Diagnosis Of Degenerative Disease Research Articles

Reoperations after fusion surgeries for degenerative spinal diseases depending on cervical and lumbar regions: a national database study

BackgroundReoperation is one of the key factors affecting postoperative clinical outcomes. The reoperation rates of cervical surgeries might be different from those of lumbar surgeries due to the anatomical and biomechanical differences. However, there has been no study to compare the reoperation rate between them. The purpose is to compare reoperation rates after fusion surgeries for degenerative spinal diseases depending on the anatomic region of cervical and lumbar spines.MethodWe used the Korean Health Insurance Review & Assessment Service national database. Subjects were included if they had any of the primary procedures of fusion combined with the procedure of decompression procedures under the diagnosis of degenerative diseases (n = 42,060). We assigned the patients into two groups based on anatomical regions: cervical and lumbar fusion group (n = 11,784 vs 30,276). The primary endpoint of reoperation was the repeat of any aforementioned fusion procedures. Age, gender, presence of diabetes, associated comorbidities, and hospital types were considered potential confounding factors.ResultsThe reoperation rate was higher in the patients who underwent lumbar fusion surgery than in the patients who underwent cervical fusion surgery during the entire follow up period (p = 0.0275). A similar pattern was found during the late period (p = 0.0468). However, in the early period, there was no difference in reoperation rates between the two groups. Associated comorbidities and hospital type were noted to be risk factors for reoperation.ConclusionsThe incidence of reoperation was higher in the patients who underwent lumbar fusion surgery than those who underwent cervical fusion surgery for degenerative spinal diseases.

Multiple Myeloma in the Practice of a Primary Care Physician: A Clinical Case

Aim. To demonstrate difficulties in diagnosing multiple myeloma at the out-patient stage on the example of a clinical case.Materials and methods. The course of establishing a diagnosis in a 58-year-old patient complaining of pain in the hip joint was analysed on the basis of the patient’s medical records both at the out-patient and in-patient stages.Results. A case of multiple myeloma occurring under the guise of common degenerative-dystrophic diseases is presented. An oncological diagnosis was suspected due to the patient’s complains of persistent pain, which was poorly relieved by non-steroidal anti-inflammatory pain agents, and progressive changes in the general blood test (acceleration of ESR to 40 mm/h, and then to 50 mm/h; reduction of hemoglobin from 145 g/l to 134 g/l). The diagnostic search started with an ultrasound examination of the abdominal cavity and pelvic organs, which revealed both an extensive formation in the pelvis in the right iliac region and the lymphadenopathy of the inguinal lymph nodes. Subsequently, spiral computed tomography of the abdominal cavity and the pelvis was conducted. In all bones at the study level, multiple spherical solid formations with uneven contours causing destruction of bone tissue were detected, allowing myeloma to be suspected. The patient was referred to the Republican Clinical Oncology Dispensary, where a percutaneous biopsy of the retroperitoneal neoplasm, as well as morphological and immunohistochemical studies, were carried out. As a result, the following diagnosis was established: multiple stage IIIA myeloma, first detected, with damage to the thoracic, lumbosacral spine, ribs, pelvic, and thigh bones. The patient was hospitalised in the Hematology Department of the First Republican Clinical Hospital, where he underwent chemotherapy according to the VCD scheme (bortezomib, dexamethasone, cyclophosphomide), and was discharged with improvement.Conclusion. The diagnosis of multiple myeloma is a challenging task for a primary care physician due to the diversity of the clinical picture and the lack of clinical suspicion. At the same time, timely diagnosis of the disease at the out-patient stage can significantly increase the effectiveness of treatment and, therefore, improve the prognosis. Thus, more attention should be paid to the differential diagnosis of degenerative diseases of the musculoskeletal system and multiple myeloma.

Exploiting LBL-assembled Au nanoparticles to enhance Raman signals for point-of-care testing of osteoporosis with excreta sample

Due to the intrinsic lack of specific biomarkers, there is an increasing demand for degenerative diseases to develop a testing method independent upon the targeting biomolecules. In this paper, we proposed a novel idea for this issue which was to analyze the characteristic information of metabolites with Raman spectrum. First, we achieved the fabrication of stable, uniform and reproducible substrate to enhance the Raman signals, which is crucial to the following analysis of information. This idea was confirmed with the osteoporosis-modeled mice. Furthermore, the testing results with clinical samples also preliminarily exhibited the feasibility of this strategy. The substrate to enhance Raman signal was fabricated by the layer-by-layer assembly of Au nanoparticles. The osteoporosis modeling was made by bilateral ovariectomy. Ten female mice were randomly divided into two groups. The urine and dejecta samples of mice were collected every week. Clinic urine samples were collected from patients with osteoporosis while the controlled samples were from the young students in our university. The LBL-assembled substrate of Au nanoparticles was uniform, stable and reproducible to significantly enhance the Raman signals from tiny amount of samples. With a simple data processing technique, the Raman signal-based method can effectively reflect the development of osteoporosis by comparison with micro-CT characterization. Moreover, the Raman signal from samples of clinic patients also showed the obvious difference with that of the control. Raman spectrum may be a good tool to convey the pathological information of metabolites in molecular level. Our results manifested that the information-based testing is possibly feasible and promising. Our strategy utilizes the characteristic information rather than the biological recognition to test the diseases which are difficult to find specific biomarkers. This will be greatly beneficial to the prevention and diagnosis of degenerative diseases. Also, we believe the combination of big bio-data and characteristic recognition will change the current paradigm of medical diagnosis essentially.

Graphene quantum dots for detecting monomeric amyloid peptides.

Detection of the concentration of amyloid monomers is of great importance in the diagnosis of amyloidogenesis. Herein, we propose a method to detect the concentration of amyloid β (Aβ) peptide monomers by utilizing the fluorescence characteristics of graphene quantum dots (GQDs). The linear dependence of the photoluminescence (PL) intensity of GQDs on the Aβ monomer concentration can be identified. It can be further illustrated that both monomeric and fibrillar Aβ peptides can be monitored by using GQDs. Conventional fluorescent dyes, such as thioflavin T (ThT), usually undergo co-incubation with amyloid peptides, which could lead to disturbance of the aggregation because of their inhibitory effect. Similar Aβ aggregation dynamics observed by using GQDs and ThT demonstrated the feasibility of the GQD-based detection method without co-incubation with soluble amyloid peptide monomers. The utilization of GQDs as a novel probe monitoring amyloid monomers could be applied in pathological detection and diagnosis of degenerative diseases and other conformational disorders.

Oscillopsia: causes and management

Oscillopsia is an illusion of an unstable visual world. It is associated with poor visual acuity and is a disabling and distressing condition reported by numerous patients with neurological disorders. The goal of this study is to review the recent findings in the various pathophysiological mechanisms of oscillopsia and the potential treatments available. Oscillopsia most often results from abnormal eye movements or from impaired vestibulo-ocular reflex. A special emphasis is provided on new hypotheses concerning the mechanisms of pendular nystagmus associated with oculopalatal tremor; on the clinical relevance of fixation instability in the diagnosis of degenerative disease; and on the causes of vestibular areflexia. Oscillopsia could also theoretically result from a deficit in mechanisms underpinning perceptual stability maintenance despite constant gaze displacement in the environment. The recent findings concerning the mechanisms and underlying neural network subserving this phenomenon of 'spatial constancy' are developed. Oscillopsia may result either from impaired ocular stability or impaired compensation or suppression of afferent visual information resulting from normal eye movements. Understanding the exact mechanisms of oscillopsia may lead to novel treatment.

Das Styloid-Syndrom

Elongated Styloid Process Syndrome requires its consideration in differential diagnosis of degenerative disease of the cervical spine. Radiating pain on certain movements of the cervical spine is a symptom of an elongated styloid process as well. First basic anatomy and pathology, symptoms and differential diagnosis of the elongated styloid syndrome are discussed. A case history is presented together with X-rays of the cervical spine and images of three dimensional CT-reconstruction to show the full length of an elongated styloid process.

Somatosensory evoked potentials in the diagnosis of degenerative diseases of the spinal cord

We examined 72 patients with complaints of pain in various parts of the spine with irradiation into the extremities, weakness and paresthesias of the back muscles in the area of innervation of nerve roots. Clinical findings: loss of sensitivity, weakness of dorsiflexion in joints, asymmetric tendon reflexes.

Cervical spine MR imaging using multislice gradient echo imaging: Comparison with cardiac gated spin echo

Forty-one patients with suspected cervical spine disorders were studied using multislice gradient echo imaging (GE) technique, with a 1.5-T system. The images were compared to cardiac-gated spin echo (CGSE) images in the diagnosis of suspected cord and spinal disorders. Images were graded for ability to detect cord lesion, cord-CSF contrast, CSF-bone contrast and contrast between CSF and extradural abnormality. The signal-to-noise ratio and contrast-to-noise ratio were used to compare images. There was 44% decrease in contrast between cord lesion and normal cord on GE when compared to CGSE, except for spinal cord hemorrhage. There was a 40% improvement between bone and CSF contrast on GE compared to CGSE. GE images were significantly better qualitatively as well as quantitatively in the detection of extradural lesions. This effect was more marked in axial plane where CGSE images are extremely suboptimal. CGSE images are better than GE for spinal cord lesions, while GE are superior in the diagnosis of degenerative disease in the cervical spine.

A comparison of glutamic-oxalacetate transaminase, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, and creatine phosphokinase activities in non-spawning, pre-spawning, and spawning pink salmon

1. 1. The activity levels of various enzymes were assayed in the serum of non-spawning, pre-spawning, and spawning salmon. The enzymes, often used in the diagnosis of degenerative diseases in humans, included glutamic-oxalacetate transaminase, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, and creatine phosphokinase. 2. 2. The activity levels of all enzymes were highest in spawning salmon as compared to non-spawning salmon. 3. 3. In other fish sera, the enzyme activity levels for all enzymes were highest in Pacific herring while sera from dogfish, ling cod, and red rock fish had activity levels approaching those found in normal human serum. 4. 4. Polyacrylamide disc-gel electrophoresis of spawning salmon lactate dehydrogenase isoenzymes showed a diversity of enzyme patterns. This suggests that LDH activity can vary considerably from fish to fish.