01

247

[The mid-term follow-up of Coflex non-fusion internal fixation in the treatment of degenerative lumbar disease].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To summarize the mid-term effectiveness of Coflex non-fusion internal fixation treatment of degenerative lumbar disease. METHODS: From October 2008 to December 2010, a retrospective analysis was carried out on 39 patients (29 males and 10 females) diagnosed as degenerative lumbar disease and treated with Coflex interspinous dynamic device, who had been followed up for 1 year at least, the average age was 45.5 years (range, 23 - 67 years). The results were assessed by Japanese Orthopedic Association (JOA) scores, visual analogue scale (VAS) scores, Oswestry disability index (ODI) scores and SF-36 scores; and the range of mobility (ROM), intervertebral disc height of the responsible and adjacent segments were measured on X-film before the operation and at last follow-up. Observed the therapeutic effect of the patients and compared the effect on the patients of different body mass index (BMI) and different age by the One-way analysis of variance and paired t test. RESULTS: The 39 patients were followed up for 30.9 months (range, 12 - 37 months). At the last follow-up, JOA, ODI, VAS and SF-36 scores were improved by 70% ± 12%, 54% ± 12%, 77% ± 10% and 51% ± 9%, and were statistically significant (t = -33.289, 26.448, 26.596 and -20.772, P = 0.00). Patients with BMI ? 25 kg/m(2) had lower improvement rates in the scores than those with BMI < 25 kg/m(2) (F = 10.561, 5.850, 5.651 and 6.519, P < 0.05). The patients were 50 years older or younger couldn't affected the improvement rates in the scores statistically (P > 0.05). There were no significant difference in remaining disc height (P > 0.05), except that the intervertebral disc height of L4-5 increased slightly compared with the preoperative (t = -2.819, P = 0.008). In addition to the ROM of L3-4, L5-S1 and L1-S1 were not significantly different from the preoperative(P > 0.05), the ROM of L4-5 were decreased (t = 12.598, P = 0.000). CONCLUSIONS: The mid-term effectiveness of Coflex non-fusion interspinous fixation in treatment of degenerative lumbar disease is worthy of recognition, and Coflex combined with Isobar has advantages in the treatment of multi-segment degenerative lumbar disease.

Liu J; Liu H; Li GH; Song YM; Li T; Zeng JC

2013-02-01

248

Temporomandibular joint MR imaging  

International Nuclear Information System (INIS)

MR imaging has been used in the temporomandibular joint (TM) for identifying the position of the disk. This report examines the significance of altered morphology and signal characteristics of the TMJ disk as they relate to the severity of the internal derangement. MR was used to examine 216 joints in 133 patients. Disk position, signal, morphology and the presence of degenerative joint disease (DJD) were determined for each joint. The duration of symptoms, severity of pain, joint noise, and restriction to opening were graded. Abnormal disk morphology and decreased disk signal had a high association with joint DJD and duration of symptoms. This grading system appears to correlate with the severity of the internal derangement

1989-12-01

249

THERAPEUTIC AGENT FOR CHORIORETINAL DEGENERATIVE DISEASES COMPRISING PYRIDINE-3-CARBALDEHYDE O-(PIPERIDIN-1-YL-PROPYL)-OXIME DERIVATIVE AS ACTIVE INGREDIENT  

UK PubMed Central (United Kingdom)

Disclosed is a novel prophylactic or therapeutic agent for chorioretinal degenerative diseases. A compound represented by general formula (1) or a salt thereof has an inhibitory effect on photoreceptor cell death and/or visual cell death in light-induced damage model mice. Therefore, the compound or the salt thereof is useful as a prophylactic or therapeutic agent for chorioretinal degenerative diseases such as age-related macular degeneration and retinitis pigmentos. In the formula, A represents a group represented by general formula (p1), (p2) or (p3) R1 represents a hydrogen atom, a lower alkyl group, an aralkyl group, a hydroxy group, or an ester of any one selected from the atom and the groups R2 represents a hydrogen atom, or a lower alkyl group R3 represents a halogen atom, a hydrogen atom, a lower alkyl group, a hydroxy group, or an ester of any one selected from the atoms and the groups, and R4 represents a halogen atom, a hydrogen atom, a hydroxy group, a lower alkoxy group, an amino group, a lower alkylamino group, or a lower cycloalkylamino group, provided that R3, R4 and a nitrogen atom may together form an unsaturated [1,2,4]oxadiazine ring R5 represents a hydrogen atom, a lower alkyl group, or a lower cycloalkyl group m represents a number of 0 or 1 and n represents a number of 0 or 1.

HIRAI SHIN-ICHIRO; YOSHIDA ATSUSHI

250

[The use of minimally invasive instrumental spinal surgical technique in lumbar diseases of degenerative or traumatic origin].  

Science.gov (United States)

Paradigm change has recently taken place in spine surgery with the application of minimally invasive techniques. Minimally invasive techniques have several advantages over the open traditional techniques: less blood loss, preservation of spine muscle integrity, shorter hospitalization, early mobilization, reduced pain levels, lower risk of infection. The presented cases cover following lumbar pathologies: segmental spinal instability, LV-SI grade II. spondylolisthesis, degenerative spondylolisthesis, spine trauma. Unilateral or bilateral mini-open technique was employed in the degenerative cases, depending on symptoms and signes. If unilateral symptoms--pathology was identified, screws and rod were implanted percutaneously on the side contralateral to the pathology. The segmental fusion between vertebral bodies was always assured by a cage and autologous bone. The presented trauma case involved combined AO type A2 and B fractures. The anterior column was strengthened with vertebral body stents filled with bone cement, the posterior column was fixed with a percutaneously implanted screw rod system. Insertion of stents in the collapsed vertebra significantly increased the vertebral body height and also improved the stability of the spine. Minimally invasive spine surgery techniques appear more advantageous over the traditional open spine surgery that necessitates for large midline approaches. PMID:23750428

Schwarcz, Attila; Kasó, Gábor; Büki, András; Dóczi, Tamás

2013-03-30

251

The radiology of joint disease. Volume 2. Third edition  

Energy Technology Data Exchange (ETDEWEB)

This book explains the diagnostic criteria and radiologic appearance of joint disease - principally arthritis. It covers the soft tissues, alignment abnormalities, bony mineralization, and abnormalities of the cartilage space of the hand; arthritis from head to foot; and the differential diagnosis of arthritis.

Forrester, D.M.; Brown, J.C.

1987-01-01

252

The Role of Electromyography in Temporomandibular Joint Diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Temporomandibular Joint Diseases (TMJD) is a term used for disorders involving temporomandibular joint, mastication muscles and structures related with them and for various clinical problems coexisting together. Anamnesis, physical examination, radiology, biochemistry and electromyography (EMG) helps in diagnosing and making the differential diagnosis for all these problems. Among these useful methods, EMG is especially effective in examining muscle and nerve functioning and in the differential diagnosis in such locations. Turk J Phys Med Rehab 2010;56 Suppl 1:7-10.

Nilay ?ahin

2010-01-01

253

Posterior migration of fusion cages in degenerative lumbar disease treated with transforaminal lumbar interbody fusion: a report of three patients.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: A case report of 3 patients with posterior migration of bullet-shaped fusion cages after transforaminal lumbar interbody fusion (TLIF). One patient required emergency revision surgery; the other 2 patients are being observed during conservative treatment. OBJECTIVE: To review cases of posterior migration of fusion cages and report ensuing clinical courses. SUMMARY OF BACKGROUND DATA: TLIF is a commonly used procedure; however, there are few reports describing cage migration after the procedure. In most cases, when posterior cage migration follows posterior lumbar interbody fusion, emergency revision surgery is required. One recent study reported a case of posterior cage migration after TLIF, which was treated conservatively. METHODS: Posterior migration of the bullet-shaped fusion cages occurred 1 to 2 months after TLIF in 3 patients. One of the 3 patients had isthmic spondylolisthesis treated by TLIF with bilateral pedicle screw fixation. The other 2 patients had degenerative scoliosis and were treated by TLIF with unilateral pedicle screw fixation. RESULTS: The patient with isthmic spondylolisthesis required revision surgery because the migrated cage caused nerve root irritation. The migrated cage was removed and a large-sized cage was employed to achieve stability. The other 2 patients had no pathologic symptoms after the posterior migration of the cage and were treated conservatively and observed. CONCLUSION: Revision surgery after TLIF appears relatively safe because the migrated cage tends to locate more laterally than in patients with cage migration after posterior lumbar interbody fusion. Cage migration subsequent to TLIF may not cause compression of neural tissues, so conservative treatment may suffice for these patients. Unilateral pedicle screw fixation may not provide sufficient stability to prevent cage migration in patients with degenerative scoliosis. Further study is needed to clarify surgical indications for unilateral pedicle screw fixation in TLIF.

Aoki Y; Yamagata M; Nakajima F; Ikeda Y; Takahashi K

2009-01-01

254

Focal degenerative dementia syndromes.  

UK PubMed Central (United Kingdom)

Focal degenerative dementia syndromes are associated with a characteristic clinical picture, such as frontotemporal dementia, primary progressive aphasia, semantic dementia, corticobasal degeneration, and the Balint syndrome. A lobar approach may be used to classify the degenerative dementias. The underlying pathology of these various syndromes seems to be less heterogeneous than previously thought.

Arvanitakis Z; Graff-Radford N

2001-05-01

255

Degenerative intraspinal cyst of the cervical spine  

Directory of Open Access Journals (Sweden)

Full Text Available We describe two cases of degenerative intraspinal cyst of the cervical spine that caused a gradually progressive myelopathy. One case had a cyst that arose from the facet joint and the other case had a cyst that formed in the ligamentum flavum. The symptoms improved immediately after posterior decompression by cystectomy with laminoplasty.

Hidetoshi Nojiri; Soichi Uta; Yoshio Sakuma

2009-01-01

256

Degenerative intraspinal cyst of the cervical spine  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We describe two cases of degenerative intraspinal cyst of the cervical spine that caused a gradually progressive myelopathy. One case had a cyst that arose from the facet joint and the other case had a cyst that formed in the ligamentum flavum. The symptoms improved immediately after posterior decom...

Hidetoshi Nojiri; Soichi Uta; Yoshio Sakuma

257

[Synthetic ACTH in theumatic diseases: (author's transl)  

UK PubMed Central (United Kingdom)

44 patients with acute irritations of degenerative articular diseases and 66 patients with soft tissue rheumatism were treated with Synacthen Depot (tetracosactide hexacetate 1 mg/ml). During the first three days of treatment the patients received an average of 2 ampoulbs Synacthen Depot, then treatment was continued at 3-4 day intervals. In the degenerative joint disease group 86.4% and 89.4% in the group with soft tissue rheumatism became free of complaints or improved with the ACTH treatment. Most of the patients with degenerative joint diseases needed a 4 week treatment; 1/3 of the patients with soft tissue rheumatism were already free of complai

Hieber F

1975-11-01

258

Obesity and worsening of chronic venous disease and joint mobility.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of this study was to investigate a possible relationship between obesity and decreased mobility of the talocrural joint and in turn chronic venous disease. SUBJECTS AND METHODS: One hundred obese patients recruited at Hospital Santa Casa de Maringa, Parana were enrolled by order of arrival at the hospital in a randomized quantitative cross-sectional study. Inclusion criteria were patients with a body mass index above 30?kg/m(2) and the exclusion criteria were infectious conditions that would interfere with the assessment. Patients were graded according to the clinical, etiological, anatomical and pathophysiological classification. Talocrural goniometry was performed to assess the degree of mobility of the legs. The Kolmogorov-Smirnov normality test, Kruskal-Wallis test, Dunn's Multiple comparison test and analysis of variance were used for statistical analysis tests with an alpha error of 5% being considered acceptable. RESULTS: The increase in body mass index is correlated to the reduction in joint mobility (Kruskal-Wallis test: p-value <0.0001) and increase in clinical, etiological, anatomical and pathophysiological classification is correlated to a decrease in joint mobility and the increase in age is associated with an increase in clinical, etiological, anatomical and pathophysiological classification (Kruskal-Wallis test: p-value <0.0001). CONCLUSION: Obesity is associated with deterioration in joint mobility and worsening of chronic venous disease.

Belczak CE; de Godoy JM; Belzack SQ; Ramos RN; Caffaro RA

2013-05-01

259

Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis  

International Nuclear Information System (INIS)

[en] A vacuum facet phenomenon, seen on computed tomography as a lens-shaped lucency within a lumbar facet joint, was observed as a consequence of degenerative spondylolisthesis. The significance of this finding is discussed

1982-01-01

260

Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis  

Energy Technology Data Exchange (ETDEWEB)

A vacuum facet phenomenon, seen on computed tomography as a lens-shaped lucency within a lumbar facet joint, was observed as a consequence of degenerative spondylolisthesis. The significance of this finding is discussed.

Lefkowitz, D.M.; Quencer, D.M.

1982-08-01

 
 
 
 
261

[Risk factors for the progression of food by oral ingestion of patients with degenerative neurological diseases in monitoring in speech therapy].  

UK PubMed Central (United Kingdom)

UNLABELLED: Currently studying the speech voice therapy effectiveness in cases of oropharyngeal dysphagia has been deepened and included the variables that prevent the patient develops treatment. OBJECTIVE: To study the possible risk factors for progression of food intake by mouth during the speech accompanying dysphagia in patients hospitalized with degenerative neurological diseases. METHOD: Retrospective study conducted at the Department of Speech Therapy in a General Hospital from January 2007 to May 2008. Were collected 117 records of patients with oropharyngeal dysphagia, and only 15 (12.8%) were diagnosed with degenerative neurological disease, evolved with complaints of dysphagia and underwent speech therapy. We used myofunctional orofacial and vocal exercises for rehabilitation. We applied Fisher's exact test and nonparametric test Mann-statistical analysis of possible relationship with risk factors, namely clinical events during therapy and respiratory conditions of patients. RESULTS: Study participants were 11 (73.3%) female patients and four (26.7%) males. Ten (66.7%) patients who progressed on the ability of oral intake and had less time in therapy, 11 (73.4%) did not present any problem, two (13.3%) had worsening of symptoms and two (13.3%) had a lowered level of consciousness during the therapeutic process. Ten of 15 patients (66.7%) showed progression in the ability of oral intake according to clinical assessment (range FOIS®), five (33.3%) remained the same conditions prior to therapy and no patient had worsening oral intake. CONCLUSION: The level of consciousness and respiratory complications in this study were associated with poor prognosis for the progression of oral in speech therapy.

Nunes MC; Duarte S; Palmonari A; Rockland A; Furkim AM

2011-11-01

262

Impact of total disc arthroplasty on the surgical management of lumbar degenerative disc disease: Analysis of the Nationwide Inpatient Sample from 2000 to 2008.  

UK PubMed Central (United Kingdom)

BACKGROUND: Spinal fusion is the most rapidly increasing type of lumbar spine surgery for various lumbar degenerative pathologies. The surgical treatment of lumbar spine degenerative disc disease may involve decompression, stabilization, or arthroplasty procedures. Lumbar disc athroplasty is a recent technological advance in the field of lumbar surgery. This study seeks to determine the clinical impact of anterior lumbar disc replacement on the surgical treatment of lumbar spine degenerative pathology. This is a retrospective assessment of the Nationwide Inpatient Sample (NIS). METHODS: The NIS was searched for ICD-9 codes for lumbar and lumbosacral fusion (81.06), anterior lumbar interbody fusion (81.07), and posterolateral lumbar fusion (81.08), as well as for procedure codes for revision fusion surgery in the lumbar and lumbosacral spine (81.36, 81.37, and 81.38). To assess lumbar arthroplasty, procedure codes for the insertion or replacement of lumbar artificial discs (84.60, 84.65, and 84.68) were queried. Results were assayed from 2000 through 2008, the last year with available data. Analysis was done using the lme4 package in the R programming language for statistical computing. RESULTS: A total of nearly 300,000 lumbar spine fusion procedures were reported in the NIS database from 2000 to 2008; assuming a representative cross-section of the US health care market, this models approximately 1.5 million procedures performed over this time period. In 2005, the first year of its widespread use, there were 911 lumbar arthroplasty procedures performed, representing 3% of posterolateral fusions performed in this year. Since introduction, the number of lumbar spine arthroplasty procedures has consistently declined, to 653 total procedures recorded in the NIS in 2008. From 2005 to 2008, lumbar arthroplasties comprised approximately 2% of lumbar posterolateral fusions. Arthroplasty patients were younger than posterior lumbar fusion patients (42.8 ± 11.5 vs. 55.9 ± 15.1 years, P < 0.0000001). The distribution of arthroplasty procedures was even between academic and private urban facilities (48.5% and 48.9%, respectively). While rates of posterolateral lumbar spine fusion steadily grew during the period (OR 1.06, 95% CI: 1.05-1.06, P < 0.0000001), rates of revision surgery and anterior spinal fusion remained static. CONCLUSIONS: The impact of lumbar arthroplasty procedures has been minimal. Measured as a percentage of more common lumbar posterior arthrodesis procedures, lumbar arthroplasty comprises only approximately 2% of lumbar spine surgeries performed in the United States. Over the first 4 years following the Food and Drug Administration (FDA) approval, the frequency of lumbar disc arthroplasty has decreased while the number of all lumbar spinal fusions has increased.

Awe OO; Maltenfort MG; Prasad S; Harrop JS; Ratliff JK

2011-01-01

263

Safety of Spironolactone in Dogs with Chronic Heart Failure because of Degenerative Valvular Disease: A Population-Based, Longitudinal Study.  

UK PubMed Central (United Kingdom)

BACKGROUND: Spironolactone treatment in humans is associated with an increased risk of hyperkalemia and renal dysfunction. HYPOTHESIS: Dogs with cardiac disease treated with spironolactone, in addition to conventional therapy, are not at higher risk for adverse events (AEs) than those receiving solely conventional therapy. ANIMALS: One hundred and ninety-six client-owned dogs with naturally occurring myxomatous mitral valve disease. METHODS: Prospective, double-blinded field study with dogs randomized to receive either spironolactone (2 mg/kg once a day) or placebo in addition to conventional therapy (angiotensin-converting enzyme inhibitor, plus furosemide and digoxin if needed). Safety was compared between treatment groups, using the frequency of AEs, death caused by cardiac disease, renal disease, or both, and variations in serum sodium, potassium, urea, and creatinine concentrations. For the latter, population-specific reference intervals were established and out of range values (ORV) analyzed. RESULTS: The number of AEs was similar in the spironolactone and reference groups (188 and 208, respectively), when followed for median duration of 217 days (range [2-1,333]). At each study time point, the percentage of dogs showing ORV was similar between groups. There were a higher number of deaths because of cardiac disease, renal disease or both in the reference group (30.7% versus 13.7%) (P = .0043). CONCLUSIONS AND CLINICAL IMPORTANCE: Dogs with heart failure receiving spironolactone in addition to conventional treatment are not at a higher risk for AEs, death caused by cardiac disease, renal disease, or both, hyperkalemia, or azotemia.

Lefebvre HP; Ollivier E; Atkins CE; Combes B; Concordet D; Kaltsatos V; Baduel L

2013-07-01

264

El ejercicio físico y su prescripción en pacientes con enfermedades crónicas degenerativas Physical exercise and its prescription in patients with chronic degenerative diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Las enfermedades crónicas degenerativas constituyen una de las principales causas de muerte a nivel mundial, por lo que su crecimiento significativo ha puesto en alerta a varios países, los cuales están adoptando medidas para combatir los factores de riesgos, algunos de los cuales son modificables; siendo el ejercicio regular, un medio de prevención y rehabilitación de estas enfermedades. Esta revisión tiene por objetivo, analizar los parámetros necesarios a tomar en cuenta en la prescripción de un programa de ejercicios en pacientes con obesidad, hipertensión arterial, dislipidemia y diabetes mellitus tipo 2.Chronic degenerative diseases constitute one of the main causes of death at a global level, and their significant increase has alerted many countries, which are taking measures to reduce risk factors, some of which are modifiable; being the regular exercise a means of prevention and rehabilitation of these diseases. The objective of this revision is to analyze the necessary parameters to take into account for the prescription of an exercise program in patients with obesity, high blood pressure dyslipidemia and diabetes mellitus type 2.

Rossana Gómez; Henrique Monteiro; Marco Antonio Cossio-Bolaños; Domingo Fama-Cortez; Angelina Zanesco

2010-01-01

265

El ejercicio físico y su prescripción en pacientes con enfermedades crónicas degenerativas/ Physical exercise and its prescription in patients with chronic degenerative diseases  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Las enfermedades crónicas degenerativas constituyen una de las principales causas de muerte a nivel mundial, por lo que su crecimiento significativo ha puesto en alerta a varios países, los cuales están adoptando medidas para combatir los factores de riesgos, algunos de los cuales son modificables; siendo el ejercicio regular, un medio de prevención y rehabilitación de estas enfermedades. Esta revisión tiene por objetivo, analizar los parámetros necesarios a tomar (more) en cuenta en la prescripción de un programa de ejercicios en pacientes con obesidad, hipertensión arterial, dislipidemia y diabetes mellitus tipo 2. Abstract in english Chronic degenerative diseases constitute one of the main causes of death at a global level, and their significant increase has alerted many countries, which are taking measures to reduce risk factors, some of which are modifiable; being the regular exercise a means of prevention and rehabilitation of these diseases. The objective of this revision is to analyze the necessary parameters to take into account for the prescription of an exercise program in patients with obesity, high blood pressure dyslipidemia and diabetes mellitus type 2.

Gómez, Rossana; Monteiro, Henrique; Cossio-Bolaños, Marco Antonio; Fama-Cortez, Domingo; Zanesco, Angelina

2010-09-01

266

Effects of lipid peroxidation products on the rat lens in organ culture: a possible mechanism of cataract initiation in retinal degenerative disease.  

UK PubMed Central (United Kingdom)

Rat lenses in organ culture which are exposed to bovine rod outer segments (ROS) or to the major fatty acid of ROS, docosahexaenoic acid, are impaired in their ability to accumulate radiolabeled compounds which lenses normally accumulate by active processes. The extent of lens damage correlates well with the extent of lipid peroxidation in the culture medium as assessed by the thiobarbituric acid assay. Addition of vitamin E to the medium inhibits the effect on the lens while addition of Fe-ADP complexes potentiates the effect. Thus, the lens damage appears to be attributable to toxic species generated by peroxidation of the polyunsaturated lipid added to the culture medium. Toxic aldehyde products appear to be major mediators of the lens damage, since semi-carbazide, which avidly reacts with aldehydes, can protect lenses in this system. These findings may have relevance to the cataracts clinically associated with retinal degenerative diseases such as retinitis pigmentosa. The highly membranous photoreceptor cells are extremely rich in polyunsaturated lipid. Degeneration of these cells, which is the primary pathology in such diseases, would likely lead to peroxidation with generation of toxic products within the eye. Such products could potentially produce secondary damage to other ocular structures including the lens.

Zigler JS Jr; Bodaness RS; Gery I; Kinoshita JH

1983-08-01

267

Joint Modeling of Transitional Patterns of Alzheimer's Disease  

Science.gov (United States)

While the experimental Alzheimer's drugs recently developed by pharmaceutical companies failed to stop the progression of Alzheimer's disease, clinicians strive to seek clues on how the patients would be when they visit back next year, based upon the patients' current clinical and neuropathologic diagnosis results. This is related to how to precisely identify the transitional patterns of Alzheimer's disease. Due to the complexities of the diagnosis of Alzheimer's disease, the condition of the disease is usually characterized by multiple clinical and neuropathologic measurements, including Clinical Dementia Rating (CDRGLOB), Mini-Mental State Examination (MMSE), a score derived from the clinician judgement on neuropsychological tests (COGSTAT), and Functional Activities Questionnaire (FAQ). In this research article, we investigate a class of novel joint random-effects transition models that are used to simultaneously analyze the transitional patterns of multiple primary measurements of Alzheimer's disease and, at the same time, account for the association between the measurements. The proposed methodology can avoid the bias introduced by ignoring the correlation between primary measurements and can predict subject-specific transitional patterns.

Liu, Wei; Zhang, Bo; Zhang, Zhiwei; Zhou, Xiao-Hua

2013-01-01

268

Degenerative alterations of the cementum-periodontal ligament complex and early tooth loss in a young patient with periodontal disease.  

Science.gov (United States)

Premature exfoliation of primary or permanent teeth in children or adolescents is extremely rare and it can be a manifestation of an underlying systemic disease. This study aims to present the histological aspects associated with early tooth loss in a case of periodontal disease developed without local inflammation and with minimal periodontal pockets and attachment loss. The maxillary left second premolar was extracted together with a gingival collar attached to the root surface. The histological analysis recorded the resorption of the cementum in multiple areas of the entire root surface with the connective tissue of the desmodontium invading the lacunae defects. The connective tissue rich in cells occupied the periodontal ligamentar space and the resorptive areas. No inflammation was obvious in the periodontal ligament connective tissue. This report may warn clinicians about the possibility of the association of cemental abnormalities with early tooth loss. PMID:23303038

Petru?iu, S A; Buiga, Petronela; Roman, Alexandra; Danciu, Theodora; Mihu, Carmen Mihaela; Mihu, D

2012-01-01

269

Degenerative alterations of the cementum-periodontal ligament complex and early tooth loss in a young patient with periodontal disease.  

UK PubMed Central (United Kingdom)

Premature exfoliation of primary or permanent teeth in children or adolescents is extremely rare and it can be a manifestation of an underlying systemic disease. This study aims to present the histological aspects associated with early tooth loss in a case of periodontal disease developed without local inflammation and with minimal periodontal pockets and attachment loss. The maxillary left second premolar was extracted together with a gingival collar attached to the root surface. The histological analysis recorded the resorption of the cementum in multiple areas of the entire root surface with the connective tissue of the desmodontium invading the lacunae defects. The connective tissue rich in cells occupied the periodontal ligamentar space and the resorptive areas. No inflammation was obvious in the periodontal ligament connective tissue. This report may warn clinicians about the possibility of the association of cemental abnormalities with early tooth loss.

Petru?iu SA; Buiga P; Roman A; Danciu T; Mihu CM; Mihu D

2012-01-01

270

Measurement of intervertebral motion using quantitative fluoroscopy: report of an international forum and proposal for use in the assessment of degenerative disc disease in the lumbar spine.  

UK PubMed Central (United Kingdom)

Quantitative fluoroscopy (QF) is an emerging technology for measuring intervertebral motion patterns to investigate problem back pain and degenerative disc disease. This International Forum was a networking event of three research groups (UK, US, Hong Kong), over three days in San Francisco in August 2009. Its aim was to reach a consensus on how best to record, analyse, and communicate QF information for research and clinical purposes. The Forum recommended that images should be acquired during regular trunk motion that is controlled for velocity and range, in order to minimise externally imposed variability as well as to correlate intervertebral motion with trunk motion. This should be done in both the recumbent passive and weight bearing active patient configurations. The main recommended outputs from QF were the true ranges of intervertebral rotation and translation, neutral zone laxity and the consistency of shape of the motion patterns. The main clinical research priority should initially be to investigate the possibility of mechanical subgroups of patients with chronic, nonspecific low back pain by comparing their intervertebral motion patterns with those of matched healthy controls.

Breen AC; Teyhen DS; Mellor FE; Breen AC; Wong KW; Deitz A

2012-01-01

271

Degenerative diseases of the cervical spine: comparison of a multiecho data image combination sequence with a magnetisation transfer saturation pulse and cervical myelography and CT  

International Nuclear Information System (INIS)

Assessing degenerative disease in the cervical spine remains a challenge. There is much controversy about imaging the cervical spine using MRI. Our aim in this prospective study was to compare a T2*-weighted 2D spoiled gradient-echo multiecho sequence (MEDIC) with a magnetisation transfer saturation pulse with cervical myelography and postmyelographic CT. Using an assessment scale we looked at the vertebral bodies, intervertebral discs, neural foramina, anterior and posterior nerve roots, grey matter, ligamenta flava, oedema in the spinal cord and stenosis of the spinal canal. We also evaluated postmyelography CT and the MEDIC sequence for assessing narrowing of the neural foramina in a cadaver cervical spine. We examined 67 disc levels in 18 patients, showing 18 disc prolapses and 21 osteophytes narrowing the spinal canal or the neural foramina. All MRI studies showed these abnormalities findings equally well. Postmyelography CT was significantly better for showing the bony structures and the anterior and posterior nerve roots. The MEDIC sequence provided excellent demonstration of soft-tissue structures such as the intervertebral disc and ligamentum flavum. No statistical differences between the imaging modalities were found in the assessment of narrowing of the neural foramina or the extent of spinal stenosis. The cadaver measurements showed no overestimation of abnormalities using the MEDIC sequence. (orig.)

2004-01-01

272

Degenerative diseases of the cervical spine: comparison of a multiecho data image combination sequence with a magnetisation transfer saturation pulse and cervical myelography and CT  

Energy Technology Data Exchange (ETDEWEB)

Assessing degenerative disease in the cervical spine remains a challenge. There is much controversy about imaging the cervical spine using MRI. Our aim in this prospective study was to compare a T2*-weighted 2D spoiled gradient-echo multiecho sequence (MEDIC) with a magnetisation transfer saturation pulse with cervical myelography and postmyelographic CT. Using an assessment scale we looked at the vertebral bodies, intervertebral discs, neural foramina, anterior and posterior nerve roots, grey matter, ligamenta flava, oedema in the spinal cord and stenosis of the spinal canal. We also evaluated postmyelography CT and the MEDIC sequence for assessing narrowing of the neural foramina in a cadaver cervical spine. We examined 67 disc levels in 18 patients, showing 18 disc prolapses and 21 osteophytes narrowing the spinal canal or the neural foramina. All MRI studies showed these abnormalities findings equally well. Postmyelography CT was significantly better for showing the bony structures and the anterior and posterior nerve roots. The MEDIC sequence provided excellent demonstration of soft-tissue structures such as the intervertebral disc and ligamentum flavum. No statistical differences between the imaging modalities were found in the assessment of narrowing of the neural foramina or the extent of spinal stenosis. The cadaver measurements showed no overestimation of abnormalities using the MEDIC sequence. (orig.)

Dorenbeck, U. [Department of Neuroradiology, University Hospital of the Saarland, 66421, Homburg (Germany); Department of Diagnostic Radiology, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg (Germany); Schreyer, A.G.; Held, P.; Feuerbach, S.; Seitz, J. [Department of Diagnostic Radiology, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg (Germany); Schlaier, J. [Department of Neurosurgery, University Hospital of Regensburg, Franz-Josef-Strauss Allee 11, 93042, Regensburg (Germany)

2004-04-01

273

Manifestações articulares nas viroses exantemáticas Joint complaints in exanthematic diseases  

Directory of Open Access Journals (Sweden)

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.

Solange Artimos de Oliveira; Luís A.B. Camacho; Lílian Rachel Bettini; Daniele Guerreiro Fernandes; Nathalia A.C. Gouvea; Roberto A.Q. Barros; Sérgio Setúbal; Marilda Mendonça Siqueira

1999-01-01

274

Manifestações articulares nas viroses exantemáticas/ Joint complaints in exanthematic diseases  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 esta (more) tisticamente 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. Abstract in english 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 (more) 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.

Oliveira, Solange Artimos de; Camacho, Luís A.B.; Bettini, Lílian Rachel; Fernandes, Daniele Guerreiro; Gouvea, Nathalia A.C.; Barros, Roberto A.Q.; Setúbal, Sérgio; Siqueira, Marilda Mendonça

1999-04-01

275

Enfermedad valvular degenerativa en perros: actualización en su diagnóstico, tratamiento y pronóstico Degeneração valvar doença Degenerative valve disease in dogs: update on diagnosis, treatment and prognosis  

Directory of Open Access Journals (Sweden)

Full Text Available La enfermedad valvular degenerativa es la principal anormalidad cardiovascular de los perros. La lesión en el aparato valvular consiste en una infiltración de mucopolisacaridos en la matriz extracelular de las aletas valvulares y las cuerdas tendinosas, lo que ocasiona una regurgitación de sangre hacia las aurículas. Esta disminución del gasto cardiaco activa mecanismos neurohormonales que originan una remodelación ventricular, causante de la aparición de signos clínicos y la muerte. Un grupo internacional de expertos en medicina interna ha propuesto nuevos lineamientos para su diagnóstico y adecuado tratamiento en cada nivel. Este artículo hace una revisión crítica sobre esta propuesta, contextualizándola en el entorno nacional y la experiencia del autor.A doença valvar degenerativa é a principal anormalidade cardiovascular dos cães. A lesão microscópica do aparelho de válvula consiste em acúmulo de mucopolissacarídeos ácidos e outras substâncias no interior dos folhetos e cordas tendíneas. Ela provoca uma insuficiência de sangue para a diminuição do débito cardíaco atrial. Isto resulta na ativação neuro-hormonais que podem levar ao remodelamento cardíaco adverso e insuficiência cardíaca congestiva. Um grupo mundial de especialistas em medicina interna propôs uma nova classificação para orientar o diagnóstico eo tratamento para cada nível. Este documento há uma revisão crítica no contexto nacional e da experiência do autor.Degenerative valve disease is the main cardiovascular abnormality in dogs. This injury consists of microscopic lesions of the valve, due to mucopolysaccharide infiltration in the extracellular matrix of the leaflets and chordae tendineae, causing regurgitation of blood into the atria. The resulting decrease in cardiac output activates neurohormonal mechanisms that cause adverse ventricular remodeling, often times accompanied of clinical signs and death. An international group of internal-medicine experts has proposed new guidelines for diagnosis and appropriate treatment of the disease. This paper consists of a critical review of that proposal, contextualizing it for the Colombian conditions, according to the experience of the author.

Leonardo Gómez-Duarte

2011-01-01

276

CT-guided ozone/steroid therapy for the treatment of degenerative spinal disease - effect of age, gender, disc pathology and multi-segmental changes  

Energy Technology Data Exchange (ETDEWEB)

Oxygen-ozone nucleolysis (ONL) is a new, minimally invasive procedure for the treatment of discogenic low back pain with or without radicular symptoms. The aim of the present study was to determine associations between the morphology of the basic disease, patient-specific factors and the outcome of the treatment. Six hundred and twelve patients not responding to conservative therapy were divided into five groups (disc bulging, disc herniation, postoperative patients, osteochondrosis, others) and subjected to nucleolysis with ozone and to periradicular infiltration with steroids and local anaesthesia. The success of treatment was assessed by means of a visual analog pain scale (VAS) and the Oswestry Disability Index (ODI). A significant reduction in the VAS was registered after 2 and 6 months (from 8.6 to 5.4 and 6.0; p<0.001) in all patient groups; an excellent therapy response (VAS below 3.0) was achieved by about a third of the patients. A significant improvement in ODI was registered in all patients (46 to 31; p<0.001), most pronounced in the herniation group (25.5, p=0.015). Patients below 50 years had significantly better values in the VAS and ODI score 6 months after treatment. Final VAS and ODI scores for patients with a single diseased segment were 4.2 and 28.0, in two affected segments 6.5 and 32 and in three segments 6.7 and 38.5 (p<0.001 and p=0.051). ONL with periradicular steroid therapy might exert a functional and sustained analgesic effect in patients with degenerative changes in the lumbar spine not responding to conservative therapy and was most effective below 50 years with disc herniation in one segment. (orig.)

Oder, Bernhard; Loewe, Maria; Reisegger, Michael; Thurnher, Siegfried A. [Hospital Brothers of St. John of God, Department of Radiology and Nuclear Medicine, Vienna (Austria); Lang, Wilfried [Hospital Brothers of St. John of God, Department of Neurology, Vienna (Austria); Ilias, Wilfried [Hospital Brothers of St. John of God, Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Vienna (Austria)

2008-09-15

277

REM sleep behavior disorder and REM sleep without atonia as an early manifestation of degenerative neurological disease.  

Science.gov (United States)

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by repeated episodes of dream enactment behavior and REM sleep without atonia (RSWA) during polysomnography recording. RSWA is characterized by increased phasic or tonic muscle activity seen on polysomnographic electromyogram channels. RSWA is a requisite diagnostic feature of RBD, but may also be seen in patients without clinical symptoms or signs of dream enactment as an incidental finding in neurologically normal individuals, especially in patients receiving antidepressant therapy. RBD may be idiopathic or symptomatic. Patients with idiopathic RBD often later develop other neurological features including parkinsonism, orthostatic hypotension, anosmia, or cognitive impairment. RSWA without clinical symptoms as well as clinically overt RBD also often occurs concomitantly with the ?-synucleinopathy family of neurodegenerative disorders, which includes idiopathic Parkinson disease, Lewy body dementia, and multiple system atrophy. This review article considers the epidemiology of RBD, clinical and polysomnographic diagnostic standards for both RBD and RSWA, previously reported associations of RSWA and RBD with neurodegenerative disorders and other potential causes, the pathophysiology of which brain structures and networks mediate dysregulation of REM sleep muscle atonia, and considerations for the effective and safe management of RBD. PMID:22328094

McCarter, Stuart J; St Louis, Erik K; Boeve, Bradley F

2012-04-01

278

REM sleep behavior disorder and REM sleep without atonia as an early manifestation of degenerative neurological disease.  

UK PubMed Central (United Kingdom)

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by repeated episodes of dream enactment behavior and REM sleep without atonia (RSWA) during polysomnography recording. RSWA is characterized by increased phasic or tonic muscle activity seen on polysomnographic electromyogram channels. RSWA is a requisite diagnostic feature of RBD, but may also be seen in patients without clinical symptoms or signs of dream enactment as an incidental finding in neurologically normal individuals, especially in patients receiving antidepressant therapy. RBD may be idiopathic or symptomatic. Patients with idiopathic RBD often later develop other neurological features including parkinsonism, orthostatic hypotension, anosmia, or cognitive impairment. RSWA without clinical symptoms as well as clinically overt RBD also often occurs concomitantly with the ?-synucleinopathy family of neurodegenerative disorders, which includes idiopathic Parkinson disease, Lewy body dementia, and multiple system atrophy. This review article considers the epidemiology of RBD, clinical and polysomnographic diagnostic standards for both RBD and RSWA, previously reported associations of RSWA and RBD with neurodegenerative disorders and other potential causes, the pathophysiology of which brain structures and networks mediate dysregulation of REM sleep muscle atonia, and considerations for the effective and safe management of RBD.

McCarter SJ; St Louis EK; Boeve BF

2012-04-01

279

Value of different MR techniques in diagnosis of degenerative disorders of the hyaline cartilage - in vitro study on 50 joint specimens of the knee with 1.5 T  

International Nuclear Information System (INIS)

[en] Purpose: An experimental study was performed on joint specimens of the knee to assess the advantages and disadvantages of 14 generally available sequences in cartilage imaging. Methods: Each of the 50 surgically exposed cadaveric joints of the knee was examined by the following sequences: T1, proton- and T2 weighted spin echo(SE) sequences, proton- and T2 weighted Turbo-SE, T1 weighted SE with fat suppression, MTC combined with T1-weighted SE and T2 weighted FLASH-2 D, STIR, FISP-3 D, FLASH-3 D (with fat suppression), and MR arthrography. We assessed the image quality by a scale, signal to noise-ratio of cartilage and joint fluid, and the accuracy in detection of cartilage lesions. Pathology and arthroscopy were reference methods to MRI, and demonstrated grade 1-4 lesions on 186 of 300 joint facettes. Results: Advanced stages of cartilage lesions (65 grade 3 and 4 lesions) were detected by standard SE sequences in 67-94%. Application of volume techniques (FISP-3 D, FLASH-3 D), high definition matrix (512 pixel), MTC with FLASH-2 D and MR-arthrography improved the sensitivity up to 82-100%. Superficial lesions (65 grade 2 lesions) were demonstrated in 3-38%, and on MR arthrography in 45%. Structural changes (56 Grade 1 lesions) were recorded on MRI in only 10%. Conclusions: With regard to standard SE sequences, the detectability of cartilage lesions can be improved by techniques that use 512 matrices, selective cartilage imaging, and volume acquisition. (orig.)[de] Ziel: In einer experimentellen Studie an Gelenkpraeparaten des Knies wurden die Vor- und Nachteile von 14 allgemein verfuegbaren MRT-Sequenzen in der Knorpeldiagnostik dargestellt. Methode: 50 chirurgisch exstirpierte Kniegelenkpraeparate wurden nacheinander mit folgenden Techniken untersucht: Klassische Spin-Echo(SE)-Sequenz in T1-, Protonen- und T2-Wichtung, Turbo-SE in Protonen- und T2-Wichtung, Fettsuppression mit T1-gew. SE, MTC in Verbindung mit T1-gew. SE und T2-gew. FLASH-2D, die STIR, FISP-3 D, FLASH-3 D mit Fettsuppression und die MR-Arthrographie. Fuer jede Sequenz wurden subjektive Qualitaetskriterien, Signal-Rausch-Verhaeltnisse von Knorpel und Gelenkfluessigkeit und Nachweisraten fuer Knorpellaesionen bestimmt. Als Referenz zur MRT dienten pathologische und arthroskopische Untersuchungen, die an 186 der 300 Knorpelflaechen degenerative Veraenderungen Grad 1-4 nachwiesen. Ergebnisse: Die Defektstadien Grad 3 und 4 (65 Laesionen) waren mit den klassischen SE-Sequenzen in 67-94% nachweisbar. Die Volumentechniken (FISP-3 D und FLASH-3 D), Sequenzen mit 512er Matrix, der MTC (mit FLASH-2 D) und die MR-Arthrographie fuehrten zu einer Verbesserung der Sensitivitaet auf 82-100%. Oberflaechliche Defekte Grad 2 (65 Laesionen) hatten Nachweisraten von 3-38%, in der MR-Arthrographie betrug sie 45%. Die rein strukturellen Knorpelveraenderungen Grad 1 (56 Faelle) wurden in ca. 10% diagnostiziert. Schlussfolgerung: Die Diagnostik von Knorpelerkrankungen laesst sich gegenueber den klassischen SE-Sequenzen mit grosser Bildmatrix, verbessertem Knorpelkontrast und Volumentechnik verwenden. (orig.)

1997-01-01

280

[Prevention of occupational diseases of lower limbs joints  

UK PubMed Central (United Kingdom)

Study covered 84 personal computer users, 48 jewelry female polishers, 92 metallic ships body assemblers. Objective investigations revealed lower limbs joints stiffness. After prevention measures based on low-intensity laser rays, the joints functions recovered.

Ushkova IN; Mal'kova NIu

2009-01-01

 
 
 
 
281

Second research co-ordination meeting for the coordinated research project on 'Application of nuclear techniques in the prevention of degenerative diseases (obesity and non-insulin dependent diseases) in ageing'. Summary report  

International Nuclear Information System (INIS)

[en] In the developed countries, research using nuclear methods has been substantially used to examine the physiological and biochemical mechanisms involved in obesity-related diseases. This Co-ordinated Research Project (CRP) is intended to promote the use of these techniques in the developing world. The specific objectives of this CRP are: 1. To define the magnitude of the obesity/NIDDM problem in developing countries. 2. To identify vulnerable groups at high risk. 3. To describe the metabolic mechanisms involved. The purpose of this first Research Co-ordination Meeting (RCM) was thus to develop a worldwide collaboration in the use of nuclear and isotopic techniques to investigate the aetiology of degenerative diseases in ageing. All countries participating in this CRP are going through the epidemiological transition with changes in lifestyles to approach those seen in the developed nations

2002-01-01

282

Comparison of the SF6D, the EQ5D, and the oswestry disability index in patients with chronic low back pain and degenerative disc disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: The need for cost effectiveness analyses in randomized controlled trials that compare treatment options is increasing. The selection of the optimal utility measure is important, and a central question is whether the two most commonly used indexes - the EuroQuol 5D (EQ5D) and the Short Form 6D (SF6D) - can be used interchangeably. The aim of the present study was to compare change scores of the EQ5D and SF6D utility indexes in terms of some important measurement properties. The psychometric properties of the two utility indexes were compared to a disease-specific instrument, the Oswestry Disability Index (ODI), in the setting of a randomized controlled trial for degenerative disc disease. METHODS: In a randomized controlled multicentre trial, 172 patients who had experienced low back pain for an average of 6 years were randomized to either treatment with an intensive back rehabilitation program or surgery to insert disc prostheses. Patients filled out the ODI, EQ5D, and SF-36 at baseline and two-year follow up. The utility indexes was compared with respect to measurement error, structural validity, criterion validity, responsiveness, and interpretability according to the COSMIN taxonomy. RESULTS: At follow up, 113 patients had change score values for all three instruments. The SF6D had better similarity with the disease-specific instrument (ODI) regarding sensitivity, specificity, and responsiveness. Measurement error was lower for the SF6D (0.056) compared to the EQ5D (0.155). The minimal important change score value was 0.031 for SF6D and 0.173 for EQ5D. The minimal detectable change score value at a 95% confidence level were 0.157 for SF6D and 0.429 for EQ5D, and the difference in mean change score values (SD) between them was 0.23 (0.29) and so exceeded the clinical significant change score value for both instruments. Analysis of psychometric properties indicated that the indexes are unidimensional when considered separately, but that they do not exactly measure the same underlying construct. CONCLUSIONS: This study indicates that the difference in important measurement properties between EQ5D and SF6D is too large to consider them interchangeable. Since the similarity with the "gold standard" (the disease-specific instrument) was quite different, this could indicate that the choice of index should be determined by the diagnosis.

Johnsen LG; Hellum C; Nygaard OP; Storheim K; Brox JI; Rossvoll I; Leivseth G; Grotle M

2013-01-01

283

[Temporomandibular joint ankylosis (TMA) in children  

UK PubMed Central (United Kingdom)

Temporomandibular joint (TMJ) ankylosis is a degenerative disease that produces a limitation of mouth opening. In children, TMJ ankylosis usually presents with facial asymmetry, difficulty in feeding and rarely upper way obstruction. Ankylosis is commonly associated with trauma, infections, systemic and congenital diseases. Diagnosis must be clinical, being CT scan and magnetic resonance imaging (MRI) the most important methods to evaluate this disease. The treatment of TMJ ankylosis requires excision of the involved structures and reconstruction. We present our experience in treatment of the temporomandibular joint ankylosis. We have analysed the following parameters: age, sex, etiology, surgical technique, pre and postoperative oral opening.

García-Aparicio L; Parri FJ; Sancho MA; Sarget R; Morales L

2000-04-01

284

Posterior interspinous fusion device for one-level fusion in degenerative lumbar spine disease : comparison with pedicle screw fixation - preliminary report of at least one year follow up.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Transpedicular screw fixation has some disadvantages such as postoperative back pain through wide muscle dissection, long operative time, and cephalad adjacent segmental degeneration (ASD). The purposes of this study are investigation and comparison of radiological and clinical results between interspinous fusion device (IFD) and pedicle screw. METHODS: From Jan. 2008 to Aug. 2009, 40 patients underwent spinal fusion with IFD combined with posterior lumbar interbody fusion (PLIF). In same study period, 36 patients underwent spinal fusion with pedicle screw fixation as control group. Dynamic lateral radiographs, visual analogue scale (VAS), and Korean version of the Oswestry disability index (K-ODI) scores were evaluated in both groups. RESULTS: The lumbar spine diseases in the IFD group were as followings; spinal stenosis in 26, degenerative spondylolisthesis in 12, and intervertebral disc herniation in 2. The mean follow up period was 14.24 months (range; 12 to 22 months) in the IFD group and 18.3 months (range; 12 to 28 months) in pedicle screw group. The mean VAS scores was preoperatively 7.16±2.1 and 8.03±2.3 in the IFD and pedicle screw groups, respectively, and improved postoperatively to 1.3±2.9 and 1.2±3.2 in 1-year follow ups (p<0.05). The K-ODI was decreased significantly in an equal amount in both groups one year postoperatively (p<0.05). The statistics revealed a higher incidence of ASD in pedicle screw group than the IFD group (p=0.029). CONCLUSION: Posterior IFD has several advantages over the pedicle screw fixation in terms of skin incision, muscle dissection and short operative time and less intraoperative estimated blood loss. The IFD with PLIF may be a favorable technique to replace the pedicle screw fixation in selective case.

Kim HJ; Bak KH; Chun HJ; Oh SJ; Kang TH; Yang MS

2012-10-01

285

A modified technique for dowel fibular strut graft placement and circumferential fusion in the setting of L5-S1 spondylolisthesis and multilevel degenerative disc disease.  

UK PubMed Central (United Kingdom)

BACKGROUND: Traditional techniques for the treatment of isthmic spondylolisthesis pass a fibular dowel graft across the L5-S1 disc by using the anterior portion of the L5 body. OBJECTIVE: To introduce a technique for the treatment of isthmic spondylolisthesis in the setting of multilevel degenerative disc disease in adults. Our modified technique allows us to traverse the L5-S1 disc via the L4-5 disc space thereby treating the degenerated disc at L4-5 simultaneously. METHODS: A standard anterior discectomy was performed on L4-5. Using biplanar fluoroscopy, a Kirschner wire was placed beginning at the anterior third of the L5 superior endplate and ending at S1. An anterior cruciate ligament reamer was used to make a channel for the fibular allograft. Then, a femoral ring allograft was placed in the disc space at L4-5, and standard anterior lumbar interbody fusions were performed at any additional cephalad level(s). Afterward, posterior instrumented fusion was performed to complement the anterior fusion procedure (except at L5), and wide decompression followed. RESULTS: All patients presented with isthmic spondylolisthesis and all had multilevel fusions. The mean slip angle was 32.6 degrees (37.8 degrees preoperatively), and mean lumbar index was 67%. After the procedure, the average endplate-to-dowel angle was 107.1 degrees compared with 134 degrees. All patients had clinical and radiographic evidence of solid fusion without the need for revisions. CONCLUSION: The proposed advantage of our modified technique is twofold. The graft is placed nearly perpendicular to the L5-S1 interface, as it will behave more efficiently with respect to interfragmental compression. Also, surgeons gain access to fuse L4-5 anteriorly and posteriorly.

Eskander MS; Eskander JP; Drew JM; Pelow-Aidlen JL; Eslami MH; Connolly PJ

2010-09-01

286

Biosynthesis, characterization, and efficacy in retinal degenerative diseases of lens epithelium-derived growth factor fragment (LEDGF1-326), a novel therapeutic protein.  

UK PubMed Central (United Kingdom)

For vision-threatening retinitis pigmentosa and dry age-related macular degeneration, there are no United States Food and Drug Administration (FDA)-approved treatments. We identified, biosynthesized, purified, and characterized lens epithelium-derived growth factor fragment (LEDGF1-326) as a novel protein therapeutic. LEDGF1-326 was produced at about 20 mg/liter of culture when expressed in the Escherichia coli system, with about 95% purity and aggregate-free homogeneous population with a mean hydrodynamic diameter of 9 ± 1 nm. The free energy of unfolding of LEDGF1-326 was 3.3 ± 0.5 kcal mol(-1), and melting temperature was 44.8 ± 0.2 °C. LEDGF1-326 increased human retinal pigment epithelial cell viability from 48.3 ± 5.6 to 119.3 ± 21.1% in the presence of P23H mutant rhodopsin-mediated aggregation stress. LEDGF1-326 also increased retinal pigment epithelial cell FluoSphere uptake to 140 ± 10%. Eight weeks after single intravitreal injection in Royal College of Surgeons (RCS) rats, LEDGF1-326 increased the b-wave amplitude significantly from 9.4 ± 4.6 to 57.6 ± 8.8 ?V for scotopic electroretinogram and from 10.9 ± 5.6 to 45.8 ± 15.2 ?V for photopic electroretinogram. LEDGF1-326 significantly increased the retinal outer nuclear layer thickness from 6.34 ± 1.6 to 11.7 ± 0.7 ?m. LEDGF1-326 is a potential new therapeutic agent for treating retinal degenerative diseases.

Baid R; Upadhyay AK; Shinohara T; Kompella UB

2013-06-01

287

Comparison of artificial total disc replacement versus fusion for lumbar degenerative disc disease: a meta-analysis of randomized controlled trials.  

UK PubMed Central (United Kingdom)

PURPOSE: To compare the efficacy and safety of TDR to that of the fusion for the treatment of lumbar degenerative disc disease (LDDD). METHODS: Randomized controlled trials comparing TDR with any other intervention for LDDD were acquired by a comprehensive search in PubMedCentral, MEDLINE, EMBASE, BIOSIS, ClinicalTrials.gov, and the FDA trials register. Methodologic quality was assessed and relevant data were retrieved, and appropriate meta-analysis was performed. Two review authors independently selected studies, extracted data, and assessed risk of bias. Results and upper bounds of confidence intervals were compared with predefined clinically relevant differences. RESULTS: Six relevant randomized controlled trials (RCTs) involving 1,603 patients were identified and reported two year follow-up results. Patients in TDR group compared with lumbar fusion group demonstrated significant improvements in ODI, VAS scores and complication rates at the two year follow-up. Meanwhile, except for operating time in anterior group, intra-operative blood loss, operating time in posterior group, and reoperation rate were without clinical significance between the two groups. In addition, the range of motion (ROM) was maintained within normal ranges after TDR. CONCLUSIONS: The results showed the TDR has significant safety and efficacy comparable to lumbar fusion at two year follow-up. Although superiority compared to fusion could not be proved, by comparing clinical symptoms relieved, motion preserved, and the low reoperation rate during long-term follow-up on TDR, TDR was considered safe and effective. Therefore, the authors suggest adopting TDR on a large scale; with failure of TDR, interbody fusion would be performed.

Wei J; Song Y; Sun L; Lv C

2013-07-01

288

[Clinical observations on the effect of Tuigua manipulation combined with quadriceps exercise for the treatment of degenerative gonarthritis].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the effect of Tuigua manipulation combined with quadriceps exercise for treating degenerative gonarthritis. METHODS: In the study, 48 patients (60 knees) meeting diagnostic criteria of degenerative gonarthritis were randomly divided into two groups: treatment group and control group. The patients in the treatment group were treated with Tuigua manipulation combined with quadriceps exercise; while the patients in the control group were treated with manipulation for osteoarthritis in Tuina Xue. All the patient in the control and treatment group were treated for 3 courses of treatment, and 10 days were one course of treatment. The index such as pain, joint range of motion, function and muscle power were observed and compared before and after treatment. RESULTS: After treatment, in the treatment group, 7 knees were cured, 21 knees got a good result and 2 knees had no effect; while in the control group, the above data were 8, 19, 3 respectively. There was no statistically differences between the therapeutic effects of the two groups. Both methods were effective to improve clinical symptoms of degenerative gonarthritis, and the index such as the pain, joint range of motion, function and muscle power of the patients in two groups were improved after the treatment (P < 0.05). Comparison between the two groups, the improvement of knee function and quadriceps muscle power of patients in treatment group was better than that of control group (P < 0.05); but the improvement of pain and joint range of motion in two groups had no statistically differences (P > 0.05). CONCLUSION: The method of Tuigua manipulation combined with quadriceps exercise is effective to improve clinical signs and symptoms of patients with degenerative gonarthritis, to improve quality of life of patients, slow down degenerative of arthrodial cartilage, prevent the disease aggravating,which is worth spreading.

Wang JL; Chai CH; Xu YM

2008-12-01

289

Impact of bone morphogenetic proteins on frequency of revision surgery, use of autograft bone, and total hospital charges in surgery for lumbar degenerative disease: review of the Nationwide Inpatient Sample from 2002 to 2008.  

UK PubMed Central (United Kingdom)

BACKGROUND CONTEXT: Bone morphogenetic proteins (BMPs) were developed with the goal of improving clinical outcomes through the promotion of bony healing and reducing morbidity from iliac crest bone graft harvest. PURPOSE: To complete a population-based assessment of the impact of BMP on use of autograft, rates of operative treatment for lumbar pseudoarthrosis, and hospital charges. STUDY DESIGN: Nationwide Inpatient Sample (NIS) retrospective cohort assessment of 46,452 patients from 2002 to 2008. PATIENT SAMPLE: All patients who underwent lumbar arthrodesis procedures for degenerative spinal disease. OUTCOME MEASURES: Use of BMP, revision surgery status as a percentage of total procedures, and autograft harvest in lumbar fusion procedures completed for degenerative diagnoses. METHODS: Demographic and geographic/practice data, hospital charges, and length of stay of all NIS patients with thoracolumbar and lumbosacral procedure codes for degenerative spinal diagnoses were recorded. Codes for autograft harvest, use of BMP, and revision surgery were included in multivariable regression analysis. RESULTS: The assessment found 46,452 patients from 2002 to 2008 undergoing thoracolumbar or lumbar arthrodesis procedures for degenerative disease. Assuming a representative sample, this cohort models more than 200,000 US patients. There was steady growth in lumbar spine fusion and in the use of BMP. The use of BMP increased from 2002 to 2008 (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.48-1.52). Revision procedures decreased over the study period (OR, 0.94; 95% CI, 0.91-0.96). The use of autograft decreased substantially after introduction of BMP but then returned to baseline levels; there was no net change in autograft use from 2002 to 2008. The use of BMP correlated with significant increases in hospital charges ($13,362.39; standard deviation±596.28, p<.00001). The use of BMP in degenerative thoracolumbar procedures potentially added more than $900 million to hospital charges from 2002 to 2008. CONCLUSIONS: There was an overall decrease in rates of revision fusion procedures from 2002 to 2008. Introduction of BMP did not correlate with decrease in use of autograft bone harvest. Use of BMP correlated with substantial increase in hospital charges. The small decrease in revision surgeries recorded, combined with lack of significant change in autograft harvest rates, may question the financial justification for the use of BMP.

Dagostino PR; Whitmore RG; Smith GA; Maltenfort MG; Ratliff JK

2012-12-01

290

Impact of bone morphogenetic proteins on frequency of revision surgery, use of autograft bone, and total hospital charges in surgery for lumbar degenerative disease: review of the Nationwide Inpatient Sample from 2002 to 2008.  

Science.gov (United States)

BACKGROUND CONTEXT: Bone morphogenetic proteins (BMPs) were developed with the goal of improving clinical outcomes through the promotion of bony healing and reducing morbidity from iliac crest bone graft harvest. PURPOSE: To complete a population-based assessment of the impact of BMP on use of autograft, rates of operative treatment for lumbar pseudoarthrosis, and hospital charges. STUDY DESIGN: Nationwide Inpatient Sample (NIS) retrospective cohort assessment of 46,452 patients from 2002 to 2008. PATIENT SAMPLE: All patients who underwent lumbar arthrodesis procedures for degenerative spinal disease. OUTCOME MEASURES: Use of BMP, revision surgery status as a percentage of total procedures, and autograft harvest in lumbar fusion procedures completed for degenerative diagnoses. METHODS: Demographic and geographic/practice data, hospital charges, and length of stay of all NIS patients with thoracolumbar and lumbosacral procedure codes for degenerative spinal diagnoses were recorded. Codes for autograft harvest, use of BMP, and revision surgery were included in multivariable regression analysis. RESULTS: The assessment found 46,452 patients from 2002 to 2008 undergoing thoracolumbar or lumbar arthrodesis procedures for degenerative disease. Assuming a representative sample, this cohort models more than 200,000 US patients. There was steady growth in lumbar spine fusion and in the use of BMP. The use of BMP increased from 2002 to 2008 (odds ratio [OR], 1.50; 95% confidence interval [CI], 1.48-1.52). Revision procedures decreased over the study period (OR, 0.94; 95% CI, 0.91-0.96). The use of autograft decreased substantially after introduction of BMP but then returned to baseline levels; there was no net change in autograft use from 2002 to 2008. The use of BMP correlated with significant increases in hospital charges ($13,362.39; standard deviation±596.28, p<.00001). The use of BMP in degenerative thoracolumbar procedures potentially added more than $900 million to hospital charges from 2002 to 2008. CONCLUSIONS: There was an overall decrease in rates of revision fusion procedures from 2002 to 2008. Introduction of BMP did not correlate with decrease in use of autograft bone harvest. Use of BMP correlated with substantial increase in hospital charges. The small decrease in revision surgeries recorded, combined with lack of significant change in autograft harvest rates, may question the financial justification for the use of BMP. PMID:23218827

Dagostino, Philip R; Whitmore, Robert G; Smith, Gabriel A; Maltenfort, Mitchell G; Ratliff, John K

2012-12-01

291

Synovial chondromatosis of the temporomandibular joint with calcium pyrophosphate dihydrate crystal deposition disease (pseudogout).  

Science.gov (United States)

This report describes a very rare case of synovial chondromatosis with deposition of calcium pyrophosphate dihydrate (CPPD) crystals (pseudogout) in the temporomandibular joint (TMJ) of a 46-year-old male patient. Synovial chondromatosis is a non-neoplastic disease characterized by metaplasia of the connective tissue leading to chondrogenesis in the synovial membrane. Pseudogout is an inflammatory disease of the joints caused by the deposition of CPPD, producing similar symptoms to those observed in gout but not hyperuricaemia. Both diseases commonly affect the knee, hip and elbow joints, but rarely affect the TMJ. PMID:23166363

Matsumura, Y; Nomura, J; Nakanishi, K; Yanase, S; Kato, H; Tagawa, T

2012-12-01

292

Synovial chondromatosis of the temporomandibular joint with calcium pyrophosphate dihydrate crystal deposition disease (pseudogout).  

UK PubMed Central (United Kingdom)

This report describes a very rare case of synovial chondromatosis with deposition of calcium pyrophosphate dihydrate (CPPD) crystals (pseudogout) in the temporomandibular joint (TMJ) of a 46-year-old male patient. Synovial chondromatosis is a non-neoplastic disease characterized by metaplasia of the connective tissue leading to chondrogenesis in the synovial membrane. Pseudogout is an inflammatory disease of the joints caused by the deposition of CPPD, producing similar symptoms to those observed in gout but not hyperuricaemia. Both diseases commonly affect the knee, hip and elbow joints, but rarely affect the TMJ.

Matsumura Y; Nomura J; Nakanishi K; Yanase S; Kato H; Tagawa T

2012-12-01

293

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)

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/mm2), 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 cm2/s) relative to patients with effusions accompanying knee trauma (greater than 2.75 x 10-5 cm2/s) and inflammatory arthritis (in vitro and in vivo greater than 3.00 x 10-5 cm2/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.)

2000-01-01

294

In vitro and in vivo spin echo diffusion imaging characteristics of synovial fluid: potential non-invasive differentiation of inflammatory and degenerative arthritis  

Energy Technology Data Exchange (ETDEWEB)

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{sup 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{sup -5} cm{sup 2}/s) relative to patients with effusions accompanying knee trauma (greater than 2.75 x 10{sup -5} cm{sup 2}/s) and inflammatory arthritis (in vitro and in vivo greater than 3.00 x 10{sup -5} cm{sup 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.)

Eustace, S.; DiMasi, M.; Adams, J.; Ward, R.; Caruthers, S.; McAlindon, T. [Harvard Medical School, Boston, MA (United States). Dept. of Radiology

2000-06-01

295

Roentgenological semiotics of joint involvement in psoriasis  

International Nuclear Information System (INIS)

The paper is concerned with the results of an X-ray study of the osteoarticular system of 103 patients with arthropathic psoriasis. Four types of disease: psoriatic polyarthritis, psoriatic polyarthrosis, psoriatic arthropathy and a mixed or combined form (the combination of inflammatory and degenerative-dystrophic changes) - were defined on the basis of X-ray findings. Roentgenological semiotics of these forms of arthropathic psoriasis with the frequency of the involvement of some joints and elements of differential radiodiagnosis was proposed

1986-01-01

296

[Occupation-related findings in patients with degenerative disc disease of the lumbar spine : Investigation of assessment relevant questions of the occupational disease number 2108 by descriptive representation of the data from the German spinal study.  

UK PubMed Central (United Kingdom)

BACKGROUND: A positive dose-response relationship between cumulative occupational lumbar load and lumbar disc herniation as well as lumbar disc narrowing among men and women was found in the EPILIFT study. The case subjects in the EPILIFT study concerning the occupational disease classification number 2108 has been described in detail. PATIENTS AND METHODS: The 915 case subjects with degenerative disc disease of the lumbar spine of the EPILIFT study have been clinically and radiologically described in detail regarding neurological symptoms, pain, limitations in everyday life, localization of the radiologically diagnosed disc damage, number of segments, accompanying spondylosis, damage to the cervical spine and non-occupational related competing causes. Concerning disc load, occupational related findings are described in this study. RESULTS: Regarding the descriptive results, no relationship was seen between the localization of the radiologically diagnosed disc damage, number of segments, accompanying spondylosis and damage of the cervical spine. Concerning the results, non-occupational related competing causes exclude an occupational disease 2108. CONCLUSION: In order to confirm the results of this study multivariate analysis with statistical tests must be carried out in a further study.

Linhardt O; Bolm-Audorff U; Bergmann A; Hering KG; Haerting J; Petereit-Haack G; Seidler A; Vaitl T; Grifka J

2013-08-01

297

Estudio comparativo de las funciones ejecutivas entre pacientes con enfermedad de Parkinson y pacientes con enfermedad degenerativa cerebelosa Comparison study of executive functions in Parkinson's disease and degenerative cerebellar disease's patients  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: Comparar el rendimiento en tareas de función ejecutiva (FE) en sujetos con enfermedad de Parkinson (EP) leve a moderada (Hoehn y Yahr OBJECTIVE: To compare executive functions (EF) in non-demented mild to moderate Parkinson's disease (PD) (Hoehn and Yahr <3) and pure degenerative cerebellar disease (CD) in order to evaluate the relative contribution and differential role of basal ganglia and cerebellum in those functions. METHOD: 14 patients with PD and 14 patients with CD matched by sex, education, disease's duration and MMSE were selected. A standardized neuropsychological battery and the Wisconsin Card Sorting Test (WCST) were administered. Z scores were compared for both groups through t-test for independent samples were used. RESULTS: The cerebellar group showed significant lower performance in measures of attention and EF, with a significant increase in both perseverative and non perseverative errors during the WCST. On the other hand the PD group showed a selective increase of non perseverative errors, without reaching significant between group difference. CONCLUSION: The CD group appears to have greater deficits in EF with a pattern of prefrontal dysfunction.

Carlos G. Abel; Gustavo Stein; Silvia Pereyra; Gabriela Ñano; Tomoko Arakaki; Nélida Garretto; Carlos Mangone; Osvaldo Genovese; Roberto E.P. Sica

2006-01-01

298

Stereotypic behaviors in degenerative dementias.  

UK PubMed Central (United Kingdom)

Stereotypies are simple or complex involuntary/unvoluntary behaviors, common in fronto-temporal dementia (FTD), but not studied in other types of degenerative dementias. The aim was to investigate stereotypy frequency and type in patients with FTD, Alzheimer's disease (AD), progressive supranuclear palsy (PSP) and Parkinson's disease with dementia (PDD) in a multicenter observational study; and to investigate the relation of stereotypies to cognitive, behavioral and motor impairment. One hundred fifty-five consecutive outpatients (45 AD, 40 FTD, 35 PSP and 35 PDD) were studied in four hospitals in northern Italy. Stereotypies were examined by the five-domain Stereotypy Rating Inventory. Cognition was examined by the Mini Mental State and Frontal Assessment Battery, neuropsychiatric symptoms by the Neuropsychiatric Inventory, and motor impairment and invalidity by the Unified Parkinson's Disease Rating Scale part III, and activities of daily living. Stereotypies were present in all groups. FTD and PDD had the greatest frequency of one-domain stereotypies; FTD also had the greatest frequency of two-or-more domain stereotypies; movement stereotypies were the most common stereotypies in all groups. AD patients had fewer stereotypies than the other groups. Stereotypies are not exclusive to FTD, but are also fairly common in PSP and PDD, though less so in AD. Stereotypies may be underpinned by dysfunctional striato-frontal circuits, known to be damaged in PSP and PDD, as well as FTD.

Prioni S; Fetoni V; Barocco F; Redaelli V; Falcone C; Soliveri P; Tagliavini F; Scaglioni A; Caffarra P; Concari L; Gardini S; Girotti F

2012-11-01

299

Stereotypic behaviors in degenerative dementias.  

Science.gov (United States)

Stereotypies are simple or complex involuntary/unvoluntary behaviors, common in fronto-temporal dementia (FTD), but not studied in other types of degenerative dementias. The aim was to investigate stereotypy frequency and type in patients with FTD, Alzheimer's disease (AD), progressive supranuclear palsy (PSP) and Parkinson's disease with dementia (PDD) in a multicenter observational study; and to investigate the relation of stereotypies to cognitive, behavioral and motor impairment. One hundred fifty-five consecutive outpatients (45 AD, 40 FTD, 35 PSP and 35 PDD) were studied in four hospitals in northern Italy. Stereotypies were examined by the five-domain Stereotypy Rating Inventory. Cognition was examined by the Mini Mental State and Frontal Assessment Battery, neuropsychiatric symptoms by the Neuropsychiatric Inventory, and motor impairment and invalidity by the Unified Parkinson's Disease Rating Scale part III, and activities of daily living. Stereotypies were present in all groups. FTD and PDD had the greatest frequency of one-domain stereotypies; FTD also had the greatest frequency of two-or-more domain stereotypies; movement stereotypies were the most common stereotypies in all groups. AD patients had fewer stereotypies than the other groups. Stereotypies are not exclusive to FTD, but are also fairly common in PSP and PDD, though less so in AD. Stereotypies may be underpinned by dysfunctional striato-frontal circuits, known to be damaged in PSP and PDD, as well as FTD. PMID:22648476

Prioni, S; Fetoni, V; Barocco, F; Redaelli, V; Falcone, C; Soliveri, P; Tagliavini, F; Scaglioni, A; Caffarra, P; Concari, L; Gardini, S; Girotti, F

2012-05-31

300

Natural history and imaging of subtalar and midfoot joint disease in rheumatoid arthritis.  

UK PubMed Central (United Kingdom)

Foot involvement is not uncommon and occurs early in the disease course of rheumatoid arthritis (RA). Inflammation and ongoing synovitis of foot joints lead to joint destruction and instability, tendon dysfunction, and eventually collapse of the medial longitudinal arch and pes planovalgus that contributes to difficulty in walking and gait abnormalities. This article reviews foot-related problems in patients with RA, focusing on the prevalence, natural history and role of imaging in both diagnosis and management of midfoot and subtalar joint disease in RA.

Chan PS; Kong KO

2013-02-01

 
 
 
 
301

Transforaminal lumbar interbody fusion with rhBMP-2 in spinal deformity, spondylolisthesis, and degenerative disease--part 1: Large series diagnosis related outcomes and complications with 2- to 9-year follow-up.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: Retrospective review of prospectively collected data. OBJECTIVE: To evaluate long-term clinical outcomes and complications of the transforaminal lumbar interbody fusion (TLIF) procedure from a large consecutive series, without industry funding. Clinical outcomes and complications are analyzed by diagnosis and primary versus revision surgery to assess whether TLIF with bone morphogenic protein (BMP) is appropriate for common use in deformity, spondylolisthesis, and degenerative disease. SUMMARY OF BACKGROUND DATA: A common method for achieving spinal arthrodesis includes TLIF with a cage and off-label interbody BMP-2, supported by posterior arthrodesis and a pedicle screw construct. There are no large studies analyzing outcomes and complications after TLIF in different diagnoses, for primary and revision surgery, leading some to question the widespread use of TLIF. METHODS: A total of 509 consecutive adults underwent open posterior instrumented fusion, augmented with TLIF at 872 discs using a cage and rhBMP-2, with minimum 2-year follow-up. Cohort diagnoses included 179 degenerative, 207 spondylolisthesis, and 123 deformity patients. Patient age averaged 61 years, 207 had undergone prior decompression or fusion surgery. All patients underwent posterior instrumented fusion and pedicle screw instrumentation at average 3.6 levels (range, 1-16); all patients had TLIF 1.7 levels (range, 1-4 levels) with BMP and autograft, stabilized with an interbody cage. RESULTS: At average 59 months follow-up, 12 patients developed pseudoarthrosis, 8 at TLIF levels (8/872 discs, 0.92%) most commonly at L5-S1 (6/8). Significant clinical improvement was noted in patients with deformity, spondylolisthesis, and degenerative disease undergoing primary and revision surgery. Overall, visual analogue scale preoperative score was 6.6, at 1 year 3.8, at 2 years 3.5 (P < 0.001) and the preoperative ODI was 50.9, at 1 year 36.1, and at 2 years 35.0 (P < 0 0.001). Pain medication requirements also declined. CONCLUSION: The efficacy of TLIF with BMP is supported in this large series with long-term follow-up, independent of industry. Reliable fusion and improved outcomes can be expected in adults undergoing TLIF for deformity, spondylolisthesis, and degenerative disease. Most complications occurred in patients with deformity.Level of Evidence: 3.

Crandall DG; Revella J; Patterson J; Huish E; Chang M; McLemore R

2013-06-01

302

Outer retinal tubulation in degenerative retinal disorders.  

UK PubMed Central (United Kingdom)

PURPOSE: To demonstrate outer retinal tubulation (ORT) in various degenerative retinal disorders. METHODS: This was a retrospective review of the multimodal imaging of 29 eyes of 15 patients with various retinal dystrophies and inflammatory maculopathies manifesting ORT. The morphologic features of ORT and its evolution over time were analyzed using spectral-domain optical coherence tomography data. RESULTS: Outer retinal tubulation was identified as round or ovoid structures with hyperreflective borders in pattern dystrophy (six eyes), acute zonal occult outer retinopathy (five eyes), retinitis pigmentosa (four eyes), Stargardt disease (four eyes), gyrate atrophy (two eyes), choroideremia (two eyes), and various other degenerative conditions. These structures appeared to develop from the invagination of photoreceptors at the junction of intact and atrophic outer retina. During follow-up, the number and distribution of ORT largely remained stable. As zones of atrophy enlarged, the frequency of ORT appeared to increase. The ORT structures were found in <10% of patients with retinitis pigmentosa, Stargardt disease, or pattern dystrophy. CONCLUSION: Outer retinal tubulation is found in various degenerative retinal disorders that share in common damage to the outer retina and/or retinal pigment epithelium. The presence of ORT may be an indicator of underlying disease stage and severity.

Goldberg NR; Greenberg JP; Laud K; Tsang S; Freund KB

2013-10-01

303

The fate of the joint space in Legg-Calve-Perthes' disease.  

UK PubMed Central (United Kingdom)

OBJECTIVE: This study was undertaken to identify variations in the hip joint space in patients with healed Legg-Calvé-Perthes' disease (LCPD) and to correlate these changes with the radiological outcome of treatment. METHODS: The width of the joint space was measured on radiographs of 121 skeletally mature individuals with healed LCPD. The joint space width at the stage of healing in 79 patients was compared with the joint space at skeletal maturity. The hips were graded by the Stulberg classification and the femoral head radius was measured. Associations between the joint space width, the Stulberg class and the femoral head radius were tested. The reproducibility of measurement was tested by measuring 30 radiographs twice and computing the intra-class correlation coefficient (ICC). The joint space width was measured on radiographs of 25 patients taken both while recumbent and standing, to determine if the joint space alters on weight-bearing. RESULTS: The reproducibility of measurements was satisfactory; no difference was noted in the joint space in recumbent and weight-bearing films. Increased joint space was noted both at healing of the disease and at skeletal maturity; the width was minimally increased in Stulberg Class I hips and considerably increased in Class III, IV and V hips. There was a significant correlation between the increase in joint space and enlargement of the femoral head. CONCLUSIONS: An increase in joint space width occurs quite frequently following LCPD; the increase is most evident in hips with a poor outcome. The implications of this observation need to be elucidated.

Vijayan S; Mehta O; Jacob G; Siddesh ND; Shah H; Joseph B

2013-03-01

304

Asymmetric uptake of Tc-99m HDP on temporomandibular joints may predict prognosis of temporomandibular joint disease  

International Nuclear Information System (INIS)

There is no reliable predictor for therapeutic efficacy for temporomandibular joint (TMJ) disease. The aim of the present study was to evaluate the usefulness of Tc-99m HDP bone scan in the pre-therapeutic assessment of prognosis for TMJ disease. Between January 2005 and July 2007, 94 patients (M: F=18: 76; mean age, 33.4±14.0 y) with TMJ disease who underwent pre-therapeutic bone scan were enrolled. Planar bone scan images were obtained at right and left lateral skull areas 3 hours post Tc-99m HDP injection (dose=1295 MBq). TMJ uptake of Tc-99m HDP was quantitated using 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratio was calculated as; (TMJ background) / background. Asymmetric indices for involved TMJ uptake (Alinvovle) were defined as; TMJ uptake ratio of involved/non-involved joint. Asymmetric indices for greater TMJ uptake regardless of disease involvement (AIgreater) were defined as; TMJ uptake ratio of greater/smaller TMJ uptake. Splint therapy was applied to all patients with mean duration of 7 months (range; 3-34 months). Therapeutic efficacy was dichotomised as improved or non-improved in consideration of mandibular movement, TMJ noise, pain, and tenderness. Seventy-six patients experienced improvement, whereas 18 patients non-improvement. There was no significant difference between improved versus non-improved patients regarding TMJ uptake ratio of involved joint (2.92±0.82 vs. 2.91±0.66), and AIinvovle (1.16±0.22 vs. 1.10±0.12) (p>0.05, t-test). However, AIgreater was significantly higher in improved patients than non-improved patients (1.20±0.19 vs. 1.13±0.09, p

2005-01-00

305

Single photon emission computed tomography in lumbar degenerative spondylolisthesis  

International Nuclear Information System (INIS)

[en] Analysis of single photon emission computed tomographic images and plain X-ray films of the lumbar vertebrae was performed in 15 patients with lumbar spondylosis and 15 patients with lumbar degenerative spondylolisthesis. The facet joint and osteophyte images were observed in particular, and the slipping ratio of spondylolisthetic vertebrae was determined. The slipping ratio of degenerative spondylolisthesis ranged from 11.8 % to 22.3 %. Hot uptake of 99mTc-HMDP by both L4-5 facet joints was significantly greater in the patients with degenerative spondylolisthesis than in those with lumbar spondylosis. The hot uptake by the osteophytes in lumbar spondylosis was nearly uniform among the three inferior segments, L3-4, L4-5 and L5-S, but was localized to the spondylolisthetic vertebrae, L4-5, or L5-S, in the patients with spondylolisthesis. Half of the osteophytes with hot uptake were assigned to the 3rd degree of Nathan's grading. It was suggested that stress was localized to the slipping vertebrae and their facet joints in patients with lumbar degenerative spondylolisthesis. (author)

1998-01-01

306

Treatment of advanced carpometacarpal joint disease: trapeziectomy and hematoma arthroplasty.  

Science.gov (United States)

Some surgical treatment options of painful basal joint arthritis do not require complex arthroplasty or suspensionplasty techniques. Simple trapeziectomy with temporary pinning of a slightly overdistracted thumb metacarpal can provide reliable pain relief, good motion, and functional stability. Recent literature supports alternative options when compared with formal ligament reconstruction or suspensionplasty procedures. Simple trapeziectomy is associated with less morbidity due to shorter operative times and the lack of need for graft harvest and ligament reconstruction. PMID:18675718

Fitzgerald, Brian T; Hofmeister, Eric P

2008-08-01

307

Treatment of advanced carpometacarpal joint disease: trapeziectomy and hematoma arthroplasty.  

UK PubMed Central (United Kingdom)

Some surgical treatment options of painful basal joint arthritis do not require complex arthroplasty or suspensionplasty techniques. Simple trapeziectomy with temporary pinning of a slightly overdistracted thumb metacarpal can provide reliable pain relief, good motion, and functional stability. Recent literature supports alternative options when compared with formal ligament reconstruction or suspensionplasty procedures. Simple trapeziectomy is associated with less morbidity due to shorter operative times and the lack of need for graft harvest and ligament reconstruction.

Fitzgerald BT; Hofmeister EP

2008-08-01

308

Lipoma arborescens: Comparison of typical and atypical disease presentations.  

UK PubMed Central (United Kingdom)

AIM: To determine whether the aetiology differed between typical cases of lipoma arborescens with unilateral knee involvement and atypical cases involving joints other than the knee, polyarticular disease, and disease outside of the knee joint. MATERIALS AND METHODS: Cases of lipoma arborescens involving the knee joint were evaluated for the distribution of the disease and severity of degenerative arthritis. Joints other than the knee were evaluated for the presence and severity of degenerative arthritis, and the distribution was classified as either intra-articular, extra-articular, or both. Clinical history was reviewed for patient age at presentation, a history of inflammatory arthritis, diabetes mellitus, and known steroid use. Fisher's exact test was used to determine whether there was a statistically significant difference between typical and atypical presentations of the disease. RESULTS: Lipoma arborescens was identified in 45 joints in 39 patients. Twenty-eight patients were classified as "typical" and 11 patients had "atypical" disease. There was no significant difference in age at presentation, presence of degenerative arthritis, or known inflammatory arthritis when comparing typical and atypical presentations of the disease. CONCLUSION: Twenty-eight percent of patients in the present study had atypical presentation of lipoma arborescens with multifocal lipoma arborescens or disease in joints other than the knee. There was no significant difference in age at presentation, presence of degenerative arthritis, or known inflammatory arthritis when comparing typical and atypical presentations of the disease. Of the 39 patients, only three had no evidence of degenerative arthritis, which suggests that many cases of lipoma arborescens are secondary to chronic reactive change in association with degenerative arthritis.

Howe BM; Wenger DE

2013-08-01

309

Carpal instabilities and secondary degenerative changes due to lesions of the radiocarpal ligament complex  

International Nuclear Information System (INIS)

This paper reports on trauma, rheumatoid arthritis, calcium pyrophosphate dihydrate crystal deposition (CPDD), neurologic disease, and beta2-microglobulin-related amyloid deposits in patients undergoing chronic hemodialysis that can lead to distinct lesions of the radiocarpal ligament complex, causing rotational subluxation of the scaphoid and ulnar translocation of the carpus. The clinical and radiologic findings were analyzed in 35 patients, examined from 1985 to 1989. Degenerative changes in rotational subluxation of the scaphoid develop in three steps. First there is osteoarthritis at the styloid process, then the degeneration progresses into the central midcarpal joint, and finally it progresses to the ulnar midcarpal joint. Despite different etiologies of ligament failure, the radiologic features are very similar, because the mechanism of degeneration is identical in posttraumatic, inflammatory, neurogenic, CPDD, or beta2-microglobulin-related instability. However, there are some distinct radiologic differences in relation to the primary cause of the ligament defect.

1990-01-01

310

Relationship between arthroscopic joint evaluation and the levels of Coll2-1, Coll2-1NO2, and myeloperoxidase in the blood and synovial fluid of horses affected with osteochondrosis of the tarsocrural joint  

DEFF Research Database (Denmark)

Objective: To evaluate the levels of plasmatic and synovial Coll2-1, Coll2-1NO and myeloperoxidase (MPO) in horses with osteochondral lesions of the tarsocrural joint and to investigate how these levels relate to arthroscopic findings of inflammation and degeneration. Materials and methods: Venous blood and synovial fluid samples were collected from 63 horses presented for arthroscopic removal of osteochondral fragments in the tarsocrural joint. Prior to removal of the osteochondral fragment, an exploration of the joint was performed and an inflammatory and degenerative score was determined. The blood and synovial levels of Coll2-1, Coll2-1NO and MPO were also measured. The effects of the arthroscopic evaluation (inflammatory and degenerative classes) on the blood and synovial markers were evaluated using a linear model (GLM procedure), and correlations between biochemical markers in the blood and synovial fluid and the arthroscopic evaluation (inflammatory and degenerative classes) were established (Pearson's correlations). Results: Significantly higher levels of Coll2-1 were detected in synovial fluid of higher degenerative classes. There was a significant correlation between the degenerative score and the synovial levels of Coll2-1 (r= 0.27). According to the logistic regression model, there was a significant effect of the degenerative class on synovial levels of Coll2-1. Conclusions: Coll2-1 correlates well with the degenerative state of tarsocrural joints as evaluated by arthroscopy. This marker can therefore be classified as a burden-of-disease marker in the assessment of joint disease in horses. © 2011 Osteoarthritis Research Society International.

Verwilghen, D.R.; Balligand, M.

2011-01-01

311

Rotary deformity in degenerative spondylolisthesis  

Energy Technology Data Exchange (ETDEWEB)

We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. We have made analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom, statistically. We also reviewed CT findings in 15 study groups. The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p < 0.01). The rotary deformity can be accompanied with degenerative spondylolisthesis. We may consider the rotary deformity as a cause of symptomatic degenerative spondylolisthesis in case that any other cause is not detected.

Kang, Sung Gwon; Kim, Jeong; Kho, Hyen Sim; Yun, Sung Su; Oh, Jae Hee; Byen, Ju Nam; Kim, Young Chul [Chosun University College of Medicine, Gwangju (Korea, Republic of)

1994-05-15

312

Medium-term Clinical Results of Microsurgical Lumbar Flavectomy That Preserves Facet Joints in Cases of Lumbar Degenerative Spondylolisthesis: Comparison of Bilateral Laminotomy With Bilateral Decompression by a Unilateral Approach.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: A retrospective study of medium-term results. OBJECTIVE: To describe a technique for posterior decompression using microsurgical lumbar flavectomy (MLF) without facetectomy, which is based on the anatomic features of the ligamentum flavum, and to examine the clinical outcomes of patients with lumbar spinal spondylolisthesis with lower extremity symptoms rather than low back pain, who underwent this procedure by 2 different approaches. SUMMARY OF BACKGROUND DATA: Posterior decompression with fusion has been the optimal and standard operative treatment for lumbar degenerative spondylolisthesis. Alternatively, minimally invasive procedures have been used for the treatment of lumbar degenerative spondylolisthesis with favorable outcomes. METHODS: A bilateral laminotomy (BL group) was performed on 44 consecutive patients, and bilateral decompression by a unilateral approach (BDU group) was performed on 23 consecutive patients. The mean follow-up period was 7.0 years. The Japanese Orthopaedic Association score and recovery rate were obtained, and radiographic assessment was performed using plain radiograms on the lateral view while standing in flexion, neutral, and extension postures before surgery and at the final follow-up. RESULTS: The Japanese Orthopaedic Association score at the final follow-up was improved in the BL and BDU groups, compared with that before MLF. The mean recovery rate was 72.4% and 68.4%, respectively. The mean % slip increased at the final follow-up, compared with that before surgery in both groups, except for the % slip in the extension posture in the BDU group. However, there was no significant difference in the dynamic % slip in the flexion-extension posture between before surgery and at the final follow-up. CONCLUSIONS: Clinical and radiologic parameters were not significantly different between the 2 groups. This technique of MLF using either approach did not increase the dynamic % slip and showed favorable medium-term clinical results in cases of lumbar degenerative spondylolisthesis.

Nakanishi K; Tanaka N; Fujimoto Y; Okuda T; Kamei N; Nakamae T; Izumi B; Ohta R; Fujioka Y; Ochi M

2013-10-01

313

Asymmetric uptake of Tc-99m HDP on temporomandibular joints may predict prognosis of temporomandibular joint disease  

Energy Technology Data Exchange (ETDEWEB)

There is no reliable predictor for therapeutic efficacy for temporomandibular joint (TMJ) disease. The aim of the present study was to evaluate the usefulness of Tc-99m HDP bone scan in the pre-therapeutic assessment of prognosis for TMJ disease. Between January 2005 and July 2007, 94 patients (M: F=18: 76; mean age, 33.4{+-}14.0 y) with TMJ disease who underwent pre-therapeutic bone scan were enrolled. Planar bone scan images were obtained at right and left lateral skull areas 3 hours post Tc-99m HDP injection (dose=1295 MBq). TMJ uptake of Tc-99m HDP was quantitated using 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratio was calculated as; (TMJ background) / background. Asymmetric indices for involved TMJ uptake (Al{sub invovle}) were defined as; TMJ uptake ratio of involved/non-involved joint. Asymmetric indices for greater TMJ uptake regardless of disease involvement (AI{sub greater}) were defined as; TMJ uptake ratio of greater/smaller TMJ uptake. Splint therapy was applied to all patients with mean duration of 7 months (range; 3-34 months). Therapeutic efficacy was dichotomised as improved or non-improved in consideration of mandibular movement, TMJ noise, pain, and tenderness. Seventy-six patients experienced improvement, whereas 18 patients non-improvement. There was no significant difference between improved versus non-improved patients regarding TMJ uptake ratio of involved joint (2.92{+-}0.82 vs. 2.91{+-}0.66), and AI{sub invovle} (1.16{+-}0.22 vs. 1.10{+-}0.12) (p>0.05, t-test). However, AI{sub greater} was significantly higher in improved patients than non-improved patients (1.20{+-}0.19 vs. 1.13{+-}0.09, p<0.05, t-test). Regardless of disease involvement of TMJ disease, asymmetricities of Tc-99m HDP uptake were more frequently found in improved group after splint therapy. Tc-99m HDP bone scan can predict the efficacy of splint therapy in TMJ disease.

Lee, Sang Mi; Lee, Won Woo; Yun, PiI Young; Kim, Young Kyun; Kim, Sang Eun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

2007-07-01

314

[Role of spiral computed tomography in the assessment of the bone and soft tissue structures of the spine in the postoperative period of degenerative diseases and traumas].  

Science.gov (United States)

The spiral computed tomography (SCT) was used in examinations of 59 patients with symptoms of neurological disorders at the postoperative period after discectomy, and 82 casualties and 24 patients with degenerative-dystrophic lesions of the spine after correcting-stabilizing operations with plasty of the vertebra with autobone, biositall-XK. An examination of this category of patients and casualties in the nearest and remote terms after operation improves the potentials of SCT-diagnostics of recurrent hernias, epidural fibrosis, spondylites, central and lateral stenoses and allows control of osteoreparation and remodelling of the spine. The improved pathogenetical treatment in these cases shortens the period of disability and does not result in persistent invalidism of the patients. PMID:12942611

Anosov, N A; Cheremisin, V M; Orlov, V P; Toptygin, S V

2003-01-01

315

[Role of spiral computed tomography in the assessment of the bone and soft tissue structures of the spine in the postoperative period of degenerative diseases and traumas  

UK PubMed Central (United Kingdom)

The spiral computed tomography (SCT) was used in examinations of 59 patients with symptoms of neurological disorders at the postoperative period after discectomy, and 82 casualties and 24 patients with degenerative-dystrophic lesions of the spine after correcting-stabilizing operations with plasty of the vertebra with autobone, biositall-XK. An examination of this category of patients and casualties in the nearest and remote terms after operation improves the potentials of SCT-diagnostics of recurrent hernias, epidural fibrosis, spondylites, central and lateral stenoses and allows control of osteoreparation and remodelling of the spine. The improved pathogenetical treatment in these cases shortens the period of disability and does not result in persistent invalidism of the patients.

Anosov NA; Cheremisin VM; Orlov VP; Toptygin SV

2003-01-01

316

Development of PET tracers for neuro inflammation imaging in neuro degenerative diseases; Developpement de radiotraceurs de la neuroinflammation pour l'imagerie des pathologies neurodegeneratives  

Energy Technology Data Exchange (ETDEWEB)

Inflammatory processes such as micro-glial or endothelial activation are involved in many neuro-degenerative conditions. Neuro-inflammation imaging is considered an attractive tool for fundamental research, diagnosis and therapeutic evaluation in neuro-pathologies. First, an aptamer was selected against a recombinant fragment of the endothelial target VCAM-1, but proved unable to bind the target protein in native conformation, as expressed by a cell line. Second, five radioligands of the peripheral benzodiazepine receptor (PBR), a marker of micro-glial activation, were evaluated in vivo using PET (Positron Emission Tomography) imaging in a rat model of neuro-inflammation, and were compared to [11C]PK11195. Four radiotracers displayed a better contrast than [11C]PK11195. In a competitive field of research, this work demonstrates the efficiency of in vivo screening of radiotracers for fast selection of clinically relevant molecules. (author)

Chauveau, F

2007-10-15

317

Ultrasonographic evaluation of knee joints in patients with Lyme disease.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of this study was to evaluate the ultrasonographic images of patients with chronic knee pain and serologic features of Lyme disease. METHODS: Seventy-six patients hospitalized in The Department of Infectious Diseases and Neuroinfections of the Medical University in Bia?ystok, Poland were included in the study. Patients were divided into two groups: (1) the Lyme disease group included patients with pain in one or both knees and anti-Borrelia burgdorferi antibodies with symptoms lasting for over 6 months; (2) the control group included patients suffering from pain in one or both knees for over 6 months, but for whom B. burgdorferi infection was excluded. RESULTS: The most frequent ultrasonographic finding in the Lyme disease group was effusion, and its frequency was significantly higher than in the control group. No patient in the control group presented with synovitis or cartilage damage, while these were quite frequent findings in the Lyme disease group. Baker's cysts were more frequent in the Lyme disease group, but this was statistically non-significant. CONCLUSIONS: Ultrasonography may be useful in following the sequelae of Lyme disease. The abnormalities found in Lyme disease patients are non-specific and ultrasonography is not useful in the differential diagnosis.

Czupryna P; Moniuszko A; Czeczuga A; Pancewicz S; Zajkowska J

2012-04-01

318

Primary hydatid disease of sacrum affecting the sacroiliac joint: a case report.  

UK PubMed Central (United Kingdom)

STUDY DESIGN: A case report of hydatid disease of the spine. OBJECTIVE: To describe an unusual case of hydatid disease of the sacrum affecting the sacroiliac joint and to discuss imaging, differential diagnosis, and treatment. SUMMARY OF BACKGROUND DATA: Hydatidosis or echinococcosis affecting the spine is rare and has a characteristic geographic distribution. Signs of sacroiliac joint involvement and accompanying neurologic deficits cause difficulties in differential diagnosis of this rare condition. METHODS: A case of 38-year-old female patient with low back pain and sciatica was presented. RESULTS: Plain radiographs, computed tomography, and magnetic resonance imaging scans revealed destructive expansive lesion located on the right sacrum and extended through the right sacroiliac joint. Surgical enucleation of the cysts was performed together with mebendazole treatment and histopathologic examination confirmed hydatidosis. CONCLUSION: This unusual disease should be kept in mind in the differential diagnosis of sacroiliac pain and sciatica, especially in endemic areas.

Yilmaz N; Ozgocmen S; Kocakoc E; Kiris A

2004-03-01

319

Therapeutic application of mesenchymal stem cells in bone and joint diseases.  

UK PubMed Central (United Kingdom)

Mesenchymal stem cells (MSCs), the non-hematopoietic progenitor cells, are multi-potent stem cells from a variety of tissues with the capability of self-renewal, proliferation, differentiation into multi-lineage cell types, as well as anti-inflammatory and immunomodulatory. These properties make MSCs an ideal source of cell therapy in bone and joint diseases. This review describes the advances of animal study and preliminary clinical application in the past few years, related to MSC-based cell therapy in the common bone and joint diseases, including osteoarthritis, rheumatoid arthritis, osteoporosis, osteonecrosis of the femoral head and osteogenesis imperfecta. It highlights the promising prospect of MSC in clinical application of bone and joint diseases.

Liu Y; Wu J; Zhu Y; Han J

2012-11-01

320

CT findings of isthmic spondylolisthesis and degenerative spondylolisthesis  

International Nuclear Information System (INIS)

[en] CT evaluate the finding useful for differential diagnosis and associated abnormalities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. We reviewed retrospectively the CT images of 164 patients who were diagnosed spondylolisthesis. One hundred twelve patients had isthmic spondylolisthesis and 52 patients had degenerative spondylolisthesis. Isthmic spondylolisthesis most frequently occurred at L5. The degree of anterior displacement was grade I and II. The defect had a horizontal plane, an irregular surface, a sclerotic margin, and protruding hypertrophic bony spur in the spinal canal. The most frequently associated structural abnormality was a herniated nucleus pulposus at the upper level of the defect. Degenerative spondylolisthesis most frequently occurred at L4-5 and were grade I. The degenerative facet joint had a vertical plane, a hypertrophic bony spur, and a vacuum facet phenomenon. We frequently detected a pseudobulging disk. The most frequently associated structural abnormality was a herniated nucleus pulposus at the level of the displacement. In spondylolisthesis, the findings in CT were valuable for differential diagnosis of isthmic and degenerative types and the detection of associated symptomatic abnormalities

1996-01-01

 
 
 
 
321

CT findings of isthmic spondylolisthesis and degenerative spondylolisthesis  

Energy Technology Data Exchange (ETDEWEB)

CT evaluate the finding useful for differential diagnosis and associated abnormalities of isthmic spondylolisthesis and degenerative spondylolisthesis on CT. We reviewed retrospectively the CT images of 164 patients who were diagnosed spondylolisthesis. One hundred twelve patients had isthmic spondylolisthesis and 52 patients had degenerative spondylolisthesis. Isthmic spondylolisthesis most frequently occurred at L5. The degree of anterior displacement was grade I and II. The defect had a horizontal plane, an irregular surface, a sclerotic margin, and protruding hypertrophic bony spur in the spinal canal. The most frequently associated structural abnormality was a herniated nucleus pulposus at the upper level of the defect. Degenerative spondylolisthesis most frequently occurred at L4-5 and were grade I. The degenerative facet joint had a vertical plane, a hypertrophic bony spur, and a vacuum facet phenomenon. We frequently detected a pseudobulging disk. The most frequently associated structural abnormality was a herniated nucleus pulposus at the level of the displacement. In spondylolisthesis, the findings in CT were valuable for differential diagnosis of isthmic and degenerative types and the detection of associated symptomatic abnormalities.

Chang, Suk Kyeong; Cho, Seong II; Chung, Gyung Ho; Lee, Sang Yong; Han, Young Min; Sohn, Myung Hee; Kim, Chong Soo; Choi, Ki Chul [Chonbuk National Univ. College of Medicine, Chonju (Korea, Republic of)

1996-01-01

322

[The Temporomandibular Joint Diseases Unit of the Villeneuve-Saint-Georges Hospital Center  

UK PubMed Central (United Kingdom)

A disease as complex as that of temporomandibular joint dysfunction can only be managed by a multidisciplinary team. The authors describe the temporomandibular joint diseases unit of the Centre Hospitalier de Villeneuve-Saint-Georges which consists of Stomatologists, Radiologists, Psychiatrists and Psychologists and a Rehabilitation Medicine doctor specialised in electrodiagnosis. The hospital's Department of Stomatology and Maxillofacial Surgery (Doctor Pierre Scheffer) coordinates this unit which holds committee meetings one a month to evaluate each case. The therapeutic decisions reflect the multiplicity of the aetiologies, none of which are mutually exclusive, which explains the necessity for a multidisciplinary approach.

Scheffer P; Lerondeau JC; Bayssette A; Massez G; Brière de Lisle Boudon R; Legeron P; Pascal A

1988-01-01

323

Principales aspectos clínicos y endoscópicos de la enfermedad degenerativa de la rodilla/ Main clinical and endoscopical aspects of the degenerative knee disease  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se realizó un estudio descriptivo y transversal de 100 pacientes atendidos en el Servicio de Reumatología del Hospital Provincial Docente "Saturnino Lora" de Santiago de Cuba con el diagnóstico de artropatía degenerativa de la rodilla, durante el período 2003-2007, a fin de caracterizarles según los principales aspectos clínicos y endoscópicos de esta afección. Entre los principales resultados sobresalieron: los pacientes con más de 60 años y el sexo femenino. (more) La gonartrosis y la condromalacia constituyeron los hallazgos endoscópicos fundamentales y como opciones terapéuticas más empleadas, predominaron el legrado y el lavado articular. Abstract in english A descriptive and cross-sectional study with one-hundred patients having a diagnosis of degenerative knee arthropathy treated at the Rheumatology Service in ¨Saturnino Lora¨ University Hospital from Santiago de Cuba was carried out between 2003 and 2007 in order to characterize them according to the main clinical and endoscopical aspects of this disorder. Among the most important results, 60-year-old and over patients and female gender were relevant. Gonarthrosis and co (more) ndromalacy constituted the main endoscopical findings while curettage and articular wash-out, being the therapeutical alternatives most used, were predominant.

Morasén Cuevas, José Ricardo; Calisté Manzano, Osvaldo; Vergés Callard, Luis

2010-12-01

324

Rotary deformity in degenerative spondylolisthesis  

International Nuclear Information System (INIS)

[en] We studied to determine whether the degenerative spondylolisthesis has rotary deformity in addition to forward displacement. We have made analysis of difference of rotary deformity between the 31 study groups of symptomatic degenerative spondylolisthesis and 31 control groups without any symptom, statistically. We also reviewed CT findings in 15 study groups. The mean rotary deformity in study groups was 6.1 degree(the standard deviation is 5.20), and the mean rotary deformity in control groups was 2.52 degree(the standard deviation is 2.16)(p

1994-01-01

325

MR imaging of inflammatory joint diseases of the foot and ankle  

International Nuclear Information System (INIS)

Pain affecting the foot and ankle is a common complaint frequently attributable to inflammatory joint diseases. Although conventional radiography is regarded as the initial step in the diagnostic investigation, MR imaging may contribute to further evaluation of these patients due to the direct visualization of the inflammatory soft tissue formed in the disease and its effects on bone, cartilage and para-articular structures. The high spatial resolution of MR imaging combined with tissue characterization often allows initial detection of inflammatory joint abnormalities at a stage that precedes radiographic evaluation. The typical MR appearance of certain inflammatory joint disorders may be helpful in narrowing the wide differential diagnosis. Furthermore, MR imaging can be used for an exact assessment of the extent of the disorder as well as its complications. Accurate diagnostic information can guide the clinician in further diagnostic tests and implementation of proper therapeutic treatment. (orig.)

1999-01-01

326

MR imaging of inflammatory joint diseases of the foot and ankle  

Energy Technology Data Exchange (ETDEWEB)

Pain affecting the foot and ankle is a common complaint frequently attributable to inflammatory joint diseases. Although conventional radiography is regarded as the initial step in the diagnostic investigation, MR imaging may contribute to further evaluation of these patients due to the direct visualization of the inflammatory soft tissue formed in the disease and its effects on bone, cartilage and para-articular structures. The high spatial resolution of MR imaging combined with tissue characterization often allows initial detection of inflammatory joint abnormalities at a stage that precedes radiographic evaluation. The typical MR appearance of certain inflammatory joint disorders may be helpful in narrowing the wide differential diagnosis. Furthermore, MR imaging can be used for an exact assessment of the extent of the disorder as well as its complications. Accurate diagnostic information can guide the clinician in further diagnostic tests and implementation of proper therapeutic treatment. (orig.)

Weishaupt, D.; Schweitzer, M.E.; Alam, F.; Karasick, D. [Thomas Jefferson Univ., Philadelphia, PA (United States). Dept. of Radiology; Wapner, K. [Dept. of Orthopedic Surgery, Hahneman Medical College, Philadelphia, PA (United States)

1999-12-01

327

O problema das doenças crônicas e degenerativas e dos acidentes nas áreas urbanizadas da América Latina/ The problem of chronic and degenerative diseases and of accidents in the urban areas of Latin America  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese A rápida urbanização que vêm sofrendo as cidades latino-americanas tem apresentado alguns problemas de saúde para as suas populações. As doenças crônicas e degenerativas e os acidentes, principalmente os de trânsito e os de trabalho, têm tido nessas áreas uma evolução ascendente quanto à incidência, medida principalmente pela mortalidade. Dentre as doenças crônicas, as cardiovasculares e os tumores, malignos apresentam coeficientes de mortalidade por vez (more) es superiores aos observados em cidades de países desenvolvidos. São discutidas também as incidências dos acidentes de trânsito e os de trabalho, as quais são bastante superiores às verificadas nos países desenvolvidos. Esses aspectos vêm cada vez mais constituindo problemas quanto à demanda de serviços, porém é discutido o fato de que ainda não devem ser considerados prioritários, tendo-se em vista que, ao lado destes agravos a saúde, existem também, em altos níveis, as doenças infecciosas, a maioria das quais já foram completamente dominadas em países desenvolvidos. Assim, por exemplo, em São Paulo, ainda que seja grande a demanda de serviços para as doenças crônicas e os acidentes, parte considerável dos gastos ainda estão voltados para as doenças infecciosas. Abstract in english Some health problems have been enhanced by the swift urbanization that Latin America cities are going through at present. Chronic and degenerative diseases besides accidents, moreover those caused by traffic and occupational hazards, in these areas have shown an increasing trend as regards incidence, measured by mortality rates. Cardiovascular problems and malignant tumours, among the chronic diseases, reveal at times higher mortality rates than those observed in cities o (more) f highly developed countries. The incidence of traffic accidents and those due to occupational hazards is also discussed. These too are indeed more often than what is usually observed in developed countries. These aspects are increasingly demanding more services but are a problem as regards priorities for, in Latin America, infeccious diseases still contribute with very high mortality rates, on the contrary of what goes on in highly developed countries where infeccious diseases have almost been abolished. Thus, for example, in the city of S. Paulo although there is a great demand for services to cope with chronic and degenerative diseases and accident hazards, a considerable ammount of public expenditures is directed towards infeccious diseases.

Laurenti, Ruy

1975-06-01

328

Calcium pyrophosphate dihydrate deposition disease (CPPD)/Pseudogout of the temporomandibular joint - FNA findings and microanalysis.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report a case of a Calcium pyrophosphate dihydrate deposition disease (CPPD) presenting as a mass in the parotid and temporomandibular joint (TMJ) that simulated a parotid tumor. A 35 year-old man presented with pain in the left ear area. A CT Scan of the area showed a large, calcified mass surro...

Naqvi Asghar; Abraham Jerrold; Kellman Robert; Khurana Kamal

329

Calcium pyrophosphate dihydrate deposition disease (CPPD)/Pseudogout of the temporomandibular joint – FNA findings and microanalysis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract We report a case of a Calcium pyrophosphate dihydrate deposition disease (CPPD) presenting as a mass in the parotid and temporomandibular joint (TMJ) that simulated a parotid tumor. A 35 year-old man presented with pain in the left ear area. A CT Scan of the area showed a large, c...

Naqvi Asghar H; Abraham Jerrold L; Kellman Robert M; Khurana Kamal K

330

Calcium pyrophosphate dihydrate deposition disease (CPPD)/Pseudogout of the temporomandibular joint – FNA findings and microanalysis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

We report a case of a Calcium pyrophosphate dihydrate deposition disease (CPPD) presenting as a mass in the parotid and temporomandibular joint (TMJ) that simulated a parotid tumor. A 35 year-old man presented with pain in the left ear area. A CT Scan of the area showed a large, calcified mass surro...

Naqvi, Asghar H; Abraham, Jerrold L; Kellman, Robert M; Khurana, Kamal K

331

Joint occurrence of aseptic necrosis of the head of the third metacarpal and Freiberg's disease.  

UK PubMed Central (United Kingdom)

Freiberg's disease of the second metatarsal was found together with the aseptic necrosis of the head of the third metacarpal in a 54-year-old female patient. No similar case was found in the available literature. The deformity of the second metatarsophalangeal joint was corrected with an operation, the alteration of the third metacarpal did not need operative correction.

Gurin J

1985-01-01

332

Freiberg's disease and dislocation of the second metatarsophalangeal joint: etiology and treatment.  

Science.gov (United States)

Surgical and conservative treatments, based on historic and current concepts, are presented for management of Freiberg's disease and dislocation of the second metatarsophalangeal joint. A preliminary review of the interpositional arthroplasty used at the University of Texas Health Science Center is presented. PMID:2253168

Beito, S B; Lavery, L A

1990-10-01

333

Joint occurrence of aseptic necrosis of the head of the third metacarpal and Freiberg's disease.  

Science.gov (United States)

Freiberg's disease of the second metatarsal was found together with the aseptic necrosis of the head of the third metacarpal in a 54-year-old female patient. No similar case was found in the available literature. The deformity of the second metatarsophalangeal joint was corrected with an operation, the alteration of the third metacarpal did not need operative correction. PMID:4002968

Gurin, J

1985-01-01

334

Freiberg's disease and dislocation of the second metatarsophalangeal joint: etiology and treatment.  

UK PubMed Central (United Kingdom)

Surgical and conservative treatments, based on historic and current concepts, are presented for management of Freiberg's disease and dislocation of the second metatarsophalangeal joint. A preliminary review of the interpositional arthroplasty used at the University of Texas Health Science Center is presented.

Beito SB; Lavery LA

1990-10-01

335

Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides).  

UK PubMed Central (United Kingdom)

The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides). The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids.

Lawler DF; Evans RH; Nieminen P; Mustonen AM; Smith GK

2012-10-01

336

Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides)  

Directory of Open Access Journals (Sweden)

Full Text Available The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides). The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids.

Dennis F. Lawler; Richard H. Evans; Petteri Nieminen; Anne-Mari Mustonen; Gail K. Smith

2012-01-01

337

Lessons from a non-domestic canid: joint disease in captive raccoon dogs (Nyctereutes procyonoides).  

Science.gov (United States)

The purpose of this study was to describe pathological changes of the shoulder, elbow, hip and stifle joints of 16 museum skeletons of the raccoon dog (Nyctereutes procyonoides). The subjects had been held in long-term captivity and were probably used for fur farming or research, thus allowing sufficient longevity for joint disease to become recognisable. The prevalence of disorders that include osteochondrosis, osteoarthritis and changes compatible with hip dysplasia, was surprisingly high. Other changes that reflect near-normal or mild pathological conditions, including prominent articular margins and mild bony periarticular rim, were also prevalent. Our data form a basis for comparing joint pathology of captive raccoon dogs with other mammals and also suggest that contributing roles of captivity and genetic predisposition should be explored further in non-domestic canids. PMID:23277118

Lawler, Dennis F; Evans, Richard H; Nieminen, Petteri; Mustonen, Anne-Mari; Smith, Gail K

338

Hypertrophic Synovitis of the Facet Joint Causing Root Pain  

Directory of Open Access Journals (Sweden)

Full Text Available Osteoarthritic changes in the facet joints are common in the presence of degenerative disc disease. Changes in the joint capsule accompany changes in the articular surfaces. Intraspinal synovial cysts that cause radicular pain, cauda equina syndrome, and myelopathy have been reported; however, there have been few reports in orthopedic or neurosurgical literature regarding hypertrophic synovitis of the facet joint presenting as an incidental para-articular mass. Here, we report a case of hypertrophic synovitis causing root pain. We describe the case of a 65-year-old man suffering from right sciatica and right leg pain in the L5 nerve-root dermatome for 1 year; magnetic resonance imaging (MRI) revealed an enhanced mass around the L4–5 facet joint. We investigated this mass pathologically. After right medial facetectomy, the symptoms resolved. Pathological investigation revealed this mass was hypertrophic synovitis. Hypertrophic synovitis of the facet joint might cause root pain.

Koichi Iwatsuki; Toshiki Yoshimine; Masanori Aoki and Kazuhiro Yoshimura

2008-01-01

339

Saposin C coupled lipid nanovesicles specifically target arthritic mouse joints for optical imaging of disease severity.  

UK PubMed Central (United Kingdom)

Rheumatoid arthritis is a chronic inflammatory disease affecting approximately 1% of the population and is characterized by cartilage and bone destruction ultimately leading to loss of joint function. Early detection and intervention of disease provides the best hope for successful treatment and preservation of joint mobility and function. Reliable and non-invasive techniques that accurately measure arthritic disease onset and progression are lacking. We recently developed a novel agent, SapC-DOPS, which is composed of the membrane-associated lysosomal protein saposin C (SapC) incorporated into 1,2-dioleoyl-sn-glycero-3-phospho-L-serine (DOPS) lipid nanovesicles. SapC-DOPS has a high fusogenic affinity for phosphatidylserine-enriched microdomains on surfaces of target cell membranes. Incorporation of a far-red fluorophore, CellVue Maroon (CVM), into the nanovesicles allows for in vivo non-invasive visualization of the agent in targeted tissue. Given that phosphatidylserine is present only on the inner leaflet of healthy plasma membranes but is "flipped" to the outer leaflet upon cell damage, we hypothesized that SapC-DOPS would target tissue damage associated with inflammatory arthritis due to local surface-exposure of phosphatidylserine. Optical imaging with SapC-DOPS-CVM in two distinct models of arthritis, serum-transfer arthritis (e.g., K/BxN) and collagen-induced arthritis (CIA) revealed robust SapC-DOPS-CVM specific localization to arthritic paws and joints in live animals. Importantly, intensity of localized fluorescent signal correlated with macroscopic arthritic disease severity and increased with disease progression. Flow cytometry of cells extracted from arthritic joints demonstrated that SapC-DOPS-CVM localized to an average of 7-8% of total joint cells and primarily to CD11b+Gr-1+ cells. Results from the current studies strongly support the application of SapC-DOPS-CVM for advanced clinical and research applications including: detecting early arthritis onset, assessing disease progression real-time in live subjects, and providing novel information regarding cell types that may mediate arthritis progression within joints.

Qi X; Flick MJ; Frederick M; Chu Z; Mason R; DeLay M; Thornton S

2012-01-01

340

Defective Gp130-Mediated Signal Transducer and Activator of Transcription (Stat) Signaling Results in Degenerative Joint Disease, Gastrointestinal Ulceration, and Failure of Uterine Implantation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The receptor subunit gp130 transduces multiple cell type–specific activities of the leukemia inhibitory factor (LIF)/interleukin (IL)-6 family of cytokines through the signal transducer and activator of transcription (STAT) and src homology 2 domain–bearing protein tyrosine phosphatase (SHP)-2/ras/E...

Ernst, Matthias; Inglese, Melissa; Waring, Paul; Campbell, Ian K.; Bao, Shisan; Clay, Fiona J.; Alexander, Warren S.

 
 
 
 
341

New pyrimidine-4,6-dicarboxamide derivatives, are selective collagenase inhibitors useful e.g. for treating degenerative joint diseases, connective tissue disorders or cancer  

UK PubMed Central (United Kingdom)

Pyrimidine-4,6-dicarboxylic acid 4-benzylamide 6-(substituted alkyl)-amide compounds (I) are new. Pyrimidine derivatives of formula (I) (including all stereoisomeric forms and their mixtures in any ratio) and their salts are new. R1 = H or alkyl R2 = alkyl, substituted by 1-3 groups R2a R2a = aryloxyalkyl -R-N(R8)-COO-alkyl -CONR9R10 aryl substituted by 1-3 groups R2b -CO-NR8-R-Ar'' -CO-NR8-R-Het' -NH-Ar'' or -NH-Het'' R = direct bond or alkylene R8 = H, alkyl (optionally substituted (os) by 1-3 of NH2, CN, OH, COOH, alkoxycarbonyl, CONHOH, NO2 or halo) or OH R9, R10 = H or alkyl or NR9R10 = 5-7 membered saturated ring, optionally containing 1 or 2 additional O, S, NH or N(alkyl) heteroatom(s) R2b = -R-COOR8, -R-CONR9R10, -R-CONHCN, -R-CO-R-Het, -R-CO-R-OH, -O-R-CONR9R10, -S(O)y-alkylene-COOR8, -S(O)z-alkylene-CONR9R10, -R-CO-NR8-R-NR9R10, -R-CO-NR8-R-Het, -R-CO-NR8-R-Ar, -R-NR9R10, -(CH2)y-NR8-CO-Alk, -R'-NR8-CO-R-Ar, -R'-NR8-CO-R-Het, -R'-NR8-CO-O-Alk', -R'-NR8-CO-O-R-Ar, -R'-NR8-CO-O-R-Het, -R'-NR8-CO-R-NR11R12, -R'-NR8-SO2-R-Ar, -R'-NR8-SO2-R-Het, -R'-NR8-SO2-NR8-Alk, -R'-NR8-SO2-NR8-R-Ar, -R'-NR8-SO2-NR8-R-Het, -R'-NR8-CO-NR8-SO2-R13, -R'-SO2-NR8-R-Ar, -R'-SO2-NR8-R-Het, -R'-SO2-NR8-R-Alk, -R'-SO2-R-Ar, -R'-SO2-R-Het, -O-R-Het, -R'-Het or phenyl (os by 1-3 of halo, alkyl, alkoxy or SO2R16) Het = saturated or unsaturated, mono- or bicyclic, 3-10 membered heterocyclic ring system, containing 1-3 of N, O and/or S as heteroatom(s)and os by 1-3 groups Q Q = halo, CN, NO2, OH, NH2, alkoxycarbonyl, COOH, alkyl (os by 1-3 halo), alkoxy (os by 1-3 of halo or NR9R10), =O, Het, alkenyl (os by 1-3 of halo or NR9R10) or alkynyl (os by 1-3 of halo or NR9R10) y = 1 or 2 z = 0-2 Ar = aryl (os by 1-3 groups Q) Alk = alkyl (os by 1-3 groups Q) R' = direct bond or 1-4C alkylene Alk' = alkyl, alkenyl or alkynyl (all os by 1-3 groups Q) R11, R12 = H, alkyl, -R-Ar, -R-Het, -CO-Alk, -CO-Cyc, -CO-R-Ar, -CO-R-Het, -SO2-Alk, -NH-SO2-Alk, -SO2-R-Ar, -SO2-R-Ar'-alkyl or -SO2-R-Het Cyc = 3-6C cycloalkyl (os by 1-3 groups Q) Ar' = arylene (os by 1-3 groups Q) R13 = alkyl, aryl or arylalkyl R16 = alkyl or NH2 Ar'' = aryl (os by 1-3 of R2b or Q) R3 - R7 = H, halo, alkyl (os by 1-3 halo), alkoxy (os by 1-3 halo) or alkylthio or R4 + R5 or R5 + R6 = group completing a 5- or 6-membered saturated or aromatic ring, optionally containing 1 or 2 N, O and/or S heteroatom(s) and os by 1 or 2 halo or alternatively R2' = alkyl substituted by 1-3 groups R2c R2c = -COOR'8 -alkylene-OR'8 aryl substituted by 1-3 groups R2d or Het'' R'8 = H or alkyl R2d = -(2-6C) alkylene-COOR'8, -O-alkylene-COOR'8, -NR14R15, -(CH2)k-NR9R10, -O-(2-6C) alkylene-NR9R10, -NR'8-CO-alkyl (os in the alkyl by 1-3 of halo, CN, NO2, OH, NH2, alkoxycarbonyl or COOH) or phenyl (os by 1-3 of halo, alkyl, alkoxy or SO2R16) Het'' = as for Het, but where the optional substituents are selected from halo, CN, NO2, OH, NH2, alkylcarbony, COOH, alkyl (os by 1-3 halo), alkoxy (os by 1-3 halo), pyridyl or phenyl (os by one or more of halo, alkoxy and alkyl) R3, R7 and the other of R4 and R6 = H (provided that an unsubstituted benzo-(1,3)-dioxole ring is excluded). Unless specified otherwise alkyl or alkylene moieties have 1-6C, alkenyl or alkynyl moieties 2-6C and aryl or arylene moieties 6-14C. An Independent claim is included for the preparation of (I).

KLINGLER OTMAR; KIRSCH REINHARD; HABERMANN JOERG; WEITHMANN KLAUS-ULRICH; ENGEL CHRISTIAN; PIRARD BERNARD

342

Deficiency of Nrf2 accelerates the effector phase of arthritis and aggravates joint disease.  

UK PubMed Central (United Kingdom)

AIMS: Although oxidative stress participates in the etiopathogenesis of rheumatoid arthritis, its importance in this inflammatory disease has not been fully elucidated. In this study, we analyzed the relevance of the transcription factor Nrf2, master regulator of redox homeostasis, in the effector phase of an animal model of rheumatoid arthritis, using the transfer of serum from K/BxN transgenic mice to Nrf2(-/-) mice. RESULTS: Nrf2 deficiency accelerated the incidence of arthritis, and animals showed a widespread disease affecting both front and hind paws. Therefore, the inflammatory response was enhanced, with increased migration of leukocytes and joint destruction in front paws. We observed an increased production of tumor necrosis factor-?, interleukin-6, and CXCL-1 in the joint, with small changes in eicosanoid levels. Serum levels of CXCL-1 and receptor activator for nuclear factor ?B ligand were enhanced and osteocalcin decreased in arthritic Nrf2(-/-) mice. The expression of cyclooxygenase-2, inducible nitric oxide synthase, and peroxynitrite in the joints was higher in Nrf2 deficiency, whereas heme oxygenase-1 was downregulated. Innovation: Nrf2 may be a therapeutic target for arthritis. CONCLUSION: Our results support a protective role of Nrf2 against joint inflammation and degeneration in arthritis.

Maicas N; Ferrándiz ML; Brines R; Ibáñez L; Cuadrado A; Koenders MI; van den Berg WB; Alcaraz MJ

2011-08-01

343

C-reactive protein in degenerative aortic valve stenosis  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Degenerative aortic valve stenosis includes a range of disorder severity from mild leaflet thickening without valve obstruction, "aortic sclerosis", to severe calcified aortic stenosis. It is a slowly progressive active process of valve modification similar to atherosclerosis for cardiovascular risk factors, lipoprotein deposition, chronic inflammation, and calcification. Systemic signs of inflammation, as wall and serum C-reactive protein, similar to those found in atherosclerosis, are present in patients with degenerative aortic valve stenosis and may be expression of a common disease, useful in monitoring of stenosis progression.

Sanchez Pedro L; Mazzone AnnaMaria

2006-01-01

344

Roentgenological assessment of diaphragm functional state in case of degenerative dystrophic injuries of the skeleton  

International Nuclear Information System (INIS)

The results of complex clinicoroengenological investigations of patients with degenerative dystrophic injuries of the backbone are presented. It is shown that the conditions of functioning of the inspiratory muscle group greatly change in the case of this pathology. The most typical picture is observed during the disease exacerbation when costovertebral and costotrasverse joints were drawn into the process. The greater increase of the motion amplitude corresponding to a half of the diagram was revealed in the presence of a considerably more pronounced osteoarthosis phenomena from any side. The necessity is shown to take into account in the case of osteochondrosis of the cervical and thoracal spinal sections the reconstruction of respiration mechanisms takes place.

1989-01-01

345

The radiographic distinction of degenerative slippage (spondylolisthesis and retrolisthesis) from traumatic slippage of the cervical spine  

International Nuclear Information System (INIS)

In a review of 42 cases of degenerative arthritis of the cervical spine and 22 cases of cervical spine trauma with an observed anterior slip-page (spondylolisthesis) or posterior slippage (retrolisthesis) of the vertebral bodies of 2 mm or more, characteristic features were observed which allowed distinction between degenerative and traumatic slippage of the cervical spine. In degenerative slippage the shape of the articular facets and width of the facet joint space may remain normal; however, in most cases the articular facets become 'ground-down' with narrowing of the facet joint space and the articular facets themselves becoming thinned or ribbon-like. In traumatic slippage the articular facets will either be normally shaped or fractured and the facet joint space will be abnormally widened. Plain radiographs will usually allow this distinction to be made; however, in difficult cases polytomography may be required. (orig.)

1986-01-01

346

Radiographic distinction of degenerative slippage (spondylolisthesis and retrolisthesis) from traumatic slippage of the cervical spine  

Energy Technology Data Exchange (ETDEWEB)

In a review of 42 cases of degenerative arthritis of the cervical spine and 22 cases of cervical spine trauma with an observed anterior slip-page (spondylolisthesis) or posterior slippage (retrolisthesis) of the vertebral bodies of 2 mm or more, characteristic features were observed which allowed distinction between degenerative and traumatic slippage of the cervical spine. In degenerative slippage the shape of the articular facets and width of the facet joint space may remain normal; however, in most cases the articular facets become 'ground-down' with narrowing of the facet joint space and the articular facets themselves becoming thinned or ribbon-like. In traumatic slippage the articular facets will either be normally shaped or fractured and the facet joint space will be abnormally widened.