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Biomedical subjects

A McInnes

Publications and source records attributed to A McInnes.

At least 37 records · Page 2Linked to original sources
PubMed1988

Somatosensory and visual evoked potentials in insulin-dependent diabetics with mild peripheral neuropathy.

Using somatosensory and visual evoked potential techniques we have looked for evidence of central neuropathy in a group of insulin-dependent diabetics with mild peripheral neuropathy. The N9, N13, and N20 components of the somatosensory evoked potential were significantly (P less than 0.001) delayed in the diabetic group compared with the control subjects. There was a small but non-significant increase in the interpeak N13-9 and N20-13 latencies in the diabetic group. The visual evoked potential (P100) showed a small but insignificant delay. The delay in cerebral evoked potentials was mostly attributable to peripheral neuropathic damage and no firm evidence was obtained in favour of central diabetic neuropathy.

Adult↗
PubMed1988

Interleukin 4 induces cultured monocytes/macrophages to form giant multinucleated cells.

Giant multinucleated cells (GMCs) are associated with granulomatous lesions that form in response to various infectious and noninfectious agents. The present study shows that mouse IL-4 induces the in vitro formation of GMCs by factor-dependent bone marrow and alveolar monocytes via cell fusion. GMCs appear 2 d after incubation of cell cultures with 20 U/ml or more of IL-4. Anti-IL-4 mAbs block the appearance of GMCs in these cultures, indicating that IL-4 acts directly on monocytes to promote fusion and does not secondarily induce the production of other soluble fusion factors. In soft agar cultures, IL-4 also causes the aggregation of macrophages and diminishes their migration. The role of IL-4 in a granulomatous inflammatory response is discussed.

Animals↗
PubMed1988

Neurophysiological measurements in patients with genuine stress incontinence of urine and the relation of neurogenic defects to the presence of spina bifida occulta.

Neurophysiological measurements comprising surface electromyography (EMG) of the urethral and anal sphincters, measurement of the sensory thresholds of the dorsal nerve (DN) of the clitoris and the urethra and sacral reflex latencies from the dorsal nerve to urethra and anus and from the urethra to anus were performed in 44 females with genuine stress incontinence, in order to detect any relationship between the clinical disorder and a neurogenic defect in the innervation of the muscles involved in maintaining continence. Plain X-rays of the renal tracts (KUB films) were also studied to establish whether the prevalence of spina bifida occulta was increased in this group of patients and was a likely explanation for the nerve defects. Forty-three patients were found to have abnormal neurophysiological responses and the prevalence of spina bifida occulta was 50%, which compares with a prevalence of 17% in normal female controls. Genuine stress incontinence appears to be at least partly associated with defective innervation of the lower urinary tract and it is likely that in some cases the defect may be related to the presence of spina bifida occulta.

Adolescent↗
PubMed1988

Neurophysiological abnormalities in genuine female stress urinary incontinence.

Perineal sensory and motor function was investigated in 28 women with genuine stress incontinence of urine and compared with a matched control group. Electrosensitivity of the dorsal nerve of the clitoris and of the urethral mucosa was significantly diminished in these patients (eight measurements 'insensitive'). Three different reflex latency measurements (dorsal nerve to external anal sphincter, dorsal nerve to urethral sphincter, urethral mucosa to external anal sphincter) were prolonged in incontinence (14 absent reflexes). Mean motor unit potential duration of the external anal sphincter was also prolonged, reflecting an early neuropathy. Anorectal manometry detected significantly weaker squeeze pressures in stress incontinence although other variables were unaffected.

Adult↗
PubMed1987

Benzodiazepine sensitivity testing in the management of intractable seizure disorders in childhood.

The use of benzodiazepine sensitivity testing in the management of 40 children with intractable seizure disorders was studied. The aetiology and clinical syndromes varied widely with myoclonic, atonic and complex absence seizures predominating. Twenty-five cases had mixed seizure disorders. There was, likewise, a wide range of EEG abnormalities. Seven cases were in non-convulsive status at the time of testing. Diazepam (0.2 mg/kg) was given slowly intravenously and its effect on the EEG was observed. In 21 cases epileptiform activity was abolished. No change was seen in 13 cases and an unusual result was seen in 3. There was a paradoxical response in 3 cases, two of these associated with clinical seizures. Only 1 child in non-convulsive status had a positive result. Following testing, 32 patients went on to long-term oral benzodiazepine treatment. Twenty-one of these patients showed subsequent clinical improvement and 16/21 (76%) had had a positive sensitivity test previously. Eleven of these patients did not improve on long-term treatment. Seven out of the 11 (64%) had had a negative sensitivity test. These results suggest that the benzodiazepine sensitivity test is of value in the long-term management of intractable seizure disorders in childhood, but also emphasise the variability and unpredictability of response to benzodiazepine treatment.

Adolescent↗
PubMed1987

Sacral reflex latency in acute retention in female patients.

Neurophysiological measurements of the innervation of the lower urinary tract were performed on 14 female patients presenting with unexplained acute urinary retention. The method consisted of (a) static electromyography (EMG) of the anal and urethral sphincter with the patient relaxed, coughing and gripping, (b) the study of sensory thresholds on the dorsal nerve of the clitoris and in the urethra, (c) the measurement of sacral reflex latencies (SRL) from the dorsal nerve of the clitoris to the anus and urethra and from the urethra to the anus. The results showed that all 14 patients had significant defects in the innervation of their lower urinary tract. These findings suggest that a neurological explanation for acute retention in women should always be sought before making any other diagnosis.

Acute Disease↗
PubMed1987

Neurophysiological measurement of the voiding reflex arcs in patients with functional disorders of the lower urinary tract.

Neurophysiological measurements were carried out in 180 patients presenting to a Joint Incontinence Clinic with a history of lower urinary tract dysfunction. A full urodynamic assessment was performed along with neurophysiological measurement of the voiding reflex arcs. The majority of patients were shown to have significantly abnormal responses on neurophysiological measurement when compared with normal controls. Two particular groups, patients with acute retention and females with stress incontinence, were shown to have markedly poorer results than patients with other urodynamic problems. These results suggest that many patients with lower urinary tract dysfunction may have a neurological component.

Adolescent↗
PubMed1987

Changes in auditory P3 event-related potential in schizophrenia and depression.

Event-related potentials during a two-tone discrimination task were recorded in 24 schizophrenic patients, 16 depressed patients and 59 control subjects. Recordings were made when patients were medication-free. Fourteen schizophrenic and 13 depressed patients were retested at 1 and 4 weeks after the start of treatment, and 13 schizophrenic patients were also tested between 6 and 24 months after the initial recordings. In the schizophrenic group, the P3 latency was significantly prolonged compared with that in the control and the depressed groups, and remained unchanged both after 4 weeks treatment with therapeutic doses of neuroleptic drugs and at long-term follow-up. In the depressed group, the P3 latency did not differ from that of controls. P3 amplitude by contrast was reduced in both the acutely depressed and schizophrenic groups and following treatment became normal in the depressed group but remained reduced in the schizophrenic group. It is suggested that a prolonged P3 latency and reduced P3 amplitude indicate an impairment of auditory information processing in some patients with schizophrenia which is independent of the presence of acute psychotic symptoms and is not influenced by neuroleptic medication.

Adult↗
PubMed1987

Recurrent dislocation of the patella. Histochemical and electromyographic evidence of primary muscle pathology.

The role of muscle function in the aetiology of recurrent dislocation of the patella has been examined. Eleven of the 12 patients we studied had joint hypermobility. Muscle biopsies from eight of nine patients treated by surgery had a predominance of abnormal Type 2C fibres, and three of six patients whose quadriceps muscles were studied by electromyography also had abnormal results. Our preliminary findings suggest that there may be a primary muscular defect in many cases of recurrent dislocation of the patella.

Adolescent↗
PubMed1987

The latency of the visual evoked potential as an index of myelin disturbance in children treated for acute lymphoblastic leukemia.

The phase of central nervous system prophylaxis using cranial irradiation and intrathecal chemotherapy during the treatment of childhood leukemia, may disturb myelination. It has been suggested that this disturbance may be permanent in some children. In this study we report the visual evoked potentials from flash and pattern stimuli in 29 children who were in long-term hematological remission following treatment for acute lymphoblastic leukemia, and who were attending normal schools. We compared these to 29 control children who were matched for age, sex and social class. No difference was detected in the latencies of the response, and we conclude that we could demonstrate no permanent disturbance of myelination by this technique in these long-term survivors.

Acute Disease↗
PubMed1986

Electrophysiological observations on the human pudendo-anal reflex.

A reproducible electrophysiological technique is described to determine the latency of reflex contraction of the external anal sphincter in response to stimulation of the dorsal genital nerve: the pudendo-anal reflex. This was studied in 38 asymptomatic control subjects and 20 women with neurogenic faecal incontinence, supplemented by determination of the mean motor unit potential duration (MUPD) of the external anal sphincter and anorectal manometry. The reflex latency in the control group was 38.5 +/- 5.8 (SD) ms and appeared to be independent of age or sex. Three patients with faecal incontinence had absent reflexes; the remainder showed significant prolongation of latency (56 +/- 12.2 SD ms) and diminution of amplitude. MUPD was prolonged in incontinence and showed significant correlation with the corresponding reflex latency determination (tau = 0.56, p less than 0.001). The latency of this polysynaptic spinal reflex hence provides a reliable index of neuropathy of the external anal sphincter.

Adult↗
PubMed1985

Patterns and significance of the sacral evoked response (the urologist's knee jerk).

Neurological examination may fail to demonstrate any abnormality in patients who have neurogenic bladder dysfunction. Standard clinical methods will include full examination of segmental nerves to the level of S1 but will not include the lower sacral segments which control sphincter function. We describe a simple method of measuring the integrity and function of these segments of the cord. The method and the common patterns of response are described. The stimulus is physiological (not supramaximal), the response is measured with surface mounted electrodes at the urethral and anal sphincters and each measurement is the average response after 100 stimuli.

Anal Canal↗
PubMed1985

Neurophysiological measurements in primary adult enuretics.

The nerve supply of the lower urinary tract was studied in 25 primary adult enuretics by full urodynamic assessment and neurophysiological measurements. The latter consisted of the measurement of static EMG, sensory thresholds and sacral reflex latencies (SRL). All patients were normal on clinical neurological examination. All neurophysiological measurements were within normal limits in only three patients and the remaining 22 had at least one abnormal response. The commonest abnormality was a high or even absent urethral sensory threshold. These defects in sensory and motor innervation correlated with the clinical dysfunction. It was concluded that this is a valuable method for the detection of nerve defects in the lower urinary tract, especially when the clinical neurological examination is normal.

Adolescent↗
PubMed1984

Clinical and pathological changes in sheep experimentally poisoned by the blue-green alga Microcystis aeruginosa.

Fifteen young sheep were inoculated intraruminally with various doses of an algal bloom of Microcystis aeruginosa. Lethally poisoned sheep died between 18 and 48 hours after inoculation. Findings included marked elevation of serum concentrations of certain enzymes and bilirubin, mild elevations of blood urea nitrogen and serum inorganic phosphorus with marked reduction in blood glucose, a mild neutrophilia with a marked left shift and marked changes in coagulation parameters. Necropsy findings included pale swollen, sometimes hemorrhagic, livers, edema involving the body cavities and widespread small hemorrhages. The primary site of toxicity was the liver which had centrilobular to near massive hepatocyte necrosis. Electron microscopic lesions were aggregation of endoplasmic reticulum with displacement of subcellular organelles towards the periphery of the hepatocyte, and vacuolation of the contents of more severely affected cells.

Animals↗
PubMed1983

The recovery cycle of the pattern visual evoked potential in normal subjects and patients with multiple sclerosis.

The recovery cycle of amplitude and latency of the P100 of the chequerboard pattern reversal visual evoked response was studied in 16 normal subjects and 20 patients with multiple sclerosis. There was no clear-cut pattern of recovery with respect to amplitude but at interstimulus intervals of less than 40 msec the latency of the test response P100 tended to be significantly delayed, the magnitude of this delay being virtually constant at intervals of 20 msec or less. Only 8 of 40 eyes from the 20 multiple sclerosis patients showed a pattern of recovery of latency significantly different from the normal subjects. Possible mechanisms for these observations are discussed with particular reference to current concepts of the pathophysiology of multiple sclerosis.

Electroencephalography↗
PubMed1981

Evoked potentials in severe head injury--analysis and relation to outcome.

Somatosensory, visual and auditory cortical and brainstem evoked responses were obtained from 32 patients with severe head injury. A simple count of the number of waves present in the various responses provided the optimum method of analysing the data. The results of each cortical response, but not of the brainstem response, correlated with outcome, and a combined assessment gave the highest correlation. The data provided only slight improvement on predictions based upon clinical features.

Brain Stem↗
PubMed1979

Inverted knee jerk: a neglected localising sign in spinal cord disease.

Two cases are described in which inversion of the quadriceps jerk was observed. It is suggested that the finding of an inverted quadriceps jerk is evidence of a spinal cord lesion at 12, 3, 4 segmental level and has for the lumbar cord the same localising value as the inverted supinator jerk for the cervical cord.

Adult↗