High Signal Changes Research Articles

Dynamic glucose-enhanced MRI of gliomas: A preliminary clinical application.

The study aimed to investigate the feasibility of dynamic glucose-enhanced (DGE) MRI technology in the clinical application of glioma. Twenty patients with glioma were examined using a preoperative DGE-MRI protocol before clinical intervention. A brief hyperglycemic state was achieved by injecting 50 mL of 50% w/w D-glucose intravenously during the DGE imaging. The total acquisition time for the DGE was 15 min. Area-under-the-curve (AUC) images were calculated using the DGE images. AUC2-7min values of the glioma core, margin area, edema area, and contralateral brain parenchyma were compared using Mann-Whitney U tests. Overall, gray and white matter areas in the AUC images showed relatively low DGE signal change and bilateral symmetry. However, the tumor cores displayed a significant hyperintensity. A high DGE signal change was also seen in the necrotic, cystic, and cerebrospinal areas. These results show that DGE MRI is a feasible technique for the study of brain tumors as part of a clinical exam. Importantly, DGE MRI showed enhancement in areas confirmed histopathologically as tumors, whereas Gd T1w MRI did not show any enhancement in this area. Since the D-glucose molecule is smaller than Gd-based contrast agents, DGE MRI may be more sensitive to subtle blood-brain barrier disruptions, thus potentially providing early information about possible malignancy. These findings provide a new perspective for the further exploration and analysis of D-glucose uptake in brain tumors.

Direct anterior decompression in patients with ossification of the posterior longitudinal ligament significantly relieves short-segment spinal cord high signal

BackgroundIn patients with ossification of the posterior longitudinal ligament of the cervical spine (OPLL), high spinal cord signal (HCS) is frequently observed in the spinal cord of the corresponding segment. However, studies on the differences in the improvement of high spinal cord signal due to different surgical approaches are limited. The aim of this study was to investigate the improvement of high spinal cord signal in long and short segments with different choices of surgical approaches.MethodsIn this study, we conducted a meticulous review of medical records for patients diagnosed with ossification of the posterior longitudinal ligament (OPLL). Demographic variables, including gender, age, and body mass index (BMI), were systematically recorded. We evaluated the severity of neurological impairment using the Japanese Orthopaedic Association (JOA) scores both preoperatively and at multiple postoperative follow-up points. Neurological assessments were complemented by serial magnetic resonance imaging (MRI) T2-weighted imaging (T2WI) to measure the extent of high-signal changes (HCS) in the spinal cord, and the alteration of the HCS was quantified by the SCR (the ratio between the signal intensity value of the HCS region and the signal intensity value of the normal spinal cord region at C7-T1).ResultsIn the short-segment high signal change (HCS) group, comparisons of JOA score improvement (Recovery1) and HCS improvement (CR1) at 6 months postoperatively did not demonstrate significant differences between the surgical approaches (P > 0.05; Table 1). However, at the 2-year follow-up, patients who underwent anterior surgery exhibited significantly greater improvements in both JOA scores (Recovery2) and HCS (CR2), with statistical significance achieved (P < 0.05; Table 1). In contrast, in the long-segment HCS group, there was no significant difference between the anterior and posterior surgical approaches in terms of JOA improvement and HCS improvement at 6 months and 2 years postoperatively (P > 0.05; Table 2).ConclusionsIn patients with OPLL who present with spinal cord high signal, anterior surgery by resection of the ossified posterior longitudinal ligament and direct decompression is more conducive to regression of small spinal cord high signal and improvement of clinical neurological function if the extent of spinal cord high signal is small.

Risk factors affecting cervical spondylotic myelopathy complicated with traumatic central cord syndrome and the efficacy of different treatment options

ObjectiveTo analyze the influencing factors and treatment options of cervical spondylotic myelopathy (CSM) complicated with traumatic central cord syndrome (TCCS).MethodsA total of 243 patients with CSM admitted to our hospital from January 2021 to September 2022 were retrospectively analyzed, and then divided into the control group (n = 152) and the observation group (n = 91) according to the presence or absence of concurrent TCCS. The clinical data and imaging data of the two groups were compared, and multivariate logistic regression was used to analyze the influencing factors of CSM complicated with TCCS. Patients in the observation group were further divided into the zero notch anterior cervical interbody fusion device (Zero-P) group (n = 45) and the cervical spine locking plate (CSLP) group (n = 46) according to the treatment mode, and the perioperative indexes of the two groups were compared. The treatment effects were evaluated by the American Spinal Injury Association (ASIA) and the Japanese Orthopedic Association (JOA) before surgery, 1 week after surgery and 6 months after surgery. The height of intervertebral space and the cervical lordosis angle were measured.ResultsMultivariate logistic regression analysis showed that the injury mechanism (hyperextension injury), hand muscle weakness, cervical instability, age, degree of cervical spinal stenosis, degree of cervical spinal cord compression, and changes in intramedullary high signal were the risk factors, while the type of compression (soft), ASIA score and JOA score were the protective factor for CSM complicated with TCCS (P < 0.05). Patients in Zero-P group had much shorter operation time and hospitalization time than these in CSLP group (P < 0.05). The cervical lordosis angle and intervertebral space height at 1 week and 6 months after operation in the two groups were both largely higher than these before operation, and the cervical lordosis angle and intervertebral space height in the Zero-P group were significantly higher than these in the CSLP group one week after surgery (P < 0.05). The ASIA score and JOA score were obviously increased in the two groups 1 week and 6 months after surgery, and the ASIA score and JOA score in the Zero-P group were significantly higher than these in the CSLP group at 1 week after surgery (P < 0.05).ConclusionThe mechanism of TCCS in CSM is still controversial, which it is generally believed to be caused by cervical hyperextension injury. The clinical symptoms are diverse, and the treatment methods are also different. This study shows that the mechanism of injury, type of compression, hand muscle weakness, cervical instability, age, cervical stenosis compression, and intramedullary high signal changes are all risk factors for CSM complicated with TCCS. Early identification of risk factors and targeted interventions can effectively reduce the complicated rate of TCCS. Zero-P and CSLP surgical fixation have good efficacy in the treatment of TCCS, and there is little difference in efficacy between the two. However, Zero-P fixation surgery has the advantages of short operation time and fast postoperative recovery.

Assessing the newly proposed MRI criteria for diagnosing sporadic Creutzfeldt-Jakob disease.

Sporadic Creutzfeldt-Jakob disease (sCJD) is a frequent differential diagnostic consideration in patients with rapidly progressive dementia (RPD). Fortunately, in the last 2 decades there has been substantial cumulative improvements in sCJD biomarkers, particularly those based on imaging and cerebrospinal fluid (CSF) interrogation. Brain MRI is a very frequently employed investigation in patients with RPD, often utilized quite early in the evaluation and thereby offering a potentially key role in prompting initial concerns for sCJD. Extant conventional MRI criteria for sCJD diagnosis are relatively stringent, requiring fluid attenuated inversion recovery (FLAIR) or diffusion weighted imaging (DWI) high signal changes in 2 or more cortical regions (excluding frontal) or in both the caudate and putamen. Challenging these conventional criteria, a recent publication described improved sensitivity and unchanged specificity if MRI criteria were arguably less rigorous, requiring DWI high signal changes in only 1 or more of 7 discrete brain regions: frontal, parietal, occipital or temporal cortices, as well as the caudate, putamen or thalamus. The aim of the current study was to test the diagnostic performance of this proposed change in MRI criteria in the Australian context and compare it with conventional criteria, as well as 2 other stringent sets of criteria, predicting that a similar improved sensitivity with unchanged specificity would be observed when the proposed criteria were utilized. Sixty-five definite sCJD cases were compared with 63 age- and sex-matched controls. Radiological review of all MRIs applying the different sets of MRI criteria was undertaken by a blinded neuroradiologist, very experienced in CJD interpretation, with independent assessment of 71 MRIs performed by a second blinded neuroradiologist less experienced in sCJD imaging findings. Our study found the sensitivity of the recently proposed MRI criteria (92.3%) to be comparable to that originally reported (90-95%) and also equivalent to the conventional MRI diagnostic criteria (92.3%), while the specificities were also quite similar between the conventional MRI criteria (87.3%) and proposed criteria (85.7%), with the latter lower than previously reported. Negative predictive values and positive predictive values were also very similar between the conventional and proposed MRI criteria. Other MRI criteria assessed were associated with unacceptably low sensitivity for clinical use. Inter-rater reliability as assessed by intra-class correlation coefficients (ICC) revealed moderate reliability for the conventional and proposed MRI criteria, modestly better in the former and when the frontal lobe was retained versus excluded in comparisons.

Abnormal lateral meniscal signal in MRI after patellar dislocation does not indicate a meniscal tear: MR findings with surgical correlation

BackgroundCombined injuries observed with first-time lateral patellar dislocation (LPD) of the knee, particularly significant soft tissue injury, can inform surgical intervention criteria. PurposeThe purpose of this study was to compare MRI findings in LPD to surgical correlation concerning meniscal pathology as a guide for surgical management. Study designRetrospective case series, Level of evidence, 4. MethodsA retrospective review was conducted of 355 cases of patients with lateral patellar dislocation from 2012 to 2022. Imaging was reviewed by musculoskeletal radiologists blinded to surgical results for evidence of soft tissue injury, and associated arthroscopic data and operative reports were reviewed. ResultsOut of 44 cases of LPD in 42 patients who underwent MPFL reconstructive surgery, 27 (61%) cases had grade 2a or higher signal changes in the anterior horn of the lateral meniscus, of which 10 (23%) had grade 3 signal changes. There were zero cases of meniscal tear in these cases upon review of operative reports and arthroscopic images. ConclusionMRI findings of signal alterations in the lateral meniscus post-LPD may not indicate an actual tear. This could aid in surgical decision-making in primary LPD management.

Magnetic resonance imaging findings related to sacroiliac joint pain in high-performance athletes.

Sacroiliac joint (SIJ) dysfunction in athletes affects competitiveness. However, the pathology and imaging features have not been clarified. To clarify the association between SIJ pain and MRI findings in high-performance athletes. Fifty-two Japanese high-performance athletes with or without SIJ pain were recruited. MRI short tau inversion recovery (STIR) semi-coronal and semi-axial images of their SIJs were taken. The relationships between high-signal changes in MRI-STIR and SIJ pain and pain duration were investigated. Six athletes with continuous SIJ pain were prospectively followed. The proportion of athletes with high-signal changes in the SIJ was significantly higher among athletes with SIJ pain for one month or more (76.9%, 10/13) than among athletes with SIJ pain for less than one month (18.2%, 2/11) and among athletes without SIJ pain (28.6%, 8/28). High-signal changes on painful SIJs were most often present in the sacrum. In three of the six athletes who were prospectively followed, the high-signal area and intensity on MRI both diminished as their symptoms improved. High-signal changes of the SIJ on MRI-STIR images in high-performance athletes may reflect their SIJ pain.

Neuropsychological, neuroimaging and autopsy findings of butane encephalopathy

BackgroundButane is an aliphatic hydrocarbon used in various commercial products. While numerous reports of sudden cardiac-related deaths from butane inhalation have been described, butane-associated acute encephalopathy has rarely been reported.Case presentationA 38-year-old man presented with cognitive dysfunction after butane gas inhalation. Neuropsychological test results showed impairments in verbal and visual memory, and frontal executive function. Diffusion weighted MRI revealed symmetric high-signal changes in the bilateral hippocampus and globus pallidus. FDG-PET demonstrated decreased glucose metabolism in the bilateral precuneus and occipital areas and the left temporal region. At the 8-month follow-up, he showed still significant deficits in memory and frontal functions. Diffuse cortical atrophy with white matter hyperintensities and extensive glucose hypometabolism were detected on follow-up MRI and FDG-PET, respectively. Brain autopsy demonstrated necrosis and cavitary lesions in the globus pallidus.ConclusionsOnly a few cases of butane encephalopathy have been reported to date. Brain lesions associated with butane encephalopathy include lesions in the bilateral thalamus, insula, putamen, and cerebellum. To the best of our knowledge, this is the first report on bilateral hippocampal and globus pallidal involvement in acute butane encephalopathy. The pathophysiology of central nervous system complications induced by butane intoxication is not yet fully understood. However, the direct toxic effects of butane or anoxic injury secondary to cardiac arrest or respiratory depression have been suggested as possible mechanisms of edematous changes in the brain after butane intoxication.

Nanofibers as optical sensors for model VOCs dispersed in aqueous phase

AbstractNanofibers mats, prepared from poly(vinyl chloride) (PVC) containing dispersed dye Nile red (NR) were applied in a proof of concept study as optical sensors for Volatile Organic Compounds (VOCs) dispersed in an aqueous phase. Benefiting from the solubility of the dye, and in some cases, also of the polymer in model solvents belonging to the group of VOCs, an increase of emission was observed for increasing solvent concentration in the sample. The optical signal formation was observed regardless if only the dye or both dye and PVC were soluble in the tested solvent. In both cases, high sensitivity emission increases for increasing VOCs present in the aqueous phase were observed within the range of concentration of model analytes: from 200 ppm of m‐xylene or from 300 ppm of styrene, to up to ca 1500 ppm. The obtained higher detection limit was lower compared to films of PVC containing the dye due to the lower availability of the material to be dissolved by analyte – solvent. The large surface area of nanofibers was useful in the detection, leading to higher signal changes compared to films.

Lyophilized bovine acellular tendon linear fiber material for the reconstruction of attachment structure of paraspinous muscles: an animal in vivo study

Low back pain is common after lumbar spine surgery and the injury from extensive detachment of paraspinal muscles during the surgery may play a vital role. Previously, we prepared a bovine acellular tendon fiber (ATF) material through lyophilization and proved that it could retain its original fibrillar structure and mechanical properties. The objective of this study is to evaluate the effectiveness of this new fiber material used for attachment structure reconstruction of paraspinal muscle. Defect of spinous process, interspinous and supraspinous ligament was established on lumbar spine in rabbit and rat and ATF linear material was implanted to reconstruct the attachment structure. Ultrasound showed the cross-sectional area of the paraspinal muscle in ATF group was larger than that of control group in rats. MRI showed the irregular shape and high signal changes in control group, but regular shape and uniform signal in the ATF group in rabbit. For Electromyogram, the frequency of evoked potential in control group was lower than ATF group and normal rats. HE and Masson staining showed good tissue healing, and immunohistochemical results showed the immune rejection of ATF is significantly lower than that of suture. Reconstruction of the attachment structure of paraspinous muscles with ATF linear material could maintain the morphology, volume and function of paraspinal muscle. ATF material has the potential to be used to manufacture personalized ligaments and other tissue engineering scaffolds.Graphical abstract

Segmental Zoster Paresis with Late-Onset Skin Rash Mimicking a Herniated Cervical Disc: A Case Report

Segmental zoster paresis (SZP) of the limbs, characterized by focal weakness of the extremity, is recognized as a rare complication of herpes zoster that can lead to a misdiagnosis of other radiculopathies or musculoskeletal problems. Here, we present a rare case where the patient experienced severe pain and weakness of the right upper extremity caused by SZP. A 58-year-old man came to the hospital with severe right upper extremity radicular pain. Cervical magnetic resonance imaging of the spinal cord showed disc protrusion at the C5-6 level with a high signal change. Anterior cervical discectomy and fusion was performed. On the first and second postoperative days, the patient’s symptoms showed slight improvements. However, on the fourth postoperative day, the patient experienced a right shoulder drop along with exacerbated radicular pain and presented a herpetic rash on the right extremity. The patient showed a dramatic improvement in pain and weakness after taking antiviral medication and undergoing a fluoroscopic-guided right C6 selective nerve root block. He fully recovered from his symptoms after 12 weeks of rehabilitation and physical therapy. This rare case involved SZP which was misunderstood as a herniated cervical disc. If a patient complains of severe pain with motor weakness inconsistent with radiologic findings, SZP should be discriminated from other possible diagnosis.

Case report long segment myelitis secondary to neuro melioidosis

BackgroundNeuro-melioidosis, comprising 4% of all cases of melioidosis carries a risk of high morbidity and mortality. We describe two Sri Lankan patients presenting with long segment myelitis secondary to melioidosis.Case presentationCase 1: 47-year-old male presented with right side hemiparesis which progressed rapidly to quadriparesis. Initial cerebro spinal fluid (CSF) analysis revealed protein 76 mg/dl and glucose 72 mg/dl but without a cellular reaction. MRI spine revealed long segment myelitis with contrast enhancement. The patient was treated with intravenous methyl prednisolone pulses (IV MPP) and plasma exchanges(PLEX) on suspicion of an immune mediated myelitis but without success. A repeat MRI revealed high signal changes in the brain stem and along the entire spinal cord with contrast enhancement. MRI brain after treatment with MPP/PLEX showed enhancing hyper intensities along the corticospinal tracts. The repeat CSF revealed protein 1187 mg/dl, glucose 78 mg/dl, lymphocytes 1600/mm3 and neutrophils 10,200/mm3. CSF culture has become positive for Burkholderia pseudomallei. Serum melioidosis antibody titre was 1: 320. He was started on IV meropenem with oral cotrimoxazole for 12 weeks followed by oral co trimoxazole. But he had poor clinical recovery.Case 2: 47-year-old female presented with bilateral lower limb weakness for 1-week duration. On examination, she had flaccid paraparesis with a sensory level at T11. Inflammatory markers were elevated. CSF analysis revealed protein 50 mg/dl with lymphocytes 172/mm3. MRI pan spine revealed a long segment myelitis. Serum melioidosis antibody titre was 1: 640. She was treated with IV meropenem for 8 weeks followed by oral co-trimoxazole with an excellent clinical and radiological response.ConclusionNumerous neurological manifestations have been described with melioidosis, however long segment myelitis with a positive CSF culture is not yet reported. These cases signify the importance of considering melioidosis as a differential in patients with long segment myelitis especially in endemic areas.

P.15 Symptomatic DMD carrier as a differential diagnosis in patients presenting asymmetrical limb weakness

Duchenne/Becker muscular dystrophy (DMD) is one of the most common myopathies, characterized by an X-linked recessive disease. Asymmetrical limb weakness is rarely present in patients with muscle diseases such as ANO5-related myopathy, facioscapulohumeral muscular dystrophy, and sporadic inclusion body myositis. We report two cases of symptomatic DMD carriers presenting with asymmetrical limb weakness. A 50-year-old woman visited the department of neurology presenting with slowly progressive weakness of the limbs since childhood. A neurological examination revealed a weakness of the right arm and both legs, which were graded 4 as MRC system. Muscle MRI showed asymmetric fatty infiltration of the limbs, markedly affected by right biceps brachii, latissimus dorsi, and gastrocnemius. Immunohistochemistry (IHC) of the C-terminal region of the dystrophin gene presented several scattered stain-negative fibers. Genetic analysis revealed c.6703delG (p.Ser2235Ilefs*12, NM_004006.2) mimicking single exon 46 deletion in MLPA. A 29-year-old female presented with an elevated level of serum creatine kinase without subjective weakness. Neurologic examination showed the subtle motor weakness of the right arm, graded 4+. Muscle MRI revealed high T1 signal change on the right biceps femoris, which was not affected clinically, in addition to right biceps brachii and latissimus dorsi. IHC showed dystrophic changes and a mosaic pattern of dystrophin expression. The diagnosis was confirmed by MLPA, revealing heterozygous deletion of exon 44 in the DMD gene. Asymmetrical limb weakness can be a remark for the diagnosis of symptomatic DMD carrier. Furthermore, muscle MRI is more sensitive in detecting pathologic changes than routine neurologic examination. And single-base point mutation can mimick the exon deletion in MLPA, which needs sequencing analysis in a case of single exon deletion in DMD. Therefore, a multidisciplinary approach is mandatory for final diagnosis and a better understanding of symptomatic DMD carriers.

Surgical Outcome and Features of C7 Spondylolisthesis with Myelopathy: A Case Series.

Reports of myelopathy with C7 anterior spondylolisthesis are extremely rare, and the surgical outcomes, clinical features, and their effects remain unknown. We describe six patients who underwent surgery for C7 spondylolisthesis with myelopathy. Six patients who underwent operative treatment for C7 spondylolisthesis with myelopathy were retrospectively reviewed. C7 spondylolisthesis was defined as an anterior slippage of more than 2 mm on X-ray or computed tomography (CT). The images were evaluated using radiography, magnetic resonance imaging (MRI), and CT. Clinical outcomes were evaluated using the thoracic Japanese Orthopedic Association (T-JOA) score and Frankel grade. Facet joint arthrosis was observed in all patients at the C7/T1 level. MRI revealed a juxta-facet cyst in the spinal segment in three cases and a high signal change in four cases. We could visualize C7 anterior slippage from the lateral radiograph in one case. The mean time from onset to diagnosis was 95 (range, 7-280) months. Posterior spinal fusion using pedicle screws and interlaminectomy was performed in five cases. Cystectomy with partial laminectomy was performed in one case with a juxta-facet cyst. The mean JOA score was 6±0.7 preoperatively and improved to 9±1.5 at the final follow-up. The Frankel grades of all patients improved by more than one grade. In this study, myelopathy with C7 spondylolisthesis was relatively severe, and we believe that the mechanical stress between the rigid thoracic vertebrae and the movable cervical spine may cause C7 spondylolisthesis. Posterior spinal fusion and partial laminectomy for C7 spondylolisthesis with myelopathy resulted in satisfactory outcomes.

Relationship between Severity of Disease and Postoperative Neurological Recovery in Patients with Cervical Spondylotic Myelopathy Combined with Developmental Spinal Stenosis.

Objective The study aimed to investigate the correlation between the severity of disease and postoperative neurological recovery in patients with cervical spondylotic myelopathy (CSM) combined with developmental spinal stenosis. Methods A retrospective analysis of the clinical data of 114 CSM patients combined with developmental spinal stenosis admitted to our hospital from June 2019 to June 2020 was performed. All of the patients who underwent posterior cervical unidoor vertebroplasty were divided into the mild, moderate, and severe groups according to the Torg–Pavlov ratio. The clinical data including patients' age, course of spinal cord high signal change, and first onset age were collected. The recovery time, preoperative, and postoperative Japanese Orthopaedic Association (JOA) scores of patients in each group were compared with the calculation of the improvement rate. The correlation between the severity of disease and postoperative neurological recovery in CSM patients combined with developmental spinal stenosis was analyzed by Pearson correlation. The factors influencing postoperative neurological recovery were analyzed using multivariate logistic regression analysis. The receiver operating characteristic curve (AUC) was used to evaluate the value of each influencing factor in predicting postoperative recovery. Results Significant differences were observed in the proportion of linear hyperintensity changes in the spinal cord, the age of first onset, the course of the disease, and the Torg–Pavlov ratio among the mild, moderate, and severe groups (P < 0.05). The postoperative recovery time of the moderate and severe groups was significantly higher than that of the mild group, while the preoperative JOA score was significantly lower than that of the mild group. On the other hand, the postoperative recovery time of the severe group was prominently higher than that of the moderate group, whereas the preoperative JOA score was observably lower than that of the moderate group (P < 0.05). Pearson correlation analysis showed that the postoperative recovery time was significantly negatively correlated with the Torg–Pavlov ratio, age at first onset, and disease course (r = −0.359, −0.502, −0.368, P < 0.05), while it was positively correlated with spinal cord linear high-signal changes (r = 0.641, P < 0.05). Multifactorial logistic regression analysis revealed that the Torg–Pavlov ratio, age at first onset, and disease course were protective factors, while spinal cord linear high-signal alterations were risk factors affecting the recovery time of postoperative neurological function (P < 0.05). The area under the curve (AUC) of the Torg–Pavlov ratio, linear hyperintensity changes in the spinal cord, age at first onset, and disease duration in predicting the postoperative neurological recovery time were 0.794, 0.767, 0.772, and 0.802, respectively. The AUC predicted by the combined detection of each factor was 0.876, which was better than the area under the curve of single prediction. Conclusion Patients with CSM combined with developmental spinal stenosis were characterized by younger age of onset, a short course of the disease, and linear changes in the spinal cord high signal. The degree of developmental spinal stenosis may affect the postoperative recovery time of neurological function in CSM patients but had little effect on postoperative neurological recovery. The Torg–Pavlov ratio, age of first onset, course of the disease, and changes in the spinal cord linear hyperintensity were the factors that affected postoperative neurological recovery, which may provide a basis for reasonably predicting a postoperative neurological recovery in patients with CSM combined with developmental spinal stenosis.

Risk Factors for Poor Prognosis of Spinal Cord Injury without Radiographic Abnormality Associated with Cervical Ossification of the Posterior Longitudinal Ligament.

Purpose To investigate the factors associated with the prognosis of spinal cord injury without radiographic abnormality (SCIWORA) accompanied by cervical ossification of the posterior longitudinal ligament (C-OPLL). Methods We retrospectively investigated 287 patients with SCIWORA associated with C-OPLL, who were admitted within 30 days after trauma to our facility between August 2014 and August 2018. All patients were divided into the good or poor prognosis group. Patient demographics were analyzed. Besides, occupying ratio on CT and spinal cord high signal changes in MRI T2WI were measured and recorded. Multivariate linear regression was applied to analyze the correlation of prognosis with spinal cord high signal changes in MRI T2WI, cause of injury, and occupying ratio. Results Occupying ratio of ossification mass was 43.5 ± 10.7% in the poor prognosis group and 27.3 ± 7.7% in the good prognosis group. The occurrence rate of high signal changes in MRI T2WI was 84.2% in the poor prognosis group and 41.3% in the good prognosis group. Poor prognosis was correlated with high occupying ratio and spinal cord high signal changes in MRI T2WI. In the patient with SCIWORA associated with C-OPLL, ROC curve of occupying ratio showed 30% as a predictor for the poor prognosis. Among the 92 patients with occupying ratio ≤ 30%, poor prognosis was observed in 5 cases (5.4%), whereas in the 72 cases with occupying ratio > 30%, poor prognosis was seen in 33 cases (45.8%). Postoperative AIS grade at final follow-up in occupying ratio > 30% group was significantly worse. Conclusions Patients suffering from SCIWORA with C-OPLL have poor prognosis when they have higher occupying ratio of ossification mass and spinal cord high signal changes in MRI T2WI. The cut-off value of occupying ratio for predicting the poor prognosis was 30% in patients with SCIWORA associated with C-OPLL.

Subclinical involvement of the trunk muscles in idiopathic inflammatory myopathies.

BackgroundWhole-body magnetic resonance imaging (WB-MRI) is a useful tool for revealing the disease-specific distribution of affected muscles and clinically asymptomatic muscle involvements in idiopathic inflammatory myopathies (IIMs).PurposeTo examine inflammatory changes in the systemic skeletal muscles, including the thoracoabdominal trunk, in IIMs using WB-MRI.Material and MethodsWe prospectively obtained WB-MRI axial images from 10 patients with IIMs, including antisynthetase syndrome (ASS), immune-mediated necrotizing myopathy (IMNM), sporadic inclusion body myositis, and myopathy associated with antimitochondrial antibody. We evaluated 108 systemic skeletal muscles in short-tau inversion recovery (STIR) images and rated changes in signal intensity using a semiquantitative scale. Correlations between STIR sum score, peak creatine kinase (CK) and muscle strength were examined. We also investigated the correlation between STIR sum score within the thoracoabdominal trunk and forced vital capacity.ResultsHigh STIR signal changes were frequently identified in asymptomatic and routinely unexamined muscles. Thoracoabdominal trunk muscles were frequently involved in ASS and IMNM. Peak CK was positively correlated with the STIR sum score (R2 = 0.62, p < .01). There was no significant correlation between the STIR sum score within the thoracoabdominal trunk and forced vital capacity.ConclusionWB-MRI can detect subclinical muscle inflammation in the systemic muscles including the trunk muscles. STIR sum score is positively correlated with serum peak CK level; therefore, it could be a biomarker of overall muscle inflammation.

Tuning CO2 sensing properties of HPTS along with newly synthesized coordination polymers (CPs)

Coordination polymers (CPs), new functional hybrid materials, have received important attention due to their structural features and many different applications such as gas storage, catalysis, energy storage, small molecule adsorption, luminescence, and chemical sensors. In this study, two newly synthesized metal-organic frameworks (MOFs); [Mn2(µ4-dmg)-(µ4-dmg)(µ-bipy)]n (CP1) and [Mn2(µ4-dmg)(µ4-dmg)(µ-dpeten)]n (CP2); were used for sensing of gaseous carbon dioxide with a spectrofluorometric method with a dye, 8-hydroxypyrene-1, 3, 6-trisulfonic acid (HPTS) as matrix additive material for the first time. The ion-pair form of the HPTS was used in the polymethyl methacrylate matrix as a thin film form. When the HPTS based sensing slides along with the CPs, resulted in many advances such as high relative signal change and larger linear response range, improved sensor dynamics, and higher sensitivity with respect to the additive-free form. More specifically, in the presence of silver nanoparticles (AgNPs), the variation in relative signal intensities of CP1 and CP2 doped HPTS sensing agents were measured as 60 and 40% for the concentration range of 0–10% pCO2, respectively. The aim of this study is to enhance the CO2 response of HPTS with doped CPs due to their useful attributes and potential applications containing selective gas absorption.

Editors' Note: Asymptomatic Optic Nerve Lesions: An Underestimated Cause of Silent Retinal Atrophy in MS

Editors' Note: Asymptomatic Optic Nerve Lesions: An Underestimated Cause of Silent Retinal Atrophy in MS

Editor Response: Asymptomatic Optic Nerve Lesions: An Underestimated Cause of Silent Retinal Atrophy in MS.

Davion et al.1 examined the frequency of asymptomatic optic nerve MRI signal in patients with multiple sclerosis (MS) on natalizumab. All patients were seronegative or had low antibody titers for JC virus (<1.50). The authors found that 60 or 73 (82.2%) eyes with a history of symptomatic optic neuritis (ON) had high signal on MRI of the orbits using 3D double inversion recovery (DIR). There were 123 asymptomatic eyes with no history of ON; nearly 50% of these eyes also showed high signal using DIR MRI. The DIR MRI findings were examined in the context of optical coherence tomography (OCT) findings and low-contrast letter acuity (LCLA) performance. This publication is of significance for several reasons. First, it shows the rate of high signal abnormality in a chronic cohort of symptomatic optic neuritis eyes. The case series also demonstrates a high rate of DIR-identified high signal change in asymptomatic eyes; the association of this finding with reduced OCT-measured retinal thickness values and impaired monocular LCLA scores is also highlighted. Results from DIR imaging of the asymptomatic eyes are notable since the most recent 2017 McDonald Criteria for MS diagnosis do not include optic nerve lesions as part of the criteria for dissemination in space by MRI.2 Thus, OCT imaging and DIR MRI may be valuable to detect subtle symptomatic or asymptomatic optic nerve abnormalities.1,3 Ongoing investigations will need to confirm the value of DIR imaging to define potential false-positive rates for identifying optic nerve disease vs changes in imaging without functional impairment. This study and others that document OCT-measured intereye differences should lead to further investigation into the role of the optic nerve as a lesion site for MS diagnosis.

Antibody- and aptamer-based competitive fluorescence polarization/anisotropy assays for ochratoxin A with tetramethylrhodamine-labeled ochratoxin A.

Ochratoxin A (OTA) is one of the mycotoxins that often contaminate a variety of food stuffs, and it is a potential carcinogen for humans. Taking advantage of selective affinity binding and simple, rapid, and sensitive fluorescence polarization (FP)/fluorescence anisotropy (FA) analysis, here, we report two competitive FP/FA assays for OTA using tetramethylrhodamine (TMR)-labeled OTA as a fluorescence tracer and either antibody or aptamer as an affinity ligand to recognize OTA. In the absence of OTA, the TMR-labeled OTA binds with a large-sized affinity ligand, showing a high FA value due to the slow rotation of the affinity complex. When OTA is present, OTA competes with the TMR-labeled OTA tracer in binding limited amount of affinity ligand, causing more free TMR-labeled OTA and a significant FA decrease. We found that the antibody showed a stronger affinity towards TMR-labeled OTA compared to the aptamer. The antibody-based FA assay showed higher signal changes than the aptamer based FA assay due to the larger size of antibody over aptamer. The antibody-based competitive FA assay enabled the detection of 2.4 nM OTA, while the aptamer-based FA assay also achieved a detection limit of 2.4 nM OTA at 10 °C with the help of streptavidin conjugation to increase the molecular size and to improve aptamer affinity. These two competitive FA assays were selective, showing capability for analysis in diluted red wine.