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Biomedical subjects

R L Jensen

Publications and source records attributed to R L Jensen.

At least 19 recordsLinked to original sources

Early pathologic findings and long-term improvement in anti-Ma2-associated encephalitis.

A 67-year-old man sequentially developed anti-Ma2-associated paraneoplastic encephalitis (PNE) and contralateral herpes simplex encephalitis (HSE). Brain biopsy 1 month before HSE revealed extensive infiltrates of T cells, B cells, and plasma cells. Most T cells expressed the cytotoxic granule-associated protein TIA-1 and the membranolytic protein granzyme-B. Although recovery was thought to be unlikely, treatment of the PNE with corticosteroids and resection of the associated lung cancer resulted in dramatic improvement for 21 months.

Aged↗

Effects of dietary supplementation with vitamins C and E on muscle function during and after eccentric contractions in humans.

Reactive oxygen species may contribute to exercise-induced skeletal muscle damage, and antioxidants may protect against such damage. This study examined the effectiveness of prophylactic supplementation with vitamins C and E on symptoms of muscle damage in a single blind, two-group study design. Twelve male volunteers were randomly assigned to either treatment or control groups. The treatment group received 500 mg of vitamin C and 1,200 IU of alpha-tocopherol daily and the control group received glucose placebo for 37 days. After 30 days of treatment, volunteers performed 300 maximal eccentric contractions of the knee extensor muscles of one leg. Maximal voluntary isometric contraction force and electrically evoked force at a frequency of 20 Hz and 50 Hz were recorded before and after exercise, and on days 1, 2 and 7 after exercise. Muscle soreness questionnaires were completed and muscle girth recorded at the same time points. Eccentric contractile torque and work during the bout declined significantly in both groups ( P<0.001), but this decline was smaller in the vitamin-supplemented group ( P<0.05). Maximal voluntary isometric contraction force and 20:50 Hz force ratio declined significantly after exercise in both groups ( P<0.01), but the decline was smaller in the treatment group on days 1 and 2 post-exercise ( P<0.05). Both groups experienced similar significant muscle soreness and swelling after exercise. These data suggest that prior supplementation with dietary antioxidants ameliorates muscle functional decrements subsequent to eccentric muscle contraction.

Administration, Oral↗

Energy expenditure, heart rate response, and metabolic equivalents (METs) of adults taking part in children's games.

AIM: The needs of physical activity can be seen through the lack of numbers participating in regular physical activity as well as the increase in prevalence of certain diseases such as Type II diabetes (especially in children), cardiovascular diseases, and some cancers. With the increase in preventable diseases that are caused in part by a sedentary lifestyle, a closer look needs to be taken into the role of family interaction as a means of increasing physical activity for both adults and children. Because of the many benefits of physical activity in relation to health, a family approach to achieving recommended levels of physical activity may be quite applicable. METHODS: Forty volunteers were recruited from the community (20 subjects and 20 children). The volunteers played 2 games: soccer and nerfball. Data was collected over 10 minutes (5 min per game). Expired air analysis was used to calculate energy expenditure and metabolic equivalents (METs). Descriptive statistics were calculated along with a regression analysis to determine differences between the 2 games, and an ACOVA to determine any significant effects of age, child age, gender, and physical activity level on the results. RESULTS: For both games, average heart rate measured approximately 88%max; average METs measured approximately 6, average energy expenditure measured approximately 40 kcal. CONCLUSIONS: S: This study showed that adults can achieve recommended physical activity levels through these specific activities if sustained for approximately 20 min.

Adult↗

Endoscopic-assisted craniofacial resection of esthesioneuroblastoma: minimizing facial incisions--technical note and report of 3 cases.

The surgical management of esthesioneuroblastoma with anterior skull base involvement has traditionally been craniofacial resection, which combines a bifrontal craniotomy with a transfacial approach. The latter usually involves a disfiguring facial incision, mid-facial degloving, lateral rhinotomy, and/or extensive facial osteotomies, which may be cosmetically displeasing to the patient. The advent of angled endoscopes has provided excellent magnification and illumination for surgeons to remove tumors using minimally invasive techniques. The authors describe their experience with three cases of esthesioneuroblastoma, which were surgically removed using a transnasal endoscopic approach, avoiding transfacial incisions. Preoperative radiographs were reviewed and tumors were staged according to the Kadish staging system. One patient had a recurrent esthesioneuroblastoma (Kadish stage B), which was removed entirely through a transnasal endoscopic approach. Two patients had intracranial extension (Kadish stage C), which were resected with a combined approach, endoscopically from below and a bifrontal craniotomy from above, to remove intracranial disease. All patients underwent reconstruction of the anterior skull base. Esthesioneuroblastomas confined to the nasal and paranasal cavities (Kadish stage A and B) were readily accessible through the transnasal endoscopic approach. If there was significant intracranial disease (Kadish stage C), adding a bifrontal craniotomy provided excellent exposure for complete resection of involved tumor. All patients underwent complete tumor resection with negative margins. None developed a cerebrospinal fluid (CSF) leak. The endoscopic-assisted craniofacial approach for the surgical management of esthesioneuroblastomas provides excellent exposure, adequate visualization, and the cosmetic benefit of avoiding an external facial incision.

Adult↗

Airway inflammation in COPD: physiological outcome measures and induced sputum.

Chronic obstructive pulmonary disease (COPD) is a result of airway inflammation, and the best predictor of COPD is the early detection of airflow limitation by spirometry. The Global Initiative for Obstructive Lung Disease Workshop Report defines airflow limitation using simple spirometric indices. Available guidelines categorise the severity of COPD using forced expiratory volume in one second (FEV1) and forced vital capacity (FVC), with symptoms playing a minor role in the assessment. Current standards define COPD by progressive loss of FEV1, and thus longitudinal decline in FEV1 will be the primary outcome variable for intervention studies aimed at preventing or reducing the loss of pulmonary function. There is evidence, however, that the variable FEV1/FVC and FEV1 are often not measured properly in all settings. This article will discuss the roles of physiological measurements in diagnosing COPD and physiological outcome measures for COPD. It does not formally compare physiological measures with other outcome measures, such as symptoms or quality of life. Additionally, improved treatment of established disease requires a better understanding of the inflammatory process and its clinical effects and treatment. The inflammatory process, and how drugs affect it, can be studied noninvasively or relatively noninvasively by using refined methods of examining spontaneous or induced sputum. Enhanced understanding of the use of induced sputum will assist in predicting patients' responses to short- and long-term inhaled corticosteroid treatment, and the methods of sputum examination need to be simplified so that they can be applied more easily to clinical practice.

Aged↗

Calcium channel antagonists inhibit growth of subcutaneous xenograft meningiomas in nude mice.

BACKGROUND: We have previously shown that calcium channel antagonists inhibit in vitro meningioma growth. This study examines the effect of calcium channel antagonists on in vivo xenograft meningioma growth. METHODS: Meningioma cells taken from human patients were mixed with Matrigel and injected into the subcutaneous space in the flank of nude mice. These animals were treated with calcium channel antagonists in their drinking water. Tumor volumes were measured over time; comparison was made between control and treatment groups. Daily weights, average daily water consumption, and serum calcium channel antagonist levels were determined. Comparison of histology and proliferation index was made between control and treatment groups. RESULTS: Diltiazem treatment decreased tumor growth over time compared to control groups. Increased tumor growth inhibition was seen with increasing doses (p > 0.05). Treatment with verapamil had similar effects; however, there are no statistically significant dose dependent decreases in growth with increasing verapamil doses. There were no tumor "cures" or spontaneous regression of tumor in any group including the control groups. Animal daily weight and average daily water consumption was unaffected by increasing calcium channel antagonist doses compared to control groups. Mouse serum drug levels increased with increasing doses of drug in the drinking water of treatment groups (p > 0.05). Histology and proliferative index of treatment groups were similar to control groups. CONCLUSION: Calcium channel antagonists decrease but do not completely inhibit the growth of meningiomas in nude mice. Clinical correlations and potential applications are discussed.

Animals↗

Single-breath carbon monoxide diffusing capacity.

Measurement of DL(CO) remains a clinically useful way to assess transfer of gases across the lung. It is important, however, to be vigilant in controlling the sources of variation and to be aware of those that remain when interpreting the measured values.

Breath Tests↗

A simple diagnostic index for asthma.

BACKGROUND: Asthma is becoming increasingly prevalent and a number of research groups are investigating its genetic and environmental basis. OBJECTIVE: To produce a brief screening tool suitable for determining phenotype in asthma research. METHODS: The scores from eight questions on symptoms and history were obtained from 678 adults and 244 children from high asthma-incidence caucasian families. An independent physician diagnosis was also obtained with the use of a modified NHLBI-CSGA questionnaire and pulmonary function test. Stepwise logistic regression was applied to determine which of the eight questions had greatest predictive value for asthma, and the quality of the resultant models was evaluated using an independent set of 643 adults and 239 children. RESULTS: For adults, the most parsimonious model used responses from three of the eight questions. It had sensitivity and specificity of 0.94 and 0.96, respectively. For children, responses to two questions gave a model with sensitivity and specificity of 0.97. For both age groups, negative predictive values were above 0.87. Positive predictive values were 0.58 and 0.78 for adults and children respectively. The latter emphasize the need for conformation, by physician, of "affected" calls made by this initial screen. CONCLUSION: The brief questionnaires described are potentially useful in a research setting, as a preliminary screening mechanism of low cost. Their use will reduce the numbers of subjects that must undergo detailed phenotyping.

Adolescent↗

Airflow limitation is underrecognized in well-functioning older people.

OBJECTIVES: Dyspnea is a common symptom in older people. A reduced forced expiratory volume in 1 second (FEV1) is associated with a higher mortality rate from cardiovascular and respiratory disease, and increased admissions to hospitals. Underrecognized or undertreated airflow limitation may exacerbate the problem. The purpose of this study was to assess the prevalence and treatment of airflow limitation in a cohort of well-functioning older people. DESIGN: Cross-sectional study. SETTING: Baseline of a clinical-epidemiological study of incident functional limitation. PARTICIPANTS: Participants attended the baseline examination of the Health, Aging, and Body Composition study, a prospective cohort study of 3,075 well-functioning subjects age 70 to 79. MEASUREMENTS: Demographic and clinical data were collected by interview. Spirometry was performed unless contraindicated and repeated until three acceptable sets of flow-volume loops were obtained. Patients on bronchodilator medications had spirometry performed posttherapy. Blinded readers assessed the flow-volume loops, and inadequate tests were omitted from analysis. Airflow limitation was defined as a reduced forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) as determined by age-, sex-, and race-normalized values. Severity of airflow limitation was defined by American Thoracic Society criteria. RESULTS: Two thousand four hundred eighty-five subjects (80.8%) had assessable spirometry and data on treatment and diagnosis (1,265 men, 1,220 women). The mean age was 73.6 years. Two hundred sixty-two subjects (10.5%) had airflow limitation; 43 (16.4%) of these never smoked. Only 37.4% of participants with airflow limitation and 55.6% of participants with severe airflow limitation reported a diagnosis of lung disease. Only 20.5% of subjects with at least moderate airflow limitation had used a bronchodilator in the previous 2 weeks. CONCLUSION: Despite their good functional status, airflow limitation was present, and underrecognized, in a considerable proportion of our older population. The low bronchodilator use suggests a significant reservoir of untreated disease. Physicians caring for older people need to be more vigilant for both the presence, and the need for treatment, of airflow limitation.

Aged↗

Influence of leisure time physical activity and television watching on atherosclerosis risk factors in the NHLBI Family Heart Study.

Physical activity favorably influences atherosclerosis risk factors but only a few studies in adults considered the time watching television (TV) as a measure of physical inactivity. We therefore determined in a population-based sample of 1778 subjects from the NHLBI Family Heart Study (FHS) whether leisure time physical activity and TV watching have independent or interactive associations with cardiovascular disease risk factors and carotid artery intima-media wall thickness (IMT). Subjects were free from diabetes mellitus and clinically-ascertained coronary artery disease and did not take lipid-lowering or antihypertensive drugs. Only 0.7 and 1.3% of the variance in leisure time physical activity in women and men, respectively, was explained by the amount of TV watching. Leisure time physical activity had a clearly favorable, and TV watching an unfavorable association with anthropometric measurements (BMI (body mass index), waist girth, waist-hip ratio, subscapular and triceps skinfold thickness). The odds ratio (95% CI) of being overweight was 0.41 (0.28-0.62) in women and 0.69 (0.46-1.04) in men in the highest quartile of leisure time physical activity compared to the lowest quartile. The odds ratio increased for increasing quartiles of TV watching to 2.12 (1.45-3.10) in women and 1.61 (1.07-2.43) in men. Watching TV only 1 h per day in women with a BMI of 30 kg/m2 and doing about 75 min of moderate exercise per week was associated with a BMI 1.8 kg/m2 lower than in women watching TV 3 h per day and doing the same amount of exercise. Those with twice the amount of moderate exercise and watching TV 1 h per day had a BMI 0.45 kg/m2 lower. Furthermore, leisure time physical activity was negatively associated with concentrations of triglycerides and positively with HDL cholesterol in both genders. TV watching was significantly positively associated with triglycerides and slightly negatively with HDL cholesterol in men. The observed associations of leisure time physical activity and TV watching with atherosclerosis risk factors were independent from each other. Finally, we analyzed the relation between leisure time physical activity, TV watching and the degree of IMT of the carotid arteries. Neither of these two measures was significantly associated with IMT. In summary, TV watching, in addition to leisure time physical activity, shows an independent association with obesity-related anthropometric measurements, HDL and triglycerides. Decreasing the amount of TV watching might be effective as a first step in reducing atherosclerosis risk factors, especially overweight.

Adult↗

The accuracy of pulse oximetry in the emergency department.

The objective of this retrospective study was to identify factors affecting the accuracy of pulse oximetry in the ED. Over a 3-year period, 664 consecutive emergency department (ED) patients had simultaneous arterial blood gas (ABG) and pulse oximeter readings taken. Pulse oximeter saturations (SpO2) were compared with ABG CO-oximeter saturations (SaO2) for accuracy. Multiple variables including age, sex, hemoglobin, bicarbonate, pH, and carboxyhemoglobin (COHb) were analyzed to see if they affected SpO2 accuracy. ROC curves were used to determine the best pulse oximeter threshold for detecting hypoxia. Using multivariate analysis, COHb was the only statistically significant factor affecting the accuracy of pulse oximetry. In patients with COHb <2%, SpO2 overestimated SaO2 by more than 4% in 8.4% of cases. In patients with COHb > or = 2%, SpO2 overestimated SaO2 by more than 4% in 35% of cases. The best pulse oximetry threshold for detecting hypoxia is 92%. At this threshold, if COHb is <2%, pulse oximetry has a sensitivity of 0.92 and specificity of 0.90. If COHb is > or =2%, sensitivity is 0.74 and specificity is 0.84. For patients likely to have a COHb < 2, pulse oximetry is an effective screening tool for detecting hypoxia. However, more caution must be exercised when using pulse oximetry in patients likely to have a COHb > or = 2%.

Blood Gas Analysis↗

Role of topical steroids in reducing dysfunction after nerve injury.

OBJECTIVE: To determine the efficacy of topical dexamethasone in reducing nerve dysfunction after axonotmesis injury. STUDY DESIGN: A three-armed, blinded study including sham, control, and test groups was designed using the rat sciatic nerve crush injury model. METHODS: Twenty-two rats were randomly assigned to a control group or a topical steroid group. A standardized sciatic nerve crush injury was performed under sterile conditions on each animal. A separate group of five rats underwent a sham operation to isolate the crush injury as the source of postoperative dysfunction in the control and steroid groups. All animals underwent walking track analysis with calculation of the sciatic functional index (SFI) before surgery and through the postoperative recovery period. Dexamethasone saturated Gelfoam was placed at the site of injury in the topical steroid group. The functional performance of each group was compared throughout the recovery period. RESULTS: No morbidity associated with topical application of steroids at the injury site was noted. The topical steroid group had improved recovery at postoperative days 14, 18, and 22. This difference was statistically significant at day 14. At the termination of the study, there was a clear trend toward superior recovery for the steroid group compared with controls (90% vs. 73%), but this difference did not reach statistical significance. CONCLUSIONS: Clinical use of topical steroids to reduce postoperative nerve dysfunction warrants further study.

Administration, Topical↗

Calcium channel antagonist effect on in vitro meningioma signal transduction pathways after growth factor stimulation.

OBJECTIVE: We have previously demonstrated that calcium channel antagonists inhibit the growth of human meningiomas in culture after stimulation with growth factors. This study examined the effects of these drugs on signaling transduction pathways in an attempt to elucidate potential mechanisms by which this growth inhibition is mediated. METHODS: Primary cell cultures from patients with intracranial meningiomas were established. Cell growth studies were performed with inhibitors and stimulators of tyrosine kinase signal transduction. Intracellular calcium changes and inositol phosphate production were measured after growth factor exposure, with or without pretreatment by calcium channel antagonists. RESULTS: The growth of meningiomas in culture can be inhibited by tyrosine kinase receptor inhibitors. Inhibitors and stimulators of phospholipase C can stimulate or inhibit the growth of in vitro meningiomas, respectively. Calcium channel antagonists inhibit intracellular calcium changes induced by serum and epidermal growth factor. Inositol phosphate production is increased after growth factor stimulation, and calcium channel antagonists potentiate this effect. CONCLUSION: Calcium channel antagonists interfere with intracellular signaling pathways of cultured meningioma cells. This inhibition is unrelated to voltage-sensitive calcium channels. The findings of this project may aid in the understanding of the signal transduction mechanisms involved in growth factor-mediated meningioma proliferation and may lead to clinically relevant strategies for growth inhibition.

Adult↗

FEV(6) is an acceptable surrogate for FVC in the spirometric diagnosis of airway obstruction and restriction.

We analyzed the FEV(1)/FEV(6) and FEV(1)/FVC results of 502 consecutive patients in the spirometric diagnosis of airway obstruction. We also examined the agreement between FEV(6) and FVC in the spirometric diagnosis of restriction. Technically acceptable test results were obtained from 337 subjects (67%). The sensitivity of FEV(1)/FEV(6) for diagnosing airway obstruction as defined by FEV(1)/ FVC was 95.0%; the specificity was 97.4%. When interpretations differed, the measured values were all close to the lower limits of the reference ranges. When analysis included +/- 100-ml variability in FEV(1) and FEV(6), the sensitivity increased to 99.5% and the specificity to 100%. The reproducibility of FEV(6) was superior to that of FVC. These results suggest that FEV(6) is an accurate, reliable alternative to FVC for diagnosing airway obstruction and that FEV(6) is reasonably comparable to FVC for the spirometric diagnosis of restriction. FEV(6) is more reproducible and less physically demanding for patients.

Adult↗

Nasal continuous positive airway pressure devices do not maintain the set pressure dynamically when tested under simulated clinical conditions.

STUDY OBJECTIVES: Nasal continuous positive airway pressure (CPAP) is standard therapy for obstructive sleep apnea syndrome. The effective nasal mask pressure may be adversely affected by factors that increase system resistance (eg, long tubing and/or water condensation) and by dynamic variables (breathing frequency [f] and tidal volume [VT]). The present study was conducted in order to assess the performance of CPAP machines throughout a range of simulated clinical conditions. DESIGN: Four currently used CPAP machines were tested at settings of 5, 10, 15, and 20 cm H(2)O using a pulmonary waveform generator to produce VTs of 0.4, 0.8, and 1.2 L at frequencies of 10, 20, and 30 breaths/min. Machines were tested under five conditions: 6-foot and 12-foot tubing, with and without an in-line humidifier, and 12-foot tubing with humidifier and water condensation. MEASUREMENTS: Maximum and minimum mask pressure measurements were obtained during five respiratory cycles for each dynamic variable under each of the five conditions and CPAP settings (180 experiments on each of four CPAP models). RESULTS: Using typical clinical parameters (VT, 0.4 L and 0.8 L; f, 10 breaths/min and 20 breaths/min; and CPAP, 5 to 15 cm H(2)O), mask pressure consistently varied above and below the set point when additional tubing and/or a humidifier were added to the system (0.7 to 2.9 cm H(2)O below and 0.5 to 1.0 cm H(2)O above the set pressure). Water condensation caused large pressure deviations (inspiratory pressure ranged from 3.5 to 5.6 cm H(2)O below set pressure, and expiratory pressure ranged from 0.7 to 3.5 cm H(2)O above set pressure). CONCLUSIONS: Therapy and compliance could be adversely affected because some CPAP machines in current use do not maintain constant continuous mask pressure when tested using simulated conditions, especially when water condenses in the tubing.

Equipment Design↗

Use of EMG analysis in challenging kinetic chain terminology.

PURPOSE: The purpose of this study was to compare mean integrated electromyographic values (EMG(int)) during biomechanically comparable closed kinetic chain/fixed external load, open kinetic chain/moveable no load, and moveable external load exercises. METHODS: EMG(int) were obtained for the pectoralis major (PM) and the long head of the triceps (T) during absorption and force phases of three biomechanically comparable exercises: the push-up (PU); the bench press-load (BP-L); and the bench press-no load (BP-NL) equated to the closed kinetic chain/fixed external load; moveable external load; and open kinetic chain/moveable no load conditions respectively. A force plate was used to equate load for the PU and BP-L exercises. Ten males (24+/-4.4 yr) participated in the three randomly ordered exercises. A pronated, closed grip was used for all exercises. The mean integrated EMG values from three isometric maximal voluntary contractions were used to determine a reference EMG (EMG(MVC)) for each muscle. Normalized EMG values (NEMG) were determined by EMG(int)/EMG(Mvc) and analyzed by one-factor repeated measures ANOVA for each muscle (PM and T) during each phase (absorption and force). RESULTS: There was no significant difference (P > 0.05) between the equivalently loaded, different boundary exercises (PU and BP). Statistical significance (P < 0.05) was determined between the differently loaded, equivalent boundary exercises (BP and BP-NL) as well as the differently loaded, different boundary exercises (PU and BP-NL). CONCLUSIONS: Results from this study support the theory that activities of similar biomechanical motions and mass of loading, regardless of the boundary condition, have comparable EMG values of primary muscle groups. In addition, this study suggests external load is more important than boundary condition in describing human activity.

Adult↗

Gonococcal infection of human fallopian tube mucosa in organ culture: relationship of mucosal tissue TNF-alpha concentration to sloughing of ciliated cells.

BACKGROUND AND OBJECTIVES: An experimental model consisting of gonococcal infection of human fallopian tube mucosa in organ culture has proven useful in studying the molecular pathogenesis of acute gonococcal salpingitis and postsalpingitis sequelae. Gonococcal infection of human fallopian tube mucosa in organ culture results in the sloughing of ciliated epithelial cells from the mucosa. This damage to the mucosa can be quantified on fallopian tube pieces by an assay of the percent of the periphery that has ciliary activity (PPCA) remaining at specific time points after infection. Although assay of the PPCA has been quite valuable, it is labor-intensive, somewhat subjective, and requires that the observers have training and experience. A more practical assay for genital mucosal damage is desirable for further investigations that employ the fallopian tube experimental model. Gonococcal infection of fallopian tube mucosa in organ culture also results in the production of easily quantified tumor necrosis factor-alpha (TNF-alpha) by the mucosa. Furthermore, treatment of the organ cultures with recombinant human TNF-alpha (rHuTNFalpha) alone also causes sloughing of ciliated cells from the mucosa. These findings strongly suggest that TNF-alpha is a mediator of the mucosal damage that attends gonococcal infection. GOALS OF THE STUDY: To determine: (1) whether the PPCA values and the TNF-alpha concentrations in fallopian tube mucosal tissues correlate closely enough to allow prediction of the PPCA from a measurement of the mucosal tissue TNF-alpha concentration; and (2) whether the correlation of the TNF-alpha mucosal tissue concentration with the sloughing of ciliated cells (measured by the PPCA) supports the hypothesis that induction of TNF-alpha by gonococcal infection, with resultant sloughing of ciliated cells, is likely to be a major pathogenic mechanism of gonococcal salpingitis and might mediate postsalpingitis infertility and ectopic pregnancy. STUDY DESIGN: A metaanalysis was performed on studies from three research groups (two laboratories in the United States and one in the United Kingdom, using identical techniques for quantifying the PPCA, TNF-alpha, or both. RESULTS: There was a close and statistically significant correlation between the TNF-alpha mucosal tissue concentration and the proportion of ciliated cells lost from the mucosa as measured by the PPCA (r = 0.95, p < 0.001). Therefore, as the mucosal tissue concentration of endogenous TNF-alpha increased, the loss of ciliated cells from the epithelium increased proportionately. CONCLUSIONS: During gonococcal infection of human fallopian tube mucosa in organ culture, the mucosal tissue concentration of TNF-alpha can be used to predict the PPCA, and therefore, the extent of mucosal damage. This finding should facilitate studies of the molecular pathogenesis of infectious diseases involving human genital mucosa. Further, the close correlation of mucosal TNF-alpha concentration with genital mucosal damage, evaluated by the PPCA, supports the hypothesis that induction of the proinflammatory cytokine, TNF-alpha, by gonococcal infection, with resultant inflammation and sloughing of ciliated cells, is an important pathogenic mechanism of gonococcal salpingitis and may mediate postsalpingitis infertility and ectopic pregnancy as well.

Cilia↗