DrSclafani answers some questions

A forum to discuss Chronic Cerebrospinal Venous Insufficiency and its relationship to Multiple Sclerosis.

Postby garyak » Sun Jun 06, 2010 8:22 pm

thanks dlb and Cece
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Postby Stacemeh » Mon Jun 07, 2010 2:37 am

I don't know about iron types but here is something I wonder about:

Hemolysis can occur when normal red cells are exposed to turbulent blood flow in large vessels, an example of which includes tramatic disruption (sounds like reflux to me) of red cells in heart disease.

Hemolysis = rupture of erythrocytes (red blood cells) with release of hemoglobin into the plasma (the fluid portion of blood).

What I wonder is if refluxed blood (due to venous stenosis) is sometimes releasing a bit of hemoglobin and that free hemoglobin is "sticking" to the vessel walls and over years (perhaps in a vicarious luxuriant fashion :) ) this hemoglobin is accumulating and breaking down leaving iron behind.

From past experience in Vet practice I happen to know that heme staining leave a kinda redish tint, not unlike that in pictures I've seen of MS lesions.

So, I wonder if this might explain the discoloration seen on the plaques formed in MS and if it might also explain why red cells have not been found by pathologists in MS lesions.

But I am not a doctor, I can only speculate.
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Postby mshusband » Mon Jun 07, 2010 7:07 am

Cece (or anyone else) ... since I can't find what I'm looking for and you seem to be more adept at doing so using whatever you're using ... perhaps you can find this for me.

I'm looking for an answer Dr. Sclafani had about finding different types of stenosis or causes of stenosis in the veins ... (I think the answer mentioned leaflets, valves, twisting, flaps) ... but I can't remember how long ago it was (nor do I have time to read 115 pages - THANK YOU SO MUCH DR. SCLAFANI FOR ALL OF THIS, SERIOUSLY, YOU'RE A GODSEND FOR INFORMATION - otherwise we'd all be adrift still).

If you can find that for me ... I think the answer also mentioned the best way of imaging those types of malformations ...

I'd really appreciate it.
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Interesting

Postby larmo » Mon Jun 07, 2010 8:03 am

I was watching the live feeds from the ROV's working on the oil spill. Whenever the picture was obscured (with oil flow, etc.) they would switch to another format to get a better picture. I think they tried the red, green & blue filters along with infrared. I see weapon/troop testing where they use an infrared camera also with excellent results.

I wonder if something as simple as this would be helpful with different types of imaging to show stuff you wouldn't normally see - that would be more helpful in a diagnosis.

I'm just trying to think outside the box. Any thoughts or comments would be welcome.
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Postby dlb » Mon Jun 07, 2010 8:24 am

Larmo,
I went to the info session that Dr. Zivadinov & Dr. Weinstock-Guttman presented at in Calgary. They described the testing that they do (in laymen's terms) and showed videos & slides of patients with MS as well as normal controls. Can't remember the name of the test but I think it was actually the doppler?? The flow of blood was shown in colors, so that you could clearly see when the blood was refluxing. Is this kind of what you are speaking of?
Last edited by dlb on Mon Jun 07, 2010 9:39 am, edited 1 time in total.
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Postby Cece » Mon Jun 07, 2010 8:45 am

mshusband wrote:I'm looking for an answer Dr. Sclafani had about finding different types of stenosis or causes of stenosis in the veins ... (I think the answer mentioned leaflets, valves, twisting, flaps) ...

Is this it?
drsclafani wrote:The body and its pathology is rarely that boring. In the case of CCSVI, there are so many variations of the disease and its anatomical pathology

To date I have seen the following: In most patients they are mixed

1. Anomalous confluens of jugular vein
2. Absent Jugular vein
3. annular stenoses
4. hypoplasia, isolated
5. hypoplasia, multiple tandem
6. duplications with stenosis
7. reversed valve
8. incomplete or fused valve leaflets
9. misplaced valve
10. false channels (may be incomplete jugular duplication)
11. webs
12. indentations/impressions
13. abnormal drainage of external and vertebral veins

So variation is the rule.

Nothing there about imaging, though...

I went to the thread index:
http://www.thisisms.com/ftopict-11433.html
hit Control F, which opens up the Find feature, and searched for malformations, but nothing came up...then glanced backwards from the end and came across one listed as "Variation of CCSVI abnormalities" on page 70...it took about a minute, it is not hard! :)[/url]
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Postby 1eye » Mon Jun 07, 2010 11:50 am

I'm just trying to think outside the box. Any thoughts or comments would be welcome.


Quite right, Larmo. Not to be morbid but maybe more post-mortem stuff is appllicable. The police use great tools, and for this they might use an ALS. Because human eyes don't see some other wavelengths too.
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'MS' is over - if you want it
Patients sans/without patience
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Postby larmo » Mon Jun 07, 2010 12:53 pm

1eye wrote:
I'm just trying to think outside the box. Any thoughts or comments would be welcome.


Quite right, Larmo. Not to be morbid but maybe more post-mortem stuff is appllicable. The police use great tools, and for this they might use an ALS. Because human eyes don't see some other wavelengths too.


dlb, this is more along the lines I was thinking about. Something that can't be seen with the naked eye in the spectrum's that we humans can see.
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Postby Cece » Mon Jun 07, 2010 6:28 pm

bestadmom wrote:Dr. S is in Italy with Paolo Zamboni for the week with no internet access. We probably won't hear from him until next weekend.

This is good to know, I was thinking we'd hear one way or another on June 9th...not so?
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Postby mshusband » Mon Jun 07, 2010 6:34 pm

"someone" will let us know ... I'm sure.
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Postby bestadmom » Mon Jun 07, 2010 7:01 pm

I hope he has a way of knowing on 6/9 and gets to a computer to post or has Holly do it.
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Postby Cece » Mon Jun 07, 2010 7:17 pm

Well, I'll have the virtual champagne and/or kleenexes at the ready! (And they keep quite well, if it's a few days later that we hear...but that's a good thought about Holly, she has posted here before.)

"Free Dr. Sclafani!" "Nobody puts DrS in the corner!" :)
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Postby Cece » Mon Jun 07, 2010 7:56 pm

Stacemeh wrote:I don't know about iron types but here is something I wonder about:

Hemolysis can occur when normal red cells are exposed to turbulent blood flow in large vessels, an example of which includes tramatic disruption (sounds like reflux to me) of red cells in heart disease.

Hemolysis = rupture of erythrocytes (red blood cells) with release of hemoglobin into the plasma (the fluid portion of blood).

What I wonder is if refluxed blood (due to venous stenosis) is sometimes releasing a bit of hemoglobin and that free hemoglobin is "sticking" to the vessel walls and over years (perhaps in a vicarious luxuriant fashion :) ) this hemoglobin is accumulating and breaking down leaving iron behind.

From past experience in Vet practice I happen to know that heme staining leave a kinda redish tint, not unlike that in pictures I've seen of MS lesions.

So, I wonder if this might explain the discoloration seen on the plaques formed in MS and if it might also explain why red cells have not been found by pathologists in MS lesions.

But I am not a doctor, I can only speculate.

I am not sure, maybe hemolysis would be more likely to happen in arteries than in veins? Because of it being high pressure in arteries but low pressure in veins...but there is still turbulence...I am out of my depth here, alas! Haacke's research definitely supports that there are iron deposits around the MS lesions, but they are probably from broken down red blood cells that leaked across the blood brain barrier that was weakened by the turbulent blood flow.
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Postby AlmostClever » Mon Jun 07, 2010 8:57 pm

mshusband wrote:Cece (or anyone else) ... since I can't find what I'm looking for and you seem to be more adept at doing so using whatever you're using ... perhaps you can find this for me.

I'm looking for an answer Dr. Sclafani had about finding different types of stenosis or causes of stenosis in the veins ... (I think the answer mentioned leaflets, valves, twisting, flaps) ... but I can't remember how long ago it was (nor do I have time to read 115 pages - THANK YOU SO MUCH DR. SCLAFANI FOR ALL OF THIS, SERIOUSLY, YOU'RE A GODSEND FOR INFORMATION - otherwise we'd all be adrift still).

If you can find that for me ... I think the answer also mentioned the best way of imaging those types of malformations ...

I'd really appreciate it.


FROM PAGE 68:

neck ultrasound with doppler hemodynamics shows abnormalities in flow that result from outflow obstructions and shows stenoses

MRVenogram shows narrowings of the jugular veins, can quantify flow, show collateral veins

CT venogram shows narrowing of the jugular veins.

catheter venogram minimally invasive test that shows narrowings, flow disturbance, abnormal valves, kinks, etc in both the jugular veins and the azygous veins. Is a precursor to treatment and is the Gold Standard test to show jugular outflow problems

IVUS endovascular ultrasound that shows the cimpliance of the wall, fixation of the valves, duplication of the veins, better than any other test for these problems


HOPE THIS HELPS!

A/C
If you can't explain it simply, you don't understand it well enough. - Al Einstein
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Postby Cece » Tue Jun 08, 2010 8:00 pm

I really hope things go our way tomorrow.
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