Search PubMed⌕ Search

Biomedical subjects

E Stolz

Publications and source records attributed to E Stolz.

At least 37 records · Page 2Linked to original sources
PubMed2000

CD45RA+ ICAM-3+ lymphocytes in cerebrospinal fluid and blood as markers of disease activity in patients with multiple sclerosis.

OBJECTIVES: Autoreactive T cells targeted against antigens of the myelin sheath are suggested to play an important role in the pathogenesis of multiple sclerosis (MS). Naive (CD45RA+) T cells and intercellular adhesion molecule-3 (ICAM-3) are markers for un-activated lymphocytes. This study was performed to investigate, whether the expression levels of these antigens both on cerebrospinal fluid (CSF) and peripheral blood lymphocytes can be used as activity markers in MS. MATERIALS AND METHODS: Corresponding blood and CSF samples were obtained from 31 patients with relapsing-remitting MS. Of the 31 MS patients 23 were suffering from acute relapses at the time of examination and all of them were treated with high-dose methylprednisolone (MP). Blood was collected again on the 10th day of therapy and after 3 months. The control group consisted of 12 healthy persons. Two-color flow cytometry was performed to evaluate the percentage of both CD45RA+ and ICAM-3+ cells within the lymphocyte population. RESULTS: The percentage of CD45RA+ ICAM-3+ cells in the CSF of MS patients with relapses was significantly increased compared to patients in remission (P<0.05). In blood, a significantly lower percentage of CD45RA+ ICAM-3+ lymphocytes was found in both patient groups compared to healthy controls (Relapse: P<0.05, Remission: P<0.10). Additionally, we found a significant increase (P < 0.01) in the percentage of CD45RA+ ICAM-3+ lymphocytes in blood of MS patients suffering from acute relapse on the 10th day of high-dose MP treatment. CONCLUSION: Our data suggest that the percentage of CD45RA+ ICAM-3+ lymphocytes in CSF can be used as marker of disease activity in MS patients.

Acute Disease↗
PubMed2000

Three-dimensional transcranial colour-coded duplex sonography of the transverse sinus.

The case of a patient with partial superior sagittal sinus and partial right sided transverse sinus thrombosis, and posterior fossa venous collaterals is presented. We report on the use of venous transcranial colour-coded duplex sonography (TCCS), combined with a new three-dimensional transcranial duplex data acquisition system, which allows free hand scanning of the region of interest. TCCS with three-dimensional image reconstruction allowed a more precise spatial localization of venous flow signals in the posterior fossa and facilitated the understanding of the haemodynamics of the venous collateral network.

Adult↗
PubMed2000

DIAS I: duplex-sonographic assessment of the cerebrovascular status in acute stroke. A useful tool for future stroke trials.

BACKGROUND AND PURPOSE: A number of controlled trials have evaluated the benefit of intravenous thrombolysis in acute stroke with inconsistent results. None of these studies assessed the initial vascular status or provided information regarding the recanalization rate after therapy. Further trials need to clarify whether certain subgroups might possibly benefit more than others from intravenous thrombolysis. Therefore, a fast and valid method for assessment of cerebrovascular status is needed. In this multicenter study, we evaluated the potentials and limitations of color-coded duplex sonography (TCCS) for cerebrovascular status assessment in acute stroke patients before and after therapy. Furthermore, we compared the recanalization rate for patients referred to thrombolytic and conservative medical therapy. METHODS: Fifty-eight patients suffering from hemispheric stroke were enrolled consecutively in 8 centers. Duplex sonography was performed on admission, 2 hours after start of therapy, and 24 hours after onset of symptoms. Therapy was started within 6 hours. RESULTS: Intravenous thrombolysis was performed in 18 patients, conservative medical therapy in 39 patients, and early thromboendarterectomy in 1 patient. The middle cerebral artery (MCA) mainstem was patent in 29 patients (53.7%), occluded in 25 (46.3%), and was not assessable in 4 patients. Recanalization of the occluded MCA after 2 and 24 hours was diagnosed in 50% and 78% of the patients treated with rtPA and in 0% and 8% in the conservatively treated patients. CONCLUSIONS: Intravenous thrombolysis is highly effective in restoring blood flow after MCA occlusion. TCCS is suitable for assessment of the cerebrovascular status in acute stroke and therefore might define therapeutically relevant subgroups of patients in future stroke trials on the basis of their vascular pathology.

Adult↗
PubMed1999

Sonographic monitoring of midline shift in hemispheric infarctions.

BACKGROUND AND OBJECTIVE: Transcranial color-coded sonography (TS) allows a noninvasive, accurate evaluation of lateral displacement of the third ventricle. The authors studied the prognostic value of TS monitoring of the midline shift (MLS) in acute hemispheric stroke. METHOD: Sixteen patients with acute middle cerebral artery (MCA) occlusion were investigated. On admission, the median modified Scandinavian Stroke Scale (mSSS) score was 6.0 (range, 5 to 8). Five patients died from cerebral herniation (group 1), 10 survived (group 2), and 1 patient (Patient 16) survived after decompressive surgery. TS was performed on days 1 to 4 (10 +/- 3, 32 +/- 4, 57 +/- 5, and 82 +/- 5 hours after onset of symptoms). Distance from the TS probe to the center of the third ventricle was measured both from the symptomatic (A) and asymptomatic (B) sides. MLS was calculated using the formula MLS = (A - B)/2. RESULTS: Ten hours after stroke onset, MLS and mSSS scores were not significantly different between the two groups. At 32, 57, and 82 hours, MLS was higher in group 1 (32 hours, p = 0.001; 57 hours, p = 0.003; 82 hours, p = 0.023) whereas there was no difference in mSSS score after 32 hours. All patients with an MLS < 4 mm at 32 hours survived, whereas patients with an MLS > 4 mm died as a result of cerebral herniation, with the exception of the one patient who underwent decompressive hemicraniectomy. CONCLUSIONS: The study of MLS at 32 hours after stroke onset in patients with severe MCA infarctions may identify patients who are unlikely to survive. The value of MLS in determining the indication of decompressive craniectomy merits further study.

Adult↗
PubMed1999

Humoral immune response against proteins E6 and E7 in cervical carcinoma patients positive for human papilloma virus type 16 during treatment and follow-up.

To investigate the humoral immune response to transforming proteins E6 and E7 of human papillomavirus type 16 before and after treatment and during follow-up, consecutive serum samples from 36 cervical cancer patients whose tumours were found to contain human papillomavirus type 16 DNA by use of the polymerase chain reaction were tested using in vitro translated proteins E6 and E7 in a radioimmunoprecipitation assay and in an E7 synthetic peptide enzyme immunoassay. Antibody levels against E6 and E7 as measured by radioimmunoprecipitation assay showed a nearly identical pattern. Seronegative patients remained seronegative throughout treatment and follow-up. Seropositive patients showed either a decrease in antibody level or stable antibody levels during treatment. In contrast to patients without evidence of disease at the end of the study, the majority of patients with recurrent disease showed increasing antibody levels during the follow-up period. These results indicate that, in patients who are seropositive before treatment antibody levels against E6 and E7 of human papillomavirus type 16 after treatment are closely linked to treatment response. The use of the more sensitive radioimmunoprecipitation assay did not lead to a better correlation of antibody levels with clinical disease status of the patients than the use of the enzyme immunoassay.

Antibodies, Viral↗
PubMed1999

Assessment of intracranial venous hemodynamics in normal individuals and patients with cerebral venous thrombosis.

BACKGROUND AND PURPOSE: Despite ongoing improvements in noninvasive imaging techniques, transcranial color-coded duplex sonography (TCCS) has so far been used only on a limited basis in patients with cerebral venous thrombosis. We evaluated the diagnostic value of both noncontrast and contrast-enhanced TCCS by comparing normal volunteers and patients with acute cerebral venous thrombosis. METHODS: In 75 healthy volunteers (aged 45.8+/-17.4 years), normal values for the deep cerebral veins (DCVs) and the posterior fossa sinuses were established by transtemporal insonation. Eight patients with cerebral venous thrombosis were assessed by TCCS, through which the hemodynamics of the DCVs were measured, and the patients were followed-up over a period of between 33 and 387 days after examination. MR angiography served as the "gold standard" technique for confirming the venous status in all 8 patients. RESULTS: No side differences in flow velocities were detected in the paired venous structures in normal volunteers. As indirect signs of (and diagnostic criteria for) cerebral venous thrombosis, pathologically increased flow velocities or significant side differences in the DCVs were registered in 5 of the 8 patients; the other patients showed nonsignificant increases in flow velocity which decreased over time. During follow-up, the status of the posterior fossa sinuses could be diagnosed correctly in seven patients after contrast enhancement when these results were compared with those of venous MR angiography. In 1 patient, a partial recanalization was mistakenly diagnosed as an occlusion. CONCLUSIONS: TCCS allows a reliable evaluation of the major DCVs and posterior fossa sinuses. The anterior and mid portions of the superior sagittal sinus and cortical veins cannot be assessed. Increased venous blood flow velocity can be used as an indirect criterion for indicating a cerebral venous thrombosis. Clinical recovery coincided with decreases in blood flow velocity in the series of patients investigated in this study.

Adult↗
PubMed1999

Frontal bone windows for transcranial color-coded duplex sonography.

BACKGROUND AND PURPOSE: The use of the conventional temporal bone window for transcranial color-coded duplex sonography (TCCS) often results in difficulties in obtaining angle-corrected flow velocity measurements of the A2 segment of the anterior cerebral artery, the posterior communicating artery, and the midline venous vasculature because of the unfavorable insonation angle. The same applies to B-mode imaging of the frontal parenchyma. However, transorbital TCCS raises problems with the insonation of the orbital lens. To overcome these drawbacks, we studied the feasibility of frontal bone windows for TCCS examinations. METHODS: In 75 healthy volunteers (mean age, 45.3+/-17.0 years; age range, 17 to 77 years), the circle of Willis and the venous midline vasculature were insonated through a lateral and paramedian frontal bone window. Insonation quality of parenchymal structures (B-mode) was graded on a 3-point scale depending on the visibility of typical parenchymal landmarks. In a similar manner, the quality of the color-/Doppler-mode imaging of the arteries of the circle of Willis and the internal cerebral veins was assessed. In 15 patients (mean age, 62.7+/-13.7 years; age range, 33 to 83 years), the color-/Doppler-mode imaging quality of the intracranial vessels before and after application of an ultrasound contrast-enhancing agent was compared. RESULTS: B-mode insonation quality was optimal to fair in 73.3% of cases using the lateral and in 52.0% of cases using the paramedian frontal bone window, with defined parenchymal structures used as reference. Insonation quality decreased in those older than 60 years. In those younger than 60 years, angle-corrected flow velocity measurements of the A2 segment of the anterior cerebral artery and the internal cerebral vein were possible in 73.6% and 60.0%, respectively. Contrast enhancement resulted in a highly significant improvement in the imaging quality of the intracranial vessels. CONCLUSIONS: The transfrontal bone windows offer new possibilities for TCCS examinations, although the insonation quality is inferior to the conventional temporal bone window in terms of failure of an acoustic window. This can be compensated for by application of an ultrasound contrast-enhancing agent.

Adolescent↗
PubMed1999

Transcranial color-coded duplex sonography of intracranial veins and sinuses in adults. Reference data from 130 volunteers.

BACKGROUND AND PURPOSE: Transcranial color-coded duplex sonography (TCCS) of intracranial veins and sinuses in adults is a new, emerging application of ultrasonographic imaging. This study reports a standardized examination protocol for venous TCCS and provides reference data for clinical application. METHODS: In 130 healthy volunteers (mean age, 45.9+/-16.9 years; range, 14 to 77 years) the intracranial venous system was examined using frequency-based transtemporal TCCS. Identification rate, blood flow velocity, resistance index, and systolic/diastolic ratio were recorded for each examined venous vessel. RESULTS: Intracranial veins and sinuses show a low pulsatile forward flow with maximal systolic blood flow velocity up to 20 cm/s. Significant side differences of blood flow velocity in the paired venous structures could not be detected. Venous flow velocities decreased with age, whereas resistance indices and systolic/diastolic ratios increased. Women showed higher flow velocities than men. Mean identification rates for all age groups ranged from 70% to 90% for the deep middle cerebral vein, the basal cerebral vein, and the great cerebral vein of Galen. The straight sinus, the transverse sinus, and the rostral part of the superior sagittal sinus could be detected in 55% to 70% of cases. Detection rates were dependent on age and decreased as age increased. CONCLUSIONS: Venous TCCS can reliably image a significant part of the cerebral venous system. This method can provide information on venous hemodynamics in normal subjects and pathological cases.

Adolescent↗
PubMed1999

Comparison of transcranial color-coded duplex sonography and cranial CT measurements for determining third ventricle midline shift in space-occupying stroke.

BACKGROUND AND PURPOSE: Transcranial color-coded duplex sonography (TCCS) allows the noninvasive, easily reproducible measurement of midline dislocation (MLD) of the third ventricle in space-occupying stroke, even in critically ill patients. However, the method has been validated only in a small number of subjects. The aim of this study was to test the method under clinical conditions. METHODS: In 61 prospectively recruited patients (mean age, 62+/-15 years) with supratentorial ischemic infarction or intracranial hemorrhage, the sonographic measurement of MLD was compared with cranial CT data in a 12-hour time window. Subgroup analysis was also undertaken for comparing TCCS and cranial CT measurements within a 3-hour time window. RESULTS: One hundred twenty-two data pairs of TCCS and cranial CT MLD measurements were correlated within the 12-hour time window. TCCS and cranial CT measurements of MLD correlated both in the total patient group and in the different subgroups with coefficients of over 0.9. The 2-SD confidence interval of the difference between the TCCS measurements and the respective means of both methods in the total patient collective was +/-1.78 mm. CONCLUSION: TCCS provides a noninvasive, easily reproducible and reliable method for monitoring MLD of the third ventricle in stroke patients. It is particularly suitable for critically ill patients who are not fit for transportation.

Adult↗
PubMed1998

Prothrombin gene G20210-->A transition is a risk factor for cerebral venous thrombosis.

BACKGROUND AND PURPOSE: It has been recently reported that a G-->A transition at nucleotide position 20210 in the 3'-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increased risk of deep venous thrombosis. To date, it is unknown whether this polymorphism also represents a risk factor for cerebral venous thrombosis (CVT). METHODS: Venous blood samples were collected from 45 patients with CVT and from 354 healthy blood donors as controls. A second control group consisted of 131 subjects with acute ischemic stroke or transient ischemic attack (TIA). Genomic DNA was isolated from peripheral blood leukocytes. Amplification of DNA was performed by polymerase chain reaction (PCR). The G-->A transition at nucleotide position 20210 of the prothrombin gene was detected by allele-specific restriction digestion. RESULTS: The G20210-->A transition in the prothrombin gene was found in a heterozygous form in 4 of 45 patients with CVT (8.9%) and in 8 of 354 healthy control subjects (2.3%). This difference was statistically significant (P=0.010). The G20210-->A transition increased the relative risk for CVT approximately 5-fold (age-adjusted odds ratio 5.7; 95% CI 1.5 to 21.5). In contrast, in the group of patients with acute cerebral ischemia, only 3 of 131 subjects (2.3%) were heterozygous for the G20210-->A transition, which corresponded to the prevalence in the group of healthy blood donors. CONCLUSIONS: The recently described G20210-->A transition in the 3'-untranslated region of the prothrombin gene is an inherited risk factor for CVT but obviously not for acute ischemic stroke or TIA.

Adolescent↗
PubMed1997

Relation between HPV-16 serology and clinico-pathological data in cervical carcinoma patients: prognostic value of anti-E6 and/or anti-E7 antibodies.

To investigate the clinical significance of the enhanced sensitivity of antibody detection by radio immunoprecipitation assays (RIPA), using in vitro translated HPV-16 E6 and E7 proteins, over synthetic-peptide enzyme-linked immunosorbent assay (ELISA), RIPA for HPV-16 E6 and E7 were performed. The results obtained with E6 and E7 RIPA were related to clinico-pathological data from cervical carcinoma patients positive for HPV type 16 DNA in their primary tumour. The data obtained with E6 and E7 RIPA were then compared to the results obtained using the E7/6-35 synthetic-peptide ELISA. The prevalence of antibodies to E6, E7, E6 and/or E7 and E6 and E7, as determined by RIPA, was significantly higher in cervical cancer patients than in both controls and cervical intraepithelial neoplasia patients. Odds ratios, calculated for cervical carcinoma patients versus controls, ranged from 7.4 to 15.4. Antibodies to E6 and/or E7 were largely restricted to patients with HPV DNA in their primary tumour. Analysis of the relation between prevalence of antibodies to E6 and E7 and clinico-pathological parameters was limited to 85 patients positive for HPV-16 DNA. The strongest relation with clinico-pathological data, such as lesion size, lymph node involvement, and prognosis, was found for E7 synthetic-peptide ELISA, whereas E6 and E7 RIPA did not reach significance. The significance of these findings is discussed.

Adult↗
PubMed1997

Detection of HPV-16 DNA by PCR in histologically cancer free lymph nodes from patients with cervical cancer.

The prognostic value of detection of human papillomavirus (HPV) type 16 DNA in histologically cancer free lymph nodes was assessed in left obturator lymph nodes from cervical cancer patients with HPV-16 positive primary tumours. HPV-16 DNA was detected by polymerase chain reaction in 12 of 35 patients with histologically cancer free lymph nodes. Of these 12 patients, only one developed a recurrence, suggesting HPV-16 DNA detection in cancer free lymph nodes has no prognostic value.

Carcinoma, Squamous Cell↗
PubMed1996

A comparative study of two different regimens of sparfloxacin versus doxycycline in the treatment of non-gonococcal urethritis in men.

A multicentre, double-blind, randomised study comparing the efficacy and safety of oral sparfloxacin (200 mg on day 1 followed by 100 mg daily for 2 or 6 additional days) with doxycycline (200 mg once daily for 7 days) in the treatment of non-gonococcal urethritis in men was conducted. The overall success rates for the three treatment groups were statistically equivalent both at the end of treatment and at the follow-up visits. For chlamydial urethritis, the rates of relapse or possible reinfection were similar in the 7-day sparfloxacin and doxycycline groups. For ureaplasmal urethritis and urethritis of unknown aetiology, the rates of relapse or possible reinfection were lower in the 7-day sparfloxacin group than in the other two treatment groups. Sparfloxacin was well tolerated. A 7-day sparfloxacin regimen appears to be a useful alternative to doxycycline for the treatment of non-gonococcal urethritis in men.

Adolescent↗
PubMed1996

Comprehensive study of several general and type-specific primer pairs for detection of human papillomavirus DNA by PCR in paraffin-embedded cervical carcinomas.

We have compared the efficacies of three general primer pairs for the detection of human papillomavirus (HPV) DNA in formaldehyde-fixed paraffin-embedded carcinomas. The use of these primer pairs leads to underestimates of the HPV prevalence (GP5/6, 61.1%; CPI/IIG, 57.4%; MY09/11, 46.9%; combined, 72.8%). The efficacy of each primer pair seemed to be inversely correlated to the length of the amplimer produced. By using newly developed type-specific primer pairs (amplimer length, approximately 100 bp), an increase in HPV DNA detection (87.6%) was found.

Base Sequence↗
PubMed1995

[Gentamicin skin ointment: 200 kilos too much].

In a 75 year old woman, with diabetic mellitus type II, bacteriological examination of a foot infection revealed a Staphylococcus aureus resistant to aminoglycosides. From a different ulcer on the same foot a genotypically identical but non-resistant bacterial strain was cultured. The patient had been treated with gentamicin ointment. According to the literature and to the Central Pharmaceutical Committee in the Netherlands there is no indication for topical use of gentamicin or other aminoglycosides. Moreover, such use may lead to antibiotic resistant bacteria. In spite of this, in the period from March 1992 to March 1993, 200 kg of the ointment was distributed in the Netherlands.

Aged↗
PubMed1995

Follow-up of antibody responses to human papillomavirus type 16 E7 in patients treated for cervical carcinoma.

A synthetic peptide comprising amino acids 6-35 of HPV-16 E7 was used in an ELISA to screen sera taken from 31 cervical carcinoma patients. Sera obtained before and during treatment, and in follow-up, were tested for the presence of antibodies to this peptide. Sixteen patients with negative pretreatment serum determination remained negative during treatment and follow-up. Of the 15 patients with positive pretreatment sera, 12 showed a decrease in anti-E7 6-35 antibody level during treatment. During follow-up an increase in anti-E7/6-35 antibody level was observed in 6 out of 7 patients with progressive or recurrent disease, whereas all patients who remained in complete remission showed stable or further decreasing antibody levels. During the course of disease of the 15 seropositive patients, serum anti-E7/6-35 antibody levels were compared with serum squamous cell carcinoma antigen (SCC-Ag) profiles, a clinically useful tumor marker in the management of cervical cancer patients. Similar patterns were observed in 10 out of 15 patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

In-vitro activity of a new quinolone (CP-99,219) compared with ciprofloxacin, pefloxacin, azithromycin and penicillin against Neisseria gonorrhoeae.

The in-vitro activities of CP-99, 219, ciprofloxacin, pefloxacin, azithromycin and penicillin was tested against 114 Neisseria gonorrhoeae strains. The MIC90s were: 0.008 mg/L (MIC range 0.001-0.06 mg/L) for CP-99, 219, 0.008 mg/L (MIC range 0.001-0.25 mg/L) for ciprofloxacin, 0.12 mg/L (MIC range 0.008-4 mg/L) for pefloxacin, 0.25 mg/L (MIC range 0.03-1 mg/L) for azithromycin and 16 mg/L (MIC range 0.015-16 mg/L) for penicillin. The activity of CP-99,219 against various N. gonorrhoeae isolates was comparable to ciprofloxacin.

Anti-Bacterial Agents↗