No stenosis found in dopple study- Japanese MS/NMO patients

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

No stenosis found in dopple study- Japanese MS/NMO patients

Postby hope410 » Sat Jul 09, 2011 8:45 am

Rinsho Shinkeigaku. 2011 Jun;51(6):430-2

[Evaluation of blood flow and the cross-sectional area of internal jugular vein in Japanese multiple sclerosis and neuromyelitis optica patients].

[Article in Japanese]

Tanaka M, Uchizumi H, Tanaka K.SourceMS Center, Utano National Hospital.

Abstract

Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency (CCSVI).

Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination.

We examined the blood flow and the cross-sectional area of the internal jugular veins using Doppler ultrasound (Vivid 7 PRO, GE Health Japan, Tokyo) in 17 MS (8 males and 9 females; 20-58 years of age, median 38 years) and 11 neuromyelitis optica (NMO) Japanese patients (1 male and 10 females; 23-60 years of age, median 44 years). Nine of the 11 NMO patients were seropositive for anti-aquaporin4 antibodies.

We did not find any obstruction or stenosis of the internal jugular veins in any patient. Other disorders such as bilateral internal and external jugular venous ligation or radical neck dissection, which result in venous stasis, are not known causes of demyelination in the central nervous system.

Our data also does not support the hypothesis of CCSVI theory, despite the fact that our study was limited to a small group of patients and the examination was performed only using Doppler ultrasound.PMID: 21735737 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/21735737
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Re: No stenosis found in dopple study- Japanese MS/NMO patie

Postby scorpion » Sat Jul 09, 2011 8:51 am

hope410 wrote:Rinsho Shinkeigaku. 2011 Jun;51(6):430-2

[Evaluation of blood flow and the cross-sectional area of internal jugular vein in Japanese multiple sclerosis and neuromyelitis optica patients].

[Article in Japanese]

Tanaka M, Uchizumi H, Tanaka K.SourceMS Center, Utano National Hospital.

Abstract

Zamboni et al proposed a new hypothesis for the pathomechanisms of multiple sclerosis (MS): chronic cerebrospinal venous insufficiency (CCSVI).

Using Doppler ultrasound and venograms, they found severe extracranial venous stenosis in MS patients. They suggested that a venous obstruction in the neck caused a reflux back into the brain, which led to edema and demyelination.

We examined the blood flow and the cross-sectional area of the internal jugular veins using Doppler ultrasound (Vivid 7 PRO, GE Health Japan, Tokyo) in 17 MS (8 males and 9 females; 20-58 years of age, median 38 years) and 11 neuromyelitis optica (NMO) Japanese patients (1 male and 10 females; 23-60 years of age, median 44 years). Nine of the 11 NMO patients were seropositive for anti-aquaporin4 antibodies.

We did not find any obstruction or stenosis of the internal jugular veins in any patient. Other disorders such as bilateral internal and external jugular venous ligation or radical neck dissection, which result in venous stasis, are not known causes of demyelination in the central nervous system.

Our data also does not support the hypothesis of CCSVI theory, despite the fact that our study was limited to a small group of patients and the examination was performed only using Doppler ultrasound.PMID: 21735737 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/pubmed/21735737


Where is damage control????
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Postby cathyb » Sat Jul 09, 2011 9:10 am

What's the deal with these newest published studies. This is the second recent study where the researchers didn't find ANY problems at all with the MS group! Isn't not finding something 100% of the time just as unbelievable as finding something 100% of the time? Are these researchers concluding that MS people, unlike the rest of the population, have NO problems at all? Maybe NOT having trouble with your blood flow is the problem related to MS.
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Postby 1eye » Sat Jul 09, 2011 9:57 am

Too small a sample of anything to have very much significance. The Zivadinov study found 50-60% over a large number. Maybe these guys would have found it in 100% of the next 17 MS and 11 NMO patients they studied. That would not be any more meaningful.

Why are these bozos making it to print?
"Try - Just A Little Bit Harder" - Janis Joplin
CCSVI procedure Albany Aug 2010
'MS' is over - if you want it
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Postby MrSuccess » Sat Jul 09, 2011 10:06 am

Damage control ? What ever for ?

Listen up -

Professor Zamboni presented the world ..... with a significant new hypothesis ...... of the possible link of MS to a condition called CCSVI.

He published the results of his investigation of this possible link.

and ............ openly challenged any and all of his peers ...... to validate his findings ......... in their own way.

In plain words ..... " this is what I found ..... this is how I did it ..... can you do the same ? "

very simple ....... even an insect can understand the process.......... :twisted:

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Postby civickiller » Sat Jul 09, 2011 10:38 am

was ccsvi found in NMO paitents ? or just MS patients?
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Postby Cece » Sat Jul 09, 2011 10:40 am

Remember the Canadian government's decision to begin clinical trials. This decision was reached because a meta-analysis of all studies, as well as early results of the 7 imaging studies, showed the association between CCSVI and MS.

We've seen mixed results, with some studies coming in showing CCSVI, some studies come in not showing it. That's why a meta-analysis was needed.

As for this one, we'd need to see the full paper. But we're past the point where one study on either side is taken as conclusive in and of itself. We always needed an abundance of research and we are on our way to having it.
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Postby cheerleader » Sat Jul 09, 2011 11:13 am

Would be interesting to see the full paper. Cece's right, hard to know what they did. Looks like they didn't use complete Zamboni protocol...no transcranial doppler mentioned, hard to know what they did without full paper in front of us. I've mentioned many times, Jeff's doppler scan at Stanford looked OK, because it picked up his vertebral collateral. It was only after Dr. Dake saw his MRV and noted spaghetti collaterals and no jugulars, Jeff opted for venography to learn more.

Found this reference in the NMO part interesting Nine of the 11 NMO patients were seropositive for anti-aquaporin4 antibodies.....decided to find out why they bothered to include that in the abstract, when they were looking at venous function. Curious. Anyway, here's more on that connection, which is important to understand in Japan. They have their own controversies there.

Devic’s neuromyelitis optica (DNMO) is a demyelinating and inflammatory disease of the central nervous system (CNS) essentially restricted to the spinal cord and the optic nerves. It is a rare disorder with a prevalence estimated at less than 1/100,000 in Western countries. Since the first description by Eugène Devic in 1894, the relationship between DNMO and multiple sclerosis (MS) has been controversial. Recent clinical, epidemiological, pathological and immunological data demonstrate that MS and DNMO are distinct entities. This distinction between DNMO and MS is crucial, as prognosis and treatment are indeed different. DNMO is now considered to be an autoimmune, antibody-mediated disease especially since the identification of a specific serum autoantibody, named NMO-IgG and directed against the main water channel of the CNS, aquaporin-4 (AQP4). The assessment of AQP4 antibodies (Abs) has initially been proposed to differentiate DNMO and MS. It has also enlarged the clinical spectrum of DNMO and proved to be helpful in predicting relapses and conversion to DNMO after a first episode of longitudinally extensive transverse myelitis or isolated optic neuritis. Lastly, the discovery of the pathogenic role of AQP4 Abs in DNMO leads to a better understanding of detailed DNMO immunopathology and the elaboration of relevant novel treatment strategies specific to DNMO. In this review, we summarize the present and future therapeutic implications generated by the discovery of the various pathogenic mechanisms of AQP4 Abs in DNMO pathophysiology.

http://tan.sagepub.com/content/3/5/311.abstract
cheer
Husband dx RRMS 3/07
dx dual jugular vein stenosis (CCSVI) 4/09
http://ccsviinms.blogspot.com
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Postby scorpion » Sat Jul 09, 2011 6:11 pm

MrSuccess wrote:Damage control ? What ever for ?

Listen up -

Professor Zamboni presented the world ..... with a significant new hypothesis ...... of the possible link of MS to a condition called CCSVI.

He published the results of his investigation of this possible link.

and ............ openly challenged any and all of his peers ...... to validate his findings ......... in their own way.

In plain words ..... " this is what I found ..... this is how I did it ..... can you do the same ?
"

very simple ....... even an insect can understand the process.......... :twisted:

Mr.Success


Unfortunately insects are not the ones who need to prove Zamboni's hypothesis AND you have oversimplified the entire scientific process Mr. Success. Zamboni needs to prove why the above study is wrong. Easy right? Zamboni can hop on a plane, evaluate the same people in this study, and point out the "CCSVI" to the Japanese researchers who could not seem to identify any difference between people without MS and people with MS. Since Zamboni found 100% of people with MS have CCSVI,per his first "results", no one has come close to that so he is the outlier. Zamboni was wrong. Of course instead of growing skepticism, which would be the natural thing to occur, we will get more pub. med articles and posts about incompetent researchers. What a shame.
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Postby Cece » Sat Jul 09, 2011 6:22 pm

Dr. Zamboni's work was preliminary and ground-breaking. Foundational. We've tossed around the term 'genius' and the possibility of a Nobel Prize and I do not think we are over-reaching. His work was not perfect but it made me look into the possibility of stenoses in my jugulars and, once severe stenoses were found, it was an easy choice to get them fixed. Zamboni was right.
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Postby MrSuccess » Sat Jul 09, 2011 7:22 pm

I can say with certainty .... Dr Zamboni would welcome any and all of his peers to investigate his theory ....... and publish their results.

all ......will add to the existing body of knowledge . And that's good.

As for our Japanese researcher's ..... they might benefit from visiting Professor Zamboni ....

others have ........




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Postby scorpion » Sun Jul 10, 2011 3:04 am

We've tossed around the term 'genius' and the possibility of a Nobel Prize .


I am truly hoping you wrote that to get a reaction out of me!

Dr. Zamboni's work was preliminary and ground-breaking. Foundational.


The reason I am saying he was wrong is not because he hypothesized there is such a condition as CCSVI, for that still remains to be proven, bUT it is HIGHLY likely Zamboni found CCSVI in 100% of his participants. If this was the case it should NOT be so hard to reproduce these results and it certainly should not take a special machine created by Zamboni himself to help other researchers verify his hypothesis. After all I do not believe Zamboni used the infamous myvinco as a tool in his "100%" study yet he still found what he found. Until researchers start duplicating these result shouldn't his whole hypothesis be called into question? Instead the skepticism that should be creeping in is replaced by a new pub. med article, a patient success story, a new vein that "needs" investigated, etc. In a likelihood, because of the egos and pride involved, Zamboni will never admit he was wrong even if he feels deep down his original study was flawed. So the game continues.....
Last edited by scorpion on Sun Jul 10, 2011 4:49 am, edited 1 time in total.
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Postby CureOrBust » Sun Jul 10, 2011 3:20 am

Whether Zamboni was right or wrong, or if its 100% or 50% does not totally consume me. What does is the fact that I personally was found to have failed two of his tests (reflux in my Jugulars found by a sonographer and a stenosis high in my jugular, missed on the initial ultrasound, but found in an MRV)
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Postby ScutFarkus » Sun Jul 10, 2011 9:14 am

cathyb wrote:What's the deal with these newest published studies. This is the second recent study where the researchers didn't find ANY problems at all with the MS group! Isn't not finding something 100% of the time just as unbelievable as finding something 100% of the time?


No, they're not the same. For example, if I publish a paper stating that 100% of the red-headed children I tested can fly, and another researcher attempts to repeat my study and reports that none of the kids he tested can do this, which report would you find more believable?

The point is, if someone reports something "surprising" or unexpected occurring in 100% of a population (in this case, CCSVI), then by definition that result is less believable than the opposite result, at least until it has been reproduced multiple times.

Also, the recent studies are not claiming they "didn't find ANY problems at all with the MS group," merely that they aren't finding CCSVI. Many people fault the methods used in these studies, e.g. Doppler ultrasound instead of more sensitive methods, but even with less sensitive techniques the difference between 100% and 0% is striking.

cathyb wrote:Are these researchers concluding that MS people, unlike the rest of the population, have NO problems at all? Maybe NOT having trouble with your blood flow is the problem related to MS.


I don't think so. I haven't read their study, but unless they included a control group of people w/o MS and they found high levels of CCSVI in those people, then I'm pretty certain their conclusion wasn't what you state above.

/Scut
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Postby MrSuccess » Sun Jul 10, 2011 10:20 am

your example is ridiculous. A study of red headed children that can fly.

Someone's seen ...... one-too-many Harry Potter films .......

If you are trying to make a point ...... a scientific point .....

use something we can use ........ and understand . Flying children ? :roll:


We recently had an original Zamboni 65 patient post some comments.

Why don't you ask this person about the study ?

I repeat once again ........ the Zamboni 65 ...... involved BOTH non-invasive testing ........ AND ........ actual intervention . THE Procedure , often refered to as ..." The Liberation ".

Why would Dr.Zamboni ........ at this point in his investigation .....
include any other people .....other than those deemed to have MS ?

There is a HUGE cost factor involved ........ still is .

Take it for what it is ....... an experimental theory ........

One that ......... makes sense .




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