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Dr F A Schelling's proposal re ligature of jugular vein
Posted: Wed Nov 11, 2009 1:04 pm
by pamf
Hello all - I am new to posting, although I have been reading up on the subject of CCSVI in recent weeks, including on this forum.
I came across
this website (click here) relating to Dr Schelling's findings regarding CCSVI. You will see on
this page (click here) he makes the following statement:
To prevent the development of “Dawson’s finger” projections, a ligature of the jugular vein carrying injurious venous back-jets into the center of the brain might form a simple method for curing an otherwise relentlessly progressing disease.
My understanding of CCSVI is rudimentary at best, but does this not contradict the liberation procedures that are being carried out? How does ligature effectively differ from stenosis?
Excuse me if I've missed something fundamental, but I would be grateful of any insight from those more familiar with CCSVI.
Many thanks.
Posted: Wed Nov 11, 2009 1:12 pm
by zap
Ugh ... that IS confusing. He seems to believe that the problem is with vigorous backjets ...
The specific brain plaques of multiple sclerosis can only be caused by energetic venous back-jets set in motion by intermittent rises in the pressure in the large collecting veins of the neck, but especially of the chest.
...so perhaps the backwards valves and collapsed or pinched jugulars could be the body's attempted defense against this - with negative side effects, but preventing bigger problems from occuring?
Scary thought!
Somebody tell me how I'm way wrong, please!
Posted: Wed Nov 11, 2009 1:30 pm
by cheerleader
This was Dr. Schelling's supposition, made back in the 1980s- way before Dr. Zamboni found a cause of reflux being the occluded jugular and azygos veins. There was no such thing as doppler or MRV technology then.
Dr. Schelling found a widening of the jugulars entering the brain in autopsied MS patients, and concluded the venous abnormalities in MS patients were due to back jets. There has been nothing noted to account for these "energetic back jets" arising from the chest in Dr. Zamboni or Dake's findings....but much has been found to tie the reflux noted to venous stenosis. But this might be a question better suited for a cardiovascular doc- like Dr. Dake....he has not made any observations of these back jets, to my knowledge.
cheer
Posted: Wed Nov 11, 2009 1:43 pm
by Jamie
Zamboni concentrates of eliminating turbulent flow which is what this is.
Turbulent flow is caused by too high a pressure too. Just like in a pipeline, there's an optimum amount of flow you can get, putting more oil through doesn't raise pressure it actually reduces pressure by creating turbulence after a certain threshold.
This is the same paradign just earlier research.
Zamboni et al claim the turbulence is caused by reflux because of stenosis. They have backed this up (in my opinion) with reasonable evidence to demonstrate this.
You have to remember that was Schelling speculating in the 80's. Restoring normal jugular flow should have the same effect knowing what Zamboni etc know now.
Posted: Thu Nov 12, 2009 7:09 am
by zap
I thought I'd see what Schelling had to say about it, and he was kind enough to respond:
Trying to reach as well a German audience, I recently mainly discussed the critical questions of venous ms in the csvi-ms.net forum.
Zamboni actually discovered that MS is more often related to a narrowing than a valvular incompetence of internal jugular and azygos veins.
From this, however, it cannot be ruled out that venous back-jet plays a critical role in the pathogenesis of MS.
Venous stasis never produces the kind of vein-dependent lesion spread and the damages to vein walls observed in cerebral MS.
In my e-book I referred to the possibility that MS-specific damages might not only be produced by venous flow inversions originating in the most central and largest venous collectors such as superior and inferior cava and anonymous (=brachiocephalic) veins. It is no less harmful for the brain to be attacked by a venous flow inversion caused by a compression of a proximally (=heart-wards) narrowed cervical collecting vein. There remain, and this is a critical fact, a priori fewer direct and mediate escape routes into other venous territories in a compression of a large, heart-wards narrowed deep cervical vein draining a smaller part of the brain than in a compression of the large chest veins.
In case MS remains active after the widening of a narrowed internal jugular vein two possibilities need to be kept in mind: the new bouts of MS can (a) be caused also by venous back-jets from a sporadically, functionally heart-wards obstructed internal jugular vein(in this case a thorough Duplex-study of the cervical veins in any possible head-position may discover the cause); or (b) the venous reflux from the neck has become superceded by venous back-jets from the large venous collectors of the chest (this possibility has to be primarily envisaged in a valvular incompetence of either one, or both, internal jugular veins).
turbulence
Posted: Thu Nov 12, 2009 7:21 am
by GiCi
Jamie,
I am sorry I have to say that you talk nonsense regarding the effects of turbulence. Laminar flow in a fluid (every layer going in straight lines) offers the least resistance and the lower pressure, while turbulent flow increases resistance to the flow and the pressure inside the pipe (or vessel in CCSVI case).
Mine is not an opinion, it is physics.
GiCi
Posted: Thu Nov 12, 2009 7:45 am
by cheerleader
Thank you for asking the source, Zap. Dr. Schelling is a wonderfully thoughtful, open and generous doc, and it was a good idea to ask him, since this was his discovery!
As Dr. Schelling suggests, we will see if MS is halted or continues to progress in those that have been permanently "opened" by stenting. If progression continues, venous backjets would be a likely issue. But it's important to note, this is only a theory...as far as I know, no actual in vivo evidence of back jets has been found. Whereas in vivo evidence of stenosis is strong.
Since my Jeff's lesions were more speckled, numerous, small and very unlike Dawson's Fingers- and his jugulars so obviously mangled, we continue to hope that we've remedied his situation. But as I've said many times, I don't have a crystal ball. Still more to learn- thanks for bringing this topic up everybody!
cheer
Posted: Thu Nov 12, 2009 8:06 am
by zap
I wonder if the small lesions, and the axonal damage seen WITHOUT any lesions might be the result of long term reflux and mild pressure - and the lesions might be the result of actual backjet pressure -
When a stenosis first occurred, there would be the lesion-forming strong back pressure - then once the collateral veins form to get the flow around the blockage, the problem is reduced to a milder, slow motion damage that does not produce the Dawson's finger style lesions.
Just thinking 'aloud' here ...
Posted: Thu Nov 12, 2009 6:56 pm
by Jamie
Gici
I respectfully disagree with specific regards to pipelines.
I work on the design of oil pipelines, perhaps the analogy isn't correct but in a pipeline too high an input causes reduced flow. Which is why we need to calculate the critical flow rate.
Perhaps this is specific to that technology and I was too far trying to stretch it.
Thanks for correcting me.
Jamie
Posted: Thu Nov 12, 2009 6:58 pm
by Jamie
Of course that's caused by several variables, such as:
o = Oil Density
g = Gas Density
re = Drainage Radius of Well
rw = Well Bore Radius
Ko = Effective Oil Permeability
Uo = Oil Viscosity
Bo = Oil Formation Volume Factor
hp = Perforated Interval
h = Oil Column Thickness
But again in medical terms you are right to correct me, but it is not 'physics'.
Posted: Thu Nov 12, 2009 7:05 pm
by Jamie
Actually I see what you are saying now.
Posted: Thu Nov 12, 2009 7:26 pm
by jay123
wow - we have so many people here with so much expertise in different areas -
OK, mine is engineering also (computers and energy management mostly). I did a lot of work with meters in pipes and my definition of laminar flow is that in a pipe the fluid flows fastest in the center, slower on the edges (which btw is the fear of clots due to low flow around the stents in veins).
Posted: Thu Nov 12, 2009 9:10 pm
by Jamie
No, you're right - I'd misunderstood what was going on two totally different things.
Thank you
Posted: Fri Nov 13, 2009 12:36 pm
by pamf
Just wanted to say thank you to those who have posted replies to my question, and esp to Zap for contacting Dr Schelling.
I think I grasp the basics of what is being suggested, ie there are potentially 2 issues: reflux, and back-jets, from 2 different areas, to put it very simply.
I will continue to follow developments with great interest and I wish everyone participating in this pioneering research every success.
Posted: Fri Dec 11, 2009 10:18 am
by zap
Just found an old collection of Schelling info from 2003 I thought was interesting ...
http://answers.google.com/answers/threa ... 71074.html
(with my history - which includes an apparent brain stem mini stroke, occasional short duration rushing/roaring sounds/sensations, and no standard stenoses visible in MRV, I'm paying fresh attention to Schelling's theories about back jet pressure and damages ...)