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Biomedical subjects

A Twijnstra

Publications and source records attributed to A Twijnstra.

At least 73 records · Page 4Linked to original sources
PubMed1991

A psychophysical method for assessing visual and acoustic hyperaesthesia in patients with mild head injury.

Although it is well known that patients with mild head injury (MHI) are less able to endure intense light and sound stimuli than normal people, there are few psychophysical studies that have objectively measured this type of hyperaesthesia. In the present study, using a computerised rating scale technique, both the maximal and submaximal levels of reduced tolerance to light and sound were assessed for a wide range of stimuli. Three to six days after the trauma, 40 MHI patients were significantly less tolerant to stimuli of intensities over 71 dB and 500 lux levels than controls. These intensities are common, and MHI patients may suffer as a consequence.

Adult↗
PubMed1990

The role of the histologic subclassification of tumor cells in patients with small cell carcinoma of the lung and central nervous system metastases.

One hundred eleven patients with small cell carcinoma of the lung (SCLC) were histologically subtyped according to the recent consensus report by the Pathology Committee of the International Association for the Study of Lung Cancer. Using pretreatment material the authors examined retrospectively the significance of subtyping of SCLC as a prognostic factor for central nervous system metastasis. The results did not reveal any significant differences between the SCLC subtypes in patients with central nervous system metastases. It was concluded that among the subtypes of SCLC significant differences with regard to the propensity for CNS metastases do not exist.

Adult↗
PubMed1989

Serial lumbar and ventricular cerebrospinal fluid biochemical marker measurements in patients with leptomeningeal metastases from solid and hematological tumors.

This study presents results of investigations of lumbar and ventricular cerebrospinal fluid (CSF) biochemical markers (Beta-glucuronidase (B-gluc), Beta-2-microglobulin (B2-m), and carcinoembrionic antigen (CEA] in 28 patients with five different tumor types with leptomeningeal metastasis diagnosed by CSF cytology and/or autopsy. All received methotrexate and radiotherapy at some stage. Decadron or other symptomatic treatments were not used. Measurements of the concentrations of B-gluc, B2-m and CEA were evaluated with the aim of correlating the results of these measurements to site of disease, of monitoring response and early relapse of leptomeningeal disease, and of establishing the duration of survival. In almost all our patients the results of ventricular CSF B-gluc, B2-m and CEA measurements were lower than those obtained from lumbar CSF. The markers did not correlate with site of disease or CSF cytology. A clear relationship was found between pretreatment lumbar CSF B2-m and CEA levels, response to therapy and survival. The markers are also useful for monitoring response. The findings of this study indicate that B2-m and CEA levels have a prognostic value with regard to response to therapy and time of survival.

Adult↗
PubMed1989

Initial bolus of conventional versus high-dose dexamethasone in metastatic spinal cord compression.

We randomly assigned dexamethasone in an initial bolus of 10 mg IV or 100 mg IV followed by 16 mg daily orally to 37 patients with metastatic spinal cord compression. The average pain score before the start of treatment was 5.2 (SD = 2.8) and decreased significantly (p less than 0.001) to 3.8 at 3 hrs, 2.8 at 24 hrs, and 1.4 after 1 week. There were no differences between the conventional and high-dose group on pain, ambulation, or bladder function.

Adult↗
PubMed1988

A lethal neurotoxic reaction after intraventricular methotrexate administration.

A case of a patient with leptomeningeal metastases from an adenocarcinoma of the lung is described. She developed a fatal neurologic reaction during intraventricular administration of methotrexate. No morphologic cause of death was found during autopsy. Similar cases of acute complications are discussed, and an outline of factors that might play a role in the pathophysiology of methotrexate neurotoxicity is given.

Adenocarcinoma↗
PubMed1988

Tumour markers in the cerebrospinal fluid of patients with central nervous system metastases from extracranial malignancies.

We have assessed the diagnostic value of the determination of cerebrospinal fluid lactate dehydrogenase, carcinoembryonic antigen, beta 2-microglobulin, beta-glucuronidase and total protein, using linear discriminant analysis, in detecting central nervous system metastases from extracranial malignancies. We conclude that, using these tests, it is impossible to differentiate between control individuals and patients with brain or epidural metastases. Leptomeningeal dissemination from either solid tumours or non-Hodgkin lymphoma could be differentiated from control individuals and patients with brain or epidural metastases. In this differentiation it is essential that bacterial, fungal or tuberculous meningitis be excluded from the differential diagnosis by other diagnostic procedures. The combination of beta-glucuronidase and beta 2-microglobulin provides almost the same diagnostic information as the combination of all parameters.

Age Factors↗
PubMed1988

Routine investigations of the CSF with special reference to meningeal malignancy and infectious meningitis.

Usefulness of cell count and concentrations of glucose and total protein in CSF are analysed with regard to the diagnosis of leptomeningeal metastasis from solid and hematological malignancy. A group of patients with pleiocytosis in CSF of non-neoplastic origin served as a reference group. It is concluded that these routine tests have limited value for the determination of the viral, bacterial or neoplastic etiology of meningeal disorders. The most important value of these tests appears to be the discriminating capacity of the finding of an increased number of polymorphonuclear leucocytes, regularly found in patients with acute bacterial meningitis.

Adolescent↗
PubMed1987

Neurotoxicity of prophylactic cranial irradiation in patients with small cell carcinoma of the lung.

This study is concerned with effects of prophylactic cranial irradiation on neurological and mental functioning of patients with small cell cancer of the lung. Results are reported of a pilot study in two parts. In a prospective clinical-neurological study, 14 patients with small cell cancer of the lung were evaluated with standard neurological and bedside mental status examinations, before and after irradiation. Their performance was compared with evaluation results of seven small cell cancer of the lung patients who received no irradiation. Dysfunctions were exclusively found in the irradiated patients, which are interpreted as a contributional effect of prophylactic cranial irradiation. Results are reported of further neuropsychological investigation in a sample of five prophylactic cranial irradiation patients. The presence of a rather specific pattern of neuropsychic deficits was confirmed. Areas of malfunctioning were described with some clinical and research implications.

Adult↗
PubMed1987

Diagnosis of leptomeningeal metastasis.

Forty-one cases of leptomeningeal metastases from solid and hematological tumours were studied clinically and pathologically. Neurological symptoms and signs, cerebrospinal fluid characteristics and radiographic appearance were reviewed. The role of the biochemical markers, computer tomography scans of the brain and myelography in the diagnosis of patients with leptomeningeal metastasis were determined. The subject of the study was an investigation of the value of various diagnostic procedures to increase the accuracy of the diagnosis leptomeningeal metastasis.

Adult↗
PubMed1987

Serial lumbar and ventricle cerebrospinal fluid lactate dehydrogenase activities in patients with leptomeningeal metastases from solid and haematological tumours.

Lactate dehydrogenase (LDH) activities were measured in cerebrospinal fluid in 350 patients with various neurological diseases to establish the sensitivity and specificity of the CSF LDH as a marker for the diagnosis of leptomeningeal metastases. Slight elevations of CSF LDH were observed in nonmalignant diseases, while marked elevations were observed in a considerable number of patients with bacterial meningitis. A sensitivity of 79% and a specificity of 83% were calculated. In the 34 patients with leptomeningeal metastases from solid and haematological tumours, the LDH in lumbar and ventricular CSF were measured simultaneously. The lumbar CSF LDH concentration in patients with leptomeningeal metastases was about five times greater than that in the ventricular CSF. No relationship was found between the CSF LDH and histology of the primary tumour. A good correlation was demonstrated between the lumbar CSF LDH and the effected area of the neuraxis. Serial determinations of CSF LDH showed a relationship between level changes and responses to therapy or progression. The findings of this study indicate that measurement of LDH in CSF can be used as an adjunctive diagnostic test for leptomeningeal metastases and in monitoring the efficacy of treatment.

Adolescent↗
PubMed1986

Cerebrospinal fluid lactate dehydrogenase activities in patients with central nervous system metastases.

Lactate dehydrogenase activities were determined in CSF from 350 patients suffering from various neurological diseases. Reference values were established as 0-26 U/l. Slight elevations of CSF LDH activities were observed in patients with the following disorders: brain metastasis and spinal epidural metastasis from solid carcinomas, primary central nervous system tumours, cerebrovascular accident, polyneuropathy and head injury. Marked elevations were observed incidentally in patients in these groups and in a considerable number of patients with bacterial meningitis and with leptomeningeal spread from solid or haematologic malignancies. When other diagnostic information is available for the proper estimation of the pre-test likelihood of disease, CSF LDH activities exceeding 50 U/l are suggestive for meningeal carcinomatosis.

Adolescent↗
PubMed1986

Cerebrospinal fluid carcinoembryonic antigen in patients with metastatic and nonmetastatic neurological diseases.

Cerebrospinal fluid (CSF) carcinoembryonic antigen (CEA) values were determined in 200 patients suffering from various neurological diseases. We found no relationship between CEA levels and age or sex. A positive test was defined as an upper limit of at least 4.0 ng/mL of CEA. We found raised CSF CEA levels in patients with leptomeningeal spread from carcinoma, but not in patients with leptomeningeal metastases from lymphoma. We also found high values of CSF CEA in three of 21 patients with epidural metastases and in two of 28 patients with cerebral metastases from solid tumors. Comparison was made with the CSF levels of total protein, glucose, and lactate dehydrogenase. The sensitivity of the CSF CEA determination in patients for the presence of leptomeningeal involvement of cancer is 31% and the specificity is 90%.

Adolescent↗
PubMed1986

Cerebrospinal fluid beta 2-microglobulin: a study in controls and patients with metastatic and non-metastatic neurological diseases.

We studied cerebrospinal fluid Beta 2-microglobulin (CSF B2-m) in 197 patients with a variety of neurological diseases to evaluate the usefulness of B2-m in the detection of meningeal dissemination of malignancy. In the control group we found a relationship between CSF log B2-m and age (P less than 10(-4)). Age standardized reference values were established as 0.65-2.2 mg/l. The results show that CSF B2-m was elevated in leptomeningeal metastases from solid and haematological tumors. We observed slight elevations of CSF B2-m in epidural and parenchyma metastases from solid tumors. Our study shows that B2-m in CSF is a sensitive marker for meningeal metastases especially from hemopoietic tumors.

Adult↗
PubMed1986

Sensitivity and specificity of single and combined tumour markers in the diagnosis of leptomeningeal metastasis from breast cancer.

The clinical efficacy of four laboratory tests in detecting leptomeningeal metastases in 57 patients with breast carcinoma was assessed. The sensitivity and specificity of beta-glucuronidase, beta 2-microglobulin, carcinoembryonic antigen and lactate dehydrogenase in cerebrospinal fluid were determined. As a single test beta-glucuronidase was the most sensitive (93%) and specific (93%) for discriminating between leptomeningeal metastases and other CNS metastases from breast cancer. Lactate dehydrogenase was the next most useful marker. Both beta 2-microglobulin and carcinoembryonic antigen had a sensitivity of 60%. More specific results were achieved by combining beta-glucuronidase and lactate dehydrogenase. CSF beta-glucuronidase may be useful by itself and in combination with lactate dehydrogenase in the detection of leptomeningeal metastases from breast carcinoma.

Adult↗
PubMed1985

Cerebrospinal fluid beta-glucuronidase activities in patients with central nervous system metastases.

beta-Glucuronidase activities were determined in cerebrospinal fluid from 249 patients suffering from various neurological diseases. Reference values were established as 9-27 mU/l. Marked elevations of cerebrospinal beta-glucuronidase activities were observed in patients with bacterial and carcinomatous meningitis. Slight elevations of cerebrospinal beta-glucuronidase activities were observed in epidural and parenchymal metastases from solid tumours. Comparison was made with the determination of total protein, glucose and lactate dehydrogenase in cerebrospinal fluid. Cerebrospinal beta-glucuronidase activity appeared the most useful test in monitoring patients at risk in developing meningeal metastases from solid primary tumours.

Adolescent↗