Showing papers by "Mayo Clinic published in 1986"
TL;DR: The MPNST is an aggressive uncommon neoplasm, and large tumor size, the presence of neurofibromatosis, and total resection are the most important prognostic indicators.
Abstract: A review was done of 120 cases of malignant peripheral nerve sheath tumor (MPNST) seen during a 71-year period. Of the 120 patients, 52 were males and 68 were females with a mean age at diagnosis of 35.3 years; 12 patients were younger than 20 years. The series included 62 (52%) patients with neurofibromatosis, 13 (11%) with postradiation sarcomas, and 19 (16%) with metaplastic foci. The incidence of MPNST arising in neurofibromatosis was 4.6% in the current series and 0.001% in the general clinic population. Tumors greater than 5 cm and the presence of neurofibromatosis adversely affected the prognosis (P less than 0.05). When both features were present, survival was greatly decreased. Patients with tumor in the extremities did better than those with head or neck lesions. Metaplastic foci or previous radiation at the tumor site did not alter the prognosis. Each tumor was graded 1 to 4 on the basis of cellularity, pleomorphism, mitotic index, and necrosis. No significant correlation was noted between survival and either grade or mitotic rate. Survival was improved when total rather than subtotal resection was done. This was most marked in patients with a small lesion, which may reflect the difficulty in adequately excising large tumors. Adjuvant radiation or chemotherapy did not appear to affect survival. The MPNST is an aggressive uncommon neoplasm, and large tumor size, the presence of neurofibromatosis, and total resection are the most important prognostic indicators.
1,448 citations
Journal Article•
TL;DR: The excitement and attention focused on cellular oncogenes in recent years is now turning toward growth factors, not only as they concern the control of normal cell growth but also the involvement of growth factor-initiated pathways in the etiology of cancer.
Abstract: Growth factors, defined as polypeptides that stimulate cell proliferation, are major growth-regulatory molecules for cells in culture and probably also for cells in vivo. Nontransformed cells show an absolute requirement for growth factors for proliferation in culture and generally more than one growth factor is required. Under usual culture conditions, growth factors are more rapidly depleted than other media components and thus become rate limiting for proliferation. The loss of or decreased requirement for specific growth factors is a common occurrence in neoplastically transformed cells and may lead to a growth advantage, a cardinal feature of cancer cells. Recent work with transforming growth factors, the platelet-derived growth factor, and oncogenes has produced some insight into the mechanisms through which alterations in growth factor-receptor-response pathways could lead to a growth advantage. Evidence has been derived for autocrine secretion in which the cell produces its own growth factor. Many transformed mesenchymal cells produce PDGF (the product of the c-sis proto-oncogene) and certain transformed cells both produce and respond in a growth-stimulatory manner to TGF beta. With TGF beta, which is a growth inhibitor for certain epithelial and other cell types, the loss of the normal inhibitory response in transformed cells could have the same result as the activation of a growth-stimulatory response. Two proto-oncogenes, erbB and fms, encode growth factor receptors. In the erbB case, the viral erbB aberrant receptor produced is truncated and appears to be constitutively activated without the need for a growth factor. Recent studies suggest that the p21 product of the ras oncogene may be an obligatory intermediate in transducing the growth factor signal. Activation of ras may, therefore, activate the growth factor pathway without the need for either a growth factor or its receptor. The transcription of myc and fos is induced by growth factor stimulation of quiescent cells. The protein products of both are nuclear associated and conceivably could be involved in regulating other genes important in the control of cell proliferation. Activation or inappropriate expression of either myc or fos could produce the same end result as stimulation of a growth factor pathway leading to a growth advantage. Study of the molecular mechanism(s) of growth factor action has just begun. The excitement and attention focused on cellular oncogenes in recent years is now turning toward growth factors, not only as they concern the control of normal cell growth but also the involvement of growth factor-initiated pathways in the etiology of cancer.(ABSTRACT TRUNCATED AT 400 WORDS)
868 citations
TL;DR: It is established that elevated cardiac filling pressure is associated with increased circulating concentrations of atrial natriuretic peptide and that congestive heart failure is not characterized by a deficiency in atrialNatriureic peptide, but with its elevation.
Abstract: A sensitive radioimmunoassay for atrial natriuretic peptide was used to examine the relation between circulating atrial natriuretic peptide and cardiac filling pressure in normal human subjects, in patients with cardiovascular disease and normal cardiac filling pressure, and in patients with cardiovascular disease and elevated cardiac filling pressure with and without congestive heart failure. The present studies establish a normal range for atrial natriuretic peptide in normal human subjects. These studies also establish that elevated cardiac filling pressure is associated with increased circulating concentrations of atrial natriuretic peptide and that congestive heart failure is not characterized by a deficiency in atrial natriuretic peptide, but with its elevation.
864 citations
TL;DR: From 1935 through 1982, keratoconus was newly diagnosed in a total of 64 residents of Olmsted County, Minnesota; there were no significant trends in incidence rates over time; the overall average annual rate was 2.0 per 100,000 population.
830 citations
TL;DR: The evidence reviewed here indicates that the eosinophil has the ability to kill many species of helminths and likely does so during worm infection and also participate in inflammation in human disease especially asthma, skin diseases, and heart disease.
Abstract: Publisher Summary This chapter reviews information on eosinophil structure and function and provide evidence for the eosinophil as an effector cell for killing helrninths and for causing tissue damage in hypersensitivity diseases. The mammalian eosinophil is distinguished by its characteristic granules. The chapter describes specific or secondary granules with an electron-dense core and an electron-radiolucent matrix and two other distinctive types of eosinophil granules as well. While granules with crystalloid cores are characteristic of most mammalian eosinophils—the horse eosinophil is a notable exception—cores have not been observed in lowest vertebrates with the exception of certain teleost fishes and some birds. The evidence reviewed in the chapter indicates that the eosinophil has the ability to kill many species of helminths and likely does so during worm infection. This toxic ability appears to be regulated by several other cells including mast cells, monocytes, and T lymphocytes. It has also been found that an eosinophil-related protein appears to play an undefined role in human reproduction.
802 citations
TL;DR: This study demonstrates the effectiveness of delayed excision after failure of closed management of fractures of the radial head with some justification for the initial closed treatment of these fractures.
Abstract: Twenty-one patients had a delayed excision of a previously fractured radial head (range, one month to more than twenty years). There were four Mason type-II and seventeen Mason type-III fractures. Five fractures had been associated with a concomitant dislocation of the elbow and four, with an ulnar fracture. All of the patients were evaluated for pain, motion, strength, stability, and function by personal interview, examination, and testing in an upper-extremity-biomechanics laboratory. The average length of follow-up was fifteen years (range, three to thirty-two years). Postoperatively, pain was less severe in 76 per cent of the patients and motion was improved in both flexion and rotation in 81 per cent. An objective functional index showed that 77 per cent of the patients had a good or excellent result while 23 per cent had a fair or poor result. This study demonstrates the effectiveness of delayed excision after failure of closed management of fractures of the radial head. Thus, some justification is offered for the initial closed treatment of these fractures, with delayed excision of the radial head to be considered as needed.
702 citations
TL;DR: The vascular endothelium is the layer of squamous epithelial cells that is in direct contact with the blood and modulates the reactivity of vascular smooth muscle.
Abstract: The vascular endothelium is the layer of squamous epithelial cells that is in direct contact with the blood. In addition to its other important functions, which include capillary transport, regulation of plasma lipids, and participation in the control of hemostasis, it modulates the reactivity of vascular smooth muscle. This regulatory role is accomplished through several mechanisms: The layer (a) interposes a physical barrier between the vascular smooth muscle and hormones and other vasoactive substances circulating in blood; (b) it extracts or metaboli cally degrades vasoactive substances such as norepinephrine, serotonin, and kinins and thereby prevents or diminishes their activity in vascular smooth muscle; (c) it converts precursors (e.g. angiotensin I) into vasoactive products; (d) it secretes known vasoactive substances, primarily prostacyclin; and (e) it releases other still unidentified inhibitory and excitatory mediators in response to vasoactive stimuli. This review will summarize the evidence that the latter mechanism exists in mammalian blood vessels.
671 citations
TL;DR: These and other findings suggest the hypothesis that the eosinophil mediates damage to the respiratory epithelium and is the prime effector cell in the pathophysiology of asthma.
Abstract: Eosinophilia of lung and blood associated with injury to the mucociliary escalator and excessive shedding of bronchial epithelium are hallmarks of both allergic and nonallergic asthma. In vitro, the eosinophil granule major basic protein (MBP) is toxic to helminths and to mammalian cells, including human respiratory epithelium. The MBP-mediated damage to the respiratory epithelium consists of desquamation and frank destruction of ciliated cells. Increased sputum MBP concentration is a good marker for asthma, and patients treated for acute asthma have high levels of MBP in their sputa, which decrease after treatment. Peak sputum MBP levels approximate concentrations toxic to respiratory epithelium in vitro. In the lungs of patients who had died of asthma, MBP has been localized outside of the eosinophil in association with damage to the epithelium. Overall, these and other findings suggest the hypothesis that the eosinophil mediates damage to the respiratory epithelium and is the prime effector cell in the pathophysiology of asthma.
612 citations
TL;DR: The ligamentous structures of the acromioclavicular joint were studied by gross examination and quantitative measurement in twelve human cadaver specimens and the conoid ligament appeared to be more important than has been previously described.
Abstract: The ligamentous structures of the acromioclavicular joint were studied by gross examination and quantitative measurement in twelve human cadaver specimens Distances between insertions at various extreme positions of the clavicle were studied with the biplane radiographic technique Ligamentous contributions to joint constraint under displacements were determined by performing load-displacement tests along with sequential sectioning of the ligaments Twelve modes of joint displacement were examined The acromioclavicular ligament acted as a primary constraint for posterior displacement of the clavicle and posterior axial rotation The conoid ligament appeared to be more important than has been previously described That ligament played a primary role in constraining anterior and superior rotation as well as anterior and superior displacement of the clavicle The trapezoid ligament contributed less constraint to movement of the clavicle in both the horizontal and the vertical plane except when the clavicle moved in axial compression toward the acromion process The various contributions of different ligaments to constraint changed not only with the direction of joint displacement but also with the amount of loading and displacement For many directions of displacement, the acromioclavicular joint contributed a greater amount to constraint at smaller degrees of displacement, while the coracoclavicular ligaments, primarily the conoid ligament, contributed a greater amount of constraint with larger amounts of displacement
568 citations
TL;DR: To define the natural history of relapsing polychondritis, the probability of survival and causes of death were determined in 112 patients seen at one institution by using covariate analysis and early clinical manifestations were identified that predicted mortality.
Abstract: To define the natural history of relapsing polychondritis, the probability of survival and causes of death were determined in 112 patients seen at one institution. By using covariate analysis, early clinical manifestations were identified that predicted mortality. The 5- and 10-year probabilities of survival after diagnosis were 74% and 55%, respectively. The most frequent causes of death were infection, systemic vasculitis, and malignancy. Only 10% of the deaths could be attributed to airway involvement by chondritis. Anemia at diagnosis was a marker for decreased survival in the entire group. There was an interaction between other disease variables and age in determining their impact on outcome. For patients less than 51 years old, saddle-nose deformity and systemic vasculitis were the worst prognostic signs. For older patients, only anemia predicted outcome. The need for corticosteroid therapy did not influence survival.
561 citations
TL;DR: A model is proposed in which the monolayer mitogenicity of transforming growth factor beta is mediated by the induction of c-sis and PDGF and the subsequent autocrine stimulation ofc-fos, c-myc, and other PDGF-inducible genes.
Abstract: Treatment of quiescent cultures of mouse embryo-derived AKR-2B cells with transforming growth factor beta resulted in an early induction of c-sis mRNA. The increase in c-sis mRNA was followed by a corresponding increase in protein similar to platelet-derived growth factor (PDGF) in the culture medium. In addition, PDGF-regulated genes (c-fos and c-myc) were stimulated by transforming growth factor beta with delayed kinetics relative to that seen in other cell systems with direct PDGF stimulation. A model is proposed in which the monolayer mitogenicity of transforming growth factor beta is mediated by the induction of c-sis and PDGF and the subsequent autocrine stimulation of c-fos, c-myc, and other PDGF-inducible genes.
TL;DR: Hallmarks of findings on aortography and CT scan include the presence of the ulcer and an intramural hematoma and the potentially progressive and serious nature of this condition may remain unappreciated.
TL;DR: The data show that before menopause little, if any, bone islost from the appendicular skeleton but substantial amounts are lost from the axial skeleton, and factors in addition to estrogen deficiency must contribute to pathogenesis of involutional osteoporosis in women.
Abstract: We made longitudinal measurements of bone mineral density (BMD) in 139 normal women (ages 20-88 yr) at midradius (99% cortical bone) and lumbar spine (approximately 70% trabecular bone) by single- and dual-photon absorptiometry. BMD was measured 2-6 (median, 3) times over an interval of 0.8-3.4 yr (median, 2.1 yr). For midradius, BMD did not change (+0.48%/yr, NS) before menopause but decreased (-1.01%/yr, P less than 0.001) after menopause. For lumbar spine, there was significant bone loss both before (-1.32%/yr, P less than 0.001) and after (-0.97%/yr, P = 0.006) menopause; these rates did not differ significantly from each other. Our data show that before menopause little, if any, bone is lost from the appendicular skeleton but substantial amounts are lost from the axial skeleton. Thus, factors in addition to estrogen deficiency must contribute to pathogenesis of involutional osteoporosis in women because about half of overall vertebral bone loss occurs premenopausally.
TL;DR: Nine risk variables recorded at entry, including age, sex, height, weight, history of smoking, presence of absence of mild disease, electrocardiographic response to exercise, family history of coronary heart disease and a history of hypertension had predictive value for survival.
TL;DR: Despite their disconcerting appearance on angiography, spontaneous dissections of the internal carotid arteries are often associated with a good prognosis.
Abstract: We studied 36 patients (21 women and 15 men) with spontaneous dissection of the internal carotid arteries. The ages of these patients ranged from 21 to 63 years. Focal unilateral headache was the most common symptom. Other common clinical manifestations (in decreasing order of frequency) included focal cerebral ischemic symptoms, oculosympathetic paresis, bruits, light-headedness, and neck pain. Less common symptoms were syncope, amaurosis fugax, scalp tenderness, swelling in the neck, and dysgeusia. Common angiographic manifestations (in decreasing order of frequency) were elongated, irregular, and frequently tapered narrowing of the lumen; abrupt luminal reconstitution (often at the carotid canal); aneurysms; intimal flaps; slow internal carotid artery--middle cerebral artery flow; tapered occlusion; and distal branch occlusions. The incidence of hypertension in these patients was considerably higher than that in the general population. Angiographic evidence of fibromuscular dysplasia was found in 14% of the patients, but atherosclerotic changes were uncommon. Follow-up ranged from 14 to 140 months (mean, 58.5 months). Twenty-three patients with 29 dissected internal carotid arteries were also restudied angiographically. The stenosis of the internal carotid artery either completely resolved or substantially improved in more than 85% of the dissected vessels. About two-thirds of the dissecting aneurysms either resolved or decreased in size. Clinically more than 85% of the patients had an excellent or complete recovery. Recurrence of the dissection or rupture of a dissecting aneurysm was not noted. Despite their disconcerting appearance on angiography, spontaneous dissections of the internal carotid arteries are often associated with a good prognosis.
TL;DR: It is concluded that for some patients with chronic inflammatory demyelinating polyradiculoneuropathy, plasma exchange has an ameliorating effect on neurologic dysfunction and nerve conduction, but in others no improvement is observed.
Abstract: Plasma exchange has been reported to be efficacious in chronic inflammatory demyelinating polyradiculoneuropathy. We performed a prospective double-blind trial in which patients with static or worsening disease were randomly assigned to plasma exchange (n = 15) or to sham exchange (n = 14) for three weeks. After three weeks, we observed statistically significant differences in combined measurements of nerve conduction (total, motor, proximal, velocity, and amplitude) favoring patients who had received plasma exchange. Improvement to a greater degree than for any patient receiving sham exchange was detected in the neurologic-disability score in five patients (P = 0.025) and in subset scores for weakness and reflex in four patients (P less than 0.057). We conclude that for some patients with chronic inflammatory demyelinating polyradiculoneuropathy, plasma exchange has an ameliorating effect on neurologic dysfunction and nerve conduction, but in others no improvement is observed. Because plasma was replaced with normal serum albumin, a humoral factor or factors may have a role in the neurologic deficit of this disorder.
TL;DR: The authors' experience involving 221 consecutive patients with giant-cell tumor who were treated from 1960 to 1982 is reported, and curettage and bone-grafting, with preservation of function of the joint, is the preferred treatment for most patients.
Abstract: Our experience involving 221 consecutive patients with giant-cell tumor who were treated from 1960 to 1982 is reported. Of one group of 146 patients, twenty-seven who were initially treated by wide resection and 112 who had thorough curettage had a recurrence rate of 23 per cent after an average length of follow-up of seven years. All thirty-three recurrences were noted less than six years after operation, and twenty-seven were noted within the first three years postoperatively. Over-all, the type of surgical removal was the most significant factor in recurrence. The recurrence rate was 34 per cent in the patients who had curettage of the lesion and 7 per cent in those who had a wide resection. In a second group of seventy-five patients, initially treated by us for a recurrent tumor, there were fifteen subsequent recurrences, after an average length of follow-up of seven years. Curettage and bone-grafting, with preservation of function of the joint, is the preferred treatment for most patients.
TL;DR: Prognosis for patients with mesenchymal chondrosarcoma is usually poor, and long‐term follow-up is necessary, and the value of irradiation or chemotherapy (or both) was difficult to assess in the current study.
Abstract: A series of 111 mesenchymal chondrosarcomas was reviewed. The ages of the patients ranged from 5 to 74 years, and approximately 60% of them were in the second and third decades of life. There was no significant sex predilection. Seventy-two tumors, including 5 that involved multiple skeletal sites, arose in bone. Thirty-eight tumors were found in extraskeletal sites. At initial diagnosis, multifocal involvement, both in bone and in soft tissue, was observed in one case. Roentgenographically, the lesions in bone frequently resembled ordinary chondrosarcomas, showing osteolytic and destructive appearances with stippled calcification. Tumors in extraskeletal sites were almost always identified as calcified masses. Histologically, a combination of cellular zones composed of undifferentiated small cells and chondroid zones typically presented a bimorphic appearance that was virtually pathognomonic in most cases. Ablative surgical treatment seemed to be the procedure of choice. The value of irradiation or chemotherapy (or both) was difficult to assess in the current study. Prognosis for patients with mesenchymal chondrosarcoma is usually poor, and long-term follow-up is necessary. In a group of 23 patients from the Mayo Clinic, the 5-year survival rate was 54.6% and the 10-year survival rate was 27.3%. Cancer 57:2444–2453, 1986.
TL;DR: Motility varied widely between and within individuals, and differences between normal patterns in the jejunum and ileum were particularly striking, suggesting levels of recordings must be defined accurately if putative abnormalities, of possible clinical significance, are to be interpreted correctly.
TL;DR: It is concluded that pyloric dysmotility forms part of the widespread disruption of gut motility that affects some patients with diabetes.
TL;DR: The cell type, clinical appearance, and degree of dysplasia did not correlate with recurrence; involvement of the margins of the initial excision was an important prognostic sign for recurrence.
TL;DR: Aprotein kinase phosphorylation site in chicken gizzard myosin light chain kinase (MLCK) has been identified, and a synthetic peptide analogue of this site has been shown to be a high-affinity calmodulin binding peptide as well as a substrate for cyclic AMP dependent protein kinase.
Abstract: A protein kinase phosphorylation site in chicken gizzard myosin light chain kinase (MLCK) has been identified, and a synthetic peptide analogue of this site has been shown to be a high-affinity calmodulin binding peptide as well as a substrate for cyclic AMP dependent protein kinase. Phosphorylation of the site in MLCK is diminished when reactions are done in the presence of calmodulin. A fragment of MLCK containing the phosphorylation site was shown to have the amino acid sequence Ala-Arg-Arg-Lys-Trp-Gln-Lys-Thr-Gly-His-Ala-Val-Arg-Ala-Ile-Gly-Arg-Leu- Ser-Ser. The interaction of calmodulin with a synthetic peptide based on this sequence was characterized by using circular dichroism and fluorescence spectroscopies and inhibition of calmodulin activation of MLCK. The peptide-calmodulin complex had an estimated dissociation constant in the range of 1 nM, underwent spectroscopic changes in the presence of calmodulin consistent with the induction of an alpha-helical structure, and interacted with calmodulin with an apparent 1:1 stoichiometry. Studies with other synthetic peptide analogues indicated that the phosphorylation of the serine residues diminished the ability of the peptide to interact with calmodulin even though the serines are not required for calmodulin binding. On the basis of the primary and secondary structural characteristics of these peptide analogues, a potential calmodulin binding region in another calmodulin binding protein, the gamma subunit of rabbit skeletal muscle phosphorylase kinase, was identified.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: It is concluded that there is increasing evidence that microvascular pathological abnormality and ischemia may be involved in the pathogenesis of human diabetic polyneuropathy.
Abstract: Pathological, morphometric, and teased fiber studies of sural nerve from 36 diabetic patients with (n = 32) and without (n = 4) neuropathy and from 47 healthy subjects provide evidence that in diabetic polyneuropathy: (1) fiber loss is primary; (2) demyelination and remyelination with or without onion bulb formation are secondary; (3) remaining fibers, on average, have the same ratio of small to large fibers as in healthy individuals, but with a greatly increased variability; and (4) the spatial distribution of fiber loss is both diffuse and multifocal. Criteria developed during the study of experimental models of ischemic neuropathy were employed to assess whether ischemic nerve damage had occurred in diabetic polyneuropathy. We conclude that there is increasing evidence that microvascular pathological abnormality and ischemia may be involved in the pathogenesis of human diabetic polyneuropathy. Cases with selective loss of small or large afferent fibers are probably extremes of a normal distribution and not different disorders.
TL;DR: A new approach to the assessment of fracture risk from bone mineral density measurements indicates that osteoporosis is an important underlying cause of hip fractures.
Abstract: The incidence of cervical and intertrochanteric proximal femur fractures at various levels of cervical and intertrochanteric bone mineral density, respectively, was estimated by using population-based data from ongoing studies of osteoporosis and fractures among women residing in Rochester, Minnesota. Hip fractures were uncommon among women with femoral bone density greater than or equal to 1.0 g/cm2, but their frequency increased as bone density declined below that point at both femoral sites. The incidence of cervical femur fractures was estimated at 8.3 per 1,000 person-years among women with cervical bone density less than 0.6 g/cm2, while the estimated incidence of intertrochanteric femur fractures reached 16.6 per 1,000 person-years among those with intertrochanteric bone density less than 0.6 g/cm2. This new approach to the assessment of fracture risk from bone mineral density measurements indicates that osteoporosis is an important underlying cause of hip fractures.
TL;DR: A total of 422 patients with malignant lymphoma of bone who were seen at the Mayo Clinic from 1907 through 1982 were placed into four major groups based on stage of disease, and treatment may be very important in outcome.
Abstract: A total of 422 patients with malignant lymphoma of bone who were seen at the Mayo Clinic from 1907 through 1982 were placed into four major groups based on stage of disease. There was one group with primary lymphoma of bone, one group with multifocal osseous lymphoma, and two groups with lymphoma of bone and nodal or soft tissue (or both) disease. The last-mentioned two groups were separated on the basis of time of onset of osseous lymphoma in relation to the nonosseous disease. The stage of disease was the single most important prognostic indicator of overall survival in malignant lymphoma of bone. The 5- and 10-year survival rates were, respectively, 58% and 53% for patients with primary bone lymphoma, 22% and 12.5% for patients with bone and nodal or soft tissue (or both) disease, and 42% and 35% for patients with multifocal osseous disease. Features having no significant prognostic value were sex of the patient, histologic grade of the lymphoma (according to the Working Formulation and the Kiel system), and presence of T-cell features or cleaved cells (or both). This study is not able to adequately address efficacy of treatment. In fact, treatment may be very important in outcome.
TL;DR: Blood-culture procedures must be designed to overcome the intermittency and low order of magnitude of most bacteremias and fungemias and to inhibit any antimicrobial properties or components of the blood.
Abstract: Blood-culture procedures must be designed to overcome the intermittency and low order of magnitude of most bacteremias and fungemias and to inhibit any antimicrobial properties or components of the blood. Among the several variables affecting yields, the volume of blood cultured appears to be most important. It is recommended that at least 10 ml, and preferably 20-30 ml, of blood be obtained for each of two to three separate cultures. More than three separate blood cultures per septic episode is rarely necessary. Other issues involve the systems used for blood culture and the procedures used for their examination.
TL;DR: Five patients had a "complex" of unusual findings including multiple pigmented skin lesions (lentiginosis), myxoid fibroadenomas of the breast, skin myxomas, and primary pigmented nodular adrenocortical disease (a cause of Cushing's syndrome).
TL;DR: Although operative mortality in patients with complex aspergilloma was high, 67% of the survivors had a good long-term result in terms of absence of symptoms, but they frequently died of underlying disease, and argues for rigorous postoperative surveillance.
TL;DR: In this paper, the eosinophil-derived neurotoxin (EDN) and eosINophil cationic protein (ECP) were isolated from lysates of human eosinsophil granules by gel filtration and ion exchange chromatography on heparin-Sepharose.
Abstract: Eosinophil-derived neurotoxin (EDN) and eosinophil cationic protein (ECP) were isolated from lysates of human eosinophil granules by gel filtration and ion exchange chromatography on heparin-Sepharose. Radioimmunoassay, using monoclonal antibodies, of fractions from the heparin-Sepharose chromatography showed one peak of EDN activity and two peaks of ECP activity (termed ECP-1 and ECP-2). EDN, ECP-1, and ECP-2 each exhibited heterogeneity in charge and molecular weight when analyzed by two-dimensional nonequilibrium pH gradient electrophoresis and NaDodSO4/PAGE. Digestion of EDN with endoglycosidase F (endo F) decreased its molecular weight and charge heterogeneity. Thus, END likely contains a single complex oligosaccharide. Endo F digestion of ECP-1 and ECP-2 decreased the molecular weight of both polypeptides, indicating that both likely contain at least one complex oligosaccharide. Amino acid sequence analyses showed that ECP-1 and ECP-2 are identical from residue 1 through residue 59 and that the sequences of EDN and ECP are highly homologous (37 of 55 residues identical). Both EDN and ECP NH2-terminal sequences showed significant homology to RNase, especially in regions of the RNase molecule involved in ligand binding. EDN, ECP-1, and ECP-2 had neurotoxic activity, causing the Gordon phenomenon at doses down to 0.15 micrograms when injected into the cisterna magna; the proteins were comparable in their activities. These results indicate that EDN and ECP are related proteins and suggest that they derived from genes associated with the RNase family.
TL;DR: Patients were divided into two groups for comparison of treatment results; results suggested that among the latter group, those treated with steroids fared better than those in any of the other treatment groups.
Abstract: The average annual incidence of Bell's palsy per 100,000 population in Rochester, Minnesota, for 1968 through 1982 was 25.0 for both sexes combined; crude rates for males and females were 22.8 and 26.9, respectively, based on 85 males and 121 females. The relationship between various clinical features, patient characteristics, and the type of recovery was analyzed. In 206 patients, 28 (14%) experienced incomplete recovery and 178 (86%) had complete recovery, based on evidence in the medical records. Using logistic regression, complete facial weakness, non-ear pain, and hypertension were identified as the most important risk factors for incomplete recovery. Patients were divided into two groups for comparison of treatment results; one group (n = 94) was without any of the three identified risk factors, and the other group (n = 112) consisted of patients who had one or more risk factors. Results suggested that among the latter group, those treated with steroids fared better than those in any of the other treatment groups.