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Biomedical subjects

G Solders

Publications and source records attributed to G Solders.

At least 19 recordsLinked to original sources
PubMed2002

Multiple MAG peptides are recognized by circulating T and B lymphocytes in polyneuropathy and multiple sclerosis.

Abnormal immune responses to myelin associated glycoprotein (MAG), a component of myelin of the central and peripheral nervous system, have been suggested to play a role in the pathogenesis of multiple sclerosis (MS) and certain types of inflammatory polyneuropathy. To identify possible immunodominant MAG peptides in neuroinflammation, we examined T and B cell responses to five selected synthetic MAG peptides and myelin proteins in 21 patients with non-inflammatory polyneuropathy, 26 patients with MS, 10 optic neuritis patients and 17 healthy subjects. Enzyme-linked immunosorbent spot-forming cell assays were adopted, allowing the detection and enumeration of individual antigen responsive T and B cells in body fluids. Patients with polyneuropathy as well as those with MS had elevated levels of T and B cells recognizing MAG and its peptides. Any of the five MAG peptides under study functioned as immunodominant T and/or B cell epitope in individual subjects. None of the MAG peptides elicited a specific disease-associated T or B cell response. The enhanced T and B cell response to myelin components like MAG may play some role in initiation and/or progression of these diseases, but they could also represent secondary responses associated with myelin damage and indicate tolerization rather than autoaggressive immunity.

Adult↗
PubMed2000

Antiretroviral therapy may improve sensory function in HIV-infected patients: a pilot study.

OBJECTIVE: To evaluate thermal and nociceptive function in a prospective, longitudinal study of 49 consecutive HIV-1-infected patients before and at 1, 4, and 8 months after initiation of highly active antiretroviral therapy. METHODS: Quantitative assessments of thermal perception thresholds for warmth (dWT), cold (dCT), and heat pain (HPT) were performed. CD4+ cell levels in blood and HIV-1 RNA levels in plasma were determined. Depending on the virologic response to treatment, the patients were divided into two groups: responders (37 of 49, 76%) and nonresponders (12 of 49, 24%). RESULTS: Before treatment, impairment of dWT was found in 26 of 49 patients, of dCT in 33 of 49 patients, and of HPT in 19 of 49 patients. Improvements of perception thresholds for dWT (p < 0.0001), dCT (p < 0.001), and HPT (p < 0.01) were observed after 8 months of treatment in the responder group but not in the nonresponders. Within the responder group, improved thermal perception thresholds was associated with higher pretreatment CD4+ levels than in patients without improvement. CONCLUSIONS: Virologically successful antiretroviral combination therapy of HIV-1-infected patients has a capacity to improve function of the thermal and nociceptive systems, especially in patients with less advanced immunodeficiency.

Adult↗
PubMed2000

Polyneuropathy in late Lyme borreliosis - a clinical, neurophysiological and morphological description.

In a prospective study, detailed clinical and neurophysiological examinations were performed in 17 patients with polyneuropathy associated with the late borrelial manifestation acrodermatitis chronica atrophicans (ACA). Similar clinical and neurophysiological signs were found in most of the patients. The findings were those of a sensory polyneuropathy, mainly affecting large nerve fibres. Marked abnormality of vibration threshold was a common finding and in 4 patients this raised a suspicion of spinal cord engagement, in addition to a polyneuropathy. Sural nerve biopsy, performed in 3 of the patients, showed a mainly axonal neuropathy. Biopsy findings did not confirm earlier reports of vasculitis of epineural vessels in ACA-associated polyneuropathy.

Acrodermatitis↗
PubMed1999

Improved survival in patients with insulin-dependent diabetes mellitus and end-stage diabetic nephropathy 10 years after combined pancreas and kidney transplantation.

BACKGROUND: The purpose of pancreatic transplantation in insulin-dependent diabetic patients is to restore normoglycemia and thereby prevent the secondary complications of diabetes. However, uncertainty remains as to whether the mortality rate in diabetic patients can be affected by this procedure. METHOD: We followed 14 patients with insulin-dependent diabetes mellitus (IDDM) and end-stage diabetic nephropathy for 10 years after successful combined kidney and pancreas transplantation. Fifteen diabetic patients subjected to kidney transplantation alone have served as controls. The glycemic control has been studied annually for 10 years and diabetic polyneuropathy has been assessed in both groups after 2, 4, and 8 years. RESULTS: In recipients of pancreas-kidney grafts, metabolic control was maintained throughout the observation period, with values of glycated hemoglobin in the normal range. In contrast, glucose metabolism was impaired in the control group, with glycated hemoglobin values around 10%. Nerve conduction and parasympathetic autonomic dysfunction improved in both groups after 2 years; there was no difference between the groups. After 4 years, we found a significant difference between the study group and the control group, and after 8 years it had widened. At the 4-year evaluation, there was no difference in mortality between the groups. At 8 years, however, a significant difference was noted, which was further substantiated at 10 years with a 20% mortality rate in the pancreas-kidney group versus an 80% mortality in the kidney alone group. CONCLUSIONS: We found a substantial reduction in mortality in IDDM patients 10 years after successful combined pancreas and kidney transplantation. We speculate that the decrease in mortality was due to the beneficial effect of long-term normoglycemia on diabetic late complications and suggest therefore that combined pancreas and kidney transplantation, rather than kidney transplantation alone, should be offered to IDDM patients with end-stage diabetic nephropathy.

Adult↗
PubMed1999

Lymphocytes in sural nerve biopsies from patients with plasma cell dyscrasia and polyneuropathy.

Sural nerve biopsies were examined in 36 patients with plasmacell dyscrasia and polyneuropathy. The M-component isotype was IgM in 19, IgG in 16 (one patient had both IgM and IgG) and IgA in 2 patients. Five of the IgM patients had Waldenström's disease, one of the IgG cases a myeloma and two lymphoma. The remaining 28 patients had monoclonal gammopathy of uncertain significance (MGUS). Nerve conduction studies showed signs of mixed axonal/demyelinating polyneuropathy in most cases. The biopsies were evaluated with regard to nerve fibre loss, segmental demyelination and inflammatory cell infiltration. Inflammatory cells infiltrating the nerves were found in 7 of 19 IgM cases and in 6 of 16 IgG cases. Immunohistochemical staining with monoclonal antibodies to B-lymphocytes and to subsets of T-lymphocytes was performed in 33 cases. An equal distribution of CD4 and CD8 positive T cells, but no B cells, were found among the inflammatory cells. The findings indicate a possible role for cell mediated immunological mechanisms in some patients with plasma cell dyscrasia associated with polyneuropathy.

Adult↗
PubMed1998

Improved peripheral nerve conduction, EEG and verbal IQ after bone marrow transplantation for adult metachromatic leukodystrophy.

A 28-year-old woman with a 4 year history of slowly progressing 'frontal dementia' was diagnosed as having adult metachromatic leukodystrophy and was followed for 4 years after bone marrow transplantation (BMT). MRI, neurophysiological tests (EEG, ENeG, VEP, SEP and BAEP) and neuropsychological assessment were performed before, and repeatedly after BMT. MRI showed symmetrical white matter lesions in the frontal and parieto-occipital lobes and in the corpus callosum. EEG showed frontal and temporal slow wave abnormalities and nerve conduction was slow. Neuropsychological tests showed cognitive impairment in executive functions, decline in visuospatial-constructive and spatial memory tasks and disorganized thinking. IQ was low (52), with slightly better values for verbal IQ than for performance IQ. After BMT, the patient was followed for 4 years. Clear improvements were seen in EEG, in peripheral nerve conduction and in neuropsychological tests (especially in verbal IQ). MRI findings were unchanged. We believe that the improvement in our patient resulted from the bone marrow transplantation.

Adult↗
PubMed1998

A double blind, randomised, parallel group study to investigate the dose equivalence of Dysport and Botox in the treatment of cervical dystonia.

OBJECTIVE: This study was designed to establish whether a ratio of three units of Dysport is equivalent to one unit of Botox for the treatment of cervical dystonia. METHODS: Patients with predominantly rotational cervical dystonia, and a minimum of four previous Botox treatments, were randomised to receive either the clinically indicated dose of Botox or three times that dose in Dysport units. Study botulinum toxin was administered in a double blind fashion, to one or more clinically indicated muscles, at one or more sites per muscle. Patients returned for assessment two, four, eight, and 12 weeks after treatment. RESULTS: A total of 73 patients (Dysport, 38; Botox, 35) were entered. The Dysport group received a mean (SD) dose of 477 (131) (range 240-720) Dysport units, and the Botox group received a mean (SD) dose of 152 (45) (range 70-240) Botox units. The mean (SEM) post-treatment Tsui scores for the Dysport group (4.8 (0.3)) and the Botox group (5.0 (0.3)) were not statistically different (p=0.66). The study had 91% power to detect a clinically significant difference of two points. Both groups showed substantial improvement in Tsui score by week 2 (mean (SD); Dysport, 46 (28)%; Botox, 37 (28)%), with a peak effect at week 4 (mean (SD); Dysport, 49 (29)%; Botox, 44 (28)%). A similar response profile was seen for other assessments of efficacy. The duration of effect, assessed by time to retreatment, was also similar (mean (SD); Dysport, 83.9 (13.6) days; Botox, 80.7 (14.4) days; p=0.85). During the study 22 of 38 (58%) Dysport patients reported 39 adverse events, and 24 of 35 (69%) Botox patients reported 56 adverse events (p=0.35). A global assessment of efficacy and safety considered that 29 of 38 (76%) Dysport patients and 23 of 35 (66%) Botox patients were treatment successes (p=0.32). CONCLUSION: Patients with predominantly rotational cervical dystonia treated with the clinically indicated dose of Botox or three times that dose in Dysport units show similar improvements and do not have significantly different safety profiles.

Adult↗
PubMed1997

Guillain-Barré syndrome in south-west Stockholm, 1973-1991, 2. Clinical epidemiology.

The clinicoepidemiological features of Guillain-Barré syndrome (GBS) were studied using population-based information from medical records of 69 patients in South-West Stockholm, during the period from January 1973 to June 1992. The diagnoses were validated according to the National Institute of Neurological and Communicative Disorders and Stroke criteria. Mean age at onset was 43 +/- 20 years. For 46 patients, events during the 30-day period preceding clinical onset, 74% of them identified as respiratory infections, were recorded. The presence of preceding events was associated with male gender. A more rapid clinical progression was found among women. A CSF/serum albumin ratio > or = 10, denervation potentials and mechanical ventilation required were associated with poor recovery or long duration of hospitalization. Reduced motor conduction velocity was more common and pronounced among older patients and with a high CSF/serum albumin ratio. These results suggest that there is clinical, electrophysiological and epidemiological heterogeneity in GBS, and that clinicoepidemiological subgroups of GBS may exist.

Adolescent↗
PubMed1997

Touch sensibility in the breast after subcutaneous mastectomy and immediate reconstruction with a prosthesis.

Touch sensibility was assessed with von Frey's monofilaments in the breasts of 10 healthy women (controls) and of 80 women with breast cancer who at least 1 year previously had undergone subcutaneous mastectomy and immediate reconstruction with a prosthesis. Touch thresholds were measured at nine positions on each breast. Low threshold values (< 3.2 mN) and good reproducibility were found in the controls. In the patients' surgically treated breasts normal (< 3.2 mN) or subnormal (< 20 mN) median threshold values were found outside the areola. Higher median values were noted on the areola and nipple; on the nipple, however, one third of the patients had normal sensibility while 14% lacked sensibility. The only factors found to influence the results were simultaneous subcutaneous reduction mammaplasty (lower touch thresholds) and the localisation of the incision (slightly lower thresholds for lazy-S than inframammary incision). These results confirm the clinical impression that touch sensibility is substantially retained after subcutaneous mastectomy and immediate reconstruction with a prosthesis.

Aged↗
PubMed1997

Nerve conduction and autonomic nerve function in diabetic children. A 10-year follow-up study.

In order to study the long-term development of diabetic neuropathy in children with newly diagnosed diabetes mellitus, 144 children were entered in a prospective study of nerve conduction and autonomic nervous function. Neurophysiological recordings of nerve conduction and parasympathetic function (R-R variations) were made at onset of diabetes and after 2, 5 and 10 years. Low sensory nerve conduction and autonomic dysfunction were found in approximately 25% of the children at onset of diabetes when the patients were not yet in complete remission. During years 0-2, an initial improvement of sensory conduction velocities was found. After 2 years, deteriorations in sensory and motor nerve conduction and autonomic nerve function were common and further deterioration was seen over time. A correlation was found between nerve conduction and glycaemic control.

Adolescent↗
PubMed1997

Proximal myotonic myopathy. Analysis of 3 Swedish cases.

Three Swedish patients with proximal muscle weakness, myotonia and lack of CTG expansion on genetical analysis are presented. Clinical neurological and neurophysiological examination and muscle biopsy were performed. There was an indication of autosomal dominant inheritance in 2 of the 3 patients. The main symptoms and clinical findings in the 3 patients were weakness of the proximal muscles, myotonia, muscle stiffness, muscle pain and muscle atrophy. Neurophysiological examination showed myotonic bursts and muscle biopsy showed a variation of fibre sizes, an increased number of muscle fibres with centralized nuclei and scattered atrophic muscle fibres. Laboratory data showed elevated CK, GT and LD in 1 patient. Before genetical analysis was performed, all 3 patients had been diagnosed as atypical cases of myotonic dystrophy. However, the symptoms, clinical signs, laboratory data, electrophysiological and muscle biopsy findings were compatible with proximal myotonic myopathy (PROMM).

Aged↗
PubMed1995

CD5 expression on B cells may be an activation marker for secretion of anti-myelin antibodies in patients with polyneuropathy associated with monoclonal gammopathy.

B cells expressing the CD5 marker belong to a subpopulation with potential autoreactive properties. Increased proportions of CD5+ B cells have been reported in autoimmune diseases. In patients with monoclonal gammopathy and demyelinating polyneuropathy, the M-component often consists of autoantibodies reacting with myelin components. We therefore investigated if CD5+ B cells were involved in the production of anti-myelin antibodies. There was no difference of mean value of CD5+ B cells between patients and controls. However, the proportion of CD5+ B cells was significantly correlated with the amount of anti-myelin antibodies. In seven patients, CD5+ B cells were enriched using an immunomagnetic technique. The number of CD5+ and CD5- B cells secreting anti-myelin antibodies was determined by ELISPOT. In two patients with high levels of antibodies, antibody-secreting cells were mainly, but not exclusively, CD5+ B cells. In five patients with low levels of antibodies, most cells secreting anti-myelin antibodies were CD5-. We conclude that CD5 expressed on B cells may be an activation marker, reflecting B cells producing high amounts of anti-myelin antibodies in patients with polyneuropathy associated with monoclonal gammopathy.

Adult↗
PubMed1995

Autonomic dysfunction in Alzheimer's disease.

Twenty-nine patients fitting the NINCDS-ADRDA criteria of Alzheimer's disease participated in a study of autonomic functions. A number of tests on parasympathetic and sympathetic functions were made. Eighteen of the patients were tested a second time one year later. Fifteen healthy subjects with no family history of dementia disorders served as controls. Compared to the controls, the patients showed signs suggesting autonomic dysfunction affecting parasympathetic, as well as vasomotor sympathetic, functions.

Age of Onset↗