摘要:

The goal of immunotherapy in multiple sclerosis (MS) is to halt disease progression by correcting an immunologic abnormality. The experiments described here sought an abnormality of immunoregulation. Specifically, the immunosuppressive activity of adherent monocytes in an in vitro assay of immunoglobulin-secreting cells was tested. Although the peak response was slightly lower, the induction, development and shutdown of the response by MS cells reproduced that of control cells. Most importantly, adherent monocytes from patients with MS exerted the same maximal suppression as did monocytes from controls. Further experiments are required to determine if the adherent monocyte is an appropriate target for immunotherapy in MS.

ISSN:0014-3022    

DOI:10.1159/000116145

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

In order to determine possible correlations to the extent of extracranial carotid artery disease (ECAD), the hemorheologic parameters (hematocrit, fibrinogen, whole blood and plasma viscosity, induced platelet aggregation) of 120 patients with acute cerebrovascular disorders (CVD) were studied and their carotid arteries were investigated by means of Duplex scanning. Plasma viscosity was only significantly elevated in CVD patients with severe ECAD (stenosis >80°/o lumen reduction and/or occlusion) in comparison to CVD patients with normal to mimimally diseased carotids and 67 normal controls. These results suggest that high plasma viscosity is an indicator for the existence of severe ECAD in CVD patients during the acute stage

ISSN:0014-3022    

DOI:10.1159/000116146

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Crossed cerebellar diaschisis (CCD) was investigated in a series of 59 patients (34 completed strokes and 25 reversible ischemic attacks, RIAs) using single photon emission computerized tomography (SPECT) with 123I-HIPDM as a cerebral blood flow (CBF) indicator. CCD was present in 17 (50%) of the patients with completed stroke and in 6 (24%) of the patients with RIAs. CCD was significantly correlated to the clinical severity (p < 0.001) and to the extension of the supratentorial lesion (p < 0.05). However, CCD was also recorded in 3 out of 16 patients with normal neurological examination and CT scan, suggesting that a ‘functional’ hemispheric disturbance may be sufficient to produce a remote effect on the contralateral cerebellar hemisphere. Time elapsed between the clinical onset and SPECT study was not critical, since CCD was recorded in the acute as well as in chronic studies. Follow-up SPECT studies showed that CCD disappeared in 5 out of 18 patients after a successful extra-intracranial bypass, while a spontaneous recovery was observed in only one of 16 nonsurgical patie

ISSN:0014-3022    

DOI:10.1159/000116147

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Fibrinopeptide A (FPA), platelet-secreted protein, platelet factor 4 and beta-thromboglobulin were determined in the cerebrospinal fluid of patients who had suffered from subarachnoid hemorrhage and were treated with 6 g tranexamic acid or 4 million KIU aprotinin to prevent rebleeding. Platelet-secreted proteins and FPA were cleared from the cerebrospinal fluid within 3 days after bleeding. Their vasoactive and thrombotic capability is limited to the initiation period of vasospasm that usually comes to clinical observation 3–8 days after bleeding. Increased thrombotic activity of the cerebrospinal fluid, as reflected by high levels of FPA and platelet-secreted protein, seemed to promote the occurrence of neurological deficit

ISSN:0014-3022    

DOI:10.1159/000116148

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Effects of hypocapnia on cerebral oxygen consumption (CMRO2) and blood flow (CBF) in cerebral ischemia were studied in 19 patients. The CMRO2 did not change significantly during hypocapnia within the whole group of patients, because 10 out of 19 cases showed a decrease (p < 0.001) and other 9 showed an increase (p < 0.01) of CMRO2 during hypocapnia. The first 10 showed higher resting CMRO2 (p < 0.001) and arteriovenous differences of oxygen content (AVDO2; p < 0.02) than the other 9 However, the resting CBF and CO2 reactivity to hypocapnia were not different between them, and clinical situations were also similar. A dissociation between flow and metabolism was suggested in the first 10 with rather preserved CMRO2, while reduced metabolic demands were suggested in the other 9. Different responses of CMRO2 to hypocapnia are expected in cerebral ischemia, i.e. in cases with rather preserved CMRO2 it decreases despite an AVDO2 increase, suggesting a capability of CMRO2 to respond to CBF reduction, while it increases in cases with more decreased CMRO2, as the AVDO2 increase exceeds the CBF reduction to maintain the decreased CMRO2 for a further CBF reduction. The vascular CO2 reactivity, therefore, might be maintained to be constant between these patients.

ISSN:0014-3022    

DOI:10.1159/000116149

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Three patients with severe athetoid-dystonic type of cerebral palsy involving the neck musculature developed in their fourth to fifth decade progressive cervical radiculomyelopathy associated with vertebral spondylarthrotic compressive lesions in addition to their long-standing neurological syndrome. It is likely that the late-onset myelopathy is linked to continuous torsion, compression and ‘wear and tear’ of the cervical spinal cord, induced by the involuntary movements. In 2 patients decompressive cervical spinal surgery was ineffective, suggesting irreversible dam

ISSN:0014-3022    

DOI:10.1159/000116150

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Nonbacterial thrombotic endocarditis (NBTE) is a presentation of an occult malignancy. The clinical, laboratory and postmortem findings of a 44-year-old man with osteopetrosis and NBTE are reported. A small apical bronchogenic carcinoma was found on postmortem examination. A thorough search for malignancy should be made in patients with unexplained cerebral emboli, especially if hematologic abnormalities are present. There is presently no evidence that anticoagulation or other treatment is beneficial.

ISSN:0014-3022    

DOI:10.1159/000116151

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Three patients with POEMS syndrome were studied: two of them had myeloma, whereas the third had M protein without myeloma. Peripheral nerve biopsies showed no deposits of anti-Ig sera at direct immunopathological examination. Ultrastructural study revealed myelino-axonal degeneration in all three cases. This was associated in the first case with a dramatic loss of myelinated fibers and there were lesions consistent with acute degeneration in the second case. In addition, all three had some fibers showing uncompacted myelin lamellae. This peculiar modification has previously been reported only in cases of dysglobulinemia, lymphoma and inflammatory demyelinating polyneuropathy, but its mode of formation remains unclear.

ISSN:0014-3022    

DOI:10.1159/000116152

出版商:S. Karger AG    

年代:1987

数据来源: Karger

摘要:

Cerebrospinal fluid (CSF) lactate and pyruvate concentrations were determined in 16 patients with hepatic encephalopathy before and/or after treatment. CSF lactate was significantly increased to 1.92 ± 0.11 mmol/1 in hepatic encephalopathy before the treatment in comparison to 1.40 ± 0.05 mmol/1 in control subjects. In 9 of 11 patients with moderate or stage 2 encephalopathy, CSF lactate levels were below 2 mmol/1. In contrast, in 4 of 5 patients with stage 3–4 encephalopathy, CSF lactate levels were higher than 2 mmol/1. CSF lactate was decreased with the recovery of neurological symptoms by the treatment. These findings indicate that CSF lactate levels reflect the severity of metabolic impairment of the brain. Hypocapnia was frequently observed in these encephalopathic patients, and arterial Pco2 correlated inversely with CSF lactate and linearly with CSF HCO–3, suggesting that CSF lactic acidosis contributes to hyperventilation in hepatic encephalopathy. It is concluded from present results that metabolic disorder of neuronal cells might be one of the important factors for the development of hepatic encephalo

ISSN:0014-3022    

DOI:10.1159/000116153

出版商:S. Karger AG    

年代:1987

数据来源: Karger

ISSN:0014-3022    

DOI:10.1159/000203507

出版商:S. Karger AG    

年代:1910

数据来源: Karger