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Biomedical subjects

A Myking

Publications and source records attributed to A Myking.

16 recordsLinked to original sources
PubMed2003

Disease severity and outcome in thymoma myasthenia gravis: a long-term observation study.

Thymomas occurring in myasthenia gravis (MG) are usually of the cortical subtype and are usually treated by thymectomy. However, the factors that influence MG outcome in thymoma MG patients are not known. In a long-term study, MG severity and treatment was observed in 24 thymoma and 24 non-thymoma MG patients for up to 30 years, and the occurrence of muscle autoantibodies was assayed. The rate of complete stable remission was low and did not differ between the two groups. There was no significant difference in MG severity between thymoma and non-thymoma MG patients at any time during the study. Titin and ryanodine receptor (RyR) antibody occurrence was significantly higher in thymoma MG patients. Four thymoma (all titin and RyR antibody positive) and two non-thymoma (both titin and one RyR antibody positive) MG patients died from MG-related respiratory insufficiency. Seventy percent of thymoma and 75% of non-thymoma MG patients were treated with immunosuppressive drugs. The number of patients who received plasmapheresis did not differ in those who were treated because of acute MG deterioration, irrespective of planned surgery.This study shows equal MG severity and outcome in thymoma and non-thymoma MG, but the presence of RyR antibodies in thymoma MG and titin/RyR in non-thymoma MG indicates a less favorable prognosis.

Adrenal Cortex Hormones↗
PubMed2003

Thymectomy in nonthymoma early-onset myasthenia gravis in correlation with disease severity and muscle autoantibodies.

OBJECTIVE: To study the clinical effect of thymectomy in a well-defined early-onset MG subgroup and to correlate it to MG severity, the presence of circulating muscle autoantibodies, and the need for pharmacological treatment in a long-term setting. METHODS: Fifty-two consecutive AChR antibody-positive early-onset MG patients (34 thymectomized and 18 nonthymectomized) were included. Severity was assessed and the pharmacological treatment monitored on a yearly basis, starting from the year of MG onset, for 5, 10, 15, and 20 consecutive years; AChR, titin, and RyR antibodies were assayed. RESULTS: In the four follow-up groups, MG severity was significantly higher in nonthymectomized compared to thymectomized MG patients. The postthymectomy MG improvement was significant and persistent. There were 21/34 remissions in thymectomized patients and only 4/18 in the nonthymectomized group. Patients with initially high or low AChR antibody concentration had a similar thymectomy outcome. Only 6 patients had titin antibodies, and none had RyR antibodies. CONCLUSION: The present study indicates a benefit of thymectomy in early-onset MG. The muscle autoantibody concentration does not influence the outcome of thymectomy in early-onset MG.

Acetylcholine↗
PubMed2002

Thymectomy and anti-muscle autoantibodies in late-onset myasthenia gravis.

Thymectomy is still widely carried out in myasthenia gravis (MG) patients, but its role, especially in late-onset MG patients, is not established. These patients are immunologically heterogeneous, some with thymoma-like and others with early onset-like features. We evaluated whether any therapeutic effects of thymectomy correlate with the presence of non-acetylcholine receptor (AChR) muscle antibodies. The severity of MG, and titin and ryanodine receptor (RyR) antibodies, were assessed yearly starting from MG onset in 21 thymectomized and 22 non-thymectomized AChR antibody positive late-onset MG patients, who were followed for 2, 3 and 5 years. Clinical or pharmacological remission were seen in six of 11 titin antibody negative but none of the 10 titin antibody positive thymectomized patients, however, the non-thymectomized cases showed an opposite trend. The three MG-related deaths were all in patients with titin antibodies. There was no significant difference in MG severity between thymectomized and non-thymectomized patients; 2 years after MG onset, both groups were significantly improved. This study showed no dramatic benefit from thymectomy in late-onset MG in general. Any limited improvement appeared less likely in cases with titin and/or RyR antibodies.

Age of Onset↗
PubMed1994

Renal effects of maintenance low-dose cyclosporin A treatment in psoriasis.

The renal effects of low-dose cyclosporin A (CsA) treatment in severe psoriasis was investigated in 10 patients treated with a mean CsA dose of 3.23 (range 1.94-4.10) mg/kg/day for 12 months. The psoriasis area and severity index was reduced by 63-76%. Ambulatory GFR (iothalamate-125I), ERPF (hippuran-131I), RVR and MAP were examined at 3-months intervals. A control renal biopsy was performed shortly before treatment start and a second biopsy was taken after 12 months of therapy. GFR was slightly but significantly reduced after 6 and 9 months; after 12 months the decrease was not significant (121.0 +/- 7.6 versus 115.2 +/- 7.8 ml/min/1.73M2, P > 0.10). After 12 months serum creatinine increased from 82 +/- 4 to 94 +/- 7 mumol/litre (P < 0.05), while an insignificant increase of ERPF was seen and FF decreased from 0.29 +/- 0.01 to 0.26 +/- 0.01 (P < 0.05). MAP remained unchanged. GFR and serum creatinine correlated significantly within each 3-month interval. A slight de novo interstitial fibrosis was seen in the second biopsy in 4 of 10 patients receiving a mean CsA dose of 3.2-4.1 mg/kg/day. In three of these patients a concomitant rise in serum creatinine was seen. In conclusion, low-dose CsA was associated with reversible fall in GFR and potentially progressive structural changes not always accompanied by corresponding functional alterations. One should consider reducing the daily dose of CsA to 3.0 mg/kg bodyweight or less in CsA therapy up to 1 year.

Adult↗
PubMed1992

Serum vitamin D metabolites and calcitriol receptor concentration in parathyroid tissue in primary hyperparathyroidism.

Vitamin D metabolites in serum and calcitriol receptor concentration in parathyroid tissue were examined in 52 patients operated on for primary hyperparathyroidism. The calcitriol receptor levels were not different in parathyroid adenomas (mean 224 fmol/mg of protein, range 29-509, N = 43), normal parathyroid tissue (mean 245, range 31-690, N = 20), and primary parathyroid hyperplasia (mean 172, range 46-477, N = 9). Preoperative serum levels of calcitriol concentration correlated inversely to the calcitriol receptor in normal parathyroid tissue in patients with adenoma (r = -0.57, N = 17, p = 0.017), but no such correlation was found in the corresponding adenomas (r = 0.14, p = 0.59). In 31 patients in whom both pre- and postoperative vitamin D metabolite analyses were carried out, 23 had lower calcitriol postoperative concentrations compared to preoperative values (p = 0.012, sign test). No change was found in the other vitamin D metabolites postoperatively. By multiple regression analysis calcitriol concentration in serum was inversely correlated to the serum concentration of urea and phosphate (p = 0.003). We conclude that calcitriol may influence calcitriol receptor expression in normal parathyroid tissue, but not in adenomatous parathyroid gland. Furthermore, serum calcitriol was correlated to the renal function, and phosphate level, and in most patients the calcitriol concentration was lower after the operation.

Adenoma↗
PubMed1992

Is Lauren's histopathological classification of importance in patients with stomach cancer? A national experience. Norwegian Stomach Cancer Trial.

This study was performed to investigate the association between Lauren's histopathological classification system and different clinico-pathological characteristics in patients with gastric carcinoma. We revealed that the percentage of intestinal type tumour (ITT) increased with advancing age (52% in patients less than 60 years compared to 73% of octogenarians (P less than 0.001)). The male:female ratio was 1.7 for ITT versus 1.3 for diffuse type tumour (DTT (P = 0.12)). ITT was more common in proximally (fundus) localized tumours than in distal lesions (77% vs 65%; P less than 0.05). The proportion of patients with ITT decreased with advancing stages of the disease (70% in stage I and II vs 52% in stage IV (P less than 0.0001)). More patients with DTT had tumour infiltration in the resection margin (21% vs 9%; P less than 0.001). Intestinal metaplasia was found in 48% of those with ITT compared with 28% of those with DTT (P less than 0.001). No association was found between Lauren's classification and the ABO blood group or between the tumour types and infiltration in lymphatic or blood vessels. We conclude that gastric adenocarcinoma occurs in at least two different biological forms and that differentiation between the two is of relevance for treatment.

Adult↗
PubMed1991

[Necrotizing sialometaplasia of the hard palate].

Necrotizing sialometaplasia is a benign, self-healing disease of salivary gland tissue and is usually confined to the minor salivary glands of the hard palate. It has clinical and histological features that simulate malignancies such as mucoepidermoid and squamous cell carcinomas. Wrong diagnosis has led to unnecessary mutilating surgical procedures. The etiology of the disease is unknown, but an ischaemic process is considered most likely. We describe two patients with necrotizing sialometaplasia, one with midline and one with bilateral symmetrical affection of the hard palate.

Adult↗
PubMed1989

[Smoking prevention. Courses on smoking prevention conducted at a regional hospital].

We present the results of four smoking cessation courses conducted during the period 1986 to 1988 and including 105 persons. 68 women and 37 men participated in weekly lessons, three prior to and two after a predetermined quit-smoking day. Physicians presented information and smoking cessation techniques, the latter based on cognitive behavioural modification. At one year follow-up 27% of the participants had stopped smoking and 49% had reduced smoking consumption. More intensive follow-up and pharmacological treatment might reduce the relapse rate further.

Hospitals, District↗
PubMed1988

Transthoracic fine-needle aspiration guided by fluoroscopy: validity and complications with 19 operators.

During a 3-year period, 19 physicians performed 271 transthoracic fine-needle aspirations (FNA) in 199 patients, using a 23-guage aspiration needle with an 18-guage guiding needle. The diagnosis was confirmed by cytological examination of the needle aspirates in 90 out of 122 patients with malignant tumors, giving a sensitivity of 74%. The specificity of the cytological diagnosis was 100%. Both cytological and histological material was available in 49 patients. The tumor typing from the FNA specimens and the biopsies was in agreement in all but 3 cases. Pneumothorax occurred in 27% of the patients, but only 3.5% required tube drainage. Small variations (p greater than 0.05) in number of diagnostic punctures and rate of complications were evident among the participating physicians and between two fluoroscopic equipments.

Adolescent↗
PubMed1988

Large intramuscular spindle-cell lipoma. With review of the literature. A case report.

A case of a large spindle-cell lipoma in an intramuscular (subfascial) localization is reported. The tumour occurred in a 58-year-old male patient and was localized subfascially in his left deltoid muscle. The tumour measured 20 X 8 X 8 cm; its weight was 780 grams. After initial biopsy, the tumour was extirpated. Microscopically, the tumour tissue consisted of mature fat cells and spindle-cell areas in varying amounts, constituting a typical appearance of a spindle-cell lipoma. There were no histological signs of malignancy. Especially, no areas of liposarcoma differentiation were detected. The patient is well, with no signs of recurrence, one and a half years after the operation. We have reviewed the literature on spindle-cell lipoma, and we believe this is the first example of this neoplasm to be reported in an intramuscular (subfascial) localization.

Humans↗
PubMed1985

Budd-Chiari syndrome with obstruction of the inferior caval vein: successful treatment by cavosplenoatrial shunt.

A 27-year-old man had a 10-month history of recurrent ascites, massive edema, and extreme fatigue. The diagnosis of Budd-Chiari syndrome with severe stenosis of the retrohepatic part of the inferior caval vein had been established. Medical treatment had failed to prevent further deterioration. A single 14 mm Gore-Tex graft (W.L. Gore & Associates, Inc. Elkton, Md.) was used to establish a cavosplenoatrial shunt. The postoperative recovery was uneventful. All signs of ascites and edema disappeared within 8 weeks after surgery. In connection with repair of a ventral hernia 8 months later, a liver biopsy specimen revealed partial normalization of liver histology and an angiography demonstrated a patent shunt. Two and a half years after the initial operation he developed a bleeding peptic ulcer demanding emergency surgery. The shunt was again found patent. Three years after the first operation the patient is free of symptoms and working full time.

Adult↗
PubMedDate not supplied

Temporary ischaemia of a large bowel segment induced by degradable starch microspheres in man.

Degradable starch microspheres were used to induce temporary ischaemia measured by electromagnetic flowmetry in colon segments during bowel resection. Severe reversible ischaemia free from unwanted side effects was induced in eight of nine patients. In one of the five patients where the tumour was included in the microsphere-embolised tissue volume no reduction in blood flow was seen. Segmental enteric ischaemia induced by degradable starch microspheres in man seems safe and may be useful for radioprotective purposes in clinical radiation therapy.

Aged↗