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Biomedical subjects

Zbigniew Stelmasiak

Publications and source records attributed to Zbigniew Stelmasiak.

At least 37 records · Page 2Linked to original sources
PubMed2002

Decreased level of kynurenic acid in cerebrospinal fluid of relapsing-onset multiple sclerosis patients.

The present study was undertaken to measure cerebrospinal fluid (CSF) levels of kynurenic acid (KYNA) in patients with relapsing-onset multiple sclerosis (MS) during remission or not progressing for at least 2 months. In these patients the levels of CSF KYNA were found to be significantly lower compared with subjects with non-inflammatory neurological diseases, as well as those with inflammatory disease (median (interquartile range): 0.41 (0.3-0.5) pmol/ml, n=26 vs. 0.67 (0.5-1.1), n=23, P<0.01 and 1.7 (1.5-2.6), n=16, P<0.001, respectively). These results provide further evidence of the alterations in the kynurenine pathway during remitting-onset MS.

Adult↗
PubMed2002

Increased serum levels of endogenous protectant secretory leukocyte protease inhibitor in acute ischemic stroke patients.

BACKGROUND: Activated leukocytes and their mediators may participate in ischemic brain injury. Secretory leukocyte protease inhibitor (SLPI) plays an important role in regulating the activity of the proteases, and may limit tissue damage. The aim of this study was to evaluate the changes in SLPI level in ischemic stroke patients. METHODS: The study comprised 20 patients with ischemic stroke and 20 controls. SLPI levels were measured in serum using enzyme-linked immunosorbent assay on the 1st, 5th and 12th day after stroke onset. RESULTS: SLPI was increased in the whole group of ischemic stroke patients compared with controls. It was also significantly increased on the 1st, 5th and 12th day after stroke in patients with larger brain tissue damage involving one or more lobe of the brain and in patients with more severe clinical status compared to controls (p < 0.05). A significant correlation between SLPI and the extent of brain tissue damage was observed on the 12th day after ischemic stroke onset (p < 0.05). CONCLUSIONS: Our results suggest that SLPI takes part in the anti-inflammatory reaction after ischemic stroke. Endogenous SLPI may have a neuroprotective effect, and could be a prototype therapeutic approach for ischemic stroke.

Acute Disease↗
PubMed2002

[Neurologic problems in tick-borne diseases--clinical and diagnostic aspects].

Tick carried illnesses frequently lead towards neurological complications. The tick-borne encephalitis and borreliosis are the most frequently encountered illnesses having such aetiopathogenesis. In the study there are presented clinical aspects of tick-borne encephalitis and borreliosis with special consideration of various neurological symptomatology. Simultaneously there are discussed current diagnostic rules of the diseases, mainly on the basis of serologic investigation.

Borrelia burgdorferi↗
PubMed2002

Histological examination of the extrabulbar segment of the optic nerve in experimental animals after administration of Cladribine.

The experiment was carried out on rabbits, females of New Zealand breed, weighting about 3 kg. Rabbits from the experimental group I received Cladribine in the dose corresponding to the schema of the experimental treatment in the hairy cell leukemia and animals from the experimental group II, the dose corresponding to the experimental treatment in multiple sclerosis. The optic nerves were collected for histological examinations in the light microscope. It appeared that administration of Cladribine in the dose corresponding to the therapeutic dose used in therapy of hairy cell leukemia and sclerosis multiplex does not cause evident morphological changes in the extrabulbar segment of the optic nerve on the level of the light microscope.

Animals↗
PubMed2002

Influence of the new medicine--2-CDA (Cladribine) on the ultrastructure of the extrabulbar segment of the optic nerve in rabbits of New Zealand breed.

Experiments were carried out on the rabbits of New Zealand breed weighting about 3 kg. Rabbits from the experimental group received Cladribine in the dose of 0.07 mg/kg/24 h each morning subcutaneously for 6 days, three cycles with 5-week intervals. Specimens of the optic nerve were stained according to the Reynold's method and observed in Tesla BS-500 transmission electron microscope. Results achieved from examinations of slides in experimental group indicate that Cladribine administered in the dose corresponding to therapeutic dose used in humans for experimental treatment of sclerosis multiplex does not cause the damage of extrabulbar segment of optic nerve in experimental animals. The achieved results suggest necessity of new research works regarding the eye structures of mesenchymal origin.

Animals↗
PubMed2002

The effect of epilepsy on emotional state in Hamilton and Beck questionnaire studies.

Patients with epilepsy present higher rate of psychological and psychiatric problems and emotional disturbances are estimated as the most frequent ones with prevalence of depression about tree times higher than it was observed in general population. In the presented study the occurrence of depressive symptoms was compared in a total of 60 adult patients with newly recognized and chronic epilepsy during remission of illness as well as pharmacoresistant. 21-items Hamilton Depressive Scale and Beck Depressive Inventory were applied once in each testified patient, consecutively by a physician or a patient himself during interictal period. Our study has found a higher level of depressive signs in newly diagnosed than in chronic patients during remission of illness but also in patients with an active process. The scoring rates both on HDRS and BDI were respectively characteristic of moderate or mild intensity of depressive disturbances. This comparison allows us to make a suggestion that diagnosis of epilepsy with its well-known stigmatization and limitations of different life activities may act as a stressing factor that enhances anxiety and depressive reactions in early phase of illness.

Adult↗
PubMed2002

Effectiveness of adjunctive therapy with tiagabine in mentally disabled patients with epilepsy.

Previous reports justified positive impact of tiagabine, a new-generation antiepileptic drug on neuropsychological functioning as well as minimal risk of psychiatric exacerbations. In this prospective, open, observational, non-comparative, short-term--6 months' study we evaluated efficacy and tolerability of tiagabine as add-on in polytherapy in 30 young adults with both refractory epilepsy and mild or moderate mental retardation. About 40% of patients experienced improvement in seizure frequency of 50% or more and none complained of seizure deterioration. Overall seizure frequency fell down from a mean 9.9 at the baseline to 6.3 seizure days per month. The seizure rate was reduced from 14.9 to 9.2 per month after 24 weeks of add-on phase. Adjunctive tiagabine therapy appeared to be associated with reduction in overall seizure severity characteristics expressed as enhancement of mild seizures from 30 to 50% of patients and reduction in severe seizures from 30 to 16%. Responders reported an improvement in most health-related quality of life domains but mostly cognition, medication effects and social functioning. The majority (90%) of patients did not report additional adverse effects with tiagabine; the most common complains associated with central nervous system (vertigo, weakness, nervousness) were transient and did not cause discontinuation. Blood counts and liver functional tests did not show any clinically relevant changes. In this short-term observation tiagabine seemed to be a beneficial antiepileptic drug for mentally retarded patients with epilepsy as it decreased seizure frequency and severity, improved the patients' sense of the quality of life without enhancement of the risk of adverse effects in polytherapy.

Adolescent↗
PubMedDate not supplied

[Analysis of epileptic pregnant women delivering between 1992-1998 in obstetric departments of the University Medical School in Lublin].

Pregnancy in woman with epilepsy arouses several serious medical problems and always belongs to the group of high obstetric risks. The aim of the present clinical study was the evaluation of the antiepileptic treatment efficiency during pregnancy, including risk factor, effects on pregnancy and delivery in epileptic patients. The study group consisted of 84 epileptic pregnant women which delivered between 1992-1998 in Obstetric Departments of University Medical School of Lublin. A randomised group 80 healthy pregnant women constituted the control group. The mean age of the analysed patients was 25 years. 51 epileptic patients were pregnant for the first time, 23 patients for the second time and 10 patients for the third time or more. The mean duration time of the disease was 8.6 years. In our study group: 45 (53.8%) patients experienced primary generalized tonic-clonic seizures and 39 (46.6%) patients experienced partial seizures. 26 patients were treated with monotherapy and the rest with polytherapy methods. The estimation of the seizure frequency during pregnancy in 52 (61.9%) patients did not change, in 13 (15.4%) patients increased. Among obstetric complications: urinary tract infections, hypertonia (EPH-gestosis) were observed. In 4 newborn congenital defects have been noted. Mothers of three of them were treated with Phenydantin (heart lesion, developmental anomaly of fingers). The fourth mother used Convulex (meningoarachnided hernia, hydrocephalus).

Abnormalities, Drug-Induced↗
PubMedDate not supplied

[Axonal damage in multiple sclerosis].

Traditionally, it was believed in MS, that axonal loss occurred in chronic lesions. However, new findings suggest that axonal transection can begin very early in the course of multiple sclerosis and axonal damage was found in active and chronic active MS lesions, particularly in areas of acute inflammation and demyelination. The mechanisms of axonal loss are uncertain, but may involve axonal degeneration secondary to demyelination, the action of inflammatory mediators and immune attack directed at axonal components. Axonal destruction and it's progression, is the major cause of irreversible damage in the CNS and the increase of disability in MS patients. Currently, new diagnostic methods (MRI, MR spectroscopy, magnetic transfer, histopathological and biochemical study) allow better to know the mechanisms of neuronal damage.

Axons↗
PubMedDate not supplied

[Detection of cerebral microemboli by transcranial doppler. Technical aspects].

The technical aspects of microemboli detection are summarised in this paper. The physical principles of the microembolus signals detection, their ultrasound characteristics, the possibility of identification of microembolus signals in Doppler spectral wave and advised equipment settings have been reviewed. Then the methods of automatic microemboli detection are described, problems concerned with identification of the nature of the microembolic material and an advised time of monitoring patients with various indications. Technical progress in microembolus signals detection, especially improved methods of their automatic both detection and recording make a good prognosis for full explanation of the clinical relevance of this phenomenon.

Humans↗
PubMedDate not supplied

[The importance of transcranial Doppler (TDC) in the assessment of cerebrovascular hemodynamics of the acute phase of ischemic stroke].

Most recent studies on transcranial Doppler (TCD) in the acute phase of ischemic stroke are reviewed in this paper. TCD is a highly sensitive and specific method of quick, bedside assessment of cerebrovascular circulation hemodynamics in the acute phase of ischemic stroke. The following issues are discussed in the paper: a new classification of ultrasound pathological changes associated with intracranial arteries occlusion or stenosis, the frequency of spontaneous re-canalisation by TCD, a comparison of TCD results with findings obtained by means of other vascular imaging techniques (e.g. DSA, CTA and MRA), relationship between TCD baseline assessment of primary blood flow changes and thrombolysis efficacy (the so-called TIBI classification, Thrombolysis in Brain Ischemia), and prognostic significance of TCD in the acute ischemic stroke. Moreover, first clinical reports on an additive effect of TCD on thrombolytic therapy are presented. The main limitations of TCD include the lack of sufficient bone window in 5-15% of patients and the lack of sufficiently trained staff capable of performing the examination a 24 h duty, since results of the examination to a large degree depend on the examiner's skills.

Acute Disease↗
PubMedDate not supplied

[Does diabetes mellitus affect the course and prognosis of ischemic stroke?].

Although diabetes is a well-known risk factor for ischemic stroke, its role in ischemic stroke outcome has not been clarified yet. Stroke subtypes according to the TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification, history of hypertension, serum glucose levels, blood pressure and OCSP (Oxfordshire Community Stroke Project) clinical types of admission, the presence of infections and seizures in the acute phase of illness, duration of hospitalisation, early and in-hospital mortality in diabetics and non-diabetic stroke patients were studied. CT scans in both groups were analysed by the size, localisation and number of ischemic foci. Significant differences were found only as regards the history of hypertension, as well as glucose levels and blood pressure on admission. The incidence of arterial hypertension prior to ischemic stroke was higher in the diabetic group. These patients had significantly higher blood glucose, systolic and diastolic blood pressure level on admission than had the non-diabetic group. No differences were found between the two groups on any other analysed variables. Our observations suggest that diabetes has no effect on the course and outcome of ischemic stroke.

Aged↗
PubMedDate not supplied

[Open trial of the effectiveness of interferon beta 1a (Avonex) in multiple sclerosis. Clinical assessment using motor coordination tests].

OBJECTIVE: The aim of the study was to evaluate clinical efficacy and safety of interferon beta 1A (Avonex) in the Polish population of remitting-relapsing multiple sclerosis (RR MS) patients. MATERIAL AND METHODS: The study was organized as an open, multi-center trial with 126 RR MS patients. Intramuscular Avonex was administered once a week in the dose of 30 mcg. The treatment duration was 24 months. The annual relapse rate (ARR), proportion of relapse-free patients, the average change in EDSS scores between the baseline and the study completion, and the proportion of patients who deteriorated on the EDSS scale during the treatment were used as evaluation parameters. Additionally, to obtain quantitative data, the 9HPT and 25 FW test results were taken into account. RESULTS: A significant decrease in the ARR was noted in the course of treatment (from 1.47 in the 2-year period preceding the study to 0.38). The mean EDSS score for the whole group was higher by 0.13 on the study completion. However, patients without motor deficits (EDSS < 2.0) at baseline improved by 0.25 on the EDSS during the treatment, while those with motor deficits (EDSS 2.0 to 4.0)--deteriorated by 0.65. In the period under study 45.8% of the patients remained stable, 26.7% improved and 27.5% deteriorated on the EDSS. The mean duration of the 9HPT test performance increased by 0.67 sec for the dominant, and by 0.97 sec for the non-dominant hand from the baseline to post-treatment evaluation. But again, in patients without any motor deficits the mean time of 9HPT test performance was shorter post-treatment than at baseline for the dominant and non-dominant hand, while in those with motor deficits it was longer for both hands on the study completion. The mean performance time on the 25 FW test was longer by 0.74 sec on the study completion for the whole group, but in patients without motor deficits the increase in the 25 FW performance time was significantly smaller than in those with baseline EDSS scores ranging from 2.0 to 4.0. Avonex did not cause any significant abnormalities in laboratory parameters monitored during the treatment, and no significant side effects were observed except for flu-like symptoms following an Avonex injection. CONCLUSION: Results of this study confirmed a beneficial effect of 1FNb 1A (Avonex) in the dose of 30 mcg per week on the clinical status of MS patients. The findings indicate a better treatment outcome in patients with less pronounced neurological deficits at baseline.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Open trial of the effectiveness of interferon beta 1a (Avonex) in the treatment of multiple sclerosis in Poland: MRI results].

OBJECTIVE: To assess the effect of interferon-beta 1A (IFNb 1A, Avonex) treatment on magnetic resonance (MR) image in patients with remitting-relapsing multiple sclerosis (RR MS) who participated in the Polish Avonex trial. PATIENTS AND METHODS: RR MS patients (N = 126) participated in a two-year randomized open trial of Avonex treatment administered in the dose of 30 mcg once a week. MRI was performed twice in each case: shortly before the patient's enrollment in the study and within a month from the study completion. Changes in T2-weighted lesion volume and T1-weighted gadolinium-enhanced lesion volume, as well as the number of new T2-weighted and T1-weighted gadolinium-enhanced lesions were measured. RESULTS: Over the two-year treatment period the mean volume of T2-weighted lesions decreased by 3.9% (p = 0.83) while that of T1-weighted gadolinium-enhanced lesions decreased by 79% (p = 0.084%) as compared to the baseline MRI evaluation. The mean number of enhanced lesions after two years of Avonex therapy was reduced by 46.1% (p = 0.0035). The total number of enhanced lesions decreased by 49.8% (p = 0.0078). Both the number of new T2-weighted lesions, 3.7 per patient, and that of new T1-weighted gadolinium-enhanced lesions, 0.7 per patient, were comparable with the results obtained in other Avonex trials. CONCLUSION: The results confirmed that interferon beta-1a (Avonex) has a significant effect in MS patients, slowing down the progress of their disease. This effect is particularly visible in T1-weighted contrast-enhanced images, indicating an impact of the treatment particularly on the inflammatory stage of the demyelination process.

Adjuvants, Immunologic↗
PubMedDate not supplied

[Epidemiological aspects of multiple sclerosis in Lublin (Poland)].

BACKGROUND AND PURPOSE: The objective of this paper was to present an epidemiological analysis of multiple sclerosis (MS) in Lublin, identify MS prevalence as well as characterize the population of MS patients. MATERIAL AND METHODS: Information about the patients was gathered and they were examined from 1996 to the end of 2000, that is within a 5-year period. The patients' data were obtained from the neurological departments in Lublin, most often neurological (but also general and ophthalmic) clinics, as well as from the Lublin MS Society. The remaining patients' data were obtained from the doctors, family members, the Lublin MS Society members, as well as from the hospital and clinic files. The patients were interviewed in detail using a prepared questionnaire. The diagnosis and its degree of certainty were determined in accordance with the Poser's criteria. The control group included 111 healthy people who were Lublin residents on the day of examination. The obtained results were analyzed in epidemiological and statistical terms. RESULTS: On the prevalence day (31 December 1997) there were 204 MS cases in Lublin, including 141 women (69%) and 63 men (31%). The calculated incidence ratio was 57.3/105. The average age of MS onset was estimated to be 30.1 years. On 31 December 1997 the average duration of the illness was 15.4 years. The average age for the examined cases was 45.5 years. The average DSS (Disability Status Scale) score was 3.5. Most often the disease began with a single symptom, in 155 cases (75.9%), whereas several symptoms occurred in 37 patients (18.1%). The most common symptoms at the illness onset were sensory impairments (52 patients), optic neuritis (42 people) and pyramidal symptoms (34 patients). The most common form of the illness was a disseminated form, which was diagnosed in 131 patients (64.2%). In the examined patient population four types of MS were recognized. The relapsing-remitting MS (RR-MS) was observed in 62 patients (30.3%), the secondary progressive MS (SP-MS) in 83 patients (40.6%), and the primary progressive MS (PP-MS) was characteristic of 40 people (19.6%), while 19 patients (9.3%) experienced a benign course of MS. CONCLUSIONS: Our results are typical for the region of high incidence of MS. They are similar to the data achieved in other populations of that region.

Adult↗
PubMedDate not supplied

[Role of matrix metalloproteinases in the pathogenesis of multiple sclerosis].

Multiple sclerosis (MS) is an autoimmune disease whose features include a massive lymphocyte recruitment into the central nervous system and segmental demyelinization of the white matter. One of the MS development factors is an increase of matrix metalloproteinases (MMPs) activity with a coincidental decrease of tissue inhibitors of MMPs (TIMPs) activity. Investigations of serum, cerebrospinal fluid and brain tissue of patients showed an increase of MMP-1, -2, -3, -7, -9 and MMP-12 activity. MMPs disrupt the blood-brain barrier (BBB), increase lymphocyte migration into the central nervous system and are involved in degradation of myelin proteins. MMPs induce the appearance of an active form of tumor necrosis factor alpha, a strong proinflammatory cytokine. The drugs used in MS treatment decrease MMPs expression. Multiple actions of MMPs prove their involvement in the pathogenesis and treatment of MS.

Blood-Brain Barrier↗