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  • 1
    Online Resource
    Online Resource
    Quantitative Neuroimaging for the Evaluation of the Effect of Stroke Treatment
    S. Karger AG ; 1998
    In:  Cerebrovascular Diseases Vol. 8, No. Suppl. 2 ( 1998), p. 23-23
    Details
    In: Cerebrovascular Diseases, S. Karger AG, Vol. 8, No. Suppl. 2 ( 1998), p. 23-23
    Abstract: A prerequisite for the successful treatment of acute ischaemic stroke is the existence of viable tissue that is morphologically intact but functionally impaired due to a flow decrease below a certain threshold. At this stage, tissue at risk of infarction can be identified only by functional imaging. This penumbral tissue can be classified as having a critical flow decrease with preservation of oxygen consumption and therefore increased oxygen extraction. Such ‘misery-perfused’ tissue has been observed consistently in the first few hours following ischaemic stroke but usually develops into necrosed tissue at follow-up observations. Several studies have indicated that penumbral tissue can be identified up to 17 h or even 48 h after stroke in the border zones of ischaemic tissue and that this condition is occasionally reversible without resulting in permanent infarction. Positron emission tomography studies of cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO 〈 sub 〉 2 〈 /sub 〉 ) and cerebral metabolic rate of glucose (CMRglc) can be used to demonstrate the effect of treatment on functional variables within tissue showing perfusional disturbances. Such studies have shown the value of these markers of ischaemia, which also correlate with clinical efficacy. However, when therapeutic strategies, such as thrombolysis, do not permit arterial blood sampling, quantitative determinations of CBF and CMRO 〈 sub 〉 2 〈 /sub 〉 are not feasible. In such cases relative indices, such as those for CBF, must be applied. Such qualitative assessments of perfusion, which were calibrated in an independent cohort of patients with acute stroke, were used to demonstrate the effect of early systemic treatment of acute ischaemia with recombinant tissue plasminogen activator. By applying operationally defined thresholds for tissue viability and the penumbra, and co-registering these tissue compartments to infarcted and non-infarcted tissue on late magnetic resonance imaging, the proportions of at-risk tissue salvaged from infarction could be revealed in individual patients. In the future, functional imaging modalities that could eventually include tracers for neuronal integrity could be used to select patients for thrombolytic therapy. In some instances such techniques may permit the extension of the critical time period for inclusion of patients to aggressive stroke management strategies.
    Type of Medium: Online Resource
    ISSN: 1015-9770 , 1421-9786
    URL: Article
    DOI: 10.1159/000047508
    Language: English
    Publisher: S. Karger AG
    Publication Date: 1998
    detail.hit.zdb_id: 1482069-9
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  • 2
    Online Resource
    Online Resource
    Relationship of spirometric, body plethysmographic, and diffusing capacity parameters to emphysema scores derived from CT scans
    SAGE Publications ; 2019
    In:  Chronic Respiratory Disease Vol. 16 ( 2019-01-01), p. 147997231877542-
    Details
    In: Chronic Respiratory Disease, SAGE Publications, Vol. 16 ( 2019-01-01), p. 147997231877542-
    Abstract: Phenotyping of chronic obstructive pulmonary disease (COPD) with computed tomography (CT) is used to distinguish between emphysema- and airway-dominated type. The phenotype is reflected in correlations with lung function measures. Among these, the relative value of body plethysmography has not been quantified. We addressed this question using CT scans retrospectively collected from clinical routine in a large COPD cohort. Three hundred and thirty five patients with baseline data of the German COPD cohort COPD and Systemic Consequences-Comorbidities Network were included. CT scans were primarily evaluated using a qualitative binary emphysema score. The binary score was positive for emphysema in 52.5% of patients, and there were significant differences between the positive/negative groups regarding forced expiratory volume in 1 second (FEV 1 ), FEV 1 /forced vital capacity (FVC), intrathoracic gas volume (ITGV), residual volume (RV), specific airway resistance (sRaw), transfer coefficient (KCO), transfer factor for carbon monoxide (TLCO), age, pack-years, and body mass index (BMI). Stepwise discriminant analyses revealed the combination of FEV 1 /FVC, RV, sRaw, and KCO to be significantly related to the binary emphysema score. The additional positive predictive value of body plethysmography, however, was only slightly higher than that of the conventional combination of spirometry and diffusing capacity, which if taken alone also achieved high predictive values, in contrast to body plethysmography. The additional information on the presence of CT-diagnosed emphysema as conferred by body plethysmography appeared to be minor compared to the well-known combination of spirometry and CO diffusing capacity.
    Type of Medium: Online Resource
    ISSN: 1479-9731 , 1479-9731
    URL: Article
    DOI: 10.1177/1479972318775423
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2222367-8
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  • 3
    Online Resource
    Online Resource
    Surgical indications and prognosis in spinal metastases
    Springer Science and Business Media LLC ; 1997
    In:  Neurosurgical Review Vol. 20, No. 2 ( 1997), p. 99-103
    Details
    In: Neurosurgical Review, Springer Science and Business Media LLC, Vol. 20, No. 2 ( 1997), p. 99-103
    Type of Medium: Online Resource
    ISSN: 0344-5607 , 1437-2320
    URL: Article
    DOI: 10.1007/BF01138191
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 1997
    detail.hit.zdb_id: 1474861-7
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  • 4
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    Online Resource
    Digital Twin of a photoacoustic trace gas sensor for monitoring methane in complex gas compositions
    Elsevier BV ; 2023
    In:  Sensors and Actuators B: Chemical Vol. 378 ( 2023-03), p. 133119-
    Details
    In: Sensors and Actuators B: Chemical, Elsevier BV, Vol. 378 ( 2023-03), p. 133119-
    Type of Medium: Online Resource
    ISSN: 0925-4005
    URL: Article
    DOI: 10.1016/j.snb.2022.133119
    RVK:
    ZG 1100
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 1500731-5
    detail.hit.zdb_id: 1021505-0
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  • 5
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    Online Resource
    Continuing Cognitive Impairment After Isolated Transient Global Amnesia
    Informa UK Limited ; 2001
    In:  International Journal of Neuroscience Vol. 106, No. 3-4 ( 2001-01), p. 159-168
    Details
    In: International Journal of Neuroscience, Informa UK Limited, Vol. 106, No. 3-4 ( 2001-01), p. 159-168
    Type of Medium: Online Resource
    ISSN: 0020-7454 , 1543-5245
    URL: Article
    DOI: 10.3109/00207450109149746
    Language: English
    Publisher: Informa UK Limited
    Publication Date: 2001
    detail.hit.zdb_id: 2041856-5
    SSG: 12
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  • 6
    Online Resource
    Online Resource
    Training as a Prerequisite for Reliable Use of NIH Stroke Scale
    Ovid Technologies (Wolters Kluwer Health) ; 1998
    In:  Stroke Vol. 29, No. 6 ( 1998-06), p. 1258-1259
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 6 ( 1998-06), p. 1258-1259
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.29.6.1258
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1998
    detail.hit.zdb_id: 1467823-8
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  • 7
    Online Resource
    Online Resource
    Permanent Cortical Damage Detected by Flumazenil Positron Emission Tomography in Acute Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 1998
    In:  Stroke Vol. 29, No. 2 ( 1998-02), p. 454-461
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 2 ( 1998-02), p. 454-461
    Abstract: Background and Purpose —Therapy of acute ischemic stroke can only be effective as long as neurons are viable and tissue is not infarcted. Since γ-aminobutyric acid receptors are abundant in the cortex and sensitive to ischemic damage, specific radioligands to their subunits, the central benzodiazepine receptors (BZR), may be useful as indicators of neuronal integrity and as markers of irreversible damage. To test this hypothesis we studied the binding of the BZR ligand [ 11 C]flumazenil (FMZ) early after ischemic stroke in comparison to the extent of final infarcts and hypometabolic cortical areas. Methods —In 10 patients cerebral blood flow, cerebral metabolic rate for oxygen (CMRO 2 ), oxygen extraction fraction (OEF), and FMZ binding were studied by positron emission tomography 3.5 to 16 hours after onset of their first hemispheric stroke. Early changes in flow, oxygen metabolism, and FMZ binding were compared with permanent disturbances in glucose metabolism, and the size of the final infarcts was determined on MRI or CT 12 to 22 days after the stroke. Results —In all patients except one cerebral blood flow was disturbed, with marked decreases in eight and a hyperperfusion in one patient corresponding to the location of neurological deficits. In these areas CMRO 2 was also reduced but to a variable degree, inducing highly variable OEF. Areas with markedly decreased CMRO 2 ( 〈 60 μmol/100 g per minute) corresponded to regions with decreased FMZ binding ( 〈 4.0 times the mean value in the white matter). In all patients the final cortical infarcts were visible on the early FMZ images. Infarcts could be discriminated from noninfarcted cortex by decreased FMZ binding despite a wide range of OEF. In finally hypometabolic cortex FMZ binding was initially decreased or normal, with OEF covering a wide range; this suggested neuronal loss and/or deactivation as the cause of metabolic disturbance. Additionally, a highly significant correlation was found between FMZ distribution within the first 2 minutes after injection and regional cerebral blood flow. Conclusions —These results demonstrate that permanently and irreversibly damaged cortex can be detected by reduced FMZ binding early after stroke. Since FMZ distribution additionally images regional cerebral perfusion, BZR radioligands have a potential as clinically useful tracers in patients with acute ischemic stroke. The evidence of tissue damage furnished by these tracers might be of relevance for the selection of individual therapeutic strategies.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.29.2.454
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 1998
    detail.hit.zdb_id: 1467823-8
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  • 8
    Online Resource
    Online Resource
    The Right Inferior Frontal Gyrus and Poststroke Aphasia : A Follow-Up Investigation
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Stroke Vol. 38, No. 4 ( 2007-04), p. 1286-1292
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 38, No. 4 ( 2007-04), p. 1286-1292
    Abstract: Background and Purpose— Recently, a combined repetitive transcranial magnetic stimulation (rTMS) and activation positron emission tomography (PET) study showed essential language function of the right inferior frontal gyrus (IFG) in some right-handed acute poststroke aphasics. We reexamined these patients in the chronic phase to test whether the right IFG remained essential for language performance. Methods— We reexamined 9 male right-handed patients, age 41 to 75 years, with aphasia 8 weeks after left hemispheric stroke. rTMS was performed over the maximum activation within the left and right IFG as defined by 15 [O]water PET to interfere with language function. A positive rTMS effect was defined as increased reaction time latency or error rate in the semantic task relative to no stimulation. Results— PET activations of the IFG were observed on the left (2 patients) and bilaterally (7). During rTMS interference over the left IFG, all patients had positive TMS effects, indicating that the left IFG remained essential. Stimulation over the right IFG yielded positive rTMS effects in 2 patients with persisting right IFG activation. Two patients with positive rTMS effects over the right side in the initial study did not show these effects at follow-up. Language performance improved in all patients. Conclusions— Successful regeneration from poststroke aphasia seems to depend more on the integration of available language-related brain regions than on recruiting new brain regions during the rehabilitation process. Restoration of the left hemisphere network seems to be more effective, although in some cases, right hemisphere areas are integrated successfully.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.0000259632.04324.6c
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
    detail.hit.zdb_id: 1467823-8
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  • 9
    Online Resource
    Online Resource
    Early [ 11 C]Flumazenil/H 2 O Positron Emission Tomography Predicts Irreversible Ischemic Cortical Damage in Stroke Patients Receiving Acute Thrombolytic Therapy
    Ovid Technologies (Wolters Kluwer Health) ; 2000
    In:  Stroke Vol. 31, No. 2 ( 2000-02), p. 366-369
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 31, No. 2 ( 2000-02), p. 366-369
    Abstract: Background and Purpose —Central benzodiazepine receptor ligands, such as [ 11 C]flumazenil (FMZ), are markers of neuronal integrity and therefore might be useful in the differentiation of functionally and morphologically damaged tissue early in ischemic stroke. We sought to assess the value of a benzodiazepine receptor ligand for the early identification of irreversible ischemic damage to cortical areas that cannot benefit from reperfusion. Methods —Eleven patients (7 male, 4 female, aged 52 to 75 years) with acute, hemispheric ischemic stroke were treated with alteplase (recombinant tissue plasminogen activator; 0.9 mg/kg according to National Institute of Neurological Disorders and Stroke protocol) within 3 hours of onset of symptoms. At the beginning of thrombolysis, cortical cerebral blood flow ([ 15 O]H 2 O) and FMZ binding were assessed by positron emission tomography (PET). Those early PET findings were related to the change in neurological deficit (National Institutes of Health Stroke Scale) and to the extent of cortical damage on MRI or CT 3 weeks after the stroke. Results —Hypoperfusion was observed in all cases, and in 8 patients the values were below critical thresholds estimated at 12 mL/100 g per minute, comprising 1 to 174 cm 3 of cortical tissue. Substantial reperfusion was seen in most of these regions 24 hours after thrombolysis. In 4 cases, distinct areas of decreased FMZ binding were detected. Those patients suffered permanent lesions in cortical areas corresponding to their FMZ defects (112 versus 146, 3 versus 3, 2 versus 1, and 128 versus 136 cm 3 ). In the other patients no morphological defects were detected on MRI or CT, although blood flow was critically decreased in areas ranging in size up to 78 cm 3 before thrombolysis. Conclusions —These findings suggest that imaging of benzodiazepine receptors by FMZ PET distinguishes between irreversibly damaged and viable penumbra tissue early after acute stroke.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/01.STR.31.2.366
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2000
    detail.hit.zdb_id: 1467823-8
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  • 10
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    Online Resource
    Safety of Statin Pretreatment in Intravenous Thrombolysis for Acute Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Stroke Vol. 46, No. 9 ( 2015-09), p. 2681-2684
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 46, No. 9 ( 2015-09), p. 2681-2684
    Abstract: A recent meta-analysis investigating the association between statins and early outcomes in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) indicated that prestroke statin treatment was associated with increased risk of 90-day mortality and symptomatic intracranial hemorrhage. We investigated the potential association of statin pretreatment with early outcomes in a large, international registry of AIS patients treated with IVT. Methods— We analyzed prospectively collected data from the Safe Implementation of Treatments in Stroke-East registry (SITS-EAST) registry on consecutive AIS patients treated with IVT during an 8-year period. Early clinical recovery within 24 hours was defined as reduction in baseline National Institutes of Health Stroke Scale score of ≥10 points. Favorable functional outcome at 3 months was defined as modified Rankin Scale scores of 0 to 1. Symptomatic intracranial hemorrhage was diagnosed using National Institute of Neurological Disorders and Stroke, European-Australasian Acute Stroke Study-II and SITS definitions. Results— A total of 1660 AIS patients treated with IVT fulfilled our inclusion criteria. Patients with statin pretreatment (23%) had higher baseline stroke severity compared with cases who had not received any statin at symptom onset. After adjusting for potential confounders, statin pretreatment was not associated with a higher likelihood of symptomatic intracranial hemorrhage defined by any of the 3 definitions. Statin pretreatment was not related to 3-month all-cause mortality (odds ratio, 0.92; 95% confidence interval, 0.57–1.49; P =0.741) or 3-month favorable functional outcome (odds ratio, 0.81; 95% confidence interval, 0.52–1.27; P =0.364). Statin pretreatment was independently associated with a higher odds of early clinical recovery (odds ratio, 1.91; 95% confidence interval, 1.25–2.92; P =0.003). Conclusions— Statin pretreatment seems not to be associated with adverse outcomes in AIS patients treated with IVT. The effect of statin pretreatment on early functional outcomes in thrombolysed AIS patients deserves further investigation.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.115.010244
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1467823-8
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