OPINIONS DR ARATA & DR HEWITT

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

Re: "published data"

Postby patientx » Sun Jul 10, 2011 11:11 am

drsclafani wrote:
patientx wrote:
Jugular wrote:
eric593 wrote:Could you please point me to the published data that demonstrates that destroying valves is 1) safe, and 2) efficacious and has some sustained, demonstrable, tangible and measurable health benefit beyond improved blood flow to your patients? Can you direct me to the published data that shows that improved blood flow in patients translates into neurological benefit and that your methods of achieving it are safe? Thank you.


Do you have any studies to show that impaired blood flow is good for the brain or at least produces no ill-effect? Thank-you.


"Venous outflow of the brain after bilateral complete jugular ligation," Ensari S, Kaptanoğlu E, Tun K, Gün T, Beşkonakli E, Celikkanat S, Dere H, Cekirge S.

http://www.ncbi.nlm.nih.gov/pubmed/18382980

Postoperative cranial MRI showed no brain edema, venous infarct or additional pathology four weeks after bilateral jugular venous system ligation (Figure 3D). The patient did not experience any signs or symptoms of intracranial hypertension. On follow-up, the patient was neurologically intact after 4 years.
...
In the present study, we demonstrated that the healthy brain can tolerate bilateral jugular vein ligation during radical neck dissection by opening invisible channels.


there are other papers that point out the opposite, neurological sequellae such as confusion, obtundation, lethargy.


Perhaps you might share the titles of some of those papers.
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Re: "published data"

Postby cheerleader » Sun Jul 10, 2011 3:10 pm

patientx wrote:
Perhaps you might share the titles of some of those papers.


You give ONE paper on ONE healthy patient followed for only 4 years, patientx....that's not exactly conclusive evidence.
In the present study, we demonstrated that the healthy brain can tolerate bilateral jugular vein ligation during radical neck dissection by opening invisible channels.

My husband's brain was anything but healthy when he was treated for severe bilateral jugular stenosis. And he had it for over 30 years, since he lost his peripheral eyesight at age 10. Pseudotumor cerebri (what he had) is linked to jugular vein ligation or blockage.

here you go:
Titles and authors of 14 papers showing a variety of effects of jugular ligation on the brain on numerous patients- including change in evoked potentials, interference with reabsorption of CSF, ischemia, blindness, optic neuropathy and edema and 8 deaths. Not exactly benign.

Serious cerebral complications following unilateral ligation of the internal jugular vein. Review of the literature and a case report.
Rolffs J, Schmelzle R.

Ophthalmoplegia secondary to raised intracranial pressure after unilateral neck dissection with internal jugular vein sacrifice
Matthew J. A. Ward MRCS1,*, Callum Faris MRCS1, Tahwinder Upile FRCS2, Nimesh N. Patel FRCS1

YungMW, SolimanAM. Changes in the brainstem evoked responses following jugular vein ligation. J Laryngol Otol 1988;102:861-864

The effect of internal jugular vein ligation on cerebral circulation in children with extrahepatic portal hypertension
[Article in Russian]
Piroganov FF, Razumovskiĭ AI, Gorbachëv OS, Stroganova TS, Ustinova OB.

KawajiriH, FuruseM, NambaR, KotaniJ, OkaT. Effect of intemal jugular vein ligation on resorption of cerebrospinal fluid. J Maxillofac Surg 1983;11:42-45

HasanM, SrimalRC, MaitraSC .Bilateral jugular vein ligation- induced alterations in the ventricular ependyma: Scanning electron microscopy. Int Surg 1980;65:533-540

ANTERIOR ISCHEMIC OPTIC NEUROPATHY FOLLOWING NECK DISSECTION
Scott E. Strome, MD,1 Jimmy S. Hill, MD,1 Michael A. Burnstine, MD,2 Jill Beck, MD,1 Douglas B. Chepeha, MD,1 Ramon M. Esclamado, MD3

Blindness following bilateral radical neck dissection
Steven C. Marks MD1, Dr. Darrell A. Jaques MD2,3,*, Richard M. Hirata MD3, John R. Saunders Jr. MD3

YuraS,SakoK,YonemasuY.The effect of disturbance of cerebral venous drainage on focalc erebral bloodflow and ischemic cerebral edema [inJapanese].Noushinkei 1990;42:269-275

Royster HP. The relationship between internal jugular vein pressure and cerebrospinal fluid pressure in the operation of radical neck dissection. Ann Surg 1953;137:826-832

Jones RK. Increased intracranial pressure following radical neck surgery. Arch Surg 1951;63:599-603

Schwizer 0,Leak GH. A study of spinal fluid pressures in operations requiring removal of both internal jugular veins.

Intracranial hypertension following neck dissection. J Laryngol Otol 1986;
100:1427-1431 19.

ChaiPJ, SkaryakLA,Ungerleider RM,etal. Jugular ligation does not increase intracranial pressure but does increase bi- hemispheric cerebral blood flow and metabolism. Crit Care Med 1995;23:1864-1871

CCSVI is most-likely a chronic, lifelong accumulation of injury to the brain, spine, and optic nerve. That's why Dr. Zamboni followed those kids in Sardinia and found that 90% had MS 20 years later.
Dr. Zamboni’s personal journey leading to the rediscovery of the vascular link to MS, and his subsequent elaboration of this connection, began more than twenty years ago, when he was a vascular surgeon in Sardinia, Italy. Sardinia is geographically isolated and, for reasons largely unknown, contains very high rates of MS. Studying children in Sardinia, Dr. Zamboni discovered that a great number of them had malformations in their jugular veins. This work lead to one of his earliest professional publications, “The so-called primary venous aneurysms,” published in Phlebology, in 1990.

http://www.ccsvi.org/index.php/the-basics/what-is-ccsvi

cheer
Last edited by cheerleader on Sun Jul 10, 2011 4:20 pm, edited 1 time in total.
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby MrSuccess » Sun Jul 10, 2011 4:19 pm

...... hunting fly's with a sledge hammer .. :P

I like it .





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Postby Jugular » Sun Jul 10, 2011 4:45 pm

In North American sport, "running up the score" occurs when a team continues to play in such a way as to score additional points after the outcome of the game is no longer in question and the team is assured of winning. In United States and Canada, it is considered poor sportsmanship to "run up the score" in most circumstances (exceptions are listed below); sporting alternatives include pulling out most of the team's first string players, or calling plays designed to run out the clock (e.g., in American football, kneeling, running the ball up the middle, punting on first down). The term and concept are not common elsewhere in the world.

That was bad sportsmanship Cheer. Go sit in the corner - and take this beer with you.

:lol:
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Re:

Postby Lyon » Sun Jul 10, 2011 5:53 pm

.
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Postby scorpion » Sun Jul 10, 2011 6:57 pm

20 years later? Wow. Wouldn't it be great if he could figure out why it took so long for the damage to accumulate so that he could apply it to the people who receive angioplasty and experience blockages within a month or two after getting the procedure? Do not worry since reading the article "Jones RK. Increased intracranial pressure following radical neck surgery. Arch Surg 1951;63:599-603" I am almost converted!!!! By the way maybe the jugulars in these kids are normal for that population and have nothing to do with the later development of MS. It would be interesting if a group of researchers would take the famous "myvinco" to Sardinia and see what they can find in the present population of children. Zamboni deserves credit for thinking outside the box and trying to approach MS from a different angle but once again I say 100 pub. med articles will not make his hypothesis true. Just out of curiosity how did they measure intracranial pressure back in 1951? I don't now for some reason I keep picturing an instrument like we measure tire pressure with stuck in someone's jug and "pop", there you have it! This thought must be a result of all the Harry Potter movies I have sat through this week that my kids watched in order to get fired up for the last movie that comes out this week! Seven Harry Potter movies in three days makes me feel like my head is going to explode!! 8O
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Postby Cece » Sun Jul 10, 2011 7:47 pm

www.thisisms.com/ftopicp-154493.html

Sardinian children were treated for phlebectasia (a soft mass that blocks the jugulars) through jugular ligation by Dr. Zamboni early in his career and developed MS years later?
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Postby patientx » Sun Jul 10, 2011 7:48 pm

(3 in a row.. I'm sure we will be accused of being the same person).
cheerleader wrote:You give ONE paper on ONE healthy patient followed for only 4 years, patientx......

I didn't realize Dr. Sclafani went by so many user names, or at least so many feel compelled to respond for him. But since you chimed in...

Maybe you could point out to me where I wrote one paper was conclusive. The poster to which I responded wrote
Do you have any studies to show that impaired blood flow is good for the brain or at least produces no ill-effect? Thank-you.

I provided one example; there are many more. But, eric593's point was a valid one. Some doctors like to fall back on published research when it fits their needs.

Cheerleader wrote:And he had it for over 30 years, since he lost his peripheral eyesight at age 10. Pseudotumor cerebri (what he had) is linked to jugular vein ligation or blockage.
It is ironic that you point out that I cited one study, while you and others will cite Dr. Zamboni's study like it was gospel, when many researchers cannot confirm his results.

It's great that you cited this laundry list of paper titles. However, my post to Dr. Scalfani was because I was interested in reading about cases that showed neurological sequellae such as confusion, obtundation, or lethargy after ligation, or from blockages, of the jugular veins, since these are symptoms usually attributed to MS. I don't have much interest in some citation contest. I think we all know you are adept at using google to find medical article abstracts (and sometimes misrepresenting those articles).


However, going through your list, edema in the brain is not a characteristic of MS, so these would not be too relevant. And some of the titles you cite not only contradict each other, but contradict what is seen in MS:
Jones RK. Increased intracranial pressure following radical neck surgery. Arch Surg 1951;63:599-603

ChaiPJ, SkaryakLA,Ungerleider RM,etal. Jugular ligation does not increase intracranial pressure but does increase bi- hemispheric cerebral blood flow and metabolism. Crit Care Med 1995;23:1864-1871

Isn't cerebral blood flow reduced in the MS brain, and hasn't this become a part of the CCSVI theory?

That's why Dr. Zamboni followed those kids in Sardinia and found that 90% had MS 20 years later.

This would be an astounding finding, and one wonders why Dr. Zamboni never published these results in any journal.
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Postby Cece » Sun Jul 10, 2011 7:52 pm

I am glad Cheerleader was able to come up with the research. I can't imagine that Dr. Sclafani has time this week, what with the symposium. He does not even have time to post his detailed cases on his thread for me (and, ok, others too) to learn and enjoy.
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Postby Lyon » Sun Jul 10, 2011 8:08 pm

.
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Postby drsclafani » Sun Jul 10, 2011 9:35 pm

Cece wrote:I am glad Cheerleader was able to come up with the research. I can't imagine that Dr. Sclafani has time this week, what with the symposium. He does not even have time to post his detailed cases on his thread for me (and, ok, others too) to learn and enjoy.


true, i am working hard to make my symposium successful
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Postby Billmeik » Thu Jul 14, 2011 9:38 am

OK I;m scheduled to go to synergy on august 24 and I want to get my belief up so my placebo effect is strong. I mean if it is placebo effect how can I increase it?

When I went to poland last june they asked to put a stent across my valve(left jugular), which I turned down, so restenosis occurred on the table, and my flow didn't improve by much. This time getting my flow to 500 has got to be the priority, but I wonder if it's possible without destroying the valve?
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Postby Cece » Thu Jul 14, 2011 10:16 am

Billmeik, do you know what size balloons and what size vein or what pressure (atms) or how long the duration of the ballooning? That would help know if you were adequately treated. If you were undertreated, there would be more hope that balloons of an adequate (but imo not too large) size would do the job this time.

Right now there is not enough known about breaking the annulus to say if it improves durability or not. We have heard from both Dr. Cumming and Dr. Sclafani that they have seen complications from annulus breaking and that their opinion is that it is too aggressive. If Dr. Arata is breaking annuli, I wonder what he is seeing in his follow-up or what percentage of his patients who have had their annulus broken come back for follow-up?

I agree about increasing the placebo effect if you can! It is going to work for you this time.
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Postby esta » Thu Jul 14, 2011 1:06 pm

billmeik

in my consultation with dr hewett this june, dr arata has a 2-10% restenosis rate for his valve procedure, but they have only been doing it for a year.

i too, went to poland, twice, and when dr. hewett looked at my CD's, he said i should have had both jugs done because the valves didn't show much blood flowing through.and said at the same time they'd probably do my azygos too.

as i had a few months of incredible changes, then back to not much, i can hardly wait to go to him, and his theory of the valves being the problem.
it just sounds right, so good luck!!!!!!!
PPMS. Liberated Katowice, Poland
06/05/10 angioplasty RJV-re-stenodsed
26/08/10 stent RJV
28/12/10 follow-up ultrasound intimal hyperplasia
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Re: OPINIONS DR ARATA & DR HEWITT

Postby Lassy » Wed Oct 12, 2011 1:55 pm

Pollyanna Dr Arata came to answer someone that asked him to via word on the FB Synergy Group that this crap/rubbish was going on this thread.
Get over yourself you obviously are not a patient of his or else you would know how he does care and is in touch with any of his patients who need questions answered anytime.

Get back to using your energy for positives on this cause because you obvioulsy have either dirty blood going backwards into your own brain still and need the CCSVI procedure yourself or you need to get laid to use off some of that anger energy.
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