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Biomedical subjects

U Steude

Publications and source records attributed to U Steude.

At least 19 recordsLinked to original sources
PubMed1994

Evaluation of patients with atypical trigeminal neuralgia for permanent electrode implant by test stimulation of the ganglion gasseri.

The treatment of so-called atypical trigeminal neuralgia, characterized by long-lasting burning pain sensations without any pain attacks was for a long time an unsolved problem in contrast to the so-called 'tic douloreux'. Following the experience with our own patients and other groups, destructive procedures in atypical trigeminal neuralgia frequently result in worsening of the clinical conditions. We have therefore transferred the well-established method in the periphery of therapeutic electrostimulation to the trigeminal region. The evaluation of the patients with atypical trigeminal neuralgia is the key for good therapeutic results. Therefore percutaneous test stimulation of the ganglion gasseri has to be performed during a hospital stay. 54% of 149 patients experienced pain relief during test stimulation. Therefore in 81 patients with positive test results, electrodes were implanted together with a neurological pulse generator (Itrel Medtronic).

Electric Stimulation Therapy↗
PubMed1993

Multiple contact foramen ovale electrode in the presurgical evaluation of epileptic patients for selective amygdala-hippocampectomy.

For stereo-EEG evaluation of patients suffering from drug resistant mesiobasal temporal lobe epilepsy a method is described to place multi-contact electrodes percutaneously through the foramen ovale near the brain stem and medial surface of the temporal lobe. The experience with 41 cases is reported. In 28 of them a unilateral well localized focus could be identified. All of them were treated by selective amygdala-hippocampectomy according to Wieser and Yaşargil. During follow-up for at least one year 22 of patients were seizure-free. An additional 5 had a reduction of seizure frequency. Complications were subarachnoid haemorrhage in one case, transient hypaesthesia in another, and transient herpes simplex of the lips in 7 cases.

Amygdala↗
PubMed1993

The stereotactic biopsy diagnosis of focal intracerebral lesions in AIDS patients.

Focal intracerebral lesions were biopsied stereotactically in 23 adult HIV-infected patients, the main indication for which was the failure to respond to anti-toxoplasma treatment. A cerebral disease was the initial or main complaint in 19 of them. In 22 of 25 stereotactic approaches, a clear-cut morphological diagnosis could be established (9 primary brain lymphoma, 7 necrotizing toxoplasma encephalitis, 5 progressive multifocal leukoencephalopathy, 1 HIV encephalitis, 3 unspecific tissue changes). In 7 of 8 deceased patients, autopsy confirmed the bioptical diagnosis. The high diagnostic yield was related to the strategy of the stereotactic method and the sample size (3 to 4 consecutive samples along the stereotactic track including the marginal zones, 1 cm long tissue cylinders). Formalin fixation and paraffin embedding of the samples provide the possibility of serial sections and special stainings (immunohistochemistry, in-situ hybridization) and kill the HIV. Stereotactic brain biopsy is a highly accurate diagnostic tool to ascertain the nature of focal intracerebral lesions in selected AIDS patients.

AIDS Dementia Complex↗
PubMed1991

Epidural spinal electrical stimulation in the treatment of severe arterial occlusive disease.

The effect of epidural spinal cord stimulation (ESES) on peripheral circulation in 10 cases with advanced vascular occlusive disease has been tested, using transcutaneous oxygen measurement (TcpO2), contact thermography and laser-speckle measurements. The values in all cases increased. Improvement was more pronounced during the first 2-3 weeks. Indications and limitations of this treatment modality are discussed.

Aged↗
PubMed1991

Accuracy of stereotactic brain tumor biopsy: comparison of the histologic findings in biopsy cylinders and resected tumor tissue.

Appropriate treatment for intracranial mass lesions depends upon accurate morphological diagnosis. In 47 of 360 patients the findings in stereotactically obtained tissue cylinders were compared with tumor resection (n = 38) or autopsy (n = 9) tissue material to define the accuracy of our stereotactic biopsy method. These biopsies were performed using the LEKSELL CT stereotactic frame and a spiral needle which procured about 10-mm-long tissue cylinders. Usually, three to four successive biopsy specimens were taken along the target trajectory placed through the whole lesion and its margins according to the CT imagings. Final morphological diagnosis was exclusively based on the histological findings of permanent paraffin sections. In 42 cases (89%), the histological results in biopsy and resection/autopsy tissue were identical, including mainly cases of low and high grade gliomas as well as some brain lymphomas, metastases, and cases of inflammatory brain lesions (aspergillosis, toxoplasmosis). In 3 patients with a diagnosis of brain lymphoma and low grade glioma on the basis of the surgical specimens, stereotactic biopsy revealed only unspecific reactive tissue changes. In two cases of the early part of the study, sampling errors occurred. This study provides evidence for the high diagnostic accuracy of the established stereotactic biopsy method which is characterized by representative tissue sampling and histological processing of the specimens.

Astrocytoma↗
PubMed1990

Diagnosis of primary cerebral lymphoma with particular reference to CT-guided stereotactic biopsy.

In establishing the histological diagnosis of primary cerebral lymphoma, stereotactic brain tumour biopsy is the method of choice as the mainstay of therapy is radiation and chemotherapy. This study describes the histopathology and diagnostic immunohistochemistry of 54 primary brain lymphomas in a mainly non-AIDS population. The stereotactic biopsies were performed using the Leksell CT stereotactic frame and a spiral needle which procured about 10-mm-long tissue cylinders. Usually, three successive biopsy cylinders were taken along the target trajectory. Histological examination revealed the prevalence of high-grade non-Hodgkin's lymphoma of the polymorphous centroblastic type. The series did not include any low-grade lymphomas or T-cell lymphomas. L-26 immunohistochemistry resulted in a positive staining of the blasts, thus confirming the B-cell origin of primary brain lymphomas. Small reactive T-lymphocytes and monohistiocytic cells were also found within and at the periphery of the lymphomas and in areas of degeneration. In the biopsies of nine patients, who had shown significant reduction of the lesions on the CT scans, after corticosteroid medication, regressive tissue changes were predominant and consisted of T-lymphocytes, macrophages, and occasionally bizarre reactive astrocytes.

Adult↗
PubMed1987

[Improvement in the prognosis of renal cell carcinoma by percutaneous transvascular embolization].

In a retrospective study of 303 patients with renal cell carcinomas the prognostic influence of the percutaneous transvasal embolization of the renal artery was demonstrated. In form of the life-table-method we compared statistically the survival rates of preoperatively or palliatively embolized patients with such ones who were only nephrectomized or treated only symptomatically. In the tumour stages T2 and T3 the preoperative percutaneous transvasal embolization leads to a clearly higher survival rate; in stage T2 statistically significant. After palliative embolization the improvement of the prognosis is evident compared with the inoperable patients who were treated only symptomatically. The prognosis after palliative preoperative percutaneous transvasal embolization and retarded nephrectomy is not worse than after preoperative percutaneous transvasal embolization and immediate nephrectomy. The effect of the preoperative and palliative embolization improving the prognosis should incite all partners who up to now objected to this therapeutic method to reconsider their therapy concept.

Carcinoma, Renal Cell↗
PubMed1981

[Preoperative renal artery embolization of malignant tumors in external patients].

In 53 external patients with extensive malignant renal tumours before nephrectomy the renal artery was closed centrally by radioopaque ivalonchips. 46 arteries were completely obturated, in 7 cases the embolization was incomplete. This method of embolization is indicated preoperatively because there are some advantages concerning technique of operation. In or ivalon-material there was only one complication without clinical symptoms. The occurring ischemic pain was controllable by medicaments and eased off within some hours. Directly after transcatheter occlusion the patients can be transported back under first aid conditions in hospital where will be nephrectomy carried out.

Adenocarcinoma↗
PubMed1976

[Percutaneous chordotomy for the treatment of pain. Technic, indications and results].

In the last 13 years, since the introduction of percutaneous chordotomy by Mullan et al. (1963),the method has been developed and has now a solid place in the neurosurgical management of pain problems. The lateral approach of the C1/C2 level with X-ray check, visualization of the spinal cord by means of positive contrast myelography, impedance measurement, and stimulation is the mostly used and the least complicated method. Percutaneous chordotomy should be mainly used in the management of intolerable pain in patients with malignancy. The results of 130 percutaneous chordotomies in 100 patients during the last 2 years are discussed.

Cordotomy↗