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Biomedical subjects

M Andary

Publications and source records attributed to M Andary.

At least 19 recordsLinked to original sources
PubMed2001

Identification of cervical radiculopathies: optimizing the electromyographic screen.

OBJECTIVE: To determine the optimal electromyography screening examination of the upper limb that ensures detection of those cervical radiculopathies, which can be electrodiagnostically confirmed, yet minimizes the number of muscles studied. DESIGN: A prospective multicenter study was conducted from May 1996 to September 1997 at five institutions. Patients who were referred to participating electrodiagnostic laboratories with suspected cervical radiculopathy were recruited. A standard set of muscles were examined by needle electromyography. Patients with electrodiagnostically confirmed cervical radiculopathies, based on electromyography findings, were selected for analysis. Muscle screens were tested against this group to determine whether the screen identified the patients with radiculopathy. RESULTS: There were 101 patients with cervical radiculopathies representing all cervical root levels. When paraspinal muscles were one of the screening muscles, five muscle screens identified 90% to 98% of radiculopathies, six muscle screens identified 94% to 99%, and seven muscle screens identified 96% to 100%. When paraspinal muscles were not part of the screen, eight distal limb muscles recognized 92% to 95% of radiculopathies. CONCLUSION: This study demonstrated that six muscle screens including paraspinal muscles yielded consistently high identification rates. Studying additional muscles led to marginal increases in identification.

Adolescent↗
PubMed2000

Postinjection vastus lateralis atrophy: 2 case reports.

We report two cases of postsurgical intramuscular meperidine injection with injury to the femoral nerve and subsequent vastus lateralis atrophy. The first case is a patient who had arthroscopic anterior cruciate ligament reconstruction; the second, a patient with a C6-C7 anterior fusion. Photographs, radiography, and electrodiagnostic studies clearly depict the nature of the injuries, and their etiology is discussed. These case reports describe a unique neuropathic injection injury that, to our knowledge, has never before been described in the literature.

Adult↗
PubMed2000

Predicting electrodiagnostic outcome in patients with upper limb symptoms: are the history and physical examination helpful?

OBJECTIVE: To determine the effectiveness of medical history and physical examination in predicting electrodiagnostic outcome in patients with suspected cervical radiculopathy. METHODS: Data on 183 subjects prospectively collected at five different electrodiagnostic laboratories were analyzed (96 cervical radiculopathies, 45 normal studies, and 42 abnormal electrodiagnostic findings other than radiculopathy). The sensitivity, specificity, positive predictive value, negative predictive value, and odds ratios were determined for symptoms and neurologic signs. RESULTS: Symptoms of numbness, weakness, and tingling were associated with twice the probability of having abnormal electrodiagnostic study results in general, yet were not helpful in identifying a cervical radiculopathy. All single and combined physical examination components had poor sensitivities, with the exception of weakness, but much higher specificities. Patients with either weakness or reduced reflexes on physical examination were up to five times more likely to have abnormal electrodiagnostic findings. In subjects with any abnormal neurologic sign, the sensitivity improved to 84%, the positive predictive value was 79%, but the specificity was low (44%). Of those subjects with normal physical examination results, almost one half had an abnormal electrodiagnostic study result (negative predictive value 52%). CONCLUSIONS: In a population of patients with suspected cervical radiculopathy, medical history and physical examination are helpful yet not sufficient to predict the electrodiagnostic outcome.

Adolescent↗
PubMed1999

Cervical radiculopathies: relationship between symptom duration and spontaneous EMG activity.

The purpose of this multicenter study was to prospectively examine whether denervation in paraspinal muscles (PSM) and in other major proximal and distal muscles is related to symptom duration in cervical radiculopathies (CRs). Information was collected on 93 electrodiagnostically confirmed CRs using standardized history, physical examination, and electromyographic (EMG) screens. Multivariate, maximum-likelihood estimates showed no evidence of correlation between PSM spontaneous activity and symptom duration. Symptom duration was also nonsignificant in eight of the remaining nine upper limb muscles analyzed. We conclude that the probability of spontaneous activity is not related to symptom duration. Clinicians, therefore, should refrain from interpreting electrodiagnostic findings based upon duration of symptoms.

Adolescent↗
PubMed1991

Shifts in interleukin-4 and interferon-gamma production by T cells of patients with elevated serum IgE levels and the modulatory effects of these lymphokines on spontaneous IgE synthesis.

Interleukin-4 (IL-4) has been demonstrated to induce IgE synthesis by peripheral blood mononuclear cells (PBMNCs) of healthy donors. In this study, we demonstrated that IL-4 also can enhance spontaneous IgE synthesis by PBMNCs of allergic/atopic patients and patients with Buckley's or hyper-IgE syndrome. Spontaneous IgE production by PBMNCs of these patients was suppressed by interferon (IFN)gamma or IFN-alpha in a dose-dependent fashion. Despite high serum IgE levels, no IL-4 could be detected in the serum of the patients, but indirect evidence was obtained indicating that enhanced IL-4 production in vivo may be associated with the high serum-IgE levels in these patients. Spontaneous IL-4 production was measured in PBMNC cultures of 4/21 patients tested. Furthermore, spontaneous IgE synthesis by PBMNCs of three other patients of seven tested in vitro was partly blocked by anti-IL-4 antiserum. In addition, levels of soluble CD23 (which is specifically induced by IL-4) were strongly elevated in sera of patients. Finally, activation of PBMNCs of the patients resulted in levels of IL-4 and of IFN-gamma synthesis that were higher and lower, respectively, than levels produced by PBMNCs of healthy control donors tested in parallel. Collectively, our data indicate that spontaneous IgE synthesis in vitro can be modulated by IL-4, IL-5, IFN-gamma, and IFN-alpha. In addition, our data suggest that enhanced IL-4 and reduced IFN-gamma production is associated with the elevated serum IgE levels observed in these patients.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1991

Treatment of infantile spasms with intravenous gamma-globulins.

In a prospective study, 23 children with infantile spasms received intravenous gammaglobulins in high doses. 19 patients present a West syndrome. 4 older patients were included in the study because infantile spasms had preceded their Lennox-Gastaut syndrome. None of the patients had recently undergone corticosteroid therapy. No effect was observed in 15 patients, while transitory clinical and/or electroencephalographic improvement was noted in 3. Complete normalization was obtained in the remaining 5 patients, of whom 4 had severe brain lesions. No correlation existed between the therapeutic results and immunological abnormalities, a deficiency in IgG subclasses in particular. On the whole, the therapeutic results were disappointing. But the existence of some cases in which spectacular electroencephalographic and/or clinical improvement was obtained leads us to suggest that IV gamma-globulins be used as auxiliary treatment in infantile spasms.

Electroencephalography↗
PubMed1990

Effect in vitro of a bacterial extract (OM-89) on interleukin 1 and interleukin 2 production by peripheral blood mononuclear cells from healthy subjects and rheumatoid arthritis patients.

The effect of a lyophilized extract from Escherichia coli strains (OM-89) on interleukin 1 and interleukin 2 production was studied by using peripheral blood mononuclear cells (PBMC) from healthy volunteers and from patients suffering from rheumatoid arthritis (RA) since, in this autoimmune disease, an abnormal cytokine network has been already described. The secretion of interleukin 1 (IL-1) was investigated in supernatants of monocytes purified by adherence, and measured by the C3H/HeJ thymocyte co-mitogenic assay. OM-89 was able to induce the secretion of IL-1 by normal and RA monocytes to about half of the level reached when the same cells were stimulated by lipopolysaccharide. The production of interleukin 2 (IL-2) was investigated in supernatants of PBMC, stimulated or not by phytohaemagglutinin (PHA) and mixed or not with various concentrations of OM-89. The level of IL-2 in supernatants, as measured by the stimulation of the CTLL2 murine cell line, was lower in RA supernatants than in control ones. In the presence of PHA and OM-89, the IL-2 production was enhanced and normalized in supernatants from RA patients. Such data may help to explain the clinical improvement previously reported in RA patients orally treated with OM-89.

Adjuvants, Immunologic↗
PubMed1990

[Alteration of IgE production by cefadroxil].

The effect of two cephalosporins, cefadroxil and cefalexine, was in vitro studied by using two models of regulation of the IgE production in healthy humans, e.g. the induction of CD23-antigens on B-cells and the IgE synthesis in cell culture supernatants after stimulation by recombinant interleukin-4. Cefadroxil clearly inhibited CD23 membrane expression on normal human B-lymphocytes. In the same way, this cephalosporin blocked up to 90% of the in vitro interleukin-4-dependent IgE production by normal peripheral blood mononuclear cells. Cefalexine was unable to do the same. There results suggest that cefadroxil interplays with the regulation processes of the IgE production in humans.

Antigens, Differentiation, B-Lymphocyte↗
PubMed1988

Increase of class II HLA molecules on the membrane of B lymphocytes from patients with rheumatoid arthritis.

Using a novel cytofluorometric method of cellular antigen quantification, we examined peripheral blood mononuclear cells (PBMC) from patients suffering from rheumatoid arthritis (RA) for quantitative modification of class II human leucocyte antigen (HLA) molecules expressed on the surface. Class II HLA molecules were detected by indirect immunofluorescence with a monomorphic monoclonal antibody. No change was observed in the density of class II HLA molecules at the surface of monocytes of RA patients as compared to that of paired healthy subjects. We confirmed that the percentage of class II HLA-bearing T cells was slightly increased in RA patients versus controls, but the density of class II antigens per cell could not be determined accurately. An increase in the density of class II HLA molecules on RA B cells was shown, suggesting that a chronic activation stage of this population contributes to the disease.

Antigens, Surface↗
PubMed1987

Regulation of interleukin-2 production in rheumatoid arthritis.

The regulation of interleukin-2 (IL-2) production was investigated using mononuclear cells from synovial fluid (SF) and peripheral blood of 12 patients with classical and active rheumatoid arthritis. Decreased phytohemagglutinin (PHA) stimulated IL-2 production by lymphocytes was observed in rheumatoid peripheral blood (5.3 +/- 10.9 units/ml) and SF (3.8 +/- 5.2 units/ml) compared to peripheral blood from 12 normal donors (18.1 +/- 15.4 units/ml) and SF from 5 patients with other rheumatic diseases (11.9 +/- 10.9 units/ml). Indomethacin, phorbol myristate acetate and irradiation of suppressor cells increased IL-2 values in rheumatoid SF and peripheral blood but did not restore normal IL-2 production. IL-2 production did not correlate with clinical activity in patients with RA.

Adolescent↗
PubMed1987

[Characterization of chronic lymphocytic proliferation in a female patient having rheumatoid polyarthritis with neutropenia].

The authors have studied the case of a female patient with rheumatoid polyarthritis, who developed a lymphocytic proliferation in the blood, the marrow, and the liver, associated with a neutropenia. Several similar cases have been recently reported in the literature. The cellular proliferation is made of large granulous lymphocytes and the study of membrane markers enables to find the following homogeneous phenotype: E rosette+, CD8+, HNK-1+, FcR+, CD4-luminal diameter "divided by degrees - -, IgS-, HLA class II-. This lymphocytic sub-population produces little interleukin-2, responds weakly to mitogens (PHA, CON A, PWM), and inhibits the response of normal lymphocytes to the same mitogens. These lymphocytes have a weak natural killer activity but, on the contrary, develop a very strong cytotoxic activity which is antibody-dependent. Clinically, splenomegaly, anemia and infections are frequent and hepatomegaly or thrombopenia more rare. Adenopathies are never present. The evolution is chronic in nature and not very aggressive, although the lymphocytic proliferation is monoclonal in origin, as demonstrated in molecular biology studies. The neutropenia might be secondary to an inhibiting effect of lymphocytes on the granular precursors of the bone marrow. There is a definite association between this lympho-proliferative syndrome and rheumatoid polyarthritis, and this association appears to be different from the Felty's syndrome.

Adult↗
PubMed1986

Characterization of an expanded subpopulation of large granular lymphocytes in a patient with rheumatoid arthritis.

We describe a rheumatoid arthritis patient who was found to have chronic T cell lymphocytosis and neutropenia. She had an increased number of lymphocytes in the peripheral blood, bone marrow, and liver, and the expanded lymphocyte subset consisted of large granular lymphocytes with a homogeneous phenotype. Of the previously described patients with these large granular lymphocytes, almost one-fourth have had rheumatoid arthritis.

Adult↗
PubMed1984

Peripheral blood T-cell subsets studied by monoclonal antibodies in type 1 (insulin-dependent) diabetes: effect of blood glucose control.

Peripheral T lymphocyte subsets were investigated, using monoclonal antibodies, in 14 patients with acute diabetes of duration less than 1 month (before insulin treatment) and after prolonged strict blood glucose control, and also in 40 healthy volunteers. At the time of diagnosis, the percentage total T cells was decreased (67.6 +/- 8.4 versus 72.8 +/- 6.6%), but T4 'helper' cells and T8 'suppressor/cytotoxic' cells were in the normal range. The T4/T8 ratio was not significantly higher than in the control group and B-cell percentages were increased (IgS: 18.3 +/- 7.1 versus 12.4 +/- 4.9%). The second T cell enumeration, performed after sustained normoglycaemia, showed a normal total T cell percentage and a decrease in the T4/T8 ratio depending on a decrease of T4 cells (38.3 +/- 12.8 versus 49.3 +/- 13.4), without any change of T8 lymphocytes; B cells remained elevated. These results suggest that insulin deficiency/metabolic derangement was responsible for an imbalance of circulating lymphocytes and underlines the importance of metabolic control in the assessment of such immunological parameters.

Adolescent↗
PubMed1984

Immunological aspects of psoriasis. VI. Impairment of isoprenaline and theophylline-induced inhibition of mitogen responsiveness.

Pharmacological abnormalities occur in the psoriatic epidermis, and if similar abnormalities occur in the peripheral blood mononuclear cells they could impair the immune responses in psoriasis. In a paired control study, we have tested the capacity of histamine, isoprenaline and theophylline (10(-5) and 10(-7) M) to inhibit the mitogen responsiveness of blood mononuclear cells from normal and psoriatic subjects, using phytohaemagglutinin and concanavalin A. In the normal controls, mitogen responsiveness was inhibited by all three pharmacological agents by about 30 to 50%. In cells from psoriatic patients, the response in the presence of histamine was inhibited (as in the controls), but isoprenaline caused no inhibition, and theophylline paradoxically increased the mitogenic responses. These results suggest there is a defect in the pharmacological response of the blood mononuclear cells in psoriasis.

Adult↗