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At least 1,351 records · Page 75Linked to original sources
PubMed1998

Significance of multimodal cerebral monitoring under moderate therapeutic hypothermia for severe head injury.

The therapeutic significance of moderate hypothermia and cerebral monitorings was assessed in the 10 patients with severe head injury. Cooling was begun as soon as possible after admission, using water blankets under general anesthesia. Jugular venous or tympanic temperature of patients was maintained at 32 degrees C for 3 to 5 days, then rewarming at the rate of 1 degree C a day was started. The intracranial pressure was controllable less than 20 mmHg under hypothermia. Moderate hypothermia reduced the jugular venous lactate (33.5%) as well as the cerebral blood flow velocity at M1 portion of middle cerebral artery (CBFV-M1) measured by transcranial Doppler (7.2%), while increase of the jugular venous oxygen saturation (SjO2) (17.9%) was observed in a majority of the patients. Our results demonstrated that moderate therapeutic hypothermia significantly reduced cerebral circulation and metabolism. Measurement of SjO2 and CBFV-M1 seems to be useful for estimation of cerebral circulation and metabolism in therapeutic hypothermia.

Adolescent↗
PubMed1997

Magnetic resonance: a multimodal approach to the brain?

Magnetic resonance of the brain offers the unique possibility of acquisition of morphological data in high resolution quality, analysis of metabolic disturbances, and the assessment of brain function. Basic principle is the BOLD effect, using the difference of the magnetic moments of oxy- and deoxyhemoglobin as intrinsic mechanism of contrast. Still the optimum techniques for functional imaging are not established: echo planar imaging requires a very costly hardware, whereas gradient echo imaging is feasible on clinical routine MR scanners. Although many experimental studies have been published on visual, motor, and auditory paradigms, clinical applications have not been established up to now. Analysis of epileptogenic foci combining high resolution imaging and functional information seems very promising as well as preoperative determination of critical areas in neurosurgery.

Brain↗
PubMed1991

Application of multimodality imaging stereotactic localization in the surgical management of vascular lesions.

Multidimensional image preplanning and accurate pre and intraoperative localization for intracranial vascular lesions have been implemented. Methodology include carbon fiber base ring, localizer plates, any X-ray tubes, PC compatible software and intraoperative localizing unit. Surgical management of deep arteriovenous malformations is especially suitable for this technique, including the use of intraoperative digital angiography.

Cerebrovascular Disorders↗
PubMed1994

Multimodal responses of the nonspiking giant interneurons in the brain of the crayfish Procambarus clarkii.

Three pairs of nonspiking giant interneurons (NGIs; G1, G2, and G3) of the crayfish brain responded with depolarizing and hyperpolarizing graded potentials to body tilt in roll to the ipsi- and contralateral sides in the dark. The higher and the larger the angle of body tilt, the larger was the amplitude of the geotactic responses. In ipsilaterally statocystectomized animals, all the NGIs responded with hyperpolarizing potentials only to the contralateral side-down tilt, whereas in contralaterally statocystectomized animals, they responded with depolarizing potentials only to the ipsilateral side-down tilt. In bilaterally statocystectomized animals, none of the NGIs responded to body tilt in the dark, but in the presence of an overhead light, they exhibited depolarizing and hyperpolarizing potentials in response to body tilt to the ipsi- and contralateral sides, respectively. All the NGIs responded with depolarizing and hyperpolarizing graded potentials to illumination of the contra- and ipsilateral eyes, respectively. The amplitude of these visual responses, however, varied in association with the amplitude of the geotactic response produced by body tilt. These results indicate that the NGIs integrate the sensory inputs from eyes and statocysts and that the interaction between sensory inputs from the left and right sensory organs with either the same modality or with different modalities enhance the directional sensitivity of NGIs as premotoneurons in the compensatory oculomotor system.

Afferent Pathways↗
PubMedDate not supplied

Multimodality treatment of cancer arising from Barrett's epithelium.

Adenocarcinoma arising in Barrett's epithelium is seen with increasing frequency. Most patients are diagnosed with advanced cancer, and the overall survival is less than 15%. Therefore novel preventive and therapeutic strategies are needed. Molecular markers are being developed that may predict which patients with Barrett's will develop cancer. Combined modality therapy with chemotherapy and surgery has been studied extensively in clinical trials. Although the results of these studies suggest improved survival, definitive proof must await completion of ongoing randomized trials. Surgical resection of adenocarcinoma provides restoration of swallowing and local tumor control with a low operative mortality.

Adenocarcinoma↗
PubMed1980

Evaluation of various brain structures in multiple sclerosis with multimodality evoked potentials, blink reflex and nystagmography.

Pattern reversal visual evoked potentials (VEP), blink reflexes, auditory brainstem evoked potentials (ABEP), spinal and scalp recorded somatosensory evoked potentials (SSEP), and nystagmographic records were investigated in 55 patients with multiple sclerosis (MS), who were separated in different categories of probability according to the clinical history, symptoms, and signs. The combined use of different electrophysiological methods forms a sensitive battery for investigating clinically uncertain cases of MS. It was stressed that care should be taken in the interpretation of the electrophysiological findings, since a single lesion in the central nervous system, particularly in the brainstem, may affect different functional systems simultaneously and therefore mimic a disseminated disease.

Adolescent↗
PubMed1982

Multimodality evoked potentials and electrically elicited blink reflex in optic neuritis.

Pattern shift visual evoked potentials, brain stem auditory evoked potentials, spinal and scalp recorded somatosensory evoked potentials, and electrically elicited blink reflexes were investigated in 32 patients with isolated optic neuritis. Eleven patients were shown to have one additional lesion in the central nervous system outside the optic nerve. Therefore, cases with optic neuritis of unknown origin should be considered as possible cases of multiple sclerosis.

Adolescent↗
PubMed1990

Multimodality evoked potentials and early prognosis in comatose patients.

In 112 comatose patients somatosensory, visual and auditory evoked potentials were registered within 36 hours after the onset of coma or admission. Main causes of coma were head injury, and intracerebral and subarachnoid haemorrhage. The initial bilateral loss of any evoked potential was associated with a mortality of 98%. Normal somatosensory evoked potentials were associated with a survival rate of 74%, while normal visual and normal auditory evoked potentials had a survival rate of 60% and 66%, respectively. It is concluded that SEPs can be valuable for the prognosis of coma after primary brain lesions.

Brain Injuries↗
PubMed1993

Intraperitoneal cisplatin and etoposide in peritoneal mesothelioma: favorable outcome with a multimodality approach.

Ten patients with histologically documented peritoneal mesothelioma were treated with intraperitoneal cisplatin 200 mg/m2, sodium thiosulfate rescue and etoposide 65-290 mg/m2 every 4 weeks for a maximum of six cycles. All had epithelial or mixed epithelial-fibrous histology. Toxicity was tolerable, with 50% sustaining grade 3 or 4 granulocytopenia. There was one episode of neutropenic fever. Grade 2 peripheral neuropathy occurred in one patient, grade 1 in five patients. Complete remission occurred in one of five patients with measurable disease. Median survival for patients whose tumors were surgically debulked to < 2 cm residua prior to treatment was 22 months, while it was 5 months for those with measurable, surgically inaccessible disease (P = 0.0731 by Cox regression proportional hazard model). These data suggest that patients who present with resectable disease may benefit from an aggressive adjuvant approach. This possibility warrants prospective testing in a randomized clinical trial.

Adult↗
PubMed1992

Effects of multimodal treatment and hyperthermia on hepatic tumors.

The therapeutic results of Lp-TAE (transcatheter arterial embolization in the presence or absence of Gelfoam particles preceded by the infusion of a mixture of lipiodol and an anticancer drug via the proper hepatic artery) or DSM-TAE (transcatheter arterial embolization with degradable starch microspheres and the arterial injection of anticancer drugs via the hepatic artery) combined with hyperthermia were evaluated in 30 patients with hepatocellular carcinoma (HCC), 5 subjects with hepatic cholangiocarcinoma, and 22 patients with metastatic liver carcinoma. Hyperthermia was performed using an 8-MHz Thermotron RF-8. Tumor temperatures could be measured in 31 patients (54.4%) with malignant lesions of the liver who had undergone hyperthermia. The mean maximal temperature (Tmax) was 41.5 degrees C in the metastatic liver cancers. The efficiency of heating in HCC was unfavorable, i.e., the mean Tmax was only 40.7 degrees C. The rise in tumor temperature was greater in either HCC or metastatic liver carcinoma associated with portal invasion of the lesion. The tumor-temperature elevation was also excellent in HCC that had been subjected to embolization with DSM in combination with hyperthermia. The response rate (complete response plus partial response) was as high as 40% (4/10) in the group in which the tumor temperature could be raised to 42 degrees C or more. Among the 52 patients who had shown a high pretreatment level of tumor marker, that value decreased in 34 cases (65.4%), and the decrease was greater than 50% in 22 cases (42.3%).

Antineoplastic Combined Chemotherapy Protocols↗