WorldWideScience
 
 
1

Peripheral degenerative joint diseases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 syn...

Nilzio Antonio da Silva; Silva Montandon, Ana Carolina Oliveira E.; Michelle Vasconcelos da Silva Prado Cabral

2008-01-01

2

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 idiopathicand 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

2008-03-01

3

Radiographic evaluation of degenerative joint disease in horses: interpretive principles  

International Nuclear Information System (INIS)

Degenerative joint disease in horses is characterized by the progressive deterioration of articular cartilage of synovial joints. The morbidity associated with degenerative joint disease, particularly the loss of function in pleasure and performance horses, costs horse owners millions of dollars each year. Although new drugs, such as polysulfated glycosaminoglycans and hyaluronic acid, are available for the treatment of patients with degenerative joint disease, the success of therapy depends on early diagnosis. Diagnostic imaging strategies, therefore, should focus on accurate and timely diagnosis of degenerative joint disease to provide prompt therapy. Early identification of degenerative joint disease is also beneficial because the use and/or training methods of affected patients may be altered, possibly limiting the progression of the disease. The pathogenesis of degenerative joint disease is complex and multifactorial. Current evidence suggests that initiating factors lead to a final common pathway-breakdown of articular cartilage. There are many diagnostic tests that aid practitioners in detecting degenerative joint disease; however, the most important imaging technique is radiography. During the early stages of the disease, radiographic changes may be slight; therefore, it is essential that practitioners have adequate equipment to obtain high-quality radiographs. Thinning of the joint space, osteophytosis, enthesopathy, changes in subchondral bone, and increased synovium and synovia provide radiographic evidence of degenerative joint disease. By understanding the pathophysiology of the disease and how technical alterations affect the subtle radiographic changes, practitioners can more accurately diagnose degenerative joint disease during its early stages and institute proper therapy

4

Chronic repetitive trauma: A cause of atypical degenerative joint disease  

International Nuclear Information System (INIS)

Six cases of amateur athletes who have severe atypical degenerative joint disease (DJD) are presented; their histories suggest that chronic, repetitive trauma was causative in the development of their arthorpathy. Although many examples of this process have been reported in professional athletes, it has not been reported in amateurs. As participation in athletic activities increases we can, perhaps, expect to see more of this type of DJD in the future. (orig.)

5

Long term results of radiotherapy of degenerative joint diseases  

International Nuclear Information System (INIS)

At the Radiologic Department of the Staedt. Krankenhaus Passau, 473 patients with degenerative diseases in the big joints and the spine were irradiated with the caesium unit between 1971 and 1979. Among these patients, 249 could be followed up during a prolonged period (1/2 to 9 years, i.e. 4.2 years on an average). According to the categories of v. Pannewitz, 11% were pain-free at this moment, 21% showed an essential improvement, 29% showed an improvement, and 39% were not influenced by the treatment. 13.5% showed recurrent pains; these were mentioned as 'not influenced' in the statistical analysis. It is proved that the relief of pain does not depend on the age of the patients, but on the anamnesis period, the results of the X-ray examiantion, and the degree of the restriction of mobility. Due to the delay of irradiation, a preliminary treatment mostly produces a less favorable radiotherapeutic result. Compared with other therapeutic methods, the long term results of radiotherapy of degenerative joint diseases are generally favorable. This conclusion is also confirmed by the results of patients checked up more than five years after the treatment. (orig.)

6

Long term results of radiotherapy of degenerative joint diseases  

Energy Technology Data Exchange (ETDEWEB)

At the Radiologic Department of the Staedt. Krankenhaus Passau, 473 patients with degenerative diseases in the big joints and the spine were irradiated with the caesium unit between 1971 and 1979. Among these patients, 249 could be followed up during a prolonged period (1/2 to 9 years, i.e. 4.2 years on an average). According to the categories of v. Pannewitz, 11% were pain-free at this moment, 21% showed an essential improvement, 29% showed an improvement, and 39% were not influenced by the treatment. 13.5% showed recurrent pains; these were mentioned as 'not influenced' in the statistical analysis. It is proved that the relief of pain does not depend on the age of the patients, but on the anamnesis period, the results of the X-ray examiantion, and the degree of the restriction of mobility. Due to the delay of irradiation, a preliminary treatment mostly produces a less favorable radiotherapeutic result. Compared with other therapeutic methods, the long term results of radiotherapy of degenerative joint diseases are generally favorable. This conclusion is also confirmed by the results of patients checked up more than five years after the treatment.

Lindner, H.; Freislederer, R.

1982-04-01

7

The Degenerative Joint Disease – Morphological Aspects in the Wild Boar  

Directory of Open Access Journals (Sweden)

Full Text Available The aim of the study was to outline some data about the morphology of the pathological wild boar articular cartilage. The study was carried out on articular cartilage samples from wild boar femoral head and condyles, 1 - 10 years old. The samples were processed and stained by usual histological techniques. The samples examination revealed different stages of articular cartilage injury and various morphological aspects that suggest the degenerative joint disease (DJD occurrence. The chondrocyte clones, the extracellular matrix alteration, the cartilage fissures, the cartilage erosions and the subchondral bone exposure were the observed morphopathological aspects. These aspects are the specific pathological lesions for DJD, as described in the specialized literature for other species.

Liliana C?rpini?an

2010-05-01

8

Regenerative therapies for equine degenerative joint disease: a preliminary study.  

Science.gov (United States)

Degenerative joint disease (DJD) is a major cause of reduced athletic function and retirement in equine performers. For this reason, regenerative therapies for DJD have gained increasing interest. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) were isolated from a 6-year-old donor horse. MSCs were either used in their native state or after chondrogenic induction. In an initial study, 20 horses with naturally occurring DJD in the fetlock joint were divided in 4 groups and injected with the following: 1) PRP; 2) MSCs; 3) MSCs and PRP; or 4) chondrogenic induced MSCs and PRP. The horses were then evaluated by means of a clinical scoring system after 6 weeks (T1), 12 weeks (T2), 6 months (T3) and 12 months (T4) post injection. In a second study, 30 horses with the same medical background were randomly assigned to one of the two combination therapies and evaluated at T1. The protein expression profile of native MSCs was found to be negative for major histocompatibility (MHC) II and p63, low in MHC I and positive for Ki67, collagen type II (Col II) and Vimentin. Chondrogenic induction resulted in increased mRNA expression of aggrecan, Col II and cartilage oligomeric matrix protein (COMP) as well as in increased protein expression of p63 and glycosaminoglycan, but in decreased protein expression of Ki67. The combined use of PRP and MSCs significantly improved the functionality and sustainability of damaged joints from 6 weeks until 12 months after treatment, compared to PRP treatment alone. The highest short-term clinical evolution scores were obtained with chondrogenic induced MSCs and PRP. This study reports successful in vitro chondrogenic induction of equine MSCs. In vivo application of (induced) MSCs together with PRP in horses suffering from DJD in the fetlock joint resulted in a significant clinical improvement until 12 months after treatment. PMID:24465787

Broeckx, Sarah; Zimmerman, Marieke; Crocetti, Sara; Suls, Marc; Mariën, Tom; Ferguson, Stephen J; Chiers, Koen; Duchateau, Luc; Franco-Obregón, Alfredo; Wuertz, Karin; Spaas, Jan H

2014-01-01

9

Regenerative Therapies for Equine Degenerative Joint Disease: A Preliminary Study  

Science.gov (United States)

Degenerative joint disease (DJD) is a major cause of reduced athletic function and retirement in equine performers. For this reason, regenerative therapies for DJD have gained increasing interest. Platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) were isolated from a 6-year-old donor horse. MSCs were either used in their native state or after chondrogenic induction. In an initial study, 20 horses with naturally occurring DJD in the fetlock joint were divided in 4 groups and injected with the following: 1) PRP; 2) MSCs; 3) MSCs and PRP; or 4) chondrogenic induced MSCs and PRP. The horses were then evaluated by means of a clinical scoring system after 6 weeks (T1), 12 weeks (T2), 6 months (T3) and 12 months (T4) post injection. In a second study, 30 horses with the same medical background were randomly assigned to one of the two combination therapies and evaluated at T1. The protein expression profile of native MSCs was found to be negative for major histocompatibility (MHC) II and p63, low in MHC I and positive for Ki67, collagen type II (Col II) and Vimentin. Chondrogenic induction resulted in increased mRNA expression of aggrecan, Col II and cartilage oligomeric matrix protein (COMP) as well as in increased protein expression of p63 and glycosaminoglycan, but in decreased protein expression of Ki67. The combined use of PRP and MSCs significantly improved the functionality and sustainability of damaged joints from 6 weeks until 12 months after treatment, compared to PRP treatment alone. The highest short-term clinical evolution scores were obtained with chondrogenic induced MSCs and PRP. This study reports successful in vitro chondrogenic induction of equine MSCs. In vivo application of (induced) MSCs together with PRP in horses suffering from DJD in the fetlock joint resulted in a significant clinical improvement until 12 months after treatment. PMID:24465787

Broeckx, Sarah; Zimmerman, Marieke; Crocetti, Sara; Suls, Marc; Marien, Tom; Ferguson, Stephen J.; Chiers, Koen; Duchateau, Luc; Franco-Obregon, Alfredo

2014-01-01

10

Pedicle marrow signal intensity changes in the lumbar spine: a manifestation of facet degenerative joint disease  

International Nuclear Information System (INIS)

Objective. Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI. The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease.Design. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease.Results. Five percent (46/890) of lumbar pedicles in 23 patients had marrow signal intensity changes. Ninety-one percent (42/46) of the abnormal pedicles had adjacent degenerative joint disease of the facets, while only 21% (189/890) of normal pedicles had adjacent facet degenerative joint disease (p<0.001). Eighty-nine percent (41/46) of the pedicles with marrow signal intensity changes had adjacent degenerative disc disease.Conclusions. Pedicle marrow signal intensity changes are not a specific sign of spondylolysis; they are commonly seen with adjacent facet degenerative joint disease in the absence of spondylolysis. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment. (orig.)

11

Pedicle marrow signal intensity changes in the lumbar spine: a manifestation of facet degenerative joint disease  

Energy Technology Data Exchange (ETDEWEB)

Objective. Signal intensity changes in lumbar pedicles, similar to those described in vertebral body endplates adjacent to degenerated discs, have been described as an ancillary sign of spondylolysis on MRI. The purpose of this study was to determine whether pedicle marrow signal intensity changes also occur in association with facet degenerative joint disease.Design. Eighty-nine lumbar spine MRI examinations without spondylolysis were reviewed for marrow signal intensity changes in pedicles and vertebral bodies as well as for facet degenerative joint disease.Results. Five percent (46/890) of lumbar pedicles in 23 patients had marrow signal intensity changes. Ninety-one percent (42/46) of the abnormal pedicles had adjacent degenerative joint disease of the facets, while only 21% (189/890) of normal pedicles had adjacent facet degenerative joint disease (p<0.001). Eighty-nine percent (41/46) of the pedicles with marrow signal intensity changes had adjacent degenerative disc disease.Conclusions. Pedicle marrow signal intensity changes are not a specific sign of spondylolysis; they are commonly seen with adjacent facet degenerative joint disease in the absence of spondylolysis. Pedicle marrow signal intensity changes are probably a response to abnormal stresses related to abnormal motion or loading caused by the degenerative changes in the spinal segment. (orig.)

Morrison, J.L.; Kaplan, P.A.; Dussault, R.G.; Anderson, M.W. [Dept. of Radiology, Univ. of Virginia Health System, Charlottesville, VA (United States)

2000-12-01

12

Biomechanical implications of degenerative joint disease in the apophyseal joints of human thoracic and lumbar vertebrae.  

Science.gov (United States)

An experimental technique for quantifying load-sharing in cadaveric spines is used to test the hypothesis that degenerative changes in human apophyseal joints are directly related to high levels of compressive load-bearing by these joints. About 36 cadaveric thoraco-lumbar motion segments aged 64-92 years were subjected to a compressive load of 1.5 kN. The distribution of compressive stress was measured in the intervertebral discs using a miniature pressure transducer, and stress measurements were summed over area to give the compressive force resisted by the disc. This was subtracted from the applied 1.5 kN to indicate compressive load-bearing by the apophyseal joints. The cartilage of each apophyseal joint surface was then graded for degree of degeneration. After maceration, each joint surface was scored for degenerative joint disease (DJD) affecting the bone. Results demonstrated that the apophyseal joints resisted 5-96% (mean 45%) of the applied compressive force. A significant positive correlation was demonstrated between age and cartilage degeneration, age and DJD bone score, apophyseal joint load-bearing and bone score, and cartilage score and load-bearing. The latter correlation was strongest for load-bearing above 50%. Ordinal regression showed that the variables describing bone DJD (marginal osteophytes, pitting, bony contour change, and eburnation) were significantly correlated with degree of cartilage degeneration. It is concluded that in elderly individuals apophyseal joint load-bearing above a threshold of 50% is associated with severe degenerative changes in cartilage and bone, and that markers of DJD observed palaeopathologically may be used as predictors of such loadingin life. PMID:18324643

Brown, Kate Robson; Pollintine, Phill; Adams, Mike A

2008-07-01

13

Pathology of articular cartilage and synovial membrane from elbow joints with and without degenerative joint disease in domestic cats.  

Science.gov (United States)

The elbow joint is one of the feline appendicular joints most commonly and severely affected by degenerative joint disease. The macroscopic and histopathological lesions of the elbow joints of 30 adult cats were evaluated immediately after euthanasia. Macroscopic evidence of degenerative joint disease was found in 22 of 30 cats (39 elbow joints) (73.33% cats; 65% elbow joints), and macroscopic cartilage erosion ranged from mild fibrillation to complete ulceration of the hyaline cartilage with exposure of the subchondral bone. Distribution of the lesions in the cartilage indicated the presence of medial compartment joint disease (most severe lesions located in the medial coronoid process of the ulna and medial humeral epicondyle). Synovitis scores were mild overall and correlated only weakly with macroscopic cartilage damage. Intra-articular osteochondral fragments either free or attached to the synovium were found in 10 joints. Macroscopic or histologic evidence of a fragmented coronoid process was not found even in those cases with intra-articular osteochondral fragments. Lesions observed in these animals are most consistent with synovial osteochondromatosis secondary to degenerative joint disease. The pathogenesis for the medial compartmentalization of these lesions has not been established, but a fragmented medial coronoid process or osteochondritis dissecans does not appear to play a role. PMID:24476939

Freire, M; Meuten, D; Lascelles, D

2014-09-01

14

MRI features of cervical articular process degenerative joint disease in Great Dane dogs with cervical spondylomyelopathy.  

Science.gov (United States)

Cervical spondylomyelopathy or Wobbler syndrome commonly affects the cervical vertebral column of Great Dane dogs. Degenerative changes affecting the articular process joints are a frequent finding in these patients; however, the correlation between these changes and other features of cervical spondylomyelopathy are uncertain. We described and graded the degenerative changes evident in the cervical articular process joints from 13 Great Danes dogs with cervical spondylomyelopathy using MR imaging, and evaluated the relationship between individual features of cervical articular process joint degeneration and the presence of spinal cord compression, vertebral foraminal stenosis, intramedullary spinal cord changes, and intervertebral disc degenerative changes. Degenerative changes affecting the articular process joints were common, with only 13 of 94 (14%) having no degenerative changes. The most severe changes were evident between C4-C5 and C7-T1 intervertebral spaces. Reduction or loss of the hyperintense synovial fluid signal on T2-weighted MR images was the most frequent feature associated with articular process joint degenerative changes. Degenerative changes of the articular process joints affecting the synovial fluid or articular surface, or causing lateral hypertrophic tissue, were positively correlated with lateral spinal cord compression and vertebral foraminal stenosis. Dorsal hypertrophic tissue was positively correlated with dorsal spinal cord compression. Disc-associated spinal cord compression was recognized less frequently. PMID:22236021

Gutierrez-Quintana, Rodrigo; Penderis, Jacques

2012-01-01

15

Segment-specific association between cervical pillar hyperplasia (CPH and 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 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.

Peterson Cynthia K

2006-09-01

16

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

Science.gov (United States)

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

17

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

Directory of Open Access Journals (Sweden)

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

2012-01-01

18

Evaluation of risk factors for degenerative joint disease associated with hip dysplasia in dogs  

International Nuclear Information System (INIS)

Passive coxofemoral joint laxity of dogs, as quantitated by a distraction-stress radiographic method, may have important prognostic value in determining susceptibility to hip dysplasia. Data from 151 dogs, representing 13 breeds, were included in a logistic regression model to evaluate the contribution of factors such as age, breed, weight, sex, distraction index, and Norberg angle to the risk of developing degenerative joint disease (DJD) of the coxofemoral joint. Of the factors studied, the amount of passive hip laxity, as quantitated by the distraction index, was the most significant (P < 0.0001) determinant of the risk to develop DJD of the coxofemoral joint. In the longitudinal and cross-sectional components of the study, distraction index was a significant (P < 0.001) risk factor for DJD, irrespective of age at evaluation (4, 12, or 24 months). The strength of the hip laxity:DJD correlation increased with the age of dog. In contrast, the Norberg angle, a measure of hip laxity on the standard hip-extended radiograph, was not found to be a significant risk factor for DJD, either in the longitudinal or cross-sectional analyses. Breed-specific probability curves of DJD susceptibility indicated that German Shepherd Dogs had a significantly (P < 0.05) greater risk of developing DJD than did the pool of non-German Shepherd Dogs. The information derived from this statistical model will help to scientifically characterize the role of passive hip laxity as a component in the pathogenesis of DJD of the coxofemoral joint

19

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

International Nuclear Information System (INIS)

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

20

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

Energy Technology Data Exchange (ETDEWEB)

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.

Lee, Shi-Uk; Lang, Philipp E-mail: phil.lang@stanford.edu

2000-08-01

 
 
 
 
21

Imaging of bone spavin. A radiographic and scintigraphic study of degenerative joint disease in the distal tarsus in Icelandic horses  

International Nuclear Information System (INIS)

Radiography and scintigraphy are commonly used for the diagnosis of skeletal disorders in horses. Icelandic Horses have a high prevalence of degenerative joint disease of the distal tarsus, generally known as bone spavin (BS). The purpose of this study was to evaluate and develop the use of radiography and scintigraphy for the detection of BS in Icelandic Horses

22

Allogenic mesenchymal stem cells as a treatment for equine degenerative joint disease: a pilot study.  

Science.gov (United States)

Cell-based therapies, such as treatments with mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) are thought to have beneficial effects on the clinical outcome of orthopedic injuries, but very few animal studies with large sample size are published so far. Therefore, the aim of this study was to assess the safety and report the clinical outcome of allogenic, immature or chondrogenic induced MSCs in combination with PRP for the treatment of degenerative joint disease (DJD) in 165 horses. MSCs and PRP were isolated from a 6-year-old donor horse and transplanted either in their native state or after chondrogenic induction in combination with PRP into degenerated stifle (n=30), fetlock (n=58), pastern (n=34) and coffin (n=43) joints. Safety was assessed by means of clinical evaluation and the outcome was defined as failure to return to work (score 0), rehabilitation (score 1), return to work (score 2) and return to previous level (score 3), shortly (6 weeks) after treatment or at 18 weeks for the patients that returned for long-term follow-up (n=91). No adverse effects were noticed, except for three patients who showed a moderate flare reaction within one week after treatment of the fetlock joint without long-term effects (1.8% of 165 horses). Already after 6 weeks, 45% (native MSCs) and 60% (chondrogenic induced MSCs) of the treated patients returned to work (? score 2+3) and the beneficial effects of the treatment further increased after 18 weeks (78% for native MSCs and 86% for chondrogenic induced MSCs). With the odds ratio of 1.47 for short-term and 1.24 for long-term, higher average scores (but statistically not significant) could be noticed using chondrogenic induced MSCs as compared to native MSCs. For all three lower limb joints a higher percentage of the treated patients returned to work after chondrogenic induced MSC treatment, whereas the opposite trend could be noticed for stifle joints. Nevertheless, more protracted follow-up data should confirm the sustainability of these joints. PMID:25175766

Broeckx, Sarah; Suls, Marc; Beerts, Charlotte; Vandenberghe, Aurelie; Seys, Bert; Wuertz-Kozak, Karin; Duchateau, Luc; Spaas, Jan H

2014-01-01

23

Influence of spinal degenerative joint disease on BMD measurement by QCT and DXA  

International Nuclear Information System (INIS)

Objective: To assess the impact of spinal degenerative joint disease (DJD) changes on bone mineral density (BMD) measured by quantitative CT (QCT) and dual X-ray absorptiometry (DXA) in a group of relative old population. Methods: Lateral (T4-L4) and anterior posterior (L1-L4) spinal radiographs in 201 subjects were reviewed for evaluation of fracture and DJD. The subjects ranged in age from 45-80 years (mean age 59.6 +- 0.8 years). Exclusion criteria included history of any bone disease or condition know to affect bone metabolism. The severity of DJD was graded as 0, 1 or 2 on the spinal lumbar film, except for DJD with vertebral osteophytes which was graded from 0 to 3. Twenty-five out of the 201 subjects were diagnosed with vertebral fractures by visual inspection using the semiquantitative method. Spinal BMD was measured by both QCT and DXA, including posteroanterior DXA (PA-DXA), lateral DXA (L-DXA), and mid lateral DXA (ML-DXA). Results: There were no significant differences in BMD measured by QCT in the 176 non-fractured subjects with and without DJD (P > 0.05). BMD measured by PA-DXA was significantly higher in subjects with DJD changes than those without, particularly when osteophytes were presented at the vertebral bodies and facet joints (P 0.05). Conclusion: QCT is JD changes (P > 0.05). Conclusion: QCT is superior to PA-DXA, L-DXA, and ML-DXA in detecting bone loss in patients with DJD. For subjects with severe DJD, BMD assessment using QCT may be advisable

24

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)

25

Clinical cases of joint disease in horse. Total glycosaminoglycans sulphate and keratansulphate in synovial fluid as markers of degenerative cartilage processes  

International Nuclear Information System (INIS)

Total glycosaminoglycans sulphate (GAGs) and keratan sulphate (KS) were measured in synovial fluid (SF) obtained from 28 horses with different joint diseases (degenerative joint disease (DJD), osteochondrosis (OCD), positivity to Flex Test (FT)) and 15 horses without any clinical sign of lameness. All groups of animals with joint disease showed levels of total GAGs significantly higher (P0.001) than normal. On the contrary, only DJD affected joints showed a significantly (P0.01) higher level of KS

26

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

Energy Technology Data Exchange (ETDEWEB)

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

27

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

International Nuclear Information System (INIS)

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

28

Chondroitin sulfate and sodium hialuronate in treatment of the degenerative joint disease in dogs. Clinical and radiological aspects  

International Nuclear Information System (INIS)

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

29

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

Directory of Open Access Journals (Sweden)

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

2012-05-01

30

Lateral meniscus allograft biologic glenoid arthroplasty in total shoulder arthroplasty for young shoulders with degenerative joint disease.  

Science.gov (United States)

To avoid potential polyethylene problems in younger shoulders with degenerative joint disease (DJD) requiring arthroplasty, lateral meniscus allograft (LMA) was used as a biologic resurfacing of the glenoid. We report preliminary, short-term results of this technique in a younger, higher-demand population. The shoulders of 20 men and 10 women, with an average age of 42 years (range, 18 to 52 years), underwent total shoulder arthroplasty with a LMA. A metallic prosthesis was used on the humerus. Etiology of the DJD was osteoarthritis in 16, postinstability surgery in 8, traumatic in 4, and failed open reduction with internal fixation in 2. Twenty-two (73%) had previous shoulder surgery. Preoperative average scores were American Shoulder and Elbow Surgeons (ASES), 38; Simple Shoulder Test (SST), 3.3; and Visual Analogue Scale (VAS), 6.4. The average active forward elevation was 96 degrees and external rotation was 26 degrees . Average follow-up was 18 months (range, 12 to 48 months). Postoperative average scores were ASES, 69; SST, 7.8; and VAS, 2.3. Active forward elevation was 139 degrees and external rotation was 53 degrees . All were significant improvements (P < .02). Most (94%) would have the surgery again. Radiologic evaluation at 1 year revealed an average joint space of 1.8 mm on anteroposterior views and 1.6 mm on axillary views. Five complications (17%) occurred within the first postoperative year, all of which required reoperation. Pain resulted in 2 conversions to a polyethylene glenoid. Polyethylene glenoids in young shoulders risk early failure. For young, high-demand shoulders with DJD requiring arthroplasty, the LMA shows promise. Most problems presented within the first year. Although not perfect, it provided significant pain relief, range-of-motion gains, and patient satisfaction without the risk of poly wear or loosening. Longer-term follow-up will be required to determine ultimate durability. PMID:17507244

Nicholson, Gregory P; Goldstein, Jordan L; Romeo, Anthony A; Cole, Brian J; Hayden, Jennifer K; Twigg, Stacy L; McCarty, L Pearce; Detterline, Alvin J

2007-01-01

31

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 blood plasma by GC/ECD as the pentafluorobenzyl-ester derivative. 3. Total concentrations of diclofenac in synovial fluid (day 4) were significantly higher in the diclofenac gel treated knee than ...

Radermacher, J.; Jentsch, D.; Scholl, M. A.; Lustinetz, T.; Fro?lich, J. C.

1991-01-01

32

Relationship between degenerative joint disease and hip joint laxity by use of distraction index and Norberg angle measurement in a group of cats  

International Nuclear Information System (INIS)

Objective: To determine the relationship between degenerative joint disease (DJD) and passive laxity of the hip joint in a group of cats. Design: Prospective study. Animals: A select (nonrandomized) group of 78 cats. Procedure: Standard hip-extended radiographic views and compression and distraction views of the pelvis were obtained from cats during sedation. Radiographs were evaluated, using an Orthopedic Foundation for Animals (OFA)-like scoring system for dogs. Passive joint laxity was measured, using Norberg angle (NA) and distraction index (DI). Hip laxity in cats with DJD was compared with hip laxity in cats without DJD. Results: Hip dysplasia (HD) was subjectively diagnosed radiographically in 25 of 78 (32%) cats using the OFA-like scoring system. Nineteen cats had mild HD 4 had moderate HD, and 2 had severe HD. Fifteen of the 25 cats with HD had DJD. The NA ranged from 56 to 105. The mean NA in cats with DJD was (84 degrees) significantly lower than in cats without DJD (95 degrees). The DI ranged from 0.2 to 0.84. The mean DI for cats with DJD was (0.6) significantly higher than that for cats without DJD (0.49). Cats with a DI < 0.4 did not have DJD. Cats had an increased likelihood of having DJD with increased laxity in the coxofemoral joint, as measured by NA or DI. Clinical Implications: The mean NA for radiographically normal cats (92.4 degrees) was lower than that in radiographically normal dogs (103 degrees). The overall mean DI for cats in this group (0.51) is similar to dogs of breeds with high joint laxity, such as the Labrador Retriever (0.5). As in dogs, there is a relationship between DJD and laxity in the hip joint of cats

33

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

34

Arthroplasty of the first metatarsophalangeal joint with a double-stem silicone implant. Results in patients who have degenerative joint disease failure of previous operations, or rheumatoid arthritis.  

Science.gov (United States)

Sixty-six patients who had a total of eighty-six double-stem silicone implants in the first metatarsophalangeal joint were followed prospectively for an average of 5.8 years (range, two to fifteen years). There were two groups of patients: thirty-four patients (thirty-seven implants) who had degenerative joint disease (including those who had hallux rigidus or in whom a previous operation on a bunion had failed) and thirty-two patients (forty-nine implants) who had rheumatoid arthritis. The implants were used only if the patient was a candidate for an excisional arthroplasty or an arthrodesis; they were not used in patients who wished to maintain or adopt very active use of the foot (such as in running, jogging, and tennis) or to wear very high heels. Twenty-eight (82 per cent) of the thirty-four patients in the first group were completely satisfied and three (9 per cent) were somewhat satisfied. However, three patients (9 per cent), all of whom had had a failed bunionectomy, were dissatisfied; the ages of these three patients were less than the average age of all patients in the first group. Radiographs showed a fracture in three implants, but the patients had a good clinical result and an additional operation was not warranted. Twenty-seven (84 per cent) of the thirty-two patients in the second group were completely satisfied, four (13 per cent) were somewhat satisfied, and one (3 per cent) was dissatisfied. Radiographs showed a fracture in five implants. Four of the implants caused no symptoms, and the result was good; the fifth one was fragmented and was removed because of symptoms. Radiographs showed radiolucent areas around the implant and hypertrophic changes in many patients. There was no evidence of synovitis, such as that caused by silicone, either clinically or radiographically. We found that the double-stem silicone implant was effective in reconstructing the first metatarsophalangeal joint but emphasize our belief that it should be used only in carefully selected patients. PMID:1583050

Cracchiolo, A; Weltmer, J B; Lian, G; Dalseth, T; Dorey, F

1992-04-01

35

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)

36

Study of the lateral raise in foot wear for the management of medial compartment degenerative joint disease of knee  

International Nuclear Information System (INIS)

A wide spread disease, which may lead the patient to severe outcomes e.g. pain, loss of joint motion, inflexibility and even disability, is Knee osteoarthritis (OA). It is most common among adults of older age and should not be ignored at all. Literature does not show any clear pathogenesis for occurrence of Knee OA, but most of the indications point toward biomechanical stresses which may influence the articular cartilage and sub chondral bone. Objective: The Aim of this study is to become aware of the effects of physical therapy with and without laterally raised footwear in the management of medial knee osteoarthritis. Methodology: We have used experimental comparative study in 35 patients which were randomly selected from Department of Physiotherapy, Fatima Memorial Hospital, Shadman, Lahore. The study consisted of 2 groups, Group I (Experimental Group): In experimental group, patients were treated with laterally raised foot wear and physical therapy both. Group II (Control Group): Whereas in control group patients were treated by physical therapy alone. Kellgren and Lawrence (KL) scale was used to assess radiograph of the knee joints after an anteroposterior weight-bearing standing. The assessment of disease in patients was done by using the Western Ontario and McMaster Universities (WOMAC) Index, Muscle flexibility, Muscle strengthening and Tolerance scales. Results: In group-I the mean age of patients observed was 59.52+-13.66 years and 65+-12.87 years in Group-II. In Group-I, 9 (52.9%) patients were males and 8 (47.1%) patients were females while in Group-II, 9 patients (50%) were male and 9 (50%) were female. In Group-I 2 (11.8%) patients used flat and open shoes, 6 (35.3%) used flat and close shoe, 3 (17.6%) patients used dress shoes and 2 (11.8%) used flat shoes. In Group-I, the frequency of patients wearing laterally raised foot wear in terms of duration was; 5 (29.4%) patients for 20 days, 4 (23.5%) for 24 days, 4 (23.5%) for 25 days, whilst 2 patients used it for 26 and 30 days respectively. Among 10 (58.8%) patients the use of lateral raised foot wear was intermittent wile in 7 (41.2%) patients the use of lateral raised foot wear was continuous. Overall Group-I presented better results compared to Group-II in this study. Conclusion: We have concluded in our study that the physical therapy with laterally raised footwear is a successful treatment in the management of medial knee OA. In laterally raised footwear the physical therapy is an effective method in terms of relief of pain in patient, improvement in function by stiffness reduction and. this treatment method is recommended for the management of medial knee OA. (author)

37

Surgical removal of fragmented coronoid processes and fractured anconeal process in an older dog with evidence of severe degenerative joint disease  

International Nuclear Information System (INIS)

A 10-year-old Labrador Retriever was admitted because of severe unilateral (left) forelimb lameness of 6 weeks' duration. Computerized tomography revealed bilateral fragmented coronoid processes (FCP) and unilateral fracture of the anconeal process. Surgery on the left elbow to remove the loose anconeal process and FCP resolved the severe lameness and improved the dog's overall activity, compared with that of the preceding 2 years. Unstable FCP can develop late in life, and a degenerative anconeal process may fracture. Surgical removal of loose fragments in a severely arthritic joint may be beneficial

38

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.

Mauron Damien

2003-12-01

39

Denervação articular coxofemoral em cães com doença articular degenerativa secundária à displasia / Joint hip denervation in dogs with degenerative joint disease secondary to dysplasia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A técnica de denervação coxofemoral é realizada em cães displásicos, com o intuito de aliviar a dor. O objetivo deste trabalho foi avaliar alívio da dor, melhora da função articular, reabilitação muscular e progressão da instabilidade em 10 cães displásicos submetidos à técnica de denervação da arti [...] culação coxofemoral. A graduação da apresentação clínica foi realizada através de avaliações específicas da andadura, testes de estação bípede, de rotação com abdução externa e de iliopsoas. A reabilitação muscular foi avaliada através da circunferência da coxa e exame físico. A avaliação da instabilidade foi feita através de técnica radiográfica para índice de distração. Na graduação da claudicação e teste de estação bípede foi verificado que houve redução significante a partir de um mês pós-cirúrgico. Já nos testes de abdução com rotação externa, houve redução da dor a partir do sétimo dia pós-cirúrgico; no teste de iliopsoas houve redução significante da dor, em todos os tempos do pós-cirúrgico. Houve aumento significante da circunferência da coxa a partir do sétimo dia. Foi observado que 90% tiveram redução do índice de distração, refletindo melhora da instabilidade. A técnica é eficaz no alívio da dor, na reabilitação muscular após a melhora na capacidade de exercitar-se e na redução da instabilidade, sendo motivo de satisfação para os proprietários. Abstract in english The hip denervation technique has been performed in dysplasic dogs, demonstrating to be efficient in the relief of pain. The objective of this work was to evaluate pain relief, improvement of joint function, muscular rehabilitation and instability progression in 10 dysplasic dogs submitted to the hi [...] p joint denervation technique. The grading of the clinical presentation was performed according to specific evaluation of walking, biped station, rotation with external abduction, subluxation and iliopsoas. The muscular rehabilitation was evaluated through the circumference of the thigh and physical examination. The instability was evaluated through the values of distraction index (DI). In the claudication graduation and the biped station test, we verified that there was a significant reduction after one month post-surgery. In the abduction with external rotation tests, there was a reduction in pain after the seventh day; in the iliopsoas test there was a significant reduction in pain in all the post-surgery times. There was a significant increase in thigh circumference after the seventh day. We observed that 90% of the articulations had a reduction in their DI, reflecting an improvement of their instability. The technique is efficient in the relief of pain, muscular rehabilitation after the improvement of the ability to exercise, and in reduction of instability, being the cause of owner satisfaction.

Leandro Branco, Rocha; Eduardo Alberto, Tudury; Cláudio, Roehsig; Durval, Baraúna; Ricardo, Chioratto; Felipe Purcell, Araújo; Bernardo, Kemper.

2013-03-01

40

Denervação articular coxofemoral em cães com doença articular degenerativa secundária à displasia / Joint hip denervation in dogs with degenerative joint disease secondary to dysplasia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A técnica de denervação coxofemoral é realizada em cães displásicos, com o intuito de aliviar a dor. O objetivo deste trabalho foi avaliar alívio da dor, melhora da função articular, reabilitação muscular e progressão da instabilidade em 10 cães displásicos submetidos à técnica de denervação da arti [...] culação coxofemoral. A graduação da apresentação clínica foi realizada através de avaliações específicas da andadura, testes de estação bípede, de rotação com abdução externa e de iliopsoas. A reabilitação muscular foi avaliada através da circunferência da coxa e exame físico. A avaliação da instabilidade foi feita através de técnica radiográfica para índice de distração. Na graduação da claudicação e teste de estação bípede foi verificado que houve redução significante a partir de um mês pós-cirúrgico. Já nos testes de abdução com rotação externa, houve redução da dor a partir do sétimo dia pós-cirúrgico; no teste de iliopsoas houve redução significante da dor, em todos os tempos do pós-cirúrgico. Houve aumento significante da circunferência da coxa a partir do sétimo dia. Foi observado que 90% tiveram redução do índice de distração, refletindo melhora da instabilidade. A técnica é eficaz no alívio da dor, na reabilitação muscular após a melhora na capacidade de exercitar-se e na redução da instabilidade, sendo motivo de satisfação para os proprietários. Abstract in english The hip denervation technique has been performed in dysplasic dogs, demonstrating to be efficient in the relief of pain. The objective of this work was to evaluate pain relief, improvement of joint function, muscular rehabilitation and instability progression in 10 dysplasic dogs submitted to the hi [...] p joint denervation technique. The grading of the clinical presentation was performed according to specific evaluation of walking, biped station, rotation with external abduction, subluxation and iliopsoas. The muscular rehabilitation was evaluated through the circumference of the thigh and physical examination. The instability was evaluated through the values of distraction index (DI). In the claudication graduation and the biped station test, we verified that there was a significant reduction after one month post-surgery. In the abduction with external rotation tests, there was a reduction in pain after the seventh day; in the iliopsoas test there was a significant reduction in pain in all the post-surgery times. There was a significant increase in thigh circumference after the seventh day. We observed that 90% of the articulations had a reduction in their DI, reflecting an improvement of their instability. The technique is efficient in the relief of pain, muscular rehabilitation after the improvement of the ability to exercise, and in reduction of instability, being the cause of owner satisfaction.

Leandro Branco, Rocha; Eduardo Alberto, Tudury; Cláudio, Roehsig; Durval, Baraúna; Ricardo, Chioratto; Felipe Purcell, Araújo; Bernardo, Kemper.

 
 
 
 
41

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

International Nuclear Information System (INIS)

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.)

42

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

43

3-D MRI for lumbar degenerative diseases  

International Nuclear Information System (INIS)

Three-dimensional (3-D) magnetic resonance (MR) images obtained from 10 patients with lumbar degenerative diseases were retrospectively reviewed to determine how far 3-D MR imaging is capable of demonstrating nerve roots. In 8 of the 10 patients, the area up to the dorsal root ganglion was visualized on 3-D MR images. Thus, it is capable of detecting a wide area of nerve roots, thereby allowing the determination of running of nerve root, and size and location of dorsal root ganglion. In delineating the area from the dural canal to root cyst, 3-D MR imaging was equal to conventional myelography. The former was superior to the latter in detecting the positional relation between the degenerative intervertebral disc and the nerve root, and herniation-compressed root cyst. In 3 of 9 patients who presented with root symptoms, disturbed nerve roots were of high signal on 3-D MR images. This may suggest that it has the potential for selectively detecting root nerves associated with clinical manifestations. (N.K.)

44

Chronic degenerative diseases in elderly: physiotherapeutic data  

Directory of Open Access Journals (Sweden)

Full Text Available Objective: To assess the most frequent chronic diseases in the elderly population of a private clinic of Physiotherapy. Methods: We assessed medical records of clients who received treatment at a Physiotherapy clinic in the period 2005 to 2008, looking for chronic diseases as diagnosis and/or related to them. Of these, we selected those which contained birth date and/or aged sixty-five years or above. An instrument like a check list, developed by the researchers, identified: quantity, gender, medical diagnosis and comorbidities. For quantification of variables we applied simple percentage calculation. Results: In the study period, there were four hundred fifty-eight records, of which forty-nine corresponded to the survey’s inclusion criteria. The majority 59.2% (n=29 referred to the year 2008; 26.6% (n=13 being males and 73.4% (n=36 females. The most commonly found diagnosis comprised osteoarthritis 57.1% (n=28, fracture and/or history of fractures 24.4% (n=12 and other diagnosis 48.9% (n=24. Associated chronic diseases included diabetes mellitus 18.3% (n=9 and systemic hypertension 57.1% (n=23. Conclusion: Chronic degenerative diseases in elderly have received increasing attention from health professionals; osteoarthritis being the most common diagnosis in this study, followed by fracture and/or history of fractures. The comorbidities represented a greater negative impact in the quality of life of elderly.

Lais Keylla Felipe

2011-09-01

45

Chondroprotectant therapy in rats with degenerative joint disease experimentally transected cranial cruciateReprodução experimental da doença articular degenerativa, pelo método cirúrgico associado à terapia condroprotetora, em ratos  

Directory of Open Access Journals (Sweden)

Full Text Available Osteoarthritis (OA is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies, one with pentosan polysulfate, one with betamethasone, and one with chondroitin sulfate/ glucosamine. In order to produce joint disease, the cranial cruciate ligament was surgically transected. Animals were kept and treated for eight days after surgery and were assessed via both radiographies and tomographies taken before surgery and eight weeks later. All animals were euthanized having both macroscopic and microscopic analysis performed to evaluate the disorder progression and therapeutic action. Macroscopic analysis showed lesion in the knees subjected to OA induction. The untreated animals presented major lesions whereas the treated ones presented mild to moderate lesions. In conclusion, pentosan polysulfate is recommendable for the treatment of iatrogenic joint lesions in rats since the other treatments showed no significant difference. A osteoartrite (OA é a doença articular mais comum em humanos e animais, o que ocasiona restrição de movimentos e dor, na região acometida. Tal enfermidade afeta mais de 25% dos humanos acima de 60 anos e, aos 70 anos, ela é considerada universal. Estima-se que nos Estados Unidos da América, 20% ou mais da população canina é acometida pela OA. O presente estudo tem como finalidade avaliar a terapia medicamentosa (polisulfato de pentosano, betametasona e sulfato de condroitina/glucosamina, em um modelo experimental de OA cirurgicamente induzido, em ratos. A doença articular foi promovida pela transecção cirúrgica do ligamento cruzado cranial, sendo que, após o procedimento cirúrgico, os animais foram mantidos e tratados por oito semanas. Foi realizada avaliação radiográfica e tomográfica antes e oito semanas após a indução da osteoartrite. Todos os animais foram submetidos à eutanásia para análise macroscópica e microscópica, que foram realizadas para avaliar a progressão da enfermidade e a ação terapêutica. Na análise macroscópica foi observadas lesões nos joelhos submetidos à indução OA. Os animais não tratados apresentaram lesões graves enquanto que, os animais tratados apresentaram lesões leves a moderadas. Concluiu-se que o polissulfato de pentosano é eficiente no tratamento de lesões articulares iatrogênicas de ratos, uma vez que outros tratamentos não mostraram qualquer diferença significativa.

Marcos Marini Melo

2013-06-01

46

Radiologic imaging of degenerative and inflammatory joint disorders in women  

International Nuclear Information System (INIS)

Pain in joints and other structures of the musculoskeletal system is a common complaint in women. It may occur as functional pain, in many cases as inflammatory episode of arthrosis or of metabolic joint disease, sometimes as early manifestation of rheumatoid disease. With conventional radiography, high resolution sonography, and MR imaging it is possible to classify many of these clinical syndromes. A semiquantitative assessment of inflammatory activity can be made by analysing the degree of joint effusion, the thickness of the synovium and the extent of hypervascularization. (author)

47

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

48

New Aspects of Correlation of Free Radical Oxidation and the Severity of Pathological Process in Congenital Dislocated Hip and Degenerative Dystrophic Diseases of Hip Joint in Children  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The aim of the investigation is to prove the correlation of free radical processes and the state of anti-oxidant system, and the severity of pathological process in children with congenital dislocated hip.Materials and Methods. There were examined 143 patients with congenital dislocated hip aged from 4 to 17 years, they were divided into three groups: the 1st group (n=39) — children with noncomplicated disease, the 2nd group (n=47) — children with coxarthrosis, the 3rd group (n=32) — ch...

Strelkova, I. G.; Musikhina, I. V.; Bogosian, ?. B.; Sidorkin, V. G.; Starikova, ?. ?.; Sidorkina, ?. N.; Kusnetsova, V. L.

2012-01-01

49

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.)

50

MR imaging of the spine: trauma and degenerative disease  

International Nuclear Information System (INIS)

The purpose of this paper is to discuss the capabilities and drawbacks of MR imaging in patients with trauma to the spine and degenerative spinal conditions. In spinal trauma MR imaging is secondary to plain X-ray films and CT because of the greater availability and ease of performance of these techniques and their superior capability for detecting vertebral fractures. Magnetic resonance imaging is useful for detecting ligamentous ruptures and intraspinal mass lesions such as hematoma, and for assessing the state of the spinal cord and prognosis of a cord injury. In degenerative spinal disease the necessity is emphasized of critically evaluating the clinical relevance of any abnormal feature detected, as findings of degenerative pathology are common in individuals without symptoms. Magnetic resonance myelography permits rapid and accurate assessment of the state of the lumbar nerve roots (compressed or not). In the cervical region the quality of the myelographic picture is often degraded in patients with a narrow spinal canal. (orig.)

51

Imaging fusion (SPECT/CT) in degenerative disease of spine  

International Nuclear Information System (INIS)

Full text: Objective: To determine the utility of Fusion Imaging SPECT/CT in degenerative pathology of the spine and to establish the impact of the use of fusion imaging in spinal pain due to degenerative changes of the spine. Materials and methods: 44 Patients (M=21, F=23) average age of 63 years and with degenerative pathology of spine were sent to Diagnosis Imaging department in FSFB. Bone scintigraphy (SPECT), CT of spine (cervical: 30%, Lumbar 70%) and fusion imaging were performed in all of them. Bone scintigraphy was carried out in a gamma camera Siemens Diacam double head attached to ESOFT computer. The images were acquired in matrix 128 x 128, 20 seg/imag, 64 images. CT of spine was performed same day or two days after in Helycoidal Siemens somatom emotion CT. The fusion was done in a Dicom workstation in sagital, axial and coronal reconstruction. The findings were evaluated by 2 Nuclear Medicine physicians and 2 radiologists of the staff of FSFB in an independent way. Results: Bone scan (SPECT) and CT of 44 patients were evaluated. CT showed facet joint osteoarthrities in 27 (61.3%) patients, uncovertebral joint arthrosis in 7 (15.9%), bulging disc in 9(20.4%), spinal nucleus lesion in 7(15.9%), osteophytes in 9 (20.4%), spinal foraminal stenosis in 7 (15.9%), spondylolysis/spondylolisthesis in 4 (9%). Bone scan showed facet joint osteoarthrities in 29 (65.9%), uncovertebral joint arthrosis in 4 (9%), osteophytes in 9 (20.4%) and normal 3 (6.8%). The imaging fusion showed coincidence findings (main lesion in CT with high uptake in scintigraphy) in 34 patients (77.2%) and no coincidence in 10 (22.8%). In 15 (34.09%) patients the fusion provided additional information. The analysis of the findings of CT and SPECT showed similar results in most of the cases and the fusion didn't provide additional information but it allowed to confirm the findings but when the findings didn't match where the CT showed several findings and SPECT only one area with high uptake which allowed us to address the treatment. In all cases, CT provided exact anatomical localization. Conclusion; Fusion imaging SPECT/CT in degenerative pathology of spine allows an integration of the anatomical detail with the functional information. It improves the diagnostic accuracy: Determining sites of greater metabolic activity in patients with multiple degenerative changes and improving the spatial localization in injuries detected by scintigraphy. Image fusion by SPECT/CT could have a clinical impact (34% of our series) in that the treatment was modified. (author)

52

Degenerative disease in lumbar spine of military parachuting instructors.  

Science.gov (United States)

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. PMID:15015796

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

2003-12-01

53

Paleoepidemiology of vertebral degenerative disease in a Pre-Columbian Muisca series from Colombia.  

Science.gov (United States)

Major manifestations of vertebral degenerative joint disease were observed on a Pre-Columbian Muisca series from the Soacha Cemetery (11th to 13th centuries) Colombia, South America. In total, 1,646 vertebrae of 83 individuals were examined. Osteophytes, vertebral body joint surface contour change ("lipping"), and vertebral body pitting were evaluated for each vertebral body. For apophyseal joints, joint surface contour change, pitting, and eburnation were recorded. Two methods of frequency calculation and five for vertebral degenerative disease diagnosis were applied and compared, allowing discussion of methodological considerations. Our study showed that 83% of individuals and 32% of vertebrae were classified as positive when diagnosed by the presence of at least one of the following manifestations: osteophytes, vertebral body joint surface contour change ("lipping"), apophyseal joint surface contour change, or eburnation (method called "Pitting excluded"). No significant differences were found between the sexes. In the youngest cohort (15-30 years), 65% of individuals and 10% of vertebrae exhibit at least one of the previously mentioned manifestations. High prevalences suggest a high level of physical activity beginning in childhood which may have accelerated the aging process in this Pre-Columbian population. Historical data are compatible with this hypothesis. PMID:18186506

Rojas-Sepúlveda, Claudia; Ardagna, Yann; Dutour, Olivier

2008-04-01

54

ENFERMEDAD ARTICULAR DEGENERATIVA Y CAMBIOS ENTESIALES EN SEIS COLECCIONES ÓSEAS PREHISPÁNICAS DEL NOROCCIDENTE DE AMÉRICA DEL SUR / DEGENERATIVE JOINT DISEASE AND ENTHESEAL CHANGES IN SIX PRE-COLUMBIAN SKELETAL COLLECTIONS FROM THE NORTHWEST OF SOUTH AMERICA  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish La enfermedad articular degenerativa (EAD) y los cambios entesiales (CE) fueron estudiados en seis colecciones óseas prehispánicas del noroeste de América del Sur con el objetivo de aportar al debate sobre las relaciones entre estos indicadores y la actividad física, así como al conocimiento sobre l [...] as condiciones de vida de los pueblos prehispánicos de la región. Se estudiaron tres series del altiplano central de Colombia (Soacha, Marín y Tunja-UPTC), dos series de Panamá (Panamá Viejo y Sitio Sierra) y una colección de la costa central peruana (Ancón 1). El uso de una metodología estandarizada permitió la comparación directa de frecuencias y perfiles de EAD y de CE. Se observó una importante variedad de perfiles y de frecuencias en las diferentes colecciones óseas, pero también algunas tendencias similares en colecciones de ambientes semejantes. Se observó una falta de correspondencia entre los resultados de la EAD y de los CE que podría indicar que, a pesar de que tienen una etiología multifactorial, podrían ser respuestas a diferentes tipos de actividad: una actividad repetitiva podría relacionarse más con la EAD, mientras que una actividad que incluya cargas pesadas podría relacionarse más con los CE. Abstract in english Degenerative joint disease (DJD) and entheseal changes (EC) were studied in six Pre-Hispanic skeletal collections from the northwest of South America, in order to give insight both into their relationship with physical activity and into life conditions in this region during Pre-Columbian times. Thre [...] e series from the highlands of Colombia (Soacha, Marín and Tunja-UPTC), two series from Panama (Panamá Viejo and Sitio Sierra) and one from the Central Coast of Peru (Ancón 1) were analyzed for this study. The use of a standardized methodology allowed direct comparisons between the frequencies and the profiles of DJD and EC. An important variability in profiles and frequencies was observed between series. However, it was also possible to observe several similar trends in series from analogous environments. There is a mismatch between results from DJD and EC which may indicate that, despite having a multi-factorial aetiology, they may respond to different types of physical activity: repetitive activity would be more related to DJD, while activities involving heavy loads would be more connected with EC.

Claudia Mercedes, Rojas-Sepúlveda; Olivier, Dutour.

55

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 Haki 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)

56

Computed tomographic evaluation of degenerative diseases of the lumbar spine  

International Nuclear Information System (INIS)

Computed tomography (CT) of the lumbar spine is a new modality of far-reaching significance. Experience with this new technique has been extremely limited, less than 3 years at most institutions. There are few hard data, and few adequate clinical studies have been performed. Accordingly, the purpose of this article is to provide an understanding of the pathogenesis as well as the CT findings of the degenerative diseases affecting the spinal canal

57

MR imaging of the spine: trauma and degenerative disease  

Energy Technology Data Exchange (ETDEWEB)

The purpose of this paper is to discuss the capabilities and drawbacks of MR imaging in patients with trauma to the spine and degenerative spinal conditions. In spinal trauma MR imaging is secondary to plain X-ray films and CT because of the greater availability and ease of performance of these techniques and their superior capability for detecting vertebral fractures. Magnetic resonance imaging is useful for detecting ligamentous ruptures and intraspinal mass lesions such as hematoma, and for assessing the state of the spinal cord and prognosis of a cord injury. In degenerative spinal disease the necessity is emphasized of critically evaluating the clinical relevance of any abnormal feature detected, as findings of degenerative pathology are common in individuals without symptoms. Magnetic resonance myelography permits rapid and accurate assessment of the state of the lumbar nerve roots (compressed or not). In the cervical region the quality of the myelographic picture is often degraded in patients with a narrow spinal canal. (orig.) With 10 figs., 14 refs.

Wilmink, J.T. [Department of Radiology, University Hospital Maastricht (Netherlands)

1999-09-01

58

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

59

An overview of underlying causes and animal models for the study of age-related degenerative disorders of the spine and synovial joints.  

Science.gov (United States)

As human lifespan increases so does the incidence of age-associated degenerative joint diseases, resulting in significant negative socioeconomic consequences. Osteoarthritis (OA) and intervertebral disc degeneration (IDD) are the most common underlying causes of joint-related chronic disability and debilitating pain in the elderly. Current treatment methods are generally not effective and involve either symptomatic relief with non-steroidal anti-inflammatory drugs and physical therapy or surgery when conservative treatments fail. The limitation in treatment options is due to our incomplete knowledge of the molecular mechanism of degeneration of articular cartilage and disc tissue. Basic understanding of the age-related changes in joint tissue is thus needed to combat the adverse effects of aging on joint health. Aging is caused at least in part by time-dependent accumulation of damaged organelles and macromolecules, leading to cell death and senescence and the eventual loss of multipotent stem cells and tissue regenerative capacity. Studies over the past decades have uncovered a number of important molecular and cellular changes in joint tissues with age. However, the precise causes of damage, cellular targets of damage, and cellular responses to damage remain poorly understood. The objectives of this review are to provide an overview of the current knowledge about the sources of endogenous and exogenous damaging agents and how they contribute to age-dependent degenerative joint disease, and highlight animal models of accelerated aging that could potentially be useful for identifying causes of and therapies for degenerative joint diseases. PMID:23483579

Vo, Nam; Niedernhofer, Laura J; Nasto, Luigi Aurelio; Jacobs, Lloydine; Robbins, Paul D; Kang, James; Evans, Christopher H

2013-06-01

60

Degenerative diseases of the nervous system in atomic bomb survivors  

International Nuclear Information System (INIS)

Degenerative diseases (DD) of the nervous system were observed in 169 of 23,418 A-bomb survivors enrolled in a cohort adult health survey. Senile dementia and parkinsonism accounted for 76 % of the DD. The incidence of DD tended to be higher with increasing exposure doses for women. This was significant for younger women at the time of bombing. No dose-dependence was seen for occurrence of DD in men. There was no significant difference in the incidence of DD between Hiroshima's and Nagasaki's survivors. (Namekawa, K.)

 
 
 
 
61

Nuclear microscopy in medical research. Investigations into degenerative diseases  

Energy Technology Data Exchange (ETDEWEB)

The high energy (1-4MeV) focused ion beam (nuclear microbeam) has found uses in many scientific disciplines through a wide variety of ion beam based techniques. Of the many techniques available, the powerful combination of Particle Induced X-Ray Emission (PIXE), Rutherford Backscattering Spectrometry (RBS), and Scanning Transmission Ion Microscopy (STIM) is proving to be extremely useful, particularly in the characterisation and elemental analysis of thin specimens. In this paper we briefly review these ion beam techniques, as well as the hardware required for their application. Finally, we describe the application of the PIXE, RBS and STIM techniques in conjunction with a scanning focused 2MeV proton microbeam (nuclear microscopy). The examples chosen to illustrate the potential of nuclear microscopy are recent investigations into the degenerative diseases atherosclerosis (coronary heart disease), Parkinson`s disease and Alzheimer`s disease. (author)

Makjanic, J.; Thong, P.; Watt, F. [National University of Singapore (Singapore). Dept. of Physics

1997-03-01

62

Nuclear microscopy in medical research. Investigations into degenerative diseases  

International Nuclear Information System (INIS)

The high energy (1-4MeV) focused ion beam (nuclear microbeam) has found uses in many scientific disciplines through a wide variety of ion beam based techniques. Of the many techniques available, the powerful combination of Particle Induced X-Ray Emission (PIXE), Rutherford Backscattering Spectrometry (RBS), and Scanning Transmission Ion Microscopy (STIM) is proving to be extremely useful, particularly in the characterisation and elemental analysis of thin specimens. In this paper we briefly review these ion beam techniques, as well as the hardware required for their application. Finally, we describe the application of the PIXE, RBS and STIM techniques in conjunction with a scanning focused 2MeV proton microbeam (nuclear microscopy). The examples chosen to illustrate the potential of nuclear microscopy are recent investigations into the degenerative diseases atherosclerosis (coronary heart disease), Parkinson's disease and Alzheimer's disease. (author)

63

MRI of degenerative lumbar spine disease: comparison of non-accelerated and parallel imaging  

Energy Technology Data Exchange (ETDEWEB)

Parallel imaging techniques such as GRAPPA have been introduced to optimize image quality and acquisition time. For spinal imaging in a clinical setting no data exist on the equivalency of conventional and parallel imaging techniques. The purpose of this study was to determine whether T1- and T2-weighted GRAPPA sequences are equivalent to conventional sequences for the evaluation of degenerative lumbar spine disease in terms of image quality and artefacts. In patients with clinically suspected degenerative lumbar spine disease two neuroradiologists independently compared sagittal GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (25 patients) and transverse GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (23 lumbar segments in six patients). Comparative analyses included the minimal diameter of the spinal canal, disc abnormalities, foraminal stenosis, facet joint degeneration, lateral recess, nerve root compression and osteochondrotic vertebral and endplate changes. Image inhomogeneity was evaluated by comparing the nonuniformity in the two techniques. Image quality was assessed by grading the delineation of pathoanatomical structures. Motion and aliasing artefacts were classified from grade 1 (severe) to grade 5 (absent). There was no significant difference between GRAPPA and non-accelerated MRI in the evaluation of degenerative lumbar spine disease (P > 0.05), and there was no difference in the delineation of pathoanatomical structures. For inhomogeneity there was a trend in favour of the conventional sequences. No significant artefacts were observed with either technique. The GRAPPA technique can be used effectively to reduce scanning time in patients with degenerative lumbar spine disease while preserving image quality. (orig.)

Noelte, Ingo; Gerigk, Lars; Brockmann, Marc A.; Kemmling, Andre; Groden, Christoph [Medical Faculty Mannheim of the University of Heidelberg, Department of Neuroradiology, Mannheim (Germany)

2008-05-15

64

MRI of degenerative lumbar spine disease: comparison of non-accelerated and parallel imaging  

International Nuclear Information System (INIS)

Parallel imaging techniques such as GRAPPA have been introduced to optimize image quality and acquisition time. For spinal imaging in a clinical setting no data exist on the equivalency of conventional and parallel imaging techniques. The purpose of this study was to determine whether T1- and T2-weighted GRAPPA sequences are equivalent to conventional sequences for the evaluation of degenerative lumbar spine disease in terms of image quality and artefacts. In patients with clinically suspected degenerative lumbar spine disease two neuroradiologists independently compared sagittal GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (25 patients) and transverse GRAPPA (acceleration factor 2, time reduction approximately 50%) and non-GRAPPA images (23 lumbar segments in six patients). Comparative analyses included the minimal diameter of the spinal canal, disc abnormalities, foraminal stenosis, facet joint degeneration, lateral recess, nerve root compression and osteochondrotic vertebral and endplate changes. Image inhomogeneity was evaluated by comparing the nonuniformity in the two techniques. Image quality was assessed by grading the delineation of pathoanatomical structures. Motion and aliasing artefacts were classified from grade 1 (severe) to grade 5 (absent). There was no significant difference between GRAPPA and non-accelerated MRI in the evaluation of degenerative lumbar spine disease (P > 0.05), and there was no difference in the delineation of pathoanatomical structures. For inhomogeneity there was a trend in favour of the conventional sequences. No significant artefacts were observed with either technique. The GRAPPA technique can be used effectively to reduce scanning time in patients with degenerative lumbar spine disease while preserving image quality. (orig.)

65

Mitochondrial DNA mutations in human degenerative diseases and aging.  

Science.gov (United States)

A wide variety of mitochondrial DNA (mtDNA) mutations have recently been identified in degenerative diseases of the brain, heart, skeletal muscle, kidney and endocrine system. Generally, individuals inheriting these mitochondrial diseases are relatively normal in early life, develop symptoms during childhood, mid-life, or old age depending on the severity of the maternally-inherited mtDNA mutation; and then undergo a progressive decline. These novel features of mtDNA disease are proposed to be the product of the high dependence of the target organs on mitochondrial bioenergetics, and the cumulative oxidative phosphorylation (OXPHOS) defect caused by the inherited mtDNA mutation together with the age-related accumulation mtDNA mutations in post-mitotic tissues. PMID:7599200

Wallace, D C; Shoffner, J M; Trounce, I; Brown, M D; Ballinger, S W; Corral-Debrinski, M; Horton, T; Jun, A S; Lott, M T

1995-05-24

66

Magnetic resonance imaging of canine degenerative lumbar spine diseases  

International Nuclear Information System (INIS)

Degenerative lumbar spine diseases, i.e., sacrolumbar stenosis, intervertebral disk degeneration and protrusion and spondylosis deformans of the canine lumbar spine were studied in eleven canine patients and three healthy controls using radiography and 0.02 T and 0.04 T low field magnetic resonance imaging. The T1 and T2 weighted images were obtained in sagittal and transverse planes. The loss of hydration of nucleus pulposus, taken as a sign of degeneration in the intervertebral disks, could be evaluated in both T1 and T2 weighted images. As a noninvasive method magnetic resonance imaging gave more exact information about the condition of intervertebral disks than did radiography. Sacrolumbar stenosis and compression of the spinal cord or cauda equina and surrounding tissue could be evaluated without contrast medium

67

Health assessment of environmental pollutants: proliferative and degenerative diseases  

International Nuclear Information System (INIS)

In order to achieve a balanced approach to risk assessment between carcinogenic and non-carcinogenic health effects one must examine the risk of disease or death in the general population exposed to a particular air pollutant that can be related quantitatively to intensity and duration of exposures (National Academy of Sciences, 1983). Such risk assessment should be based upon careful evaluation of scientific findings of dose-response relationships in the chronically exposed population. Quantitative assessment of environmentally produced disease in man has proven to be complex and demanding. A variety of factors play important roles in this task. As an example, there are induction-latency periods for chronic diseases, including cancer, which may range from five to twenty-five years. The diseases themselves, whether proliferative or degenerative, may follow several stages of progression. There is only sparse epidemiological data on serious health effects that may be due to environmental as compared to occupational exposures. Exposures to chemical or radiological air contaminants do not occur singly but to a multiplicity of agents, and disease processes are frequently markedly affected by the interaction of a variety of factors, particularly that of cigarette smoking. There is growing recognition of potentially sensitive subpopulations, including the elderly and the very young, but adequate techniques for assessing the magnitude of increased risks to these groups have n of increased risks to these groups have not yet been developed

68

Fat saturation technique and gadolinium in MRI of lumbar spinal degenerative disease.  

Science.gov (United States)

We evaluated the potential of MR sequences with Fat Saturation and gadolinium in patients with degenerative disease of the lumbar spine and low back pain, by studying both anterior and posterior elements of the lumbar spine. We examined 3323 patients (age range 15-78 years) presenting low back pain. We used T2-weighted sequences with Fat Saturation and in some selected cases (1063 patients, 32%) administered gadolinium using T1-weighted sequences with Fat Saturation. In particular we used gadolinium in the following cases: 1) presence of hyperintense areas on T2 weighted images with Fat Saturation in the osteo-articular and muscular-ligamentous structures of the lumbar spine; 2) Clinical-radiological discrepancy in patients without disc-root conflict and clinical suspicion of posterior vertebral compartment syndrome. We found degenerative-inflammatory changes in osteo-articular, ligamentous and muscular structures in 1063 patients: osteochondrosis, "aseptic discitis", facet joint effusion and synovitis, osteoarthritis, synovial cysts, spondylolysis, degenerative-inflammatory changes of the posterior ligaments (flava, interspinous and supraspinous ligaments) and posterior perispinal muscles. To improve diagnostic accuracy and allow correct therapeutic guidance, MR examination in patients with low back pain must evaluate both anterior and posterior elements of the lumbar spine. Our study indicates that T2 sequences with Fat Saturation and, in selected cases, gadolinium administration, better visualize or disclose degenerative-inflammatory changes in the lumbar spine, showing the active-inflammatory phase and extension of these processes which may not be depicted during a standard MR examination. PMID:24351270

D'Aprile, P; Tarantino, A; Lorusso, V; Brindicci, D

2006-11-30

69

The value of fat saturation sequences and contrast medium administration in MRI of degenerative disease of the posterior/perispinal elements of the lumbosacral spine.  

Science.gov (United States)

Degenerative-inflammatory lumbar spinal pathology is one of the most common reasons why individuals seek medical care, and low back pain is the main symptom among those most commonly associated with this pathologic condition. Pain is commonly attributed to degenerative disc disease, particularly herniated discs, but many different spinal and perispinal structures may undergo degenerative-inflammatory phenomena and produce pain: discs, bone, facet joints, ligaments and muscles. In particular, in patients with non-radicular low back pain, this syndrome may arise from changes of the posterior elements/perispinal tissues of the lumbar spine (i.e., the "posterior vertebral compartment"). They include: facet joint pathology (e.g., osteoarthritis, joint effusion, synovitis and synovial cysts), spondylolysis, spinal/perispinal ligamentous degenerative-inflammatory changes and perispinal muscular changes. It is well known that magnetic resonance is the most sensitive imaging method for the evaluation of spinal degenerative pathology, even in the initial stages of the disease. T2-weighted sequences with fat saturation, and when indicated the use of contrast-enhanced T1-weighted images with fat saturation, permit the visualization of degenerative-inflammatory changes of the posterior elements of the lumbar spine that in most cases would have been overlooked with conventional non-fat suppressed imaging. PMID:16733673

D'Aprile, P; Tarantino, A; Jinkins, J R; Brindicci, D

2007-02-01

70

The value of fat saturation sequences and contrast medium administration in MRI of degenerative disease of the posterior/perispinal elements of the lumbosacral spine  

Energy Technology Data Exchange (ETDEWEB)

Degenerative-inflammatory lumbar spinal pathology is one of the most common reasons why individuals seek medical care, and low back pain is the main symptom among those most commonly associated with this pathologic condition. Pain is commonly attributed to degenerative disc disease, particularly herniated discs, but many different spinal and perispinal structures may undergo degenerative-inflammatory phenomena and produce pain: discs, bone, facet joints, ligaments and muscles. In particular, in patients with non-radicular low back pain, this syndrome may arise from changes of the posterior elements/perispinal tissues of the lumbar spine (i.e., the ''posterior vertebral compartment''). They include: facet joint pathology (e.g., osteoarthritis, joint effusion, synovitis and synovial cysts), spondylolysis, spinal/perispinal ligamentous degenerative-inflammatory changes and perispinal muscular changes. It is well known that magnetic resonance is the most sensitive imaging method for the evaluation of spinal degenerative pathology, even in the initial stages of the disease. T2-weighted sequences with fat saturation, and when indicated the use of contrast-enhanced T1-weighted images with fat saturation, permit the visualization of degenerative-inflammatory changes of the posterior elements of the lumbar spine that in most cases would have been overlooked with conventional non-fat suppressed imaging. (orig.)

D' Aprile, P. [San Paolo Hospital, Department of Neuroradiology, Bari (Italy); U.O. Radiologia, Sezione di Neuroradiologia, Ospedale ' ' S. Paolo' ' , Via Caposcardicchio, Bari (Italy); Tarantino, A. [San Paolo Hospital, Department of Neuroradiology, Bari (Italy); Jinkins, J.R. [State University of New York, Department of Radiology, Downstate Medical Center, Brooklyn, NY (United States); Brindicci, D. [San Paolo Hospital, Department of Radiology, Bari (Italy)

2007-02-15

71

The value of fat saturation sequences and contrast medium administration in MRI of degenerative disease of the posterior/perispinal elements of the lumbosacral spine  

International Nuclear Information System (INIS)

Degenerative-inflammatory lumbar spinal pathology is one of the most common reasons why individuals seek medical care, and low back pain is the main symptom among those most commonly associated with this pathologic condition. Pain is commonly attributed to degenerative disc disease, particularly herniated discs, but many different spinal and perispinal structures may undergo degenerative-inflammatory phenomena and produce pain: discs, bone, facet joints, ligaments and muscles. In particular, in patients with non-radicular low back pain, this syndrome may arise from changes of the posterior elements/perispinal tissues of the lumbar spine (i.e., the ''posterior vertebral compartment''). They include: facet joint pathology (e.g., osteoarthritis, joint effusion, synovitis and synovial cysts), spondylolysis, spinal/perispinal ligamentous degenerative-inflammatory changes and perispinal muscular changes. It is well known that magnetic resonance is the most sensitive imaging method for the evaluation of spinal degenerative pathology, even in the initial stages of the disease. T2-weighted sequences with fat saturation, and when indicated the use of contrast-enhanced T1-weighted images with fat saturation, permit the visualization of degenerative-inflammatory changes of the posterior elements of the lumbar spine that in most cases would have been overlooked with conventional non-fat suppressed imaging. (orig.)

72

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

2011-09-01

73

Vertebral degenerative disc disease severity evaluation using random forest classification  

Science.gov (United States)

Degenerative disc disease (DDD) develops in the spine as vertebral discs degenerate and osseous excrescences or outgrowths naturally form to restabilize unstable segments of the spine. These osseous excrescences, or osteophytes, may progress or stabilize in size as the spine reaches a new equilibrium point. We have previously created a CAD system that detects DDD. This paper presents a new system to determine the severity of DDD of individual vertebral levels. This will be useful to monitor the progress of developing DDD, as rapid growth may indicate that there is a greater stabilization problem that should be addressed. The existing DDD CAD system extracts the spine from CT images and segments the cortical shell of individual levels with a dual-surface model. The cortical shell is unwrapped, and is analyzed to detect the hyperdense regions of DDD. Three radiologists scored the severity of DDD of each disc space of 46 CT scans. Radiologists' scores and features generated from CAD detections were used to train a random forest classifier. The classifier then assessed the severity of DDD at each vertebral disc level. The agreement between the computer severity score and the average radiologist's score had a quadratic weighted Cohen's kappa of 0.64.

Munoz, Hector E.; Yao, Jianhua; Burns, Joseph E.; Pham, Yasuyuki; Stieger, James; Summers, Ronald M.

2014-03-01

74

Music and language in degenerative disease of the brain.  

Science.gov (United States)

Music and language functions were studied in two musicians with degenerative disease. Both patients were tested on a standardized language battery and a series of music tasks. In the first case with left cortical atrophy and primary progressive aphasia, expressive music functions were spared with impaired reception of rhythm. The second case with posterior cortical atrophy, greater on the right, was nonaphasic, had spatial agraphia, a visuopractic deficit, and severe expressive music deficits, but intact rhythm repetition. The aphasic patient showed dissociations between music and language in fluency and content; continuous, organized, although reiterative music production was contrasted with nonfluent language. The nonaphasic patient showed the opposite pattern of deficits; unmusical production with impaired melody and rhythm organization that was contrasted with fluent, intelligible language. The double dissociation between language and music functions supports the existence of independent cognitive systems, one consistent with conventional left lateralization models of language, temporal sequence, and analytic music processing and another with a right lateralization model of implicit music cognition. PMID:7684592

Polk, M; Kertesz, A

1993-05-01

75

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.

1998-08-01

76

Laser technologies in treatment of degenerative-dystrophic bone diseases in children  

Science.gov (United States)

Two low invasive laser technologies for treatment of degenerative-dystrophic bone diseases in children are presented. The first is the transcutaneous laser osteoperforation developed by us and initially applied for treatment of different inflammatory and traumatic diseases (osteomyelitides, osteal and osteoarticular panaritiums, delayed unions, false joints, and others). Now the technology was applied to treatment of aseptic osteonecrosis of different localizations in 134 children aged from 1 to 16 years, including 56 cases with necrosis of femoral head (Legg-Calve-Perthes disease), 42 with necrosis of 2nd metatarsal bone head (Kohler II disease), and 36 with necrosis of tibial tuberosity (Osgood-Schlatter disease). The second technology is the laser intracystic thermotherapy for treatment of bone cysts. The method was applied to 108 children aged from 3 to 16 years with aneurismal and solitary cysts of different localizations. In both technologies a 970 nm diode laser was used. The suggested technologies increase the efficiency of treatment, reduce its duration, can be performed on outpatient basis, which resulted in great economical effect.

Abushkin, Ivan A.; Privalov, Valery A.; Lappa, Alexander V.; Noskov, Nikolay V.; Neizvestnykh, Elena A.; Kotlyarov, Alexander N.; Shekunova, Yulia G.

2014-03-01

77

Magnetic resonance imaging in joint diseases  

International Nuclear Information System (INIS)

Magnetic resonance imaging has proven an invaluable method in the diagnosis of joint diseases associated with osteonecrotic, inflammatory, traumatic and degenerative processes. At the clinical level, it has an important role in decisions about the method of treatment and evaluations of the therapeutic success. When the merits of MRT are balanced against those of conventional radiography including tomography and CT, which both ensure better spatial resolution in the visualisation of cortical and spongy bone structures, it becomes quite evident that MRT must not be regarded as an alternative method of imaging but as one that can be used additionally to obtain the most information for the diagnosis of arthropathy. The question as to whether new pulse sequences (snap shots) or invasive techniques like intra-articular injection of paramagnetic substances (MR arthrography) are likely to become routine procedures in the detection of joint diseases using MRT remains to be examined in further studies. (orig.)

78

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

79

Cerebral atrophic and degenerative changes following various cerebral diseases, (1)  

International Nuclear Information System (INIS)

Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

80

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. PMID:23761982

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

2013-01-01

 
 
 
 
81

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.

2003-08-01

82

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 SciELO Brazil | Language: Portuguese 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 d [...] ias, 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. 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 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.

2003-08-01

83

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 SciELO Brazil | Language: Portuguese 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 d [...] ias, 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. 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 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.

84

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

85

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

2013-11-01

86

PET studies in Alzheimer disease and other degenerative dementias  

International Nuclear Information System (INIS)

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

87

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

88

Synovial cysts of the lumbar facet joints: a retrospective magnetic resonance imaging study investigating their relation with degenerative spondylolisthesis.  

Science.gov (United States)

Patients with synovial cysts of the facet joints were compared with patients with degenerative spondylolisthesis (DS), based on the magnetic resonance imaging (MRI) findings of their spondyloses. The lumbar MRI of 30 patients with DS (group 1) 24 patients with synovial cysts of the facet joints (group 2) were studied. All patients were evaluated in terms of facet joint arthritis, disc degeneration, facet joint effusion, and the thickness of the flaval ligament. 54.1% of the patients with synovial cysts had associated DS. The mean grade of disc degeneration (2.43+/-0.50 and 2.13+/-0.68 in groups 1 and 2, respectively) and the mean thickness of the flaval ligament (3.20+/-1.22 mm and 3.83+/-1.46 mm in groups 1 and 2, respectively) did not differ between the groups (p=0.093 and p=0.097). The mean grade of facet joint osteoarthritis (2.53+/-0.51 and 2.08+/-0.72 in groups 1 and 2, respectively) was significantly higher in group 1 (p=0.18). The co-existance of synovial effusion was significantly higher in cases with synovial cysts. (p=0.008). Synovial cysts are associated with DS and facet joint osteoarthritis. The presence of synovial effusion and the high degree of disc degeneration are prominent features in patients with synovial cysts. Although osteoarthritis and DS are highly concomitant with facet joint synovial cysts, both conditions do not invariably lead to a cyst formation. PMID:20059882

Alicioglu, B; Sut, N

2009-01-01

89

Radiology of chronic diseases of the ankle joint  

International Nuclear Information System (INIS)

The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless,nd the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or high-resolution coils, the investigation of the ankle joint still offers a wide spectrum of innovation for the next years, which is particularly enforced by the increasing demand for specific diagnosis of chronic diseases in orthopedic medicine. (orig.)

90

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.)

91

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

92

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. PMID:23857173

Perusek, Lindsay; Maeda, Tadao

2013-01-01

93

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.

Tadao Maeda

2013-07-01

94

Is MS an inflammatory or primary degenerative disease?  

Science.gov (United States)

Multiple sclerosis (MS) is characterized by multiple areas of inflammation, demyelination and neurodegeneration. Multiple molecular and cellular components mediate neuroinflammation in MS. They involve: adhesion molecules, chemokines, cytokines, matalloproteases and the following cells: CD4+ T cells, CD8+ T cells, B cells, microglia and macrophages. Infiltrating Th1 CD4+ T cells secrete proinflammatory cytokines. They stimulate the release of chemokines, expression of adhesion molecules and can be factors that cause damage to the myelin sheath and axons. Chemokines stimulate integrin activation, mediate leukocyte locomotion on endothelial cells and participate in transendothelial migration. CD8+ cells can directly damage axons. B cells are involved in the production of antibodies which can participate in demyelination. B cells can also function as antigen presenting cells and contribute to T cell activation. Neuroinflammation is not only present in relapsing-remitting MS, but also in the secondary and primary progressive forms of the disease. The association between inflammation consisting of T cells, B cells, plasma cells and macrophages and axonal injury exists in MS patients including the progressive forms of the disease. The above association does not exclude the possibility that neurodegeneration can exist independently from inflammation. Very little inflammation is seen in cortical MS plaques. Anti-inflammatory therapies with different mode of action change the course of MS. Anti-inflammatory and immunomodulatory treatments are beneficial in the early relapsing stage of MS, but these treatments are ineffective in secondary progressive and primary progressive MS. In the stage of progressive MS, inflammation becomes trapped behind a closed or repaired blood-brain barrier. In such a situation current immunomodulatory, immunosuppressive or anti-inflammatory treatments might not reach this inflammatory process to exert a beneficial effect. PMID:24057507

Losy, Jacek

2013-10-01

95

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

2013-05-01

96

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

2009-06-01

97

Clinical significance of cerebrospinal fluid nitric oxide concentrations in degenerative cervical and lumbar diseases.  

Science.gov (United States)

In animal models of degenerative lumbar disease, inducible nitric oxide synthase (iNOS) is expressed in macrophages and Schwann cells following compression of the cauda equina. We previously reported that NO metabolites (nitrite plus nitrate: [NOx]) in the cerebrospinal fluid (CSF) correlate with postoperative pain relief in patients with degenerative lumbar disease and with neurologic recovery rate postoperatively or after conservative treatment in patients with spinal cord injury. The objective of the present study was to examine the relationship between [NOx] and neurologic severity, and recovery in degenerative cervical and lumbar diseases. Two hundred fifty-seven cases, including 85 patients with cervical compression myelopathy (CCM), 25 with cervical disc herniation (CDH), 70 with lumbar canal stenosis (LCS), and 77 with lumbar disc herniation (LDH), were examined. The CSF [NOx] was measured using the Griess method. Severity of neurologic impairment and clinical recovery was assessed using the Japanese Orthopedic Association score and Hirabayashi's method. [NOx] in CCM and LCS, but not CDH and LDH groups, was significantly higher than that in controls, and correlated with postoperative recovery rates, but not with preoperative neurologic severity. [NOx] significantly correlated with neurologic recovery following surgery for CCM and LCS. PMID:21190044

Denda, Hiroshi; Kimura, Shinji; Yamazaki, Akiyoshi; Hosaka, Noboru; Takano, Yuichi; Imura, Kenji; Yajiri, Yoichi; Endo, Naoto

2011-04-01

98

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)

99

Update on the pathophysiology of degenerative disc disease and new developments in treatment strategies  

Directory of Open Access Journals (Sweden)

Full Text Available Adam H Hsieh1,2 , S Tim Yoon31Fischell Department of Bioengineering, University of Maryland, College Park, MD, USA; 2Department of Orthopedics, University of Maryland, Baltimore, MD, USA; 3Department of Orthopedic Surgery, Emory University, Chief of Orthopedic Surgery, Veterans Affairs Medical Center, Atlanta, GA, USAAbstract: Degenerative disc disease (DDD continues to be a prevalent condition that afflicts populations on a global scale. The economic impact and decreased quality of life primarily stem from back pain and neurological deficits associated with intervertebral disc degeneration. Although much effort has been invested into understanding the etiology of DDD and its relationship to the onset of back pain, this endeavor is a work in progress. The purpose of this review is to provide focused discussion on several areas in which recent advances have been made. Specifically, we have categorized these advances into early, middle, and late phases of age-related or degenerative changes in the disc and into promising minimally invasive treatments, which aim to restore mechanical and biological functions to the disc.Keywords: degenerative disc disease, quality of life, intervertebral, aging

Adam H Hsieh

2010-10-01

100

Degenerative disc disease in the lumbar spine: Another cause for focally reduced activity on marrow scintigraphy  

International Nuclear Information System (INIS)

A patient is presented in whom a focal reduction in marrow activity in the lumbar spine on both leucocyte and nanocolloid marrow scintigraphy was subsequently shown to be due to fatty infiltration of marrow in association with disc degeneration. Degenerative disease in the lumbar spine has not been previously described as a cause of abnormal bone marrow distribution by such means and needs to be distinguished from a more serious pathology, such as malignant infiltration and vertebral infection, which it may mimic. In a retrospective review of 33 nanocolloid bone marrow and 117 leucocyte scintigrams, 8 showed a degree of reduced marrow activity in the lumbar spine consistent with that caused by degenerative changes. (orig.)

 
 
 
 
101

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

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

2009-01-01

102

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English 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 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.

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

103

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 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.

Zhigang Qu

2013-01-01

104

Degenerative periodontal-diseases and oral osteonecrosis: The role of gene-environment interactions  

International Nuclear Information System (INIS)

Chronic-degenerative dentistry diseases, including periodontal diseases and oral osteonecrosis, are widespread in human populations and represent a significant problem for public health. These diseases result from pathogenic mechanisms created by the interaction between environmental genotoxic risk-factors and genetic assets conferring individual susceptibility. Osteonecrosis occurs in subjects undergoing exposure to high doses of DNA-damaging agents for chemo- and radiotherapy of neoplastic diseases. In susceptible patients, ionizing radiation and biphosphonate-chemotherapy induce severe, progressive, and irreversible degeneration of facial bones, resulting in avascular necrosis of the jaw. This may also occur in patients receiving biphosphonate for osteoporosis therapy. Periodontal diseases include chronic, aggressive, and necrotizing periodontitis, often resulting in severe alteration of periodontal tissues and tooth loss. Cigarette smoking and chronic inflammation caused by specific bacteria are the main risk factors for periodontitis. Oxidative damage plays a fundamental pathogenic role, as established by detection of mitochondrial DNA damage in the gingival tissue of patients with periodontitis. Endogenous risk factors in dental diseases include polymorphisms for metabolic enzymes such as glutathione transferases M1 and T1, N-acetyl transferase 2, and CYP 1A1. Other genetic polymorphisms that confer susceptibility to dentistry diseases affect genes encoding metatistry diseases affect genes encoding metalloproteases (involved in periodontal tissue remodeling and degradation), cytokines (involved in inflammation), prothrombin, and DNA repair activities. These findings provide evidence that dentistry diseases are related to risk factors associated with environmental mutagenesis. This issue warrants future investigations aimed at improving oral health and preventing oral degenerative diseases using molecular and experimental approaches currently utilized in mutagenicity studies.

105

Degenerative periodontal-diseases and oral osteonecrosis: The role of gene-environment interactions  

Energy Technology Data Exchange (ETDEWEB)

Chronic-degenerative dentistry diseases, including periodontal diseases and oral osteonecrosis, are widespread in human populations and represent a significant problem for public health. These diseases result from pathogenic mechanisms created by the interaction between environmental genotoxic risk-factors and genetic assets conferring individual susceptibility. Osteonecrosis occurs in subjects undergoing exposure to high doses of DNA-damaging agents for chemo- and radiotherapy of neoplastic diseases. In susceptible patients, ionizing radiation and biphosphonate-chemotherapy induce severe, progressive, and irreversible degeneration of facial bones, resulting in avascular necrosis of the jaw. This may also occur in patients receiving biphosphonate for osteoporosis therapy. Periodontal diseases include chronic, aggressive, and necrotizing periodontitis, often resulting in severe alteration of periodontal tissues and tooth loss. Cigarette smoking and chronic inflammation caused by specific bacteria are the main risk factors for periodontitis. Oxidative damage plays a fundamental pathogenic role, as established by detection of mitochondrial DNA damage in the gingival tissue of patients with periodontitis. Endogenous risk factors in dental diseases include polymorphisms for metabolic enzymes such as glutathione transferases M1 and T1, N-acetyl transferase 2, and CYP 1A1. Other genetic polymorphisms that confer susceptibility to dentistry diseases affect genes encoding metalloproteases (involved in periodontal tissue remodeling and degradation), cytokines (involved in inflammation), prothrombin, and DNA repair activities. These findings provide evidence that dentistry diseases are related to risk factors associated with environmental mutagenesis. This issue warrants future investigations aimed at improving oral health and preventing oral degenerative diseases using molecular and experimental approaches currently utilized in mutagenicity studies.

Baldi, D. [Department of Medical, Biophysical, and Dentistry Sciences and Technologies, University of Genoa (Italy); Izzotti, A. [Department of Health Sciences, University of Genoa, Via A. Pastore 1 (Italy); Bonica, P.; Pera, P. [Department of Medical, Biophysical, and Dentistry Sciences and Technologies, University of Genoa (Italy); Pulliero, A., E-mail: alessandra.pulliero@unige.it [Department of Health Sciences, University of Genoa, Via A. Pastore 1 (Italy)

2009-07-10

106

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

107

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

International Nuclear Information System (INIS)

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 od 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

108

Management of degenerative disc disease above an L5-S1 segment requiring arthrodesis.  

Science.gov (United States)

Clear guidelines exist for treating spondylolisthetic deformity and instability. How the surgeon handles adjacent-level degenerative disease is not as well established. Because magnetic resonance imaging now provides us with far more information on the "health" of radiographically normal intervertebral discs, the treatment of dehydrated or degenerated discs adjacent to a fusion is becoming more problematic. In this discussion, two experts discuss their approach to symptomatic lumbosacral spondolisthesis accompanied by adjacent-level disc degeneration. Drs. Herkowitz and Abraham believe strongly that the adjacent segment should be left alone, whereas Dr. Albert recommends extending the fusion in many instances. PMID:10382258

Herkowitz, H N; Abraham, D J; Albert, T J

1999-06-15

109

Computer aided diagnosis of degenerative intervertebral disc diseases from lumbar MR images.  

Science.gov (United States)

This paper presents a novel method for the automated diagnosis of the degenerative intervertebral disc disease in midsagittal MR images. The approach is based on combining distinct disc features under a machine learning framework. The discs in the lumbar MR images are first localized and segmented. Then, intensity, shape, context, and texture features of the discs are extracted with various techniques. A Support Vector Machine classifier is applied to classify the discs as normal or degenerated. The method is tested and validated on a clinical lumbar spine dataset containing 102 subjects and the results are comparable to the state of the art. PMID:24972858

Oktay, Ayse Betul; Albayrak, Nur Banu; Akgul, Yusuf Sinan

2014-10-01

110

[Analgetic irradiation of degenerative-inflammatory skeletal diseases. Benefits and risks].  

Science.gov (United States)

Between 1980 and 1991, ionizing radiation was applied for analgesic purposes to 181 patients (97 men, 84 women, mean age 54 [29-81] years) with degenerative-inflammatory skeletal disease. The long-term effects were evaluated by questionnaire. Radiation of 2.5 to 6.0 Gy achieved lasting pain relief in 21 of 30 patients (70%) with arthritis of the shoulder or humeroscapular periarthritis, 15 of 21 (71%) with arthritis of the hip, in 12 of 15 (80%) with heel spurs or Achilles tendon bursitis and 10 of 11 (91%) with epicondylitis. Pain relief lasted for longer than two years in 41 of the 77 patients (53%). There were no side effects at the stated dosage. According to dose measurements the theoretical risk of malignant tumour induction is 20-40/million radiated patients and thus four orders of magnitude below the spontaneous malignant tumour incidence rate. The genetic risk is even lower. Ionizing radiation of degenerative-inflammatory diseases is thus an effective form of treatment with few side effects. PMID:8467752

Sautter-Bihl, M L; Liebermeister, E; Scheurig, H; Heinze, H G

1993-04-01

111

MR imaging of degenerative lumbar disc disease emphasizing on signal intensity changes in vertebral body  

International Nuclear Information System (INIS)

Magnetic resonance imaging was performed in 400 patients with degenerative disc disease. Signal changes and their sites in the vertebral body were classified and referred to narrowing of the intervertebral disc space. MR findings were compared with those of plain roentgenograms of the lumbar spine. Signal changes in the vertebral body were noted in 83 cases (102 vertebral bodies). Low-intensity abnormality on both T1- and T2-weighted images (WI) was the most common finding, and was most frequently seen at the end plate and/or the angle. These changes were correlated with narrowing of the disc space and osteosclerosis on the plain roentgenogram of the lumbar spine. Signal changes occasionally occurred in the inner region of the vertebral body, and these lesions tended to show a high-intensity abnormality on T1-WI. We conclude that signal changes in degenerative disc disease are not specific, but are sometimes difficult to distinguish from the signal changes in other conditions such as spinal tumor or bone marrow disorder. (author)

112

Joint Modeling of Disease Pairs  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 dependenci...

To?th, Gergely; Kabos, Sa?ndor; Surja?n, Gyo?rgy

2012-01-01

113

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

2012-03-01

114

3-D MRI for lumbar degenerative diseases; Visualization of nerve roots  

Energy Technology Data Exchange (ETDEWEB)

Three-dimensional (3-D) magnetic resonance (MR) images obtained from 10 patients with lumbar degenerative diseases were retrospectively reviewed to determine how far 3-D MR imaging is capable of demonstrating nerve roots. In 8 of the 10 patients, the area up to the dorsal root ganglion was visualized on 3-D MR images. Thus, it is capable of detecting a wide area of nerve roots, thereby allowing the determination of running of nerve root, and size and location of dorsal root ganglion. In delineating the area from the dural canal to root cyst, 3-D MR imaging was equal to conventional myelography. The former was superior to the latter in detecting the positional relation between the degenerative intervertebral disc and the nerve root, and herniation-compressed root cyst. In 3 of 9 patients who presented with root symptoms, disturbed nerve roots were of high signal on 3-D MR images. This may suggest that it has the potential for selectively detecting root nerves associated with clinical manifestations. (N.K.).

Aota, Yoichi; Kumano, Kiyoshi; Hirabayashi, Shigeru; Ogawa, Yu; Izumi, Yasujiro; Yoshikawa, Koki (Kanto Rosai Hospital, Kawasaki (Japan)); Yamazaki, Tatsuo

1993-07-01

115

Histochemical and magnetic resonance imaging study of degenerative diseases in human intervertebral discs  

International Nuclear Information System (INIS)

The aim of this study was to compare degenerative changes by means of histochemical study (with nicotinamide adenine dinucleotide phosphate diaphorase - NADPH-d) and magnetic resonance imaging (MRI) findings of degenerated human intervertebral disc (IVD). We used surgical specimens from patients undergoing surgical treatment in the lumbar region and fresh cadaveric lumbar spines for histochemical study and MRI examination of patients with low back pain. The rate of IVD degeneration depends on age, weight, abnormal mechanical load, genetics, trauma, inflammation and others. All structures from IVD (nucleus pulposus, annulus fibrosus, cartilage end plate) and the vertebral body were assessed. The histochemical study showed an increase in the intensity of NADPH-d reaction in the cells, parallel to the increase in the degree of IVD degeneration. Degenerative diseases of IVD showed different MRI findings related to the decrease in the water content of IVD, protrusion, extrusion, stenosis of vertebral canal, osteochondrosis, osteophits of the vertebral body, ossification and hypertrophy of longitudinal ligaments, Modic I and II changes and compression of the dural sac. The correlation between the histochemical results and MRI findings depended basically on aging

116

Visuo-proprioceptive interactions in degenerative cervical spine diseases requiring surgery.  

Science.gov (United States)

Cervical proprioception plays a key role in postural control, but its specific contribution is controversial. Postural impairment was shown in whiplash injuries without demonstrating the sole involvement of the cervical spine. The consequences of degenerative cervical spine diseases are underreported in posture-related scientific literature in spite of their high prevalence. No report has focused on the two different mechanisms underlying cervicobrachial pain: herniated discs and spondylosis. This study aimed to evaluate postural control of two groups of patients with degenerative cervical spine diseases with or without optokinetic stimulation before and after surgical treatment. Seventeen patients with radiculopathy were recruited and divided into two groups according to the spondylotic or discal origin of the nerve compression. All patients and a control population of 31 healthy individuals underwent a static posturographic test with 12 recordings; the first four recordings with the head in 0° position: eyes closed, eyes open without optokinetic stimulation, with clockwise and counter clockwise optokinetic stimulations. These four sensorial situations were repeated with the head rotated 30° to the left and to the right. Patients repeated these 12 recordings 6weeks postoperatively. None of the patients reported vertigo or balance disorders before or after surgery. Prior to surgery, in the eyes closed condition, the herniated disc group was more stable than the spondylosis group. After surgery, the contribution of visual input to postural control in a dynamic visual environment was reduced in both cervical spine diseases whereas in a stable visual environment visual contribution was reduced only in the spondylosis group. The relative importance of visual and proprioceptive inputs to postural control varies according to the type of pathology and surgery tends to reduce visual contribution mostly in the spondylosis group. PMID:24120556

Freppel, S; Bisdorff, A; Colnat-Coulbois, S; Ceyte, H; Cian, C; Gauchard, G; Auque, J; Perrin, P

2013-01-01

117

Neurophysiological evaluation of patients with degenerative diseases of the cervical spine  

Directory of Open Access Journals (Sweden)

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.

2011-01-01

118

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

119

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

Energy Technology Data Exchange (ETDEWEB)

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

120

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

 
 
 
 
121

[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 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

2010-01-01

122

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 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.

Luciano Miller Reis Rodrigues

2011-01-01

123

Adult degenerative and senile degenerative hyperostosis triangularis ilii  

International Nuclear Information System (INIS)

A randomised study of 2000 patients (1000 males, 1000 females) revealed two forms of the triangular hyperostosis of the ilium in female patients. The hyperostosis triangularis ilii, HTI, is also known as osteitis condensans. One form of HTI concerning women under the age of 50 is called the adult generative HTI, the other beyond the age of 50 senile degenerative HTI. These two forms are not evident in male patients. The 3.05% incidence of HTI in adults appeared to be higher than presumed till now. The sex incidence male/female of 1:1.6 diverges considerably from preceding investigations. Histomorphological studies of two autopsies of cases of senile degenerative HTI revealed no signs of inflammation. Statistical correlations of HTI with other chronic diseases of the pelvis and hip could doubtlessly and generally be established only for osteoarthrosis of the sacro-iliac joints in females beyond the age of 50 and in males as a matter of principle. (orig.)

124

Gd-DTPA-enhanced Three-dimensional MR imaging of degenerative disease of the cervical spine  

International Nuclear Information System (INIS)

This paper assesses cervical spine three-dimensional (3D) MR imaging with Gd-DTPA, with the hypothesis that an enhanced 3D sequence with reconstructions would suffice for the evaluation of degenerative disease. Sixty patients were examined with (1) T1-weighted spin-echo and axial 2D gradient-echo low-flip-angle images representing the standard examination; and (2) one of two different enhanced 3D gradient-echo techniques: 30 patients with 3D fast low-angle shot (FLASH) imaging (TR 40/TE 7, 40 degrees flip angle, 64 2-mm sagittal partitions, one excitation, 10:67 minutes) and 30 with 3D Turbo FLASH imaging (MP RAGE) (7/5, 10 degrees, 128 1.5-mm partitions, one excitation, 6:07 minutes). 3D studies were reconstructed at 45 degrees obliquities for foramina, and axially. Standard and 3D studies were evaluated independently by two neuroradiologists for the location and size of extradural disease

125

National trends in outpatient surgical treatment of degenerative cervical spine disease.  

Science.gov (United States)

Study Design?Retrospective population-based observational study. Objective?To assess the growth of cervical spine surgery performed in an outpatient setting. Methods?A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revision Clinical Modification (ICD-9-CM) codes were used to identify operations for degenerative cervical spine diseases in adults (age?>?20 years). Disposition and complication rates were examined. Results?There was an increase in cervical spine surgeries performed in an ambulatory setting during the study period. Anterior cervical diskectomy and fusion accounted for 68% of outpatient procedures; posterior decompression made up 21%. Younger patients predominantly underwent anterior fusion procedures, and patients in the eighth and ninth decades of life had more posterior decompressions. Charlson comorbidity index and complication rates were substantially lower for ambulatory cases when compared with inpatients. The majority (>99%) of patients were discharged home following ambulatory surgery. Conclusions?Recently, the number of cervical spine surgeries has increased in general, and more of these procedures are being performed in an ambulatory setting. The majority (>99%) of patients are discharged home but the nature of analyzing administrative data limits accurate assessment of postoperative complications and thus patient safety. This increase in outpatient cervical spine surgery necessitates further discussion of its safety. PMID:25083354

Baird, Evan O; Egorova, Natalia N; McAnany, Steven J; Qureshi, Sheeraz A; Hecht, Andrew C; Cho, Samuel K

2014-08-01

126

Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget's disease of bone.  

Science.gov (United States)

We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget's disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget's disease of the bone. PMID:25276115

Al Kaissi, Ali; Ganger, Rudolf; Mindler, Gabriel; Klaushofer, Klaus; Grill, Franz

2014-01-01

127

Evaluation of degenerative diseases of the lumbar spine with reformatted and 3-dimensional computed tomography images.  

Directory of Open Access Journals (Sweden)

The 2DMPR and 3DCT images provide significant anatomic and diagnostic information not readily derived from axial CT. It is useful in detecting degenerative conditions of the spine and associated complications.

Murvet Yuksel

2012-07-01

128

The Standardization of the Terminologies Used in the Reporting of Degenerative Disc Disease  

Directory of Open Access Journals (Sweden)

Full Text Available Many different groups have expressed the need to standardize the terms and classifications used in the reporting of spine MRI, particularly in the lumbar spine."nSeveral studies have shown "moderate" (17-20% ob-server variations in MRI lumbar spine reporting. The main discrepancies occur when deciding what consti-tutes a bulging or herniated disc and this represents more than 50% of all inter-observer disagreement. A variety of different terms are used to describe disc pathology on the preference of the reporting individ-ual."nRecently, there is a universal consensus of terms and a nomenclature framework for degenerative disc dis-ease which using of them are encouraged by the American Society of Neuroradiology (ASNR."nIn this presentation, first some inter-observer varia-tions of MRI reporting in our center will be shown. "nThen a review of articles about standard MRI report-ing nomenclature with some relevant interesting cases from our MRI center will be presented.

M. Barzin

2008-01-01

129

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

International Nuclear Information System (INIS)

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.)

130

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

131

Dynamic computed tomography myelography for the investigation of cervical degenerative disease. Technical note  

International Nuclear Information System (INIS)

Dynamic computed tomography (CT) myelography was conducted in 15 patients with cervical degenerative disease to assess the lesions responsible for their symptoms. CT myelography was performed using a multi-detector row helical CT system in dynamic positions (flexion or extension or both) in addition to the neutral position. Fine sagittal reconstructed images could be obtained in addition to axial images. This method provided static information including cervical vertebral body deformities, and good contrast images of the spinal cord, nerve roots, and cerebrospinal fluid space. In addition, laterality of the offending lesion and changes exaggerated by cervical motion were clearly shown in both axial and sagittal images. Ten of 15 patients demonstrated dynamic changes including dynamic canal stenosis or spinal cord impingement. The operative strategies were changed based on dynamic CT myelography findings in three of the 15 patients. Dynamic CT myelography can provide the axial and sagittal images required for flexion-extension studies, and in combination with conventional imaging modalities, provides valuable information for determining treatment strategies and objectives. (author)

132

Surgical treatment of degenerative cervical spine diseases: Analyses of 90 patients clinical study  

Directory of Open Access Journals (Sweden)

Full Text Available 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.

2012-01-01

133

Hybrid Surgery of Multilevel Cervical Degenerative Disc Disease : Review of Literature and Clinical Results  

Science.gov (United States)

Objective In the present study, we evaluated the effect, safety and radiological outcomes of cervical hybrid surgery (cervical disc prosthesis replacement at one level, and interbody fusion at the other level) on the multilevel cervical degenerative disc disease (DDD). Methods Fifty-one patients (mean age 46.7 years) with symptomatic multilevel cervical spondylosis were treated using hybrid surgery (HS). Clinical [neck disability index (NDI) and Visual Analogue Scale (VAS) score] and radiologic outcomes [range of motion (ROM) for cervical spine, adjacent segment and arthroplasty level] were evaluated at routine postoperative intervals of 1, 6, 12, 24 months. Review of other similar studies that examined the HS in multilevel cervical DDD was performed. Results Out of 51 patients, 41 patients received 2 level hybrid surgery and 10 patients received 3 level hybrid surgery. The NDI and VAS score were significantly decreased during the follow up periods (p<0.05). The cervical ROM was recovered at 6 and 12 month postoperatively and the mean ROM of inferior adjacent segment was significantly larger than that of superior adjacent segments after surgery. The ROM of the arthoplasty level was preserved well during the follow up periods. No surgical and device related complications were observed. Conclusion Hybrid surgery is a safe and effective alternative to fusion for the management of multilevel cervical spondylosis. PMID:23323165

Lee, Sang-Bok; Kim, Jong-Youn; Yoo, Do-Sung; Lee, Tae-Gyu; Huh, Pil-Woo

2012-01-01

134

Differentiation of malignant and degenerative benign bone disease using Tc-99m Citrate and Tc-99m MDP scintigraphy  

International Nuclear Information System (INIS)

Full text: For the evaluation of bone metastases in patients (pts) with cancer, 99mTcMDP bone scintigraphy is an important tool, but some limitations exist. One of these is the differential diagnosis of malignant and degenerative benign bone disease. The aim of this study was to differentiate them using 99mTcCitrate and 99mTcMDP scintigraphy. Methods: 39 pts (92 lesions) with known malignant or degenerative benign bone disease were studied. 23 pts had malignant bone disease (48 lesions, group 1), the other 16 pts had degenerative benign bone disease (44 lesions, group2), for which the results of 99mTcMDP scintigraphy were positive. In both groups, 99mTcCitrate scintigraphy was performed within a time interval of 2-7 days after 99mTcMDP scintigraphy (555?740MBq. static, 3hr, planar or SPECT i m a g e s w h e n r e q u i r e d ) . The 99mTccitrate/99mTcMDP lesion-to-background radioisotope uptake ratio (RUR) was calculated for each lesion. Conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up) were considered to be proof of the presence of bone metastases and degenerative benign bone disease. Results: Uptake of 99mTcMDP in the two groups is the same (1.96±0.25 vs. 1.87±0.21; t=1.178, P>0.20), while in 99mTcCitrate image, malignant lesions demonstrated a higher uptake of lesion activity than that of benign degenerative lesions (1.47±0.42 vs. 1.09±0.38; t=2.887, P<0.01). The mean 99mTccitrate/99mTcMDP RUR in the malignant group was significantly higher than the mean in the benign group (0.78±0.21 vs. 0.54±0.19; t=3.646, P<0.001). Conclusions: The preliminary results of the study confirm the usefulness and feasibility of 99mTcCitrate scintigraphy for differentiating malignant from benign degenerative lesions seen as areas of increased activity on 99mTcMDP bone scintigraphy. (author)

135

Controversies about interspinous process devices in the treatment of degenerative lumbar spine diseases: past, present, and future.  

Science.gov (United States)

A large number of interspinous process devices (IPD) have been recently introduced to the lumbar spine market as an alternative to conventional decompressive surgery in managing symptomatic lumbar spinal pathology, especially in the older population. Despite the fact that they are composed of a wide range of different materials including titanium, polyetheretherketone, and elastomeric compounds, the aim of these devices is to unload spine, restoring foraminal height, and stabilize the spine by distracting the spinous processes. Although the initial reports represented the IPD as a safe, effective, and minimally invasive surgical alternative for relief of neurological symptoms in patients with low back degenerative diseases, recent studies have demonstrated less impressive clinical results and higher rate of failure than initially reported. The purpose of this paper is to provide a comprehensive overview on interspinous implants, their mechanisms of action, safety, cost, and effectiveness in the treatment of lumbar stenosis and degenerative disc diseases. PMID:24822224

Gazzeri, Roberto; Galarza, Marcelo; Alfieri, Alex

2014-01-01

136

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Jeng, Chin-ming; Cheng, Tzu-chieh; Kung, Ching-huei; Hsu, Hue-chen

2011-01-01

137

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

2012-06-01

138

Degenerative Mitral Valve Repair  

Directory of Open Access Journals (Sweden)

Full Text Available Degenerative mitral regurgitation (MR is a rather common pathology1. If untreated, severe MR leads to left ventricular failure, pulmonary hypertension, atrial fibrillation and death 2. Correction of MR can be associated with a life expectancy and a quality of life similar to those of the normal healthy population, when performed appropriately and timely 3.In many patients, degenerative MR is characterised by an excess of valve tissue with elongated or ruptured chordae (Barlow’s disease 4, while in others, the leaflets are thinner and translucent and chordae are very fragile (fibroelastic deficiency. Mitral valve prolapse is the consequence of these anatomical alterations affecting primarily the leaflets and the subvalvular apparatus.American and European guidelines for the treatment of heart valve disease 5,6 indicate the criteria for appropriate management of patients with degenerative MR.The aim of this editorial is to briefly explore the optimal management of patients affected by degenerative MR.

Ottavio Alfieri MD.

2011-08-01

139

Degenerative changes of the skeleton; Degenerative Skelettveraenderungen  

Energy Technology Data Exchange (ETDEWEB)

Degeneration of the articular cartilage induces subchondral bone remodelling, which can be recognized in the bone scan by an enhanced radionuclide uptake. It cannot be distinguished from radionuclide uptake caused by other bony lesions. Thus the scintigraphic diagnosis of degenerative bone disease bases essentially on the consideration of its sites of predilection and on the exclusion of inflammation by three-phase bone scans. Due to the higher spatial resolution compared to planar imaging, SPECT is preferably used in the detection of degenerative changes of the vertebral column. As radionuclide uptake is enhanced already in the early stage of degenerative changes and only in sites of active disease but not in old, healed lesions, SPECT-imaging can make a contribution to the differential diagnosis of back pain. (orig.) [Deutsch] Degenerative Veraenderungen des Gelenkknorpels bewirken subchondrale Knochenumbauprozesse, die zu einer vermehrten Anreicherung knochenaffiner Radiopharmaka wie Tc-99m-MDP fuehren. Sie ist nicht von einer vermehrten Akkretion aufgrund anderer Knochenlaesionen zu unterscheiden. Der szintigraphische Nachweis degenerativer Skelettveraenderungen beruht daher auf der Beruecksichtigung ihrer Praedilektionsstellen und auf dem Ausschluss entzuendlicher Prozesse mit Hilfe der Drei-Phasen-Skelettszintigraphie. Wegen der im Vergleich zur planaren Szintigraphie besseren raeumlichen Aufloesung wird zum Nachweis degenerativer Prozesse im Bereich der Wirbelsaeule bevorzugt die SPECT-Technik eingesetzt. Da sich eine vermehrte Nuklidanreicherung bereits vor Entstehung morphologischer Veraenderungen bzw. nur in degenerativen Prozessen mit gesteigertem Knochenumbau, aber nicht in ausgeheilten Prozessen zeigt, kann mit Hilfe der Wirbelsaeulen-SPECT ein Beitrag zur Differentialdiagnose von Wirbelsaeulenbeschwerden geleistet werden. (orig.)

Hoeffken, H. [Marburg Univ. (Germany). Abt. fuer Klinische Nuklearmedizin

1997-10-01

140

Joint disease in children of Asiatic origin  

International Nuclear Information System (INIS)

Joint disorders in Asian children are varied due to the diversity of the Asian population and show some ethnic trends. The ethnic diversity, socio-economic and geographic factors in Asia have limited the availability of data from some of the ethnic groups, many of whom live in remote and relatively underdeveloped areas, are not subjected to epidemiological surveillance and have little awareness of these diseases and their consequences. Geographic and socio-economic factors also play a significant role in some of the joint diseases peculiar to Asian children. In general, the current available data suggests that there are no large differences in the epidemiology and clinical features between the Western and Asian children. This article reviews the available literature on joint diseases in Asian children

 
 
 
 
141

Degenerative changes of the skeleton; Degenerative Skelettveraenderungen  

Energy Technology Data Exchange (ETDEWEB)

Primary or secondary degeneration of the articular cartilage induces subchondral bone remodelling, which can be recognized in the bone scan by an enhanced radionuclide uptake. It cannot be distinguished from radionuclide uptake caused by other bone affections. Thus the scintigraphic diagnosis of degenerative bone disease bases essentially on the consideration of its sites of predilection. Degenerative bone changes can be differentiated from inflamation or osteonecrosis by three-phase bone scans. As SPECT provides imaging without superposition, this technique should be preferably used in the detection of degenerative changes of the vertebral column. (orig.) [Deutsch] Durch primaere oder sekundaere Degeneration des Gelenkknorpels werden subchondrale Knochenumbauprozesse eingeleitet, die im Szintigramm an einer vermehrten Akkretion zu erkennen sind. Sie sind nicht von Mehranreicherungen aufgrund anderer Knochenaffektionen zu unterscheiden. Der szintigraphische Nachweis degenerativer Skelettveraenderungen beruht daher wesentlich auf der Beruecksichtigung ihrer Praedilektionsstellen. Mit der Drei-Phasen-Skelett-Szintigraphie lassen sich degenerative Veraenderungen von entzuendlichen Prozessen oder Osteonekrosen abgrenzen. Durch die SPECT koennen die dicht beieinanderliegenden Strukturen der Wirbelsaeule ueberlagerungsfrei dargestellt werden. Daher sollte zum Nachweis degenerativer Veraenderungen der Wirbelsaeule bevorzugt diese Methode eingesetzt werden. (orig.)

Hoeffken, H. [Abt. fuer Klinische Nuklearmedizin, Klinikum der Philipps-Universitaet, Marburg (Germany)

1994-12-01

142

Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States Medicare population: potential economic implications of a new minimally-invasive technology  

Directory of Open Access Journals (Sweden)

Full Text Available Stacey J Ackerman1, David W Polly Jr2, Tyler Knight3, Karen Schneider4, Tim Holt5, John Cummings61Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Covance Market Access Services Inc, Sydney, NSW, Australia; 5Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 6Community Health Network, Neurosurgery, Indianapolis, IN, USAIntroduction: The economic burden associated with the treatment of low back pain (LBP in the United States is significant. LBP caused by sacroiliac (SI joint disruption/degenerative sacroiliitis is most commonly treated with nonoperative care and/or open SI joint surgery. New and effective minimally invasive surgery (MIS options may offer potential cost savings to Medicare.Methods: An economic model was developed to compare the costs of MIS treatment to nonoperative care for the treatment of SI joint disruption in the hospital inpatient setting in the US Medicare population. Lifetime cost savings (2012 US dollars were estimated from the published literature and claims data. Costs included treatment, follow-up, diagnostic testing, and retail pharmacy pain medication. Costs of SI joint disruption patients managed with nonoperative care were estimated from the 2005–2010 Medicare 5% Standard Analytic Files using primary International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM diagnosis codes 720.2, 724.6, 739.4, 846.9, or 847.3. MIS fusion hospitalization cost was based on Diagnosis Related Group (DRG payments of $46,700 (with major complications - DRG 459 and $27,800 (without major complications - DRG 460, weighted assuming 3.8% of patients have complications. MIS fusion professional fee was determined from the 2012 Medicare payment for Current Procedural Terminology code 27280, with an 82% fusion success rate and 1.8% revision rate. Outcomes were discounted by 3.0% per annum.Results: The extrapolated lifetime cost of treating Medicare patients with MIS fusion was $48,185/patient compared to $51,543/patient for nonoperative care, resulting in a $660 million savings to Medicare (196,452 beneficiaries at $3,358 in savings/patient. Including those with ICD-9-CM code 721.3 (lumbosacral spondylosis increased lifetime cost estimates (up to 478,764 beneficiaries at $8,692 in savings/patient.Conclusion: Treating Medicare beneficiaries with MIS fusion in the hospital inpatient setting could save Medicare $660 million over patients' lifetimes.Keywords: sacroiliac joint disruption, degenerative sacroiliitis, minimally invasive surgery, epidural injection, iFuse, cost

Ackerman SJ

2013-11-01

143

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

International Nuclear Information System (INIS)

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 T1- and T2-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)

144

Interspinous spacers in the treatment of degenerative lumbar spinal disease: our experience with DIAM and Aperius devices.  

Science.gov (United States)

Insertion of an interspinous devices has became a common procedure for the treatment of different clinical picture of degenerative spinal disease. We present our experience in 1,575 patients with the use of two different interspinous spacers: Device for Intervertebral Assisted Motion (DIAM) and Aperius PercLID system. From 2000 through 2008, 1,315 consecutive patients underwent DIAM implantation and 260 had an Aperius PercLID procedure. The main surgical indications included: degenerative disc disease (478 patients), canal and/or foraminal stenosis (347 patients), disc herniation (283 patients), black disc and facet syndrome (143) and topping-off (64 patients). 1,100 patients underwent a single level implant and 475 had a multiple level implant. Mean operating time was 35 min for DIAM and 7 min for Aperius. Complications were detected in 20 patients (10 cases of infections, 10 fractures of the posterior spinous processes). 40 patients were subsequently treated with posterior arthrodesis (n = 30) or total disc replacement (n = 10). Patient's postoperative clinical status was rated according to the modified Macnab criteria: symptoms resolution or improvement was achieved in 1,505 patients; and unchanged or unsatisfactory results in 70. Both techniques are safe, simple and less technically demanding. These approaches appear to be an effective alternative in selected cases, although conventional posterior lumbar decompression and fusion still may be required. PMID:21409561

Fabrizi, Antonio P; Maina, Raffaella; Schiabello, Luigi

2011-05-01

145

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 1: introduction and methodology.  

Science.gov (United States)

Fusion procedures are an accepted and successful management strategy to alleviate pain and/or neurological symptoms associated with degenerative disease of the lumbar spine. In 2005, the first version of the "Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine" was published in the Journal of Neurosurgery: Spine. In an effort to incorporate evidence obtained since the original publication of these guidelines, an expert panel of neurosurgical and orthopedic spine specialists was convened in 2009. Topics reviewed were essentially identical to the original publication. Selected manuscripts from the first iteration of these guidelines as well as relevant publications between 2005 through 2011 were reviewed. Several modifications to the methodology of guideline development were adopted for the current update. In contrast to the 2005 guidelines, a 5-tiered level of evidence strategy was employed, primarily allowing a distinction between lower levels of evidence. The qualitative descriptors (standards/guidelines/options) used in the 2005 recommendations were abandoned and replaced with grades to reflect the strength of medical evidence supporting the recommendation. Recommendations that conflicted with the original publication, if present, were highlighted at the beginning of each chapter. As with the original guideline publication, the intent of this update is to provide a foundation from which an appropriate treatment strategy can be formulated. PMID:24980578

Kaiser, Michael G; Eck, Jason C; Groff, Michael W; Watters, William C; Dailey, Andrew T; Resnick, Daniel K; Choudhri, Tanvir F; Sharan, Alok; Wang, Jeffrey C; Mummaneni, Praveen V; Dhall, Sanjay S; Ghogawala, Zoher

2014-07-01

146

Balance rehabilitation therapy by tongue electrotactile biofeedback in patients with degenerative cerebellar disease.  

Science.gov (United States)

Few clinical studies have evaluated physiotherapeutic interventions in patients with degenerative cerebellar ataxia. Investigations on the effectiveness of biofeedback-based interventions for training postural control in these patients have not been conducted yet. The aim of the present study was to assess the effectiveness of a 2-week intensive tongue-placed electrotactile biofeedback program for patients with progressive cerebellar ataxia. Subjects were seven adult patients suffering from cerebellar degeneration. Postural control was assessed with static posturography in two sensory conditions eyes open/closed on firm surface. For quantification of postural behavior, we used area, sway path and mean velocity of the centre of foot pressure (CoP). Effects of treatment were determined by comparing Pre, Post and one month follow-up (Retention) experimental sessions. Analysis of measured CoP parameters for tests on firm surface showed a significant main effect of visual condition and no difference across test sessions under open eyes condition. Under eyes closed condition, there were significant differences between Pre versus Post and Pre versus Retention, while the difference Post versus Retention was not significant. Our results suggest that a balance rehabilitation program with postural exercise performed with a head position-based tongue-placed biofeedback system could significantly improve bipedal postural control in patients suffering from degenerative cerebellar ataxia. PMID:23232167

Cakrt, Ond?ej; Vyhnálek, Martin; Slabý, Kryštof; Funda, Tomáš; Vuillerme, Nicolas; Kolá?, Pavel; Je?ábek, Jaroslav

2012-01-01

147

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

Directory of Open Access Journals (Sweden)

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.

Karl Stefan Delank

2010-03-01

148

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

International Nuclear Information System (INIS)

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)

149

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

Energy Technology Data Exchange (ETDEWEB)

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

150

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 13oo. 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.

151

Risk factors for the development of adjacent segment disease following anterior cervical arthrodesis for degenerative cervical disease: comparison between fusion methods.  

Science.gov (United States)

This study aimed to determine the risk factors for developing adjacent segment disease (ASDz) after anterior cervical arthrodesis for the treatment of degenerative cervical disease by analyzing patients treated with various fusion methods. We enrolled 242 patients who had undergone anterior cervical fusion for degenerative cervical disease, and had at least 5years of follow-up. We evaluated the development of ASDz and the rate of revision surgery. To identify the risk factors for ASDz, the sagittal alignment, spinal canal diameter, range of motion of the cervical spine, number of fusion segments, and fusion methods were evaluated. The patients were divided into three groups according to the fusion method: Group A contained patients who had received autogenous bone graft only (53 patients), Group B contained patients who received autogenous bone graft and plate augmentation (62 patients), and Group C contained patients who underwent cage and plate augmentation (127 patients). ASDz occurred in 33 patients, of whom 19 required additional surgery. The risk of developing ASDz was significantly higher in male patients (p=0.043), patients whose range of motion of the cervical spine was >30° (p=0.027), and patients with spinal canal stenosis (p=0.010). The rate of development of ASDz was not different depending on the number of fusion segments. The rate of development of ASDz was 41.5% in Group A, 9.6% in Group B, and 5.51% in Group C (p=0.03). In patients who underwent anterior cervical arthrodesis for degenerative disease, the occurrence of ASDz was related to age, the cervical spine range of motion, and spinal canal stenosis. Additional plate augmentation for anterior cervical arthrodesis surgery can lower the rate of ASDz development. PMID:24331625

Song, Ji-Soo; Choi, Byung-Wan; Song, Kyung-Jin

2014-05-01

152

Degenerative disorders of the spine  

International Nuclear Information System (INIS)

Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

153

Degenerative disorders of the spine  

Energy Technology Data Exchange (ETDEWEB)

Patients with back pain and degenerative disorders of the spine have a significant impact on health care costs. Some authors estimate that up to 80% of all adults experience back pain at some point in their lives. Disk herniation represents one of the most frequent causes. Nevertheless, other degenerative diseases have to be considered. In this paper, pathology and imaging of degenerative spine diseases will be discussed, starting from pathophysiology of normal age-related changes of the intervertebral disk and vertebral body. (orig.)

Gallucci, Massimo; Puglielli, Edoardo; Splendiani, Alessandra [University of L' Aquila, Department of Radiology, L' Aquila (Italy); Pistoia, Francesca; Spacca, Giorgio [S. Salvatore Hospital, Department of Neuroscience, L' Aquila (Italy)

2005-03-01

154

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 degeneration UCLA 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

155

Can facet joint infiltrative analgesia reduce postoperative pain in degenerative lumbar disc surgery? / ¿Puede reducirse el dolor postoperatorio en la cirugía discal degenerativa lumbar con infiltración de analgésicos?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivo. La analgesia peroperatoria influye en el curso del dolor postquirúrgico. El propósito del estudio reside en la evaluación de la posible relación entre el consumo de dolantina y otros analgésicos en el control del dolor postquirúrgico de origen facetario lumbar en la enfermedad discal degen [...] erativa. Métodos. Empleamos peroperatoriamente infiltra- ciones percutáneas de bupivacaína intra y perifacetaria para reducir el dolor postoperartorio tras cirugía discal lumbar. El estudio fue randomizado y oculto al observador y se realizó sobre 40 pacientes operados de cirugía electiva por enfermedad degenerativa lumbar, con una situación general Clase I-II de la clasifica-ción de la American Society of Anesthesiologist. Los pacientes se dividieron en dos grupos de 20 .El Grupo 1 se le administró bupivacaína en el tejido subcutáneo y capas musculares. El grupo 2 recibió una inyección adicional de bupivacaína intra y perifacetaria. Durante el postoperatorio, los pacientes, dispusieron de una bomba programable de analgesia controlada, que se activó exclusivamente a demanda para infundir dolantina en las 24 horas siguientes a la operación. En la Unidad de Reanimación postquirúrgicas se recogieron las necesidades de dolantina de los distintos pacientes. Resultados. No se encontraron diferencias esta- dísticamente significativas entre ambos grupos en relación a los valores de la escala analógica visual. El tiempo de demanda del primer bolo analgésico fue significativamente mayor en el grupo de facetas infiltradas (p=0,006). La acumulación de las dosis de dolantina fue también significativamente inferior en el grupo de facetas infiltradas (p=0.001). Conclusión. Los resultados indican que la infiltración de la faceta articular con anestésico local puede tener un efecto positivo reduciendo las necesidades analgésicas postoperatorias de dolantina. Abstract in english Objective. Perioperative analgesia effects the postoperative course of pain. The purpose of this study was to evaluate its possible relation with the consumption of dolantine and analgesics and the facet-induced pain and postoperative pain score in degenerative disc surgery. Methods. We employed per [...] ioperative intra- and perifacet bupivacaine infiltration technique to reduce the postoperative pain after lumbar disc surgery. The study was randomized and observer blinded enrolling 40 American Society of Anesthesiologists physical status class I-II patients scheduled for elective degenerative lumbar disc surgery. The patients were divided into two groups of 20 of which Group 1 underwent injection of bupivacaine into the subcutaneous and muscular layers around the incision site, while Group 2 underwent additional intra- and perifacetal joint infiltration. Postoperatively, the patients were provided with a programmed patient-controlled pump which was only activated on demand to infuse dolantine for the next 24 hours. In the postanesthesia care unit the delay for analgesia and the dose of dolantine used were recorded. Results. There was no statistical significance between these two groups regarding postoperative visual analoque scale scores. The time before the first analgesic request was significantly longer in facet group (p= 0,006). The cumulative dolantine dose was also significantly lower in the facet group (p= 0,001) Conclusion. The results indicate that facet joint infiltrative analgesia may have an effect on the postoperative analgesic requirement and reduce the dolantine consumption.

G., Bademci; H., Basar; S., Sahin; S., Ozcakir; H., Anbarci; C., Evliyaoglu; S., Keskil.

2008-02-01

156

Can facet joint infiltrative analgesia reduce postoperative pain in degenerative lumbar disc surgery? / ¿Puede reducirse el dolor postoperatorio en la cirugía discal degenerativa lumbar con infiltración de analgésicos?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Spain | Language: English Abstract in spanish Objetivo. La analgesia peroperatoria influye en el curso del dolor postquirúrgico. El propósito del estudio reside en la evaluación de la posible relación entre el consumo de dolantina y otros analgésicos en el control del dolor postquirúrgico de origen facetario lumbar en la enfermedad discal degen [...] erativa. Métodos. Empleamos peroperatoriamente infiltra- ciones percutáneas de bupivacaína intra y perifacetaria para reducir el dolor postoperartorio tras cirugía discal lumbar. El estudio fue randomizado y oculto al observador y se realizó sobre 40 pacientes operados de cirugía electiva por enfermedad degenerativa lumbar, con una situación general Clase I-II de la clasifica-ción de la American Society of Anesthesiologist. Los pacientes se dividieron en dos grupos de 20 .El Grupo 1 se le administró bupivacaína en el tejido subcutáneo y capas musculares. El grupo 2 recibió una inyección adicional de bupivacaína intra y perifacetaria. Durante el postoperatorio, los pacientes, dispusieron de una bomba programable de analgesia controlada, que se activó exclusivamente a demanda para infundir dolantina en las 24 horas siguientes a la operación. En la Unidad de Reanimación postquirúrgicas se recogieron las necesidades de dolantina de los distintos pacientes. Resultados. No se encontraron diferencias esta- dísticamente significativas entre ambos grupos en relación a los valores de la escala analógica visual. El tiempo de demanda del primer bolo analgésico fue significativamente mayor en el grupo de facetas infiltradas (p=0,006). La acumulación de las dosis de dolantina fue también significativamente inferior en el grupo de facetas infiltradas (p=0.001). Conclusión. Los resultados indican que la infiltración de la faceta articular con anestésico local puede tener un efecto positivo reduciendo las necesidades analgésicas postoperatorias de dolantina. Abstract in english Objective. Perioperative analgesia effects the postoperative course of pain. The purpose of this study was to evaluate its possible relation with the consumption of dolantine and analgesics and the facet-induced pain and postoperative pain score in degenerative disc surgery. Methods. We employed per [...] ioperative intra- and perifacet bupivacaine infiltration technique to reduce the postoperative pain after lumbar disc surgery. The study was randomized and observer blinded enrolling 40 American Society of Anesthesiologists physical status class I-II patients scheduled for elective degenerative lumbar disc surgery. The patients were divided into two groups of 20 of which Group 1 underwent injection of bupivacaine into the subcutaneous and muscular layers around the incision site, while Group 2 underwent additional intra- and perifacetal joint infiltration. Postoperatively, the patients were provided with a programmed patient-controlled pump which was only activated on demand to infuse dolantine for the next 24 hours. In the postanesthesia care unit the delay for analgesia and the dose of dolantine used were recorded. Results. There was no statistical significance between these two groups regarding postoperative visual analoque scale scores. The time before the first analgesic request was significantly longer in facet group (p= 0,006). The cumulative dolantine dose was also significantly lower in the facet group (p= 0,001) Conclusion. The results indicate that facet joint infiltrative analgesia may have an effect on the postoperative analgesic requirement and reduce the dolantine consumption.

G., Bademci; H., Basar; S., Sahin; S., Ozcakir; H., Anbarci; C., Evliyaoglu; S., Keskil.

157

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

Directory of Open Access Journals (Sweden)

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

2009-05-01

158

Management of sacroiliac joint disruption and degenerative sacroiliitis with nonoperative care is medical resource-intensive and costly in a United States commercial payer population  

Directory of Open Access Journals (Sweden)

Full Text Available Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Tim Holt,4 John Cummings5 1Covance Market Access Services Inc, San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc, Gaithersburg, MD, USA; 4Montgomery Spine Center, Orthopaedic Surgery, Montgomery, AL, USA; 5Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and originates in the sacroiliac (SI joint in 15%–30% of cases. Traditional SI joint disruption/degenerative sacroiliitis treatments include nonoperative care or open SI joint fusion. To evaluate the usefulness of newly developed minimally-invasive technologies, the costs of traditional treatments must be better understood. We assessed the costs of nonoperative care for SI joint disruption to commercial payers in the United States (US. Methods: A retrospective study of claim-level medical resource use and associated costs used the MarketScan® Commercial Claims and Encounters as well as Medicare Supplemental Databases of Truven Healthcare. Patients with a primary ICD-9-CM diagnosis code for SI joint disruption (720.2, 724.6, 739.4, 846.9, or 847.3, an initial date of diagnosis from January 1, 2005 to December 31, 2007 (index date, and continuous enrollment for ?1 year before and 3 years after the index date were included. Claims attributable to SI joint disruption with a primary or secondary ICD-9-CM diagnosis code of 71x.xx, 72x.xx, 73x.xx, or 84x.xx were identified; the 3-year medical resource use-associated reimbursement and outpatient pain medication costs (measured in 2011 US dollars were tabulated across practice settings. A subgroup analysis was performed among patients with lumbar spinal fusion. Results: The mean 3-year direct, attributable medical costs were $16,196 (standard deviation [SD] $28,592 per privately-insured patient (N=78,533. Among patients with lumbar spinal fusion (N=434, attributable 3-year mean costs were $91,720 (SD $75,502 per patient compared to $15,776 (SD $27,542 per patient among patients without lumbar spinal fusion (N=78,099. Overall, inpatient hospitalizations (19.4%, hospital outpatient visits and procedures (14.0%, and outpatient pain medications (9.6% accounted for the largest proportion of costs. The estimated 3-year insurance payments attributable to SI joint disruption were $1.6 billion per 100,000 commercial payer beneficiaries. Conclusion: The economic burden of SI joint disruption among privately-insured patients in the US is substantial, highlighting the need for more cost-effective therapies. Keywords: cost, epidural injection, lumbar spinal fusion surgery

Ackerman SJ

2014-02-01

159

Histone acetylation as a potential therapeutic target in motor neuron degenerative diseases.  

Science.gov (United States)

Among hereditary diseases, the group of motor neuron diseases (MNDs) includes some of the most devastating and rapidly progressive lethal conditions. Although degeneration of motor neurons is common to all of them, the phenotypic spectrum of MNDs is relatively broad and ranges from perinatal conditions like spinal muscular atrophy (SMA) to adult-onset diseases such as amyotrophic lateral sclerosis (ALS). While the understanding of the pathology of the diseases is constantly growing, the development of therapeutic approaches lags behind. In fact, there is no approved therapy for MNDs available at the moment. Recent findings demonstrated the existence of some patterns that are shared by several MNDs such as transcriptional dysregulation. In addition, conditions like SMA or certain types of Charcot-Marie-Tooth disease provide some defined targets which may be amenable to therapeutic approaches. Consequently, counteracting this dysregulation may be a valuable therapeutic option and ameliorate disease progression in MND patients. The feasibility of such an approach has been proven during the past years by the epigenetic treatment of various neoplastic entities with histone deacetylase inhibitors (HDACi). On these grounds, also epigenetic therapy of MNDs has become a promising option. So far, several HDACi have been tested in vitro and in animal models and some proceeded further and were evaluated in clinical trials. This review will summarize the advances of HDACi in MNDs and will give a perspective where the road will lead us. PMID:23448465

Garbes, Lutz; Riessland, Markus; Wirth, Brunhilde

2013-01-01

160

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 dis 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.)

 
 
 
 
161

Varus deformity of the left lower extremity causing degenerative lesion of the posterior horn of the left medial meniscus in a patient with Paget’s disease of bone  

Directory of Open Access Journals (Sweden)

Full Text Available [english] We report on a 42-year-old woman who presented with persistent pain in her left knee with no history of trauma. Sagittal T1-weighted MRI of the left knee showed discontinuity between the anterior and posterior horns of the left medial meniscus, causing effectively the development of degenerative lesion of the posterior horn. The latter was correlated to varus deformity of the left lower extremity associated with subsequent narrowing of the medial knee joint. The unusual craniofacial contour of the patient, the skeletal survey and the elevated serum alkaline phosphatase were compatible with the diagnosis of Paget’s disease of the bone. To alleviate the adverse effect of the mal-alignment of the left femur onto the left knee, corrective osteotomy of the left femoral diaphysis by means of fixators was performed. To the best of our knowledge this is the first clinical report describing the management and the pathological correlation of a unilateral varus deformity of the femoral shaft and degenerative lesions of the left knee in a patient with Paget’s disease of the bone.

Al Kaissi, Ali

2014-09-01

162

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)

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.)

163

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

Directory of Open Access Journals (Sweden)

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

2011-06-01

164

Percutaneous posterior-lateral lumbar interbody fusion for degenerative disc disease using a B-Twin expandable spinal spacer.  

Science.gov (United States)

Degenerative disc disease (DDD) causes gradual intervertebral space collapse, concurrent discogenic or facet-induced pain, and possible compression radiculopathy. A new minimal invasion procedure of percutaneous posterior-lateral lumbar interbody fusion (PPLIF) using a B-Twin stand-alone expandable spinal spacer (ESS) was designed to treat this disease and evaluated by follow-up more than 1 year. 12 cases with chronic low back pain and compressive radiculopathy due to DDD refractory were selected to conservative treatment. Under fluoroscopy in the posterior-lateral position, a K-wire was advanced into the intervertebral space and a dilator and working cannula were introduced into the disc space step by step. Discectomy and endplate scratching were performed through the cannula using pituitary forceps and endplate curettage. An ESS was inserted into the intervertebral space by a B-Twin expandable spinal delivery system after some bone graft chips implanted into the disc space. The ongoing study includes intraoperative difficulties, complications, radiologic evidence of fusion and clinical outcome as scored by pre- and postoperative questionnaires pertaining to pain intensity and degree of disability. The 12 procedures of lumbar interbody fusion using stand-alone expandable spinal system through percutaneous approach were successful. Radiologic study demonstrated fusion in a total of 11 cases and only 1 exception after more than 1 year visiting. The values of Visual Analog Scale (VAS) on movement and Oswestry Disability Index (ODI) dropped by more than 80 and 67.4%, respectively. Disk space heights averaging 9.0 mm before procedure were increased to 11.5 mm 1 month (a significant difference compared with preprocedure, P surgery and stabilized at 10.8 mm upon final follow-up (a significant difference compared with preprocedure, P lumbar interbody fusion using expandable spinal system is a valuable micro-invasion method for the DDD patients and can achieve the same outcome as with other methods. PMID:19784677

Xiao, Lizu; Xiong, Donglin; Zhang, Qiang; Jian, Jin; Zheng, Husan; Luo, Yuhui; Dai, Juanli; Zhang, Deren

2010-02-01

165

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

Energy Technology Data Exchange (ETDEWEB)

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

166

Vegetables as a Source of Dietary Fiber to Prevent Degenerative Diseases  

Directory of Open Access Journals (Sweden)

Full Text Available For long time vegetables were thought only as sources of several vitamins; however, it has been shown that vegetables contain other component, which is also important for maintaining body's health, i.e., dietary fiber. Dietary fiber is a group of polysaccharides oan other polymers, which cannot be digested by upper gastro-intestinal system of human. Dietary fiber can be grouped as soluble and insoluble dietary fiber, showing in different physiological effect. Soluble dietary fiber (SDF is effective in preventing cardiovascular disease, while insoluble dietary fiber (IDF can prevent the development of colon cancer, diverticulosis as well as obesity.Local vegetables found to contain high SDF (higher than 3,06% db are: watercress, green bean, carrot, eggplant, lettuce, broccoli, spinach, string bean, and aubergine; while which contain high IDF (higher than 40,60% db are: winged bean, watercress, chinese leaves, katuk leaves, lettuce, green bean, broccoli, carrot and spinach. Cooking (i.e. boiling, steaming and pan frying decrease the IDF content of vegetables, while their SDF content is not affected by cooking treatments.

Deddy Muchtadi

2001-04-01

167

Nuclear magnetic resonance in the evaluation of the disk luxation in the temporomandibular articulation conditioned for degenerative osseous changes  

International Nuclear Information System (INIS)

Purpose: The temporomandibular dysfunction is a common pathology. It appears with many symptoms as: joint pain, mechanic disturbance, and loss of mouth motion. The Magnetic Resonance Image is the chose method to study these alterations. The purposes of this paper are to demonstrate according to sex, the distribution of temporomandibular dysfunction and to determinant the relationships between the disc dislocation and the degenerative disease of the junction. Material and Method: 215 patients were evaluated between January 1999 and August 2004. An Elscint MRI 2 Tesla machine was used with Spin-echo (T1 and T2) Fat-sat sequences, in coronal, axial and sagittal planes. The follow alterations were evaluated: dislocation, degenerative disease of articular surface, osteochondritis, discal perforation, and retrodiscal lesions. Results: 175 of all showed pathologic alterations in IRM examination. The other 40 patients were excluded due to present a normal (MRI) study. The patients were 146 females and 29 men. The most common dislocation site was the anterior. Performance of the IRM was useful in all the cases to demonstrate degenerative changes in the temporomandibular joint (TMJ). And was a very precise relationship between the dislocation and degenerative disease of the joint. Conclusion: the female patient is the most frequently affected by temporomandibular joint pathology. The IRM is the selection method to study the TMJ. The degenerative changes are responsible for joinenerative changes are responsible for joint dislocation without reduction. (author)

168

Radiology of chronic diseases of the ankle joint; Chronische Krankheitsbilder am Sprunggelenk  

Energy Technology Data Exchange (ETDEWEB)

The etiology of chronic diseases of the ankle joint comprises a wide spectrum including chronic inflammatory processes and chronic degenerative, tumorous and neuropathic processes, as well as some specific syndromes based on chronic changes of the ankle joint. Of the inflammatory processes, chronic juvenile arthritis (JVC) is the most common disease. However, also Reiter disease, psoriasis or chronic monoarthritid diseases such as gout, as well as granulomatous diseases (tuberculosis, sarcoidosis) and fungal infections, may affect the ankle joint in a chronic course. Chronic degenerative changes are usually secondary due to abnormal positioning of the joint constituents or repetitive trauma. Neuropathic changes, as frequently seen in the course of diabetes, present with massive osseous destruction and malposition of the articular constituents. Chronic osseous as well as cartilaginous and synovial changes are seen in hemoplici patients. Chronic traumatic changes are represented by pigmented villonodular synovitis (PVNS), and chondromatosis, both with a predilection for the ankle joint. Due to the possibilities of magnetic resonance imaging (MRI), diagnosis of chronic ankle changes includes chronic ligamentous, tendinous and soft tissue changes. With the use MRI, specific syndromes can be defined which particularly affect the ankle joint in a chronic way, such as the os trigonum syndrome, the anterolateral impingement syndrome and the sinus tarsi syndrome. Nevertheless, plain film radiographs are still the basic element of any investigation. MRI, however, can be potentially used as a second investigation, saving an unnecessary cascade of investigations with ultrasound and CT. The latter investigations are used only with very specific indications, for instance CT for subtle bone structures and sonography for a limited investigation of tendons or evaluation of fluid. Particularly due to the possibilities of MRI and the development of special gradient-echo imaging or high-resolution coils, the investigation of the ankle joint still offers a wide spectrum of innovation for the next years, which is particularly enforced by the increasing demand for specific diagnosis of chronic diseases in orthopedic medicine. (orig.) [Deutsch] Die Aetiologie chronischer Krankheitsbilder am Sprunggelenk ist vielfaeltig. Chronisch entzuendliche Veraenderungen, wie sie im Rahmen einer chronisch juvenilen Arthritis, des M. Reiter, der Psoriasis oder chronischer Monoarthritiden, wie der chronischen Gicht zu beobachten sind, haben nicht selten ihre Manifestation am Sprunggelenk. Seltenere entzuendlich chronische Affektionen hingegen koennen jedoch auch bei enteropathischen Arthritiden, granulomatoesen Erkrankungen, wie der Tuberkulose oder Sarkoidose, beobachtet werden. Auch chronisch verlaufende Pilzaffektionen koennen zu atypischen Bildern fuehren. Chronisch degenerative Erkrankungen entstehen am Sprunggelenk fast ausschliesslich sekundaer. Praedisponierend sind hier angeborene oder erworbene Fehlhaltungen sowie chronische Veraenderungen auf Basis abgelaufener oder repetitiver Traumen. Der neuropathische Formenkreis stellt eine weitere Causa chronischer Veraenderungen dar, mit im fortgeschrittenem Stadium massiven Gelenks- und ossaeren Veraenderungen. Chronische Veraenderungen sind auch bei der Haemophilie im Rahmen des Blutergelenkes zu erwarten. Als chronisch tumoroese Veraenderungen koennen die pigmentierte villonodulaere Synovitis (PVNS) und die Gelenkschondromatose betrachtet werden, mit teils ossaeren und teils charakteristischen Kapsel und Weichteilveraenderungen. Die modernen Gelenkdiagnostik umfasst zudem auch chronische Veraenderungen an den Sehnen und Baendern. Besondere diagnostische Herausforderungen stellen letztendlich Syndrome dar, die klinisch zwar beobachtet, jedoch erst durch moderne Bildgebung in den letzten Jahren zunehmend spezifiert werden konnten. Diese umfassen zum Beispiel das `Os-trigonum-Syndrom`, das `anterolaterale Weichteilimpingement` und das `Sinus-tarsi-Syndrom`. Wie in der allgmeinen Gelenkdiagnostik ist auch wei

Rand, T. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie]|[Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Trattnig, S.; Breitenseher, M.; Imhof, H. [Vienna Univ. (Austria). Einrichtung fuer Magnetresonanztomographie; Kreuzer, S. [Universitaetsklinik fuer Radiodiagnostik, Vienna (Austria); Wagesreither, S. [Vienna Univ. (Austria). Klinik fuer Zahn-, Mund- und Kieferheilkunde

1999-01-01

169

Interspinous spacer decompression (X-STOP) for lumbar spinal stenosis and degenerative disk disease: a multicenter study with a minimum 3-year follow-up.  

Science.gov (United States)

Interspinous distraction devices provide an effective treatment for patients suffering from lumbar spinal stenosis and/or degenerative disk disease. The aim of this multicenter study was the prospective evaluation of patients treated for symptomatic lumbar spinal stenosis with interspinous process decompression (IPD) implants compared with a population of patients managed with conservative treatment. 542 patients affected by symptomatic lumbar spine degenerative disease were enrolled in a controlled trial. 422 patients underwent surgical treatment consisting of X-STOP device implantation, whereas 120 control cases were managed conservatively. Both patient groups underwent follow-up evaluations at 6, 12, 24, and 36 months using the Zurich Claudication Questionnaire, the Visual Analog Scale score and spinal lumbar X-rays, CT scans and MR imaging. One-year follow-up evaluation revealed positive good results in the 83.5% of patients treated with IPD with respect to 50% of the nonoperative group cases. During the first three years, in 38 out of the 120 control cases, a posterior decompression and/or spinal fixation was performed because of unsatisfactory results of the conservative therapy. In 24 of 422 patients, the IPD device had to be removed, and a decompression and/or pedicle screw fixation was performed because of the worsening of neurological symptoms. Our results support the effectiveness of surgery in patients with stenosis. IPD may offer an effective and less invasive alternative to classical microsurgical posterior decompression in selected patients with spinal stenosis and lumbar degenerative disk diseases. PMID:25064150

Puzzilli, Fabrizio; Gazzeri, Roberto; Galarza, Marcelo; Neroni, Massimiliano; Panagiotopoulos, Konstantinos; Bolognini, Andrea; Callovini, Giorgio; Agrillo, Umberto; Alfieri, Alex

2014-09-01

170

Application of stable isotopic techniques in the prevention of degenerative diseases like obesity and NIDDM in developing societies  

International Nuclear Information System (INIS)

Economic development in developing societies characterized by industrialization, urbanization and globalization has seen the emergence of an epidemic of diet and life-style related chronic degenerative diseases. A research project has been initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria, under its Co-ordinated Research Programme (CRP) to promote the use of stable isotopic techniques to document the extent of the problem and to understand the determinants of this epidemic. The principal objectives of this CRP involving countries both in the North and the South are to define the magnitude of the problem of obesity and non-insulin Dependent diabetes mellitus (NIDDM) in developing countries, to identify the vulnerable groups at increased risk and to attempt to describe the metabolic and physiological mechanisms underlying this phenomenon. These comparative international studies of obesity and NIDDM are looking at the effects of childhood malnutrition (Brazil and socio-economic differentials (Mexico) on adult risk factors; the composition of the daily diet on obesity (Chile); levels of patterns of physical activity of older adults (China) as well as their influence on weight gain and obesity (Cuba, Nigeria); the impact of body composition and energy expenditure on the evolution frank diabetes from impaired glucose tolerance (Jamaica), and of body compositional changes and the role of inflammatory cytokines on impaired glucose tolerance (India). The last study conducted in New Zealand was aimed at comparing the energy expenditures of Maori (Pacific Island) with New Zealanders of European descent. The findings of the CRP of the MEA in this area carried out in several countries are presented in this article. (author)

171

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.  

Science.gov (United States)

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. PMID:23804144

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

172

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

2013-06-01

173

Long-term follow-up of functional outcomes and radiographic changes at adjacent levels following lumbar spine fusion for degenerative disc disease.  

Science.gov (United States)

There are very few studies with more than 20 years' follow-up of lumbar spine fusions for disc degeneration. Currently, there is a lot of interest in the subject of degenerative changes above the level of fusion; this study is concerned with such changes in the very long term (30 years). Twenty-eight patients showing sound fusion on radiographs following posterior midline spinal fusion performed by a single surgeon between 1968 and 1970 were compared with an age- and gender-matched group of 28 patients who had undergone surgery for degenerative disc disease without fusion during the same period, by the same surgeon and using similar criteria for evaluation (Short Form 36 and Oswestry Disability Index; functional testing using self-paced walk and timed up-and-go; flexion and extension lateral radiographs of the lumbar spine). In this study, the incidence of radiographic changes at levels above the level of previous involvement was twice as high in the fusion group as in the non-fusion group. However, there was no statistically significant difference between the two groups in the outcomes measured using validated scales and functional testing. The study emphasises the importance of complete evaluation of these patients using validated outcome measurement instruments against the background of radiographic changes and subjective assessment of back pain. It also shows that radiographic changes do not necessarily mean functional impairment in all patients following lumbar spine fusion for degenerative disc disease. PMID:11563616

Kumar, M N; Jacquot, F; Hall, H

2001-08-01

174

Sacroiliac joint pain: burden of disease  

Directory of Open Access Journals (Sweden)

Full Text Available Daniel Cher,1 David Polly,2 Sigurd Berven31SI-BONE, Inc., San Jose, CA, USA; 2Department of Orthopedic Surgery, University of Minnesota, Minneapolis, MN, USA; 3Department of Orthopedic Surgery, University of California San Francisco, San Francisco, CA, USAObjectives: The sacroiliac joint (SIJ is an important and significant cause of low back pain. We sought to quantify the burden of disease attributable to the SIJ.Methods: The authors compared EuroQol 5D (EQ-5D and Short Form (SF-36-based health state utility values derived from the preoperative evaluation of patients with chronic SIJ pain participating in two prospective clinical trials of minimally invasive SIJ fusion versus patients participating in a nationally representative USA cross-sectional survey (National Health Measurement Study [NHMS]. Comparative analyses controlled for age, sex, and oversampling in NHMS. A utility percentile for each SIJ subject was calculated using NHMS as a reference cohort. Finally, SIJ health state utilities were compared with utilities for common medical conditions that were published in a national utility registry.Results: SIJ patients (number [n]=198 had mean SF-6D and EQ-5D utility scores of 0.51 and 0.44, respectively. Values were significantly depressed (0.28 points for the SF-6D utility score and 0.43 points for EQ-5D; both P<0.0001 compared to NHMS controls. SIJ patients were in the lowest deciles for utility compared to the NHMS controls. The SIJ utility values were worse than those of many common, major medical conditions, and similar to those of other common preoperative orthopedic conditions.Conclusion: Patients with SIJ pain presenting for minimally invasive surgical care have marked impairment in quality of life that is worse than in many chronic health conditions, and this is similar to other orthopedic conditions that are commonly treated surgically. SIJ utility values are in the lowest two deciles when compared to control populations.Keywords: sacroiliac joint fusion, chronic lower back pain, quality of life, utility assessment, comparative assessments

Cher D

2014-04-01

175

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

176

Effect of posterior subsidence on cervical alignment after anterior cervical corpectomy and reconstruction using titanium mesh cages in degenerative cervical disease.  

Science.gov (United States)

Subsidence after anterior cervical reconstruction using a titanium mesh cage (TMC) has been a matter of debate. The authors investigated and analyzed subsidence and its effect on clinical and radiologic parameters after cervical reconstruction using a TMC for degenerative cervical disease. Thirty consecutive patients with degenerative cervical spine disorders underwent anterior cervical corpectomy followed by reconstruction with TMC. Twenty-four patients underwent a single-level corpectomy, and six patients underwent a two-level corpectomy. Clinical outcomes were assessed using a Visual Analogue Scale (VAS), the Japanese Orthopedic Association (JOA) score and the Neck Disability Index (NDI). Fusion status, anterior and posterior subsidence of the TMC, segmental angle (SA) and cervical sagittal angle (CSA) were assessed by lateral and flexion-extension radiographs of the neck. The mean follow-up period was 27.6months (range, 24 to 49months). The VAS, NDI and JOA scores were all significantly improved at the last follow-up. No instances of radiolucency or motion-related pseudoarthrosis were detected on radiographic analysis, yielding a fusion rate of 100%. Subsidence occurred in 28 of 30 patients (93.3%). The average anterior subsidence of the cage was 1.4±0.9mm, and the average posterior subsidence was 2.9±1.2mm. The SA and CSA at the final follow-up were significantly increased toward a lordotic angle. Anterior cervical reconstruction using TMC and plating in patients with cervical degenerative disease provides good clinical and radiologic outcomes. Cage subsidence occurred frequently, especially at the posterior part of the cage. Despite the prominent posterior subsidence of the TMC, SA and CSA were improved on final follow-up radiographs, suggesting that posterior subsidence may contribute to cervical lordosis. PMID:24957629

Jang, Jae-Won; Lee, Jung-Kil; Lee, Jung-Heon; Hur, Hyuk; Kim, Tae-Wan; Kim, Soo-Han

2014-10-01

177

STUDY ON THE LIMITS AND POSSIBILITIES OF THE HCP “DESOSPITALIZAR” IN PATIENTS WITH CHRONIC DEGENERATIVE DISEASES IN THE REGIONAL HEALTH OF PARANOÁ.  

Directory of Open Access Journals (Sweden)

Full Text Available This research project intends to evaluate the possibilities, challenges and impacts of health actions made by Home Care Program (PID, effected at the Regional Center for Home Care (NRAD, about the vacancy of hospital beds occupied by people from Paranoá's Regional. It is a descriptive study where was applied an validated instrument with title, Classification System for Patients: construction and validation of an instrument. (PERROCA. M.G.; GAIDZINSKI, R. R., et al, 1998. The data collection period was between January and March 2013 in Paranoá's NRAD. Were analyzed 29 patients with chronic degenerative diseases who are in home care. On scores of 29 patients admitted in this program, it was found that 13 patients require minimal care (44.82% and 13 patients, equally, require intermediate care (44.82%. So, it is concluded that the obtained data in this research indicates that the limits and possibilities of the Regional Center for Home Care Program (NRAD in "desospitalizar" (take out of the hospital patients with chronic degenerative diseases at Paranoá's Regional Health are favoring patients admitted with scores below the pre-established ones, according to criteria of the program through the scale used for intermediate care.

Camila Reis Santana

2014-02-01

178

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 ...

179

Computed tomography for diseases of the knee joint  

International Nuclear Information System (INIS)

CT was performed on 126 knee joints of 63 patients with diseases of the knee joint, and the results were discussed. CT was useful to know changes in the patella, because CT images of the patella-femoral joint could visualize the position of the joint minutely and the congruence angle of the joint could be measured on CT images taken at extension position. CT images of diseases with rupture of cartilage such as steroid arthritis could visualize the rupture as the defect. Therefore, CT was useful for the following invasive therapy. In osteoarthritis of the knee joint, the progress of osteosclerosis could be observed by measuring subcartilaginous trabeculae on sequential CT images. Transaxial image of meniscus injuries by CT could visualize the meniscus. Clear CT image of crucial ligament could be obtained by air injection quadricepts femoris atrophy could be observed quantitatively by CT and furthermore CT could clearly visualize folds of synovial membrane within the patella. CT made it possible to make a diagnosis of knee joint disorders. (Tsunoda, M.)

180

Comparison of degree of postoperative muscle damage between MIS-TLIF- and PLIF treatment for single-level degenerative lumbar disease  

Directory of Open Access Journals (Sweden)

Full Text Available Objective?To compare the postoperative muscle damage after either posterior lumbar interbody fusion (PLIF or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF with the aid of X-Tube system in patients with singlelevel degenerative lumbar spinal disease. Methods?The clinical data of 52 patients (males 28, females 24, aged 54.3±7.8 years with single-level degenerative lumbar spinal disease undergoing MIS-TLIF assisted by the X-Tube system from Oct 2010 to Sep 2011 was analyzed retrospectively. The operative time, intraoperative blood loss, postoperative drainage volume, postoperative bedtime, and serum creatine kinase (CK level 1 day before surgery and 1, 3 and 5 days after surgery were recorded and compared with those of 38 patients (males 20, females 18, aged 51.6±8.6 years with the same disease undergoing conventional open PLIF during the corresponding period. The back pain visual analogue score (VAS, Oswestry disability index (ODI score and imaging examination were performed before operation, after operation and during follow-up duration for each patient. Results?There was no significant difference in the gender, age, clinical diagnosis, lesion location, preoperative CK level, VAS and ODI scores between the two groups (P>0.05. The operative time was longer in MIS-TLIF group than in PLIF group (P0.05. Radiological followup observation revealed good fusion 6 months after operation in all the patients. Conclusion?The X-Tube-assisted MIS-TLIF has several advantages over conventional open PLIF, such as less intraoperative blood loss, milder muscle damage, and lighter back pain. DOI: 10.11855/j.issn.0577-7402.2013.12.04

Liang ZHOU

2014-01-01

 
 
 
 
181

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 5: correlation between radiographic outcome and function.  

Science.gov (United States)

In an effort to diminish pain or progressive instability, due to either the pathological process or as a result of surgical decompression, one of the primary goals of a fusion procedure is to achieve a solid arthrodesis. Assuming that pain and disability result from lost mechanical integrity of the spine, the objective of a fusion across an unstable segment is to eliminate pathological motion and improve clinical outcome. However, conclusive evidence of this correlation, between successful fusion and clinical outcome, remains elusive, and thus the necessity of documenting successful arthrodesis through radiographic analysis remains debatable. Although a definitive cause and effect relationship has not been demonstrated, there is moderate evidence that demonstrates a positive association between radiographic presence of fusion and improved clinical outcome. Due to this growing body of literature, it is recommended that strategies intended to enhance the potential for radiographic fusion are considered when performing a lumbar arthrodesis for degenerative spine disease. PMID:24980582

Dhall, Sanjay S; Choudhri, Tanvir F; Eck, Jason C; Groff, Michael W; Ghogawala, Zoher; Watters, William C; Dailey, Andrew T; Resnick, Daniel K; Sharan, Alok; Mummaneni, Praveen V; Wang, Jeffrey C; Kaiser, Michael G

2014-07-01

182

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: assessment of functional outcome following lumbar fusion.  

Science.gov (United States)

Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome. PMID:24980579

Ghogawala, Zoher; Resnick, Daniel K; Watters, William C; Mummaneni, Praveen V; Dailey, Andrew T; Choudhri, Tanvir F; Eck, Jason C; Sharan, Alok; Groff, Michael W; Wang, Jeffrey C; Dhall, Sanjay S; Kaiser, Michael G

2014-07-01

183

Clinical study to evaluate the safety and effectiveness of the Aesculap Activ-L™ artificial disc in the treatment of degenerative disc disease  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The objective of this clinical study is to evaluate the safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine in patients who have been unresponsive to at least six months of prior conservative care. The hypothesis of the study is that the Activ-L Disc is non-inferior to the control (the Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine] with respect to the rate of individual subject success at 24 months. Individual subject success is a composite of effectiveness and safety. Methods/Design The study proposed is a prospective, randomized, single-masked, controlled, multi-center clinical trial consisting of an estimated 414 subjects with single-level DDD of the lumbar spine (L4/L5, or L5/S1 who have failed to improve with conservative treatment for at least six months prior to enrollment. After enrollment, subjects will be randomized in a 2:1 ratio to either the Activ-L Disc (investigational device or the control (Charité or ProDisc-L. Radiographic endpoints will be evaluated by an independent reviewer at an imaging core laboratory. Each subject will be followed for 5 years post-treatment. Discussion The safety and effectiveness of the Activ-L Artificial Disc for treatment of single-level degenerative disc disease of the lumbar spine will be equivalent to Charité® Artificial Disc [DePuy Spine] or ProDisc-L® Total Disc Replacement [Synthes Spine] at 24 months. Trial Registration Current Controlled Trials NCT00589797.

Mo Fred F

2010-04-01

184

Posterior lumbar interbody fusion for degenerative disc disease using a minimally invasive B-twin expandable spinal spacer: a multicenter study.  

Science.gov (United States)

Acquired degenerative disc disease causes gradual disc space collapse, concurrent discogenic or facet-induced pain, and possible compression radiculopathy. Surgical treatment aims to re-expand the intervertebral space and stabilize the involved segment in balanced alignment until fusion is complete. The prevailing methods make use of a twin cage device of predetermined size. Their implantation requires extensive exposure, entailing the sacrifice of posterior stabilizing structures. The procedure also results in significant traction on the dural sac and the cauda equina and is thereby a potential source of neurologic damage. The new expandable spinal spacer (ESS) was designed to mitigate all the shortcomings alluded to above. A prospective multicenter clinical study was conducted of 87 patients with chronic low back pain due to degenerative disc disease, treated by posterior lumbar interbody fusion (PLIF) using a newly designed ESS. The study protocol was approved by the ethics committees of all the participating institutions. The objective was to test the safety and efficacy of the device. Each participant was followed periodically for >1 postoperative year. The ongoing record included intraoperative difficulties and complications, if any, radiologic evidence of fusion and clinical outcome as scored by pre- and postoperative questionnaires pertaining to pain intensity and degree of disability. No dural lacerations or neurologic deficit occurred. There were no mechanical failures of the spacer. Radiologic study demonstrated fusion in all but one patient. Disc space height that averaged 7.53 +/- 2.42 mm before surgery increased to 10.03 +/- 2.00 mm at the time of surgery and stabilized at 9.47 +/- 2.10 mm upon final follow-up. Visual Analog Scale and Oswestry Index decreased by 60% and 58%, respectively. PLIF using the ESS achieves the same ultimate outcome as do other methods currently in use but does not share the handicaps and hazards and is more user-friendly to the surgeon. PMID:14526194

Folman, Yoram; Lee, Sang-Ho; Silvera, Jose Raul; Gepstein, Reuven

2003-10-01

185

Studies on the pathogenesis of the degenerative lumbar canal stenosis by CT, 3. Clinical studies on the pathogenesis of the degenerative LCS  

Energy Technology Data Exchange (ETDEWEB)

Computed tomography (CT) scans of lumbar canal stenosis (LCS, n = 20), osteoarthritis (OA, n = 65), disk herniation (n = 21), and lumbar pain (n = 23) were reviewed for the quanlitative evaluation of the vertebral canal and stenosis factors. Trefoil type on transverse sections of the bony vertebral canal was observed in 23 %, having no implications for pathologic significance at the L5 level. The degree of degeneration in soft tissues inside the vertebral canal varied according to diseases. This was most noticeable at the L4/L5 level in the LCS group. The morphological CT appearance of vertebral arch were divided into three types: I - the concave inner part, II - the linear inner part, and III - the convex inner part to the vertebral canal. In the group of LCS, the incidences of types II and III were high at the L5/S1 and at the L4/L5 levels, respectively. As for the angle of apophyseal joint, the incidence of sagittal joint was high at the L3/L4 and L4/L5 levels in the group of LCS. The incidence of degenerative changes was high in the groups of LCS and OA, suggesting some relationship between degenerative degree and both sagittal and asymmetric joints. This was noticeable at the L4/L5 level. Calcification surrounding the joint was seen in 13 %, reflecting the relationship to the degenerative changes. There was no relationship between degenerative changes and vacuum joint phenomenon observed in 18 %. As for the area less than 90 mm/sup 2/ of the dural canal, there was no morphological change between the LCS and OA groups. In the symptomatic mechanism in the case of LCS, morphological dynamic and unstable factors may be involved. (Namekawa, K.) 67 refs.

Kido, Kenji

1988-03-01

186

Temporomandibular joint dysfunction in various rheumatic diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Temporomandibular disorder (TMD is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA, osteoarthrosis (OA, ankylosing spondylitis (AS and systemic lupus erythematosus, and to define the limitations in everyday’s life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1 the presence of pain; 2 difficulty on mouth opening, chewing or speaking; 3 the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%. Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005. We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16% patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily.

F.J. Aceves-Avila

2013-07-01

187

Quantitative assessment of bone scintigraphy in the hip joint disease  

International Nuclear Information System (INIS)

Quantitative assessment of bone scintigraphy was performed in fifty-six patients with hip joint disease including femoral neck fracture, aseptic necrosis of the femoral head, traumatic dislocation of the hip, Perthes disease, and transient synovitis of the hip. In the static study, bone scintigraphy was obtained 3 hours after injection of sup(99m)Tc-MDP by gamma camera equipped with a computer and uptake ratios were calculated. In the dynamic study, bone scintigraphy was performed in one, 3 and 5 hours after injection of radionuclide. Femoral head uptake ratio was markedly decreased in osteonecrosis following femoral neck fracture and characteristically increased in aseptic necrosis of the femoral head but prolonged retention of sup(99m)Tc-MDP could be observed. Uptake ratios of epiphysis were decreased in Perthes disease but normal in transient synovitis of the hip. Static and dynamic study of bone scintigraphy may be useful for early diagnosis and treatment in the hip joint disease. (author)

188

The radiology of joint disease. Volume 2. Third edition  

International Nuclear Information System (INIS)

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

189

Vacuum facet phenomenon: a computed tomographic sign of degenerative spondylolisthesis  

International Nuclear Information System (INIS)

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

190

Calidad de vida relacionada con la salud en personas con enfermedades crónicas degenerativas / Quality of life related to health in persons with chronic degenerative diseases  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish INTRODUCCIÓN. La calidad de vida relacionada con la salud es un indicador que incorpora la apreciación del individuo sobre su enfermedad. En la revisión bibliográfica se encontró que en Cuba no hay experiencia en el uso del WHOQOL _ BREF como instrumento de medición de esta, por lo que se pretende d [...] escribirlo en personas que presentan enfermedades crónicas degenerativas, para determinar si es aplicable en el contexto cubano. MÉTODOS. Estudio descriptivo de calidad de vida relacionada con la salud en 300 personas con enfermedades crónicas degenerativas que están entre las tres primeras causas de mortalidad en el país. Se aplicaron encuestas con el instrumento WHOQOL _ BREF. RESULTADOS. Fueron contestadas el 100 % de las encuestas. El porcentaje se desglosó como sigue: 51,3 de los enfermos consideraron su calidad de vida relacionada con la salud "ni pobre ni buena" y 33,3 como "buena". 48,6 se valoró "ni satisfecho ni insatisfecho" y 33,3 "satisfecho". La salud psicológica fue calificada "alta" en los tres tipos de enfermedades y el dominio que explora ambiente recibió la calificación de "regular." Las mujeres, en ambos grupos de edades, la consideraron "aceptable". Por tipo de enfermedad, las de 45 y más años, que padecían un tumor, tenían una "alta" calidad de vida relacionada con la salud. CONCLUSIONES. El WHOQOL _ BREF permitió medir correctamente la calidad de vida relacionada con la salud en personas con enfermedades crónicas degenerativas, lo que supone que es aplicable al contexto cubano. La salud psicológica resultó la mejor valorada en cualesquiera de las enfermedades estudiadas. Abstract in english INTRODUCTION: The quality of life related to health is an indicator that incorporates the individual's appreciation of his illness. In the bibliographical review it was found that in Cuba there is no experience in the use of the WHOQOL_BREF as an instrument to measure it. That's why, it is intended [...] to describe it in persons with chronic degenerative illness to determine if it can be applied to the Cuban context. METHODS: A descriptive study of the quality of life connected with health was conducted in 300 individuals with chronic degenerative diseases that are among the first three causes of death in the country. Surveys were done with the WHOQOL_BREF instrument. RESULTS: 100% of the surveys were answered. 51.3% of the sick persons considered its quality of life in relation to health neither poor nor good and 33.3% considered it good. 48.6 % evaluated themselves as neither satisfied nor unsatisfied and 33.3 % as satisfied. The psychological health was rated as "high" in the three types of diseases, whereas the domain exploring environment was estimated as fair. Females, in both groups of ages, considered it "acceptable." According to the type of disease, those aged 45 and over suffering from a tumor had a high quality of life related to health. CONCLUSIONS: The WHOQOL_BREF allowed to measure correctly the quality of life related to health in people with chronic degenerative diseases, which makes us suppose that it is applicable to the Cuban context. The psychological health was the best assessed in any of the studied diseases

Antonio, Castillo Guzmán; Carmen, Arocha Meriño; Nurys B, Armas Rojas; Ivette, Castillo Arocha; Michel Ernesto, Cueto Cañabate; Marys Leidis, Herrera Giró.

191

Calidad de vida relacionada con la salud en personas con enfermedades crónicas degenerativas Quality of life related to health in persons with chronic degenerative diseases  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUCCIÓN. La calidad de vida relacionada con la salud es un indicador que incorpora la apreciación del individuo sobre su enfermedad. En la revisión bibliográfica se encontró que en Cuba no hay experiencia en el uso del WHOQOL _ BREF como instrumento de medición de esta, por lo que se pretende describirlo en personas que presentan enfermedades crónicas degenerativas, para determinar si es aplicable en el contexto cubano. MÉTODOS. Estudio descriptivo de calidad de vida relacionada con la salud en 300 personas con enfermedades crónicas degenerativas que están entre las tres primeras causas de mortalidad en el país. Se aplicaron encuestas con el instrumento WHOQOL _ BREF. RESULTADOS. Fueron contestadas el 100 % de las encuestas. El porcentaje se desglosó como sigue: 51,3 de los enfermos consideraron su calidad de vida relacionada con la salud "ni pobre ni buena" y 33,3 como "buena". 48,6 se valoró "ni satisfecho ni insatisfecho" y 33,3 "satisfecho". La salud psicológica fue calificada "alta" en los tres tipos de enfermedades y el dominio que explora ambiente recibió la calificación de "regular." Las mujeres, en ambos grupos de edades, la consideraron "aceptable". Por tipo de enfermedad, las de 45 y más años, que padecían un tumor, tenían una "alta" calidad de vida relacionada con la salud. CONCLUSIONES. El WHOQOL _ BREF permitió medir correctamente la calidad de vida relacionada con la salud en personas con enfermedades crónicas degenerativas, lo que supone que es aplicable al contexto cubano. La salud psicológica resultó la mejor valorada en cualesquiera de las enfermedades estudiadas.INTRODUCTION: The quality of life related to health is an indicator that incorporates the individual's appreciation of his illness. In the bibliographical review it was found that in Cuba there is no experience in the use of the WHOQOL_BREF as an instrument to measure it. That's why, it is intended to describe it in persons with chronic degenerative illness to determine if it can be applied to the Cuban context. METHODS: A descriptive study of the quality of life connected with health was conducted in 300 individuals with chronic degenerative diseases that are among the first three causes of death in the country. Surveys were done with the WHOQOL_BREF instrument. RESULTS: 100% of the surveys were answered. 51.3% of the sick persons considered its quality of life in relation to health neither poor nor good and 33.3% considered it good. 48.6 % evaluated themselves as neither satisfied nor unsatisfied and 33.3 % as satisfied. The psychological health was rated as "high" in the three types of diseases, whereas the domain exploring environment was estimated as fair. Females, in both groups of ages, considered it "acceptable." According to the type of disease, those aged 45 and over suffering from a tumor had a high quality of life related to health. CONCLUSIONS: The WHOQOL_BREF allowed to measure correctly the quality of life related to health in people with chronic degenerative diseases, which makes us suppose that it is applicable to the Cuban context. The psychological health was the best assessed in any of the studied diseases

Antonio Castillo Guzmán

2008-12-01

192

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

2010-04-01

193

Symptomatic sacroiliac joint disease and radiographic evidence of femoroacetabular impingement.  

Science.gov (United States)

Symptomatic sacroiliac (SI) joint disease is poorly understood. The literature provides no clear aetiology for SI joint pathology, making evaluation and diagnosis challenging. We hypothesised that patients with documented sacroiliac pain might provide insight into the aetiology of these symptoms. Specifically, we questioned whether SI joint symptoms might be associated with abnormal hip radiographs. We reviewed the pelvic and hip radiographs of a prospectively collected cohort of 30 consecutive patients with SI joint pathology. This database included 33 hips from 30 patients. Radiographic analysis included measurements of the lateral centre edge angle, Tönnis angle, and the triangular index, of the ipsilateral hip. Evidence for retrotorsion of the hemipelvis was recorded. Hips were graded on the Tönnis grading system for hip arthrosis. In this cohort 14/33 (42%) of hips had evidence of significant osteoarthrosis indicated by Tönnis grade 2 or greater and 15/33 (45%) displayed subchondral cyst formation around the hip or head neck junction. In assessing acetabular anatomy, 21% (7/33) had retroversion, 12% (4/33) had a lateral centre edge angle >40° with 3% (1/33) >45°. Tönnis angle was joint pain had radiographic evidence of femoroacetabular impingement (FAI) and hip arthrosis. The clinician should maintain FAI in the differential diagnosis when investigating patients with buttock pain. PMID:23417531

Morgan, Patrick M; Anderson, Anthony W; Swiontkowski, Marc F

2013-01-01

194

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 SciELO Peru | Language: Spanish 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 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 o [...] f 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.

2010-07-01

195

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 SciELO Public Health | Language: Spanish 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 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 o [...] f 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.

2010-09-01

196

Co-ordinated research project on application of nuclear techniques in the prevention of degenerative diseases (obesity and non-insulin dependent diabetes) in ageing  

International Nuclear Information System (INIS)

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. This first meeting was held in the Agency's headquarters in Vienna, with participation of contract and agreement holders, experts, observer, and in-house staff

197

The diagnostic and prognostic significance of CT in neuro-degenerative, metabolic and leucodystrophic diseases in childhood  

International Nuclear Information System (INIS)

At the Hospital for Sick Children, Great Ormond Street, London, approximately 1% of the patients scanned with computed tomography (CT) are ultimately found to have neurological abnormalities due to a proven metabolic disease. To obtain all scanned cases of metabolic disease causing neurological abnormalities the clinical diagnosis at the time of referral for CT, the CT diagnosis and the records of the biochemical and neuropathological departments were reviewed. The material thus collected was then checked against the final diagnosis and only cases in which a precise diagnosis of a recognized metabolic disorder was established were included. The CT appearances are correlated with diagnosis, age at onset, duration and progress of the disease and prognosis. They show the various abnormalities diagnosed histologically or biochemically and may be helpful in the clinical context in suggesting the nature of the disease process. (Auth.)

198

Studies on the pathogenesis of the degenerative lumbar canal stenosis by CT, 3  

International Nuclear Information System (INIS)

Computed tomography (CT) scans of lumbar canal stenosis (LCS, n = 20), osteoarthritis (OA, n = 65), disk herniation (n = 21), and lumbar pain (n = 23) were reviewed for the quanlitative evaluation of the vertebral canal and stenosis factors. Trefoil type on transverse sections of the bony vertebral canal was observed in 23 %, having no implications for pathologic significance at the L5 level. The degree of degeneration in soft tissues inside the vertebral canal varied according to diseases. This was most noticeable at the L4/L5 level in the LCS group. The morphological CT appearance of vertebral arch were divided into three types: I - the concave inner part, II - the linear inner part, and III - the convex inner part to the vertebral canal. In the group of LCS, the incidences of types II and III were high at the L5/S1 and at the L4/L5 levels, respectively. As for the angle of apophyseal joint, the incidence of sagittal joint was high at the L3/L4 and L4/L5 levels in the group of LCS. The incidence of degenerative changes was high in the groups of LCS and OA, suggesting some relationship between degenerative degree and both sagittal and asymmetric joints. This was noticeable at the L4/L5 level. Calcification surrounding the joint was seen in 13 %, reflecting the relationship to the degenerative changes. There was no relationship between degenerative changes and vacuum joint phenomenon observed in 18 %. As for the area less than 90 mm2 of the dural canal, there was no morphological change between the LCS and OA groups. In the symptomatic mechanism in the case of LCS, morphological dynamic and unstable factors may be involved. (Namekawa, K.) 67 refs

199

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 14: brace therapy as an adjunct to or substitute for lumbar fusion.  

Science.gov (United States)

The utilization of orthotic devices for lumbar degenerative disease has been justified from both a prognostic and therapeutic perspective. As a prognostic tool, bracing is applied prior to surgery to determine if immobilization of the spine leads to symptomatic relief and thus justify the performance of a fusion. Since bracing does not eliminate motion, the validity of this assumption is questionable. Only one low-level study has investigated the predictive value of bracing prior to surgery. No correlation between response to bracing and fusion outcome was observed; therefore a trial of preoperative bracing is not recommended. Based on low-level evidence, the use of bracing is not recommended for the prevention of low-back pain in a general working population, since the incidence of low-back pain and impact on productivity were not reduced. However, in laborers with a history of back pain, a positive impact on lost workdays was observed when bracing was applied. Bracing is recommended as an option for treatment of subacute low-back pain, as several higher-level studies have demonstrated an improvement in pain scores and function. The use of bracing following instrumented posterolateral fusion, however, is not recommended, since equivalent outcomes have been demonstrated with or without the application of a brace. PMID:24980591

Dailey, Andrew T; Ghogawala, Zoher; Choudhri, Tanvir F; Watters, William C; Resnick, Daniel K; Sharan, Alok; Eck, Jason C; Mummaneni, Praveen V; Wang, Jeffrey C; Groff, Michael W; Dhall, Sanjay S; Kaiser, Michael G

2014-07-01

200

Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 6: discography for patient selection.  

Science.gov (United States)

Identifying the etiology of pain for patients suffering from chronic low-back pain remains problematic. Noninvasive imaging modalities, used in isolation, have not consistently provided sufficient evidence to support performance of a lumbar fusion. Provocative testing has been used as an adjunct in this assessment, either alone or in combination with other modalities, to enhance the diagnostic capabilities when evaluating patients with low-back pain. There have been a limited number of studies investigating this topic since the publication of the original guidelines. Based primarily on retrospective studies, discography, as a stand-alone test, is not recommended to formulate treatment strategies for patients with low-back pain. A single randomized cohort study demonstrated an improved potential of discoblock over discography as a predictor of success following lumbar fusion. It is therefore recommended that discoblock be considered as a diagnostic option. There is a possibility, based on a matched cohort study, that an association exists between progression of degenerative disc disease and the performance of a provocative discogram. It is therefore recommended that patients be counseled regarding this potential development prior to undergoing discography. PMID:24980583

Eck, Jason C; Sharan, Alok; Resnick, Daniel K; Watters, William C; Ghogawala, Zoher; Dailey, Andrew T; Mummaneni, Praveen V; Groff, Michael W; Wang, Jeffrey C; Choudhri, Tanvir F; Dhall, Sanjay S; Kaiser, Michael G

2014-07-01

 
 
 
 
201

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.)

202

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

203

Artroplastia total cementada en enfermedad degenerativa de cadera: Su evaluación clínica / Arthroplastie totale cimentée dans la maladie dégénérative de hanche: Son évaluation clinique / Cemented total arthrosplasty in degenerative hip disease: Its clinical ev  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se realizó un estudio descriptivo, transversal y prospectivo con el objetivo de evaluar la evolución clínica de 12 pacientes operados por enfermedad degenerativa articular a los que se les realizó sustitución protésica total cementada primaria de cadera, en el período comprendido entre enero de 2004 [...] a diciembre de 2006. Se incluyeron pacientes en edades de 50 años y más. Para su evaluación se utilizó la puntuación de la Clínica de los Hermanos Mayo, creada en 1985, la cual otorga un máximo de 80 puntos. Como resultado se obtuvo que 10 pacientes fueron evaluados entre excelente y bien, para un 83,3 %, y el promedio de la evaluación por dicha escala fue de 68,5 puntos, con 6 caderas por encima de esta cifra, lo que constituyó el 50% de la muestra. Se demostró el bienestar social que recibieron los pacientes sometidos a este proceder quirúrgico en nuestro centro hospitalario. Abstract in english A descriptive, cross-sectional and prospective study was conducted in order to evaluate the clinical evolution of 12 patients operated on due to degenerative joint disease that underwent cemented primary total prosthetic replacement of the hip from January 2004 to December 2006. Patients 50 and over [...] were included. For their evaluation it was used the scoring system of Mayo Clinic created in 1985, which gives a maximum of 80 points. As a result 10 patients were evaluated as good or excellent, accounting for 83.3 %. The average evaluation according to this scale was 68.5 points, with 6 hips over this figure, which represented 50 % of the sample. The social well-being received by the patients that underwent this surgical procedure was proved.

Orlando Manuel, Pérez Rivera; Lourdes E., Palanco Domínguez.

204

Sirtuin-1 mediates the obesity induced risk of common degenerative diseases: Alzheimer’s disease, coronary artery disease and type 2 diabetes  

Directory of Open Access Journals (Sweden)

Full Text Available


Obesity, especially at mid-life, is a major risk factor for atherosclerosis, insulin resistance and the metabolic syndrome, which in turn contribute to coronary artery disease (CAD, Type 2 diabetes and Alzheimer’s disease (AD. The rise in overweight and obesity in all societies is prompting intense research into the causes and effects of the condition. Obesity disrupts many body systems including glucose and lipid metabolism, circadian rhythms and liver function. It also causes or increases inflammation and oxidative stress. Within cells, the endoplasmic reticulum (ER appears to be particularly susceptible to such metabolic disruption. Sirtuin 1 (Sirt1 and leptin have received attention recently as they are central regulatory factors for the body’s metabolic pathways which interact at particular levels, for example lipid and Abeta metabolism. This mini-review discusses recent findings concerning obesity, lipid metabolism and the role of Sirtuin 1 and how all influence the ER. A greater understanding of obesity and its effects on metabolic control systems of the body are required, to develop pharmacological, dietary and lifestyle changes that will reduce the incidence of CAD, Type 2 diabetes and AD.


2012-12-01

205

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

International Nuclear Information System (INIS)

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 nd 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.)

206

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

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in portuguese 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 d [...] o 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. Abstract in spanish 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 ha [...] cia 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. Abstract in english 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.

207

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

2011-06-01

208

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

209

Co-ordinated research project on application of nuclear techniques in the prevention of degenerative diseases (obesity and non-Insulin dependent diseases) in ageing. Report on the second research co-ordination meeting  

International Nuclear Information System (INIS)

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

210

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)

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

211

Correlation between 3D microstructural and 2D histomorphometric properties of subchondral bone with healthy and degenerative cartilage of the knee joint.  

Science.gov (United States)

Cartilage degeneration of the knee joint is considered to be a largely mechanically driven process. We conducted a microstructural and histomorphometric analysis of subchondral bone samples of intact cartilage and in samples with early and higher- grade arthritic degeneration to compare the different states and correlate the findings with the condition of hyaline cartilage. These findings will enable us to evaluate changes in biomechanical properties of subchondral bone during the evolution of arthritic degeneration, for which bone density alone is an insufficient parameter. From a continuous series of 80 patients undergoing implantation of total knee endoprosthesis 30 osteochondral samples with lesions macroscopically classified as ICRS grade 1b (group A) and 30 samples with ICRS grade 3a or 3b lesions (group B) were taken. The bone samples were assessed by 2D histomorphometry (semiautomatic image analysis system) and 3D microstructural analysis (high-resolution micro-CT system). The cartilage was examined using the semiquantitative real-time PCR gene expression of collagen type I and II and aggrecan. Both histomorphometry and microstructural and biomechanical analysis of subchondral bone in groups A and B consistently revealed progressive changes of both bone and cartilage compared with healthy controls. The severity of cartilage degeneration as assessed by RT PCR was significantly correlated with BV/TV (Bone Volume Fraction), Tb.Th (Trabecular Thickness) showed a slight increase. Tb.N (Trabecular Number), Tb.Sp (Trabecular separation) SMI (Structure Model Index), Conn.D (Connectivity Density) and DA (Degree of Anisotropy) were inversely correlated. We saw sclerotic transformation and phagocytic reticulum cells. Bone volume fraction decreased with an increasing distance from the cartilage with the differences compared with healthy controls becoming greater in more advanced cartilage damage. The density of subchondral bone alone is considered an unreliable parameter for classifying changes evolving over time. The progressive damage of subchondral bone seen in the present study correlates well with cartilage changes. Trabecular orientation is also impaired, which explains the changes in biomechanical parameters and the inadequate load transfer and excessive loading of cartilage. Besides subchondral bone density, which in turn correlates with cartilage thickness, other parameters such as structure model index and grade of anisotropy best reflect mechanical properties such as Young modulus, compressive strength, tensile stress, and failure energy. However, it remains unclear whether the mechanical interaction of the mineralized subchondral tissues with articular cartilage works vice versa. The possibility of a biochemical signalling from the degenerating cartilage via the synovial fluid and bone- cartilage crosstalks via subchondral pores may indeed explain a certain depth-dependency of subchondral bone changes. PMID:24828695

Lahm, Andreas; Kasch, Richard; Spank, Heiko; Erggelet, Christoph; Esser, Jan; Merk, Harry; Mrosek, Eike

2014-11-01

212

Scintigraphic diagnosis of inflammatory bone and joint diseases  

International Nuclear Information System (INIS)

Inflammatory bone and joint diseases often show multifocal spread, or cannot clinically be precisely localized, so that scintigraphy is still indicated in addition to MRT as a wholebody method. The highlysensitive but not always adequately specific multiphase bone scintigraphy is increasingly supplemented or even replaced to individual degrees by specific inflammation markers, especially leukocyte scintigraphy, either using labeled autologous leukocytes or by immunoscintigraphy with Tc-99m-antigranulocyte antibody fragments. In addressing the question of acute osteomyelitis in neonates or children, the 2-phase bone scintigraphy has to be taken as sufficient for time reasons, whereas in investigating septic or aseptic loosening of joint prostheses, bone marrow scintigraphy with Tc-99m-colloid (not nanocolloid) should be performed in addition to the 2-phase bone scintigraphy and leukocyte scintigraphy in order to avoid misinterpretations. SPECT is obligatory in the proof of inflammatory processes in the base of skull and viscerocranium and is to the strongly recommended in the spine and major joints. (orig.)

213

Lateral collateral ligament avulsion of the humeroradial joint in a horse  

International Nuclear Information System (INIS)

This report describes traumatic avulsion of the lateral collateral ligament of the humeroradial joint in a horse. The history and diagnostic procedures are included with relevant radiographs and ultrasonographs. The poor prognosis associated with this injury is due to degenerative joint disease

214

Degenerative disc disease as a cause of back pain in the thalassaemic population: a case-control study using MRI and plain radiographs  

Energy Technology Data Exchange (ETDEWEB)

The aim of this study was to test our observation that back pain in thalassemic patients could be caused by premature and extensive lumbar degenerative disc disease, when compared to non-thalassemic patients with back pain. Sixteen thalassemic patients with their sex- and age-matched controls were recruited into the study, 12 with thalassemia major, and 4 with thalassemia intermedia. Both the thalassemia patients and control subjects suffered from back pain, which was subjective rather than measured/pain scored. All subjects underwent magnetic resonance (MR) imaging of the lumbar spine, and 11 of the cases and 8 controls had lumbar spine radiographs. Each lumbar disc was scored for radiographic appearances and MR features of disc degeneration and disc protrusion. Proportion values for these parameters and median scores were derived at each disc level, and were analyzed and compared. There was a statistically-significant difference between proportion values of cases and controls for the MR features (P value=0.01, n=16) and the radiographic features (P value=0.01, n=11 cases, n=8 controls) of disc degeneration. The median disc level scores for the thalassemic group were uniformly high across all lumbar discs, and at all levels except at L 4/5. The control group conversely demonstrated a predilection for disc degeneration at L4/5 level. The distribution of lumbar disc degeneration in thalassemic patients with back pain is more extensive, severe and multi-level in nature compared to matched controls, and disc degeneration should be considered as a significant cause of back pain in this population group. (orig.)

Desigan, S.; Hall-Craggs, M.A.; Ho, C.-P. [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Eliahoo, J. [University College London Hospitals NHS Trust, Research and Development Directorate, London (United Kingdom); Porter, J.B. [University College Hospital, Department of Haematology, University College London Hospitals NHS Trust, London (United Kingdom)

2006-02-15

215

Geographic variation in the surgical treatment of degenerative cervical disc disease: American Board of Orthopedic Surgery Quality Improvement Initiative; part II candidates.  

LENUS (Irish Health Repository)

STUDY DESIGN: Retrospective case series. OBJECTIVE: To examine and document the change in rates and the geographic variation in procedure type and utilization of plating by orthopedic surgeons for anterior cervical discectomy-fusion. SUMMARY OF BACKGROUND: Age- and sex-adjusted rates of cervical spine surgery have not increased, but the rate of cervical spinal fusion has, accounting for 41% of all fusion procedures in 2004. METHODS: Records were selected from the American Board of Orthopedic Surgeons part II examination from 1999 to 2008. Current Procedural Terminology (CPT) and International Classification of Diseases, 9th Revision, Clinical Modification (ICDM-9-CM) codes were used to determine utilization of structural allograft, autograft\\/interbody devices, and anterior cervical plating over time and within geographic region. Main outcome measures were physician workforce, and rates and variation of procedure types. RESULTS: From 1999 to 2008, the number of self-declared orthopedic spine surgeon candidates increased 24%. Over this period, the annual number of discectomies with fusions for degenerative cervical disc disease increased by 67%, whereas the number of such operations per surgeon operating on at least 1 such case increased 48% (P = 0.018). Interbody device (0%-31%; P < 0.0001), anterior cervical plating (39%-79%; P < 0.0001), and allograft (14%-59%; P < 0.0001) use increased, whereas autograft use decreased (86%-10%; P < 0.0001). The Southwest and Southeast were more likely than the Midwest to use interbody devices (OR: 2.42 and 1.66, respectively). The Southwest and Northeast were more likely than the Midwest to use autograft (OR: 1.55 and 1.49). The Southwest, Northeast, and Southeast were less likely to use allograft than the Midwest (OR: 0.408, 0.742, and 0.770). The Northeast was less likely and the Southeast more likely than the Midwest to utilize anterior cervical plating (OR: 0.67 and 1.33). Surgical complications were more often associated with autograft compared with allograft (OR: 1.61). CONCLUSION: From 1999 to 2008, the number of orthopedic surgeon candidates performing spine surgery has increased. These surgeons are performing more fusions and utilizing more structural allografts, interbody devices, and\\/or anterior cervical plates. Regional variations also remain in the types of constructs utilized.

McGuire, Kevin J

2012-02-01

216

The joint capsule: structure, composition, ageing and disease.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The joint capsule is vital to the function of synovial joints. It seals the joint space, provides passive stability by limiting movements, provides active stability via its proprioceptive nerve endings and may form articular surfaces for the joint. It is a dense fibrous connective tissue that is attached to the bones via specialised attachment zones and forms a sleeve around the joint. It varies in thickness according to the stresses to which it is subject, is locally thickened to form capsul...

Ralphs, J. R.; Benjamin, M.

1994-01-01

217

Tissue engineering in the rheumatic diseases  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Diseases such as degenerative or rheumatoid arthritis are accompanied by joint destruction. Clinically applied tissue engineering technologies like autologous chondrocyte implantation, matrix-assisted chondrocyte implantation, or in situ recruitment of bone marrow mesenchymal stem cells target the treatment of traumatic defects or of early osteoarthritis. Inflammatory conditions in the joint hamper the application of tissue engineering during chronic joint diseases. Here, most likely, cartila...

Ringe, Jochen; Sittinger, Michael

2009-01-01

218

Charcot-like joints in calcium pyrophosphate dihydrate deposition disease  

International Nuclear Information System (INIS)

Two cases of Charcot-like joints in patients with pseudogout who were otherwise neurologically intact are presented. The arthropathy of pseudogout should include Charcot-like joints and it is emphasized that an apparent Charcot joint should raise the question of pseudogout. (orig.)

219

[ESC/EASD joint guidelines on diabetes and cardiovascular diseases].  

Science.gov (United States)

The ESC/EASD (European Society of Cardiology/European Association for the Study of Diabetes) joint Guidelines on diabetes, pre-diabetes, and cardiovascular diseases have, for the first time, addressed diabetes mellitus and cardiovascular diseases (CVD) as a pathophysiological entity in Europe. Based on these guidelines, diabetes mellitus is regarded from the outset to be a cardiovascular disease, whose life-threatening complications myocardial infarction and stroke can only be avoided by an interdisciplinary concerted action. The most important information of these guidelines for the interdisciplinary cooperation of primary-care physicians, diabetologists and cardiologists are the postulations that patients with the main diagnosis diabetes mellitus with or without known CVD should, at regular intervals, be referred to a cardiologist, and patients with the main diagnosis CVD with or without diabetes mellitus should, at regular intervals, be referred to a diabetologist. Of fundamental importance is the prevention of diabetes and CVD by a comprehensive lifestyle modification including smoking cessation, regular physical activity and weight control, flanked by an evidence-based drug therapy. Within the framework of a multimodal risk management, an optimal antihypertensive therapy of a concomitant elevated blood pressure; a statin therapy in case of elevated LDL cholesterol or regardless of an elevated LDL in proven CVD; ACE inhibitors, angiotensin II receptor blockers, or beta-blockers in case of heart failure; and an anticoagulant therapy for the prevention of cardioembolic stroke in patients with atrial fibrillation all have class I recommendations. Concerning the preferred coronary revascularization procedure in diabetics, today no rigid general recommendation can be given in favor of or against coronary bypass surgery, or in favor of or against percutaneous coronary intervention. The decision for a specific revascularization procedure should, in any case, be based on a detailed analysis of the individual coronary anatomy. PMID:19214406

Motz, Wolfgang; Dörr, Rolf

2009-02-01

220

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

 
 
 
 
221

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.)

222

Classification, clinical findings and operative treatment of degenerative and posttraumatic shoulder disease What do we really need to know from an imaging report to establish a treatment strategy?  

International Nuclear Information System (INIS)

Successful patient care involves interdisciplinary Cupertino. Images allow an interpretation of a static dimension, but may not be sufficient to develop a surgical treatment strategy, since many shoulder problems have its origin in a dynamic pathology. This article outlines dynamic clinical tests of shoulder pathology, classifies various degenerative and posttraumatic shoulder problems and stresses key facts an imaging report should include in order to plan surgery. This article conveys basic knowledge of those tests and the dynamic background of shoulder pathology. Basic surgical treatment principles are summarised briefly

223

Classification, clinical findings and operative treatment of degenerative and posttraumatic shoulder disease What do we really need to know from an imaging report to establish a treatment strategy?  

Energy Technology Data Exchange (ETDEWEB)

Successful patient care involves interdisciplinary Cupertino. Images allow an interpretation of a static dimension, but may not be sufficient to develop a surgical treatment strategy, since many shoulder problems have its origin in a dynamic pathology. This article outlines dynamic clinical tests of shoulder pathology, classifies various degenerative and posttraumatic shoulder problems and stresses key facts an imaging report should include in order to plan surgery. This article conveys basic knowledge of those tests and the dynamic background of shoulder pathology. Basic surgical treatment principles are summarised briefly.

Boenisch, U. E-mail: uboenisch@aol.com; Lembcke, O.; Naumann, Th

2000-08-01

224

Radiotherapy of rheumatic diseases of the bone joints  

International Nuclear Information System (INIS)

Treatment of rheumatoid arthritis can be either systemic or local. 'Synoviorthesis', the intraarticular injection of radio-colloids, has shown to be very effective in withholding persistent synovitis, even compared with synovectomy. For large joints, e.g. knees, favourable results can be anticipated, with smaller joints results are poorer. Physical and biological data, indications and results are presented. (orig.)

225

Aging changes in the bones - muscles - joints  

Science.gov (United States)

... knee joints may begin to lose joint cartilage (degenerative changes). The finger joints lose cartilage and the ... mainly because of shortening of the trunk and spine. Inflammation, pain, stiffness, and deformity may result from ...

226

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

227

Análise comparativa dos resultados da cirurgia do labirinto (Cox-maze) para fibrilação atrial crônica em pacientes com doença valvar mitral reumática ou degenerativa / Comparative results of maze procedure for chronic atrial fibrillation in rheumatic and degenerative mitral valve disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Comparar resultados da correção de Fibrilação Atrial (FA) Crônica em Doença Mitral Reumática (R) ou Degenerativa (D) a curto e médio prazos. CASUÍSTICA E MÉTODOS: De 1994 a 1997, 57 pacientes foram submetidos à Cirurgia do Labirinto e correção mitral. Oito (20%) reumáticos eram do sexo [...] masculino; 32 (80%) feminino. Dos degenerativos 8 (47%) eram do sexo masculino; 9 (53%) femininos, (NS). Idade 47 ± 11 anos R; 54 ± 17 D (p Abstract in english The results of maze procedure in rheumatic mitral valve disease are subject to debate. This paper reports medium term results in rheumatic and degenerative mitral valve surgery associated with maze procedure. From 1994 to 1997, 57 patients were operated on. They were divided into two Groups; R (rheu [...] matic) 40 patients and D (degenerative) 17. Group R included 8 (20%) males and 32 (80%) females. Group D: 8 (47%) males and 9 (53%) females (NS). Age in R = 47 ± 11 and D 54 ± 17 years (p

Renato A. K., KALIL; Bartira, CUNHA; Álvaro S., ALBRECHT; Paulo, MORENO; Rogério, ABRAHÃO; Paulo R., PRATES; João R. M., SANT' ANNA; Ivo A., NESRALLA.

228

Análise comparativa dos resultados da cirurgia do labirinto (Cox-maze) para fibrilação atrial crônica em pacientes com doença valvar mitral reumática ou degenerativa / Comparative results of maze procedure for chronic atrial fibrillation in rheumatic and degenerative mitral valve disease  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Comparar resultados da correção de Fibrilação Atrial (FA) Crônica em Doença Mitral Reumática (R) ou Degenerativa (D) a curto e médio prazos. CASUÍSTICA E MÉTODOS: De 1994 a 1997, 57 pacientes foram submetidos à Cirurgia do Labirinto e correção mitral. Oito (20%) reumáticos eram do sexo [...] masculino; 32 (80%) feminino. Dos degenerativos 8 (47%) eram do sexo masculino; 9 (53%) femininos, (NS). Idade 47 ± 11 anos R; 54 ± 17 D (p Abstract in english The results of maze procedure in rheumatic mitral valve disease are subject to debate. This paper reports medium term results in rheumatic and degenerative mitral valve surgery associated with maze procedure. From 1994 to 1997, 57 patients were operated on. They were divided into two Groups; R (rheu [...] matic) 40 patients and D (degenerative) 17. Group R included 8 (20%) males and 32 (80%) females. Group D: 8 (47%) males and 9 (53%) females (NS). Age in R = 47 ± 11 and D 54 ± 17 years (p

Renato A. K., KALIL; Bartira, CUNHA; Álvaro S., ALBRECHT; Paulo, MORENO; Rogério, ABRAHÃO; Paulo R., PRATES; João R. M., SANT' ANNA; Ivo A., NESRALLA.

1999-07-01

229

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

230

Biglycan and Fibromodulin Have Essential Roles in Regulating Chondrogenesis and Extracellular Matrix Turnover in Temporomandibular Joint Osteoarthritis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The temporomandibular joint is critical for jaw movements and allows for mastication, digestion of food, and speech. Temporomandibular joint osteoarthritis is a degenerative disease that is marked by permanent cartilage destruction and loss of extracellular matrix (ECM). To understand how the ECM regulates mandibular condylar chondrocyte (MCC) differentiation and function, we used a genetic mouse model of temporomandibular joint osteoarthritis that is deficient in two ECM proteins, biglycan a...

Embree, Mildred C.; Kilts, Tina M.; Ono, Mitsuaki; Inkson, Colette A.; Syed-picard, Fatima; Karsdal, Morten A.; Oldberg, A?ke; Bi, Yanming; Young, Marian F.

2010-01-01

231

Degenerative disc disease of the lumbar spine: a prospective comparison of fast T1-weighted fluid-attenuated inversion recovery and T1-weighted turbo spin echo MR imaging  

International Nuclear Information System (INIS)

Objective: To compare fast T1-weighted fluid-attenuated inversion recovery (FLAIR) and T1-weighted turbo spin-echo (TSE) imaging of the degenerative disc disease of the lumbar spine. Materials and methods: Thirty-five consecutive patients (19 females, 16 males; mean age 41 years, range 31-67 years) with suspected degenerative disc disease of the lumbar spine were prospectively evaluated. Sagittal images of the lumbar spine were obtained using T1-weighted TSE and fast T1-weighted FLAIR sequences. Two radiologists compared these sequences both qualitatively and quantitatively. Results: On qualitative evaluation, CSF nulling, contrast at the disc-CSF interface, the disc-spinal cord (cauda equina) interface, and the spinal cord (cauda equina)-CSF interface of fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.001). On quantitative evaluation of the first 15 patients, signal-to-noise ratios of cerebrospinal fluid of fast T1-weighted FLAIR imaging were significantly lower than those for T1-weighted TSE images (P < 0.05). Contrast-to-noise ratios of spinal cord/CSF and normal bone marrow/disc for fast T1-weighted FLAIR images were significantly higher than those for T1-weighted TSE images (P < 0.05). Conclusion: Results in our study have shown that fast T1-weighted FLAIR imaging may be a valuable imaging modality in the armamentarium of lumbar spinal T1-weighted MR imaging, because the former technique has definite superior advantages such as CSF nulling, conspicuousness of the normal anatomic structures and changes in the lumbar spinal discogenic disease and image contrast and also almost equally acquisition times

232

Synovial chondromatosis: Report of a rare surgical problem of the temporomandibular joint.  

Science.gov (United States)

Synovial chondromatosis of the joint is a rare benign condition characterized by the formation of metaplastic cartilage in the synovium of the joint resulting in numerous attached and unattached osteocartilagenous bodies. It may recur after surgical intervention. For this reason removal of the synovium and the bodies is advocated. This is a report of a case which occurred in the temporomandibular joint which had numerous loose bodies and exhibited features of degenerative joint disease as well. The loose bodies were removed, a high condylar shave performed and the synovium left intact. The patient is still free from joint problems five years later. PMID:8975024

Thompson, I O; Berezowski, B M; van Wyk, C W; Phillips, V M

1995-07-01

233

[Spontaneous femoral condyle necrosis of the knee joint (Ahlbäck disease)].  

Science.gov (United States)

The aetiology of Morbus Ahlbäck (spontaneous osteonecrosis of the femoral condyles of the knee joint) is still unknown. Sudden onset of pain characterises the beginning of complaints. Only scintimetry results in early diagnosis. Larger osteonecroses are to be treated surgically, for example by osteotomy. In extensive osteonecroses we prefer alloarthroplastic replacement (mostly unicondylar). PMID:3895774

Albers, W; Blümlein, H; Sühler, H

1985-01-01

234

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.atio 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<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

235

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 SciELO Cuba | Language: Spanish 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. 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 condromalacy constituted the main endoscopical findings while curettage and articular wash-out, being the therapeutical alternatives most used, were predominant.

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

236

Development of modulators against degenerative aging using radiation fusion technology  

Energy Technology Data Exchange (ETDEWEB)

1. Objectives Establishment of modelling of degenerative aging using radiation technology Development of aging modulators using radiation degenerative aging model 2. Project results Establishment of the modeling of degenerative aging using radiation technology - The systematic study on the comparison of radiation-induced degeneration and natural aging process in animals and cells confirmed the biological similarity between these two degeneration models - The effective biomarkers were selected for the modelling of degenerative aging using radiation (10 biomarkers for immune/hematopoiesis, 1 for oxidative stress, 6 for molecular signaling, 3 for lipid metabolism) - The optimal irradiation condition was established for the modelling of degerative aging (total 5Gy with fractionation by over 10 times, lapse of over 4 months) - The molecular mechanisms of radiation-induced degeneration were studied including chronic inflammation (lung), inflammation-related lipid metabolism disturbance, mitochondria biogenesis and dynamics - The radiation degenerative model was evaluated with previously known natural substances (resveratrol, EGCG, etc) Development of aging modulators using radiation degenerative aging model - After the screening of about 800 natural herb extracts, 5 effective substances were selected for aging modulation. - 3 candidate compositions were selected from 20 compositions made from effective substances by in vitro evaluation (WAH2, WAH6, WAH7) - 1 composition (WAH6) was selected as the best aging modulator by in vivo evaluation in radiation-induced aging models and degenerative disease models. 3. Expected benefits and plan of application The modelling of degenerative aging using radiation can facilitate the aging research by providing the useful cell/animal models for aging research A large economic benefits are expected by the commercialization of developed aging modulators (over 10 billion KW in 2015.

Jo, S. K.; Park, H. R.; Jang, B. S.; Roh, C. H.; Eom, H. S.; Choi, N. H.; Seol, M. A.; Kim, S. H.; Choi, H. M.; Park, M. K.; Shin, H. J.; Ryu, D. K.; Oh, W. J.; Kim, S. H; Yee, S. T.

2012-04-15

237

Development of modulators against degenerative aging using radiation fusion technology  

International Nuclear Information System (INIS)

1. Objectives Establishment of modelling of degenerative aging using radiation technology Development of aging modulators using radiation degenerative aging model 2. Project results Establishment of the modeling of degenerative aging using radiation technology - The systematic study on the comparison of radiation-induced degeneration and natural aging process in animals and cells confirmed the biological similarity between these two degeneration models - The effective biomarkers were selected for the modelling of degenerative aging using radiation (10 biomarkers for immune/hematopoiesis, 1 for oxidative stress, 6 for molecular signaling, 3 for lipid metabolism) - The optimal irradiation condition was established for the modelling of degerative aging (total 5Gy with fractionation by over 10 times, lapse of over 4 months) - The molecular mechanisms of radiation-induced degeneration were studied including chronic inflammation (lung), inflammation-related lipid metabolism disturbance, mitochondria biogenesis and dynamics - The radiation degenerative model was evaluated with previously known natural substances (resveratrol, EGCG, etc) Development of aging modulators using radiation degenerative aging model - After the screening of about 800 natural herb extracts, 5 effective substances were selected for aging modulation. - 3 candidate compositions were selected from 20 compositions made from effective substances by in vitro evaluation (WAH2, WAH6, WAH7) - 1 composition (WAH6) was selected as the best aging modulator by in vivo evaluation in radiation-induced aging models and degenerative disease models. 3. Expected benefits and plan of application The modelling of degenerative aging using radiation can facilitate the aging research by providing the useful cell/animal models for aging research A large economic benefits are expected by the commercialization of developed aging modulators (over 10 billion KW in 2015

238

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 SciELO Public Health | Language: Portuguese 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 vezes 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 of 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.

Ruy, Laurenti.

239

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 SciELO Brazil | Language: Portuguese 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 vezes 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 of 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.

Ruy, Laurenti.

240

Degenerative meniscus: Pathogenesis, diagnosis, and treatment options.  

Science.gov (United States)

The symptomatic degenerative meniscus continues to be a source of discomfort for a significant number of patients. With vascular penetration of less than one-third of the adult meniscus, healing potential in the setting of chronic degeneration remains low. Continued hoop and shear stresses upon the degenerative meniscus results in gross failure, often in the form of complex tears in the posterior horn and midbody. Patient history and physical examination are critical to determine the true source of pain, particularly with the significant incidence of simultaneous articular pathology. Joint line tenderness, a positive McMurray test, and mechanical catching or locking can be highly suggestive of a meniscal source of knee pain and dysfunction. Radiographs and magnetic resonance imaging are frequently utilized to examine for osteoarthritis and to verify the presence of meniscal tears, in addition to ruling out other sources of pain. Non-operative therapy focused on non-steroidal anti-inflammatory drugs and physical therapy may be able to provide pain relief as well as improve mechanical function of the knee joint. For patients refractory to conservative therapy, arthroscopic partial meniscectomy can provide short-term gains regarding pain relief, especially when combined with an effective, regular physiotherapy program. Patients with clear mechanical symptoms and meniscal pathology may benefit from arthroscopic partial meniscectomy, but surgery is not a guaranteed success, especially with concomitant articular pathology. Ultimately, the long-term outcomes of either treatment arm provide similar results for most patients. Further study is needed regarding the short and long-term outcomes regarding conservative and surgical therapy, with a particular focus on the economic impact of treatment as well. PMID:25405088

Howell, Richard; Kumar, Neil S; Patel, Nimit; Tom, James

2014-11-18

 
 
 
 
241

Anatomy and biomechanics of the acromioclavicular and sternoclavicular joints.  

Science.gov (United States)

The acromioclavicular and sternoclavicular joints have important soft-tissue static constraints that, based on biomechanical studies, imply a great deal of stability. The infrequency of significant symptoms following dislocations of these joints certainly highlights the fact that the dynamic muscle support is also very important. In performing resections of these joints for degenerative disease, our goal should be to preserve these important ligamentous supports by minimizing the amount of bone excised, as this seems to optimize results [84]. Precise isometric reconstruction of these complex, three-dimensional ligamentous structures merits further investigation in the laboratory and clinical settings. PMID:12825527

Renfree, Kevin J; Wright, Thomas W

2003-04-01

242

[Bone and joint diseases in children. Effects of sports on bone and joint disorders during childhood].  

Science.gov (United States)

Recently, opposing trends have appeared to be either excessiveness or lack in the frequency of exercise or sports during childhood, both of which are believed to be associated with various sports-related injuries. In childhood, the bones, muscles, and ligaments are developing and not yet matured; though soft and flexible, their relative low strength is inadequate to tolerate abnormal external forces. Although a child's body normally has substantial self-healing ability, there is the risk of causing a lifelong deformity or growth disorder if not treated properly. A comprehensively organized system for the prevention, early detection, and treatment of bone and joint disorders in children should be developed in the future. PMID:20513945

Uchio, Yuji; Matsusaki, Masahiko; Yamamoto, Soichiro; Kumahashi, Nobuyuki

2010-06-01

243

The degenerative and traumatized knee: Use of radioisotopes for diagnosis, evaluation and treatment  

International Nuclear Information System (INIS)

Full text: Bone SPECT is a highly valuable method of investigation for the assessment of the knee joint. Its speed and low cost probably make it a suitable screening procedure for most knee traumatic and degenerative diseases. Consequently, bone SPECT is inevitably seen as a competitive and complementary procedure to MRI. The technique of radiation synovectomy has been available for more than 40 years in the management of joint diseases. Recently, there has been renewed interest in radiation synovectomy, following the introduction of some new and efficient radiopharmaceuticals. We present here our experience with the diagnosis and treatment of the traumatized and degenerative knees in 358 patients, together with the review of the literature. A special emphasis will be placed on the following topics: 1. Correlative imaging of planar and SPECT scintigraphy with correlation to MRI. 2. Quantitative and prognostic parameters. 3. The value of the method in sports and military medicine. 4. The value of bone scintigraphy in choosing candidates and planning arthroscopic and radiation synovectomy. 5. The clinical efficacy of particulate versus colloid radiopharmaceutical for radiation synovectomy. 6. The response rate to a single injection versus routine repeated injections of the radiopharmaceutical. 7. The clinical importance of some different techniques of treatment in different clinics, including injected dose, injection procedure, safety precautions, etc. 8. Comparison of safety precautions, etc. 8. Comparison of the efficacy of radiation synovectomy to intra-articular corticosteroid injection. 9. The use of different 90Y colloids (resin, citrate, cilicate and ferric hydroxide), comparing especially the extent of regional lymph node irritation as a result of joint leakage. 10. The clinical importance of co-injection of corticosteroids with the radiopharmaceutical, in either colloidal or particular radiopharmaceuticals. 11. The importance of combined procedures of saline irrigation with radiopharmaceutical and/or possible corticosteroid injection, for improving patients' outcome. 12. The value of post treatment full rest (hospitalization?) to prevent extra- articular leakage and optimal response. 13. Some financial and cost-effective considerations. (author)

244

Pelvic bone and hip joint hydatid disease revealing a retroperitoneal location  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Echinococcosis is a parasitic disease produced by the larval stage of Echinococcus granulosus. Hydatid disease of bone is rarely seen in humans and it has been reported in only 1–2% of cases of echinococcosis. We present a patient who developed hydatid disease of the left pelvic and femoral bones with cartilage destruction of the ipsilateral hip joint revealing a retroperitoneal location of hydatid cyst. Hydatid bone must be present in the differential diagnosis of chronic monoarthritis. Sk...

Elmrini, A.; Daoudi, A.; Ankouz, A.; Abdelhalim El Ibrahimi

2009-01-01

245

Correlation between degenerative myopia and diabetic retinopathy  

Directory of Open Access Journals (Sweden)

Full Text Available AIM: To investigate the correlation between degenerative myopia and diabetic retinopathy(DR. METHODS: Totally 106 cases with diabetes B were divided into the degenerative myopia group(48 casesand the no degenerative myopia group(58 cases. Fundus examination and fluorescence fundus angiography(FFAwere performed on all cases. The occurrence and stage of DR were compared between the 2 groups. RESULTS: The occurrence of DR of the no degenerative myopia group(93.1%was much higher than that of the degenerative myopia group(70.8%. Only retinopathy of stage?or ? was observed in the degenerative myopia group without lesion in proliferating phase, while retinopathy of stage?to ? could be found in the no degenerative myopia group.CONCLUSION: Degenerative myopia can prevent DR from occurrence and may be a protective factor for DR.

Qing-Hua Hu

2014-05-01

246

Socioeconomic and physical characteristics of degenerative lumbar spinal stenosis individuals.  

Science.gov (United States)

ABSTRACT: Study Design. A descriptive study of the association between demographic factors, and physical characteristics, and degenerative lumbar spinal stenosis (DLSS).Objective. To shed light on the association of socioeconomic parameters and physical characteristics with DLSS.Summary of Background Data. Lumbar spinal stenosis is a prevalent and disabling condition in the aging population. DLSS is considered to be the most common type and is essentially associated with disc disease, facet joint arthrosis, ligamentum flavum thickening and osteophyte formation. While there is ample information regarding the association between BMI, cardiovascular disorders, smoking habits and disc disease, very little is known about their association with DLSS. Data on the association of body physique (e.g., height and weight) and DLSS are limited.Methods. Two sample populations were studied. The first included 165 individuals with DLSS (mean age 64 ± 9.9 years) and the second 180 individuals without spinal stenosis related symptoms (mean age 62.5 ± 12.6 years). An evaluation of the cross-sectional area of the dural sac and degenerative listhesis for all participants was performed on CT lumbar spine images, utilizing Philips EBW station (Brilliance 64, Philips Medical System, Cleveland Ohio). All participants were interviewed in order to obtain demographic, physical and health data. Independent T- test, Mann-Whitney and Chi-square tests were used to determine the association between parametric and non-parametric variables and DLSS. Logistic regression analysis was carried out in order to reveal predicting variables for DLSS.Results. Stenosis females were significantly heavier and shorter compared to their counterparts in the control group. We also noticed that they delivered babies more often than those in the control group. Prevalence of individuals suffering from diabetes mellitus was significantly higher in the stenosis males compared to control group. In the stenosis group, the frequencies of individuals engaged in heavy manual labor (males) and housekeeping (females) were significantly higher compared to their counterparts in the control group.Conclusions. Heavy manual labor and diabetes mellitus in males and housekeeping (females) play major roles in the genesis of DLSS. PMID:23380820

Abbas, J; Hamoud, K; May, H; Peled, N; Sarig, R; Stein, D; Alperovitch-Najenson, D; Hershkovitz, I

2013-02-01

247

Comparison of the costs of nonoperative care to minimally invasive surgery for sacroiliac joint disruption and degenerative sacroiliitis in a United States commercial payer population: potential economic implications of a new minimally invasive technology  

Directory of Open Access Journals (Sweden)

Full Text Available Stacey J Ackerman,1 David W Polly Jr,2 Tyler Knight,3 Karen Schneider,4 Tim Holt,5 John Cummings Jr6 1Covance Market Access Services Inc., San Diego, CA, USA; 2University of Minnesota, Orthopaedic Surgery, Minneapolis, MN, USA; 3Covance Market Access Services Inc., Gaithersburg, MD, USA; 4Covance Market Access Services Inc., Sydney, Australia; 5Montgomery Spine Center, Orthopedic Surgery, Montgomery, AL, USA; 6Community Health Network, Neurosurgery, Indianapolis, IN, USA Introduction: Low back pain is common and treatment costly with substantial lost productivity and lost wages in the working-age population. Chronic low back pain originating in the sacroiliac (SI joint (15%–30% of cases is commonly treated with nonoperative care, but new minimally invasive surgery (MIS options are also effective in treating SI joint disruption. We assessed whether the higher initial MIS SI joint fusion procedure costs were offset by decreased nonoperative care costs from a US commercial payer perspective. Methods: An economic model compared the costs of treating SI joint disruption with either MIS SI joint fusion or continued nonoperative care. Nonoperative care costs (diagnostic testing, treatment, follow-up, and retail pharmacy pain medication were from a retrospective study of Truven Health MarketScan® data. MIS fusion costs were based on the Premier's Perspective™ Comparative Database and professional fees on 2012 Medicare payment for Current Procedural Terminology code 27280. Results: The cumulative 3-year (base-case analysis and 5-year (sensitivity analysis differentials in commercial insurance payments (cost of nonoperative care minus cost of MIS were $14,545 and $6,137 per patient, respectively (2012 US dollars. Cost neutrality was achieved at 6 years; MIS costs accrued largely in year 1 whereas nonoperative care costs accrued over time with 92% of up front MIS procedure costs offset by year 5. For patients with lumbar spinal fusion, cost neutrality was achieved in year 1. Conclusion: Cost offsets from new interventions for chronic conditions such as MIS SI joint fusion accrue over time. Higher initial procedure costs for MIS were largely offset by decreased nonoperative care costs over a 5-year time horizon. Optimizing effective resource use in both nonoperative and operative patients will facilitate cost-effective health care delivery. The impact of SI joint disruption on direct and indirect costs to commercial insurers, health plan beneficiaries, and employers warrants further consideration. Keywords: epidural injection, iFuse, economic model, sacroiliac joint fusion, sacroiliac joint pain, insurance

Ackerman SJ

2014-05-01

248

Degenerative lumbosacral stenosis in dogs  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Degenerative lumbosacral stenosis (DLSS) is the most common disorder of the caudal lumbar spine in dogs. This article reviews the management of this disorder and highlights the most important new findings of the last decade. Dogs with DLSS are typically neuro-orthopedic patients and can be presented with varying clinical signs, of which the most consistent is lumbosacral pain. Due to the availability of advanced imaging techniques such as computed tomography and magnetic resonance imaging tha...

Meij, B. P.; Bergknut, N.

2010-01-01

249

Temporomandibular Joint Disorders  

Medline Plus

Full Text Available ... common form of TMJ disorders. Derangement Disorders These disorders are related to derangement of the TM joint, such as ... displaced disk, and injured bone. Degenerative Disorders These disorders are related to wear and tear of the TM joint, ...

250

Effects of Spinal Stabilization Exercise on the Cross-sectional Areas of the Lumbar Multifidus and Psoas Major Muscles, Pain Intensity, and Lumbar Muscle Strength of Patients with Degenerative Disc Disease.  

Science.gov (United States)

[Purpose] The aim of this study was to evaluate the efficacy of using spinal stabilizing exercise to reduce atrophy of the multifidus and psoas major muscles, reduce the levels of pain and disability, and increase paraspinal muscle strength in patients with degenerative disc disease (DDD). [Subjects and Methods] In 33 patients (Age range: 25-65?years) diagnosed with DDD, spinal stabilization exercise was conducted for 8 weeks. The levels of pain and disability were measured before and after exercise using the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Paraspinal muscular strength in four directions was evaluated with a CENTAUR 3D Spatial Rotation Device. Cross-sectional areas (CSAs) of both the left and right multifidus and the psoas major at the upper endplate of L4 were measured before and after exercise using computed tomography (CT). [Results] After 8 weeks of spinal stabilization exercise, the pain and lumbar disability in subjects decreased significantly from 6.12±1.24 to 2.43±1.14. The ODI score also improved from 20.18±7.14 to 8.81±5.73. In addition, paraspinal muscle strength increased significantly, while the CSAs of the left and right multifidus and psoas major widened as compared with the pre-exercise size. [Conclusion] Spinal stabilization exercise was effective for reducing pain and disability in DDD patients. It was an effective adjunct to aid rehabilitation in these cases. PMID:24764637

Kim, Seongho; Kim, Hyungguen; Chung, Jaeyeop

2014-04-01

251

Radiopharmaceuticals for SPECT exploration of dopaminergic systems. Diagnosis and surveillance of neuro-degenerative diseases; Les radiopharmaceutiques pour l`exploration des system dopaminergique en TEMP. Interet pour le diagnostic et le suivi des maladies neurodegeneratives  

Energy Technology Data Exchange (ETDEWEB)

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 {beta}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{beta}-carbometoxy -3{beta}-(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

Gouilloteau, D.; Prunier-Levallon, C.; Zimmer, L.; Autret, A.; Besnard, J-Cl.; Baulieu, J-L. [CHU TOURS (France)

1997-12-31

252

Osteoarthritis and meniscus disorders of the knee as occupational diseases of miners  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Aim: To determine whether kneeling or squatting for prolonged periods is sufficiently causally associated with an increased risk of injury or degenerative disease of the knee joint as to meet the classic criteria to be considered an occupational disease of coal miners for whom these are or have been routine working postures.

Mcmillan, G.; Nichols, L.

2005-01-01

253

Gender differences in knee joint cartilage thickness, volume and articular surface areas: assessment with quantitative three-dimensional MR imaging  

International Nuclear Information System (INIS)

eight and body weight x body height. The study demonstrates significant gender differences in cartilage volume and surface area of men and women, which need to be taken into account when retrospectively estimating articular cartilage loss in patients with symptoms of degenerative joint disease. Differences in cartilage volume are primarily due to differences in joint surface areas (epiphyseal bone size), not to differences in cartilage thickness. (orig.)

254

Joint principles of motor and cognitive dysfunction in Parkinson's disease.  

Science.gov (United States)

Traditionally, the lateral premotor cortex (PM) is assigned a role in stimulus-driven rather than memory-driven motor control, whereas the opposite holds for the mesial premotor cortex (supplementary motor area, SMA). Consistently, patients with Parkinson's Disease (PD), in which a specific functional degradation of the mesial loop (i.e., SMA-Striatum) occurs, show impaired memory-driven but relatively preserved stimulus-driven motor control. However, both parts of the premotor cortex are involved in perceptual prediction tasks as well. Here we tested whether the functional bias described on the motor level (i.e., memory-driven/mesial versus stimulus-driven/lateral) can also be detected in perceptual prediction tasks thereby suggesting that PD patients exhibit the same pattern of impaired memory-driven and preserved stimulus-driven control in the cognitive domain. To this end, we investigated 20 male PD-patients "on" and "off" dopaminergic medication while performing a serial prediction task (SPT). A specific modification was implemented to the classical SPT (SPT0) that caused shifts from stimulus- to memory-based prediction (SPT+). As a result, PD patients showed a significantly impaired performance "off" compared to "on" medication for SPT+, whereas no significant "on"/"off"-effects were found for SPT0. Descriptively, the "off"-performance decreased gradually with increasing demands on memory-based prediction. Furthermore, the severity of motor deficits according to the UPDRS III correlated significantly with impaired performance in SPT0 "on" medication. Importantly, an even stronger dependency was found for UPDRS III and SPT+. These findings point to a role of the SMA-striatal loop in memory-driven serial prediction beyond the motor domain. PMID:23628367

Schönberger, Anna R; Barbe, Michael T; Hagelweide, Klara; Kühn, Anne B; Fink, Gereon R; Schubotz, Ricarda I

2013-07-01

255

Pelvic bone and hip joint hydatid disease revealing a retroperitoneal location  

Directory of Open Access Journals (Sweden)

Full Text Available Echinococcosis is a parasitic disease produced by the larval stage of Echinococcus granulosus. Hydatid disease of bone is rarely seen in humans and it has been reported in only 1-2% of cases of echinococcosis. We present a patient who developed hydatid disease of the left pelvic and femoral bones with cartilage destruction of the ipsilateral hip joint revealing a retroperitoneal location of hydatid cyst. Hydatid bone must be present in the differential diagnosis of chronic monoarthritis; the risk is to perform a total hip replacement in a septic environment.

A. Elmrini

2009-06-01

256

Heart rate variability and arrhythmias evaluated with Holter in dogs with degenerative mitral valve disease / Variabilidade da frequência cardíaca e arritmias detectadas pelo exame Holter em cães com degeneração valvar mitral  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese As cardiopatias cursam com alterações do controle autonômico do coração, resultando em taquicardia e consequente diminuição na variabilidade da frequência cardíaca (VFC). O objetivo deste estudo foi avaliar se o desenvolvimento de insuficiência cardíaca secundária à degeneração valvar mitral (DVM) l [...] eva a alterações no controle autonômico do coração, as quais podem ser determinadas pela eletrocardiografia contínua (Holter). Cães foram distribuídos em grupos experimentais após avaliação clínica e ecocardiográfica da seguinte maneira: controle (saudáveis; n=6), DVM sem insuficiência cardíaca (n=8) e DVM com insuficiência cardíaca (n=13). Arritmias e VFC foram determinadas pelo Holter. Animais portadores de DVM, quando comparados ao controle, apresentaram diminuição significativa da potência total, a qual é representativa de toda a VFC. Somente cães doentes e com insuficiência cardíaca apresentaram incidência elevada de arritmias supraventriculares, frequência cardíaca aumentada, pequena quantidade de pausas superiores a 2,0s entre batimentos consecutivos, permanência por mais tempo em taquicardia do que em bradicardia, diminuído índice de alta frequência (indicativo de controle parassimpático) e elevado índice de baixa frequência (indicativo de controle simpático e parassimpático), quando comparados ao controle (p Abstract in english Cardiac diseases promote alterations in the autonomic control of the heart, leading to an increase in heart rate and, as a result, a decrease in heart rate variability (HRV).The aim of this study was to evaluate if the development of heart failure secondary to degenerative mitral valve disease (DMVD [...] ) concurs with changes in autonomic modulation of heart rhythm which are assessed by long electrocardiography examination (Holter). Dogs were evaluated by clinical examination and echocardiography in order to be categorized into the following groups: Control (healthy; n=6), DMVD (disease without heart failure; n=8), and DMVD heart failure (disease with heart failure; n=13). Arrhythmias and frequency domain HRV were determined by Holter. Diseased animals, when compared to healthy, had significantly lower total power, which indicates overall HRV. DMVD heart failure dogs also showed other disturbances such as high incidence of supraventricular arrhythmias, high heart rate, little amount of pauses (2.0s long between consecutive heartbeats), longer time in tachycardia, shorter time in bradycardia, low high frequency (parasympathetic control), and high low frequency (sympathetic and parasympathetic control) when compared to control (p

M.S., Oliveira; R.A.L., Muzzi; R.B., Araújo; L.A.L., Muzzi; D.F., Ferreira; E.F., Silva.

257

Heart rate variability and arrhythmias evaluated with Holter in dogs with degenerative mitral valve disease / Variabilidade da frequência cardíaca e arritmias detectadas pelo exame Holter em cães com degeneração valvar mitral  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese As cardiopatias cursam com alterações do controle autonômico do coração, resultando em taquicardia e consequente diminuição na variabilidade da frequência cardíaca (VFC). O objetivo deste estudo foi avaliar se o desenvolvimento de insuficiência cardíaca secundária à degeneração valvar mitral (DVM) l [...] eva a alterações no controle autonômico do coração, as quais podem ser determinadas pela eletrocardiografia contínua (Holter). Cães foram distribuídos em grupos experimentais após avaliação clínica e ecocardiográfica da seguinte maneira: controle (saudáveis; n=6), DVM sem insuficiência cardíaca (n=8) e DVM com insuficiência cardíaca (n=13). Arritmias e VFC foram determinadas pelo Holter. Animais portadores de DVM, quando comparados ao controle, apresentaram diminuição significativa da potência total, a qual é representativa de toda a VFC. Somente cães doentes e com insuficiência cardíaca apresentaram incidência elevada de arritmias supraventriculares, frequência cardíaca aumentada, pequena quantidade de pausas superiores a 2,0s entre batimentos consecutivos, permanência por mais tempo em taquicardia do que em bradicardia, diminuído índice de alta frequência (indicativo de controle parassimpático) e elevado índice de baixa frequência (indicativo de controle simpático e parassimpático), quando comparados ao controle (p Abstract in english Cardiac diseases promote alterations in the autonomic control of the heart, leading to an increase in heart rate and, as a result, a decrease in heart rate variability (HRV).The aim of this study was to evaluate if the development of heart failure secondary to degenerative mitral valve disease (DMVD [...] ) concurs with changes in autonomic modulation of heart rhythm which are assessed by long electrocardiography examination (Holter). Dogs were evaluated by clinical examination and echocardiography in order to be categorized into the following groups: Control (healthy; n=6), DMVD (disease without heart failure; n=8), and DMVD heart failure (disease with heart failure; n=13). Arrhythmias and frequency domain HRV were determined by Holter. Diseased animals, when compared to healthy, had significantly lower total power, which indicates overall HRV. DMVD heart failure dogs also showed other disturbances such as high incidence of supraventricular arrhythmias, high heart rate, little amount of pauses (2.0s long between consecutive heartbeats), longer time in tachycardia, shorter time in bradycardia, low high frequency (parasympathetic control), and high low frequency (sympathetic and parasympathetic control) when compared to control (p

M.S., Oliveira; R.A.L., Muzzi; R.B., Araújo; L.A.L., Muzzi; D.F., Ferreira; E.F., Silva.

2014-04-01

258

Inclusion body myositis: a degenerative muscle disease associated with intra-muscle fiber multi-protein aggregates, proteasome inhibition, endoplasmic reticulum stress and decreased lysosomal degradation.  

Science.gov (United States)

Sporadic inclusion body myositis (s-IBM), the most common muscle disease of older persons, is of unknown cause, and there is no enduring treatment. Abnormal accumulation of intracellular multi-protein inclusions is a characteristic feature of the s-IBM phenotype, and as such s-IBM can be considered a "conformational disorder," caused by protein unfolding/misfolding combined with the formation of inclusion bodies. Abnormal intracellular accumulation of unfolded proteins may lead to their aggregation and inclusion body formation. The present article is focusing on the multiple proteins that are accumulated in the form of aggregates within s-IBM muscle fibers, and it explores the most recent research advances directed toward a better understanding of mechanisms causing their impaired degradation and abnormal aggregation. We illustrate that, among other factors, abnormal misfolding, accumulation and aggregation of proteins are associated with their inadequate disposal-and these factors are combined with, and perhaps provoked by, an aging intracellular milieu. Other concurrent and possibly provocative phenomena known within s-IBM muscle fibers are: endoplasmic reticulum stress and unfolded protein response, mitochondrial abnormalities, proteasome inhibition, lysosome abnormality and endodissolution. Together, these appear to lead to the s-IBM-specific vacuolar degeneration, and muscle fiber atrophy, concluding with muscle fiber death. PMID:19563541

Askanas, Valerie; Engel, W King; Nogalska, Anna

2009-07-01

259

Discovering joint associations between disease and gene pairs with a novel similarity test  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Genes in a functional pathway can have complex interactions. A gene might activate or suppress another gene, so it is of interest to test joint associations of gene pairs. To simultaneously detect the joint association between disease and two genes (or two chromosomal regions, we propose a new test with the use of genomic similarities. Our test is designed to detect epistasis in the absence of main effects, main effects in the absence of epistasis, or the presence of both main effects and epistasis. Results The simulation results show that our similarity test with the matching measure is more powerful than the Pearson's ?2 test when the disease mutants were introduced at common haplotypes, but is less powerful when the disease mutants were introduced at rare haplotypes. Our similarity tests with the counting measures are more sensitive to marker informativity and linkage disequilibrium patterns, and thus are often inferior to the similarity test with the matching measure and the Pearson's ?2 test. Conclusions In detecting joint associations between disease and gene pairs, our similarity test is a complementary method to the Pearson's ?2 test.

Lin Wan-Yu

2010-10-01

260

Iron behaving badly: inappropriate iron chelation as a major contributor to the aetiology of vascular and other progressive inflammatory and degenerative diseases  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular 'reactive oxygen species' (ROSs can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. Review We review the considerable and wide-ranging evidence for the involvement of this combination of (superoxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation. The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, since in some circumstances (especially the presence of poorly liganded iron molecules that are nominally antioxidants can actually act as pro-oxidants. The reduction of redox stress thus requires suitable levels of both antioxidants and effective iron chelators. Some polyphenolic antioxidants may serve both roles. Understanding the exact speciation and liganding of iron in all its states is thus crucial to separating its various pro- and anti-inflammatory activities. Redox stress, innate immunity and pro- (and some anti-inflammatory cytokines are linked in particular via signalling pathways involving NF-kappaB and p38, with the oxidative roles of iron here seemingly involved upstream of the IkappaB kinase (IKK reaction. In a number of cases it is possible to identify mechanisms by which ROSs and poorly liganded iron act synergistically and autocatalytically, leading to 'runaway' reactions that are hard to control unless one tackles multiple sites of action simultaneously. Some molecules such as statins and erythropoietin, not traditionally associated with anti-inflammatory activity, do indeed have 'pleiotropic' anti-inflammatory effects that may be of benefit here. Conclusion Overall we argue, by synthesising a widely dispersed literature, that the role of poorly liganded iron has been rather underappreciated in the past, and that in combination with peroxide and superoxide its activity underpins the behaviour of a great many physiological processes that degrade over time. Understanding these requires an integrative, systems-level approach that may lead to novel therapeutic targets.

Kell Douglas B

2009-01-01

 
 
 
 
261

Comparison of the outcomes of three surgical treatments for end-stage temporomandibular joint disease.  

Science.gov (United States)

The aim of this study was to determine whether there are any differences between condylectomy, rib grafts, and prosthetic joints (Biomet TMJ stock prosthesis) with regard to outcomes for patients with end-stage temporomandibular joint (TMJ) disease. Fifty-six of a total 127 patients who presented with category 5 end-stage TMJ disease over 3 years (2010-2013) agreed to participate in this retrospective, comparative, cohort study. Patients were divided into four groups: preoperative (n=16), condylectomy (n=8), rib graft (n=16), and prosthetic joint (n=16). They were assessed for major postoperative complications (i.e., return to theatre) and maximum range of mandibular motion, and all completed a specific quality of life (QOL) questionnaire. Whilst the condylectomy group demonstrated the best mandibular range of motion (Ptheatre. The prosthesis group recorded the best mean aggregate QOL score, but the difference compared to the rib graft and condylectomy groups was not statistically significant. The results of this study suggest that for dentate patients, prosthetic joints are highly dependable with no returns to theatre and favourable QOL outcomes. For edentulous patients, condylectomies alone also appear to work well. Future TMJ prosthetic designs should focus on improving mandibular range of motion, as the current stock prosthesis allows only a restricted range, no better than that achieved with rib graft (P>0.05) and far less than that achieved with condylectomy (P<0.01). PMID:24629849

Dimitroulis, G

2014-08-01

262

Avaliação ocular multimodal em doenças heredodistróficas e degenerativas da retina / Multimodal fundus imaging in heredodystrophic and degenerative diseases of the retina  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A tomografia de coerência óptica incorporou-se gradativamente ao contemporâneo arsenal diagnóstico em Oftalmologia, passando a exercer papel fundamental na investigação e condução de doenças oculares, particularmente na especialidade de Retina e Vítreo. A disponibilização comercial da nova geração d [...] e aparelhos, chamada de tomografia de coerência óptica "espectral", baseada em conceito físico distinto que permite a aquisição de imagens em alta velocidade, marcou o início de uma nova era desta tecnologia de investigação auxiliar. Adicionalmente, sua recente combinação com o oftalmoscópio de varredura a laser confocal (confocal scanning laser ophthalmoscope) vem propiciando a aquisição de imagens tomográficas guiadas em tempo real pelos diferentes modos de imagem (autofluorescência de fundo, reflectância com luz "infravermelha" e angiografia com fluoresceína ou indocianina verde). A avaliação ocular multimodal (multimodal fundus imaging) permite a correlação real e minuciosa de achados da morfologia retiniana e do epitélio pigmentar com dados de estudos angiográficos e de autofluorescência ou reflectância, propiciando assim inferências valiosas sobre a fisiologia do tecido. Neste artigo, discutimos brevemente as possíveis implicações da avaliação ocular multimodal na prática da especialidade de Retina e Vítreo. Abstract in english Optical coherence tomography was progressively incorporated to the contemporary diagnostic arsenal in Ophthalmology, playing a crucial role in the diagnosis and management of eye diseases, particularly in the specialty of retina and vitreous. The commercial availability of the new generation of devi [...] ces, coined "spectral" optical coherence tomography, which is based in a distinct physical concept that permits high-speed image acquisition, launched a new era for this investigative ancillary tool. In addition, the recent combination of this new technology with a confocal scanning laser ophthalmoscope has permitted the acquisition of tomographic images driven by different imaging modalities simultaneously (fundus autofluorescence, near-infrared reflectance, and fluorescein or indocyanine-green angiographies). Multimodal fundus imaging permits a reliable and detailed correlation between the morphological findings of the retina or retinal pigment epithelium and angiographic studies or fundus autofluorescence, leading to valuable insights about retina physiology. In this article, we briefly discuss possible practical implications of this new diagnostic modality for the retina specialist.

Daniela Cavalcanti, Ferrara; Daniela, Calucci; Juliana Lambert, Oréfice; Rogério Alves, Costa.

263

Avaliação ocular multimodal em doenças heredodistróficas e degenerativas da retina / Multimodal fundus imaging in heredodystrophic and degenerative diseases of the retina  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A tomografia de coerência óptica incorporou-se gradativamente ao contemporâneo arsenal diagnóstico em Oftalmologia, passando a exercer papel fundamental na investigação e condução de doenças oculares, particularmente na especialidade de Retina e Vítreo. A disponibilização comercial da nova geração d [...] e aparelhos, chamada de tomografia de coerência óptica "espectral", baseada em conceito físico distinto que permite a aquisição de imagens em alta velocidade, marcou o início de uma nova era desta tecnologia de investigação auxiliar. Adicionalmente, sua recente combinação com o oftalmoscópio de varredura a laser confocal (confocal scanning laser ophthalmoscope) vem propiciando a aquisição de imagens tomográficas guiadas em tempo real pelos diferentes modos de imagem (autofluorescência de fundo, reflectância com luz "infravermelha" e angiografia com fluoresceína ou indocianina verde). A avaliação ocular multimodal (multimodal fundus imaging) permite a correlação real e minuciosa de achados da morfologia retiniana e do epitélio pigmentar com dados de estudos angiográficos e de autofluorescência ou reflectância, propiciando assim inferências valiosas sobre a fisiologia do tecido. Neste artigo, discutimos brevemente as possíveis implicações da avaliação ocular multimodal na prática da especialidade de Retina e Vítreo. Abstract in english Optical coherence tomography was progressively incorporated to the contemporary diagnostic arsenal in Ophthalmology, playing a crucial role in the diagnosis and management of eye diseases, particularly in the specialty of retina and vitreous. The commercial availability of the new generation of devi [...] ces, coined "spectral" optical coherence tomography, which is based in a distinct physical concept that permits high-speed image acquisition, launched a new era for this investigative ancillary tool. In addition, the recent combination of this new technology with a confocal scanning laser ophthalmoscope has permitted the acquisition of tomographic images driven by different imaging modalities simultaneously (fundus autofluorescence, near-infrared reflectance, and fluorescein or indocyanine-green angiographies). Multimodal fundus imaging permits a reliable and detailed correlation between the morphological findings of the retina or retinal pigment epithelium and angiographic studies or fundus autofluorescence, leading to valuable insights about retina physiology. In this article, we briefly discuss possible practical implications of this new diagnostic modality for the retina specialist.

Daniela Cavalcanti, Ferrara; Daniela, Calucci; Juliana Lambert, Oréfice; Rogério Alves, Costa.

2009-10-01

264

Avaliação ocular multimodal em doenças heredodistróficas e degenerativas da retina Multimodal fundus imaging in heredodystrophic and degenerative diseases of the retina  

Directory of Open Access Journals (Sweden)

Full Text Available A tomografia de coerência óptica incorporou-se gradativamente ao contemporâneo arsenal diagnóstico em Oftalmologia, passando a exercer papel fundamental na investigação e condução de doenças oculares, particularmente na especialidade de Retina e Vítreo. A disponibilização comercial da nova geração de aparelhos, chamada de tomografia de coerência óptica "espectral", baseada em conceito físico distinto que permite a aquisição de imagens em alta velocidade, marcou o início de uma nova era desta tecnologia de investigação auxiliar. Adicionalmente, sua recente combinação com o oftalmoscópio de varredura a laser confocal (confocal scanning laser ophthalmoscope vem propiciando a aquisição de imagens tomográficas guiadas em tempo real pelos diferentes modos de imagem (autofluorescência de fundo, reflectância com luz "infravermelha" e angiografia com fluoresceína ou indocianina verde. A avaliação ocular multimodal (multimodal fundus imaging permite a correlação real e minuciosa de achados da morfologia retiniana e do epitélio pigmentar com dados de estudos angiográficos e de autofluorescência ou reflectância, propiciando assim inferências valiosas sobre a fisiologia do tecido. Neste artigo, discutimos brevemente as possíveis implicações da avaliação ocular multimodal na prática da especialidade de Retina e Vítreo.Optical coherence tomography was progressively incorporated to the contemporary diagnostic arsenal in Ophthalmology, playing a crucial role in the diagnosis and management of eye diseases, particularly in the specialty of retina and vitreous. The commercial availability of the new generation of devices, coined "spectral" optical coherence tomography, which is based in a distinct physical concept that permits high-speed image acquisition, launched a new era for this investigative ancillary tool. In addition, the recent combination of this new technology with a confocal scanning laser ophthalmoscope has permitted the acquisition of tomographic images driven by different imaging modalities simultaneously (fundus autofluorescence, near-infrared reflectance, and fluorescein or indocyanine-green angiographies. Multimodal fundus imaging permits a reliable and detailed correlation between the morphological findings of the retina or retinal pigment epithelium and angiographic studies or fundus autofluorescence, leading to valuable insights about retina physiology. In this article, we briefly discuss possible practical implications of this new diagnostic modality for the retina specialist.

Daniela Cavalcanti Ferrara

2009-10-01

265

Joint Hypermobility Syndrome and Dysautonomia: Expanding Spectrum of Disease Presentation and Manifestation  

Directory of Open Access Journals (Sweden)

Full Text Available The varying clinical presentations of not so well recognized diseases, which continue to haunt patients is well described in the above quotes. Clinicians may not recognize associated subtle early presentations of the disease, till the disease has fully manifested itself. Of all the disorders of human body, autonomic syndromes are still the least understood. Presentation and association of autonomic diseases with other disorders may be so varied and subtle that clinicians may fail to recognize autonomic disturbance as an individual clinical entity within the disease and therefore appropriate management still remains inadequate. Similar association between joint hypermobility disorder, in which postural orthostatic tachycardia syndrome and dysautonomia is increasingly being recognized as an associated clinical entity, has been further elaborated.

Shomu Bohora

2010-04-01

266

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

2008-01-01

267

Host and parasite diversity jointly control disease risk in complex communities.  

Science.gov (United States)

Host-parasite interactions are embedded within complex communities composed of multiple host species and a cryptic assemblage of other parasites. To date, however, surprisingly few studies have explored the joint effects of host and parasite richness on disease risk, despite growing interest in the diversity-disease relationship. Here, we combined field surveys and mechanistic experiments to test how transmission of the virulent trematode Ribeiroia ondatrae was affected by the diversity of both amphibian hosts and coinfecting parasites. Within natural wetlands, host and parasite species richness correlated positively, consistent with theoretical predictions. Among sites that supported Ribeiroia, however, host and parasite richness interacted to negatively affect Ribeiroia transmission between its snail and amphibian hosts, particularly in species-poor assemblages. In laboratory and outdoor experiments designed to decouple the relative contributions of host and parasite diversity, increases in host richness decreased Ribeiroia infection by 11-65%. Host richness also tended to decrease total infections by other parasite species (four of six instances), such that more diverse host assemblages exhibited ?40% fewer infections overall. Importantly, parasite richness further reduced both per capita and total Ribeiroia infection by 15-20%, possibly owing to intrahost competition among coinfecting species. These findings provide evidence that parasitic and free-living diversity jointly regulate disease risk, help to resolve apparent contradictions in the diversity-disease relationship, and emphasize the challenges of integrating research on coinfection and host heterogeneity to develop a community ecology-based approach to infectious diseases. PMID:24082092

Johnson, Pieter T J; Preston, Daniel L; Hoverman, Jason T; LaFonte, Bryan E

2013-10-15

268

Degenerative lumbosacral stenosis in dogs.  

Science.gov (United States)

Degenerative lumbosacral stenosis (DLSS) is the most common disorder of the caudal lumbar spine in dogs. This article reviews the management of this disorder and highlights the most important new findings of the last decade. Dogs with DLSS are typically neuro-orthopedic patients and can be presented with varying clinical signs, of which the most consistent is lumbosacral pain. Due to the availability of advanced imaging techniques such as computed tomography and magnetic resonance imaging that allow visualization of intervertebral disc degeneration, cauda equina compression, and nerve root entrapment, tailor-made treatments can be adopted for the individual patient. Current therapies include conservative treatment, decompressive surgery, and fixation-fusion of the L7-S1 junction. New insight into the biomechanics and pathobiology of DLSS and developments in minimally invasive surgical techniques will influence treatment options in the near future. PMID:20732601

Meij, Björn P; Bergknut, Niklas

2010-09-01

269

Comparative diagnostic imaging of the canine shoulder joint ultrasonography and radiography  

CERN Document Server

radiographically. 6 of 17 supraspinatus insertion tendinopathies (35.3 %) and 4 of 5 bicipital tendon calcifications (80 %) were detected only with ultrasonography. Radiographic findings of bony proliferations in the intertuberal groove without signs of degenerative joint disease of the shoulder joint are indicative of severe or chronic biciptal tendon disease. In many cases, the stage and severity of cartilaginous and subchondral bone lesions with osteochondritis dissecans can be determined ultrasonographically. Osteochondritis dissecans defects not seen on radiographs are occasionally visible with ultrasound, although a negative finding is not always accurate. Ultrasonography of shoulder joint disease has been applied in humans for some time. In this study, the use of radiography and ultrasonography as diagnostic imaging modalities to determine shoulder joint lesions is presented. The ultrasonographic anatomy and pathology of the shoulder joint are described. Comparative radiographic and ultrasonographic fi...

Mayer, B

2000-01-01

270

Imaging of hip joint arthroplasty  

International Nuclear Information System (INIS)

The hip joint is the largest joint in the human body and consequently, its evaluation by diagnostic imaging is highly important. This includes imaging of hip joint arthroplasty, which is used to avoid joint immobility following a wide spectrum of diseases, such as end-stage degenerative disease, avascular necrosis of the femoral head or post-traumatic fractures. Conventional radiography is still the standard imaging modality for the evaluation of hip arthroplasty both directly following surgery and for periodical follow-up. In the majority of cases conventional radiography enables adequate assessment of early and late complications that can arise following hip arthroplasty, such as loosening, prosthetic or periprosthetic fracture, luxation, infection and soft tissue calcification. If the diagnosis cannot be established by means of radiography, advanced imaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI), with or without injection of contrast media, may provide additional information. This is particularly true for the depiction of inflammatory processes. Regardless of the imaging modality used patients' clinical symptoms must also be taken into account in order to establish the correct diagnosis. (orig.)

271

Muscle diseases with prominent joint contractures: Main entities and diagnostic strategy.  

Science.gov (United States)

Muscle diseases may have various clinical manifestations including muscle weakness, atrophy or hypertrophy and joint contractures. A spectrum of non-muscular manifestations (cardiac, respiratory, cutaneous, central and peripheral nervous system) may be associated. Few of these features are specific. Limb joint contractures or spine rigidity, when prevailing over muscle weakness in ambulant patients, are of high diagnostic value for diagnosis orientation. Within this context, among several disorders, four groups of diseases should systematically come to mind including the collagen VI-related myopathies, the Emery-Dreifuss muscular dystrophies, the SEPN1 and FHL1 related myopathies. More rarely other genetic or acquired myopathies may present with marked contractures. Diagnostic work-up should include a comprehensive assessment including family history, neurological, cardiologic and respiratory evaluations. Paraclinical investigations should minimally include muscle imaging and electromyography. Muscle and skin biopsies as well as protein and molecular analyses usually help to reach a precise diagnosis. We will first describe the main muscle and neuromuscular junction diseases where contractures are typically a prominent symptom of high diagnostic value for diagnosis orientation. In the following chapters, we will present clues for the diagnostic strategy and the main measures to be taken when, at the end of the diagnostic work-up, no definite muscular disease has been identified. PMID:24021317

Eymard, B; Ferreiro, A; Ben Yaou, R; Stojkovic, T

2013-01-01

272

[Revised consensus classification. Histopathological classification of diseases associated with joint endoprostheses].  

Science.gov (United States)

The revised classification of the periprosthetic membrane (synovial-like interface membrane SLIM) encompasses all pathological alterations which can occur as a result of endoprosthetic replacement of major joints and lead to a reduction in durability of prostheses. This also includes the established consensus classification of SLIM by which aseptic and septic prosthetic loosening can be subdivided into four histological types and histopathological criteria for additional pathologies: endoprosthesis-associated arthrofibrosis, immunological/allergic alterations and osseous pathologies. This revision represents the foundation for the histopathological diagnostics of the total spectrum of diseases associated with joint prostheses, is a suitable basis for a standardized diagnostic procedure and etiological clarification of endoprosthesis failure and also as a data standard for endprosthesis registers, in particular for registers based on routine data (e.g. German endoprosthesis register). PMID:23446461

Krenn, V; Morawietz, L; Kienapfel, H; Ascherl, R; Matziolis, G; Hassenpflug, J; Thomsen, M; Thomas, P; Huber, M; Schuh, C; Kendoff, D; Baumhoer, D; Krukemeyer, M G; Perino, G; Zustin, J; Berger, I; Rüther, W; Poremba, C; Gehrke, T

2013-05-01

273

Treatment of Joint Inflammatory Diseases in the Lame Backyard Chickens with NSAIDs  

Directory of Open Access Journals (Sweden)

Full Text Available The effects of several Non-Steroidal Anti-Inflammatory Drugs (NSAIDs were determined in 200 mature backyard chickens with clinical signs of lameness. The NSAIDs, diclofenac, carprofen, ketoprofen and meloxicam with doses 0.5, 1, 2, 3 and 4 mg/kg were used in these groups, orally. Chickens were monitored on a daily basis for general condition, joint inflammation reduction and mortality. Diclofenac, carprofen and ketoprofen were associated with mortality. In contrast, there were no reported mortalities for the NSAID, meloxicam in this study. Results of the current study revealed that the meloxicam was the drug of choice with relative safety for treatment of joint inflammatory diseases in chickens.

M.M. Hadipour

2011-04-01

274

Classificação diagnóstica dos portadores de doenças degenerativas de retina, integrantes dos grupos Retina São Paulo e Retina Vale do Paraíba / Diagnostic classification of retinal degenerative diseases São Paulo and Vale Retina groups  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO:Organizar um banco de dados regional de todos os indivíduos portadores de doenças degenerativas da retina, com o objetivo de classificar cada paciente de acordo com o tipo de distrofia e padrão de herança. MÉTODOS: Durante o encontro do Grupo Retina São Paulo no dia 5 de maio de 2001, duzen [...] tas e quarenta e três pessoas foram registradas, sendo que parte forneceu dados de antecedentes oculares, pessoais e familiares e árvore genealógica. Noventa e três pacientes foram questionados quanto a idade, origem, tipo de distrofia, história familiar e árvore genealógica, tipo de herança, outras anomalias sistêmicas e exames complementares. Foram classificados quanto ao diagnóstico e padrão de herança. RESULTADOS: Dos duzentos e quarenta e três pacientes registrados, as distrofias encontradas foram retinose pigmentária, doença de Stargardt, síndrome de Usher, amaurose congênita de Leber e coroideremia. Quanto à divisão por doença dos 93 pacientes argüidos, havia 62 pacientes com retinose pigmentária, 13 com doença de Stargardt, 13 com síndrome de Usher, três com amaurose congênita de Leber e dois com coroideremia. Dos pacientes com retinose pigmentária, o padrão de herança detectado foi autossômico dominante em quatro casos (7%), autossômico recessivo em vinte casos (32%), ligado ao cromossomo X recessivo em sete casos (11%), caso isolado em vinte e nove (47%) e padrão indeterminado em dois (3%). Para a doença de Stargardt três indivíduos (23%) seguiam o padrão de herança autossômico recessivo e dez (77%) eram casos isolados. Dos treze pacientes com síndrome de Usher, oito (61,5%) apresentavam herança autossômica recessiva, quatro (31%) eram casos isolados e um (7,5%) tinha o padrão de herança indeterminado. Os dois pacientes com coroideremia seguiam o padrão de herança ligado ao X recessivo. Para amaurose congênita de Leber, um paciente (33,5%) tinha padrão autossômico recessivo de herança e dois (66,5%) eram casos isolados. CONCLUSÃO: Destaca-se assim a importância desta classificação como a primeira referência nacional dos padrões de hereditariedade das distrofias retinianas do país. Este é o primeiro passo para se proceder em seguida a classificação genético-molecular baseada no seqüenciamento de cada gene responsável por cada um dos padrões de herança. A freqüência de cada tipo específico é semelhante à encontrada em outros trabalhos epidemiológicos de outros países. Abstract in english PURPOSE: To organize a regional data bank of all individuals that have retinal degenerative diseases, with the aim to classify each patient according to the type of distrophy and pattern of inheritance. METHODS: During the meeting of the São Paulo Retina Group on May 5th, 2001, two hundred and forty [...] -three persons were registered, part of whom provided information concerning ocular, personal and family history and family tree. Ninety-three patients were asked about age, origin, type of dystrophy, family history and family tree information, type of inheritance, other systemic abnormalities and complementary examination. They were classified according to the diagnosis and pattern of inhe-ritance. RESULTS: The distrophies found in the registered two hundred and forty-three patients, were: retinitis pigmentosa, Stargardt disease, Usher syndrome, Leber congenital amaurosis and choroideremia. Of the ninety-three patients examined on the same day, sixty-two had retinitis pigmentosa, thirteen had Stargardt disease, thirteen had Usher syndrome, three had Leber congenital amaurosis and two had choroideremia. The inheritance pattern of the patients with retinitis pigmentosa was autosomal dominant in 4 cases (7%), autosomal recessive in twenty cases (32%), X-linked recessive in 7 cases (11%). Twenty-nine cases were isolated (47%) and two had an indeterminate pattern of inheritance (3%). Of the Stargardt disease patients, three (23%) were autosomal recessive and ten (77%) were iso

Nichard, Unonius; Michel Eid, Farah; Juliana M. Ferraz, Sallum.

2003-08-01

275

Classificação diagnóstica dos portadores de doenças degenerativas de retina, integrantes dos grupos Retina São Paulo e Retina Vale do Paraíba / Diagnostic classification of retinal degenerative diseases São Paulo and Vale Retina groups  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO:Organizar um banco de dados regional de todos os indivíduos portadores de doenças degenerativas da retina, com o objetivo de classificar cada paciente de acordo com o tipo de distrofia e padrão de herança. MÉTODOS: Durante o encontro do Grupo Retina São Paulo no dia 5 de maio de 2001, duzen [...] tas e quarenta e três pessoas foram registradas, sendo que parte forneceu dados de antecedentes oculares, pessoais e familiares e árvore genealógica. Noventa e três pacientes foram questionados quanto a idade, origem, tipo de distrofia, história familiar e árvore genealógica, tipo de herança, outras anomalias sistêmicas e exames complementares. Foram classificados quanto ao diagnóstico e padrão de herança. RESULTADOS: Dos duzentos e quarenta e três pacientes registrados, as distrofias encontradas foram retinose pigmentária, doença de Stargardt, síndrome de Usher, amaurose congênita de Leber e coroideremia. Quanto à divisão por doença dos 93 pacientes argüidos, havia 62 pacientes com retinose pigmentária, 13 com doença de Stargardt, 13 com síndrome de Usher, três com amaurose congênita de Leber e dois com coroideremia. Dos pacientes com retinose pigmentária, o padrão de herança detectado foi autossômico dominante em quatro casos (7%), autossômico recessivo em vinte casos (32%), ligado ao cromossomo X recessivo em sete casos (11%), caso isolado em vinte e nove (47%) e padrão indeterminado em dois (3%). Para a doença de Stargardt três indivíduos (23%) seguiam o padrão de herança autossômico recessivo e dez (77%) eram casos isolados. Dos treze pacientes com síndrome de Usher, oito (61,5%) apresentavam herança autossômica recessiva, quatro (31%) eram casos isolados e um (7,5%) tinha o padrão de herança indeterminado. Os dois pacientes com coroideremia seguiam o padrão de herança ligado ao X recessivo. Para amaurose congênita de Leber, um paciente (33,5%) tinha padrão autossômico recessivo de herança e dois (66,5%) eram casos isolados. CONCLUSÃO: Destaca-se assim a importância desta classificação como a primeira referência nacional dos padrões de hereditariedade das distrofias retinianas do país. Este é o primeiro passo para se proceder em seguida a classificação genético-molecular baseada no seqüenciamento de cada gene responsável por cada um dos padrões de herança. A freqüência de cada tipo específico é semelhante à encontrada em outros trabalhos epidemiológicos de outros países. Abstract in english PURPOSE: To organize a regional data bank of all individuals that have retinal degenerative diseases, with the aim to classify each patient according to the type of distrophy and pattern of inheritance. METHODS: During the meeting of the São Paulo Retina Group on May 5th, 2001, two hundred and forty [...] -three persons were registered, part of whom provided information concerning ocular, personal and family history and family tree. Ninety-three patients were asked about age, origin, type of dystrophy, family history and family tree information, type of inheritance, other systemic abnormalities and complementary examination. They were classified according to the diagnosis and pattern of inhe-ritance. RESULTS: The distrophies found in the registered two hundred and forty-three patients, were: retinitis pigmentosa, Stargardt disease, Usher syndrome, Leber congenital amaurosis and choroideremia. Of the ninety-three patients examined on the same day, sixty-two had retinitis pigmentosa, thirteen had Stargardt disease, thirteen had Usher syndrome, three had Leber congenital amaurosis and two had choroideremia. The inheritance pattern of the patients with retinitis pigmentosa was autosomal dominant in 4 cases (7%), autosomal recessive in twenty cases (32%), X-linked recessive in 7 cases (11%). Twenty-nine cases were isolated (47%) and two had an indeterminate pattern of inheritance (3%). Of the Stargardt disease patients, three (23%) were autosomal recessive and ten (77%) were iso

Nichard, Unonius; Michel Eid, Farah; Juliana M. Ferraz, Sallum.

276

Classificação diagnóstica dos portadores de doenças degenerativas de retina, integrantes dos grupos Retina São Paulo e Retina Vale do Paraíba Diagnostic classification of retinal degenerative diseases São Paulo and Vale Retina groups  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO:Organizar um banco de dados regional de todos os indivíduos portadores de doenças degenerativas da retina, com o objetivo de classificar cada paciente de acordo com o tipo de distrofia e padrão de herança. MÉTODOS: Durante o encontro do Grupo Retina São Paulo no dia 5 de maio de 2001, duzentas e quarenta e três pessoas foram registradas, sendo que parte forneceu dados de antecedentes oculares, pessoais e familiares e árvore genealógica. Noventa e três pacientes foram questionados quanto a idade, origem, tipo de distrofia, história familiar e árvore genealógica, tipo de herança, outras anomalias sistêmicas e exames complementares. Foram classificados quanto ao diagnóstico e padrão de herança. RESULTADOS: Dos duzentos e quarenta e três pacientes registrados, as distrofias encontradas foram retinose pigmentária, doença de Stargardt, síndrome de Usher, amaurose congênita de Leber e coroideremia. Quanto à divisão por doença dos 93 pacientes argüidos, havia 62 pacientes com retinose pigmentária, 13 com doença de Stargardt, 13 com síndrome de Usher, três com amaurose congênita de Leber e dois com coroideremia. Dos pacientes com retinose pigmentária, o padrão de herança detectado foi autossômico dominante em quatro casos (7%, autossômico recessivo em vinte casos (32%, ligado ao cromossomo X recessivo em sete casos (11%, caso isolado em vinte e nove (47% e padrão indeterminado em dois (3%. Para a doença de Stargardt três indivíduos (23% seguiam o padrão de herança autossômico recessivo e dez (77% eram casos isolados. Dos treze pacientes com síndrome de Usher, oito (61,5% apresentavam herança autossômica recessiva, quatro (31% eram casos isolados e um (7,5% tinha o padrão de herança indeterminado. Os dois pacientes com coroideremia seguiam o padrão de herança ligado ao X recessivo. Para amaurose congênita de Leber, um paciente (33,5% tinha padrão autossômico recessivo de herança e dois (66,5% eram casos isolados. CONCLUSÃO: Destaca-se assim a importância desta classificação como a primeira referência nacional dos padrões de hereditariedade das distrofias retinianas do país. Este é o primeiro passo para se proceder em seguida a classificação genético-molecular baseada no seqüenciamento de cada gene responsável por cada um dos padrões de herança. A freqüência de cada tipo específico é semelhante à encontrada em outros trabalhos epidemiológicos de outros países.PURPOSE: To organize a regional data bank of all individuals that have retinal degenerative diseases, with the aim to classify each patient according to the type of distrophy and pattern of inheritance. METHODS: During the meeting of the São Paulo Retina Group on May 5th, 2001, two hundred and forty-three persons were registered, part of whom provided information concerning ocular, personal and family history and family tree. Ninety-three patients were asked about age, origin, type of dystrophy, family history and family tree information, type of inheritance, other systemic abnormalities and complementary examination. They were classified according to the diagnosis and pattern of inhe-ritance. RESULTS: The distrophies found in the registered two hundred and forty-three patients, were: retinitis pigmentosa, Stargardt disease, Usher syndrome, Leber congenital amaurosis and choroideremia. Of the ninety-three patients examined on the same day, sixty-two had retinitis pigmentosa, thirteen had Stargardt disease, thirteen had Usher syndrome, three had Leber congenital amaurosis and two had choroideremia. The inheritance pattern of the patients with retinitis pigmentosa was autosomal dominant in 4 cases (7%, autosomal recessive in twenty cases (32%, X-linked recessive in 7 cases (11%. Twenty-nine cases were isolated (47% and two had an indeterminate pattern of inheritance (3%. Of the Stargardt disease patients, three (23% were autosomal recessive and ten (77% were isolated cases. Of the thirteen patients with Usher syndrome, eight (61.5% were autosomal recessive, four (31% were i

Nichard Unonius

2003-08-01

277

Joint sparing correction of cavovarus feet in Charcot-Marie-Tooth disease: what are the limits?  

Science.gov (United States)

Charcot-Marie-Tooth disease is an inherited neuropathy that results in lower limb muscle imbalance and a resultant cavovarus deformity of the foot. With recognized poor outcomes of triple arthrodeses in the young patient, joint sparing surgery is preferred, which takes the form of osteotomies, soft-tissue releases, and tendon transfers to achieve a plantigrade and balanced foot. Due to the variability in muscle involvement and the presence of both mobile and fixed deformities, surgery must be individualized to each patient. PMID:24215832

Barton, Tristan; Winson, Ian

2013-12-01

278

Nuclear Medicine in Diagnosis and Therapy of Bone and Joint Diseases  

International Nuclear Information System (INIS)

Concerning bone and joint diseases therapy of rheumatic synovitis (radiosynoviorthesis) was introduced in 1952 before clinically relevant diagnostic procedures were developed. Radionuclides of Sr and later on 99mTc phosphonates then started the wide use of bone scintigraphy since > 30 years. The diagnostic methods have an excellent sensitivity for detection of local abnormalities of bone metabolism, the specificity of such studies, however, is low. Modifications of the technique (3-phase-bone-scintigraphy, pinhole collimators, ROI-technique), increasing knowledge of pathological scan patterns and introduction of other radionuclide studies (67Ga, 201Tl, inflammation scans with 99mTc-leukocytes or 99mTc-HIG) as well as 18FDG-PET have increased the specificity significantly in recent years and improvements of imaging systems (SPECT) also increased the accuracy of diagnostic methods in diseases of bone and joints. Therapy of such diseases has made considerable progress: inflamed, swollen joints can effectively be treated with 90Y-, 186Re, 169Er-colloids or with 165Dy-particles by radiosynoviorthesis. Severe pain due to disseminated bone metastases of cancer or polyarthritis can be controlled by radionuclide therapy with 89Sr, 153Sm-EDTMP, 186Re- or 188Re-HEDP and possibly 117mSn-DTPA with an acceptable risk of myelodepression. Possibilities, technical details and limitations of radionuclide applications for diagnostic and therapeutic purposes must be considered if optimal benefit for individual patients should be achieved. Overall Nuclear Medicine can become an essential element in management of bone and joint diseases. The relationship of Nuclear Medicine to bone and joint pathology is peculiar: In 1952 treatment of rheumatic synovitis by radiosynoviorthesis with 198Au Colloid was started by Fellinger and Schmid before diagnostic approaches to bone pathology existed. Bone scintigraphy was introduced only in 1961 using 85Sr but obviously the unfavourable radiation characteristics of this radionuclide limited it's broad application and 87mSr did not improve this situation. Only when 99mTc phosphonates were developed by Subramanian the importance of bone scintigraphy became apparent: The excellent imaging properties of these radiotracers showed, that abnormal bone metabolism could be visualized even before morphological alterations in the skeleton become visible on radiographies or even CT-scans. Moreover, proposals made earlier to use 32P or 89Sr for palliation of pain in patients with disseminated skeletal metastases were picked up again and led also to other radiopharmaceuticals (186Re-HEDP, 153Sm-EDTMP, 117mSn-DTPA) which are applied today for the same purpose with very good success. Therefore Nuclear Medicine today has a broad program for diagnostic and therapeutic approaches to diseases of bone and joints. In bone scanning the high sensitivity led to inclusion of this method for routine staging and re-staging programs in a variety of cancer forms which have a trend to develop bone metastases (e.g. breast, lung, prostate, melanoma) but the low specificity of abnormal patterns on such scans can impair the diagnostic value of the technique. To increase specificity and to define inflammatory lesions, radiotracers used for ''inflammation scanning'' were introduced such as labeled granulocytes, 99mTc Human Immunoglobuline and others but also a simple modification of bone scanning - triple phase bone scintigraphy - was used. Recently the excellent properties of 18F for PET of the skeleton were rediscovered again and emission CT scanning - possibly with overlay with transmission CT or MRT pictures - can enhance the diagnostic impact of radionuclide bone studies. (author)

279

Degenerative spine disorders in the context of clinical findings  

Energy Technology Data Exchange (ETDEWEB)

Hardly any other structure in the human body is held responsible for so many complaints, pain, and costs as the spine and its degenerative disorders. In the following article, the role of imaging procedures in diagnosing disorders of the spine is presented. Due to the fact that disk herniation represents the most frequent cause for degenerative disorders the anatomy of the intervertebral disk and the pathology of the entities that can cause diseases of the disks are described. In particular, the authors focus on the significance of radiological findings with respect to patient history, subjective symptoms, and objective clinical findings. In addition to presenting the technical procedures and their indications and contraindications also practical tips and tricks in conducting these examinations are presented in this paper.

Freund, Michael [Institut fuer Radiologie und Neuroradiologie, Klinikum Aschaffenburg, Am Hasenkopf 1, 63739 Aschaffenburg (Germany) and Abteilung fuer Neuroradiologie, Universitaetsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany)]. E-mail: michael.freund@klinikum-aschaffenburg.de; Sartor, Klaus [Abteilung fuer Neuroradiologie, Universitaetsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg (Germany)

2006-04-15

280

Degenerative spine disorders in the context of clinical findings  

International Nuclear Information System (INIS)

Hardly any other structure in the human body is held responsible for so many complaints, pain, and costs as the spine and its degenerative disorders. In the following article, the role of imaging procedures in diagnosing disorders of the spine is presented. Due to the fact that disk herniation represents the most frequent cause for degenerative disorders the anatomy of the intervertebral disk and the pathology of the entities that can cause diseases of the disks are described. In particular, the authors focus on the significance of radiological findings with respect to patient history, subjective symptoms, and objective clinical findings. In addition to presenting the technical procedures and their indications and contraindications also practical tips and tricks in conducting these examinations are presented in this paper

 
 
 
 
281

MRI of cystic collection of the three joint; Les collections kystiques du genou en IRM  

Energy Technology Data Exchange (ETDEWEB)

We present the main MR features of cystic lesions around the knee joint. Popliteal cysts are the most frequently seen. The usually result from extrusion of joint fluid into the gastrocnemio-semimembranosus bursa but they can have an atypical location or extension. They are most often due to a meniscal, ligamentous, degenerative or inflammatory joint disease responsible for a chronic joint effusion. Meniscal cysts are always associated with a horizontal tear. Medial meniscal cysts are larger and can extend far from the joint. Bursitis occur as a result of inflammation or infection of a bursa. Their location is stereotyped and they do not communicate with the knee joint. Ganglion cysts or ganglia are benign cystic lesions which can affect peri-articular tissues as well as subchondral bone or cruciate ligaments. MRI is now a simple and noninvasive way of obtaining etiologic diagnosis and guiding therapy. (authors). 46 refs.

Boutry, N.; Cotten, A.; Dewatre, F.; Chastanet, P.; Gougeon, F. [Hopital R. Salengro, C.H.U., 59 - Lille (France)

1997-09-01

282

Retinal imaging in perimacular degenerative retinoschisis.  

Science.gov (United States)

Macula-threatening degenerative retinoschisis is a rare clinical problem. In the current report, imaging of three patients with asymptomatic and nonprogressive retinoschisis is presented. The visual and anatomic findings have remained stable during follow-up. PMID:24392918

Weng, Christina Y; Flynn, Harry W

2014-01-01

283

Biokinetic Study of the Wrist joint?  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Quantification of joint mobility by ROM (range of movement, meaning the ?maximal range of joint angle, is used to evaluate the degenerative joint disorders and the efficacy ?of treatment. Age, gender, individual habits, daily activities and tissue degeneration influence the ?joint ROM. The wrist joint, with many supporting tissues to perform a motion, is a complex ?structure. Many studies mentioned ROM may be different in various racial groups because of ?their body built, underlying diseases.?Objective: This study aims to establish a database of wrist joint ROM and factors influencing it ?among Myanmar population.?Method: 120 Myanmar volunteers with no past history of musculoskeletal or neural lesions, but ?with normal functional wrist joints of both sides, were included. 30 subjects (15 males and 15 ?females each from 5-17 year, 18-40 year, 41-60 year, 61 year and above age groups participated. ?Various ranges of wrist joint motions were measured by hand goniometry in pronation position ?only as most of the daily activities were usually performed in pronation.?Result: The average of ROM of wrist-joint flexion was 68.3 degrees, extension was 68.2 ?degrees, radial deviation was 19.6 degrees and ulnar deviation was 26.1 degrees. Significant ?difference between male and female was found in ulnar deviation of right side.5-17 year age ?group had wider range of motion than other age groups while over 60 people has lowest.?Conclusion: The findings highlighted the decline in wrist-joint motion capability with age. If ?facilities are available, ROM of wrist joint during both pronation and supination should be ?measured by using electrogoniometer.?

Tin Tin Myint?

2012-05-01

284

Joint disease mapping using six cancers in the Yorkshire region of England  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Objectives The aims of this study were to model jointly the incidence rates of six smoking related cancers in the Yorkshire region of England, to explore the patterns of spatial correlation amongst them, and to estimate the relative weight of smoking and other shared risk factors for the relevant disease sites, both before and after adjustment for socioeconomic background (SEB. Methods Data on the incidence of oesophagus, stomach, pancreas, lung, kidney, and bladder cancers between 1983 and 2003 were extracted from the Northern & Yorkshire Cancer Registry database for the 532 electoral wards in the Yorkshire region. Using postcode of residence, each case was assigned an area-based measure of SEB using the Townsend index. Standardised incidence ratios (SIRs were calculated for each cancer site and their correlations investigated. The joint analysis of the spatial variation in incidence used a Bayesian shared-component model. Three components were included to represent differences in smoking (for all six sites, bodyweight/obesity (for oesophagus, pancreas and kidney cancers and diet/alcohol consumption (for oesophagus and stomach cancers. Results The incidence of cancers of the oesophagus, pancreas, kidney, and bladder was relatively evenly distributed across the region. The incidence of stomach and lung cancers was more clustered around the urban areas in the south of the region, and these two cancers were significantly associated with higher levels of area deprivation. The incidence of lung cancer was most impacted by adjustment for SEB, with the rural/urban split becoming less apparent. The component representing smoking had a larger effect on cancer incidence in the eastern part of the region. The effects of the other two components were small and disappeared after adjustment for SEB. Conclusion This study demonstrates the feasibility of joint disease modelling using data from six cancer sites. Incidence estimates are more precise than those obtained without smoothing. This methodology may be an important tool to help authorities evaluate healthcare system performance and the impact of policies.

Edwards Kimberley L

2008-07-01

285

Bone marrow derived stem cells in joint and bone diseases: a concise review.  

Science.gov (United States)

Stem cells have huge applications in the field of tissue engineering and regenerative medicine. Their use is currently not restricted to the life-threatening diseases but also extended to disorders involving the structural tissues, which may not jeopardize the patients' life, but certainly influence their quality of life. In fact, a particularly popular line of research is represented by the regeneration of bone and cartilage tissues to treat various orthopaedic disorders. Most of these pioneering research lines that aim to create new treatments for diseases that currently have limited therapies are still in the bench of the researchers. However, in recent years, several clinical trials have been started with satisfactory and encouraging results. This article aims to review the concept of stem cells and their characterization in terms of site of residence, differentiation potential and therapeutic prospective. In fact, while only the bone marrow was initially considered as a "reservoir" of this cell population, later, adipose tissue and muscle tissue have provided a considerable amount of cells available for multiple differentiation. In reality, recently, the so-called "stem cell niche" was identified as the perivascular space, recognizing these cells as almost ubiquitous. In the field of bone and joint diseases, their potential to differentiate into multiple cell lines makes their application ideally immediate through three main modalities: (1) cells selected by withdrawal from bone marrow, subsequent culture in the laboratory, and ultimately transplant at the site of injury; (2) bone marrow aspirate, concentrated and directly implanted into the injury site; (3) systemic mobilization of stem cells and other bone marrow precursors by the use of growth factors. The use of this cell population in joint and bone disease will be addressed and discussed, analysing both the clinical outcomes but also the basic research background, which has justified their use for the treatment of bone, cartilage and meniscus tissues. PMID:25005462

Marmotti, Antonio; de Girolamo, Laura; Bonasia, Davide Edoardo; Bruzzone, Matteo; Mattia, Silvia; Rossi, Roberto; Montaruli, Angela; Dettoni, Federico; Castoldi, Filippo; Peretti, Giuseppe

2014-09-01

286

MTADM: The new Joint Master Programme in Transboundary Animal Disease Management for Eastern Africa  

International Nuclear Information System (INIS)

Full text: New Partnership for Africa's Development (NEPAD) flagship Comprehensive Africa Agriculture Development Programme (CAADP). Focus is on livestock for trade and export. Better policies, institutions, regulatory framework and technologies are sought for livestock production and management and delivery of veterinary services and disease control. The disease status of African countries places the pivotal constraints on trade possibilities. Animal health standards imposed by importing countries for international, regional or bi-lateral trade, and through the World Trade Organisation's (WTO) Sanitary and Phytosanitary (SPS) agreement must be met. 12 of the 15 most important transboundary animal diseases persist in Africa. Disease control under SPS, entailing new standards, regulations and technologies, can and is not be covered by conventional veterinary training. This specialist area of its own has to be addressed in a specialised postgraduate course for young personnel already involved and responsible for public, private and hybrid animal disease control services. Ambitious visions of a new African livestock sector with changed focus on production, disease, trade, marketing, organisation, delivery and internationality are only realistic with newly trained animal disease control personnel. To target these issues at the academic level the Addis Ababa University / Ethiopia with universities of 3 regional partner countries (Kenya, Uganda, Sudan) and the Freie Universenya, Uganda, Sudan) and the Freie Universitaet Berlin, Germany, successfully applied for a grant to establish a Joint Master Course in Transboundary Animal Disease Management (MTADM) for Africa. The 3-year project is funded under the EU - EDULINK Programme of the 9th European Development Funds (EDF) as from 2008 to 2010. Currently, preparatory work is ongoing on the final technical details of the MTADM Course. The overall objective of the programme is to strengthen the capacity of national veterinary services in Africa to control and manage trans-boundary and epidemic diseases more effectively in a regional concerted action so as to (a) contributing towards developing or expanding exports markets and trade for animals and animal products and, (b) improve in the longer run the livelihood of livestock keepers as well as consumers demands on quality and safety of animal products. The specific objectives are to build human resource capacity by producing an effective cadre of professionals in regional / trans-boundary animal disease control and management and to strengthen the regional network of the veterinary faculties of the participating African countries. This is to be achieved through: - the development of an innovative and state-of-the-art curriculum for the Joint MTAD Programme, - a first MTADM course executed at Addis Ababa University/Ethiopia, Freie Universitaet Berlin, and the African home country of the participant, - a second MTADM Course prepared and ready to be launched at a second Regional Partner University, and - a first group of at least 15 graduates being highly qualified and ready to take up meaningful employment in the animal disease control sectors. The MTADM Master Course is delivered as cross-border 'sandwich' programme, in modular form (EU system of ECTS credits; 120 ECTS total) with the Master Thesis carried out as a field study project under guidance of the partner universities in the African region. The MTADM Master Programme is directed towards young early-career professionals already involved in animal disease and sanitary control activities but who identified academic master-level training needs for innovative tools and methods in transboundary animal disease management to advance their career. The Course Announcement will be circulated early 2009 and applications are welcome before October 2009; qualified candidates may apply for scholarships provided by German, regional and international organisations. (author)

287

GDF5 SNP rs143383 is associated with lumbar disc disease in northern European women.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJECTIVE: Lumbar degenerative disc disease (LDD) is a serious social and medical problem which has been shown to be highly heritable. It has similarities with peripheral joint osteoarthritis (OA) both in terms of epidemiology and pathological processes. A few known genetic variants have been identified using a candidate gene approach, but many more are thought to exist. GDF5 is a gene whose variants have been shown to play a role in skeletal height as well as predisposing to peripheral joint...

Williams, F.; Popham, M.; Hart, D.; Schepper, E.; Bierma-zeinstra, S.; Hofman, A.; Uitterlinden, Ag; Arden, N.; Cooper, C.; Spector, T.; Valdes, A.; Meurs, J.

2010-01-01

288

Scintigraphic diagnosis of inflammatory bone and joint diseases; Szintigraphische Diagnostik entzuendlicher Knochen- und Gelenkerkrankungen  

Energy Technology Data Exchange (ETDEWEB)

Inflammatory bone and joint diseases often show multifocal spread, or cannot clinically be precisely localized, so that scintigraphy is still indicated in addition to MRT as a wholebody method. The highlysensitive but not always adequately specific multiphase bone scintigraphy is increasingly supplemented or even replaced to individual degrees by specific inflammation markers, especially leukocyte scintigraphy, either using labeled autologous leukocytes or by immunoscintigraphy with Tc-99m-antigranulocyte antibody fragments. In addressing the question of acute osteomyelitis in neonates or children, the 2-phase bone scintigraphy has to be taken as sufficient for time reasons, whereas in investigating septic or aseptic loosening of joint prostheses, bone marrow scintigraphy with Tc-99m-colloid (not nanocolloid) should be performed in addition to the 2-phase bone scintigraphy and leukocyte scintigraphy in order to avoid misinterpretations. SPECT is obligatory in the proof of inflammatory processes in the base of skull and viscerocranium and is to the strongly recommended in the spine and major joints. (orig.) [Deutsch] Entzuendliche Knochen- und Gelenkerkrankungen breiten sich oft multifokal aus oder sind klinisch nicht genau lokalisierbar, so dass neben MRT die Szintigraphie als Ganzkoerpersuchmethode weiterhin indiziert ist. Die hochsensitive, aber nicht immer ausreichend spezifische Mehrphasen-Skelettszintigraphie wird in individueller Abstufung zunehmend durch spezifische Entzuendungsmarker ergaenzt oder ersetzt, allem voran durch die Leukozytenszintigraphie, entweder mit markierten autologen Leukozyten oder durch die Immunszintigraphie mit Tc-99m-Antigranulozyten-Antikoerperfragmenten. So muss bei der Frage akute Osteomyelitis bei Neugeborenen oder Kindern aus Zeitgruenden die Zweiphasen-Skelettszintigraphie meist ausreichen, bei der Frage septische oder aseptische Gelenkprothesenlockerung sollte neben der Zweiphasen-Skelettszintigraphie und der Leukozytenszintigraphie noch eine Darstellung des Knochenmarks mit Tc-99m Kolloid (nicht Nanokolloid) angeschlossen werden, um Fehlinterpretationen zu vermeiden. SPECT ist obligat beim Nachweis entzuendlicher Prozesse in der Schaedelbasis und im Gesichtsschaedel, sehr empfehlenswert in der Wirbelsaeule und in den grossen Gelenken. (orig.)

Schuemichen, C. [Univ. Rostock (Germany). Klinik und Poliklinik fuer Nuklearmedizin

1997-10-01

289

[Radiofrequency denervation of intervertebral joints in management of facet pain syndrome].  

Science.gov (United States)

Back pain is very widespread and represents a socially significant problem of modern health care. During lifetime 90% of population experiences 1 or more episodes of back pain. This study focuses on assessment of effectiveness of radiofrequency denervation of intervertebral joints in management of patients with low back pain caused by facet pain syndrome. From 2007 till 2008 124 patients were examined in spinal clinic "Axiso". In 112 (80%) patients pain regressed. Clinical series was analyzed using the scale for assessment of severity of lumbosacral spinal degenerative disease developed in Burdenko Neurosurgical Institute (Moscow, Russia). The performed study confirmed effectiveness of the assessed technique which allowed including of radiofrequency denervation of intervertebral joints in the algorithm of management of patients with degenerative changes in the lumbosacral spine as the surgical method used in case of ineffectiveness of conservative treatment. PMID:21793296

Konovalov, N A; Proshutinski?, S D; Nazarenko, A G; Korolishin, V A

2011-01-01

290

Scintigraphy by Means of Radioisotopes of Short Half-Life for Diagnosing Diseases of the Joints  

International Nuclear Information System (INIS)

Persons suffering from articular diseases exhibit an increase in vascularization associated with a concomitant inflammatory process. This hyper-vascularization can be visualized in cases of rheumatoid arthritis by means of radiotracer scanning of the vascular compartment, as indicated by Maxfield in 1965. The authors present the results of a study of 107 persons suffering from various articular conditions. The study was based on radioisotope scanning with 99mTc and 113mIn. For this purpose they made use of commercial apparatus with a .5-in. crystal and an 85-hole focussed collimator. They applied 6-10 mCi of 99mTc in the form of sodium pertechnetate and 8-10 mCi as indium chloride (adjusted to pH 3.5), both administered intravenously at 24-hour intervals. Different scintigraphic images were observed for each of the radioisotopes, the degree of concentration not being identical for a given joint. The procedure was useful for the early diagnosis of articular lesions and in some cases for carrying out differential diagnosis. It is also indicated that the increase in vascular permeability would afford the most satisfactory explanation for the increaised radioactivity in the joints when 99mTc is used as pertechnetate, even though other factors might exist apart from the increase in vascularization, which was not satisfactorily shown when 113mIn was used. (author)

291

Percutaneous transluminal angioplasty of chronic arterial occlusive disease below the knee joint  

International Nuclear Information System (INIS)

The purpose of this study was to determine the safety and efficacy of the percutaneous transluminal angioplasty(PTA) in patients with chronic arterial occlusive disease below the knee joint. We retrospectively analyzed the results of 36 procedures in 16 patients. There were 15 men and one woman, aged 57-75 years(mean, 62 years). Indications were disabling claudication (SVS/ISCVS grade 1, category 3) in five cases, rest pain(grade 2, category 4) in three cases, and non-healing ulceration or gangrene(grade3, category 5) in eight cases. PTA was performed by using small vessel balloon catheter of 2-4 mm and 3 mm monorail balloon catheter in tibioperoneal vessels and 5-6 mm balloon catheter in distal popliteal artery and tibioperoneal trunk. Combined thrombolytic therapy with Urokinase was performed in 14 patients. Involved infrapopliteal vessels were four distal popliteal arteries, 15 tibioperoneal trunks, six anterior tibial arteries, five posterior tibial arteries, and seven peroneal arteries. Technical success was determined when post-PTA angiogram showed less than 30% of residual stenosis. Clinical success was defined as improvement of clinical symptoms, such as disappearance of claudication or rest pain, and healing of ulcereation. Technical success was achieved in 30 of 36 arteries(83%). Clinical success was achieved in 12 of 16 patients(75%) at an average follow-up of 13.3 months(range, 2-46 months). Clinical success rate was 100% in grade 1 category 3 patients, 67% in grade 2 category 4 patients, and 63% in grade 3 category 5 patients. Complication included two distal emboli, one vessel rupture, one vessel thrombosis, and one occluding intimal flap. PTA was an effective method for treatment of chronic arterial occlusive disease below the knee joint and considered as the procedure of first choice. Severe claudicant(grade1) should be included in the indication of the tibioperoneal PTA

292

Degenerative myelopathy in a family of Siberian Husky dogs.  

Science.gov (United States)

Three closely related, Siberian Husky dogs had chronic progressive paresis and ataxia with muscle atrophy in the hindlimbs. Radiologic and myelographic examination of the spine revealed no abnormalities. On histologic examination, disseminated degeneration of the white matter, particularly in the thoracic segments, was seen. The clinical and pathological findings were similar to those described in aging large dogs with so-called degenerative myelopathy. The cause of this disease is unknown but the fact that these 3 Huskies were closely related suggest that hereditary factors may play a role. PMID:12002594

Bichsel, P; Vandevelde, M; Lang, J; Kull-Hächler, S

1983-11-01

293

Defining the research agenda to reduce the joint burden of disease from diabetes mellitus and tuberculosis  

DEFF Research Database (Denmark)

The steadily growing epidemic of diabetes mellitus poses a threat for global tuberculosis (TB) control. Previous studies have identified an important association between diabetes mellitus and TB. However, these studies have limitations: very few were carried out in low-income countries, with none in Africa, raising uncertainty about the strength of the diabetes mellitus-TB association in these settings, and many critical questions remain unanswered. An expert meeting was held in November 2009 to discuss where there was sufficient evidence to make firm recommendations about joint management of both diseases, to address research gaps and to develop a research agenda. Ten key research questions were identified, of which 4 were selected as high priority: (i) whether, when and how to screen for TB in patients with diabetes mellitus and vice versa; (ii) the impact of diabetes mellitus and non-diabetes mellitus hyperglycaemia on TB treatment outcomes and deaths, and the development of strategies to improve outcomes;(iii) implementation and evaluation of the tuberculosis 'DOTS' model for diabetes mellitus management; and (iv) the development and evaluation of better point-of-care diagnostic and monitoring tests, including measurements of blood glucose and glycated haemoglobin A(1c) (HbA(1c)) for patients with diabetes mellitus. Implementation of this research agenda will benefit the control of both diseases.

Harries, Anthony D; Murray, Megan B

2010-01-01

294

Muscle and tendon injuries of the knee joint  

International Nuclear Information System (INIS)

Muscles and tendons contribute greatly to stabilization of the knee joint and are crucial elements for normal joint function. Therefore, injuries of those structures cause variable degrees of disability, depending on the severity of the lesion. Due to the characteristic structural changes and alterations of signal intensities, MR imaging allows accurate identification and staging of acute injuries of muscles and tendons, as well as assessment of chronic or degenerative disease. The knowledge of anatomy and normal function of muscles and tendons, together with a thorough understanding of the mechanism and usual combinations of their injuries (e.g., posterolateral structures) allows an exact evaluation of injury-induced functional impairments to the knee joint. A detailed and exact radiological report is of the greatest importance for the referring clinician and the patient to determine optimal therapeutic strategies. (orig.)

295

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Spanish Abstract in spanish OBJETIVO: Comparar el rendimiento en tareas de función ejecutiva (FE) en sujetos con enfermedad de Parkinson (EP) leve a moderada (Hoehn y Yahr [...] ebelo en esa función. MÉTODO: Se evaluaron 14 pacientes con EP y 14 con EC apareados por sexo, educación, duración de enfermedad y MMSE, mediante tests neuropsicológicos estándar y el test de Wisconsin [WCST]). Se compararon puntajes Z promedio de cada grupo mediante prueba de "t" para muestras independientes. RESULTADOS: El grupo EC rindió significativamente menos en pruebas de atención y FE presentando errores perseverativos y no perseverativos durante el WCST. El grupo EP mostró aumento significativo de errores no perseverativos en relación al estándar esperado, sin alcanzar diferencias significativas con el grupo EC. CONCLUSIÓN: el grupo EC mostró defectos significativamente mayores en tareas de FE exhibiendo un patrón de disfunción prefrontal. Abstract in english OBJECTIVE: To compare executive functions (EF) in non-demented mild to moderate Parkinson's disease (PD) (Hoehn and Yahr [...] 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.

2006-09-01

296

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Spanish Abstract in spanish OBJETIVO: Comparar el rendimiento en tareas de función ejecutiva (FE) en sujetos con enfermedad de Parkinson (EP) leve a moderada (Hoehn y Yahr [...] ebelo en esa función. MÉTODO: Se evaluaron 14 pacientes con EP y 14 con EC apareados por sexo, educación, duración de enfermedad y MMSE, mediante tests neuropsicológicos estándar y el test de Wisconsin [WCST]). Se compararon puntajes Z promedio de cada grupo mediante prueba de "t" para muestras independientes. RESULTADOS: El grupo EC rindió significativamente menos en pruebas de atención y FE presentando errores perseverativos y no perseverativos durante el WCST. El grupo EP mostró aumento significativo de errores no perseverativos en relación al estándar esperado, sin alcanzar diferencias significativas con el grupo EC. CONCLUSIÓN: el grupo EC mostró defectos significativamente mayores en tareas de FE exhibiendo un patrón de disfunción prefrontal. Abstract in english OBJECTIVE: To compare executive functions (EF) in non-demented mild to moderate Parkinson's disease (PD) (Hoehn and Yahr [...] 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.

297

Computer-aided diagnosis of knee-joint disorders via vibroarthrographic signal analysis: a review.  

Science.gov (United States)

The knee is the lower-extremity joint that supports nearly the entire weight of the human body. It is susceptible to osteoarthritis and other knee-joint disorders caused by degeneration or loss of articular cartilage. The detection of a knee-joint abnormality at an early stage is important, because it helps increase therapeutic options that may slow down the degenerative process. Imaging-based arthrographic modalities can provide anatomical images of the joint cartilage surfaces, but fail to demonstrate the functional integrity of the cartilage. Knee-joint auscultation, by means of recording the vibroarthrographic (VAG) signal during bending motion of a knee, could be used to develop a noninvasive diagnostic tool. Computer-aided analysis of VAG signals could provide quantitative indices for screening of degenerative conditions of the cartilage surface and staging of osteoarthritis. In addition, the diagnosis of knee-joint pathology by means of VAG signal analysis may reduce the number of semi-invasive diagnostic arthroscopic examinations. This article reviews studies related to VAG signal analysis, first summarizing the pilot studies that demonstrated the diagnostic potential of knee-joint auscultation for the detection of degenerative diseases, and then describing the details of recent progress in analysis of VAG signals using temporal analysis, frequency-domain analysis, time-frequency analysis, and statistical modeling. The decision-making methods used in the related studies are summarized, followed by a comparison of the diagnostic performance achieved by different pattern classifiers. The final section is a perspective on the future and further development of VAG signal analysis. PMID:20932239

Wu, Yunfeng; Krishnan, Sridhar; Rangayyan, Rangaraj M

2010-01-01

298

Total hip replacement in patients with Down syndrome and degenerative osteoarthritis of the hip.  

Science.gov (United States)

Dysplasia of the hip, hypotonia, osteopenia, ligamentous laxity, and mental retardation increase the complexity of performing and managing patients with Down syndrome who require total hip replacement (THR). We identified 14 patients (six males, eight females, 21 hips) with Down syndrome and degenerative disease of the hip who underwent THR, with a minimum follow-up of two years from 1969 to 2009. In seven patients, bilateral THRs were performed while the rest had unilateral THRs. The mean clinical follow-up was 5.8 years (standard deviation (sd) 4.7; 2 to 17). The mean Harris hip score was 37.9 points (sd 7.8) pre-operatively and increased to 89.2 (sd 12.3) at final follow-up (p = 1x10(-9)). No patient suffered a post-operative dislocation. In three patients, four hips had revision THR for aseptic loosening at a mean follow-up of 7.7 years (sd 6.3; 3 to 17). This rate of revision THR was higher than expected. Our patients with Down syndrome benefitted clinically from THR at mid-term follow-up. Cite this article: Bone Joint J 2014;96-B:1455-8. PMID:25371456

Amanatullah, D F; Rachala, S R; Trousdale, R T; Sierra, R J

2014-11-01

299

Hinged distraction of the hip joint in the treatment of Perthes disease: evaluation at skeletal maturity.  

Science.gov (United States)

The aim of this work is to determine the effect of this type of treatment on the shape of the femoral head, the range of motion (ROM), radiological changes in the femoral head, and the prognosis of Perthes disease at skeletal maturity. From 1998 to 2007, 53 patients with Perthes disease were treated with a combination of soft tissue release and joint distraction with a hinged monolateral external fixator in 32 patients and by Ilizarov external fixator in 21 patients. Nineteen of our 53 patients attained skeletal maturity and were evaluated in our study. This study included 15 boys and four girls, mean age at surgery 9.3 years (range 7.2-13.1), and mean age at the last follow-up 17.4 years (range 14.9-21.3). The duration of symptoms varied from a period of 6 to 60 months before the operation. Radiographs taken during the fragmentation stage of the disease were classified by the lateral pillar classification of Herring; 19 of our patients attained skeletal maturity and were evaluated. Clinical assessment included the Harris hip score, hip ROM, and limb length discrepancy. Radiographic assessment included sharp transverse acetabular inclination, the uncoverage percentage, the epiphyseal index before surgery (modified Eyre-Brook), at frame removal, and at the last follow-up, the epiphyseal quotient (of Sjovall), and the Stulberg classification. The mean follow-up was 7.2 years (range 4.1-11.3). The mean Harris hip score was 87.1/100 (range 49.2-94.8). An improvement in hip (ROM) of 83.3% of the normal range was restored. There was a marked improvement in the degree of pain and limp postoperatively. The hip ROM was slightly limited in most patients, and seven patients had limb shortening of between 1 and 3 cm. The mean sharp transverse acetabular inclination of the affected side was 44° (range 35-51) compared with 37° for the unaffected side (P=0.042). The mean uncoverage percentage was 36% (range 24-45) compared with 21% for the unaffected side (P=0.027). The mean epiphyseal index was 0.74 (range 0.36-0.94) before surgery, 0.78 (range 0.49-0.89) at frame removal (P=0.017), and 0.80 (range 0.54-0.91) at the last follow-up (P=0.701). The epiphyseal quotient was 0.74 (range 0.51-0.94) and the Stulberg classifications were type II in eight patients, type III in seven patients, type IV in three patients, and type V in one patient. Arthrodiastasis of the hip joint with soft tissue release may represent a good contribution toward the treatment of Legg-Calvé-Perthes disease. This method of treatment has many advantages such as easy technique, minimal rate of complications, a short hospitalization period, correction of shortening because it adds to the length of the limb, and a higher rate of acceptable results than would be expected compared with other methods. It also improves the ROM, reduces superior and lateral subluxation, and provides better radiographic sphericity of the femoral head. In addition, it does not distort the anatomy of the pelvis or the proximal femur; it can be used with equal success in older children who are typically expected to have a poor prognosis. Distraction treatment is not limited by hip stiffness, degree of femoral head deformity, or subluxation, and can be used when other methods of treatment are contraindicated. PMID:22713742

Laklouk, Mohamed Abdel-Rehim; Hosny, Gamal Ahmed

2012-09-01

300

Analgesic effects of intra-articular botulinum toxin Type B in a murine model of chronic degenerative knee arthritis pain  

Directory of Open Access Journals (Sweden)

Full Text Available Stephanie Anderson1,2, Hollis Krug1,2, Christopher Dorman1, Pari McGarraugh1, Sandra Frizelle1, Maren Mahowald1,21Rheumatology Section, Veteran’s Affairs Medical Center, Minneapolis, Minnesota; 2Division of Rheumatology and Autoimmune Diseases, University of Minnesota Medical School, Minneapolis, Minnesota, USAObjective: To evaluate the analgesic effectiveness of intra-articular botulinum toxin Type B (BoNT/B in a murine model of chronic degenerative arthritis pain.Methods and materials: Chronic arthritis was produced in adult C57Bl6 mice by intra-articular injection of Type IV collagenase into the left knee. Following induction of arthritis, the treatment group received intra-articular BoNT/B. Arthritic control groups were treated with intra-articular normal saline or sham injections. Pain behavior testing was performed prior to arthritis, after induction of arthritis, and following treatments. Pain behavior measures included analysis of gait impairment (spontaneous pain behavior and joint tenderness evaluation (evoked pain response. Strength was measured as ability to grasp and cling.Results: Visual gait analysis showed significant impairment of gait in arthritic mice that improved 43% after intra-articular BoNT/B, demonstrating a substantial articular analgesic effect. Joint tenderness, measured with evoked pain response scores, increased with arthritis induction and decreased 49.5% after intra-articular BoNT/B treatment. No improvement in visual gait scores or decrease in evoked pain response scores were found in the control groups receiving intra-articular normal saline or sham injections. Intra-articular BoNT/B was safe, and no systemic effects or limb weakness was noted.Conclusions: This study is the first report of intra-articular BoNT/B for analgesia in a murine model of arthritis pain. The results of this study validate prior work using intra-articular neurotoxins in murine models. Our findings show chronic degenerative arthritis pain can be quantitated in a murine model by measuring gait impairment using visual gait analysis scores (spontaneous pain behavior and joint tenderness scores (evoked pain responses. Reduction of joint pain seen in this study is consistent with our hypothesis of inhibition of release of pain mediators by intra-articular BoNT/B, supporting further investigation of this novel approach to treatment of arthritis pain with intra-articular neurotoxins.Keywords: intra-articular BoNT/B, osteoarthritis

Stephanie Anderson

2010-09-01

 
 
 
 
301

Morphological cervical disc analysis applied to traumatic and degenerative lesions.  

Science.gov (United States)

Trauma and degenerative pathologies at the lower cervical spine are different from lumbar spine pathologies. However, the description of cervical discs is classically taught similarly to that of the lumbar discs. Recent studies have raised this issue, and in 1999, Mercer and Bogduk described ventral annulus fibrosus as a crescent-shaped interosseous ligament. We propose a metric analysis of the different components of the cervical disc to examine this description. We analyzed 140 sagittal and coronal transections of 35 discs. These discs were taken from seven cervical spines at the five lower levels, C2-C3, C3-C4, C4-C5, C5-C6 and C6-C7. We measured quantitative parameters on sagittal, para-sagittal, ventral coronal and dorsal coronal colored transections: disc length (L), ventral annulus thickness (VAF), lateral annulus thickness (LAF), dorsal annulus thickness (DAF), length of the fibrocartilaginous tissue (FC), sagittal and coronal fibrocartilaginous core ratio (% Core) and intra-disc cleft length (Cleft). We also measured two qualitative parameters: degenerative disease of cartilaginous end plates and total intra-disc cleft. Finally, we examined 114 transections, and 18.5% were ruled out. The results showed thick ventral annulus fibrosus, thin lateral annulus and a very thin dorsal annulus. Fibrocartilaginous tissue filled the dorsal sagittal half of the disc. Intra-disc cleft split the fibrocartilaginous tissue and spread through the ventral annulus only six times. The shape of the ventral annulus at the lower cervical spine is compared to a pivot-hinge device. The aspect is functionally discussed in regard to teardrop fractures, unilateral locked facet syndrome and degenerative changes in the unco-vertebral area. PMID:15682275

Tonetti, J; Potton, L; Riboud, R; Peoc'h, M; Passagia, J-G; Chirossel, J-P

2005-08-01

302

Development of Modulators Against Degenerative Aging Using Radiation Fusion Technology  

International Nuclear Information System (INIS)

In this study, we selected final 20 biomarkers for the degenerative aging to develop radiation aging modeling, and validated a few of selected markers to utilize them in the screening of aging modulators. To select the biomarkers of the degenerative aging, 4 categories of aging-related markers (immune/hematopoiesis, oxidative damage, signaling molecule, lipid metabolism) were comparatively analyzed in irradiated and normally aged biosystems (cell lines or mice). In result, most of the biomarkers showed similar changes by irradiation and normal aging. Regarding the immune/hematopoiesis, the decline of immune cell functions (lymphocyte, NK cell) and Th1/Th2 imbalance, and decreased antigen-presenting of dendritic cells were observed and 10 biomarkers were selected in this category. mtDNA deletion was selected for the oxidative damage marker, 6 biomarkers including p21 and p-FOXO3a for signaling molecule biomarkers, and 3 biomarkers including the adipose tissue weight were selected for lipid metabolism. In addition, the various radiation application conditions by single/factionated irradiation and the periods after the irradiation were investigated for the optimal induction of changes of biomarker, which revealed that total 5Gy of 10 or more fractionated irradiations and 4 months or greather period were observed to be optimal. To found the basis for the screening of natural aging modulators, some selected aging biomarkers were validated by their inhibition by well-known natural agents (EGCG, HemoHIM, etc) in aged cell or mouse model. Additionally, by evaluating the reductive efficacy of 5 natural agents on the degeneration of skin and reproductive organs induced by radiation and chemicals (cyclophosphamide, etc), we established the base for the screening of degenerative diseases by various factors

303

Development of Modulators Against Degenerative Aging Using Radiation Fusion Technology  

Energy Technology Data Exchange (ETDEWEB)

In this study, we selected final 20 biomarkers for the degenerative aging to develop radiation aging modeling, and validated a few of selected markers to utilize them in the screening of aging modulators. To select the biomarkers of the degenerative aging, 4 categories of aging-related markers (immune/hematopoiesis, oxidative damage, signaling molecule, lipid metabolism) were comparatively analyzed in irradiated and normally aged biosystems (cell lines or mice). In result, most of the biomarkers showed similar changes by irradiation and normal aging. Regarding the immune/hematopoiesis, the decline of immune cell functions (lymphocyte, NK cell) and Th1/Th2 imbalance, and decreased antigen-presenting of dendritic cells were observed and 10 biomarkers were selected in this category. mtDNA deletion was selected for the oxidative damage marker, 6 biomarkers including p21 and p-FOXO3a for signaling molecule biomarkers, and 3 biomarkers including the adipose tissue weight were selected for lipid metabolism. In addition, the various radiation application conditions by single/factionated irradiation and the periods after the irradiation were investigated for the optimal induction of changes of biomarker, which revealed that total 5Gy of 10 or more fractionated irradiations and 4 months or greather period were observed to be optimal. To found the basis for the screening of natural aging modulators, some selected aging biomarkers were validated by their inhibition by well-known natural agents (EGCG, HemoHIM, etc) in aged cell or mouse model. Additionally, by evaluating the reductive efficacy of 5 natural agents on the degeneration of skin and reproductive organs induced by radiation and chemicals (cyclophosphamide, etc), we established the base for the screening of degenerative diseases by various factors

Jo, Sung Kee; Jung, U.; Park, H. R.

2010-04-15

304

[Epidemiology of bone and joint disease - the present and future - . Epidemiology of falls].  

Science.gov (United States)

A longitudinal analysis using a population-based cohort study known as Research on Osteoarthritis/osteoporosis Against Disability (ROAD) clarified the associations of physical performance and bone and joint diseases with falls. A total of 452 men and 896 women were analyzed in the present study (mean age, 63.9 years). A questionnaire was used to assess the number of falls during the 3-year follow-up. Grip strength, 6-m walking time, and chair stand time were measured at baseline. Knee osteoarthritis (OA) and lumbar spondylosis were defined as Kellgren Lawrence = 3 or 4. Vertebral fracture (VFx) was assessed with the Japanese Society of Bone and Mineral Research criteria. Knee and lower back pain were estimated by an interview. During a 3-year follow-up, 17.4% men and 24.1% women reported at least one fall. Multinomial logistic regression analysis after adjustment for age and BMI showed that a longer 6-m walking time was a risk factor for multiple falls in men and women. Knee pan was also a risk factor for multiple falls in women. Walking time and knee pain may be a simple and quick option for measuring the risk of falling. PMID:24769678

Muraki, Shigeyuki

2014-05-01

305

Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership.  

Science.gov (United States)

The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care. PMID:19369812

Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James

2009-01-01

306

Joint pain  

Science.gov (United States)

... or conditions. It may be linked to arthritis , bursitis , and muscle pain . No matter what causes it, ... Autoimmune diseases such as rheumatoid arthritis and lupus Bursitis Chondromalacia patellae Crystals in the joint: gout (especially ...

307

Registration of knee joint surfaces for the in vivo study of joint injuries based on magnetic resonance imaging  

Science.gov (United States)

In-vivo quantitative assessments of joint conditions and health status can help to increase understanding of the pathology of osteoarthritis, a degenerative joint disease that affects a large population each year. Magnetic resonance imaging (MRI) provides a non-invasive and accurate means to assess and monitor joint properties, and has become widely used for diagnosis and biomechanics studies. Quantitative analyses and comparisons of MR datasets require accurate alignment of anatomical structures, thus image registration becomes a necessary procedure for these applications. This research focuses on developing a registration technique for MR knee joint surfaces to allow quantitative study of joint injuries and health status. It introduces a novel idea of translating techniques originally developed for geographic data in the field of photogrammetry and remote sensing to register 3D MR data. The proposed algorithm works with surfaces that are represented by randomly distributed points with no requirement of known correspondences. The algorithm performs matching locally by identifying corresponding surface elements, and solves for the transformation parameters relating the surfaces by minimizing normal distances between them. This technique was used in three applications to: 1) register temporal MR data to verify the feasibility of the algorithm to help monitor diseases, 2) quantify patellar movement with respect to the femur based on the transformation parameters, and 3) quantify changes in contact area locations between the patellar and femoral cartilage at different knee flexion angles. The results indicate accurate registration and the proposed algorithm can be applied for in-vivo study of joint injuries with MRI.

Cheng, Rita W. T.; Habib, Ayman F.; Frayne, Richard; Ronsky, Janet L.

2006-03-01

308

Instrumenta??o interespinhosa na doença degenerativa da coluna lombar: medição da altura do disco no segmento instrumentado Instrumentación interespinosa en la enfermedad degenerativa de la columna lumbar: medición de la altura del disco en el segmento instrumentado Interspinous instrumentation in patients with degenerative lumbar spine disease: disc height measurement on instrumented segment  

Directory of Open Access Journals (Sweden)

Full Text Available INTRODUÇÃO: na última década, a instrumentação interespinhosa vem sendo mais frequentemente utilizada. Apesar dos inúmeros artigos publicados em revistas internacionais de reconhecido mérito científico, são escassas as referências à modificação da altura do disco no segmento tratado, secundária àquela instrumentação. OBJECTIVO: quantificar uma eventual modifica??o da altura discal decorrente da aplicação de instrumentação interespinhosa (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©. MÉTODOS: o autor avalia um grupo de 20 pacientes com patologia degenerativa da coluna lombar e os seguintes critérios de inclusão: idade >40 e 6; Oswestry Disability Index (ODI >30; Zung Depression Rating Scale INTRODUCCIÓN: la instrumentación interespinosa tiene sido empleada con creciente frecuencia en la última década. Pero, apesar de las numerosas publicaciones científicas hechas en jornales científicos de reconocido mérito internacional, se han producido muy escasas referencias a una hipotética modificación de la altura discal dependiente de la técnica. OBJETIVO: cuantificar una eventual modificación de la altura discal inherente a la aplicación de instrumentación interespinosa. MÉTODOS: el autor hace una evaluación de un grupo de 20 pacientes con patología degenerativa de la columna lumbar, y diversos criterios de inclusión, a saber: edad >40 y 6; Oswestry Disability Index >30; Zung Depression Rating Scale INTRODUCTION: the use of interspinous instrumentation has been increasing in the last decade. However, in spite of the numerous papers seen in relevant scientific publications, there are very few references to an eventual disc height variation in the instrumented segment. OBJECTIVE: to certify eventual changes in disk height after interspinous instrumentation (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©. METHODS: the author evaluated 20 patients with degenerative lumbar disease and the following criteria: age >40 and 6; Oswestry Inability Index >30; Zung Depression Rating Scale <39; Modified Somatic Perception Questionnaire <15; degenerative bone disease grade 2 and 3 according to Benzel classification and degenerative disk disease grade 3 and 4 according to Pfirmann classification. Using a special formula and a computer image program (Adobe Photoshop 9.0 CS2, side radiograms of the lumbar spine in orthostatic position and with 70% amplification were obtained pre-surgery and two years after surgery. RESULTS: after applying the mentioned formula, the results showed an increased global disk height average 1.53 mm, with a standard deviation of 1.09 mm and p=0.0002. However, there was a large increase (0.45 mm in posterior disk height (p=0.0002 when compared with anterior measurement (p=0.001 pointing out a slight kyphosing effect related to the instrumentation. CONCLUSIONS: in Benzel grade 2 and 3 and Pfirmann grade 3 and 4 degenerative lumbar disease, the use of an interspinous system seemed to be able to increase disk height and to improve neural canal dimensions.

José Alberto de Castro Guimarães Consciência

2009-09-01

309

Radiation treatment of painful degenerative skeletal conditions  

International Nuclear Information System (INIS)

The study reported was intended to present own experience with irradiation for treatment of painful degenerative skeletal conditions and examine the long-term effects of this treatment. A retrospective study was performed covering the period from 1985 until 1991, examining 157 patients suffering from painful degenerative skeletal conditions who entered information on the success of their radiation treatment in a questionnaire. 94 of the questionnaires could be used for evaluation. Pain anamnesis revealed periods of more than one year in 45% of the cases. 74% of the patients had been treated without success with drug or orthopedic therapy. Immediately after termination of the radiotherapy, 38% of the patients said to be free of pain or to feel essentially relieved, while at the time the questionnaire was distributed, the percentage was 76%. Thus in our patient material, radiotherapy for treatment of painful degenerative skeletal lesions was successful in 76% of the cases and for long post-treatment periods, including those cases whith long pain anamnesis and unsuccessful conventional pre-treatment. (orig./MG)

310

Migrating lumbar facet joint cysts  

Energy Technology Data Exchange (ETDEWEB)

The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints. (orig.)

Palmieri, Francesco; Cassar-Pullicino, Victor N.; Lalam, Radhesh K.; Tins, Bernhard J.; Tyrrell, Prudencia N.M.; McCall, Iain W. [Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Department of Radiology, Oswestry (United Kingdom)

2006-04-15

311

Migrating lumbar facet joint cysts  

International Nuclear Information System (INIS)

The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints. (orig.)

312

Estenosis espinal lumbar degenerativa / Degenerative spinal lumbar stenosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: el aumento progresivo de la esperanza de vida viene acompañado de una mayor incidencia de las enfermedades degenerativas del raquis como la estenosis espinal. Objetivo: actualizar y sistematizar los conocimientos sobre la estenosis espinal degenerativa del canal espinal lumbar. Método: s [...] e realizó una revisión de la literatura de los último cinco años. Se insistió en la clasificación, patogenia, diagnóstico y tratamiento. Desarrollo: la estenosis espinal degenerativa del canal lumbar es un desorden multifactorial caracterizado por un estrechamiento del canal vertebral, del receso lateral o de los agujeros de conjunción secundaria a hipertrofia degenerativa y progresiva de cualquiera de las estructuras óseas, cartilaginosas o ligamentosas que culmina en una compresión neurológica y vascular. La claudicación neurogéna es de los síntomas más característicos. El diagnóstico se basa en las mediciones realizadas en las imágenes de tomografía axial computarizada y en la resonancia nuclear magnética. Las opciones terapéuticas incluyen el tratamiento conservador y el quirúrgico, con las técnicas descompresivas convencionales y las de mínima invasión, preferidas en la actualidad. Conclusiones: la estenosis espinal degenerativa es una enfermedad multifactorial. El diagnóstico se fundamenta en la sospecha clínica confirmada en los estudios imagenológicos. Para la elección del tratamiento deben tenerse en cuenta factores relacionados con el paciente, con las características de la estenosis y con la disponibilidad de la tecnología. El objetivo de la cirugía se encaminará a descomprimir las estructuras neurovasculares y respetar la estabilidad del raquis para disminuir la morbilidad posoperatoria. Abstract in english Background: the progressive increase of life expectancy came along with a greater incidence of degenerative diseases of the rachis like spinal stenosis. Objective: to systematize and bring the knowledge about degenerative spinal stenosis of the spinal lumbar channel up to date. Method: a review of t [...] he literature from the last five years was made, making emphasis in the classification, pathogeny, diagnosis, and treatment. Development: degenerative spinal stenosis of the lumbar channel is a multifactorial disorder characterized by a narrowing of the vertebral channel, of the lateral recess, or of the secondary intervertebral foramina, conditions commonly observed in degenerative and progressive hypertrophy of any of the cartilaginous, ligamentous, or osseous structures that ends in a neurologic or vascular squeeze. Neurogenic claudication is one of the most characteristic symptoms. The diagnosis is based on measuring made through the images in the computerized axial tomography and in the nuclear magnetic resonance. The therapeutic options include the conservative treatment and the surgical treatment, with conventional decompressing techniques and the techniques of minimal invasion that are the most used nowadays. Conclusions: degenerative spinal stenosis is a multifactorial disease. The diagnosis is based on the clinical suspicion confirmed through imagenology studies. Some factors related to the patient, to the characteristics of the stenosis, and to the availability of the technology should be taken into consideration for choosing the treatment. The objective of the surgery will be aimed at decompressing the neurovascular structures and keeping the stability of the rachis in order to reduce the postoperative morbidity.

Erick Héctor, Hernández González; Antonio, Puente Álvarez; Gretel, Mosquera Betancourt.

313

Estenosis espinal lumbar degenerativa / Degenerative spinal lumbar stenosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Fundamento: el aumento progresivo de la esperanza de vida viene acompañado de una mayor incidencia de las enfermedades degenerativas del raquis como la estenosis espinal. Objetivo: actualizar y sistematizar los conocimientos sobre la estenosis espinal degenerativa del canal espinal lumbar. Método: s [...] e realizó una revisión de la literatura de los último cinco años. Se insistió en la clasificación, patogenia, diagnóstico y tratamiento. Desarrollo: la estenosis espinal degenerativa del canal lumbar es un desorden multifactorial caracterizado por un estrechamiento del canal vertebral, del receso lateral o de los agujeros de conjunción secundaria a hipertrofia degenerativa y progresiva de cualquiera de las estructuras óseas, cartilaginosas o ligamentosas que culmina en una compresión neurológica y vascular. La claudicación neurogéna es de los síntomas más característicos. El diagnóstico se basa en las mediciones realizadas en las imágenes de tomografía axial computarizada y en la resonancia nuclear magnética. Las opciones terapéuticas incluyen el tratamiento conservador y el quirúrgico, con las técnicas descompresivas convencionales y las de mínima invasión, preferidas en la actualidad. Conclusiones: la estenosis espinal degenerativa es una enfermedad multifactorial. El diagnóstico se fundamenta en la sospecha clínica confirmada en los estudios imagenológicos. Para la elección del tratamiento deben tenerse en cuenta factores relacionados con el paciente, con las características de la estenosis y con la disponibilidad de la tecnología. El objetivo de la cirugía se encaminará a descomprimir las estructuras neurovasculares y respetar la estabilidad del raquis para disminuir la morbilidad posoperatoria. Abstract in english Background: the progressive increase of life expectancy came along with a greater incidence of degenerative diseases of the rachis like spinal stenosis. Objective: to systematize and bring the knowledge about degenerative spinal stenosis of the spinal lumbar channel up to date. Method: a review of t [...] he literature from the last five years was made, making emphasis in the classification, pathogeny, diagnosis, and treatment. Development: degenerative spinal stenosis of the lumbar channel is a multifactorial disorder characterized by a narrowing of the vertebral channel, of the lateral recess, or of the secondary intervertebral foramina, conditions commonly observed in degenerative and progressive hypertrophy of any of the cartilaginous, ligamentous, or osseous structures that ends in a neurologic or vascular squeeze. Neurogenic claudication is one of the most characteristic symptoms. The diagnosis is based on measuring made through the images in the computerized axial tomography and in the nuclear magnetic resonance. The therapeutic options include the conservative treatment and the surgical treatment, with conventional decompressing techniques and the techniques of minimal invasion that are the most used nowadays. Conclusions: degenerative spinal stenosis is a multifactorial disease. The diagnosis is based on the clinical suspicion confirmed through imagenology studies. Some factors related to the patient, to the characteristics of the stenosis, and to the availability of the technology should be taken into consideration for choosing the treatment. The objective of the surgery will be aimed at decompressing the neurovascular structures and keeping the stability of the rachis in order to reduce the postoperative morbidity.

Erick Héctor, Hernández González; Antonio, Puente Álvarez; Gretel, Mosquera Betancourt.

2013-08-01

314

Facet joint syndrome  

International Nuclear Information System (INIS)

It is the purpose of the study to demonstrate the clinical relevance of degenerative changes in the facet joint of patients with low back pain irradiating to the lower extremities, and discuss some problems relating to diagnosis and different diagnosis. 119 patients presenting the listed bellow syndromes are covered by the study: scoliosis, polytopic pain vertebral syndrome, paresis and history of trauma. all patients undergo comprehensive neurological examination with special attention focused on the spine: CT and plain x-rays are taken of the lumbosacral segment to assess the condition of the facet joints. The neurological examination demonstrates in all cases pain syndrome in the lumbar spine referred to one or both lower extremities. In 56% it is a matter of persisting pain, and in 44% - recurrent. More than half of the patients complain of sacroiliac (SI) dislocation and palpatory pain. Unilateral or bilateral degenerative changes are documented by imaging studies in all patients, including: subchondral thickening, osteopathy narrowing the lateral or central part of the spinal canal with ensuing nerve root compression. The lumbosacral zygoapophyseal joints are source of pseudoradicular pain. A correlation between clinical picture and GT changes is noted in all patients with facet joint syndrome. CT is an indispensable method in diagnosing facet joint syndrome. (authors)

315

Serum amyloid A isoforms in serum and synovial fluid from spontaneously diseased dogs with joint diseases or other conditions  

DEFF Research Database (Denmark)

Serum amyloid A (SAA) is a major acute phase protein in dogs. However, knowledge of qualitative properties of canine SAA and extent of its synthesis in extrahepatic tissues is limited. The aim of the study was to investigate expression of different SAA isoforms in serum and synovial fluid in samples obtained from dogs (n = 16) suffering from different inflammatory or non-inflammatory conditions, which were either related or unrelated to joints. Expression of SAA isoforms was visualized by denaturing isoelectric focusing and Western blotting. Serum amyloid A was present in serum from all dogs with systemic inflammatory activity, and up to four major isoforms with apparent isoelectric points between 6.1 and 7.9 were identified. In synovial fluid from inflamed joints one or more highly alkaline SAA isoforms (with apparent isoelectric points above 9.3) were identified, with data suggesting local production of these isoforms in the canine inflamed joint.

Kjelgaard-Hansen, Mads Jens; Christensen, Michelle B.

2007-01-01

316

[Degenerative lesions of the peripheral retina].  

Science.gov (United States)

Degenerative lesions of the peripheral retina are present from teenage years onwards and increase with age. These abnormabilities are frequent, some of them being benign while others predispose to retinal tears and detachment. In the latter case, the lesions are rhegmatogenous and may justify prophylactic treatment by laser photocoagulation. We distinguish congenital lesions of the peripheral retina and intraretinal, chorioretinal and vitreoretinal degenerations. The holes and tears observed in 2% of the population consist of round atrophic holes, "horseshoe" tears, oral dialyses and giant tears. PMID:24239217

Conart, J-B; Baron, D; Berrod, J-P

2014-01-01

317

[The effect of magnetotherapy on the immunobiochemical indices of subjects with diseases of the periodontal tissues and joints].  

Science.gov (United States)

Kept under medical surveillance in a health resort setting were 52 patients with disorders of the parodontium and large joints. All patients were given a complex therapy involving dietotherapy, therapeutic exercise, hydrotherapy, mud-treatment. Those patients having parodontium diseases were also prescribed topical treatment (chloride-sodium mouth baths and mud applications to the gingiva area). The main group subjects were also exposed to VMF using the unit for low-frequency therapy "Gradient-1". Laboratory means were also made use of, as a complex of biochemical tests characterizing changes in lipid metabolism. The level of the natural bodily resistance was determined by nitroblue tetrazolium test (NBT-test). The condition of the parodontium was evaluated by the Loë-Silness index. Adaptive reactions were studied by the lymphocytes-to-segmented neutrophils ratio. Adoption of therapy involving physiobalneofactors in patients with afflictions of the parodontium tissues and large joints makes for development of favourable in prognostic respect adaptive reactions. PMID:10424014

Samo?lovich, V A

1999-01-01

318

Avaliação clínica e funcional no pré-operatório de doenças degenerativas da coluna vertebral Evaluación clínica y funcional en el preoperatorio de patologías degenerativas de columna Clinical and functional evaluation in preoperative period of degenerative disease spine surgery  

Directory of Open Access Journals (Sweden)

Full Text Available OBJETIVO: a utilização de instrumentos de avaliação clínica e funcional nos pacientes com doenças da coluna vertebral pode determinar a evolução e predizer o desfecho pós-operatório. O objetivo deste estudo foi descrever a metodologia de avaliação de doenças degenerativas espinhais e verificar os resultados. MÉTODOS: após a indicação de tratamento cirúrgico nos pacientes com doenças das colunas lombar e cervical, os mesmos foram informados dos objetivos do estudo e convidados a participar. Os questionários foram respondidos no consultório médico, onde possíveis dúvidas surgidas durante o preenchimento eram esclarecidas por uma pessoa treinada não envolvida com a cirurgia. Todos os instrumentos de avaliação usados eram autoaplicativos. Foram utilizados a escala numérica de dor, o Questionário de Qualidade de Vida SF-36, o Questionário de Evitação por Medos e Crenças (FABq, o Inventário de Depressão de Beck (BDI, a Escala de Depressão e Ansiedade Hospitalar (HAD, o Índice de Incapacidade Oswestry (ODI e o Índice de Disfunção Relacionado ao Pescoço (NDI. RESULTADOS: foram avaliados 220 pacientes com doenças da coluna lombar e 32 da cervical. A prevalência de depressão segundo o BDI foi de 28,0% e de 31,2% em pacientes com doença cirúrgica lombar e cervical, e a prevalência de ansiedade pelo HAD-A de 40,1% e 46,9%, respectivamente. A média do ODI foi de 46,5, e a do NDI, de 25,4. Quanto ao preenchimento dos questionários, a maioria dos pacientes, uma vez instruídos, não apresentou dificuldades em finalizá-los. O tempo médio de preenchimento de todos os instrumentos foi de 25 a 35 minutos. CONCLUSÕES: a utilização de instrumentos validados para avaliação dos pacientes com doenças degenerativas vertebrais é exequível e deve ser estimulada entre os cirurgiões que atuam no âmbito da coluna vertebral.OBJETIVO: la utilización de instrumentos de evaluación clínica y funcional de patologías vertebrales, además de determinar la evolución después del tratamiento, puede predecir el resultado postoperatorio. El objetivo de este estudio es describir la metodología de evaluación de patologías degenerativas de la columna y verificar los resultados. MÉTODOS: luego de la indicación del tratamiento quirúrgico, los pacientes son invitados a participar del estudio mediante firma de un término de consentimiento libre y claro. Los pacientes responden los cuestionarios en el consultorio médico y son auxiliados cuanto a dudas al completarlo por una persona no involucrada con la cirugía. Todos los instrumentos de evaluación utilizados son auto-aplicativos. Se utilizan: escala numérica del dolor (NRS, Cuestionario SF-36, Cuestionario de Evitación por Miedos y Creencias (FABq, Inventario de Depresión de Beck (BDI, Escala de Depresión y Ansiedad Hospitalaria (HAD, Índice de Discapacidad Oswestry (ODI, Índice de Disfunción Relacionado al Cuello (NDI. RESULTADOS: se evaluaron 220 pacientes con patologías de la columna lumbar y 32 de la cervical. La prevalencia de depresión según el BDI fue del 28,0 y 31,2% en pacientes con enfermedad quirúrgica lumbar y cervical, y la prevalencia de ansiedad por el HAD-A del 40,1 y 46,9%, respectivamente. El promedio de ODI fue de 46,5 y del NDI de 25,4. Cuanto a la viabilidad de completar los cuestionarios, se observo que la mayoría de los pacientes, una vez instruidos cuanto a la manera de completarlos, no presenta dificultades para hacerlo. El tiempo promedio para completar todos los instrumentos es de 25 a 35 minutos. CONCLUSIÓN: la utilización de instrumentos validados para evaluación de los pacientes con enfermedades degenerativas vertebrales es viable y debe ser estimulada entre los cirujanos de columna.OBJECTIVE: the use of clinical and functional evaluation instruments for vertebral pathologies, besides determining how the situation evolves after treatment, can predict the postoperative outcome. The objective of this study was to describe the methodology to evaluate spinal degenerative pathologies a

Asdrubal Falavigna

2009-09-01

319

Local ASIC3 modulates pain and disease progression in a rat model of osteoarthritis  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Recent data have suggested a relationship between acute arthritic pain and acid sensing ion channel 3 (ASIC3) on primary afferent fibers innervating joints. The purpose of this study was to clarify the role of ASIC3 in a rat model of osteoarthritis (OA) which is considered a degenerative rather than an inflammatory disease. Methods We induced OA via intra-articular mono-iodoacetate (MIA) injection, and evaluated pain-related behavior...

Izumi Masashi; Ikeuchi Masahiko; Ji Qinghui; Tani Toshikazu

2012-01-01

320

Joint Hypermobility Syndrome and Dysautonomia: Expanding Spectrum of Disease Presentation and Manifestation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

The varying clinical presentations of not so well recognized diseases, which continue to haunt patients is well described in the above quotes. Clinicians may not recognize associated subtle early presentations of the disease, till the disease has fully manifested itself. Of all the disorders of human body, autonomic syndromes are still the least understood. Presentation and association of autonomic diseases with other disorders may be so varied and subtle that clinicians may fail to recognize...

Shomu Bohora

2010-01-01

 
 
 
 
321

The use of compliant layer prosthetic components in orthopedic joint repair and replacement: a review.  

Science.gov (United States)

The surgical repair or treatment of degenerative joint disease has traditionally involved the substitution of synthetic materials for one or both surfaces of the joint. Engineering thermoplastics, metals, and ceramics have either been widely accepted or experimentally evaluated for use as bearing surfaces in these prostheses. When engineering thermoplastics are used, the opposing surface is a metal or a ceramic, but metal-on-metal, metal-on-ceramic, and ceramic-on-ceramic have also been used or tested. Researchers have sought the opportunity to utilize materials with compressive mechanical properties more closely matching those of the natural articular cartilage. This review discusses the theory, testing, and application of elastomers for one bearing component of articular joint prostheses. PMID:24596145

St John, Kenneth R

2014-08-01

322

The joint modeling of a longitudinal disease progression marker and the failure time process in the presence of cure.  

Science.gov (United States)

In this paper we present an extension of cure models: to incorporate a longitudinal disease progression marker. The model is motivated by studies of patients with prostate cancer undergoing radiation therapy. The patients are followed until recurrence of the prostate cancer or censoring, with the PSA marker measured intermittently. Some patients are cured by the treatment and are immune from recurrence. A joint-cure model is developed for this type of data, in which the longitudinal marker and the failure time process are modeled jointly, with a fraction of patients assumed to be immune from the endpoint. A hierarchical nonlinear mixed-effects model is assumed for the marker and a time-dependent Cox proportional hazards model is used to model the time to endpoint. The probability of cure is modeled by a logistic link. The parameters are estimated using a Monte Carlo EM algorithm. Importance sampling with an adaptively chosen t-distribution and variable Monte Carlo sample size is used. We apply the method to data from prostate cancer and perform a simulation study. We show that by incorporating the longitudinal disease progression marker into the cure model, we obtain parameter estimates with better statistical properties. The classification of the censored patients into the cure group and the susceptible group based on the estimated conditional recurrence probability from the joint-cure model has a higher sensitivity and specificity, and a lower misclassification probability compared with the standard cure model. The addition of the longitudinal data has the effect of reducing the impact of the identifiability problems in a standard cure model and can help overcome biases due to informative censoring. PMID:12933597

Law, Ngayee J; Taylor, Jeremy M G; Sandler, Howard

2002-12-01

323

Long-term follow-up of mobile-bearing total ankle replacement in patients with inflammatory joint disease.  

Science.gov (United States)

Little is known about the long-term outcome of mobile-bearing total ankle replacement (TAR) in the treatment of end-stage arthritis of the ankle, and in particular for patients with inflammatory joint disease. The aim of this study was to assess the minimum ten-year outcome of TAR in this group of patients. We prospectively followed 76 patients (93 TARs) who underwent surgery between 1988 and 1999. No patients were lost to follow-up. At latest follow-up at a mean of 14.8 years (10.7 to 22.8), 30 patients (39 TARs) had died and the original TAR remained in situ in 28 patients (31 TARs). The cumulative incidence of failure at 15 years was 20% (95% confidence interval (CI) 11 to 28). The mean American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score of the surviving patients at latest follow-up was 80.4 (95% CI 72 to 88). In total, 21 patients (23 TARs) underwent subsequent surgery: three implant exchanges, three bearing exchanges and 17 arthrodeses. Neither design of TAR described in this study, the LCS and the Buechel-Pappas, remains currently available. However, based both on this study and on other reports, we believe that TAR using current mobile-bearing designs for patients with end-stage arthritis of the ankle due to inflammatory joint disease remains justified. PMID:24293596

Kraal, T; van der Heide, H J L; van Poppel, B J; Fiocco, M; Nelissen, R G H H; Doets, H C

2013-12-01

324

Degenerative dementia: nosological aspects and results of single photon emission computed tomography  

International Nuclear Information System (INIS)

Ten years ago, the diagnosis discussion of a dementia case for the old patient was limited to two pathologies: the Alzheimer illness and the Pick illness. During these last years, the frame of these primary degenerative dementia has fallen into pieces. The different diseases and the results got with single photon emission computed tomography are discussed. for example: fronto-temporal dementia, primary progressive aphasia, progressive apraxia, visio-spatial dysfunction, dementia at Lewy's bodies, or cortico-basal degeneration. (N.C.)

325

Genetics Home Reference: Alzheimer disease  

Science.gov (United States)

... gov Research studies OMIM Genetic disorder catalog Conditions > Alzheimer disease On this page: Description Genetic changes Inheritance Diagnosis ... names Glossary definitions Reviewed May 2013 What is Alzheimer disease? Alzheimer disease is a degenerative disease of the ...

326

Arthroscopical treatment of elbow joint disease / Tratamento artroscópico de doenças da articulação do cotovelo  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Artroscopia do cotovelo foi realizada em 30 cães de diferentes raças, bilateral em 20, totalizando 50 articulações. Foram encontradas diferentes lesões que variavam de fissuras na cartilagem (8) a fragmentação (42). Osteocondrose dissecante (OCD) do côndilo medial do úmero estava associada à fragmen [...] tação do processo coronoide (FCP) medial da ulna em quatro casos. Em todas articulações verificou-se sinovite em graus variados. Osteoartrose (OA) de diferentes intensidades foi observada em 44 articulações. O tratamento foi instituído na maioria dos casos, dois a quatro meses após a manifestação dos sinais clínicos. Recuperação clínica satisfatória ocorreu naqueles com mínima lesão articular, cujo diagnóstico e tratamento se fizeram dentro de quatro semanas após a manifestação clínica. O diagnóstico precoce e o tratamento artroscópico previne a osteoartrose e preserva a função locomotora. Abstract in english Elbow arthroscopy was performed in 30 dogs of different breeds. The procedure was performed bilaterally in 20 of these dogs, yielding a total of 50 joints. Different lesions were found, varying from cartilage fissures (8) to fragmentation (42) of medial coronoid process (FCP) of the ulna. Osteochond [...] ritis dissecans (OCD) of the humerus medial condyle was associated in four of them. All of these cases displayed varying degrees of synovitis. Osteoarthrosis (OA) in varying intensity was observed in 44 joints. The majority of cases were treated two to four months after the manifestation of clinical signs. Good clinical recovery occurred in dogs with minimal joint lesions, where these were diagnosed and treated within four weeks of the onset of clinical symptoms. Early diagnosis and arthroscopic treatment prevent osteoarthrosis and preserve locomotor function.

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

2012-02-01

327

Drug therapies for peripheral joint disease in psoriatic arthritis: a systematic review.  

Science.gov (United States)

In 2009, GRAPPA published their first evidence-based recommendations for the treatment of psoriasis and psoriatic arthritis (PsA). Since then, new information has been published and drugs developed. We summarize evidence for the efficacy of available treatments for peripheral joint involvement in PsA. We performed a systematic review of current literature on the efficacy of different therapies, management, and therapeutic strategies for peripheral arthritis involvement in PsA, in order to provide information for the development of the new GRAPPA treatment recommendations. PMID:25362711

Acosta Felquer, Maria Laura; Coates, Laura C; Soriano, Enrique R; Ranza, Roberto; Espinoza, Luis R; Helliwell, Philip S; FitzGerald, Oliver; McHugh, Neil; Roussou, Euthalia; Mease, Philip J

2014-11-01

328

Acquired degenerative changes of the intervertebral segments at and suprajacent to the lumbosacral junction A radioanatomic analysis of the nondiscal structures of the spinal column and perispinal soft tissues  

Energy Technology Data Exchange (ETDEWEB)

A review of the imaging features of normal and degenerative anatomy of the spine on medical imaging studies shows features that have been largely overlooked or poorly understood by the imaging community in recent years. The imaging methods reviewed included computed tomography (CT) with multiplanar reconstructions and magnetic resonance imaging (MRI). A routine part of the MRI examination included fat-suppressed T2 weighted fast-spin- or turbo-spin-echo acquisitions. As compared to the normal features in asymptomatic volunteers, alterations in the observed CT/MRI morphology and MR signal characteristics were sought in symptomatic individuals. Findings in symptomatic subjects which departed from the normal anatomic features of the posterior spinal elements in asymptomatic volunteers included: rupture of the interspinous ligament(s), neoarthrosis of the interspinous space with perispinous cyst formation, posterior spinal facet (zygapophyseal joint) arthrosis, related central spinal canal, lateral recess (subarticular zone) and neural foramen stenosis, posterior element alterations associated with various forms of spondylolisthesis, and perispinal muscle rupture/degeneration. These findings indicate that the posterior elements are major locations of degenerative spinal and perispinal disease that may accompany or even precede degenerative disc disease. Although not as yet proven as a reliable source of patient signs and symptoms in all individuals, because these observations may be seen in patients with radicular, referred and/or local low back pain, they should be considered in the evaluation of the symptomatic patient presenting with a clinical lumbosacral syndrome. Imaging recommendations, in addition to the usual close scrutiny of these posterior spinal elements and perispinal soft tissues on CT and MRI, include the acquisition of high-resolution multiplanar CT reconstructions, and fat-suppressed T2 weighted fast-spin- or turbo-spin-echo sequence MRI in at least one plane in every examination of the lumbar spine.

Jinkins, J. Randy E-mail: jrjinkins@aol.com

2004-05-01

329

Environmental Radon Gas and Degenerative Conditions An Overview  

International Nuclear Information System (INIS)

Radon, a naturally occurring radioactive gas, has variable distribution in the environment as a decay product of uranium occurring in a wide range of rocks, soils and building materials. Although radon dissipates rapidly in outdoor air, it concentrates in the built environment, and inhalation of 222Rn and its progeny 218Po and 214Po is believed to provide the majority of the radioactive dose to the respiratory system. While the connection between radon and lung cancer has long been recognised and investigated, recent studies have highlighted potential links between radon and other conditions, among them Multiple Sclerosis, Alzheimer and Parkinson Diseases, and Paget Disease of Bone. A strong case exists for clarifying the relationship between radon and these other conditions, not least since radon remediation to reduce lung cancer may conceivably have additional benefits hitherto unrecognized. The present status of the postulated links between environmental radon gas and degenerative conditions is reviewed, and recommendations for further research into levering current anti-radon campaigns are made. (authors)

330

Environmental Radon Gas and Degenerative Conditions An Overview  

Energy Technology Data Exchange (ETDEWEB)

Radon, a naturally occurring radioactive gas, has variable distribution in the environment as a decay product of uranium occurring in a wide range of rocks, soils and building materials. Although radon dissipates rapidly in outdoor air, it concentrates in the built environment, and inhalation of {sup 222}Rn and its progeny {sup 218}Po and {sup 214}Po is believed to provide the majority of the radioactive dose to the respiratory system. While the connection between radon and lung cancer has long been recognised and investigated, recent studies have highlighted potential links between radon and other conditions, among them Multiple Sclerosis, Alzheimer and Parkinson Diseases, and Paget Disease of Bone. A strong case exists for clarifying the relationship between radon and these other conditions, not least since radon remediation to reduce lung cancer may conceivably have additional benefits hitherto unrecognized. The present status of the postulated links between environmental radon gas and degenerative conditions is reviewed, and recommendations for further research into levering current anti-radon campaigns are made. (authors)

Groves-Kirkby, C.J. [Medical Physics Department, Northampton General Hospital, Northampton NN1 5BD (United Kingdom)]|[School of Health, University of Northampton, Northampton NN2 7AL (United Kingdom); Denman, A.R. [Medical Physics Department, Northampton General Hospital, Northampton NN1 5BD (United Kingdom); Woolridge, A.C. [School of Health, University of Northampton, Northampton NN2 7AL (United Kingdom)]|[School of Applied Sciences, University of Northampton, Northampton NN2 7AL (United Kingdom); Phillips, P.S. [School of Applied Sciences, University of Northampton, Northampton NN2 7AL (United Kingdom); Phillips, C. [School of Health, University of Northampton, Northampton NN2 7AL (United Kingdom)

2006-07-01

331

Treatment choice for osteoarthritis of the knee joint according to semi-automatic MRI based assessment of disease severity  

International Nuclear Information System (INIS)

Objective assessment of disease severity of osteoarthritis of the knee joint (OA knee) is fundamental to establish adequate treatment system. Regrettably, there is no such a reliable system. Grading system based upon X-ray findings or measurement of joint space narrowing is widely used method for this purpose but they are still far from satisfaction. Our previous study elucidated that measuring irregularity of the contour of the femoral condyle on MRI (irregularity index) using newly developed software enabled us to assess disease severity of OA objectively. Advantages of this system are expressing severity by metric variable and semi-automatic character. In the present study, we examined relationship between treatment selection and irregularity index. Sixty-one medial type OA knees that received total knee arthroplasty (TKA), arthroscopic surgery (AS), and conservative treatment (CT) were involved. Their x-ray grading, irregularity index were recorded at the time of corresponding treatment. Irregularity index of each group were compared. As for AS group, pre- and post-operative knee score employing JOA score were also examined to study relationship between irregularity index and improvement of knee score. All the four parameters that represent irregularity of femoral condyle were significantly higher in TKA group than in AS group, whereas no significant difference was observed between AS group and CT group. Negative correlation was observed between irregularity indexon was observed between irregularity index and improvement of knee score after arthroscopic surgery. Although treatment selection was determined by skillful knee surgeon in this series, irregularity index could indicate adequate timing of TKA. It also served as an indicator to predict outcome of arthroscopic surgery, and could be used as to show limitation of arthroscopic surgery. Our new system to assess disease severity of OA knee can serve as an index to determine treatment options. (author)