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D W Paty

Publications and source records attributed to D W Paty.

At least 109 records · Page 6Linked to original sources
PubMed1986

Progressive multiple sclerosis: abnormal immune functions in vitro and aberrant correlation with enumeration of lymphocyte subpopulations.

In a series of 27 consecutive progressive multiple sclerosis (MS) patients under age 50 we have simultaneously measured 3 in vitro immune functions and 6 markers and compared their results to a group of 21 controls. We have confirmed a reduction of concanavalin A (Con A) -induced suppression and NK function contrasting with increased IgG secretion in response to pokeweed mitogen (PWM). Among 6 monoclonal antibody-recognized subpopulation (Leu 1, Leu 2, OKT8, Leu 3, Leu 7 and Leu 11) only Leu 2+ lymphocytes were statistically reduced. OKT8+ were slightly reduced, Leu 3+ were slightly increased. Discriminant analysis revealed that the 3 immune functions together with the results of OKT8 and Leu 3 enumeration were sufficient to appropriately classify most of the individuals. Only 3 MS and 4 controls were misclassified. Correlation analysis suggested disappearance of the doubly labelled OKT8/Leu 7 population in MS patients. In MS as opposed to controls Con A-induced suppression did not correlate with suppressor cell markers but correlated with NK cell markers suggesting that in MS this population mediates Con A-induced suppression. IgG secretion and Con A suppressor cell function were inversely correlated in MS patients but not in controls, suggesting that in chronic progressive multiple sclerosis a common abnormality underlies both increased response to PWM and decreased induction of suppression by Con A.

Adult↗
PubMed1986

Multiple sclerosis.

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Evoked Potentials, Auditory↗
PubMed1985

Postpartum rubella immunization: association with development of prolonged arthritis, neurological sequelae, and chronic rubella viremia.

Six women developed chronic long-term arthropathy after postpartum immunization against rubella. All individuals developed acute polyarticular arthritis within 12 days to three weeks postimmunization and have had continuing chronic or recurrent arthralgia or arthritis for two to seven years after vaccination. Acute neurological manifestations, consisting of carpal tunnel syndrome or multiple paresthesiae, developed postvaccination in three women. Two have developed continuing active or chronic recurrent episodes of blurred vision, paresthesiae, and painful limb syndromes together with recurrent joint symptoms. Chronic rubella viremia has been detected in peripheral blood mononuclear cell (MNC) populations in five of the six women up to six years after vaccination. In addition rubella virus was isolated from breast milk MNCs in one individual at nine months postvaccination and from peripheral blood MNCs in two of four breast-fed infants studied at 12-18 months of age. Immune responses to rubella virus studied at sequential intervals after vaccination correlated with development of rheumatologic and neurological manifestations.

Adult↗
PubMed1985

Familial arteriovenous malformations. Report of four cases in one family.

Familial arteriovenous malformations (AVM's) are uncommon entities, with only seven reported cases in the English literature. Some have been associated with hereditary telangiectasia. A family in which AVM's were found in four male members of two generations is reported. In addition, one patient had a large cyst associated with his AVM without previous evidence of acute hemorrhage, which is an uncommon presentation. The family is discussed and a brief review of the literature is presented.

Adolescent↗
PubMed1984

A serial study of peripheral blood T lymphocyte subsets in relapsing-remitting multiple sclerosis.

Twelve patients with relapsing-remitting multiple sclerosis and 3 control subjects were evaluated weekly for six months. Peripheral blood lymphocyte subsets were enumerated using monoclonal antibodies and analysis with a dual-laser fluorescence-activated cell sorter. Results were correlated with clinically assessed disease activity. Fluctuations occurred in the number of T lymphocytes (Leu 1+) and cells with the helper/inducer phenotype (Leu 3a/OKT4+) in both patients and controls. Fluctuations in the number of cells with the suppressor/cytotoxic (Ts/c) cell phenotype (OKT5, OKT8, Leu 2a+) also occurred. Variations in the relative numbers of cells labeled with all three Ts/c monoclonals did occur, but with OKT5 generally labeling fewer cells than OKT8 or anti-Leu 2a. When findings were correlated with disease activity, OKT5 was a more sensitive gauge of disease activity than either OKT8 or anti-Leu 2a. When peripheral blood lymphocyte subsets were correlated with disease activity, the following patterns were observed: a reduction in the number of Ts/c cells without evidence of clinical disease (four episodes), the development of new symptoms suggestive of an acute relapse but without a reduction in the number of Ts/c cells (two episodes), and a reduction in the number of Ts/c cells associated with acute relapse (two episodes). In the two patients with acute relapse and a reduction in the number of Ts/c cells, clinical disease preceded a reduction in the number of Ts/c cells in 1 patient, whereas the two events occurred simultaneously in the other patient. Taken together, these limited results indicate that in some cases a reduction in the number of Ts/c cells may be the result rather than the cause of disease activity and may represent an epiphenomenon.

Adult↗
PubMed1984

A two-label microfluorometric analysis of the expression of OKT5 and Leu 2a antigens on peripheral blood lymphocytes in patients with multiple sclerosis.

Four patients with relapsing-remitting multiple sclerosis (MS) and one control were evaluated serially over a 10-week interval. Peripheral blood lymphocyte (PBL) subsets were enumerated using a double labelling technique, OKT5 and anti-Leu 2a monoclonal antibodies, and FACS IV analysis. Results were correlated with clinically assessed disease activity. Two subsets were identified. Subset 1 is characterized by cells positive for Leu 2a and either weakly positive or negative for OKT5 . Subset 2 was positive for both. Subset 1 was constantly present in both patients and controls while subset 2 was variable in presence and in size. No associations between these subsets and disease activity were made in this preliminary study, however, no acute relapses occurred in this interval. It is postulated that the reason for the differences in results of studies attempting to correlate disease activity with PBL phenotypes as assessed by different monoclonal antibodies may be the result of the suppressor/cytotoxic cell subpopulation being nonhomogeneous for the expression of various cell surface antigens. The technique of multiple labelling of lymphocytes may be useful in defining subsets which correlate more closely with disease activity.

Adult↗
PubMed1984

Study of alleles of the second complement component (C2) on Canadian HLA haplotypes.

Typing for genetic variation in the second complement component C2 was performed on sera from HLA haplotyped Canadian families. Part of the data has been studied and analysed as a population; in addition there is a further random collection of haplotypes bearing the C2*2 allele. In the population data there were 444 separate haplotypes from unrelated parents or other founders: 4.7% of the haplotypes carried the uncommon allele C2*2; one haplotype carried the rare C2*3. Study of C2 2-1 heterozygotes in the population data revealed 59 haplotypes which carried the common C2*1 allele and one which carried a deficiency allele C2*0. The remaining haplotypes carried either C2*1 or else an undetectable C2*0 allele. In the entire data there were 281 meioses informative for C2. The only recombinant between HLA-B and C2 showed the C2 locus to be on the DR side of the B locus. Strong allelic association between C2 *2 and Bw22 and less strong association between C2 *2 and B15 suggested the possibility of two ancestral C2 mutants. Examination of other markers on these and subsequently collected haplotypes do not conflict with this idea since the B15 haplotypes mostly carry C4A *4, C4B *2 whilst the Bw22 haplotypes mostly carry C4A *4, C4B *4. The alternative idea, that there was one original mutant which crossed over from a B15 to a Bw22 haplotype or vice versa is not excluded, however. Since approximate equilibrium has been reached between Bw22 and the HLA-A locus alleles on these C2 *2 bearing haplotypes, we conclude that this mutation is at least 5000 years old. Other haplotypes carrying C2 *2 are assumed to be ancestral recombinants; if this is true, the C2 locus map position between HLA-B and HLA-DR is confirmed. Study of C2 mutation may provide a model for understanding the genetics of some disease susceptibility genes in the HLA region.

Alleles↗
PubMed1984

Field testing of a minimal record of disability in multiple sclerosis: the United States and Canada.

The IFMSS Minimal Record of Disability (MRD) in Multiple Sclerosis was field tested at eight medical centers in the U.S. and Canada. The goals were to conduct a qualitative and quantitative evaluation of the MRD. Assessment were completed on 249 patients with definite MS by neurologists and allied health professionals. Effective administration required some study and practice. Refinement of some unclear wording and awkward format will improve ease of administration. The MRD fit well into clinic routines and was accepted by staff and patients. Scoring presented few problems and these were related to overlap among the MRD scales, poor wording, and content not appropriate to MS. Quantitative evaluation of the MRD indicated that Incapacity Status primarily reflects disability in mobility and self-care when used as a composite score. Heterogeneity of content in Incapacity Status suggests that summed scores be used cautiously. Both Incapacity and Environmental Status had high levels of reliability and high correlations with established measures of impairment in MS. Inter-rater agreement of the ISS and ESS were also high. Once some necessary revisions are made, the MRD should be well on its way to achieving the IFMSS goal of developing a brief, reliable, valid, and appropriate instrument acceptable to a wide variety of workers in MS.

Activities of Daily Living↗
PubMed1984

Linoleic acid and multiple sclerosis: a reanalysis of three double-blind trials.

Data from three double-blind trials of linoleic acid in the treatment of multiple sclerosis (MS) were reanalyzed to examine whether inconsistency in the results was due to a relationship between patient characteristics and treatment response. The combined data consisted of neurologic assessments over 2 1/2-year trials for 87 treated patients and 85 control patients. Treated patients with minimal or no disability at entry had a smaller increase in disability than did controls (p less than 0.05). In addition, treatment reduced the severity and duration of relapses at all levels of disability and duration of illness at entry to the trials.

Clinical Trials as Topic↗
PubMed1984

Neuroimaging in multiple sclerosis.

Conventional CT studies were the first neuroimaging tools shown to be frequently useful in the assessment of patients with multiple sclerosis. The most commonly noted abnormalities are cerebral atrophy, foci of decreased density, and contrast enhancing lesions. Hypodense lesions may represent either recent or remote sites of demyelination and this can be determined in part by the response of these abnormalities to contrast administration and by their evolution with serial CT studies. There is compelling evidence that CT enhancing lesions correspond to sites of active inflammation and demyelination. High-volume delayed CT studies increase the number of CT abnormalities seen, particularly in patients examined at the time of clinical disease activity. These studies appear to be well-tolerated in properly hydrated patients with normal renal function. NMRI studies appear to be the most sensitive way to detect MS lesions and are particularly useful in demonstrating abnormalities in the posterior fossa. Less is known of the pathologic substrate and the evolution of these NMR abnormalities. It appears likely that NMR detected lesions usually do not resolve completely and consequently changes seen with this neuroimaging technique may represent the cumulative effects of past and present disease activity.

Atrophy↗