Biomedical subjects
Publications and source records attributed to T Mathiesen.
A patient with delayed onset of deteriorating consciousness and episodes of opisthotonos, following rupture of an aneurysm of the basilar artery is described. The condition was reversed by intravenous nimodipine and the final outcome was excellent.
Serum and CSF calcium, magnesium, potassium and sodium were analyzed in 14 patients suffering from subarachnoid haemorrhage and in 10 healthy controls. The calcium and potassium concentrations in serum and CSF were decreased while magnesium unchanged and sodium were unchanged. A deranged electrolyte homeostasis was thus detectable in the CSF following subarachnoid haemorrhage. It could not be established whether symptoms of delayed cerebral ischemia were related to CSF calcium and/or potassium levels.
Neopterin concentrations, reflecting T-cell macrophage activation, were analyzed in serum and cerebrospinal fluid (CSF) obtained from 14 patients with subarachnoid hemorrhage (SAH). Neopterin concentrations were elevated in both the serum and CSF. The increase in neopterin concentrations was most marked in the CSF, rising from Days 1 to 3 through Days 6 to 9; levels were highest in patient suffering from delayed cerebral ischemia. The present data were interpreted as signs of an ongoing T cell activation both systemically and in the CSF compartment following SAH.
H2S (hydrogen sulfide) is a very toxic gas. Even brief exposure to high concentrations may be fatal. Unconsciousness may occur without warning. Those who try to help are often poisoned too. In Norway, most poisonings have been described in connection with the herring oil and fish meal industry, farmers handling manure, and sewage work. The risk of hypoxic damage to the nervous system is considerable. The clinical picture varies, and the connection between the patients' symptoms and the poisoning is easily overlooked, especially with delayed sequelae, which may occur several weeks after the acute poisoning. The risk of damage depends on both the exposure time and the concentration of H2S, and a thorough anamnesis, noting the course of events, is important in order to achieve a correct diagnosis.
The IgG subclass distribution to the E34/E32 peptides, derived from the HIV-1 glycoprotein 41 transmembrane protein, was analyzed in ELISA. Sera from individuals at different stages of the disease were assayed. A restricted subclass response of mainly IgG1 and IgG2 was found. The subclass response was of a different type than the one observed to HIV whole Ag and to a synthetic peptide from the C'-terminal part of the HIV-1 p24 core protein. An increased subclass restriction was observed in progressed stages of the disease.
Acute H2S (hydrogen sulfide) poisoning can cause permanent damage to the nervous system. We describe two patients with such damage. Both reported nausea, feeling unwell and irritation of the eyes during work, and have developed persistent memory problems and neurasthenic symptoms. Neither of them had been unconscious. The first patient was exposed during one and a half hours welding of a sewage pump. The second patient worked for three weeks in a laboratory where hydrogen sulfide leaked from faulty equipment. The cases demonstrate the need for thorough work and symptom anamnesis together with neuropsychological testing in order to achieve a correct diagnosis of encephalopathy caused by hydrogen sulfide exposure.
Three established glial fibrillary acidic protein (GFAP)-negative cell lines from human gliomas were transplanted to the anterior chamber of the rat eye. Short-term survival was seen with all transplants. The cells expressed GFAP following transplantation. For comparison, 4 GFAP-positive cell lines were transplanted. With grafting of 5000 cells of any of 6 bipolar cell lines, the transplanted cells could be seen to develop multiple, slender processes reminiscent of mature astrocytes. When 50,000 cells were grafted, vascularized cell mats covering the corneae were seen. The induction of GFAP production and the phenotypic changes were interpreted as signs of differentiation induced by the new environment. All transplanted cells were rejected after 8 weeks.
Total IgG subclass levels, anti-viral, anti-myelin basic protein (anti-MBP), and anti-ganglioside 1 (anti-GM1) IgG subclass levels were measured in 6 patients with herpes simplex virus encephalitis (HSVE), 16 with borreliosis, 8 with other bacterial infections, 12 with multiple sclerosis (MS), 13 with subacute sclerosing panencephalitis (SSPE), 5 with glioblastoma and 12 controls. Total IgG1 levels were elevated in cerebrospinal fluid (CSF) from all patient groups (but not in the controls), IgG2 in bacterial infections, IgG3 in HSVE and borreliosis and IgG4 in some SSPE patients. The anti-viral (anti-measles, varicella zoster virus and rubella) IgG antibodies in MS were restricted to IgG1, anti-measles IgG to IgG1 and sometimes IgG4 in SSPE, anti-borrelia IgG to IgG1, IgG2 and IgG3. In contrast to anti-viral antibodies, anti-MBP and GM1 antibodies belonged to IgG1, IgG3 or IgG4 in MS. The nature of the immunological activation appears to be reflected in the subclass patterns elicited in the central nervous system. Different IgG subclass patterns in infectious diseases and MS suggest a difference between antigen-specific and non-specific B-cell activation.
A 30-yr-old woman whose left occipital lobe had been removed because of an arteriovenous malformation was tested for her ability to detect stationary flashing and moving luminance gratings in the right (blind) visual field. With stationary gratings the performance remained close to chance level, but with moving gratings her performance on a 2AFC task rose to an average of close to 68% during 1200 trials. Signals mediated via midbrain structures might be the basis for the above-chance detection of movement.
Glioblastoma cells from three established lines were transplanted in oculo and in cerebrum to rat hosts. A very low dose of Cyclosporine A was found sufficient to allow graft survival whereas grafts in non-immunosuppressed animals did not survive. Moderate immunosuppression permitted long term graft survival without aggressive growth of glioblastoma cells, creating a protracted course during which neither cell rejection nor tumor proliferation occurred. A tumor reminiscent of a glioblastoma was only seen in one animal on high immunosuppression. Phenotypic changes such as the induction of glial fibrillary acidic protein (GFAP) production and an astrocytic morphology were observed in the cells growing in oculo but not in cerebrum. Vascularization was easily demonstrated with laminin immunofluorescence but the endothelial proliferation typical of glioblastomas was not seen.
Fifteen HIV seropositive patients were studied. It was possible to enhance detection of HIV antigen and HIV and myelin basic protein (MBP) antibodies after dissociation of immune complexes by acid hydrolysis. HIV p24 antigen was then detected in four patients, three of whom were previously antigen negative. In 14 patients the treatment resulted in increased anti-HIV IgG subclass levels. Anti-MBP IgG was detected in 12 patients. Intrathecal synthesis of anti-MBP IgG subclasses was found in eight patients, five of whom had symptoms from the central nervous system.
The varicella zoster virus (VZV) and herpes simplex virus (HSV) IgGl-4 subclasses were compared in serum and cerebrospinal fluid (CSF) of 22 patients with VZV-associated neurological symptoms, 12 patients with HSV-associated neurological symptoms and 14 controls. The clinical syndromes of the VZV-associated diseases comprised meningo-encephalitis, myelitis, myelopathies and polyneuropathies, mostly with a favourable outcome. A characteristic finding was an intrathecal synthesis of VZV IgG1 and HSV-3. Commonly also IgG2 and 4 were seen in CSF of VZV patients. Their intrathecally synthesised HSV IgG was restricted to IgG1. VZV IgG3 occurred in serum and/or CFS together with VZV IgM in 14 cases and may be a marker of recent VZV replication. In patients with HSV-associated neurological disease, a multi-IgG subclass HSV response and concomitant VZV antibodies restricted to IgG1 was found. Intrathecal synthesis of both HSV and VZV IgG occurred in 20 patients. Detection of two or more VZV or HSV specific IgG subclasses synthesised intrathecally identified the aetiological agent in 19 of these 20 cases.
The histopathology and clinical course of 15 benign (grade I) and nine anaplastic (grade II-III) meningiomas was reviewed and compared with the nuclear DNA distribution patterns of the tumour cells as determined by Feulgen staining with ensuing image and flow cytometry. In addition, eight haemangioblastomas were studied. One benign meningioma, three anaplastic meningiomas and two haemangioblastomas were aneuploid. The outcome could be well predicted from standard histopathological criteria and a critical evaluation of the extent of removal at operation. The determination of nuclear DNA contents did not add further information useful in the management of these meningioma patients. Histopathologically aggressive or frankly anaplastic tumours had a bad outcome. The clinical results underline the importance of aggressive treatment of anaplastic meningiomas.
To define the amino acids involved in IgG subclass reactivity to two overlapping HIV-1 gp41 (E34/32; amino acid positions 582-613) peptides, sera from 18 HIV-infected individuals were studied. Peptides mimicking E34 but with single amino acid deletions or glycine substitutions were used to define the amino acid residues necessary for antibody binding. Two dominating immunogenic epitopes, containing highly hydrophilic amino acids, were found on the original peptide. Further analysis was undertaken with two corresponding omission sets of dodecapeptides representing halves of the complete E34 plus a terminal cystein peptide. The subclass reactivities usually differed between the patients with regard to the epitopes with which the different IgG subclasses reacted and also to the importance of different amino acids in antibody binding. The 600 glycine and the 601 lysine were involved in the binding of all IgG1, 2 and 4 and most IgG3. The development of E34/32-reactive IgM and IgG subclasses showed different patterns in four patients with primary HIV infections, contradicting the existence of a general pattern for the development of IgG subclasses to this peptide. The findings suggest that different progenitor clones are selected for synthesis of the different subclasses.
Fifteen amino acid peptides, sequentially overlapping by 10 amino acids, were synthesized on the basis of the HTLV-III sequences of the gag and env proteins. They were used as antigens in IgG subclass ELISAs and T-cell stimulation assays. Sera and cells were obtained from 30 asymptomatic, HIV-infected homosexuals. In all subclasses reactivity was found to parts of the gag protein, while IgG1 dominated anti-env peptide responses. It was possible to delineate peptides showing restricted IgG subclass responses that were dominated by either IgG1, 2, 3 or 4. A negative correlation was generally observed between B-cell and T-cell reactivity, but a T-cell and B-cell co-operation was suggested by the response to two IgG1-restricted peptides. The IgG3-dominated epitopes were present in peptides previously known to be amphipathic and capable of T-cell stimulation. The analysis of subclass-restricted responses on the peptide level will assist the understanding of the subclass expression in vivo, since the peptide mapping approximates the delineation of a subclass-restricted response at the level of single epitopes.
In a comprehensive search for T-cell epitopes of HIV-1, several new regions were discovered. The analysis was performed with lymphocytes of HIV-1-infected persons in various stages of the infection. Peptides covering the entire group antigen (gag), and transmembrane (gp41) regions, and one-half of envelope (gp120) regions of HTLV-IIIB were studied. Both common and patient-unique responses were identified. Twelve common gag T-cell sites were discovered, as well as patient-unique activating peptides. The gag peptides elicited the most frequent cell responses and the responses remained in late stages of disease. Only 1 of the 12 T-cell activating gag peptides was reactive with specific anti-HIV IgG. Eighteen common env-representing peptides evoked T-cell responses. They could be grouped into four previously undescribed regions of gp120 and two known sites, the hypervariable stretch and part of the CD4 binding region. Cell responses to env peptides were common in early stages of disease and tended to decrease in ARC and AIDS. The gp41-representing peptides evoked a cellular response to a region close to the N-terminus of the hydrophobic transmembrane region. In addition to the T-cell activating peptides, peptides representing p15 and p19 as well as previously recognized regions of gp120 and gp41 appeared to be potent B-cell epitopes.
Explore the source record for details and available documents.
Cerebrospinal fluid (CSF) and serum samples from 17 patients seropositive for the human immunodeficiency virus (HIV) were analysed for specific IgG1-4 against HIV and cytomegalovirus (CMV). Measles IgG was studied as a reference to detect blood-brain barrier (BBB) defects. All patients had IgG1 antibodies against HIV in both CSF and serum, and all had CMV IgG1 in serum (16 in CSF). Anti-HIV IgG was synthesised intrathecally in 11 patients, IgG3 in three patients, and IgG4 in three patients. Intrathecal production of anti-CMV IgG1 was found in three patients, IgG2 in one, IgG3 in three, and IgG4 in one. Intrathecal anti-HIV IgG synthesis could be demonstrated in all stages of the disease. Analysis of all IgG subclasses allowed intrathecal HIV and/or IgG production to be detected also in patients in whom intrathecally synthesised IgG was restricted to IgG2, 3, or 4. The expression of HIV-specific IgG subclasses in CSF and serum was more restricted in AIDS patients than in HIV-infected persons without clinical AIDS. On the contrary, the largest number of CMV-specific IgG subclasses was found in AIDS patients. Intrathecal HIV or CMV IgG subclass production was seen both with and without neurological symptoms. The peripheral T4 cell counts were not obviously related to neurological symptoms. Even patients with low peripheral T4 cell counts had evidence of intrathecal antibody synthesis against HIV and sometimes CMV, suggesting a retained helper function of T cells in the central nervous system.