METHODS: A prospectively maintained surgical database, supplemented
with updates from telephone conversations, of all patients presenting 5-Fluoracil mw to the Barrow Neurological Institute from 1992 to the present was reviewed.
RESULTS: Seventy-three patients (17 males, 56 females; mean age, 40 years; range, 5-80 years) underwent 77 resections. The mean length of follow-up was 27 months (range, 0-129 months). Presenting symptoms included headache (75%), followed by endocrinopathy (49%), and visual symptoms (39%). Preoperative chiasmopathy resolved in 75% and improved in 21% of the patients. Patients’ preoperative endocrinopathy resolved at various rates, depending on the specific axis (29%-100%). Endocrinopathies were more likely to resolve in females than males. New postoperative endocrinopathies also occurred (0-8%). Headache resolved (68%) or improved (21%) in most patients. No patient had worsened headaches. Eight patients had a recurrence, 4 of whom underwent reoperation. The presence of squamous metaplasia was the only predictor
of recurrence.
CONCLUSION: Surgical fenestration and/or resection of Rathke cleft cyst via the transsphenoidal approach are a rational choice for surgical management of these lesions when symptomatic. MDV3100 clinical trial In most cases, visual symptoms and headache can be expected to improve. New persistent endocrine deficits can be expected in a small percentage of patients, but preexisting endocrinopathies resolve in many patients.”
“Neutrophil numbers must be tightly controlled to maintain host protection and prevent neutrophil-mediated tissue injury. CD18 deficiency leads to neutrophilia and myeloid
hyperplasia in the bone marrow (BM). These studies examined the function of CD18 in regulating neutrophil production and determined whether the defects in neutrophil production that are observed in CD18 deficiency persist in the presence many of wild-type (WT) leukocytes that confer host protection. Neutrophil production was evaluated in CD18(-/-) mice and lethally irradiated WT mice reconstituted with mixtures of CD18(-/-) and WT stem cells. Neutrophil kinetic studies suggest that CD18 may facilitate the release of the most mature neutrophils into the circulation. The proportion of CD18(-/-) neutrophils in chimeric animals was greater than the proportion of CD18(-/-) donor cells used to reconstitute the mice, and the percentage of CD18(-/-) leukocytes that were neutrophils was greater than for WT leukocytes, indicating that CD18 may regulate the lineage distribution of hematopoietic cells in the blood and BM. The proportion of Annexin V+ Gr-1+ cells in both the BM of chimeric animals and in vitro cultures of WT and CD18(-/-) hematopoietic stem cells was lower in CD18(-/-) than in WT cells, suggesting that CD18 modulates apoptosis. These data suggest that CD18 directly regulates neutrophil production, in part by limiting the survival of neutrophils and their precursors.