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Biomedical subjects

R C Richards

Publications and source records attributed to R C Richards.

At least 37 records · Page 2Linked to original sources

Concentrations of epidermal growth factor in mouse milk throughout lactation.

A radioimmunoassay was used to measure the concentration of epidermal growth factor (EGF) in mouse milk throughout lactation. The EGF content of mouse milk increased steadily from birth to a concentration of 427 micrograms/l at day 8 of lactation. These high levels were maintained until the approach of weaning, when values decreased from day 17 to 130 micrograms/l at day 22. Milk samples chromatographed on a Biogel P10 column gave a major peak of immunoreactivity at the point at which pure standard EGF was eluted. The origin of milk EGF is unknown, but the high concentrations of this peptide identified in mouse milk suggest that it must play a role in the neonate.

Animals↗

Spontaneous mesenteric fibromatosis in Gardner's syndrome.

Mesenteric fibromatosis has been reported in frequent association with familial polyposis and with Gardner's syndrome. This vague "benign" process has been characterized as a postsurgical phenomenon with low morbidity. Two cases of spontaneous mesenteric fibromatosis, noted at the time of original laparotomy for colectomy in Gardner's syndrome patients, are reported. No history of abdominal trauma was present, and both have well-documented Gardner's findings. A 32% incidence of desmoid reaction is reported among affected members of the original Gardner's syndrome Kindred 109; five or 55% of these patients had the mesenteric form of the process. The potential fatal course of the mesenteric disease is emphasized.

Adult↗

Splenectomy for immune thrombocytopenic purpura.

Of 481 splenectomies performed at the University of Utah, Salt Lake City, 78 (16.2%) were for immune (idiopathic) thrombocytopenic purpura (ITP). The mean platelet count prior to therapy was 13,800/cu mm (range, 500 to 80,000/cu mm). All but two patients were initially treated with corticosteroids, and 58.2% responded with an increase in platelets (mean, 77,900/cu mm). The indications for splenectomy included (1) failure to respond to steroids (33.8%); (2) inability to taper steroids (52.1%); (3) recurrent ITP (5.6%); and (4) miscellaneous (8.5%). There was one death following splenectomy, and the postoperative morbidity was 14.1%. Complete remission occurred in 77.3%, and 84.8% were judged to have benefited from the procedure. The remission rate following splenectomy in patients who responded to preoperative steroids was 93.2%, whereas improvement fell to 68.3% in patients who failed to respond to steroids. This study confirms the benefit of splenectomy for ITP and demonstrates a predictive correlation with response to preoperative preparation with corticosteroids in these patients.

Adolescent↗

The current role of thymectomy for myasthenia gravis.

Myasthenia gravis is an autoimmune disease characterized by muscle weakness and fatigability due to a reduction in available acetylcholine receptors at the neuromuscular junction. Treatment with anticholinesterase drugs and corticosteroids has improved the prognosis for patients with this disease. However, controversy continues concerning the indications for thymectomy. During a 9 year period, 27 patients who underwent thymectomy by median sternotomy were reviewed. Eighty-one percent of these patients benefited from the procedure. Clinical improvement did not correlate with age, sex, duration of symptoms, severity of disease or thymic histology, This suggests that the indications for thymectomy should be liberalized to include most patients with generalized myasthenia who fail to respond readily to conventional medical therapy. The importance of immunosuppression nd plasmapheresis in the therapy of myasthenia gravis awaits further delineation of the immune defect associated with the disease.

Adolescent↗

Desmoid tumors and mesenteric fibromatosis in Gardner's syndrome: report of kindred 109.

Kindred 109, from which Gardner's syndrome was first described, now has 224 members, 28 of whom have inherited the syndrome. Among the group of 28, desmoid tumors or mesenteric fibromatosis or both have developed in eight (29%). In four patients, the fibrous dysplasia appeared to originate in postsurgical abdominal incisional scars; in two of these cases, the mesenteric involvement resulted in death. In one patient, the process was present in the mesentery at the original operation. In three patients, the fibrous dysplastic lesions were extraincisional, with no known trauma associated with their occurrence.

Abdominal Muscles↗

Miners, health--2.

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Accidents, Occupational↗