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Sample records for degenerative joint disease

  1. Radiographic evaluation of degenerative joint disease in horses: interpretive principles

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

  2. Long term results of radiotherapy of degenerative joint diseases

    Lindner, H.; Freislederer, R.

    1982-04-01

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

  3. Inflammatory and degenerative disease in the temporomandibular joint

    Gynther, Göran W.

    1996-01-01

    Temporomandibular joint (TMJ) arthroscopy is an established technique withhigh diagnostic accuracy regarding synovitis and degenerative changes of the articularfibrocartilage and disk. However, so far no studies have been done to correlate themacroscopic and histologic findings with each arthroscopic criterion. Thereforepatients with TMJ internal derangement (ID) were investigated by arthroscopy andarthrotomy (with biopsy) and the findings were compared with observations usinglight microscopy...

  4. Diagnosis and Treatment of Degenerative Joint Disease in a Captive Male Chimpanzee (Pan troglodytes)

    Videan, Elaine N; Lammey, Michael L; Lee, D Rick

    2011-01-01

    Degenerative joint disease (DJD), also known as osteoarthritis, has been well documented in aging populations of captive and free-ranging macaques; however, successful treatments for DJD in nonhuman primates have not been published. Published data on chimpanzees show little to no DJD present in the wild, and there are no published reports of DJD in captive chimpanzees. We report here the first documented case of DJD of both the right and left femorotibial joints in a captive male chimpanzee. ...

  5. Stress radiographs in the evaluation of degenerative femorotibial joint disease

    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.)

  6. Degenerative joint disease in cattle and buffaloes in the Amazon region: a retrospective study

    José Diomedes Barbosa; Danillo Henrique S. Lima; Alessandra S. Belo-Reis; Cleyton P. Pinheiro; Melina G.S. Sousa; Jenevaldo B. Silva; Felipe M. Salvarani; Carlos Magno C. Oliveira

    2014-01-01

    A retrospective study of the epidemiological and clinic-pathological aspects of cattle and buffaloes with degenerative joint disease (DJD) was conducted in the state of Pará, Brazil. From 1999 to 2014, eleven cattle and 24 buffaloes were evaluated. All the treated animals with suspected DJD underwent a clinical examination of the musculoskeletal system. In seven cattle and eight buffaloes with clinical signs of the disease postmortem examination was performed. The common clinical signs observ...

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

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

  8. Degenerative Nerve Diseases

    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 ...

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

    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

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

    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.

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

    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

  12. Degenerative joint disease in cattle and buffaloes in the Amazon region: a retrospective study

    José Diomedes Barbosa

    2014-09-01

    Full Text Available A retrospective study of the epidemiological and clinic-pathological aspects of cattle and buffaloes with degenerative joint disease (DJD was conducted in the state of Pará, Brazil. From 1999 to 2014, eleven cattle and 24 buffaloes were evaluated. All the treated animals with suspected DJD underwent a clinical examination of the musculoskeletal system. In seven cattle and eight buffaloes with clinical signs of the disease postmortem examination was performed. The common clinical signs observed in both species were chronic lameness, stiff gait, postural changes, audible crackles in the affected limb, prolonged recumbency, difficulty in getting up and progressive weight loss. The lesions observed at necropsy were: irregular articular surfaces, erosion of the articular cartilage and the underlying bone tissue, and proliferation of the periarticular bone tissue with formation of osteophytes. The most affected joints in cattle and buffaloes wereof the hind limb. In buffaloes, the main predisposing factor to the onset of DJD was phosphorus deficiency. In cattle, defects of the anatomical conformation of the hind limbs, chronic trauma due to the activities performed, such as semen collection, and advanced age possibly contributed to the emergence of the disease.

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

    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

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

    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

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

    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.

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

    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)

  17. Low back pain and degenerative disc disease

    Jandrić Slavica; Antić Branislav

    2006-01-01

    Introduction. Various clinical conditions can cause low back pain, and in most cases it is of a degenerative origin. Degenerative disc disease is a common condition which affects young to middle-aged men and women equally. Changes in the mechanical properties of the disc lead to degenerative arthritis in the intervertebral joints, osteophytes, and narrowing the intervertebral foramen or the spinal canal. Pathophysiology. Degenerative cascade, described by Kirkaldy-Willis, is the widely accept...

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

    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

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

    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

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

    Ezhov М.Yu.

    2012-06-01

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

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

    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...

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

    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

  3. Low back pain and degenerative disc disease

    Jandrić Slavica

    2006-01-01

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

  4. Degenerative diseases of the vertebral column.

    Resnick, D

    1985-07-01

    Several distinct degenerative processes affect the articulations of the vertebral column; each is associated with characteristic radiographic and pathologic abnormalities, and many are accompanied by significant clinical manifestations. A discussion of these processes is best accomplished according to the type of joint that is involved. With regard to cartilaginous articulations, of which the intervertebral disk is most important, intervertebral (osteo)chondrosis, spondylosis deformans, and, in the cervical spine, uncovertebral arthrosis are the major degenerative disorders. Osteoarthritis (osteoarthrosis) affects any of the synovium-lined joints of the vertebral column, including the apophyseal, costovertebral, transitional lumbosacral, median atlantoaxial, and sacroiliac articulations. Fibrous articulations, ligaments, or entheses (sites of tendon or ligament attachment to bone) are involved in diffuse idiopathic skeletal hyperostosis, ossification of the posterior spinal ligaments, and Baastrup disease. Of the many complications of these degenerative processes, alignment abnormalities (including segmental instability, degenerative spondylolisthesis, senile kyphosis, and degenerative scoliosis), intervertebral disk displacement, calcification or ossification, and spinal stenosis are the most important. PMID:3923556

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

    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.

  6. Computerized tomography in the diagnosis of degenerative vertebral diseases

    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

  7. Neuro degenerative diseases: clinical concerns

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

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

    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

  9. 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

    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)

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

    Mauron Damien

    2003-12-01

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

  11. Inherited Retinal Degenerative Disease Registry

    2016-03-21

    Eye Diseases Hereditary; Retinal Disease; Achromatopsia; Bardet-Biedl Syndrome; Bassen-Kornzweig Syndrome; Batten Disease; Best Disease; Choroidal Dystrophy; Choroideremia; Cone Dystrophy; Cone-Rod Dystrophy; Congenital Stationary Night Blindness; Enhanced S-Cone Syndrome; Fundus Albipunctatus; Goldmann-Favre Syndrome; Gyrate Atrophy; Juvenile Macular Degeneration; Kearns-Sayre Syndrome; Leber Congenital Amaurosis; Refsum Syndrome; Retinitis Pigmentosa; Retinitis Punctata Albescens; Retinoschisis; Rod-Cone Dystrophy; Rod Dystrophy; Rod Monochromacy; Stargardt Disease; Usher Syndrome

  12. Physiochemical basis of human degenerative disease

    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.

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

    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

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

    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

  15. MR imaging of degenerative disc disease

    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.

  16. MR imaging of degenerative disc disease

    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

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

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

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

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

    2010-06-15

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

  19. Stem cell treatment of degenerative eye disease

    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.

  20. Developing cellular therapies for retinal degenerative diseases.

    Bharti, Kapil; Rao, Mahendra; Hull, Sara Chandros; Stroncek, David; Brooks, Brian P; Feigal, Ellen; van Meurs, Jan C; Huang, Christene A; Miller, Sheldon S

    2014-02-01

    Biomedical advances in vision research have been greatly facilitated by the clinical accessibility of the visual system, its ease of experimental manipulation, and its ability to be functionally monitored in real time with noninvasive imaging techniques at the level of single cells and with quantitative end-point measures. A recent example is the development of stem cell-based therapies for degenerative eye diseases including AMD. Two phase I clinical trials using embryonic stem cell-derived RPE are already underway and several others using both pluripotent and multipotent adult stem cells are in earlier stages of development. These clinical trials will use a variety of cell types, including embryonic or induced pluripotent stem cell-derived RPE, bone marrow- or umbilical cord-derived mesenchymal stem cells, fetal neural or retinal progenitor cells, and adult RPE stem cells-derived RPE. Although quite distinct, these approaches, share common principles, concerns and issues across the clinical development pipeline. These considerations were a central part of the discussions at a recent National Eye Institute meeting on the development of cellular therapies for retinal degenerative disease. At this meeting, emphasis was placed on the general value of identifying and sharing information in the so-called "precompetitive space." The utility of this behavior was described in terms of how it could allow us to remove road blocks in the clinical development pipeline, and more efficiently and economically move stem cell-based therapies for retinal degenerative diseases toward the clinic. Many of the ocular stem cell approaches we discuss are also being used more broadly, for nonocular conditions and therefore the model we develop here, using the precompetitive space, should benefit the entire scientific community. PMID:24573369

  1. MR imaging of degenerative disc disease.

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

    2015-09-01

    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. PMID:26094867

  2. Canine Degenerative Valve Disease: A Case Report

    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.

  3. Lumbar Disc Degenerative Disease: Disc Degeneration Symptoms and Magnetic Resonance Image Findings

    Saleem, Shafaq; Aslam, Hafiz Muhammad; Rehmani, Muhammad Asim Khan; Raees, Aisha; Alvi, Arsalan Ahmad; Ashraf, Junaid

    2013-01-01

    Study Design Cross sectional and observational. Purpose To evaluate the different aspects of lumbar disc degenerative disc disease and relate them with magnetic resonance image (MRI) findings and symptoms. Overview of Literature Lumbar disc degenerative disease has now been proven as the most common cause of low back pain throughout the world. It may present as disc herniation, lumbar spinal stenosis, facet joint arthropathy or any combination. Presenting symptoms of lumbar disc degeneration ...

  4. 3-D MRI for lumbar degenerative diseases

    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.)

  5. Time estimation in Parkinson's disease and degenerative cerebellar disease

    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

  6. Operative Management of Lumbar Degenerative Disc Disease.

    Lee, Yu Chao; Zotti, Mario Giuseppe Tedesco; Osti, Orso Lorenzo

    2016-08-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  7. Operative Management of Lumbar Degenerative Disc Disease

    Lee, Yu Chao; Osti, Orso Lorenzo

    2016-01-01

    Lumbar degenerative disc disease is extremely common. Current evidence supports surgery in carefully selected patients who have failed non-operative treatment and do not exhibit any substantial psychosocial overlay. Fusion surgery employing the correct grafting and stabilization techniques has long-term results demonstrating successful clinical outcomes. However, the best approach for fusion remains debatable. There is some evidence supporting the more complex, technically demanding and higher risk interbody fusion techniques for the younger, active patients or patients with a higher risk of non-union. Lumbar disc arthroplasty and hybrid techniques are still relatively novel procedures despite promising short-term and mid-term outcomes. Long-term studies demonstrating superiority over fusion are required before these techniques may be recommended to replace fusion as the gold standard. Novel stem cell approaches combined with tissue engineering therapies continue to be developed in expectation of improving clinical outcomes. Results with appropriate follow-up are not yet available to indicate if such techniques are safe, cost-effective and reliable in the long-term. PMID:27559465

  8. Total Disc Arthroplasty for Treating Lumbar Degenerative Disc Disease

    Mostofi, Keyvan

    2015-01-01

    Study Design Lumber disc arthroplasty is a technological advancement that has occurred in the last decade to treat lumbar degenerative disk diseases. Purpose The aim of this retrospective study was to establish the impact and outcomes of managing patients with lumbar degenerative disk disease who have been treated with lumbar total disc arthroplasty (TDA). Overview of Literature Several studies have shown promising results following this surgery. Methods We reviewed the files of 104 patients ...

  9. Imaging of lumbar degenerative disk disease: history and current state

    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.)

  10. Skipping Posterior Dynamic Transpedicular Stabilization for Distant Segment Degenerative Disease

    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.

  11. Neuromuscular exercise as treatment of degenerative knee disease

    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....

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

    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

  13. Revisiting the term neuroprotection in chronic and degenerative diseases

    Marco Orsini

    2016-04-01

    Full Text Available Thanks to the development of several new researches, the lifetime presented a significant increase, even so, we still have many obstacles to overcome − among them, manage and get responses regarding neurodegenerative diseases. Where we are in the understanding of neuroprotection? Do we really have protective therapies for diseases considered degeneratives such as amyotrophic lateral sclerosis and its variants, Parkinson’s disease, Alzheimer’s disease and many others? Neuroprotection is defined by many researches as interactions and interventions that can slow down or even inhibit the progression of neuronal degeneration process. We make some considerations on this neuroprotective effect.

  14. Vitiligo: a possible model of degenerative diseases.

    Barbara Bellei

    Full Text Available Vitiligo is characterized by the progressive disappearance of pigment cells from skin and hair follicle. Several in vitro and in vivo studies show evidence of an altered redox status, suggesting that loss of cellular redox equilibrium might be the pathogenic mechanism in vitiligo. However, despite the numerous data supporting a pathogenic role of oxidative stress, there is still no consensus explanation underlying the oxidative stress-driven disappear of melanocytes from the epidermis. In this study, in vitro characterization of melanocytes cultures from non-lesional vitiligo skin revealed at the cellular level aberrant function of signal transduction pathways common with neurodegenerative diseases including modification of lipid metabolism, hyperactivation of mitogen-activated protein kinase (MAPK and cAMP response element-binding protein (CREB, constitutive p53-dependent stress signal transduction cascades, and enhanced sensibility to pro-apoptotic stimuli. Notably, these long-term effects of subcytotoxic oxidative stress are also biomarkers of pre-senescent cellular phenotype. Consistent with this, vitiligo cells showed a significant increase in p16 that did not correlate with the chronological age of the donor. Moreover, vitiligo melanocytes produced many biologically active proteins among the senescence-associated secretory phenotype (SAPS, such as interleukin-6 (IL-6, matrix metallo proteinase-3 (MMP3, cyclooxygenase-2 (Cox-2, insulin-like growth factor-binding protein-3 and 7 (IGFBP3, IGFBP7. Together, these data argue for a complicated pathophysiologic puzzle underlying melanocytes degeneration resembling, from the biological point of view, neurodegenerative diseases. Our results suggest new possible targets for intervention that in combination with current therapies could correct melanocytes intrinsic defects.

  15. Vitiligo: A Possible Model of Degenerative Diseases

    Bellei, Barbara; Pitisci, Angela; Ottaviani, Monica; Ludovici, Matteo; Cota, Carlo; Luzi, Fabiola; Dell'Anna, Maria Lucia; Picardo, Mauro

    2013-01-01

    Vitiligo is characterized by the progressive disappearance of pigment cells from skin and hair follicle. Several in vitro and in vivo studies show evidence of an altered redox status, suggesting that loss of cellular redox equilibrium might be the pathogenic mechanism in vitiligo. However, despite the numerous data supporting a pathogenic role of oxidative stress, there is still no consensus explanation underlying the oxidative stress-driven disappear of melanocytes from the epidermis. In this study, in vitro characterization of melanocytes cultures from non-lesional vitiligo skin revealed at the cellular level aberrant function of signal transduction pathways common with neurodegenerative diseases including modification of lipid metabolism, hyperactivation of mitogen-activated protein kinase (MAPK) and cAMP response element-binding protein (CREB), constitutive p53-dependent stress signal transduction cascades, and enhanced sensibility to pro-apoptotic stimuli. Notably, these long-term effects of subcytotoxic oxidative stress are also biomarkers of pre-senescent cellular phenotype. Consistent with this, vitiligo cells showed a significant increase in p16 that did not correlate with the chronological age of the donor. Moreover, vitiligo melanocytes produced many biologically active proteins among the senescence-associated secretory phenotype (SAPS), such as interleukin-6 (IL-6), matrix metallo proteinase-3 (MMP3), cyclooxygenase-2 (Cox-2), insulin-like growth factor-binding protein-3 and 7 (IGFBP3, IGFBP7). Together, these data argue for a complicated pathophysiologic puzzle underlying melanocytes degeneration resembling, from the biological point of view, neurodegenerative diseases. Our results suggest new possible targets for intervention that in combination with current therapies could correct melanocytes intrinsic defects. PMID:23555779

  16. Adjacent segment disease in degenerative pathologies with posterior instrumentation

    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.

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

    J.A. García Liñeiro

    2006-12-01

    effective in equine medicine. The clinical model consisted of 10 horses with a standardized diagnostic protocol of tarsometatarsial degenerative joint disease; these were subjected to both treatments with an interval of 6 months, then results were compared. Treatments were performed every day and the clinic evaluation every two days (five controls. The clinic parameters considered were: a- straight and circle trot, in hard and soft surface. b- Tarsus Flexion test c- Tarsus Test (Churchill test. McNemar's test was performed in order to compare lameness and forced flexion tests at 'control 5' stage, after applying TENS and RAME treatments; no significant differences were found between both treatments (p=0,2568. The Mc Nemar's test also used to compare tarsal flexion tests (Churchill's Test after TENS and RAME treatments, showed no significant differences between Both (p=0,7055. It was therefore concluded that there is little difference between the two methods, while there is an important decrease as from 'control 2'. This situation lets us assume that both methods may be used indistinctly in an effective manner, choosing to use one or the other according to the advantages and disadvantages of its applications.

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

    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)

  19. Degenerative diseases of the nervous system in atomic bomb survivors

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

  20. Nuclear microscopy in medical research. Investigations into degenerative diseases

    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)

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

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

    2008-05-15

    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.)

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

    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. PMID:26493766

  3. Imaging techniques for diagnosis after surgery for degenerative disc disease

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

  4. Magnetic resonance imaging of canine degenerative lumbar spine diseases

    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

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

    Du, Hong-Gen; Liao, Sheng-Hui; Jiang, Zhong; Huang, Huan-Ming; Ning, Xi-Tao; Jiang, Neng-Yi; Pei, Jian-Wei; Huang, Qin; Wei, Hui

    2016-05-01

    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. PMID:27275119

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

    Marcos Marini Melo; Paulo Ricardo Mallmann; Dábila Aráujo Sonego; Alessandro Tadeu Marques; Gentil Ferreira Gonçalves; Rosana Zanatta; Marcos Almeida Souza; Pedro Eduardo Brandini Néspoli; Roberto Lopes de Souza

    2013-01-01

    Osteoarthritis (OA) is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies,...

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

    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.)

  8. Chronic sole ulcerations associated with degenerative bone disease in two Asian elephants (Elephas maximus).

    Luikart, Kimberly A; Stover, Susan M

    2005-12-01

    Chronic foot lesions and degenerative joint disease are common causes of morbidity in elephants. Lesions may become intractable and progressive despite intensive treatment regimens. The forelimbs of two Asian elephants (Elephas maximus) with chronic nonhealing sole ulcerations were examined using manual dissection and computed tomography. Both elephants had abnormal limb conformation that preceded the development of sole ulcerations. In both cases, sole ulcers were associated with remodeling and degeneration of underlying bones of the digits. Conformational abnormalities and altered weight distribution in these individuals may have induced compensatory bony degeneration and secondary ulcer formation. Sole ulcerations associated with digital abnormalities may have a guarded prognosis for resolution, even with aggressive treatment. Because limb conformational abnormalities could predispose to or result from chronic digital lesions, elephants with conformational abnormalities may have increased likelihood of having chronic sole ulcerations. PMID:17312727

  9. Frying process in the relation fat/degenerative diseases.

    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

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

    Marcos Marini Melo

    2013-06-01

    Full Text Available Osteoarthritis (OA is the most common joint disease in both humans and animals, and it results in movement restriction and pain at the affected area. This disorder affects more than 25% of people over 60 years of age, and it is considered universal for 70-year-old people. OA is estimated to affect over 20% of the canine population from the United States of America. The present study aimed to evaluate the treatment of rats that were surgically induced to OA using two different drug therapies, one with pentosan polysulfate, one with betamethasone, and one with chondroitin sulfate/ glucosamine. In order to produce joint disease, the cranial cruciate ligament was surgically transected. Animals were kept and treated for eight days after surgery and were assessed via both radiographies and tomographies taken before surgery and eight weeks later. All animals were euthanized having both macroscopic and microscopic analysis performed to evaluate the disorder progression and therapeutic action. Macroscopic analysis showed lesion in the knees subjected to OA induction. The untreated animals presented major lesions whereas the treated ones presented mild to moderate lesions. In conclusion, pentosan polysulfate is recommendable for the treatment of iatrogenic joint lesions in rats since the other treatments showed no significant difference. A osteoartrite (OA é a doença articular mais comum em humanos e animais, o que ocasiona restrição de movimentos e dor, na região acometida. Tal enfermidade afeta mais de 25% dos humanos acima de 60 anos e, aos 70 anos, ela é considerada universal. Estima-se que nos Estados Unidos da América, 20% ou mais da população canina é acometida pela OA. O presente estudo tem como finalidade avaliar a terapia medicamentosa (polisulfato de pentosano, betametasona e sulfato de condroitina/glucosamina, em um modelo experimental de OA cirurgicamente induzido, em ratos. A doença articular foi promovida pela transecção cir

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

    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.

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

    Matthis Synofzik; Winfried Ilg

    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 s...

  13. Magnetic resonance imaging in joint diseases

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

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

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

    2009-12-01

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

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

    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

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

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

  17. Expression of immune response genes in the stifle joint of dogs with oligoarthritis and degenerative cranial cruciate ligament rupture.

    Muir, P; Schaefer, S L; Manley, P A; Svaren, J P; Oldenhoff, W E; Hao, Z

    2007-10-15

    Dysregulation of immune responses within joints plays an important role in development of inflammatory arthritis. We determined expression of a panel of immune response and matrix turnover genes in synovial fluid collected from a group of dogs with stifle oligoarthritis and associated degenerative cranial cruciate ligament (CCL) rupture (n=27). We also studied synovial fluid gene expression in dogs affected with other forms of degenerative arthritis (n=9) and in the stifle joint of healthy dogs with intact CCL (n=14). After collection, synovial cells were pelleted and RNA was isolated. Relative expression of cathepsin K, cathepsin S, tartrate-resistant acid phosphatase (TRAP), matrix metalloproteinase-9 (MMP-9), invariant chain (li), toll-like receptor-2 (TLR-2), and TLR-9 was determined using real-time quantitative RT-PCR. Data were normalized to peripheral blood mononuclear cells (PBMC) as an internal control. Relative expression of cathepsin K, MMP-9, TRAP, and li was increased in the stifle synovial fluid of dogs with oligoarthritis, when compared with the stifles of healthy dogs (Pdogs. TRAP expression was also significantly increased in the stifle joints of dogs with oligoarthritis, when compared to joint expression of TRAP in dogs with other forms of degenerative arthritis (Pdogs with stifle oligoarthritis, expression of both matrix turnover and immune response genes was increased in stifle synovial fluid, when compared with the internal PBMC control, whereas in healthy dogs and dogs with other forms of arthritis, only expression of matrix turnover genes was increased in synovial fluid, when compared with the internal PBMC control (Pdogs with oligoarthritis and degenerative CCL rupture. PMID:17629954

  18. The Main Biomechanical Risk Factors for the Prevalence of the Left Hip Joint Traumatic and Degenerative Changes

    Lovrić, Ivan; Splavski, Bruno; Jovanović, Savo; Soldo, Ivan; Kvolik, Slavica; Has, Borislav

    2009-01-01

    The aim of this paper is to examine characteristic biomechanical features leading to the acetabular fracture and hip joint arthrosis, and to explain the prevalence of the left side traumatic and degenerative pelvic pathology that is usually seen in diverse groups of patients. A total of 253 patients were analyzed in a retrospective case-control study during a six-year period. The patients were divided into the case group of 103 patients suffering traumatic acetabular fractures and into the co...

  19. THE MITOCHONDRIAL DERANGEMENTS IN NEURONAL DEGENER ATION AND NEURODEGENERATIVE DISEASES

    Xue, Qi-ming; Gao, Feng; Chen, Qin-tang

    2000-01-01

    @@There are diverse concepts on the pathogenesis of neuronal degeneration and the neurodegenerative diseases. Among them there are different factors which might influence the initiation of neuronal degeneration as well as the pathogenesis of neurodegenerative diseases, such as Alzheimer′s disease, Parkinson′s disease, motor neuron disease, and so on.

  20. Restoration of synaptic function in sight for degenerative retinal disease

    Schubert, Timm; Wissinger, Bernd

    2015-01-01

    Synaptic disorganization is a prominent feature of many neurological diseases of the CNS, including Parkinson’s disease, intellectual development disorders, and autism. Although synaptic plasticity is critical for learning and memory, it is unclear whether this innate property helps restore synaptic function in disease once the primary cause of disease is abrogated. An answer to this question may come from a recent investigation in X-linked retinoschisis, a currently untreatable retinopathy. ...

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

    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

  2. Short aggrecan gene repetitive alleles associated with lumbar degenerative disc disease in Turkish patients.

    Eser, O; Eser, B; Cosar, M; Erdogan, M O; Aslan, A; Yıldız, H; Solak, M; Haktanır, A

    2011-01-01

    We investigated a possible association between aggrecan gene polymorphism and lumbar degenerative disc disease in Turkish patients. One hundred 20-30-year-old patients with or without low back pain were selected for the study. Lumbar magnetic resonance imaging was performed on all patients. The patient group had low back pain clinically and degenerative disc disease radiographically. The control group included patients with and without low back pain: all were negative radiographically for degenerative disc disease. Genomic DNA was extracted from all participants. A PCR assay were used to evaluate variable number of tandem repeat polymorphism of aggrecan gene alleles to determine if there was any correlation with degenerative disc disease. Significant associations were found between short repeated alleles of the aggrecan gene and severe disc degeneration. A significant association was also found between short repeated alleles of the aggrecan gene and multilevel disc herniation as well as extrusion and sequestration types of disc herniation. In Turkish population, short repeated alleles of the aggrecan gene are associated with increased disc degeneration and disc herniation. PMID:21948754

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

    Udby, Peter M.; Bech-Azeddine, Rachid

    2015-01-01

    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...

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

    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.

  5. Motor training in degenerative spinocerebellar disease: ataxia-specific improvements by intensive physiotherapy and exergames.

    Synofzik, Matthis; Ilg, Winfried

    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

  6. PET studies in Alzheimer disease and other degenerative dementias

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

  7. PET studies in Alzheimer disease and other degenerative dementias

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

    2003-02-01

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

  8. Efficacy of a Human Amniotic Tissue-derived Allograft, NuCel, in Patients Undergoing Posteriolateral Lumbar Fusions for Degenerative Disc Disease

    2016-03-28

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

  9. Restoration of synaptic function in sight for degenerative retinal disease.

    Schubert, Timm; Wissinger, Bernd

    2015-07-01

    Synaptic disorganization is a prominent feature of many neurological diseases of the CNS, including Parkinson's disease, intellectual development disorders, and autism. Although synaptic plasticity is critical for learning and memory, it is unclear whether this innate property helps restore synaptic function in disease once the primary cause of disease is abrogated. An answer to this question may come from a recent investigation in X-linked retinoschisis, a currently untreatable retinopathy. In this issue of the JCI, Ou, Vijayasarathy, and colleagues showed progressive disorganization of key functional elements of the synapse between photoreceptors and ON-bipolar cells in a retinoschisin-deficient mouse model. Moreover, they demonstrated that adeno-associated virus-mediated (AAV-mediated) delivery of the retinoschisin gene restores structure and function to the photoreceptor to ON-bipolar cell synapse in mouse models, even in adults at advanced stages of the disease. The results of this study hold promise that AAV-based supplemental gene therapy will benefit patients with X-linked retinoschisis in a forthcoming clinical trial. PMID:26098210

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

    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/cm2 in the femoral neck, while for controls the corresponding figures were 0.989g/cm2 and 0.765g/cm2. 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

  11. A Study of the Association Between Sleep Bruxism, Low Quality of Sleep, and Degenerative Changes of the Temporomandibular Joint.

    Dias, Glaucia Marques; Bonato, Letícia Ladeira; Guimarães, Josemar Parreira; Silva, Jesca Neftali Nogueira; Ferreira, Luciano Ambrosio; Grossmann, Eduardo; Carvalho, Antonio Carlos Pires

    2015-11-01

    The aim of this study was to evaluate the presence of degenerative bone changes of the temporomandibular joint (TMJ) in individuals suffering from sleep bruxism (SB), associating these characteristics with the quality of sleep. For this, we followed the International Classification of Sleep Disorders for the diagnosis of SB, in addition to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) for the classification of TMD and cone beam computed tomography. It was found that 97.7% of the individuals with bruxism had at least 1 RDC/TMD group III diagnosis, 75.6% of the subjects considered their sleep quality as poor, and the largest group (23%) had centric bruxism. There was no significant association between the pattern of sleep quality (P = 0.36), the type of SB (P = 0.277), and the presence of degenerative changes of the TMJ. Regardless of the quality of sleep and the type of bruxism presented, the prevalence of degenerative bone disorders was high (67%) among women with a mean age of 46 years and a clinical diagnosis of SB. PMID:26501968

  12. [Role of defective intracellular proteolysis in human degenerative diseases].

    Nezelof, Christian

    2012-11-01

    the nature of proteolysis. In this article, therefore, the following distinction should be made:--Lysosomal failures. They represent hereditary metabolic disorders involving all categories of cells. They are characterized by the accumulation of homogeneous material related to the underlying disease. Young people are predominantly affected--UPS failures. They represent sporadic conditions principally involving long-lived cells. The accumulated material is heterogeneous, composed of abnormal proteins and various "garbage-like" waste, including pigments. The elderly are predominatly affected, suggesting an epigenetic wear and tear process. Hypothetically, most the sporadic neurodegenerative diseases, from retinal macular degeneration and its associated drüsen to Alzheimer's disease, Parkinson's disease may represent fairly good examples of the UPS deficit. PMID:24313014

  13. [Whiplash injury of the cervical spine--on the role of pre-existing degenerative diseases].

    Meenen, N M; Katzer, A; Dihlmann, S W; Held, S; Fyfe, I; Jungbluth, K H

    1994-06-01

    Radiological investigations contribute little in differentiating the problems of patients with whiplash injuries. Nevertheless the more prolonged cases of whiplash injuries must not be attributed to preexisting degenerative disease, despite radiologically-proven medicolegal opinion. In this study, 60 patients who were seen for whiplash injuries in the Department for Trauma and Reconstructive Surgery at the University Hospital Hamburg-Eppendorf for clinical and radiological evaluation, an average of 5.7 years post injury, were divided into two groups (n = 30) depending on radiologically-proven preexisting degenerative changes of the cervical spine. On average the patients with degenerative changes were 11.2 years older than those with healthy vertebral columns and also demonstrated an increase in acute symptoms in the lower cervical spine (cervicobrachial syndrome). The chronicity of individual symptoms such as neck-pain, dizziness, nausea and psychological illness was also observed in both groups. Problems such as paresthesias as well as pain in the shoulder-arm-area appeared to increase in subsequent check-ups, irrespective of the earlier degenerative changes. Patients with typical posterior headaches recovered faster when they had radiologically normal spines. Presenting late, there was a significant accumulation of patients with pre-existing degenerative changes complaining merely of tinnitus. The earlier changes in any individual motion segment do not determine the clinical course of whiplash injuries, but merely represent an area of increased vulnerability to trauma. On the other hand, trauma has not been proven to influence the development or aggravation of degenerative changes in normal or diseased spines. We are not able to differentiate the posttraumatic course from the natural history of the degenerative process, either clinically or radiologically. Considering the involvement of sensitive neurological structures the classical objective organic diagnosis

  14. Neurochemical imaging of Alzheimer's disease and other degenerative dementias

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

  15. [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].

    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: PMID:26255528

  16. Roentgenological differential diagnosis in diseases of the sacroiliac joints

    Conventional diagnostic radiology lends itself to the diagnosis of diseases of the sacroiliac joints and tomography in the dorsal position is useful in the identification of discrete changes. Processes of either an inflammatory or a degenerative etiology can be differentiated roentgenologically. Inflammatory disorders can be defined and differentiated to some extent radiomorphologically; this requires to analyse the dimension and temporal sequence of reaction forms of the sacroiliac joints - destruction, sklerosis, ankylosis. The 'colourful picture' is characteristic of morbus Bechterew; however, it is no exclusive proof since a number of other disorders cause similar changes. (orig.)

  17. Roentgenological differential diagnosis in diseases of the sacroiliac joints

    Erlemann, R.; Peters, P.E.

    1985-12-01

    Conventional diagnostic radiology lends itself to the diagnosis of diseases of the sacroiliac joints and tomography in the dorsal position is useful in the identification of discrete changes. Processes of either an inflammatory or a degenerative etiology can be differentiated roentgenologically. Inflammatory disorders can be defined and differentiated to some extent radiomorphologically; this requires to analyse the dimension and temporal sequence of reaction forms of the sacroiliac joints - destruction, sklerosis, ankylosis. The 'colourful picture' is characteristic of morbus Bechterew; however, it is no exclusive proof since a number of other disorders cause similar changes.

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

    Ridder, Hanne Mette Ochsner

    2004-01-01

    When dialogue fails. Music therapy with elderly with neurological degenerative diseases. In persons suffering from neurological degenerative diseases we often see the following symptoms: difficulties in remembering, concentrating, perceiving input, and controlling and timing movements. Normal every...... it is possible to adjust the communication in order to enter dialogue. The dialogue is the potential for sharing emotions and meeting psychosocial needs. The core of the music therapy is seen as the moments where interaction and dialogue occurs. But these moments are only “highlights” of the sessions, and before....... Conclusion 1. In order to compensate for missing short-term memory it is important to work deliberately with cuing. A specific song in the beginning of the music therapy session will e.g. signalise that the music therapy is to start. Using songs as cues activates cortical memory function, and work as memory...

  19. Neuroimaging and genetic risk for Alzheimer's disease and addiction-related degenerative brain disorders.

    Roussotte, Florence F; Daianu, Madelaine; Jahanshad, Neda; Leonardo, Cassandra D; Thompson, Paul M

    2014-06-01

    Neuroimaging offers a powerful means to assess the trajectory of brain degeneration in a variety of disorders, including Alzheimer's disease (AD). Here we describe how multi-modal imaging can be used to study the changing brain during the different stages of AD. We integrate findings from a range of studies using magnetic resonance imaging (MRI), positron emission tomography (PET), functional MRI (fMRI) and diffusion weighted imaging (DWI). Neuroimaging reveals how risk genes for degenerative disorders affect the brain, including several recently discovered genetic variants that may disrupt brain connectivity. We review some recent neuroimaging studies of genetic polymorphisms associated with increased risk for late-onset Alzheimer's disease (LOAD). Some genetic variants that increase risk for drug addiction may overlap with those associated with degenerative brain disorders. These common associations offer new insight into mechanisms underlying neurodegeneration and addictive behaviors, and may offer new leads for treating them before severe and irreversible neurological symptoms appear. PMID:24142306

  20. Revisiting the application of integrated physiotherapy in degenerative-dystrophic diseases of the musculoskeletal system

    Kotenko K.V.

    2014-12-01

    Full Text Available Aim. The authors described a comprehensive program of frozen shoulder treatment, including extracorporeal shock wave therapy and pelotherapy. Objective: To evaluate the effectiveness of the inclusion of extracorporeal shock wave therapy and pelotherapy in rehabilitation of patients with degenerative diseases of the musculoskeletal system. Materials and Methods: there had been examined 120 patients during the study. Results: The result of the application of complex physiotherapy normalized indicators of metabolic and electrolyte imbalances that are important in the formation of a therapeutic effect. Conclusion: The application of extracorporeal shock wave therapy and in combination with pelotherapy in patients with scapula-humeral periarthritis is the elimination of metabolic and electrolyte imbalance, which is important in degenerative diseases of the musculoskeletal system

  1. Oxygen-ozone therapy for degenerative spine disease in the elderly: a prospective study.

    Bonetti, Matteo; Fontana, Alessandro; Martinelli, Francesco; Andreula, Cosma

    2011-01-01

    We describe our experience of oxygen-ozone therapy to treat degenerative spine disease in the elderly. From April 2004 to March 2008 we selected 129 patients with CT and/or MR evidence of spondyloarthrosis and disc degeneration of the lumbar spine. All patients enrolled in the study had contraindications to the administration of commonly used analgesic and anti-inflammatory drugs.Oxygen-ozone therapy was given by CT-guided intraforaminal injection as the first treatment followed by 4 weekly paralumbar infiltrations on an outpatient basis. The full treatment lasted a month. Clinical outcome was assessed 3 months and 1 year after treatment. The good results obtained indicate that oxygen-ozone therapy is an ideal treatment with no side-effects in elderly patients with degenerative spine disease. PMID:21107950

  2. Radiology of chronic diseases of the ankle joint

    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

  3. Operative Outcomes for Cervical Degenerative Disease: A Review of the Literature

    Kazuya Nishizawa; Kanji Mori; Yasuo Saruhashi; Yoshitaka Matsusue

    2012-01-01

    To date, several studies were conducted to find which procedure is superior to the others for the treatment of cervical myelopathy. The goal of surgical treatment should be to decompress the nerves, restore the alignment of the vertebrae, and stabilize the spine. Consequently, the treatment of cervical degenerative disease can be divided into decompression of the nerves alone, fixation of the cervical spine alone, or a combination of both. Posterior approaches have historically been considere...

  4. Anterior Cervical Corpectomy and Fusion Accelerates Degenerative Disease at Adjacent Vertebral Segments

    Pickett, Gwynedd E.; Duggal, Neil; Theodore, Nicholas; Sonntag, Volker K.H.

    2008-01-01

    Background Anterior cervical corpectomy provides the most direct and thorough surgical approach for anterior decompression when spinal cord compression is found directly behind the vertebral body. However, anterior cervical fusion has been shown to be associated with the development of new degenerative changes at levels immediately adjacent to the fused segments. Th e incidence of adjacent segment disease (ASD) following anterior cervical corpectomy has not been widely reported. We set out to...

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

    Creina S Stockley

    2009-01-01

    Creina S StockleyThe Australian Wine Research Institute, Adelaide, South Australia, AustraliaAbstract: Population aging is associated with the increased incidence cancer and of degenerative diseases. Population aging is occurring on a global scale, with faster aging projected for the coming decades than has occurred in the past. Globally, the population aged 60 years and over is projected to nearly triple by 2050, while the population aged 80 years and over is projected to experience a more t...

  6. Revisiting the application of integrated physiotherapy in degenerative-dystrophic diseases of the musculoskeletal system

    Kotenko K.V.; Korchazhkina N.B.; Mikhaylova A.A.; Epifanov A.V.; Portnov V.V.; Danilova D.P.

    2014-01-01

    Aim. The authors described a comprehensive program of frozen shoulder treatment, including extracorporeal shock wave therapy and pelotherapy. Objective: To evaluate the effectiveness of the inclusion of extracorporeal shock wave therapy and pelotherapy in rehabilitation of patients with degenerative diseases of the musculoskeletal system. Materials and Methods: there had been examined 120 patients during the study. Results: The result of the application of complex physiotherapy normalized ind...

  7. Lumbar Degenerative Disc Disease: Current and Future Concepts of Diagnosis and Management

    Fadi Taher; David Essig; Lebl, Darren R.; Hughes, Alexander P.; Sama, Andrew A.; Cammisa, Frank P.; Girardi, Federico P.

    2012-01-01

    Low back pain as a result of degenerative disc disease imparts a large socioeconomic impact on the health care system. Traditional concepts for treatment of lumbar disc degeneration have aimed at symptomatic relief by limiting motion in the lumbar spine, but novel treatment strategies involving stem cells, growth factors, and gene therapy have the theoretical potential to prevent, slow, or even reverse disc degeneration. Understanding the pathophysiological basis of disc degeneration is essen...

  8. The Impact of Obesity on Perioperative Resource Utilization after Elective Spine Surgery for Degenerative Disease

    Planchard, Ryan F.; Higgins, Dominique M.; Mallory, Grant W.; Puffer, Ross C.; Jacob, Jeffrey T.; Curry, Timothy B.; Kor, Daryl J.; Clarke, Michelle J.

    2015-01-01

    Study Design Retrospective case series. Objective To determine the effect of obesity on the resource utilization and cost in 3270 consecutive patients undergoing elective noninstrumented decompressive surgeries for degenerative spine disease at Mayo Clinic Rochester between 2005 and 2012. Methods Groups were assessed for baseline differences (age, gender, and American Society of Anesthesiologists [ASA] classification, procedure type, and number of operative levels). Outcome variables included...

  9. Neuroimaging and Genetic Risk for Alzheimer’s Disease and Addiction-Related Degenerative Brain Disorders

    Roussotte, Florence F.; Daianu, Madelaine; Jahanshad, Neda; Leonardo, Cassandra D.; Thompson, Paul M.

    2014-01-01

    Neuroimaging offers a powerful means to assess the trajectory of brain degeneration in a variety of disorders, including Alzheimer’s disease (AD). Here we describe how multimodal imaging can be used to study the changing brain during the different stages of AD. We integrate findings from a range of studies using magnetic resonance imaging (MRI), positron emission tomography (PET), functional MRI (fMRI) and diffusion weighted imaging (DWI). Neuroimaging reveals how risk genes for degenerative ...

  10. Preliminary evaluation of posterior dynamic lumbar stabilization in lumbar degenerative disease in Chinese patients

    JIA Yu-hua; SUN Peng-fei

    2012-01-01

    Background There has been some controversy related to the use of the Wallis system,rather than disc fusion in the treatment of patients with degenerative spine disease.Furthermore,there are no reports concerning the application of this dynamic stabilization system in Chinese patients,who have a slightly different lifestyle with Western patients.The aim of this study was to assess the safety and efficacy of the dynamic stabilization system in the treatment of degenerative spinal diseases in Chinese patients.Methods The clinical outcomes of 20 patients with lumbar degenerative disease treated by posterior decompression with the Wallis posterior dynamic lumbar stabilization implant were studied.All of the patients completed the visual analogue scale and the Chinese version of the Oswestry Disability Index.The following radiologic parameters were measured in all patients:global lordotic angles and segmental lordotic angles (stabilized segments,above and below adjacent segments).The range of motion was then calculated.Results Nineteen patients (95%) were available for follow-up.The mean follow-up period was (27.25±5.16) months (range 16-35 months).The visual analogue scale decreased from 8.55±1.21 to 2.20±1.70 (P <0.001),and the mean score on the Chinese version of the Oswestry Disability Index was improved from 79.58%±15.93% to 22.17%±17.24% (P <0.001).No significant changes were seen in the range of motion at the stabilized segments (P=0.502) and adjacent segments (above,P=0.453; below,P=0.062).The good to excellent result was 94.4% at the latest follow-up.No complications related to the use of the Wallis posterior dynamic lumbar stabilization occurred.Conclusions It was found to be both easy and safe to use the Wallis posterior dynamic lumbar stabilization implant in the treatment of degenerative lumbar disease,and the early therapeutic effectiveness is good.The Wallis system provides an alternative method for the treatment of lumbar degenerative

  11. Adenosine in inflammatory joint diseases

    Chan, E. S. L.; Fernandez, P.; Cronstein, B. N.

    2007-01-01

    Inflammatory joint diseases are a group of heterogeneous disorders with a variety of different etiologies and disease manifestations. However, there are features that are common to all of them: first, the recruitment of various inflammatory cell types that are attracted to involved tissues over the course of the disease process. Second, the treatments used in many of these diseases are commonly medications that suppress or alter immune function. The demonstration that adenosine has endogenous...

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

    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

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

    Zhigang Qu

    2013-01-01

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

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

    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

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

    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.

  16. Comparison of the Dynesys Dynamic Stabilization System and Posterior Lumbar Interbody Fusion for Lumbar Degenerative Disease.

    Yang Zhang

    Full Text Available There have been few studies comparing the clinical and radiographic outcomes between the Dynesys dynamic stabilization system and posterior lumbar interbody fusion (PLIF. The objective of this study is to compare the clinical and radiographic outcomes of Dynesys and PLIF for lumbar degenerative disease.Of 96 patients with lumbar degenerative disease included in this retrospectively analysis, 46 were treated with the Dynesys system and 50 underwent PLIF from July 2008 to March 2011. Clinical and radiographic outcomes were evaluated. We also evaluated the occurrence of radiographic and symptomatic adjacent segment degeneration (ASD.The mean follow-up time in the Dynesys group was 53.6 ± 5.3 months, while that in the PLIF group was 55.2 ± 6.8 months. At the final follow-up, the Oswestry disability index and visual analogue scale score were significantly improved in both groups. The range of motion (ROM of stabilized segments in Dynesys group decreased from 7.1 ± 2.2° to 4.9 ± 2.2° (P < 0.05, while that of in PLIF group decreased from 7.3 ± 2.3° to 0° (P < 0.05. The ROM of the upper segments increased significantly in both groups at the final follow-up, the ROM was higher in the PLIF group. There were significantly more radiographic ASDs in the PLIF group than in the Dynesys group. The incidence of complications was comparable between groups.Both Dynesys and PLIF can improve the clinical outcomes for lumbar degenerative disease. Compared to PLIF, Dynesys stabilization partially preserves the ROM of the stabilized segments, limits hypermobility in the upper adjacent segment, and may prevent the occurrence of ASD.

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

    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.

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

    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.

  19. Efficacy of the Dynamic Interspinous Assisted Motion system in clinical treatment of degenerative lumbar disease

    ZHAO Yu; WANG Yi-peng; QIU Gui-xing; ZHAO Hong; ZHANG Jian-guo; ZHOU Xi

    2010-01-01

    Background The Dynamic Interspinous Assisted Motion (DIAM) system was designed to stabilize degenerative spinal segments without fusion surgery, maintain segment motion and prevent adjacent segment degeneration. The aim of thisstudy was to investigate clinical efficacy of the DIAM system in treatment of degenerative lumbar disease in China.Methods Eight cases of lumbar vertebral instability were treated with the DIAM system at Peking Union MedicalCollege Hospital from June 2006 to January 2008. There were 6 female and 2 male subjects with a mean age of 46.9years and a range of 40-52 years. Radiographs and scores on outcome measures included the visual analogue scale (VAS) for pain and the Oswestry disability index (ODI). These scores were recorded before surgery and after surgery at intervals of 3-month, 6-month, 1-year and the final follow-up visit.Results The follow-up time ranged from 12-31 months, with an average of 20.6 months. There were significant differences between preoperative and postoperative scores at each follow-up evaluation (P <0.05). However, there was no significant difference between each postoperative follow-up score (P >0.05). There were significant differences between preoperative and postoperative L4-5 segment activity at each time interval (P <0.05), but no obvious difference was found within each postoperative follow-up evaluation (P >0.05). The ODI and VAS score improvements were directly correlated with segment activity (r >0.7, P <0.05).Conclusions The DIAM system appears to be a useful and effective treatment in the surgical management of degenerative lumbar disease in certain patients. However, long-term follow-up is needed to evaluate the clinical outcomes of the device.

  20. MINIMALLY INVASIVE TRANSFORAMINAL LUMBAR INTERBODY FUSION IN DEGENERATIVE LUMBAR SPINE DISEASE

    Pankaj

    2015-12-01

    Full Text Available OBJECTIVE To assess the clinical and radiological outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion (MI-TLIF and to analyze the surgical outcome for degenerative lumbar spine disease. METHODS A multicenter retrospective analysis of 20 patients who underwent a MI-TLIF by image guidance from 1 January 2012 to April 2015. The study included 13 males and 7 females (Mean age 53 year. CT scan of operating area was done to evaluate the pedicle screw, cage placement and fusion at 6 months post operatively. Oswestry Disability Index (ODI scores and Visual Analogue Scale (VAS were recorded pre-operatively and at 6-month followup. RESULTS Eighteen (90% patients had evidence of fusion at 6 months post operatively with a mean improvement of 34 on the ODI score. Mean length of hospital stay was 4 days. The mean operative time was 170min. One patient developed transient nerve root pain in the postoperative period which was managed conservatively and one patient developed superficial wound infection. There was no case of CSF leak. CONCLUSION MI-TLIF is a safe and effective surgical procedure for management of degenerative lumbar spine disease.

  1. [Prediction of outcomes of surgical treatment of degenerative lumbar disk disease].

    Zhuravlev, Iu I; Nazarenko, G I; Cherkashov, A M; Riazanov, V V; Nazarenko, A G

    2009-01-01

    The paper focuses on algorithms of outcomes assessment of surgical treatment of the patients with degenerative lumbar disk disease. From 1997 to 2006 389 patients with discogenic lumbar pain were operated in the Medical Center of Central Bank of Russia. 185 patients underwent radiofrequency destruction of facet nerves, laser percutaneous lumbar discectomy was performed in 39 patients, microdiscectomy -- in 131, and decompression combined with lumbar spine stabilization -- in 31 cases. Clinical and radiological data of each patient were recorded in the database using 3-point scale according to intensity of the feature. Assessment of patients' condition was performed pre- and postoperatively (after discharge and after 6, 12 and 24 months interval). Postoperative outcome was recorded for the current period in compliance with modified criteria of Kawabata et al. Obtained data were mathematically and statistically processed. Developed algorithms allowed assessment of postoperative outcome in the patients with degenerative lumbar disk disease. Outcome data can be used for evaluation of feasibility of surgical treatment as well as for selection of surgical technique. PMID:19505029

  2. 3-D MRI for lumbar degenerative diseases; Visualization of nerve roots

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

    1993-07-01

    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.).

  3. Redox Signaling as a Therapeutic Target to Inhibit Myofibroblast Activation in Degenerative Fibrotic Disease

    Natalie Sampson

    2014-01-01

    Full Text Available Degenerative fibrotic diseases encompass numerous systemic and organ-specific disorders. Despite their associated significant morbidity and mortality, there is currently no effective antifibrotic treatment. Fibrosis is characterized by the development and persistence of myofibroblasts, whose unregulated deposition of extracellular matrix components disrupts signaling cascades and normal tissue architecture leading to organ failure and death. The profibrotic cytokine transforming growth factor beta (TGFβ is considered the foremost inducer of fibrosis, driving myofibroblast differentiation in diverse tissues. This review summarizes recent in vitro and in vivo data demonstrating that TGFβ-induced myofibroblast differentiation is driven by a prooxidant shift in redox homeostasis. Elevated NADPH oxidase 4 (NOX4-derived hydrogen peroxide (H2O2 supported by concomitant decreases in nitric oxide (NO signaling and reactive oxygen species scavengers are central factors in the molecular pathogenesis of fibrosis in numerous tissues and organs. Moreover, complex interplay between NOX4-derived H2O2 and NO signaling regulates myofibroblast differentiation. Restoring redox homeostasis via antioxidants or NOX4 inactivation as well as by enhancing NO signaling via activation of soluble guanylyl cyclases or inhibition of phosphodiesterases can inhibit and reverse myofibroblast differentiation. Thus, dysregulated redox signaling represents a potential therapeutic target for the treatment of wide variety of different degenerative fibrotic disorders.

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

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

  5. Neurophysiological evaluation of patients with degenerative diseases of the cervical spine

    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.

  6. Chemical pathology of homocysteine. V. Thioretinamide, thioretinaco, and cystathionine synthase function in degenerative diseases.

    McCully, Kilmer S

    2011-01-01

    Hyperhomocysteinemia was first associated with degenerative disease by observation of accelerated arteriosclerosis in children with inherited disorders of cystathionine synthase, methionine synthase, and methylene tetrohydrofolate reductase. The metabolic blockade of sulfate synthesis from homocysteine thiolactone in malignant cells is ascribed to a deficiency of a chemopreventive derivative of homocysteine thiolactone that occurs in normal cells. Its chemical structure was elucidated by the organic synthesis of thioretinamide from retinoic acid and homocysteine thiolactone. Oxidation of the sulfur atom of homocysteine is inhibited in scorbutic guinea pigs, demonstrating ascorbate function in sulfate synthesis from homocysteine. Studies of homocysteine metabolism in protein energy malnutrition led to the conclusion that the biosynthesis of thioretinamide from the retinol of transthyretin is catalyzed by dehydroascorbate and superoxide generated from the heme oxygenase group of cystathionine synthase. Newly synthesized thioretinamide is complexed with cobalamin to form thioretinaco, which is activated by ozone and oxygen to function as the active site of oxidative phosphorylation. In accordance with the trophoblastic theory of cancer, pancreatic enzymes are believed to be oncolytic because they hydrolyze the homocysteinylated proteins, nucleic acids and glycosaminoglycans of malignant tissues. The clonal selection of malignant cells that are deficient in the heme oxygenase function of cystathionine synthase produces cells dependent upon glycolysis for ATP synthesis, since they are deficient in synthesis of thioretinamide, thioretinaco and thioretinaco ozonide. The vulnerable plaque of arteriosclerosis originates from complexes of microbes with homocysteinylated lipoproteins, obstructing vasa vasorum narrowed by endothelial dysfunction, causing arterial ischemia, and intimal micro-abscesses. Degenerative diseases may be ameliorated by a proposed therapeutic protocol

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

    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. PMID:27190462

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

    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

    2016-01-01

    [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. PMID:27190462

  9. Lumbosacral transitional vertebrae, canine hip dysplasia, and sacroiliac joint degenerative changes on ventrodorsal radiographs of the pelvis in police working German shepherd dogs.

    Komsta, Renata; Łojszczyk-Szczepaniak, Anna; Dębiak, Piotr

    2015-03-01

    Lumbosacral transitional vertebrae (LTV) frequently occur in German shepherd dogs. The aim of the study was to evaluate the prevalence and interdependence between LTV and canine hip dysplasia (CHD) as well as sacroiliac joint degenerative changes visualized on ventrodorsal radiographs of the pelvis in both working and companion German shepherd dogs. The presence of LTV was found in 12% of working dogs and in 33% of companion dogs. Similar incidence of hip dysplasia in both the groups was found. It has been shown that dogs with LTV have a higher frequency of severe CHD. A higher percentage of sacroiliac joint degenerative changes was observed in dogs with no signs of LTV and in working dogs. PMID:26041591

  10. 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.

    Demissew S Mern

    Full Text Available 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

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

    Jacobs, W.; Willems, P.C.P.H.; Kruyt, M.; Limbeek, J. van; Anderson, P.G.; Pavlov, P.; Bartels, R.H.M.A.; Oner, C.

    2011-01-01

    STUDY DESIGN: A systematic review of randomized controlled trials. OBJECTIVE: To determine which technique of anterior cervical interbody fusion (ACIF) gives the best outcome in patients with cervical degenerative disc disease. SUMMARY OF BACKGROUND DATA: The number of surgical techniques for decomp

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

    Luciano Miller Reis Rodrigues

    2011-01-01

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

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

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

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

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

  15. Radiographic evaluation of the use of transverse traction device in vertebral arthrodesis for degenerative diseases

    Edgar Takao Utino

    2014-03-01

    Full Text Available OBJECTIVE: Perform radiographic analysis of the use of Transverse Traction Device (DTT with respect to fusion rate in patients submitted to vertebral arthrodesis for degenerative lumbar diseases. METHODS: We selected x-ray images on anteroposterior, lateral and oblique views and with maximum flexion and extension dynamics of 23 patients submitted to posterolateral arthrodesis of the lumbar spine with a minimum follow-up period of six months. The images were evaluated and classified by the Linovitz's system by two spine surgeons. RESULTS: We evaluated the radiographs of 23 patients after the minimum postoperative period of 6 months and of these, 11 have used DTT. With regard to the consolidation rate, seven patients (63.6% in the group of DTT were classified as fusion as well as six patients (50% who were not submitted to the treatment. There was no statistical difference between the groups regarding the consolidation rate. CONCLUSION: The use of transverse traction device in this study showed no significant difference in the rate of consolidation in radiographic evaluation. Studies on the effective participation of this device in the stability of pedicle fixation systems are still lacking in the literature.

  16. Amyloid β accumulation and inner retinal degenerative changes in Alzheimer's disease transgenic mouse.

    Gupta, Vivek K; Chitranshi, Nitin; Gupta, Veer B; Golzan, Mojtaba; Dheer, Yogita; Wall, Roshana Vander; Georgevsky, Dana; King, Anna E; Vickers, James C; Chung, Roger; Graham, Stuart

    2016-06-01

    The APP-PS1ΔE9 mouse model of Alzheimer's disease (AD) exhibits age dependent amyloid β (Aβ) plaque formation in their central nervous system due to high expression of mutated human APP and PSEN1 transgenes. Here we evaluated Aβ deposition and changes in soluble Aβ accumulation in the retinas of aged APP-PS1 mice using a combination of immunofluorescence, retinal flat mounts and western blotting techniques. Aβ accumulation in the retina has previously been shown to be associated with retinal ganglion cell apoptosis in animal models of glaucoma. This study investigated changes in the inner retinal function and structure in APP-PS1 mice using electrophysiology and histological approaches respectively. We report for the first time a significant decline in scotopic threshold response (STR) amplitudes which represents inner retinal function in transgenic animals compared to the wild type counterparts (p<0.0001). Thinning of the retina particularly involving inner retinal layers and reduction in axonal density in the optic nerve was also observed. TUNEL staining was performed to examine neuronal apoptosis in the inner retina. Intraocular pressure (IOP) measurements showed that APP-PS1ΔE9 mice had a slightly elevated IOP, but the significance of this finding is not yet known. Together, these results substantiate previous observations and highlight that APP-PS1ΔE9 mice show evidence of molecular, functional and morphological degenerative changes in the inner retina. PMID:27133194

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

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

    1988-05-01

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

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

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

  19. Degenerative alterations in noradrenergic neurons of the locus coeruleus in Alzheimer’s disease****

    Lihua Liu; Saiping Luo; Leping Zeng; Weihong Wang; Liming Yuan; Xiaohong Jian

    2013-01-01

    Mice carrying mutant amyloid-β precursor protein and presenilin-1 genes (APP/PS1 double trans-genic mice) have frequently been used in studies of Alzheimer’s disease; however, such studies have focused mainly on hippocampal and cortical changes. The severity of Alzheimer’s disease is known to correlate with the amount of amyloid-βprotein deposition and the number of dead neurons in the locus coeruleus. In the present study, we assigned APP/PS1 double transgenic mice to two groups according to age: young mice (5–6 months old) and aged mice (16–17 months old). Age-matched wild-type mice were used as controls. Immunohistochemistry for tyrosine hydroxylase (a marker of catecholaminergic neurons in the locus coeruleus) revealed that APP/PS1 mice had 23%fewer cel s in the locus coeruleus compared with aged wild-type mice. APP/PS1 mice also had increased numbers of cel bodies of neurons positive for tyrosine hydroxylase, but fewer tyrosine hydroxylase-positive fibers, which were also short, thick and broken. Quantitative analysis using unbiased stereology showed a significant age-related increase in the mean volume of tyrosine hy-droxylase-positive neurons in aged APP/PS1 mice compared with young APP/PS1 mice. Moreover, the mean volume of tyrosine hydroxylase-positive neurons was positively correlated with the total volume of the locus coeruleus. These findings indicate that noradrenergic neurons and fibers in the locus coeruleus are predisposed to degenerative alterations in APP/PS1 double transgenic mice.

  20. Controversies about Interspinous Process Devices in the Treatment of Degenerative Lumbar Spine Diseases: Past, Present, and Future

    Roberto Gazzeri

    2014-01-01

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

  1. Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

    Oh, Hyeong-Seok; Shim, Chan Shik; Kim, Jin-Sung; Lee, Sang-Ho

    2013-01-01

    Objective This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with ...

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

    Jeng, Chin-Ming; Cheng, Tzu-Chieh; Kung, Ching-Huei; Hsu, Hue-Chen

    2010-01-01

    The objective of the current study was to find out whether yoga practice was beneficial to the spine by comparing degenerative disc disease in the spines of long-time yoga practitioners and non-yoga practicing controls, using an objective measurement tool, magnetic resonance imaging. This matched case–control study comprised 18 yoga instructors with teaching experience of more than 10 years and 18 non-yoga practicing asymptomatic individuals randomly selected from a health checkup database. A...

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

    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.)

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

    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.)

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

    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.

  6. Occupational diseases of skeleton and bone joints

    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

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

    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)

  8. 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

    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

  9. Joint disease in children of Asiatic origin

    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

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

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

  11. Quantitative magnetic resonance imaging and studies of degenerative diseases of the developing human brain

    The Rett syndrome is a progressive disorder which is associated with regression of psychomotor development and precipitous deceleration of brain growth during the first year of life. General histopathological surveys in postmortem specimens have identified degeneration of subpopulations of neurons of the nigrostriatal system but no other evidence of degenerative process. Magnetic resonance imaging-based morphometry may usefully guide application of rigorous but demanding quantitative histologic search for evidence of neuronal degeneration. The volumes of the principal set of cortical and nuclear structures of principal interest in the disorder may be measured by currently avaiable MRI-based methods. Opimized levels of precision now allow detection of volumetric changes over time in the same brain of approximately 10% at the 95% confidence level. (author)

  12. Quantitative magnetic resonance imaging and studies of degenerative diseases of the developing human brain

    Caviness, V.S. Jr. (Massachusetts General Hospital, Boston, MA (United States)); Phil, D.; Filipek, P.A.; Kennedy, D.N.

    1992-05-01

    The Rett syndrome is a progressive disorder which is associated with regression of psychomotor development and precipitous deceleration of brain growth during the first year of life. General histopathological surveys in postmortem specimens have identified degeneration of subpopulations of neurons of the nigrostriatal system but no other evidence of degenerative process. Magnetic resonance imaging-based morphometry may usefully guide application of rigorous but demanding quantitative histologic search for evidence of neuronal degeneration. The volumes of the principal set of cortical and nuclear structures of principal interest in the disorder may be measured by currently avaiable MRI-based methods. Opimized levels of precision now allow detection of volumetric changes over time in the same brain of approximately 10% at the 95% confidence level. (author).

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

    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

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

    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.

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

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

  16. Degenerative disorders of the spine

    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.)

  17. Degenerative disorders of the spine

    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.)

  18. The degenerative cervical spine.

    Llopis, E; Belloch, E; León, J P; Higueras, V; Piquer, J

    2016-04-01

    Imaging techniques provide excellent anatomical images of the cervical spine. The choice to use one technique or another will depend on the clinical scenario and on the treatment options. Plain-film X-rays continue to be fundamental, because they make it possible to evaluate the alignment and bone changes; they are also useful for follow-up after treatment. The better contrast resolution provided by magnetic resonance imaging makes it possible to evaluate the soft tissues, including the intervertebral discs, ligaments, bone marrow, and spinal cord. The role of computed tomography in the study of degenerative disease has changed in recent years owing to its great spatial resolution and its capacity to depict osseous components. In this article, we will review the anatomy and biomechanical characteristics of the cervical spine, and then we provide a more detailed discussion of the degenerative diseases that can affect the cervical spine and their clinical management. PMID:26878769

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

    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

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

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

  1. Idiopathic REM sleep behavior disorder in the transition to degenerative disease.

    Postuma, Ronald B; Gagnon, Jean-Francois; Vendette, Melanie; Montplaisir, Jacques Y

    2009-11-15

    Idiopathic REM sleep behavior disorder (RBD) predicts Parkinson's disease (PD) and dementia. However, the nature of the disease that emerges from RBD has not been fully characterized. Since 2004, we have been conducting a prospective study of idiopathic RBD patients, providing an opportunity to directly observe patients as they transitioned to a defined neurodegenerative syndrome. Patients with idiopathic RBD underwent an extensive annual evaluation of motor function, olfaction, color vision, autonomic function, cognition and psychiatric symptoms. Neurodegenerative disease was defined according to standard criteria. We compared these measures in patients who had developed PD to those with dementia, all within the first year of developing disease. Of 67 patients, 6 developed PD and eleven developed dementia. Except for cognitive functioning, all tests of olfaction, color vision, autonomic function, depression, and quantitative measures of motor speed were similar in patients with PD and dementia. Of dementia patients, seven met criteria for probable Lewy body dementia (LBD) and four for Alzheimer's disease (or, possible LBD). In all probable LBD cases, the diagnosis was made because of parkinsonism, with no patient experiencing hallucinations or fluctuations. Patients with "Alzheimer's disease" seemed to have LBD, as they demonstrated typical LBD cognitive profiles on neuropsychological testing and were indistinguishable from LBD patients in ancillary measures. Therefore, among RBD patients with new-onset LBD, hallucinations or fluctuations are absent, suggesting that RBD is a reliable early sign of LBD. The indistinguishability of dementia and PD in all ancillary measures suggests a single unitary "RBD-then-neurodegeneration" process, the clinical presentation of which depends upon selective neuronal vulnerability. PMID:19768814

  2. Huntington disease: a single-gene degenerative disorder of the striatum

    Nopoulos, Peggy C.

    2016-01-01

    Huntington disease (HD) is an autosomal dominant, neurodegenerative disorder with a primary etiology of striatal pathology. The Huntingtin gene (HTT) has a unique feature of a DNA trinucleotide (triplet) repeat, with repeat length ranging from 10 to 35 in the normal population. Repeat lengths between 36 and 39 cause HD at reduced penetrance (some will get the disease, others won't) and when expanded to 40 or more repeats (mHTT), causes HD at full penetrance (every person with this length or beyond will definitely develop the disease). The symptoms of HD may be motor, cognitive, and psychiatric, and are consistent with the pathophysiology of frontostriatal circuitry malfunction. Expressed ubiquitously and throughout the entire life cycle (development through adulthood), mHTT causes initial dysfunction and eventual death of a specific cell population within the striatum. Although all areas of the brain are eventually affected, the primary pathology of the disease is regionally specific. As a single-gene disorder, HD has the distinction of having the potential of treatment that is aimed directly at the known pathogenic mechanism by gene silencing, providing hope for neuroprotection and ultimately, prevention. PMID:27069383

  3. 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

    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.

  4. Estrogen’s action on cognitive function, memory processes, neuro- degenerative diseases: A Review.

    Robel Abay

    2015-01-01

    Estrogen has an effect on cognitive enhancing and neuroprotection and in the incidence progress and manifestations of most of central nervous system disorders, including neurodegenerative disease. Estrogen effects on cognition depend on the cognitive task and its dependent brain regions. In hippocampus estrogen induces increased numbers of synapses on multiple synaptic boutons between neurons not previously connected. There are fundamental differences between men and women in the underlying p...

  5. National Trends in Outpatient Surgical Treatment of Degenerative Cervical Spine Disease

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

    2014-01-01

    Study Design Retrospective population-based observational study. Objective To assess the growth of cervical spine surgery performed in an outpatient setting. Methods A retrospective study was conducted using the United States Healthcare Cost and Utilization Project's State Inpatient and Ambulatory Surgery Databases for California, New York, Florida, and Maryland from 2005 to 2009. Current Procedural Terminology, fourth revision (CPT-4) and International Classification of Diseases, ninth revis...

  6. Assistive technology in occupational therapy practice with a child with degenerative disease of the central nervous system

    Tácia Caroline de Lima Rodrigues

    2015-07-01

    Full Text Available This paper aims to report the effects of the interventions, using the resource of assistive technology, carried out with a child with degenerative disease of the central nervous system at his home. This is a study case, which was conducted in seven meetings, addressing the child and his caregivers during a process of evaluation, preparation of assistive devices, family orientation, and evaluation of the family environment repercussion. The results showed that the child presents significant motor, cognitive, and psychosocial impairments, resulting in difficulties in performing activities of daily living, communication, and play. Adjustments were proposed to facilitate the child’s involvement and alleviate family difficulties on equipment and environments, such as wheelchair, bedroom, bathroom, orthosis, toys and communication. Finally, it was possible to note that the assistive technology resources were used according to the child’s needs and his own reality, and that the domiciliary visits contributed positively to the family’s life because they facilitated the child’s care, despite the limitations faced.

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

    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.)

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

    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.

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

    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

  10. Estrogen’s action on cognitive function, memory processes, neuro- degenerative diseases: A Review.

    Robel Abay

    2015-12-01

    Full Text Available Estrogen has an effect on cognitive enhancing and neuroprotection and in the incidence progress and manifestations of most of central nervous system disorders, including neurodegenerative disease. Estrogen effects on cognition depend on the cognitive task and its dependent brain regions. In hippocampus estrogen induces increased numbers of synapses on multiple synaptic boutons between neurons not previously connected. There are fundamental differences between men and women in the underlying pathophysiology, incidence, manifestation, severity, and/or progression of CNS disorders such as PD, schizophrenia, attention deficit/hyperactivity disorder, and autism.

  11. A combination of two diseases of the knee joint

    Status of the problem of joint and diagnosis of this disease are discussed. A case of biomedical radiography of knee joint of 72 y.o. man is described. The correct diagnosis was stated using routine biomedical radiography

  12. Neurochemical imaging of Alzheimer`s disease and other degenerative dementias

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

    1998-09-01

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

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

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

    2006-06-15

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

  14. Vegetables as a Source of Dietary Fiber to Prevent Degenerative Diseases

    Deddy Muchtadi

    2001-04-01

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

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

    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)

  16. Radiographic Results of Single Level Transforaminal Lumbar Interbody Fusion in Degenerative Lumbar Spine Disease: Focusing on Changes of Segmental Lordosis in Fusion Segment

    Kim, Sang-Bum; Jeon, Taek-Soo; Heo, Youn-Moo; Lee, Woo-Suk; Yi, Jin-Woong; Kim, Tae-kyun; Hwang, Cheol-Mog

    2009-01-01

    Background To assess the radiographic results in patients who underwent transforaminal lumbar interbody fusion (TLIF), particularly the changes in segmental lordosis in the fusion segment, whole lumbar lordosis and disc height. Methods Twenty six cases of single-level TLIF in degenerative lumbar diseases were analyzed. The changes in segmental lordosis, whole lumbar lordosis, and disc height were evaluated before surgery, after surgery and at the final follow-up. Results The segmental lordosi...

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

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

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

    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

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

    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.

  20. Analytical comparison study of the clinical and radiological outcome of spine fixation using posterolateral, posterior lumber interbody and transforaminal lumber interbody spinal fixation techniques to treat lumber spine degenerative disc disease

    Al Barbarawi, Moh’d M; Audat, Ziad M; Mohammed Z. Allouh

    2015-01-01

    Background Degenerative disc disease is a common cause of chronic and disabling back pain that requires surgical intervention, posterolateral and posterior instrumental fixation (PLF), posterior lumber interbody fusion (PLIF) and transforaminal lumber interbody fusion (TLIF) are the techniques used to deal with such a problem. Objective To compare the clinical and radiological outcome of the variable surgical techniques used to deal with Lumber degenerative disc disease and to recommend the t...

  1. Structural Studies on Acetylcholinesterase and Paraoxonase Directed Towards Development of Therapeutic Biomolecules for the Treatment of Degenerative Diseases and Protection Against Chemical Threat Agents

    Sussman, Joel L.; Silman, Israel

    Acetylcholinesterase and paraoxonase are important targets for treatment of degenerative diseases, Alzheimer's disease and atherosclerosis, respectively, both of which impose major burdens on the health care systems in Western society. Acetylcholinesterase is the target of lethal nerve agents, and paraoxonase is under consideration as a bioscavenger for their detoxification. Both are thus the subject of research and development in the context of nerve agent toxicology. The crystal structures of the two enzymes are described, and structure/function relationships are discussed in the context of drug development and of development of means of protection against chemical threats.

  2. Clinical and radiologic comparison of dynamic cervical implant arthroplasty versus anterior cervical discectomy and fusion for the treatment of cervical degenerative disc disease.

    Li, Zhonghai; Yu, Shunzhi; Zhao, Yantao; Hou, Shuxun; Fu, Qiang; Li, Fengning; Hou, Tiesheng; Zhong, Hongbin

    2014-06-01

    This study compared the clinical and radiological outcomes of dynamic cervical implant (DCI; Scient'x, Villers-Bretonneux, France) arthroplasty versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease. This prospective cohort study enrolled patients with single-level cervical degenerative disc disease who underwent DCI arthroplasty or ACDF between September 2009 and June 2011. Patients were followed up for more than 2years. Clinical evaluation included the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36), Neck Disability Index (NDI), Japan Orthopedic Association (JOA) score, and visual analog scale (VAS) scores for neck and arm pain. Radiological assessments included segmental range of motion (ROM), overall ROM (C2-C7), disc height (DHI), and changes in adjacent disc spaces. The VAS, SF-36, JOA, and NDI scores improved significantly after surgery in both the DCI and ACDF groups. The VAS, JOA, and SF-36 scores were not significantly different between the DCI and ACDF groups at the final follow-up. The segmental ROM at the treated level and overall ROM increased significantly after surgery in the DCI group, but the ROM in the adjacent cephalad and caudal segments did not change significantly. The mean DHI at the treated level was significantly restored after surgery in both groups. Five patients (12.8%) in the DCI group showed new signs of adjacent segment degeneration. These results indicate that DCI is an effective, reliable, and safe procedure for the treatment of cervical degenerative disc disease. However, there is no definitive evidence that DCI arthroplasty has better intermediate-term results than ACDF. PMID:24411326

  3. Early results and review of the literature of a novel hybrid surgical technique combining cervical arthrodesis and disc arthroplasty for treating multilevel degenerative disc disease: opposite or complementary techniques?

    Barbagallo, Giuseppe M. V.; Assietti, Roberto; Corbino, Leonardo; Olindo, Giuseppe; Foti, Pietro V.; Russo, Vittorio; Albanese, Vincenzo

    2009-01-01

    We report the clinical and radiological results on the safety and efficacy of an unusual surgical strategy coupling anterior cervical discectomy and fusion and total disc replacement in a single-stage procedure, in patients with symptomatic, multilevel cervical degenerative disc disease (DDD). The proposed hybrid, single-stage, fusion–nonfusion technique aims either at restoring or maintaining motion where appropriate or favouring bony fusion when indicated by degenerative changes. Twenty-fou...

  4. Effects of age, replicative lifespan and growth rate of human nucleus pulposus cells on selecting age range for cell-based biological therapies for degenerative disc diseases.

    Lee, J S; Lee, S M; Jeong, S W; Sung, Y G; Lee, J H; Kim, K W

    2016-07-01

    Autologous disc cell implantation, growth factors and gene therapy appear to be promising therapies for disc regeneration. Unfortunately, the replicative lifespan and growth kinetics of human nucleus pulposus (NP) cells related to host age are unclear. We investigated the potential relations among age, replicative lifespan and growth rate of NP cells, and determined the age range that is suitable for cell-based biological therapies for degenerative disc diseases. We used NP tissues classified by decade into five age groups: 30s, 40s, 50s, 60s and 70s. The mean cumulative population doubling level (PDL) and population doubling rate (PDR) of NP cells were assessed by decade. We also investigated correlations between cumulative PDL and age, and between PDR and age. The mean cumulative PDL and PDR decreased significantly in patients in their 60s. The mean cumulative PDL and PDR in the younger groups (30s, 40s and 50s) were significantly higher than those in the older groups (60s and 70s). There also were significant negative correlations between cumulative PDL and age, and between PDR and age. We found that the replicative lifespan and growth rate of human NP cells decreased with age. The replicative potential of NP cells decreased significantly in patients 60 years old and older. Young individuals less than 60 years old may be suitable candidates for NP cell-based biological therapies for treating degenerative disc diseases. PMID:27149303

  5. Scintigraphy in evaluating avascular joint disease and joint prostheses

    Interruption of blood flow to the femoral head may occur as a result of trauma, medications, underlying small vessel disease or as an idiopathic process of unclear etiology. Tetracycline fluorescence of bone tissue specimens is a well-established method of determining relative bone blood flow but is poorly suited as a noninvasive or preoperative procedure. sup(99m)Tc sulfur colloid has also been used to demonstrate femoral head reticuloendothelial elements and thereby indirectly establish the presence or absence of blood supply, however, this method lacks specificity. It has been documented that 18F and, to a great extent, sup(99m)Tc phosphate compounds localize in bone as a direct function of bone blood flow. Since the radiation dose associated with sup(99m)Tc phosphates is modest and excellent images with fine detail can be obtained using the Anger camera and pinhole collimator, this technique has become the method of choice for noninvasive evaluation of vascularity of the femoral head. Specific clinical applications are presented in this chapter. (Auth.)

  6. New aspects of radionuclide therapy of bone and joint diseases

    Whereas in developing countries P-32 is widely used for radionuclide therapy of painful bone metastases, in Europe three radionuclides or radiopharmaceutical agents are available for pain palliation: Sr-89, Sm-153-EDTMP, and Re-186-HEDP. Radionuclide therapy for pain palliation is indicated for bone pain due to metastatic malignancy that has involved multiple skeletal sites and has evoked an osteoblastic response on bone scintigraphy. Response rates of about 70-80% in patients with breast or prostate cancer is reported in the literature, less in metastatic lesions of other primary malignancies. Sm-153-EDTMP may also be used for curative treatment of primary bone tumours or their metastases. Radiosynovectomy as therapeutic procedure or rheumatoid arthritis, other inflammatory joint diseases, persistent synovial perfusion, and other joint diseases is widely used. Using Y-90 for the knee joint, Re-186 for middle sized joints, and Er-169 for small joints an improvement of symptoms may be observed in about 70-80%. (author)

  7. Treatment of Nongout Joint Deposition Diseases: An Update

    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.

  8. Treatment of nongout joint deposition diseases: an update.

    Pascart, Tristan; Richette, Pascal; Flipo, René-Marc

    2014-01-01

    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. PMID:24895535

  9. Treatment of Nongout Joint Deposition Diseases: An Update

    Tristan Pascart; Pascal Richette; René-Marc Flipo

    2014-01-01

    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...

  10. [Concomitant diseases in primary joint hypermobility syndrome].

    Skoumal, Martin; Haberhauer, Günther; Mayr, Hans

    2004-10-15

    The primary joint hypermobility syndrome (pJH) is an overlap disorder of connective-tissue dysplasias, which incorporates features seen in the Marfan syndromes (MFS), Ehlers-Danlos syndromes (EDS), and osteogenesis imperfecta. Patients with pJH usually present arthralgia, back pain, soft-tissue lesions, recurrent joint dislocation, or subluxation. Extraarticular features may include, e. g., striae cutis, keratoconus, easy bruising, mitral valve prolapse, aortic incompetence, aneurysms, pneumothorax, hernia, urinary incontinence, and pelvic floor prolapse. Due to the high frequency of critical dissection and rupture, the early recognition of rare life-threatening complications such as dilatation of the aortic root and aneurysms is important. Therefore, patients (and their family members) with pJH should also be examined for life-threatening features seen in MFS and EDS. PMID:15490074

  11. Joint hypermobility: emerging disease or illness behaviour?

    Grahame, Rodney

    2013-12-01

    Joint hypermobility syndrome is a common clinical entity which is much misunderstood, overlooked, misdiagnosed and mistreated. It was first described in the 1960s as a purely musculoskeletal condition due to joint laxity and hypermobility occurring in otherwise healthy individuals. Some four decades later it is now perceived to be a multi-systemic heritable disorder of connective tissue with manifestations occurring far beyond the confines of the locomotor system and with ramifications potentially affecting most, if not all, of the bodily systems in one way or another. Most authorities in the field find it clinically indistinguishable from the Ehlers-Danlos syndrome--hypermobility type (formerly, EDS type III). In >50% of patients the diagnosis is delayed for ≥10 years. Failure to diagnose and treat the condition correctly results in needless pain and suffering and in many patients to a progressive decline in their quality of life and in some to a loss of independence. PMID:24298184

  12. Joint diseases in animal paleopathology: Veterinary approach

    Oliver Stevanović,; Maciej Janeczek,; Aleksander Chrószcz; Nemanja Marković

    2015-01-01

    Animal paleopathology is not a very well known scientific discipline within veterinary science, but it has great importance for historical and archaeological investigations. In this paper, authors attention is focused on the description of one of the most common findings on the skeletal remains of animals - osteoarthropathies. This review particularly emphasizes the description and classification of the most common pathological changes in synovial joints. The authors have provided their obser...

  13. Degenerative intraspinal cyst of the cervical spine

    Hidetoshi Nojiri

    2009-08-01

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

  14. [Ultrasonographic examination of the stifle joint in the dog. Part 2: Impaired wound healing and neoplastic, congenital, developmental, degenerative and traumatic disorders].

    Nayseh, K; Kramer, M; Ondreka, N

    2015-01-01

    Ultrasonography is a cost-effective, non-invasive technique, which can be performed in conscious dogs. It frequently contributes valuable and even crucial diagnostic information in patients with lameness attributed to the stifle joint. Within the first part of this article, technical requirements and limitations as well as the standardized scanning protocol and ultrasonographic anatomy of the stifle joint are described. Additionally, ultrasonographic features of common pathologies of the stifle joint, including cranial cruciate ligament rupture and meniscal pathologies, are discussed. The second part of the article focuses on the ultrasonographic approach to other, less common pathologies of the canine stifle joint, including impaired wound healing and congenital, neoplastic, developmental and traumatic disorders. PMID:25966794

  15. Novel information on the non-neuronal cholinergic system in orthopedics provides new possible treatment strategies for inflammatory and degenerative diseases

    Sture Forsgren

    2009-07-01

    Full Text Available Anti-cholinergic agents are used in the treatment of several pathological conditions. Therapy regimens aimed at up-regulating cholinergic functions, such as treatment with acetylcholinesterase inhibitors, are also currently prescribed. It is now known that not only is there a neuronal cholinergic system but also a non-neuronal cholinergic system in various parts of the body. Therefore, interference with the effects of acetylcholine (ACh brought about by the local production and release of ACh should also be considered. Locally produced ACh may have proliferative, angiogenic, wound-healing, and immunomodulatory functions. Interestingly, cholinergic stimulation may lead to anti-inflammatory effects. Within this review, new findings for the locomotor system of a more widespread non-neuronal cholinergic system than previously expected will be discussed in relation to possible new treatment strategies. The conditions discussed are painful and degenerative tendon disease (tendinopathy/tendinosis, rheumatoid arthritis, and osteoarthritis.

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

    Kido, Kenji

    1988-03-01

    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/sup 2/ of the dural canal, there was no morphological change between the LCS and OA groups. In the symptomatic mechanism in the case of LCS, morphological dynamic and unstable factors may be involved. (Namekawa, K.) 67 refs.

  17. Combined transforaminal lumbar interbody fusion with posterolateral instrumented fusion for degenerative disc disease can be a safe and effective treatment for lower back pain

    Ara J Deukmedjian

    2015-01-01

    Full Text Available Background: Lumbar fusion is a proven treatment for chronic lower back pain (LBP in the setting of symptomatic spondylolisthesis and degenerative scoliosis; however, fusion is controversial when the primary diagnosis is degenerative disc disease (DDD. Our objective was to evaluate the safety and effectiveness of lumbar fusion in the treatment of LBP due to DDD. Materials and Methods: Two-hundred and five consecutive patients with single or multi-level DDD underwent lumbar decompression and instrumented fusion for the treatment of chronic LBP between the years of 2008 and 2011. The primary outcome measures in this study were back and leg pain visual analogue scale (VAS, patient reported % resolution of preoperative back pain and leg pain, reoperation rate, perioperative complications, blood loss and hospital length of stay (LOS. Results: The average resolution of preoperative back pain per patient was 84% (n = 205 while the average resolution of preoperative leg pain was 90% (n = 190 while a mean follow-up period of 528 days (1.5 years. Average VAS for combined back and leg pain significantly improved from a preoperative value of 9.0 to a postoperative value of 1.1 (P ≤ 0.0001, a change of 7.9 points for the cohort. The average number of lumbar disc levels fused per patient was 2.3 (range 1-4. Median postoperative LOS in the hospital was 1.2 days. Average blood loss was 108 ml perfused level. Complications occurred in 5% of patients (n = 11 and the rate of reoperation for symptomatic adjacent segment disease was 2% (n = 4. Complications included reoperation at index level for symptomatic pseudoarthrosis with hardware failure (n = 3; surgical site infection (n = 7; repair of cerebrospinal fluid leak (n = 1, and one patient death at home 3 days after discharge. Conclusion: Lumbar fusion for symptomatic DDD can be a safe and effective treatment for medically refractory LBP with or without leg pain.

  18. Sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life in patients with lumbar degenerative disc disease.

    Gautschi, Oliver P; Corniola, Marco V; Smoll, Nicolas R; Joswig, Holger; Schaller, Karl; Hildebrandt, Gerhard; Stienen, Martin N

    2016-05-01

    Sex differences in pain perception are known to exist; however, the exact pathomechanism remains unclear. This work aims to elucidate sex differences in subjective and objective measures of pain, functional impairment, and health-related quality of life (HRQoL) in patients with lumbar degenerative disc disease. In a prospective 2-center study, back and leg pain (visual analogue scale [VAS]), functional disability (Oswestry Disability Index and Roland-Morris Disability Index), and HRQoL (EuroQol-5D and Short Form [SF12]) were collected for consecutive patients undergoing lumbar spine surgery. Objective functional impairment (OFI) was estimated using age-adjusted and sex-adjusted cutoff values for the timed-up-and-go (TUG) test. A healthy cohort of n = 110 subjects served as the control group. Univariate and multivariate analyses were performed to test the association between sex and pain, subjective and OFIs, and HRQoL. The study comprised n = 305 patients (41.6% females). Female patients had more VAS back pain (P = 0.002) and leg pain (P = 0.014). They were more likely to report higher functional impairment in terms of Oswestry Disability Index (P = 0.005). Similarly, HRQoL measured with the EuroQol-5D index (P = 0.012) and SF12 physical composite score (P = 0.005) was lower in female patients. Female patients reported higher VAS back and leg pain, functional impairment, and reduced HRQoL than male patients. However, there were no sex differences with respect to the presence and degree of OFI measured by the TUG test using age-adjusted and sex-adjusted cutoff values. As such, the TUG may be a good test to overcome sex bias for the clinical assessment of patients with degenerative disc disease. PMID:26761383

  19. Nise (Nimesulide) in treatment nf joint diseases

    N. V. Cliichasova; G. R. Imametdinova

    2004-01-01

    Selectivity of nonsteroidal anti-inflammatory drugs (NSAID) and connected with it treatment adverse events are discussed. Effecacy, tolerability and problem of a selective NSAID nise (nimesulid) optimal dose selection in inflammatory and non inflammatory rheumatic diseases are considered.

  20. Amyloid ß-derived switch-peptides as tool to study conformational changes relevant in degenerative diseases

    Camus, Marie-Stéphanie; Mutter, Manfred

    2008-01-01

    The rapid growing number of patients diagnosed with a neurodegenerative disease and more particularly with Alzheimer's disease (AD) has stimulated intensive research in determining and understanding biological phenomena causing such devastating diseases and hence allowing for the elaboration of adapted therapeutic treatments. These diseases are also commonly called "conformational" diseases because they result from the misfolding of a protein leading to the formation of self-associated β-shee...

  1. Can combined use of low-level lasers and hyaluronic acid injections prolong the longevity of degenerative knee joints?

    Ip D

    2015-08-01

    Full Text Available David Ip, Nga Yue FuAsia Medical Pain Centre, Grand Plaza, Mong Kok, Hong KongBackground: This study evaluated whether half-yearly hyaluronic acid injection together with low-level laser therapy in addition to standard conventional physical therapy can successfully postpone the need for joint replacement surgery in elderly patients with bilateral symptomatic tricompartmental knee arthritis.Methods: In this prospective, double-blind, placebo-controlled study, 70 consecutive unselected elderly patients with bilateral tricompartmental knee arthritis were assigned at random to either one of two conservative treatment protocols to either one of the painful knees. Protocol A consisted of conventional physical therapy plus a sham light source plus saline injection, and protocol B consisted of protocol A with addition of half-yearly hyaluronic acid injection as well as low-level laser treatment instead of using saline and a sham light source. Treatment failure was defined as breakthrough pain necessitating joint replacement.Results: Among the 140 painful knees treated with either protocol A or protocol B, only one of the 70 painful knees treated by protocol B required joint replacement, whereas 15 of the 70 painful knees treated by protocol A needed joint replacement surgery (P<0.05.Conclusion: We conclude that half-yearly hyaluronic acid injections together with low-level laser therapy should be incorporated into the standard conservative treatment protocol for symptomatic knee arthritis, because it may prolong the longevity of the knee joint without the need for joint replacement.Keywords: knee osteoarthritis, hyaluronic acid injection, low-level laser, outcome

  2. Radiotherapy of degenerative joint disorders. Indication, technique and clinical results; Radiotherapie bei schmerzhaften degenerativ-entzuendlichen Gelenkerkrankungen. Indikation, Technik und klinische Ergebnisse

    Keilholz, L.; Sauer, R. [Erlangen-Nuernberg Univ. (Germany). Strahlentherapeutische Klinik und Poliklinik; Seegenschmiedt, M.H. [Erlangen-Nuernberg Univ. (Germany). Strahlentherapeutische Klinik und Poliklinik]|[Alfred-Krupp-Krankenhaus, Essen (Germany). Klinik fuer Strahlentherapie und Radioonkologie

    1998-05-01

    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) [Deutsch] Von 1984 bis 1994 wurden 85 Patienten wegen schmerzhaft arthrotischer Gelenkerkrankungen bestrahlt. 73 Patienten (103

  3. Temporomandibular joint dysfunction in various rheumatic diseases.

    Aceves-Avila, F J; Chávez-López, M; Chavira-González, J R; Ramos-Remus, C

    2013-01-01

    Temporomandibular disorder (TMD) is an inclusive term in which those conditions disturbing the masticatory function are embraced. It has been estimated that 33% of the population have signs of TMD, but less than 5% of the population will require treatment. The objective of this study was to measure the frequency of TMD in rheumatoid arthritis (RA), osteoarthrosis (OA), ankylosing spondylitis (AS) and systemic lupus erythematosus, and to define the limitations in everyday's life that patients perceive when present. A six-month survey of consecutive outpatients in a rheumatology clinic in a teaching hospital in Mexico was carried out. We defined TMD as: 1) the presence of pain; 2) difficulty on mouth opening, chewing or speaking; 3) the presence of non-harmonic movements of the temporomaxilar joints. All three characteristics had to be present. Z test was used to define differences between proportions. We present the results of 171 patients. Overall, 50 patients had TMD according to our operational definition (29.24%). Up to 76% of the sample had symptoms associated with the condition. TMD is more frequent in OA and in AS (29.24% vs 38% OA, P=0.009; 39% AS; P=0.005). We found no association between the severity of TMD and the request for specific attention for the discomfort produced by the condition. Only 8 of 50 (16%) patients with TMD had requested medical help for their symptoms, and they were not the most severe cases. TMD is more frequent in RA and OA. Although it may produce severe impairment, patients seem to adapt easily. PMID:23884028

  4. Temporomandibular joint dysfunction in various rheumatic diseases

    F.J. Aceves-Avila

    2013-07-01

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

  5. Magnetic resonance imaging of peripheral joints in rheumatic diseases

    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...

  6. Angiogenesis in the pathogenesis of inflammatory joint and lung diseases

    Walsh, D. A.; Pearson, C.I.

    2001-01-01

    This paper reviews hypotheses about roles of angiogenesis in the pathogenesis of inflammatory disease in two organs, the synovial joint and the lung. Neovascularisation is a fundamental process for growth and tissue repair after injury. Nevertheless, it may contribute to a variety of chronic inflammatory diseases, including rheumatoid arthritis, osteoarthritis, asthma, and pulmonary fibrosis. Inflammation can promote angiogenesis, and new vessels may enhance tissue inflammation. Angiogenesis ...

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

    Ackerman SJ; Polly Jr DW; Knight T; Holt T; Cummings J

    2014-01-01

    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%–...

  8. Biomechanics of Degenerative Spinal Disorders

    Iorio, Justin A.; Jakoi, Andre M.

    2016-01-01

    The spine has several important functions including load transmission, permission of limited motion, and protection of the spinal cord. The vertebrae form functional spinal units, which represent the smallest segment that has characteristics of the entire spinal column. Discs and paired facet joints within each functional unit form a three-joint complex between which loads are transmitted. Surrounding the spinal motion segment are ligaments, composed of elastin and collagen, and joint capsules which restrict motion to within normal limits. Ligaments have variable strengths and act via different lever arm lengths to contribute to spinal stability. As a consequence of the longer moment arm from the spinous process to the instantaneous axis of rotation, inherently weaker ligaments (interspinous and supraspinous) are able to provide resistance to excessive flexion. Degenerative processes of the spine are a normal result of aging and occur on a spectrum. During the second decade of life, the intervertebral disc demonstrates histologic evidence of nucleus pulposus degradation caused by reduced end plate blood supply. As disc height decreases, the functional unit is capable of an increased range of axial rotation which subjects the posterior facet capsules to greater mechanical loads. A concurrent change in load transmission across the end plates and translation of the instantaneous axis of rotation further increase the degenerative processes at adjacent structures. The behavior of the functional unit is impacted by these processes and is reflected by changes in the stress-strain relationship. Back pain and other clinical symptoms may occur as a result of the biomechanical alterations of degeneration. PMID:27114783

  9. [Musculoskeletal pathology in occupational risks and common degenerative disease: reflections on the intensity and duration of the risk].

    Bergamini, Roberta; Astengo, Rossana

    2014-01-01

    Nowadays, in Italy the reports of mnusculoskeletal diseases increase as confirmed in the last INAIL (national insurance for occupational diseases and injuries) annual report. The Emilia-Ronmagna is one of the region with the highest number of reports: 15.9% of the total in 2012. The decree no. 81/08 has partially simplified the medico-legal activities related to musculoskeletal diseases; however, the medico-legal physicians have still to deal with some issues such as risk assessment quality, economic crisis, and specific work environments (e.g. agriculture and many handicraft activities). Tire risk factors of musculoskeletal diseases and their assessments are quite well studied. The latency period of these diseases needs to be investigated, since it could be a relevant aspect for legal medical judgment, insurance protection and prevention. Based on literature data and INAIL experience, authors propose some considerations useful for a scientific debate. PMID:25558730

  10. Clinical research of surgical treatment of degenerative lumbar spinal stenosis disease%退变性腰椎管狭窄手术治疗的临床研究

    胡祥怀; 高宏斌; 徐宏光

    2011-01-01

    Objective To analyze and summarize surgical indications, operation methods selection and complications of treatment in degenerative lumbar spinal stenosis disease (LSS) . Methods Totally 32 cases with lumbar spinal stenosis merger instability lumbar degenerative spondylolisthesis choose omni -posterior excision, side fossae and intervertebral foramen decompression, vertebral pedicle screw, small joints between vertebral bodies and the poster lateral using bone graft, follow - up and evluat operation effect. Results All cases were followed up for 8 months to 6 years. The results were evaluated in accordance with the standard of Amundsen, which were excellent in 21 cases, good in 8, fair in 3, no difference magnitude cases. Conclusions According to the clinical symptoms, signs and considering its diagnostic imaging and its complications to choose the scope and surgical decompression of bone fusion and (or) inside fixed or not, so as to improve the clinical symptoms, improve their quality of life.%目的 探讨退变性腰椎管狭窄症(ISS)手术指征、手术方式的选择及合并症的处理.方法 对32例腰椎管狭窄合并不稳定性腰椎退变性滑脱选择全椎板切除、侧隐窝及椎间孔减压、椎弓根螺钉固定、椎体间及小关节后外侧植骨术,术后随访,评价手术效果.结果 32例均获随访,时间8个月~6年.采用参照Amundsen评分标准评价术后疗效,优21例,良8例,可3例,无差级病例.结论 根据患者的临床症状、体征及影像学综合考虑其诊断及其合并症来选择手术减压的范围和植骨融合和(或)内固定与否,从而改善临床症状,提高其生活质量.

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

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

  12. Surgical treatment of degenerative lumbar spine diseases in elderly patients%高龄患者腰椎退变性疾病的手术治疗

    苏庆军; 刘铁; 康南; 杨晋才; 藏磊; 孟祥龙; 袁帅; 海涌

    2013-01-01

    Objective To investigate the safety and clinical effects of surgical treatment of degenerative lumbar spine diseases in elderly patients. Methods 42 patients with degenerative lumbar spine diseases who were enrolled from January 2008 to December 2011 selectively underwent surgical treatment, including 6 patients with lumbar disc herniation, 10 patients with lumbar disc herniation and spinal stenosis, 6 patients with degenerative lumbar spondylolisthesis and 20 patients with spinal stenosis. There were 28 males and 14 females, with an average age of 77.2 years old ( range;75-84 years ). They were followed up for a mean period of 31 months ( range;17-64 months ). The preoperative concomitant diseases, postoperative complications and relevant treatment methods were analyzed. The clinical effects were evaluated by the Oswestry Disability Index ( ODI ) and the Visual Analogue Scale ( VAS ). Based on the anteroposterior ( AP ), lateral and dynamic X-ray iflms of the lumbar spine during the follow-up, the lumbar spinal stability, lumbar spinal fusion and implants were observed after the surgery. Results The postoperative complications included 7 cases of increased blood pressure, 1 case of angina, 1 case of cerebral infarction, 4 cases of pulmonary infection and 3 cases of cerebrospinal lfuid leakage. Operational segment instability or internal ifxation failure was not found based on the X-ray films 1 year after the surgery or in the latest follow-up. The ODI was improved from ( 71.1±19.2 )%preoperatively to ( 22.0±11.3 )%postoperatively ( P<0.01 ). The VAS of low back pain was improved from ( 6.0±2.1 ) preoperatively to ( 2.2±1.7 ) postoperatively ( P<0.01 ). The VAS of lower leg pain was improved from ( 7.9±1.7 ) to ( 3.1±2.1 ) ( P<0.01 ). 39 of 42 patients got satisifed results, and the other 3 patients were basically content with the results. Conclusions With the concomitant diseases and postoperative complications actively controlled, elderly patients with

  13. Effect of complications within 90 days on patient-reported outcomes 3 months and 12 months following elective surgery for lumbar degenerative disease.

    Chotai, Silky; Parker, Scott L; Sivaganesan, Ahilan; Sielatycki, J Alex; Asher, Anthony L; McGirt, Matthew J; Devin, Clinton J

    2015-12-01

    OBJECT There is a paradigm shift toward rewarding providers for quality rather than volume. Complications appear to occur at a fairly consistent frequency in large aggregate data sets. Understanding how complications affect long-term patient-reported outcomes (PROs) following degenerative lumbar surgery is vital. The authors hypothesized that 90-day complications would adversely affect long-term PROs. METHODS Nine hundred six consecutive patients undergoing elective surgery for degenerative lumbar disease over a period of 4 years were enrolled into a prospective longitudinal registry. The following PROs were recorded at baseline and 12-month follow-up: Oswestry Disability Index (ODI) score, numeric rating scales for back and leg pain, quality of life (EQ-5D scores), general physical and mental health (SF-12 Physical Component Summary [PCS] and Mental Component Summary [MCS] scores) and responses to the North American Spine Society (NASS) satisfaction questionnaire. Previously published minimum clinically important difference (MCID) threshold were used to define meaningful improvement. Complications were divided into major (surgicalsite infection, hardware failure, new neurological deficit, pulmonary embolism, hematoma and myocardial infarction) and minor (urinary tract infection, pneumonia, and deep venous thrombosis). RESULTS Complications developed within 90 days of surgery in 13% (118) of the patients (major in 12% [108] and minor in 8% [68]). The mean improvement in ODI scores, EQ-5D scores, SF-12 PCS scores, and satisfaction at 3 months after surgery was significantly less in the patients with complications than in those who did not have major complications (ODI: 13.5 ± 21.2 vs 21.7 ± 19, controlling for an array of preoperative variables, the occurrence of a major complication was not associated with worsening ODI scores 12 months after surgery. There was no difference in the percentage of patients achieving the MCID for disability (66% vs 64%), back pain

  14. Oleuropein Aglycone: A Possible Drug against Degenerative Conditions. In Vivo Evidence of its Effectiveness against Alzheimer's Disease

    Casamenti F; Grossi C.; Rigacci S; Pantano D; Luccarini I; Stefani M

    2015-01-01

    The amyloid plaques and neurofibrillary tangles found in the Alzheimer's disease (AD) brain arise as a result of self-assembly into fibrillar material of amyloid-β protein (Aβ) and hyperphosphorylated tau, respectively, through a pathological process starting with the appearance of aggregation nuclei and neurotoxic oligomers. Accordingly, the search of inhibitors of oligomer nucleation and growth is considered a promising target to prevent amyloid toxicity. In recent years, a number of dietar...

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

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

    2004-04-01

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

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

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

  17. Low micronutrient intake may accelerate the degenerative diseases of aging through allocation of scarce micronutrients by triage.

    Ames, Bruce N

    2006-11-21

    Inadequate dietary intakes of vitamins and minerals are widespread, most likely due to excessive consumption of energy-rich, micronutrient-poor, refined food. Inadequate intakes may result in chronic metabolic disruption, including mitochondrial decay. Deficiencies in many micronutrients cause DNA damage, such as chromosome breaks, in cultured human cells or in vivo. Some of these deficiencies also cause mitochondrial decay with oxidant leakage and cellular aging and are associated with late onset diseases such as cancer. I propose DNA damage and late onset disease are consequences of a triage allocation response to micronutrient scarcity. Episodic shortages of micronutrients were common during evolution. Natural selection favors short-term survival at the expense of long-term health. I hypothesize that short-term survival was achieved by allocating scarce micronutrients by triage, in part through an adjustment of the binding affinity of proteins for required micronutrients. If this hypothesis is correct, micronutrient deficiencies that trigger the triage response would accelerate cancer, aging, and neural decay but would leave critical metabolic functions, such as ATP production, intact. Evidence that micronutrient malnutrition increases late onset diseases, such as cancer, is discussed. A multivitamin-mineral supplement is one low-cost way to ensure intake of the Recommended Dietary Allowance of micronutrients throughout life. PMID:17101959

  18. Magnetic resonance imaging of peripheral joints in rheumatic diseases

    Østergaard, Mikkel; Duer, Anne; Møller, Uffe; Ejbjerg, Bo

    2004-01-01

    radiographical outcome in RA. Similarly, there is solid evidence for MRI synovitis representing true synovial inflammation and being of considerable practical, clinical and radiological significance in RA. Describing the encouraging current knowledge regarding MRI for diagnosis, monitoring and prognosis, 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...

  19. Associative learning in degenerative neostriatal disorders: contrasts in explicit and implicit remembering between Parkinson's and Huntington's diseases.

    Sprengelmeyer, R; Canavan, A G; Lange, H W; Hömberg, V

    1995-01-01

    The performances of 12 patients with Parkinson's disease (PD), 16 with Huntington's disease (HD), and young and old healthy controls were assessed on a number of tests of verbal and nonverbal declarative memory, on a test of nonmotor conditional associative learning (words and colors), and on a number of reaction time (RT) tasks. The RT tasks consisted of cued simple and choice reactions. The relationship between the precue and the imperative stimulus in the S1-S2 paradigm was nonarbitrary in the first series and arbitrary in the second series. The series with arbitrary S1-S2 associations was repeated across two successive blocks of trials. The rationale of the study was to investigate the function of the basal ganglia "complex loop," and it was postulated that HD patients would show greater deficits because of greater involvement of the caudate nucleus. The patients with HD had the slowest RTs. Across the two blocks with arbitrary S1-S2 associations, the patients with HD but not PD nevertheless showed evidence of learning in their precued RTs. In contrast, the patients with PD were better able to remember the associations in free recall than were the HD patients. It is concluded that patients with PD have relatively greater deficits in procedural learning, whereas those with HD have relatively more impairments in declarative memory, and the greater level of cognitive impairment in HD overall is interpreted as being due to more serious damage to the caudate loop. PMID:7885356

  20. A Chaplain-led Spiritual Life Review Pilot Study for Patients with Brain Cancers and Other Degenerative Neurologic Diseases

    Katherine M. Piderman

    2015-04-01

    Full Text Available Objective: This pilot study was designed to describe changes in spiritual well-being (SWB, spiritual coping, and quality of life (QOL in patients with brain cancer or other neurodegenerative diseases participating in a chaplain-led spiritual life review interview and development of a spiritual legacy document (SLD. Methods: Eligible participants were enrolled and completed baseline questionnaires. They were interviewed by a board-certified chaplain about spiritual influences, beliefs, practices, values, and spiritual struggles. An SLD was prepared for each participant, and one month follow-up questionnaires were completed. Two cases are summarized, and spiritual development themes are illustrated within a spiritual development framework. Results: A total of 27 patients completed baseline questionnaires and the interview; 24 completed the SLD, and 15 completed the follow-up questionnaire. Increases in SWB, religious coping, and QOL were detected. The majority maintained the highest (best scores of negative religious coping, demonstrating minimal spiritual struggle. Conclusions: Despite the challenges of brain cancers and other neurodegenerative diseases, participants demonstrated improvements in SWB, positive religious coping, and QOL. Patient comments indicate that benefit is related to the opportunity to reflect on and integrate spiritual experiences and to preserve them for others. Research with a larger, more diverse sample is needed, as well as clinical applications for those too vulnerable to participate in longitudinal follow-up.

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

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

    2008-09-15

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

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

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

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

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

    2012-04-01

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

  4. Degenerative cervical myelopathy.

    Kato, So; Fehlings, Michael

    2016-09-01

    Cervical myelopathy is the most common cause of acquired spinal cord compromise. The concept of degenerative cervical myelopathy (DCM), defined as symptomatic myelopathy associated with degenerative arthropathic changes in the spine axis, is being introduced. Given its progressive nature, treatment options have to be chosen in a timely manner. Surgical options include anterior discectomy and fusion (ACDF), anterior corpectomy and fusion (ACCF), arthroplasty (in highly select cases), posterior laminectomy with/without fusion, and laminoplasty. Indications for each should be carefully considered in individual patients. Riluzole, a sodium-glutamate antagonist, is a promising option to optimize neurologic outcomes post-surgery and is being examined in the CSM-Protect Randomized Controlled Trial. Preoperative risk assessment is mandatory for prognostication. Sagittal alignment is known to play an important role to optimize surgical outcome. Guidelines for optimal management of DCM are in process. In principle, all but the mildest cases of DCM should be offered surgery for optimal outcome. PMID:27250040

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

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

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

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

  7. Expression of CGRP in the temporomandibular joint

    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

  8. Clinical and radiologic comparison of dynamic cervical implant arthroplasty and cervical total disc replacement for single-level cervical degenerative disc disease.

    Shichang, Liu; Yueming, Song; Limin, Liu; Lei, Wang; Zhongjie, Zhou; Chunguang, Zhou; Xi, Yang

    2016-05-01

    Anterior cervical discectomy and fusion, to date the most successful spine procedure for the surgical treatment of cervical radiculopathy, has limitations that have led to the development of non-fusion cervical procedures, such as cervical total disc replacement (TDR) and dynamic cervical implant (DCI) arthroplasty. We compared the clinical and radiological results of DCI and cervical TDR for the treatment of single-level cervical degenerative disc disease in Chinese patients. A retrospective review of 179 patients with cervical spondylotic myelopathy who underwent DCI or TDR between April 2010 and October 2012 was conducted, and 152 consecutive patients (67 patients single-level DCI and 85 single-level TDR) who completed at least 2years of follow-up were included. Clinical and radiological assessments were performed preoperatively and at 1week and 3, 6, 12, and 24months postoperatively. The most common operative level was C5/C6 (49.3%). The differences in blood loss, duration of surgery, and duration of hospitalization were not statistically significant. The Japanese Orthopaedic Association scale, Visual Analog Scale, Neck Disability Index, and Short Form-36 scores improved significantly after surgery in both the DCI and TDR groups (P<0.05), but the differences were not statistically significant at the final follow-up. The rate of occurrence of heterotopic ossification was 22.4% and 28.2% in the DCI and TDR groups, respectively. As an effective non-fusion technique, DCI is a more economical procedure. Further prospective, randomized studies with long-term follow-up periods are needed to determine the long-term effects. PMID:26928156

  9. Increasing Incidence of Degenerative Spinal Diseases in Japan during 25 Years: The Registration System of Spinal Surgery in Tohoku University Spine Society.

    Aizawa, Toshimi; Kokubun, Shoichi; Ozawa, Hiroshi; Kusakabe, Takashi; Tanaka, Yasuhisa; Hoshikawa, Takeshi; Hashimoto, Ko; Kanno, Haruo; Morozumi, Naoki; Koizumi, Yutaka; Sato, Tetsuro; Hyodo, Hironori; Kasama, Fumio; Ogawa, Shinji; Murakami, Eiichi; Kawahara, Chikashi; Yahata, Jun-Ichiro; Ishii, Yushin; Itoi, Eiji

    2016-01-01

    Spinal disorders affect mainly older people and cause pain, paralysis and/or deformities of the trunk and/or extremities, which could eventually disturb locomotive functions. For ensuring safe and high-quality treatment of spinal disorders, in 1987, the Tohoku University Spine Society (TUSS) was established by orthopedic departments in Tohoku University School of Medicine and its affiliated hospitals in and around Miyagi Prefecture. All spine surgeries have been enrolled in the TUSS Spine Registry since 1988. Using the data from this registration system between 1988 and 2012, we demonstrate here the longitudinal changes in surgical trends for spinal disorders in Japan that has rushed into the most advanced "aging society" in the world. In total, data on 56,744 surgeries were retrieved. The number of spinal surgeries has annually increased approximately 4-fold. There was a particular increase among patients aged ≥ 70 years and those aged ≥ 80 years, with a 20- to 90-fold increase. Nearly 90% of the spinal operations were performed for degenerative disorders, with their number increasing approximately 5-fold from 705 to 3,448. The most common disease for surgery was lumbar spinal stenosis (LSS) (35.9%), followed by lumbar disc herniation (27.7%) and cervical myelopathy (19.8%). In 2012, approximately half of the patients with LSS and cervical myelopathy were ≥ 70 years of age. In conclusion, the number of spinal operations markedly increased during the 25-year period, particularly among older patients. As Japan has a notably aged population, the present study could provide a near-future model for countries with aging population. PMID:26876801

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

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

    2006-02-15

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

  11. Lateral collateral ligament avulsion of the humeroradial joint in a horse

    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

  12. Radiotherapy of benign diseases

    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)

  13. Joint and tendon involvement predict disease progression in systemic sclerosis

    Avouac, Jérôme; Walker, Ulrich A; Hachulla, Eric; Riemekasten, Gabriela; Cuomo, Giovanna; Carreira, Patricia E; Caramaschi, Paola; Ananieva, Lidia P; Matucci-Cerinic, Marco; Czirjak, Laszlo; Denton, Christopher; Ladner, Ulf Müller; Allanore, Yannick

    2014-01-01

    OBJECTIVE: To determine whether joint synovitis and tendon friction rubs (TFRs) can predict the progression of systemic sclerosis (SSc) over time. PATIENTS AND METHODS: We performed a prospective cohort study that included 1301 patients with SSc from the EUSTAR database with disease duration ≤3...... years at inclusion and with a follow-up of at least 2 years. Presence or absence at clinical examination of synovitis and TFRs was extracted at baseline. Outcomes were skin, cardiovascular, renal and lung progression. Overall disease progression was defined according to the occurrence of at least one...... organ progression. RESULTS: Joint synovitis (HR: 1.26, 95% CI 1.01 to 1.59) and TFRs (HR: 1.32, 95% CI 1.03 to 1.70) were independently predictive of overall disease progression, as were also the diffuse cutaneous subset (HR: 1.30, 95% CI 1.05 to 1.61) and positive antitopoisomerase-I antibodies (HR: 1...

  14. Sacro-iliac joint disease in drug abusers: The role of bone scintigraphy

    Bone scintigrams demonstrated increased uptake in the sacroiliac joint in twenty drug addicts with low back pain and signs of localized sepsis. The localization of the disease was decisive for the orthopedist in the aspiration of the affected joint. (orig.)

  15. Minimum 5-year follow-up study on the effects of the Wallis dynamic stabilization system in the treatment of lumbar degenerative disease

    Chen Zheng; Peng Baogan; Li Duanming; Pang Xiaodong; Yang Hong

    2014-01-01

    Background Short-term outcomes of the Wallis system in the treatment of lumbar degenerative disease (LDD) have been shown to be effective,whereas there is a paucity of studies on the mid-long-term effects of the treatment of the Wallis system.This study was to evaluate the mid-long-term effects of the Wallis dynamic stabilization system in the treatment of LDD.Methods A total of 26 patients who received the treatment of the Wallis system between February 2008 and January 2009 were included in the study,with 14 patients (Group 1) with L4/5 disc herniation and 12 patients (Group 2) with L5/S1 disc herniation and L4/5 intervertebral disc degeneration (IDD).Visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the clinical outcomes and lumbar x-rays and MRI were obtained to observe imaging changes before and after operation.Results The mean follow-up period was (63.50±2.12) months.The mean ODI and VAS scores decreased obviously three months and five years after operation (P <0.05).In Groups 1 and 2,L4/5 Cobb angle and range of motion (ROM) decreased and L4/5 posterior disc height increased at the last follow-up (P <0.05).There were no statistically significant changes in L4/5 anterior disc height and L3/4 University of California at Los Angeles grading before and after operation.There was no statistically significant change in Pfirrmann grading system of L4/5 IDD in Group 2 before and after operation.Adjacent segment degeneration at the last follow-up was found in two patients (2/26,7.69%) and Modic changes in L4/5 endplates were detected in one patient (1/26,3.85%).Conclusions The mid-long-term effects of the Wallis system in the treatment of LDD were satisfied.The Wallis system,as a dynamic stabilization system,which can preserve some ROM of the fixed segment,sustain the lumbar stabilization,and prevent adjacent segment disease and fixed segment degeneration,is an effective instrument to treat LDD.

  16. Dementia neuro degenerative diseases and bio markers: a new strategy for an early diagnosis; Affections neurodegeneratives dementielles et biomarqueurs: une nouvelle strategie pour un diagnostic precoce

    Mahieu, F.; Du Boisgueheneuc, F.; Andrieux, A.; Neau, J.P.; Gil, R.; Houeto, J.L. [CHU de Poitiers, Service de neurologie, 86 (France); Salmon, F. [CHU de Poitiers, Service de neurologie, 86 (France); Paccalin, M. [CHU de Poitiers, Service de medecine nucleaire, 86 (France); Lecron, J.C. [universite de Poitiers, EA 4331, laboratoire inflammation, tissus epitheliaux et cytokines, pole biologie sante, 86 (France); Ingrand, P. [CHU de Poitiers, unite de methodologie de la recherche clinique, centre d' investigation clinique P 802, 86 (France)

    2010-07-01

    the neuro degenerative dementia (particularly focal beginning forms) can be diagnosed earlier by analyzing the combination of the rate of phosphorylated tau protein, IITE score and perfusion in right anterior cingulate gyrus, the Broca area, and left angular gyrus. A prospective study is underway to validate this model. (N.C.)

  17. Arthroscopic surgery for degenerative knee

    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....... DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... STUDIES: Randomised controlled trials assessing benefit of arthroscopic surgery involving partial meniscectomy, debridement, or both for patients with or without radiographic signs of osteoarthritis were included. For harms, cohort studies, register based studies, and case series were also allowed...

  18. PHD/HIF-1 upregulates CA12 to protect against degenerative disc disease: a human sample, in vitro and ex vivo study.

    Chen, Shuai; Fang, Xiang-Qian; Wang, Qiang; Wang, Shao-Wei; Hu, Zhi-Jun; Zhou, Zhi-Jie; Xu, Wen-Bing; Wang, Ji-Ying; Qin, An; Fan, Shun-Wu

    2016-05-01

    Intervertebral disc degeneration is a major cause of low back pain. The nucleus pulposus (NP) is an important intervertebral disc component. Recent studies have shown that carbonic anhydrase 12 (CA12) is a novel NP marker. However, the mechanism by which CA12 is regulated and its physiological function are unclear. In our study, CA12, hypoxia-inducible factor 1α (HIF-1α) and HIF-2α expression levels were examined in 81 human degenerated NP samples using real-time RT-PCR, immunohistochemistry and western blot. Rat NP cells were cultured in a hypoxic environment, and hypoxia-induced CA12 expression was examined. Rat NP cells were treated with HIF-1α siRNA or the prolyl hydroxylase (PHD) inhibitor dimethyloxalylglycine (DMOG) to evaluate the role of PHD/HIF-1 in regulating CA12 expression. Rat NP cells were treated with CA12 siRNA to determine the function of CA12. A rat ex vivo model was established to confirm that PHD, HIF-1, and CA12 have important roles in disc degeneration. We found that CA12 was significantly downregulated in degenerated human NP samples at the mRNA and protein levels. CA12 expression sharply increased by ~30-fold in response to hypoxia. The expression of HIF-1α, but not HIF-2α, also decreased in degenerated human NP samples and was positively correlated with CA12 expression. HIF-1α knockdown under hypoxia reduced the CA12 mRNA and protein expression levels. DMOG treatment increased HIF-1α and CA12 expression. CA12 knockdown significantly inhibited anabolic protein expression, whereas catabolic enzymes remained unchanged. The ex vivo experiments supported our in vitro studies of the role of PHD/HIF-1/CA12. In conclusion, CA12 is downregulated in degenerated NPs, and its expression may be regulated by the PHD/HIF-1 axis. Decreased CA12 expression may lead to decreased extracellular matrix synthesis, which contributes to degenerative disc disease progression. PMID:26901836

  19. Atherosclerotic cardiovascular disease in patients with chronic inflammatory joint disorders.

    Agca, R; Heslinga, S C; van Halm, V P; Nurmohamed, M T

    2016-05-15

    Inflammatory joint disorders (IJD), including rheumatoid arthritis (RA), ankylosing spondylitis (ASp) and psoriatic arthritis (PsA), are prevalent conditions worldwide with a considerable burden on healthcare systems. IJD are associated with increased cardiovascular (CV) disease-related morbidity and mortality. In this review, we present an overview of the literature. Standardised mortality ratios are increased in IJD compared with the general population, that is, RA 1.3-2.3, ASp 1.6-1.9 and PsA 0.8-1.6. This premature mortality is mainly caused by atherosclerotic events. In RA, this CV risk is comparable to that in type 2 diabetes. Traditional CV risk factors are more often present and partially a consequence of changes in physical function related to the underlying IJD. Also, chronic systemic inflammation itself is an independent CV risk factor. Optimal control of disease activity with conventional synthetic, targeted synthetic and biological disease-modifying antirheumatic drugs decreases this excess risk. High-grade inflammation as well as anti-inflammatory treatment alter traditional CV risk factors, such as lipids. In view of the above-mentioned CV burden in patients with IJD, CV risk management is necessary. Presently, this CV risk management is still lacking in usual care. Patients, general practitioners, cardiologists, internists and rheumatologists need to be aware of the substantially increased CV risk in IJD and should make a combined effort to timely initiate CV risk management in accordance with prevailing guidelines together with optimal control of rheumatic disease activity. CV screening and treatment strategies need to be implemented in usual care. PMID:26888573

  20. Disk degenerative disease in childhood: Scheuermann`s disease, Schmorl`s nodes, and the limbus vertebra: MRI findings in 12 patients

    Swischuk, L.E. [Departments of Radiology and Pediatrics, Children`s Hospital, University of Texas, Galveston, TX (United States); John, S.D.; Allbery, S. [Children`s Hospital, University of Texas Medical Branch, Galveston, Texas (United States)

    1998-05-01

    Twelve pediatric patients were studied with MRI. All had various disk problems including Scheuermann`s disease, Schmorl`s nodes and limbus vertebrae. All patients shared loss of disk height, altered disk hydration and variable herniation of nuclear material. (orig.) With 6 figs., 1 tab., 14 refs.

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

    Objective. This study was undertaken to analyse the diffusion characteristics of synovial fluid in degenerative and inflammatory arthropathies.Design and patients. Ten in vitro specimens of synovial fluid from patients with both degenerative and inflammatory arthropathy were studied at body temperature with a navigator-corrected spin echo diffusion sequence (B values 0-512 s/mm2), on a Philips 1.5-T Gyroscan. Subsequently synovial fluid from knee joint effusions of 25 patients (10 patients with osteoarthritis, 10 patients with effusions following trauma and 5 patients with effusions secondary to inflammatory arthritis) was evaluated with the same navigator-corrected spin echo diffusion sequence.Results. Both in vitro and in vivo study demonstrated decreased diffusion in patients with effusions secondary to degenerative joint disease (less than 2.40 x 10-5 cm2/s) relative to patients with effusions accompanying knee trauma (greater than 2.75 x 10-5 cm2/s) and inflammatory arthritis (in vitro and in vivo greater than 3.00 x 10-5 cm2/s).Conclusion. Synovial fluid in degenerative arthritis shows less diffusion or free water movement than synovial fluid in inflammatory arthritis. Diffusion characteristics of synovial fluid may be used to predict the nature of the underlying form of arthritis in patients presenting with knee joint effusions. (orig.)

  2. Somatomedin activity in synovial fluid from patients with joint diseases

    The somatomedin activity in synovial fluids from 50 patients with a variety of joint diseases has been studied and compared with the activity in each of the Patient's own serum and a standard reference serum (SRS). The porcine costal cartilage bioassay of Van den Brande and Du Caju (Acta Endocrinologica, 75, 233, 1974), has been used with the isotopes 3H-thymidine and 35S-sulphate. Synovial fluids from most patients with post-traumatic and post-operative effusions, osteoarthritis and arthritis associated with psoriasis, Reiter's disease, and ankylosing spondylitis stimulated the synthesis of DNA and proteoglycans in cartilage. Synovial fluids from patients with rheumatoid arthritis either had impaired capacity to stimulate DNA synthesis, or they inhibited it; a similar, but less evident pattern was observed for proteoglycan synthesis. Some synovial fluids from patients with miscellaneous synovitides stimulated, while other inhibited cartilage metabolism. It is concluded that the synovial fluid from patients with rheumatoid arthritis and from patients with miscellaneous synovitides contained an inhibitor(s) to DNA and possible proteoglycan synthesis. The sera from nearly all the patients stimulated both DNA and proteoglycan synthesis, but the somatomedin potency ratios for serum in terms of SRS were generally less than 1.0. There was a significant inverse correlation between the serum somatomedin potency ratio and the age of the patient. (author)

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

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

  4. The Influence of Magnetic Resonance Imaging Findings of Degenerative Disease on Dual-Energy X-ray Absorptiometry Measurements in Middle-Aged Men

    Purpose: To examine degenerative features based on magnetic resonance imaging (MRI) measurements at the lumbar spine in relation to dual-energy X-ray absorptiometry (DXA), and to investigate whether bone mineral density (BMD) is reflected in the substitution of bone trabecular structure by fat at the vertebral body level indicated by MRI T1 relaxation time, endplate concavity, and hypertrophic (osteophytes and endplate sclerosis) MRI findings. Material and Methods: The sample for this cross-sectional study was composed of 102 subjects, 35-70 years old, from a population-based cohort. Data collection included DXA in the anterior-posterior projection at the L1-L4 vertebrae and right femoral neck, and MRI of the lumbar spine in the midsagittal plane. Results: Age, vertebral signal intensity, osteophytes, and endplate concavity collectively explained 20% of the variance in spine BMD. Conclusion: The study findings suggest that degenerative findings based on MRI measurements at the lumbar spine have an influence on bone assessment using DXA. Therefore, an overall bone assessment such as DXA might not offer an accurate measure of BMD

  5. The Influence of Magnetic Resonance Imaging Findings of Degenerative Disease on Dual-Energy X-ray Absorptiometry Measurements in Middle-Aged Men

    Donescu, O.S.; Battie, M.C.; Videman, T. [Faculty of Rehabilitation Medicine and Dept. of Physical Therapy, Univ. of Alberta (Canada)

    2007-02-15

    Purpose: To examine degenerative features based on magnetic resonance imaging (MRI) measurements at the lumbar spine in relation to dual-energy X-ray absorptiometry (DXA), and to investigate whether bone mineral density (BMD) is reflected in the substitution of bone trabecular structure by fat at the vertebral body level indicated by MRI T1 relaxation time, endplate concavity, and hypertrophic (osteophytes and endplate sclerosis) MRI findings. Material and Methods: The sample for this cross-sectional study was composed of 102 subjects, 35-70 years old, from a population-based cohort. Data collection included DXA in the anterior-posterior projection at the L1-L4 vertebrae and right femoral neck, and MRI of the lumbar spine in the midsagittal plane. Results: Age, vertebral signal intensity, osteophytes, and endplate concavity collectively explained 20% of the variance in spine BMD. Conclusion: The study findings suggest that degenerative findings based on MRI measurements at the lumbar spine have an influence on bone assessment using DXA. Therefore, an overall bone assessment such as DXA might not offer an accurate measure of BMD.

  6. PERIPROSTHETIC INFECTION AFTER ENDOPROSTHETIC REPLACEMENT OF THE HIP JOINT IN PATIENTS WITH RHEUMATOID DISEASES

    Vadim Petrovich Pavlov

    2013-01-01

    Full Text Available Periprosthetic infection (PI in patients with rheumatoid diseases (RD after total hip joint endoprosthesis (THJE is a relevant problem of rheumoorphopedics that has not been solved yet. The relative assessment of PI incidence rate after THJE and treatment outcomes in patients with this complication is expected to be carried out. A total of 1201 THJE performed in 1069 patients with RD are considered. The female : male ratio was 3.6 : 1; the mean age was 49.6 years (range: 16 to 83 years. 323 patients had rheumatoid arthritis (RA; 124 patients had juvenile rheumatoid arthritis (JRA; 80 patients had ankylosing spondylitis (AS; 79 patients had systemic lupus erythematosus (SLE; 11 patients had systemic sclerodermatitis (SSD; 18 patients had psoriatic arthropathy (PsA; and 353 patients had osteoarthritis (OA. Other RD were revealed in 81 patients. PI were detected in 9 (0.84% of 1069 patients with RD, including 7 (2.17% of 323 patients with RA; 1 (0.8% of 124 patients with JRA; and 1 (0.28% of 353 patients with OA. No PI were detected in 81 patients who had other RD. An eightfold (in patients with RA and a threefold (in patients with JRA increase in PI compared to that in patients with OA attests to the high risk of this complication in patients with inflammatory as compared to the patients with degenerative RD. After integrated treatment (revision surgery, sanation, continuous irrigation with antibiotics/lavasept, the graft was preserved in OA patients; the complication was prevented in RA patients. Six patients will be subjected to repeated revision surgery; one patient died of diabetes complications after the graft had been removed. A significant increase in PI incidence rate after THJE in patients with RA and JRA as compared to that in OA patients allows one to regard inflammatory RD as risk factors of this complication. The low effectiveness of the procedure for integrated therapy for PI in RD patients indicates that it needs to

  7. Manifestations of joint disease of domestic carnivores in X-ray view

    Lazarević-Macanović Mirjana

    2014-01-01

    Full Text Available Changes caused by joint diseases that are manifested in X-ray are very diverse. Some of them are present in all arthroparthies while some are specific to certain diseases. For all the arthropathies it is specific that the duration of a disease significantly influences the presence and intensity of radiological changes. In this paper there analyzed in detail some basic radiological joint diseases manifestations such as: distension of the joint capsule, change of size (width of the joint space, change of position of corresponding bones within the joint, change in quality of subchondral bone, the appearance of intra-articular mineralization and calcified structures, as well as the presence of perichondral and periarticular bone proliferations. Beside that, there are described in detail arthropathies of different etiology. [Projekat Ministarstva nauke Republike Srbije, br. 175061

  8. Roentgenological semiotics of joint involvement in psoriasis

    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

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

    Chauveau, F

    2007-10-15

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

  10. Influence of disease activity and treatment on rate of joint destruction in rheumatoid arthritis

    D V Goryachev; O A Krichevskaya; A. P. Zornyak; N V Chichasova; Sh. F. Erdes

    2008-01-01

    Severity of hands and feet joint destruction is the most objective marker of rheumatoid arthritis (RA) progression determining functional disability. The main aim of RA treatment is suppression of joint destruction. Objective. To study dependence of joint erosions forming speed on disease modifying anti-rhcumatic drugs (DMARD) administration and RA activity. Material and methods. Retrospective analysis of 451 cases of RA treatment was performed. Erosions were counted according to modified Sha...

  11. The differential diagnosis of inflammatory joint disease in maternal-fetal microchimerism

    Seme Youssef Reda

    2013-12-01

    Full Text Available This study aimed at making the differential diagnosis of joint disease in a case of genetic chimerism in a female multiparous donor from the Regional Blood Bank of Guarapuava-PR (Hemocentro Regional de Guarapuava-PR, who had had three pregnancies of male fetuses. The patient showed joint pain prior to the last donation. It was possible to identify fetal cells remaining in circulation 20 years after her last pregnancy. Laboratory tests for acute phase proteins revealed possible termination of immune tolerance to circulating fetal cells. Thus, a hypothesis of graft-versus-host disease was formulated to explain the joint disease manifested by the donor.

  12. Tumor-like diseases of the knee joint

    Radiological diagnostics of tumor-like lesions of the knee joint. Magnetic resonance imaging (MRI), computed tomography (CT) and X-ray imaging. Up to now there have been no studies regarding sensitivity and specificity of the various diagnostic tools (MRI, CT, X-ray) for the visualization of soft tissue tumors of the knee. The method of first choice for detecting soft tissue tumors and tumor-like lesions in the knee joint is MRI. (orig.)

  13. Rheumatoid arthritis affecting temporomandibular joint

    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.

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

    Erdem, L. Oktay [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)]. E-mail: sunarerdem@yahoo.com; Erdem, C. Zuhal [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey); Acikgoz, Bektas [Department of Neurosurgery, Zonguldak Karaelmas University, School of Medicine, Zonguldak (Turkey); Gundogdu, Sadi [Department of Radiology, Zonguldak Karaelmas University, School of Medicine, 6700 Kozlu, Zonguldak (Turkey)

    2005-08-01

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

  15. Patient and implant survival following joint replacement because of metastatic bone disease

    Sørensen, Michala S; Gregersen, Kristine G; Grum-Schwensen, Tomas;

    2013-01-01

    Patients suffering from a pathological fracture or painful bony lesion because of metastatic bone disease often benefit from a total joint replacement. However, these are large operations in patients who are often weak. We examined the patient survival and complication rates after total joint...

  16. Complications and clinical outcomes of minimally invasive transforaminal lumbar interbody fusion for the treatment of one- or two-level degenerative disc diseases of the lumbar spine in patients older than 65 years

    WU Wen-jian; LIANG Yu; ZHANG Xin-kai; CAO Peng; ZHENG Tao

    2012-01-01

    Background Minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has been successfully used to treat degenerative diseases of the lumbar spine.There are few reports comparing the complications and clinical outcomes in older patients who have undergone one- or two-level MIS-TLIF with those of younger patients.The aim of this study was to investigate the clinical outcomes of MIS-TLIF in the treatment of degenerative disc disease of lumbar spine of the patients older than 65 years,with an emphasis on perioperative complications compared to the younger patients.Methods One hundred and fifty-one consecutive cases of one- or two-level degenerative disc disease of lumbar spine treated with MIS-TLIF were reviewed for the radiological and clinical outcomes.They were divided into elderly group (age ≥65 years old) and younger group (age <65 years old),and were followed for at least 6 months.Radiographs were obtained before and after surgery,3 months postoperatively,and at the final follow-up to determine the presence of fusion,hardware-related problems.The clinical outcomes were evaluated using the Oswestry Disability Index (ODI)before and after surgery,and at the final follow-up.The visual analogue scale (VAS) score of back and leg pain were evaluated as well.The intra-operative data and peri-operative complications were recorded.Results The mean age of these patients at operation was (57.7±14.2) years (range 26-82 years).Of 151 patients,62were 65 years or older.The elderly patients had more comorbidities and more porportion of lumbar canal stenosis.The overall fusion rate was 88.4% at the final follow-up,with no significant difference between younger and elderly patients.The ODI,the VAS of back pain and radicular pain of both young and elderly group were significantly improved aftersurgery and at the final follow-up,without significant difference between two groups.There were 16 complications with an incidence of 10.6%,including 7 major complications

  17. Development of modulators against degenerative aging using radiation fusion technology

    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

  18. Development of modulators against degenerative aging using radiation fusion technology

    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.

  19. Research progress on Hybrid surgery treating multilevel cervical degenerative disc diseases%Hybrid术式治疗多节段颈椎退行性疾病的研究进展

    张耐洋(综述); 彭宝淦(审校)

    2016-01-01

    Nowdays, anterior cervical discectomy and fusion (ACDF) and cervical artificial disc replacement (CADR) are the most accepted procedure to treat multilevel cervical degenerative disc diseases. However, ACDF reduces the motion of the cervical spine and accelerates adjacent level degeneration. Strict indications and hyper-mobility of the operative levels may limit the application of multilevel CADR. Some experts put forward the method of Hybrid surgery incorporating ACDF and CADR. The purpose of this study is to review the progress of Hybrid surgery treating multilevel cervical degenerative disc diseases.%目前对于多节段颈椎退变性疾病的治疗术式中以颈前路减压植骨融合内固定术(anterior cervical discectomy and fusion,ACDF)和颈椎间盘置换术(cervical artificial disc replacement,CADR)为主,然而ACDF消除了颈椎融合节段的活动度,加速了颈椎临近节段的退变;CADR的适应证狭窄并且手术节段的活动度不理想。所以有学者提出在治疗多节段颈椎退行性疾病中将ACDF和CADR结合起来即Hybrid术式,笔者就目前Hybrid术式治疗多节段颈椎退行性疾病的研究进展做一综述。

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

    José Ricardo Morasén Cuevas

    2010-12-01

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

  1. A Joint Lab Against Viral Diseases Created in Southwest China

    2004-01-01

    @@ With approval of the CAS Steering Committee for Research Bases in Southwest China, a laboratory devoted to the development of natural anti-virus medicines is to be set up under the joint sponsorship of the CAS Kunming Institute of Botany (KIB)and the CAS Kunming Institute of Zoology (KIZ).

  2. The degenerative spine: pattern recognition and guidelines to image interpretation.

    Parizel, P M; Van Hoyweghen, A J L; Bali, A; Van Goethem, J; Van Den Hauwe, L

    2016-01-01

    Degenerative disease of the spine, in the form of intervertebral disc degeneration and bony growth, causing osteophytes and impinging upon the spinal canal and neural foramina, is the most frequent disorder affecting the spine. In this chapter we first discuss briefly the indications for computed tomography or magnetic resonance imaging in suspected degenerative spine disease. We then describe changes of disc height, signal intensity, and disc contour with aging and repeated microtrauma, as well as the imaging techniques most appropriate to image them. A grading system for lumbar disc changes is provided. Stenosis of the canal and neural foramina is reviewed next, concluding with a description of degenerative changes affecting the vertebral endplates and bone marrow. PMID:27430442

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

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

  4. Study on 3.0 T Superconducting MR Imaging in the Diagnosis of Senile Degenerative Osteoarthrosis of Knee Joints%3.0T超导磁共振成像对老年膝关节退行性骨关节病的诊断研究

    王志利; 徐丹凤; 赵树军; 刘兵; 孟凡州

    2015-01-01

    目的:探讨3.0T超导磁共振成像对老年膝关节退行性骨关节病的诊断价值。方法回顾性分析2012年6月至2013年4月衡水市哈励逊国际和平医院临床确诊的90例老年膝关节退行性骨关节病患者的磁共振影像表现。结果90例患者均出现不同程度的关节软骨损伤(Ⅱ级36例,Ⅲ级54例),骨质增生改变及不等量的关节腔积液;关节软骨下骨质破坏68例;骨髓水肿34例;半月板退变及损伤72例(Ⅰ级15例,Ⅱ级44例,Ⅲ级13例);韧带损伤18例(交叉韧带10例,侧副韧带8例);关节腔游离体5例(软骨游离体2例,骨性游离体3例)。结论3.0T超导磁共振成像能清晰地显示老年膝关节退行性骨关节病患者的关节骨质、关节软骨、滑膜、韧带及半月板等结构,为临床准确诊断与评估损伤程度提供直接影像依据。%Objective To study the diagnostic value of 3.0 T superconducting MR imaging in senile degenerative osteoarthrosis of knee joints.Methods MR imaging manifestations of 90 aged patients with degenerative osteoarthrosis of knee joints diagnosed in Hengshui Halison International Peace Hospital from Jun.2012 to Apr.2013 were retrospectively analyzed.Results There were different degrees of arthrodial cartilage damage in all the cases(grade Ⅱ in 36 cases,grade Ⅲ in 54 cases),as well as bone hyperplasia and different amounts of arthroedema;there were also destruction of bone under arthrodial cartilage in 68 cases,bone marrow edema in 34 cases, meniscus degeneration and injury in 72 cases( gradeⅠin 15 cases, grade Ⅱ in 44 cases,grade Ⅲ in 13 cases),ligament injury in 18 cases(cruciate ligament injury in 10 cases,collateral ligament injury in 8 cases) ,joint loose body in 5 cases ( cartilage loose body in 2 cases,bone loose body in 3 cases) among all the 90 cases.Conclusion Structures of joint bone,articular cartilage, synovium, ligament and meniscus of elderly patients

  5. The clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation%骨质疏松腰椎退行性疾病的手术治疗分析

    孔祥瑞; 刘德政; 刘海峰; 杨计策; 赵志超

    2015-01-01

    ObjectiveTo explore the clinical effects of osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. Methods 82 cases of patients with lumbar degenerative dis-ease of osteoporosis word randomly divided into experiment group(41 cases) and control group(41 cases). The control group were treated by transpedicle screws fixation, the experiment group were treated by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. The time of operation, mean bleeding volum, the scores of VAS, ODI, JOA were com-pared for the two groups. ResultsThe time of operation, mean bleeding volum for the experiment group were better than the control group; There was no significant difference on the scores of VAS, ODI, JOA; The scores of VAS, ODI for the experiment group were lower than the control group postoperation for 1 week, 2 months, 12 months; The scores of JOA for the experiment group were higher than the control group postoperation for 1 week, 2 months, 12 months. ConclusionIt can improve the scores of VAS, ODI, JOA for the patients with osteoporosis of lumbar degenerative disease by injectable calcium sulfate bone cement to strengthen pedicle screw internal fixation. It is worthy of clinical promotion.%目的:探讨可注射硫酸钙骨水泥强化椎弓根钉内固定治疗骨质疏松腰椎退行性疾病的临床疗效。方法:按照随机数字表法将我院收治的82例骨质疏松腰椎退行性疾病患者均分为实验组和对照组,对照组给予单纯椎弓根内固定治疗,实验组给予可注射硫酸钙骨水泥强化椎弓根钉内固定治疗。比较两组患者手术时间、术中出血量以及治疗前后疼痛视觉模拟评分(VAS)、Oswestry 功能障碍指数(ODI)、JOA 腰椎病疗效评分变化情况。结果:实验组患者手术时间和术中出血量显著高于对照组;两组患者术前 VAS 评分、ODI 评分、JOA

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

    Ackerman SJ

    2014-05-01

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

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

    Rossana Gómez

    2010-09-01

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

  8. Influence of disease activity and treatment on rate of joint destruction in rheumatoid arthritis

    D V Goryachev

    2008-10-01

    Full Text Available Severity of hands and feet joint destruction is the most objective marker of rheumatoid arthritis (RA progression determining functional disability. The main aim of RA treatment is suppression of joint destruction. Objective. To study dependence of joint erosions forming speed on disease modifying anti-rhcumatic drugs (DMARD administration and RA activity. Material and methods. Retrospective analysis of 451 cases of RA treatment was performed. Erosions were counted according to modified Sharp method. Erosions forming speed was counted as ratio of erosion number increase to a year’s time space. Averaged disease activity was calculated as arithmetic mean for all DAS28 values obtained during disease course. Considering close relationship between disease activity and DMARD administration two-factor analysis was used. DMARD administration (>3 months and mean activity of RA were considered as factors. Results. Variance analysis (ANOVA with covariant showed that mean RA activity is a significant factor influencing erosions forming speed (F=12,5; p=4xl0 4. Character of DMARD, fact of its administration and disease duration did not significantly influence erosions forming speed considering disease activity covariant. Regression model with inclusion disease duration factor mean disease activity and DMARD administration at the moment of assessment allowed to explain 42% of dispersion (determination coefficient. Conclusion. Activity of RA is the main factor influencing erosions forming speed. Therapy not decreasing activity of RA does not change erosions forming speed

  9. MRI of cystic collection of the three joint

    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)

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

    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.)

  11. Consensus statement on surgical pathology of the aorta from the Society for Cardiovascular Pathology and the Association For European Cardiovascular Pathology: II. Noninflammatory degenerative diseases - nomenclature and diagnostic criteria.

    Halushka, Marc K; Angelini, Annalisa; Bartoloni, Giovanni; Basso, Cristina; Batoroeva, Lubov; Bruneval, Patrick; Buja, L Maximilian; Butany, Jagdish; d'Amati, Giulia; Fallon, John T; Gallagher, Patrick J; Gittenberger-de Groot, Adriana C; Gouveia, Rosa H; Kholova, Ivana; Kelly, Karen L; Leone, Ornella; Litovsky, Silvio H; Maleszewski, Joseph J; Miller, Dylan V; Mitchell, Richard N; Preston, Stephen D; Pucci, Angela; Radio, Stanley J; Rodriguez, E Rene; Sheppard, Mary N; Stone, James R; Suvarna, S Kim; Tan, Carmela D; Thiene, Gaetano; Veinot, John P; van der Wal, Allard C

    2016-01-01

    Surgical aortic specimens are usually examined in Pathology Departments as a result of treatment of aneurysms or dissections. A number of diseases, genetic syndromes (Marfan syndrome, Loeys-Dietz syndrome, etc.), and vasculopathic aging processes involved in vascular injury can cause both distinct and nonspecific histopathologic changes with degeneration of the media as a common denominator. Terminology for these changes has varied over time leading to confusion and inconsistencies. This consensus document has established a revised, unified nomenclature for the variety of noninflammatory degenerative aortic histopathologies seen in such specimens. Older terms such as cystic medial necrosis and medionecrosis are replaced by more technically accurate terms such as mucoid extracellular matrix accumulation (MEMA), elastic fiber fragmentation and/or loss, and smooth muscle cell nuclei loss. A straightforward system of grading is presented to gauge the extent of medial degeneration and synoptic reporting tables are provided. Herein we present a standardized nomenclature that is accessible to general pathologists and useful for future publications describing these entities. PMID:27031798

  12. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 7: lumbar fusion for intractable low-back pain without stenosis or spondylolisthesis.

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

    2014-07-01

    Establishing an appropriate treatment strategy for patients presenting with low-back pain, in the absence of stenosis or spondylolisthesis, remains a controversial subject. Inherent to this situation is often an inability to adequately identify the source of low-back pain to justify various treatment recommendations, such as lumbar fusion. The current evidence does not identify a single best treatment alternative for these patients. Based on a number of prospective, randomized trials, comparable outcomes, for patients presenting with 1- or 2-level degenerative disc disease, have been demonstrated following either lumbar fusion or a comprehensive rehabilitation program with a cognitive element. Limited access to such comprehensive rehabilitative programs may prove problematic when pursuing this alternative. For patients whose pain is refractory to conservative care, lumbar fusion is recommended. Limitations of these studies preclude the ability to present the most robust recommendation in support of lumbar fusion. A number of lesser-quality studies, primarily case series, also support the use of lumbar fusion in this patient population. PMID:24980584

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

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

    1997-12-31

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

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

    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.)

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

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

    1986-08-01

    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.

  16. Economic evaluation of interventions for inflammatory rheumatic joint diseases

    2015-01-01

    The effectiveness of biologic disease-modifying antirheumatic drugs (bDMARDs) in the treatment of rheumatoid arthritis (RA) has been documented in randomized controlled clinical trials (RCTs). The medical costs of using bDMARDs are substantially higher than those of synthetic DMARDs (sDMARDs). The overarching aim of this thesis was to compare costs and effectiveness of bDMARDs versus sDMARDs for patients with RA. The papers constituting the thesis used observational data from the Norwegia...

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

    Purpose: An experimental study was performed on joint specimens of the knee to assess the advantages and disadvantages of 14 generally available sequences in cartilage imaging. Methods: Each of the 50 surgically exposed cadaveric joints of the knee was examined by the following sequences: T1, proton- and T2 weighted spin echo(SE) sequences, proton- and T2 weighted Turbo-SE, T1 weighted SE with fat suppression, MTC combined with T1-weighted SE and T2 weighted FLASH-2 D, STIR, FISP-3 D, FLASH-3 D (with fat suppression), and MR arthrography. We assessed the image quality by a scale, signal to noise-ratio of cartilage and joint fluid, and the accuracy in detection of cartilage lesions. Pathology and arthroscopy were reference methods to MRI, and demonstrated grade 1-4 lesions on 186 of 300 joint facettes. Results: Advanced stages of cartilage lesions (65 grade 3 and 4 lesions) were detected by standard SE sequences in 67-94%. Application of volume techniques (FISP-3 D, FLASH-3 D), high definition matrix (512 pixel), MTC with FLASH-2 D and MR-arthrography improved the sensitivity up to 82-100%. Superficial lesions (65 grade 2 lesions) were demonstrated in 3-38%, and on MR arthrography in 45%. Structural changes (56 Grade 1 lesions) were recorded on MRI in only 10%. Conclusions: With regard to standard SE sequences, the detectability of cartilage lesions can be improved by techniques that use 512 matrices, selective cartilage imaging, and volume acquisition. (orig.)

  18. Arthroscopic surgery for degenerative knee

    Thorlund, Jonas Bloch; Juhl, C B; Roos, E M;

    2015-01-01

    . DATA SOURCES: Systematic searches for benefits and harms were carried out in Medline, Embase, CINAHL, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) up to August 2014. Only studies published in 2000 or later were included for harms. ELIGIBILITY CRITERIA FOR SELECTING...... 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 and...

  19. JOINT DISEASE IN CHILDREN WITH X-LINKED AGAMMAGLOBULINEMIA

    Lidija Kareva

    2013-11-01

    Full Text Available Patients with X-linked agammaglobulinemia (XLA are prone to recurrent bacterial infections due to low levels of immunoglobulins. Clinical symptoms include recurrent bacterial otitis media, bronchitis, pneumonia, meningitis, skin infection and arthritis.In the majority of cases arthritis can be shown to be caused by infection, but also aseptic arthritis and autoimmune diseases may be present. Monoarthritis and oligoarthritis is usual pattern, although polyarthritis may occur. This paper presents diagnostic and therapeutic problems in our patients with agammaglobulinemia and arthritis.

  20. Influence of degenerative changes of intervertebral disc

    WANG Yi

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principles of reliability, advancement and efficiency, the obtained data were primarily examined, and the original source was retrieved to read the full-text. Repetitive articles were excluded. The data of material properties of normal and degenerated IVDs were summarized and analyzed by meta-analysis. Results: The data of Young's modulus, Poisson's ratio, shear modulus, hydraulic permeability and intradiscal pres-sure of normal and degenerated IVDs were obtained. Com-pared with normal IVDs, the Young's modulus and shear modulus of annulus fibrosus and nucleus pulposus were higher in degenerated IVDs, the Poisson's ratio was lower while the hydraulic permeability and intradiscal pressure were higher. Besides, the degeneration-related alterations in IVDs had an influence both on itself and other spinal structures, leading to diseases such as bulging disc, discogenic pain and spinal stenosis. Meanwhile, the heavy mechanical loading and injury indicated important pathways to IVD degeneration. Conclusions: To a certain extent, the degenerative changes of IVD influence its material properties. And the degeneration-related alterations of composition can cause structural failure of IVDs, leading to injuries and diseases. Key words: Intervertebral disc; Mechanical phenomena; Degeneration; Elastic modulus; Permeability; Pathology

  1. US Assessment of Hip Joint Synovitis in Rheumatic Diseases A comparison with MR imaging

    Purpose: To assess the significance of ultrasonography (US) in detecting hip joint synovitis in patients with rheumatic diseases. Material and Methods: Forty patients with rheumatic disease and suspected hip joint synovitis underwent MRI and US of the hip joint. In addition to the throughout MRI evaluation, the anterior collum-capsule distance (CCD) was determined by both MRI and US. Thirteen healthy volunteers were examined with MRI to establish the criteria for normal findings in MRI when classifying hip joints to those with synovitis and those without. MRI was used as a gold standard. Results: Synovitis was found using MRI in 31 hips of 22 patients (9 patients had bilateral synovitis). The intraclass correlation was 0.61 between MRI and US in measuring CCD. In classifying hip joint synovitis with US, the sensitivity of the method was 87% and specificity 42%, when the CCD criterion for synovitis was determined to be 7 mm. If the cut-off point was raised to 9 mm, the sensitivity decreased to 61% while specificity increased to 94%. A difference in CCD of 1 mm between the hips as an additional criterion for synovitis increased the number of false-positive findings. Conclusion: Measurement of CCD with US proved to be a rather inaccurate method to point out synovitis in rheumatic patients when using MRI as a reference. The main reason for this result was the thickened capsule, which US could not differentiate from a thickened synovium

  2. Treatment of post-traumatic degenerative changes of the radio-carpal and distal radio-ulnar joints by combining radius, scaphoid, and lunate (RSL) fusion with ulnar head replacement

    van Groningen, Jorg Melcher; Schuurman, Arnold H.

    2011-01-01

    Distal radial fractures are a common type of fracture. In the case of intra-articular fractures, they often result in post-traumatic arthrosis. The objective of this study is to describe a novel alternative to the established salvage techniques for the treatment of post-traumatic arthrosis of the radio-carpal and distal radio-ulnar joints (DRUJ). Six patients with radio-carpal and DRUJ arthrosis were treated with a combined radius, scaphoid, and lunate (RSL) arthrodesis and as a Herbert ulnar...

  3. Neuronal degenerative disorders studied by positron emission tomography-dopamine D1 and D2 receptors in Parkinson's disease and striato-nigral degeneration

    It is well established that patients with Parkinson's disease (PD) respond well to L-dopa therapy, but those with striato-nigral degeneration (SND) respond poorly. A possible explanation could be a loss of striatal dopamine receptors in SND. However, few attempts have been made to examine the alterations of the striatal dopamine receptors in SND. The authors studied the dopamine D1 and D2 receptors in PD (n=7), SND (N=4) and controls (n=11) by positron emission tomography (PET). [11C] N-methylspipernoe [11C] NMSP) was used as a ligand to study D2 receptors, and [11C] SCH23390 was used to study D1 receptors. The results showed that D1 and D2 receptors in PD were not significantly different from those in controls, but there was a trend toward elevated binding potential of D1 and D2 receptors in PD. The binding potential of D1 and D2 receptors in SND was significantly lower than those in controls and PD. PET images showed that the decrease of D1 and D2 receptors in SND was remarkable in the posterior putamen. PET imaging of dopamine receptors is useful for differentiating the two disorders. (author)

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

    Kell Douglas B

    2009-01-01

    Full Text Available Abstract Background The production of peroxide and superoxide is an inevitable consequence of aerobic metabolism, and while these particular 'reactive oxygen species' (ROSs can exhibit a number of biological effects, they are not of themselves excessively reactive and thus they are not especially damaging at physiological concentrations. However, their reactions with poorly liganded iron species can lead to the catalytic production of the very reactive and dangerous hydroxyl radical, which is exceptionally damaging, and a major cause of chronic inflammation. Review We review the considerable and wide-ranging evidence for the involvement of this combination of (superoxide and poorly liganded iron in a large number of physiological and indeed pathological processes and inflammatory disorders, especially those involving the progressive degradation of cellular and organismal performance. These diseases share a great many similarities and thus might be considered to have a common cause (i.e. iron-catalysed free radical and especially hydroxyl radical generation. The studies reviewed include those focused on a series of cardiovascular, metabolic and neurological diseases, where iron can be found at the sites of plaques and lesions, as well as studies showing the significance of iron to aging and longevity. The effective chelation of iron by natural or synthetic ligands is thus of major physiological (and potentially therapeutic importance. As systems properties, we need to recognise that physiological observables have multiple molecular causes, and studying them in isolation leads to inconsistent patterns of apparent causality when it is the simultaneous combination of multiple factors that is responsible. This explains, for instance, the decidedly mixed effects of antioxidants that have been observed, since in some circumstances (especially the presence of poorly liganded iron molecules that are nominally antioxidants can actually act as pro

  5. Typical MR intensity distribution patterns in different knee joint diseases using a gradient echo sequence

    The knee joints of 31 patients and 3 volunteers were examined with a 1.5 T Magnetom using 3D-gradient echo sequences. We measured for the most widespread diseases: The gonarthrosis (n=23) and rheumatoid arthritis (n=8) the signal intensities in all joint parts and the typical signal plots were worked out. In case of minimal changes at the articular cartilage, the method developed and tried out by us can facilitate diagnosis. A special aspect of this method is also the patient follow-up which is now possible quantitatively and objectively. (orig.)

  6. Novel BAC mouse model of Huntington’s disease with 225 CAG repeats exhibits an early widespread and stable degenerative phenotype

    Wegrzynowicz, Michal; Bichell, Terry Jo; Soares, Barbara D.; Loth, Meredith K.; McGlothan, Jennifer L.; Alikhan, Fatima S.; Hua, Kegang; Coughlin, Jennifer M.; Holt, Hunter K.; Jetter, Christopher S.; Mori, Susumu; Pomper, Martin G.; Osmand, Alexander P.; Guilarte, Tomás R.; Bowman, Aaron B.

    2015-01-01

    BACKGROUND Unusually large CAG repeat expansions (>60) in exon one of Huntingtin (HTT) are invariably associated with a juvenile-onset form of Huntington’s disease (HD), characterized by a more extensive and rapidly progressing neuropathology than the more prevalent adult-onset form. However, existing mouse models of HD that express the full-length Htt gene with CAG repeat lengths associated with juvenile HD (ranging between ~75 to ~150 repeats in published models) exhibit selective neurodegenerative phenotypes more consistent with adult-onset HD. OBJECTIVE To determine if a very large CAG repeat (>200) in full-length Htt elicits neurodegenerative phenotypes consistent with juvenile HD. METHODS Using a bacterial artificial chromosome (BAC) system, we generated mice expressing full-length mouse Htt with ~225 CAG repeats under control of the mouse Htt promoter. Mice were characterized using behavioral, neuropathological, biochemical and brain imaging methods. RESULTS BAC-225Q mice exhibit phenotypes consistent with a subset of features seen in juvenile-onset HD: very early motor behavior abnormalities, reduced body weight, widespread and progressive increase in Htt aggregates, gliosis, and neurodegeneration. Early striatal pathology was observed, including reactive gliosis and loss of dopamine receptors, prior to detectable volume loss. HD-related blood markers of impaired energy metabolism and systemic inflammation were also increased. Aside from an age-dependent progression of diffuse nuclear aggregates at 6 months of age to abundant neuropil aggregates at 12 months of age, other pathological and motor phenotypes showed little to no progression. CONCLUSIONS The HD phenotypes present in animals 3 to 12 months of age make the BAC-225Q mice a unique and stable model of full-length mutant Htt associated phenotypes, including body weight loss, behavioral impairment and HD-like neurodegenerative phenotypes characteristic of juvenile-onset HD and/or late-stage adult

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

    Dennis F. Lawler

    2012-12-01

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

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

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

    2012-01-01

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

  9. Clinical outcomes of two types of cages used in transforaminal lumbar interbody fusion for the treatment of degenerative lumbar diseases: n-HA/PA66 cages versus PEEK cages.

    Deng, Qian-Xing; Ou, Yun-Sheng; Zhu, Yong; Zhao, Zeng-Hui; Liu, Bo; Huang, Qiu; Du, Xing; Jiang, Dian-Ming

    2016-06-01

    This study reports the clinical effects of nano-hydroxyapatite/polyamide66 cages (n-HA/PA66 cages) and compares the clinical outcomes between n-HA/PA66 and polyetheretherketone cages (PEEK cages) for application in transforaminal lumbar interbody fusion (TLIF). A retrospective and case-control study involving 124 patients using n-HA/PA66 cages and 142 patients using PEEK cages was conducted. All patients underwent TLIF and had an average of 2-years of follow-up. The Oswestry Disability Index and Visual Analog Scale were selected to assess the pain of low back and leg, as well as neurological status. The intervertebral space height and segmental angle were also measured to estimate the radiological changes. At the 1-year and final follow-ups, the fusion and subsidence rates were evaluated. There was no significant difference between the two groups regarding clinical and radiological results. At the final follow-up, the bony fusion rate was 92.45 and 91.57 % for the n-HA/PA66 and PEEK groups, respectively, and the subsidence rate was 7.55 and 8.99 %, respectively. The study indicated that both n-HA/PA66 and PEEK cages could promote effective clinical and radiographic outcomes when used to treat degenerative lumbar diseases. The high fusion and low subsidence rates revealed that n-HA/PA66 cages could be an alternative ideal choice as the same to PEEK cages for lumbar reconstruction after TLIF. PMID:27091044

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

    Xiaoyang Qi

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

  11. Hypertrophic Synovitis of the Facet Joint Causing Root Pain

    Koichi Iwatsuki

    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.

  12. Vitiligo: A Possible Model of Degenerative Diseases

    Barbara Bellei; Angela Pitisci; Monica Ottaviani; Matteo Ludovici; Carlo Cota; Fabiola Luzi; Maria Lucia Dell'Anna; Mauro Picardo

    2013-01-01

    Vitiligo is characterized by the progressive disappearance of pigment cells from skin and hair follicle. Several in vitro and in vivo studies show evidence of an altered redox status, suggesting that loss of cellular redox equilibrium might be the pathogenic mechanism in vitiligo. However, despite the numerous data supporting a pathogenic role of oxidative stress, there is still no consensus explanation underlying the oxidative stress-driven disappear of melanocytes from the epidermis. In thi...

  13. Using Nutrition Against Aging and Degenerative Disease.

    Rokosz, Francis M.

    A review of historical and research literature presents various perspectives on the growing controversy surrounding the use of vitamin and mineral supplements to maintain good health and for preventive health care. Several points are made in opposition to many health professionals' opinions that most nutritional supplements are unnecessary.…

  14. Local Gene Transfer of OPG Prevents Joint Damage and Disease Progression in Collagen-Induced Arthritis

    Qingguo Zhang; Weiming Gong; Bin Ning; Lin Nie; Paul H. Wooley; Shang-You Yang

    2013-01-01

    This study examined the influence of osteoprotegerin (OPG) gene transfer on a murine collagen-induced arthritis model. A single periarticular injection of AAV-OPG or AAV-LacZ on the arthritic paw successfully incorporated the exogenous gene to the local tissue and resulted in marked transgene expression in the joint homogenate for at least three weeks. Clinical disease scores were significantly improved in OPG treated mice starting at 28-day post-treatment (P < 0.05). Histological assessment ...

  15. Multiple Bone and Joint Diseases in a Nigerian Sickle Cell Anaemia: a Case Report

    Olaniyi, John A.; Alagbe, Adekunle E.; Olutoogun, Toluwalase A.; Busari, Oluwasogo E.

    2012-01-01

    This case highlights the fact that bone involvement is the commonest clinical manifestation of Sickle Cell Disease (SCD) both in the acute settings such as painful vaso-occlusive crisis (VOC) and as a source of chronic, progressive debility such as avascular necrosis (AVN), chronic osteomyelitis and fixed flexion deformity of joints. Protracted multiple bone involvement i.e. bilateral femoral and left humeral chronic osteomyelitis, Left elbow, Left knee and right humeral septic arthritis toge...

  16. Ranking of MR in the diagnosis of diseases of the shoulder joint

    In a prospective study 43 patients with shoulder pain were examined by sonography and MRI. The findings were controlled by plain radiography, arthrography, and CT arthrography. Joint effusions and humeral head defects were equally identified by MR and sonography. In the diagnosis of labrum lesions, rotator cuff lesions, subacromial spurs, and synovial inflammatory disease sonography was not as accurate as MR. A special MR scoring system improved the diagnosis of an impingement syndrome. (orig.)

  17. Comparative diagnostic imaging of the canine shoulder joint ultrasonography and radiography

    Mayer, B

    2000-01-01

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

  18. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    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.)

  19. Premature epiphyseal fusion and degenerative arthritis in chronic recurrent multifocal osteomyelitis

    Piddo, C. [Pediatric Radiology, Children' s Hospital, Winnipeg, Manitoba (Canada); Reed, M.H. [Pediatric Radiology, Children' s Hospital, Winnipeg, Manitoba (Canada); Department of Pediatrics and Child Health, Children' s Hospital and the University of Manitoba, Winnipeg (Canada); Black, G.B. [Department of Pediatrics and Child Health, Children' s Hospital and the University of Manitoba, Winnipeg (Canada); F.R.C.S. Section of Orthopedics, Children' s Hospital and the University of Manitoba, Winnipeg, Manitoba (Canada)

    2000-02-01

    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.)

  20. WHO/IAEA joint research programme on trace elements in cardiovascular diseases

    After several years of support by WHO and IAEA for the joint research programme on trace elements in cardiovascular diseases, a consultants' meeting was held (1) to examine the present status of the programme with a view to advising on actions necessary for its completion, and (2) to advise on the form, content and timing of a final report. The meeting was attended by the invited experts and other persons. The main work of this research programme is divided, as before, between two projects, (1) on Cd, Cr, Cu, Se, Zn and other elements in relation to ischaemic heart disease, and (2) on Cd, Se and Zn in relation to arterial hypertension

  1. [Primary and secondary prevention procedures of temporo-mandibular joint disease in the evolutive age].

    Ciavarella, D; Mastrovincenzo, M; Sabatucci, A; Campisi, G; Di Cosola, M; Suriano, M; Lo Muzio, L

    2009-02-01

    In the last years prevention of temporomandiboular joint (TMJ) disease had acquired great importance. According to the neuro-occlusal rehabilitation (RNO) it is possible to say that TMJ disease starts since first years of life. So it is important both for dentist and for pediatric know what are the conditions and the atypical functions which predispose to this pathology. The aim of this work was to show how it is possible to intercept since primary teeth and the correct norms of primary and secondary prevention. PMID:19180004

  2. Imaging of hip joint arthroplasty

    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.)

  3. Psoriatic nail involvement and its relationship with distal interphalangeal joint disease.

    Lai, T L; Pang, H T; Cheuk, Y Y; Yip, M L

    2016-08-01

    Psoriatic nail disease and distal interphalangeal (DIP) arthritis both are common manifestations of psoriatic arthritis (PsA). Several clinical characteristics are allegedly associated with DIP joint damage, particularly nail psoriasis. However, there is little evidence to substantiate this phenomenon. The purpose of this study is to investigate the relationship between DIP involvement, nail psoriasis and other parameters. A cross-sectional study involved 45 patients from local rheumatology clinic. Four hundred fifty psoriatic fingernails scored, and the radiographs of all these fingers were reviewed to define PsA DIP arthritic changes. 64.4 % patients had nail psoriasis and 35.6 % had DIP arthritis. Univariate analysis identified that swollen joint-count, digits with chronic dactylitis, HLA-B27 status and nail psoriasis were associated with DIP arthritis. Regression model supported that nail disease was the most significant associated factor of DIP arthritis (OR 9.7, p = 0.05). Nail psoriasis was identified in 40.2 % of digits. Pitting (29.6 %), onycholysis (15.1 %), crumbling (8.2 %), nail bed hyperkeratosis (2.0 %) were noted with the mean modified Nail Psoriasis Severity Index of 0.95 +/-1.68. Among all digits, 57 had DIP arthritis while 393 did not. Within DIP joints with PsA radiological change, 59.6 % had nail disease. Chi-square test with the Bonferroni correction further supported an association between nail psoriasis and DIP involvement with p value of 0.001. Two specific nail subtypes-crumbling and onycholysis-were found to be significantly associated with DIP disease. A significant proportion of PsA patients had nail involvement and DIP arthritis. PsA patients with nail changes may be more susceptible to DIP disease. PMID:27251673

  4. Accuracy of clinical diagnosis in primary degenerative dementia: correlation with neuropathological findings.

    Sulkava, R; Haltia, M; A. Paetau; Wikström, J; Palo, J.

    1983-01-01

    Neuropathological features and causes of death are presented in 27 deceased patients belonging to a prospective series of 71 hospitalised patients with primary degenerative dementia. The clinical criteria for primary degenerative dementia used in the present study were accurate enough to exclude patients with multi-infarct dementia. At necropsy, 82% of the cases had neuropathological changes of Alzheimer's disease. The clinical features of patients with other neuropathological changes are des...

  5. Outcomes observed during a 1-year clinical and radiographic follow-up of patients treated for 1- or 2-level cervical degenerative disease using a biodegradable anterior cervical plate.

    Chen, Mengcun; Yang, Shuhua; Yang, Cao; Xu, Weihua; Ye, Shunan; Wang, Jing; Feng, Yong; Yang, Wen; Liu, Xianzhe

    2016-08-01

    OBJECTIVE The purpose of this study was to present an initial surgical experience in the management of 1- or 2-level degenerative disc disease of the cervical spine using biodegradable anterior cervical plates (bACPs) in anterior cervical discectomy and fusion (ACDF). The authors also aimed to provide insight into this critical and controversial clinical issue by clarifying outcomes for patients receiving bACPs and by comparing their outcomes with those achieved using a traditional metallic anterior cervical plate (mACP) implant. METHODS A retrospective review was conducted for 2 series of patients who had undergone ACDF using either bACP (31 patients, 38 segments) or mACP (47 patients, 57 segments) instrumentation. The patients were followed up for a mean 13.5 ± 0.9 months (range 12-18 months) in the bACP group and 14.8 ± 1.5 months (range 14-22 months) in the mACP group. Clinical outcomes were determined according to scores on the visual analog scale (VAS), the modified Japanese Orthopaedic Association (mJOA) scoring system, and Odom's criteria. Radiological images were used to assess fusion rates, intervertebral height, Cobb's angle, and the width of prevertebral soft tissue. RESULTS Both VAS and mJOA scores were significantly improved at each follow-up in both groups. Excellent or good results according to Odom's criteria were achieved in 93.5% (29/31) of patients in the bACP group and 93.6% (44/47) of patients in the mACP group. At 6 months postoperatively, the fusion rate was 94.7% (36/38) in the bACP group and 96.5% (55/57) in the mACP group, but subsidence of the intervertebral space at the surgical level was more evident in the bACP group. Angulation, as measured by Cobb's angle, demonstrated obvious healing in both groups, while better maintenance was observed in the mACP group. The local inflammatory reaction was uneventful during follow-up. Dysphonia and dysphagia were observed in both groups during the follow-up. CONCLUSIONS The relatively comparable

  6. Degenerative spine disorders in the context of clinical findings

    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

  7. Joint effects of smoking and silicosis on diseases to the lungs.

    Lap Ah Tse

    Full Text Available Smokers are subject to being more susceptible to the long-term effects of silica dust, whilst it remains unclear whether the joint effect of smoking and silicosis differs amongst diseases to the lungs; this study aims to address this knowledge gap. This was a historical cohort study comprised of 3202 silicotics in Hong Kong during 1981-2005 who were followed up till 31/12/2006. We estimated the standardized mortality ratio (SMR in the smoking and never smoking silicotics using the mortality rates of male general population indiscriminately by smoking status, but these SMRs were regarded as biased. We adjusted these biased SMRs using "smoking adjustment factors (SAF". We assessed the multiplicative interaction between smoking and silicosis using 'relative silicosis effect (RSE' that was the ratio of SAF-corrected SMR of smoking silicotics to the never smokers. A RSE differs significantly from one implies the presence of multiplicative interaction. A significant excess SMR was observed for respiratory diseases (lung cancer, chronic obstructive pulmonary diseases [COPD], silicosis and other diseases to the lungs (pulmonary heart disease, tuberculosis. All the 'biased-SMRs' in smokers were higher than those in never smokers, but the SAF-corrected SMRs became higher in never smokers. The RSE was 0.95 (95%CI: 0.37-3.55, 0.94 (95%CI: 0.42-2.60, and 0.81 (95%CI: 0.60-1.19 for lung cancer, COPD, and silicosis; whilst it was 1.21 (95%CI: 0.32-10.26 for tuberculosis and 1.02 (95%CI: 0.16-42.90 for pulmonary heart disease. This study firstly demonstrated the joint effect of smoking and silicosis may differ amongst diseases to the lungs, but power is limited.

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

    M.M. Hadipour

    2011-04-01

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

  9. Wallis棘突间动态固定防治腰椎退变的短期效果%Early clinical observation of Wallis interspinous dynamic stabilization in treatment of lumbar degenerative disease

    杨述华; 许伟华; 叶树楠; 唐欣; 吴星火; 刘先哲; 王晶

    2009-01-01

    Objective To summarize the early experience of the implantation of Wallis posterior dynamic stabilization system for the treatment of early lumbar degenerative disease.Methods During January 2007 to May 2008, 36 patients (37 intervertebral spaces) with early lumbar degenerative disease were treated with Wallis system.There were 23 males and 13 females; 1 case of L2-3, 1 case L3-4-5 intervertebral space, and 35 cases are L4-5 intervertebral space.The spinous process of the segment with intervertebral disk hernia was not excised, and the Wallis system was implanted after the excision of herniated disk with spinal microscope.The JOA and visual analogue scale (VAS) were given before and after the operation.The patients were followed up for average 13.5 months (range, 3-17 months) after the operation.Results The evaluation of therapeutic effect was excellent except 1 case.JOA score were 15-17 with the average of 16.3, and VAS were 0-2 with the average of 0.6.The MRI showed that no compression of spinal cord and improvement of disc signal.The degeneration of the proximal disc did not aggravate.No leakage of cerebrospinal fluid, infection or hernia of residual intervertebral disk.No recur of intervertebral disk hernia and displace of the Wallis system.Conclusion The Wallis posterior dynamic stabilization system, as a non-rigid fixation technique, can preserve the mobility, anatomy and stability of operated lumbar vertebral bodies, promote the recover of the lesion discs, and prevent the degeneration of adjacent discs.%目的 总结Wallis棘突间动态稳定系统置入治疗早期腰椎退变性疾病的短期疗效.方法 2007年1月至2008年5月,共治疗36例(37间隙)腰椎间盘突出症患者.L2-3 1例,L3-4并L4-5 1例,其余均为L4-5间隙.男23例,女13例;年龄38~55岁,平均43岁.手术保留椎间盘突出节段棘突,以脊柱显微镜配合摘除突出的椎间盘,置入Wallis棘突间动态稳定系统并固定缝合.对

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

    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.

  11. Hip and pelvis diseases on lumbar AP radiographs including both hip joints

    To determine the frequency of diseases of the hip and pelvis, as seen of plain radiography of the lumbar spine in patients with suspicious lumbar disease, and to evaluate the methods used of lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1252 patients, taken using 14' x 17' film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesions, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesions in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 of the 20 hospitals which responded, 14' x 17' film was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful was to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis

  12. 渐进式功能锻炼对腰椎退行性变患者术后功能恢复的影响%Effect of progressive functional exercises on post--operative rehabilitation of function for patients with degenerative diseases of lumbar vertebrae

    王飞; 潘淑慧; 程红梅; 朱红芳

    2011-01-01

    Objective To study the effect of progressive functional exercises on post--operative rehabilitation of function for patients with degenerative diseases of lumbar vertebrae. Method 32 patients with degenerative diseases of lumbar vertebrae receive rehabilitation exercise by progressive functional exercises method from 2 days before to 3 months after the surgry. Result The accuracy of straight leg raising, lumbar posture correction training and dorsal abdominal muscle are 100%at discharge. Pre--operation score of Oswestry functional disorder is (32. 09±5. 16) and 3 months post-operation score is (14. 09±3. 17). Flucuation of scores for 23 patients is more than 15. Conclusion progressive functional exercise can improve rehabilitation of physical function for patients with degenerative diseases of lumbar vertebrae effectively.%目的 探讨渐进式功能锻炼对腰椎退行性变患者术后功能恢复的效果.方法 对32例腰椎退行性变患者于术前2 d至术后3个月采用渐进式功能锻炼方案实施康复锻炼.结果 出院时直腿抬高、腰椎姿势纠正训练、腹背肌训练等项目的 正确率为100%;Oswestry功能障碍评分术前(32.09±5.16)分、术后3个月(14.09±3.17)分,其中23例患者评分变化>15分.结论 渐进式功能锻炼可有效促进腰椎退行性变患者术后功能恢复.

  13. Rosai-Dorfman disease in a child with involvement of extra-nodal wrist joint

    Rajjyoti Das

    2015-01-01

    Full Text Available Rosai-Dorfman Disease (RDD is a benign condition primarily affecting the lymph nodes. The term sinus histiocytosis with massive lymphadenopathy was first used. There may be extra-nodal presentation of RDD with or without constitutional symptoms. A 10-year-old boy presented with massive bilateral cervical lymphadenopathy which mimicked the diagnosis of lymphoma. We describe here a case of RDD in a child with extra-nodal bone involvement of the wrist joint, its diagnosis by histopathological examination supported by immunohistochemistry and consequent initial management. [Int J Res Med Sci 2015; 3(1.000: 357-360

  14. Joint Disorders

    A joint is where two or more bones come together, like the knee, hip, elbow, or shoulder. Joints can be damaged by many types of injuries or diseases, including Arthritis - inflammation of a joint. It causes pain, stiffness, and swelling. Over time, ...

  15. Nuclear Medicine in Diagnosis and Therapy of Bone and Joint Diseases

    Concerning bone and joint diseases therapy of rheumatic synovitis (radiosynoviorthesis) was introduced in 1952 before clinically relevant diagnostic procedures were developed. Radionuclides of Sr and later on 99mTc phosphonates then started the wide use of bone scintigraphy since > 30 years. The diagnostic methods have an excellent sensitivity for detection of local abnormalities of bone metabolism, the specificity of such studies, however, is low. Modifications of the technique (3-phase-bone-scintigraphy, pinhole collimators, ROI-technique), increasing knowledge of pathological scan patterns and introduction of other radionuclide studies (67Ga, 201Tl, inflammation scans with 99mTc-leukocytes or 99mTc-HIG) as well as 18FDG-PET have increased the specificity significantly in recent years and improvements of imaging systems (SPECT) also increased the accuracy of diagnostic methods in diseases of bone and joints. Therapy of such diseases has made considerable progress: inflamed, swollen joints can effectively be treated with 90Y-, 186Re, 169Er-colloids or with 165Dy-particles by radiosynoviorthesis. Severe pain due to disseminated bone metastases of cancer or polyarthritis can be controlled by radionuclide therapy with 89Sr, 153Sm-EDTMP, 186Re- or 188Re-HEDP and possibly 117mSn-DTPA with an acceptable risk of myelodepression. Possibilities, technical details and limitations of radionuclide applications for diagnostic and therapeutic purposes must be considered if optimal benefit for individual patients should be achieved. Overall Nuclear Medicine can become an essential element in management of bone and joint diseases. The relationship of Nuclear Medicine to bone and joint pathology is peculiar: In 1952 treatment of rheumatic synovitis by radiosynoviorthesis with 198Au Colloid was started by Fellinger and Schmid before diagnostic approaches to bone pathology existed. Bone scintigraphy was introduced only in 1961 using 85Sr but obviously the unfavourable radiation

  16. Associations between APOE Genotypes and Disease Susceptibility, Joint Damage and Lipid Levels in Patients with Rheumatoid Arthritis

    Maehlen, Marthe T.; Provan, Sella A.; de Rooy, Diederik P. C.; van der Helm-van Mil, Annette H. M.; Annemarie Krabben; Tore Saxne; Elisabet Lindqvist; Anne Grete Semb; Till Uhlig; Désirée van der Heijde; Inger Lise Mero; Olsen, Inge C.; Kvien, Tore K; Lie, Benedicte A.

    2013-01-01

    Objective: Apolipoprotein E (APOE) genotypes are associated with cardiovascular disease (CVD) and lipid levels. In rheumatoid arthritis (RA), an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. Method: A Norwegian cohort of 945 RA patients and 988 controls were genotyped for tw...

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

    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).

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

    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)

  19. Canonical feature selection for joint regression and multi-class identification in Alzheimer's disease diagnosis.

    Zhu, Xiaofeng; Suk, Heung-Il; Lee, Seong-Whan; Shen, Dinggang

    2016-09-01

    Fusing information from different imaging modalities is crucial for more accurate identification of the brain state because imaging data of different modalities can provide complementary perspectives on the complex nature of brain disorders. However, most existing fusion methods often extract features independently from each modality, and then simply concatenate them into a long vector for classification, without appropriate consideration of the correlation among modalities. In this paper, we propose a novel method to transform the original features from different modalities to a common space, where the transformed features become comparable and easy to find their relation, by canonical correlation analysis. We then perform the sparse multi-task learning for discriminative feature selection by using the canonical features as regressors and penalizing a loss function with a canonical regularizer. In our experiments on the Alzheimer's Disease Neuroimaging Initiative (ADNI) dataset, we use Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) images to jointly predict clinical scores of Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) and also identify multi-class disease status for Alzheimer's disease diagnosis. The experimental results showed that the proposed canonical feature selection method helped enhance the performance of both clinical score prediction and disease status identification, outperforming the state-of-the-art methods. PMID:26254746

  20. Hip and pelvis diseases on lumbar AP radiographs including both hip joints

    To determine the frequency of disease, and to evaluate the methods used for lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1215 patients, taken using 14x17 inch film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesion, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesion in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 or the 20 hospitals which responded, 14x17film was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis

  1. Hip and pelvis diseases on lumbar AP radiographs including both hip joints

    Lim, Hyun Soo; Juhng, Seon Kwan; Kim, Eun A; Kim, Jeong Ho; Song, Ha Heon; Shim, Dae Moo [Wonkwang University School of Medicine, Iksan (Korea, Republic of)

    2002-12-01

    To determine the frequency of disease, and to evaluate the methods used for lumbar spine radiography in Korea. Sixty university and training hospitals were randomly selected and asked to describe the projections, film size and radiographic techniques employed for routine radiography in patients with suspected disease of the lumbar spine. Plain radiographs of 1215 patients, taken using 14x17 inch film and depicting both hip joints and the lumbar region, were analysed between March 1999 and February 2000. In 15 patients (1.2%), the radiographs revealed hip or pelvic lesion, confirmed as follows: avascular necrosis of the femoral head (n=11, with bilateral lesion in four cases); sustained ankylosing spondylitis (n=2); acetabular dysplasia (n=1); and insufficiency fracture of the pubic rami secondary to osteoporosis (n=1). In 11 or the 20 hospitals which responded, 14{sup x}17{sup f}ilm was being used for lumbar radiography, while in the other nine, film size was smaller. Plain radiography of the lumbar spine including both hip joints, may be a useful way to simultaneously evaluate lesions not only of the lumbar spine but also of the hip and/or pelvis.

  2. Total reconstruction of the temporomandibular joint. Up to 8 years of follow-up of patients treated with Biomet(®) total joint prostheses.

    Westermark, A

    2010-10-01

    12 patients underwent temporomandibular joint (TMJ) reconstruction with Biomet total joint prostheses. Indications for TMJ reconstruction included ankylosis, rheumatoid arthritis, degenerative joint disease and condylar resorption. Five patients had unilateral procedures, seven had bilateral. The follow-up ranged between 2 and 8 years. Amongst the ankylotic patients the mean jaw-opening capacity increased from 3.8mm preoperatively to 30.2mm 1 year after surgery, and in most of those patients the opening capacity remained stable over the years. The other patients maintained a mean opening capacity of more than 35 mm. Joint related pain and interference with eating were eliminated after TMJ reconstruction. There were no permanent facial nerve disturbance, no postoperative infections and no device related complications. The outcome supports prosthetic TMJ reconstruction as a useful treatment modality in patients with advanced TMJ disease. PMID:20594807

  3. Isolated septic facet joint arthritis as a rare cause of acute and chronic low back pain – a case report and literature review

    Klekot, Dominika; Zimny, Anna; Czapiga, Bogdan; Sąsiadek, Marek

    2012-01-01

    Summary Background: The most common cause of low back pain is degenerative disease of the intervertebral disc and other structures of the lumbar spine. However, in some cases other less frequent causes of such pain can be seen, for example septic facet joint arthritis. Until now, only 40 cases of such inflammatory changes within the spine have been reported in the literature. The disease is probably underestimated due to improper diagnostic pathway. Case Report: The authors describe a case of...

  4. SHOULD DISEASE-MODIFYING THERAPY BE STOPPED IN PATIENTS WITH RHEUMATOID ARTHRITIS BEFORE ENDOPROSTHETIC JOINT REPLACEMENT?

    N. A. Savenkova

    2011-06-01

    Full Text Available Objective: to analyze disease activity, functional state, quality of life (QL, and the frequency of infectious complications in methotrexate (MT – or leflunomide (LF-treated patients with rheumatoid arthritis (RA who had undergone endoprosthetic replacement of the large joints of the lower limbs. Subjects and methods. One hundred and fourteen patients with RA who had undergone endoprosthetic replacement of the knee and hip joints were divided into 3 groups: 1 36 patients who continuously received MT or LF in the perioperative period; 2 42 patients who dis- continued MT or LF 2 and 4 weeks, respectively, prior to surgery; 3 36 patients who took no disease-modifying anti-rheumatic drugs (DMARDs within 12 months before surgery. Disease activity was estimated by the DAS28 index. QL was determined using the EQ-5D questionnaire and functional capacity was estimated by the HAQ index. Results and discussion. In all the groups, there was a preponderance of patients with moderate RA activity (more than 60%. In Groups 1 and 2, the mean dose of MT was about 10 mg weekly and that of LF was 20 mg daily. The use duration of glucocorticoids (GC and their doses were comparable in all the groups. Twelve months after surgery, DAS28 significantly reduced from 4.22±1.08 to 3.58±1.07 months in Group 1 (p = 0.01; in Group 2, the decrease was insignificant: from 4.17±1.17 to 3.80±1.15 (p > 005; in Group 3, RA activity remained as before. All the groups achieved 50% functional improvement; better results were obtained in the group of patients who continued to use DMARDs in the perioperative period (∆HAQ=-0.67. The difference in the Eq-5D index corresponded to a moderate QL improvement: ∆EQ-5D = 0.28, 0.29, and 0.31 in Groups 1, 2, and 3, respectively (p < 0.05. There were no significant group differences. Deep infection in the endoprosthetic replacement area was detected in 2.8, 2.4, and 8.3% of cases, respectively (p > 005. Conclusion. Continuous use of MT

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

    Full text: New Partnership for Africa's Development (NEPAD) flagship Comprehensive Africa Agriculture Development Programme (CAADP). Focus is on livestock for trade and export. Better policies, institutions, regulatory framework and technologies are sought for livestock production and management and delivery of veterinary services and disease control. The disease status of African countries places the pivotal constraints on trade possibilities. Animal health standards imposed by importing countries for international, regional or bi-lateral trade, and through the World Trade Organisation's (WTO) Sanitary and Phytosanitary (SPS) agreement must be met. 12 of the 15 most important transboundary animal diseases persist in Africa. Disease control under SPS, entailing new standards, regulations and technologies, can and is not be covered by conventional veterinary training. This specialist area of its own has to be addressed in a specialised postgraduate course for young personnel already involved and responsible for public, private and hybrid animal disease control services. Ambitious visions of a new African livestock sector with changed focus on production, disease, trade, marketing, organisation, delivery and internationality are only realistic with newly trained animal disease control personnel. To target these issues at the academic level the Addis Ababa University / Ethiopia with universities of 3 regional partner countries (Kenya, Uganda, Sudan) and the Freie Universitaet Berlin, Germany, successfully applied for a grant to establish a Joint Master Course in Transboundary Animal Disease Management (MTADM) for Africa. The 3-year project is funded under the EU - EDULINK Programme of the 9th European Development Funds (EDF) as from 2008 to 2010. Currently, preparatory work is ongoing on the final technical details of the MTADM Course. The overall objective of the programme is to strengthen the capacity of national veterinary services in Africa to control and manage

  6. Flexible Stabilisation of the Degenerative Lumbar Spine Using PEEK Rods

    Jacques Benezech

    2016-01-01

    Full Text Available Posterior lumbar interbody fusion using cages, titanium rods, and pedicle screws is considered today as the gold standard of surgical treatment of lumbar degenerative disease and has produced satisfying long-term fusion rates. However this rigid material could change the physiological distribution of load at the instrumental and adjacent segments, a main cause of implant failure and adjacent segment disease, responsible for a high rate of further surgery in the following years. More recently, semirigid instrumentation systems using rods made of polyetheretherketone (PEEK have been introduced. This clinical study of 21 patients focuses on the clinical and radiological outcomes of patients with lumbar degenerative disease treated with Initial VEOS PEEK®-Optima system (Innov’Spine, France composed of rods made from PEEK-OPTIMA® polymer (Invibio Biomaterial Solutions, UK without arthrodesis. With an average follow-up of 2 years and half, the chances of reoperation were significantly reduced (4.8%, quality of life was improved (ODI = 16%, and the adjacent disc was preserved in more than 70% of cases. Based on these results, combined with the biomechanical and clinical data already published, PEEK rods systems can be considered as a safe and effective alternative solution to rigid ones.

  7. Structural and biomechanical aspects of equine sacroiliac joint function and their relationship to clinical disease.

    Goff, L M; Jeffcott, L B; Jasiewicz, J; McGowan, C M

    2008-06-01

    Pain originating from the sacroiliac joint (SIJ) in horses has long been associated with poor performance, yet specific diagnosis of sacroiliac dysfunction (SID) has been difficult to achieve. Clinical presentation of SID appears to fall into two categories. The first, presenting as pain and poor performance, is responsive to local analgesia of periarticular structures with poorly defined pathology. The second presents primarily as poor performance with bony pathological changes as a result of chronic instability. Diagnostic tests based on biomechanics as well as manual provocation for SIJ pain have formed the basis of tests currently used to diagnose SIJ dysfunction in humans. This review summarises the anatomy and biomechanics of the equine SIJ and current biomechanical, innervation and motor control concepts in human SID. The relationship between abnormal SIJ motion and altered neuromotor control with clinical disease of the equine SIJ are discussed. Future utilisation of these principles to develop new diagnostic and management tools for the equine SID is promising. PMID:17493851

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

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

  9. Stargardt Disease

    ... Congenital Amaurosis Macular Degeneration Retinitis Pigmentosa Stargardt Disease Usher Syndrome Other Retinal Diseases Glossary News & Research News & ... for retinal degenerative diseases like retinitis pigmentosa (RP), Usher syndrome and macular degeneration . Back to top What ...

  10. MRI of the wrist and finger joints in inflammatory joint diseases at 1-year interval: MRI features to predict bone erosions

    Savnik, Anette [Department of Rheumatology, Parker Institute, Frederiksberg Hospital, Copenhagen (Denmark); Department of Radiology, University Hospital at Herlev, Copenhagen (Denmark); Department of Radiology, Frederiksberg Hospital, Copenhagen (Denmark); Malmskov, Hanne; Graff, Lykke B.; Danneskiold-Samsoee, Bente; Bliddal, Henning [Department of Rheumatology, Parker Institute, Frederiksberg Hospital, Copenhagen (Denmark); Thomsen, Henrik S. [Department of Radiology, University Hospital at Herlev, Copenhagen (Denmark); Nielsen, Henrik [Department of Rheumatology, University Hospital at Herlev, Copenhagen (Denmark); Boesen, Jens [Department of Radiology, Frederiksberg Hospital, Copenhagen (Denmark)

    2002-05-01

    The aim of this study was to assess the ability of MRI determined synovial volumes and bone marrow oedema to predict progressions in bone erosions after 1 year in patients with different types of inflammatory joint diseases. Eighty-four patients underwent MRI, laboratory and clinical examination at baseline and 1 year later. Magnetic resonance imaging of the wrist and finger joints was performed in 22 patients with rheumatoid arthritis less than 3 years (group 1) who fulfilled the American College of Rheumatology (ACR) criteria for rheumatoid arthritis, 18 patients with reactive arthritis or psoriatic arthritis (group 2), 22 patients with more than 3 years duration of rheumatoid arthritis, who fulfilled the ACR criteria for rheumatoid arthritis (group 3), and 20 patients with arthralgia (group 4). The volume of the synovial membrane was outlined manually before and after gadodiamide injection on the T1-weighted sequences in the finger joints. Bones with marrow oedema were summed up in the wrist and fingers on short-tau inversion recovery sequences. These MRI features was compared with the number of bone erosions 1 year later. The MR images were scored independently under masked conditions. The synovial volumes in the finger joints assessed on pre-contrast images was highly predictive of bone erosions 1 year later in patients with rheumatoid arthritis (groups 1 and 3). The strongest individual predictor of bone erosions at 1-year follow-up was bone marrow oedema, if present at the wrist at baseline. Bone erosions on baseline MRI were in few cases reversible at follow-up MRI. The total synovial volume in the finger joints, and the presence of bone oedema in the wrist bones, seems to be predictive for the number of bone erosions 1 year later and may be used in screening. The importance of very early bone changes on MRI and the importance of the reversibility of these findings remain to be clarified. (orig.)

  11. Cervical degenerative intraspinal cyst: a case report and literature review involving 132 cases

    Machino, Masaaki; YUKAWA, YASUTSUGU; ITO, KEIGO; KATO, FUMIHIKO

    2012-01-01

    Intraspinal and extradural cysts in the cervical spine are rare disorders that may cause myelopathy or radiculopathy. A synovial cyst or ganglion derived from the facet joint and that from a ligamentum flavum have been reported. We report a surgical case of degenerative intraspinal cyst, causing cervical myelopathy. MRI of a case revealed cystic lesion at C4–5. Spinal cord was compressed by cyst and symptoms of myelopathy were also observed. The patient with cervical spinal canal stenosis und...

  12. Health Care Providers' Knowledge and Practice Gap towards Joint Zoonotic Disease Surveillance System: Challenges and Opportunities, Gomma District, Southwest Ethiopia.

    Gemeda, Desta Hiko; Sime, Abiot Girma; Hajito, Kifle Woldemichael; Gelalacha, Benti Deresa; Tafese, Wubit; Gebrehiwot, Tsegaye Tewelde

    2016-01-01

    Background. Health care providers play a crucial role for realization of joint zoonotic diseases surveillance by human and animal health sectors, yet there is limited evidence. Hence, this study aimed to determine knowledge and practice gap of health care providers towards the approach for Rabies and Anthrax in Southwest Ethiopia. Methods. A cross-sectional survey was conducted from December 16, 2014, to January 14, 2015. Eligible health care providers were considered for the study. Data were entered in to Epi-data version 3.1 and analyzed using SPSS version 20. Results. A total of 323 (92.02%) health care providers participated in the study. Three hundred sixteen (97.8%) of participants reported that both human and animal health sectors can work together for zoonotic diseases while 96.9% of them replied that both sectors can jointly conduct surveillance. One hundred seventeen (36.2%) of them reported that their respective sectors had conducted joint surveillance for zoonotic diseases. Their involvement was, however, limited to joint outbreak response. Conclusion. There is good opportunity in health care providers' knowledge even though the practice was unacceptably low and did not address all surveillance components. Therefore, formal joint surveillance structure should be in place for optimal implementation of surveillance. PMID:27579311

  13. Comparative diagnostic imaging of the canine shoulder joint: ultrasonography and radiography

    Ultrasonography of shoulder joint disease has been applied in humans for some time. In this study, the use of radiography and ultrasonography as diagnostic imaging modalities to determine shoulder joint lesions is presented. The ultrasonographic anatomy and pathology of the shoulder joint are described. Comparative radiographic and ultrasonographic findings in 67 dogs with front limb lameness and/or radiographically visible shoulder joint lesions are presented. Shoulder joint lesions include insertion tendinopathies of the supra- and infraspinatus muscles, distension of the subtendinous bursa of the infraspinatus muscle, bicipital tendinopathies, such as tendovaginitis, calcifications, partial and complete rupture, and avulsion fractures at the supraglenoid tubercle, osteochondritis dissecans, degenerative joint disease, bony proliferations in the intertuberal groove, and neoplasia of bones and soft-tissues. Ultrasonographic diagnosis of tendon abnormalities and other soft tissue lesions is a necessary supplemental examination to radiographs, which should always be the basis for orthopedic diagnostic imaging. When using both imaging techniques, the exact location of radio-opaque mineralizations can be determined and a more accurate diagnosis made. The ultrasonographic appearance of an infraspinatus muscle insertion tendinopathy in conjunction with distension of the subtendinous bursa is reported for the first time. Low-density calcifications are not visible radiographically. 6 of 17 supraspinatus insertion tendinopathies (35.3 %) and 4 of 5 bicipital tendon calcifications (80 %) were detected only with ultrasonography. Radiographic findings of bony proliferations in the intertuberal groove without signs of degenerative joint disease of the shoulder joint are indicative of severe or chronic biciptal tendon disease. In many cases, the stage and severity of cartilaginous and subchondral bone lesions with osteochondritis dissecans can be determined ultrasonographically

  14. MicroRNA Expression Signature in Degenerative Aortic Stenosis

    2016-01-01

    Degenerative aortic stenosis, characterized by narrowing of the exit of the left ventricle of the heart, has become the most common valvular heart disease in the elderly. The aim of this study was to investigate the microRNA (miRNA) signature in degenerative AS. Through microarray analysis, we identified the miRNA expression signature in the tissue samples from healthy individuals (n = 4) and patients with degenerative AS (n = 4). Six miRNAs (hsa-miR-193a-3p, hsa-miR-29b-1-5p, hsa-miR-505-5p, hsa-miR-194-5p, hsa-miR-99b-3p, and hsa-miR-200b-3p) were overexpressed and 14 (hsa-miR-3663-3p, hsa-miR-513a-5p, hsa-miR-146b-5p, hsa-miR-1972, hsa-miR-718, hsa-miR-3138, hsa-miR-21-5p, hsa-miR-630, hsa-miR-575, hsa-miR-301a-3p, hsa-miR-636, hsa-miR-34a-3p, hsa-miR-21-3p, and hsa-miR-516a-5p) were downregulated in aortic tissue from AS patients. GeneSpring 13.1 was used to identify potential human miRNA target genes by comparing a 3-way comparison of predictions from TargetScan, PITA, and microRNAorg databases. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were performed to identify potential pathways and functional annotations associated with AS. Twenty miRNAs were significantly differentially expressed between patients with AS samples and normal controls and identified potential miRNA targets and molecular pathways associated with this morbidity. This study describes the miRNA expression signature in degenerative AS and provides an improved understanding of the molecular pathobiology of this disease.

  15. Manifestações articulares nas viroses exantemáticas Joint complaints in exanthematic diseases

    Solange Artimos de Oliveira

    1999-04-01

    Full Text Available A freqüência de manifestações articulares foi avaliada em 251 pacientes com diagnóstico clínico e laboratorial (detecção de IgM por ensaio imunoenzimático de virose exantemática. As artropatias (artralgia e/ou artrite foram mais observadas nos casos de dengue (49% e de rubéola (38,2% do que naqueles com parvovirose humana (30% e sarampo (28,1%. Com exceção do sarampo, as artropatias predominaram nos adultos (315 anos de idade, sendo tal diferença estatisticamente significativa. A ocorrência maior de artropatias em adultos foi mais evidente nos pacientes com parvovirose (75%, rubéola (65% e dengue (57,7% do que naqueles com sarampo (31%. As queixas articulares também predominaram nos pacientes do sexo feminino para todas as viroses avaliadas. Os resultados encontrados demonstram o freqüente acometimento articular nas doenças estudadas, e indicam a necessidade de comprovação laboratorial para o diagnóstico diferencial entre elas.The frequency of arthropathy was evaluated in 251 patients with clinical and serological diagnosis (specific IgM detection by enzyme immunoassay of exanthematic disease. Arthropathy (arthralgia and/or arthritis was more frequent in dengue fever (49% and rubella (38.2% cases than in human parvovirus (30% and measles (28.1% cases. Except for measles cases, joint complaints prevailed in adults (315 years of age and this difference was significant. The higher frequency of arthropathy in adults was more evident in human parvovirus (75%, rubella (65% and dengue fever (57.7% cases than in measles cases (31%. Arthropathy was also more frequent in females for all rash diseases studied. The results of this study showed the high occurrence of joint complaints in the diseases described here and the importance of laboratory confirmation for their differential diagnosis.

  16. Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases.

    Helenius, L M J; Tervahartiala, P; Helenius, I; Al-Sukhun, J; Kivisaari, L; Suuronen, R; Kautiainen, H; Hallikainen, D; Lindqvist, C; Leirisalo-Repo, M

    2006-11-01

    The aim of this study was to investigate the condition of the temporomandibular joint (TMJ) in patients with different rheumatic diseases, and report correlations between the clinical, radiographic and magnetic resonance imaging (MRI) findings. The 67 patients were divided into four groups: 16 with rheumatoid arthritis (RA), 15 with mixed connective tissue disease (MCTD), 18 with ankylosing spondylitis (AS) and 18 with spondyloarthropathy (SPA). They were clinically examined, and panoramic tomography, lateral panoramic radiography and MRI of the TMJ were performed. MRI showed reduced articular cartilage in 25% (4/16) of RA, 0% (0/15) of MCTD, 17% (3/18) of AS and 17% (3/18) of SPA patients. Condylar changes included erosion, osteophytes and abnormal shape. Disc alterations included perforation, abnormal anterior position and decreased movement. These abnormalities were most frequent in RA patients, and least frequent in MCTD and SPA patients. Crepitation and reduced maximum opening of the mouth correlated with abnormalities of the disc and articular cartilage as shown by MRI. Severe condylar erosion in panoramic tomograms significantly correlated with MRI findings of condylar erosion (Pjaw often indicated structural damage to the TMJ. Panoramic radiographs provide an alternative method to MRI but, to obtain a more detailed anatomic picture, MRI is recommended for patients with acute unexplained pain or as part of preoperative work up. A panoramic recording is not indicated when MRI is planned. PMID:17052893

  17. PERIPROSTHETIC JOINT INFECTION IN PATIENTS WITH RHEUMATIC DISEASES: THE PROBLEMS OF DIAGNOSIS, PREVENTION, AND TREATMENT

    A. E. Khramov

    2015-01-01

    Full Text Available One of the most menacing complications of large joint total endoprosthesis (TE in patients with rheumatic diseases (RD is the development of periprosthetic infection (PI, progression of which may give rise not only to limb loss, but also death. At the same time, early diagnosis and adequate surgical care make it possible not only to arrest the infectious process, but also to preserve an implanted joint.Objective: to define criteria for the diagnosis, prevention, and treatment of PI after hip and knee joint (HJ and KJ TE in patients with RD.Subjects and methods. In 2009 to 2013, 654 KJ and 549 HJ TE was performed in the V.A. Nasonova Research Instituteof Rheumatology performed KJ (n = 654 and HJ (n = 549 joint ERs.Results and discussion. PI developed in 12 (3.63% and 8 (2.95% patients after KJ and HJ ER, respectively. Early, delayed, and late PI was seen in 11, 6, and 3 patients, respectively. Eleven patients with early PI underwent joint revision/ debridement with preservation of an endoprosthesis and replacement of HJ endoprosthetic inserts and heads. The operations were completed with the collagen hemobiotics being left in the wound and its drainage. Systemic antibiotic therapy was used for 4–6 weeks. No recurrent infection was observed in 9 cases. Two patients underwentresurgery, by setting suction-irrigation systems. Nine patients with delayed or late PI had the following operations: A single-stage revision operation (the endoprosthesis was removed and a new one was implanted was performed in two cases of stable endoprosthetic components and accurately verified low-virulent microorganisms susceptible to certain antibiotics. It was imperative to use cement with an antibiotic, collagen hemobiotics, and systemic antibiotic therapy for 6 weeks. The other 7 patients with unstable endoprosthetic components underwent two-stage revision: Stage 1, endoprosthetic removal and antibiotic-loaded spacer implantation; 6-12 weeks after

  18. Development of Modulators Against Degenerative Aging Using Radiation Fusion Technology

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

    2010-04-15

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

  19. Development of Modulators Against Degenerative Aging Using Radiation Fusion Technology

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

  20. (18)F Sodium Fluoride PET/CT in Patients with Prostate Cancer: Quantification of Normal Tissues, Benign Degenerative Lesions, and Malignant Lesions.

    Oldan, Jorge D; Hawkins, A Stewart; Chin, Bennett B

    2016-01-01

    Understanding the range and variability of normal, benign degenerative, and malignant (18)F sodium fluoride ((18)F NaF) positron emission tomography/computed tomography (PET/CT) uptake is important in influencing clinical interpretation. Further, it is essential for the development of realistic semiautomated quantification techniques and simulation models. The purpose of this study is to determine the range of these values in a clinically relevant patient population with prostate cancer. (18)F NaF PET/CT scans were analyzed in patients with prostate cancer (n = 47) referred for evaluation of bone metastases. Mean and maximum standardized uptake values [SUVs (SUVmean and SUVmax)] were made in normal background regions (n = 470) including soft tissues (liver, aorta, bladder, adipose, brain, and paraspinal muscle) and osseous structures (T12 vertebral body, femoral diaphyseal cortex, femoral head medullary space, and ribs). Degenerative joint disease (DJD; n = 281) and bone metastases (n = 159) were identified and quantified by an experienced reader using all scan information including coregistered CT. For normal bone regions, the highest (18)F NaF PET SUVmean occurred in T12 (6.8 ± 1.4) and it also showed the lowest coefficient of variation (cv = 21%). For normal soft tissues, paraspinal muscles showed very low SUVmean (0.70 ± 0.11) and also showed the lowest variability (cv = 16%). Average SUVmean in metastatic lesions is higher than uptake in benign degenerative lesions but values showed a wide variance and overlapping values (16.3 ± 13 vs 11.1 ± 3.8; P disease, and osseous metastases are comparable to those reported for a general population with a wide variety of diagnoses. These normal ranges, specifically for prostate cancer patients, will aid in clinical interpretation and also help to establish the basis of normal limits in a semiautomated data analysis algorithm. PMID:27134560

  1. The Effects on Knowledge of the Systematic Education of Patients with Joint Diseases Treated with NSAIDs and Diuretics.

    Linne, Agneta Bjorck; Liedholm, Hans; Jacobsson, Lennart

    2001-01-01

    In a randomized, controlled trial, patients with joint diseases and concomitant treatment with NSAIDs and diuretics received systematic education. The intervention group was given information focusing on awareness of drug interactions and encouragement of self-adjustment of treatment. Results reveal that the intervention group achieved greater…

  2. Application of Zero-P interbody fusion in degenerative disease at the adjacent segments after anterior cervical fusion%Zero-P椎间融合术在治疗颈前路融合术后相邻节段退变性疾病中的应用

    程彩霞; 卢旭华; 谢宁; 郭翔; 郭群峰; 倪斌

    2012-01-01

    Objective To investigate the clinical outcomes of Zero-P interbody fusion in the treatment of degenerative disease at the adjacent segments after anterior cervical decompression and fusion with internal fixation. Methods Sixteen patients with degenerative diseases at adjacent segments after anterior cervical decompression and fusion with internal fixation received Zero-P anterior cervical interbody fusion. Japanese Orthopaedic Association ( JOA) scores were compared before and after the operation. Postoperative dysphagia and intervertebral fusion were observed. Results Postoperative JOA score was significantly increased as compared with preoperative score (P<0.05). No dysphagia occurred and all the patients obtained solid fusion. Conclusion The mid- and short-term curative effect is satisfactory for the Zero-P intervertebral fusion in the treatment of cervical degenerative disease in the adjacent segments after anterior cervical fusion.%目的 探讨采用Zero-P椎间融合术治疗颈前路减压融合内固定术后相邻节段退变性疾病的疗效.方法 对16例颈前路减压融合内固定术后发生相邻节段退变性疾病的患者采用Zero-P行颈前路椎间融合术,比较患者手术前后日本骨科学会(Japanese Orthopaedic Association,JOA)评分,观察患者术后吞咽困难发生情况及椎间融合情况.结果 患者术后JOA评分较术前提高,差异有统计学意义(P<0.05),未发生吞咽困难,所有患者均获得牢固融合.结论 采用Zero-P椎间融合术治疗颈前路融合术后相邻节段退变性疾病中短期疗效较好.

  3. Common surgical complications in degenerative spinal surgery

    Papadakis, Michael; Aggeliki, Lianou; Papadopoulos, Elias C.; Girardi, Federico P.

    2013-01-01

    The rapid growth of spine degenerative surgery has led to unrelenting efforts to define and prevent possible complications, the incidence of which is probably higher than that reported and varies according to the region of the spine involved (cervical and thoracolumbar) and the severity of the surgery. Several issues are becoming progressively clearer, such as complication rates in primary versus revision spinal surgery, complications in the elderly, the contribution of minimally invasive sur...

  4. Influence of degenerative changes of intervertebral disc

    Wang, Yi; Chen, Hai-Bin; Zhang, Ling; ZHANG Li-ying; Liu, Jing-cheng; WANG Zheng-guo

    2012-01-01

    【Abstract】Objective: To investigate the material properties of normal and degenerated intervertebral discs (IVDs) and examine the effect of degenerative changes on IVD pathology. Methods: A computer-based online search was under-taken to identify English articles about material properties of IVDs published from January 1950 to 2011 in PubMed database. The retrieved keywords included material properties, intervertebral disc and degeneration. Based on the principle...

  5. Systems to assess the progression of finger joint osteoarthritis and the effects of disease modifying osteoarthritis drugs.

    Verbruggen, G; Goemaere, S; Veys, E M

    2002-06-01

    Our objective was to assess the progression of osteoarthritis (OA) using scoring systems based on the anatomical changes recorded in the finger joints on standard radiographs and to test how far these scoring systems could be used to evaluate the effects of candidate "disease modifying osteoarthritis drugs" (DMOAD). The appearance and growth of osteophytes, narrowing of the joint space and subchondral bone changes allowed the classic OA-associated anatomical lesions to be used to score the progression of finger joint OA. Progression of OA in the finger joints was also assessed by the their evolution through previously described and predictable anatomical phases on standard X-rays. These phases were characterised by complete loss of the joint space preceding or coinciding with the appearance of subchondral cysts eroding the entire subchondral plate, and have been described in "inflammatory" or "erosive" OA. The erosive episodes were followed by processes of remodelling. In order to interfere with the progression of osteoarthritis, two chondroitin sulphates with possible DMOAD effects were used in two series of patients with OA of the finger joints. The patients were included in two separate randomised, double-blind placebo-controlled trials: 46 of them received chondroitin polysulphate and 34 received chondroitin sulphate. Eighty-five patients were kept on placebo medication and were used as controls. All 165 patients were followed for 3 years. Posteroanterior X-rays of the metacarpophalangeal and interphalangeal (IP) finger joints were obtained at the start of this prospective study and at yearly intervals thereafter. Almost 80% of the distal IP and 50% of the proximal IP were affected at study entry. In approximately 40% of the patients the classic picture of OA of the IP joints was complicated by manifest erosive OA changes. The two systems to score the progression of OA (Anatomical Lesion and Anatomical Phase Progression Score System) showed definite progression

  6. Joint pain

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

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

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

    2006-03-01

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

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

    Laklouk, Mohamed Abdel-Rehim; Hosny, Gamal Ahmed

    2012-09-01

    The aim of this work is to determine the effect of this type of treatment on the shape of the femoral head, the range of motion (ROM), radiological changes in the femoral head, and the prognosis of Perthes disease at skeletal maturity. From 1998 to 2007, 53 patients with Perthes disease were treated with a combination of soft tissue release and joint distraction with a hinged monolateral external fixator in 32 patients and by Ilizarov external fixator in 21 patients. Nineteen of our 53 patients attained skeletal maturity and were evaluated in our study. This study included 15 boys and four girls, mean age at surgery 9.3 years (range 7.2-13.1), and mean age at the last follow-up 17.4 years (range 14.9-21.3). The duration of symptoms varied from a period of 6 to 60 months before the operation. Radiographs taken during the fragmentation stage of the disease were classified by the lateral pillar classification of Herring; 19 of our patients attained skeletal maturity and were evaluated. Clinical assessment included the Harris hip score, hip ROM, and limb length discrepancy. Radiographic assessment included sharp transverse acetabular inclination, the uncoverage percentage, the epiphyseal index before surgery (modified Eyre-Brook), at frame removal, and at the last follow-up, the epiphyseal quotient (of Sjovall), and the Stulberg classification. The mean follow-up was 7.2 years (range 4.1-11.3). The mean Harris hip score was 87.1/100 (range 49.2-94.8). An improvement in hip (ROM) of 83.3% of the normal range was restored. There was a marked improvement in the degree of pain and limp postoperatively. The hip ROM was slightly limited in most patients, and seven patients had limb shortening of between 1 and 3 cm. The mean sharp transverse acetabular inclination of the affected side was 44° (range 35-51) compared with 37° for the unaffected side (P=0.042). The mean uncoverage percentage was 36% (range 24-45) compared with 21% for the unaffected side (P=0.027). The mean

  9. Improved flow cytometric assessment reveals distinct microvesicle (cell-derived microparticle signatures in joint diseases.

    Bence György

    Full Text Available INTRODUCTION: Microvesicles (MVs, earlier referred to as microparticles, represent a major type of extracellular vesicles currently considered as novel biomarkers in various clinical settings such as autoimmune disorders. However, the analysis of MVs in body fluids has not been fully standardized yet, and there are numerous pitfalls that hinder the correct assessment of these structures. METHODS: In this study, we analyzed synovial fluid (SF samples of patients with osteoarthritis (OA, rheumatoid arthritis (RA and juvenile idiopathic arthritis (JIA. To assess factors that may confound MV detection in joint diseases, we used electron microscopy (EM, Nanoparticle Tracking Analysis (NTA and mass spectrometry (MS. For flow cytometry, a method commonly used for phenotyping and enumeration of MVs, we combined recent advances in the field, and used a novel approach of differential detergent lysis for the exclusion of MV-mimicking non-vesicular signals. RESULTS: EM and NTA showed that substantial amounts of particles other than MVs were present in SF samples. Beyond known MV-associated proteins, MS analysis also revealed abundant plasma- and immune complex-related proteins in MV preparations. Applying improved flow cytometric analysis, we demonstrate for the first time that CD3(+ and CD8(+ T-cell derived SF MVs are highly elevated in patients with RA compared to OA patients (p=0.027 and p=0.009, respectively, after Bonferroni corrections. In JIA, we identified reduced numbers of B cell-derived MVs (p=0.009, after Bonferroni correction. CONCLUSIONS: Our results suggest that improved flow cytometric assessment of MVs facilitates the detection of previously unrecognized disease-associated vesicular signatures.

  10. Partial antiviral activities detection of chicken Mx jointing with neuraminidase gene (NA against Newcastle disease virus.

    Yani Zhang

    Full Text Available As an attempt to increase the resistance to Newcastle Disease Virus (NDV and so further reduction of its risk on the poultry industry. This work aimed to build the eukaryotic gene co-expression plasmid of neuraminidase (NA gene and myxo-virus resistance (Mx and detect the gene expression in transfected mouse fibroblasts (NIH-3T3 cells, it is most important to investigate the influence of the recombinant plasmid on the chicken embryonic fibroblasts (CEF cells. cDNA fragment of NA and mutant Mx gene were derived from pcDNA3.0-NA and pcDNA3.0-Mx plasmid via PCR, respectively, then NA and Mx cDNA fragment were inserted into the multiple cloning sites of pVITRO2 to generate the eukaryotic co-expression plasmid pVITRO2-Mx-NA. The recombinant plasmid was confirmed by restriction endonuclease treatment and sequencing, and it was transfected into the mouse fibroblasts (NIH-3T3 cells. The expression of genes in pVITRO2-Mx-NA were measured by RT-PCR and indirect immunofluorescence assay (IFA. The recombinant plasmid was transfected into CEF cells then RT-PCR and the micro-cell inhibition tests were used to test the antiviral activity for NDV. Our results showed that co-expression vector pVITRO2-Mx-NA was constructed successfully; the expression of Mx and NA could be detected in both NIH-3T3 and CEF cells. The recombinant proteins of Mx and NA protect CEF cells from NDV infection until after 72 h of incubation but the individually mutagenic Mx protein or NA protein protects CEF cells from NDV infection till 48 h post-infection, and co-transfection group decreased significantly NDV infection compared with single-gene transfection group (P<0. 05, indicating that Mx-NA jointing contributed to delaying the infection of NDV in single-cell level and the co-transfection of the jointed genes was more powerful than single one due to their synergistic effects.

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

    Ott, Oliver J. [University Hospitals Erlangen, Dept. of Radiation Oncology, Erlangen (Germany); Niewald, Marcus [Saarland University Medical School, Dept. of Radiotherapy and Radiation Oncology, Homburg/Saar (Germany); Weitmann, Hajo-Dirk [Fulda Hospital, Dept. of Radiooncology and Radiotherapy, Fulda (Germany); Jacob, Ingrid [Municipal Hospital Traunstein, Dept. of Radiotherapy, Traunstein (Germany); Adamietz, Irenaeus A. [Marien Hospital Herne/Ruhr University Bochum, Dept. of Radiotherapy and Radiation Oncology, Herne (Germany); Schaefer, Ulrich [Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Keilholz, Ludwig [Bayreuth Hospital, Dept. of Radiotherapy, Bayreuth (Germany); Heyd, Reinhard [Center for Radiosurgery, Frankfurt a. M. (Germany); Muecke, Ralph [Marien Hospital Herne/Ruhr University Bochum, Dept. of Radiotherapy and Radiation Oncology, Herne (Germany); Lippe Hospital, Dept. of Radiotherapy, Lemgo (Germany); Collaboration: German Cooperative Group on Radiotherapy for Benign Diseases (GCG-BD)

    2014-09-20

    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.) [German] Zusammenfassung der Empfehlungen der DEGRO-S2e-Leitlinie zur Niedrigdosis-Radiotherapie von gutartigen schmerzhaften degenerativen Skeletterkrankungen. Die vorliegende Zusammenfassung berichtet ueber die Bedeutung der Niedrigdosis-Radiotherapie in der Behandlung von Enthesiopathien (Schultersyndrom, Ellenbogensyndrom, Bursitis trochanterica, Fasciitis plantaris) und schmerzhaften Arthrosen (Knie-, Hueft, Hand- und Fingergelenksarthrosen). Die wichtigsten Aspekte der aktuellen DEGRO-S2e-Konsensus-Leitlinie Strahlentherapie gutartiger Erkrankungen bezueglich Diagnostik, Therapieentscheidungen, Dosisempfehlungen und Durchfuehrung einer Radiotherapie werden

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

    Kjelgaard-Hansen, Mads Jens; Christensen, Michelle B.; Lee, Marcel Huisung;

    2007-01-01

    in samples obtained from dogs (n = 16) suffering from different inflammatory or non-inflammatory conditions, which were either related or unrelated to joints. Expression of SAA isoforms was visualized by denaturing isoelectric focusing and Western blotting. Serum amyloid A was present in serum from all dogs...... with systemic inflammatory activity, and up to four major isoforms with apparent isoelectric points between 6.1 and 7.9 were identified. In synovial fluid from inflamed joints one or more highly alkaline SAA isoforms (with apparent isoelectric points above 9.3) were identified, with data suggesting local...... production of these isoforms in the canine inflamed joint....

  13. Associations between APOE genotypes and disease susceptibility, joint damage and lipid levels in patients with rheumatoid arthritis.

    Marthe T Maehlen

    Full Text Available OBJECTIVE: Apolipoprotein E (APOE genotypes are associated with cardiovascular disease (CVD and lipid levels. In rheumatoid arthritis (RA, an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. METHOD: A Norwegian cohort of 945 RA patients and 988 controls were genotyped for two APOE polymorphisms. We examined longitudinal associations between APOE genotypes and C-reactive protein (CRP, erythrocyte sedimentation rate (ESR as well as hand radiographs (van der Heijde Sharp Score(SHS in 207 patients with 10 year longitudinal data. Lipid levels, cardiovascular markers and history of CVD were compared across genotypes in a cross sectional study of 136 patients. Longitudinal radiological data of cohorts from Lund and Leiden were available for replication. (N = 935, with 4799 radiographs. RESULTS: In the Norwegian cohort, associations between APOE genotypes and total cholesterol (TC and low-density lipoproteins (LDL were observed (ε2 < ε3/ε3 < ε4, p = 0.03 and p = 0.02, respectively. No association was present for acute phase reactant or CVD markers, but a longitudinal linear association between APOE genotypes and radiographic joint damage was observed (p = 0.007. No association between APOE genotypes and the severity of joint destruction was observed in the Lund and Leiden cohorts, and a meta- analysis combining all data was negative. CONCLUSION: APOE genotypes are associated with lipid levels in patients with RA, and may contribute to dyslipidemia in some patients. APOE genotypes are not consistently associated with markers of inflammation or joint destruction in RA.

  14. Associations between APOE Genotypes and Disease Susceptibility, Joint Damage and Lipid Levels in Patients with Rheumatoid Arthritis

    Maehlen, Marthe T.; Provan, Sella A.; de Rooy, Diederik P. C.; van der Helm - van Mil, Annette H. M.; Krabben, Annemarie; Saxne, Tore; Lindqvist, Elisabet; Semb, Anne Grete; Uhlig, Till; van der Heijde, Désirée; Mero, Inger Lise; Olsen, Inge C.; Kvien, Tore K.; Lie, Benedicte A.

    2013-01-01

    Objective Apolipoprotein E (APOE) genotypes are associated with cardiovascular disease (CVD) and lipid levels. In rheumatoid arthritis (RA), an association has been found with disease activity. We examined the associations between APOE genotypes and disease susceptibility and markers of disease severity in RA, including radiographic joint damage, inflammatory markers, lipid levels and cardiovascular markers. Method A Norwegian cohort of 945 RA patients and 988 controls were genotyped for two APOE polymorphisms. We examined longitudinal associations between APOE genotypes and C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) as well as hand radiographs (van der Heijde Sharp Score(SHS)) in 207 patients with 10 year longitudinal data. Lipid levels, cardiovascular markers and history of CVD were compared across genotypes in a cross sectional study of 136 patients. Longitudinal radiological data of cohorts from Lund and Leiden were available for replication. (N = 935, with 4799 radiographs). Results In the Norwegian cohort, associations between APOE genotypes and total cholesterol (TC) and low-density lipoproteins (LDL) were observed (ε2<ε3/ε3<ε4, p = 0.03 and p = 0.02, respectively). No association was present for acute phase reactant or CVD markers, but a longitudinal linear association between APOE genotypes and radiographic joint damage was observed (p = 0.007). No association between APOE genotypes and the severity of joint destruction was observed in the Lund and Leiden cohorts, and a meta- analysis combining all data was negative. Conclusion APOE genotypes are associated with lipid levels in patients with RA, and may contribute to dyslipidemia in some patients. APOE genotypes are not consistently associated with markers of inflammation or joint destruction in RA. PMID:23613766

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

    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.

  16. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases.

    Prusinowska, Agnieszka; Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint. PMID:27504021

  17. Physical activity in the elderly who underwent joint replacement surgery in the course of rheumatic diseases

    Komorowski, Arkadiusz; Przepióra, Wiktor; Księżopolska-Orłowska, Krystyna

    2016-01-01

    According to the forecasts of the Central Statistical Office of Poland, in 2030 people at the age of 65 and older will account for 23.8%, i.e. their number will amount to approx. 8.5 m people. Geriatric rheumatic patients more often decide to undergo surgical joint replacement. According to the National Health Fund, the number of joint replacement services provided in 2014 increased by 93%, as compared to 2005. Improving the physical performance of this constantly expanding group of patients requires taking into account many factors to raise their functional status, reduce the risk of falling, teach rules of proper functioning with an artificial joint and encourage unassisted physical activity. Restoring fitness and independence is a difficult but necessary task due to an increasing number of seniors with replaced joint. PMID:27504021

  18. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study

    Jacobsen, Steffen; Sonne-Holm, Stig; Rovsing, Hans; Monrad, Henrik; Gebuhr, Peter

    2007-01-01

    = 0.001), 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 < 0.001; L5: P < 0.001). CONCLUSIONS: BMI longitudinally and at index evaluations, age, and angle of lordosis were significantly associated with degenerative spondylolisthesis in women. In men, no individual risk factors for...

  19. Joint space width in dysplasia of the hip

    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. The...

  20. Ultrasound colour Doppler measurements in a single joint as measure of disease activity in patients with rheumatoid arthritis--assessment of concurrent validity

    Ellegaard, K; Torp-Pedersen, S; Terslev, L;

    2009-01-01

    investigated if the amount of CDU activity in a single joint can be used to quantify disease activity in RA. METHODS: A total of 109 patients with RA and affection of the wrist joint underwent a standardized CDU examination assessing three positions in their most affected wrist at start up in biological...

  1. Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

    Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms ''cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC'', considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment. (orig.)

  2. Current knowledge and importance of dGEMRIC techniques in diagnosis of hip joint diseases

    Zilkens, Christoph; Krauspe, Ruediger; Bittersohl, Bernd [University of Duesseldorf, Medical Faculty, Department of Orthopedic Surgery, Duesseldorf (Germany); Tiderius, Carl Johann [Lund University Hospital, Department of Orthopedic Surgery, Lund (Sweden)

    2015-08-15

    Accurate assessment of early hip joint cartilage alterations may help optimize patient selection and follow-up of hip joint preservation surgery. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC) is sensitive to the glycosaminoglycan content in cartilage that is lost early in the development of osteoarthritis (OA). Hence, the dGEMRIC technique holds promise for the development of new diagnostic and therapeutic procedures. However, because of the location of the hip joint deep within the body and due to the fairly thin cartilage layers that require high spatial resolution, the diagnosis of early hip joint cartilage alterations may be problematic. The purpose of this review is to outline the current status of dGEMRIC in the assessment of hip joint cartilage. A literature search was performed with PubMed, using the terms ''cartilage, osteoarthritis, hip joint, MRI, and dGEMRIC'', considering all levels of studies. This review revealed that dGEMRIC can be reliably used in the evaluation of early stage cartilage pathology in various hip joint disorders. Modifications in the technique, such as the operation of three-dimensional imaging and dGEMRIC after intra-articular contrast medium administration, have expanded the range of application. Notably, the studies differ considerably in patient selection and technical prerequisites. Furthermore, there is a need for multicenter prospective studies with the required technical conditions in place to establish outcome based dGEMRIC data to obtain, in conjunction with clinical data, reliable threshold values for normal and abnormal cartilage, and for hips that may benefit from conservative or surgical treatment. (orig.)

  3. Current developments in imaging of the temporomandibular joint

    The purpose of this paper is to provide a simple systematic approach to the diagnosis of polyarticular and monoarticular disease. The first part deals with common polyarticular disease, specifically the inflammatory, crystalline, and degenerative arthritides. The changes seen around the joint, as well as the distribution of the changes, characteristics of each anthropathy are demonstrated through the use of hand films. The second part of the presentation addresses the less well-known monoarticular diseases, specifically disorders that are diagnosed primarily by the radiologist rather than the clinician. These disorders include infectious arthritis, pigmented villonodular synovitis, synovial chondromatosis, and neuropathic arthropathy. The radiographic findings are not well known. Three categories of radiographic abnormalities are emphasized as an aid to diagnosis: juxtaarticular osteoporosis, subchondral cysts, and synovial calcification and debris

  4. The clinical observation of laminectomy and spinal internal fixation treatment for older degenerative lumbar spinal stenosis disease%全椎板切除脊柱内固定用于老年退行性腰椎管狭窄症治疗的临床观察

    王冰

    2012-01-01

    目的 观察全椎板切除脊柱内固定术治疗老年退行性腰椎管狭窄症的临床疗效.方法 选取2007年5月~2011年12月我院收治54例老年退行性腰椎管狭窄症患者为研究对象,所有患者均行全椎板切除加脊柱内固定手术治疗,观察患者手术后疗效以及X线表现的改变.结果 ①本组术后1个月时椎体间相对距离为0.812±0.048,与术前比较有所增加,差异有统计学意义(P<0.05);椎体间矢状面活动角度、椎体间冠状面活动角度和椎体间水平面活动角度手术前后变化不明显,差异无统计学意义(P>0.05).②术后疗效,优29例,良18例,中7例,优良率为87.04%.术后随访1~3个月,X线检查显示植骨均融合,内固定未见松动或断裂.结论 全椎板切除减压脊柱内固定术治疗老年退行性腰椎管狭窄症,在正确掌握适应症的情况下,可获得满意的效果,既可实现彻底减压的目的,又能维持术后脊柱稳定性.%Objective To observe the clinical effects of lamineetomy and spinal internal fixation treatment for older degenerative lumbar spinal stenosis disease. Methods From May 2007 to December 2011, 54 cases of elder patients with degenerative lumbar spinal stenosis disease were selected as the research object, all of patients were given laminectomy and spinal internal fixation treatment, with observing the curative effect and X-ray performance change after surgery. Results (1)one month after surgery, the relative distance of adjacen vertebral bodies was 0. 812 ±0. 048 which was higher than the preoperative, the comparing difference was statistical significance (P <0. 05) , The difference of vertebral activities angle at the sagittal view, coronal plane and horizontal plane before and after operation was not change significantly, comparative differences was not statistically significant (P >0. 05). (2)In this group of patients, the optimal curative effect was 29 cases, the good curative effect was

  5. Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review

    The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered “standard of care”, are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, since more than a decade, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment. Another promising line of research is represented by the so-called dynamic stabilization (non-fusion or motion preservation back surgery), which aims to provide stabilization to the lumbar spinal units (SUs), while maintaining their mobility and function. Risk of potential complications of traditional fusion methods (infection, CSF leaks, harvest site pain, instrumentation failure) are reduced, particularly transitional disease (i.e., the biomechanical stresses imposed on the adjacent segments, resulting in delayed degenerative changes in adjacent facet joints and discs). Dynamic stabilization modifies the distribution of loads within the SU, moving them away from sensitive (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to clarify the mode of action of the different posterior stabilization devices. Most devices are minimally invasive or percutaneous, thus accessible to radiologists’ interventional practice. Devices will be described, together with indications for patient selection, surgical approaches and possible complications

  6. Minimally-invasive posterior lumbar stabilization for degenerative low back pain and sciatica. A review

    Bonaldi, G., E-mail: bbonaldi@yahoo.com [Neuroradiology Department, Ospedale Papa Giovanni XXIII, Bergamo (Italy); Brembilla, C. [Department of neurosurgery, Ospedale Papa Giovanni XXIII, Bergamo (Italy); Cianfoni, A. [Neuroradiology of Neurocenter of Italian Switzerland, Lugano, CH (Switzerland)

    2015-05-15

    The most diffused surgical techniques for stabilization of the painful degenerated and instable lumbar spine, represented by transpedicular screws and rods instrumentation with or without interbody cages or disk replacements, require widely open and/or difficult and poorly anatomical accesses. However, such surgical techniques and approaches, although still considered “standard of care”, are burdened by high costs, long recovery times and several potential complications. Hence the effort to open new minimally-invasive surgical approaches to eliminate painful abnormal motion. The surgical and radiological communities are exploring, since more than a decade, alternative, minimally-invasive or even percutaneous techniques to fuse and lock an instable lumbar segment. Another promising line of research is represented by the so-called dynamic stabilization (non-fusion or motion preservation back surgery), which aims to provide stabilization to the lumbar spinal units (SUs), while maintaining their mobility and function. Risk of potential complications of traditional fusion methods (infection, CSF leaks, harvest site pain, instrumentation failure) are reduced, particularly transitional disease (i.e., the biomechanical stresses imposed on the adjacent segments, resulting in delayed degenerative changes in adjacent facet joints and discs). Dynamic stabilization modifies the distribution of loads within the SU, moving them away from sensitive (painful) areas of the SU. Basic biomechanics of the SU will be discussed, to clarify the mode of action of the different posterior stabilization devices. Most devices are minimally invasive or percutaneous, thus accessible to radiologists’ interventional practice. Devices will be described, together with indications for patient selection, surgical approaches and possible complications.

  7. Diagnostic steps in disc luxations and other frequent diseases of the temporomandibular joint

    Modern diagnosis of the temporomandibular joint (TMJ) consists of multiple steps, based on each other and amplifying one another. The first step is the clinical functional analysis, respecting general medical as well as specific dental aspects. If need arises electronic axiography, recording the movement of TMJ hingeaxis, is being added as well as occlusal analysis on mounted plaster casts. In case of open questions at this point of analysis, magnetresonance- and computer-tomographic imaging is brought in. The present paper is an overview describing the current step by step diagnosis of TMJ disorders, with special attention to luxation-reduction mechanism in the joints. (orig.)

  8. Disease: H00163 [KEGG MEDICUS

    Full Text Available ate [CPD:C00544] Ascorbic acid [DR:D00018] ICD-10: E70.2 MeSH: D000474 OMIM: 203500 PMID:18336562 Helliwell TR, Gallagher...ation of joints and the aortic valve. Inherited metabolic disease hsa00350(3081+C00544) Tyrosin...H00163 Alkaptonuria Alkaptonuria is a rare, inherited defect of homogentisic acid 1...,2-dioxygenase that leads to the widespread deposition of polymeric homogentisic acid, and clinical symptoms from degener...nandez-Ruiz E, Penalva MA, Rodriguez de Cordoba S The molecular basis of alkaptonuria. Nat Genet 14

  9. Intervertebral disc degeneration and bone density in degenerative lumbar scoliosis: a comparative study between patients with degenerative lumbar scoliosis and patients with lumbar stenosis

    DING Wen-yuan; YANG Da-long; CAO Lai-zhen; SUN Ya-peng; ZHANG Wei; XU Jia-xin; ZHANG Ying-ze; SHEN Yong

    2011-01-01

    Background Degenerative lumbar scoliosis is common in older patients.Decreased bone density and the degeneration of intervertebral discs are considered to be correlated with degenerative lumbar scoliosis.A means of quantifying the relative signal intensity for degenerative disc disease has not been previously discussed.The purpose of this study was to compare bone mineral density and intervertebral disc degeneration between degenerative lumbar scoliosis and lumbar spinal stenosis patients in a nine-year retrospective study.Methods From January 2001 to August 2010,96 patients with degenerative lumbar scoliosis were retrospectively enrolled and 96 patients with lumbar spinal stenosis were selected as controls.Cobb angle,height of the apical disc and the contiguous disc superiorly and inferiorly on convex and concave sides,the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly were measured in the scoliosis group.The height of L2/L3,L3/L4,L4/L5 discs and the height of L2/L4 vertebral body was measured in the control group.The grade of intervertebral disc degeneration was evaluated using T2WI sagittal images in both groups.The bone density of lumbar vertebrae was measured with dual-energy X-ray.Results In scoliosis group,the intervertebral disc height on the convex side was greater than the height on the concave side (P <0.001 ).The vertebral body height on the convex side was greater than the height on the concave side (P=0.016).There was a significant difference between the scoliosis group and the control group (P=0.003),and between T-value and the rate of osteoporosis between the two groups (both P <0.001).Results were verified using multiple linear regression analysis.Conclusions Degenerative lumbar scoliosis is accompanied by height asymmetry between the intervertebral disc and vertebral body regarding the convex and concave surfaces.There is a positive correlation between the angle of scoliosis and

  10. Assessment of disease activity in juvenile idiopathic arthritis. The number and the size of joints matter

    Berntson, Lillemor; Wernroth, Lisa; Fasth, Anders;

    2007-01-01

    Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA.......Variables for assessment of disease activity of juvenile idiopathic arthritis (JIA) were studied, in order to develop a disease activity score for children with JIA....

  11. The relationship between the cerebral blood flow, oxygen consumption and glucose metabolism in primary degenerative dementia

    The CBF, CMRO2 and CMRGlu were measured in patients with primary degenerative dementia including 5 patients with dementia of Alzheimer's type and 4 patients with Pick's disease, and then the correlation between the cerebral blood flow and energy metabolism was evaluated. The control subjects consisted of 5 age-matched normal volunteers. The CBF, CMRO2 and CMRGlu decreased in the bilateral frontal, temporal and parietal regions in the patients with Alzheimer's dementia, while they decreased in the bilateral frontal and temporal regions in the patients with Pick's disease. Both the CBF and CMRO2 were closely correlated with each other. However, the CMRGlu was more severely impaired than the CBF or CMRO2 in both pathological conditions. These results suggested that CMRGlu began to decrease before the reduction of the aerobic metabolism and thus measuring the CMRGlu is considered to be the most sensitive method for detecting abnormal regions in primary degenerative dementia. (author)

  12. Comparation of levels of anxiety and depression in patients with autommune and chronic-degenerative rheumatic: preliminary data

    M.R. Muscatello; N. Gambardella; Bruno, A.; De Filippis, G.; Caliri, A.; L.G. De Filippis; Bagnato,G; R. Cambria; R. Zoccali

    2011-01-01

    Scientific research on rheumatic diseases was often focused on the link between psychological features and disease. Depression and anxiety are frequently observed with an higher incidence among rheumatic patients in comparison to general population. In autoimmune diseases, such as rheumatoid arthritis, an important role for psychiatric symptoms could be played by the alteration of cytokines levels. In the chronic-degenerative diseases, psychological factors such as stress and depression, can ...

  13. Factors affecting results of fluoroscopy-guided facet joint injection: Probable differences in the outcome of treatment between pure facet joint hypertrophy and concomitant diseases

    Akif Albayrak; Baris Ozkul; Mehmet Bulent Balioglu; Yunus Atici; Muhammet Zeki Gultekin; Merih Dilan Albayrak

    2016-01-01

    Study Design: Retrospective cohort study. Purpose: Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Materials and Methods: Facet joint injection was applied to 94 patients treated at our hospital between 2011 and 2012 (mean age 59.5 years; 80 women and 14 men). For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertro...

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

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

  15. Situación actual de la cirugía de la columna vertebral degenerativa aplicada al manejo del dolor lumbar crónico: Estenosis de canal. Discopatia degenerativa, resultados basados en la evidencia científica Present state of degenerative back surgery and its implications in the management of chronic lumbar pain, canal stenosis and degenerative disk disease: Evidence based outcomes

    F. J. Robaina

    2006-04-01

    there is not any correctly done study that compares the conservative and surgical treatments in the manegement of her-niated lumbar disc. For that reason , we are still triying to find new treatment options in the nonsurgical field of her-niated lumbar disc. When we analize the published results of the spine surgery, we must beard in mind what have been call in the "American Stock and Excahnge" "the bubble of spine surgery". The scientific literature does not show clear evidence in the cost-benefict studies of most instrumented surgical interventions of the spine compare with the conservative treatments. It has not been yet demostrated that fusion surgery and disc replacement are better options than the conservtive treatment. It´s necesary to point out that at present "there are relationships between the industry and back pain and there is also an industry of the back pain" . Nontheless, the "market of the spine surgery" is growing up because patients are demanding solutions for their back problems. The tide of scientific evidence seams to go against of the spinal fusions in the degenerative disc disease, discogenic pain and inespecific back pain. After decades of technological advances in this field, the results of spinal fusions are mediocre. Recent epidemiological studies show that "spinal fusion must be accepted as a non proved or experimental method for the treatment of back pain". The surgical literature on spinal fusion published in the last 20 years following the Cochrane’s method stablish that: 1- this is at least incomplete, not realiable and careless; 2- the instrumentation seems to sligthy increase the fusion rate ; 3- the instrumentation doesn’t improve the clinical results in general, lacking studies in subgroups of patients. We still are needing randomized studies to compare the surgical results with the natural history of the disease, the pacebo effect, or the conservative treatment. The European Guidelines for lumbar chronic pain management shows a

  16. Environmental Radon Gas and Degenerative Conditions An Overview

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

    2006-07-01

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

  17. Environmental Radon Gas and Degenerative Conditions An Overview

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

  18. Multiple bone and joint disease in a sickle cell anaemia patient: a case report

    John Ayodele Olaniyi; Alagbe, Adekunle E.; Olutoogun O Toluwalase; Olorunsogo E Busari

    2012-01-01

    Objective: To further highlight the fact that bone involvement is the commonest clinical manifestation of SCD both in the acute settins such painful VOC and as a source of chronic , progressive debility such as AVN, chronic osteomyelitis and fixed flexion deformity of joints. Protracted multiple bone involvement i.e. Bilateral femoral and left humeral chronic osteomyelitis, Left elbow, Left knee and right humeral septic arthritis together with aseptic necrosis of both femoral and right hum...

  19. Spinal Cord Diseases

    ... this can also injure the spinal cord. Other spinal cord problems include Tumors Infections such as meningitis and polio Inflammatory diseases Autoimmune diseases Degenerative diseases such as amyotrophic lateral ...

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

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

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

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

    2004-05-01

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

  2. 神经退化性疾病生物能量代谢和氧化应激研究进展%Bioenergetic and Oxidative Stress in Neuro degenerative Diseases

    张铭湘; 夏家辉

    2000-01-01

    衰老是导致几种常见的神经系统退化性疾病的主要危险因素,包括帕金森氏病(Parkinson's disease PD),肌萎缩性侧索硬化(Amyotrophic lateral sclerosis, ALS),早老性痴呆(Alzheimer's disease AD) 和亨廷顿氏病(Huntington's disease HD).最近研究表明,神经退化性疾病涉及到线粒体缺陷,氧化应激等因素.在脑和其它组织中,老化可导致线粒体功能的损伤和氧化损伤的增强.PD病人中,已发现线粒体复合酶体I活性降低,氧化损伤增加和抗氧化系统活性的改变. 在几例家族性ALS病人中,也发现Cu、Zn 超氧化物歧化酶(Cu,Zn SOD)基因的突变,导致 Cu、Zn超氧化物歧化酶活性减低;散发的ALS病人氧化损伤增高.在HD病人中已发现能量代谢异常和皮质乳酸水平的增高.AD病人中,线粒体复合酶体IV活性降低,AD、PD病人发现有线粒体DNA突变.因此,渐进性神经退化性疾病很可能由于能量代谢和氧化应激循环过程受损而导致.

  3. Effect of major lifestyle risk factors, independent and jointly, on life expectancy with and without cardiovascular disease

    O'Doherty, Mark G; Cairns, Karen; O'Neill, Vikki;

    2016-01-01

    -free" years, though a healthy lifestyle was also associated with extra years lived after a CVD event. There are sizeable benefits to LE without CVD and also for survival after CVD onset when people favour a lifestyle characterized by salutary behaviours. Remaining a non-smoker yielded the greatest extra years......Seldom have studies taken account of changes in lifestyle habits in the elderly, or investigated their impact on disease-free life expectancy (LE) and LE with cardiovascular disease (CVD). Using data on subjects aged 50+ years from three European cohorts (RCPH, ESTHER and Tromsø), we used multi......-state Markov models to calculate the independent and joint effects of smoking, physical activity, obesity and alcohol consumption on LE with and without CVD. Men and women aged 50 years who have a favourable lifestyle (overweight but not obese, light/moderate drinker, non-smoker and participates in vigorous...

  4. Canonical feature selection for joint regression and multi-class identification in Alzheimer’s disease diagnosis

    Zhu, Xiaofeng; Suk, Heung-Il

    2016-01-01

    Fusing information from different imaging modalities is crucial for more accurate identification of the brain state because imaging data of different modalities can provide complementary perspectives on the complex nature of brain disorders. However, most existing fusion methods often extract features independently from each modality, and then simply concatenate them into a long vector for classification, without appropriate consideration of the correlation among modalities. In this paper, we propose a novel method to transform the original features from different modalities to a common space, where the transformed features become comparable and easy to find their relation, by canonical correlation analysis. We then perform the sparse multi-task learning for discriminative feature selection by using the canonical features as regressors and penalizing a loss function with a canonical regularizer. In our experiments on the Alzheimer’s Disease Neuroimaging Initiative (ADNI) dataset, we use Magnetic Resonance Imaging (MRI) and Positron Emission Tomography (PET) images to jointly predict clinical scores of Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog) and Mini-Mental State Examination (MMSE) and also identify multi-class disease status for Alzheimer’s disease diagnosis. The experimental results showed that the proposed canonical feature selection method helped enhance the performance of both clinical score prediction and disease status identification, outperforming the state-of-the-art methods. PMID:26254746

  5. 胚胎干细胞衍生的视网膜色素上皮细胞移植治疗眼病%Therapy for retinal degenerative diseases by human embryonic stem cells derived retinal pigment epithelium transplantation

    胡诞宁

    2014-01-01

    Schwartz等报告的用从人胚胎干细胞分化成的视网膜色素上皮细胞(RPE)移植治疗视网膜病,已观察4月,尚属成功。这是首次用从人胚胎干细胞(hESC)定向分化而成的细胞移植至患者取得成功。本文复习RPE移植的历史与现况;hESC分化而成的RPE(hESC-RPE)的实验研究以及临床移植的意义、方法、效果及存在问题,并展望了应用干细胞分化的RPE移植的前景。%The first description of human embryonic stem cell-derived cells transplanted into human patients was reported by Schwartz et al, who performed the transplantation of hESC-derived retinal pigment epithelium (RPE) into the subretinal space in patients with retinal diseases and obtained successful results after 4 months’ observation. We review the past and present status of ocular pigment epithelium transplantation; the significance, methodology, results and problems of experimental and clinical hESC-derived RPE transplantation, and to discuss the strategies of using stem cell-derived RPE for the treatment of eye diseases.

  6. Studies of computed tomography as a contribution to differential diagnosis between dementia due to cerebrovascular disease (multi-infract type) and due to primarily degenerative cerebral atrophy (Alzheimers type)

    Kohlmeyer, K.

    Studies of computed tomography were performed in 367 patients diagnosed as dementia clinically. The mean age was 70.1 years. By the clinicians 240 were classified as senile dementia of Alzheimer's type, 79 as multiinfarct dementia, and 48 were not determined definitely. In 3%, the CT studies did detect treatable causes like tumors, subdural hematomas and communicating hydrocephalus. In about 57% was found by CT a diffuse brain atrophy without focal tissue changes as to expect if occurring a cerebrovascular disease. In 25% there were focal changes of the brain tissue in CT to define as residuals of infarctions in addition to the signs of cerebral atrophy. The results of the CT studies were normal in 15% despite the evidence of dementia clinically. The analysis of the material did show that a cerebrovascular disease as a cause of dementia is suspected clinically in much more cases than CT studies are able to prove focal pathological changes of the brain tissue due to disorders of cerebral blood flow.

  7. Studies of computed tomography as a contribution to differential diagnosis between dementia due to cerebrovascular disease (multi-infract type) and due to primarily degenerative cerebral atrophy (Alzheimers type)

    Studies of computed tomography were performed in 367 patients diagnosed as dementia clinically. The mean age was 70.1 years. By the clinicians 240 were classified as senile dementia of Alzheimer's type, 79 as multiinfarct dementia, and 48 were not determined definitely. In 3%, the CT studies did detect treatable causes like tumors, subdural hematomas and communicating hydrocephalus. In about 57% was found by CT a diffuse brain atrophy without focal tissue changes as to expect if occurring a cerebrovascular disease. In 25% there were focal changes of the brain tissue in CT to define as residuals of infarctions in addition to the signs of cerebral atrophy. The results of the CT studies were normal in 15% despite of the evidence of dementia clinically. The analysis of the material did show that a cerebrovascular disease as a cause of dementia is suspected clinically in much more cases than CT studies are able to prove focal pathological changes of the brain tissue due to disorders of cerebral blood flow really. (orig.)

  8. Advantages and limits of sup(99m)Tc pyrophosphate scintigraphy in the study of joint diseases

    The results of sup(99m)Tc pyrophosphate bone scintigraphy are studied for a wide range of joint diseases. 215 scintigraphs are analysed, the results compared with those of authors who have used not only Tc phosphates but also other isotopes after comparison of their advantages and disadvantages, and possible applications suggested for each type of lesion. - The 99m Tc pyrophosphate scintigraphic examination is simple, harmless (a whole-skeleton examination delivers only 80 millirads to the narrow whereas a set of spine and pelvis X-rays delivers 325), reliable and highly sensitive, often anticipating data from radiographic examinations. - In the majority of developing joint diseases of whatever kind, apart from arthroses and certain osteolytic lesions unaccompanied by any healing reaction, a hyperfixation is observed. Generally speaking a scintigraph may be requested whenerver an evolutive bone lesion is suspected in the absence of clinical, radiological and biological evidence. The major disadvantage of the method is that, being highly sensitive, it lacks specificity and is hence unable alone to provide an etiological diagnosis

  9. Degenerative spondylolisthesis is associated with low spinal bone density

    Andersen, Thomas; Christensen, Finn; Langdahl, Bente Lomholt;

    2013-01-01

    degenerative spondylolisthesis patients. 81 patients older than 60 years, who underwent DXA-scanning of their lumbar spine one year after a lumbar spinal fusion procedure, were included. Radiographs were assessed for disc height, vertebral wedging, and osteophytosis. Pain was assessed using the Low Back Pain...... Rating Scale pain index. T-score of the lumbar spine was significantly lower among degenerative spondylolisthesis patients compared with spinal stenosis patients (-1.52 versus -0.52, P = 0.04). Thirty-nine percent of degenerative spondylolisthesis patients were classified as osteoporotic and further 30...

  10. Current Trends in the Use of Patient-Reported Outcome Instruments in Degenerative Cervical Spine Surgery.

    Ueda, Haruki; Cutler, Holt S; Guzman, Javier Z; Cho, Samuel K

    2016-05-01

    Study Design Bibliometric analysis. Objective To determine trends, frequency, and distribution of patient-reported outcome instruments (PROIs) in degenerative cervical spine surgery literature over the past decade. Methods A search was conducted via PubMed from 2004 to 2013 on five journals (The Journal of Bone and Joint Surgery, The Bone and Joint Journal, The Spine Journal, European Spine Journal, and Spine), which were chosen based on their impact factors and authors' consensus. All abstracts were screened and articles addressing degenerative cervical spine surgery using PROIs were included. Articles were then analyzed for publication date, study design, journal, level of evidence, and PROI trends. Prevalence of PROIs and level of evidence of included articles were analyzed. Results From 19,736 articles published, 241 articles fulfilled our study criteria. Overall, 53 distinct PROIs appeared. The top seven most frequently used PROIs were: Japanese Orthopaedic Association score (104 studies), visual analog scale for pain (100), Neck Disability Index (72), Short Form-36 (38), Nurick score (25), Odom criteria (21), and Oswestry Disability Index (15). Only 11 PROIs were used in 5 or more articles. Thirty-three of the PROIs were appeared in only 1 article. Among the included articles, 16% were of level 1 evidence and 32% were of level 4 evidence. Conclusion Numerous PROIs are currently used in degenerative cervical spine surgery. A consensus on which instruments to use for a given diagnosis or procedure is lacking and may be necessary for better communication and comparison, as well as for the accumulation and analysis of vast clinical data across multiple studies. PMID:27099815

  11. Five-year clinical results of cervical total disc replacement compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled, multicenter investigational device exemption clinical trial.

    Radcliff, Kris; Coric, Domagoj; Albert, Todd

    2016-08-01

    OBJECTIVE The purpose of this study was to report the outcome of a study of 2-level cervical total disc replacement (Mobi-C) versus anterior cervical discectomy and fusion (ACDF). Although the long-term outcome of single-level disc replacement has been extensively described, there have not been previous reports of the 5-year outcome of 2-level cervical disc replacement. METHODS This study reports the 5-year results of a prospective, randomized US FDA investigational device exemption (IDE) study conducted at 24 centers in patients with 2-level, contiguous, cervical spondylosis. Clinical outcomes at up to 60 months were evaluated, including validated outcome measures, incidence of reoperation, and adverse events. The complete study data and methodology were critically reviewed by 3 independent surgeon authors without affiliation with the IDE study or financial or institutional bias toward the study sponsor. RESULTS A total of 225 patients received the Mobi-C cervical total disc replacement device and 105 patients received ACDF. The Mobi-C and ACDF follow-up rates were 90.7% and 86.7%, respectively (p = 0.39), at 60 months. There was significant improvement in all outcome scores relative to baseline at all time points. The Mobi-C patients had significantly more improvement than ACDF patients in terms of Neck Disability Index score, SF-12 Physical Component Summary, and overall satisfaction with treatment at 60 months. The reoperation rate was significantly lower with Mobi-C (4%) versus ACDF (16%). There were no significant differences in the adverse event rate between groups. CONCLUSIONS Both cervical total disc replacement and ACDF significantly improved general and disease-specific measures compared with baseline. However, there was significantly greater improvement in general and disease-specific outcome measures and a lower rate of reoperation in the 2-level disc replacement patients versus ACDF control patients. Clinical trial registration no. NCT00389597

  12. Genetics Home Reference: Sandhoff disease

    ... links) Health Topic: Degenerative Nerve Diseases Health Topic: Tay-Sachs Disease Genetic and Rare Diseases Information Center (1 ... UK) National Organization for Rare Disorders (NORD) National Tay-Sachs and Allied Diseases Association Genetic Testing Registry (1 ...

  13. Genetics Home Reference: Alzheimer disease

    ... Me Understand Genetics Home Health Conditions Alzheimer disease Alzheimer disease Enable Javascript to view the expand/collapse boxes. Print All Open All Close All Description Alzheimer disease is a degenerative disease of the brain ...

  14. Radiographic changes in the hip joint in children suffering from Perthes disease

    Froberg, Lonnie; Christensen, Finn Kjær; Pedersen, Niels Wisbech; Overgaard, Søren

    2012-01-01

    The purpose was to compare radiographic parameters with a sex-matched and age-matched control group at the onset of disease and at skeletal maturity. The study comprised 143 patients with Legg-Calvé-Perthes disease, treated using a Thomas splint. Wiberg's centre-edge angle and the acetabular inde...

  15. Comparative effectiveness of open versus minimally invasive sacroiliac joint fusion

    Ledonio, Charles GT; Polly, David W.; Swiontkowski, Marc F.; Cummings, John T

    2014-01-01

    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 ty...

  16. Degenerative lumbar spondylolisthesis: an epidemiological perspective: the Copenhagen Osteoarthritis Study

    Jacobsen, Steffen; Sonne-Holm, Stig; Rovsing, Hans;

    2007-01-01

    registered health parameters since 1976. In 1993, standardized, lateral radiographs of the lumbar spine were recorded. There were 1533 men and 2618 women. METHODS: Statistical correlations were made between degenerative spondylolisthesis, and physical, occupational, and general epidemiological data. RESULTS...

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

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

  18. 多学科协同治疗骨关节疾病%Multidisciplinary treatment of bone and joint diseases

    张奉春

    2012-01-01

    The bone and joint diseases are very common, have chronic, recurrent characteristics and often lead to discomfort and disability in China. These diseases affect human health seriously. The etiology and pathogenesis are unknown. They may be related with genetic, environmental factors and autoimmune reaction. Rehabilitation exercise, health education, medical treatment and operation are the main methods in the treatment of the diseases. The expected benefits of the treatment are pain relief, improvement or prevention of further deterioration, and prevention of deformity. The types of treatments are different for various diseases. Short-term or long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs) can relive the pain of bone and joint. Disease-modifying antirheumatic drugs (DMARDs) are selected in the first-line treatment as soon as possible in rheumatoid arthritis, and seronegative spondylo-arthropathies can be treated with SASP and symptoms of some patients are relieved. Advances in the understanding of the pathogenesis of the disease have fostered the development of new therapeutics (biological drugs such as TNF-a inhibitors and rituximab), with improved outcomes. However, operation for advanced stage or medicine ineffective patients is also very important. Rheumatology is very young in China, which is still facing the lack of the rheumatology physician after more than 20 years' development. The cooperation of surgeons and rheumatology physicians is very important, but it has not been recognized and emphasized so far. We should pay more attention to the cooperation in the clinical work in the future.%@@ 一、概述 世界卫生组织将2000年至2010年定为"骨与关节的十年",这一项以"增进患有肌肉与骨骼疾病患者的健康,进一步改善他们的生活质量"作为目标的活动意义重大.骨关节病的范围广泛,除了骨关节炎、类风湿关节炎等各种关节疾病外,还包括脊柱疾病、骨质疏松症以

  19. DEGENERATIVE AORTIC STENOSIS: PATHOGENESIS AND NEW PRINCIPLES OF TREATMENT

    O. V. Andropova; V. N. Anokhin

    2016-01-01

    Aim. To reveal of markers of inflammation and progression of calcification in patients with degenerative aortic stenosis (DAS). Material and methods. A single-stage study was done in 85 patients with degenerative calcification of aortic valve (42 patients with DAS and 43 patients without DAS). The techniques for assessing the severity of aortic valve calcification included ultrasonic diagnostics and multislice spiral computed tomography. Markers of inflammation and lipid profile were investig...

  20. Case report of cheilitis granulomatosa and joint complaints as presentation of Crohn's disease.

    Hoekman, Daniël R; Roelofs, Joris J T H; van Schuppen, Joost; Schonenberg-Meinema, Dieneke; D'Haens, Geert R; Benninga, Marc A

    2016-04-01

    Cheilitis granulomatosa is characterized by granulomatous lip swelling. We report a case of a 13-year-old girl who presented with orofacial swelling and arthralgia, who eventually was diagnosed with Crohn's disease, which was successfully treated with infliximab and azathioprine combination therapy. Recurrent or persistent orofacial swelling should prompt consideration of cheilitis granulomatosa, and further diagnostic evaluation to exclude the presence of Crohn's disease seems warranted. PMID:27017505

  1. Automatic 3D MR image registration and its evaluation for precise monitoring of knee joint disease

    We describe a technique for the registration of three dimensional (3D) knee femur surface points from MR image data sets; it is a technique that can track local cartilage thickness changes over time. In the first coarse registration step, we use the direction vectors of the volume given by the cloud of points of the MR image to correct for different knee joint positions and orientations in the MR scanner. In the second fine registration step, we propose a global search algorithm that simultaneously determines the optimal transformation parameters and point correspondences through searching a six dimensional space of Euclidean motion vectors (translation and rotation). The present algorithm is grounded on a mathematical theory- Lipschitz optimization. Compared with the other three registration approaches (iterative closest point (ICP), EM-ICP, and genetic algorithms), the proposed method achieved the highest registration accuracy on both animal and clinical data. (author)

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

    Samoĭlovich, V A

    1999-01-01

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

  3. Vaccinations in adults with chronic inflammatory joint disease: Immunization schedule and recommendations for patients taking synthetic or biological disease-modifying antirheumatic drugs.

    Morel, Jacques; Czitrom, Séverine Guillaume; Mallick, Auriane; Sellam, Jérémie; Sibilia, Jean

    2016-03-01

    The risk of infection associated with autoimmune diseases is further increased by the use of biotherapies. Recommendations to minimize this risk include administering the full complement of vaccines on the standard immunization schedule, as well as the pneumococcal and influenza vaccines. Adults with chronic inflammatory joint disease (IJD) may receive a 13-valent pneumococcal conjugate vaccine, as well as a live attenuated vaccine against recurrent herpes zoster, recently licensed by European regulatory authorities. Live attenuated vaccines can be given only after an interval without immunosuppressant and/or glucocorticoid therapy. The effectiveness of vaccines, as assessed based on titers of protective antibodies, varies across vaccine types and disease-modifying antirheumatic drugs (DMARDs). Thus, methotrexate and rituximab are usually associated with decreased vaccine responses. The risks associated with vaccines are often considerably exaggerated by the media, which serve lobbies opposed to immunizations and make some patients reluctant to accept immunizations. Increasing immunization coverage may diminish the risk of treatment-related infections. A physician visit dedicated specifically to detecting comorbidities in patients with chronic IJD may result in improved immunization coverage. In this review, we discuss immunizations for adults with chronic IJD based on the treatments used, as well as immunization coverage. Many questions remain unanswered and warrant investigation by studies coordinated by the French networks IREIVAC (Innovative clinical research network in vaccinology) and IMIDIATE (Immune-Mediated Inflammatory Disease Alliance for Translational and Clinical Research). PMID:26453106

  4. Novel Lesions of Bones and Joints Associated with Chikungunya Virus Infection in Two Mouse Models of Disease: New Insights into Disease Pathogenesis

    Goupil, Brad A.; McNulty, Margaret A.; Martin, Matthew J.; McCracken, Michael K.; Christofferson, Rebecca C.; Mores, Christopher N.

    2016-01-01

    Chikungunya virus is an arbovirus spread predominantly by Aedes aegypti and Ae. albopictus mosquitoes, and causes debilitating arthralgia and arthritis. While these are common manifestations during acute infection and it has been suggested they can recur in patients chronically, gaps in knowledge regarding the pathogenesis still exist. Two established mouse models were utilized (adult IRF 3/7 -/- -/- and wild-type C57BL/6J mice) to evaluate disease manifestations in bones and joints at various timepoints. Novel lesions in C57BL/6J mice consisted of periostitis (91%) and foci of cartilage of necrosis (50% of mice at 21 DPI). Additionally, at 21 DPI, 50% and 75% of mice exhibited periosteal bone proliferation affecting the metatarsal bones, apparent via histology and μCT, respectively. μCT analysis did not reveal any alterations in trabecular bone volume measurements in C57BL/6J mice. Novel lesions demonstrated in IRF 3/7 -/- -/- mice at 5 DPI included focal regions of cartilage necrosis (20%), periosteal necrosis (66%), and multifocal ischemic bone marrow necrosis (100%). Contralateral feet in 100% of mice of both strains had similar, though milder lesions. Additionally, comparison of control IRF 3/7 -/- -/- and wild-type C57BL/6J mice demonstrated differences in cortical bone. These experiments demonstrate novel manifestations of disease similar to those occurring in humans, adding insight into disease pathogenesis, and representing new potential targets for therapeutic interventions. Additionally, results demonstrate the utility of μCT in studies of bone and joint pathology and illustrate differences in bone dynamics between mouse strains. PMID:27182740

  5. Novel Lesions of Bones and Joints Associated with Chikungunya Virus Infection in Two Mouse Models of Disease: New Insights into Disease Pathogenesis.

    Goupil, Brad A; McNulty, Margaret A; Martin, Matthew J; McCracken, Michael K; Christofferson, Rebecca C; Mores, Christopher N

    2016-01-01

    Chikungunya virus is an arbovirus spread predominantly by Aedes aegypti and Ae. albopictus mosquitoes, and causes debilitating arthralgia and arthritis. While these are common manifestations during acute infection and it has been suggested they can recur in patients chronically, gaps in knowledge regarding the pathogenesis still exist. Two established mouse models were utilized (adult IRF 3/7 -/- -/- and wild-type C57BL/6J mice) to evaluate disease manifestations in bones and joints at various timepoints. Novel lesions in C57BL/6J mice consisted of periostitis (91%) and foci of cartilage of necrosis (50% of mice at 21 DPI). Additionally, at 21 DPI, 50% and 75% of mice exhibited periosteal bone proliferation affecting the metatarsal bones, apparent via histology and μCT, respectively. μCT analysis did not reveal any alterations in trabecular bone volume measurements in C57BL/6J mice. Novel lesions demonstrated in IRF 3/7 -/- -/- mice at 5 DPI included focal regions of cartilage necrosis (20%), periosteal necrosis (66%), and multifocal ischemic bone marrow necrosis (100%). Contralateral feet in 100% of mice of both strains had similar, though milder lesions. Additionally, comparison of control IRF 3/7 -/- -/- and wild-type C57BL/6J mice demonstrated differences in cortical bone. These experiments demonstrate novel manifestations of disease similar to those occurring in humans, adding insight into disease pathogenesis, and representing new potential targets for therapeutic interventions. Additionally, results demonstrate the utility of μCT in studies of bone and joint pathology and illustrate differences in bone dynamics between mouse strains. PMID:27182740

  6. Novel Lesions of Bones and Joints Associated with Chikungunya Virus Infection in Two Mouse Models of Disease: New Insights into Disease Pathogenesis.

    Brad A Goupil

    Full Text Available Chikungunya virus is an arbovirus spread predominantly by Aedes aegypti and Ae. albopictus mosquitoes, and causes debilitating arthralgia and arthritis. While these are common manifestations during acute infection and it has been suggested they can recur in patients chronically, gaps in knowledge regarding the pathogenesis still exist. Two established mouse models were utilized (adult IRF 3/7 -/- -/- and wild-type C57BL/6J mice to evaluate disease manifestations in bones and joints at various timepoints. Novel lesions in C57BL/6J mice consisted of periostitis (91% and foci of cartilage of necrosis (50% of mice at 21 DPI. Additionally, at 21 DPI, 50% and 75% of mice exhibited periosteal bone proliferation affecting the metatarsal bones, apparent via histology and μCT, respectively. μCT analysis did not reveal any alterations in trabecular bone volume measurements in C57BL/6J mice. Novel lesions demonstrated in IRF 3/7 -/- -/- mice at 5 DPI included focal regions of cartilage necrosis (20%, periosteal necrosis (66%, and multifocal ischemic bone marrow necrosis (100%. Contralateral feet in 100% of mice of both strains had similar, though milder lesions. Additionally, comparison of control IRF 3/7 -/- -/- and wild-type C57BL/6J mice demonstrated differences in cortical bone. These experiments demonstrate novel manifestations of disease similar to those occurring in humans, adding insight into disease pathogenesis, and representing new potential targets for therapeutic interventions. Additionally, results demonstrate the utility of μCT in studies of bone and joint pathology and illustrate differences in bone dynamics between mouse strains.

  7. Joint swelling

    Swelling of a joint ... Joint swelling may occur along with joint pain . The swelling may cause the joint to appear larger or abnormally shaped. Joint swelling can cause pain or stiffness. After an ...

  8. Fusion of the distal intertarsal and tarsometatarsal joints in the horse using intra-articular sodium monoiodoacetate

    Six normal horses received 3 intra-articular injections of sodium monoiodoacetate (MIA) in the distal intertarsal (DIT) and tarsometatarsal (TMT) joints of one hindlimb. Injections were at three week intervals, and post injection pain was controlled with routine administration of phenylbutazone for five days following each injection. All horses underwent a gradually increasing exercise programme consisting of walking and trotting beginning one week after the first injection and continuing for 24 weeks. All treated joints showed increasingly severe radiographic evidence of degenerative joint disease with time. Clinical signs were mild or absent during exercise. All treated joints showed radiographic and histological evidence of fusion 24 weeks after the first injection. Amount of radiographic fusion ranged from 54.49 per cent to 88.64 per cent of the joint space. Histologically, the joint space that appeared radiographically fused was filled mainly with woven and lamellar bone. Fibrocartilage and fibrous tissue was seen frequently in the transition between fused and unfused areas. Articular cartilage in unfused areas was thin, fibrillated, hypocellular and histochemically showed diminished proteoglycan content. Existing joint space was filled with fibrin and necrotic, acellular chondroid matrix. We conclude that MIA will produce fusion of the DIT and TMT joints of normal horses in 24 weeks, and may offer a relatively easy, inexpensive and non-invasive treatment for distal tarsal osteoarthritis in the horse

  9. Combined scintigraphic and radiographic diagnosis of bone and joint diseases. Including gamma correction interpretation. 4. rev. and enl. ed.

    Bahk, Yong-Whee [Sung Ae General Hospital, Seoul (Korea, Republic of). Dept. of Nuclear Medicine and Radiology

    2013-07-01

    In this fourth edition of Combined Scintigraphic and Radiographic Diagnosis of Bone and Joint Diseases, the text has been thoroughly amended, updated, and partially rearranged to reflect the latest advances. In addition to discussing the role of pinhole imaging in the range of disorders previously covered, the new edition pays detailed attention to the novel diagnostic use of gamma correction pinhole bone scan in a broad spectrum of skeletal disorders, including physical, traumatic, and sports injuries, infectious and non-infectious bone diseases, benign and malignant bone tumors, and soft tissue diseases. A large number of state of the art pinhole scans and corroborative CT, MRI, and/or ultrasound images are presented side by side. The book has been enlarged to encompass various new topics, including occult fractures; cervical sprain and whiplash trauma; bone marrow edema; microfractures of trabeculae; evident, gaping, and stress fractures; and differential diagnosis. This new edition will be essential reading for practitioners and researchers in not only nuclear medicine but also radiology, orthopedic surgery, and pathology.

  10. Validity and Agreement between the 28-Joint Disease Activity Score Based on C-Reactive Protein and Erythrocyte Sedimentation Rate in Patients with Rheumatoid Arthritis

    Nielung, Louise; Christensen, Robin; Danneskiold-Samsøe, Bente;

    2015-01-01

    Objective. To validate the agreement between the 28-joint disease activity score based on erythrocyte sedimentation rate (DAS28-ESR) and the 28-joint disease activity score based on C-reactive protein (DAS28-CRP) in a group of Danish patients with rheumatoid arthritis (RA). Methods. Data from 109...... Danish RA patients initiating biologic treatment were analysed at baseline and following one year of treatment. Participants were retrospectively enrolled from a previous cohort study and were considered eligible for this project if CRP and ESR were measured at baseline and at the follow-up visit. To...

  11. Factors affecting results of fluoroscopy-guided facet joint injection: Probable differences in the outcome of treatment between pure facet joint hypertrophy and concomitant diseases

    Akif Albayrak

    2016-01-01

    Full Text Available Study Design: Retrospective cohort study. Purpose: Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Materials and Methods: Facet joint injection was applied to 94 patients treated at our hospital between 2011 and 2012 (mean age 59.5 years; 80 women and 14 men. For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertrophy were placed in group A (47 patients, 41 women and 6 men, mean age 55.3 years and patients who had any additional major pathology to facet hypertrophy were placed in group B (47 patients, 39 women and 8 men, mean age 58.9 years. Injections were applied around the facet joint under surgical conditions utilizing fluoroscopy device guidance. A mixture of methylprednisolone and lidocaine was used as the injection ingredient. Results: In terms of Oswestry Disability Index (ODI and visual analog scale (VAS scores, no significant difference was found between preinjection and immediate postinjection values in both groups, and the scores of group A patients were significantly lower (P < 0.005 compared with that of group B patients at the end of the third, sixth, and twelfth month. Conclusion: For low-back pain caused by facet hypertrophy, steroid injection around the facet joint is an effective treatment, but if there is an existing major pathology, it is not as effective.

  12. 微创与开放经椎间孔腰椎椎间融合术治疗腰椎退变性疾病的临床对照研究%Clinical control study on MiTLIF and open-TLIF for treatment of lumber degenerative diseases

    赵冬冬; 王奇; 殷成; 冯海龙

    2013-01-01

    目的 回顾性分析微创(MiTLIF)和常规开放经椎间孔腰椎椎间融合术(TLIF)治疗腰椎退变性疾病的临床效果.方法 回顾性分析2010年3月至2012年6月四川省人民医院神经外科手术治疗腰椎退变性疾病患者75例,按手术方法,分为MiTLIF组32例,开放TLIF组43例.MiTLIF组均采用可扩张通道(Quadrant)和经皮椎弓根螺钉(Sextant)技术.收集分析比较两组的手术时间、术中出血量、住院时间和并发症.采用视觉模拟量表(VAS)评分评估临床结果,腰椎动力位X线片和薄层CT扫描重建检查评价椎间融合情况.结果 MiTLIF组的总的手术并发症率为19% (6/32),开放组21% (9/43),P=0.12.手术时间在MiTLIF组为(1.5±0.3)h,开放组为(1.6±0.5)h,P=0.56.术中出血量在MiTLIF组为(136.0±43.0) ml,开放组为(292.0±112.0)ml,P<0.0001.平均住院时间在MiTLIF组为(4.5±2.7)d,开放组为(7.2±4.6)d,P=0.0015.术前与术后腰腿痛VAS评分的平均变化(5.4与5.2,P=0.9).末次随访MiTLIF组椎间融合率为94%(30/32),开放组为98%(42/43),P=0.22.结论 采用MiTLIF技术治疗腰椎退行性疾病可以达到与开放TLIF相同的治疗效果,且出血更少,住院时间更短,严重的手术并发症更低.%Objective To investigate the clinical outcomes and complications of minimally invasive transforaminal lumber interbody fusion (MiTLIF) and open-TLIF for lumber degenerative diseases.Methods Between March,2010 and June,2012,75 patients of lumber degenerative diseases were operated in neurosurgical department of Sichuan Provincial People,s Hospital.MiTLIF and open-TLIF was performed in 32 and 43 patients,respectively.MiTLIF was done by using expandable working tubes (Quadrant)and percutaneous pedicle screws(Sextant).Operative time,intraoperative blood loss,length of hospital-stay,and complications were collected.Visual analog scale (VAS) scores were recorded to evaluate clinical outcomes.Interbody fusion was evaluated via dynamic

  13. Life Quality Evaluation of the Degenerative Spine Disease by QLS-DSD and SF-36 Scale%QLS-DSD与SF-36量表对脊椎退行性疾病患者生命质量评估的比较

    张敏; 徐宏光; 王弘; 刘平; 宋俊兴; 吴志宏; 邱贵兴

    2012-01-01

    目的:以目前世界通用的普适性健康状况量表(SF-36量表)为标准,分析脊椎生活量表(QLS- DSD)在临床实际运用中的可行性、信度、区分效度和反应度.方法:采用横断面调查法,分别用SF-36量表及QLS- DSD对符合纳入标准的134例脊椎退行性疾病患者进行问卷调查,根据完成量表时间、完成率评价量表的可行性;采用Cronbach α系数、分半信度评价两个量表的信度;分别计算适用手术治疗与保守治疗患者的生活质量各领域得分和总得分,再进行t检验,来评价量表的区分效度和反应度.结果:SF-36量表平均应答时间为(11.3±4.6)min,QLS-DSD平均应答时间为( 4.5±1.4) min,两者的完成率均为 94.03%.SF- 36 量表总的Cronbach α系数为0.853,总分半信度系数为0.866;QLS-DSD总的Cronbach α系数为0.883,总分半信度系数为0.907.两种量表对手术治疗与保守治疗患者的生活质量评估差异均具有统计学意义(P<0.01).结论:与SF-36量表相比,QLS-DSD的内容更符合中国人文化及生活习惯,被采访者完成量表所需时间更短,同时具有较好的信度、区分效度和反应度,临床操作可行,可以作为脊椎退行性疾病患者生活质量的评价工具,并且可做为适用不同治疗方案的参考指标.%Objective: Taking the 36 - item short form health status survey ( SF - 36) as a standard , to evaluate the clinical practical use of the feasibility , reliability, distinguish validity and responsiveness of quality of life scale for patients with degenerative spine disease ( QLS - DSD) . Methods: A cross - sectional survey was conducted and 134 cases with spinal degenerative diseases met the inclusion criteria question by the SF -36 scale and spine Life Scale ( QLS - of DSD) . Based on the scale of time to complete and the rating scale feasibil -ity to calculate the patient s quality of life score and total score of those were suitable to surgical treatment and those who

  14. Cervical and lumbar MRI in asymptomatic older male lifelong athletes: Frequency of degenerative findings

    Healy, J.F.; Healy, B.B.; Wong, W.H.M.; Olson, E.M. [Univ. of California, San Diego, CA (United States)

    1996-01-01

    The athletic activity of the adult U.S. population has increased markedly in the last 20 years. To evaluate the possible long-term effects of such activity on the cervical and lumbar spine, we studied a group of asymptomatic currently very active lifelong male athletes over age 40 (41-69 years old, av. age 53). Nineteen active, lifelong male athletes were studied with MRI and the results compared with previous imaging studies of other populations. An athletic history and a spine history were also taken. Evidence of asymptomatic degenerative spine disease was similar to that seen in published series of other populations. Degenerative changes including disk protrusion and herniation, spondylosis, and spinal stenosis were present and increased in incidence with increasing patient age. In this group, all MRI findings proved to be asymptomatic and did not limit athletic activity. The incidence of lumbar degenerative changes in our study population of older male athletes was similar to those seen in other populations. 14 refs., 8 figs., 1 tab.

  15. Creutzfeldt-Jakob Disease

    Creutzfeldt-Jakob disease (CJD) is a rare, degenerative brain disorder. Symptoms usually start around age 60. Memory problems, behavior changes, vision ... during a medical procedure Cattle can get a disease related to CJD called bovine spongiform encephalopathy (BSE) ...

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

    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 mm2 for DS or ≤ 118 mm2 for soft-tissue LC at the levels of L3-4; 2) a transverse area of ≤ 90 mm2 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.)

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

    José Alberto de Castro Guimarães Consciência

    2009-09-01

    Full Text Available INTRODUÇÃO: na última década, a instrumentação interespinhosa vem sendo mais frequentemente utilizada. Apesar dos inúmeros artigos publicados em revistas internacionais de reconhecido mérito científico, são escassas as referências à modificação da altura do disco no segmento tratado, secundária àquela instrumentação. OBJECTIVO: quantificar uma eventual modificação da altura discal decorrente da aplicação de instrumentação interespinhosa (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©. MÉTODOS: o autor avalia um grupo de 20 pacientes com patologia degenerativa da coluna lombar e os seguintes critérios de inclusão: idade >40 e 6; Oswestry Disability Index (ODI >30; Zung Depression Rating Scale INTRODUCCIÓN: la instrumentación interespinosa tiene sido empleada con creciente frecuencia en la última década. Pero, apesar de las numerosas publicaciones científicas hechas en jornales científicos de reconocido mérito internacional, se han producido muy escasas referencias a una hipotética modificación de la altura discal dependiente de la técnica. OBJETIVO: cuantificar una eventual modificación de la altura discal inherente a la aplicación de instrumentación interespinosa. MÉTODOS: el autor hace una evaluación de un grupo de 20 pacientes con patología degenerativa de la columna lumbar, y diversos criterios de inclusión, a saber: edad >40 y 6; Oswestry Disability Index >30; Zung Depression Rating Scale INTRODUCTION: the use of interspinous instrumentation has been increasing in the last decade. However, in spite of the numerous papers seen in relevant scientific publications, there are very few references to an eventual disc height variation in the instrumented segment. OBJECTIVE: to certify eventual changes in disk height after interspinous instrumentation (DIAM - Cousin-Biotech - Medtronic Sofamor Danek Inc©. METHODS: the author evaluated 20 patients with degenerative lumbar disease and the following

  18. Cerebral atrophic and degenerative changes following various cerebral diseases, (2)

    CT images of a patient with sequelae after viral encephalitis, a patient with acute encephalopathy, a patient suspected to have Reye syndrome, an infant who had acute encephalopathy and was suspected to have had neonatal multiple cystic encephalopathy, a patient with progressive paralysis, a patient with multiple sclerosis, a patient with radiation injury, a patient who had intracerebral calcification after radiotherapy, a patient who was given intrathecal methotrexate, a patient with alcoholic cerebellar atrophy, a patient with porencephaly, an infant with communicating hydroencephalus, and a patient having normal pressure hydrocephalus were explained. Periventricular luency visualized on CT images during the courses of hydroencephalus at an acute stage and normal pressure hydrocephalus was also described. (Tsunoda, M.)

  19. Experimental colitis does not increase the prevalence of ANKENT, a spontaneous joint disease in mice

    Čapková, Jana; Štěpánková, Renata; Hudcovic, Tomáš; Šinkora, Jiří; Řeháková, Zuzana

    2004-01-01

    Roč. 49, č. 6 (2004), s. 745-750. ISSN 0015-5632 R&D Projects: GA ČR(CZ) GA310/00/1371; GA ČR(CZ) GA305/03/0287 Institutional research plan: CEZ:AV0Z5052915 Keywords : ankylosing spondylitis * ankylosing enthesopathy * inflammatory bowel disease Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 1.034, year: 2004

  20. Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I recommendations

    Dheeraj Gupta

    2013-01-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a major public health problem in India. Although several International guidelines for diagnosis and management of COPD are available, yet there are lot of gaps in recognition and management of COPD in India due to vast differences in availability and affordability of healthcare facilities across the country. The Indian Chest Society (ICS and the National College of Chest Physicians (NCCP of India have joined hands to come out with these evidence-based guidelines to help the physicians at all levels of healthcare to diagnose and manage COPD in a scientific manner. Besides the International literature, the Indian studies were specifically analyzed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a definitions, epidemiology, and disease burden; (b disease assessment and diagnosis; (c pharmacologic management of stable COPD; (d management of acute exacerbations; and (e nonpharmacologic and preventive measures. The modified grade system was used for classifying the quality of evidence as 1, 2, 3, or usual practice point (UPP. The strength of recommendation was graded as A or B depending upon the level of evidence.

  1. Spinal deformity in aged zebrafish is accompanied by degenerative changes to their vertebrae that resemble osteoarthritis.

    Anthony J Hayes

    Full Text Available Age-related degenerative changes within the vertebral column are a significant cause of morbidity with considerable socio-economic impact worldwide. An improved understanding of these changes through the development of experimental models may lead to improvements in existing clinical treatment options. The zebrafish is a well-established model for the study of skeletogenesis with significant potential in gerontological research. With advancing age, zebrafish frequently develop gross deformities of their vertebral column, previously ascribed to reduced trunk muscle tone. In this study, we assess degenerative changes specifically within the bone and cartilage of the vertebral column of zebrafish at 1, 2 and 3-years of age. We show increased frequency and severity of spinal deformities/curvatures with age. Underlying the most severe phenotypes are partial or complete vertebral dislocations and focal thickening of the vertebral bone at the joint margins. MicroCT examination demonstrates small defects, fractures and morphological evidence suggestive of bone erosion and remodeling (i.e. osteophytes within the vertebrae during aging, but no significant change in bone density. Light and electron microscopic examination reveal striking age-related changes in cell morphology, suggestive of chondroptosis, and tissue remodelling of the vertebral cartilage, particularly within the pericellular micro-environment. Glycosaminoglycan analysis of the vertebral column by HPLC demonstrates a consistent, age-related increase in the yield of total chondroitin sulfate disaccharide, but no change in sulfation pattern, supported by immunohistochemical analysis. Immunohistochemistry strongly identifies all three chondroitin/dermatan sulphate isoforms (C-0-S, C-4-S/DS and C-6-S within the vertebral cartilage, particularly within the pericellular micro-environment. In contrast, keratan sulfate immunolocalises specifically with the notochordal tissue of the intervertebral

  2. MRI based volumetric assessment of knee cartilage after ACL-reconstruction, correlated with qualitative morphologic changes in the joint and with clinical outcome. Is there evidence for early posttraumatic degeneration?; MRT-basierte Knorpelvolumetrie nach Kreuzbandersatzplastik in Korrelation mit qualitativen Gelenkveraenderungen und dem klinischen Outcome. Gibt es Hinweise auf fruehzeitige posttraumatische degenerative Veraenderungen?

    Arnoldi, A.P.; Weckbach, S.; Horng, A.; Reiser, M. [Ludwig-Maximilians-Univ. Muenchen (Germany). Dept. of Clinical Radiology; Nussbickel, C. [Klinikum Garmisch-Partenkirchen (Germany). Dept. of Internal Medicine; Noebauer, I. [Medizinische Universitaet Wien (Austria). Klinik fuer Radiodiagnostik; Zysk, S. [Orthopaedie Zentrum Groebenzell (Germany). Center of Orthopaedics; Glaser, C. [NYU Medical Center, New York, NY (United States). Dept. of Radiology

    2011-12-15

    Purpose: The purpose of this study was to analyze potential quantitative and qualitative changes of the knee cartilage and joint indicative of early posttraumatic OA 4 years after ACL-reconstruction and to correlate the MRI-findings with the clinical outcome (CO). Materials and Methods: 1.5 T MRI-scans were performed on 9 patients post-op and 4 years later. Using a high-resolution T 1-w-fs-FLASH-3D-sequence cartilage volume (cVol) and thickness (mTh) were quantified. Using standard PD-w fs and T 1-w sequences qualitative changes of the joint structures were analyzed based on the WORMS-score. CO was rated by an orthopaedic surgeon using Lysholm-score, OAK-score, Tegner-activity-score (TAS), and Arthrometer KT-1000 testing. Results: Mean changes of cVol were -1.8 % (range: -5.9 %; + 0.7 %) and of mTh -0.8 % (range: -3.0 %; + 1.1 %). No significant change (95 %-CI) could be identified for any compartment. Three patients developed new peripatellar ostheophytes, acute trauma related changes mostly decreased. Mean outcome of Lysholm-score and OAK-score were 90 pts and 86 pts, mean TAS was 4.3 pts. Average maximum tibial translation reached 5.2 mm comparing to 6.7 mm on the healthy contralateral side. Conclusion: Despite a tendency towards decreased cVol and mTh 4 years after ACL-reconstruction qMRI revealed no significant cartilage loss. Newly developing osteophytes did not match with the observed good CO. This small pilot study motivates future quantitative and qualitative-structural MRI-based assessment of articular cartilage and other joint structures in order to improve diagnostic tools for the detection of early OA. (orig.)

  3. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    Goncalves, B., E-mail: belarmino.goncalves@gmail.com [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Ambrosio, C.; Serra, S. [Department of Rheumatology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F. [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal)

    2011-09-15

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  4. Joint Association of Dietary Pattern and Physical Activity Level with Cardiovascular Disease Risk Factors among Chinese Men: A Cross-Sectional Study

    Wang, D.; He, Y.; Li, Y.P.; Luan, D.C.; Zhai, F.Y.; Yang, X.G.; Ma, G.S.

    2013-01-01

    The purpose of this cross-sectional study was to investigate the joint associations of physical activity level (PAL) and dietary patterns in relation to cardiovascular disease (CVD) risk factors among Chinese men. The study population consisted of 13 511 Chinese males aged 18-59 years from the 2002

  5. Lack of effect of doxycycline on disease activity and joint damage in patients with rheumatoid arthritis. A double blind, placebo controlled trial

    Laan, W. van der; Molenaar, E.; Ronday, K.; Verheijen, J.; Breedveld, F.; Greenwald, R.; Dijkmans, B.; Tekoppele, J.

    2001-01-01

    Objective. To investigate the effects of doxycycline on disease activity and joint destruction in patients with rheumatoid arthritis (RA). Methods. A 36 week double blind, placebo controlled crossover trial was conducted. Patients (n = 66) received 50 mg doxycycline or placebo twice a day during 12,

  6. Radiographic changes in the hip joint in children suffering from Perthes disease.

    Froberg, Lonnie; Christensen, Finn; Pedersen, Niels Wisbech; Overgaard, Søren

    2012-05-01

    The purpose was to compare radiographic parameters with a sex-matched and age-matched control group at the onset of disease and at skeletal maturity. The study comprised 143 patients with Legg-Calvé-Perthes disease, treated using a Thomas splint. Wiberg's centre-edge angle and the acetabular index angle were applied. The age at diagnosis was 6.6 years with no difference between boys and girls. At the time of diagnosis, the centre-edge angle was decreased from 18° in the control group to 10° in the affected hip. The age at follow-up was 16 (SD 2) years for the boys and 15 (SD 3) years for the girls. At the time of skeletal maturity, the centre-edge angle was decreased and the acetabular index angle increased in the affected hip and the nonaffected hip in Stulberg class III/IV/V hips compared with the control group. Initially radiographic changes only occur on the affected hip. At skeletal maturity both hips show radiographic changes. PMID:22186707

  7. Distribuição da gordura corporal em pacientes com e sem doenças crônicas: uso da relação cintura-quadril e do índice de gordura do braço Body fat distribution in patients with and without chronic-degenerative diseases: use of the waist to hip relationship and arm fat index

    Anderson Marliere NAVARRO

    2001-04-01

    Full Text Available O objetivo deste trabalho foi avaliar a distribuição de gordura corporal, visceral e não visceral, em pacientes internados, medida por meio da antropometria. Foram avaliados 157 pacientes internados, distribuídos em dois grupos: Grupo I (95 pacientes portadores de doenças crônicas e Grupo II (62 pacientes portadores de hepatopatias, pneumopatias, nefropatias, neoplasias, úlceras, gastrites, e doenças hematológicas, denominados PTodos. Em cada paciente, foram obtidas as seguintes medidas antropométricas: peso, altura, prega cutânea tricipital e circunferências (cintura e quadril. Os maiores valores dos parâmetros relação cintura/quadril e índice de gordura do braço foram encontrados no Grupo I e estes valores foram significativamente superiores quando comparados ao Grupo II. Os resultados demonstraram que, no grupo de pacientes estudados, houve uma distribuição de gordura corporal diferenciada entre pacientes Grupo I e Grupo II. Estas relações confirmam que os pacientes portadores de doenças crônicas (Grupo I apresentam valores de relação cintura/quadril e índice de gordura do braço que são discriminatórios em relação aos dos pacientes portadores de hepatopatias, pneumopatias, nefropatias, neoplasias, úlceras, gastrites e doenças hematológicas (Grupo II.The objective of this work was to evaluate the distribution of corporal, visceral and not visceral fat, in hospitalized patients, measured by means of the anthropometry. The study evaluated 157 hospitalized patients, distributed in two groups: Group I (95 patients with chronic-degenerative diseases and Group II (62 patients with liver, lung and kidney diseases, neoplasms, ulcers, gastritis, and hematologic diseases. The following anthropometric measurements were obtained from each patient: weight, height, triceps skinfold thickness and circumferences (waist and hip. The largest values of the parameters waist to hip relationship and arm fat index were found in the

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

    Harries, Anthony D; Murray, Megan B; Jeon, Christie Y;

    2010-01-01

    The steadily growing epidemic of diabetes mellitus poses a threat for global tuberculosis (TB) control. Previous studies have identified an important association between diabetes mellitus and TB. However, these studies have limitations: very few were carried out in low-income countries, with none...... monitoring tests, including measurements of blood glucose and glycated haemoglobin A(1c) (HbA(1c)) for patients with diabetes mellitus. Implementation of this research agenda will benefit the control of both diseases.......The steadily growing epidemic of diabetes mellitus poses a threat for global tuberculosis (TB) control. Previous studies have identified an important association between diabetes mellitus and TB. However, these studies have limitations: very few were carried out in low-income countries, with none...

  9. CASAD -- Computer-Aided Sonography of Abdominal Diseases - the concept of joint technique impact

    T. Deserno

    2010-03-01

    Full Text Available Ultrasound image is the primary (input information for every ultrasonic examination. Since being used in ultrasound images analysis the both knowledge-base decision support and content-based image retrieval techniques have their own restrictions, the combination of these techniques looks promissory for covering the restrictions of one by advances of another. In this work we have focused on implementation of the proposed combination in the frame of CASAD (Computer-Aided Sonography of Abdominal Diseases system for supplying the ultrasound examiner with a diagnostic-assistant tool based on a data warehouse of standard referenced images. This warehouse serves: to manifest the diagnosis when the ecographist specifies the pathology and then looks through corresponding images to verify his opinion; to suggest a second opinion by automatic analysis of the annotation of relevant images that were assessed from the repository using content-based image retrieval.

  10. Familial disease, the HLA-DRB1 shared epitope and anti-CCP antibodies influence time at appearance of substantial joint damage in rheumatoid arthritis.

    Rojas-Villarraga, Adriana; Diaz, Francisco J; Calvo-Páramo, Enrique; Salazar, Juan C; Iglesias-Gamarra, Antonio; Mantilla, Ruben D; Anaya, Juan-Manuel

    2009-02-01

    Rheumatoid arthritis (RA) progresses more rapidly in some patients than in others and diverse factors influence radiographic progression in a specific population. Thus, we searched for variables that are associated with an early appearance of substantial joint damage in patients with RA by using radiographic assessments. A cohort of 157 consecutively enrolled Colombian RA patients was followed for an average of 3.2+/-3.1 years. Information on patient demographics and cumulative clinical and laboratory manifestations over the course of the disease was registered, including family history of RA in first-degree relatives, extra-articular manifestations, rheumatoid factor, anti-CCP3 antibodies, TNF single nucleotide polymorphism at -308 position, and HLA-DRB1 status. Radiographs were scored according to the Sharp-van der Heijde method. Survival analyses of the time at appearance of substantial joint damage were performed by using Weibull models. A review of literature about the influence of familial RA on the progression of disease was done. Our results show that family history of RA is consistently associated with joint damage (i.e. erosive and joint narrowing disease). This effect was not found in all the populations reviewed. In addition, we confirm the effect of HLA-DRB1 shared epitope and anti-CCP seropositivity on erosive disease. Family history of RA is a key risk factor for joint damage and depends on the investigated population because variations in both additive and non-additive genetic factors and the environmental variance are specific to the population. Our results emphasize the usefulness of assessing familial disease, testing anti-CCP antibodies and genotyping HLA-DRB1 gene in patients with RA because these factors may be used to predict clinical outcomes and guide therapeutic interventions. PMID:19117726

  11. Joint imaging

    Joint imaging is a proven diagnostic procedure which has become indispensable to the detection and treatment of different joint diseases in almost all disciplines. The method is suited for early diagnosis of joint affections both in soft tissue and bone which cannot be detected by X-ray or other procedures. The local activity accumulation depends on the rate of metabolism and is visualized in the scan, which in turn enables the extension and floridity of focal lesions to be evaluated and followed-up. Although joint scans may often give hints to probabilities relevant to differential diagnosis, the method is non-specific and only useful if based on the underlying clinical picture and X-ray finding, if possible. The radiation exposure is very low and does not represent a hazard in cases of adequate assessment of indication. In pregnant women and children the assessment of indication has to be based on very strict principles. The method is suited for out-patient diagnosis and can be applied in all installations equipped with a gamma camera and a technetium generator. (orig.)

  12. Clinical effect of minimally invasive transforaminal lumbar interbody fusion combined with unilateral pedicle fixation on elderly lumbar degenerative diseases%微创经椎间孔椎间融合术并单侧椎弓根固定治疗老年人腰椎退变性疾病的临床疗效观察

    张建乔; 曾忠友; 叶招明; 宋永兴; 韩建福; 籍剑飞

    2015-01-01

    Objective To analyze the clinical effect of minimally invasive transforaminal lumbar interbody fusion (MI-TLIF) in combination with unilateral pedicle fixation on lumbar degenerative diseases in the elderly.Methods From June 2011 and June 2013,51 elderly patients with lumbar degenerative diseases who underwent MI-TLIF in combination with unilateral pedicle fixation,including 39 males and 12 females,aged from 60 to 72 years (average 65 years old),were included in this study.All the 51 cases had mono segmental lesion,including 11 cases with the lesion in L3.4,22 cases with the lesion in L4.5,and 18 cases with the lesion in L5-S1.The operation time,blood loss,postoperative drainage and complications were recorded.Postoperative outpatient follow-ups were conducted once every 2-3 months for all cases,and JOA scoring criteria (29 points) of lower back pain were adopted to evaluate the clinical effects.Thin-layer helical CT scanning reconstruction was applied to evaluate the fusion rate of bone grafting.X-ray film of lumbar vertebra AP & LAT was employed to evaluate the intervertebral space height,the internal fixation and the position of cage.Results The operation time ranged between 50-90 min with a mean value of 65 min; blood loss ranged between 80-180 ml (average 110 ml); and postoperative drainage volume ranged between 20-70 ml (average 40 ml).Healing phase I was achieved in 49 cases,while post-operative local cutaneous necrosis around the incision site occurred in 2 case and the wound healed well after wound dressing.Dural laceration without nerve root injury occurred in 2 cases.The follow up in 51 patients ranged between 18 24 months (average 20 months).In terms of JOA scoring,the preoperative score was (9.7± 1.6),the post operative score was (21.4 ± 1.4) 7 d after operation and the score was (25.4 ± 1.2) in the final follow up.During the final follow-up,35 cases were evaluated as excellent,11 cases as good and 5 cases as moderate,the excellent and good rate was

  13. 骨水泥强化与常规椎弓根螺钉固定治疗老年退行性腰椎疾病的比较%Comparison of bone cement augmented with traditional pedicle screw in the treatment of degenerative lumbar disease

    吴志彬; 刘宏建; 尚国伟; 贾杰; 魏琛; 王俊魁; 周权发; 皮国富; 王义生

    2015-01-01

    目的 比较骨水泥强化与常规椎弓根螺钉固定治疗老年退行性腰椎疾病的疗效.方法 回顾性分析2013年5月至2015年5月采用腰椎融合术治疗40例老年退行性腰椎疾病患者资料,根据置入椎弓根螺钉的椎体内是否注入骨水泥分为常规组(未置入骨水泥,20例,男5例,女15例;年龄平均73.2岁;腰椎间盘突出 12例,腰椎管狭窄8例)和骨水泥强化组(置入骨水泥,20例,男6例,女14例;年龄平均73.7岁;腰椎间盘突出12例,腰椎管狭窄8例),螺钉分别置入L3、L4、L5及S1共170个椎体.分别评估术前、术后30天及末次随访的Oswestry功能障碍指数、固定节段上位相邻椎间隙高度、固定节段上位相邻椎体变形指数、固定节段Cobb角、固定节段椎体上缘终板及相邻上位椎体下缘终板凹陷角度.结果 40例患者经3~24个月随访,平均随访12.2个月.末次随访Oswestry功能障碍指数常规组及骨水泥强化组评分分别为13.0%±4.9%和11.0%±8.0%,两组比较差异无统计学意义.末次随访与术后30 d的平均Cobb角的变化值常规组及骨水泥强化组分别为5.53°±1.64°、2.15°±0.97°.骨水泥强化组术后30 d出现上终板凹陷角度增大,末次随访时相邻上位椎体下终板凹陷角度、椎体变形指数及相邻椎间隙均减小,且前两项指标的改变程度明显大于常规组.结论 骨水泥强化与常规椎弓根螺钉固定均能缓解患者症状,但骨水泥强化椎弓根螺钉能明显提高老年患者内固定术后椎体的稳定性.%Objective To compare post-operative clinical outcomes between bone cement augmented pedicle screw and traditional pedicle screw in treatment of degenerative lumbar disease.Methods Data of 40 cases with lumbar degenerative disease who had surgery from May 2013 to May 2015 were retrospectively analyzed.They were divided into two groups according to whether the bone cement was injected in the vertebral body with pedicle

  14. Echocardiographic diastolic abnormalities of the left ventricle in inflammatory joint disease.

    Rowe, I F; Gibson, D G; Keat, A C; Brewerton, D A

    1991-01-01

    Echocardiographic early diastolic abnormalities have been shown recently in 50% of men with ankylosing spondylitis. Similar techniques were used to investigate subjects with rheumatoid arthritis and psoriatic arthritis with or without spondylitis. These subjects had no clinical, radiographic, or electrocardiographic evidence of cardiac or respiratory disease. Echocardiographic abnormalities seen resembled those of ankylosing spondylitis in that the interval between minimum left ventricular dimension and mitral valve opening was prolonged in 12 of 22 subjects with rheumatoid arthritis and in seven of 11 subjects with psoriatic arthritis. Isovolumic relaxation time was significantly prolonged in four subjects with rheumatoid arthritis and one with psoriatic arthritis. Unlike ankylosing spondylitis, however, there was consistent reduction in peak rate of left ventricular dimension increase in subjects with rheumatoid arthritis and psoriatic arthritis. In addition, the dimension increase during atrial systole was greater than normal in nine subjects with rheumatoid arthritis and two with psoriatic arthritis. The most likely cause of these abnormalities is increased connective tissue deposition in the myocardium. Images PMID:2029204

  15. Transplantation of adult mouse iPS cell-derived photoreceptor precursors restores retinal structure and function in degenerative mice.

    Budd A Tucker

    Full Text Available This study was designed to determine whether adult mouse induced pluripotent stem cells (iPSCs, could be used to produce retinal precursors and subsequently photoreceptor cells for retinal transplantation to restore retinal function in degenerative hosts. iPSCs were generated using adult dsRed mouse dermal fibroblasts via retroviral induction of the transcription factors Oct4, Sox2, KLF4 and c-Myc. As with normal mouse ES cells, adult dsRed iPSCs expressed the pluripotency genes SSEA1, Oct4, Sox2, KLF4, c-Myc and Nanog. Following transplantation into the eye of immune-compromised retinal degenerative mice these cells proceeded to form teratomas containing tissue comprising all three germ layers. At 33 days post-differentiation a large proportion of the cells expressed the retinal progenitor cell marker Pax6 and went on to express the photoreceptor markers, CRX, recoverin, and rhodopsin. When tested using calcium imaging these cells were shown to exhibit characteristics of normal retinal physiology, responding to delivery of neurotransmitters. Following subretinal transplantation into degenerative hosts differentiated iPSCs took up residence in the retinal outer nuclear layer and gave rise to increased electro retinal function as determined by ERG and functional anatomy. As such, adult fibroblast-derived iPSCs provide a viable source for the production of retinal precursors to be used for transplantation and treatment of retinal degenerative disease.

  16. Procedure of Sauve-Kapandji modified for posttraumatic and degenerative disorders of the radioulnar distal articulation

    This is observational prospective study type series of cases that shows the experience of the group of surgery of hand of the Central Military Hospital between January of 1998 and Julio the 2003. 65 patients were included like surgery of salvage of the articulation radioulnar distal in different traumatic and degenerative pathologies, comparing the results with those published in the world literature. According to the modified functional scale of May this procedure showed excellent and good results in 90% of the patients. They recovered the lost function and improved the function of the distal radioulnar joint, returning to their activities of the daily life. This technique is recommended as a sure and efficient procedure, because the patients present a remarkable improvement in its quality of life and they can return to its labor activity, these results correlated with the results of the published literature

  17. Three-Dimensional Quantitative Morphometric Analysis (QMA for In Situ Joint and Tissue Assessment of Osteoarthritis in a Preclinical Rabbit Disease Model.

    Kathryn S Stok

    intercept (m, Χ of joint contact to demonstrate altered loading with disease progression, as well as traditional bone and cartilage and histo-morphometry measures. We demonstrate correlation of microCT and histology, sensitive discrimination of OA change and robust reproducibility.

  18. Three-Dimensional Quantitative Morphometric Analysis (QMA) for In Situ Joint and Tissue Assessment of Osteoarthritis in a Preclinical Rabbit Disease Model

    Stok, Kathryn S.; Besler, Bryce A.; Steiner, Thomas H.; Villarreal Escudero, Ana V.; Zulliger, Martin A.; Wilke, Markus; Atal, Kailash; Quintin, Aurelie; Koller, Bruno; Müller, Ralph; Nesic, Dobrila

    2016-01-01

    (m, Χ) of joint contact to demonstrate altered loading with disease progression, as well as traditional bone and cartilage and histo-morphometry measures. We demonstrate correlation of microCT and histology, sensitive discrimination of OA change and robust reproducibility. PMID:26808542

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

    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%

  20. The results of decompressive surgery and instrumented posterolateral fusion in refractory degenerative spondylolisthesis

    Behtash H

    2009-02-01

    Full Text Available "nBackground: Degenerative spondylolisthesis is a common disease of the lumbar spine especially in older ones. The disease represents a challenge to the treating physician. At present, for those patients that deteriorate clinically, there are many proposed algorithms for the surgical treatment. This before and after study was undertaken to assess the surgical results of decompression and instrumented posterolateral fusion in these patients. "nMethods: The study population consisted of 23 patients who had undergone no prior surgery for degenerative spondylolisthesis on the lumbar spine. These patients were treated by decompression, bilateral posterolateral fusion, and segmental (pedicle screw instrumentation with mean follow-up of 29 months (range, 13-73 months. Finally, The clinical results were evaluated for all patients by means of an Oswestry Disability Index (ODI version 2.1, the Henderson's functional capacity, and persistence of leg symptoms, low back pain or claudication. Mann-Whitney and Chi-Square tests were used to assess the average values and comparison, respectively. "nResults: Henderson's functional capacity at the last visit session was excellent in 14 (60.9%, good in 7 (30.4%, fair in 2 (8.7% cases. ODI decreased from 72.2% (50-88% preoperatively to 14.4% (0-54% at the latest follow-up visit. A history of leg pain or claudication was correlated significantly with the amount of decline in ODI score and Henderson's functional capacity (p<0.05. "nConclusion: In spite of limited number of our patients, decompressive surgery plus instrumented posterolateral fusion is a safe, reliable, and satisfactory procedure for treating degenerative lumbar spondylolisthesis. This procedure may be done when conservative treatment was failed and psychological problems can be ruled out.

  1. Regional cerebral blood flow in primary degenerative dementia

    Regional cerebral blood flow (rCBF) was examined, using SPECT by Xe-133 inhalation, in patients with primary degenerative dementia who were subgrouped according to predominant symptoms with respect to amnesia, apraxia, agnosia, aphasia, and personality changes. Also the effect of sex and age at dementia onset on the rCBF patterns was assessed. (author). 26 refs.; 1 fig.; 7 tabs

  2. Hemodynamic Alteration of the Cervical Venous Circulation in a Patient Suffering From Atlantoaxial Degenerative Osteoarthritis with Subluxation: A Case Report

    Lee, Hyun; Jang, Yi Sheng; Lee, Sang Jin; Hwang, Byeong Wook [Busan Wooridul Spine Hospital, Busan (Korea, Republic of); Lee, Sang Ho [Seoul Wooridul Hospital, Gimpio (Korea, Republic of); Choi, Won Gyu [Wooridul Spine Hospital, Seoul (Korea, Republic of)

    2010-01-15

    A 52-year-old female patient was admitted to our hospital with severe occipitocervical pain. The radiographic examination revealed degenerative osteoarthritis and subluxation of the right atlantoaxial joint. Her pain was completely and immediately relieved after occipitocervical reduction and fusion. The marked dilatation of the extradural venous plexus around the vertebral artery and the enlarged deep cervical veins seen on the preoperative MR images had returned to normal dimensions on the postoperative MR images, and this explained the observed rapid pain relief. We report here on this case together with a review of the relevant literature.

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

    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

  4. [Dynamics of hip joint biomechanics in patients with coxarthrosis at the time of hippotherapy].

    Nareklishvili, T M

    2008-02-01

    The problems of degenerative-dystrophic abnormalities stimulate the development of new skills and methods of treatment and rehabilitation of the diseases. The goal of the study was to determine the efficacy of hippotherapy in patients with coxarthrosis, according to functional and biomechanical parameters. Hippotherapy involves the utilization of horseback riding to stimulate the patient's normal reactions and locomotion; to improve the balance and coordination of movement, normalize muscle tension, and eliminate pathological reflexes. The advantage of the hippotherapy is in the specific posture, which is adopted by hip joint at the time of riding and in movement, which is accomplished by rider, at different paces of the horse. 10 female patients from 14 to 32 years old with coxarthrosis were under the observation. The rehabilitation of the patients was carried out by means of hippotherapy, which consisted of three months riding three times a week. To evaluate the efficacy of treatment, a new method of biomechanical registration of hip joint movement during hippotherapy on pacing horse was developed. The dynamics of biomechanical curves before and after the treatment, as well as the clinical and functional parameters of the patients allowed the authors to conclude: hippotherapy improves a hip joint functional state in patients with coxarthrosis; improves the muscle-tendineous component of hip joint movement. Hippotherapy may be considered as the pathogenetic method of treatment of coxarthrosis. Drawing the biomechanical curve of hip joint movement at the time of riding is the objective method of studying its function. PMID:18401052

  5. Bone Marrow Transplantation in Hindlimb Muscles of Motoneuron Degenerative Mice Reduces Neuronal Death and Improves Motor Function

    Pastor, Diego; Viso-León, Mari Carmen; Botella-López, Arancha; Jaramillo-Merchan, Jesus; Moraleda, Jose M.; Jones, Jonathan; Martínez, Salvador

    2013-01-01

    Bone marrow has proved to be an adequate source of stem cells for the treatment of numerous disorders, including neurodegenerative diseases. Bone marrow can be easily and relatively painlessly extracted from a patient or allogenic donor and then transplanted into the degenerative area. Here, the grafted cells will activate a number of mechanisms in order to protect, repair, and/or regenerate the damaged tissue. These properties make the bone marrow a feasible source for cell therapy. In this ...

  6. Association between lumbar Modic changes and MRI finding of degenerative disc in patients with low back pain

    Seyed Reza Saadat Mostafavi

    2016-01-01

    Full Text Available Background: Recent studies have indicated the relation of vertebral endplate lesions (Modic changes to low back pain (LBP. The aim of this study was to investigate the Modic changes in magnetic resonance imaging (MRI of patients with low back pain, and its correlation with age, sex, type of changes, number of involved segments and location of changes. Additionally, association of degenerative disc changes and disc herniation was assessed. Methods: In this retrospective study, MRI records of 229 patients with LBP referring to Medical Center of Hazrat-e-Rasoul Hospital, Tehran, Iran, from August to February 2014, were assessed and Modic changes and degenerative and herniated disc changes were recorded. Results: Based on our observations, a significant association between Modic type and age (P= 0.003 existed in patients with LBP. The highest prevalence in Modic location were observed in anterior part of vertebral endplate (48.8%, P= 0.001. Although, observation of the Modic changes in superior vertebral endplate was higher than inferior parts, but this differences was not statistically significant. The highest prevalence in degenerative disc disease was disc dehydration which was observed in 18.1% of patients (P= 0.04. The relationship between the degenerative changes and Modic type was significant (P= 0.04, while the most prevalent change of disc contour was disc bulging which occurred in 23.7% of patients (P= 0.01. The highest frequency of abnormal disc contour were observed in Modic type 2 which was statistically significant (P= 0.01. Modic surface involvement above 25% was significantly associated with disc herniation (P= 0.04. There was no significant association between Modic height involvement above 25% and disc herniation. Conclusion: Considering significant association between Modic changes and degenerative and herniated disc changes, reporting of Modic changes is necessary.

  7. Acute chondrolysis complicating Legg-Calve-Perthes disease

    Of 270 children with Legg-Calve-Perthes (LCP) disease, roentgenographic evidence of chondrolysis was noted in 12 (4.5%) within one year after diagnosis and appropriate management. Only in six hips of these 12 patients did the retrospective clinical, histological, and orthopedic findings fulfill the diagnostic requirements for chondrolysis. Sequential roentgenographic findings included initial periarticular osteoporosis and subchondral cortical irregularities, subsequent narrowing of the joint space, premature fusion of the growth plate, and eventual development of degenerative arthritis. The early roentgenographic recognition of chondrolysis is emphasized because it has an untoward effect on the prognosis of LCP and should therefore prompt a different orthopedic approach. (orig.)

  8. Degenerative spondylolisthesis in the cervical spine: a report of a case

    Mierau, Dale; Cassidy, J David

    1984-01-01

    Degenerative spondylolisthesis is a phenomenon in which the posterior elements undergo degenerative change allowing one vertebra to slip forward on another. The sequela of degenerative spondylolisthesis may be instability and/or nerve root entrapment with or without chronic pain. Patients with this condition may be treated with mobilization and manipulation, however, this must be done with caution. The case reported illustrates the successful treatment of degenerative spondylolisthesis with s...

  9. AN ASSOCIATION OF CYTOKINE LEVELS WITH DISEASE ACTIVITY, AUTOANTIBODY LEVELS, AND JOINT DESTRUCTIVE CHANGES IN EARLY RHEUMATOID ARTHRITIS

    A. S. Avdeeva

    2015-09-01

    Full Text Available Objective: to assess the association of cytokine profile measures with disease activity, autoantibody levels, and joint destructive changes in patients with early rheumatoid arthritis (RA.Subjects and methods. Forty-five patients, including 35 women, with early RA were examined. Their median age was 53.5 [46; 59.5] years; the duration of the disease – 7.0 [4.0; 11.5] months; DAS28 – 5.8 [4.9; 6.4]; 91 and 96% of the patents were positive for rheumatoid factor (RF and anticyclic citrullinated peptide antibodies, respectively. Serum cytokine concentrations were estimated using the xMAP multiplex technology. The modified Sharp method was employed to quantify radiographic changes.Results and discussion. A group of 30 patients with high disease activity (DAS28 >5.1 had higher levels of interleukin (IL-6 (62.3 [36.1; 127.5] pg/ml and IP-10 (6367.8 [3682.7; 10691.3] pg/ml than 15 patients with moderate/low disease activity (DAS28 ≤5.1 (35.8 [13.4; 64.2] and 3222.6 [1881.0; 5671.9] pg/ml, respectively, p < 0.05. The patients highly positive for IgM RF had higher levels (pg/ml of proinflammatory cytokines, such as IL-1β, IL-2, IL-6, IL-12, IL-15, interferon-γ, and tumor necrosis factor-α; the chemokine monocyte chemotactic protein-1 and the growth factors IL-7 and vascular endothelial growth factor (4.8 [2.8; 19.3], 23.0 [7.1; 55.8], 64.2 [41.6; 170.5], 52.2 [30.9; 126.9], 2.4 [0.2; 11.2], 210.8 [119.9; 584.2], 90.7 [42.7; 307/9], 57.5 [26.1; 93.8], 54.9 [37.1; 123.7], and 143.3 [70.6; 249.6] pg/ml than those who were negative/lowly positive for IgM RF (2.3 [1.9; 3.1], 4.9 [2.9; 16.8], 24.9 [20.4; 45.4], 25.6 [19.9; 57.1], 0.2 [0.01; 1.65], 94.4 [86.3; 138.9], 37.3 [23.6; 47.7], 20.9 [12.3; 33.9], 32.6 [28.1; 37.8], 74.2 [53.5; 147.6], respectively (p < 0.05.Conclusion. There are significant differences in cytokine profile measures in patients with early RA in relation to disease activity and serum autoantibody levels.

  10. Proceedings of a Joint Meeting held between The Norwegian Society of Infectious Diseases and the Royal Society of Tropical Medicine and Hygiene, Oslo, 20th June 2008

    Newport, Melanie J.; Myrvang, Bjorn

    2009-01-01

    The Royal Society of Tropical Medicine and Hygiene (RSTMH) has a tradition of holding joint meetings with fellow European Societies, providing opportunities to facilitate discussion, exchange information, foster mutual interests and develop collaboration between the societies’ members and fellows. This paper presents the proceedings from a scientific meeting that was held between The RSTMH and the Norwegian Infectious Diseases Society at Ulleval University Hospital, Oslo on 20th June 2008. Th...

  11. Joint Association of Dietary Pattern and Physical Activity Level with Cardiovascular Disease Risk Factors among Chinese Men: A Cross-Sectional Study

    Dong Wang; Yuna He; Yanping Li; Dechun Luan; Fengying Zhai; Xiaoguang Yang; Guansheng Ma

    2013-01-01

    The purpose of this cross-sectional study was to investigate the joint associations of physical activity level (PAL) and dietary patterns in relation to cardiovascular disease (CVD) risk factors among Chinese men. The study population consisted of 13 511 Chinese males aged 18-59 years from the 2002 China National Nutrition and Health Survey. Based on dietary data collected by a food frequency questionnaire, four dietary patterns were identified and labeled as "Green Water'' (high consumption ...

  12. Estimating a Multivariate Familial Correlation Using Joint Models for Canonical Correlations: Application to Memory Score Analysis from Familial Hispanic Alzheimer's Disease Study

    Lee, Hye-Seung; Paik, Myunghee Cho; Lee, Joseph H.

    2008-01-01

    Analysis of multiple traits can provide additional information beyond analysis of a single trait, allowing better understanding of the underlying genetic mechanism of a common disease. To accommodate multiple traits in familial correlation analysis adjusting for confounders, we develop a regression model for canonical correlation parameters and propose joint modeling along with mean and scale parameters. The proposed method is more powerful than the regression method modeling pairwise correla...

  13. Imaging of hip joint arthroplasty; Bildgebung bei Hueftgelenkendoprothesen

    Mayerhoefer, M.E.; Fruehwald-Pallamar, J.; Czerny, C. [Univ.-Klinik fuer Radiodiagnostik, Medizinische Universitaet Wien, Abteilung fuer Neuroradiologie und Muskuloskelettale Radiologie, Wien (Austria)

    2009-05-15

    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.) [German] Dem Hueftgelenk als groesstem Gelenk des menschlichen Koerpers kommt eine besondere Bedeutung in der muskuloskelettalen Radiologie zu. Entsprechend wichtig ist auch die radiologische Beurteilung von Hueftgelenkendoprothesen, die z. B. infolge degenerativer Gelenkerkrankungen, einer Hueftkopfnekrose oder einer Fraktur eingesetzt werden. Die Projektionsradiographie ist weiterhin die primaere Modalitaet zur Beurteilung von Hueftgelenkendoprothesen, direkt postoperativ und zur laengerfristigen Verlaufskontrolle. Diese Methode erlaubt in der Mehrzahl der Faelle eine suffiziente Antwort auf die Frage nach Lockerung, periprothetischer Fraktur oder Prothesenmaterialbruch, Luxation, Infektion und Weichteilkalzifikation

  14. Comparation of levels of anxiety and depression in patients with autommune and chronic-degenerative rheumatic: preliminary data

    M.R. Muscatello

    2011-09-01

    Full Text Available Scientific research on rheumatic diseases was often focused on the link between psychological features and disease. Depression and anxiety are frequently observed with an higher incidence among rheumatic patients in comparison to general population. In autoimmune diseases, such as rheumatoid arthritis, an important role for psychiatric symptoms could be played by the alteration of cytokines levels. In the chronic-degenerative diseases, psychological factors such as stress and depression, can be involved in perception of pain. Objective: We aimed at evaluating in a sample of 50 patients (25 with rheumatoid arthritis and 25 with osteoarthritis levels of pain, anxiety and depression. Methods: we evaluated two group of patients with rheumatic disease, group A (25 with Rheumatoid Arthritis, mean age = 45.1; DS =15.24 and group B (25 with osteoarthritis, mean age = 54.3; DS =14.74 by clinic examination and with the following tests, SF-MPQ, HAQ, HAM-A, HAM-D. Results: We found in group A higher levels of depression and anxiety but lower levels of pain, which was more expressed in group B. Conclusion: Depression and anxiety were observed with an higher prevalence in patients with autoimmune disease, whereas pain was stronger in patients with osteoarthritis, a degenerative disease. We could explain this phenomenon considering the aetiopathology of the two conditions. As regard to autoimmune disorders, these symptoms may reflect the direct effect of cytokines on the central nervous system. As far as it concerns chronic-degenerative diseases, anxiety and depression are usually considered “reactive” to pain, not “constitutive”.

  15. Joint GWAS Analysis: Comparing similar GWAS at different genomic resolutions identifies novel pathway associations with six complex diseases

    McGeachie, Michael J.; Clemmer, George L.; Jessica Lasky-Su; Amber Dahlin; Raby, Benjamin A.; Weiss, Scott T.

    2014-01-01

    We show here that combining two existing genome wide association studies (GWAS) yields additional biologically relevant information, beyond that obtained by either GWAS separately. We propose Joint GWAS Analysis, a method that compares a pair of GWAS for similarity among the top SNP associations, top genes identified, gene functional clusters, and top biological pathways. We show that Joint GWAS Analysis identifies additional enriched biological pathways that would be missed by traditional Si...

  16. DEGENERATIVE AORTIC STENOSIS: PATHOGENESIS AND NEW PRINCIPLES OF TREATMENT

    O. V. Andropova

    2006-01-01

    Full Text Available Aim. To reveal of markers of inflammation and progression of calcification in patients with degenerative aortic stenosis (DAS. Material and methods. A single-stage study was done in 85 patients with degenerative calcification of aortic valve (42 patients with DAS and 43 patients without DAS. The techniques for assessing the severity of aortic valve calcification included ultrasonic diagnostics and multislice spiral computed tomography. Markers of inflammation and lipid profile were investigated.    Results. Higher blood levels of total holesterol and holesterol of low density lipoprotein were revealed in patients with DAS in comparison with patients without DAS. They also had higher levels of inflammation markers: C-reactive protein and interleukin-6. There were significant correlations between DAS severity, lipid metabolism disturbances and inflammation markers. Conclusion. Atherogenesis and inflammation may have pathogenic influence on progression of aortic valve calcification and DAS development by lipid infiltration and endothelium cells damage.

  17. Analysis of inner heating dry needle therapy in the treatment of degenerative disc disease with continuous dynamic ECG monitoring%内热针治疗椎间盘退行性疾病过程中动态心电监护的结果分析

    田羽玲; 高谦; 王刚; 孙关玲; 张琳; 于丽伟

    2016-01-01

    目的 通过监测内热针治疗(Inner heating dry needle therapy)椎间盘退行性疾病(degenerative disc disease,DDD)过程中不同时间点生命体征的变化,探讨内热针疗法的安全性.方法 2015年4月~2015年10月解放军总医院康复医学中心病区及门诊收治的椎间盘退行性疾病患者278例,进行内热针治疗,动态监测患者入室时、麻醉时、针刺时、治疗中及治疗后心率、呼吸、血压及血氧饱和度的变化.结果 所有患者在心电监护下顺利完成治疗,术中无明显不适主诉,无心血管意外发生.心率、呼吸及血压在麻醉时和针刺时有升高趋势(P<0.05),一般持续10 ~ 20 min,但均在可控范围之内.麻醉时心率(77.13±11.78)次/min,呼吸(18.94±3.25)次/min,收缩压(130.8±17.06) mmHg,舒张压(75.40±12.05) mmHg;针刺时心率(76.67±11.85)次/min,呼吸(18.10±3.29)次/min,收缩压(128.97±16.84) mmHg,舒张压(74.23±11.79) mmHg.血氧饱和度在各个时间点差异无统计学意义.治疗后各指标恢复至入室前状态.结论 在内热针治疗椎间盘退行性疾病过程中,心率、呼吸、血压在麻醉时和针刺时可出现一过性升高,但总体波动平稳可控,对生命体征影响较小,是一种安全性的治疗方法.治疗过程中应全程动态心电监护,尤其要密切关注麻醉和针刺时各生命体征的变化.

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

    Asdrubal Falavigna

    2009-09-01

    this study was to describe the methodology to evaluate spinal degenerative pathologies and verify the results. METHODS: after the indication of surgical treatment, the patients were invited to participate in the study by signing a letter of free and informed consent. The patients completed the questionnaires at the doctor's office, and were helped regarding doubts in filling them out by a person who was not involved in the surgery. All the evaluation instruments used are self-applied. The following were used: numerical rating scale of pain (NRS, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36, Fear-Avoidance Beliefs Questionnaire (FABq, Beck Depression Inventory (BDI, Hospital Anxiety and Depression (HAD Scale, Oswestry Disability Index (ODI and Neck Disability Index (NDI. RESULTS: 220 patients with lumbar spine pathologies and 32 with cervical pathologies were evaluated. The prevalence of depression, according to the BDI, was 28.0% and 31.2% in patients with lumbar and cervical surgical disease, and the prevalence of anxiety according to HAD-A was 40.1% and 46.9%, respectively. The mean of ODI was 46.5, and of NDI, 25.4. As to the feasibility of completing the questionnaires, it was observed that most of the patients, when they have been instructed about completing them, did not have any difficulty in finishing them. The mean time for the completion of all instruments was 25 to 35 minutes. CONCLUSION: the use of instruments validated to evaluate patients with degenerative spinal diseases is feasible and should be encouraged among the spinal surgeons.

  19. Prevalência e relação de fatores emocionais e clínicos em pacientes com discopatia degenerativa La prevalencia y la relación de los factores clínicos y los trastornos emocionales en pacientes con discopatia degenerativa del disco Prevalence and relationship of emotional and clinical factors in patients with degenerative disc disease

    Vivian Amaral

    2010-06-01

    la cirugía para la cirugía electiva. En esta evaluación, se recogieron datos socio-demográficos: de género; edad; situación laboral actual; la aparición de retiro debido a la discapacidad; y la clínica del dolor psicológico: la restricción física; uso de medicación psiquiátrica controlada; el grado de ansiedad; el grado de depresión; el grado de la desesperanza; expectativas antes de la meta quirúrgica. RESULTADOS: el grupo estaba compuesto por 13 mujeres y 14 hombres, edad media de 44,3 años (23 a 65 años. Los parámetros de dolor y de la restricción física están en la acción suele ser indicativa de la cirugía, lo que indica ninguna peculiaridad en el grupo de estudio. Hemos demostrado una alta prevalencia y las correlaciones de cambios psicológicos en pacientes: el 50% en la depresión, el 54% en el marco de la ansiedad y el 22% en el marco de la desesperanza. Además, era posible mostrar altas tasas de ausencia del trabajo debido a la discapacidad y la correlación de la presencia física de la ansiedad y la depresión de los casos donde las expectativas eran engañosas en cuanto a los resultados. CONCLUSIONES: el dolor lumbar crónico se acompaña de imágenes de dolor y los trastornos psicológicos tales como ansiedad, depresión y la desesperanza. Estos parámetros indican la necesidad de una evaluación psicológica antes de la cirugía y el seguimiento, con miras a la rehabilitación del paciente.OBJECTIVES: to describe the psychosocial conditions, at the time of surgical indication, of patients with chronic low back pain caused by degenerative disc disease. METHODS: in a series of 32 cases of degenerative disc disease elective surgery, a psychological evaluation was performed before the surgery. In this evaluation, socio-demographic data were collected: gender; age; present working status; occurrence of withdrawal due to disability; and clinical-psychological data: pain; physical restraint; use of psychiatric medication controlled

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

    Nichard Unonius

    2003-08-01

    ,5% eram casos isolados. CONCLUSÃO: Destaca-se assim a importância desta classificação como a primeira referência nacional dos padrões de hereditariedade das distrofias retinianas do país. Este é o primeiro passo para se proceder em seguida a classificação genético-molecular baseada no seqüenciamento de cada gene responsável por cada um dos padrões de herança. A freqüência de cada tipo específico é semelhante à encontrada em outros trabalhos epidemiológicos de outros países.PURPOSE: To organize a regional data bank of all individuals that have retinal degenerative diseases, with the aim to classify each patient according to the type of distrophy and pattern of inheritance. METHODS: During the meeting of the São Paulo Retina Group on May 5th, 2001, two hundred and forty-three persons were registered, part of whom provided information concerning ocular, personal and family history and family tree. Ninety-three patients were asked about age, origin, type of dystrophy, family history and family tree information, type of inheritance, other systemic abnormalities and complementary examination. They were classified according to the diagnosis and pattern of inhe-ritance. RESULTS: The distrophies found in the registered two hundred and forty-three patients, were: retinitis pigmentosa, Stargardt disease, Usher syndrome, Leber congenital amaurosis and choroideremia. Of the ninety-three patients examined on the same day, sixty-two had retinitis pigmentosa, thirteen had Stargardt disease, thirteen had Usher syndrome, three had Leber congenital amaurosis and two had choroideremia. The inheritance pattern of the patients with retinitis pigmentosa was autosomal dominant in 4 cases (7%, autosomal recessive in twenty cases (32%, X-linked recessive in 7 cases (11%. Twenty-nine cases were isolated (47% and two had an indeterminate pattern of inheritance (3%. Of the Stargardt disease patients, three (23% were autosomal recessive and ten (77% were isolated cases. Of the

  1. Keeping up appearances : The role of identity concealment in the workplace among adults with degenerative eye conditions and its relationship with wellbeing and career outcomes

    Spiegel, Tali; De Bel, Vera; Steverink, Nardi

    2016-01-01

    Purpose: This study aims to describe the interplay between the work trajectories and the passing patterns of individuals with degenerative eye conditions in different phases of their career, as well as the disease progression and the career and well-being outcomes associated with different works and

  2. Keeping up appearances: the role of identity concealment in the workplace among adults with degenerative eye conditions and its relationship with wellbeing and career outcomes

    Spiegel, Tali; De Bel, Vera; Steverink, Nardi

    2016-01-01

    Purpose: This study aims to describe the interplay between the work trajectories and the passing patterns of individuals with degenerative eye conditions in different phases of their career, as well as the disease progression and the career and well-being outcomes associated with different works and

  3. Mielopatía Degenerativa canina: signos clínicos, diagnóstico y terapéutica (Canine degenerative myelopathy: clinical signs, diagnosis and therapy

    Suraniti, A.P

    2011-08-01

    Full Text Available ResumenLa mielopatía degenerativa canina es una enfermedad neurológica progresiva autoinmune que afecta principalmente a caninos adultos de talla grande sin predilección de sexo.SummaryCanine degenerative myelopathy is a progressive neurological autoimmune disease that primarily affects large size adult dogs and no sex predilection.

  4. A Heme Oxygenase-1 Transducer Model of Degenerative and Developmental Brain Disorders

    Hyman M. Schipper

    2015-03-01

    Full Text Available Heme oxygenase-1 (HO-1 is a 32 kDa protein which catalyzes the breakdown of heme to free iron, carbon monoxide and biliverdin. The Hmox1 promoter contains numerous consensus sequences that render the gene exquisitely sensitive to induction by diverse pro-oxidant and inflammatory stimuli. In “stressed” astroglia, HO-1 hyperactivity promotes mitochondrial iron sequestration and macroautophagy and may thereby contribute to the pathological iron deposition and bioenergetic failure documented in Alzheimer disease, Parkinson disease and certain neurodevelopmental conditions. Glial HO-1 expression may also impact neuroplasticity and cell survival by modulating brain sterol metabolism and the proteasomal degradation of neurotoxic proteins. The glial HO-1 response may represent a pivotal transducer of noxious environmental and endogenous stressors into patterns of neural damage and repair characteristic of many human degenerative and developmental CNS disorders.

  5. Use of (/sup 99m/Tc)-HM-PAO in the diagnosis of primary degenerative dementia

    Testa, H.J.; Snowden, J.S.; Neary, D.; Shields, R.A.; Burjan, A.W.; Prescott, M.C.; Northen, B.; Goulding, P.

    1988-12-01

    The clinical value of single photon emission computed tomography (SPECT) in the differential diagnosis of dementia due to cerebral atrophy was evaluated by comparing the pattern of distribution (/sup 99m/Tc)-HM-PAO in three dementing conditions. Imaging was carried out in 26 patients with suspected Alzheimer's disease, 14 with dementia of the frontal-lobe type, and 13 with progressive supranuclear palsy. Images were evaluated and reported without knowledge of clinical diagnosis with respect to regions of reduced uptake of tracer. Reduced uptake in the posterior cerebral hemispheres was characteristic of Alzheimer's disease, while selective anterior hemisphere abnormalities characterized both dementia of the frontal-lobe type and progressive supranuclear palsy. The latter conditions could be distinguished on the basis of the appearance of integrity of the rim of the frontal cortex. The technique has an important role in the differentiation of degenerative dementias.

  6. Use of [/sup 99m/Tc]-HM-PAO in the diagnosis of primary degenerative dementia

    The clinical value of single photon emission computed tomography (SPECT) in the differential diagnosis of dementia due to cerebral atrophy was evaluated by comparing the pattern of distribution [/sup 99m/Tc]-HM-PAO in three dementing conditions. Imaging was carried out in 26 patients with suspected Alzheimer's disease, 14 with dementia of the frontal-lobe type, and 13 with progressive supranuclear palsy. Images were evaluated and reported without knowledge of clinical diagnosis with respect to regions of reduced uptake of tracer. Reduced uptake in the posterior cerebral hemispheres was characteristic of Alzheimer's disease, while selective anterior hemisphere abnormalities characterized both dementia of the frontal-lobe type and progressive supranuclear palsy. The latter conditions could be distinguished on the basis of the appearance of integrity of the rim of the frontal cortex. The technique has an important role in the differentiation of degenerative dementias

  7. Proteomic profile of human aortic stenosis: insights into the degenerative process.

    Martín-Rojas, Tatiana; Gil-Dones, Felix; Lopez-Almodovar, Luis F; Padial, Luis R; Vivanco, Fernando; Barderas, Maria G

    2012-03-01

    Degenerative aortic stenosis is the most common worldwide cause of valve replacement. While it shares certain risk factors with coronary artery disease, it is not delayed or reversed by reducing exposure to risk factors (e.g., therapies that lower lipids). Therefore, it is necessary to better understand its pathophysiology for preventive measures to be taken. In this work, aortic valve samples were collected from 20 patients that underwent aortic valve replacement (55% males, mean age of 74 years) and 20 normal control valves were obtained from necropsies (40% males, mean age of 69 years). The proteome of the samples was analyzed by quantitative differential electrophoresis (2D-DIGE) and mass spectrometry, and 35 protein species were clearly increased in aortic valves, including apolipoprotein AI, alpha-1-antitrypsin, serum albumin, lumican, alfa-1-glycoprotein, vimentin, superoxide dismutase Cu-Zn, serum amyloid P-component, glutathione S-transferase-P, fatty acid-binding protein, transthyretin, and fibrinogen gamma. By contrast, 8 protein species were decreased (transgelin, haptoglobin, glutathione peroxidase 3, HSP27, and calreticulin). All of the proteins identified play a significant role in cardiovascular processes, such as fibrosis, homeostasis, and coagulation. The significant changes observed in the abundance of key cardiovascular proteins strongly suggest that they can be involved in the pathogenesis of degenerative aortic stenosis. Further studies are warranted to better understand this process before we can attempt to modulate it. PMID:22276806

  8. 骨水泥钉道强化联合空心侧孔椎弓根螺钉治疗伴骨质疏松症的腰椎退行性病变的临床疗效观察%Comparison of the clinical effect of PMMA bone cement augmented screw passageway and bone cement-injectable cannulated pedicle screw in treatment of degenerative lumbar disease with osteoporosis

    刘松明; 宋洁富; 荆志振

    2016-01-01

    目的:比较空心侧孔椎弓根螺钉和骨水泥钉道( PMMA)强化方法应用于伴骨质疏松症的腰椎退行性病变的临床效果。方法选取伴骨质疏松症的腰椎退行性病变患者48例,男21例,女27例;年龄54~78岁,平均64.5岁。其中腰椎管狭窄症17例,腰椎间盘突出症18例,退行性腰椎滑脱症8例,腰椎退行性侧凸5例。按手术方式分为两组,A组23例采用空心侧孔椎弓根螺钉+PMMA。 B组25例采用PMMA行钉道强化+普通椎弓根螺钉内固定术。比较两组手术时间、出血量、住院时间。采用疼痛视觉模拟量表( visual analogue scale,VAS)评分,Oswestry功能障碍指数( Oswestry disability index,ODI)评价患者术后疼痛和功能恢复情况。术前及术后1、3、6、12个月及术后每年行X线检查评估椎间隙高度丢失、内固定失败率和椎间植骨融合率。结果48例患者均得到随访,随访时间1~3.5年。 A组手术时间、出血量、住院时间显著优于B组(均P<0.05)。 A组、B组植骨融合率分别为92.1%、91.2%,两组差异无统计学意义( P>0.05)。A组发生螺钉断裂1例,B组未出现此类情况(P<0.05)。 B组发生内固定松动、螺钉拔出内固定失败1例, A组未发生此类情况(P<0.05)。 A组椎间隙高度丢失(2.7±1.7)mm,B组椎间隙高度丢失(3.7±2.1)mm,两组差异有统计学意义(P<0.05)。根据VAS评分和ODI,两组患者术后疼痛与功能均得到改善,A组效果优于B组(均P<0.05)。结论空心侧孔椎弓根螺钉+PMMA强化内固定用于伴骨质疏松症的腰椎退行性病变是一种具有较好安全性和有效性的方法。%Objective To compare the clinical effect of PMMA bone cement augmented screw passageway and bone cement-injectable cannulated pedicle screw in treatment of degenerative lumbar disease with osteoporosis. Methods

  9. Magnetic resonance imaging-determined synovial membrane volume as a marker of disease activity and a predictor of progressive joint destruction in the wrists of patients with rheumatoid arthritis

    Østergaard, Mikkel; Hansen, M; Stoltenberg, M;

    1999-01-01

    OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease-modifying a......OBJECTIVE: To evaluate the synovial membrane volume, determined by magnetic resonance imaging (MRI), as a marker of joint disease activity and a predictor of progressive joint destruction in rheumatoid arthritis (RA). METHODS: Twenty-six patients with RA, randomized to receive disease......-Pratt analysis). The rate of erosive progression on MRI was highly correlated with baseline scores and, particularly, with area under the curve (AUC) values of synovial membrane volume (Spearman's sigma = 0.69, P < 0.001), but not with baseline or AUC values of local or global clinical or biochemical parameters...

  10. SDF‑1/CXCR4 axis induces apoptosis of human degenerative nucleus pulposus cells via the NF‑κB pathway.

    Liu, Zongchao; Ma, Chuan; Shen, Jieliang; Wang, Dawu; Hao, Jie; Hu, Zhenming

    2016-07-01

    Intervertebral disc degeneration (IVDD) is a major cause of lower back pain, and increased cell apoptosis is a key characteristic of IVDD. The present study aimed to investigate the effects and mechanism of the stromal cell‑derived factor‑1 (SDF‑1)/C‑X‑C motif chemokine receptor 4 (CXCR4) axis on apoptosis in human degenerative nucleus pulposus cells (NPCs). The expression levels of SDF‑1 and CXCR4 in human intervertebral discs (IVD) were determined using immunohistochemistry and western blot analysis. Apoptosis of primary cultured NPCs was quantified by Annexin V/propidium iodide staining following stimulation with SDF‑1 and knockdown of CXCR4 using small interfering RNA (siRNA). The association with the nuclear factor‑κB (NF‑κB) signaling pathway was investigated using CXCR4‑siRNA and NF‑κB inhibitor, pyrrolidine dithiocarbamate (PDTC), treatment. The results demonstrated that SDF‑1 and its receptor, CXCR4, were upregulated in degenerative IVD samples compared with normal samples. Stimulation with SDF‑1 increased the level of apoptosis in cultured NPCs, and conversely, the apoptosis level was suppressed post‑transfection with CXCR4 siRNA compared with SDF‑1 stimulation alone. Furthermore, SDF‑1 treatment increased the level of phosphorylated NF‑κB subunit P65, which was downregulated following CXCR4 siRNA and PDTC treatment. In addition, CXCR4 siRNA and PDTC inhibited the nuclear translocation of P65, which was induced by SDF‑1. Taken together, SDF‑1‑mediated apoptosis was suppressed by NF‑κB inhibition using PDTC. In conclusion, the SDF‑1/CXCR4 axis promoted cell apoptosis in human degenerative NPCs via the NF‑κB pathway, thus suggesting that SDF‑1/CXCR signaling may be a therapeutic target for the treatment of degenerative IVD diseases. PMID:27220474

  11. SDF-1/CXCR4 axis induces apoptosis of human degenerative nucleus pulposus cells via the NF-κB pathway

    LIU, ZONGCHAO; MA, CHUAN; SHEN, JIELIANG; WANG, DAWU; HAO, JIE; HU, ZHENMING

    2016-01-01

    Intervertebral disc degeneration (IVDD) is a major cause of lower back pain, and increased cell apoptosis is a key characteristic of IVDD. The present study aimed to investigate the effects and mechanism of the stromal cell-derived factor-1 (SDF-1)/C-X-C motif chemokine receptor 4 (CXCR4) axis on apoptosis in human degenerative nucleus pulposus cells (NPCs). The expression levels of SDF-1 and CXCR4 in human intervertebral discs (IVD) were determined using immunohistochemistry and western blot analysis. Apoptosis of primary cultured NPCs was quantified by Annexin V/propidium iodide staining following stimulation with SDF-1 and knockdown of CXCR4 using small interfering RNA (siRNA). The association with the nuclear factor-κB (NF-κB) signaling pathway was investigated using CXCR4-siRNA and NF-κB inhibitor, pyrrolidine dithiocarbamate (PDTC), treatment. The results demonstrated that SDF-1 and its receptor, CXCR4, were upregulated in degenerative IVD samples compared with normal samples. Stimulation with SDF-1 increased the level of apoptosis in cultured NPCs, and conversely, the apoptosis level was suppressed post-transfection with CXCR4 siRNA compared with SDF-1 stimulation alone. Furthermore, SDF-1 treatment increased the level of phosphorylated NF-κB subunit P65, which was downregulated following CXCR4 siRNA and PDTC treatment. In addition, CXCR4 siRNA and PDTC inhibited the nuclear translocation of P65, which was induced by SDF-1. Taken together, SDF-1-mediated apoptosis was suppressed by NF-κB inhibition using PDTC. In conclusion, the SDF-1/CXCR4 axis promoted cell apoptosis in human degenerative NPCs via the NF-κB pathway, thus suggesting that SDF-1/CXCR signaling may be a therapeutic target for the treatment of degenerative IVD diseases. PMID:27220474

  12. Internal derangements of the temporomandibular joint: findings in the pediatric age group

    Findings in 31 pediatric patients with pain and dysfunction of the temporomandibular joint (TMJ) are reported. The average age was 14 years and the average duration of symptoms was 21.4 months. Internal derangements were found in 29 patients (94%) and degenerative arthritis in 13 (42%). In 12 patients (39%), the problem could be traced to an injury to the jaw. Secondary condylar hypoplasia was associated with the meniscal abnormality in 3 patients (10%). Further awareness of internal derangements of the TMJ in the pediatric population should permit greater recognition of their etiology. It is important that threatment be initiated as soon as possible, not only to minimize the development of osseous disease in young adults but also to prevent facial growth deformities

  13. Studies on the pathogenesis of degenerative lumbar canal stenosis by computed tomography, 2. Investigation about measurements of the lumbar canal

    Kido, Kenji

    1987-07-01

    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 less than or equal to 100 mm/sup 2/ for DS or less than or equal to 118 mm/sup 2/ for soft-tissue LC at the levels of L3-4; 2) a transverse area of less than or equal to 90 mm/sup 2/ for DS and an angle of less than or equal to 90 deg for the intervertebral joint at the levels of L4-5; and 3) lateral recess of less than or equal to 3 mm in anteroposterior diameter at the levels of L5-S1. (Namekawa, K.).

  14. Neurologic Diseases

    The brain, spinal cord, and nerves make up the nervous system. Together they control all the workings of the body. When something goes wrong ... develops, such as spina bifida Degenerative diseases, where nerve cells are ... to the spinal cord and brain Seizure disorders, such as epilepsy ...

  15. Early onset degenerative dementias: demographic characteristics and etiologic classification in a tertiary referral center.

    Maiovis, Pantelis; Ioannidis, Panagiotis; Konstantinopoulou, Elina; Karacostas, Dimitris

    2015-03-01

    Early onset dementia (EOD) is a major diagnostic challenge as it often presents with atypical features and may be attributed to treatable diseases. Primary degenerative dementias (Alzheimer's disease-AD, frontotemporal lobar degeneration-FTLD, Lewy body dementia-LBD), although traditionally considered to affect older people, are still a main cause of EOD. 491 demented patients were assessed from January 1, 2003 to December 31, 2010 in the Neurology Department of a tertiary referral center. Patients were classified as AD, behavioral variant frontotemporal dementia (bvFTD), non-fluent agrammatic variant primary progressive aphasia (naPPA), semantic variant PPA (svPPA), corticobasal degeneration (CBD), or progressive supranuclear palsy (PSP) who also met criteria for naPPA and LBD. Finally, their demographic characteristics were analysed, according to age at onset (EOD <65 years, late onset dementia-LOD ≥65 years). From the 491 patients, 137 (27.9 %) were EOD. In the EOD group, 52 (38 %) were diagnosed with bvFTD, 34 (24.8 %) with AD, 27 (19.7 %) with naPPA, 10 (7.2 %) with svPPA, 12 (8.8 %) with CBD or PSP, and 2 (1.5 %) with LBD. Demographic characteristics did not differ significantly among diagnostic categories in the EOD group, while in the LOD group FTLD patients were younger and more frequently men compared to both AD and LBD patients. EOD patients had more years of education than LOD patients. Degenerative disorders as causes of EOD are not rare. High clinical alertness is warranted to achieve correct and timely diagnosis. PMID:24878660

  16. Risk factors for adjacent segment degeneration after surgical correction of degenerative lumbar scoliosis

    Kee-yong Ha

    2013-01-01

    Full Text Available Background: Degenerative lumbar scoliosis surgery can lead to development of adjacent segment degeneration (ASD after lumbar or thoracolumbar fusion. Its incidence, risk factors, morbidity and correlation between radiological and clinical symptoms of ASD have no consensus. We evaluated the correlation between the occurrence of radiologic adjacent segment disease and certain imperative parameters. Materials and Methods: 98 patients who had undergone surgical correction and lumbar/thoracolumbar fusion with pedicle screw instrumentation for degenerative lumbar scoliosis with a minimum 5 year followup were included in the study. We evaluated the correlation between the occurrence of radiologic adjacent segment disease and imperative patient parameters like age at operation, sex, body mass index (BMI, medical comorbidities and bone mineral density (BMD. The radiological parameters taken into consideration were Cobb′s angle, angle type, lumbar lordosis, pelvic incidence, intercristal line, preoperative existence of an ASD on plain radiograph and magnetic resonance imaging (MRI and surgical parameters were number of the fusion level, decompression level, floating OP (interlumbar fusion excluding L5-S1 level and posterolateral lumbar interbody fusion (PLIF. Clinical outcomes were assessed with the Visual Analogue Score (VAS and Oswestry Disability Index (ODI. Results: ASD was present in 44 (44.9% patients at an average period of 48.0 months (range 6-98 months. Factors related to occurrence of ASD were preoperative existence of disc degeneration (as revealed by MRI and age at operation ( P = 0.0001, 0.0364. There were no statistically significant differences between radiological adjacent segment degeneration and clinical results (VAS, P = 0.446; ODI, P = 0.531. Conclusions: Patients over the age of 65 years and with preoperative disc degeneration (as revealed by plain radiograph and MRI were at a higher risk of developing ASD.

  17. Wallis棘突间动态稳定系统治疗腰椎退行性疾病的中期疗效及并发症分析%Mid-term efficacy and complications of Wallis interspinous dynamic stabilization system for the treatment of lumbar degenerative diseases

    顾宏林; 詹世强; 昌耘冰; 曾时兴; 梁昌详; 刘斌; 王义生; 郑秋坚; 曾辉

    2014-01-01

    目的:总结和分析Wallis棘突间动态稳定系统治疗腰椎退行性疾病的中期疗效及并发症发生情况。方法回顾性分析2008年7月至2013年3月采用Wallis棘突间动态稳定系统治疗的130例腰椎退行性疾病患者的临床资料。采用视觉模拟量表(VAS)评分评定临床症状改善情况,腰痛日本骨科学会(JOA)评分、Oswestry功能障碍指数(ODI)评分评价术后功能恢复情况;通过腰椎正侧位及动力位X线片检查,测量和比较手术前后手术节段椎间盘平均高度(DH)和活动度(ROM);观察术中、术后并发症并分析其原因。结果130例患者中127例获得完整随访,随访时间13~58个月(平均38.4个月)。末次随访时患者VAS、JOA及ODI评分均较术前明显改善(P<0.05);末次随访时手术节段DH与术前相比,差异无统计学意义[(11.3±1.8)cm vs(11.4±1.8)cm,P>0.05),ROM则较术前显著降低[(22.0±10.0)° vs(25.5±10.1)°,P<0.05]。6例(4.7%)患者出现并发症,1例术中假体爆裂、2例术后分别出现手术节段及邻近节段椎间盘突出复发、2例术后感染(浅部和深部感染各1例)、1例术后顽固性腰痛。结论Wallis棘突间动态稳定系统治疗腰椎退行性疾病中期疗效确切,安全性好,但存在一定并发症风险,应严格把握适应证。%Objective To summarize and analyze the mid-term efficacy and complications of Wallis interspinous dynamic stabilization system for lumbar degenerative diseases (LDD). Methods From July 2008 to March 2013, 130 patients with LDD were treated by Wallis interspinous implants in Guangdong General Hospital, and clinical data of the patients were analyzed retrospectively. Symptoms were assessed by visual analogue scale (VAS), lumbar functions were evaluated according to Japanese Orthopaedic Association (JOA) score and Oswestry disability index (ODI); The disc height (DH) and

  18. Voxel-based analysis of cerebral glucose metabolism in AD and non-AD degenerative dementia using statistical parametric mapping

    Objective: It is know that Alzheimer's disease (AD) and non-AD degenerative dementia have some clinical features in common. The aim of this study was to investigate the specific patterns of regional, cerebral glucose metabolism of AD and non-AD degenerative dementia patients, using a voxel-based 18F-fluorodeoxyglucose (FDG) PET study. Methods: Twenty-three AD patients and 24 non-AD degenerative dementia patients including 9 Parkinson's disease with dementia(PDD), 7 frontal-temporal dementia (FTD), 8 dementia of Lewy bodies (DLB) patients, and 40 normal controls (NC)were included in the study. To evaluate the relative cerebral metabolic rate of glucose (rCMRglc), 18F-FDG PET imaging was performed in all subjects. Subsequently, statistical comparison of PET data with NC was performed using statistical parametric mapping (SPM). Results: The AD-associated FDG imaging pattern typically presented as focal cortical hypometabolism in bilateral parietotemporal association cortes and(or) frontal lobe and the posterior cingulate gyms. As compared with the comparative NC, FTD group demonstrated significant regional reductions in rCMRglc in bilateral frontal, parietal lobes, the cingulate gyri, insulae, left precuneus, and the subcortical structures (including right putamen, right medial dorsal nucleus and ventral anterior nucleus). The PDD group showed regional reductions in rCMRglc in bilateral frontal cortexes, parietotemporal association cortexes, and the subcortical structures (including left caudate, right putamen, the dorsomedial thalamus, lateral posterior nucleus, and pulvinar). By the voxel-by-voxel comparison between the DLB group and NC group, regional reductions in rCMRglc included bilateral occipital cortexes, precuneuses, frontal and parietal lobes, left anterior cingulate gyms, right superior temporal cortex, and the subcortical structures including putamen, caudate, lateral posterior nucleus, and pulvinar. Conclusions: The rCMRglc was found to be different

  19. The use of biosimilars in immune-mediated disease: A joint Italian Society of Rheumatology (SIR), Italian Society of Dermatology (SIDeMaST), and Italian Group of Inflammatory Bowel Disease (IG-IBD) position paper.

    Fiorino, Gionata; Girolomoni, Giampiero; Lapadula, Giovanni; Orlando, Ambrogio; Danese, Silvio; Olivieri, Ignazio

    2014-07-01

    Biological agents are widely used in rheumatology, dermatology and inflammatory bowel disease. Evidence about their efficacy and safety has been strengthened for all those therapeutic indications over the last decade. Biosimilar agents are monoclonal antibodies similar to previously approved biologics. In the European Union, they have been approved for all the indications in the management of immune-mediated inflammatory diseases (IMIDs), although data only in rheumatoid arthritis and ankylosing spondylitis are currently available. Direct evidence on efficacy, safety, and immunogenicity of biosimilars is mandatory in psoriasis, psoriatic arthritis, and inflammatory bowel disease, as well as in children. Based on the current evidence in the literature, we present the joint official position of the Italian Societies of Rheumatology, Dermatology and Inflammatory Bowel Disease on the use of biosimilars in IMIDs. PMID:24657898

  20. Joint GWAS Analysis: Comparing similar GWAS at different genomic resolutions identifies novel pathway associations with six complex diseases

    Michael J. McGeachie

    2014-12-01

    Full Text Available We show here that combining two existing genome wide association studies (GWAS yields additional biologically relevant information, beyond that obtained by either GWAS separately. We propose Joint GWAS Analysis, a method that compares a pair of GWAS for similarity among the top SNP associations, top genes identified, gene functional clusters, and top biological pathways. We show that Joint GWAS Analysis identifies additional enriched biological pathways that would be missed by traditional Single-GWAS analysis. Furthermore, we examine the similarities of six complex genetic disorders at the SNP-level, gene-level, gene-cluster-level, and pathway-level. We make concrete hypotheses regarding novel pathway associations for several complex disorders considered, based on the results of Joint GWAS Analysis. Together, these results demonstrate that common complex disorders share substantially more genomic architecture than has been previously realized and that the meta-analysis of GWAS needs not be limited to GWAS of the same phenotype to be informative.

  1. Joint ventures

    Sørensen, Karsten Engsig

    Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret......Afhandlingen analysere de konkurrenceretlige og selskabsretlige regler som er bestemmende for hvordan et joint venture samarbejde er struktureret...

  2. Dynamic of Grassland Biomass in Different Degenerative Stages

    YAN Yan; LIU Shuzhen; ZHOU Wei

    2006-01-01

    The dynamics of plant community and above- and belowground biomass of the different degenerative stages was researched of Kobresia humlis meadows of Nakchu prefecture in Tibet Autonomous Region. The results indicated that the aggravation of the degree of deterioration of alpine meadow is, the lower the vegetation coverage, percentage of excellent forage, and biodiversity are. The total aboveground biomass is highest in the lightly degraded stages while it is lowest in the extremely degraded stages. With the aggravation of degradation, the aboveground biomass of forbs increases while that of Cyperaceae decreases. We found that the belowground biomass was mostly distributed in the 0-10 cm soil depth in the alpine meadow with a "T"-shape distribution feature, and with the acceleration of deterioration, the numbers of roots becomes less and less. Meanwhile, the above- and belowground biomass of the different degraded communities was significantly correlated(r=0.963). There is an obvious positive correlation with the above- and belowground biomass in different degenerative stages, and their ratio increased with the aggravation of degradation.

  3. Demanda por doenças crônico-degenerativas entre adultos matriculados em uma unidade básica de saúde em São Carlos - SP Ocurrencias de males crónico-degenerativos entre adultos inscritos en una unidad básica de salud en São Carlos-SP Demand for chronic-degenerative diseases among adults attended in a basic health unit at the city of São Carlos-SP

    Adriana Barbieri Feliciano

    1999-07-01

    la UBS parece ubicarse en modelo polarizado de transición donde los males crónico-degenerativos conviven con las infecto-parasitarias. El modelo tradicional de atención de la unidad que focaliza la salud materno-infantil parece no estar adecuado al envejecimiento progresivo de la población al priorizar una clientela que aunque joven ya denota la necesidad de que se desenvuelvan acciones colectivas mirando hacia la prevención primaria y secundaria de los males crónico-degenerativos.The purpose of this study was to find out the profile of the larger clientele more than 12 years old of a Basic Health Unit (BHU, according to socio-demographic variables such as sex,, age group, color, marital status, origin and to characterize the diseases profile according to the chapters of the Internacional Classification of Diseases (ICD X- Revision and group specific diagnoses standing out the group of the chronic-degenerative diseases, searching for its its characterization in the context of the demographic-epidemiology transition. The study was of the transversal type and the population was constituted by the clientele registered in the BHU until August 31, 1996. Individuals in situation of abandonment, the ones tansferred to another units and those who died were excluded. The population studied was formed by 1013 individuals. Data were processed in the software FOXPRO vs 2.0 and the analysis developed in EPIINFO vs 6.04. Authors verified that the studied population was basically formed by women (87.1%. Regarding age, 69.6% were between 12 and 40 years old, 95.6% were of white color, 57.2% were married and 97% coming from the urban zone. The classification according to ICD chapters showed disturbances of the urinary tract and of the genital system (35.5%, breathing system (11.5% and symptons and signs (9.9%. The classification according to specific groups of causes showed similar proportions among the infect-parasitic diseases (24.8% and the chronic-degenerative diseases (24

  4. Coracoclavicular joint

    The coracoclvicular joint, a rear abnormality which may be the cause of pain in the shoulder and limitation of motion of the shoulder joint, is discussed. A case of coracoclvicular joint with shoulder pain was observed in 65 yrs old Korean male

  5. Age-Related Degenerative Functional, Radiographic, and Histological Changes of the Shoulder in Non-Human Primates

    Plate, Johannes F.; Bates, Christopher M.; Mannava, Sandeep; Smith, Thomas L.; Jorgensen, Matthew J.; Register, Thomas C.; Stehle, John R.; High, Kevin P.; Shively, Carol A.; Kaplan, Jay R.; Saul, Katherine R.; Tuohy, Christopher J.

    2013-01-01

    Background Non-human primates have similar shoulder anatomy and physiology compared to humans and may represent a previously underutilized model for shoulder research. This study sought to identify naturally occurring bony and muscular degeneration in the shoulder of non-human primates and to assess relationships between structural and functional aspects of the shoulder and measures of physical function of the animals. We hypothesized that age-related degenerative changes in the shoulders of non-human primates would resemble those observed in aging humans. Methods Middle-aged (n=5, ages 9.4 to 11.8 years) and elderly (n=6, ages 19.8 to 26.4 years) female vervet monkeys were studied for changes in mobility and shoulder function, and radiographic and histologic signs of age-related degeneration. Results Four out of six (4/6) elderly animals had degenerative changes of the glenoid compared to 0/5 of the middle-aged animals (p=0.005). Elderly animals had glenoid retroversion, decreased joint space, walked slower and spent less time climbing and hanging than middle-aged vervets (protator cuff tears were not observed in any of the eleven animals. Discussion and Conclusion The vervet monkey naturally undergoes age-related functional, radiographic and histological changes of the shoulder and may qualify as an animal model for selected translational research of shoulder osteoarthritis. Level of evidence Basic Science Study, in-vivo Animal Model PMID:23352182

  6. Development of an Arthroscopic Joint Capsule Injury Model in the Canine Shoulder.

    David Kovacevic

    Full Text Available The natural history of rotator cuff tears can be unfavorable as patients develop fatty infiltration and muscle atrophy that is often associated with a loss of muscle strength and shoulder function. To facilitate study of possible biologic mechanisms involved in early degenerative changes to rotator cuff muscle and tendon tissues, the objective of this study was to develop a joint capsule injury model in the canine shoulder using arthroscopy.Arthroscopic surgical methods for performing a posterior joint capsulectomy in the canine shoulder were first defined in cadavers. Subsequently, one canine subject underwent bilateral shoulder joint capsulectomy using arthroscopy, arthroscopic surveillance at 2, 4 and 8 weeks, and gross and histologic examination of the joint at 10 weeks.The canine subject was weight-bearing within eight hours after index and follow-up surgeries and had no significant soft tissue swelling of the shoulder girdle or gross lameness. Chronic synovitis and macroscopic and microscopic evidence of pathologic changes to the rotator cuff bony insertions, tendons, myotendinous junctions and muscles were observed.This study demonstrates feasibility and proof-of-concept for a joint capsule injury model in the canine shoulder. Future work is needed to define the observed pathologic changes and their role in the progression of rotator cuff disease. Ultimately, better understanding of the biologic mechanisms of early progression of rotator cuff disease may lead to clinical interventions to halt or slow this process and avoid the more advanced and often irreversible conditions of large tendon tears with muscle fatty atrophy.

  7. Transition joint

    A transition joint is disclosed for joining together tubular pieces formed respectively from a low alloy or carbon steel and a high temperature alloy composition having substantially different characteristics such as coefficient of thermal expansion, the transition joint including a plurality of tubular parts interconnected with each other by means of friction weld joints formed at an angle of 900 to the axis of the transition joint, the tubular parts at opposite ends of the transition joint being selected to facilitate in situ welding to the low alloy or carbon steel and high temperature alloy respectively. This friction welded transition joint can be used whenever different tubular pieces need to be joined together so that the joint can withstand high temperatures, for instance in heat exchangers and the such like. (Auth.)

  8. PARKINSON’S DISEASE: A BRIEF REVIEW

    . Adinarayana; Ajay Babu; Karuna Devi

    2014-01-01

    Parkinson’s disease (PD) is an age-related neurodegenerative disorder affecting many people in the world. Several gene mutations have shed light on the mechanisms of pathogenesis of PD. The parkinsonian syndrome is associated with several other degenerative and non-degenerative diseases. Genes linked to PD are synuclein, Parkinson's disease autosomal recessive, juvenile 2, Parkinson's disease autosomal recessive, early onset 7, PTEN-induced putative kinase 1 and leucine-rich repeat kinase 2. ...

  9. An unusual combination of a tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aorta.

    Avaro, Jean-Philippe; Amabile, Philippe; Paule, Philippe; Peloni, Jean-Michel; Piquet, Philippe

    2011-07-01

    Tuberculous aneurysms of the aorta are rare and give rise to various issues related to their diagnosis and treatment. In this article, we report on an exceptional case concerning a patient who presented with a false tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aorta concomitantly. A discussion on how we approached the diagnosis and devised a therapeutic strategy that allowed us to treat this dual aortic disease effectively has also been provided. The discussion includes details of the order of treatment and the choice between an endovascular and a surgical approach. PMID:21724110

  10. The cricothyroid joint in elderly Japanese individuals.

    Serikawa, Masamitu; Yamamoto, Masahito; Kawamoto, Ai; Katori, Yukio; Kinoshita, Hideaki; Matsunaga, Satoru; Abe, Shin-Ichi

    2016-06-01

    Using 15 cricothyroid joint (CT joint) specimens obtained from donated cadavers of elderly individuals, we examined the morphologies of the ceratocricoid ligaments as well as the synovial tissue. The ligaments consistently contained abundant elastic fibers: the fibers tended to be straight on the anterior side in contrast to a mesh-like arrangement on the posterior side. Thick and/or long synovial folds were often evident in the CT joint. The synovial tissue usually contained CD68-positive macrophages, but the positive cells were often restricted to certain parts of the tissue. Factor VIII-positive capillaries were present but few in number, and CD3- or IgM-positive lymphocytes were absent in the synovial tissue. Degenerative changes in the joint cartilage, such as roughness or thinning, were often present, but no cartilage defects were evident. Therefore, in contrast to the small, non-weight-bearing joints of the musculoskeletal system, we considered the degeneration of the CT joint to be a specific, silent form of osteoarthritis. For high-pitched phonation and ossification of the laryngeal cartilage, the CT joint in elderly individuals seemed to maintain its anterior gliding and rotation with the aid of elastic fiber-rich tissues compensating for the loss of congruity between the joint cartilage surfaces. PMID:26286109

  11. Significance of radionucleid examination of joints in diagnosis of subclinical arthritis background

    Background. A large group of inflammation arthritis is represented by seronegative spondyloarthropathies (SpA), including several nosologies: psoriatic arthritis Bechterev's disease, Reiter's disease, etc. One of the most common SpA forms is Reactive arthritis (ReA). Inflammation process in joints is the most characteristic symptom, which determines severeness, course and prognosis of the disease. One of the most sensitive methods of examination of joints is radionucleid (RN) examination. Increased RNV accumulation in the joints is not a specific feature .for a concrete disease, and growth of its accumulation corresponds to the exudative component of inflammation process which reveals the early stage of joint inflammation (subclinical arthritis). Objectives: To find out how often subclinical inflammation processes (subclinical sinovitis) are observed in patients with minimal systemic activity of ReA. To detect in which joints subclinical sinovitis localizes most commonly. To evaluate significance of radionucleid examinations in diagnosis of subclinical arthritis. Material and methods. RN examination of joints was performed in 41 patient with ReA in I stage of activity and in 35 patients with ReA in II stage of activity, when the causative agent of infection - Chlamydia trachomatis - is localized in the urogenital tract. ReA was diagnosed according to diagnostic criteria of French Rheumatologists Association. For clinical description of joints index was used, characterized by pain intensity during joint palpation, and expressed by gradation degree from 0-3. In 76 patients with ReA I activity degree (ReA I) and ReA II activity degree (ReA II) radionucleid examination was done with marked 99Tc and analysis of the obtained joint scintigrams for SI area. In the control group, 90 joint scintigrams were analyzed for patients with degenerative joint diseases without palpation pain in the examined joints, determining Tc index (Tc ind) in separate joints and summary Tc ind

  12. Improvement of balance in progressive degenerative cerebellar ataxias after Ayurvedic therapy: A preliminary report

    Sriranjini S

    2009-01-01

    Full Text Available Background: The treatment options for improving the balance in degenerative cerebellar ataxias are very few. Ayurvedic texts have described diverse treatment regimens for this disease. Aims: To determine the change in balance indices, if any, by dynamic posturography (Biodex Balance System, USA in progressive cerebellar ataxia following Ayurvedic treatment. Materials and Methods: We performed a preliminary open labelled study on ten patients diagnosed with progressive cerebellar ataxia. The patients were treated over a period of one month. Treatment consisted of Shirobasti (therapeutic retention of medicament over the scalp in male patients and Shirodhara (pouring of a steady stream of medicament on the forehead in female patients with Dhanvantaram tailam (medicated oil for 45 minutes daily, followed by Abhyanga (methodical massage with Dhanvantaram tailam and Bhashpa sweda (steam bath, for 14 days. In addition, the treatment also consisted Abhyantara aushadha (oral medicines of Maharasnadi kashayam 15ml thrice daily, Dhanvantaram capsules 101 two capsules thrice daily, and Ashwagandha tablet 500 mg one tablet thrice daily, for one month. The patients were assessed on the Biodex balance system before and after the treatment. Results were analyzed using paired samples ′t′ test. Results: All patients tolerated the treatment well without any adverse events and reported subjective improvement in walking. There was a statistically significant improvement in the overall and anteroposterior balance indices of dynamic stability. Conclusions: Over the short period of the present study, Ayurvedic therapy was found to be safe and, showed improvement in the balance in patients with progressive degenerative cerebellar ataxia. Further randomized placebo-control double-blind studies are needed to validate the results.

  13. Scintigraphic evaluation of the sacroiliac joints in anklylosing spondylitis

    The sedimentation of sup(99m)Tc-phosphate complexes into the sacroiliac joints was investigated in 94 patients with loin pains and suspected of ankylosing spondylitis (SpA) and a control group of 96 healthy patients. The investigation yields the following results: 1. the visual evaluation of the scintigrams does not allow a reliable diagnosis and should be replaced by a semi-quantitative technique, 2. the index ISC/sacrum does remarkably depend on age, 3rd even in young patients the scintigraphic examination appears to be useful to alidate the clinical suspicion of sacroilictis which is in contradiction to literature, 4th with increasing SpA the scintigraphic detectability of changes in the ISG decreases. 5th the floriditily of the ISG process determines the scintigraphic detectability of the process of the disease, 6th the scintigraphic finding is unspecific. Inflammatory states of the disease of different genesis and degenerative processes in the ISG equally yield pathological index values. (orig./MG)

  14. Continuation of medically necessary platelet aggregation inhibitors - acetylsalicylic acid and clopidogrel - during surgery for spinal degenerative disorders: Results in 100 patients

    Reza Akhavan-Sigari

    2014-01-01

    Full Text Available Background: Patients undergoing spinal surgery while under anticoagulation therapy are at risk of developing bleeding complications, even though lower incidences have been reported for joint arthroplasty surgery. There is a gap in the medical literature examining the incidence of postoperative spinal bleeding in patients who were under anticoagulation medication at the time of surgery. Methods: We prospectively followed a consecutive cohort of 100 patients (58 male, 42 female undergoing spinal surgery. The average patient age was 48.7 years and the minimum follow up time was 12 months. Diagnosis was lumbar spinal stenosis in 20, herniated lumbar discs in 63, degenerative cervical disc disease in 3, and cervical disc herniation in 14 cases. In our study, platelet aggregation inhibitors (clopidogrel and/or acetylsalicylic acid were given for the treatment of cardiovascular and cerebrovascular thrombotic events, to reduce risk of stroke in patients who have had transient ischemia of the brain or acute coronary syndrome, and as secondary prevention of atherosclerotic events (fatal or nonfatal myocardial infarction (MI. A cessation of anticoagulants (acetylsalicylic acid or clopidogrel in our patients in the peri- and postoperative period was contraindicated. Results: Sixty-three patients were on both clopidogrel and acetylsalicylic acid and 37 on acetylsalicylic acid only. None of the patients suffered any postoperative bleeding complication. Three patients suffered postoperative wound dehiscence and one patient had an infection that required reoperation. Conclusion: The question of whether preoperative platelet aggregation inhibitors must be stopped before elective spinal surgery has never been answered in the literature. In our prospective series, we have found no increase in the risk of postoperative spinal bleeding with the use of clopidogrel or acetylsalicylic acid. This finding suggests that spine surgery can be done without stopping

  15. Degenerative Mitral Stenosis: Unmet Need for Percutaneous Interventions.

    Sud, Karan; Agarwal, Shikhar; Parashar, Akhil; Raza, Mohammad Q; Patel, Kunal; Min, David; Rodriguez, Leonardo L; Krishnaswamy, Amar; Mick, Stephanie L; Gillinov, A Marc; Tuzcu, E Murat; Kapadia, Samir R

    2016-04-19

    Degenerative mitral stenosis (DMS) is an important cause of mitral stenosis, developing secondary to severe mitral annular calcification. With the increase in life expectancy and improved access to health care, more patients with DMS are likely to be encountered in developed nations. These patients are generally elderly with multiple comorbidities and often are high-risk candidates for surgery. The mainstay of therapy in DMS patients is medical management with heart rate control and diuretic therapy. Surgical intervention might be delayed until symptoms are severely limiting and cannot be managed by medical therapy. Mitral valve surgery is also challenging in these patients because of the presence of extensive calcification. Hence, there is a need to develop an alternative percutaneous treatment approach for patients with DMS who are otherwise inoperable or at high risk for surgery. In this review, we summarize the available data on the epidemiology of DMS and diagnostic considerations and current treatment strategies for these patients. PMID:27142604

  16. CT scanning of the brain and lumbar CSF monoamine metabolites in spinocerebellar degenerative disorders

    Sasaki, Hidenao; Kanazawa, Ichiro; Nakanishi, Takao; Kuramoto, Kenmei (Tsukuba Univ., Sakura, Ibaraki (Japan))

    1984-08-01

    Eight patients with parenchymatous cerebellar degeneration (PCD) group (3 with late cortical cerebellar atrophy and 5 with Holmes' hereditary ataxia), 14 with olivo-ponto-cerebellar atrophy (OPCA) group (4 with Shy-Drager syndrome, 6 with OPCA without family history and 4 with Menzel type SCS), 15 with Parkinson's disease and 44 control with other neurological diseases were studied. In all the spinocerebellar degenerative disorders (SCD) cases, CVI values corresponding to the cerebellar atrophy were definitely reduced. On the other hand, PVI values corresponding to the pontine atrophy were only significantly decreased in OPCA group. However, since there were several cases showing only questionable pontine atrophy, it seems difficult to clearly differentiate individual OPCA cases from other SCD cases on CT films alone. Concerning monoamine metabolites in CSF, it was noted that a significant reduction of HVA and total MHPG was found in the OPCA group. Among them, the patients with overt autonomic failure showed the lowest HVA level and the cases of Menzel type of SCD showed a slight reduction of HVA but an unexpected elevation of free MHPG values. The cases of Parkinson's disease showed a definite reduction of HVA. On the other hand, the cases of PCD group showed no significant difference against controls. 5-HIAA levels were not significantly different among the SCD subgroups.

  17. CT scanning of the brain and lumber CSF monoamine metabolites in spinocerebellar degenerative disorders

    Eight patients with parenchymatous cerebellar degeneration (PCD) group (3 with late cortical cerebellar atrophy and 5 with Holmes' hereditary ataxia), 14 with olivo-ponto-cerebellar atrophy (OPCA) group (4 with Shy-Drager syndrome, 6 with OPCA without family history and 4 with Menzel type SCS), 15 with Parkinson's disease and 44 control with other neurological diseases were studied. In all the spinocerebellar degenerative disorder s (SCD) cases, CVI values corresponding to the cerebellar atrophy were definitely reduced. On the other hand, PVI values corresponding to the pontine atrophy were only significantly decreased in OPCA group. However, since there were several cases showing only questionable pontine atrpphy, it seems difficult to clearly differentiate individual OPCA cases from other SCD cases on CT films alone. Concerning monoamine metabolites in CSF, it was noted that a significant reduction of HVA and total MHPG was found in the OPCA group. Among them, the patients with overt autonomic failure showed the lowest HVA level and the cases of Menzel type of SCD showed a slight reduction of HVA but an unexpected elevation of free MHPG values. The cases of Parkinson's disease showed a definite reduction of HVA. On the other hand, the cases of PCD group showed no significant difference against controls. 5-HIAA levels were not significantly different among the SCD subgroups. (J.P.N.)

  18. Regional cerebral blood flow study with 123I-IMP in patients with degenerative dementia

    Regional cerebral blood flow was evaluated by single-photon emission CT (SPECT) with 123I-N-isopropyl-p-iodoamphetamine (123I-IMP) in 11 patients with dementia of the Alzheimer type, three patients with progressive dementia and motor neuron disease, and eight healthy control subjects. Regional blood flow measurements in the bilateral frontal, parietal association, and temporal cortices were lower in the Alzheimer dementia patients than in controls. Flow deficits in the parietal association cortex were demonstrated in all patients with Alzheimer-type dementia; these deficits were correlated with the severity of disease. Lateral hemispheric asymmetry was seen in nine of 11 patients with Alzheimer-type dementia. In all three patients with progressive dementia and motor neuron disease, flow deficits were demonstrated in the bilateral frontal and temporal cortices, but no flow deficits were seen in the parietal association cortex. Brain SPECT with 123I-IMP may be useful in the differential diagnosis and evaluation of the severity of degenerative dementia

  19. Molecular biology as applied to the prevention of chronic-degenerative

    Alberto Izzotti

    2005-03-01

    Full Text Available

    Dear Sir, Chronic-degenerative diseases (CDD, including atherosclerosis, cancer and chronic-obstructive pulmonary diseases, are the main causes of death in developed countries, accounting for approximately 90% of mortality. These pathologies arise from a complex network of risk-factors both exogenous and endogenous in origin.

    The role of preventive medicine in counteracting this major public-health problem is pivotal, especially since treatment of these diseases is difficult. The goal of preventive medicine is to shed light on the network of CDDrelated risk factors in healthy subjects, thus allowing for primary preventive interventions aimed at removing harmful exposures, increasing host-defence mechanisms and activating targeted early-screening programs in susceptible individuals.CDD risk-factors are identified by anamnestic evaluation and questionnaires as well as chemical-laboratory analyses and the clinical examination of patients.

    For example, the risk assessment for atherosclerosis is performed by analysing diet and smoke-exposure habits, measuring blood pressure, lipid profile, etc., however, a similar approach may only in part be pursued for cancer because the majority of the related pathogenic phenomena occurs at molecular level.

  20. Identification of Early Degenerative Changes in the Knee after Anterior Cruciate Ligament Rupture

    B.L. van Meer (Belle)

    2015-01-01

    markdownabstractOsteoarthritis (OA) is a common disease of the musculoskeletal system. In the Netherlands approximately 1.2 million people suffer from OA. OA can arise in all synovial joints, but knee, hand and hip are most often affected. The incidence rate of OA is growing after the age of 50 year