ABSTRACT
OBJECTIVES: This study aimed to evaluate serum otolin-1 levels in patients with benign paroxysmal positional vertigo and to compare these levels with healthy individuals. METHOD: This was a case-control study. After obtaining institutional ethical committee clearance, the serum level of otolin-1 was calculated in adult individuals (18-75 years old) who were divided into group 1 (patients presenting with benign paroxysmal positional vertigo) and group 2 (healthy patients without benign paroxysmal positional vertigo as the control group). Data analysis was carried out to compare the serum levels in the cases and controls. A p-value less than 0.05 was considered significant. RESULTS: A total of 70 age-matched individuals (cases, n = 40; controls, n = 30) were included in the study. The mean serum level of otolin-1 was 636.8 pg/ml (range, 259-981 pg/ml) in the group of patients with benign paroxysmal positional vertigo and 236.2 pg/ml (range, 189-370 pg/ml) in the control group. The difference was statistically significant (p = 0.0000). CONCLUSION: The serum levels of otolin-1 in patients with benign paroxysmal positional vertigo are significantly higher compared with individuals without benign paroxysmal positional vertigo.
Subject(s)
Benign Paroxysmal Positional Vertigo/blood , Extracellular Matrix Proteins/blood , Adult , Aged , Case-Control Studies , Enzyme-Linked Immunosorbent Assay , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
STUDY DESIGN: Lumbar MRI of normal adults. Image analysis to measure lumbar CSF volumes at rest and during physiologic maneuvers. OBJECTIVES: 1) Validate an MRI technique to measure CSF volumes, 2) use this technique to measure the resting volume of lumbar CSF, 3) measure changes in CSF volume with physiologic maneuvers, and 4) demonstrate the anatomic basis for these volume changes. SUMMARY OF BACKGROUND DATA: Studies using radiograph and radionuclide myelography in dogs and humans in the 1960s-1980s qualitatively showed decreases in spinal CSF volume with physiologic maneuvers. Theories were proposed to explain these changes, but they could not be confirmed because only the contrast-laden CSF was visualized using these techniques. METHODS: Four adult volunteers had lumbar MRI using a fat-saturated T2-weighted three-dimensional fast spin-echo sequence. Quantitative analysis of images was used to measure lumbar CSF volume; the technique was validated using a water phantom. Lumbar CSF volume was measured 1) at rest, 2) with hyperventilation, 3) with abdominal compression, and 4) with both hyperventilation and abdominal compression. RESULTS: Resting lumbar CSF volume ranged from 28 to 42 mL. Reversible changes in lumbar CSF volume resulting from physiologic maneuvers are visualized by MR myelography and measured. The volume change (10% reduction in volume with hyperventilation, 28% with compression, and 41% with combined hyperventilation and abdominal compression) is directly visualized to be caused by engorgement of the epidural venous plexus, compressing the thecal sac. CONCLUSIONS: MRI provides a noninvasive means to measure spinal CSF volume and demonstrates the anatomic basis of physiologic volume changes. This has important implications for spinal anesthesia.
Subject(s)
Cerebrospinal Fluid/metabolism , Magnetic Resonance Imaging/methods , Abdomen , Adult , Female , Humans , Hyperventilation/metabolism , Lumbar Vertebrae , Male , Pressure , Spinal Cord/anatomy & histology , Spinal Cord/metabolismABSTRACT
Low tissue concentrations of the essential fatty acid, linoleic acid, occur in communities with high rates of coronary disease and in patients with angina and myocardial infarction. This relationship is independent of lipids and blood pressure, but in smokers linoleic acid is particularly low because they eat less linoleic acid-containing foods.
Subject(s)
Coronary Disease/etiology , Linoleic Acids/deficiency , Coronary Disease/physiopathology , Humans , Linoleic Acids/administration & dosage , Linoleic Acids/metabolism , Male , Risk FactorsABSTRACT
Systemic allergic reactions to food ingestion rarely result in life-threatening situations. When these reactions occur during pregnancy, however, the accompanying physiologic changes may result in fetal distress. A case of repetitive late decelerations in the fetal heart rate during a maternal allergic reaction is presented. Prompt and aggressive medical management brought about total resolution of maternal and fetal compromise.
Subject(s)
Fetal Distress/etiology , Food Hypersensitivity , Shellfish/adverse effects , Adult , Diphenhydramine/therapeutic use , Ephedrine/therapeutic use , Female , Fetal Heart/drug effects , Fluid Therapy , Food Hypersensitivity/drug therapy , Heart Rate/drug effects , Humans , Oxygen/therapeutic use , PregnancyABSTRACT
A case of acute bacterial endocarditis with aortic valve abscess, aortic insufficiency, and congestive heart failure at 32 weeks' gestation is described. Prompt valve replacement is indicated due to the risks of embolism to the coronary arteries and brain, and to the high mortality of such patients with medical management only. The infant was delivered prematurely to avoid the intraoperative risks to the fetus of cardiac surgery. General rather than regional anesthesia was chosen because venous pooling from a regional block would necessitate preoperative fluid loading and vasopressor therapy, which would be stressful for an already failing heart. In the presence of severe congestive heart failure, the patient underwent cesarean section and delivered a health 2020-g male infant; 36 hours later the aortic valve was successfully replaced with a no. 21 Byork-Shiley prosthesis. The infecting organism was Streptococcus viridans.
