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O Lyon-Caen

Publications and source records attributed to O Lyon-Caen.

At least 109 records · Page 6Linked to original sources

[Demyelination in in vitro culture in multiple sclerosis: facts and controversies].

The myelinotoxicity of sera from multiple sclerosis (MS) patients was determined by the assessment of visible myelin damage in guinea-pig spinal cord-spinal ganglia and in rat cerebella cultivated on collagen-coated coverslips in Leighton tubes. No change was seen in 22 cases. These data show that serum myelinotoxicity is low in MS - as compared with that of Experimental Allergic Encephalomyelitis. It appears a little specific phenomenon, the mechanism of which remains unclear. It can be easily assessed only in very sensitive culture techniques and is best measured by biochemical methods. This does not preclude the pathophysiological significance of the serum myelinotoxicity in MS. Supernatants of cerebro-spinal fluid (CSF) cell cultures in 10 MS patients caused no demyelination. Pooled concentrated supernatants of CSF cell cultures from 13 to 20 MS patients--containing from 7.3 to 11.7 micrograms IgG/ml gave no patent in vitro demyelination in 3 different experiments. The released products of CSF cell cultures in MS are not very toxic for myelin. However these experiments have to be repeated with more sensitive culture techniques, biochemical assay of myelinotoxicity and more concentrated CSF cultures supernatants.

Animals↗

Cognitive function in recent-onset demyelinating diseases.

To determine cognitive disturbances in recent demyelinating disease, we studied 21 patients with definite or probable multiple sclerosis (MS) of less than two years' duration and nine patients with recently isolated optic neuritis. None had any clinical or social evidence of cognitive impairment. Mild to moderate cognitive impairment. Mild to moderate cognitive impairment was present in 18 (60%) of 30 cases, affecting visual and/or verbal efficiency. These abnormalities were statistically significant when compared with the results of a control group of 29 patients. There was no correlation with a depressive status, between the presence of cognitive impairment and either the degree of handicap or the activity of the disease. The frequency of cognitive dysfunction (60%) appears to be comparable to that reported in other series in which MS evolution is over ten years. The natural history of cognitive functions in MS has to be identified. Neuropsychologic tests could be useful in the diagnosis of monosymptomatic or paucisymptomatic forms of MS (ie, visual or medullary).

Adult↗

Early onset multiple sclerosis. Clinical study of 12 pathologically proven cases.

Among 70 pathologically proven MS cases, we found 12 cases with onset before 25. Only females were affected. There was no positive familial history of MS. In every case the diagnosis was considered during life. Mean duration of the disease was 29.1 +/- 12.5 years. This was significantly longer (p less than 0.001) than in the control group (58 pathologically proven cases with onset after 25). There were no acute courses. Progressive courses (1 case) and remittent courses (5 cases) were less frequent than in the control group (p less than 0.001 and p less than 0.01, respectively). The frequency of remittent-progressive courses (6 cases) was similar in both groups. The length of remittent-progressive courses (30.2 +/- 16.2) and remittent courses (28.6 +/- 9.7) was longer than that of control group (p less than 0.001). The symptomatology of onset was similar in both groups and had no predictive value for prognosis. The overall frequency of signs and symptoms was not statistically different in both groups. For each sign, the percentage of affected patients, throughout the course of the disease, was always smaller in early onset MS than in control group, except for optic neuritis which was as frequent in both groups. However, this was statistically significant only for ocular motricity and nystagmus.

Adult↗

Immunoblot analysis of circulating antibodies against muscle proteins in amyotrophic lateral sclerosis and other neurologic diseases.

Serum from patients with amyotrophic lateral sclerosis (ALS) was tested by immunoblotting for reactivity against three muscle-derived preparations: denervated chick leg muscle extracts, media conditioned by denervated rat hemidiaphragms, and a human muscle extract. For each preparation, multiple bands were present using serum from all patients and controls, and no band was unique to ALS. Against rat muscle-conditioned medium, bands in the 56,000 (56K) molecular weight range were present to an equal degree in ALS and in controls; in addition, different bands near 56K were recognized by serum from different ALS patients. These results fail to confirm a recent report suggesting that anti-56K reactivity is characteristic of ALS.

Adult↗

[Double-blind treatment of 49 cases of chronic multiple sclerosis using hyperbaric oxygen].

Forty nine patients with a chronic form of multiple sclerosis (MS) [progressive or stable] were treated with hyperbaric oxygen (HO) in a double blind trial. Patients were divided in three groups: the first group (group I) received a course of 2.3 ATA HO with diazepam (5 mg); the second group (group II) received a course of 2 ATA HO; the third group (group III) was the control group. Each patient breathed an adapted gaseous mixture in high pressure. Each patient received 20 sessions of this procedure during 4 weeks. Patients were evaluated with clinical, neurophysiological and immunological parameters. Clinical examination consisted in the evaluation of the Kurtzke's Disability Status Scale (DSS) and Functional Status Scale (FSS). This evaluation was done in the week before the procedure, the week following the treatment, then in the third and sixth month. The neurophysiological study was a comparative analysis from the variations of visual, somesthesic and brain stem auditory potentials. The immunological study was the analysis of the lymphocyte populations (OKT4/OKT8 ratio). Each examination was carried out the week before, then the week following the procedure. We found no amelioration into three groups. Subjectively, some patients thought to be better, but this was true in the two treated groups (I, II) and in the control group (III). There was not an FSS significant variation. We also found no significant variation of evoked potentials and OKT4/OKT8 ratio. We observed some incidental effects of the treatment, particularly in group I, in which patients were treated with a higher pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain↗

Value of multiple sclerosis diagnostic criteria. 70 autopsy-confirmed cases.

We have evaluated the sensitivity of the most recent and most frequently used criteria for the diagnosis of definite multiple sclerosis by the retrospective study of the clinical files of 70 pathologically confirmed cases. For each case, the date of diagnosis was determined separately using different sets of criteria. The delay of diagnosis was then calculated. The diagnosis was made significantly earlier when certain criteria were used. This was more marked in the earlier years of the disease. We also found that cases of multiple sclerosis with progressive courses were diagnosed later than cases with other courses, whatever the criteria used. This was statistically significant only for a single criterion.

Autopsy↗

Late onset multiple sclerosis. A clinical study of 16 pathologically proven cases.

In 70 pathologically proven MS cases, we found 16 cases with onset after 45. Sex ratio (3/1) was the same in the late onset cases and early onset control group. There was no positive family history of MS. The diagnosis was more frequently never considered in late onset cases (3/16) than in control cases (3/54). Mean duration of the disease was 8.6 +/- 6 years (8.1 +/- 6 in female patients). This was significantly shorter (P less than 0.05) than in the control group. In addition, in remittent-progressive courses and in progressive courses, it appeared that the duration of the disease was shorter in late onset MS - although this was not statistically significant. Progressive courses (8 cases) and acute courses (4 cases) were more frequent (P less than 0.05) than in control cases. Initial signs and symptoms were not significantly different from those of control cases. The length of the evolution of the disease was higher in cases with vestibular-cerebellar onset. New signs and symptoms occurred at the same rate in the late onset cases as in the control cases. Although motor, sensory and bladder disturbances were more frequent in the late onset cases than in the control cases, this was not statistically significant. Amyotrophy was more frequent in late onset MS; on the contrary optic neuritis, vestibulo-cerebellar disturbances and nystagmus were less frequent in late onset MS than in the control group (P less than 0.05).

Brain↗

[Spinal forms of multiple sclerosis. Value and criticism of examination by cerebral magnetic resonance. Apropos of 4 cases].

Four observations of spinal forms of multiple sclerosis (MS) have been studied by Magnetic Resonance Imaging (MRI) (Magniscan Thomson CGR 0,15 and 0,5 T). They concerned 3 females and 1 male, aged between 29 and 60. Evolution of MS varied between 1 year and 9 years. There were no familial story of neurological illness; there were no signs and symptoms of visual, oculo-motor, labyrinthic and cerebellar disorders in the past. VEP were abnormal in 2 cases (no 1, 3), BAEP in 1 case (no 2). CSF examination showed increased gamma globulins with an oligoclonal pattern in 2 cases (no 3,4). CT Scan performed with iodine contrast injection was normal in 3 cases (no 2,3,4). In all the cases, MRI using T2 weighted-SE sequences, showed high signal lesions in the white matter of the brain and/or the cerebellum, and periventricular patchy white matter lesions. It seems to be no relationship between the duration of MS and the number of abnormal high signals areas, but more important series are necessary to confirm or not such a result. These lesions seem to be without aetiological specificity. They have to be discussed according to the clinical biological, electro-physiological data and sometimes others neuroradiological procedures.

Adult↗

[Clinical analysis of 70 neuropathologic cases of multiple sclerosis].

A retrospective study of clinical files of 70 pathologically confirmed cases of Multiple Sclerosis (MS) (53 women and 17 men), selected from the records of the Laboratoire de Neuropathologie Charles Foix (Hôpital de la Salpêtrière) was performed. The following data were recorded and analysed by a computer program (HP 85): sex, age of onset of disease, clinical course (classified into Remittent, Remittent-Progressive, Progressive and Acute) and the date of each new neurological symptom or sign. The mean age of onset was 36.8 +/- 12. In women, the disease began earlier (34.6 +/- 12) and the duration was longer (17.4 +/- 12). In men the age onset was 40.6 +/- 11 and the duration was 12.5 +/- 6. In remittent courses, the mean age of onset was 30.8 +/- 13 and the duration was 21 +/- 10. In progressive courses, the age at onset was 45 +/- 10 and the duration was 2. In women, progressive courses began significantly later (42.3 +/- 9.2) and were shorter (15 +/- 8) than remittent courses which began at 26.8 +/- 8.2 and lasted 23 +/- 10. The histogram of the duration of clinical courses showed three groups: acute courses (8 cases less than 5 years long), intermediate courses (41 cases, between 5 and 20 years long), and long courses (21 cases longer than 20 years). Women were more often affected with acute (7/8 cases) or long courses (20/21 cases). The mean duration of the disease was the same when the symptoms and signs at onset were motor weakness, sensory disturbances, optic neuritis or diplopia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Monocular blindness with preserved direct and consensual pupillary reflex in multiple sclerosis.

A 22-year-old woman with definite multiple sclerosis had right-eye blindness with preserved direct and consensual pupillary reflex to light. The anatomy of the fibers inside the optic nerve did not give a satisfactory explanation of this phenomenon. On the other hand, this case appeared to support the idea of biochemical differences between the myelin of visual pathways and that of reflex pathways. Studies are necessary to confirm this hypothesis.

Adult↗

[Multiple sclerosis. Current status of research. I].

Multiple sclerosis (MS) affects nearly 40 000 patients in France. Many factors are mixed up in the development of MS. Epidemiologic studies demonstrate the importance of environmental factors and some possible epidemics of MS in Faroe Islands and Iceland. Recent investigations in Orkney Islands present the hypothesis of two periods of peculiar vulnerability. In Caucasians, genetic investigations show the overpresentation of antigens HLA A3, B7, DR2-DW2. It is possible that remittent MS is related to B7, DW2, DR2 and progressive MS to DR3, B8 DR3, A1 B8 DR3. This distinctions could be also applied to response to immunosuppressive treatment. However, studies of familial MS suggest that only one gene is not able to induce susceptibility to MS. Interpretation of virologic studies is difficult; recent advances in virologic research (isolation, hybridization) will perhaps demonstrate the importance of viral components in MS. Interpretation of presence of myelin basic protein, antimyelin antibodies, anti-oligodendrocytes antibodies, antigangliosides antibodies, antibrain antibodies is also difficult because identification methods are in constant progress and it is not possible to know whether these antibodies are cause or only consequence of pathologic process. Lymphocytic populations studies demonstrate that immunoregulation is probably defective in MS and that T lymphocytes subpopulations fluctuate, according to the state of the illness. Variations of NK activity are discussed. MS lymphocyte production of interferon is probably decreased. Recent advances in neuropathologic studies, central nervous system tissue cultures and in experimental demyelination are summarized. Cultures of precursors of oligodendrocytes and their maturation in vitro, selection and culture of mature oligodendrocytes, their applications to MS oligodendrocytes are emphasized. The recent models of chronic experimental allergic encephalomyelitis (EAE), the prevention of EAE by interferon, basic protein, copolymer I have already place and implication in the comprehension and treatment of MS. Virologic models are also in important progress. Interests of evoked potentials, C.T. Scan and of nuclear magnetic resonance are discussed. Main therapeutic trends are emphasized. The underlying ethic problem of the choice of a therapy is discussed.

Antibodies, Viral↗

[Trichinosis of the central nervous system. One case (author's transl)].

A case of trichinosis involving the cental nervous system is presented. The neurological symptoms developed 20 days after ingestion of the larvae and 3 days after the onset of facial oedema. They consisted of behavioural disorders, tetraparesis, incontinence and oculomotor paralysis. All symptoms progressively regressed. Computed tomography showed transient low-density areas in the white matter. The main manifestations and the physiopathological mechanisms (transport of the parasite through the bloodstream, immuno-allergic reaction) of cerebral trichinosis are discussed.

Adult↗