1,721,252 research outputs found
Production of human monoclonal antibodies to hepatitis C virus and their characterization
No full text: Human monoclonal antibodies (hMAb) provide novel ways to probe the B-cell repertoire in health and disease. However, the development of hMAb technology has met with several difficulties owing to the instability of the cell lines, the low level of specific antibody secretion, and the poor cloning efficiency, particularly when using lymphoblastoid cells (1,2). In order to overcome these problems, some investigators have fused human B lymphocytes with human/mouse myeloma heterohybrids. However, in such systems, human chromosomes are unstable and may occasionally be deleted. Despite the potential emergence of technical pitfalls, B-cell immortalization with EBV has been extensively used for hMAb production, because of its simplicity and because EBV can bind to and penetrate in virtually all B lymphocytes, theoretically allowing the exploration of the whole B-cell repertoire. The most recent protocols have made use of techniques aimed at expanding the population of antigen-specific B-cell precursors and improving the capacity of B-cells to grow at low density. These methods will be discussed below
Factors influencing the diagnostic process of carpal tunnel syndrome
No full textThere are no studies regarding the course leading to carpal tunnel syndrome (CTS) diagnosis and factors influencing the diagnostic process. The study aim is to analyse CTS diagnostic path assessing whether the type of physician (general practitioners or specialist) may influence the manner and timing of diagnosis, and whether CTS severity at diagnosis may be predicted by factors related to Public Health Service and/or to patient. A medical history form was filled in by 375 consecutive patients with idiopathic CTS enrolled at an electromyography service. The patient answered a self-administered questionnaire on symptom severity and the neurophysiologist quantified clinical and electrophysiological CTS severity. The patients going directly to general practitioner were older and more blue collars, had minor education level, more symptom duration, more clinical and electrophysiological severity, more medical examination numbers, more time elapsing between first visit to a doctor and referral for EMG than those going to a specialist. But all variables are interrelated and when multivariate logistic regression analyses were performed, only patient age and some other few independent variables related to patient or health care but not to referring doctor could predict CTS severity at the diagnosis. Typology of the first doctor did not influence diagnostic path. The patients should reduce the time elapsing between CTS symptom onset and consulting doctor thus, permitting early treatments. Some corrective actions on diagnostic path may concern the public health service by reducing waiting lists to perform electrodiagnostic testing and giving greater information to population at risk. © 2012 Springer-Verlag Italia
Rare mononeuropathies of the upper limb in bodybuilders
No full textClinical and electrophysiological findings of mononeuropathies of thoracodorsal, dorsoscapular, terminal branch of suprascapular, and medial pectoral nerves are reported in 4 bodybuilders. All athletes used anabolic steroids. After about 1 year partial improvement of symptoms was evident in 2 cases and complete recovery in the other 2. The data are discussed in the light of the few other existing reports and possible pathogenetic mechanism
Carpal tunnel syndrome incidence in a general population
No full textObjective: To determine the incidence of carpal tunnel syndrome (CTS) in a general population of a restricted area in the middle part of Italy. Methods: Prospective study to identify cases of CTS, newly diagnosed on the basis of clinical symptoms and delay in distal conduction velocity of the median nerve. In the 8-year period from 1991 to 1998, cases were identified by electromyographic services in the Siena area of Local Health District No. 7 of Tuscany (Italy). This area has a population of 120,000. Results: In the 8-year period, 3,142 cases (79.7% women and 20.3% men; mean age, 55 years; range, 13 to 97 years) were identified. The mean annual crude incidence was 329 cases per 100,000 person-years, and the standardized incidence was 276. The sex-specific incidences were 139 for men and 506 for women. The mean annual incidence for men increased moderately but significantly during the study period, whereas that for women remained constant. The age-specific incidence for women increased gradually with age, reaching a peak between 50 and 59 years, after which it declined. In men, there was a bimodal distribution with peaks between 50 and 59 years and between 70 and 79 years. Rural and industrial areas had higher crude and age- and sex-specific incidences than did urban areas. Conclusions: The incidence in the Siena area is about threefold that reported in the Rochester area (Minnesota) and is similar to that of Marshfield (Wisconsin). The different results with respect to US reports may depend on case inclusion criteria and occupational activities of the population at risk
Clinical and electrophysiological findings and follow-up in tarsal tunnel syndrome
No full textThe authors report clinical and electrophysiological findings in 59 patients with tarsal tunnel syndrome (TTS) and follow-up in 23 of them. The entrapment was prevalent in females; was bilateral in 6 patients and involved medial plantar in 7 and lateral plantar nerves in two cases. Eleven presented with other nerve entrapment syndromes or focal mononeuropathies, due to hereditary neuropathy with liability to pressure palsy or systemic diseases. The other 48 subjects had TTS without any other related entrapment syndromes: 23 were idiopathic cases, 13 had a history of local trauma, 3 had systemic diseases and the others had external or intrinsic compressions. The most frequent symptoms were paraesthesia or dysaesthesia (86% of feet) and pain (55%). Hypoaesthesia of the sole and weakness of toe flexion were evident in 74% and 22% of feet, respectively. Absence of sensory action potential or slowing of sensory conduction velocity (SCV) of the plantar nerves were present in 77% of feet; significant differences of SCV between affected and unaffected plantar nerves and/or between distal sural and plantar nerves were evident in 14%. Abnormalities of plantar SCV were therefore absent in only 9% of feet. Distal motor latency was delayed in 55% and electromyography showed neurogenic changes in 45% of sole muscles. Five cases (6 feet) underwent surgery with excellent or good results in 5, 4 of them also showing improvement in distal conduction of the plantar nerves. Nine were treated with local steroid injections, with good results shown in 6 patients. Nine other patients who did not receive any therapy showed a disappearance of symptoms or good outcome in 6 cases. The subjects with poor therapeutic results had S1 radiculopathy or systemic diseases. The authors underline that patients with connective tissue diseases should not be treated by surgical decompression because they may have subclinical neuropathy. Some subjects with idiopathic or trauma-induced TTS recover spontaneously. Surgical release should be limited to cases with space-occupying lesions and when conservative treatments fail. Copyright (C) 1998 Elsevier Science Ireland Ltd
Ulnar neuropathy at the elbow in diabetics
No full textObjective: To compare the prevalence of diabetes in a consecutive sample of patients with ulnar neuropathy at the elbow (UNE) with that in patients with carpal tunnel syndrome (CTS) and to assess differences in demographic, clinical, and electrophysiologic findings between diabetic, idiopathic, and posttraumatic UNE.
Design: Six thousand eight hundred seventy-one and 434 consecutive patients diagnosed with CTS and UNE, respectively, were admitted to an outpatient electromyography service between 1995 and 2006. Twenty-six UNE and 452 CTS patients also had diabetes.
Results: Prevalence of diabetes in UNE was 6.0% and did not differ from that in CTS (6.6%); there were more male diabetic UNE patients (61.5%) than diabetic CTS patients (35.8%). There was no difference in occupation, duration of symptoms, association with CTS, polyneuropathy, and many neurographic findings of the ulnar, median, and radial nerves between diabetic and idiopathic or posttraumatic UNE patients when UNE groups were matched by sex and age, except for differences in sensory action potential amplitudes of diabetics vs. the other two groups.
Conclusions: The prevalence of diabetes is the same in UNE and CTS patients. The patients with UNE and diabetes are clinically and electrophysiologically indistinguishable from other groups of UNE patients, except for a reduction in sensory action potential amplitudes in the diabetic UNE group, presumably owing to diabetic polyneuropathy. Subjects with UNE and diabetes could therefore be treated in the same way as patients with idiopathic forms
Evidence of improvement in distal conduction of ulnar nerve sensory fibers after carpal tunnel release
No full textOBJECTIVE:
The aim of this study was to verify any effect of carpal tunnel release (CTR) on distal ulnar nerve conduction findings, using the database of a previous study performed to establish a protocol for CTR outcome.
METHODS:
The motor and sensory ulnar distal conduction findings of 251 consecutive hands belonging to 217 patients (175 women and 42 men; mean age, 55.6 years) with idiopathic carpal tunnel syndrome (CTS) were reanalyzed before and 1 and 6 months after CTR.
RESULTS:
Before surgery, 115 hands (45.8%) showed reduction of ulnar nerve sensory action potential (SAP) amplitude; this number was reduced significantly to 85 (33.9%) after CTR. The SAP amplitude and sensory conduction velocity values of the ulnar nerve showed significant improvement 1 month after CTR; SAP amplitude values showed further significant improvement 6 months after CTR. Patients' ages and occupations were independent predictors of reduced baseline SAP amplitudes of the ulnar nerve in CTS.
CONCLUSION:
These results demonstrate an improvement in conduction values in sensory ulnar fibers in a percentage of patients with CTS after CTR, providing further support for the conclusion that in CTS ulnar fibers may be subject to compressive forces in the Guyon canal as a consequence of high pressure in the carpal tunne
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