STUDY DESIGN: This is a retrospective radiologic study OBJECTIVES: The aim of this study is to analyze the signals and configurations of the MRI findings of osteoporotic vertebral fractures and the clinical consequences of each type of the MRI findings. SUMMARY OF THE LITERATURE REVIEW: There have been some reports that have focused on the MR findings for the differentiation of osteoporotic and metastatic fractures, but there are few reports on the characteristics of the early stage of osteoporotic vertebral fractures. MATERIALS AND METHODS: From July 2002 to April 2008, the MRI findings and medical records of 97 patients who were diagnosed with acute or subacute osteoporotic vertebral fractures and who were followed-up for more than 1 year were analyzed. The patients with minor trauma within 3 months before obtaining MRIs and they had decreased bone density were included in this study. Those with fractures due to severe trauma or pathologic causes or normal bone density were excluded. Three spine surgeons evaluated, at three times per each surgeon, the T1-weighted, T2-weighted and fat suppression T1-enhanced sagittal images for the signal of the vertebral body bone marrow and the type of the intravertebral body lesion shape. The relationships between the type of MRI findings and the time from the trauma and the follow up clinical consequences were analyzed. RESULTS: The MRI patterns of 97 patients with 111 fractures of the vertebrae were divided into three types. There were 56 cases of Type I (50.5%), which was defined as diffuse typical signal intensity in the vertebral body, 39 cases (35.1%) of Type II, which was defined as geographic low signal in the center of the vertebral body with typical signal changes, and 16 cases (14.4%). of type III, which was defined as atypical signal intensity or a shape of lesion that did not correspond to type 1 nor type 2. The average time from trauma was 10.8+/-19.0days (0~90) for type I, 19.1+/-24.9days (0~90) for type III and 37.5+/-31.1days (0~90) for type III, which showed differences among each types (p<0.001). CONCLUSIONS: The analysis of the relationship between the time from trauma and the signal intensity and the type of lesion on MRI examination revealed that the low signal intensity in the typical vertebral body signal or an atypical signal or shape were poor prognostic factors of osteoporotic vertebral fracture
Bone Density ; Bone Marrow ; Follow-Up Studies ; Humans ; Medical Records ; Osteoporosis ; Retrospective Studies ; Spine

STUDY DESIGN: Retrospective case-control study OBJECTIVE: To use MRI to assess intervertebral disc degeneration at adjacent levels after spinal fusion and after discectomy. SUMMARY OF LITERATURE REVIEW: Degeneration of adjacent intervertebral discs following lumbar spinal fusion is one of the principal reasons for considering motion preservation techniques, such as placement of an artificial disc. Much attention has recently been directed toward disc morphometric studies using MRI. MATERIALS AND METHODS: Fifty-six patients who underwent spinal surgery for lumbar degenerative disease and who underwent a minimum of 2 years of follow-up MRIs were included in this study. Thirty-four patients were included in the lumbar fusion study group, and 22 patients were included in the discectomy control group. The MRI Thompson classification was used to grade both upper and lower adjacent disc degeneration preoperatively and at the time of last follow-up. RESULTS: There were significant changes in Thompson degenerative grade in the upper adjacent levels for both the fusion group patients and in the discectomy group patients. However, there was no statistically significant difference between the two groups with regard to either the upper or lower adjacent levels (p=0.146 and 0.350, respectively). CONCLUSIONS: In this short-term study comparing MRI outcomes in spinal fusion and discectomy patients, no significant difference in adjacent disc degeneration was observed between the two group.
Case-Control Studies ; Diskectomy ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Intervertebral Disc Degeneration ; Retrospective Studies ; Spinal Fusion

STUDY DESIGN: Retrospective radiologic assessment OBJECTIVES: To assess the clinical importance of MRI for the diagnosis of posterior spinal ligament complex injuries in thoracolumbar fractures. SUMMARY OF LITERATURE REVIEW: Evaluation of spinal instability is important in thoracolumbar fractures. When simple radiography and CT alone are performed, spinal instability may be missed, especially that involving the posterior spinal ligament complex. MATERIALS AND METHODS: Eighty-seven patients who were evaluated using simple radiography, computed tomography (CT), and magnetic resonance imaging (MRI) between March 1994 and March 2003 were included in the study. The local kyphotic angle was measured on lateral radiography, and it was then compared to the fracture pattern on MRI. Statistical analysis was performed using ANOVA. RESULTS: There was no correlation between the local kyphotic angle on radiography and fracture involvement on MRI (p=0.106). In 41 patients who were found to have involvement of the anterior column on CT, 25 had anterior column involvement, 4 had middle column involvement, and 12 had posterior column involvement on MRI. In 36 patients who were found to have involvement of the middle column on CT, 17 had involvement of the middle column and 19 had involvement of the posterior column on MRI. The fractures of the ten patients who were found to have posterior column involvement on CT were all seen on MRI. The coincidence of fracture patterns between CT and MRI, which was evaluated using Cohen's Kappa analysis, was 0.434. The sensitivity of CT compared with MRI was 0.741 in the middle column and 0.243 in the posterior column. CONCLUSIONS: Many thoracolumbar fractures are missed on both simple radiography and CT. MRI is essential for accurate diagnosis of posterior spinal ligament complex injuries, especially when there is involvement above the middle column, or when canal encroachment is seen on CT.
Humans ; Ligaments ; Magnetic Resonance Imaging ; Retrospective Studies ; Spinal Fractures

BACKGROUND: Hematopoietic stem cell transplantation (HSCT) patients need parenteral nutrition because of nausea, vomiting, and mucositis caused by conditioning regimens. The demand for glutamine increases during the HSCT period. We evaluated the effects of glutamine-containing parenteral nutrition on the clinical outcomes of HSCT patients. METHODS: In this retrospective analysis, we reviewed HSCT patients from Seoul National University from August 2013 to July 2017. Depending on their glutamine supplementation status, 91 patients were divided into 2 groups: glutamine group (N=44) and non-glutamine group (N=47). We analyzed the rate of weight change, infection (clinically/microbiologically documented), complications (duration of mucositis and neutropenia, acute graft versus host disease), and 100-days mortality in each group. RESULTS: Regarding the clinical characteristics of the patients, there were no significant differences between the 2 groups except that there was a larger proportion of myeloablative conditioning regimen in the glutamine group (P=0.005). In the glutamine group, the average number of days of glutamine use, parenteral nutrition, and mucositis was 7.6±1.4, 14.6±9.9, and 13.3±9.5, respectively. Furthermore, multivariate analysis revealed odds ratios of 0.37 (95% CI, 0.14–0.96; P=0.042) and 0.08 (95% CI, 0.01–0.98; P=0.048) for clinically documented infection and 100-days mortality, respectively, in the glutamine group. CONCLUSION: Results showed that the glutamine group had less clinically documented infection and 100-days mortality than the non-glutamine group, but the other outcomes did not show significant differences. The extended duration of glutamine supplementation according to the period of total parenteral nutrition and mucositis should be considered.
Adult ; Glutamine ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; Humans ; Mortality ; Mucositis ; Multivariate Analysis ; Nausea ; Neutropenia ; Odds Ratio ; Parenteral Nutrition ; Parenteral Nutrition, Total ; Retrospective Studies ; Seoul ; Transplants ; Vomiting

We encountered a case of coincidental congenital complete absence of the posterior arch of the atlas and the unilateral lumbosacral articular process. A 21-year-old man presented with pain in the lower back and right buttock. The patient was a swimming coach. On plain radiography, computerized tomography and magnetic resonance imaging, the congenital absence of the unilateral lumbosacral articular process was noted. Six months later, the patient developed severe neck pain and suboccipital headaches without neurological signs. On plain radiography and computerized tomography, the congenital complete absence of the posterior arch of the atlas was noted. Magnetic resonance imaging showed no abnormal signs originating from the posterior spinal cord. There was no segmental instability. For this case, the lower back pain and neck pain were managed by conservative treatment. To the best of our knowledge, this is the first case of a coincidental congenital complete absence of the posterior arch of the atlas and the unilateral lumbosacral articular process.
Buttocks ; Headache ; Humans ; Low Back Pain ; Magnetic Resonance Imaging ; Neck Pain ; Radiography ; Spinal Cord ; Swimming ; Young Adult

BACKGROUND: Subepithelial fibrosis plays a major role in the development of irreversible airway obstruction in asthma. Eosinophils are major effector cells in allergic inflammation, and it has been suggested that eosinophil-derived mediators such as transforming growth factor-beta (TGF-beta) play a role in the pathogenesis of airway remodeling. OBJECTIVE: The aim of this study was to evaluate whether eosinophils activated by IL-5 plays a major role in the collagen gel contraction by lung fibroblasts. METHOD: Various cell numbers of lung fibroblasts were cultured in collagen gels to determine the appropriate numbers of fibroblasts. Purified human peripheral blood eosinophils were activated by IL-5 for 3 days, and TGF-beta mRNA expression was evaluated using semiquantitative RT- PCR. The cultured supernatants with or without TGF-beta were added to the collagen gel media with lung fibroblasts, and collagen gel diameter was serially measured to evaluate collagen gel contraction. RESULTS: The amount of collagen gel contraction was significantly associated with the number of fibroblasts (p< 0.05), and TGF-beta significantly contracted the collagen gel to contract in a dose-dependent manner (p< 0.05). However, supernatants derived from IL-5-activated eosinophils did not contract the collagen gel compared to controls (p> 0.05). Moreover, expression of TGF-beta mRNA in eosinophils was the same before and after stimulus of IL-5. CONCLUSION: Activated eosinophils by IL-5 may play a minor role in the collagen gel contraction by lung fibroblasts.
Airway Obstruction ; Airway Remodeling ; Asthma ; Cell Count ; Collagen* ; Eosinophils* ; Fibroblasts* ; Fibrosis ; Gels ; Humans ; Inflammation ; Interleukin-5 ; Lung* ; Polymerase Chain Reaction ; RNA, Messenger ; Transforming Growth Factor beta