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Biomedical subjects

T Stijnen

Publications and source records attributed to T Stijnen.

At least 181 records · Page 10Linked to original sources
PubMed1988

Mortality caused by stomach cancer after remote partial gastrectomy for benign conditions: 40 years of follow up of an Amsterdam cohort of 2633 postgastrectomy patients.

Mortality caused by stomach cancer was analysed in a cohort of 2633 postgastrectomy patients who underwent surgery for benign conditions in the academic medical centre of the University of Amsterdam between 1931-1960. In comparison with mortality from gastric cancer in the general Dutch population, the observed versus expected ratio in the postgastrectomy group was significantly increased among women, after a postoperative latency of more than 15 years (O/E: 4.77; p = 0.011) and among men after a postoperative latency of more than 25 years (O/E: 3.13; p = 0.005). The analysis confirms that the discrepancies in risk appraisal which seem to exist between reports published in Europe and the USA may be explained by the differences in length of follow up in these studies.

Adult↗
PubMed1988

Blood flow velocity pattern of the anterior cerebral arteries. Before and after drainage of posthemorrhagic hydrocephalus in the newborn.

The blood flow velocity pattern of the anterior cerebral artery (ACA) was investigated using transcutaneous Doppler technique in ten preterm infants with posthemorrhagic hydrocephalus (PHH), before and after drainage of cerebrospinal fluid. The pulsatility index of the ACA was elevated during PHH, mainly due to an increase of peak systolic flow velocity, explained by an increased compliance of the vascular wall. The end diastolic flow velocity and the area under the velocity curve were not different before and after drainage, indicating that cerebrovascular resistance was not changed and blood flow through the ACA was not affected in the studied infants during PHH.

Blood Flow Velocity↗
PubMed1988

Flow cytometric and morphologic studies of HNK1+ (Leu 7+) lymphocytes in relation to cytomegalovirus carrier status.

CMV carrier status of healthy individuals causes a persistent increase in the numbers of lymphocytes expressing the HNK1 (Leu 7) antigen. We investigated this phenomenon by correlating HNK1 fluorescence intensity of the CD3+, CD4+, CD8+ and CD16+ lymphocytes with their morphology. The study was performed on 112 healthy individuals as a function of their CMV carrier status. To this end, the CD3+, CD4+, CD8+ and CD16+ lymphocytes were stratified into subsets with undetectable (-), weak (+) and strong (++) levels of HNK1 fluorescence intensity, as well as into subsets with low, intermediate or high perpendicular light scatter (PLS) signals. Among the CD3+, CD4+ and CD8+ lymphocytes. CMV carrier status was associated with significantly increased numbers of HNK1(+) and particularly HNK1(++) cells. Among the CD16+ lymphocytes, CMV carrier status increased only the HNK1(++) ones significantly. There were clear positive correlations between the PLS characteristics of the CD3+, CD4+, CD8+ and CD16+ lymphocytes and their HNK1 fluorescence intensity. Microscopic analysis of CD3+ lymphocytes sorted into HNK1(-), HNK1(+) and HNK1(++) fractions revealed that the percentage of those cells containing azurophilic granules and the numbers of such granules per cell increased in proportion to their HNK1 fluorescence intensity. Thus, CMV also interacts with the HNK1+ lymphocytes of its healthy carriers by increasing the level of expression of that antigen which is accompanied by increased granularity. Those granular lymphocytes may include cytotoxic cells which are involved in the control of viral replication.

Adolescent↗
PubMed1988

Mercuric chloride-induced autoimmunity in the brown Norway rat. Cellular kinetics and major histocompatibility complex antigen expression.

HgCl2 induces an autoimmune syndrome in Brown Norway rats that involves synthesis of anti-glomerular basement membrane (GBM) antibodies and development of nephritis with high proteinuria. HgCl2-induced changes in the composition of leukocyte populations and in the expression of MHC antigens in lymphoid and nonlymphoid organs were investigated by flow cytometry and immunohistochemistry. An early increase of CD4+ splenocytes was followed by a transient proliferation of CD4+ as well as CD8+ and B lymphocytes in peripheral lymphoid organs; in contrast, progressive depletion of the thymic cortex was found. B lymphocyte activation involved mainly the IgG1 and IgE isotypes. Nonlymphoid organs were infiltrated by MHC class II antigen expressing CD4+ and CD8+ T lymphocytes and monocytes; secondary to infiltration, mainly epithelial cells, being the main target of infiltrating cells, showed increased expression of MHC antigens. In glomeruli a 2.7-fold increase of CD8+ lymphocytes occurred after HgCl2-administration. The diverse autoimmune phenomena observed in this study fit with the hypothesized involvement of T lymphocytes autoreactive with MHC class II antigens. Apart from anti-GBM autoantibodies, a role for autoreactive CD8+ T lymphocytes must be considered in the pathogenesis of the HgCl2-induced autoimmune syndrome.

Animals↗
PubMed1988

Adenocarcinoma of the colon and rectum: a report on 624 cases.

A total of 624 patients with adenocarcinoma of the large bowel and operated between 1958 and 1978 were retrospectively studied. According to the period of operation, patients were divided into group A (1958 to 1968, n = 259) and group B (1969 to 1978, n = 365). Symptoms were closely related to tumour location. Blood loss and change in bowel habits were most frequent in patients with left-sided cancer, while anaemia, loss of body weight and abdominal pain turned out to be the predominant symptoms in patients with right-sided cancer. Patients with cancer of the transverse colon or splenic flexure showed a high incidence of ileus (19%). Resection of the primary tumour was possible in 86% of the cases. The overall morbidity was 48% and the postoperative mortality was 8%. Anastomotic dehiscence occurred in 4% of our patients. There was no significant difference in postoperative mortality between the two patient groups. The mortality is closely related to the Dukes stage (Dukes A 4%, Dukes D 19%). The overall crude survival was 45%, the corrected survival 57%. Patients with cancer of the descending colon or (recto)sigmoid had a higher corrected 5-year survival when compared to patients with cancers in other tumour sites (65% versus 52%, p less than 0.01). Dukes stage, ileus as primary symptom were also correlated with survival, while sex distribution, age and duration of symptoms were not.

Adenocarcinoma↗
PubMed1987

Herpes-virus immunity and acute graft-versus-host disease.

The influence of pretransplant herpes-virus antibodies in 126 marrow-graft recipients and their HLA-identical (A, B, C, DR) sibling donors on the incidence of grades II-IV acute graft-versus-host disease (GVHD) was studied in relation to previously reported risk factors for GVHD. Logistic regression procedures were used to control for confounding factors. Increasing donor age (odds ratio 3.7 per decade; p = 0.02) and donor seronegativity for Epstein-Barr virus (EBV; odds ratio 10.1; p = 0.005) were associated with a high incidence of GVHD. Total rather than selective gastrointestinal decontamination (odds ratio 0.1; p = 0.004), donor seronegativity for herpes simplex virus (HSV; odds ratio 0.1; p = 0.003), and recipient EBV-seronegativity (odds ratio 0.05; p = 0.002) were associated with a low incidence of GVHD. Pretransplant EBV and HSV serology may thus contribute substantially to the estimation of the risk for GVHD.

Acute Disease↗
PubMed1987

Perioperative blood transfusion and cancer prognosis. Different effects of blood transfusion on prognosis of colon and breast cancer patients.

A detailed retrospective analysis was undertaken of the effect of perioperative blood transfusion on long-term survival of 113 patients with Dukes' Stages A, B and C1 cancer of the colon and 383 patients with invasive cancer of the breast who were treated in our institution between 1973 and 1978 and followed for 5 to 10 years. In the patients with colon cancer, a significant adverse effect of transfusion on long-term survival was seen. In this group there was a cumulative 5-year overall survival of 48% for the transfused and 74% for the nontransfused patients (P = 0.007, log-rank test). Perioperative blood transfusion was associated with a relative risk of 3.42 for all deaths (P = 0.005) and 4.25 for death due to cancer (P = 0.03), after adjustment for other important variables such as age, sex, stage, location of tumor, surgical procedure, and preoperative hemoglobin level. In contrast, in our study group of patients with breast cancers, who all underwent a modified radical mastectomy, no effect of blood transfusion on long-term survival was seen. Multivariate analysis adjusting for size of tumor, number of positive regional lymph nodes, menopausal status, estrogen receptor status and the addition or absence of chemotherapy, did not show any increased risk in all deaths or death due to cancer associated with blood transfusion. Although no definite explanation is available, our data show that there seems to be a difference in the relationship between perioperative blood transfusion and survival for colon and breast cancer patients.

Aged↗
PubMed1987

Cerebral blood flow velocity pattern in healthy and asphyxiated newborns: a controlled study.

In a controlled study serial determinations of cerebral blood flow velocity using Doppler ultrasound and repeated real-time ultrasonographic- or computerized axial tomographic studies of the brain were performed in 17 (nearly) full-term newborns who experienced perinatal asphyxia and in 17 healthy matched controls during the first week of life. A higher cerebral blood flow velocity was found during the first 4 days of life, indicating a lower cerebrovascular resistance in the asphyxiated infants compared to the control infants. These haemodynamic changes coincided with cerebral oedema and neurological abnormalities. It is speculated that the changes in the cerebral circulation in asphyxiated infants are at least partly caused by cerebral oedema-induced increase of intracranial pressure due to severe perinatal asphyxia. Serial Doppler ultrasound investigations of the brain may be a useful non-invasive method for early detection and follow-up of the consequences of severe perinatal asphyxia.

Asphyxia Neonatorum↗
PubMed1987

Aetiological rôle of cerebral blood-flow alterations in development and extension of peri-intraventricular haemorrhage.

The aetiology and extension of peri-intraventricular haemorrhage (PIVH) are thought to be related to cerebral blood-flow alterations, and especially to increased cerebral blood-flow and fluctuating velocity of blood-flow. Using transcutaneous Doppler technique, the authors investigated cerebral blood-flow in 60 infants with gestations of less than 34 weeks. Pulsatility index (PI) and area under the velocity curve (AUVC) of the anterior cerebral arteries (ACA) were used as qualitative measures of cerebral blood-flow, and the coefficient of variation of PI and AUVC as indicators of fluctuations in blood-flow velocity. A reasonable correlation was found between PI and AUVC and their coefficients of variation in the ACA. First onset of PIVH was related to fluctuating blood-flow velocity, and extension of PIVH with both increased velocity (indicating increased blood-flow) and fluctuating velocity. Increased cerebral blood-flow and its fluctuating pattern were positively correlated with arterial carbon dioxide tension.

Brain↗
PubMed1987

Discontinuation of antiepileptic therapy: a prospective study in children.

Anticonvulsant medication was stopped in a prospective study in 116 children with epilepsy who had had no seizures for a period of 2 years. A remission rate of 80.5% was found 5 years after withdrawal. The population studied was unselected, and based on children directly referred by general practitioners to the outpatient department. Among the many variables examined, such as type of epilepsy or seizure, presence of concomitant neurological or intellectual deficit, and epileptiform activity on the EEG, only the age of onset of seizures was significantly and positively correlated with the probability of recurrence after discontinuation of medication. In contrast to other recent studies, it was concluded that there are no reliable predictive factors for withholding from any individual "epileptic" child the benefit of attempts to stop medication after 2 years of seizure freedom.

Adolescent↗
PubMed1987

The influence of cytomegalovirus carrier status on lymphocyte subsets and natural immunity.

The influence of the cytomegalovirus (CMV) carrier status on peripheral lymphocyte subsets was studied in 70 healthy individuals. IgG-class antibodies against CMV late antigen were used as markers for the presence of CMV in those individuals. The 39 CMV-seropositive individuals had significantly higher numbers of CD3+ (P = 0.009), CD8+ (P = 0.005) and HNK1+ (P = 0.002) cells than the 31 CMV-seronegative individuals. Two-colour immunofluorescence studies revealed that the HNK1+ cells coexpressing CD4 or high density CD8 were particularly increased in the number under the influence of CMV, but not the HNK1+ cells coexpressing CD16. Since HNK1 and CD16 are markers associated with natural killer (NK) activity and antibody-dependent cellular cytotoxicity (ADCC), we investigated the influence of the CMV carrier status on those functions. The NK and ADCC functions of peripheral blood mononuclear cells (PBMC), HNK1+ and HNK1- cells were correlated with the percentages of CD16+ cells among those cells. Although CMV-seropositive individuals had significantly less CD16+ cells among their HNK1+ cells than CMV-seronegative individuals (mean and s.d.: 39 and 19%, versus 58 and 11%, P = 0.003), the NK and ADCC functions of the HNK1+ cells were similar in both groups. Also, the CMV carrier status did not influence significantly those functions of PBMC and HNK1- cells. We conclude that the CMV carrier status, i.e. CMV-seropositivity, is associated with a significant increase in the numbers of HNK1+ lymphocytes coexpressing T cell markers. That situation may reflect the continuing interaction between CMV and the immune system of its host.

Adult↗
PubMed1987

Effects of herpes virus carrier status on peripheral T lymphocyte subsets.

We studied the effects of herpes virus carrier status on peripheral blood T lymphocyte subsets in 334 healthy individuals. IgG-class antibodies against cytomegalovirus (CMV), Epstein-Barr virus (EBV), herpes simplex virus (HSV), and varicella-zoster virus (VZV) were used as markers for the carrier status of those viruses. CMV carrier status was associated with significant increases in the numbers of some T cell subsets, whereas the carrier status of EBV, HSV, and VZV had no significant effects. The 159 CMV-seropositive individuals had higher numbers of HNK1+ T cells than did the 175 CMV-seronegative individuals [mean (SD), 292 (196)/microL v 164 (89)/microL, respectively], including the CD4+HNK1+ T cells [38 (48)/microL v 9 (13)/microL, respectively] and the CD8+HNK1+ T cells [166 (146)/microL v 73 (54)/microL, respectively]. Morphological and cytochemical studies showed that the expression of HNK1 by the CD4+ and CD8+ T cells was associated with the occurrence of azurophilic cytoplasmatic granules and a loss of nonspecific esterase activity. The numbers of CD4+HNK1+ and CD8+HNK1+ T cells increased proportionally to the levels of the IgG-class CMV antibody titers. We suggest that the increased numbers of CD4+HNK1+ and CD8+HNK1+ granular T cells in CMV carriers reflect the persistent interaction between CMV and the immune system of its hosts.

Age Factors↗
PubMed1987

Marrow donor immunity to herpes simplex virus: association with acute graft-versus-host disease.

The interactions between humoral and cellular immunity to herpes simplex virus (HSV) in bone marrow donors, the occurrence of active HSV infections, and the development of grades II-IV acute graft-versus-host disease (GVHD) in their HLA-A,B,C,DR-identical sibling recipients were studied. The absence of IgG-class HSV antibodies in the marrow donors was associated with a low incidence of GVHD: 38 of 53 recipients (72%) of marrow from HSV-seropositive donors developed GVHD versus only two of 15 recipients (13%) with HSV-seronegative donors (p = 0.0004). The cellular immunity to HSV was studied in vitro by evaluating the degree of lymphocyte proliferative responses to that virus and was also significantly associated with GVHD: 30 of 43 recipients (70%) of marrow from donors with a positive test developed GVHD versus 10 of 25 recipients (40%) of marrow from donors with a negative test (p = 0.03). The previously reported risk for GVHD attributed to donor CMV antibodies increased the risk of GVHD due to donor HSV antibodies. Of 31 recipients of marrow from donors who were both HSV- and CMV-seropositive, 27 (85%) developed GVHD versus 11 of 22 recipients (50%) of marrow from HSV-seropositive but CMV-seronegative donors (p = 0.008).

Adolescent↗