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  • 11
    Electronic Resource
    Electronic Resource
    Dose escalation trial of a novel calcium antagonist, AT877, in patients with aneurysmal subarachnoid haemorrhage (1990)
    Springer
    Acta neurochirurgica 107 (1990), S. 11-15 
    Details
    ISSN: 0942-0940
    Keywords: Subarachnoid haemorrhage ; chronic cerebral vasospasm ; calcium antagonist ; AT877 ; HA 1077
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The initial dose-escalating clinical trial of a novel calcium antagonist, AT877, in patients with aneurysmal subarachnoid haemorrhage is reported. AT877 is characterized by its strong spasmolytic activity, its inhibition of intracellular calcium ion activity, and the inhibiton of several protein kinases. A total of 113 patients (Hunt and Hess grades I to IV) who had undergone surgery within 3 days of aneurysmal rupture entered the study. Patients were divided into 5 groups according to the total daily dose of AT877: I: 20 mg; II: 40 mg; III: 60 mg; IV: 90 mg; and V: 120–180 mg. AT877 was given by intravenous infusion over 30 min two or three times a day for 14 days after surgery. Although AT877 did not completely abolish angiographic vasospasm, severe vasospasm was seen less frequently in patients given higher doses. Vasospasm was the cause of a poor clinical outcome (Glasgow outcome scale rating 3 or greater) in 19%, 7%, 9%, 8%, and 6% of the patients in groups I to V, respectively. The results indicated a favourable clinical effect of AT877 at doses above 40 mg per day. Only mild hypotension was seen, even when 60 mg of AT877 was infused over 30 min. AT877 appears to be effective in patients with subarachnoid haemorrhage. Part of its effect may be attributable to protection of the brain from ischaemic insults due to chronic cerebral vasospasm. However, the drug still needs to be evaluated in a placebo-controlled double-blind trial (which is currently being carried out).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01402606
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  • 12
    Electronic Resource
    Electronic Resource
    Superior sagittal sinus thrombosis treated with combined local thrombolytic and systemic anticoagulation therapy (1997)
    Springer
    Acta neurochirurgica 139 (1997), S. 332-335 
    Details
    ISSN: 0942-0940
    Keywords: Superior sagittal sinus thrombosis ; local thrombolytic therapy ; anticoagulation therapy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We recently encountered a patient with thrombosis of the superior sagittal sinus of an idiopathic cause. The patient was treated initially with combined local thrombolytic therapy through the burr hole over the superior sagittal sinus and systemic anticoagulant therapy. Continuous ventricular drainage and hyperbaric oxygenation therapy were used to control the increased intracranial pressure. The superior sagittal sinus was successfully recanalized. Whereas the patient suffered a complication with subacute subdural haematoma, he was successfully treated with the combination of these therapies. The rationale and approach are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808829
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  • 13
    Electronic Resource
    Electronic Resource
    Current Treatment Strategies and Factors influencing Outcome in Patients with Bacterial Brain Abscess (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 1263-1270 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Brain abscess; infection; mortality; outcome; intraventricular rupture of brain abscess.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  We clearly determined the key to managing patients with brain abscess by retrospectively evaluating the factors affecting poor outcome in these patients. This study included 113 patients with brain abscess diagnosed in the CT era. Basic characteristics and therapeutic parameters were estimated as independent predictors of poor outcome by using univariate and multivariate logistic regression analysis. Patients with poor outcomes more frequently had deeply-located abscesses (p〈0.02), IVROBA (intraventricular rupture of brain abscess) (p〈0.001) and were in a severely deteriorated neurological state (p〈0.001) than those with good outcomes. Multiple logistic regression analysis predicted that IVROBA (ORs, 24.5; 95% CI, 3.04 to 197.9) and severely deteriorated cases (ORs, 13.7; 95% CI, 2.34 to 80.8) resulting from IVROBA increased the relative risk of poor outcome. Patients with IVROBA more frequently had also deeply-located abscesses (p〈0.005), positively immunocompromised states (p〈0.05) an (p〈0.003) than those without IVROBA. Patients with metastatic abscess had also IVROBA (p〈0.006). Multiple logistic regression analysis anticipated that deeply-located abscess (ORs, 3.90; 95% CI, 1.38 to 11.04), and metastatic abscess (ORs, 12.26; 95% CI, 1.35 to 111.2) increased the relative risk of IVROBA. Patients in an obtunded state and with marked neurological deficit had IVROBA more often than patients in an alert state and/or mild neurological deficit (ORs, 3.23; 95% CI, 1.17 to 8.86, (p〈0.03) before treatment. Our findings suggest that IVROBA strongly influences poor outcome in patients with brain abscess. The key to decreasing poor outcomes may be the prevention and management of IVROBA, by evaluating intracranial pressure pathophysiology. IVROBA should be aggressively treated by aspiration methods for the abscess coupled with appropriate intravenous and intrathecial administration of antibiotics.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050248
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  • 14
    Electronic Resource
    Electronic Resource
    Ganglioside GD3 shedding by human gliomas (1991)
    Springer
    Acta neurochirurgica 109 (1991), S. 34-36 
    Details
    ISSN: 0942-0940
    Keywords: Ganglioside GD3 ; glioma ; shedding
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The proportion of ganglioside GD3 increases in glioma tissue and GD3 content is correlated with malignancy of gliomas. This ganglioside can be detected in the sera of patients with glioma by thin-layer chromatographic analysis. Ganglioside GD3 was not detected in the sera of healthy donors and astrocytoma grade 2 patients. However, serum GD3 was detected in one of three astrocytoma grade 3 patients and seven of nine glioblastoma patients. These results show that shedding of GD3 increases in proportion to the degree of malignancy of gliomas. Nevertheless, all of the glioblastoma patients in this study were advanced cases. Considering the high reliability of radiological diagnostic techniques in the neurosurgical field, further study will be necessary to clarify the relationships between the GD3 level in serum and the properties of tumours.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405694
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  • 15
    Electronic Resource
    Electronic Resource
    Reversibility of cerebral ischaemia dynamic and xenon computed tomography study on ischaemic cerebrovascular disease (1994)
    Springer
    Acta neurochirurgica 127 (1994), S. 151-156 
    Details
    ISSN: 0942-0940
    Keywords: Dynamic CT ; xenon CT ; ischaemic cerebrovascular disease ; reversibility of ischaemia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Flow studies using dynamic CT and xenon (Xe) CT were carried out in 25 patients with ischaemic stroke in the territory of the middle cerebral artery to define the clinical characteristics of cerebral ischaemia at a chronic stage. The parameter of peak height/mean transit time (PH/MTT) obtained from dynamic CT can provide an accurate index for blood circulation in the cerebral vascular bed. Xe CT measurements revealed various kinds of ischaemia around the infarction even in the chronic stages. In mild ischaemia of more than 30ml/100g/min, reduction of cerebral blood flow (CBF) was well correlated to the PH/MTT. However, in severe ischaemia between 20 and 30 ml/100 g/ min, changes of CBF were no longer correlated with the PH/MTT. There were cases showing severe reduction of CBF but which showed sufficient blood circulation (moderate value of PH/MTT). Mild reductions of CBF in parallel with decreased blood supply were often found in the peri-infarct area of infarctions in the centrum semiovale. On the other hand, infarctions in the cortico-subcortical region showed severe ischaemia, in even where blood circulation was relatively well sustained.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808758
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  • 16
    Electronic Resource
    Electronic Resource
    Chronic expanding epidural haematoma (1995)
    Springer
    Acta neurochirurgica 132 (1995), S. 150-153 
    Details
    ISSN: 0942-0940
    Keywords: Epidural haematoma ; chronic epidural haematoma ; chronic expanding haematoma ; haematoma membrane
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary An encapsulated fluid epidural haematoma in a 9-year-old boy was successfully evacuated by a simple burr hole procedure 5 months after a minor head injury. Clinicopathological findings suggested that chronic expansion of an initially unsuspected epidural haematoma occurred as a result of repeated haemorrhages from the haematoma membrane, resulting in an unusually long delayed appearance of clinical evidence. This case demonstrates that a chronic expanding process similar to that seen in chronic subdural haematoma needs to be considered as a possible complication of epidural haematoma and indicates an important role for the haematoma membrane in the chronic expansion of epidural haematoma.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01404865
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  • 17
    Electronic Resource
    Electronic Resource
    Phenytoin as a liquid material for embolisation of tumours (1999)
    Springer
    Neuroradiology 41 (1999), S. 320-323 
    Details
    ISSN: 1432-1920
    Keywords: Key words Meningioma ; embolisation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We carried out embolisation with phenytoin in seven patients with meningiomas; in three by cannulation of the middle meningeal artery during surgery and in four by microcatheter introduced into the middle meningeal artery. Phenytoin (125–500 mg) diluted with saline (25 mg/ml) was injected slowly as a bolus. There was no evidence of devascularisation in two meningiomas treated with 125 mg and 150 mg of phenytoin. Large areas of ischaemic and haemorrhagic necrosis were found in five meningiomas treated with 250–500 mg. After embolisation, the tumour blush disappeared, with preservation of the feeding arteries. Total resection of the tumour was performed with minimum blood loss. Caution and proper use are emphasised to avoid increase in tumour volume and reflux. Phenytoin could be a suitable material for superselective embolisation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002340050756
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  • 18
    Electronic Resource
    Electronic Resource
    Inverse dose-rate effect of DNA breaks and inactivation of transforming activity induced by tritiated water and60COγ-rays (1992)
    Springer
    Radiation and environmental biophysics 31 (1992), S. 299-310 
    Details
    ISSN: 1432-2099
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Physics
    Notes: Summary When an aqueous solution of plasmid DNA at a constant low concentration of 5 µg/cm3 was irradiated with60Coγ-rays, D37 dose of single-strand breaks was decreased from 18 Gy at a dose-rate of 6.77 Gy/h of acute irradiation to 2.3 Gy at a dose-rate of 0.00212 Gy/h. OrG value was increased from 0.0010 to 0.0081. Similar dose-rate dependency of D37 dose andG value were also found when the plasmid DNA solution was treated with various concentrations of tritiated water at various dose-rates, ranging from 5.13 Gy/h to 0.000118 Gy/h. RBE of tritiumß-rays for single-strand breaks was ranged from 0.3 to 0.5 in a wide range of dose-rates. When the DNA solution was saturated with argon to remove oxygen, the dose-rate dependency ofγ-rays was abolished and that of tritiumß-rays was significantly supressed. When the DNA solution in air was kept at 4° C for 50 h or 25 days after acute irradiation, theG value of DNA breaks was the same as that kept at —20° C for the same period, but much lower than that of the solution irradiated for the same period at a lower dose-rate to give the same total doses. This shows that the inverse dose-rate effect could not be induced from the different exposure periods but from continuous irradiation of different dose-rates. The inverse dose-rate effect for inactivation of transforming activity of DNA irradiated with tritiated water was also observed in the range from 0.0588 Gy/h to 0.00118 Gy/h.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01210210
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