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Biomedical subjects

A J Thompson

Publications and source records attributed to A J Thompson.

At least 307 records · Page 17Linked to original sources
PubMed1989

Sarcoidosis presenting with stroke.

A 25-year-old black man with sarcoidosis presented with transient ischemic attacks followed by sudden, persistent right hemiparesis. He gave a history of recent, recurrent lower motor neuron facial palsy. Computed tomography demonstrated an infarct in the left internal capsule. Chest x-ray film showed bilateral hilar and mediastinal lymphadenopathy and multiple opacities in the lung fields. Serum angiotensin converting enzyme concentration was raised, and a Kveim test was positive for sarcoidosis. Despite clear pathologic reports of cerebral vasculitis in neurosarcoidosis, the occurrence of stroke is extremely rare.

Adult↗
PubMed1989

Relative efficacy of intravenous methylprednisolone and ACTH in the treatment of acute relapse in MS.

To compare the efficacy of high-dose intravenous methylprednisolone with intramuscular ACTH in the treatment of acute relapse in multiple sclerosis, we undertook a double-blind, randomized, controlled study involving 61 patients. There was a marked improvement in both groups in the course of the study, but no difference between them in either the rate of recovery or the final outcome. High-dose IV methylprednisolone is a safe alternative to ACTH in the management of acute relapse in MS.

Acute Disease↗
PubMed1988

Polysaccharide storage myopathy.

In a woman with a slowly progressive adult onset proximal myopathy, muscle biopsy showed storage of PAS positive material in type 1 fibers. This material consisted of a branched chain polysaccharide associated with a mucoprotein. No abnormality of glycogen-pathway enzymes was detected. This suggested that this polysaccharide accumulation occurred because the polysaccharide was laid down in a non-bioavailable form. The clinical and histochemical features in this patient and in the few similar reported cases indicate that polysaccharide storage myopathy is a distinct entity that is allied to the glycogen storage myopathies.

Electromyography↗
PubMed1988

Patterns of selective involvement of thigh muscles in neuromuscular disease.

In 14 patients with limb girdle muscular dystrophy, polymyositis, and type 3 spinal muscular atrophy, CT scans of the thigh muscles were correlated with single fiber EMG studies in vastus lateralis, semimembranosus and biceps femoris muscles. There was a relation between the extent of CT scan abnormality and increased fiber density in the three muscles studied, except in the most severely affected muscles in which in some muscles the fiber density values were lower than expected. These results were independent of the underlying pathology. Correlative CT/SFEMG studies provide insights into the pattern of selective involvement of certain muscles in neuromuscular disorders.

Adult↗
PubMed1988

Autopsy validation of MRI in central pontine myelinolysis.

In a fatal case of central pontine myelinolysis (CPM) a low field strength (0.08 Tesla) magnetic resonance image revealed reduction of image intensity in the pons with sparing of two central symmetrical areas in the ventral portion. The latter correlated with preservation of centrally located groups of longitudinal myelinated nerve fibres shown at autopsy. Although such sparing is well recognised in pathological studies of CPM it has never previously been demonstrated in life.

Adult↗
PubMed1988

Central motor conduction in multiple sclerosis: evaluation of abnormalities revealed by transcutaneous magnetic stimulation of the brain.

Magnetic stimulation of the brain and spinal column was used to assess conduction in the descending central motor pathways controlling arm and leg muscles of 20 patients with multiple sclerosis, and 10 normal subjects. The multiple sclerosis patients had relapsing and remitting disease but all were ambulant and in stable clinical remission. Increased central motor conduction times (CMCTs), up to three times normal, were frequently encountered in multiple sclerosis patients and in leg muscles these correlated closely with clinical signs of upper motor neuron disturbance; in the upper limb muscles a higher proportion of subclinical lesions was present. Weak muscles were almost invariably associated with abnormal central conduction but increased CMCTs were also found for 52 of the 104 muscles with normal strength. CMCTs for lower limb muscles were directly related (p less than 0.005) to functional motor disability (Kurtzke and Ambulatory Index Scales). No patient developed clinical evidence of relapse during follow-up of at least 8 months. Magnetic brain stimulation is easy to perform, painless, and safe, and provides clinically relevant information in the diagnosis and monitoring of multiple sclerosis patients.

Adult↗
PubMed1987

Three possible laboratory indexes of disease activity in multiple sclerosis.

In a search for an objective measure of disease activity in MS, we studied three laboratory indexes in 15 patients over 12 months, relating them to the occurrence of relapse and the development of increased disability. Relapse was associated with detection of myelin basic protein (MBP) in the CSF (p less than 0.01), but not with decreased numbers of peripheral blood T lymphocytes. Persistently low T-cell numbers and more frequent detection of MBP in remission were associated with increased disability (p less than 0.01). There were no associations between other CSF abnormalities and either relapse or increased disability.

Adult↗
PubMed1986

The pharmacokinetics of pyrimethamine in the rat: effect of mefloquine.

The pharmacokinetics and tissue distribution of pyrimethamine have been determined in the rat. Following administration of pyrimethamine alone, drug concentrations declined biexponentially. By contrast, in the presence of mefloquine, the decline in pyrimethamine concentration more closely fitted a monoexponential pattern and the AUC0-6h for pyrimethamine was significantly reduced. Significantly more pyrimethamine was recovered from the livers but less from the lungs of the mefloquine-dosed rats compared with control. This study outlines a potentially clinically relevant drug interaction.

Animals↗
PubMed1986

Peripheral blood T lymphocyte changes in multiple sclerosis: a marker of disease progression rather than of relapse?

A serial study of peripheral blood T lymphocytes in 27 patients with clinically definite multiple sclerosis and 11 healthy controls was carried out over a 12 month period. This showed that contrary to many previous reports, relapses were not consistently associated with reduced numbers of peripheral blood suppressor T lymphocytes or any other T cells. Persistently low T cells numbers, including both the helper and suppressor T cell subsets, were, however, associated with disease activity as measured by the development of increased disability during the course of the study. This was true both for the patients with relapsing/remitting disease and those with progressive disease. The importance of carrying out a serial study was emphasised by the consistent and significant differences that were detected between individuals in both the control and the patient groups. A serial study is the most reliable means by which clinical events can clearly be correlated with laboratory estimations. The association in this study between the development of increased disability and persistently low levels of peripheral blood T lymphocytes suggest that both may be related to the underlying disease process in multiple sclerosis.

Adult↗
PubMed1986

A clinical and laboratory study of benign multiple sclerosis.

In a hospital-based study of 400 patients with multiple sclerosis (MS), 42 per cent of patients who had had MS for 10 years or more had benign disease. Early age of onset and a long first remission were significantly associated with a good prognosis. There was a suggestion that initial presentation with paraesthesiae and possibly optic neuritis were associated with a benign prognosis, but the only significant finding was the association between limb weakness and a poor outcome (p less than 0.05). Fewer patients with benign disease had a progressive element to their disease than those in the more disabled group (p less than 0.001). The only laboratory test which was associated with a benign prognosis was the absence of CSF myelin basic protein in remission. Abnormalities of visual evoked response, CSF IgG and peripheral blood T lymphocytes appeared to have no value in assessing prognosis in the patients studied.

Adult↗
PubMed1985

Possible in vivo modulation of Leu 2a expression on suppressor T cells in active multiple sclerosis.

Reduced numbers of suppressor T lymphocytes were identified by monoclonal antibodies in the peripheral blood of patients with multiple sclerosis (MS) in acute relapse. In vitro culture of cells from these patients resulted in a significant increase in the number of cells identified with the suppressor T cell marker Leu 2a but not OKT 8. The expression of other T cell antigens (Leu 4 and Leu 3a) remained unchanged. This change in Leu 2a expression did not occur when cells from healthy controls were similarly treated.

Antibodies, Monoclonal↗
PubMed1985

Suppressor T cell changes in active multiple sclerosis: analysis with three different monoclonal antibodies.

This study demonstrates a significant reduction in the number of both total T cells and suppressor T cells identified by monoclonal antibodies in multiple sclerosis patients in acute relapse but not in those in remission. The reduction in the number of suppressor T cells was shown by all three monoclonal antibodies used but was most clearly demonstrated using Leu 2a rather than either OKT 8 or OKT 5. These findings suggest that the choice of monoclonal antibody used in a study of suppressor T cell numbers will influence the results and may help explain the lack of agreement in previous studies.

Antibodies, Monoclonal↗
PubMed1985

Suspected and clinically definite multiple sclerosis: the relationship between CSF immunoglobulins and clinical course.

CSF immunoglobulins were examined in 103 patients with clinically definite multiple sclerosis, 106 patients with either suspected or progressive possible multiple sclerosis and 72 patients with other neurological diseases. Raised CSF IgG index and oligoclonal banding were found in 71% and 75% of clinically definite multiple sclerosis patients respectively and both tests were abnormal in 11% of patients with other neurological diseases. The CSF IgG index and the presence of oligoclonal IgG did not relate to the severity or duration of established disease in these patients. In patients with suspected and progressive possible multiple sclerosis, both a raised IgG index and the presence of oligoclonal banding were found significantly more frequently than in the OND group. Abnormalities of these parameters were significantly correlated with the presence of an abnormal evoked response in these patients (chi 2 = 10.16 p less than 0.01). When 47 patients with suspected multiple sclerosis were studied prospectively the presence of oligoclonal banding at presentation was associated with development of further disease activity.

Brain Stem↗