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Y Palmers

Publications and source records attributed to Y Palmers.

At least 19 recordsLinked to original sources
PubMed2003

T cell vaccination in multiple sclerosis patients with autologous CSF-derived activated T cells: results from a pilot study.

Myelin-reactive T cells are considered to play an essential role in the pathogenesis of multiple sclerosis (MS), an autoimmune disease of the central nervous system. We have previously studied the effects of T cell vaccination (TCV), a procedure by which MS patients are immunized with attenuated autologous myelin basic protein (MBP)-reactive T cell clones. Because several myelin antigens are described as potential autoantigens for MS, T cell vaccines incorporating a broad panel of antimyelin reactivities may have therapeutic effects. Previous reports have shown an accumulation of activated T cells recognizing multiple myelin antigens in the cerebrospinal fluid (CSF) of MS patients. We conducted a pilot clinical trial of TCV with activated CD4+ T cells derived from CSF in five MS patients (four RR, one CP) to study safety, feasibility and immune effects of TCV. CSF lymphocytes were cultured in the presence of rIL-2 and depleted for CD8 cells. After 5-8 weeks CSF T cell lines (TCL) were almost pure TCR alpha beta+CD4+ cells of the Th1/Th0 type. The TCL showed reactivity to MBP, MOG and/or PLP as tested by Elispot and had a restricted clonality. Three immunizations with irradiated CSF vaccines (10 million cells) were administered with an interval of 2 months. The vaccinations were tolerated well and no toxicity or adverse effects were reported. The data from this small open-label study cannot be used to support efficacy. However, all patients remained clinically stable or had reduced EDSS with no relapses during or after the treatment. Proliferative responses against the CSF vaccine were observed in 3/5 patients. Anti-ergotypic responses were observed in all patients. Anti-MBP/PLP/MOG reactivities remained low or were reduced in all patients. Based on these encouraging results, we recently initiated a double-blind placebo-controlled trial with 60 MS patients to study the effects of TCV with CSF-derived vaccines in early RR MS patients.

Adoptive Transfer↗
PubMed1999

Wernicke encephalopathy: MR findings in two patients.

Wernicke encephalopathy is a serious neurologic disorder caused by vitamin-B1 or thiamine deficiency. In the literature the characteristic symmetric paraventricular lesions of Wernicke encephalopathy are hyperintense on T2-weighted sequences spin-echo (SE) and enhance on T1-weighted SE sequences after intravenous gadolinium administration in the acute phase. We present two patients in the acute phase of Wernicke encephalopathy with special reference to the MR imaging. One of our reported cases is special because of the MR demonstration of a hemorrhagic focus in the caput of the right nucleus caudatus. The other case demonstrates no enhancement on SE T1-weighted sequences after intravenous gadolinium administration.

Aged↗
PubMed1999

A double-blind, prospective, randomized, multicenter group comparison study of iopromide 240 vs iohexol 240 in myelography.

The aim of this study was to evaluate the safety and efficacy of iopromide 240 mgI/ml in comparison with iohexol 240 mgI/ml in myelography. A total of 421 patients in seven centers and four countries received an average of 11.9 ml of either iopromide 240 (278 patients) or iohexol 240 (143 patients) for X-ray and/or CT myelography in a randomized (2:1), prospective, double-blind study. All patients were followed up 3-4 h after the procedure, and 327 patients remained hospitalized for 24 h. In 82 patients an EEG was recorded prior to as well as 3-4 h and 24 h after myelography. Physical examinations, including measurement of vital signs, were performed in all patients at these time points. The results were subject to statistical analysis with the primary variable being the incidence of adverse events. Both contrast media (CM) were equally effective in terms of opacification. The rating for opacity was "good" or "excellent" in 88 % for both CM. Four patients (iopromide group: n = 3; iohexol group: n = 1) had transient EEG changes but did not show clinical symptomatology. The overall rate of patients experiencing any adverse event (AE) was 16.9 % for iopromide 240 and 14.0 % for iohexol 240. Equivalence testing was inconclusive; however, the results indicated equivalence. The rate for AEs considered as study-drug related was slightly lower with iopromide 240 than with iohexol 240 (7.2 vs 7.7 %, respectively). Neither unknown nor unexpected AEs known for myelographic X-ray CM nor serious adverse events were observed. Iopromide 240 and iohexol 240 are equally safe and effective and can be recommended for myelography.

Adolescent↗
PubMed1998

Hydatid cyst of the kidney.

We report a case of hydatidosis of the kidney and stress the importance of the different radiological modalities. In the presented case, diagnostic radiological procedures included plain radiography of the abdomen, intravenous urography, ultrasonography, computerized tomography and magnetic resonance imaging. The combination of all the radiological findings lead to a correct pre-operative diagnosis, which is important as cyst rupture and spillage may cause anaphylactic reaction.

Adult↗
PubMed1994

High field magnetic resonance imaging of normal and pathologic human medulla oblongata.

High field proton magnetic resonance (MR) imaging has been applied to depict the MR appearance of the normal excised human cervicomedullary junction, based on which neuropathologic specimens can be described. More specifically, two normal cases and one case of Chiari deformity were imaged in the transverse, sagittal, and coronal dimensions using a 9.4 Tesla vertical bore magnet. The MR images of the normal specimens reveal most of the neuroanatomical microstructures described in literature. An accurate description of the Chiari deformity could be made by comparing the MR reference images with those of the pathologic specimen. All MR detected abnormalities were confirmed by histopathology, by which no additional lesions could be found.

Aged↗
PubMed1993

A double-blind study comparing safety, tolerability and efficacy of iodixanol 320 mgI/ml and ioxaglate 320 mgI/ml in cerebral arteriography.

Iodixanol is a new nonionic dimer, isotonic with blood at all concentrations. Iodixanol 320 mgI/ml was compared in a double-blind, randomized study to the ionic dimer ioxaglate 320 mgI/ml for evaluation of safety and efficacy parameters during cerebral arteriography. Eighty adult patients were enrolled and all completed the trial. Radiographic efficacy was assessed from the diagnostic information and the radiographic density. Safety was evaluated by recording discomfort and other adverse events, changes in ECG, heart rate and blood pressure, changes in intra-arterial blood pressure and circulation time. No difference between the two contrast media were noted radiographically. No clinically important changes from baseline or between the two contrast media were found in ECG, heart rate, blood pressure or intra-arterial blood pressure. Although not statistically significant, a somewhat longer mean circulation time was found with iodixanol, probably due to its slightly higher viscosity. Injection-associated warmth sensation and pain were more intense with ioxaglate than with iodixanol, and pain was statistically more frequent after injection of ioxaglate. A high incidence of adverse events other than discomfort is reported in this study, mainly related to the selective arteriographic procedure itself. The adverse events related to the contrast medium were more frequent with ioxaglate (27% of the total number of adverse events) than with iodixanol (10%). The new isotonic nonionic dimer iodixanol offers significantly better comfort to the patient than does ioxaglate. This is an important feature, especially in relatively risky procedures that are unpleasant for the patients, such as conventional cerebral angiography.

Adolescent↗
PubMed1980

Computed tomography of the normal and pathologic muscular system.

A standard program of computed tomographic (CT) scanning of the human skeletal muscular system was developed. Scans were obtained on five levels: the neck, the shoulder girdle, the pelvic girdle, the thigh, and the lower leg. The normal size and density of several muscles were determined. CT scans were also obtained in patients with various neuromuscular diseases. Several types of lesions were found, and their morphologic descriptions and quantitative data are presented. It is concluded that CT opens new possibilities for the evaluation of muscular atrophy and hypertrophy.

Adolescent↗
PubMed1979

Computed tomography of the human skeletal muscular system.

A description of different levels of the normal adult human skeletal muscular system is given as derived by computed tomography (CT). A standard program is presented by which a maximum number of muscles which are affected by neuromuscular diseases can be examined with a minimum of radiation. Twenty-four patients of different ages, 12 males and 12 females, were examined. Descriptions of different levels of the skeletal muscular system, with measurements of cross-section and density of a number of important marker muscles are presented. Variations of these parameters with age, sex, and cerebral dominance are discussed. It is concluded that CT scans can greatly enhance our insight into the effects of neuromusclar diseases on normal and abnormal skeletal muscles.

Absorptiometry, Photon↗
PubMedDate not supplied

Computed tomography of muscle.

Computed tomography (CT) scans of skeletal muscles of 3 patients with pseudohypertrophic muscular dystrophy are presented. Different patterns of muscle alterations and particularly of pseudohypertrophy are described. The significance of the radiological findings for clinical examination, electromyography, and needle biopsy is discussed.

Female↗
PubMedDate not supplied

Diffusion-weighted MR imaging in the evaluation of renal infection: preliminary results.

Diffusion-weighted (DW) magnetic resonance imaging (MRI) has already gained status in the neuroradiological MRI approach of a patient suffering from a variety of neurological diseases. The clinical application of DW MRI in the evaluation of renal disease is not standard. This manuscript describes preliminary results of the application of DW imaging in renal infection to aid differential diagnosis and/or lesion detection in clinical MRI. Three patients with acute pyelonephritis and two patients with renal abscess (one with xanthogranulomatous pyelonephritis, the other with a solitary pyogenic renal abscess) were examined with MRI. Areas of acute pyelonephritis and abscedation have restricted proton diffusion and are demonstrated on the DW images. Refinement of the technique, in-depth investigation of the pathological background of the MR findings and evaluation of its true clinical value need further investigation. This manuscripts shows preliminary findings of DW imaging in patients with renal infectious disease.

Abscess↗
PubMedDate not supplied

MRI in the assessment of pregnancy related intrauterine bleeding: a valuable adjunct to ultrasound?

MR imaging using ultrafast MR sequences is a useful method in assessing pregnancies at risk. This is especially the case for fetal imaging. However, reports of imaging of the placenta or the uterus are rare. We report the MR findings in 8 pregnant patients with vaginal blood loss in whom the obstetrical ultrasound was equivocal. MR imaging was performed with a 1.5 T magnet and consisted of T2- (HASTE), fat-suppressed gradient echo T1- and gradient echo T2-weighted images. Adequate anatomical visualisation of the uterus, the placentary tissue and the intrauterine bleeding irrespective of size and location of the latter, were obtained in all cases.

Adult↗