Parkinson's Disease
Parkinson's disease is a slowly progressive disorder that affects movement, muscle control, and balance. It occurs when cells are destroyed in certain parts of the brain stem, particularly the crescent-shaped cell mass known as the substantia nigra. This cell loss negatively effects the nerves and muscles controlling movement and coordination, resulting in major symptoms characteristic of Parkinson's disease.
Most - but not all - Parkinson's disease victims are elderly. Some studies indicate that the very elderly are not susceptible to the disease, indicating that the aging process itself is not the major player in the disease. Aging does appear to reduce the concentration of dopamine in structures called dopamine transporters, which carry the neurotransmitter back and forth between nerve cells.
Symptoms often start with an occasional tremor in one finger that spreads over time to involve the whole arm. The tremor is often rhythmic - 4 to 5 cycles per second - and frequently causes an action of the thumb and fingers known as the pill-rolling tremor. Tremor is present when the limb is at rest or held up in a stiff, unsupported position and usually disappears briefly during movement. Tremors can also occur in the head, lips, tongue, and feet - although they do not occur during sleep. Symptoms can occur on one or both sides of the body.
About half of Parkinson's patients develop some speech difficulty caused by rigidity of the facial muscles, loss of motor control and impaired breath control. Tone can become monotonous, words may be repeated over and over, or the rate of speech may even be very fast. Swallowing may be difficult.
Parkinson's disease is not fatal, but it reduces longevity. It also seriously impairs the quality of life and may sometimes lead to severe incapacity within 10 to 20 years. Treatments are increasingly effective however in alleviating symptoms and even slowing progression of the disease. Over time, however, the side effects of many of these medications can be nearly as distressing as the disease itself, and the drugs may eventually lost their effectiveness. Parkinson's disease is sometimes categorized as either tremor predominant or postural instability and gait disturbed (PIGD). In younger patients tremor is usually predominant and progression of the disease is slow. Elderly people are more apt to have PIGD. Some studies have suggested that early PIGD symptoms predict a faster decline than having tremor predominant. Gait disturbance is a particularly serious sign in the elderly.
For more information visit:
www.parkinson.org
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Vascular Disease
The patient population that requires vascular surgery is as varied as the techniques performed by vascular surgeons. Although patients span all age groups, the vast majority are over age 50 - at which time a lifetime of atherosclerosis, or hardening of the arteries, has taken its toll.
Besides more common diseases treated by vascular surgeons, about 20% of patients have other vascular problems, such as Takayasus's arteritis, an inflammation of the arteries that results in scarring and occlusion, primarily affecting people from the Pacific Rim and Latin American countries, and is not uncommon in Southern California.
Other problems vascular surgeons treat include acute traumatic vascular injuries, chronic arterial injuries and entrapment syndromes that involve a bony or muscular entrapment of blood vessels - the most common being thoracic outlet syndrome. Vascular surgeons also treat individuals with venous disease including varicose veins. This surgery used to be considered purely cosmetic, but today we view the treatment as important from a functional perspective as well. These patients have extremity pain and heaviness - symptoms which can be very debilitating and can be relieved by surgery.
For more information visit:
www.vdf.org
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