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  • 11
    ISSN: 1433-0350
    Schlagwort(e): Key words Hydrocephalus model ; Kaolin ; Micro-balloon ; Rat
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We used three types of specialized micro-balloons 0.7–1.35 mm in outer diameter instead of kaolin to develop a reproducible rat model of hydrocephalus with a low experimental mortality. The micro-balloon was inserted 6 mm deep into the cisterna magna via a burr hole immediately behind the lambda. The angle of introduction was 50°. We also set up kaolin-induced hydrocephalic models in 25 rats as controls. The kaolin model revealed 52% mortality with an 80% induction rate of hydrocephalus, while the balloon model showed 9% mortality with a 60% induction rate. Balloon-induced hydrocephalus was maximal at 1 week and tended to decrease after 2–3 weeks. The pathological findings were not different between the two models. We concluded that the micro-balloon model for hydrocephalus is an easily reproducible model with low experimental mortality.
    Materialart: Digitale Medien
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  • 12
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 3 (1987), S. 259-265 
    ISSN: 1433-0350
    Schlagwort(e): Trigonocephaly ; Operation ; Technique
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The clinical features, surgical and anatomical concepts based on an evaluation of the development of the anterior cranial fossa in metopic synostosis are discussed. Thirteen cases of trigonocephaly of infancy during last 4 years are described. Five children were mentally retarded. A more marked triangular cranial configuration with acute nasopterional angle was associated with more severe mental retardation and other unfavorable conditions, including cardiopulmonary disorders and chromosome anomalies. From a quantitative analysis of the anterior cranial fossa development obtained from CT measurement in comparison with values in normal infants, the following procedures appeared to be important: (1) correction of acute nasopterional angle, achieving a flat forehead; (2) forward advancement of both pterions and anterolateral parts of the frontal bones, rebuilding the orbital roof and frontal eminences; (3) shortening of the overgrown midline structure by removal of the bony ridge of the metopic suture. Our procedure on the basis of these measurements for determination of surgical intervention is described.
    Materialart: Digitale Medien
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  • 13
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 5 (1989), S. 76-82 
    ISSN: 1433-0350
    Schlagwort(e): Premature infants ; Hydrocephalus ; Etiology ; Pathophysiology ; Shunt and shunt problems
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Twenty-onepremature infants with various underlying conditions developed hydrocephalus. The characteristic clinical pictures as well as the therapeutic problems are discussed. The causative underlying conditions included intraventricular hemorrhage in the neonate or fetus, bronchopulmonary dysplasia, congenital malformations such as holoprosencephaly with chromosome anomalies, and others. The pathophysiological aspects were considered to be characterized by the underdevelopment of major cerebrospinal fluid pathway, extremely high intracranial compliance, and demyelinating process of the nervous system. The shunt problems in these patients with such low body weight were also unique, showing an extremely high incidence of postshunt hydrocele, shunt migration into the scrotum, shunt malfunction, slit-like ventricle, and isolated ventricles. Intensive management, combined with better control of the hydrocephalus with these concepts, will help to improve the long-term outcome of these premature infants.
    Materialart: Digitale Medien
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  • 14
    ISSN: 1433-0350
    Schlagwort(e): Congenital brain tumor ; Teratoma ; Intrauterine diagnosis ; Alpha-fetoprotein
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The authors describe a case of congenital intracranial teratoma. The patient was diagnosed to be hydrocephalic at 29 weeks' gestation, and to have a huge intraventricular mass lesion at 34 weeks' gestation. Subsequently, the patient underwent subtotal resection of the mass, resulting in a significant decrease in the remarkably elevated alpha-fetoprotein in serum and cerebrospinal fluid. Histological analysis revealed a malignant teratoma, also with alpha-fetoprotein-positive elements in the immunohistochemical study.
    Materialart: Digitale Medien
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  • 15
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 8 (1992), S. 337-342 
    ISSN: 1433-0350
    Schlagwort(e): Spina bifida ; Neurological deficit ; Scoring system ; Grading ; Tethered cord
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Neurological symptoms present in neonates with spinal dysraphism often progress with growth. A simple, objective scoring system for quantitative analysis of spinal neurological deficits, called the Spina Bifida Neurological Scale (SBNS), is proposed. Scoring is based on (1) motor function, (2) reflexes, and (3) bladder and bowel function. These are each divided into six, four, and five points respectively with respect to the level of spinal funcion. Motor function and reflexes are bilaterally analyzed, and the maximum SBNS score of 15 points reflects a normal spinal neurological state (grade I). This scoring system was correlated with the clinical condition of 89 patients with spinal bifida who were graded from I to V. A total score of less than 5 was associated with a nonambulatory state (grade IV or V) in 84.0% of patients, and a score of 5–9 was associated with an ambulatory state (grade III) in 93.8% of patients. Scores of 10–14 reflected control of bladder and bowel function (grade II) in all patients. The application of a standardized scoring scheme will assist in the evaluation of patients' clinical status and will enable analysis of chronological changes in neurological function.
    Materialart: Digitale Medien
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  • 16
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 9 (1993), S. 128-128 
    ISSN: 1433-0350
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 17
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 1 (1985), S. 189-193 
    ISSN: 1433-0350
    Schlagwort(e): Childhood hydrocephalus ; Slit ventricle ; Isolated unilateral hydrocephalus ; Isolated fourth ventricle ; CSF hydrodynamics
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract In a follow-up study of 164 hydrocephalic children without tumors treated with ventriculoperitoneal shunts, 46 (28.0%) developed slit ventricles, 5 (3.0%) developed isolated fourth ventricles, and 4 (2.4%) developed isolated unilateral hydrocephalus. All of the patients with isolated unilateral hydrocephalus and 3 with isolated fourth ventricles had associated slit ventricles, 2 of whom had enlarged ventricles as double-compartment hydrocephalus. Reopening of the foramen of Monro or the aqueduct was achieved in one of the former and two of the latter cases with re-expansion of the slit ventricles. It is suggested that in some cases, the slit ventricle could be a causative factor in post-shunt isolated ventricle.
    Materialart: Digitale Medien
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  • 18
    Digitale Medien
    Digitale Medien
    Springer
    Child's nervous system 14 (1998), S. 33-35 
    ISSN: 1433-0350
    Schlagwort(e): Key words Pineal region tumors ; Japan ; Korea ; Treatment
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The therapeutic modalities for pineal region tumors in Western countries differ from those in Japan, mainly because of the different patient populations. The majority of pineal region tumors in Japan are radio- and/or chemosensitive, and adjuvant therapy rather than extensive surgery plays the main part in the treatment of these tumors. The specific clinical features of and therapeutic modalities for pineal region tumors, together with racial differences, were analyzed at the joint symposium of the Japanese Society for Pediatric Neurosurgery and the Korean Society for Pediatric Neurosurgery. The results of a cooperative study, together with the collective experience in Korea, confirmed that this specific patient population is nearly identical to the Japanese one. The new therapeutic approaches to pineal region tumors recommended included neuroendoscopic or stereotactic biopsy as a “minimally invasive” initial procedure. The adjuvant therapeutic modalities were further analyzed and neoadjuvant chemotherapy, mainly with cisplatin or carboplatin with or without etoposide (VP-16), was recommended for the treatment of germinoma and nongerminomatous malignant germ cell tumors. “Target radiation therapy” with extensive chemotherapy is a hopeful regimen and a future subject of research.
    Materialart: Digitale Medien
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  • 19
    ISSN: 1433-0350
    Schlagwort(e): Dysraphism ; Neuronal maturation ; Neuron-specific enolase ; Somatostatin ; Overgrowth
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Starting from knowledge obtained in our previous studies of experimental dysraphism in chick embryos, the entity of neuronal over-growth observed in exencephaly was further investigated. The ontogenic expression of neuron-specific enolase (NSE), vasoactive intestinal polypeptide (VIP), and somatostatin was analyzed both in chick exencephaly of the natural product and in normal chick fetuses by carrying out immunohistochemical studies. In normal fetuses, immunostained elements positive for NSE first appeared in the spinal gray matter on postincubation day 16 and increased in intensity during the fetal period. By postnatal day 2, the cerebral peduncle, brain stem neurofibers, molecular layer of the cerebellum, corpus striatum, and piriform cortex became immunoreactive. No immunohistochemical reaction to VIP was observed during these stages. Somatostatin-positive elements were not identified during the fetal period, except in limited regions, such as the corpus striatum, which appeared to have weakly positive straining on day 21. The exencephalic fetuses, however, demonstrated extremely advanced neuronal maturation, with intense immunoreactivity already being manifest in various regions, including the corpus striatum, piriform cortex, spinal gray matter, and brain stem nuclei, on day 16 of the fetal period. Somatostatin-positive elements also appeared at this stage in chick exencephaly, but such immunoreactivity was localized, particularly in the overgrown foci. The present study showed that the neuronal maturation process in some neurons of exencephalic brain and spinal cord was definitely further advanced than that in normal controls. A possible clinical application of NSE and somatostatin measurement as markers for dysraphic states in the fetus is suggested.
    Materialart: Digitale Medien
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  • 20
    ISSN: 1433-0350
    Schlagwort(e): Aqueductal stenosis ; Congenital hydrocephalus ; Experimental hydrocephalus ; Inbred rat (LEW/Jms)
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We studied the microscopic morphological changes in congenital hydrocephalus in the inbred rat, LEW/Jms, on gestational days 17, 18, and 20 and during the neonatal period to clarify the etiopathogenesis, focusing particularly on the aqueductal changes. At 1 day of age, ventriculomegaly was limited to the lateral and III ventricles, and the aqueduct was obstructed, with the appearance of simple stenosis. On gestational days 20 and 18, the hydrocephalic rats showed occluded aqueducts, which paralleled the finding of hydrocephalus in the newborn rats. On gestational day 17, all eight models examined showed the same size ventricles. However, an aqueductal obstruction was observed in one of them. The other seven rats showed the aqueduct patent. From these observations, it can be concluded that the rat shows an aqueductal obstruction on gestational day 17 and appears to develop hydrocephalus with age. The aqueductal obstruction was considered to be the primary change and not a secondary phenomenon. The site of obstruction was the anterior part of the aqueduct (level of anterior colliculus) at every stage. Aqueductal obstruction following the developmental anomaly of the midbrain in the embryonic stage might thus be the primary cause of congenital hydrocephalus in rats LEW/Jms.
    Materialart: Digitale Medien
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