Criterion Validation Testing of Clinical Metrology Instruments for Measuring Degenerative Joint Disease Associated Mobility Impairment in Cats.

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Gruen, Margaret E; Griffith, Emily H; Thomson, Andrea E; Simpson, Wendy; Lascelles, B Duncan X

2015-01-01

Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI) and the Client Specific Outcome Measures (CSOM). Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period. Activity counts were increased in cats during treatment with daily meloxicam (pdegenerative joint disease.

Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine.

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Sebro, Ronnie; O'Brien, Liam; Torriani, Martin; Bredella, Miriam A

2016-09-01

The purpose of this study was (1) to evaluate the association of trunk muscle density assessed by computed tomography (CT) with age, gender, and BMI and (2) to evaluate the association between trunk muscle CT density and degenerative disc and facet joint disease of the lumbar spine. The study was IRB approved and HIPAA compliant. The study group comprised 100 subjects (mean age 44.4 ± 22.2 years, 51 % male) who underwent CT of the abdomen and pelvis without intravenous contrast. Exclusion criteria included prior abdominal or spine surgery, active malignancy and scoliosis. CTs were reviewed and the attenuation of the rectus abdominis, transverse abdominis, internal and external obliques, psoas, multifidus, longissimus and gluteus maximus were measured bilaterally at consistent levels. Degenerative disc and bilateral facet joint disease were scored using established methods. Univariate analyses were performed using linear regression. Multivariate linear regression was performed to adjust for age, gender and BMI. CT density of each trunk muscle correlated inversely with age (p degenerative disc and facet joint disease in the univariate analyses (p degenerative disc and facet joint disease respectively in the multivariate analysis. Fatty infiltration of trunk musculature increases with age and BMI. Fatty infiltration of the gluteus maximus and transverse abdominis are associated with degenerative disc and facet joint disease, independent of age, gender and BMI.

The effects of temporomandibular joint internal derangement and degenerative joint disease on tomographic and arthrotomographic images.

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Brand, J W; Whinery, J G; Anderson, Q N; Keenan, K M

1989-02-01

In a blind study, 243 arthrograms were interpreted as showing normal disk position, anterior disk displacement with reduction, or anterior disk displacement without reduction. The presence or absence of a perforation of the posterior attachment or disk was recorded. Later, tomograms of the same patient were interpreted. The presence or absence of evidence of temporomandibular degenerative joint disease (TMDJD) was recorded. The condyle-to-fossa relationship was characterized as retropositioned or not retropositioned. O the 106 cases with tomographic evidence of TMDJD, 100 (94%) had arthrographic evidence of internal derangement (p less than 0.0001), whereas 47% of the cases with internal derangement (211) had evidence of TMDJD. Perforations were seen in 29 (27%) of the cases with degenerative joint disease and in none (0%) of the cases without TMDJD (p less than 0.001). In cases without TMDJD, 90% of the cases with internal derangement revealed condylar retropositioning (p less than 0.0001). With tomographic evidence of TMDJD present, the relationship between condylar position and disk position was not significant.

Posterior Radioscaphoid Angle as a Predictor of Wrist Degenerative Joint Disease in Patients With Scapholunate Ligament Tears.

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Gondim Teixeira, Pedro Augusto; De Verbizier, Jacques; Aptel, Sabine; Wack, Maxime; Dap, François; Dautel, Gilles; Blum, Alain

2016-01-01

The purpose of this study is to determine whether the posterior radioscaphoid angle, a marker of posterior displacement of the scaphoid, is associated with degenerative joint disease in patients with scapholunate ligament tears. Images from 150 patients with wrist pain who underwent CT arthrography and radiography were retrospectively evaluated. Patients with and without scapholunate ligament ruptures were divided into two groups according to CT arthrography findings. The presence of degenerative changes (scapholunate advanced collapse [SLAC] wrist) was evaluated and graded on conventional radiographs. Images were evaluated by two readers independently, and an adjudicator analyzed the discordant cases. Posterior radioscaphoid angle values were correlated with CT arthrography and radiographic findings. The association between posterior radioscaphoid angle and degenerative joint disease was evaluated. Scapholunate and radiolunate angles were considered in the analysis. The posterior radioscaphoid angle was measurable in all patients, with substantial interobserver agreement (intraclass correlation coefficient, 0.75). The posterior radioscaphoid angle performed better than did the scapholunate and radiolunate angles in the differentiation of patients with and without SLAC wrist (p degenerative wrist disease, with potential prognostic implications in patients with wrist trauma and scapholunate ligament ruptures.

Assessment of trunk muscle density using CT and its association with degenerative disc and facet joint disease of the lumbar spine

International Nuclear Information System (INIS)

Sebro, Ronnie; O'Brien, Liam; Torriani, Martin; Bredella, Miriam A.

2016-01-01

The purpose of this study was (1) to evaluate the association of trunk muscle density assessed by computed tomography (CT) with age, gender, and BMI and (2) to evaluate the association between trunk muscle CT density and degenerative disc and facet joint disease of the lumbar spine. The study was IRB approved and HIPAA compliant. The study group comprised 100 subjects (mean age 44.4 ± 22.2 years, 51 % male) who underwent CT of the abdomen and pelvis without intravenous contrast. Exclusion criteria included prior abdominal or spine surgery, active malignancy and scoliosis. CTs were reviewed and the attenuation of the rectus abdominis, transverse abdominis, internal and external obliques, psoas, multifidus, longissimus and gluteus maximus were measured bilaterally at consistent levels. Degenerative disc and bilateral facet joint disease were scored using established methods. Univariate analyses were performed using linear regression. Multivariate linear regression was performed to adjust for age, gender and BMI. CT density of each trunk muscle correlated inversely with age (p < 0.001) and BMI (p < 0.001). CT density of each trunk muscle correlated inversely with degenerative disc and facet joint disease in the univariate analyses (p < 0.001); however, only the gluteus maximus and the transverse abdominis remained significant predictors of degenerative disc and facet joint disease respectively in the multivariate analysis. Fatty infiltration of trunk musculature increases with age and BMI. Fatty infiltration of the gluteus maximus and transverse abdominis are associated with degenerative disc and facet joint disease, independent of age, gender and BMI. (orig.)

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

International Nuclear Information System (INIS)

Kuenzel, W.; Breit, S.; Knaus, I.

2002-01-01

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)

Computerized tomography in the diagnosis of degenerative vertebral diseases

International Nuclear Information System (INIS)

Bokarev, V.S.; Savchenko, A.P.; Ternovoj, S.K.

1989-01-01

CT and roentgenography were used for the investigation of 78 patients with the radicular syndrome. The state of the intervertebral disks, intervertebral joints and cerebrospinal canal in degenerative vertebral diseases was assessed. CT permits the detection of hernia, protrusion of the intervertebral disks, deformity of the intervertebral joints, and the narrowing of the cerebrospinal canal as a result of degenerative changes, as well as establishing the cause of the affection of neural structures in the cerebrospinal canal, radicular holes. CT possesses some advantages over roentgenography in the diagnosis of degenerative vertebral diseases

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)

Martini, F.M.; Pezzoli, G.; Borghetti, P.; Benazzi, C.

1997-01-01

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 [it

A radiological study on the degenerative joint disease of the lumbar spine in Korean adult men below the age of forty

International Nuclear Information System (INIS)

Lee, Sook Hi; Lee, Sang Seun

1979-01-01

It is generally believed that this disease is a degenerative process, a part of the general phenomena, hastened by excessive functional demand and a decreasing efficiency of blood supply. Though degenerative joint disease is the commonest of all ailments, its manifestations do not appear as a rule until the fourth or fifth decade, and it is not always easy to diagnose because we know less about it than about many less common types. Little information is available on its frequency in person below the age of forty. The present study was designed to obtain more precise information about development of this disease in person below the age of forty. After a detailed clinical examination, x-ray findings of a total of 566 men with low back pain checked at the Department of Radiology, National Public Hospital from Jan. 1976 to Dec. 1978 were received. The following result were obtained: 1. 111 (19.6%) of the 566 men had radiologic evidence of degenerative disease in lumbar spine. The degenerative joint disease first appeared on the age of 26. The degenerative joint disease was found in 16 (14.9%) of the 107 men between 25 and 29 years old, 14 (16.3%) of the 86 men between 35 and 39 years old, 31 (27.4%) of the 113 men between 35 and 39 years old, and 50 (50%) of the 100 between 40 and 44 years old. 2.The 4th lumbar spine was most commonly involved, being in 82.0% of the cases, and less frequent sites were the 5th lumbar spine (67.6%), the 3rd lumbar spine (51.3%), the 2nd lumbar spine (18.9%) and the 1st lumbar spine (3.6%). 38 (28.8%) of the 111 cases revealed single level involvement, but 79 (71.2%) cases showed multiple level involvement with the highest incidence at 14 and 15. 3. 111 cases of the 566 revealed marginal spurring. Bridging was noted in 8 cases, space narrowing 8 cases, and eburnation 7 caes.

Primary degenerative joint disease of the shoulder in a colony of Beagles

International Nuclear Information System (INIS)

Morgan, J.P.; Pool, R.R.; Miyabayashi, T.

1987-01-01

Shoulder joints of 149 Beagles over 8 years old at the time of death (mean age, 13.8 years +/- 3.21), were examined radiographically throughout their life-times for the frequency of degenerative joint disease (DJD). Clinical histories revealed no underlying cause for DJD. The shoulder joints of a subgroup of 18 dogs were examined at necropsy, and thin sections of the joints were evaluated radiographically and histologically. Serial clinical radiographic studies indicated that normal shoulder joint development during the first year of life was followed by the appearance of subchondral bone sclerosis and bony remodeling of normal joint contour, and by the formation of periarticular osteophytes and enthesiophytes. All changes were progressive with age and typical for DJD in dogs. Bilateral involvement was common. Evaluation of specimens obtained at necropsy revealed: articular cartilage change with roughening of the surface layer, degeneration and death of superficial chondrocytes, exposure of deeper layers of chondrocytes that had proliferated with fissuring of the damaged cartilage, total cartilage loss with polishing of the exposed subchondral bone, mixed patterns of subchondral bone sclerosis and osteoporosis, change in contour of the articular surfaces, and formation of periarticular osteophytes and enthesiophytes. Joint capsule thickening, synovitis, pannus formation, and synovial chondroma formation were observed. Because of the available clinical information, in addition to the typical changes of DJD, it was thought that the changes were primary. Instability appeared to play a role in the pathogenesis of the joint disease described; however, it was not clear whether the instability caused abnormal forces on healthy cartilage or whether the primary cartilage wear caused the instability

[The impact of the spa therapy on reduction of the perception of pain intensity in patients with degenerative joints and disc disease].

Science.gov (United States)

Kuciel-Lewandowska, Jadwiga; Paprocka-Borowicz, Małgorzata

2015-01-01

Degenerative joints and disc disease is accompanied by chronic pain which is the main symptom of the disease. Medical spa therapy has the task of providing comprehensive treatment embracing diseases of limbs as well as other systems and the essential role of medical treatment, in particular spa therapy, is pain relief. The aim of the study was to evaluate the effect of the spa treatment on the level of pain perception in patients with degenerative joints and disc disease. The observation embraced 120 people with degenerative joints and disc disease treated in the spa. The study included a comprehensive therapy conducted over a 21-day stays at the spa Przerzeczyn-Zdrój with the application of selected physical treatments, physiotherapy and the use of therapeutic natural resources: peloid mud and healing radon-sulphide water. Moreover, there was psychological counseling and health education conducted. The study also included observation of 21 persons from the control group. However, the patients in the control group did not benefit from balneotherapy, psychological care and education. There was a standard VAS scale for pain and non-standard questionnaire of pain assessment constructed for the study purposes. The assessment of pain using the VAS scale and questionnaire of pain assessment both in the study group and the control group were performed before and after the treatment. The results were analyzed statistically, there was Statistica program in Polish version used. In the analysis of the obtained results there were two tests scheduled: the sign test, the Wilcoxon test and descriptive statistics. As a result of the spa therapy and treatments administered on an outpatient basis there was reduction of pain intensity observed. 1. Spa therapy and outpatient treatment reduce the level of pain in patients with degenerative joints and disc disease. 2. The reduction of pain level was more effective in case of therapy conducted in the spa.

Brachygnathia superior and degenerative joint disease: a new lethal syndrome in Angus calves.

Science.gov (United States)

Jayo, M; Leipold, H W; Dennis, S M; Eldridge, F E

1987-03-01

Brachygnathia superior and generalized diarthrodial degenerative joint disease were seen in 17 related, purebred Angus calves ranging in age from 2 days to 4 months. Craniometrical studies revealed decreased maxillary and palatine bone lengths and increased cranial, skull, and facial indices. Radiological evaluation of major appendicular joints demonstrated lipping of the joint margins with osteophyte formation, sclerosis of subchondral bone, and narrowing of joint spaces. Synovial fluid evaluation indicated joint degeneration but no etiologic agent. Rheumatoid factor analysis of plasma was negative. Grossly, all major appendicular joints were defective including the atlanto-occipital articulation. Lesions ranged from loss of surface luster to erosions and deep ulcers with eburnation of the subchondral bone and secondary proliferative synovitis. Histological changes were degeneration of the articular cartilage matrix, chondrocyte necrosis, flaking and fibrillation, chondrone formation, erosions and ulcers of the articular cartilage with subchondral bone sclerosis, vascular invasion with fibrosis, and chronic, nonsuppurative, proliferative synovitis. Growth plates had defective chondrocyte proliferation and hypertrophy with aberrant ossification of calcified cartilaginous matrix. Histochemical analysis of cartilage and bone failed to incriminate which component was defective, glycosaminoglycan or collagen, but indicated different distribution or absence of one or the other. Genealogic studies revealed a genetic basis for the new defect.

Degenerative Changes of the Facet Joints in Adults With Lumbar Spondylolysis.

Science.gov (United States)

Goda, Yuichiro; Sakai, Toshinori; Harada, Taihei; Takao, Shoichiro; Takata, Yoichiro; Higashino, Kosaku; Harada, Masafumi; Sairyo, Koichi

2017-07-01

Radiologic analysis using computed tomography. To analyze the degenerative changes of the facet joints in patients with spondylolysis in comparison with control subjects. Defects of the pars interarticularis are thought to result in a reduction of biomechanical stress on adjacent facet joints. Therefore, degenerative changes of the facet joints in patients with spondylolysis are expected to be less than those in patients without spondylolysis. Abdominal and pelvic multidetector computed tomography scans of 2000 subjects, performed for conditions unrelated to low back pain, were reviewed. A total of 107 patients (37 women and 70 men) with L5 spondylolysis were identified [spondylolysis (+) group]. Sex-matched and age-matched controls without spondylolysis were chosen randomly [spondylolysis (-) group]. Subjects in the spondylolysis group were subdivided into either bilateral spondylolysis or unilateral spondylolysis groups for comparison with the control group. Four radiologic findings (narrowing, sclerosis, osteophyte, and bone cyst) indicative of degenerative change of the facet joints adjacent to the L5 pars defects were evaluated and the degree of degenerative change was graded by summing the number of degenerative changes (score range, 0-4). The χ test and Mann-Whitney U test were used for statistical analysis. Significantly more degenerative changes in both L4/L5 and L5/S facet joints were found in the spondylolysis (+) group than in the spondylolysis (-) group (χ test, P spondylolysis (+) group than in the spondylolysis (-) group. Degenerative changes of the facet joints at both L4/L5 and L5/S were more severe in the unilateral spondylolysis (+) group than in the spondylolysis (-) group. Degenerative changes of the facet joints in patients with lumbar spondylolysis were more severe than those without spondylolysis.

Degenerative Nerve Diseases

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Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many ... viruses. Sometimes the cause is not known. Degenerative nerve diseases include Alzheimer's disease Amyotrophic lateral sclerosis Friedreich's ...

Physical Therapy in Elderly Suffering from Degenerative Diseases.

Science.gov (United States)

Svraka, Emira; Pecar, Muris; Jaganjac, Amila; Hadziomerovic, Amra Macak; Kaljic, Eldad; Kovacevic, Almir

2017-12-01

Osteoarthritis of the joints (osteoarthritis or arthritis) represents the largest group of rheumatic diseases. Within rheumatic diseases 50% are degenerative rheumatic diseases, 10% inflammatory and 40% extra-articular. To determine the modalities of physical therapy for elderly with degenerative diseases. The study is retrospective-prospective and descriptive. The survey conducted included 25 patients with degenerative diseases of the musculoskeletal and nervous systems in Gerontology Center in Sarajevo, from May 1, 2014- April 30, 2015. As research instruments were used: Questionnaire for users of physical therapy in Gerontology Center in Sarajevo, self-developed, visual-analog scale to assess pain and patient records. Of the total number of patients with degenerative diseases (25), 10 (40%) were male and 15 (60%) were female. The most common degenerative disease is knee osteoarthritis which had 11 patients (29%), 3 males and 8 females. From physical therapy modalities in the treatment of degenerative diseases at the Gerontology Center in Sarajevo, kinetic therapy was administered to all patients, followed by manual massage and TENS in 15 cases (60%). From twenty-two patients, who completed a questionnaire, 11 (50%, 2 male and 9 female) rated their health as poor. Seven patients (32%, 3 male and 4 female) assessed their health as good. Three patients (14%, 2 male and 1 female) rated their health as very poor, and one patient (4%, 1 male) rated its health as very good. The Research Physical therapy in elderly with degenerative diseases is a pilot project, which highlights the need for: Conducting research for a longer time period, with a larger sample; Quality of keeping health records; Implementation of a continuous evaluation of functional status and; Stricter control for optimal effectiveness of physical therapy in order to improve the quality of life of elderly patients.

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)

Eksell, P.

2000-01-01

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

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

Directory of Open Access Journals (Sweden)

Sarah Broeckx

Full Text Available 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.

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

International Nuclear Information System (INIS)

Smith, G.K.; Popovitch, C.A.; Gregor, T.P.; Shofer, F.S.

1995-01-01

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

Radiologic manifestations of degenerative-dystrophic lesion of false joints of the limbs

International Nuclear Information System (INIS)

Novikov, V.P.

1980-01-01

There have been examined 752 patients with false joints and defects of articular ends of the long tubular bones. Various forms of degenerative-dystrophic lesion of the false joints and neoarthrosis which developed after resection of the articular end, as well as of other sections of bones and joints preconditioned by the long-term overload, have been studied in that group. Degenerative-dystrophic damage has been established to be one of the main causes of secondary sub-and decompensation that manifests by cystic transformation, aseptic necrosis and, in extremely rare cases, deforming arthrosis of the former lesion area. Similar alterations in the adjacent and distant overloaded sections of bones and joints are also thought to belong to causative factors. The importance of the timely multiple X-ray examination has been shown, particularly in detecting early manifestations of degenerative-dystrophic lesion in clinical and preclinical phases

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

Science.gov (United States)

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

2012-01-27

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. 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). 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.

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

Directory of Open Access Journals (Sweden)

Lascelles B Duncan X

2012-01-01

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.

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

International Nuclear Information System (INIS)

Lee, Shi-Uk; Lang, Philipp

2000-01-01

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

Joint diseases

International Nuclear Information System (INIS)

Weissman, S.D.

1989-01-01

The authors discuss how x-ray examination is essential in the diagnosis and evaluation of the arthritides. Most arthritides are first suspected by the clinician, and x-ray evaluation of these entities along with laboratory testing is important for confirmation of the clinical diagnosis and in staging of the disease process. Several arthritides are often diagnosed first by the podiatrist on x-ray evaluation, including pseudogout, ankylosing spondylitis, early rheumatoid arthritis, degenerative joint disease, and tuberculosis of bone. The joint responds to insult in only a limited number of ways that become apparent on x-ray. The soft tissues surrounding the joint, the articulating bones, and alignment of the joint space may all be involved by the arthritic process. On roentgenographic examination, the soft tissues must be examined for edema, masses, calcifications, and atrophy. The articulating bones must be examined for demineralization, erosions, osteophytes, periosteal reaction, cysts and sclerosis

Pathological study of degenerative changes of finger joints in cadavers of aged persons

OpenAIRE

岩田,芳之

1987-01-01

In the present study, soft x-ray and light microscopic examinations were carried out on 17 interphalangeal (IP) joints and 85 distal interphalangeal (DIP) joints with Heberden's nodes from 15 cadavers. Microradiograms of the IP and DIP joints were analyzed as to the degenerative changes in the antero-posterior and lateral views according to our own criteria. Degenerative changes were more severe in females than in males. Advanced degeneration was found in the index, middle and little fingers,...

[Urinary incontinence in degenerative spinal disease].

Science.gov (United States)

De Riggo, J; Benčo, M; Kolarovszki, B; Lupták, J; Svihra, J

2011-01-01

The aim of the study was to evaluate the presence of urinary incontinence in patients with chronic degenerative spinal disease and to identify factors affecting the occurrence and changes in urinary incontinence after surgery. The group evaluated comprised 214 patients undergoing surgery for degenerative spinal disease at our department between January 1 and December 31, 2008. The patients were categorised according to the type of their degenerative disease (cervical disc herniation, lumbar disc herniation, spinal stenosis, spinal instability or olisthesis) and the spine level involved (cervical or lumbar spine). The symptoms of urinary incontinence included leakage of urine and non-obstructive chronic urinary retention developing in association with the manifestation of vertebrogenic disorder. Patients with diseases known to increase the risk of incontinence were not included in the study. Based on a retrospective analysis of the patients' clinical notes, the occurrence of urinary incontinence in each type of degenerative spinal disease was assessed. The effect of gender, age, body mass index (BMI), neurological status and spinal disease type on the development of incontinence was statistically evaluated. The efficacy of surgical treatment was assessed on the basis of the patients' subjective complaints at the first follow-up one month after surgery. The data were evaluated by the statistical programme InSTAT (analysis of variance ANOVA, t-test). All tests were two-sided; a 0.05 level of statistical significance was used. Of the 214 patients with degenerative spinal disease, 27 (12.6%) had urinary incontinence. A higher risk of developing incontinence was found in women (p = 0.008) and in patients with radicular weakness (p = 0.023). The patients with urinary incontinence had their BMI significantly lower than patients without this disorder (p = 0.019). Age had no effect. The differences in the occurrence of urinary incontinence amongst the different types of

The influence of the body weight index (BMI in the recovery of the degenerative diseases of the joints

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Sînziana Călina Silişteanu

2016-05-01

Full Text Available Objective: The trial proposes the evaluation of an efficient kinetic programme supported by hygiene and diet for the patients with degenerative diseases at the level of the joints. Material and method: The trial was carried out under ambulatory conditions for a period of six months and it included two lots of patients diagnosed with degenerative diseases at the level of the hips and of the knees. They used a complex physical kinetic therapeutic treatment supported by a diet. The lots were evaluated according to the pain scale VAS, to the scale WOMAC, to the quality of life index QOL and to the body weight index BMI. The family’s involvement was also monitored during the patients’ recovery period. The results pointed out that the patients who had followed a complex physical kinetic therapeutic treatment and a diet had significantly better results in comparison to the ones who did not follow the indications of the diet. It was noticed that some patients abandoned the physical exercises, predominantly the women. Conclusions: The complex recovery treatment depends on a complex team: the physician, the physio-kinetic therapist, the nutritionist, the dietetician and the psychologist. The profilaxy of these diseases is very important and the treatment has to be individualised. It was noticed that the motivation and the education were defining elements for the recovery. It is also worth mentioning the involvement of the family/friends in the period of recovery treatment.

Temporomandibular joint

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Westesson, P.L.; Hatala, M.; Tallents, R.H.; Katzberg, R.W.; Musgrave, M.; Levitt, S.

1990-01-01

This paper determines the frequency of MR signs of abnormal temporomandibular joints (TMJs) in asymptomatic volunteers. Forty-two volunteers with 84 clinically normal TMJs were imaged in the sagittal and coronal planes with surface coil MR imaging. Sagittal closed and open and coronal closed views were obtained bilaterally in all volunteers. The images were classified as normal (superior disk position) or abnormal (disk displacement of degenerative joint disease). Eighteen joints in 11 volunteers were abnormal; 12 had disk displacement with reduction and six had disk displacement without reduction, with associated degenerative joint disease in three of the six. Asymptomatic internal derangement and degenerative joint disease occur in about one-fourth of asymptomatic volunteers

Mitochondrial dysfunction in the neuro-degenerative and cardio-degenerative disease, Friedreich's ataxia.

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Chiang, Shannon; Kalinowski, Danuta S; Jansson, Patric J; Richardson, Des R; Huang, Michael L-H

2017-08-04

Mitochondrial homeostasis is essential for maintaining healthy cellular function and survival. The detrimental involvement of mitochondrial dysfunction in neuro-degenerative diseases has recently been highlighted in human conditions, such as Parkinson's, Alzheimer's and Huntington's disease. Friedreich's ataxia (FA) is another neuro-degenerative, but also cardio-degenerative condition, where mitochondrial dysfunction plays a crucial role in disease progression. Deficient expression of the mitochondrial protein, frataxin, is the primary cause of FA, which leads to adverse alterations in whole cell and mitochondrial iron metabolism. Dys-regulation of iron metabolism in these compartments, results in the accumulation of inorganic iron deposits in the mitochondrial matrix that is thought to potentiate oxidative damage observed in FA. Therefore, the maintenance of mitochondrial homeostasis is crucial in the progression of neuro-degenerative conditions, particularly in FA. In this review, vital mitochondrial homeostatic processes and their roles in FA pathogenesis will be discussed. These include mitochondrial iron processing, mitochondrial dynamics (fusion and fission processes), mitophagy, mitochondrial biogenesis, mitochondrial energy production and calcium metabolism. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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Morimoto, Daijiro; Isu, Toyohiko; Shimoda, Yuusuke; Hamauchi, Shuuji; Sasamori, Tooru; Sugawara, Atsushi; Kim, Kyongsong; Matsumoto, Ryouji; Isobe, Masanori

2009-09-01

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

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

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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

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.)

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)

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

2007-01-01

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.)

Contribution of microglia-mediated neuroinflammation to retinal degenerative diseases.

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Madeira, Maria H; Boia, Raquel; Santos, Paulo F; Ambrósio, António F; Santiago, Ana R

2015-01-01

Retinal degenerative diseases are major causes of vision loss and blindness worldwide and are characterized by chronic and progressive neuronal loss. One common feature of retinal degenerative diseases and brain neurodegenerative diseases is chronic neuroinflammation. There is growing evidence that retinal microglia, as in the brain, become activated in the course of retinal degenerative diseases, having a pivotal role in the initiation and propagation of the neurodegenerative process. A better understanding of the events elicited and mediated by retinal microglia will contribute to the clarification of disease etiology and might open new avenues for potential therapeutic interventions. This review aims at giving an overview of the roles of microglia-mediated neuroinflammation in major retinal degenerative diseases like glaucoma, age-related macular degeneration, and diabetic retinopathy.

Degenerative-dystrophic diseases

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Vinner, M.G.

1983-01-01

Differential diagnosis of degenerative-dystrophic diseases of lungs, such a s acquired emphysema and progressing dystrophy of lungs, has been elucidated. I t is shown, that roentgenofunctional tests are of a great diagnostic value. Roe ntgenologic and bronchographic rictures of different forms of emphysema and dystrophy of lungs are described

Correlation between facet tropism and lumbar degenerative disease: a retrospective analysis.

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Gao, Tian; Lai, Qi; Zhou, Song; Liu, Xuqiang; Liu, Yuan; Zhan, Ping; Yu, Xiaolong; Xiao, Jun; Dai, Min; Zhang, Bin

2017-11-22

The aim of this study was to investigate the correlation between facet tropism and spinal degenerative diseases, such as degenerative lumbar spondylolisthesis, degenerative lumbar scoliosis, and lumbar disc herniation. This study retrospectively analysed clinical data from the Department of Orthopaedics at The First Affiliated Hospital of Nanchang University. Ninety-two patients were diagnosed with lumbar spondylolisthesis, 64 patients with degenerative scoliosis, and 86 patients with lumbar disc herniation between 1 October 2014 and 1 October 2016. All patients were diagnosed using 3.0 T magnetic resonance imaging and underwent conservative or operative treatment. Facet tropism was defined as greater than a ten degree between the facet joint angles on both sides. For L3-L4 degenerative lumbar spondylolisthesis, one out of six cases had tropism compared to seven out of the 86 controls (p = 0.474). At the L4-L5 level, 17/50 cases had tropism compared to 4/42 cases in the control group (p = 0.013). At the L5-S1 level, 18/36 cases had tropism compared to 7/56 controls (p = 0.000). For degenerative lumbar scoliosis at the L1-L5 level, 83/256 cases had tropism as compared to 36/256 controls (p = 0.000). For L3-L4 lumbar disc herniation two out of eight cases had tropism compared to 14/78 controls (p = 0.625). At the L4-L5 level, 19/44 cases had tropism compared to four out of 42 controls (p = 0.001). At the L5-S1 level, 24/34 cases had tropism compared to 10/52 controls (p = 0.000). At the L4-5 and L5-S1 levels, facet tropism is associated with degenerative spondylolisthesis. In the degenerative lumbar scoliosis group, the number of case with facet tropism was significantly higher than that of the control group. Facet tropism was associated with lumbar disc herniation at the L4-5 and L5-S1 levels. Overall, in these three lumbar degenerative diseases, facet tropism is a common phenomenon.

Association between disk position and degenerative bone changes of the temporomandibular joints: an imaging study in subjects with TMD.

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Cortés, Daniel; Sylvester, Daniel Cortés; Exss, Eduardo; Marholz, Carlos; Millas, Rodrigo; Moncada, Gustavo

2011-04-01

The aim of this study was to determine the frequency and relationship between disk position and degenerative bone changes in the temporomandibular joints (TMJ), in subjects with internal derangement (ID). MRI and CT scans of 180 subjects with temporomandibular disorders (TMD) were studied. Different image parameters or characteristics were observed, such as disk position, joint effusion, condyle movement, degenerative bone changes (flattened, cortical erosions and irregularities), osteophytes, subchondral cysts and idiopathic condyle resorption. The present study concluded that there is a significant association between disk displacement without reduction and degenerative bone changes in patients with TMD. The study also found a high probability of degenerative bone changes when disk displacement without reduction is present. No association was found between TMD and condyle range of motion, joint effusion and/or degenerative bone changes. The following were the most frequent morphological changes observed: flattening of the anterior surface of the condyle; followed by erosions and irregularities of the joint surfaces; flattening of the articular surface of the temporal eminence, subchondral cysts, osteophytes; and idiopathic condyle resorption, in decreasing order.

Physiochemical basis of human degenerative disease.

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Zeliger, Harold I; Lipinski, Boguslaw

2015-03-01

The onset of human degenerative diseases in humans, including type 2 diabetes, cardiovascular disease, neurological disorders, neurodevelopmental disease and neurodegenerative disease has been shown to be related to exposures to persistent organic pollutants, including polychlorinated biphenyls, chlorinated pesticides, polybrominated diphenyl ethers and others, as well as to polynuclear aromatic hydrocarbons, phthalates, bisphenol-A and other aromatic lipophilic species. The onset of these diseases has also been related to exposures to transition metal ions. A physiochemical mechanism for the onset of degenerative environmental disease dependent upon exposure to a combination of lipophilic aromatic hydrocarbons and transition metal ions is proposed here. The findings reported here also, for the first time, explain why aromatic hydrocarbons exhibit greater toxicity than aliphatic hydrocarbons of equal carbon numbers.

Physiochemical basis of human degenerative disease

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Zeliger Harold I.

2015-03-01

Full Text Available The onset of human degenerative diseases in humans, including type 2 diabetes, cardiovascular disease, neurological disorders, neurodevelopmental disease and neurodegenerative disease has been shown to be related to exposures to persistent organic pollutants, including polychlorinated biphenyls, chlorinated pesticides, polybrominated diphenyl ethers and others, as well as to polynuclear aromatic hydrocarbons, phthalates, bisphenol-A and other aromatic lipophilic species. The onset of these diseases has also been related to exposures to transition metal ions. A physiochemical mechanism for the onset of degenerative environmental disease dependent upon exposure to a combination of lipophilic aromatic hydrocarbons and transition metal ions is proposed here. The findings reported here also, for the first time, explain why aromatic hydrocarbons exhibit greater toxicity than aliphatic hydrocarbons of equal carbon numbers.

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)

Langenbach, A.; Giger, U.; Green, P.; Rhodes, H.; Gregor, T.P.; Lafond, E.; Smith, G.

1998-01-01

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

Biomechanical analysis of press-extension technique on degenerative lumbar with disc herniation and staggered facet joint

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Hong-gen Du

2016-05-01

Full Text Available This study investigates the effect of a new Chinese massage technique named “press-extension” on degenerative lumbar with disc herniation and facet joint dislocation, and provides a biomechanical explanation of this massage technique. Self-developed biomechanical software was used to establish a normal L1–S1 lumbar 3D FE model, which integrated the spine CT and MRI data-based anatomical structure. Then graphic technique is utilized to build a degenerative lumbar FE model with disc herniation and facet joint dislocation. According to the actual press-extension experiments, mechanic parameters are collected to set boundary condition for FE analysis. The result demonstrated that press-extension techniques bring the annuli fibrosi obvious induction effect, making the central nucleus pulposus forward close, increasing the pressure in front part. Study concludes that finite element modelling for lumbar spine is suitable for the analysis of press-extension technique impact on lumbar intervertebral disc biomechanics, to provide the basis for the disease mechanism of intervertebral disc herniation using press-extension technique.

Degenerative disease of the spine

International Nuclear Information System (INIS)

Czervionke, L.F.; Daniels, D.L.

1991-01-01

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

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

International Nuclear Information System (INIS)

Noelte, Ingo; Gerigk, Lars; Brockmann, Marc A.; Kemmling, Andre; Groden, Christoph

2008-01-01

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.)

Skipping Posterior Dynamic Transpedicular Stabilization for Distant Segment Degenerative Disease

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Bilgehan Solmaz

2012-01-01

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

[Degenerative cerebellar diseases and differential diagnoses].

Science.gov (United States)

Reith, W; Roumia, S; Dietrich, P

2016-11-01

Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions.

Minimally invasive surgical treatment options for patients with degenerative lumbar spine disease

International Nuclear Information System (INIS)

Durny, P.

2014-01-01

The most common cause of reduced activity in working people is degenerative disc disease and spondylosis of lumbar spine. The variety of clinical findings such as segmental lumbago or severe form of mixed radicular compression syndromes can be occurred. Neurosurgical intervention is indicated in case of failure of conservative treatment and graphical findings correlating with a clinical picture. Large decompressive surgical procedures can destabilize segments previously affected. Recommendations from recent years suggested the functional reconstruction of damaged parts of the vertebrae, intervertebral discs and joints. Continuously improving surgical procedures and instrumentations, intended for operative treatment of lumbar spine degenerative diseases is primarily an effort to improve the properties of implants while minimizing tissue damage during the approach to the target structure. To protect functions of active spine stabilizer and paraspinal muscles is an important factor for the final outcome of the operation. Depend on the nature and extent of the disease the approaches to the spine can be an anterior, lateral and posterior as open surgery or minimally invasive procedures. (author)

Radiology of chronic diseases of the ankle joint

International Nuclear Information System (INIS)

Rand, T.; Trattnig, S.; Breitenseher, M.; Imhof, H.; Wagesreither, S.

1999-01-01

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

Degenerative cerebellar diseases and differential diagnoses

International Nuclear Information System (INIS)

Reith, W.; Roumia, S.; Dietrich, P.

2016-01-01

Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions. (orig.) [de

Characterization of Individuals with Sacroiliac Joint Bridging in a Skeletal Population: Analysis of Degenerative Changes in Spinal Vertebrae

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Takeshi Imamura

2014-01-01

Full Text Available The aim of this study was to characterize the individuals with sacroiliac joint bridging (SIB by analyzing the degenerative changes in their whole vertebral column and comparing them with the controls. A total of 291 modern Japanese male skeletons, with an average age at death of 60.8 years, were examined macroscopically. They were divided into two groups: individuals with SIB and those without bridging (Non-SIB. The degenerative changes in their whole vertebral column were evaluated, and marginal osteophyte scores (MOS of the vertebral bodies and degenerative joint scores in zygapophyseal joints were calculated. SIB was recognized in 30 individuals from a total of 291 males (10.3%. The average of age at death in SIB group was significantly higher than that in Non-SIB group. The values of MOS in the thoracic spines, particularly in the anterior part of the vertebral bodies, were consecutively higher in SIB group than in Non-SIB group. Incidence of fused vertebral bodies intervertebral levels was obviously higher in SIB group than in Non-SIB group. SIB and marginal osteophyte formation in vertebral bodies could coexist in a skeletal population of men. Some systemic factors might act on these degenerative changes simultaneously both in sacroiliac joint and in vertebral column.

Characterization of Individuals with Sacroiliac Joint Bridging in a Skeletal Population: Analysis of Degenerative Changes in Spinal Vertebrae

Science.gov (United States)

Imamura, Takeshi; Saiki, Kazunobu; Okamoto, Keishi; Maeda, Junichiro; Matsuo, Hiroaki; Wakebe, Tetsuaki; Ogami, Keiko; Tomita, Masato; Tagami, Atsushi; Shindo, Hiroyuki; Tsurumoto, Toshiyuki

2014-01-01

The aim of this study was to characterize the individuals with sacroiliac joint bridging (SIB) by analyzing the degenerative changes in their whole vertebral column and comparing them with the controls. A total of 291 modern Japanese male skeletons, with an average age at death of 60.8 years, were examined macroscopically. They were divided into two groups: individuals with SIB and those without bridging (Non-SIB). The degenerative changes in their whole vertebral column were evaluated, and marginal osteophyte scores (MOS) of the vertebral bodies and degenerative joint scores in zygapophyseal joints were calculated. SIB was recognized in 30 individuals from a total of 291 males (10.3%). The average of age at death in SIB group was significantly higher than that in Non-SIB group. The values of MOS in the thoracic spines, particularly in the anterior part of the vertebral bodies, were consecutively higher in SIB group than in Non-SIB group. Incidence of fused vertebral bodies intervertebral levels was obviously higher in SIB group than in Non-SIB group. SIB and marginal osteophyte formation in vertebral bodies could coexist in a skeletal population of men. Some systemic factors might act on these degenerative changes simultaneously both in sacroiliac joint and in vertebral column. PMID:25276825

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

International Nuclear Information System (INIS)

Zanetti, Marco; Hodler, Juerg

2000-01-01

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

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

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

2000-08-01

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.

Nanotechnology and nanocarrier-based approaches on treatment of degenerative diseases

Science.gov (United States)

Chowdhury, Anindita; Kunjiappan, Selvaraj; Panneerselvam, Theivendren; Somasundaram, Balasubramanian; Bhattacharjee, Chiranjib

2017-04-01

Degenerative diseases are results of deterioration of cells and tissues with aging either by unhealthy lifestyle or normal senescence. The degenerative disease likely affects central nervous system and cardiovascular system to a great extent. Certain medications and therapies have emerged for the treatment of degenerative diseases, but in most cases bearing with poor solubility, lower bioavailability, drug resistance, and incapability to cross the blood-brain barrier (BBB). Hence, it has to be overcome with conventional treatment system; in this connection, nanotechnology has gained a great deal of interest in recent years. Moreover, nanotechnology and nanocarrier-based approach drug delivery system could revolutionize the treatment of degenerative diseases by faster absorption of drug, targeted interaction at specific site, and its release in a controlled manner into human body with minimal side effects. The core objective of this review is to customize and formulate therapeutically active molecules with specific site of action and without affecting other organs and tissues to obtain effective result in the improvement of quality of health. In addition, the review provides a concise insight into the recent developments and applications of nanotech and nanocarrier-based drug delivery for the treatment of various degenerative diseases.

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

International Nuclear Information System (INIS)

Bernal, P.; Ucros, G.; Bermudez, S.; Ocampo, M.

2007-01-01

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

Neuromuscular exercise as treatment of degenerative knee disease

DEFF Research Database (Denmark)

Ageberg, Eva; Roos, Ewa M.

2015-01-01

Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional...... instability associated with the degenerative knee disease than traditionally used training methods.SUMMARY FOR TABLE OF CONTENTS PAGECurrent data suggests that the effect from neuromuscular exercise on pain and function is comparable to the effects seen from other forms of exercise....

Imaging of lumbar degenerative disk disease: history and current state

International Nuclear Information System (INIS)

Emch, Todd M.; Modic, Michael T.

2011-01-01

One of the most common indications for performing magnetic resonance (MR) imaging of the lumbar spine is the symptom complex thought to originate as a result of degenerative disk disease. MR imaging, which has emerged as perhaps the modality of choice for imaging degenerative disk disease, can readily demonstrate disk pathology, degenerative endplate changes, facet and ligamentous hypertrophic changes, and the sequelae of instability. Its role in terms of predicting natural history of low back pain, identifying causality, or offering prognostic information is unclear. As available modalities for imaging the spine have progressed from radiography, myelography, and computed tomography to MR imaging, there have also been advances in spine surgery for degenerative disk disease. These advances are described in a temporal context for historical purposes with a focus on MR imaging's history and current state. (orig.)

MR imaging of degenerative disc disease

International Nuclear Information System (INIS)

Farshad-Amacker, Nadja A.; Farshad, Mazda; Winklehner, Anna; Andreisek, Gustav

2015-01-01

Highlights: • This systematic literature review summarizes the current knowledge on MR imaging in degenerative disc disease. • Different classification systems for segmental spine degeneration are summarized. • It outlines the diagnostic limitations of MR imaging. - Abstract: Magnet resonance imaging (MRI) is the most commonly used imaging modality for diagnosis of degenerative disc disease (DDD). Lack of precise observations and documentation of aspects within the complex entity of DDD might partially be the cause of poor correlation of radiographic findings to clinical symptoms. This literature review summarizes the current knowledge on MRI in DDD and outlines the diagnostic limitations. The review further sensitizes the reader toward awareness of potentially untended aspects of DDD and the interaction of DDD and endplate changes. A summary of the available classifications for DDD is provided

MR imaging of degenerative disc disease

Energy Technology Data Exchange (ETDEWEB)

Farshad-Amacker, Nadja A., E-mail: nadja.farshad@usz.ch [Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich (Switzerland); Farshad, Mazda [Department of Orthopaedic Surgery, Balgrist University Hospital, Zurich (Switzerland); Winklehner, Anna; Andreisek, Gustav [Institute of Diagnostic and Interventional Radiology, University Hospital of Zurich, Zurich (Switzerland)

2015-09-15

Highlights: • This systematic literature review summarizes the current knowledge on MR imaging in degenerative disc disease. • Different classification systems for segmental spine degeneration are summarized. • It outlines the diagnostic limitations of MR imaging. - Abstract: Magnet resonance imaging (MRI) is the most commonly used imaging modality for diagnosis of degenerative disc disease (DDD). Lack of precise observations and documentation of aspects within the complex entity of DDD might partially be the cause of poor correlation of radiographic findings to clinical symptoms. This literature review summarizes the current knowledge on MRI in DDD and outlines the diagnostic limitations. The review further sensitizes the reader toward awareness of potentially untended aspects of DDD and the interaction of DDD and endplate changes. A summary of the available classifications for DDD is provided.

Serum and synovial fluid C-reactive protein level variations in dogs with degenerative joint disease and their relationships with physiological parameters.

Science.gov (United States)

Boal, S; Miguel Carreira, L

2015-09-01

Degenerative joint disease (DJD) is a progressive, chronic joint disease with an inflammatory component promoting an acute phase protein (APP) response. C-reactive protein (CRP) is one of the most important APPs, used as an inflammation marker in human, but not veterinary medicine. The study was developed in a sample of 48 dogs (n = 48) with DJD and aimed to: 1) identify and quantify the synovial fluid CRP (SFCRP) in these specimens using a validated ELISA test for serum CRP (SCRP) detection and quantification; and 2) to study the possible relationship between SCRP and SFCRP levels variations in DJD patients evaluating the influence of some physical parameters such as gender, body weight, pain level, DJD grade, and the physical activity (PA) of the patients. Statistical analysis considered the results significant for p values <0.05. Our study showed that it is possible to detect and quantify SFCRP levels in DJD patients using a previously validated canine SCRP ELISA test, allowing us to point out a preliminary reference value for SFCRP in patients with DJD. Although, individuals with DJD presents SCRP values within the normal reference range and the SFCRP levels were always lower. Obesity, pain, and the DJD grade presented by the patients are conditions which seem to influence the SCRP levels but not the SFCRP.

Degenerative cerebellar diseases and differential diagnoses; Degenerative Kleinhirnerkrankungen und Differenzialdiagnosen

Energy Technology Data Exchange (ETDEWEB)

Reith, W.; Roumia, S.; Dietrich, P. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

2016-11-15

Cerebellar syndromes result in distinct clinical symptoms, such as ataxia, dysarthria, dysmetria, intention tremor and eye movement disorders. In addition to the medical history and clinical examination, imaging is particularly important to differentiate other diseases, such as hydrocephalus and multi-infarct dementia from degenerative cerebellar diseases. Degenerative diseases with cerebellar involvement include Parkinson's disease, multiple system atrophy as well as other diseases including spinocerebellar ataxia. In addition to magnetic resonance imaging (MRI), nuclear medicine imaging investigations are also helpful for the differentiation. Axial fluid-attenuated inversion recovery (FLAIR) and T2-weighted sequences can sometimes show a signal increase in the pons as a sign of degeneration of pontine neurons and transverse fibers in the basilar part of the pons. The imaging is particularly necessary to exclude other diseases, such as normal pressure hydrocephalus (NPH), multi-infarct dementia and cerebellar lesions. (orig.) [German] Klinisch imponieren Kleinhirnsyndrome durch Ataxie, Dysarthrie, Dysmetrie, Intentionstremor und Augenbewegungsstoerungen. Neben der Anamnese und klinischen Untersuchung ist die Bildgebung v. a. wichtig um andere Erkrankungen wie Hydrozephalus und Multiinfarktdemenz von degenerativen Kleinhirnerkrankungen zu differenzieren. Zu den degenerativen Erkrankungen mit Kleinhirnbeteiligung gehoeren der Morbus Parkinson, die Multisystematrophie sowie weitere Erkrankungen einschliesslich der spinozerebellaeren Ataxien. Neben der MRT sind auch nuklearmedizinische Untersuchungen zur Differenzierung hilfreich. Axiale Fluid-attenuated-inversion-recovery(FLAIR)- und T2-gewichtete Sequenzen koennen mitunter eine Signalsteigerung im Pons als Ausdruck einer Degeneration der pontinen Neuronen und transversalen Bahnen im Brueckenfuss zeigen. Die Bildgebung ist aber v. a. notwendig, um andere Erkrankungen wie Normaldruckhydrozephalus

Diagnostic dilemma of degenerative joint disease, chronic avascular necrosis or metastasis in planar Tc-99m-methylene diphosphonate planar skeletal scintigraphy excluded by single positron emission computed tomography/computed tomography

International Nuclear Information System (INIS)

Jain, Tarun Kumar; Phulsunga, Rohit Kumar; Basher, Rajender Kumar; Kumar, Narendra; Bhattacharya, Anish; Mittal, Bhagwant Rai

2005-01-01

We present a 71-year-old male patient subjected to skeletal scintigraphy for metastasis work up of prostate cancer. Whole body planar images revealed a solitary focal tracer uptake in left femoral head mimicking as solitary metastatic focus. Single positron emission computed tomography/computed tomography images localized this increased tracer uptake to the subchondral cysts with minimal sclerosis in left femur head with no decrease in size of femur head and was reported as (degenerative joint disease)

Dietary Phytochemicals: Natural Swords Combating Inflammation and Oxidation-Mediated Degenerative Diseases.

Science.gov (United States)

Islam, Md Asiful; Alam, Fahmida; Solayman, Md; Khalil, Md Ibrahim; Kamal, Mohammad Amjad; Gan, Siew Hua

2016-01-01

Cumulatively, degenerative disease is one of the most fatal groups of diseases, and it contributes to the mortality and poor quality of life in the world while increasing the economic burden of the sufferers. Oxidative stress and inflammation are the major pathogenic causes of degenerative diseases such as rheumatoid arthritis (RA), diabetes mellitus (DM), and cardiovascular disease (CVD). Although a number of synthetic medications are used to treat these diseases, none of the current regimens are completely safe. Phytochemicals (polyphenols, carotenoids, anthocyanins, alkaloids, glycosides, saponins, and terpenes) from natural products such as dietary fruits, vegetables, and spices are potential sources of alternative medications to attenuate the oxidative stress and inflammation associated with degenerative diseases. Based on in vitro , in vivo , and clinical trials, some of these active compounds have shown good promise for development into novel agents for treating RA, DM, and CVD by targeting oxidative stress and inflammation. In this review, phytochemicals from natural products with the potential of ameliorating degenerative disease involving the bone, metabolism, and the heart are described.

Dietary Phytochemicals: Natural Swords Combating Inflammation and Oxidation-Mediated Degenerative Diseases

Directory of Open Access Journals (Sweden)

Md. Asiful Islam

2016-01-01

Full Text Available Cumulatively, degenerative disease is one of the most fatal groups of diseases, and it contributes to the mortality and poor quality of life in the world while increasing the economic burden of the sufferers. Oxidative stress and inflammation are the major pathogenic causes of degenerative diseases such as rheumatoid arthritis (RA, diabetes mellitus (DM, and cardiovascular disease (CVD. Although a number of synthetic medications are used to treat these diseases, none of the current regimens are completely safe. Phytochemicals (polyphenols, carotenoids, anthocyanins, alkaloids, glycosides, saponins, and terpenes from natural products such as dietary fruits, vegetables, and spices are potential sources of alternative medications to attenuate the oxidative stress and inflammation associated with degenerative diseases. Based on in vitro, in vivo, and clinical trials, some of these active compounds have shown good promise for development into novel agents for treating RA, DM, and CVD by targeting oxidative stress and inflammation. In this review, phytochemicals from natural products with the potential of ameliorating degenerative disease involving the bone, metabolism, and the heart are described.

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

International Nuclear Information System (INIS)

Marchegiani, Silvio; Guzman Urquhart, Romel; Marangoni, Alberto; Alvarez, Federico; Surur, Alberto

2006-01-01

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 joint dislocation without reduction. (author) [es

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

International Nuclear Information System (INIS)

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

2003-01-01

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 [pt

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

Science.gov (United States)

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

2013-01-01

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. 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. 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%). 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.

Postoperative braces for degenerative lumbar diseases

NARCIS (Netherlands)

Machado, Andre N.; Ayala, Ana Patricia; Rubinstein, Sidney M.; El Dib, Regina; Rodrigues, Luciano M.; Gotfryd, Alberto Ofenhejm; Tamaoki, Marcel Jun; Belloti, João Carlos

2017-01-01

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The primary objective is to evaluate the effectiveness of orthosis following lumbar spinal surgery for people with degenerative disease on pain reduction and improvement of functional status. Secondary objectives

Novel Insights into Acid-Sensing Ion Channels: Implications for Degenerative Diseases.

Science.gov (United States)

Zhou, Ren-Peng; Wu, Xiao-Shan; Wang, Zhi-Sen; Xie, Ya-Ya; Ge, Jin-Fang; Chen, Fei-Hu

2016-08-01

Degenerative diseases often strike older adults and are characterized by progressive deterioration of cells, eventually leading to tissue and organ degeneration for which limited effective treatment options are currently available. Acid-sensing ion channels (ASICs), a family of extracellular H(+)-activated ligand-gated ion channels, play critical roles in physiological and pathological conditions. Aberrant activation of ASICs is reported to regulate cell apoptosis, differentiation and autophagy. Accumulating evidence has highlighted a dramatic increase and activation of ASICs in degenerative disorders, including multiple sclerosis, Parkinson's disease, Huntington's disease, intervertebral disc degeneration and arthritis. In this review, we have comprehensively discussed the critical roles of ASICs and their potential utility as therapeutic targets in degenerative diseases.

Simple versus complex degenerative mitral valve disease.

Science.gov (United States)

Javadikasgari, Hoda; Mihaljevic, Tomislav; Suri, Rakesh M; Svensson, Lars G; Navia, Jose L; Wang, Robert Z; Tappuni, Bassman; Lowry, Ashley M; McCurry, Kenneth R; Blackstone, Eugene H; Desai, Milind Y; Mick, Stephanie L; Gillinov, A Marc

2018-07-01

At a center where surgeons favor mitral valve (MV) repair for all subsets of leaflet prolapse, we compared results of patients undergoing repair for simple versus complex degenerative MV disease. From January 1985 to January 2016, 6153 patients underwent primary isolated MV repair for degenerative disease, 3101 patients underwent primary isolated MV repair for simple disease (posterior prolapse), and 3052 patients underwent primary isolated MV repair for complex disease (anterior or bileaflet prolapse), based on preoperative echocardiographic images. Logistic regression analysis was used to generate propensity scores for risk-adjusted comparisons (n = 2065 matched pairs). Durability was assessed by longitudinal recurrence of mitral regurgitation and reoperation. Compared with patients with simple disease, those undergoing repair of complex pathology were more likely to be younger and female (both P values < .0001) but with similar symptoms (P = .3). The most common repair technique was ring/band annuloplasty (3055/99% simple vs 3000/98% complex; P = .5), followed by leaflet resection (2802/90% simple vs 2249/74% complex; P < .0001). Among propensity-matched patients, recurrence of severe mitral regurgitation 10 years after repair was 6.2% for simple pathology versus 11% for complex pathology (P = .007), reoperation at 18 years was 6.3% for simple pathology versus 11% for complex pathology, and 20-year survival was 62% for simple pathology versus 61% for complex pathology (P = .6). Early surgical intervention has become more common in patients with degenerative MV disease, regardless of valve prolapse complexity or symptom status. Valve repair was associated with similarly low operative risk and time-related survival but less durability in complex disease. Lifelong annual echocardiographic surveillance after MV repair is recommended, particularly in patients with complex disease. Copyright © 2018 The American Association for Thoracic Surgery

SENILE DEGENERATIVE CHANGES IN ADULT LUMBAR SPINE! - A PROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Garjesh Singh

2015-11-01

Full Text Available : BACKGROUND: Low back pain (LBP is a common presenting complaint affecting mostly middle aged and older person and traditionally considered as ageing process, but now-a-days large number of younger people are also affected by this debilitating chronic disorder. The cause of early onset of degenerative spine disease is multifactorial, but genetical predisposition plays very important role. AIMS AND OBJECTIVE: To find out association between genetic predisposition and degenerative spine disease in adult patients and to assess the pattern of MRI findings of various degenerative diseases in lumbo-sacral spine. MATERIAL AND METHOD: The present cross-sectional study had been performed among 100 selected patients in 1yr period, who presented with chief complaint of chronic low back pain. After taking detailed clinical and professional history, MRI of lumbosacral spine had been performed. Total 100 patients were divided in two groups on the basis of genetical predisposition. Prevalence and spectrum of degenerative changes were compared between both groups. RESULTS: Hundred patients of 20 to 35-year age had been selected with mean age of 27yr. Out of 100 patients; 47 were male and 53 were female. The most common degenerative findings were desiccation of disc (95% followed by disc bulge, herniation, spinal canal stenosis, ligamentum flavum hypertrophy, facet joint hypertrophy and modic changes. L4-L5 and L5- S1 were the most commonly involved spinal levels for any degenerative pathology. CONCLUSION: Good association is seen between early onset of degenerative spine disease and genetical predisposition in patients who have history of similar type degenerative spine disease in one or more first degree relatives in comparison to those patients who do not have any genetical predisposition. So it can be concluded that heredity play important role in early onset of degenerative spine disease in adults.

Spinal decompensation in degenerative lumbar scoliosis

NARCIS (Netherlands)

de Vries, A.A.; Mullender, M.G.; Pluymakers, W.J.; Castelein, R.M.; van Royen, B.J.

2010-01-01

Due to the aging population, degenerative scoliosis is a growing clinical problem. It is associated with back pain and radicular symptoms. The pathogenesis of degenerative scoliosis lies in degenerative changes of the spinal structures, such as the intervertebral disc, the facet joints and the

Time estimation in Parkinson's disease and degenerative cerebellar disease

NARCIS (Netherlands)

Beudel, Martijin; Galama, Sjoukje; Leenders, Klaus L.; de Jong, Bauke M.

2008-01-01

With functional MRI, we recently identified fronto-cerebellar activations in predicting time to reach a target and basal ganglia activation in velocity estimation, that is, small interval assessment. We now tested these functions in patients with Parkinson's disease (PD) and degenerative cerebellar

Targeting Protein Aggregation for the Treatment of Degenerative Diseases

Science.gov (United States)

Eisele, Yvonne S.; Monteiro, Cecilia; Fearns, Colleen; Encalada, Sandra E.; Wiseman, R. Luke; Powers, Evan T.; Kelly, Jeffery W.

2015-01-01

The aggregation of specific proteins is hypothesized to underlie several degenerative diseases, collectively called amyloid disorders. However, the mechanistic connection between the process of protein aggregation and tissue degeneration is not yet fully understood. Here, we review current and emerging strategies to ameliorate aggregation-associated degenerative disorders, with a focus on disease-modifying strategies that prevent the formation of and/or eliminate protein aggregates. Persuasive pharmacologic and genetic evidence now support protein aggregation as the cause of post-mitotic tissue dysfunction or loss. However, a more detailed understanding of the factors that trigger and sustain aggregate formation, as well as the structure-activity relationships underlying proteotoxicity are needed to develop future disease-modifying therapies. PMID:26338154

Two cases of joint disease in post-medieval church cemetery of St. Ilija.

Science.gov (United States)

Durić, Marija; Rakocević, Zoran; Bumbasirević, Marko; Lesić, Aleksandar; Kelecević, Julija

2004-01-01

Evidence of disease was analyzed from the skeletal remains of 11 individuals dating to the post-Medieval period from church cemetery of St. Ilija in Serbia. Two individuals showed pathological condition affecting joints. It was supposed that first individual had been suffering from Legg-Calvé-Perthes disease. It seems that this condition remained untreated, with extensive bone remodeling, and that the deformity of femoral head and acetabulum caused secondary degenerative joint disease at a relatively early age of this individual. Second case was related to the bony akylosis of the hand finger, probably caused by Dupuytren's disease. In addition, we discussed development of differential diagnosis in both pathological conditions.

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

Directory of Open Access Journals (Sweden)

Igor L. Shlykov, PhD¹, ScD¹

2013-06-01

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

[Operative treatment of degenerative diseases of the lumbar spine].

Science.gov (United States)

Czabanka, M; Thomé, C; Ringel, F; Meyer, B; Eicker, S-O; Rohde, V; Stoffel, M; Vajkoczy, P

2018-04-20

Degenerative diseases of the lumbar spine and associated lower back pain represent a major epidemiological and health-related economic challenge. A distinction is made between specific and unspecific lower back pain. In specific lower back pain lumbar disc herniation and spinal canal stenosis with or without associated segment instability are among the most frequent pathologies. Diverse conservative and operative strategies for treatment of these diseases are available. The aim of this article is to present an overview of current data and an evidence-based assessment of the possible forms of treatment. An extensive literature search was carried out via Medline plus an additional evaluation of the authors' personal experiences. Conservative and surgical treatment represent efficient treatment options for degenerative diseases of the lumbar spine. Surgical treatment of lumbar disc herniation shows slight advantages compared to conservative treatment consisting of faster recovery of neurological deficits and a faster restitution of pain control. Surgical decompression is superior to conservative measures for the treatment of spinal canal stenosis and degenerative spondylolisthesis. In this scenario conservative treatment represents an important supporting measure for surgical treatment in order to improve the mobility of patients and the outcome of surgical treatment. The treatment of specific lower back pain due to degenerative lumbar pathologies represents an interdisciplinary challenge, requiring both conservative and surgical treatment strategies in a synergistic treatment concept in order to achieve the best results for patients.

Intervertebral Fusion with Mobile Microendoscopic Discectomy for Lumbar Degenerative Disc Disease.

Science.gov (United States)

Xu, Bao-Shan; Liu, Yue; Xu, Hai-Wei; Yang, Qiang; Ma, Xin-Long; Hu, Yong-Cheng

2016-05-01

The aim of this article is to introduce a technique for lumbar intervertebral fusion that incorporates mobile microendoscopic discectomy (MMED) for lumbar degenerative disc disease. Minimally invasive transforaminal lumbar interbody fusion is frequently performed to treat degenerative diseases of the lumbar spine; however, the scope of such surgery and vision is limited by what the naked eye can see through the expanding channel system. To expand the visual scope and reduce trauma, we perform lumbar intervertebral fusion with the aid of a MMED system that provides a wide field through freely tilting the surgical instrument and canals. We believe that this technique is a good option for treating lumbar degenerative disc disease that requires lumbar intervertebral fusion. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

Expression of CGRP in the temporomandibular joint

International Nuclear Information System (INIS)

Caviedes Bucheli, Javier; Medina Buitrago, Diana Marcela

2002-01-01

The presence and content of calcitonin gene-related peptide (CGRP) is evaluated in the hyperplastic retrodiscal tissue of the temporomandibular joint in patients with joint degenerative disease by radioimmunoassay. Study population has included 8 female patients in pre-menopausic status, without to be pregnant, without to be lactating for a year and with diagnostic of joint degenerative disease (osteoarthrosis). Pain levels are registered with visual analog scale, where 0 is absence of pain and 16 acute pain. A bone degeneration is classified as mild, moderate and severe, according to findings of nuclear magnetic resonance. The 15 retrodiscal hyperplastic tissue samples are taken from patients undergoing to open surgery of temporomandibular joint. The specimens were placed in plastic blocks with freezing medium and are stored at -70 degrees celsius until neuropeptide extraction by radioimmunoassay with kit for CGRP. A directly proportional relationship is established between the degree of bone degeneration and neuropeptide expression and between the osteoarthrosis classification with analogue visual scale. Findings have shown definitive correlation between pain levels and expression of neuropeptide. CGRP is expressed in the retrodiscal tissue of temporomandibular joint in human with joint degenerative disease and is directly related with levels osteoarthrosis and pain [es

The Clinical Correlations between Diabetes, Cigarette Smoking and Obesity on Intervertebral Degenerative Disc Disease of the Lumbar Spine.

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Jakoi, Ande M; Pannu, Gurpal; D'Oro, Anthony; Buser, Zorica; Pham, Martin H; Patel, Neil N; Hsieh, Patrick C; Liu, John C; Acosta, Frank L; Hah, Raymond; Wang, Jeffrey C

2017-06-01

Retrospective analysis of a nationwide private insurance database. Chi-square analysis and linear regression models were utilized for outcome measures. The purpose of this study was to investigate any relationship between lumbar degenerative disc disease, diabetes, obesity and smoking tobacco. Diabetes, obesity, and smoking tobacco are comorbid conditions known to individually have effect on degenerative disc disease. Most studies have only been on a small populous scale. No study has yet to investigate the combination of these conditions within a large patient cohort nor have they reviewed the combination of these conditions on degenerative disc disease. A retrospective analysis of insurance billing codes within the nationwide Humana insurance database was performed, using PearlDiver software (PearlDiver, Inc., Fort Wayne, IN, USA), to identify trends among patients diagnosed with lumbar disc degenerative disease with and without the associated comorbidities of obesity, diabetes, and/or smoking tobacco. Patients billed for a comorbidity diagnosis on the same patient record as the lumbar disc degenerative disease diagnosis were compared over time to patients billed for lumbar disc degenerative disease without a comorbidity. There were no sources of funding for this manuscript and no conflicts of interest. The total number and prevalence of patients (per 10,000) within the database diagnosed with lumbar disc degenerative disease increased by 241.4% and 130.3%, respectively. The subsets of patients within this population who were concurrently diagnosed with either obesity, diabetes, tobacco use, or a combination thereof, was significantly higher than patients diagnosed with lumbar disc degenerative disease alone ( p degenerative disease and smoking rose significantly more than patients diagnosed with lumbar disc degenerative disease and either diabetes or obesity ( p degenerative disease, smoking and obesity rose significantly more than the number of patients

Degenerative joint disease in female ballet dancers

NARCIS (Netherlands)

van Dijk, C. N.; Lim, L. S.; Poortman, A.; Strübbe, E. H.; Marti, R. K.

1995-01-01

The relationship between long-term ballet dancing and eventual arthrosis of the hip, ankle, subtalar, and first metatarsophalangeal joint was examined in 19 former professional female dancers, aged 50 to 70 years. The dancers were compared with pair-matched controls. All 38 women underwent medical

Impact of body mass index on adjacent segment disease after lumbar fusion for degenerative spine disease.

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Ou, Chien-Yu; Lee, Tao-Chen; Lee, Tsung-Han; Huang, Yu-Hua

2015-04-01

Adjacent segment disease is an important complication after fusion of degenerative lumbar spines. However, the role of body mass index (BMI) in adjacent segment disease has been addressed less. To examine the relationship between BMI and adjacent segment disease after lumbar fusion for degenerative spine diseases. For this retrospective study, we enrolled 190 patients undergoing lumbar fusion surgery for degeneration. BMI at admission was documented. Adjacent segment disease was defined by integration of the clinical presentations and radiographic criteria based on the morphology of the dural sac on magnetic resonance images. Adjacent segment disease was identified in 13 of the 190 patients, accounting for 6.8%. The interval between surgery and diagnosis as adjacent segment disease ranged from 21 to 66 months. Five of the 13 patients required subsequent surgical intervention for clinically relevant adjacent segment disease. In the logistic regression model, BMI was a risk factor for adjacent segment disease after lumbar fusion for degenerative spine diseases (odds ratio, 1.68; 95% confidence interval, 1.27-2.21; P disease rate by 67.6%. The patients were subdivided into 2 groups based on BMI, and up to 11.9% of patients with BMI ≥ 25 kg/m were diagnosed as having adjacent segment disease at the last follow-up. BMI is a risk factor for adjacent segment disease in patients undergoing lumbar fusion for degenerative spine diseases. Because BMI is clinically objective and modifiable, controlling body weight before or after surgery may provide opportunities to reduce the rate of adjacent segment disease and to improve the outcome of fusion surgery.

Determination of characteristics of degenerative joint disease using optical coherence tomography and polarization sensitive optical coherence tomography.

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Xie, Tuqiang; Guo, Shuguang; Zhang, Jun; Chen, Zhongping; Peavy, George M

2006-10-01

Previous studies have demonstrated that optical coherence tomography (OCT) could be used to delineate alterations in the microstructure of cartilage, and have suggested that changes in the polarization state of light as detected by OCT could provide information on the birefringence properties of articular cartilage as influenced by disease. In this study we have used both OCT and polarization sensitive optical coherence tomography (PS-OCT) technologies to evaluate normal and abnormal bovine articular cartilage according to established structural, organizational, and birefringent characteristics of degenerative joint disease (DJD) in order to determine if this technology can be used to differentiate various stages of DJD as a minimally invasive imaging tool. Fresh bovine femoral-tibial joints were obtained from an abattoir, and 45 cartilage specimens were harvested from 8 tibial plateaus. Whole ex vivo specimens of normal and degenerative articular cartilage were imaged by both OCT and PS-OCT, then fixed and processed for histological evaluation. OCT/PS-OCT images and corresponding histology sections of each specimen were scored according to a modified Mankin structural grading scale and compared. OCT and PS-OCT imaging allowed structural evaluation of intact articular cartilage along a 6 mm surface length to a depth of 2 mm with a transverse resolution of 12 microm and an axial resolution of 10 microm. The OCT and PS-OCT images demonstrated characteristic alterations in the structure of articular cartilage with a high correlation to histological evaluation (kappa = 0.776). The OCT images were able to demonstrate early to advanced structural changes of articular cartilage while the optical phase retardation images obtained by PS-OCT imaging were able to discriminate areas where disorganization of the cartilage matrix was present, however, these characteristics are much different than those reported where OCT images alone were used to characterize tissue

Comparative long-term results of mitral valve repair in adults with chronic rheumatic disease and degenerative disease: is repair for "burnt-out" rheumatic disease still inferior to repair for degenerative disease in the current era?

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Dillon, Jeswant; Yakub, Mohd Azhari; Kong, Pau Kiew; Ramli, Mohd Faizal; Jaffar, Norfazlina; Gaffar, Intan Fariza

2015-03-01

Mitral valve repair is perceived to be of limited durability for advanced rheumatic disease in adults. We aim to examine the long-term outcomes of repair for rheumatic disease, identify predictors of durability, and compare with repair for degenerative disease. Rheumatic and degenerative mitral valve repairs in patients aged 40 years or more were prospectively analyzed. The primary outcomes investigated were mortality, freedom from reoperation, and valve failure. Logistic regression analysis was performed to define predictors of poor outcome. Between 1997 and 2011, 253 rheumatic and 148 degenerative mitral valves were repaired. The age of patients in both groups was similar, with a mean of 54.1 ± 8.4 years versus 55.6 ± 7.3 years (P = .49). Freedom from reoperation for rheumatic valves at 5 and 10 years was 98.4%, comparable to 95.3% (P = .12) for degenerative valves. Freedom from valve failure at 5 and 10 years was 91.4% and 81.5% for rheumatic repairs and 82.5% and 75.4% for degenerative repairs, respectively (P = .15). The presence of residual mitral regurgitation greater than 2+ before discharge was the only significant independent predictor of reoperation, whereas residual mitral regurgitation greater than 2+ and leaflet procedures were significant risk factors for valve failure. The durability of rheumatic mitral valve repair in the current era has improved and is comparable to the outstanding durability of repairs for degenerative disease, even in the adult rheumatic population. Modifications of standard repair techniques, adherence to the importance of good leaflet coaptation, and strict quality control with stringent use of intraoperative transesophageal echocardiography have all contributed to the improved long-term results. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Plant Polyphenolic Antioxidants in Management of Chronic Degenerative Diseases

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R.K. Das

2017-12-01

Full Text Available With the over growing global population, degenerative diseases are on rise, despite using modern medicine for its cure. People prefer alternative systems of medicine like natural therapy and polyherbal therapy due to adverse effects of allopathic medication. According to W.H.O. report about 70% of world population relying on natural plant-based therapy. For a suitable, sustainable and cost effective cure use of polyphenolic natural antioxidants may be an appropriate tool. Now a day’s most food and pharmaceutical products contain synthetic antioxidants. But recent data indicating that, long term use of synthetic antioxidants could have carcinogenic effects on human cells. Thus, search for new natural and efficient antioxidants is need of the hour. Phenolic compounds (polyphenols are products of secondary metabolites and constitute one of the most widely distributed groups of substance in plant kingdom with more than 10,000 phenolic structures. Polyphenols are structurally characterized by the presence of one or more aromatic benzene ring compounds with one or more functional hydroxyl groups. Polyphenols are naturally occurring and most abundant antioxidants in human diets found largely in the fruits, vegetables and beverages. Plant flavonoids are the largest and best studied class of polyphenols which include more than 4000 compounds. Numerous studies confirm that, flavonoids exert a protective action on human health and are key components of a healthy and balanced diet. Epidemiological studies and associated meta-analysis correlate and strongly   suggest that, long term consumption of diets rich in plant flavonoids offer protection against development of chronic and degenerative diseases, such as cardiovascular diseases , diabetes , cancer, osteoporosis and neurodegenerative diseases. One of the main reasons for the age related diseases is linked with reduction in cellular oxidative stress. The involvement of reactive oxygen species (ROS in

MRI in degenerative diseases of the cervical spine

International Nuclear Information System (INIS)

Schubeus, P.; Sander, B.; Hosten, N.; Mayer, H.M.; Weber, U.; Felix, R.

1994-01-01

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.) [de

[Theoretic basis on the same therapeutic program for different degenerative brain diseases in terms of the Governor Vessel: Alzheimer's disease and Parkinson's disease].

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Wu, Junyan; Wang, Jie; Zhang, Junlong

2015-05-01

Through the consultation of TCM ancient classical theory, the relationship of kidney essence, marrow and brain is analyzed. It is discovered that the degenerative brain diseases, represented by Alzheimer's disease (AD) and Parkinson's disease (PD) share the same etiological basis as "kidney essence deficiency and brain marrow emptiness" and have the mutual pathological outcomes as yang qi declining. The Governor Vessel gathers yang qi of the whole body and maintains the normal functional activity of zangfu organs in the human body through the storage, regulation and invigoration of yang qi. It is viewed that the theory of the Governor Vessel is applied to treat the different degenerative brain diseases, which provides the theoretic support and practice guide for the thought of TCM as the same therapeutic program for the different diseases. As a result, the degenerative brain diseases can be retarded and the approach is provided to the effective prevention and treatment of degenerative diseases in central nerve system:

MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis

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Jans, L., E-mail: lennartjans@hotmail.com [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Van Praet, L.; Elewaut, D.; Van den Bosch, F.; Carron, P. [Department of Rheumatology, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium); Jaremko, J.L. [Department of Radiology, University of Alberta Hospital, 8440-112 Street, Edmonton T6G 2B7, Alberta (Canada); Behaeghe, M.; Denis, A.; Huysse, W.; Lambrecht, V.; Verstraete, K. [Department of Radiology and Medical Imaging, Ghent University Hospital, De Pintelaan 185, 9000 Gent (Belgium)

2014-01-15

Purpose: To determine the prevalence of clinically relevant non-inflammatory disease on MRI of the sacroiliac (SI) joints in patients suspected of sacroiliitis. To assess the added value of axial imaging of the pelvis in these patients. Methods: In a retrospective study of 691 patients undergoing MRI of the SI joints from January 2006 to December 2012 for inflammatory back pain the prevalence of sacroiliitis and non-inflammatory disease was recorded. Results: In 285 (41%) patients MRI did not show any abnormal findings. In 36% of patients MRI features of sacroiliitis were present. Spinal degenerative changes were the most common non-inflammatory finding in 305 patients (44.1%) and consisted of disc degeneration in 222 (32%) patients, facet joint arthrosis in 58 (8.4%) patients and disc herniation in 25 (3.6%) patients. Hip joint disease in 44 (6.4%) patients, lumbosacral transitional anomaly in 41 (5.9%) patients, SI joint degenerative changes in 25 (3.6%) patients and diffuse idiopathic skeletal hyperostosis in 24 (3.5%) patients were also common. Osteitis condensans ilii in 17 (2.5%) patients, tumour in 11 (1.6%) patients, fracture in 8 (1.2%) patients, infection in 4 (0.6%) patients and acute spondylolysis in 2 patients (0.3%) were less frequently seen. Conclusion: Our study shows that non-inflammatory disease is more common than true sacroiliitis on MRI of the SI joints in patients with inflammatory type back pain. Axial pulse sequences may demonstrate unexpected findings that remain undetected if only coronal images are obtained. Clinical relevance statement:, MRI of the SI joints may demonstrate conditions that clinically mimic sacroiliitis. Axial imaging of the pelvis may help detect these unexpected findings.

MRI of the SI joints commonly shows non-inflammatory disease in patients clinically suspected of sacroiliitis

International Nuclear Information System (INIS)

Jans, L.; Van Praet, L.; Elewaut, D.; Van den Bosch, F.; Carron, P.; Jaremko, J.L.; Behaeghe, M.; Denis, A.; Huysse, W.; Lambrecht, V.; Verstraete, K.

2014-01-01

Purpose: To determine the prevalence of clinically relevant non-inflammatory disease on MRI of the sacroiliac (SI) joints in patients suspected of sacroiliitis. To assess the added value of axial imaging of the pelvis in these patients. Methods: In a retrospective study of 691 patients undergoing MRI of the SI joints from January 2006 to December 2012 for inflammatory back pain the prevalence of sacroiliitis and non-inflammatory disease was recorded. Results: In 285 (41%) patients MRI did not show any abnormal findings. In 36% of patients MRI features of sacroiliitis were present. Spinal degenerative changes were the most common non-inflammatory finding in 305 patients (44.1%) and consisted of disc degeneration in 222 (32%) patients, facet joint arthrosis in 58 (8.4%) patients and disc herniation in 25 (3.6%) patients. Hip joint disease in 44 (6.4%) patients, lumbosacral transitional anomaly in 41 (5.9%) patients, SI joint degenerative changes in 25 (3.6%) patients and diffuse idiopathic skeletal hyperostosis in 24 (3.5%) patients were also common. Osteitis condensans ilii in 17 (2.5%) patients, tumour in 11 (1.6%) patients, fracture in 8 (1.2%) patients, infection in 4 (0.6%) patients and acute spondylolysis in 2 patients (0.3%) were less frequently seen. Conclusion: Our study shows that non-inflammatory disease is more common than true sacroiliitis on MRI of the SI joints in patients with inflammatory type back pain. Axial pulse sequences may demonstrate unexpected findings that remain undetected if only coronal images are obtained. Clinical relevance statement:, MRI of the SI joints may demonstrate conditions that clinically mimic sacroiliitis. Axial imaging of the pelvis may help detect these unexpected findings

Heat-shock proteins in stromal joint tissues: innocent bystanders or disease-initiating proteins?

Science.gov (United States)

Lambrecht, Stijn; Juchtmans, Nele; Elewaut, Dirk

2014-02-01

Heat-shock proteins (HSPs) are molecular chaperones that are highly conserved between species. In recent decades it has become clear that these proteins play an important role in the pathogenesis of inflammatory and degenerative joint diseases by (dys)regulating the immune system and by direct effects on the stromal tissues of the joint. In this review we discuss current insights into the expression pattern of HSPs in connective tissues, the direct biological role of HSPs in stromal tissues and the potential clinical applications.

[Modern treatments for degenerative disc diseases of the lumbosacral spine. A literature review].

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Konovalov, N A; Nazarenko, A G; Asyutin, D S; Zelenkov, P V; Onoprienko, R A; Korolishin, V A; Cherkiev, I U; Martynova, M A; Zakirov, B A; Timonin, S Yu; Kosyr'kova, A V; Pimenova, L F; Pogosyan, A L; Batyrov, A A

Many researchers consider degenerative diseases of the spine as a pandemic of the XXIst century. Herniated intervertebral discs of the lumbosacral spine occur in 61% of patients with degenerative spine diseases. Of these, 15% of patients have herniated discs at the LII-LIII level, 10% of patients at the LIII-LIV level, and 40% of patients at the LIV-LV and LV-SI levels. A high cost of conservative treatment of degenerative spine disease symptoms and its low efficacy in reducing the intensity and duration of pain necessitate the development of new methods of surgical treatment. In this paper, we analyze the literature data on minimally invasive spine surgery and demonstrate the main advantages of percutaneous endoscopic surgical techniques.

Cartilage repair in the degenerative ageing knee

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Brittberg, Mats; Gomoll, Andreas H; Canseco, José A; Far, Jack; Lind, Martin; Hui, James

2016-01-01

Background and purpose Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists. A group of clinicians was given the task of discussing the role of tissue engineering in the treatment of degenerative cartilage lesions in ageing patients. We present the outcomes of our discussions on current treatment options for such lesions, with particular emphasis on different biological repair techniques and their supporting level of evidence. Results and interpretation Based on the studies on treatment of degenerative lesions and early OA, there is low-level evidence to suggest that cartilage repair is a possible treatment for such lesions, but there are conflicting results regarding the effect of advanced age on the outcome. We concluded that further improvements are needed for direct repair of focal, purely traumatic defects before we can routinely use such repair techniques for the more challenging degenerative lesions. Furthermore, we need to identify trigger mechanisms that start generalized loss of cartilage matrix, and induce subchondral bone changes and concomitant synovial pathology, to maximize our treatment methods for biological repair in degenerative ageing joints. PMID:27910738

Inherited Retinal Degenerative Disease Clinical Trial Network. Addendum

Science.gov (United States)

2010-10-01

Stargardt disease, and Usher syndrome represent the predominant forms of inherited orphan retinal degenerative diseases and are estimated to affect...working with Oxford Biomedica and a separate project with academic investigators on gene therapy for Usher lb syndrome (deaf-blindness due to a gene...s. The NEER Network will also develop standard protocols for data collection, mainta i n and expand patient databases, classified by genotype and

Characterisation of the correlation between standing lordosis and degenerative joint disease in the lower lumbar spine in women and men: a radiographic study.

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Murray, Kelvin J; Le Grande, Michael R; Ortega de Mues, Arantxa; Azari, Michael F

2017-08-01

Degenerative joint disease (DJD) in the lumbar spine is a common condition that is associated with chronic low back pain. Excessive loading of lumbar joints is a risk factor for DJD. Changes in lumbar lordosis significantly redistribute the forces of weight-bearing on the facet joints and the intervertebral discs. However, the relationship between lumbar lordosis and DJD has not been characterized in men and women. We characterised the correlation between standing lumbar lordosis and DJD in standing radiographic images from 301 adult female and male chiropractic patients. DJD was rated using the Kellgren-Lawrence scale, and lordosis was measured using the Cobb angle. Linear and curvilinear correlations were investigated while controlling for age and sex. We found a highly significant curvilinear correlation between lordosis and DJD of the lower lumbar spine in both sexes, but especially in women, irrespective of the effects of age. We found the effect size of lordosis on lower lumbar DJD to be between 17.4 and 18.1% in women and 12.9% in older men. In addition, lordosis of 65 (95% CI 55.3-77.7) and 68 (98% CI 58.7-73.3) degrees were associated with minimal DJD in the lower lumbar spine of women and men respectively, and were therefore considered 'optimal'. This optimal lordotic angle was 73 (95% CI 58.8-87.2) degrees in older men. Both hypo- and hyper-lordosis correlate with DJD in the lumbar spine, particularly in women and in older men. These findings may well be of relevance to spinal pain management and spinal rehabilitation.

Applications of CRISPR/Cas9 in retinal degenerative diseases

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Peng, Ying-Qian; Tang, Luo-Sheng; Yoshida, Shigeo; Zhou, Ye-Di

2017-01-01

Gene therapy is a potentially effective treatment for retinal degenerative diseases. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) system has been developed as a new genome-editing tool in ophthalmic studies. Recent advances in researches showed that CRISPR/Cas9 has been applied in generating animal models as well as gene therapy in vivo of retinitis pigmentosa (RP) and leber congenital amaurosis (LCA). It has also been shown as a potential attempt for clinic by combining with other technologies such as adeno-associated virus (AAV) and induced pluripotent stem cells (iPSCs). In this review, we highlight the main points of further prospect of using CRISPR/Cas9 in targeting retinal degeneration. We also emphasize the potential applications of this technique in treating retinal degenerative diseases. PMID:28503441

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

International Nuclear Information System (INIS)

Juhng, Seon Kwan; Koplyay, Peter; Jeffrey Carr, J.; Lenchik, Leon

2001-01-01

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 2 in the femoral neck, while for controls the corresponding figures were 0.989g/cm 2 and 0.765g/cm 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

Interpersonal traits change as a function of disease type and severity in degenerative brain diseases.

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Sollberger, Marc; Neuhaus, John; Ketelle, Robin; Stanley, Christine M; Beckman, Victoria; Growdon, Matthew; Jang, Jung; Miller, Bruce L; Rankin, Katherine P

2011-07-01

Different degenerative brain diseases result in distinct personality changes as a result of divergent patterns of brain damage; however, little is known about the natural history of these personality changes throughout the course of each disease. To investigate how interpersonal traits change as a function of degenerative brain disease type and severity. Using the Interpersonal Adjective Scales, informant ratings of retrospective premorbid and current scores for dominance, extraversion, warmth and ingenuousness were collected annually for 1 to 4 years on 188 patients (67 behavioural variant frontotemporal dementia (bvFTD), 40 semantic dementia (SemD), 81 Alzheimer's disease (AD)) and 65 older healthy controls. Using random coefficient models, interpersonal behaviour scores at very mild, mild or moderate-to-severe disease stages were compared within and between patient groups. Group-level changes from premorbid personality occurred as a function of disease type and severity, and were apparent even at a very mild disease stage (Clinical Dementia Rating=0.5) for all three diseases. Decreases in interpersonal traits were associated with emotional affiliation (ie, extraversion, warmth and ingenuousness) and more rigid interpersonal behaviour differentiated bvFTD and SemD patients from AD patients. Specific changes in affiliative interpersonal traits differentiate degenerative brain diseases even at a very mild disease stage, and patterns of personality change differ across bvFTD, SemD and AD with advancing disease. This study describes the typical progression of change of interpersonal traits in each disease, improving the ability of clinicians and caregivers to predict and plan for symptom progression.

NONFUSION STABILIZATION IN THE DEGENERATIVE LUMBAR SPINE DISEASES

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Matjaž Voršič

2009-04-01

Conclusions Cosmic is a posterior dynamic nonfusion pedicle screw-rod system for the stabilization of the lumbar vertebral column. It represents the new step in the development of the spinal instrumentation and can efficiently replace the spondylodesis in the treatment of painful degenerative diseases of the lumbar spine.

Stem cell treatment of degenerative eye disease

Directory of Open Access Journals (Sweden)

Ben Mead

2015-05-01

Full Text Available Stem cell therapies are being explored extensively as treatments for degenerative eye disease, either for replacing lost neurons, restoring neural circuits or, based on more recent evidence, as paracrine-mediated therapies in which stem cell-derived trophic factors protect compromised endogenous retinal neurons from death and induce the growth of new connections. Retinal progenitor phenotypes induced from embryonic stem cells/induced pluripotent stem cells (ESCs/iPSCs and endogenous retinal stem cells may replace lost photoreceptors and retinal pigment epithelial (RPE cells and restore vision in the diseased eye, whereas treatment of injured retinal ganglion cells (RGCs has so far been reliant on mesenchymal stem cells (MSC. Here, we review the properties of non-retinal-derived adult stem cells, in particular neural stem cells (NSCs, MSC derived from bone marrow (BMSC, adipose tissues (ADSC and dental pulp (DPSC, together with ESC/iPSC and discuss and compare their potential advantages as therapies designed to provide trophic support, repair and replacement of retinal neurons, RPE and glia in degenerative retinal diseases. We conclude that ESCs/iPSCs have the potential to replace lost retinal cells, whereas MSC may be a useful source of paracrine factors that protect RGC and stimulate regeneration of their axons in the optic nerve in degenerate eye disease. NSC may have potential as both a source of replacement cells and also as mediators of paracrine treatment.

Stem cell treatment of degenerative eye disease.

Science.gov (United States)

Mead, Ben; Berry, Martin; Logan, Ann; Scott, Robert A H; Leadbeater, Wendy; Scheven, Ben A

2015-05-01

Stem cell therapies are being explored extensively as treatments for degenerative eye disease, either for replacing lost neurons, restoring neural circuits or, based on more recent evidence, as paracrine-mediated therapies in which stem cell-derived trophic factors protect compromised endogenous retinal neurons from death and induce the growth of new connections. Retinal progenitor phenotypes induced from embryonic stem cells/induced pluripotent stem cells (ESCs/iPSCs) and endogenous retinal stem cells may replace lost photoreceptors and retinal pigment epithelial (RPE) cells and restore vision in the diseased eye, whereas treatment of injured retinal ganglion cells (RGCs) has so far been reliant on mesenchymal stem cells (MSC). Here, we review the properties of non-retinal-derived adult stem cells, in particular neural stem cells (NSCs), MSC derived from bone marrow (BMSC), adipose tissues (ADSC) and dental pulp (DPSC), together with ESC/iPSC and discuss and compare their potential advantages as therapies designed to provide trophic support, repair and replacement of retinal neurons, RPE and glia in degenerative retinal diseases. We conclude that ESCs/iPSCs have the potential to replace lost retinal cells, whereas MSC may be a useful source of paracrine factors that protect RGC and stimulate regeneration of their axons in the optic nerve in degenerate eye disease. NSC may have potential as both a source of replacement cells and also as mediators of paracrine treatment. Copyright © 2015. Published by Elsevier B.V.

Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty

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Czech Szymon

2017-12-01

Full Text Available An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients’ willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.

Sports Activity Following Cementless Metaphyseal Hip Joint Arthroplasty.

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Czech, Szymon; Hermanson, Jacek; Rodak, Piotr; Stołtny, Tomasz; Rodak, Łukasz; Kasperczyk, Sławomir; Koczy, Bogdan; Mielnik, Michał

2017-12-01

An adequate level of physical activity has a substantial effect on both mental and physical human health. Physical activity is largely dependent on the function of the musculoskeletal and articular system. One of the most frequent diseases of this system is degenerative joint disease. Due to the changing and more demanding lifestyles and patients' willingness to be involved in sports activity, the expectations of hip joint arthroplasty are becoming increasingly high. Alleviating pain ceases to be the only reason for which patients choose surgical interventions, while the expectations often include involvement in various sports. Only few studies contain recommendations concerning the frequency, type and intensity of sports activity which are acceptable after hip joint arthroplasty. The aim of the study was to evaluate function and physical activity of people following cementless short-stem hip joint arthroplasty in the observation of at least five years. The study group comprised 106 patients who underwent total hip arthroplasty due to degenerative joint diseases, chosen according to inclusion criteria. Patients underwent routine physical examinations following the Harris Hip Score protocol, responded to the UCLA scale and questionnaires concerning pre-surgical and current physical activity. Our results demonstrated that hip joint arthroplasty in people suffering from degenerative joint diseases has a beneficial effect on their level of functioning and physical activity. Although physical activity and the level of functioning obviously reduced as a person aged, the level of physical activity continued to be very high in both groups, with function of the hip joint evaluated as very good.

Imaging and translational research: neuro degenerative diseases

International Nuclear Information System (INIS)

Hantraye, P.

2009-01-01

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

Canine Degenerative Valve Disease: A Case Report

Directory of Open Access Journals (Sweden)

Carmenza Janneth Benavides Melo

2014-07-01

Full Text Available Degenerative valvular disease or endocardiosis is the most common cardiovascular pathology in dogs. It is characterized by regurgitation of blood into the atria with decreased cardiac output, leading to volume overload with eccentric hypertrophy and congestive heart failure. This report describes the clinical and autopsy findings of a dog, suggestive of valvular endocardiosis. The patient was admitted to the outpatient Veterinary Clinic “Carlos Martínez Hoyos” at the University of Nariño (Pasto, Colombia. His owner said the dog was sick for two months, with signs of respiratory disease, weight loss, and decay. Clinical examination showed very pale mucous membranes, inspiratory dyspnea, rale, split S2, grade 4 mid-systolic murmur of regurgitation, and abdominal dilatation with sign of positive shock wave. Necropsy evidenced plenty of translucent watery material in the abdominal, chest and pericardium cavity, severely enlarged and rounded heart with thickened atrioventricular valves, moderate reduction in liver size and signs of lobulation, severely diminished and pale kidneys with irregular surface showing the presence of multiple cystic areas in corticomedullary region. Samples were taken from these tissues and fixed in 10% buffered formalin to be processed for histopathological analysis at the Laboratory of Pathology at the University of Nariño, using hematoxylin and eosin stain. This way, degenerative valvular disease was diagnosed.

Stress radiographs in the evaluation of degenerative femorotibial joint disease

Energy Technology Data Exchange (ETDEWEB)

Tallroth, K.; Lindholm, T.S.

1987-11-01

Thirty-eight osteoarthrotic knees were examined to assess the widths of the femorotibial joint spaces. Radiographs were exposed with the patient lying, in a standing position, and with an adduction and abduction force. Forced compression of the osteoarthrotic joint compartment caused, on average, 18% greater narrowing than when loading it in the standing position. Compared to the joint space at rest, the non-weight-bearing compartment widened by 16% in the standing position and narrowed by 20% when stress was applied. Furthermore, the results showed an increase in laxity proportional to the degree of arthrosis. Stress radiographs significantly display the real cartilage width of both joint compartments. Knowledge of the condition of the articular cartilage in the non-weight-bearing compartment is important when considering a transfer of loading stresses by means of osteotomy. (orig.)

Stress radiographs in the evaluation of degenerative femorotibial joint disease

International Nuclear Information System (INIS)

Tallroth, K.; Lindholm, T.S.

1987-01-01

Thirty-eight osteoarthrotic knees were examined to assess the widths of the femorotibial joint spaces. Radiographs were exposed with the patient lying, in a standing position, and with an adduction and abduction force. Forced compression of the osteoarthrotic joint compartment caused, on average, 18% greater narrowing than when loading it in the standing position. Compared to the joint space at rest, the non-weight-bearing compartment widened by 16% in the standing position and narrowed by 20% when stress was applied. Furthermore, the results showed an increase in laxity proportional to the degree of arthrosis. Stress radiographs significantly display the real cartilage width of both joint compartments. Knowledge of the condition of the articular cartilage in the non-weight-bearing compartment is important when considering a transfer of loading stresses by means of osteotomy. (orig.)

MR imaging of the spine: trauma and degenerative disease

International Nuclear Information System (INIS)

Wilmink, J.T.

1999-01-01

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.)

MR imaging of the spine: trauma and degenerative disease

Energy Technology Data Exchange (ETDEWEB)

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

1999-09-01

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.

Characterization of degenerative changes in the temporomandibular joint of the bengal tiger (Panthera tigris tigris) and siberian tiger (Panthera tigris altaica).

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

2013-11-01

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. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain.

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Arnbak, Bodil; Jensen, Tue S; Egund, Niels; Zejden, Anna; Hørslev-Petersen, Kim; Manniche, Claus; Jurik, Anne G

2016-04-01

To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. • The location of vertebral endplate signal changes supports a mechanical aetiology. • Several sacroiliac joint findings were associated with female gender and pregnancy-related back pain. • Sacroiliac joint bone marrow oedema was frequent and age-associated, indicating a possible degenerative aetiology. • More knowledge of the clinical importance of sacroiliac joint MRI findings is needed.

Lipoma arborescens: Comparison of typical and atypical disease presentations

International Nuclear Information System (INIS)

Howe, B.M.; Wenger, D.E.

2013-01-01

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

Use of transfer learning to detect diffuse degenerative hepatic diseases from ultrasound images in dogs: A methodological study.

Science.gov (United States)

Banzato, T; Bonsembiante, F; Aresu, L; Gelain, M E; Burti, S; Zotti, A

2018-03-01

The aim of this methodological study was to develop a deep convolutional neural network (DNN) to detect degenerative hepatic disease from ultrasound images of the liver in dogs and to compare the diagnostic accuracy of the newly developed DNN with that of serum biochemistry and cytology on the same samples, using histopathology as a standard. Dogs with suspected hepatic disease that had no prior history of neoplastic disease, no hepatic nodular pathology, no ascites and ultrasonography performed 24h prior to death were included in the study (n=52). Ultrasonography and serum biochemistry were performed as part of the routine clinical evaluation. On the basis of histopathology, dogs were categorised as 'normal' (n=8), or having 'vascular abnormalities'(n=8), or 'inflammatory'(n=0), 'neoplastic' (n=4) or 'degenerative'(n=32) disease; dogs with 'neoplastic' disease were excluded from further analysis. On cytological evaluation, dogs were categorised as 'normal' (n=11), or having 'inflammatory' (n=0), 'neoplastic' (n=4) or 'degenerative' (n=37) disease. Dogs were categorised as having 'degenerative' (n=32) or 'non-degenerative' (n=16) liver disease for analysis due to the limited sample size. The DNN was developed using a transfer learning methodology on a pre-trained neural network that was retrained and fine-tuned to our data set. The resultant DNN had a high diagnostic accuracy for degenerative liver disease (area under the curve 0.91; sensitivity 100%; specificity 82.8%). Cytology and serum biochemical markers (alanine transaminase and aspartate transaminase) had poor diagnostic accuracy in the detection of degenerative liver disease. The DNN outperformed all the other non-invasive diagnostic tests in the detection of degenerative liver disease. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Bone and joint decade--"mile step" in diagnostics and treatment of movement system diseases?].

Science.gov (United States)

Brongel, Leszek; Lorkowski, Jacek; Hładki, Waldemar; Trybus, Marek

2006-01-01

Musculoskeletal disorders affect hundreds of millions of people across the world and are the most common causes of severe long-term pain and physical disability. The impact from such disorders on the individual and on society let to propose by WHO for the Decade of the Bone and Joint from 2000 to 2010. The goal of the Decade is to improve the health-related quality of life for people with musculoskeletal disorders throughout the world and this could be achieved by raising awareness of the growing burden of bone and joint diseases on society, promoting prevention and treatment and advancing understanding of musculoskeletal disorders through research. The main fields of interest during the Decade are joint diseases, spinal disorders and low back pain, osteoporosis and severe trauma of the extremities. In our Department we study problems concerning on traumatology of old patients, multitrauma injury, biomechanics in spinal disorders, in degenerative joint disease and foot diseases. Apart from contemporary imaging methods like US or CT we use pedobarographic diagnostics and fotogrammetric examination. In this study we present strategic goals and the summary of our ongoing projects in our Department related to the goals of the Bone and Joint Decade.

Stem Cell-Based Therapeutic Applications in Retinal Degenerative Diseases.

OpenAIRE

Huang Yiming; Enzmann Volker; Ildstad Suzanne T

2011-01-01

Retinal degenerative diseases that target photoreceptors or the adjacent retinal pigment epithelium (RPE) affect millions of people worldwide. Retinal degeneration (RD) is found in many different forms of retinal diseases including retinitis pigmentosa (RP), age-related macular degeneration (AMD), diabetic retinopathy, cataracts, and glaucoma. Effective treatment for retinal degeneration has been widely investigated. Gene-replacement therapy has been shown to improve visual function in inheri...

Single photon emission computed tomography in lumbar degenerative spondylolisthesis

International Nuclear Information System (INIS)

Ito, S.; Muro, T.; Eisenstein, S.

1998-01-01

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

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

International Nuclear Information System (INIS)

Kido, Kenji

1988-01-01

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 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

Polyetheretherketone (PEEK) rods: short-term results in lumbar spine degenerative disease.

Science.gov (United States)

Colangeli, S; Barbanti Brodàno, G; Gasbarrini, A; Bandiera, S; Mesfin, A; Griffoni, C; Boriani, S

2015-06-01

Pedicle screw and rod instrumentation has become the preferred technique for performing stabilization and fusion in the surgical treatment of lumbar spine degenerative disease. Rigid fixation leads to high fusion rates but may also contribute to stress shielding and adjacent segment degeneration. Thus, the use of semirigid rods made of polyetheretherketone (PEEK) has been proposed. Although the PEEK rods biomechanical properties, such as anterior load sharing properties, have been shown, there are few clinical studies evaluating their application in the lumbar spine surgical treatment. This study examined a retrospective cohort of patients who underwent posterior lumbar fusion for degenerative disease using PEEK rods, in order to evaluate the clinical and radiological outcomes and the incidence of complications.

Transcriptomic alterations during ageing reflect the shift from cancer to degenerative diseases in the elderly.

Science.gov (United States)

Aramillo Irizar, Peer; Schäuble, Sascha; Esser, Daniela; Groth, Marco; Frahm, Christiane; Priebe, Steffen; Baumgart, Mario; Hartmann, Nils; Marthandan, Shiva; Menzel, Uwe; Müller, Julia; Schmidt, Silvio; Ast, Volker; Caliebe, Amke; König, Rainer; Krawczak, Michael; Ristow, Michael; Schuster, Stefan; Cellerino, Alessandro; Diekmann, Stephan; Englert, Christoph; Hemmerich, Peter; Sühnel, Jürgen; Guthke, Reinhard; Witte, Otto W; Platzer, Matthias; Ruppin, Eytan; Kaleta, Christoph

2018-01-30

Disease epidemiology during ageing shows a transition from cancer to degenerative chronic disorders as dominant contributors to mortality in the old. Nevertheless, it has remained unclear to what extent molecular signatures of ageing reflect this phenomenon. Here we report on the identification of a conserved transcriptomic signature of ageing based on gene expression data from four vertebrate species across four tissues. We find that ageing-associated transcriptomic changes follow trajectories similar to the transcriptional alterations observed in degenerative ageing diseases but are in opposite direction to the transcriptomic alterations observed in cancer. We confirm the existence of a similar antagonism on the genomic level, where a majority of shared risk alleles which increase the risk of cancer decrease the risk of chronic degenerative disorders and vice versa. These results reveal a fundamental trade-off between cancer and degenerative ageing diseases that sheds light on the pronounced shift in their epidemiology during ageing.

Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

Science.gov (United States)

2014-01-01

The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”). The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability). Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease. PMID:24877117

No publication bias in industry funded clinical trials of degenerative diseases of the spine.

Science.gov (United States)

Son, Colin; Tavakoli, Samon; Bartanusz, Viktor

2016-03-01

Industry sponsorship of clinical research of degenerative diseases of the spine has been associated with excessive positive published results as compared to research carried out without industry funding. We sought the rates of publication of clinical trials of degenerative diseases of the spine based on funding source as a possible explanation for this phenomenon. We reviewed all clinical trials registered at clinicaltrials.gov relating to degenerative diseases of the spine as categorized under six medical subject heading terms (spinal stenosis, spondylolisthesis, spondylolysis, spondylosis, failed back surgery syndrome, intervertebral disc degeneration) and with statuses of completed or terminated. These collected studies were categorized as having, or not having, industry funding. Published results for these studies were then sought within the clinicaltrials.gov database itself, PubMed and Google Scholar. One hundred sixty-one clinical trials met these criteria. One hundred nineteen of these trials had industry funding and 42 did not. Of those with industry funding, 45 (37.8%) had identifiable results. Of those without industry funding, 17 (40.5%) had identifiable results. There was no difference in the rates of publication of results from clinical trials of degenerative diseases of the spine no matter the funding source. Copyright © 2015 Elsevier Ltd. All rights reserved.

Motor Training in Degenerative Spinocerebellar Disease: Ataxia-Specific Improvements by Intensive Physiotherapy and Exergames

Directory of Open Access Journals (Sweden)

Matthis Synofzik

2014-01-01

Full Text Available The cerebellum is essentially involved in movement control and plays a critical role in motor learning. It has remained controversial whether patients with degenerative cerebellar disease benefit from high-intensity coordinative training. Moreover, it remains unclear by which training methods and mechanisms these patients might improve their motor performance. Here, we review evidence from different high-intensity training studies in patients with degenerative spinocerebellar disease. These studies demonstrate that high-intensity coordinative training might lead to a significant benefit in patients with degenerative ataxia. This training might be based either on physiotherapy or on whole-body controlled videogames (“exergames”. The benefit shown in these studies is equal to regaining one or more years of natural disease progression. In addition, first case studies indicate that even subjects with advanced neurodegeneration might benefit from such training programs. For both types of training, the observed clinical improvements are paralleled by recoveries in ataxia-specific dysfunctions (e.g., multijoint coordination and dynamic stability. Importantly, for both types of training, the retention of the effects seems to depend on the frequency and continuity of training. Based on these studies, we here present preliminary recommendations for clinical practice, and articulate open questions that might guide future studies on neurorehabilitation in degenerative spinocerebellar disease.

[Biorheological contribution to the problem of rheumatic joint diseases].

Science.gov (United States)

Ribitsch, V; Rainer, F; Ribitsch, G; Schurz, J; Klein, G

1981-01-01

The rheological properties of synovial fluids from patients with different rheumatic diseases are discussed. Viscosities of 73 samples were determined and are compared to a standard of "healthy" human synovial fluid p. m. and to bovine synovia. Typical differences between "healthy", degenerative and inflammatory synovial fluids could be discerned. These differences can be characterized with several rheological parameters. The mechanism of lubrication in joints and the role of synovial fluid as a lubricant are discussed. Rheological properties of polymere solutions which could serve as a substitute for sick synovial fluids are described and compared to the properties of healthy synovia. Several possibilities for molecular changes which could account for the deterioration of synovial fluids in patients with different rheumatic diseases are discussed.

Human Amniotic Tissue-derived Allograft, NuCel, in Posteriolateral Lumbar Fusions for Degenerative Disc Disease

Science.gov (United States)

2017-09-14

Lumbar Degenerative Disc Disease; Spinal Stenosis; Spondylolisthesis; Spondylosis; Intervertebral Disk Displacement; Intervertebral Disk Degeneration; Spinal Diseases; Bone Diseases; Musculoskeletal Diseases; Spondylolysis

Wearable human body joint and posture measuring system

NARCIS (Netherlands)

Dunias, P.; Gransier, R.; Jin, A.; Statham, A.; Willems, P.

2011-01-01

In many medical applications, especially the orthopaedic setting, ambulatory, monitoring of human joint angles could be of substantial value to improving rehabilitation strategies and unravelling the pathomechanics of many degenerative joint diseases (e.g. knee osteoarthritis). With the ageing of

Does football cause an increase in degenerative disease of the lumbar spine?

Science.gov (United States)

Gerbino, Peter G; d'Hemecourt, Pierre A

2002-02-01

Degenerative disease of the lumbar spine is exceedingly common. Whether any specific activity increases the likelihood of developing degenerative disc disease (DDD) or facet degeneration (FD) has enormous implications. Within the field of occupational medicine there are specific activities, occupations, and morphologic characteristics that have been related to low back pain. Several specific risk factors have been conclusively linked to low back pain, and in particular DDD and FD. Within the sport of American football, there has long been the feeling that many athletes have or will develop low back pain, DDD, and FD. Proving that certain risk factors present in football will predictably lead to an increase in LBP, DDD, and FD is more difficult. At this time, it can be said that football players, in general, increase their risk of developing low back pain, DDD, and FD as their years of involvement with their sport increase. Because specific spine injuries like fracture, disc herniation, and spondylolysis are more frequent in football players, the resulting DDD and FD are greater than that of the general population. The weightlifting and violent hyperextension that are part of American football are independent risk factors for degenerative spine disease.

Radiologic imaging of degenerative and inflammatory joint disorders in women

International Nuclear Information System (INIS)

Krestan, C.R.; Grampp, S.; Kainberger . christian.krestan@univie.ac.at

2001-01-01

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)

3-D MRI for lumbar degenerative diseases

International Nuclear Information System (INIS)

Aota, Yoichi; Kumano, Kiyoshi; Hirabayashi, Shigeru; Ogawa, Yu; Izumi, Yasujiro; Yoshikawa, Koki; Yamazaki, Tatsuo.

1993-01-01

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.)

Clinical outcomes of two minimally invasive transforaminal lumbar interbody fusion (TLIF) for lumbar degenerative diseases.

Science.gov (United States)

Tian, Yonghao; Liu, Xinyu

2016-10-01

There are two modified TLIF, including MIS-TLIF and TLIF through Wiltse approach (W-TLIF). Although both of the two minimally invasive surgical procedures can be effective in the treatment for lumbar degenerative diseases, no comparative analysis has been made so far regarding their clinical outcomes. To compare the clinical outcomes of MIS-TLIF and W-TLIF for the treatment for single-segment degenerative lumbar diseases. Ninety-seven patients with single-segment degenerative lumbar disorders were included in this study. Forty-seven underwent MIS-TLIF surgery (group A). For group B, fifty patients underwent W-TLIF. The Japanese Orthopedic Association (JOA) score, the visual analog scale (VAS) of low back pain (LBP) and leg pain, MRI score and atrophy rate of CSA, interbody fusion rate were assessed during the postoperative follow-up. Incision length, blood loss, operative time, CPK, and postoperative incision pain VAS were better in group A (P degenerative disease. MIS-TLIF has less blood loss, shorter surgical incision, and less lower postoperative back pain, while W-TLIF is less expensive for hospital stay with lower exposure to X-rays.

Magnetic Resonance Imaging in degenerative disease of the lumbar spine: Fat Saturation technique and contrast medium.

Science.gov (United States)

D'Aprile, Paola; Nasuto, Michelangelo; Tarantino, Alfredo; Cornacchia, Samantha; Guglielmi, Giuseppe; Jinkins, J Randy

2018-01-19

To examine both anterior and posterior elements of the lumbar spine in patients with low back pain using MRI T2-weighted sequences with Fat Saturation (FS) and contrast enhanced T1-weighted sequences with FS. Two thousand eight hundred and twenty (2820) patients (1628 male, 1192 female, mean age 54) presenting low back pain underwent MRI standard examination (Sagittal T1w TSE and T2w TSE, axial T1 SE) with the addition of sagittal and axial T2w Fat Sat (FS) sequences. Among all the patients, 987 (35%) have been studied adding Contrast Enhanced (CE) T1w FS sequences after administration of contrast medium. Among 987 patients studied with contrast medium, we found: active-inflammatory intervertebral osteochondrosis in 646 (65%) patients; degenerative-inflammatory changes in facet joints (facet joint effusion, synovitis, synovial cysts) in 462 (47%); spondylolysis in 69 (7%); degenerative-inflammatory changes of the flava, interspinous and supraspinous ligaments in 245 (25%); inflammatory changes of posterior perispinal muscles in 84 (8%) patients. In patients with suspected no-disc-related low back pain, the implementation of T2w FS and CE T1w FS sequences to the standard MR protocol could allow a better identification of degenerative-inflammatory changes more likely associated to the pain.

Morgan line and its relationship with distraction index, angle of inclination and degenerative joint disease in the diagnosis of canine hip dysplasia

Directory of Open Access Journals (Sweden)

F.G. Miranda

2016-08-01

Full Text Available ABSTRACT We evaluated 160 hip joint radiographs of 40 dogs of different large breeds (25 females and 15 males from the metropolitan area of Belo Horizonte, Minas Gerais, Brazil. The radiographs of each dog were obtained at two different stages: stage 1 (mean 7.23 months and stage 2 (mean 14.25. The conventional radiographic method (CRM and the radiographic distraction method (RDM were used, carried out in both stages. CRM measured the Norberg angle (NA, the angle of inclination (AI and evaluated the presence of degenerative joint disease (DJD. The MRD was performed to establish the distraction index (DI. The aims were to evaluate the presence of the Morgan line and other signs of DJD and correlate them with the degree of canine hip dysplasia (CHD and also check if the DI greater than 0.3 (first stage was associated with the presence of ML (second stage. It was found that DI, AI and changes of femoral neck and the formation of osteophytes were associated with the presence of ML. It was observed that if the DI is greater than 0.3 at the first stage, the chance of a positive outcome of ML in the second stage increases by 7.2 times. Thus, 49 joints showed DI > 0.3 at the first stage, in which 31 (63.3 % presented ML at the second stage. Of the 31 animals that showed DI ≤ 0.3 at first, six (19.4% had LM at the second stage. There has been a significant association between the presence of ML and the degree of CHD. The more severe the CHD, the higher the percentage of positive ML results. Thus, among the 24 (60 % animals that showed ML, 11 (45.83 % were classified as severe dysplastics, 5 (20.83% as moderate and 8 (33.33 % as mild. None of the animals classified as normal or borderline presented ML. Among the 8 animals classified as mild dysplastics, 5 showed only ML as DJD.

Durability of mitral valve repair for mitral regurgitation due to degenerative mitral valve disease.

Science.gov (United States)

David, Tirone E

2015-09-01

Degenerative diseases of the mitral valve (MV) are the most common cause of mitral regurgitation in the Western world and the most suitable pathology for MV repair. Several studies have shown excellent long-term durability of MV repair for degenerative diseases. The best follow-up results are obtained with isolated prolapse of the posterior leaflet, however even with isolated prolapse of the anterior leaflet or prolapse of both leaflets the results are gratifying, particularly in young patients. The freedom from reoperation on the MV at 15 years exceeds 90% for isolated prolapse of the posterior leaflet and it is around 70-85% for prolapse of the anterior leaflet or both leaflets. The degree of degenerative change in the MV also plays a role in durability of MV repair. Most studies have used freedom from reoperation to assess durability of the repair but some studies that examined valve function late after surgery suggest that recurrent mitral regurgitation is higher than estimated by freedom from reoperation. We can conclude that MV repair for degenerative mitral regurgitation is associated with low probability of reoperation for up to two decades after surgery. However, almost one-third of the patients develop recurrent moderate or severe mitral regurgitation suggesting that surgery does not arrest the degenerative process.

Hip Fractures and the Bundle: A Cost Analysis of Patients Undergoing Hip Arthroplasty for Femoral Neck Fracture vs Degenerative Joint Disease.

Science.gov (United States)

Grace, Trevor R; Patterson, Joseph T; Tangtiphaiboontana, Jennifer; Krogue, Justin D; Vail, Thomas P; Ward, Derek T

2018-06-01

The purpose of this study is to determine whether episode Target Prices in the Bundled Payment for Care Improvement (BPCI) initiative sufficiently match the complexities and expenses expected for patients undergoing hip arthroplasty for femoral neck fracture (FNF) as compared to hip degenerative joint disease (DJD). Claims data under BPCI Model 2 were collected for patients undergoing hip arthroplasty at a single institution over a 2-year period. Payments from the index hospitalization to 90 days postoperatively were aggregated by Medicare Severity Diagnosis-Related Group (469 or 470), indication (DJD vs FNF), and categorized as index procedure, postacute services, and related hospital readmissions. Actual episode costs and Target Prices were compared in both the FNF and DJD cohorts undergoing hip arthroplasty to gauge the cost discrepancy in each group. A total of 183 patients were analyzed (31 with FNFs, 152 with DJD). In total, the FNF cohort incurred a $415,950 loss under the current episode Target Prices, whereas the DJD cohort incurred a $172,448 gain. Episode Target Prices were significantly higher than actual episode prices for the DJD cohort ($32,573 vs $24,776, P expenses incurred by FNF patients undergoing hip arthroplasty. Better risk-adjusting Target Prices for this fragile population should be considered to avoid disincentives and delays in care. Copyright © 2018 Elsevier Inc. All rights reserved.

Degenerative disorders of the spine

International Nuclear Information System (INIS)

Gallucci, Massimo; Puglielli, Edoardo; Splendiani, Alessandra; Pistoia, Francesca; Spacca, Giorgio

2005-01-01

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.)

Degenerative disorders of the spine

Energy Technology Data Exchange (ETDEWEB)

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

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.)

Short term outcome of posterior dynamic stabilization system in degenerative lumbar diseases.

Science.gov (United States)

Yang, Mingyuan; Li, Chao; Chen, Ziqiang; Bai, Yushu; Li, Ming

2014-11-01

Decompression and fusion is considered as the 'gold standard' for the treatment of degenerative lumbar diseases, however, many disadvantages have been reported in several studies, recently like donor site pain, pseudoarthrosis, nonunion, screw loosening, instrumentation failure, infection, adjacent segment disease (ASDis) and degeneration. Dynamic neutralization system (Dynesys) avoids many of these disadvantages. This system is made up of pedicle screws, polyethylene terephthalate cords, and polycarbonate urethane spacers to stabilize the functional spinal unit and preserve the adjacent motion after surgeries. This was a retrospective cohort study to compare the effect of Dynesys for treating degenerative lumbar diseases with posterior lumbar interbody fusion (PLIF) based on short term followup. Seventy five consecutive patients of lumbar degenerative disease operated between October 2010 and November 2012 were studied with a minimum followup of 2 years. Patients were divided into two groups according to the different surgeries. 30 patients underwent decompression and implantation of Dynesys in two levels (n = 29) or three levels (n = 1) and 45 patients underwent PLIF in two levels (n = 39) or three levels (n = 6). Clinical and radiographic outcomes between two groups were reviewed. Thirty patients (male:17, female:13) with a mean age of 55.96 ± 7.68 years were included in Dynesys group and the PLIF group included 45 patients (male:21, female:24) with a mean age of 54.69 ± 3.26 years. The average followup in Dynesys group and PLIF group was 2.22 ± 0.43 year (range 2-3.5 year) and 2.17 ± 0.76 year (range 2-3 year), respectively. Dynesys group showed a shorter operation time (141.06 ± 11.36 min vs. 176.98 ± 6.72 min, P degenerative disease showed clinical benefits with motion preservation of the operated segments, but does not have the significant advantage on motion preservation at adjacent segments, to avoid the degeneration of adjacent intervertebral disk.

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

Energy Technology Data Exchange (ETDEWEB)

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

1983-01-01

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

Perspectives of Stem Cell-Based Therapy for Age-Related Retinal Degenerative Diseases.

Science.gov (United States)

Holan, Vladimir; Hermankova, Barbora; Kossl, Jan

2017-09-01

Retinal degenerative diseases, which include age-related macular degeneration, retinitis pigmentosa, diabetic retinopathy, and glaucoma, mostly affect the elderly population and are the most common cause of decreased quality of vision or even blindness. So far, there is no satisfactory treatment protocol to prevent, stop, or cure these disorders. A great hope and promise for patients suffering from retinal diseases is represented by stem cell-based therapy that could replace diseased or missing retinal cells and support regeneration. In this respect, mesenchymal stem cells (MSCs) that can be obtained from the particular patient and used as autologous cells have turned out to be a promising stem cell type for treatment. Here we show that MSCs can differentiate into cells expressing markers of retinal cells, inhibit production of pro-inflammatory cytokines by retinal tissue, and produce a number of growth and neuroprotective factors for retinal regeneration. All of these properties make MSCs a prospective cell type for cell-based therapy of age-related retinal degenerative diseases.

Evaluation of degenerative changes in articular cartilage of osteoarthritis by Raman spectroscopy

Science.gov (United States)

Oshima, Yusuke; Ishimaru, Yasumitsu; Kiyomatsu, Hiroshi; Hino, Kazunori; Miura, Hiromasa

2018-02-01

Osteoarthritis (OA) is a very common joint disease in the aging population. Main symptom of OA is accompanied by degenerative changes of articular cartilage. Cartilage contains mostly type II collagen and proteoglycans, so it is difficult to access the quality and morphology of cartilage tissue in situ by conventional diagnostic tools (X-ray, MRI and echography) directly or indirectly. Raman spectroscopy is a label-free technique which enables to analyze molecular composition in degenerative cartilage. In this proposal, we aim to develop Raman spectroscopic system for the quality assessment of articular cartilage during arthroscopic surgery. Toward this goal, we are focusing on the proteoglycan content and collagen fiber alignment in cartilage matrix which may be associated with degenerative changes in OA, and we designed an original Raman device for remote sensing during arthroscopic surgery. In this project, we define the grading system for cartilage defect based on Raman spectroscopy, and we complete the evaluation of the Raman probing system which makes it possible to detect early stage of degenerative cartilage as a novel tool for OA diagnosis using human subject.

Imaging of demyelinating and degenerative diseases of the brain

International Nuclear Information System (INIS)

Drayer, B.P.

1987-01-01

The emergence of cross-sectional brain imaging in the past decade has greatly expanded the role of imaging as a primary diagnostic modality for demyelinating and degenerative brain disorders. To remain an effective neurologic consultant, the radiologist must better understand the neuropathology and functional significance of these disorders. MR imaging has become the dominant imaging modality for multiple sclerosis and all demyelinating and dysmyelinating disorders. Detection is most sensitive with intermediate and T2-weighted spin-echo pulse sequences. Although increased signal intensity in the white matter is a sensitive but nonspecific finding, a knowledge of the patient's history and disease pathoanatomy greatly improves diagnostic specificity. Since an increasing proportion of the population is over 65 years of age, the distinction of normal versus pathologic aging becomes critical. The role of imaging in dementing illness is to distinguish primary degenerative dementia from normal aging changes, vascular medullary artery distribution disease, microangiopathic leukoencephalopathy, communicating hydrocephalus, and mass lesions. The role of MR imaging, including brain iron mapping, is analyzed in bradykinetic, choreiform, and dystonic disorders. The complications of chronic ethanol abuse, including vermian atrophy, central pontine myelinolysis, and Wernicke encephalopathy, are also reviewed

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle

NARCIS (Netherlands)

Marijnissen, ACA; van Roermund, PM; van Melkebeek, J; Schenk, W; Verbout, AJ; Bijlsma, JWJ; Lafeber, FPJG

Objective. Osteoarthritis, (OA) is a degenerative, disabling joint disease that affects >10% of the adult population. No effective disease-modifying treatment is available. In the present study, we used joint distraction, a relatively new treatment in Which mechanical contact between the articular

Changes in rates of arthroscopy due to degenerative knee disease and traumatic meniscal tears in Finland and Sweden.

Science.gov (United States)

Mattila, Ville M; Sihvonen, Raine; Paloneva, Juha; Felländer-Tsai, Li

2016-02-01

Knee arthroscopy is commonly performed to treat degenerative knee disease symptoms and traumatic meniscal tears. We evaluated whether the recent high-quality randomized control trials not favoring arthroscopic surgery for degenerative knee disease affected the procedure incidence and trends in Finland and Sweden. We conducted a bi-national registry-based study including all adult (aged ≥18 years) inpatient and outpatient arthroscopic surgeries performed for degenerative knee disease (osteoarthritis (OA) and degenerative meniscal tears) and traumatic meniscal tears in Finland between 1997 and 2012, and in Sweden between 2001 and 2012. In Finland, the annual number of operations was 16,389 in 1997, reached 20,432 in 2007, and declined to 15,018 in 2012. In Sweden, the number of operations was 9,944 in 2001, reached 11,711 in 2008, and declined to 8,114 in 2012. The knee arthroscopy incidence for OA was 124 per 10(5) person-years in 2012 in Finland and it was 51 in Sweden. The incidence of knee arthroscopies for meniscal tears coded as traumatic steadily increased in Finland from 64 per 10(5) person-years in 1997 to 97 per 10(5) person-years in 2012, but not in Sweden. The incidence of arthroscopies for degenerative knee disease declined after 2008 in both countries. Remarkably, the incidence of arthroscopy for degenerative knee disease and traumatic meniscal tears is 2 to 4 times higher in Finland than in Sweden. Efficient implementation of new high-quality evidence in clinical practice could reduce the number of ineffective surgeries.

Changes in rates of arthroscopy due to degenerative knee disease and traumatic meniscal tears in Finland and Sweden

Science.gov (United States)

Mattila, Ville M; Sihvonen, Raine; Paloneva, Juha; Felländer-Tsai, Li

2016-01-01

Background and purpose Knee arthroscopy is commonly performed to treat degenerative knee disease symptoms and traumatic meniscal tears. We evaluated whether the recent high-quality randomized control trials not favoring arthroscopic surgery for degenerative knee disease affected the procedure incidence and trends in Finland and Sweden. Patients and methods We conducted a bi-national registry-based study including all adult (aged ≥18 years) inpatient and outpatient arthroscopic surgeries performed for degenerative knee disease (osteoarthritis (OA) and degenerative meniscal tears) and traumatic meniscal tears in Finland between 1997 and 2012, and in Sweden between 2001 and 2012. Results In Finland, the annual number of operations was 16,389 in 1997, reached 20,432 in 2007, and declined to 15,018 in 2012. In Sweden, the number of operations was 9,944 in 2001, reached 11,711 in 2008, and declined to 8,114 in 2012. The knee arthroscopy incidence for OA was 124 per 105 person-years in 2012 in Finland and it was 51 in Sweden. The incidence of knee arthroscopies for meniscal tears coded as traumatic steadily increased in Finland from 64 per 105 person-years in 1997 to 97 per 105 person-years in 2012, but not in Sweden. Interpretation The incidence of arthroscopies for degenerative knee disease declined after 2008 in both countries. Remarkably, the incidence of arthroscopy for degenerative knee disease and traumatic meniscal tears is 2 to 4 times higher in Finland than in Sweden. Efficient implementation of new high-quality evidence in clinical practice could reduce the number of ineffective surgeries. PMID:26122621

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

Energy Technology Data Exchange (ETDEWEB)

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

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

Development of Therapeutics That Induce Mitochondrial Biogenesis for the Treatment of Acute and Chronic Degenerative Diseases.

Science.gov (United States)

Cameron, Robert B; Beeson, Craig C; Schnellmann, Rick G

2016-12-08

Mitochondria have various roles in cellular metabolism and homeostasis. Because mitochondrial dysfunction is associated with many acute and chronic degenerative diseases, mitochondrial biogenesis (MB) is a therapeutic target for treating such diseases. Here, we review the role of mitochondrial dysfunction in acute and chronic degenerative diseases and the cellular signaling pathways by which MB is induced. We then review existing work describing the development and application of drugs that induce MB in vitro and in vivo. In particular, we discuss natural products and modulators of transcription factors, kinases, cyclic nucleotides, and G protein-coupled receptors.

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

International Nuclear Information System (INIS)

Guo Rui; Jin Jianhua; Li Sijin; Li Xianfeng; Zhang Xiaojuan; Ren Yuan

2008-01-01

Objective: To differentiate malignant and degenerative benign bone disease using 99m Tc- 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 99m Te-methylene diphosphonate( 99m Tc- MDP) scintigraphy were positive. 99m Tc-citrate scintigraphy was performed within a time interval of 2-7 days after 99m Tc-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 99m Tc-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 99m Tc-citrate. In semiquantitative analysis of 99m Tc- 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, P 99m Tc-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: 99m Tc- citrate scintigraphy is a promising method to differentiate malignant from benign degenerative lesions seen as areas of increased activity on 99m Tc-MDP bone scintigraphy. (authors)

Adjacent segment disease in degenerative pathologies with posterior instrumentation

Directory of Open Access Journals (Sweden)

Ana Guadalupe Ramírez Olvera

2015-03-01

Full Text Available OBJECTIVE: To establish the real incidence of adjacent segment disease after fusion, and to identify the levels and predisposing factors for the pathology, as well as the functional results. METHODS: a retrospective case series study with level of evidence IIB, in a sample of 179 patients diagnosed with stenosis of the lumbar spine, spondylolisthesis and degenerative scoliosis, submitted to surgery in the period 2005 to December 2013, with posterior instrumentation and posterolateral fusion, with follow-up from 2007 until May 2014, in which the symptomology and radiographic findings were evaluated, to establish the diagnosis and treatment. RESULTS: the study included 179 patients diagnosed with stenosis of the lumbar spine (n=116, isthmic and degenerative spondylolisthesis (n=50 and degenerative scoliosis (n=13; during the study, 20 cases of adjacent level segment were identified, 80% of which were treated surgically with extension of the instrumentation, while 20% were treated conservatively with NSAIDs and therapeutic blocks. CONCLUSION: An incidence of 11% was found, with an average of 3.25 years in diagnosis and treatment, a prevalence of females and diagnosis of stenosis of the lumbar canal on posterior instrumentation, a predominance of levels L4-L5; 80% were treated with extension of the instrumentation. The complications were persistent radiculopathy, infection of the surgical wound, and one death due to causes not related to the lumbar pathology.

A Survey of Vitamin D Status in Patients with Degenerative Diseases of the Spine.

Science.gov (United States)

Zolfaghari, Farid; Faridmoayer, Alireza; Soleymani, Bahram; Taji, Mohammadreza; Mahabadi, Maryam

2016-10-01

Descriptive cross-sectional study. To determine the prevalence of vitamin D deficiency in patients with degenerative diseases of the spine about to undergo spinal surgery and the relations between such deficiency and potential risk factors. Vitamin D has a major role in musculoskeletal system health maintenance. Recently, studies on degenerative diseases of the spine have shown a high prevalence of vitamin D deficiency in patients undergoing spine surgery. Serum levels of 25(OH)D were determined by an electrochemiluminescence detection assay. The other variables were determined through relevant questionnaires, and the data was analyzed through analysis of variance, t -test, chi-square and multivariate logistic regression analysis. A total of 110 patients were enrolled in the study. The mean serum level of 25(OH)D was 27.45±18.75 ng/mL, and 44.5% of patients showed vitamin D deficiency (25(OH)Ddegenerative diseases of the spine. On the other hand, the conventional risk factors such as old age or female sex alone did not seem to be sufficient in determining the likelihood of deficiency. Thus, it is recommended that vitamin D deficiency prevention strategies comprise a broader spectrum of the population through which such degenerative diseases and their consequences may be prevented or delayed.

Evidence Report: Risk of Cardiovascular Disease and Other Degenerative Tissue Effects from Radiation Exposure

Science.gov (United States)

Patel, Zarana; Huff, Janice; Saha, Janapriya; Wang, Minli; Blattnig, Steve; Wu, Honglu; Cucinotta, Francis

2015-01-01

Occupational radiation exposure from the space environment may result in non-cancer or non-CNS degenerative tissue diseases, such as cardiovascular disease, cataracts, and respiratory or digestive diseases. However, the magnitude of influence and mechanisms of action of radiation leading to these diseases are not well characterized. Radiation and synergistic effects of radiation cause DNA damage, persistent oxidative stress, chronic inflammation, and accelerated tissue aging and degeneration, which may lead to acute or chronic disease of susceptible organ tissues. In particular, cardiovascular pathologies such as atherosclerosis are of major concern following gamma-ray exposure. This provides evidence for possible degenerative tissue effects following exposures to ionizing radiation in the form of the GCR or SPEs expected during long-duration spaceflight. However, the existence of low dose thresholds and dose-rate and radiation quality effects, as well as mechanisms and major risk pathways, are not well-characterized. Degenerative disease risks are difficult to assess because multiple factors, including radiation, are believed to play a role in the etiology of the diseases. As additional evidence is pointing to lower, space-relevant thresholds for these degenerative effects, particularly for cardiovascular disease, additional research with cell and animal studies is required to quantify the magnitude of this risk, understand mechanisms, and determine if additional protection strategies are required.The NASA PEL (Permissive Exposure Limit)s for cataract and cardiovascular risks are based on existing human epidemiology data. Although animal and clinical astronaut data show a significant increase in cataracts following exposure and a reassessment of atomic bomb (A-bomb) data suggests an increase in cardiovascular disease from radiation exposure, additional research is required to fully understand and quantify these adverse outcomes at lower doses (less than 0.5 gray

Lateral collateral ligament avulsion of the humeroradial joint in a horse

International Nuclear Information System (INIS)

Chopin, J.B.; Wright, J.D.; Melville, L.; Robinson, W.F.

1997-01-01

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

Back pain in patients with degenerative spine disease and intradural spinal tumor: what to treat? when to treat?

Science.gov (United States)

Bellut, David; Mutter, Urs M; Sutter, Martin; Eggspuehler, Andreas; Mannion, Anne F; Porchet, François

2014-04-01

Back pain is common in industrialized countries and one of the most frequent causes of work incapacity. Successful treatment is, therefore, not only important for improving the symptoms and the quality of life of these patients but also for socioeconomic reasons. Back pain is frequently caused by degenerative spine disease. Intradural spinal tumors are rare with an annual incidence of 2-4/1,00,000 and are mostly associated with neurological deficits and radicular and nocturnal pain. Back pain is not commonly described as a concomitant symptom, such that in patients with both a tumor and degenerative spine disease, any back pain is typically attributed to the degeneration rather than the tumor. The aim of the present retrospective investigation was to study and analyze the impact of microsurgery on back/neck pain in patients with intradural spinal tumor in the presence of degenerative spinal disease in adjacent spinal segments. Fifty-eight consecutive patients underwent microsurgical, intradural tumor surgery using a standardized protocol assisted by multimodal intraoperative neuromonitoring. Clinical symptoms, complications and surgery characteristics were documented. Standardized questionnaires were used to measure outcome from the surgeon's and the patient's perspectives (Spine Tango Registry and Core Outcome Measures Index). Follow-up included clinical and neuroradiological examinations 6 weeks, 3 months and 1 year postoperatively. Back/neck pain as a leading symptom and coexisting degenerative spine disease was present in 27/58 (47 %) of the tumor patients, and these comprised to group under study. Patients underwent tumor surgery only, without addressing the degenerative spinal disease. Remission rate after tumor removal was 85 %. There were no major surgical complications. Back/neck pain as the leading symptom was eradicated in 67 % of patients. There were 7 % of patients who required further invasive therapy for their degenerative spinal disease. Intradural

Polyetheretherketone (PEEK) Rods in Lumbar Spine Degenerative Disease: A Case Series.

Science.gov (United States)

Ormond, D Ryan; Albert, Ladislau; Das, Kaushik

2016-08-01

Retrospective case series. The purpose of our study was to retrospectively review the results of posterior lumbar fusion using polyetheretherketone (PEEK) rods. Pedicle screw and rod instrumentation has become the preferred technique for performing stabilization and fusion in the lumbar spine for degenerative disease. Rigid fixation with titanium rods leads to high fusion rates, but may also contribute to stress shielding and adjacent segment degeneration (ASD). Thus, some have advocated using semirigid rods made of PEEK. Although the biomechanical properties of PEEK rods have shown improved stress-shielding characteristics and anterior load-sharing properties, there are very few clinical studies evaluating their application in the lumbar spine. We evaluated a retrospective cohort of 42 patients who underwent posterior lumbar fusion from 2007 to 2009 for the treatment of lumbar spine degenerative disease using PEEK rods. Reoperation rate was the primary outcome evaluated. Fusion rate was also evaluated. Eight of the 42 patients with PEEK rods required reoperation. Reasons for reoperation mainly included ASD (5/8) and nonunion with cage migration (3/8). Radiographically, documented fusion rate was 86%. Mean follow-up was 31.4 months. No statistical differences were found in fusion rates or reoperation between age above 55 years and younger than 55 years (P=1.00), male and female (P=0.110), single or multilevel fusion (P=0.67), and fusion with and without an interbody graft (P=0.69). Smokers showed a trend towards increased risk of reoperation for ASD or instrumentation failure (P=0.056). PEEK rods demonstrate a similar fusion and reoperation rate in comparison to other instrumentation modalities in the treatment of degenerative lumbar spine disease.

Short term outcome of posterior dynamic stabilization system in degenerative lumbar diseases

Directory of Open Access Journals (Sweden)

Mingyuan Yang

2014-01-01

Conclusion: Dynamic stabilization system treating lumbar degenerative disease showed clinical benefits with motion preservation of the operated segments, but does not have the significant advantage on motion preservation at adjacent segments, to avoid the degeneration of adjacent intervertebral disk.

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

International Nuclear Information System (INIS)

Eustace, S.; DiMasi, M.; Adams, J.; Ward, R.; Caruthers, S.; McAlindon, T.

2000-01-01

Objective. This study was undertaken to analyse the diffusion characteristics of synovial fluid in degenerative and inflammatory arthropathies.Design and patients. Ten in vitro specimens of synovial fluid from patients with both degenerative and inflammatory arthropathy were studied at body temperature with a navigator-corrected spin echo diffusion sequence (B values 0-512 s/mm 2 ), on a Philips 1.5-T Gyroscan. Subsequently synovial fluid from knee joint effusions of 25 patients (10 patients with osteoarthritis, 10 patients with effusions following trauma and 5 patients with effusions secondary to inflammatory arthritis) was evaluated with the same navigator-corrected spin echo diffusion sequence.Results. Both in vitro and in vivo study demonstrated decreased diffusion in patients with effusions secondary to degenerative joint disease (less than 2.40 x 10 -5 cm 2 /s) relative to patients with effusions accompanying knee trauma (greater than 2.75 x 10 -5 cm 2 /s) and inflammatory arthritis (in vitro and in vivo greater than 3.00 x 10 -5 cm 2 /s).Conclusion. Synovial fluid in degenerative arthritis shows less diffusion or free water movement than synovial fluid in inflammatory arthritis. Diffusion characteristics of synovial fluid may be used to predict the nature of the underlying form of arthritis in patients presenting with knee joint effusions. (orig.)

Computer tomography of inflammatory rheumatic degenerative and reparative affections and transformation processes in the region of the sacroiliac joints

International Nuclear Information System (INIS)

Heller, M.; Guertler, K.F.; Dihlmann, W.; Allgemeines Krankenhaus Barmbek, Hamburg

1980-01-01

Inflammatory rheumatic, degenerative and reparative affections and transformation processes in the region of the sacroiliac joints can be demonstrated via computer tomography and/or conventinal roentgenology. It is found that computer tomography is superior to plain roentgenography diagnosis, including tomography, in respect of malpositioning of the articulating bones and reparative phenomena. On the other hand, early diagnosis of inflammatory rheumatic changes does not yield any additional information via computer tomography. (orig.) [de

Surgical apgar score in patients undergoing lumbar fusion for degenerative spine diseases.

Science.gov (United States)

Ou, Chien-Yu; Hsu, Shih-Yuan; Huang, Jian-Hao; Huang, Yu-Hua

2017-01-01

Lumbar fusion is a procedure broadly performed for degenerative diseases of spines, but it is not without significant morbidities. Surgical Apgar Score (SAS), based on intraoperative blood loss, blood pressure, and heart rate, was developed for prognostic prediction in general and vascular operations. We aimed to examine whether the application of SAS in patients undergoing fusion procedures for degeneration of lumbar spines predicts in-hospital major complications. One hundred and ninety-nine patients that underwent lumbar fusion operation for spine degeneration were enrolled in this retrospective study. Based on whether major complications were present (N=16) or not (N=183), the patients were subdivided. We identified the intergroup differences in SAS and clinical parameters. The incidence of in-hospital major complications was 8%. The duration of hospital stay for the morbid patents was significantly prolonged (p=0.04). In the analysis of multivariable logistic regression, SAS was an independent predicting factor of the complications after lumbar fusion for degenerative spine diseases [p=0.001; odds ratio (95% confidence interval)=0.35 (0.19-0.64)]. Lower scores were accompanied with higher rates of major complications, and the area was 0.872 under the receiver operating characteristic curve. SAS is an independent predicting factor of major complications in patients after fusion surgery for degenerative diseases of lumbar spines, and provides good risk discrimination. Since the scoring system is relatively simple, objective, and practical, we suggest that SAS be included as an indicator in the guidance for level of care after lumbar fusion surgery. Copyright © 2016 Elsevier B.V. All rights reserved.

Rheumatoid arthritis affecting temporomandibular joint

Directory of Open Access Journals (Sweden)

Amandeep Sodhi

2015-01-01

Full Text Available Rheumatoid arthritis (RA is a chronic, systemic, autoimmune inflammatory disorder that is characterized by joint inflammation, erosive properties and symmetric multiple joint involvement. Temporomandibular joint (TMJ is very rare to be affected in the early phase of the disease, thus posing diagnostic challenges for the dentist. Conventional radiographs fail to show the early lesions due to its limitations. More recently cone-beam computed tomography (CBCT has been found to diagnose the early degenerative changes of TMJ and hence aid in the diagnosis of the lesions more accurately. Our case highlights the involvement of TMJ in RA and the role of advanced imaging (CBCT in diagnosing the bony changes in the early phase of the disease.

Neuro degenerative diseases: clinical concerns

International Nuclear Information System (INIS)

Ibanez, V.

2005-01-01

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 [ 18 F]-deoxyglucose and [ 18 F]-dopa. Nigrostriatal dopaminergic function is altered in PD, as evidenced by the low uptake of [ 18 F]-dopa in the posterior putamen as compared to anterior putamen and caudate nucleus. In contrast, [ 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)

Nuclear microscopy in medical research. Investigations into degenerative diseases

Energy Technology Data Exchange (ETDEWEB)

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

1997-03-01

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)

Radiotherapy of benign diseases

International Nuclear Information System (INIS)

Haase, W.

1982-01-01

Still today radiotherapy is of decisive relevance for several benign diseases. The following ones are briefly described in this introductory article: 1. Certain inflammatory and degenerative diseases as furuncles in the face, acute thrombophlebitis, recurrent sudoriparous abscesses, degenerative skeletal diseases, cervical syndrome and others; 2. rheumatic joint diseases; 3. Bechterew's disease; 4. primary presenile osteoporosis; 5. synringomyelia; 6. endocrine ophthalmopathy; 7. hypertrophic processes of the connective tissue; 8. hemangiomas. A detailed discussion and a profit-risk analysis is provided in the individual chapters of the magazine. (MG) [de

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

Energy Technology Data Exchange (ETDEWEB)

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

2005-04-15

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)

Inherited Retinal Degenerative Clinical Trial Network. Addendum

Science.gov (United States)

2013-10-01

inherited orphan retinal degenerative diseases and dry age-related macular degeneration (AMD) through the conduct of clinical trials and other...design and conduct of effective and efficient clinical trials for inherited orphan retinal degenerative diseases and dry AMD; • Limited number and...linica l trial in the NEER network for autosomal dominant retinitis pigmentosa, and the ProgSTAR studies for Stargardt disease ) . As new interventions b

Disparities in Rates of Spine Surgery for Degenerative Spine Disease Between HIV Infected and Uninfected Veterans

Science.gov (United States)

King, Joseph T.; Gordon, Adam J.; Perkal, Melissa F.; Crystal, Stephen; Rosenthal, Ronnie A.; Rodriguez-Barradas, Maria C.; Butt, Adeel A.; Gibert, Cynthia L.; Rimland, David; Simberkoff, Michael S.; Justice, Amy C.

2011-01-01

Study Design Retrospective analysis of nationwide Veterans Health Administration (VA) clinical and administrative data. Objective Examine the association between HIV infection and the rate of spine surgery for degenerative spine disease. Summary of Background Data Combination anti-retroviral therapy (cART) has prolonged survival in patients with HIV/AIDS, increasing the prevalence of chronic conditions such as degenerative spine disease that may require spine surgery. Methods We studied all HIV infected patients under care in the VA from 1996–2008 (n=40,038) and uninfected comparator patients (n=79,039) matched on age, gender, race, year, and geographic region. The primary outcome was spine surgery for degenerative spine disease defined by ICD-9 procedure and diagnosis codes. We used a multivariate Poisson regression to model spine surgery rates by HIV infection status, adjusting for factors that might affect suitability for surgery (demographics, year, comorbidities, body mass index, cART, and laboratory values). Results Two-hundred twenty eight HIV infected and 784 uninfected patients underwent spine surgery for degenerative spine disease during 700,731 patient-years of follow-up (1.44 surgeries per 1,000 patient-years). The most common procedures were spinal decompression (50%), and decompression and fusion (33%); the most common surgical sites were the lumbosacral (50%), and cervical (40%) spine. Adjusted rates of surgery were lower for HIV infected patients (0.86 per 1,000 patient-years of follow-up) than for uninfected patients (1.41 per 1,000 patient-years; IRR 0.61, 95% CI: 0.51, 0.74, Pdegenerative spine disease. Possible explanations include disease prevalence, emphasis on treatment of non-spine HIV-related symptoms, surgical referral patterns, impact of HIV on surgery risk-benefit ratio, patient preferences, and surgeon bias. PMID:21697770

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

Energy Technology Data Exchange (ETDEWEB)

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

1988-12-15

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

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

International Nuclear Information System (INIS)

Kim, Myeong Jin; Suh, Jin Seok; Lee, Jong Doo; Park, Chang Yoon

1988-01-01

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

Degenerative changes of the skeleton

International Nuclear Information System (INIS)

Hoeffken, H.

1997-01-01

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.) [de

Arthroscopic surgery for degenerative knee

DEFF Research Database (Denmark)

Thorlund, J B; Juhl, C B; Roos, E M

2015-01-01

OBJECTIVE: To determine benefits and harms of arthroscopic knee surgery involving partial meniscectomy, debridement, or both for middle aged or older patients with knee pain and degenerative knee disease. DESIGN: Systematic review and meta-analysis. MAIN OUTCOME MEASURES: Pain and physical function....... RESULTS: The search identified nine trials assessing the benefits of knee arthroscopic surgery in middle aged and older patients with knee pain and degenerative knee disease. The main analysis, combining the primary endpoints of the individual trials from three to 24 months postoperatively, showed a small...... included symptomatic deep venous thrombosis (4.13 (95% confidence interval 1.78 to 9.60) events per 1000 procedures), pulmonary embolism, infection, and death. CONCLUSIONS: The small inconsequential benefit seen from interventions that include arthroscopy for the degenerative knee is limited in time...

Degenerative changes of the skeleton

International Nuclear Information System (INIS)

Hoeffken, H.

1994-01-01

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.) [de

Association of rs731236 polymorphism in the vitamin D receptor gene with degenerative disc disease: evidence from a meta-analysis.

Science.gov (United States)

Zong, Qiang; Ni, Dongkui; Li, Lijun; Shi, Yubo

2015-01-01

The purpose of this study was to investigate the association between the rs731236 polymorphism in the vitamin D receptor gene and degenerative disc disease, especially in Chinese. We elaborately searched the relevant studies through China National Knowledge Infrastructure (CNKI), PubMed and EMBASE databases. Odds ratios (ORs) and 95% confidence intervals (CIs) were used to evaluate the strength of the association. A total of 10 studies involving 1,220 cases and 1,225 controls were included in the present study. Overall, no evidence of significant risk between rs731236 polymorphism and degenerative disc disease was found in any genetic models. In addition, stratified analyses by ethnicity revealed similar results. However, stratified analyses by sample size in Chinese population show that sample size may be the primary source of heterogeneity. This meta-analysis suggested that the rs731236 polymorphism may not be associated with degenerative disc disease. However, for Asians, there existed some diversities, especially in Chinese population. Therefore, a large number of well-designed studies are still required to assess this polymorphism and degenerative disc disease.

CT findings of isthmic spondylolisthesis and degenerative spondylolisthesis

International Nuclear Information System (INIS)

Chang, Suk Kyeong; Cho, Seong II; Chung, Gyung Ho; Lee, Sang Yong; Han, Young Min; Sohn, Myung Hee; Kim, Chong Soo; Choi, Ki Chul

1996-01-01

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

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

International Nuclear Information System (INIS)

Baldi, D.; Izzotti, A.; Bonica, P.; Pera, P.; Pulliero, A.

2009-01-01

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.

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

Energy Technology Data Exchange (ETDEWEB)

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

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.

Degenerative disease of the lumbar spine.

Science.gov (United States)

Kovacs, F M; Arana, E

2016-04-01

In the last 25 years, scientific research has brought about drastic changes in the concept of low back pain and its management. Most imaging findings, including degenerative changes, reflect anatomic peculiarities or the normal aging process and turn out to be clinically irrelevant; imaging tests have proven useful only when systemic disease is suspected or when surgery is indicated for persistent spinal cord or nerve root compression. The radiologic report should indicate the key points of nerve compression, bypassing inconsequential findings. Many treatments have proven inefficacious, and some have proven counterproductive, but they continue to be prescribed because patients want them and there are financial incentives for doing them. Following the guidelines that have proven effective for clinical management improves clinical outcomes, reduces iatrogenic complications, and decreases unjustified and wasteful healthcare expenditures. Copyright © 2016 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

Correlation between degenerative spine disease and bone marrow density: a retrospective investigation

International Nuclear Information System (INIS)

Grams, Astrid Ellen; Rehwald, Rafael; Bartsch, Alexander; Honold, Sarah; Freyschlag, Christian Franz; Knoflach, Michael; Gizewski, Elke Ruth; Glodny, Bernhard

2016-01-01

Spondylosis leads to an overestimation of bone mineral density (BMD) with dual-energy x-ray absorptiometry (DXA) but not with quantitative computed tomography (QCT). The correlation between degenerative changes of the spine and QCT-BMD was therefore investigated for the first time. One hundred thirty-four patients (66 female and 68 male) with a mean age of 49.0 ± 14.6 years (range: 19–88 years) who received a CT scan and QCT-BMD measurements of spine and hip were evaluated retrospectively. The occurrence and severity of spondylosis, osteochondrosis, and spondylarthrosis and the height of the vertebral bodies were assessed. A negative correlation was found between spinal BMD and number of spondylophytes (ρ = −0.35; p < 0.01), disc heights (r = −0.33; p < 0.01), number of discal air inclusions (ρ = −0.34; p < 0.01), the number of Schmorl nodules (ρ = −0.25; p < 0.01), the number (ρ = −0.219; p < 0.05) and the degree (ρ = −0.220; p < 0.05) of spondylarthrosis. Spinal and hip BMD correlated moderately, but the latter did not correlate with degenerative changes of the spine. In linear regression models age, osteochondrosis and spondylarthrosis were factors influencing spinal BMD. Degenerative spinal changes may be associated with reduced regional spinal mineralization. This knowledge could lead to a modification of treatment of degenerative spine disease with early treatment of osteopenia to prevent secondary fractures

Association of altered collagen content and lysyl oxidase expression in degenerative mitral valve disease.

Science.gov (United States)

Purushothaman, K-Raman; Purushothaman, Meerarani; Turnbull, Irene C; Adams, David H; Anyanwu, Anelechi; Krishnan, Prakash; Kini, Annapoorna; Sharma, Samin K; O'Connor, William N; Moreno, Pedro R

Collagen cross-linking is mediated by lysyl oxidase (LOX) enzyme in the extracellular matrix (ECM) of mitral valve leaflets. Alterations in collagen content and LOX protein expression in the ECM of degenerative mitral valve may enhance leaflet expansion and disease severity. Twenty posterior degenerative mitral valve leaflets from patients with severe mitral regurgitation were obtained at surgery. Five normal posterior mitral valve leaflets procured during autopsy served as controls. Valvular interstitial cells (VICs) density was quantified by immunohistochemistry, collagen Types I and III by picro-sirius red staining and immunohistochemistry, and proteoglycans by alcian blue staining. Protein expression of LOX and its mediator TGFβ1 were quantified by immunofluorescence and gene expression by PCR. VIC density was increased, structural Type I collagen density was reduced, while reparative Type III collagen and proteoglycan densities were increased (PDegenerative Mitral Valve Disease may be secondary to alterations in LOX protein expression, contributing to disorganization of ECM and disease severity. Copyright © 2017 Elsevier Inc. All rights reserved.

Joint space width in dysplasia of the hip

DEFF Research Database (Denmark)

Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K

2005-01-01

. Neither subjects with dysplasia nor controls had radiological signs of ongoing degenerative disease at admission. The primary radiological discriminator of degeneration of the hip was a change in the minimum joint space width over time. There were no significant differences between these with dysplasia...

Mortality for chronic-degenerative diseases in Tuscany: Ecological study comparing neighboring areas with substantial differences in environmental pollution.

Science.gov (United States)

Marabotti, Claudio; Piaggi, Paolo; Scarsi, Paolo; Venturini, Elio; Cecchi, Romina; Pingitore, Alessandro

2017-06-19

Environmental pollution is associated with morbidity and mortality for chronic-degenerative diseases. Recent data points out a relationship between proximity to industrial plants and mortality due to neoplasms. The aim of this study has been to compare mortality due to chronic-degenerative diseases in the area of Tuscany (Bassa Val di Cecina), Italy, characterized by the presence of 2 neighboring municipalities similar in terms of size but with substantial differences in industrial activities: Rosignano (the site of chemical, energy production and waste processing industries) and Cecina (with no polluting activity). Standardized mortality rates for the 2001-2010 decade were calculated; the data of the whole Tuscany was assumed as reference. Environmental levels of pollutants were obtained by databases of the Environmental Protection Agency of Tuscany Region (Agenzia Regionale per la Protezione Ambientale della Toscana - ARPAT). Maximum tolerated pollutant levels set by national laws were assumed as reference. In the whole Bassa Val di Cecina, significantly elevated standardized mortality rates due to mesothelioma, ischemic heart diseases, cerebrovascular diseases and Alzheimer and other degenerative diseases of nervous system were observed. In the municipality of Rosignano, a significant excess of mortality for all these groups of diseases was confirmed. On the contrary, the municipality of Cecina showed only significantly higher mortality rates for ischemic heart diseases. Elevated levels of heavy metals in sea water and of particulate matter which contains particles of diameter ≤ 10 mm (PM10) and ozone in air were detected in Rosignano. This study shows an excess of mortality for chronic-degenerative diseases in the area with elevated concentration of polluting factories. Proximity to industrial plants seems to represent a risk factor for those diseases. Int J Occup Med Environ Health 2017;30(4):641-653. This work is available in Open Access model and licensed

Mortality for chronic-degenerative diseases in Tuscany: Ecological study comparing neighboring areas with substantial differences in environmental pollution

Directory of Open Access Journals (Sweden)

Claudio Marabotti

2017-08-01

Full Text Available Objectives: Environmental pollution is associated with morbidity and mortality for chronic-degenerative diseases. Recent data points out a relationship between proximity to industrial plants and mortality due to neoplasms. The aim of this study has been to compare mortality due to chronic-degenerative diseases in the area of Tuscany (Bassa Val di Cecina, Italy, characterized by the presence of 2 neighboring municipalities similar in terms of size but with substantial differences in industrial activities: Rosignano (the site of chemical, energy production and waste processing industries and Cecina (with no polluting activity. Material and Methods: Standardized mortality rates for the 2001–2010 decade were calculated; the data of the whole Tuscany was assumed as reference. Environmental levels of pollutants were obtained by databases of the Environmental Protection Agency of Tuscany Region (Agenzia Regionale per la Protezione Ambientale della Toscana – ARPAT. Maximum tolerated pollutant levels set by national laws were assumed as reference. Results: In the whole Bassa Val di Cecina, significantly elevated standardized mortality rates due to mesothelioma, ischemic heart diseases, cerebrovascular diseases and Alzheimer and other degenerative diseases of nervous system were observed. In the municipality of Rosignano, a significant excess of mortality for all these groups of diseases was confirmed. On the contrary, the municipality of Cecina showed only significantly higher mortality rates for ischemic heart diseases. Elevated levels of heavy metals in sea water and of particulate matter which contains particles of diameter ≤ 10 mm (PM10 and ozone in air were detected in Rosignano. Conclusions: This study shows an excess of mortality for chronic-degenerative diseases in the area with elevated concentration of polluting factories. Proximity to industrial plants seems to represent a risk factor for those diseases. Int J Occup Med Environ Health

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

Directory of Open Access Journals (Sweden)

Olcay Eser

2013-01-01

Full Text Available Objective. Posterior dynamic stabilization is an effective alternative to fusion in the treatment of chronic instability and degenerative disc disease (DDD of the lumbar spine. This study was undertaken to investigate the efficacy of dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2. Modic types 1 and 2 degeneration can be painful. Classic approach in such cases is spine fusion. We operated 88 DDD patients with Modic types 1 and 2 via posterior dynamic stabilization. Good results were obtained after 2 years of followup. Methods. A total of 88 DDD patients with Modic types 1 and 2 were selected for this study. The patients were included in the study between 2004 and 2010. All of them were examined with lumbar anteroposterior (AP and lateral X-rays. Lordosis of the lumbar spine, segmental lordosis, and ratio of the height of the intervertebral disc spaces (IVSs were measured preoperatively and at 3, 12, and 24 months after surgery. Magnetic resonance imaging (MRI analysis was carried out, and according to the data obtained, the grade of disc degeneration was classified. The quality of life and pain scores were evaluated by visual analog scale (VAS score and Oswestry Disability Index (ODI preoperatively and at 3, 12, and 24 months after surgery. Appropriate statistical method was chosen. Results. The mean 3- and 12-month postoperative IVS ratio was significantly greater than that of the preoperative group (P0.05. Furthermore, the mean preoperative and 1 and 2 postoperative angles of lumbar lordosis and segmental lordosis were not significantly different (P>0.05. The mean VAS score and ODI, 3, 12, and 24 months after surgery, decreased significantly, when compared with the preoperative scores in the groups (P=0.000. Conclusion. Dynamic stabilization in chronic degenerative disc disease with Modic types 1 and 2 was effective.

Plasma and tissue oxidative stress index in patients with rheumatic and degenerative heart valve disease.

Science.gov (United States)

Rabus, Murat; Demirbağ, Recep; Sezen, Yusuf; Konukoğlu, Oğuz; Yildiz, Ali; Erel, Ozcan; Zeybek, Rahmi; Yakut, Cevat

2008-12-01

We investigated whether patients with rheumatic and degenerative heart valve disease (HVD) differed with regard to plasma and tissue oxidative stress index (OSI). The study included 56 patients who underwent valve replacement due to rheumatic (n=32; 15 males; mean age 47+/-10 years) and degenerative (n=24; 13 males; mean age 55+/-12 years) HVD. Plasma and tissue total oxidative status (TOS) and total antioxidative capacity (TAC) levels were measured and OSI was calculated. Patients with degenerative HVD had significantly higher age, increased interventricular septum thickness, and higher frequency of aortic stenosis, whereas the incidence of mitral stenosis was higher in patients with rheumatic HVD (p0.05). Tissue TAC was significantly lower in patients with rheumatic HVD (p=0.027), whereas tissue TOS and OSI were similar between the two HVD groups (p>0.05). In bivariate analysis, plasma OSI did not show any correlation with clinical, laboratory, and echocardiographic variables (p>0.05). Our data show that plasma and tissue OSI levels are similar in patients with rheumatic and degenerative HVD.

Thermo-sensitive injectable glycol chitosan-based hydrogel for treatment of degenerative disc disease.

Science.gov (United States)

Li, Zhengzheng; Shim, Hyeeun; Cho, Myeong Ok; Cho, Ik Sung; Lee, Jin Hyun; Kang, Sun-Woong; Kwon, Bosun; Huh, Kang Moo

2018-03-15

The use of injectable hydrogel formulations have been suggested as a promising strategy for the treatment of degenerative disc disease to both restore the biomechanical function and reduce low back pain. In this work, a new thermo-sensitive injectable hydrogels with tunable thermo-sensitivity and enhanced stability were developed with N-hexanoylation of glycol chitosan (GC) for treatment of degenerative disc disease, and their physico-chemical and biological properties were evaluated. The sol-gel transition temperature of the hydrogels was controlled in a range of 23-56 °С, depending on the degree of hexanoylation and the polymer concentration. In vitro and in vivo tests showed no cytotoxicity and no adverse effects in a rat model. The hydrogel filling of the defective IVD site in an ex vivo porcine model maintained its stability for longer than 28 days. These results suggest that the hydrogel can be used as an alternative material for treatment of disc herniation. Copyright © 2018 Elsevier Ltd. All rights reserved.

Adjacent segment pathology following anterior decompression and fusion using cage and plate for the treatment of degenerative cervical spinal diseases.

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Song, Kyung-Jin; Choi, Byung-Wan; Kim, Jong-Kil

2014-12-01

Retrospective study. To analyze the incidence and prevalence of clinical adjacent segment pathology (CASP) following anterior decompression and fusion with cage and plate augmentation for degenerative cervical diseases. No long-term data on the use of cage and plate augmentation have been reported. The study population consisted of 231 patients who underwent anterior cervical discectomy and fusion (ACDF) with cage and plate for degenerative cervical spinal disease. The incidence and prevalence of CASP was determined by using the Kaplan-Meier survival analysis. To analyze the factors that influence CASP, data on preoperative and postoperative sagittal alignment, spinal canal diameter, the distance between the plate and adjacent disc, extent of fusion level, and the presence or absence of adjacent segment degenerative changes by imaging studies were evaluated. CASP occurred in 15 of the cases, of which 9 required additional surgery. At 8-year follow-up, the average yearly incidence was 1.1%. The rate of disease-free survival based on Kaplan-Meier survival analysis was 93.6% at 5 years and 90.2% at 8 years. No statistically significant differences in CASP incidence based on radiological analysis were observed. Significantly high incidence of CASP was observed in the presence of increased adjacent segment degenerative changes (pdegenerative cervical disease is associated with a lower incidence in CSAP by 1.1% per year, and the extent of preoperative adjacent segment degenerative changes has been shown as a risk factor for CASP.

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

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Al Kaissi, Ali

2014-09-01

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.

The Burden of Pulmonary Hypertension in Patients with Degenerative Mitral Valve Disease in Enugu South-East Nigeria: An Echocardiographic Based Study.

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Ejim, E C; Oguanobi, N I

2016-01-01

Pulmonary hypertension is a common complication of degenerative mitral valve disease, and contributes significantly to both morbidity and mortality. The use of medications for reduction of pulmonary pressure in patients is not a common practice by most physicians in this part of the world because of the absence of data on pulmonary hypertension. The authors set out to find the prevalence of pulmonary hypertension in patients with degenerative mitral valve disease and to determine if there are gender differences in affectation. This will form a basis for future research on the management of pulmonary hypertension in sub-Saharan Africa. The echocardiographic records of 1390 patients carried out over a period of 4 years were retrospectively reviewed. The examinations were done with a Logic 500 MD echocardiographic machine. Tricuspid valve regurgitation velocity above 250 cm/s defined pulmonary hypertension. Data obtained included presence of degenerative mitral valve disease, pulmonary hypertension, age, and gender. A total of 1390 echocardiogram reports done at Conquest Medical Imaging, Enugu, from July 2009 to August 2013 were retrospectively reviewed. Degenerative mitral valve disease was noted in 18.7% of the patients, (259/1390) made up of 149 males and 110 females with a mean age of 68.3 (14.4) years. Pulmonary hypertension was present in 30% of the patients (78/259) and affected males more than females. Pulmonary hypertension is common in patients with degenerative mitral valve disease in Enugu, and affects males more than females.

Vitamin K, osteoporosis and degenerative diseases of ageing.

Science.gov (United States)

Vermeer, Cees; Theuwissen, Elke

2011-03-01

The function of vitamin K is to serve as a co-factor during the post-translational carboxylation of glutamate (Glu) residues into γ-carboxyglutamate (Gla) residues. The vital importance of the Gla-proteins essential for normal haemostasis is well recognized. During recent years, new Gla-containing proteins have been discovered and the vitamin K-dependent carboxylation is also essential for their function. It seems, however, that our dietary vitamin K intake is too low to support the carboxylation of at least some of these Gla-proteins. According to the triage theory, long-term vitamin K inadequacy is an independent, but modifiable risk factor for the development of degenerative diseases of ageing including osteoporosis and atherosclerosis.

A 10-year institutional experience with open branched graft reconstruction of aortic aneurysms in connective tissue disorders versus degenerative disease.

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Hicks, Caitlin W; Lue, Jennifer; Glebova, Natalia O; Ehlert, Bryan A; Black, James H

2017-11-01

Aortic reconstruction for complex thoracoabdominal aortic aneurysms (TAAAs) can be challenging, especially in patients with connective tissue disorders (CTDs) in whom tissue fragility is a major concern. Branched graft reconstruction is a more complex operation compared with inclusion patch repair of the aorta but is frequently necessary in patients with CTDs or other pathologies because of anatomic reasons. We describe our institutional experience with open branched graft reconstruction of aortic aneurysms and compare outcomes for patients with CTDs vs degenerative pathologies. We retrospectively analyzed all patients undergoing open aortic reconstruction using branched grafts at our institution between July 2006 and December 2015. Postoperative outcomes, including perioperative morbidity and mortality, midterm graft patency, and the development of new aneurysms, were compared for patients with CTD vs degenerative disease. During the 10-year study period, 137 patients (CTD, 29; degenerative, 108) underwent aortic repair with branched graft reconstruction. CTD patients were significantly younger (39 ± 1.9 vs 68 ± 1.0 years; P disease, coronary artery disease; P degenerative disease. Perioperative mortality (CTD: 10% [n = 3] vs degenerative: 6% [n = 6]; P = .40) and any complication (62% vs 55%; P = .47) were similar between groups. At a median follow-up time of 14.5 months (interquartile range: 6.5, 43.9 months), CTD patients were more likely to develop both new aortic (21%) and nonaortic (14%) aneurysms compared with the degenerative group (7% and 4% for aortic and nonaortic aneurysms, respectively; P = .02). Loss of branch graft patency occurred in 0 of 99 grafts (0%) in CTD patients and in 13 of 167 grafts (7.8%) in degenerative disease patients (P = .005). Loss of branch graft patency occurred most commonly in left renal artery bypass grafts (77%) and was clinically asymptomatic (creatinine: 1.77 ± 0.13 mg/dL currently vs 1.41 ± 0

Novel Strategies for the Improvement of Stem Cells' Transplantation in Degenerative Retinal Diseases

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Nicoară, Simona Delia; Șușman, Sergiu; Tudoran, Oana; Bărbos, Otilia; Cherecheș, Gabriela; Aștilean, Simion; Potara, Monica; Sorițău, Olga

2016-01-01

Currently, there is no cure for the permanent vision loss caused by degenerative retinal diseases. One of the novel therapeutic strategies aims at the development of stem cells (SCs) based neuroprotective and regenerative medicine. The main sources of SCs for the treatment of retinal diseases are the embryo, the bone marrow, the region of neuronal genesis, and the eye. The success of transplantation depends on the origin of cells, the route of administration, the local microenvironment, and the proper combinative formula of growth factors. The feasibility of SCs based therapies for degenerative retinal diseases was proved in the preclinical setting. However, their translation into the clinical realm is limited by various factors: the immunogenicity of the cells, the stability of the cell phenotype, the predilection of SCs to form tumors in situ, the abnormality of the microenvironment, and the association of a synaptic rewiring. To improve SCs based therapies, nanotechnology offers a smart delivery system for biomolecules, such as growth factors for SCs implantation and differentiation into retinal progenitors. This review explores the main advances in the field of retinal transplantology and applications of nanotechnology in the treatment of retinal diseases, discusses the challenges, and suggests new therapeutic approaches in retinal transplantation. PMID:27293444

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

International Nuclear Information System (INIS)

Lee, C.; Woodring, J.H.; Rogers, L.F.; Kim, K.S.

1986-01-01

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

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

International Nuclear Information System (INIS)

Jin, J.; Guo, R.; Li, S.-J.; Ren, Y.; Zhang, C.; Zhang, X.

2007-01-01

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)

Osteoarthrosis of Temporomandibular Joint Related to the Defects of Posterior Dentition: A Retrospective Study

OpenAIRE

Jitka Levorová; Vladimír Machoň; Anasuya Guha; René Foltán

2016-01-01

Osteoarthrosis (OA) of temporomandibular joint (TMJ) is a progressive degenerative disease, gradually affecting cartilage, synovial membrane and bone structures. OA of TMJ clinically manifests with joint noises, pain and restricted mouth opening. In late stages, it results in severe damage of TMJ structures and development of ankylosis. Osteoarthrosis is a multifactorial disease; the occurrence is associated with TMJ overloading. The cohort included 619 patients [538 women (87%) and 81 men (1...

Advanced glycation end-products produced systemically and by macrophages: A common contributor to inflammation and degenerative diseases.

Science.gov (United States)

Byun, Kyunghee; Yoo, YongCheol; Son, Myeongjoo; Lee, Jaesuk; Jeong, Goo-Bo; Park, Young Mok; Salekdeh, Ghasem Hosseini; Lee, Bonghee

2017-09-01

Advanced glycation end products (AGEs) and their receptor have been implicated in the progressions of many intractable diseases, such as diabetes and atherosclerosis, and are also critical for pathologic changes in chronic degenerative diseases, such as Alzheimer's disease, Parkinson's disease, and alcoholic brain damage. Recently activated macrophages were found to be a source of AGEs, and the most abundant form of AGEs, AGE-albumin excreted by macrophages has been implicated in these diseases and to act through common pathways. AGEs inhibition has been shown to prevent the pathogenesis of AGEs-related diseases in human, and therapeutic advances have resulted in several agents that prevent their adverse effects. Recently, anti-inflammatory molecules that inhibit AGEs have been shown to be good candidates for ameliorating diabetic complications as well as degenerative diseases. This review was undertaken to present, discuss, and clarify current understanding regarding AGEs formation in association with macrophages, different diseases, therapeutic and diagnostic strategy and links with RAGE inhibition. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

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

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

2000-08-01

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

Left atrial and left ventricular diastolic function after the maze procedure for atrial fibrillation in mitral valve disease: degenerative versus rheumatic.

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Kim, Hwan Wook; Moon, Mi Hyoung; Jo, Keon Hyun; Song, Hyun; Lee, Jae Won

2015-02-01

The present study was aimed to compare the left atrial and left ventricular diastolic functions amongst the rheumatic and degenerative mitral valve disease patients in atrial fibrillation who reverted to normal sinus rhythm following Cox-maze procedure. We prospectively investigated the left atrial and left ventricular function with Doppler echocardiography, by dividing into the rheumatic (N = 105) and the degenerative group (N = 47). Over the follow-up period (mean: 4.4 ± 1.2 years in the rheumatic group, 4.8 ± 1.3 years in the degenerative group), the rheumatic group showed statistically significant decrease in A' velocity and E' velocity, on contrary to degenerative group (A' velocity: mean decrease of 0.43 ± 0.13 cm/s in the rheumatic group, mean increase of 0.57 ± 0.11 cm/s in the degenerative group, p = 0.029, E' velocity: mean decrease of 0.23 ± 0.17 cm/s in the rheumatic group, mean increase of 0.21 ± 0.15 cm/s in the degenerative group, p = 0.031). In addition, the rheumatic group showed statistically significant increase in E/E' ratio than the degenerative group (mean increase of 4.49 ± 1.98 in the rheumatic group, mean increase of 1.74 ± 1.52 in the degenerative group, p = 0.047). Despite successful sinus rhythm restoration, the progressive loss of LA function as well as LV diastolic function is more prominent in the rheumatic group than the degenerative group. Therefore, differentiated strategies for postoperative surveillance are needed according to the pathology of mitral valve disease.

Does hybrid fixation prevent junctional disease after posterior fusion for degenerative lumbar disorders? A minimum 5-year follow-up study.

Science.gov (United States)

Baioni, Andrea; Di Silvestre, Mario; Greggi, Tiziana; Vommaro, Francesco; Lolli, Francesco; Scarale, Antonio

2015-11-01

Medium- to long-term retrospective evaluation of clinical and radiographic outcome in the treatment of degenerative lumbar diseases with hybrid posterior fixation. Thirty patients were included with the mean age of 47.8 years (range 35 to 60 years). All patients underwent posterior lumbar instrumentation using hybrid fixation for lumbar stenosis with instability (13 cases), degenerative spondylolisthesis Meyerding grade I (6 cases), degenerative disc disease of one or more adjacent levels in six cases and mild lumbar degenerative scoliosis in five patients. Clinical outcomes were evaluated using Oswestry disability index (ODI), Roland and Morris disability questionnaire (RMDQ), and the visual analog scale (VAS) pain scores. All patients were assessed by preoperative, postoperative and follow-up standing plain radiographs and lateral X-rays with flexion and extension. Adjacent disc degeneration was also evaluated by magnetic resonance imaging (MRI) at follow-up. At a mean follow-up of 6.1 years, we observed on X-rays and/or MRI 3 cases of adjacent segment disease (10.0 %): two of them (6.6 %) presented symptoms and recurred a new surgery. The last patient (3.3 %) developed asymptomatic retrolisthesis of L3 not requiring revision surgery. The mean preoperative ODI score was 67.6, RMDQ score was 15.1, VAS back pain score was 9.5, and VAS leg pain score was 8.6. Postoperatively, these values improved to 28.1, 5.4, 3.1, and 2.9, respectively, and remained substantially unchanged at the final follow-up: (27.7, 5.2, 2.9, and 2.7, respectively). After 5-year follow-up, hybrid posterior lumbar fixation presented satisfying clinical outcomes in the treatment of degenerative disease.

Do musculoskeletal degenerative diseases affect mortality and cause of death after 10 years in Japan?

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Tsuboi, Masaki; Hasegawa, Yukiharu; Matsuyama, Yukihiro; Suzuki, Sadao; Suzuki, Koji; Imagama, Shiro

2011-03-01

There are several reports from Europe and the United States on mortality from musculoskeletal degenerative diseases; however, no reports have been published from Japan. This study is the first that has examined whether musculoskeletal degenerative diseases affect life prognosis in Japan. As many as 944 persons who were 60 years of age and older and who underwent one or more musculoskeletal checkups (knee, lower back, and bone mineral density examination) were enrolled. Survival and death after 10 years were examined. For each knee, lower back, and bone mineral density examination, subjects were divided into normal and abnormal groups. For each of the examinations (knee, lower back, or bone mineral density), 10-year mortality was compared between the two groups. Also, causes of death were examined after 10 years. As many as 805 subjects survived and 125 died. For those with and without osteoarthritis of the knee, mortality after 10 years was 17 and 10%, respectively. For those with and without lower back abnormalities, mortality after 10 years was 12 and 14%, respectively. For those with or without low bone mineral density, mortality after 10 years was 17 and 10%, respectively. Multivariate analysis adjusted for age, gender, body mass index, and lifestyle revealed that odds ratio of death after 10 years was 2.32 and 2.33 in the presence of osteoarthritis of the knee and a low bone mineral density, respectively, and thus the risk of death after 10 years was significantly high. With regard to the cause of death, cerebrovascular and cardiovascular diseases were most frequently evident in patients with osteoarthritis of the knee. Musculoskeletal degenerative diseases influence mortality after 10 years.

Perspectives of Stem Cell-Based Therapy for Age-Related Retinal Degenerative Diseases

Czech Academy of Sciences Publication Activity Database

Holáň, Vladimír; Heřmánková, Barbora; Kössl, Jan

2017-01-01

Roč. 26, č. 9 (2017), s. 1538-1541 ISSN 0963-6897 R&D Projects: GA ČR(CZ) GA17-04800S; GA MŠk(CZ) ED1.1.00/02.0109; GA MŠk(CZ) LO1309 Institutional support: RVO:68378041 Keywords : age-related retinal degenerative diseases * mesenchymal stem cells * stem cell therapy Subject RIV: FF - HEENT, Dentistry OBOR OECD: Ophthalmology Impact factor: 3.006, year: 2016

The prevalence of sacroiliac joint degeneration in asymptomatic adults.

Science.gov (United States)

Eno, Jonathan-James T; Boone, Christopher R; Bellino, Michael J; Bishop, Julius A

2015-06-03

Degenerative changes of the sacroiliac joint have been implicated as a cause of lower back pain in adults. The purpose of this study was to determine the prevalence of sacroiliac joint degeneration in asymptomatic patients. Five hundred consecutive pelvic computed tomography (CT) scans, made at a tertiary-care medical center, of patients with no history of pain in the lower back or pelvic girdle were retrospectively reviewed and analyzed for degenerative changes of the sacroiliac joint. After exclusion criteria were applied, 373 CT scans (746 sacroiliac joints) were evaluated for degenerative changes. Regression analysis was used to determine the association between age and the degree of sacroiliac joint degeneration. The prevalence of sacroiliac joint degeneration was 65.1%, with substantial degeneration occurring in 30.5% of asymptomatic subjects. The prevalence steadily increased with age, with 91% of subjects in the ninth decade of life displaying degenerative changes. Radiographic evidence of sacroiliac joint degeneration is highly prevalent in the asymptomatic population and is associated with age. Caution must be exercised when attributing lower back or pelvic girdle pain to sacroiliac joint degeneration seen on imaging. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Transcription factor EB: from master coordinator of lysosomal pathways to candidate therapeutic target in degenerative storage diseases.

Science.gov (United States)

Sardiello, Marco

2016-05-01

The lysosome is the main catabolic hub of the cell. Owing to its role in fundamental processes such as autophagy, plasma membrane repair, mTOR signaling, and maintenance of cellular homeostasis, the lysosome has a profound influence on cellular metabolism and human health. Indeed, inefficient or impaired lysosomal function has been implicated in the pathogenesis of a number of degenerative diseases affecting various organs and tissues, most notably the brain, liver, and muscle. The discovery of the coordinated lysosomal expression and regulation (CLEAR) genetic program and its master controller, transcription factor EB (TFEB), has provided an unprecedented tool to study and manipulate lysosomal function. Most lysosome-based processes-including macromolecule degradation, autophagy, lysosomal exocytosis, and proteostasis-are under the transcriptional control of TFEB. Interestingly, impaired TFEB signaling has been suggested to be a contributing factor in the pathogenesis of several degenerative storage diseases. Preclinical studies based on TFEB exogenous expression to reinstate TFEB activity or promote CLEAR network-based lysosomal enhancement have highlighted TFEB as a candidate therapeutic target for the treatment of various degenerative storage diseases. © 2016 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of New York Academy of Sciences.

Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint.

Science.gov (United States)

Krüger, T; Wohlrab, D; Birke, A; Hein, W

2000-01-01

A retrospective study was performed of 161 patients who had undergone arthroscopic operation for chondromalacia of the knee joint. After an average follow-up period of 40 (range 10-72) months, patients with severe articular cartilage lesions who had undergone articular lavage alone showed significantly poorer results (P chondromalacia and having undergone the same surgical procedure, younger patients showed better results than older patients. The more effective interruption of the circulus vitiosus during the development of degenerative joint diseases is the primary cause for better results achieved by mechanical debridement of the joint for patients suffering from grade 2 or higher. According to the literature, aggressive subchondral abrasion in severely degenerated knees does not show any benefits. Apparently, the success of the therapy depends to a great extent on the inferiority of the potential degenerative regenerate (lack of capacity of intrinsic regeneration of the hyaline cartilage) as well as on the grade and the progression of chondromalacia. Almost every second patient suffering from grade 4 chondromalacia complained of recurrent pain 1 year postoperatively. One of every 6 patients received a knee joint prosthesis within the 1st year. Therefore, the patients' preoperative expectations have to be clearly objectified. The surgical procedure as an operation with a low complication risk can also be justified as a temporary alternative to total knee arthroplasty in patients suffering from a high-grade degeneration of the joint.

Transforaminal lumbar interbody fusion using unilateral pedicle screw fixation plus contralateral translaminar facet screw fixation in lumbar degenerative diseases.

Science.gov (United States)

Liu, Fubing; Jiang, Chun; Cao, Yuanwu; Jiang, Xiaoxing; Feng, Zhenzhou

2014-07-01

Transforaminal lumbar interbody fusion (TLIF) has been used in lumbar degenerative diseases. Some researchers have applied unilateral fixation in TLIF to reduce operational trauma without compromising the clinical outcome, but it is always suspected biomechanically unstable. The supplementary contralateral translaminar facet screw (cTLFS) seemed to be able to overcome the inherent drawbacks of unilateral pedicle screw (uPS) fixation theoretically. This study evaluates the safety, feasibility and efficacy of TLIF using uPS with cTLFS fixation in the treatment of lumbar degenerative diseases (LDD). 50 patients (29 male) underwent the aforementioned surgical technique for their LDD between December 2009 and April 2012. The results were evaluated based on visual analogue scale (VAS) of the leg and back, Japanese Orthopedic Association (JOA) score and Oswestry Disability Index (ODI) were recorded. The radiographic examinations in form of X-ray, computed tomography (CT) or magnetic resonance imaging was done preoperatively and 1 week, 3 months, 6 months, 12 months and 24 months postoperatively. The student t-test was used for comparison between the preoperative values and postoperative counterparts. P degenerative diseases short termly.

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

Energy Technology Data Exchange (ETDEWEB)

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

1994-12-01

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.).

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)

Seki, Michihiro; Kikuchi, Shinichi

1994-01-01

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.)

evaluation of a new method for the treatment of degenerative disc disease

OpenAIRE

Leidenberger, Tilman Albert Ulrich

2015-01-01

Introduction – Purpose: Evaluation of a new treatment option and applicator-system for MR-guided Percutaneous Intradiscal Thermotherapy (MRgPIT), a combinative method of Percutaneous Laser Discus Decompression (PLDD) and annuloplasty for the treatment of degenerative disc disease in open MRI. Materials and Methods: We evaluated the application of a MR-compatible thermoablative applicator-system (Invivo Germany GmbH, Schwerin, D) as well as different laser protocols for annuloplasty in an o...

CLINICAL-RADIOGRAPHIC CORRELATION OF DEGENERATIVE CHANGES OF THE SPINE - SYSTEMATIC REVIEW

Directory of Open Access Journals (Sweden)

Emiliano Neves Vialle

Full Text Available ABSTRACT Systematic review of the literature on the evaluation of images of degenerative changes of the spine and its clinical correlation. A systematic literature review was conducted, and the results evaluated for the presence of clinical correlation, as well as the type of imaging method used. The search terms were "Intervertebral Disc Degeneration", "Intervertebral disc", "Classification", "Anulus fibrosus", "Nucleus pulposus", "Lumbar spine", "Degenerative disc disease", "Degeneration", "Zygapophyseal Joint". We also assessed whether there were inter- and intraobserver agreement in the selected works and possible guidelines regarding the treatment and prognosis of patients. Of the 91 reviewed abstracts, 31 articles were selected that met the inclusion criteria. Six articles were related to the cervical spine, 13 to the lumbar spine and 12 were about changes not related specifically to a single segment of the spine. Articles that determined limiting values considered normal were also included, since variations were considered signs of degeneration or pathology. It was not possible to establish the relationship between the changes identified in imaging and the clinical history of patients, either define treatment and prognosis guidelines.

Efficacy and safety of Mobi-C cervical artificial disc versus anterior discectomy and fusion in patients with symptomatic degenerative disc disease: A meta-analysis.

Science.gov (United States)

Lu, Hui; Peng, Lihua

2017-12-01

Total disc replacement (TDR) using Mobi-C cervical artificial disc might be promising to treat symptomatic degenerative disc disease. However, the results remained controversial. We conducted a systematic review and meta-analysis to compare the efficacy and safety of Mobi-C cervical artificial disc and anterior cervical discectomy and fusion (ACDF) in patients with symptomatic degenerative disc disease. PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of Mobi-C versus ACDF on the treatment of symptomatic degenerative disc disease were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcomes were neck disability index (NDI) score, patient satisfaction, and subsequent surgical intervention. Meta-analysis was performed using the random-effect model. Four RCTs were included in the meta-analysis. Overall, compared with ACDF surgery for symptomatic degenerative disc disease, TDR using Mobi-C was associated with a significantly increased NDI score (Std. mean difference = 0.32; 95% CI = 0.10-0.53; P = .004), patient satisfaction (odds risk [OR] = 2.75; 95% confidence interval [CI] = 1.43-5.27; P = .002), and reduced subsequent surgical intervention (OR = 0.20; 95% CI = 0.11-0.37; P degenerative disc disease, TDR using Mobi-C cervical artificial disc resulted in a significantly improved NDI score, patient satisfaction, and reduced subsequent surgical intervention. There was no significant difference of neurological deterioration, radiographic success, and overall success between TDR using Mobi-C cervical artificial disc versus ACDF surgery. TDR using Mobi-C cervical artificial disc should be recommended for the treatment of symptomatic degenerative disc disease.

Neurophysiological evaluation of patients with degenerative diseases of the cervical spine

Directory of Open Access Journals (Sweden)

Ilić Tihomir V.

2011-01-01

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.

The Use of Functional Data Analysis to Evaluate Activity in a Spontaneous Model of Degenerative Joint Disease Associated Pain in Cats

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Gruen, Margaret E.; Alfaro-Córdoba, Marcela; Thomson, Andrea E.; Worth, Alicia C.; Staicu, Ana-Maria; Lascelles, B. Duncan X.

2017-01-01

Introduction and objectives Accelerometry is used as an objective measure of physical activity in humans and veterinary species. In cats, one important use of accelerometry is in the study of therapeutics designed to treat degenerative joint disease (DJD) associated pain, where it serves as the most widely applied objective outcome measure. These analyses have commonly used summary measures, calculating the mean activity per-minute over days and comparing between treatment periods. While this technique has been effective, information about the pattern of activity in cats is lost. In this study, functional data analysis was applied to activity data from client-owned cats with (n = 83) and without (n = 15) DJD. Functional data analysis retains information about the pattern of activity over the 24-hour day, providing insight into activity over time. We hypothesized that 1) cats without DJD would have higher activity counts and intensity of activity than cats with DJD; 2) that activity counts and intensity of activity in cats with DJD would be inversely correlated with total radiographic DJD burden and total orthopedic pain score; and 3) that activity counts and intensity would have a different pattern on weekends versus weekdays. Results and conclusions Results showed marked inter-cat variability in activity. Cats exhibited a bimodal pattern of activity with a sharp peak in the morning and broader peak in the evening. Results further showed that this pattern was different on weekends than weekdays, with the morning peak being shifted to the right (later). Cats with DJD showed different patterns of activity from cats without DJD, though activity and intensity were not always lower; instead both the peaks and troughs of activity were less extreme than those of the cats without DJD. Functional data analysis provides insight into the pattern of activity in cats, and an alternative method for analyzing accelerometry data that incorporates fluctuations in activity across

TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

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Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R [University of Wisconsin, Madison, Wisconsin (United States); Meyer, E [Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)

2014-06-15

Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

TU-C-12A-12: Differentiating Bone Lesions and Degenerative Joint Disease in NaF PET/CT Scans Using Machine Learning

International Nuclear Information System (INIS)

Perk, T; Bradshaw, T; Muzahir, S; Jeraj, R; Meyer, E

2014-01-01

Purpose: [F-18]NaF PET can be used to image bone metastases; however, tracer uptake in degenerative joint disease (DJD) often appears similar to metastases. This study aims to develop and compare different machine learning algorithms to automatically identify regions of [F-18]NaF scans that correspond to DJD. Methods: 10 metastatic prostate cancer patients received whole body [F-18]NaF PET/CT scans prior to treatment. Image segmentation resulted in 852 ROIs, 69 of which were identified by a nuclear medicine physician as DJD. For all ROIs, various PET and CT textural features were computed. ROIs were divided into training and testing sets used to train eight different machine learning classifiers. Classifiers were evaluated based on receiver operating characteristics area under the curve (AUC), sensitivity, specificity, and positive predictive value (PPV). We also assessed the added value of including CT features in addition to PET features for training classifiers. Results: The training set consisted of 37 DJD ROIs with 475 non-DJD ROIs, and the testing set consisted of 32 DJD ROIs with 308 non-DJD ROIs. Of all classifiers, generalized linear models (GLM), decision forests (DF), and support vector machines (SVM) had the best performance. AUCs of GLM (0.929), DF (0.921), and SVM (0.889) were significantly higher than the other models (p<0.001). GLM and DF, overall, had the best sensitivity, specificity, and PPV, and gave a significantly better performance (p<0.01) than all other models. PET/CT GLM classifiers had higher AUC than just PET or just CT. GLMs built using PET/CT information had superior or comparable sensitivities, specificities and PPVs to just PET or just CT. Conclusion: Machine learning algorithms trained with PET/CT features were able to identify some cases of DJD. GLM outperformed the other classification algorithms. Using PET and CT information together was shown to be superior to using PET or CT features alone. Research supported by the Prostate

Minimally Invasive Transforaminal Lumbar Interbody Fusion and Unilateral Fixation for Degenerative Lumbar Disease.

Science.gov (United States)

Wang, Hui-Wang; Hu, Yong-Cheng; Wu, Zhan-Yong; Wu, Hua-Rong; Wu, Chun-Fu; Zhang, Lian-Suo; Xu, Wei-Kun; Fan, Hui-Long; Cai, Jin-Sheng; Ma, Jian-Qing

2017-08-01

To evaluate the clinical effect of the minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation using a tubular retractor in the management of degenerative lumbar disease. A retrospective analysis was conducted to analyze the clinical outcome of 58 degenerative lumbar disease patients who were treated with minimally invasive transforaminal lumbar interbody fusion combined with posterolateral fusion and unilateral fixation during December 2012 to January 2015. The spine was unilaterally approached through a 3.0-cm skin incision centered on the disc space, located 2.5 cm lateral to the midline, and the multifidus muscles and longissimus dorsi were stripped off. After transforaminal lumbar interbody fusion and posterolateral fusion the unilateral pedicle screw fixation was performed. The visual analogue scale (VAS) for back and leg pain, the Oswestry disability index (ODI), and the MacNab score were applied to evaluate clinical effects. The operation time, peri-operative bleeding, postoperative time in bed, hospitalization costs, and the change in the intervertebral height were analyzed. Radiological fusion based on the Bridwell grading system was also assessed at the last follow-up. The quality of life of the patients before and after the operation was assessed using the short form-36 scale (SF-36). Fifty-eight operations were successfully performed, and no nerve root injury or dural tear occurred. The average operation time was 138 ± 33 min, intraoperative blood loss was 126 ± 50 mL, the duration from surgery to getting out of bed was 46 ± 8 h, and hospitalization cost was 1.6 ± 0.2 ten thousand yuan. All of the 58 patients were followed up for 7-31 months, with an average of 14.6 months. The postoperative VAS scores and ODI score were significantly improved compared with preoperative data (P degenerative lumbar disease, and the short-term clinical outcome is satisfactory

Evaluation of degenerative disease of the lumbar spine: MR/MR myelography versus conventional myelography/post-myelography CT.

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Shiban, Ehab; von Lehe, Marec; Simon, Matthias; Clusmann, Hans; Heinrich, Petra; Ringel, Florian; Wilhelm, Kai; Urbach, Horst; Meyer, Bernhard; Stoffel, Michael

2016-08-01

To compare the use of magnetic resonance (MR)/MR myelography (MRM) with conventional myelography/post-myelography CT (convM) for detailed surgery planning in degenerative lumbar disease. Twenty-six patients with suspected complex lumbar degenerative disease underwent MRM in addition to convM as preoperative workup. Surgery was planned based on convM-as usual at our department. Post hoc, surgical planning was repeated planned again-now based on MRM. Furthermore, the MRM-based planning was performed by six independent neurosurgeons (three groups) of different degrees of specialisation. In only 31 % of the patients, post hoc MRM-based planning resulted in the same surgical decision as originally performed, whereas in 69 % (n = 18) a different procedure was indicated. In patients with non-concurring convM- and MRM-based surgical plans, a less extended procedure was the result of MRM in six patients (23 %), a more extended one in five (19 %), and a related to side/level of decompression or nucleotomy different plan in six patients (23 %). In one patient (4 %), the MRM-based planning would have led to a completely different surgery compared to convM. Overall interobserver agreement on the MRM-based planning was substantial. Detailed planning of operative procedures for complex lumbar degenerative disease is highly dependent on the image modality used.

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

DEFF Research Database (Denmark)

Wigram, Anthony Lewis

2004-01-01

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...

Complement, a target for therapy in inflammatory and degenerative diseases.

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Morgan, B Paul; Harris, Claire L

2015-12-01

The complement system is a key innate immune defence against infection and an important driver of inflammation; however, these very properties can also cause harm. Inappropriate or uncontrolled activation of complement can cause local and/or systemic inflammation, tissue damage and disease. Complement provides numerous options for drug development as it is a proteolytic cascade that involves nine specific proteases, unique multimolecular activation and lytic complexes, an arsenal of natural inhibitors, and numerous receptors that bind to activation fragments. Drug design is facilitated by the increasingly detailed structural understanding of the molecules involved in the complement system. Only two anti-complement drugs are currently on the market, but many more are being developed for diseases that include infectious, inflammatory, degenerative, traumatic and neoplastic disorders. In this Review, we describe the history, current landscape and future directions for anti-complement therapies.

Effects of right ventricular morphology and function on outcomes of patients with degenerative mitral valve disease.

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Ye, Ying; Desai, Ravi; Vargas Abello, Lina M; Rajeswaran, Jeevanantham; Klein, Allan L; Blackstone, Eugene H; Pettersson, Gösta B

2014-11-01

The study objective was to investigate whether, in patients undergoing surgery for degenerative mitral valve disease, associated right ventricular remodeling and dysfunction are stronger determinants of preoperative organ dysfunction and prognosis than functional tricuspid regurgitation. From January 2001 to January 2011, 4197 patients underwent primary mitral valve surgery for degenerative valve disease at Cleveland Clinic. Using a quasi-experimental enriched study design, 781 patients were randomly selected within each grade of functional tricuspid regurgitation. Renal function was assessed by glomerular filtration rate and blood urea nitrogen, and hepatic function was assessed by Model for End-stage Liver Disease (MELD) score. Preoperative and postoperative right ventricular morphology and function were measured de novo on stored echocardiographic images. To assess survival, 3471 patient-years of follow-up data were available for analysis. Several preoperative right ventricular variables, but not functional tricuspid regurgitation grade (P>.05), were associated with preoperative renal and hepatic dysfunction, but neither was associated with early mortality (.2), was among the risk factors for later mortality. Postoperative unadjusted right ventricular function, but not functional tricuspid regurgitation grade (P≥.2), was associated with both early (P=.04) and later (P=.01) mortality, but in multivariable analysis appeared to be a surrogate for worse preoperative condition. Together with patient comorbidities and operative factors, right ventricular morphology and function are associated more strongly with preoperative organ dysfunction and prognosis than is functional tricuspid regurgitation severity in patients undergoing surgery for degenerative mitral valve disease. Our previous study showed that tricuspid valve repair remains the most effective treatment to improve right ventricular function. Copyright © 2014 The American Association for Thoracic Surgery

Micro PIXE investigations. Time sequencing studies in degenerative diseases

International Nuclear Information System (INIS)

Watt, F.; Minqin, R.; Patricia Thong ps

1999-01-01

The simultaneously applied techniques of Particle Induced X-ray Emission (PIXE), Rutherford Backscattering Spectrometry (RBS) and Scanning Transmission Ion Microscopy (STIM), have been successful in mapping and quantifying trace elements during the progression of several human diseases, in particular those degenerative diseases which have a corresponding animal model. In atherosclerosis, iron has been shown to be present in increased concentrations at the early stage of lesion formation, and when the animal model has been kept anaemic, the artery wall shows a reduced uptake of iron and a delay in lesion formation compared with controls. In Parkinson's disease, there is also an increased concentration of iron in the substantia nigra region of the brain. Although the increase in bulk iron appears to lag behind the dopaminergic cell death, we have detected an increase in localized deposits of iron at the onset of cell death. These two results infer that iron may play a role in both diseases, perhaps through the mediation of free radicals. The induction of epilepsy through the injection of kainic acid has shown that the cell death is accompanied by an increase in calcium levels as early as one day after injection. The increase in calcium is consistent with activation of phospholipase A 2 and free radical damage. (author)

Lower thoracic degenerative spondylithesis with concomitant lumbar spondylosis.

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Hsieh, Po-Chuan; Lee, Shih-Tseng; Chen, Jyi-Feng

2014-03-01

. The average Nurick scale score improved from 3.75 before the operation to 2 after the operation. Lower thoracic degenerative spondylolisthesis is a rare disease, which may occur concomitantly with lumbar spondylosis and confuse clinicians. Diagnosis should be made properly, especially because symptoms/signs cannot be explained purely on the basis of the available images. Micromotion due to facet joint laxity and disc degeneration was believed as the cause of progressive myelopathy. Posterior decompression with fixation/fusion procedure was appropriate for the treatment of thoracic spondylolisthesis secondary to thoracic disc degeneration. Copyright © 2013 Elsevier B.V. All rights reserved.

Preoperative Optimization of Total Joint Arthroplasty Surgical Risk: Obesity.

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Fournier, Matthew N; Hallock, Justin; Mihalko, William M

2016-08-01

Obesity is a problem that is increasing in prevalence in the United States and in other countries, and it is a common comorbidity in patients seeking total joint arthroplasty for degenerative musculoskeletal diseases. Obesity, as well as commonly associated comorbidities such as diabetes mellitus, cardiovascular disease, and those contributing to the diagnosis of metabolic syndrome, have been shown to have detrimental effects on total joint arthroplasty outcomes. Although there are effective surgical and nonsurgical interventions which can result in weight loss in these patients, concomitant benefit on arthroplasty outcomes is not clear. Preoperative optimization of surgical risk in obese total joint arthroplasty patients is an important point of intervention to improve arthroplasty outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Health assessment of environmental pollutants: proliferative and degenerative diseases

International Nuclear Information System (INIS)

Stuart, B.O.

1988-01-01

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 not yet been developed

Imaging of hip joint arthroplasty

International Nuclear Information System (INIS)

Mayerhoefer, M.E.; Fruehwald-Pallamar, J.; Czerny, C.

2009-01-01

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.) [de

Biology and therapy of inherited retinal degenerative disease: insights from mouse models

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Veleri, Shobi; Lazar, Csilla H.; Chang, Bo; Sieving, Paul A.; Banin, Eyal; Swaroop, Anand

2015-01-01

Retinal neurodegeneration associated with the dysfunction or death of photoreceptors is a major cause of incurable vision loss. Tremendous progress has been made over the last two decades in discovering genes and genetic defects that lead to retinal diseases. The primary focus has now shifted to uncovering disease mechanisms and designing treatment strategies, especially inspired by the successful application of gene therapy in some forms of congenital blindness in humans. Both spontaneous and laboratory-generated mouse mutants have been valuable for providing fundamental insights into normal retinal development and for deciphering disease pathology. Here, we provide a review of mouse models of human retinal degeneration, with a primary focus on diseases affecting photoreceptor function. We also describe models associated with retinal pigment epithelium dysfunction or synaptic abnormalities. Furthermore, we highlight the crucial role of mouse models in elucidating retinal and photoreceptor biology in health and disease, and in the assessment of novel therapeutic modalities, including gene- and stem-cell-based therapies, for retinal degenerative diseases. PMID:25650393

Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

International Nuclear Information System (INIS)

Piddo, C.; Reed, M.H.; Black, G.B.

2000-01-01

A 9-year-old boy was diagnosed with chronic recurrent multifocal osteomyelitis affecting multiple sites. During an 8-year follow-up he developed premature closure of a distal radial epiphysis and degenerative changes in the adjacent radiocarpal joint. (orig.)

Evaluation of Coflex interspinous stabilization following decompression compared with decompression and posterior lumbar interbody fusion for the treatment of lumbar degenerative disease: A minimum 5-year follow-up study.

Science.gov (United States)

Yuan, Wei; Su, Qing-Jun; Liu, Tie; Yang, Jin-Cai; Kang, Nan; Guan, Li; Hai, Yong

2017-01-01

Few studies have compared the clinical and radiological outcomes between Coflex interspinous stabilization and posterior lumbar interbody fusion (PLIF) for degenerative lumbar disease. We compared the at least 5-year clinical and radiological outcomes of Coflex stabilization and PLIF for lumbar degenerative disease. Eighty-seven consecutive patients with lumbar degenerative disease were retrospectively reviewed. Forty-two patients underwent decompression and Coflex interspinous stabilization (Coflex group), 45 patients underwent decompression and PLIF (PLIF group). Clinical and radiological outcomes were evaluated. Coflex subjects experienced less blood loss, shorter hospital stays and shorter operative time than PLIF (all pdisease was higher in the PLIF group, but this did not achieve statistical significance (11.1% vs. 4.8%, p=0.277). Both groups provided sustainable improved clinical outcomes for lumbar degenerative disease through at least 5-year follow-up. The Coflex group had significantly better early efficacy than the PLIF group. Coflex interspinous implantation after decompression is safe and effective for lumbar degenerative disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

Association between nutritional status and Modic classification in degenerative disc disease.

Science.gov (United States)

Seyithanoglu, Hakan; Aydin, Teoman; Taşpınar, Ozgur; Camli, Adil; Kiziltan, Huriye; Eris, Ali Hikmet; Hocaoglu, Ilknur Turk; Ozder, Aclan; Denizli, Ebru; Kepekci, Muge; Keskin, Yasar; Mutluer, Ahmet Serdar

2016-04-01

[Purpose] This study was conducted to examine the association between Modic classification and the eating habits in patients with degenerative disc disease (DDD) and to determine the influence of nutrition on disease severity. [Subjects and Methods] Sixty patients with DDD visiting a low back pain outpatient clinic were enrolled. Through face-to-face interviews, they completed questionnaires regarding their demographics, disease activity, smoking and alcohol use, concomitant diseases, disease duration, and nutritional status.Exclusion criteria were age 65 years, other comorbidities, missing MRI data, and inability to speak Turkish. [Results] Forty patients were finally included in the study. The frequency with which they consumed water, salt, fast food, eggs, milk, yogurt, cheese, whole wheat bread, white bread, butter, and margarine was recorded. A weak negative correlation was observed between the Modic types and fish and egg consumption. [Conclusion] Modic changes, which indicate the severity of DDD, seem to be correlated to patients' dietary habits. However, studies with comparison groups and larger samples are needed to confirm our promising results before any cause-and-effect relationship can be proposed.

Aspects of atypical degenerative lesions of vertebrae

International Nuclear Information System (INIS)

Battikha, J.G.; Garcia, J.F.; Wettstein, P.

1981-01-01

Over the last 20 years, several authors have reported aspects of degenerative disease of the vertebral column with irregularity and sclerosis of the margins of the vertebral bodies [2, 4, 7-9, 13, 15, 17]. Twenty cases of such atypical degenerative vertebral lesions have been studied over a two year period and their radiological characteristics have been compared with vertebral lesions of infective origin and in the rheumatoid disorders. (orig.)

Temporomandibular joint involvement in rheumatoid arthritis patients: association between clinical and tomographic data

OpenAIRE

Cordeiro, Patrícia C. F; Guimaraes, Josemar P; de Souza, Viviane A; Dias, Isabela M; Silva, Jesca N. N; Devito, Karina L; Bonato, Leticia L

2016-01-01

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation and synovial hyperplasia, which usually affects multiple joints. The temporomandibular joint (TMJ) becomes susceptible to the development of changes resulting from RA. The aim of this study was to evaluate the presence of TMD and degenerative bone changes in TMJ in patients diagnosed with RA (rheumatoid arthritis). The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/ TMD) questio...

The emerging role of interleukin (IL)-1 in the pathogenesis and treatment of inflammatory and degenerative eye diseases.

Science.gov (United States)

Fabiani, Claudia; Sota, Jurgen; Tosi, Gian Marco; Franceschini, Rossella; Frediani, Bruno; Galeazzi, Mauro; Rigante, Donato; Cantarini, Luca

2017-10-01

Interleukin (IL)-1 plays a key role in the pathogenesis and thereafter in the search for specific treatments of different inflammatory and degenerative eye diseases. Indeed, an overactivity of IL-1 might be an initiating factor for many immunopathologic sceneries in the eye, as proven by the efficacy of the specific IL-1 blockade in different ocular diseases. For instance, the uveitis in monogenic autoinflammatory disorders, such as Blau syndrome and cryopyrin-associated periodic syndrome, or in complex polygenic autoinflammatory disorders, such as Behçet's disease, has been successfully treated with IL-1 blockers. Similarly, therapy with the IL-1 receptor antagonist anakinra has proven successful also in scleritis and episcleritis in the context of different rheumatic conditions. Moreover, interesting findings deriving from animal models of ocular disease have set a rational basis from a therapeutic viewpoint to manage patients also with dry eye disease and a broadening number of ocular inflammatory and degenerative conditions, which start from an imbalance between IL-1 and its receptor antagonist.

Magnetic resonance imaging of canine degenerative lumbar spine diseases

International Nuclear Information System (INIS)

Karkkainen, M.; Punto, L.U.; Tulamo, R.M.

1993-01-01

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

Depression, social factors, and pain perception before and after surgery for lumbar and cervical degenerative vertebral disc disease.

Science.gov (United States)

Jabłońska, Renata; Ślusarz, Robert; Królikowska, Agnieszka; Haor, Beata; Antczak, Anna; Szewczyk, Maria

2017-01-01

The purpose of this study was to evaluate the effects of psychosocial factors on pain levels and depression, before and after surgical treatment, in patients with degenerative lumbar and cervical vertebral disc disease. The study included 188 patients (98 women, 90 men) who were confirmed to have cervical or lumbar degenerative disc disease on magnetic resonance imaging, and who underwent a single microdiscectomy procedure, with no postoperative surgical complications. All patients completed two questionnaires before and after surgery - the Beck Depression Inventory scale (I-IV) and the Visual Analog Scale for pain (0-10). On hospital admission, all patients completed a social and demographic questionnaire. The first pain and depression questionnaire evaluations were performed on the day of hospital admission (n=188); the second on the day of hospital discharge, 7 days after surgery (n=188); and the third was 6 months after surgery (n=140). Patient ages ranged from 22 to 72 years, and 140 patients had lumbar disc disease (mean age, 42.7±10.99 years) and 44 had cervical disc disease (mean age, 48.9±7.85 years). Before surgery, symptoms of depression were present in 47.3% of the patients (11.7% cervical; 35.6% lumbar), at first postoperative evaluation in 25.1% of patients (7% cervical; 18.1% lumbar), and 6 months following surgery in 31.1% of patients (7.5% cervical; 23.6% lumbar). Patients with cervical disc disease who were unemployed had the highest incidence of depression before and after surgery ( p =0.037). Patients with lumbar disc disease who had a primary level of education or work involving standing had the highest incidence of depression before and after surgery ( p =0.368). This study highlighted the association between social and demographic factors, pain perception, and depression that may persist despite surgical treatment for degenerative vertebral disc disease.

Temporomandibular joint space in children without joint disease

International Nuclear Information System (INIS)

Larheim, T.A.

1981-01-01

Bilateral assessment of the temporomandibular joint space in children without joint disease is reported. Twenty-eight children were examined with conventional radiography and 23 with tomography. High prevalence of asymmetric joint spaces with both techniques indicated that great care should be taken when using narrowing or widening of the joint space as a diagnostic criterion in children with juvenile rheumatoid arthritis. Other signs, such as restricted translation of the mandibular head, and clinical symptoms should be evaluated. (Auth.)

Association of rs2228570 polymorphism of vitamin D receptor gene with degenerative disc disease: a meta-analysis involving 2947 subjects.

Science.gov (United States)

Zong, Qiang; Ni, Dongkui; Li, Lijun; Shi, Yubo

2015-01-01

This study aimed to explore the association between the rs2228570 polymorphism in the vitamin D receptor gene and degenerative disc disease (IDD), especially in European. We perform a meta-analysis to analyze the association after searching the relevant studies through China National Knowledge Infrastructure (CNKI), PubMed, Medline and EMBASE databases. And odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the strength of the association. A total of 10 studies involving 1,465 cases and 1,482 controls were included in the meta-analysis. Overall, there was not significant risk between rs2228570 polymorphism and degenerative disc disease in any genetic models. In addition, stratified analyses by ethnicity revealed similar results. However, stratified analyses by others indicates an association between IDD and the FF genotype (OR=0.62, 95% CI=0.43- 0.90, P=0.486) in age =40, and the F allele (OR=0.84, 95% CI=0.73-0.96, P=0.992), FF genotype (OR=0.78, 95% CI=0.65-0.93, P=0.853) in sample size > 300, and ff genotype (OR=0.91, 95% CI=1.11-3.29, P=0.783), FF genotype (OR=0.70, 95% CI=0.51-0.96, P=0.258) in Northern European. This meta-analysis suggested that the rs2228570 polymorphism may not be associated with degenerative disc disease. However, there existed some diversities, especially in age 300, countries in Northern Europe, suggesting that carrying the VDR FokI F allele may be a protective factor against IDD development. But a large number of well-designed studies are still required to assess this polymorphism and degenerative disc disease.

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

International Nuclear Information System (INIS)

Toyoda, Keiko; Ida, Masahiro; Murakami, Yoshitaka; Harada, Junta; Tada, Shimpei

1992-01-01

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)

Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

Energy Technology Data Exchange (ETDEWEB)

Arnbak, Bodil; Jensen, Tue S.; Manniche, Claus [Hospital Lillebaelt, Research Department, Spine Centre of Southern Denmark, Middelfart (Denmark); University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); Egund, Niels; Zejden, Anna [Aarhus University Hospital, Department of Radiology, Aarhus C (Denmark); Hoerslev-Petersen, Kim [University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); King Christian 10th Hospital for Rheumatic Diseases, Graasten, Graasten (Denmark); Jurik, Anne G. [Hospital Lillebaelt, Research Department, Spine Centre of Southern Denmark, Middelfart (Denmark); University of Southern Denmark, Institute of Regional Health Research, Odense C (Denmark); Aarhus University Hospital, Department of Radiology, Aarhus C (Denmark)

2016-04-15

To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. (orig.)

Prevalence of degenerative and spondyloarthritis-related magnetic resonance imaging findings in the spine and sacroiliac joints in patients with persistent low back pain

International Nuclear Information System (INIS)

Arnbak, Bodil; Jensen, Tue S.; Manniche, Claus; Egund, Niels; Zejden, Anna; Hoerslev-Petersen, Kim; Jurik, Anne G.

2016-01-01

To estimate the prevalence of degenerative and spondyloarthritis (SpA)-related magnetic resonance imaging (MRI) findings in the spine and sacroiliac joints (SIJs) and analyse their association with gender and age in persistent low back pain (LBP) patients. Degenerative and SpA-related MRI findings in the whole spine and SIJs were evaluated in Spine Centre patients aged 18-40 years with LBP. Among the 1,037 patients, the prevalence of disc degeneration, disc contour changes and vertebral endplate signal (Modic) changes were 87 % (±SEM 1.1), 82 % (±1.2) and 48 % (±1.6). All degenerative spinal findings were most frequent in men and patients aged 30-40 years. Spinal SpA-related MRI findings were rare. In the SIJs, 28 % (±1.4) had at least one MRI finding, with bone marrow oedema being the most common (21 % (±1.3)). SIJ erosions were most prevalent in patients aged 18-29 years and bone marrow oedema in patients aged 30-40 years. SIJ sclerosis and fatty marrow deposition were most common in women. SIJ bone marrow oedema, sclerosis and erosions were most frequent in women indicating pregnancy-related LBP. The high prevalence of SIJ MRI findings associated with age, gender, and pregnancy-related LBP need further investigation of their clinical importance in LBP patients. (orig.)

[Analysis of the prevalence and risk factors of preoperative angiography confirmed coronary artery stenosis in patients with degenerative valvular heart disease].

Science.gov (United States)

Xu, Z J; Pan, J; Zhou, Q; Wang, D J

2017-10-24

Objective: To estimate the prevalence and the risk factors of preoperative coronary angiography (CAG) confirmed coronary stenosis in patients with degenerative valvular heart disease. Methods: A total of 491 patients who underwent screening CAG before valvular surgery due to degenerative valvular heart disease were enrolled from January 2011 to September 2014 in our hospital, and clinical data were analyzed. According to CAG results, patients were divided into positive CAG result (PCAG) group or negative CAG (NCAG) group. Positive CAG result was defined as stenosis ≥50% of the diameter of the left main coronary artery or stenosis ≥70% of the diameter of left anterior descending, left circumflex artery, and right coronary artery.Risk factors of positive CAG result were analyzed by multivariable logistic regression analysis, and Bootstrap method was used to verify the results. Results: There were 47(9.57%)degenerative valvular heart disease patients with PCAG. Patients were older ((68.0±7.6)years vs.(62.6±7.1)years, P valvular heart disease patients. Bootstrap method revealed satisfactory repeatability of multivariable logistic regression analysis results (age: OR =1.118, 95% CI 1.068-1.178, P =0.001; typical angina: OR =8.970, 95% CI 2.338-35.891, P =0.001; serum concentration of apolipoprotein B: OR =20.311, 95% CI 4.639-91.977, P =0.001). Conclusions: A low prevalence of PCAG before valvular surgery is observed in degenerative valvular heart disease patients in this patient cohort. Age, typical angina, and serum concentration of apolipoprotein B are independent risk factors of PCAG in this patient cohort.

Cytokine Involvement in Biological Inflammation Related to Degenerative Disorders of the Intervertebral Disk: A Narrative Review.

Science.gov (United States)

De Geer, Christopher M

2018-03-01

The purpose of this narrative literature review is to discuss the literature regarding the potential role that cytokines play in degenerative disk disease. The inclusion criteria were studies that used inflammatory mediators in advancing disk disease processes. Research studies were limited to the last 3 decades that had free full-text available online in English. Exclusion criteria were review articles and articles pertaining to temporomandibular joints and other joints of the body other than the intervertebral disk. The following databases were searched: PubMed, EBSCOhost, and Google Scholar through March 13, 2017. A total of 82 studies were included in this review. The papers were reviewed for complex mechanisms behind the degenerative cascade, emphasizing the role of proinflammatory cytokines, which may be instrumental in processes of inflammation, neurologic pain, and disk degeneration. Interleukin-1β and tumor necrosis factor α were among the more notable cytokines involved in this cascade. Because monocyte chemoattractant protein-1 stimulates and activates macrophages in the event of infiltration, additional proinflammatory cytokines are released to act on molecules to promote blood and nerve ingrowth, resulting in pain signaling and tissue degradation. Excessive inflammation and/or tissue damage initiates a pathologic imbalance between anabolic and catabolic processes. This literature review describes how inflammatory and biochemical changes may trigger disk degeneration. Proinflammatory cytokines stimulate microvascular blood and nerve ingrowth, resulting in pain signaling and tissue degradation. This may sensitize a person to chemical and/or mechanical stimuli, contributing to severe low back pain.

The Mircen project, neuro-degenerative disease: mechanisms, therapeutics and imaging research Unit URA Cea Cnrs 2210

International Nuclear Information System (INIS)

Hantraye, Ph.

2006-01-01

During the post-genomic era, significant advances in our understanding of the molecular basis of disease have been made. The power of functional and molecular imaging in translating this knowledge into effective therapy is now being more and more recognized. Thus, molecular imaging plays a vital role in the early identification of disease-related molecular markers, in the development of molecular-targeted therapies, and in monitoring phenotypic response to therapy both in experimental animals and in human patients. In this context, MIRCen (acronym for Molecular Imaging Research Center ) provides a comprehensive resource available to empower basic, translational, and clinical research through the application of imaging and drug, cell, and gene based technologies. The MIR center will be dedicated to the development of pre-clinical trials for the treatment of various seriously debilitating diseases such as neuro-degenerative diseases, cardiac and hepatic disorders, and infectious diseases (AIDS). Despite the fact that many of these pathologies are still incurable, recent advances in drug, cell and gene therapy point to the feasibility of new therapeutic approaches. The long term goals of MIRCen are therefore to develop and validate: - pertinent animal models for neuro-degenerative, hepatic, cardiac and infectious diseases in rodents as well as non-human primates, - novel technologies for in vivo sensing and imaging of disease-related molecular events,- drug, gene and cell based palliative and or curative therapeutic strategies aiming at protecting and /or restoring damaged or lost functions. (author)

Biology and therapy of inherited retinal degenerative disease: insights from mouse models

Directory of Open Access Journals (Sweden)

Shobi Veleri

2015-02-01

Full Text Available Retinal neurodegeneration associated with the dysfunction or death of photoreceptors is a major cause of incurable vision loss. Tremendous progress has been made over the last two decades in discovering genes and genetic defects that lead to retinal diseases. The primary focus has now shifted to uncovering disease mechanisms and designing treatment strategies, especially inspired by the successful application of gene therapy in some forms of congenital blindness in humans. Both spontaneous and laboratory-generated mouse mutants have been valuable for providing fundamental insights into normal retinal development and for deciphering disease pathology. Here, we provide a review of mouse models of human retinal degeneration, with a primary focus on diseases affecting photoreceptor function. We also describe models associated with retinal pigment epithelium dysfunction or synaptic abnormalities. Furthermore, we highlight the crucial role of mouse models in elucidating retinal and photoreceptor biology in health and disease, and in the assessment of novel therapeutic modalities, including gene- and stem-cell-based therapies, for retinal degenerative diseases.

Bilaterally Asymmetric Effects of Quantitative Trait Loci (QTLs): QTLs That Affect Laxity in the Right Versus Left Coxofemoral (Hip) Joints of the Dog (Canis familiaris)

OpenAIRE

Chase, Kevin; Lawler, Dennis F.; Adler, Fred R.; Ostrander, Elaine A.; Lark, Karl G.

2004-01-01

In dogs hip joint laxity that can lead to degenerative joint disease (DJD) is frequent and heritable, providing a genetic model for some aspects of the human disease. We have used Portuguese water dogs (PWDs) to identify Quantitative trait loci (QTLs) that regulate laxity in the hip joint.A population of 286 PWDs, each characterized by ca. 500 molecular genetic markers, was analyzed for subluxation of the hip joint as measured by the Norberg angle, a quantitative radiographic measure of laxit...

'Lumbar Degenerative Kyphosis' Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception.

Science.gov (United States)

Lee, Chang-Hyun; Chung, Chun Kee; Jang, Jee-Soo; Kim, Sung-Min; Chin, Dong-Kyu; Lee, Jung-Kil

2017-03-01

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name "primary degenerative sagittal imbalance" (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK.

CHI: A contemporaneous health index for degenerative disease monitoring using longitudinal measurements.

Science.gov (United States)

Huang, Yijun; Meng, Qiang; Evans, Heather; Lober, William; Cheng, Yu; Qian, Xiaoning; Liu, Ji; Huang, Shuai

2017-09-01

In this paper, we develop a novel formulation for contemporaneous patient risk monitoring by exploiting the emerging data-rich environment in many healthcare applications, where an abundance of longitudinal data that reflect the degeneration of the health condition can be continuously collected. Our objective, and the developed formulation, is fundamentally different from many existing risk score models for different healthcare applications, which mostly focus on predicting the likelihood of a certain outcome at a pre-specified time. Rather, our formulation translates multivariate longitudinal measurements into a contemporaneous health index (CHI) that captures patient condition changes over the course of progression. Another significant feature of our formulation is that, CHI can be estimated with or without label information, different from other risk score models strictly based on supervised learning. To develop this formulation, we focus on the degenerative disease conditions, for which we could utilize the monotonic progression characteristic (either towards disease or recovery) to learn CHI. Such a domain knowledge leads us to a novel learning formulation, and on top of that, we further generalize this formulation with a capacity to incorporate label information if available. We further develop algorithms to mitigate the challenges associated with the nonsmooth convex optimization problem by first identifying its dual reformulation as a constrained smooth optimization problem, and then, using the block coordinate descent algorithm to iteratively solve the optimization with a derived efficient projection at each iteration. Extensive numerical studies are performed on both synthetic datasets and real-world applications on Alzheimer's disease and Surgical Site Infection, which demonstrate the utility and efficacy of the proposed method on degenerative conditions that include a wide range of applications. Copyright © 2017 Elsevier Inc. All rights reserved.

Small molecule therapeutics for inflammation-associated chronic musculoskeletal degenerative diseases: Past, present and future.

Science.gov (United States)

Chen, Yangwu; Huang, Jiayun; Tang, Chenqi; Chen, Xiao; Yin, Zi; Heng, Boon Chin; Chen, Weishan; Shen, Weiliang

2017-10-01

Inflammation-associated chronic musculoskeletal degenerative diseases (ICMDDs) like osteoarthritis and tendinopathy often results in morbidity and disability, with consequent heavy socio-economic burden. Current available therapies such as NSAIDs and glucocorticoid are palliative rather than disease-modifying. Insufficient systematic research data on disease molecular mechanism also makes it difficult to exploit valid therapeutic targets. Small molecules are designed to act on specific signaling pathways and/or mechanisms of cellular physiology and function, and have gradually shown potential for treating ICMDDs. In this review, we would examine and analyze recent developments in small molecule drugs for ICMDDs, suggest possible feasible improvements in treatment modalities, and discuss future research directions. Copyright © 2017. Published by Elsevier Inc.

Connecting Malfunctioning Glial Cells and Brain Degenerative Disorders.

Science.gov (United States)

Kaminsky, Natalie; Bihari, Ofer; Kanner, Sivan; Barzilai, Ari

2016-06-01

The DNA damage response (DDR) is a complex biological system activated by different types of DNA damage. Mutations in certain components of the DDR machinery can lead to genomic instability disorders that culminate in tissue degeneration, premature aging, and various types of cancers. Intriguingly, malfunctioning DDR plays a role in the etiology of late onset brain degenerative disorders such as Parkinson's, Alzheimer's, and Huntington's diseases. For many years, brain degenerative disorders were thought to result from aberrant neural death. Here we discuss the evidence that supports our novel hypothesis that brain degenerative diseases involve dysfunction of glial cells (astrocytes, microglia, and oligodendrocytes). Impairment in the functionality of glial cells results in pathological neuro-glial interactions that, in turn, generate a "hostile" environment that impairs the functionality of neuronal cells. These events can lead to systematic neural demise on a scale that appears to be proportional to the severity of the neurological deficit. Copyright © 2016 The Authors. Production and hosting by Elsevier Ltd.. All rights reserved.

Connecting Malfunctioning Glial Cells and Brain Degenerative Disorders

Directory of Open Access Journals (Sweden)

Natalie Kaminsky

2016-06-01

Full Text Available The DNA damage response (DDR is a complex biological system activated by different types of DNA damage. Mutations in certain components of the DDR machinery can lead to genomic instability disorders that culminate in tissue degeneration, premature aging, and various types of cancers. Intriguingly, malfunctioning DDR plays a role in the etiology of late onset brain degenerative disorders such as Parkinson’s, Alzheimer’s, and Huntington’s diseases. For many years, brain degenerative disorders were thought to result from aberrant neural death. Here we discuss the evidence that supports our novel hypothesis that brain degenerative diseases involve dysfunction of glial cells (astrocytes, microglia, and oligodendrocytes. Impairment in the functionality of glial cells results in pathological neuro-glial interactions that, in turn, generate a “hostile” environment that impairs the functionality of neuronal cells. These events can lead to systematic neural demise on a scale that appears to be proportional to the severity of the neurological deficit.

MRI of cystic collection of the three joint

International Nuclear Information System (INIS)

Boutry, N.; Cotten, A.; Dewatre, F.; Chastanet, P.; Gougeon, F.

1997-01-01

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)

Cell-based therapeutic strategies for replacement and preservation in retinal degenerative diseases

Science.gov (United States)

Jones, Melissa K.; Lu, Bin; Girman, Sergey; Wang, Shaomei

2017-01-01

Cell-based therapeutics offer diverse options for treating retinal degenerative diseases, such as age-related macular degeneration (AMD) and retinitis pigmentosa (RP). AMD is characterized by both genetic and environmental risks factors, whereas RP is mainly a monogenic disorder. Though treatments exist for some patients with neovascular AMD, a majority of retinal degenerative patients have no effective therapeutics, thus indicating a need for universal therapies to target diverse patient populations. Two main cell-based mechanistic approaches are being tested in clinical trials. Replacement therapies utilize cell-derived retinal pigment epithelial (RPE) cells to supplant lost or defective host RPE cells. These cells are similar in morphology and function to native RPE cells and can potentially supplant the responsibilities of RPE in vivo. Preservation therapies utilize supportive cells to aid in visual function and photoreceptor preservation partially by neurotrophic mechanisms. The goal of preservation strategies is to halt or slow the progression of disease and maintain remaining visual function. A number of clinical trials are testing the safety of replacement and preservation cell therapies in patients; however, measures of efficacy will need to be further evaluated. In addition, a number of prevailing concerns with regards to the immune-related response, longevity, and functionality of the grafted cells will need to be addressed in future trials. This review will summarize the current status of cell-based preclinical and clinical studies with a focus on replacement and preservation strategies and the obstacles that remain regarding these types of treatments. PMID:28111323

[Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis].

Science.gov (United States)

Sun, H L; Li, C D; Yang, Z C; Yi, X D; Liu, H; Lu, H L; Li, H; Wang, Y

2016-12-18

To describe the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis. Observation group included 14 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws from November 2014 to July 2015, control group included 12 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation with traditional pedicle screws.The operation time, blood loss, number of pedicle screws and number of augmented pedicle screws in the two groups were compared. The bone cement leakage and pulmonary bone cement embolism in the two groups were also compared. The fusion rate and pedicle screws loosening by lumbar X ray and dynamic X ray were evaluated. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopaedic Association scores (JOA), Prolo functional scores and Oswestry disability (ODI) scores. Differences of operation time and blood loss in the two groups were not statistically significant. The average number of pedicle screws was 9.9±4.7 and the average number of augmented pedicle screws was 5.9±2.6 in observation group while the average number of pedicle screws was 7.1±2.8 and the average number of augmented pedicle screws was 3.0±1.9 in control group. The ratio of augmented pedicle screws was higher in observation group than in control group (0.69±0.30 vs.0.47±0.30,Pdegenerative lumbar diseases with osteoporosis was effective, with simple working processes and lower risk of bone cement leakage. The short-term clinical result was good.

The development of biomarkers for degenerative musculoskeletal conditions.

Science.gov (United States)

Jayabalan, Prakash; Sowa, Gwendolyn A

2014-02-01

With an aging population, degenerative musculoskeletal conditions will become more prevalent with significantly increasing costs to society over the next several decades. The majority of these conditions are diagnosed radiographically, at which point the disease process is often more advanced and challenging to treat. The commonly available radiographic studies also do not adequately provide information as to the exact pain generator and findings often do not correlate either to patient symptoms or function. Personalized medicine involves formulating treatments based on a patient's own biology. The development of biological markers (biomarkers) pertaining to disease is a rapidly growing area within this field of medicine. For degenerative musculoskeletal conditions, biomarkers have the potential to provide an early non-invasive method of assessing the location and severity of tissue damage and presence of inflammation. By outlining mechanisms of disease they could allow the formulation of further treatment targets and through sub-categorizing patients into different groups based on their biomarker profile, one could provide more efficacious treatments for patients. The present article is a review of the development of biomarkers for these purposes specifically as they pertain to degenerative musculoskeletal conditions.

Schwann Cell-Mediated Preservation of Vision in Retinal Degenerative Diseases via the Reduction of Oxidative Stress: A Possible Mechanism.

Science.gov (United States)

Mahmoudzadeh, Raziyeh; Heidari-Keshel, Saeed; Lashay, Alireza

2016-01-01

After injury to the central nervous system (CNS), regeneration is often inadequate, except in the case of remyelination. This remyelination capacity of the CNS is a good example of a stem/precursor cell-mediated renewal process. Schwann cells have been found to act as remyelinating agents in the peripheral nervous system (PNS), but several studies have highlighted their potential role in remyelination in the CNS too. Schwann cells are able to protect and support retinal cells by secreting growth factors such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, and basic fibroblast growth factor. Retinal degenerative diseases can be highly debilitating, and they are a major concern in countries with an ageing populations. One of the leading causes of permanent loss of vision in the West is a retinal degenerative disease known as age-related macular degeneration (AMD). In the United States, nearly 1.75 million people over the age of 40 have advanced AMD, and it is estimated that this number will increase to approximately 3 million people by 2020. One of the most common pathways involved in the initiation and development of retinal diseases is the oxidative stress pathway. In patients with diabetes, Schwann cells have been shown to be able to secrete large amounts of antioxidant enzymes that protect the PNS from the oxidative stress that results from fluctuations in blood glucose levels. This antioxidant ability may be involved in the mechanism by which Schwann cells are able to promote reconstruction in the CNS, especially in individuals with retinal injuries and degenerative diseases.

A prospective comparison study of fast T1 weighted fluid attenuation inversion recovery and T1 weighted turbo spin echo sequence at 3 T in degenerative disease of the cervical spine.

Science.gov (United States)

Ganesan, K; Bydder, G M

2014-09-01

This study compared T1 fluid attenuation inversion recovery (FLAIR) and T1 turbo spin echo (TSE) sequences for evaluation of cervical spine degenerative disease at 3 T. 72 patients (44 males and 28 females; mean age of 39 years; age range, 27-75 years) with suspected cervical spine degenerative disease were prospectively evaluated. Sagittal images of the spine were obtained using T1 FLAIR and T1 TSE sequences. Two experienced neuroradiologists compared the sequences qualitatively and quantitatively. On qualitative evaluation, cerebrospinal fluid (CSF) nulling and contrast at cord-CSF, disc-CSF and disc-cord interfaces were significantly higher on fast T1 FLAIR images than on T1 TSE images (p degenerative disease, owing to higher cord-CSF, disc-cord and disc-CSF contrast. However, intrinsic cord contrast is low on T1 FLAIR images. T1 FLAIR is more promising and sensitive than T1 TSE for evaluation of degenerative spondyloarthropathy and may provide a foundation for development of MR protocols for early detection of degenerative and neoplastic diseases.

‘Lumbar Degenerative Kyphosis’ Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception

Science.gov (United States)

Lee, Chang-Hyun; Chung, Chun Kee; Jang, Jee-Soo; Kim, Sung-Min; Chin, Dong-Kyu; Lee, Jung-Kil

2017-01-01

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal deformity. Unlike what its name suggests, LDK does not only include sagittal balance disorder of the lumbar spine and kyphosis, but also sagittal balance disorder of the whole spine and little lordosis of the lumbar spine. Moreover, this disease is closely related to the occupation of female farmers and an outdated Asian life style. These reasons necessitate a change in the nomenclature of this disorder to prevent misunderstanding. We suggest the name “primary degenerative sagittal imbalance” (PDSI), which encompasses degenerative sagittal misalignments of unknown origin in the whole spine in older-age patients, and is associated with back muscle wasting. LDK may be regarded as a subgroup of PDSI related to an occupation in agriculture. Conservative treatments such as exercise and physiotherapy are recommended as first-line treatments for patients with PDSI, and surgical treatment is considered only if conservative treatments failed. The measurement of spinopelvic parameters for sagittal balance is important prior to deformity corrective surgery. LDK can be considered a subtype of PDSI that is more likely to occur in female farmers, and hence the use of LDK as a global term for all degenerative sagittal imbalance disorders is better avoided. To avoid confusion, we recommend PDSI as a newer, more accurate diagnostic term instead of LDK. PMID:28264231

The impact of routine whole spine MRI screening in the evaluation of spinal degenerative diseases.

Science.gov (United States)

Kanna, Rishi Mugesh; Kamal, Younis; Mahesh, Anupama; Venugopal, Prakash; Shetty, Ajoy Prasad; Rajasekaran, S

2017-08-01

Magnetic resonance imaging (MRI) of the spine is a sensitive investigation, which not only provides detailed images of the spinal column but also adjacent spinal regions and para-vertebral organ systems. Such incidental findings (IF) can be asymptomatic but significant. The efficacy of whole spine T2 sagittal screening in providing additional information has been demonstrated in several spinal diseases but its routine use in patients with spinal degenerative diseases has not been studied. A review of 1486 consecutive T2w whole spine screening MRI performed for cervical, thoracic or lumbar spinal imaging for degenerative diseases, was performed to document the incidence and significance of asymptomatic IF in the spinal and extra-spinal regions. 236 (15.88%) patients had IF with a M:F ratio of 102:134 and the mean age being 50.3 years. Of these, spinal IF was observed in 122 (51.7%-Group A) while extra-spinal IF was present in 114 (48.3%-Group B). In Group A, 84 patients had IF in the vertebral column and 38 patients had IF in the spinal cord. IF within the spine included vertebral haemangioma (n = 60, 4.5%), diffuse vertebral marrow changes (n = 18, 1.2%), vertebral metastasis (n = 2), incidental cord myelopathy (n = 21), intradural tumour (n = 7), and others. 33 patients required surgical intervention of the IF (2.2%). In Group B, pelvic IF were most prevalent (n = 79, 5.3%) followed by retro-peritoneal abdominal IF in 22 (1.48%) and intra-cranial IF in 9 (0.60%). 32 (2.1%) of these pathologies required further specialist medical or surgical evaluation. Routine T2 whole spine screening MRI identified 15.8% IF of the spinal and extra-spinal regions. 65 patients (4.3%) required either spine surgical intervention or other specialist care. Considering the potential advantages in identifying significant IF and the minimal extra time spent to perform whole spine screening, its application can be considered to be incorporated in routine imaging of spinal

Stem cells as a novel tool for drug screening and treatment of degenerative diseases.

Science.gov (United States)

Zuba-Surma, Ewa K; Wojakowski, Wojciech; Madeja, Zbigniew; Ratajczak, Mariusz Z

2012-01-01

Degenerative diseases similarly as acute tissue injuries lead to massive cell loss and may cause organ failure of vital organs (e.g., heart, central nervous system). Therefore, they belong to a group of disorders that may significantly benefit from stem cells (SCs)-based therapies. Several stem and progenitor cell populations have already been described as valuable tools for developing therapeutic strategies in regenerative medicine. In particular, pluripotent stem cells (PSCs), including adult-tissue-derived PSCs, neonatal-tissue-derived SCs, embryonic stem cells (ESCs), and recently described induced pluripotent stem cells (iPSCs), are the focus of particular attention because of their capacity to differentiate into all the cell lineages. Although PSCs are predominantly envisioned to be applied for organ regeneration, they may be also successfully employed in drug screening and disease modeling. In particular, adult PSCs and iPSCs derived from patient tissues may not only be a source of cells for autologous therapies but also for individual customized in vitro drug testing and studies on the molecular mechanisms of disease. In this review, we will focus on the potential applications of SCs, especially PSCs i) in regenerative medicine therapies, ii) in studying mechanisms of disease, as well as iii) in drug screening and toxicology tests that are crucial in new drug development. In particular, we will discuss the application of SCs in developing new therapeutic approaches to treat degenerative diseases of the neural system and heart. The advantage of adult PSCs in all the above-mentioned settings is that they can be directly harvested from patient tissues and used not only as a safe non-immunogenic source of cells for therapy but also as tools for personalized drug screening and pharmacological therapies.

Roentgenological semiotics of joint involvement in psoriasis

International Nuclear Information System (INIS)

Spuzyak, M.I.

1986-01-01

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

X-ray atlas of rheumatic diseases

International Nuclear Information System (INIS)

Dihlmann, W.

1986-01-01

This atlas comprises instructive X-rays of the various inflammatory rheumatic joint diseases in all stages at the extremities and the spinal column. In addition, the complex pattern of the wide range of arthroses, also known as degenerative rheumatic disease is included. Besides the instructive pointers to X-ray diagnosis, the book is also a guide to differential diagnosis. Hence, this book is actually an X-ray atlas of joint diseases in general. Selected Contents: Introduction: What Does ''Rheumatism'' Actually Mean?/Radiographic Methodology in Rheumatic Diseases of the Locomotor System/The Mosaic of Arthritis/Adult Rheumatoid Arthritis/Seronegative Spondylarthritis/Classic Collagen Diseases/Enthesiopathies/Gout-Pseudogout

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

International Nuclear Information System (INIS)

Stabler, A.; Berger, H.; Lissner, J.

1990-01-01

This paper reports on trauma, rheumatoid arthritis, calcium pyrophosphate dihydrate crystal deposition (CPDD), neurologic disease, and beta 2 -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 beta 2 -microglobulin-related instability. However, there are some distinct radiologic differences in relation to the primary cause of the ligament defect

D-penicillamine induced degenerative dermopathy

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Sujay Khandpur

2015-01-01

Full Text Available D-penicillamine interferes with elastin and collagen metabolism and produces several cutaneous and multi-systemic side-effects. We present two cases of Wilson′s disease who on long-term penicillamine therapy developed drug-induced degenerative dermopathy manifesting as skin fragility over pressure sites and cutis laxa-like changes.

Prognosis of intervertebral disc loss from diagnosis of degenerative disc disease

Science.gov (United States)

Li, S.; Lin, A.; Tay, K.; Romano, W.; Osman, Said

2015-03-01

Degenerative Disc Disease (DDD) is one of the most common causes of low back pain, and is a major factor in limiting the quality of life of an individual usually as they enter older stages of life, the disc degeneration reduces the shock absorption available which in turn causes pain. Disc loss is one of the central processes in the pathogenesis of DDD. In this study, we investigated whether the image texture features quantified from magnetic resonance imaging (MRI) could be appropriate markers for diagnosis of DDD and prognosis of inter-vertebral disc loss. The main objective is to use simple image based biomarkers to perform prognosis of spinal diseases using non-invasive procedures. Our results from 65 subjects proved the higher success rates of the combination marker compared to the individual markers and in the future, we will extend the study to other spine regions to allow prognosis and diagnosis of DDD for a wider region.

Osteoporosis and the Management of Spinal Degenerative Disease (II)

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Tomé-Bermejo, Félix; Piñera, Angel R.; Alvarez, Luis

2017-01-01

Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been considered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequate procedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patients increase, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseases becomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible to operate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses the biomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions, as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients with osteoporosis who need spine operations. PMID:29299490

Facet joint syndrome

International Nuclear Information System (INIS)

Zigrai, M.; Zakovic, J.; Brezinova, M.; Pavlovicova, M.

2002-01-01

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)

Radiographical analysis concernig the etiology of degenerative spondylolisthesis of the lumbar spine

International Nuclear Information System (INIS)

Ihara, Koichiro

1989-01-01

The purpose of this article is to evaluate radiographically degenerative spondylolisthesis of the lumbar spine, with the main focus on the configuration of posterior elements. A comparative study between 49 cases of degenerative spondylolisthesis and 99 cases of other lumbar disorders was performed, using 13 radiographical parameters. The results clearly indicate the posterior elements of degenerative spondylolisthesis shifted horizontally and sagittally to allow slipping. This was due to the weak bony hook mechanism. Furthermore, almost all facet joints were morphologically classified as sagittal or intermediate type. Another meaningful difference was the alignment of the lumbar spine which showed an increase in both lordosis and lumbosacral angle. On the other hand, the level of Jacoby's line was almost the same in both groups. These characteristic configurations could be the cause of listhesis, although further study should be carried out to elucidate whether they are present at the non-listhetic stage. (author)

Radiographical analysis concernig the etiology of degenerative spondylolisthesis of the lumbar spine

Energy Technology Data Exchange (ETDEWEB)

Ihara, Koichiro [Yamaguchi Univ., Ube (Japan). School of Medicine

1989-12-01

The purpose of this article is to evaluate radiographically degenerative spondylolisthesis of the lumbar spine, with the main focus on the configuration of posterior elements. A comparative study between 49 cases of degenerative spondylolisthesis and 99 cases of other lumbar disorders was performed, using 13 radiographical parameters. The results clearly indicate the posterior elements of degenerative spondylolisthesis shifted horizontally and sagittally to allow slipping. This was due to the weak bony hook mechanism. Furthermore, almost all facet joints were morphologically classified as sagittal or intermediate type. Another meaningful difference was the alignment of the lumbar spine which showed an increase in both lordosis and lumbosacral angle. On the other hand, the level of Jacoby's line was almost the same in both groups. These characteristic configurations could be the cause of listhesis, although further study should be carried out to elucidate whether they are present at the non-listhetic stage. (author).

Medium-term effects of Dynesys dynamic stabilization versus posterior lumbar interbody fusion for treatment of multisegmental lumbar degenerative disease.

Science.gov (United States)

Wu, Haiting; Pang, Qingjiang; Jiang, Guoqiang

2017-10-01

Objective To compare the medium-term clinical and radiographic outcomes of Dynesys dynamic stabilization and posterior lumbar interbody fusion (PLIF) for treatment of multisegmental lumbar degenerative disease. Methods Fifty-seven patients with multisegmental lumbar degenerative disease underwent Dynesys stabilization (n = 26) or PLIF (n = 31) from December 2008 to February 2010. The mean follow-up period was 50.3 (range, 46-65) months. Clinical outcomes were evaluated using a visual analogue scale (VAS) and the Oswestry disability index (ODI). Radiographic evaluations included disc height and range of motion (ROM) of the operative segments and proximal adjacent segment on lumbar flexion-extension X-rays. The intervertebral disc signal change was defined by magnetic resonance imaging, and disc degeneration was classified by the Pfirrmann grade. Results The clinical outcomes including the VAS score and ODI were significantly improved in both groups at 3 months and the final follow-up, but the difference between the two was not significant. At the final follow-up, the disc height of stabilized segments in both groups was significantly increased; the increase was more notable in the Dynesys than PLIF group. The ROM of stabilized segments at the final follow-up decreased from 6.20° to 2.76° and 6.56° to 0.00° in the Dynesys and PLIF groups, respectively. There was no distinct change in the height of the proximal adjacent segment in the two groups. The ROM of the proximal adjacent segment in both groups increased significantly at the final follow-up; the change was significantly greater in the PLIF than Dynesys group. Only one case of adjacent segment degeneration occurred in the PLIF group, and this patient underwent a second operation. Conclusions Both Dynesys stabilization and PLIF can improve the clinical and radiographic outcomes of multisegmental lumbar degenerative disease. Compared with PLIF, Dynesys stabilization can maintain the mobility of the

Gradient-echo imaging of intervertebral disk degeneration and facet joint disease

International Nuclear Information System (INIS)

Berns, D.H.; Kormos, D.; Modic, M.T.; Carter, J.; Masaryk, T.J.; Ross, J.S.

1988-01-01

The purpose of this study was to evaluate the accuracy of gradient-echo, partial-flip angle images in the evaluation of components of degenerative spine disease. First, cadaveric spines were studied with plain radiographs, high-resolution CT, T1-weighted spin-echo (SE) MR images (repetition time msec/echo time msec=500/17). T2-weighted SE images (2,000/30-90), and fast low-angle shot (FLASH) images (200/10.50 0 ) before and after intradiskal injection of air (0.1-1cc). Second, lumbar spine MR images were retrospectively evaluated to compare gradient-echo and SE sequences. Results indicate that the signal intensity changes of the intervertebral disk related to degeneration were best appreciated on T2-weighted SE studies in both groups. Vacuum phenomenon and calcification were most accurately assessed with FLASH imaging (based on susceptibility changes) and CT images. SE images appeared more sensitive to adjacent marrow change. In the facet joints, CT was more accurate for changes in the subarticular bone, but FLASH images were more sensitive to change in the articular cartilage

Laron syndrome abnormalities: spinal stenosis, os odontoideum, degenerative changes of the atlanto-odontoid joint, and small oropharynx.

Science.gov (United States)

Kornreich, Liora; Horev, Gadi; Schwarz, Michael; Karmazyn, Boaz; Laron, Zvi

2002-04-01

Patients with Laron syndrome have an inborn growth hormone resistance. We investigated abnormalities in the upper airways and cervical spine in patients with Laron syndrome. We prospectively examined 11 patients (one child aged 9 years and 10 adults aged 36-68 years), 10 of whom underwent MR imaging of the spine or head; nine, radiography of the cervical spine; and four, CT of C1-C2. The width of the spinal canal was evaluated visually and quantitatively and compared with reference values. The smallest diameter of the oropharynx and the thickness of the palate were measured and compared with reference values. Nine age-matched female patients referred for MR imaging for unrelated reasons served as control subjects. Cervical spinal stenosis was present in seven of the adult patients, within a confidence interval of 95%. Anomaly of the dens compatible with os odontoideum was present in three patients, causing focal myelomalacia in two. The atlanto-odontoid joint showed osteoarthritic changes in six of the adult patients. The mediolateral diameter of the oropharynx was significantly smaller in the patients with Laron syndrome than in the control subjects (P Laron syndrome develop significant narrowing of the cervical spinal canal and early degenerative changes of the atlanto-odontoid joint. Laron syndrome is associated with os odontoideum causing myelomalacia. The dimensions of the oropharynx are small. Patients may be prone to neurologic morbidity and sleep disturbances. Routine MR imaging of the cervical spine is recommended in these patients.

[Effect evaluation of over 5 year follow up of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion for lumbar degenerative diseases].

Science.gov (United States)

Wang, Chong; Ying, Jin-He; Xie, Pan-Pan; Wu, Xiao-Guang

2016-07-25

To evaluate the clinical effects of over 5 year follow up of unilateral pedicle screw fixation with transforaminal lumbar interbody fusion(TLIF) in treating lumbar degenerative diseases. The clinical data of 24 patients with lumbar degenerative disease underwent unilateral pedicle screw fixation with transforaminal lumbar interbody fusion from March 2007 to October 2009, were retrospectively analyzed. There were 13 males and 11 females, aged from 34 to 68 years old with an average of 52 years. Postoperative pain and functional results were analyzed by the visual analogue scale(VAS) and Oswestry Disability Index(ODI). Radiological examination was obtained for each patient to assess the height of intervertebral space, postoperative intervertebral fusion conditions and general complications. All patients were followed up from 5 to 8 years with an average of 6.7 years. VAS scores of low back pain and leg pain decreased from preoperative 7.82±0.71, 8.42±1.24 to postoperative 1.87±0.81, 2.23±1.62, respectively( P degenerative diseases according to over 5 year follow up, however, its indications should be well considered. But the problems such as intervertebral space height of operated side loss and adjacent segment degeneration after unilateral pedicle screw fixation need further clinical study.

Climbing fiber-Purkinje cell synaptic pathology in tremor and cerebellar degenerative diseases

Science.gov (United States)

Lin, Chi-Ying; Wang, Jie; Sims, Peter A.; Pan, Ming-Kai; Liou, Jyun-you; Lee, Danielle; Tate, William J.; Kelly, Geoffrey C.; Louis, Elan D.; Faust, Phyllis L.

2017-01-01

Changes in climbing fiber-Purkinje cell (CF-PC) synaptic connections have been found in the essential tremor (ET) cerebellum, and these changes are correlated with tremor severity. Whether these postmortem changes are specific to ET remains to be investigated. We assessed CF-PC synaptic pathology in the postmortem cerebellum across a range of degenerative movement disorders [10 Parkinson’s disease (PD) cases, 10 multiple system atrophy (MSA) cases, 10 spinocerebellar ataxia type 1 (SCA1) cases, and 20 ET cases] and 25 controls. We observed differences in terms of CF pathological features across these disorders. Specifically, PD cases and ET cases both had more CFs extending into the parallel fiber (PF) territory, but ET cases had more complex branching and increased length of CFs in the PF territory along with decreased CF synaptic density compared to PD cases. MSA cases and SCA1 cases had the most severely reduced CF synaptic density and a marked paucity of CFs extending into the PF territory. Furthermore, CFs in a subset of MSA cases formed collateral branches parallel to the PC layer, a feature not seen in other diagnostic groups. Using unsupervised cluster analysis, the cases and controls could all be categorized into four clusters based on the CF pathology and features of PC pathology, including counts of PCs and their axonal torpedoes. ET cases and PD cases co-segregated into two clusters, whereas SCA1 cases and MSA cases formed another cluster, separate from the control cluster. Interestingly, the presence of resting tremor seemed to be the clinical feature that separated the cases into the two ET-PD clusters. In conclusion, our study demonstrates that these degenerative movement disorders seem to differ with respect to the pattern of CF synaptic pathology they exhibit. It remains to be determined how these differences contribute to the clinical presentations of these diseases. PMID:27704282

Intravenous administration of puppy deciduous teeth stem cells in degenerative valve disease

Directory of Open Access Journals (Sweden)

Soontaree Petchdee

2016-12-01

Full Text Available Aim: The objective of this study is to investigate the improvement of heart function in dogs with chronic valvular heart disease after puppy deciduous teeth stem cells (pDSCs administration. Materials and Methods: 20 client-owned dogs with degenerative valvular heart disease underwent multiple intravenous injections of allogeneic pDSCs. Dogs were randomly assigned to two groups: (i Control group (n=10 with standard treatment for heart failure and (ii group with standard treatment and multiple administrations of pDSCs (n=10. Electrocardiography, complete transthoracic echocardiography, thoracic radiography, and blood pressure were recorded before and after pDSCs injections for 15, 30 and 60 days. Results: Post pDSCs injection showed measurable improvement in left ventricular ejection fraction, American College of Veterinary Internal Medicine (ACVIM functional class significantly improved and improved quality of life scores were observed. In the control group, there were no significant enhancements in heart function or ACVIM class. Conclusions: This finding suggests that pDSCs could be a supplement for valvular heart disease treatment.

Radiographical analysis concernig the etiology of degenerative spondylolisthesis of the lumbar spine

Energy Technology Data Exchange (ETDEWEB)

Ihara, Koichiro (Yamaguchi Univ., Ube (Japan). School of Medicine)

1989-12-01

The purpose of this article is to evaluate radiographically degenerative spondylolisthesis of the lumbar spine, with the main focus on the configuration of posterior elements. A comparative study between 49 cases of degenerative spondylolisthesis and 99 cases of other lumbar disorders was performed, using 13 radiographical parameters. The results clearly indicate the posterior elements of degenerative spondylolisthesis shifted horizontally and sagittally to allow slipping. This was due to the weak bony hook mechanism. Furthermore, almost all facet joints were morphologically classified as sagittal or intermediate type. Another meaningful difference was the alignment of the lumbar spine which showed an increase in both lordosis and lumbosacral angle. On the other hand, the level of Jacoby's line was almost the same in both groups. These characteristic configurations could be the cause of listhesis, although further study should be carried out to elucidate whether they are present at the non-listhetic stage. (author).

Imbalanced Protein Expression Patterns of Anabolic, Catabolic, Anti-Catabolic and Inflammatory Cytokines in Degenerative Cervical Disc Cells: New Indications for Gene Therapeutic Treatments of Cervical Disc Diseases

Science.gov (United States)

Mern, Demissew S.; Beierfuß, Anja; Fontana, Johann; Thomé, Claudius; Hegewald, Aldemar A.

2014-01-01

Degenerative disc disease (DDD) of the cervical spine is common after middle age and can cause loss of disc height with painful nerve impingement, bone and joint inflammation. Despite the clinical importance of these problems, in current publications the pathology of cervical disc degeneration has been studied merely from a morphologic view point using magnetic resonance imaging (MRI), without addressing the issue of biological treatment approaches. So far a wide range of endogenously expressed bioactive factors in degenerative cervical disc cells has not yet been investigated, despite its importance for gene therapeutic approaches. Although degenerative lumbar disc cells have been targeted by different biological treatment approaches, the quantities of disc cells and the concentrations of gene therapeutic factors used in animal models differ extremely. These indicate lack of experimentally acquired data regarding disc cell proliferation and levels of target proteins. Therefore, we analysed proliferation and endogenous expression levels of anabolic, catabolic, ant-catabolic, inflammatory cytokines and matrix proteins of degenerative cervical disc cells in three-dimensional cultures. Preoperative MRI grading of cervical discs was used, then grade III and IV nucleus pulposus (NP) tissues were isolated from 15 patients, operated due to cervical disc herniation. NP cells were cultured for four weeks with low-glucose in collagen I scaffold. Their proliferation rates were analysed using 3-(4, 5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide. Their protein expression levels of 28 therapeutic targets were analysed using enzyme-linked immunosorbent assay. During progressive grades of degeneration NP cell proliferation rates were similar. Significantly decreased aggrecan and collagen II expressions (P<0.0001) were accompanied by accumulations of selective catabolic and inflammatory cytokines (disintegrin and metalloproteinase with thrombospondin motifs 4 and 5, matrix

Clinical outcome of stand-alone ALIF compared to posterior instrumentation for degenerative disc disease

DEFF Research Database (Denmark)

Udby, Peter M.; Bech-Azeddine, Rachid

2015-01-01

The objective of the article was to: a) present results from a case cohort pilot study comparing stand-alone ALIF and TLIF and, b) review the literature on studies comparing the clinical outcome of stand-alone ALIF with posterior instrumentation including TLIF or PLIF, in patients with disabling...... low back pain resulting from degenerative disc disease. ALIF surgery has previously been linked with certain high risk complications and unfavorable long term fusion results. Newer studies suggest that stand-alone ALIF can possibly be advantageous compared to other types of posterior instrumented...

Modern approaches to diagnostics of combined degenerative hip and spine pathology

Directory of Open Access Journals (Sweden)

V. V. Khominets

2014-01-01

Full Text Available The results of standard radiographs of 90 patients with hip-spine syndrome associated with one unilateral or bilateral III stage hip osteoarthhrosis were analyzed with the aim to improve the diagnostics of pathological changes in the "hip joint-pelvis- spine" complex. 12 parameters of sagittal spinal-pelvic balance and 3 parameters of frontal one were studied and the degenerative changes in spinal motional segments were evaluated. The statistical processing of obtained data was made. It was stated that the most frequent variant of sagittal spinal-pelvic profile is hyperlordosic one, followed by formation of degenerative changes especially in dorsal regions of spine (р=0,076.The strategy of patient examination with hip-spine syndrome was established from clinical and radiographic positions.

Valve Repair Is Superior to Replacement in Most Patients With Coexisting Degenerative Mitral Valve and Coronary Artery Diseases.

Science.gov (United States)

Javadikasgari, Hoda; Gillinov, A Marc; Idrees, Jay J; Mihaljevic, Tomislav; Suri, Rakesh M; Raza, Sajjad; Houghtaling, Penny L; Svensson, Lars G; Navia, José L; Mick, Stephanie L; Desai, Milind Y; Sabik, Joseph F; Blackstone, Eugene H

2017-06-01

For mitral regurgitation (MR) from degenerative mitral disease in patients with coexisting coronary artery disease, the appropriate surgical strategy remains controversial. From 1985 to 2011, 1,071 adults (age 70 ± 9.3 years, 77% men) underwent combined coronary artery bypass grafting and either mitral valve repair (n = 872, 81%) or replacement (n=199, 19%) for degenerative MR. Propensity matching (177 patient pairs, 89% of possible matches) was used to compare early outcomes and time-related recurrence of MR after mitral valve repair, mitral valve reoperation, and mortality. Risk factors for death were identified with multivariable, multiphase hazard-function analysis. Patients undergoing valve replacement were older, with more valve calcification and a higher prevalence of preoperative atrial fibrillation and heart failure (all p < .0001). Among matched pairs, mitral replacement versus repair was associated with higher hospital mortality (5.0% vs 1.0%, p = .0001) and more postoperative renal failure (7.0% vs 3.2%, p = .01), reexplorations for bleeding (6.0% vs 3.1%, p = .05), and respiratory failure (14% vs 4.7%, p < .0001). Of matched patients undergoing repair, 18% had MR above 3+ by 5 years. Mitral valve durability was similar between matched groups, but survival at 15 years was 18% after replacement versus 52% after repair. Nomograms from the multivariable equation revealed that in 94% of cases, 10-year survival was calculated to be higher after repair than after replacement. In patients with coexisting degenerative mitral valve and coronary artery diseases, mitral valve repair is expected to confer a long-term survival advantage over replacement despite some recurrence of MR. When feasible, it is the procedure of choice for these patients. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Dynamic and quantitative evaluation of degenerative mitral valve disease: a dedicated framework based on cardiac magnetic resonance imaging.

Science.gov (United States)

Sturla, Francesco; Onorati, Francesco; Puppini, Giovanni; Pappalardo, Omar A; Selmi, Matteo; Votta, Emiliano; Faggian, Giuseppe; Redaelli, Alberto

2017-04-01

Accurate quantification of mitral valve (MV) morphology and dynamic behavior over the cardiac cycle is crucial to understand the mechanisms of degenerative MV dysfunction and to guide the surgical intervention. Cardiac magnetic resonance (CMR) imaging has progressively been adopted to evaluate MV pathophysiology, although a dedicated framework is required to perform a quantitative assessment of the functional MV anatomy. We investigated MV dynamic behavior in subjects with normal MV anatomy (n=10) and patients referred to surgery due to degenerative MV prolapse, classified as fibro-elastic deficiency (FED, n=9) and Barlow's disease (BD, n=10). A CMR-dedicated framework was adopted to evaluate prolapse height and volume and quantitatively assess valvular morphology and papillary muscles (PAPs) function over the cardiac cycle. Multiple comparison was used to investigate the hallmarks associated to MV degenerative prolapse and evaluate the feasibility of anatomical and functional distinction between FED and BD phenotypes. On average, annular dimensions were significantly (Pframework allows for the quantitative and dynamic evaluation of MV apparatus, with quantifiable annular alterations representing the primary hallmark of severe MV degeneration. This may aid surgeons in the evaluation of the severity of MV dysfunction and the selection of the appropriate MV treatment.

Differential diagnosis of metastatic bone disease and benign bone disease on spine SPECT in patients with low back pain

International Nuclear Information System (INIS)

Lee, Seung Hun; Choi, Yun Young; Cho, Suk Shin

2001-01-01

One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients, as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. We reviewed spine SPECT studies obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2 Posterior element; posterior to body (pedicle), posterior to intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Sixty-nine bone lesions were detected on SPECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis: linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients

Hip Osteoarthritis: Genetics, epidemiological risk factors and burden of the disease

NARCIS (Netherlands)

M.C. Castaño Betancourt (Martha)

2015-01-01

markdownabstract__Abstract__ Osteoarthritis (OA) is the most common degenerative joint disease, characterized by progressive damage of the articular cartilage, osteophyte formation and alterations in the subchondral bone. OA is associated with an extremely high burden in terms of health

The role of transient receptor potential channels in joint diseases.

Science.gov (United States)

Krupkova, O; Zvick, J; Wuertz-Kozak, K

2017-10-10

Transient receptor potential channels (TRP channels) are cation selective transmembrane receptors with diverse structures, activation mechanisms and physiological functions. TRP channels act as cellular sensors for a plethora of stimuli, including temperature, membrane voltage, oxidative stress, mechanical stimuli, pH and endogenous, as well as, exogenous ligands, thereby illustrating their versatility. As such, TRP channels regulate various functions in both excitable and non-excitable cells, mainly by mediating Ca2+ homeostasis. Dysregulation of TRP channels is implicated in many pathologies, including cardiovascular diseases, muscular dystrophies and hyperalgesia. However, the importance of TRP channel expression, physiological function and regulation in chondrocytes and intervertebral disc (IVD) cells is largely unexplored. Osteoarthritis (OA) and degenerative disc disease (DDD) are chronic age-related disorders that significantly affect the quality of life by causing pain, activity limitation and disability. Furthermore, currently available therapies cannot effectively slow-down or stop progression of these diseases. Both OA and DDD are characterised by reduced tissue cellularity, enhanced inflammatory responses and molecular, structural and mechanical alterations of the extracellular matrix, hence affecting load distribution and reducing joint flexibility. However, knowledge on how chondrocytes and IVD cells sense their microenvironment and respond to its changes is still limited. In this review, we introduced six families of mammalian TRP channels, their mechanisms of activation, as well as, activation-driven cellular consequences. We summarised the current knowledge on TRP channel expression and activity in chondrocytes and IVD cells, as well as, the significance of TRP channels as therapeutic targets for the treatment of OA and DDD.

The role of transient receptor potential channels in joint diseases

Directory of Open Access Journals (Sweden)

O Krupkova

2017-10-01

Full Text Available ransient receptor potential channels (TRP channels are cation selective transmembrane receptors with diverse structures, activation mechanisms and physiological functions. TRP channels act as cellular sensors for a plethora of stimuli, including temperature, membrane voltage, oxidative stress, mechanical stimuli, pH and endogenous, as well as, exogenous ligands, thereby illustrating their versatility. As such, TRP channels regulate various functions in both excitable and non-excitable cells, mainly by mediating Ca2+ homeostasis. Dysregulation of TRP channels is implicated in many pathologies, including cardiovascular diseases, muscular dystrophies and hyperalgesia. However, the importance of TRP channel expression, physiological function and regulation in chondrocytes and intervertebral disc (IVD cells is largely unexplored. Osteoarthritis (OA and degenerative disc disease (DDD are chronic age-related disorders that significantly affect the quality of life by causing pain, activity limitation and disability. Furthermore, currently available therapies cannot effectively slow-down or stop progression of these diseases. Both OA and DDD are characterised by reduced tissue cellularity, enhanced inflammatory responses and molecular, structural and mechanical alterations of the extracellular matrix, hence affecting load distribution and reducing joint flexibility. However, knowledge on how chondrocytes and IVD cells sense their microenvironment and respond to its changes is still limited. In this review, we introduced six families of mammalian TRP channels, their mechanisms of activation, as well as, activation-driven cellular consequences. We summarised the current knowledge on TRP channel expression and activity in chondrocytes and IVD cells, as well as, the significance of TRP channels as therapeutic targets for the treatment of OA and DDD.

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

International Nuclear Information System (INIS)

Dmitriev, A.E.; Arapov, N.A.

1989-01-01

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

The twenty-four/four hour ratio (T/F ratio) of Tc-99m MDP uptake in patients with bone metastases and degenerative changes

International Nuclear Information System (INIS)

Israel, O.; Kleinhaus, U.; Keren, R.; Frankel, A.; Front, D.

1984-01-01

Normal and metastatic bone differ in their histological structure. Normal bone is mainly lamellar while metastatic bone formation is made in a large part out of new woven bone. The woven bone has a much larger surface area than the more stable lamellar bone and it is lined with metabolically active osteoblasts. The crystalline structures in the woven bone are smaller and have a larger surface area available for absorption. Uptake of bone seeking radiopharmaceuticals continues in new woven bone longer than in the lamellar bone. Bone scintigraphy was performed in 89 patients at four hours and 24 hours using a digital camera. The lesion to non lesion (L/N) ratio was determined using the camera computer. The T/F ratio was calculated: T/F=((L/N)-24)/((L/N)-4). Three groups were investigated. In 15 patients with metastatic bone carcinoma, T/F ratio was 1.46 +- 0.4. In 47 patients with degenerative joint disease the T/F ratio was 1.05 +- 0.06. In 27 patients with treated metastatic bone carcinoma the T/F ratio was 1.12 +- 0.13. The T/F ratio is significantly (p<0.001) different in patients with metastases compared to patients with benign degenerative disease. Chemotherapeutic and hormonal treatment cause significant (p<0.001) reduction in the T/F ratio. The T/F ratio may have a potential in differentiating degenerative from neoplastic diseases and in the evaluation of patients with bone metastases undergoing treatment

Hypertrophic Synovitis of the Facet Joint Causing Root Pain

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Koichi Iwatsuki M.D.

2008-01-01

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.

Outcomes of oblique lateral interbody fusion for degenerative lumbar disease in patients under or over 65 years of age.

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Jin, Chengzhen; Jaiswal, Milin S; Jeun, Sin-Soo; Ryu, Kyeong-Sik; Hur, Jung-Woo; Kim, Jin-Sung

2018-02-20

Oblique lateral interbody fusion (OLIF) offers the solution to problems of anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF). However, OLIF technique for degenerative spinal diseases of elderly patients has been rarely reported. The objective of this study was to determine the clinical and radiological results of OLIF technique for degenerative spinal diseases in patients under or over 65 years of age. Sixty-three patients who underwent OLIF procedure were enrolled, including 29 patients who were less than 65 years of age and 34 patients who were over 65 years of age. Fusion rate, change of disc height and lumbar lordotic angle, Numeric Rating Scale (NRS), return to daily activity, patient's satisfaction rate (PSR), and Oswestry disability index (ODI) were used to assess clinical and functional outcomes. The mean NRS scores for back and leg pain decreased, respectively, from 4.6 and 5.9 to 2.3 and 1.8 in the group A (less than 65 years) and from 4.5 and 6.8 to 2.6 and 2.2 in the group B (over 65 years) at the final follow-up period. The mean ODI scores improved from 48.4 to 24.0% in the group A and from 46.5 to 25.2% in the group B at the final follow-up period. In both groups, the NRS and ODI scores significantly changed preoperatively to postoperatively (p degenerative lumbar diseases in elderly patients showed favorable clinical and radiological outcomes.

Diagnostic accuracy of electrocardiographic P wave related parameters in the assessment of left atrial size in dogs with degenerative mitral valve disease.

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Soto-Bustos, Ángel; Caro-Vadillo, Alicia; Martínez-DE-Merlo, Elena; Alonso-Alegre, Elisa González

2017-10-07

The purpose of this research was to compare the accuracy of newly described P wave-related parameters (P wave area, Macruz index and mean electrical axis) with classical P wave-related parameters (voltage and duration of P wave) for the assessment of left atrial (LA) size in dogs with degenerative mitral valve disease. One hundred forty-six dogs (37 healthy control dogs and 109 dogs with degenerative mitral valve disease) were prospectively studied. Two-dimensional echocardiography examinations and a 6-lead ECG were performed prospectively in all dogs. Echocardiography parameters, including determination of the ratios LA diameter/aortic root diameter and LA area/aortic root area, were compared to P wave-related parameters: P wave area, Macruz index, mean electrical axis voltage and duration of P wave. The results showed that P wave-related parameters (classical and newly described) had low sensitivity (range=52.3 to 77%; median=60%) and low to moderate specificity (range=47.2 to 82.5%; median 56.3%) for the prediction of left atrial enlargement. The areas under the curve of P wave-related parameters were moderate to low due to poor sensitivity. In conclusion, newly P wave-related parameters do not increase the diagnostic capacity of ECG as a predictor of left atrial enlargement in dogs with degenerative mitral valve disease.

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

International Nuclear Information System (INIS)

Keilholz, L.; Sauer, R.; Seegenschmiedt, M.H.; Alfred-Krupp-Krankenhaus, Essen

1998-01-01

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

Foot drop caused by lumbar degenerative disease: clinical features, prognostic factors of surgical outcome and clinical stage.

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Kun Liu

Full Text Available OBJECTIVE: The purpose of this study was to analyze the clinical features and prognostic factors of surgical outcome of foot drop caused by lumbar degenerative disease and put forward the clinical stage. METHODS: We retrospectively reviewed 135 patients with foot drop due to lumbar degenerative disease. The clinical features and mechanism were analyzed. Age, sex, duration of palsy, preoperative muscle strength of tibialis anterior (TA, sensation defect of affected lower limb, affected foot, diagnosis and compressed nerve roots were recorded and compared with surgical outcome. RESULTS: Foot drop was observed in 8.1% of all inpatients of lumbar degenerative disease. L5 nerve root compression was observed in 126 of all 135 patients (93.3%. Single, double and triple roots compression was observed respectively in 43, 83, and 9 patients (31.9%, 61.5%, and 6.6%. But there was no significant relationship between preoperative muscle strength of TA and the number of compressed roots. The muscle strength of TA was improved in 113 (83.7% patients after surgery, but it reached to >=4 in only 21 (15.6% patients. Improvement of the muscle strength of TA was almost stable at the 6-month follow-up. At the last follow-up, the muscle strength of TA was 1, 2, 3, 4, 5 respectively in 28, 24, 62, 13, 8 patients. Multivariate logistic regression showed duration of palsy (p=0.0360, OR=2.543, preoperative muscle strength of TA (p=0.0064, OR=5.528 and age (p=0.0309, OR=3.208 were factors that influenced recovery following an operation. CONCLUSIONS: L5 nerve root was most frequently affected. The muscle strength of TA improved in most patients after surgery, but few patients can get a good recovery from foot drop. Patients of shorter duration of palsy, better preoperative muscle strength of TA and younger age showed a better surgical outcome.

Occupational diseases of skeleton and bone joints

International Nuclear Information System (INIS)

Sokolik, L.I.

1981-01-01

The essence of roentgeno-morphological features of locomotor system occupational diseases lies in development of dystrophic, degenerative and necrotic processes. Pathological changes take place during vibration, recoil and strain as well as under the effect of unfavourable microclimate (high humidity, cold), vibration being the most important as compared to other harmful factors. Detailed sanitary-and-hygienic and labour characteristics of working conditions of personnel, subjected to the effect of those factors as well as roentgenological characteristics of locomotor system occupational changes are given [ru

Minimally Invasive Transforaminal Lumbar Interbody Fusion with Percutaneous Bilateral Pedicle Screw Fixation for Lumbosacral Spine Degenerative Diseases. A retrospective database of 40 consecutive treated cases and literature review.

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Millimaggi, Daniele Francesco; DI Norcia, Valerio; Luzzi, Sabino; Alfiero, Tommaso; Galzio, Renato Juan; Ricci, Alessandro

2017-04-12

To report our results about minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) with bilateral pedicle screw fixation, in patients with degenerative lumbosacral spine disease. To describe the indications, surgical technique and results of a consecutive series of 40 patients undergone MI-TLIF. Despite the limited number of clinical studies, published data suggest tremendous potential advantages of this technique. Forty patients with radiological findings of degenerative lumbosacral spine disease were undergone MI-TLIF between July 2012 and January 2015. Clinical outcomes were assessed by means of Oswestry Disability Index (ODI) and Health Survey Scoring (SF36) before surgery and at first year follow-up. Furthermore, the following parameters were retrospectively reviewed: age, sex, working activity, body mass index (BMI), type of degenerative disease, number of levels of fusion, operative time, blood loss, length of hospital stay. Average operative time was of 230 minutes, mean estimated blood loss 170 mL, average length of hospital stay 5 days. The ODI improved from a score of 59, preoperatively, to post-operative score of 20 at first year follow-up. Average SF36 score increased from 36 to 54 (Physical Health) and from 29 to 50 (Mental Health) at first year outcome evaluation. MI-TLIF with bilateral pedicle screw fixation is an excellent choice for selected patients suffering from symptomatic degenerative lumbosacral spine disease, especially secondary to recurrent disk herniations.

Prediction of Postoperative Clinical Recovery of Drop Foot Attributable to Lumbar Degenerative Diseases, via a Bayesian Network.

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Takenaka, Shota; Aono, Hiroyuki

2017-03-01

Drop foot resulting from degenerative lumbar diseases can impair activities of daily living. Therefore, predictors of recovery of this symptom have been investigated using univariate or/and multivariate analyses. However, the conclusions have been somewhat controversial. Bayesian network models, which are graphic and intuitive to the clinician, may facilitate understanding of the prognosis of drop foot resulting from degenerative lumbar diseases. (1) To show a layered correlation among predictors of recovery from drop foot resulting from degenerative lumbar diseases; and (2) to develop support tools for clinical decisions to treat drop foot resulting from lumbar degenerative diseases. Between 1993 and 2013, we treated 141 patients with decompressive lumbar spine surgery who presented with drop foot attributable to degenerative diseases. Of those, 102 (72%) were included in this retrospective study because they had drop foot of recent development and had no diseases develop that affect evaluation of drop foot after surgery. Specifically, 28 (20%) patients could not be analyzed because their records were not available at a minimum of 2 years followup after surgery and 11 (8%) were lost owing to postoperative conditions that affect the muscle strength evaluation. Eight candidate variables were sex, age, herniated soft disc, duration of the neurologic injury (duration), preoperative tibialis anterior muscle strength (pretibialis anterior), leg pain, cauda equina syndrome, and number of involved levels. Manual muscle testing was used to assess the tibialis anterior muscle strength. Drop foot was defined as a tibialis anterior muscle strength score of less than 3 of 5 (5 = movement against gravity and full resistance, 4 = movement against gravity and moderate resistance, 3 = movement against gravity through full ROM, 3- = movement against gravity through partial ROM, 2 = movement with gravity eliminated through full ROM, 1 = slight contraction but no movement, and 0 = no

The lumbar spine age-related degenerative disease influences the BMD not the TBS: the Osteolaus cohort.

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Padlina, I; Gonzalez-Rodriguez, E; Hans, D; Metzger, M; Stoll, D; Aubry-Rozier, B; Lamy, O

2017-03-01

We evaluated the influence of degenerative disease and fractured vertebra on lumbar spine bone mineral density (BMD) and trabecular bone score (TBS) in 1500 women aged 50-80 years. TBS was not affected by a degenerative disease. While BMD increases after 62.5 years, TBS continues to decline. TBS should play a leading role in lumbar spine evaluation. After menopause, lumbar spine (LS) BMD and TBS values decrease. Degenerative disease (DD) increases with age and affect LS BMD. The aim of this study was to measure changes in LS BMD and TBS in women 50 to 80 years old, taking into account the impact of fractured vertebrae and DD. LS BMD, TBS, and vertebral fracture assessment were evaluated in the OsteoLaus cohort (1500 women, 50-80 years old). The exams were analyzed following ISCD guidelines to identify vertebrae with fractures or DD (Vex). 1443 women were enrolled: mean age 66.7 ± 11.7 years, BMI 25.7 ± 4.4. LS BMD and TBS were weakly correlated (r2 = 0.16). The correlation (Vex excluded) between age and BMD was +0.03, between age and TBS -0.34. According to age group, LS BMD was 1.2 to 3.2% higher before excluding Vex (p < 0.001). TBS had an insignificant change of <1% after excluding Vex. LS BMD (Vex) decreased by 4.6% between 52.5 and 62.5 years, and increased by 2.6% between 62.5 and 77.5 years. TBS (Vex excluded) values decreased steadily with age with an overall loss of 8.99% between 52.5 and 77.5 years. Spine TBS, femoral neck, and total hip BMD gradually decreased with age, reaching one SD between the oldest and youngest group. TBS is not affected by DD. While BMD increases after 62.5 years, TBS continues to decline. For lumbar spine evaluation, in view of its independence from DD, TBS should play a leading role in the diagnosis in complement to BMD.

Degenerative osteoarthritis of atlanto-odontoid joint: CT findings and clinical analysis

International Nuclear Information System (INIS)

Xu Aide; Wang Song; Mao Yunhua

1998-01-01

Purpose: To analyze the CT appearances and clinical aspects of the degeneration at atlanto-odontoid(A-O) joint. Methods: Thin section axial CT scans, of AO joints were studied in 317 consecutive patients who underwent brain or cervical spine CT examinations. The images were viewed using double-blind method. Observation included: osteophytosis, changes of joint space and transverse ligament, and the clinical symptoms as well. Results: CT findings of AO joint degeneration included: formation of osteophyte, narrowing of joint space, transverse ligament calcification, and joint vacuum phenomenon. Among individuals above 40 years of age, the incidence of degeneration at AO joint went up gradually (P<0.01). Conclusion: Degeneration of AO joint was not uncommon among aged people, CT could better demonstrate the pathological changes

Treatment of Nongout Joint Deposition Diseases: An Update

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Tristan Pascart

2014-01-01

Full Text Available This update develops the actual therapeutic options in the management of the joint involvement of calcium pyrophosphate deposition disease (CPPD, basic calcium phosphate (BCP deposition disease, hemochromatosis (HH, ochronosis, oxalosis, and Wilson’s disease. Conventional pharmaceutical treatment provides benefits for most diseases. Anti-interleukine-1 (IL-1 treatment could provide similar results in CPPD than in gout flares. There is only limited evidence about the efficacy of preventive long-term colchicine intake, methotrexate, and hydroxychloroquine in chronic CPPD. Needle aspiration and lavage have satisfactory short and midterm results in BCP. Extracorporeal shockwave therapy has also proved its efficacy for high-doses regimes. Phlebotomy does not seem to have shown real efficacy on joint involvement in HH so far. Iron chelators’ effects have not been assessed on joint involvement either, while IL-1 blockade may prove useful. NSAIDs have limited efficacy on joint involvement of oxalosis, while colchicine and steroids have not been assessed either. The use of nitisinone for ochronotic arthropathy is still much debated, but it could provide beneficial effects on joint involvement. The effects of copper chelators have not been assessed either in the joint involvement of Wilson’s disease. NSAIDs should be avoided because of the liver affection they may worsen.

Trends in hospital admissions and surgical procedures for degenerative lumbar spine disease in England: a 15-year time-series study

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Sivasubramaniam, Vinothan; Patel, Hitesh C; Ozdemir, Baris A; Papadopoulos, Marios C

2015-01-01

Objectives Low back pain (LBP), from degenerative lumbar spine disease, represents a significant burden on healthcare resources. Studies worldwide report trends attributable to their country's specific demographics and healthcare system. Considering England's specific medico-socioeconomic conditions, we investigate recent trends in hospital admissions and procedures for LBP, and discuss the implications for the allocation of healthcare resources. Design Retrospective cohort study using Hospital Episode Statistics data relating to degenerative lumbar spine disease in England, between 1999 and 2013. Regression models were used to analyse trends. Outcome measures Trends in the number of admissions and procedures for LBP, mean patient age, gender and length of stay. Results Hospital admissions and procedures have increased significantly over the study period, from 127.09 to 216.16 and from 24.5 to 48.83 per 100 000, respectively, (pdisease, and highlight the need for services capable of dealing with the increased comorbidity burden associated with an ageing patient group. PMID:26671956

Molecular Therapy for Degenerative Disc Disease: Clues from Secretome Analysis of the Notochordal Cell-Rich Nucleus Pulposus

Science.gov (United States)

Matta, Ajay; Karim, M. Zia; Isenman, David E.; Erwin, W. Mark

2017-01-01

Degenerative disc disease (DDD) is associated with spinal pain often leading to long-term disability. However, the non-chondrodystrophic canine intervertebral disc is protected from the development of DDD, ostensibly due to its retention of notochordal cells (NC) in the nucleus pulposus (NP). In this study, we hypothesized that secretome analysis of the NC-rich NP will lead to the identification of key proteins that delay the onset of DDD. Using mass-spectrometry, we identified 303 proteins including components of TGFβ- and Wnt-signaling, anti-angiogeneic factors and proteins that inhibit axonal ingrowth in the bioactive fractions of serum free, notochordal cell derived conditioned medium (NCCM). Ingenuity Pathway Analysis revealed TGFβ1 and CTGF as major hubs in protein interaction networks. In vitro treatment with TGFβ1 and CTGF promoted the synthesis of healthy extra-cellular matrix proteins, increased cell proliferation and reduced cell death in human degenerative disc NP cells. A single intra-discal injection of recombinant TGFβ1 and CTGF proteins in a pre-clinical rat-tail disc injury model restored the NC and stem cell rich NP. In conclusion, we demonstrate the potential of TGFβ1 and CTGF to mitigate the progression of disc degeneration and the potential use of these molecules in a molecular therapy to treat the degenerative disc. PMID:28358123

Development of modulators against degenerative aging using radiation fusion technology

Energy Technology Data Exchange (ETDEWEB)

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

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.

Development of modulators against degenerative aging using radiation fusion technology

International Nuclear Information System (INIS)

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.

2012-04-01

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

On Patellofemoral joint replacement - Clinical, radiological, and numerical studies.

NARCIS (Netherlands)

Jonbergen, J.P.W. van

2011-01-01

Patellofemoral, osteoarthritis, joint replacement, arthroplasty, anterior knee pain Isolated patellofemoral joint osteoarthritis is a degenerative disorder of the knee estimated to occur in approximately 4% to 24% of patients with osteoarthritis of the knee. Mild isolated patellofemoral

Correlation of radiographic, necropsy and histologic findings in 8 dogs with elbow dysplasia

International Nuclear Information System (INIS)

Keller, G.G.; Kreeger, J.M.; Mann, F.A.; Lattimer, J.C.

1997-01-01

Elbow dysplasia is osteoarthrosis/degenerative joint disease due to abnormal development of the elbow joint. The abnormal development is the result of specific inherited etiologies alone or in combination. This paper attempts to clarify the diagnosis of elbow dysplasia based on the presence of degenerative joint disease by correlating radiographic, necropsy, and histopathologic results using elbows from 8 German Shepherd dogs. All elbows had radiographic changes consistent with osteoarthrosis/degenerative joint disease which were identified best on the flexed medial-lateral projection. Radiographically, a specific diagnosis was made in seven elbows; ununited anconeal process (6) and osteochondrosis (1). At necropsy these lesions were confirmed plus 14 elbows were identified that had fragmented medial coronoid process (6), abnormally shaped medial coronoid processes or fissures in the articular cartilage of the medial coronoid process (8). Additionally, histopathologically there was proliferative synovitis at the radial notch of the ulna and degenerative changes on the proximal, nonarticular surface of the anconeal process at the site of insertion of the olecranon ligament and joint capsule. Therefore, for screening the elbow joint to identify elbow dysplasia, the recognition of osteoarthrosis/degenerative joint disease on an extreme flexed mediolateral radiograph appears to be sufficient

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)

Ackerman SJ

2013-11-01

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

Short-Term Therapeutic Efficacy of the Isobar TTL Dynamic Internal Fixation System for the Treatment of Lumbar Degenerative Disc Diseases.

Science.gov (United States)

Qian, Jiale; Bao, Zhaohua; Li, Xuefeng; Zou, Jun; Yang, Huilin

2016-07-01

At present, posterior interbody fusion surgery with pedicle internal fixation is the gold standard for the treatment of lumbar degenerative disc diseases. However, an increasing number of studies have shown that because fused lumbar vertebrae lose their physiological activity, the compensatory range of motion (ROM) of the adjacent levels increases. To address this issue, dynamic internal fixation systems have been developed. Our goal was to investigate the short-term therapeutic efficacy of the Isobar TTL dynamic internal fixation system for the treatment of lumbar degenerative disc diseases and its effect on the ROM of the surgical segments. Retrospective Evaluation. Tertiary hospital setting in China. Twenty-four lumbar degenerative disc disease patients who underwent posterior lumbar decompression and single-segment Isobar TTL dynamic internal fixation at our hospital between January 2013 and July 2014 were retrospectively analyzed. The preoperative and one month, 3 month, and 12 month postoperative visual analog scale (VAS) pain scores, Japanese Orthopedic Association (JOA) scores, and Oswestry Disability Index (ODI) scores were observed and recorded to assess the clinical therapeutic effect; the lumbar ROM was measured preoperatively and at the last follow-up to evaluate the preservation of functional movement in the dynamically stabilized segment. All patients underwent the operation successfully without complications during hospitalization and were followed for 12 to 27 months, with an average of 18 months. The patients' preoperative and one month, 3 month, and 12 month postoperative VAS scores were 6.42 ± 0.72, 1.71 ± 0.86, 1.38 ± 0.65, and 1.37 ± 0.58, respectively, and their JOA scores were 9.54 ± 1.89, 21.21 ± 1.98, 22.50 ± 1.47, and 23.46 ± 1.32, respectively. The preoperative ODI score was 42.04 ± 2.63; the one month, 3 month, and 12 month postoperative ODI scores were 22.79 ± 1.61, 18.63 ± 1.61, and 15.08 ± 1.21, respectively. These

Quantitative survey radiographic evaluation of the lumbosacral spine of normal dogs and dogs with degenerative lumbosacral stenosis

International Nuclear Information System (INIS)

Mattoon, J.S.; Koblik, P.D.

1993-01-01

Survey radiographic studies of the lumbosacral region for 93 normal dogs and for 26 dogs with confirmed degenerative lumbosacral stenosis were reviewed. Normal dogs were divided into 9 groups based on age and body weight. For normal dogs, increasing age and body weight were associated with a decreased ability to extend the lumbosacral joint and with increased incidence and severity of spondylosis. Transitional lumbosacral vertebrae and evidence of lumbosacral disc space collapse were very infrequent findings, and the pivot point for lumbosacral motion was consistently centered over the lumbosacral disc space. Relative to an age/weight matched sub-population of normal dogs, dogs with degenerative lumbosacral stenosis had similar mean normalized lumbosacral vertebral canal height, larger mean neutral lumbosacral angle, decreased extension of the lumbosacral joint, increased flexion of the lumbosacral joint, reduced lumbosacral range of motion, increased lumbosacral dynamic malalignment, higher incidence and severity of spondylosis, higher incidence of transitional vertebrae, and higher incidence of lumbosacral disc space collapse. A logistic model based strictly on radiographic parameters was able to discriminate normal from affected dogs with an overall accuracy rate of 86%

[Efficacy analysis on hip replacement for hip-joint diseases with Parkinson disease].

Science.gov (United States)

Sun, Qi-Cai; Ru, Xuan-Liang; Xia, Yan-Fei; Liu, Xiao-Li; Song, Bai-Shan; Qiao, Song; Yan, Shi-Gui; Wang, Xiang-Hua

2017-12-25

To explore clinical efficacy of hip replacement for hip-joint diseases with Parkinson disease. From December 2011 to December 2016, 18 patients with hip-joint diseases with Parkinson disease treated by hip replacement, including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them, 3 cases were developmental dysplasia of hip, 3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation. The incision were healed well, and pain were alleviated or disappeared, and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of 2.3 years. At the latest follow up, 14 cases recovered freedom-walk, 2 cases could walk with walking stick, 1 case could walk with walking aid and 1 case was died. Among 18 patients, 2 cases were occurred dislocation, and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative (41.7±1.4), 6 months after operation(80.1±5.4) and the final follow-up (83.4±2.1), and 10 cases got excellent result, 4 good, 1 fair and 2 poor. Application of hip replacement for hip-joint diseases with Parkinson disease is a safe and effective clinical therapy, and has advantages of less complications and rapid recovery of hip joint function.

Evaluation of Pain Syndromes, Headache, and Temporomandibular Joint Disorders in Children.

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Horswell, Bruce B; Sheikh, Jason

2018-02-01

After a thorough review of the history and presentation of a child's facial pain, a targeted head and neck examination is critical to the appropriate diagnosis of facial pain and temporomandibular joint disorders. It is critical to distinguish between the structural (trauma, degenerative disease, and tumor) and nonstructural (neurogenic, myogenic, and psychological) causes of pain, which will allow for incorporation of appropriate strategies of medical, psychological, dental, and surgical therapies. Copyright © 2017 Elsevier Inc. All rights reserved.

Joint disease in children of Asiatic origin

International Nuclear Information System (INIS)

Tan, T.H.; Ong, K.L.

2000-01-01

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

[Clinical effects of Dynesys system and transfacet decompression through Wiltse approach in the treatment of lumbar degenerative diseases].

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Shang, K; Chen, M J; Wang, D G

2017-05-23

Objective: To investigate the early clinical effects of Dynesys system and transfacet decompression by Wiltse approach in the treatment of lumbar degenerative diseases. Methods: From January 2010 to December 2013, 48 patients suffering from lumbar degenerative diseases were treated with Dynesys system in addition to transfacet decompression through Wiltse approach.There were 28 males and 20 females with age of (51.8±6.8). The preoperative diagnosis included lumbar spinal stenosis(10 cases); lumber intervertebral disc herniation (38 cases). There were 23 cases in L4/5, 16 cases in L5/S1 and 9 cases in both of L4/5 and L5/S1.Posterolateral fixation with Dynesys pedicle screw through Wiltse approach.Unilateral resection of the inferior articular facet of the superior vertebra and the superior articular facet of the inferior vertebra.Decompression of the vertebral canal until the never root was decompressed satisfactorily.In the end, Dynesys was performed according to normal procedure.VAS, ODI evaluating standards were applied to evaluate the therapeutic effect.The intervertebral space and ROM of the lumbar were observed by X ray. Results: All patients underwent surgery safely without severe complications occurred.The average following up time was 33.5 (24-60) months.Compared with preoperative parameters (7.7±1.3, 70.8±13.5), the scores of VAS and ODI decreased significantly after surgery (2.3±1.5, 23.6±12.2) and at the final follow-up (2.2±1.4, 20.0±9.8) ( P 0.05). X-ray scan showed neither instability or internal fixation loosen, breakage or distortion in follow-up. Conclusion: Dynesys system in addition to transfacet decompression through Wiltse approach is a therapy option for mild lumbar degenerative disease.This method can retention the structure of lumbar posterior complex and the activity of the fixed segment, reduce the risk of low back pain together with nerve root decompressed.The early clinical results are satisfactory.

Osseous temporomandibular joint abnormalities in rheumatic disease

International Nuclear Information System (INIS)

Larheim, T.A.; Kolbenstvedt, A.; Rikshospitalet, Oslo

1990-01-01

Computed tomography (CT) of the temporomandibular joint (TMJ) was compared with hypocycloidal tomography in 30 joints of 15 adults with rheumatic disease. CT included 1.5 mm thick axial scans (at 1.0 mm intervals) with reformatted oblique sagittal and oblique coronal sections. Multisection (at 2.0 mm intervals) tomography included oblique sagittal and occasionally, oblique coronal sections. CT demonstrated bone abnormalities in 21 and tomography in 20 joints, indicating high agreement between the imaging modalities regarding number of abnormal TMJs. Bone structures were, however, better visualized by multiplanar CT due to superior contrast and spatial resolution particularly in the most lateral and medial parts of the joint, indicating superiority of CT for depicting subtle bony TMJ abnormalities in patients with rheumatic disease. (orig.)

Increased expression of damage-associated molecular patterns (DAMPs) in osteoarthritis of human knee joint compared to hip joint.

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Rosenberg, John H; Rai, Vikrant; Dilisio, Matthew F; Sekundiak, Todd D; Agrawal, Devendra K

2017-12-01

Osteoarthritis (OA) is a degenerative disease characterized by the destruction of cartilage. The greatest risk factors for the development of OA include age and obesity. Recent studies suggest the role of inflammation in the pathogenesis of OA. The two most common locations for OA to occur are in the knee and hip joints. The knee joint experiences more mechanical stress, cartilage degeneration, and inflammation than the hip joint. This could contribute to the increased incidence of OA in the knee joint. Damage-associated molecular patterns (DAMPs), including high-mobility group box-1, receptor for advanced glycation end products, and alarmins (S100A8 and S100A9), are released in the joint in response to stress-mediated chondrocyte and cartilage damage. This facilitates increased cartilage degradation and inflammation in the joint. Studies have documented the role of DAMPs in the pathogenesis of OA; however, the comparison of DAMPs and its influence on OA has not been discussed. In this study, we compared the DAMPs between OA knee and hip joints and found a significant difference in the levels of DAMPs expressed in the knee joint compared to the hip joint. The increased levels of DAMPs suggest a difference in the underlying pathogenesis of OA in the knee and the hip and highlights DAMPs as potential therapeutic targets for OA in the future.

An intervertebral disc whole organ culture system to investigate proinflammatory and degenerative disc disease condition.

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Lang, Gernot; Liu, Yishan; Geries, Janna; Zhou, Zhiyu; Kubosch, David; Südkamp, Norbert; Richards, R Geoff; Alini, Mauro; Grad, Sibylle; Li, Zhen

2018-04-01

The aim of this study was to compare the effect of different disease initiators of degenerative disc disease (DDD) within an intervertebral disc (IVD) organ culture system and to understand the interplay between inflammation and degeneration in the early stage of DDD. Bovine caudal IVDs were cultured within a bioreactor for up to 11 days. Control group was cultured under physiological loading (0.02-0.2 MPa; 0.2 Hz; 2 hr/day) and high glucose (4.5 g/L) medium. Detrimental loading (0.32-0.5 MPa, 5 Hz; 2 hr/day) and low glucose (2 g/L) medium were applied to mimic the condition of abnormal mechanical stress and limited nutrition supply. Tumour necrosis factor alpha (TNF-α) was injected into the nucleus pulposus (100 ng per IVD) as a proinflammatory trigger. TNF-α combined with detrimental loading and low glucose medium up-regulated interleukin 1β (IL-1β), IL-6, and IL-8 gene expression in disc tissue, nitric oxide, and IL-8 release from IVD, which indicate a proinflammatory effect. The combined initiators up-regulated matrix metalloproteinase 1 gene expression, down-regulated gene expression of Type I collagen in annulus fibrosus and Type II collagen in nucleus pulposus, and reduced the cell viability. Furthermore, the combined initiators induced a degradative effect, as indicated by markedly higher glycosaminoglycan release into conditioned medium. The combination of detrimental dynamic loading, nutrient deficiency, and TNF-α intradiscal injection can synergistically simulate the proinflammatory and degenerative disease condition within DDD. This model will be of high interest to screen therapeutic agents in further preclinical studies for early intervention and treatment of DDD. Copyright © 2018 John Wiley & Sons, Ltd.

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

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Marc Röllinghoff

2010-01-01

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

Expression of CGRP in the temporomandibular joint; Expresion de CGRP en la articulacion temporomandibular

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Caviedes Bucheli, Javier [Pontificia Universidad Javeriana, Facultad de Odontologia, Bogota, D.C. (Colombia); Medina Buitrago, Diana Marcela [Pontificia Universidad Javeriana, Bogota, D.C. (Colombia)

2002-07-01

The presence and content of calcitonin gene-related peptide (CGRP) is evaluated in the hyperplastic retrodiscal tissue of the temporomandibular joint in patients with joint degenerative disease by radioimmunoassay. Study population has included 8 female patients in pre-menopausic status, without to be pregnant, without to be lactating for a year and with diagnostic of joint degenerative disease (osteoarthrosis). Pain levels are registered with visual analog scale, where 0 is absence of pain and 16 acute pain. A bone degeneration is classified as mild, moderate and severe, according to findings of nuclear magnetic resonance. The 15 retrodiscal hyperplastic tissue samples are taken from patients undergoing to open surgery of temporomandibular joint. The specimens were placed in plastic blocks with freezing medium and are stored at -70 degrees celsius until neuropeptide extraction by radioimmunoassay with kit for CGRP. A directly proportional relationship is established between the degree of bone degeneration and neuropeptide expression and between the osteoarthrosis classification with analogue visual scale. Findings have shown definitive correlation between pain levels and expression of neuropeptide. CGRP is expressed in the retrodiscal tissue of temporomandibular joint in human with joint degenerative disease and is directly related with levels osteoarthrosis and pain [Spanish] La presencia y el contenido del peptido relacionado con el gen de la calcitonina (CGRP) es evaluado en el tejido retrodiscal hiperplasico de la articulacion temporomandibular en pacientes con enfermedad degenerativa articular mediante radioinmunoensayo. La poblacion del estudio ha incluido 8 pacientes de genero femenino en estado premenopausico, sin estar embarazada, sin estar lactando por un ano y con diagnostico de enfermedad degenerativa articular (osteoartrosis). Los niveles de dolor son registrados con escala visual analoga, donde 0 es ausencia de dolor y 16 dolor agudo. Una

Pathophysiology of Degenerative Mitral Regurgitation: New 3-Dimensional Imaging Insights.

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Antoine, Clemence; Mantovani, Francesca; Benfari, Giovanni; Mankad, Sunil V; Maalouf, Joseph F; Michelena, Hector I; Enriquez-Sarano, Maurice

2018-01-01

Despite its high prevalence, little is known about mechanisms of mitral regurgitation in degenerative mitral valve disease apart from the leaflet prolapse itself. Mitral valve is a complex structure, including mitral annulus, mitral leaflets, papillary muscles, chords, and left ventricular walls. All these structures are involved in physiological and pathological functioning of this valvuloventricular complex but up to now were difficult to analyze because of inherent limitations of 2-dimensional imaging. The advent of 3-dimensional echocardiography, computed tomography, and cardiac magnetic resonance imaging overcoming these limitations provides new insights into mechanistic analysis of degenerative mitral regurgitation. This review will detail the contribution of quantitative and qualitative dynamic analysis of mitral annulus and mitral leaflets by new imaging methods in the understanding of degenerative mitral regurgitation pathophysiology. © 2018 American Heart Association, Inc.

Comparison of Findings from Oblique Radiographs of the Raised Limb with Those of the Weight-bearing Limb for Selected Diseases of the Equine Digit

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J. Šterc

2007-01-01

Full Text Available In the present study, the radiographic examination of the distal and proximal interphalangeal joints was performed in 43 randomly selected horses. A total of 86 forelimbs were examined. On the forelimbs, dorsolateral-palmaromedial, and dorsomedial-palmarolateral oblique views were performed. The oblique views were performed on raised limbs placed in a navicular block and on weight-bearing limbs placed on a pedestal made at the equine clinic. In total, 688 dorsolateral-palmaromedial and dorsomedial-palmarolateral views were taken. During the evaluation of the radiographs we focused on the detection of signs of degenerative joint disease of the distal and proximal iterphalangeal joints, and the detection of new bone formation in the phalanx regions, not associated with a disease of the distal or proximal interphalangeal joints. Based on the radiographic signs visible on these views, we diagnosed 9 cases of degenerative joint disease of the distal intraphalangeal joint, 13 cases of the degenerative joint disease of the proximal intraphalangeal joint and 21 cases of new bone formation in the phalanx regions. These signs were observed in 253 of 688 oblique views. Positive radiographic findings of the above-mentioned disorders were shown on 127 oblique views of the raised limb placed in the navicular block and 126 oblique views of the weight-bearing limb placed on the pedestal we made. When 128 oblique views of the weight-bearing limb (placed on the pedestal were compared with those of the raised limb (in the navicular block, there were different radiographic findings in three cases only. The differences in detection rates of radiographic signs between different type views showed no statistical significance (p ≥ 0.05. Therefore we assume that the pedestal we made can be routinely used for the radiographic examination of the distal and proximal interphalangeal joints on DL-PM and DM-PL oblique views, as part of pre-purchase examination or diagnosis

The synovial microenvironment of osteoarthritic joints alters RNA-seq expression profiles of human primary articular chondrocytes

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Lewallen, Eric A.; Bonin, Carolina A.; Li, Xin; Smith, Jay; Karperien, Marcel; Larson, A. Noelle; Lewallen, David G.; Cool, Simon M.; Westendorf, Jennifer J.; Krych, Aaron J.; Leontovich, Alexey A.; Im, Hee-Jeong; van Wijnen, Andre J.

2018-01-01

Osteoarthritis (OA) is a disabling degenerative joint disease that prompts pain with limited treatment options. To permit early diagnosis and treatment of OA, a high resolution mechanistic understanding of human chondrocytes in normal and diseased states is necessary. In this study, we assessed the biological effects of OA-related changes in the synovial microenvironment on chondrocytes embedded within anatomically intact cartilage from joints with different pathological grades by next generation RNA-sequencing (RNA-seq). We determined the transcriptome of primary articular chondrocytes derived from pristine knees and ankles, as well as from joints affected by OA. The GALAXY bioinformatics platform was used to facilitate biological interpretations. Comparisons of patient samples by k-means, hierarchical clustering and principal component analysis reveal that primary chondrocytes exhibit OA grade-related differences in gene expression, including genes involved in cell-adhesion, ECM production and immune response. We conclude that diseased synovial microenvironments in joints with different histopathological OA grades directly alter gene expression in chondrocytes. One ramification of this finding is that sampling anatomically intact cartilage from OA joints is not an ideal source of healthy chondrocytes, nor should they be used to generate a normal baseline for the molecular characterization of diseased joints. PMID:27378743

Candidate gene investigation of spinal degenerative osteoarthritis in Greek population.

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Liva, Eleni; Panagiotou, Irene; Palikyras, Spyros; Parpa, Efi; Tsilika, Eleni; Paschou, Peristera; Mystakidou, Kyriaki

2017-12-01

Few data exist concerning the natural history of degenerative osteoarthritis (OA) of the spine and its associated gene investigation. Degenerative spinal OA demonstrates an international prevalence of 15% in the general population. The aim of this Greek case-control study is to examine gene polymorphisms that have been previously shown or hypothesized to be correlated to degenerative OA. Gene polymorphisms, especially for OA, have never been previously studied in the Greek population. The study was conducted from May 2009 to December 2012. Eligible subjects who agreed to take part in the study were Greek adults from all of Greece, referred for consultation to the Palliative Care and Pain Relief Unit of Aretaieion University Hospital, in Athens, Greece. A total of 601 matched pairs (cases and controls) participated in the study, 258 patients (188 women and 70 men) with clinically and radiologically confirmed degenerative OA and 243 control subjects (138 women and 105 men). All patients presented with chronic pain at the spine (cervical, thoracic or lumbar) caused by sympomatic osteophytes or disc narrowing, whereas clinical diagnosis of OA was based on the presence of both joint symptoms and evidence of structural changes seen on plain conventional X-rays. We investigated genetic variation across candidate OA gene GDF5, CDMP1, CDMP2, Asporin, SMAD3, and chromosomal region 7q22, in a sample of 258 patients with clinically and radiologically confirmed degenerative OA, and 243 control subjects from the Greek population. All subjects (patients and controls) were subsequently matched for the epidemiologic, demographic, and clinical risk factors, to prevent selection biases. A tagging single nucleotide polymorphism (SNP) approach was pursued to cover variation across all targeted loci. Single marker tests as well as haplotypic tests of association were performed. There is no conflict of interest, and also, there are no study funding sources. We found significant

DEGRO guidelines for the radiotherapy of non-malignant disorders. Part II: Painful degenerative skeletal disorders

International Nuclear Information System (INIS)

Ott, Oliver J.; Niewald, Marcus; Weitmann, Hajo-Dirk; Jacob, Ingrid; Adamietz, Irenaeus A.; Schaefer, Ulrich; Keilholz, Ludwig; Heyd, Reinhard; Muecke, Ralph

2015-01-01

The purpose of this article is to summarize the updated DEGRO consensus S2e guideline recommendations for the treatment of benign painful degenerative skeletal disorders with low-dose radiotherapy. This overview reports on the role of low-dose radiotherapy in the treatment of enthesiopathies (shoulder syndrome, trochanteric bursitis, plantar fasciitis, and elbow syndrome) and painful arthrosis (knee, hip, hand, and finger joints). The most relevant aspects of the DEGRO S2e Consensus Guideline Radiation Therapy of Benign Diseases 2014 regarding diagnostics, treatment decision, dose prescription as well as performance of radiotherapy and results are summarized. For all indications mentioned above, retrospective and some prospective analyses have shown remarkable effects in terms of pain relief. Nevertheless, the Level of Evidence (LoE) and the Grade of Recommendation (GR) vary: LoE 1b-4 and GR A-C. Low-dose radiotherapy for painful degenerative skeletal disorders is effective in the majority of the patients and therefore it may be a reasonable therapeutic alternative when simple and non-invasive methods have been used without persistent success. For all discussed entities, single fraction doses of 0.5-1.0 Gy and total doses of 3.0-6.0 Gy/series applied with 2-3 fractions per week are recommended. (orig.) [de

Association between temporomandibular joint symptoms, signs, and clinical diagnosis using the RDC/TMD and radiographic findings in temporomandibular joint tomograms.

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Wiese, Mie; Svensson, Peter; Bakke, Merete; List, Thomas; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Wenzel, Ann

2008-01-01

To identify associations between clinical symptoms of temporomandibular joint disorders and radiographic findings. Two hundred four adult patients (156 women, 48 men, mean age 40 years) with temporomandibular joint (TMJ) pain/sounds or changes in mandibular motion were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bilateral sagittal corrected TMJ tomograms in closed and open positions were assessed for the presence of flattening, erosion, osteophytes, and sclerosis in the joint components and the range of mandibular motion. Logistic regression analyses were performed with the radiographic findings as the dependent variables and the following clinical variables as independent variables: opening pattern, maximal jaw opening, TMJ sounds, number of painful muscle/TMJ sites, duration of pain, presence of arthritic disease, depression and somatization scores, graded chronic pain, and age and gender. Coarse crepitus on opening/closing (odds ratio [OR] > or = 3.12), on lateral excursions (odds ratio > or = 4.06), and on protrusion (OR > or = 5.30) was associated with increased risk of degenerative findings in tomograms. A clinical diagnosis of osteoarthritis increased the risk of radiographic findings (OR > or = 2.95) and so did increasing age (OR > or = 1.03 per year) and the female gender (OR > or = 2.36). Maximal assisted opening and maximal opening without pain (position (OR > or = 2.60). No other significant associations were observed. Age, gender, and coarse crepitus, but no pain-related variables, were associated with increased risk of degenerative findings in TMJ tomograms. Maximal opening < 40 mm was associated with a posterior condyle-to-articular tubercle relation on opening.

The immediate effects of taping therapy on knee pain and depression in patients with degenerative arthritis.

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Han, Ji-Won; Lee, Dong-Kyu; Park, Chi-Bok

2018-05-01

[Purpose] This study aims to identify the immediate effects of taping therapy on knee pain and depression among patients with degenerative arthritis. [Subjects and Methods] In total, 32 patients with degenerative arthritis were randomly assigned to one of two groups: the experimental group that underwent taping therapy and the control group that underwent regular treatment (16 patients per group). In the experimental group, therapeutic tape was wrapped all around the knee joint. Pain and depression were measured using the visual analogue scale (VAS) and the Beck Depression Inventory (BDI), respectively. [Results] The intra-group comparison showed significant differences in VAS and BDI for the experimental group. The intergroup comparison showed that the differences in VAS and BDI within the experimental group appeared significant relative to the control group. [Conclusion] It was observed that taping therapy showed an immediate effect in decreasing knee pain and depression among patients with degenerative arthritis.

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

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

2012-01-01

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...

Patient-perceived surgical indication influences patient expectations of surgery for degenerative spinal disease.

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Wilson, Thomas J; Franz, Eric; Vollmer, Carolyn F; Chang, Kate W-C; Upadhyaya, Cheerag; Park, Paul; Yang, Lynda J-S

2017-06-01

Patients frequently have misconceptions regarding diagnosis, surgical indication, and expected outcome following spinal surgery for degenerative spinal disease. In this study, we sought to understand the relationship between patient-perceived surgical indications and patient expectations. We hypothesized that patients reporting appendicular symptoms as a primary surgical indication would report a higher rate of having expectations met by surgery compared to those patients reporting axial symptoms as a primary indication. Questionnaires were administered to patients who had undergone surgery for degenerative spinal disease at 2 tertiary care institutions. Questions assessed perception of the primary indication for undergoing surgery (radicular versus axial), whether the primary symptom improved after surgery, and whether patient expectations were met with surgery. Outcomes of interest included patient-reported symptomatic improvement following surgery and expectations met by surgery. Various factors were assessed for their relationship to these outcomes of interest. There were 151 unique survey respondents. Respondents were nearly split between having a patient-perceived indication for surgery as appendicular symptoms (55.6%) and axial symptoms (44.4%). Patient-perceived surgical indication being appendicular symptoms was the only factor predictive of patient-reported symptomatic improvement in our logistic regression model (OR 2.614; 95% CI 1.218-5.611). Patient-perceived surgical indication being appendicular symptoms (OR 3.300; 95% CI 1.575-6.944) and patient-reported symptomatic improvement (OR 33.297; 95% CI 12.186-90.979) were predictive of patients reporting their expectations met with surgery in both univariate and multivariate logistic regression modeling. We found that patient-reported appendicular symptoms as the primary indication for surgery were associated with a higher rate of both subjective improvement following surgery and having expectations met

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

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

1997-09-01

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.

Rotary deformity in degenerative spondylolisthesis

International Nuclear Information System (INIS)

Kang, Sung Gwon; Kim, Jeong; Kho, Hyen Sim; Yun, Sung Su; Oh, Jae Hee; Byen, Ju Nam; Kim, Young Chul

1994-01-01

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

Microglia in Alzheimer’s Disease: Activated, Dysfunctional or Degenerative

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Victoria Navarro

2018-05-01

Full Text Available Microglial activation has been considered a crucial player in the pathological process of multiple human neurodegenerative diseases. In some of these pathologies, such as Amyotrophic Lateral Sclerosis or Multiple Sclerosis, the immune system and microglial cells (as part of the cerebral immunity play a central role. In other degenerative processes, such as Alzheimer’s disease (AD, the role of microglia is far to be elucidated. In this “mini-review” article, we briefly highlight our recent data comparing the microglial response between amyloidogenic transgenic models, such as APP/PS1 and AD patients. Since the AD pathology could display regional heterogeneity, we focus our work at the hippocampal formation. In APP based models a prominent microglial response is triggered around amyloid-beta (Aβ plaques. These strongly activated microglial cells could drive the AD pathology and, in consequence, could be implicated in the neurodegenerative process observed in models. On the contrary, the microglial response in human samples is, at least, partial or attenuated. This patent difference could simply reflect the lower and probably slower Aβ production observed in human hippocampal samples, in comparison with models, or could reflect the consequence of a chronic long-standing microglial activation. Beside this differential response, we also observed microglial degeneration in Braak V–VI individuals that, indeed, could compromise their normal role of surveying the brain environment and respond to the damage. This microglial degeneration, particularly relevant at the dentate gyrus, might be mediated by the accumulation of toxic soluble phospho-tau species. The consequences of this probably deficient immunological protection, observed in AD patients, are unknown.

Current and future perspectives on lumbar degenerative disc disease: a UK survey exploring specialist multidisciplinary clinical opinion

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McGregor, Alison H

2016-01-01

Objectives Despite lumbar degenerative disc disease (LDDD) being significantly associated with non-specific low back pain and effective treatment remaining elusive, specialist multidisciplinary clinical stakeholder opinion remains unexplored. The present study examines the views of such experts. Design A reliable and valid electronic survey was designed to establish trends using theoretical constructs relating to current assessment and management practices. Clinicians from the Society of Back Pain Research (SBPR) UK were invited to take part. Quantitative data were collated and coded using Bristol Online Surveys (BOS) software, and content analysis was used to systematically code and categorise qualitative data. Setting Specialist multidisciplinary spinal interest group in the UK. Participants 38/141 clinically active, multidisciplinary SBPR members with specialist spinal interest participated. Among them, 84% had >9 years postgraduate clinical experience. Interventions None. Outcome measures Frequency distributions were used to establish general trends in quantitative data. Qualitative responses were coded and categorised in relation to each theme and percentage responses were calculated. Results LDDD symptom recurrence, in the absence of psychosocial influence, was associated with physical signs of joint stiffness (26%), weakness (17%) and joint hypermobility (6%), while physical factors (21%) and the ability to adapt (11%) were postulated as reasons why some experience pain and others do not. No one management strategy was supported exclusively or with consensus. Regarding effective modalities, there was no significant difference between allied health professional and medic responses (p=0.1–0.8). The future of LDDD care was expressed in terms of improvements in patient communication (35%), patient education (38%) and treatment stratification (24%). Conclusions Results suggest that multidisciplinary expert spinal clinicians appear to follow UK

A prospective randomized trial comparing anterior cervical discectomy and fusion versus plate-only open-door laminoplasty for the treatment of spinal stenosis in degenerative diseases.

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Jiang, Yun-Qi; Li, Xi-Lei; Zhou, Xiao-Gang; Bian, Chong; Wang, Han-Ming; Huang, Jian-Ming; Dong, Jian

2017-04-01

For three or more involved cervical levels, there is a debate over which approach yields the best outcomes for the treatment of multilevel cervical degenerative disease. Our objective is to compare the radiological and clinical outcomes of two treatments for multilevel cervical degenerative disease: anterior cervical discectomy and fusion (ACDF) versus plate-only open-door laminoplasty (laminoplasty). Patients were randomized on a 1:1 randomization schedule with 17 patients in the ACDF group and 17 patients in the laminoplasty group. Clinical outcomes were assessed by a visual analog scale (VAS), Japanese Orthopedic Association (JOA) scores, operative time, blood loss, rates of complications, drainage volume, discharge days after surgery, and complications. The cervical spine curvature index (CI) and range of motion (ROM) were assessed with radiographs. The mean VAS score, the mean JOA score, and the rate of complications did not differ significantly between groups. The laminoplasty group had greater blood loss, a longer operative time, more drainage volume, and a longer hospital stay than the ACDF group. There were no significant differences in the CI and ROM between the two groups at baseline and at each follow-up time point. ROM in both groups decreased significantly after surgery. Both ACDF and laminoplasty are effective and safe treatments for multilevel cervical degenerative disease. ACDF causes fewer traumas than laminoplasty.

[The shor-term clinical outcomes and safety of extreme lateral interbody fusion combined with percutaneous pedicle screw fixation for the treatment of degenerative lumbar disease].

Science.gov (United States)

Hu, Xu-Dong; Ma, Wei-Hu; Jiang, Wei-Yu; Ruan, Chao-Yue; Chen, Yun-Lin

2017-02-25

To evaluate the early efficacy and safety of extreme lateral interbody fusion (XLIF) combined with percutaneous pedicle screw fixation for lumbar degenerative disease. From January 2013 to June 2014, 13 patients with degenerative lumbar disease were treated with XLIF combined with percutaneous pedicle screw fixation, including 8 cases of lumbar instability, 5 cases of mild to moderate lumbar spondylolisthesis;there were 5 males and 8 females, aged from 56 to 73 years with an average of 62.1 years. All patients were single segment fusion. Operation time, perioperative bleeding and perioperative complications were recorded. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical efficacy. Interbody fusion rate was observed and the intervertebral foramen area changes were compared preoperation and postoperation by X-rays and CT scanning. The mean operation time and perioperative bleeding in the patients respectively was(62.8±5.2) min and(82.5±22.6) ml. One case occurred in the numbness of femoribus internus and 1 case occurred in the muscle weakness of hip flexion after operation, both of them recovered within 2 weeks. All the patients were followed up from 12 to 19 months with an average of 15.6 months. VAS was decreased from preoperative 7.31±0.75 to 2.31±0.75 at final follow-up( P degenerative disease.

Magnetic resonance imaging of peripheral joints in rheumatic diseases

DEFF Research Database (Denmark)

Østergaard, Mikkel; Duer, Anne; Møller, Uffe

2004-01-01

The need for better methods than the conventional clinical, biochemical and radiographical examinations in the management of inflammatory joint diseases is evident, since these methods are not sensitive or specific to early pathologies and subtle changes. Magnetic resonance imaging (MRI) offers...... improved sensitivity to early inflammatory and destructive changes in peripheral joints in rheumatoid arthritis (RA) and, even though less well documented, in other inflammatory joint diseases. Good evidence is available that MRI bone erosions represent true bone abnormalities and are predictors......, this chapter discusses the potential for the use of MRI in the clinical management of patients with suspected and diagnosed inflammatory joint diseases, as well as research priorities and clinical situations where the use of MRI could be suggested...

?Lumbar Degenerative Kyphosis? Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception

OpenAIRE

Lee, Chang-Hyun; Chung, Chun Kee; Jang, Jee-Soo; Kim, Sung-Min; Chin, Dong-Kyu; Lee, Jung-Kil

2017-01-01

Lumbar degenerative kyphosis (LDK) is a subgroup of the flat-back syndrome and is most commonly caused by unique life styles, such as a prolonged crouched posture during agricultural work and performing activities of daily living on the floor. Unfortunately, LDK has been used as a byword for degenerative sagittal imbalance, and this sometimes causes confusion. The aim of this review was to evaluate the exact territory of LDK, and to introduce another appropriate term for degenerative sagittal...

Frying process in the relation fat/degenerative diseases.

Directory of Open Access Journals (Sweden)

Varela, G.

1998-08-01

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

Joint space width in dysplasia of the hip

DEFF Research Database (Denmark)

Jacobsen, Steffen; Sonne-Holm, Stig; Søballe, K

2005-01-01

In a longitudinal case-control study, we followed 81 subjects with dysplasia of the hip and 136 control subjects without dysplasia for ten years assessing radiological evidence of degeneration of the hip at admission and follow-up. There were no cases of subluxation in the group with dysplasia....... Neither subjects with dysplasia nor controls had radiological signs of ongoing degenerative disease at admission. The primary radiological discriminator of degeneration of the hip was a change in the minimum joint space width over time. There were no significant differences between these with dysplasia...... and controls in regard to age, body mass index or occupational exposure to daily repeated lifting at admission.We found no significant differences in the reduction of the joint space width at follow-up between subjects with dysplasia and the control subjects nor in self-reported pain in the hip...

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

Science.gov (United States)

Ackerman, Stacey J; Polly, David W; Knight, Tyler; Holt, Tim; Cummings, John

2014-01-01

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

Anterior Versus Posterior Approach for Multilevel Degenerative Cervical Disease: A Retrospective Propensity Score-Matched Study of the MarketScan Database.

Science.gov (United States)

Cole, Tyler; Veeravagu, Anand; Zhang, Michael; Azad, Tej D; Desai, Atman; Ratliff, John K

2015-07-01

Retrospective 2:1 propensity score-matched analysis on a national longitudinal database between 2006 and 2010. To compare rates of adverse events, revisions procedure rates, and payment differences in anterior cervical fusion procedures compared with posterior laminectomy and fusion procedures with at least 3 levels of instrumentation. The comparative benefits of anterior versus posterior approach to multilevel degenerative cervical disease remain controversial. Recent systematic reviews have reached conflicting conclusions. We demonstrate the comparative economic and clinical outcomes of anterior and posterior approaches for multilevel cervical degenerative disk disease. We identified 13,662 patients in a national billing claims database who underwent anterior or posterior cervical fusion procedures with 3 or more levels of instrumentation. Cohorts were balanced using 2:1 propensity score matching and outcomes were compared using bivariate analysis. With the exception of dysphagia (6.4% in anterior and 1.4% in posterior), overall 30-day complication rates were lower in the anterior approach group. The rate of any complication excluding dysphagia with anterior approaches was 12.3%, significantly lower (P disease provide clinical advantages over posterior approaches, including lower overall complication rates, revision procedure rates, and decreased length of stay. Anterior approach procedures are also associated with decreased overall payments. These findings must be interpreted in light of limitations inherent to retrospective longitudinal studies including absence of subjective and radiographical outcomes. 3.

Lower complication and reoperation rates for laminectomy rather than MI TLIF/other fusions for degenerative lumbar disease/spondylolisthesis: A review

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Epstein, Nancy E.

2018-01-01

Background: Utilizing the spine literature, we compared the complication and reoperation rates for laminectomy alone vs. instrumented fusions including minimally invasive (MI) transforaminal lumbar interbody fusion (TLIF) for the surgical management of multilevel degenerative lumbar disease with/without degenerative spondylolisthesis (DS). Methods: Epstein compared complication and reoperation rates over 2 years for 137 patients undergoing laminectomy alone undergoing 2-3 level (58 patients) and 4-6 level (79 patients) Procedures for lumbar stenosis with/without DS. Results showed no new postoperative neurological deficits, no infections, no surgery for adjacent segment disease (ASD), 4 patients (2.9%) who developed intraoperative cerebrospinal fluid (CSF) fistulas, no readmissions, and just 1 reopereation for a (postoperative day 7). These rates were compared to other literature for lumbar laminectomies vs. fusions (e.g. particularly MI TLIF) addressing pathology comparable to that listed above. Results: Some studies in the literature revealed an average 4.8% complication rate for laminectomy alone vs. 8.3% for decompressions/fusion; at 5 postoperative years, reoperation rates were 10.6% vs. 18.4%, respectively. Specifically, the MI TLIF literature complication rates ranged from 7.7% to 23.0% and included up to an 8.3% incidence of wound infections, 6.1% durotomies, 9.7% permanent neurological deficits, and 20.2% incidence of new sensory deficits. Reoperation rates (1.6–6%) for MI TLIF addressed instrumentation failure (2.3%), cage migration (1.26–2.4%), cage extrusions (0.8%), and misplaced screws (1.6%). The learning curve (e.g. number of cases required by a surgeon to become proficient) for MI TLIF was the first 33-44 cases. Furthermore, hospital costs for lumbar fusions were 2.6 fold greater than those for laminectomy alone, with overall neurosurgeon reimbursement quoted in one study as high as $142,075 per year. Conclusions: The spinal literature revealed

A Cost-Utility Analysis of Lumbar Decompression With and Without Fusion for Degenerative Spine Disease in the Elderly.

Science.gov (United States)

Devin, Clinton J; Chotai, Silky; Parker, Scott L; Tetreault, Lindsay; Fehlings, Michael G; McGirt, Matthew J

2015-10-01

Value-based purchasing is rapidly being implemented to rein in the unsustainably rising costs of the US healthcare system. With a growing elderly population, it is vital to understand the value of spinal surgery in this group of individuals. To compare the cost-effectiveness of lumbar decompression with and without fusion for degenerative spine disease in elderly vs nonelderly patients. A total of 221 patients undergoing elective primary surgery for degenerative lumbar pathology who were enrolled in a prospective longitudinal registry were analyzed. Patient-reported outcomes of Oswestry Disability Index, numeric rating scale for back and leg pain, and quality-of-life scores (EuroQol-5D) were recorded. Two-year back-related medical resource use, missed work, and health-state values (quality-adjusted life-years [QALYs]) were assessed. Two-year resource use was multiplied by unit costs based on Medicare national allowable payment amounts (direct cost). Patient and caregiver workday losses were multiplied by gross-of-tax wage rate (indirect cost). Patients were divided into age groups <70 and ≥70 years. Mean cumulative 2-year QALYs gained were statistically similar between younger and older patients for both decompression alone (0.67 ± 0.65 vs 0.56 ± 0.65; P = .47) and decompression with fusion (0.56 ± 0.55 vs 0.59 ± 0.55; P = .26). Mean 2-year cost per QALY gained between younger and older patients was similar for both decompression alone ($24,365 vs $31,750 per QALY; P = .11) and decompression with fusion ($64,228 vs $60,183 per QALY; P = .09). Surgical treatment provided significant improvements in pain, disability, and quality of life for elderly patients with degenerative lumbar disease. Observed costs per QALY gained for lumbar decompression with and without fusion were similar for younger and older patients, demonstrating that lumbar spine surgery in the elderly is an equally cost-effective and valuable intervention.

Genetic architecture of retinal and macular degenerative diseases: the promise and challenges of next-generation sequencing

Science.gov (United States)

2013-01-01

Inherited retinal degenerative diseases (RDDs) display wide variation in their mode of inheritance, underlying genetic defects, age of onset, and phenotypic severity. Molecular mechanisms have not been delineated for many retinal diseases, and treatment options are limited. In most instances, genotype-phenotype correlations have not been elucidated because of extensive clinical and genetic heterogeneity. Next-generation sequencing (NGS) methods, including exome, genome, transcriptome and epigenome sequencing, provide novel avenues towards achieving comprehensive understanding of the genetic architecture of RDDs. Whole-exome sequencing (WES) has already revealed several new RDD genes, whereas RNA-Seq and ChIP-Seq analyses are expected to uncover novel aspects of gene regulation and biological networks that are involved in retinal development, aging and disease. In this review, we focus on the genetic characterization of retinal and macular degeneration using NGS technology and discuss the basic framework for further investigations. We also examine the challenges of NGS application in clinical diagnosis and management. PMID:24112618

Diffusion tensor imaging differentiates vascular parkinsonism from parkinsonian syndromes of degenerative origin in elderly subjects

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Deverdun, Jérémy [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier (France); I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier (France); Menjot de Champfleur, Sophie [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Clinique du Parc, Castelnau-le-Lez (France); Cabello-Aguilar, Simon [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); I2FH, Institut d’Imagerie Fonctionnelle Humaine, Hôpital Gui de Chauliac, CHRU de, Montpellier (France); Maury, Florence [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Molino, François [Laboratoire Charles Coulomb, CNRS UMR 5221 - Université Montpellier II, Montpellier (France); Institut de Génomique Fonctionnelle, UMR 5203 - INSERM U661 - Université Montpellier II - Université, Montpellier I (France); Charif, Mahmoud [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Leboucq, Nicolas [Department of Neuroradiology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); Ayrignac, Xavier; Labauge, Pierre [Department of Neurology, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier (France); and others

2014-11-15

Background and Purpose: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. Materials and Methods: Thirty-five patients were prospectively included (multiple-system atrophy, n = 5; Parkinson's disease, n = 15; progressive supranuclear palsy, n = 9; vascular parkinsonism, n = 6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. Results: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p = 0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p = 0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. Conclusion: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data.

Diffusion tensor imaging differentiates vascular parkinsonism from parkinsonian syndromes of degenerative origin in elderly subjects

International Nuclear Information System (INIS)

Deverdun, Jérémy; Menjot de Champfleur, Sophie; Cabello-Aguilar, Simon; Maury, Florence; Molino, François; Charif, Mahmoud; Leboucq, Nicolas; Ayrignac, Xavier; Labauge, Pierre

2014-01-01

Background and Purpose: The etiologic diagnosis of parkinsonian syndromes is of particular importance when considering syndromes of vascular or degenerative origin. The purpose of this study is to find differences in the white-matter architecture between those two groups in elderly patients. Materials and Methods: Thirty-five patients were prospectively included (multiple-system atrophy, n = 5; Parkinson's disease, n = 15; progressive supranuclear palsy, n = 9; vascular parkinsonism, n = 6), with a mean age of 76 years. Patients with multiple-system atrophy, progressive supranuclear palsy and Parkinson's disease were grouped as having parkinsonian syndromes of degenerative origin. Brain MRIs included diffusion tensor imaging. Fractional anisotropy and mean-diffusivity maps were spatially normalized, and group analyses between parkinsonian syndromes of degenerative origin and vascular parkinsonism were performed using a voxel-based approach. Results: Statistical parametric-mapping analysis of diffusion tensor imaging data showed decreased fractional anisotropy value in internal capsules bilaterally in patients with vascular parkinsonism compared to parkinsonian syndromes of degenerative origin (p = 0.001) and showed a lower mean diffusivity in the white matter of the left superior parietal lobule (p = 0.01). Fractional anisotropy values were found decreased in the middle cerebellar peduncles in multiple-system atrophy compared to Parkinson's disease and progressive supranuclear palsy. The mean diffusivity was increased in those regions for these subgroups. Conclusion: Clinically defined vascular parkinsonism was associated with decreased fractional anisotropy in the deep white matter (internal capsules) compared to parkinsonian syndromes of degenerative origin. These findings are consistent with previously published neuropathological data

[Clinical efficacy of unilateral percutaneous transfacet screws combined with contralateral pedicle screw versus bilateral pedicle screws fixation in the treatment of the degenerative lumbar disease].

Science.gov (United States)

Hao, Rong-Xue; Zhou, Hui; Pan, Hao; Yue, Jun; Chen, Hui-Guo; Yang, He-Jie; Jia, Gao-Yong; Wang, Dong; Lin, Yan; Xu, Hua-Zi

2017-09-25

To investigate the surgical outcome of unilateral pedicle screw(UPS) after TLIF technique combined with contralateral percutaneous transfacet screw(PTS) fixation vs bilateral pedicle screws(BPS) fixation in treatment of degenerative lumbar disease. From January 2009 to June 2012, 46 patients with degenerative lumbar diseases, including 30 males and 16 females with an average age of 51.5 years old, who were divided into two groups according to different fixation methods. Twenty-two cases underwent UPS after TLIF technique combined with contralateral PTS fixation (group A), while the others underwent BPS fixation(group B). The relative data were analyzed, such as blood loss volume, operative time, fusion rate, ODI score, JOA score and so on. All the patients were followed up for 1 to 3 years with an average of 22 months. Except one case of each group was uncertainty fusion, the rest have obtained bony fusion, and the fusion rates in group A and B were 95.5% and 95.8%, respectively. No displacement and breakage of screw were found during follow-up. Operative time and blood loss volume in group A were better than of group B( P 0.05). Two approaches had similar clinical outcomes for degenerative lumbar disease with no severe instability. Compared with BPS fixation, the UPS after TLIF technique and contralateral PTS fixation has the advantages of less trauma, shorter operative time and less blood loss, and it is a safe and feasible surgical technique.

Primary joint disease in the shoulder of the beagle dog

International Nuclear Information System (INIS)

Morgan, J.P.; Pool, R.R.; Miyabayashi, T.; Soo, S.

1985-01-01

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

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

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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

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.

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)

Buck, Florian M.; Nico, Marcelo A.C.; Gheno, Ramon; Trudell, Debra J.; Resnick, Donald

2011-01-01

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 o . Conclusion: In conclusion the DRUJ is accessible to US except in the central 13 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.

Association of COL1A1 rs1800012 polymorphism with musculoskeletal degenerative diseases: a meta-analysis.

Science.gov (United States)

Zhong, Binlong; Huang, Donghua; Ma, Kaige; Deng, Xiangyu; Shi, Deyao; Wu, Fashuai; Shao, Zengwu

2017-09-26

It has been reported that the single nucleotide polymorphism (SNP) rs1800012 in COL1A1 gene might be linked to the susceptibility of musculoskeletal degenerative diseases, such as osteoarthritis (OA) and intervertebral disc degeneration (IVDD). However, the data from different studies is contradictory. Here we aimed to comprehensively summarize and clarify the relationship between the SNP and musculoskeletal degenerative diseases. Seven eligible studies including 1339 cases and 5406 controls were screened out from PubMed, Web Of Science and Cochrane library databases. Significant association was identified in sub group analysis of IVDD in homozygote model (GG versus TT: OR = 0.33, 95% CI 0.14-0.78, P = 0.012), heterozygote model (GT versus TT: OR = 0.29, 95% CI 0.11-0.72, P = 0.008) and dominant model (GG/GT versus TT: OR = 0.31, 95% CI 0.13-0.74, P = 0.008). Additionally, significant relationship was also found in sub group analysis of severe degree of IVDD in homozygote model (GG versus TT: OR = 0.37, 95% CI 0.15-0.91, P = 0.031), heterozygote model (GT versus TT: OR = 0.33, 95% CI 0.13-0.87, P = 0.024) and dominant model (GG/GT versus TT: OR = 0.36, 95% CI 0.14-0.88, P = 0.025). Although no significance was observed, there is a trend that the more G allele at COL1A1 rs1800012 site, the less possibility of IVDD and severe IVDD would happen. Our results indicate that COL1A1 rs1800012 polymorphism associates with the susceptibility of IVDD. However, this polymorphism may not be associated with OA risk.

Joint assessment in von Willebrand disease : Validation of the Haemophilia Joint Health score and Haemophilia Activities List

NARCIS (Netherlands)

van Galen, Karin P. M.; Timmer, Merel A.; de Kleijn, Piet; Fischer, Kathelijn; Foppen, Wouter; Schutgens, Roger E. G.; Eikenboom, Jeroen; Meijer, Karina; Cnossen, Marjon H.; Fijnvandraat, Karin; van der Bom, Johanna G.; Laros-van Gorkom, Britta A. P.; Leebeek, Frank W. G.; Mauser-Bunschoten, Eveline P.

Assessment of clinical outcome after joint bleeding is essential to identify joint damage and optimise treatment, to prevent disability. However, disease-specific tools to assess the musculoskeletal status in patients with von Willebrand disease (VWD) are lacking. We aimed to determine validity and

Getting an Insight into the Complexity of Major Chronic Inflammatory and Degenerative Diseases: A Potential New Systemic Approach to Their Treatment.

Science.gov (United States)

Biava, Pier M; Norbiato, Guido

2015-01-01

As the modern society is troubled by multi-factorial diseases, research has been conducted on complex realities including chronic inflammation, cancer, obesity, HIV infection, metabolic syndrome and its detrimental cardiovascular complications as well as depression and other brain disorders. Deterioration of crucial homeostatic mechanisms in such diseases invariably results in activation of inflammatory mediators, chronic inflammation, loss in immunological function, increased susceptibility to diseases, alteration of metabolism, decrease of energy production and neuro-cognitive decline. Regulation of genes expression by epigenetic code is the dominant mechanism for the transduction of environmental inputs, such as stress and inflammation to lasting physiological changes. Acute and chronic stress determines DNA methylation and histone modifications in brain regions which may contribute to neuro-degenerative disorders. Nuclear glucocorticoids receptor interacts with the epigenoma resulting in a cortisol resistance status associated with a deterioration of the metabolic and immune functions. Gonadal steroids receptors have a similar capacity to produce epigenomic reorganization of chromatine structure. Epigenomic-induced reduction in immune cells telomeres length has been observed in many degenerative diseases, including all types of cancer. The final result of these epigenetic alterations is a serious damage to the neuro-endocrine-immune-metabolic adaptive systems. In this study, we propose a treatment with stem cells differentiation stage factors taken from zebrafish embryos which are able to regulate the genes expression of normal and pathological stem cells in a different specific way.

Relationship between MRI and clinical findings in the acromioclavicular joint

International Nuclear Information System (INIS)

Jordan, L.K.; Griffiths, H.L.; Kenter, K.

2002-01-01

Objective: To determine the relationship between the magnetic resonance (MR) appearance of the acromioclavicular (AC) joint and the physical findings. Design: A total of 116 consecutive patients underwent routine MR imaging (MRI) of the shoulder over an 18-month period. All MR studies were interpreted by a blinded, experienced musculoskeletal radiologist. Eleven variables were studied: the presence of osteophytes; fluid in the joint; fluid outside the joint; high signal in the clavicle or in the acromion; fluid in the subacromial bursa; irregularity of the joint margins; bulging of the capsule; widening of the joint; the age of the patient; and the presence of a rotator cuff tear. The clinical information was supplied by an experienced shoulder surgeon blinded to the MRI findings. A control group of 23 normal volunteers was also studied. Results: The only statistically significant correlation (P=0.0249) was between high signal in the distal clavicle and degenerative changes found clinically. A weaker relationship existed between fluid in the joint and the clinical examination and between increasing degenerative changes and advancing age. Otherwise, no material relationship was found between any of the other MR abnormalities and the clinical picture. Conclusion: There appears to be no real correlation between the MR appearances and the clinical findings in the AC joint. (orig.)

Relationship between MRI and clinical findings in the acromioclavicular joint

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Jordan, L.K.; Griffiths, H.L. [Department of Radiology, University of Missouri Health Care (United States); Kenter, K. [Department of Orthopedics, University of Missouri Health Care (United States)

2002-09-01

Objective: To determine the relationship between the magnetic resonance (MR) appearance of the acromioclavicular (AC) joint and the physical findings. Design: A total of 116 consecutive patients underwent routine MR imaging (MRI) of the shoulder over an 18-month period. All MR studies were interpreted by a blinded, experienced musculoskeletal radiologist. Eleven variables were studied: the presence of osteophytes; fluid in the joint; fluid outside the joint; high signal in the clavicle or in the acromion; fluid in the subacromial bursa; irregularity of the joint margins; bulging of the capsule; widening of the joint; the age of the patient; and the presence of a rotator cuff tear. The clinical information was supplied by an experienced shoulder surgeon blinded to the MRI findings. A control group of 23 normal volunteers was also studied. Results: The only statistically significant correlation (P=0.0249) was between high signal in the distal clavicle and degenerative changes found clinically. A weaker relationship existed between fluid in the joint and the clinical examination and between increasing degenerative changes and advancing age. Otherwise, no material relationship was found between any of the other MR abnormalities and the clinical picture. Conclusion: There appears to be no real correlation between the MR appearances and the clinical findings in the AC joint. (orig.)

Yeast as a model for the identification of novel survival-promoting compounds applicable to treat degenerative diseases.

Science.gov (United States)

Verbandt, Sara; Cammue, Bruno P A; Thevissen, Karin

2017-01-01

Programmed cell death (PCD) plays an important role in development and normal metabolic functioning of organisms. Excessive cell death is the cause of many degenerative diseases, like neurodegenerative disorders and Wilson's disease, for which current therapies remain insufficient. Current therapies are mainly focused on decreasing the disease symptoms following cell death, rather than blocking the cell death process itself. The latter can be obtained by either decreasing the presence of the toxic trigger (like protein aggregation in case of many commonly known neurodegenerative diseases) or by blocking death-inducing signaling cascade(s). Given the high conservation in PCD processes between yeast and mammalian cells, in this review, we will focus on yeast as a model organism to study PCD-related diseases as well as on its use for drug discovery purposes. More specifically, we will provide a comprehensive overview of new compounds, which were identified in yeast-based drug screens, that either decrease the amount of toxic trigger or inhibit PCD signaling cascades under PCD-inducing conditions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Temporo-mandibular joint disease in ankylosing spondylitis.

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Davidson, C; Wojtulewski, J A; Bacon, P A; Winstock, D

1975-01-01

The occurrence of temporo-mandibular joint (TMJ) disease in ankylosing spondylitis is not widely recognized and its incidence is disputed. Seventy-nine patients attending two routine rheumatology clinics were therefore examined by dental surgeon and nine (11-5 per cent) were considered to have specific TMJ involvement. These patients were older than the remainder, and had more extensive spinal and peripheral joint disease. Symptoms were mild and the predominant clinical feature was restricted mouth opening, which could present considerable difficulties during emergency anaesthesia. Bilateral condylectomy was undertaken in one patient with some benefit. Images PMID:1124959

Degenerative Pannus Mimicking Clival Chordoma Resected via an Endoscopic Transnasal Approach.

Science.gov (United States)

Khaldi, Ahmad; Griauzde, Julius; Duckworth, Edward A M

2011-05-01

Lesions of the lower clivus represent a technically challenging subset of skull base disease that requires careful treatment. A 75-year-old woman with tongue atrophy was referred for resection of a presumed clival chordoma. The lesion was resected via an endoscopic transnasal transclival approach with no complications. Pathology revealed only chronic inflammatory tissue consistent with a degenerative pannus. Degenerative pannus should be included in the differential diagnosis of lower clival extradural lesions. The endoscopic transnasal transclival corridor should be considered for resection of such lesions as an alternative to larger, more morbid, traditional skull base approaches.

Degenerative spine disorders in the context of clinical findings

International Nuclear Information System (INIS)

Freund, Michael; Sartor, Klaus

2006-01-01

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

Degenerative spine disorders in the context of clinical findings

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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

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.

Clinical and Pathogenetic Significance of Osteoassociated Microelements in the Joint Diseases. Report I. Microelementosis in the Blood

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O.V. Syniachenko

2016-04-01

Full Text Available Relevance. Microelementosis (imbalance in the body of certain microelements — ME is considered as one of the most important clinical and pathogenetic components of degenerative and inflammatory joint diseases, and ME can play the role of co-factors involved in the processes of articular inflammation. The objective: to study the levels in the blood serum and to assess the clinical and pathogenetic significance of osteoassociated ME (cobalt — Co, copper — Cu, iron — Fe, litium — Li, manganese — Mn, lead — Pb, strontium — Sr, zinc — Zn in a variety of arthritis — rheumatoid (RA, Chlamydia-induced urogenital reactive arthritis (ReA, psoriatic (PsA, gouty (GA and osteoarthritis (OA. Material and methods. There were 262 patients under observation, among them 89 persons suffering from RA, 31 — ReA, 35 — PsA, 49 — GA and 58 — OA. The distribution of males and females in these groups were 1 : 2, 2 : 1, 1 : 1, 11 : 1, 1 : 3, respectively, the average age of the patients was 47, 34, 42, 48 and 58 years, and the duration of clinical manifestations of the disease — 10, 4, 11, 7 and 12 years. ME in the blood serum were studied using atomic absorption spectrometer with electrographite atomizer SolAAr-Mk2-MOZe. Results. Microelementosis in arthritis is manifested by increased blood concentrations of toxic Li, Pb and Sr, moreover, the feature of ReA is a normal ferremia level, PsA — hyperkupremia, and OA — hypozincemia. Microelement blood composition depends on the activity, clinical and laboratory signs of disease, the prevalence of articular process, aggravation of bone destructive changes in the joints (subchondral sclerosis, osteocystosis, bone erosions, epiphyseal osteoporosis, etc, the presence of systemic osteoporosis, spondylopathies (osteochondrosis, spondyloarthrosis and extra-articular manifestations of arthritis (lesions of the skin, muscles, peripheral nervous system, lymph nodes, internal organs. Blood indexes

Reconstructive surgery for patellofemoral joint incongruency.

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Neumann, M V; Stalder, M; Schuster, A J

2016-03-01

A retrospective analysis of a heterogeneous patient cohort was performed to determine the outcome and eligibility of a combined trochleaplasty and soft tissue-balancing technique for repair of patellofemoral joint disorders. A strict surgical treatment algorithm including trochleaplasty and reconstruction of the medial patellofemoral ligament and vastus medialis oblique muscle was implemented to restore the patellofemoral joint. A heterogeneous patient cohort including 46 consecutively treated symptomatic knees was reviewed. The median follow-up period was 4.7 years (range 24-109 months). No patellar redislocation occurred post-operatively, and the median Kujala score improved from 62 (9-96) to 88 (47-100) points (p patellofemoral degenerative changes showed progression of osteoarthrosis according to the Kellgren and Lawrence classification. The surgical combination of trochleaplasty and reconstruction of the medial patellofemoral ligament and vastus medialis oblique muscle offers excellent clinical and radiological results. The overall results of the present study showed significant improvement of the Kujala score in patients with Dejour grades C and D dysplasia. These results outline the clinical relevance of trochleaplasty with additional soft tissue balancing as an effective joint-preserving method with satisfying results in patients with pre-existing degenerative changes. IV.

Cell-Based Therapies Used to Treat Lumbar Degenerative Disc Disease: A Systematic Review of Animal Studies and Human Clinical Trials

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David Oehme

2015-01-01

Full Text Available Low back pain and degenerative disc disease are a significant cause of pain and disability worldwide. Advances in regenerative medicine and cell-based therapies, particularly the transplantation of mesenchymal stem cells and intervertebral disc chondrocytes, have led to the publication of numerous studies and clinical trials utilising these biological therapies to treat degenerative spinal conditions, often reporting favourable outcomes. Stem cell mediated disc regeneration may bridge the gap between the two current alternatives for patients with low back pain, often inadequate pain management at one end and invasive surgery at the other. Through cartilage formation and disc regeneration or via modification of pain pathways stem cells are well suited to enhance spinal surgery practice. This paper will systematically review the current status of basic science studies, preclinical and clinical trials utilising cell-based therapies to repair the degenerate intervertebral disc. The mechanism of action of transplanted cells, as well as the limitations of published studies, will be discussed.

Total hip replacement for Mseleni Joint Disease undertaken in a ...

African Journals Online (AJOL)

found that hip surgery in this setting is of great benefit to Mseleni Joint Disease ... Conclusions: Hip surgery in this setting is of great benefit to the Mseleni Joint Disease patients but further attention .... The total hip score was divided into pain.

Lipid Profile and Inflammation in Degenerative Valvular Disease

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Mehmet Yamak

2015-03-01

Full Text Available Aim: Degenerative valvular heart disease (DVHD may cause serious cardiac problems and mortality. Determination of the factors related to DVHD may render possible the prevention and/or slowing down the progression of DVHD. In this study, we evaluated the relationship of DVHD with lipid profile, microalbuminuria and high sensitive C-reactive protein (hsCRP levels. Methods: 50 patients (age=65.6±12.4 years with DVHD were compared with the control group including 20 patients (age=57.3±13.9 years with left ventricle hypertrophy, but no DVHD. Microalbuminuria, blood lipid parameters and hsCRP levels were measured besides routine biochemical tests. Clinical, laboratory and echocardiographic findings were compared between the groups. Results: Total cholesterol, HDL-cholesterol and LDL-cholesterol levels were significantly higher in DVHD group (215.26±48.59 mg/dL vs. 177.45±22.47 mg/dL, p=0.001; 45.04±11.03 mg/dL vs. 38.90±11.82 mg/dL, p=0.043 and 138.49±40.69 mg/dL vs. 114.26±16.07 mg/dL, p=0.001 compared with control group. hsCRP and microalbuminuria levels were relatively higher in DVHD group. Conclusion: Hyperlipidaemia is related to DHVD development, and the progress of DHVD may be related to the inflammatory process. Elevated hsCRP levels may be an indicator of pathologies active in DVHD development. Routine echocardiographic analysis in hypertensive patients with high hsCRP and LDL-cholesterol levels might be useful for screening of DVHD. (The Medical Bulletin of Haseki 2015; 53: 62-6

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

International Nuclear Information System (INIS)

Kuroki, Hiroshi; Tajima, Naoya; Kubo, Shinichiro

2002-01-01

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

Chronic degenerative diseases in elderly: physiotherapeutic data - doi:10.5020/18061230.2011.p221

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Lais Keylla Felipe

2012-01-01

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.

EFFECTIVENESS OF RADIOFREQUENCY DENERVATION FOR PAIN RELIEF IN HIP DEGENERATIVE DISEASES

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G. I. Nazarenko

2014-01-01

Full Text Available Objective - to compare the effectiveness of radiofrequency denervation (RFD and conservative treatment of patients with hip degenerative diseases. Material and methods. 66 patients with various stages of hip degeneration were followed up for 12 months, including 36 patients who underwent RFD and 30 patients of control group with conservative treatment. Treatment results were assessed using Visual Analogue Scale (VAS and Harris Hip Score before treatment, during the first day, 2 days later, as well as at 1, 6 and 12 months. Results: RFD patients demonstrated significantly better results compared with conservative group. Patients with coxarthrosis stage I and II, besides higher efficiency had prolonged period of remission, while patients with coxarthrosis stage III returned to the near-baseline level of pain only in 3-6 months. Conclusions: RFD is an effective treatment modality for patients with initial coxarthrosis stages, which helps to reduce significantly the disability period compared with conservative therapy. RFD is the only method of effective hip pain relieve in patients with severe comorbidities allowing to reduce analgesic consumption. This method is minimally invasive, has low cost, permits repeated procedures, making it attractive for both physicians and patients.

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

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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

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.

Differentiation of Pluripotent Stem Cells to Retinal Pigment Epithelial Cells: An Approach Toward Retinal Degenerative Diseases Treatment

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Maryam Parvini

2013-10-01

Full Text Available Pluripotent stem cells as the cells with a capacity for self-renewal and differentiation into various specificcell types have been highly regarded in regenerative medicine studies. To repair the eye disease damages, thedifferentiation into retinal pigment epithelial cells of pluripotent stem cells has gained great importance inrecent decades because the inappropriate function of these cells is the main cause of degenerative diseases suchas the age-related macular degeneration. Millions of people in the world suffer this disease.To restore the damaged cells and, finally, to improve the vision, numerous studies have been conducted on usingpluripotent stem cells, their differentiation into retinal pigment epithelial cells, and finally, their applicationin cell therapy. Based on this, many researchers have attempted to produce highly efficient retinal pigmentepithelial cells, such that they show a proper function after transplant, along with the host cells. In this reviewarticle, the importance and the role of pigment epithelial cells, as well as, the studies on the in vitro productionof these cells were examined

PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies.

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Laver, Lior; Marom, Niv; Dnyanesh, Lad; Mei-Dan, Omer; Espregueira-Mendes, João; Gobbi, Alberto

2017-10-01

To explore the utilization of platelet-rich plasma (PRP) for degenerative cartilage processes and evaluate whether there is sufficient evidence to better define its potential effects. Systematic literature reviews were conducted in PubMed/MEDLINE and Cochrane electronic databases till May 2015, using the keywords "platelet-rich plasma OR PRP OR autologous conditioned plasma OR ACP AND cartilage OR chondrocyte OR chondrogenesis OR osteoarthritis (OA) OR arthritis." The final result yielded 29 articles. Twenty-six studies examined PRP administration for knee OA and 3 involved PRP administration for hip OA. The results included 9 prospective randomized controlled trials (RCTs) (8 knee and 1 hip), 4 prospective comparative studies, 14 case series, and 2 retrospective comparative studies. Hyaluronic acid (HA) was used as a control in 11 studies (7 RCTs, 2 prospective comparative studies, and 2 retrospective cohort). Overall, all RCTs reported on improved symptoms compared to baseline scores. Only 2 RCTs-one for knee and one for hip-did not report significant superiority of PRP compared to the control group (HA). Nine out of 11 HA controlled studies showed significant better results in the PRP groups. A trend toward better results for PRP injections in patients with early knee OA and young age was observed; however, lack of uniformity was evident in terms of indications, inclusion criteria, and pathology definitions in the different studies. Current clinical evidence supports the benefit in PRP treatment for knee and hip OA, proven to temporarily relieve pain and improve function of the involved joint with superior results compared with several alternative treatments. Further research to establish the optimal preparation protocol and characteristics of PRP injections for OA is needed.

Utility of Intraoperative Neuromonitoring during Minimally Invasive Fusion of the Sacroiliac Joint

OpenAIRE

Woods, Michael; Birkholz, Denise; MacBarb, Regina; Capobianco, Robyn; Woods, Adam

2014-01-01

Study Design. Retrospective case series. Objective. To document the clinical utility of intraoperative neuromonitoring during minimally invasive surgical sacroiliac joint fusion for patients diagnosed with sacroiliac joint dysfunction (as a direct result of sacroiliac joint disruptions or degenerative sacroiliitis) and determine stimulated electromyography thresholds reflective of favorable implant position. Summary of Background Data. Intraoperative neuromonitoring is a well-accepted adjunct...

Anaerobic prosthetic joint infection.

Science.gov (United States)

Shah, Neel B; Tande, Aaron J; Patel, Robin; Berbari, Elie F

2015-12-01

In an effort to improve mobility and alleviate pain from degenerative and connective tissue joint disease, an increasing number of individuals are undergoing prosthetic joint replacement in the United States. Joint replacement is a highly effective intervention, resulting in improved quality of life and increased independence [1]. By 2030, it is predicted that approximately 4 million total hip and knee arthroplasties will be performed yearly in the United States [2]. One of the major complications associated with this procedure is prosthetic joint infection (PJI), occurring at a rate of 1-2% [3-7]. In 2011, the Musculoskeletal Infectious Society created a unifying definition for prosthetic joint infection [8]. The following year, the Infectious Disease Society of America published practice guidelines that focused on the diagnosis and management of PJI. These guidelines focused on the management of commonly encountered organisms associated with PJI, including staphylococci, streptococci and select aerobic Gram-negative bacteria. However, with the exception of Propionibacterium acnes, management of other anaerobic organisms was not addressed in these guidelines [1]. Although making up approximately 3-6% of PJI [9,10], anaerobic microorganisms cause devastating complications, and similar to the more common organisms associated with PJI, these bacteria also result in significant morbidity, poor outcomes and increased health-care costs. Data on diagnosis and management of anaerobic PJI is mostly derived from case reports, along with a few cohort studies [3]. There is a paucity of published data outlining factors associated with risks, diagnosis and management of anaerobic PJI. We therefore reviewed available literature on anaerobic PJI by systematically searching the PubMed database, and collected data from secondary searches to determine information on pathogenesis, demographic data, clinical features, diagnosis and management. We focused our search on five commonly

Nuclear magnetic resonance in the evaluation of the disk luxation in the temporomandibular articulation conditioned for degenerative osseous changes; Resonancia magnetica nuclear en la valoracion de la luxacion discal en la articulacion temporomandibular condicionada por cambios degenerativos oseos

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Marchegiani, Silvio; Guzman Urquhart, Romel; Marangoni, Alberto; Alvarez, Federico; Surur, Alberto [Sanatorio Allende, Cordoba (Argentina). Servicio de Diagnostico por Imagenes

2006-07-01

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 joint dislocation without reduction. (author) [Spanish] Proposito: Las disfunciones temporomandibulares son muy frecuentes. Los sintomas pueden ser: dolor a nivel de la articulacion, alteracion en la traslacion discocondilar (chasquido) y dificultad en la apertura bucal; dichos problemas conllevan a una consulta creciente de medicos clinicos como de odontologos. En la actualidad la Imagen por Resonancia Magnetica Nuclear (RM) es el estudio de eleccion. Los objetivos de este trabajo fueron demostrar la

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

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Liang ZHOU

2014-01-01

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

Effect of minimally invasive surgery on related serum factors in patients with lumbar degenerative disease

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Yi-Zhong Sun

2016-11-01

Full Text Available Objective: To explore the effect of minimally invasive surgery and transforaminal lumbar interbody fusion (TLIF on the related serum factors in patients with lumbar degenerative disease. Methods: A total of 100 patients with lumbar degenerative disease who were admitted in our hospital from May, 2014 to May, 2016 were included in the study and divided into the observation group and the control group according to different surgical methods. The patients in the observation group were given MIS-TLIF, while the patients in the control group were given the traditional TLIF. The peripheral venous blood before operation, 2 h, 4 h, 8 h and 24 h after operation in the two groups was collected, and centrifuged for the serum. ELISA was used to detect the serum IL-6 and IL-10 levels. The peripheral venous blood before operation, 1 h, 3 h, 5 h and 7 d after operation in the two groups was collected. DGKC velocity method was used to detect CK activity and fusion rate. The fusion grade was evaluated 6 months after operation according to Bridwell fusion grading standard. Results: The serum IL-6 and IL-10 levels 2 h, 4 h, 8 h and 24 h after operation in the two groups were significantly elevated when compared with before operation, and the serum IL-6 and IL-10 levels at each timing point after operation in the observation group were significantly lower than those in the control group. CK activity 1 d, 3 d, 5 d, and 7d after operation in the two groups was significantly elevated when compared with before operation, and CK activity at each timing point after operation in the observation group was significantly lower than that in the control group. Conclusions: MISTLIF has a small damage on the tissues, can effectively alleviate the inflammatory reaction, and preferably retain the stable structure of posterior column, whose advantage is significantly superior to that by the traditional TLIF.

Balneotherapy in elderly patients: effect on pain from degenerative knee and spine conditions and on quality of life.

Science.gov (United States)

Gaál, János; Varga, József; Szekanecz, Zoltán; Kurkó, Julia; Ficzere, Andrea; Bodolay, Edit; Bender, Tamás

2008-05-01

Balneotherapy is an established treatment modality for musculoskeletal disease, but few studies have examined the efficacy of spa therapy in elderly patients with degenerative spine and joint diseases. To assess the effects of balneotherapy on chronic musculoskeletal pain, functional capacity, and quality of life in elderly patients with osteoarthritis of the knee or with chronic low back pain. The 81 patients in the study group underwent a 1 day course of 30 minute daily baths in mineral water. Changes were evaluated in the following parameters: pain intensity, functional capacity, quality of life, use of non-steroidal anti-inflammatory or analgesic drugs, subjective disease severity perceived by the patients, investigator-rated disease severity, and severity of pain perceived by the patients. We analyzed the results of 76 subjects as 5 did not complete the study. Compared to baseline, all monitored parameters were significantly improved by balneotherapy in both investigated groups. Moreover, the favorable effect was prolonged for 3 months after treatment. This study showed that balneotherapy is an effective treatment modality in elderly patients with osteoarthritis of the knee or with chronic low back pain, and its benefits last for at least 3 months after treatment.

[Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?].

Science.gov (United States)

Lozano-Álvarez, C; Pérez-Prieto, D; Saló-Bru, G; Molina, A; Lladó, A; Cáceres, E; Ramírez, M

2014-01-01

To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β=14.146; 95% CI: 9.09 - 29.58; P<.01 and β=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (β=-8.568; 95% CI: -14.88 - -2.26; p<.01 and β=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively). Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

Increased joint loads during walking--a consequence of pain relief in knee osteoarthritis

DEFF Research Database (Denmark)

Henriksen, Marius; Simonsen, Erik B; Alkjaer, T

2006-01-01

Joint pain is a primary symptom in knee osteoarthritis (OA), but the effect of pain and pain relief on the knee joint mechanics of walking is not clear. In this study, the effects of local knee joint analgesia on knee joint loads during walking were studied in a group of knee osteoarthritis....... Although the patients walked with less compressive knee joint forces compared to the reference group, the effects of pain relief may accelerate the degenerative changes....

Discussion: DMARDs and biologic therapies in the management of inflammatory joint diseases.

Science.gov (United States)

Vaz, Austin; Lisse, Jeffrey; Rizzo, Warren; Albani, Salvatore

2009-05-01

Therapy for inflammatory joint diseases, such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis, includes various conventional disease-modifying antirheumatic drugs (DMARDs). These therapeutic agents are termed DMARDs because they have the potential to reduce or prevent joint damage and preserve joint integrity and function. Conventional DMARDs are used as monotherapy or in combination and include methotrexate, leflunomide, azathioprine, ciclosporin, hydroxychloroquine, sulfasalazine, gold and minocycline. Biologic response modifiers, which are based on proteins made by living cells, are newer agents available for the treatment of various inflammatory joint diseases. Biologic therapies now approved for use in inflammatory joint diseases are TNF inhibitors, T-cell modulators and B-cell depleters. They have all been shown to have clinical efficacy and are able to retard structural damage. However, all current immune-modulating therapies also have potential side effects, and the decision to use a particular agent for treatment should be based on a thorough discussion of the benefits and risks with the patient. Newer biologic response modifiers and other immunologic therapies are currently being developed for the treatment of inflammatory joint diseases and are discussed in this review.

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

International Nuclear Information System (INIS)

Ahmad, A.; Manawar, A.

2014-01-01

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

Knee arthroscopy versus conservative management in patients with degenerative knee disease: a systematic review

Science.gov (United States)

Brignardello-Petersen, Romina; Guyatt, Gordon H; Buchbinder, Rachelle; Poolman, Rudolf W; Chang, Yaping; Sadeghirad, Behnam; Evaniew, Nathan; Vandvik, Per O

2017-01-01

Objective To determine the effects and complications of arthroscopic surgery compared with conservative management strategies in patients with degenerative knee disease. Design Systematic review. Main outcome measures Pain, function, adverse events. Data sources MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar and Open Grey up to August 2016. Eligibility criteria For effects, randomised clinical trials (RCTs) comparing arthroscopic surgery with a conservative management strategy (including sham surgery) in patients with degenerative knee disease. For complications, RCTs and observational studies. Review methods Two reviewers independently extracted data and assessed risk of bias for patient-important outcomes. A parallel guideline committee (BMJ Rapid Recommendations) provided input on the design and interpretation of the systematic review, including selection of patient-important outcomes. We used the GRADE approach to rate the certainty (quality) of the evidence. Results We included 13 RCTs and 12 observational studies. With respect to pain, the review identified high-certainty evidence that knee arthroscopy results in a very small reduction in pain up to 3 months (mean difference =5.4 on a 100-point scale, 95% CI 2.0 to 8.8) and very small or no pain reduction up to 2 years (mean difference =3.1, 95% CI −0.2 to 6.4) when compared with conservative management. With respect to function, the review identified moderate-certainty evidence that knee arthroscopy results in a very small improvement in the short term (mean difference =4.9 on a 100-point scale, 95% CI 1.5 to 8.4) and very small or no improved function up to 2 years (mean difference =3.2, 95% CI −0.5 to 6.8). Alternative presentations of magnitude of effect, and associated sensitivity analyses, were consistent with the findings of the primary analysis. Low-quality evidence suggested a very low probability of serious complications after knee arthroscopy

Frailty and postoperative outcomes in patients undergoing surgery for degenerative spine disease.

Science.gov (United States)

Flexman, Alana M; Charest-Morin, Raphaële; Stobart, Liam; Street, John; Ryerson, Christopher J

2016-11-01

Frailty is defined as a state of decreased reserve and susceptibility to stressors. The relationship between frailty and postoperative outcomes after degenerative spine surgery has not been studied. This study aimed to (1) determine prevalence of frailty in the degenerative spine population; (2) describe patient characteristics associated with frailty; and (3) determine the association between frailty and postoperative complications, mortality, length of stay, and discharge disposition. This is a retrospective analysis on a prospectively collected cohort from the National Surgical Quality Improvement Program (NSQIP). A total of 53,080 patients who underwent degenerative spine surgery between 2006 and 2012 were included in the study. A modified frailty index (mFI) with 11 variables derived from the NSQIP dataset was used to determine prevalence of frailty and its correlation with a composite outcome of perioperative complications as well as hospital length of stay, mortality, and discharge disposition. After calculating the mFI for each patient, the prevalence and predictors of frailty were determined for our cohort. The association of frailty with postoperative outcomes was determined after adjusting for known and suspected confounders using multivariate logistic regression. Frailty was present in 2,041 patients within the total population (4%) and in 8% of patients older than 65 years. Frailty severity increased with increasing age, male sex, African American race, higher body mass index, recent weight loss, paraplegia or quadriplegia, American Society of Anesthesiologists (ASA) score, and preadmission residence in a care facility. Frailty severity was an independent predictor of major complication (OR 1.15 for every 0.10 increase in mFI, 95%CI 1.09-1.21, pdegenerative spine surgery. Preoperative recognition of frailty may be useful for perioperative optimization, risk stratification, and patient counseling. Copyright © 2016 Elsevier Inc. All rights reserved.

EFFECTS OF KINESIOTAPING ALONG WITH QUADRICEPS STRENGTHENING EXERCISES ON PAIN, JOINT RANGE OF MOTION AND FUNCTIONAL ACTIVITIES OF KNEE IN SUBJECTS WITH PATELLOFEMORAL OSTEOARTHRITIS

OpenAIRE

M. Harshitha; K. Senthil kumar; K. Madhavi

2014-01-01

Background: Patello femoral Osteoarthritis is the most common degenerative disease in older age group, causing pain, physical disability, and decreased quality of life.As many treatment options available, kinesiotaping is an efficacious treatment for management of pain & disability in patellofemoral joint osteoarthritis. Previous studies have shown that kinesiotaping as well as quadriceps strengthening significantly yields functional benefits. But there is lack of evidence revealing combined ...

Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey.

Science.gov (United States)

Greiner-Perth, R; Sellhast, N; Perler, G; Dietrich, D; Staub, L P; Röder, C

2016-08-01

Dynamic stabilization of the degenerated spine was invented to overcome the negative side effects of fusion surgery like adjacent segment degeneration. Amongst various different implants DSS(®) is a pedicle-based dynamic device for stabilizing the spine and preserving motion. Nearly no clinical data of the implant have been reported so far. The current analysis presents results from a single spine surgeon who has been using DSS(®) for the past 5 years and recorded all treatment and outcome data in the international Spine Tango registry. From the prospectively documented overall patient pool 436 cases treated with DSS(®) could be identified. The analysis was enhanced with a mailing of COMI patient questionnaires for generating longer-term follow-ups up to 4 years. 387 patients (189 male, 198 female; mean age 67.3 years) with degenerative lumbar spinal disease including degenerative spondylolisthesis (6.1 %) could be evaluated. The type of degeneration was mainly spinal stenosis (89.9 %). After a mean follow-up of 1.94 years, the COMI score and NRS back and leg pain improved significantly and to a clinically relevant extent. The postoperative trend analysis could not determine a relevant deterioration of these outcomes until 4 years postoperative. 10 patients were revised (2.6 %) and the implant was removed; in most cases, a fusion was performed. Another 5 cases (1.3 %) had an extension of the dynamic stabilization system to the adjacent level. 84.2 % of patients rated that the surgery had helped a lot or had helped. The results of this large consecutive series with a follow-up up to 4 years could demonstrate a good and stable clinical outcome after posterior dynamic stabilization with DSS(®). For degenerative diseases of the lumbar spine, this treatment seems to be a valid alternative to fusion surgery.

The aging process in the sacroiliac joint. Helical computed tomography analysis

Energy Technology Data Exchange (ETDEWEB)

Shibata, Yasuaki; Shirai, Yasumasa; Miyamoto, Masabumi [Nippon Medical School, Tokyo (Japan)

2002-07-01

The purpose of this study was to compare the frequency of degenerative changes in the sacroiliac joint by age, sex, laterality, body mass index, and childbearing experience, based on computed tomography (CT) images obtained from the lower back of symptom-free subjects in different age groups. These data were used to trace the development of the sacroiliac joint until the occurrence of osteoarthritis with aging. CT transverse and coronal images were examined for the presence of the following degenerative signs: joint space narrowing, sclerosis, osteophytes, cysts, and erosion. The results indicated that joint degeneration begins in the 20s and tends to progress with age. Each form of degeneration was markedly more frequent in the 40s or older, and some type of degeneration was observed in the joints of all subjects aged 50 years or older. In terms of the localization of the joint degeneration, sclerosis was common on the upper and middle anterior of the articular surface of the ilium, osteophytes were common on the anterior surface of the sacrum. Degeneration had progressed further in women than in men in every age group, and tended to progress faster in parous than in nulliparous women, It was presumed that the birth of the first child, rather than subsequent births had the greatest effect on the sacroiliac joint. (author)

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

Science.gov (United States)

Ackerman, Stacey J; Polly, David W; Knight, Tyler; Schneider, Karen; Holt, Tim; Cummings, John

2013-01-01

Introduction 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

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)

Ackerman SJ

2014-02-01

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

Computed tomography of sternoclavicular joint lesions in spondylarthropathies

International Nuclear Information System (INIS)

Louvel, J.P.; Duvey, A.; Silva, F. da; Primard, E.; Mejjad, O.; Henry, J.; Le Loet, X.

1997-01-01

To evaluate the computed tomography (CT) findings of inflammatory lesions of the sternoclavicular joints (SCJ) in spondylarthropathies. Design and patients. CT scans of the SCJs were obtained in 23 patients (group 1) with inflammatory SCJ lesions in spondylarthropathies. These scans were reviewed by four readers and compared with the CT scans of 23 matched controls (group 2). Each reader had to complete a 27-item grid. Results and conclusion. In the 23 patients of group 1, the mean number of observed signs was 5.3±4.2 higher (P<0.01) than in the group of 23 matched controls (2.4±1.6). Four signs were more frequently observed (P<0.05) in group 1: surrounded subchondral clavicular erosions and cysts, surrounded subchondral sternal cysts and sternal bone sclerosis. A cyst and/or an erosion was associated with hyperostosis and/or bone sclerosis in 9 of 23 patients in group 1. This association was not observed in group 2; the difference was significant (P<0.001). A cyst and/or an erosive lesion was observed 18 times in group 1 versus 11 times in group 2; the difference was significant (P<0.05). Conversely, signs of degenerative lesions (osteophytes, subchondral sclerosis, unevenness of joint surface) were no more frequently observed in controls than in group 1. This study emphasizes the diagnostic value of CT, in particular in the identification of inflammatory lesions, even when pre-existing degenerative disease is present. (orig.). With 3 figs., 2 tabs

A Mitochondrial Paradigm of Metabolic and Degenerative Diseases, Aging, and Cancer: A Dawn for Evolutionary Medicine

Science.gov (United States)

Wallace, Douglas C.

2005-01-01

Life is the interplay between structure and energy, yet the role of energy deficiency in human disease has been poorly explored by modern medicine. Since the mitochondria use oxidative phosphorylation (OXPHOS) to convert dietary calories into usable energy, generating reactive oxygen species (ROS) as a toxic by-product, I hypothesize that mitochondrial dysfunction plays a central role in a wide range of age-related disorders and various forms of cancer. Because mitochondrial DNA (mtDNA) is present in thousands of copies per cell and encodes essential genes for energy production, I propose that the delayed-onset and progressive course of the age-related diseases results from the accumulation of somatic mutations in the mtDNAs of post-mitotic tissues. The tissue-specific manifestations of these diseases may result from the varying energetic roles and needs of the different tissues. The variation in the individual and regional predisposition to degenerative diseases and cancer may result from the interaction of modern dietary caloric intake and ancient mitochondrial genetic polymorphisms. Therefore the mitochondria provide a direct link between our environment and our genes and the mtDNA variants that permitted our forbears to energetically adapt to their ancestral homes are influencing our health today. PMID:16285865

Studies on the pathogenesis of degenerative lumbar canal stenosis by computed tomography, 2

International Nuclear Information System (INIS)

Kido, Kenji

1987-01-01

To evaluate the significance of measurement parameters for the lumbar canal (LC), a retrospective analysis was made of computed tomography (CT) scans in a total of 129 patients, including 20 with degenerative lumbar canal stenosis (DLCS), 65 with degenerative spondylosis, 21 with disc hernia, and 23 with lumbar pain. The shape of the transverse LC was not reflected by the anteroposterior and transverse diameters of LC, but was somewhat reflected by the transverse area of LC. The transverse area of dural sac (DS) was considered important in determining the degree of stenosis. Regarding the transverse area, the DS correlated more strongly with the LC with soft-tissue windows than that with bone windows. The angle of intervertebral joint was likely to be related to the pathophysiology of the LC. In particular, sagittal tendency was seen at the levels of L3-4 and L4-5 in the DLCS group. There was correlation between the angle of intervertebral joint and the transverse areas of both soft-tissue LC and DS at the levels of L4-5. A multivariate analysis suggested the possibility that the significance of measurement parameters might vary depending on the vertebral level for the lower lumbar spine. The following criteria for indicating DLCS were obtained: 1) a transverse area of ≤ 100 mm 2 for DS or ≤ 118 mm 2 for soft-tissue LC at the levels of L3-4; 2) a transverse area of ≤ 90 mm 2 for DS and an angle of ≤ 90 deg for the intervertebral joint at the levels of L4-5; and 3) lateral recess of ≤ 3 mm in anteroposterior diameter at the levels of L5-S1. (Namekawa, K.)

Patient-specific induced pluripotent stem cells (iPSCs) for the study and treatment of retinal degenerative diseases.

Science.gov (United States)

Wiley, Luke A; Burnight, Erin R; Songstad, Allison E; Drack, Arlene V; Mullins, Robert F; Stone, Edwin M; Tucker, Budd A

2015-01-01

Vision is the sense that we use to navigate the world around us. Thus it is not surprising that blindness is one of people's most feared maladies. Heritable diseases of the retina, such as age-related macular degeneration and retinitis pigmentosa, are the leading cause of blindness in the developed world, collectively affecting as many as one-third of all people over the age of 75, to some degree. For decades, scientists have dreamed of preventing vision loss or of restoring the vision of patients affected with retinal degeneration through drug therapy, gene augmentation or a cell-based transplantation approach. In this review we will discuss the use of the induced pluripotent stem cell technology to model and develop various treatment modalities for the treatment of inherited retinal degenerative disease. We will focus on the use of iPSCs for interrogation of disease pathophysiology, analysis of drug and gene therapeutics and as a source of autologous cells for cell transplantation and replacement. Copyright © 2014. Published by Elsevier Ltd.

Hip and Knee Replacement in the HIV positive patient | Anand ...

African Journals Online (AJOL)

Arthroplasty is used to relieve pain associated with degenerative or inflammatory joint disease, some post-traumatic joint problems, and avascular necrosis. Avascular necrosis, inflammatory and post-traumatic problems are seen on a regular basis in areas of high HIV seroprevalence. Degenerative arthritis is rare in ...

Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion

Directory of Open Access Journals (Sweden)

Ledonio CGT

2014-06-01

Full Text Available Charles GT Ledonio,1 David W Polly Jr,1 Marc F Swiontkowski,1 John T Cummings Jr2 1Department of Orthopaedic Surgery, University of Minnesota, Twin Cities, MN, 2Community Neurosurgical Care, Indianapolis, IN, USA Background: The mainstay of sacroiliac joint disruption/degenerative sacroiliitis therapy has been nonoperative management. This nonoperative management often includes a regimen of physical therapy, chiropractic treatment, therapeutic injections, and possibly radiofrequency ablation at the discretion of the treating physician. When these clinical treatments fail, sacroiliac joint fusion has been recommended as the standard treatment. Open and minimally invasive (MIS surgical techniques are typical procedures. This study aims to compare the perioperative measures and Oswestry Disability Index (ODI outcomes associated with each of these techniques. Methods: A comparative retrospective chart review of patients with sacroiliac joint fusion and a minimum of 1 year of follow-up was performed. Perioperative measures and ODI scores were compared using the Fisher's exact test and two nonparametric tests, ie, the Mann–Whitney U test and the Wilcoxon signed-rank test. The results are presented as percent or median with range, as appropriate. Results: Forty-nine patients from two institutions underwent sacroiliac joint fusion between 2006 and 2012. Ten patients were excluded because of incomplete data, leaving 39 evaluable patients, of whom 22 underwent open and 17 underwent MIS sacroiliac joint fusion. The MIS group was significantly older (median age 66 [39–82] years than the open group (median age 51 [34–74] years. Surgical time and hospital stay were significantly shorter in the MIS group than in the open group. Preoperative ODI was significantly greater in the open group (median 64 [44–78] than in the MIS group (median 53 [14–84]. Postoperative improvement in ODI was statistically significant within and between groups, with MIS

[Intra-articular injections of hyaluronic acid for anterior disc displacement of temporomandibular joint].

Science.gov (United States)

Long, X

2017-03-09

Anterior disc displacement (ADD) of temporomandibular joint (TMJ) is regarded as one of the major findings in temporomandibular disorders (TMD). It is related to joint noise, pain, mandibular dysfunction, degenerative change and osteoarthritis. In the mean time, the pathological changes were found in synovial membrane and synovial fluid. Hyaluronic acid is a principal component of the synovial fluid which plays an important role in nutrition, lubrication, anti-inflammation and cartilage repair. The synthesis, molecule weight, and concentration of hyaluronic acid are decreased during TMD and cause TMJ degenerative changes. The clinical conditions, pathological changes, the mechanism of action for hyaluronic acid and the treatment of anterior disc displacement of TMJ are discussed in this article.

Degenerative Changes of the Spine of Pilots of the RNLAF

Science.gov (United States)

2000-08-01

views of the spine taken in standing 7-3 Table 2 Classification of disorders Disorder Levels General: Osteo-arthrosis / Spondylosis / Arthrosis...Deformans Cervical, thoracic, lumbar Scoliosis Cervical, thoracic, lumbar Abnormal alignment Cervical, lumbar Scheuermann’s disease / Enchondrosis Thoracic... lumbar Specific: Degenerative changes in the intervertebral disc / Discopathy Cervical, thoracic, lumbar Presence of Osteophyte’s / Osteophytic

Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study

DEFF Research Database (Denmark)

Jacobsen, Steffen; Sonne-Holm, Stig; Rovsing, Hans

2007-01-01

.001), and between BMI in 1993 and both L4 and L5 olisthesis were found (L4: P = 0.003; L5: P = 0.006). Lumbar lordosis was associated with degenerative spondylolisthesis in women. Occupational exposures to daily lifting or smoking were not associated with degenerative spondylolisthesis. Degenerative...... spondylolisthesis was associated with increased age in both sexes (L4: P lordosis were significantly associated with degenerative spondylolisthesis in women. In men, no individual risk factors for degenerative...

Matrix metalloproteinases. Their role in degenerative chronic diseases of abdominal aorta.

Science.gov (United States)

Palombo, D; Maione, M; Cifiello, B I; Udini, M; Maggio, D; Lupo, M

1999-04-01

The main chronic degenerative diseases of the abdominal aorta, namely aneurysmatic and steno-obstructive pathologies, have a common denominator: atherosclerosis. Both pathologies are characterised by the destruction of the structural integrity of the extracellular protein matrix (ME). A number of studies have shown the presence and involvement of a group of enzymes with proteolytic activity towards one or more ME components, the matrix metalloproteinases (MMPs), in the pathogenesis of aneurysms of the abdominal aorta. Other authors have underlined the role of MMPs in the proliferation and migration process of smooth muscle cells into the intima in the pathogenesis of atheromasic plaque. The aim of this study was to evaluate the possible role of these enzymes in the pathogenesis of chronic degenerative diseases of the aorta. Fragments of aortic wall were removed from patients undergoing elective aortic surgery for aneurysms (14 patients) or aortic steno-obstruction (4 patients). The samples obtained were treated appropriately and then subject to immunohistochemical analysis. The preparations were incubated with specific anti-MMP antibodies and were also incubated with substrate and chromogen, forming a pigmented precipitate on the site of the antigen, before being observed using an optic microscopic at an enlargement of 250x. Nuclear positivity linked to the presence of the antigen testified the validity of staining. Lastly, the MMP INDEX, or in other words the number of positive cells out of 100, was stained in the adventitia and in the tunica media in each preparation. MMPs were divided into three main groups: interstitial collagenase (MMP1) which degrade type I and III native collagen; gelatinases (MMP9, MMP2) which act on elastin and type IV collagen; stromelysins (MMP3) with specific proteolytic action towards proteoglycans, fibronectin and laminine. In our experience, those preparations obtained from aorta affected by steno-obstructive pathologies (4 patients

Environmental toxicants, incidence of degenerative diseases, and therapies from the epigenetic point of view.

Science.gov (United States)

Hodjat, Mahshid; Rahmani, Soheila; Khan, Fazlullah; Niaz, Kamal; Navaei-Nigjeh, Mona; Mohammadi Nejad, Solmaz; Abdollahi, Mohammad

2017-07-01

Epigenotoxicology is an emerging field of study that investigates the non-genotoxic epigenetic effects of environmental toxicants resulting in alteration of normal gene expression and disruption of cell function. Recent findings on the role of toxicant-induced epigenetic modifications in the development of degenerative diseases have opened up a promising research direction to explore epigenetic therapy approaches and related prognostic biomarkers. In this review, we presented comprehensive data on epigenetic alterations identified in various diseases, including cancer, autoimmune disorders, pulmonary conditions as well as cardiovascular, gastrointestinal and bone disease. Although data on abnormalities of DNA methylation and their role in the development of diseases are abundant, less is known about the impact of histone modifications and microRNA expressions. Further, we discussed the effects of selected common environmental toxicants on epigenetic modifications and their association with particular abnormalities. A number of different environmental toxicants have been identified for their role in aberrant DNA methylation, histone modifications, and microRNA expression. Such epigenetic effects were shown to be tissue-type specific and highly associated with the level and duration of exposure. Finally, we described present and future therapeutic strategies, including medicines and dietary compounds for combating the toxicant-induced epigenetic alterations. There are currently seven histone deacetylase inhibitors and two DNA methyltransferase inhibitors approved for clinical use and many other promising candidates are in preclinical and clinical testing. Dietary compounds are thought to be the effective and safe strategies for treating and prevention of epigenetic pathophysiological conditions. Still more concentrated epigenetic researches are required for evaluation of chemical toxicity and identifying the causal association between key epigenetic alteration and

A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears.