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Biomedical subjects

E Maida

Publications and source records attributed to E Maida.

At least 19 recordsLinked to original sources
PubMed1989

Changes within the "normal" cerebral white matter of multiple sclerosis patients during acute attacks and during high-dose cortisone therapy assessed by means of quantitative MRI.

Changes in the apparently unaffected cerebral white matter of multiple sclerosis (MS) patients were studied during acute attacks as well as during high-dose prednisolone therapy. Serial MR scans of patients with a clinically definite diagnosis were performed on four defined occasions: before an episode, within three days after its onset, after 10 days of therapy as well as four weeks later. Thirteen patients agreed to cooperate in forming a MRI data base and to be rescanned immediately after the onset of an acute relapse. Within one year, six patients had such episodes, one of them had a second bout. Both T1 and T2 relaxation times within the apparently normal white matter were significantly prolonged in all cerebral lobes compared to a control group of healthy volunteers. During the acute attacks as well as during therapy the T1 values remained as before. The T2 values were elevated only in two out of six cases during the episode. After therapy a considerable clinical improvement was seen in all cases, but a significant T2 decrease as a possible effect of cortisone was noted in only one case. We conclude that the prolonged relaxation times T1 and T2 within the apparently normal cerebral white matter of MS patients are the result of a number of molecular events differing considerably among individual patients and that serial measurements of these relaxation times do not consistently change during an acute relapse and do not reflect clinical improvement after high dose prednisolone therapy.

Acute Disease↗
PubMed1986

Cerebrospinal fluid alterations in bacterial meningitis.

239 matched cerebrospinal fluid and serum samples of 50 patients with bacterial meningitis were investigated during the course of the disease. Special attention was drawn to thecal immunoglobulin (Ig) production, which was determined by Link's index and by Reiber's formula with a modification for IgM and IgA being more sensitive for these two Igs than Link's index. A correlation was found between the duration of local IgM production and the outcome of the disease.

Bacterial Infections↗
PubMed1986

Long-term lymphocytapheresis therapy in multiple sclerosis. Preliminary observations.

Long-term lymphocytapheresis (LPH) therapy was applied in 9 patients with a relapsing-remitting course of multiple sclerosis (MS) and a high frequency of bouts. The therapeutic scheme included series of 4 LPH within 8 days, which were repeated every 6-8 weeks during 1 year or longer, until the myelin-reactive T cell test--which was used for immunological control--became normal. Altogether, the therapy was well tolerated, but severe problems with the veins occurred in 2 of the 9 patients. No bouts during LPH therapy were seen in 7 of the 9 patients. The 3 patients with the shortest duration of the disease showed an improvement of the Kurtzke scale. No relapses or a reduced relapse rate--compared to the time before LPH therapy--was observed in 6 of the 9 patients during the follow-up period of up to 23 months. Conclusively, long-term LPH therapy seems to be recommended as an alternative to the continuous administration of immunosuppressive drugs, especially for active cases of MS with a short duration of the disease.

Adolescent↗
PubMed1986

CSF cytology of a patient with conversion of an acute lymphatic leukemia to an acute eosinophilic leukemia.

The course of leukemic disease in a male adolescent with meningeal leukemia is described. The bone marrow aspirates showed a conversion from an acute lymphatic leukemia to an eosinophilic leukemia. Four weeks after the peripheral shift of phenotype two different cell clones were detected in one CSF smear. While under ultrahigh dose araC therapy the patient died 3 months after conversion. Possible explanation for the shift of phenotype and the peculiar leptomeningeal infiltration are discussed.

Adolescent↗
PubMed1986

[Cerebrospinal fluid changes in Garin-Bujadoux-Bannwarth meningoradiculitis].

56 cerebrospinal fluid (CSF) and 46 matched serum samples were investigated in 23 patients, who suffered from meningopolyneuritis Garin-Bujadoux-Bannwarth. CSF cells and proteins were elevated for several months. The most prominent findings were the predominantly lymphocytic cell reactions with high numbers of plasma cells and the persistence of humoral immune reactions, i.e. intrathecally produced IgG, IgM and IgA. Both give evidence that the responsible infectious agent has rather low pathogenic but high immunogenic properties and that it has a tendency for a long persistence in the nervous system.

Borrelia Infections↗
PubMed1985

Acute encephalopathy associated with continuous vincristine sulfate combination therapy: case report.

Neurotoxicity is a well-recognized and commonly observed side effect associated with the use of vincristine sulfate in cancer chemotherapy. The clinical manifestations of vincristine neuropathy cover a wide spectrum of peripheral neurologic dysfunctions that have been described to be reversible and cumulative in most instances (1, 2). Paresthesias, loss of tendon reflexes, and progressive weakness are the most common clinical features (3, 4). Sensory impairment, cranial nerve palsies, gastrointestinal disturbances, and autonomic dysfunctions including atonic bladder, impotence, and orthostatic hypotension may occur (5). Acute CNS complications, usually presenting as generalized seizures, are extremely rare and only a few cases have been reported which were without underlying biochemical or structural abnormalities (1, 5-9). We describe the case of a woman with multiple myeloma, who developed fulminant encephalopathy following 4 days of continuous vincristine, adriamycin, and day 1-4 pulse dexamethasone (VAD) combination therapy.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1983

Immunological reactions against Mycoplasma pneumoniae in multiple sclerosis: preliminary findings.

Humoral and cellular immune reactions against Mycoplasma pneumoniae (MPn) were investigated in 18 multiple sclerosis (MS) patients. All patients were in the remission stage. Complement-fixing antibodies against MPn were present in serum and cerebrospinal fluid, concentrated to contain the same protein levels. The CSF titres after concentration were as high as or higher than the corresponding serum titres, thus indicating intrathecal antibody production. Sensitization to MPn was demonstrable in all 18 MS patients by the antigen-reactive active E-rosette assay and antibody-dependent cellular cytotoxicity assay, in 17 of the 18 patients by the lymphocyte transformation test and in 8 patients by the cell-mediated cytotoxicity assay. The possibility of a pathogenetic role of MPn for MS is discussed.

Adult↗
PubMed1982

[Acute viral encephalitis with primary psychotic symptoms--diagnosis, course and prognosis].

In 13 cases referred to psychiatric treatment between 1974 and 1980 acute viral encephalitis was diagnosed in the further course of the illness. The majority were female patients. Positive virological or pathological evidence was obtained in 38% of all cases. The most frequent etiology to be found was the herpes-simplex virus. These findings correspond to 36 cases from the literature. 90% of all cases showed neurological symptoms within two weeks of hospital admission. EEG and cerebrospinal fluid examinations proved to yield most in diagnosis, whereas angiography and brain scanning did not have special diagnostic importance. The present diagnostic value of CT is mainly restricted to the detection of herpes-simplex virus encephalitis and acute leukoencephalitis. Initially psychopathological findings varied largely and fluctuations in the level of consciousness were a prominent feature in most cases. In others no difference to schizophrenic psychosis could be noted on admission. Compared to other studies on acute viral encephalitis with initial neurological symptoms, patients with a psychotic onset of the illness tend to have a higher morbidity, while the mortality remains the same.

Acute Disease↗
PubMed1982

Cerebrospinal fluid findings in mycoplasma pneumoniae infections with neurological complications.

The cerebrospinal fluid (CSF) findings of 16 patients with mycoplasma pneumoniae infections and different neurologic complications are presented. In acute meningitis there was predominantly a mononuclear cell reaction remitting in accordance with the improvement of the clinical symptoms. An early switch from IgM to IgG was observed. In cranial nerve neuritis and radiculitis in the beginning complement factors were decreased. Far beyond the clinical remission IgM and cell count were elevated. In Guillain-Barré-syndrome no IgM but increased IgG levels were detectable. In all patients both CSF IgM and IgG markedly exceeded the corresponding serum values. The possibility that different pathogenetic mechanisms are underlying these phenomena depending on the actual state of the hosts' immunity is discussed.

Adolescent↗
PubMed1982

Serum and cerebrospinal fluid immune complexes containing hepatitis B surface antigen in Guillain-Barré syndrome.

A 76-yr-old male presented with Guillain-Barré syndrome after acute hepatitis B virus infection. Main immunologic features were: (a) high levels of circulating hepatitis B surface antigen-containing immune complexes in serum and cerebrospinal fluid during the acute neurologic syndrome, and (b) clearance of immune-complex material with recovery. Our data indicate that these immune complexes in cerebrospinal fluid reflect leakage from the systemic circulation via a deranged blood-brain barrier and are not generated in the cerebrospinal compartment. Possibly deposition of such immune complexes along nerve structures is important in the immunopathogenesis of some cases of Guillain-Barré syndrome.

Aged↗
PubMed1981

[Multiple sclerosis and chromosomal aberrations (author's transl)].

Chromosomal investigations were performed after peripheral lymphocytes taken from 25 healthy females and from 35 female patients suffering from various types of multiple sclerosis had been cultured for 48 hours. The incidence of cells with chromosomal breaks in multiple sclerosis patients (2.0%) was significantly higher than in controls (1.1%): Chi2 = 7.26; DF = 1; p less than 0.01. Furthermore, chromosomal rearrangements (dicentric chromosomes, translocation chromosomes, chromatid exchange figures) were observed more frequently in the MS patients than in the controls. Analysis of the interchromosomal distribution of breaks found in the patients revealed a relative surplus in chromosome A2 and D-group chromosomes.

Adolescent↗
PubMed1981

Cyclic adenosine 3',5' monophosphate in cerebrospinal fluid of multiple sclerosis patients.

Cyclic adenosine 3',5' monophosphate (cAMP) was assayed in CSF and plasma obtained from patients with multiple sclerosis. Decreased CSF cAMP levels were found in more than half of the patients while plasma cAMP was normal. The decrease is correlated significantly with the disability of the patient and with the progression of the disease. A low CSF cAMP level can be considered as prognostically unfavorable, particularly in the early stage of the disease. There was no correlation between the cAMP levels and the duration of the disease or with bouts and remissions. ACTH therapy did not normalize the decreased values. Obviously the decrease of CSF cAMP is related to the demyelination and not to the intensity of the pathological immunoreactions.

Adrenocorticotropic Hormone↗
PubMed1980

Stiff-man syndrome with abnormalities in CSF and computerized tomography findings. Report of a case.

We report a case of stiff-man syndrome with abnormal spinal fluid. Serum protein values were normal, but the spinal fluid levels of immunogammaglobulin G and acute-phase proteins were elevated. We discuss the possibility of an inflammatory process of the nervous system as a cause for these findings. Another interesting observation in our patient was that of local atrophies seen on computerized tomography, indicating hemispheral and especially brainstem lesions. Furthermore, as a new therapeutic possibility, we demonstrated the improvement of spasms and rigidity under the influence of heat.

Atrophy↗