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Biomedical subjects

L Erickson

Publications and source records attributed to L Erickson.

At least 19 recordsLinked to original sources
PubMed2006

Dysplastic naevi with moderate to severe histological dysplasia: a risk factor for melanoma.

BACKGROUND: The risk of malignant melanoma associated with histologically dysplastic naevi (HDN) has not been defined. While clinically atypical naevi appear to confer an independent risk of melanoma, no study has evaluated the extent to which HDN are predictive of melanoma. OBJECTIVES: To estimate the risk of melanoma associated with HDN. Secondarily, the risk associated with number of naevi and large naevi is estimated. METHODS: We enrolled 80 patients with newly diagnosed melanoma along with 80 spousal controls. After obtaining information on melanoma risk factors and performing a complete cutaneous examination, the most clinically atypical naevus was biopsied in both cases and controls. Histological dysplasia was then assessed independently by 13 dermatopathologists (0, no dysplasia; 1, mild dysplasia; 2, moderate dysplasia; 3, severe dysplasia). The dermatopathologists were blinded as to whether the naevi were from melanoma subjects or controls. Multivariate analyses were performed to determine if there was an independent association between the degree of histological dysplasia in naevi and a personal history of melanoma. RESULTS: In persons with naevi receiving an average score of > 1 (i.e. naevi considered to have greater than mild histological dysplasia), there was an increased risk of melanoma [odds ratio (OR) 2.60, 95% confidence interval (CI) 0.99-6.86] which persisted after adjustment for confounders (OR 3.99, 95% CI 1.02-15.71). Very few dermatopathologists reliably graded naevi of subjects with melanoma as being more dysplastic than naevi of control subjects. Among the entire group, the interobserver reliability associated with grading histological dysplasia in naevi was poor (weighted kappa 0.28). CONCLUSIONS: HDN do appear to confer an independent risk of melanoma. However, this result may add more to our biological understanding of melanoma risk than to clinical assessment of risk, because HDN assessed by a single pathologist generally cannot be used to assess risk of melanoma. Future studies should be directed at establishing reproducible, predictive criteria for grading naevi.

Adult↗
PubMed2005

Down-regulation of TGF-beta and VCAM-1 is associated with successful treatment of chronic rejection in rats.

We measured the expression levels of transforming growth factor-beta (TGF-beta) and vascular cell adhesion molecule (VCAM-1) in rat kidney grafts undergoing chronic rejection and treated the rats with six different regimens in order to determine correlation between their expression levels and severity of chronic rejection. F344 or Lewis kidneys were transplanted into Lewis recipients to generate allograft or isograft groups, respectively. Graft recipients were treated with one of the following regimens: (1) untreated isograft, (2) untreated allograft, (3) tacrolimus (FK506), 1 mg/kg/d for 10 days, (4) triptolide (PG490-88), 0.5 mg/kg/d for 10 days, and (5) leflunomide analogue (FK778), 10 mg/kg/d for 10 days. Kidneys were harvested on day 90 after transplantation and subjected to histological analysis and gene expression analysis by real-time reverse transcriptase polymerase chain reaction (RT-PCR) for TGF-beta and VCAM-1. Gene expression values were compared to measurements of chronic rejection by linear regression analysis. Modified Banff score for transplant pathology show that chronic rejection was mild in the FK778 group, moderate in the PG490-88 group, and severe in the FK506 and allograft control groups. Overall, the expression levels of TGF-beta and VCAM-1 show high correlations with histological changes of chronic rejection. Suppression of the expression levels of TGF-beta and VCAM-1 is associated with the amelioration of chronic rejection by various drugs, suggesting that these molecules are important key molecules in chronic rejection.

Animals↗
PubMed2001

Adrenocortical carcinoma: surgical progress or status quo?

HYPOTHESIS: Outcome of patients with adrenocortical carcinoma (ACC) has improved with the advent of more widely available and higher quality imaging. Operative management strategies and use of adjuvant therapy have not changed. DESIGN: Retrospective review of patient histories, imaging studies, operative data, adjuvant therapy, and outcomes at a single institution. Follow-up was complete for a mean of 53 months. Data was compared with prior institutional experience. SETTING: Tertiary care referral center. PATIENTS: All patients undergoing operative management for ACC during the period from 1980 to 1996. MAIN OUTCOME MEASURES: Determinants of recurrence, survival, and the effect of adjuvant therapy on overall outcome. RESULTS: Fifty-eight patients (30 men, 28 women) with a mean age of 53 years underwent primary operative management for ACC. Functional tumors were identified in 27 patients (47%). Mean tumor size was 12.5 cm. Stage according to the TNM staging system (AJCC Cancer Staging Manual) at presentation was I (n = 0), II (n = 30), III (n = 7), and IV (n = 21). Surgical management included curative resection in 41 (71%), noncurative resection in 14 (24%), and open biopsy in 3 (5%). Perioperative mortality was 5%. Recurrence occurred in 30 patients (73%) with a median time to recurrence of 17 months. Five-year survival by the Kaplan-Meier method was 37%. Prognostic factors (P<.05) included functional status, stage, and chemotherapy in stage III/IV patients. When compared with our prior institutional experience (1960-1980), current patients were more likely to present with stages I to II (52% vs. 34%), have curative resections (71% vs. 50%), and have improved 5-year survival (37% vs. 16%). CONCLUSIONS: (1) Surgical resection remains the principal treatment for stage I to III disease. (2) Adjuvant therapy may improve survival in patients with stage III or IV disease. (3) Current patients were more likely to present at an earlier stage, undergo curative resections, and have improved 5-year survival than institutional historical comparisons.

Adolescent↗
PubMed2000

Immunogenicity of porcine transmissible gastroenteritis virus spike protein expressed in plants.

Transgenic plants expressing recombinant proteins from pathogenic microorganisms provide an inexpensive edible vaccine for induction of local immunity. Three transgenic plant lines were generated expressing the spike (S) protein of transmissible gastroenteritis virus (TGEV), a protein crucial for establishing mucosal immunity. All three of them were driven by a strong plant promoter. One construct contained the 3.7 kb 5' end of the native S gene sequence. In the second construct part of the S gene, from nucleotide 49 to 1785, was modified for optimal plant recognition and was fused to a plant signal peptide coding sequence. The third construct contained the D epitope-coding region of the S gene, from nucleotide 1201 to 1591, which was fused to the alfalfa beta-amylase gene. The S gene products were detected by enzyme-linked immunosorbent assay (ELISA) and Western blotting. Antigens from all three transgenic plant lines induced TGEV-specific immune responses in pigs as determined by virus neutralization and ELISA, and the resultant antibody titers for all three constructs were similar.

Animals↗
PubMed2000

Attitudes of emergency nurses regarding patient assaults.

INTRODUCTION: The purpose of this study was to investigate the frequency of patient assaults on emergency nurses and to explore nurses' attitudes about patient assaults. METHOD: A convenience sample of ED nurses (N = 55) from 2 hospitals in the mid-south region of the United States was used. All subjects completed a 31-item questionnaire that assessed frequency of assaults and attitudes about patient assaults. RESULTS: Eighty-two percent of nurses surveyed had been assaulted during their careers. In the preceding year, 56% of nurses had been assaulted; 29% of these assaults were unreported. The majority of nurses (73%) believed that being assaulted "goes with the job." Only 2 nurses (3.6%) felt safe from the possibility of patient assault at work "all of the time." DISCUSSION: The high rate of patient assault and the subsequent underreporting of patient assault identified in our study are consistent with rates reported by other researchers. It is alarming that, although many of these other studies were conducted 10 or more years ago, the assault rates are nearly the same. Of the 45 nurses in this study who had been the victim of patient assaults, only 9 believed that reporting their assaults had been beneficial. Lack of support for nursing, whether it be from other nurses, management, the institution, or society, appears to be responsible for the vast underreporting of patient assaults. Nurses themselves are also unsure of how to proceed. Whereas 91% of the surveyed nurses stated that they believed they had a right to take legal action against an assaultive patient, only 65% stated that it was ethically appropriate and even less (33%) stated that they would actually press charges against an assaultive patient.

Adult↗
PubMed2000

Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs.

OBJECTIVE: Our purpose was to elicit a better understanding of the presentation of acute appendicitis in pregnancy and to clarify diagnostic dilemmas reported in the literature. STUDY DESIGN: We retrospectively reviewed 66,993 consecutive deliveries from 1986 to 1995 by a computer program. Selected records were reviewed for gestational age; signs and symptoms at presentation; complications including preterm contractions, preterm labor, and appendiceal rupture; and histologic diagnosis of appendicitis. RESULTS: Of 66, 993 deliveries, 67 (0.1%) were complicated by a preoperative diagnosis of probable appendicitis. Acute appendicitis was confirmed histologically in 45 (67%) of the 67 cases, for an incidence of 1 in 1493 pregnancies in this population. Distribution of suspected appendicitis in pregnancy was as follows: first trimester, 17 cases (25%); second trimester, 27 (40%); and third trimester, 23 (34%). Right-lower-quadrant pain was the most common presenting symptom regardless of gestational age (first trimester, 12 [86%] of 14 cases; second trimester, 15 [83%] of 18 cases; and third trimester, 10 [78%] of 13 cases). The mean maximal temperature for proven appendicitis was 37.6 degrees C (35.5 degrees C-39.4 degrees C), in comparison with 37.8 degrees C (36.7 degrees C-38.9 degrees C; not significant) for those with normal histologic findings. The mean leukocyte count in patients with proven appendicitis was 16.4 x 10(9)/L (8.2-27.0 x 10(9)/L), in comparison with 14.0 x 10(9)/L (5. 9-25.0 x 10(9)/L) for patients with normal histologic findings. At the time of surgery, perforation had occurred in 8 cases. Of 23 patients at > or =24 weeks' gestational age, 19 (83%) had contractions and an additional 3 patients (13%) had preterm labor with documented cervical change. One patient was delivered in the immediate postoperative period because of abruptio placentae. CONCLUSION: Pain in the right lower quadrant of the abdomen is the most common presenting symptom of appendicitis in pregnancy regardless of gestational age. Fever and leukocytosis are not clear indicators of appendicitis in pregnancy and preterm labor is a problem after appendectomy, but preterm delivery is rare.

Abdominal Pain↗
PubMed1999

A simplified coculture system using homologous, attached cumulus tissue results in improved human embryo morphology and pregnancy rates during in vitro fertilization.

PURPOSE: This study was undertaken to evaluate simplified methods of human embryo coculture using either attached or nonattached autologous cumulus tissue. METHODS: Eight hundred one zygotes were cultured for 48 hr in a prospective, randomized trial comparing culture of embryos either with intact cumulus tissue, with cumulus tissue added to the droplet of culture medium, or without any cumulus tissue. In a follow-up study, embryo quality, pregnancy rates, and implantation rates were compared in 120 consecutive patients undergoing in vitro fertilization with a coculture system using cumulus tissue compared to a cohort of 127 patients undergoing IVF immediately preceding the institution of the coculture protocol. RESULTS: Embryo morphology was significantly improved (P < 0.05) following culture with attached cumulus tissue (5.61 +/- 0.29) and culture with added cumulus tissue (4.72 +/- 0.31) compared to that of embryos grown in culture medium without cumulus tissue (3.95 +/- 0.26). The clinical pregnancy rate improved from 39.4% (50/127) to 49.2% (59/120) following institution of a system of coculture with attached cumulus tissue. CONCLUSIONS: These data indicate that a simple coculture system using autologous cumulus tissue can result in improved embryo morphology, implantation rates, and clinical pregnancy rates during in vitro fertilization. This coculture system is simple, is non-labor intensive, and eliminates many of the risks which may be present in other embryo coculture systems.

Cell Culture Techniques↗
PubMed1998

Complications and sequelae of meningococcal disease in Quebec, Canada, 1990-1994.

To study complications and sequelae of serogroup B and C meningococcal disease, a retrospective survey examined the outcome of all culture-proven cases reported in the province of Quebec, Canada, from January 1990 through December 1994 (serogroup B, 167 cases; serogroup C, 304 cases). Data were collected from medical files, postal questionnaires, and telephone interviews. Age groups having the most cases were the 10-19-year age group for serogroup C and the < 1-year age group for serogroup B. Fatality rates were 7% for serogroup B and 14% for serogroup C disease. Only 3% of survivors of serogroup B disease had physical sequelae, compared with 15% of survivors of serogroup C disease (skin scars, 12%; amputations, 5%; hearing loss, 2%; renal problems, 1%; and other sequelae, 4%). These results confirm the gravity of disease caused by serogroup C, serotype 2a Neisseria meningitidis and justify liberal use of vaccination for outbreak control.

Adolescent↗
PubMed1998

Expression of p27kip1 in prostatic adenocarcinoma.

p27kip1 (p27) protein is an inhibitor of cyclin and cyclin-dependent kinase complexes and prevents progression of cells from G1 to the S phase of the cell cycle. p27 might have tumor suppressor activity, and decreased p27 expression is associated with aggressive tumor behavior in several human malignancies. The object of this study was to evaluate p27 expression in prostatic adenocarcinoma treated by radical prostatectomy and to assess its association with numerous morphologic and clinical features. One hundred thirty-eight prostatic adenocarcinomas were evaluated for p27 expression by quantifying nuclear immunohistochemical staining. p27 expression was tested for association with patient age, family history of prostate cancer, preoperative serum prostate-specific antigen level, Gleason score, extraprostatic extension, seminal vesicle involvement, lymph node metastases, tumor-node-metastasis stage, DNA ploidy by flow cytometric analysis, and subclinical biochemical failure. p27 expression was analyzed as a continuous variable, and we also classified the tumors as low expressors (< 50% of cells p27 positive) or high expressors (> 50% of cells p27 positive) for comparison. Patients with adenocarcinomas that exhibited low p27 expression had higher mean Gleason scores than did high expressors (7 vs. 6.2, respectively; P = .002). Low p27 expression correlated with positive surgical margins (P = .05), seminal vesicle involvement (P = .007), lymph node metastasis (P = .03), and aneuploid cancers (P = .003), but it did not correlate with subclinical biochemical failure. p27 expression correlated with a number of prognostic morphologic features in prostatic adenocarcinoma, and the evaluation of p27 expression might provide additional prognostic information.

Adenocarcinoma↗
PubMed1997

Oral health promotion and prevention for older adults.

An oral health promotion and prevention program customized to individual needs begins with a thorough assessment of function and risk profile for dental diseases. Toothbrushes and interproximal cleaners can be selected or adapted to meet special needs of older adults. Fluoride use based on caries risk is an important adjunct to any prevention program. Other preventive agents such as chlorhexidine rinses and xylitol gum supplement the program as risk factors increase or when health and disability limit the ability to effectively perform oral hygiene procedures. Oral cancer screening examination is advocated on a regular basis for all older persons.

Adult↗
PubMed1996

PO149, a new member of pollen pectate lyase-like gene family from alfalfa.

PO149 is a low-copy-number gene expressed in the late stages of pollen development. The promoter region contains no similarities in DNA sequence to those of other pollen-specific genes, except for a tobacco sequence (AAATGA), which occurs four times in this alfalfa gene and much further upstream than in tobacco. Four distinct TATA boxes were detected in the promoter with the distal and proximal TATA boxes being separated by a spacer of 269 nucleotides. Hairpin loop structures were found in the 5'- and 3'-untranslated regions of PO149 mRNA. The coding region of PO149 is interrupted by two introns and encodes a putative prepeptide of 450 amino acids with homology to pollen pectate lyase-like proteins and pollen allergens. The coding region also contains sequences characteristic of both a signal peptide and a nuclear localization signal.

Allergens↗
PubMed1996

Cloning and characterization of PO22, a pollen-expressed gene in alfalfa.

Genomic and cDNA clones have been isolated for a new gene (PO22) expressed in mature pollen of alfalfa. PO22 represents a single- or low-copy gene containing 4 introns, 2 transcriptional start sites, and coding for a predicted protein of 340 amino acids with no signal peptide and a coiled coil structure of 39 amino acids near the carboxyl end. The amino acid sequence of PO22 is 38% identical to that of an early nodule-specific gene (ENOD8), also from alfalfa.

Cloning, Molecular↗