RESUMEN
STUDY DESIGN: Clinical findings of spinal stenosis were compared to graded radiologic findings of dural sac narrowing. OBJECTIVES: To examine the changes of the dural sac area of the lumbar spine on computerized tomography (CT) performed without and with axial loading, and study the correlations between the radiologic findings and clinical symptoms suggestive of spinal stenosis. SUMMARY OF BACKGROUND DATA: Although several studies have been performed regarding the advantage of an external compression device in lumbar CT, to our knowledge, none of these studies have correlated radiologic findings with clinical symptoms. METHODS: The cross-sectional areas of the dural sac at the 3 lowest lumbar intravenous spaces, measured by CT both without and with external compression, were correlated to the clinical symptoms suggestive of spinal stenosis in 117 patients and 351 intervertebral levels. RESULTS: No statistically significant correlation between the severity of the clinical symptoms of spinal stenosis and dural cross-sectional areas was found. Neither did the use of an external compression device improve the correlation. CONCLUSION: Although an external compression simulates the dynamic condition in the back during standing position, it does not eliminate the need to compare the radiologic findings with the clinical symptoms of patients examined because of a suspected narrowing of the spinal canal.
Asunto(s)
Duramadre/diagnóstico por imagen , Estenosis Espinal/diagnóstico por imagen , Estenosis Espinal/fisiopatología , Tomografía Computarizada por Rayos X , Femenino , Humanos , Vértebras Lumbares/fisiopatología , Masculino , Persona de Mediana Edad , Dolor/etiología , Dolor/fisiopatología , Índice de Severidad de la Enfermedad , Estenosis Espinal/complicaciones , Soporte de PesoRESUMEN
Asthma is a phenotypically heterogeneous disease. Two subgroups are defined here based initially on skin test reactivity to the allergen Alternaria at age 6 from among a large population of children born and raised in the Southwestern desert environment of Tucson, Arizona. When compared with asthma among Alternaria-positive subjects, asthma among Alternaria-negative subjects was associated with lower levels of total serum IgE, no relation to local aeroallergen skin tests, a younger age at diagnosis, greater remittance by age 11, and more frequent wheezing lower respiratory illnesses (LRIs) in the first year of life. Despite the difference in total serum IgE, however, IgE concentrations were significantly higher in each asthma group compared with its respective control group. Asthma in each parent contributed approximately equivalent risk for Alternaria-positive asthma in the child. However, neither parental skin test sensitization nor total serum IgE levels provided risk for asthma in the child. Inheritance patterns for Alternaria-negative asthma revealed a contribution from maternal but not paternal asthma. Thus, dividing asthma in children at age 6 into Alternaria-positive and Alternaria-negative groups identifies subphenotypes that are further distinguished by differences in phenotypic markers and parental influences.
Asunto(s)
Asma/genética , Fenotipo , Alternaria/inmunología , Asma/diagnóstico , Asma/inmunología , Niño , Preescolar , Femenino , Estudios de Seguimiento , Marcadores Genéticos/genética , Humanos , Inmunoglobulina E/sangre , Lactante , Recién Nacido , Pruebas Intradérmicas , Masculino , Estudios Prospectivos , Hipersensibilidad Respiratoria/diagnóstico , Hipersensibilidad Respiratoria/genética , Hipersensibilidad Respiratoria/inmunologíaRESUMEN
Endothelins (ETs) are a family of vasoactive peptides that may be involved in granulosa cell (GC) luteinization or follicular maturation. However, the precise role of ET in ovarian physiology remains unknown. We have investigated whether the rat GC is a site of ET reception and have characterized the antigonadotropic effect of ET in cultured GC from immature rats. Two major ET binding species (52 and 30 kDa) were observed after cross-linking of GC membranes with radiolabeled ET-1, although the smaller protein may represent a degradative product. Unlabeled ET-1, ET-2, or ET-3 were equipotent in displacing radiolabeled ET-1 from these putative ET receptors, with EC50s of 0.3-0.7 x 10(-9) M. Similarly, ET-1, ET-2, and ET-3 were equipotent (EC50s of about 10(-10) to 10(-9) M) in inhibiting the FSH-supported accumulation of progesterone. ET-1 (10(-7) M) also inhibited (> 90%) FSH-supported estrogen accumulation. Maximum progesterone inhibition (> 90%) by ET-1 (10(-7) M) was achieved throughout the range of FSH does and cell densities tested and by 48 h or 72 h of culture. ET-1 was not cytotoxic in the dose range tested. Forskolin-stimulated progesterone accumulation was similarly inhibited by ET-1, suggesting that ET-1 inhibits cAMP-mediated (e.g., FSH or forskolin-stimulated) progesterone accumulation. ET-1 inhibited (74%) the FSH-stimulated accumulation of cAMP, suggesting that it acts at sites related to cAMP generation or degradation. In addition, ET-1 inhibited 8-bromo-cAMP-generated progesterone accumulation (60%), suggesting that it also acts at sites distal to cAMP generation.(ABSTRACT TRUNCATED AT 250 WORDS)