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PubMed1989

[Evaluation of the skin sympathetic function by the decrease of skin temperature at the finger tip immersed into cold water].

The change of the skin temperature at the finger tip immersed into cold water was measured in normal volunteers and in patients with disturbances of various portions of sympathetic nervous system with copper-constant thermocouple. The skin temperature of the normal subjects decreased soon after the immersion, partly due to cooling by the cold water, and partly due to the decrease of the skin blood flow. The skin sympathetic activity recorded from three normal subjects using the technique of microneurography presented an increase during the decreasing phase of the skin temperature. The skin temperature of the patients who received stellate ganglion block did not fall and maintained higher level compared to that of normal subjects. These data indicated that the decreasing phase of the skin temperature of the immersed finger is related to the increase of skin sympathetic activity. Cases of vascular neuropathy (lesion in post-ganglionic fiber), Shy-Drager syndrome and pure autonomic failure (lesion in pre-ganglionic fiber), cervical spondylosis and cervical disc herniation (lesion in descending tract of sympathetic system in spinal cord), and bleeding in pons tegmentum (lesion in descending tract in brain stem) were examined and all of them presented poor decrease of the skin temperature during the immersion. The skin temperature decreased, but incompletely in the patients, who had suffered from thalamic infarct and post-central gyrus infarct, and did not feel any sense on the immersion. These results indicate that the decreasing phase of the skin temperature of the finger immersed into cold water depends more upon the efferent than upon the afferent system, and this test is useful for evaluation of the skin sympathetic function.

Adult↗
PubMed1989

[The x-ray semeiotics of spinal involvement in psoriasis].

X-ray examinations of the bone and joint system in psoriasis patients with pain syndromes in the limb joints have revealed spinal involvement in many cases. The authors have distinguished and described x-ray semeiotics of the inflammatory (spondylitis, spondyloarthritis, sacroiliitis), degenerative dystrophic (intervertebral osteochondrosis, spondylarthrosis deformans, spondylosis), and mixed or combined (inflammatory + degenerative dystrophic) involvements of the spine in psoriasis.

Adult↗
PubMed1989

[Clinical applications of somatosensory evoked potentials for cervical cord lesions].

Measurement of interpeak latencies and evaluation of peak forms with added measurement of Nll besides N9, N13 and N20 and with utilization of normal standard values of interpeak latencies in 20 healthy persons proved to be useful for diagnosing the level responsible for neurological manifestations in cases with multiple cervical cord compressions, in such cases as multiple sclerosis without mechanical compression and also for differential diagnosis of incipient motor neuron disease from cervical spondylosis with muscle atrophy. It also proved that elongation of the interpeak latencies between N9-N11 evoked by stimulating the median and ulnar nerve at the wrist level occurred only when more than one cervical cord segment receiving median and ulnar nerve fibers was afflicted.

Adolescent↗
PubMed1977

HLA antigens and alkaptonuria.

Thirty members of Family C, which included cases of alkaptonuria and ochronosis, were investigated by means of HLA typing and homogentistic acid determination. The antigen HLA B27 was found in one of the two members of the first generation, in all eight members of the second generation, and in 15 of the 21 members of the third generation. Eight of 10 subjects suffering from alkaptonuria, with or without ochronotic arthropathy or spondylosis, had B27. The gene for B27 is not the gene determining homogentisic acid oxydase synthesis but this study suggests that it may be associated or linked to it.

Alkaptonuria↗
PubMed1989

Phase IV evaluation of piroxicam in acute and chronic painful inflammatory disorders: an Indian study.

We report the first phase-IV computerized study on Piroxicam in Indian patients. Comprehensive subject record sheets were distributed to 1,000 doctors. Piroxicam at 20 mg/day was given to patients categorized as suffering from rheumatoid arthritis (RA), osteoarthritis (OA), cervical spondylitis (CS), ankylosing spondylosis (AS), soft-tissue & other pains (ST) for up to 12 weeks. Assessments of pain, tenderness, swelling, range of movements, morning stiffness as well as the grip test and walking test, were made at 24 and 72 h, and 1, 4 and 8 weeks after therapy. All side-effects were noted. Data entry and statistical analysis (95% confidence interval) for proportions expressed as percentages) were handled by computer. A total of 174 doctors (17.4%) co-operated by giving data for 844 patients, consisting of the following cases: RA (306), OA (253), AS (52), CS (113) and ST (120). Piroxicam was found to be uniformly effective in the above disorders, a favourable response to the treatment being obtained in 82%-96% of the patients. The overall response rates (with 95% confidence interval in brackets) were 93% (91-95%) in pain, 93% (91-95%) in tenderness, 90% (80-93%) in swelling, 90% (87-92%) in range of movements and 86% (83-89%) in morning stiffness. The average duration of therapy ranged from 22 to 42 days. A total of 88 (10.4%) patients reported 224 incidences of side-effects, 91% of them being gastrointestinal, but no patient had ulcer or GI bleeding. In 1.9% of the patients, therapy was stopped due to an adverse reaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Clinico-radiographic evaluation of the state of the spine in stomach and duodenal diseases].

Data are given on the condition of the thoracic spine of 465 patients with certain gastric and duodenal diseases. Degenerative-dystrophic lesions (spondylosis deformans and intervertebral osteochondrosis) of the thoracic spine together with osteoarthritis deformans of the costovertebral and costotransverse articulations lead to neurodystrophy of the gastric and duodenal mucosa through chronic stimulation by osteophytes of the thoracic sympathetic ganglia. Disorders of gastric and duodenal motor activity are also important. The attendant reflux gastritis is stipulated by reflux of the intestinal contents into the gastric lumen. Condition of the stomach and duodenum can be improved by relieving changes in the spine.

Adult↗
PubMed1989

[Android and gynecoid types of obesity as factors in the onset of certain related diseases].

The prevalence of some diseases was studied in 238 android and 720 gynoid obese women and 180 android obese men with the aim to establish the relationship between the type of obesity and relevant diseases. In the selected group of obese patients (25 android and 90 gynoid obese women and 26 android obese men) fed on a reducing diet (1000 kcal--4.2 M.J.) 67 women were engaged in intensified physical activity during the 90 days of dieting. The relationship between the weight loss and the type of obesity as well as the relationship between the weight loss in women engaged in intensified physical activity and those abstaining from it was investigated. The investigation has shown that the prevalence of hypertension, coronary heart disease and diabetes was much higher in men and women affected by the android type of obesity than in women affected by the gynoid type of obesity. The prevalence of gallbladder's as well as venous system diseases and spondylosis in women affected by both types of obesity was much higher than in android obese men, but the prevalence of constipation was higher in gynoid obese women. From data relating to response to reducing diet it is concluded that the weight loss was equal among the women affected by the android and gynoid types of obesity, but the weight loss in android and gynoid obese women engaged in intensified physical activity was significantly higher than in those abstaining from it.2+herefore, for the prevention and

Adult↗
PubMed1989

[Detectability of metastatic bone tumor by Ga-67 scintigraphy].

Ga-67 scintigrams in patients with malignant diseases sometimes reveal uptake of the tracer in the bone metastases. Detectability of Ga-67 scintigraphy for metastatic bone tumors and benign bone lesions was compared with that of Tc-99m bone scintigraphy. Countable bone metastases detected by bone scintigraphy were evaluated whether the lesion showed apparent, faint, or negative Ga-67 uptake. Of 47 lesions 23 (49%) showed apparent uptake and 17 (36%) showed negative uptake. On the other hand, of 71 benign bone lesions, only 7 (10%), mostly fracture/osteotomy, showed apparent uptake of the tracer. Uptake in the other benign lesions such as trauma of the ribs, spondylosis deformans, and arthrosis deformans was rather faint. In patients with multiple bone metastases, 9 patients (82%) out of 11 showed more prominent abnormal findings in Tc-99m MDP bone scintigraphy than in Ga-67 scintigraphy; that is, Ga-67 scintigraphy was not able to reveal all metastatic bone lesions. In patients with untreated or recurrent tumors, relation between Ga-67 uptake in the tumors and that in the bone metastases was evaluated. Of 7 patients with negative Ga-67 uptake in the primary tumors, 5 showed positive Ga-67 uptake in the bone metastases; that is, there seemed to be little relation between Ga-67 affinity to the primary tumors and that to the bone metastases. Mechanisms of the Ga-67 uptake in the bone metastases were discussed. Not only the tumor cells or tissues in the bone metastases but also bone mineral or osteoclasts might be the deposition sites of Ga-67.

Aged↗
PubMed1989

[Flexion myelopathy due to tic of neck].

A 22-year-old male developed a tic of neck-flexion at the age of 14. The tic occurred 40 to 50 times per minute on its peak at age 16. Since then he noticed the atrophy and weakness of his both upper limbs. His right leg became weak at age 22. On admission, neurological examination revealed tic of lip and neck, severe muscle atrophy and weakness of bilateral upper limbs, mild muscle weakness and spasticity of right lower limb and hyperreflexia in four limbs. Needle EMG studies revealed fibrillation, positive sharp wave and giant MUP in the biceps, triceps and first interossei muscles. There were no abnormal findings suggesting cervical spondylosis or disc herniation on neck roentgenogram and neck MRI in neutral position. Neck MRI in the ventro-flexed position showed a flattening of the lower cervical cord and a band-like isointensity lesion in the posterior epidural space at C4-6. This isointensity lesion was considered to represent a congestion of the internal vertebral venous plexus. These findings suggest that frequent neck flexion by itself causes the injury of the lower cervical cord through (1) over-stretching of the cord, (2) compression of the cord by dural sac, (3) arterior ischemia, and/or (4) stagnant hypoxia due to venous congestion. Flexion myelopathy may represent one of the most important mechanisms of cervical cord injury accompanied with involuntary movement of neck.

Adult↗
PubMed1989

[Cerebrospinal fluid level of aldolase C in patients with various neurological disorders: comparison with neuron-specific enolase, S-100b protein and creatine kinase BB isoenzyme].

By employing a highly sensitive immunoassay method, concentration of aldolase C (Ald C) was determined in cerebrospinal fluid (CSF) of 180 patients with various neurological disorders and 46 age-and-sex matched control subjects. The results were compared with CSF levels of neuron-specific enolase (NSE), S-100b proteins (S-100b) and creatine kinase BB isoenzyme (CK-BB) in the same samples. Normal level of Ald C was 7.95 +/- 2.52 (mean +/- SD) ng/ml. CSF level of Ald C was elevated not only in patients with acute disorders, but also those of degenerative diseases. It increased significantly in purulent meningitis, encephalitis, cerebral infarction, and cervical spondylosis as compared with control subjects. The levels of Ald C were reached the peak levels later than those of NSE, S-100b and CK-BB. Concentration of Ald C in CSF correlated well with that of NSE but poorly with that of S-100b or CK-BB. These results suggested that Ald C in CSF was one of the useful marker in neurological disorders. Since these proteins have different distributions in the central nervous system and have different molecular weights, simultaneous determination of Ald C, NSE, S-100b and CK-BB levels in CSF might provide valuable information about pathologic nature of the underlying neurological disorders.

Adolescent↗
PubMed1989

[Anterior discectomy as treatment for a cervical radicular syndrome].

The results are presented of a retrospective survey of anterior cervical surgery followed by fusion with autologous bone grafting for the treatment of radiculopathy due to cervical intervertebral disc prolapse or spondylosis. The study included 46 patients, with a follow-up period of at least a year. Follow-up examination was performed by an independent observer. Of the patients 38 (83%) were improved, 34 (74%) having a 'good' or 'excellent' response. Postoperative complications were minor; the most frequent complication was pain or dysaesthesia at the donor site of the bone graft, the iliac crest. It is questionable whether autologous bone grafting is indicated following anterior discectomy.

Adult↗
PubMed1989

[Magnetic resonance imaging of the lumbar spine--comparison of multiple spin echo and low flip angle gradient echo imaging].

Sixteen patients including 13 cases with disk herniation and 3 cases with spondylosis of lumbar spine were examined on a resistive MRI system operating at 0.1 T. All lesions were studied with both multiple spin echo (MSE) and low flip angle gradient echo (LF) techniques to evaluate which technique is more effective in detecting the disk degeneration and the indentation on subarachnoid space. MSE images were obtained with repetition time (TR) of 1100-1500 ms or cardiac gating, an echo time (TE) of 30, 60, 90, 120, 150, and 180 ms symmetrical 6 echoes, and total acquisition time of more than 281 sec. LF images were obtained with TR of 500, 250, and 100 ms, TE of 18 ms, a flip angle of 30 degree, and total acquisition time of 128 sec. Eleven lesions of spinal disk degeneration and 12 of indentation on subarachnoid space were detected with LF. On the other hand, 26 lesions of spinal disk degeneration and 38 of indentation on subarachnoid space were detected with MSE. Although the parameters of LF employed in this study were relatively effective to emphasize T2*-based contrast, the ability of LF in detection of spinal disk degeneration and indentation on subarachnoid space is less than that of MSE. Signal contrast to noise ratios for normal disk and degenerative disk, epidural-fat and disk herniated material, CSF and disk herniated material, and epidural-fat and CSF were less than 4 with LF, but more than 4 with MSE.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1989

[Lumbar intervertebral disk disease and its sequelae: segmental instability, intervertebral disk displacement, lumbar spinal stenosis--change in a common disease].

Clinical, radiological, surgical and experimental experiences allow to construct a theory of degeneration of the lumbar spine, which explains the pathogenesis of spondylosis, stenosis and disc displacement as well. The centre of the whole process is the segmental instability due to disc derangement. Several partially new criteria for a rational surgical and conservative therapy follow from such theory, which we try to explain by some exemplaric cases. Finally, we describe shortly own surgical procedure for combined operation of decompression and lumbar fusion.

Follow-Up Studies↗
PubMed1989

[Morphology and endocrinology of a fatal course of Addison crisis].

A 36 year-old man fell ill with violent dorsalgia seemingly related to spondylosis. The diagnosis of tuberculous spondylitis was made as late as 18 months after the onset of symptoms. The disease rapidly progressed to death in spite of adequate tuberculostatic and surgical therapy. The post-mortem examination revealed a massively caseating tuberculosis of both adrenal glands suggestive of Addison's disease. Severe adrenocortical insufficiency was confirmed by low steroid hormone levels in the post-mortem blood; the validity of these results is indicated by comparative hormone level determinations in a series of recent and stored post-mortem blood specimens.

Addison Disease↗
PubMed1989

Analysis of monoamines in the cerebrospinal fluid of Chinese patients with neurological diseases.

Levels of dopamine (DA), 3-methoxy-4-hydroxy-phenylacetic acid (HVA), 5-hydroxy-indoleacetic acid (HIAA), 5-hydroxytryptamine (HT), 5-hydroxytryptophan (HTP), and 3, 4-dihydroxyphenylalanine (DOPA) in cerebrospinal fluids (CSF) of twenty-four Chinese with or without neurological diseases were determined simultaneously. The level of HIAA in the CSF of myelopathy-spondylosis patients and the level of DA in CSF of the myelopathy-tumor patients were higher than that of the control. No difference in levels of monoamines and their metabolites was observed between the control and patients with dementia.

Adolescent↗
PubMed1988

[Function of the long spinal cord pathways in cervical spinal stenosis--an electrophysiologic study].

Cervical spinal stenosis is radiologically defined by a reduced inner diameter (X less than 13 mm) of the cord canal and in most cases etiologically connected with spondylosis. The following study describes the results of non-invasive assessment of the long ascending and descending spinal tracts in 12 patients. The long ascending spinal tracts were examined by spinal and cortical SEP after stimulation of the tibial nerve; for the assessment of the descending spinal tracts motor responses of the tibial anterior muscle were recorded after non-invasive stimulation of the motor cortex. Clinically symptomatic patients (N = 2) exhibited clear-cut functional motor and sensory deficits of the central pathways. In asymptomatic patients (N = 10) corticomotoneuronal latencies to the lower limbs were increased in 8 cases. In comparison, increased central sensory latencies were found in 9/10. In conclusion, the studies showed that the technique of non-invasive stimulation of the motor cortex may play a role in the detection of subclinical lesions of the long descending motor tracts due to a chronic mechanical irritation.

Cerebral Cortex↗
PubMed1988

Cervical laminaplasty: its role in the treatment of cervical radiculopathy.

Krita in 1968 described the use of laminaplasty for the treatment of cervical myelopathy. Since then, several authors have modified this technique, settling on the "expansive open door laminaplasty" as the technique of choice for cervical myelopathy. There have been no reports to date on the use of the cervical laminaplasty procedure for the treatment of cervical radiculopathy. The purpose of this paper is to report on the initial 16 patients undergoing this procedure for the surgical treatment of cervical radiculopathy due to cervical spondylosis and/or cervical spinal stenosis. There were 16 patients (8 males and 8 females) whose age ranged from 54 to 84 years, with a mean of 67.2 years. The follow-up average was 2.7 years, with a range of 2.1 to 5.5 years. Seven patients were categorized as having brachalgia-cord type myelopathy and nine patients were categorized as radiculopathy only. Arm pain was unilateral in seven patients and bilateral in nine patients. Of those with bilateral pain, eight patients had pain predominately in one arm, with one patient having equal left and right arm complaints. Cervical laminaplasty was carried out from C3-6 in six patients and C3-7 in six patients and one patient had each of the following: C4-7, C4-T1, C5-T1, and C3-T1. The results were excellent in five cases, good in nine, and poor in two. The results of patients with unilateral symptoms and signs were compared to those with bilateral findings using chi 2 analysis. There was no statistical difference when performing laminaplasty for patients with bilateral findings as opposed to unilateral symptoms and signs. The amount of spinal canal expansion obtained by the laminaplasty procedure ranged from 4 to 12 mm. The conclusions of this study were (a) laminaplasty appears to be an effective alternative to laminectomy or anterior cervical fusion for multilevel cervical spondylotic radiculopathy or myeloradiculopathy and (b) complications of anterior fusion and laminectomy are avoided with the laminoplasty procedure.

Aged↗