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  • 1
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    The diagnostic value of ictal SPECT —A retrospective, semiquantitative monocenter study
    Wiley ; 2023
    In:  Epilepsia Open Vol. 8, No. 1 ( 2023-03), p. 183-192
    Details
    In: Epilepsia Open, Wiley, Vol. 8, No. 1 ( 2023-03), p. 183-192
    Abstract: Ictal single photon emission computed tomography (SPECT) can be used as an advanced diagnostic modality to detect the seizure onset zone in the presurgical evaluation of people with epilepsy. In addition to visual assessment (VSA) of ictal and interictal SPECT images, postprocessing methods such as ictal‐interictal SPECT analysis using SPM (ISAS) can visualize regional ictal blood flow differences. We aimed to evaluate and differentiate the diagnostic value of VSA and ISAS in the Bonn cohort. Methods We included 161 people with epilepsy who underwent presurgical evaluation at the University Hospital Bonn between 2008 and 2020 and received ictal and interictal SPECT and ISAS. We retrospectively assigned SPECT findings to one of five categories according to their degree of concordance with the clinical focus hypothesis. Results Seizure onset zones could be identified more likely on a sublobar concordance level by ISAS than by VSA (31% vs. 19% of cases; OR = 1.88; 95% Cl [1.04, 3.42]; P  = 0.03). Both VSA and ISAS more often localized a temporal seizure onset zone than an extratemporal one. Neither VSA nor ISAS findings were predicted by the latency between seizure onset and tracer injection ( P  = 0.75). In people who underwent successful epilepsy surgery, VSA and ISAS indicated the correct resection site in 54% of individuals, while MRI and EEG showed the correct resection localization in 96% and 33% of individuals, respectively. It was more likely to become seizure‐free after epilepsy surgery if ISAS or VSA had been successful. There was no MR‐negative case with successful surgery, indicating that ictal SPECT is more useful for confirmation than for localization. Significance The results of the most extensive clinical study of ictal SPECT to date allow an assessment of the diagnostic value of this elaborate examination and emphasize the importance of postprocessing routines.
    Type of Medium: Online Resource
    ISSN: 2470-9239 , 2470-9239
    URL: Issue
    URL: Article
    DOI: 10.1002/epi4.v8.1
    DOI: 10.1002/epi4.12694
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2863427-5
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  • 2
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    A novel geometry‐based analysis of hippocampal morphometry in mesial temporal lobe epilepsy
    Wiley ; 2023
    In:  Human Brain Mapping Vol. 44, No. 12 ( 2023-08-15), p. 4467-4479
    Details
    In: Human Brain Mapping, Wiley, Vol. 44, No. 12 ( 2023-08-15), p. 4467-4479
    Abstract: Hippocampal volumetry is an essential tool in researching and diagnosing mesial temporal lobe epilepsy (mTLE). However, it has a limited ability to detect subtle alterations in hippocampal morphometry. Here, we establish and apply a novel geometry‐based tool that enables point‐wise morphometric analysis based on an intrinsic coordinate system of the hippocampus. We hypothesized that this point‐wise analysis uncovers structural alterations not measurable by volumetry, but associated with histological underpinnings and the neuropsychological profile of mTLE. We conducted a retrospective study in 204 individuals with mTLE and 57 age‐ and gender‐matched healthy subjects. FreeSurfer‐based segmentations of hippocampal subfields in 3T‐MRI were subjected to a geometry‐based analysis that resulted in a coordinate system of the hippocampal mid‐surface and allowed for point‐wise measurements of hippocampal thickness and other features. Using point‐wise analysis, we found significantly lower thickness and higher FLAIR signal intensity in the entire affected hippocampus of individuals with hippocampal sclerosis (HS‐mTLE). In the contralateral hippocampus of HS‐mTLE and the affected hippocampus of MRI‐negative mTLE, we observed significantly lower thickness in the presubiculum. Impaired verbal memory was associated with lower thickness in the left presubiculum. In HS‐mTLE histological subtype 3, we observed higher curvature than in subtypes 1 and 2 (all p   〈  .05). These findings could not be observed using conventional volumetry (Bonferroni‐corrected p   〈  .05). We show that point‐wise measures of hippocampal morphometry can uncover structural alterations not measurable by volumetry while also reflecting histological underpinnings and verbal memory. This substantiates the prospect of their clinical application.
    Type of Medium: Online Resource
    ISSN: 1065-9471 , 1097-0193
    URL: Issue
    URL: Article
    DOI: 10.1002/hbm.v44.12
    DOI: 10.1002/hbm.26392
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 1492703-2
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  • 3
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    A survey of the European Reference Network EpiCARE on clinical practice for selected rare epilepsies
    Wiley ; 2021
    In:  Epilepsia Open Vol. 6, No. 1 ( 2021-03), p. 160-170
    Details
    In: Epilepsia Open, Wiley, Vol. 6, No. 1 ( 2021-03), p. 160-170
    Abstract: Clinical care of rare and complex epilepsies is challenging, because evidence‐based treatment guidelines are scarce, the experience of many physicians is limited, and interdisciplinary treatment of comorbidities is required. The pathomechanisms of rare epilepsies are, however, increasingly understood, which potentially fosters novel targeted therapies. The objectives of our survey were to obtain an overview of the clinical practice in European tertiary epilepsy centers treating patients with 5 arbitrarily selected rare epilepsies and to get an estimate of potentially available patients for future studies. Methods Members of the European Reference Network for rare and complex epilepsies ( EpiCARE) were invited to participate in a web‐based survey on clinical practice of patients with Dravet syndrome, tuberous sclerosis complex (TSC), autoimmune encephalitis, and progressive myoclonic epilepsies including Unverricht Lundborg and Unverricht‐like diseases. A consensus‐based questionnaire was generated for each disease. Results Twenty‐six of 30 invited epilepsy centers participated. Cohorts were present in most responding centers for TSC (87%), Dravet syndrome (85%), and autoimmune encephalitis (71%). Patients with TSC and Dravet syndrome represented the largest cohorts in these centers. The antiseizure drug treatments were rather consistent across the centers especially with regard to Dravet syndrome, infantile spasms in TSC, and Unverricht Lundborg / Unverricht‐like disease. Available, widely used targeted therapies included everolimus in TSC and immunosuppressive therapies in autoimmune encephalitis. Screening for comorbidities was routinely done, but specific treatment protocols were lacking in most centers. Significance The survey summarizes the current clinical practice for selected rare epilepsies in tertiary European epilepsy centers and demonstrates consistency as well as heterogeneity in the treatment, underscoring the need for controlled trials and recommendations. The survey also provides estimates for potential participants of clinical trials recruited via EpiCARE, emphasizing the great potential of Reference Networks for future studies to evaluate new targeted therapies and to identify novel biomarkers.
    Type of Medium: Online Resource
    ISSN: 2470-9239 , 2470-9239
    URL: Issue
    URL: Article
    DOI: 10.1002/epi4.v6.1
    DOI: 10.1002/epi4.12459
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2863427-5
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  • 4
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    Seizure underreporting in LGI1 and CASPR2 antibody encephalitis
    Wiley ; 2022
    In:  Epilepsia Vol. 63, No. 9 ( 2022-09)
    Details
    In: Epilepsia, Wiley, Vol. 63, No. 9 ( 2022-09)
    Abstract: Patients with anti‐leucine‐rich glioma‐inactivated 1 protein (LGI1) or anti‐contactin‐associated protein 2 (CASPR2) antibody encephalitis typically present with frequent epileptic seizures. The seizures generally respond well to immunosuppressive therapy, and the long‐term seizure outcome seems to be favorable. Consequentially, diagnosing acute symptomatic seizures secondary to autoimmune encephalitis instead of autoimmune epilepsy was proposed. However, published data on long‐term seizure outcomes in CASPR2 and LGI1 antibody encephalitis are mostly based on patient reports, and seizure underreporting is a recognized issue. Clinical records from our tertiary epilepsy center were screened retrospectively for patients with LGI1 and CASPR2 antibody encephalitis who reported seizure freedom for at least 3 months and received video‐electroencephalography (EEG) for 〉 24 h at follow‐up visits. Twenty (LGI1, n  = 15; CASPR2, n  = 5) of 32 patients with LGI1 ( n  = 24) and CASPR2 ( n  = 8) antibody encephalitis fulfilled these criteria. We recorded focal aware and impaired awareness seizures in four of these patients (20%) with reported seizure‐free intervals ranging from 3 to 27 months. Our results question the favorable seizure outcome in patients with CASPR2 and LGI1 antibody encephalitis and suggest that the proportion of patients who have persistent seizures may be greater. Our findings underline the importance of prolonged video‐EEG telemetry in this population.
    Type of Medium: Online Resource
    ISSN: 0013-9580 , 1528-1167
    URL: Issue
    URL: Article
    DOI: 10.1111/epi.v63.9
    DOI: 10.1111/epi.17338
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2002194-X
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  • 5
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    Temporal lobe epilepsy surgery: Piriform cortex resection impacts seizure control in the long‐term
    Wiley ; 2022
    In:  Annals of Clinical and Translational Neurology Vol. 9, No. 8 ( 2022-08), p. 1206-1211
    Details
    In: Annals of Clinical and Translational Neurology, Wiley, Vol. 9, No. 8 ( 2022-08), p. 1206-1211
    Abstract: Recently, we showed that resection of at least 27% of the temporal part of piriform cortex (PiC) strongly correlated with seizure freedom 1 year following selective amygdalo‐hippocampectomy (tsSAHE) in patients with mesial temporal lobe epilepsy (mTLE). However, the impact of PiC resection on long‐term seizure outcome following tsSAHE is currently unknown. The aim of this study was to evaluate the impact of PiC resection on long‐term seizure outcome in patients with mTLE treated with tsSAHE. Methods Between 2012 and 2017, 64 patients were included in the retrospective analysis. Long‐term follow‐up (FU) was defined as at least 2 years postoperatively. Seizure outcome was assessed according to the International League against Epilepsy (ILAE). The resected proportions of hippocampus, amygdala, and PiC were volumetrically assessed. Results The mean FU duration was 3.75 ± 1.61 years. Patients with ILAE class 1 revealed a significantly larger median proportion of resected PiC compared to patients with ILAE class 2–6 [46% (IQR 31–57) vs. 16% (IQR 6–38), p  = 0.001]. Resected proportions of hippocampus and amygdala did not significantly differ for these groups. Among those patients with at least 27% resected proportion of PiC, there were significantly more patients with seizure freedom compared to the patients with 〈 27% resected proportion of PiC (83% vs. 39%, p  = 0.0007). Conclusions Our results show a strong impact of the extent of PiC resection on long‐term seizure outcome following tsSAHE in mTLE. The authors suggest the PiC to constitute a key target volume in tsSAHE to achieve seizure freedom in the long term.
    Type of Medium: Online Resource
    ISSN: 2328-9503 , 2328-9503
    URL: Issue
    URL: Article
    DOI: 10.1002/acn3.v9.8
    DOI: 10.1002/acn3.51620
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2740696-9
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  • 6
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    Bemessung zyklisch beanspruchter Schweißverbindungen aus höchst- und ultrahochfesten Stählen : Bemessung zyklisch beanspruchter Schweißverbindungen aus höchst- und ultrahochfesten Stählen
    Wiley ; 2015
    In:  Stahlbau Vol. 84, No. 9 ( 2015-09), p. 620-628
    Details
    In: Stahlbau, Wiley, Vol. 84, No. 9 ( 2015-09), p. 620-628
    Type of Medium: Online Resource
    ISSN: 0038-9145
    URL: Issue
    URL: Article
    DOI: 10.1002/stab.v84.9
    DOI: 10.1002/stab.201510303
    RVK:
    ZG 1100
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2159000-X
    detail.hit.zdb_id: 240072-8
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  • 7
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    Laserstrahl‐ und Laserhybridschweißverbindungen aus ultrahochfesten Feinkornbaustählen – Teil 1: Verfahren und Schweißnahtcharakterisierung
    Wiley ; 2022
    In:  Stahlbau Vol. 91, No. 6 ( 2022-06), p. 397-408
    Details
    In: Stahlbau, Wiley, Vol. 91, No. 6 ( 2022-06), p. 397-408
    Abstract: Laser beam and laser‐GMAW‐hybrid welded joints made of high‐strength fine‐grained structural steels – part 1: procedure and weld characterisation In the case of fine‐grained structural steels with the currently highest nominal yield strengths of up to 1300 MPa, the execution of high‐quality welded joints represents a particular challenge. Innovative welding processes, such as laser beam and laser hybrid welding, show high application potential, but have only rarely been used due to a lack of experience so far. This article, therefore, presents a weld characterisation carried out on four different materials (S960MC, S1100M, S1100QL, S1300QL) and two welding process variants (laser beam welding without filler metal, laser‐GMAW‐hybrid welding). The investigations of butt welds include visual, dye penetration and X‐ray tests as well as transverse tensile tests and hardness field measurements. The weld zones show remarkably small dimensions and only moderate softening, which is particularly concentrated in the tempering zone. Exceptions are the joints of the S1100M, where no softening is observed in the tempering zone.
    Type of Medium: Online Resource
    ISSN: 0038-9145 , 1437-1049
    URL: Issue
    URL: Article
    DOI: 10.1002/stab.v91.6
    DOI: 10.1002/stab.202200017
    RVK:
    ZG 1100
    Language: German
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2159000-X
    detail.hit.zdb_id: 240072-8
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  • 8
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    Laserstrahl‐ und Laserhybridschweißverbindungen aus ultrahochfesten Feinkornbaustählen – Teil 2: Ermüdungsfestigkeit
    Wiley ; 2022
    In:  Stahlbau Vol. 91, No. 7 ( 2022-07), p. 489-497
    Details
    In: Stahlbau, Wiley, Vol. 91, No. 7 ( 2022-07), p. 489-497
    Abstract: Laser beam and laser‐GMAW‐hybrid welded joints made of high‐strength fine‐grained structural steels – part 2: fatigue strength Innovative welding processes, such as laser beam and laser‐GMAW‐hybrid welding, offer advantages over conventional gas metal arc welding (abbr.: GMAW) processes due to a reduced heat input during the welding of high‐strength fine‐grained structural steels. The materials, with nominal yield strengths of up to 1300 MPa, are already being used in mobile crane construction and related industries, particularly in telescopic booms. So far, both conventionally welded and laser beam welded joints have been avoided in highly‐stressed areas of load‐bearing structures. For the latter, in particular, this is due to a lack of experience and design rules. To counter this, part 1 presented the basics of laser beam and laser hybrid welding processes, welding tests and a characterisation of butt welds (visual, dye penetration and X‐ray tests as well as transverse tensile tests and hardness field measurements). This article (part 2) focuses the fatigue strength of these welded joints made of the high‐strength fine‐grained structural steels S960MC, S1100M, S1100QL and S1300QL. The properties under cyclic loading are quantified for the details butt joint with and without different sheet thicknesses as well as for longitudinal stiffeners. In particular, the laser beam welded joints show a high fatigue strength with a remarkably low scatter of the individual test results. Based on the fatigue test results, fatigue classifications for the nominal stress concept are derived and design recommendations are presented.
    Type of Medium: Online Resource
    ISSN: 0038-9145 , 1437-1049
    URL: Issue
    URL: Article
    DOI: 10.1002/stab.v91.7
    DOI: 10.1002/stab.202200040
    RVK:
    ZG 1100
    Language: German
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2159000-X
    detail.hit.zdb_id: 240072-8
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  • 9
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    Interstitial photodynamic therapy of nonresectable malignant glioma recurrences using 5‐aminolevulinic acid induced protoporphyrin IX
    Wiley ; 2007
    In:  Lasers in Surgery and Medicine Vol. 39, No. 5 ( 2007-06), p. 386-393
    Details
    In: Lasers in Surgery and Medicine, Wiley, Vol. 39, No. 5 ( 2007-06), p. 386-393
    Abstract: Limited knowledge of the light and temperature distribution within the target volume in combination with non‐selective accumulation of the applied photosensitizers (PS) has hampered the clinical relevance of interstitial photodynamic therapy (iPDT) for treatment of malignant glioma patients. The current pilot study focused on the development and the clinical implementation of an accurate and reproducible irradiation scheme for iPDT using 5‐aminolevulinic acid (5‐ALA) induced protoporphyrin IX (PPIX) as a selectively working PS. Study Design/Materials and Methods Monte Carlo simulations of fluence rate and heat transport simulations were performed using the optical properties of normal brain tissue infiltrated by tumor cells (absorption coefficient µ a  = 0.2 cm −1 , reduced scattering coefficient: µ ′ s  = 20 cm −1 ). A modified 3‐D treatment‐planning software was used to calculate both, the treatment‐volume and the exact position of the light diffusers within the lesion. The feasibility and the risk of iPDT were tested in 10 patients with small and circumscribed recurrent malignant gliomas. Results The optimum distance between the implanted light diffusers was determined to be 9 mm with regard to both fluence rate and temperature distribution. For this distance a temperature increase above 42°C was not expected to occur. Up to six cylindrical light diffusers were stereotactically implanted to achieve a complete irradiation of the tumor volume, which was possible in every single patient (mean tumor volume: 5.9 cm 3 ). The total applied light fluence was between 4,320 J and 11,520 J. Side effects of iPDT were not observed. Median survival was 15 months. Conclusion 5‐ALA iPDT in combination with a 3‐D treatment‐planning (which was based on optical and thermal simulations) is a safe and feasible treatment modality. The clinical impact of these findings deserves further prospective evaluation. Lasers Surg. Med. 39:386–393, 2007. © 2007 Wiley‐Liss, Inc.
    Type of Medium: Online Resource
    ISSN: 0196-8092 , 1096-9101
    URL: Issue
    URL: Article
    DOI: 10.1002/lsm.v39:5
    DOI: 10.1002/lsm.20507
    Language: English
    Publisher: Wiley
    Publication Date: 2007
    detail.hit.zdb_id: 1475539-7
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  • 10
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    On the Monotonic and Cyclic Behavior of an Al‐Mg‐Zn‐Cu‐Si Compositionally Complex Alloy
    Wiley ; 2023
    In:  Advanced Engineering Materials
    Details
    In: Advanced Engineering Materials, Wiley
    Abstract: In present work, the monotonic and cyclic properties of a novel Al‐Mg‐Zn‐Cu‐Si compositionally complex alloy (CCA) are investigated. Microstructural studies reveal that a eutectic phase and fishbone‐type structures are embedded in the Al‐matrix. The mechanical properties of this CCA obtained under compressive loading are found to be promising. However, low ultimate strength and brittle behavior are seen under tension. The fatigue performance of the alloy in the low‐cycle fatigue (LCF) regime is poor. Microstructural features and fracture surface analysis point to the fact that the presence of brittle intermetallic phases and shrinkage defects are responsible for the poor tensile properties and inferior LCF behavior. Homogenization at 460 and 465 °C for 3 h, 6 h, and 24 h results in spheroidization of all coarse precipitates. However, the heat treatment used is unsuitable to enhance the mechanical properties of this CCA.
    Type of Medium: Online Resource
    ISSN: 1438-1656 , 1527-2648
    URL: Article
    DOI: 10.1002/adem.202300892
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2016980-2
    detail.hit.zdb_id: 1496512-4
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