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  • 1
    Electronic Resource
    Electronic Resource
    Continuous intrathecal baclofen infusion in severe spasticity after traumatic or hypoxic brain injury (1997)
    Springer
    Journal of neurology 244 (1997), S. 160-166 
    Details
    ISSN: 1432-1459
    Keywords: Key words Intrathecal infusion ; Baclofen ; Supraspinal spasticity ; Cerebral palsy ; Implantable pump
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Severe spinal spasticity has been shown to be a good indication for continuous intrathecal baclofen infusion (CIBI), but there is only limited experience with this treatment in patients with supraspinal spasticity. Eighteen patients with severe spasticity from traumatic or hypoxic brain injury were treated with CIBI. In all patients spasticity could be reduced significantly. The mean Ashworth score was reduced from 4.5 to 2.33 and the mean Spasm frequency score from 2.16 to 0.94. This reduction of spasticity led to a marked pain reduction. Nursing, perineal care and mobilization became much easier. The complication rate was low. In this series we saw one infection in the pump pocket, one epileptic seizure after a bolus application of baclofen and one spinal catheter displacement. The results are similar to those reported from series of patients with spinal spasticity and correspond to the limited experience we have so far with supraspinal spasticity patients. To prevent limb contractures CIBI should be performed as soon as the patient is in a stable clinical condition after brain injury. Further prospective clinical trials will be necessary to obtain more experience with patients suffering from supraspinal spasticity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050067
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  • 2
    Electronic Resource
    Electronic Resource
    Gangliosides in meningiomas: Correlation of Glac 2 to intermediary filament (1992)
    Springer
    Acta neurochirurgica 117 (1992), S. 166-171 
    Details
    ISSN: 0942-0940
    Keywords: Glycosphingolipids ; meningiomas ; intermediary filaments
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Human meninges and 29 meningiomas were analyzed as to their glycosphingolipid composition. In the neutral fraction GSL, a mostly even distribution of mono-, di-, tri-and tetrahexoside was demonstrated. In the group of the gangliosides, Glac 1 in one broad band in chromatogramms occurred in almost all meningiomas; Glac 2 was present in 84% of tumours. Members of the Gtri-family were only found in a small minority of tumours while various Gtet-gangliosides were detectable in nearly half of them. No constant pattern or patterns emerged and no correlation to either morphological subtype or malignancy grade could be established. Immunohistochemistry revealed focal presence of Glac 2 in a pattern similar to that of vimentin expression. Semiquantitative evaluation showed good correlation between both parameters.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01400615
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  • 3
    Electronic Resource
    Electronic Resource
    Probleme bei der postoperativen und posttraumatischen Ernährung von neurochirurgischen Patienten (1966)
    Springer
    Acta neurochirurgica 15 (1966), S. 96-108 
    Details
    ISSN: 0942-0940
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Problems concerning the balances of water, electrolytes and protein are discussed with special consideration of states of dehydration and of hyperhydration. The protein- and electrolyte-sparing effect of carbohydrate and its importance as a source of energy are pointed out. The treatment of the postoperative and the post-traumatic syndrome of protein loss is presented together with its problems. Finally, the uncertainties and the dangers in neurosurgical patients of the parenteral use of fat-losing substances are indicated—(our experiences relate to the preparation “Infonutrol”).
    Abstract: Résumé Les auteurs discutent en insistant tout particulièrement sur les états de déshydratation et d'hyper-hydratation, des problèmes ayant trait à l'équilibre hydrique, électrolytique, et protéique. L'effet d'épargne protidique et électrolytique des hydrates de carbone et son importance comme source d'énergie est souligné. Le traitement du syndrome de déperdition protidique post-opératoire et post-traumatique, est envisagé en mÊme temps que ces problèmes. Finalement, les incertitudes et les dangers de l'administration intra-veineuse de solutions lipidiques chez les malades neuro-chirurgicaux sont exposés, (l'expérience des auteurs se rapporte à une préparation connue sous le nom d'Infonutrol).
    Notes: Zusammenfassung Es werden Bilanzierungsprobleme des Wasser-, Elektrolyt-. und Eiweißhaushaltes besprochen mit besonderer Berücksichtigung von Dehydrations- und Hyperhydrationszuständen. Die eiweiß- und elektrolytsparende Wirkung der Kohlehydrate und ihre Bedeutung als Energiequelle werden aufgezeigt. Die Behandlung des postoperativen und posttraumatischen Eiweißverlustsymdroms und seine Problematik wird dargestellt. Abschließend werden Unklarheiten und Gefahren der parenteralen Applikation von Fettlösungen — unsere Erfahrungen beziehen sich auf das Präparat Infonutrol — bei neurochirurgischen Kranken aufgezeigt.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01405072
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  • 4
    Electronic Resource
    Electronic Resource
    Glycosphingolipid component profiles of human gliomas correlate with histological tumour types: Analysis of inter-individual and tumour-regional distribution (1994)
    Springer
    Acta neurochirurgica 126 (1994), S. 170-178 
    Details
    ISSN: 0942-0940
    Keywords: Gliomas ; glycosphingolipids ; gangliosides
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Three types of glycosphingolipid (GSL) component profiles have been established for human intracranial gliomas. GSL-type I shows only Glac- and lacto-series-sialoglycolipids. Type II consist of Glac- and Gtri-gangliosides, whereas only GSL-type III contains sulphatide and, as a major neutral glycolipid, galactocerebroside, besides gangliosides of the Glac-, Gtri-, and Gtet-families. Whole gliomas of malignancy grading I/II, III and IV, display GSL-Types III, II, and I, respectively. Thus, the GSL component distribution of the samples taken after surgery from three individual gliomas and two biopsies correlate closely with the general diagnosis of these tumours. Arthrobacter ureafaciens sialidase was used for the characterization of gangliosides. GSL-type analysis of multiple regional samples, taken from necropsy and biopsy, were determined by microanalysis of microscopic cryostat section, and shown to be in good agreement with their histology. The results validate the relevance of tumour ganglioside analysis for the characterization and diagnosis of gliomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476429
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  • 5
    Electronic Resource
    Electronic Resource
    Peri-operative changes of cellular and humoral components of immunity with brain tumour surgery (1994)
    Springer
    Acta neurochirurgica 126 (1994), S. 93-101 
    Details
    ISSN: 0942-0940
    Keywords: Brain tumour ; dexamethasone ; immune response ; lymphocytes ; nosocomial infections ; T helper cells
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Nosocomial infections, which are not uncommon in neurosurgical intensive care medicine, may possibly be favoured by an impairment of immunological competence of the patient. In a prospective observational trial, we investigated several parameters of cellular and humoral immunity in 32 patients before and after resection of an intracranial tumour. We quantified the effects of operative procedure, dexamethasone pretreatment, and tumour type. Dexamethasone alone causes an increase of neutrophilic granulocyte count and monocytes, whereas IgG and eosinophilic granulocytes decrease as well as lymphocytes. CD4+ T lymphocytes (T helper cells) and CD8 + T lymphocytes (T cytotoxic/suppressor cells) were more severely affected than B lymphocytes. Dexamethasone and operation in combination act synergistically on T lymphocytes and IgG, while no synergism is obvious in other clinical test parameters. The skin sensitivity reaction was depressed accordingly. With intracerebral tumours (gliomas WHO grades II to IV), levels of T helper cells and eosinophilic granulocytes were lower, and levels of IgM and neutrophilic granulocytes were higher than with benign extracerebral neoplasms. Postoperative nosocomial infections of the lower respiratory tract occurred almost exclusively in patients subject to severe depression of T helper cells.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01476416
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  • 6
    Electronic Resource
    Electronic Resource
    Cystic meningioma with unusual histopathological features (1989)
    Springer
    Virchows Archiv 416 (1989), S. 169-175 
    Details
    ISSN: 1432-2307
    Keywords: Cystic (“forme humide”) meningioma ; Hyaline inclusions (Pseudopsammoma bodies) ; Immunohistochemistry: vimentin ; Fibronectin ; Cytokeratin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A parasagittal meningioma of an eighty year old female patient showed by light and electron microscopy cystic architecture (forme humide) as well as nuclear vacuoles (indentations) and cytoplasmic inclusions. The latter are the known pseudopsammoma bodies or hyaline inclusions as demonstrated by light and electron microscopy. Light microcopy on paraffin sections and cytological smear preparations revealed, in addition to the cells of endotheliomatous meningioma and those containing the inclusions a third type with small granular cytoplasmic content. Electron microscopy showed characteristic features of meningioma such as folded double membranes, desmosomes and filaments and thus gave evidence of the meningiomatous nature of the tumor. By immunohistochemistry tumor cells in slightly focal distribution contained vimentin, whereas small clusters of cells with hyaline inclusions were strongly positive for cytokeratin. The dispersed cells of granular cytoplasmic content were positive for fibronectin. These findings, especially of the inclusion containing cytokeratin positive cell clusters may shed new light upon the concept of histogenesis and classification.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01606323
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  • 7
    Electronic Resource
    Electronic Resource
    Monoclonal antibodies against epitopes on ganglioside GD2 and its lactones (1989)
    Springer
    Cancer immunology immunotherapy 29 (1989), S. 171-178 
    Details
    ISSN: 1432-0851
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Monoclonal antibodies (mAbs) BW 625 and BW 704, of the IgG3 isotype, bound to immunochemically indistinguishable epitopes on ganglioside II3(NeuAc)2-GgOse3-Cer. Despite this fact the mAbs showed a differential binding pattern on human glioma cell lines i.e. immunohistochemical data indicate that the detected epitopes are not identical. Furthermore, either mAb is able to mediate the antibody-dependent cellular cytotoxicity reaction (ADCC) and the human-complement-dependent cytotoxicity reaction (CDC) with epitope-expressing tumor cells. All cryopreserved tissue specimens from gliomas and neuroblastomas were immunohistochemically stained, whereas the other small round cell tumors of childhood, as well as melanomas and small-cell lung carcinomas, were essentially negative. Positive staining of normal cryopreserved tissues was restricted to amyelinic axons, Hassal's bodies and some connective tissue fibers in thymus and the tegumentary epithelium of skin. The high selectivity of mAb BW 704 for gliomas and neuroblastomas, the lack of cross-reactivity with major tissues and the strong ADCC and CDC potential argue for the use of mAb BW 704 in immunotherapy of neuroblastomas and gliomas.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00199992
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  • 8
    Electronic Resource
    Electronic Resource
    Suitability of non-glucose-carbohydrates for parenteral nutrition (1975)
    Springer
    Intensive care medicine 1 (1975), S. 105-113 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Postoperative parenteral nutrition can only be optimally effective if the characteristics of post-traumatic metabolism are taken into account. Two main possibilities are discussed for the carbohydrate component of parenteral nutrition during this phase: glucose with high doses of insulin or non-glucose carbohydrates (sugar substitutes) possibly in a suitable combination with glucose. The risks as well as the technical and organisational problems involved in the use of them are discussed and the authors prefer the second of the two alternatives. Possible side effects of nonglucose carbohydrates are pointed out and it is shown how these can be avoided by observing dose guidelines. So far a combination of fructose : glucose : xylitol in a ratio of 2 : 1 : 1 with a total dose of 0.50 g/kg/hour has been studied most thoroughly. This combination normalises the fat metabolism and improves glucose tolerance without requiring exogenous insulin. Experiences with this combination as well as individual non-glucose carbohydrates in the postoperative phase are mentioned. Controlled infusions of non glucose carbohydrates on operated patients have been given continuously for up to 7 days and in some cases even for several weeks. No side effects, no deviations from a steady state and no abnormal changes of the laboratory values occurred. The authors are of the opinion that non glucose carbohydrates are necessary if the facilities for frequent blood sugar controls are not available.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00571657
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  • 9
    Electronic Resource
    Electronic Resource
    Dumb-bell ganglioneuroma of the spine misinterpreted as progressive idiopathic scoliosis (1989)
    Springer
    Archives of orthopaedic and trauma surgery 108 (1989), S. 189-194 
    Details
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Es wird über ein riesenhaftes Ganglioneurom als Ursache für eine progrediente Lumbalskoliose bei einem 16jährigen Mädchen berichtet. Zwischen dem Beginn der orthopädischen Skoliosebehandlung und der Diagnose der wahren Ursache der Skoliose sind mehr als 4 Jahre vergangen, so daß ein riesenhafter, teils intrakanalikulär, teils retroperitoneal wachsender Tumor sowie die Destruktion von 4 Lendenwirbelkörpern entstehen konnte. Neben der Beschreibung der kombinierten neurochirurgischen allgemeinchirurgischen und orthopädich-chirurgischen Therapie werden die Ergebnisse der licht-, immun- und elektronenmikroskopischen Untersuchungen sowie neurochemischen Analysen des resezierten Tumors mitgeteilt.
    Notes: Summary A giant ganglioneuroma generating a progressive scoliosis in a 16-year-old girl is presented. The interval between the start of the orthopaedic treatment and the diagnosis of the true nature of the disease was more than 4 years, thus allowing the development of a giant partly intracanalicularly partly retroperitonealy expanding tumormass. The report emphasizes and describes the combined neurosurgical, general surgical and orthopaedic surgical treatment and presents the results of light- and electron microsopical, immunohistochemical and quantitative neurochemical investigations of the resected tumor.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00934267
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