Cross-sectional open population based study (nested in a prospective cohort study).
To explore the association of the different individual radiographic features, including osteophytes and disc space ...narrowing, with self-reported low back pain (LBP). Different definitions of lumbar disc degeneration with self-reported LBP and disability were considered in a large open population sample. Furthermore, in order to disentangle the discrepancies in reported strength of the associations, we characterized the frequency of the different individual radiographic features of lumbar disc degeneration and definitions of lumbar disc degeneration, as well as their association with LBP status, by age, gender, and vertebral level.
Currently within the literature, there have been no studies that have explored different definitions of lumbar disc degeneration and their association with LBP within one study sample.
The intervertebral disc spaces (L1/2 to L5-S1) were evaluated for the presence and severity of anterior osteophytes and disc space narrowing using a semiquantitative score (grade 0-3). Logistic regression was used to determine the association between these individual radiographic features of lumbar disc degeneration and different definitions of lumbar disc degeneration for LBP.
Lumbar radiographs were scored for 1204 men, and 1615 women. Osteophytes were the most frequent radiographic feature observed, with men having the greatest frequency. Disc space narrowing was more frequent in women than men. Both radiographic features increased in frequency with age.Disc space narrowing appeared more strongly associated with LBP than osteophytes, especially in men (odds ratio OR = 1.9; 95% confidence interval CI: 1.4-2.8). Disc space narrowing at 2 or more levels appeared more strongly associated with LBP than disc space narrowing at only 1 level (OR = 2.4; 95% CI: 1.6-3.4). After excluding level L5-S1, the strength of almost all associations increased.
We are the first to report different possible lumbar disc degeneration definitions and their associations with LBP. Disc space narrowing at 2 or more levels appeared more strongly associated with LBP than other radiographic features, especially after excluding level L5-S1.
Summary
Background It is well known that inflammation has a profound impact on the neuromuscular apparatus of the gastrointestinal tract during the inflammatory insult and in periods of remission, ...at the site of inflammation and at distance from this site. The importance of this interaction is illustrated by the higher prevalence of functional gut disorders in patients with inflammatory bowel disease.
Aims To document the epidemiological and clinical significance of functional alterations of gut motility and sensitivity in patients with inflammatory bowel disease and to formulate potential pathophysiological mechanisms.
Results and conclusions Functional gut disorders occur frequently in patients with inflammatory bowel disease, both during inflammatory episodes and in periods of remission, and have a major impact on their quality of life. The clinical manifestations of these motility and sensitivity disorders vary and are often difficult to treat, mainly because therapeutic guidelines and specific diagnostic tests to distinguish inflammatory bowel disease from functional gut disorders are lacking. Chronic bowel inflammation results in a complicated interaction between neuroendocrine serotonin‐predominant cells of the mucosa, inflammatory cells (particularly mast cells) in the submucosa, the intrinsic and extrinsic innervation and the muscular apparatus including the interstitial cells of Cajal. The outcome of this interaction is a perturbation of gastrointestinal motor function, both locally and at distance from the site of inflammation and during both acute inflammation and remission.
A palynological analysis with marine palynomorphs (dinoflagellate cysts, acritarchs, green algae) and terrestrial palynomorphs (pollen and spores) of the Kasterlee and Poederlee formations provides ...new insights in the depositional history at the southern border of the North Sea basin (northern Belgium) around the Miocene–Pliocene transition. Dinoflagellate cyst stratigraphy constrains the age of the Kasterlee Formation in the Oud-Turnhout borehole between 7.5 and 5.32 Ma. The upper boundary of the formation can be correlated with sequence boundary Me2 at 5.73 Ma of Hardenbol and co-workers, which further constrains its age to the time interval 7.5–5.73 Ma. The palynomorph assemblages reflect a near-coast depositional environment. Where present, the Kasterlee Formation thus terminates the Miocene series in northern Belgium. The overall shallow nature of the latest Miocene deposits is related to a sea-level lowering caused by the onset of globally cooling conditions. For the first time, palynology is applied to estimate the age of the Poederlee Formation, suggesting it was deposited during the Mid-Pliocene warm period. Dinoflagellate cysts and sequence stratigraphy together constrain the age of the unit between 3.21 and 2.76 Ma, and possibly even between 3.21 and 3.15 Ma. The Poederlee Formation was deposited in neritic environments, which shoaled in the upper part of the unit as a consequence of the decreasing availability of accommodation space. We demonstrate that the magnitude of the hiatus between the Miocene and Pliocene series varies strongly at the southern boundary of the North Sea Basin, and lasts in the Antwerp area c. 3.2 million years and c. 2.52 million years in the Campine area.
Organic-walled palynomorph assemblages from the Kasterlee Formation in northern Belgium provide new insights into the Late Miocene depositional history and palaeoenvironments of the southernmost ...North Sea Basin. Ranges of key dinoflagellate cysts constrain the unit between 7.5 and 5.32 Ma, that is, a latest Tortonian to Messinian age. The palynomorph assemblage is characterized, amongst others, by Geonettia clineae, an opportunistic species that thrives in mesotrophic, coastal embayments with a low sediment influx. This environmental setting is corroborated by the notable presence of Gramocysta verricula, a species with preference for shallow marine environments. The occurrence of species of the fresh water green alga Pediastrum indicates manifest river discharge in a near-shore environment or embayment. The coastal depositional environment mirrored by the palynomorphs of the Kasterlee Formation succeeds the distinct transgressive and fully marine environments of the underlying Diest Formation in the Campine area. The results from the palynological study, combined with lithological and geophysical data, show that both Upper Miocene formations are two distinct depositional cycles separated by an erosional or regressive phase. The upper boundary of the Kasterlee Formation is correlated with the Me2 sequence boundary at 5.73 Ma. The Kasterlee Formation is herein formally moved from the Lower Pliocene series to the Upper Miocene series. The coastal environment, probably characterized by a shoaling phase, recorded at the border of the southern North Sea Basin, matches the global record of regressive phases in Messinian sedimentary sequences, which are linked to cooling and increasing global ice volume.
To investigate and compare the opinions and expectations regarding the radiology report of radiologists and referring clinicians and to identify trends, discordance, and discontent.
A total of 3884 ...clinicians and 292 radiologists were invited by e-mail to participate in two internet surveys, COVER (for clinical specialists and general practitioners) and ROVER (for radiologists). Respondents were asked to state their level of agreement with 46 statements according to a Likert scale. Dichotomized results were compared by using the χ(2) statistic.
Eight hundred seventy-three completed forms were prepared for analysis, corresponding to a response rate of 21%. Most clinicians declared themselves satisfied with the radiology report. A large majority considered it an indispensable tool and accepted that the radiologist is the best person to interpret the images. Nearly all agreed that they need to provide adequate clinical information and state clearly what clinical question they want to have answered. Itemized reporting was preferred for complex examinations by both the clinicians and the radiologists. A majority in both groups were convinced that learning to report needs to be taught in a structured way.
The surveys emphasize the role of the radiologist as a well-informed medical imaging specialist; however, some of the preferences of radiologists and clinicians diverge fundamentally from the way radiology is practiced and taught today, and implementing these preferences may have far-reaching consequences.
Calculated gas/vapor–liquid two-phase co-current horizontal flow regimes are compared with experimental data, taken from the Baker chart. For the calculation of the two-phase flow regimes, use is ...made of the well-known volume of fluid (VOF) multiphase flow model that uses a piecewise linear interface calculation (PLIC) interface reconstruction method in each computational cell, implemented in a computational fluid dynamics (CFD) code.
The flow regimes for water–air flow are reproduced. All simulations give good agreement with the flow regimes expected from the Baker chart. Horizontal flow regimes for two-phase liquid–vapor gasoil flow are also reproduced. To the best of our knowledge, this is the first time that the flow regimes for gasoil liquid–vapor flow as predicted by the Baker chart are simulated. Again, a good agreement between the simulated and expected flow regime is obtained. All horizontal flow regimes appearing in the Baker chart can thus be calculated using CFD.
Elucidation of the biological framework underlying the development of neurofibromatosis type 1 (NF1)–related symptoms has proved to be difficult. Complicating factors include the large size of the
...NF1 gene, the presence of several
NF1 pseudogenes, the complex interactions between cell types, and the
NF1-haploinsufficient state of all cells in the body. Here, we investigate three patients with distinct NF1-associated clinical manifestations (neurofibromas only, pigmentary changes only, and association of both symptoms). For each patient, various tissues and cell types were tested with comprehensive and quantitative assays capable of detecting low-percentage
NF1 mutations. This approach confirmed the biallelic
NF1 inactivation in Schwann cells in neurofibromas and, for the first time, demonstrated biallelic
NF1 inactivation in melanocytes in NF1-related café-au-lait macules. Interestingly, both disease features arise even within a background of predominantly
NF1 wild-type cells. Together, the data provide molecular evidence that (1) the distinct clinical picture of the patients is due to mosaicism for the
NF1 mutation and (2) the mosaic phenotype reflects the embryonic timing and, accordingly, the neural crest–derived cell type involved in the somatic
NF1 mutation. The study of the affected cell types provides important insight into developmental concepts underlying particular NF1-related disease features and opens avenues for improved diagnosis and genetic counseling of individuals with mosaic NF1.
Abstract Objective To investigate the relation between lumbar disc degeneration (LDD) and all type of osteoporotic (OP) fractures including vertebral. Methods This study is part of the Rotterdam ...study, a large prospective population-based cohort study among men and women aged 55 years and over. In 2819 participants spine radiographs were scored for LDD (osteophytes and disc space narrowing (DSN)) from L1 till S1, using the Lane atlas. Osteoporotic (OP) fracture data were collected and verified by specialists during 12.8 years. We considered two types of vertebral fractures (VFx): Clinical VFx (symptomatic fractures recorded by medical practitioners) and Radiographic VFx (using the McCloskey–Kanis method). Meta-analysis of published studies reporting an association of LDD features and VFx was performed. Differences in Bone Mineral Density (BMD) between participants with and without LDD features were analyzed using ANOVA. Risk of OP-fractures was analyzed using Cox regression. Results In a total of 2385 participants, during 12.8 years follow-up, 558 suffered an OP-fracture. Subjects with LDD had an increased OP fracture risk compared to subjects without LDD (HR: 1.29, CI: 1.04–1.60). LDD-cases have between 0.3 and 0.72 standard deviations more BMD than non-cases in all analyzed regions including total body BMD and skull BMD (P < 0.001). Only males with LDD had increased risk for OP-fractures compared to males without LDD (adjusted-HR: 1.80, 95%CI: 1.20–2.70, P = 0.005). The risk was also higher for VFx in males (HR: 1.64, CI: 1.03–2.60, P: 0.04). The association LDD–OP-fractures in females was lower and not significant (adjusted-HR: 1.08, 95%CI: 0.82–1.41). Meta-analyses showed that the risk of VFx in subjects with LDD has been studied only in women and there is not enough evidence to confidently analyze the relationship between LDD-features (DSN or/and OPH) and VFx due to low power and heterogeneity in phenotype definition in the collected studies. Conclusions Male subjects with LDD have a higher osteoporotic fracture risk, in spite of systemically higher BMD.
Clifford analysis may be regarded as a higher-dimensional analogue of the theory of holomorphic functions in the complex plane. It has proven to be an appropriate framework for higher-dimensional ...continuous wavelet transforms, based on specific types of multi-dimensional orthogonal polynomials, such as the Clifford–Hermite polynomials, which form the building blocks for so-called Clifford–Hermite wavelets, offering a refinement of the traditional Marr wavelets. In this paper, a generalization of the Clifford–Hermite polynomials to a two-parameter family is obtained by taking the double monogenic extension of a modulated Gaussian, i.e. the classical Morlet wavelet. The eventual goal being the construction of new Clifford wavelets refining the Morlet wavelet, we first investigate the properties of the underlying polynomials.
Objective
Lumbar disc degeneration (LDD) is a serious social and medical problem which has been shown to be highly heritable. It has similarities with peripheral joint osteoarthritis (OA) in terms of ...both epidemiology and pathologic processes. A few known genetic variants have been identified using a candidate gene approach, but many more are thought to exist. GDF5 is a gene whose variants have been shown to play a role in skeletal height as well as predisposing to peripheral joint OA. In vitro, the gene product growth differentiation factor 5 has been shown to promote growth and repair of animal disc. This study was undertaken to investigate whether the GDF5 gene plays a role in LDD.
Methods
We investigated whether the 5′ upstream single‐nucleotide polymorphism (SNP) variant rs143383 was associated with LDD, using plain radiography and magnetic resonance imaging to identify disc space narrowing and osteophytes, in 5 population cohorts from Northern Europe.
Results
An association between LDD and the SNP rs143383 was identified in women, with the same risk allele as in knee and hip OA (odds ratio 1.72 95% confidence interval 1.15–2.57, P = 0.008).
Conclusion
Our findings in 5 population cohorts from Northern Europe indicate that a variant in the GDF5 gene is a risk factor for LDD in women. Many more such variants are predicted to exist, but this result highlights the growth and differentiation cellular pathway as a possible route to a better understanding of the process behind lumbar disc degeneration.
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