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  • 1
    Electronic Resource
    Electronic Resource
    Autonomic dysfunction in polyneuropathies: a report on 106 cases (1983)
    Springer
    Journal of neurology 230 (1983), S. 111-121 
    Details
    ISSN: 1432-1459
    Keywords: Autonomic dysfunction ; Guillain-Barré syndrome ; Diabetic polyneuropathy ; Alcoholic polyneuropathy ; Cardiac pacemaker
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Autonome Funktionsstörungen sind eine häufige Begleiterscheinung im Rahmen von Polyradiculoneuropathien. Die vorliegende Studie untersucht anhand von 106 Fällen die Art und Häufigkeit derartiger Störungen. Die pathophysiologischen Mechanismen werden diskutiert, wobei sich ein denervationsbedingter Funktionsausfall betroffener Organe in Verbindung mit einer Denervierungsüberempfindlichkeit der Reflexmechanismen als beste Erklärung anbietet. Als therapeutische Konsequenz wird der frühzeitige Einsatz eines temporären Herzschrittmachers empfohlen, um lebensbedrohlichen kardialen Komplikationen begegnen zu können.
    Notes: Summary Autonomic dysfunction is a common feature in various forms of polyradiculoneuropathy. This study investigated the kinds and frequency of autonomic dysfunction in 106 cases. Denervation insufficiency of organs associated with supersensitivity of reflex mechanisms was found to be the best explanation of the pathophysiology. Early insertion of a transient cardiac pacemaker is recommended to counteract life-threatening cardiac failure.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00313638
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  • 2
    Electronic Resource
    Electronic Resource
    Intra-Operative Colour-Duplex-Sonography in the Surgical Management of Cerebral AV-Malformations (1998)
    Springer
    Acta neurochirurgica 140 (1998), S. 689-698 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Arteriovenous malformations; intraoperative ultrasound; colour-duplex-sonography; neuronavigation.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  In this prospective study the role of intra-operative Colour-Duplex-Sonography (=CDS) during surgery of arteriovenous malformations (=AVM) is evaluated.  During the last three years 20 consecutive patients with supratentorial AVMs were examined by intra-operative CDS in order to evaluate the potential of CDS to 1) localize the AVM, 2) differentiate between embolized and perfused parts, 3) identify feeding and draining vessels and 4) control the complete excision of the AVM.  All AVMs were localized supratentorially, 9 were grade I and II (according to Spetzler and Martin [31]), 8 grade III and 3 grade IV. 11 were partly embolized and 8 associated with an intracerebral bleeding.  In all cases the nidus was correctly localized sonographically by its typical bidirectional flow pattern in Colour-mode. CDS guided the surgeon directly to all (11 cases) deep-seated AVMs (2 to 4cm subcortically). The smallest nidus measured 10 mm.  28 of 34 angiographically defined main feeding and 18 of 23 draining vessels were identified. 14 patients were controlled sonographically at the end of the resection regarding the completeness of excision. In 11 patients CDS was negative and was confirmed by either postoperative angiography or MRI in 10 patients. In one case residual AVM tissue was missed by CDS. Positve CDS findings in 3 cases were all confirmed by microscopic re-inspection, angiography and CCT.  Our results suggest that CDS is able to localize AVMs intra-operatively with minimal instrumentation. It allows safe navigation to deep-seated malformations with high accuracy. Feeding and draining vessels can be identified and completeness of resection can be controlled.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050164
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  • 3
    Electronic Resource
    Electronic Resource
    Localization and Characterization of Intracerebral Cavernous Angiomas by Intra-Operative High-Resolution Colour-Duplex-Sonography (1999)
    Springer
    Acta neurochirurgica 141 (1999), S. 143-152 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Cavernous angioma; Colour-Duplex-Sonography intra-operative ultrasound; neuronavigation.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary  The aim of this prospective study was to evaluate the reliability of high-resolution Colour-Duplex-Sonography (= CDS) in intra-operative localization, guiding and characterization of intracerebral cavernous angiomas (= CA).  During a time period from 5/93 to 12/96 a total of 26 patients with 21 supratentorial and 5 infratentorial CA (15 of them deep-seated) were examined intra-operatively by CDS. The study focussed on 1. sonographic characterization, 2. localization in relationship to anatomical landmarks, 3. navigation, 4. correlation of sonographic to magnetic resonance imaging (= MRI), intra-arterial angiography (= DSA) and histological results and 5. control of complete resection.  All CA appeared sonographically as hyperechoic lesions without flow-signals in Colour-mode. Imaging of anatomical landmarks as cerebral sulci, brain stem, insular cistern, falx, ventricles and vessels could be used for precise localization and successful guiding to 15 deep-seated lesions. The correlation of the size between MRI and CDS was excellent (1.4 mm mean difference, range from 0 to 5 mm). All 4 associated venous anomalies, as verified by pre-operative DSA, could be visualized and identified by CDS. The completeness of exstirpation was controlled sonographically in 14 cases and confirmed by MRI (= 10) and CT (= 4).  This study provides the first comprehensive intra-operative characterization of CAs by CDS and correlation to MRI and DSA. Furthermore it demonstrates the reliability of CDS for intra-operative localization and guiding as well as its potential to control the complete exstirpation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010050278
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  • 4
    Electronic Resource
    Electronic Resource
    Correlation of intra-operative ultrasound with histopathologic findings after tumour resection in supratentorial gliomas (1996)
    Springer
    Acta neurochirurgica 138 (1996), S. 1391-1398 
    Details
    ISSN: 0942-0940
    Keywords: Gliomas ; intra-operative ultrasound ; tumour resection ; biopsy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The aim of this study was to evaluate whether intra-operative ultrasound (=IOUS) is a suitable tool to detect residual tumour tissue after gross total resection in supratentorial gliomas. During a period of 18 months 45 patients with supratentorial gliomas (38 high-grade and 9 low-grade, according to the WHO-grading system [42]) were operated on. A series of 78 biopsies was taken from the resection cavity under continuous sonographic control at the end of surgery. Gross total tumour resection was intended in 34 patients (=76%). The biopsy specimens were matched with the sonographic features at each biopsy site. The sonographic appearance of the resection margins were classified into 2 groups: (1) Irregular hyperechoic areas extending from the cavity into the iso-echogenic brain tissue and (2) a dense small (≤3 mm in diameter) rather regular hyperechoic rim surrounding the resection cavity. 47 out of 53 biopsies taken from hyperechoic areas (group 1) (36 high-grade/11 low-grade) revealed solid tumour tissue (=89%). 34 (=72%) of these 47 areas were microscopically assessed as inconspicuous by the surgeon. 6 samples (4 high-grade/2 low-grade) contained tumour infiltration zone. 25 biopsies (23 high-grade/2 low-grade) taken from the hyperechoic rim [group 2] were diagnosed as follows: Normal brain tissue in 11, tumour infiltration zone in 8 and solid tumour tissue in 6 cases. Of 34 cases with “gross total removal” according to the surgeon's assessement 25 showed sonographic signs of residual tumour tissue, which was confirmed histologically as solid tumour tissue in 22 of these cases. It is concluded, that IOUS following resection of supratentorial gliomas can detect residual tumour tissue with high specificity and thus improve gross total resection. However, a thin hyperechoic rim surrounding the resection cavity (less than 3 mm in diameter) is a non-specific finding, which can mask thin residual tumour layers and therefore needs further evaluation of its nature.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01411117
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  • 5
    Electronic Resource
    Electronic Resource
    Early Postoperative Transcranial Sonography (TCS), CT, and MRI after Resection of High Grade Glioma: Evaluation of Residual Tumour and its Influence on Prognosis (2000)
    Springer
    Acta neurochirurgica 142 (2000), S. 1089-1097 
    Details
    ISSN: 0942-0940
    Keywords: Keywords: Brain neoplasms; magnetic resonance imaging; tomography, X-ray computed; ultrasonics.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary ¶ Purpose. In this prospective study the results of multimodal postoperative neuro-imaging were related to the survival of patients with high grade gliomas.  Methods. All 73 patients included underwent microsurgical tumour resection and had postoperative CT and transcranial sonography (TCS) examinations. In addition, 35 of the 73 patients received an early postoperative MRI. Patients were followed up for at least one year.  Findings. At the end of the 7 year study period 56 patients had died. The median survival time was 371 days. Survival rate was significantly higher in patients with anaplastic astrocytomas and inpatients displaying complete tumour resection on MRI (log-rank-test, p〈0.05) or a small postoperative residual tumour bulk on TCS (log-rank-test, p〈0.05). Cox proportional hazards model identified histological tumour grade, postoperative Karnofsky index, complete resection based on MRI and small postoperative residual tumour mass on TCS as independent predictors of survival.  Interpretation. This study demonstrates that early postoperative neuro-imaging has prognostic implications for the survival of patients with high grade gliomas. According to our results postoperative imaging with MRI and TCS is a valuable prognostic with regard to patient survival and should therefore be implemented in postoperative follow-up. It also helps to evaluate the efficacy of adjuvant therapy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s007010070035
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  • 6
    Electronic Resource
    Electronic Resource
    Ureteral injury in lumbar disc surgery (1985)
    Springer
    Acta neurochirurgica 78 (1985), S. 108-112 
    Details
    ISSN: 0942-0940
    Keywords: Ureteral injury ; lumbar disc surgery ; anatomical relationship ; prevention
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Among retroperitoneal injuries in lumbar disc surgery ureteral transection is a rare complication and only 8 cases have been reported so far. They are analysed and a ninth case is added and described. In this case the complication was recognized immediately and successfully treated by end-to-end anastomosis of the ureter with an internal stent. Usually the diagnosis was delayed due to uncharacteristic symptoms (fever, haematuria, abdominal pain and distension, ileus, palpable mass etc.) which led to septic courses and nephrectomy in 3 cases. The anatomical relationship of the lumbar spine and retroperitoneal structures is illustrated by CT scans. Factors contributing to these injuries and ways of recognizing and preventing complications are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01808688
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  • 7
    Electronic Resource
    Electronic Resource
    MMPI profiles of cocaine-addicted individuals in residential treatment: Implications for practical treatment planning
    Amsterdam : Elsevier
    Journal of Substance Abuse Treatment 7 (1990), S. 151-154 
    Details
    ISSN: 0740-5472
    Keywords: Cocaine ; MMPI ; personality ; treatment planning
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Medicine , Psychology
    Type of Medium: Electronic Resource
    URL: http://linkinghub.elsevier.com/retrieve/pii/0740-5472(90)90015-I
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  • 8
    Electronic Resource
    Electronic Resource
    Reliability of transcranial colour-coded real-time sonography in assessment of brain tumours: correlation of ultrasound, computed tomography and biopsy findings (1994)
    Springer
    Neuroradiology 36 (1994), S. 585-590 
    Details
    ISSN: 1432-1920
    Keywords: Brain tumours ; Ultrasonography ; Computed tomography ; Stereotactic biopsy ; Transcranial colour-coded real time sonography ; Glloma ; Central nervous system ; Duplex sonography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Transcranial colour-coded real-time sonography (TCCS) was carried out in 25 patients with brain tumours to determine whether this noninvasive method provides additional information about the extent of solid tumour, its differentiation from oedema, and its tissue components. All 25 patients had serial computed tomography (CT)-guided stereotactic biopsies. Comparison of ultrasound, CT and histological findings revealed that the vast majority of contrast enhancing areas on CT were hyperechogenic (32/33; 97%) and contained tumour tissue (29/32; 91%). Hyperechogenic areas always represented solid tumour (23/23 patients), even when CT showed low density non-enhancing lesions. In lestons hypoechogenic on TCCS and low density on CT, histology consistently revealed necrotic tumour (7/7). Biopsies obtained from parenchyma with normal echogenicity revealed tumour in only 3 of 16 speciemens. Despite the high specificity of TCCS in the differentiation of tumour components, its sensitivity to tumour was inferior to that of CT (24/25; 96%). TCCS thus allows noninvasive preoperative identification of tumour tissue and its extent setting.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00600414
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  • 9
    Electronic Resource
    Electronic Resource
    Reservoir systems for intraventricular chemotherapy (1998)
    Springer
    Journal of neuro-oncology 38 (1998), S. 141-143 
    Details
    ISSN: 1573-7373
    Keywords: neoplastic meningiosis ; intraventricular chemotherapy ; ventriculostomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This paper describes the current techniques for intraventricular drug administration in patients with meningiosis. Advantages and disadvantages of different reservoir systems, the standard implantation procedure and more recently developed image-guided techniques are discussed. In patients with slit ventricles, the CT-based stereotactic approach is recommended for reservoir implantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1005991027029
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