Myelopathy associated with human T cell lymphotropic virus type 1 in a white European native to England.
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England↗
Biomedical subjects
P Rudge
Publications and source records attributed to P Rudge.
Gadolinium-enhanced magnetic resonance imaging of the central nervous system in systemic lupus erythematosus.
Gadolinium (Gd)-DTPA enhanced magnetic resonance imaging (MRI) was performed in 15 systemic lupus erythematosus patients with past (12) or present (3) features suggesting central nervous system (CNS) involvement. Symptomatic Gd-DTPA enhancing lesions were seen in 2 patients, and immunosuppressive treatment was associated with a rapid reversal of enhancement. The pattern of enhancement was different from that usually seen in multiple sclerosis. Gd-DTPA enhanced MRI may sometimes be useful in demonstrating the activity of CNS lupus.
Adolescent↗
Dendritic cells from patients with tropical spastic paraparesis are infected with HTLV-1 and stimulate autologous lymphocyte proliferation.
Dendritic cells (DC), important antigen-presenting cells for recruiting T cells into immune responses, are susceptible to infection with HIV-1 and this can cause either stimulatory or suppressive effects on T cells. We examined another human retrovirus, HTLV-1, to determine whether DC were infected and caused any changes in T-cell function. Patients infected with HTLV-1 who have tropical spastic paraparesis (TSP) show high 'spontaneous' lymphocyte proliferation. We studied the basis for this by analyzing the interactions in vitro between lymphocytes and antigen-presenting cells and compared cells taken from HTLV-1-positive TSP patients with those taken from HTLV-1-positive healthy carriers and HTLV-1-negative family members. In HTLV-1-positive individuals, 0.4-5.1% of the DC were infected with HTLV-1 as determined by in situ hybridisation. In TSP patients, depletion of DC and purification of T cells abolished 'spontaneous' lymphocyte proliferation. Reinstating the DC, but not B cells or macrophages, restored proliferation, an effect that was blocked by antibodies either to class II major histocompatibility antigens or to HTLV-1 itself. Thus, presentation of HTLV-1 antigens by infected DC to autologous T cells could result in the abnormal T-cell proliferation and cause the inflammatory reaction leading to tissue damage in TSP. We also speculate that persistent infection of DC with HTLV-1 and consequent continuous stimulation of T cells might be instrumental in the development of HTLV-1-mediated T-cell leukemia.
Dendritic Cells↗
Torsional nystagmus. A neuro-otological and MRI study of thirty-five cases.
Thirty-five patients with torsional nystagmus (TN) underwent vestibular and ocular motor assessment and magnetic resonance image (MRI) scanning of the head. Patients were divided into two groups according to whether TN was predominant and present in primary gaze (Group I, 23 patients) or elicited by head positioning or gaze deviation and less prominent than other concurrent nystagmus (Group II, 12 patients). The main aetiologies in both groups were demyelination, vascular disease and posterior fossa tumours. In Group I, a frequent pattern of findings, occurring in 30-50% of cases, was a caloric canal paresis contralateral to the direction of the fast phases ('beat') of the TN, whereas the duration of horizontal caloric/rotational nystagmus and the slow-phase eye velocity of pursuit and of optokinetic nystagmus were all reduced in the direction of beating. The TN was more frequently and consistently modulated by vertical canal stimuli (head oscillation in roll) than by otolith stimuli (static tilt). Statistical analysis of the MRI showed significant overlap of abnormal MRI signals in the area of the vestibular nuclei, on the side opposite to the beat direction of TN. These results suggest that TN originates in a central imbalance of vertical semicircular canal function, resulting from lesions involving the vestibular nuclei on the opposite side of the TN. Group II was heterogeneous with no consistent pattern of neuro-otological findings, although lesions ipsilateral to the TN were frequent occurrence; in these cases cerebellar system lesions may have produced ipsilateral vestibular nuclei disinhibition.
Adolescent↗
Oligoclonal immunoglobulins and plasma cells in spinal fluid of patients with multiple sclerosis.
A new modification of polyacrylamide gel electrophoresis (PAGE) was applied to cerebrospinal fluid proteins from patients with multiple sclerosis (MS). The same spinal fluids were also examined by a cytological technique. Over 90% of patients with clinically definite or early probable or latent MS showed abnormal PAGE patterns in the form of oligoclonal gammaglobulin bands. Reactive (atypical, large) lymphocytes or typical plasma cells were found in some patients. In all such cases an oligoclonal pattern was present. The findings of oligoclonal bands provides valuable supporting evidence for the diagnosis of MS in the less definite clinical categories.
Electrophoresis, Polyacrylamide Gel↗
Proteolytic enzyme activity of blood leukocytes and cerebrospinal fluid in multiple sclerosis.
Upon stimulation by immune complexes, the polymorphonuclear (PMN) blood secretes lysosomal hydrolases, including neutral proteinase, which is concentrated in the PMN cell. Neutral and acid proteinase activity were increased and decreased, respectively, in the circulating white cells of patients with multiple sclerosis during an exacerbation of the disease, but there was no correlation with serum immune complex levels. Neutral proteolytic activity in the cellular fraction of the cerebrospinal fluid was also found to be elevated in acute multiple sclerosis, as monitored by digestion of myelin basic protein.
Antigen-Antibody Complex↗
The stability of the auditory evoked potentials in normal man and patients with multiple sclerosis.
Sequential records of the early and middle components of the auditory evoked potential in response to a click stimulus have been obtained over a period of 2.5 years in normal subjects and in patients with multiple sclerosis. The latencies of all the components were highly consistent in the control subjects and in the patients who were clinically stable throughout the period of study. In constrast, in some of the patients who had clinical relapses during the study there was variation in the latency and amplitude of some of the components. The significance of this variation is discussed and the poor correlation between the sites of the new lesions as determined clinically and the auditory evoked potential variability is emphasised.
Acoustic Stimulation↗
Abnormalities of the auditory evoked potentials in patients with multiple sclerosis.
Fifteen components of the auditory evoked potential can be recorded within 300 ms of a click stimulus and these can be classified by latency in early (0-8 ms), middle (8-60 ms) and late (greater than 60 ms) components. Follwing a click stimulus of high intensity these components have been studied in 45 normal subjects and in 88 patients with definite multiple sclerosis. Component V, thought to arise from brain-stem structures, was the most consistently abnormal in patients and there was a correlation between the abnormalities and clinical evidence of a brain-stem lesion. Thus in 79 per cent of patients with definite evidence of a brain-stem lesion and in 51 per cent of those without clinical signs related to the brain-stem, component V was abnormal. Abnormalities were also detected for components Pa, Nb and P1 of the middle components, and in 12 per cent of these the early components were normal. The late components were normal in all but 3 patients. Evidence is presented to show that pairs of click stimuli, 5 ms apart, presented at a fast stimulus rate, stress the auditory system in normal subjects. Using this technique abnormalities of component V in patients became more marked and the proportion of abnormalities detected was increased. The contribution of the reflex muscle responses to the click to the middle components of the auditory evoked potential has also been studied. It is concluded that components Pa, Nb and P1 are independent of these reflexes.
Adult↗
Gaze failure, drifting eye movements, and centripetal nystagmus in cerebellar disease.
Three abnormalities of eye movement in man are described which are indicative of cerebellar system disorder, namely, centripetally beating nystagmus, failure to maintain lateral gaze either in darkness or with eye closure, and slow drifting movements of the eyes in the absence of fixation. Similar eye movement signs follow cerebellectomy in the primate and the cat. These abnormalities of eye movement, together with other signs of cerebellar disease, such as rebound alternating, and gaze paretic nystagmus, are explained by the hypothesis that the cerebellum helps to maintain lateral gaze and that brain stem mechanisms which monitor gaze position generate compensatory biases in the absence of normal cerebellar function.
Adult↗
Axonal velocities of motor units in the hand and foot muscles of the baboon.
The axonal velocities of single motor units in the small hand and foot muscles of the baboon were studied by means of a collision technique which produced selective blocking of most of the fast-conducting fibres. In the abductor pollicis brevis muscle velocities ranged from 43 to 82 m/sec, and in the abductor digiti minimi muscle from 40 to 78 m/sec. In the extensor digitorum brevis muscle the range was 40-70 m/sec. When velocities were plotted as percentages of the maximal obtained in the same experiment, the range was similar in the 3 muscles studied. Most motor units had velocities greater than 65% of maximal but, in a few, velocities were between 55% and 65% of maximal. The possible relevance of these findings to human motor nerves is discussed.
Animals↗
Analysis of a case of periodic alternating nystagmus.
A patient is described in whom there was periodic deviation of the eyes in darkness associated with alternating nystagmus. An exactly similar situation occurs in normal man subjected to a pendular stimulus. It is proposed that in this patient there was alternating activity of the vestibular nuclei on either side of the brain-stem as a result of a removal of cerebellar inhibition, and that this caused periodic shifts in the null region of Daroff and Dell'Osso.
Adolescent↗
Auditory evoked responses in multiple sclerosis.
The early components of the auditory evoked responses (waves I-V) have been studied in 30 patients with multiple sclerosis. There were abnormalities in 22 patients. All patients with an internuclear ophthalmoplegia and half those with no detectable brainstem abnormality had abnormal responses, although none was clinically deaf.
Adolescent↗
Leucocyte proteinase activity and acute multiple sclerosis.
Increased leucocyte neutral proteinase activity is associated with an attack of multiple sclerosis. Raised neutral proteinase is found in other diseases with rapid destruction of neural tissues. Increased enzyme activity may be responsible for removing antigenic protein from the blood.
Humans↗
The cerebral pathways of optokinetic nystagmus: a neuro-anatomical study.
Abnormalities of optokinetic nystagmus are described in a patient with pathologically proven bilateral infarcts in the middle cerebral artery territories. There were no other central nervous system lesions. These abnormalities of eye movement are interpreted as indicating an inhibitory effect of the frontal eye fields upon the occipital lobes.
Adult↗
Peripheral neuropathy in baboons.
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Acrylamides↗