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2009年11月29日 星期日

Italian doctor may have found surprisingly simple cure for Multiple Sclerosis 這項發現掀起國際的一陣不小的騷動

Italian doctor may have found surprisingly simple cure for Multiple Sclerosis
這項發現掀起國際的一陣不小的騷動

An Italian doctor has been getting dramatic results with a new type of treatment for Multiple Sclerosis, or MS, which affects up to 2.5 million people worldwide. In an initial study, Dr. Paolo Zamboni took 65 patients with relapsing-remitting MS, performed a simple operation to unblock restricted bloodflow out of the brain - and two years after the surgery, 73% of the patients had no symptoms. Dr. Zamboni's thinking could turn the current understanding of MS on its head, and offer many sufferers a complete cure.

Multiple sclerosis, or MS, has long been regarded as a life sentence of debilitating nerve degeneration. More common in females, the disease affects an estimated 2.5 million people around the world, causing physical and mental disabilities that can gradually destroy a patient's quality of life.

MS目前全球有約250萬病人

It's generally accepted that there's no cure for MS, only treatments that mitigate the symptoms - but a new way of looking at the disease has opened the door to a simple treatment that is causing radical improvements in a small sample of sufferers.

Italian Dr. Paolo Zamboni has put forward the idea that many types of MS are actually caused by a blockage of the pathways that remove excess iron from the brain - and by simply clearing out a couple of major veins to reopen the blood flow, the root cause of the disease can be eliminated.

Dr. Zamboni's revelations came as part of a very personal mission - to cure his wife as she began a downward spiral after diagnosis. Reading everything he could on the subject, Dr. Zamboni found a number of century-old sources citing excess iron as a possible cause of MS. It happened to dovetail with some research he had been doing previously on how a buildup of iron can damage blood vessels in the legs - could it be that a buildup of iron was somehow damaging blood vessels in the brain?

He immediately took to the ultrasound machine to see if the idea had any merit - and made a staggering discovery. More than 90% of people with MS have some sort of malformation or blockage in the veins that drain blood from the brain. Including, as it turned out, his wife.

MS病患中有90%以上的人發現有靜脈血管窄化的現象

He formed a hypothesis on how this could lead to MS: iron builds up in the brain, blocking and damaging these crucial blood vessels. As the vessels rupture, they allow both the iron itself, and immune cells from the bloodstream, to cross the blood-brain barrier into the cerebro-spinal fluid. Once the immune cells have direct access to the immune system, they begin to attack the myelin sheathing of the cerebral nerves - Multiple Sclerosis develops.

He named the problem Chronic Cerebro-Spinal Venous Insufficiency, or CCSVI.

Zamboni immediately scheduled his wife for a simple operation to unblock the veins - a catheter was threaded up through blood vessels in the groin area, all the way up to the effected area, and then a small balloon was inflated to clear out the blockage. It's a standard and relatively risk-free operation - and the results were immediate. In the three years since the surgery, Dr. Zamboni's wife has not had an attack.

Widening out his study, Dr. Zamboni then tried the same operation on a group of 65 MS-sufferers, identifying blood drainage blockages in the brain and unblocking them - and more than 73% of the patients are completely free of the symptoms of MS, two years after the operation.

65位Ms病患在確認靜脈血管窄化的情性後進行手術, 手術後2年 超過73%的病患沒有復發..

In some cases, a balloon is not enough to fully open the vein channel, which collapses either as soon as the balloon is removed, or sometime later. In these cases, a metal stent can easily be used, which remains in place holding the vein open permanently.

Dr. Zamboni's lucky find is yet to be accepted by the medical community, which is traditionally slow to accept revolutionary ideas. Still, most agree that while further study needs to be undertaken before this is looked upon as a cure for MS, the results thus far have been very positive.

Naturally, support groups for MS sufferers are buzzing with the news that a simple operation could free patients from what they have always been told would be a lifelong affliction, and further studies are being undertaken by researchers around the world hoping to confirm the link between CCSVI and MS, and open the door for the treatment to become available for sufferers worldwide.

It's certainly a very exciting find for MS sufferers, as it represents a possible complete cure, as opposed to an ongoing treatment of symptoms. We wish Dr. Zamboni and the various teams looking further into this issue the best of luck.


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12 則留言:

  1. 我在病友會上曾跟病友提及過這個消息..但是病友都跟我說這是不可能的事情...然後還跟我說網路的消息都是假的...就說如果真的可以手術..那為什ㄇ醫師在病友會上都說是沒有解決ㄉ方法...要是有醫師會比我們慢知道ㄇ?醫學雜誌會沒有刊登出來ㄇ?要是有可以治癒的方法...早就上頭條的新聞ㄌ..等等的話語....我聽ㄌ真ㄉ好無言....

    Golden hunt dog

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  2. Hi 獵犬, 事實上你可以發現,多半台灣的Ms病友 幾乎都是處於被動的狀態, 只有等待, 而且多半因為語言上,資訊以及醫學知識的不足,再加上過去被很多道聽塗說的江湖術士騙,才會導致今天的結果. 而且,不要忘記了,白色巨塔是不容易被輕易的質疑和挑戰的, 你可以看看英代爾總裁:Andy Groove他的故事就知道 (我BLOG有提到他的書-活著就是贏家) .若你沒有具備夠多的知識,要想挑戰醫師如此高的權威,無疑是自尋死路, 更何況,大家長期以來也都是這樣了, 我想, 沒關係, 自己的命是要靠自己掌握的, 不願意相信的人自然有他們的選擇, 我不願意就這麼屈服, 再者, 國外的病例多如牛毛, 國內才一千位阿, 也許美國一個城市上的MS病患就已經是台灣一半病人的數目了,那那個小鎮上的醫師不就可以和台灣最厲害的醫師相提並論? 所以我覺得以臨床經驗和研究進度而言,MS的研究一定是國外比國內還要領先. 不參考國外的意見, 還要參考那兒的呢?
    若能夠以開放的態度來面對這一切才能夠找出真正最好的解決方式, 不是嗎?

    其實醫師平時工作就已經夠忙得了,要他們隨時注意新的消息,並不是那麼即時,畢竟醫師也是人,也需要休息睡覺.

    再加上和H1N1比起來,MS在台灣只不過才1000多名臨床病例, 誰會去關注個話題? 所以我們要自立自強!!

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  3. 我的天阿 台灣的MS病患已經超過1000名了, 我記得去年9月在榮總病友會的時後,才只是800多名.....
    每年以150名的速度在增加, 看來這是未來全人類的威脅!

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  4. 關於近來這篇報導,小弟我有一些想法,想跟大家討論
    1.如果照超音波後顯示靜脈血管窄化的現象,那所進行的手術,她算是新手術嗎?如果不是,台灣應該也有這技術吧
    2.不知道那些手術後的病人,在術後,是不是還有繼續使用一些藥物針劑控制,如果沒有,那那73%的確讓人振奮
    3.我跟大家都一樣,很想知道MS在醫學上研究究竟進展到什麼地步,無奈好像都沒有什麼消息會出現,所以真的很感謝JIMMY

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  5. ㄞ ! 文明病...現代人灰熊忙碌..生活緊張..心理壓力大..管理不好最基本ㄉ吃喝拉撒睡.窩也素..ㄏ...MS似乎包含大部分ㄉ身心症狀~呼~殺很大

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  6. 病友會當天是說有領到重大傷病卡是961位..所以應該會有1000位吧...

    Golden HuntDog

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  7. 1.如果照超音波後顯示靜脈血管窄化的現象,那所進行的手術,她算是新手術嗎?如果不是,台灣應該也有這技術吧?

    這個需要請教外科醫師,不過第一步應該是先作到正確的超音波檢測,我覺得不是一般的超音波(因為是位於身體內深層的靜脈)

    2.不知道那些手術後的病人,在術後,是不是還有繼續使用一些藥物針劑控制,如果沒有,那那73%的確讓人振奮

    是啊,若沒有的話的確很振奮!!

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  8. 直覺告訴我,意大利醫生的發現是正確的。長期以來,我感覺自己大腦一側缺血,有明顯血管堵塞的感覺。我每次告訴醫生這個癥狀,他們根本不相信,我真的很受打擊。現在終于有醫生來證明這一點,我真的非常激動,因為長期的想法得到驗證。這無疑是無數的MS病人的福音!

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  9. 我相信意大利醫生的發現是一個革命性的突破,一個所謂的幾千年的不治之癥已經被攻克。這個新的發現正像旋風一樣激蕩全球,美國和加拿大的醫生正在驗證這個理論是否正確,主要通過MS患者的腦部圖像觀察是否的確有靜脈堵塞現象,如果肯定的話,手術會馬上推廣。一些迫不及待的美國人已經去意大利做手術,據說效果很好。下一步,臺灣醫生應該也會這樣做。當然,大部分的醫生會等待,等到更多的成功報告出來,然后跟進。保守等待有他的好處,比如沒有風險,而且一個手術的效果需要時間的考驗,不同的國家和醫生可能會有更多的改進和創新,等等。

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  10. Hi Peng:

    我也覺得他的發現打開了另一扇通往治癒的大門,其實只要內外科醫師彼此通力合作,絕對能夠解決這個問題.至於是否能夠完全解決,恢復程度多少,也是要看每個病人的狀況而定.只要手術過程中沒有疏失的話,我想至少能夠維持5年不發病就相當不錯了.再者,應該是要討論,為什麼鐵離子特別喜歡聚集在某些靜脈血管內?然後來預防這種現象的發生!~

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  11. 我发现一篇文章比较有意思,介绍了历史上科学家有关静脉堵塞与MS关系的研究发现,当然是英文,有时间可以慢慢看:

    The venous connection to MS- a timeline
    Sun at 6:09pm
    To those doctors who insist the venous connection to MS is an unproven theory, I offer a timeline of doctors who might beg to differ.

    1863 Rindfleisch
    Dr. E. Rindfleisch noticed that, consistently in all the autopsy specimens of MS brains he viewed with his microscope, a vein engorged with blood was present at the centre of each lesion.

    Rindfleisch wrote:
    "If one looks carefully at freshly altered parts of the white matter ... one perceives already with the naked eye a red point or line in the middle of each individual focus,.. the lumen of a small vessel engorged with blood ... All this leads us to search for the primary cause of the disease in an alteration of individual vessels and their ramifications; All vessels running inside the foci, but also those which traverse the immediately surrounding but still intact parenchyma are in a state characteristic of chronic inflammation."

    Rindfleisch E. - "Histologisches detail zu der grauen degeneration von gehirn und ruckenmark". Archives of Pathological Anatomy and Physiology. 1863;26:474–483.

    1930s Putnam
    Dr. T. J. Putnam researched lesions and noted that thrombosis of small veins could be the underlying mechanism of plaque formation-
    Putnam, T.J. (1937) Evidence of vascular occlusion in multiple sclerosis

    1942 Dow and Berglund
    Dr. Robert Dow and Dr. George Berglund continue on with Dr. Putnam's research and continue finding venous connections to MS lesions.
    VASCULAR PATTERN OF LESIONS OF MULTIPLE SCLEROSIS Arch Neurol Psychiatry. 1942;47(1):1-18.

    1950 Zimmermann and Netsky
    Dr Zimmerman and Netsky carry on with Dow and Berglund's research, and note that the lesions are indeed venous in nature, but not caused by small thrombosis as Putnam surmised.
    Zimmerman, H. M., Netsky, M. G.: The pathology of multiple sclerosis. Res. Publ. Ass. Nerv. Ment. Dis. New York 28, 271--312 (1950)

    1960s Fog
    Dr. Torben Fog, a Danish professor – noted that MS lesions are predominantly around the small veins. His subsequent study of 51 plaques from two cases of typical MS, making thin sections of the plaques and following their shape and course with direct drawings of each section, showed that most were prolongations of periventricular plaques, and that the plaques did follow the course of the venous system.

    Fog Torben, The topography of plaques in multiple sclerosis, with special reference to cerebral plaques. Acta Neurol Scand, 41,Suppl. 15:1, 1965)

    Fog T. On the vessel-plaque relations in the brain in multiple sclerosis. Acta Psychiat Neurol Scand. 1963; 39, suppl. 4:258

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  12. 文章第二部分:
    1980s Schelling
    The story began in 1973, at the University of Innsbruck, when F. Alfons Schelling, M.D. began investigations into the causes and consequences of the enormous individual differences in the widths of the venous outlets of the human skull. The results of this study appeared, in 1978, in the official organ of the German-speaking Anatomical Societies, the "Anatomischer Anzeiger".

    F.A. Schelling's 1981 discovery, at the Hospital for Nervous Diseases in Salzburg, of a striking widening of the main venous passageways through the skulls in victims of multiple sclerosis were to occupy the author's thoughts through the following decades of his quite diversified medical career. And in putting together, bit by bit, all the observations on the venous involvement in the emergence of the specific, and, in particular, cerebral lesions of multiple sclerosis, he was able to recognize their causes.

    "Unequal propagation of central venous excess pressure into the different cerebral and spinal venous drainage systems is the rule rather than the exception. The intensity of the forces thus to be exerted on vulnerable cerebrospinal structures by the resulting pressure-gradients in the craniovertebral space is unknown. There is a need to consider the various conditions which may cause individual proneness to heavier reflux into particular cerebral as well as epi- and subdural spinal venous compartments. An attempt is made to indicate eventual consequences of excessive retrograde dilatation especially of internal cerebral veins. The importance of elucidating the neuropathological and clinical implications of undue reflux into the skull or spine is deduced from the probability of relations between localized backflow into the craniovertebral space and unexplicated cerebrospinal diseases. In this regard the features of multiple sclerosis are discussed."

    Damaging venous reflux into the skull or spine: relevance to multiple sclerosis.
    Schelling F.

    Here is Dr. Schelling's website for more information. His book (available for free on his site) outlines the history of the connection of MS to the venous system. Dr. Schelling is a brilliant, kind and generous man. When he came public with his research, he was dismissed, ridiculed and mocked. I am so happy that he is able to now witness Dr. Zamboni's technological corroboration of his findings. It was my pleasure and honor to meet him in Bologna, and to share his research with you.
    http://www.ms-info.net/evo/msmanu/984.htm

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