Biomedical subjects

O Sorge

Publications and source records attributed to O Sorge.

5 recordsLinked to original sources

PubMed1999

Preliminary experience with interactive guided brain biopsies using a vertically opened 0.5-T MR system.

The purpose of our study was to evaluate the feasibility and accuracy of brain biopsies performed within a vertically opened MR system. We worked with the interventional 0.5-T MR "SIGNA SP" (General Electric Medical Systems, Milwaukee, Wis.) with an integrated tracking device "Flashpoint Position Encoder" (Image Guided Technologies, USA). As a holding device for this instrument we constructed a special frame. The whole system allows an exact adjustment of an optimum biopsy direction and guidance of the biopsy in a non-stereotactic, interactive mode in near real-time. As biopsy tools we used MR-compatible aspiration and specially made side-cut needles (Daum, Germany; E-Z-EM, USA). We performed a prospective diagnostic brain biopsy study in 18 patients. Guidance of the needle was carried out using gradient-echo single-slice technique. The sample was taken after controlling the exact position of the needle tip on spin-echo images. In 12 cases an exact neuropathological diagnosis was possible. In 6 cases of negative biopsy (4 aspiration biopsies) the samples were not representative. Our results demonstrate the feasibility of interactive MR-guided minimally invasive brain biopsies in an open MR system. The best results were achieved using cut needles for biopsies of contrast-enhancing lesions visible on T1-weighted gradient-echo guidance sequence.

Adult↗

PubMed1999

Serum S-100B protein in severe head injury.

OBJECTIVE: Despite the significant recent progress in cerebral monitoring, it is still difficult to quantify the extent of primary brain injury and ongoing secondary damage after head injury. The objective of our study was to investigate S-100B protein as a serum marker of brain damage after severe head injury. METHODS: Eighty-four patients with severe head injury (Glasgow Coma Scale score < or =8) were included in this prospective study. Venous blood samples for S-100B protein were obtained as soon as possible after admission and every 24 hours thereafter, for a maximum of 10 consecutive days. Serum levels of S-100B protein were compared with outcome after 6 months, clinical variables, and the category of the Marshall classification of initial computed tomographic findings. RESULTS: Patients who died had significantly higher serum S-100B values compared with those who survived (median, 2.7 microg/L versus 0.54 microg/L; P < 0.0001, Mann-Whitney U test). Nineteen (58%) of 33 patients who died had peak S-100B values of 2 microg/L or higher, compared with 4 (8%) of the 51 surviving patients (P < 0.0005, Fisher's exact test). There was also a strong correlation between S-100B values and computed tomographic findings. Logistic regression analysis in a model with age, Glasgow Coma Scale score, intracranial pressure, and computed tomographic findings revealed S-100B as an independent predictor of outcome. Persistent elevation of S-100B levels for 2 to 6 days, even in patients with favorable outcome, may reflect ongoing secondary damage after severe head injury. CONCLUSION: S-100B may be a promising serum marker for assessing the extent of primary injury and the time course of secondary damage after severe head injury.

Adolescent↗

PubMed1998

Correlation of computed tomography findings and serum brain damage markers following severe head injury.

The objective of our study was to investigate the association between the initial levels of serum S-100B protein and neuron specific enolase and the severity of radiologically visible brain damage and outcome after severe head injury. Admission computed tomography (CT) scans of forty-four patients with severe head injury were analysed. Initial levels of S-100B protein and neuron specific enolase were compared between the different outcome groups at 6 month, the different categories of the Marshall classification, the presence of traumatic subarachnoid haemorrhage, the type of haematoma and the volume of contusion. Serum S-100B was significantly higher in patients with unfavourable outcome (1.1 micrograms/l versus 0.3 microgram/l, p < 0.005, Mann-Whitney U test). In diffuse injury, unfavourable outcome significantly increased with higher Marshall grades (p < 0.05). There was a significant correlation between the four grades of diffuse injury and initial serum S-100B protein (r = 0.48, p < 0.001). Patients with focal mass lesions and a favourable outcome after 6 month had significantly lower S-100B values than those who had an unfavourable outcome (0.51 microgram/l versus 1.3 micrograms/l, p < 0.05). A significant correlation was demonstrated between the volume of contusion visible on CT scans and serum S-100B (r = 0.58, p < 0.001). In our study, initial serum S-100B protein was a powerful predictor of outcome even within the same category of radiologically visible brain damage. Serum S-100B protein may provide independent information about the severity of primary brain damage after head injury.

Adolescent↗

PubMed1995

[Severe pulmonary complications following venous air embolism in neurosurgical operations in sitting position--2 case reports].

The occurrence of air embolism during neurosurgical operations in sitting position is described in two cases. Besides the Doppler ultrasound evidence, relevant effects on the cardiopulmonary situation during surgery were observed, which in one case forced an early end of the operation. Postoperative management in both cases was complicated by a pulmonary oedema. In severe intraoperative cardiopulmonary complications in connection with venous air embolism, the existence of pulmonary oedema should be assumed. Confirmation of the diagnosis and the correct therapy depend upon frequent postoperative chest X-rays.

Brain Neoplasms↗

PubMed1994

[A new set for percutaneous implantation of the cardiac catheter in ventriculo-atrial shunt systems. A new technical note].

The percutaneous insertion of the atrial catheter for ventriculoatrial shunts reveals as a sufficient alternative method for the open surgical preparation of neck veins. The authors use a special set based on the Seldinger-Technique. The direct punction procedure of the internal jugular vein is a wellknown method in anaesthesia and intensive-care-medicine. First experiences show as well as a shorter operation times and better cosmetic results in the neck region.

Adult↗