The relevance of the impact factor for scientific neurosurgery.
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Bibliometrics↗
Biomedical subjects
Raimund Firsching
Publications and source records attributed to Raimund Firsching.
Prognostic relevance of MAPK expression in glioblastoma multiforme.
The objective of this study was to determine the immunoexpression pattern of the mitogen-activated protein kinase (MAPK), and related signalling proteins [protein kinase C (PKC), phospholipase Cgamma (PLCgamma)], in glioblastoma multi-forme, and to investigate their prognostic value. Paraffin-embedded biopsy samples from 26 patients [13 patients with long-term survival (LTS; N=13; median 28 months, range 13-76 months), and, for comparison, 13 patients with short-term survival (STS; N=13; median 7 months, range 1-12 months)] were investigated for the immunoexpression of MAPK, the activated pMAPK, PKC, PLCgamma, EGFR, and PTEN. Additionally, the MIB-1 proliferation index was determined. The immunoexpression pattern were related to clinical data, including analysis of their prognostic value using the Cox-proportional hazard model. No significant differences were found between STS and LTS in terms of age, Karnofsky performance status, and treatment. Whereas EGFR expression did not differ between STS and LTS and does not influence survival, expression of MAPK and activated pMAPK was significantly correlated with survival time. The percentage of pMAPK expressing cells correlated strongly with the percentage of MIB-1 positive cells. Furthermore, survival in patients with tumors expressing PKC or PLCgamma was significantly shorter. No differences were found for PTEN expression. Our findings indicate that the MAPK pathway is correlated with proliferation in gliomas, and that patient subgroups exist, in which expression of MAPK-related signalling proteins (PKC, PLCgamma) is associated with poorer prognosis. These patient subgroups may benefit from additional chemotherapeutic agents which specifically inhibit these signalling proteins.
Adult↗
Brain stem lesions after head injury.
There is little knowledge on the morphology of the brain stem in survivors of head injury, as CT fails to shown brain stem lesions, and neuropathological data is only available from autopsies. As magnetic resonance imaging (MRI) sheds new light on morphological lesions of the brain, the authors investigated 100 patients with a severe head injury. MRI was performed in a prospective study within the first seven days after head injury while the patients were still in coma and on ventilation. Relating the location of the lesions as depicted by MRI with the initial CT scan and outcome, death appeared to be closely linked to the phenomenon of bilateral pontine lesions. The extent of supratentorial lesions had no bearing on survival at all in the absence of brain stem lesions. Altogether the brain stem was affected in 52%. Obviously the occurrence of bilateral upper pontine lesions is of highest predictive value for a fatal outcome. Severe destruction of supratentorial white matter as demonstrated by MRI is not related to increased mortality, as long as the brain stem is spared.
Adolescent↗
Electromagnetic field hazards involving adjustable shunt valves in hydrocephalus.
OBJECT: Standard therapy for hydrocephalus involves shunts and valves, which are frequently adjustable. Because of increasing "electromagnetic smog" (for example, that generated by cellular phones), these valves are often exposed to electromagnetic fields. METHODS: Various magnetic fields were tested for their effects on two different kinds of adjustable valves. The minimum magnetic flux density affecting the adjustment of the valve was determined. Results were compared with magnetic fields found in contemporary everyday life. In homogeneous magnetic fields the adjustment of one valve (Sophysa model SM8) was changed at 5 mT, whereas the second valve (Codman Hakim model CM) was not affected. In nonhomogeneous fields the SM8 valve was affected at 25 mT and the CM valve at 15 mT. Thus, these valves may be affected by headphones and telephone receivers. Surroundings such as the Japanese magnetic suspension railway and the lead cabin of electrical railway engines, in which critical levels of magnetic flux may be present, may also affect adjustable valves. The high-frequency fields of cellular phones, however, have no effect on these valves. CONCLUSIONS: Every surgeon who implants these valves and every patient who receives them should know the possible hazards. The valve selection should be adapted to the environment of the patient. Devices with critical levels of electromagnetic flux that are used in the homes of patients should be replaced by ones with lower magnetic fields. The future construction of these valves should be modified in such a way that their adjustment requires a higher magnetic flux density, so that the valves become less sensitive to unwanted effects from environmental magnetic fields.
Cerebrospinal Fluid Shunts↗