Histological analysis of surgical lumbar intervertebral disc tissue provides evidence for an association between disc degeneration and increased body mass index

<p>Abstract</p> <p>Background</p> <p>Although histopathological grading systems for disc degeneration are frequently used in research, they are not yet integrated into daily care routine pathology of surgical samples. Therefore, data on histopathological changes in surgically excised disc material and their correlation to clinical parameters such as age, gender or body mass index (BMI) is limited to date. The current study was designed to correlate major physico-clinical parameters from a population of orthopaedic spine center patients (gender, age and BMI) with a quantitative histologic degeneration score (HDS).</p> <p>Methods</p> <p>Excised lumbar disc material from 854 patients (529 men/325 women/mean age 56 (15-96) yrs.) was graded based on a previously validated histologic degeneration score (HDS) in a cohort of surgical disc samples that had been obtained for the treatment of either disc herniation or discogenic back pain. Cases with obvious inflammation, tumor formation or congenital disc pathology were excluded. The degree of histological changes was correlated with sex, age and BMI.</p> <p>Results</p> <p>The HDS (0-15 points) showed significantly higher values in the nucleus pulposus (NP) than in the annulus fibrosus (AF) (Mean: NP 11.45/AF 7.87), with a significantly higher frequency of histomorphological alterations in men in comparison to women. Furthermore, the HDS revealed a positive significant correlation between the BMI and the extent of histological changes. No statistical age relation of the degenerative lesions was seen.</p> <p>Conclusions</p> <p>This study demonstrated that histological disc alterations in surgical specimens can be graded in a reliable manner based on a quantitative histologic degeneration score (HDS). Increased BMI was identified as a positive risk factor for the development of symptomatic, clinically significant disc degeneration.</p

Breath

Breath is set in a country recovering from a brutal and divisive civil war between north and south. The war may be over but people’s memories are long and hatreds are slow to fade. A teenage boy, Jamie, is knocked off his bike and dies in a city street. His father, Geoff Andrews, manager of the main hospital, is asked if he will allow one of Jamie’s lungs to be removed and flown north for a transplant. He agrees, and the mercy mission begins: six hours to get the lung out of one body and into another. As the night unfolds, and the plane travels through storms across the war-ravaged country and over the border, we see the drama from three different perspectives: Andrews, grieving for the son he perhaps never knew well enough – this one single death overwhelming, even after the deaths of so many; the lung’s recipient, Baras, an old man fighting for breath, and life – a northerner with blood on his hands; and in the turbulent sky between them, Jude, the young pilot, who is closest to Jamie – or at least to his breath, his spirit, his voice. A novel about violence and vengeance, and what must take their place, Breath is a moving and timely examination of the fractures of war and grief and the long struggle towards peace and reconciliatio

The half healed

The poems in Michael Symmons Roberts’s fifth collection move in a world riven by violence and betrayal, between nations and individuals. As ever, this is a metaphysical poetry rooted in physical detail – but the bodies here are displaced, disguised, in need of rescue. A man in a fox suit prowls the woods afraid of meeting true foxes, while a vixen dressed as a man moves among the powerful at society soirées. God no longer ‘walks in his garden in the cool of the day’, but drives through a damaged city in the small hours. At the same time a couple celebrate armistice with an act of love in an anonymous hotel room

Corpus

Corpus - Michael Symmons Roberts' Whitbread-Prize winning fourth collection - centres around the body. Mystical, philosophical and erotic, the bodies in these poems move between different worlds - life and after-life, death and resurrection - encountering pathologists' blades, geneticists' maps and the wounds of love and war. Equally at ease with scripture (Jacob wrestling the Angel in 'Choreography') and science ('Mapping the Genome'), these poems are a thrilling blend of modern and ancient wisdom, a profound and lyrical exploration of the mysteries of the body:' So the martyrs took the lamb./ It tasted rich, steeped in essence/ Of anchovy. They picked it clean/ And found within, a goose, its pink/ Beak in the lamb's mouth like a tongue.' Ranging effortlessly between the physical extremes of death - from putrefaction to purification - and life - drought and flood, hunger and satiation - the poems in Corpus speak most movingly of 'living the half-life between two elements', of what it is to be unique and luminously alive

Deaths of the Poets

A creative non-fiction study of the post-Romantic myth of the doomed poet, taking the form of a series of journeys to explore the lives and deaths and afterlives of over twenty poets since Thomas Chatterton, using elements of travelogue, place and archival research