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  • 1
    Keywords: DISEASE ; NUCLEUS ; magnetic resonance imaging (MRI) ; BASAL GANGLIA ; PARKINSONS-DISEASE ; Deep brain stimulation (DBS) ; ELECTROPHYSIOLOGICAL GUIDANCE ; IRON CONTENT ; Parkinson's disease (PD) ; BILATERAL SUBTHALAMIC STIMULATION ; Direct stereotactic targeting ; Dystonia ; Internal globus pallidus (GPi) ; MOVEMENT-DISORDERS ; PARS INTERNA ; PRIMARY GENERALIZED DYSTONIA ; TARGET LOCALIZATION
    Abstract: BACKGROUND: Deep-brain stimulation (DBS) of the internal globus pallidus (GPi) has shown remarkable therapeutic benefits for treatment-resistant neurological disorders including dystonia and Parkinson's disease (PD). The success of the DBS is critically dependent on the reliable visualization of the GPi. The aim of the study was to evaluate promising 3.0 Tesla magnetic resonance imaging (MRI) methods for pre-stereotactic visualization of the GPi using a standard installation protocol. METHODS: MRI at 3.0 T of nine healthy individuals and of one patient with PD was acquired (FLAIR, T1-MPRAGE, T2-SPACE, T2*-FLASH2D, susceptibility-weighted imaging mapping (SWI)). Image quality and visualization of the GPi for each sequence were assessed by two neuroradiologists independently using a 6-point scale. Axial, coronal, and sagittal planes of the T2*-FLASH2D images were compared. Inter-rater reliability, contrast-to-noise ratios (CNR) and signal-to-noise ratios (SNR) for the GPi were determined. For illustration, axial T2*-FLASH2D images were fused with a section schema of the Schaltenbrand-Wahren stereotactic atlas. RESULTS: The GPi was best and reliably visualized in axial and to a lesser degree on coronal T2*-FLASH2D images. No major artifacts in the GPi were observed in any of the sequences. SWI offered a significantly higher CNR for the GPi compared to standard T2-weighted imaging using the standard parameters. The fusion of the axial T2*-FLASH2D images and the atlas projected the GPi clearly in the boundaries of the section schema. CONCLUSIONS: Using a standard installation protocol at 3.0 T T2*-FLASH2D imaging (particularly axial view) provides optimal and reliable delineation of the GPi.
    Type of Publication: Journal article published
    PubMed ID: 22167532
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  • 2
    Keywords: brain ; APOPTOSIS ; CANCER ; CELLS ; IN-VITRO ; SURVIVAL ; AGENTS ; CELL ; Germany ; IN-VIVO ; VITRO ; DEATH ; DRUG ; SURGERY ; LINES ; TIME ; PATIENT ; LIGAND ; primary ; INDUCTION ; tumour ; treatment ; culture ; ACID ; CELL-DEATH ; PLASMA ; RATES ; RESECTION ; PHARMACOKINETICS ; CISPLATIN ; FUTURE ; TRAIL ; AGENT ; POTENT ; REGRESSION ; IV ; GRADE ; brain tumour ; betulinic acid ; CERAMIDE ; glioblastoma multiforme WHOIV
    Abstract: Background. Glioblastoma multiforme (WHO Grade IV, GBM) is the most malignant brain tumour with a mean survival time of less than one year. Betulinic acid, ceramide and TRAIL (TNF-related apoptosis inducing ligand) represent novel therapeutic agents for potential use in GBM. Method. Primary GBM cells of 21 patients with macroscopically complete tumour resection were tested in vitro for cell death induction by betulinic acid, ceramide, TRAIL and established therapeutics (BCNU, cisplatin, doxorubicin, vincristin and gamma-irradiation). Findings. At peak plasma concentrations (PPC), Betulinic acid, ceramide and TRAIL induced cell death in primary GBM cells at higher rates than established cytotoxic drugs. Specific cell death greater than or equal to75% was observed in 43% (9/21), 38% (8/21), and 19% (4/21) for betulinic acid, ceramide, and TRAIL respectively, while this was only found in 5% (1/21) of gamma-irradiated and cisplatin-treated cells, and in none of the GBM cultures, where BCNU or vincristin were applied in PPC. Conclusion. Due to a markedly improved cell death of GBM cells as compared with established therapeutics, Betulinic acid, ceramide and TRAIL might represent potent substances for future treatment of GBM
    Type of Publication: Journal article published
    PubMed ID: 15197616
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  • 3
    Keywords: SURVIVAL ; tumor ; THERAPY ; FOLLOW-UP ; LONG-TERM ; SURGERY ; PATIENT ; IMPACT ; RESECTION ; GLIOMAS ; MANAGEMENT ; ADULT ; REGRESSION ; THERAPIES ; GLIOMA ; methods ; LONG ; LOW-GRADE GLIOMA ; multivariate analysis ; EXTENT ; surgical resection ; LOW-GRADE ; PROGRESSION-FREE SURVIVAL ; outcome ; Low grade gliomas ; A ; randomized studies
    Abstract: Purpose: The appropriate management of low-grade gliomas is still a matter of debate. So far, there are no randomized studies that analyze the impact of surgical resection on patient outcome. The value of the data obtained from the few retrospective reports available is often limited. Patients and methods: In the present study, we performed an analysis on data of 130 adult low-grade glioma patients. Extent of the resection was evaluated in correlation to the overall survival (OS) and progression-free survival (PFS) using Cox regression multivariate analysis. Results: Extended surgery was shown to prolong OS and PFS significantly. Re-surgery in the case of a tumor relapse has a significant impact on OS and PFS, too. Conclusions: In summary, we could retrospectively evaluate a large case series of well-defined low-grade gliomas patients with a long follow-up period showing that extended surgery would be the most effective therapy for low-grade glioma patients even in recurrent diseases.
    Type of Publication: Journal article published
    PubMed ID: 19730773
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  • 4
    Keywords: ENVIRONMENT ; CELLS ; ENDOTHELIAL-CELLS ; EXPRESSION ; GROWTH ; GROWTH-FACTOR ; IN-VITRO ; INVASION ; tumor ; TUMOR-CELLS ; CELL ; Germany ; THERAPY ; GENERATION ; ACTIVATION ; MECHANISM ; CARCINOGENESIS ; mechanisms ; cytokines ; STIMULATION ; TARGET ; UP-REGULATION ; NUMBER ; STRATEGIES ; TARGETS ; GLIOMAS ; COLONY-STIMULATING FACTOR ; growth factors ; MANAGEMENT ; EPIDERMAL-GROWTH-FACTOR ; FACTOR SCATTER FACTOR ; glioma,growth factor,invasion ; GRANULOCYTE-MACROPHAGE ; HUMAN GLIOBLASTOMA CELLS ; INTEGRIN EXPRESSION ; RECEPTOR C-MET
    Abstract: Recent studies using molecular and cellular techniques of the factors regulating the invasion process have revealed a crucial role for a number of growth factors and cytokines. Their function lies on the one hand in the autocrine stimulation of the tumor cells themselves, resulting in the stimulation of protease expression and an enhancement of migratory potential. On the other hand, the growth factors and cytokines seem to play a major role in the paracrine activation of the tumor surrounding stroma. Through stimulation of the strong angiogenic response that is characteristic for gliomas and also of the expression of proteases in the stromal cells, they contribute critically to the generation of a stromal environment that is permissive or even inductive for tumor cell invasion. Understanding of the mechanisms by which soluble factors modulate glioma cell invasion therefore will help to determine targets for the modification of existing therapies and lead to the development of novel therapeutic strategies in the management of gliomas
    Type of Publication: Journal article published
    PubMed ID: 14628206
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  • 5
    Keywords: RISK-FACTORS ; BASAL GANGLIA ; 3.0 T ; PARKINSONS-DISEASE ; ELECTROPHYSIOLOGICAL GUIDANCE ; GLOBUS-PALLIDUS ; IRON CONTENT ; MOVEMENT-DISORDERS ; ELECTRICAL-STIMULATION ; STEREOTACTIC ATLAS
    Abstract: BACKGROUND: Deep-brain stimulation (DBS) of the subthalamic nucleus (STN) is an accepted neurosurgical technique for the treatment of medication-resistant Parkinson's disease and other neurological disorders. The accurate targeting of the STN is facilitated by precise and reliable identification in pre-stereotactic magnetic resonance imaging (MRI). The aim of the study was to compare and evaluate different promising MRI methods at 7.0 T for the pre-stereotactic visualisation of the STN METHODS: MRI (T2-turbo spin-echo [TSE], T1-gradient echo [GRE], fast low-angle shot [FLASH] two-dimensional [2D] T2* and susceptibility-weighted imaging [SWI]) was performed in nine healthy volunteers. Delineation and image quality for the STN were independently evaluated by two neuroradiologists using a six-point grading system. Inter-rater reliability, contrast-to-noise ratios (CNRs) and signal-to-noise ratios (SNRs) for the STN were calculated. For the anatomical validation, the coronal FLASH 2D T2* images were co-registered with a stereotactic atlas (Schaltenbrand-Wahren). RESULTS: The STN was clearly and reliably visualised in FLASH 2D T2* imaging (particularly coronal view), with a sharp delineation between the STN, the substantia nigra and the zona incerta. No major artefacts in the STN were observed in any of the sequences. FLASH 2D T2* and SWI images offered significantly higher CNR for the STN compared with T2-TSE. The co-registration of the coronal FLASH 2D T2* images with the stereotactic atlas affirmed the correct localisation of the STN in all cases. CONCLUSION: The STN is best and reliably visualised in FLASH 2D T2* imaging (particularly coronal orientation) at 7.0-T MRI.
    Type of Publication: Journal article published
    PubMed ID: 22930282
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 100 (1989), S. 3-11 
    ISSN: 0942-0940
    Keywords: Far lateral disc herniation ; extracanalicular disc herniation ; CT-study ; reformation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A retrospective analysis of 45 patients with intra- and extracanalicular lumbar disc herniations (ICDH, ECDH), collected over a 3 year period, is presented. When an intra- or extracanalicular DH was suspected, 1.5 mm axial cuts were made with a GE 9800 from the cranial pedicle through the intervertebral canal to the pedicle of the lower vertebral body. Constructions were then made in coronal and paraxial planes to identify the pathology and its relation to the nerve root. 47% of all ICDH and ECDH were found at the level L4/5, 24% each at the levels L3/4 and L5/S1 respectively and 4% at the level L2/3. In 78% of our patients, the disc fragment was extruded and found well above the level of the disc space, in 22% at the level of the disc space. The coronal reformated views were in general better for demonstrating the course of the compressed nerve root at the levels L2/3–L4/5, while at L5/S1 the paraxial reformated view may yield better images. The distance from the midline of the spinal canal to the medial and lateral edge of the ECDH averages 16.4±3.4 and 33.3±3.6 mm and in some cases the lateral edge was found 39–44 mm from the midline. Pitfalls in the diagnosis of ECDH may be caused by scar tissue, sometimes by an upwardly displaced nerve root or ganglion and, very rarely, by a neurinoma. Pitfalls in therapy, i.g. false negative intraspinal exploration in cases of intraor extracanalicular disc herniations or exploration of the wrong intervertebral canal, may result due to insufficient neuroradiological analysis or from insufficient consideration of the anatomical situation by the neurosurgeon.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; plasma renin activity ; sympathetic nervous system ; brainstem dysfunction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The possible relationship between plasma renin activity and neurological deficits was examined in ten patients with spontaneous subarachnoid haemorrhage in a prospective clinical study. The patients were examined daily, particular attention being given to signs of brain stem dysfunction. The degree of impaired consciousness was assessed using the Glasgow Coma Score. Plasma renin activity was determined on days 1–5, 7, 9, 11, 13, 15 and 21 after the initial bleeding episode using an Angiotensin-I-radioimmunoassay. Six of seven patients with signs of brain stem dysfunction displayed a marked increase in plasma renin activity. Thus a significant negative correlation between the degree of consciousness and the plasma renin activity resulted. An explanation for this correlation may be found in the localization of the autonomous centres and the high concentrations of renin in the hypothalamus and brain stem. The individual changes in plasma renin activity have prognostic significance, whereas single estimated plasma renin activities show great interindividual differences and have only limited prognostic value.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 0942-0940
    Keywords: Brain contusion ; contusion volume ; quantitative assessment, CT ; CSF-CKBB clearance ; outcome
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to evaluate if it is practically possible to assess the volume of contused brain tissue from the CT pictures, a comparison has been carried out between the size of the cerebral contusion(s)-as estimated from the CT scans-and the post-traumatic CSF-CKBB activity, in a series of 29 patients with severe head injury. A clearance curve for the elimination of CKBB from the CSF was constructed. The relation between contusion volume and CSF-CKBB-activity was not statistically significant, while the relationships between contusion volume and outcome, and between CSF-CKBB, as estimated at 6 hours after trauma from the clearance curve, and outcome, were.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 0942-0940
    Keywords: Experimental subarachnoid haemorrhage ; 6-hydroxydopamine ; denervation ; ultrastructure of cerebral vessels
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Transmission electron microscopy of the middle cerebral artery from cats exposed to subarachnoid injection of blood 3 and 7 days before, showed several damage of the vascular ultrastructure. The intima was thickened with swelling and vacuolization of endothelial cells, with a plump appearance and disruption of tight junctions. The cellular surface was corrugated and the subendothelial space contained proliferating and vacuolated smooth muscle cells capped by elastin and collagen fibres. The internal elastic lamina was also corrugated and disrupted. The adventitial changes were axonic cytoplasmic and mitochondrial swelling, virtual absence of synaptic vesicles, and disruption of the outer axonal membrane, suggesting denervation of cerebral vessels. With administration of 6-hydroxydopamine (6-OHDA), similar ultrastructural changes were observed in the adventitia. These observations indicate that denervation induced by subarachnoid bleeding could be involved in the pathophysiology of cerebrovascular spasm. Subarachnoid haemorrhage, but not 6-OHDA, affects also intima and tunica media, suggesting other mechanisms, in addition to denervation, can participate in the vasospasm.
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Acta neurochirurgica 101 (1989), S. 1-2 
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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