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T Holmøy

Publications and source records attributed to T Holmøy.

6 recordsLinked to original sources

T cells from multiple sclerosis patients recognize immunoglobulin G from cerebrospinal fluid.

Idiotopic sequences are created after V, D and J recombinations and by somatic mutations during affinity maturation of immunoglobulin (Ig) molecules, and may therefore be potential immunogenic epitopes. Idiotope-specific T cells are able to activate and sustain the B cells producing such idiotopes. It is therefore possible that idiotope-specific intrathecal T cells could help maintain the persisting intrathecal synthesis of oligoclonal IgG observed in patients with multiple sclerosis (MS). This study was undertaken to examine T-cell responses to cerebrospinal fluid (CSF) IgG. Peripheral blood mononuclear cells (PBMC) from 14 of 21 MS patients and four of 17 control patients with other neurological diseases proliferated upon stimulation with autologous CSF IgG, while five and three, respectively, responded to serum IgG. By comparison, responses to myelin basic protein were recorded in only four MS and three control patients. Data from a limited number of patients indicate that the CSF IgG responsive cells were CD4+ and human leucocyte antigen DR restricted, that PBMC also respond to CSF IgG from other MS patients and that the CSF may contain T cells responding to autologous CSF IgG. This suggests that CSF IgG, or substances bound to this IgG, may represent T-cell immunogens, which could contribute to the intrathecal immune response in MS.

Adult↗

[Early postoperative complications in carotid surgery].

Carotid endarterectomy has a documented stroke preventing effect in symptomatic high-grade carotid stenosis when the rate of serious complications is below 6%. In the period 1986-96, 160 procedures were performed on 150 patients at the Department of Neurosurgery, Ullevål Hospital. Oslo. The indication for surgery was hemispheric transient ischemic attack and/or amaurosis fugax in 137 patients and/or minor stroke in 49 in addition to a high-grade stenosis. Mean age was 61 years (42-74 years). One patient (0.6%) died four hours after surgery. Three patients (1.9%) suffered disabling postoperative stroke. The rate of serious complications was thus 2.5%. In addition, nine patients experienced minor and temporary paresis. Three patients were reoperated for haematoma and one for wound infection. Our surgical morbidity and mortality rate is comparable to larger series.

Aged↗

[Painless femoral neck fracture in a patient with multiple sclerosis].

We describe a patient with multiple sclerosis who suffered a painless hip fracture. She was admitted to the hospital three weeks after falling on her left hip. She had been unable to walk after the trauma, but had had no pain. The condition was initially misinterpreted as multiple sclerosis schub. X-ray examination showed fracture of the left femoral neck, and by the time she was admitted to hospital the patient was paretic. She has improved substantially after an operation involving cementless total hip arthroplasty. Painless fractures in patients with multiple sclerosis may be confused with exacerbations of their neurological disease.

Adult↗

[Cerebellar infarctions].

Infarction of the cerebellum comprises about 1.5 percent of all strokes. The symptoms are initially very similar to those of benign labyrinthitis, and the diagnosis is easy to miss. There are three major causes of clinical deterioration and death: Expansion of the infarct to the brainstem, swelling of the infarcted cerebellum with compression of the brainstem, and hydrocephalus. Surgical intervention may be lifesaving if hydrocephalus develops. Five patients admitted to our department are described. All described sudden vertigo or dizziness, which in three of them was accompanied by headache. All had ataxia. In four this was ipsilateral to the infarction and in one bilateral. Two had slight hemiparesis and plantar inversion. Two patients developed hydrocephalus. One was operated with external drainage. It is important to have this diagnosis in mind in all patients with acute labyrinthine symptoms. Acute CT scanning should be carried out if the patient becomes less conscious.

Cerebellum↗