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  • 1
    In: International Journal of Oncology, Spandidos Publications, Vol. 44, No. 1 ( 2014-01), p. 78-90
    Type of Medium: Online Resource
    ISSN: 1019-6439 , 1791-2423
    RVK:
    Language: English
    Publisher: Spandidos Publications
    Publication Date: 2014
    detail.hit.zdb_id: 2079608-0
    detail.hit.zdb_id: 1154403-X
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  • 2
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2021
    In:  Neuroradiology Vol. 63, No. 6 ( 2021-06), p. 967-970
    In: Neuroradiology, Springer Science and Business Media LLC, Vol. 63, No. 6 ( 2021-06), p. 967-970
    Abstract: Computed tomography (CT) imaging in acute stroke is an established and fairly widespread approach, but there is no data on applicability of intraosseous (IO) contrast administration in the case of failed intravenous (IV) cannula placement. Here, we present the first case of IO contrast administration for CT imaging in suspected acute stroke providing a dedicated CT examination protocol and analysis of achieved image quality as well as a review of available literature.
    Type of Medium: Online Resource
    ISSN: 0028-3940 , 1432-1920
    RVK:
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1462953-7
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  • 3
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2023
    In:  Langenbeck's Archives of Surgery Vol. 408, No. 1 ( 2023-07-16)
    In: Langenbeck's Archives of Surgery, Springer Science and Business Media LLC, Vol. 408, No. 1 ( 2023-07-16)
    Abstract: Celiac axis stenosis (CAS) often is an incidental finding in terms of diagnostic for hepatobiliary surgery since most cases remain asymptomatic. It remains unclear whether CAS is a risk factor for postoperative complications after hepatobiliary surgery. Therefore, the aim of this study was to evaluate the impact of an asymptomatic CAS on the postoperative morbidity and survival of patients undergoing hepatobiliary surgery. Methods We retrospectively analyzed CT scans and clinicopathological data of 250 consecutive patients undergoing hepatobiliary surgery between 2011 and 2018 in our tertiary center. We compared the postoperative course between patients with and without an incidental CAS as well as their overall survival. Results CAS was caused by atherosclerotic stenosis in 16 (64%) patients, by ligamentous stenosis in 4 (16%) and by combined conditions in 5 cases (20%). Mean age of patients in the CAS group was significantly higher in comparison to patients of the non-CAS group (71.0 vs. 59.1 years, p   〈  0.001). Major hepatectomy was conducted in 40% of the CAS patients and 19.6% of non-CAS patients, respectively ( p  = 0.036). Interestingly, no statistically significant differences in postoperative morbidity (40 vs. 46.2%, p  = 0.673) or in overall survival between the groups (41.3 vs. 51.9 months, p  = 0.611) were observed. Conclusion Our analysis found no correlation between an asymptomatic celiac axis stenosis and postoperative complications or overall survival after hepatobiliary surgery. Which impact the incidental CAS may have in highly complex cases remains unclear. Further studies are needed to identify patients who benefit from CAS treatment before hepatobiliary surgery.
    Type of Medium: Online Resource
    ISSN: 1435-2451
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 1459390-7
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  • 4
    In: Brain Sciences, MDPI AG, Vol. 13, No. 10 ( 2023-09-29), p. 1388-
    Abstract: Objective: In rare cases, Lyme neuroborreliosis (LNB) can induce cerebral vasculitis leading to severe stenosis of the cerebral vasculature and consecutive ischemia. Therapy is based on anti-biotic treatment of the tick-borne disease, whereas interventional therapeutic options have not been assessed yet. Material and Methods: We report on a patient with LNB and concomitant stenoses and progressive and fatal vasculitis of the cerebral vessels despite all therapeutic efforts by the departments of neurology and interventional neuroradiology. In this context, we also conducted a literature review on endovascular treatment of LNB-associated cerebral ischemia. Results: A 52-year-old female presented with transient neglect and psychomotor slowdown (initial NIHSS = 0). MRI and serology led to the diagnosis of basal meningitis due to LNB with vasculitis of cerebral arteries. Despite immediate treatment with antibiotics and steroids, neurologic deterioration (NIHSS 8) led to an emergency angiography on day 2 after admission. Hemodynamically relevant stenoses of the MCA were treated via spasmolysis and PTA, leading to almost complete neurological recovery. Despite intensified medical treatment, the vasculitis progressed and could only be transiently ameliorated via repetitive spasmolysis. On day 19, she again presented with significant neurologic deterioration (NIHSS 9), and PTA and stenting of the nearly occluded MCA were performed with a patent vessel, initially without hemorrhagic complications. Despite all therapeutic efforts and preserved stent perfusion, vasculitis worsened and the concurrent occurrence of subdural hemorrhage led to the death of the patient. Conclusion: Neuroradiological interventions, i.e., spasmolysis, PTA, and, if necessary, stenting, can and should be considered in cases of LNB-induced vasculitis and stroke that are refractory to best medical treatment alone. Key point: Neuroradiological interventions can be considered in patients with vascular complications of Lyme neuroborreliosis as an additional extension of the primary drug therapy.
    Type of Medium: Online Resource
    ISSN: 2076-3425
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2651993-8
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  • 5
    Online Resource
    Online Resource
    S. Karger AG ; 2007
    In:  Cellular Physiology and Biochemistry Vol. 20, No. 5 ( 2007), p. 679-686
    In: Cellular Physiology and Biochemistry, S. Karger AG, Vol. 20, No. 5 ( 2007), p. 679-686
    Type of Medium: Online Resource
    ISSN: 1015-8987 , 1421-9778
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1482056-0
    SSG: 12
    SSG: 15,3
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  • 6
    Online Resource
    Online Resource
    Elsevier BV ; 2008
    In:  European Journal of Cell Biology Vol. 87, No. 8-9 ( 2008-09), p. 591-599
    In: European Journal of Cell Biology, Elsevier BV, Vol. 87, No. 8-9 ( 2008-09), p. 591-599
    Type of Medium: Online Resource
    ISSN: 0171-9335
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2008
    detail.hit.zdb_id: 2056855-1
    SSG: 12
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  • 7
    In: Journal of NeuroInterventional Surgery, BMJ, Vol. 13, No. 11 ( 2021-11), p. 1053-1057
    Abstract: Thrombus composition has been shown to be a major determinant of recanalization success and occurrence of complications in mechanical thrombectomy. The most important parameters of thrombus behavior during interventional procedures are relative fractions of fibrin and red blood cells (RBCs). We hypothesized that quantitative information from admission non-contrast CT (NCCT) and CT angiography (CTA) can be used for machine learning based prediction of thrombus composition. Methods The analysis included 112 patients with occlusion of the carotid-T or middle cerebral artery who underwent thrombectomy. Thrombi samples were histologically analyzed and fractions of fibrin and RBCs were determined. Thrombi were semi-automatically delineated in CTA scans and NCCT scans were registered to the same space. Two regions of interest (ROIs) were defined for each thrombus: small-diameter ROIs capture vessel walls and thrombi, large-diameter ROIs reflect peri-vascular tissue responses. 4844 quantitative image markers were extracted and evaluated for their ability to predict thrombus composition using random forest algorithms in a nested fivefold cross validation. Results Test set receiver operating characteristic area under the curve was 0.83 (95% CI 0.80 to 0.87) for differentiating RBC-rich thrombi and 0.84 (95% CI 0.80 to 0.87) for differentiating fibrin-rich thrombi. At maximum Youden-Index, RBC-rich thrombi were identified at 77% sensitivity and 74% specificity; for fibrin-rich thrombi the classifier reached 81% sensitivity at 73% specificity. Conclusions Machine learning based analysis of admission imaging allows for prediction of clot composition. Perspectively, such an approach could allow selection of clot-specific devices and retrieval procedures for personalized thrombectomy strategies.
    Type of Medium: Online Resource
    ISSN: 1759-8478 , 1759-8486
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2506028-4
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  • 8
    In: Journal of NeuroInterventional Surgery, BMJ, Vol. 13, No. 5 ( 2021-05), p. 409-414
    Abstract: Different imaging characteristics such as clot burden score, collaterals, and pre-interventional thrombus migration are associated with functional outcome in patients with acute ischemic stroke. Moreover, histological thrombus composition is associated with pre-interventional thrombus migration. We hypothesized that smaller clots may more likely migrate and that collateral status in ischemic stroke patients may mediate this tendency of the clot to migrate. Methods In this prospective cohort of consecutive ischemic stroke patients, clot burden scores and collateral scores were rated and the retrieved thrombi were histologically analyzed. We then investigated the relationship between clot burden score, probability for thrombus migration, and collateral scores using mediation analysis. Results 163 patients are included of which 36 (22.1%) had a clot migration. Probability of thrombus migration was significantly associated with lower collateral scores (P 〈 0.01), higher clot burden scores (P 〈 0.01), shorter thrombi (P 〈 0.01), and higher RBC count (P 〈 0.01). In the mediator pathway, higher collateral scores were significantly associated with higher clot burden scores (P 〈 0.01) and younger age (P=0.029). The total effect of an increase in clot burden score by one grade on thrombus migration is composed of the direct effect (+18%, P 〈 0.01) and the collateral score-mediated indirect effect (−5%, P 〈 0.01). Conclusions Smaller, erythrocyte-rich thrombi tend to migrate more often. Good collaterals seem to have a considerable effect on limiting migration. This supports the hypothesis that larger clots have stronger adherence with the vessel wall and that good collaterals increase the counter pressure distal of the clot.
    Type of Medium: Online Resource
    ISSN: 1759-8478 , 1759-8486
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2506028-4
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  • 9
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 8 ( 2020-08-06), p. 2543-
    Abstract: Background and Purpose: Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort. Methods: This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed. Results: Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9–29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%). Conclusion: This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662592-1
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  • 10
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 12, No. 1 ( 2022-08-11)
    Abstract: To investigate the applicability and performance of automated machine learning (AutoML) for potential applications in diagnostic neuroradiology. In the medical sector, there is a rapidly growing demand for machine learning methods, but only a limited number of corresponding experts. The comparatively simple handling of AutoML should enable even non-experts to develop adequate machine learning models with manageable effort. We aim to investigate the feasibility as well as the advantages and disadvantages of developing AutoML models compared to developing conventional machine learning models. We discuss the results in relation to a concrete example of a medical prediction application. In this retrospective IRB-approved study, a cohort of 107 patients who underwent gross total meningioma resection and a second cohort of 31 patients who underwent subtotal resection were included. Image segmentation of the contrast enhancing parts of the tumor was performed semi-automatically using the open-source software platform 3D Slicer. A total of 107 radiomic features were extracted by hand-delineated regions of interest from the pre-treatment MRI images of each patient. Within the AutoML approach, 20 different machine learning algorithms were trained and tested simultaneously. For comparison, a neural network and different conventional machine learning algorithms were trained and tested. With respect to the exemplary medical prediction application used in this study to evaluate the performance of Auto ML, namely the pre-treatment prediction of the achievable resection status of meningioma, AutoML achieved remarkable performance nearly equivalent to that of a feed-forward neural network with a single hidden layer. However, in the clinical case study considered here, logistic regression outperformed the AutoML algorithm. Using independent test data, we observed the following classification results (AutoML/neural network/logistic regression): mean area under the curve = 0.849/0.879/0.900, mean accuracy = 0.821/0.839/0.881, mean kappa = 0.465/0.491/0.644, mean sensitivity = 0.578/0.577/0.692 and mean specificity = 0.891/0.914/0.936. The results obtained with AutoML are therefore very promising. However, the AutoML models in our study did not yet show the corresponding performance of the best models obtained with conventional machine learning methods. While AutoML may facilitate and simplify the task of training and testing machine learning algorithms as applied in the field of neuroradiology and medical imaging, a considerable amount of expert knowledge may still be needed to develop models with the highest possible discriminatory power for diagnostic neuroradiology.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2615211-3
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