ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04194.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

To determine the effects of high‐dose intravenous methylprednisolone (MP) on lymphocytes and lymphocyte subpopulations in the cerebrospinal fluid (CSF) and peripheral blood (PB) in multiple sclerosis (MS) patients, we studied 67 patients with definite MS treated with MP. They were classified according to the disease course: 32 chronic progressive (CP) patients, 25 relapsing‐remitting (RR) patients, and 10 patients with a chronic progressive disease course accompanied by relapses and remissions (CP + RR). MS patients were treated with 1000 mgr intravenous MP daily for 10 consecutive days. Before and after MP treatment we simultaneously studied CSF and PB CD3 +, CD4 +, CD8 +, CD20 +, and Ial + cells subsets. Kurtzke's Expanded Disability Status Scale (EDSS) was used for clinical evaluation. Progression rate was defined as the ratio of EDSS to disease duration. Thirteen patients with lumbar disk herniation were investigated as controls. Before MP, we found in MS patients, especially in the CP group, significantly lower CD4 + T‐cell percentages in the PB with respect to controls (P<0.05). The percentage of CD4 + T‐cells in the CSF of MS patients was significantly higher compared with PB (p = 0.0001), and tended to be higher than in controls (p = 0.072). The CSF mononuclear cell counts were significantly correlated with higher percentages of CSF CD3 + (r = 0.40) and CD4 + (r = 0.47) T‐cells and lower CSF CD8 + (r = ‐0.33) T‐cell percentages. B‐cell percentages in the CSF were significantly elevated compared with controls for all MS groups. No relation could be obtained between T‐ or B‐cell subsets and EDSS or progression rate. After MP, a significant decrease in PB CD8 + T‐cell percentage and simultaneously an increase of the percentage CD8 + T‐cells in CSF was noted in the entire MS group and in the CP and RR MS patients. Except for the CP + RR MS patients, CD4 + T‐cell percentages in the PB or CSF showed insignificant changes. Our findings support the view that in MS MP might affect the inflammatory process of demyelination by a selective and dissociative effect on T‐suppressor/cytoto

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04195.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This study compared change scores obtained on patient self‐reported symptoms (MS‐RS) with the neurological examination of the Kurtzke Functional Systems (FS) and change scores obtained on patient self‐reported activities of daily living (ADL‐MS) with the neurologist‐determined Expanded Disability Status Scale (EDSS) that were obtained from two separate times separated by approximately seven months for 100 patients with multiple sclerosis. Percent agreement based on ≥ 1 unit difference between patient and neurologists’ change scores (Time 2‐Time 1) ranged between 73% and 86% for MS‐RS and FS measures and was 72% for ADL‐MS and EDSS. Together, the ADL and MS‐RS patient self‐report scales provide health status information from the patient's perspective that can be useful in guiding the physical examination, in making comparisons from visit to visit and/or between visits, in assessing patients’ quality of life, and in increasing patient satis

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04196.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The specificity for GFAP (glial fibrillary acidic protein) of oligoclonal IgG bands in the CSF of a patient with acute myelitis was demonstrated by isoelectric focusing and affinity blotting. Findings were confirmed by western blotting using a monoclonal antibody to GFAP as a reference. Immune reactions to this astrocyte protein are considered as arising secondary to spinal cord tissue lesion.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04197.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Pentoxifylline, a widely used methylxanthine, has been proven to inhibit the production and action of the cytokine TNF α. Since it has been suggested that TNF α is the major cytokine involved in the pathogenesis of multiple sclerosis, we tested pentoxifylline for its capacity to prevent experimental allergic encephalomyelitis (EAE). 26 Lewis rats with acute EAE were treated with either pentoxifylline or saline. The pentoxifylline treated rats showed a significantly lower incidence of clinical signs as well as significantly lower histological inflammation. The exact mechanism of this preventive effect remains to be clarified but it might be mainly related to inhibition of TNF α release from central nervous system macrophag

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04198.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Histopathological and immune‐histochemical studies were carried out in four cases with multiple lacunes of the central grey matter and in control cases without such lesions. Routine light microscopic techniques were applied on paraffin‐embedded material to identify lesions that may represent developing lacunes. In addition, polyclonal antisera to human albumin, IgG, fibrinogen and fibronectin were chosen as markers for extravasated plasma proteins. The brain tissue between lacunes contained several forms of focal injuries which may represent precursors of lacunes. Such lesions included foci of status spongiosus and status cribrosus, regions with dilated extracellular spaces and astrocytic gliosis, and multi‐locular cysts. These “lacune‐associated lesions” often included albumin immune‐reactivity in extracellular spaces, nerve cell bodies and astrocytes. Less frequently signs of extravasated IgG, fibrinogen and fibronectin were identified. Thus, lacunes of the human brain frequently showed signs of antigenic sites to albumin. The extracellular deposits probably represent extravasated material from the blood. Vasogenic and cytotoxic oedema combined with other factors probably play important roles during the formation of some o

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04199.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

We have investigated the reliability of transcranial doppler compared with cerebral angiography in acute ischemic stroke in the middle cerebral artery territories. We studied 48 patients, 28 men and 21 women, mean age 68.1 (range 54–75), observed within 5 h of the onset of ischemic stroke in the middle cerebral artery territory. Ultrasound evaluation (duplex scanner and transcranial doppler) and cerebral angiography were carried out in close sequence immediately after CT scan. CT was repeated by Day 7 to estimate the infarct size: 27/48 patients had intracranial arterial obstructions. An acoustic temporal “window” was not found in 6.25%. Transcranial doppler showed a sensitivity of 80.0% and a specificity of 90.0% compared with cerebral Angiography for patients with patent acoustic temporal “windows”. Accuracy was 79.2%, when patients with no “windows” were included. With respect to intracranial internal carotid artery and middle cerebral artery mainstem, transcranial doppler showed a sensitivity of 95.0%, and a specificity of 92.0%. Including patients with no windows, accuracy was 87.5%. Conclusions: Our data suggest that Transcranial Doppler can be reliably used to demonstrate intracranial internal carotid artery or middle cerebral artery mainstem obstructions in the acute phase of a bra

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04200.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Quantified magnetic resonance imaging (MRI) was related to neuropsychological (NP) test scores in an asymptomatic HIV‐1 seropositive group, a non‐demented AIDS/ARC group, a group of subjects with HIV‐1 dementia, and a seronegative control group. The MRIs were quantified using three planimetric measures of brain structure: the bicaudate ratio (a measure of caudate region atrophy), the bifrontal ratio (a measure of frontal region atrophy), and the ventricle to brain ratio (a measure of overall cerebral atrophy). Cognitive performance was assessed with standard NP tests. Significant correlations between the MRI ratios and many of the NP tests were observed. Of the tests grooved pegboard, part B of the trail making test, the verbal fluency test, and the digit span forward were associated with MRI abnormalities. The bicaudate ratio was most closely associated with the NP tests. These findings indicate that ventricular enlargement, especially in the region of the caudate, is closely related to poor NP test performance in HIV‐1 in

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04201.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Twenty‐five HIV‐seropositive drug abusers (DA + HIV +) (groups II‐III and IV [A, C2 and E] of the CDC classification) were evaluated by use of the WAIS scale to determine any possible involvement of cognitive functions in the not yet overt phases of AIDS. The results were compared with those obtained in two control populations composed of 19 seronegative drug abusers (DA + HIV ‐) and 24 healthy subjects (DA ‐ HIV ‐) to evaluate, in addition to the disease, the possible effect of the use of alcohol and toxic substances on cognitive performance. In spite of the small number of subjects, the study indicated that drug abuse is the main factor, among those analyzed, in determining a decline in cognitiv

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04202.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

To determine involvements of the brainstem and/or cerebellum in autism, we compared midsagittal magnetic resonance images of the brains of high functioning autistic children with those of normal controls. We found that the midbrain and medulla oblongata were significantly smaller in these autistic children than in the control children. The pons area did not differ between the two groups, nor was there any difference in the cerebellar vermis area. The ratio of the brain stem and cerebellum to the posterior fossa area did not differ significantly between the high functioning autistic and the control children. A positive correlation between age and area of the cerebellar vermis was observed in autistic children but not in control children. Thus, it was suggested that significant anatomical changes in the midbrain and medulla oblongata existed in the autistic children and that growth of the cerebellar vermis in autistic children was different from normal children.

ISSN:0001-6314    

DOI:10.1111/j.1600-0404.1993.tb04203.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY