In osteoporotic VCFs, pulmonary cement embolism was detected in 23% of PVP sessions, developed in the distal to third-order pulmonary arteries, and was related to leakage into the inferior vena cava.

Purpose:To prospectively evaluate the short-and midterm effectiveness of transforaminal epidural steroid injection (TFESI) for lumbosacral radiculopathy with respect to injection level. Materials and Methods:Institutional review board approval and written informed consent were obtained. From March 2005 to February 2006, 239 consecutive patients (106 male, 133 female; mean age, 49.8 years; range, 13-82 years) who were scheduled to undergo lumbar TFESI were enrolled. The patients were randomly assigned to either the ganglionic (TFESI at the location of the exiting nerve root) or preganglionic group (TFESI at the supraadjacent intervertebral disk level). Follow-up was conducted within 1 month (short term) and more than 6 months (midterm) after injections. Short-and midterm outcomes were measured by using a visual analog scale and a four-grade scale. Univariate analysis (by using the Fisher exact and 2 tests) and multiple logistic regression analysis were performed to evaluate the relationship between possible outcome predictors (ganglionic or preganglionic injection levels, cause of radiculopathy, duration of symptoms, age group, and sex) and the therapeutic effect. Results:Univariate analysis showed that the preganglionic group had a better treatment effect (99 of 112, 88.4%) than did the ganglionic group (90 of 127, 70.9%) at short-term follow-up (P ϭ .001). Multiple logistic regression analysis showed that the only significant outcome predictor at short-term follow-up was injection level (odds ratio ϭ 2.232, P ϭ .037). No significant difference was identified regarding TFESI approach or cause of radiculopathy at midterm follow-up. Conclusion:TFESI for lumbosacral radiculopathy with a preganglionic approach is more effective than TFESI with a ganglionic approach at short-term follow-up. RSNA, 2007

Gastrointestinal stromal tumor (GIST) represents the most common kind of mesenchymal tumor that arises from the alimentary tract. GIST is currently defined as a gastrointestinal tract mesenchymal tumor showing CD117 (c-kit protein) positivity at immunohistochemistry. Throughout the whole length of the gastrointestinal tract, GIST arises most commonly from the stomach followed by the small intestine, the colorectum, and the esophagus. Only 3%-5% of GISTs occur in the duodenum, and especially, if GIST arises from the C loop of the duodenum, it can be difficult to differentiate from the pancreas head mass because of its anatomical proximity. Here, we report a case of duodenal GIST, which was assessed as a pancreatic head tumor preoperatively.

MRI with a microscopy coil was useful in the preoperative assessment of small soft-tissue masses of the hand and foot.

Objectives. The aim of this study was to evaluate the effects of early intensive insulin therapy on body fat distribution, lean body mass and β-cell function in patients with newly diagnosed type 2 diabetes. Methods. Thirty-eight subjects with newly diagnosed type 2 diabetes participated in a 12-week course of intensive insulin therapy. Patients were administered a 75 g oral glucose tolerance test (OGTT), underwent measurement of visceral and subcutaneous adipose tissues (VAT and SAT) using computed tomography and appendicular skeletal muscle (ASM) mass was assessed using dual-energy X-ray absorptiometry. Results. After intensive insulin therapy, fasting plasma glucose and HbA1c levels decreased. Homeostasis model assessment (HOMA)-B, the insulinogenic index, and the C-peptide-to-glucose area under the curve (AUC) ratio increased. The insulin sensitivity index and the glucose AUC decreased after 12 weeks. The body composition analysis revealed that the VAT and the ratio of VAT to SAT decreased, whereas body weight and total fat mass increased nonsignificantly. The ASM/weight and skeletal muscle mass index increased. The restoration of β-cell function, as identified by HOMA-B, the insulinogenic index, and the C-peptide-to-glucose AUC ratio, was correlated with the changes in VAT when controlled for age and gender. In multiple regression analyses, the decrease in VAT was shown to independently contribute to improved HbA1c over the study period, after adjusting for confounding factors. Conclusions. These results suggest that a shift in fat distribution from visceral to subcutaneous fat after early intensive insulin therapy is associated with improvements in glycemic control and β-cell function in patients with newly diagnosed type 2 diabetes.

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BackgroundOsteochondroma is a disease of growing bone and thus typically presents in younger patients. It has rarely been described in middle-aged and elderly patients. Data on the occurrence of osteochondroma show that the reported incidence of costal osteochondroma is very low. Moreover, costal osteochondroma arising at the costovertebral junction with neural foraminal extension and spinal cord compression is extremely rare.Case presentationThis study reports the case of a 58-year-old patient with a solitary osteochondroma of the 12th rib with intraspinal extension and spinal cord compression. The clinical history, plain radiographs, computed tomography (CT), magnetic resonance imaging, and pathologic findings of the reported patient have been reviewed. The relevant medical literature has also been reviewed. The patient was treated with surgery for complete tumour excision to avoid tumour recurrence. After surgery, the patient's symptoms improved. An additional CT scan obtained at 1 year after surgery did not show any evidence of recurrence.ConclusionsThis patient is the oldest patient reported to have this rare form of costal osteochondroma. The age of the patient and the erosion of the adjacent bones raised clinical suspicion of malignancy; therefore, surgical management involved complete tumour excision with thoracolumbar fixation and fusion.

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