The lung depicted in CT images was segmented and the extent of emphysema was assessed using the density-mask technique. Wall area as a percentage of total airway area (WA%), which has been associated with lung function, , was computed using a partial membership algorithm developed at the University of Pittsburgh, and used as a measure of bronchial thickening. The apical bronchus of the right upper lobe was manually selected from the CT images and analyzed in cross-section. Images were reconstructed contiguously at 2.5 mm section thickness with a 2.5 mm interval using a GE Healthcare high-spatial frequency kernel with a range of pixel dimensions from 0.54 to 0.98 mm. The CT examinations were acquired using a helical technique at 120 or 140 kVp with a mean tube current-time product of 28.9 (+7.9) mAs. The subjects underwent low-dose CT examinations performed on either a LightSpeed Plus 4-detector (n = 110) or LightSpeed Ultra 8-detector (n = 124) (GE Healthcare). Therefore, we conducted a cross-sectional study examining both the association of unique serum inflammatory profiles with quantitative CT derived airway and parenchymal phenotypes of COPD and the variation of these associations with smoking status. Whereas the recent evolution of quantitative computed tomography (CT) technology has provided a non-invasive method of estimating the contribution of airway thickening versus parenchymal emphysema within an individual patient, ,, ,, we postulated that characterization of the inflammatory profile within radiographic sub-types of COPD will provide a basis for the refinement of disease classification, offer insights into variations in disease pathogenesis and identify novel therapeutic targets and surrogates associated with clinically meaningful outcomes. However, the variation of peripheral inflammatory mediators and the association with pulmonary histopathologic phenotypes remains a largely uninvestigated research area. The diverse presentation of disease resulting from a single environmental exposure, cigarette smoke, suggests the presence of distinct bio-molecular and cellular pathways leading to a divergence of anatomic phenotypes. In fact, future research efforts will be immobilized without a more thorough understanding of the molecular pathogenesis driving phenotype expression and a more refined schema for characterizing disease.Īlthough the presence of systemic inflammation in COPD is widely accepted, ,, , the inter-individual variation in the patterns of the inflammatory response is not emphasized in the existing literature. The precise classification of these disease phenotypes is paramount to the elucidation of pathogenic mechanisms and the development of innovative, effective therapies for COPD. Varying contributions of airway remodeling and emphysema can be found in any individual, leading to significant heterogeneity in disease expression,. All in all, if you can stand the trade off of exclusive pictures for small picture size and an annoying watermark, a week's membership through is defanately recommended.īig mitigating factor: the lesbian initiations are definitely one-of-a-kind (the trampoline orgy was my favorite) and pretty much worth the price of admission.While airflow obstruction is the hallmark of chronic obstructive pulmonary disease (COPD), the distinct processes of parenchymal destruction and small airway fibrosis can induce similar impairments in expiratory flow. I recognized a number of other non-exclusive models as well: Joey Lane from FTV, Lilly Ann, Charlie Lane, Felix Viscious, and Lexi Matthews were a few of the stand-out hotties there. The tawnee pics are old and have been floating around Usenet for years, and there are only 4 or so sets of Jordan because she has her own website (and is featured prominantly on as well, where I think the LS stands for "LeSbian" instead of LightSpeed ) Of the Lightspeed exclusive girls, Tawnee Stone and Jordan Capri (mmmm, Jordan Capri, ) are the hottest in my opinion, although they do make a big deal out of Rachel, I guess because she doesn't have her own website. I would recommend, however, shelling out $9.95 for the 1-week offer through instead - you get access to 3 great sites (and a bunch of shitty sites) for one low price. Like the other lightspeed sites, monthly membership is high, but there is a "hidden" 1-week trial offer of $6.95 if you navigate the the "Join Now!" page and then close your browser to get a popup window with the offer. Hot girls, unique content, small pictures, annoying watermark.
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