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Sample records for macular degenerative disease

  1. Degenerative Nerve Diseases

    Science.gov (United States)

    Degenerative nerve diseases affect many of your body's activities, such as balance, movement, talking, breathing, and heart function. Many of these diseases are genetic. Sometimes the cause is a medical ...

  2. Peripheral degenerative joint diseases

    Directory of Open Access Journals (Sweden)

    Nilzio Antonio da Silva

    2008-03-01

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

  3. Degenerative disease of the spine.

    Science.gov (United States)

    Gallucci, Massimo; Limbucci, Nicola; Paonessa, Amalia; Splendiani, Alessandra

    2007-02-01

    Degenerative disease of the spine is a definition that includes a wide spectrum of degenerative abnormalities. Degeneration involves bony structures and the intervertebral disk, although many aspects of spine degeneration are strictly linked because the main common pathogenic factor is identified in chronic overload. During life the spine undergoes continuous changes as a response to physiologic axial load. These age-related changes are similar to pathologic degenerative changes and are a common asymptomatic finding in adults and elderly persons. A mild degree of degenerative changes is paraphysiologic and should be considered pathologic only if abnormalities determine symptoms. Imaging allows complete evaluation of static and dynamic factors related to degenerative disease of the spine and is useful in diagnosing the different aspects of spine degeneration.

  4. Contribution of Microglia-Mediated Neuroinflammation to Retinal Degenerative Diseases

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    Maria H. Madeira

    2015-01-01

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

  5. Inherited Retinal Degenerative Disease Registry

    Science.gov (United States)

    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

  6. [Dysexecutive syndromes and degenerative diseases].

    Science.gov (United States)

    Pillon, B; Czernecki, V; Dubois, B

    2004-04-01

    A dysexecutive syndrome is observed not only in frontotemporal lobar degeneration, but also in subcortical degenerative diseases, and even in Alzheimer's disease whose lesions predominate in temporoparietal associative areas. The association between a dysexecutive syndrome and various cerebral localisations may be explained by the fact that cognitive and behavioral organisation recruits anatomofunctional frontostriatal and frontoparietal circuits. Both animal experimentation and human clinical observation argue in favour of a functional continuity and complementarity among these loops. The prefrontal cortex would be particularly needed in new situations, to inhibit old programs of action not adapted to the present context and to elaborate new ones; the basal ganglia would be rather required by the repetition of the situation to progressively transform the new program in routine. If we refer to Shallice model, we can hypothesize that optimal executive functions require the preservation not only of the Supervisory Attentional System, mainly dependent on the prefrontal cortex, but also of the Contention Scheduling, recruiting the basal ganglia, and of the Schemas of Action, represented in parietal and premotor areas. Therefore, the neuropsychological assessment of patients with degenerative diseases contributes to the understanding of the anatomofunctional architecture of executive functions.

  7. Pathology of Macular Foveoschisis Associated with Degenerative Myopia

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    Johnny Tang

    2010-01-01

    Full Text Available This is a clinicopathological paper on the histologic findings in myopia-associated macular foveoschisis. The findings on ophthalmic pathological study of a 73-year-old woman with high myopia are reviewed. Multiple retinoschisis cavities involving both the macula and retinal periphery were disclosed. Our paper offers tissue evidence and supports recent ocular coherence tomography reports of eyes with high myopia and associated macular foveoschisis.

  8. Degenerative cerebellar diseases and differential diagnoses; Degenerative Kleinhirnerkrankungen und Differenzialdiagnosen

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

    2016-11-15

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

  9. Low back pain and degenerative disc disease

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    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. .

  10. Physiochemical basis of human degenerative disease

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    Zeliger Harold I.

    2015-03-01

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

  11. Cell-Based Therapy for Degenerative Retinal Disease.

    Science.gov (United States)

    Zarbin, Marco

    2016-02-01

    Stem cell-derived retinal pigment epithelium (RPE) and photoreceptors (PRs) have restored vision in preclinical models of human retinal degenerative disease. This review discusses characteristics of stem cell therapy in the eye and the challenges to clinical implementation that are being confronted today. Based on encouraging results from Phase I/II trials, the first Phase II clinical trials of stem cell-derived RPE transplantation are underway. PR transplant experiments have demonstrated restoration of visual function in preclinical models of retinitis pigmentosa and macular degeneration, but also indicate that no single approach is likely to succeed in overcoming PR loss in all cases. A greater understanding of the mechanisms controlling synapse formation as well as the immunoreactivity of transplanted retinal cells is urgently needed.

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

    Indian Academy of Sciences (India)

    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.

  13. Age-related macular disease : studies on incidence, risk factors, and prognosis

    NARCIS (Netherlands)

    R. van Leeuwen (Redmer)

    2003-01-01

    textabstractAge-related macular disease (AMD) is a new name, recently coined by Bird,25 for a progressive and degenerative disease in elderly persons affecting the macula lutea. Dysfunction of this part of the retina, and especially its centre, the fovea, results in the inability to read, recognize

  14. MR imaging of degenerative disc disease

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    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.

  15. [Pharmacotherapy of degenerative joint diseases in dogs].

    Science.gov (United States)

    Klee, S; Ungemach, F R

    1998-02-01

    The pharmacological treatment of degenerative joint diseases is restricted essentially to the alleviation of acute symptoms of activated arthropathies. Suitable compounds are the non-steroidal and steroidal antiinflammatory drugs, which however do not allow long-term therapy due to their overall catabolic effects on cartilage metabolism. Since causally acting drugs are not available, the progressive course of the disease cannot be prevented so far. Natural components of the cartilage's matrix, being recommended as so-called chondroprotective drugs, do not fulfill the expectation of a remission of the degenerative process. Indeed, regarding the necessity of multiple local applications of these drugs, they are not superior to antiinflammatory drugs. Provided careful dosing and surveillance of untoward gastrointestinal effects, non-steroidal antiinflammatory agents still are the drugs of first choice.

  16. Degenerative spinal disease in large felids.

    Science.gov (United States)

    Kolmstetter, C; Munson, L; Ramsay, E C

    2000-03-01

    Degenerative spinal disorders, including intervertebral disc disease and spondylosis, seldom occur in domestic cats. In contrast, a retrospective study of 13 lions (Panthera leo), 16 tigers (Panthera tigris), 4 leopards (Panthera pardis), 1 snow leopard (Panthera uncia), and 3 jaguars (Panthera onca) from the Knoxville Zoo that died or were euthanatized from 1976 to 1996 indicated that degenerative spinal disease is an important problem in large nondomestic felids. The medical record, radiographic data, and the necropsy report of each animal were examined for evidence of intervertebral disc disease or spondylosis. Eight (three lions, four tigers, and one leopard) animals were diagnosed with degenerative spinal disease. Clinical signs included progressively decreased activity, moderate to severe rear limb muscle atrophy, chronic intermittent rear limb paresis, and ataxia. The age at onset of clinical signs was 10-19 yr (median = 18 yr). Radiographic evaluation of the spinal column was useful in assessing the severity of spinal lesions, and results were correlated with necropsy findings. Lesions were frequently multifocal, included intervertebral disc mineralization or herniation with collapsed intervertebral disc spaces, and were most common in the lumbar area but also involved cervical and thoracic vertebrae. Marked spondylosis was present in the cats with intervertebral disc disease, presumably subsequent to vertebral instability. Six of the animals' spinal cords were examined histologically, and five had acute or chronic damage to the spinal cord secondary to disc protrusion. Spinal disease should be suspected in geriatric large felids with decreased appetite or activity. Radiographic evaluation of the spinal column is the most useful method to assess the type and severity of spinal lesions.

  17. Contribution of Microglia-Mediated Neuroinflammation to Retinal Degenerative Diseases

    OpenAIRE

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

    2015-01-01

    Retinal degenerative diseases are major causes of vision loss and blindness worldwide and are characterized by chronic and progressive neuronal loss. One common feature of retinal degenerative diseases and brain neurodegenerative diseases is chronic neuroinflammation. There is growing evidence that retinal microglia, as in the brain, become activated in the course of retinal degenerative diseases, having a pivotal role in the initiation and propagation of the neurodegenerative process. A bett...

  18. Canine Degenerative Valve Disease: A Case Report

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    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.

  19. Degenerative disease of the lumbar spine.

    Science.gov (United States)

    Kovacs, F M; Arana, E

    2016-04-01

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

  20. [Sighting dominance in patients with macular disease].

    Science.gov (United States)

    Akaza, Eriko; Fujita, Kyoko; Shimada, Hiroyuki; Yuzawa, Mitsuko

    2007-04-01

    To study sighting dominance by comparing macular disease patients undergoing surgical treatment with controls. We studied visual acuity and sighting dominance in 92 macular disease patients, 27 of whom were assessed for both outcomes. We also studied visual acuity and sighting dominance in 412 controls. Sighting dominance was evaluated using the hole-in-card test. Among the controls, 70% showed right sighting dominance, and 30%, left sighting dominance. On the other hand, in patients with macular disease, right sighting dominance was demonstrated in 51%, and left in 49%; that is, 24% showed sighting dominance of the affected eye and 76%, of the fellow eye. During follow-up, sighting dominance of three of the 27 macular disease patients shifted from the affected eye to the fellow eye, which showed improvement in visual acuity. This study raises the possibility of sighting dominance shifting in patients with macular disease. There were differences among cases in the timing of the shift in sighting dominance, indicating that visual acuity may not be the only factor influencing sighting dominance. Further study is needed to confirm the factors contributing to sighting dominance.

  1. Chronic degenerative diseases in elderly: physiotherapeutic data

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    Lais Keylla Felipe

    2011-09-01

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

  2. Computed tomography in lumbar degenerative disease

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    Isu, Toyohiko; Miyasaka, Kazuo; Abe, Satoru; Takei, Hidetoshi; Kaneda, Kiyoshi (Hokkaido Univ., Sapporo (Japan). School of Medicine)

    1984-02-01

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

  3. Inflammation and the degenerative diseases of aging.

    Science.gov (United States)

    McGeer, Patrick L; McGeer, Edith G

    2004-12-01

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

  4. Etiology, pathophysiology and conservative management of degenerative joint disease

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    Jandrić Slavica

    2002-01-01

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

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

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    Emch, Todd M. [Cleveland Clinic, Division of Neuroradiology, Imaging Institute, Neuroradiology L-10, Cleveland, OH (United States); Modic, Michael T. [Cleveland Clinic, Division of Neuroradiology, Imaging Institute, Neurological Institute T-13, Cleveland, OH (United States)

    2011-09-15

    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.)

  6. Non degenerative disease in MRI cervical spine of symptomatic patients

    Directory of Open Access Journals (Sweden)

    Dan B Karki

    2016-01-01

    Full Text Available Background & Objectives: The most common etiology of neck pain is degenerative disc disease, however non-degenerative disease can be important cause of neck pain. This study aims to study the non-degenerative findings in cervical MRI in symptomatic patients with neck and radicular pain.Materials & Methods: The study was a institutional record based retrospective study performed for the duration of 3 years. MRI performed for patients with neck pain and/ or radiculopathy were reviewed. Patients with post operative findings were excluded from the study. Statistical analysis was done using SPSS 21.0.Results: A total of 721 MRI were performed for neck pain and radiculopathy, among which 91 (12.13% cases had non-degenerative changes. Most common non degenerative change was traumatic lesions followed by neoplastic lesions and syrinx. Traumatic lesions were more common in males as compared to females. Infection was more common in females as compared to males. C5 and C6 vertebrae were most common vertebra involved in trauma and infection. Some cases like signal change in spinal cord, and syrinx were also noted in our study.Conclusion: Non degenerative cause of neck pain were less common but important cause of neck pain. Traumatic lesions were the most common cause of non degenerative neck pain.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 20-23

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

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    Bilgehan Solmaz

    2012-01-01

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

  8. Destructive discovertebral degenerative disease of the lumbar spine.

    Science.gov (United States)

    Charran, A K; Tony, G; Lalam, R; Tyrrell, P N M; Tins, B; Singh, J; Eisenstein, S M; Balain, B; Trivedi, J M; Cassar-Pullicino, V N

    2012-09-01

    The uncommon variant of degenerative hip joint disease, termed rapidly progressive osteoarthritis, and highlighted by severe joint space loss and osteochondral disintegration, is well established. We present a similar unusual subset in the lumbar spine termed destructive discovertebral degenerative disease (DDDD) with radiological features of vertebral malalignment, severe disc resorption, and "bone sand" formation secondary to vertebral fragmentation. Co-existing metabolic bone disease is likely to promote the development of DDDD of the lumbar spine, which presents with back pain and sciatica due to nerve root compression by the "bone sand" in the epidural space. MRI and CT play a complimentary role in making the diagnosis.

  9. Neuromuscular exercise as treatment of degenerative knee disease

    DEFF Research Database (Denmark)

    Ageberg, Eva; Roos, Ewa M.

    2015-01-01

    Exercise is recommended as first-line treatment of degenerative knee disease. Our hypothesis is that neuromuscular exercise is feasible and at least as effective as tradionally used strength or aerobic training, but aims to more closely target the sensorimotor deficiencies and functional instabil......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....

  10. Effects of interspinous spacers on lumbar degenerative disease.

    Science.gov (United States)

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

    2013-03-01

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

  11. Inherited Retinal Degenerative Disease Clinical Trial Network. Addendum

    Science.gov (United States)

    2010-10-01

    gene therapy program with Oxford Biomedica to bring gene therapy for juvenile macular degeneration (Stargardt’s disease). This phase I clinical trial...working with Oxford Biomedica and a separate project with academic investigators on gene therapy for Usher lb syndrome (deaf-blindness due to a gene... Biomedica collaboration will begin no later than 04 2011. 3. NNRI has held multiple clinical investigator meetings to define clinical trial outcomes for

  12. Revisiting the Term Neuroprotection in Chronic and Degenerative Diseases

    Science.gov (United States)

    Orsini, Marco; Nascimento, Osvaldo J.M.; Matta, Andre P.C.; Reis, Carlos Henrique Melo; de Souza, Olivia Gameiro; Bastos, Victor Hugo; Moreira, Rayele; Ribeiro, Pedro; Fiorelli, Stenio; Novellino, Pietro; Pessoa, Bruno; Cunha, Mariana; Pupe, Camila; Morales, Pedro S.; Filho, Pedro F. Moreira; Trajano, Eduardo Lima; Oliveira, Acary Bulle

    2016-01-01

    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. PMID:27127599

  13. Vitiligo: a possible model of degenerative diseases.

    Directory of Open Access Journals (Sweden)

    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.

  14. Vitiligo: A Possible Model of Degenerative Diseases

    Science.gov (United States)

    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

  15. Vitiligo: a possible model of degenerative diseases.

    Science.gov (United States)

    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.

  16. Adjacent segment disease in degenerative pathologies with posterior instrumentation

    OpenAIRE

    Ana Guadalupe Ramírez Olvera; Manuel Villarreal Arroyo; Luis Mario Hinojosa Martínez; Enrique Méndez Pérez; Luis Romeo Ramos Hinojosa

    2015-01-01

    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, ...

  17. MR imaging of the spine: trauma and degenerative disease

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-09-01

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

  18. Adjacent segment disease in degenerative pathologies with posterior instrumentation

    Directory of Open Access Journals (Sweden)

    Ana Guadalupe Ramírez Olvera

    2015-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-04-15

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

  20. TRACTION-EXTENDED THERAPY OF PATIENTS WITH LUMBAR DEGENERATIVE DISEASE

    OpenAIRE

    V. A. Zhirnov; D. P. Krest'yanov; A. K. Vasil'kin

    2013-01-01

    Based on the survey of 148 patients with an lumbar degenerative disease, there have been studied immediate and medium-term results of the comprehensive conservative treatment of the patients with and without application of traction exposure on the spine. It was found out that the traction of the spine leads to a quicker and more durable relief of symptoms in comparison with the control groups where traction therapy wasn't carried out. Application of the traction-extended therapy in three plan...

  1. Adeno-associated virus mediated gene therapy for retinal degenerative diseases.

    Science.gov (United States)

    Stieger, Knut; Cronin, Therese; Bennett, Jean; Rolling, Fabienne

    2011-01-01

    Retinal gene therapy holds great promise for the treatment of inherited and noninherited blinding diseases such as retinitis pigmentosa and age-related macular degeneration. The most widely used vectors for ocular gene delivery are based on adeno-associated virus (AAV) because it mediates long-term transgene expression in a variety of retinal cell types and elicits minimal immune responses. Inherited retinal diseases are nonlethal and have a wide level of genetic heterogeneity. Many of the genes have now been identified and their function elucidated, providing a major step towards the development of gene-based treatments. Extensive preclinical evaluation of gene transfer strategies in small and large animal models is key to the development of successful gene-based therapies for the retina. These preclinical studies have already allowed the field to reach the point where gene therapy to treat inherited blindness has been brought to clinical trial.In this chapter, we focus on AAV-mediated specific gene therapy for inherited retinal degenerative diseases, describing the disease targets, the preclinical studies in animal models and the recent success of the LCA-RPE65 clinical trials.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-03-01

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

  3. Long term results of radiotherapy of degenerative joint diseases

    Energy Technology Data Exchange (ETDEWEB)

    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.

  4. Raptor Acupuncture for Treating Chronic Degenerative Joint Disease

    Directory of Open Access Journals (Sweden)

    Keum Hwa Choi

    2016-12-01

    Full Text Available A permanently captive 21-year-old male bald eagle was diagnosed with chronic degenerative joint disease in the right stifle with severe lameness (Grade 5 based on radiography. Clinical signs included decreased movement, vocalization, non weight-bearing on the affected limb, inappetence, depression, and pododermatitis on the left foot (bumblefoot, Grade 3. The eagle was treated with anti-inflammatory or analgesic drugs including carprofen and celecoxib. As there was no observed clinical improvement with any of the treatments, acupuncture treatment was provided. The eagle was treated with dry needle acupuncture once per week for 2 months and biweekly for another 2 months. The Traditional Eastern Medicine diagnosis of this eagle was Bony Bi syndrome. The selected acupuncture points were ST 36, LI 4, BL 40, BL 60, GB 34, and Ba Feng (Table 3. The lameness score improved from Grade 5 to Grade 1 after 4 months of acupuncture treatment. The observed pododermatitis improved from Grade 3 to Grade 0. Symptoms including inappetence and vocalizations were significantly reduced over the 4 month period. There was no significant improvement in the radiographic signs. In conclusion, acupuncture may be a potential medical option for permanently captive raptors having musculoskeletal conditions, such as degenerative joint disease.

  5. Raptor Acupuncture for Treating Chronic Degenerative Joint Disease.

    Science.gov (United States)

    Choi, Keum Hwa; Buhl, Gail; Ponder, Julia

    2016-12-01

    A permanently captive 21-year-old male bald eagle was diagnosed with chronic degenerative joint disease in the right stifle with severe lameness (Grade 5) based on radiography. Clinical signs included decreased movement, vocalization, non weight-bearing on the affected limb, inappetence, depression, and pododermatitis on the left foot (bumblefoot, Grade 3). The eagle was treated with anti-inflammatory or analgesic drugs including carprofen and celecoxib. As there was no observed clinical improvement with any of the treatments, acupuncture treatment was provided. The eagle was treated with dry needle acupuncture once per week for 2 months and biweekly for another 2 months. The Traditional Eastern Medicine diagnosis of this eagle was Bony Bi syndrome. The selected acupuncture points were ST 36, LI 4, BL 40, BL 60, GB 34, and Ba Feng (Table 3). The lameness score improved from Grade 5 to Grade 1 after 4 months of acupuncture treatment. The observed pododermatitis improved from Grade 3 to Grade 0. Symptoms including inappetence and vocalizations were significantly reduced over the 4 month period. There was no significant improvement in the radiographic signs. In conclusion, acupuncture may be a potential medical option for permanently captive raptors having musculoskeletal conditions, such as degenerative joint disease. Copyright © 2016. Published by Elsevier B.V.

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

    Science.gov (United States)

    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.

  7. Degenerative spine disease : pathologic findings in 985 surgical specimens.

    Science.gov (United States)

    Pytel, Peter; Wollmann, Robert L; Fessler, Richard G; Krausz, Thomas N; Montag, Anthony G

    2006-02-01

    A number of pathologic changes have been reported in spinal surgery specimens. The frequency of many of these is not well defined. We retrospectively reviewed the histologic features of 985 extradural spinal surgery specimens. Of the cases, 1.6% were identified clinically as synovial cysts. In addition, synovial tissue was seen in another 5.3% of cases, often embedded within disk material. Neovascularization of disk tissue was present in 8.1% of cases, chondrocyte clusters in 18.3%, and calcium pyrophosphate crystals in 2.8%, predominantly within disk material. With the exception of crystal deposits, all of these changes were significantly more common in the lumbar spine. A better understanding of cell-based degenerative changes will become essential with increasing research into cell-based therapies for spinal disk disease. We report data on the frequency of different pathologic changes and describe synovial metaplasia as a reactive change not previously reported.

  8. Vitamin K, osteoporosis and degenerative diseases of ageing.

    Science.gov (United States)

    Vermeer, Cees; Theuwissen, Elke

    2011-03-01

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

  9. TRACTION-EXTENDED THERAPY OF PATIENTS WITH LUMBAR DEGENERATIVE DISEASE

    Directory of Open Access Journals (Sweden)

    V. A. Zhirnov

    2013-01-01

    Full Text Available Based on the survey of 148 patients with an lumbar degenerative disease, there have been studied immediate and medium-term results of the comprehensive conservative treatment of the patients with and without application of traction exposure on the spine. It was found out that the traction of the spine leads to a quicker and more durable relief of symptoms in comparison with the control groups where traction therapy wasn't carried out. Application of the traction-extended therapy in three planes with a usage of robotized set for dry skeletal traction of a new generation KinetracKNX-7000 is proved to increase the effectiveness of treatment for the patients with stated pathology, fasten regress of the pain syndrome and clinical symptomatology, lead to more durable and lasting remission of the desease, in comparison with the patients that had traction of the spine in one plane only during the treatment.

  10. [The age-related macular degeneration as a vascular disease/part of systemic vasculopathy: contributions to its pathogenesis].

    Science.gov (United States)

    Fischer, Tamás

    2015-03-01

    The wall of blood vessels including those in choroids may be harmed by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic, and genetic impacts (risk factors), which may trigger a protracted response, the so-called host defense response. As a consequence, pathological changes resulting in vascular injury (e. g. atherosclerosis, age-related macular degeneration) may be evolved. Risk factors can also act directly on the endothelium through an increased production of reactive oxygen species promoting an endothelial activation, which leads to endothelial dysfunction, the onset of vascular disease. Thus, endothelial dysfunction is a link between the harmful stimulus and vascular injury; any kind of harmful stimuli may trigger the defensive chain that results in inflammation that may lead to vascular injury. It has been shown that even early age-related macular degeneration is associated with the presence of diffuse arterial disease and patients with early age-related macular degeneration demonstrate signs of systemic and retinal vascular alterations. Chronic inflammation, a feature of AMD, is tightly linked to diseases associated with ED: AMD is accompanied by a general inflammatory response, in the form of complement system activation, similar to that observed in degenerative vascular diseases such as atherosclerosis. All these facts indicate that age-related macular degeneration may be a vascular disease (or part of a systemic vasculopathy). This recognition could have therapeutic implications because restoration of endothelial dysfunction may prevent the development or improve vascular disease resulting in prevention or improvement of age-related macular degeneration as well.

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

    Science.gov (United States)

    2017-09-14

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

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

    Science.gov (United States)

    MAHMOUDZADEH, Raziyeh; HEIDARI-KESHEL, Saeed; LASHAY, Alireza

    2016-01-01

    After injury to the central nervous system (CNS), regeneration is often inadequate, except in the case of remyelination. This remyelination capacity of the CNS is a good example of a stem/precursor cell-mediated renewal process. Schwann cells have been found to act as remyelinating agents in the peripheral nervous system (PNS), but several studies have highlighted their potential role in remyelination in the CNS too. Schwann cells are able to protect and support retinal cells by secreting growth factors such as brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor, and basic fibroblast growth factor. Retinal degenerative diseases can be highly debilitating, and they are a major concern in countries with an ageing populations. One of the leading causes of permanent loss of vision in the West is a retinal degenerative disease known as age-related macular degeneration (AMD). In the United States, nearly 1.75 million people over the age of 40 have advanced AMD, and it is estimated that this number will increase to approximately 3 million people by 2020. One of the most common pathways involved in the initiation and development of retinal diseases is the oxidative stress pathway. In patients with diabetes, Schwann cells have been shown to be able to secrete large amounts of antioxidant enzymes that protect the PNS from the oxidative stress that results from fluctuations in blood glucose levels. This antioxidant ability may be involved in the mechanism by which Schwann cells are able to promote reconstruction in the CNS, especially in individuals with retinal injuries and degenerative diseases. PMID:28293647

  13. Vertebral degenerative disc disease severity evaluation using random forest classification

    Science.gov (United States)

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

    2014-03-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-12-01

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

  15. [Complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases of juxtaarticular soft tissues].

    Science.gov (United States)

    Saks, L A

    2014-04-01

    The aim of the article is an evaluation of effectiveness of the complex outpatient care to patients with osteoarthrosis and degenerative-dystrophic diseases ofjuxtaarticular soft tissues. Recent researches showed that the key factors of the pathogenesis of diseases were degenerative-dystrophic and inflammatory changes in the synovio-entheseal complex ofparaarticular muscles' tendon. 411 patients with osteoarthrosis of 531 synovial joints and degenerative-dystrophic diseases of periarticular soft tissues underwent sequential corticosteroid therapy combined with hyaluronic acid injections. In 84% of cases positive results were observed.

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

    Directory of Open Access Journals (Sweden)

    Varela, G.

    1998-08-01

    Full Text Available Among the various components of the diet, fat receives very dose attention because of its relationship to several chronic degenerative diseases (CDD. Currently most of the available information on these relationships is derived from epidemiologic or experimental studies in which lipid intake is calculated using food composition tables. In most of these tables the quoted lipid content is that of raw food, whereas most foods are usually consumed only after being subjected to several culinary processes. Often there is no indication of the type of fat used in food processing in general or in frying in particular. But as it known, in the course of these processes the lipid content undergoes important qualitative and quantitative changes and not keeping them in mind may be the underlying cause of the difficulties an the confounding results in studies trying to establish the relationship between lipid intake an health. In the Mediterranean diet, about 50% of total dietary fat is derived not from the food itself but from the cooking fat, of which only a small fraction is eaten raw (as dressings and the greatest proportion is used in thermal culinary processes, mainly deep-frying. The scientific study of the process whereby fat penetrates into fried foods has shown the benefits of this cooking method. If the process is correctly carried out, the amount of fat ingested with fried foodstuffs is not greater than when other procedures involving fat are used (for example, sautening, stewing or canning in oil. Very schematically deep-frying is a technique that replaces a fraction of the water content of food by cooking fat. Consecuently, the fat composition of the fried lean foods will be the same as that cooking fat. The process is more complex with fatty foods, and there are not great changes in the total quantity of fat in the fried food before and after frying. However, there are notable quality changes and these depend on the concentration gradients

  17. Scaphocapitolunate arthrodesis and radial styloidectomy for posttraumatic degenerative wrist disease.

    Science.gov (United States)

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

    2012-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Mingyuan Yang

    2014-01-01

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

  19. Echocardiographic Follow-up of Robotic Mitral Valve Repair for Mitral Regurgitation due to Degenerative Disease

    Directory of Open Access Journals (Sweden)

    Yao Wang

    2016-01-01

    Conclusion: Robotic MV repair for MR due to degenerative disease is associated with a low rate of recurrent MR, and a significant improvement in MR grade, LAD, and LVEDD, but a significant decrease in LVEF at echocardiographic follow-up.

  20. [Drinking water hardness and chronic degenerative diseases. II. Cardiovascular diseases].

    Science.gov (United States)

    Monarca, S; Zerbini, I; Simonati, C; Gelatti, U

    2003-01-01

    Since the 1950s a causal relation between water hardness and cardiovascular diseases (CVD) in humans has been hypothesized. In order to evaluate the influence of calcium and magnesium, the minerals responsible for the hardness of drinking water, on human health, a review of all the articles published on the subject from 1980 up to today has been carried out. Many but not all geographic correlation studies showed an inverse association between water hardness and mortality for CVD. Most case-control and one cohort studies showed an inverse relation, statistically significant, between mortality from CVD and water levels of magnesium, but not calcium. Consumption of water containing high concentrations of magnesium seems to reduce of about 30-35% the mortality for CVD, but not the incidence. This inverse association is supported by clinical and experimental findings and is biologically plausible and in line with Hill's criteria for a cause-effect relationship.

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

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    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...... interaction with others means that psychosocial needs are not met, and this leads to secondary symptoms of the neurological degeneration. Secondary symptoms might be expressed as repetitive behaviour, catastrophic reactions and situationally inappropriate behaviour. In a music therapeutical setting...

  2. X-82 to Treat Age-related Macular Degeneration

    Science.gov (United States)

    2017-01-12

    Age-Related Macular Degeneration (AMD); Macular Degeneration; Exudative Age-related Macular Degeneration; AMD; Macular Degeneration, Age-related, 10; Eye Diseases; Retinal Degeneration; Retinal Diseases

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

    Science.gov (United States)

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

    2016-05-01

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

  4. Artificial chordae for degenerative mitral valve disease: critical analysis of current techniques

    Science.gov (United States)

    Ibrahim, Michael; Rao, Christopher; Athanasiou, Thanos

    2012-01-01

    The surgical repair of degenerative mitral valve disease involves a number of technical points of importance. The use of artificial chordae for the repair of degenerative disease has increased as a part of the move from mitral valve replacement to repair of the mitral valve. The use of artificial chordae provides an alternative to the techniques pioneered by Carpentier (including the quadrangular resection, transfer of native chordae and papillary muscle shortening/plasty), which can be more technically difficult. Despite a growth in their uptake and the indications for their use, a number of challenges remain for the use of artificial chordae in mitral valve repair, particularly in the determination of the correct length to ensure optimal leaflet coaptation. Here, we analyse over 40 techniques described for artificial chordae mitral valve repair in the setting of degenerative disease. PMID:22962321

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

    DEFF Research Database (Denmark)

    Wigram, Anthony Lewis

    2004-01-01

    traces in the brain. Using the same “hello-song” in the beginning of a session - session after session - gives stability. Stability is constancy and familiarity of cues over time (Roberts & Algase 1988), and even people with severe memory deficits are capable of creating new memory traces and of learning......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...... degenerative disease like e.g. dementia are often socially isolated because of their failing abilities to communicate. Even if they live in a facility and are surrounded by care staff and peer residents, they might experience the environment as chaotic and the people as non-comprehensible. A missing meaningful...

  6. Macular hole in Behçet′s disease

    Directory of Open Access Journals (Sweden)

    Hassan Al-Dhibi

    2011-01-01

    Full Text Available Objective: To investigate the clinical features, prevalence, role of surgical intervention and the visual prognosis of macular holes (MH in patients with Behcet′s disease (BD. Materials and Methods: Retrospective study of patients with BD and MH from January 1998 to November 2008. Results: Out of 159 patients, 21 eyes of 17 patients were identified with MH. The mean age was 38.59 (range 23-61 years and the mean follow-up period was 5.1 years (range 13-164 months. The prevalence of MH was 7%. Visual acuity (VA at the time of presentation ranged from 20/70 to hand-motion. Optical coherence tomography (OCT findings revealed intraretinal cysts at the edge of the MH. The mean size of MH was 983.6 um; 52% had elevated edges, 43% had flat edges and only one eye (5% was closed postoperatively. Fluorescein angiography (FA was consistent with macular ischemia in 76% of the cases. Human leukocyte antigen (HLA B51 association was found in 14 of the 15 patients investigated. Six patients (out of 17 underwent pars plana vitrectomy. The final VA on their last follow-up ranged from 20/70 to 2/200. Surgical intervention for MH did not result in any visual improvement as compared to non-operated eyes. One patient lost vision completely due to elevated intraocular pressure post vitrectomy and silicon oil tamponade. Conclusions: MH in patients with BD may lead to significant visual disability. Surgical intervention does not seem to have any potential beneficial effect on the VA, probably due to significant macular ischemia and sequelae from the ocular inflammation.

  7. Osteoporosis and the Management of Spinal Degenerative Disease

    Directory of Open Access Journals (Sweden)

    Felix Tome-Bermejo

    2017-09-01

    Full Text Available Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosispredisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concernbefore performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often beenconsidered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequateprocedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patientsincrease, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseasesbecomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible tooperate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses thebiomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions,as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients withosteoporosis who need spine operations.

  8. Shoulder activity level and progression of degenerative cuff disease.

    Science.gov (United States)

    Keener, Jay D; Skelley, Nathan W; Stobbs-Cucchi, Georgia; Steger-May, Karen; Chamberlain, Aaron M; Aleem, Alex W; Brophy, Robert H

    2017-09-01

    This study prospectively examined the relationship of direct and indirect measures of shoulder activity with the risks of tear progression and pain development in subjects with an asymptomatic degenerative rotator cuff tear. A cohort of asymptomatic degenerative rotator cuff tears was prospectively monitored annually, documenting tear size progression with ultrasound imaging and potential shoulder pain development. Shoulder activity level, self-reported occupational and physical demand level, and hand dominance were compared with risks of tear enlargement and future pain development. The study monitored 346 individuals with a mean age of 62.1 years for a median duration of 4.1 years (interquartile range [IQR], 2.4-7.9 years). Tear enlargement was seen in 177 shoulders (51.2%), and pain developed in 161 shoulders (46.5%) over time. Tear presence in the dominant shoulder was associated with a greater risk of tear enlargement (hazard ratio, 1.40; P = .03) and pain development (hazard ratio, 1.63; P = .002). Shoulder activity level (P = .37) and occupational demand level (P = .62) were not predictive of tear enlargement. Occupational demand categories of manual labor (P = .047) and "in between" (P = .045) had greater risks of pain development than sedentary demands. The median shoulder activity score for shoulders that became painful was lower than for shoulders that remained asymptomatic (10.0 [IQR, 7.0-13.0] vs. 11.0 [IQR, 8.0-14.0], P = .02). Tear enlargement and pain development in asymptomatic tears are more common with involvement of the dominant shoulder. Shoulder activity level is not related to tear progression risks. Pain development is associated with a lower shoulder activity level even though patients with higher occupational demands are more likely to develop pain. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Md. Asiful Islam

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Degenerative Achilles tendon disease; Assessment by magnetic resonance and ultrasonography

    Energy Technology Data Exchange (ETDEWEB)

    Neuhold, A.; Stiskal, M. (Rudolfinerhaus, Vienna (Austria). Department of Diagnostic Imaging); Kainberger, F.; Schwaighofer, B. (Vienna Univ. (Austria). 2. Medizinische Klinik)

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

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

    DEFF Research Database (Denmark)

    Udby, Peter M.; Bech-Azeddine, Rachid

    2015-01-01

    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...

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

    Science.gov (United States)

    Son, Colin; Tavakoli, Samon; Bartanusz, Viktor

    2016-03-01

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

  14. Temporomandibular degenerative joint disease. Part I. Anatomy, pathophysiology, and clinical description.

    Science.gov (United States)

    Kreutziger, K L; Mahan, P E

    1975-08-01

    The anatomy and function of the temporomandibular joint (TMJ) are described in the detail needed to evaluate and treat temporomandibular degenerative joint disease (TDJD). Innervation of the joint and the mechanism of arthralgia are described and related to TDJD. The clinical course of TDJD, radiographic evaluation of it, histopathologic description, and etiology are presented.

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

    Directory of Open Access Journals (Sweden)

    Matthis Synofzik

    2014-01-01

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

  16. Cystoid macular edema in a patient with Danon disease

    Directory of Open Access Journals (Sweden)

    Heather G Mack

    2014-01-01

    Full Text Available To report a patient with Danon retinopathy with cystoid macular edema treated with topical dorzolamide 2% eye drops and oral acetazolamide. A 37-year-old Caucasian man with Danon disease treated with topical and oral carbonic anhydrase inhibitors participated in the study. Examinations performed before and during treatment included visual acuity (VA, spectral-domain optical coherence tomography, and electroretinography. Following total 48 weeks of treatment, VA decreased from 20/30 OD, 20/200 OS, to 20/40 OD, CF OS. The mean central retinal thickness was unchanged from baseline 263 μm OD , 226 μm OS, after treatment 283 μm OD and 202 μm OS. In our case, carbonic anydrase inhibitors were not effective. However, a general recommendation cannot be given based on a single case.

  17. Effect of vascular endothelial growth factor inhibitors on choroid in patients with macular choroid neovascular membrane and degenerative myopia . Preliminary report

    OpenAIRE

    V. A. Solomin; D.A. Magaramov; G. F. Kachalina

    2012-01-01

    Purpose: to assess the effect of vascular endothelial growth factor inhibitors on choroid in patients with myopic macular choroid neovascular membrane.Methods: 12 eyes (12 patients) aged 19-47 years with myopia and macular choroid neovascular membrane (mCNV) were enrolled in a study group. A control group included fellow eyes with early «dry» form age-related macular degeneration. Eyes with mCNV under- went one intravitreal injection of vascular endothelial growth factor inhibitor Ranibizumab...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-04-01

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

  19. Physical esercise and its prescription in patients with chronic degenerative diseases

    OpenAIRE

    Gómez, Rossana; Faculdade de Ciências, Universidade Estadual Paulista. São Paulo, Brasil. Magíster en Educación Física.; Monteiro, Henrique; Faculdade de Ciências, Universidade Estadual Paulista. São Paulo, Brasil. Doctor en educación física.; Cossio-Bolaños, Marco Antonio; Instituto del Deporte Universitario, Universidad Nacional de San Agustín. Arequipa, Perú. Faculdade de Educação Física, Universidade Estadual de Campinas. São Paulo, Brasil. Magíster en Educación Física.; Fama-Cortez, Domingo; Facultad de Medicina, Universidad de Córdova. Cordova, España. Médica.; Zanesco, Angelina; Instituto de Biociencias, Universidade Estadual Paulista. São Paulo, Brasil. Doctor en educación física.

    2010-01-01

    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 pressur...

  20. Hyperhomocysteinemia: a new risk factor for degenerative diseases.

    Science.gov (United States)

    Herrmann, Wolfgang; Knapp, Jean-Pierre

    2002-01-01

    Hyperhomocysteinemia (HHCY) is a consequence of disturbed methionine metabolism. It results from enzyme and/or vitamin deficiency. Epidemiological and clinical studies have proven HHCY to be an independent risk factor for atherosclerotic cardiovascular diseases, stroke, peripheral arterial occlusive disease and venous thrombosis. Trials in progress may clarify the "causality" of high homocysteine (HCY) concentrations and will assess the value of HCY lowering therapy. HHCY is also seen as a risk factor for neurodegenerative diseases such as cognitive impairment, dementia, Alzheimer's disease, and also for depression. There is a high prevalence of HHCY as a syndrome of vitamin shortage in elderly subjects, which strongly increases with advancing age. Elderly people have a high frequency of vitamin B12 deficiency which is more reliably diagnosed by measurement of serum methylmalonic acid and holotranscobalamin II, the metabolically active B12 fraction, than by total serum vitamin B12. Subjects who follow a strict vegetarian diet also have a high prevalence of HHCY caused by vitamin B12 deficiency. For prevention of neurological damages an early diagnosis of vitamin B12 deficiency is important. Furthermore, HHCY is a factor in the pathogenesis of neural tube defects and preeclampsia. HCY should be measured in patients with a history of atherothrombotic vessel diseases, in patients with diabetes or hyperlipidemia, in renal patients, in adipose subjects, in elderly people, in vegetarians, in postmenopausal women, and in early pregnancy.

  1. [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].

    Science.gov (United States)

    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:

  2. Vitamin A derivatives as treatment options for retinal degenerative diseases.

    Science.gov (United States)

    Perusek, Lindsay; Maeda, Tadao

    2013-07-12

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

  3. Vitamin A Derivatives as Treatment Options for Retinal Degenerative Diseases

    Directory of Open Access Journals (Sweden)

    Tadao Maeda

    2013-07-01

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

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

    Science.gov (United States)

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

    2015-06-01

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

  5. Regeneration of the retina: toward stem cell therapy for degenerative retinal diseases.

    Science.gov (United States)

    Jeon, Sohee; Oh, Il-Hoan

    2015-04-01

    Degenerative retinal diseases affect millions of people worldwide, which can lead to the loss of vision. However, therapeutic approaches that can reverse this process are limited. Recent efforts have allowed the possibility of the stem cell-based regeneration of retinal cells and repair of injured retinal tissues. Although the direct differentiation of pluripotent stem cells into terminally differentiated photoreceptor cells comprises one approach, a series of studies revealed the intrinsic regenerative potential of the retina using endogenous retinal stem cells. Muller glial cells, ciliary pigment epithelial cells, and retinal pigment epithelial cells are candidates for such retinal stem cells that can differentiate into multiple types of retinal cells and be integrated into injured or developing retina. In this review, we explore our current understanding of the cellular identity of these candidate retinal stem cells and their therapeutic potential for cell therapy against degenerative retinal diseases.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Science.gov (United States)

    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.

  8. Correlation of Macular Focal Electroretinogram with Ellipsoid Zone Extension in Stargardt Disease

    Directory of Open Access Journals (Sweden)

    Edoardo Abed

    2017-01-01

    Full Text Available Stargardt disease (STGD1 is the most common cause of inherited juvenile macular degeneration. This disease is characterized by a progressive accumulation of lipofuscin in the outer retina and subsequent loss of photoreceptors and retinal pigment epithelium. The aim of this study was to evaluate the relationship between cone photoreceptor function and structure in STGD1. Macular function was assessed by visual acuity measurement and focal electroretinogram (FERG recording while spectral domain optical coherence tomography (SD-OCT imaging was performed to evaluate the integrity of photoreceptors. FERG amplitude was significantly reduced in patients with Stargardt disease (p<0.0001. The amplitude of FERG showed a negative relationship with interruption of ellipsoid zone (EZ (R2=0.54, p<0.0001 and a positive correlation with average macular thickness (AMT. Conversely, visual acuity was only weakly correlated with central macular thickness (CMT (R2=0.12, p=0.04. In conclusion, this study demonstrates that FERG amplitude is a reliable indicator of macular cone function while visual acuity reflects the activity of the foveal region. A precise assessment of macular cone function by FERG recording may be useful to monitor the progression of STGD1 and to select the optimal candidates to include in future clinical trials to treat this disease.

  9. Advances in Susceptibility Genetics of Intervertebral Degenerative Disc Disease

    Directory of Open Access Journals (Sweden)

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

    2008-01-01

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

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

    OpenAIRE

    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...

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    OpenAIRE

    Edgar Takao Utino; João Paulo Machado Bergamaschi; Luciano Antonio Nassar Pellegrino; Ricardo Shigueaki Galhego Umeta; Maria Fernanda Silber Caffaro; Robert Meves; Osmar Avanzi

    2014-01-01

    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 ...

  13. Prevalence and Prognosis of Anemia in Dogs with Degenerative Mitral Valve Disease

    OpenAIRE

    Yu, Ivarosa Bing-Ye; Huang, Hui-Pi

    2016-01-01

    In humans, heart failure (HF) and renal insufficiency (RI) have negative reciprocal effects, and anemia can exacerbate their progression. In this retrospective study, the prevalence and prognostic significance of anemia in 114 dogs with degenerative mitral valve disease (DMVD) was investigated. Pretreatment clinical parameters, prevalence of anemia and azotemia, and survival time were analyzed in relation to HF severity. The prevalence of anemia was highest in dogs with the modified New York ...

  14. Electromagnetic fields in the treatment of chronic lower back pain in patients with degenerative disc disease

    OpenAIRE

    Arneja, Amarjit S; Kotowich, Alan; Staley, Doug; Summers, Randy; Tappia, Paramjit S

    2016-01-01

    Aim: To examine the effects of low-amplitude, low frequency electromagnetic field therapy (EMF) therapy in patients with persistent chronic lower back pain associated with degenerative disc disease. Design: Double-blind, randomized and placebo controlled. Intervention: EMF using a medical device resonator; control group underwent same procedures, except the device was turned off. Outcome measures: Pain reduction and mobility. Results: Improvements in overall physical health, social functionin...

  15. Pluripotent Stem Cells for Gene Therapy of Degenerative Muscle Diseases.

    Science.gov (United States)

    Loperfido, Mariana; Steele-Stallard, Heather B; Tedesco, Francesco Saverio; VandenDriessche, Thierry

    2015-01-01

    Human pluripotent stem cells represent a unique source for cell-based therapies and regenerative medicine. The intrinsic features of these cells such as their easy accessibility and their capacity to be expanded indefinitely overcome some limitations of conventional adult stem cells. Furthermore, the possibility to derive patient-specific induced pluripotent stem (iPS) cells in combination with the current development of gene modification methods could be used for autologous cell therapies of some genetic diseases. In particular, muscular dystrophies are considered to be a good candidate due to the lack of efficacious therapeutic treatments for patients to date, and in view of the encouraging results arising from recent preclinical studies. Some hurdles, including possible genetic instability and their efficient differentiation into muscle progenitors through vector/transgene-free methods have still to be overcome or need further optimization. Additionally, engraftment and functional contribution to muscle regeneration in pre-clinical models need to be carefully assessed before clinical translation. This review offers a summary of the advanced methods recently developed to derive muscle progenitors from pluripotent stem cells, as well as gene therapy by gene addition and gene editing methods using ZFNs, TALENs or CRISPR/Cas9. We have also discussed the main issues that need to be addressed for successful clinical translation of genetically corrected patient-specific pluripotent stem cells in autologous transplantation trials for skeletal muscle disorders.

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

    Directory of Open Access Journals (Sweden)

    Creina S Stockley

    2009-06-01

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

  17. Bone marrow stromal cells. An alternative source of restorative therapy in degenerative diseases of the central nervous system

    National Research Council Canada - National Science Library

    Alberti-Amador, E; García-Miniet, R

    2003-01-01

    The aim of this study is to describe the capacity of bone marrow cells to limit or slow down the damage and chronic neuronal degeneration produced by degenerative diseases of the central nervous system (CNS...

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

    Institute of Scientific and Technical Information of China (English)

    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

  19. Imaging of degenerative spine disease--the state of the art.

    Science.gov (United States)

    Sasiadek, Marek J; Bladowska, Joanna

    2012-01-01

    The authors review the current state of imaging of degenerative spinal disease (DSD), which is one of the most common disorders in humans. The most important definitions as well as short descriptions of the etiopathology and clinical presentation of DSD are provided first, followed by an overview of conventional and advanced imaging methods that are used in DSD. The authors then discuss in detail the imaging patterns of particular types of degenerative changes. Finally, the current imaging algorithm in DSD is presented. The imaging method of choice is magnetic resonance, including advanced techniques--especially diffusion tensor imaging. Other imaging methods (plain radiography, computed tomography, vascular studies, scintigraphy, positron emission tomography, discography) play a supplementary role ).

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

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, M. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology); Miles, K.A. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Wraight, E.P. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Nuclear Medicine); Dixon, A.K. (Addenbrookes Hospital, Cambridge (United Kingdom). Dept. of Radiology Cambridge Univ. (United Kingdom))

    1992-05-01

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

  1. Screening for macular disorders: the optometrist's perspective

    Directory of Open Access Journals (Sweden)

    Elsner AE

    2015-03-01

    Full Text Available Ann E Elsner, Brett J King School of Optometry, Indiana University, Bloomington, IN, USA Abstract: Macular screening services can take many forms, offering a variety of roles for optometrists. The need for screening has been demonstrated in industrialized and developing nations alike. Populations of particular interest for macular screening services include individuals at high risk for diabetes, not just diagnosed diabetics, since a significant proportion of those with diabetes do not realize it. Individuals who know they have diabetes are frequently not examined at the recommended intervals. Related populations include patients with a high likelihood of retinal vascular disease and high blood pressure. A second population is older individuals, who are at risk for age-related macular degeneration and degenerative myopia, key causes of vision loss depending upon geographic location and ethnicity. Images showing the complexity of lesions from diabetic retinopathy, age-related macular degeneration, and degenerative myopia illustrate the challenges of screening and classification. A third population to be screened is the large pediatric one. While many children are at risk for developing myopia, which could lead to high myopia, the risk of myopia and retinal damage is far more common in individuals who had low birth weight or premature birth. A variety of types of screening instrumentation are discussed in terms of practicality of use and cost. The technical challenges in populations with dark eyes, small pupils, and poor anterior-segment media are discussed. We discuss the wealth of screening strategies, from permanent sites with trained staff and expert graders to planned campaigns that target specific populations. Successful screening systems include instrumentation that is used within its limits, feedback and supervision during screening and grading, and clear pathways for referral for a complete examination or treatment. Keywords: vision

  2. The diet-induced proinflammatory state: a cause of chronic pain and other degenerative diseases?

    Science.gov (United States)

    Seaman, David R

    2002-01-01

    It is the rare physician who includes diet therapy and nutritional supplements in patient care. Perhaps this is because chiropractic and medical schools devote very few classroom hours to nutrition. It is also possible that physicians are under the misconception that a detailed biochemical understanding of each individual disease is required before nutritional interventions can be used. The purpose of this article is two-fold: (1) to demonstrate that chronic pain and other degenerative conditions encountered in clinical practice have similar biochemical etiologies, such as a diet-induced proinflammatory state, and (2) to outline a basic nutritional program that can be used by all practitioners. The data were accumulated over a period of years by reviewing contemporary articles and books and subsequently by retrieving relevant articles. Articles were also selected through MEDLINE and manual library searches. The typical American diet is deficient in fruits and vegetables and contains excessive amounts of meat, refined grain products, and dessert foods. Such a diet can have numerous adverse biochemical effects, all of which create a proinflammatory state and predispose the body to degenerative diseases. It appears that an inadequate intake of fruits and vegetables can result in a suboptimal intake of antioxidants and phytochemicals and an imbalanced intake of essential fatty acids. Through different mechanisms, each nutritional alteration can promote inflammation and disease. We can no longer view different diseases as distinct biochemical entities. Nearly all degenerative diseases have the same underlying biochemical etiology, that is, a diet-induced proinflammatory state. Although specific diseases may require specific treatments, such as adjustments for hypomobile joints, beta-blockers for hypertension, and chemotherapy for cancer, the treatment program must also include nutritional protocols to reduce the proinflammatory state.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2010-09-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Novel Strategies for the Improvement of Stem Cells’ Transplantation in Degenerative Retinal Diseases

    Directory of Open Access Journals (Sweden)

    Simona Delia Nicoară

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  8. MRI assessment of lumbar intervertebral disc degeneration with lumbar degenerative disease using the Pfirrmann grading systems.

    Directory of Open Access Journals (Sweden)

    Li-Peng Yu

    Full Text Available BACKGROUND: To evaluate by MRI intervertebral disc degeneration in patients with lumbar degenerative disease using the Pfirrmann grading system and to determine whether Modic changes correlated with the Pfirrmann grades and modified Pfirrmann grades of disc degeneration. METHODS: The clinical data of 108 surgical patients with lumbar degenerative disease were reviewed and their preoperative MR images were analyzed. Disc degeneration was evaluated using the Pfirrmann grading system. Patients were followed up and low back pain was evaluated using the visual analog scale (VAS and the effect of back pain on the daily quality of life was assessed using Oswestry disability index (ODI. RESULTS: Forty-four cases had normal anatomical appearance (Modic type 0 and their Pfirrmann grades were 3.77±0.480 and their modified Pfirrmann grades were of 5.81±1.006. Twenty-seven cases had Modic type I changes and their Pfirrmann grades were 4.79±0.557 and their modified Pfirrmann grades were 7.00±0.832. Thirty-six cases exhibited Modic type II changes and their Pfirrmann grades and modified Pfirrmann grades were 4.11±0.398 and 6.64±0.867, respectively. One case had Modic type III changes. Kruskal-Wallis test revealed significant difference in modified Pfirrmann grade among Modic type 0, I and II changes (P0.05. Binary regression analysis showed that Modic changes correlated most strongly with disc degeneration. Follow up studies indicated that the VAS and ODI scores were markedly improved postoperatively. However, no difference was noted in VAS and ODI scores among patients with different Modic types. CONCLUSION: Modic changes correlate with the Pfirrmann and modified Pfirrmann grades of disc degeneration in lumbar degenerative disease. There is no significant correlation between Modic types and surgical outcomes.

  9. [Algorithm of the diagnostics of trauma and degenerative diseases of the spine].

    Science.gov (United States)

    Shchedrenok, V V; Sebelev, K I; Anikeev, N V; Tiul'kin, O N; Kaurova, T A; Moguchaia, O V

    2011-01-01

    Clinico-radial data were compared in 583 patients with trauma and degenerative diseases of the spine. The clinico-diagnostic complex included radiography of the spine (round-up and functional), magnetic resonance imaging, computerized helical tomography of the spine with spondylometric measurements. Indices of the measurements of the cross-section area of the vertebral artery canal at the level of C3-C6 vertebrae and the volume of the intervertebral canal at different levels in health among men and women are presented. An algorithm of radiation diagnostics in pathology of the spine is proposed.

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

    Directory of Open Access Journals (Sweden)

    Peterson Cynthia K

    2006-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-10

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

  12. Transplantation of Fetal Stem Cells: a New Horizon for Treat¬ment of Degenerative Diseases

    Directory of Open Access Journals (Sweden)

    Farideh RAZI

    2015-10-01

    Full Text Available Background: The purpose of the current study was to present an overview of different types of stem-cells and their application for treatment different degenerative disorders with specific focus on ongoing clinical trials. Methods: For the purpose of the current narrative review article, a comprehensive search was carried out on the existing literature in Google Scholar, PubMed and Scopus using the keywords: stem-cell (fetal and mesenchymal, regenerative. Relevant articles published from 1957 to 2013 are extracted and presented. Results: During the past decades, different types of stem-cells (including adult and fetal have been used for treatment of a wide range of immunologic (Severe Combined Immunodeficiency, Di George syndrome, neurologic (Parkinson’s disease, Huntington Chorea, Cerebral Palsy, musculoskeletal (ALS, and cardiovascular diseases (heart failure and cardiomyopathies as well as chronic and acute ulcers, and diabetes. Conclusion: The results of our study demonstrated that during the past decades, stem-cell technology has been applied for treatment of a wide range of degenerative disorders with considerable success. The current ongoing clinical trials clearly demonstrate a great potential and a promising future for the technology in terms of offering curative treatment for a wide range of hitherto-incurable diseases. Keywords: Stem cell, Transplantation, Treatment, Review Article 

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

    Institute of Scientific and Technical Information of China (English)

    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.

  14. Echocardiographic Follow-up of Robotic Mitral Valve Repair for Mitral Regurgitation due to Degenerative Disease

    Institute of Scientific and Technical Information of China (English)

    Yao Wang; Chang-Qing Gao; Yah-Song Shen; Gang Wang

    2016-01-01

    Background:Mitral valve (MV) repair can now be carried out through small incisions with the use of robotic assistance.Previous reports have demonstrated the excellent clinical result of robotic MV repair for degenerative mitral regurgitation (MR).However,there has been limited information regarding the echocardiographic follow-up of these patients.The present study was therefore to evaluate the echocardiographic follow-up outcomes after robotic MV repair in patients with MR due to degenerative disease of the MV.Methods:A retrospective analysis was undertaken using data from the echocardiographic database of our department.Between March 2007 and February 2015,84 patients with degenerative MR underwent robotic MV repair.The repair techniques included leaflet resection in 67 patients (79.8%),artificial chordae in 20 (23.8%),and ring annuloplasty in 79 (94.1%).Eighty-one (96.4%) of the 84 patients were eligible for echocardiographic follow-up assessment,and no patients were lost to follow-up.Results:At a median echocardiographic follow-up of 36.0 months (interquartile range 14.3-59.4 months),four patients (4.9%) developed recurrent mild MR,and no patients had more than mild MR.Mean MR grade,left atrial diameter (LAD),left ventricular end-diastolic diameter (LVEDD),and left ventricular ejection fraction (LVEF) were significantly decreased when compared with preoperative values.Mean MR grade decreased from 3.96 ± 0.13 to 0.17 ± 0.49 (Z =-8.456,P < 0.001),LAD from 43.8 ± 5.9 to 35.5 ± 3.8 mm (t =15.131,P < 0.001),LVEDD from 51.0 ± 5.0 to 43.3 ± 2.2 mm (t =14.481,P < 0.001),and LVEF from 67.3 ± 7.0% to 63.9 ± 5.1% (t =4.585,P < 0.001).Conclusion:Robotic MV repair for MR due to degenerative disease is associated with a low rate of recurrent MR,and a significant improvement in MR grade,LAD,and LVEDD,but a significant decrease in LVEF at echocardiographic follow-up.

  15. Dynesys dynamic stabilization system for the lumbar degenerative disease: a preliminary report from China

    Institute of Scientific and Technical Information of China (English)

    LI Hai-peng; LI Fang; GUAN Kai; ZHAO Guang-ming; SHAN Jian-lin; SUN Tian-sheng

    2013-01-01

    Background Dynesys dynamic stabilization system was first implanted in patients in 1994,and introduced to China in 2007.Therefore,it was a new technique for Chinese orthopedics and hence necessary to collect clinical data about Dynesys in China.The objective of this study was to report the preliminary results of Dynesys for the lumbar degenerative disease in China.Methods Twenty-seven patients were treated with the Dynesys between July 2007 and January 2009.The diagnosis included degenerative spondylolisthesis (12 cases),degenerative spinal stenosis (nine cases),and lumbar intervertebral disc herniation (six cases).Back pain and leg pain were evaluated using 100-mm visual analog scales (VAS).The Oswestry Disability Index (ODI) was used to evaluate the patients' function.The intervertebral disc height and range of motion at the operative level were taken on radiographs.Results All the patients were followed-up,with an average of (22.40±4.23) months (range 15-32 months).VAS of back pain and leg pain were improved significantly (P <0.05) at follow-up.The ODI scores were reduced from (62.58±12.01)%preoperatively to (15.01±5.71)% at follow-up (P <0.05).The preoperative mean height of the intervertebral disc was (11.21±1.58) mm (range 8.5-13.8 mm) and mean was (10.10±1.78) mm (range 7.0-13.4 mm) at follow-up (P <0.05).The mean range of motion of the implanted segment was (6.00±1.79)° (range 2.5-9.3°) preoperatively and (5.47±1.27)°(range 2.9-7.8°) at follow-up (P=0.11).Conclusions The preliminary results of Dynesys for the lumbar degenerative disease in China are similar to the published results of other countries.It can significantly improve the clinic symptoms and preserved motion at the level of implantation.However,the long-term follow-up data need to be collected.

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

    Science.gov (United States)

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

    2015-08-01

    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 the transfusion requirements during surgery, the total anesthesia and surgical times, intensive care unit (ICU) admissions, standardized costs, as well as the ICU and hospital length of stay (LOS). Regression analysis was used to evaluate for strength of association between obesity and outcome variables. Results Baseline differences between the groups (nonobese: n = 1,853; obese: n = 1,417) were found with respect to age, ASA class, gender, procedure type, and number of operative levels. After correcting for differences, we found significant associations between obesity and surgical (p degenerative spine disease.

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

    Energy Technology Data Exchange (ETDEWEB)

    Toyoda, Keiko; Ida, Masahiro; Murakami, Yoshitaka; Harada, Junta; Tada, Shimpei (Jikei Univ., Tokyo (Japan). School of Medicine)

    1992-12-01

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

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

    Science.gov (United States)

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

    2013-03-01

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

  19. Prognosis of intervertebral disc loss from diagnosis of degenerative disc disease

    Science.gov (United States)

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

    2015-03-01

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

  20. Nicotinic systems in central nervous systems disease: degenerative disorders and beyond.

    Science.gov (United States)

    Newhouse, P A; Kelton, M

    2000-03-01

    Advances in the understanding of the structure, function, and distribution of central nervous system (CNS) nicotinic receptors has provided the impetus for new studies examining the role(s) that these receptors and associated processes may play in CNS functions. Further motivation has come from the realization that such receptors are changed in degenerative neurologic diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD). Ongoing investigations of the molecular substructure of CNS nicotinic receptors and their pharmacology have begun to open up new possibilities for novel CNS therapeutics with nicotinic agents. Exploiting these possibilities will require understanding of the role(s) that these receptor systems play in human cognitive, behavioral, motor, and sensory functioning. Clues from careful studies of human cognition and behavior are beginning to emerge and will provide direction for studies of potentially therapeutic novel nicotinic agents. Modulation of these receptors with the ultimate goal of producing therapeutic benefits is the goal of these investigations and drug development. This paper will review studies from our laboratory and others that point to the importance of CNS nicotinic mechanisms in normal human cognitive and behavioral functioning as well as their role in disease states. In addition, this paper will examine potential clinical applications of nicotine and/or nicotinic agonists in a variety of CNS disorders with particular emphasis on structural brain disease including: movement disorders such as Parkinson's disease and Tourette's syndrome, cognitive/behavioral disorders such as Alzheimer's disease, attention deficit/hyperactivity disorder, and schizophrenia, and other more speculative applications. Important results from early therapeutic studies of nicotine and/or nicotinic agonists in these disease states are presented. For example, recent studies with nicotine and novel nicotinic agonists such as ABT-418 by our group

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ilić Tihomir V.

    2011-01-01

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

  5. Evolution of Oswestry 2.0 questionnaire and the physical component (PCS) of SF-36 during the first postoperative year of lumbar spine fusion in degenerative diseases

    OpenAIRE

    Alexandre Henrique Silveira Bechara; Guilherme Rebechi Zuiani; Marcelo Ítalo Risso Neto; Paulo Tadeu Maia Cavali; Ivan Guidolin Veiga; Wagner Pasqualini; Elcio Landim

    2013-01-01

    OBJECTIVE: Assess the clinical improvement of patients undergoing decompression and posterolateral lumbar arthrodesis for degenerative diseases, evaluating the evolution of the scores of Oswestry 2.0 questionnaire and the physical component (PCS) of the SF-36 scale. METHODS: Prospective study of 19 patients with degenerative disc disease (disc herniation, lumbar stenosis or degenerative spondylolisthesis) that underwent decompression and posterolateral arthrodesis. All patients included in ou...

  6. Synaptic Dysfunction in Alzheimer’s Disease and Glaucoma: From Common Degenerative Mechanisms Toward Neuroprotection

    Science.gov (United States)

    Criscuolo, Chiara; Fabiani, Carlotta; Cerri, Elisa; Domenici, Luciano

    2017-01-01

    Alzheimer’s disease (AD) and glaucoma are two distinct multifactorial neurodegenerative diseases, primarily affecting the elderly. Common pathophysiological mechanisms have been elucidated in the past decades. First of all both diseases are progressive, with AD leading to dementia and glaucoma inducing blindness. Pathologically, they all feature synaptic dysfunction with changes of neuronal circuitry, progressive accumulation of protein aggregates such as the beta amyloid (Aβ) and intracellular microtubule inclusions containing hyperphosphorylated tau, which belongs to microtubule associated protein family. During an early phase of degeneration, both diseases are characterized by synaptic dysfunction and changes of mitogen-activated protein kinases (MAPK). Common degenerative mechanisms underlying both diseases are discussed here, along with recent results on the potential use of the visual system as a biomarker for diagnosis and progression of AD. Common neuropathological changes and mechanisms in AD and glaucoma have facilitated the transfer of therapeutic strategies between diseases. In particular, we discuss past and present evidence for neuroprotective effects of brain-derived neurotrophic factor (BDNF).

  7. Dynamic Stabilization for Challenging Lumbar Degenerative Diseases of the Spine: A Review of the Literature

    Directory of Open Access Journals (Sweden)

    Tuncay Kaner

    2013-01-01

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

  8. CHANGES FACETS JOINTS IN TRAUMA AND DEGENERATIVE DISEASES OF THE LUMBAR SPINE

    Directory of Open Access Journals (Sweden)

    V. V. Shchedrenok

    2011-01-01

    Full Text Available Produced spondilometric measurements of the lumbosacral spine is normal (20 cases and in patients with spinal cord injury and degenerative-dystrophic diseases of the spine (43 cases. The width of the facet joint space joints on both sides, its relation to the longitudinal axis of the body in degrees and another on the same level were studied. The width of the facet joint space at the lumbosacral level of 3.5–4.0 mm, the area of the intervertebral foramen varies from 96–132 mm2. Among the changes in the parameters of the vertebral-motor segment can distinguish moderate, marked and significant extent that is important in determining the amount of the alleged operation.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1993-10-01

    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.)

  10. [Drinking water hardness and chronic degenerative diseases. I. Analysis of epidemiological research].

    Science.gov (United States)

    Nardi, G; Donato, F; Monarca, S; Gelatti, U

    2003-01-01

    For many years a causal relation between drinking water hardness and cardiovascular or other chronic degenerative diseases in humans has been hypothesized. In order to evaluate the association between the concentration of minerals (calcium and magnesium) responsible for the hardness of drinking water and human health, a review of all the articles published on the subject from 1980 up to today has been carried out. The retrieved articles have been divided into 4 categories: geographic correlation studies, cross-sectional studies, case-control and cohort studies, and clinical trials. The methods for the selection of the articles and the extraction and analysis of the data are detailed in this paper. Epidemiological studies have been reviewed critically, and some conclusions have been drawn taking into account the research in basic sciences and experimental studies. However, a formal meta-analysis has not been performed, due to the heterogeneity of measures of effect among the different studies.

  11. Wet Macular Degeneration

    Science.gov (United States)

    ... macular degeneration Overview By Mayo Clinic Staff Wet macular degeneration is a chronic eye disease that causes blurred vision or a blind spot in your visual field. It's generally caused by abnormal blood vessels that leak fluid or blood into ... macular degeneration is one of two types of age-related ...

  12. Predictive factors of hyaluronic acid injections short-term effectiveness for TMJ degenerative joint disease.

    Science.gov (United States)

    Guarda-Nardini, L; Ferronato, G; Favero, L; Manfredini, D

    2011-05-01

    This study attempted to identify baseline predictors of positive outcome of arthrocenteses plus hyaluronic acid injections in degenerative temporomandibular joint disease (TMJ DJD). Ninety (n=90) consecutive patients with Research Diagnostic Criteria for Temporomandibular Disorders TMJ osteoarthritis (RDC/TMD 1.0 Axis I Group IIIb) underwent a cycle of five arthrocenteses with injections of 1mL hyaluronic acid and were followed up for 3months. Eight potential predictors of positive treatment outcome (sex, age, pain duration, baseline pain at chewing, presence of uni- or bilateral arthritis, presence of other concurrent RDC/TMD diagnoses, type of intervention and tolerability of treatment) were included in a logistic regression model to identify baseline predictors of treatment effectiveness. At follow-up, 85·6% of patients improved with respect to baseline VAS values, and 64·4% had a 50% or more decrease (positive outcomes). Correlation with positive outcomes existed only for unilateral osteoarthritis, and the logistic regression identified the side of arthritis (unilateral/bilateral) as the only predictor of positive treatment outcome (P=0·032). The achievement of any treatment improvement was predicted by high baseline pain levels (P=0·016). The regression models explained only 7·7-15% of the variance in the outcome variable. The attempts to find predictors of positive treatment outcome with HA injections for TMJ degenerative joint disease have been successful only in part. The search for other outcome predictors is likely to benefit from the assessment of psychosocial features associated with TMJ disorders.

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2014-03-01

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

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

    Science.gov (United States)

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

    2016-01-01

    [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

  16. Effect of vascular endothelial growth factor inhibitors on choroid in patients with macular choroid neovascular membrane and degenerative myopia . Preliminary report

    Directory of Open Access Journals (Sweden)

    V. A. Solomin

    2012-01-01

    Full Text Available Purpose: to assess the effect of vascular endothelial growth factor inhibitors on choroid in patients with myopic macular choroid neovascular membrane.Methods: 12 eyes (12 patients aged 19-47 years with myopia and macular choroid neovascular membrane (mCNV were enrolled in a study group. A control group included fellow eyes with early «dry» form age-related macular degeneration. Eyes with mCNV under- went one intravitreal injection of vascular endothelial growth factor inhibitor Ranibizumab 0.5 mg. Retina and choroid examination was performed with SPECtRALIS HRA+OCt (Heidelberg Engineering. Eyes were examined before treatment, in 1 month and in 3 months after treatment.Results: Mean best corrected visual acuity in 1 moth after ranibizumab 0.5 mg injection improved from 0.37±0.18 to 0.47±0.24. In 3 months after treatment best corrected visual acuity was 0.53±0.24. Mean foveal retinal thickness before treatment was 311.4±57.2 μm; 1 month and 3 months after treatment mean foveal retinal thickness decreased to 229.1±41.8 μm and 221.8±29.3 μm, respec- tively. Mean choroid thickness in 1 moth decreased from 54.4±23.7 μm to 37.4±17.0 μm, in 3 moths mean choroid thickness was 48.9±20.1 μm. In the control group best corrected visual acuity was 0.79±0.18, mean foveal retinal thickness and mean choroid thick- ness were 187.1±10.5 μm and 93.7±24.5 μm, respectively.Conclusion: Injection of vascular endothelial growth factor inhibitor allowed transient choroid thinning.

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

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    Lais Keylla Felipe

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Introduction Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI) and the Client Specific Outcome Measures (CSOM). Methods Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period. Results Activity counts were increased in cats during treatment with daily meloxicam (pcats with degenerative joint disease. PMID:26162101

  19. Comparison of Snellen acuity, VER acuity, and Arden grating scores in macular and optic nerve diseases.

    Science.gov (United States)

    Skalka, H W

    1980-01-01

    Patients with various macular and optic nerve abnormalities underwent Snellen acuity, transient VER acuity, and Arden grating testing. Snellen acuity was the coarsest of the 3 evaluations, generally falling after Arden scores and VER acuity had already undergone significant degradation. The Arden gratings appeared to be the most sensitive of the 3 tests, equalling VER performance in optic nerve diseases and surpassing it in macular diseases. Variations in results between the different tests are generally understandable if one considers the functions tested by each and the anatomical derangements caused by the diseases in question. The Arden grating test appears to be an excellent and sensitive screening test for central visual disturbances. Images PMID:7356929

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

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    Soontaree Petchdee

    2016-12-01

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

  1. Characterization of Intercostal Muscle Pathology in Canine Degenerative Myelopathy: A Disease Model for Amyotrophic Lateral Sclerosis

    Science.gov (United States)

    Morgan, Brandie R.; Coates, Joan R.; Johnson, Gayle C.; Bujnak, Alyssa C.; Katz, Martin L.

    2014-01-01

    Dogs homozygous for missense mutations in the SOD1 gene develop a late-onset neuromuscular disorder called degenerative myelopathy (DM) that has many similarities to amyotrophic lateral sclerosis (ALS). Both disorders are characterized by widespread progressive declines in motor functions accompanied by atrophic changes in the descending spinal cord tracts , and some forms of ALS are also associated with SOD1 mutations. In end-stage ALS, death usually occurs as a result of respiratory failure due to severe functional impairment of respiratory muscles. The mechanisms that lead to this loss of function are not known. Dogs with DM are euthanized at all stages of disease progression providing an opportunity to characterize the onset and progression of any pathological changes in the respiratory muscles that may precede respiratory failure. To characterize such potential disease-related pathology we evaluated intercostal muscles from Boxer and Pembroke Welsh Corgi dogs that were euthanized at various stages of DM disease progression. DM was found to result in intercostal muscle atrophy, fibrosis, increased variability in muscle fiber size and shape, and an alteration in muscle fiber type composition. This pathology was not accompanied by retraction of the motor neuron terminals from the muscle acetylcholine receptor complexes, suggesting that the muscle atrophy did not result from physical denervation. These findings provide a better understanding of the mechanisms that likely lead to respiratory failure in at least some forms of ALS and will be useful in the development and evaluation of potential therapeutic interventions using the DM model. PMID:24043596

  2. Adipokines in the skeleton: influence on cartilage function and joint degenerative diseases.

    Science.gov (United States)

    Gomez, Rodolfo; Lago, Francisca; Gomez-Reino, Juan; Dieguez, Carlos; Gualillo, Oreste

    2009-07-01

    The discovery of leptin in 1994 marked the beginning of a new understanding about white adipose tissue (WAT) and modified a static vision of this tissue which was viewed up to the end of the 20th century as an inert tissue, devoted to body protection from heat loss and to passively storing energy. The identification of the product of the gene obese accentuated the role of adipose tissue in the physiopathology of obesity-linked diseases, and led to the discovery of various adipokines, many of a pro-inflammatory nature. It has become progressively manifest that WAT-derived adipokines can now be considered as the fulcrum between obesity-related environmental causes, such as nutrition and lifestyle, and the biochemical shifts that lead to metabolic syndrome, inflammatory and/or autoimmune conditions, and rheumatic diseases. Herein, we review recent adipokine research, with particular emphasis to the role of leptin, adiponectin, resistin, and visfatin in chondrocyte function and skeleton, as well as in inflammatory and degenerative cartilage joint diseases.

  3. Aging Is Not a Disease: Distinguishing Age-Related Macular Degeneration from Aging

    OpenAIRE

    Ardeljan, Daniel; Chan, Chi-Chao

    2013-01-01

    Age-related macular degeneration (AMD) is a disease of the outer retina, characterized most significantly by atrophy of photoreceptors and retinal pigment epithelium accompanied with or without choroidal neovascularization. Development of AMD has been recognized as contingent on environmental and genetic risk factors, the strongest being advanced age. In this review, we highlight pathogenic changes that destabilize ocular homeostasis and promote AMD development. With normal aging, photorecept...

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

    Science.gov (United States)

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

    2014-08-01

    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 revision Clinical Modification (ICD-9-CM) codes were used to identify operations for degenerative cervical spine diseases in adults (age > 20 years). Disposition and complication rates were examined. Results There was an increase in cervical spine surgeries performed in an ambulatory setting during the study period. Anterior cervical diskectomy and fusion accounted for 68% of outpatient procedures; posterior decompression made up 21%. Younger patients predominantly underwent anterior fusion procedures, and patients in the eighth and ninth decades of life had more posterior decompressions. Charlson comorbidity index and complication rates were substantially lower for ambulatory cases when compared with inpatients. The majority (>99%) of patients were discharged home following ambulatory surgery. Conclusions Recently, the number of cervical spine surgeries has increased in general, and more of these procedures are being performed in an ambulatory setting. The majority (>99%) of patients are discharged home but the nature of analyzing administrative data limits accurate assessment of postoperative complications and thus patient safety. This increase in outpatient cervical spine surgery necessitates further discussion of its safety.

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

    Science.gov (United States)

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

    2013-04-01

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

  6. Preclinical studies on specific gene therapy for recessive retinal degenerative diseases.

    Science.gov (United States)

    Stieger, Knut; Chauveau, Christine; Rolling, Fabienne

    2010-10-01

    Inherited retinal diseases are non-lethal and have a wide level of genetic heterogeneity. Many of the genes involved have now been identified and their function elucidated, providing a major step towards the development of gene-based treatments. The most widely used vectors for ocular gene delivery are based on adeno-associated virus (AAV) because they mediate long-term transgene expression in a variety of retinal cell types and elicit minimal immune responses. Extensive preclinical evaluation of gene transfer strategies in small and large animal models is key to the development of successful gene-based therapies for the retina. These preclinical studies have already allowed the field to reach the point where gene therapy to treat inherited blindness has been brought to clinical trial. In this manuscript, we focus on recombinant AAV-mediated specific gene therapy for recessive retinal degenerative diseases we describe the preclinical studies for the treatment of retinal degeneration caused by retinal pigmented epithelium (RPE) cells or photoreceptor defects and the immune response induced by retinal rAAV gene transfer.

  7. Prevalence and patterns of comorbid cognitive impairment in low vision rehabilitation (LVR) for macular disease

    Science.gov (United States)

    Whitson, Heather E.; Ansah, Deidra; Whitaker, Diane; Potter, Guy; Cousins, Scott W.; MacDonald, Heather; Pieper, Carl F.; Landerman, Lawrence; Steffens, David C.; Cohen, Harvey J.

    2009-01-01

    The prevalence of comorbid cognitive impairment among older adults referred to LVR for macular disease is unknown. We performed cognitive testing on 101 adults aged 65 years or older with macular disease who were referred to The Duke LVR Clinic between September 2007 and March 2008. Scores on the telephone interview for cognitive status-modified (TICS-m) ranged from 7 to 44, with 18.8% of scores below an established cutoff for cognitive impairment (≤ 27) and an additional 27.7% of scores considered marginal (28-30). On letter fluency, 46% of participants scored at least 1 × S.D. below the mean for their age, gender, race, and education level, and 18% of participants scored at least 2 × S.D. below their demographic mean. On logical memory, 26% of participants scored at least 1 × S.D. below the mean for their age group and race and 6% scored at least 2 × S.D. below their demographic mean. High prevalence of cognitive impairment, with particular difficulty in verbal fluency and verbal memory, may compromise the success of low vision rehabilitation interventions among macular disease patients. Additional work is needed to develop strategies to maximize function in older adults with this common comorbidity. PMID:19427045

  8. Role of Diffusion Tensor MR Imaging in Degenerative Cervical Spine Disease: a Review of the Literature.

    Science.gov (United States)

    Banaszek, A; Bladowska, J; Podgórski, P; Sąsiadek, M J

    2016-09-01

    In the article we review the current role of diffusion tensor imaging (DTI), a modern magnetic resonance (MR) technique, in the diagnosis and the management of cervical spondylotic myelopathy (CSM), the most serious complication of degenerative cervical spine disease (DCSD). The pathogenesis of DCSD is presented first with an emphasis placed on the pathological processes leading to myelopathy development. An understanding of the pathophysiological background of DCSD is necessary for appropriate interpretation of MR images, both plain and DTI. Conventional MRI is currently the imaging modality of choice in DCSD and provides useful information concerning the extent of spondylotic changes and degree of central spinal canal stenosis; however its capability in myelopathy detection is limited. DTI is a state of the art imaging method which recently has emerged in spinal cord investigations and has the potential to detect microscopic alterations which are beyond the capability of plain MRI. In the article we present the physical principles underlying DTI which determine its sensitivity, followed by an overview of technical aspects of DTI acquisition with a special consideration of spinal cord imaging. Finally, the scientific reports concerning DTI utility in DSCD are also reviewed. DTI detects spinal cord injury in the course of DCSD earlier than any other method and could be useful in predicting surgical outcomes in CMS patients, however technical and methodology improvement as well as standardization of acquisition protocols and postprocessing methods among the imaging centers are needed before its implementation in clinical practice.

  9. Prevalence and Prognosis of Anemia in Dogs with Degenerative Mitral Valve Disease.

    Science.gov (United States)

    Yu, Ivarosa Bing-Ye; Huang, Hui-Pi

    2016-01-01

    In humans, heart failure (HF) and renal insufficiency (RI) have negative reciprocal effects, and anemia can exacerbate their progression. In this retrospective study, the prevalence and prognostic significance of anemia in 114 dogs with degenerative mitral valve disease (DMVD) was investigated. Pretreatment clinical parameters, prevalence of anemia and azotemia, and survival time were analyzed in relation to HF severity. The prevalence of anemia was highest in dogs with the modified New York Heart Association (NYHA) class IV HF (33.3%), followed by classes III (15.2%) and II (0%; p 1.6 mg/dL (both p dogs had a shorter median survival [13 months; 95% confidence interval (CI): 0.7-19.1] than nonanemic dogs (28 months; 95% CI: 15.3-40.7; p 1.7 (HR: 2.7, 95% CI: 1.7-4.2; p = 0.001), and presence of anemia (HR: 1.43, 95% CI: 1.1-1.9; p = 0.004) emerged as predictors of mortality. A cardiorenal-anemia syndrome-like triangle was observed and anemia was a prognostic factor for survival in dogs with DMVD.

  10. Prevalence and Prognosis of Anemia in Dogs with Degenerative Mitral Valve Disease

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    Ivarosa Bing-Ye Yu

    2016-01-01

    Full Text Available In humans, heart failure (HF and renal insufficiency (RI have negative reciprocal effects, and anemia can exacerbate their progression. In this retrospective study, the prevalence and prognostic significance of anemia in 114 dogs with degenerative mitral valve disease (DMVD was investigated. Pretreatment clinical parameters, prevalence of anemia and azotemia, and survival time were analyzed in relation to HF severity. The prevalence of anemia was highest in dogs with the modified New York Heart Association (NYHA class IV HF (33.3%, followed by classes III (15.2% and II (0%; p 1.6 mg/dL (both p 1.7 (HR: 2.7, 95% CI: 1.7–4.2; p = 0.001, and presence of anemia (HR: 1.43, 95% CI: 1.1–1.9; p = 0.004 emerged as predictors of mortality. A cardiorenal-anemia syndrome-like triangle was observed and anemia was a prognostic factor for survival in dogs with DMVD.

  11. EFFECTIVENESS OF RADIOFREQUENCY DENERVATION FOR PAIN RELIEF IN HIP DEGENERATIVE DISEASES

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    G. I. Nazarenko

    2014-01-01

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

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

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    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.

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

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    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.

  14. Validation of the clinical diagnostic criteria for temporomandibular disorders for the diagnostic subgroup of degenerative joint disease.

    Science.gov (United States)

    Brandlmaier, I; Grüner, S; Rudisch, A; Bertram, S; Emshoff, R

    2003-04-01

    Research is needed to assess the validity of the Clinical Diagnostic Criteria for Temporomandibular Disorders (CDC/TMD). The purpose of this study was to test the reliability of the clinical diagnosis of temporomandibular joint (TMJ) degenerative joint disease (DJD) as compared with the magnetic resonance imaging (MRI) 'gold standard'. The TMJ DJD group comprised 48 joints in 24 consecutive patients who were assigned a clinical bilateral diagnosis of TMJ DJD. The TMJ non-DJD group consisted of 82 joints in 41 consecutive patients without a TMJ-related diagnosis of TMD. Bilateral sagittal and coronal MR images were obtained subsequently to establish the corresponding diagnosis of degenerative joint changes. An MRI diagnosis of osteoarthrosis (OA) was defined by the presence of flattening, subchondral sclerosis, surface irregularities, and erosion of the condyle or presence of condylar deformities associated with flattening, subchondral sclerosis, surface irregularities, erosion and osteophyte. For the CDC/TMD interpretations, the positive predictive of DJD for OA was 67%, and for the presence of degenerative joint changes 88%. The overall diagnostic agreement for DJD was 44.6% with a corresponding K-value of 0.01. Most of the disagreement was due to false-negative interpretations of asymptomatic joints. The results suggest CDC/TMD to be predictive for degenerative joint changes but insufficient for determination of OA. Patients assigned a clinical TMJ-related diagnosis of DJD may need to be supplemented by evidence from MRI to determine the presence or absence of OA.

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

    Science.gov (United States)

    Freire, M; Meuten, D; Lascelles, D

    2014-09-01

    The elbow joint is one of the feline appendicular joints most commonly and severely affected by degenerative joint disease. The macroscopic and histopathological lesions of the elbow joints of 30 adult cats were evaluated immediately after euthanasia. Macroscopic evidence of degenerative joint disease was found in 22 of 30 cats (39 elbow joints) (73.33% cats; 65% elbow joints), and macroscopic cartilage erosion ranged from mild fibrillation to complete ulceration of the hyaline cartilage with exposure of the subchondral bone. Distribution of the lesions in the cartilage indicated the presence of medial compartment joint disease (most severe lesions located in the medial coronoid process of the ulna and medial humeral epicondyle). Synovitis scores were mild overall and correlated only weakly with macroscopic cartilage damage. Intra-articular osteochondral fragments either free or attached to the synovium were found in 10 joints. Macroscopic or histologic evidence of a fragmented coronoid process was not found even in those cases with intra-articular osteochondral fragments. Lesions observed in these animals are most consistent with synovial osteochondromatosis secondary to degenerative joint disease. The pathogenesis for the medial compartmentalization of these lesions has not been established, but a fragmented medial coronoid process or osteochondritis dissecans does not appear to play a role. © The Author(s) 2014.

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

    Science.gov (United States)

    Gazzeri, Roberto; Galarza, Marcelo; Alfieri, Alex

    2014-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Accelerated Degenerative Joint Disease After Staged Hip Arthroscopy and Periacetabular Osteotomy in a Patient with Hip Dysplasia.

    Science.gov (United States)

    Guss, Michael; Youm, Thomas

    2017-05-01

    Hip dysplasia, when significant, is effectively treated with periacetabular osteotomy. There have been good results reported with hip arthroscopy when dysplasia is mild. However, when dysplasia is significant, hip arthroscopy with labral repair alone has led to poor results and even rapid decline to end stage arthritis. Staged hip arthroscopy and periacetabular osteotomy would potentially treat the labral lesion and correct the underlying bony abnormality that resulted in the labral pathology. Such a staged treatment plan should help prevent progression to degenerative joint disease. We report a case of a 33-year-old woman who presented with left hip pain and was diagnosed with mild hip dysplasia and a labral tear. She underwent staged hip arthroscopy and labral repair followed by periacetabular osteotomy 2 weeks later. Three and a half months after surgery she developed constant pain and began limping at 5 months. Radiographs showed progression to severe degenerative joint disease. The patient was indicated for total hip arthroplasty.

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

    Institute of Scientific and Technical Information of China (English)

    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. An analysis of spinopelvic sagittal alignment after lumbar lordosis reconstruction for degenerative spinal diseases: how much balance can be obtained?

    Science.gov (United States)

    Liu, Hui; Li, Sibei; Wang, Jiranru; Wang, Taiping; Yang, Hao; Li, Zemin; Li, Xiang; Zheng, Zhaomin

    2014-12-15

    A retrospective and radiological study of degenerative spinal diseases. To explore the changes in spinopelvic sagittal alignment after lumbar instrumentation and fusion of degenerative spinal diseases. Efforts have been paid to clarify the ideal postoperative sagittal profile for degenerative spinal diseases. However, little has been published about the actual changes of sagittal alignment after lumbar lordosis reconstruction. Radiographical analysis of 83 patients with spinal degeneration was performed by measuring sagittal parameters before and after operations. Comparative studies of sagittal parameters between short (1 level) and long (≥ 2 level) instrumentation and fusion were performed. Different variances (Δ) of these sagittal parameters before and after operations were calculated and compared. Correlative study and linear regression were performed to establish the relationship between variances. No significant changes were shown in the short-fusion group postoperatively. In the long-fusion group, postoperative lumbar lordosis (LL) and sacral slope (SS) were significantly increased; pelvic tilt (PT), sagittal vertical axis (SVA), pelvic incidence minus lumbar lordosis, and PT/SS were significantly decreased. Different variances of ΔLL, ΔSS, ΔPT, ΔSVA, Δ(pelvic incidence - LL), and ΔPT/SS were significantly greater in the long-fusion group than the short-fusion group. Close correlations were mainly shown among ΔLL, ΔPT, and ΔSVA. Linear regression equations could be developed (ΔPT = -0.185 × ΔLL - 7.299 and ΔSVA = -0.152ΔLL - 1.145). In degenerative spinal diseases, long instrumentation and fusion (≥ 2 levels) provides more efficient LL reconstruction. PT, SS, and SVA improve corresponding to LL in a linear regression model. Linear regression equations could be developed and used to predict PT and SVA change after long instrumentation and fusion for LL reconstruction.

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

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    Margaret E Gruen

    Full Text Available Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI and the Client Specific Outcome Measures (CSOM.Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period.Activity counts were increased in cats during treatment with daily meloxicam (p<0.0001 compared to baseline. The FMPI results and activity count data offer concurrent validation for the FMPI, though the relationship between baseline activity counts and FMPI scores at baseline was poor (R2=0.034. The CSOM did not show responsiveness for improvement in this study, and the relationship between baseline activity counts and CSOM scores at baseline was similarly poor (R2=0.042.Refinements to the FMPI, including abbreviation of the instrument and scoring as percent of possible score are recommended. This study offered further validation of the FMPI as a clinical metrology instrument for use in detecting therapeutic efficacy in cats with degenerative joint disease.

  2. Galectin-3 in cardiac muscle and circulation of dogs with degenerative mitral valve disease.

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    Sakarin, S; Rungsipipat, A; Surachetpong, S D

    2016-03-01

    This study aimed to determine the association of cardiac fibrosis with the galectin-3 (Gal-3) expression, a fibrosis marker in the myocardium and to compare plasma Gal-3 levels in normal and degenerative mitral valve disease (DMVD) dogs. Studies of muscle expression and plasma levels of Gal-3 were performed in separate groups of dogs. The tissue study was performed on cardiac tissues collected from 22 dogs. The plasma study was performed on 46 client-owned dogs. Papillary muscle and left ventricular (LV) wall obtained from 10 normal and 12 DMVD dogs were stained with Masson trichrome and Gal-3 immunohistochemistry to determine fibrosis areas and Gal-3 expression. Plasma samples were collected from 19 normal and 27 DMVD dogs for Gal-3 measurement by ELISA. Percentage of fibrosis was higher in papillary muscle and LV wall of DMVD dogs (66.13 ± 5.58%; 52.98 ± 8.45%) than in normal dogs (35.40 ± 8.46%; 27.41 ± 7.91%; p Fibrosis areas correlated strongly with the Gal-3 expression (r = 0.821, p fibrosis and was higher in DMVD dogs than in normal dogs. DMVD dogs had higher plasma Gal-3 concentrations than normal dogs. Tissue Gal-3 is a candidate of fibrosis biomarker in DMVD; however, further investigation of associations between plasma Gal-3 and myocardial fibrosis is necessary. Copyright © 2015 Elsevier B.V. All rights reserved.

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

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    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.

  4. Etodolac, aspirin, and placebo in patients with degenerative joint disease: a twelve-week study.

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    Andelman, S Y

    1983-01-01

    Thirty patients from a private practice were enrolled in an investigation designed to compare the efficacy and safety of a new nonsteroidal anti-inflammatory drug, etodolac, with those of aspirin and placebo in ameliorating pain, inflammation, and functional deficits associated with degenerative joint disease. The 12-week, double-blind, parallel-group study was divided into drug-titration and maintenance periods and was preceded by a washout period of up to two weeks. There were ten patients in each of the three treatment groups. The mean daily maintenance dosages of etodolac and aspirin were 384 mg and 4,322 mg, respectively. Etodolac was significantly (less than or equal to 0.05) more effective than placebo according to 11 of 15 clinical indexes of efficacy: three assessments of the range of motion of the knee joint, and one each of pain while standing, pain while walking, pain while climbing stairs, the average of pains while bearing weight, pain at night, joint tenderness, patient's self-evaluation, and the time required to walk 50 feet. Aspirin was significantly more effective than placebo in only three assessments: two of the range of motion of the knee joint and one of pain while standing. One patient taking etodolac, three patients taking aspirin, and six patients taking placebo withdrew from the trial because of insufficient therapeutic response. There were four withdrawals due to adverse effects, two in the aspirin group and two in the placebo group. Adverse effects (tinnitus and hearing loss) leading to withdrawal of one of the two aspirin patients were probably due to drug administration. No significant side effects were reported by patients in the etodolac group.

  5. Evidence showing the relationship between sagittal balance and clinical outcomes in surgical treatment of degenerative spinal diseases: a literature review.

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    Le Huec, Jean-Charles; Faundez, Antonio; Dominguez, Dennis; Hoffmeyer, Pierre; Aunoble, Stéphane

    2015-01-01

    The measure of radiographic pelvic and spinal parameters for sagittal balance analysis has gained importance in reconstructive surgery of the spine and particularly in degenerative spinal diseases (DSD). Fusion in the lumbar spine may result in loss of lumbar lordosis (LL), with possible compensatory mechanisms: decreased sacral slope (SS), increased pelvic tilt (PT) and decreased thoracic kyphosis (TK). An increase in PT after surgery is correlated with postoperative back pain. A decreased SS and/or abnormal sagittal vertical axis (SVA) after fusion have a higher risk of adjacent segment degeneration. High pelvic incidence (PI) increases the risk of sagittal imbalance after spine fusion and is a predictive factor for degenerative spondylolisthesis. Restoration of a normal PT after surgery is correlated with good clinical outcome. Therefore, there is a need for comparative prospective studies that include pre- and postoperative spinopelvic parameters and compare complication rate, degree of disability, pain and quality of life.

  6. An exploratory study evaluating the effects of macular carotenoid supplementation in various retinal diseases

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    Crosby-Nwaobi R

    2016-05-01

    Full Text Available Roxanne Crosby-Nwaobi, Philip Hykin, Tunde Peto, Sobha Sivaprasad NIHR Clinical Research Facility, NIHR Moorfields Biomedical Research Centre, London, UK Purpose: The aim of this study was to assess the impact of daily oral supplementation with Macushield (10 mg/d meso-zeaxanthin, 10 mg/d lutein, and 2 mg/d zeaxanthin on eye health in patients with retinal diseases by assessing the macular pigment (MP profile, the visual function, and the quality of life. Methods: Fifty-one patients with various retinal diseases were supplemented daily and followed up for 6 months. The MP optical density was measured using the customized heterochromatic flicker photometry and dual-wavelength autofluorescence. Visual function was evaluated by assessing the change in best corrected visual acuity, contrast sensitivity, and glare sensitivity in mesopic and photopic conditions. Vision-related and general quality of life changes were determined using the National Eye Insititute- Visual Function Questionnaire-25 (NEI-VFQ-25 and EuroQoL-5 dimension questionnaires. Results: A statistically significant increase in the MP optical density was observed using the dual-wavelength autofluorescence (P=0.04 but not with the customized heterochromatic flicker photometry. Statistically significant (P<0.05 improvements in glare sensitivity in low and medium spatial frequencies were observed at 3 months and 6 months. Ceiling effects confounded other visual function tests and quality of life changes. Conclusion: Supplementation with the three carotenoids enhances certain aspects of visual performance in retinal diseases. Keywords: macular pigment optical density, diabetes, central serous retinopathy, age-related macular degeneration

  7. The role of stem cell therapies in degenerative lumbar spine disease: a review.

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    Oehme, David; Goldschlager, Tony; Rosenfeld, Jeffrey V; Ghosh, Peter; Jenkin, Graham

    2015-07-01

    Degenerative conditions of the lumbar spine are extremely common. Ninety percent of people over the age of 60 years have degenerative change on imaging; however, only a small minority of people will require spine surgery (Hicks et al. Spine (Phila Pa 1976) 34(12):1301-1306, 2009). This minority, however, constitutes a core element of spinal surgery practice. Whilst the patient outcomes from spinal surgeries have improved in recent years, some patients will remain with pain and disability despite technically successful surgery. Advances in regenerative medicine and stem cell therapies, particularly the use of mesenchymal stem cells and allogeneic mesenchymal precursor cells, have led to numerous clinical trials utilising these cell-based therapies to treat degenerative spinal conditions. Through cartilage formation and disc regeneration, fusion enhancement or via modification of pain pathways, stem cells are well suited to enhance spinal surgery practice. This review will focus on the outcomes of lumbar spinal procedures and the role of stem cells in the treatment of degenerative lumbar conditions to enhance clinical practice. The current status of clinical trials utilising stem cell therapies will be discussed, providing clinicians with an overview of the various cell-based treatments likely to be available to patients in the near future.

  8. Analysis of trace element in intervertebral disc by Atomic Absorption Spectrometry techniques in degenerative disc disease in the Polish population

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    Andrzej Nowakowski

    2015-05-01

    Full Text Available Objective. Although trace elements are regarded crucial and their content has been determined in number of tissue there are only few papers addressing this problem in intervertebral disc in humans. Most of the trace elements are important substrates of enzymes influencing metabolism and senescence process. Others are markers of environmental pollution. Therefore the aim of the research was to analyzed of the trace element content in the intervertebral disc, which may be a vital argument recognizing the background of degenerative changes to be the effect of the environment or metabolic factors. Materials and methods. Material consist of 18 intervertebral disc from 15 patients, acquired in surgical procedure of due to the degenerative disease with Atomic Absorption Spectrometry content of Al, Cd, Co, Pb, Cu, Ni, Mo, Mg, Zn was evaluated. Results. Only 4 of the trace elements were detected in all samples. The correlation analysis showed significant positive age correlation with Al and negative in case of Co. Among elements significant positive correlation was observed between Al/Pb, Co/Mo, Al/Mg, Al/Zn Pb/Zn and Mg/Zn. Negative correlation was observed in Al/Co, Cd/Mg, Co/Mg, Mo/Mg, Co/Zn and Mo/Zn. Conclusions. This study is the first to our knowledge that profiles the elements in intervertebral disc in patients with degenerative changes. We have confirmed significant differences between the trace element contents in intervertebral disc and other tissue. It can be ground for further investigation.

  9. The timed up and go test for lumbar degenerative disc disease.

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    Gautschi, Oliver P; Corniola, Marco V; Joswig, Holger; Smoll, Nicolas R; Chau, Ivan; Jucker, Dario; Stienen, Martin N

    2015-12-01

    We report on the use and performance of an objective measure of functional impairment, the timed up and go (TUG) test, in clinical practice for patients with lumbar degenerative disc disease (DDD). We illustrate nine representative patients with lumbar DDD, who were selected from an ongoing prospective study, to report our clinical experience with the TUG test. In addition, a preliminary sample of 30 non-selected consecutive patients is presented. The following parameters were assessed preoperatively, and 3 days and 6 weeks postoperatively: back and leg pain using the visual analogue scale (VAS); functional impairment using the Oswestry disability index (ODI) and Roland-Morris disability index (RMDI); health-related quality of life using the EuroQol 5D (EQ5D) and Short-Form 12 (SF-12). The TUG test results improved by 2.6 and 5.4s after 3 days and 6 weeks compared to the baseline assessment. The mean VAS for back and leg pain decreased by 2.3 and 5.3, respectively, after 3 days, and by 2.7 and 4.6 after 6 weeks. The mean RMDI and ODI decreased by 3.4 and 23.3, respectively, after 3 days, and by 7.0 and 28.0 after 6 weeks. The mean EQ5D increased by 0.38 after 3 days and 0.358 after 6 weeks. The mean SF-12 mental component scale decreased by 0.2 after 3 days and increased by 5.6 after 6 weeks, whereas the mean SF-12 physical component scale increased by 6.4 after 3 days and by 9.8 after 6 weeks. The TUG test proved to be a useful, easy to use tool that could add a new, objective dimension to the armamentarium of clinical tests for the diagnosis and management of DDD. From our preliminary experience, we conclude that the TUG test accurately reflects a patient's objective functional impairment before and after surgery. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

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

    2013-08-01

    Minimally invasive unilateral pedicle screw fixation for the treatment of degenerative lumbar diseases has won the support of many surgeons. However, few data are available regarding clinical research on unilateral pedicle screw fixation associated with minimally invasive techniques for the treatment of lumbar spinal diseases. The purpose of this study was to evaluate clinical outcomes in a selected series of patients with lumbar degenerative diseases treated with minimally invasive unilateral vs classic bilateral pedicle screw fixation and lumbar interbody fusion. Patients in the unilateral group (n=43) underwent minimally invasive unilateral pedicle screw fixation with the Quadrant system (Medtronic, Memphis, Tennessee). The bilateral group (n=42) underwent bilateral instrumentation via the classic approach. Visual analog scale pain scores, Oswestry Disability Index scores, fusion rate, operative time, blood loss, and complications were analyzed. Mean operative time was 75 minutes in the unilateral group and 95 minutes in the bilateral group. Mean blood loss was 220 mL in the unilateral group and 450 mL in the bilateral group. Mean postoperative visual analog scale pain score was 3.10±0.16 in the unilateral group and 3.30±1.10 in the bilateral group. Mean postoperative Oswestry Disability Index score was 15.67±2.3 in the unilateral group and 14.93±2.6 in the bilateral group. Successful fusion was achieved in 92.34% of patients in the unilateral group and 93.56% of patients in the bilateral group. Minimally invasive unilateral pedicle screw fixation is an effective and reliable option for the surgical treatment of lumbar degenerative disease. It causes less blood loss, requires less operative time, and has a fusion rate comparable with that of conventional bilateral fixation. Copyright 2013, SLACK Incorporated.

  11. Comorbid Cognitive Impairment and Functional Trajectories in Low Vision Rehabilitation for Macular Disease

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    Whitson, Heather E.; Ansah, Deidra; Sanders, Linda L; Whitaker, Diane; Potter, Guy G.; Cousins, Scott W.; Steffens, David C.; Landerman, Lawrence R.; Pieper, Carl F.; Cohen, Harvey Jay

    2011-01-01

    Background and Aims Comorbid cognitive impairment is common among visually impaired older adults. This study investigated whether baseline cognitive status predicts functional trajectories among older adults in low vision rehabilitation (LVR) for macular disease. Methods The Telephone Interview for Cognitive Status – modified (TICS-m) was administered to macular disease patients aged ≥ 65 years receiving outpatient LVR. Mixed models assessed the rate of change in instrumental activities of daily living and visual function measures over a mean follow-up of 115 days. Results Of 91 participants, 17 (18.7%) had cognitive impairment (TICS-m score ≤ 27) and 23 (25.3%) had marginal impairment (TICS-m scores 28 to 30). Controlling for age and gender, baseline cognitive status did not predict most functional outcomes. However, participants with marginal cognitive impairment experienced worse functional trajectories in ability to prepare meals (p=0.03).and activities that require distance vision (p = 0.05). Conclusion Patients with mild to moderate cognitive impairment should not be excluded from LVR, but programs should be prepared to detect and accommodate a range of cognitive ability. PMID:22526069

  12. Aging is not a disease: distinguishing age-related macular degeneration from aging.

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    Ardeljan, Daniel; Chan, Chi-Chao

    2013-11-01

    Age-related macular degeneration (AMD) is a disease of the outer retina, characterized most significantly by atrophy of photoreceptors and retinal pigment epithelium accompanied with or without choroidal neovascularization. Development of AMD has been recognized as contingent on environmental and genetic risk factors, the strongest being advanced age. In this review, we highlight pathogenic changes that destabilize ocular homeostasis and promote AMD development. With normal aging, photoreceptors are steadily lost, Bruch's membrane thickens, the choroid thins, and hard drusen may form in the periphery. In AMD, many of these changes are exacerbated in addition to the development of disease-specific factors such as soft macular drusen. Para-inflammation, which can be thought of as an intermediate between basal and robust levels of inflammation, develops within the retina in an attempt to maintain ocular homeostasis, reflected by increased expression of the anti-inflammatory cytokine IL-10 coupled with shifts in macrophage plasticity from the pro-inflammatory M1 to the anti-inflammatory M2 polarization. In AMD, imbalances in the M1 and M2 populations together with activation of retinal microglia are observed and potentially contribute to tissue degeneration. Nonetheless, the retina persists in a state of chronic inflammation and increased expression of certain cytokines and inflammasomes is observed. Since not everyone develops AMD, the vital question to ask is how the body establishes a balance between normal age-related changes and the pathological phenotypes in AMD.

  13. Quality of Life Score as a Predictor of Death in Dogs with Degenerative Mitral Valve Disease.

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    Strunz, Célia M C; Marcondes-Santos, Mário; Takada, Julio Yoshio; Fragata, Fernanda S; Mansur, Antônio de Pádua

    2017-04-01

    The knowledge of the variables predicting mortality is important in clinical practice and for therapeutic monitoring in mitral valve disease. To determine whether a quality of life score evaluated with the Functional Evaluation of Cardiac Health questionnaire would predict mortality in dogs with degenerative mitral valve disease (DMVD). Thirty-six client-owned dogs with mitral valve disease underwent clinical, laboratory, and echocardiographic evaluations at baseline and were monitored for 6 months. Cardiovascular death was the primary outcome. The 36 dogs were classified as survivors or nonsurvivors. Higher values of the following variables were obtained at baseline in the nonsurviving group (12 dogs): amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, plasma norepinephrine, heart rate, quality of life score, diastolic left ventricular internal dimension to aortic root ratio, systolic left ventricular internal dimension to aortic root ratio, and left atrium to aortic root ratio. NT-proBNP levels and quality life score were independently associated with death in the multivariable analysis. The quality life score was an independent variable for cardiac death in dogs with DMVD. This result is encouraging, as this score is easy to apply and does not require any technology, only a veterinarian and an observant owner. O conhecimento das variáveis preditoras de mortalidade é importante para a prática clínica e para o acompanhamento terapêutico na doença da valva mitral. Determinar se um escore de qualidade de vida avaliado com o Functional Evaluation of Cardiac Health poderia auxiliar na predição de mortalidade em cães com doença degenerativa da valva mitral (DDVM). Trinta e seis cães de estimação com doença valvar mitral foram submetidos a avaliação clínica, laboratorial e ecocardiográfica no início do estudo e monitorizados durante 6 meses. A morte cardiovascular foi o desfecho primário. Os 36 cães foram classificados como

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

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    Kun Liu

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

  15. A comparison of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion for lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    Yang Xiaoming; Wang Hong; Zhao Quanlai; Xu Hongguang; Liu Ping; Jin Yuelong

    2014-01-01

    Background Bilateral transpedicular screw fixation in conjunction with interbody fusion is widely used to treat lumbar degenerative diseases; however,there are some disadvantages of using this fixation system.This study comparatively analyzes the results of unilateral and bilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion (TLIF) for one-level lumbar degenerative diseases.Methods Sixty-six cases with one-level lumbar degenerative diseases were studied.The patients were divided according to surgical approach into a unilateral group (Group A) and a bilateral group (Group B).The patients were evaluated for pain by visual analog scale (VAS) and Oswestry Disability Index (ODI).Operating time,blood loss,duration of hospitalization,and complication rate were also evaluated.Patients were examined at 1,3,6,and 12 months postoperatively and every year thereafter.Results Group A patients' average preoperative VAS and ODI scores were 7.03 ± 0.98 and (64.22±6.38)%,respectively,significantly decreased to 2.91 ± 0.88 and (14.42±2.08)%,respectively,at the last follow-up (P =0.000).In Group B,the average preoperative VAS and ODI scores were 6.79±0.86 and (63.22±4.70)%,respectively,significantly decreased to 3.12±0.96 and (14.62±2.08)%,respectively,at the last follow-up (P=0.000).No significant difference in the duration of hospitalization was found between groups.Operating time and blood loss of (125.9±13.0) minutes and (211.4±28.3) ml,respectively,in Group A were significantly less than (165.2±15.3) minutes and (258.6±18.3) ml,respectively,in Group B (P=-0.000).All patients achieved good bone union and had no pseudarthrosis at the last follow-up.Conclusions There are no clinical differences between unilateral and bilateral pedicle screw fixation combined with TLIF for one-level lumbar degenerative diseases.Unilateral fixation reduces operating time,bleeding,and cost of hospitalization.

  16. [Non-pharmacologic therapy of age-related macular degeneration, based on the etiopathogenesis of the disease].

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    Fischer, Tamás

    2015-07-12

    It has a great therapeutic significance that the disorder of the vascular endothelium, which supplies the affected ocular structures, plays a major role in the development of age-related macular degeneration. Chronic inflammation is closely linked to diseases associated with endothelial dysfuncition and age-related macular degeneration is accompanied by a general inflammatory response. The vascular wall including those in chorioids may be activated by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic and genetic factors causing a protracted host defence response with a consequent vascular damage, which leads to age-related macular degeneration. Based on this concept, age-related macular degeneration is a local manifestation of the systemic vascular disease. This recognition should have therapeutic implications because restoration of endothelial dysfunction can stabilize the condition of chronic vascular disease including age-related macular degeneration, as well. Restoration of endothelial dysfunction by non-pharmacological or pharmacological interventions may prevent the development or improve endothelial dysfunction resulting in prevention or improvement of age-related macular degeneration. Non-pharmacological interventions which may have beneficial effect in endothelial dysfunction include (1) smoking cessation; (2) reduction of increased body weight; (3) adequate physical activity; (4) appropriate diet (a) proper dose of flavonoids, polyphenols and kurcumin; (b) omega-3 long-chain polyunsaturated fatty acids: docosahexaenoic acid and eicosapentaenoic acid; (c) carotenoids, lutein and zeaxanthins), (d) management of dietary glycemic index, (e) caloric restriction, and (5) elimination of stressful lifestyle. Non-pharmacological interventions should be preferable even if medicaments are also used for the treatment of endothelial dysfunction.

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

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    Sînziana Călina Silişteanu

    2016-05-01

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

  18. Automated Fovea Detection in Spectral Domain Optical Coherence Tomography Scans of Exudative Macular Disease

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    Jing Wu

    2016-01-01

    Full Text Available In macular spectral domain optical coherence tomography (SD-OCT volumes, detection of the foveal center is required for accurate and reproducible follow-up studies, structure function correlation, and measurement grid positioning. However, disease can cause severe obscuring or deformation of the fovea, thus presenting a major challenge in automated detection. We propose a fully automated fovea detection algorithm to extract the fovea position in SD-OCT volumes of eyes with exudative maculopathy. The fovea is classified into 3 main appearances to both specify the detection algorithm used and reduce computational complexity. Based on foveal type classification, the fovea position is computed based on retinal nerve fiber layer thickness. Mean absolute distance between system and clinical expert annotated fovea positions from a dataset comprised of 240 SD-OCT volumes was 162.3 µm in cystoid macular edema and 262 µm in nAMD. The presented method has cross-vendor functionality, while demonstrating accurate and reliable performance close to typical expert interobserver agreement. The automatically detected fovea positions may be used as landmarks for intra- and cross-patient registration and to create a joint reference frame for extraction of spatiotemporal features in “big data.” Furthermore, reliable analyses of retinal thickness, as well as retinal structure function correlation, may be facilitated.

  19. Correlation between Modic changes in cervical spine and cervical degenerative disease%颈椎Modic改变与颈椎退行性疾病的关系

    Institute of Scientific and Technical Information of China (English)

    许耀丰; 马智佳; 姜宏; 俞鹏飞; 俞振翰; 陈梦菲

    2014-01-01

    Objective To investigate the association between Modic changes in cervical spine and cervical degenera-tive disease. Methods 78 outpatients with both Modic changes in cervical spine and cervical degenerative disease were calculated. The correlation between Modic changes in cervical spine and cervical degenerative disease were ana-lyzed. Results 30 patients (38. 5%) were diagnosed with mild cervical degenerative disease;26 (33. 3%) were diagnosed with moderate cervical degenerative disease, 22 (28. 2%) were diagnosed with severe cervical degenera-tive disease. Conclusions Modic changes in cervical spine often occurs in old patients, mostly type Ⅱ, in C5~6 , C6~7 segments. There is no obvious correlation between Modic changes and the severity of cervical degenerative dis-ease.%目的:探讨颈椎Modic改变与颈椎退行性疾病之间的关系。方法对78例Modic改变患者的颈椎退行性疾病进行统计,分析其与Modic改变之间的关系。结果78例患者中30例(38.5%)诊断为轻度颈椎退行性疾病,26例(33.3%)诊断为中度颈椎退行性疾病,22例(28.2%)诊断为重度颈椎退行性疾病。结论颈椎Modic改变好发于老年患者,以Ⅱ型改变居多,多发生于C5~6、C6~7节段,与颈椎退行性疾病的程度无明显关系。

  20. Patient with Macular Disease, Good Visual Acuity, and Central Visual Field Disruption and Significant Difficulties with Activities of Daily Living

    Science.gov (United States)

    Fletcher, Donald C.; Schuchard, Ronald A.; Walker, Joseph P.; Raskauskas, Paul A.

    2008-01-01

    It is generally appreciated that patients with macular disease frequently experience reduced visual acuity. It is not as widely appreciated that they often have significant central visual field disruption, which, by itself, can cause significant problems with activities of daily living, such as reading and driving, even when they maintain good…

  1. Patient with Macular Disease, Good Visual Acuity, and Central Visual Field Disruption and Significant Difficulties with Activities of Daily Living

    Science.gov (United States)

    Fletcher, Donald C.; Schuchard, Ronald A.; Walker, Joseph P.; Raskauskas, Paul A.

    2008-01-01

    It is generally appreciated that patients with macular disease frequently experience reduced visual acuity. It is not as widely appreciated that they often have significant central visual field disruption, which, by itself, can cause significant problems with activities of daily living, such as reading and driving, even when they maintain good…

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  3. Sagittal balance of the pelvis-spine complex and lumbar degenerative diseases. A comparative study about 85 cases.

    Science.gov (United States)

    Barrey, Cédric; Jund, Jérôme; Noseda, Olivier; Roussouly, Pierre

    2007-09-01

    Retrospective analysis of the spino-pelvic alignment in a population of 85 patients with a lumbar degenerative disease. Several previous publications reported the analysis of spino-pelvic alignment in the normal and low back pain population. Data suggested that patients with lumbar diseases have variations of sagittal alignment such as less distal lordosis, more proximal lumbar lordosis and a more vertical sacrum. Nevertheless most of these variations have been reported without reference to the pelvis shape which is well-known to strongly influence spino-pelvic alignment. The objective of this study was to analyse spino-pelvic parameters, including pelvis shape, in a population of 85 patients with a lumbar degenerative disease and compare these patients with a control group of normal volunteers. We analysed three different lumbar degenerative diseases: disc herniation (DH), n = 25; degenerative disc disease (DDD), n = 32; degenerative spondylolisthesis (DSPL), n = 28. Spino-pelvic alignment was analysed pre-operatively on full spine radiographs. Spino-pelvic parameters were measured as following: pelvic incidence, sacral slope, pelvic tilt, lumbar lordosis, thoracic kyphosis, spino-sacral angle and positioning of C7 plumb line. For each group of patients the sagittal profile was compared with a control population of 154 asymptomatic adults that was the subject of a previous study. In order to understand variations of spino-pelvic parameters in the patients' population a stratification (matching) according to the pelvic incidence was done between the control group and each group of patients. Concerning first the pelvis shape, patients with DH and those with DDD demonstrated to have a mean pelvic incidence equal to 49.8 degrees and 51.6 degrees, respectively, versus 52 degrees for the control group (no significant difference). Only young patients, less than 45 years old, with a disc disease (DH or DDD) demonstrated to have a pelvic incidence significantly lower (48

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

    Science.gov (United States)

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

    2014-07-01

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

  5. Usefulness of the Core Outcome Measures Index in Daily Clinical Practice for Assessing Patients with Degenerative Lumbar Disease

    Directory of Open Access Journals (Sweden)

    Carlos Lozano-Álvarez

    2012-01-01

    Full Text Available Introduction. Outcome evaluation is an important aspect of the treatment of patients with degenerative lumbar disease. We evaluated the usefulness of the Core Outcome Measures Index (COMI in assessing people affected by degenerative lumbar disease in daily clinical practice. Methods. We evaluated 221 patients who had completed preoperatively and 2 years after surgery VAS pain, Short Form-36 (SF-36, Oswestry Disability Index (ODI and COMI. We calculated the change of scores and its sensitivity to change. The internal consistency of the COMI items and the correlation between the COMI scores and the scores of the other measurements were assessed. Results. Statistically significant differences were observed between the mean scores of the preoperative and 2 years questionnaires for nearly all measurements. COMI showed a good internal consistency, except for the preoperative pain subscale. The sensitivity to change was high for the total COMI and its pain and well-being subscales and moderate for the rest. The COMI demonstrated strong correlation with the other measurements. Conclusions. The COMI is a useful tool for assessing the patient-based outcome in the studied population. Given its simplicity, good correlation with the SF-36 and ODI and its good sensitivity to change, it could replace more cumbersome instruments in daily clinical practice.

  6. Low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular diseases: a pilot study.

    Science.gov (United States)

    Vingolo, Enzo M; Salvatore, Serena; Cavarretta, Sonia

    2009-06-01

    Macular disease is one of the main causes of visual impairment. We studied the efficacy of low-vision rehabilitation by means of MP-1 biofeedback examination in patients with different macular disease. Five patients were enrolled (3 female and 2 male, mean age 53.8 years) and a total of 9 eyes was examined: 2 eyes with vitelliform dystrophy, 1 with a post-traumatic macular scar, 2 with Stargardt disease, 2 with myopic macular degeneration, 2 with cone dystrophy. All the patients underwent the following tests: visual acuity, reading speed, fixation test, MP-1 microperimetry. Low-vision rehabilitation, which lasted 10 weeks, consisted of 10 training sessions of 10 min for each eye, performed once a week using the MP-1 biofeedback examination. Statistical analysis was performed using Student's t-test. p values less than 0.05 were considered statistically significant. After training all patients displayed an improvement in visual acuity, fixation behaviour, retinal sensitivity and reading speed. Fixation behaviour within the 2 degrees diameter circle improved and was statistically significant for reading speed (p = 0.01). Reading speed improved from a mean value of 64.3 to 92 words/min. Our results show that audio feedback can, by increasing attentional modulation, help the brain to fix the final preferred retinal locus. Audio feedback facilitates stimuli transmission between intraretinal neurons as well as between the retina and brain, which is where the highest level of stimuli processing occurs, thereby probably supporting a "remapping phenomenon".

  7. Usefulness of pinhole collimator in differential diagnosis of metastatic disease and degenerative joint disease in the vertebrae; Evaluation by receiver operating characteristics (ROC) analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kosuda, Shigeru; Kawahara, Syunji; Ishibashi, Akihiko; Tamura, Kohei; Tsukatani, Yasushi; Fujii, Hiroshi (Okura National Hospital, Tokyo (Japan)); Kubo, Atsushi; Hashimoto, Shozo

    1989-11-01

    In order to evaluate the diagnostic efficacy of pinhole collimator (PHC) imaging combined with an X-ray for vertebral metastasis, our prospective study has employed receiver operating characteristics (ROC) analysis in 21 patients, 11 with osseous metastasis and 15 with degenerative joint disease in the lumbar vertebrae. PHC imaging provided better anatomic information on the extent of {sup 99m}Tc-MDP accumulation. PHC vertebral scintigraphy had a considerable impact on the decision-making process, although with variations and not very satisfactory results among the physicians with little experience. Our study suggests that PHC imaging and X-ray film are useful in differentiating between osseous metastasis and degenerative joint disease in the vertebra. (author).

  8. Association between macular degeneration and mild to moderate chronic kidney disease

    Science.gov (United States)

    Chen, Chun-Yu; Dai, Ciou-Sia; Lee, Chin-Chan; Shyu, Yu-Chiau; Huang, Ting-Shuo; Yeung, Ling; Sun, Chi-Chin; Yang, Huang-Yu; Wu, I-Wen

    2017-01-01

    Abstract Chronic kidney disease (CKD) and macular degeneration (MD) are 2 grave diseases leading to significant disability secondary to renal failure and blindness. The 2 diseases share not only common risk factors but also similar pathogenic mechanisms to renal and retinal injuries. Previous epidemiological studies indicated association between these 2 diseases. However, this concept is challenged by recent investigations. Patients with mild to moderate CKD (n = 30,696) between January 1, 1995 and December 31, 2005 were selected from the Taiwan National Health Insurance Database. Controls (n = 122,784) were matched by age, gender, diabetes mellitus type 2, and hypertension status (1:4 ratios). The risk of MD was compared between the 2 groups. The mean age of patients was 54.9 ± 15.7 years. The proportion of MD was 2.7% in mild to moderate CKD patients and 1.9% in normal controls (P disease, and peripheral vascular disease, model 2; OR: 1.369; 95% CI: 1.264–1.484; P < 0.001) and all these factors (model 3; OR: 1.320, 95% CI: 1.218–1.431, P < 0.001). This association was consistent in the subanalysis, excluding those patients with diabetic retinopathy. Proper diagnosis and timely intervention should be warranted to retard visual loss of these patients. PMID:28296786

  9. Characteristics of Macular Edema in Behcet Disease after Intravitreal Bevacizumab Injection

    Science.gov (United States)

    Ghassemi, Fariba; Mirak, Sohrab Afshari; Chams, Hormoz; Sabour, Siamak; Ahmadabadi, Mehdi Nilli; Davatchi, Fereidoun; Shahram, Farhad

    2017-01-01

    Purpose: To investigate the effect of intravitreal bevacizumab (IVB) injection on macular edema (ME) secondary to Behcet's disease. Methods: This prospective case series included 15 patients with bilateral ME due to Behcet's disease. Intravitreal bevacizumab was injected into the more severely involved eye; the contralateral eye was evaluated as the control. Patients were followed up with comprehensive ocular examination, optical coherence tomography, and fluorescein angiography (FA) for a minimum of 6 months by a single ophthalmologist. Results: Patients with a mean age of 30.6 ± 7.4 years received a mean number of 3.3 IVB injections during the 6 months. The mean preinjection vision was 0.6 ± 0.3 and 0.4 ± 0.4 LogMAR in the case and control groups, respectively, with no significant improvement at 6 months. Mean central foveal thickness was 375.3 ± 132.1 and 307.2 ± 84.5 μm in the case and control groups, respectively, and these changed to 401 ± 199.9 (P = 0.65) and 307.7 ± 82.8 μm (P = 0.73) at month 6, respectively. A statistically nonsignificant improvement in ME was observed during the first 3 months in the case group. However, it did not persist up to month 6 on an as-needed basis. IVB injections caused a disproportionate decrease in the thickness of macular subfields. A reduction in disc leakage was observed on FA (P = 0.058). Logistic regression analysis revealed no statistically significant predictive factor for an improvement in visual acuity (VA) and a reduction in foveal thickness. Conclusion: During a 6-month period, IVB injections based on an as-needed protocol provided no statistically significant improvement in VA and ME. PMID:28299006

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1983-01-01

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

  11. Gas-filled parasymphyseal pubic cyst associated with degenerative joint disease

    Energy Technology Data Exchange (ETDEWEB)

    Martel, J.P.; Spouge, A.R. [London Health Science Centre, Diagnostic Imaging University Hospital, London, ON (Canada)

    2007-06-15

    Parasymphyseal cysts are a rare and poorly understood entity. This case report describes a gas-containing parasymphyseal cystic lesion associated with degenerative change and vacuum phenomenon in the pubic symphysis. The mass was discovered incidentally in a 72-year-old asymptomatic male who underwent a transrectal ultrasound-guided biopsy of the prostate and the nature of the lesion was confirmed on magnetic resonance imaging (MRI) and computed tomography (CT). We hypothesize that the gas within the parasymphyseal cystic mass arose from a vacuum phenomenon in the pubic symphysis, with subsequent extrusion of gas from the joint into the cyst itself. It is important for radiologists to be aware of the existence of this entity to avoid unnecessary surgery for patients. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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. Mechanisms of age-related macular degeneration and therapeutic opportunities.

    Science.gov (United States)

    van Lookeren Campagne, Menno; LeCouter, Jennifer; Yaspan, Brian L; Ye, Weilan

    2014-01-01

    As the age of the population increases in many nations, age-related degenerative diseases pose significant socioeconomic challenges. One of the key degenerative diseases that compromise quality of life is age-related macular degeneration (AMD). AMD is a multi-faceted condition that affects the central retina, which ultimately leads to blindness in millions of people worldwide. The pathophysiology and risk factors for AMD are complex, and the symptoms manifest in multiple related but distinct forms. The ability to develop effective treatments for AMD will depend on a thorough understanding of the underlying pathophysiology, risk factors, and driver molecular pathways, as well as the ability to develop useful animal models. This review provides an overview of the aforementioned aspects in AMD.

  14. Enhanced text spacing improves reading performance in individuals with macular disease.

    Directory of Open Access Journals (Sweden)

    Sally Blackmore-Wright

    Full Text Available The search by many investigators for a solution to the reading problems encountered by individuals with no central vision has been long and, to date, not very fruitful. Most textual manipulations, including font size, have led to only modest gains in reading speed. Previous work on spatial integrative properties of peripheral retina suggests that 'visual crowding' may be a major factor contributing to inefficient reading. Crowding refers to the fact that juxtaposed targets viewed eccentrically may be difficult to identify. The purpose of this study was to assess the combined effects of line spacing and word spacing on the ability of individuals with age-related macular degeneration (ARMD to read short passages of text that were printed with either high (87.5% or low contrast (17.5% letters. Low contrast text was used to avoid potential ceiling effects and to mimic a possible reduction in letter contrast with light scatter from media opacities. For both low and high contrast text, the fastest reading speeds we measured were for passages of text with double line and double word spacing. In comparison with standard single spacing, double word/line spacing increased reading speed by approximately 26% with high contrast text (p < 0.001, and by 46% with low contrast text (p < 0.001. In addition, double line/word spacing more than halved the number of reading errors obtained with single spaced text. We compare our results with previous reading studies on ARMD patients, and conclude that crowding is detrimental to reading and that its effects can be reduced with enhanced text spacing. Spacing is particularly important when the contrast of the text is reduced, as may occur with intraocular light scatter or poor viewing conditions. We recommend that macular disease patients should employ double line spacing and double-character word spacing to maximize their reading efficiency.

  15. Enhanced text spacing improves reading performance in individuals with macular disease.

    Science.gov (United States)

    Blackmore-Wright, Sally; Georgeson, Mark A; Anderson, Stephen J

    2013-01-01

    The search by many investigators for a solution to the reading problems encountered by individuals with no central vision has been long and, to date, not very fruitful. Most textual manipulations, including font size, have led to only modest gains in reading speed. Previous work on spatial integrative properties of peripheral retina suggests that 'visual crowding' may be a major factor contributing to inefficient reading. Crowding refers to the fact that juxtaposed targets viewed eccentrically may be difficult to identify. The purpose of this study was to assess the combined effects of line spacing and word spacing on the ability of individuals with age-related macular degeneration (ARMD) to read short passages of text that were printed with either high (87.5%) or low contrast (17.5%) letters. Low contrast text was used to avoid potential ceiling effects and to mimic a possible reduction in letter contrast with light scatter from media opacities. For both low and high contrast text, the fastest reading speeds we measured were for passages of text with double line and double word spacing. In comparison with standard single spacing, double word/line spacing increased reading speed by approximately 26% with high contrast text (p spacing more than halved the number of reading errors obtained with single spaced text. We compare our results with previous reading studies on ARMD patients, and conclude that crowding is detrimental to reading and that its effects can be reduced with enhanced text spacing. Spacing is particularly important when the contrast of the text is reduced, as may occur with intraocular light scatter or poor viewing conditions. We recommend that macular disease patients should employ double line spacing and double-character word spacing to maximize their reading efficiency.

  16. Metric properties of the MacDQoL, individualized macular-disease-specific quality of life instrument, and newly identified subscales in French, German, Italian, and American populations

    OpenAIRE

    Berdeaux, G; Mesbah, M; Bradley, Clare

    2011-01-01

    The aims of this analysis were to confirm the UK results in other countries and to explore the possibility of subscales of the 25-Item Macular disease Dependent Quality of Life (MacDQoL) questionnaire.

  17. Degenerative disorders of the spine

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-03-01

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

  18. Evolution of Muscles Dysfunction From Myofascial Pain Syndrome Through Cervical Disc-Root Conflict to Degenerative Spine Disease.

    Science.gov (United States)

    Lisiński, Przemysław; Huber, Juliusz

    2017-02-01

    Comparative clinical and neurophysiological study in three groups of patients with general diagnosis of neck pain. To determine symptoms of muscles dysfunction in patients with myofascial pain syndrome, disc-root conflict, and degenerative changes at cervical spine. The explanation for cervical pain origin should be based on results from chosen clinical and neurophysiological studies in correlation with neuroimaging findings. Three subgroups of patients (N = 60 each) with certain symptoms were examined. Clinical evaluation included examination of pain intensity in VAS scale, muscle strength in Lovett scale, evaluation of reflexes, Spurling test, assessment of active trigger points (TRPs), and superficial sensory perception. Neurophysiological testing included surface electromyography at rest (rEMG) and during maximal contraction (mcEMG) as well as electroneurography (ENG). The greatest pain intensity with its decentralization phenomenon occurred in patients with disc-root conflict. Significant decrease of muscle strength was detected in trapezius muscle in myofascial pain syndrome subgroup. Weakness of abductor pollicis brevis muscle in patients with disc-root conflict differed them from patients with myofascial pain syndrome (P = 0.05). Patients with disc-root conflict and degenerative spine disease showed differences (P = 0.03) in reflexes evoked from triceps brachii. Positive Spurling symptom was most common (56.7%) in disc-root conflict subgroup. TRPs in trapezius muscle were found in all patients with myofascial pain syndrome. Results of rEMG amplitude measurements differed patients at P = 0.05. Only mcEMG recording from abductor pollicis brevis muscle allows for their clear cut differentiation. ENG studies showed abnormalities in patients with disc-root conflict and degenerative spine disease (P from 0.05 to 0.02). Positive correlation of VAS, TRPs, and rEMG as well as Lovett scores, mcEMG, and ENG results was found. Only applying several

  19. HLA analysis in patients with degenerative diseases of the temporomandibular joint.

    Science.gov (United States)

    Learreta, Jorge A; Bono, Andrea E; Durst, Andreas C

    2011-01-01

    The aim of this study was to determine the presence of HLA alleles, specifically HLA-DR alleles, and to correlate them with clinical and radiological features of patients with degenerative processes (DP) of the temporomandibular joint (TMJ). The final goal was to determine which allele can be used to identify patients having more aggressive forms of the articular pathologies. Thirty-two (32) Caucasian patients with DP of the TMJ were included in the study. The SSOP (Luminex Corp., Austin, TX) method was used to determine class II HLA alleles. The presence of HLA-II DR in patients with DP of the TMJ was 98%. The presence of HLA was significantly higher in patients with DP of the TMJ than in healthy subjects (66%) (p=0.003). HLA DR52 was significantly more frequent in patients than in healthy individuals (40.62% vs. 13.79%, p = 0.041). While the percentage of DR11 positive individuals was also higher among patients than among healthy control subjects, the association with DP of the TMJ was not significant (p=0.220). Patients having the DR52 allele had higher deformation or DP. It was concluded that HLA-DR54 and DR11 alleles are associated with a higher susceptibility to DP of the TMJ, and HLA-DR54 and DR52 are associated with a higher severity of DP.

  20. Echocardiographic Assessment of Degenerative Mitral Stenosis: A Diagnostic Challenge of an Emerging Cardiac Disease.

    Science.gov (United States)

    Oktay, Ahmet Afşşin; Gilliland, Yvonne E; Lavie, Carl J; Ramee, Stephen J; Parrino, Patrick E; Bates, Michael; Shah, Sangeeta; Cash, Michael E; Dinshaw, Homeyar; Qamruddin, Salima

    2017-03-01

    Degenerative mitral stenosis (DMS) is characterized by decreased mitral valve (MV) orifice area and increased transmitral pressure gradient due to chronic noninflammatory degeneration and subsequent calcification of the fibrous mitral annulus and the MV leaflets. The "true" prevalence of DMS in the general population is unknown. DMS predominantly affects elderly individuals, many of whom have multiple other comorbidities. Transcatheter MV replacement techniques, although their long-term outcomes are yet to be tested, have been gaining popularity and may emerge as more effective and relatively safer treatment option for patients with DMS. Echocardiography is the primary imaging modality for evaluation of DMS and related hemodynamic abnormalities such as increased transmitral pressure gradient and pulmonary arterial pressure. Classic echocardiographic techniques used for evaluation of mitral stenosis (pressure half time, proximal isovelocity surface area, continuity equation, and MV area planimetry) lack validation for DMS. Direct planimetry with 3-dimensional echocardiography and color flow Doppler is a reasonable technique for determining MV area in DMS. Cardiac computed tomography is an essential tool for planning potential interventions or surgeries for DMS. This article reviews the current concepts on mitral annular calcification and its role in DMS. We then discuss the epidemiology, natural history, differential diagnosis, mechanisms, and echocardiographic assessment of DMS.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-08-01

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

  2. Cystoid Macular Edema: Possible Complication of Infliximab Therapy in Behçet’s Disease

    Directory of Open Access Journals (Sweden)

    Junko Ikewaki

    2010-06-01

    Full Text Available Aim: Infliximab, an anti-tumor necrosis factor (TNF-α monoclonal antibody, has been reported to be effective in refractory uveoretinitis in Behçet’s disease. Because it has been used clinically for a short time, information on its adverse effects is limited. We report a patient who developed cystoid macular edema (CME following infliximab use for uveoretinitis associated with Behçet’s disease. Case Report: A 27-year-old man had refractory uveoretinitis and neuro-Behçet’s disease, and intravenous infliximab was administered. Results: One day after infliximab infusion, the patient complained of a decrease in the vision in his left eye. The visual acuity had decreased from 1.2 to 0.5. Daily optical coherence tomographic evaluations showed a progressive worsening of the CME, and fluorescein angiography showed a typical staining with a cystic pattern. Two weeks later, the height of CME appeared to reach a maximum level and thereafter gradually resolved in spite of the continuation of infliximab administration. The visual acuity improved while the patient was treated with repeated subtenon injections of steroids in addition to continuation of infliximab and finally increased from 0.15 to 1.2. Conclusions: Although the mechanism of CME is not known, clinicians should be aware that infliximab therapy might cause a development and worsening of CME. Thus, it is crucial to rule out preexisting abnormalities in the macula prior to commencing infliximab infusion.

  3. Non-familial degenerative disease and atrophy of brainstem and cerebellum. Clinical and CT data in 47 patients.

    Science.gov (United States)

    Staal, A; Meerwaldt, J D; van Dongen, K J; Mulder, P G; Busch, H F

    1990-03-01

    We studied the clinical features of 47 patients with a non-hereditary degenerative disease and with atrophy of brainstem or cerebellum or both in CT scanning. There was no relation between the CT findings and duration or severity of the disease, nor with the kind of the neurological signs which comprised ataxia, a hypokinetic rigid syndrome, oculomotor abnormalities, upper and lower motor neuron signs, orthostatic hypotension and dementia. The 2 main diagnoses were olivopontocerebellar atrophy (OPCA), or a combination of OPCA and striatonigral degeneration (SND). The differential diagnosis with Parkinson's disease and progressive supranuclear palsy was discussed. We concluded, that a CT scan is warranted in all cases of suspected Parkinson's disease, especially in those without tremor, and in cases of motoneuron disease with broad-based gait. In our patients with mainly hypokinesia and rigidity, levodopa treatment had no or brief beneficial effects. If ataxia predominated, OPCA appeared the most sensible diagnosis; if a hypokinetic-rigid syndrome predominated, the diagnoses SND plus OPCA appeared the most suitable. We assessed the degree of atrophy on CT subjectively, because an interobserver study of 60 normal CT scans, did not produce reliable measurements.

  4. Memory Deficit is Associated with Worse Functional Trajectories Among Older Adults in Low Vision Rehabilitation for Macular Disease

    Science.gov (United States)

    Whitson, Heather E.; Whitaker, Diane; Sanders, Linda L.; Potter, Guy G.; Cousins, Scott W.; Ansah, Deidra; McConnell, Eleanor; Pieper, Carl F.; Landerman, Lawrence; Steffens, David C.; Cohen, Harvey J.

    2012-01-01

    Objectives Older adults with macular disease are at increased risk of memory decline and incident dementia. Low vision rehabilitation (LVR) aims to preserve independence in people with irreversible vision loss, but comorbid memory problems could limit the success of rehabilitation. This study examined whether performance on a brief memory test is related to functional outcomes among older patients undergoing LVR for macular disease. Design Observational cohort study of patients receiving outpatient LVR Setting Academic center Participants 91 seniors (average age 80.1 years) with macular disease Measurements Memory was assessed at baseline with a 10-word list; memory deficit was defined as immediate recall of ≤ two words. Vision-related function was measured with the 25-item Visual Function Questionnaire (VFQ-25)administered at baseline and during subsequent interviews (mean length of follow up = 115 days). Linear mixed models (LMMs) were constructed to compare average trajectories of four VFQ-25 subscales: near activities, distance activities, dependency, and role difficulty. Results The 29.7% of patients with memory deficit tended to decline in ability to accomplish activities that involve near vision. Controlling for age, sex, and education, the functional trajectory of participants with memory deficit differed significantly from that of participants with better memory (p=0.002), who tended to report improvements in ability to accomplish near activities. Conclusion Among older adults receiving LVR for macular disease, those with memory deficit experienced worse functional trajectories in their ability to perform specific visually mediated tasks. A brief memory screen may help explain variability in rehabilitation outcomes and identify patients who might require special accommodations. PMID:23126548

  5. Memory deficit associated with worse functional trajectories in older adults in low-vision rehabilitation for macular disease.

    Science.gov (United States)

    Whitson, Heather E; Whitaker, Diane; Sanders, Linda L; Potter, Guy G; Cousins, Scott W; Ansah, Deidra; McConnell, Eleanor; Pieper, Carl F; Landerman, Lawrence; Steffens, David C; Cohen, Harvey J

    2012-11-01

    To examine whether performance on a brief memory test is related to functional outcomes in older individuals undergoing low-vision rehabilitation (LVR) for macular disease. Observational cohort study of individuals receiving outpatient LVR. Academic center. Ninety-one individuals (average age 80.1) with macular disease. Memory was assessed at baseline using a 10-word list; memory deficit was defined as immediate recall of two or fewer words. Vision-related function was measured using the 25-item Visual Function Questionnaire (VFQ-25) administered at baseline and during subsequent interviews (mean follow-up, 115 days). Linear mixed models were constructed to compare average trajectories of four VFQ-25 subscales: near activities, distance activities, dependency, and role difficulty. The 29.7% of participants with memory deficits tended to decline in ability to accomplish activities that involved near vision. Controlling for age, sex, and education, the functional trajectory of participants with memory deficit differed significantly from that of those with better memory (P = .002), who tended to report improvements in ability to accomplish near activities. Of older adults receiving LVR for macular disease, those with memory deficits experienced worse functional trajectories in their ability to perform specific visually mediated tasks. A brief memory screen may help explain variability in rehabilitation outcomes and identify individuals who might require special accommodations. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  6. The prevalence and classification of chronic kidney disease in cats randomly selected within four age groups and in cats recruited for degenerative joint disease studies

    Science.gov (United States)

    Marino, Christina L; Lascelles, B Duncan X; Vaden, Shelly L; Gruen, Margaret E; Marks, Steven L

    2015-01-01

    Chronic kidney disease (CKD) and degenerative joint disease are both considered common in older cats. Information on the co-prevalence of these two diseases is lacking. This retrospective study was designed to determine the prevalence of CKD in two cohorts of cats: cats randomly selected from four evenly distributed age groups (RS group) and cats recruited for degenerative joint disease studies (DJD group), and to evaluate the concurrence of CKD and DJD in these cohorts. The RS group was randomly selected from four age groups from 6 months to 20 years, and the DJD group comprised cats recruited to four previous DJD studies, with the DJD group excluding cats with a blood urea nitrogen and/or serum creatinine concentration >20% (the upper end of normal) for two studies and cats with CKD stages 3 and 4 for the other two studies. The prevalence of CKD in the RS and DJD groups was higher than expected at 50% and 68.8%, respectively. CKD was common in cats between 1 and 15 years of age, with a similar prevalence of CKD stages 1 and 2 across age groups in both the RS and DJD cats, respectively. We found significant concurrence between CKD and DJD in cats of all ages, indicating the need for increased screening for CKD when selecting DJD treatments. Additionally, this study offers the idea of a relationship and causal commonality between CKD and DJD owing to the striking concurrence across age groups and life stages. PMID:24217707

  7. Complex inheritance of ABCA4 disease: four mutations in a family with multiple macular phenotypes.

    Science.gov (United States)

    Lee, Winston; Xie, Yajing; Zernant, Jana; Yuan, Bo; Bearelly, Srilaxmi; Tsang, Stephen H; Lupski, James R; Allikmets, Rando

    2016-01-01

    Over 800 mutations in the ABCA4 gene cause autosomal recessive Stargardt disease. Due to extensive genetic heterogeneity, observed variant-associated phenotypes can manifest tremendous variability of expression. Furthermore, the high carrier frequency of pathogenic ABCA4 alleles in the general population (~1:20) often results in pseudo-dominant inheritance patterns further complicating the diagnosis and characterization of affected individuals. This study describes a genotype/phenotype analysis of an unusual family with multiple macular disease phenotypes spanning across two generations and segregating four distinct ABCA4 mutant alleles. Complete sequencing of ABCA4 discovered two known missense mutations, p.C54Y and p.G1961E. Array comparative genomic hybridization revealed a large novel deletion combined with a small insertion, c.6148-698_c.6670del/insTGTGCACCTCCCTAG, and complete sequencing of the entire ABCA4 genomic locus uncovered a new deep intronic variant, c.302+68C>T. Patients with the p.G1961E mutation had the mildest, confined maculopathy phenotype with peripheral flecks while those with all other mutant allele combinations exhibited a more advanced stage of generalized retinal and choriocapillaris atrophy. This family epitomizes the clinical and genetic complexity of ABCA4-associated diseases. It contained variants from all classes of mutations, in the coding region, deep intronic, both single nucleotide variants and copy number variants that accounted for varying phenotypes segregating in an apparent dominant fashion. Unequivocally defining disease-associated alleles in the ABCA4 locus requires a multifaceted approach that includes advanced mutation detection methods and a thorough analysis of clinical phenotypes.

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

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    Danko Charles G

    2009-05-01

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

  9. Disturbed Matrix Metalloproteinase Pathway in Both Age-Related Macular Degeneration and Alzheimer's Disease

    Science.gov (United States)

    Lee, Yunhee; Zhang, Jin-Jun; Francis, Paul T.

    2017-01-01

    Purpose. Abnormal protein deposits including β-amyloid, found in ageing Bruch's membrane and brain, are susceptible to degradation by matrix metalloproteinases (MMPs). In ageing Bruch's membrane, these MMPs become less effective due to polymerisation and aggregation reactions (constituting the MMP Pathway), a situation much advanced in age-related macular degeneration (AMD). The likely presence of this MMP Pathway in brain with the potential to compromise the degradation of β-amyloid associated with Alzheimer's disease (AD) has been investigated. Methods. Presence of high molecular weight MMP species (HMW1 and HMW2) together with the much larger aggregate termed LMMC was determined by standard zymographic techniques. Centrigugation and gel filtration techniques were used to separate and quantify the distribution between bound and free MMP species. Results. The MMP Pathway, initially identified in Bruch's membrane, was also present in brain tissue. The various MMP species displayed bound-free equilibrium and in AD samples, the amount of bound HMW1 and pro-MMP9 species was significantly reduced (p < 0.05). The abnormal operation of the MMP Pathway in AD served to reduce the degradation potential of the MMP system. Conclusion. The presence and abnormalities of the MMP Pathway in both brain and ocular tissues may therefore contribute to the anomalous deposits associated with AD and AMD.

  10. Owner-assessed indices of quality of life in cats and the relationship to the presence of degenerative joint disease.

    Science.gov (United States)

    Benito, Javier; Gruen, Margaret E; Thomson, Andrea; Simpson, Wendy; Lascelles, B Duncan X

    2012-12-01

    This study evaluated the types of items owners consider important to their cats' quality of life (QoL). We hypothesized that items contributing to QoL in cats are predominantly items requiring mobility. The objectives of the study were to describe the types of items considered important by owners for their cats' QoL; to describe the proportion of these items that involve mobility; to evaluate what patient factors, including severity of degenerative joint disease (DJD), affect this distribution; and to evaluate whether the proportion of QoL items involving mobility chosen by owners is different in cats presenting for a DJD study compared with a randomly selected population. A total of 830 client-generated items were evaluated. Regardless of DJD status, 40% of items listed by owners involved mobility, while 60% were 'inactive' items, rejecting our hypothesis. This highlights the need to assess non-active items that owners consider to constitute QoL to fully assess the impact of diseases like DJD and, therefore, the success of therapeutic interventions.

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

    Science.gov (United States)

    Nopoulos, Peggy C

    2016-03-01

    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.

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

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

    1994-12-01

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

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

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    Kuciel-Lewandowska, Jadwiga; Paprocka-Borowicz, Małgorzata

    2015-01-01

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

  14. Arthrocentesis with or without additional drugs in temporomandibular joint inflammatory-degenerative disease: comparison of six treatment protocols*.

    Science.gov (United States)

    Manfredini, D; Rancitelli, D; Ferronato, G; Guarda-Nardini, L

    2012-04-01

    The aim of the present pilot investigation was to compare the effectiveness of six treatment protocols providing temporomandibular joint (TMJ) arthrocentesis with or without additional drugs to manage symptoms in patients with inflammatory-degenerative TMJ disease. A consecutive series of 72 patients with TMJ osteoarthritis (axis group IIIb) with pain lasting from more than 6 months were randomly assigned to one of the groups receiving the following treatment protocols: single-session two-needle arthrocentesis (A), single-session two-needle arthrocentesis plus corticosteroid (B), single-session two-needle arthrocentesis plus low molecular weight hyaluronic acid (HA) (C), single-session two-needle arthrocentesis plus high molecular weight HA (D), 5 weekly two-needle arthrocenteses plus low molecular weight HA (E) and 5 weekly single-needle arthrocenteses plus low molecular weight HA (F). At the 3-month follow-up, improvement with respect to mean baseline values was recorded in all the five treatment groups completing the protocol. No significant differences emerged between groups in any outcome variable. The protocol providing five sessions of two-needle arthrocenteses plus low molecular weight HA allowed achieving the highest improvement in almost all the outcome variables. Findings suggested that no statistically significant differences existed between the treatment groups. The clinical significance of these findings needs to be tested with future studies on larger samples with longer follow-up periods.

  15. Instrumented posterior lumbar interbody fusion (PLIF) with interbody fusion device (Cage) in degenerative disc disease (DDD): 3 years outcome.

    Science.gov (United States)

    Ahsan, M K; Hossain, M A; Sakeb, N; Khan, S I; Zaman, N

    2013-10-01

    This prospective interventional study carried out at Bangabandhu Sheikh Mujib Medical University and a private hospital in Dhaka, Bangladesh during the period from October 2003 to September 2011. Surgical treatment of degenerative disc disease (DDD) should aim to re-expand the interbody space and stabilize until fusion is complete. The present study conducted to find out the efficacy of using interbody fusion device (Cage) to achieve interbody space re-expansion and fusion in surgical management of DDD. We have performed the interventional study on 53 patients, 42 female and 11 male, with age between 40 to 67 years. All the patients were followed up for 36 to 60 months (average 48 months). Forty seven patients were with spondylolisthesis and 06 with desiccated disc. All subjects were evaluated with regard to immediate and long term complications, radiological fusion and interbody space re-expansion and maintenance. The clinical outcome (pain and disability) was scored by standard pre and postoperative questionnaires. Intrusion, extrusion and migration of the interbody fusion cage were also assessed. Forty seven patients were considered to have satisfactory outcome in at least 36 months follow up. Pseudoarthrosis developed in 04 cases and 06 patients developed complications. In this series posterior lumbar interbody fusion (PLIF) with interbody cage and instrumentation in DDD showed significant fusion rate and maintenance of interbody space. Satisfactory outcome observed in 88.68% cases.

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

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    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.

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

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    Shetty, Prakash; Iyengar, Venkatesh; Sawaya, Ana; Diaz, Erik; Ma, Guansheng; Hernandez-Triana, Manuel; Yajnik, Chittaranjan; Forrester, Terrence; Valencia, Mauro; Rush, Elaine; Adeyemo, Adebowale; Jahoor, Farook; Roberts, Susan

    2002-09-01

    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 was initiated under the aegis of the International Atomic Energy Agency (IAEA), Vienna, Austria under its Coordinated 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 socioeconomic 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.

  18. Pathologic Manifestations on Surgical Biopsy and Their Correlation with Clinical Indices in Dogs with Degenerative Mitral Valve Disease.

    Science.gov (United States)

    Lee, J; Mizuno, M; Mizuno, T; Harada, K; Uechi, M

    2015-01-01

    Evaluation of myocardial function is clinically challenging in dogs with degenerative mitral valve disease (DMVD). Although myocardial dysfunction is caused by pathologic degeneration, histopathologic progression is poorly understood. To characterize myocardial and pulmonary pathologic changes according to severity in dogs with naturally occurring DMVD, and to investigate whether or not pathologic degeneration is reflected by traditional clinical indices. One hundred and seventeen dogs with naturally occurring DMVD. Prospective observational study. Biopsied left atrium (LA), left ventricle (LV), and lung were evaluated histologically, and an attempt was made to correlate pathologic findings with clinical indices. Severe myocardial changes were observed in all International Small Animal Cardiac Health Council classes. In the lung, heart failure cell levels were significantly increased in class III patients (P fibrosis (P < .0001). In contrast, myocardial cells were more hypertrophied in the LV than in the LA (P < .0001). Left ventricular end-diastolic dimension (LVEDd) was associated with fatty replacement (P = .033, R(2) = 0.584) and myocardial vacuolization (P = .003, R(2) = 0.588) in the LA. In DMVD, although severe pathologic changes may be evident even in early stages, there may be pathologic discrepancy between the LA and the LV. Myocardial degeneration may be reflected by clinical indices such as LVEDd and EF. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

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

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    Vasile Pâncotan

    2011-06-01

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

  20. INTRAVITREAL DEXAMETHASONE IMPLANT FOR THE TREATMENT OF REFRACTORY MACULAR EDEMA IN RETINAL VASCULAR DISEASES: Results of the KKESH International Collaborative Retina Study Group.

    Science.gov (United States)

    Alshahrani, Saeed T; Dolz-Marco, Rosa; Gallego-Pinazo, Roberto; Diaz-Llopis, Manuel; Arevalo, J Fernando

    2016-01-01

    To evaluate the safety and efficacy of intravitreal dexamethasone implant (Ozurdex) for treating refractory macular edema in retinal vascular diseases. This is a retrospective consecutive series of 53 eyes with refractory macular edema secondary to central retinal vein occlusion (13 eyes), branch retinal vein occlusion (14 eyes), and diabetic macular edema (26 eyes) treated with a single 0.7 mg dexamethasone implant. Data were collected on best-corrected visual acuity, intraocular pressure, and central macular thickness preoperatively and at 1, 3, and 6 months postoperatively. Baseline best-corrected visual acuity was 20/160 and improved statistically significantly to 20/80 and 20/60 at 1 months and 3 months, respectively (P 0.05). The central macular thickness at baseline was 569.96 ± 178.11 μm, and it decreased statistically significantly to 305.81 ± 155.94 μm, 386 ± 210.79 μm, and 446.41 ± 221.21 μm at 1, 3 and 6 months, respectively (P central macular thickness that remained stable to 3 months and 6 months, respectively.

  1. Macular Hole Associated with Vogt-Koyanagi-Harada Disease at the Acute Uveitic Stage

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    Masaharu Mizuno

    2015-09-01

    Full Text Available We describe a case with macular hole (MH associated with Vogt-Koyanagi-Harada (VKH disease. A 71-year-old Japanese woman presented with visual loss and headaches. The best-corrected visual acuity (BCVA was 0.02 in the right eye (RE and 0.1 in the left eye (LE. The patient was diagnosed with VKH based on circumferential choroidal detachments, multiple serous retinal detachments, and optic disc hyperemia. The multiple serous retinal detachments improved with high-dose corticosteroid therapy and gradual tapering. The BCVA was recovered to 1.2/0.7 in the RE/LE. Six weeks after the initial administration of steroid, vitreomacular traction was found by optical coherence tomography in the LE, which progressed to stage 4 MH with the BCVA of 0.2 in the LE. Twenty-three weeks after the initial treatment, vitrectomy was performed with the standard surgical procedures, including inner limiting membrane peeling around the fovea and air tamponade. The MH was closed successfully and the BCVA was 0.4 in the LE 5 weeks after the vitrectomy. This is the first report of a case with MH secondary to the acute uveitic stage of VKH. Successful closure of MH was achieved with the standard surgical intervention for an idiopathic MH. To conclude, at the early stage of VKH, there is a possibility of MH formation due to the rapid progress of vitreous traction following the inflammation, and the surgical procedure could be effective to resolve this secondary disorder.

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

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    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.

  3. Cultured cells of the nervous system, including human neurones, in the study of the neuro-degenerative disorder, Alzheimer's disease: an overview.

    Science.gov (United States)

    De Boni, U

    1985-01-01

    Human nervous-system cells in culture are a suitable model for the study of the degenerative changes associated with Alzheimer's disease. Alzheimer-diseased brain contains a factor which induces the formation of paired helical filaments (PHF) in cultured cells, similar to that seen in Alzheimer's disease. The excitotoxic amino acids, glutamate and aspartate, induce similar PHE formation in cultured cells. The neurotoxic element aluminium is present in high concentrations in the brain in several human neurological disorders, including Alzheimer's disease. In cultured-cell systems, aluminium interacts with acidic nuclear proteins, decreases steroid binding, produces a form of neurofibrillary degeneration and alters nucleoside metabolism.

  4. Pigmentos maculares Macular pigments

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    Renata Canovas

    2009-12-01

    Full Text Available A luteína e a zeaxantina são pigmentos amarelos que se localizam na mácula. Devido à sua localização, diminuem e filtram a quantidade de luz principalmente azul que chega aos fotorreceptores, atuam como antioxidantes e podem melhorar a qualidade visual. Esta é uma revisão do seu mecanismo de incorporação, ação, possíveis aplicações e conhecimento científico a respeito.Lutein and Zeaxanthin are yellow pigments located at the macula. Because of your location macular pigments decrease and filter the amount of blue light that reach photoreceptors, protect the outer retina from oxidative stress and may improve the vision quality. This is a review regarding incorporation mechanism, function and knowledge update.

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

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    Riepe Matthias W

    2011-12-01

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

  6. Is age-related macular degeneration a manifestation of systemic disease? New prospects for early intervention and treatment.

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    Cheung, C M G; Wong, T Y

    2014-08-01

    Age-related macular degeneration (AMD) is a common vision-threatening condition affecting the elderly. AMD shares common risk factors and processes, including vascular and inflammatory pathways, with many systemic disorders. Associations have been reported between AMD and hypertension, cardiovascular disease, cerebrovascular disease, dyslipidaemia, chronic kidney disease and neurodegenerative disorders. An increasing amount of evidence suggests that individuals with AMD are also at risk of systemic diseases such as stroke. In this review, we summarize the latest evidence to support the notion that AMD is an ocular manifestation of systemic disease processes, and discuss the potential systemic side effects of ocular AMD therapy of which general physicians should be aware. Recent genetic discoveries and understanding of the pathogenic pathways in AMD in relation to systemic disorders are also highlighted.

  7. Custom cerium oxide nanoparticles protect against a free radical mediated autoimmune degenerative disease in the brain.

    Science.gov (United States)

    Heckman, Karin L; DeCoteau, William; Estevez, Ana; Reed, Kenneth J; Costanzo, Wendi; Sanford, David; Leiter, James C; Clauss, Jennifer; Knapp, Kylie; Gomez, Carlos; Mullen, Patrick; Rathbun, Elle; Prime, Kelly; Marini, Jessica; Patchefsky, Jamie; Patchefsky, Arthur S; Hailstone, Richard K; Erlichman, Joseph S

    2013-12-23

    Cerium oxide nanoparticles are potent antioxidants, based on their ability to either donate or receive electrons as they alternate between the +3 and +4 valence states. The dual oxidation state of ceria has made it an ideal catalyst in industrial applications, and more recently, nanoceria's efficacy in neutralizing biologically generated free radicals has been explored in biological applications. Here, we report the in vivo characteristics of custom-synthesized cerium oxide nanoparticles (CeNPs) in an animal model of immunological and free-radical mediated oxidative injury leading to neurodegenerative disease. The CeNPs are 2.9 nm in diameter, monodispersed and have a -23.5 mV zeta potential when stabilized with citrate/EDTA. This stabilizer coating resists being 'washed' off in physiological salt solutions, and the CeNPs remain monodispersed for long durations in high ionic strength saline. The plasma half-life of the CeNPs is ∼4.0 h, far longer than previously described, stabilized ceria nanoparticles. When administered intravenously to mice, the CeNPs were well tolerated and taken up by the liver and spleen much less than previous nanoceria formulations. The CeNPs were also able to penetrate the brain, reduce reactive oxygen species levels, and alleviate clinical symptoms and motor deficits in mice with a murine model of multiple sclerosis. Thus, CeNPs may be useful in mitigating tissue damage arising from free radical accumulation in biological systems.

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2014-09-01

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

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

    Science.gov (United States)

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

    2017-08-28

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

  12. The use of comparative effectiveness research to inform policy decisions on the inclusion of bevacizumab for the treatment of macular diseases in Thailand's pharmaceutical benefit package

    Directory of Open Access Journals (Sweden)

    Anothaisintawee T

    2012-12-01

    Full Text Available Thunyarat Anothaisintawee,1,2 Pattara Leelahavarong,1 Tanapat Ratanapakorn,3 Yot Teerawattananon11Health Intervention and Technology Assessment Program, Ministry of Public Health, Nonthaburi, Thailand; 2Family Medicine Department and Section of Clinical Epidemiology and Biostatistics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 3Department of Ophthalmology, Khon Kaen Univerity, Khon Kaen, ThailandAbstract: There is increasing impetus to use pharmaceutical interventions, ie, ranibizumab or bevacizumab, for the treatment of particular macular diseases. This paper describes the evidence and decision-making of the National List of Essential Medicines Committee that recently announced the inclusion of bevacizumab for the treatment of macular diseases in its pharmaceutical benefit package. The findings of a systematic review and meta-analysis in this paper indicate that the intravitreal administration of bevacizumab is superior to nonpharmaceutical treatments for age-related macular degeneration (AMD and diabetic macular edema (DME, but inconclusive for retinal vein occlusion, given the limited evidence. The study also failed to distinguish among the differences in terms of visual acuity improvement, reduction of central macular thickness, and response to treatment between AMD and DME patients treated with bevacizumab and those treated with ranibizumab. Although bevacizumab was not licensed for AMD and DME, the committee decided to include bevacizumab in the National List of Essential Medicines. It is expected that many patients who are in need of treatment but who are unable to afford the expensive alternative drug, ranibizumab, will be able to receive this effective treatment instead and be prevented from suffering irreversible loss of vision. At the same time, this policy will help generate evidence about the real-life effectiveness and safety profiles of the drug for future policy development in Thailand and other settings

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

    Science.gov (United States)

    McGregor, Alison H

    2016-01-01

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

  14. Long-term Treatment Effects of Lumbar Arthrodeses in Degenerative Disk Disease: A Systematic Review With Meta-Analysis.

    Science.gov (United States)

    Noshchenko, Andriy; Hoffecker, Lilian; Lindley, Emily M; Burger, Evalina L; Cain, Christopher M J; Patel, Vikas V

    2015-11-01

    Systematic review with meta-analysis. To (1) evaluate long-term patient-centered clinical outcomes after lumbar arthrodesis with or without decompression for lumbar spondylosis (LS); and (2) compare these outcomes with those of alternative treatments, including nonsurgical and surgical which maintain mobility of the lumbar spine. The effective treatment of LS is a complex clinical and economic concern for patients and health care providers. (1) randomized controlled clinical trials (RCTs) comparing treatment effects of lumbar arthrodesis with other interventions; (2) participants: skeletally mature adults with lumbar degenerative disk disease. Ovid MEDLINE, Embase, the Cochrane Library, and others. All years through February of 2013 were included. Patient-centered clinical outcomes before treatment, at 12, 24, or >24 months of follow-up, and rate of complications and additional surgical treatment were collected. A meta-analysis was performed to evaluate pooled treatment effects. The GRADE approach was applied to evaluate the level of evidence. The review included 38 studies of 5738 participants. All studies showed strong or at least moderate treatment effects of lumbar arthrodesis at 12, 24, and 48-72 months of follow-up. The level of evidence was moderate at 12 and 24 months, and low at 48-72 months. The pooled long-term treatment effect of lumbar arthrodesis exceeded those of: nonsurgical treatment (Pinferiority versus arthroplasty at 12 and 24 months of follow-up (P<0.001), but not after 24 months postoperative. This review indicates that surgical stabilization of the lumbar spine is an effective treatment for LS; in particular, for patients with severe chronic low back pain that has been resistant to ≥3 months of conservative therapy.

  15. One decade follow up after nucleoplasty in the management of degenerative disc disease causing low back pain and radiculopathy

    Science.gov (United States)

    Cincu, Rafael; Lorente, Francisco de Asis; Gomez, Joaquin; Eiras, Jose; Agrawal, Amit

    2015-01-01

    Objectives: Nucleoplasty is a minimally invasive procedure that is developed to treat patients with symptomatic, but contained disc herniations or bulging discs. The purpose of this study was to evaluate a decade follow-up of coblation nucleoplasty treatment for protruded lumbar intervertebral disc. Methods: In this retrospective study there a total 50 patients who underwent intradiscal coblation therapy for symptomatic, but contained lumbar degenerative disc disease were included. Relief of low back pain, leg pain and numbness after the operation were assessed by visual analog pain scale (VAS). Function of lower limb and daily living of patients were evaluated by the Oswestry disability index (ODI) and subjective global rating of overall satisfaction were recorded and analyzed. Results: There were 27 male and 23 female with followup mean follow up of 115 months (range 105–130 months) with a mean age was 52 years (range 26–74 years). Analgesic consumption was reduced or stopped in 90% of these cases after 1 year. At 24 months follow up VAS was four points and ODI was 7.2. In three patients, we repeated the cool ablation after 36 months, at L3–4 level in two cases. Ten patients continue to be asymptomatic after 114 months of intervention. There were no complications with the procedure including nerve root injury, discitis or allergic reactions. Conclusions: Nucleoplasty may provide intermittent relief in contained disc herniation without significant complications and minimal morbidity. In accordance with the literature the evidence for intradiscal coablation therapy is moderate in managing chronic discogenic low back pain; nucleoplasty appears to be safe and effective. PMID:25767571

  16. Study on risk factors for lumbar degenerative disc disease%腰椎间盘退变性疾病危险因素分析及治疗

    Institute of Scientific and Technical Information of China (English)

    李军; 麻文谦; 秦涛; 朱玮; 王逸群; 曹磊; 徐晓彬

    2011-01-01

    目的 探索腰椎间盘退变性疾病的危险因素,为该类疾病的预防和治疗提供依据.方法 采用病例对照研究方法,在2008-06-2010-03我院脊柱专科门诊确诊为腰椎间盘退变性疾病的960例患者中随机抽取118例设为病例组,体检中心随机抽取167例无下腰痛病史人员为对照组,问卷调查性别、年龄、身高、体重、职业工种、腰背部外伤史、腰椎疾病家族史等,建立单因素四格表资料的F检验和多因素非条件LogiStie回归分析.结果 单因素四格表资料的F检验和非条件Logistic回归分析结果显示超重、固定工作体位、腰背部外伤史、腰椎疾患家族史是该地区居民腰椎间盘退变的危险因素.结论 腰椎间盘退变性疾病患者的发病与肥胖、职业工种、腰椎疾患家族史、腰背部外伤史等因素有密切的关系,治疗应个体化多样化,并加强健康卫生宣教.%Objective To explore risk factors for lumbar degenerative disc disease. Methods With a case-control study, 118 cases of 960 patients diagnosed by CT/Mfll as lumbar degenerative disc disease and 202 controls without low back pain, questionnaires were used to collect information on the exposure to risk factors including gender,age,occupation、weight、back injury history Jamily history of lumbar degenerative disc disease and analyzed by non-conditional logistic method. Results Through non-conditional logistic regression analysis,Obesity Jamily history of lumbar degenerative disc disease,back injury history .permanent work pose were the risk factors among residents from the area. Conclusion Obesity,Family history,back injury history,permanent work pose are the main risk factors for lumbar degenerative disc disease.

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

    Directory of Open Access Journals (Sweden)

    Yasuhara,Takao

    2013-06-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Oehme, David; Goldschlager, Tony; Ghosh, Peter; Rosenfeld, Jeffrey V; Jenkin, Graham

    2015-01-01

    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. Arthroscopic surgery for degenerative knee

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  1. Correlations between M-CHARTS and PHP findings and subjective perception of metamorphopsia in patients with macular diseases.

    Science.gov (United States)

    Arimura, Eiko; Matsumoto, Chota; Nomoto, Hiroki; Hashimoto, Shigeki; Takada, Sonoko; Okuyama, Sachiko; Shimomura, Yoshikazu

    2011-01-05

    To assess the correlations between a patient's subjective perception of metamorphopsia and the clinical measurements of metamorphopsia by M-CHARTS and PreView PHP (PHP). The authors designed a 10-item questionnaire focusing on the symptoms of metamorphopsia and verified its validity with a Rasch analysis. M-CHARTS measured the minimum visual angle of a dotted line needed to detect metamorphopsia, and PHP used the hyperacuity function for detection. Subjects were 39 patients with idiopathic epiretinal membrane (ERM), 22 patients with idiopathic macular hole (M-hole), 19 patients with age-related macular degeneration (AMD), and 51 healthy controls. Rasch analysis suggested the elimination of one question. The nine-item questionnaire score significantly correlated to the M-CHARTS score in ERM (r = 0.59; P = 0.0004) but not in M-hole and to the PHP result in AMD (r = -0.29; P = 0.04) but not in ERM. Eighty percent of ERM patients with greater horizontal M-CHARTS score subjectively perceived horizontal metamorphopsia more often. M-CHARTS showed better sensitivities than PHP in both ERM (89% vs. 42%) and AMD (74% vs. 68%) and better specificity (100% vs. 71%) in healthy controls. Rasch analysis indicated that the present form of the questionnaire is better suited for moderate to severe cases of metamorphopsia than for mild cases. The questionnaire appears to be a valid assessment of patient subjective perception of metamorphopsia and can be used to supplement the clinical measurements of metamorphopsia by M-CHARTS and PHP in patients with macular diseases.

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

    Science.gov (United States)

    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.

  3. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Español Eye Health / Eye Health A-Z Macular Edema Sections What Is Macular Edema? What Causes Macular ... Edema Diagnosis Macular Edema Treatment What Is Macular Edema? Dec. 01, 2010 Macular edema is swelling or ...

  4. Anterior discectomies and interbody cage fusion without plate fixation for 5-level cervical degenerative disc disease: A 5-year follow-up

    Directory of Open Access Journals (Sweden)

    Cheng-Wei Chu

    2011-11-01

    Full Text Available Anterior discectomy and interbody fusion have been proven to be a safe and effective procedure for the treatment of cervical degenerative disc disease. Clinical results for 1- to 4-level interbody cage fusion without plate fixation are encouraging. Five-level cervical interbody cage fusion without plate fixation has not yet been previously reported. We report a 63-year-old female patient suffering from severe pain of the bilateral shoulders and left upper extremity with numbness and weakness of legs. Magnetic resonance imaging showed cervical degenerative disc herniation with cord compression between the levels of C2 and C7. Anterior cervical discectomy and interbody cage fusion without plate fixation were performed. Pain and neurological function improved dramatically after surgery. Asymptomatic subsidence of the cage occurred at the level of C6-7 two months postoperatively with no further progression of subsidence 5 years postoperatively. Good stability of the cages was seen on flexion and extension radiographs 5 years postoperatively. We report the first case with good long-term results of 5-level interbody cage fusion without plate fixation for anterior cervical degenerative disc surgery.

  5. 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.

    Directory of Open Access Journals (Sweden)

    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

  6. Diabetic Macular Edema

    Science.gov (United States)

    Lobo, Conceição; Pires, Isabel; Cunha-Vaz, José

    The optical coherence tomography (OCT), a noninvasive and noncontact diagnostic method, was introduced in 1995 for imaging macular diseases. In diabetic macular edema (DME), OCT scans show hyporeflectivity, due to intraretinal and/or subretinal fluid accumulation, related to inner and/or outer blood-retinal barrier breakdown. OCT tomograms may also reveal the presence of hard exudates, as hyperreflective spots with a shadow, in the outer retinal layers, among others. In conclusion, OCT is a particularly valuable diagnostic tool in DME, helpful both in the diagnosis and follow-up procedure.

  7. Macular Degeneration Prevention and Risk Factors

    Science.gov (United States)

    ... Grant Terms & Conditions Patent & Intellectual Property Policy For Current Awardees FAQs Our Funding Philosophy ... Alzheimer’s Disease Research Macular Degeneration Research National Glaucoma Research ...

  8. Incidence and risk factors of adjacent segment disease following posterior decompression and instrumented fusion for degenerative lumbar disorders

    Science.gov (United States)

    Wang, Hui; Ma, Lei; Yang, Dalong; Wang, Tao; Liu, Sen; Yang, Sidong; Ding, Wenyuan

    2017-01-01

    Abstract The purpose of this study was to explore incidence and risk factors of adjacent segment disease (ASD) following posterior decompression and instrumented fusion for degenerative lumbar disorders, and hope to provide references in decision making and surgical planning for both spinal surgeon and surgically treated patients. By retrieving the medical records from January 2011 to December 2013 in our hospital, 237 patients were retrospectively reviewed. According to the occurrence of ASD at follow up, patients were divided into 2 groups: ASD and N-ASD group. To investigate risk values for the occurrence of ASD, 3 categorized factors were analyzed statistically: Patient characteristics: age, sex, body mass index (BMI), bone mineral density (BMD), duration. Surgical variables: surgical strategy, number of fusion level, surgery segment, surgery time, blood loss, intraoperative superior facet joint violation. Radiographic parameters: preoperative lumbar lordosis, preoperative angular motion at adjacent segment, preoperative adjacent segment disc degeneration, preoperative paraspinal muscle degeneration. Postoperative ASD was developed in 15 of 237 patients (6.3%) at final follow up. There was no statistically significant difference between the 2 groups in patient characteristics of age, sex composition, BMD, duration, while the BMI was higher in ASD group than that in N-ASD group. There was no difference in surgical variables of surgical strategy, number of fusion level, surgery segment, surgery time, blood loss, while intraoperative superior facet joint violation was more common in ASD group than that in N-ASD group. There was no difference in radiographic parameters of preoperative lumbar lordosis, preoperative paraspinal muscle degeneration, while preoperative adjacent segment disc degeneration were more severe in ASD group than that in N-ASD group. The Logistic regression analysis revealed that, BMI >25 kg/m2, preoperative disc degeneration, and superior

  9. Comparing minimally invasive and open transforaminal lumbar interbody fusion for treatment of degenerative lumbar disease: a meta-analysis

    Institute of Scientific and Technical Information of China (English)

    SUN Zhi-jian; LI Wen-jing; ZHAO Yu; QIU Gui-xing

    2013-01-01

    Background Transforaminal lumbar interbody fusion (TLIF) through a minimally invasive approach (mTLIF) was introduced to reduce soft tissue injury and speed recovery.Studies with small numbers of patients have been carried out,comparing mTLIF with traditional open TLIF (oTLIF),but inconsistent outcomes were reported.Methods We conducted a meta-analysis to evaluate the effectiveness of mTLIF and oTLIF in the treatment of degenerative lumbar disease.We searched PubMed,Embase and Cochrane Database of Systematic Reviews in March 2013 for studies directly comparing mTLIF and oTLIF.Patient characteristics,interventions,surgical-related messages,early recovery parameters,long-term clinical outcomes,and complications were extracted and relevant results were pooled.Results Twelve cohort studies with a total of 830 patients were identified.No significant difference regarding average operating time was observed when comparing mTLIF group with oTLIF group (-0.35 minute,95% confidence interval (C/):-20.82 to 20.13 minutes).Intraoperative blood loss (-232.91 ml,95% CI:-322.48 to-143.33 ml) and postoperative drainage (-111.24.ml,95% CI:-177.43 to-45.05 ml) were significantly lower in the mTLIF group.A shorter hospital stay by about two days was observed in patients who underwent mTLIF (-2.11 days,95% CI:-2.76 to-1.45 days).With regard to long-term clinical outcomes,no significant difference in visual analog scale score (-0.25,95% CI:-0.63 to 0.13) was observed; however,there was a slight improvement in Oswestry Disability Index (-1.42,95% CI:-2.79 to-0.04) during a minimum of 1-year follow-up between the two groups.The incidence of complications did not differ significantly between the procedures (RR=1.06,95% CI:0.7 to 1.59).Reoperation was more common in patients in mTLIF group than in oTLIF group (5% vs.2.9%),but this difference was not significant (RR=1.62,95% CI:0.75 to 3.51).Conclusion Current evidence suggests that,compared with traditional open surgery

  10. Incidence and risk factors of adjacent segment disease following posterior decompression and instrumented fusion for degenerative lumbar disorders.

    Science.gov (United States)

    Wang, Hui; Ma, Lei; Yang, Dalong; Wang, Tao; Liu, Sen; Yang, Sidong; Ding, Wenyuan

    2017-02-01

    The purpose of this study was to explore incidence and risk factors of adjacent segment disease (ASD) following posterior decompression and instrumented fusion for degenerative lumbar disorders, and hope to provide references in decision making and surgical planning for both spinal surgeon and surgically treated patients.By retrieving the medical records from January 2011 to December 2013 in our hospital, 237 patients were retrospectively reviewed. According to the occurrence of ASD at follow up, patients were divided into 2 groups: ASD and N-ASD group. To investigate risk values for the occurrence of ASD, 3 categorized factors were analyzed statistically: Patient characteristics: age, sex, body mass index (BMI), bone mineral density (BMD), duration. Surgical variables: surgical strategy, number of fusion level, surgery segment, surgery time, blood loss, intraoperative superior facet joint violation. Radiographic parameters: preoperative lumbar lordosis, preoperative angular motion at adjacent segment, preoperative adjacent segment disc degeneration, preoperative paraspinal muscle degeneration.Postoperative ASD was developed in 15 of 237 patients (6.3%) at final follow up. There was no statistically significant difference between the 2 groups in patient characteristics of age, sex composition, BMD, duration, while the BMI was higher in ASD group than that in N-ASD group. There was no difference in surgical variables of surgical strategy, number of fusion level, surgery segment, surgery time, blood loss, while intraoperative superior facet joint violation was more common in ASD group than that in N-ASD group. There was no difference in radiographic parameters of preoperative lumbar lordosis, preoperative paraspinal muscle degeneration, while preoperative adjacent segment disc degeneration were more severe in ASD group than that in N-ASD group. The Logistic regression analysis revealed that, BMI >25 kg/m, preoperative disc degeneration, and superior facet joint

  11. Degenerative myelopathy in dogs

    Directory of Open Access Journals (Sweden)

    Nikolovski Goran

    2010-05-01

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

  12. Research Progress of Pathogenesis in Degenerative Aortic Valvular Disease%主动脉瓣退行性变发病机制的研究进展

    Institute of Scientific and Technical Information of China (English)

    孙静; 王联群

    2013-01-01

    Aortic stenosis caused by degenerative aortic valvular disease has become the most common cause of aortic valve replacement in western countries.A milder form of degenerative aortic valvular disease characterized by stiffening of aortic valve.Even in the absence of a hemodynamically significant obstruction,it is associated with a higher death risk from cardiovascular causes which is increased up to 50 percent.Gradually getting into aging society,it can be expected there will be more and more people suffering from aortic valve degeneration.Degenerative aortic valvular disease is an active process.Hemodynamics,Inflammatory infiltrate,lipid deposition,extracellular matrix remodeling,ossification and genetics are involved in this process.This article reviews that.%主动脉瓣退行性变导致的主动脉瓣狭窄已成为西方国家主动脉瓣置换的最常见原因,该病早期的表现为主动脉瓣硬化.即使在血流动力学没有显著阻塞的情况下,主动脉瓣退行性变造成的心血管原因死亡的风险也增加到50%.我国渐入老龄社会,可以预见将会有更多的人患主动脉瓣退行性变.主动脉瓣退行性变的发病是一个主动的过程,在其发病中有多机制的参与:血流动力学的影响、炎症、脂质沉积、细胞外的基质重构、骨化和遗传学均参与了这一过程,对此做一综述.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. A Study of Spectral Electroretinogram of Color Vision Defects Due to Macular Diseases

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    Studies of spectral electroretinograms in central serous retinopa-thy (CSR) and hereditary macular degeneration (HMD) showed that the b-wave amplitudes of most wavelengths of CSR were significantly decreased as compared with normal controls, and those of HMD were obviously lower than the normal values. Patients of HMD with type-A color vision defects (CVD) had primarily a reduction of b-wave amplitudes in the full spectrum of 480-620 nm, and patients with type- I CVD a reduction of b-wave amplitudes wav...

  15. [Five-component visual analogue scale for assessement of pain status retrospective analysis of outcomes after surgical treatment of degenerative spine disease].

    Science.gov (United States)

    Bikmullin, V N; Klitsenko, O A; Shulev, Iu A; Rychkov, V L; Tsyruleva, O A

    2011-01-01

    The study was performed for development of more precise criteria for assessment of pain using five-component visual analogue scale. Pain status was studied in 493 patients who underwent lumbar spinal nerve root decompression. Pain scale included the following parameters: pain at the moment, usual pain, maximal pain, minimal pain and overall pain score which was calculated as an average quantity of the previous four parameters. Overall pain score is a more precise criterion for evaluation of postoperative pain status in patients with degenerative lumbar spine disease.

  16. Characterization of thoracic motor and sensory neurons and spinal nerve roots in canine degenerative myelopathy, a potential disease model of amyotrophic lateral sclerosis.

    Science.gov (United States)

    Morgan, Brandie R; Coates, Joan R; Johnson, Gayle C; Shelton, G Diane; Katz, Martin L

    2014-04-01

    Canine degenerative myelopathy (DM) is a progressive, adult-onset, multisystem degenerative disease with many features in common with amyotrophic lateral sclerosis (ALS). As with some forms of ALS, DM is associated with mutations in superoxide dismutase 1 (SOD1). Clinical signs include general proprioceptive ataxia and spastic upper motor neuron paresis in pelvic limbs, which progress to flaccid tetraplegia and dysphagia. The purpose of this study was to characterize DM as a potential disease model for ALS. We previously reported that intercostal muscle atrophy develops in dogs with advanced-stage DM. To determine whether other components of the thoracic motor unit (MU) also demonstrated morphological changes consistent with dysfunction, histopathologic and morphometric analyses were conducted on thoracic spinal motor neurons (MNs) and dorsal root ganglia (DRG) and in motor and sensory nerve root axons from DM-affected boxers and Pembroke Welsh corgis (PWCs). No alterations in MNs or motor root axons were observed in either breed. However, advanced-stage PWCs exhibited significant losses of sensory root axons, and numerous DRG sensory neurons displayed evidence of degeneration. These results indicate that intercostal muscle atrophy in DM is not preceded by physical loss of the motor neurons innervating these muscles, nor of their axons. Axonal loss in thoracic sensory roots and sensory neuron death suggest that sensory involvement may play an important role in DM disease progression. Further analysis of the mechanisms responsible for these morphological findings would aid in the development of therapeutic intervention for DM and some forms of ALS.

  17. Research Progress of Lumbar Degenerative Disease%腰椎间盘退变性疾病的研究进展

    Institute of Scientific and Technical Information of China (English)

    乔成钢; 杨学军

    2015-01-01

    As a common spinal diseases, lumbar degenerative disk diease (LDDD) is defined by relevant scholars as the general name of a series of disease which have the clinical manifestation of waist and leg pain caused by degenerative changes of lumbar disc, articular process cartilages and surrounding ligament, and it always results in degenerative lumbar spinal stenosis and spondylolisthesis. Its clinical effect is not good because of complex causes and undefined pathogenesis. This paper reviews the progress of many new technologies such as gene technology and biology which greatly improve the research progress of LDDD in recent years so as to provide reference for clinical study.%LDDD属于临床常见脊柱疾病,相关学者将其定义为,因腰椎间盘与关节突的关节软骨及周围韧带退行性变化所致腰腿疼痛等临床表现一系列疾病总称,多造成退变性腰椎管狭窄、腰椎滑脱等病变。 LDDD病因较为复杂,且尚未明确其发病机制,因而临床未能取得理想疗效。近年来,诸多新技术如基因技术生物学,极大促进了LDDD的研究进展,该研究对其具体进展进行综合论述,以期为临床研究提供参考。

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

    Science.gov (United States)

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

    2014-10-01

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

  19. Association between macular degeneration and mild to moderate chronic kidney disease: A nationwide population-based study.

    Science.gov (United States)

    Chen, Chun-Yu; Dai, Ciou-Sia; Lee, Chin-Chan; Shyu, Yu-Chiau; Huang, Ting-Shuo; Yeung, Ling; Sun, Chi-Chin; Yang, Huang-Yu; Wu, I-Wen

    2017-03-01

    Chronic kidney disease (CKD) and macular degeneration (MD) are 2 grave diseases leading to significant disability secondary to renal failure and blindness. The 2 diseases share not only common risk factors but also similar pathogenic mechanisms to renal and retinal injuries. Previous epidemiological studies indicated association between these 2 diseases. However, this concept is challenged by recent investigations. Patients with mild to moderate CKD (n = 30,696) between January 1, 1995 and December 31, 2005 were selected from the Taiwan National Health Insurance Database. Controls (n = 122,784) were matched by age, gender, diabetes mellitus type 2, and hypertension status (1:4 ratios). The risk of MD was compared between the 2 groups. The mean age of patients was 54.9 ± 15.7 years. The proportion of MD was 2.7% in mild to moderate CKD patients and 1.9% in normal controls (P disease, and peripheral vascular disease, model 2; OR: 1.369; 95% CI: 1.264-1.484; P < 0.001) and all these factors (model 3; OR: 1.320, 95% CI: 1.218-1.431, P < 0.001). This association was consistent in the subanalysis, excluding those patients with diabetic retinopathy. Proper diagnosis and timely intervention should be warranted to retard visual loss of these patients.

  20. Red Grape Skin Polyphenols Blunt Matrix Metalloproteinase-2 and -9 Activity and Expression in Cell Models of Vascular Inflammation: Protective Role in Degenerative and Inflammatory Diseases

    Directory of Open Access Journals (Sweden)

    Nadia Calabriso

    2016-08-01

    Full Text Available Matrix metalloproteinases (MMPs are endopeptidases responsible for the hydrolysis of various components of extracellular matrix. MMPs, namely gelatinases MMP-2 and MMP-9, contribute to the progression of chronic and degenerative diseases. Since gelatinases’ activity and expression are regulated by oxidative stress, we sought to evaluate whether supplementation with polyphenol-rich red grape skin extracts modulated the matrix-degrading capacity in cell models of vascular inflammation. Human endothelial and monocytic cells were incubated with increasing concentrations (0.5–25 μg/mL of Negroamaro and Primitivo red grape skin polyphenolic extracts (NSPE and PSPE, respectively or their specific components (0.5–25 μmol/L, before stimulation with inflammatory challenge. NSPE and PSPE inhibited, in a concentration-dependent manner, endothelial invasion as well as the MMP-9 and MMP-2 release in stimulated endothelial cells, and MMP-9 production in inflamed monocytes, without affecting tissue inhibitor of metalloproteinases (TIMP-1 and TIMP-2. The matrix degrading inhibitory capacity was the same for both NSPE and PSPE, despite their different polyphenolic profiles. Among the main polyphenols of grape skin extracts, trans-resveratrol, trans-piceid, kaempferol and quercetin exhibited the most significant inhibitory effects on matrix-degrading enzyme activities. Our findings appreciate the grape skins as rich source of polyphenols able to prevent the dysregulation of vascular remodelling affecting degenerative and inflammatory diseases.

  1. [Pathogenesis of age-related macular degeneration].

    Science.gov (United States)

    Kaarniranta, Kai; Seitsonen, Sanna; Paimela, Tuomas; Meri, Seppo; Immonen, Ilkka

    2009-01-01

    Age-related macular degeneration is a multiform disease of the macula, the region responsible for detailed central vision. In recent years, plenty of new knowledge of the pathogenesis of this disease has been obtained, and the treatment of exudative macular degeneration has greatly progressed. The number of patients with age-related macular degeneration will multiply in the following decades, because knowledge of mechanisms of development of macular degeneration that could be subject to therapeutic measures is insufficient. Central underlying factors are genetic inheritance, exposure of the retina to chronic oxidative stress and accumulation of inflammation-inducing harmful proteins into or outside of retinal cells.

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

    Science.gov (United States)

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

    2013-03-30

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

  3. Age-related macular degeneration: genetic and environmental factors of disease.

    Science.gov (United States)

    Chen, Yuhong; Bedell, Matthew; Zhang, Kang

    2010-10-01

    Age-related macular degeneration (AMD) is the most common cause of visual impairment among the elderly in developed countries, and its prevalence is thus increasing as the population ages; however, treatment options remain limited because the etiology and pathogenesis of AMD are incompletely defined. Recently, much progress has been made in gene discovery and mechanistic studies, which clearly indicate that AMD involves the interaction of multiple genetic and environmental factors. The identification of genes that have a substantial impact on the risk for AMD is not only facilitating the diagnosis and screening of populations at risk but is also elucidating key molecular pathways of pathogenesis. Pharmacogenetic studies of treatment responsiveness among patients with the "wet" form of AMD are increasingly proving to be clinically relevant; pharmacogenetic approaches hold great promise for both identifying patients with the best chance for vision recovery as well as tailoring individualized therapies.

  4. [Drinking water hardness and chronic degenerative diseases. III. Tumors, urolithiasis, fetal malformations, deterioration of the cognitive function in the aged and atopic eczema].

    Science.gov (United States)

    Donato, F; Monarca, S; Premi, S; Gelatti, U

    2003-01-01

    For several decades a causal relation has been hypothesised between drinking water hardness and cardiovascular and other chronic degenerative diseases in humans. Only recently some epidemiological studies also investigated the association between the concentration of the minerals responsible for the hardness of drinking water (calcium and magnesium) and other chronic diseases. Some case-control studies carried out in Taiwan using aggregated data showed a possible protective effect of water hardness toward the risk of dying from various neoplasms, though more research is needed on the issue, possibly based on individual data, to draw definitive conclusions. There is a substantial evidence that consumption of water with high levels of calcium does not increase, and maybe reduces the risk of developing urinary stones of the most common type in developed countries (calcium oxalate), on the contrary, there is no conclusive evidence on the relation between water hardness and foetal malformations, cognitive functions in old men, diabetes and eczema.

  5. Cancer--a degenerative disorder?

    Science.gov (United States)

    Rew, D A

    1998-10-01

    Cancer is primarily a disease of ageing epithelia, and of ageing individuals. We now possess detailed insights into the changes in cell regulatory genes and DNA repair systems which accumulate with time and which manifest in malignancy. These demonstrate how cancer is frequently characterized by degenerative change in the genotype, from the most subtle base pair mutations to gross aneuploidy, and by deterioration in cell and tissue regulatory control, be it of proliferation, programmed cell death or signalling. Cancer may thus be as much a phenomenon of loss or deterioration of normal genomic control as of the acquisition of new, neoplastic functions. This distinction may be more than semantic, not least because it governs our approach to the search for therapeutic strategies. This essay considers the concept of cancer as a degenerative disease and its implications, and proposes the neologism aldoplasia to describe this phenomenon of cancer biology.

  6. Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 11: interbody techniques for lumbar fusion.

    Science.gov (United States)

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

    2014-07-01

    Interbody fusion techniques have been promoted as an adjunct to lumbar fusion procedures in an effort to enhance fusion rates and potentially improve clinical outcome. The medical evidence continues to suggest that interbody techniques are associated with higher fusion rates compared with posterolateral lumbar fusion (PLF) in patients with degenerative spondylolisthesis who demonstrate preoperative instability. There is no conclusive evidence demonstrating improved clinical or radiographic outcomes based on the different interbody fusion techniques. The addition of a PLF when posterior or anterior interbody lumbar fusion is performed remains an option, although due to increased cost and complications, it is not recommended. No substantial clinical benefit has been demonstrated when a PLF is included with an interbody fusion. For lumbar degenerative disc disease without instability, there is moderate evidence that the standalone anterior lumbar interbody fusion (ALIF) has better clinical outcomes than the ALIF plus instrumented, open PLF. With regard to type of interbody spacer used, frozen allograft is associated with lower pseudarthrosis rates compared with freeze-dried allograft; however, this was not associated with a difference in clinical outcome.

  7. Optimal screw orientation for the fixation of cervical degenerative disc disease using nonlinear C3-T2 multi-level spinal models and neuro-genetic algorithms.

    Science.gov (United States)

    Chang, Ting-Kuo; Hsu, Ching-Chi; Chen, Kuan-Ting

    2015-01-01

    Anterior cervical discectomy and fusion is a common surgical procedure performed to remove a degenerative or herniated disc in cervical spine. Unfortunately, clinical complications of anterior cervical plate (ACP) systems still occur, such as weak fixation stability and implant loosening. Previous researchers have attempted to ameliorate these complications by varying screw orientations, but the screw orientations are mainly determined according to the investigator's experiences. Thus, the aim of this study was to discover the optimal screw orientations of ACP systems to achieve acceptable fixation stability using finite element simulations and engineering algorithms. Three-dimensional finite element models of C3-T2 multi-level segments with an ACP system were first developed to analyze the fixation stability using ANSYS Workbench 14.5. Then, artificial neural networks were applied to create one objective function, and the optimal screw orientations of an ACP system were discovered by genetic algorithms. Finally, the numerical models and the optimization study were validated using biomechanical tests. The results showed that the optimal design of the ACP system had highest fixation stability compared with other ACP designs. The neuro-genetic algorithm has effectively reduced the time and effort required for discovering for the optimal screw orientations of an ACP system. The optimum screw orientation of the ACP system could be successfully discovered, and it revealed excellent fixation stability for the treatment of cervical degenerative disc disease. This study could directly provide the biomechanical rationale and surgical suggestion to orthopedic surgeons.

  8. Evaluation of the Macular, Peripapillary Nerve Fiber Layer and Choroid Thickness Changes in Behçet's Disease with Spectral-Domain OCT.

    Science.gov (United States)

    Ataş, Mustafa; Yuvacı, Isa; Demircan, Süleyman; Güler, Emel; Altunel, Orhan; Pangal, Emine; Göktaş, Altan; Sütbeyaz, Serap; Zararsız, Gökmen

    2014-01-01

    Purpose. To assess the macular, choroid, and peripapillary nerve fiber layer thickness (RNFL) in Behçet's disease (BD) patients with and without ocular involvement by means of optical coherence tomography (OCT) and compare these findings with healthy controls. Design. Eighty patients with BD and 40 healthy controls who were followed up at the Uveitis and Retina Clinic of the Kayseri Research and Education Hospital in Turkey were enrolled in this prospective study. Subjects and Controls. The patients with BD were divided into two groups according to the presence of ocular involvement. Group 1 consisted of 40 eyes of 40 patients with ocular involvement and group 2 consisted of 40 eyes of 40 patients without ocular involvement. Methods. All of the patients and controls underwent macular, choroid, and peripapillary nerve fiber layer thickness analysis with Spectralis domain OCT (Spectralis OCT Heidelberg Engineering, Dossenheim, Germany). Main Outcome Measures. The differences in macular, choroid, and peripapillary nerve fiber layer thicknesses between groups were analyzed statistically. Results. Macular thickness was thinner in patients with BD than in the control group; this result was statistically significant (P = 0.05). There was no statistically significant difference in thickness between RNFL analysis of the patients with BD and control subjects. However, the BD patients with ocular involvement had statistically significant thinning in RNFL compared with BD patients without ocular involvement. Although the choroid was thicker in patients with BD than in the control group, it did not reach a statistically significant level (P = 0.382). Conclusions. BD with ocular involvement may be associated with decreased macular and RNFL thickness measured with spectral-domain OCT.

  9. Evaluation of the Macular, Peripapillary Nerve Fiber Layer and Choroid Thickness Changes in Behçet’s Disease with Spectral-Domain OCT

    Directory of Open Access Journals (Sweden)

    Mustafa Ataş

    2014-01-01

    Full Text Available Purpose. To assess the macular, choroid, and peripapillary nerve fiber layer thickness (RNFL in Behçet’s disease (BD patients with and without ocular involvement by means of optical coherence tomography (OCT and compare these findings with healthy controls. Design. Eighty patients with BD and 40 healthy controls who were followed up at the Uveitis and Retina Clinic of the Kayseri Research and Education Hospital in Turkey were enrolled in this prospective study. Subjects and Controls. The patients with BD were divided into two groups according to the presence of ocular involvement. Group 1 consisted of 40 eyes of 40 patients with ocular involvement and group 2 consisted of 40 eyes of 40 patients without ocular involvement. Methods. All of the patients and controls underwent macular, choroid, and peripapillary nerve fiber layer thickness analysis with Spectralis domain OCT (Spectralis OCT Heidelberg Engineering, Dossenheim, Germany. Main Outcome Measures. The differences in macular, choroid, and peripapillary nerve fiber layer thicknesses between groups were analyzed statistically. Results. Macular thickness was thinner in patients with BD than in the control group; this result was statistically significant (P = 0.05. There was no statistically significant difference in thickness between RNFL analysis of the patients with BD and control subjects. However, the BD patients with ocular involvement had statistically significant thinning in RNFL compared with BD patients without ocular involvement. Although the choroid was thicker in patients with BD than in the control group, it did not reach a statistically significant level (P = 0.382. Conclusions. BD with ocular involvement may be associated with decreased macular and RNFL thickness measured with spectral-domain OCT.

  10. Clinical outcomes of lumbar degenerative disc disease treated with posterior lumbar interbody fusion allograft spacer: a prospective, multicenter trial with 2-year follow-up.

    Science.gov (United States)

    Arnold, Paul M; Robbins, Stephen; Paullus, Wayne; Faust, Stephen; Holt, Richard; McGuire, Robert

    2009-07-01

    The clinical benefits and complications of posterior lumbar interbody fusion (PLIF) have been studied over the past 60 years. In recent years, spine surgeons have had the option of treating low back pain caused by degenerative disc disease using PLIF with machined allograft spacers and posterior pedicle fixation. The purpose of this clinical series was to assess the clinical benefits of using a machined PLIF allograft spacer and posterior pedicle fixation to treat degenerative disc disease, both in terms of fusion rates and patient outcomes, and to compare these results with those in previous studies using autograft and metal interbody fusion devices. Results were also compared with results from studies using transverse process fusion. This prospective, nonrandomized clinical series was conducted at 10 US medical centers. Eighty-nine (55 male, 34 female) patients underwent PLIF with a presized, machined allograft spacer and posterior pedicle fixation between January 2000 and April 2003. Their outcomes were compared with outcomes in previous series described in the literature. All patients had experienced at least 6 months of low back pain that had been unresponsive to nonsurgical treatment. Physical examinations were performed before surgery, after surgery, and at 4 follow-up visits (6 weeks, 6 months, 12 months, 24 months). At each interval, we obtained radiographs and patient outcome measures, including SF-36 Bodily Pain Score, visual analog scale pain rating, and Oswestry Disability Index. The primary outcome was fusion results at 12 and 24 months; the secondary outcomes were pain, disability, function/quality of life, and satisfaction. One-level PLIFs were performed in 65 patients, and 2-level PLIFs in 24 patients. Flexion-extension radiographs at 12 and 24 months revealed a 98% fusion rate. Of the 72 patients who reached the 12-month follow-up, 86% reported decreased pain and disability as measured with the Oswestry Disability Index. Decreased pain as measured

  11. Validity and Reliability of a Measurement of Objective Functional Impairment in Lumbar Degenerative Disc Disease: The Timed Up and Go (TUG) Test.

    Science.gov (United States)

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

    2016-08-01

    There are few objective measures of functional impairment to support clinical decision making in lumbar degenerative disc disease (DDD). We present the validation (and reliability measures) of the Timed Up and Go (TUG) test. In a prospective, 2-center study, 253 consecutive patients were assessed using the TUG test. A representative cohort of 110 volunteers served as control subjects. The TUG test values were assessed for validity and reliability. The TUG test had excellent intra- (intraclass correlation coefficient: 0.97) and interrater reliability (intraclass correlation coefficient: 0.99), with a standard error of measurement of 0.21 and 0.23 seconds, respectively. The validity of the TUG test was demonstrated by a good correlation with the Visual Analog Scale (VAS) back (Pearson's correlation coefficient [PCC]: 0.25) and VAS (PCC: 0.29) leg pain, functional impairment (Roland-Morris Disability Index [PCC: 0.38] and Oswestry Disability Index [PCC: 0.34]), as well as with health-related quality of life (Short Form-12 Mental Component Summary score [PCC: -0.25], Short Form-12 Physical Component Summary score [PCC: -0.32], and EQ-5D [PCC: -0.28]). The upper limit of "normal" was 11.52 seconds. Mild (lower than the 33rd percentile), moderate (33rd to 66th percentiles), and severe objective functional impairment (higher than the 66th percentile) as determined by the TUG test was 18.4 seconds, respectively. The TUG test is a quick, easy-to-use, valid, and reliable tool to evaluate objective functional impairment in patients with lumbar degenerative disc disease. In the clinical setting, patients scoring a TUG test time of over 12 seconds can be considered to have functional impairment. BMI, body mass indexDDD, degenerative disc diseaseHRQOL, health-related quality of lifeICC, intraclass correlationLDH, lumbar disc herniationLSS, lumbar spinal stenosisODI, Oswestry Disability IndexOFI, objective functional impairmentPCC, Pearson's correlation coefficientPCS, Physical

  12. Evaluation of the Macular, Peripapillary Nerve Fiber Layer and Choroid Thickness Changes in Behçet’s Disease with Spectral-Domain OCT

    OpenAIRE

    Mustafa Ataş; İsa Yuvacı; Süleyman Demircan; Emel Güler; Orhan Altunel; Emine Pangal; Altan Göktaş; Serap Sütbeyaz; Gökmen Zararsız

    2014-01-01

    Purpose. To assess the macular, choroid, and peripapillary nerve fiber layer thickness (RNFL) in Behçet’s disease (BD) patients with and without ocular involvement by means of optical coherence tomography (OCT) and compare these findings with healthy controls. Design. Eighty patients with BD and 40 healthy controls who were followed up at the Uveitis and Retina Clinic of the Kayseri Research and Education Hospital in Turkey were enrolled in this prospective study. Subjects and Control...

  13. Adult degenerative and senile degenerative hyperostosis triangularis ilii

    Energy Technology Data Exchange (ETDEWEB)

    Nebel, G.; Hering, L.; Lingg, G.

    1981-10-01

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

  14. Global Transcriptome Analysis of the Tentacle of the Jellyfish Cyanea capillata Using Deep Sequencing and Expressed Sequence Tags: Insight into the Toxin- and Degenerative Disease-Related Transcripts.

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    Guoyan Liu

    Full Text Available Jellyfish contain diverse toxins and other bioactive components. However, large-scale identification of novel toxins and bioactive components from jellyfish has been hampered by the low efficiency of traditional isolation and purification methods.We performed de novo transcriptome sequencing of the tentacle tissue of the jellyfish Cyanea capillata. A total of 51,304,108 reads were obtained and assembled into 50,536 unigenes. Of these, 21,357 unigenes had homologues in public databases, but the remaining unigenes had no significant matches due to the limited sequence information available and species-specific novel sequences. Functional annotation of the unigenes also revealed general gene expression profile characteristics in the tentacle of C. capillata. A primary goal of this study was to identify putative toxin transcripts. As expected, we screened many transcripts encoding proteins similar to several well-known toxin families including phospholipases, metalloproteases, serine proteases and serine protease inhibitors. In addition, some transcripts also resembled molecules with potential toxic activities, including cnidarian CfTX-like toxins with hemolytic activity, plancitoxin-1, venom toxin-like peptide-6, histamine-releasing factor, neprilysin, dipeptidyl peptidase 4, vascular endothelial growth factor A, angiotensin-converting enzyme-like and endothelin-converting enzyme 1-like proteins. Most of these molecules have not been previously reported in jellyfish. Interestingly, we also characterized a number of transcripts with similarities to proteins relevant to several degenerative diseases, including Huntington's, Alzheimer's and Parkinson's diseases. This is the first description of degenerative disease-associated genes in jellyfish.We obtained a well-categorized and annotated transcriptome of C. capillata tentacle that will be an important and valuable resource for further understanding of jellyfish at the molecular level and information

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

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    Liang ZHOU

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

    Objectives Low back pain (LBP), from degenerative lumbar spine disease, represents a significant burden on healthcare resources. Studies worldwide report trends attributable to their country's specific demographics and healthcare system. Considering England's specific medico-socioeconomic conditions, we investigate recent trends in hospital admissions and procedures for LBP, and discuss the implications for the allocation of healthcare resources. Design Retrospective cohort study using Hospital Episode Statistics data relating to degenerative lumbar spine disease in England, between 1999 and 2013. Regression models were used to analyse trends. Outcome measures Trends in the number of admissions and procedures for LBP, mean patient age, gender and length of stay. Results Hospital admissions and procedures have increased significantly over the study period, from 127.09 to 216.16 and from 24.5 to 48.83 per 100 000, respectively, (pTrends in hospital admissions were characterised by a widening gender gap, increasing mean patient age, and decreasing mean hospital stay (pTrends in procedures were characterised by a narrowing gender gap, increasing mean patient age (p=0.014) and decreasing mean hospital stay (pmodels estimate that each hospital admission translates to 0.27 procedures, per 100 000 (95% CI 0.25 to 0.30, r 0.99, ptrends demonstrate an increasing demand for specialists involved in the surgical and non-surgical management of this disease, and highlight the need for services capable of dealing with the increased comorbidity burden associated with an ageing patient group. PMID:26671956

  17. Intravitreal Injection of Dexamethasone Implant in Serous Macular Detachment Associated with Waldenström's Disease

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    Vito Fenicia

    2013-07-01

    Full Text Available Purpose: To evaluate the efficacy of one intravitreal injection of dexamethasone (Ozurdex®; Allergan, Inc., Irvine, Calif., USA in serous macular detachment (SMD of one eye, associated with bilateral central retinal vein occlusion (CRVO in a patient affected by Waldenström's macroglobulinemia (WM. Patients and Methods: A female patient, affected by WM, complained of a progressive decrease in visual acuity, mainly in the left eye (LE. SMD in the LE associated with bilateral CRVO was diagnosed. One intravitreal injection of dexamethasone was administered in the LE and the patient was tested 1, 2, and 6 months after the injection. Results: 1, 2, and 6 months after the injection, the spectral domain optical coherence tomography (SD-OCT showed a progressive slight reduction of foveal thickness that was not related to any improvement of visual function. Conclusions: Treatment with dexamethasone (Ozurdex induced a progressive slight reduction of SMD but no improvement of visual acuity, and it is possible that this is related to the condition of hematic hyperviscosity that is present in WM.

  18. Macular Diplopia.

    Science.gov (United States)

    Shippman, Sara; Cohen, Kenneth R; Heiser, Larissa

    2015-01-01

    Maculopathies affect point-to-point foveal correspondence causing diplopia. The effect that the maculopathies have on the interaction of central sensory fusion and peripheral fusion are different than the usual understanding of treatment for diplopia. This paper reviews the pathophysiology of macular diplopia, describes the binocular pathology causing the diplopia, discusses the clinical evaluation, and reviews the present treatments including some newer treatment techniques.

  19. Serum levels of BMP-2, 4, 7 and AHSG in patients with degenerative joint disease requiring total arthroplasty of the hip and temporomandibular joints.

    Science.gov (United States)

    Albilia, Jonathan B; Tenenbaum, Howard C; Clokie, Cameron M L; Walt, David R; Baker, Gerald I; Psutka, David J; Backstein, David; Peel, Sean A F

    2013-01-01

    To date, there is no objective or reliable means of assessing the severity of degenerative joint disease (DJD) and need for joint replacement surgery. Hence, it is difficult to know when an individual with DJD has reached a point where total arthroplasty is indicated. The purpose of the present study is to determine whether serum levels of Alpha-2 HS-glycoprotein (AHSG) as well as bone morphogenetic proteins (BMP-2, 4, 7) can be used to predict the presence of severe DJD of the hip and/or temporomandibular joint (TMJ) (specifically: joints that require replacement). A total of 30 patients scheduled for arthroplasty (diseased) (15 HIP, 15 TMJ) and 120 age-matched controls (healthy/non-diseased) were included. Blood samples were collected from all patients ≥8 weeks after the last arthroplasty. Concentrations of serum analytes were measured using enzyme-linked immunosorbent assays, and these were compared between the Diseased and Healthy groups, utilizing the Mann-Whitney U-test. Patients with disease had significantly higher levels of BMP-2 and BMP-4 and lower levels of AHSG in serum compared to non-diseased humans (p < 0.01). Higher levels of BMP-2, 4 and reduced levels of AHSG appear to characterize patients who have DJD that is severe enough to require total joint replacement. Perhaps measurements of these proteins can be used to make objective decisions regarding the need for total arthroplasty as opposed to the current subjective approaches.

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Science.gov (United States)

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

    2014-07-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Assessment of the trauma degree and spinal cord function of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    Zheng Bo-long; He Bao-rong; Yang Xiao-bin; Yang Ming; Yan Liang; Bai Xiao-fan; Hao Ding-jun

    2016-01-01

    Objective:To study the trauma degree of para-median minimally invasive and open TLIF for single segmental lumbar degenerative disease and the effect on spinal cord function.Methods:A total of 78 cases of patients with single segmental lumbar disc herniation who received TLIF treatment in our hospital were selected as the research subjects and randomly divided into two groups, minimally invasive group received para-median minimally invasive TLIF and open group received open TLIF. Perioperative serum levels of oxidative stress indicators and pain mediators as well as spinal cord function were compared between two groups.Results: 1 d and 3 d after operation, serum SOD, GSH-Px and SP levels of minimally invasive group were significantly higher than those of open group, and MDA, AOPP, NO,β-EP, PGE2 and CGRP levels were significantly lower than those of open group; 1 week after operation, NCV and DL of common peroneal nerve and tibial nerve of two groups were not different from those before operation; 4 weeks and 16 weeks after operation, NCV of common peroneal nerve and tibial nerve of both groups were higher than those before operation while DL were lower than those before operation, and NCV of common peroneal nerve and tibial nerve of minimally invasive group were significantly higher than those of open group while DL were significantly lower than those of open group.Conclusion:The trauma degree of para-median minimally invasive TLIF for single segmental lumbar degenerative disease is less and the postoperative spinal cord function recovery is more ideal.

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

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    Mo Fred F

    2010-04-01

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

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 148 Predictive Model for Return to Work After Elective Surgery for Lumbar Degenerative Disease: An Analysis From National Neurosurgery Quality Outcomes Database Registry.

    Science.gov (United States)

    Asher, Anthony L; Chotai, Silky; Devin, Clinton J; Archer-Swygert, Kristen; Parker, Scott L; Bydon, Mohamad; Hui, Nian; Harrell, Frank; Speroff, Theodore; Dittus, Robert; Philips, Sharon; Shaffrey, Christopher I; Foley, Kevin T; McGirt, Matthew J

    2016-08-01

    The current costs associated with spine care are unsustainable. The productivity loss and time away from work in gainfully employed patients contributes greatly to the financial burden. Therefore, it is vital to identify the factors associated with returning to work after lumbar spine surgery. We present a predictive model of ability to return to work (RTW) after lumbar spine surgery for degenerative spine disease. Total 4694 patients undergoing elective spine surgery for degenerative lumbar disease who were employed were entered into a prospective multicenter registry (N2QOD). Baseline and 3-month postoperative patient-reported outcomes: Oswestry Disability Index (ODI), EQ-5D, NRS back and leg pain were recorded. The time to RTW was defined as the period between operation time and date of returning to work. A multivariable Cox proportional hazards regression model, including an array of preoperative factors, was fitted for RTW. The model performance was measured by the c-index. Eighty-two percent of patients (n = 3855) returned to work within 3 -months postoperatively. The risk-adjusted predictors of lower likelihood of RTW were preoperatively employed but not working at the time of presentation, those occupied with manual labor, on worker's compensation, on liability insurance, baseline ODI and NRS-BP scores, female sex, African American race, history of diabetes mellitus, and higher ASA grades. The likelihood of RTW within 3 months was higher in patients with higher education level compared with those with less than high school level education. The c-index of our model performance was 0.71. We present a novel predictive model for probability of RTW after lumbar spine surgery. Spine care providers can use this model to educate patients and encourage them in shared decision making regarding the RTW outcome. This will result in better communication between patients and clinicians and improve recovery expectations, which will ultimately increase the likelihood of a

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

    Science.gov (United States)

    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.

  8. Contralateral interlaminar approach for intraforaminal lumbar degenerative disease with special emphasis on L5-S1 level: A technical note

    Science.gov (United States)

    Zekaj, Edvin; Menghetti, Claudia; Saleh, Christian; Isidori, Alessandra; Bona, Alberto R.; Aimar, Enrico; Servello, Domenico

    2016-01-01

    Background: Intraforaminal disc herniations at the L5-S1 level are extremely surgically challenging lesions. Intracanal approaches frequently require partial or total facetectomy, which may lead to instability. Solely extraforaminal approaches may offer limited visualization of the more medial superiorly exiting and inferiorly exiting nerve roots; this approach is also more complicated at L5-S1 due to the often large L5 transverse process and the iliac wing. Methods: Nine patients with intraforaminal L5-S1 disc herniations, foraminal stenosis, or synovial cysts underwent contralateral interlaminar approaches for lesion resection. Preoperative and postoperative visual analog scale scores were evaluated, and complications were reviewed. Results: All 9 patients demonstrated immediate postoperative clinical improvement. None of the patients exhibited complications and none developed instability or neuropathic disorders. Conclusions: Although the number of cases in our sample was very small (9 in total), the contralateral interlaminar approach appeared to effectively address multiple degenerative L5-S1 foraminal pathologies. Large studies are needed to further evaluate the pros and cons of this approach. PMID:27713854

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

    Science.gov (United States)

    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, lumbar spine surgery have significant impact on the short-term PROs. Patients with complications, however, do eventually achieve clinically meaningful outcomes and report satisfaction equivalent to those without major complications. This information allows a physician to

  10. iPS cell modeling of Best disease: insights into the pathophysiology of an inherited macular degeneration.

    Science.gov (United States)

    Singh, Ruchira; Shen, Wei; Kuai, David; Martin, Jessica M; Guo, Xiangrong; Smith, Molly A; Perez, Enio T; Phillips, M Joseph; Simonett, Joseph M; Wallace, Kyle A; Verhoeven, Amelia D; Capowski, Elizabeth E; Zhang, Xiaoqing; Yin, Yingnan; Halbach, Patrick J; Fishman, Gerald A; Wright, Lynda S; Pattnaik, Bikash R; Gamm, David M

    2013-02-01

    Best disease (BD) is an inherited degenerative disease of the human macula that results in progressive and irreversible central vision loss. It is caused by mutations in the retinal pigment epithelium (RPE) gene BESTROPHIN1 (BEST1), which, through mechanism(s) that remain unclear, lead to the accumulation of subretinal fluid and autofluorescent waste products from shed photoreceptor outer segments (POSs). We employed human iPS cell (hiPSC) technology to generate RPE from BD patients and unaffected siblings in order to examine the cellular and molecular processes underlying this disease. Consistent with the clinical phenotype of BD, RPE from mutant hiPSCs displayed disrupted fluid flux and increased accrual of autofluorescent material after long-term POS feeding when compared with hiPSC-RPE from unaffected siblings. On a molecular level, RHODOPSIN degradation after POS feeding was delayed in BD hiPSC-RPE relative to unaffected sibling hiPSC-RPE, directly implicating impaired POS handling in the pathophysiology of the disease. In addition, stimulated calcium responses differed between BD and normal sibling hiPSC-RPE, as did oxidative stress levels after chronic POS feeding. Subcellular localization, fractionation and co-immunoprecipitation experiments in hiPSC-RPE and human prenatal RPE further linked BEST1 to the regulation and release of endoplasmic reticulum calcium stores. Since calcium signaling and oxidative stress are critical regulators of fluid flow and protein degradation, these findings likely contribute to the clinical picture of BD. In a larger context, this report demonstrates the potential to use patient-specific hiPSCs to model and study maculopathies, an important class of blinding disorders in humans.

  11. Are degenerative rotator cuff disorders a cause of shoulder pain? Comparison of prevalence of degenerative rotator cuff disease to prevalence of nontraumatic shoulder pain through three systematic and critical reviews.

    Science.gov (United States)

    Vincent, Karl; Leboeuf-Yde, Charlotte; Gagey, Olivier

    2017-05-01

    The role of degeneration is not well understood for rotator cuff pain. If age-related degenerative changes would be the cause of symptoms, degeneration would precede or concur with self-reported pain. We performed 3 systematic literature reviews. Our objectives were to determine the prevalence estimates for rotator cuff partial or complete tears (1) in cadavers and (2) in the general population and (3) to estimate the incidence/prevalence of self-reported nontraumatic shoulder pain in the general population in order to compare their respective age-related profiles. We searched PubMed and ScienceDirect, including 2015, for cadaveric studies and transverse and longitudinal studies of the general population reporting the incidence/prevalence of rotator cuff disorders or nontraumatic shoulder pain, or both, according to age. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Results were interpreted visually. We found 6 cadaveric studies, 2 studies from the general population reporting complete tears, and 10 articles on nontraumatic shoulder pain in the general population that met our criteria. The profiles of degeneration vs. pain were very similar in early years. Although degenerative rotators cuff lesions increased gradually after 50 years, the incidence/prevalence of nontraumatic shoulder pain decreased after 65 years. The profile of age-related degenerative rotator cuff disorders fails to correlate systematically with self-reported nontraumatic shoulder pain, particularly in older age; thus, it appears that degeneration should not be considered the primary source of the pain. Physical activity may play an important role in the production of the pain, a theory that warrants further study. Copyright © 2017. Published by Elsevier Inc.

  12. 腰椎退行性疾病椎旁肌的渐进变化%Change of paravertebral muscle in patients with lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    乔培柳; 塔依尔·阿不都哈德尔

    2014-01-01

    BACKGROUND:Lumbar paravertebral muscles play an important role for lumbar spinal stability. Increasing studies emphasize on the change of paravertebral muscles in patients with lumbar degenerative disease and therefore have important clinical significance for the rehabilitation training of paravertebral muscle in patients with lumbar degenerative disease. OBJECTIVE:To review the research progress of the change of paravertebral muscle in patients with lumbar degenerative disease and to look into the future development prospects. METHODS:A computer-based online search of PubMed and WANFANG DATA between 1986 and 2014 was performed with the key words“lumbar vertebra, paravertebral muscle, psoas major, multifidus muscle, cross sectional area, muscle atrophy, fatty infiltration, muscle biopsy, MRI, electromyography”in English and Chinese, respectively. The clinical and experimental studies addressing the changes of paravertebral muscle in patients with lumbar degenerative disease were included. According to the inclusion and exclusion criteria, 48 literatures were included into the final analysis, 8 Chinese and 40 English. RESULTS AND CONCLUSION:The change of paravertebral muscle in patients with lumbar degenerative disease includes muscle atrophy and fatty infiltration. The changes of paravertebral muscles are often detected with B-ultrasound, CT, MRI, EMG and muscle biopsy. Due to the differences of sample size, age and study method, there are different results, even conflicting. So some limitations of sample size, age and study method are needed to obtain accurate results. In addition, further studies wil focus on the verification of which nerve specifical y dominants lumbar paravertebral muscles.%背景:腰部椎旁肌对于腰椎稳定具有重要作用,关于腰椎退行性疾病患者椎旁肌改变的研究越来越多,此类研究对于腰椎椎旁肌康复训练具有重要临床意义。  目的:综述腰椎退行性疾病椎旁肌变化的

  13. 椎间盘退行性疾病生物治疗研究的进展%Advances in biotherapies for the treatment of degenerative disc diseases

    Institute of Scientific and Technical Information of China (English)

    何守玉; 邱勇

    2013-01-01

    Degenerative disc disease ( DDD ) is one of the leading causes of low back pain in the adult population, and the surgical treatment is known as the gold standard for such diseases. A large percentage of patients are relieved after undergoing disc resection and spinal fusion. Older patients who are easily to suffer from DDDs have limited tolerance of the surgical treatment. And meanwhile, there are some surgical risks and complications. In some researches, it is found that DDDs occur when the cells of intervertebral disc die or become dysfunctional. Therefore, there is a great clinical need for biotherapies to alleviate pain associated with DDDs. In the past decade, the number of treatment methods for DDDs has dramatically increased due to the advances in biologicals and biomaterials and the deepened understanding of the spinal physiology and pathology. In this article, advances in biotherapies used for treating DDDs in recent years are mainly reviewed, including cell therapy, bioactive factor therapy, gene therapy and the technique of intervertebral disc tissue engineering scaffold. As some of these methods are still in experimental phases, defects and limitations of each biotherapy are noted in this review. Finally, the research direction and challenge of biotherapies for the treatment of DDDs in the next few years are proposed.

  14. 改良TLIF治疗腰椎退变性疾病%Modified transforaminal lumbar interbody fusion for the treatment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    荣树; 马兆钦

    2011-01-01

    目的 探讨改良TLIF治疗腰椎退变性疾病的疗效.方法 用改良TLIF手术治疗L~S退变性疾病患者24例,共融合40个节段,其中单节段8例,双节段16例.男14例,女lO例;年龄56~78岁,平均64.6岁.退变性滑脱伴椎管狭窄6例,峡不连性滑脱4例,退变性腰椎管狭窄症10例,巨大椎间盘脱出合并椎间失稳4例.术中根据病情需要,采用椎管扩大减压后切除整个下关节突,切除上关节突上部的内侧半,部分开放椎间孔后壁,椎间隙自体微粒骨打压植骨,Cage斜向中线40.方向植入椎间隙,辅以椎弓根螺钉固定完成改良TLIF.结果 术中无并发症发生,24例均获得随访,时间12~20个月,平均17.4个月.所有患者于术后1年随访时均达椎体间融合,无螺钉断裂和Cage移位、沉陷.10例腰椎滑脱者滑脱完全复位并维持良好.根据JOA评分法,本组术前(13.8±4.1)分,末次随访时(24.9±3.0)分,临床改善程度达优16例,良6例,可2例,平均改善率79.5%.结论 改良TLIF扩大了手术适应证,贯彻了TLIF技术的设计思想和微创理念,使操作更加简单、安全,用于下腰椎退变性疾患的治疗效果满意.%Objective To analyze the clinical effects Of modified transforaminal lumbar interbody fusion (TLIF)for the treatment of lumbar degenerative disease. Mothods 24 patients with lumbar degenerative disease (L3-S1) were treated by modified TLIF. There were 14 males and 10 females with an average age of 64.6years(56~78years). A total of 40 levels were fused, including 8 cases of single level and 16 cases of double levels. The results of preoperative diagnosis were lumbar degenerative spondylolisthesis with stenosis (6cases), isthmic spondylolisthesis (4cases), degenerative lumbar stenosis (10cases), huge herniated disc with segmental instability (4cases). During the modified TLIF procedure, total inferior facet process and inner half summit of superior facet process of TLIF side were resected to make the

  15. Effect of hemodialysis on visual acuity, intraocular pressure, and macular thickness in patients with chronic kidney disease

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    Chelala E

    2015-01-01

    Full Text Available Elias Chelala,1,2,* Ali Dirani,1,2,* Ali Fadlallah,1,2 Elise Slim,1,2 Youssef Abdelmassih,1,2 Henry Fakhoury,3 Patrick Baz,1,2 Riad Bejjani1,2 1Faculty of Medicine, Saint-Joseph University, 2Hôtel-Dieu de France Hospital, Saint-Joseph University, 3Eye and Ear Hospital, Beirut, Lebanon *These two authors contributed equally to this work Background: The aim of this study was to evaluate the effects of hemodialysis (HD on visual acuity, intraocular pressure (IOP, and central foveal thickness (CFT in patients with chronic kidney disease.Materials and methods: Forty-nine eyes from 49 chronic kidney-disease patients were analyzed. Causes of chronic kidney disease included diabetes mellitus (n=9 patients, hypertensive nephrosclerosis (n=15 patients, and other causes (n=25 patients. All patients underwent HD in the Dialysis Unit of Hôtel-Dieu de France Hospital. Best-corrected visual acuity, CFT, and IOP were evaluated before and after HD. CFT was measured with spectral domain optical coherence tomography, and IOP was measured with Goldmann applanation tonometry.Results: Neither decimal best-corrected visual acuity (pre-HD 0.71±0.32, post-HD 0.72±0.31; P=0.877 nor CFT (pre-HD 251.39±39.29, post-HD 253.09±39.26; P=0.272 significantly changed after HD. However, mean IOP significantly decreased from 13.99±2.48 before HD to 12.65±2.41 mmHg after HD (P=0.001. IOP change was significantly correlated with serum albumin levels (P=0.008 and weight changes (P=0.047.Conclusion: HD can affect various ocular parameters. This is particularly true of IOP, which decreases significantly following HD. Keywords: chronic kidney disease, hemodialysis, visual acuity, central macular thickness, intraocular pressure

  16. Twelve-Month Follow-Up of Dexamethasone Implants for Macular Edema from Various Diseases in Vitrectomized and Nonvitrectomized Eyes

    Science.gov (United States)

    Filho, Paulo Augusto de Arruda Mello; Dias, João Rafael de Oliveira; de Andrade, Gabriel C.; Louzada, Ricardo N.; Ávila, Marcos; Berrocal, Maria; Farah, Michel

    2016-01-01

    Purpose. To evaluate the best-corrected visual acuity (BCVA), central retinal thickness (CRT), and the number of dexamethasone implants needed to treat cystoid macular edema (CME) from various etiologies over 12 months in vitrectomized and nonvitrectomized eyes. Methods. This multicenter retrospective cohort study included 112 patients with CME secondary to retinal diseases treated pro re nata (PRN) with a 0.7 mg intravitreal dexamethasone implant for 12 months. The BCVA, CRT, adverse events, safety data, and number of implants were recorded. Results. Vitrectomized and nonvitrectomized eyes received means of three implants and one implant, respectively, over 12 months (P < 0.001). The mean BCVA of all patients improved from 0.13 at baseline to 0.33 (P < 0.001) 12 months after one (P = 0.001), two (P = 0.041), and three (P < 0.001) implants but not four implants (P = 0.068). The mean baseline CRT decreased significantly (P < 0.001) from 463 to 254 microns after 12 months with one (P < 0.001), two (P = 0.002), and three (P = 0.001) implants but not with four implants (P = 0.114). The anatomic and functional outcomes were not significantly different between vitrectomized and nonvitrectomized eyes. Increased IOP was the most common adverse event (23.2%). Conclusions. Dexamethasone implant administered PRN improved VA and decreased CRT in CME, with possible long-term clinically relevant benefits for treating CME from various etiologies. Vitrectomized eyes needed more implants compared with nonvitrectomized eyes. PMID:27721989

  17. Twelve-Month Follow-Up of Dexamethasone Implants for Macular Edema from Various Diseases in Vitrectomized and Nonvitrectomized Eyes

    Directory of Open Access Journals (Sweden)

    Eduardo A. Novais

    2016-01-01

    Full Text Available Purpose. To evaluate the best-corrected visual acuity (BCVA, central retinal thickness (CRT, and the number of dexamethasone implants needed to treat cystoid macular edema (CME from various etiologies over 12 months in vitrectomized and nonvitrectomized eyes. Methods. This multicenter retrospective cohort study included 112 patients with CME secondary to retinal diseases treated pro re nata (PRN with a 0.7 mg intravitreal dexamethasone implant for 12 months. The BCVA, CRT, adverse events, safety data, and number of implants were recorded. Results. Vitrectomized and nonvitrectomized eyes received means of three implants and one implant, respectively, over 12 months (P<0.001. The mean BCVA of all patients improved from 0.13 at baseline to 0.33 (P<0.001 12 months after one (P=0.001, two (P=0.041, and three (P<0.001 implants but not four implants (P=0.068. The mean baseline CRT decreased significantly (P<0.001 from 463 to 254 microns after 12 months with one (P<0.001, two (P=0.002, and three (P=0.001 implants but not with four implants (P=0.114. The anatomic and functional outcomes were not significantly different between vitrectomized and nonvitrectomized eyes. Increased IOP was the most common adverse event (23.2%. Conclusions. Dexamethasone implant administered PRN improved VA and decreased CRT in CME, with possible long-term clinically relevant benefits for treating CME from various etiologies. Vitrectomized eyes needed more implants compared with nonvitrectomized eyes.

  18. Complement factor H and age-related macular degeneration: the role of glycosaminoglycan recognition in disease pathology.

    Science.gov (United States)

    Clark, Simon J; Bishop, Paul N; Day, Anthony J

    2010-10-01

    AMD (age-related macular degeneration) is the major cause of blindness in the western world, associated with the formation of extracellular deposits called drusen in the macula, i.e. the central region of the retina. These drusen contain cellular debris and proteins, including components of the complement system such as the regulator CFH (complement factor H); dysregulation of complement is thought to play a major role in the development of AMD. CFH acts through its capacity to recognize polyanionic structures [e.g. sulfated GAGs (glycosaminoglycans)] found on host tissues, and thereby inactivates any C3b that becomes deposited. Importantly, a common polymorphism in CFH (Y402H) has been strongly associated with an increased risk of AMD. This polymorphism, which causes a tyrosine to histidine coding change, has been shown to alter the binding of CFH to sulfated GAGs, as well as to other ligands including C-reactive protein, necrotic cells and bacterial coat proteins. Of these, the change in the GAG-recognition properties of CFH is likely to be of most significance to AMD. Recent research has revealed that the disease-associated 402H allotype interacts less well (compared with 402Y) with binding sites within the macula (e.g. Bruch's membrane), where the GAGs heparan sulfate and dermatan sulfate play a major role in mediating the interaction with CFH. Reduced binding of the 402H allotype could result in impaired regulation of complement leading to chronic local inflammation that may contribute to the accumulation of drusen and thus the initiation, development and progression of AMD.

  19. An analysis from the Quality Outcomes Database, Part 2. Predictive model for return to work after elective surgery for lumbar degenerative disease.

    Science.gov (United States)

    Asher, Anthony L; Devin, Clinton J; Archer, Kristin R; Chotai, Silky; Parker, Scott L; Bydon, Mohamad; Nian, Hui; Harrell, Frank E; Speroff, Theodore; Dittus, Robert S; Philips, Sharon E; Shaffrey, Christopher I; Foley, Kevin T; McGirt, Matthew J

    2017-10-01

    OBJECTIVE Current costs associated with spine care are unsustainable. Productivity loss and time away from work for patients who were once gainfully employed contributes greatly to the financial burden experienced by individuals and, more broadly, society. Therefore, it is vital to identify the factors associated with return to work (RTW) after lumbar spine surgery. In this analysis, the authors used data from a national prospective outcomes registry to create a predictive model of patients' ability to RTW after undergoing lumbar spine surgery for degenerative spine disease. METHODS Data from 4694 patients who underwent elective spine surgery for degenerative lumbar disease, who had been employed preoperatively, and who had completed a 3-month follow-up evaluation, were entered into a prospective, multicenter registry. Patient-reported outcomes-Oswestry Disability Index (ODI), numeric rating scale (NRS) for back pain (BP) and leg pain (LP), and EQ-5D scores-were recorded at baseline and at 3 months postoperatively. The time to RTW was defined as the period between operation and date of returning to work. A multivariable Cox proportional hazards regression model, including an array of preoperative factors, was fitted for RTW. The model performance was measured using the concordance index (c-index). RESULTS Eighty-two percent of patients (n = 3855) returned to work within 3 months postoperatively. The risk-adjusted predictors of a lower likelihood of RTW were being preoperatively employed but not working at the time of presentation, manual labor as an occupation, worker's compensation, liability insurance for disability, higher preoperative ODI score, higher preoperative NRS-BP score, and demographic factors such as female sex, African American race, history of diabetes, and higher American Society of Anesthesiologists score. The likelihood of a RTW within 3 months was higher in patients with higher education level than in those with less than high school

  20. Correlations Between Macular, Skin, and Serum Carotenoids

    Science.gov (United States)

    Conrady, Christopher D.; Bell, James P.; Besch, Brian M.; Gorusupudi, Aruna; Farnsworth, Kelliann; Ermakov, Igor; Sharifzadeh, Mohsen; Ermakova, Maia; Gellermann, Werner; Bernstein, Paul S.

    2017-01-01

    Purpose Ocular and systemic measurement and imaging of the macular carotenoids lutein and zeaxanthin have been employed extensively as potential biomarkers of AMD risk. In this study, we systematically compare dual wavelength retinal autofluorescence imaging (AFI) of macular pigment with skin resonance Raman spectroscopy (RRS) and serum carotenoid levels in a clinic-based population. Methods Eighty-eight patients were recruited from retina and general ophthalmology practices from a tertiary referral center and excluded only if they did not have all three modalities tested, had a diagnosis of macular telangiectasia (MacTel) or Stargardt disease, or had poor AFI image quality. Skin, macular, and serum carotenoid levels were measured by RRS, AFI, and HPLC, respectively. Results Skin RRS measurements and serum zeaxanthin concentrations correlated most strongly with AFI macular pigment volume under the curve (MPVUC) measurements up to 9° eccentricity relative to MPVUC or rotationally averaged macular pigment optical density (MPOD) measurements at smaller eccentricities. These measurements were reproducible and not significantly affected by cataracts. We also found that these techniques could readily identify subjects taking oral carotenoid-containing supplements. Conclusions Larger macular pigment volume AFI and skin RRS measurements are noninvasive, objective, and reliable methods to assess ocular and systemic carotenoid levels. They are an attractive alternative to psychophysical and optical methods that measure MPOD at a limited number of eccentricities. Consequently, skin RRS and MPVUC at 9° are both reasonable biomarkers of macular carotenoid status that could be readily adapted to research and clinical settings. PMID:28728169

  1. Could astrocytes be the primary target of an offending agent causing the primary degenerative diseases of the human central nervous system? A hypothesis.

    Science.gov (United States)

    Sica, Roberto E

    2015-05-01

    Most of the named primary degenerative diseases of the human central nervous system have been attributed to a direct, primary damage of some particular population of neurons. Within the spectrum of these illnesses there are disorders like amyotrophic lateral sclerosis, fronto-temporal dementia, Alzheimer's dementia, Parkinson's disease, Huntington's dementia and cerebellar ataxias affecting exclusively the human species. In the last years it has been shown that non-neural cells, mainly astrocytes, have a crucial role in the starting and development of these diseases. We suggest that the causative agent of these illnesses gets home first within the astrocytes, rather than the neurons, making them sick by modifying the structure of some proteins; from these cells the abnormal process would start a trip to other astrocytes having the same genetic, metabolic, structural and functional profiles that the originally affected astrocytes have, going through the gap junctions which connect that particular population devoted to a particular set of neurons. This appears to be a likely hypothesis because the astrocytes related to a defined population of neurons have their own, private properties and characteristics needed to support one particular set of neurons performing a defined function, making them a different and unique population, a fact which would limit the spreading of the disease to those astrocytes, sparing other astrocyte populations which do not share those characteristics. If this were the mechanism underlying these illnesses, the neurons, which their health depends on those astrocytes, would be deprived of their patronage and would start all the changes that characterizes a programmed cell death, and the clinical manifestations of a defined pathology would consequently appear. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. 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

    Institute of Scientific and Technical Information of China (English)

    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

  3. Ranibizumab for the treatment of degenerative ocular conditions

    Directory of Open Access Journals (Sweden)

    Triantafylla M

    2014-06-01

    Full Text Available Magdalini Triantafylla,1 Horace F Massa,2 Doukas Dardabounis,1 Zisis Gatzioufas,2 Vassilios Kozobolis,1 Konstantinos Ioannakis,1 Irfan Perente,1,3 Georgios D Panos1,21Department of Ophthalmology, University General Hospital of Alexandroupolis, School of Medicine, University of Thrace, Alexandroupolis, Greece; 2Department of Ophthalmology, Geneva University Hospitals, Faculty of Medicine, University of Geneva, Switzerland; 3Beyoglou Eye Research and Teaching Hospital, Istanbul University, Istanbul, TurkeyAbstract: Degenerative ocular conditions, such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and myopic degeneration, have become a major public health problem and a leading cause of blindness in developed countries. Anti-vascular endothelial growth factor (VEGF drugs seem to be an effective and safe treatment for these conditions. Ranibizumab, a humanized monoclonal antibody antigen-binding fragment, which inhibits all biologically active isoforms of VEGF-A, is still the gold standard treatment for the majority of these pathological entities. In this review, we present the results of the most important clinical trials concerning the efficacy and safety of ranibizumab for the treatment of degenerative ocular conditions.Keywords: age-related macular degeneration, diabetic macular edema, retinal vein occlusion, anti-VEGF, safety, efficacy, quality of life

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

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

    2014-07-01

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

  6. Combined use of platelet rich plasma & micro-fat in sport and race horses with degenerative joint disease: preliminary clinical study in eight horses.

    Science.gov (United States)

    Bembo, Fabrizio; Eraud, Julia; Philandrianos, Cecile; Bertrand, Baptiste; Silvestre, Alain; Veran, Julie; Sabatier, Florence; Magalon, Guy; Magalon, Jeremy

    2016-01-01

    To assess the safety and potential efficacy of a standardized technique consisting of intra-articular injection of 10 cc of a homogeneous mixed product using autologous micro-fat and platelet rich plasma (PRP) (ratio 1:1) in the carpus or the fetlock joint of sport horses presenting degenerative joint disease (DJD). Eight sport horses with DJD confirmed by radiography and ultrasonography and causing lameness and the impossibility to compete were treated. PRP was prepared after a double centrifugation whereas micro-fat was harvested and purified using a closed system. The two products were connected and mixed by gentle back and forth shaking of the syringes to finally obtain 10 ml of an homogeneous mixed product. Follow up was performed from 5 to 10 months with assessment of AAEP lameness score and return to training and competition. Nine joints were treated with significant improvement of the AAEP lameness score three months after the procedure (p = 0.021). Four horses returned to official competition between 5 to 10 months after the procedure (7.0±2.5) and three of them resumed intensive training between 5 to 9 months (6.3±2.3). No adverse event occurred. This study is a first step in the development of innovative therapy for DJD which combines the potential chondrogenic differentiation of MSCs inside equine adipose tissue with the proliferative effect of growth factors present in PRP.

  7. Radiographic results of single level transforaminal lumbar interbody fusion in degenerative lumbar spine disease: focusing on changes of segmental lordosis in fusion segment.

    Science.gov (United States)

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

    2009-12-01

    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. 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. The segmental lordosis increased significantly after surgery but decreased at the final follow-up. Compared to the preoperative values, the segmental lordosis did not change significantly at the final follow-up. Whole lumbar lordosis at the final follow-up was significantly higher than the preoperative values. The disc height was significantly higher in after surgery than before surgery (p = 0.000) and the disc height alter surgery and at the final follow-up was similar. When performing TLIF, careful surgical techniques and attention are needed to restore and maintain the segmental lordosis at the fusion level.

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

    Directory of Open Access Journals (Sweden)

    Alan C. Breen

    2012-01-01

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

  9. Segmental mobility, disc height and patient-reported outcomes after surgery for degenerative disc disease: a prospective randomised trial comparing disc replacement and multidisciplinary rehabilitation.

    Science.gov (United States)

    Johnsen, L G; Brinckmann, P; Hellum, C; Rossvoll, I; Leivseth, G

    2013-01-01

    This prospective multicentre study was undertaken to determine segmental movement, disc height and sagittal alignment after total disc replacement (TDR) in the lumbosacral spine and to assess the correlation of biomechanical properties to clinical outcomes.A total of 173 patients with degenerative disc disease and low back pain for more than one year were randomised to receive either TDR or multidisciplinary rehabilitation (MDR). Segmental movement in the sagittal plane and disc height were measured using distortion compensated roentgen analysis (DCRA) comparing radiographs in active flexion and extension. Correlation analysis between the range of movement or disc height and patient-reported outcomes was performed in both groups. After two years, no significant change in movement in the sagittal plane was found in segments with TDR or between the two treatment groups. It remained the same or increased slightly in untreated segments in the TDR group and in this group there was a significant increase in disc height in the operated segments. There was no correlation between segmental movement or disc height and patient-reported outcomes in either group.In this study, insertion of an intervertebral disc prosthesis TDR did not increase movement in the sagittal plane and segmental movement did not correlate with patient-reported outcomes. This suggests that in the lumbar spine the movement preserving properties of TDR are not major determinants of clinical outcomes.

  10. Posterior Transpedicular Dynamic Stabilization versus Total Disc Replacement in the Treatment of Lumbar Painful Degenerative Disc Disease: A Comparison of Clinical Results

    Directory of Open Access Journals (Sweden)

    Tunc Oktenoglu

    2013-01-01

    Full Text Available Study Design. Prospective clinical study. Objective. This study compares the clinical results of anterior lumbar total disc replacement and posterior transpedicular dynamic stabilization in the treatment of degenerative disc disease. Summary and Background Data. Over the last two decades, both techniques have emerged as alternative treatment options to fusion surgery. Methods. This study was conducted between 2004 and 2010 with a total of 50 patients (25 in each group. The mean age of the patients in total disc prosthesis group was 37,32 years. The mean age of the patients in posterior dynamic transpedicular stabilization was 43,08. Clinical (VAS and Oswestry and radiological evaluations (lumbar lordosis and segmental lordosis angles of the patients were carried out prior to the operation and 3, 12, and 24 months after the operation. We compared the average duration of surgery, blood loss during the surgery and the length of hospital stay of both groups. Results. Both techniques offered significant improvements in clinical parameters. There was no significant change in radiologic evaluations after the surgery for both techniques. Conclusion. Both dynamic systems provided spine stability. However, the posterior dynamic system had a slight advantage over anterior disc prosthesis because of its convenient application and fewer possible complications.

  11. [A scale for measuring symptoms related to degenerative diseases of the cervical spine. A reference in determining indications and evaluating surgical outcome].

    Science.gov (United States)

    Koller, M; Kienapfel, H; Hinder, D; Sabau, E; Wingert, G; Pfeiffer, M; Griss, P; Lorenz, W

    1999-11-01

    A scale for measuring symptoms related to degenerative diseases of the cervical spine is presented. Twenty typical symptoms are listed, e. g., neck pain, dysesthesia, and reduced mobility. Responses are assessed via a 6-point scaling ("did not have symptom" - "had symptom and suffered very strongly".) The cervical spine scale was tested in three samples: patients having undergone cervical spine surgery (n = 70), patients with other orthopedic diagnoses (n = 104), and healthy students (n = 100). The single items of the scale were aggregated into four scores: total number of symptoms, degree of overall symptom distress, functional disability, and pain/psychological distress. Statistical analyses proved the high reliability (Cronbach's alpha = 0.85 to 0.95) and validity (content, convergent, discriminant) of all scores. The scale differs clearly between cervical spine patients, other orthopedic patients and healthy individuals, and between cervical spine patients with different subjective operative outcomes. For applied clinical purposes the cervical spine scale can be included in a quality of life profile (QL-profile); this allows for a readily understandable graphic depiction of individual patients' QL-status.

  12. Why AMD is a disease of ageing and not of development: mechanisms and insights

    Directory of Open Access Journals (Sweden)

    Kaushal eSharma

    2014-07-01

    Full Text Available Age related macular degeneration (AMD is retinal degenerative disorder which starts with the progression of age. Metabolism plays important role in initiation of ageing related diseases. The cholesterol metabolism components and their oxidized products like 7-ketocholesterol have been shown impact on RPE cells degeneration. These molecules can initiate the mitochondrial apoptotic process and also influenced the complements factors and expression of angiogenic proteins like VEGF etc. In this review we have suggested that AMD is ageing disorder not developmental which has been substantiated with disrupted cholesterol metabolism as described in several age related degenerative diseases.

  13. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Eye ... What Is Macular Edema? Dec. 01, 2010 Macular ...

  14. [Clinical and diagnostic considerations on degenerative spino-cerebellar diseases. A clinical and instrumental description of 2 cases].

    Science.gov (United States)

    Trebini, F; Appiotti, A; Scarzella, G

    1990-11-01

    Two cases of spino-cerebellar heredoataxia are reported. The first patient, aged 18, presented the clinical peculiarities of Friedreich's disease; subjected to encephalic CT and encephalomedullary NMR the proved normal; EMG study and visual, acoustic and somatosensorial evoked potentials were not normal but there was nothing specifically wrong. The second patient, aged 30, followed up for more than 10 years, presented the clinical aspects of Pierre Marie disease; stress is laid on encephalic CT examinations carried out at the age of 20 and 30. These were pathological due to the marked dilatation of the IVth ventricle and the basal cisternae; evoked potential changes were aspecific. The nosography is discussed, especially as regards clinical diagnosis, in the absence of typical neuroradiological or other instrumental aspects and, obviously, in the absence of anatomopathological signs.

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

    Science.gov (United States)

    Petruţiu, S A; Buiga, Petronela; Roman, Alexandra; Danciu, Theodora; Mihu, Carmen Mihaela; Mihu, D

    2012-01-01

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

  16. Age-Related Macular Degeneration and the Incidence of Cardiovascular Disease: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Wu, Juan; Uchino, Miki; Sastry, Srinivas M.; Schaumberg, Debra A.

    2014-01-01

    Importance Research has indicated some shared pathogenic mechanisms between age-related macular degeneration (AMD) and cardiovascular disease (CVD). However, results from prior epidemiologic studies have been inconsistent as to whether AMD is predictive of future CVD risk. Objective To systematically review population-based cohort studies of the association between AMD and risk of total CVD and CVD subtypes, coronary heart disease (CHD) and stroke. Data Sources A systematic search of the PubMed and EMBASE databases and reference lists of key retrieved articles up to December 20, 2012 without language restriction. Data Extraction Two reviewers independently extracted data on baseline AMD status, risk estimates of CVD and methods used to assess AMD and CVD. We pooled relative risks using random or fixed effects models as appropriate. Results Thirteen cohort studies (8 prospective and 5 retrospective studies) with a total of 1,593,390 participants with 155,500 CVD events (92,039 stroke and 62,737 CHD) were included in this meta-analysis. Among all studies, early AMD was associated with a 15% (95% CI, 1.08–1.22) increased risk of total CVD. The relative risk was similar but not significant for late AMD (RR, 1.17; 95% CI, 0.98–1.40). In analyses restricted to the subset of prospective studies, the risk associated with early AMD did not appreciably change; however, there was a marked 66% (95% CI, 1.31–2.10) increased risk of CVD among those with late AMD. Conclusion Whereas the results from all cohort studies suggest that both early and late AMD are predictive of a small increase in risk of future CVD, subgroup analyses limited to prospective studies demonstrate a markedly increased risk of CVD among people with late AMD. Retrospective studies using healthcare databases may have inherent methodological limitations that obscure such association. Additional prospective studies are needed to further elucidate the associations between AMD and specific CVD outcomes

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

    Science.gov (United States)

    Ames, Bruce N.

    2006-01-01

    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. Can Vitamin A be Improved to Prevent Blindness due to Age-Related Macular Degeneration, Stargardt Disease and Other Retinal Dystrophies?

    Science.gov (United States)

    Saad, Leonide; Washington, Ilyas

    2016-01-01

    We discuss how an imperfect visual cycle results in the formation of vitamin A dimers, thought to be involved in the pathogenesis of various retinal diseases, and summarize how slowing vitamin A dimerization has been a therapeutic target of interest to prevent blindness. To elucidate the molecular mechanism of vitamin A dimerization, an alternative form of vitamin A, one that forms dimers more slowly yet maneuvers effortlessly through the visual cycle, was developed. Such a vitamin A, reinforced with deuterium (C20-D3-vitamin A), can be used as a non-disruptive tool to understand the contribution of vitamin A dimers to vision loss. Eventually, C20-D3-vitamin A could become a disease-modifying therapy to slow or stop vision loss associated with dry age-related macular degeneration (AMD), Stargardt disease and retinal diseases marked by such vitamin A dimers. Human clinical trials of C20-D3-vitamin A (ALK-001) are underway.

  19. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... Edema Treatment What Is Macular Edema? Leer en Español: ¿Qué Es un Edema Macular? Dec. 01, 2010 ...

  20. Effect of sagittal spinal balance, levels of posterior instrumentation, and length of follow-up on low back pain in patients undergoing posterior decompression and instrumented fusion for degenerative lumbar spine disease: a multifactorial analysis.

    Science.gov (United States)

    Korovessis, Panagiotis; Repantis, Thomas; Papazisis, Zisis; Iliopoulos, Panagiotis

    2010-04-15

    Prospective controlled clinical study on low back pain (LBP). To investigate the possible effects of radiographic and other related parameters on LBP in patients underwent decompression and posterolateral instrumented fusion for degenerative lumbar spine disease. Sagittal balance of the spine after spine surgery has gained increasing interest regarding its correlation with LBP and fusion rate. To our knowledge, no advanced statistical analysis on the effects of sagittal roentgenographic and other parameters on LBP after lumbar surgery has been published. Forty-five patients with an average age of 63 years, who underwent pedicle-screw fixation in 2, 3, and 4 vertebrae for degenerative lumbar spine disease were selected to be included in this study. Radiographic and self-assessment (bodily pain, short form-36) data were evaluated using advanced statistics (multifactorial analysis) to investigate all possible correlations between a dependent parameter (LBP) and independent parameters (sex, extension of instrumentation, sagittal spinal balance, and angular motion at the adjacent free level above instrumentation). All patients were observed for an average of 5.5 years (range, 5-7 years). Male patients showed significantly more improvement of LBP than female counterparts (P = 0.024). LBP improved after surgery by the first year (P spine disease.This research suggests that the methods directed at the improvement in sagittal spinal balance of the lumbar spine, careful selection of fusion levels, and improvement of fusion rate might be beneficial for decreasing LBP after surgery in degenerative lumbar spine disease.

  1. [Multiple system atrophy and Alzheimer's disease: a case report of a rare association of two neuro-degenerative disorders].

    Science.gov (United States)

    Rusina, R; Bourdain, F; Matej, R

    2007-12-01

    Multiple system atrophy (MSA) is a neurodegenerative disorder typically characterised by cerebellar dysfunction, parkinsonism, pyramidal signs and dysautonomy. Cognitive impairement is usually limited to a moderate subcortical dysexecutive syndrom. We report the case of a 62-year-old woman suffering from MSA who progressively developed severe dementia. Neuropathological examination confirmed the diagnosis of definite MSA and also showed histopathological hallmarks of Alzheimer's disease. This association is extremely rare in the literature. Our observation confirmes that franc dementia in MSA should prompt a search for another associated cause and underlines the usefulness of neuropathological verifications in atypical clinical pictures.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Interactive Image Analysis in Age-related Macular Degeneration (AMD) and Stargardt Disease (STGD).

    Science.gov (United States)

    Smith, R Theodore; Lee, Noah; Chen, Jian; Busuioc, Mihai; Laine, Andrew F

    2008-10-26

    The literature of the last three decades is replete with automatic methods for retinal image analysis. Acceptance has been limited due to post-processing or tuning requirements that may be just as time consuming as the original manual methods. The point of view herein is that by taking advantage of the human visual system and expert knowledge from the outset, the promised efficiencies of digital methods can be achieved in practice as well as in theory. Thus, simple labeling of regions of interest that is accepted and easily performed in a few moments by the human can provide enormous advantage to an already well-developed algorithm. Three examples are provided: drusen segmentation, image registration, and geographic atrophy segmentation, with applications to disease understanding.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  5. Research Process of Treatment of Spinal Degenerative Diseases that Based on Syndrome Differentiation from Liver and Spleen%从肝脾论治脊柱退行性疾病研究进展

    Institute of Scientific and Technical Information of China (English)

    夏梦; 陈少清; 王诗忠

    2015-01-01

    通过检索中国期刊全文数据库(CNKI)、万方数据知识服务平台、维普数据库,外文检索Science Direct、PubMed查找相关近5年的文献资料,并基于“肝主筋,脾主肌肉”的中医理论指导,采用综合分析法论述脊柱退行性疾病的发病机制和研究最新进展。发现肝脾虚对脊柱退行性病变的重要因素均产生不良影响,可促进脊柱退变的发生、发展。通过从肝脾角度探讨脊柱退行性疾病机制,有利于临床从调理肝脾角度治疗脊柱退行性疾病。%Through searching the related literature in recent 5 years by retrieving the CNKI, Wanfang Data knowledge service platform, VIP database and foreign language databases like Science Direct and PubMed, to discuss the pathogenesis and latest process of spinal degenerative diseases with comprehensive analysis. The job has found that the important factors of spinal degenerative diseases can be harmfully affected by deficiency of liver and spleen, which also promotes the occurrence and development of spinal degeneration. Discussing the pathogenesis of spinal degenerative diseases from the perspective of liver and spleen is propitious to the clinical treatment of spinal degenerative diseases with conditioning liver and spleen.

  6. D-penicillamine induced degenerative dermopathy

    Directory of Open Access Journals (Sweden)

    Sujay Khandpur

    2015-01-01

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

  7. Potential role of retinal pigment epithelial lipofuscin accumulation in age-related macular degeneration.

    Science.gov (United States)

    Katz, Martin L

    2002-01-01

    Age-related macular degeneration (AMD) is a leading cause of severe visual impairment in developed countries. The vision loss associated with AMD is the result of degenerative changes in the central region of the retina called the macula. Maintenance of normal structure and function of the macular retina, and of the remainder of the retina as well, is critically dependent on the supporting role of the adjacent retinal pigment epithelium (RPE). Impairment of normal RPE functions is known to result in retinal degeneration and loss of visual function. Thus, it has been hypothesized that the retinal degeneration that characterizes AMD is secondary to age-related deterioration in RPE support functions. Like many other postmitotic cell types, the RPE accumulates autofluorescent lysosomal storage bodies (lipofuscin) during senescence. In human eyes, lipofuscin comes to occupy a substantial fraction of the RPE cytoplasmic volume in the elderly. Does this lipofuscin accumulation contribute to the development of AMD? This question is a specific case of the broader question of whether lipofuscin accumulation in general is detrimental to cells. Unfortunately, definitive data do not exist to allow these questions to be answered. Although a correlation between RPE lipofuscin content and AMD has been reported, a cause-and-effect relationship between RPE lipofuscin accumulation and the development of this disease has not been established. It has been reported that a mutation in a gene encoding a photoreceptor-specific protein results in massive RPE lipofuscin accumulation and early-onset macular degeneration. However, again the accelerated RPE lipofuscin accumulation has not been shown to be the cause of the accompanying macular degeneration. The lack of a definitive link between RPE lipofuscin accumulation and AMD illustrates one of the biggest challenges remaining in lipofuscin research-determining whether lipofuscin accumulation per se has an impact on cell function.

  8. Parainflammation associated with advanced glycation endproduct stimulation of RPE in vitro: implications for age-related degenerative diseases of the eye.

    Science.gov (United States)

    Lin, Tony; Walker, Gregory Brett; Kurji, Khaliq; Fang, Edward; Law, Geoffrey; Prasad, Shiv S; Kojic, Luba; Cao, Sijia; White, Valerie; Cui, Jing Z; Matsubara, Joanne A

    2013-06-01

    Age related macular degeneration (AMD) is one of the leading causes of blindness in Western society. A hallmark of early stage AMD are drusen, extracellular deposits that accumulate in the outer retina. Advanced glycation endproducts (AGE) accumulate with aging and are linked to several age-related diseases such as Alzheimer's disease, osteoarthritis, atherosclerosis and AMD. AGE deposits are found in drusen and in Bruch's membrane of the eye and several studies have suggested its role in promoting oxidative stress, apoptosis and lipofuscin accumulation. Recently, complement activation and chronic inflammation have been implicated in the pathogenesis of AMD. While AGEs have been shown to promote inflammation in other diseases, whether it plays a similar role in AMD is not known. This study investigates the effects of AGE stimulation on pro- and anti-inflammatory pathways in primary culture of human retinal pigment epithelial cells (RPE). Differential gene expression studies revealed a total of 41 up- and 18 down-regulated RPE genes in response to AGE stimulation. These genes fell into three categories as assessed by gene set enrichment analysis (GSEA). The main categories were inflammation (interferon-induced, immune response) and proteasome degradation, followed by caspase signaling. Using suspension array technology, protein levels of secreted cytokines and growth factors were also examined. Anti-inflammatory cytokines including IL10, IL1ra and IL9 were all overexpressed. Pro-inflammatory cytokines including IL4, IL15 and IFN-γ were overexpressed, while other pro-inflammatory cytokines including IL8, MCP1, IP10 were underexpressed after AGE stimulation, suggesting a para-inflammation state of the RPE under these conditions. Levels of mRNA of chemokine, CXCL11, and viperin, RSAD2, were up-regulated and may play a role in driving the inflammatory response via the NF-kB and JAK-STAT pathways. CXCL11 was strongly immunoreactive and associated with drusen in the AMD

  9. [Impact of obesity in the pathophysiology of degenerative disk disease and in the morbidity and outcome of lumbar spine surgery].

    Science.gov (United States)

    Delgado-López, Pedro David; Castilla-Díez, José Manuel

    2017-07-24

    Obesity (BMI>30Kg/m(2)) is a pandemic with severe medical and financial implications. There is growing evidence that relates certain metabolic processes within the adipose tissue, preferentially abdominal fat, with a low-intensity chronic inflammatory state mediated by adipokines and other substances that favor disk disease and chronic low back pain. Obesity greatly conditions both the preoperative evaluation and the spinal surgical technique itself. Some meta-analyses have confirmed an increase of complications following lumbar spine surgery (mainly infections and venous thrombosis) in obese subjects. However, functional outcomes after lumbar spine surgery are favorable although inferior to the non-obese population, acknowledging that obese patients present with worse baseline function levels and the prognosis of conservatively treated obese cohorts is much worse. The impact of preoperative weight loss in spine surgery has not been prospectively studied in these patients. Copyright © 2017 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. 宣痹合剂治疗腰椎退行性骨关节病疼痛的临床研究%Clinical Study on Xuanbi Mixture in the Treatment of Lumbar Degenerative Bone Joint Disease Pain

    Institute of Scientific and Technical Information of China (English)

    崔长锋

    2016-01-01

    Objective To investigate the effect Xuanbi mixture in the treatment of lumbar degenerative bone joint disease pain symptoms. Methods The control group received routine clinical. The research group used Xuanbi mixture on the basis of the Western medicine. The improvement of lumbar degenerative bone joint disease pain before and after treatment was recorded, and the resulting data were implemented statistical test. Results The two groups had no significant difference in pain intensity ( P >0. 05 ) . After corresponding treatment, the improvement of lumbar degenerative bone joint disease pain of the two groups was significantly improved, the research group was better than the control group, and the difference was statistically significant (P0.05);治疗后两组疼痛程度均较之前显著改善,且研究组改善效果优于对照组,对比结果具有统计学意义(P<0.05)。结论对腰椎退行性骨关节病患者给予常规治疗联合宣痹合剂可获得更为理想的临床疗效,有利于保障患者生活质量及身心健康。

  11. 刘柏龄教授腰椎退行性疾病治疗经验总结%The treatment experience of Professor Liu Bailing in lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    刘钟华; 闻辉; 赵文海

    2015-01-01

    腰椎退行性疾病多由腰椎间盘和关节突关节的关节软骨及周围韧带组织的退行性改变所致,属于中医“腰腿痛”“腰痛”“痹症”的范畴。刘柏龄教授以“二步十法”联合中药和运动疗法治疗腰椎退行性疾病疗效较好,本文总结了刘柏龄教授的治疗经验,为临床治疗提供参考。%The retrogression of lumbar disc and arthritis and joint of articular cartilage and ligament around the organization lead to the lumbar degenerative disease, and the lumbar degenerative disease belongs to “lumbocrural pain”“back pain”“poliomyelitis” category of Chinese medicine. Professor Liu Bailing lumbar degenerative disease curative effect is better, who with “two step method of ten” ,chinese traditional medicine and exercise effect,in order to provide a reference for clinical treatment.

  12. 腰椎退行性病变与原发性膝关节骨关节炎发病的关系%Primary study of relationship between lumbar degenerative disease and morbidity of primary knee osteoarthritis

    Institute of Scientific and Technical Information of China (English)

    姜军; 任中华; 吕厚山

    2010-01-01

    Objective To study the relationship between lumbar degenerative disease and morbidity of primary unilateral knee osteoarthritis.Methods The clinical data of 115 unilateral knee osteoarthritis patients and 119 bilateral knee osteoarthritis patients undergoing TKR(total knee replacement)at our hospital in 2008 were retrospectively analyzed.According to clinical signs of lumbar degenerative disease and radiological changes,these patients were divided into upper / lower / whole / none lumbar degenerative disease group respectively.X~2 test was performed to compare the difference of lumbar degenerative conditions between unilateral knee osteoarthritis and bilateral knee osteoarthritis patients.Results The morbidity side of lumbar intervertebral disc protrusion or nerve root canal stenosis in primary unilateral osteoarthfitis patients was the same as the morbidity side of primary unilateral osteoarthritis.Lumbar degenerative disease morbidity [(34+20+15)/115=60%]of primary unilateral knee osteoarthritis was higher than that[(3+5+4+6+19)/119=31.1%]of primary bilateral knee osteoarthritis(X~2=19.723,P=0.000);Upper lumbar degenerative disease morbidity(34/115=29.6%)of primary unilateral knee osteoarthritis was higher than that[(3+5)/119=6.7%]of primary bilateral knee osteoarthritis,(X~2=20.720,P=0.000);lower lumbar degenerative disease morbidity(20/115=17.4%)of primary unilateral knee osteoarthritis was higher than that[(4+6)/119=8.4%]of primary bilateral knee osteoarthritis(X~2=4.227,P=0.040);there was no difference for whole lumbar degenerative disease morbidity between primary unilateral and bilateral knee osteoarthritis patients(X~2=0.402,P=0.526).Conclusion The primary unilateral knee osteoarthritis morbidity is correlated with lumbar degenerative disease for the same elder patient.Upper lumbar degenerative disease can induce the incidence and aggravation of primary unilateral knee osteoarthritis;the flexion deformity of primary knee osteoarthritis may cause the

  13. AGE-RELATED MACULAR DEGENERATION IS A VASCULAR DISEASE, PART OF VASCULOPATHY: HOLISTIC APPROACH OF THE AMD’S PATHOPHYSIOLOGY, PREVENTION AND PREVENTIVE TREATMENT

    Directory of Open Access Journals (Sweden)

    Tamás Fischer

    2012-12-01

    Full Text Available The endothelial system assures unhindered functioning and stability of the internal milieu maintaining vascular health and protecting against vascular injury, noxa. by producing, synthesising and excreting various substances: vasodilators and vasoconstrictors, growth factors and their inhibitors, pro-inflammatory and antiinflammatory agents, pro-thrombotic and fibrinolytic factors, and by keeping them in a strict equilibrium: endothelial dysfunction is the change of these properties, what is inappropriate with regard to the preservation of organ function. In the genesis and later development of age-related macular degeneration (AMD, endothelial dysfunction (ED has a crucial key role. AMD-risk factors often are identical wih the risk factors of (cardiovascular (CV diseases, so the two conditions have a similar pathogenesis. These risk factors lead to vascular injury through the same mechanism of actions, by inducing oxidative stress (OS → ED!: harm (noxa, i.e. |AMD| risk factors → oxidative stress [OS] → endothelial activation [EA], endothlial dysfunction [ED], respectively → vacular injury, vascular disease. Disordered function of endothelium in the vessels supplying the affected ocular structures with blood (ED have a key role in the genesis and development of age-related macular degeneration. Wall of blood vessels including thoose in choroids may be triggered by several repeated and/or prolonged mechanical, physical, chemical, microbiological, immunologic, and genetic influences-impacts-stimuli (noxa, against which protracted response, the so-called host defense response may develop, and in consequence of this, vascular damage pathological consecutive changes ending in AMD, ultimately, may develop. As the human vascular system is uniform and consubstantial, the medicines/non-medicinal methods desribed below [the RAAS-inhibiting (1 angiotensin converting enzyme ihibitors and (2 angiotensinreceptor blockers |AT1 receptor blocker

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

    Science.gov (United States)

    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.

  15. Effects of Smoking on Subjective and Objective Measures of Pain Intensity, Functional Impairment, and Health-Related Quality of Life in Lumbar Degenerative Disk Disease.

    Science.gov (United States)

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

    2017-03-01

    Numerous studies assessed the effects of smoking on lumbar degenerative disk disease (DDD); they focused on patient-reported outcome measures (PROMs) and yielded conflicting results. In this 2-center study on consecutive patients receiving surgical treatment for lumbar DDD, subjective functional impairment (SFI) in terms of PROMs including visual analog scale back and leg pain, Roland-Morris, Oswestry Disability Index, Euro-Qol-5D, and a Short-Form 12 physical component summary was determined at baseline, 3 days, 6 weeks, 6 months, and 1 year postoperatively. Age- and sex-adjusted T-scores of objective functional impairment (OFI) were determined using the Timed Up and Go test up to 6 weeks postoperatively. The responder status was defined by the minimal clinically important difference. We analyzed 375 patients (n = 96 [25.6%] smokers and n = 279 [74.4%] nonsmokers). SFI on any of the PROMs before treatment was similar in smokers and nonsmokers. Smokers were more likely to have OFI in univariate logistic regression analysis (95% confidence interval 1.31-3.37, P = 0.002). In multivariate analysis, however, this relationship became insignificant (95% confidence interval 0.85-2.38, P = 0.184). The smoking status had no predictive capacity on the 6-week SFI or OFI responder status, and there were no differences in any of the PROMs until the 1-year follow-up. PROMs measuring SFI for pain intensity, functional impairment, and health-related quality of life were similar in smokers and nonsmokers before surgery for lumbar DDD, as well as postoperatively. The smoking status has negligible impact on the Timed Up and Go test, which appears to be a robust assessment tool for OFI. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Science.gov (United States)

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

    2017-01-01

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

  18. Long-Term Outcomes of Posterior Lumbar Interbody Fusion Using Stand-Alone Ray Threaded Cage for Degenerative Disk Disease: A 20-Year Follow-Up

    Science.gov (United States)

    Medrano, Belen G.; Noriega, David C.

    2016-01-01

    Study Design Retrospective study. Purpose To analyze outcomes of posterior lumbar interbody fusion (PLIF) stand-alone cages. Overview of Literature PLIF for degenerative disk disease using stand-alone cages has lost its popularity owing to implant-related complications and pseudoarthrosis. Methods We analyzed the records of 45 patients (18 women, 27 men), operated between January 1994 and December 1996, with a mean follow-up of 18 years 3 months (20 years 3 months–22 years 3 months). Clinical outcomes were measured using visual analogue score (VAS), Oswestry disability index (ODI), Odom's criteria, and radiological measurements of fusion rate, Cobb angle, and implant-related complications conducted at the preoperative evaluation, hospital discharge, 12-month follow-up, and final follow-up. Results Preoperative mean VAS (back) was 6.9 and VAS (radicular) was 7.2, with mean improvements (p Pseudoarthrosis was observed in five patients (11.1%), of whom, three (6.6%) required re-operation. Preoperative disk height was 9.23 mm, which increased to 13.33 mm in the immediate postoperative evaluation and was maintained at 10.0 mm at the final follow-up (p <0.05). The preoperative mean L1–S1 Cobb angle was 34.7°, which changed to 44.7° in the immediate postoperative evaluation and dropped to 39.7° at the final follow-up (p <0.005). Conclusions PLIF stand-alone cages were associated with good clinical outcomes. Although the fusion rate was excellent, maintenance of disk heights and a lordotic alignment were not achieved in the long term. PMID:27994787

  19. Assessment of the Minimum Clinically Important Difference in the Timed Up and Go Test After Surgery for Lumbar Degenerative Disc Disease.

    Science.gov (United States)

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

    2017-03-01

    The Timed Up and Go Test (TUG Test) has previously been described as a reliable tool to evaluate objective functional impairment in patients with degenerative disc disease. The aim of this study was to assess the minimum clinically important difference (MCID) of the TUG Test. The TUG Test (measured in seconds) was correlated with validated patient-reported outcome measures (PROs) of pain intensity (Visual Analog Scale for back and leg pain), functional impairment (Oswestry Disability Index, Roland Morris Disability Index), and health-related quality of life measures (Short Form-12 and EuroQol 5D). Three established methods were used to establish anchor-based MCID values using responders of the following PROs (Visual Analog Scale back and leg pain, Oswestry Disability Index, Roland Morris Disability Index, EuroQol 5D index, and Short Form-12 Physical Component Summary) as anchors: (1) average change, (2) minimum detectable change, and (3) change difference approach. One hundred patients with a mean ± SD age of 56.2 ± 16.1 years, 57 (57%) male, 45 patients undergoing microdiscectomy, 35 undergoing lumbar decompression, and 20 undergoing fusion surgery were studied. The 3 MCID computation methods revealed a range of MCID values according to the PRO used from 0.9 s (Oswestry Disability Index based on the change difference approach) to 6.0 s (EuroQol 5D index based on the minimum detectable change approach), with a mean MCID of 3.4 s for all measured PROs. The MCID for the TUG Test time is highly variable depending on the computation technique used. The average TUG Test MCID was 3.4 s using all 3 methods and all anchors.

  20. Patients' Preference of the Timed Up and Go Test or Patient-Reported Outcome Measures Before and After Surgery for Lumbar Degenerative Disk Disease.

    Science.gov (United States)

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

    2017-03-01

    The Timed Up and Go (TUG) test, as a measure of objective functional impairment in lumbar degenerative disk disease (DDD), complements patient-reported outcome measures (PROMs) of subjective functional impairment. Prospective 2-center study on consecutive patients scheduled for surgical treatment for lumbar DDD who underwent an objective (TUG test) and subjective (PROMs) functional assessment before and 1 and 3 days after surgery. PROMs included the visual analog scale (VAS), Roland-Morris Disability Index (RMDI), Oswestry Disability Index (ODI), Euro-Qol (EQ-5D), and Short Form 12 (SF-12) questionnaires. On completion of each assessment, patients were asked whether they would prefer performing the TUG test or completing the PROMs questionnaires. A total of 109 of 125 patients (87.2%) completed the assessments. Preoperatively, patients were 2.18 times as likely to prefer the TUG test to the PROMs (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.27-3.75). On postoperative days 1 and 3, patients were 5.79 (OR, 5.79; 95% CI, 3.23-10.37) and 6.33 times as likely to prefer the TUG test to the PROMs, respectively (OR, 6.33; 95% CI, 3.51-11.41). There were no statistical differences in baseline characteristics, TUG t scores, VAS, RMDI, ODI, SF-12, and EQ-5D index between patients preferring either the TUG test or the PROMs questionnaires. The TUG test is preferred over a battery of PROMs by 60%-70% of patients with lumbar DDD not only in the preoperative, but also in the postoperative, setting. High functional disability does not result in avoidance of the TUG test, and repeated assessments lead to higher preference. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2017-01-01

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

  2. Emphasis on the integration of advanced biological technology in retinal degenerative diseases%重视前沿生物技术在视网膜退行性疾病中的整合应用

    Institute of Scientific and Technical Information of China (English)

    张敬学; 卢清君

    2015-01-01

    Retinal degenerative diseases , such as retinitis pigmentosa ( RP ) , age-related macular degeneration ( AMD ) , as well as glaucoma and other diseases the main pathological basis of abnormal structure and function of retinal neurons at all levels ,resulting in irreversible damage to the visual acuity ,is the leading cause of irreversible blindness , and lack of effective treatment methods .With the rapid development of science and technology in recent years , gene therapy , stem cell therapy , adaptive optics technology and artificial vision to the treatment of these diseases may be provided .The completion of the human genome project and the wide application of the related sequencing technology have brought a new revolution to the nature of the disease ,and also brought new impetus to the disease molecular classification , biological diagnosis and gene therapy .People′s understanding of the eye disease is also more comprehensive , the treatment plan on the basis of gene replacement therapy ,and further integrated cell factor therapy ,and the treatment of light genetics , etc..The gene therapy technology has made great progress in Department of Ophthalmology ,but it can not stop some of the functions of cell apoptosis , which requires us to combine a class of genes that can save the cell apoptosis ,or need to use alternative treatment ,the functional cells instead of the injured cells , thereby restoring its function .Because of the unlimited proliferation and multi differentiation potential of stem cells ,it has become a new hope for cell replacement therapy .The retinal stem cell transplantation ,which is integrated into the retina ,and differentiated into the target cells ,to reconstruct the retinal function , has brought the light to the irreversible blindness .The self-renewal and multiple differentiation potential of neural stem cells ,which are suitable for the cell transplantation ,and the expansion of the widely used neural stem cells in vitro and in

  3. Association of systemic health and functional outcomes with changes in hard exudates associated with clinically significant macular oedema over the natural course of the disease.

    Science.gov (United States)

    Kameda, Yusuke; Kumakawa, Makiko; Endo, Naoko; Iwamoto, Yasuhiko; Kitano, Shigehiko

    2010-06-01

    Hard exudates associated with clinically significant macular oedema (CSMO) do not always increase without laser photocoagulation and can generally be classified as regressing or progressing. We studied the systemic differences and functional outcomes between the two groups. In this retrospective observational controlled study, we compared blood pressure, biochemical parameters and best corrected visual acuity (BCVA) between 26 patients with regressed hard exudates with CSMO (group A) and 27 patients with progressing hard exudates with CSMO (group B). The eyes had no history of ophthalmic treatments including laser therapy for diabetic retinopathy or maculopathy until the end of the study. Group B had significant increases in the mean total cholesterol (TC) (p=0.0194) and mean low-density lipoprotein (LDL) cholesterol (p=0.0147) after at least 6 months of follow-up compared with group A. The final mean BCVA was significantly (p=0.0189) higher in group A than group B. A separate within-group analysis showed a significant (p=0.0015) decrease in BCVA from baseline in group B at the final visit. For hard exudates associated with CSMO, strict lipid-lowering therapy, especially regulation of elevated TC and LDL, before a decrease in visual acuity might result in better macular anatomical outcomes and visual preservation through the natural course of the disease.

  4. [Macular serpiginous choroiditis complicated by macular hole].

    Science.gov (United States)

    Brănişteanu, D; Moraru, Andreea

    2014-01-01

    Macular serpiginouschoroiditis is a rare variant of serpiginous choroiditis characterized by a severe recurrent inflammation of both central choroid and retinal pigment epithelium. Visual prognosis is severe due to subsequent distruction of retinal structures. Permanent central visual loss is the consequence of retinal pigment epithelium hyper or hypoplasia and/or subretinal neovascularization leading to fibrous scarring. This article reports the unusual case of rapid development of a macular hole soon after the onset of characteristic clinical features. Despite anti-inflammatory treatment and successful macular hole surgery the visual function remained significantly impaired by secondary central retinal pigment epithelium changes.

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

    Directory of Open Access Journals (Sweden)

    Garjesh Singh

    2015-11-01

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

  6. Diagnosis and treatment for degenerative lumbar spinal disease%退变性腰椎疾病的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    林红; 董健

    2005-01-01

    腰腿痛是困扰人类的常见病和多发病,引起腰腿痛的主要原因是退变性腰椎疾病(degenerative lumbar spinal dis-ease,DLSD)。笔者对DLSD的诊断及治疗进展作一综述。

  7. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    Institute of Scientific and Technical Information of China (English)

    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.

  9. 脊柱退行性疾病的骨质疏松影响分析%Analysis of the effect of osteoporosis on the spinal degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    陈戈; 段洪; 卞鸿燕; 贺云; 尹劲; 吴波; 杨海青; 周兆文

    2014-01-01

    质疏松加速脊柱退行性变、脊柱不稳、胸腰椎骨折、椎管狭窄、脊柱畸形、颈椎病、脊柱滑脱等脊柱退行性疾病的发病。%Objective To investigate the relationship between low remodelling osteoporosis and the spinal degenerative diseases, and to explore the damage of osteoporosis on the spine degeneration in the elderly patients.Methods The bone mineral density ( BMD) was detected using dual-energy X-ray absorptiometry.The clinical observation and the collection of the imaging data were performed.The large-sample random sampling was also performed.A SPSS 13.0 statistical software was used to analyze all the data of 505 patients over 50 years old in a year.The data of the spinal diseases with low remodelling osteoporosis were collected. Results The comparison of BMD of different lumbar vertebrae in each group was performed using single factor analysis of variance.The enumeration data were analyzed using Spearman rank correlation analysis.The correlation between osteoporosis and diseases such as the lumbar instability was analyzed using non-conditional logistic regression analysis.The results revealed that the partial regression coefficient of the thoraco-lumbar fracture was 1.026 (P=0.021, OR 2.789).The partial regression coefficient of the spinal degeneration was 0.225 (P=0.035, OR 2.253).The partial regression coefficient of the lumbar instability was 0.828 (P=0.004, OR 2.289).The partial regression coefficient of the spondylolisthesis was 0.782 (P=0.024, OR 2.185).The partial regression coefficient of the cervical spondylosis was 0.691 (P=0.045, OR 1.211).The partial regression coefficient of the spinal stenosis was 0.972 (P=0.031, OR 2.57).The partial regression coefficient of the spinal deformity was 0.972 (P=0.025, OR 1.002).The partial regression coefficient of age was 0.048 (P=0.000, OR 1.049).The partial regression coefficient of gender was -1.035 (P=0.000, OR 0.355).Osteoporosis and the spinal degenerative diseases

  10. Progress in Mitral Valve Replacement of Complete Apparatus Preservation in Treating Senile Degen-erative Valvular Heart Disease%保留全瓣及瓣下结构的二尖瓣置换术治疗老年退行性瓣膜病的进展

    Institute of Scientific and Technical Information of China (English)

    陈景伟(综述); 程可洛(审校)

    2015-01-01

    The morbidity of senile degenerative valvular heart disease has been increasing in recent years.Severe cases need surgery.Because of the long course of disease and functional failure of important organs,the surgical mortality and complication rate of mitral valve replacement is still high in elder people . Mitral valve replacement of complete apparatus preservation can keep the normal connection of valvular leaf-let,tendinous chorda,papillary muscle and ventricle,and maintain the original constriction support of ventric-ular wall,so as to avoid severe complications and promote left ventricular function after surgery ,and increase the cure rate of senile degenerative valvular heart disease and preserve better heart function of long term .Here is to make a review of the clinical application of mitral valve replacement of complete apparatus preservation in surgical therapy for senile degenerative valvular heart disease .%老年退行性瓣膜病的发病率近年来有逐渐增加的趋势。严重的退行性二尖瓣病变需要外科手术治疗。老年患者的病程较长,各重要脏器功能退化不全,手术病死率较高,术后并发症发生率较高。保留全瓣及瓣下结构的二尖瓣置换术能保持瓣叶、腱索、乳头肌与左心室之间的正常联系,维护了心室壁原有的收缩支撑力,从而避免严重并发症和改善术后左心室功能,提高老年退行性瓣膜病的手术治愈率和维持较好的远期心功能状况。该文就保留全瓣及瓣下结构的二尖瓣置换术治疗老年退行性瓣膜病的临床应用进行综述。

  11. Differentiating full thickness macular holes from impending macular holes and macular pseudoholes

    OpenAIRE

    Tsujikawa, M; Ohji, M; Fujikado, T.; Saito, Y.; Motokura, M.; Ishimoto, I.; Tano, Y.

    1997-01-01

    AIMS—The reliability of scanning laser ophthalmoscope (SLO) microperimetry in differentiating full thickness macular holes from macular pseudoholes and impending macular holes was evaluated.
METHODS—106 eyes with the clinical diagnosis of full thickness macular holes, macular pseudoholes, and impending (stage 1) macular holes were examined for the presence of deep or relative scotoma using SLO microperimetry. The relation between these scotomas and the clinical diagnosis was studied.
RESULTS—...

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

    Directory of Open Access Journals (Sweden)

    F.G. Miranda

    2016-08-01

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

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

    Directory of Open Access Journals (Sweden)

    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

  14. Pre- and postoperative correlation of patient-reported outcome measures with standardized Timed Up and Go (TUG) test results in lumbar degenerative disc disease.

    Science.gov (United States)

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

    2016-10-01

    The Timed Up and Go (TUG) test is a reliable tool for evaluating objective functional impairment (OFI) in patients with degenerative disc disease before a surgical intervention. The aim of this study is to assess the validity of the TUG test to measure change in function postoperatively. In a prospective two-center study, OFI was assessed by the TUG test in patients scheduled for lumbar spine surgery, as well as 3 days (D3) and 6 weeks (W6) postoperatively. At each time point, the TUG test results were correlated with established subjective measures of pain intensity (visual analogue scale (VAS) for back and leg pain), functional impairment (Oswestry Disability Index (ODI)) and health-related quality of life (HRQoL; Short Form-12 (SF12)). The patient cohort comprised 136 patients with a mean age of 57.7 years; 76 were males, 54 had a microdiscectomy for lumbar disc herniation, 58 a decompression for a lumbar spinal stenosis, 24 had a surgical fusion procedure. The mean OFI t-score was 125.1 before surgery, and as patients improved on the subjective measures in the postoperative interval, the OFI t-score likewise decreased to 118.8 (D3) and 103.4 (W6). The Pearson correlation coefficient (PCC) between the OFI t-score and VAS leg pain was 0.187 preoperatively (p = 0.029) and 0.252 at W6 (p = 0.003). The PCC between OFI t-score and the ODI was 0.324 preoperatively (p < 0.001) and 0.413 at W6 (p < 0.001). The PCC between OFI t-score and physical HRQoL (SF12) was -0.091 preoperatively (p = 0.293) and -0.330 at W6 (p < 0.001). The TUG test is sensitive to change, and reflects the postoperative functional outcome even more exact than preoperatively, as indicated by better correlation coefficients of the OFI t-score with subjective measures of pain intensity, functional impairment and HRQoL.

  15. Treatment of lumbar degenerative disc disease-associated radicular pain with culture-expanded autologous mesenchymal stem cells: a pilot study on safety and efficacy.

    Science.gov (United States)

    Centeno, Christopher; Markle, Jason; Dodson, Ehren; Stemper, Ian; Williams, Christopher J; Hyzy, Matthew; Ichim, Thomas; Freeman, Michael

    2017-09-22

    Degenerative disc disease (DDD) is a common cause of lower back pain with radicular symptoms and has a significant socioeconomic impact given the associated disability. Limited effective conservative therapeutic options result in many turning to surgical alternatives for management, which vary in the rate of success and also carry an increased risk of morbidity and mortality associated with the procedures. Several animal based studies and a few human pilot studies have demonstrated safety and suggest efficacy in the treatment of DDD with mesenchymal stem cells (MSCs). The use of bone marrow-derived MSCs for the treatment of DDD is promising and in the present study we report on the safety and efficacy findings from a registry based proof of concept study using a percutaneous intradiscal injection of cultured MSCs for the management of DDD with associated radicular symptoms. Thirty-three patients with lower back pain and disc degeneration with a posterior disc bulge diagnosed on magnetic resonance imaging (MRI) met the inclusion criteria and were treated with culture-expanded, autologous, bone marrow-derived MSCs. Prospective registry data was obtained at multiple time intervals up to 6 years post-treatment. Collected outcomes included numeric pain score (NPS), a modified single assessment numeric evaluation (SANE) rating, functional rating index (FRI), measurement of the intervertebral disc posterior dimension, and adverse events. Three patients reported pain related to procedure that resolved. There were no serious adverse events (i.e. death, infection, or tumor) associated with the procedure. NPS change scores relative to baseline were significant at 3, 36, 48, 60, and 72 months post-treatment. The average modified SANE ratings showed a mean improvement of 60% at 3 years post-treatment. FRI post-treatment change score averages exceeded the minimal clinically important difference at all time points except 12 months. Twenty of the patients treated underwent

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  17. Chinese Medicine for Eye Diseases: Principles of Treatment of Age Related Macular Degeneration-AMD%Chinese Medicine for Eye Diseases:Principles of Treatment of Age Related Macular Degeneration-AMD

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ The AMD causes a deterioration of the central field of vision of the human eye caused by loss of function of the macula. The macula is the central part of the retina, the part that receives the most freely detailed information since it contains a considerable number of daylight sensitive and colour sensitive photoreceptor cells. People with little skin pigments like European people are more frequently affected than people from the Asian continent for example. Three quarters of the people who are affected by AMD suffer from the dry form of macular degeneration which means lack of fluid or dehydration of the back part of the eye. There is no effective treatment to be known so far.

  18. Falls in degenerative cerebellar ataxias

    NARCIS (Netherlands)

    van de Warrenburg, Bart P C; Steijns, Janneke A G; Munneke, Marten; Kremer, Berry P H; Bloem, Bastiaan R

    2005-01-01

    We retrospectively and prospectively assessed the frequency and characteristics of falls in patients with degenerative cerebellar ataxias. The results show that falls occur very frequently in patients with degenerative cerebellar ataxias and that these falls are serious and often lead to injuries or

  19. [Degenerative adult scoliosis].

    Science.gov (United States)

    García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A

    2015-01-01

    Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.

  20. Stereotypic behaviors in degenerative dementias.

    Science.gov (United States)

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

    2012-11-01

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

  1. 脊椎退行性疾病患者生命质量量表的编制%Development of a quality of life scale for Chinese patients with degenerative spine disease

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 贾瑞平; 王弘; 吴志宏; 邱贵兴

    2011-01-01

    目的 编制适用于我国脊椎退行性疾病患者的生命质量量表(QLS-DSD).方法 采用议题小组和核心小组的程序化决策方式并借鉴国内外建立量表的经验制定量表,对296例脊椎退行性疾病患者进行调查,采用离散趋势法、相关系数法、反应度分析、逐步回归法和因子分析法等统计学方法对结果进行分析.结果 采用上述5种方法删除3个条目,最终得到23个条目.结论 QLS-DSD准确反映脊椎退行性疾病患者的生命质量.%Objective Objective To develop a quality of life scale for Chinese patients with degenerative spine disease (QLS-DSD). Methods The scale was established by using the methods of programmed decisions of the team and the core team issues and referencing the experience at home and abroad. Totally 296 degenerative spine disease patients were investigated in this study. Discrete trend method, correlation coefficient method, degree of reaction analysis, stepwise regression method and factor analysis was applied to analyze the survey results. Results According to the above 5 methods, we deleted 4 items and formed a scale with 23 entries at last. Conclusion QLS-DSD exactly reflects the quality of life for Chinese patients with vertebrae degenerative disease.

  2. Clinical Value of Elastic Fixation in Operation for Lumbar Degenerative Disease%弹性内固定在腰椎退行性病变手术治疗中的临床价值

    Institute of Scientific and Technical Information of China (English)

    高峰; 王大麟

    2014-01-01

    Objective Analysis the clinical value of elastic fixation in treatment of lumbar degenerative diseases in operation. Methods The author selected 64 patients with lumbar degenerative diseases according to the treatment methods were divided into the observation group of 30 cases (elastic fixation) and 34 cases of the control group (non elastic fixation), compared the effect of two groups of patients . Results In the observation group, the clinical curative effect of the excellent and good rate was significantly higher than that of control group (P<0.05). Conclusion Lumbar degenerative diseases in the back operation is used in the treatment of elastic fixation, can reduce the pain of patients.%目的:分析弹性内固定在腰椎退行性病变手术治疗中的临床价值。方法64例腰椎退行性病变患者根据治疗方式分为观察组30例(弹性内固定)及对照组34例(非弹性内固定),对比两组患者治疗效果。结果观察组临床疗效优良率明显高于对照组,疼痛程度轻于对照组,并发症发生率少于对照组(P <0.05)。结论在腰椎退行性病变手术治疗中采用弹性内固定,可减轻患者疼痛。

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

    Directory of Open Access Journals (Sweden)

    Carlos G. Abel

    2006-09-01

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

  4. Wallis棘突间动态稳定系统在腰椎退行性疾病手术治疗中的应用%Early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    李斌; 牛光峰; 孙建民; 蒋振松; 崔新刚; 杨超群; 王乃国

    2012-01-01

    [Objective] To evaluate the early effect of posterior dynamic lumbar stabilization in lumbar degenerative disease. [Methods] The clinical outcomes of 65 patients with lumbar degenerative disease treated by posterior decompression with Wallis posterior dynamic lumbar stabilization implant or combined with posterior lumbar fusion were retrospectively studied, and assessed with visual analogue scale (VAS) and spinal operative standard of Chinese Medical Association. The early effect and complications associated with Wallis posterior dynamic lumbar stabilization were recorded. [ Results ] The operative procedure of Wallis posterior dynamic lumbar stabilization implant was easy and less invasive. The VAS scores were improved significantly at one day preoperatively, two week postoperatively and final follow - up, respectively. The good to excellent result was 92% at the final follow-up. No completion related with Wallis posterior dynamic lumbar stabilization was found. [Conclusion] It is easy and safe to use Wallis posterior dynamic lumbar stabilization in treatment of degenerative lumbar disease, and the early effect is good. The Wallis system provides an alternative for treatment of lumbar degenerative disease.%[目的]探讨椎管减压加Wallis棘突间动态稳定系统治疗腰椎退行性疾病的初期效果.[方法]分析自2008~2011年65例单独采用Wallis棘突间动态稳定系统或结合固定融合方法治疗腰椎退行性疾病的临床疗效和初期随访结果,采用VAS疼痛10分法和中华医学会骨科分会脊柱外科学组腰椎手术疗效标准评估手术疗效,随访有无Wallis动态固定系统相关并发症及疗效.[结果]Wallis棘突间动态稳定系统手术操作简便、创伤小,术前ld、术后2周及末次随访疼痛VAS评分改善明显,影像学检查未发现内置物移位、邻近节段退变加重.[结论]Wallis棘突间动态稳定系统或结合固定融合方法治疗腰椎退行性疾病简便安全,初期

  5. What Is Macular Edema?

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / Eye Health A-Z Macular Edema ... for Thinning Retina Mar 10, 2014 Leer en Español: ¿Qué Es un Edema Macular? Find an Ophthalmologist ...

  6. Visual loss related to macular subretinal fluid and cystoid macular edema in HIV-related optic neuropathy

    DEFF Research Database (Denmark)

    Gautier, David; Rabier, Valérie; Jallet, Ghislaine;

    2012-01-01

    Optic nerve involvement may occur in various infectious diseases, but is rarely reported after infection by the human immunodeficiency virus (HIV). We report the atypical case of a 38-year-old patient in whom the presenting features of HIV infection were due to a bilateral optic neuropathy associ...... associated with macular subretinal fluid and cystoid macular edema, which responded well to antiretroviral therapy....

  7. 脊柱退行性疾病对腰椎前后位骨密度的影响分析%The impact analysis of degenerative spinal disease on lumbar bone mineral density in the anteroposterior view

    Institute of Scientific and Technical Information of China (English)

    臧渊; 雷伟; 吴子祥

    2012-01-01

    双能X线骨密度仪检测骨密度是诊断骨质疏松症的“金标准”,学者推荐50岁以上人群采用腰椎前后位进行测量.然而骨质疏松症发病率较高的老年人群,常常合并罹患多种脊柱退行性疾病,例如腰椎间盘突出、退行性侧凸、骨赘增生等,这些病理改变可导致腰椎前后位骨密度值准确性降低.因此,提高腰椎骨密度测量准确性,对于骨质疏松症的诊断和治疗具有重要意义.本文就常见的脊柱退行性疾病对腰椎前后位骨密度的影响作一综述,以期帮助临床医生全面评估和诊断骨质疏松症.%Objective Bone mineral density (BMD) detected by dual-energy X-ray absorptiometry can be regarded as the "gold standard" for the diagnosis of osteoporosis. The scholars recommend that all adults over SO years old should conduct the anteroposterior position measurement. However, the elderly population with high incidence of osteoporosis often combines with many degenerative spinal diseases, such as intervertebral disc herniation, degenerative scoliosis, osteophyte formation, etc. These pathological changes in the lumbar spine might reduce the accuracy of BMD in anteroposterior position. So the increase of BMD accuracy is of great significance in diagnosis and treatment of osteoporosis. This article reviews the impacts of spinal degenerative diseases on lumbar bone mineral density and aims to facilitate clinicians to assess and diagnose osteoporosis comprehensively.

  8. Correlation of end plate shape on MRI and disc degeneration in surgically treated patients with degenerative disc disease and herniated nucleus pulposus.

    Science.gov (United States)

    Pappou, Ioannis P; Cammisa, Frank P; Girardi, Federico P

    2007-01-01

    The sagittal profile of the lumbar end plates on magnetic resonance imaging (MRI) has not been investigated in patients with degenerative disc disease (DDD) or herniated nucleus pulposus (HNP). To examine the shape of the end plates in patients treated surgically for a) low back pain or b) radiculopathy with HNP. Furthermore, to investigate the correlation between end plate shape and disc degeneration on the one, and end plate shape and symptoms on the other. Retrospective review of charts and radiographs. The charts, operative reports, preoperative lateral plain radiographs, and MRI scans of 178 patients (85 with low back pain and 93 with HNP) were reviewed. End plate shape was determined on midsagittal MRI cuts, disc degeneration was graded on T2 sequences, and disc height was measured on lateral plain radiographs from L1 to S1 in all patients. Student t-test and chi(2) test were used to detect significant differences and associations. Flat and irregular levels were most common in the lower lumbar spine. The L5/S1 segment was flat in most cases, due to a flat sacral end plate. In DDD patients, disc degeneration on MRI and plain radiographs worsened from concave to flat, to irregular levels. In HNP patients, MRI demonstrated concave levels to be less degenerated, whereas no difference was detected between flat and irregular levels. Disc height of irregular levels was well preserved in HNP patients. Comparing the two groups, flat levels were more degenerated on MRI in HNP patients. Despite similar degrees of degeneration on MRI, concave and irregular levels in DDD patients had lower disc heights. A higher frequency of symptoms was found in flat and irregular levels for both patient groups. The sagittal profile of end plates in the lumbar spine was described for patients with DDD on the one and HNP on the other. A higher association with symptoms was observed for flat and irregular levels in both patient groups. In DDD patients, disck degeneration on both MRI and

  9. [New aspects in age related macular degeneration].

    Science.gov (United States)

    Turlea, C

    2012-01-01

    Being the leading cause of blindness in modern world Age Related Macular Degeneration has beneficiated in the last decade of important progress in diagnosis, classification and the discovery of diverse factors who contribute to the etiology of this disease. Treatments have arised who can postpone the irreversible evolution of the disease and thus preserve vision. Recent findings have identified predisposing genetic factors and also inflamatory and imunological parameters that can be modified trough a good and adequate prevention and therapy This articole reviews new aspects of patology of Age Related Macular Degeneration like the role of complement in maintaining inflamation and the role of oxidative stress on different structures of the retina.

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

    Science.gov (United States)

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

    2017-03-01

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

  11. Three-year results of visual outcome with disease activity-guided ranibizumab algorithm for the treatment of exudative age-related macular degeneration.

    Science.gov (United States)

    Lala, Ceklic; Framme, Carsten; Wolf-Schnurrbusch, Ute E K; Wolf, Sebastian

    2013-09-01

    To evaluate 3-year follow-up treatment outcomes with ranibizumab (Lucentis(®)) 0.5 mg administered either monthly or quarterly on a pro re nata (PRN) basis according to a disease activity-guided monitoring and treatment algorithm. A total of 316 treatment-naive eyes of 316 patients with exudative age-related macular degeneration met the criteria for inclusion in this retrospective, interventional case series. Patients were treated with ranibizumab 0.5 mg according to a disease activity-guided algorithm with monthly monitoring. Optical coherence tomography and fluorescein angiography were routinely used to assess disease activity: active lesions were treated with a series of three monthly injections, whereas inactive lesions were treated with quarterly injections. Mean Early Treatment Diabetic Retinopathy Study best-corrected visual acuity improved from 52 letters at baseline to 59 letters at 12 months, achieved with a mean of 7.1 injections, 61 letters at 24 months with a mean of 5.0 injections administered in the second year and 60 letters at 36 months with a mean number of 5.2 injections. Monthly visits and a morphology-driven PRN regimen with 3 injections in case of recurrence plus quarterly injections in case of inactive CNV resulted in an average VA gain of 7-9 letters that could be maintained over 3 years. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  12. 老年退行性心脏瓣膜病超声心动图的临床应用%The diagnostic value of echocardiogram in degenerative valvular disease

    Institute of Scientific and Technical Information of China (English)

    许慧敏

    2013-01-01

    目的 探讨超声心动图在老年退行性瓣膜病中的应用价值,评价超声心动图对老年退行性心脏瓣膜病的检查价值.方法 回顾分析2010-2011年600例60岁以上老年人的彩色多谱勒超声心动图及临床资料.通过超声观察心脏瓣膜的形态、回声、厚度、活动度、室间隔、左室后壁厚度、心腔大小及左心功能.结果 检出退行性钙化瓣病350例,总患病率58.3%,其中男性检出150例(42.9%),女性检出200例(57.1%).随着年龄的增长,男、女的检出率变化差异无统计学意义(P>0.05),但检出率逐渐增高,差异有统计学意义(P<0.01).结论 随着年龄的增长,老年退行性瓣膜病呈递增趋势,超声心动图可及早发现,为临床早期治疗提供诊断依据.%Objective To discuss eehocardiographic features of senile degenerative valvular disease, and evaluate the application value of echocardiogram in elderly degenerative valvular disease and analyze the relative risk factors of these diseases. Methods 600 patients at the age of over 60 years from 2010 to 2011 were retrospectively analyzed. Echocardiography was used to observe the morphology, echo, thickness and activity of the heart valve, the thickness of interventricular septum and ventricular posterior wall, and left cardiac size and function. Results Detection degenerative disc disease calcification in 350, the total rates by 58.3%. The detection rate of men 150 cases (42.9%), women detection rate 200 cases (57.1%). As the growth of the age, the change of the men and women have no obvious difference (P>0.05), as the growth of the age, the detection rate was higher, there was significant difference (P<0.01). Conclusion With the growth of age, the positive rate of degenerative valvular disease is increasing. Echocardiogram may get degenerative valvular disease detected in the early stage and provide defining characteristics for early clinic treatment.

  13. Cystoid macular edema

    Directory of Open Access Journals (Sweden)

    Tryfon G Rotsos

    2008-10-01

    Full Text Available Tryfon G Rotsos1, Marilita M Moschos21Medical Retina Service, Moorfields Eye Hospital, London, UK; 2Department of Ophthalmology, University of Athens, GreeceAbstract: We review the epidemiology, pathophysiology, and etiology of cystoid macular edema (CME. Inflammatory, diabetic, post-cataract, and macular edema due to age-related macular degeneration is described. The role of chronic inflammation and hypoxia and direct macular traction is evaluated in each case according to different views from the literature. The different diagnostic methods for evaluating the edema are described. Special attention is given to fluoroangiography and the most modern methods of macula examination, such as ocular coherence tomography and multifocal electroretinography. Finally, we discuss the treatment of cystoid macular edema in relation to its etiology. In this chapter we briefly refer to the therapeutic value of laser treatment especially in diabetic maculopathy or vitrectomy in some selected cases. Our paper is focused mainly on recent therapeutic treatment with intravitreal injection of triamcinolone acetonide and anti-VEGF factors like bevacizumab (Avastin, ranibizumab (Lucentis, pegaptamid (Macugen, and others. The goal of this paper is to review the current status of this treatment for macular edema due to diabetic maculopathy, central retinal vein occlusion and post-cataract surgery. For this reason the results of recent multicenter clinical trials are quoted, as also our experience on the use of intravitreal injections of anti-VEGF factors and we discuss its value in clinical practice.Keywords: cystoid macular edema, anti-VEGF, fluoroangiography, OCT, multifocal electroretinography

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

    Directory of Open Access Journals (Sweden)

    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.

  15. 非融合技术在腰椎退行性疾病中的临床应用%Clinical Application of Non-Fusion Technology in the Lumbar Degenerative Disease

    Institute of Scientific and Technical Information of China (English)

    李新炜

    2011-01-01

    腰椎融合手术一段时间以来是治疗腰椎退行性疾病的有效方法.近年来,由于融合手术术后并发症的发生,使得非融合手术应运而生并得到发展.通过研究国内外非融合手术的随访文献发现非融合技术在保持病变节段一定的活动度、减缓邻近节段的退行性变、限制异常活动等方面有独特的优势.因此,非融合技术可以作为一种行之有效的手术方式来治疗腰椎退行性疾病.%Fusion surgery has been an effective way for the treatment of lumbar degenerative diseases for a long time. Due to the complications after surgery seen in recent years,the non-fusion technology has appeared and developed. According to studies of the recent follow-up literatures,it's learned that the non-fusion technology has some advantages such as retaining some residual motion, delaying degeneration of adjacent segment,and limiting abnormal activity etc.. Therefore,the non-fusion technology can be applied as an effective way of treating lumbar degenerative disease.

  16. Degenerative lumbosacral stenosis in dogs

    NARCIS (Netherlands)

    Suwankong, N.

    2007-01-01

    Degenerative lumbosacral stenosis (DLS) is now recognized as a significant cause of caudal lumbar pain and pelvic limb lameness in dogs. The condition includes lumbosacral intervertebral disc degeneration and protrusion, spondylosis deformans, sclerosis of the vertebral end plates, osteoarthrosis of

  17. Rotary deformity in degenerative spondylolisthesis

    Energy Technology Data Exchange (ETDEWEB)

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

    1994-05-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  19. Correlation analysis of carotid atherosclerosis and senile degenerative heart valvular disease%颈动脉粥样硬化与老年退行性心脏瓣膜病的相关性研究

    Institute of Scientific and Technical Information of China (English)

    宫文亮

    2014-01-01

    Objective:To explore the correlation of carotid atherosclerosis and degenerative valvular heart disease through high-frequency ultrasound carotid and echocardiographic examination in elderly patients. Methods:Eighty-eight cases of degenerative valvular heart disease were selected as the study group,49 cases of non-degenerative valvular heart disease as control group,the states of mitral and aortic valve,the internal-middle thickness(IMT) in carotid artery and carotid atherosclerotic plaques were measured and compared in the two groups. Results:The IMT,plaque score,plaque detection rate were higher in study group than in control group( P<0. 05 to P<0. 01). In study group,the obliteration rate was 2. 27%,the stenosis rate was 90. 91%;in control group,there were no luminal occlusion,the stenosis rate was 18. 37%,there was no statistical difference of the obliteration rate in the two groups(P =0. 573),while the stenosis rate in study group was significantly higher than in control group(P<0. 01);the complications of coronary heart disease,hypertension,diabetes and hyperlipidemia were significantly higher in study group(P<0. 01). Conclusions:There are the close relationship between carotid atherosclerosis and degenerative changes in heart valve,the degree of carotid atherosclerosis are increased with the degree of heart valve calcification, carotid atherosclerosis ultrasound should be performed for senile patients with degenerative heart valve disease.%目的:通过高频超声对老年患者颈动脉及超声心动图检查,探讨颈动脉粥样硬化与老年退行性心脏瓣膜病的相关性。方法:选择88例老年退行性心脏瓣膜病患者作为研究组,49例无老年退行性心脏瓣膜病患者作为对照组。检测并比较2组患者二尖瓣和主动脉瓣情况、颈动脉内-中层厚度( IMT)及颈动脉粥样硬化斑块情况。结果:研究组患者IMT、斑块积分、斑块检出率均高于对照组(P<0.05~P<0.01)

  20. 频域光学相干断层扫描在黄斑部疾病的应用%Application of spectral domain optical coherence tomography in macular diseases

    Institute of Scientific and Technical Information of China (English)

    黄中宁; 黄杜茹; 张良; 尹东明

    2011-01-01

    Objective To evaluate the application of the spectral domain optical coherence tomography in macular diseases.Methods Retrospective analysis the data of spectral domain optical coherence tomography which from 49 patients with macular diseases whom were received treatment from 13th May 2010 to 13th June 2010 at department of ophthalmology in Guangdong General Hospital.Results The 49 patients' OCT examination images showed characteristic morphological changes in different macular diseases.Conclusions Spectral domain optical coherence tomography is a reliable and noninvasive examination method for the diagnosis of macular disease and for the follow up procedure.%目的 观察并评估频域光学相干断层扫描在黄斑部病变的应用价值.方法 回顾分析2010年5月13日至2010年6月13日在广东省人民医院眼科就诊的49例累及眼底黄斑部的患者,用频域光学相干断层扫描的检查结果.结果 49例累及黄斑部的眼底疾病患者频域光学相干扫描图像显示其各自特征性形态学改变.结论 频域光学相干断层扫描对于黄斑部疾病的诊断及随诊是一种可靠的无创性检查方法.

  1. CKD Increases the Risk of Age-Related Macular Degeneration

    OpenAIRE

    Liew, Gerald; Mitchell, Paul; Wong, Tien Yin; Iyengar, Sudha K; Wang, Jie Jin

    2008-01-01

    Age-related macular degeneration is the leading cause of irreversible blindness in the United States and often coexists with chronic kidney disease. Both conditions share common genetic and environmental risk factors. A total of 1183 participants aged 54+ were examined in the population-based, prospective cohort Blue Mountains Eye Study (Australia) to determine if chronic kidney disease increases the risk of age-related macular degeneration. Moderate chronic kidney disease (estimated glomerul...

  2. [Age related macular degeneration].

    Science.gov (United States)

    Sayen, Alexandra; Hubert, Isabelle; Berrod, Jean-Paul

    2011-02-01

    Age-related macular degeneration (ARMD) is a multifactorial disease caused by a combination of genetic and environmental factors. It is the first cause of blindness in patients over 50 in the western world. The disease has been traditionally classified into early and late stages with dry (atrophic) and wet (neovascular) forms: neovascular form is characterized by new blood vessels development under the macula (choroidal neovascularisation) which lead to a rapid decline of vision associated with metamorphopsia and requiring an urgent ophtalmological examination. Optical coherence tomography is now one of the most important part of the examination for diagnosis and treatment. Patient with age related maculopathy should consider taking a dietary supplement such that used in AREDS. The treatment of the wet ARMD has largely beneficied since year 2006 of anti-VEGF (vascular endothelial growth factor) molecules such as ranibizumab or bevacizumab given as repeated intravitreal injections. A systematic follow up each 4 to 8 week in required for several years. There is no effective treatment at the moment for dry AMD. For patients with binocular visual acuity under 60/200 rehabilitation includes low vision specialist, vision aids and psychological support.

  3. Generic and disease-specific estimates of quality of life in macular degeneration:Mapping the MacDQoL onto the EQ-5D-3L

    OpenAIRE

    Dixon, Padraig; Dakin, Helen; Wordsworth, Sarah

    2016-01-01

    Purpose The macular degeneration quality of life (MacDQoL) instrument is a validated condition-specific measure of quality of life in patients with macular degeneration. This paper presents the first mapping algorithm to predict EQ-5D from responses to the MacDQoL instrument. Methods Responses to the MacDQoL and EQ-5D-3L instruments from 482 patients were collected from the IVAN multicentre trial of two alternative drug treatments for neovascular age-related macular degeneration. Regression ...

  4. Peritalar destabilisation syndrome (adult flatfoot with degenerative glenopathy).

    Science.gov (United States)

    Pisani, Giacomo

    2010-12-01

    In cases of adult acquired flatfoot associated with peritalar destabilisation, special reference is made to the plantar calcaneo-navicular (spring) ligament's degenerative disease (degenerative glenopathy) and to the presence of the accessory navicular bone as a possible pathogenic cause. Peritalar destabilization syndrome is proposed for the articular (subtalar and talo-navicular joints) or tendinosis (tibialis posterior tendon) separately or in association with degenerative glenopathy of the coxa pedis. In degenerative glenopathy surgical reconstruction of the glenoid also makes use of a posterior tibial split to create a new tibial-navicular ligament. The concept of pronatory syndrome deemed as the root the pathological subtalar pronation, which is an entirely secondary factor in peritalar destabilisation, must be questioned. We must keep in mind that subtalar pronation and supination are respectively subsequent to opening and closing of the coxa pedis (talo-calcaneo-navicular joint) kinetic chain.

  5. QLS-DSD与JOA评分量表在脊柱退行性疾病患者评分应用中的比较%A comparison between QLS-DSD and JOA scale in assessment of spinal degenerative disease

    Institute of Scientific and Technical Information of China (English)

    徐宏光; 张敏; 王弘; 刘平; 吴志宏; 邱贵兴

    2013-01-01

    背景:脊柱退行性疾病的发病率日渐上升,目前我国对疾病病情及愈合的评估一直沿用国外的统计量表,因此制定一套适合我国国情的关于脊柱退行性疾病患者的评估量表成为当务之急。  目的:比较脊椎生活量表(QLS-DSD)与汉化版JOA颈、腰椎评分量表在脊柱退行性疾病患者评价中的使用情况,评估两种量表的信度、区分效度和反应度。  方法:采用横、纵联合调查法利用QLS-DSD与汉化版JOA颈、腰椎量表分别对符合纳入标准的44例颈椎和61例腰椎退行性疾病手术治疗患者进行问卷调查,采用Cronbachα系数和分半信度评价两类量表的信度;计算患者术前、术后各量表在各领域得分和总得分,再进行t检验分析,来评价量表的区分效度和反应度。  结果:QLS-DSD总Cronbachα系数为0.891,总分半信度系数为0.908;JOA颈椎量表总Cronbachα系数为0.896,总分半信度系数为0.842;JOA腰椎量表总的Cronbachα系数为0.845,总分半信度系数为0.852。JOA量表在颈、腰椎患者手术前后的总分比较均有显著差异(P<0.05)。QLS-DSD仅在颈椎患者的手术前后总分中有显著差异(P<0.05),而在腰椎患者中差异无统计学意义(P>0.05)。  结论:QLS-DSD和JOA量表一样其使用信度良好,故可将其用在临床上对脊柱疾病患者的评价中。但QLS-DSD主要是为评估脊柱退行性疾病患者生活质量而制定的,不能较好的反映手术治疗后短期内治疗效果,但通过观察其改变趋势,可预见QLS-DSD可以很好的反映术后较长时间内的治疗效果对患者生活质量的影响。%Background:The incidence of spinal degenerative diseases has been gradually increasing. Foreign statistical scale has been used for the assessment of the disease in China. Therefore it becomes imperative to develop a set of assessment scale for Chinese with

  6. Genome-wide association studies: getting to pathogenesis, the role of inflammation/complement in age-related macular degeneration.

    Science.gov (United States)

    Cooke Bailey, Jessica N; Pericak-Vance, Margaret A; Haines, Jonathan L

    2014-09-11

    Age-related macular degeneration (AMD) is a chronic, degenerative, and significant cause of visual impairment and blindness in the elderly. Genetic and epidemiological studies have confirmed that AMD has a strong genetic component, which has encouraged the application of increasingly sophisticated genetic techniques to uncover the important underlying genetic variants. Although various genes and pathways have been implicated in the risk for AMD, complement activation has been emphasized repeatedly throughout the literature as having a major role both physiologically and genetically in susceptibility to and pathogenesis of this disease. This article explores the research efforts that brought about the discovery and characterization of the role of inflammatory and immune processes (specifically complement) in AMD. The focus herein is on the genetic evidence for the role of complement in AMD as supported specifically by genome-wide association (GWA) studies, which interrogate hundreds of thousands of variants across the genome in a hypothesis-free approach, and other genetic interrogation methods.

  7. What Is Macular Edema?

    Medline Plus

    Full Text Available ... health and preserving your vision. Privacy Policy Related Studies Show Zika Virus May Cause More Serious Eye Damage in Babies Than Thought May 31, 2016 Study Compares Eylea, Lucentis and Avastin for Diabetic Macular ...

  8. What Is Macular Edema?

    Medline Plus

    Full Text Available ... or recognize a face. Macular edema develops when blood vessels in the retina are leaking fluids. The macula ... Your Laser Pointer Dangerous Enough to Cause Eye Injury? Dec 20, 2013 Study Finds Tablets Help People ...

  9. Consensus Paper: Management of Degenerative Cerebellar Disorders

    Science.gov (United States)

    Ilg, W.; Bastian, A. J.; Boesch, S.; Burciu, R. G.; Celnik, P.; Claaßen, J.; Feil, K.; Kalla, R.; Miyai, I.; Nachbauer, W.; Schöls, L.; Strupp, M.; Synofzik, M.; Teufel, J.

    2015-01-01

    Treatment of motor symptoms of degenerative cerebellar ataxia remains difficult. Yet there are recent developments that are likely to lead to significant improvements in the future. Most desirable would be a causative treatment of the underlying cerebellar disease. This is currently available only for a very small subset of cerebellar ataxias with known metabolic dysfunction. However, increasing knowledge of the pathophysiology of hereditary ataxia should lead to an increasing number of medically sensible drug trials. In this paper, data from recent drug trials in patients with recessive and dominant cerebellar ataxias will be summarized. There is consensus that up to date, no medication has been proven effective. Aminopyridines and acetazolamide are the only exception, which are beneficial in patients with episodic ataxia type 2. Aminopyridines are also effective in a subset of patients presenting with downbeat nystagmus. As such, all authors agreed that the mainstays of treatment of degenerative cerebellar ataxia are currently physiotherapy, occupational therapy, and speech therapy. For many years, well-controlled rehabilitation studies in patients with cerebellar ataxia were lacking. Data of recently published studies show that coordinative training improves motor function in both adult and juvenile patients with cerebellar degeneration. Given the well-known contribution of the cerebellum to motor learning, possible mechanisms underlying improvement will be outlined. There is consensus that evidence-based guidelines for the physiotherapy of degenerative cerebellar ataxia need to be developed. Future developments in physiotherapeutical interventions will be discussed including application of non-invasive brain stimulation. PMID:24222635

  10. Cataracts and macular degeneration.

    Science.gov (United States)

    Shoch, D

    1979-09-01

    The intraocular lens restores general vision and some degree of independence and mobility to patients with dense cataracts and macular degeneration. The patient, however, must be repeatedly warned that fine central vision, particularly reading, will not be possible after the surgery. An aphakic spectacle leaves such patients a narrow band of vision when superimposed over the macular lesion, and contact lenses are too small for the patient to manage insertion without help.

  11. 组织工程在视网膜退行性疾病中的应用进展%Research advance in application of tissue engineering in degenerative retinal diseases

    Institute of Scientific and Technical Information of China (English)

    张敬学

    2011-01-01

    视网膜退行性疾病的主要病理基础是视网膜各级神经元的结构和功能性异常,最终造成患者视力的不可逆性损害,目前缺乏有效的治疗方法.近年来干细胞替代治疗方法的出现为此类致盲性眼病的治疗带来了希望,其相关研究已取得一定的进展.但是在研究中发现,干细胞的眼部移植仍存在着一些难点,如移植后细胞的移行能力、存活效率以及向目的细胞的分化能力等.因此,最近研究显示,视网膜组织工程技术的研究和发展有助于解决或弥补以上问题.针对目前干细胞和组织工程视网膜的研究状况,对视网膜组织工程的种子细胞、支架材料、体内移植技术等研究进展、取得的成绩和存在的问题进行综述.%The pathogenic basis of degenerative retinal diseases is structural and functional abnormality of neuron of retina.The irreversible damage of visual function is the unfortunate results of degenerative retinal diseases,and some effective treating approach to these blindness eye diseases is still in expectation.In recent years,stem cells replacement therapy is increasingly developed and is a prospective way for degenerative retinal diseases.But some formidable challenges for successfully grafting cells to the retina are waiting for further solving,such as migration,survival,and differentiation of the stem cells etc.Recent studies showed that retinal tissue engineering technique may be a good alternation to address all the problems mentioned above.The current advances in stem cell and tissue engineering retina researches,including selectable seed cells,appropriate scaffold materials and transferring method in vivo,are reviewed in this paper.

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

    Energy Technology Data Exchange (ETDEWEB)

    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)

  13. Disease: H00814 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available H00814 Vitelliform macular dystrophy, including: Best disease / Juvenile vitelliform macular... dystrophy (VMD2) ; Adult-onset vitelliform macular dystrophy (AVMD); Autosomal recessive bestrophi...nopathy (ARB) Vitelliform macular dystrophy is characterized by autosomal dominant inheritance and autofluor...f Adult-onset vitelliform macular dystrophy (AVMD) is between 30 and 50 years accompanied by slowly progress...RPH2 in juvenile and adult vitelliform macular dystrophies: a rationale for molecular analysis. Ophthalmolog

  14. CKD increases the risk of age-related macular degeneration.

    Science.gov (United States)

    Liew, Gerald; Mitchell, Paul; Wong, Tien Yin; Iyengar, Sudha K; Wang, Jie Jin

    2008-04-01

    Age-related macular degeneration is the leading cause of irreversible blindness in the United States and often coexists with chronic kidney disease. Both conditions share common genetic and environmental risk factors. A total of 1183 participants aged 54+ were examined in the population-based, prospective cohort Blue Mountains Eye Study (Australia) to determine if chronic kidney disease increases the risk of age-related macular degeneration. Moderate chronic kidney disease (estimated glomerular filtration rate macular degeneration was 3.9% in participants with no/mild chronic kidney disease (35 of 897) and 17.5% in those with moderate chronic kidney disease (50 of 286). After adjusting for age, sex, cigarette smoking, hypertension, complement factor H polymorphism, and other risk factors, persons with moderate chronic kidney disease were 3 times more likely to develop early age-related macular degeneration than persons with no/mild chronic kidney disease (odds ratio = 3.2; 95% confidence interval, 1.8 to 5.7, P macular degeneration (odds ratio = 2.0; 95% confidence interval, 1.5 to 2.8, P chronic kidney disease have a higher risk of early age-related macular degeneration, suggesting the possibility of shared pathophysiologic mechanisms between the two conditions.

  15. Mechanisms of activation of the transcription factor Nrf2 by redox stressors, nutrient cues, and energy status and the pathways through which it attenuates degenerative disease

    Science.gov (United States)

    Tebay, Lauren E.; Robertson, Holly; Durant, Stephen T.; Vitale, Steven R.; Penning, Trevor M.; Dinkova-Kostova, Albena T.; Hayes, John D.

    2015-01-01

    by β-transducin repeat-containing protein (β-TrCP), present in the Skp1–cullin-1–F-box protein (SCF) ubiquitin ligase complex SCFβ-TrCP. The ability of SCFβ-TrCP to suppress Nrf2 activity is itself enhanced by prior phosphorylation of the transcription factor by glycogen synthase kinase-3 (GSK-3) through formation of a DSGIS-containing phosphodegron. However, formation of the phosphodegron in Nrf2 by GSK-3 is inhibited by stimuli that activate protein kinase B (PKB)/Akt. In particular, PKB/Akt activity can be increased by phosphoinositide 3-kinase and mTORC2, thereby providing an explanation of why antioxidant-responsive element-driven genes are induced by growth factors and nutrients. Thus Nrf2 activity is tightly controlled via CRLKeap1 and SCFβ-TrCP by oxidative stress and energy-based signals, allowing it to mediate adaptive responses that restore redox homeostasis and modulate intermediary metabolism. Based on the fact that Nrf2 influences multiple biochemical pathways in both positive and negative ways, it is likely its dose–response curve, in terms of susceptibility to certain degenerative disease, is U-shaped. Specifically, too little Nrf2 activity will lead to loss of cytoprotection, diminished antioxidant capacity, and lowered β-oxidation of fatty acids, while conversely also exhibiting heightened sensitivity to ROS-based signaling that involves receptor tyrosine kinases and apoptosis signal-regulating kinase-1. By contrast, too much Nrf2 activity disturbs the homeostatic balance in favor of reduction, and so may have deleterious consequences including overproduction of reduced glutathione and NADPH, the blunting of ROS-based signal transduction, epithelial cell hyperplasia, and failure of certain cell types to differentiate correctly. We discuss the basis of a putative U-shaped Nrf2 dose–response curve in terms of potentially competing processes relevant to different stages of tumorigenesis. PMID:26122708

  16. Mechanism of Inflammation in Age-Related Macular Degeneration: An Up-to-Date on Genetic Landmarks

    Directory of Open Access Journals (Sweden)

    Francesco Parmeggiani

    2013-01-01

    Full Text Available Age-related macular degeneration (AMD is the most common cause of irreversible visual impairment among people over 50 years of age, accounting for up to 50% of all cases of legal blindness in Western countries. Although the aging represents the main determinant of AMD, it must be considered a multifaceted disease caused by interactions among environmental risk factors and genetic backgrounds. Mounting evidence and/or arguments document the crucial role of inflammation and immune-mediated processes in the pathogenesis of AMD. Proinflammatory effects secondary to chronic inflammation (e.g., alternative complement activation and heterogeneous types of oxidative stress (e.g., impaired cholesterol homeostasis can result in degenerative damages at the level of crucial macular structures, that is photoreceptors, retinal pigment epithelium, and Bruch’s membrane. In the most recent years, the association of AMD with genes, directly or indirectly, involved in immunoinflammatory pathways is increasingly becoming an essential core for AMD knowledge. Starting from the key basic-research notions detectable at the root of AMD pathogenesis, the present up-to-date paper reviews the best-known and/or the most attractive genetic findings linked to the mechanisms of inflammation of this complex disease.

  17. Mechanism of inflammation in age-related macular degeneration: an up-to-date on genetic landmarks.

    Science.gov (United States)

    Parmeggiani, Francesco; Sorrentino, Francesco S; Romano, Mario R; Costagliola, Ciro; Semeraro, Francesco; Incorvaia, Carlo; D'Angelo, Sergio; Perri, Paolo; De Nadai, Katia; Bonomo Roversi, Elia; Franceschelli, Paola; Sebastiani, Adolfo; Rubini, Michele

    2013-01-01

    Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment among people over 50 years of age, accounting for up to 50% of all cases of legal blindness in Western countries. Although the aging represents the main determinant of AMD, it must be considered a multifaceted disease caused by interactions among environmental risk factors and genetic backgrounds. Mounting evidence and/or arguments document the crucial role of inflammation and immune-mediated processes in the pathogenesis of AMD. Proinflammatory effects secondary to chronic inflammation (e.g., alternative complement activation) and heterogeneous types of oxidative stress (e.g., impaired cholesterol homeostasis) can result in degenerative damages at the level of crucial macular structures, that is photoreceptors, retinal pigment epithelium, and Bruch's membrane. In the most recent years, the association of AMD with genes, directly or indirectly, involved in immunoinflammatory pathways is increasingly becoming an essential core for AMD knowledge. Starting from the key basic-research notions detectable at the root of AMD pathogenesis, the present up-to-date paper reviews the best-known and/or the most attractive genetic findings linked to the mechanisms of inflammation of this complex disease.

  18. European survey on the opinion and use of micronutrition in age-related macular degeneration: 10 years on from the Age-Related Eye Disease Study

    Directory of Open Access Journals (Sweden)

    Aslam T

    2014-10-01

    Full Text Available Tariq Aslam,1 Cécile Delcourt,2 Frank Holz,3 Alfredo García-Layana,4 Anita Leys,5 Rufino M Silva,6 Eric Souied7 1Manchester Royal Eye Hospital, Manchester, UK; 2University of Bordeaux, Bordeaux, France; 3University of Bonn, Bonn, Germany; 4Clínica Universidad de Navarra, Pamplona, Spain; 5University Hospitals, Leuven, Belgium; 6University of Coimbra, Coimbra, Portugal; 7Université Paris Est Créteil, Créteil, FrancePurpose: To evaluate ophthalmologists’ opinion of, and use of, micronutritional dietary supplements 10 years after publication of the first Age-Related Eye Disease Study (AREDS study.Methods: Participation was solicited from 4,000 European ophthalmologists. Responding physicians were screened, and those treating at least 40 patients with age-related macular degeneration (AMD per month and prescribing nutrition supplements at least 4 times per month were admitted and completed a 40-item questionnaire.Results: The surveyed sample included 112 general ophthalmologists and 104 retinal specialists. Most nutritional supplements (46% were initiated when early/intermediate AMD was confirmed, although 18% were initiated on confirmation of neovascular AMD. Clinical studies were well known: 90% were aware of AREDS, with 88% aware of AREDS1 and 36% aware of the, as-yet-unpublished, AREDS2 studies. Respondents considered lutein, zeaxanthin, zinc, omega-3, and vitamins to be the most important components of nutritional supplements, with the results of AREDS2 already having been taken into consideration by many. Ophthalmologists anticipate more scientific studies as well as improved product quality but identify cost as a barrier to wider uptake.Conclusion: Micronutrition is now part of the routine management of AMD for many ophthalmologists. Ophthalmologists choosing to use nutritional supplements are well-informed regarding current scientific studies. Keywords: age-related macular degeneration, micronutrition, nutritional

  19. Combined therapy of integration and non-fusion fixation to lumbar degenerative disease%融合联合非融合固定治疗腰椎退行性病

    Institute of Scientific and Technical Information of China (English)

    孙义忠; 刘宝平; 何强; 范先东; 李铁军; 王锋宝

    2012-01-01

    Objective To investigate the clinical efficacy of the combined therapy of integration and non-fusion fixation to lumbar degenerative disease. Methods Forty-two patients who received integration and non-fusion fixation for the treatment of lumbar disc herniation and another 30 patients who received spondylolisthesis merge adjacent segments intcrvcrtebral herniation between May 2006 to December 2011 were in included in the study. After surgery, patients had an average follow-up of 19 (6-50) months. Visual analogue scales (VAS) and Oswestry disability index (ODI) were employed to assess postoperative efficacy. Results No postoperative infection, nerve root injury, cerebrospinal fluid leakage and other complications occurred. VAS and ODI evaluation results showed that postoperative changes in VAS and ODI scores were statistically significant (P<0. 01) . Conclusion Integration and non-fusion fixation for the treatment of lumbar degenerative disease has marked decompression effect with reliable fixation. It can effectively mitigate the adjacent inter-vcrtebral disc degeneration. Thus it is an effective method in the treatment of lumbar degenerative disease.%目的 探讨融合联合非融合固定联合治疗腰椎退行性病的临床疗效.方法 选取我院2006年5月~2011年12月作者采用融合联合非融合固定治疗腰椎间盘突出症患者42例及腰椎滑脱合并椎间盘突出症30例.术后患者获得平均19(6~50)个月的随访,采用视觉模拟评分法(VAS)及腰椎功能障碍指数(ODI)评定患者手术后的治疗疗效.结果 本组患者术后均无感染、神经根损伤、脑脊液漏等并发症发生.VAS及ODI评定结果显示患者术后VAS及ODI分值改善优于术前,手术前后比较差异有统计学意义(P<0.01).结论 融合联合非融合固定治疗腰椎退行性病减压效果明显、固定可靠,有效减缓了相邻椎间盘退变,是治疗腰椎退行性病的一种有效方法.

  20. 改良的腰椎后路植骨融合术治疗腰椎退行性疾病的疗效%Modified Posterior Lumbar Interbody Fusion for Lumbar Degenerative Diseases

    Institute of Scientific and Technical Information of China (English)

    高松; 马勇; 张斌; 刘远

    2014-01-01

    目的:探讨改良的腰椎后路椎间植骨融合术治疗腰椎退行性疾病的临床疗效。方法对76例腰椎退行性疾病患者均采用改良的腰椎后路椎间植骨融合术治疗,并采用视觉模拟评分(VAS)法、日本骨科协会评估治疗分数(JOA)评分法对76例患者术前、术后随访3个月时进行VAS、JOA评分。术后随访1年,行X线检查,同时观察植骨融合率的情况。结果76例患者术后随访3个月VAS得分明显低于术前、JOA得分明显高于术前(P<0.05)。术后随访1年,X线检查示76例患者植骨块无明显移位,无断钉、断棒和松动;植骨融合率为97.4%(74/76)。结论改良的腰椎后路椎间植骨融合术是治疗腰椎退行性疾病的一种有效方法。%Objective To explore the clinical efficacy of modified posterior lumbar interbody fusion (PLIF) in the treatment of lumbar degenerative diseases. Methods Seventy-six patients with lumbar degenerative diseases were treated with the modified PLIF. The clinical outcomes were evaluated by visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scores before and 3 months after operation. The rate of fusion was measured by X-ray 1 year after operation. Results VAS scores decreased and JOA scores increased after operation (P<0.05). No obvious bone graft displacement, screw breakage, rod breakage and screw loosening were found in all patients after 1 year of follow-up. The bone graft fusion rate was 97.4%(74/76).Conclusion The modified posterior lumbar interbody fusion is effective for lumbar degenerative diseases.

  1. 动态中和固定系统治疗腰椎退行性疾病的研究进展%Progress on dynamic neutralization system in treating lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    陈喜君; 范顺武

    2013-01-01

    动态固定技术治疗腰椎退行性疾病日益成为基础和临床研究的热点.动态中和固定系统(dynamic neutralization system,Dynesys)作为动态固定技术的一种,既能保持脊柱的活动能力,改善患者的临床症状,还在延缓邻近节段退变方面表现出一定的优势.Dynesys技术可作为腰椎融合之外治疗腰椎退行性疾病的另一最佳选择,主要适用于轻至中度的腰椎退变性疾病,但它缺乏保持和恢复腰椎前凸的机制需要患者主动伸展实现前凸.如何延长使用寿命、预防并发症发生等问题有待解决,其远期疗效及延缓邻近节段退变作用机制需进一步明确.%Dynamic stabilization technology has increasingly become the hot spot in basic and clinical research for treating lumbar degenerative diseases.As one kind of dynamic stabilization technology,dynamic neutralization system (Dynesys) keeps the spinal motion ability and improve clinical symptoms of patients,moreover,it shows a certain advantage in delaying the degeneration of adjacent segments.From the available documents,the preliminary biomechanical and clinical results of Dynesys were optimistically,it has become another choice in treating the lumbar degenerative diseases besides the lumbar fusion,and it primarily applies to the treatment of mild to moderate lumbar degenerative disease.However,it lacks a mechanism to maintain and restore the lumbar lordosis and patients need active stretching to achieve lordosis.What's more,how to extend the service life and prevent complications remain to be solved,the long-term effect and the mechanism of delaying the adjacent segment degeneration need further investigation.In this article,the design principle,biomechanical research,clinical outcome and clinical application of Dynesys was reviewed.

  2. RP1L1 variants are associated with a spectrum of inherited retinal diseases including retinitis pigmentosa and occult macular dystrophy.

    Science.gov (United States)

    Davidson, Alice E; Sergouniotis, Panagiotis I; Mackay, Donna S; Wright, Genevieve A; Waseem, Naushin H; Michaelides, Michel; Holder, Graham E; Robson, Anthony G; Moore, Anthony T; Plagnol, Vincent; Webster, Andrew R

    2013-03-01

    In one consanguineous family with retinitis pigmentosa (RP), a condition characterized by progressive visual loss due to retinal degeneration, homozygosity mapping, and candidate gene sequencing suggested a novel locus. Exome sequencing identified a homozygous frameshifting mutation, c.601delG, p.Lys203Argfs*28, in RP1L1 encoding RP 1-like1, a photoreceptor-specific protein. A screen of a further 285 unrelated individuals with autosomal recessive RP identified an additional proband, homozygous for a missense variant, c.1637G>C, p.Ser546Thr, in RP1L1. A distinct retinal disorder, occult macular dystrophy (OCMD) solely affects the central retinal cone photoreceptors and has previously been reported to be associated with variants in the same gene. The association between mutations in RP1L1 and the disorder OCMD was explored by screening a cohort of 28 unrelated individuals with the condition; 10 were found to harbor rare (minor allele frequency ≤0.5% in the 1,000 genomes dataset) heterozygous RP1L1 missense variants. Analysis of family members revealed many unaffected relatives harboring the same variant. Linkage analysis excluded the possibility of a recessive mode of inheritance, and sequencing of RP1, a photoreceptor protein that interacts with RP1L1, excluded a digenic mechanism involving this gene. These findings imply an important and diverse role for RP1L1 in human retinal physiology and disease.

  3. Design, synthesis, and evaluation of nonretinoid retinol binding protein 4 antagonists for the potential treatment of atrophic age-related macular degeneration and Stargardt disease.

    Science.gov (United States)

    Cioffi, Christopher L; Dobri, Nicoleta; Freeman, Emily E; Conlon, Michael P; Chen, Ping; Stafford, Douglas G; Schwarz, Daniel M C; Golden, Kathy C; Zhu, Lei; Kitchen, Douglas B; Barnes, Keith D; Racz, Boglarka; Qin, Qiong; Michelotti, Enrique; Cywin, Charles L; Martin, William H; Pearson, Paul G; Johnson, Graham; Petrukhin, Konstantin

    2014-09-25

    Accumulation of lipofuscin in the retina is associated with pathogenesis of atrophic age-related macular degeneration and Stargardt disease. Lipofuscin bisretinoids (exemplified by N-retinylidene-N-retinylethanolamine) seem to mediate lipofuscin toxicity. Synthesis of lipofuscin bisretinoids depends on the influx of retinol from serum to the retina. Compounds antagonizing the retinol-dependent interaction of retinol-binding protein 4 (RBP4) with transthyretin in the serum would reduce serum RBP4 and retinol and inhibit bisretinoid formation. We recently showed that A1120 (3), a potent carboxylic acid based RBP4 antagonist, can significantly reduce lipofuscin bisretinoid formation in the retinas of Abca4(-/-) mice. As part of the NIH Blueprint Neurotherapeutics Network project we undertook the in vitro exploration to identify novel conformationally flexible and constrained RBP4 antagonists with improved potency and metabolic stability. We also demonstrate that upon acute and chronic dosing in rats, 43, a potent cyclopentyl fused pyrrolidine antagonist, reduced circulating plasma RBP4 protein levels by approximately 60%.

  4. Age-related macular degeneration--emerging pathogenetic and therapeutic concepts.

    Science.gov (United States)

    Gehrs, Karen M; Anderson, Don H; Johnson, Lincoln V; Hageman, Gregory S

    2006-01-01

    Today, the average life expectancy in developed nations is over 80 years and climbing. And yet, the quality of life during those additional years is often significantly diminished by the effects of age-related, degenerative diseases, including age-related macular degeneration (AMD), the leading cause of blindness in the elderly worldwide. AMD is characterized by a progressive loss of central vision attributable to degenerative and neovascular changes in the macula, a highly specialized region of the ocular retina responsible for fine visual acuity. Estimates gathered from the most recent World Health Organization (WHO) global eye disease survey conservatively indicate that 14 million persons are blind or severely visually impaired because of AMD. The disease has a tremendous impact on the physical and mental health of the geriatric population and their families and is becoming a major public health burden. Currently, there is neither a cure nor a means to prevent AMD. Palliative treatment options for the less prevalent, late-stage 'wet' form of the disease include anti-neovascular agents, photodynamic therapy and thermal laser. There are no current therapies for the more common 'dry' AMD, except for the use of antioxidants that delay progression in 20%-25% of eyes. New discoveries, however, are beginning to provide a much clearer picture of the relevant cellular events, genetic factors, and biochemical processes associated with early AMD. Recently, compelling evidence has emerged that the innate immune system and, more specifically, uncontrolled regulation of the complement alternative pathway plays a central role in the pathobiology of AMD. The complement Factor H gene--which encodes the major inhibitor of the complement alternative pathway--is the first gene identified in multiple independent studies that confers a significant genetic risk for the development of AMD. The emergence of this new paradigm of AMD pathogenesis should hasten the development of novel

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-15

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

  6. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Treatment of neovascular age-related macular degeneration in patients with diabetes

    Directory of Open Access Journals (Sweden)

    Michael Cummings

    2008-06-01

    Full Text Available Michael Cummings1, José Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Association for Innovation and Biomedical Research on Light and Image, Coimbra, PortugalAbstract: The number of patients with type 2 diabetes continues to rise; an anticipated 300 million people will be affected by 2025. The immense social and economic burden of the condition is exacerbated by the initial asymptomatic nature of type 2 diabetes, resulting in a high prevalence of micro- and macrovascular complications at presentation. Diabetic retinopathy, one of the potential microvascular complications associated with diabetes, and neovascular age-related macular degeneration (AMD are the two most frequent retinal degenerative diseases, and are responsible for the majority of blindness due to retinal disease. Both conditions predominantly affect the central macula, and are associated with the presence of retinal edema and an aggressive inflammatory repair process that accelerates disease progression. The associated retinal edema and the inflammatory repair process are directly involved in the breakdown of the blood-retinal barrier (BRB. Yet, the underlying alterations to the BRB caused by the diseases are very different. The coexistence of the two conditions appears to be relatively uncommon, suggesting that diabetes may even protect patients from developing neovascular AMD. However, it is thought that the inflammatory repair responses associated with diabetic retinopathy and neovascular AMD may be cumulative and, in patients affected by both, could result in chronic diffuse cystoid edema. Treatment considerations in such patients should, therefore, include the role of retinal edema and the increased susceptibility of patients with

  8. 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

    Institute of Scientific and Technical Information of China (English)

    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

  9. BioFlex Dynamic Stabilization System in Treatment of Lumbar Degenerative Diseases%BioFlex动态稳定系统治疗腰椎退行性变疾病

    Institute of Scientific and Technical Information of China (English)

    黄升峰; 李展振; 张海存; 吴沧陆; 黄明

    2015-01-01

    BioFlex动态稳定系统是目前临床运用较多的后路非融合系统之一,具有容易安装、对组织损伤小、去除病变并保留手术节段功能等优点,治疗腰椎退行性变疾病疗效肯定。%BioFlex dynamic stabilization system is one of the currently most used posterior non-fusion systems, which has some advantages such as easy installing, slight tissue damage, lesions removing and the functions of operated segments can be kept, and significant curative effect would be got when it's used in treatment of lumbar degenerative diseases.

  10. 退变性腰椎间盘病外科治疗现状与研究%The present status of surgical treatment and research of degenerative lumbar disk disease

    Institute of Scientific and Technical Information of China (English)

    党耕町

    2002-01-01

    @@ 本期刊登有关脊柱疾患的论文9篇,其中5篇是关于腰椎间盘病的病理与手术治疗的研究.作者根据临床实践或实验研究中的问题,进行了系统地观察、分析、总结,得出结论并提出各自的观点. 退变性椎间盘病 (degenerative disk disease, DDD)是中老年人群中的常见病、多发病,是脊柱外科医生或骨科医生几乎每天都要处理的临床问题.

  11. Effect of macular hole volume on postoperative central macular thickness

    Directory of Open Access Journals (Sweden)

    Taylan Ozturk

    2016-06-01

    Full Text Available ABSTRACT Purpose: To evaluate the association between macular hole volume (MHV and postoperative central macular thickness (CMT using spectral-domain optical coherence tomography (SD-OCT. Methods: Thirty-three eyes of 30 patients with a large full-thickness idiopathic macular hole with or without vitreomacular traction who underwent surgical intervention were included in this cross-sectional study. Complete ophthalmological examination, including SD-OCT, was performed for all participants during the pre- and postoperative visits. MHV was preoperatively measured using SD-OCT, which captured the widest cross-sectional image of the hole. For normal distribution analysis of the data, the Kolmogorov-Smirnov test was performed, and for statistical analyses, chi-square, Student's t-test, Mann-Whitney U test, and Pearson's correlation coefficient test were performed. Results: Mean preoperative best-corrected visual acuity (BCVA and MHV were found to be 0.99 ± 0.36 (range, 0.3-2.0 logMAR and 0.139 ± 0.076 (range, 0.004-0.318 mm3, respectively. Mean follow-up was 16.3 ± 14.3 (range, 3-50 months. No statistical correlations were found between MHV and postoperative BCVA (p=0.588 and between MHV and disease recurrence (p=0.544. A weak negative correlation existed between MHV and final CMT scores (p=0.04, r=-0.383. Conclusions: Greater MHV was found to be weakly associated with lower postoperative CMT scores.

  12. Machine learning based detection of age-related macular degeneration (AMD) and diabetic macular edema (DME) from optical coherence tomography (OCT) images

    OpenAIRE

    Wang, Yu; Zhang, Yaonan; Yao, Zhaomin; Zhao, Ruixue; Zhou, Fengfeng

    2016-01-01

    Non-lethal macular diseases greatly impact patients’ life quality, and will cause vision loss at the late stages. Visual inspection of the optical coherence tomography (OCT) images by the experienced clinicians is the main diagnosis technique. We proposed a computer-aided diagnosis (CAD) model to discriminate age-related macular degeneration (AMD), diabetic macular edema (DME) and healthy macula. The linear configuration pattern (LCP) based features of the OCT images were screened by the Corr...

  13. 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

    Institute of Scientific and Technical Information of China (English)

    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。

  14. 老年退行性心脏瓣膜病合并心力衰竭临床治疗探析%Investigation of clinical treatment of senile degenerative valvular heart disease with heart failure

    Institute of Scientific and Technical Information of China (English)

    匡时权

    2014-01-01

    目的:探讨老年退行性心脏瓣膜病合并心力衰竭的临床治疗。方法本次选择60例患者,随机分组就常规治疗(对照组)与加用血管紧张素转换酶抑制剂(观察组)的预后对比。结果观察组临床总有效率96.7%,明显高于对照组73.3%(P<0.05)。结论老年退行性心脏瓣膜病合并心力衰竭采用血管紧张素转换酶抑制治疗,可提高预后,改善心功能,加快病情康复。%Objective To investigate the clinical treatment of senile degenerative valvular heart disease with heart failure. Methods Sixty patients were randomized to conventional treatment (control group) and conventional treatment combined with angiotensin-converting enzyme (ACE) inhibitor (observation group). The two groups were compared in terms of treatment outcome. Results The observation group had a significantly higher overall response rate than the control group (96.7% vs 73.3%, P<0.05). Conclusion ACE inhibitor can improve prognosis and cardiac function and promote recovery in the treatment of senile degenerative valvular heart disease with heart failure.

  15. Treatment of modified minimally invasive TLIF and unilateral nail holding system for lumbar degenerative disease%微创改良TLIF联合单侧钉棒系统固定治疗腰椎退行性疾病

    Institute of Scientific and Technical Information of China (English)

    赖征文; 李敏; 熊卜贵; 李平安; 刘云彬

    2011-01-01

    [目的]探讨采用微创(minimally invasive)改良经腰椎间孔椎体间融合(modified transforaminal lumbar interbody fusion,TLIF)联合单侧钉棒系统治疗腰椎退行性疾病(lumbar vertebrae degenerative disease)的适应证、手术方法、初步疗效及并发症.[方法]2010年1月~2011年3月,随机选取有微创TLIF术适应证腰椎退行性疾病病例30例,其中微创改良TLIF联合单侧钉棒系统固定组(A组)15例,常规开放TLIF组(B组)15例,行各自术式手术并进行对照研究.[结果]术后6个月A组同B组在腰椎椎间植骨融合率、JOA评分等比较差异均显著,具有统计学意义(P(0.05).[结论]微创改良TLIF联合单侧钉棒系统固定治疗腰椎退行性疾病具有软组织损伤小、出血量少、不破坏对侧正常结构、住院时间短、腰椎椎间植骨融合率高、临床症状、体征及括约肌功能改善率高、并发症发生率低的优点,值得在临床推广应用.%[Objective]To discuss the treatment indications, surgical methods, preliminary results and complications of modified minimally invasive TLIF and unilateral nail holding system for lumbar degenerative disease.[Method]Thirty patients with indications of minimally invasive TLIF technique for degenerative illness were randomly selected from January 2010 to March 2011,15 cases were for minimally invasive TLIF improved holding system of the united unilateral screw fixation group ( group A ),15 cases were for conventional open TLIF technique ( group B).Controlled study was made for each surgical procedure.[Result]The lumbar interbody fusion rate, JOA scores between groups A and B showed statistically significant difference ( P < 0.05 ).[Conclusion]Modified minimally invasive TLIF and unilateral nail holding system for lumbar degenerative diseases has advantages of less soft tissue injury,less blood loss, avoiding destroying normal structure of contralateral, shorter hospital stay, higher lumbar interbody fusion rate

  16. [Physiopathology of macular edema in central vein occlusion].

    Science.gov (United States)

    Stanca, Horia T; Manea, Georgiana

    2012-01-01

    Retinal Vein Occlusions are vascular diseases affecting the Central Retinal Vein and its branches causing decreased retinal drainage resulting in significant clinical and functional pathological changes. RVO determines the increase of vascular permeability, with edema and hemorrhage and development of collateral vessels in a few weeks. Among the serious consequences of venous occlusion is the installation of macular edema to which depends long-term visual prognosis. Macular Edema is the accumulation of intraretinal serous fluid in the macular area caused by the breakdown of blood-retinal barrier.

  17. Differentiating full thickness macular holes from impending macular holes and macular pseudoholes

    Science.gov (United States)

    Tsujikawa, M.; Ohji, M.; Fujikado, T.; Saito, Y.; Motokura, M.; Ishimoto, I.; Tano, Y.

    1997-01-01

    AIMS—The reliability of scanning laser ophthalmoscope (SLO) microperimetry in differentiating full thickness macular holes from macular pseudoholes and impending macular holes was evaluated.
METHODS—106 eyes with the clinical diagnosis of full thickness macular holes, macular pseudoholes, and impending (stage 1) macular holes were examined for the presence of deep or relative scotoma using SLO microperimetry. The relation between these scotomas and the clinical diagnosis was studied.
RESULTS—Deep and relative scotomas were detected in all 57 eyes with clinically defined full thickness macular holes. In contrast, among 49 eyes diagnosed with macular pseudoholes or impending macular holes, no deep and only one relative scotoma was observed. The sensitivity of the presence of a deep scotoma as an indicator of the clinical diagnosis of a full thickness macular hole was 100% (57 of 57), and the specificity was 100% (49 of 49). The sensitivity of the presence of a relative scotoma was 100% (57 of 57) and the specificity was 98.0% (48 of 49).
CONCLUSION—With SLO microperimetry, full thickness macular holes can be precisely and objectively distinguished from other conditions that mimic macular holes.

 PMID:9059244

  18. Occult Macular Dystrophy

    Directory of Open Access Journals (Sweden)

    Işıl Sayman Muslubaş

    2016-04-01

    Full Text Available Occult macular dystrophy is an inherited macular dystrophy characterized by a progressive decline of bilateral visual acuity with normal fundus appearance, fluorescein angiogram and full-field electroretinogram. This case report presents a 20-year-old female patient with bilateral progressive decline of visual acuity for six years. Her visual acuity was 3-4/10 in both eyes. Anterior segment and fundus examination, fluorescein angiogram and full-field electroretinogram were normal. She could read all Ishihara pseudoisochromatic plates. Fundus autofluorescence imaging was normal. There was a mild central hyporeflectance on fundus infrared reflectance imaging in both eyes. Reduced foveal thickness and alterations of the photoreceptor inner and outer segment junction were observed by optical coherence tomography in both eyes. Central scotoma was also found by microperimetry and reduced central response was revealed by multifocal electroretinogram in both eyes. These findings are consistent with the clinical characteristics of occult macular dystrophy

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

    Science.gov (United States)

    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.

  20. Advance in etiology of age-related macular degeneration%老年性黄斑变性病因研究新进展

    Institute of Scientific and Technical Information of China (English)

    潘俊如; 余其林; 张述; 李斌; 胡军

    2013-01-01

    老年性黄斑变性(age-related macular degeneration,AMD)是发达国家首要致盲眼病,在我国的发病率也呈逐年上升的趋势.AMD主要分为干性(地图样萎缩)及湿性(新生血管性)两类,极大的影响了患者的视功能,晚期AMD常导致严重的中心视力下降甚至失明.作为环境因素与遗传基因共同作用的复杂眼底病变,AMD的明确病因尚不完全清楚,近年来研究指出遗传基因、表观遗传、氧化应激、炎症反应、脉络膜血流动力学等均参与了AMD的病变过程,本文就老年性黄斑变性的可能病因做一系统阐述并重点指出表观遗传调控与眼部疾病特别是AMD的密切联系.%Age-related macular degeneration (AMD) is the most common cause of blindness in developed countries. Meanwhile, over the past decade, the incidence increases year by year in China. AMD is classified as atrophic macular degeneration and exudative macular degeneration, always leading to severe central vision loss even blindness in the late stage of AMD. As a degenerative disorder the pathogenesis of AMD remains unclear. Many possible causative factors have been implicated including oxidative stress, lipofuscin accumulation, chronic inflammation, mutation in the complement system, and dysfunctional ocular microcirculation. This review will shed light on the pathogenesis of the disease, especially elaborate the relationship between epigenetic regulation and AMD.

  1. 微创经椎间孔腰椎间融合术治疗腰椎退变性疾病%Clinical outcome of minimally invasive transforaminal lumbar interbody fusion in the treat-ment of lumbar degenerative disease

    Institute of Scientific and Technical Information of China (English)

    高爱国; 赵鹏; 张钦; 程力

    2016-01-01

    目的:探讨微创经椎间孔腰椎间融合术( MIS-TLIF)治疗腰椎退变性疾病的可行性和早期疗效。方法采用MIS-TLIF治疗30例腰椎退变性疾病患者,其中Ⅰ~Ⅱ度退行性或峡部裂型腰椎滑脱症12例,退行性腰椎管狭窄伴节段性不稳8例,腰椎间盘突出症10例。均为单节段融合。结果手术时间127~209(168±41) min;术中出血量23~361(192±169) ml;术中X线照射时间72~136(104±32) s;术后首次下床活动时间1.4~3.8(2.6±1.2) d。疼痛VAS评分术前(7.20±1.02)分,末次随访(1.71±0.66)分,差异有统计学意义(P<0.01)。末次随访椎间融合率为100%。未发生并发症。 X线片显示cage无移位、松动、下沉,椎弓根钉无松动、折断。结论 MIS-TLIF对腰椎的解剖结构破坏小,对椎旁肌肉的剥离少,患者术后恢复快,是一种有效、安全、损伤较小的手术方法,可用于腰椎不稳、局限节段椎间盘病变、≤Ⅱ度以下腰椎滑脱的患者;但手术时间较长,医患X线暴露较多。%Objective To investigate the feasibility and early curative effect of minimally invasive transforaminal lum-bar interbody fusion ( MIS-TLIF) in the treatment of low lumbar degenerative disease. Methods A total of 30 pa-tients underwent MIS-TLIF for low lumbar degenerative disease. They contained 12 cases ofⅠ~Ⅱdegree spondylo-listhesis,8 cases of degenerative lumbar spinal stenosis with segmental instability and 10 cases of protrusion of lumbar intervertebral disc. All the patients underwent one-level fusion by the same surgeon. Results The surgical time, in-traoperative blood loss volume, X-ray exposed time and the first leaving bed time after surgery were 127~209(168 ± 41) min, 23~361(192 ± 169) ml, 72~136(104 ± 32) s,1. 4~3. 8(2. 6 ± 1. 2) d. VAS of the preoperative and the last follow-up were (7. 20 ± 1. 02)points and (1. 71 ± 0. 66)points,the difference had statistical significance(P<0. 01

  2. Detection of degenerative cartilage disease: comparison of high-resolution morphological MR and quantitative T2 mapping at 3.0 Tesla.

    Science.gov (United States)

    Apprich, S; Welsch, G H; Mamisch, T C; Szomolanyi, P; Mayerhoefer, M; Pinker, K; Trattnig, S

    2010-09-01

    The aim of the study was to investigate the association of T2 relaxation times of the knee with early degenerative cartilage changes. Furthermore the impact of unloading the knee on T2 values was evaluated. Forty-three patients with knee pain and an ICRS (International Cartilage Repair Society) cartilage defect grade Morphological cartilage grading was based on high-resolution proton-density (PD), turbo-spin-echo (TSE) and three-dimensional (3D) isotropic True fast imaging with steady-state precession (FISP) images of slices covering the cartilage layer above the posterior horn of the meniscus. T2 maps were calculated from a multi-echo, spin-echo (MESE) sequence, performed at the beginning and at the end of the scan (time interval 40 min). Influence of cartilage defect grading on deep, superficial, and global T2 values as well as on T2 values for zonal variation was assessed using analysis of variance (ANOVA) and Spearman rank correlation test. Differences among both T2 measurements were compared using paired t-test. Global and superficial T2 values significantly increased with cartilage defect grade regardless of the time elapsed from unloading (global T2: ICRS grade 0, 38.9 and 40.1 ms; grade 1, 41.2 and 44.5 ms; grade 2, 47.7 and 53.4 ms; P=0.041 and 0.008) with stronger correlation for second T2 measurement. In contrast there were no significant differences among grades in the zonal variation at any time. Significant differences for T2 values between the two subsequent measurements were consistently found. T2 mapping might be a sensitive method for the detection of early cartilage degeneration. From our results we would recommend to measure T2 after unloading. Copyright 2010. Published by Elsevier Ltd.

  3. Edema macular diabético Diabetic macular edema

    Directory of Open Access Journals (Sweden)

    J. Andonegui

    2008-01-01

    Full Text Available El edema macular diabético representa la primera causa de pérdida visual en los pacientes con diabetes mellitus. Su complejidad, unida a la aparición de nuevos métodos de diagnóstico así como de novedosas alternativas de tratamiento, hace que el enfoque de esta enfermedad suponga un importante reto para el oftalmólogo. A lo largo de este artículo se describen su patofisiología, manifestaciones clínicas, clasificación, diagnóstico y tratamiento, haciendo especial énfasis en los nuevos métodos diagnósticos y en las diferentes opciones terapéuticas.Diabetic macular edema is the principal cause of visual loss in patients with diabetes mellitus. Its complexity, together with the appearance of new methods of diagnosis and new alternatives for treatment, mean that the approach to this disease is an important challenge for ophthalmologists. This article describes its pathophysiology, clinical manifestations, classification, diagnosis and treatment, with special emphasis on the new diagnostic methods and on the different therapeutic options.

  4. Multiple extra macular branch retinal vein occlusions in hyperhomocysteinemia

    Directory of Open Access Journals (Sweden)

    Abhijit Diwakar Gore

    2014-01-01

    Full Text Available Hyperhomocysteinemia is a well-known modifiable risk factor for thromboembolism. Retinal vascular occlusion in patients having hyperhomocysteinemia is a known entity, particularly in young patients. However, multiple extra macular branch retinal vein occlusion (BRVO is a rare condition, which can be a presentation of this disease. We present a patient who had multiple extra macular BRVO; on complete systemic workup, he was found to have raised homocysteine levels.

  5. One day wonder: Fast resolution of macular edema following intravitreal ranibizumab in retinal venous occlusions

    Directory of Open Access Journals (Sweden)

    Lalit Verma

    2013-01-01

    Full Text Available Macular edema is a significant cause of vision loss in patients with central retinal vein occlusions and branch retinal vein occlusions. Vascular endothelial growth factor (VEGF appears to be a key factor in the pathogenesis of this disease. Anti-VEGF therapy, such as intravitreal ranibizumab provides an effective treatment against vision-threatening macular edema. We report three patients of retinal vein occlusion with macular edema who demonstrated overnight resolution of macular edema following treatment with intravitreal ranibizumab (0.5 mg. 3D optical coherence tomography (Optovue was used as a tool for comparison of the macular thickness before and after treatment. The significant reductions in the central foveal thickness demonstrated in these patients one night after intravitreal injections could have significant influence on modifying current treatment protocols. Early treatment of macular edema related to retinal venous occlusive disease with anti-VEGF injections could result in faster visual rehabilitation in these patients.

  6. Cellular Reparative Mechanisms of Mesenchymal Stem Cells for Retinal Diseases

    Directory of Open Access Journals (Sweden)

    Suet Lee Shirley Ding

    2017-07-01

    Full Text Available The use of multipotent mesenchymal stem cells (MSCs has been reported as promising for the treatment of numerous degenerative disorders including the eye. In retinal degenerative diseases, MSCs exhibit the potential to regenerate into retinal neurons and retinal pigmented epithelial cells in both in vitro and in vivo studies. Delivery of MSCs was found to improve retinal morphology and function and delay retinal degeneration. In this review, we revisit the therapeutic role of MSCs in the diseased eye. Furthermore, we reveal the possible cellular mechanisms and identify the associated signaling pathways of MSCs in reversing the pathological conditions of various ocular disorders such as age-related macular degeneration (AMD, retinitis pigmentosa, diabetic retinopathy, and glaucoma. Current stem cell treatment can be dispensed as an independent cell treatment format or with the combination of other approaches. Hence, the improvement of the treatment strategy is largely subjected by our understanding of MSCs mechanism of action.

  7. Current status in diabetic macular edema treatments

    Institute of Scientific and Technical Information of China (English)

    Pedro; Romero-Aroca

    2013-01-01

    Diabetes is a serious chronic condition,which increase the risk of cardiovascular diseases,kidney failure and nerve damage leading to amputation.Furthermore the ocular complications include diabetic macular edema,is the leading cause of blindness among adults in the industrialized countries.Today,blindness from diabetic macular edema is largely preventable with timely detection and appropriate interventional therapy.The treatment should include an optimized control of glycemia,arterial tension,lipids and renal status.The photocoagulation laser is currently restricted to focal macular edema in some countries,but due the high cost of intravitreal drugs,the use of laser treatment for focal and diffuse diabetic macular edema(DME),can be valid as gold standard in many countries.The intravitreal anti vascular endothelial growth factor drugs(ranibizumab and bevacizumab),are indicated in the treatment of all types of DME,but the correct protocol for administration should be defined for the different Retina Scientific Societies.The corticosteroids for diffuse DME,has a place in pseudophakic patients,but its complications restricted the use of these drugs for some patients.Finally the intravitreal interface plays an important role and its exploration is mandatory in all DME patients.

  8. Macular Amyloidosis and Epstein-Barr Virus

    Directory of Open Access Journals (Sweden)

    Yalda Nahidi

    2016-01-01

    Full Text Available Background. Amyloidosis is extracellular precipitation of eosinophilic hyaline material of self-origin with special staining features and fibrillar ultrastructure. Macular amyloidosis is limited to the skin, and several factors have been proposed for its pathogenesis. Detection of Epstein-Barr virus (EBV DNA in this lesion suggests that this virus can play a role in pathogenesis of this disease. Objective. EBV DNA detection was done on 30 skin samples with a diagnosis of macular amyloidosis and 31 healthy skin samples in the margin of removed melanocytic nevi by using PCR. Results. In patients positive for beta-globin gene in PCR, BLLF1 gene of EBV virus was positive in 23 patients (8 patients in case and 15 patients in the control group. There was no significant difference in presence of EBV DNA between macular amyloidosis (3.8% and control (23.8% groups (P=0.08. Conclusion. The findings of this study showed that EBV is not involved in pathogenesis of macular amyloidosis.

  9. Dominant cystoid macular dystrophy

    NARCIS (Netherlands)

    Saksens, N.T.M.; Huet, R.A.C. van; Lith-Verhoeven, J.J. van; Hollander, A.I. den; Hoyng, C.B.; Boon, C.J.

    2015-01-01

    OBJECTIVE: To describe the clinical characteristics and long-term follow-up in patients with autosomal dominant cystoid macular dystrophy (DCMD). DESIGN: Retrospective case series. PARTICIPANTS: Ninety-seven patients with DCMD. METHODS: Extensive ophthalmic examination, including visual acuity (VA),

  10. What Is Macular Edema?

    Medline Plus

    Full Text Available ... may be mild to severe, but in many cases, your peripheral (side) vision remains. Macular edema is often a complication of diabetic retinopathy , and is the most common form of vision loss for people with ... Related Studies Show Zika Virus May Cause More Serious Eye ...

  11. Dynesys dynamic neutralization system for the treatment of lumbar degenerative disease and the effect on the adjacent segment%Dynesys系统治疗腰椎退行性疾病对邻近节段的影响**☆

    Institute of Scientific and Technical Information of China (English)

    杨波; 万盛钰; 曾勉东; 吕玉明; 方世兵; 谢景开

    2013-01-01

      背景:大多数文献报道Dynesys动态中和稳定系统在治疗腰椎退行性疾病中取得了较好的临床疗效,但能否防止邻近节段退行性病变发生仍然存在争议。  目的:观察Dynesys系统治疗腰椎退行性疾病的临床疗效及对邻近节段的影响。  方法:自2009年3月至2012年10月收治20例腰椎退行性疾病患者,均采用手术减压加Dynesys系统动态固定治疗。Dynesys动态系统由Zimmer公司提供,由钛合金椎弓根螺钉、聚氨基甲酸乙酯套管和聚对苯二甲酸乙酯绳索组成。以目测类比评分、Oswestry 功能障碍指数进行临床疗效评价;依照Woodend评分评估邻近椎间盘退变程度;治疗有效率按Macnab标准评价。  结果与结论:20例患者全部获得随访,时间22-31个月。临床疗效按Macnab标准评价:优11例,良6例,可3例,优良率达85%。末次随访时,患者目测类比评分显著低于治疗前[(2.25±1.67)分,(8.29±1.50)分,P0.05)。提示Dynesys系统动态固定治疗腰椎退变性疾病早期疗效确切,长期疗效及其防止或延缓邻近节段退变的作用尚需多中心随机对照临床试验来证实。%BACKGROUND:Numerous studies show Dynesys dynamic neutralization system has achieved good clinical efficacy in the treatment of lumbar degenerative disease. But whether Dynesys dynamic neutralization system can prevent the adjacent segment degenerative disease is stil controversial. OBJECTIVE:To investigate the efficacy of the Dynesys system for the treatment of lumbar degenerative disease and impact on adjacent segments. METHODS:From March 2009 to October 2012, 20 consecutive patients with lumbar degenerative disease were included in this study. Al the patients were treated with surgical decompression plus Dynesys system dynamic fixation. The Dynesys system was provided by Zimmer Company, and composed with titanium al oy pedicle screws, polyurethane sleeve and

  12. Genetics of Immunological and Inflammatory Components in Age-related Macular Degeneration

    OpenAIRE

    Tuo, Jingsheng; Grob, Seanna; Zhang, Kang; Chan, Chi-Chao

    2012-01-01

    Age-related macular degeneration (AMD), affecting 30 to 50 million elder individuals worldwide, is a disease affecting the macular retina and choroid that can lead to irreversible central vision loss and blindness. Recent findings support a role for immunologic processes in AMD pathogenesis, including generation of inflammatory related molecules in the Bruch’s membrane, recruitment of macrophages, complement activation, microglial activation and accumulation in the macular lesions. Pro-inflam...

  13. Durable recovery of the macular architecture and functionality of a diagnosed age-related macular degeneration 1 year after a single intravitreal injection of dobesilate

    OpenAIRE

    Cuevas, P; Outeiriño, L A; Azanza, C; Giménez-Gallego, G

    2013-01-01

    Among the age-related diseases that affect vision, age-related macular degeneration is the most frequent cause of blindness in patients older than 60 years. In this communication, we report the full anatomical and functional recovery of a patient diagnosed with wet age-related macular degeneration 1 year after a single intravitreal injection of dobesilate.

  14. Durable recovery of the macular architecture and functionality of a diagnosed age-related macular degeneration 1 year after a single intravitreal injection of dobesilate.

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Azanza, C; Giménez-Gallego, G

    2013-11-13

    Among the age-related diseases that affect vision, age-related macular degeneration is the most frequent cause of blindness in patients older than 60 years. In this communication, we report the full anatomical and functional recovery of a patient diagnosed with wet age-related macular degeneration 1 year after a single intravitreal injection of dobesilate.

  15. Durable recovery of the macular architecture and functionality of a diagnosed age-related macular degeneration 1 year after a single intravitreal injection of dobesilate

    Science.gov (United States)

    Cuevas, P; Outeiriño, L A; Azanza, C; Giménez-Gallego, G

    2013-01-01

    Among the age-related diseases that affect vision, age-related macular degeneration is the most frequent cause of blindness in patients older than 60 years. In this communication, we report the full anatomical and functional recovery of a patient diagnosed with wet age-related macular degeneration 1 year after a single intravitreal injection of dobesilate. PMID:24225910

  16. ROLE OF DIETARY SUPPLEMENTATION IN PREVENTING PROGRESSION OF AGE-RELATED MACULAR DEGENERATION

    Directory of Open Access Journals (Sweden)

    N. A. Ermakova

    2016-01-01

    Full Text Available Age-related macular degeneration (AMD is a chronic, progressive, degenerative eye disease affecting the central retina. It is the leading cause of blindness among individuals of 65 years and older. In the early stage patients have drusen and/or alterations of pigmentation in the macular region. This disease can progress to geographic atrophy and/or choroidal neovascularization. It has been shown that oxidative stress and hypoxia are important in the pathogenesis of AMD. Patients may gain some visual improvement with inhibitors of vascular endothelial growth factor, but complete restoration of visual function is achieved only in small cases. No effective therapies are known for atrophic AMD. Many large observational studies have shown that dietary antioxidant supplementation is beneficial in preventing the progression of AMD from early to late stages. The Age-Related Eye Disease Study (AREDS demonstrated that daily oral supplementation with vitamins C (500 mg and E (400 IU, beta carotene (15 mg, zinc (80 mg and copper (2 mg reduced the risk of progression to advanced AMD by 25% at 5 years. In primary analyses AREDS II failed to show further reduce of this risk by addition of lutein (10 mg and zeaxanthin (2mg, or/and omega-3 long-chain polyunsaturated fatty acids [docosahexaenoic acid (350 mg DHA and eicosapentaenoic acid 650 mg (EPA] to the AREDS formulation. But there was no true placebo group. The simultaneous administration of beta carotene, lutein and zeaxanthin may suppress tissue level of the both laters because of competitive absorption of carotenoids. Subgroup analyses revealed that dietary supplementation with lutein, zeaxanthin and AREDS formulation without beta carotene may reduce the risk of progression to advanced AMD.The LUNA (Lutein nutrition effects measured by autofluorescence study demonstrated that supplementation with lutein (12 mg, zeaxanthin (1 mg, vitamin C (120 mg, vitamin E (17,6 mg, zinc (10 mg, selenium (40 mg resulted

  17. Dietary analysis and patterns of nutritional supplement use in normal and age-related macular disease affected subjects: a prospective cross-sectional study

    Directory of Open Access Journals (Sweden)

    Eperjesi Frank

    2004-09-01

    Full Text Available Abstract Background Poor diet is thought to be a risk factor for many diseases, including age-related macular disease (ARMD, which is the leading cause of blind registration in those aged over 60 years in the developed world. The aims of this study were 1 to evaluate the dietary food intake of three subject groups: participants under the age of 50 years without ARMD (U50, participants over the age of 50 years without ARMD (O50, and participants with ARMD (AMD, and 2 to obtain information on nutritional supplement usage. Methods A prospective cross-sectional study designed in a clinical practice setting. Seventy-four participants were divided into three groups: U50; 20 participants aged 50 years, from 52 to 77 (62.7 ± 6.8 years, and ARMD; 27 participants aged > 50 years with ARMD, from 55 to 79 (66.0 ± 5.8 years. Participants were issued with a three-day food diary, and were also asked to provide details of any daily nutritional supplements. The diaries were analysed using FoodBase 2000 software. Data were input by one investigator and statistically analysed using Microsoft Excel for Microsoft Windows XP software, employing unpaired t-tests. Results Group O50 consumed significantly more vitamin C (t = 3.049, p = 0.005 and significantly more fibre (t = 2.107, p = 0.041 than group U50. Group ARMD consumed significantly more protein (t = 3.487, p = 0.001 and zinc (t = 2.252, p = 0.029 than group O50. The ARMD group consumed the highest percentage of specific ocular health supplements and the U50 group consumed the most multivitamins. Conclusions We did not detect a deficiency of any specific nutrient in the diets of those with ARMD compared with age- and gender-matched controls. ARMD patients may be aware of research into use of nutritional supplementation to prevent progression of their condition.

  18. Quality of Life with Macular Degeneration Is Not as Dark as It May Seem: Patients’ Perceptions of the MacDQoL Questionnaire

    OpenAIRE

    Ord, Lisa M.; Wright, JoAnne; Margaret M. DeAngelis; Feehan, Michael

    2015-01-01

    To determine the perceived relevance and value of an individualized measure of the impact of macular degeneration on quality of life (QoL) for elderly people with Age-Related Macular Degeneration (AMD) in the USA, through the assessment of the suitability of the measure’s domains and by gaining a deeper insight into the impact of AMD on patients’ QoL vis-á-vis these domains, community-dwelling older adults in the metropolitan Salt Lake City, Utah area were interviewed using the macular degene...

  19. Unilateral instrumented transforaminal lumbar interbody fusion in low lumbar degenerative diseases%单侧椎弓根固定经椎间孔椎体间融合术治疗下腰椎退行性疾病

    Institute of Scientific and Technical Information of China (English)

    贾其余; 俞宇; 王林; 郭万根; 胡联英; 程晓东

    2014-01-01

    目的:评价单侧椎弓根固定经椎间孔腰椎椎体间融合术( TLIF)治疗下腰椎退行性疾病的疗效。方法采用单侧TLIF术治疗41例下腰椎退行性疾病患者,均为单节段手术。观察手术时间、术中出血量及并发症情况。采用腰痛和腿痛视觉模拟评分( VAS)与Oswestry功能障碍指数( ODI)评价临床效果,并通过影像学检查对椎体间融合情况进行评价。结果41例均获随访,时间24~59(38±6)个月。手术时间80~180(125±10)min,术中出血量100~550(310±30)ml。手术切口均一期愈合。腰痛VAS分值由术前的(6.5±2.1)分下降至末次随访时的(2.3±0.9)分(P<0.01),腿痛VAS分值由术前的(7.6±2.3)分下降至末次随访时的(1.2±0.8)分(P<0.01),ODI由术前的54.2±10.9下降至末次随访时的13.8±2.1(P<0.01)。末次随访融合率为95%,未发现继发性脊柱侧弯、螺钉松动、断裂及Cage移位等情况。结论单侧TLIF术可有选择地治疗下腰椎退行性疾病,其疗效确切,并具有创伤小、手术时间短、出血少、并发症少等优点。%Objective To investigate the effect of unilateral instrumented transforaminal lumbar interbody fusion ( TLIF) in the treatment of low lumbar degenerative diseases. Methods 41 patients with low lumbar degenerative diseases in single segment were treated with unilateral pedicle screw fixation TLIF. Operative time, intraoperative blood loss and complications were observed. The visual analogue scale ( VAS ) and the Oswestry disability index ( ODI) were used to evaluate clinical effect, and radiographic parameters were used to evaluate the fusion rates. Re-sults All cases were followed up for 24~59(38 ±6)months. The operative time was 80~180(125 ±10)min, the intraoperative blood loss was 100~550(310 ± 30) ml. All incisions healed by first intention. The lumbar pain VAS scores dropped from 6. 5 ± 2. 1 preoperatively to 2. 3 ± 0. 9 at final followed-up (P <0. 01), the limb pain VAS

  20. 旁正中入路单侧固定椎间融合治疗腰椎退行性疾病%Unilateral Fixation and Intervertebral Fusion by Paramedian Approach to Treat Lumbar Degenerative Diseases

    Institute of Scientific and Technical Information of China (English)

    王晓斌

    2015-01-01

    Objective To analyze the clinical effects of lumbar degenerative diseases treated with unilateral fixation and transforaminal lumbar interbody fusion (TLIF) by paramedian approach. Methods 60 patients who suffered from lumbar degenerative diseases admitted to our hospital were selected. All patients were treated with unilateral pedicle screw internal fixation combined with TLIF. The intraoperative blood loss, operation time and length of incision were observed. Visual analogue scale (VAS) score and Oswestry disability index (ODI) were used to evaluate the back pain, leg pain, and functional recovery before surgery, 3 months after surgery and at last follow-up. Results All the operations were successful, with the length of incision of (4.3 ± 0.4) cm (3.5~5.2 cm), intraoperative blood loss of (169 ± 73) mL (120 ~340 mL), and operation time of (104 ± 13) min (80 ~130 min). No serious complication was found after surgery, and the VAS scores of back pain and leg pain, and ODI after surgery were significantly lower than those before surgery (P<0.05). Conclusions The therapy of unilateral fixation and transforaminal lumbar interbody fusion (TLIF) by paramedian approach for lumbar degenerative diseases has the advantages of less trauma, less bleeding and faster postoperative recovery, which can help to alleviate back pain, and improve quality of life. Surgical indications must be considered comprehensively to ensure the best clinical outcomes.%目的 探讨旁正中入路单侧固定经椎间孔椎间融合 (TLIF) 治疗腰椎退行性疾病的临床效果. 方法 选取我院2012年1月至2015年1月收治的60例腰椎退行性疾病患者, 均采用旁正中入路单侧椎弓根螺钉内固定TLIF治疗, 观察术中出血量、手术时间、 切口长度等, 采用疼痛VAS评分、 功能障碍指数 (ODI) 于术前、 术后3个月及末次随访对患者腰痛、 腿痛、 功能恢复进行评估. 结果 60例患者均顺利完成手术, 手术切口长度3

  1. 经后路椎体间融合术治疗腰椎退变性疾病的临床疗效分析%Clinical efficacy analysis of PLIF in the treatment of degenerative lumbar disease

    Institute of Scientific and Technical Information of China (English)

    周先爱; 王利民; 谭洪宇

    2014-01-01

    Objective To investigate the clinical efficacy of posterior lumbar interbody fusion on degenerative lumbar disease.Methods The clinical data of 96 patients with degenerative lumbar disease who were treated in our hospital from August 2003 to February 2009 were analyzed retrospectively.All patients were treated by posterior lumbar interbody fusion(PLIF).The JOA score,VAS score and imaging evaluation of treatment were evaluated.Results All of the patients were followed-up for 12-35 months (average of 18.5 months),the preoperative JOA score was(6.55 ± 1.35),and JOA score was(12.65 ± 2.43) after 3 months,the JOA score at last follow-up was(13.33 ± 1.80) ; the preoperative VAS score was(7.80 ± 1.62),and VAS score was (2.64 ± 1.42) after 3 months,the VAS score at last follow-up was (1.09 ± 0.27).All patients had perfect interbody fusion by imaging examination after half a year,except for one patient with pedicle fracture caused by an accident,the remaining patients had no loosening or fracture.One case was complicated with incision infection,and cured by antibiotics.Two cases had cerebrospinal fluid leakage,and they were cured after improved nutrition and drainage.Conclusions PLIF is effiective and reliable in the treatment of degenerative lumbar disease.%目的 探讨腰椎退变患者行经后路椎体间融合术(PLIF)治疗的临床疗效.方法 对2003年8月至2009年2月入院治疗的96例腰椎退变疾病患者的临床资料行回顾性分析,所有患者均行PLIF术,分别对比患者术前、术后3个月及末次随访JOA评分、VAS评分以及影像学检查,评价患者的治疗效果.结果 术后随访12~35个月,平均18.5个月,术前JOA、VAS评分分别为(6.55±1.35)分、(7.80±1.62)分;术后3个月分别为(12.65±2.43)分、(2.64±1.42)分;末次随访分别为(13.33±1.80)分、(1.09±0.27)分.所有患者术后半年影像学检查均显示椎间融合良好,除1例患者术后发生车祸导致钉棒断裂外,其余患者内固

  2. Clinical outcomes of Isobar TTL dynamic stabilization system in the treatment of lumbar degenerative diseases%滑动牵张技术对膝关节创伤术后功能康复的影响

    Institute of Scientific and Technical Information of China (English)

    万里; 卞荣; 朱奕

    2012-01-01

    Objective To investigate the clinical outcomes of Isobar TTL dynamic stabilization system in the treatment of lumbar degenerative diseases. Methods A total of 74 patients with lumbar degenerative diseases was treated by decompressive surgery via posterior approach with Isobar TTL dynamic fixation operation(36 cases.group A) or with conventioal rigid fixation(38 cases,group B). The patients were followed up for 2 years and the clinical outcomes were compared. Results There was no difference in the operation time, intraoperative blood loss and complications of two groups were similar. The correct values of lumbar lordotic angle and sacral slope angle of group A were (20. 5 ± 2. 2) degrees and (15. 8±2. 9) degrees, which were greater than (14. 1±1.1) degrees and (12. 3± 2. 2) degrees of group B(P<0. 05). The excellence rates of JOA scores at 6 months, 1 year and 2 years were 88. 89%,94. 44% and 97. 22% in group A,which were greater than 65. 79%,73. 68% and 76. 32% in group B (P<0. 05). Conclusion Isobar TTL dynamic stabilization system is better than conventioal rigid fixation in the treatment of degenerative lumbar disease.%目的 探讨滑动牵张技术对膝关节创伤术后功能康复的影响.方法 膝关节创伤术后功能障碍患者70例均分为治疗组和对照组.对照组进行物理因子、运动疗法及手法治法,每天1小时.10d为1个疗程,共治疗4个疗程.治疗组在上述治疗的基础上,增加对髌股关节及胫股关节的滑动牵张治疗,每次20分钟.评估患膝关节治疗前后的关节活动范围(ROM);应用HSS全膝关节评定系统,评估患者治疗前后膝关节功能.结果 治疗后,两组膝关节ROM及HSS评分均较治疗前明显提高(P<0.05).治疗组膝关节ROM和HSS评分高于对照组[(115.2±14.7)度vs.(90.3±12.6)度和(83.7±14.4)分vs.(60.8±11.6)分](P<0.05).结论 加用膝关节滑动牵张技术能有效提高膝关节创伤术后的功能康复.

  3. Wallis动态稳定系统治疗腰椎退行性疾病%Preliminary observation of Wallis dynamic stabilization system for treatment of lumbar degenerative diseases

    Institute of Scientific and Technical Information of China (English)

    普有登; 汤逊; 周田华; 石健; 姜伟; 张金鹏

    2011-01-01

    Objective To analyze the early clinical effects of Wallis dynamic stabilization system for the treatment of lumbar degenerative diseases, and to discuss the indications of this technique.Methods The clinical outcomes of 26 patients with lumbar degenerative diseases treated by only Wallis interspinous dynamic stabilization system or combined with posterior lumbar fusion were studied retrospectively.The visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) scores were recorded pre- and postoperatively.The ratio of JOA was applied to evaluate the curative effect.Results All the cases were followed up for a mean period of 14months ( rangel 6-24 months).Imaging showed all implants no loosening, dislocation or fracture.The VAS scores were 7.62 ± 1.50, 2.42 ± 1.03, 0.85 ± 0.73 at 1 d preoperative, 2 weeks postoperative and the final follow-up respectively.JOA scores were 10.12 ± 2.42, 20.62 ± 2.28, 24.92 ± 2.45 at 1 d preoperative, 2 weeks postoperative and the final follow-up respectively.The JOA improvement rates of 24 cases(92.3% ) were good/excellent at the final follow-up.Conclusion It is benefit to use Wallis interspinous dynamic stabilization system or combination with postreior lumbar fusion for remaining motor function of reserved spinal segments, with the advantage of mini-tissue damage and excellent effects.It is a good choice for the treatment of lumbar degenerative diseases.%目的 分析Wallis棘突间动态稳定系统治疗腰椎退行性疾病的早期效果,并探讨其手术适应证.方法 分析26例单独采用Wallis棘突间动态稳定系统或联合固定融合术治疗腰椎退行性疾病患者的临床疗效和初期随访结果,记录术前及术后疼痛视觉模拟量表(visual analogue scale,VAS)评分(10分法)、下腰痛日本骨科协会(Japanese Orthopaedic Association,JOA)评分(29分法),计算JOA改善率评估手术疗效.结果 经6~24个月(平均14个月)的随访,影像学显示内置物无

  4. 小针刀治疗早期退行性下颈椎失稳症的临床观察%Clinical study of akupotomye therapy on early degenerative disease of cervical spine instability

    Institute of Scientific and Technical Information of China (English)

    陈青; 龚志贤; 张月娟; 周芳

    2011-01-01

    Objective To observe and compare the clinical efficacy of the treatment in early degenerative disease of cervical spine instability with the akupotomye and neck collar protection.Methods 60 patients the disease were randomly divided into test group (akupotomye group)and control group(cervical collar group), 30 patients in each group.The indexes of neck pain before and after treatment and the changes of AD HD imaging value were measured.Results 1.After treatment, the indexes of pain in both groups were significantly lowered, and the test group was much lower than that in control group (P<0.05); the total effective rate was 83.3% in test group and 73.3% in control group (P<0.05).2.The imaging values of HD in test group was better than that in control group (P<0.05), but the D-value of AD was not significant (P>0.05).Conclusion The akupotomye therapy for early degenerative disorder of lower cervical spine instability can significantly reduce the neck pain index figure and significantly improve the HD and AD values, which is effective therapy for early degenerative disease of the lower cervical spine instability.%目的 观察并比较小针刀与颈托保护治疗早期退行性下颈椎失稳症的临床疗效.方法 早期退行性下颈椎失稳症患者60例,随机分为试验组(针刀组)和对照组(颈托组),每组各30例.观察两组患者治疗前后疼痛指数、影像学水平位移之和(HD)值及角位移(AD)值变化.结果 1.两组治疗后疼痛指数积分均显著降低,试验组优于对照组(P<0.01);颈痛指数疗效试验组总有效率达83.3%,对照组为73.3%,试验组优于对照组(P<0.05).2.两组治疗前后影像学HD差值试验组优于对照组(P<0.05);AD差值两组差异无统计学意义(P<0.05).结论 小针刀治疗早期退行性下颈椎失稳症能明显降低患者颈痛指数,并显著改善HD值及AD值,是治疗早期退行性下颈椎失稳症的一种疗效确切的治疗方法.

  5. Correlative radiological, self-assessment and clinical analysis of evolution in instrumented dorsal and lateral fusion for degenerative lumbar spine disease. Autograft versus coralline hydroxyapatite.

    Science.gov (United States)

    Korovessis, Panagiotis; Koureas, Georgios; Zacharatos, Spyridon; Papazisis, Zisis; Lambiris, Elias

    2005-09-01

    This prospective longitudinal randomized clinical and radiological study compared the evolution of instrumented posterolateral lumbar and lumbosacral fusion using either coralline hydroxyapatite (CH), or iliac bone graft (IBG) or both in three comparable groups, A, B and C, which included 19, 18 and 20 patients, respectively, who suffered from symptomatic degenerative lumbar spinal stenosis and underwent decompression and fusion. The patients were divided randomly according to the graft used and the side that it was applied. The spines of group A received autologous IBG bilaterally; group B, IBG on the left side and hydroxyapatite mixed with local bone and bone marrow on the right side; group C, hydroxyapatite mixed with local bone and bone marrow bilaterally. The age of the patients in the groups A, B and C was 61+/-11 years, 64+/-8 years and 58+/-8 years, respectively. The SF-36, Oswestry Disability Index (ODI), and Roland-Morris (R-M) surveys were used for subjective evaluation of the result of the surgery and the Visual Analogue Scale (VAS) for pain severity. Plain roentgenograms including anteroposterior, lateral and oblique views, and lateral plus frontal bending views of the instrumented spine and CT scan were used to evaluate the evolution of the posterolateral fusion in all groups and sides. Two independent senior orthopaedic radiologists were asked to evaluate first the evolution of the dorsolateral bony fusion 3-48 months postoperatively with the Christiansen's radiologic method, and secondly the hydroxyapatite resorption course in the spines of groups B and C. The diagnosis of solid spinal fusion was definitively confirmed with the addition of the bending views, CT scans and self-assessment scores. The intraobserver and interobserver agreement (r) for radiological fusion was 0.71 and 0.69, respectively, and 0.83 and 0.76 for evaluation of CH resorption. T(12)-S(1) lordosis and segmental angulation did not change postoperatively. There was no

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Clinical results of pedicle screws with cement augmentation for treating lumbar degenerative diseases in the elderly%椎弓根螺钉骨水泥强化修复老年腰椎退变的早期效果

    Institute of Scientific and Technical Information of China (English)

    陈荣国; 代凤雷; 欧先锋; 杨超; 钱建吉; 曾怿; 任家云; 虞泽龙

    2014-01-01

    背景:老年腰椎退变患者在手术中常面临椎弓根螺钉把持力不足情况,易发生脱钉、固定不牢靠等风险,如何增加螺钉的把持力成为研究的热点。目的:探讨使用椎弓根螺钉骨水泥强化方案治疗老年腰椎退变的早期临床效果。方法:选择2012年8月至2014年4月收治的患腰椎退行性疾病行腰椎内固定治疗的患者65例,根据修复方案分为2组,椎弓根螺钉内固定骨水泥强化组24例,常规椎弓根螺钉内固定组41例。比较两组患者的一般情况,采用目测类比评分法和日本矫形科学学会腰椎功能评分表对患者腰背疼痛及下肢神经功能恢复情况进行评估。结果与结论:65例患者均完成手术,获得随访,随访时间为3-20个月,随访中均行腰椎正侧位片X射线片,未发现螺钉松动、脱落、断裂、椎间隙高度丢失等情况。椎弓根螺钉内固定骨水泥强化组患者的手术出血量、住院时间与常规椎弓根螺钉内固定组差异无显著性意义(P>0.05),椎弓根螺钉内固定骨水泥强化组术后3,6个月日本矫形科学学会腰椎功能评分及术后3个月的目测类比评分均较常规椎弓根螺钉内固定组显著改善(P 0.05)。提示将骨水泥沿椎弓根螺钉钉道注入椎弓根及椎体,可达到螺钉骨水泥强化的目的,增加螺钉的把持力,重建腰椎的稳定性,取得了满意的近期疗效。%BACKGROUND:Elderly patients with degenerative lumbar degeneration often appear insufficient holding power of pedicle screw in spine surgery, which is prone to occur de-pinning and leads to insecure fixation. How to increase the holding power of screws has become a hot research. OBJECTIVE:To observe the early clinical effect of pedicle screws with cement augmentation for treating lumbar degenerative diseases in elderly patients. METHODS:A total of 65 old patients with lumbar degenerative diseases received a treatment

  8. Continuous clinical observation of the Dynesys dynamic neutralization system for degenerative lumbar spine diseases%Dynesys动态稳定系统治疗下腰椎疾病效果观察

    Institute of Scientific and Technical Information of China (English)

    刘先哲; 许伟华; 叶树楠; 冯勇; 张波; 杨述华

    2013-01-01

    Objective To evaluate the clinical indications and outcomes of dynesys neutralization system in the treatment of degenerative lumbar diseases.Methods From January 2007 to December 2011,102 consecutive patients with degenerative lumbar spine diseases underwent posterior decompression and internal fixation with the Dynesys dynamic neutralization system.Among them,69 patients were followed up,including 39 males and 30 females,aged from 30 to 62 years (average,44 years).The series of cases were composed of 24 cases of lumber disc herniation,35 cases of degenerative spinal stenosis,10 cases of degenerative changes of lumbar discs.Results The mean follow-up period was 35 months (range,6-44 months).The visual analogue scale (VAS) score decreased from preoperative 8.6 (range,6-9) to postoperative 2.8 (range,0-5),and the Oswestry disability index (ODI) improved from preoperative 73% (range,30%-91%) to postoperative 30% (range,0-61%).There were no implant failure or infection.According to the evaluation criteria of surgical treatment for low back pain,which was established by the Chinese Orthopaedic Association,the result was excellent in 53 patients,good in 12 patients,fair in 4 patients and poor in 1 patient.Conclusion The Dynesys dynamic neutralization system is effective in the treatment of degenerative lumbar spine disease,which can reserve the range of motion of stabilized segments,prevent degeneration of adjacent segments and improve clinical outcomes.%目的 探讨Dynesys动态稳定系统治疗腰椎退行性疾病的应用指征及安全性.方法 回顾性分析2007年1月至2011年12月采用后路减压+Dynesys动态内固定系统治疗102例腰椎退行性疾病患者中69例完整的随访资料,男39例,女30例;年龄30~62岁,平均44岁;单纯腰椎间盘突出24例,腰椎间盘突出并退行性椎管狭窄35例,椎间盘退行性改变10例.手术固定节段:L2,32例,L3,44例,L4,5 42例,L5S115例,L3~L5 5例,T12~L4 1

  9. Clinical Observation on Juvenile Macular Hole without Trauma and Hypermyopia

    Institute of Scientific and Technical Information of China (English)

    Tieying Zhao; Qingshan Chen; Ming Li; Xunqing Gu; Rulong Gao; Feng Wen

    2005-01-01

    Purpose: To investigate the clinical characteristics of juvenile macular hole without trauma and hypermyopia, and research the mechanism of macular hole.Methods: Sixty-seven patients less than 40 years of age were studied retrospectively from June 1998 to March 2003. Five cases (7 eyes) aged from 22 to 38 years were reported and the clinical characteristics that had macular hole without trauma or hypermyopia were summed up.Results: There was 1 male and 4 females with visual acuity from 0.08 to 0.8. The images of optical coherence tomography (OCT) showed full thickness macular hole in 5 patients (7 eyes), and the diameters were from 87 to 1043 μm. Among them, 2 cases were combined with retina pigmentosa; 1 case with binocular Coat's disease; 1 case had bilateral macular hole combined with Eagles' disease; 1 case was combined with 2-2.5PD old retinochoroidal lesion under middle-peripheral fundus, and 1.5 PD retinal pigment epithelium (RPE) defect on the optical disk.Conclusion: The juvenile macular hole without trauma and hypermyopia combined the different retina vascular damages and the RPE defects.

  10. Coflex与传统手术方法治疗腰椎退行性疾病疗效的Meta分析%Coflex versus posterior lumbar interbody fusion in the treatment of lumbar spine degenerative diseases: a Meta analysis

    Institute of Scientific and Technical Information of China (English)

    赵海恩; 郭明君; 梅玉峰; 于洋; 王育才; 马保安; 姬振伟; 范清宇

    2012-01-01

    [Objective] To analyze the efficacy and safety of Coflex versus posterior lumbar interbody fusion in the treatment of lumbar spine degenerative diseases such as LSS. [ Methods ] A systematic computer - based search of Medline, EM-BASE, Cochrance Central, and manual search of related journals were performed for collecting controlled trials. RevMan 5. 1 software was used for meta analysis. [Results] Twelve studies involving a total of 684 patients were included. The meta - analysis indicated that statistically significance were noted between two procedures for the operation time, length of hospital stay, blood loss and range of motion of lumbar. While no differences were noted for the low back VAS, ODI and JO A. [Conclusion] Both procedures were effective and safe in pain relief and functional recovery for lumbar spine degenerative diseases. Coflex could also shorten the operation time and length of hospital stay, decrease the blood loss. It showed that Coflex had biomechanical superiority in a short follow - up period.%[目的]系统评价Coflex与传统融合固定两种手术方法治疗腰椎退行性病变的有效性和安全性.[方法]计算机检索数据库,手工检索骨科相关杂志,纳入关于Coflex与传统治疗腰椎退行性病变的研究并进行Meta分析.[结果]纳入12篇研究共684病例,Meta分析结果显示:Coflex与传统手术方法相比较,前者在手术时间和住院时间上短于后者,失血量少于后者,手术节段的ROM大于后者,差异具有统计学意义.后背VAS和JOA差异无统计学意义.[结论]在达到相同治疗效果的情况下,Coflex可以明显减少手术时间、术中出血量和住院时间,而且可以保持手术节段腰椎存在一定活动度,避免了邻近节段的退变,术后短期内随访显示了其生物力学上优越性.

  11. Climical application of Wallis mechanical normalization system in lumbar degenerative disease%棘突间动态稳定系统(Wallis)在腰椎退变性疾病中的临床应用

    Institute of Scientific and Technical Information of China (English)

    徐西强; 李峰; 吴华

    2012-01-01

    Objective To observe the clinical effects of the lumbar spinal canal decompression and the implantation of Wallis mechanical normalization system to treat lumbar degenerative disease. Methods All of 20 cases of lumbar degenerative disease were treated with lumbar spinal canal decompression and the implantation of Wallis mechanical normalization system. Results Nineteen patients were followed up for 28 to 40 months, with 30 months on average. JOA score and VAS score before operation were (10.65±2.43) and (7.50±0.95) respectively, and two years later they were (26.87±1.43) and (0.21 ±0.01) respectively. Conclusion Wallis mechanical normalization system (Wallis) has the merits of less trauma, less bleeding and better human biomechanics. As a soft fixation, it plays a palliative role from rigid fusion to the non-fusion, and it's a promising alternative treatment to the end-stage treatment of the spine (spinal fusion surgery).%目的 评价棘突间动态稳定系统(Wallis)治疗腰椎退变性疾病的临床效果.方法 对20例腰椎退变性疾病行髓核摘除并Wallis置入固定手术.结果 本组19例获随访28~40个月,平均30个月.术前JOA和VAS评分分别为(10.65±2.43)分、(7.50±0.95)分,术后2年JOA和VAS评分分别为(26.87±1.43)分、(0.21±0.01)分.结论 脊柱后路Wallis具有创伤小、出血少、符合人体生物力学等特点.其作为一种软性固定可以起到从僵硬融合节段向正常非融合活动节段的缓冲连接作用,同时亦是延缓脊柱终末期治疗(脊柱融合手术)的有应用前景的中间替代治疗措施.

  12. 高血压合并老年退行性心瓣膜病的超声资料分析%Analysis of ultrasound data in aged patients with hypertension complicated degenerative valvular heart disease

    Institute of Scientific and Technical Information of China (English)

    钱岚; 张勇; 吴亚丹; 王武; 周德聪; 李海燕

    2012-01-01

    Objective: To analyze the influence of essential hypertension (EH) on senile degenerative valvular heart disease (SDVHD). Methods: Age, valvular features and complications of SDVHD were retrospectively summarized and analyzed in 90 aged EH + SDVHD patients (EH+ SDVHD group) and 63 aged SDVHD patients with normal blood pressure (SDVHD group). Results: Compared with SDVHD group, there were significant increase in incidence rates of aortic valve calcification (52. 4% vs. 78. 9%), mitral valve calcification (15. 9% vs. 24. 4%), aortic valve calcification complicated mitral valve calcification (31. 7% vs. 52. 2%), and aortic valve stenosis + moderate reflux (31. 7% vs. 63. 3%) in EH + SDVHD group, P<0. 05 all; age of EH + SDVHD group was also significantly lower than that of SDVHD group [ (67. 5 ?6. 28) years vs. (76. 5 + 7. 33) years, P<0. 05]. Conclusion: Hypertension possesses important influence on incidence and complication of SDVHD, and it's an important risk factor of senile degenerative valvular heart disease.%目的:分析高血压对老年退行性心瓣膜病(SDVHD)的影响.方法:对90例老年高血压合并SDVHD患者(高血压+SDVHD组)和63例老年血压正常的SDVHD患者(SDVHD组)的年龄结构,瓣膜特征,SDVHD并发症进行回顾性总结、分析.结果:与老年SDVHD组比较,老年高血压+SDVHD组主动脉瓣钙化发生率(52.4%比78.9%)、二尖瓣钙化发生率(15.9%比24.4%)、主动脉瓣钙化合并二尖瓣钙化发生率(31.7%比52.2%)、主动脉瓣瓣膜狭窄及中度以上反流的发生率(31.7%比63.3%)均明显升高(P<0.05);老年高血压+SDVHD组的年龄也明显小于老年SDVHD组[(67.5±6.28)比(76.5±7.33),P<0.05].结论:高血压对老年退行性心瓣膜病的发生和发展有重要影响,加重其并发症;是形成老年退行性心瓣膜病的重要危险因素.

  13. Diagnosis and Treatment Technology for Degenerative Disc Disease%退化性椎间盘疾病诊断与治疗技术的研究进展

    Institute of Scientific and Technical Information of China (English)

    施长城; 姚海

    2015-01-01

    退化性椎间盘疾病(Degenerative Disc Disease, DDD)是严重影响人们正常生活的重大疾病之一。随着人类现代生活方式的改变,其已呈现了发病率逐年递增与发病人群年轻化的趋势。因此,针对该疾病的诊断与治疗技术亟需不断提高与完善。本文简单介绍了人体椎间盘的解刨学基础与其组织中的生化成分和功能,着重分析了针对该疾病的各种医学诊断技术,包括传统的分级评价系统以及各种定量化磁共振成像技术,重点介绍比较了现今临床上两种主要的手术治疗方法——脊柱融合术与全椎间盘置换术,并最终在总结诊断与治疗方法研究中所存在问题的基础上,对未来研究的发展趋势提出展望。%Degenerative disc disease (DDD) is a major health concern which signiifcantly affects people’s daily activities due to limited functionality of the spine. Considering modern ways of living and working, the annual incidence of DDD has been continuously increasing as well as afficting an increasingly younger age group. Therefore, the technologies for the diagnosis and treatment of DDD need to be further developed. The basic anatomy of the human intervertebral disc (IVD) as well as its biochemical components and their related functions are brielfy introduced in this review. Furthermore, the different diagnostic techniques for DDD are summarized and compared, including the conventional IVD grading system as well as varied quantitative magnetic resonance imaging (MRI) methods. In addition, two current surgical treatments, e.g., spinal fusion and total disc replacement, were discussed and analyzed. After evaluating the literatures and identifying existing issues involving available diagnostic techniques and clinical treatment options for DDD, the future directions of DDD related research and studies were presented.

  14. Molecular composition of drusen and possible involvement of anti-retinal autoimmunity in two different forms of macular degeneration in cynomolgus monkey (Macaca fascicularis).

    Science.gov (United States)

    Umeda, Shinsuke; Suzuki, Michihiro T; Okamoto, Haru; Ono, Fumiko; Mizota, Atsushi; Terao, Keiji; Yoshikawa, Yasuhiro; Tanaka, Yasuhiko; Iwata, Takeshi

    2005-10-01

    We have previously reported a cynomolgus monkey (Macaca fascicularis) pedigree with early onset macular degeneration that develops drusen at 2 yr after birth. In this study, the molecular composition of drusen in monkeys affected with late onset and early onset macular degeneration was both characterized. Involvement of anti-retinalautoimmunity in the deposition of drusen and the pathogenesis of the disease was also evaluated. Funduscopic and histological examinations were performed on 278 adult monkeys (mean age=16.94 yr) for late onset macular degeneration. The molecular composition of drusen was analyzed by immunohistochemistry and/or direct proteome analysis using liquid chromatography tandem mass spectroscopy (LC-MS/MS). Anti-retinal autoantibodies in sera were screened in 20 affected and 10 age-matched control monkeys by Western blot techniques. Immunogenic molecules were identified by 2D electrophoresis and LC-MS/MS. Relative antibody titer against each antigen was determined by ELISA in sera from 42 affected (late onset) and 41 normal monkeys. Yellowish-white spots in the macular region were observed in 90 (32%) of the late onset monkeys that were examined. Histological examination demonstrated that drusen or degenerative retinal pigment epithelium (RPE) cells were associated with the pigmentary abnormalities. Drusen in both late and early onset monkeys showed immunoreactivities for apolipoprotein E, amyloid P component, complement component C5, the terminal C5b-9 complement complex, vitronectin, and membrane cofactor protein. LC-MS/MS analyses identified 60 proteins as constituents of drusen, including a number of common components in drusen of human age-related macular degeneration (AMD), such as annexins, crystallins, immunoglobulins, and complement components. Half of the affected monkeys had single or multiple autoantibodies against 38, 40, 50, and 60 kDa retinal proteins. The reacting antigens of 38 and 40 kDa were identified as annexin II and mu

  15. [Age-related macular degeneration (AMD)].

    Science.gov (United States)

    Michels, Stephan; Kurz-Levin, Malaika

    2009-03-01

    Today age-related macular degeneration (AMD) is the most frequent cause for legal blindness in western industrialized countries. The prevalence of this disease rises with increasing age. A multifactorial pathogenesis of AMD is postulated including genetic predisposition and environmental risk factors. The most relevant modifiable risk factor is smoking. Up to today there is no cure of this chronic disease. Prophylaxis, including a healthy diet and antioxidants as nutrional supplements for selected patients, aims to slow down the disease progression. Significant progress has been made in the treatment of the neovascular form of the disease using inhibitors of the vascular endothelial growth factor (VEGF).

  16. Depression in Age-Related Macular Degeneration

    OpenAIRE

    Casten,Robin; Rovner,Barry

    2008-01-01

    Age-related macular degeneration (AMD) is a major cause of disability in the elderly, substantially degrades the quality of their lives, and is a risk factor for depression. Rates of depression in AMD are substantially greater than those found in the general population of older people, and are on par with those of other chronic and disabling diseases. This article discusses the effect of depression on vision-related disability in patients with AMD, suggests methods for screening for depressio...

  17. Rehabilitation Approaches in Macular Degeneration Patients

    OpenAIRE

    Maniglia, Marcello; Benoit R Cottereau; Soler, Vincent; Trotter, Yves

    2016-01-01

    Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient’s quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in...

  18. Animal models of age related macular degeneration

    OpenAIRE

    Pennesi, Mark E.; Neuringer, Martha; Courtney, Robert J.

    2012-01-01

    Age related macular degeneration (AMD) is the leading cause of vision loss of those over the age of 65 in the industrialized world. The prevalence and need to develop effective treatments for AMD has lead to the development of multiple animal models. AMD is a complex and heterogeneous disease that involves the interaction of both genetic and environmental factors with the unique anatomy of the human macula. Models in mice, rats, rabbits, pigs and non-human primates have recreated many of the ...

  19. [Pathopshysiological mechanisms in macular edema].

    Science.gov (United States)

    Turlea, Cristian; Zolog, Ileana; Blăjan, Codruta; Roşca, C; Turlea, Magdalena; Munteanu, Mihnea; Boruga, Ovidiu

    2014-01-01

    The treatment of diabetic macular edema has known a fast development in the last 5 years where the transition from laser monotherapy to intravitreal pharmacotherapy is becoming standard practice. Intravitreal injections therapy is in a continuous development with promising positive results. The use of intratvitreal devices in the treatment of macular edema of vascular cause has become a viable alternative also in treating diabetic macular edema. Several clinical studies have revealed the superiority of intravitreal treatment versus laser monotherapy. This article is evaluating and reviewing present and future treatments used to combat diabetic macular edema. [corrected].

  20. Relationship between central visual acuity and retinal volume of macular fovea accessed by spectral domain optical coherence tomography in Stargardt disease%Stargardt病的频域相干光断层扫描图像分析

    Institute of Scientific and Technical Information of China (English)

    张枝桥; 张承芬; 董方田; 陈有信; 于伟泓; 戴荣平; 郑霖

    2011-01-01

    Objective To assess the relationship between central visual acuity and retinal volume of macular fovea in patients with Stargardt disease by spectral-domain optical coherence tomography ( SD OCT). Methods It was a retrospective case series study. Twenty eyes of 10 patients with Stargardt disease were investigated by three-dimensional spectral-domain optical coherence tomography. SD OCT images were obtained and retrospectively analyzed. The retinal volumes of macular fovea were measured by SD OCT,whose diameters were set as 3 mm and 1 mm separately ( volume 3 and volume 1). The retinal thickness of macular fovea (macular thickness) and the width of IS/OS conjunction loss of macular fovea (IS/OS loss)were also measured by SD OCT. We correlated the logMAR BCVA with IS/OS loss, macular thickness,volume 3 and volume 1 by linear regression analysis. Results LogMAR BCVA was from 0. 3 to 1. 22.IS/OS loss was from 847 μm to 5306 μm. Macular thickness was from 20 μm to 126μm. Volume 3 and volume 1 was from 1. 06 to 1. 76 mm3 and 0. 06 to 0. 13 mm3. LogMAR BCVA correlated with the IS/OS loss (r = 0.695,P<0. 05) , macular thickness (r= - 0. 601 ,P < 0. 05), and volume 3 ( r = -0.725,P<0. 05 ). LogMAR BCVA did not correlate with volume 1 ( r = - 0. 364, P > 0. 05). Conclusions SD OCT could demonstrate the retinal structure of Stargardt disease clearly. The retinal volume of macular fovea accessed by SD OCT correlated with the visual acuity of Stargardt disease.%目的 应用频域相干光断层扫描(OCT)技术评价Stargardt病患者黄斑区视网膜容积与中心视力之间的关系.方法 回顾性病例系列研究.收集10例(20只眼)Stargardt病的临床资料进行回顾性分析.所有患者均使用频域OCT分别测量黄斑中心凹区视网膜厚度、黄斑中心凹区光感受器细胞内外节缺失宽度、黄斑中心凹区直径3 mm和1 mm范围内的视网膜容积.运用线性回归分析法,比较最小分辨角对数(logMAR)视力与黄

  1. Photo-damage, photo-protection and age-related macular degeneration.

    Science.gov (United States)

    Marquioni-Ramella, Melisa D; Suburo, Angela M

    2015-09-26

    Age-related macular degeneration (AMD) is a degenerative retinal disease that causes blindness in people 60-65 years and older, with the highest prevalence appearing in people 90 years-old or more. Epidemiological estimates indicate that the number of cases is increasing, and will almost double in the next 20 years. Preventive measures require precise etiological knowledge. This is quite difficult, since AMD is a multifactorial condition with intricate relationships between causes and risk factors. In this review, we describe the impact of light on the structure and physiology of the retina and the pigment epithelium, taking into account the continuous exposure to natural and artificial light sources along the life of an individual. A large body of experimental evidence demonstrates the toxic effects of some lighting conditions on the retina and the pigment epithelium, and consensus exists about the importance of photo-oxidation phenomena in the causality chain between light and retinal