Biomedical subjects

A Brawanski

Publications and source records attributed to A Brawanski.

At least 19 recordsLinked to original sources

PubMed2002

Glial and neuronal serum markers after controlled cortical impact injury in the rat.

The aim of this study was to investigate the time course and the correlation of glial fibrillary acidic protein (GFAP), protein S-100B, and neuron specific enolase (NSE) serum levels to the severity of traumatic brain injury in rats. Male Wistar rats (n = 65 S-100B, NSE group and n = 55 GFAP group) underwent a severe cortical impact injury (100PSI, 2 mm deformation). Blood samples were drawn directly after trauma, 1 h, 6 h, 12 h, 24 h, and 48 h post trauma as well as in sham operated animals directly after craniotomy, after 6 h and 48 h. Serum levels at different severities were estimated in 20 rats (45PSI, 75PSI, 2 mm deformation). We found a time-dependent release of NSE and GFAP into serum after trauma. The highest NSE values were detected six hours after trauma (31.5 micrograms/l, mean, p < 0.0001), the highest GFAP levels were measured one hour after trauma (0.079 microgram/l, mean, p < 0.0014). Additionally we found a close relationship between NSE serum levels and the severity of traumatic brain injury (45PSI = 12.7 micrograms/l, 75PSI = 16.17 micrograms/l, 100PSI = 28.45 micrograms/l, p < 0.05). S-100B serum levels showed an increase (0.92 microgram/l, p < 0.005) but no time-dependent release. S-100B and GFAP showed no relationship to trauma severity. Serum levels of GFAP, S-100B and NSE are significantly elevated in the early phase after experimental traumatic brain injury. In this experimental model of cortical impact injury only NSE, but not GFAP and S-100B serum levels are time-dependently correlated with the severity of cortical impact.

Animals↗

PubMed2002

Dynamic correlation between tissue PO2 and near infrared spectroscopy.

Multimodal O2 monitoring including tissue pO2 measurements and near infrared spectroscopy (NIRS) are techniques increasingly employed for monitoring patients on neurosurgical intensive care units. NIRS measures a mixed venous arterial oxygen saturation, whereas tissue pO2 evaluates the oxygen pressure in the white matter. In contrast to the tissue pO2 measurements, the NIRS at the moment has not been completely established in clinical practice. We wanted to evaluate whether both techniques are monitoring different dynamic changes. Thirteen patients were included (SAH n = 3, TBI n = 10), 12 patients were male and 1 was female. Mean age was 34 years with a range from 16-76 years. Tissue pO2 probes (Licox, GMS, Germany) were implanted in the frontal lobe showing most pathological changes on the initial CT scan. A near infrared spectroscopy sensor (Invos, Somanetics, USA) was placed simultaneously at the patient's forehead. Due to the drift of the tissue pO2 probe, only data sets were taken into further account in which a tissue pO2 value above 15 mmHg was measured. 66 data sets were analyzed by calculating the spectral coherence with multi taper methods. The coherence of two independent white noise signals were defined as an observation by chance. The significance level for correlated frequencies was 90%. In the spectral long time regime (frequency > or = 0.02), more than 80% of the data sets showed a higher percentage of correlated frequencies as compared to the observation by chance. The assumption that tissue pO2 and near infrared spectroscopy probes are measuring different dynamic changes in neurosurgical intensive care patients could not be supported by our data.

Adolescent↗

PubMed2002

Early S-100B serum level correlates to quality of life in patients after severe head injury.

PURPOSE: S-100B protein is a new possible indicator of brain damage after severe head injury. In outcome assessment there is an increasing focus on measures of health outcome incorporating the person's own perspective. Therefore, the aim of the study was to investigate the correlation of early S-100B serum level to the quality of life. METHOD: fifty-one patients with severe head injury were included in a prospective study. Blood samples were taken on admission (mean 2.5 hours). The outcome was assessed at follow-up using the Glasgow Outcome Scale and a questionnaire according to Blau to assess the quality of life. RESULTS: high serum concentrations of S-100B on admission correlate to unfavourable outcome according to the GOS (4.9 micro g/l vs 1.6 micro g/l, mean, p < 0.0008). In addition, the S-100B serum concentrations on admission correlate to quality of life in the survivor group. Patients with S-100B serum levels < or = 0.5 micro g/l scored 71.4 points (mean) on the QoL index compared to patients with elevated S-100B concentrations, who scored 55.4 points (mean, p < 0.05). CONCLUSION: S-100B seems to be able to assess the extent of primary brain damage after trauma.

Adolescent↗

PubMed2001

Neuron-specific enolase serum levels after controlled cortical impact injury in the rat.

The aim of this study was to investigate the time course and the correlation of neuron-specific enolase (NSE) serum levels to the severity of traumatic brain injury in rats. Sixty-five male Wistar rats were subjected to severe cortical impact injury (100 PSI, 2 mm deformation). Blood samples were drawn directly after trauma and after 1, 6, 12, 24, and 48 h in the trauma group. In the sham operated levels animals samples were drawn directly after craniotomy and after 6 and 48 h. Additionally, NSE serum levels after controlled cortical impact at different levels of severity samples (45 PSI, 75 PSI; 2 mm deformity) were compared to sham-operated animals. The severity of the injury was not validated histopathologically. NSE serum levels were estimated with a commercially available enzyme immunoassay (LIA mat Sangtec). The control animals showed a NSE serum level of 8.82 microg/L (mean, n = 10) and the injured animals demonstrated a time-dependent release of NSE into the serum. The highest NSE serum values were detected 6 h after trauma (31.5 microg/L mean, n = 10). In addition, we found a close relationship between NSE serum levels and the severity of traumatic brain injury in the cortical impact model. NSE serum levels reflect in a time-dependent manner the severity of brain trauma induced by cortical impact model in rat.

Animals↗

PubMed2000

Influence of macrophage infiltration of herniated lumbar disc tissue on outcome after lumbar disc surgery.

STUDY DESIGN: An immunohistochemical examination of the presence of inflammatory cells in routinely processed resection specimens of the lumbar disc, and a comparison of the histologic results with clinical data collected prospectively before and after surgery. OBJECTIVES: To assess the influence of inflammatory reactions in herniated lumbar disc specimens on the outcome after lumbar disc surgery. SUMMARY OF BACKGROUND DATA: Histologic and biochemical studies on herniated lumbar disc tissue led to the notion of inflammation-induced sciatic pain. At this writing, no investigations have sought to discover how outcome after lumbar disc surgery is influenced by histologically described inflammation. METHODS: Disc specimens from 79 patients who underwent surgery for lumbar disc herniation were studied immunohistologically with regard to the presence of inflammatory reactions. Of these, 92% were followed up approximately 7 months after surgery. The histologic results were compared with the outcome at follow-up evaluation. RESULTS: A statistically significant correlation was found between the histologically proven inflammation and the outcome, as shown by the pain grading scale. CONCLUSIONS: The results from this study seem to support the theory of a foreign body reaction to the herniated material. This reaction may result in inflammation-induced sciatic pain.

Adult↗

PubMed2000

S-100 serum levels and outcome after severe head injury.

S-100B a protein of astroglial cells is described as a marker for neuronal damage. Reliable outcome prediction from severe head injury is still unresolved. Clinical scores like the Glasgow Coma Score (GCS) and diagnostic scores like the Marshall CT Classification (MCTC) are well established and investigated, but there are still some concerns about these tools. The aim of this study was to investigate the predictive value of the initial serum level of S-100B. 44 patients with severe head injury (GCS < 9) were included. Blood samples were drawn within 1 to 6 hours of injury. After a period of 11 months their outcome was correlated using the Glasgow Outcome Scale. Patients with good outcome had significantly lower serum concentrations of S-100 on admission (0.96 microgram/l versus 5.5 micrograms/l mean, p < 0.0001). In addition patients with a S-100 serum level below 2 micrograms/l showed a significant better rating on the GOS at follow-up (4 points versus 1.8 points mean, p < 0.0001). With this cut-off line it was possible to predict longterm outcome with a sensitivity of 75% and specitivity of 82%. The serum level of S-100B calculated with one to six hours of a severe head injury is a useful additional outcome predictor.

Adolescent↗

PubMed2000

Time profile of neuron specific enolase serum levels after experimental brain injury in rat.

The aim of this study was to investigate the time course of NSE serum levels after traumatic brain injury in rats. 65 male Wistar rats were subjected to severe cortical impact injury (100 PSI, 2 mm deformation). Blood samples were drawn directly after trauma, after 1 h, 6 h, 12 h, 24 h, and 48 h in the trauma group as well as in sham operated animals directly after craniotomy, after 6 h and after 48 h. NSE serum levels were estimated with a commercially available enzyme immuno assay (LIA-mat Sangtec). The control animals showed a NSE serum level of 8.82 micrograms/l (mean, n = 10). We demonstrated a time dependent release of NSE into the serum after trauma. The highest NSE serum values were detected six hours after trauma (31.5 micrograms/l, mean, n = 10). NSE serum level seems to reflect neuronal damage after cortical contusion in the rat in a time dependent manner.

Animals↗

PubMed2000

S-100B protein serum levels after controlled cortical impact injury in the rat.

S-100B is described to provide information about the severity of brain damage in man. Estimation of serum markers appears to be an easy method of obtaining information regarding severity and outcome after head injury. However less is known about the post traumatic time course of this protein in the serum. The aim of this study was to provide further information about the posttraumatic enzymekinetik. 65 male Wistar rats were subjected to severe cortical impact injury (100 PSI, 2 mm deformation). Blood samples were drawn directly after trauma, then after 1 h, 6 h, 12 h, 24 h, and 48 h. In sham operated animals blood samples were drawn directly after craniotomy, then after 6 h and after 48 h. Also compared were S-100B serum levels at different severities in 20 rats (45 PSI, 75 PSI; 2 mm deformity) after controlled cortical impact to sham operated animals. S-100B serum levels were estimated with a commercially available enzyme immuno-assay (DAKO). The mean serum level in the sham group was 0.38 microg/l. Serum levels at 100 PSI differed statistically significantly directly after trauma up to 24 h. The 48 h S-100B levels showed no significant difference in the sham group. Serum levels at different severities differed significantly from the sham group, but did not differ concerning level of severity. The controlled cortical impact model is able to produce a raised serum level of the S-100B protein for 24 hours. Different trauma severities were not reflected.

Animals↗

PubMed2000

Long term outcome after cervical foraminotomy.

We recently demonstrated the effectiveness of dorsal foraminotomy in lateral herniated cervical disc after 1 year follow-up in a prospective study.(1) The goal of this paper is to confirm these results concerning long term outcome. We carried out a prospective, consecutive study on 54 patients, operated on for lateral herniated cervical disc. We analysed demographic data, the case history, the neurological examination on admission and imaging data. Ninety per cent were followed up for 3.5 years postoperatively. According to their ratings on a pain scale the group were divided into favourable and unfavourable outcomes. These groups were analysed in relation to the patient's initial condition. At follow up, 90% of patients showed complete recovery or improvement. A long standing preoperative neurological deficit seems to be an important prognostic factor for unfavourable long term outcome after cervical foraminotomy.

Adult↗

PubMed2000

[Fatal intracerebral gas gangrene in a 10-month-old child].

Today, intracerebral infections by gas forming bacteria are very rare. They are mostly seen after penetrating injuries and more rarely after trivial trauma. Although prognosis of this kind of infection is severe, the general outcome of these patients after surgical and antibiotic treatment is good. We report a ten months old boy suffering a pecking injury just above the left ear with perforation of the temporal bone and dura. In between 48 hrs he developed a rapidly progressive gas gangrene encephalitis due to infection with C. perfringens and died despite of surgical and antibiotic treatment due to massive brain swelling and cardio-pulmonary failure.

Animals↗

PubMed2000

[A simple and cosmetically ideal method large cranioplasty].

Repair of large skull defects is indicated as well to improve cosmetic as to protect the brain. A simply and easy to use procedure for exact duplication of cranial bone flaps used in cranioplasty is described. The original bone flap must be available to produce the definitive prosthesis.

Humans↗

PubMed1999

Variability of outcome after lumbar disc surgery.

STUDY DESIGN: A prospective, consecutive study of patients' outcome at three subsequent follow-up times after lumbar disc surgery. OBJECTIVES: To evaluate how consistent outcome remained in a group of patients after lumbar disc surgery. SUMMARY OF BACKGROUND DATA: Despite similar results concerning the overall outcome, results in most studies show different prognostic factors for lumbar disc surgery at different follow-up times. A reason for this observation could be that patients shift to a different outcome group during the observation period. METHODS: Before surgery and at the three follow-ups (3, 12, and 28 months after surgery) the Low Back Outcome Score was calculated. Groups with favorable and unfavorable outcome were determined after each follow-up according to the scores. RESULTS: Ninety-eight patients were studied. Forty percent showed an unstable outcome at different follow-up times. For each follow-up, three prognostic factors were determined. No prognostic factor showed significance at all follow-up examinations. CONCLUSIONS: Patients whose outcome after lumbar disc surgery does not remain stable present a major problem in the calculation of prognostic factors.

Adolescent↗

PubMed1999

Ossifying lipoma.

Lipomas are very common, but osseous changes within these tumours are rare. A lipoma with osseous components is presented, with an overview of the literature and pathogenesis of this unusual lesion and considerations relating to the differential diagnosis.

Aged↗

PubMed1999

Rapid evaluation of S-100 serum levels. Case report and comparison to previous results.

The aim of this case report is to describe the time course of S-100 serum levels of a patient, after severe head injury, whose blood sample could be drawn very soon after injury. The results were compared to a group of patients in which a correlation between S-100 serum levels and outcome after traumatic brain injury could be demonstrated. Blood samples were taken on admission (mean 2.3 hours), 6, 12 and 24 hours after trauma and then every 24 hours up until and including the fifth day. The outcome was estimated on discharge using the Glasgow Outcome Scale. The S-100 serum level of the patient described in the case report with a favourable outcome had initially risen to 10.0 micrograms/l and showed a rapid decline. In the previous group, patients with unfavourable outcome had a S-100 serum level of 7 micrograms/l mean concerning the first probe (after 2.3 hours mean) compared to 1.5 micrograms/l mean (after 2.23 hours mean) in patients with favourable outcome (p < 0.05). In comparison to the literature, there seems to be differences regarding the enzyme liberation in stroke and head injury. Therefore, S-100 serum levels need to be interpreted with regard to collection time and underlying pathology.

Adult↗

PubMed1999

Comparison of clinical, radiologic, and serum marker as prognostic factors after severe head injury.

BACKGROUND: S-1OOB, a protein of astroglial cells, is described as a marker for neuronal damage. Reliable outcome prediction from severe head injury is still unresolved. Clinical scores such as the Glasgow Coma Scale score (GCS) and diagnostic scores such as the Marshall Computed Tomographic Classification are well established and investigated, but there are still some concerns about these tools. The aim of this study was to investigate the predictive value of the initial serum level of S-100B compared with the predictive value of the GCS score and the Marshall Computed Tomographic Classification to outcome after severe head injury. METHODS: Forty-four patients with severe head injury (GCS score < 9) were included. Blood samples were drawn within 1 to 6 hours of injury. After a period of 11 months, their outcome was correlated by using the Glasgow Outcome Scale. Patients with an S-100B serum level above 2 microg/L, a GCS score between 3 and 5, and a computed tomographic scan in the categories 4 to 6 are predicted to have an unfavorable outcome. The predictive values of these tools were calculated according to these definitions. RESULTS: The protein S-100B had with 17% the lowest total misclassification rate. When compared with the GCS score and Marshall Computed Tomographic Classification the S-100B serum level calculated on admission had the highest positive predictive value (87%) and negative predictive value (77%). CONCLUSION: The serum level of S-100B calculated within 1 to 6 hours of a severe head injury is a useful additional outcome predictor.

Adolescent↗

PubMed1999

Functional MR imaging of the motor cortex in healthy volunteers and patients with brain tumours: qualitative and quantitative results.

The purpose of this study was to compare functional magnetic resonance (MR) imaging of the motor cortex in healthy volunteers and patients with brain tumours. Functional MR imaging was performed in 14 healthy volunteers and 14 patients with tumours in or near the primary motor cortex with groups being matched for age, sex, and handedness. Functional images were acquired during motion of the right and left hand. Time courses of signal intensity within the contralateral, ipsilateral, and supplementary motor cortex as well as z-maps were calculated, their quality being assessed visually. Mean signal increase between activation and rest were evaluated within the contralateral, ipsilateral, and supplementary motor cortex, the activated area in those regions of interest was measured using z-maps. The quality of functional MR experiments was generally lower in patients than in volunteers. The quantitative results showed a trend towards increased ipsilateral activation in volunteers during left hand compared to right hand motion and in patients during motion of the affected compared to the non-affected hand. Considering quantitative and qualitative results, significantly increased ipsilateral activation was found in patients compared to healthy volunteers. In conclusion, functional MR imaging quality was significantly reduced in patient studies compared to healthy volunteers, even if influences of age, sex, and handedness were excluded. Increased ipsilateral activation was found in patients with brain tumours which can be interpreted by an improved connectivity between both hemispheres.

Adult↗

PubMed1999

Telemedicine in neurosurgical daily practice.

Telemedicine has been in daily practice at our neurosurgical department for five years. In our experience the standard personal computer-based telemedicine systems Medicom and especially RADO Look are reliable, easy to use, and of high quality performance. Telemedicine makes possible better patient management at regional hospitals and the avoidance of patient transports. Therefore treatment costs in neurosurgical patients can be highly reduced.

Cost Savings↗

PubMed1998

Is there a clinical correlate to the histologic evidence of inflammation in herniated lumbar disc tissue?

STUDY DESIGN: The presence of inflammatory cells was examined immunohistochemically in routinely processed resection specimens of the lumbar disc. The histologic results were compared with prospectively obtained clinical data. OBJECTIVES: To assess the clinical relevance of inflammatory cells in herniated lumbar disc specimens. SUMMARY OF BACKGROUND DATA: It is postulated that in addition to nerve root compression, an inflammatory stimulus of the herniated lumbar disc is responsible for sciatic pain and radiculopathy. However, the clinical relevance of the histologically described inflammatory infiltrates is not defined clearly. METHODS: Disc specimens from 44 patients who underwent surgery for lumbar disc herniation were studied immunohistologically. Before surgery, severity of pain was classified in each patient according to a visual analog scale, and general clinical data were recorded prospectively. RESULTS: Varying amounts of inflammatory cells could be demonstrated in the resected disc tissue. In the statistical analysis, no statistically significant correlation between the histologic evidence of macrophage infiltrates and the pain grading scale or the clinical data was noted. CONCLUSIONS: There is no statistically significant correlation between macrophage infiltrates in herniated lumbar disc specimens and the obtained clinical data.

Adult↗