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Biomedical subjects

L Milner

Publications and source records attributed to L Milner.

13 recordsLinked to original sources

Urinary basic fibroblast growth factor: a noninvasive marker of progressive cystic renal disease in a child.

Autosomal recessive polycystic kidney disease (ARPKD) is a hereditary condition with an estimated incidence of 1 in 20,000 live births. Various growth factors have been implicated in the causation of this disease. We describe a child with ARPKD whose levels of urinary basic fibroblast growth factor (bFGF) were markedly elevated. The concentrations of bFGF increased further following right nephrectomy, in response to the compensatory growth of the remaining kidney. We hypothesize that measurement of urinary bFGF may be useful as a noninvasive marker to assess progression of cystic renal development.

Adult↗

Two-staged biatrial linear and focal ablation to restore sinus rhythm in patients with refractory chronic atrial fibrillation: procedure experience and follow-up beyond 1 year.

Recent observations regarding the mechanisms of chronic atrial fibrillation (CAF) plus a few encouraging clinical reports have created a paradigm shift regarding treatment strategies and the potential for restoring normal sinus rhythm (NSR) utilizing available catheter-based ablation techniques. The initial and late follow-up clinical experience with a two-staged biatrial linear and focal radiofrequency ablation (BALF I, II) procedure to restore NSR in patients with CAF are described. Pre-BALF management included confirming drug refractoriness and optimizing anticoagulation therapy. BALF I and II were preceded by transesophageal echocardiography to exclude thrombus. Femoral venous catheters were placed in the left atrium and the right atrium with extensive left atrial mapping, ablation (linear and focal) and more limited right atrial ablation. Localized electrogram recordings demonstrated rapid, localized, stable focal driving rotors (FDRs) in the left atrium (nine patients) and in the right atrium (one patient). Atrial or intraatrial tachycardia (IAT) commonly recurred after BALF I. BALF II addresses these recurrences by repeat mapping and ablation techniques. There were no thromboembolic complications. Two patients developed pericardial tamponade that responded to medical management. Of the 11 patients with late follow-up data, 9 have NSR, atrial function, and are no longer experiencing CAF. Left atrial ablation lines decrease continuous electrogram activity, probably isolate portions of the atrium, and unmask FDRs. Focal and linear ablations appear helpful in transforming CAF to NSR. FDRs are commonly localized to pulmonary vein ostium, trabeculated portions of the atrium, and left atrial appendage.

Adult↗

Spinal cord oligodendrocytes develop from a limited number of migratory highly proliferative precursors.

Oligodendrocytes are responsible for myelin formation in spinal cord white matter. In the mature spinal cord, the majority of white matter is localized peripherally. During early development, however, the first oligodendrocyte precursors arise in the ventral ventricular zone of the developing cord. Thus, prior to myelination, both migration and proliferation of oligodendrocyte precursors must occur. When and where these events occur is currently unclear. In the chick spinal cord, oligodendrocyte precursors express antigens recognized by the monoclonal antibody O4. Here we show that all chick spinal cord oligodendrocytes are derived from O4+ cells and all O4+ cells appear to give rise to oligodendrocytes. Analysis of the number and distribution of oligodendrocyte precursors in chick spinal cord at different stages of development suggests that relatively few cells migrate from the ventricular source which then proliferate extensively in white matter. This migration is guided by general dispersive cues. Clonal analysis of oligodendrocyte development in cultures derived from different regions of the rodent spinal cord indicated that the cells that initially populate dorsal and peripheral spinal cord retained similar clonal properties to those in ventral spinal cord, suggesting the migrating cells were immature, highly proliferative precursors. Consistent with these results, BrdU incorporation studies indicate that glial proliferation is extensive and persistent in postnatal rat spinal cord white matter. Together, these studies suggest that spinal cord white matter is initially populated by very immature precursors that then undergo extensive local proliferation prior to myelination.

Animals↗

Nephropathic cystinosis in black children. Case reports.

Cystinosis is thought to be rare in Black patients. Two cases of nephropathic cystinosis in Blacks in early childhood are reported. One patient presented with classic features of Fanconi's syndrome with failure to thrive and rickets, while the other had polyuria, growth failure and rickets. This article highlights the need for the exclusion of cystinosis in any Black patient presenting with Fanconi's syndrome.

Acidosis, Renal Tubular↗