Biomedical subjects

Martin Barth

Publications and source records attributed to Martin Barth.

5 recordsLinked to original sources

PubMed2006

Effect of nicardipine prolonged-release implants on cerebral vasospasm and clinical outcome after severe aneurysmal subarachnoid hemorrhage: a prospective, randomized, double-blind phase IIa study.

BACKGROUND AND PURPOSE: The purpose of this study was to investigate the effect of nicardipine prolonged-release implants (NPRIs) on cerebral vasospasm and clinical outcome after severe subarachnoid hemorrhage. METHODS: Thirty-two patients with severe subarachnoid hemorrhage and undergoing aneurysm clipping were included into this single center, randomized, double-blind trial. Sixteen patients received NPRIs implanted into the basal cisterns in direct contact to the exposed proximal blood vessels; in 16 control patients, the basal cisterns were opened and washed out only without leaving implants. Angiography was performed preoperatively and at day 8+/-1. Computed tomography imaging was analyzed for the incidence of territorial infarcts unrelated to surgery. Patient outcome was assessed using the modified Rankin and National Institute of Health Stroke scales. RESULTS: The incidence of angiographic vasospasm in proximal vessel segments was significantly reduced after implantation of NPRIs (73% control versus 7% NPRIs). Significant differences occurred also for the majority of distal vessel segments. Computed tomography scans revealed a lower incidence of delayed ischemic lesions (47% control versus 14% NPRIs). The NPRI group demonstrated more favorable modified Rankin and National Institute of Health Stroke scales as well as a significantly lower incidence of deaths (38% control versus 6% NPRIs). CONCLUSIONS: Implantation of NPRIs reduces the incidence of cerebral vasospasm and delayed ischemic deficits and improves clinical outcome after severe subarachnoid hemorrhage.

Adult↗

PubMed2006

Persistent postpartum headache from a chronic subdural hematoma after peridural anesthesia.

BACKGROUND: Postpartum headache after peridural anesthesia is usually attributed to accidental perforation of the dura causing postlumbar puncture headache. CASE: In a patient with persistent headache after peridural anesthesia for labor, a chronic subdural hematoma was diagnosed 5 weeks postpartum. CONCLUSION: Caution is warranted in patients with peridural anesthesia for labor who present with unusually persistent headache.

Anesthesia, Epidural↗

PubMed2006

A versatile technique for the investigation of gunshot residue patterns on fabrics and other surfaces: m-XRF.

With heavy-metal-free ammunitions becoming more and more popular, it is necessary to find methods to visualize patterns of those elements in gunshot residues (GSRs) that are not accessible by chemographic coloring tests. The recently introduced millimeter-X-ray fluorescence analysis (m-XRF) spectrometer Spectro Midex M offers an easy way to record mappings of GSRs containing such elements in order to determine shooting distances as well as the general composition of these particles. A motorized stage enables samples of a maximum size of 20 x 20 cm to be investigated, like fabric, clothes, adhesive tapes (Filmolux films), and polyvinylalcohol gloves of shooter's hands. Human tissues can be measured using a Peltier-cooled specimen holder that is mounted onto the stage. As the spot size of the exiting X-rays lies in the millimeter range, which is adequate for the assessment of the residue patterns for shooting distance determination, a significant reduction in measurement time is achieved compared with mu-XRF methods. Test shots with heavy-metal-free ammunitions were performed on different target materials, like pork skin and fabric, and the elemental distributions of Ti, K, and Ga were determined. In order to show the capability of the spectrometer for conventional lead ammunitions as well, a shot series of 5-100 cm shooting distance and an adhesive tape of a shooter's hand were investigated analogously. A comparison of several methods applied in GSR investigation shows the advantages of the m-XRF method.

Journal Article↗

PubMed2005

Outcome after lumbar sequestrectomy compared with microdiscectomy: a prospective randomized study.

OBJECT: Microdiscectomy currently constitutes the standard treatment for herniated lumbar discs. Although limiting surgery to excision of fragments has occasionally been suggested, prospective data are lacking. Therefore, the objective of this study was to compare early outcome and recurrence rates after sequestrectomy and microdiscectomy. METHODS: Eighty-four consecutive patients 60 years of age or younger who harbored free, subligamentary, or transanular herniated lumbar discs refractory to conservative treatment were randomized to one of two treatment groups. Intraoperative parameters and findings were documented as well as pre- and postoperative symptoms such as pain, Patient Satisfaction Index (PSI), Prolo Scale score, and Short Form (SF)-36 subscale results. Follow up of at least 12 months was available in 73 patients (87%). Preoperative intergroup symptoms did not differ significantly. Surgery was significantly shorter in the sequestrectomy-treated group. Overall, low-back pain and sciatica were drastically reduced in both groups and most sensorimotor deficits improved. At 4 to 6 months, SF-36 subscales and PSI scores showed a trend in favor of sequestrectomy, leaving 3% of patients unsatisfied compared with 18% of those treated with discectomy. Outcome according to the Prolo Scale was good or excellent in 76% of discectomy-treated patients and 92% of sequestrectomy-treated patients. Reherniation occurred in four patients after discectomy (10%) and two patients after sequestrectomy (5%) within 18 months. CONCLUSIONS: Sequestrectomy does not seem to entail a higher rate of early recurrences compared with microdiscectomy. Analysis of early outcome demonstrated a trend toward superior results when sequestrectomy is performed. Although long-term follow-up data are mandatory, sequestrectomy may be an advantageous alternative to standard microdiscectomy.

Adult↗

PubMed2002

Pre-embedding immunogold labeling of TUNEL stain enables evaluation of DNA strand breaks and ultrastructural alterations in individual cells of neuronal tissue.

In the brain apoptosis may occur as a physiological phenomenon during periods of programmed cell death as well as under pathological conditions such as ischemia, trauma, tumor, and degenerative diseases. While the definition of apoptotic cell death was originally based on ultrastructural alterations, the detection of DNA double-strand breaks has become an important feature in studies of apoptosis. Currently, the terminal transferase-mediated dUTP nick-end labeling (TUNEL) procedure is widely used for detection of apoptotic cell death. However, there is a growing body of evidence to suggest that the TUNEL staining does not label apoptotic alterations exclusively. Therefore, a new staining procedure was developed combining TUNEL methodology with pre-embedding nanogold labeling to detect DNA double-strand breaks in individual cells by electron microscopy and assess the accompanying ultrastructural alterations. In vitro DNAse-treated vibratome sections (thickness, 20 micro m) from normal adult rat brains were used to develop the staining procedure consisting of the following steps: (i) TUNEL staining of free-floating vibratome sections using fluorescein isothiocyanate (FITC)-labeled UTP, (ii) conversion of the fluorescence signal into an electron-dense signal using an anti-FITC antibody coupled with ultrasmall (diameter, 0.8 nm) gold particles followed by silver enhancement, and (iii) osmification, embedding in Spurr resin and cutting of ultrathin sections. Early postnatal brain tissue was used to study physiologically occurring apoptotic cell death. Under these conditions different patterns of gold staining were observed probably representing different states of cellular decay along the apoptotic avenue. Severe focal brain ischemia was studied as a pathological situation in which intense TUNEL staining occurs. Under these conditions TUNEL labeling of cells was regularly observed in conjunction with ultrastructural alterations indicative of necrosis. These results suggest that under pathological conditions apoptosis and necrosis are not mutually exclusive mechanisms but rather may occur concurrently along a continuum in which cell death occurs.

Animals↗