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推薦頻道:Gimmy a break

2009年11月24日 星期二

重大的醫學發現 : MS的原因找到了?!


The Liberation Treatment: A whole new approach to MS

一位義大利外科醫師,Dr. Paolo Zamboni利用超音波檢查人體的神經細胞,發現有MS病患中的血管有某部分會呈現"窄化"現象. 而這些現象正是引發MS的原因 (這真是太棒了! 找到了目前看起來算是物理上最接近的原因了!!)你們一定要點選第一行的連結到原始的網頁去看影片,說明的相當棒且清楚!!

CTV.ca News Sta

Date: Sat. Nov. 21 2009 6:02 PM ET

Amid the centuries-old castles of the ancient city of Ferrara is a doctor who has come upon an entirely new idea about how to treat multiple sclerosis, one that may profoundly change the lives of patients.

Dr. Paolo Zamboni, a former vascular surgeon and professor at the University of Ferrara in northern Italy, began asking questions about the debilitating condition a decade ago, when his wife Elena, now 51, was diagnosed with MS.

Watching his wife Elena struggle with the fatigue, muscle weakness and visual problems of MS led Zamboni to begin an intense personal search for the cause of her disease. He found that scientists who had studied the brains of MS patients had noticed higher levels of iron in their brain, not accounted for by age. The iron deposits had a unique pattern, often forming in the core of the brain, clustered around the veins that normally drain blood from the head. No one had ever fully explained this phenomenon, considering the excess iron a toxic byproduct of the MS itself.

他懷疑血液中過多的鐵會聚集在血管(靜脈)周圍,而阻礙了流出頭部的血液,而過去沒有人完全解釋這個現象,只是認為鐵的存在是一個毒性物質.

Dr. Zamboni wondered if the iron came from blood improperly collecting in the brain. Using Doppler ultrasound, he began examining the necks of MS patients and made an extraordinary finding. Almost 100 per cent of the patients had a narrowing, twisting or outright blockage of the veins that are supposed to flush blood from the brain. He then checked these veins in healthy people, and found none of these malformations. Nor did he find these blockages in those with other neurological conditions.

Dr. Zamboni利用都卜勒超音波檢驗MS病患的頸部而有重大的發現!! 他所檢查的MS病患中全部的頸部血管都有只窄化的現象, 而正常人則不會有此一問題!!

"In my mind, this was unbelievable evidence that further study was necessary to understand the link between venous function and iron deposits on the other," Zamboni told W5 from his research lab in Ferrara.

What was equally astounding, was that not only was the blood not flowing out of the brain, it was "refluxing" reversing and flowing back upwards. Zamboni believes that as the blood moves into the brain, pressure builds in the veins, forcing blood into the brain's grey matter where it sets off a host of reactions, possibly explaining the symptoms of MS.

也因為如此, 所以血液無法順利的流出或流進大腦,進而造成腦部血管壓力的上升而產生了白色的斑塊

"For me, it was really unbelievable to understand that iron deposits in MS were exactly around the veins. So probably, it is a dysfunction of drainage of the veins," Zamboni said.

"This is very important, because iron is very dangerous, because it produces free radicals, and free radicals are killers for cells. So we need to eliminate iron accumulation."

我們要解決鐵的不當聚集和沈積!!

Zamboni dubbed the vein disorder he discovered CCSVI, or Chronic Cerebrospinal Venous Insufficiency(請按此連結瞭解何謂CCSVI), and began publishing his preliminary research in neurology journals.

CCSVI: 靜脈血管無法即時的將缺氧的血液排出.

He soon found that the severity of the vein blockages were located corresponded to the severity of the patient's symptoms. Patients with only one vein blocked usually had milder forms of the disease; those with two or more damaged veins had more severe illness.

Zamboni found blockages not only in the veins in the neck directly beneath the brain -- the jugular veins --but in a central drainage vein, the azygos vein, which flushes blood down from the brain along the spine. Blockages here, he found were associated with the most severe form of MS, primary progressive, in which patients rapidly deteriorate. For this form of MS, there currently is no effective treatment.

Dr. Zamboni發現不只在頸部腦幹下方的靜脈會發生,很多靜脈都會發生,如: the azygos vein(jugular veins;靠近脊椎的靜脈)

As for how these vein abnormalities form, Zamboni isn't sure. He believes, though, that congenital defects, problems that likely formed before birth, can be blamed for most of the problems, though this has not been conclusively proven.

但是為何會造成靜脈的窄化呢? 仍無法回答此一問題.

Most neurologists Zamboni initially approached with his findings dismissed them. But one specialist, Dr. F. Salvi, at Bellaria Hospital in Bologna, was intrigued by the concept. He began sending Zamboni MS patients for CCVIS testing, to see if what he was finding was correct. The images of narrowed or blocked veins, called "strictures," were irrefutable for Salvi.

Focus on a treatment

But Dr. Zamboni had an even more important idea. If key veins of MS patients were blocked, perhaps he could open them and restore normal blood flow?

Taking a page from standard angiography, in which doctors use balloons to open up blocked arteries that feed blood from the heart, he enlisted the help of vascular surgeon Dr. R. Galeotti, also at the University of Ferrara and Santa Anna Hospital. Three years ago, the team began a study in which they treated 65 MS patients to see if endovascular surgery would restore flow in these vessels and lessen MS symptoms.

The study detailing those results will be published in the Journal of Vascular Surgery on Nov. 24. But preliminary results, already released, show patients had a decrease in the number of new MS attacks, a big reduction in the number of brain lesions that define MS, and improved quality of life. The only time symptoms returned for the patients was when the veins re-narrowed.

Because the surgery freed the blood flow, the team dubbed the procedure "The Liberation Treatment."

Zamboni's sense is that the earlier patients are diagnosed and treated, the more function they will preserve, and the less damage the improper blood flow will do to the brain.

"Because MS is a progressive disease and strikes young people, if we lose time, there are a lot of young people that will progress without possibility to get back. This is very heavy for me," he says.

Zamboni has also been studying the prevalence of CCSVI with a team at the University of Buffalo in New York, in collaboration with Dr. Robert Zivadinov. That study, to be published in January, has looked at 16 MS patients, including eight from the U.S and eight from Italy. All have been found to have blocked veins of CCSVI, just as Zamboni described, and all eventually underwent the Liberation Treatment.

Relief for patients

One of those patients was Buffalo resident Kevin Lipp. Lipp had MS for over a decade, and as part of the study, discovered he had five blocked veins in his neck. After undergoing the Liberation Treatment 10 months ago, he says he hasn't had a single new MS attack.

Zamboni emphasizes that the Liberation Treatment does not make people in wheelchairs walk again. Rather, it seems to stop the development of further MS attacks, and in some cases, improves movement and decreases the debilitating fatigue that are the hallmarks of MS.

Zamboni強調, 這種血管擴張手術(Liberation Treatment )無法使坐著輪椅的病人再度站起來,但是這能夠阻止MS的發作, 而且有例子顯示, 能夠改善行動能力和減少疲勞感

The foundation that has sponsored Zamboni's research, the Hilarescere Foundation, also urges cautious restraint.

"We can't give the illusion to patients that this is a guaranteed treatment and it is easy. This is not right. And we have never done this," says Hilarescere President Fabio Roversi-Monaco. "We don't say this is a cure for M.S. We only say that research is advancing, and there is encouraging data but we are waiting for more conclusions."

Dr. Zivadinov in Buffalo is now starting a new study, recruiting 1,600 adults and 100 children, half of them MS patients. He plans to use ultrasound and MRI scans to confirm if those with MS also have CCSVI and if their family members have the abnormalities too.

Prof. Mark Haake, a neuro-imaging scientist at McMaster University and Wayne State University in Detroit is also intrigued by Zamboni's findings. He has long been seeing iron deposits in the brains of MS patients using a specialized MRI analysis called SWI - specific weighted imaging. When he saw Zamboni's initial publications, he immediately contacted the Italian doctor and began collaborating.

Population studies under way

Haake too is initiating a study, asking neurological centres across North America and Europe to take some extra MRI scans of the neck and upper chest of MS patients. The scans can then be electronically sent to his research team for analysis. He believes this grassroots approach could spur larger and more in depth studies. He's hoping he can engage MS specialists and vascular surgeons, interventional radiologist around the world to study the theory and then move to diagnosing and treating MS patients quickly.

"I think patients do play a role, because there are millions and millions of dollars donated to MS Societies and a lot of money set aside by the government to study MS research and right now, 99.9 per cent of that money goes somewhere else," he told W5.

"So the patients need to speak up and say 'We want something like this investigated, at least at an early stage, to see if there is credence to this theory.' Even if it is 10 or 20 per cent of these people who can be helped, that needs to be investigated," says Haacke.

Haake's research is being done with no funding; he's unwilling to wait the nine months to a year needed to get formal research funding applications approved. Urgency, he says, is needed in finding the answer to the question of whether Dr. Zamboni is right.

"Certainly, I continue my battle because I am fully convinced that this is the right thing for the patient," he says.

The MS Societies of Canada and the U.S. are reticent to support Zamboni's theories. They maintain that: "Based on results published about these findings to date, there is not enough evidence to say that obstruction of veins causes MS... It is still not clear whether relieving venous obstructions would be beneficial."

Interest in CCSVI growing

But CCSVI has become a subject of intense interest among MS patients who are texting and emailing details of Zamboni's work, locating the few centres around the world that have started to work on studies on CCSVI and the Liberation Treatment.

Zamboni says every day, MS patients hear about his theory and either write, email or call him asking for treatment he can't yet provide. Still, some surgeons in the U.S. are now offering the surgery Zamboni's team has pioneered.

Jeff Beal, an L.A-based, Emmy-Award-winning musical director has already paid to have the surgery procedure. After he was diagnosed with MS five years ago, he was left unable to work a full day and worrying he would spend the rest of his life in a wheelchair. Unable to come to terms with the diagnosis, his wife, Joan, set to find new treatments and eventually came upon Zamboni's work. Unable to get her husband treated in Italy, she convinced a Californian vascular surgeon who already performs similar surgery on leg veins to look at Zamboni's work and test Jeff for CCSVI. Jeff was diagnosed with two blocked jugular veins and treated with the Liberation Treatment. (with a slightly different procedure than the italan one..using Stents) He now says he has much more energy and none of the chronic fatigue that used to limit his activity.

"I reached what I would call sort of a higher plateau, in the sense of the most debilitating symptom, which is the fatigue. So, I still have fatigue every day, I still battle it; it's still one of my symptoms. But in terms of the total reservoir of energy, it's much greater than it used to be. And that's a huge gift, especially to my family," Beal told W5.

His wife Joan was delighted with the surgery's results.

"Suddenly, he's helping Henry with his homework and he's playing trumpet duets with Henry and he's awake. And there's this presence in the house that hadn't been there for two years," she said.

Joan has now become a "cheerleader" of Zamboni's work on MS chat sites, urging other patients to show their neurologists the material being published by the Italian team and to ask them to consider setting up a study in other MS clinics.

Among all of Zamboni's success stories and the patients who sing his praises is his wife Elena. Her MS caused her to lose her vision for a time and develop what she called "violent" attacks. She had difficulty walking and was losing her balance and feared a life in a wheelchair unable to care for herself. Elena became one of her husband's first ultrasound test patients and was found to have a complete closure of the azygos vein in her central chest. She was one of the first to be liberated almost three years ago. After having regular debilitating MS attacks for nearly a decade before, Elena has been symptom-free ever since. An elegant, intelligent woman, she now has a quick walk, with no sign of disability. Her husband couldn't be happier.

"What I think is this is probably the best prize of the research," says Zamboni.

偉大的Dr. Paolo Zamboni!!

無疑的, 這是一項對於阻止Ms再發做的一項外科手術的成就!!



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20 則留言:

  1. 這真是太棒了! 找到了目前看起來算是物理上最接近的原因了!!

    不知道這種手術何時會引進台灣? 不然就要飛到義大利去做了呢~

    有沒有人要同行的啊?

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  2. 所以對應到中醫的觀點: 血路不通就是主要原因

    只是不通的地方很深,影響了神經.也許是神經細胞缺氧而造成脫髓鞘的反應.

    同樣的,也就可以說明為何高壓氧是有用的了, 因為補充了神經細胞不足的氧氣!!

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  3. 真的嗎?那時的事~^_@.. Jamie

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  4. 謝謝你為我們收集ㄌ那麼多ㄉ相關資料..感恩你..

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  5. 從文章來看,這個實驗至少已經進行一年了, 昨天才被完整的報導出來!

    我想這是我能盡的微薄之力,真的很想去做這種手術耶, 揪團一起去嗎?
    還是揪團請蔡醫師或陽醫師去義大利做技術移轉?

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  6. 如需要聯名上書..請來信通知...謝謝...
    我會去多買些人手來聯名...

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  7. 常常是在你這邊得到好多資料......真ㄉ很謝謝

    Orange

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  8. 同時可以解釋為什麼類固醇的治療有用了, 因為類固醇(就是腎上腺皮質素)這種激素一產生,心跳加快,也同時會讓血管擴張,血液流動的速度加快,自然而然靜脈窄化的地方就暫時獲得了舒張,症狀進而緩解...終於, 這一切的解釋都相當合理, 真相越來越大白!!

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  9. 那用治療中風的藥不就有效了?可以擴張血管…
    我的想法是沒那麼樂觀啦,不過我有盡量樂觀地生活。
    我的斑塊以頸部居多,符合本文的研究報告。
    做肩頸按摩有沒有效果?自然療法也有提到頸椎的按摩有效果。 薇

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  10. Jimmy,

    真是太感謝你的資料了,一直以來
    總感覺在你這裡可以看到希望依然存在

    但是這看起來是預防再發作,若是要能夠達到治癒的可能
    是不是有其他可能呢?

    我目前再做高壓氧,第16次了
    有需要任何幫忙的地方儘管吩咐喔
    不管是聯名或是要聚會~~

    dada

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  11. 請問達達你作高壓氧治療可以辦理住院嗎?還是得完全自費?

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  12. 給Dada:
    由 文章內容提到有病患在手術後10個月完全沒有發作, 但是我想對於神經細胞受損不嚴重的病患,要治癒還是有機會,畢竟我相信細胞仍有自我修復和再生的能力,只是希望不要受損太嚴重就有機會.

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  13. 不過...神經內科不是不操刀的嗎?
    或是請他們帶外科醫生去?
    不知道學那技術需要多久的時間...
    不過有這消息還是很振奮人心!
    -辛-

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  14. 所以愈高緯度國家人民得ms比例愈高的原因,也可能是天氣太冷血管收縮的緣故?
    不過,我們為什麼多是天熱發作呢?

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  15. 我的醫師同意我住院做高壓氧
    針對住院的話,我的保險是有幾付住院費用的
    住院一天2000,而我住院期間做了10次

    所以我住院了2個星期.
    但還是不能不去上班,所以我出院之後再接著做10次
    這10次就完全自掏腰包.$20400..........@@
    目前做到17了

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  16. 不過...神經內科不是不操刀的嗎?
    或是請他們帶外科醫生去?
    不知道學那技術需要多久的時間...
    不過有這消息還是很振奮人心!

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  17. 我也是病友
    謝謝你提供的訊息

    到義大利去
    我可能沒有財力(旅費&手術費)
    可是知道這個消息
    還是振奮了一下

    9898

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  18. 好久沒上來了!
    感謝Jimmy帶給我們這麼有進步的消息!
    旅費&手術費多少 ?成功率多少?
    感恩!!
    circle

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  19. 所有的ms報導,這個報導最被病友期待與相信了。
    但這也是不小的手術吧?

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  20. 詳情可以再看下一篇, 成功率蠻高的
    阻止復發率也很高 2年不復發

    重點:必需要先做超音波檢測
    先確認是否有靜脈窄化現象

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