Browsing by Author "Johnson, A. J."

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    Factors Associated with Traumatic Fluoroscopy-Guided Lumbar Punctures: A Retrospective Review
    (American Journal of Neuroradiology, 2009-03-01) Yu, S. D.; Chen, M. Y.; Johnson, A. J.; Surgery, School of Medicine
    BACKGROUND AND PURPOSE: To minimize diagnostic confusion, a CSF specimen should be free from traumatically introduced red blood cells (RBCs). The purpose of this research is to determine if patient age, sex, gauge of the lumbar puncture (LP) needle, or the level of LP is associated with an increased risk for traumatic fluoroscopy-guided LP. MATERIALS AND METHODS: Data were collected retrospectively for consecutive male and female patients of all ages (n = 756) who underwent a fluoroscopy-guided LP for a 2-year period. We defined traumatic LP as a CSF sample with an RBC count more than 500 cells/mm3 without xanthochromia. RESULTS: Rate of traumatic LP was 13.3%. The rate of traumatic LP at the L4-L5 level (19%) was significantly higher than at the L2-L3 (9%) or L3-L4 level (10%). Patients older than 80 years had higher traumatic LP rates (25.9%) compared with patients between ages 11 and 80 years (12.4%). Sex and gauge of the spinal needle were not associated with increased rate of traumatic LP. Patients younger than 1 year had failed LP rate of 58.8% compared with 3.2% failure rate in older patients. CONCLUSIONS: Fluoroscopy-guided LP at the L4-L5 level is associated with nearly twice the risk for traumatic puncture compared with the L2-L3 or L3-L4 level. Rates of traumatic result are twice as high in adults older than 80 years compared with younger patients. Failure rates for fluoroscopy-guided LP are low except in children younger than 1 year, in whom failure occurs in most cases.
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    Immune signatures underlying post-acute COVID-19 lung sequelae
    (AAAS, 2021-11) Cheon, I. S.; Li, C.; Son, Y. M.; Goplen, N. P.; Wu, Y.; Cassmann, T.; Wang, Z.; Wei, X.; Tang, J.; Li, Y.; Marlow, H.; Hughes, S.; Hammel, L.; Cox, T. M.; Goddery, E.; Ayasoufi, K.; Weiskopf, D.; Boonyaratanakornkit, J.; Dong, H.; Li, H.; Chakraborty, R.; Johnson, A. J.; Edell, E.; Taylor, J. J.; Kaplan, M. H.; Sette, A.; Bartholmai, B. J.; Kern, R.; Vassallo, R.; Sun, J.; Microbiology and Immunology, School of Medicine
    Severe coronavirus disease 2019 (COVID-19) pneumonia survivors often exhibit long-term pulmonary sequelae, but the underlying mechanisms or associated local and systemic immune correlates are not known. Here, we have performed high-dimensional characterization of the pathophysiological and immune traits of aged COVID-19 convalescents, and correlated the local and systemic immune profiles with pulmonary function and lung imaging. We found that chronic lung impairment was accompanied by persistent respiratory immune alterations. We showed that functional severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–specific memory T and B cells were enriched at the site of infection compared with those of blood. Detailed evaluation of the lung immune compartment revealed that dysregulated respiratory CD8+ T cell responses were associated with the impaired lung function after acute COVID-19. Single-cell transcriptomic analysis identified the potential pathogenic subsets of respiratory CD8+ T cells contributing to persistent tissue conditions after COVID-19. Our results have revealed pathophysiological and immune traits that may support the development of lung sequelae after SARS-CoV-2 pneumonia in older individuals, with implications for the treatment of chronic COVID-19 symptoms.