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Biomedical subjects

P Hudgson

Publications and source records attributed to P Hudgson.

At least 55 records · Page 3Linked to original sources
PubMed1978

Moebius syndrome, peripheral neuropathy and hypogonadotrophic hypogonadism.

The association of congenital ophthalmoplegia and facial paresis (Moebius syndrome) with a variety of other developmental somatic defects has been widely recognised. Its co-existence with hypogonadism of hypothalamic/pituitary origin and subclinical peripheral neuropathy has been reported and in this paper we describe the second case of the Moebius syndrome in association with hypogonadotrophic hypogonadism and a progressive peripheral neuropathy of mixed axonal and demyelinating type.

Adolescent↗
PubMed1978

A clinical and genetic study of spinal muscular atrophy of adult onset: the autosomal recessive form as a discrete disease entity.

A clinical and genetic study of spinal muscular atrophy (SMA) of adult onset is reported. A genetic analysis of all cases of SMA occurring over a ten-year period in North-east England (48 index cases) has shown that chronic proximal SMA of adult onset is a distinct clinical and genetic entity, and is not a variant of the more common and relatively benign late juvenile cases. Nine cases of SMA of adult onset have been studied, occurring in 6 families. The median age of clinical onset was 35 years and the mean age at initial medical presentation was 37 years. The sex ratio was 5:4 (males:females). The condition is relatively benign and there is no evidence to date that life expectancy is shortened; there is usually no premonitory evidence of muscular weakness in early adult life. The muscular involvement is relatively symmetrical and the distal musculature is well preserved; clinical progression of the disease is interrupted by periods of apparent arrest. No patient was able to walk completely unaided twenty years after the initial clinical onset; the median age of patients in the study was 61 years but only one was confined to a wheelchair. In the early stages the recessive form of familial motor neuron disease must be excluded. A segregation analysis of sibs born after index cases was undertaken (segregation ratio of 0.20). This finding is consistent with autosomal recessive inheritance with an extended period during which the disease might initially present. The presence of new dominant mutations cannot be excluded, but is unlikely to account for more than 10% of cases. The carrier rate in the English population is estimated to be 1 in 300, with a gene frequency q = 0.00165. Prevalence is 0.32 per 100,000 in the general population. Empirical risks for genetic counselling are presented.

Adolescent↗
PubMed1977

Experimental serotonin myopathy.

One hundred and eight Wistar rats were injected with serotonin (20 mg per kilogram of body weight intraperitoneally) or imipramine hydrochloride (20 mg per kilogram intraperitoneally), or both, in a single cycle or in multiple (up to 18 weeks) weekly cycles. In contrast to previous reports, a characteristic myopathy was produced with serotonin alone, identical to that produced by serotonin and imipramine in combination. Imipramine alone produced no significant change. The myopathy produced was characterized by (1) preferential damage to myofibers with high oxidative capacity (types I and IIA), (2) prominent regenerative activity occurring as early as 48 hours, and (3) degeneratio of capillary endothelium (thickening, vacuolar degeneration, proliferation of marginal folds, dissolution of mitochondria). Small groups of degenerating fibers and increased connective tissue were not observed. There was no loss of myofibers or fat replacement. The changes suggested repeated acute insults followed the complete recovery. These observations suggest that although the pathogenesis of serotonin and serotonin-imipramine myopathy is primarily ischemic, it is not a satisfactory model of human Duchenne muscular dystrophy.

Animals↗
PubMed1977

Localised nodular myositis: a clinical and pathological variant of polymyositis.

Three cases of a painful, inflammatory, nodular myopathy in young and middle-aged adult males are described. In two of the cases the nodular process gradually evolved into a diffuse proximal myopathy accompanied by dysphagia, and manifesting the so-called "facioscapulohumeral syndrome". The electromyogram (EMG) in all three cases was "myopathic" in type and in two cases abnormalities consistent with an inflammatory muscle disorder were seen. Muscle biopsy revealed a consistent pattern of intense, predominantly interstitial, pleomorphic infiltration of muscle with scattered foci of muscle fibre destruction and regeneration, which resembled muscle infarcts. It is suggested that this syndrome, whilst readily recognizable from both the clinical and pathological standpoints, is not a nosological entity in its own right but rather an unusual presentation of polymyositis.

Adult↗
PubMed1976

Carnitine-palmityl-transferase deficiency.

An increasing number of cases of myopathy due to disordered lipid metabolism have recently been recognised and these appear to fall into two contrasting clinical and biochemical categories. Some patients present with steadily prograssive proximal weakness which sometimes responds to steroid therapy and which is due to carnitine deficiency in skeletal muscle. In the second category, patients usually present with muscle cramps on exertion then followed by myoglobinuria without established proximal myopathy and their symptoms are associated with deficiency of carnitine palmityl transferase in skeletal muscle. In this paper we report a patient who has well-documented carnitine palmityl transferase deficiency, whose symptoms were triggered by violent exercise after fasting and in whom there was variable histochemical and ultrastructural evidence of lipid accumulation in muscle biopsy samples. Development of the patient's symptoms was suppressed by a high carbohydrate diet.

Acyltransferases↗
PubMed1976

Polymositis.

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Adult↗
PubMed1975

The pathology of type II skeletal muscle glycogenosis. A light and electron-microscopic study.

Muscle biopsies were obtained from three infants under the age of 12 mth, each of whom was diagnosed as having Pompe's disease. The biopsies revealed a severe vacuolar myopathy with accumulation of large amounts of PAS positive material within the muscle fibres, changes similar to those in adult cases of the disease. In addition large amounts of metachromatic material were found within the muscle fibres in all three cases and in two of them scattered, rather sparse perivascular lymphocytic infiltrates were seen in the interstitial tissue. Review of material previously obtained from two adult cases showed no accumulation of metachromatic material in the older case and only moderate amounts in the younger. However, dense interstitial lymphocytic infiltrates were seen in the former, some concentrated around small vessels. These observations suggest that the pathogenesis of the muscle disorder in acid maltase deficiency may not depend on abnormal glycogen storage only.

Adult↗
PubMed1975

A comparison of the structure of small blood vessels in normal, denervated and dystrophic human muscle.

A light- and electron-microscopic study of the small arterial vessels and capillaries in muscle from 20 patients with Duchenne muscular dystrophy failed to adduce any direct morphological evidence that the necrobiotic muscle lesions in this disease are produced by muscle ischaemia. However the electron-microscopic studies showed that the basement membrane width in 3 out of 4 cases of Duchenne dystrophy so studied was significantly less than that or normal control material. In further case of Duchenne dystrophy, selected for study because some vessels in the biopsy muscle were surrounded by small round cell infilitrates, the basement membrane width was significantly greater than that in the normal control material. In the single case of spinal muscular atrophy studied, the basement membrane width was also significantly less than the control measurements. The possible relationship of these observations to the "ischaemic" theory of the pathogenesis of muscular dystrophy is discussed.

Basement Membrane↗
PubMed1975

Correlations between histochemical and ultrastructural studies of diseased muscle.

The acceptance of a syndrome as a distinct nosological entity depends upon our ability to demonstrate that it consistent genetic, pathological and biochemical abnormalities. During the past two decades the application of enzyme histochemistry and electronmicroscopy to the study of biopsy muscle from patients from a variety of ill-defined neuromuscular disorders has enabled us to classify them with much greater precision. This approach, together with increasingly sophisticated electrophysiological techniques, has lead to a much clearer separation of neurogenic and primarily myopathic disorders with a consequent shrinkage in the category of pure muscular dystrophy. Perhaps the most useful application of morphological techniques alone has been in the field of congenital and metabolic myopathies, the histochemical and ultrastructural abnormalities in some cases providing valuable clues to the pathogenesis or even the aetiology of the underlying disease process. This applies particularly to the various glycogen storage diseases affecting skeletal muscle, disorders in which there appear to be structural and functional abnormalities of muscle mitochondria or in which excessive amounts of lipid are stored in muscle fibres. In this communication the histochemical and ultrastructural characteristics of these diseases will be detailed, their possible significance discussed and the relative non-specificity of some of these morphological abnormalities will be noted. A comment will be made on the frequency with which simple Type II fibre atrophy (as demonstrated by the myofibrillar ATPase preparation) may be accompanied by gross and bizarre ultrastructural abnormalities, e.g. in the myopathy accompanying chronic renal failure. Such inconsistencies underline the fact that it is not always possible to demonstrate a close correlation between histochemical and ultrastructural abnormalities in muscle disease. However, it should be emphasized that the combined approach is essential to the rational morphological study of these disorders.

Biopsy↗