Thesis (Ph. D.)--Drexel University, 2006. / Includes abstract and vita. Includes bibliographical references (leaves 170-193).

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-02-09T10:36:15Z No. of bitstreams: 2 Dissertação - Nara Lígia Leão Casa - 2015.pdf: 3128154 bytes, checksum: 290faf6f7e255eb06dcfd7b0baf48e03 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-02-09T10:36:36Z (GMT) No. of bitstreams: 2 Dissertação - Nara Lígia Leão Casa - 2015.pdf: 3128154 bytes, checksum: 290faf6f7e255eb06dcfd7b0baf48e03 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-02-09T10:36:36Z (GMT). No. of bitstreams: 2 Dissertação - Nara Lígia Leão Casa - 2015.pdf: 3128154 bytes, checksum: 290faf6f7e255eb06dcfd7b0baf48e03 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2015-12-02 / Introduction: Lumbar disc herniation (LDH) is the most common diagnosis among the degenerative changes in the lumbar spine and it can lead to functional limitations. Although several studies have shown a positive association between polymorphisms in the aggrecan gene and LDH, results are conflicting and vary across populations. Until now, such studies have not been carried out in Brazil. An understanding of this association can help in the prevention and intervention processes in patients with LDH. Objective: Investigate the association between polymorphisms in the aggrecan gene and LDH. Methods: This is a Case-Control study, paired by gender and age. A total of 119 male and female individuals from Goiania (Brazil) participated in the study; 39 individuals in the Case Group (CaG) and 80 in the Control Group (CtG). For each individual, sociodemographic and clinical data were collected as well as blood samples for genetic analysis. DNA was isolated and genotyped at the variable number of tandem repeats (VNTR) region of the aggrecan gene using polymerase chain reaction. Results: Both groups were homogeneous for socio-demographic, anthropometric, and life style variables. The sum of allele sizes at the VNTR region of the aggrecan gene were significantly lower in individuals with LDH, with allele A22 showing significantly higher frequency in this group. Comparison of allele size distribution indicated that shorter alleles (i.e., A13-A25) were more frequent in individuals with LDH, whereas alleles with a higher number of repeats were more frequent among healthy individuals. It should be noted, however, that differences were not significant. The most frequent alleles in both groups were A28, A27 and A29, respectively. Genotype A26/A26 was the most common among individuals in the CaG. Conclusions: An association between short alleles and LDH was observed in this study. This finding is in agreement with other reports in the literature, corroborating the hypothesis that individuals with shorter alleles have an aggrecan gene with fewer repeats. Therefore, a smaller number of chondroitin sulfate chains bind to the aggrecan in the intervertebral disc, leading to a decrease in its physiological function of hydration of the intervertebral disc, and thus to an increase in LDH susceptibility. / Introdução: A hérnia de disco lombar (HDL) é um diagnóstico frequente dentre as alterações degenerativas da coluna lombar e causa limitações funcionais importantes. Alguns estudos apontam para uma associação positiva entre polimorfismos no gene aggrecan e a HDL, porém os resultados ainda são conflitantes e variam entre as populações, não havendo pesquisas sobre o tema na população brasileira até o momento. Compreender essa associação pode auxiliar na prevenção e intervenção junto às pessoas com HDL. Objetivo: Investigar a associação entre polimorfismos no gene aggrecan com a hérnia de disco lombar. Métodos: Estudo caso-controle, pareado em quinquênio por idade e sexo. Participaram do estudo 119 pessoas de ambos os sexos, domiciliadas em Goiânia (Brasil), sendo 39 no Grupo Caso (Ca) e 80 no Controle (Ct). Foram coletados dados sociodemográficos e clínicos e amostras de sangue periférico; o DNA foi isolado para posterior genotipagem do número variável de repetições em Tandem (VNTR) do gene aggrecan (ACAN) através de PCR convencional. Resultados: Os grupos mostraram-se homogêneos quanto às variáveis sociodemográficas, antropométricas e hábitos de vida. O escore alélico do VNTR do gene aggrecan foi significativamente menor nos voluntários com HDL; o alelo A22 mostrou-se significativamente mais prevalente nesse mesmo grupo; no grupo Ca houve maior frequência dos alelos pequenos A13 - A25, enquanto no Ct maior frequência dos alelos grandes, porém, sem diferença estatisticamente significativa; em ambos os grupos os alelos mais frequentes foram A28, A27 e A29, respectivamente; o genótipo A26/A26 foi significativamente mais comum no Grupo Ca. Conclusões: Houve associação entre alelos pequenos com a HDL nos adultos pesquisados e compatibilidade com a literatura internacional, corroborando a hipótese de que indivíduos que possuem alelos pequenos possuem um aggrecan com menor número de repetições. Portanto, um número menor de cadeias de sulfato de condroitina se ligam no aggrecan do disco intervertebral, o que resulta na diminuição da sua função fisiológica de hidratação do disco e, consequentemente, aumenta a susceptibilidade individual à HDL.

INTRODUÇÃO: A degeneração do disco intervertebral (DIV) é um processo crônico e apontado como o maior causador de cervicalgia e lombalgia. Esse processo geralmente conta com a degradação da matriz extracelular, expressão de citocinas inflamatórias e fatores angiogênicos e axonogênicos. Entretanto, muito pouco se sabe sobre esse processo em DIVs assintomáticos durante o envelhecimento, principalmente no segmento cervical. O objetivo desse estudo foi de delinear o perfil de moléculas relacionadas à degeneração discal em DIVs cervicais e lombares. MÉTODOS: Discos intervertebrais humanos cervicais e lombares (C4-C6 e L4-S1) foram coletados em autópsia de 30 indivíduos presumivelmente assintomáticos e divididos em grupos jovem (GJ < 35 anos, n=60) e idoso (GI > 65 anos, n=60). O nível de degeneração foi constatado pela escala de Thompson, e foi correlacionado com a detecção imuno-histoquímica das moléculas de MMP-1, -2, -3, TIMP-1, IL-1beta, TNF-alfa, VEGF, NGF-beta e BDNF. RESULTADOS: Todos os DIVs mostraram algum grau de degeneração, embora mais acentuadas no GI. As moléculas empenhadas no estudo foram identificadas em ambos grupos. A detecção imuno-histoquímica foi prevalente no citoplasma das células nativas do DIV e na região de interseção entre a placa vertebral e o arranjo fibro-colágeno. O envelhecimento propiciou, no disco cervical, maior expressão de MMP-2, -3, VEGF, NGF-beta e BDNF, enquanto que no disco lombar, a maior expressão foi de MMP-1, -2 -3, TIMP-1, TNF-alfa, VEGF e NGF-beta. DISCUSSÃO: O envelhecimento de DIVs cervicais e lombares caracterizou-se por exibir um processo catabólico e extensivo remodelamento da matriz extracelular, os quais podem ser interpretados como eventos que antecipam a doença degenerativa discal. Esse processo é capaz de levar a angiogênese e axonogênese de modo a ampliar o metabolismo aeróbio do DIV e captar informação nociceptiva como forma de defesa, uma vez que até nos discos lombares de indivíduos jovens essa última característica pôde ser observada. Discos assintomáticos também exibem moléculas relacionadas à doença degenerativa discal e talvez a inibição de parte dessas possa resultar em terapia preventiva / INTRODUCTION: Degeneration of the intervertebral disc (DIV) is a chronic process that pointed as a major cause of neck and low back pain. This process generally includes an extracellular matrix degradation, expression of inflammatory cytokines, angiogenesis and axonogenesis factors. However, there is a little known about this process in asymptomatic DIVs during aging, especially in the cervical region. The aim of this study was to delineate the profile of molecules related to disc degeneration in the cervical and lumbar discs. METHODS: Human cervical and lumbar intervertebral discs (C4-C6 e L4-S1) were harvested at autopsy from 30 asymptomatic individuals, and divided according to age with young (GJ < 35 years old, n=60) and elderly (GI > 65 years old, n=60) groups. Gross degeneration was graded according to the Thompson scale and this was correlated to the immunohistochemical detection of molecules of MMP-1, -2, -3, TIMP-1, IL-1beta, TNF-alfa, VEGF, NGF-beta e BDNF. RESULTS: Discs from GJ were significantly less degenerated than those of GI. The molecules involved in the study were identified in both groups. The immunohistochemical detection was prevalent in the cytoplasm of native disc cells and the region between the vertebral plate and fibrous collagen arrangement (intersection). Aging provided in cervical disc, increased expression of MMP-2, -3, VEGF, NGF and BDNF-beta, whereas in the lumbar disc the highest expression of MMP-1, -2, -3, TIMP-1, TNF-alfa, VEGF and NGF-beta was seen. DISCUSSION: The aging of cervical and lumbar DIV was marked by catabolic process and a extensive remodeling on extracellular matrix which can be interpreted as a predict event of the degenerative disc disease. This process can lead to angiogenesis and axonogenesis in order to expand the aerobic metabolism of the DIV and get nociceptive information as a defense, since even in the lumbar discs of young individuals this last feature can be observed. Asymptomatic discs also exhibit molecules related to degenerative disc disease and perhaps the inhibition some of these can result in preventive therapy

Abstract Genetic factors have been implicated to play a role in both degenerative lumbar spinal stenosis (LSS) and intervertebral disc disease (IDD). Sequence variations in the genes coding for collagen IX and inflammatory mediators have been indicated as risk factors for IDD. Nine genes coding for intervertebral disc (IVD) collagens I, II, IX and XI and aggrecan (AGC1) were analyzed for sequence variations in 29 Finnish individuals with LSS. In addition, two polymorphisms in the vitamin D receptor gene and one in the matrix metalloproteinase-3 gene were studied. Study subjects were analyzed both clinically and radiologically. Results indicated an association between the COL11A2 IVS6-4 a to t polymorphism and LSS (p = 0.0016). Moreover, the t/t genotype was found more often in the patient group compared to controls (p = 0.0011). A novel splicing mutation, likely resulting in the synthesis of a truncated protein, was identified in COL9A2. Eight hundred four Chinese individuals were screened for the presence of the Trp2 and Trp3 alleles. The Trp2 allele was found in 20% of the individuals compared to the previously reported 5% in Finnish patients with IDD characterized by sciatica. The Trp2 allele was found to predispose to IVD degeneration and end plate herniations, increasing the risk by 2.4-fold from 40 to 49 years of age. In addition, the degeneration was worse in individuals with the Trp2 allele. The risk for annular tears was 4-fold greater in study subjects from 30 to 39 years of age who were Trp2 positive. Surprisingly, the Trp3 allele was absent even though it was found in about 9% of Finnish individuals. One hundred fifty-five Finnish individuals with IDD characterized by sciatica were analyzed for sequence variations in four genes coding for inflammatory mediators IL1A, IL1B, IL6, and TNFA. In addition, sixteen polymorphisms in inflammatory mediator genes were analyzed. The results identified an association between sciatica and the E5+15T>A polymorphism in IL6 (p = 0.007). A significant association was also seen in the IL6 haplotype analysis (-597 g>a, -572 g>c, -174 g>c and E5+15T>A). The association of the GGGA haplotype with the disease was highly significant (p = 0.0033).

Abstract Genetic factors have been shown to have an important role in intervertebral disc disease. The associations of known genetic risk factors and whole-body vibration, a proposed environmental risk factor, for intervertebral disc disease (IDD) were evaluated. Eleven variations in eight genes (COL9A2, COL9A3, COL11A2, IL1A, IL1B, IL6, MMP-3 and VDR) were genotyped in 150 male train engineers with an average of 21-year exposure to whole-body vibration and 61 male paper mill workers with no occupational exposure to vibration. The number of individuals belonging to the IDD group was significantly higher among train engineers (42% of train engineers vs. 17.5% of sedentary workers; p = 0.005). In addition, the IL1A-889T allele represented a risk factor for the IDD-phenotype. In order to clarify the role of genetic variations in the genes coding for several proinflammatory mediators, hundred fifty-five Finnish individuals with IDD were analyzed for mutations in the genes coding for inflammatory mediators IL-1α, IL-1β, IL-6 and TNF-α. In addition, sixteen single nucleotide polymorphisms (SNPs) in inflammatory mediator genes were genotyped. An association was identified between IDD and IL6 polymorphism +15T>A in exon 5 (p = 0.007). In addition, IL6 haplotype GGGA of -597G>A, -572G>C, -174G>C and +15T>A in exon 5 associated with IDD (p = 0.0033). A functional SNP in the CILP gene has been suggested to cause IDD in the Japanese population. This functional variation was analyzed in 243 Finnish IDD patients and 259 controls, and in 348 Chinese individuals with degenerative MRI findings and 343 Chinese individuals with normal MRI. No association was found in the Finnish and Chinese study populations. In order to reveal chromosomal susceptibility loci and new candidate gene(s) for IDD a genome-wide scan was performed on 14 Finnish families with 186 individuals. Genome-wide and fine mapping analysis provided maximum two-point LOD scores of 2.71, 2.36 and 2.04 for chromosomes 21, 4, and 6, respectively. Second fine mapping confirmed the susceptibility of chromosome 21. Two candidate genes, ADAMTS-1 and ADAMTS-5, were analyzed in the region suggesting linkage, leading to the identification of thirteen sequence variations. However, none of the variations were disease causing.

The purpose of this study was to determine whether magnetic resonance imaging (MRI) accurately predicts surgical findings in dachshund dogs with thoracolumbar intervertebral disc extrusions (TLDE). Sixteen dogs presenting with signs of acute TLDE took part in this investigation. MRI was performed on each dog. This was followed by decompressive surgery with the completion of an intra-operative questionnaire documenting the site of the extrusion and spatial distribution of the disc material for each dog. An independent veterinary radiologist evaluated each MRI study, measured and recorded the same parameters from images, utilising 3 sequences (T1-, T2-weighted and Short T1 Inversion recovery) without knowledge of the surgical findings. The imaging findings were compared with the intra-operative measurements. The specific intervertebral disc (IVD) space from which the material extruded and lateralization of the extruded disc material (EDM) were found to be similar between MRI and surgical observations. Longitudinal distribution of the EDM was described as being cranial, caudal or equally distributed in relation to the affected IVD. A Kappa test showed moderate agreement in longitudinal distribution between MRI and surgery. Circumferential distribution was recorded on transverse images and compared to surgical findings. Recorded distribution only coincided completely in 1 case, although the rest of the cases showed good overlap of findings between the MRI and intraoperative findings.Our results could not demonstrate a statistically significant difference between T1-, T2-weighted or STIR sequences when determining the length of the extruded mass in the vertebral canal. We found that when evaluating the absolute error and range of error for each sequence, that the T2-weighted sequence had a narrower range of errors and was thus more consistent in predicting the size of the lesion pre-surgically. MRI was validated as a very useful imaging modality for neurological disorders in dogs. / Dissertation (MMedVet)--University of Pretoria, 2007. / Companion Animal Clinical Studies / unrestricted

<p> This study is one of the projects of the artificial joints group conducted by Professor W. R. Newcombe, Department of Mechanical Engineering and Dr. G. R. Viviani, Department of Surgery.</p> <p> A summary of the literature survey of the lower back which is pertinent to the design of a replacement for the lumbar spine is reported. Motions, force system, and strengths of the lumbar intervertebral joint are obtained from the literatures and calculation.</p> <p> Advantages of silicone elastomer and titanium as the biomaterials for the artificial disc are presented. An experiment to test the bond between titanium and silicone reveals that the strength provided by only applying primer is insufficient.</p> <p> Surface structure for prosthetic stabilization and initial fixation is discussed. Proposed design alternatives for artificial discs are presented with the attempts to reduce the number of moulds needed by introducing a prosthesis with a more regular shape.</p> <p> An important part of this thesis is to indicate the direction in which further work in this area should proceed.</p> / Thesis / Master of Engineering (MEngr)

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Call number: LD2668 .T4 1985 W33 / Master of Science