Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eighty-six hips in eighty-five patients who were considered to be at risk for heterotopic ossification following a total hip arthroplasty were prospectively randomized or assigned to one of two treatment groups that received a single 800-centigray dose of limited-field radiation either preoperatively (Group I) or postoperatively (Group II). The risk factors for postoperative heterotopic ossification included previous heterotopic ossification following an operation about the hip, hypertrophic osteoarthrosis or post-traumatic osteoarthrosis characterized by the presence of extensive osteophytes, radiographic evidence of diffuse idiopathic skeletal hyperostosis, and ankylosing spondylitis. The hips in Group I were irradiated within 6.1 hours before the operation and those in Group II, within 51.3 hours after the operation. Either extra-field ossification or heterotopic ossification was observed in forty-one (48 per cent) of the eighty-six hips, thereby confirming the high risk for the population in this study. After a minimum duration of follow-up of six months, thirty-seven (76 per cent) of the forty-nine hips that had been treated with preoperative irradiation exhibited no new heterotopic ossification and eleven, progression to grade-I or II ossification. The remaining hip in that group was in a woman who had Paget disease as well as previous grade-IV (ankylosing) heterotopic ossification about the ipsilateral hip; heterotopic ossification progressed from grade II on the radiographs made immediately after the index revision procedure to grade III at the most recent follow-up assessment. Of the thirty-seven hips that had been treated with postoperative irradiation, twenty-seven (73 per cent) exhibited no new heterotopic ossification and nine had progression from grade-0 to grade-I ossification. The remaining hip in that group was in a man who had Parkinson disease and previous grade-III ossification about the ipsilateral hip; heterotopic ossification progressed from grade III immediately post-operatively to grade IV at the time of the most recent evaluation. Extra-field ossification was identified in twelve (24 per cent) of the forty-nine hips that had been irradiated preoperatively compared with three (8 per cent) of the thirty-seven hips that had been irradiated postoperatively (p = 0.05). Extra-field ossification was not associated with clinical symptoms of bursitis of the greater trochanter in any hip. Three of the ten hips that had a revision operation subsequently had a non-union of the greater trochanter; all three had been treated with preoperative irradiation. The findings of the present study suggest that pre-operative irradiation is effective for the prevention of heterotopic ossification following total hip arthroplasty and that it eliminates the discomfort and morbidity that are associated with conventional postoperative treatment. Furthermore, the efficacy of preoperative irradiation suggests that osteogenic precursor cells that are active in this process are derived from the local tissues within the operative field rather than from distant blood-borne cell lines.
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PMID:Preoperative irradiation for prevention of heterotopic ossification following total hip arthroplasty. 866 5

Cervical spine disorders which can cause swallowing difficulties (cervicogenic dysphagia; CD) are: chronic multisegmental/MS dysfunction (dysfunction=functional blockade) of the facet joints, changes in physiological curvature of the cervical spine, degenerative changes (anterior osteophytes, anterior disc herniation, osteochondrosis, osteoarthritis), inflammatory rheumatic diseases, diffuse idiopathic skeletal hyperostosis, injuries, conditions after anterior cervical spine surgery, congenital malformations and tumors. According to our clinical observations, degenerative changes in the cervical discs and facet joints and chronic MS dysfunction of the cervical spine facet joints are disorders which can cause swallowing difficulties. However, these disorders have not been recognized enough as the causes of dysphagia and they are not even mentioned in differential diagnosis. Because of the close anatomical relationship of cervical spine with the pharynx and cervical part of esophagus, the consequences of the degenerative changes in the cervical discs and facet joints and chronic MS dysfunction of the cervical spine facet joints such as the changes in the physiological curvature of the cervical spine, changes in elasticity and contractility in the neck muscles and decreased mobility of the cervical spine, adversely affect the dimensions of the pharynx and cervical part of esophagus, that is, swallowing capacity which can result in dysphagia. Degenerative changes in the cervical discs and facet joints are common additional cause of dysphagia in elderly people with disorders of the central control of swallowing (stroke, Parkinson's disease, senile dementia etc). The most important therapeutic options in patients with CD are: medicamentous therapy, physical therapy, manual therapy, kinesiotherapy and surgical treatment. The aim of the conservative therapy in patients with CD is to improve the swallowing capacity (for example, soft tissue techniques, stretching of the shortened muscles, passive and active mobilization of the facet joints). As the patients with CD usually respond well to the appropriate therapy, cervical causes of dysphagia cannot be overlooked in patients with difficulty swallowing, including patients with disorders of the central control of swallowing.
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PMID:[Cervicogenic dysphagia: swallowing difficulties caused by functional and organic disorders of the cervical spine]. 2367 76

Pseudoarthrosis at the intervertebral space in patients with ankylosing spondylitis has occasionally been reported, but symptomatic pseudoarthrosis at the intervertebral disc level is rare in patients with diffuse idiopathic skeletal hyperostosis (DISH). Here, we report a case of symptomatic pseudoarthrosis at the L2-L3 intervertebral space that was diagnosed based on clinical history. We first performed L1-L5 fixation, but back-out of the pedicle screw occurred in the early postoperative phase and may have been caused by a short fixation range and concomitant Parkinson's disease. However, the prognosis of the case was favorable after a second surgery. This case indicates that a fixation range of at least 3 above and 3 below is necessary for bone fracture of a thoracolumbar vertebra and pseudoarthrosis in patients with DISH.
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PMID:Spontaneous symptomatic pseudoarthrosis at the l2-l3 intervertebral space with diffuse idiopathic skeletal hyperostosis: a case report. 2429 32

A 77-year-old woman with Parkinson's disease presented with left chest pain. Physical examination revealed tenderness at her second left sternocostal joint. There was no skin rash. Chest CT revealed hyperostosis of the sternocostal joint, and cervical MRI showed vertebral osteosclerosis and osteolysis. 99mTc-MDP bone scintigraphy showed an increased activity in the sternocostal joint and vertebral column. The patient was diagnosed with SAHPO syndrome according to the diagnostic criteria. Her chest pain was relieved after oral administration of nonsteroidal anti-inflammatory drugs. Although pain is a common non-motor symptom of Parkinson's disease, chest pain is relatively rare, according to a previous reports. When patients with Parkinson's disease complain of chest pain, physicians should make an appropriate differential diagnosis after excluding emergent cardiovascular disease. To the best of our knowledge, this is the first report of Parkinson's disease associated with SAPHO syndrome. The relationship between the two diseases is unclear. However, peripheral inflammation is known to exacerbate ongoing neuronal damage in neurodegenerative diseases, such as Parkinson's disease. Therefore, systemic inflammation of SAPHO syndrome may affect the disease course of Parkinson's disease.
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PMID:[Parkinson's disease associated with SAPHO syndrome: a case report]. 2971 19