CASE STUDY:- DISCITIS Katherine Taylor PHYSIOCLINICPLUS SUBJECTIVE HISTORY: A 73 year old gentleman presented with a 4 month history of low back pain with no history of trauma. He had a 20 year history of low back pain, but the pain over the last 4 months had been significantly worse. The pain was intermittent and initially it radiated into the right leg and increased with cough
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Arkworld.netA Report On Arginine
By Harry Elwardt, N.D., PhD.
“. A few grams of prevention is worth a ton of cure.” 1
So just what is Nitric Oxide (NO)? Over 20,000 articles in the medicalliterature since 1980 attest that “absolutely everything in the body dependson it.” Its function in human physiology is so important that the AmericanAcademy of Science named Nitric Oxide the “Molecule of the year” in1992. The Nobel Peace prize in Medicine was awarded to scientists whobegan the research on Nitric Oxide in 1998 and now NO has been referredto as “The Molecule of the Millennium”. Dr. Jonathan S. Stamler, aprofessor of medicine at Duke University Medical Center, put it best whenhe said of Nitric Oxide: “It does everything, everywhere. You cannot name a major cellular response or
physiological effect in which [Nitric Oxide] is not implicated today. It’s involved in
complex behavioral changes in the brain, airway relaxation, beating of the heart,
dilation of blood vessels, regulation of intestinal movement, function of blood
cells, the immune system, even how fingers and arms move.”
There are three types of NO. Endothelial-derived NO diffuses out of endothelial cells
(cells lining arteries and veins) and into smooth muscle cells of arteries enhancing
relaxation and other properties of vascular physiology.
Endothelial-derived NO also functions in platelets (blood cells responsible for blood clots)
to inhibit aggregation or blood clotting. Brain-derived NO affects several types of nerve
cells and appears to be important in neurotransmitter pathways in both the central as well
as peripheral nervous system and regulates the production and release of many
hormones. Macrophage-derived NO is important in the immune system. This type of NO
helps macrophages (a type of immune cell) kill bacteria and tumor cells. So, NO is
important to the nervous system, the immune system and the vascular system, which
supplies nutrients to all parts of the body. Arginine, when combined with Oxygen, forms
NO. Arginine, as found in Ark1™ is the source of all forms of NO.2, 3
NO decreases with age 4, 5, 6, various age related conditions and many medications7,8.
Among the most common disease states to affect NO and therefore sexual function are: • Some of the most common drugs affecting NO and/or sexual functions are antidepressants – many common drugs like Elavil®, Prozac®. Paxil®, Zoloft®, etc.
• Anti-anxiety drugs, including Xanax® and Valium® • Other Cardiac drugs, like lanoxin or other drugs that affect cardiac rhythm • Anti-heartburn drugs like Tagamet® and Zantac® • Opioids especially chronic use of legal (e.g., Lortab®, codeine, etc.) and illegal (e.g., heroin) narcotics and pain medicines The use of many of these drugs and the incidence of most of this disease conditionsincrease after the age of 40. Obviously it is also the age group most likely to benefit fromthe use of Ark1™, though any age group can benefit. The 40 and above age group isalso the most likely age group (both men and women) to want to use Ark1™ for thetreatment of sexual dysfunction. In the genital tissue, NO triggers the release of c-GMP,which is a molecule that causes engorgement of this tissue. The arginine found in Ark1™releases NO to make sure there is plenty of c-GMP. Viagra, on the other hand, is a drugthat blocks an enzyme to make sure there is plenty of c-GMP. Arginine has been shownto be a safe and effective alternative to Viagra®. Viagra® has been reported to be safe;however, the FDA public records suggest the opposite. These records reported thatbetween April of 1998 and May of 1999 there were 1,473 adverse events including 255serious heart rhythm disturbances, 53 episodes of congestive heart failure (weakenedheart) 119 strokes, 517 heart attacks and 522 deaths.9 Every major disease process today is directly or indirectly related to lack of NO.
Diabetes, Hypertension, Hyperlipidemia, Hypercholesterolemia, Cancer, Peripheral
Vascular Disease, Coronary Artery Disease, Sickle Cell, Scleroderma, Renal
Failure, Pulmonary Hypertension and Atherosclerosis are all associated with
decreased levels of NO. (With the exception of cancer, where NO functions in the
immune system, most of these disease processes involve the vascular system and
endothelial derived NO).
The primary function of endothelial derived NO is vascular homeostasis, or balance. NOmaintains vascular health by enhancing endothelial reactivity. The endothelium is theinner lining of the blood vessels and as long as the endothelium remains reactive, theyare supple, pliable and flexible. They are able to respond appropriately to the variouschanges that occur in blood vessels in the course of normal and abnormal physiology,when NO decreases, the vessels become stiff and rigid.
This is called atherosclerosis or hardening of the arteries. When we developatherosclerosis, the results are high blood pressure, heart attack and stroke andultimately death. As long as we have plenty of NO, as can be supplied by the arginine inArk1™, our blood pressure remains low and we have protection from many of theconsequences of the aging process.
To date arginine has been shown in animal as well as human trials that it may beeffective in the following: • Decreasing and reversing atherosclerosis by decreasing intimal thickening and • Restore normal endothelial function in hypercholesterolemia 14,15,16,17,18,19,20,21 • Reversing consequences of coronary artery disease 22,23,24,25,26,27,28,29,30 • Decreasing cholesterol and triglycerides 32 • Improves walking distance in peripheral vascular disease 31,33,34,35,36 • Improves pain in interstitial cystitis 37,38 • Prolonged administration of arginine reverses adverse effects of high blood • Decreases post operative infection and length of stay 44 • Increases human growth hormone 45,46,47,48,49,50,116 • Improves outcome after bypass surgery 51 • Improves renal function 55,56,57,58,59,60 • Improves glucose uptake in muscle cells 61 • Improves cell mediated immunity 67,68,69,70,71 • Improves pituitary responsiveness and modulates hormonal control 72,73,74 • Improves diabetes and reverses damage 76,77,78,79 • Reduces blood clots and strokes 80,81,82 • Helps prevent restenosis after angioplasty and bypass 83,84,85 • Helps prevent post surgical damage after intestinal manipulation 86 • May improve irritable bowel syndrome 87 • May give protection against size of heart attack 90 • Helps protect in cardiac transplants 91,92 • Improves exercise capacity in pulmonary hypertension 96,117,118 • Improves peripheral vascular disease 103,104 • Improves outcome of cancer treatment 107,108 • Improve alzheimer’s 109,110,111,112 • Improves memory and cognitive functions 113,114,115 • L-arginine has been shown to safe in the above studies as well as others 100,116 To summarize, arginine by virtue of being a safe and natural Nitric Oxide donor can be anextremely significant factor in the treatment and reversal of most major diseases.
The impact of the arginine in Ark1™ on preventative healthcare and anti-aging isprofound, not to mention that it is a safe and effective replacement for the Viagra® typedrugs.
1. Fried R, Merrell WC. The Arginine Solution. New York, NY. Warner Books, 1999.
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49. Ghigo E, Arvat E, Gianotti L, et al. Hypothalamic growth hormone-insulin-like growth facto-1 axis across the human life span. J Pediatr Endocrinol Metab 2000;13 Suppl 6:1493-502 50. Korbonits M, Kaltsas G, Perry LA, et al. The growth hormone secretagogue hexarelin stimulates the hypothalamo- pituitary-adrenal axis via arginine vasopressin. J Clin Endocrinol Metab 1999 Jul;84(7):2489-95 51. Wallace AW, Ratcliffe MB, Galindez D, Kong JS. L-arginine infusion dilates coronary vasculature in patients undergoing coronary bypass surgery Aenesthesiology 1999 Jun;90(6):1577-8 52. Chen J, Wollman Y, Chernichovsky T, et al. Effect of high dose nitric oxide donor L-arginine in men with organic erectile dysfunction. BJU Int 1999 Feb;83(3):269-73 53. Kobayashi N, Nakamura M, Hiramori K. Effects of infusion of L-arginine on exercise-induced myocardial ischemic changes and capacity to exercise of patients with stable angina pectoris. Coron Artery Dis 1999 Jul;10(5):321-6 54. 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80. Kaposzta Z, et al. L-arginine and S-nitroglutathione reduce embolization in Humans. Circulation 81. Bode-Boger SM, Boger RH, et al. Differential inhibition of human platelet aggregation and thromboxane A 2 formation by L-arginine in vivo and in vitro. Arch Pharmacol 1998; 357:143-150 82. Wolf A, et al. Dietary L-arginine supplementation normalizes platelet aggregation in hypercholesterolemic humans.
83. Le Yorneau T, Van Belle E, Corseaux D, et al . Role of nitric oxide in re-stenosis after experimental balloon angioplasty in the hypercholesterolemic rabbit. J Am CollCardiol 1999 Mar;33(3):876-82 84. Janero DR, Ewing JF. Nitric Oxide and Postangioplasty re-stenosis: Pathologicalcorrelates and therapeutic potential. Free Radic Biol Med 2000 Dec 15;29(12):1199-221 85. Severin P, et al. Local intramural delivery of l-arginine enhances nitric oxide generation and inhibits lesion formation after balloon angioplasty. Circulation 1997;95(7):1863-9 86. Thomas S, Ramachandran A, Patra S, et al. Nitric oxide protects the intestine from the damage induced by laparotomy and gut manipulation. J Surg Res 2001 Jul;99(1):25-3287.Sahin AS, Atalik KE, Gunel E, Dogan N. Nonadrenergic, noncholinergic responses of the human colon smoothmuscle and the role of K+channels in these responses. Methods Find Exp Clin Pharmacol 2001 Jan-Feb;23(1):13-7 88. Fini M, et al. Effect of l-lysine and L-arginine on primary osteoblast cultures from normal and osteopenic rats Biomed Pharmacother 2001 May;55(4):213-21 89. Aikawa K, Yokota T, et al. Endogenous nitric oxide-mediated relaxation and nitrinergic innervation in the rabbit prostate: the change with aging. Prostate 2001 Jun 15;48(1):40-6 90. Suematsu Y, Ohtsuka T, et al. L-Arginine given after ischemic preconditioning can enhance cardioprotection in isolated rat hearts. Eur J Cardiothorac Surg 2001, Jun;19(6):873-9 91. Koglin J. Pathogenetic mechanisms of cardiac allograft vasculopathy-impact of nitric oxide. Z Kardiol 2000;89 92. Kown MH, Van Der Steenhoven T, Uemura S, et al. L-Arginine polymer mediated inhibition of graft coronary artery disease after cardiac transplantation. Transplantation 2001 June 15;71(11):1542-8 93. Freedman RR, Girgis R, Mayers MD. Acute effect if nitric oxide on Raynaud’s phenomenon in scleroderma. Lancet 94. Morric CR, Kuypers FA, et al. Patterns of arginine and nitric oxide in patients with sickle cell disease with vaso- occlusive crisis and acute chest syndrome. J Ped Hemat/Onc 2000 Nov-Dec;22(6):515-20 95. Kumar CA, Das UN. Lipid peroxides, antioxidants and nitric oxide in patients with pre-eclampsia and essential hypertension. Med Sci Monitor 2000 Sep-Oct;6(5):901-7 96. Nagaya N, Uematsu M, et al. Short term oral administration of l-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmonary hypertension. Am J Resp Crit Care Med 2001 April;163(4):887-91 97. Barbul A, et al. Arginine enhances wound healing and lymphocyte immune responsesin humans. Surgery 1990 98. Kirk SJ, et al Arginine stimulates wound healing and immune function in elderly humans. Surgery 1993 99. De-Souza DA, Greene LJ. Pharmacological nutrition after burn injury. J of Nutri 1998 May;128(5):797-803100.Blum A, Cannon RO, Costello R, et al. Endocrine and lipid effects of oral L-arginine treatment in healthy postmenopausal women. J Lab Clin Med 2000 Mar;135(3):231-7101.Ohta Y, Nishida K., Protective effect of l-arginine against stress-induced gastric mucosal lesions in rats and itsrelation to nitric acid-mediated inhibition of neutrophil infiltration. Pharmacal Res 2001 Jun;43(6):535-41 102.Khattab MM, Gad MZ, Abdallah D. Protective role of nitric oxide in indomethacin- induced gastric ulceration by a mechanism independent of gastric acid secretion. Pharmacol Res 2001 May;43(5):463-7 103.Calver A, Collier J, Vallance P. Dilator actions of arginine in human peripheral vasculature. Clin Sci 1991 104.Bode-Boger SM, Boger RH,et al. L-arginine induces nitric oxide-dependent vasodilation in patients with critical limb ischemia. A randomized, controlled study. Circulation 1996 Jan 1; 93(1):85-90 105.Vallet B. Microthrombosis in sepsis. Minerva Anestesiol 2001 Apr;67(4):298-301.
106.Hambrecht R, et al. Correction of endothelial dysfunction in chronic heart failure: additional effects of exercise training and oral L-arginine supplementation. J Am Coll Cardiol 2000 Mar 1; 35(3):706-13 107.Heys SD, et al. Dietary supplementation with L-arginine: Modulation of tumor infiltrating lymphocytes in patients with colo-rectal cancer. Br J Surg 1997 Feb;84(2):238-41 108.Brittenden J, et al. Dietary supplementation with L-arginine in patients with breast cancer(> 4cm.) receiving multi- modality treatment: report of a feasibility study. Br J Cancer 1994 May;69(5):918-21 109.McCarty MF. Vascular nitric oxide, sex hormone replacement, and fish oil may help to prevent Alzheimer’s disease by suppressing synthesis of acute-phase cytokines. Med Hypotheses 1999 Nov;53(3):369-74 110.Tarkowski E, et al. Intrathecal release of nitric oxide in Alzheimer’s disease and vascular dementia. Dement Geriatr 111.de la Torre JC, Stefano GB. Evidence that Alzheimer’s disease is a microvascular disorder: the role of constitutive nitric oxide. Brain Res Brain Res Rev 2000 Dec;34(3):119-36 112.Kuiper MA, et al. Decrease cerebrospinal fluid nitrate levels in Parkinson’s disease, Alzheimer’s disease and multiple system atrophy patients. J Neurol Sci 1994 Jan; 121(1):46-9 113.Pautler EL. The possible role and treatment of deficient microcirculation regulation in age-associated memory impairment. Med Hypotheses 1994 Jun;42(6):363-6 114.Pandhi P, Balakrishnan S. Cognitive dysfunction induced by phenytoin and valproate in rats: effect of nitric oxide.
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How to Use a Metered -Dose Inhaler (MDI) Follow these guidelines to help you use your MDI properly to get the most benefit from your medication. Have a member of your healthcare team watch you use the inhaler to make suggestions on improving your technique and answer any questions you have. 1. Shake the inhaler 5 or 6 times immediately before use. 2. Remove the cap from the mouthpiece. If t